45 CFR 96.13 - Reallotments.

Code of Federal Regulations, 2014 CFR

2014-10-01

... fiscal year under the reallotment provisions pertaining to the alcohol and drug abuse and mental health services, maternal and child health services, and preventive health and health services block grants. The... Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS General Procedures § 96.13...

45 CFR 96.13 - Reallotments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... fiscal year under the reallotment provisions pertaining to the alcohol and drug abuse and mental health services, maternal and child health services, and preventive health and health services block grants. The... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS General Procedures § 96.13...

45 CFR 96.13 - Reallotments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... fiscal year under the reallotment provisions pertaining to the alcohol and drug abuse and mental health services, maternal and child health services, and preventive health and health services block grants. The... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS General Procedures § 96.13...

45 CFR 96.13 - Reallotments.

Code of Federal Regulations, 2013 CFR

2013-10-01

... fiscal year under the reallotment provisions pertaining to the alcohol and drug abuse and mental health services, maternal and child health services, and preventive health and health services block grants. The... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS General Procedures § 96.13...

28 CFR 33.60 - General.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false General. 33.60 Section 33.60 Judicial Administration DEPARTMENT OF JUSTICE BUREAU OF JUSTICE ASSISTANCE GRANT PROGRAMS Criminal Justice Block Grants Submission and Review of Applications § 33.60 General. This subpart describes the process and criteria for...

45 CFR 96.112 - Community services block grant.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Community services block grant. 96.112 Section 96.112 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Transition Provisions § 96.112 Community services block grant. (a) For the fiscal year beginning October 1...

45 CFR 96.70 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Scope. 96.70 Section 96.70 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social Services Block Grants § 96.70 Scope. This subpart applies to the social services block grant. ...

45 CFR 96.90 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Scope. 96.90 Section 96.90 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Community Services Block Grants § 96.90 Scope. This subpart applies to the community services block grant. ...

45 CFR 96.100 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Scope. 96.100 Section 96.100 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Primary Care Block Grants § 96.100 Scope. This subpart applies to the primary care block grant. ...

45 CFR 96.70 - Scope.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Scope. 96.70 Section 96.70 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social Services Block Grants § 96.70 Scope. This subpart applies to the social services block grant. ...

45 CFR 96.70 - Scope.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Scope. 96.70 Section 96.70 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social Services Block Grants § 96.70 Scope. This subpart applies to the social services block grant. ...

45 CFR 96.70 - Scope.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Scope. 96.70 Section 96.70 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Social Services Block Grants § 96.70 Scope. This subpart applies to the social services block grant. ...

45 CFR 96.70 - Scope.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Scope. 96.70 Section 96.70 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social Services Block Grants § 96.70 Scope. This subpart applies to the social services block grant. ...

14 CFR 33.57 - General conduct of block tests.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Section 33.57 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Block Tests; Reciprocating Aircraft Engines § 33.57 General conduct of... that, if a separate engine is used for the endurance test it must be subjected to a calibration check...

14 CFR 33.57 - General conduct of block tests.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Section 33.57 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Block Tests; Reciprocating Aircraft Engines § 33.57 General conduct of... that, if a separate engine is used for the endurance test it must be subjected to a calibration check...

14 CFR 33.57 - General conduct of block tests.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Section 33.57 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Block Tests; Reciprocating Aircraft Engines § 33.57 General conduct of... that, if a separate engine is used for the endurance test it must be subjected to a calibration check...

14 CFR 33.57 - General conduct of block tests.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Section 33.57 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Block Tests; Reciprocating Aircraft Engines § 33.57 General conduct of... that, if a separate engine is used for the endurance test it must be subjected to a calibration check...

14 CFR 33.57 - General conduct of block tests.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Section 33.57 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Block Tests; Reciprocating Aircraft Engines § 33.57 General conduct of... that, if a separate engine is used for the endurance test it must be subjected to a calibration check...

45 CFR 96.3 - Information collection approval numbers.

Code of Federal Regulations, 2012 CFR

2012-10-01

... numbers: 0930-0080Alcohol and Drug Abuse and Mental Health Services Block Grant Reporting Requirements 0920-0106Preventive Health and Health Services Block Grant Reporting Requirements 0915-0023Primary Care... Section 96.3 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS...

45 CFR 96.3 - Information collection approval numbers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... numbers: 0930-0080Alcohol and Drug Abuse and Mental Health Services Block Grant Reporting Requirements 0920-0106Preventive Health and Health Services Block Grant Reporting Requirements 0915-0023Primary Care... Section 96.3 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS...

45 CFR 96.3 - Information collection approval numbers.

Code of Federal Regulations, 2011 CFR

2011-10-01

... numbers: 0930-0080Alcohol and Drug Abuse and Mental Health Services Block Grant Reporting Requirements 0920-0106Preventive Health and Health Services Block Grant Reporting Requirements 0915-0023Primary Care... Section 96.3 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS...

45 CFR 96.3 - Information collection approval numbers.

Code of Federal Regulations, 2014 CFR

2014-10-01

... numbers: 0930-0080Alcohol and Drug Abuse and Mental Health Services Block Grant Reporting Requirements 0920-0106Preventive Health and Health Services Block Grant Reporting Requirements 0915-0023Primary Care... Section 96.3 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS...

45 CFR 96.3 - Information collection approval numbers.

Code of Federal Regulations, 2013 CFR

2013-10-01

... numbers: 0930-0080Alcohol and Drug Abuse and Mental Health Services Block Grant Reporting Requirements 0920-0106Preventive Health and Health Services Block Grant Reporting Requirements 0915-0023Primary Care... Section 96.3 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS...

45 CFR 96.92 - Termination of funding.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Community Services Block Grants § 96.92 Termination of funding. Where a State determines pursuant to section 675(c)(11) of the Community Services Block Grant Act that it will terminate present or future funding of any...

45 CFR 96.2 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Introduction § 96.2 Definitions... appropriate with respect to each block grant, the Commonwealth of Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, the Commonwealth of the Northern Mariana Islands, and for purposes of the block grants...

45 CFR 96.74 - Annual reporting requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social Services Block Grants § 96.74 Annual reporting requirements. (a) Annual report. In accordance with 42 U.S.C... Block Grant, showing separately the number of children and the number of adults who received such...

45 CFR 96.137 - Payment schedule.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Payment schedule. 96.137 Section 96.137 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.137 Payment schedule. (a) The Block Grant money that may be spent...

45 CFR 96.137 - Payment schedule.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Payment schedule. 96.137 Section 96.137 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.137 Payment schedule. (a) The Block Grant money that may be spent...

45 CFR 96.137 - Payment schedule.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Payment schedule. 96.137 Section 96.137 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.137 Payment schedule. (a) The Block Grant money that may be spent...

45 CFR 96.137 - Payment schedule.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Payment schedule. 96.137 Section 96.137 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.137 Payment schedule. (a) The Block Grant money that may be spent...

45 CFR 96.137 - Payment schedule.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Payment schedule. 96.137 Section 96.137 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.137 Payment schedule. (a) The Block Grant money that may be spent...

45 CFR 96.10 - Prerequisites to obtain block grant funds.

Code of Federal Regulations, 2010 CFR

2010-10-01

..., primary care, preventive health and health services, alcohol and drug abuse and mental health services... Section 96.10 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS... application or the related submission required by the statute. For the maternal and child health block grant...

45 CFR 96.11 - Basis of award to the States.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Basis of award to the States. 96.11 Section 96.11 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS General Procedures § 96.11 Basis of award to the States. The Secretary will award the block grant funds allotted to...

45 CFR 96.30 - Fiscal and administrative requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Fiscal and administrative requirements. 96.30 Section 96.30 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.30 Fiscal and administrative requirements. (a) Fiscal control and accounting...

45 CFR 96.30 - Fiscal and administrative requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Fiscal and administrative requirements. 96.30 Section 96.30 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.30 Fiscal and administrative requirements. (a) Fiscal control and accounting...

45 CFR 96.30 - Fiscal and administrative requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Fiscal and administrative requirements. 96.30 Section 96.30 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.30 Fiscal and administrative requirements. (a) Fiscal control and accounting...

45 CFR 96.30 - Fiscal and administrative requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Fiscal and administrative requirements. 96.30 Section 96.30 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.30 Fiscal and administrative requirements. (a) Fiscal control and accounting...

45 CFR 96.124 - Certain allocations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse... to increase (relative to fiscal year 1992) the availability of treatment services designed for... 1992 alcohol and drug services Block Grant expenditures and State expenditures for pregnant women and...

45 CFR 96.124 - Certain allocations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse... to increase (relative to fiscal year 1992) the availability of treatment services designed for... 1992 alcohol and drug services Block Grant expenditures and State expenditures for pregnant women and...

45 CFR 96.124 - Certain allocations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse... to increase (relative to fiscal year 1992) the availability of treatment services designed for... 1992 alcohol and drug services Block Grant expenditures and State expenditures for pregnant women and...

45 CFR 96.124 - Certain allocations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse... to increase (relative to fiscal year 1992) the availability of treatment services designed for... 1992 alcohol and drug services Block Grant expenditures and State expenditures for pregnant women and...

45 CFR 96.124 - Certain allocations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse... to increase (relative to fiscal year 1992) the availability of treatment services designed for... 1992 alcohol and drug services Block Grant expenditures and State expenditures for pregnant women and...

45 CFR 96.132 - Additional agreements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... and treatment of substance abuse, the requirement involved is unnecessary for maintaining quality in... Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.132 Additional agreements. (a) With respect to...

45 CFR 96.132 - Additional agreements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... and treatment of substance abuse, the requirement involved is unnecessary for maintaining quality in... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.132 Additional agreements. (a) With respect to...

45 CFR 96.132 - Additional agreements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... and treatment of substance abuse, the requirement involved is unnecessary for maintaining quality in... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.132 Additional agreements. (a) With respect to...

45 CFR 96.49 - Due date for receipt of all information required for completion of tribal applications for the...

Code of Federal Regulations, 2010 CFR

2010-10-01

... for completion of tribal applications for the low-income home energy assistance block grants. 96.49 Section 96.49 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS... required for completion of tribal applications for the low-income home energy assistance block grants...

45 CFR 96.72 - Transferability of funds.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the preventive health and health services, alcohol and drug abuse and mental health services, primary care, maternal and child health services, and low-income home energy assistance block grants. In... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social...

45 CFR 96.72 - Transferability of funds.

Code of Federal Regulations, 2012 CFR

2012-10-01

... the preventive health and health services, alcohol and drug abuse and mental health services, primary care, maternal and child health services, and low-income home energy assistance block grants. In... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social...

45 CFR 96.72 - Transferability of funds.

Code of Federal Regulations, 2014 CFR

2014-10-01

... the preventive health and health services, alcohol and drug abuse and mental health services, primary care, maternal and child health services, and low-income home energy assistance block grants. In... Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Social...

45 CFR 96.72 - Transferability of funds.

Code of Federal Regulations, 2013 CFR

2013-10-01

... the preventive health and health services, alcohol and drug abuse and mental health services, primary care, maternal and child health services, and low-income home energy assistance block grants. In... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social...

45 CFR 96.72 - Transferability of funds.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the preventive health and health services, alcohol and drug abuse and mental health services, primary care, maternal and child health services, and low-income home energy assistance block grants. In... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social...

Can We Perform Distal Nerve Block Instead of Brachial Plexus Nerve Block Under Ultrasound Guidance for Hand Surgery?

PubMed Central

Ince, Ilker; Aksoy, Mehmet; Celik, Mine

2016-01-01

Objective: Distal nerve blocks are used in the event of unsuccessful blocks as rescue techniques. The primary purpose of this study was to determine the sufficiency for anesthesia of distal nerve block without the need for deep sedation or general anesthesia. The secondary purpose was to compare block performance times, block onset times, and patient and surgeon satisfaction. Materials and Methods: Patients who underwent hand surgery associated with the innervation area of the radial and median nerves were included in the study. Thirty-four patients who were 18–65 years old and American Society of Anesthesiologists grade I–III and who were scheduled for elective hand surgery under conscious nerve block anesthesia were randomly included in an infraclavicular block group (Group I, n=17) or a radial plus median block group (Group RM, n=17). The block performance time, block onset time, satisfaction of the patient and surgeon, and number of fentanyl administrations were recorded. Results: The numbers of patients who needed fentanyl administration and conversion to general anesthesia were the same in Group I and Group RM and there was no statistically significant difference (p>0.05). The demographics, surgery times, tourniquet times, block perfomance times, and patient and surgeon satisfaction of the groups were similar and there were no statistically significant differences (p>0.05). There was a statistically significant difference in block onset times between the groups (p<0.05). Conclusions: Conscious hand surgery can be performed under distal nerve block anesthesia safely and successfully. PMID:28149139

14 CFR 33.42 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false General. 33.42 Section 33.42 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Block Tests; Reciprocating Aircraft Engines § 33.42 General. Before each...

14 CFR 33.42 - General.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false General. 33.42 Section 33.42 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Block Tests; Reciprocating Aircraft Engines § 33.42 General. Before each...

14 CFR 33.82 - General.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false General. 33.82 Section 33.82 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Block Tests; Turbine Aircraft Engines § 33.82 General. Before each endurance...

14 CFR 33.82 - General.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false General. 33.82 Section 33.82 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Block Tests; Turbine Aircraft Engines § 33.82 General. Before each endurance...

14 CFR 33.82 - General.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false General. 33.82 Section 33.82 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Block Tests; Turbine Aircraft Engines § 33.82 General. Before each endurance...

14 CFR 33.82 - General.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 1 2013-01-01 2013-01-01 false General. 33.82 Section 33.82 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Block Tests; Turbine Aircraft Engines § 33.82 General. Before each endurance...

45 CFR 96.73 - Sterilization.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Sterilization. 96.73 Section 96.73 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social Services Block Grants § 96.73 Sterilization. If a State authorizes sterilization as a family planning service, it must comply...

45 CFR 96.73 - Sterilization.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Sterilization. 96.73 Section 96.73 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Social Services Block Grants § 96.73 Sterilization. If a State authorizes sterilization as a family planning service, it must comply...

45 CFR 96.73 - Sterilization.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Sterilization. 96.73 Section 96.73 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social Services Block Grants § 96.73 Sterilization. If a State authorizes sterilization as a family planning service, it must comply...

45 CFR 96.73 - Sterilization.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Sterilization. 96.73 Section 96.73 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social Services Block Grants § 96.73 Sterilization. If a State authorizes sterilization as a family planning service, it must comply...

45 CFR 96.73 - Sterilization.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Sterilization. 96.73 Section 96.73 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social Services Block Grants § 96.73 Sterilization. If a State authorizes sterilization as a family planning service, it must comply...

45 CFR 96.102 - Carryover of unobligated funds.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Carryover of unobligated funds. 96.102 Section 96.102 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Primary Care Block Grants § 96.102 Carryover of unobligated funds. In implementing section 1925(a)(2) of the...

45 CFR 96.134 - Maintenance of effort regarding State expenditures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Maintenance of effort regarding State expenditures. 96.134 Section 96.134 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.134 Maintenance of effort...

45 CFR 96.134 - Maintenance of effort regarding State expenditures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Maintenance of effort regarding State expenditures. 96.134 Section 96.134 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.134 Maintenance of effort...

45 CFR 96.134 - Maintenance of effort regarding State expenditures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Maintenance of effort regarding State expenditures. 96.134 Section 96.134 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.134 Maintenance of effort...

45 CFR 96.134 - Maintenance of effort regarding State expenditures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Maintenance of effort regarding State expenditures. 96.134 Section 96.134 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.134 Maintenance of effort...

45 CFR 98.61 - Allotments from the Discretionary Fund.

Code of Federal Regulations, 2011 CFR

2011-10-01

... appropriated for the Child Care and Development Block Grant, less amounts reserved for technical assistance and... seq) an amount up to two percent of the amount appropriated for the Child Care and Development Block... Section 98.61 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND...

45 CFR 98.61 - Allotments from the Discretionary Fund.

Code of Federal Regulations, 2014 CFR

2014-10-01

... appropriated for the Child Care and Development Block Grant, less amounts reserved for technical assistance and... seq) an amount up to two percent of the amount appropriated for the Child Care and Development Block... Section 98.61 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION CHILD CARE AND...

An ADPE Protest Primer: Lessons Learned from GSBCA Protest Decisions

DTIC Science & Technology

1991-06-01

reverse if necessary and identify, by block number) The General services Administration’s Board of Contract Appeals (GSBCA) is a significant venue for...David R. Whipple,i D ep a rtm en t of A d i i t a i eS ci ce iim ABSTRACT The General Services Administration’s Board of Contract Appeals (GSBCA) is a...Administration Board of Contract Appeals (GSBCA) ADPE protest decisions. In effect this study will serve as a primer to familiarize new Federal ADPE

45 CFR 96.129 - Revolving funds for establishment of homes in which recovering substance abusers may reside.

Code of Federal Regulations, 2013 CFR

2013-10-01

... which recovering substance abusers may reside. 96.129 Section 96.129 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.129 Revolving funds for establishment of homes in which recovering substance abusers may...

45 CFR 96.129 - Revolving funds for establishment of homes in which recovering substance abusers may reside.

Code of Federal Regulations, 2014 CFR

2014-10-01

... which recovering substance abusers may reside. 96.129 Section 96.129 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.129 Revolving funds for establishment of homes in which recovering substance abusers may...

45 CFR 96.129 - Revolving funds for establishment of homes in which recovering substance abusers may reside.

Code of Federal Regulations, 2010 CFR

2010-10-01

... which recovering substance abusers may reside. 96.129 Section 96.129 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.129 Revolving funds for establishment of homes in which recovering substance abusers may...

45 CFR 96.129 - Revolving funds for establishment of homes in which recovering substance abusers may reside.

Code of Federal Regulations, 2012 CFR

2012-10-01

... which recovering substance abusers may reside. 96.129 Section 96.129 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.129 Revolving funds for establishment of homes in which recovering substance abusers may...

45 CFR 96.129 - Revolving funds for establishment of homes in which recovering substance abusers may reside.

Code of Federal Regulations, 2011 CFR

2011-10-01

... which recovering substance abusers may reside. 96.129 Section 96.129 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.129 Revolving funds for establishment of homes in which recovering substance abusers may...

45 CFR 96.33 - Referral of cases to the Inspector General.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Section 96.33 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.33 Referral of cases to the Inspector General. State or tribal officials who have information indicating the commission or potential commission of fraud or other offenses against the United...

45 CFR 96.33 - Referral of cases to the Inspector General.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 96.33 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.33 Referral of cases to the Inspector General. State or tribal officials who have information indicating the commission or potential commission of fraud or other offenses against the United...

45 CFR 96.33 - Referral of cases to the Inspector General.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Section 96.33 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.33 Referral of cases to the Inspector General. State or tribal officials who have information indicating the commission or potential commission of fraud or other offenses against the United...

45 CFR 96.33 - Referral of cases to the Inspector General.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Section 96.33 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.33 Referral of cases to the Inspector General. State or tribal officials who have information indicating the commission or potential commission of fraud or other offenses against the United...

45 CFR 96.33 - Referral of cases to the Inspector General.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Section 96.33 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.33 Referral of cases to the Inspector General. State or tribal officials who have information indicating the commission or potential commission of fraud or other offenses against the United...

45 CFR 96.71 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Definitions. 96.71 Section 96.71 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social Services Block Grants § 96.71 Definitions. (a) Section 2005 (a)(2) and (a)(5) (42 U.S.C. 1397d (a)(2) and (a)(5)) of the Social...

45 CFR 96.71 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Definitions. 96.71 Section 96.71 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social Services Block Grants § 96.71 Definitions. (a) Section 2005 (a)(2) and (a)(5) (42 U.S.C. 1397d (a)(2) and (a)(5)) of the Social...

45 CFR 96.71 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Definitions. 96.71 Section 96.71 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Social Services Block Grants § 96.71 Definitions. (a) Section 2005 (a)(2) and (a)(5) (42 U.S.C. 1397d (a)(2) and (a)(5)) of the Social...

45 CFR 96.71 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Definitions. 96.71 Section 96.71 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social Services Block Grants § 96.71 Definitions. (a) Section 2005 (a)(2) and (a)(5) (42 U.S.C. 1397d (a)(2) and (a)(5)) of the Social...

45 CFR 96.71 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Definitions. 96.71 Section 96.71 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social Services Block Grants § 96.71 Definitions. (a) Section 2005 (a)(2) and (a)(5) (42 U.S.C. 1397d (a)(2) and (a)(5)) of the Social...

Needle breakage during an inferior alveolar nerve block in a child with KBG syndrome: A case report.

PubMed

Bagattoni, S; D'Alessandro, G; Marzo, G; Piana, G

2018-04-01

Needle breakage during the administration of dental analgesia is an extremely rare event. A case of needle breakage during the administration of an inferior alveolar nerve block occurred in a child with KBG syndrome. During the injection, a sudden movement of the child caused the breakage of the needle. The next day, the retrieval of the needle was performed surgically under general analgesia. Three months after the surgery the healing was good. Two years later the child underwent a dental extraction with the aid of nitrous oxide/oxygen analgesia/anxiolysis. Needle fracture is a possible event during the administration of dental analgesia in children.

Serotonergic mechanisms in emesis

NASA Technical Reports Server (NTRS)

Lucot, J. B.; Crampton, G. H.

1988-01-01

The observation that the cerebrospinal fluid of cats which are susceptible to motion sickness contained lower baseline levels of 5-hydroxyindoleacetic acid, among other constituents, led to the hypothesis that serotonin inhibits emesis. The hypothesis was tested by administration of the serotonin-1A agonists buspirone and 8-OH-DPAT before motion testing in cats susceptible to motion sickness. Both drugs blocked motion sickness in a dose-dependent fashion. To determine if these drugs blocked emesis elicited by other stimuli, they were administered before subcutaneous administration of the alpha-2 noradrenergic agonist, xylazine. Both drugs also blocked xylazine-induced emesis. It was concluded that the stimulation of serotonin-1A receptors inhibits emesis elicited by the two stimuli and that this mechanism may exert a general antiemetic effect.

45 CFR 96.101 - Review of a State decision to discontinue funding of a community health center.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Review of a State decision to discontinue funding of a community health center. 96.101 Section 96.101 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Primary Care Block Grants § 96.101 Review of a State decision...

45 CFR 96.130 - State law regarding sale of tobacco products to individuals under age of 18.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false State law regarding sale of tobacco products to individuals under age of 18. 96.130 Section 96.130 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.130 State...

45 CFR 96.130 - State law regarding sale of tobacco products to individuals under age of 18.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false State law regarding sale of tobacco products to individuals under age of 18. 96.130 Section 96.130 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.130 State...

45 CFR 96.130 - State law regarding sale of tobacco products to individuals under age of 18.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false State law regarding sale of tobacco products to individuals under age of 18. 96.130 Section 96.130 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.130 State...

45 CFR 96.130 - State law regarding sale of tobacco products to individuals under age of 18.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false State law regarding sale of tobacco products to individuals under age of 18. 96.130 Section 96.130 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.130 State...

45 CFR 96.130 - State law regarding sale of tobacco products to individuals under age of 18.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false State law regarding sale of tobacco products to individuals under age of 18. 96.130 Section 96.130 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.130 State...

45 CFR 96.18 - Participation by faith-based organizations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Participation by faith-based organizations. 96.18 Section 96.18 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS General Procedures § 96.18 Participation by faith-based organizations. The funds provided under this part...

45 CFR 96.18 - Participation by faith-based organizations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Participation by faith-based organizations. 96.18 Section 96.18 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS General Procedures § 96.18 Participation by faith-based organizations. The funds provided under this part...

45 CFR 96.18 - Participation by faith-based organizations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Participation by faith-based organizations. 96.18 Section 96.18 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS General Procedures § 96.18 Participation by faith-based organizations. The funds provided under this part...

45 CFR 96.18 - Participation by faith-based organizations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Participation by faith-based organizations. 96.18 Section 96.18 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS General Procedures § 96.18 Participation by faith-based organizations. The funds provided under this part...

45 CFR 96.18 - Participation by faith-based organizations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Participation by faith-based organizations. 96.18 Section 96.18 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS General Procedures § 96.18 Participation by faith-based organizations. The funds provided under this part...

A case series of re-establishment of neuromuscular block with rocuronium after sugammadex reversal.

PubMed

Iwasaki, Hajime; Sasakawa, Tomoki; Takahoko, Kenichi; Takagi, Shunichi; Nakatsuka, Hideki; Suzuki, Takahiro; Iwasaki, Hiroshi

2016-06-01

We report the use of rocuronium to re-establish neuromuscular block after reversal with sugammadex. The aim of this study was to investigate the relationship between the dose of rocuronium needed to re-establish neuromuscular block and the time interval between sugammadex administration and re-administration of rocuronium. Patients who required re-establishment of neuromuscular block within 12 h after the reversal of rocuronium-induced neuromuscular block with sugammadex were included. After inducing general anesthesia and placing the neuromuscular monitor, the protocol to re-establish neuromuscular block was as follows. An initial rocuronium dose of 0.6 mg/kg was followed by additional 0.3 mg/kg doses every 2 min until train-of-four responses were abolished. A total of 11 patients were enrolled in this study. Intervals between sugammadex and second rocuronium were 12-465 min. Total dose of rocuronium needed to re-establish neuromuscular block was 0.6-1.2 mg/kg. 0.6 mg/kg rocuronium re-established neuromuscular block in all patients who received initial sugammadex more than 3 h previously. However, when the interval between sugammadex and second rocuronium was less than 2 h, more than 0.6 mg/kg rocuronium was necessary to re-establish neuromuscular block.

45 CFR 96.136 - Independent peer review.

Code of Federal Regulations, 2013 CFR

2013-10-01

... treatment services. The review will focus on treatment programs and the substance abuse service system... Director for Substance Abuse Services. ... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance...

45 CFR 96.136 - Independent peer review.

Code of Federal Regulations, 2011 CFR

2011-10-01

... treatment services. The review will focus on treatment programs and the substance abuse service system... Director for Substance Abuse Services. ... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance...

45 CFR 96.136 - Independent peer review.

Code of Federal Regulations, 2014 CFR

2014-10-01

... treatment services. The review will focus on treatment programs and the substance abuse service system... Director for Substance Abuse Services. ... Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Substance...

45 CFR 96.136 - Independent peer review.

Code of Federal Regulations, 2012 CFR

2012-10-01

... treatment services. The review will focus on treatment programs and the substance abuse service system... Director for Substance Abuse Services. ... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance...

[Effectiveness of Sacral Intervertebral Epidural Block for Umbilical Hernia Repair in Children].

PubMed

Nagamine, Norimitsu; Furuya, Atsushi; Suzuki, Sho; Kondo, Satoko; Kiuchi, Riko; Suzuki, Satomi; Nonaka, Akihiko

2015-02-01

Effectiveness of sacral intervertebral epidural block (S 2-3 block) for umbilical hernia repair has not been clarified. We investigate 24 children, undergoing umbilical hernia repair; mean age of 3 years (age range: 20-65 months). Under general anesthesia, epidural block was performed at S 2-3 interspace with 1 ml x kg(-1) ropivacaine (0.2%) at injecting rate of 1 ml x sec(-1) followed by 0.25 ml x kg(-1) normal saline. In all cases, neither systolic blood pressure nor heart rate increased > 15% from those just before the block. Postoperative analgesics were given in 6 patients (25%) rectally. Mean time between the block and the administration of analgesic was 10.5 hours. S 2-3 block can be effective for postoperative pain in umbilical hernia repair.

45 CFR 96.12 - Grant payment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Grant payment. 96.12 Section 96.12 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS General Procedures § 96.12 Grant payment. The Secretary will make payments at such times and in such amounts to each State from its awards...

45 CFR 96.17 - Annual reporting requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... annually for preventive health and health services (42 U.S.C. 300w-5(a)(1)), community mental health... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS General.... 300x-21 et. seq.), maternal and child health services (42 U.S.C. 706(a)(1)), and the social services...

45 CFR 96.14 - Time period for obligation and expenditure of grant funds.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Time period for obligation and expenditure of grant funds. 96.14 Section 96.14 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS General Procedures § 96.14 Time period for obligation and expenditure of grant funds...

45 CFR 96.14 - Time period for obligation and expenditure of grant funds.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Time period for obligation and expenditure of grant funds. 96.14 Section 96.14 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS General Procedures § 96.14 Time period for obligation and expenditure of grant funds...

45 CFR 96.14 - Time period for obligation and expenditure of grant funds.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Time period for obligation and expenditure of grant funds. 96.14 Section 96.14 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS General Procedures § 96.14 Time period for obligation and expenditure of grant funds...

45 CFR 96.14 - Time period for obligation and expenditure of grant funds.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Time period for obligation and expenditure of grant funds. 96.14 Section 96.14 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS General Procedures § 96.14 Time period for obligation and expenditure of grant funds...

45 CFR 96.14 - Time period for obligation and expenditure of grant funds.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Time period for obligation and expenditure of grant funds. 96.14 Section 96.14 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS General Procedures § 96.14 Time period for obligation and expenditure of grant funds...

Peripheral nerve blocks for paediatric day-stay surgery: one year's experience in a district general hospital.

PubMed Central

Keohane, M.; McAuley, D.; Ardill, A. C.

1995-01-01

Two hundred children underwent day-care surgery using peripheral nerve blockade as an adjunct to general anaesthesia during a twelve month period. Total post-operative analgesia was achieved in 86%, simple oral analgesia was needed in 9% and the remaining 5% of patients required systemic opiate administration for pain. PMID:7502400

48 CFR 504.570 - Procedures for using the EPS.

Code of Federal Regulations, 2010 CFR

2010-10-01

... GENERAL ADMINISTRATIVE MATTERS Electronic Commerce in Contracting 504.570 Procedures for using the EPS. (a... [Identify address block in the solicitation]. (e) The Electronic Posting System Manual provides detailed... that electronic access to a solicitation will result in adequate competition, distribute the...

45 CFR 96.110 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Transition Provisions § 96.110 Scope. Except as otherwise stated, this subpart applies to the community services, preventive health and health services, alcohol and drug abuse and mental health services, and maternal and child health...

45 CFR 96.40 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.40 Scope. This subpart applies to the community services, alcohol and drug abuse and mental health services, preventive health and health services, primary care, and low...

45 CFR 96.110 - Scope.

Code of Federal Regulations, 2013 CFR

2013-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Transition Provisions § 96.110 Scope. Except as otherwise stated, this subpart applies to the community services, preventive health and health services, alcohol and drug abuse and mental health services, and maternal and child health...

45 CFR 96.110 - Scope.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Transition Provisions § 96.110 Scope. Except as otherwise stated, this subpart applies to the community services, preventive health and health services, alcohol and drug abuse and mental health services, and maternal and child health...

45 CFR 96.110 - Scope.

Code of Federal Regulations, 2011 CFR

2011-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Transition Provisions § 96.110 Scope. Except as otherwise stated, this subpart applies to the community services, preventive health and health services, alcohol and drug abuse and mental health services, and maternal and child health...

45 CFR 96.110 - Scope.

Code of Federal Regulations, 2012 CFR

2012-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Transition Provisions § 96.110 Scope. Except as otherwise stated, this subpart applies to the community services, preventive health and health services, alcohol and drug abuse and mental health services, and maternal and child health...

Efficacy of popliteal block in postoperative pain control after ankle fracture fixation: a prospective randomized study.

PubMed

Goldstein, Rachel Y; Montero, Nicole; Jain, Sudheer K; Egol, Kenneth A; Tejwani, Nirmal C

2012-10-01

To compare postoperative pain control in patients treated surgically for ankle fractures who receive popliteal blocks with those who received general anesthesia alone. Institutional Review Board approved prospective randomized study. Metropolitan tertiary-care referral center. All patients being treated with open reduction internal fixation for ankle fractures who met inclusion criteria and consented to participate were enrolled. Patients were randomized to receive either general anesthesia (GETA) or intravenous sedation and popliteal block. Patients were assessed for duration of procedure, total time in the operating room, and postoperative pain at 2, 4, 8, 12, 24, and 48 hours after surgery using a visual analog scale. Fifty-one patients agreed to participate in the study. Twenty-five patients received popliteal block, while 26 patients received GETA. There were no anesthesia-related complications. At 2, 4, and 8 hours postoperatively, patients who underwent GETA demonstrated significantly higher pain. At 12 hours, there was no significant difference between the 2 groups with regard to pain control. However, by 24 hours, those who had received popliteal blocks had significantly higher pain with no difference by 48 hours. Popliteal block provides equivalent postoperative pain control to general anesthesia alone in patients undergoing operative fixation of ankle fractures. However, patients who receive popliteal blocks do experience a significant increase in pain between 12 and 24 hours. Recognition of this "rebound pain" with early narcotic administration may allow patients to have more effective postoperative pain control.

45 CFR 96.31 - Audits.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Audits. 96.31 Section 96.31 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.31... and private and governmental organizations) providing goods and services to State and local...

45 CFR 96.31 - Audits.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Audits. 96.31 Section 96.31 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.31... and private and governmental organizations) providing goods and services to State and local...

45 CFR 96.31 - Audits.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Audits. 96.31 Section 96.31 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.31... and private and governmental organizations) providing goods and services to State and local...

45 CFR 96.31 - Audits.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Audits. 96.31 Section 96.31 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.31... and private and governmental organizations) providing goods and services to State and local...

From d-tubocurarine to sugammadex: the contributions of T. Cecil Gray to modern anaesthetic practice.

PubMed

Shafer, S L

2011-07-01

One hundred years after Morton's demonstration of the anaesthetic effects of ether, T. Cecil Gray revolutionized anaesthesia with his introduction of balanced general anaesthesia. Gray's technique involved i.v. induction, administration of a neuromuscular blocking agent (curare), tracheal intubation, controlled ventilation, maintenance of unconsciousness with a light inhaled anaesthetic (supplemented with opioids if necessary), and reversal of neuromuscular blocking agent at the conclusion of the anaesthetic. In the 65 yr since his seminal papers, our drugs have changed, and i.v. anaesthetics suitable for maintenance of anaesthesia have been introduced, but the basic principles of general anaesthesia today are those set forward by Gray 65 yr ago.

45 CFR 96.32 - Financial settlement.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Financial settlement. 96.32 Section 96.32 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.32 Financial settlement. The State must repay to the Department amounts found after audit...

45 CFR 96.65 - Discovery.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Discovery. 96.65 Section 96.65 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Hearing Procedure § 96.65 Discovery. The use of interrogatories, depositions, and other forms of discovery shall not be allowed. ...

45 CFR 96.65 - Discovery.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Discovery. 96.65 Section 96.65 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Hearing Procedure § 96.65 Discovery. The use of interrogatories, depositions, and other forms of discovery shall not be allowed. ...

45 CFR 96.65 - Discovery.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Discovery. 96.65 Section 96.65 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Hearing Procedure § 96.65 Discovery. The use of interrogatories, depositions, and other forms of discovery shall not be allowed. ...

45 CFR 96.65 - Discovery.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Discovery. 96.65 Section 96.65 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Hearing Procedure § 96.65 Discovery. The use of interrogatories, depositions, and other forms of discovery shall not be allowed. ...

45 CFR 96.65 - Discovery.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Discovery. 96.65 Section 96.65 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Hearing Procedure § 96.65 Discovery. The use of interrogatories, depositions, and other forms of discovery shall not be allowed. ...

45 CFR 96.61 - Initiation of hearing.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Hearing Procedure § 96... written communication; (2) Specify the facts and the action that are the subject of the opportunity for a... by mail, telegram, telex, personal delivery, or any other mode of written communication, addressed to...

45 CFR 96.32 - Financial settlement.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Financial settlement. 96.32 Section 96.32 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.32 Financial settlement. The State must repay to the Department amounts found after audit...

45 CFR 96.32 - Financial settlement.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Financial settlement. 96.32 Section 96.32 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.32 Financial settlement. The State must repay to the Department amounts found after audit...

45 CFR 96.32 - Financial settlement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Financial settlement. 96.32 Section 96.32 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.32 Financial settlement. The State must repay to the Department amounts found after audit...

45 CFR 96.32 - Financial settlement.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Financial settlement. 96.32 Section 96.32 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Financial Management § 96.32 Financial settlement. The State must repay to the Department amounts found after audit...

45 CFR 96.40 - Scope.

Code of Federal Regulations, 2012 CFR

2012-10-01

... drug abuse and mental health services, preventive health and health services, primary care, and low... 45 Public Welfare 1 2012-10-01 2012-10-01 false Scope. 96.40 Section 96.40 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes...

45 CFR 96.40 - Scope.

Code of Federal Regulations, 2011 CFR

2011-10-01

... drug abuse and mental health services, preventive health and health services, primary care, and low... 45 Public Welfare 1 2011-10-01 2011-10-01 false Scope. 96.40 Section 96.40 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes...

45 CFR 96.40 - Scope.

Code of Federal Regulations, 2013 CFR

2013-10-01

... drug abuse and mental health services, preventive health and health services, primary care, and low... 45 Public Welfare 1 2013-10-01 2013-10-01 false Scope. 96.40 Section 96.40 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes...

45 CFR 96.40 - Scope.

Code of Federal Regulations, 2014 CFR

2014-10-01

... drug abuse and mental health services, preventive health and health services, primary care, and low... 45 Public Welfare 1 2014-10-01 2014-10-01 false Scope. 96.40 Section 96.40 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes...

45 CFR 96.51 - Hearings.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Hearings. 96.51 Section 96.51 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Enforcement § 96.51 Hearings. (a... notice of the order and an opportunity for a hearing. Opportunity for a hearing will not be provided...

45 CFR 96.51 - Hearings.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Hearings. 96.51 Section 96.51 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Enforcement § 96.51 Hearings. (a... notice of the order and an opportunity for a hearing. Opportunity for a hearing will not be provided...

45 CFR 96.51 - Hearings.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Hearings. 96.51 Section 96.51 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Enforcement § 96.51 Hearings. (a... notice of the order and an opportunity for a hearing. Opportunity for a hearing will not be provided...

45 CFR 96.87 - Leveraging incentive program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Low-income... paragraphs (a)(2)(ii) and (a)(2)(iii) of this section. (ii) Indian tribes that received LIHEAP services under... resources leveraged by the tribe are reported, and the tribe receives LIHEAP services under section 2602(b...

45 CFR 96.87 - Leveraging incentive program.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Low-income... paragraphs (a)(2)(ii) and (a)(2)(iii) of this section. (ii) Indian tribes that received LIHEAP services under... resources leveraged by the tribe are reported, and the tribe receives LIHEAP services under section 2602(b...

45 CFR 98.15 - Assurances and certifications.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT... categories of care or types of providers, pursuant to § 98.30(f). (6) That if expenditures for pre... Child Care and Development Block Grant Act of 1990, as amended, section 418 of the Social Security Act...

45 CFR 98.15 - Assurances and certifications.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT... categories of care or types of providers, pursuant to § 98.30(f). (6) That if expenditures for pre... Child Care and Development Block Grant Act of 1990, as amended, section 418 of the Social Security Act...

45 CFR 98.15 - Assurances and certifications.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT... categories of care or types of providers, pursuant to § 98.30(f). (6) That if expenditures for pre... Child Care and Development Block Grant Act of 1990, as amended, section 418 of the Social Security Act...

45 CFR 98.15 - Assurances and certifications.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT... categories of care or types of providers, pursuant to § 98.30(f). (6) That if expenditures for pre... Child Care and Development Block Grant Act of 1990, as amended, section 418 of the Social Security Act...

45 CFR 98.15 - Assurances and certifications.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT... categories of care or types of providers, pursuant to § 98.30(f). (6) That if expenditures for pre... Child Care and Development Block Grant Act of 1990, as amended, section 418 of the Social Security Act...

45 CFR 96.45 - Preventive health and health services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Preventive health and health services. 96.45 Section 96.45 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.45 Preventive health and health services...

45 CFR 96.45 - Preventive health and health services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Preventive health and health services. 96.45 Section 96.45 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.45 Preventive health and health services...

45 CFR 96.45 - Preventive health and health services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Preventive health and health services. 96.45 Section 96.45 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.45 Preventive health and health services...

45 CFR 96.45 - Preventive health and health services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Preventive health and health services. 96.45 Section 96.45 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.45 Preventive health and health services...

45 CFR 96.45 - Preventive health and health services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Preventive health and health services. 96.45 Section 96.45 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Direct Funding of Indian Tribes and Tribal Organizations § 96.45 Preventive health and health services...

45 CFR 96.1 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Scope. 96.1 Section 96.1 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Introduction § 96.1 Scope. This part....C. 300w-300w-8). (c) Community mental health services (Public Health Service Act, sections 1911-1920...

45 CFR 96.74 - Annual reporting requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Annual reporting requirements. 96.74 Section 96.74 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Social... individuals who receive services paid for in whole or in part with federal funds under the Social Services...

45 CFR 96.74 - Annual reporting requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Annual reporting requirements. 96.74 Section 96.74 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social... individuals who receive services paid for in whole or in part with federal funds under the Social Services...

45 CFR 96.74 - Annual reporting requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Annual reporting requirements. 96.74 Section 96.74 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social... individuals who receive services paid for in whole or in part with federal funds under the Social Services...

45 CFR 96.74 - Annual reporting requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Annual reporting requirements. 96.74 Section 96.74 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Social... individuals who receive services paid for in whole or in part with federal funds under the Social Services...

45 CFR 96.123 - Assurances.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Assurances. 96.123 Section 96.123 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and... recovering substance abusers is in place consistent with the provisions of § 96.129 and the loans will be...

45 CFR 96.123 - Assurances.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Assurances. 96.123 Section 96.123 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and... recovering substance abusers is in place consistent with the provisions of § 96.129 and the loans will be...

45 CFR 96.123 - Assurances.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Assurances. 96.123 Section 96.123 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and... recovering substance abusers is in place consistent with the provisions of § 96.129 and the loans will be...

45 CFR 96.123 - Assurances.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Assurances. 96.123 Section 96.123 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and... recovering substance abusers is in place consistent with the provisions of § 96.129 and the loans will be...

45 CFR 96.51 - Hearings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Hearings. 96.51 Section 96.51 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Enforcement § 96.51 Hearings. (a... notice of the order and an opportunity for a hearing. Opportunity for a hearing will not be provided...

45 CFR 98.71 - Content of reports.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND... the amended Child Care and Development Block Grant Act; (2) The number of children served by payments... eligibility; (2) County of residence; (3) Gender and month/year of birth of children; (4) Ethnicity and race...

45 CFR 98.71 - Content of reports.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CHILD CARE AND DEVELOPMENT FUND... the amended Child Care and Development Block Grant Act; (2) The number of children served by payments... eligibility; (2) County of residence; (3) Gender and month/year of birth of children; (4) Ethnicity and race...

45 CFR 96.63 - Communications to presiding officer.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Communications to presiding officer. 96.63 Section 96.63 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Hearing Procedure § 96.63 Communications to presiding officer. (a) Those persons who are directly involved...

45 CFR 96.64 - Intervention.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Intervention. 96.64 Section 96.64 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Hearing Procedure § 96.64 Intervention. Participation as parties in the hearing by persons other than the State and the Department is not...

45 CFR 96.64 - Intervention.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Intervention. 96.64 Section 96.64 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Hearing Procedure § 96.64 Intervention. Participation as parties in the hearing by persons other than the State and the Department is not...

45 CFR 96.64 - Intervention.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Intervention. 96.64 Section 96.64 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Hearing Procedure § 96.64 Intervention. Participation as parties in the hearing by persons other than the State and the Department is not...

45 CFR 96.64 - Intervention.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 1 2014-10-01 2014-10-01 false Intervention. 96.64 Section 96.64 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION BLOCK GRANTS Hearing Procedure § 96.64 Intervention. Participation as parties in the hearing by persons other than the State and the Department is not...

45 CFR 96.64 - Intervention.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 1 2012-10-01 2012-10-01 false Intervention. 96.64 Section 96.64 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Hearing Procedure § 96.64 Intervention. Participation as parties in the hearing by persons other than the State and the Department is not...

Removal of a fractured needle during inferior alveolar nerve block: two case reports.

PubMed

You, Jae-Seek; Kim, Su-Gwan; Oh, Ji-Su; Choi, Hae-In; Jih, Myeong-Kwan

2017-09-01

The inferior alveolar nerve block is the most common method of local anesthesia for intraoral surgery at the posterior mandibular region. However, unexpected complications may occur when administering the local anesthesia. One of these uncommon complications is the fracture of the needle. If the injection needle is broken during the surgery, it should be removed immediately. However, this is one of the most difficult procedures. In this report, we present two cases of needle fracture during the procedure, and its successful removal under general/local anesthesia administration.

45 CFR 96.67 - Right to counsel.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 1 2010-10-01 2010-10-01 false Right to counsel. 96.67 Section 96.67 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Hearing Procedure § 96.67 Right to counsel. Any party to a hearing under this part has the right at all times to be advised...

Case report: Neuromuscular block induced by rocuronium following sugammadex administration.

PubMed

Askin, Tugba; Unver, Suheyla; Oguz, Deniz; Kutay, Kubra

2017-02-01

We present a case in which rocuronium was applied for muscle relaxation following the administration of sugammadex. An emergency surgery under general anesthesia was planned for a 43-year-old male patient due to an L1 vertebral corpus and right tibia-fibula shaft fracture. Anesthesia was induced with fentanyl, propofol and lidocaine. After applying only 30mg of the total induction dose of rocuronium, it was learned that the neurological examination should be controlled again from the surgeon because of the controversial of the neurological deficit. As a result, patient awakened from anesthesia. We administered 2mg/kg sugammadex and spontaneous breathing of patient returned immediately. The patient became conscious and orientated immediately afterwards. The neurological examination of the lower extremities was performed. The patient was anesthetized once again and 0.6mg/kg rocuronium was given in order to gain neoromuscular block approximately 10min after sugammadex administration. 2min later, the patient was smoothly intubated. Neuromuscular monitorization was not used because of emergency. We administered 2mg/kg sugammadex at the end of the procedure and the patient was extubated. The most suitable time for the re-establishment of rocuronium following sugammadex is currently unclear. This case showed that neuromuscular block can be effectively re-induced by rocuronium following the reversal of rocuronium-induced neuromuscular block with sugammadex. In this case, we consider that the ability to effectively reuse normal induction doses of rocuronium is an important clinical observation. Copyright © 2016 Elsevier Inc. All rights reserved.

Transient delayed facial nerve palsy after inferior alveolar nerve block anesthesia.

PubMed

Tzermpos, Fotios H; Cocos, Alina; Kleftogiannis, Matthaios; Zarakas, Marissa; Iatrou, Ioannis

2012-01-01

Facial nerve palsy, as a complication of an inferior alveolar nerve block anesthesia, is a rarely reported incident. Based on the time elapsed, from the moment of the injection to the onset of the symptoms, the paralysis could be either immediate or delayed. The purpose of this article is to report a case of delayed facial palsy as a result of inferior alveolar nerve block, which occurred 24 hours after the anesthetic administration and subsided in about 8 weeks. The pathogenesis, treatment, and results of an 8-week follow-up for a 20-year-old patient referred to a private maxillofacial clinic are presented and discussed. The patient's previous medical history was unremarkable. On clinical examination the patient exhibited generalized weakness of the left side of her face with a flat and expressionless appearance, and she was unable to close her left eye. One day before the onset of the symptoms, the patient had visited her dentist for a routine restorative procedure on the lower left first molar and an inferior alveolar block anesthesia was administered. The patient's medical history, clinical appearance, and complete examinations led to the diagnosis of delayed facial nerve palsy. Although neurologic occurrences are rare, dentists should keep in mind that certain dental procedures, such as inferior alveolar block anesthesia, could initiate facial nerve palsy. Attention should be paid during the administration of the anesthetic solution.

Transient Delayed Facial Nerve Palsy After Inferior Alveolar Nerve Block Anesthesia

PubMed Central

Tzermpos, Fotios H.; Cocos, Alina; Kleftogiannis, Matthaios; Zarakas, Marissa; Iatrou, Ioannis

2012-01-01

Facial nerve palsy, as a complication of an inferior alveolar nerve block anesthesia, is a rarely reported incident. Based on the time elapsed, from the moment of the injection to the onset of the symptoms, the paralysis could be either immediate or delayed. The purpose of this article is to report a case of delayed facial palsy as a result of inferior alveolar nerve block, which occurred 24 hours after the anesthetic administration and subsided in about 8 weeks. The pathogenesis, treatment, and results of an 8-week follow-up for a 20-year-old patient referred to a private maxillofacial clinic are presented and discussed. The patient's previous medical history was unremarkable. On clinical examination the patient exhibited generalized weakness of the left side of her face with a flat and expressionless appearance, and she was unable to close her left eye. One day before the onset of the symptoms, the patient had visited her dentist for a routine restorative procedure on the lower left first molar and an inferior alveolar block anesthesia was administered. The patient's medical history, clinical appearance, and complete examinations led to the diagnosis of delayed facial nerve palsy. Although neurologic occurrences are rare, dentists should keep in mind that certain dental procedures, such as inferior alveolar block anesthesia, could initiate facial nerve palsy. Attention should be paid during the administration of the anesthetic solution. PMID:22428971

77 FR 24139 - State Community Development Block Grant Program: Administrative Rule Changes

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-23

...-AC22 State Community Development Block Grant Program: Administrative Rule Changes AGENCY: Office of the... rule makes changes to several sections of the regulations for the Community Development Block Grant... ``Community Development Block Grants''). Under the State CDBG program, states have the opportunity to...

Rocuronium-induced neuromuscular block and sugammadex in pediatric patient with duchenne muscular dystrophy

PubMed Central

Kim, Ji Eun; Chun, Hea Rim

2017-01-01

Abstract Introduction: Anesthetic management of patients with Duchenne muscular dystrophy (DMD) is complicated because these patients are more sensitive to nondepolarizing neuromuscular blocking agents (NMBAs) and are vulnerable to postoperative complications, such as postoperative residual curarization and respiratory failure. Sugammadex is a new reversal agent for aminosteroidal NMBAs, but its safety in children is controversial. Clinical features: An 11-year-old boy with DMD underwent general anesthesia for a percutaneous nephrolithotomy. We used rocuronium bromide and sugammadex to reverse the deep neuromuscular block. Reversal of neuromuscular block was done 15 minutes after administration of 2 mg/kg of sugammadex. The patient's recovery from anesthesia was uneventful, and he was discharged to the postoperative recovery ward. Conclusion: A delayed recovery was achieved, but no adverse events were observed, such as recurarization or hypersensitivity to sugammadex. We report safe use of 2 mg/kg of sugammadex to reverse a deep neuromuscular block in a child with DMD. PMID:28353578

Rocuronium-induced neuromuscular block and sugammadex in pediatric patient with duchenne muscular dystrophy: A case Report.

PubMed

Kim, Ji Eun; Chun, Hea Rim

2017-03-01

Anesthetic management of patients with Duchenne muscular dystrophy (DMD) is complicated because these patients are more sensitive to nondepolarizing neuromuscular blocking agents (NMBAs) and are vulnerable to postoperative complications, such as postoperative residual curarization and respiratory failure. Sugammadex is a new reversal agent for aminosteroidal NMBAs, but its safety in children is controversial. An 11-year-old boy with DMD underwent general anesthesia for a percutaneous nephrolithotomy. We used rocuronium bromide and sugammadex to reverse the deep neuromuscular block. Reversal of neuromuscular block was done 15 minutes after administration of 2 mg/kg of sugammadex. The patient's recovery from anesthesia was uneventful, and he was discharged to the postoperative recovery ward. A delayed recovery was achieved, but no adverse events were observed, such as recurarization or hypersensitivity to sugammadex. We report safe use of 2 mg/kg of sugammadex to reverse a deep neuromuscular block in a child with DMD.

14 CFR 156.7 - Enforcement of State block grant agreements and other related grant assurances.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 3 2010-01-01 2010-01-01 false Enforcement of State block grant agreements... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIRPORTS STATE BLOCK GRANT PILOT PROGRAM § 156.7 Enforcement of State block grant agreements and other related grant assurances. The Administrator may take any...

Development and Validation of a New Air Carrier Block Time Prediction Model and Methodology

NASA Astrophysics Data System (ADS)

Litvay, Robyn Olson

Commercial airline operations rely on predicted block times as the foundation for critical, successive decisions that include fuel purchasing, crew scheduling, and airport facility usage planning. Small inaccuracies in the predicted block times have the potential to result in huge financial losses, and, with profit margins for airline operations currently almost nonexistent, potentially negate any possible profit. Although optimization techniques have resulted in many models targeting airline operations, the challenge of accurately predicting and quantifying variables months in advance remains elusive. The objective of this work is the development of an airline block time prediction model and methodology that is practical, easily implemented, and easily updated. Research was accomplished, and actual U.S., domestic, flight data from a major airline was utilized, to develop a model to predict airline block times with increased accuracy and smaller variance in the actual times from the predicted times. This reduction in variance represents tens of millions of dollars (U.S.) per year in operational cost savings for an individual airline. A new methodology for block time prediction is constructed using a regression model as the base, as it has both deterministic and probabilistic components, and historic block time distributions. The estimation of the block times for commercial, domestic, airline operations requires a probabilistic, general model that can be easily customized for a specific airline’s network. As individual block times vary by season, by day, and by time of day, the challenge is to make general, long-term estimations representing the average, actual block times while minimizing the variation. Predictions of block times for the third quarter months of July and August of 2011 were calculated using this new model. The resulting, actual block times were obtained from the Research and Innovative Technology Administration, Bureau of Transportation Statistics (Airline On-time Performance Data, 2008-2011) for comparison and analysis. Future block times are shown to be predicted with greater accuracy, without exception and network-wide, for a major, U.S., domestic airline.

[Inadvertent injection of succinylcholine as an epidural test dose].

PubMed

Pourzitaki, Chryssa; Tsaousi, Georgia; Logotheti, Helena; Amaniti, Ekaterini

Epidural action of neuromuscular blocking agents could be explained under the light of their physicochemical characteristics and epidural space properties. In the literature there are few cases of accidental neuromuscular agent's epidural administration, manifesting mainly with neuromuscular blockade institution or fasciculations. We report a case of accidental succinylcholine administration as an epidural test dose, in a female patient undergoing scheduled laparotomy, under combined general and epidural anesthesia. Approximately 2min after the succinylcholine injection the patient complained for shortness of breath, while mild fasciculations appeared in her trunk and face, managed by immediate general anesthesia institution. With the exception of a relatively longer duration of neuromuscular blockade compared with intravenous administration, no neurological or cardiovascular sequelae or other symptoms of local or systemic toxicity were observed. Oral administration of diazepam seems to lessen the adverse effects from accidental epidural administration of succinylcholine. The meticulous and discriminative labeling of syringes, as well as keeping persistent cautions during all anesthesia procedures remains of crucial importance. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

45 CFR 96.82 - Required report on households assisted.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 1 2013-10-01 2013-10-01 false Required report on households assisted. 96.82 Section 96.82 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Low-income Home Energy Assistance Program § 96.82 Required report on households assisted. (a) Each grantee which is a State or an insular area which...

Ophthalmic regional blocks: management, challenges, and solutions

PubMed Central

Palte, Howard D

2015-01-01

In the past decade ophthalmic anesthesia has witnessed a major transformation. The sun has set on the landscape of ophthalmic procedures performed under general anesthesia at in-hospital settings. In its place a new dawn has ushered in the panorama of eye surgeries conducted under regional and topical anesthesia at specialty eye care centers. The impact of the burgeoning geriatric population is that an increasing number of elderly patients will present for eye surgery. In order to accommodate increased patient volumes and simultaneously satisfy administrative initiatives directed at economic frugality, administrators will seek assistance from anesthesia providers in adopting measures that enhance operating room efficiency. The performance of eye blocks in a holding suite meets many of these objectives. Unfortunately, most practicing anesthesiologists resist performing ophthalmic regional blocks because they lack formal training. In future, anesthesiologists will need to block eyes and manage common medical conditions because economic pressures will eliminate routine preoperative testing. This review addresses a variety of topical issues in ophthalmic anesthesia with special emphasis on cannula and needle-based blocks and the new-generation antithrombotic agents. In a constantly evolving arena, the sub-Tenon’s block has gained popularity while the deep angulated intraconal (retrobulbar) block has been largely superseded by the shallower extraconal (peribulbar) approach. Improvements in surgical technique have also impacted anesthetic practice. For example, phacoemulsification techniques facilitate the conduct of cataract surgery under topical anesthesia, and suture-free vitrectomy ports may cause venous air embolism during air/fluid exchange. Hyaluronidase is a useful adjuvant because it promotes local anesthetic diffusion and hastens block onset time but it is allergenic. Ultrasound-guided eye blocks afford real-time visualization of needle position and local anesthetic spread. An advantage of sonic guidance is that it may eliminate the hazard of globe perforation by identifying abnormal anatomy, such as staphyloma. PMID:26316814

45 CFR 96.15 - Waivers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... health services block grant; to the Administrator, Substance Abuse and Mental Health Services Administration in the case of the community mental health services block grant and the substance abuse prevention... maternal and child health services block grant; and to the Director, Office of Community Services in the...

[Indications and possibilities of blockade of the sympathetic nerve].

PubMed

Meyer, J

1987-04-01

Treatment of chronic pain through permanent or temporary interruption of sympathetic activity is marked by great clinical success, but nevertheless there are rather skeptical reports about long-term results of these blocks as therapeutic measures. There are many symptoms and signs of chronic pain, while diagnosis is expensive, the pathogenesis is complex, and the etiology is generally due to multiple factors. Indications for sympathetic blockade depend upon the possible means of access, as in the cervicothoracic, thoracic, lumbar, or sacral regions. General indications are: symptoms not limited segmentally within peripheral body areas; pain resulting from microtraumata and lesions of peripheral nerve branches; and pain caused by intensified sympathetic tone with consequent circulatory disturbances. Peripheral circulatory disturbances are the most common indication for sympathetic blockade, as the block produces a vasomotor reaction that leads to increased capillary circulation. Pain caused by herpes zoster, sudden hearing loss, hyperhidrosis, and pseudesthesia can also be influenced by sympathetic blockade. There are several possibilities for reducing or interrupting sympathetic activity; for us, however, blocking of the sympathetic trunk is the most important. During the last 16 years we performed 15,726 sympathetic blockades on 2385 patients, which included: 3735 stellate ganglion blocks, 6121 blocks of the lumbar sympathetic trunk, 5037 continuous peridural anesthesias, 29 blocks of the thoracic sympathetic trunk, and 12 celiac blocks. In 792 cases sympathetic blocks were performed using neurolytic drugs, in most cases 96% ethyl alcohol and less often 10% ammonium sulphate. Other possibilities, such as enteral administration or infusion of sympatholytic drugs, were not taken into consideration; regional intravascular injection of guanethidine can be recommended, however.(ABSTRACT TRUNCATED AT 250 WORDS)

Block Scheduling in Missouri: A Study of Administrator and Teacher Perceptions.

ERIC Educational Resources Information Center

Stader, David L.; DeSpain, B. C.

This paper reports on a Missouri study that compared block scheduling to traditional schedules in small high schools (schools with fewer than 500 students in grades 9 to 12). The study focused on small-school administrator and teacher perceptions of the effects of block scheduling on student achievement, school climate, and teacher methodology.…

12. Interior view of second floor west administrative/support office block ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

12. Interior view of second floor west administrative/support office block looking north. - Manchester Airport, Large Hangar, East edge of airport between East Apron & Kelly Avenue, Manchester, Hillsborough County, NH

11. Interior view of first floor east administrative/support office block ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

11. Interior view of first floor east administrative/support office block looking north. - Manchester Airport, Large Hangar, East edge of airport between East Apron & Kelly Avenue, Manchester, Hillsborough County, NH

13. Interior view of second floor east administrative/support office block ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

13. Interior view of second floor east administrative/support office block looking north. - Manchester Airport, Large Hangar, East edge of airport between East Apron & Kelly Avenue, Manchester, Hillsborough County, NH

Consolidation of Federal Aid Programs for Education: A Case for Block Grant Funding.

ERIC Educational Resources Information Center

Main, Robert G.

The need for a new approach to federal support of education by reducing the number of narrow categorical aid programs is developed through a case study of the 1976 Ford Administration proposal for a consolidated block grant of 24 separate authorities. The merits of block grant funding are examined both in terms of the administration-sponsored bill…

View of the southwest guard tower, cell blocks seven and ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

View of the southwest guard tower, cell blocks seven and eight, administration building west tower, and Fairmount Avenue, looking from the administration building facing west - Eastern State Penitentiary, 2125 Fairmount Avenue, Philadelphia, Philadelphia County, PA

Preemptive, preventive, multimodal analgesia: what do they really mean?

PubMed

Rosero, Eric B; Joshi, Girish P

2014-10-01

To improve postoperative pain management, several concepts have been developed, including preemptive analgesia, preventive analgesia, and multimodal analgesia. This article will discuss the role of these concepts in improving perioperative pain management. Preemptive analgesia refers to the administration of an analgesic treatment before the surgical insult or tissue injury. Several randomized clinical trials have, however, provided equivocal evidence regarding the benefits of preincisional compared with postincisional analgesic administration. Current general consensus, therefore, indicates that use of preemptive analgesia does not translate into consistent clinical benefits after surgery. Preventive analgesia is a wider concept where the timing of analgesic administration in relation to the surgical incision is not critical. The aim of preventive analgesia is to minimize sensitization induced by noxious stimuli arising throughout the perioperative period. Multimodal analgesia consists of the administration of 2 or more drugs that act by different mechanisms for providing analgesia. These drugs may be administered via the same route or by different routes. Thus, the aim of multimodal analgesia is to improve pain relief while reducing opioid requirements and opioid-related adverse effects. Analgesic modalities currently available for postoperative pain control include opioids, local anesthetic techniques [local anesthetic infiltration, peripheral nerve blocks, and neuraxial blocks (epidural and paravertebral)], acetaminophen, nonsteroidal anti-inflammatory drugs, and cyclooxygenase-2-specific inhibitors as well as analgesic adjuncts such as steroids, ketamine, α-2 agonists, and anticonvulsants.

Medial Versus Traditional Approach to US-guided TAP Blocks for Open Inguinal Hernia Repair

ClinicalTrials.gov

2012-04-30

Abdominal Muscles/Ultrasonography; Adult; Ambulatory Surgical Procedures; Anesthetics, Local/Administration & Dosage; Ropivacaine/Administration & Dosage; Ropivacaine/Analogs & Derivatives; Hernia, Inguinal/Surgery; Humans; Nerve Block/Methods; Pain Measurement/Methods; Pain, Postoperative/Prevention & Control; Ultrasonography, Interventional

The adequate rocuronium dose required for complete block of the adductor muscles of the thigh.

PubMed

Fujimoto, M; Kawano, K; Yamamoto, T

2018-03-01

Rocuronium can prevent the obturator jerk during transurethral resection of bladder tumors. We investigated the adequate rocuronium dose required for complete block of the thigh adductor muscles, and its correlation with individual responses of the adductor pollicis muscle to rocuronium. Eleven patients scheduled for transurethral resection of bladder tumors under general anesthesia were investigated. After general anesthesia induction, neuromuscular monitoring of the adductor pollicis muscle and ultrasonography-guided stimulation of the obturator nerve was commenced. Rocuronium, 0.15 mg/kg, was repeatedly administered intravenously. The adequate rocuronium dose required for complete block of the thigh muscles, defined as the cumulative dose of rocuronium administered until that time, and its correlation with the first twitch response of the adductor pollicis muscle on train-of-four stimulation after initial rocuronium administration was analyzed. The rocuronium dose found adequate for complete block of the thigh muscles was 0.30 mg/kg in seven patients and 0.45 mg/kg in the remaining four patients, which did not correlate with the first twitch response. At the time of complete block of the thigh muscles, the neuromuscular blockade level of the adductor pollicis muscle varied greatly, although the level was never more profound than a post-tetanic count of 1. Although the response of the adductor pollicis muscle to rocuronium cannot be used to determine the adequate rocuronium dose required for complete block of the thigh muscles, intense blockade, with maintenance of post-tetanic count at ≤ 1 in the adductor pollicis muscle is essential to prevent the obturator jerk. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Back to basics: The effects of block vs. interleaved trial administration on pro- and anti-saccade performance

PubMed Central

Zeligman, Liran; Zivotofsky, Ari Z.

2017-01-01

The pro and anti-saccade task (PAT) is a widely used tool in the study of overt and covert attention with promising potential role in neurocognitive and psychiatric assessment. However, specific PAT protocols can vary significantly between labs, potentially resulting in large variations in findings across studies. In light of recent calls towards a standardization of PAT the current study's objective was to systematically and purposely evaluate the effects of block vs. interleaved administration—a fundamental consideration—on PAT measures in a within subject design. Additionally, this study evaluated whether measures of a Posner-type cueing paradigm parallels measures of the PAT paradigm. As hypothesized, results indicate that PAT performance is highly susceptible to administration mode. Interleaved mode resulted in larger error rates not only for anti (blocks: M = 22%; interleaved: M = 42%) but also for pro-saccades (blocks: M = 5%; interleaved: M = 12%). This difference between block and interleaved administration was significantly larger in anti-saccades compared to pro-saccades and cannot be attributed to a 'speed/accuracy tradeoff'. Interleaved mode produced larger pro and anti-saccade differences in error rates while block administration produced larger latency differences. Results question the reflexive nature of pro-saccades, suggesting they are not purely reflexive. These results were further discussed and compared to previous studies that included within subject data of blocks and interleaved trials. PMID:28222173

Speed of spinal vs general anaesthesia for category-1 caesarean section: a simulation and clinical observation-based study.

PubMed

Kathirgamanathan, A; Douglas, M J; Tyler, J; Saran, S; Gunka, V; Preston, R; Kliffer, P

2013-07-01

Controversy exists as to whether effective spinal anaesthesia can be achieved as quickly as general anaesthesia for a category-1 caesarean section. Sixteen consultants and three fellows in obstetric anaesthesia were timed performing spinal and general anaesthesia for category-1 caesarean section on a simulator. The simulation time commenced upon entry of the anaesthetist into the operating theatre and finished for the spinal anaesthetic at the end of intrathecal injection and for the general anaesthetic when the anaesthetist was happy for surgery to start. In the second clinical part of the study, the time from intrathecal administration to 'adequate surgical anaesthesia' (defined as adequate for start of a category-1 caesarean section) was estimated in 100 elective (category-4) caesarean sections. The median (IQR [range]) times (min:s) for spinal procedure, onset of spinal block and general anaesthesia were 2:56 (2:32-3:32 [1:22-3:50]), 5:56 (4:23-7:39 [2:9-13:32]) and 1:56 (1:39-2:9 [1:13-3:12]), respectively. The limiting factor in urgent spinal anaesthesia is the unpredictable time needed for adequate surgical block to develop. Anaesthesia © 2013 The Association of Anaesthetists of Great Britain and Ireland.

Magnesium sulphate: an adjuvant to tracheal intubation without muscle relaxation--a randomised study.

PubMed

Aissaoui, Younes; Qamous, Youssef; Serghini, Issam; Zoubir, Mohammed; Salim, Jaafar Lalaoui; Boughalem, Mohammed

2012-08-01

Tracheal intubation without administration of a neuromuscular blocking drug is used frequently in anaesthesia. Several techniques and adjuvants have been tried to improve intubating conditions. Magnesium sulphate is an agent with analgesic, anaesthetic and muscle relaxant effects. To assess the effect of magnesium sulphate on intubating conditions after induction of anaesthesia without a neuromuscular blocking drug. Double-blinded randomised study. Sixty patients with American Society of Anesthesiologists physical status 1/2 scheduled for elective surgery under general anaesthesia were included. Avicenna Military Hospital between June 2010 and March 2011. Before induction of general anaesthesia, patients were assigned to receive either a 10-min infusion of magnesium sulphate 45 mg kg(-1) in 100 ml of isotonic saline (magnesium group, n = 30) or the same volume of saline (control group, n = 30). Anaesthesia was induced with fentanyl 3 μg kg(-1) followed 3 min later by propofol 2.5 mg kg(-1). Intubating conditions were evaluated by a blinded anaesthesiologist using the criteria of the Copenhagen consensus conference: ease of laryngoscopy, vocal cord position and/or movement and response to intubation or cuff inflation (cough or diaphragmatic movement). Intubating conditions were considered as acceptable (excellent or good) or unacceptable (poor). Mean arterial pressure and heart rate were also recorded during the study period. The two groups were comparable in their demographic profiles. Clinically acceptable intubating conditions were observed more frequently in the magnesium group than in the control group: 25 (83%) vs. 18 patients (60%) (P = 0.042). There was no failed intubation. There were no differences between the groups with regard to haemodynamic variables. Addition of magnesium sulphate to propofol and fentanyl at induction of anaesthesia significantly improved intubating conditions without administration of a neuromuscular blocking drug.

Blockade of Cocaine or σ Receptor Agonist Self Administration by Subtype-Selective σ Receptor Antagonists

PubMed Central

Hiranita, Takato; Kopajtic, Theresa A.; Rice, Kenner C.; Mesangeau, Christophe; Narayanan, Sanju; Abdelazeem, Ahmed H.; McCurdy, Christopher R.

2016-01-01

The identification of sigma receptor (σR) subtypes has been based on radioligand binding and, despite progress with σ1R cellular function, less is known about σR subtype functions in vivo. Recent findings that cocaine self administration experience will trigger σR agonist self administration was used in this study to assess the in vivo receptor subtype specificity of the agonists (+)-pentazocine, PRE-084 [2-(4-morpholinethyl) 1-phenylcyclohexanecarboxylate hydrochloride], and 1,3-di-o-tolylguanidine (DTG) and several novel putative σR antagonists. Radioligand binding studies determined in vitro σR selectivity of the novel compounds, which were subsequently studied for self administration and antagonism of cocaine, (+)-pentazocine, PRE-084, or DTG self administration. Across the dose ranges studied, none of the novel compounds were self administered, nor did they alter cocaine self administration. All compounds blocked DTG self administration, with a subset also blocking (+)-pentazocine and PRE-084 self administration. The most selective of the compounds in binding σ1Rs blocked cocaine self administration when combined with a dopamine transport inhibitor, either methylphenidate or nomifensine. These drug combinations did not decrease rates of responding maintained by food reinforcement. In contrast, the most selective of the compounds in binding σ2Rs had no effect on cocaine self administration in combination with either dopamine transport inhibitor. Thus, these results identify subtype-specific in vivo antagonists, and the utility of σR agonist substitution for cocaine self administration as an assay capable of distinguishing σR subtype selectivity in vivo. These results further suggest that effectiveness of dual σR antagonism and dopamine transport inhibition in blocking cocaine self administration is specific for σ1Rs and further support this dual targeting approach to development of cocaine antagonists. PMID:27189970

Control of muscle relaxation during anesthesia: a novel approach for clinical routine.

PubMed

Stadler, Konrad S; Schumacher, Peter M; Hirter, Sibylle; Leibundgut, Daniel; Bouillon, Thomas W; Glattfelder, Adolf H; Zbinden, Alex M

2006-03-01

During general anesthesia drugs are administered to provide hypnosis, ensure analgesia, and skeletal muscle relaxation. In this paper, the main components of a newly developed controller for skeletal muscle relaxation are described. Muscle relaxation is controlled by administration of neuromuscular blocking agents. The degree of relaxation is assessed by supramaximal train-of-four stimulation of the ulnar nerve and measuring the electromyogram response of the adductor pollicis muscle. For closed-loop control purposes, a physiologically based pharmacokinetic and pharmacodynamic model of the neuromuscular blocking agent mivacurium is derived. The model is used to design an observer-based state feedback controller. Contrary to similar automatic systems described in the literature this controller makes use of two different measures obtained in the train-of-four measurement to maintain the desired level of relaxation. The controller is validated in a clinical study comparing the performance of the controller to the performance of the anesthesiologist. As presented, the controller was able to maintain a preselected degree of muscle relaxation with excellent precision while minimizing drug administration. The controller performed at least equally well as the anesthesiologist.

49 CFR 236.804 - Signal, block.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Signal, block. 236.804 Section 236.804 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Signal, block. A roadway signal operated either automatically or manually at the entrance to a block. ...

Dexamethasone does not diminish sugammadex reversal of neuromuscular block - clinical study in surgical patients undergoing general anesthesia.

PubMed

Rezonja, Katja; Mars, Tomaz; Jerin, Ales; Kozelj, Gordana; Pozar-Lukanovic, Neva; Sostaric, Maja

2016-10-21

Sugammadex reverses neuromuscular block (NMB) through binding aminosteroid neuromuscular blocking agents. Although sugammadex appears to be highly selective, it can interact with other drugs, like corticosteroids. A prospective single-blinded randomized clinical trial was designed to explore the significance of interactions between dexamethasone and sugammadex. Sixty-five patients who were anesthetized for elective abdominal or urological surgery were included. NMB was assessed using train-of-four stimulation (TOF), with rocuronium used to maintain the desired NMB depth. NMB reversal at the end of anaesthesia was achieved using sugammadex. According to their received antiemetics, the patients were randomized to either the granisetron or dexamethasone group. Blood samples were taken before and after NMB reversal, for plasma dexamethasone and rocuronium determination. Primary endpoint was time from sugammadex administration to NMB reversal. Secondary endpoints included the ratios of the dexamethasone and rocuronium concentrations after NMB reversal versus before sugammadex administration. There were no differences for time to NMB reversal between the control (mean 121 ± 61 s) and the dexamethasone group (mean 125 ± 57 s; P = 0.760). Time to NMB reversal to a TOF ratio ≥0.9 was significantly longer in patients with lower TOF prior to sugammadex administration (Beta = -0.268; P = 0.038). The ratio between the rocuronium concentrations after NMB reversal versus before sugammadex administration was significantly affected by sugammadex dose (Beta = -0.375; P = 0.004), as was rocuronium dose per hour of operation (Beta = -0.366; p = 0.007), while it was not affected by NMB depth before administration of sugammadex (Beta = -0.089; p = 0.483) and dexamethasone (Beta = -0.186; p = 0.131). There was significant drop in plasma dexamethasone after sugammadex administration and NMB reversal (p < 0.001). Administration of dexamethasone to anesthetized patients did not delay NMB reversal by sugammadex. The trial was retrospectively registered with The Australian New Zealand Clinical Trials Registry (ANZCTR) on February 28th 2012 (enrollment of the first patient on February 2nd 2012) and was given a trial ID number ACTRN12612000245897 and universal trial number U1111-1128-5104.

28 CFR 33.41 - Application content.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Application content. 33.41 Section 33.41 Judicial Administration DEPARTMENT OF JUSTICE BUREAU OF JUSTICE ASSISTANCE GRANT PROGRAMS Criminal Justice Block Grants Application Requirements § 33.41 Application content. (a) Format. Applications from the states for criminal justice block grants...

28 CFR 33.41 - Application content.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Application content. 33.41 Section 33.41 Judicial Administration DEPARTMENT OF JUSTICE BUREAU OF JUSTICE ASSISTANCE GRANT PROGRAMS Criminal Justice Block Grants Application Requirements § 33.41 Application content. (a) Format. Applications from the states for criminal justice block grants...

28 CFR 33.41 - Application content.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Application content. 33.41 Section 33.41 Judicial Administration DEPARTMENT OF JUSTICE BUREAU OF JUSTICE ASSISTANCE GRANT PROGRAMS Criminal Justice Block Grants Application Requirements § 33.41 Application content. (a) Format. Applications from the states for criminal justice block grants...

28 CFR 33.41 - Application content.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Application content. 33.41 Section 33.41 Judicial Administration DEPARTMENT OF JUSTICE BUREAU OF JUSTICE ASSISTANCE GRANT PROGRAMS Criminal Justice Block Grants Application Requirements § 33.41 Application content. (a) Format. Applications from the states for criminal justice block grants...

49 CFR Appendix A to Part 604 - Listing of Human Service Federal Financial Assistance Programs

Code of Federal Regulations, 2013 CFR

2013-10-01

... Programs Health Resources and Services Administration Department of Health and Human Services. 34 Substance Abuse Prevention and Treatment Block Grant Substance Abuse and Mental Health Services Administration Department of Health and Human Services. 35 Prevention and Texas Block Grant Substance Abuse and Mental...

49 CFR Appendix A to Part 604 - Listing of Human Service Federal Financial Assistance Programs

Code of Federal Regulations, 2011 CFR

2011-10-01

... Programs Health Resources and Services Administration Department of Health and Human Services. 34 Substance Abuse Prevention and Treatment Block Grant Substance Abuse and Mental Health Services Administration Department of Health and Human Services. 35 Prevention and Texas Block Grant Substance Abuse and Mental...

28 CFR 33.41 - Application content.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Application content. 33.41 Section 33.41 Judicial Administration DEPARTMENT OF JUSTICE BUREAU OF JUSTICE ASSISTANCE GRANT PROGRAMS Criminal Justice Block Grants Application Requirements § 33.41 Application content. (a) Format. Applications from the states for criminal justice block grants...

31 CFR 515.407 - Administration of blocked estates of decedents.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Administration of blocked estates of decedents. 515.407 Section 515.407 Money and Finance: Treasury Regulations Relating to Money and Finance... qualification of personal representatives, the collection and liquidation of assets, the payment of claims, and...

31 CFR 515.407 - Administration of blocked estates of decedents.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Administration of blocked estates of decedents. 515.407 Section 515.407 Money and Finance: Treasury Regulations Relating to Money and Finance... qualification of personal representatives, the collection and liquidation of assets, the payment of claims, and...

31 CFR 500.407 - Administration of blocked estates of decedents.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Administration of blocked estates of decedents. 500.407 Section 500.407 Money and Finance: Treasury Regulations Relating to Money and Finance... qualification of personal representatives, the collection and liquidation of assets, the payment of claims, and...

31 CFR 515.407 - Administration of blocked estates of decedents.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Administration of blocked estates of decedents. 515.407 Section 515.407 Money and Finance: Treasury Regulations Relating to Money and Finance... qualification of personal representatives, the collection and liquidation of assets, the payment of claims, and...

31 CFR 515.407 - Administration of blocked estates of decedents.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Administration of blocked estates of decedents. 515.407 Section 515.407 Money and Finance: Treasury Regulations Relating to Money and Finance... qualification of personal representatives, the collection and liquidation of assets, the payment of claims, and...

31 CFR 515.407 - Administration of blocked estates of decedents.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Administration of blocked estates of decedents. 515.407 Section 515.407 Money and Finance: Treasury Regulations Relating to Money and Finance... qualification of personal representatives, the collection and liquidation of assets, the payment of claims, and...

[Perioperative management of a patient with myotonic dystrophy developing the cardiac symptoms initially prior to the neuromuscular symptoms].

PubMed

Wake, M; Matsushita, M; Aono, H; Matsumoto, M; Kohri, Y

1994-08-01

The authors anesthetized a 48-year-old woman with endometrial cancer and a large ovarian cyst. She developed cardiac failure initially followed by the sick sinus syndrome and A-V block from hypertrophic cardiomyopathy, prior to neuromuscular symptoms. Epidural anesthesia assisted by general anesthesia was carried out safely without intravenous administration of any muscle relaxants. From this experience, it is considered that epidural anesthesia assisted with some other proper methods is suitable for surgery of lower abdomen.

49 CFR 236.709 - Block, absolute.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Block, absolute. 236.709 Section 236.709 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Block, absolute. A block in which no train is permitted to enter while it is occupied by another train. ...

49 CFR 236.709 - Block, absolute.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 4 2011-10-01 2011-10-01 false Block, absolute. 236.709 Section 236.709 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Block, absolute. A block in which no train is permitted to enter while it is occupied by another train. ...

29 CFR 1919.32 - Specially designed blocks and components.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 7 2010-07-01 2010-07-01 false Specially designed blocks and components. 1919.32 Section 1919.32 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION... Treatment; Competent Persons § 1919.32 Specially designed blocks and components. (a) Blocks and connecting...

75 FR 66304 - New Animal Drugs; Change of Sponsor; Monensin Blocks

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-28

... [Docket No. FDA-2010-N-0002] New Animal Drugs; Change of Sponsor; Monensin Blocks AGENCY: Food and Drug Administration, HHS. ACTION: Final rule. SUMMARY: The Food and Drug Administration (FDA) is amending the animal... animal drug regulations as a sponsor of an approved application. Accordingly, Sec. 510.600 is being...

A Combination of Buprenorphine and Naltrexone Blocks Compulsive Cocaine Intake in Rodents Without Producing Dependence

PubMed Central

Wee, Sunmee; Vendruscolo, Leandro F.; Misra, Kaushik K.; Schlosburg, Joel E.; Koob, George F.

2012-01-01

Buprenorphine, a synthetic opioid that acts at both μ and κ opioid receptors, can decrease cocaine use in individuals with opioid addiction. However, the potent agonist action of buprenorphine at μ opioid receptors raises its potential for creating opioid dependence in non–opioid-dependent cocaine abusers. Here, we tested the hypothesis that a combination of buprenorphine and naltrexone (a potent μ opioid antagonist with weaker δ and κ antagonist properties) could block compulsive cocaine self-administration without producing opioid dependence. The effects of buprenorphine and various doses of naltrexone on cocaine self-administration were assessed in rats that self-administered cocaine under conditions of either short access (noncompulsive cocaine seeking) or extended access (compulsive cocaine seeking). Buprenorphine alone reproducibly decreased cocaine self-administration. Although this buprenorphine-alone effect was blocked in a dose-dependent manner by naltrexone in both the short-access and the extended-access groups, the combination of the lowest dose of naltrexone with buprenorphine blocked cocaine self-administration in the extended-access group but not in the short-access group. Rats given this low dose of naltrexone with buprenorphine did not exhibit the physical opioid withdrawal syndrome seen in rats treated with buprenorphine alone, and naltrexone at this dose did not block κ agonist–induced analgesia. The results suggest that the combination of buprenorphine and naltrexone at an appropriate dosage decreases compulsive cocaine self-administration with minimal liability to produce opioid dependence and may be useful as a treatment for cocaine addiction. PMID:22875830

A combination of buprenorphine and naltrexone blocks compulsive cocaine intake in rodents without producing dependence.

PubMed

Wee, Sunmee; Vendruscolo, Leandro F; Misra, Kaushik K; Schlosburg, Joel E; Koob, George F

2012-08-08

Buprenorphine, a synthetic opioid that acts at both μ and κ opioid receptors, can decrease cocaine use in individuals with opioid addiction. However, the potent agonist action of buprenorphine at μ opioid receptors raises its potential for creating opioid dependence in non-opioid-dependent cocaine abusers. Here, we tested the hypothesis that a combination of buprenorphine and naltrexone (a potent μ opioid antagonist with weaker δ and κ antagonist properties) could block compulsive cocaine self-administration without producing opioid dependence. The effects of buprenorphine and various doses of naltrexone on cocaine self-administration were assessed in rats that self-administered cocaine under conditions of either short access (noncompulsive cocaine seeking) or extended access (compulsive cocaine seeking). Buprenorphine alone reproducibly decreased cocaine self-administration. Although this buprenorphine-alone effect was blocked in a dose-dependent manner by naltrexone in both the short-access and the extended-access groups, the combination of the lowest dose of naltrexone with buprenorphine blocked cocaine self-administration in the extended-access group but not in the short-access group. Rats given this low dose of naltrexone with buprenorphine did not exhibit the physical opioid withdrawal syndrome seen in rats treated with buprenorphine alone, and naltrexone at this dose did not block κ agonist-induced analgesia. The results suggest that the combination of buprenorphine and naltrexone at an appropriate dosage decreases compulsive cocaine self-administration with minimal liability to produce opioid dependence and may be useful as a treatment for cocaine addiction.

Blockade of Cocaine or σ Receptor Agonist Self Administration by Subtype-Selective σ Receptor Antagonists.

PubMed

Katz, Jonathan L; Hiranita, Takato; Kopajtic, Theresa A; Rice, Kenner C; Mesangeau, Christophe; Narayanan, Sanju; Abdelazeem, Ahmed H; McCurdy, Christopher R

2016-07-01

The identification of sigma receptor (σR) subtypes has been based on radioligand binding and, despite progress with σ1R cellular function, less is known about σR subtype functions in vivo. Recent findings that cocaine self administration experience will trigger σR agonist self administration was used in this study to assess the in vivo receptor subtype specificity of the agonists (+)-pentazocine, PRE-084 [2-(4-morpholinethyl) 1-phenylcyclohexanecarboxylate hydrochloride], and 1,3-di-o-tolylguanidine (DTG) and several novel putative σR antagonists. Radioligand binding studies determined in vitro σR selectivity of the novel compounds, which were subsequently studied for self administration and antagonism of cocaine, (+)-pentazocine, PRE-084, or DTG self administration. Across the dose ranges studied, none of the novel compounds were self administered, nor did they alter cocaine self administration. All compounds blocked DTG self administration, with a subset also blocking (+)-pentazocine and PRE-084 self administration. The most selective of the compounds in binding σ1Rs blocked cocaine self administration when combined with a dopamine transport inhibitor, either methylphenidate or nomifensine. These drug combinations did not decrease rates of responding maintained by food reinforcement. In contrast, the most selective of the compounds in binding σ2Rs had no effect on cocaine self administration in combination with either dopamine transport inhibitor. Thus, these results identify subtype-specific in vivo antagonists, and the utility of σR agonist substitution for cocaine self administration as an assay capable of distinguishing σR subtype selectivity in vivo. These results further suggest that effectiveness of dual σR antagonism and dopamine transport inhibition in blocking cocaine self administration is specific for σ1Rs and further support this dual targeting approach to development of cocaine antagonists. U.S. Government work not protected by U.S. copyright.

21 CFR 882.5070 - Bite block.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Bite block. 882.5070 Section 882.5070 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5070 Bite block. (a) Identification. A bite block...

21 CFR 882.5070 - Bite block.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Bite block. 882.5070 Section 882.5070 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Therapeutic Devices § 882.5070 Bite block. (a) Identification. A bite block...

30 CFR 77.1505 - Auger holes; blocking.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Auger holes; blocking. 77.1505 Section 77.1505 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH... § 77.1505 Auger holes; blocking. Auger holes shall be blocked with highwall spoil or other suitable...

30 CFR 77.1505 - Auger holes; blocking.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Auger holes; blocking. 77.1505 Section 77.1505 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH... § 77.1505 Auger holes; blocking. Auger holes shall be blocked with highwall spoil or other suitable...

30 CFR 77.1505 - Auger holes; blocking.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Auger holes; blocking. 77.1505 Section 77.1505 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH... § 77.1505 Auger holes; blocking. Auger holes shall be blocked with highwall spoil or other suitable...

30 CFR 77.1505 - Auger holes; blocking.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Auger holes; blocking. 77.1505 Section 77.1505 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH... § 77.1505 Auger holes; blocking. Auger holes shall be blocked with highwall spoil or other suitable...

30 CFR 77.1505 - Auger holes; blocking.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Auger holes; blocking. 77.1505 Section 77.1505 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH... § 77.1505 Auger holes; blocking. Auger holes shall be blocked with highwall spoil or other suitable...

Rework and workarounds in nurse medication administration process: implications for work processes and patient safety.

PubMed

Halbesleben, Jonathon R B; Savage, Grant T; Wakefield, Douglas S; Wakefield, Bonnie J

2010-01-01

Health care organizations have redesigned existing and implemented new work processes intended to improve patient safety. As a consequence of these process changes, there are now intentionally designed "blocks" or barriers that limit how specific work actions, such as ordering and administering medication, are to be carried out. Health care professionals encountering these designed barriers can choose to either follow the new process, engage in workarounds to get past the block, or potentially repeat work (rework). Unfortunately, these workarounds and rework may lead to other safety concerns. The aim of this study was to examine rework and workarounds in hospital medication administration processes. Observations and semistructured interviews were conducted with 58 nurses from four hospital intensive care units focusing on the medication administration process. Using the constant comparative method, we analyzed the observation and interview data to develop themes regarding rework and workarounds. From this analysis, we developed an integrated process map of the medication administration process depicting blocks. A total of 12 blocks were reported by the participants. Based on the analysis, we categorized them as related to information exchange, information entry, and internal supply chain issues. Whereas information exchange and entry blocks tended to lead to rework, internal supply chain issues were more likely to lead to workarounds. A decentralized pharmacist on the unit may reduce work flow blocks (and, thus, workarounds and rework). Work process redesign may further address the problems of workarounds and rework.

General view of east yard, facing south (note from right ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

General view of east yard, facing south (note from right to left: cell block fourteen, cell block eleven, cell block fifteen, cell block two, greenhouse, and cell block ten) - Eastern State Penitentiary, 2125 Fairmount Avenue, Philadelphia, Philadelphia County, PA

Administration of magnesium sulphate before rocuronium: effects on speed of onset and duration of neuromuscular block.

PubMed

Kussman, B; Shorten, G; Uppington, J; Comunale, M E

1997-07-01

The speeds of onset of pancuronium, atracurium and vecuronium are increased by prior administration of magnesium sulphate. A prospective, randomized, double-blind, controlled, clinical study was performed to examine the effects of prior i.v. administration of magnesium sulphate 60 mg kg-1 on the neuromuscular blocking effects of rocuronium 0.6 mg kg-1 during isoflurane anaesthesia. Neuromuscular function was measured electromyographically (Relaxograph) in 30 patients who received either magnesium sulphate 60 mg kg-1 or normal saline, 1-min before rocuronium 0.6 mg kg-1. Mean onset times were similar in the two groups (magnesium sulphate 71 (SD 20) s; normal saline 75 (23) s), but times to initial, 10% and 25% recovery from neuromuscular block were significantly longer in the magnesium sulphate group (42.1 (16.3), 49.0 (12.4) and 56.5 (13.2) min, respectively) than in the saline group (25.1 (9.1), 33.0 (11.1) and 35.6 (13.2) min, respectively) (P < 0.05 in all three cases). Administration of magnesium sulphate was not associated with adverse haemodynamic effects. Prior administration of magnesium sulphate, under the study conditions described, prolonged rocuronium-induced neuromuscular block but did not increase speed of onset.

Effect of Oral Premedication on the Efficacy of Inferior Alveolar Nerve Block in Patients with Symptomatic Irreversible Pulpitis: A Prospective, Double-Blind, Randomized Controlled Clinical Trial.

PubMed

Saha, Suparna Ganguly; Jain, Sohini; Dubey, Sandeep; Kala, Shubham; Misuriya, Abhinav; Kataria, Devendra

2016-02-01

It is generally accepted that achieving complete anaesthesia with an Inferior Alveolar Nerve Block (IANB) in mandibular molars with symptomatic irreversible pulpitis is more challenging than for other teeth. Therefore, administration of Non-Steroidal Anti-Inflammatory Agents (NSAIDs) 1 hour prior to anaesthetic administration has been proposed as a means to increase the efficacy of the IANB in such patients. The purpose of this prospective, double-blind, randomized clinical trial was to determine the effect of administration of oral premedication with ketorolac (KETO) and diclofenac potassium (DP) on the efficacy of IANB in patients with irreversible pulpitis. One hundred and fifty patients with irreversible pulpitis were evaluated preoperatively for pain using Heft Parker visual analogue scale, after which they were randomly divided into three groups. The subjects received identical tablets of ketorolac, diclofenac pottasium or cellulose powder (placebo), 1 hour prior to administration of IANB with 2% lidocaine containing 1:200 000 epinephrine. Lip numbness as well as positive and negative responses to cold test were ascertained. Additionally pain score of each patient was recorded during cavity preparation and root canal instrumentation. Success was defined as the absence of pain or mild pain based on the visual analog scale readings. The data was analysed using One-Way Anova, Post-Hoc Tukey pair wise, Paired T - Test and chi-square test. Trial Registery Number is 4722/2015 for this clinical trial study. There were no significant differences with respect to age (p =0.098), gender (p = 0.801) and pre-VAS score (DP-KETO p=0.645, PLAC-KETO p =0.964, PLAC-DP p = 0.801) between the three groups. All patients had subjective lip anaesthesia with the IAN blocks. Patients of all the three groups reported a significant decrease in active pain after local anaesthesia (p< 0.05). The post injection VAS Score was least in group 1 (KETO) followed by group II (DP) & maximum in group III (PLACEBO). Oral pre-medication with 10 mg KETO resulted in significantly higher percentage of successful inferior alveolar block in patients with irreversible pulpitis than pre-medication with 50 mg DP & PLAC.

Effect of Oral Premedication on the Efficacy of Inferior Alveolar Nerve Block in Patients with Symptomatic Irreversible Pulpitis: A Prospective, Double-Blind, Randomized Controlled Clinical Trial

PubMed Central

Saha, Suparna Ganguly; Dubey, Sandeep; Kala, Shubham; Misuriya, Abhinav; Kataria, Devendra

2016-01-01

Introduction It is generally accepted that achieving complete anaesthesia with an Inferior Alveolar Nerve Block (IANB) in mandibular molars with symptomatic irreversible pulpitis is more challenging than for other teeth. Therefore, administration of Non-Steroidal Anti-Inflammatory Agents (NSAIDs) 1 hour prior to anaesthetic administration has been proposed as a means to increase the efficacy of the IANB in such patients. Aim The purpose of this prospective, double-blind, randomized clinical trial was to determine the effect of administration of oral premedication with ketorolac (KETO) and diclofenac potassium (DP) on the efficacy of IANB in patients with irreversible pulpitis. Materials and Methods One hundred and fifty patients with irreversible pulpitis were evaluated preoperatively for pain using Heft Parker visual analogue scale, after which they were randomly divided into three groups. The subjects received identical tablets of ketorolac, diclofenac pottasium or cellulose powder (placebo), 1 hour prior to administration of IANB with 2% lidocaine containing 1:200 000 epinephrine. Lip numbness as well as positive and negative responses to cold test were ascertained. Additionally pain score of each patient was recorded during cavity preparation and root canal instrumentation. Success was defined as the absence of pain or mild pain based on the visual analog scale readings. The data was analysed using One-Way Anova, Post-Hoc Tukey pair wise, Paired T – Test and chi-square test. Trial Registery Number is 4722/2015 for this clinical trial study. Results There were no significant differences with respect to age (p =0.098), gender (p = 0.801) and pre-VAS score (DP-KETO p=0.645, PLAC-KETO p =0.964, PLAC-DP p = 0.801) between the three groups. All patients had subjective lip anaesthesia with the IAN blocks. Patients of all the three groups reported a significant decrease in active pain after local anaesthesia (p< 0.05). The post injection VAS Score was least in group 1 (KETO) followed by group II (DP) & maximum in group III (PLACEBO). Conclusion Oral pre-medication with 10 mg KETO resulted in significantly higher percentage of successful inferior alveolar block in patients with irreversible pulpitis than pre-medication with 50 mg DP & PLAC. PMID:27042580

Pectoral nerve block (Pecs block) with sedation for breast conserving surgery without general anesthesia.

PubMed

Moon, Eun-Jin; Kim, Seung-Beom; Chung, Jun-Young; Song, Jeong-Yoon; Yi, Jae-Woo

2017-09-01

Most regional anesthesia in breast surgeries is performed as postoperative pain management under general anesthesia, and not as the primary anesthesia. Regional anesthesia has very few cardiovascular or pulmonary side-effects, as compared with general anesthesia. Pectoral nerve block is a relatively new technique, with fewer complications than other regional anesthesia. We performed Pecs I and Pec II block simultaneously as primary anesthesia under moderate sedation with dexmedetomidine for breast conserving surgery in a 49-year-old female patient with invasive ductal carcinoma. Block was uneventful and showed no complications. Thus, Pecs block with sedation could be an alternative to general anesthesia for breast surgeries.

77 FR 42749 - Proposed Change in State Title V Maternal and Child Health Block Grant Allocations

Federal Register 2010, 2011, 2012, 2013, 2014

2012-07-20

... Change in State Title V Maternal and Child Health Block Grant Allocations AGENCY: Health Resources and... the State Title V Maternal and Child Health (MCH) Block Grant allocations. Through the Health Resources and Services Administration's Maternal and Child Health Bureau (MCHB), Title V MCH Block Grant...

Pectoral nerve block (Pecs block) with sedation for breast conserving surgery without general anesthesia

PubMed Central

Moon, Eun-Jin; Kim, Seung-Beom; Chung, Jun-Young; Song, Jeong-Yoon

2017-01-01

Most regional anesthesia in breast surgeries is performed as postoperative pain management under general anesthesia, and not as the primary anesthesia. Regional anesthesia has very few cardiovascular or pulmonary side-effects, as compared with general anesthesia. Pectoral nerve block is a relatively new technique, with fewer complications than other regional anesthesia. We performed Pecs I and Pec II block simultaneously as primary anesthesia under moderate sedation with dexmedetomidine for breast conserving surgery in a 49-year-old female patient with invasive ductal carcinoma. Block was uneventful and showed no complications. Thus, Pecs block with sedation could be an alternative to general anesthesia for breast surgeries. PMID:28932733

49 CFR 236.710 - Block, latch.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Block, latch. 236.710 Section 236.710 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Block, latch. The lower extremity of a latch rod which engages with a square shoulder of the segment or...

Repeated chlorpromazine administration increases a behavioural response of rats to 5-hydroxytryptamine receptor stimulation.

PubMed Central

Green, A R

1977-01-01

1 The hyperactivity syndrome produced in rats by administration of tranylcypromine (20 mg/kg i.p.) followed 30 min later by L-tryptophan (50 mg/kg i.p.) is generally considered to be due to increased 5-hydroxytryptamine (5-HT) functional activity. It is inhibited by chlorpromazine (30 mg/kg i.p.) injected 60 min before the tranylcypromine. However, chlorpromazine injection for 4 days either at a dose of 30 mg/kg once daily or 5 mg/kg twice daily results in an enhanced hyperactivity response to tranylcypromine and L-tryptophan administration 24 h after the final dose of chlorpromazine. 2 One injection of chlorpromazine (30 mg/kg) did not produce enhancement 24 h later and the inhibition of the tranylcypromine/L-tryptophan hyperactivity observed after acute chlorpromazine injection was seen if the rats were given tranylcypromine and L-tryptophan 1 h after the fourth chlorpromazine (30 mg/kg) dose. 3 Chlorpromazine (30 mg/kg) once daily or 5 mg/kg twice daily for 4 days resulted in rats displaying enhanced behavioral responses to the suggested 5-HT agonist 5-methoxy N,N-dimethyltryptamine (2 mg/kg) on day 5. 4 Chlorpromazine (30 mg/kg) once daily for 4 days produces a slight increase in brain 5-hydroxytryptamine (5-HT) concentration on day 5, but no difference in the rate of brain 5-HT synthesis or the rate of 5-HT accumulation after tranylcypromine and L-tryptophan administration. 5. There is some evidence that chlorpromazine blocks 5-HT receptors. It has also been observed that several other neuroleptic drugs do not produce enhanced 5-HT responses after repeated administration. It is suggested therefore that the enhanced behavioural response to 5-HT receptor stimulation following repeated chlorpromazine administration may be because this drug blocks 5-HT receptors. PMID:264797

Blocking effect of McN-A-343 on cardiac slowing produced by vagal stimulation

PubMed Central

Chiba, S.; Hashimoto, K.; Kubota, K.; Satoh, S.

1971-01-01

The effect of McN-A-343 was studied by direct administration into the sinus node artery of dogs vagotomized at the mid-cervical level. McN-A-343 blocked sinus bradycardia caused by electrical stimulation of the right vagus, while bradycardia induced by administration of acetylcholine or nicotine into the sinus node artery was not modified. PMID:5157729

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

Edwards, P.L.

As the Oct. 31 deadline for an initial design review approaches, the four participants in the Energy Research and Development Administration's (ERDA) industrial process hot water program are putting the final touches to plans for solar systems that will supplement conventional energy sources in the textile, food processing, concrete block and cleaning industries. Participating in the project are AAI Corp., Baltimore, which designed a solar hot water system for the concrete block curing operation of York Building Products Co., Harrisburg, Pa.; Acurex Corp., Mountain View, Calif., which designed a solar hot water system for a can washing line at themore » Campbell Soup Co. plant in Sacramento, Calif.; General Electric Co., Philadelphia, which designed a solar hot water system for Riegel Textile Corp., La France, S.C.; and Jacobs Engineering Co., Pasadena, Calif., which designed a solar hot water and steam system for commercial laundry use at American Linen Supply in El Centro., Calif. (MCW)« less

Generalized seizures and transient contralateral hemiparesis following retrobulbar anesthesia: a case report.

PubMed

Dettoraki, Maria; Dimitropoulou, Chrisafoula; Nomikarios, Nikolaos; Moschos, Marilita M; Brοuzas, Dimitrios

2015-07-28

Retrobulbar block is a local anesthetic technique widely used for intraocular surgery. Although retrobulbar anesthesia is considered to be relatively safe, a number of serious adverse events have been reported. To our knowledge, immediate onset of generalized seizures with contralateral hemiparesis after retrobulbar anesthesia has not been reported. A 62-year-old Caucasian healthy male with a right eye retinal detachment was admitted for pars plana vitrectomy. During retrobulbar anesthesia with ropivacaine and before needle withdrawal, the patient developed twitching of the face which rapidly progressed to generalized tonic-clonic seizures. Arterial oxygen saturation decreased to 75 %. Chin lift was performed and 100 % oxygen was administrated via face mask, which increased saturation to 99 %. Midazolam 2 mg was administrated intravenously to control seizures. After cessation of seizures, left-sided hemiparesis was evident. Brain computed tomography and electroencephalogram were normal 3 h later. The patient underwent pars plana vitrectomy under general anesthesia 4 days later. Serious complications of local anesthesia for ophthalmic surgery are uncommon. We present a case in which generalized tonic-clonic seizures developed during retrobulbar anesthesia, followed by transient contralateral hemiparesis. The early onset of seizures indicated intra-arterial injection of the anesthetic. Our case suggested the need for close monitoring during the performance of retrobulbar anesthesia and the presence of well-trained personnel for early recognition and immediate management of the complications.

Effect of preoperative alprazolam on the success of inferior alveolar nerve block for teeth with irreversible pulpitis.

PubMed

Khademi, Abbas Ali; Saatchi, Masoud; Minaiyan, Mohsen; Rostamizadeh, Nasim; Sharafi, Fatemeh

2012-10-01

Success of inferior alveolar nerve (IAN) block decreases in patients with irreversible pulpitis. The purpose of this study was to evaluate the effect of preoperative administration of alprazolam on the success of the IAN block for teeth with irreversible pulpitis. Sixty patients with irreversible pulpitis of a mandibular molar were selected for this prospective, randomized, double-blind, placebo-controlled study. The patients received identical capsules of either 0.5 mg of alprazolam or placebo 45 minutes before the administration of a conventional IAN block. Access cavity preparation was initiated 15 minutes after the IAN block injection. Lip numbness was recorded for all the patients. Success was defined as no or mild pain on the basis of visual analogue scale recordings during access cavity preparation and initial instrumentation. Data were analyzed by t test, Mann-Whitney, and χ(2) tests. The success rate was 53% for alprazolam group and 40% for placebo group, with no significant difference between the 2 groups (P = .301). Within the scope of the current study, preoperative oral administration of 0.5 mg of alprazolam did not improve the success of the IAN block in mandibular molars in patients with irreversible pulpitis, and the success rate was not adequate to ensure profound pulpal anesthesia. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

A Role for Sigma Receptors in Stimulant Self-Administration and Addiction.

PubMed

Katz, Jonathan L; Hiranita, Takato; Hong, Weimin C; Job, Martin O; McCurdy, Christopher R

2017-01-01

Sigma receptors (σRs) are structurally unique proteins that function intracellularly as chaperones. Historically, σRs have been implicated as modulators of psychomotor stimulant effects and have at times been proposed as potential avenues for modifying stimulant abuse. However, the influence of ligands for σRs on the effects of stimulants, such as cocaine or methamphetamine, in various preclinical procedures related to drug abuse has been varied. The present paper reviews the effects of σR agonists and antagonists in three particularly relevant procedures: stimulant discrimination, place conditioning, and self-administration. The literature to date suggests limited σR involvement in the discriminative-stimulus effects of psychomotor stimulants, either with σR agonists substituting for the stimulant or with σR antagonists blocking stimulant effects. In contrast, studies of place conditioning suggest that administration of σR antagonists or down-regulation of σR protein can block the place conditioning induced by stimulants. Despite place conditioning results, selective σR antagonists are inactive in blocking the self-administration of stimulants. However, compounds binding to the dopamine transporter and blocking σRs can selectively decrease stimulant self-administration. Further, after self-administration of stimulants, σR agonists are self-administered, an effect not seen in subjects without that specific history. These findings suggest that stimulants induce unique changes in σR activity, and once established, the changes induced create redundant, and dopamine independent reinforcement pathways. Concomitant targeting of both dopaminergic pathways and σR proteins produces a selective antagonism of those pathways, suggesting new avenues for combination chemotherapies to specifically combat stimulant abuse.

49 CFR 230.65 - Steam blocking view of engine crew.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Steam blocking view of engine crew. 230.65 Section... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION STEAM LOCOMOTIVE INSPECTION AND MAINTENANCE STANDARDS Boilers and Appurtenances Steam Leaks § 230.65 Steam blocking view of engine crew. The steam locomotive owner and/or...

Conformal blocks from Wilson lines with loop corrections

NASA Astrophysics Data System (ADS)

Hikida, Yasuaki; Uetoko, Takahiro

2018-04-01

We compute the conformal blocks of the Virasoro minimal model or its WN extension with large central charge from Wilson line networks in a Chern-Simons theory including loop corrections. In our previous work, we offered a prescription to regularize divergences from loops attached to Wilson lines. In this paper, we generalize our method with the prescription by dealing with more general operators for N =3 and apply it to the identity W3 block. We further compute general light-light blocks and heavy-light correlators for N =2 with the Wilson line method and compare the results with known ones obtained using a different prescription. We briefly discuss general W3 blocks.

45 CFR 96.50 - Complaints.

Code of Federal Regulations, 2011 CFR

2011-10-01

... Services Administration. Complaints with respect to the social services block grant must be submitted in... block grant programs. In resolving any issue raised by a complaint or a Federal audit the Department...

[Effect of spatial location on the generality of block-wise conflict adaptation between different types of scripts].

PubMed

Watanabe, Yurina; Yoshizaki, Kazuhito

2014-10-01

This study aimed to investigate the generality of conflict adaptation associated with block-wise conflict frequency between two types of stimulus scripts (Kanji and Hiragana). To this end, we examined whether the modulation of the compatibility effect with one type of script depending on block-wise conflict frequency (75% versus 25% generalized to the other type of script whose block-wise conflict frequency was kept constant (50%), using the Spatial Stroop task. In Experiment 1, 16 participants were required to identify the target orientation (up or down) presented in the upper or lower visual-field. The results showed that block-wise conflict adaptation with one type of stimulus script generalized to the other. The procedure in Experiment 2 was the same as that in Experiment 1, except that the presentation location differed between the two types of stimulus scripts. We did not find a generalization from one script to the other. These results suggest that presentation location is a critical factor contributing to the generality of block-wise conflict adaptation.

High prevalence and risk factors associated with latent tuberculous infection in two Colombian prisons.

PubMed

Rueda, Z V; Arroyave, L; Marin, D; López, L; Keynan, Y; Giraldo, M R; Pulido, H; Arbeláez, M P

2014-10-01

Two prisons in Medellín and Itagüí, Colombia. To determine the prevalence of tuberculin skin test (TST) positivity in prisoners and the annual risk of tuberculous infection (ARTI), to identify risk factors associated with a positive result, and to describe progression to active disease. Cross-sectional study. Inmates were included if time of incarceration was ⩾1 year and excluded if subjects had had previous or active tuberculosis (TB), or conditions that could hamper TST administration or interpretation. We screened 1014 inmates. The overall prevalence of TST positivity was 77.6%. The first TST administration resulted in 66% positivity, and the second TST an additional 11.6%. In Prison One, the ARTI was 5.09% in high TB incidence cell blocks and 2.72% in low TB incidence blocks. In Prison Two, the ARTI was 2.77%. Risk factors associated with TST positivity were history of previous incarceration and length of incarceration. Among all those included in the study, four individuals developed active pulmonary TB. Prevalence of TST positivity in prisoners and the ARTI were higher than in the general population, but differed between prisons; it is important to apply a second TST to avoid an overestimation of converters during follow-up.

A Miracle That Accelerates Operating Room Functionality: Sugammadex

PubMed Central

Dogan, Erdal; Akdemir, Mehmet Salim; Guzel, Abdulmenap; Yildirim, Mehmet Besir; Baysal Yildirim, Zeynep; Kuyumcu, Mahir; Gümüş, Abdurrahman; Akelma, Hakan

2014-01-01

Background. Sugammadex offers a good alternative to the conventional decurarisation process currently performed with cholinesterase inhibitors. Sugammadex, which was developed specifically for the aminosteroid-structured rocuronium and vecuronium neuromuscular blockers, is a modified cyclodextrin made up of 8 glucose monomers arranged in a cylindrical shape. Methods. In this study, the goal was to investigate the efficacy of sugammadex. Sugammadex was used when there was insufficient decurarisation following neostigmine. This study was performed on 14 patients who experienced insufficient decurarisation (TOF <0.9) with neostigmine after general anaesthesia in the operating rooms of a university and a state hospital between June, 2012, and January, 2014. A dose of 2 mg/kg of sugammadex was administered. Results. Time elapsed until sugammadex administration following neostigmine 37 ± 6 min, following sugammadex it took 2.1 ± 0.9 min to reach TOF ≥0.9, and the extubation time was 3.2 ± 1.4 min. No statistically significant differences were detected in the hemodynamic parameters before and after sugammadex application. From the time of administration of sugammadex to the second postoperative hour, no side effects or complications occurred. None of the patients experienced acute respiratory failure or residual block during this time period. Conclusion. Sugammadex was successfully used to reverse rocuronium-induced neuromuscular block in patients where neostigmine was insufficient. PMID:25202709

78 FR 27472 - Agency Information Collection Activities: Requests for Comments; Clearance of New Approval of...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-10

... Display to Industry (ASDI) Block Requests AGENCY: Federal Aviation Administration (FAA), DOT. ACTION... information will be used by the National Air Space Data Release Office to block aircraft flight data as... Display to Industry (ASDI) Block Requests. Form Numbers: There are no FAA forms associated with this...

14 CFR 33.41 - Applicability.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT AIRWORTHINESS STANDARDS: AIRCRAFT ENGINES Block Tests; Reciprocating Aircraft Engines § 33.41 Applicability. This subpart prescribes the block tests and inspections for reciprocating aircraft engines. ...

Blocking Infralimbic Basic Fibroblast Growth Factor (bFGF or FGF2) Facilitates Extinction of Drug Seeking After Cocaine Self-Administration.

PubMed

Hafenbreidel, Madalyn; Twining, Robert C; Rafa Todd, Carolynn; Mueller, Devin

2015-12-01

Drug exposure results in structural and functional changes in brain regions that regulate reward and these changes may underlie the persistence of compulsive drug seeking and relapse. Neurotrophic factors, such as basic fibroblast growth factor (bFGF or FGF2), are necessary for neuronal survival, growth, and differentiation, and may contribute to these drug-induced changes. Following cocaine exposure, bFGF is increased in addiction-related brain regions, including the infralimbic medial prefrontal cortex (IL-mPFC). The IL-mPFC is necessary for extinction, but whether drug-induced overexpression of bFGF in this region affects extinction of drug seeking is unknown. Thus, we determined whether blocking bFGF in IL-mPFC would facilitate extinction following cocaine self-administration. Rats were trained to lever press for intravenous infusions of cocaine before extinction. Blocking bFGF in IL-mPFC before four extinction sessions resulted in facilitated extinction. In contrast, blocking bFGF alone was not sufficient to facilitate extinction, as blocking bFGF and returning rats to their home cage had no effect on subsequent extinction. Furthermore, bFGF protein expression increased in IL-mPFC following cocaine self-administration, an effect reversed by extinction. These results suggest that cocaine-induced overexpression of bFGF inhibits extinction, as blocking bFGF during extinction permits rapid extinction. Therefore, targeted reductions in bFGF during therapeutic interventions could enhance treatment outcomes for addiction.

Accuracy of pulse oximeter perfusion index in thoracic epidural anesthesia under basal general anesthesia.

PubMed

Xu, Zifeng; Zhang, Jianhai; Xia, Yunfei; Deng, Xiaoming

2014-01-01

To observe the change of PVI after thoracic epidural block on the basis of general anesthesia. In 26 patients undergoing elective upper abdominal operations, changes of SVI, PVI, SVV, PPV and CVP were monitored immediately before and 10 minutes after T8-9 thoracic epidural anesthesia on the basis of general anesthesia. The definition was that patients with ΔSVI greater than 10% belonged to response group to epidural block. Before epidural block, the PVI, SVV and PPV baseline values in patients of response group were significantly higher than those in patients of non-response group. PVI, SVV and PPV after epidural block were significantly higher than immediately before epidural block (P < 0.001). PVI, SVV and PPV baseline values immediately before epidural block were positively correlated with ΔSVI; the correlation coefficients were 0.70, 0.71 and 0.63, respectively, P ≤ 0.001. The optimal critical values for PVI, SVV and PPV to predict response to T8-9 gap epidural block under general anesthesia were 16% (sensitivity 80%, specificity 92%), 13% (sensitivity 90%, specificity 62%) and 12% (sensitivity 90%, specificity 77%), respectively. PVI can be used as a noninvasive indictor to monitor volume change after thoracic epidural block on the basis of general anesthesia.

Ultrasound guided transversus abdominis plane vs surgeon administered intraoperative regional field infiltration with bupivacaine for early postoperative pain control in children undergoing open pyeloplasty.

PubMed

Lorenzo, Armando J; Lynch, Johanne; Matava, Clyde; El-Beheiry, Hossam; Hayes, Jason

2014-07-01

Regional analgesic techniques are commonly used in pediatric urology. Ultrasound guided transversus abdominis plane block has recently gained popularity. However, there is a paucity of information supporting a benefit over regional field infiltration. We present a parallel group, randomized, controlled trial evaluating ultrasound guided transversus abdominis plane block superiority over surgeon delivered regional field infiltration for children undergoing open pyeloplasty at a tertiary referral center. Following ethics board approval and registration, children 0 to 6 years old were recruited and randomized to undergo perioperative transversus abdominis plane block or regional field infiltration for early post-pyeloplasty pain control. General anesthetic delivery, surgical technique and postoperative analgesics were standardized. A blinded assessor regularly captured pain scores in the recovery room using the FLACC (Face, Legs, Activity, Cry, Consolability) scale. The primary outcome was the need for rescue morphine administration based on a FLACC score of 3 or higher. Two pediatric urologists performed 57 pyeloplasties during a 2.5-year period, enrolling 32 children (16 in each group, balanced for age and weight). There were statistically significant differences in the number of children requiring rescue morphine administration (13 of 16 receiving transversus abdominis plane block and 6 of 16 receiving regional field infiltration, p = 0.011), mean ± SD total morphine consumption (0.066 ± 0.051 vs 0.028 ± 0.040 mg/kg, p = 0.021) and mean ± SD pain scores (5 ± 5 vs 2 ± 3, p = 0.043) in the recovery room, in favor of surgeon administered regional field infiltration. No local anesthetic specific adverse events were noted. Ultrasound guided transversus abdominis plane block is not superior to regional field infiltration with bupivacaine as a strategy to minimize early opioid requirements following open pyeloplasty in children. Instead, our data suggest that surgeon delivered regional field infiltration provides better pain control. Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Optimization of aircraft seat cushion fire blocking layers

NASA Technical Reports Server (NTRS)

Kourtides, D. A.; Parker, J. A.; Ling, A. C.; Hovatter, W. R.

1983-01-01

This report describes work completed by the National Aeronautics and Space Administration - for the Federal Aviation Administration Technical Center. The purpose of this work was to examine the potential of fire blocking mechanisms for aircraft seat cushions in order to provide an optimized seat configuration with adequate fire protection and minimum weight. Aluminized thermally stable fabrics were found to provide adequate fire protection when used in conjunction with urethane foams, while maintaining minimum weight and cost penalty.

An Examination of General Psychology as a Foundation Block in Psychology

ERIC Educational Resources Information Center

Parish, Thomas S.; Swenka, Jobyna J.

2007-01-01

What is "General Psychology?" Is it just one course that could be an elective, part of a minor, or part of a student's major? Or could "General Psychology" literally be the "corner stone" or "foundation block" upon which all the other psychology courses, taken afterwards, add to like bricks upon a "foundation block?" This paper will seek to…

Anticonvulsant effects of mefloquine on generalized tonic-clonic seizures induced by two acute models in rats.

PubMed

Franco-Pérez, Javier; Ballesteros-Zebadúa, Paola; Manjarrez-Marmolejo, Joaquín

2015-03-01

Mefloquine can cross the blood-brain barrier and block the gap junction intercellular communication in the brain. Enhanced electrical coupling mediated by gap junctions is an underlying mechanism involved in the generation and maintenance of seizures. For this reason, the aim of this study was to analyze the effects of the systemic administration of mefloquine on tonic-clonic seizures induced by two acute models such as pentylenetetrazole and maximal electroshock. All the control rats presented generalized tonic-clonic seizures after the administration of pentylenetetrazole. However, the incidence of seizures induced by pentylenetetrazole significantly decreased in the groups administered systematically with 40 and 80 mg/kg of mefloquine. In the control group, none of the rats survived after the generalized tonic-clonic seizures induced by pentylenetetrazole, but survival was improved by mefloquine. Besides, mefloquine significantly modified the total spectral power as well as the duration, amplitude and frequency of the epileptiform activity induced by pentylenetetrazole. For the maximal electroshock model, mefloquine did not change the occurrence of tonic hindlimb extension. However, this gap junction blocker significantly decreased the duration of the tonic hindlimb extension induced by the acute electroshock. These data suggest that mefloquine at low doses might be eliciting some anticonvulsant effects when is systemically administered to rats.

Assessment of tolerance to the effects of methamphetamine on daytime and nighttime activity evaluated with actigraphy in rhesus monkeys.

PubMed

Berro, Laís F; Andersen, Monica L; Howell, Leonard L

2017-08-01

Methamphetamine is one of the most largely consumed illicit drugs, and its use is associated with abuse liability and several adverse health effects, such as sleep impairment. Importantly, sleep quality can influence addiction treatment outcomes. Evidence suggests that tolerance can develop to the sleep-disrupting effects of stimulant drugs. The aim of the present study was to investigate the development of tolerance to the actigraphy-based sleep-disrupting and stimulant effects of methamphetamine self-administration in rhesus monkeys. Methamphetamine (0.03 mg/kg/inf, i.v.) self-administration was carried out following three different protocols: 14 consecutive days of self-administration, 5 days/week for 3 weeks, with a 2-day interval between 5-day blocks of self-administration, and 3 days/week for 3 weeks, with a 4-day interval between 3-day blocks of self-administration. Daytime activity and activity-based sleep measures were evaluated with Actiwatch monitors a week before (baseline parameters) and throughout each protocol. Methamphetamine self-administration markedly disrupted sleep-like measures and increased daytime activity. Tolerance developed to those effects with repeated methamphetamine intake exceeding five consecutive days. Inclusion of washout periods (2 or 4 days) between blocks of methamphetamine self-administration attenuated the development of tolerance, with longer breaks from methamphetamine intake being more effective in maintaining the sleep-disrupting and stimulant effects of methamphetamine. Tolerance can develop to the stimulant and sleep-disrupting effects of methamphetamine self-administration. Interruption of drug intake extends the effects of methamphetamine on sleep-like measures and daytime activity.

Chronological Changes in Ropivacaine Concentration and Analgesic Effects Between Transversus Abdominis Plane Block and Rectus Sheath Block.

PubMed

Murouchi, Takeshi; Iwasaki, Soshi; Yamakage, Michiaki

2015-01-01

Transversus abdominis plane block (TAPB) and rectus sheath block (RSB) are popular methods of controlling postoperative pain. Chronological changes in blood concentrations of local anesthetics have not been described, although a large amount of local anesthetic is required to block these compartments. We postulated that blood concentrations of anesthetics would peak earlier during TAPB than RSB (primary end point). Secondary end points were elapsed time from block until first postoperative rescue analgesia and affected dermatomes. This prospective, randomized study included 22 patients scheduled for laparoscopic ovarian surgery under general anesthesia. The patients were randomized to receive either a bilateral single-shot TAPB or a bilateral RSB (15 mL of 0.5% ropivacaine per side). Arterial blood was sampled 10, 20, 30, 45, 60, 90, and 120 minutes after ropivacaine administration. This trial was registered at the UMIN-Clinical Trials Registry (UMIN000012133) before patient recruitment. Arterial ropivacaine levels after block peaked earlier in the TAPB than in RSB [Tmax: 35 (12) vs 53 (16) minutes; P = 0.02], whereas peak ropivacaine concentrations did not significantly differ between the groups [Cmax: 1.83 (0.41) vs 1.79 (0.33) μg/mL; P = 0.54]. Peak ropivacaine concentrations exceeded 2.2 μg/mL in 1 and 2 patients in the RSB and TAPB groups, respectively, although symptoms of local anesthetic systemic toxicity were not evident in any of them. The median [interquartile range] duration of analgesia was significantly longer for TAPB than RSB (421 [335-536] vs 196 [168-277] minutes; P = 0.01). Peak ropivacaine concentrations were comparable during TAPB and RSB, but peaked earlier during TAPB. Although 150 mg of ropivacaine remained effective significantly longer during TAPB than RSB during laparoscopic surgery, this dose could cause local anesthetic systemic toxicity. The analgesic effects of blocks with less ropivacaine should be assessed.

Weight shifting operators and conformal blocks

NASA Astrophysics Data System (ADS)

Karateev, Denis; Kravchuk, Petr; Simmons-Duffin, David

2018-02-01

We introduce a large class of conformally-covariant differential operators and a crossing equation that they obey. Together, these tools dramatically simplify calculations involving operators with spin in conformal field theories. As an application, we derive a formula for a general conformal block (with arbitrary internal and external representations) in terms of derivatives of blocks for external scalars. In particular, our formula gives new expressions for "seed conformal blocks" in 3d and 4d CFTs. We also find simple derivations of identities between external-scalar blocks with different dimensions and internal spins. We comment on additional applications, including deriving recursion relations for general conformal blocks, reducing inversion formulae for spinning operators to inversion formulae for scalars, and deriving identities between general 6 j symbols (Racah-Wigner coefficients/"crossing kernels") of the conformal group.

Oversight on Community Services Administration, Child Abuse Prevention and Treatment, and Adoption Opportunities, and Native American Programs Act. Hearing before the Subcommittee on Aging, Family and Human Services of the Committee on Labor and Human Resources. United States Senate, Ninety-Seventh Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Labor and Human Resources.

Oversight hearings were conducted on April 23, 1981 in reference to social service block grants for the Community Services Administration, child abuse prevention and treatment and adoption programs, and Native American Programs Act. Testimonies for support of block grants advocated ability of States to decide how program resources can best be…

Comparison of anesthetic efficacy between lidocaine with and without magnesium sulfate USP 50% for inferior alveolar nerve blocks in patients with symptomatic irreversible pulpitis.

PubMed

Shetty, Krishna Prasad; Satish, Sarvepalli Venkata; Kilaru, Krishna Rao; Sardar, Poonam; Luke, Alexander M

2015-04-01

The purpose of this prospective, randomized, double-blind, placebo-controlled study was to compare the anesthetic efficacy between lidocaine with and without magnesium sulfate USP 50% for inferior alveolar nerve (IAN) blocks in patients with symptomatic irreversible pulpitis. One hundred patients with symptomatic irreversible pulpitis of mandibular posterior teeth were selected for the study. The patients received 1 mL magnesium sulfate USP 50% or distilled water (placebo) 1 hour before administration of conventional IAN block. Endodontic access cavity preparation was initiated 15 minutes after the IAN block injection. Lip numbness was recorded for all the patients. Success of IAN block was defined as no or mild pain on the visual analogue scale during access cavity preparation and initial instrumentation. The success rate for the IAN block was 58% for magnesium sulfate group and 32% for the placebo group, with statistically significant difference between the 2 groups (P = .016). In mandibular posterior teeth diagnosed with symptomatic irreversible pulpitis, preoperative administration of 1 mL magnesium sulfate USP 50% resulted in statistically significant increase in success of IAN block compared with placebo. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

TAP Catheters Versus Intrathecal Morphine for Cesarean Section

ClinicalTrials.gov

2012-05-07

Abdominal Muscles/Ultrasonography; Adult; Anesthetics, Local/Administration & Dosage; Ropivacaine/Administration & Dosage; Ropivacaine/Analogs & Derivatives; Cesarean Section; Humans; Nerve Block/Methods; Pain Measurement/Methods; Pain, Postoperative/Prevention & Control; Ultrasonography, Interventional

Block LU factorization

NASA Technical Reports Server (NTRS)

Demmel, James W.; Higham, Nicholas J.; Schreiber, Robert S.

1992-01-01

Many of the currently popular 'block algorithms' are scalar algorithms in which the operations have been grouped and reordered into matrix operations. One genuine block algorithm in practical use is block LU factorization, and this has recently been shown by Demmel and Higham to be unstable in general. It is shown here that block LU factorization is stable if A is block diagonally dominant by columns. Moreover, for a general matrix the level of instability in block LU factorization can be founded in terms of the condition number kappa(A) and the growth factor for Gaussian elimination without pivoting. A consequence is that block LU factorization is stable for a matrix A that is symmetric positive definite or point diagonally dominant by rows or columns as long as A is well-conditioned.

Time-dependent effects of rapamycin on consolidation of predator stress-induced hyperarousal.

PubMed

Fifield, Kathleen; Hebert, Mark; Williams, Kimberly; Linehan, Victoria; Whiteman, Jesse D; Mac Callum, Phillip; Blundell, Jacqueline

2015-06-01

Previous studies have indicated that rapamycin, a potent inhibitor of the mammalian target of rapamycin (mTOR) pathway, blocks consolidation of shock-induced associative fear memories. Moreover, rapamycin's block of associative fear memories is time-dependent. It is unknown, however, if rapamycin blocks consolidation of predator stress-induced non-associative fear memories. Furthermore, the temporal pattern of mTOR activation following predator stress is unknown. Thus, the goal of the current studies was to determine if rapamycin blocks consolidation of predator stress-induced fear memories and if so, whether rapamycin's effect is time-dependent. Male rats were injected systemically with rapamycin at various time points following predator stress. Predator stress involves an acute, unprotected exposure of a rat to a cat, which causes long-lasting non-associative fear memories manifested as generalized hyperarousal and increased anxiety-like behaviour. We show that rapamycin injected immediately after predator stress blocked consolidation of stress-induced startle. However, rapamycin injected 9, 24 or 48h post predator stress potentiated stress-induced startle. Consistent with shock-induced associative fear memories, we show that mTOR signalling is essential for consolidation of predator stress-induced hyperarousal. However, unlike shock-induced fear memories, a second, persistent, late phase mTOR-dependent process following predator stress actually dampens startle. Consistent with previous findings, our data support the potential role for rapamycin in treatment of stress related disorders such as posttraumatic stress disorder. However, our data suggest timing of rapamycin administration is critical. Copyright © 2015 Elsevier B.V. All rights reserved.

Making Nasopalatine Blocks Comfortable: A Randomised Prospective Clinical Comparison of Pain Associated with the Injection Using an Insulin Syringe and a Standard Disposable 3 mL Syringe.

PubMed

Prabhu, Sundararaman; Faizel, Syed; Pahlajani, Vedant; Prabhu, Shweta Jha

2013-12-01

This study was conducted to compare and evaluate the pain associated with administration of Nasopalatine blocks using a disposable insulin syringe and the conventional disposable 3 mL syringe. Forty patients requiring intraalveolar extractions of maxillary central incisors were randomly assigned to two groups of 20 patients each; one (Group A) received the nasopalatine block with a standard 3mL syringe and the other (Group B) received the block with an insulin syringe. Patients were asked to rate the pain associated with the injection on a visual analog scale (VAS) and the results were analysed using a Chi Square Test. The mean VAS score for Group A and B was 1.55 and 1 respectively. Chi Square value was calculated to be 8.603 (degree of freedom= 3, P value= 0.0351). There were no differences in the effectiveness of anesthesia between the groups. Pain associated with administration of the nasopalatine blocks may be significantly mitigated by using the Insulin syringe.

Regularized Generalized Canonical Correlation Analysis

ERIC Educational Resources Information Center

Tenenhaus, Arthur; Tenenhaus, Michel

2011-01-01

Regularized generalized canonical correlation analysis (RGCCA) is a generalization of regularized canonical correlation analysis to three or more sets of variables. It constitutes a general framework for many multi-block data analysis methods. It combines the power of multi-block data analysis methods (maximization of well identified criteria) and…

31 CFR 598.301 - Blocked account; blocked property.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Blocked account; blocked property. 598.301 Section 598.301 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... REGULATIONS General Definitions § 598.301 Blocked account; blocked property. The terms blocked account and...

31 CFR 598.301 - Blocked account; blocked property.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Blocked account; blocked property. 598.301 Section 598.301 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... REGULATIONS General Definitions § 598.301 Blocked account; blocked property. The terms blocked account and...

31 CFR 598.301 - Blocked account; blocked property.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Blocked account; blocked property. 598.301 Section 598.301 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... REGULATIONS General Definitions § 598.301 Blocked account; blocked property. The terms blocked account and...

31 CFR 598.301 - Blocked account; blocked property.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Blocked account; blocked property. 598.301 Section 598.301 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued... REGULATIONS General Definitions § 598.301 Blocked account; blocked property. The terms blocked account and...

An electromyographic study of muscle relaxants in man.

PubMed

Suzuki, H; Kanayama, T; Nakagawa, H; Yazaki, S; Shiratsuchi, T

1975-05-01

Supramaximal paired stimuli were applied to the ulnar nerve, and the amplitude of the muscle action potential evoked in the abductor digiti minimi by the second member of the stimulus pair (test response) was compared with that evoked by the first component (conditioning response). The interval between the two components of the stimulus pair (the pair interval) was increased stepwise from 7 to 100 msec and a curve (recovery curve) was obtained by relating the changes in pair interval to the difference in amplitude of the test and conditioning responses. Alterations of the recovery curve (RC) during partial paralysis by muscle relaxants were investigated in healthy adult patients under the lightest plane of general anaesthesia. The control curve obtained in 32 subjects before the administration of a muscle relaxant drug was characterized by slight depressions at very short intervals of paired stimuli, followed by a slight potentiation at 20-100 msec. With non-depolarizing relaxants, RC altered to the characteristic pattern of potentiation at very short intervals of stimuli, followed by a notable depression at longer intervals. In depolarizing blocks with small doses of suxamethonium, the depression of RC at short intervals in the control was enhanced and the pattern of RC was different from that of non-depolarizing agents. When desensitization blocks were instigated by the i.v. administration of suxamethonium, the RC patterns were similar to those of competitive agents.

Does naltrexone affect craving in abstinent opioid-dependent patients?

PubMed

Dijkstra, Boukje A G; De Jong, Cor A J; Bluschke, Sarah M; Krabbe, Paul F M; van der Staak, Cees P F

2007-06-01

Naltrexone blocks the opioid receptors that modulate the release of dopamine in the brain reward system and therefore blocks the rewarding effects of heroin and alcohol. It is generally assumed that naltrexone leads to reduction of craving, but few studies have been performed to prove this. The purpose of the present study was to examine the effect of the administration of naltrexone on craving level after rapid opioid detoxification induced by naltrexone. A naturalistic study was carried out in which patients were followed during 10 months after rapid detoxification. Data about abstinence, relapse, and naltrexone use were collected by means of urine specimens. Craving was measured by the visual analogue scale craving, the Obsessive Compulsive Drug Use Scale, and the Desires for Drug Questionnaire. Results showed that patients who relapsed in opioid use experienced obviously more craving than abstinent people. Patients who took naltrexone did not experience significant less craving than those who did not. These results suggest that the use of opioids is associated with increased craving and that abstinence for opioids is associated with less craving, independent of the use of naltrexone. This is in contrast to the general opinion. Because of the naturalistic design of the study, no firm conclusions can be drawn, but the results grounded the needs of an experimental study.

The First Amendment on Campus: A Handbook for College and University Administrators

ERIC Educational Resources Information Center

Bird, Lee E., Ed.; Mackin, Mary Beth, Ed.; Schuster, Saundra K., Ed.

2006-01-01

What should college and university administrators do when the First Amendment seemingly conflicts with tightly held institutional values? Should administrators block, discourage, or attempt to adjudicate speech because it doesn't agree with their belief systems or institutional mission statements? This reader-friendly handbook addresses the…

Why Block Grants Should Increase Administrative Costs.

ERIC Educational Resources Information Center

Baker, Keith

1983-01-01

Federal education programs increase costs because they attach fewer strings to funds than state or local grants, and this is likely to lead to administrative empire-building. Bureaucracy tends pathologically as it grows to generate more work for itself independent of true administrative needs. Some policy implications are drawn. (MJL)

Effect of preoperative acetaminophen/hydrocodone on the efficacy of the inferior alveolar nerve block in patients with symptomatic irreversible pulpitis: a prospective, randomized, double-blind, placebo-controlled study.

PubMed

Fullmer, Spencer; Drum, Melissa; Reader, Al; Nusstein, John; Beck, Mike

2014-01-01

The purpose of this prospective, randomized, double-blind, placebo-controlled study was to determine the effect of the administration of the combination acetaminophen/hydrocodone on the anesthetic success of mandibular posterior teeth in patients experiencing symptomatic irreversible pulpitis. One hundred emergency patients in moderate to severe pain diagnosed with symptomatic irreversible pulpitis of a mandibular posterior tooth randomly received, in a double-blind manner, identical capsules of either a combination dose of 1000 mg acetaminophen/10 mg hydrocodone or placebo 60 minutes before the administration of a conventional inferior alveolar nerve (IAN) block. Endodontic access was begun 15 minutes after completion of the block, and all patients used for data analysis had profound lip numbness. Success was defined as no or mild pain (visual analog scale recordings) on pulpal access or instrumentation. The success rate for the IAN block was 32% for the combination dose of 1000 mg acetaminophen/10 hydrocodone and 28% for the placebo dose, with no statistically significant difference between the 2 groups (P = .662). A combination dose of 1000 mg acetaminophen/10 mg hydrocodone given 60 minutes before the administration of the IAN block did not result in a statistically significant increase in anesthetic success for mandibular posterior teeth in patients experiencing symptomatic irreversible pulpitis. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Double-Blind Crossover Study to Compare Pain Experience During Inferior Alveolar Nerve Block Administration Using Buffered Two Percent Lidocaine in Children.

PubMed

Chopra, Radhika; Jindal, Garima; Sachdev, Vinod; Sandhu, Meera

2016-01-01

Buffering of anesthetic solutions has been suggested to reduce pain on injection and onset of anesthesia. The purpose of this study was to assess the reduction in pain on injection during inferior alveolar nerve block administration in children. A double blind crossover study was designed where 30 six- to 12-year-old patients received two sessions of inferior alveolar nerve block scheduled one week apart. Two percent lidocaine with 1:200,000 epinephrine was given during one appointment, and a buffered solution was given during the other. Pain on injection was assessed using the sound, eye, and motor (SEM) scale, and the time to onset was assessed after gingival probing. The Heft-Parker visual analogue scale (HP-VAS) was self recorded by the patient after administration of local anesthesia. When tested using Mann-Whitney analysis, no significant differences were found between the SEM scores (P=0.71) and HP-VAS scores (P=0.93) for the two solutions used. Student's t test was used to assess the difference in the onset of anesthesia, which was also found to be statistically insignificant (P=0.824). Buffered lidocaine did not reduce the pain on injection or time to onset of anesthesia for inferior alveolar nerve block in children.

Characteristics of acetaminophen absorption in healthy unweaned calves as an indirect measurement of the oroduodenal transit rate of liquid meals.

PubMed

Schaer, S; Herrli-Gygi, M; Kosmeas, N; Boschung, H; Steiner, A

2005-09-01

Abomasal emptying plays an important role in the incidence of digestive problems in calves. Our aim was to evaluate the acetaminophen absorption test (APAT) for characterization of the oroduodenal transit (ODT) of liquid meals in unweaned calves. Six healthy, unweaned Simmental x Red Holstein crossbred calves were involved in the project. The study was performed in three blocks at 3, 6 and 9 weeks of the calves' age. Within blocks, APAT was performed twice at an interval of at least 24 h. Once per each block, liquid transit was carried out with non-coagulating electrolyte solution (NES). The second test within a block was performed either while atropine sulphate was administered (block I), or by feeding a coagulating milk replacer (block II), or by administration of NES by ruminal tube (block III). Data were compared within and among blocks. Significant differences of several APAT traits were present for the different types of feeding, the different types of meals, the administration of atropine sulphate and the different ages of the calves. The emptying index T(max)/C(max) was suggested to be a valuable kinetic parameter for the characterization of ODT in these calves. We conclude that APAT represents a valid technique for characterization of ODT of liquid meals in healthy unweaned calves and may be a valuable tool for the evaluation of the reticular groove mechanism, the abomasal emptying and the absorption capacity of the duodenum.

Additives to local anesthetics for peripheral nerve blocks: Evidence, limitations, and recommendations.

PubMed

Bailard, Neil S; Ortiz, Jaime; Flores, Roland A

2014-03-01

The therapeutic rationale, clinical effectiveness, and potential adverse effects of medications used in combination with local anesthetics for peripheral nerve block therapy are reviewed. A wide range of agents have been tested as adjuncts to peripheral nerve blocks, which are commonly performed for regional anesthesia during or after hand or arm surgery, neck or spine surgery, and other procedures. Studies to determine the comparative merits of nerve block adjuncts are complicated by the wide variety of coadministered local anesthetics and sites of administration and by the heterogeneity of primary endpoints. Sodium bicarbonate has been shown to speed the onset of mepivacaine nerve blocks but delay the onset of others. Epinephrine has been shown to prolong sensory nerve blockade and delay systemic uptake of local anesthetics, thus reducing the risk of anesthetic toxicity. Tramadol, buprenorphine, dexamethasone, and clonidine appear to be effective additives in some situations. Midazolam, magnesium, dexmedetomidine, and ketamine cannot be routinely recommended as nerve block additives due to a dearth of supportive data, modest efficacy, and (in the case of ketamine) significant adverse effects. Recent studies suggest that administering additives intravenously or intramuscularly can provide many of the benefits of perineural administration while reducing the potential for neurotoxicity, contamination, and other hazards. Some additives to local anesthetics can hasten the onset of nerve block, prolong block duration, or reduce toxicity. On the other hand, poorly selected or unnecessary additives may not have the desired effect and may even expose patients to unnecessary risks.

General purpose programmable accelerator board

DOEpatents

Robertson, Perry J.; Witzke, Edward L.

2001-01-01

A general purpose accelerator board and acceleration method comprising use of: one or more programmable logic devices; a plurality of memory blocks; bus interface for communicating data between the memory blocks and devices external to the board; and dynamic programming capabilities for providing logic to the programmable logic device to be executed on data in the memory blocks.

Neuromuscular blocking agent administration for emergent tracheal intubation is associated with decreased prevalence of procedure-related complications.

PubMed

Wilcox, Susan R; Bittner, Edward A; Elmer, Jonathan; Seigel, Todd A; Nguyen, Nicole Thuy P; Dhillon, Anahat; Eikermann, Matthias; Schmidt, Ulrich

2012-06-01

Emergent intubation is associated with a high rate of complications. Neuromuscular blocking agents are routinely used in the operating room and emergency department to facilitate intubation. However, use of neuromuscular blocking agents during emergent airway management outside of the operating room and emergency department is controversial. We hypothesized that the use of neuromuscular blocking agents is associated with a decreased prevalence of hypoxemia and reduced rate of procedure-related complications. Five hundred sixty-six patients undergoing emergent intubations in two tertiary care centers, Massachusetts General Hospital, Boston, MA, and the University of California Los Angeles, Ronald Reagan Medical Center, Los Angeles, CA, were enrolled in a prospective, observational study. The 112 patients intubated during cardiopulmonary resuscitation were excluded, leaving 454 patients for analysis. All intubations were supervised by attendings trained in Critical Care Medicine. We measured intubating conditions, oxygen saturation during and 5 mins following intubation. We assessed the prevalence of procedure-related complications defined as esophageal intubation, traumatic intubation, aspiration, dental injury, and endobronchial intubation. The use of neuromuscular blocking agents was associated with a lower prevalence of hypoxemia (10.1% vs. 17.4%, p = .022) and a lower prevalence of procedure-related complications (3.1% vs. 8.3%, p = .012). This association persisted in a multivariate analysis, which controlled for airway grade, sedation, and institution. Use of neuromuscular blocking agents was associated with significantly improved intubating conditions (laryngeal view, p = .014; number of intubation attempts, p = .049). After controlling for the number of intubation attempts and laryngoscopic view, muscle relaxant use is an independent predictor of complications associated with emergency intubation (p = .037), and there is a trend towards improvement of oxygenation (p = .07). The use of neuromuscular blocking agents, when used by intensivists with a high level of training and experience, is associated with a decrease in procedure-related complications.

Effect of intercostal nerve block combined with general anesthesia on the stress response in patients undergoing minimally invasive mitral valve surgery.

PubMed

Zhan, Yanping; Chen, Guo; Huang, Jian; Hou, Benchao; Liu, Weicheng; Chen, Shibiao

2017-10-01

The aim of the present study was to investigate the effect of intercostal nerve block combined with general anesthesia on the stress response and postoperative recovery in patients undergoing minimally invasive mitral valve surgery (MIMVS). A total of 30 patients scheduled for MIMVS were randomly divided into two groups (n=15 each): Group A, which received intercostal nerve block combined with general anesthesia and group B, which received general anesthesia alone. Intercostal nerve block in group A was performed with 0.5% ropivacaine from T3 to T7 prior to anesthesia induction. In each group, general anesthesia was induced using midazolam, sufentanil, propofol and vecuronium. Central venous blood samples were collected to determine the concentrations of cortisol, glucose, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) at the following time points: During central venous catheterization (T 1 ), 5 min prior to cardiopulmonary bypass (T 2 ), perioperative (T 3 ) and 24 h following surgery (T 4 ). Clinical data, including parameters of opioid (sufentanil) consumption, time of mechanical ventilation, duration of intensive care unit (ICU) stay, visual analog scale scores and any complications arising from intercostal nerve block, were recorded. Levels of cortisol, glucose, IL-6 and TNF-α in group A were significantly lower than those in group B at T 2 (all P<0.001; cortisol, P<0.05), T 3 (all P<0.001) and T 4 (all P<0.001; glucose, P<0.05), suggesting that intercostal nerve block combined with general anesthesia may inhibit the stress response to MIMVS. Additionally, intercostal nerve block combined with general anesthesia may significantly reduce sufentanil consumption (P<0.001), promote early tracheal extubation (P<0.001), shorten the duration of ICU stay (P<0.01) and attenuate postoperative pain (P<0.001), compared with general anesthesia alone. Thus, these results suggest that intercostal nerve block combined with general anesthesia conforms to the concept of rapid rehabilitation surgery and may be suitable for clinical practice.

Pitfalls and challenges when assessing the depth of hypnosis during general anaesthesia by clinical signs and electronic indices.

PubMed

Jensen, E W; Litvan, H; Struys, M; Martinez Vazquez, P

2004-11-01

The objective of this article was to review the present methods used for validating the depth of hypnosis. We introduce three concepts, the real depth of hypnosis (DHreal), the observed depth of hypnosis (DHobs), and the electronic indices of depth of hypnosis (DHel-ind). The DHreal is the real state of hypnosis that the patient has in a given moment during the general anaesthesia. The DHobs is the subjective assessment of the anaesthesiologist based on clinical signs. The DHel-ind is any estimation of the depth of hypnosis given by an electronic device. The three entities DHreal, DHobs and DHel-ind should in the ideal situation be identical. However, this is rarely the case. The correlation between the DHobs and the DHel-ind can be affected by a number of factors such as the stimuli used for the assessment of the level of consciousness or the administration of analgesic agents or neuro muscular blocking agents. Opioids, for example, can block the response to tactile and noxious stimuli, and even the response to verbal command could vanish, hence deeming the patient in a lower depth of hypnosis than the real patient state. The DHel-ind can be disturbed by the presence of facial muscular activity. In conclusion, although several monitors and clinical scoring scales are available to assess the depth of hypnosis during general anaesthesia, care should be taken when interpreting their results.

Supplemental Interscalene Blockade to General Anesthesia for Shoulder Arthroscopy: Effects on Fast Track Capability, Analgesic Quality, and Lung Function.

PubMed

Zoremba, Martin; Kratz, Thomas; Dette, Frank; Wulf, Hinnerk; Steinfeldt, Thorsten; Wiesmann, Thomas

2015-01-01

After shoulder surgery performed in patients with interscalene nerve block (without general anesthesia), fast track capability and postoperative pain management in the PACU are improved compared with general anesthesia alone. However, it is not known if these evidence-based benefits still exist when the interscalene block is combined with general anesthesia. We retrospectively analyzed a prospective cohort data set of 159 patients undergoing shoulder arthroscopy with general anesthesia alone (n = 60) or combined with an interscalene nerve block catheter (n = 99) for fast track capability time. Moreover, comparisons were made for VAS scores, analgesic consumption in the PACU, pain management, and lung function measurements. The groups did not differ in mean time to fast track capability (22 versus 22 min). Opioid consumption in PACU was significantly less in the interscalene group, who had significantly better VAS scores during PACU stay. Patients receiving interscalene blockade had a significantly impaired lung function postoperatively, although this did not affect postoperative recovery and had no impact on PACU times. The addition of interscalene block to general anesthesia for shoulder arthroscopy did not enhance fast track capability. Pain management and VAS scores were improved in the interscalene nerve block group.

31 CFR 598.301 - Blocked account; blocked property.

Code of Federal Regulations, 2010 CFR

2010-07-01

.... 598.301 Section 598.301 Money and Finance: Treasury Regulations Relating to Money and Finance... REGULATIONS General Definitions § 598.301 Blocked account; blocked property. The terms blocked account and blocked property mean any account or property subject to § 598.202 held in the name of a specially...

Baclofen blocks yohimbine-induced increases in ethanol-reinforced responding in rats.

PubMed

Williams, Keith L; Nickel, Melissa M; Bielak, Justin T

2016-05-01

Chronic or repeated stress increases alcohol consumption. The GABA-B agonist baclofen decreases alcohol consumption and may be most effective for individuals with comorbid anxiety/stress disorders. The present study sought to determine if baclofen blocks stress-induced increases in ethanol self-administration as modeled by repeated yohimbine injections in rats. Rats were trained to respond for 15% w/v ethanol in operant chambers using a method that applies neither water deprivation nor saccharin/sucrose fading. Following training, the rats received 6 injections of 1.25mg/kg yohimbine were given immediately prior to the operant sessions during a 2-week time period. Subsequently, some rats were pair-matched to receive either 1.25mg/kg yohimbine or saline in the presence of 0.3, 1, and 3mg/kg baclofen prior to sessions. Acquisition of ethanol self-administration was poor. Pretreatment with yohimbine consistently increased responding across repeated injections. Yohimbine's effect on ethanol intake unexpectedly diverged from the effect on responding as the rats failed to consume all reinforcers earned. Smaller doses of baclofen paired with saline injections had no effect on ethanol responding; only 3mg/kg baclofen reduced ethanol self-administration. The smallest baclofen dose of 0.3mg/kg failed to block the yohimbine-induced increase in self-administration. The large baclofen dose of 3mg/kg continued to suppress ethanol self-administration when given with yohimbine. Baclofen 1mg/kg blocked the effect of yohimbine even though it had no effect when given in the absence of yohimbine. Exposure to high ethanol concentrations may induce self-administration only in certain conditions. The dissociation between responding and intake suggests that repeated yohimbine injections may initiate other behavioral or physiological mechanisms that confound its effects as a pharmacological stressor. Furthermore, an optimal baclofen dose range may specifically protect against stress-induced alcohol self-administration, highlighting a specific contribution of GABA-B receptors and a potential therapeutic efficacy of GABA-B agonists at a non-sedating dose. Copyright © 2016 Elsevier Inc. All rights reserved.

N-acetylcysteine treatment blocks the development of ethanol-induced behavioural sensitization and related ΔFosB alterations.

PubMed

Morais-Silva, Gessynger; Alves, Gabrielle Cunha; Marin, Marcelo T

2016-11-01

Ethanol addiction is a serious public health problem that still needs more effective pharmacological treatment. A key factor in the development and maintenance of this disease is the advent of neuroadaptations in the mesocorticolimbic brain pathway upon chronic ethanol abuse. In general, these neuroadaptations are maladaptive and affect numerous neurotransmitter systems and intracellular molecules. One of these molecules is ΔFosB, a transcription factor that is altered after chronic drug use. Behavioural sensitization is a useful model for the study of the neuroadaptations related to addiction. Recent works have shown a role for the imbalance of glutamatergic neurotransmission in the symptoms found in addicted people. In this sense, the treatment with N-acetylcysteine, a l-cysteine prodrug that acts by restoring extrasynaptic concentrations of glutamate through the activation of cystine-glutamate antiporter, has shown promising results in the treatment of addiction. Thus, an animal model of behavioural sensitization was used to evaluate the effects of N-acetylcysteine treatment in the behavioural and molecular alterations induced by chronic ethanol administration. Swiss mice were subject to 13 days of daily ethanol administration to induce behavioural sensitization. Two hours before each ethanol administration and locomotor activity evaluation, the animals received intraperitoneally N-acetylcysteine injections. Immediately after the last test session, their brains were removed for ΔFosB and cystine-glutamate antiporter quantification. It was found that N-acetylcysteine treatment blocked ethanol-induced behavioural sensitization, the increase of ΔFosB content in the prefrontal cortex, and its reduction in the nucleus accumbens. The results suggest a possible use of N-acetylcysteine in ethanol-related disorders. Copyright © 2016 Elsevier Ltd. All rights reserved.

Land-cover change in the Lower Mississippi Valley, 1973-2000

USGS Publications Warehouse

Karstensen, Krista A.; Sayler, Kristi L.

2009-01-01

The Land Cover Trends is a research project focused on understanding the rates, trends, causes, and consequences of contemporary United States land-use and land-cover change. The project is coordinated by the Geographic Analysis and Monitoring Program of the U.S. Geological Survey (USGS) in conjunction with the U.S. Environmental Protection Agency (EPA) and the National Aeronautics and Space Administration (NASA). Using the EPA Level III ecoregions as the geographic framework, scientists process geospatial data collected between 1973 and 2000 were processed to characterize ecosystem responses to land-use changes. The 27-year study period was divided into four temporal periods: 1973 to1980, 1980 to 1986, 1986 to 1992, 1992 to 2000 and overall from 1973 to 2000. General land-cover classes for these periods were interpreted from Landsat Multispectral Scanner, Thematic Mapper, and Enhanced Thematic Mapper Plus imagery to categorize and evaluate land-cover change using a modified Anderson Land Use Land Cover Classification System (Anderson and others, 1976) for image interpretation.The rates of land-cover change were estimated using a stratified, random sampling of 10-kilometer (km) by 10-km blocks allocated within each ecoregion. For each sample block, satellite images were used to interpret land-cover change. The sample block data then were incorporated into statistical analyses to generate an overall change matrix for the ecoregion. These change statistics are applicable for different levels of scale, including total change for the individual sample blocks and change estimates for the entire ecoregion.

Convergence to Diagonal Form of Block Jacobi-type Processes

NASA Astrophysics Data System (ADS)

Hari, Vjeran

2008-09-01

The main result of recent research on convergence to diagonal form of block Jacobi-type processes is presented. For this purpose, all notions needed to describe the result are introduced. In particular, elementary block transformation matrices, simple and non-simple algorithms, block pivot strategies together with the appropriate equivalence relations are defined. The general block Jacobi-type process considered here can be specialized to take the form of almost any known Jacobi-type method for solving the ordinary or the generalized matrix eigenvalue and singular value problems. The assumptions used in the result are satisfied by many concrete methods.

21 CFR 882.1925 - Ultrasonic scanner calibration test block.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Ultrasonic scanner calibration test block. 882.1925 Section 882.1925 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES NEUROLOGICAL DEVICES Neurological Diagnostic Devices § 882.1925...

A novel combination of peripheral nerve blocks for arthroscopic shoulder surgery.

PubMed

Musso, D; Flohr-Madsen, S; Meknas, K; Wilsgaard, T; Ytrebø, L M; Klaastad, Ø

2017-10-01

Interscalene brachial plexus block is currently the gold standard for intra- and post-operative pain management for patients undergoing arthroscopic shoulder surgery. However, it is associated with block related complications, of which effect on the phrenic nerve have been of most interest. Side effects caused by general anesthesia, when this is required, are also a concern. We hypothesized that the combination of superficial cervical plexus block, suprascapular nerve block, and infraclavicular brachial plexus block would provide a good alternative to interscalene block and general anesthesia. Twenty adult patients scheduled for arthroscopic shoulder surgery received a combination of superficial cervical plexus block (5 ml ropivacaine 0.5%), suprascapular nerve block (4 ml ropivacaine 0.5%), and lateral sagittal infraclavicular block (31 ml ropivacaine 0.75%). The primary aim was to find the proportion of patients who could be operated under light propofol sedation, without the need for opioids or artificial airway. Secondary aims were patients' satisfaction and surgeons' judgment of the operating conditions. Nineteen of twenty patients (95% CI: 85-100) underwent arthroscopic shoulder surgery with light propofol sedation, but without opioids or artificial airway. The excluded patient was not comfortable in the beach chair position and therefore received general anesthesia. All patients were satisfied with the treatment on follow-up interviews. The surgeons rated the operating conditions as good for all patients. The novel combination of a superficial cervical plexus block, a suprascapular nerve block, and an infraclavicular nerve block provides an alternative anesthetic modality for arthroscopic shoulder surgery. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Picture of All Solutions of Successive 2-Block Maxbet Problems

ERIC Educational Resources Information Center

Choulakian, Vartan

2011-01-01

The Maxbet method is a generalized principal components analysis of a data set, where the group structure of the variables is taken into account. Similarly, 3-block[12,13] partial Maxdiff method is a generalization of covariance analysis, where only the covariances between blocks (1, 2) and (1, 3) are taken into account. The aim of this paper is…

45 CFR 96.133 - Submission to Secretary of Statewide assessment of needs.

Code of Federal Regulations, 2011 CFR

2011-10-01

... ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.133 Submission to Secretary... description on current substance abuse prevention and treatment activities: (i) For fiscal year 1993, the... goals and objectives for improving substance abuse treatment and prevention activities and shall report...

45 CFR 96.133 - Submission to Secretary of Statewide assessment of needs.

Code of Federal Regulations, 2012 CFR

2012-10-01

... ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.133 Submission to Secretary... description on current substance abuse prevention and treatment activities: (i) For fiscal year 1993, the... goals and objectives for improving substance abuse treatment and prevention activities and shall report...

45 CFR 96.133 - Submission to Secretary of Statewide assessment of needs.

Code of Federal Regulations, 2013 CFR

2013-10-01

... ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.133 Submission to Secretary... description on current substance abuse prevention and treatment activities: (i) For fiscal year 1993, the... goals and objectives for improving substance abuse treatment and prevention activities and shall report...

45 CFR 96.133 - Submission to Secretary of Statewide assessment of needs.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.133 Submission to Secretary... description on current substance abuse prevention and treatment activities: (i) For fiscal year 1993, the... goals and objectives for improving substance abuse treatment and prevention activities and shall report...

21 CFR 892.5710 - Radiation therapy beam-shaping block.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Radiation therapy beam-shaping block. 892.5710 Section 892.5710 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Therapeutic Devices § 892.5710 Radiation therapy beam-shaping...

Effect of nitrous oxide on the efficacy of the inferior alveolar nerve block in patients with symptomatic irreversible pulpitis.

PubMed

Stanley, William; Drum, Melissa; Nusstein, John; Reader, Al; Beck, Mike

2012-05-01

The inferior alveolar nerve (IAN) block does not always result in successful pulpal anesthesia. Anesthetic success rates might be affected by increased anxiety. Nitrous oxide has been shown to have both anxiolytic and analgesic properties. Therefore, the purpose of this prospective, randomized, double-blind, placebo-controlled study was to determine the effect of nitrous oxide on the anesthetic success of the IAN block in patients experiencing symptomatic irreversible pulpitis. One hundred emergency patients diagnosed with symptomatic irreversible pulpitis of a mandibular posterior tooth were enrolled in this study. Each patient was randomly assigned to receive an inhalation regimen of nitrous oxide/oxygen mix or room air/oxygen mix (placebo) 5 minutes before the administration of the IAN block. Endodontic access was begun 15 minutes after completion of the IAN block, and all patients had profound lip numbness. Success was defined as no or mild pain (visual analog scale recordings) on access or instrumentation. The success rate for the IAN block was 50% for the nitrous oxide group and 28% for the placebo group. There was a statistically significant difference between the 2 groups (P = .024). For mandibular teeth diagnosed with symptomatic irreversible pulpitis, administration of 30%-50% nitrous oxide resulted in a statistically significant increase in the success of the IAN block compared with room air/oxygen. Copyright © 2012 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Cryogenic expansion machine

DOEpatents

Pallaver, Carl B.; Morgan, Michael W.

1978-01-01

A cryogenic expansion engine includes intake and exhaust poppet valves each controlled by a cam having adjustable dwell, the valve seats for the valves being threaded inserts in the valve block. Each cam includes a cam base and a ring-shaped cam insert disposed at an exterior corner of the cam base, the cam base and cam insert being generally circular but including an enlarged cam dwell, the circumferential configuration of the cam base and cam dwell being identical, the cam insert being rotatable with respect to the cam base. GI CONTRACTUAL ORIGIN OF THE INVENTION The invention described herein was made in the course of, or under, a contract with the UNITED STATES ENERGY RESEARCH AND DEVELOPMENT ADMINISTRATION.

[Combined blockade of AMPA- and NMDA-receptors has maximum effect to eliminate development of pentylenetetrazole-induced kindling in rats].

PubMed

Serdiuk, S E; Gmiro, V E; Veselkina, O S

2013-05-01

Peroral chronic administration the standard antiepileptic drug sodium valproate in a dose of 200 mg/kg eliminates development of generalized clonic-tonic pentylenetetrazol kindling seizures in 100% of rats, but only in 57% of rats this treatment prevents clonic kindling seizures. In the specified dose sodium valproate decreases in 1.7 times average severity of pentylenetetrazol kindling seizures compare with control. IEM-2121, causing combined blockade of NMDA- and AMPA-glutamate receptors, as well as IEM-1676, which also blocks AMPA-, NMDA- and N-cholinoreceptors, both after peroral chronic administration in a doses 10 mg/kg and 20 mg/kg accordingly, possess higher, than sodium valproate, anticonvulsant activity because reduce average severity of pentylenetetrazol kindling seizures in 2.4-2.7 times in comparison with control and prevents clonic kindling seizures in 87% of rats. Combined blockade of AMPA- and NMDA-receptors and perhars N-cholinoreceptors has maximum effect to eliminate epileptogenesis both clonic, and clonic-tonic pentylenetetrazol kindling seizures.

Efficacy of premixed versus sequential administration of clonidine as an adjuvant to hyperbaric bupivacaine intrathecally in cesarean section

PubMed Central

Sachan, Prachee; Kumar, Nidhi; Sharma, Jagdish Prasad

2014-01-01

Background: Density of the drugs injected intrathecally is an important factor that influences spread in the cerebrospinal fluid. Mixing adjuvants with local anesthetics (LA) alters their density and hence their spread compared to when given sequentially in seperate syringes. Aims: To evaluate the efficacy of intrathecal administration of hyperbaric bupivacaine (HB) and clonidine as a mixture and sequentially in terms of block characteristics, hemodynamics, neonatal outcome, and postoperative pain. Setting and Design: Prospective randomized single blind study at a tertiary center from 2010 to 2012. Materials and Methods: Ninety full-term parturient scheduled for elective cesarean sections were divided into three groups on the basis of technique of intrathecal drug administration. Group M received mixture of 75 μg clonidine and 10 mg HB 0.5%. Group A received 75 μg clonidine after administration of 10 mg HB 0.5% through separate syringe. Group B received 75 μg clonidine before HB 0.5% (10 mg) through separate syringe. Statistical analysis used: Observational descriptive statistics, analysis of variance with Bonferroni multiple comparison post hoc test, and Chi-square test. Results: Time to achieve complete sensory and motor block was less in group A and B in which drugs were given sequentially. Duration of analgesia lasted longer in group B (474.3 ± 20.79 min) and group A (472.50 ± 22.11 min) than in group M (337 ± 18.22 min) with clinically insignificant influence on hemodynamic parameters and sedation. Conclusion: Sequential technique reduces time to achieve complete sensory and motor block, delays block regression, and significantly prolongs the duration of analgesia. However, it did not matter much whether clonidine was administered before or after HB. PMID:25886098

NOP Receptor Mediates Anti-analgesia Induced by Agonist-Antagonist Opioids

PubMed Central

Gear, Robert W.; Bogen, Oliver; Ferrari, Luiz F.; Green, Paul G.; Levine, Jon D.

2014-01-01

Clinical studies have shown that agonist-antagonist opioid analgesics that produce their analgesic effect via action on the kappa-opioid receptor, produce a delayed-onset anti-analgesia in men but not women, an effect blocked by co-administration of a low dose of naloxone. We now report the same time-dependent anti-analgesia and its underlying mechanism in an animal model. Using the Randall-Selitto paw-withdrawal assay in male rats, we found that nalbuphine, pentazocine, and butorphanol each produced analgesia during the first hour followed by anti-analgesia starting at ~90 minutes after administration in males but not females, closely mimicking its clinical effects. As observed in humans, co-administration of nalbuphine with naloxone in a dose ratio of 12.5:1 blocked anti-analgesia but not analgesia. Administration of the highly selective kappa-opioid receptor agonist U69,593 produced analgesia without subsequent anti-analgesia, and confirmed by the failure of the selective kappa antagonist nor-binaltorphimine to block nalbuphine-induced anti-analgesia, indicating that anti-analgesia is not mediated by kappa-opioid receptors. We therefore tested the role of other receptors in nalbuphine anti-analgesia. Nociceptin/orphanin FQ (NOP) and sigma-1 and sigma-2 receptors were chosen on the basis of their known anti-analgesic effects and receptor binding studies. The selective NOP receptor antagonists, JTC801, and J113397, but not the sigma receptor antagonist, BD 1047, antagonized nalbuphine anti-analgesia. Furthermore, the NOP receptor agonist NNC 63-0532 produced anti-analgesia with the same delay in onset observed with the three agonist-antagonists, but without producing preceding analgesia and this anti-analgesia was also blocked by naloxone. These results strongly support the suggestion that clinically used agonist-antagonists act at the NOP receptor to produce anti-analgesia. PMID:24188792

28 CFR 31.501 - Eligible applicants.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Eligible applicants. 31.501 Section 31.501 Judicial Administration DEPARTMENT OF JUSTICE OJJDP GRANT PROGRAMS Juvenile Accountability Incentive Block Grants § 31.501 Eligible applicants. (a) Eligible applicants. Eligible applicants in FY 1998...

28 CFR 31.501 - Eligible applicants.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Eligible applicants. 31.501 Section 31.501 Judicial Administration DEPARTMENT OF JUSTICE OJJDP GRANT PROGRAMS Juvenile Accountability Incentive Block Grants § 31.501 Eligible applicants. (a) Eligible applicants. Eligible applicants in FY 1998...

28 CFR 31.501 - Eligible applicants.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Eligible applicants. 31.501 Section 31.501 Judicial Administration DEPARTMENT OF JUSTICE OJJDP GRANT PROGRAMS Juvenile Accountability Incentive Block Grants § 31.501 Eligible applicants. (a) Eligible applicants. Eligible applicants in FY 1998...

28 CFR 31.501 - Eligible applicants.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Eligible applicants. 31.501 Section 31.501 Judicial Administration DEPARTMENT OF JUSTICE OJJDP GRANT PROGRAMS Juvenile Accountability Incentive Block Grants § 31.501 Eligible applicants. (a) Eligible applicants. Eligible applicants in FY 1998...

28 CFR 31.501 - Eligible applicants.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Eligible applicants. 31.501 Section 31.501 Judicial Administration DEPARTMENT OF JUSTICE OJJDP GRANT PROGRAMS Juvenile Accountability Incentive Block Grants § 31.501 Eligible applicants. (a) Eligible applicants. Eligible applicants in FY 1998...

45 CFR 96.126 - Capacity of treatment for intravenous substance abusers.

Code of Federal Regulations, 2014 CFR

2014-10-01

... ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.126 Capacity of treatment... programs that receive funding under the grant and that treat individuals for intravenous substance abuse to... 45 Public Welfare 1 2014-10-01 2014-10-01 false Capacity of treatment for intravenous substance...

45 CFR 96.126 - Capacity of treatment for intravenous substance abusers.

Code of Federal Regulations, 2013 CFR

2013-10-01

... ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.126 Capacity of treatment... programs that receive funding under the grant and that treat individuals for intravenous substance abuse to... 45 Public Welfare 1 2013-10-01 2013-10-01 false Capacity of treatment for intravenous substance...

45 CFR 96.126 - Capacity of treatment for intravenous substance abusers.

Code of Federal Regulations, 2012 CFR

2012-10-01

... ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.126 Capacity of treatment... programs that receive funding under the grant and that treat individuals for intravenous substance abuse to... 45 Public Welfare 1 2012-10-01 2012-10-01 false Capacity of treatment for intravenous substance...

45 CFR 96.126 - Capacity of treatment for intravenous substance abusers.

Code of Federal Regulations, 2011 CFR

2011-10-01

... ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.126 Capacity of treatment... programs that receive funding under the grant and that treat individuals for intravenous substance abuse to... 45 Public Welfare 1 2011-10-01 2011-10-01 false Capacity of treatment for intravenous substance...

45 CFR 96.126 - Capacity of treatment for intravenous substance abusers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.126 Capacity of treatment... programs that receive funding under the grant and that treat individuals for intravenous substance abuse to... 45 Public Welfare 1 2010-10-01 2010-10-01 false Capacity of treatment for intravenous substance...

29 CFR 1919.32 - Specially designed blocks and components.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 7 2011-07-01 2011-07-01 false Specially designed blocks and components. 1919.32 Section 1919.32 Labor Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) GEAR CERTIFICATION Certification of Vessels: Tests and Proof Loads; Heat Treatment; Competent Persons § 1919.32...

A general multiblock Euler code for propulsion integration. Volume 1: Theory document

NASA Technical Reports Server (NTRS)

Chen, H. C.; Su, T. Y.; Kao, T. J.

1991-01-01

A general multiblock Euler solver was developed for the analysis of flow fields over geometrically complex configurations either in free air or in a wind tunnel. In this approach, the external space around a complex configuration was divided into a number of topologically simple blocks, so that surface-fitted grids and an efficient flow solution algorithm could be easily applied in each block. The computational grid in each block is generated using a combination of algebraic and elliptic methods. A grid generation/flow solver interface program was developed to facilitate the establishment of block-to-block relations and the boundary conditions for each block. The flow solver utilizes a finite volume formulation and an explicit time stepping scheme to solve the Euler equations. A multiblock version of the multigrid method was developed to accelerate the convergence of the calculations. The generality of the method was demonstrated through the analysis of two complex configurations at various flow conditions. Results were compared to available test data. Two accompanying volumes, user manuals for the preparation of multi-block grids (vol. 2) and for the Euler flow solver (vol. 3), provide information on input data format and program execution.

Blood pressure response to combined general anaesthesia/interscalene brachial plexus block for outpatient shoulder arthroscopy.

PubMed

Janssen, Hauke; Stosch, Roland von; Pöschl, Rupert; Büttner, Benedikt; Bauer, Martin; Hinz, José Maria; Bergmann, Ingo

2014-01-01

Shoulder surgery is often performed in the beach-chair position, a position associated with arterial hypotension and subsequent risk of cerebral ischaemia. It can be performed under general anaesthesia or with an interscalene brachial plexus block, each of which has specific advantages but also specific negative effects on blood pressure control. It would be worthwhile to combine the advantages of the two, but the effects of the combination on the circulation are not well investigated. We studied blood pressure, heart rate, and incidence of adverse circulatory events in patients undergoing shoulder surgery in general anaesthesia with or without an interscalene block. Prospective, randomised, blinded study in outpatients (age 18 to 80 years) undergoing shoulder arthroscopy. General anaesthesia was with propofol/opioid, interscalene block with 40 ml 1% mepivacaine. Hypotension requiring treatment was defined as a mean arterial pressure <60 mmHg or a systolic pressure <80% of baseline; relevant bradycardia was a heart rate <50 bpm with a decrease in blood pressure. Forty-two patients had general anaesthesia alone, 41 had general anaesthesia plus interscalene block. The average systolic blood pressure under anaesthesia in the beach-chair position was 114 ± 7.3 vs. 116 ± 8.3 mmHg (p = 0.09; all comparisons General vs. General-Regional). The incidence of a mean arterial pressure under 60 mmHg or a decrease in systolic pressure of more than 20% from baseline was 64% vs. 76% (p = 0.45). The number of patients with a heart rate lower than 50 and a concomitant blood pressure decrease was 8 vs. 5 (p = 0.30). One can safely combine interscalene block with general anaesthesia for surgery in the beach-chair position in ASA I and II patients. DRKS00005295.

Novel use of combination of electromyography and ultrasound to guide quadratus lumborum block after open appendicectomy.

PubMed

Mullins, Cormac F; O'Brien, Conor; O'Connor, Therese C

2017-05-15

The quadratus lumborum (QL) block facilitates the administration of anaesthesia to the anterior abdominal wall. The use of ultrasound (US) improves the accuracy of the QL block and reduces the risk of adverse events. Electromyography (EMG) in combination with US for muscle plane blocks has not been described previously. We postulated that the addition of EMG-guided needle positioning might assist the execution of this block. This case report describes the first use of combined needle EMG and US to carry out a QL block performed for postoperative analgesia following an open appendicectomy. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A role for sigma receptors in stimulant self-administration and addiction.

PubMed

Katz, Jonathan L; Hong, Weimin C; Hiranita, Takato; Su, Tsung-Ping

2016-04-01

Sigma-1 receptors (σ1Rs) are structurally unique intracellular proteins that function as chaperones. σ1Rs translocate from the mitochondria-associated membrane to other subcellular compartments, and can influence a host of targets, including ion channels, G-protein-coupled receptors, lipids, and other signaling proteins. Drugs binding to σRs can induce or block the actions of σRs. Studies indicate that stimulant self-administration induces the reinforcing effects of σR agonists, because of dopamine transporter actions. Once established, the reinforcing effects of σR agonists are independent of dopaminergic mechanisms traditionally thought to be critical to the reinforcing effects of stimulants. Self-administered doses of σR agonists do not increase dopamine concentrations in the nucleus accumbens shell, a transmitter and brain region considered important for the reinforcing effects of abused drugs. However, self-administration of σR agonists is blocked by σR antagonists. Several effects of stimulants have been blocked by σR antagonists, including the reinforcing effects, assessed by a place-conditioning procedure. However, the self-administration of stimulants is largely unaffected by σR antagonists, indicating fundamental differences in the mechanisms underlying these two procedures used to assess the reinforcing effects. When σR antagonists are administered in combination with dopamine uptake inhibitors, an effective and specific blockade of stimulant self-administration is obtained. Actions of stimulant drugs related to their abuse induce unique changes in σR activity and the changes induced potentially create redundant and, once established, independent reinforcement pathways. Concomitant targeting of both dopaminergic pathways and σR proteins produces a selective antagonism of stimulant self-administration, suggesting new avenues for combination chemotherapies to specifically combat stimulant abuse.

A Role for σRs in Stimulant Self-administration and Addiction

PubMed Central

Katz, Jonathan L.; Hong, Weimin C.; Hiranita, Takato; Su, Tsung-Ping

2015-01-01

Sigma-1 receptors (σ1Rs) are structurally unique intracellular proteins that function as chaperones. σ1Rs translocate from the mitochondria-associated membrane to other sub-cellular compartments, and can influence a host of targets, including ion channels, G-protein-coupled receptors, lipids, and other signaling proteins. Drugs binding to σRs can induce or block the actions of σRs. Studies indicate that stimulant self-administration induces reinforcing effects of σR agonists, due to dopamine transporter actions. Once established the reinforcing effects of σR agonists are independent of dopaminergic mechanisms traditionally thought to be critical in the reinforcing effects of stimulants. Self-administered doses of σR agonists do not increase dopamine concentrations in the nucleus accumbens shell, a transmitter and brain region considered important for reinforcing effects of abused drugs. However, the self-administration of σR agonists is blocked by σR antagonists. Several effects of stimulants have been blocked by σR antagonists, including reinforcing effects assessed by a place-conditioning procedure. However, the self-administration of stimulants is largely unaffected by σR antagonists, indicating fundamental differences in the mechanisms underlying these two procedures used to assess reinforcing effects. When σR antagonists are administered in combination with dopamine uptake inhibitors an effective and specific blockade of stimulant self-administration is obtained. Actions of stimulant drugs related to their abuse induce unique changes in σR activity and the changes induced potentially create redundant, and once established, independent reinforcement pathways. Concomitant targeting of both dopaminergic pathways and σR proteins produces a selective antagonism of stimulant self-administration, suggesting new avenues for combination chemotherapies to specifically combat stimulant abuse. PMID:26650253

Peripheral Nerve Block as a Supplement to Light or Deep General Anesthesia in Elderly Patients Receiving Total Hip Arthroplasty: A Prospective Randomized Study.

PubMed

Mei, Bin; Zha, Hanning; Lu, Xiaolong; Cheng, Xinqi; Chen, Shishou; Liu, Xuesheng; Li, Yuanhai; Gu, Erwei

2017-12-01

Peripheral nerve block combined with general anesthesia is a preferable anesthesia method for elderly patients receiving hip arthroplasty. The depth of sedation may influence patient recovery. Therefore, we investigated the influence of peripheral nerve blockade and different intraoperative sedation levels on the short-term recovery of elderly patients receiving total hip arthroplasty. Patients aged 65 years and older undergoing total hip arthroplasty were randomized into 3 groups: a general anesthesia without lumbosacral plexus block group, and 2 general anesthesia plus lumbosacral plexus block groups, each with a different level of sedation (light or deep). The extubation time and intraoperative consumption of propofol, sufentanil, and vasoactive agent were recorded. Postoperative delirium and early postoperative cognitive dysfunction were assessed using the Confusion Assessment Method and Mini-Mental State Examination, respectively. Postoperative analgesia was assessed by the consumption of patient-controlled analgesics and visual analog scale scores. Discharge time and complications over a 30-day period were also recorded. Lumbosacral plexus block reduced opioid intake. With lumbosacral plexus block, intraoperative deep sedation was associated with greater intake of propofol and vasoactive agent. In contrast, patients with lumbosacral plexus block and intraoperative light sedation had lower incidences of postoperative delirium and postoperative cognitive decline, and earlier discharge readiness times. The 3 groups showed no difference in complications within 30 days of surgery. Lumbosacral plexus block reduced the need for opioids and offered satisfactory postoperative analgesia. It led to better postoperative outcomes in combination with intraoperative light sedation (high bispectral index).

A Shifted Block Lanczos Algorithm 1: The Block Recurrence

NASA Technical Reports Server (NTRS)

Grimes, Roger G.; Lewis, John G.; Simon, Horst D.

1990-01-01

In this paper we describe a block Lanczos algorithm that is used as the key building block of a software package for the extraction of eigenvalues and eigenvectors of large sparse symmetric generalized eigenproblems. The software package comprises: a version of the block Lanczos algorithm specialized for spectrally transformed eigenproblems; an adaptive strategy for choosing shifts, and efficient codes for factoring large sparse symmetric indefinite matrices. This paper describes the algorithmic details of our block Lanczos recurrence. This uses a novel combination of block generalizations of several features that have only been investigated independently in the past. In particular new forms of partial reorthogonalization, selective reorthogonalization and local reorthogonalization are used, as is a new algorithm for obtaining the M-orthogonal factorization of a matrix. The heuristic shifting strategy, the integration with sparse linear equation solvers and numerical experience with the code are described in a companion paper.

Assessing neuromuscular block at the larynx: the effect of change in resting cuff pressure and a comparison with video imaging in anesthetized humans.

PubMed

Girling, K J; Bedforth, N M; Spendlove, J L; Mahajan, R P

1999-02-01

Neuromuscular block (NMB) at the larynx has been assessed by measuring the cuff pressure (CP) in an endotracheal tube (ETT) placed between the vocal cords. In this study, we evaluated the decrease in resting cuff pressure (RCP) after the administration of rocuronium and the effect of this decrease on the assessment of NMB, and we compared CP measurement with an alternative technique, video imaging (VI). In 20 patients, NMB was determined at the hand by mechanomyography and at the larynx initially by CP and subsequently by VI, recording images using a fiberoptic bronchoscope via a laryngeal mask. Train-of-four stimuli were applied at both sites. After baseline measurements, the ETT was replaced, and rocuronium was infused to achieve a steady-state 50% (n = 10) or 75% (n = 10) block at the hand. CP measurements were recorded before and after restoration of RCP to prerocuronium pressure, followed by further VI measurements. The mean RCP decreased from 21 +/- 4 to 12 +/- 5 mm Hg after rocuronium. At 50% block at the hand, the CP estimate of block at the larynx with reduced RCP was 62% +/- 18%, and that after restoring RCP was 29% +/- 13%; VI estimated 27% +/- 14% block. At 75% block at the hand, CP and VI estimated 52% +/- 11% and 46% +/- 9% block, respectively (RCP maintained). We conclude that RCP decreases after the administration of rocuronium, that restoring RCP significantly alters CP estimates of NMB, and that VI is in agreement with CP measurement if RCP is maintained at prerelaxant values. In this study, we show that a muscle relaxant-induced decrease in resting tension at the larynx may confound the assessment of neuromuscular block by cuff pressure measurement. The preliminary data suggest that video imaging may provide a suitable alternative to cuff pressure measurement to assess neuromuscular block at the larynx.

Efficacy of ketamine hydrochloride administered as a basilar sesamoid nerve block in alleviating foot pain in horses caused by natural disease.

PubMed

Schumacher, J; DeGraves, F; Cesar, F; Duran, S

2014-09-01

A local anaesthetic agent capable of temporarily resolving lameness after being administered perineurally would be helpful because rapid return of lameness would allow for other analgesic techniques to be performed within a short period of time. To determine if a 3% solution of ketamine hydrochloride (HCl), administered around the palmar nerves at the level of the base of the proximal sesamoid bones, can improve naturally occurring lameness that can be improved or abolished with a basilar sesamoid nerve block performed using lidocaine HCl and to compare the change in gait produced using lidocaine to the change in gait produced using ketamine by using objective lameness assessment. Experimental trial using research horses with naturally occurring lameness. Seven horses, chronically lame on a thoracic limb, were chosen for the study. A wireless, inertial, sensor-based, motion analysis system was used to evaluate lameness before and after administration of 2% lidocaine and later, before and after administration of 3% ketamine over the palmar digital nerves at the base of the proximal sesamoid bones (a basilar sesamoid nerve block) at 5 min intervals for 30 min. Lameness scores obtained before and after administration of lidocaine and ketamine HCl were compared using repeated measures analysis. Gait significantly improved after basilar sesamoid nerve blocks using 2% lidocaine, but gait did not significantly improve after performing the same nerve block using 3% ketamine HCl. Ketamine (3%) administered perineurally for regional anaesthesia of the digit does not desensitise the digit to the same extent as does lidocaine and thus 3% ketamine appears to have no value as a local anaesthetic agent for diagnostic regional anaesthesia. © 2013 EVJ Ltd.

Evolution of transversus abdominis plane infiltration techniques for postsurgical analgesia following abdominal surgeries.

PubMed

Gadsden, Jeffrey; Ayad, Sabry; Gonzales, Jeffrey J; Mehta, Jaideep; Boublik, Jan; Hutchins, Jacob

2015-01-01

Transversus abdominis plane (TAP) infiltration is a regional anesthesia technique that has been demonstrated to be effective for management of postsurgical pain after abdominal surgery. There are several different clinical variations in the approaches used for achieving analgesia via TAP infiltration, and methods for identification of the TAP have evolved considerably since the landmark-guided technique was first described in 2001. There are many factors that impact the analgesic outcomes following TAP infiltration, and the various nuances of this technique have led to debate regarding procedural classification of TAP infiltration. Based on our current understanding of fascial and neuronal anatomy of the anterior abdominal wall, as well as available evidence from studies assessing local anesthetic spread and cutaneous sensory block following TAP infiltration, it is clear that TAP infiltration techniques are appropriately classified as field blocks. While the objective of peripheral nerve block and TAP infiltration are similar in that both approaches block sensory response in order to achieve analgesia, the technical components of the two procedures are different. Unlike peripheral nerve block, which involves identification or stimulation of a specific nerve or nerve plexus, followed by administration of a local anesthetic in close proximity, TAP infiltration involves administration and spread of local anesthetic within an anatomical plane of the surgical site.

The effect of cisatracurium and rocuronium on lung function in anesthetized children.

PubMed

Yang, Charles I; Fine, Gavin F; Jooste, Edmund H; Mutich, Rebecca; Walczak, Stephen A; Motoyama, Etsuro K

2013-12-01

Neuromuscular blocking drugs have been implicated in intraoperative bronchoconstrictive episodes. We examined the effects of clinically relevant doses of cisatracurium and rocuronium on the lung mechanics of pediatric subjects. We hypothesized that cisatracurium and rocuronium would have bronchoconstrictive effects. We studied ASA physical status I and II pediatric subjects having elective dental or urological procedures, requiring general anesthesia with endotracheal intubations with either cisatracurium or rocuronium. Pulmonary function tests were performed before and after neuromuscular blocking drug dosing and again after albuterol administration. Using forced deflation and passive deflation techniques, forced vital capacity (FVC) and maximum expiratory flow rate at 10% (MEF10) of FVC were obtained. Fractional changes from the baseline were used to compare subjects. Changes in MEF10 of >30% were considered clinically significant. A Shapiro-Wilk test, paired t test, and Wilcoxon rank sum test were used to analyze the data. Twenty-five subjects (median age = 5.25 years; range = 9 months-9.9 years) were studied; 12 subjects received cisatracurium and 13 subjects received rocuronium. Data are shown as mean proportional change ± SD or, in the case of not normally distributed, median proportional change (first, third quartile) with P values. In the cisatracurium group, there were no differences between baseline and postneuromuscular blocker administration in the fractional change from the baselines of FVC (1.00 ± 0.04, P = 0.5), but there was a significant decrease in MEF10 (0.80 ± 0.18, P = 0.002). In the rocuronium group, there were small yet significant decreases of FVC (0.99 [first quartile 0.97, third quartile 1], P = 0.02) and significant decreases in MEF10 (0.78 ± 0.26, P = 0.008). After administration of albuterol in the cisatracurium group, FVC increased slightly but significantly from baseline values (1.02 ± 0.02, P = 0.005). MEF10 increased significantly beyond baseline values (1.24 ± 0.43, P =0.04). In the rocuronium group, there were also significant differences between baseline and postalbuterol administration from the baseline value of FVC (1.02 ± 0.02, P = 0.004) and MEF10 (1.23 ± 0.29, P = 0.01). At clinically relevant doses, both cisatracurium and rocuronium caused changes in lung function, indicating constriction of smaller airways. In general, these changes were mild and not clinically detectable. However, in the rocuronium group, 3 of 13 patients showed more noticeable decreases in MEF10 (≤50%), demonstrating the potential for significant broncho-bronchiolar constriction in susceptible patients.

31 CFR 546.302 - Blocked account; blocked property.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Blocked account; blocked property. 546.302 Section 546.302 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY DARFUR SANCTIONS REGULATIONS General...

31 CFR 510.301 - Blocked account; blocked property.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Blocked account; blocked property. 510.301 Section 510.301 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NORTH KOREA SANCTIONS REGULATIONS General...

On the Application of Time-Reversed Space-Time Block Code to Aeronautical Telemetry

DTIC Science & Technology

2014-06-01

Keying (SOQPSK), bit error rate (BER), Orthogonal Frequency Division Multiplexing ( OFDM ), Generalized time-reversed space-time block codes (GTR-STBC) 16...Alamouti code [4]) is optimum [2]. Although OFDM is generally applied on a per subcarrier basis in frequency selective fading, it is not a viable...Calderbank, “Finite-length MIMO decision feedback equal- ization for space-time block-coded signals over multipath-fading channels,” IEEE Transac- tions on

45 CFR 96.133 - Submission to Secretary of Statewide assessment of needs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... ADMINISTRATION BLOCK GRANTS Substance Abuse Prevention and Treatment Block Grant § 96.133 Submission to Secretary... submit data which shows the incidence and prevalence in the State of drug abuse and the incidence and prevalence in the State of alcohol abuse and alcoholism. For fiscal years 1993 through 1996, the State shall...

32 CFR 635.23 - DA Form 4833 (Commander's Report of Disciplinary or Administrative Action).

Code of Federal Regulations, 2014 CFR

2014-07-01

... the PMO. The Battalion Commander or the first Lieutenant Colonel in the chain of command is... DA Form 4833 within 45 days of receipt. (1) Appropriate blocks will be checked and blanks annotated... the disposition on DA Form 4833 as appropriate. That portion of the signature block of DA Form 4833...

32 CFR 635.23 - DA Form 4833 (Commander's Report of Disciplinary or Administrative Action).

Code of Federal Regulations, 2010 CFR

2010-07-01

... the PMO. The Battalion Commander or the first Lieutenant Colonel in the chain of command is... DA Form 4833 within 45 days of receipt. (1) Appropriate blocks will be checked and blanks annotated... the disposition on DA Form 4833 as appropriate. That portion of the signature block of DA Form 4833...

32 CFR 635.23 - DA Form 4833 (Commander's Report of Disciplinary or Administrative Action).

Code of Federal Regulations, 2011 CFR

2011-07-01

... the PMO. The Battalion Commander or the first Lieutenant Colonel in the chain of command is... DA Form 4833 within 45 days of receipt. (1) Appropriate blocks will be checked and blanks annotated... the disposition on DA Form 4833 as appropriate. That portion of the signature block of DA Form 4833...

32 CFR 635.23 - DA Form 4833 (Commander's Report of Disciplinary or Administrative Action).

Code of Federal Regulations, 2013 CFR

2013-07-01

... the PMO. The Battalion Commander or the first Lieutenant Colonel in the chain of command is... DA Form 4833 within 45 days of receipt. (1) Appropriate blocks will be checked and blanks annotated... the disposition on DA Form 4833 as appropriate. That portion of the signature block of DA Form 4833...

32 CFR 635.23 - DA Form 4833 (Commander's Report of Disciplinary or Administrative Action).

Code of Federal Regulations, 2012 CFR

2012-07-01

... the PMO. The Battalion Commander or the first Lieutenant Colonel in the chain of command is... DA Form 4833 within 45 days of receipt. (1) Appropriate blocks will be checked and blanks annotated... the disposition on DA Form 4833 as appropriate. That portion of the signature block of DA Form 4833...

28 CFR 33.10 - State government.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false State government. 33.10 Section 33.10 Judicial Administration DEPARTMENT OF JUSTICE BUREAU OF JUSTICE ASSISTANCE GRANT PROGRAMS Criminal Justice Block Grants Eligible Applicants § 33.10 State government. All states are eligible to apply for and...

28 CFR 33.10 - State government.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 1 2014-07-01 2014-07-01 false State government. 33.10 Section 33.10 Judicial Administration DEPARTMENT OF JUSTICE BUREAU OF JUSTICE ASSISTANCE GRANT PROGRAMS Criminal Justice Block Grants Eligible Applicants § 33.10 State government. All states are eligible to apply for and...

28 CFR 33.10 - State government.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 1 2012-07-01 2012-07-01 false State government. 33.10 Section 33.10 Judicial Administration DEPARTMENT OF JUSTICE BUREAU OF JUSTICE ASSISTANCE GRANT PROGRAMS Criminal Justice Block Grants Eligible Applicants § 33.10 State government. All states are eligible to apply for and...

28 CFR 33.10 - State government.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 1 2013-07-01 2013-07-01 false State government. 33.10 Section 33.10 Judicial Administration DEPARTMENT OF JUSTICE BUREAU OF JUSTICE ASSISTANCE GRANT PROGRAMS Criminal Justice Block Grants Eligible Applicants § 33.10 State government. All states are eligible to apply for and...

28 CFR 33.10 - State government.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false State government. 33.10 Section 33.10 Judicial Administration DEPARTMENT OF JUSTICE BUREAU OF JUSTICE ASSISTANCE GRANT PROGRAMS Criminal Justice Block Grants Eligible Applicants § 33.10 State government. All states are eligible to apply for and...

Dateline Child Care.

ERIC Educational Resources Information Center

Child Care Information Exchange, 1993

1993-01-01

Reports on the Clinton administration's budget decisions concerning Head Start and the Child Care and Development Block Grant; the Children's Defense Fund's support of Clinton administration policies; cuts in United Way aid to local charities; and the ineligibility of a center at which Bible stories are read to receive a Small Business…

Synthesis of most polyene natural product motifs using just twelve building blocks and one coupling reaction

PubMed Central

Woerly, Eric M.; Roy, Jahnabi; Burke, Martin D.

2014-01-01

The inherent modularity of polypeptides, oligonucleotides, and oligosaccharides has been harnessed to achieve generalized building block-based synthesis platforms. Importantly, like these other targets, most small molecule natural products are biosynthesized via iterative coupling of bifunctional building blocks. This suggests that many small molecules also possess inherent modularity commensurate with systematic building block-based construction. Supporting this hypothesis, here we report that the polyene motifs found in >75% of all known polyene natural products can be synthesized using just 12 building blocks and one coupling reaction. Using the same general retrosynthetic algorithm and reaction conditions, this platform enabled the synthesis of a wide range of polyene frameworks covering all of this natural product chemical space, and first total syntheses of the polyene natural products asnipyrone B, physarigin A, and neurosporaxanthin β-D-glucopyranoside. Collectively, these results suggest the potential for a more generalized approach for making small molecules in the laboratory. PMID:24848233

Enhancing instruction scheduling with a block-structured ISA

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

Melvin, S.; Patt, Y.

It is now generally recognized that not enough parallelism exists within the small basic blocks of most general purpose programs to satisfy high performance processors. Thus, a wide variety of techniques have been developed to exploit instruction level parallelism across basic block boundaries. In this paper we discuss some previous techniques along with their hardware and software requirements. Then we propose a new paradigm for an instruction set architecture (ISA): block-structuring. This new paradigm is presented, its hardware and software requirements are discussed and the results from a simulation study are presented. We show that a block-structured ISA utilizes bothmore » dynamic and compile-time mechanisms for exploiting instruction level parallelism and has significant performance advantages over a conventional ISA.« less

Ephedrine fails to accelerate the onset of neuromuscular block by vecuronium.

PubMed

Komatsu, Ryu; Nagata, Osamu; Ozaki, Makoto; Sessler, Daniel I

2003-08-01

The onset time of neuromuscular blocking drugs is partially determined by circulatory factors, including muscle blood flow and cardiac output. We thus tested the hypothesis that a bolus of ephedrine accelerates the onset of vecuronium neuromuscular block by increasing cardiac output. A prospective, randomized study was conducted in 53 patients scheduled for elective surgery. After the induction of anesthesia, the ulnar nerve was stimulated supramaximally every 10 s, and the evoked twitch response of the adductor pollicis was recorded with accelerometry. Patients were maintained under anesthesia with continuous infusion of propofol for 10 min and then randomly assigned to ephedrine 210 microg/kg (n = 27) or an equivalent volume of saline (n = 26). The test solution was given 1 min before the administration of 0.1 mg/kg of vecuronium. Cardiac output was monitored with impedance cardiography. Ephedrine, but not saline, increased cardiac index (17%; P = 0.003). Nonetheless, the onset of 90% neuromuscular block was virtually identical in the patients given ephedrine (183 +/- 41 s) and saline (181 +/- 47 s). There was no correlation between cardiac index and onset of the blockade. We conclude that the onset of the vecuronium-induced neuromuscular block is primarily determined by factors other than cardiac output. The combination of ephedrine and vecuronium thus cannot be substituted for rapid-acting nondepolarizing muscle relaxants. Ephedrine increased cardiac index but failed to speed onset of neuromuscular block with vecuronium. We conclude that ephedrine administration does not shorten the onset time of vecuronium.

A randomised trial of the analgesic efficacy of ultrasound-guided transversus abdominis plane block after caesarean delivery under general anaesthesia.

PubMed

Tan, Terry T; Teoh, Wendy H L; Woo, David C M; Ocampo, Cecilia E; Shah, Mukesh K; Sia, Alex T H

2012-02-01

Previous studies examining the efficacy of transversus abdominis plane block after caesarean section have mostly been in parturients under spinal anaesthesia. We postulated that the advantage of performing transversus abdominis plane block after caesarean section might be even more obvious after general anaesthesia, resulting in reduced 24-h consumption of morphine. DESIGN, SETTING, PATIENTS AND INTERVENTIONS: In this single centre, randomised double-blind controlled trial, 40 women who underwent caesarean delivery under general anaesthesia were allocated randomly to receive a transversus abdominis plane block or no block. In those who received the block, 20 ml of levobupivacaine 2.5 mg ml was deposited bilaterally into the transversus abdominis plane under ultrasound guidance using a Sonosite Titan (SonoSite, Bothell, Washington, USA) 7-13 MHz linear transducer at the end of surgery when the patient was still anaesthetised. We recorded patient-controlled intravenous morphine use for 24 h, pain scores at rest and activity, sedation, nausea and vomiting, use of antiemetic medication and overall maternal satisfaction. The primary outcome was 24-h morphine consumption. Patients who received the transversus abdominis plane block used significantly less morphine in 24 h than those in the control group [12.3 (2.6) vs. 31.4 mg (3.1), P<0.001) and had higher satisfaction scores [16 (80%) vs. 5 (25%), P = 0.012). There were no differences between groups in the visual analogue pain scores, sedation level, nausea and vomiting or the use of antiemetic medication. Ultrasound-guided transversus abdominis plane block reduced morphine consumption following caesarean section under general anaesthesia, with increased maternal satisfaction.

Toward Generalization of Iterative Small Molecule Synthesis

PubMed Central

Lehmann, Jonathan W.; Blair, Daniel J.; Burke, Martin D.

2018-01-01

Small molecules have extensive untapped potential to benefit society, but access to this potential is too often restricted by limitations inherent to the customized approach currently used to synthesize this class of chemical matter. In contrast, the “building block approach”, i.e., generalized iterative assembly of interchangeable parts, has now proven to be a highly efficient and flexible way to construct things ranging all the way from skyscrapers to macromolecules to artificial intelligence algorithms. The structural redundancy found in many small molecules suggests that they possess a similar capacity for generalized building block-based construction. It is also encouraging that many customized iterative synthesis methods have been developed that improve access to specific classes of small molecules. There has also been substantial recent progress toward the iterative assembly of many different types of small molecules, including complex natural products, pharmaceuticals, biological probes, and materials, using common building blocks and coupling chemistry. Collectively, these advances suggest that a generalized building block approach for small molecule synthesis may be within reach. PMID:29696152

28 CFR 18.2 - Application.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Application. 18.2 Section 18.2 Judicial Administration DEPARTMENT OF JUSTICE OFFICE OF JUSTICE PROGRAMS HEARING AND APPEAL PROCEDURES § 18.2 Application. (a) These procedures apply to all appeals and hearings of State formula or block grant applicants or...

General view, south fourthfloor (attic) room, center block, looking northeast. ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

General view, south fourth-floor (attic) room, center block, looking northeast. Originally two rooms, the partition wall was likely removed when a cistern was installed, formerly set on the platform at the center of this view. - Lazaretto Quarantine Station, Wanamaker Avenue and East Second Street, Essington, Delaware County, PA

[Radical hysterectomy in a patient with Steinert disease: spinal anaesthesia, ketamine and TAP and rectus sheath blocks].

PubMed

Armendáriz-Buil, I; Marenco-Arellano, V

2015-01-01

The case of a patient with Steinert disease who underwent surgery for radical hysterectomy is presented. Because of her advanced disease, she suffered from chronic respiratory failure which required non-invasive ventilation (NIV) at night. Spinal anaesthesia was chosen as an anaesthetic treatment. At the time of aortic lymphadenectomy, the patient reported moderate pain at hypogastrium, which was well controlled with boluses of 10 mg of ketamine. Postoperatively, opioid administration was avoided by applying abdominal wall blocks: transverse abdominis plane (TAP) block and sheath of rectus abdominis muscle block. The evolution of the patient was satisfactory and she was discharged on the fifth day after surgery.

Synthesis of most polyene natural product motifs using just 12 building blocks and one coupling reaction.

PubMed

Woerly, Eric M; Roy, Jahnabi; Burke, Martin D

2014-06-01

The inherent modularity of polypeptides, oligonucleotides and oligosaccharides has been harnessed to achieve generalized synthesis platforms. Importantly, like these other targets, most small-molecule natural products are biosynthesized via iterative coupling of bifunctional building blocks. This suggests that many small molecules also possess inherent modularity commensurate with systematic building block-based construction. Supporting this hypothesis, here we report that the polyene motifs found in >75% of all known polyene natural products can be synthesized using just 12 building blocks and one coupling reaction. Using the same general retrosynthetic algorithm and reaction conditions, this platform enabled both the synthesis of a wide range of polyene frameworks that covered all of this natural-product chemical space and the first total syntheses of the polyene natural products asnipyrone B, physarigin A and neurosporaxanthin b-D-glucopyranoside. Collectively, these results suggest the potential for a more generalized approach to making small molecules in the laboratory.

Synthesis of most polyene natural product motifs using just 12 building blocks and one coupling reaction

NASA Astrophysics Data System (ADS)

Woerly, Eric M.; Roy, Jahnabi; Burke, Martin D.

2014-06-01

The inherent modularity of polypeptides, oligonucleotides and oligosaccharides has been harnessed to achieve generalized synthesis platforms. Importantly, like these other targets, most small-molecule natural products are biosynthesized via iterative coupling of bifunctional building blocks. This suggests that many small molecules also possess inherent modularity commensurate with systematic building block-based construction. Supporting this hypothesis, here we report that the polyene motifs found in >75% of all known polyene natural products can be synthesized using just 12 building blocks and one coupling reaction. Using the same general retrosynthetic algorithm and reaction conditions, this platform enabled both the synthesis of a wide range of polyene frameworks that covered all of this natural-product chemical space and the first total syntheses of the polyene natural products asnipyrone B, physarigin A and neurosporaxanthin β-D-glucopyranoside. Collectively, these results suggest the potential for a more generalized approach to making small molecules in the laboratory.

Second-degree atrioventricular block.

PubMed

Zipes, D P

1979-09-01

1) While it is possible only one type of second-degree AV block exists electrophysiologically, the available data do not justify such a conclusion and it would seem more appropriate to remain a "splitter," and advocate separation and definition of multiple mechanisms, than to be a "lumper," and embrace a unitary concept. 2) The clinical classification of type I and type II AV block, based on present scalar electrocardiographic criteria, for the most part accurately differentiates clinically important categories of patients. Such a classification is descriptive, but serves a useful function and should be preserved, taking into account the caveats mentioned above. The site of block generally determines the clinical course for the patient. For most examples of AV block, the type I and type II classification in present use is based on the site of block. Because block in the His-Purkinje system is preceded by small or nonmeasurable increments, it is called type II AV block; but the very fact that it is preceded by small increments is because it occurs in the His-Purkinje system. Similar logic can be applied to type I AV block in the AV node. Exceptions do occur. If the site of AV block cannot be distinguished with certainity from the scalar ECG, an electrophysiologic study will generally reveal the answer.

[Correlation between the inspired fraction of oxygen, maternal partial oxygen pressure, and fetal partial oxygen pressure during cesarean section of normal pregnancies].

PubMed

Castro, Carlos Henrique Viana de; Cruvinel, Marcos Guilherme Cunha; Carneiro, Fabiano Soares; Silva, Yerkes Pereira; Cabral, Antônio Carlos Vieira; Bessa, Roberto Cardoso

2009-01-01

Despite changes in pulmonary function, maternal oxygenation is maintained during obstetric regional blocks. But in those situations, the administration of supplementary oxygen to parturients is a common practice. Good fetal oxygenation is the main justification; however, this has not been proven. The objective of this randomized, prospective study was to test the hypothesis of whether maternal hyperoxia is correlated with an increase in fetal gasometric parameters in elective cesarean sections. Arterial blood gases of 20 parturients undergoing spinal block with different inspired fractions of oxygen were evaluated and correlated with fetal arterial blood gases. An increase in maternal inspired fraction of oxygen did not show any correlation with an increase of fetal partial oxygen pressure. Induction of maternal hyperoxia by the administration of supplementary oxygen did not increase fetal partial oxygen pressure. Fetal gasometric parameters did not change even when maternal parameters changed, induced by hyperoxia, during cesarean section under spinal block.

Impact of high- versus low-dose neuromuscular blocking agent administration on unplanned 30-day readmission rates in retroperitoneal laparoscopic surgery.

PubMed

Boon, Martijn; Martini, Chris; Yang, H Keri; Sen, Shuvayu S; Bevers, Rob; Warlé, Michiel; Aarts, Leon; Niesters, Marieke; Dahan, Albert

2018-01-01

Recent data shows that a neuromuscular block (NMB) induced by administration of high doses of rocuronium improves surgical conditions in certain procedures. However, there are limited data on the effect such practices on postoperative outcomes. We performed a retrospective analysis to compare unplanned 30-day readmissions in patients that received high-dose versus low-dose rocuronium administration during general anesthesia for laparoscopic retroperitoneal surgery. This retrospective cohort study was performed in the Netherlands in an academic hospital where routine high-dose rocuronium NMB has been practiced since July 2015. Charts of patients receiving anesthesia between January 2014 and December 2016 were searched for surgical cases receiving high-dose rocuronium and matched with respect to procedure, age, sex and ASA classification to patients receiving low-dose rocuronium. The primary post-operative outcome was unplanned 30-day readmission rate. There were 130 patients in each cohort. Patients in the high- and low-dose rocuronium cohorts received 217 ± 49 versus 37 ± 5 mg rocuronium, respectively. In the high-dose rocuronium group neuromuscular activity was consistently monitored; matched patients were unreliably monitored. All patients receiving high-dose rocuronium were reversed with sugammadex, while just 33% of matched patients were reversed with sugammadex and 20% with neostigmine; the remaining patients were not reversed. Unplanned 30-day readmission rate was significantly lower in the high-dose compared to the low-dose rocuronium cohort (3.8% vs. 12.7%; p = 0.03; odds ratio = 0.33, 95% C.I. 0.12-0.95). This small retrospective study demonstrates a lower incidence of unplanned readmissions within 30-days following laparoscopic retroperitoneal surgery with high-dose relaxant anesthesia and sugammadex reversal in comparison to low-dose relaxant anesthesia. Further prospective studies are needed in larger samples to corroborate our findings and additionally assess the pharmacoeconomics of high-dose relaxant anesthesia taking into account the benefits (reduced readmissions) and harm (cost of relaxants and reversal agents) of such practice.

Pre-operative brachial plexus block compared with an identical block performed at the end of surgery: a prospective, double-blind, randomised clinical trial.

PubMed

Holmberg, A; Sauter, A R; Klaastad, Ø; Draegni, T; Raeder, J C

2017-08-01

We evaluated whether pre-emptive analgesia with a pre-operative ultrasound-guided infraclavicular brachial plexus block resulted in better postoperative analgesia than an identical block performed postoperatively. Fifty-two patients undergoing fixation of a fractured radius were included. All patients received general anaesthesia with remifentanil and propofol. Patients were randomly allocated into two groups: a pre-operative block or a postoperative block with 0.5 ml.kg -1 ropivacaine 0.75%. After surgery, all patients received regular paracetamol plus opioids for breakthrough pain. Mean (SD) time to first rescue analgesic after emergence from general anaesthesia was 544 (217) min in the pre-operative block group compared with 343 (316) min in the postoperative block group (p = 0.015). Postoperative pain scores were higher and more patients required rescue analgesia during the first 4 h after surgery in the postoperative block group. There were no significant differences in plasma stress mediators between the groups. Analgesic consumption was lower at day seven in the pre-operative block group. Pain was described as very strong at block resolution in 27 (63%) patients and 26 (76%) had episodes of mild pain after 6 months. We conclude that a pre-operative ultrasound-guided infraclavicular brachial plexus block provides longer and better analgesia in the acute postoperative period compared with an identical postoperative block in patients undergoing surgery for fractured radius. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

Toxicity evaluation of methoxy poly(ethylene oxide)-block-poly(ε-caprolactone) polymeric micelles following multiple oral and intraperitoneal administration to rats.

PubMed

Binkhathlan, Ziyad; Qamar, Wajhul; Ali, Raisuddin; Kfoury, Hala; Alghonaim, Mohammed

2017-09-01

Methoxy poly(ethylene oxide)- block -poly(ɛ-caprolactone) (PEO- b -PCL) copolymers are amphiphilic and biodegradable copolymers designed to deliver a variety of drugs and diagnostic agents. The aim of this study was to synthesize PEO- b -PCL block copolymers and assess the toxic effects of drug-free PEO- b -PCL micelles after multiple-dose administrations via oral or intraperitoneal (ip) administration in rats. Assembly of block copolymers was achieved by co-solvent evaporation method. To investigate the toxicity profile of PEO- b -PCL micelles, sixty animals were divided into two major groups: The first group received PEO- b -PCL micelles (100 mg/kg) by oral gavage daily for seven days, while the other group received the same dose of micelles by ip injections daily for seven days. Twenty-four hours following the last dose, half of the animals from each group were sacrificed and blood and organs (lung, liver, kidneys, heart and spleen) were collected. Remaining animals were observed for further 14 days and was sacrificed at the end of the third week, and blood and organs were collected. None of the polymeric micelles administered caused any significant effects on relative organ weight, animal body weight, leucocytes count, % lymphocytes, liver and kidney toxicity markers and organs histology. Although the dose of copolymers used in this study is much higher than those used for drug delivery, it did not cause any significant toxic effects in rats. Histological examination of all the organs confirmed the nontoxic nature of the micelles.

Comparison of the efficacy of articaine and prilocaine local anaesthesia for pulpotomy of maxillary and mandibular primary molars.

PubMed

Yilmaz, Y; Eyuboglu, O; Keles, S

2011-06-01

The aim of this study was to compare the local anaesthetic efficacy of articaine HCl and prilocaine HCl during an operative procedure after their administration by either mandibular nerve block or maxillary infiltration. The study was a double-blind clinical study which comprised 162 children (81 boys and 81 girls), who required a pulpotomy on their primary molars. Pain-related behaviours were used to assess the severity of pain during the injection of either prilocaine HCl or articaine HCl and the operative procedures following either a maxillary infiltration or mandibular nerve block of the two local anaesthetic agents. The frequencies of post-procedural adverse events in the prilocaine and articaine anaesthetised groups were also determined. Significantly more discomfort (p<0.05) was observed following maxillary infiltration compared to mandibular nerve block. There were no significant differences in the pain-related behaviours scores between the two local anaesthetic agents administered during the dental operative procedures, except for the removal of the coronal pulp. For this latter procedure, the pain-related behaviour score was 1.5- times higher in the prilocain-anaesthetised children than in the articaine-anaesthetised children. The frequencies of post- procedural adverse events in the prilocaine-treated children were similar to those found in the articaine-treated children. We concluded that local anaesthesia following mandibular nerve block is more effective than that following maxillary infiltration in 6-8-year-old children. However, the intensity of pain that was experienced by the children during administration of either prilocaine or articaine and some of the dental procedures after their administration were similar.

Cognitive Dissonance, Supervision, and Administrative Team Conflict

ERIC Educational Resources Information Center

Zepeda, Sally J.

2006-01-01

Purpose: The purpose of this paper is to record and summarize the tensions and problems experienced by a high school administrative team as they attempted to change supervision alongside instruction in a transition to a new block schedule. Design/methodology/approach: A case study method was used. As a case study, the research is contextual in…

28 CFR 31.503 - Notice of proposed use of funds.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Notice of proposed use of funds. 31.503 Section 31.503 Judicial Administration DEPARTMENT OF JUSTICE OJJDP GRANT PROGRAMS Juvenile Accountability Incentive Block Grants § 31.503 Notice of proposed use of funds. The mechanism for a State to report on the...

28 CFR 31.503 - Notice of proposed use of funds.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Notice of proposed use of funds. 31.503 Section 31.503 Judicial Administration DEPARTMENT OF JUSTICE OJJDP GRANT PROGRAMS Juvenile Accountability Incentive Block Grants § 31.503 Notice of proposed use of funds. The mechanism for a State to report on the...

28 CFR 31.503 - Notice of proposed use of funds.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Notice of proposed use of funds. 31.503 Section 31.503 Judicial Administration DEPARTMENT OF JUSTICE OJJDP GRANT PROGRAMS Juvenile Accountability Incentive Block Grants § 31.503 Notice of proposed use of funds. The mechanism for a State to report on the...

28 CFR 31.503 - Notice of proposed use of funds.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Notice of proposed use of funds. 31.503 Section 31.503 Judicial Administration DEPARTMENT OF JUSTICE OJJDP GRANT PROGRAMS Juvenile Accountability Incentive Block Grants § 31.503 Notice of proposed use of funds. The mechanism for a State to report on the...

28 CFR 31.503 - Notice of proposed use of funds.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Notice of proposed use of funds. 31.503 Section 31.503 Judicial Administration DEPARTMENT OF JUSTICE OJJDP GRANT PROGRAMS Juvenile Accountability Incentive Block Grants § 31.503 Notice of proposed use of funds. The mechanism for a State to report on the...

47 CFR 52.26 - NANC Recommendations on Local Number Portability Administration.

Code of Federal Regulations, 2012 CFR

2012-10-01

... perform a database query to determine if the telephone number has been ported to another local exchange carrier, the local exchange carrier may block the unqueried call only if performing the database query is... manage and oversee the local number portability administrators, subject to review by the NANC, but only...

47 CFR 52.26 - NANC Recommendations on Local Number Portability Administration.

Code of Federal Regulations, 2014 CFR

2014-10-01

... perform a database query to determine if the telephone number has been ported to another local exchange carrier, the local exchange carrier may block the unqueried call only if performing the database query is... manage and oversee the local number portability administrators, subject to review by the NANC, but only...

Form, Content, and Gender Differences in Lego[R] Block Creations by Japanese Adolescents

ERIC Educational Resources Information Center

Kato, Daiki; Morita, Miyako

2009-01-01

This study examined general features of Lego block creations produced by Japanese adolescents with no known mental health disorders. The block creations of 33 participants were assessed for form, content, and gender differences. Time spent on the task, amount of area covered, and quantity and types of blocks used were measured and correlated with…

Two syringe spinal anesthesia technique for cesarean section: A controlled randomized study of a simple way to achieve more satisfactory block and less hypotension.

PubMed

Keera, Amr Aly Ismail; Elnabtity, Ali Mohamed Ali

2016-01-01

Multiple trials have been tried to prevent hypotension during spinal anesthesia. However, the drug choice and mode of administration is still a matter of debate. To compare the outcome of spinal injection of hyperbaric bupivacaine and fentanyl separately to standard injection of mixed fentanyl with hyperbaric bupivacaine. A randomized, controlled clinical trial. One hundred twenty-four parturient scheduled for elective cesarean section were randomly allocated into two groups, each 62 parturient: Group M received spinal anesthesia using 10 mg bupivacaine 0.5% premixed with 25 μg fentanyl in the same syringe and Group S received 25 μg fentanyl in one syringe and 10 mg bupivacaine 0.5% without barbotage in a second syringe. Patients with intraoperative pain that was controllable without the need for a shift to general anesthesia was significantly lower in Group S (3.2%) than in Group M (16.1%). The frequency of hypotension was significantly lower in Group S compared to Group M (P < 0.05). Time till the onset of sensory block was nonsignificantly shorter with nonsignificantly higher mean level of maximal sensory block in Group S compared to Group M (P > 0.05). There was no significant difference in the time till occurrence of hypotension, duration of hypotension, mean dose of ephedrine used for the treatment of hypotension and frequency of patients developed itching between the groups (P > 0.05). Separate intrathecal injection of fentanyl and hyperbaric bupivacaine provided a significant improvement in the quality of sensory block and significant reduction of the frequency of hypotension compared to injection of mixed medications.

Land-Cover Change in the Central Irregular Plains, 1973-2000

USGS Publications Warehouse

Karstensen, Krista A.

2009-01-01

Spearheaded by the Geographic Analysis and Monitoring Program of the U.S. Geological Survey (USGS) in collaboration with the U.S. Environmental Protection Agency (EPA) and the National Aeronautics and Space Administration (NASA), the Land Cover Trends is a research project focused on understanding the rates, trends, causes, and consequences of contemporary United States land-use and land-cover change. Using the EPA Level III ecoregions as the geographic framework, scientists process geospatial data collected between 1973 and 2000 to characterize ecosystem responses to land-use changes. The 27-year study period was divided into five temporal periods: 1973-1980, 1980-1986, 1986-1992, 1992-2000 and 1973-2000. General land-cover classes for these periods were interpreted from Landsat Multispectral Scanner, Thematic Mapper, and Enhanced Thematic Mapper Plus imagery to categorize land-cover change and evaluate using a modified Anderson Land Use Land Cover Classification System for image interpretation. The rates of land-cover change are estimated using a stratified, random sampling of 10-kilometer (km) by 10-km blocks allocated within each ecoregion. For each sample block, satellite images are used to interpret land-cover change. Additionally, historical aerial photographs from similar timeframes and other ancillary data such as census statistics and published literature are used. The sample block data are then incorporated into statistical analyses to generate an overall change matrix for the ecoregion. These change statistics are applicable for different levels of scale, including total change for the individual sample blocks and change estimates for the entire ecoregion. The results illustrate that there is no single profile of land-cover change but instead point to geographic variability that results from land uses within ecoregions continuously adapting to various factors including environmental, technological, and socioeconomic.

[Peribulbar block combined with general anesthesia in babies undergoing laser treatment for retinopathy of prematurity: a retrospective analysis].

PubMed

Pinho, Daniela Filipa Rodrigues; Real, Cátia; Ferreira, Leónia; Pina, Pedro

2018-03-12

Currently there is no agreement regarding which one is the most adequate anesthetic technique for the treatment of retinopathy of prematurity. Peribulbar block may reduce the incidence of oculocardiac reflex and postoperative apnea. The goal of this study was to report the outcomes of peribulbar block, when combined with general anesthesia, for the laser treatment for retinopathy of prematurity, in premature babies. A retrospective analysis of anesthetic records of all babies who underwent laser treatment for retinopathy of prematurity from January 2008 through December 2015 in a tertiary hospital was performed. During that period a total of six babies was submitted to laser treatment for retinopathy of prematurity, all under peribulbar block combined with general anesthesia. A single infratemporal injection of 0.15mL.kg -1 per eye ropivacaine 1% or 0.75% was performed. At the end of the procedure, all babies resumed spontaneous ventilation. No perioperative complications were reported. Peribulbar block was a safe anesthetic technique in our sample considered. Copyright © 2018 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

Implementation of Block Scheduling in a Four-Year High School: A Literary Review and a Handbook for Administrators, Teachers and Parents.

ERIC Educational Resources Information Center

Scroggins, Gary V.; Karr-Kidwell, PJ

High schools today face problems of culturally diverse student populations, diversity of student learning styles, and a growing public perception that high schools do not adequately prepare their graduates for either work or college. This paper offers an extensive review of literature on block scheduling as well as a handbook for gaining support…

Effects of continuous infusion of tumor necrosis factor-alpha (TNF) into adipose tissue on glucose and fatty acid metabolism in lactating dairy cattle

USDA-ARS?s Scientific Manuscript database

Late-lactation Holstein cows (n=9/treatment) were used to evaluate effects of TNF-alpha administration on glucose and fatty acid (FA) metabolism. Cows were blocked by feed intake and milk yield and randomly assigned within block to 1 of 3 treatments: control, TNF-alpha, and pair-fed control. Treatme...

Radiological study to evaluate the spreading of two volumes (10 vs. 20ml) of radiological contrast in the block of cutaneous branches of intercostal nerves in medial axillary line (BRILMA) in a porcine experimental model.

PubMed

Varela, O; Melone, A; López-Menchaca, R; Sevilla, R; Callejo, D; López-Álvarez, S; Román Fernández, A; García, S; Mantilla, I; Zaballos, M

2018-06-07

Interfascial blocks of the thoracic wall are being developed as an alternative to central blocks in breast surgery. However, there are few studies that have evaluated the anatomical extension of the local anaesthetic. The objective of this study was to analyse, using fluoroscopy, the spreading of two volumes (10 vs. 20ml) of radiological contrast in the serratus-intercostal plane block in an experimental pig model. Ten Large-White breed pigs were selected to have a bilateral ultrasound serratus-intercostal plane block performed, with the administering of 10ml and 20ml of iopamidol in the right and left hemithorax, respectively. The spreading of contrast was analysed by fluoroscopy. The Spearman test correlation was used to evaluate the relationship between the administered volume and radiological spreading. A value of P<.05 was considered significant. Twenty anaesthetic blocks were performed, being able to analyse 18 of them. The administration of 10ml of contrast was associated with a mean spreading of 2.28±0.31 (95% CI; 2.01-2.54) intercostal spaces, while the administration of 20ml showed a spreading of 3±0.25 (95% CI; 2.81-3.18) intercostal spaces. There was a significant correlation between the injected volume and the spreading of the contrast (Spearman correlation coefficient of 0.81; P=.0001). The results showed a spreading of volume subject to the serratus-intercostal plane block, although not maintaining a 1:1 ratio. Doubling the volume increased the blocked segments by 31%. These findings, if corroborated in the clinical practice, would allow a more precise adjustment in the anaesthetic volume administered. Copyright © 2018 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

Block 2. Photograph represents general view taken from the north/west ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Block 2. Photograph represents general view taken from the north/west region of the May D & F Tower. Photograph shows the main public gathering space for Skyline Park and depicts a light feature and an “Information” sign - Skyline Park, 1500-1800 Arapaho Street, Denver, Denver County, CO

Duration of motor block with intrathecal ropivacaine versus bupivacaine for caesarean section: a meta-analysis.

PubMed

Malhotra, R; Johnstone, C; Halpern, S; Hunter, J; Banerjee, A

2016-08-01

Bupivacaine is a commonly used local anaesthetic for spinal anaesthesia for caesarean section, but may produce prolonged motor block, delaying discharge from the post-anaesthesia care unit. Ropivacaine may have a shorter time to recovery of motor function compared with bupivacaine. We performed a meta-analysis to assess the time difference in duration of motor block with intrathecal ropivacaine compared with bupivacaine for caesarean section. We searched MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials databases for randomised controlled trials comparing ropivacaine with bupivacaine in parturients undergoing elective caesarean section under spinal anaesthesia. The primary outcome was the duration of motor block. Secondary outcomes included the time to onset of sensory block, need for conversion to general anaesthesia and the incidence of hypotension. Thirteen trials comprising 743 spinal anaesthetics were included. Intrathecal ropivacaine resulted in a reduced duration of motor block, regressing 35.7min earlier compared with intrathecal bupivacaine (P<0.00001). There was no difference in the time to onset of sensory block (P=0.25) or the incidence of hypotension (P=0.10). Limited data suggested no difference in the rate of conversion to general anaesthesia, but an earlier request for postoperative analgesia with ropivacaine. Compared with bupivacaine, intrathecal ropivacaine is associated with more rapid recovery of motor block despite similar sensory properties and no increased rate of conversion to general anaesthesia. This may be useful in centres in which recovery of motor block is a criterion for discharge from the post-anaesthesia care unit. However, small numbers of trials and significant heterogeneity limit the interpretation of our results. Copyright © 2016 Elsevier Ltd. All rights reserved.

Proposal for a new definition of congenital complete atrioventricular block.

PubMed

Brucato, A; Jonzon, A; Friedman, D; Allan, L D; Vignati, G; Gasparini, M; Stein, J I; Montella, S; Michaelsson, M; Buyon, J

2003-01-01

The classic old definition of congenital heart block by Yater (1929) is still generally accepted: 'Heart block established in a young patient. There must be some evidence of the existence of the slow pulse at a fairly early age and absence of a history of any infection which might cause the condition after birth: notably diphtheria, rheumatic fever, chorea and congenital syphilis'. However, other definitions are used. We systematically reviewed 1825 cases from 38 separate studies. We conclude that complete AV blocks detected in utero in the absence of structural abnormalities differ from blocks detected later in life with respect to pathogenesis (they are generally associated with maternal anti-Ro/SSA antibodies), poorer childhood prognosis, increased risk of developing late-onset dilated cardiomyopathy, different maternal clinical features and increased risk of recurrence in future pregnancies. For these reasons we propose a new modern definition of congenital complete AV block which might be acceptable to cardiologists, rheumatologists, pediatricians and obstetricians: 'an AV block is defined as congenital if it is diagnosed in utero, at birth or within the neonatal period (0-27 days after birth)'.

Oxytocin Reduces Ethanol Self-Administration in Mice

PubMed Central

King, Courtney E.; Griffin, William C.; Luderman, Lauryn N.; Kates, Malcolm M.; McGinty, Jacqueline F.; Becker, Howard C.

2017-01-01

Background Excessive ethanol consumption remains an important health concern and effective treatments are lacking. The central oxytocin system has emerged as a potentially important therapeutic target for alcohol and drug addiction. These studies tested the hypothesis that oxytocin reduces ethanol consumption. Methods Male C57BL/6J mice were given access to ethanol (20% v/v) using a model of binge-like drinking (“drinking-in-the-dark”) that also included the use of lickometer circuits to evaluate the temporal pattern of intake as well as 2-bottle choice drinking in the home cage. In addition, ethanol (12% v/v) and sucrose (5% w/v) self-administration on fixed- and progressive- ratio schedules were also evaluated. A wide range of systemically administered oxytocin doses were tested (0 to 10 mg/kg) in these models. Results Oxytocin (0, 0.3, 1, 3 or 10mg/kg) dose-dependently reduced ethanol consumption (maximal 45% reducton) in the binge drinking model, with lower effective doses having minimal effects on general locomotor activity. Oxytocin’s effect was blocked by pretreatment with an oxytocin receptor antagonist and the pattern of contacts (licks) at the ethanol bottle suggested a reduction in motivation to drink ethanol. Oxytocin decreased 2-bottle choice drinking without altering general fluid intake. Oxytocin also reduced operant responding for ethanol and sucrose in a dose-related manner. However, oxytocin decreased responding and motivation (breakpoint values) for ethanol at doses that did not alter responding for sucrose. Discussion These results indicate that oxytocin reduces ethanol consumption in different models of self-administration. The effects are not likely due to a general sedative effect of the neuropeptide. Further, oxytocin reduces motivation for ethanol at doses that do not alter responding for a natural reward (sucrose). While some evidence supports a role for oxytocin receptors in mediating these effects, additional studies are needed to further elucidate underlying mechanisms. Neverthess, these results support the therapeutic potential of oxytocin as a treatment for alcohol use disorder. PMID:28212464

Transversus abdominis plane block reduces postoperative pain intensity and analgesic consumption in elective cesarean delivery under general anesthesia.

PubMed

Eslamian, Laleh; Jalili, Zorvan; Jamal, Ashraf; Marsoosi, Vajiheh; Movafegh, Ali

2012-06-01

It is reported that following abdominal surgery, transversus abdominis plane (TAP) block can reduce postoperative pain. The primary outcome of this study was the evaluation of the efficacy of TAP block on pain intensity following cesarean delivery with Pfannenstiel incision. Fifty pregnant women were randomized blindly to receive either a TAP block with 15 ml 0.25% bupivacaine in both sides (group T, n = 25) or no blockade (group C, n = 25) at the end of the surgery, which was performed with a Pfannenstiel incision under general anesthesia. The pain intensity in the patients was assessed by a blinded investigator at the time of discharge from recovery and at 6, 12, and 24 h postoperatively, with a visual analogue scale (VAS) for pain. The women in the TAP block group had significantly lower VAS pain scores at rest and during coughing and consumed significantly less tramadol than the women in group C [50 mg (0-150) vs. 250 mg (0-400), P = 0.001]. There was a significantly longer time to the first request for analgesic in the TAP block group [210 min (0-300) vs. 30 min (10-180) in group C, P = 0.0001]. Two-sided TAP block with 0.25% bupivacaine in parturients who undergo cesarean section with a Pfannenstiel incision under general anesthesia can decrease postoperative pain and analgesic consumption. The time to the first analgesic rescue was longer in the parturients who received the TAP block.

47 CFR 15.120 - Program blocking technology requirements for television receivers.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 1 2011-10-01 2011-10-01 false Program blocking technology requirements for television receivers. 15.120 Section 15.120 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES Unintentional Radiators § 15.120 Program blocking technology requirements for television...

47 CFR 15.120 - Program blocking technology requirements for television receivers.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 1 2014-10-01 2014-10-01 false Program blocking technology requirements for television receivers. 15.120 Section 15.120 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES Unintentional Radiators § 15.120 Program blocking technology requirements for television...

47 CFR 15.120 - Program blocking technology requirements for television receivers.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 1 2012-10-01 2012-10-01 false Program blocking technology requirements for television receivers. 15.120 Section 15.120 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES Unintentional Radiators § 15.120 Program blocking technology requirements for television...

47 CFR 15.120 - Program blocking technology requirements for television receivers.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 1 2013-10-01 2013-10-01 false Program blocking technology requirements for television receivers. 15.120 Section 15.120 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES Unintentional Radiators § 15.120 Program blocking technology requirements for television...

47 CFR 15.120 - Program blocking technology requirements for television receivers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Program blocking technology requirements for television receivers. 15.120 Section 15.120 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES Unintentional Radiators § 15.120 Program blocking technology requirements for television...

28 CFR 0.142 - Per diem and travel allowances.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Explosives, Director of the United States Marshals Service, and Assistant Attorney General, Office of Justice... Administrator of General Services and the Assistant Attorney General for Administration. (b) Fixing rates in... Administrator of General Services and the Assistant Attorney General for Administration. (c) Authorizing travel...

28 CFR 0.142 - Per diem and travel allowances.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Explosives, Director of the United States Marshals Service, and Assistant Attorney General, Office of Justice... Administrator of General Services and the Assistant Attorney General for Administration. (b) Fixing rates in... Administrator of General Services and the Assistant Attorney General for Administration. (c) Authorizing travel...

28 CFR 0.142 - Per diem and travel allowances.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Explosives, Director of the United States Marshals Service, and Assistant Attorney General, Office of Justice... Administrator of General Services and the Assistant Attorney General for Administration. (b) Fixing rates in... Administrator of General Services and the Assistant Attorney General for Administration. (c) Authorizing travel...

28 CFR 0.142 - Per diem and travel allowances.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Explosives, Director of the United States Marshals Service, and Assistant Attorney General, Office of Justice... Administrator of General Services and the Assistant Attorney General for Administration. (b) Fixing rates in... Administrator of General Services and the Assistant Attorney General for Administration. (c) Authorizing travel...

Bayesian block-diagonal variable selection and model averaging

PubMed Central

Papaspiliopoulos, O.; Rossell, D.

2018-01-01

Summary We propose a scalable algorithmic framework for exact Bayesian variable selection and model averaging in linear models under the assumption that the Gram matrix is block-diagonal, and as a heuristic for exploring the model space for general designs. In block-diagonal designs our approach returns the most probable model of any given size without resorting to numerical integration. The algorithm also provides a novel and efficient solution to the frequentist best subset selection problem for block-diagonal designs. Posterior probabilities for any number of models are obtained by evaluating a single one-dimensional integral, and other quantities of interest such as variable inclusion probabilities and model-averaged regression estimates are obtained by an adaptive, deterministic one-dimensional numerical integration. The overall computational cost scales linearly with the number of blocks, which can be processed in parallel, and exponentially with the block size, rendering it most adequate in situations where predictors are organized in many moderately-sized blocks. For general designs, we approximate the Gram matrix by a block-diagonal matrix using spectral clustering and propose an iterative algorithm that capitalizes on the block-diagonal algorithms to explore efficiently the model space. All methods proposed in this paper are implemented in the R library mombf. PMID:29861501

Lateral geniculate lesions block circadian phase-shift responses to a benzodiazepine.

PubMed Central

Johnson, R F; Smale, L; Moore, R Y; Morin, L P

1988-01-01

Several pharmacological treatments, including application of an excitatory neurotoxin to the lateral geniculate nucleus (LGN) and systemic administration of triazolam, a clinically effective benzodiazepine, can elicit large phase shifts in a circadian rhythm according to the time of administration. The hypothesis that the LGN might mediate the effect of triazolam on circadian clock function was tested. Bilateral lesions of the LGN, which destroyed the connection from the intergeniculate leaflet to the suprachiasmatic nucleus, blocked phase-shift responses to triazolam. The requirement of an intact LGN for triazolam to shift circadian phase suggests that the LGN may be a site through which stimuli gain access to the circadian clock to modulate rhythm phase and entrainment. Images PMID:3293053

Using administrative medical claims data to supplement state disease registry systems for reporting zoonotic infections.

PubMed

Jones, Stephen G; Coulter, Steven; Conner, William

2013-01-01

To determine what, if any, opportunity exists in using administrative medical claims data for supplemental reporting to the state infectious disease registry system. Cases of five tick-borne (Lyme disease (LD), babesiosis, ehrlichiosis, Rocky Mountain spotted fever (RMSF), tularemia) and two mosquito-borne diseases (West Nile virus, La Crosse viral encephalitis) reported to the Tennessee Department of Health during 2000-2009 were selected for study. Similarly, medically diagnosed cases from a Tennessee-based managed care organization (MCO) claims data warehouse were extracted for the same time period. MCO and Tennessee Department of Health incidence rates were compared using a complete randomized block design within a general linear mixed model to measure potential supplemental reporting opportunity. MCO LD incidence was 7.7 times higher (p<0.001) than that reported to the state, possibly indicating significant under-reporting (∼196 unreported cases per year). MCO data also suggest about 33 cases of RMSF go unreported each year in Tennessee (p<0.001). Three cases of babesiosis were discovered using claims data, a significant finding as this disease was only recently confirmed in Tennessee. Data sharing between MCOs and health departments for vaccine information already exists (eg, the Vaccine Safety Datalink Rapid Cycle Analysis project). There may be a significant opportunity in Tennessee to supplement the current passive infectious disease reporting system with administrative claims data, particularly for LD and RMSF. There are limitations with administrative claims data, but health plans may help bridge data gaps and support the federal administration's vision of combining public and private data into one source.

Antibacterials: A sweet vaccine

NASA Astrophysics Data System (ADS)

Bundle, David

2016-03-01

Vaccination with a synthetic glycoconjugate, in combination with the administration of an inhibitor that blocks capsular polysaccharide synthesis in bacteria, could offer an alternative route to combat bacterial infections.

Technology Implementation and Workarounds in the Nursing Home

PubMed Central

Vogelsmeier, Amy A.; Halbesleben, Jonathon R.B.; Scott-Cawiezell, Jill R.

2008-01-01

Objective This study sought to explore the relationship of workarounds related to the implementation of an electronic medication administration record and medication safety practices in five Midwestern nursing homes. Design As a part of a larger study, this qualitative evaluation was conducted to identify workarounds associated with the implementation of an electronic medication administration record. Data were collected using multimethods including direct observation, process mapping, key informant interviews, and review of field notes from medication safety team meetings. Measurements Open and axial coding techniques were used to identify and categorize types of workarounds in relation to work flow blocks. Results Workarounds presented in two distinct patterns, those related to work flow blocks introduced by technology and those related to organizational processes not reengineered to effectively integrate with the technology. Workarounds such as safety alert overrides and shortcuts to documentation resulted from first-order problem solving of immediate blocks. Nursing home staff as individuals frequently used first-order problem solving instead of the more sophisticated second-order problem solving approach used by the medication safety team. Conclusion This study provides important practical examples of how nursing home staff work around work flow blocks encountered during the implementation of technology. Understanding these workarounds as a means of first-order problem solving is an important consideration to understanding risk to medication safety. PMID:17947626

Local infiltration of analgesia and sciatic nerve block provide similar pain relief after total knee arthroplasty.

PubMed

Tanikawa, Hidenori; Harato, Kengo; Ogawa, Ryo; Sato, Tomoyuki; Kobayashi, Shu; Nomoto, So; Niki, Yasuo; Okuma, Kazunari

2017-07-11

Although femoral nerve block provides satisfactory analgesia after total knee arthroplasty (TKA), residual posterior knee pain may decrease patient satisfaction. We conducted a randomized controlled trial to clarify the efficacy of the sciatic nerve block (SNB) and local infiltration of analgesia with steroid (LIA) regarding postoperative analgesia after TKA, when administrated in addition to femoral nerve block (FNB). Seventy-eight patients were randomly allocated to the two groups: concomitant administration of FNB and SNB or FNB and LIA. The outcome measures included post-operative pain, passive knee motion, C-reactive protein level, time to achieve rehabilitation goals, the Knee Society Score at the time of discharge, patient satisfaction level with anesthesia, length of hospital stay, surgical time, and complications related to local anesthesia. The patients in group SNB showed less pain than group LIA only on postoperative hours 0 and 3. Satisfactory postoperative analgesia after TKA was also achieved with LIA combined with FNB, while averting the risks associated with SNB. The influence on progress of rehabilitation and length of hospital stay was similar for both anesthesia techniques. The LIA offers a potentially safer alternative to SNB as an adjunct to FNB, particularly for patients who have risk factors for sciatic nerve injury.

3 CFR - Designation of Officers of the General Services Administration to Act as Administrator of General...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 3 The President 1 2014-01-01 2014-01-01 false Designation of Officers of the General Services Administration to Act as Administrator of General Services Presidential Documents Other Presidential Documents... Administrator. Sec. 3. Prior Memorandum Superseded. This memorandum supersedes the President's Memorandum of...

Interaction between glucocorticoids and glucagon in the hormonal modification of calcium retention by isolated rat liver mitochondria.

PubMed

Hughes, B P; Barritt, G J

1979-05-15

1. The administration of dexamethasone to intact fed rats by intraperitoneal injection for 3h was associated with a 6-fold increase in the time for which mitochondria subsequently isolated from the liver retain a given load of exogenous Ca2+. This effect was blocked by the co-administration of cycloheximide with dexamethasone, and partially blocked by the co-administration of puromycin. Daily administration of dexamethasone for periods of 4--7 days resulted in liver mitochondria that exhibited a decreased ability to retain exogenous Ca2+. 2. When glucagon was administered to fed adrenalectomized rats, the increase in mitochondrial Ca2+-retention time that results from the action of this hormone was reduced by 50% when compared with its effect on intact animals. The administration of dexamethasone to adrenalectomized rats partially restored the full effect of glucagon. 3. Dexamethasone did not enhance the effect of glucagon on mitochondrial Ca2+-retention time when administered to intact fed rats. 4. It is concluded that these data support the hypothesis that the hormone-induced modification of liver mitochondria, which results in an increase in the time for which exogenous Ca2+ is retained, involves a step in which new protein is synthesized.

Performance analysis of a generalized upset detection procedure

NASA Technical Reports Server (NTRS)

Blough, Douglas M.; Masson, Gerald M.

1987-01-01

A general procedure for upset detection in complex systems, called the data block capture and analysis upset monitoring process is described and analyzed. The process consists of repeatedly recording a fixed amount of data from a set of predetermined observation lines of the system being monitored (i.e., capturing a block of data), and then analyzing the captured block in an attempt to determine whether the system is functioning correctly. The algorithm which analyzes the data blocks can be characterized in terms of the amount of time it requires to examine a given length data block to ascertain the existence of features/conditions that have been predetermined to characterize the upset-free behavior of the system. The performance of linear, quadratic, and logarithmic data analysis algorithms is rigorously characterized in terms of three performance measures: (1) the probability of correctly detecting an upset; (2) the expected number of false alarms; and (3) the expected latency in detecting upsets.

Quasi-Block Copolymers Based on a General Polymeric Chain Stopper.

PubMed

Sanguramath, Rajashekharayya A; Nealey, Paul F; Shenhar, Roy

2016-07-11

Quasi-block copolymers (q-BCPs) are block copolymers consisting of conventional and supramolecular blocks, in which the conventional block is end-terminated by a functionality that interacts with the supramolecular monomer (a "chain stopper" functionality). A new design of q-BCPs based on a general polymeric chain stopper, which consists of polystyrene end-terminated with a sulfonate group (PS-SO3 Li), is described. Through viscosity measurements and a detailed diffusion-ordered NMR spectroscopy study, it is shown that PS-SO3 Li can effectively cap two types of model supramolecular monomers to form q-BCPs in solution. Furthermore, differential scanning calorimetry data and structural characterization of thin films by scanning force microscopy suggests the existence of the q-BCP architecture in the melt. The new design considerably simplifies the synthesis of polymeric chain stoppers; thus promoting the utilization of q-BCPs as smart, nanostructured materials. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

26 CFR 1.1248-3 - Earnings and profits attributable to stock in complex cases.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 2. (5) Share or block. In general, the computation under this paragraph shall be made separately for each share of stock sold or exchanged, except that if a group of shares constitute a block of stock the computation may be made in respect of the block. For purposes of this section, the term block of stock means a...

26 CFR 1.1248-3 - Earnings and profits attributable to stock in complex cases.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 2. (5) Share or block. In general, the computation under this paragraph shall be made separately for each share of stock sold or exchanged, except that if a group of shares constitute a block of stock the computation may be made in respect of the block. For purposes of this section, the term block of stock means a...

26 CFR 1.1248-3 - Earnings and profits attributable to stock in complex cases.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 2. (5) Share or block. In general, the computation under this paragraph shall be made separately for each share of stock sold or exchanged, except that if a group of shares constitute a block of stock the computation may be made in respect of the block. For purposes of this section, the term block of stock means a...

26 CFR 1.1248-3 - Earnings and profits attributable to stock in complex cases.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 2. (5) Share or block. In general, the computation under this paragraph shall be made separately for each share of stock sold or exchanged, except that if a group of shares constitute a block of stock the computation may be made in respect of the block. For purposes of this section, the term block of stock means a...

26 CFR 1.1248-3 - Earnings and profits attributable to stock in complex cases.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 2. (5) Share or block. In general, the computation under this paragraph shall be made separately for each share of stock sold or exchanged, except that if a group of shares constitute a block of stock the computation may be made in respect of the block. For purposes of this section, the term block of stock means a...

Evaluating atmospheric blocking in the global climate model EC-Earth

NASA Astrophysics Data System (ADS)

Hartung, Kerstin; Hense, Andreas; Kjellström, Erik

2013-04-01

Atmospheric blocking is a phenomenon of the midlatitudal troposphere, which plays an important role in climate variability. Therefore a correct representation of blocking in climate models is necessary, especially for evaluating the results of climate projections. In my master's thesis a validation of blocking in the coupled climate model EC-Earth is performed. Blocking events are detected based on the Tibaldi-Molteni Index. At first, a comparison with the reanalysis dataset ERA-Interim is conducted. The blocking frequency depending on longitude shows a small general underestimation of blocking in the model - a well known problem. Scaife et al. (2011) proposed the correction of model bias as a way to solve this problem. However, applying the correction to the higher resolution EC-Earth model does not yield any improvement. Composite maps show a link between blocking events and surface variables. One example is the formation of a positive surface temperature anomaly north and a negative anomaly south of the blocking anticyclone. In winter the surface temperature in EC-Earth can be reproduced quite well, but in summer a cold bias over the inner-European ocean is present. Using generalized linear models (GLMs) I want to study the connection between regional blocking and global atmospheric variables further. GLMs have the advantage of being applicable to non-Gaussian variables. Therefore the blocking index at each longitude, which is Bernoulli distributed, can be analysed statistically with GLMs. I applied a logistic regression between the blocking index and the geopotential height at 500 hPa to study the teleconnection of blocking events at midlatitudes with global geopotential height. GLMs also offer the possibility of quantifying the connections shown in composite maps. The implementation of the logistic regression can even be expanded to a search for trends in blocking frequency, for example in the scenario simulations.

A possible role for endogenous glucocorticoids in orchiectomy-induced atrophy of the rat levator ani muscle - Studies with RU 38486, a potent and selective antiglucocorticoid

NASA Technical Reports Server (NTRS)

Konagaya, Masaaki; Max, Stephen R.

1986-01-01

RU38486, a potent and selective antiglucocorticoid, was employed to study a possible role for endogenous glucocorticoids in atrophy of the levator ani muscle secondary to castration of male rats. RU38486 was shown to block (3H) triamcinolone acetonide binding to cytosol from levator ani muscle. Daily oral administration of RU38486 to castrated rats partially prevented atrophy of the levator ani muscle, as well as a decrease in RNA concentration. In a control group receiving RU38486 alone, the levator ani underwent significant 20 percent hypertrophy. Administration of exogenous dexamethasone also caused pronounced atrophy of the levator ani muscle. This atrophy was prevented, to a significant degree, by simultaneous oral administration of Ru38486. It is concluded that endogenous glucocorticoids, the actions of which are blocked by RU38486, may be involved in regulation of the mass of the levator ani muscle in intact rats.

A possible role for endogenous glucocorticoids in orchiectomy-induced atrophy of the rat levator ani muscle: Studies with RU38486, a potent and selective antiglucocorticoid

NASA Technical Reports Server (NTRS)

Konagaya, M.; Max, S. R.

1985-01-01

RU38486, a potent and selective antiglucocorticoid, was employed to study a possible role for endogenous glucocorticoids in atrophy of the levator ani muscle secondary to castration of male rats. RU38486 was shown to block (3H) triamcinolone acetonide binding to cytosol from levator ani muscle. Daily oral administration of RU38486 to castrated rats partially prevented atrophy of the levator ani muscle, as well as a decrease in RNA concentration. In a control group receiving RU38486 alone, the levator ani underwent significant (20%) hypertrophy. Administration of exogenous dexamethasone also caused pronounced atrophy of the levator ani muscle. This atrophy was prevented, to a significant degree, by simultaneous oral administration of RU38486. It is concluded that endogenous glucocorticoids, the actions of which are blocked by RU38486, may be involved in regulation of the mass of the levator ani muscle in intact rats.

The route of administration influences the therapeutic index of an anti-proNGF neutralizing mAb for experimental treatment of Diabetic Retinopathy.

PubMed

Barcelona, Pablo F; Galan, Alba; Nedev, Hinyu; Jian, Yifan; Sarunic, Marinko V; Saragovi, H Uri

2018-01-01

Many neurodegenerative retinal diseases are treated with monoclonal antibodies (mAb) delivered by invasive intravitreal injection (IVT). In Diabetic Retinopathy there is a scarcity of effective agents that can be delivered using non-invasive methods, and there are significant challenges in the validation of novel therapeutic targets. ProNGF represents a potential novel target, and IVT administration of a function-blocking anti-proNGF mAb is therapeutic in a mouse model of DR. We therefore compared invasive IVT to less invasive systemic intravenous (IV) and local subconjunctival (SCJ) administration, for therapy of Diabetic Retinopathy. The IV and SCJ routes are safe, afford sustained pharmacokinetics and tissue penetration of anti-proNGF mAb, and result in long-term therapeutic efficacy that blocks retinal inflammation, edema, and neuronal death. SCJ may be a more convenient and less-invasive approach for ophthalmic use and may enable reduced frequency of intervention for the treatment of retinal pathologies.

Impact of paracervical block on postabortion pain in patients undergoing abortion under general anesthesia.

PubMed

Lazenby, Gweneth B; Fogelson, Nicholas S; Aeby, Tod

2009-12-01

Paracervical block is used as a way to decrease postoperative pain in patients having abortions under general anesthesia. To date, no studies have evaluated the efficacy of this practice. Patients were recruited from a university-based family planning clinic. Seventy-two patients seeking abortion under general anesthesia were enrolled into the single-blinded study. Thirty-nine patients were randomized to receive a paracervical block, and 33 were randomized to no local anesthesia. The patients completed a demographic survey and visual analog pain scales for pain prior to and at several time points after the procedure. Data regarding the need for additional pain medications postoperatively were recorded. Analysis of variance single factor and two-sample one-sided t test were used in data analysis. Experimental and control groups were similar in all measured demographic characteristics. They were also similar in gestational age, number of laminaria required, preoperative dilation, operative time, estimated blood loss and reported complications. Postoperative pain was not significantly affected by placement of a paracervical block prior to abortion under general anesthesia. The need for postoperative pain medication during recovery was similar between groups. This study does not support the hypothesized benefit of local anesthesia prior to surgical abortion under general anesthesia to reduce postoperative pain.

76 FR 7695 - Iranian Human Rights Abuses Sanctions Regulations

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-11

... 562.301 Blocked account; blocked property. 562.302 Effective date. 562.303 Entity. 562.304 Interest. 562.305 Licenses; general and specific. 562.306 Person. 562.307 Property; property interest. 562.308... and acquisition of an interest in blocked property. 562.404 Transactions ordinarily incident to a...

A Design Selection Procedure.

ERIC Educational Resources Information Center

Kroeker, Leonard P.

The problem of blocking on a status variable was investigated. The one-way fixed-effects analysis of variance, analysis of covariance, and generalized randomized block designs each treat the blocking problem in a different way. In order to compare these designs, it is necessary to restrict attention to experimental situations in which observations…

Native American Literature.

ERIC Educational Resources Information Center

Porter, C. Fayne; And Others

Designed to accommodate a semester course in Native American Literature for secondary students, this teacher's guide includes a general introduction, a statement of the philosophy and goals upon which it is predicated, a nine-week block on post-Columbian literature, a nine-week block on oral literature, separate appendices for each block, a…

Does discontinuation of desflurane at the time of neostigmine administration speed recovery from cisatracurium block compared to that with a propofol-based technique?

PubMed

Kirkegaard-Nielsen, H; Caldwell, J E; Abengochea, A; Berry, P D; Heier, T

2001-05-01

Volatile anaesthetics are known to influence the effect of neostigmine as an antagonist of neuromuscular block. The aim of the present study was to investigate whether discontinuation of desflurane at the time of neostigmine administration shortens reversal time from cisatracurium block, compared to that with a propofol-based anaesthesia. Ten volunteers were studied twice. For one study, anaesthesia was induced with alfentanil and propofol and maintained with nitrous oxide 70% and propofol 150 microg. kg-1. min-1. For the other study, experimental conditions were replicated except that desflurane 6% was administered and the dose of propofol was only 50 microg. kg-1. min-1. The evoked mechanical response of the adductor pollicis to train-of-four (TOF) stimulation was recorded. Neuromuscular block was induced with cisatracurium 0.2 mg. kg-1. When the magnitude of the first TOF response (T1) had recovered to 10%, the block was antagonized with neostigmine 70 microg. kg-1. At this time, propofol was decreased to 50 microg. kg-1. min-1, or the desflurane was discontinued. There were no significant differences between the two techniques of anaesthesia in the rate of neostigmine-induced recovery of the TOF ratio. The times (mean+/-SD) to achieve TOF ratios of 0.7, 0.8, and 0.9 were (propofol first, desflurane second) 6.1+/-2.2 and 6.5+/-1.6 min; 10.4+/-4.2 and 9.6+/-2.7 min; 17.1+/-6.9 and 21.0+/-13.0 min, respectively. Discontinuing desflurane does not speed neostigmine-induced recovery from cisatracurium neuromuscular block, when compared to that during propofol-based anaesthesia.

Adult age differences in task switching.

PubMed

Kray, J; Lindenberger, U

2000-03-01

Age differences in 2 components of task-set switching speed were investigated in 118 adults aged 20 to 80 years using task-set homogeneous (e.g., AAAA ...) and task-set heterogeneous (e.g., AABBAABB ... ) blocks. General switch costs were defined as latency differences between heterogeneous and homogeneous blocks. whereas specific switch costs were defined as differences between switch and nonswitch trials within heterogeneous blocks. Both types of costs generalized over verbal, figural, and numeric stimulus materials; were more highly correlated to fluid than to crystallized abilities; and were not eliminated after 6 sessions of practice, indicating that they reflect basic and domain-general aspects of cognitive control. Most important, age-associated increments in costs were significantly greater for general than for specific switch costs, suggesting that the ability to efficiently maintain and coordinate 2 alternating task sets in working memory instead of 1 is more negatively affected by advancing age than the ability to execute the task switch itself.

Hypersomnolence with beta-adrenergic blockers.

PubMed

Thachil, J; Zeller, J R; Kochar, M S

1987-11-01

An elderly, mildly demented, hypertensive male patient developed hypersomnolence on administration of propranolol for treatment of hypertension; no other cause for hypersomnolence was detected. Upon replacement of propranolol with atenolol, he felt better but continued to be quite somnolent. When atenolol was discontinued, he reported to have lack of sleep. On readministration of subtherapeutic doses of the same beta-adrenergic blocking agents, he once again experienced excessive sleepiness. By discontinuing beta-blocking agents and introducing captopril, he felt much better, became pleasant and talkative, and blood pressure was well controlled. Beta antagonists are important drugs in the management of many cardiovascular problems. Propranolol, a lipophilic beta-blocking agent, and atenolol, a hydrophilic beta-blocking agent, are two of the major agents currently used clinically in the United States. Numerous neuropsychiatric side-effects of the beta-adrenergic blocking drugs have been reported, but hypersomnolence is not readily recognized as one of them.

Lamotrigine blocks repeated high-dose methamphetamine-induced behavioral sensitization to dizocilpine (MK-801), but not methamphetamine in rats.

PubMed

Nakato, Yasuya; Abekawa, Tomohiro; Inoue, Takeshi; Ito, Koki; Koyama, Tsukasa

2011-10-24

We recently proposed a new psychostimulant animal model of the progressive pathophysiological changes of schizophrenia. Studies using that model produced a treatment strategy for preventing progression. Lamotrigine (LTG) blocks repeated high-dosage methamphetamine (METH)-induced initiation and expression of prepulse inhibition deficit and development of apoptosis in the medial prefrontal cortex (mPFC). Moreover, it inhibits METH-induced increases in extracellular glutamate levels in the mPFC (Nakato et al., 2011, Neurosci. Lett.). Abnormal behavior induced by METH or NMDA receptor antagonists is regarded as an animal model of schizophrenia. This study examined the effects of LTG on the development of behavioral sensitization to METH and cross-sensitization to dizocilpine (MK-801) by repeated administration of high-dose METH (2.5mg/kg, 10 times s.c.). Rats were injected repeatedly with LTG (30mg/kg) after 120min METH administration (2.5mg/kg). Repeated co-administration of LTG blocked the development of behavioral cross-sensitization to MK-801 (0.15mg/kg), but it did not prevent behavioral sensitization to METH (0.2mg/kg). The LTG-induced prevention of increased glutamate by high-dose METH might be related to the former finding. Combined results of our previous studies and this study suggest that LTG is useful to treat schizophrenia, especially at a critical point in its progression. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

The effect on outcome of peribulbar anaesthesia in conjunction with general anesthesia for vitreoretinal surgery.

PubMed

Ghali, A M; El Btarny, A M

2010-03-01

The purpose of this study was to evaluate peri-operative outcome after vitreoretinal surgery when peribulbar anaesthesia is combined with general anaesthesia. Sixty adult patients undergoing elective primary retinal detachment surgery with scleral buckling or an encircling procedure received either peribulbar anaesthesia in conjunction with general anaesthesia or general anaesthesia alone. For peribulbar anaesthesia a single percutaneous injection of 5-7 ml of local anaesthetic solution (0.75% ropivacaine with hyaluronidase 15 iu.ml(-1)) was used. The incidence of intra-operative oculocardiac reflex and surgical bleeding interfering with the surgical field, postoperative pain and analgesia requirements, and postoperative nausea and vomiting were recorded. In the block group there was a lower incidence of oculocardiac reflex and surgical bleeding intra-operatively. Patients in the block group also had better postoperative analgesia and a lower incidence of postoperative nausea and vomiting compared with the group without a block. The use of peribulbar anaesthesia in conjunction with general anesthesia was superior to general anaesthesia alone for vitreoretinal surgery with scleral buckling.

Perfusion index and plethysmographic variability index in patients with interscalene nerve catheters.

PubMed

Sebastiani, Anne; Philippi, Larissa; Boehme, Stefan; Closhen, Dorothea; Schmidtmann, Irene; Scherhag, Anton; Markstaller, Klaus; Engelhard, Kristin; Pestel, Gunther

2012-12-01

Interscalene nerve blocks provide adequate analgesia, but there are no objective criteria for early assessment of correct catheter placement. In the present study, pulse oximetry technology was used to evaluate changes in the perfusion index (PI) in both blocked and unblocked arms, and changes in the plethysmographic variability index (PVI) were evaluated once mechanical ventilation was instituted. The PI and PVI values were assessed using a Radical-7™ finger pulse oximetry device (Masimo Corp., Irvine, CA, USA) in both arms of 30 orthopedic patients who received an interscalene catheter at least 25 min before induction of general anesthesia. Data were evaluated at baseline, on application of local anesthetics; five, ten, and 15 min after onset of interscalene nerve blocks; after induction of general anesthesia; before and after a 500 mL colloid fluid challenge; and five minutes thereafter. In the 25 patients with successful blocks, the difference between the PI values in the blocked arm and the PI values in the contralateral arm increased within five minutes of the application of the local anesthetics (P < 0.05) and increased progressively until 15 min. After induction of general anesthesia, the PI increased in the unblocked arm while it remained relatively constant in the blocked arm, thus reducing the difference in the PI. A fluid challenge resulted in a decrease in PVI values in both arms. The perfusion index increases after successful interscalene nerve blockade and may be used as an indicator for successful block placement in awake patients. The PVI values before and after a fluid challenge can be useful to detect changes in preload, and this can be performed in both blocked and unblocked arms.

[Intervention among patients with right bundle branch block and left anterior hemiblock. Operatory risk (author's transl)].

PubMed

Coriat, P; Harari, A; Tarot, J P; Ducardonnet, A; Viars, P

1981-01-01

In order to assess the risk of advanced heart block during anesthesia in patients with right bundle branch block and left anterior hemiblock, 35 consecutive patients were monitored throughout the pre-, intra- and postoperative period. As conventional ECG monitoring may only detect advanced atrioventricular block, patients were monitored according to the Holter method which can easily detect even minor changes of atrioventricular conduction namely slight increased PR interval or dropped P wave. All patients were asymptomatic, in normal sinus rhythm without second degree AV block. Surgical procedures were performed under general anesthesia (n = 15) and epidural anesthesia using lidocaine (n = 20). No episode of second or third degree atrioventricular block occurred. The only modifications observed were rare and transient increase of PR, occurring during surgical procedures in 5 patients, always associated with a sinus bradycardia. They immediately regressed at the termination of the sinus bradycardia either spontaneously or following atropine injection, strongly suggesting the responsability of increased vagal tone. Thus general or epidural anesthesia did not compromise infranodal conduction in any of the observed patients. These data indicate that anesthesia can be safely used without prophylactic preoperative insertion of pacemakers in patients with asymptomatic chronic right bundle branch block and left anterior hemi-block.

Temporary Blindness after Inferior Alveolar Nerve Block.

PubMed

Barodiya, Animesh; Thukral, Rishi; Agrawal, Shaila Mahendra; Rai, Anshul; Singh, Siddharth

2017-03-01

Inferior Alveolar Nerve Block (IANB) anaesthesia is one of the common procedures in dental clinic. This procedure is safe, but complications may still occur. Ocular complications such as diplopia, loss of vision, or ophthalmoplegia are extremely rare. This case report explains an event where due to individual anatomic variation of the sympathetic vasoconstrictor nerve and maxillary and middle meningeal arteries, intravascular administration of anaesthetic agent caused unusual ocular signs and symptoms such as temporary blindness.

76 FR 5375 - Public Availability of General Services Administration FY 2010 Service Contract Inventory

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-31

... GENERAL SERVICES ADMINISTRATION [2011-MV-1; Docket No. 2011-0006; Sequence 4] Public Availability of General Services Administration FY 2010 Service Contract Inventory AGENCY: Office of Acquisition Policy; General Services Administration (GSA). ACTION: Notice. SUMMARY: This notice announces that GSA is...

77 FR 5253 - Public Availability of General Services Administration FY 2011 Service Contract Inventory

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-02

... GENERAL SERVICES ADMINISTRATION [Notice-MV-2012-01; Docket 2012-0002; Sequence 3] Public Availability of General Services Administration FY 2011 Service Contract Inventory AGENCY: Office of Acquisition Policy (MV); General Services Administration (GSA). ACTION: Notice of public availability of FY...

77 FR 54917 - Public Availability of General Services Administration FY 2012 Federal Activities Inventory...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-06

... GENERAL SERVICES ADMINISTRATION [Notice-MV-2012-02; Docket No. 2012-0002; Sequence 14] Public Availability of General Services Administration FY 2012 Federal Activities Inventory Reform (FAIR) Act Inventory AGENCY: General Services Administration (GSA). ACTION: Notice of Public Availability of Fiscal...

Dutasteride

MedlinePlus

... alpha reductase inhibitors. It works by blocking the production of a natural substance that enlarges the prostate. ... send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http:// ...

Glycopyrrolate

MedlinePlus

... of medications called anticholinergics. It decreases stomach acid production by blocking the activity of a certain natural ... send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online (http:// ...

78 FR 42524 - Leasing versus Renting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-16

... DEPARTMENT OF DEFENSE GENERAL SERVICES ADMINISTRATION NATIONAL AERONAUTICS AND SPACE... Defense (DoD), General Services Administration (GSA), and National Aeronautics and Space Administration... your attached document. Fax: 202-501-4067. Mail: General Services Administration, Regulatory...

Aggravation of pre-existing atrioventricular block, Wenckebach type, provoked by application of X-ray contrast medium.

PubMed

Brodmann, Marianne; Seinost, Gerald; Stark, Gerhard; Pilger, Ernst

2006-01-01

Significant bradycardia followed by cardiac arrest related to single bolus administration of X-ray contrast medium into a peripheral artery has not, to our knowledge, been described in the literature. While performing a percutaneous transluminal angioplasty of the left superficial femoral artery in a 68-year old patient with a pre-existing atrioventricular (AV) block, Wenckebach type, he developed an AV block III after a single bolus injection of intra-arterial X-ray contrast medium. We believe that application of contrast medium causes a transitory ischemia in the obstructed vessel and therefore elevation of endogenous adenosine. In the case of a previously damaged AV node this elevation of endogenous adenosine may be responsible for the development of a short period of third-degree AV block.

75 FR 48872 - General Services Administration Acquisition Regulation; Rewrite of GSAR Part 541, Acquisition of...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-12

... Acquisition Regulation; Rewrite of GSAR Part 541, Acquisition of Utility Services AGENCIES: Office of Acquisition Policy, General Services Administration (GSA). ACTION: Final rule. SUMMARY: The General Services Administration (GSA) is amending the General Services Administration Acquisition Regulation (GSAR) to improve the...

78 FR 10174 - Public Availability of General Services Administration FY 2012 Service Contract Inventory

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-13

... GENERAL SERVICES ADMINISTRATION [Notice-MV-2013-02; Docket No. 2013-0002; Sequence 3] Public Availability of General Services Administration FY 2012 Service Contract Inventory AGENCY: General Services Administration (GSA). ACTION: Notice of Public Availability of FY 2012 Service Contract Inventories. SUMMARY: In...

78 FR 73863 - Public Availability of General Services Administration FY 2013 Federal Activities Inventory...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-09

... GENERAL SERVICES ADMINISTRATION [Notice-MV-2013-03; Docket No. 2013-0002; Sequence 37] Public... Inventory AGENCY: General Services Administration (GSA). ACTION: Notice of public availability of FY 2013...) Circular A-76, General Services Administration (GSA) is publishing this notice to advise the public of the...

Effect of perineural dexmedetomidine on the quality of supraclavicular brachial plexus block with 0.5% ropivacaine and its interaction with general anaesthesia.

PubMed

Gurajala, Indira; Thipparampall, Anil Kumar; Durga, Padmaja; Gopinath, R

2015-02-01

The effect of perineural dexmedetomidine on the time to onset, quality and duration of motor block with ropivacaine has been equivocal and its interaction with general anaesthesia (GA) has not been reported. We assessed the influence of dexmedetomidine added to 0.5% ropivacaine on the characteristics of supraclavicular brachial plexus block and its interaction with GA. In a randomised, double blind study, 36 patients scheduled for orthopaedic surgery on the upper limb under supraclavicular block and GA were divided into either R group (35 ml of 0.5% ropivacaine with 0.5 ml of normal saline [n - 18]) or RD group (35 mL of 0.5% ropivacaine with 50 μg dexmedetomidine [n - 18]). The onset time and duration of motor and sensory blockade were noted. The requirement of general anaesthetics was recorded. Both the groups were comparable in demographic characteristics. The time of onset of sensory block was not significantly different. The proportion of patients who achieved complete motor blockade was more in the RD group. The onset of motor block was earlier in group RD than group R (P < 0.05). The durations of analgesia, sensory and motor blockade were significantly prolonged in group RD (P < 0.00). The requirement of entropy guided anaesthetic agents was not different in both groups. The addition of dexmedetomidine to 0.5% ropivacaine improved the time of onset, quality and duration of supraclavicular brachial plexus block but did not decrease the requirement of anaesthetic agents during GA.

Operating unit time use is associated with anaesthesia type in below-knee surgery in adults.

PubMed

Lohela, T J; Chase, R P; Hiekkanen, T A; Kontinen, V K; Hynynen, M J

2017-03-01

Peripheral nerve blocks could reduce the operating unit and theatre time spent on high-risk patients who are particularly vulnerable to complications of general anaesthesia or have medications that prevent application of central neuraxial blocks. Medical record data of 617 and 254 elderly adults undergoing below-knee surgery in Jorvi and Meilahti hospitals (Helsinki University Hospital) between January 2010 and December 2012 were used to investigate the influence of anaesthetic technique on operating theatre times and on operating unit times using flexible parametric survival models. We report operating theatre and unit exit ratios (i.e. hazard ratios but using ratios of exit rates) for different types of anaesthesia. Adjusted analyses: In Jorvi Hospital, anaesthesia type was associated with large initial differentials in operating theatre times. The theatre exit ratios remained lower for general anaesthesia and central neuraxial blocks compared to peripheral nerve blocks until 30 min. In Meilahti Hospital, anaesthesia type did not influence theatre time, but was the best predictor of operating unit times. Compared to peripheral nerve blocks, the exit ratio remained lower for general anaesthesia until five operating unit hours in both hospitals and for central neuraxial blocks until 1 h in Meilahti Hospital and until 3 h in Jorvi Hospital. Holding area was used more in Jorvi Hospital compared to Meilahti Hospital. Peripheral nerve block anaesthesia reduces time spent in the operating unit and can reduce time spent in the operating theatre if induced in holding area outside of theatre. © 2017 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

48 CFR 1846.672-3 - Multiple consignee instructions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... SPACE ADMINISTRATION CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports... description. (c) Block 17—Enter the “total” quantity shipped by item or, if applicable, grouped identical...

48 CFR 1846.672-3 - Multiple consignee instructions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... SPACE ADMINISTRATION CONTRACT MANAGEMENT QUALITY ASSURANCE Material Inspection and Receiving Reports... description. (c) Block 17—Enter the “total” quantity shipped by item or, if applicable, grouped identical...

The Effect of Rectus Sheath Block as a Supplement of General Anesthesia on Postoperative Analgesia in Adult Patient Undergoing Umbilical Hernia Repair.

PubMed

Kartalov, Andrijan; Jankulovski, Nikola; Kuzmanovska, Biljana; Zdravkovska, Milka; Shosholcheva, Mirjana; Tolevska, Marija; Naumovski, Filip; Srceva, Marija; Petrusheva, Aleksandra Panovska; Selmani, Rexhep; Sivevski, Atanas

2017-12-01

Ultrasound guided rectus sheath block can block the ventral rami of the 7th to 12th thoracolumbar nerves by injection of local anesthetic into the space between the rectus muscle and posterior rectus sheath. The aim of this randomized double-blind study was to evaluate the analgesic effect of the bilateral ultrasound guided rectus sheath block as supplement of general anesthesia on patents undergoing elective umbilical hernia repair. After the hospital ethics committee approval, 60 (ASA I-II) adult patients scheduled for umbilical hernia repair were included in this study. The group I (n=30) patents received only general anesthesia. In the group II (n = 30) patents after induction of general anesthesia received a bilateral ultrasound guided rectus sheath block with 40 ml of 0.25% bupivacaine. In this study we assessed demographic and clinical characteristics, pain score - VAS at rest at 2, 4, 6, 12 and 24 hours after operation and total analgesic consumption of morphine dose over 24-hours. There were statistically significant differences in VAS scores between the groups I and II at all postoperative time points - 2hr, 4 hr, 6 hr, 12 hr and 24 hr. (P < 0.00001). The cumulative 24 hours morphine consumption after the operation was significantly lower in the group II (mean = 3.73 ± 1. 41) than the group I (mean = 8.76 ± 2.41). This difference was statistically significant (p = 0.00076). The ultrasound guided rectus sheath block used for umbilical hernia repair could reduce postoperative pain scores and the amount of morphine consumption in 24 hours postoperative period.

A Role for Sigma Receptors in Stimulant Self Administration and Addiction

PubMed Central

Katz, Jonathan L.; Su, Tsung-Ping; Hiranita, Takato; Hayashi, Teruo; Tanda, Gianluigi; Kopajtic, Theresa; Tsai, Shang-Yi

2011-01-01

Sigma1 receptors (σ1Rs) represent a structurally unique class of intracellular proteins that function as chaperones. σ1Rs translocate from the mitochondria-associated membrane to the cell nucleus or cell membrane, and through protein-protein interactions influence several targets, including ion channels, G-protein-coupled receptors, lipids, and other signaling proteins. Several studies have demonstrated that σR antagonists block stimulant-induced behavioral effects, including ambulatory activity, sensitization, and acute toxicities. Curiously, the effects of stimulants have been blocked by σR antagonists tested under place-conditioning but not self-administration procedures, indicating fundamental differences in the mechanisms underlying these two effects. The self administration of σR agonists has been found in subjects previously trained to self administer cocaine. The reinforcing effects of the σR agonists were blocked by σR antagonists. Additionally, σR agonists were found to increase dopamine concentrations in the nucleus accumbens shell, a brain region considered important for the reinforcing effects of abused drugs. Although the effects of the σR agonist, DTG, on dopamine were obtained at doses that approximated those that maintained self administration behavior those of another agonist, PRE-084 required higher doses. The effects of DTG were antagonized by non-selective or a preferential σ2R antagonist but not by a preferential σ1R antagonist. The effects of PRE-084 on dopamine were insensitive to σR antagonists. The data suggest that the self administration of σR agonists is independent of dopamine and the findings are discussed in light of a hypothesis that cocaine has both intracellular actions mediated by σRs, as well as extracellular actions mediated through conventionally studied mechanisms. The co-activation and potential interactions among these mechanisms, in particular those involving the intracellular chaperone σRs, may lead to the pernicious addictive effects of stimulant drugs. PMID:21904468

A Role for Sigma Receptors in Stimulant Self Administration and Addiction.

PubMed

Katz, Jonathan L; Su, Tsung-Ping; Hiranita, Takato; Hayashi, Teruo; Tanda, Gianluigi; Kopajtic, Theresa; Tsai, Shang-Yi

2011-01-01

Sigma(1) receptors (σ(1)Rs) represent a structurally unique class of intracellular proteins that function as chaperones. σ(1)Rs translocate from the mitochondria-associated membrane to the cell nucleus or cell membrane, and through protein-protein interactions influence several targets, including ion channels, G-protein-coupled receptors, lipids, and other signaling proteins. Several studies have demonstrated that σR antagonists block stimulant-induced behavioral effects, including ambulatory activity, sensitization, and acute toxicities. Curiously, the effects of stimulants have been blocked by σR antagonists tested under place-conditioning but not self-administration procedures, indicating fundamental differences in the mechanisms underlying these two effects. The self administration of σR agonists has been found in subjects previously trained to self administer cocaine. The reinforcing effects of the σR agonists were blocked by σR antagonists. Additionally, σR agonists were found to increase dopamine concentrations in the nucleus accumbens shell, a brain region considered important for the reinforcing effects of abused drugs. Although the effects of the σR agonist, DTG, on dopamine were obtained at doses that approximated those that maintained self administration behavior those of another agonist, PRE-084 required higher doses. The effects of DTG were antagonized by non-selective or a preferential σ(2)R antagonist but not by a preferential σ(1)R antagonist. The effects of PRE-084 on dopamine were insensitive to σR antagonists. The data suggest that the self administration of σR agonists is independent of dopamine and the findings are discussed in light of a hypothesis that cocaine has both intracellular actions mediated by σRs, as well as extracellular actions mediated through conventionally studied mechanisms. The co-activation and potential interactions among these mechanisms, in particular those involving the intracellular chaperone σRs, may lead to the pernicious addictive effects of stimulant drugs.

General, kappa, delta and mu opioid receptor antagonists mediate feeding elicited by the GABA-B agonist baclofen in the ventral tegmental area and nucleus accumbens shell in rats: reciprocal and regional interactions.

PubMed

Miner, Patricia; Shimonova, Lyudmila; Khaimov, Arthur; Borukhova, Yaffa; Ilyayeva, Ester; Ranaldi, Robert; Bodnar, Richard J

2012-03-14

Food intake is significantly increased following administration of agonists of GABA and opioid receptors into the nucleus accumbens shell (NACs) and ventral tegmental area (VTA). GABA-A or GABA-B receptor antagonist pretreatment within the VTA or NACs differentially affects mu-opioid agonist-induced feeding elicited from the same site. Correspondingly, general or selective opioid receptor antagonist pretreatment within the VTA or NACs differentially affects GABA agonist-induced feeding elicited from the same site. Regional interactions have been evaluated in feeding studies by administering antagonists in one site prior to agonist administration in a second site. Thus, opioid antagonist-opioid agonist and GABA antagonist-GABA agonist feeding interactions have been identified between the VTA and NACs. However, pretreatment with GABA-A or GABA-B receptor antagonists in the VTA failed to affect mu opioid agonist-induced feeding elicited from the NACs, and correspondingly, these antagonists administered in the NACs failed to affect mu opioid-induced feeding elicited from the VTA. To evaluate whether regional and reciprocal VTA and NACs feeding interactions occur for opioid receptor modulation of GABA agonist-mediated feeding, the present study examined whether feeding elicited by the GABA-B agonist, baclofen microinjected into the NACs was dose-dependently blocked by pretreatment with general (naltrexone: NTX), mu (beta-funaltrexamine: BFNA), kappa (nor-binaltorphamine: NBNI) or delta (naltrindole: NTI) opioid antagonists in the VTA, and correspondingly, whether VTA baclofen-induced feeding was dose-dependently blocked by NACs pretreatment with NTX, BFNA, NBNI or NTI in rats. Bilateral pairs of cannulae aimed at the VTA and NACs were stereotaxically implanted in rats, and their food intakes were assessed following vehicle and baclofen (200 ng) in each site. Baclofen produced similar magnitudes of increased food intake following VTA and NACs treatment. Baclofen administration in the VTA or NACs was also preceded by administration of NTX (0.1, 1, 5 μg, 0.5 h), BFNA (0.4, 4 μg, 24 h), NBNI (0.6, 6 μg, 0.5 h) or NTI (0.4, 4 μg, 0.5 h) into the other site with intake measured 1, 2 and 4 h after agonist treatment. VTA NTX significantly reduced NACs baclofen-induced feeding. Correspondingly, NACs NTX significantly reduced VTA baclofen-induced feeding, indicating a robust and bidirectional general opioid and GABA-B receptor feeding interaction. Whereas the high, but not low VTA BFNA dose reduced NACs baclofen-induced feeding, NACs BFNA failed to affect VTA baclofen-induced feeding, indicating a unidirectional mu opioid and GABA-B receptor feeding interaction. Whereas VTA NBNI at both doses reduced NACs baclofen-induced feeding, the high, but not low NACs NBNI dose significantly reduced VTA baclofen-induced feeding, indicating a bidirectional kappa opioid and GABA-B receptor feeding interaction. Whereas VTA NTI only transiently reduced NACs baclofen-induced feeding, NACs NTI failed to affect VTA baclofen-induced feeding, indicating a weak unidirectional delta opioid and GABA-B receptor interaction. Whereas administration of NTX or BFNA into the NACs or VTA marginally reduced spontaneous food intake, NBNI or NTI into the same sites failed to alter food intake alone. Therefore, the present study suggests that GABA employs a distributed brain network in mediating its ingestive effects that is dependent upon intact opioid receptor signaling with kappa opioid receptors more involved than mu and delta opioid receptors underlying these regional effects. An alternative hypothesis to be considered is that these effects could be the sum of two independent drug effects (opioid antagonists decreasing and baclofen increasing food intake). Copyright © 2012 Elsevier B.V. All rights reserved.

Exogenous NAD(+) decreases oxidative stress and protects H2O2-treated RPE cells against necrotic death through the up-regulation of autophagy.

PubMed

Zhu, Ying; Zhao, Ke-Ke; Tong, Yao; Zhou, Ya-Li; Wang, Yi-Xiao; Zhao, Pei-Quan; Wang, Zhao-Yang

2016-05-31

Increased oxidative stress, which can lead to the retinal pigment epithelium (RPE) cell death by inducing ATP depletion and DNA repair, is believed to be a prominent pathology in age-related macular degeneration (AMD). In the present study, we showed that and 0.1 mM nicotinamide adenine dinucleotide (NAD(+)) administration significantly blocked RPE cell death induced by 300 μM H2O2. Further investigation showed that H2O2 resulted in increased intracellular ROS level, activation of PARP-1 and subsequently necrotic death of RPE cells. Exogenous NAD(+) administration significantly decreased intracellular and intranuclear ROS levels in H2O2-treated RPE cells. In addition, NAD(+) administration to H2O2-treated RPE cells inhibited the activation of PARP-1 and protected the RPE cells against necrotic death. Moreover, exogenous NAD(+) administration up-regulated autophagy in the H2O2-treated RPE cells. Inhibition of autophagy by LY294002 blocked the decrease of intracellular and intranuclear ROS level. Besides, inhibition of autophagy by LY294002 abolished the protection of exogenous NAD(+) against H2O2-induced cell necrotic death. Taken together, our findings indicate that that exogenous NAD(+) administration suppresses H2O2-induced oxidative stress and protects RPE cells against PARP-1 mediated necrotic death through the up-regulation of autophagy. The results suggest that exogenous NAD(+) administration might be potential value for the treatment of AMD.

Hydrodynamic delivery of plasmid DNA encoding human FcγR-Ig dimers blocks immune-complex mediated inflammation in mice.

PubMed

Shashidharamurthy, R; Machiah, D; Bozeman, E N; Srivatsan, S; Patel, J; Cho, A; Jacob, J; Selvaraj, P

2012-09-01

Therapeutic use and function of recombinant molecules can be studied by the expression of foreign genes in mice. In this study, we have expressed human Fcγ receptor-Ig fusion molecules (FcγR-Igs) in mice by administering FcγR-Ig plasmid DNAs hydrodynamically and compared their effectiveness with purified molecules in blocking immune-complex (IC)-mediated inflammation in mice. The concentration of hydrodynamically expressed FcγR-Igs (CD16A(F)-Ig, CD32A(R)-Ig and CD32A(H)-Ig) reached a maximum of 130 μg ml(-1) of blood within 24 h after plasmid DNA administration. The in vivo half-life of FcγR-Igs was found to be 9-16 days and western blot analysis showed that the FcγR-Igs were expressed as a homodimer. The hydrodynamically expressed FcγR-Igs blocked 50-80% of IC-mediated inflammation up to 3 days in a reverse passive Arthus reaction model. Comparative analysis with purified molecules showed that hydrodynamically expressed FcγR-Igs are more efficient than purified molecules in blocking IC-mediated inflammation and had a higher half-life. In summary, these results suggest that the administration of a plasmid vector with the FcγR-Ig gene can be used to study the consequences of blocking IC binding to FcγRs during the development of inflammatory diseases. This approach may have potential therapeutic value in treating IC-mediated inflammatory autoimmune diseases such as lupus, arthritis and autoimmune vasculitis.

48 CFR 50.203 - General.

Code of Federal Regulations, 2012 CFR

2012-10-01

... management protections for sellers of QATTs and others in the supply and distribution chain. (b) The SAFETY... website are block designations and block certifications granted by DHS. [72 FR 63030, Nov. 7, 2007, as...

48 CFR 50.203 - General.

Code of Federal Regulations, 2013 CFR

2013-10-01

... management protections for sellers of QATTs and others in the supply and distribution chain. (b) The SAFETY... website are block designations and block certifications granted by DHS. [72 FR 63030, Nov. 7, 2007, as...

48 CFR 50.203 - General.

Code of Federal Regulations, 2011 CFR

2011-10-01

... management protections for sellers of QATTs and others in the supply and distribution chain. (b) The SAFETY... website are block designations and block certifications granted by DHS. [72 FR 63030, Nov. 7, 2007, as...

48 CFR 50.203 - General.

Code of Federal Regulations, 2014 CFR

2014-10-01

... management protections for sellers of QATTs and others in the supply and distribution chain. (b) The SAFETY... website are block designations and block certifications granted by DHS. [72 FR 63030, Nov. 7, 2007, as...

A general parallel sparse-blocked matrix multiply for linear scaling SCF theory

NASA Astrophysics Data System (ADS)

Challacombe, Matt

2000-06-01

A general approach to the parallel sparse-blocked matrix-matrix multiply is developed in the context of linear scaling self-consistent-field (SCF) theory. The data-parallel message passing method uses non-blocking communication to overlap computation and communication. The space filling curve heuristic is used to achieve data locality for sparse matrix elements that decay with “separation”. Load balance is achieved by solving the bin packing problem for blocks with variable size.With this new method as the kernel, parallel performance of the simplified density matrix minimization (SDMM) for solution of the SCF equations is investigated for RHF/6-31G ∗∗ water clusters and RHF/3-21G estane globules. Sustained rates above 5.7 GFLOPS for the SDMM have been achieved for (H 2 O) 200 with 95 Origin 2000 processors. Scalability is found to be limited by load imbalance, which increases with decreasing granularity, due primarily to the inhomogeneous distribution of variable block sizes.

Maternal and Child Health Block Grant: Program Changes Emerging under State Administration.

DTIC Science & Technology

1984-05-07

client information relating to age, sex , health condi- tion, treatment and outcome, and cost per unit of service. 2Other than for crippled children or high...types of data collected in- clude quantity of services delivered, geographic location or residence of clients served, age and sex of client population...ABOUT THE 901 Of IFORiATION THAT WERE OF GREAT IMOTAWEI NCH BLOCK GRAT DECISIONS STATISTICAL HEASUMES OP PEWORA4CE STATISTICAL MEASURES OF SEVICE NEDC

Energy management installation at North Middlesex Hospital.

PubMed

Hart, V A

1986-05-01

The author is the Energy Conservation Officer for the Haringey Health Authority. The North Middlesex Hospital is an acute unit with approximately 700 beds. Currently, twenty-one outstations control the maternity/radio therapy tower complex plus the outpatients' department. Plans have been approved to extend the system and Phase 2 will cover pathology, administration, medical and surgical blocks together with x-ray and casualty blocks. Transmitton Ltd, as in Phase 1, will supply the hardware and contract management.

Is topical haloperidol a useful glaucoma treatment?

PubMed Central

Lavin, M. J.; Andrews, V.

1986-01-01

A randomised, double blind, single dose study of topical haloperidol, a dopamine receptor blocking drug, was performed on 20 healthy volunteers. After its administration a modest reduction in intraocular pressure was recorded over the six-hour study period, but the difference was not significant at the p less than 0.05 level. Although dopamine blocking agents are effective in reducing intraocular pressure in experimental animals, topical haloperidol appears unlikely to be clinically useful in the treatment of glaucoma. PMID:3718908

Opioid receptors mediate direct predictive fear learning: evidence from one-trial blocking.

PubMed

Cole, Sindy; McNally, Gavan P

2007-04-01

Pavlovian fear learning depends on predictive error, so that fear learning occurs when the actual outcome of a conditioning trial exceeds the expected outcome. Previous research has shown that opioid receptors, including mu-opioid receptors in the ventrolateral quadrant of the midbrain periaqueductal gray (vlPAG), mediate such predictive fear learning. Four experiments reported here used a within-subject one-trial blocking design to study whether opioid receptors mediate a direct or indirect action of predictive error on Pavlovian association formation. In Stage I, rats were trained to fear conditioned stimulus (CS) A by pairing it with shock. In Stage II, CSA and CSB were co-presented once and co-terminated with shock. Two novel stimuli, CSC and CSD, were also co-presented once and co-terminated with shock in Stage II. The results showed one-trial blocking of fear learning (Experiment 1) as well as one-trial unblocking of fear learning when Stage II training employed a higher intensity footshock than was used in Stage I (Experiment 2). Systemic administrations of the opioid receptor antagonist naloxone (Experiment 3) or intra-vlPAG administrations of the selective mu-opioid receptor antagonist CTAP (Experiment 4) prior to Stage II training prevented one-trial blocking. These results show that opioid receptors mediate the direct actions of predictive error on Pavlovian association formation.

Preparing for the unexpected: special considerations and complications after sugammadex administration.

PubMed

Iwasaki, Hajime; Renew, J Ross; Kunisawa, Takayuki; Brull, Sorin J

2017-10-17

Sugammadex, a modified gamma-cyclodextrin, has changed clinical practice of neuromuscular reversal dramatically. With the introduction of this selective relaxant binding agent, rapid and reliable neuromuscular reversal from any depth of block became possible. Sugammadex can reverse neuromuscular blockade without the muscarinic side effects typically associated with the administration of acetylcholinesterase inhibitors. However, what remained unchanged is the incidence of residual neuromuscular blockade. It is known that sugammadex cannot always prevent its occurrence, if appropriate dosing is not chosen based on the level of neuromuscular paralysis prior to administration determined by objective neuromuscular monitoring. Alternatively, excessive doses of sugammadex administered in an attempt to ensure full and sustained reversal may affect the effectiveness of rocuronium in case of immediate reoperation or reintubation. In such emergent scenarios that require onset of rapid and reliable neuromuscular blockade, the summary of product characteristics (package insert) recommends using benzylisoquinolinium neuromuscular blocking agents or a depolarizing agent. However, if rapid intubation is required, succinylcholine has a significant number of side effects, and benzylisoquinolinium agents may not have the rapid onset required. Therefore, prior administration of sugammadex introduces a new set of potential problems that require new solutions. This novel reversal agent thus presents new challenges and anesthesiologists must familiarize themselves with specific issues with its use (e.g., bleeding risk, hypermagnesemia, hypothermia). This review will address sugammadex administration in such special clinical situations.

Feasibility and limits of inguinal hernia repair under local anaesthesia in a limited resource environment: a prospective controlled study.

PubMed

Bourgouin, S; Goudard, Y; Montcriol, A; Bordes, J; Nau, A; Balandraud, P

2017-10-01

Local anaesthesia (LA) has proven effective for inguinal hernia repair in developed countries. Hernias in low to middle income countries represent a different issue. The aim of this study was to analyse the feasibility of LA for African hernia repairs in a limited resource environment. Data from patients who underwent herniorrhaphy under LA or spinal anaesthesia (SA) by the 6th and 7th Forward Surgical Team were prospectively collected. All of the patients benefited from a transversus abdominis plane (TAP) block for postoperative analgesia. Primary endpoints concerned the pain response and conversion to general anaesthesia. Secondary endpoints concerned the complication and recurrence rates. Predictors of LA failure were then identified. In all, 189 inguinal hernias were operated during the study period, and 119 patients fulfilled the inclusion criteria: 57 LA and 62 SA. Forty-eight percent of patients presented with inguinoscrotal hernias. Local anaesthesia led to more pain during surgery and necessitated more administration of analgesics but resulted in fewer micturition difficulties and better postoperative pain control. Conversion rates were not different. Inguinoscrotal hernia and a time interval <50 min between the TAP block and skin incision were predictors of LA failure. Forty-four patients were followed-up at one month. No recurrence was noted. Local anaesthesia is a safe alternative to SA. Small or medium hernias can easily be performed under LA in rural centres, but inguinoscrotal hernias required an ultrasound-guided TAP block performed 50 min before surgery to achieve optimal analgesia, and should be managed only in centres equipped with ultrasonography.

Scale effects in food environment research: Implications from assessing socioeconomic dimensions of supermarket accessibility in an eight-county region of South Carolina

PubMed Central

Barnes, Timothy L.; Colabianchi, Natalie; Hibbert, James D.; Porter, Dwayne E.; Lawson, Andrew B.; Liese, Angela D.

2016-01-01

Choice of neighborhood scale affects associations between environmental attributes and health-related outcomes. This phenomenon, a part of the modifiable areal unit problem, has been described fully in geography but not as it relates to food environment research. Using two administrative-based geographic boundaries (census tracts and block groups), supermarket geographic measures (density, cumulative opportunity and distance to nearest) were created to examine differences by scale and associations between three common U.S. Census–based socioeconomic status (SES) characteristics (median household income, percentage of population living below poverty and percentage of population with at least a high school education) and a summary neighborhood SES z-score in an eight-county region of South Carolina. General linear mixed-models were used. Overall, both supermarket density and cumulative opportunity were higher when using census tract boundaries compared to block groups. In analytic models, higher median household income was significantly associated with lower neighborhood supermarket density and lower cumulative opportunity using either the census tract or block group boundaries, and neighborhood poverty was positively associated with supermarket density and cumulative opportunity. Both median household income and percent high school education were positively associated with distance to nearest supermarket using either boundary definition, whereas neighborhood poverty had an inverse association. Findings from this study support the premise that supermarket measures can differ by choice of geographic scale and can influence associations between measures. Researchers should consider the most appropriate geographic scale carefully when conducting food environment studies. PMID:27022204

Scale effects in food environment research: Implications from assessing socioeconomic dimensions of supermarket accessibility in an eight-county region of South Carolina.

PubMed

Barnes, Timothy L; Colabianchi, Natalie; Hibbert, James D; Porter, Dwayne E; Lawson, Andrew B; Liese, Angela D

2016-03-01

Choice of neighborhood scale affects associations between environmental attributes and health-related outcomes. This phenomenon, a part of the modifiable areal unit problem, has been described fully in geography but not as it relates to food environment research. Using two administrative-based geographic boundaries (census tracts and block groups), supermarket geographic measures (density, cumulative opportunity and distance to nearest) were created to examine differences by scale and associations between three common U.S. Census-based socioeconomic status (SES) characteristics (median household income, percentage of population living below poverty and percentage of population with at least a high school education) and a summary neighborhood SES z-score in an eight-county region of South Carolina. General linear mixed-models were used. Overall, both supermarket density and cumulative opportunity were higher when using census tract boundaries compared to block groups. In analytic models, higher median household income was significantly associated with lower neighborhood supermarket density and lower cumulative opportunity using either the census tract or block group boundaries, and neighborhood poverty was positively associated with supermarket density and cumulative opportunity. Both median household income and percent high school education were positively associated with distance to nearest supermarket using either boundary definition, whereas neighborhood poverty had an inverse association. Findings from this study support the premise that supermarket measures can differ by choice of geographic scale and can influence associations between measures. Researchers should consider the most appropriate geographic scale carefully when conducting food environment studies.

Preventive Analgesia by Local Anesthetics: The Reduction of Postoperative Pain by Peripheral Nerve Blocks and Intravenous Drugs

PubMed Central

Barreveld, Antje; Witte, Jürgen; Chahal, Harkirat; Durieux, Marcel E.; Strichartz, Gary

2012-01-01

The use of local anesthetics to reduce acute postoperative pain has a long history, but recent reports have not been systematically reviewed. In addition, the need to include only those clinical studies that meet minimum standards for randomization and blinding must be adhered to. In this review we have applied stringent clinical study design standards to identify publications on the use of perioperative local anesthetics. We first examined several types of peripheral nerve blocks, covering a variety of surgical procedures, and second, for effects of intentionally administered IV local anesthetic (lidocaine) for suppression of postoperative pain. Thirdly, we have examined publications in which vascular concentrations of local anesthetics were measured at different times after peripheral nerve block procedures, noting the incidence when those levels reached ones achieved during intentional IV administration. Importantly, the very large number of studies using neuraxial blockade techniques (epidural, spinal) has not been included in this review but will be dealt with separately in a later review. The overall results showed a strongly positive effect of local anesthetics, by either route, for suppressing postoperative pain scores and analgesic (opiate) consumption. In only a few situations were the effects equivocal. Enhanced effectiveness with the addition of adjuvants was not uniformly apparent. The differential benefits between drug delivery before, during, or immediately after a surgical procedure are not obvious, and a general conclusion is that the significant antihyperalgesic effects occur when the local anesthetic is present during the acute postoperative period, and its presence during surgery is not essential for this action. PMID:23408672

Interlocking Toy Building Blocks as Hands-On Learning Modules for Blind and Visually Impaired Chemistry Students

ERIC Educational Resources Information Center

Melaku, Samuel; Schreck, James O.; Griffin, Kameron; Dabke, Rajeev B.

2016-01-01

Interlocking toy building blocks (e.g., Lego) as chemistry learning modules for blind and visually impaired (BVI) students in high school and undergraduate introductory or general chemistry courses are presented. Building blocks were assembled on a baseplate to depict the relative changes in the periodic properties of elements. Modules depicting…

26 CFR 1.964-2 - Treatment of blocked earnings and profits.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 26 Internal Revenue 10 2013-04-01 2013-04-01 false Treatment of blocked earnings and profits. 1... blocked earnings and profits. (a) General rule. If, in accordance with paragraph (d) of this section, it... profits of a controlled foreign corporation for the taxable year (determined under § 1.964-1) was subject...

26 CFR 1.964-2 - Treatment of blocked earnings and profits.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 26 Internal Revenue 10 2012-04-01 2012-04-01 false Treatment of blocked earnings and profits. 1... blocked earnings and profits. (a) General rule. If, in accordance with paragraph (d) of this section, it... profits of a controlled foreign corporation for the taxable year (determined under § 1.964-1) was subject...

26 CFR 1.964-2 - Treatment of blocked earnings and profits.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 26 Internal Revenue 10 2011-04-01 2011-04-01 false Treatment of blocked earnings and profits. 1... blocked earnings and profits. (a) General rule. If, in accordance with paragraph (d) of this section, it... profits of a controlled foreign corporation for the taxable year (determined under § 1.964-1) was subject...

26 CFR 1.964-2 - Treatment of blocked earnings and profits.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 26 Internal Revenue 10 2014-04-01 2013-04-01 true Treatment of blocked earnings and profits. 1.964... blocked earnings and profits. (a) General rule. If, in accordance with paragraph (d) of this section, it... profits of a controlled foreign corporation for the taxable year (determined under § 1.964-1) was subject...

30 CFR 250.404 - What are the requirements for the crown block?

Code of Federal Regulations, 2012 CFR

2012-07-01

... OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations General Requirements § 250.404 What are the requirements for the crown block... block. You must check the device for proper operation at least once per week and after each drill-line...

30 CFR 250.404 - What are the requirements for the crown block?

Code of Federal Regulations, 2014 CFR

2014-07-01

... OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations General Requirements § 250.404 What are the requirements for the crown block... block. You must check the device for proper operation at least once per week and after each drill-line...

30 CFR 250.404 - What are the requirements for the crown block?

Code of Federal Regulations, 2013 CFR

2013-07-01

... OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations General Requirements § 250.404 What are the requirements for the crown block... block. You must check the device for proper operation at least once per week and after each drill-line...

Knowledge and Processes in Design

DTIC Science & Technology

1992-09-03

Orqanization Name(s) and Address(es). Self-explanatory. Block 16. Price Code. Enter approoriate price Block 8. Performing Organization Report code...NTIS on/y). Number. Enter the unique alphanumerc report number(s) assigned by the organization periorming the report. Blocks 17.-19...statement codings were then organized into larger control-flow structures centered around design components called modules. The general assumption was

5 CFR 1303.1 - General

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false General 1303.1 Section 1303.1 Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET ADMINISTRATIVE PROCEDURES PUBLIC INFORMATION PROVISIONS OF THE ADMINISTRATIVE PROCEDURES ACT Organization § 1303.1 General This information is furnished for...

20 CFR 655.1055 - Notice to the Employment and Training Administration (ETA) and the Attorney General (AG).

Code of Federal Regulations, 2010 CFR

2010-04-01

... Administration (ETA) and the Attorney General (AG). 655.1055 Section 655.1055 Employees' Benefits EMPLOYMENT AND...-Campus Work § 655.1055 Notice to the Employment and Training Administration (ETA) and the Attorney General (AG). (a) The Administrator shall notify the Attorney General and ETA of the final determination...

Ultrasound-guided bilateral greater occipital nerve block for the treatment of post-dural puncture headache

PubMed Central

Akyol, Fethi; Binici, Orhan; Kuyrukluyildiz, Ufuk; Karabakan, Guldane

2015-01-01

Background and Objective: Post-dural puncture headache (PDPH) is one of the complications frequently observed after spinal or epidural anesthesia with dural penetration. For PDPH patients who do not respond to conservative medical treatment, alternative treatments such as bilateral occipital nerve block should be considered.In this study the efficacy of bilateral occipital nerve block was retrospectively evaluated in patients with post-dural puncture headache. Methods: Ultrasound-guided bilateral occipital nerve block was administrated in 21 patients who developed PDPH after spinal anesthesia, but did not respond to conservative medical treatment within 48 hours between January 2012 and February 2014. The study was conducted at Erzincan University Faculty of Medicine Gazi Mengucek Education and Research Hospital Results: Mean Visual Analog Scale (VAS) pain scores at 10 minutes and 6, 10, 15 and 24 hours after the block were significantly improved compared to the patients with a pre-block VAS score between 4 and 6 as well as patients with a pre-block VAS score between 7 and 9 (p<0.01). After 24 hours of the block applied, VAS pain score dropped to 1 for all 12 patients who had a pre-block VAS score between 4 and 6. Whereas, VAS score decreased to 2 at 24 hours after the block in only one of the patients with a pre-block VAS between 7 and 9. For the patients with a pre-block VAS score between 7 and 9, there was no significant improvement in the mean VAS score 24 hours after the block. Conclusions: For patients with PDPH and a pre-block VAS score between 4 and 6 who do not respond to conservative medical treatment, an ultrasound-guided bilateral occipital nerve block may be effective. PMID:25878625

Blocks in the asymmetric simple exclusion process

NASA Astrophysics Data System (ADS)

Tracy, Craig A.; Widom, Harold

2017-12-01

In earlier work, the authors obtained formulas for the probability in the asymmetric simple exclusion process that the mth particle from the left is at site x at time t. They were expressed in general as sums of multiple integrals and, for the case of step initial condition, as an integral involving a Fredholm determinant. In the present work, these results are generalized to the case where the mth particle is the left-most one in a contiguous block of L particles. The earlier work depended in a crucial way on two combinatorial identities, and the present work begins with a generalization of these identities to general L.

Aggravation of Pre-Existing Atrioventricular Block, Wenckebach Type, Provoked by Application of X-Ray Contrast Medium

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

Brodmann, Marianne, E-mail: marianne.brodmann@meduni-graz.at; Seinost, Gerald; Stark, Gerhard

2006-12-15

Background. Significant bradycardia followed by cardiac arrest related to single bolus administration of X-ray contrast medium into a peripheral artery has not, to our knowledge, been described in the literature. Methods and Results. While performing a percutaneous transluminal angioplasty of the left superficial femoral artery in a 68-year old patient with a pre-existing atrioventricular (AV) block, Wenckebach type, he developed an AV block III after a single bolus injection of intra-arterial X-ray contrast medium. Conclusion. We believe that application of contrast medium causes a transitory ischemia in the obstructed vessel and therefore elevation of endogenous adenosine. In the case ofmore » a previously damaged AV node this elevation of endogenous adenosine may be responsible for the development of a short period of third-degree AV block.« less

General Mechanism of Morphology Transition and Spreading Area-dependent Phase Diagram of Block Copolymer Self-assembly at the Air/Water Interface

NASA Astrophysics Data System (ADS)

Kim, Dong Hyup; Kim, So Youn

Block copolymers (BCPs) can be self-assembled forming periodic nanostructures, which have been employed in many applications. While general agreements exist for the phase diagrams of BCP self-assembly in bulk or thin films, a fundamental understanding of BCP structures at the air/water interface still remain elusive. The current study explains morphology transition of BCPs with relative fraction of each block at the air/water interface: block fraction is the only parameter to control the morphology. In this study, we show morphology transitions from spherical to cylindrical and planar structures with neat polystyrene-b-poly(2-vinylpyridine) (PS-b-P2VP) via reducing the spreading area of BCP solution at the air/water interface. For example, PS-b-P2VP in a fixed block fraction known to form only spheres can experience sphere to cylinder or lamellar transitions depending on the spreading area at the air/water interface. Suggesting a new parameter to control the interfacial assembly of BCPs, a complete phase diagram is drawn with two paramters: relative block fraction and spreading area. We also explain the morphology transition with the combinational description of dewetting mechanism and spring effect of hydrophilic block.

Newer regional analgesia interventions (fascial plane blocks) for breast surgeries: Review of literature.

PubMed

Garg, Rakesh; Bhan, Swati; Vig, Saurabh

2018-04-01

Surgical resection of the primary tumour with axillary dissection is one of the main modalities of breast cancer treatment. Regional blocks have been considered as one of the modalities for effective perioperative pain control. With the advent of ultrasound, newer interventions such as fascial plane blocks have been reported for perioperative analgesia in breast surgeries. Our aim is to review the literature for fascial plane blocks for analgesia in breast surgeries. The research question for initiating the review was 'What are the reported newer regional anaesthesia techniques (fascial plane blocks) for female patients undergoing breast surgery and their analgesic efficacy?.' The participants, intervention, comparisons, outcomes and study design were followed. Due to the paucity of similar studies and heterogeneity, the assessment of bias, systematic review or pooled analysis/meta-analysis was not feasible. Of the 989 manuscripts, the present review included 28 manuscripts inclusive of all types of published manuscripts. 15 manuscripts directly related to the administration of fascial plane blocks for breast surgery across all type of study designs and cases were reviewed for the utility of fascial plane blocks in breast surgeries. Interfascial blocks score over regional anaesthetic techniques such as paravertebral block as they have no risk of sympathetic blockade, intrathecal or epidural spread which may lead to haemodynamic instability and prolonged hospital stay. This review observed that no block effectively covers the whole of breast and axilla, thus a combination of blocks should be used depending on the site of incision and extent of surgical resection.

Glucuronic acid and the ethanol metabolite ethyl-glucuronide cause Toll-like receptor 4 activation and enhanced pain

PubMed Central

Lewis, Susannah S.; Hutchinson, Mark R.; Zhang, Yingning; Hund, Dana K.; Maier, Steven F.; Rice, Kenner C.; Watkins, Linda R.

2013-01-01

We have previously observed that the non-opioid morphine metabolite, morphine-3-glucuronide, enhances pain via a toll-like receptor 4 (TLR4) dependent mechanism. The present studies were undertaken to determine whether TLR4-dependent pain enhancement generalizes to other classes of glucuronide metabolites. In silico modeling predicted that glucuronic acid alone and ethyl glucuronide, a minor but long-lasting ethanol metabolite, would dock to the same MD-2 portion of the TLR4 receptor complex previously characterized as the docking site for morphine-3-glucuronide. Glucuronic acid, ethyl glucuronide and ethanol all caused an increase in TLR4-dependent reporter protein expression in a cell line transfected with TLR4 and associated co-signaling molecules. Glucuronic acid-, ethyl glucuronide-, and ethanol-induced increases in TLR4 signaling were blocked by the TLR4 antagonists LPS-RS and (+)-naloxone. Glucuronic acid and ethyl glucuronide both caused allodynia following intrathecal injection in rats, which was blocked by intrathecal co-administration of the TLR4 antagonist LPS-RS. The finding that ethyl glucuronide can cause TLR4-dependent pain could have implications for human conditions such as hangover headache and alcohol withdrawal hyperalgesia, as well as suggesting that other classes of glucuronide metabolites could have similar effects. PMID:23348028

Postoperative pain management of liver transplantation in cystic fibrosis: Is it time to start US-guided neuraxial blocks?

PubMed

Piazza, M; Martucci, G; Arcadipane, A

2016-01-01

Cystic fibrosis (CF) is the most common life-limiting genetic disease in Caucasians. Declining lung function is the principal cause of death, but liver involvement can lead to the need for liver transplantation. General anesthesia has detrimental effects on pulmonary function, increasing perioperative morbidity and mortality in CF patients. Regional anesthetic techniques improve outcomes by reducing anesthetic drugs and administration of opioids, and hastening extubation, awakening, and restarting respiratory of physiotherapy. There is a growing evidence that thoracic epidural anesthesia is feasible in pediatric patients. Concerns about coagulopathy and immunosuppression have limited its use in liver transplantation. Ultrasonography is becoming an adjunct tool in neuraxial blocks, allowing faster and easier recognition of the epidural space, and reducing vertebral touch and number of attempts. In pediatric patients, it is still debated whether anesthesia has detrimental effects on cognitive development. Efforts to make regional techniques easier and safer by ultrasonography are ongoing. We report the first case of continuous thoracic epidural analgesia after pediatric liver transplantation in a 10-year-old boy affected with CF with macronodular cirrhosis. Despite a challenging coagulation profile, the echo-assisted procedure was safely performed and allowed extubation in the odds ratio, postoperative awakening and comfort, and quick resumption of respiratory physiotherapy.

75 FR 34093 - Information Collection; General Program Administration

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-16

... DEPARTMENT OF AGRICULTURE Farm Service Agency Information Collection; General Program... supports Farm Loan Programs (FLP) for the General Program Administration. DATES: We will consider comments.... SUPPLEMENTARY INFORMATION: Title: Farm Loan Programs--General Program Administration (7 CFR part 761). OMB...

Are You Overworked . . . or Underorganized?

ERIC Educational Resources Information Center

Stegman, Wayne G.; Mackenzie, R. Alec

1985-01-01

Successful administrators practice time management by delegating effectively and scheduling blocks of time to work without interruption. In addition, they set clear goals for meetings, avoid unnecessary meetings, and use weekly and monthly calendars. (MLF)

Palonosetron Injection

MedlinePlus

... works by blocking the action of serotonin, a natural substance that may cause nausea and vomiting. ... beat or heart rhythm dizziness or lightheadedness fainting fast, slow or ... the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting ...

Dolasetron Injection

MedlinePlus

... works by blocking the action of serotonin, a natural substance that may cause nausea and vomiting. ... beat or heart rhythm dizziness lightheadedness, or fainting fast, slow or ... the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting ...

Effects of global competition on health care administration in Finland and the United States. What you can do to save your practice.

PubMed

Thompson, J W; Stocks, R M; Shmerling, J E; Dempsey, J

1996-03-01

Global competition, a faltering Finnish economy, and deep recession are forcing difficult decisions on the health care administrators of this Nordic country known for its extensive social welfare safety net and socialized health care system. In the first part of this article the Finnish health care system and its problems, as well as possible solutions, are presented. Similarities to our own system are noted and discussed. In an interview, the director general for the Minister of Social Affairs and Health of Finland, Kimmo Leppo, expressed concern about future funding sources in his country for the same levels of social welfare and health care programs that presently exist. The Finns are considering managed competition among providers, increasing copayments, excess hospital beds, anticipated hospital closures in their country, block grants, and how to deal with rising physician unemployment. He was interested in the proposed US government health care plans, and especially the state of Tennessee's TennCare plan, a state plan that closely resembled the failed Clinton health care reform package. The second part of this article explores how global competition has brought the pressure of modern competitive economics into the US medical arena.

Neural Compensations After Lesion of the Cerebral Cortex

PubMed Central

Kolb, Bryan; Brown, Russell; Witt-Lajeunesse, Alane; Gibb, Robbin

2001-01-01

Functional improvement after cortical injury can be stimulated by various factors including experience, psychomotor stimulants, gonadal hormones, and neurotrophic factors. The, timing of the administration of these factors may be critical, however. For example, factors such as gonadal hormones, nerve growth factor, or psychomotor stimulants may act to either enhance or retard recovery, depending upon the timing of administration. Nicotine, for instance, stimulates recovery if given after an injury but is without neuroprotective effect and may actually retard recovery if it is given only preinjury. A related timing problem concerns the interaction of different treatments. For example, behavioral therapies may act, in part, via their action in stimulating the endogenous production of trophic factors. Thus, combining behavioral therapies with pharmacological administration of compounds to increase the availability of trophic factors enhances functional outcome. Finally, anatomical evidence suggests that the mechanism of action of many treatments is through changes in dendritic arborization, which presumably reflects changes in synaptic organization. Factors that enhance dendritic change stimulate functional compensation, whereas factors that retard or block dendritic change block or retard compensation. PMID:11530881

21 CFR 1309.41 - Administrative review generally.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 9 2013-04-01 2013-04-01 false Administrative review generally. 1309.41 Section... MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS OF LIST I CHEMICALS Action on Applications for Registration: Revocation Or Suspension of Registration § 1309.41 Administrative review generally. The Administrator may...

21 CFR 1309.41 - Administrative review generally.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Administrative review generally. 1309.41 Section... MANUFACTURERS, DISTRIBUTORS, IMPORTERS AND EXPORTERS OF LIST I CHEMICALS Action on Applications for Registration: Revocation Or Suspension of Registration § 1309.41 Administrative review generally. The Administrator may...