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

78 FR 18353 - Guidance for Industry: Blood Establishment Computer System Validation in the User's Facility...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-26

...; (Formerly FDA-2007D-0393)] Guidance for Industry: Blood Establishment Computer System Validation in the User... Industry: Blood Establishment Computer System Validation in the User's Facility'' dated April 2013. The... document entitled ``Guidance for Industry: Blood Establishment Computer System Validation in the User's...

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.

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

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.

Blood banking services in India.

PubMed

Sardana, V N

1996-01-01

India's health care sector has made impressive strides toward providing health for all by the year 2000. That progress, however, has not been supported by a modern transfusion services network which continues to improve itself. In India, blood collection, storage, and delivery occur mainly in blood banks attached to hospitals, most of which are under central and state government controls. A significant portion of blood banking activity is also done by voluntary agencies and private sector blood banks. A study found the blood transfusion services infrastructure to be highly decentralized and lacking of many critical resources; an overall shortage of blood, especially from volunteer donors; limited and erratic testing facilities; an extremely limited blood component production/availability/use; and a shortage of health care professionals in the field of transfusion services. Infrastructural modernization and the technical upgrading of skills in the blood banks would, however, provide India with a dynamic transfusion services network. The safety of blood transfusion, the national blood safety program, HIV testing facilities, modernization of blood banks, the rational use of blood, program management, manpower development, the legal framework, voluntary blood donation, and a 1996 Supreme Court judgement on the need to focus greater attention upon the blood program are discussed.

Dual-modality arterial pulse monitoring system for continuous blood pressure measurement.

PubMed

Wen-Xuan Dai; Yuan-Ting Zhang; Jing Liu; Xiao-Rong Ding; Ni Zhao

2016-08-01

Accurate and ambulatory measurement of blood pressure (BP) is essential for efficient diagnosis, management and prevention of cardiovascular diseases (CVDs). However, traditional cuff-based BP measurement methods provide only intermittent BP readings and can cause discomfort with the occlusive cuff. Although pulse transit time (PTT) method is promising for cuffless and continuous BP measurement, its pervasive use is restricted by its limited accuracy and requirement of placing sensors on multiple body sites. To tackle these issues, we propose a novel dual-modality arterial pulse monitoring system for continuous blood pressure measurement, which simultaneously records the pressure and photoplethysmography (PPG) signals of radial artery. The obtained signals can be used to generate a pressure-volume curve, from which the elasticity index (EI) and viscosity index (VI) can be extracted. Experiments were carried out among 7 healthy subjects with their PPG, ECG, arterial pressure wave and reference BP collected to examine the effectiveness of the proposed indexes. The results of this study demonstrate that a linear regression model combining EI and VI has significantly higher BP tracking correlation coefficient as compared to the PTT method. This suggests that the proposed system and method can potentially be used for convenient and continuous blood pressure estimation with higher accuracy.

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

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

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

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 0.55Â

Optical sensor technology for a noninvasive continuous monitoring of blood components

NASA Astrophysics Data System (ADS)

Kraitl, Jens; Timm, Ulrich; Lewis, Elfed; Ewald, Hartmut

2010-02-01

NIR-spectroscopy and Photoplethysmography (PPG) is used for a measurement of blood components. The absorptioncoefficient of blood differs at different wavelengths. This fact is used to calculate the optical absorbability characteristics of blood which is yielding information about blood components like hemoglobin (Hb), carboxyhemoglobin (CoHb) and arterial oxygen saturation (SpO2). The measured PPG time signals and the ratio between the peak to peak pulse amplitudes are used for a measurement of these parameters. Hemoglobin is the main component of red blood cells. The primary function of Hb is the transport of oxygen from the lungs to the tissue and carbon dioxide back to the lungs. The Hb concentration in human blood is an important parameter in evaluating the physiological status of an individual and an essential parameter in every blood count. Currently, invasive methods are used to measure the Hb concentration, whereby blood is taken from the patient and subsequently analyzed. Apart from the discomfort of drawing blood samples, an added disadvantage of this method is the delay between the blood collection and its analysis, which does not allow real time patient monitoring in critical situations. A noninvasive method allows pain free continuous on-line patient monitoring with minimum risk of infection and facilitates real time data monitoring allowing immediate clinical reaction to the measured data.

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.

A novel wearable device for continuous, non-invasion blood pressure measurement.

PubMed

Xin, Qin; Wu, Jianping

2017-08-01

In this paper, we have developed a wearable cuffless device for daily blood pressure (BP) measurement. We incorporated the light based sensor and other hard wares in a small volume for BP detection. With optimized algorithm, the real-time BP reading could be achieved, the data could be presented in the screen and be transmitted by internet of things (IoT) for history data comparison and multi-terminal viewing. Thus, further analysis provides the probability for diet or sports suggestion and alarm. We have measured BP from more than 60 subjects, compare to traditional mercury blood pressure meter, no obvious error in both systolic blood pressure (SBP) and diastolic blood pressure (DBP) are detected. Such device can be used for continues non-invasion BP detection, and further data docking and health analysis could be achieved. Copyright © 2017. Published by Elsevier Ltd.

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.

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.

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

Effect of continuous vs pulsed iontophoresis of treprostinil on skin blood flow.

PubMed

Kotzki, Sylvain; Roustit, Matthieu; Arnaud, Claire; Godin-Ribuot, Diane; Cracowski, Jean-Luc

2015-05-25

Systemic sclerosis (SSc) is a rare disease affecting digital microcirculation, leading to finger ulcers and in some cases to amputation. Prostacyclin analogues can be used intravenously but their therapeutic effect is counterbalanced by potentially serious vasodilatation-induced side effects. Iontophoresis of treprostinil could be a promising local therapeutic alternative for SSc-related digital ulcers. Iontophoretic drug delivery is complex, and whether continuous or periodic current should be used remains debated. The objective of the present work is to compare the effect of continuous vs pulsed iontophoresis of treprostinil in rats. Treprostinil (0.64 mM and 0.064 mM) and NaCl were delivered by cathodal iontophoresis onto the hindquarters of anaesthetized rats. Three protocols delivering the same quantity of current were compared: one was continuous (100 μA during 20 min) and two were periodic (B: twenty 1-min cycles with 200 μA during 30 s followed by 30 s Off; and C: twenty 1-min cycles with 600 μA during 10s followed by 50s Off) (n=8 for each protocol with each concentration). Skin blood flow was quantified using laser Doppler imaging and skin resistance was calculated with Ohm's law. All protocols induced a significant increase in skin blood flow. At the lower concentration (0.064 mM treprostinil) the pulsed 10/50 sequence significantly enhanced cutaneous blood flow (Table 1; Fig. 1B) compared to continuous iontophoresis or the 30/30 sequence. We noted that the pulsed iontophoresis of NaCl (10/50 sequence) induced a significant early increase in cutaneous blood flow in comparison with continuous iontophoresis. Skin resistance measures were negatively correlated with current intensity delivered. In conclusion, pulsed iontophoresis of treprostinil with a 10 s/50 s (On/Off) protocol at 600 μA increases the efficacy of iontophoresis at 0.064 mM but not at a tenfold higher concentration. Pulsed iontophoresis could be used to optimize treprostinil

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.

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

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).

Noninvasive and continuous blood pressure measurement via superficial temporal artery tonometry.

PubMed

Canning, Julia; Helbert, Kendall; Iashin, Grigoriy; Matthews, Jonathan; Yang, Jason; Delano, Margaret K; Sodini, Charles G; Quan Zhang

2016-08-01

The measurement of blood pressure is an important cardiovascular health assessment, yet the current set of methodologies is limited in resolution, repeatability, accuracy, simplicity, and safety. This paper presents the design and prototype implementation of a novel and easy-to-use medical device for noninvasive and continuous blood pressure monitoring through tonometry at the superficial temporal artery (STA). The device features a stable form factor inspired by over-ear headphones that adjusts easily from person to person using a combination prismatic and rotational joint. A stepper motor and pressure sensor, built into the device, apply a controlled force to flatten the artery and measure the wearer's blood pressure. The design is fully wireless, using Bluetooth communication to connect to a custom control and monitoring interface on the user's laptop that allows for easy calibration and real-time measurement. Preliminary testing of the device showed a percentage error from a blood pressure cuff mean arterial pressure measurement of 7.7% (7.0 mmHg). This was also compared to a Nexfin vascular unloading device, which showed a percentage error from the blood pressure cuff of 7.3% (6.6 mmHg).

Continuous blood densitometry - Fluid shifts after graded hemorrhage in animals

NASA Technical Reports Server (NTRS)

Hinghofer-Szalkay, H.

1986-01-01

Rapid fluid shifts in four pigs and two dogs subjected to graded hemorrhage are investigated. Arterial blood density (BD), mean arterial pressure (MAP), central venous pressure (CVP), arterial plasma density (PD), hematocrit (Hct) and erythrocyte density were measured. The apparatus and mechancial oscillator technique for measuring density are described. Fluid shifts between red blood cells and blood plasma and alterations in the whole-body-to-large vessel Hct, F(cell) are studied using two models. The bases of the model calculations are discussed. A decrease in MAP, CVP, and BP is detected at the beginning of hemorrhaging; continued bleeding results in further BD decrease correlating with volume displacement. The data reveal that at 15 ml/kg blood loss the mean PD and BD dropped by 0.99 + or - 0.15 and 2.42 + or 0.26 g/liter, respectively, and the Hct dropped by 2.40 + or 0.47 units. The data reveal that inward-shifted fluid has a higher density than normal ultrafiltrate and/or there is a rise in the F(cell) ratio. It is noted that rapid fluid replacement ranged from 5.8 + or - 0.8 to 10.6 + or - 2.0 percent of the initial plasma volume.

A continuously self regenerating high-flux neutron-generator facility

NASA Astrophysics Data System (ADS)

Rogers, A. M.; Becker, T. A.; Bernstein, L. A.; van Bibber, K.; Bleuel, D. L.; Chen, A. X.; Daub, B. H.; Goldblum, B. L.; Firestone, R. B.; Leung, K.-N.; Renne, P. R.; Waltz, C.

2013-10-01

A facility based on a next-generation, high-flux D-D neutron generator (HFNG) is being constructed at UC Berkeley. The current generator, designed around two RF-driven multicusp deuterium ion sources, is capable of producing a neutron output of >1011 n/s. A specially designed titanium-coated copper target located between the ion sources accelerates D+ ions up to 150 keV, generating 2.45 MeV neutrons through the d(d,3He)n fusion reaction. Deuterium in the target is self loaded and regenerating through ion implantation, enabling stable and continuous long-term operation. The proposed science program is focused on pioneering advances in the 40Ar/39Ar dating technique for geochronology, new nuclear data measurements, basic nuclear science research including statistical model studies of radiative-strength functions and level densities, and education. An overview of the facility and its unique capabilities as well as first measurements from the HFNG commissioning will be presented. Work supported by NSF Grant No. EAR-0960138, U.S. DOE LBL Contract No. DE-AC02-05CH11231, and U.S. DOE LLNL Contract No. DE-AC52-07NA27344.

Diagnostic accuracy of blood centers in the screening of blood donors for viral markers

PubMed Central

Dogbe, Elliot Eli; Arthur, Fareed

2015-01-01

Introduction Blood transfusion still remains a life saving intervention in almost all healthcare facilities worldwide. Screening of blood donors/blood units is done in almost every blood bank facility before the blood units/blood components are transfused to prevent transfusion-transmissible infections. The kind of testing kits or the methods used by a facility and the technical expertise of the personnel greatly affects the screening results of a facility. This study was aimed at evaluating the diagnostic accuracy of five hospital-based blood bank testing facilities (Komfo Anokye Teaching Hospital KNUST, Kwame Nkrumah University of Science and Technology, Agogo, Bekwai and Sunyani) that used rapid immunochromatograhic assays (RIA) in screening blood donors/blood units in Ghana. Methods Blood samples (300) from the five testing facilities and their screening results for hepatitis B surface antigen (HBsAg), antibodies to hepatitis C virus (HCV) and human immunodeficiency virus (HIV) using RIAs were obtained. All the samples were then analysed for the three viral markers using 3rd generational enzyme linked immunosorbent assay (ELISA) kit as the gold standard. Results The mean false positive for HBsAg was 2.2% with Bekwai testing facility having the highest of 4.4%. For HCV, the mean false positive was 2.8% with Agogo and Bekwai testing facilities having the highest of 8.7% respectively. For HIV screening, the mean false positive was 11.1% with Bekwai testing facility having the highest of 28.0%. The mean false negative for the facilities were 3.0% for HBV, 75.0% for HCV and 0.0% for HIV with KATH having the highest of 6.3% for HBV, Bekwai having the highest of 100% for HCV and no facility showing false negative for HIV. Mean sensitivity of the screening procedure for the facilities was 97.0%, 25.0% and 100.0% whilst the mean specificity was 97.8%, 97.2% and 88.9% for HBV, HCV and HIV respectively. Statistical comparison among the testing facilities showed no

Differential Effects of Continuous Versus Discontinuous Aerobic Training on Blood Pressure and Hemodynamics.

PubMed

Landram, Michael J; Utter, Alan C; Baldari, Carlo; Guidetti, Laura; McAnulty, Steven R; Collier, Scott R

2018-01-01

Landram, MJ, Utter, AC, Baldari, C, Guidetti, L, McAnulty, SR, and Collier, SR. Differential effects of continuous versus discontinuous aerobic training on blood pressure and hemodynamics. J Strength Cond Res 32(1): 97-104, 2018-The purpose of this study was to compare the hemodynamic, arterial stiffness, and blood flow changes after 4 weeks of either continuous or discontinuous aerobic exercise in adults. Forty-seven subjects between the ages of 18 and 57 were recruited for 1 month of either continuous aerobic treadmill work for 30 minutes at 70% max heart rate or 3 bouts of 10 minutes of exercise at 70% of max heart rate with two 10 minutes break periods in between, totaling 30 minutes of aerobic work. After exercise, both continuous (CON) and discontinuous (DIS) groups demonstrated a significant improvement in maximal oxygen uptake (V[Combining Dot Above]O2max, CON 35.39 ± 1.99 to 38.19 ± 2.03; DIS 36.18 ± 1.82 to 39.33 ± 1.75), heart rate maximum (CON 183.5 ± 3.11 to 187.17 ± 3.06; DIS 179.06 ± 2.75 to 182 ± 2.61), decreases in systolic blood pressure (CON 119 ± 1.82 to 115.11 ± 1.50; DIS 117.44 ± 1.90 to 112.67 ± 1.66), diastolic blood pressure (CON 72.56 ± 1.65 to 70.56 ± 1.06; DIS 71.56 ± 1.59 to 69.56 ± 1.43), augmentation index (CON 17.17 ± 2.17 to 14.9 ± 1.92; DIS 19.71 ± 2.66 to 13.91 ± 2.46), central pulse wave velocity (CON 8.29 ± 0.32 to 6.92 ± 0.21; DIS 7.85 ± 0.30 to 6.83 ± 0.29), peripheral pulse wave velocity (CON 9.49 ± 0.35 to 7.72 ± 0.38; DIS 9.11 ± 0.37 to 7.58 ± 0.47), and significant increases in average forearm blood flow (CON 4.06 ± 0.12 to 4.34 ± 0.136; DIS 4.26 ± 0.18 to 4.53 ± 0.15), peak forearm blood flow (FBF) after reactive hyperemia (CON 28.45 ± 0.094 to 29.96 ± 0.45; DIS 29.29 ± 0.46 to 30.6 ± 0.38), area under the curve (AUC) of FBF (CON 28.65 ± 1.77 to 30.4 ± 1.08; DIS 30.52 ± 1.9 to 31.67 ± 1.44), and AUC peak FBF after reactive hyperemia (CON 222.3 ± 5.68 to 231.95 ± 4.42; DIS 230.81 Â

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.

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.

Continuous neonatal blood gas monitoring using a multiparameter intra-arterial sensor

PubMed Central

Morgan, C; Newell, S; Ducker, D; Hodgkinson, J; White, D; Morley, C; Church, J

1999-01-01

AIMS—To compare arterial blood gas (ABG) readings obtained with a multiparameter intra-arterial sensor with those from an ABG analyser.
METHODS—An MPIAS with the ability to measure continuously pH, PaCO2, and PaO2 was introduced via an umbilical arterial catheter in 27 neonates requiring intensive care. They underwent 3260 hours of MPIAS monitoring, during which 753 ABG readings were performed.
RESULTS—Overall bias (mean difference: MPIAS-ABG) and precision (standard deviation of differences) values were: −0.002 and 0.022,respectively, for pH; +0.26 and 0.52 for PaCO2 (kPa); and −0.19 and 0.99 for PaO2 (kPa). This gave 95% limits of agreement as: −0.047 to +0.042 for pH, −0.76 to +1.28 kPa for PaCO2, and −2.13 to +1.75 kPa for PaO2. For each variable, precision across readings from the same individual was better than overall precision for all data. No complications related to the use of the catheter were observed.
CONCLUSIONS—Continuous MPIAS ABG monitoring is an exciting development, with the potential to reduce blood transfusions and improve ABG homeostasis.

 PMID:10325783

Continuous quality improvement in substance abuse treatment facilities: How much does it cost?

PubMed

Hunt, Priscillia; Hunter, Sarah B; Levan, Deborah

2017-06-01

Continuous quality improvement (CQI) has grown in the U.S. since the 1970s, yet little is known about the costs to implement CQI in substance abuse treatment facilities. This paper is part of a larger group randomized control trial in a large urban county evaluating the impact of Plan-Study-Do-Act (PDSA)-CQI designed for community service organizations (Hunter, Ober, Paddock, Hunt, & Levan, 2014). Operated by one umbrella organization, each of the eight facilities of the study, four residential and four outpatient substance abuse treatment facilities, selected their own CQI Actions, including administrative- and clinical care-related Actions. Using an activity-based costing approach, we collected labor and supplies and equipment costs directly attributable to CQI Actions over a 12-month trial period. Our study finds implementation of CQI and meeting costs of this trial per facility were approximately $2000 to $10,500 per year ($4500 on average), or $10 to $60 per admitted client. We provide a description of the sources of variation in these costs, including differing intensity of the CQI Actions selected, which should help decision makers plan use of PDSA-CQI. Copyright © 2017. Published by Elsevier Inc.

Neutron skyshine from end stations of the Continuous Electron Beam Accelerator Facility

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

Sun, Rai-Ko S.

1991-12-01

The MORSE{_}CG code from Oak Ridge National Laboratory was applied to the estimation of the neutron skyshine from three end stations of the Continuous Electron Beam Accelerator Facility (CEBAF), Newport News, VA. Calculations with other methods and an experiment had been directed at assessing the annual neutron dose equivalent at the site boundary. A comparison of results obtained with different methods is given, and the effect of different temperatures and humidities will be discussed.

Neutron skyshine from end stations of the Continuous Electron Beam Accelerator Facility

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

Sun, Rai-Ko S.

1991-12-01

The MORSE{ }CG code from Oak Ridge National Laboratory was applied to the estimation of the neutron skyshine from three end stations of the Continuous Electron Beam Accelerator Facility (CEBAF), Newport News, VA. Calculations with other methods and an experiment had been directed at assessing the annual neutron dose equivalent at the site boundary. A comparison of results obtained with different methods is given, and the effect of different temperatures and humidities will be discussed.

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...

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

Continued decline in blood collection and transfusion in the United States–2015

PubMed Central

Ellingson, Katherine D.; Sapiano, Mathew R. P.; Haass, Kathryn A.; Savinkina, Alexandra A.; Baker, Misha L.; Chung, Koo-Whang; Henry, Richard A.; Berger, James J.; Kuehnert, Matthew J.; Basavaraju, Sridhar V.

2017-01-01

BACKGROUND In 2011 and 2013, the National Blood Collection and Utilization Survey (NBCUS) revealed declines in blood collection and transfusion in the United States. The objective of this study was to describe blood services in 2015. STUDY DESIGN AND METHODS The 2015 NBCUS was distributed to all US blood collection centers, all hospitals performing at least 1000 surgeries annually, and a 40% random sample of hospitals performing 100 to 999 surgeries annually. Weighting and imputation were used to generate national estimates for units of blood and components collected, deferred, distributed, transfused, and outdated. RESULTS Response rates for the 2015 NBCUS were 78.4% for blood collection centers and 73.9% for transfusing hospitals. In 2015, 12,591,000 units of red blood cells (RBCs) (95% confidence interval [CI], 11,985,000–13,197,000 units of RBCs) were collected, and 11,349,000 (95% CI, 10,592,000–11,747,000) were transfused, representing declines since 2013 of 11.6% and 13.9%, respectively. Total platelet units distributed (2,436,000; 95% CI, 2,230,000–2,642,000) and transfused (1,983,000; 95% CI, 1,816,000=2,151,000) declined by 0.5% and 13.1%, respectively, since 2013. Plasma distributions (3,714,000; 95% CI, 3,306,000–4,121,000) and transfusions (2,727,000; 95% CI, 2,594,000–2,859,000) in 2015 declined since 2013. The median price paid per unit in 2015—$211 for leukocyte-reduced RBCs, $524 for apheresis platelets, and $54 for fresh frozen plasma—was less for all components than in 2013. CONCLUSIONS The 2015 NBCUS findings suggest that continued declines in demand for blood products resulted in fewer units collected and distributed Maintaining a blood inventory sufficient to meet routine and emergent demands will require further monitoring and understanding of these trends. PMID:28591469

Epidermal devices for noninvasive, precise, and continuous mapping of macrovascular and microvascular blood flow

PubMed Central

Webb, R. Chad; Ma, Yinji; Krishnan, Siddharth; Li, Yuhang; Yoon, Stephen; Guo, Xiaogang; Feng, Xue; Shi, Yan; Seidel, Miles; Cho, Nam Heon; Kurniawan, Jonas; Ahad, James; Sheth, Niral; Kim, Joseph; Taylor VI, James G.; Darlington, Tom; Chang, Ken; Huang, Weizhong; Ayers, Joshua; Gruebele, Alexander; Pielak, Rafal M.; Slepian, Marvin J.; Huang, Yonggang; Gorbach, Alexander M.; Rogers, John A.

2015-01-01

Continuous monitoring of variations in blood flow is vital in assessing the status of microvascular and macrovascular beds for a wide range of clinical and research scenarios. Although a variety of techniques exist, most require complete immobilization of the subject, thereby limiting their utility to hospital or clinical settings. Those that can be rendered in wearable formats suffer from limited accuracy, motion artifacts, and other shortcomings that follow from an inability to achieve intimate, noninvasive mechanical linkage of sensors with the surface of the skin. We introduce an ultrathin, soft, skin-conforming sensor technology that offers advanced capabilities in continuous and precise blood flow mapping. Systematic work establishes a set of experimental procedures and theoretical models for quantitative measurements and guidelines in design and operation. Experimental studies on human subjects, including validation with measurements performed using state-of-the-art clinical techniques, demonstrate sensitive and accurate assessment of both macrovascular and microvascular flow under a range of physiological conditions. Refined operational modes eliminate long-term drifts and reduce power consumption, thereby providing steps toward the use of this technology for continuous monitoring during daily activities. PMID:26601309

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.

Non-invasive continuous blood pressure monitoring of tachycardic episodes during interventional electrophysiology

PubMed Central

Maggi, Roberto; Viscardi, Valentina; Furukawa, Toshiyuki; Brignole, Michele

2010-01-01

Aims We thought to evaluate feasibility of continuous non-invasive blood pressure monitoring during procedures of interventional electrophysiology. Methods and results We evaluated continuous non-invasive finger blood pressure (BP) monitoring by means of the Nexfin device in 22 patients (mean age 70 ± 24 years), undergoing procedures of interventional electrophysiology, in critical situations of hypotension caused by tachyarrhythmias or by intermittent incremental ventricular temporary pacing till to the maximum tolerated systolic BP fall (mean 61 ± 14 mmHg per patient at a rate of 195 ± 37 bpm). In all patients, Nexfin was able to detect immediately, at the onset of tachyarrythmia, the changes in BP and recorded reliable waveforms. The quality of the signal was arbitrarily classified as excellent in 11 cases, good in 10 cases, and sufficient in 1 case. In basal conditions, calibrations of the signal occurred every 49.2 ± 24.3 s and accounted for 4% of total monitoring time; during tachyarrhythmias their frequency increased to one every 12.7 s and accounted for 19% of total recording duration. A linear correlation for a range of BP values from 41 to 190 mmHg was found between non-invasive and intra-arterial BP among a total of 1055 beats from three patients who underwent simultaneous recordings with both methods (coefficient of correlation of 0.81, P < 0.0001). Conclusion In conclusion, continuous non-invasive BP monitoring is feasible in the clinical practise of an interventional electrophysiology laboratory without the need of utilization of an intra-arterial BP line. PMID:20837572

Non-invasive continuous blood pressure monitoring of tachycardic episodes during interventional electrophysiology.

PubMed

Maggi, Roberto; Viscardi, Valentina; Furukawa, Toshiyuki; Brignole, Michele

2010-11-01

We thought to evaluate feasibility of continuous non-invasive blood pressure monitoring during procedures of interventional electrophysiology. We evaluated continuous non-invasive finger blood pressure (BP) monitoring by means of the Nexfin device in 22 patients (mean age 70 ± 24 years), undergoing procedures of interventional electrophysiology, in critical situations of hypotension caused by tachyarrhythmias or by intermittent incremental ventricular temporary pacing till to the maximum tolerated systolic BP fall (mean 61 ± 14 mmHg per patient at a rate of 195 ± 37 bpm). In all patients, Nexfin was able to detect immediately, at the onset of tachyarrythmia, the changes in BP and recorded reliable waveforms. The quality of the signal was arbitrarily classified as excellent in 11 cases, good in 10 cases, and sufficient in 1 case. In basal conditions, calibrations of the signal occurred every 49.2 ± 24.3 s and accounted for 4% of total monitoring time; during tachyarrhythmias their frequency increased to one every 12.7 s and accounted for 19% of total recording duration. A linear correlation for a range of BP values from 41 to 190 mmHg was found between non-invasive and intra-arterial BP among a total of 1055 beats from three patients who underwent simultaneous recordings with both methods (coefficient of correlation of 0.81, P < 0.0001). In conclusion, continuous non-invasive BP monitoring is feasible in the clinical practise of an interventional electrophysiology laboratory without the need of utilization of an intra-arterial BP line.

Business continuity in blood services: two case studies from events with potentially catastrophic effect on the national provision of blood components.

PubMed

Morgan, S J; Rackham, R A; Penny, S; Lawson, J R; Walsh, R J; Ismay, S L

2015-02-01

NHS Blood and Transplant (NHSBT) and the Australian Red Cross Blood Service (ARCBS) are national blood establishments providing blood components to England and North Wales, and Australia, respectively. In 2012, both services experienced potentially catastrophic challenges to key assets. NHSBT suffered a flood that closed the largest blood-manufacturing centre in Europe, whilst ARCBS experienced the failure of a data centre network switch that rendered the national blood management system inaccessible for 42 h. This paper describes both crisis events, including the immediate actions, recovery procedures and lessons learned. Both incidents triggered emergency response plans. These included hospital reprovisioning and recovery from the incident. Once normal services had been restored, both events were subjected to root cause analysis (RCA) and production of 'lessons learned' reports. In both scenarios, the key enablers of rapid recovery were established emergency plans, clear leadership and the support of a flexible workforce. Product issues to hospitals were unaffected, and there were no abnormal trends in hospital complaints. RCA identified the importance of risk mitigations that require co-operation with external organizations. Reviews of both events identified opportunities to enhance business resilience through prior identification of external risks and improvements to contingency plans, for example by implementing mass messaging to staff and other stakeholders. Blood establishment emergency plans tend to focus on responding to mass casualty events. However, consolidation of manufacturing to fewer sites combined with a reliance on national IT systems increases the impact of loss of function. Blood services should develop business continuity plans which include prevention of such losses, and the maintenance of services and disaster recovery. © 2014 International Society of Blood Transfusion.

Cuff-less PPG based continuous blood pressure monitoring: a smartphone based approach.

PubMed

Gaurav, Aman; Maheedhar, Maram; Tiwari, Vijay N; Narayanan, Rangavittal

2016-08-01

Cuff-less estimation of systolic (SBP) and diastolic (DBP) blood pressure is an efficient approach for non-invasive and continuous monitoring of an individual's vitals. Although pulse transit time (PTT) based approaches have been successful in estimating the systolic and diastolic blood pressures to a reasonable degree of accuracy, there is still scope for improvement in terms of accuracies. Moreover, PTT approach requires data from sensors placed at two different locations along with individual calibration of physiological parameters for deriving correct estimation of systolic and diastolic blood pressure (BP) and hence is not suitable for smartphone deployment. Heart Rate Variability is one of the extensively used non-invasive parameters to assess cardiovascular autonomic nervous system and is known to be associated with SBP and DBP indirectly. In this work, we propose a novel method to extract a comprehensive set of features by combining PPG signal based and Heart Rate Variability (HRV) related features using a single PPG sensor. Further, these features are fed into a DBP feedback based combinatorial neural network model to arrive at a common weighted average output of DBP and subsequently SBP. Our results show that using this current approach, an accuracy of ±6.8 mmHg for SBP and ±4.7 mmHg for DBP is achievable on 1,750,000 pulses extracted from a public database (comprising 3000 people). Since most of the smartphones are now equipped with PPG sensor, a mobile based cuff-less BP estimation will enable the user to monitor their BP as a vital parameter on demand. This will open new avenues towards development of pervasive and continuous BP monitoring systems leading to an early detection and prevention of cardiovascular diseases.

The Utility of Continuous Temperature Monitoring of Refrigerators in a Long-Term Care Facility.

PubMed

Worz, Chad; Postolski, Josh; Williams, Kevin

2017-04-01

It is the current practice in most long-term care facilities to use manual logs when documenting refrigerator temperatures. This process is commonly associated with poor or fabricated compliance, little oversight, and documentation errors, both because of overt omissions and unsubstantiated values. It is also well-established that medication storage requirements are mandated by the Centers for Medicare & Medicaid Services (CMS). This analysis demonstrates the potential risk of poor cold-chain management of medications and establishes the possible utility of digitally recorded continuous temperature monitoring over manual logs. This small case-oriented review of a large nursing facility's storage process attempts to expose the risk associated with improper medication storage. The primary outcome of the study was to determine if a difference existed between temperature logs completed manually compared with those done with a continuous monitor. American Thermal Instruments (ATI) thermometers were placed into each of the existing refrigerators in a 147-bed nursing facility. Through a mobile app, the data recorded in each refrigerator were compiled into daily reports. Data were collected from a total of 12 refrigerators, 3 of which were medication refrigerators. Logging intervals were done over a 263-minute period and compiled the lowest recorded temperature, highest recorded temperature, and the average temperature for each refrigerator. In addition, reports showing the real-time results were compiled using the ATI DataNow service. All of the refrigerators analyzed had highest temperature recorded readings exceeding the maximum allowable temperature (50°F for refrigerator). All of the refrigerators had lowest temperature recorded readings below the minimum allowable temperature (32°F for refrigerators). All of the refrigerators also reported average temperatures outside of the allowable temperature range. The results necessitated the replacement of a refrigerator and

Continuous inertial microparticle and blood cell separation in straight channels with local microstructures.

PubMed

Wu, Zhenlong; Chen, Yu; Wang, Moran; Chung, Aram J

2016-02-07

Fluid inertia which has conventionally been neglected in microfluidics has been gaining much attention for particle and cell manipulation because inertia-based methods inherently provide simple, passive, precise and high-throughput characteristics. Particularly, the inertial approach has been applied to blood separation for various biomedical research studies mainly using spiral microchannels. For higher throughput, parallelization is essential; however, it is difficult to realize using spiral channels because of their large two dimensional layouts. In this work, we present a novel inertial platform for continuous sheathless particle and blood cell separation in straight microchannels containing microstructures. Microstructures within straight channels exert secondary flows to manipulate particle positions similar to Dean flow in curved channels but with higher controllability. Through a balance between inertial lift force and microstructure-induced secondary flow, we deterministically position microspheres and cells based on their sizes to be separated downstream. Using our inertial platform, we successfully sorted microparticles and fractionized blood cells with high separation efficiencies, high purities and high throughputs. The inertial separation platform developed here can be operated to process diluted blood with a throughput of 10.8 mL min(-1)via radially arrayed single channels with one inlet and two rings of outlets.

Optical coherence tomography-guided laser microsurgery for blood coagulation with continuous-wave laser diode.

PubMed

Chang, Feng-Yu; Tsai, Meng-Tsan; Wang, Zu-Yi; Chi, Chun-Kai; Lee, Cheng-Kuang; Yang, Chih-Hsun; Chan, Ming-Che; Lee, Ya-Ju

2015-11-16

Blood coagulation is the clotting and subsequent dissolution of the clot following repair to the damaged tissue. However, inducing blood coagulation is difficult for some patients with homeostasis dysfunction or during surgery. In this study, we proposed a method to develop an integrated system that combines optical coherence tomography (OCT) and laser microsurgery for blood coagulation. Also, an algorithm for positioning of the treatment location from OCT images was developed. With OCT scanning, 2D/3D OCT images and angiography of tissue can be obtained simultaneously, enabling to noninvasively reconstruct the morphological and microvascular structures for real-time monitoring of changes in biological tissues during laser microsurgery. Instead of high-cost pulsed lasers, continuous-wave laser diodes (CW-LDs) with the central wavelengths of 450 nm and 532 nm are used for blood coagulation, corresponding to higher absorption coefficients of oxyhemoglobin and deoxyhemoglobin. Experimental results showed that the location of laser exposure can be accurately controlled with the proposed approach of imaging-based feedback positioning. Moreover, blood coagulation can be efficiently induced by CW-LDs and the coagulation process can be monitored in real-time with OCT. This technology enables to potentially provide accurate positioning for laser microsurgery and control the laser exposure to avoid extra damage by real-time OCT imaging.

Optical coherence tomography-guided laser microsurgery for blood coagulation with continuous-wave laser diode

NASA Astrophysics Data System (ADS)

Chang, Feng-Yu; Tsai, Meng-Tsan; Wang, Zu-Yi; Chi, Chun-Kai; Lee, Cheng-Kuang; Yang, Chih-Hsun; Chan, Ming-Che; Lee, Ya-Ju

2015-11-01

Blood coagulation is the clotting and subsequent dissolution of the clot following repair to the damaged tissue. However, inducing blood coagulation is difficult for some patients with homeostasis dysfunction or during surgery. In this study, we proposed a method to develop an integrated system that combines optical coherence tomography (OCT) and laser microsurgery for blood coagulation. Also, an algorithm for positioning of the treatment location from OCT images was developed. With OCT scanning, 2D/3D OCT images and angiography of tissue can be obtained simultaneously, enabling to noninvasively reconstruct the morphological and microvascular structures for real-time monitoring of changes in biological tissues during laser microsurgery. Instead of high-cost pulsed lasers, continuous-wave laser diodes (CW-LDs) with the central wavelengths of 450 nm and 532 nm are used for blood coagulation, corresponding to higher absorption coefficients of oxyhemoglobin and deoxyhemoglobin. Experimental results showed that the location of laser exposure can be accurately controlled with the proposed approach of imaging-based feedback positioning. Moreover, blood coagulation can be efficiently induced by CW-LDs and the coagulation process can be monitored in real-time with OCT. This technology enables to potentially provide accurate positioning for laser microsurgery and control the laser exposure to avoid extra damage by real-time OCT imaging.

Pulse Oximeter Derived Blood Pressure Measurement in Patients With a Continuous Flow Left Ventricular Assist Device.

PubMed

Hellman, Yaron; Malik, Adnan S; Lane, Kathleen A; Shen, Changyu; Wang, I-Wen; Wozniak, Thomas C; Hashmi, Zubair A; Munson, Sarah D; Pickrell, Jeanette; Caccamo, Marco A; Gradus-Pizlo, Irmina; Hadi, Azam

2017-05-01

Currently, blood pressure (BP) measurement is obtained noninvasively in patients with continuous flow left ventricular assist device (LVAD) by placing a Doppler probe over the brachial or radial artery with inflation and deflation of a manual BP cuff. We hypothesized that replacing the Doppler probe with a finger-based pulse oximeter can yield BP measurements similar to the Doppler derived mean arterial pressure (MAP). We conducted a prospective study consisting of patients with contemporary continuous flow LVADs. In a small pilot phase I inpatient study, we compared direct arterial line measurements with an automated blood pressure (ABP) cuff, Doppler and pulse oximeter derived MAP. Our main phase II study included LVAD outpatients with a comparison between Doppler, ABP, and pulse oximeter derived MAP. A total of five phase I and 36 phase II patients were recruited during February-June 2014. In phase I, the average MAP measured by pulse oximeter was closer to arterial line MAP rather than Doppler (P = 0.06) or ABP (P < 0.01). In phase II, pulse oximeter MAP (96.6 mm Hg) was significantly closer to Doppler MAP (96.5 mm Hg) when compared to ABP (82.1 mm Hg) (P = 0.0001). Pulse oximeter derived blood pressure measurement may be as reliable as Doppler in patients with continuous flow LVADs. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

The Welsh Blood Service - 70 years of continuous change.

PubMed

Poole, G D

2017-06-01

The National Blood Transfusion Service (NBTS) in England and Wales was established as a single entity in 1946 and operated as such for almost half a century. During those 50 years, the blood service in Wales, as in the rest of the UK, saw many technological and operational changes. The automation of donation testing, the introduction of successive layers of microbiological screening, the creation of the Tissue Typing Laboratory (later renamed the Welsh Transplantation and Immunogenetics Laboratory) and the development of information technology brought - over a relatively long period - highly significant improvements to an organisation that had begun life as an Emergency Medical Service. Differing funding and reporting arrangements for the Welsh and English blood services made little difference in practice, but the devolution of government following the 1997 referendum in Wales would have a profound influence. Four years before the Government of Wales Act (1998) was passed through the UK parliament, the National Blood Authority (NBA) assumed executive control of the English blood services but not the blood service in Wales. The Scottish National Blood Transfusion Service and the Northern Ireland Blood Transfusion Service had been created as independent organisations in 1946; thus, the scene was set for diversification between the four independent blood services, each operating in different political environments with different funding streams. The creation of the UK Blood Services Forum and its Joint Professional Advisory Committee in 1999 has, however, ensured consistency in professional matters. The blood transfusion service in Wales, in its new headquarters in Talbot Green, became known as the Welsh Blood Service (WBS), or Gwasanaeth Gwaed Cymru in Welsh, reporting for most of its life to the Velindre NHS Trust, part of NHS Wales. Considerable changes would impact the WBS in the 21st century. Social changes would mean that the role of recruitment and marketing

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.

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.

Faster Blood Flow Rate Does Not Improve Circuit Life in Continuous Renal Replacement Therapy: A Randomized Controlled Trial.

PubMed

Fealy, Nigel; Aitken, Leanne; du Toit, Eugene; Lo, Serigne; Baldwin, Ian

2017-10-01

To determine whether blood flow rate influences circuit life in continuous renal replacement therapy. Prospective randomized controlled trial. Single center tertiary level ICU. Critically ill adults requiring continuous renal replacement therapy. Patients were randomized to receive one of two blood flow rates: 150 or 250 mL/min. The primary outcome was circuit life measured in hours. Circuit and patient data were collected until each circuit clotted or was ceased electively for nonclotting reasons. Data for clotted circuits are presented as median (interquartile range) and compared using the Mann-Whitney U test. Survival probability for clotted circuits was compared using log-rank test. Circuit clotting data were analyzed for repeated events using hazards ratio. One hundred patients were randomized with 96 completing the study (150 mL/min, n = 49; 250 mL/min, n = 47) using 462 circuits (245 run at 150 mL/min and 217 run at 250 mL/min). Median circuit life for first circuit (clotted) was similar for both groups (150 mL/min: 9.1 hr [5.5-26 hr] vs 10 hr [4.2-17 hr]; p = 0.37). Continuous renal replacement therapy using blood flow rate set at 250 mL/min was not more likely to cause clotting compared with 150 mL/min (hazards ratio, 1.00 [0.60-1.69]; p = 0.68). Gender, body mass index, weight, vascular access type, length, site, and mode of continuous renal replacement therapy or international normalized ratio had no effect on clotting risk. Continuous renal replacement therapy without anticoagulation was more likely to cause clotting compared with use of heparin strategies (hazards ratio, 1.62; p = 0.003). Longer activated partial thromboplastin time (hazards ratio, 0.98; p = 0.002) and decreased platelet count (hazards ratio, 1.19; p = 0.03) were associated with a reduced likelihood of circuit clotting. There was no difference in circuit life whether using blood flow rates of 250 or 150 mL/min during continuous renal replacement therapy.

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.

Blood-brain barrier disruption by continuous-wave radio frequency radiation.

PubMed

Sirav, Bahriye; Seyhan, Nesrin

2009-01-01

The increasing use of cellular phones and the increasing number of associated base stations are becoming a widespread source of non ionizing electromagnetic radiation. Some biological effects are likely to occur even at low-level EM fields. This study was designed to investigate the effects of 900 and 1,800 MHz Continuous Wave Radio Frequency Radiation (CW RFR) on the permeability of Blood Brain Barrier (BBB) of rats. Results have shown that 20 min RFR exposure of 900 and 1,800 MHz induces an effect and increases the permeability of BBB of male rats. There was no change in female rats. The scientific evidence on RFR safety or harm remains inconclusive. More studies are needed to demonstrate the effects of RFR on the permeability of BBB and the mechanisms of that breakdown.

A wearable diffuse reflectance sensor for continuous monitoring of cutaneous blood content

NASA Astrophysics Data System (ADS)

Zakharov, P.; Talary, M. S.; Caduff, A.

2009-09-01

An optical diffuse reflectance sensor for characterization of cutaneous blood content and optimized for continuous monitoring has been developed as part of a non-invasive multisensor system for glucose monitoring. A Monte Carlo simulation of the light propagation in the multilayered skin model has been performed in order to estimate the optimal geometrical separation of the light source and detector for skin and underlying tissue. We have observed that the pathlength within the upper vascular plexus of the skin which defines the sensor sensitivity initially grows with increasing source-detector distance (SDD) before reaching a maximum at 3.5 mm and starts to decay with further increase. At the same time, for distances above 2.4 mm, the sensor becomes sensitive to muscle blood content, which decreases the specificity to skin perfusion monitoring. Thus, the SDDs in the range from 1.5 mm to 2.4 mm satisfy the requirements of sensor sensitivity and specificity. The hardware implementation of the system has been realized and tested in laboratory experiments with a venous occlusion procedure and in an outpatient clinical study in 16 patients with type 1 diabetes mellitus. For both testing procedures, the optical sensor demonstrated high sensitivity to perfusion change provoking events. The general build-up of cutaneous blood under the sensor has been observed which can be associated with pressure-induced vasodilation as a response to the sensor application.

Continuous Postoperative Pericardial Flushing: A Pilot Study on Safety, Feasibility, and Effect on Blood Loss

PubMed Central

Manshanden, Johan S.J.; Gielen, Chantal L.I.; de Borgie, Corianne A.J.M.; Klautz, Robert J.M.; de Mol, Bas A.J.M.; Koolbergen, David R.

2015-01-01

Background Prolonged or excessive blood loss is a common complication after cardiac surgery. Blood remnants and clots, remaining in the pericardial space in spite of chest tube drainage, induce high fibrinolytic activity that may contribute to bleeding complications. Continuous postoperative pericardial flushing (CPPF) with an irrigation solution may reduce blood loss by preventing the accumulation of clots. In this pilot study, the safety and feasibility of CPPF were evaluated and the effect on blood loss and other related complications was investigated. Methods Between November 2011 and April 2012 twenty-one adult patients undergoing surgery for congenital heart disease (CHD) received CPPF from sternal closure up to 12 h postoperative. With an inflow Redivac drain that was inserted through one of the chest tube incision holes, an irrigation solution (NaCl 0.9% at 38 °C) was delivered to the pericardial cavity using a volume controlled flushing system. Safety aspects, feasibility issues and complications were registered. The mean actual blood loss in the CPPF group was compared to the mean of a retrospective group (n = 126). Results CPPF was successfully completed in 20 (95.2%) patients, and no method related complications were observed. Feasibility was good in this experimental setting. Patients receiving CPPF showed a 30% (P = 0.038) decrease in mean actual blood loss 12 h postoperatively. Conclusions CPPF after cardiac surgery was found to be safe and feasible in this experimental setting. The clinically relevant effect on blood loss needs to be confirmed in a randomized clinical trial. PMID:26501121

Prevalence and correlates of hospital-based autologous blood programs: a statewide survey.

PubMed

Hull, A L; Neuhauser, D V; Goodnough, L T

1992-05-01

To identify potential barriers to use of autologous blood procurement to minimize homologous blood transfusion needs during elective surgery, the authors conducted a telephone survey of 120 blood bank directors, representing 138 Ohio hospitals. The prevalence of autologous blood procurement facilities, estimated volume of autologous blood, and attitudes and perceptions of the directors toward autologous blood predeposit programs were assessed. Analysis of the data indicated that 30% of Ohio hospitals have autologous blood procurement facilities; larger hospitals were more likely to have this facility. Overall, 5.5% of transfusions involve predeposited autologous blood. No significant differences were found according to hospital bed size or whether the hospital had a procurement facility. Blood bank directors perceived surgeons to be knowledgeable about autologous predeposit; patient demand and surgical practice were felt to be more effective in promoting the use of autologous blood at the hospital than were blood bank efforts. Directors who had autologous predeposit procurement facilities perceived that the facility provided a marketing advantage. Respondents from larger hospitals were more likely to perceive that these programs could be financially self-sufficient. The authors conclude that an economic cost-benefit analysis of hospital-based autologous blood procurement programs is important. Positive findings may influence transfusion services to adopt autologous blood procurement programs, whereas negative findings may convince hospitals that community blood donor facilities can provide better autologous blood procurement.

Noninvasive arterial blood pressure waveforms in patients with continuous-flow left ventricular assist devices.

PubMed

Martina, Jerson R; Westerhof, Berend E; de Jonge, Nicolaas; van Goudoever, Jeroen; Westers, Paul; Chamuleau, Steven; van Dijk, Diederik; Rodermans, Ben F M; de Mol, Bas A J M; Lahpor, Jaap R

2014-01-01

Arterial blood pressure and echocardiography may provide useful physiological information regarding cardiac support in patients with continuous-flow left ventricular assist devices (cf-LVADs). We investigated the accuracy and characteristics of noninvasive blood pressure during cf-LVAD support. Noninvasive arterial pressure waveforms were recorded with Nexfin (BMEYE, Amsterdam, The Netherlands). First, these measurements were validated simultaneously with invasive arterial pressures in 29 intensive care unit patients. Next, the association between blood pressure responses and measures derived by echocardiography, including left ventricular end-diastolic dimensions (LVEDDs), left ventricular end-systolic dimensions (LVESDs), and left ventricular shortening fraction (LVSF) were determined during pump speed change procedures in 30 outpatients. Noninvasive arterial blood pressure waveforms by the Nexfin monitor slightly underestimated invasive measures during cf-LVAD support. Differences between noninvasive and invasive measures (mean ± SD) of systolic, diastolic, mean, and pulse pressures were -7.6 ± 5.8, -7.0 ± 5.2, -6.9 ± 5.1, and -0.6 ± 4.5 mm Hg, respectively (all <10%). These blood pressure responses did not correlate with LVEDD, LVESD, or LVSF, while LVSF correlated weakly with both pulse pressure (r = 0.24; p = 0.005) and (dP(art)/dt)max (r = 0.25; p = 0.004). The dicrotic notch in the pressure waveform was a better predictor of aortic valve opening (area under the curve [AUC] = 0.87) than pulse pressure (AUC = 0.64) and (dP(art)/dt)max (AUC = 0.61). Patients with partial support rather than full support at 9,000 rpm had a significant change in systolic pressure, pulse pressure, and (dP(art)/dt)max during ramp studies, while echocardiographic measures did not change. Blood pressure measurements by Nexfin were reliable and may thereby act as a compliment to the assessment of the cf-LVAD patient.

Continuous monitoring of blood pressure in children and adolescents,a review of the literature.

PubMed

Mercado, Arlene B

2008-08-01

Continuous or ambulatory blood pressure monitoring (CBPM or ABPM) is becoming a useful tool in the early detection of hypertension in children and adolescents. With increased obesity in pediatrics, chronic diseases such as hypertension, diabetes, dyslipidemia and metabolic syndrome which was more commonly seen in adults in the early years, can now be seen in this population. This review provides the clinical reports of the use of CBPM for diagnosis and management of hypertension in the pediatric population.

Effect of continuous positive airway pressure on blood pressure and metabolic profile in women with sleep apnoea.

PubMed

Campos-Rodriguez, Francisco; Gonzalez-Martinez, Monica; Sanchez-Armengol, Angeles; Jurado-Gamez, Bernabe; Cordero-Guevara, Jose; Reyes-Nuñez, Nuria; Troncoso, Maria F; Abad-Fernandez, Araceli; Teran-Santos, Joaquin; Caballero-Rodriguez, Julian; Martin-Romero, Mercedes; Encabo-Motiño, Ana; Sacristan-Bou, Lirios; Navarro-Esteva, Javier; Somoza-Gonzalez, Maria; Masa, Juan F; Sanchez-Quiroga, Maria A; Jara-Chinarro, Beatriz; Orosa-Bertol, Belen; Martinez-Garcia, Miguel A

2017-08-01

Continuous positive airway pressure (CPAP) reduces blood pressure levels in hypertensive patients with obstructive sleep apnoea (OSA). However, the role of CPAP in blood pressure and the metabolic profile in women has not yet been assessed. In this study we investigated the effect of CPAP on blood pressure levels and the glucose and lipid profile in women with moderate-to-severe OSA.A multicentre, open-label, randomised controlled trial was conducted in 307 women diagnosed with moderate-to-severe OSA (apnoea-hypopnoea index ≥15 events·h -1 ) in 19 Spanish Sleep Units. Women were randomised to CPAP (n=151) or conservative treatment (n=156) for 12 weeks. Changes in office blood pressure measures as well as in the glucose and lipid profile were assessed in both groups.Compared with the control group, the CPAP group achieved a significantly greater decrease in diastolic blood pressure (-2.04 mmHg, 95% CI -4.02- -0.05; p=0.045), and a nonsignificantly greater decrease in systolic blood pressure (-1.54 mmHg, 95% CI -4.58-1.51; p=0.32) and mean blood pressure (-1.90 mmHg, 95% CI -4.0-0.31; p=0.084). CPAP therapy did not change any of the metabolic variables assessed.In women with moderate-to-severe OSA, 12 weeks of CPAP therapy improved blood pressure, especially diastolic blood pressure, but did not change the metabolic profile, compared with conservative treatment. Copyright ©ERS 2017.

Effect of continuous positive airway pressure on blood pressure and metabolic profile in women with sleep apnoea

PubMed Central

Gonzalez-Martinez, Monica; Sanchez-Armengol, Angeles; Jurado-Gamez, Bernabe; Cordero-Guevara, Jose; Reyes-Nuñez, Nuria; Troncoso, Maria F.; Abad-Fernandez, Araceli; Teran-Santos, Joaquin; Caballero-Rodriguez, Julian; Martin-Romero, Mercedes; Encabo-Motiño, Ana; Sacristan-Bou, Lirios; Navarro-Esteva, Javier; Somoza-Gonzalez, Maria; Masa, Juan F.; Sanchez-Quiroga, Maria A.; Jara-Chinarro, Beatriz; Orosa-Bertol, Belen; Martinez-Garcia, Miguel A.

2017-01-01

Continuous positive airway pressure (CPAP) reduces blood pressure levels in hypertensive patients with obstructive sleep apnoea (OSA). However, the role of CPAP in blood pressure and the metabolic profile in women has not yet been assessed. In this study we investigated the effect of CPAP on blood pressure levels and the glucose and lipid profile in women with moderate-to-severe OSA. A multicentre, open-label, randomised controlled trial was conducted in 307 women diagnosed with moderate-to-severe OSA (apnoea–hypopnoea index ≥15 events·h–1) in 19 Spanish Sleep Units. Women were randomised to CPAP (n=151) or conservative treatment (n=156) for 12 weeks. Changes in office blood pressure measures as well as in the glucose and lipid profile were assessed in both groups. Compared with the control group, the CPAP group achieved a significantly greater decrease in diastolic blood pressure (−2.04 mmHg, 95% CI −4.02– −0.05; p=0.045), and a nonsignificantly greater decrease in systolic blood pressure (−1.54 mmHg, 95% CI −4.58–1.51; p=0.32) and mean blood pressure (−1.90 mmHg, 95% CI −4.0–0.31; p=0.084). CPAP therapy did not change any of the metabolic variables assessed. In women with moderate-to-severe OSA, 12 weeks of CPAP therapy improved blood pressure, especially diastolic blood pressure, but did not change the metabolic profile, compared with conservative treatment. PMID:28798089

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.

The effect of continuous nursing intervention guided by chronotherapeutics on ambulatory blood pressure of older hypertensive patients in the community.

PubMed

Cheng, Mei; Cheng, Shu-Ling; Zhang, Qing; Jiang, He; Cong, Ji-Yan; Zang, Xiao-Ying; Zhao, Yue

2014-08-01

To explore the effect of continuous nursing intervention guided by chronotherapeutics so as to provide the easy, noninvasive, effective and acceptable intervention for older hypertensive patients in the community. Many researchers studied the effect of administration at different times on blood pressure control and circadian rhythm. However, the individual administrative time was set ambiguously in previous studies. A semi-experimental study. In the study, 90 eligible patients were recruited and separated into three groups randomly, which were the control group, intervention group A (behaviour and chronotherapy intervention) and intervention group B (behaviour intervention). At 6 and 12 months after the study, the intervention groups were measured 24-hour ambulatory blood pressure monitoring. There were significant differences in ambulatory blood pressure monitoring parameters of the two intervention groups at different measurement times, and there were interaction between measurement time and different groups. The number of patients with dipper increased and reverse dipper decreased in group A as the intervention applied. There were statistical differences between two groups. The number of patients with morning surge in group A decreased more, and there were statistical differences between two groups at six months after the intervention. The behaviour and chronotherapy intervention based on the patients' ambulatory blood pressure monitoring can control casual blood pressure much better and last longer, which can also improve patients' indexes of ambulatory blood pressure monitoring better than behaviour intervention only. The behaviour and chronotherapy intervention can increase patients' nocturnal blood pressure drop, increase the number of patients with dipper and decrease reverse dipper, and improve blood pressure surge in the morning. Nurses can use continuous nursing intervention guided by chronotherapeutics to help improve hypertension of older patients

Work continues on Destiny, the U.S. Lab module, in the Space Station Processing Facility

NASA Technical Reports Server (NTRS)

1999-01-01

In the Space Station Processing Facility (SSPF), work continues on the U.S. Lab module, Destiny, which is scheduled to be launched on Space Shuttle Endeavour in early 2000. It will become the centerpiece of scientific research on the International Space Station. Destiny shares space in the SSPF with the Shuttle Radar Topography Mission (SRTM) and Leonardo, the Multipurpose Logistics Module (MPLM) built by the Agenzia Spaziale Italiana (ASI). The SRTM is targeted for launch on mission STS-99 in September 1999. Leonardo is scheduled to launch on mission STS- 102 in June 2000.

Plasma surface reflectance spectroscopy for non-invasive and continuous monitoring of extracellular component of blood

NASA Astrophysics Data System (ADS)

Sakota, Daisuke; Takatani, Setsuo

2012-04-01

To achieve the quantitative optical non-invasive diagnosis of blood during extracorporeal circulation therapies, the instrumental technique to extract extracellular spectra from whole blood was developed. In the circuit, the continuous blood flow was generated by a centrifugal blood pump. The oxygen saturation was maintained 100% by an oxygenator. The developed glass optical flow cell was attached to the outlet tubing of the oxygenator. The halogen lamp including the light from 400 to 900 nm wavelength was used for the light source. The light was guided into an optical fiber. The light emitted by the fiber was collimated and emitted to the flow cell flat surface at the incident angle of 45 degrees. The light just reflected on the boundary between inner surface of the flow cell and plasma at 45 degrees was detected by the detection fiber. The detected light was analyzed by a spectral photometer. The obtained spectrum from 400 to 600nm wavelength was not changed with respect to the hematocrit. In contrast, the signal in the spectral range was changed when the plasma free hemoglobin increased. By using two spectral range, 505+/-5 nm and 542.5+/-2.5 nm, the differential spectrum was correlated with the free hemoglobin at R2=0.99. On the other hand, as for the hematocrit, the differential spectrum was not correlated at R2=0.01. Finally, the plasma free hemoglobin was quantified with the accuracy of 22+/-19mg/dL. The result shows that the developed plasma surface reflectance spectroscopy (PSRS) can extract the plasma spectrum from flowing whole blood.

Towards development of a mobile RF Doppler sensor for continuous heart rate variability and blood pressure monitoring.

PubMed

Insoo Kim; Bhagat, Yusuf A

2016-08-01

The standard in noninvasive blood pressure (BP) measurement is an inflatable cuff device based on the oscillometric method, which poses several practical challenges for continuous BP monitoring. Here, we present a novel ultra-wide band RF Doppler radar sensor for next-generation mobile interface for the purpose of characterizing fluid flow speeds, and for ultimately measuring cuffless blood flow in the human wrist. The system takes advantage of the 7.1~10.5 GHz ultra-wide band signals which can reduce transceiver complexity and power consumption overhead. Moreover, results obtained from hardware development, antenna design and human wrist modeling, and subsequent phantom development are reported. Our comprehensive lab bench system setup with a peristaltic pump was capable of characterizing various speed flow components during a linear velocity sweep of 5~62 cm/s. The sensor holds potential for providing estimates of heart rate and blood pressure.

Continuous monitoring of myocardial acid-base status during intermittent warm blood cardioplegia.

PubMed

Graffigna, A C L; Nollo, G; Pederzolli, C; Ferrari, P; Widesott, L; Antolini, R

2002-06-01

Intermittent warm blood cardioplegia (IWBC) is a well-established technique for myocardial protection during cardiac operations. According to standardized protocols, IWBC administration is currently performed every 15-20 min regardless of any individual variable and in the absence of any instrumental monitoring. We devised a new system for continuous measurement of the acid-base status of coronary sinus blood for on-line evaluation of myocardial oxygenation during IWBC. In 19 patients undergoing cardiac surgery for coronary artery bypass graft and/or valve surgery and receiving IWBC (34-37 degrees C) by antegrade induction (3 min) and retrograde or antegrade maintenance (2 min) every 15 min, continuous monitoring of myocardial oxygenation and acid/base status was performed by means of a multiparameter PO(2), PCO(2), pH, and temperature sensor (Paratrend7 (R), Philips Medical System) inserted into the coronary sinus. Mean cross-clamping time was 76+/-26 min; ischemic time was 13+/-0.2 min. pH decline was not linear, showing an initial fast decline, a point of flexus, and a progressive slow decline. After every ischemic period, the pH adaptation curve showed a complex pattern reaching step-by-step lower minimum levels (7.28+/-0.14 during the first ischemic period, to 7.16+/-0.19 during the third ischemic period - P=0.003). PO(2) decreased rapidly at 90% in 5.0+/-1.2 min after every reperfusion. During ischemia, PCO(2) increased steadily at 1.6+/-0.1 mmHg per minute, with progressively incomplete removal after successive reperfusion, and progressive increase of maximal level (42+/-12 mmHg during the first ischemic period, to 53+/-23 mmHg during the third ischemic period - P=0.05). Myocardial oxygen, carbon dioxide, and pH show marked changes after repeated IWBC. Myocardial ischemia is not completely reversed by standardized reperfusions, as reflected by steady deterioration of PCO(2) and pH after each reperfusion. Progressive increase of reperfusion durations or

Changes in blood transfusion practices in the UK role 3 medical treatment facility in Afghanistan, 2008-2011.

PubMed

Jansen, J O; Morrison, J J; Midwinter, M J; Doughty, H

2014-06-01

To document blood component usage in the UK medical treatment facility, Afghanistan, over a period of 4 years; and to examine the relationship with transfusion capability, injury pattern and survival. Haemostatic resuscitation is now firmly established in military medical practice, despite the challenges of providing such therapy in austere settings. Retrospective study of blood component use in service personnel admitted for trauma. Data were extracted from the UK Joint Theatre Trauma Registry. A total of 2618 patients were identified. Survival increased from 76 to 84% despite no change in injury severity. The proportion of patients receiving blood components increased from 13 to 32% per annum; 417 casualties received massive transfusion (≥10 units of RCC), the proportion increasing from 40 to 62%. Use of all blood components increased significantly in severely injured casualties, to a median (IQR) of 16 (9-25) units of red cell concentrate (P = 0·006), 15 (8-24) of plasma (P = 0·002), 2 (0-5) of platelets (P < 0·001) and 1 (0-3) of cryoprecipitate (P < 0·001). Cryoprecipitate (P = 0·009) and platelet use (P = 0·005) also increased in moderately injured casualties. The number of blood components transfused to individual combat casualties increased during the 4-year period, despite no change in injury severity or injury pattern. Survival also increased. Combat casualties requiring massive transfusion have a significantly higher chance of survival than civilian patients. Survival is the product of the entire system of care. However, we propose that the changes in military transfusion practice and capability have contributed to increased combat trauma survival. © 2013 Crown copyright. Transfusion Medicine © 2013 British Blood Transfusion Society. This article is published with the permission of the Controller of HMSO and the Queen's Printer for Scotland.

Blood Pressure Estimation Using Pulse Transit Time From Bioimpedance and Continuous Wave Radar.

PubMed

Buxi, Dilpreet; Redout, Jean-Michel; Yuce, Mehmet Rasit

2017-04-01

We have developed and tested a new architecture for pulse transit time (PTT) estimation at the central arteries using electrical bioimpedance, electrocardiogram, and continuous wave radar to estimate cuffless blood pressure. A transmitter and receiver antenna are placed at the sternum to acquire the arterial pulsation at the aortic arch. A four-electrode arrangement across the shoulders acquires arterial pulse across the carotid and subclavian arteries from bioimpedance as well as a bipolar lead I electrocardiogram. The PTT and pulse arrival times (PATs) are measured on six healthy male subjects during exercise on a bicycle ergometer. Using linear regression, the estimated PAT and PTT values are calibrated to the systolic and mean as well as diastolic blood pressure from an oscillometric device. For all subjects, the Pearson correlation coefficients for PAT-SBP and PTT-SBP are -0.66 (p = 0.001) and -0.48 (p = 0.0029), respectively. Correlation coefficients for individual subjects ranged from -0.54 to -0.9 and -0.37 to -0.95, respectively. The proposed system architecture is promising in estimating cuffless arterial blood pressure at the central, proximal arteries, which obey the Moens-Korteweg equation more closely when compared to peripheral arteries. An important advantage of PTT from the carotid and subclavian arteries is that the PTT over the central elastic arteries is measured instead of the peripheral arteries, which potentially reduces the changes in PTT due to vasomotion. Furthermore, the sensors can be completely hidden under a patients clothes, making them more acceptable by the patient for ambulatory monitoring.

Continuous Glucose Monitoring (CGM) or Blood Glucose Monitoring (BGM): Interactions and Implications.

PubMed

Heinemann, Lutz

2018-04-01

At the 2017 10th annual International Conference on Advanced Technologies and Treatments for Diabetes (ATTD) in Paris, France, four speakers presented their perspectives on the roles of continuous glucose monitoring (CGM) and of blood glucose monitoring (BGM) in patient management within one symposium. These presentations included discussions of the differences in the accuracy of CGM and BGM, a clinical perspective on the physiological reasons behind differences in CGM and BGM values, and an overview of the impact of variations in device accuracy on patients with diabetes. Subsequently a short summary of these presentations is given, highlighting the value of good accuracy of BGM or CGM systems and the ongoing need for standardization. The important role of both BGM and CGM in patient management was a theme across all presentations.

Ionised calcium levels in major trauma patients who received blood en route to a military medical treatment facility.

PubMed

Kyle, Tony; Greaves, Ian; Beynon, Anthony; Whittaker, Vicky; Brewer, Mike; Smith, Jason

2018-03-01

Hypocalcaemia is a common metabolic derangement in critically ill patients. Blood transfusion can also contribute to depleted calcium levels. The aims of this study were to identify the incidence of hypocalcaemia in military trauma patients receiving blood products en route to a deployed hospital facility and to determine if intravenous calcium, given during the prehospital phase, has an effect on admission calcium levels. This was a retrospective review of patients transported by the UK Medical Emergency Response Team in Afghanistan between January 2010 and December 2014 who were treated with blood products in the prehospital setting. Total units of blood products administered, basic demographics, Injury Severity Score and trauma type were collected. Ionised serum calcium levels on admission to hospital were compared between those who received blood products without prehospital intravenous calcium supplemental therapy (non-treatment) and patients who were treated with 10 mL of intravenous calcium chloride (10%) concurrently with blood products (treatment). The study included 297 patients; 237 did not receive calcium and 60 did. The incidence of hypocalcaemia in the non-treatment group was 70.0% (n=166) compared with 28.3% (n=17) in the treatment group. Serum calcium levels were significantly different between the groups (1.03 mmol/L vs 1.25 mmol/L, difference 0.22 mmol/L, 95% CI 0.15 to 0.27). In the non-treatment group, 26.6% (n=63) had calcium levels within the normal range compared with 41.7% (n=25) in those who received calcium. There was a dose response of calcium level to blood products with a significant decrease in calcium levels as the volume of blood products increased. Trauma patients who received blood products were at high risk of hypocalcaemia. Aggressive management of these patients with intravenous calcium during transfusion may be required. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018

Smart catheter flow sensor for real-time continuous regional cerebral blood flow monitoring

NASA Astrophysics Data System (ADS)

Li, Chunyan; Wu, Pei-Ming; Hartings, Jed A.; Wu, Zhizhen; Ahn, Chong H.; LeDoux, David; Shutter, Lori A.; Narayan, Raj K.

2011-12-01

We present a smart catheter flow sensor for real-time, continuous, and quantitative measurement of regional cerebral blood flow using in situ temperature and thermal conductivity compensation. The flow sensor operates in a constant-temperature mode and employs a periodic heating and cooling technique. This approach ensures zero drift and provides highly reliable data with microelectromechanical system-based thin film sensors. The developed flow sensor has a sensitivity of 0.973 mV/ml/100 g/min in the range from 0 to 160 ml/100 g/min with a linear correlation coefficient of R2 = 0.9953. It achieves a resolution of 0.25 ml/100 g/min and an accuracy better than 5 ml/100 g/min.

Reliable long-term continuous blood glucose monitoring for patients in critical care using microdialysis and infrared spectrometry

NASA Astrophysics Data System (ADS)

Heise, H. Michael; Damm, Uwe; Kondepati, Venkata R.

2006-02-01

For clinical research, in-vivo blood glucose monitoring is an ongoing important topic to improve glycemic control in patients with non-adequate blood glucose regulation. Critically ill patients received much interest, since the intensive insulin therapy treatment, as established for diabetics, reduces mortality significantly. Despite the existence of commercially available, mainly amperometric biosensors, continued interest is in infrared spectroscopic techniques for reagent-free glucose monitoring. For stable long-term operation, avoiding also sensor recalibration, a bed-side device coupled to a micro-dialysis probe was developed for quasi-continuous glucose monitoring. Multivariate calibration is required for glucose concentration prediction due to the complex composition of dialysates from interstitial body fluid. Measurements were carried out with different test persons, each experiment lasting for more than 8 hours. Owing to low dialysis recovery rates, glucose concentrations in the dialysates were between 0.83 and 4.44 mM. Standard errors of prediction (SEP) obtained with Partial Least Squares (PLS) calibration and different cross-validation strategies were mainly between 0.13 and 0.18 mM based on either full interval data or specially selected spectral variables.

Evaluation of the BD BACTEC FX blood volume monitoring system as a continuous quality improvement measure.

PubMed

Coorevits, L; Van den Abeele, A-M

2015-07-01

The yield of blood cultures is proportional to the volume of blood cultured. We evaluated an automatic blood volume monitoring system, recently developed by Becton Dickinson within its BACTEC EpiCenter module, that calculates mean volumes of negative aerobic bottles and generates boxplots and histograms. First, we evaluated the filling degree of 339 aerobic glass blood cultures by calculating the weight-based volume for each bottle. A substantial amount of the bottles (48.3%) were inadequately filled. Evaluation of the accuracy of the monitoring system showed a mean bias of -1.4 mL (-15.4%). Additional evaluation, using the amended software on 287 aerobic blood culture bottles, resulted in an acceptable mean deviation of -0.3 mL (-3.3%). The new software version was also tested on 200 of the recently introduced plastic bottles, which will replace the glass bottles in the near future, showing a mean deviation of +2.8 mL (+26.7%). In conclusion, the mean calculated volumes can be used for the training of a single phlebotomist. However, filling problems appear to be masked when using them for phlebotomist groups or on wards. Here, visual interpretation of boxplots and histograms can serve as a useful tool to observe the spread of the filling degrees and to develop a continuous improvement program. Re-adjustment of the software has proven to be necessary for use with plastic bottles. Due to our findings, BD has developed further adjustments to the software for validated use with plastic bottles, which will be released soon.

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

Thrombogenesis with continuous blood flow in the inferior vena cava. A novel mouse model.

PubMed

Diaz, José A; Hawley, Angela E; Alvarado, Christine M; Berguer, Alexandra M; Baker, Nichole K; Wrobleski, Shirley K; Wakefield, Thomas W; Lucchesi, Benedict R; Myers, Daniel D

2010-08-01

Several rodent models have been used to study deep venous thrombosis (DVT). However, a model that generates consistent venous thrombi in the presence of continuous blood flow, to evaluate therapeutic agents for DVT, is not available. Mice used in the present study were wild-type C57BL/6 (WT), plasminogen activator inhibitor-1 (PAI-1) knock out (KO) and Delta Cytoplasmic Tail (DCT). An electrolytic inferior vena cava (IVC) model (EIM) was used. A 25G stainless-steel needle, attached to a silver coated copper wire electrode (anode), was inserted into the exposed caudal IVC. Another electrode (cathode) was placed subcutaneously. A current of 250 muAmps over 15 minutes was applied. Ultrasound imaging was used to demonstrate the presence of IVC blood flow. Analyses included measurement of plasma soluble P-selectin (sP-Sel), thrombus weight (TW), vein wall morphometrics, P-selectin and Von Willebrand factor (vWF) staining, transmission electron microscopy (TEM), scanning electron microscopy (SEM); and the effect of enoxaparin on TW was evaluated. A current of 250 muAmps over 15 minutes consistently promoted thrombus formation in the IVC. Plasma sP-Sel was decreased in PAI-1 KO and increased in DCT vs. WT (WT/PAI-1: p=0.003, WT/DCT: p=0.0002). Endothelial activation was demonstrated by SEM, TEM, P-selectin and vWF immunohistochemistry and confirmed by inflammatory cell counts. Ultrasound imaging demonstrated thrombus formation in the presence of blood flow. Enoxaparin significantly reduced the thrombus size by 61% in this model. This EIM closely mimics clinical venous disease and can be used to study endothelial cell activation, leukocyte migration, thrombogenesis and therapeutic applications in the presence of blood flow.

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...

Construction continues on the RLV complex at the Shuttle Landing Facility

NASA Technical Reports Server (NTRS)

1999-01-01

At the construction site of the Reusable Launch Vehicle (RLV) complex at KSC, a worker takes a measurement. Located near the Shuttle Landing Facility, the complex will include facilities for related ground support equipment and administrative/ technical support. It will be available to accommodate the Space Shuttle; the X-34 RLV technology demonstrator; the L-1011 carrier aircraft for Pegasus and X-34; and other RLV and X-vehicle programs. The complex is jointly funded by the Spaceport Florida Authority, NASA's Space Shuttle Program and KSC. The facility will be operational in early 2000.

Construction continues on the RLV complex at the Shuttle Landing Facility

NASA Technical Reports Server (NTRS)

1999-01-01

Construction is under way for the X-33/X-34 hangar complex near the Shuttle Landing Facility at KSC. The Reusable Launch Vehicle (RLV) complex will include facilities for related ground support equipment and administrative/ technical support. It will be available to accommodate the Space Shuttle; the X-34 RLV technology demonstrator; the L-1011 carrier aircraft for Pegasus and X-34; and other RLV and X-vehicle programs. The complex is jointly funded by the Spaceport Florida Authority, NASA's Space Shuttle Program and KSC. The facility will be operational in early 2000.

Effect of continuous negative-pressure breathing on skin blood flow during exercise in a hot environment.

PubMed

Nagashima, K; Nose, H; Takamata, A; Morimoto, T

1998-06-01

To assess the impact of continuous negative-pressure breathing (CNPB) on the regulation of skin blood flow, we measured forearm blood flow (FBF) by venous-occlusion plethysmography and laser-Doppler flow (LDF) at the anterior chest during exercise in a hot environment (ambient temperature = 30 degreesC, relative humidity = approximately 30%). Seven male subjects exercised in the upright position at an intensity of 60% peak oxygen consumption rate for 40 min with and without CNPB after 20 min of exercise. The esophageal temperature (Tes) in both conditions increased to 38.1 degreesC by the end of exercise, without any significant differences between the two trials. Mean arterial pressure (MAP) increased by approximately 15 mmHg by 8 min of exercise, without any significant difference between the two trials before CNPB. However, CNPB reduced MAP by approximately 10 mmHg after 24 min of exercise (P < 0.05). The increase in FBF and LDF in the control condition leveled off after 18 min of exercise above a Tes of 37.7 degreesC, whereas in the CNPB trial the increase continued, with a rise in Tes despite the decrease in MAP. These results suggest that CNPB enhances vasodilation of skin above a Tes of approximately 38 degrees C by stretching intrathoracic baroreceptors such as cardiopulmonary baroreceptors.

Continuous monitoring of blood pressure by analyzing the blood flow sound of arteriovenous fistula in hemodialysis patients.

PubMed

Kamijo, Yuka; Kanda, Eiichiro; Horiuchi, Hayato; Kounoue, Noriyuki; Ono, Keisuke; Maeda, Keizo; Yanai, Akane; Honda, Kazuya; Tsujimoto, Ryuji; Yanagi, Mai; Ishibashi, Yoshitaka; Yoshida, Masayuki

2018-06-01

Patients with end-stage renal disease undergoing hemodialysis (HD) have an elevated risk of cardiovascular disease-related morbidity and mortality. To prevent from such a life-threatening event, the continuous blood pressure (BP) monitoring system may contribute to detect BP decline in early stages and may help to do appropriate disposal. Our research team has introduced an electronic stethoscope (Asahi Kasei Co, Ltd., Tokyo, Japan), which translates sound intensity of Arteriovenous Fistula (AVF) to BP data using the technique of Fourier transformation that can predict continuous BP non-invasively. This study, we investigated whether electronic stethoscope-guided estimated BP (e-BP) would actually reflect systolic BP measured by sphygmomanometer (s-BP), and whether e-BP could predict fall of BP during HD. Twenty-six patients who underwent HD treatment in our hospital were evaluated prospectively. We obtained sound intensity data from the electronic stethoscope which was equipped with the return line of HD. Then, the data were translated into e-BP data to be compared with s-BP. Correlation of total of 315 data sets obtained from each method was examined. An accuracy of diagnosis of intra-dialytic hypotension (IDH) was evaluated. Total of 315 data sets were obtained. A close correlation was observed between e-BP and s-BP (r = 0.887, p < 0.0001). Sensitivity and positive predictive value of predicted-BP for detection of IDH was 90 and 81.3%, respectively. Electronic stethoscope-guided BP measurement would be helpful for real-time diagnosis of BP fall in HD patients. Further investigations are needed.

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.

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.

Construction continues on the RLV complex at the Shuttle Landing Facility

NASA Technical Reports Server (NTRS)

1999-01-01

At the construction site of the Reusable Launch Vehicle (RLV) complex at KSC, workers take measurements for one of the buildings. Located near the Shuttle Landing Facility, the complex will include facilities for related ground support equipment and administrative/ technical support. It will be available to accommodate the Space Shuttle; the X-34 RLV technology demonstrator; the L-1011 carrier aircraft for Pegasus and X-34; and other RLV and X-vehicle programs. The complex is jointly funded by the Spaceport Florida Authority, NASA's Space Shuttle Program and KSC. The facility will be operational in early 2000.

Continuous separation of breast cancer cells from blood samples using multi-orifice flow fractionation (MOFF) and dielectrophoresis (DEP).

PubMed

Moon, Hui-Sung; Kwon, Kiho; Kim, Seung-Il; Han, Hyunju; Sohn, Joohyuk; Lee, Soohyeon; Jung, Hyo-Il

2011-03-21

Circulating tumor cells (CTCs) are highly correlated with the invasive behavior of cancer, so their isolations and quantifications are important for biomedical applications such as cancer prognosis and measuring the responses to drug treatments. In this paper, we present the development of a microfluidic device for the separation of CTCs from blood cells based on the physical properties of cells. For use as a CTC model, we successfully separated human breast cancer cells (MCF-7) from a spiked blood cell sample by combining multi-orifice flow fractionation (MOFF) and dielectrophoretic (DEP) cell separation technique. Hydrodynamic separation takes advantage of the massive and high-throughput filtration of blood cells as it can accommodate a very high flow rate. DEP separation plays a role in precise post-processing to enhance the efficiency of the separation. The serial combination of these two different sorting techniques enabled high-speed continuous flow-through separation without labeling. We observed up to a 162-fold increase in MCF-7 cells at a 126 µL min(-1) flow rate. Red and white blood cells were efficiently removed with separation efficiencies of 99.24% and 94.23% respectively. Therefore, we suggest that our system could be used for separation and detection of CTCs from blood cells for biomedical applications. This journal is © The Royal Society of Chemistry 2011

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.

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...

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...

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.

Twenty-four-hour variations in blood glucose level in Japanese type 2 diabetes patients based on continuous glucose monitoring.

PubMed

Hajime, Maiko; Okada, Yosuke; Mori, Hiroko; Otsuka, Takashi; Kawaguchi, Mayuko; Miyazaki, Megumi; Kuno, Fumi; Sugai, Kei; Sonoda, Satomi; Tanaka, Kenichi; Kurozumi, Akira; Narisawa, Manabu; Torimoto, Keiichi; Arao, Tadashi; Tanaka, Yoshiya

2018-01-01

High fluctuations in blood glucose are associated with various complications. The correlation between glycated hemoglobin (HbA1c) level and fluctuations in blood glucose level has not been studied in Japanese patients with type 2 diabetes. In the present study, blood glucose profile stratified by HbA1c level was evaluated by continuous glucose monitoring (CGM) in Japanese type 2 diabetes patients. Our retrospective study included 294 patients with type 2 diabetes who were divided by HbA1c level into five groups (≥6.0 to <7.0%, ≥7.0 to <8.0%, ≥8.0 to <9.0%, ≥9.0 to <10.0% and ≥10%). The correlation between HbA1c level and CGM data was analyzed. The primary end-point was the difference in blood glucose fluctuations among the HbA1c groups. The mean blood glucose level increased significantly with increasing HbA1c (P trend  < 0.01). The standard deviation increased with increases in HbA1c (P trend  < 0.01). The mean amplitude of glycemic excursions did not vary significantly with HbA1c. The levels of maximum blood glucose, minimum blood glucose, each preprandial blood glucose, each postprandial maximum blood glucose, range of increase in postprandial glucose from pre-meal to after breakfast, the area under the blood concentration-time curve >180 mg/dL and percentage of the area under the blood concentration-time curve >180 mg/dL were higher with higher HbA1c. Mean glucose level and pre-breakfast blood glucose level were significant and independent determinants of HbA1c. In Japanese patients treated for type 2 diabetes, the mean amplitude of glycemic excursions did not correlate with HbA1c, making it difficult to assess blood glucose fluctuations using HbA1c. Parameters other than HbA1c are required to evaluate fluctuations in blood glucose level in patients receiving treatment for type 2 diabetes. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia

A Universal Noninvasive Continuous Blood Pressure Measurement System for Remote Healthcare Monitoring.

PubMed

Mukherjee, Ramtanu; Ghosh, Sanchita; Gupta, Bharat; Chakravarty, Tapas

2018-01-22

The effectiveness of any remote healthcare monitoring system depends on how much accurate, patient-friendly, versatile, and cost-effective measurement it is delivering. There has always been a huge demand for such a long-term noninvasive remote blood pressure (BP) measurement system, which could be used worldwide in the remote healthcare industry. Thus, noninvasive continuous BP measurement and remote monitoring have become an emerging area in the remote healthcare industry. Photoplethysmography-based (PPG) BP measurement is a continuous, unobtrusive, patient-friendly, and cost-effective solution. However, BP measurements through PPG sensors are not much reliable and accurate due to some major limitations like pressure disturbance, motion artifacts, and variations in human skin tone. A novel reflective PPG sensor has been developed to eliminate the abovementioned pressure disturbance and motion artifacts during the BP measurement. Considering the variations of the human skin tone across demography, a novel algorithm has been developed to make the BP measurement accurate and reliable. The training dataset captured 186 subjects' data and the trial dataset captured another new 102 subjects' data. The overall accuracy achieved by using the proposed method is nearly 98%. Thus, demonstrating the efficacy of the proposed method. The developed BP monitoring system is quite accurate, reliable, cost-effective, handy, and user friendly. It is also expected that this system would be quite useful to monitor the BP of infants, elderly people, patients having wounds, burn injury, or in the intensive care unit environment.

Comparative analysis of Micrococcus luteus isolates from blood cultures of patients with pulmonary hypertension receiving epoprostenol continuous infusion.

PubMed

Hirata, Yoshinori; Sata, Makoto; Makiuchi, Yuko; Morikane, Keita; Wada, Akihito; Okabe, Nobuhiko; Tomoike, Hitonobu

2009-12-01

During the period 2002-2008, at the National Cardiovascular Center, Osaka, 28 Micrococcus luteus isolates and one Kocuria spp. isolate were obtained from blood cultures of pulmonary hypertension (PH) patients who were receiving continuous infusion therapy with epoprostenol. Pulsed-field gel electrophoresis patterns of the isolates were unrelated, suggesting that the infections had multiple origins. The preparation of epoprostenol solution by patients themselves was thought to be a risk factor.

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.

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...

Promoting sustainability in quality improvement: an evaluation of a web-based continuing education program in blood pressure measurement.

PubMed

Block, Lauren; Flynn, Sarah J; Cooper, Lisa A; Lentz, Caroline; Hull, Tammie; Dietz, Katherine B; Boonyasai, Romsai T

2018-01-10

The accuracy of blood pressure measurement is variable in office-based settings. Even when staff training programs are effective, knowledge and skills decay over time, supporting the need for ongoing staff training. We evaluated whether a web-based continuing education program in blood pressure measurement reinforced knowledge and skills among clinical staff and promoted sustainability of an existing quality improvement program. Medical assistants and nurses at six primary care clinics within a health system enrolled in a 30-min online educational program designed to refresh their knowledge of blood pressure measurement. A 20-question pre- and post-intervention survey addressed learners' knowledge and attitudes. Direct observation of blood pressure measurement technique before and after the intervention was performed. Differences in responses to pre- and post-module knowledge and attitudes questions and in observation data were analyzed using chi-square tests and simple logistic regression. All 88 clinical staff members participated in the program and completed the evaluation survey. Participants answered 80.6% of questions correctly before the module and 93.4% afterwards (p < 0.01). Scores improved significantly among staff from all job types. Licensed practical nurses and staff who had been in their current job at least a year were more likely to answer questions correctly than registered nurses and those in their current job less than a year. Attitudes toward correct blood pressure measurement were high at baseline and did not improve significantly. Prior to the intervention, staff adhered to 9 of 18 elements of the recommended technique during at least 90% of observations. Following the program, staff was more likely to explain the protocol, provide a rest period, measure an average blood pressure, and record the average blood pressure, but less likely to measure blood pressure with the arm at heart level and use the right arm. We designed, implemented, and

Comparison of the clinical information provided by the FreeStyle Navigator continuous interstitial glucose monitor versus traditional blood glucose readings.

PubMed

McGarraugh, Geoffrey V; Clarke, William L; Kovatchev, Boris P

2010-05-01

The purpose of the analysis was to compare the clinical utility of data from traditional self-monitoring of blood glucose (SMBG) to that of continuous glucose monitoring (CGM). A clinical study of the clinical accuracy of the FreeStyle Navigator CGM System (Abbott Diabetes Care, Alameda, CA), which includes SMBG capabilities, was conducted by comparison to the YSI blood glucose analyzer (YSI Inc., Yellow Springs, OH) using 58 subjects with type 1 diabetes. The Continuous Glucose-Error Grid Analysis (CG-EGA) was used as the analytical tool. Using CG-EGA, the "clinically accurate," "benign errors," and "clinical errors" were 86.8%, 8.7%, and 4.5% for SMBG and 92.7%, 3.7%, and 3.6% for CGM, respectively. If blood glucose is viewed as a process in time, SMBG would provide accurate information about this process 86.8% of the time, whereas CGM would provide accurate information about this process 92.7% of the time (P < 0.0001). In the hypoglycemic range, however, SMBG is more accurate as the "clinically accurate," "benign errors," and "clinical errors" were 83.5%, 6.4%, and 10.1% for SMBG and 57.1%, 8.4%, and 34.5% (P < 0.0001) for CGM, respectively. While SMBG produces more accurate instantaneous glucose values than CGM, control of blood glucose involves a system in flux, and CGM provides more detailed insight into the dynamics of that system. In the normal and elevated glucose ranges, the additional information about the direction and rate of glucose change provided by the FreeStyle Navigator CGM System increases the ability to make correct clinical decisions when compared to episodic SMBG tests.

Intercomparison of active, passive and continuous instruments for radon and radon progeny measurements in the EML chamber and test facility

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

Scarpitta, S.C.; Tu, K.W.; Fisenne, I.M.

1996-10-01

Results are presented from the Fifth Intercomparison of Active, Passive and Continuous Instruments for Radon and Radon Progeny Measurements conducted in the EML radon exposure and test facility in May 1996. In total, thirty-four government, private and academic facilities participated in the exercise with over 170 passive and electronic devices exposed in the EML test chamber. During the first week of the exercise, passive and continuous measuring devices were exposed (usually in quadruplicate) to about 1,280 Bq m{sup {minus}3} {sup 222}Rn for 1--7 days. Radon progeny measurements were made during the second week of the exercise. The results indicate thatmore » all of the tested devices that measure radon gas performed well and fulfill their intended purpose. The grand mean (GM) ratio of the participants` reported values to the EML values, for all four radon device categories, was 0.99 {plus_minus} 0.08. Eighty-five percent of all the radon measuring devices that were exposed in the EML radon test chamber were within {plus_minus}1 standard deviation (SD) of the EML reference values. For the most part, radon progeny measurements were also quite good as compared to the EML values. The GM ratio for the 10 continuous PAEC instruments was 0.90 {plus_minus} 0.12 with 75% of the devices within 1 SD of the EML reference values. Most of the continuous and integrating electronic instruments used for measuring the PAEC underestimated the EML values by about 10--15% probably because the concentration of particles onto which the radon progeny were attached was low (1,200--3,800 particles cm{sup {minus}3}). The equilibrium factor at that particle concentration level was 0.10--0.22.« less

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

A Novel Continuous Blood Pressure Estimation Approach Based on Data Mining Techniques.

PubMed

Miao, Fen; Fu, Nan; Zhang, Yuan-Ting; Ding, Xiao-Rong; Hong, Xi; He, Qingyun; Li, Ye

2017-11-01

Continuous blood pressure (BP) estimation using pulse transit time (PTT) is a promising method for unobtrusive BP measurement. However, the accuracy of this approach must be improved for it to be viable for a wide range of applications. This study proposes a novel continuous BP estimation approach that combines data mining techniques with a traditional mechanism-driven model. First, 14 features derived from simultaneous electrocardiogram and photoplethysmogram signals were extracted for beat-to-beat BP estimation. A genetic algorithm-based feature selection method was then used to select BP indicators for each subject. Multivariate linear regression and support vector regression were employed to develop the BP model. The accuracy and robustness of the proposed approach were validated for static, dynamic, and follow-up performance. Experimental results based on 73 subjects showed that the proposed approach exhibited excellent accuracy in static BP estimation, with a correlation coefficient and mean error of 0.852 and -0.001 ± 3.102 mmHg for systolic BP, and 0.790 and -0.004 ± 2.199 mmHg for diastolic BP. Similar performance was observed for dynamic BP estimation. The robustness results indicated that the estimation accuracy was lower by a certain degree one day after model construction but was relatively stable from one day to six months after construction. The proposed approach is superior to the state-of-the-art PTT-based model for an approximately 2-mmHg reduction in the standard derivation at different time intervals, thus providing potentially novel insights for cuffless BP estimation.

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.

Sustained effect of glucagon on body weight and blood glucose: Assessed by continuous glucose monitoring in diabetic rats

PubMed Central

Thomsen, Maria; Rosenkilde, Mette Marie

2018-01-01

Insulin is a vital part of diabetes treatment, whereas glucagon is primarily used to treat insulin-induced hypoglycemia. However, glucagon is suggested to have a central role in the regulation of body weight, which would be beneficial for diabetic patients. Since the glucagon effect on blood glucose is known to be transient, it is relevant to investigate the pharmacodynamics of glucagon after repeated dosing. In the present study, we used telemetry to continuously measure blood glucose in streptozotocin induced diabetic Sprague-Dawley rats. This allowed for a more detailed analysis of glucose regulation compared to intermittent blood sampling. In particular, we evaluated the blood glucose-lowering effect of different insulin doses alone, and in combination with a long acting glucagon analog (LAG). We showed how the effect of the LAG accumulated and persisted over time. Furthermore, we found that addition of the LAG decreased body weight without affecting food intake. In a subsequent study, we focused on the glucagon effect on body weight and food intake during equal glycemic control. In order to obtain comparable maximum blood glucose lowering effect to insulin alone, the insulin dose had to be increased four times in combination with 1 nmol/kg of the LAG. In this set-up the LAG prevented further increase in body weight despite the four times higher insulin-dose. However, the body composition was changed. The insulin group increased both lean and fat mass, whereas the group receiving four times insulin in combination with the LAG only significantly increased the fat mass. No differences were observed in food intake, suggesting a direct effect on energy expenditure by glucagon. Surprisingly, we observed decreased levels of FGF21 in plasma compared to insulin treatment alone. With the combination of insulin and the LAG the blood glucose-lowering effect of insulin was prolonged, which could potentially be beneficial in diabetes treatment. PMID:29558502

Trends in blood culture contamination: a College of American Pathologists Q-Tracks study of 356 institutions.

PubMed

Bekeris, Leonas G; Tworek, Joseph A; Walsh, Molly K; Valenstein, Paul N

2005-10-01

Blood culture contamination extends hospital stays and increases the cost of care. To measure blood culture contamination rates in a large number of institutions over time and to elucidate practice patterns and demographic factors associated with sustained reduction in contamination rates. Longitudinal cohort study of 356 clinical laboratories that provided quarterly data about blood culture results, using a uniform definition of contamination. Mixed linear model analysis of the 1999 through 2003 data set. Blood culture contamination was significantly higher in institutions that used nonlaboratory personnel to collect blood (P = .03) and significantly lower in facilities that used a dedicated phlebotomy team (P < .001). Higher volume of blood collection was significantly associated with lower contamination rates (P < .001). Continued participation in the Q-Tracks monitoring program was associated with significant and progressive reduction in contamination rates. By the fifth year of participation, the median institution had reduced its blood culture contamination rate by 0.67% (P < .001). Institutions that use decentralized patient-centered personnel rather than dedicated phlebotomy teams to collect blood cultures experience significantly higher contamination rates. Long-term monitoring of contamination is associated with sustained improvement in performance.

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 493.1101 - 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...

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...

Alarm characterization for a continuous glucose monitor that replaces traditional blood glucose monitoring.

PubMed

McGarraugh, Geoffrey

2010-01-01

Continuous glucose monitoring (CGM) devices available in the United States are approved for use as adjuncts to self-monitoring of blood glucose (SMBG); all CGM alarms require SMBG confirmation before treatment. In this report, an analysis method is proposed to determine the CGM threshold alarm accuracy required to eliminate SMBG confirmation. The proposed method builds on the Clinical and Laboratory Standards Institute (CLSI) guideline for evaluating CGM threshold alarms using data from an in-clinic study of subjects with type 1 diabetes. The CLSI method proposes a maximum time limit of +/-30 minutes for the detection of hypo- and hyperglycemic events but does not include limits for glucose measurement accuracy. The International Standards Organization (ISO) standard for SMBG glucose measurement accuracy (ISO 15197) is +/-15 mg/dl for glucose <75 mg/dl and +/-20% for glucose > or = 75 mg/dl. This standard was combined with the CLSI method to more completely characterize the accuracy of CGM alarms. Incorporating the ISO 15197 accuracy margins, FreeStyle Navigator CGM system alarms detected 70 mg/dl hypoglycemia within 30 minutes at a rate of 70.3%, with a false alarm rate of 11.4%. The device detected high glucose in the range of 140-300 mg/dl within 30 minutes at an average rate of 99.2%, with a false alarm rate of 2.1%. Self-monitoring of blood glucose confirmation is necessary for detecting and treating hypoglycemia with the FreeStyle Navigator CGM system, but at high glucose levels, SMBG confirmation adds little incremental value to CGM alarms. 2010 Diabetes Technology Society.

The willingness to donate blood: an empirical analysis of socio-demographic and motivation-related determinants.

PubMed

Tscheulin, Dieter K; Lindenmeier, Jörg

2005-08-01

Since the willingness to donate blood is not very high among large parts of the population, a better understanding of the determinants for the willingness to donate blood is of significant importance. This article is intended to contribute to higher uniformity of results in the context of research on blood donation behaviour. Exploratory factor analysis non-parametric tests are used to accomplish this. Potentially important socio-demographic and motivation-related variables particularly affecting the willingness to donate blood are examined. As an addition to the existing literature, the influence of the individual importance structural of characteristics of blood donation facilities, such as the standard of the facility's medical equipment or the training of the facility's staff, will be tested for its effects on the willingness to donate blood. The analysis will also include the influence of direct or indirect personal involvement on the part of the respondent. The results of the study indicate that typical blood donors are young women or men who are studying or possess a higher level of education. Furthermore, potential blood donors can easily be attracted by pecuniary incentives and word of mouth. Unlike non-donors, potential blood donors are not idle, have no fear of infections due to the donation and want reasonable opening hours of blood donation facilities.

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

[Application of continuous intra-arterial blood gas monitoring system "Paratrend 7" for pulmonary lavage of a patient with alveolar proteinosis].

PubMed

Harigae, M; Hirose, Y; Gamo, M; Hirose, M; Fujiwara, C; Matsuo, K

1999-03-01

We applied a continuous intra-arterial blood gas monitoring system (Paratrend 7) to a patient with pulmonary alveolar proteinosis during pulmonary lavage. Lavage was performed under general anesthesia with one lung ventilation. We inserted the sensor of Patatrend 7 through a 20 G catheter into the radial artery, and monitored pH, PaCO2 and PaO2 continuously throughout the procedure. SpO2 and EtCO2 were also monitored. Saline 1000-1500 ml was instilled and drained repeatedly by volume limited methods. PaO2 values by Paratrend 7 increased during instillation and decreased during drainage of the irrigating fluid. In contrast, PaCO2 value by Paratrend 7 decreased slightly during instillation and increased during drainage. The change of SpO2 was almost the same as that by Paratrend 7, but the response time of pulse oxymetry was a little quicker than Paratrend 7. During the lavage procedure, respiratory and circulatory condition changed very rapidly, and it is necessary to monitor blood gas change intensively. Paratrend 7 is useful as a perioperative monitoring system, but pulse oxymetry might be sufficient during pulmonary lavage considering its cost.

49 CFR 192.613 - Continuing surveillance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Continuing surveillance. 192.613 Section 192.613... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.613 Continuing surveillance. (a) Each operator shall have a procedure for continuing surveillance of its facilities to determine and take...

49 CFR 192.613 - Continuing surveillance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Continuing surveillance. 192.613 Section 192.613... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.613 Continuing surveillance. (a) Each operator shall have a procedure for continuing surveillance of its facilities to determine and take...

49 CFR 192.613 - Continuing surveillance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false Continuing surveillance. 192.613 Section 192.613... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.613 Continuing surveillance. (a) Each operator shall have a procedure for continuing surveillance of its facilities to determine and take...

49 CFR 192.613 - Continuing surveillance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 3 2014-10-01 2014-10-01 false Continuing surveillance. 192.613 Section 192.613... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.613 Continuing surveillance. (a) Each operator shall have a procedure for continuing surveillance of its facilities to determine and take...

49 CFR 192.613 - Continuing surveillance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false Continuing surveillance. 192.613 Section 192.613... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Operations § 192.613 Continuing surveillance. (a) Each operator shall have a procedure for continuing surveillance of its facilities to determine and take...

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

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...

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...

The National Ignition Facility: Transition to a User Facility

NASA Astrophysics Data System (ADS)

Moses, E. I.; Atherton, J.; Lagin, L.; Larson, D.; Keane, C.; MacGowan, B.; Patterson, R.; Spaeth, M.; Van Wonterghem, B.; Wegner, P.; Kauffman, R.

2016-03-01

The National Ignition Facility (NIF) at Lawrence Livermore National Laboratory (LLNL) has been operational since March 2009 and has been transitioning to a user facility supporting ignition science, high energy density science (HEDS), national security applications, and fundamental science. The facility has achieved its design goal of 1.8 MJ and 500 TW of 3ω light on target, and has performed target experiments with 1.9 MJ at peak powers of 410 TW. The facility is on track to perform over 200 target shots this year in support of all of its user communities. The facility has nearly 60 diagnostic systems operational and has shown flexibility in laser pulse shape and performance to meet the requirements of its multiple users. Progress continues on its goal of demonstrating thermonuclear burn in the laboratory. It has performed over 40 indirect-drive experiments with cryogenic-layered capsules. New platforms are being developed for HEDS and fundamental science. Equation-of-state and material strength experiments have been done on a number of materials with pressures of over 50 MBars obtained in diamond, conditions never previously encountered in the laboratory and similar to those found in planetary interiors. Experiments are also in progress investigating radiation transport, hydrodynamic instabilities, and direct drive implosions. NIF continues to develop as an experimental facility. Advanced Radiographic Capability (ARC) is now being installed on NIF for producing high-energy radiographs of the imploded cores of ignition targets and for short pulse laser-plasma interaction experiments. One NIF beam is planned for conversion to two picosecond beams in 2014. Other new diagnostics such as x-ray Thomson scattering, low energy neutron spectrometer, and multi-layer reflecting x-ray optics are also planned. Incremental improvements in laser performance such as improved optics damage performance, beam balance, and back reflection control are being pursued.

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...

[Handover between home and respite care facilities : Delphi survey within the context of continuity of care for people with dementia].

PubMed

Kuske, S; Roes, M; Bartholomeyczik, S

2016-07-01

Criteria for the handover between healthcare settings were identified based on a review and on results of empirical data. This study was carried out to select the most relevant criteria for defining the quality of continuity of care of people with dementia (PwD) in the context of the handover between care at home and respite care facilities. A modified classical two-step Delphi design was used in combination with a group Delphi design. A total of 28 core criteria with a consensus strength of > 60 % are presented. Safety-relevant information, especially the personal habits of PwD and the role of informal caregivers in the handover between care settings are important. Furthermore, the following general principles to ensure the quality of continuity of the care of PwD were deduced: completeness, verification, multipath communication, timeliness and topicality, accessibility and defined responsibilities, roles and standardization. A successful transition of PwD to respite care facilities relies on the provision of relevant information, considering personal habits, before the day of transition. Furthermore, a timely preparation for discharge is important. The individual needs of the informal caregivers with regard to their support should be considered. Professionals who are responsible in handover processes should have solid communication competence in order to collect relevant information from informal caregivers, who have a strong individual care experience with the PwD.

Detection of hypoglycemia with continuous interstitial and traditional blood glucose monitoring using the FreeStyle Navigator Continuous Glucose Monitoring System.

PubMed

McGarraugh, Geoffrey; Bergenstal, Richard

2009-03-01

The objective of the analysis was to compare detection of hypoglycemic episodes (glucose <70 mg/dL lasting >15 min) with the FreeStyle Navigator Continuous Glucose Monitoring System (FSN-CGM) (Abbott Diabetes Care, Alameda, CA) alarms to detection with traditional finger stick testing at an average frequency of eight tests per day. The performance of FSN-CGM alarms was evaluated in a clinic setting using 58 subjects with type 1 diabetes mellitus (T1DM) monitoring interstitial glucose concentration over a 5-day period compared to reference YSI measurements (instrument manufactured by YSI, Yellow Springs, OH) at 15-min intervals. Finger stick glucose testing was evaluated in the home environment with 91 subjects with TIDM monitoring with the blood glucose meter integrated into the FreeStyle Navigator (FSN-BG) over a 20-day period. The reference was FSN-CGM with results masked from the subjects. Blood glucose values <=85 mg/dL were considered the optimal treatment level to avoid or reverse hypoglycemia. With a threshold alarm setting of 85 mg/dL, 90.6% of hypoglycemic episodes were detected within +/- 30 min by FSN-CGM in the clinic study. When the alarm was activated, YSI glucose was <= 85 mg/dL 77.2% of the time. In the home environment, the average FSN-BG testing frequency was 7.9 tests per day. Hypoglycemia was verified within +/- 30 min by FSN-BG measurements <= 85 mg/dL at a rate of 27.5%. Even with a high rate of FSN-BG testing, hypoglycemia detected by FSN-CGM was verified by patients with T1DM very infrequently. A high rate of hypoglycemia detection with a moderate rate of unnecessary alarms can be attained using FSN-CGM.

Continuous, Real-Time Monitoring of Cocaine in Undiluted Blood Serum via a Microfluidic, Electrochemical Aptamer-Based Sensor

PubMed Central

Swensen, James S.; Xiao, Yi; Ferguson, Brian S.; Lubin, Arica A.; Lai, Rebecca Y.; Heeger, Alan J.; Plaxco, Kevin W.; Soh, H. Tom.

2009-01-01

The development of a biosensor system capable of continuous, real-time measurement of small-molecule analytes directly in complex, unprocessed aqueous samples has been a significant challenge, and successful implementation has been achieved for only a limited number of targets. Towards a general solution to this problem, we report here the Microfluidic Electrochemical Aptamer-based Sensor (MECAS) chip wherein we integrate target-specific DNA aptamers that fold, and thus generate an electrochemical signal, in response to the analyte with a microfluidic detection system. As a model, we demonstrate the continuous, real-time (~1 minute time resolution) detection of the small molecule drug cocaine at near physiological, low micromolar concentrations directly in undiluted, otherwise unmodified blood serum. We believe our approach of integrating folding-based electrochemical sensors with miniaturized detection systems may lay the ground work for the real-time, point-of-care detection of a wide variety of molecular targets. PMID:19271708

Atypical blood glucose response to continuous and interval exercise in a person with type 1 diabetes: a case report.

PubMed

Moser, Othmar; Tschakert, Gerhard; Mueller, Alexander; Groeschl, Werner; Pieber, Thomas R; Koehler, Gerd; Eckstein, Max L; Bracken, Richard M; Hofmann, Peter

2017-06-30

Therapy must be adapted for people with type 1 diabetes to avoid exercise-induced hypoglycemia caused by increased exercise-related glucose uptake into muscles. Therefore, to avoid hypoglycemia, the preexercise short-acting insulin dose must be reduced for safety reasons. We report a case of a man with long-lasting type 1 diabetes in whom no blood glucose decrease during different types of exercise with varying exercise intensities and modes was found, despite physiological hormone responses. A Caucasian man diagnosed with type 1 diabetes for 24 years performed three different continuous high-intensity interval cycle ergometer exercises as part of a clinical trial (ClinicalTrials.gov identifier NCT02075567). Intensities for both modes of exercises were set at 5% below and 5% above the first lactate turn point and 5% below the second lactate turn point. Short-acting insulin doses were reduced by 25%, 50%, and 75%, respectively. Measurements taken included blood glucose, blood lactate, gas exchange, heart rate, adrenaline, noradrenaline, cortisol, glucagon, and insulin-like growth factor-1. Unexpectedly, no significant blood glucose decreases were observed during all exercise sessions (start versus end, 12.97 ± 2.12 versus 12.61 ± 2.66 mmol L -1 , p = 0.259). All hormones showed the expected response, dependent on the different intensities and modes of exercises. People with type 1 diabetes typically experience a decrease in blood glucose levels, particularly during low- and moderate-intensity exercises. In our patient, we clearly found no decline in blood glucose, despite a normal hormone response and no history of any insulin insensitivity. This report indicates that there might be patients for whom the recommended preexercise therapy adaptation to avoid exercise-induced hypoglycemia needs to be questioned because this could increase the risk of severe hyperglycemia and ketosis.

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...

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...

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...

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...

Left ventricular hypertrophy and blood pressure control in automated and continuous ambulatory peritoneal dialysis patients.

PubMed

Ataş, Nuh; Erten, Yasemin; Okyay, Gülay Ulusal; Inal, Salih; Topal, Salih; Öneç, Kürşad; Akyel, Ahmet; Çelik, Bülent; Tavil, Yusuf; Bali, Musa; Arınsoy, Turgay

2014-06-01

Hypertension, non-dipper blood pressure (BP) pattern and decrease in daily urine output have been associated with left ventricular hypertrophy (LVH) in peritoneal dialysis (PD) patients. However, there is lack of data regarding the impact of different PD regimens on these factors. We aimed to investigate the impact of circadian rhythm of BP on LVH in end-stage renal disease patients using automated peritoneal dialysis (APD) or continuous ambulatory peritoneal dialysis (CAPD) modalities. Twenty APD (7 men, 13 women) and 28 CAPD (16 men, 12 women) patients were included into the study. 24-h ambulatory blood pressure monitoring (ABPM) and transthoracic echocardiography besides routine blood examinations were performed. Two groups were compared with each other for ABPM measurements, BP loads, dipping patterns, left ventricular mass index (LVMI) and daily urine output. Mean systolic and diastolic BP measurements, BP loads, LVMI, residual renal function (RRF) and percentage of non-dippers were found to be similar for the two groups. There were positive correlations of LVMI with BP measurements and BP loads. LVMI was found to be significantly higher in diastolic non-dippers compared to dippers (140.4 ± 35.3 vs 114.5 ± 29.7, respectively, P = 0.02). RRF and BP were found to be independent predictors of LVMI. Non-dipping BP pattern was a frequent finding among all PD patients without an inter-group difference. Additionally, higher BP measurements, decrease in daily urine output and non-dipper diastolic BP pattern were associated with LVMI. In order to avoid LVH, besides correction of anemia and volume control, circadian BP variability and diastolic dipping should also be taken into consideration in PD patients. © 2014 The Authors. Therapeutic Apheresis and Dialysis © 2014 International Society for Apheresis.

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 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...

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...

Nanobiotechnology advanced antifouling surfaces for the continuous electrochemical monitoring of glucose in whole blood using a lab-on-a-chip.

PubMed

Picher, Maria M; Küpcü, Seta; Huang, Chun-Jen; Dostalek, Jakub; Pum, Dietmar; Sleytr, Uwe B; Ertl, Peter

2013-05-07

In the current work we have developed a lab-on-a-chip containing embedded amperometric sensors in four microreactors that can be addressed individually and that are coated with crystalline surface protein monolayers to provide a continuous, stable, reliable and accurate detection of blood glucose. It is envisioned that the microfluidic device will be used in a feedback loop mechanism to assess natural variations in blood glucose levels during hemodialysis to allow the individual adjustment of glucose. Reliable and accurate detection of blood glucose is accomplished by simultaneously performing (a) blood glucose measurements, (b) autocalibration routines, (c) mediator-interferences detection, and (d) background subtractions. The electrochemical detection of blood glucose variations in the absence of electrode fouling events is performed by integrating crystalline surface layer proteins (S-layer) that function as an efficient antifouling coating, a highly-oriented immobilization matrix for biomolecules and an effective molecular sieve with pore sizes of 4 to 5 nm. We demonstrate that the S-layer protein SbpA (from Lysinibacillus sphaericus CCM 2177) readily forms monomolecular lattice structures at the various microchip surfaces (e.g. glass, PDMS, platinum and gold) within 60 min, eliminating unspecific adsorption events in the presence of human serum albumin, human plasma and freshly-drawn blood samples. The highly isoporous SbpA-coating allows undisturbed diffusion of the mediator between the electrode surface, thus enabling bioelectrochemical measurements of glucose concentrations between 500 μM to 50 mM (calibration slope δI/δc of 8.7 nA mM(-1)). Final proof-of-concept implementing the four microfluidic microreactor design is demonstrated using freshly drawn blood. Accurate and drift-free assessment of blood glucose concentrations (6. 4 mM) is accomplished over 130 min at 37 °C using immobilized enzyme glucose oxidase by calculating the difference between

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...

Blood substitutes.

PubMed Central

Kostrzewska, E.

1976-01-01

With the development of modern methods of surgery, anaesthesia, and pre- and postoperative care the requirement for blood substitutes is continuously increasing. We present a review of the different blood substitutes which are already in clinical use or in an advanced stage of experimental investigation for possible practical administration. Our own clinical experience with dextrans and experimental studies on stroma-free haemoglobin and hydroxyethyl starch solutions are described. PMID:57736

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.

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.

Continuous determination of blood glucose in children admitted with malaria in a rural hospital in Mozambique.

PubMed

Madrid, Lola; Sitoe, Antonio; Varo, Rosauro; Nhampossa, Tacilta; Lanaspa, Miguel; Nhama, Abel; Acácio, Sozinho; Riaño, Isolina; Casellas, Aina; Bassat, Quique

2017-05-02

Hypoglycaemia is a frequent complication among admitted children, particularly in malaria-endemic areas. This study aimed to estimate the occurrence of hypoglycaemia not only upon admission but throughout the first 72 h of hospitalization in children admitted with malaria. A simple pilot study to continuously monitor glycaemia in children aged 0-10 years, admitted with malaria in a rural hospital was conducted in Southern Mozambique by inserting continuous glucose monitors (CGMs) in subcutaneous tissue of the abdominal area, producing glycaemia readings every 5 min. Glucose was continuously monitored during a mean of 48 h, in 74 children. Continuous measurements of blood glucose were available for 72/74 children (97.3%). Sixty-five of them were admitted with density-specific malaria diagnosis criteria (17 severe, 48 uncomplicated). Five children (7.7%) had hypoglycaemia (<54 mg/dL) on admission as detected by routine capillary determination. Analysing the data collected by the CGMs, hypoglycaemia episodes (<54 mg/dL) were detected in 10/65 (15.4%) of the children, of which 7 (10.8%) could be classified as severe (≤45 mg/dL). No risk factors were independently associated with the presence of at least one episode of hypoglycaemia (<54 mg/dL) during hospitalization. Only one death occurred among a normoglycaemic child. All episodes of hypoglycaemia detected by CGMs were subclinical episodes or not perceived by caregivers or clinical staff. Hypoglycaemia beyond admission in children with malaria appears to be much more frequent than what had been previously described. The clinical relevance of these episodes of hypoglycaemia in the medium or long term remains to be determined.

Treatment with continuous positive airway pressure may affect blood glucose levels in nondiabetic patients with obstructive sleep apnea syndrome.

PubMed

Czupryniak, Leszek; Loba, Jerzy; Pawlowski, Maciej; Nowak, Dariusz; Bialasiewicz, Piotr

2005-05-01

Obstructive sleep apnea syndrome (OSAS) is often associated with impaired glucose metabolism. Data on the effects of OSAS treatment with continuous positive airway pressure (CPAP) on blood glucose and insulin resistance are conflicting. The study aimed at assessing the immediate effect of CPAP on glucose control measured with a continuous glucose monitoring system (CGMS). Nine non-diabetes subjects with OSAS (mean age 53.0 +/- 8.0 years; body mass index 34.8 +/- 5.3 kg/m2) underwent 2 overnight polysomnographic examinations: a diagnostic study and one with CPAP treatment. Continuous glucose monitoring system (CGMS) was applied overnight on both occasions. Glucose metabolism was assessed with a 75-g oral glucose tolerance test, plasma insulin and homeostatic model assessment of insulin resistance (HOMA-IR) index. The mean (+/- SD) apnoea-hypopnea index (AHI) at diagnostic polysomnography was 54.3 +/- 29.3 (range 16-81). Fasting plasma insulin levels in patients with OSAS was 84.3 +/- 43.4 pM at baseline, and the HOMA-IR was 3.6 +/- 2.2. CPAP treatment in the subjects with OSAS resulted in a significant reduction in the AHI to 4.5 +/- 7.1. All of the major saturation parameters improved significantly on CPAP. CGMS showed mean glucose values significantly higher during the CPAP night than during the diagnostic night: 80 +/- 11 mg/dL versus 63 +/- 7 mg/dL (P < .01). Fasting insulin and HOMA-IR measured after the CPAP night tended to be higher than at baseline (98.4 +/- 51.0 pmol vs 84.3 +/- 43.4 pmol and 3.9 pmol +/- 2.6 vs 3.6 +/- 2.2 pmol, respectively, P > .05). CPAP treatment in nondiabetic obese patients with OSAS may have an immediate elevating effect on blood glucose.

Use of a haemostatic matrix (Floseal®) does not reduce blood loss in minimally invasive total knee arthroplasty performed under continued aspirin

PubMed Central

Schwab, Pierre-Emmanuel; Thienpont, Emmanuel

2016-01-01

Background Aspirin is being used for primary and secondary cardiovascular prevention. It has been proposed that aspirin should be discontinued 5 to 7 days before surgery. However, discontinuation might increase the risk of cardiac and thrombo-embolic co-morbidity. Aspirin also increases the risk of bleeding during and after total knee arthroplasty. This study evaluated if the intra-articular use of a haemostatic matrix (Floseal®) might decrease blood loss in total knee arthroplasty performed under continued aspirin use. Materials and methods We retrospectively compared matched pairs in two groups (80 patients in each group). Patients in both groups were taking aspirin: one group was managed with conventional haemostasis (with bovie electrocoagulation), while the other group was treated with an intra-articular haemostatic matrix as an adjunct to electrocoagulation. The outcomes compared were haemoglobin and haematocrit levels at days 2 and 4 after surgery as surrogates for blood loss, transfusion rate, surgical time, and length of stay in the hospital. Results No differences were observed between the two groups for haemoglobin and haematocrit levels on days 2 and 4. There were no differences in transfusion rate, surgical time or length of stay in hospital between the two groups. Discussion The present study shows that the use of Floseal® has no effect on reducing either visible or hidden blood loss after total knee arthroplasty with peri-operative continuation of aspirin use, as assessed by a drop in haemoglobin or haematocrit. PMID:26057492

Intercomparison of active, passive and continuous instruments for radon and radon progeny measurements in the EML chamber and test facility

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

George, A.C.; Knutson, E.O.; Tu, K.W.

1995-12-01

The results from the May 1995 Intercomparison of Active, Passive and Continuous Instruments for Radon and Radon Progeny Measurement conducted in the EML radon exposure and test facility are presented. Represented were 13 participants that measure radon with open faced and diffusion barrier activated carbon collectors, 10 with nuclear alpha track detectors, 9 with short-term and long-term electret/ionization chambers, and 13 with active and passive commercial electronic continuous monitors. For radon progeny, there were four participants that came in person to take part in the grab sampling methodology for measuring individual radon progeny and the potential alpha energy concentration (PAEC).more » There were 11 participants with continuous and integrating commercial electronic instruments that are used for measuring the PAEC. The results indicate that all the tested instruments that measure radon fulfill their intended purpose. All instruments and methods used for grab sampling for radon progeny did very well. However, most of the continuous and integrating electronic instruments used for measuring the PAEC or working level appear to underestimate the potential risk from radon progeny when the concentration of particles onto which the radon progeny are attached is <5,000 cm{sup -3}.« less

Assessing ABO/Rh Blood Group Frequency and Association with Asymptomatic Malaria among Blood Donors Attending Arba Minch Blood Bank, South Ethiopia

PubMed Central

Alemu, Getaneh; Mama, Mohammedaman

2016-01-01

Background. Determination of the various ABO/Rh blood group distributions and their association with malaria infection has paramount importance in the context of transfusion medicine and malaria control. Methods. Facility based cross-sectional study was conducted from February to June, 2015, to assess ABO/Rh blood groups distribution and their association with asymptomatic malaria. A structured questionnaire was used to collect data. Blood grouping was done using monoclonal antibodies. Thin and thick blood films were examined for Plasmodium parasites. Data were analyzed using SPSS version 20.0. Results. A total of 416 blood donors participated with median age of 22 ± 0.29 (median ± standard error of the mean). Distribution of ABO phenotypes, in decreasing order, was O (175, 42.1%), A (136, 32.7%), B (87, 20.9%), and AB (18, 4.3%). Most of them were Rh+ (386, 92.8%). The overall malaria prevalence was 4.1% (17/416). ABO blood group is significantly associated with malaria infection (P = 0.022). High rate of parasitemia was seen in blood group O donors (6.899, P = 0.003) compared to those with other ABO blood groups. Conclusion. Blood groups O and AB phenotypes are the most and the least ABO blood groups, respectively. There is significant association between ABO blood group and asymptomatic malaria parasitemia. PMID:26925291

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

Pre-exercise blood glucose affects glycemic variation of aerobic exercise in patients with type 2 diabetes treated with continuous subcutaneous insulin infusion.

PubMed

Hu, Yun; Zhang, Dan-Feng; Dai, Lu; Li, Zheng; Li, Hui-Qin; Li, Feng-Fei; Liu, Bing-Li; Sun, Xiao-Juan; Ye, Lei; He, Ke; Ma, Jian-Hua

2018-05-03

Considering the insulin sensitivity may increase by exercise particularly in patients with type 2 diabetes (T2D), glycemic variation during exercise needs to be studied when the patients are treated with insulin. This study aimed to explore the influence factors of the efficacy and safety of aerobic exercise in patients with T2D treated with Continuous Subcutaneous Insulin Infusion (CSII). A total of 267 patients with T2D, treated with CSII, were included. Glycemic variations were assessed by continuous glucose monitoring (CGM). Patients were asked to complete 30 min aerobic exercise for at least one time during CGM. The patients were divided into effective and ineffective group by incremental glucose area under curve from 0 to 60 min after exercise (AUC 0-60 min ). The patients completed a total of 776 times of aerobic exercises. Blood glucose decreased fastest in the first 60 min of exercise. Pre-exercise blood glucose (PEBG) was negatively correlated with AUC 0-60 min (standardized β = -0.386, P < 0.001) and incremental AUC of blood glucose ≤ 4.4 mmol/L (standardized β = -0.078, P = 0.034), and was significantly higher in effective group than in ineffective group (P < 0.001). The Δglucose AUC 0-60 min during post-dinner was significantly higher than that during pre-lunch, post-lunch and pre-dinner (P < 0.05 for all). PEBG is positively correlated with efficacy of aerobic exercise. Aerobic exercise will not worsen hyperglycemia when the PEBG > 16.7 mmol/L. Post-dinner exercise decreases the blood glucose better than other periods of the day. ChiCTR-ONC-17010400, www.chictr.org.cn. Copyright © 2018 Elsevier B.V. All rights reserved.

Seroprevalence of Trypanosoma cruzi in blood donors at the National Blood Transfusion Services--Guyana.

PubMed

Bwititi, P T; Browne, J

2012-09-01

Blood transfusion is an important transmission route of Trypanosoma cruzi (T cruzi), a major parasitic infection in Central and South America. The limited treatment options are most effective in acute Chagas' infection. At present, there is no current data on the prevalence of T cruzi in the blood donor population of Guyana. This information is necessary to protect the supply of the blood donation programme. This study sought to determine the prevalence of T cruzi in the blood supply at the National Blood Transfusion Services of Guyana with the hope of providing knowledge to the on-going surveillance for Chagas' disease worldwide and therefore address the risk of its spread by blood transfusion. Two commercialized ELISAs utilizing crude or recombinant T cruzi antigens were used to study 2000 blood samples voluntarily donated for the purpose of altruistic or family replacement donation retrospectively. The results showed that approximately 1 in 286 donations tested positive for antibodies to T cruzi. These results indicate that T cruzi continues to be a risk in Guyana and there is a need to continue screening donated blood. Trypanosoma cruzi is a life-long infection and infected persons may be asymptomatic chronic carriers of the disease. Education, housing improvement, and controlled use of insecticides should be introduced to contain Chagas' disease.

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.

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...

Continuous and Cuffless Blood Pressure Monitoring Based on ECG and SpO2 Signals ByUsing Microsoft Visual C Sharp.

PubMed

Younessi Heravi, M A; Khalilzadeh, M A; Joharinia, S

2014-03-01

One of the main problems especially in operating room and monitoring devices is measurement of Blood Pressure (BP) by sphygmomanometer cuff. Objective :In this study we designed a new method to measure BP changes continuously for detecting information between cuff inflation times by using vital signals in monitoring devices. This will be achieved by extraction of the time difference between each cardiac cycle and a relative pulse wave. Finger pulse and ECG signals in lead I were recorded by a monitoring device. The output of monitoring device wasinserted in a computer by serial network communication. A software interface (Microsoft Visual C#.NET ) was used to display and process the signals in the computer. Time difference between each cardiac cycle and pulse signal was calculated throughout R wave detection in ECG and peak of pulse signal by the software. The relation between time difference in two waves and BP was determined then the coefficients of equation were obtained in different physical situations. The results of estimating BP were compared with the results of sphygmomanometer method and the error rate was calculated. In this study, 25 subjects participated among them 15 were male and 10 were female. The results showed that BP was linearly related to time difference. Average of coefficient correlation was 0.9±0.03 for systolic and 0.82±0.04 for diastolic blood pressure. The highest error percentage was calculated 8% for male and 11% for female group. Significant difference was observed between the different physical situation and arm movement changes. The relationship between time difference and age was estimated in a linear relationship with a correlation coefficient of 0.76. By determining linear relation values with high accuracy, BP can be measured with insignificant error. Therefore it can be suggested as a new method to measure the blood pressure continuously.

Continuous measurements of ammonia, nitrous oxide and methane from air scrubbers at pig housing facilities.

PubMed

Van der Heyden, C; Brusselman, E; Volcke, E I P; Demeyer, P

2016-10-01

Ammonia, largely emitted by agriculture, involves a great risk for eutrophication and acidification leading to biodiversity loss. Air scrubbers are widely applied to reduce ammonia emission from pig and poultry housing facilities, but it is not always clear whether their performance meets the requirements. Besides, there is a growing international concern for the livestock related greenhouse gases methane and nitrous oxide but hardly any data concerning their fate in air scrubbers are available. This contribution presents the results from measurement campaigns conducted at a chemical, a biological and a two-stage biological air scrubber installed at pig housing facilities in Flanders. Ammonia, nitrous oxide and methane at the inlet and outlet of the air scrubbers were monitored on-line during one week using a photoacoustic gas monitor, which allowed to investigate diurnal fluctuations in the removal performance of air scrubbers. Additionally, the homogeneity of the air scrubbers, normally checked by gas detection tubes, was investigated in more detail using the continuous data. The biological air scrubber with extra nitrification tank performed well in terms of ammonia removal (86 ± 6%), while the two-stage air scrubber suffered from nitrifying bacteria inhibition. In the chemical air scrubber the pH was not kept constant, lowering the ammonia removal efficiency. A lower ammonia removal efficiency was found during the day, when the ventilation rate was the highest. Nitrous oxide was produced inside the biological and two-stage scrubber, resulting in an increased outlet concentration of more than 200%. Methane could not be removed in the different air scrubbers because of its low water solubility. Copyright © 2016 Elsevier Ltd. All rights reserved.

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...

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...

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...

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...

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

Blood banking in China.

PubMed

Shan, Hua; Wang, Jing-Xing; Ren, Fu-Rong; Zhang, Yuan-Zhi; Zhao, Hai-Yan; Gao, Guo-Jing; Ji, Yang; Ness, Paul M

2002-11-30

While transfusion-transmissible diseases, including AIDS and viral hepatitis, continue to spread especially in developing countries, the issue of safeguarding the world's blood supply is of paramount importance. China houses more than 20% of the earth's population, and thus its blood supply has the potential to affect the global community. In recent years, Chinese blood centres have tried to improve the nation's blood safety. Although substantial progress has already been made, many daunting difficulties remain. Traditional cultural barriers need to be overcome to successfully mobilise volunteer blood donors. Gaps in information and technology still need to be closed. Insufficiency of economic resources also restrict the blood bank industry. Other developing countries face many of the same challenges as China.

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.

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...

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.

Hypertension and hematologic parameters in a community near a uranium processing facility

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

Wagner, Sara E., E-mail: swagner@uga.edu; Burch, James B.; South Carolina Statewide Cancer Prevention and Control Program, Columbia, SC

Background: Environmental uranium exposure originating as a byproduct of uranium processing can impact human health. The Fernald Feed Materials Production Center functioned as a uranium processing facility from 1951 to 1989, and potential health effects among residents living near this plant were investigated via the Fernald Medical Monitoring Program (FMMP). Methods: Data from 8216 adult FMMP participants were used to test the hypothesis that elevated uranium exposure was associated with indicators of hypertension or changes in hematologic parameters at entry into the program. A cumulative uranium exposure estimate, developed by FMMP investigators, was used to classify exposure. Systolic and diastolicmore » blood pressure and physician diagnoses were used to assess hypertension; and red blood cells, platelets, and white blood cell differential counts were used to characterize hematology. The relationship between uranium exposure and hypertension or hematologic parameters was evaluated using generalized linear models and quantile regression for continuous outcomes, and logistic regression or ordinal logistic regression for categorical outcomes, after adjustment for potential confounding factors. Results: Of 8216 adult FMMP participants 4187 (51%) had low cumulative uranium exposure, 1273 (15%) had moderate exposure, and 2756 (34%) were in the high (>0.50 Sievert) cumulative lifetime uranium exposure category. Participants with elevated uranium exposure had decreased white blood cell and lymphocyte counts and increased eosinophil counts. Female participants with higher uranium exposures had elevated systolic blood pressure compared to women with lower exposures. However, no exposure-related changes were observed in diastolic blood pressure or hypertension diagnoses among female or male participants. Conclusions: Results from this investigation suggest that residents in the vicinity of the Fernald plant with elevated exposure to uranium primarily via inhalation

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...

Indoor Lighting Facilities

NASA Astrophysics Data System (ADS)

Matsushima, Koji; Saito, Yoshinori; Ichikawa, Shigenori; Kawauchi, Takao; Tanaka, Tsuneo; Hirano, Rika; Tazuke, Fuyuki

According to the statistics by the Ministry of Land, Infrastructure and Transport, the total floor space of all building construction started was 188.87 million m2 (1.5% increase y/y), marking the fourth straight year of increase. Many large-scale buildings under construction in central Tokyo become fully occupied by tenants before completion. As for office buildings, it is required to develop comfortable and functional office spaces as working styles are becoming more and more diversified, and lighting is also an element of such functionalities. The total floor space of construction started for exhibition pavilions, multipurpose halls, conference halls and religious architectures decreased 11.1% against the previous year. This marked a decline for 10 consecutive years and the downward trend continues. In exhibition pavilions, the light radiation is measured and adjusted throughout the year so as not to damage the artworks by lighting. Hospitals, while providing higher quality medical services and enhancing the dwelling environment of patients, are expected to meet various restrictions and requirements, including the respect for privacy. Meanwhile, lighting designs for school classrooms tend to be homogeneous, yet new ideas are being promoted to strike a balance between the economical and functional aspects. The severe economic environment continues to be hampering the growth of theaters and halls in both the private and public sectors. Contrary to the downsizing trend of such facilities, additional installations of lighting equipment were conspicuous, and the adoption of high efficacy lighting appliances and intelligent function control circuits are becoming popular. In the category of stores/commercial facilities, the construction of complex facilities is a continuing trend. Indirect lighting, high luminance discharge lamps with excellent color rendition and LEDs are being effectively used in these facilities, together with the introduction of lighting designs

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

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...

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...

Revisions to labeling requirements for blood and blood components, including source plasma. Final rule.

PubMed

2012-01-03

The Food and Drug Administration (FDA) is revising the labeling requirements for blood and blood components intended for use in transfusion or for further manufacture by combining, simplifying, and updating specific regulations applicable to labeling and circulars of information. These requirements will facilitate the use of a labeling system using machine-readable information that would be acceptable as a replacement for the ``ABC Codabar'' system for the labeling of blood and blood components. FDA is taking this action as a part of its efforts to comprehensively review and, as necessary, revise its regulations, policies, guidances, and procedures related to the regulation of blood and blood components. This final rule is intended to help ensure the continued safety of the blood supply and facilitate consistency in labeling.

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...

Continuous and interval training programs using deep water running improves functional fitness and blood pressure in the older adults.

PubMed

Reichert, Thaís; Kanitz, Ana Carolina; Delevatti, Rodrigo Sudatti; Bagatini, Natália Carvalho; Barroso, Bruna Machado; Kruel, Luiz Fernando Martins

2016-02-01

This study aimed to investigate the effects of two periodized training programs of deep water running on functional fitness and blood pressure in the older adults. Thirty-six individuals were divided into continuous group (CONT) and interval group (INT). Both groups were trained for 28 weeks (twice weekly). Measures were performed before the training period, after 12 weeks and training period. Two-way ANOVA and post hoc of Bonferroni were used (α = 0.05). There were no differences between groups in functional tests, with the exception of the flexibility of the upper limbs, in which the INT group showed the highest values. There was a significant improvement in both groups of foot up-and-go test (CONT 6.45 to 5.67; INT 6.59 to 5.78, in seconds), flexibility of lower limbs (CONT -4.76 to -0.61; INT 0.54 to 4.63, in centimeters), strength of upper (CONT 18.76 to 27.69; INT 18.66 to 26.58, in repetitions) and lower limbs (CONT 14.46 to 21.23; INT 14.40 to 21.58, in repetitions), and 6-min walk (CONT 567.50 to 591.16; INT 521.41 to 582.77, in meters). No differences were shown between groups for systolic blood pressure; however, diastolic blood pressure remained higher in CONT during all training. The blood pressure decreased significantly in both groups after the training (CONT 142 ± 16/88 ± 3 to 125 ± 14/77 ± 7 mmHg; INT 133 ± 15/75 ± 7 to 123 ± 17 and 69 ± 11 mmHg). Both programs of deep water running training promoted improvements of similar magnitude in all parameters of functional fitness, with the exception of flexibility of upper limbs, and decreased blood pressure in the older individuals.

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...

[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.

Continuous low- to moderate-intensity exercise training is as effective as moderate- to high-intensity exercise training at lowering blood HbA(1c) in obese type 2 diabetes patients.

PubMed

Hansen, D; Dendale, P; Jonkers, R A M; Beelen, M; Manders, R J F; Corluy, L; Mullens, A; Berger, J; Meeusen, R; van Loon, L J C

2009-09-01

Exercise represents an effective interventional strategy to improve glycaemic control in type 2 diabetes patients. However, the impact of exercise intensity on the benefits of exercise training remains to be established. In the present study, we compared the clinical benefits of 6 months of continuous low- to moderate-intensity exercise training with those of continuous moderate- to high-intensity exercise training, matched for energy expenditure, in obese type 2 diabetes patients. Fifty male obese type 2 diabetes patients (age 59 +/- 8 years, BMI 32 +/- 4 kg/m(2)) participated in a 6 month continuous endurance-type exercise training programme. All participants performed three supervised exercise sessions per week, either 55 min at 50% of whole body peak oxygen uptake (VO(2)peak (low to moderate intensity) or 40 min at 75% of VO(2)peak (moderate to high intensity). Oral glucose tolerance, blood glycated haemoglobin, lipid profile, body composition, maximal workload capacity, whole body and skeletal muscle oxidative capacity and skeletal muscle fibre type composition were assessed before and after 2 and 6 months of intervention. The entire 6 month intervention programme was completed by 37 participants. Continuous endurance-type exercise training reduced blood glycated haemoglobin levels, LDL-cholesterol concentrations, body weight and leg fat mass, and increased VO(2)peak, lean muscle mass and skeletal muscle cytochrome c oxidase and citrate synthase activity (p < 0.05). No differences were observed between the groups training at low to moderate or moderate to high intensity. When matched for energy cost, prolonged continuous low- to moderate-intensity endurance-type exercise training is equally effective as continuous moderate- to high-intensity training in lowering blood glycated haemoglobin and increasing whole body and skeletal muscle oxidative capacity in obese type 2 diabetes patients. ISRCTN32206301 None.

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...

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.

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…

[Evaluation of blood grouping in ABO and Rh systems in health facilities in Benin].

PubMed

Anani, L Y; Lafia, E; Ahlonsou, F; Sogbohossou, P; Bigot, A; Fagbohoun, J; Meton, A; Adjaka, A; Latoundji, S; Py, J-Y; Zohoun, I S

2014-05-01

The goal of this work is to assess the modalities of blood typing achievement in Benin with the view of their improvement. On the basis of a questionnaire including the detailed operative process, a prospective investigation has been achieved in public and private health centers laboratories. It came out that the execution of ABO and Rh blood typing took place globally on the fringe of the standards. We note that 72.4% of the private laboratories and 48.9% of the public ones lacked at least one equipment and 51.3% at least one material for blood withdrawal; 38.2% of the laboratories did not respect blood withdrawal standards; 1.32% of the laboratories applied the 4×2 rule. The assessment revealed that respectively 10.8% and 30.7% of the blood centers and non-blood centers achieved the globular test solely; the same 40.5% and 46.2% used reagents of different brands. Anti-A1 and anti-H sera, and A1 and A2 red cells were not available in any laboratory. More than 64% of laboratories have senior technicians and biomedical analysis engineers but only 6.6% of the laboratories were directed by biologists, and 9.2% of the laboratories function with only one technician. Instead of some assets, the laboratories assessment noted important non-conformities we ought to raise as a matter of urgency. It is a challenge whose resolution must give blood transfusion centers a reference position relatively to blood grouping when facing blood typing difficulties. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

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...

Effect of health insurance and facility quality improvement on blood pressure in adults with hypertension in Nigeria: a population-based study.

PubMed

Hendriks, Marleen E; Wit, Ferdinand W N M; Akande, Tanimola M; Kramer, Berber; Osagbemi, Gordon K; Tanovic, Zlata; Gustafsson-Wright, Emily; Brewster, Lizzy M; Lange, Joep M A; Schultsz, Constance

2014-04-01

IMPORTANCE Hypertension is a major public health problem in sub-Saharan Africa, but the lack of affordable treatment and the poor quality of health care compromise antihypertensive treatment coverage and outcomes. OBJECTIVE To report the effect of a community-based health insurance (CBHI) program on blood pressure in adults with hypertension in rural Nigeria. DESIGN, SETTING, AND PARTICIPANTS We compared changes in outcomes from baseline (2009) between the CBHI program area and a control area in 2011 through consecutive household surveys. Households were selected from a stratified random sample of geographic areas. Among 3023 community-dwelling adults, all nonpregnant adults (aged ≥18 years) with hypertension at baseline were eligible for this study. INTERVENTION Voluntary CBHI covering primary and secondary health care and quality improvement of health care facilities. MAIN OUTCOMES AND MEASURES The difference in change in blood pressure from baseline between the program and the control areas in 2011, which was estimated using difference-in-differences regression analysis. RESULTS Of 1500 eligible households, 1450 (96.7%) participated, including 564 adults with hypertension at baseline (313 in the program area and 251 in the control area). Longitudinal data were available for 413 adults (73.2%) (237 in the program area and 176 in the control area). Baseline blood pressure in respondents with hypertension who had incomplete data did not differ between areas. Insurance coverage in the hypertensive population increased from 0% to 40.1% in the program area (n = 237) and remained less than 1% in the control area (n = 176) from 2009 to 2011. Systolic blood pressure decreased by 10.41 (95% CI, -13.28 to -7.54) mm Hg in the program area, constituting a 5.24 (-9.46 to -1.02)-mm Hg greater reduction compared with the control area (P = .02), where systolic blood pressure decreased by 5.17 (-8.29 to -2.05) mm Hg. Diastolic blood pressure decreased by 4.27 (95

SELF BLOOD GLUCOSE MONITORING UNDERESTIMATES HYPERGLYCEMIA AND HYPOGLYCEMIA AS COMPARED TO CONTINUOUS GLUCOSE MONITORING IN TYPE 1 AND TYPE 2 DIABETES.

PubMed

Mangrola, Devna; Cox, Christine; Furman, Arianne S; Krishnan, Sridevi; Karakas, Sidika E

2018-01-01

When glucose records from self blood glucose monitoring (SBGM) do not reflect estimated average glucose from glycosylated hemoglobin (HgBA1) or when patients' clinical symptoms are not explained by their SBGM records, clinical management of diabetes becomes a challenge. Our objective was to determine the magnitude of differences in glucose values reported by SBGM versus those documented by continuous glucose monitoring (CGM). The CGM was conducted by a clinical diabetes educator (CDE)/registered nurse by the clinic protocol, using the Medtronic iPRO2 â„¢ system. Patients continued SBGM and managed their diabetes without any change. Data from 4 full days were obtained, and relevant clinical information was recorded. De-identified data sets were provided to the investigators. Data from 61 patients, 27 with type 1 diabetes (T1DM) and 34 with T2DM were analyzed. The lowest, highest, and average glucose recorded by SBGM were compared to the corresponding values from CGM. The lowest glucose values reported by SBGM were approximately 25 mg/dL higher in both T1DM ( P = .0232) and T2DM ( P = .0003). The highest glucose values by SBGM were approximately 30 mg/dL lower in T1DM ( P = .0005) and 55 mg/dL lower in T2DM ( P<.0001). HgBA1c correlated with the highest and average glucose by SBGM and CGM. The lowest glucose values were seen most frequently during sleep and before breakfast; the highest were seen during the evening and postprandially. SBGM accurately estimates the average glucose but underestimates glucose excursions. CGM uncovers glucose patterns that common SBGM patterns cannot. CDE = certified diabetes educator; CGM = continuous glucose monitoring; HgBA1c = glycosylated hemoglobin; MAD = mean absolute difference; SBGM = self blood glucose monitoring; T1DM = type 1 diabetes; T2DM = type 2 diabetes.

Facilities, testing, and continuing studies on carbon-black loaded styrene-butadiene rubber

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

Goldberg, A.; Sanchez, R.J.; LeMay, J.D.

The Lawrence Livermore National Laboratory (LLNL) has been involved with investigations dealing with the response of the rubber in tank track pads to various loading scenarios, both in the field and in the laboratory. In the laboratory, numerous studies were also performed on a number of other rubber formulations primarily involving a range of carbon-black loadings in SBR and NR. Reference is made to reports and papers addressing each of the studies involved in this program. Work performed during the final stages of this program is described. These studies were directed primarily at developing an understanding of the effects ofmore » cycling and notching histories, notch radius, notch depth, and specimen thickness on the deformation behavior, strain distributions, hysteresis, and residual strength of SBR containing various amounts of carbon black. Significant improvements were realized in our testing methodology, computer-controlled facilities, and data-acquisition system, and in our ability to obtain continuous photomicrographic documentation in ''real time'' of the tearing improvements, as they relate to the various studies, are detailed in this document. Results obtained in these studied involve (1) the fabrication and testing of thick tensile specimens, (2) the effect of notching under load on the residual strength, (3) the effect of cycling on residual strength of notched and notch-free specimens, (4) the effect of cycling on hysteresis, (5) the effect of notch radius for various notch depths on loss of strength, and (6) evaluation of strain at a notch tip and remote from the notch tip at various specimen extensions by analyzing the specimen grid markings, which were obtained with the microscope-video-Polaroid system. 15 refs., 27 figs.« less

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.

Continuous positive airway pressure reduces blood pressure in patients with obstructive sleep apnea; a systematic review and meta-analysis with 1000 patients.

PubMed

Schein, Andressa S O; Kerkhoff, Alessandra C; Coronel, Christian C; Plentz, Rodrigo D M; Sbruzzi, Graciele

2014-09-01

Obstructive sleep apnea (OSA) may lead to the development of hypertension and therapy with continuous positive airway pressure (CPAP) can promote reduction in blood pressure. The objective of this study is to review systematically the effects of CPAP on blood pressure in patients with OSA. The search was conducted in the following databases, from their beginning until February 2013: MEDLINE, Embase, Cochrane CENTRAL, Lilacs and PEDro. In addition, a manual search was performed on references of published studies. Randomized clinical trials (RCTs) that used CPAP compared with placebo CPAP or subtherapeutic CPAP for treatment of patients with OSA and that evaluated office SBP and DBP and 24-h ambulatory blood pressure were selected. Sixteen RCTs were included among 3409 publications, totaling 1166 patients. The use of CPAP resulted in reductions in office SBP [-3.20  mmHg; 95% confidence interval (CI) -4.67 to -1.72] and DBP (-2.87  mmHg; 95% CI -5.18 to -0.55); in night-time SBP (-4.92  mmHg; 95% CI -8.70 to -1.14); in mean 24-h blood pressure (-3.56  mmHg; 95% CI -6.79 to -0.33), mean night-time blood pressure (-2.56  mmHg; 95% CI -4.43 to -0.68) and 24-h DBP (-3.46  mmHg; 95% CI -6.75 to -0.17). However, no significant change was observed in daytime SBP (-0.74  mmHg; 95% CI -3.90 to 2.41) and daytime DBP (-1.86  mmHg; 95% CI -4.55 to 0.83). Treatment with CPAP promoted significantly but small reductions in blood pressure in individuals with OSA. Further studies should be performed to evaluate the effects of long-term CPAP and the impact on cardiovascular risk.

42 CFR 456.436 - Continued stay review process.

Code of Federal Regulations, 2010 CFR

2010-10-01

... (CONTINUED) MEDICAL ASSISTANCE PROGRAMS UTILIZATION CONTROL Utilization Control: Intermediate Care Facilities... mentally retarded, the recipient's qualified mental retardation professional, within 1 working day of its... final decision on the need for the continued stay; (g) If the attending physician or qualified mental...

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...

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.

Biotechnology Facility: An ISS Microgravity Research Facility

NASA Technical Reports Server (NTRS)

Gonda, Steve R.; Tsao, Yow-Min

2000-01-01

The International Space Station (ISS) will support several facilities dedicated to scientific research. One such facility, the Biotechnology Facility (BTF), is sponsored by the Microgravity Sciences and Applications Division (MSAD) and developed at NASA's Johnson Space Center. The BTF is scheduled for delivery to the ISS via Space Shuttle in April 2005. The purpose of the BTF is to provide: (1) the support structure and integration capabilities for the individual modules in which biotechnology experiments will be performed, (2) the capability for human-tended, repetitive, long-duration biotechnology experiments, and (3) opportunities to perform repetitive experiments in a short period by allowing continuous access to microgravity. The MSAD has identified cell culture and tissue engineering, protein crystal growth, and fundamentals of biotechnology as areas that contain promising opportunities for significant advancements through low-gravity experiments. The focus of this coordinated ground- and space-based research program is the use of the low-gravity environment of space to conduct fundamental investigations leading to major advances in the understanding of basic and applied biotechnology. Results from planned investigations can be used in applications ranging from rational drug design and testing, cancer diagnosis and treatments and tissue engineering leading to replacement tissues.

Plasma extraction rate enhancement scheme for a real-time and continuous blood plasma separation device using a sheathless cell concentrator

NASA Astrophysics Data System (ADS)

Kang, Dong-Hyun; Kim, Kyongtae; Kim, Yong-Jun

2018-02-01

Microfluidic devices for plasma extraction are popular because they offer the advantage of smaller reagent consumption compared to conventional centrifugations. The plasma yield (volume percentage of plasma that can be extracted) is an important factor for diagnoses in microdevices with small reagent consumptions. However, recently designed microfluidic devices tend to have a low plasma yield because they have been optimized to improve the purity of extracted plasma. Thus, these devices require large amounts of reagents, and this complexity has eliminated the advantage of microfluidic devices that can operate with only small amounts of reagents. We therefore propose a continuous, real-time, blood plasma separation device, for plasma extraction rate enhancements. Moreover, a blood plasma separation device was designed to achieve improved plasma yields with high-purity efficiency. To obtain a high plasma yield, microstructures were placed on the bottom side of the channel to increase the concentration of blood cells. Plasma separation was then accomplished via microfluidic networks based on the Zweifach-Fung effect. The proposed device was fabricated based on the polydimethylsiloxane molding process using the SU-8 microfluidic channel for the fabrication of the mold and bottom structures. Human blood diluted in a phosphate buffered saline solution (25% hematocrit) was injected into the inlet of the device. The purity efficiencies were approximately equal to 96% with a maximum of 96.75% at a flow rate of 2 µl min-1, while the plasma yield was approximately 59% with a maximum of 59.92% at a flow rate of 4 µl min-1. Compared to results obtained using other devices, our proposed device could obtain comparable or higher plasma purity and a high plasma yield.

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, 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...

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...

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

First-time blood donors: demographic trends.

PubMed

Wu, Y; Glynn, S A; Schreiber, G B; Wright, D J; Lo, A; Murphy, E L; Kleinman, S H; Garratty, G

2001-03-01

With changing demographics of the United States population and the continuous need to recruit new donors, it is important to monitor the demographic profile of first-time donors and to evaluate changes in the donor pool to improve recruitment targeting. First-time whole blood (n = 901,862) donors at five United States blood centers between 1991 and 1996 were analyzed. The total number of first-time donors appears to be decreasing. Over the 6-year period, there was an overall increase in the proportion of Hispanic and other minority first-time donors and a concurrent decrease in the proportion of white donors at Retrovirus Epidemiology Donor Study centers. Other variables, including age, sex, and education, did not show a consistent trend. The demographic profile of first-time donors is changing. These data highlight the importance for blood centers to continuously monitor the donor population. A better understanding of the donor population may help blood centers adjust their donor outreach, recruitment, and retention programs. New recruitment efforts appear needed to counter general apathy toward donating blood, and minority groups appear to be receptive to becoming blood donors.

Clinical assessment of blood glucose homeostasis in horses: comparison of a continuous glucose monitoring system with a combined intravenous glucose and insulin test protocol.

PubMed

Johnson, P J; Wiedmeyer, C E; LaCarrubba, A; Messer, N T; Dingfelder, H A; Cogswell, A M; Amorim, J R R; Ganjam, V K

2011-01-01

The combined glucose-insulin test (CGIT) is helpful for evaluating insulin sensitivity. A continuous glucose monitoring system (CGMS) reports changes in interstitial glucose concentrations as they occur in the blood. Use of the CGMS minimizes animal contact and may be useful when performing a CGIT. Results obtained using a CGMS are useful for the evaluation of glucose responses during the evaluation of insulin sensitivity in equids. Seven mature, obese ponies. Ponies were equipped with CGMS for determination of interstitial glucose concentrations. Glucose (150 mg/kg, i.v.) and insulin (0.1 U/kg, i.v.) were administered and blood glucose concentrations determined at (minutes after time zero) 1, 5, 15, 25, 35, 45, 60, 75, 90, 105, and 120 with a hand-held glucometer. Blood chemistry results were compared with simultaneously obtained results using CGMS. Concordance coefficients determined for comparison of blood glucose concentrations determined by a hand-held glucometer and those determined by CGMS after the zero time point were 0.623, 0.764, 0.834, 0.854, and 0.818 (for delays of 0, 5, 10, 15, and 20 minutes, respectively). Interstitial glucose concentrations obtained by the CGMS compared favorably to blood glucose concentrations. CGMS may be useful for assessment of glucose dynamics in the CGIT. Copyright © 2010 by the American College of Veterinary Internal Medicine.

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...

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...

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...

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...

Readiness of district and regional hospitals in Burkina Faso to provide caesarean section and blood transfusion services: a cross-sectional study.

PubMed

Compaoré, Georges Dayitaba; Sombié, Issiaka; Ganaba, Rasmané; Hounton, Sennen; Meda, Nicolas; Brouwere, Vincent De; Borchert, Matthias

2014-05-02

Health centres and hospitals play a crucial role in reducing maternal mortality and morbidity by offering respectively Basic Emergency Obstetric and Newborn Care (BEmONC) and Comprehensive Emergency Obstetric and Newborn Care (CEmONC). The readiness of hospitals to provide CEmONC depends on the availability of qualified human resources, infrastructure like surgical theatres, and supplies like drugs and blood for transfusion. We assessed the readiness of district and regional hospitals in Burkina Faso to provide two key CEmONC functions, namely caesarean section and blood transfusion. As countries conduct EmONC needs assessments it is critical to provide national and subnational data, e.g. on the distribution of EmONC facilities as well as on facilities lacking the selected signal functions, to support the planning process for upgrading facilities so that they are ready to provide CEmONC. In a cross-sectional study we assessed the availability of relevant health workers, obstetric guidelines, caesarean section and blood transfusion services and experience with quality assurance approaches across all forty-three (43) district and nine (9) regional hospitals. The indicator corresponding to one comprehensive emergency care unit for 500,000 inhabitants was not achieved in Burkina Faso. Physicians with surgical skills, surgical assistants and anaesthesiologist assistants are sufficiently available in only 51.2%, 88.3% and 72.0% of district hospitals, respectively. Two thirds of regional and 20.9% of district hospitals had blood banks. Most district hospitals as opposed to only one third of regional hospitals had experience in maternal death reviews. Our findings suggest that only 27.8% of hospitals in Burkina Faso at the time of the study could continuously offer caesarean sections and blood transfusion services. Four years later, progress has likely been made but many challenges remain to be overcome. Information provided in this study can serve as a baseline for

Design of an 81.25 MHz continuous-wave radio-frequency quadrupole accelerator for Low Energy Accelerator Facility

NASA Astrophysics Data System (ADS)

Ma, Wei; Lu, Liang; Xu, Xianbo; Sun, Liepeng; Zhang, Zhouli; Dou, Weiping; Li, Chenxing; Shi, Longbo; He, Yuan; Zhao, Hongwei

2017-03-01

An 81.25 MHz continuous wave (CW) radio frequency quadrupole (RFQ) accelerator has been designed for the Low Energy Accelerator Facility (LEAF) at the Institute of Modern Physics (IMP) of the Chinese Academy of Science (CAS). In the CW operating mode, the proposed RFQ design adopted the conventional four-vane structure. The main design goals are providing high shunt impendence with low power losses. In the electromagnetic (EM) design, the π-mode stabilizing loops (PISLs) were optimized to produce a good mode separation. The tuners were also designed and optimized to tune the frequency and field flatness of the operating mode. The vane undercuts were optimized to provide a flat field along the RFQ cavity. Additionally, a full length model with modulations was set up for the final EM simulations. Following the EM design, thermal analysis of the structure was carried out. In this paper, detailed EM design and thermal simulations of the LEAF-RFQ will be presented and discussed. Structure error analysis was also studied.

Influences of Climate Warming and Facility Management on Continuous Permafrost at Matterhorn Glacier Paradise, Zermatt, Swiss Alps.

NASA Astrophysics Data System (ADS)

King, Lorenz; Duishonakunov, Murataly; Imbery, Stephan

2014-05-01

In many parts of the Alps, hazardous bedrock instabilities occur more often during the past 30 years. In many cases, permafrost degradation played a central role for instability (e.g. in 1987 the Val Pola rockslide, Italy). At other events, the role of permafrost degradation is more complex or unpredictable (e.g. in 1991 the Randa rockfall, Wallis, Swiss Alps). However, instabilities in perennially frozen bedrock may also be provoked by human influence. This is exemplarily shown at touristic facilities in the Alps. Human impact on permafrost is often underestimated, or even carelessly taken into account. The tourist resort Zermatt with more than 1.8 million overnight stays per year is located at 1600 m a.s.l. and is surrounded by high mountain ranges that often reach above 4000 m. The dry and sunny climate results in a high glacier equilibrium line thus leaving space for vast non-glaciated permafrost terrain. Numerous tourist facilities provide excellent logistics and easy access to permafrost sites, and the region is thus especially suitable for permafrost research. The infrastructure erected on permafrost consists of hotels, restaurants and mountain huts, station buildings of railways, funiculars, ski lifts and installations for artificial snowing the ski-runs. Some problems at these constructions due to permafrost degradation are shown. At the Matterhorn Glacier Paradise station at an altitude of 3820 meters, todays MAAT ranges between -6 °C and -8°C. During the construction of a tunnel in 1981 bedrock temperatures were at -12°C. Over the past 30 years, these bedrock temperatures have risen to -3 to -2°C, due to the heat brought into the tunnel by facilities and more than 490,000 visitors per year. In an elevator shaft, the temperature temporarily even rose above freezing point. Several new construction sites in continuous permafrost are described and new research data is presented. Another interesting site for permafrost and ice studies at Matterhorn

Cuff for Blood-Vessel Pressure Measurements

NASA Technical Reports Server (NTRS)

Shimizu, M.

1982-01-01

Pressure within blood vessel is measured by new cufflike device without penetration of vessel. Device continuously monitors blood pressure for up to 6 months or longer without harming vessel. Is especially useful for vessels smaller than 4 or 5 millimeters in diameter. Invasive methods damage vessel wall, disturb blood flow, and cause clotting. They do not always give reliable pressure measurements over prolonged periods.

Planning continuing training.

PubMed

Nacef, T; Argellies, J L

1982-01-01

Suggests new direction in the approach to planning continued training of medical personnel. Under this new scheme, health problems themselves will be the sole basis for the planning of the continuing training program. This approach assures the involvement of health professionals at various levels and fosters a multiprofessional involvement in continuing training. It is also recommended that the preventive aspects of medicine be stressed far more than is typical of traditional hospital services. The method for decision making in program planning includes 6 steps: 1) choice of health problem to be solved (includes considerations of severity of the problems and the degree to which continuing training will be of value); 2) analysis of the number and type of health personnel needed; 3) determination of desired skill acquisition; 4) analysis of teaching/educational requirements; 5) inventory of resources (time, facilities, staff, instructional materials) available; 6) evaluation. Coordination at different levels, both national and regional, ensures the cohesion of the multiprofessional continuing training system. Regional cell groups, composed of 2 paramedicals and a doctor administer continuing training sessions under policy established at a national level by a national advisory committee. This approach makes continuing training an important and immediate component of health policy aimed at delivering basic health services to the entire population.

Survey of solar thermal test facilities

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

Masterson, K.

The facilities that are presently available for testing solar thermal energy collection and conversion systems are briefly described. Facilities that are known to meet ASHRAE standard 93-77 for testing flat-plate collectors are listed. The DOE programs and test needs for distributed concentrating collectors are identified. Existing and planned facilities that meet these needs are described and continued support for most of them is recommended. The needs and facilities that are suitable for testing components of central receiver systems, several of which are located overseas, are identified. The central contact point for obtaining additional details and test procedures for these facilitiesmore » is the Solar Thermal Test Facilities Users' Association in Albuquerque, N.M. The appendices contain data sheets and tables which give additional details on the technical capabilities of each facility. Also included is the 1975 Aerospace Corporation report on test facilities that is frequently referenced in the present work.« less

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...

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...

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...

Continuous flow microfluidic separation and processing of rare cells and bioparticles found in blood - A review.

PubMed

Antfolk, Maria; Laurell, Thomas

2017-05-01

Rare cells in blood, such as circulating tumor cells or fetal cells in the maternal circulation, posses a great prognostic or diagnostic value, or for the development of personalized medicine, where the study of rare cells could provide information to more specifically targeted treatments. When conventional cell separation methods, such as flow cytometry or magnetic activated cell sorting, have fallen short other methods are desperately sought for. Microfluidics have been extensively used towards isolating and processing rare cells as it offers possibilities not present in the conventional systems. Furthermore, microfluidic methods offer new possibilities for cell separation as they often rely on non-traditional biomarkers and intrinsic cell properties. This offers the possibility to isolate cell populations that would otherwise not be targeted using conventional methods. Here, we provide an extensive review of the latest advances in continuous flow microfluidic rare cell separation and processing with each cell's specific characteristics and separation challenges as a point of view. Copyright © 2017 Elsevier B.V. All rights reserved.

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

Effects of continuous positive airway pressure on blood pressure in patients with resistant hypertension and obstructive sleep apnea: a systematic review and meta-analysis of six randomized controlled trials

PubMed Central

Lei, Qiang; Lv, Yunhui; Li, Kai; Ma, Lei; Du, Guodong; Xiang, Yan; Li, Xuqing

2017-01-01

ABSTRACT Objective: To evaluate systematically the effects of continuous positive airway pressure (CPAP) on blood pressure in patients with resistant hypertension and obstructive sleep apnea (OSA). Methods: The Cochrane Library, PubMed, ScienceDirect, and the Web of Science were searched for studies investigating the effects of CPAP on blood pressure in patients with resistant hypertension and OSA. The selected studies underwent quality assessment and meta-analysis, as well as being tested for heterogeneity. Results: Six randomized controlled trials were included in the meta-analysis. The pooled estimates of the changes in mean systolic blood pressure and mean diastolic blood pressure (as assessed by 24-h ambulatory blood pressure monitoring) were −5.40 mmHg (95% CI: −9.17 to −1.64; p = 0.001; I2 = 74%) and −3.86 mmHg (95% CI: −6.41 to −1.30; p = 0.00001; I2 = 79%), respectively. Conclusions: CPAP therapy can significantly reduce blood pressure in patients with resistant hypertension and OSA. PMID:28767770

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...

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...

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...

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.

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.

Noninvasive, low-noise, fast imaging of blood volume and deoxygenation changes in muscles using light-emitting diode continuous-wave imager

NASA Astrophysics Data System (ADS)

Lin, Yuanqing; Lech, Gwen; Nioka, Shoko; Intes, Xavier; Chance, Britton

2002-08-01

This article focuses on optimizing the signal to noise ratio (SNR) of a three-wavelength light-emitting diode (LED) near-infrared continuous-wave (cw) imager and its application to in vivo muscle metabolism measurement. The shot-noise limited SNR is derived and calculated to be 2 x104 for the physiological blood concentrations of muscle. Aiming at shot-noise limited SNR performance and fast imaging, we utilize sample and hold circuits to reduce high-frequency noise. These circuits have also been designed to be parallel integrating, through which SNR of 2 x103 and 2 Hz imaging acquisition rate have been achieved when the probe is placed on a muscle model. The noise corresponds to 2 x10-4 optical density error, which suggests an in vitro resolution of 15. 4 nM blood volume and 46.8 nM deoxygenation changes. A 48 dB digital gain control circuit with 256 steps is employed to enlarge the dynamic range of the imager. We utilize cuff ischemia as a living model demonstration and its results are reported. The instrument is applied during exercise to measure the changes of blood volume and deoxygenation, which provides important information about muscle metabolism. We find that the primary source of noise encountered during exercise experiment is from the random motion of muscle. The results demonstrate that the LED cw imager is ideal for the noninvasive study of muscle metabolism.

A quantitative method for optimized placement of continuous air monitors.

PubMed

Whicker, Jeffrey J; Rodgers, John C; Moxley, John S

2003-11-01

Alarming continuous air monitors (CAMs) are a critical component for worker protection in facilities that handle large amounts of hazardous materials. In nuclear facilities, continuous air monitors alarm when levels of airborne radioactive materials exceed alarm thresholds, thus prompting workers to exit the room to reduce inhalation exposures. To maintain a high level of worker protection, continuous air monitors are required to detect radioactive aerosol clouds quickly and with good sensitivity. This requires that there are sufficient numbers of continuous air monitors in a room and that they are well positioned. Yet there are no published methodologies to quantitatively determine the optimal number and placement of continuous air monitors in a room. The goal of this study was to develop and test an approach to quantitatively determine optimal number and placement of continuous air monitors in a room. The method we have developed uses tracer aerosol releases (to simulate accidental releases) and the measurement of the temporal and spatial aspects of the dispersion of the tracer aerosol through the room. The aerosol dispersion data is then analyzed to optimize continuous air monitor utilization based on simulated worker exposure. This method was tested in a room within a Department of Energy operated plutonium facility at the Savannah River Site in South Carolina, U.S. Results from this study show that the value of quantitative airflow and aerosol dispersion studies is significant and that worker protection can be significantly improved while balancing the costs associated with CAM programs.

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.

A health maintenance facility for space station freedom

NASA Technical Reports Server (NTRS)

Billica, R. D.; Doarn, C. R.

1991-01-01

We describe a health care facility to be built and used on an orbiting space station in low Earth orbit. This facility, called the health maintenance facility, is based on and modeled after isolated terrestrial medical facilities. It will provide a phased approach to health care for the crews of Space Station Freedom. This paper presents the capabilities of the health maintenance facility. As Freedom is constructed over the next decade there will be an increase in activities, both construction and scientific. The health maintenance facility will evolve with this process until it is a mature, complete, stand-alone health care facility that establishes a foundation to support interplanetary travel. As our experience in space continues to grow so will the commitment to providing health care.

Autologous Blood Transfusion for Postpartum Hemorrhage.

PubMed

Greenawalt, Julia A; Zernell, Denise

Postpartum hemorrhage (PPH) is a leading contributor to maternal morbidity and mortality in the United States and globally. Although the rate of PPH is generally decreasing nationally, severity of PPH appears to be increasing, potentially related to the various comorbidities associated with women of childbearing age. There is increasing evidence of risks associated with allogeneic blood transfusion, which has historically been the classic therapeutic approach for treatment to PPH. Pregnant women are particularly susceptible to the implications of sensitization to red cell antigens, a common sequela to allogenic blood transfusion. Autologous blood transfusion eliminates the potential of communicable disease transmission as well as the conceivable threat of a blood transfusion reaction. Recent technological advances allow cell salvage coupled with the use of a leukocyte filter to be used as an alternative approach for improving the outcome for women experiencing a PPH. Modest changes in standard operating procedure and continued training in use and application of cell salvaged blood may assist in minimizing negative outcomes from PPH. Salvaged blood has been demonstrated to be at least equal and often superior to banked blood. We discuss nursing implications for application of this technology for women with PPH. Continued research is warranted to evaluate the impact that application of cell salvage with filtration has on the patient experiencing a PPH.

21 CFR 862.1120 - Blood gases (PCO2, PO2) and blood pH test system.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Blood gases (PCO2, PO2) and blood pH test system. 862.1120 Section 862.1120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

21 CFR 862.1120 - Blood gases (PCO2, PO2) and blood pH test system.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Blood gases (PCO2, PO2) and blood pH test system. 862.1120 Section 862.1120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

21 CFR 862.1120 - Blood gases (PCO2, PO2) and blood pH test system.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Blood gases (PCO2, PO2) and blood pH test system. 862.1120 Section 862.1120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

21 CFR 862.1120 - Blood gases (PCO2, PO2) and blood pH test system.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Blood gases (PCO2, PO2) and blood pH test system. 862.1120 Section 862.1120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry...

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...

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...

Automatic blood pressure measuring system (M092)

NASA Technical Reports Server (NTRS)

Nolte, R. W.

1977-01-01

The Blood Pressure Measuring System is described. It measures blood pressure by the noninvasive Korotkoff sound technique on a continual basis as physical stress is imposed during experiment M092, Lower Body Negative Pressure, and experiment M171, Metabolic Activity.

[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.

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...

Smart blood pressure holter.

PubMed

Ä°lhan, Ä°lhan

2018-03-01

In this study, a wireless blood pressure holter that can be used with smart mobile devices was developed. The developed blood pressure holter consists of two parts, which are a smart mobile device and a cuff. The smart mobile device is used as a recording, control and display device through a developed interface, while the cuff was designed to take measurements from the arm. Resistor-Capacitor (RC) and digital filters were used on the cuff that communicates with the smart mobile device via Bluetooth. The blood pressure was estimated using the Simple Hill Climbing Algorithm (HCA). It is possible to measure instantaneous or programmable blood pressure and heart rate values at certain intervals using this holter. The test was conducted with 30 individuals at different ages with the guidance of a specialist health personnel. The results showed that an accuracy at 93.89% and 91.95% rates could be obtained for systolic and diastolic pressure values, respectively, when compared with those obtained using a traditional sphygmomanometer. The accuracy level for the heart rate was measured as 97.66%. Furthermore, this device was tested day and night in the holter mode in terms of working time, the continuity of the Bluetooth connection and the reliability of the measurement results. The test results were evaluated separately in terms of measurement accuracy, working time, the continuity of the Bluetooth connection and the reliability of the measurement results. The measurement accuracy for systolic, diastolic blood pressure and heart rate values was obtained as 93.89%, 91.95% and 97.66%, respectively. The maximum number of measurements which can be conducted with four 1000 mA alkaline batteries at 20 min intervals was found approximately 79 (little more than 24 h). In addition, it was determined that the continuity of the Bluetooth connection and the reliability of the measurement results were automatically achieved through the features in the interface developed for the

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...

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.

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...

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...

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...

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...

Investments in blood safety improve the availability of blood to underserved areas in a sub-Saharan African country

PubMed Central

Pitman, J. P.; Wilkinson, R.; Basavaraju, S. V.; von Finckenstein, B.; Sibinga, C. Smit; Marfin, A. A.; Postma, M. J.; Mataranyika, M.; Tobias, J.; Lowrance, D. W.

2015-01-01

Background and Objectives Since 2004, several African countries, including Namibia, have received assistance from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR). Gains have been documented in the safety and number of collected units in these countries, but the distribution of blood has not been described. Materials and Methods Nine years of data on blood requests and issues from Namibia were stratified by region to describe temporal and spatial changes in the number and type of blood components issued to Namibian healthcare facilities nationally. Results Between 2004 and 2007 (early years of PEPFAR support) and 2008–2011 (peak years of PEPFAR support), the average number of red cell units issued annually increased by 23.5% in seven densely populated but less-developed regions in northern Namibia; by 30% in two regions with urban centres; and by 35.1% in four sparsely populated rural regions. Conclusion Investments in blood safety and a policy decision to emphasize distribution of blood to underserved regions improved blood availability in remote rural areas and increased the proportion of units distributed as components. However, disparities persist in the distribution of blood between Namibia’s urban and rural regions. PMID:26478742

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...

Low-cost, disposable microfluidics device for blood plasma extraction using continuously alternating paramagnetic and diamagnetic capture modes

PubMed Central

Kim, Pilkee; Ong, Eng Hui; Yoon, Yong-Jin; Ng, Sum Huan Gary; Puttachat, Khuntontong

2016-01-01

Blood plasma contains biomarkers and substances that indicate the physiological state of an organism, and it can be used to diagnose various diseases or body condition. To improve the accuracy of diagnostic test, it is required to obtain the high purity of blood plasma. This paper presents a low-cost, disposable microfluidics device for blood plasma extraction using magnetophoretic behaviors of blood cells. This device uses alternating magnetophoretic capture modes to trap and separate paramagnetic and diamagnetic cells away from blood plasma. The device system is composed of two parts, a disposable microfluidics chip and a non-disposable (reusable) magnetic field source. Such modularized device helps the structure of the disposable part dramatically simplified, which is beneficial for low-cost mass production. A series of numerical simulation and parametric study have been performed to describe the mechanism of blood cell separation in the microchannel, and the results are discussed. Furthermore, experimental feasibility test has been carried out in order to demonstrate the blood plasma extraction process of the proposed device. In this experiment, pure blood plasma has been successfully extracted with yield of 21.933% from 75 μl 1:10 dilution of deoxygenated blood. PMID:27042252

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.

Report of a workshop on ensuring sustainable access to safe blood in developing countries: International Blood Safety Forum, March 24, 2017.

PubMed

Katz, Louis M; Donnelly, John J; Gresens, Christopher J; Holmberg, Jerry A; MacPherson, James; Zacharias, Peter J K; Stanley, Jean; Bales, Christine

2018-05-01

On March 24, 2017, more than 90 experts in blood safety and international development from blood centers, industry, government, and international and nongovernmental organizations gathered in Arlington, Virginia, for the Third International Blood Safety Forum, cosponsored by America's Blood Centers and Global Healing. This report summarizes presentations and major conclusions. The meeting explored ways to increase access to affordable, safe blood for low- and lower-middle-income countries (LMICs) in an era when funding from the US President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund has been redirected from preventing the spread of human immunodeficiency virus (HIV) to diagnosing and treating the 25 million-plus people living with HIV in LMICs. More effective management systems must be developed to improve cost recovery for blood. While blood systems become more sustainable, continued investment is required to keep them operating. The traditional model of large grants from bilateral and multilateral donors will need to be supplemented (or replaced) with public-private partnerships and nongovernmental investment. A continued emphasis on quality is fundamental. Blood systems must build quality programs, based on accepted standards, including hospitals, clinics, and rural health care providers to ensure proper and safe use of blood. Proposals to resolve health care inequities between LMICs and high-income countries (HICs) must include helping LMICs to define sustainable national policies and practices for blood availability and utilization to suit local contexts. The blood safety lexicon should be revised to include availability, accessibility, and affordability of safe blood and blood products as the goal of all blood safety initiatives. © 2018 AABB.

Thomas Jefferson National Accelerator Facility

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

Grames, Joseph; Higinbotham, Douglas; Montgomery, Hugh

The Thomas Jefferson National Accelerator Facility (Jefferson Lab) in Newport News, Virginia, USA, is one of ten national laboratories under the aegis of the Office of Science of the U.S. Department of Energy (DOE). It is managed and operated by Jefferson Science Associates, LLC. The primary facility at Jefferson Lab is the Continuous Electron Beam Accelerator Facility (CEBAF) as shown in an aerial photograph in Figure 1. Jefferson Lab was created in 1984 as CEBAF and started operations for physics in 1995. The accelerator uses superconducting radio-frequency (srf) techniques to generate high-quality beams of electrons with high-intensity, well-controlled polarization. Themore » technology has enabled ancillary facilities to be created. The CEBAF facility is used by an international user community of more than 1200 physicists for a program of exploration and study of nuclear, hadronic matter, the strong interaction and quantum chromodynamics. Additionally, the exceptional quality of the beams facilitates studies of the fundamental symmetries of nature, which complement those of atomic physics on the one hand and of high-energy particle physics on the other. The facility is in the midst of a project to double the energy of the facility and to enhance and expand its experimental facilities. Studies are also pursued with a Free-Electron Laser produced by an energy-recovering linear accelerator.« less

BION-M 1: First continuous blood pressure monitoring in mice during a 30-day spaceflight

NASA Astrophysics Data System (ADS)

Andreev-Andrievskiy, Alexander; Popova, Anfisa; Lloret, Jean-Christophe; Aubry, Patrick; Borovik, Anatoliy; Tsvirkun, Daria; Vinogradova, Olga; Ilyin, Eugeniy; Gauquelin-Koch, Guillemette; Gharib, Claude; Custaud, Marc-Antoine

2017-05-01

Animals are an essential component of space exploration and have been used to demonstrate that weightlessness does not disrupt essential physiological functions. They can also contribute to space research as models of weightlessness-induced changes in humans. Animal research was an integral component of the 30-day automated Russian biosatellite Bion-M 1 space mission. The aim of the hemodynamic experiment was to estimate cardiovascular function in mice, a species roughly 3000 times smaller than humans, during prolonged spaceflight and post-flight recovery, particularly, to investigate if mice display signs of cardiovascular deconditioning. For the first time, heart rate (HR) and blood pressure (BP) were continuously monitored using implantable telemetry during spaceflight and recovery. Decreased HR and unchanged BP were observed during launch, whereas both HR and BP dropped dramatically during descent. During spaceflight, BP did not change from pre-flight values. However, HR increased, particularly during periods of activity. HR remained elevated after spaceflight and was accompanied by increased levels of exercise-induced tachycardia. Loss of three of the five mice during the flight as a result of the hardware malfunction (unrelated to the telemetry system) and thus the limited sample number constitute the major limitation of the study. For the first time BP and HR were continuously monitored in mice during the 30-day spaceflight and 7-days of post-flight recovery. Cardiovascular deconditioning in these tiny quadruped mammals was reminiscent of that in humans. Therefore, the loss of hydrostatic pressure in space, which is thought to be the initiating event for human cardiovascular adaptation in microgravity, might be of less importance than other physiological mechanisms. Further experiments with larger number of mice are needed to confirm these findings.

BION-M 1: First continuous blood pressure monitoring in mice during a 30-day spaceflight.

PubMed

Andreev-Andrievskiy, Alexander; Popova, Anfisa; Lloret, Jean-Christophe; Aubry, Patrick; Borovik, Anatoliy; Tsvirkun, Daria; Vinogradova, Olga; Ilyin, Eugeniy; Gauquelin-Koch, Guillemette; Gharib, Claude; Custaud, Marc-Antoine

2017-05-01

Animals are an essential component of space exploration and have been used to demonstrate that weightlessness does not disrupt essential physiological functions. They can also contribute to space research as models of weightlessness-induced changes in humans. Animal research was an integral component of the 30-day automated Russian biosatellite Bion-M 1 space mission. The aim of the hemodynamic experiment was to estimate cardiovascular function in mice, a species roughly 3000 times smaller than humans, during prolonged spaceflight and post-flight recovery, particularly, to investigate if mice display signs of cardiovascular deconditioning. For the first time, heart rate (HR) and blood pressure (BP) were continuously monitored using implantable telemetry during spaceflight and recovery. Decreased HR and unchanged BP were observed during launch, whereas both HR and BP dropped dramatically during descent. During spaceflight, BP did not change from pre-flight values. However, HR increased, particularly during periods of activity. HR remained elevated after spaceflight and was accompanied by increased levels of exercise-induced tachycardia. Loss of three of the five mice during the flight as a result of the hardware malfunction (unrelated to the telemetry system) and thus the limited sample number constitute the major limitation of the study. For the first time BP and HR were continuously monitored in mice during the 30-day spaceflight and 7-days of post-flight recovery. Cardiovascular deconditioning in these tiny quadruped mammals was reminiscent of that in humans. Therefore, the loss of hydrostatic pressure in space, which is thought to be the initiating event for human cardiovascular adaptation in microgravity, might be of less importance than other physiological mechanisms. Further experiments with larger number of mice are needed to confirm these findings. Copyright © 2017 The Committee on Space Research (COSPAR). Published by Elsevier Ltd. All rights reserved.

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...

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...

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...

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...

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...

21 CFR 870.1100 - Blood pressure alarm.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Blood pressure alarm. 870.1100 Section 870.1100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1100 Blood pressure alarm...

21 CFR 870.1110 - Blood pressure computer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Blood pressure computer. 870.1110 Section 870.1110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1110 Blood pressure...

21 CFR 870.1120 - Blood pressure cuff.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Blood pressure cuff. 870.1120 Section 870.1120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1120 Blood pressure cuff...

The ISOLDE facility

NASA Astrophysics Data System (ADS)

Catherall, R.; Andreazza, W.; Breitenfeldt, M.; Dorsival, A.; Focker, G. J.; Gharsa, T. P.; J, Giles T.; Grenard, J.-L.; Locci, F.; Martins, P.; Marzari, S.; Schipper, J.; Shornikov, A.; Stora, T.

2017-09-01

The ISOLDE facility has undergone numerous changes over the last 17 years driven by both the physics and technical community with a common goal to improve on beam variety, beam quality and safety. Improvements have been made in civil engineering and operational equipment while continuing developments aim to ensure operations following a potential increase in primary beam intensity and energy. This paper outlines the principal technical changes incurred at ISOLDE by building on a similar publication of the facility upgrades by Kugler (2000 Hyperfine Interact. 129 23-42). It also provides an insight into future perspectives through a brief summary issues addressed in the HIE-ISOLDE design study Catherall et al (2013 Nucl. Instrum. Methods Phys. Res. B 317 204-207).

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.

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.

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 61.81 - 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...

The use of continuing adult education

NASA Technical Reports Server (NTRS)

Redd, Frank J.

1990-01-01

The objectives of the National Space Grant and Fellowship Program include the expansion of space-oriented educational programs beyond the traditional boundaries of university campuses to reach 'non-traditional' students whose personal and professional lives would be enhanced by access to such programs. These objectives coincide with those of the continuing education programs that exist on most university campuses. By utilizing continuing educations resources and facilities, members of the National Space Grant Program can greatly enhance the achievement of program objectives.

Do high blood glucose peaks contribute to higher HbA1c? Results from repeated continuous glucose measurements in children.

PubMed

Ulf, Samuelsson; Ragnar, Hanas; Arne, Whiss Per; Johnny, Ludvigsson

2008-08-01

HbA1c levels are influenced by the glycemic control of previous 2-3 months. Sometimes patients have surprisingly low HbA1c in spite of many correctly measured high blood glucose values, which is difficult to explain. As glucose sensors give an objective picture based on glucose readings several times per minute over 24 hours, we used the area under the curve (AUC) of such subcutaneous glucose profiles to evaluate their relationship with HbA1c. Thirty-two patients were randomized into two study arms, one open and the other blinded. Both arms had 8 pump users and 8 patients with multiple daily injections (MDI). After three months the two arms crossed over. Both study arms wore a continuous glucose monitoring system (CGMS) for 3 days every 2 weeks. HbA1c was determined before and after each 3-month study period. There was no relationship between HbA1c and s.c. glucose AUC or between HbA1c and the number of peaks >15.0 mmol/L when all CGMS profiles during the 6 months were taken together. Children on MDI showed a positive relationship between HbA1c and AUC (P<0.01) as well as the number of peaks (P<0.01). Children with a negative relationship between HbA1c and AUC generally had fewer fluctuations in blood glucose values, whereas children with a positive relationship had wide fluctuations. between s.c. glucose AUC and HbA1c, the results indicate that wide blood glucose fluctuations may be related to high HbA1c values. Therefore, complications and therapeutic interventions should aim at reducing such fluctuations. Although there was no relationship between s.c. glucose AUC and HbA1c, the results indicate that wide blood glucose fluctuations may be related to high HbA1c values. Therefore, complications and therapeutic interventions should aim at reducing such fluctuations.

POLYNOMIAL-BASED DISAGGREGATION OF HOURLY RAINFALL FOR CONTINUOUS HYDROLOGIC SIMULATION

EPA Science Inventory

Hydrologic modeling of urban watersheds for designs and analyses of stormwater conveyance facilities can be performed in either an event-based or continuous fashion. Continuous simulation requires, among other things, the use of a time series of rainfall amounts. However, for urb...

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). ...

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...

Fresenius AS.TEC204 blood cell separator.

PubMed

Sugai, Mikiya

2003-02-01

Fresenius AS.TEC204 is a third-generation blood cell separator that incorporates the continuous centrifugal separation method and automatic control of the cell separation process. Continuous centrifugation separates cell components according to their specific gravity, and different cell components are either harvested or eliminated as needed. The interface between the red blood cell and plasma is optically detected, and the Interface Control (IFC) cooperates with different pumps, monitors and detectors to harvest required components automatically. The system is composed of three major sections; the Front Panel Unit; the Pump Unit, and the Centrifuge Unit. This unit can be used for a wide variety of clinical applications including collection of platelets, peripheral blood stem cells, bone marrow stem cells, granulocytes, mononuclear cells, and exchange of plasma or red cells, and for plasma treatment.

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...

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.

Development of Chemically Amplified Optical Sensors for Continuous Blood Glucose Monitoring Final Report CRADA No. TSB-1162-95

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

Lane, Stephen M.; Mastrototaro, John J.

Diabetes is a chronic disease that affects 14 million people in the U.S. and more than 110 million people worldwide. Each year in this country 27,000 diabetic patients become blind, 15,000 have kidney failure, and over 54,000 have peripheral limb amputations. In 1992, total healthcare costs in the U.S. for diabetes were more than $105 billion, approximately 15% of our healthcare budget. Conventional therapy for the most severe form of diabetes, insulin-dependent diabetes mellitus (IDDM) or Type I diabetes, is to administer one or two injections per day of various forms of insulin while monitoring blood glucose levels twice ormore » three times daily with commercial glucometers that require blood samples. Near normal blood sugar levels (glycemic control) is difficult to achieve with conventional therapy. In the fall of 1993, the results of the 10-year $165 million Diabetes Control and Complications Trial (DCCT) were published which showed that intensive insulin management would lead to dramatically fewer cases of retinopathy (which leads to blindness), nephropathy (which leads to kidney failure), and neuropathy (which can lead to limb amputations) [New England Journal of Medicine, Vo1239, No.14 977-986 (1993)]. If existing commercial insulin pumps could be combined with a continuous glucose sensor, a more physiological and fine-tuned therapy could be provided - in effect, an artificial biomechanical pancreas would be available. Existing research suggested that such a development would dramatically improve glucose control, thus greatly reducing morbidity and mortality from this disease. MiniMed Technologies in Sylmar, CA, identified a number of optically based sensor strategies as well as candidate chemical reactions that could be used to implement a minimally invasive opto-chemical glucose sensor. LLNL evaluated these sensor strategies and chemical reactions. These evaluations were the first steps leading to development of a sensor of considerable importance that

21 CFR 870.1110 - Blood pressure computer.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Blood pressure computer. 870.1110 Section 870.1110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... computer. (a) Identification. A blood pressure computer is a device that accepts the electrical signal from...

21 CFR 870.1110 - Blood pressure computer.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Blood pressure computer. 870.1110 Section 870.1110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... computer. (a) Identification. A blood pressure computer is a device that accepts the electrical signal from...

21 CFR 870.1110 - Blood pressure computer.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Blood pressure computer. 870.1110 Section 870.1110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... computer. (a) Identification. A blood pressure computer is a device that accepts the electrical signal from...

21 CFR 870.1110 - Blood pressure computer.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Blood pressure computer. 870.1110 Section 870.1110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... computer. (a) Identification. A blood pressure computer is a device that accepts the electrical signal from...

Laser materials processing facility

NASA Technical Reports Server (NTRS)

Haggerty, J. S.

1982-01-01

The laser materials processing facility and its capabilities are described. A CO2 laser with continuous wave, repetitive pulse, and shaped power-time cycles is employed. The laser heated crystal growth station was used to produce metal and metal oxide single crystals and for cutting and shaping experiments using Si3N4 to displace diamond shaping processes.

National space test centers - Lewis Research Center Facilities

NASA Technical Reports Server (NTRS)

Roskilly, Ronald R.

1990-01-01

The Lewis Research Center, NASA, presently has a number of test facilities that constitute a significant national space test resource. It is expected this capability will continue to find wide application in work involving this country's future in space. Testing from basic research to applied technology, to systems development, to ground support will be performed, supporting such activities as Space Station Freedom, the Space Exploration Initiative, Mission to Planet Earth, and many others. The major space test facilities at both Cleveland and Lewis' Plum Brook Station are described. Primary emphasis is on space propulsion facilities; other facilities of importance in space power and microgravity are also included.

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...

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.

Letter to editor: Blood pressure, hypertension and lead exposure.

PubMed

Yang, Wen-Yi; Staessen, Jan A

2018-02-19

A significant association of office diastolic blood pressure with low-level blood lead exposure was reported in a Brazilian adult population. However, caution should be taken to interpret these results. The multivariable-adjusted association with blood pressure was positive for diastolic blood pressure, but inverse for systolic blood pressure. The association sizes were infinitesimal without clinical relevance. The outcome measures, i.e. blood pressure and the prevalence of hypertension were analysed across categories of the blood lead distribution - not in relation to blood lead as continuous variable. Blood pressure was the average of two oscillometric office readings, whereas ambulatory monitoring is the state-of-the-art.

The Continuity Project, Fall 1997 Report.

ERIC Educational Resources Information Center

Wasilko, Peter J.

The Continuity Project is a research, development, and technology transfer initiative aimed at creating a "Library of the Future" by combining features of an online public access catalog (OPAC) and a campus wide information system (CWIS) with advanced facilities drawn from such areas as artificial intelligence (AI), knowledge…

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...

NENIMF: Northeast National Ion Microprobe Facility - A Multi-User Facility for SIMS Microanalysis

NASA Astrophysics Data System (ADS)

Layne, G. D.; Shimizu, N.

2002-12-01

The MIT-Brown-Harvard Regional Ion Microprobe Facility was one of the earliest multi-user facilities enabled by Dan Weill's Instrumentation and Facilities Program - and began with the delivery of a Cameca IMS 3f ion microprobe to MIT in 1978. The Northeast National Ion Microprobe Facility (NENIMF) is the direct descendant of this original facility. Now housed at WHOI, the facility incorporates both the original IMS 3f, and a new generation, high transmission-high resolution instrument - the Cameca IMS 1270. Purchased with support from NSF, and from a consortium of academic institutions in the Northeast (The American Museum of Natural History, Brown University, The Lamont-Doherty Earth Observatory, MIT, Rensselaer Polytechnic Institute, WHOI) - this latest instrument was delivered and installed during 1996. NENIMF continues to be supported by NSF EAR I&F as a multi-user facility for geochemical research. Work at NENIMF has extended the original design strength of the IMS 1270 for microanalytical U-Pb zircon geochronology to a wide variety of novel and improved techniques for geochemical research. Isotope microanalysis for studies in volcanology and petrology is currently the largest single component of facility activity. This includes the direct measurement of Pb isotopes in melt inclusions, an application developed at NENIMF, which is making an increasingly significant contribution to our understanding of basalt petrogenesis. This same technique has also been extended to the determination of Pb isotopes in detrital feldspar grains, for the study of sedimentary provenance and tectonics of the Himalayas and other terrains. The determination of δ11B in volcanic melt inclusions has also proven to be a powerful tool in the modeling of subduction-related magmatism. The recent development of δ34S and δ37Cl determination in glasses is being applied to studies of the behavior of these volatile elements in both natural and experimental systems. Other recent undertakings

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...

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...

19 CFR 151.24 - Unlading facilities for bulk sugar.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 19 Customs Duties 2 2014-04-01 2014-04-01 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, 2012 CFR

2012-04-01

... 19 Customs Duties 2 2012-04-01 2012-04-01 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, 2013 CFR

2013-04-01

... 19 Customs Duties 2 2013-04-01 2013-04-01 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, 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...

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 1271.190 - Facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Facilities. 1271.190 Section 1271.190 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) REGULATIONS UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION HUMAN CELLS, TISSUES, AND...

21 CFR 1271.190 - Facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Facilities. 1271.190 Section 1271.190 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) REGULATIONS UNDER CERTAIN OTHER ACTS ADMINISTERED BY THE FOOD AND DRUG ADMINISTRATION HUMAN CELLS, TISSUES, AND...

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...

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

Overview of the Neutron experimental facilities at LANSCE

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

Mocko, Michal

2016-06-30

This presentation gives an overview of the neutron experimental facilities at LANSCE. The layout is mentioned in detail, with a map of the south-side experimental facilities, information on Target-4 and the Lujan Center. Then it goes into detail about neutron sources, specifically continuous versus pulsed. Target 4 is then discussed. In conclusion, we have introduced the south-side experimental facilities in operation at LANSCE. 1L target and Target 4 provide complementary neutron energy spectra. Two spallation neutron sources taken together cover more than 11 orders of magnitude in neutron energy.

The Blood Stocks Management Scheme, a partnership venture between the National Blood Service of England and North Wales and participating hospitals for maximizing blood supply chain management.

PubMed

Chapman, J F; Cook, R

2002-10-01

The Blood Stocks Management Scheme (BSMS) has been established as a joint venture between the National Blood Service (NBS) in England and North Wales and participating hospitals to monitor the blood supply chain. Stock and wastage data are submitted to a web-based data-management system, facilitating continuous and complete red cell data collection and 'real time' data extraction. The data-management system enables peer review of performance in respect of stock holding levels and red cell wastage. The BSMS has developed an innovative web-based data-management system that enables data collection and benchmarking of practice, which should drive changes in stock management practice, therefore optimizing the use of donated blood.

Blood feeding behavior of the stable fly

USDA-ARS?s Scientific Manuscript database

Stable fly is a fly that looks similar to a house fly but both sexes are blood feeders. Blood is required for successful fertilization and development of eggs. Bites are painful but there is usually no pain after the fly stops feeding. The stable fly is a persistent feeder and will continue trying t...

National facilities study. Volume 5: Space research and development facilities task group

NASA Technical Reports Server (NTRS)

1994-01-01

With the beginnings of the U.S. space program, there was a pressing need to develop facilities that could support the technology research and development, testing, and operations of evolving space systems. Redundancy in facilities that was once and advantage in providing flexibility and schedule accommodation is instead fast becoming a burden on scarce resources. As a result, there is a clear perception in many sectors that the U.S. has many space R&D facilities that are under-utilized and which are no longer cost-effective to maintain. At the same time, it is clear that the U.S. continues to possess many space R&D facilities which are the best -- or among the best -- in the world. In order to remain world class in key areas, careful assessment of current capabilities and planning for new facilities is needed. The National Facility Study (NFS) was initiated in 1992 to develop a comprehensive and integrated long-term plan for future aerospace facilities that meets current and projected government and commercial needs. In order to assess the nation's capability to support space research and development (R&D), a Space R&D Task Group was formed. The Task Group was co-chaired by NASA and DOD. The Task Group formed four major, technologically- and functionally- oriented working groups: Human and Machine Operations; Information and Communications; Propulsion and Power; and Materials, Structures, and Flight Dynamics. In addition to these groups, three supporting working groups were formed: Systems Engineering and Requirements; Strategy and Policy; and Costing Analysis. The Space R&D Task Group examined several hundred facilities against the template of a baseline mission and requirements model (developed in common with the Space Operations Task Group) and a set of excursions from the baseline. The model and excursions are described in Volume 3 of the NFS final report. In addition, as a part of the effort, the group examined key strategic issues associated with space R

40 CFR 63.471 - Facility-wide standards.

Code of Federal Regulations, 2010 CFR

2010-07-01

... manufacture of narrow tubing, and continuous web cleaning machines, located at a major source that are subject... engineering calculations included in the compliance report. (4) Each owner or operator of an affected facility...

40 CFR 63.471 - Facility-wide standards.

Code of Federal Regulations, 2011 CFR

2011-07-01

... manufacture of narrow tubing, and continuous web cleaning machines, located at a major source that are subject... engineering calculations included in the compliance report. (4) Each owner or operator of an affected facility...

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…

Continuous noninvasive monitoring in the neonatal ICU.

PubMed

Sahni, Rakesh

2017-04-01

Standard hemodynamic monitoring such as heart rate and systemic blood pressure may only provide a crude estimation of organ perfusion during neonatal intensive care. Pulse oximetry monitoring allows for continuous noninvasive monitoring of hemoglobin oxygenation and thus provides estimation of end-organ oxygenation. This review aims to provide an overview of pulse oximetry and discuss its current and potential clinical use during neonatal intensive care. Technological advances in continuous assessment of dynamic changes in systemic oxygenation with pulse oximetry during transition to extrauterine life and beyond provide additional details about physiological interactions among the key hemodynamic factors regulating systemic blood flow distribution along with the subtle changes that are frequently transient and undetectable with standard monitoring. Noninvasive real-time continuous systemic oxygen monitoring has the potential to serve as biomarkers for early-organ dysfunction, to predict adverse short-term and long-term outcomes in critically ill neonates, and to optimize outcomes. Further studies are needed to establish values predicting adverse outcomes and to validate targeted interventions to normalize abnormal values to improve outcomes.

Life Sciences Centrifuge Facility review

NASA Technical Reports Server (NTRS)

Young, Laurence R.

1994-01-01

The Centrifuge Facility Project at ARC was reviewed by a code U team to determine appropriateness adequacy for the ISSA. This report represents the findings of one consultant to this team and concentrates on scientific and technical risks. This report supports continuation of the project to the next phase of development.

[Syphilis and blood transfusion].

PubMed

Jenum, Pål A; Flesland, Øystein; Blystad, Hans; Vik, Inger Sofie Samdal; Hervig, Tor; Maeland, Arild; Saeter, Gunnar

2010-04-22

In 2007, previous syphilis infection was diagnosed in a blood donor who had given blood regularly for 15 years. This was discovered when the donor was tested for syphilis, as a new donor in another blood bank. The time of infection is unknown. An expert group, set up by The Norwegian Directorate of Health, was commissioned to evaluate the risk of syphilis transmission through blood products in Norway. The expert group based its evaluation on the epidemiology of syphilis, risk of infection and properties of the syphilis bacterium, especially in relation to blood donation. Specific information about the actual incident, made available by the Norwegian Directorate of Health, was also evaluated. Of 54 blood recipients 21 were alive and 18 (86 %) were tested for syphilis, all with a negative result. For 11 deceased the hospital records were studied without discovering signs of syphilis infection. The risk of transfusion-transmitted syphilis is low for several reasons: The prevalence of syphilis in the population is low, a compulsory interview and completion of a questionnaire before donation in Norway excludes patients who are ill or at risk of being infected; the proportion of fresh blood donations is very low and syphilis bacteria die quickly during normal storage conditions for blood. An incidental infection is symptomatic and easily treated by antibiotics. The expert group recommends to not start syphilis testing of each blood donor but to continue the present routine testing of new donors.

21 CFR 870.1140 - Venous blood pressure manometer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Venous blood pressure manometer. 870.1140 Section 870.1140 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CARDIOVASCULAR DEVICES Cardiovascular Diagnostic Devices § 870.1140 Venous blood...

Targeting Continuing Medical Education on Decision Makers: Who Decides to Transfuse Blood?

ERIC Educational Resources Information Center

Goodnough, Lawrence T.; And Others

1992-01-01

Staff communication patterns were observed during 13 open-heart surgeries to identify the transfusion decision makers. It was determined that targeting decision makers for continuing medical education would improve the quality of transfusion practice and increase the efficiency of continuing education. (SK)

Association of low-level blood lead and blood pressure in NHANES 1999-2006

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

Scinicariello, Franco, E-mail: fes6@cdc.gov; Abadin, Henry G.; Edward Murray, H.

This study investigated whether low blood-lead levels ({<=}10 {mu}g/dL) were associated with blood pressure (BP) outcomes. The authors analyzed data from National Health and Nutrition Examination Survey 1999-2006 and participants aged 20 years or older. Outcome variables were systolic and diastolic BP measurements, pulse pressure, and hypertension status. Multivariable linear and logistic regressions stratified by race/ethnicity and gender were performed. Blood lead levels (BLL) were significantly correlated with higher systolic BP among black men and women, but not white or Mexican-American participants. BLLs were significantly associated with higher diastolic BPs among white men and women and black men, whereas, amore » negative association was observed in Mexican-American men that had, also, a wider pulse pressure. Black men in the 90th percentile of blood lead distribution (BLL{>=}3.50 {mu}g/dL) compared to black men in the 10th percentile of blood lead distribution (BLL{<=}0.7 {mu}g/dL) had a significant increase of risk of having hypertension (adjusted POR=2.69; 95% CI: 1.08-6.72). In addition, blood cadmium was significantly associated with hypertension and systolic and diastolic blood. This study found that, despite the continuous decline in blood lead in the U.S. population, lead exposure disparities among race and gender still exist.« less

The Portuguese gamma irradiation facility

NASA Astrophysics Data System (ADS)

Mendes, C. M.; Almeida, J. C.; Botelho, M. L.; Cavaco, M. C.; Almeida-Vara, E.; Andrade, M. E.

A Gamma Radiation Facility was built up in the National Laboratory of Industrial Technology and Engineering (LNETI), Lisbon, Portugal. This plant (UTR GAMA-Pi) is a Cobalt-60 dry storage continuous facility with a nominal capacity of 1.5X10 16 Bq. The initial activity is 1.1X10 16 Bq and the troughput capacity 10 3 ton/year for product with a bulk density of 0.2 g/cm 3 treated with a minimum absorbed dose of 25 kGy. Complementary control devices were installed: ventilation system, closed water refrigeration circuit, internal TV system, detection and extinction fire system and emergency power group. It must be emphasized that the best attention was given to the conception and efficiency of the interlock safety systems. This facility will be utilized mainly for radiosterilization of medical articles and decontamination of wine cork stoppers.

A Bioinformatics Facility for NASA

NASA Technical Reports Server (NTRS)

Schweighofer, Karl; Pohorille, Andrew

2006-01-01

Building on an existing prototype, we have fielded a facility with bioinformatics technologies that will help NASA meet its unique requirements for biological research. This facility consists of a cluster of computers capable of performing computationally intensive tasks, software tools, databases and knowledge management systems. Novel computational technologies for analyzing and integrating new biological data and already existing knowledge have been developed. With continued development and support, the facility will fulfill strategic NASA s bioinformatics needs in astrobiology and space exploration. . As a demonstration of these capabilities, we will present a detailed analysis of how spaceflight factors impact gene expression in the liver and kidney for mice flown aboard shuttle flight STS-108. We have found that many genes involved in signal transduction, cell cycle, and development respond to changes in microgravity, but that most metabolic pathways appear unchanged.

Total Quality Management for Campus Facilities.

ERIC Educational Resources Information Center

Reynolds, Gary L.

1992-01-01

This article examines the total quality management (TQM) concept as it is applied to higher education campus facilities. Each of the fundamental principles of TQM are examined as follows: customer-centered orientation; leadership; improved communication; continuous improvement; accountability; and quality of life. (GLR)

45 CFR 618.410 - Comparable facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 618.410 Comparable facilities...

45 CFR 618.410 - Comparable facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 618.410 Comparable facilities...

45 CFR 618.410 - Comparable facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 618.410 Comparable facilities...

45 CFR 618.410 - Comparable facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Discrimination on the Basis of Sex in Education Programs or Activities Prohibited § 618.410 Comparable facilities...

Reductions in Red Blood Cell 2,3-Diphosphoglycerate Concentration during Continuous Renal Replacment Therapy

PubMed Central

Brugnara, Carlo; Betensky, Rebecca A.; Waikar, Sushrut S.

2015-01-01

Background and objectives Hypophosphatemia is a frequent complication during continuous renal replacement therapy (CRRT), a dialytic technique used to treat AKI in critically ill patients. This study sought to confirm that phosphate depletion during CRRT may decrease red blood cell (RBC) concentration of 2,3-diphosphoglycerate (2,3-DPG), a crucial allosteric effector of hemoglobin’s (Hgb’s) affinity for oxygen, thereby leading to impaired oxygen delivery to peripheral tissues. Design, setting, participants, & measurements Phosphate mass balance studies were performed in 20 patients with severe AKI through collection of CRRT effluent. RBC concentrations of 2,3-DPG, venous blood gas pH, and oxygen partial pressure required for 50% hemoglobin saturation (P50) were measured at CRRT initiation and days 2, 4, and 7. Similar measurements were obtained on days 0 and 2 in a reference group of 10 postsurgical patients, most of whom did not have AKI. Associations of 2,3-DPG with laboratory parameters and clinical outcomes were examined using mixed-effects and Cox regression models. Results Mean 2,3-DPG levels decreased from a mean (±SD) of 13.4±3.4 µmol/g Hgb to 11.0±3.1 µmol/g Hgb after 2 days of CRRT (P<0.001). Mean hemoglobin saturation P50 levels decreased from 29.7±4.4 mmHg to 26.7±4.0 mmHg (P<0.001). No significant change was seen in the reference group. 2,3-DPG levels after 2 days of CRRT were not significantly lower than those in the reference group on day 2. Among patients receiving CRRT, 2,3-DPG decreased by 0.53 µmol/g Hgb per 1 g phosphate removed (95% confidence interval 0.38 to 0.68 µmol/g Hgb; P<0.001). Greater reductions in 2,3-DPG were associated with higher risk for death (hazard ratio, 1.43; 95% confidence interval, 1.09 to 1.88; P=0.01). Conclusions CRRT-induced phosphate depletion is associated with measurable reductions in RBC 2,3-DPG concentration and a shift in the O2:Hgb affinity curve even in the absence of overt hypophosphatemia. 2

Reductions in red blood cell 2,3-diphosphoglycerate concentration during continuous renal replacment therapy.

PubMed

Sharma, Shilpa; Brugnara, Carlo; Betensky, Rebecca A; Waikar, Sushrut S

2015-01-07

Hypophosphatemia is a frequent complication during continuous renal replacement therapy (CRRT), a dialytic technique used to treat AKI in critically ill patients. This study sought to confirm that phosphate depletion during CRRT may decrease red blood cell (RBC) concentration of 2,3-diphosphoglycerate (2,3-DPG), a crucial allosteric effector of hemoglobin's (Hgb's) affinity for oxygen, thereby leading to impaired oxygen delivery to peripheral tissues. Phosphate mass balance studies were performed in 20 patients with severe AKI through collection of CRRT effluent. RBC concentrations of 2,3-DPG, venous blood gas pH, and oxygen partial pressure required for 50% hemoglobin saturation (P50) were measured at CRRT initiation and days 2, 4, and 7. Similar measurements were obtained on days 0 and 2 in a reference group of 10 postsurgical patients, most of whom did not have AKI. Associations of 2,3-DPG with laboratory parameters and clinical outcomes were examined using mixed-effects and Cox regression models. Mean 2,3-DPG levels decreased from a mean (±SD) of 13.4±3.4 µmol/g Hgb to 11.0±3.1 µmol/g Hgb after 2 days of CRRT (P<0.001). Mean hemoglobin saturation P50 levels decreased from 29.7±4.4 mmHg to 26.7±4.0 mmHg (P<0.001). No significant change was seen in the reference group. 2,3-DPG levels after 2 days of CRRT were not significantly lower than those in the reference group on day 2. Among patients receiving CRRT, 2,3-DPG decreased by 0.53 µmol/g Hgb per 1 g phosphate removed (95% confidence interval 0.38 to 0.68 µmol/g Hgb; P<0.001). Greater reductions in 2,3-DPG were associated with higher risk for death (hazard ratio, 1.43; 95% confidence interval, 1.09 to 1.88; P=0.01). CRRT-induced phosphate depletion is associated with measurable reductions in RBC 2,3-DPG concentration and a shift in the O2:Hgb affinity curve even in the absence of overt hypophosphatemia. 2,3-DPG reductions may be associated with higher risk for in-hospital death and represent a

Blood Pressure Response to Losartan and Continuous Positive Airway Pressure in Hypertension and Obstructive Sleep Apnea.

PubMed

Thunström, Erik; Manhem, Karin; Rosengren, Annika; Peker, Yüksel

2016-02-01

Obstructive sleep apnea (OSA) is common in people with hypertension, particularly resistant hypertension. Treatment with an antihypertensive agent alone is often insufficient to control hypertension in patients with OSA. To determine whether continuous positive airway pressure (CPAP) added to treatment with an antihypertensive agent has an impact on blood pressure (BP) levels. During the initial 6-week, two-center, open, prospective, case-control, parallel-design study (2:1; OSA/no-OSA), all patients began treatment with an angiotensin II receptor antagonist, losartan, 50 mg daily. In the second 6-week, sex-stratified, open, randomized, parallel-design study of the OSA group, all subjects continued to receive losartan and were randomly assigned to either nightly CPAP as add-on therapy or no CPAP. Twenty-four-hour BP monitoring included assessment every 15 minutes during daytime hours and every 20 minutes during the night. Ninety-one patients with untreated hypertension underwent a home sleep study (55 were found to have OSA; 36 were not). Losartan significantly reduced systolic, diastolic, and mean arterial BP in both groups (without OSA: 12.6, 7.2, and 9.0 mm Hg; with OSA: 9.8, 5.7, and 6.1 mm Hg). Add-on CPAP treatment had no significant changes in 24-hour BP values but did reduce nighttime systolic BP by 4.7 mm Hg. All 24-hour BP values were reduced significantly in the 13 patients with OSA who used CPAP at least 4 hours per night. Losartan reduced BP in OSA, but the reductions were less than in no-OSA. Add-on CPAP therapy resulted in no significant changes in 24-hour BP measures except in patients using CPAP efficiently. Clinical trial registered with www.clinicaltrials.gov (NCT00701428).​

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...

Environmental assessment of the Carlsbad Environmental Monitoring and Research Center Facility

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

NONE

1995-10-01

This Environmental Assessment has been prepared to determine if the Carlsbad Environmental Monitoring and Research Center (the Center), or its alternatives would have significant environmental impacts that must be analyzed in an Environmental Impact Statement. DOE`s proposed action is to continue funding the Center. While DOE is not funding construction of the planned Center facility, operation of that facility is dependent upon continued funding. To implement the proposed action, the Center would initially construct a facility of approximately 2,300 square meters (25,000 square feet). The Phase 1 laboratory facilities and parking lot will occupy approximately 1.2 hectares (3 acres) ofmore » approximately 8.9 hectares (22 acres) of land which were donated to New Mexico State University (NMSU) for this purpose. The facility would contain laboratories to analyze chemical and radioactive materials typical of potential contaminants that could occur in the environment in the vicinity of the DOE Waste Isolation Pilot Plant (WIPP) site or other locations. The facility also would have bioassay facilities to measure radionuclide levels in the general population and in employees of the WIPP. Operation of the Center would meet the DOE requirement for independent monitoring and assessment of environmental impacts associated with the planned disposal of transuranic waste at the WIPP.« less

Sustainable data policy for a data production facility: a work in (continual) progress

NASA Astrophysics Data System (ADS)

Ketcham, R. A.

2017-12-01

The University of Texas High-Resolution X-Ray Computed Tomography Facility (UTCT) has been producing volumetric data and data products of geological and other scientific specimens and engineering materials for over 20 years. Data volumes, both in terms of the size of individual data sets and overall facility production, have progressively grown and fluctuated near the upper boundary of what can be managed by contemporary workstations and lab-scale servers and network infrastructure, making data policy a preoccupation for our entire history. Although all projects have been archived since our first day of operation, policies on which data to keep (raw, reconstructed after corrections, processed) have varied, and been periodically revisited in consideration of the cost of curation and the likelihood of revisiting and reprocessing data when better techniques become available, such as improved artifact corrections or iterative tomographic reconstruction. Advances in instrumentation regularly make old data obsolete and more advantageous to reacquire, but the simple act of getting a sample to a scanning facility is a practical barrier that cannot be overlooked. In our experience, the main times that raw data have been revisited using improved processing to improve image quality were predictable, high-impact charismatic projects (e.g., Archaeopteryx, A. Afarensis "Lucy"). These cases actually provided the impetus for development of the new techniques (ring and beam hardening artifact reduction), which were subsequently incorporated into our data processing pipeline going forward but were rarely if ever retroactively applied to earlier data sets. The only other times raw data have been reprocessed were when reconstruction parameters were inappropriate, due to unnoticed sample features or human error, which are usually recognized fairly quickly. The optimal data retention policy thus remains an open question, although erring on the side of caution remains the default

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

Noninvasive Continuous Monitoring of Tear Glucose Using Glucose-Sensing Contact Lenses.

PubMed

Ascaso, Francisco J; Huerva, Valentín

2016-04-01

: The incidence of diabetes mellitus is dramatically increasing in the developed countries. Tight control of blood glucose concentration is crucial to diabetic patients to prevent microvascular complications. Self-monitoring of blood glucose is widely used for controlling blood glucose levels and usually performed by an invasive test using a portable glucometer. Many technologies have been developed over the past decades with the purpose of obtaining a continuous physiological glycemic monitoring. A contact lens is the ideal vehicle for continuous tear glucose monitoring of glucose concentration in tear film. There are several research groups that are working in the development of contact lenses with embedded biosensors for continuously and noninvasively monitoring tear glucose levels. Although numerous aspects must be improved, contact lens technology is one step closer to helping diabetic subjects better manage their condition, and these contact lenses will be able to measure the level of glucose in the wearer's tears and communicate the information to a mobile phone or computer. This article reviews studies on ocular glucose and its monitoring methods as well as the attempts to continuously monitor the concentration of tear glucose by using contact lens-based sensors.

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...

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...

Design of a Continuous Blood Pressure Measurement System Based on Pulse Wave and ECG Signals.

PubMed

Li, Jian-Qiang; Li, Rui; Chen, Zhuang-Zhuang; Deng, Gen-Qiang; Wang, Huihui; Mavromoustakis, Constandinos X; Song, Houbing; Ming, Zhong

2018-01-01

With increasingly fierce competition for jobs, the pressures on people have risen in recent years, leading to lifestyle and diet disorders that result in significantly higher risks of cardiovascular disease. Hypertension is one of the common chronic cardiovascular diseases; however, mainstream blood pressure measurement devices are relatively heavy. When multiple measurements are required, the user experience and the measurement results may be unsatisfactory. In this paper, we describe the design of a signal collection module that collects pulse waves and electrocardiograph (ECG) signals. The collected signals are input into a signal processing module to filter the noise and amplify the useful physiological signals. Then, we use a wavelet transform to eliminate baseline drift noise and detect the feature points of the pulse waves and ECG signals. We propose the concept of detecting the wave shape associated with an instance, an approach that minimizes the impact of atypical pulse waves on blood pressure measurements. Finally, we propose an improved method for measuring blood pressure based on pulse wave velocity that improves the accuracy of blood pressure measurements by 58%. Moreover, the results meet the american medical instrument promotion association standards, which demonstrate the feasibility of our measurement system.

Design of a Continuous Blood Pressure Measurement System Based on Pulse Wave and ECG Signals

PubMed Central

Li, Jian-Qiang; Li, Rui; Chen, Zhuang-Zhuang; Deng, Gen-Qiang; Wang, Huihui; Mavromoustakis, Constandinos X.; Ming, Zhong

2018-01-01

With increasingly fierce competition for jobs, the pressures on people have risen in recent years, leading to lifestyle and diet disorders that result in significantly higher risks of cardiovascular disease. Hypertension is one of the common chronic cardiovascular diseases; however, mainstream blood pressure measurement devices are relatively heavy. When multiple measurements are required, the user experience and the measurement results may be unsatisfactory. In this paper, we describe the design of a signal collection module that collects pulse waves and electrocardiograph (ECG) signals. The collected signals are input into a signal processing module to filter the noise and amplify the useful physiological signals. Then, we use a wavelet transform to eliminate baseline drift noise and detect the feature points of the pulse waves and ECG signals. We propose the concept of detecting the wave shape associated with an instance, an approach that minimizes the impact of atypical pulse waves on blood pressure measurements. Finally, we propose an improved method for measuring blood pressure based on pulse wave velocity that improves the accuracy of blood pressure measurements by 58%. Moreover, the results meet the american medical instrument promotion association standards, which demonstrate the feasibility of our measurement system. PMID:29541556

Human melatonin during continuous magnetic field exposure

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

Graham, C.; Cook, M.R.; Riffle, D.W.

This report describes the third in a series of double-blind, laboratory-based studies that were aimed at determining the effects of nocturnal exposure to power frequency magnetic fields on blood levels of melatonin in human volunteers. The two earlier studies evaluated effects on melatonin of intermittent exposure to 60 Hz circularly polarized magnetic fields at 10 and 200 mG. No overall effects on melatonin levels were found. In the present study, men were exposed continuously rather than intermittently through the night to the same 200 mG magnetic field condition that was used previously; again, no overall effects on melatonin levels weremore » found. The authors conclude that the intermittent and continuous exposure conditions used in the laboratory to date are not effective in altering nocturnal blood levels of melatonin in human volunteers.« less

17 CFR 23.603 - Business continuity and disaster recovery.

Code of Federal Regulations, 2013 CFR

2013-04-01

..., facilities, infrastructure, personnel and competencies essential to the continued operations of the swap.... The individuals identified shall be authorized to make key decisions on behalf of the swap dealer or...

17 CFR 23.603 - Business continuity and disaster recovery.

Code of Federal Regulations, 2014 CFR

2014-04-01

..., facilities, infrastructure, personnel and competencies essential to the continued operations of the swap.... The individuals identified shall be authorized to make key decisions on behalf of the swap dealer or...

Evaluating the clinical accuracy of two continuous glucose sensors using continuous glucose-error grid analysis.

PubMed

Clarke, William L; Anderson, Stacey; Farhy, Leon; Breton, Marc; Gonder-Frederick, Linda; Cox, Daniel; Kovatchev, Boris

2005-10-01

To compare the clinical accuracy of two different continuous glucose sensors (CGS) during euglycemia and hypoglycemia using continuous glucose-error grid analysis (CG-EGA). FreeStyle Navigator (Abbott Laboratories, Alameda, CA) and MiniMed CGMS (Medtronic, Northridge, CA) CGSs were applied to the abdomens of 16 type 1 diabetic subjects (age 42 +/- 3 years) 12 h before the initiation of the study. Each system was calibrated according to the manufacturer's recommendations. Each subject underwent a hyperinsulinemic-euglycemic clamp (blood glucose goal 110 mg/dl) for 70-210 min followed by a 1-mg.dl(-1).min(-1) controlled reduction in blood glucose toward a nadir of 40 mg/dl. Arterialized blood glucose was determined every 5 min using a Beckman Glucose Analyzer (Fullerton, CA). CGS glucose recordings were matched to the reference blood glucose with 30-s precision, and rates of glucose change were calculated for 5-min intervals. CG-EGA was used to quantify the clinical accuracy of both systems by estimating combined point and rate accuracy of each system in the euglycemic (70-180 mg/dl) and hypoglycemic (<70 mg/dl) ranges. A total of 1,104 data pairs were recorded in the euglycemic range and 250 data pairs in the hypoglycemic range. Overall correlation between CGS and reference glucose was similar for both systems (Navigator, r = 0.84; CGMS, r = 0.79, NS). During euglycemia, both CGS systems had similar clinical accuracy (Navigator zones A + B, 88.8%; CGMS zones A + B, 89.3%, NS). However, during hypoglycemia, the Navigator was significantly more clinically accurate than the CGMS (zones A + B = 82.4 vs. 61.6%, Navigator and CGMS, respectively, P < 0.0005). CG-EGA is a helpful tool for evaluating and comparing the clinical accuracy of CGS systems in different blood glucose ranges. CG-EGA provides accuracy details beyond other methods of evaluation, including correlational analysis and the original EGA.

42 CFR 440.150 - Intermediate care facility (ICF/IID) services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 4 2014-10-01 2014-10-01 false Intermediate care facility (ICF/IID) services. 440.150 Section 440.150 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.150 Intermediate care facility (ICF/IID)...

Composite analysis E-area vaults and saltstone disposal facilities

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

Cook, J.R.

1997-09-01

This report documents the Composite Analysis (CA) performed on the two active Savannah River Site (SRS) low-level radioactive waste (LLW) disposal facilities. The facilities are the Z-Area Saltstone Disposal Facility and the E-Area Vaults (EAV) Disposal Facility. The analysis calculated potential releases to the environment from all sources of residual radioactive material expected to remain in the General Separations Area (GSA). The GSA is the central part of SRS and contains all of the waste disposal facilities, chemical separations facilities and associated high-level waste storage facilities as well as numerous other sources of radioactive material. The analysis considered 114 potentialmore » sources of radioactive material containing 115 radionuclides. The results of the CA clearly indicate that continued disposal of low-level waste in the saltstone and EAV facilities, consistent with their respective radiological performance assessments, will have no adverse impact on future members of the public.« less

Simultaneous determination of parabens, alkylphenols, phenylphenols, bisphenol A and triclosan in human urine, blood and breast milk by continuous solid-phase extraction and gas chromatography-mass spectrometry.

PubMed

Azzouz, Abdelmonaim; Rascón, Andrés J; Ballesteros, Evaristo

2016-02-05

A highly sensitive gas chromatography-mass spectrometry (GC-MS) method for the determination of endocrine disrupting chemicals (EDCs) including parabens, alkylphenols, phenylphenols, bisphenol A and triclosan in human breast milk, blood and urine samples is proposed. Blood and milk require a pretreatment to remove proteins and other substances potentially interfering with the continuous solid-phase extraction (SPE) system used; on the other hand, urine samples can be directly introduced into the system after filtering. Analytes are retained on a LiChrolut EN column and derivatized by silylation following elution with acetonitrile. The resulting trimethylsilyl derivatives are determined by GC-MS. The proposed method exhibited good linearity (r(2)>0.995) for all target EDCs over the concentration range 0.7-10,000ng/l in urine, and 3.3-50,000ng/l in blood and milk. Also, it provided low limits of detection (0.2-1.8ng/l in urine, and 1.0-9.0ng/l in blood and milk), good precision (relative standard deviations less than 7%) and recoveries from 86 to 104%. A total of 24 human fluid samples were analyzed and most found to contain some target EDC at concentrations from 0.10 to 14μg/l. Copyright © 2015 Elsevier B.V. All rights reserved.

Comparison of Physiological and Perceptual Responses Between Continuous and Intermittent Cycling

PubMed Central

Brasil, Roxana M.; Barreto, Ana C.; Nogueira, Leandro; Santos, Edil; Novaes, Jefferson S.; Reis, Victor M.

2011-01-01

The present study tested the hypothesis that the exercise protocol (continuous vs. intermittent) would affect the physiological response and the perception of effort during aquatic cycling. Each protocol was divided on four stages. Heart rate, arterial blood pressure, blood lactate concentration, central and peripheral rate of perceived exertion were collected in both protocols in aquatic cycling in 10 women (values are mean ± SD): age=32.8 ± 4.8 years; height=1.62 ± 0.05 cm; body mass=61.60 ± 5.19 kg; estimated body fat=27.13 ± 4.92%. Protocols were compared through two way ANOVA with Scheffé’s post-hoc test and the test of Mann- Whitney for rate of perceived exertion with α=0.05. No systematic and consistent differences in heart rate, arterial blood pressure, double product and blood lactate concentration were found between protocols. On the other hand, central rate of perceived exertion was significantly higher at stage four during continuous protocol compared with intermittent protocol (p=0.01), while the peripheral rate of perceived exertion presented higher values at stages three (p=0.02) and four (p=0.00) in the continuous protocol when compared to the results found in intermittent protocol. These findings suggest that although the aquatic cycling induces similar physiologic demands in both protocols, the rate of perceived exertion may vary according to the continuous vs. intermittent nature of the exercise. PMID:23487483

Cord blood units collected at a remote site: a collaborative endeavor to collect umbilical cord blood through the Hawaii Cord Blood Bank and store the units at the Puget Sound Blood Center.

PubMed

Wada, Randal K; Bradford, Andrea; Moogk, Margery; Yim, Robyn; Strong, D Michael; Drachman, Jonathan; Reems, Jo Anna

2004-01-01

Umbilical cord blood is a useful source of hematopoietic stem cells, especially because compared to equivalent HLA-matched stem cells from unrelated adult donors. A network of community collection sites targeted at particular ethnic groups and serviced by a central processing and storage facility can maximize the genetic diversity of banked cord blood units (CBUs) in a cost-effective fashion. The present study compared CBUs collected near the Puget Sound Blood Center in Seattle, WA, with those collected in Honolulu, HI, and processed in Seattle. Evaluated variables include collection volume, total nucleated cell count, cellular viability, CD34+ cell count, clonogenic activity, and donor race for a total of 1646 CBUs received from July 1998 through November 2002. CBUs from the two sites did not differ with regard to volume or total nucleated cells. Those from Hawaii had significantly longer transit times (p < 0.001) and lower whole cord blood cell viability. However, the numbers of CFU and viable CD34+ cells were not affected by remote collection. CBUs screened from Seattle were largely from Caucasian donors, whereas over 85 percent of those from Honolulu were from donors of Asian-Pacific Islander or mixed ethnicity. These studies demonstrate the feasibility of long-distance umbilical cord blood banking. Arrangements such as those described here could be used to help target cost-effective collection from minority populations and increase the HLA and ethnic diversity for CBUs.

[Blood pressure variability: clinical interest or simple curiosity?].

PubMed

Ciaroni, Stefano

2007-03-14

Blood pressure variability is a physiological phenomenon influenced by many internal and external factors. This variability could be also influenced by pathological conditions such as arterial hypertension. Two forms must be mainly distinguished: the blood pressure variability at long and short-term. The latter could only be studied by continuous recordings. In this article will be analysed the interest of measuring blood pressure variability, its cardiovascular prognosis and the therapeutic tools when it is increased.

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...

33 CFR 105.225 - Facility recordkeeping requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... exercise, list of participants, and any best practices or lessons learned which may improve the Facility... each continuing DoS for at least 90 days after the end of its effective period; and (8) Annual audit of...

33 CFR 105.225 - Facility recordkeeping requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... exercise, list of participants, and any best practices or lessons learned which may improve the Facility... each continuing DoS for at least 90 days after the end of its effective period; and (8) Annual audit of...

33 CFR 105.225 - Facility recordkeeping requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... exercise, list of participants, and any best practices or lessons learned which may improve the Facility... each continuing DoS for at least 90 days after the end of its effective period; and (8) Annual audit of...

33 CFR 105.225 - Facility recordkeeping requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... exercise, list of participants, and any best practices or lessons learned which may improve the Facility... each continuing DoS for at least 90 days after the end of its effective period; and (8) Annual audit of...

33 CFR 105.225 - Facility recordkeeping requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... exercise, list of participants, and any best practices or lessons learned which may improve the Facility... each continuing DoS for at least 90 days after the end of its effective period; and (8) Annual audit of...

Churches as High Blood Pressure Control Centers

PubMed Central

Kong, B. Wayne; Miller, Joseph M.; Smoot, Roland T.

1982-01-01

High blood pressure, a severe medical problem in the black community, can be controlled to a significant degree by proper medication. Discovery of hypertension and continuing thereapy, however, are difficult. The establishment of churches as high blood pressure control centers is a promising approach to overcome these deficits. The initial experiences with the creation of such a program are presented.

Effect of continuous positive airway pressure therapy on hypothalamic-pituitary-adrenal axis function and 24-h blood pressure profile in obese men with obstructive sleep apnea syndrome.

PubMed

Carneiro, Gláucia; Togeiro, Sônia Maria; Hayashi, Lílian F; Ribeiro-Filho, Fernando Flexa; Ribeiro, Artur Beltrame; Tufik, Sérgio; Zanella, Maria Teresa

2008-08-01

Obstructive sleep apnea syndrome (OSAS) increases the risk of cardiovascular events. Sympathetic nervous system and hypothalamic-pituitary-adrenal (HPA) axis activation may be the mechanism of this relationship. The aim of this study was to evaluate HPA axis and ambulatory blood pressure monitoring in obese men with and without OSAS and to determine whether nasal continuous positive airway pressure therapy (nCPAP) influenced responses. Twenty-four-hour ambulatory blood pressure monitoring and overnight cortisol suppression test with 0.25 mg of dexamethasone were performed in 16 obese men with OSAS and 13 obese men controls. Nine men with severe apnea were reevaluated 3 mo after nCPAP therapy. Body mass index and blood pressure of OSAS patients and obese controls were similar. In OSAS patients, the percentage of fall in systolic blood pressure at night (P = 0.027) and salivary cortisol suppression postdexamethasone (P = 0.038) were lower, whereas heart rate (P = 0.022) was higher compared with obese controls. After nCPAP therapy, patients showed a reduction in heart rate (P = 0.036) and a greater cortisol suppression after dexamethasone (P = 0.001). No difference in arterial blood pressure (P = 0.183) was observed after 3 mo of nCPAP therapy. Improvement in cortisol suppression was positively correlated with an improvement in apnea-hypopnea index during nCPAP therapy (r = 0.799, P = 0.010). In conclusion, men with OSAS present increased postdexamethasone cortisol levels and heart rate, which were recovered by nCPAP.

42 CFR 440.150 - Intermediate care facility (ICF/MR) services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 4 2011-10-01 2011-10-01 false Intermediate care facility (ICF/MR) services. 440.150 Section 440.150 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.150 Intermediate care facility (ICF/MR) service...

Optic nerve head blood flow response to reduced ocular perfusion pressure by alteration of either the blood pressure or intraocular pressure.

PubMed

Wang, Lin; Cull, Grant A; Fortune, Brad

2015-04-01

To test the hypothesis that blood flow autoregulation in the optic nerve head has less reserve to maintain normal blood flow in the face of blood pressure-induced ocular perfusion pressure decrease than a similar magnitude intraocular pressure-induced ocular perfusion pressure decrease. Twelve normal non-human primates were anesthetized by continuous intravenous infusion of pentobarbital. Optic nerve blood flow was monitored by laser speckle flowgraphy. In the first group of animals (n = 6), the experimental eye intraocular pressure was maintained at 10 mmHg using a saline reservoir connected to the anterior chamber. The blood pressure was gradually reduced by a slow injection of pentobarbital. In the second group (n = 6), the intraocular pressure was slowly increased from 10 mmHg to 50 mmHg by raising the reservoir. In both experimental groups, optic nerve head blood flow was measured continuously. The blood pressure and intraocular pressure were simultaneously recorded in all experiments. The optic nerve head blood flow showed significant difference between the two groups (p = 0.021, repeat measures analysis of variance). It declined significantly more in the blood pressure group compared to the intraocular pressure group when the ocular perfusion pressure was reduced to 35 mmHg (p < 0.045) and below. There was also a significant interaction between blood flow changes and the ocular perfusion pressure treatment (p = 0.004, adjusted Greenhouse & Geisser univariate test), indicating the gradually enlarged blood flow difference between the two groups was due to the ocular perfusion pressure decrease. The results show that optic nerve head blood flow is more susceptible to an ocular perfusion pressure decrease induced by lowering the blood pressure compared with that induced by increasing the intraocular pressure. This blood flow autoregulation capacity vulnerability to low blood pressure may provide experimental evidence related to the

Whole blood and component use in resource poor settings.

PubMed

Marwaha, Neelam

2010-01-01

Data on blood collection, testing and component preparation has improved worldwide; however, there is limited information on blood utilization from the developing countries. Blood requirement in the Southeast Asia region is 15 million units against a collection of 9.3 million. There is huge diversity in the management of blood transfusion services, the voluntary blood collection (range 40-100%) and proportion of blood separated into components (10-95%). The major indications for transfusion are for emergency obstetric care, surgery, pediatric and trauma patients. The prevalence of thalassemia in this region is high and in India alone 2 million units of packed red cells are required for transfusion to these patients. The Blood Safety Program in India has developed as a component of the National Aids Control Program and has lead to infrastructure development, blood component separation facilities and formulation of a National Blood Policy. In order to facilitate emergency obstetric care nearer home, blood storage centers are being established at primary health care centers. Emerging infectious threats like dengue hemorrhagic fever necessitate platelet transfusion therapy. A few centers in India issue NAT screened blood. It is envisaged to establish a nationally co-ordinated transfusion service for cost-effective quality blood/components for appropriate clinical use. Copyright 2009 The International Association for Biologicals. Published by Elsevier Ltd. All rights reserved.

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...

45 CFR 1170.32 - Existing facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 3 2011-10-01 2011-10-01 false Existing facilities. 1170.32 Section 1170.32 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE HUMANITIES NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY...

45 CFR 1170.32 - Existing facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Existing facilities. 1170.32 Section 1170.32 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL FOUNDATION ON THE ARTS AND THE HUMANITIES NATIONAL ENDOWMENT FOR THE HUMANITIES NONDISCRIMINATION ON THE BASIS OF HANDICAP IN FEDERALLY...

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 69.304 - 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...

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...

On-orbit technology experiment facility definition

NASA Technical Reports Server (NTRS)

Russell, Richard A.; Buchan, Robert W.; Gates, Richard M.

1988-01-01

A study was conducted to identify on-orbit integrated facility needs to support in-space technology experiments on the Space Station and associated free flyers. In particular, the first task was to examine the proposed technology development missions (TDMX's) from the model mission set and other proposed experimental facilities, both individually and by theme, to determine how and if the experiments might be combined, what equipment might be shared, what equipment might be used as generic equipment for continued experimentation, and what experiments will conflict with the conduct of other experiments or Space Station operations. Then using these results, to determine on-orbit facility needs to optimize the implementation of technology payloads. Finally, to develop one or more scenarios, design concepts, and outfitting requirements for implementation of onboard technology experiments.

Phased Demolition of an Occupied Facility

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

Brede, Lawrence M.; Lauterbach, Merl J.; Witt, Brandon W.

2008-01-15

The U.S. government constructed the K-1401 facility in the late 1940's as a support building for various projects supporting the uranium gaseous diffusion process. In 2004 the U.S. Department of Energy authorized Bechtel Jacobs Company, LLC (BJC) to decontaminate and demolish the facility. The K-1401 facility was used for a variety of industrial purposes supporting the gaseous diffusion process. Many different substances were used to support these processes over the years and as a result different parts of the facility were contaminated with fluorine, chlorine trifluoride, uranium and technetium radiological contamination, asbestos, and mercury. The total facility area is 46,015more » m{sup 2} (495,000 sf) including a 6,800 m{sup 2} basement (73,200 sf). In addition to the contamination areas in the facility, a large portion was leased to businesses for re-industrialization when the D and D activities began. The work scope associated with the facility included purging and steam cleaning the former fluorine and chlorine trifluoride systems, decontaminating loose radiologically contaminated and mercury spill areas, dismantling former radiological lines contaminated with uranium oxide compounds and technetium, abating all asbestos containing material, and demolishing the facility. These various situations contributed to the challenge of successfully conducting D and D tasks on the facility. In order to efficiently utilize the work force, demolition equipment, and waste hauling trucks the normal approach of decontaminating the facility of the hazardous materials, and then conducting demolition in series required a project schedule of five years, which is not cost effective. The entire project was planned with continuous demolition as the goal end state. As a result, the first activities, Phase 1, required to prepare sections for demolition, including steam cleaning fluorine and chlorine trifluoride process lines in basement and facility asbestos abatement, were

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 766.6 - 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 766.6 - 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.