Impact of conditioning with TBI in adult patients with T-cell ALL who receive a myeloablative allogeneic stem cell transplantation: a report from the acute leukemia working party of EBMT.

PubMed

Cahu, X; Labopin, M; Giebel, S; Aljurf, M; Kyrcz-Krzemien, S; Socié, G; Eder, M; Bonifazi, F; Bunjes, D; Vigouroux, S; Michallet, M; Stelljes, M; Zuckerman, T; Finke, J; Passweg, J; Yakoub-Agha, I; Niederwieser, D; Sucak, G; Sengeløv, H; Polge, E; Nagler, A; Esteve, J; Mohty, M

2016-03-01

Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a therapeutic option for adult patients with T-cell ALL (T-ALL). Meanwhile, few allo-SCT data specific to adult T-ALL have been described thus far. Specifically, the optimal myeloablative conditioning regimen is unknown. In this retrospective study, 601 patients were included. Patients received allo-SCT in CR1, CR2, CR >2 or in advanced disease in 69%, 15%, 2% and 14% of cases, respectively. With an overall follow-up of 58 months, 523 patients received a TBI-based regimen, whereas 78 patients received a chemotherapy-based regimen including IV busulfan-cyclophosphamide (IV Bu-Cy) (n=46). Unlike patients aged ⩾35 years, patients aged <35 years who received a TBI-based regimen displayed an improved outcome compared with patients who received a chemotherapy-based regimen (5-year leukemia-free survival (LFS) of 50% for TBI versus 18% for chemo-only regimen or IV Bu-Cy regimens, P=10(-5) and 10(-4), respectively). In multivariate analysis, use of TBI was associated with an improved LFS (hazard ratio (HR)=0.55 (0.34-0.86), P=0.01) and overall survival (HR=0.54 (0.34-0.87), P=0.01) in patients aged <35 years. In conclusion, younger adult patients with T-ALL entitled to receive a myeloablative allo-SCT may benefit from TBI-based regimens.

Effect of Cord Blood Processing on Transplant Outcomes after Single Myeloablative Umbilical Cord Blood Transplantation

PubMed Central

Ballen, Karen K.; Logan, Brent R.; Laughlin, Mary J.; He, Wensheng; Ambruso, Daniel R.; Armitage, Susan E.; Beddard, Rachel L.; Bhatla, Deepika; Hwang, William Y.K.; Kiss, Joseph E.; Koegler, Gesine; Kurtzberg, Joanne; Nagler, Arnon; Oh, David; Petz, Lawrence D.; Price, Thomas H.; Quinones, Ralph R.; Ratanatharathorn, Voravit; Rizzo, J. Douglas; Sazama, Kathleen; Scaradavou, Andromachi; Schuster, Michael W.; Sender, Leonard S.; Shpall, Elizabeth J.; Spellman, Stephen R.; Sutton, Millicent; Weitekamp, Lee Ann; Wingard, John R.; Eapen, Mary

2015-01-01

Variations in cord blood manufacturing and administration are common, and the optimal practice, not known. We compared processing and banking practices at 16 public cord blood banks (CBB) in the United States, and assessed transplant outcomes on 530 single umbilical cord blood (UCB) myeloablative transplantations for hematologic malignancies, facilitated by these banks. UCB banking practices were separated into three mutually exclusive groups based on whether processing was automated or manual; units were plasma and red blood cell reduced or buffy coat production method or plasma reduced. Compared to the automated processing system for units, the day-28 neutrophil recovery was significantly lower after transplantation of units that were manually processed and plasma reduced (red cell replete) (odds ratio [OR] 0.19 p=0.001) or plasma and red cell reduced (OR 0.54, p=0.05). Day-100 survival did not differ by CBB. However, day-100 survival was better with units that were thawed with the dextran-albumin wash method compared to the “no wash” or “dilution only” techniques (OR 1.82, p=0.04). In conclusion, CBB processing has no significant effect on early (day 100) survival despite differences in kinetics of neutrophil recovery. PMID:25543094

Reducing Treatment-Related Mortality Did Not Improve Outcomes of Allogeneic Myeloablative Hematopoietic Cell Transplantation for High-Risk Multiple Myeloma: A University of Michigan Prospective Series.

PubMed

Pawarode, Attaphol; Mineishi, Shin; Reddy, Pavan; Braun, Thomas M; Khaled, Yasser A; Choi, Sung W; Magenau, John M; Harris, Andrew C; Connelly, James A; Kitko, Carrie L; Parkin, Brian L; Goldstein, Steven C; Yanik, Gregory A; Levine, John E; Ferrara, James L; Couriel, Daniel R

2016-01-01

Despite the ongoing advent of more effective immunomodulators and proteasome inhibitors, multiple myeloma (MM) remains incurable and no effective therapy is available for advanced aggressive disease. Although allogeneic (Allo) hematopoietic cell transplantation (HCT) has a curative potential, the outcomes remain poor because of high treatment-related mortality (TRM), mostly due to regimen-related toxicities and graft-versus-host disease (GVHD) in case of myeloablative conditionings, high relapse rate in case of reduced-intensity or nonmyeloablative regimens, and possibly other unknown MM-specific issues. In an attempt to improve TRM, without compromising conditioning intensity, we prospectively explored the feasibility and efficacy of a myeloablative but reduced-toxicity conditioning regimen, consisting of fludarabine and busulfan (FluBu4; fludarabine 40 mg/m(2)/day and busulfan 3.2 mg/kg/day i.v. × 4 days) in 22 patients with high-risk or advanced refractory MM. The majority (14 of 22, 64%) had prior autologous HCT. The median HCT-specific comorbidity index score was 3 (range, 0 to 6), with 46% having a Karnofsky performance score < 80%. Ten patients had unrelated donors, 3 of whom were 7/8 HLA-loci matched. GVHD prophylaxis was tacrolimus and methotrexate in 20 (91%). Most patients had active MM at transplantation, with a partial response in 12 of 22 (46%) and stable disease in 1 of 22 (4.5%). All 22 patients tolerated the FluBu4 conditioning well, without early toxic deaths or graft failure. Common regimen-related toxicities included mild to moderate mucositis (18 of 22, 82%) and mild transient liver function abnormality (9 of 22, 41%). There were no grade 4 toxicities but grade 3 mucositis occurred in 7 of 22 patients (32%). The cumulative incidence of severe, grades III and IV acute GVHD at day 180 was 23% (95% confidence interval [CI], 10% to 47%) and that of chronic GVHD was 68% (95% CI, 46% to 88%). The cumulative incidences of TRM at 100 days, 1�

Factors Influencing Pulmonary Toxicity in Children Undergoing Allogeneic Hematopoietic Stem Cell Transplantation in the Setting of Total Body Irradiation-Based Myeloablative Conditioning.

PubMed

Abugideiri, Mustafa; Nanda, Ronica H; Butker, Charlotte; Zhang, Chao; Kim, Sungjin; Chiang, Kuang-Yueh; Butker, Elizabeth; Khan, Mohammad K; Haight, Ann E; Chen, Zhengjia; Esiashvili, Natia

2016-02-01

This study evaluated factors associated with increased risk of pulmonary toxicity (PT) from any cause in pediatric patients after myeloablative conditioning, using total body irradiation (TBI), followed by allogeneic hematopoietic stem cell transplantation (HSCT). The records of 129 consecutive pediatric patients (range: 1-21 years of age) who underwent TBI-based myeloablative conditioning for hematologic malignancies at our institution between January 2003 and May 2014 were reviewed. Although total TBI doses ranged from 10.5 to 14 Gy, lung doses were limited to 10 Gy with partial transmission blocks. TBI dose rates ranged from 5.6 cGy/min to 20.9 cGy/min. PT was classified using clinical symptoms, radiographic evidence, and ventilatory defects on pulmonary function tests. Noninfectious (idiopathic) pneumonia syndrome (IPS) was characterized by patients exhibiting PT while demonstrating no signs of infection throughout the follow-up period. PT from any cause developed in 70.5% of patients and was significantly associated with increased transplantation-related mortality (TRM) (P=.03) and decreased overall survival (OS) (P=.02). IPS developed in 23.3% of patients but was not associated with increased TRM (P=.6) or decreased OS (P=.5). Acute graft-versus-host disease (GVHD) significantly affected PT (P=.001) but did not significantly influence the development of IPS (P=.4). Infection was a leading cause of PT (75.8%). TBI dose rate significantly affected development of overall PT (P=.02) and was the sole factor to significantly influence the incidence of IPS (P=.002). TBI total dose, dose per fraction, disease type, transplantation chemotherapy, age of patient, sex, and donor type did not significantly impact overall PT or IPS. A high incidence of PT was noted in this large series of homogeneously treated pediatric patients undergoing TBI for allogeneic HSCT. TBI dose rates affected overall PT and strongly influenced IPS. TBI dose rate is a contributing factor

The Cost of Hematopoietic Stem-Cell Transplantation in the United States

PubMed Central

Broder, Michael S.; Quock, Tiffany P.; Chang, Eunice; Reddy, Sheila R.; Agarwal-Hashmi, Rajni; Arai, Sally; Villa, Kathleen F.

2017-01-01

Background Hematopoietic stem-cell transplantation (HSCT) requires highly specialized, resource-intensive care. Myeloablative conditioning regimens used before HSCT generally require inpatient stays and are more intensive than other preparative regimens, and may therefore be more costly. Objective To estimate the costs associated with inpatient HSCT according to the type of the conditioning regimen used and other potential contributors to the overall cost of the procedure. Method We used data from the Truven Health MarketScan insurance claims database to analyze healthcare costs for pediatric (age <18 years) and adult (age ≥18 years) patients who had autologous or allogeneic inpatient HSCT between January 1, 2010, and September 23, 2013. We developed an algorithm to determine whether conditioning regimens were myeloablative or nonmyeloablative/reduced intensity. Results We identified a sample of 1562 patients who had inpatient HSCT during the study period for whom the transplant type and the conditioning regimen were determinable: 398 patients had myeloablative allogeneic HSCT; 195 patients had nonmyeloablative/reduced-intensity allogeneic HSCT; and 969 patients had myeloablative autologous HSCT. The median total healthcare cost at 100 days was $289,283 for the myeloablative allogeneic regimen cohort compared with $253,467 for the nonmyeloablative/reduced-intensity allogeneic regimen cohort, and $140,792 for the myeloablative autologous regimen cohort. The mean hospital length of stay for the index (first claim of) HSCT was 35.6 days in the myeloablative allogeneic regimen cohort, 26.6 days in the nonmyeloablative/reduced-intensity allogeneic cohort, and 21.8 days in the myeloablative autologous regimen cohort. Conclusion Allogeneic HSCT was more expensive than autologous HSCT, regardless of the regimen used. Myeloablative conditioning regimens led to higher overall costs than nonmyeloablative/reduced-intensity regimens in the allogeneic HSCT cohort, indicating a

Evaluation of the Pharmacokinetics and Efficacy of a Busulfan Test Dose in Adult Patients Undergoing Myeloablative Hematopoietic Cell Transplantation.

PubMed

Weil, Elizabeth; Zook, Felicia; Oxencis, Carolyn; Canadeo, Angela; Urmanski, Angela; Waggoner, Mindy; Eastwood, Daniel; Pasquini, Marcelo; Hamadani, Mehdi; Hari, Parameswaran

2017-06-01

Owing to interpatient variability in busulfan exposure, therapeutic monitoring of busulfan is often used in myeloablative allogeneic transplantation to ensure that patients are near the optimal steady-state goal of 900 ng/mL. One challenge in therapeutic monitoring of busulfan is the brief course of busulfan treatment, requiring prompt analysis and dose adjustments as needed. Pharmacokinetic evaluation of a busulfan test dose before the start of the conditioning regimen would allow for all conditioning regimen doses to be given at the calculated optimized dose. An observational study was completed to evaluate the effects of a busulfan test dose of 0.9 mg/kg administered before the start of a myeloablative intravenous busulfan-based conditioning regimen. Sixty adult patients who received a busulfan conditioning regimen were reviewed, including 30 patients prior to the implementation of the busulfan test dose (pretest dose group) and 30 patients who received the busulfan test dose (posttest dose group). The primary objective was a pharmacokinetic evaluation of the percentage of patients who achieved the desired steady-state goal using the test dose strategy. The safety and efficacy of the busulfan test dose were evaluated as well. The average busulfan steady-state level after the first dose of the conditioning regimen was significantly lower in the pre-test dose group compared with the post-test dose group (660 ng/mL versus 879.9 ng/mL; P < 0.001). Compared with the post-test dose group, significantly fewer patients in the pre-test dose group were within 10% of the busulfan steady-state goal (10% versus 73.3%; P < 0.001) or within 5% of the goal (0% versus 53%; P < 0.001). Requirements for parenteral nutrition and/or patient-controlled analgesia owing to mucositis and rates of veno-occlusive disease were not significantly different between the pre-test dose group and the post-test dose group. The rates of disease relapse, mortality, and acute

Prophylaxis of mucosal toxicity by oral propantheline and cryotherapy in children with malignancies undergoing myeloablative chemo-radiotherapy.

PubMed

Sato, Atsushi; Saisho-Hattori, Takako; Koizumi, Yoshitsugu; Minegishi, Masayoshi; Iinuma, Kazuie; Imaizumi, Masue

2006-12-01

Mucosal toxicity is an incapacitating complication of intensive chemo-radiotherapy for children with malignant disorders, and is physically and psychologically distressful. It is therefore important to minimize mucosal toxicity in those patients. In this report, the effects of the combined prophylaxis of oral cooling (cryotherapy) and administration of propantheline, an anticholinergic drug, were studied in patients (aged 2-16 year) with acute leukemias or solid tumors, who underwent myeloablative chemo-radiotherapy and autologous peripheral blood stem cell rescue from 1993 to 1997. Patients were pretreated with the combined prophylaxis (n = 12) or single prophylaxis (n = 5), or left untreated (n = 7). The combined prophylaxis significantly reduced the severe mucositis (combined, 8.3%; single, 20.0%; and untreated, 42.9%) and severe diarrhea (combined, 16.7%; single, 60.0%; and untreated, 57.1%). Moreover, the combined prophylaxis tended to shorten the periods of febrile episodes defined as temperature > 38 degrees C (combined, 3.8 days; single, 4.6 days; and untreated, 5.6 days). Therefore, the combination of propantheline and oral cryotherapy may be feasible and effective for reduction of mucosal toxicity in patients with malignancy who undergo high-dose chemotherapy.

Outcome of High-Risk Stage 3 Neuroblastoma with Myeloablative Therapy and 13-cis-Retinoic Acid: A Report from the Children’s Oncology Group

PubMed Central

Park, Julie R.; Villablanca, Judith G.; London, Wendy B.; Gerbing, Robert B.; Haas-Kogan, Daphne; Stanton Adkins, E.; Attiyeh, Edward F.; Maris, John M.; Seeger, Robert C.; Patrick Reynolds, C.; Matthay, Katherine K.

2009-01-01

Background The components of therapy required for patients with INSS Stage 3 neuroblastoma and high risk features remain controversial. Procedure A retrospective cohort design was used to determine if intensive chemoradiotherapy with purged autologous bone marrow rescue (ABMT) and/or 13-cis-retinoic acid (13-cis-RA) improved outcome for patients with high-risk neuroblastoma that was not metastatic to distant sites. We identified 72 patients with INSS Stage 3 neuroblastoma enrolled between 1991 and 1996 on the Phase III CCG 3891 randomized trial. Patients were analyzed on an intent-to-treat basis using a log-rank test. Results The 5-year event-free survival (EFS) and overall survival (OS) rates for patients with Stage 3 neuroblastoma were 55 +/- 6% and 59% +/- 6%, respectively (n=72). Patients randomized to ABMT (n=20) had 5-year EFS of 65% +/- 11% and OS of 65% +/- 11% compared to 41% +/- 11 (p=0.21) and 46% +/- 11% (p=0.23) for patients randomized to CC (n=23), respectively. Patients randomized to 13-cis-RA (n=23) had 5-year EFS of 70% +/- 10% and OS of 78% +/- 9% compared to 63% +/- 12% (p=0.67) and 67% +/- 12% (p=0.55) for those receiving no further therapy (n=16), respectively. Patients randomized to both ABMT and 13-cis-RA (n=6) had a 5-year EFS of 80% ± 11% and OS of 100%. Conclusion Patients with high-risk Stage 3 neuroblastoma have an overall poor prognosis despite aggressive chemoradiotherapy. Further studies are warranted to determine if myeloablative consolidation followed by 13-cis-RA maintenance therapy statistically significantly improves outcome. PMID:18937318

Comparison of pediatric allogeneic transplant outcomes using myeloablative busulfan with cyclophosphamide or fludarabine

PubMed Central

Artz, Andrew; Frangoul, Haydar; Loren, Alison; Mineishi, Shin

2018-01-01

Busulfan combined with cyclophosphamide (BuCy) has long been considered a standard myeloablative conditioning regimen for allogeneic hematopoietic cell transplantation (HCT), including both nonmalignant conditions and myeloid diseases. Substituting fludarabine for cyclophosphamide (BuFlu) to reduce toxicity without an increase in relapse has been increasingly performed in children, but without comparison with BuCy. We retrospectively analyzed 1781 children transplanted from 2008 to 2014 to compare the effectiveness of BuCy with BuFlu. Nonmalignant and malignant disease populations were analyzed separately. Overall mortality was comparable for children with nonmalignant conditions who received BuFlu or BuCy (relative risk [RR], 1.14, P = .52). Lower incidences of sinusoidal obstruction syndrome (P = .04), hemorrhagic cystitis (P = .04), and chronic graft-versus-host disease (P = .02) were observed after BuFlu, but the influence of the conditioning regimen could not be assessed by multivariate analysis because of the low frequency of these complications. Children transplanted for malignancies were more likely to receive BuFlu if they had higher hematopoietic cell transplantation-comorbidity index scores (P < .001) or their donor was unrelated and HLA-mismatched (P = .004). Nevertheless, there were no differences in transplant toxicities and comparable transplant-related mortality (RR, 1.2; P = .46), relapse (RR, 1.2; P = .15), and treatment failure (RR, 1.2; P = .12). BuFlu was associated with higher overall mortality (RR, 1.4; P = .008) related to inferior postrelapse survival (P = .001). Our findings demonstrated that outcomes after BuFlu are similar to those for BuCy for children, but for unclear reasons, those receiving BuFlu for malignancy may be at risk for shorter postrelapse survival. PMID:29844205

131I-tositumomab myeloablative radioimmunotherapy for non-Hodgkin’s lymphoma: radiation dose to the testes

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

Hattori, Naoya; Gopal, Ajay K.; Shields, Andrew T.

Purpose: To investigate radiation doses to the testes delivered by a radiolabeled anti-CD20 antibody and its effects on male sex hormone levels. Materials and methods: Testicular uptake and retention of 131I-tositumomab were measured, and testicular absorbed doses were calculated for 67 male patients (54+/-11 years of age) with non-Hodgkin's lymphoma who had undergone myeloablative radioimmunotherapy (RIT) using 131I-tositumomab. Time-activity curves for the major organs, testes, and whole body were generated from planar imaging studies. In a subset of patients, male sex hormones were measured before and 1 year after the therapy. Results: The absorbed dose to the testes showed considerablemore » variability (range=4.4-70.2 Gy). Pretherapy levels of total testosterone were below the lower limit of the reference range, and post-therapy evaluation demonstrated further reduction [4.6+/-1.8 nmol/l (pre-RIT) vs. 3.8+/-2.9 nmol/l (post-RIT), P<0.05]. Patients receiving higher radiation doses to the testes (>=25 Gy) showed a greater reduction [4.7+/-1.6 nmol/l (pre-RIT) vs. 3.3+/-2.7 nmol/l (post-RIT), P<0.05] compared with patients receiving lower doses (<25 Gy), who showed no significant change in total testosterone levels. Conclusion: The testicular radiation absorbed dose varied highly among individual patients. Finally, patients receiving higher doses to the testes were more likely to show post-RIT suppression of testosterone levels.« less

Evaluation of the spectra Optia® mononuclear cell collection procedure in multiple myeloma patients.

PubMed

Long, Gwynn; Waller, Edmund K; Gregurek, Steven; Tricot, Guido; Marschner, Susanne; Bill, Jerry

2015-02-01

Peripheral blood stem cell (PBSC) rescue following myeloablative therapy is a mainstay of cancer therapy. To evaluate the ability of the Spectra Optia Apheresis System (SO), a newly developed apheresis device, the device was studied in multiple myeloma patients undergoing a first autologous PBSC transplant. To demonstrate that neutrophil recovery was not inferior to historical controls when SO harvested PBSCs were reinfused following myeloablative therapy. Multiple myeloma patients were mobilized according to the standard practice at four clinical sites. Following mobilization, MNC collections were performed on the SO. The collected cells were cryopreserved and reinfused following myeloablative chemotherapy. Neutrophil recovery defined by an absolute neutrophil count exceeding 500/μL (ANC500) was compared to historical data for patients transplanted following apheresis using the COBE Spectra (CS) device. The median day to neutrophil recovery was 12 days (range 10-14 days), with no significant difference in engraftment comparing patients transplanted with stem cells collected using the SO versus historical cohort of patients collected with the CS. CD34+ cell and MNC collection efficiency (CE) were 69.3% and 65.0% for the SO and CS, respectively. Platelet CE, product hematocrit and product granulocytes (as % of WBCs) using the SO were 21%, 2.3% and 28%, respectively. There were no device-related severe adverse events. The study's results confirm that the Spectra Optia Apheresis System's MNC Collection Protocol is safe and effective for its intended use and that engraftment kinetics of cells collected by SO is not inferior to the CS System. © 2014 Wiley Periodicals, Inc.

Tandem autologous non-myeloablative allogeneic transplantation in patients with multiple myeloma relapsing after a first high dose therapy.

PubMed

Karlin, L; Arnulf, B; Chevret, S; Ades, L; Robin, M; De Latour, R P; Malphettes, M; Kabbara, N; Asli, B; Rocha, V; Fermand, J P; Socie, G

2011-02-01

We retrospectively studied a series of 23 patients (median age 50 years, range 29-59 years) with multiple myeloma (MM), treated in first relapse by a sequential autologous-allogeneic tandem approach. Tandem transplantation (TT) consisted in high dose melphalan (HDT) and auto-SCT followed by an (allo-SCT) preceded by two gray TBI non-myeloablative conditioning. All patients received a first HDT as frontline treatment. At day 100 post allo-SCT, complete donor chimerism was detected in 22 patients (95%). Acute GVHD was observed in 19 patients (15 grade I-II (65%) and 4 grade III-IV (17%)). Ten patients (43%) developed an extensive chronic GVHD. The non-relapse mortality at 1 year was 17%. After TT, the overall response rate was 91% (17% partial response, 35% very good partial remission and 39% complete remission). At 2 years, OS was 61%. Median event-free survival and OS were 36.8 and 60 months, respectively. Based on the propensity score matching method, a significant survival advantage could be seen in patients treated with TT as compared with non-allografted patients. Thus, allo-SCT, in TT approach, provides a high response rate with low toxicity and may improve survival of patients with relapsing MM.

Similar and Promising Outcomes in Lymphoma Patients Treated with Myeloablative or Nonmyeloablative Conditioning and Allogeneic Hematopoietic Cell Transplantation

PubMed Central

Tomblyn, Marcie; Brunstein, Claudio; Burns, Linda J.; Miller, Jeffrey S.; MacMillan, Margaret; DeFor, Todd E.; Weisdorf, Daniel J.

2008-01-01

We compared the outcomes of 141 consecutive patients who received allogeneic transplantation with either myeloablative (MA) or nonmyeloablative/reduced intensity (NMA) conditioning for non-Hodgkin and Hodgkin lymphoma at the University of Minnesota. All patients were transplanted between 1997 and 2004. NMA transplant recipients were older and received umbilical cord blood grafts more frequently (MA: 6 [9%]; NMA: 33 [43%], P < .001). NMA patients had more advanced disease and 30 (39%) patients had undergone prior autologous transplantation. The 4-year overall survival (OS) (MA: 46% versus NMA: 49%; p = .34) and the 3-year progression-free survival (PFS) (MA: 44% versus NMA: 31%; P = 0.82) were similar after MA or NMA conditioning. However, MA conditioning resulted in significantly higher 1-year treatment-related mortality (TRM) (MA: 43% versus NMA: 17%; P < .01) but a lower risk of relapse at 3 years (MA: 11% versus NMA: 36%; P < .01). We conclude that similar transplant outcomes are achieved after allogeneic hematopoietic stem cell transplantation using MA conditioning in younger patients and NMA conditioning in older patients or those with prior autologous transplantation not eligible for MA conditioning. Modifications to refine patient assignment to the preferred conditioning intensity and reduce relapse risks with NMA approaches are needed. PMID:18410896

Adoptive Cell Therapy for Patients With Metastatic Melanoma: Evaluation of Intensive Myeloablative Chemoradiation Preparative Regimens

PubMed Central

Dudley, Mark E.; Yang, James C.; Sherry, Richard; Hughes, Marybeth S.; Royal, Richard; Kammula, Udai; Robbins, Paul F.; Huang, JianPing; Citrin, Deborah E.; Leitman, Susan F.; Wunderlich, John; Restifo, Nicholas P.; Thomasian, Armen; Downey, Stephanie G.; Smith, Franz O.; Klapper, Jacob; Morton, Kathleen; Laurencot, Carolyn; White, Donald E.; Rosenberg, Steven A.

2008-01-01

Purpose The two approved treatments for patients with metastatic melanoma, interleukin (IL)-2 and dacarbazine, mediate objective response rates of 12% to 15%. We previously reported that adoptive cell therapy (ACT) with autologous antitumor lymphocytes in lymphodepleted hosts mediated objective responses in 51% of 35 patients. Here, we update that study and evaluate the safety and efficacy of two increased-intensity myeloablative lymphodepleting regimens. Patients and Methods We performed two additional sequential trials of ACT with autologous tumor-infiltrating lymphocytes (TIL) in patients with metastatic melanoma. Increasing intensity of host preparative lymphodepletion consisting of cyclophosphamide and fludarabine with either 2 (25 patients) or 12 Gy (25 patients) of total-body irradiation (TBI) was administered before cell transfer. Objective response rates by Response Evaluation Criteria in Solid Tumors (RECIST) and survival were evaluated. Immunologic correlates of effective treatment were studied. Results Although nonmyeloablative chemotherapy alone showed an objective response rate of 49%, when 2 or 12 Gy of TBI was added, the response rates were 52% and 72% respectively. Responses were seen in all visceral sites including brain. There was one treatment-related death in the 93 patients. Host lymphodepletion was associated with increased serum levels of the lymphocyte homeostatic cytokines IL-7 and IL-15. Objective responses were correlated with the telomere length of the transferred cells. Conclusion Host lymphodepletion followed by autologous TIL transfer and IL-2 results in objective response rates of 50% to 70% in patients with metastatic melanoma refractory to standard therapies. PMID:18809613

[Allogeneic hematopoietic stem cell transplantation using myeloablative conditioning including total body irradiation for pediatric acute lymphoblastic leukemia: a single-center retrospective analysis].

PubMed

Honda, Mamoru; Arakawa, Yuki; Kawakami, Ryota; Itabashi, Toshikazu; Yanagi, Masato; Sasaki, Koji; Watanabe, Kentaro; Isobe, Kiyotaka; Mori, Makiko; Hanada, Ryoji; Koh, Katsuyoshi

2018-01-01

This study aimed to investigate the clinical outcomes of hematopoietic stem cell transplantation (HSCT) with total body irradiation-based myeloablative conditioning (TBI-MAC) in pediatric patients with acute lymphoblastic leukemia (ALL). We retrospectively examined patients with ALL who underwent HSCT with TBI-MAC from January 2000 to August 2016 at our institute. We enrolled 67 patients with a median follow-up period of 8 years. The 5-year event-free survival (EFS) and overall survival (OS) were 51.2% and 59.6%, respectively. At the first complete remission, HSCT exhibited significantly superior EFS and OS in our patients than that in patients with other diseases. We encountered 57.9% of patients with at least one late complication. Major late complications were short stature (26.3%) and hypogonadism (18.4%). While late complications were observed in several recipients of HSCT, late complication-related deaths occurred in three patients. The TBI-MAC regimen led to favorable clinical outcomes in pediatric patients with ALL who underwent HSCT. Thus, proper evaluation and management of late complications are mandatory.

Factors Influencing Pulmonary Toxicity in Children Undergoing Allogeneic Hematopoietic Stem Cell Transplantation in the Setting of Total Body Irradiation-Based Myeloablative Conditioning

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

Abugideiri, Mustafa, E-mail: Mabugid@emory.edu; Nanda, Ronica H.; Butker, Charlotte

Purpose: This study evaluated factors associated with increased risk of pulmonary toxicity (PT) from any cause in pediatric patients after myeloablative conditioning, using total body irradiation (TBI), followed by allogeneic hematopoietic stem cell transplantation (HSCT). Methods and Materials: The records of 129 consecutive pediatric patients (range: 1-21 years of age) who underwent TBI-based myeloablative conditioning for hematologic malignancies at our institution between January 2003 and May 2014 were reviewed. Although total TBI doses ranged from 10.5 to 14 Gy, lung doses were limited to 10 Gy with partial transmission blocks. TBI dose rates ranged from 5.6 cGy/min to 20.9 cGy/min. PT was classified usingmore » clinical symptoms, radiographic evidence, and ventilatory defects on pulmonary function tests. Noninfectious (idiopathic) pneumonia syndrome (IPS) was characterized by patients exhibiting PT while demonstrating no signs of infection throughout the follow-up period. Results: PT from any cause developed in 70.5% of patients and was significantly associated with increased transplantation-related mortality (TRM) (P=.03) and decreased overall survival (OS) (P=.02). IPS developed in 23.3% of patients but was not associated with increased TRM (P=.6) or decreased OS (P=.5). Acute graft-versus-host disease (GVHD) significantly affected PT (P=.001) but did not significantly influence the development of IPS (P=.4). Infection was a leading cause of PT (75.8%). TBI dose rate significantly affected development of overall PT (P=.02) and was the sole factor to significantly influence the incidence of IPS (P=.002). TBI total dose, dose per fraction, disease type, transplantation chemotherapy, age of patient, sex, and donor type did not significantly impact overall PT or IPS. Conclusions: A high incidence of PT was noted in this large series of homogeneously treated pediatric patients undergoing TBI for allogeneic HSCT. TBI dose rates affected overall PT and

Engraftment kinetics and graft failure after single umbilical cord blood transplantation using a myeloablative conditioning regimen.

PubMed

Ruggeri, Annalisa; Labopin, Myriam; Sormani, Maria Pia; Sanz, Guillermo; Sanz, Jaime; Volt, Fernanda; Michel, Gerard; Locatelli, Franco; Diaz De Heredia, Cristina; O'Brien, Tracey; Arcese, William; Iori, Anna Paola; Querol, Sergi; Kogler, Gesine; Lecchi, Lucilla; Pouthier, Fabienne; Garnier, Federico; Navarrete, Cristina; Baudoux, Etienne; Fernandes, Juliana; Kenzey, Chantal; Eapen, Mary; Gluckman, Eliane; Rocha, Vanderson; Saccardi, Riccardo

2014-09-01

Umbilical cord blood transplant recipients are exposed to an increased risk of graft failure, a complication leading to a higher rate of transplant-related mortality. The decision and timing to offer a second transplant after graft failure is challenging. With the aim of addressing this issue, we analyzed engraftment kinetics and outcomes of 1268 patients (73% children) with acute leukemia (64% acute lymphoblastic leukemia, 36% acute myeloid leukemia) in remission who underwent single-unit umbilical cord blood transplantation after a myeloablative conditioning regimen. The median follow-up was 31 months. The overall survival rate at 3 years was 47%; the 100-day cumulative incidence of transplant-related mortality was 16%. Longer time to engraftment was associated with increased transplant-related mortality and shorter overall survival. The cumulative incidence of neutrophil engraftment at day 60 was 86%, while the median time to achieve engraftment was 24 days. Probability density analysis showed that the likelihood of engraftment after umbilical cord blood transplantation increased after day 10, peaked on day 21 and slowly decreased to 21% by day 31. Beyond day 31, the probability of engraftment dropped rapidly, and the residual probability of engrafting after day 42 was 5%. Graft failure was reported in 166 patients, and 66 of them received a second graft (allogeneic, n=45). Rescue actions, such as the search for another graft, should be considered starting after day 21. A diagnosis of graft failure can be established in patients who have not achieved neutrophil recovery by day 42. Moreover, subsequent transplants should not be postponed after day 42. Copyright© Ferrata Storti Foundation.

Myeloablative Versus Reduced-Intensity Hematopoietic Cell Transplantation for Acute Myeloid Leukemia and Myelodysplastic Syndromes

PubMed Central

Pasquini, Marcelo C.; Logan, Brent R.; Wu, Juan; Devine, Steven M.; Porter, David L.; Maziarz, Richard T.; Warlick, Erica D.; Fernandez, Hugo F.; Alyea, Edwin P.; Hamadani, Mehdi; Bashey, Asad; Giralt, Sergio; Geller, Nancy L.; Leifer, Eric; Le-Rademacher, Jennifer; Mendizabal, Adam M.; Horowitz, Mary M.; Deeg, H. Joachim; Horwitz, Mitchell E.

2017-01-01

Purpose The optimal regimen intensity before allogeneic hematopoietic cell transplantation (HCT) is unknown. We hypothesized that lower treatment-related mortality (TRM) with reduced-intensity conditioning (RIC) would result in improved overall survival (OS) compared with myeloablative conditioning (MAC). To test this hypothesis, we performed a phase III randomized trial comparing MAC with RIC in patients with acute myeloid leukemia or myelodysplastic syndromes. Patients and Methods Patients age 18 to 65 years with HCT comorbidity index ≤ 4 and < 5% marrow myeloblasts pre-HCT were randomly assigned to receive MAC (n = 135) or RIC (n = 137) followed by HCT from HLA-matched related or unrelated donors. The primary end point was OS 18 months post–random assignment based on an intent-to-treat analysis. Secondary end points included relapse-free survival (RFS) and TRM. Results Planned enrollment was 356 patients; accrual ceased at 272 because of high relapse incidence with RIC versus MAC (48.3%; 95% CI, 39.6% to 56.4% and 13.5%; 95% CI, 8.3% to 19.8%, respectively; P < .001). At 18 months, OS for patients in the RIC arm was 67.7% (95% CI, 59.1% to 74.9%) versus 77.5% (95% CI, 69.4% to 83.7%) for those in the MAC arm (difference, 9.8%; 95% CI, −0.8% to 20.3%; P = .07). TRM with RIC was 4.4% (95% CI, 1.8% to 8.9%) versus 15.8% (95% CI, 10.2% to 22.5%) with MAC (P = .002). RFS with RIC was 47.3% (95% CI, 38.7% to 55.4%) versus 67.8% (95% CI, 59.1% to 75%) with MAC (P < .01). Conclusion OS was higher with MAC, but this was not statistically significant. RIC resulted in lower TRM but higher relapse rates compared with MAC, with a statistically significant advantage in RFS with MAC. These data support the use of MAC as the standard of care for fit patients with acute myeloid leukemia or myelodysplastic syndromes. PMID:28380315

Similar Survival for Patients Undergoing Reduced-Intensity Total Body Irradiation (TBI) Versus Myeloablative TBI as Conditioning for Allogeneic Transplant in Acute Leukemia

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

Mikell, John L., E-mail: jmikell@emory.edu; Waller, Edmund K.; Switchenko, Jeffrey M.

Purpose: Hematopoietic stem cell transplantation (HSCT) is the mainstay of treatment for adults with acute leukemia. Total body irradiation (TBI) remains an important part of the conditioning regimen for HCST. For those patients unable to tolerate myeloablative TBI (mTBI), reduced intensity TBI (riTBI) is commonly used. In this study we compared outcomes of patients undergoing mTBI with those of patients undergoing riTBI in our institution. Methods and Materials: We performed a retrospective review of all patients with acute leukemia who underwent TBI-based conditioning, using a prospectively acquired database of HSCT patients treated at our institution. Patient data including details ofmore » the transplantation procedure, disease status, Karnofsky performance status (KPS), response rates, toxicity, survival time, and time to progression were extracted. Patient outcomes for various radiation therapy regimens were examined. Descriptive statistical analysis was performed. Results: Between June 1985 and July 2012, 226 patients with acute leukemia underwent TBI as conditioning for HSCT. Of those patients, 180 had full radiation therapy data available; 83 had acute lymphoblastic leukemia and 94 had acute myelogenous leukemia; 45 patients received riTBI, and 135 received mTBI. Median overall survival (OS) was 13.7 months. Median relapse-free survival (RFS) for all patients was 10.2 months. Controlling for age, sex, KPS, disease status, and diagnosis, there were no significant differences in OS or RFS between patients who underwent riTBI and those who underwent mTBI (P=.402, P=.499, respectively). Median length of hospital stay was shorter for patients who received riTBI than for those who received mTBI (16 days vs 23 days, respectively; P<.001), and intensive care unit admissions were less frequent following riTBI than mTBI (2.22% vs 12.69%, respectively, P=.043). Nonrelapse survival rates were also similar (P=.186). Conclusions: No differences in OS or RFS were seen

The Sequence of Cyclophosphamide and Myeloablative Total Body Irradiation in Hematopoietic Cell Transplantation for Patients with Acute Leukemia.

PubMed

Holter-Chakrabarty, Jennifer L; Pierson, Namali; Zhang, Mei-Jie; Zhu, Xiaochun; Akpek, Görgün; Aljurf, Mahmoud D; Artz, Andrew S; Baron, Frédéric; Bredeson, Christopher N; Dvorak, Christopher C; Epstein, Robert B; Lazarus, Hillard M; Olsson, Richard F; Selby, George B; Williams, Kirsten M; Cooke, Kenneth R; Pasquini, Marcelo C; McCarthy, Philip L

2015-07-01

Limited clinical data are available to assess whether the sequencing of cyclophosphamide (Cy) and total body irradiation (TBI) changes outcomes. We evaluated the sequence in 1769 (CyTBI, n = 948; TBICy, n = 821) recipients of related or unrelated hematopoietic cell transplantation who received TBI (1200 to 1500 cGY) for acute leukemia from 2003 to 2010. The 2 cohorts were comparable for median age, performance score, type of leukemia, first complete remission, Philadelphia chromosome-positive acute lymphoblastic leukemia, HLA-matched siblings, stem cell source, antithymocyte globulin use, TBI dose, and type of graft-versus-host disease (GVHD) prophylaxis. The sequence of TBI did not significantly affect transplantation-related mortality (24% versus 23% at 3 years, P = .67; relative risk, 1.01; P = .91), leukemia relapse (27% versus 29% at 3 years, P = .34; relative risk, .89, P = .18), leukemia-free survival (49% versus 48% at 3 years, P = .27; relative risk, .93; P = .29), chronic GVHD (45% versus 47% at 1 year, P = .39; relative risk, .9; P = .11), or overall survival (53% versus 52% at 3 years, P = .62; relative risk, .96; P = .57) for CyTBI and TBICy, respectively. Corresponding cumulative incidences of sinusoidal obstruction syndrome were 4% and 6% at 100 days (P = .08), respectively. This study demonstrates that the sequence of Cy and TBI does not impact transplantation outcomes and complications in patients with acute leukemia undergoing hematopoietic cell transplantation with myeloablative conditioning. Copyright © 2015 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Prospective, Randomized, Double-Blind, Phase III Clinical Trial of Anti-T-Lymphocyte Globulin to Assess Impact on Chronic Graft-Versus-Host Disease-Free Survival in Patients Undergoing HLA-Matched Unrelated Myeloablative Hematopoietic Cell Transplantation.

PubMed

Soiffer, Robert J; Kim, Haesook T; McGuirk, Joseph; Horwitz, Mitchell E; Johnston, Laura; Patnaik, Mrinal M; Rybka, Witold; Artz, Andrew; Porter, David L; Shea, Thomas C; Boyer, Michael W; Maziarz, Richard T; Shaughnessy, Paul J; Gergis, Usama; Safah, Hana; Reshef, Ran; DiPersio, John F; Stiff, Patrick J; Vusirikala, Madhuri; Szer, Jeff; Holter, Jennifer; Levine, James D; Martin, Paul J; Pidala, Joseph A; Lewis, Ian D; Ho, Vincent T; Alyea, Edwin P; Ritz, Jerome; Glavin, Frank; Westervelt, Peter; Jagasia, Madan H; Chen, Yi-Bin

2017-12-20

Purpose Several open-label randomized studies have suggested that in vivo T-cell depletion with anti-T-lymphocyte globulin (ATLG; formerly antithymocyte globulin-Fresenius) reduces chronic graft-versus-host disease (cGVHD) without compromising survival. We report a prospective, double-blind phase III trial to investigate the effect of ATLG (Neovii Biotech, Lexington, MA) on cGVHD-free survival. Patients and Methods Two hundred fifty-four patients 18 to 65 years of age with acute leukemia or myelodysplastic syndrome who underwent myeloablative HLA-matched unrelated hematopoietic cell transplantation (HCT) were randomly assigned one to one to placebo (n =128 placebo) or ATLG (n = 126) treatment at 27 sites. Patients received either ATLG or placebo 20 mg/kg per day on days -3, -2, -1 in addition to tacrolimus and methotrexate as GVHD prophylaxis. The primary study end point was moderate-severe cGVHD-free survival. Results Despite a reduction in grade 2 to 4 acute GVHD (23% v 40%; P = .004) and moderate-severe cGVHD (12% v 33%; P < .001) in ATLG recipients, no difference in moderate-severe cGVHD-free survival between ATLG and placebo was found (2-year estimate: 48% v 44%, respectively; P = .47). Both progression-free survival (PFS) and overall survival (OS) were lower with ATLG (2-year estimate: 47% v 65% [ P = .04] and 59% v 74% [ P = .034], respectively). Multivariable analysis confirmed that ATLG was associated with inferior PFS (hazard ratio, 1.55; 95% CI, 1.05 to 2.28; P = .026) and OS (hazard ratio, 1.74; 95% CI, 1.12 to 2.71; P = .01). Conclusion In this prospective, randomized, double-blind trial of ATLG in unrelated myeloablative HCT, the incorporation of ATLG did not improve moderate-severe cGVHD-free survival. Moderate-severe cGVHD was significantly lower with ATLG, but PFS and OS also were lower. Additional analyses are needed to understand the appropriate role for ATLG in HCT.

Single-unit umbilical cord blood transplantation from unrelated donors in patients with hematological malignancy using busulfan, thiotepa, fludarabine and ATG as myeloablative conditioning regimen.

PubMed

Sanz, J; Boluda, J C H; Martín, C; González, M; Ferrá, C; Serrano, D; de Heredia, C D; Barrenetxea, C; Martinez, A M; Solano, C; Sanz, M A; Sanz, G F

2012-10-01

Attempts to optimize outcomes in cord blood transplantation (CBT) by using new conditioning regimens and standardization of cord blood unit selection are warranted. In all, 88 patients (18 children and 70 adults) with hematological malignancy from nine Spanish institutions underwent a single-unit CBT after an i.v. BU-based myeloablative conditioning regimen. All evaluable patients except one engrafted. The overall cumulative incidence (CI) of myeloid engraftment was 94% at a median time of 19 days. In multivariate analysis, nonadvanced disease stage was the only factor with a favorable impact on myeloid engraftment. The CI of acute GVHD grades II-IV and chronic extensive GVHD were 24% each. The CI of nonrelapse mortality at 100 days, 180 days and 5 years was 14, 23 and 44%, respectively. The 5-year CI of relapse was 18%, whereas disease-free survival (DFS) was 46%, 39% and 11% for patients transplanted in early, intermediate and advanced stages of the disease, respectively. Our study shows high rates of engraftment with fast neutrophil recovery in patients undergoing single-unit CBT using a BU-based conditioning regimen. Long-term DFS can be achieved in a substantial number of patients with high-risk hematological malignancies, particularly when transplanted in an early stage of the disease.

Results of a prospective multicentre myeloablative double-unit cord blood transplantation trial in adult patients with acute leukaemia and myelodysplasia.

PubMed

Barker, Juliet N; Fei, Mingwei; Karanes, Chatchada; Horwitz, Mitchell; Devine, Steven; Kindwall-Keller, Tamila L; Holter, Jennifer; Adams, Alexia; Logan, Brent; Navarro, Willis H; Riches, Marcie

2015-02-01

Double-unit cord blood (CB) grafts may improve engraftment and relapse risk in adults with haematological malignancies. We performed a prospective high-dose myeloablative double-unit CB transplantation (CBT) trial in adults with high-risk acute leukaemia or myelodysplasia (MDS) between 2007 and 2011. The primary aim was to establish the 1-year overall survival in a multi-centre setting. Fifty-six patients (31 acute myeloid leukaemia, 19 acute lymphoblastic leukaemia, 4 other acute leukaemias, 2 myelodysplastic syndrome [MDS]) were transplanted at 10 centres. The median infused total nucleated cell doses were 2·62 (larger unit) and 2·02 (smaller unit) x 10(7) /kg. The cumulative incidence of day 100 neutrophil engraftment was 89% (95% confidence interval [CI]: 80-96). Day 180 grade II-IV acute graft-versus-host disease (GVHD) incidence was 64% (95%CI: 51-76) and 36% (95%CI: 24-49) of patients had chronic GVHD by 3-years. At 3-years post-transplant, the transplant-related mortality (TRM) was 39% (95%CI: 26-52), and the 3-year relapse incidence was 11% (95%CI: 4-21). With a median 37-month (range 23-71) follow-up of survivors, the 3-year disease-free survival was 50% (95%CI: 37-63). Double-unit CBT is a viable alternative therapy for high-risk acute leukaemia/ MDS in patients lacking a matched unrelated donor. This is especially important for minority patients. The relapse incidence was low but strategies to ameliorate TRM are needed. © 2014 John Wiley & Sons Ltd.

A single apheresis procedure in the donor may be enough to complete an allograft using the "Mexican method" of non-ablative allografting.

PubMed

Ruiz-Delgado, Guillermo J; Gutiérrez-Riveroll, Karla I; Gutiérrez-Aguirre, César H; Gómez-Almaguer, David; Eyzaguirre-Zapata, Renee; Priesca-Marin, Manuel; González-Carrillo, Martha L; Ruiz-Argüelles, Guillermo J

2009-04-01

Since 1999, in Mexico we have been using a regimen to conduct allografts that involves non-myeloablative conditioning and peripheral blood stem cells (PBSC) and have introduced some changes with the main goal of decreasing the cost of the procedure. We analysed the salient apheresis features of a group of 175 allogeneic peripheral blood stem cell transplants conducted in two institutions in a 7-year period. The grafts were conducted using the "Mexican" non-myelo ablative conditioning regimen employing oral busulphan, i.v. cyclophosphamide and i.v. fludarabine. In all instances, the apheresis machine employed was the Baxter CS3000 Plus and donors were mobilised with filgrastim. The apheresis procedures were performed on days 0, +1 and +2, the end-point of collection being 5,000 mL of blood/m2 in each procedure. Three apheresis sessions were planned but the number was adjusted according to the cell yield. The final number of allografted CD34 cells ranged between 0.5 and 25.4 x 10(6)/Kg of the recipient's body weight (median, 5.2 x 10(6)/Kg). One to three apheresis procedures were needed to obtain a product containing more than 0.5 x 10(6) CD34 cells/Kg of the recipient, the median being two procedures; in 72 cases (41%) a single apheresis procedure was sufficient to obtain the target number of CD34 cells. The volumes of apheresis ranged between 50 and 600 mL (median, 400 mL). Since the median cost of each apheresis procedure is 900 USD, the fact that two apheresis procedures was spared in 72 cases and one apheresis was spared in another 65 cases, led to a total saving of approximately 188,100 USD. It can be concluded that, in many cases, allogeneic transplants can be completed with a single apheresis session and that there are considerable financial benefits from this practice.

Outcome of high-risk stage 3 neuroblastoma with myeloablative therapy and 13-cis-retinoic acid: a report from the Children's Oncology Group.

PubMed

Park, Julie R; Villablanca, Judith G; London, Wendy B; Gerbing, Robert B; Haas-Kogan, Daphne; Adkins, E Stanton; Attiyeh, Edward F; Maris, John M; Seeger, Robert C; Reynolds, C Patrick; Matthay, Katherine K

2009-01-01

The components of therapy required for patients with INSS Stage 3 neuroblastoma and high-risk features remain controversial. A retrospective cohort design was used to determine if intensive chemoradiotherapy with purged autologous bone marrow rescue (ABMT) and/or 13-cis-retinoic acid (13-cis-RA) improved outcome for patients with high-risk neuroblastoma that was not metastatic to distant sites. We identified 72 patients with INSS Stage 3 neuroblastoma enrolled between 1991 and 1996 on the Phase 3 CCG-3891 randomized trial. Patients were analyzed on an intent-to-treat basis using a log-rank test. The 5-year event-free survival (EFS) and overall survival (OS) rates for patients with Stage 3 neuroblastoma were 55 +/- 6% and 59 +/- 6%, respectively (n = 72). Patients randomized to ABMT (n = 20) had 5-year EFS of 65 +/- 11% and OS of 65 +/- 11% compared to 41 +/- 11 (P = 0.21) and 46 +/- 11% (P = 0.23) for patients randomized to CC (n = 23), respectively. Patients randomized to 13-cis-RA (n = 23) had 5-year EFS of 70 +/- 10% and OS of 78 +/- 9% compared to 63 +/- 12% (P = 0.67) and 67 +/- 12% (P = 0.55) for those receiving no further therapy (n = 16), respectively. Patients randomized to both ABMT and 13-cis-RA (n = 6) had a 5-year EFS of 80 +/- 11% and OS of 100%. Patients with high-risk Stage 3 neuroblastoma have an overall poor prognosis despite aggressive chemoradiotherapy. Further studies are warranted to determine if myeloablative consolidation followed by 13-cis-RA maintenance therapy statistically significantly improves outcome.

Donor-Recipient Matching for KIR Genotypes Reduces Chronic GVHD and Missing Inhibitory KIR Ligands Protect against Relapse after Myeloablative, HLA Matched Hematopoietic Cell Transplantation

PubMed Central

Faridi, Rehan Mujeeb; Kemp, Taylor J.; Dharmani-Khan, Poonam; Lewis, Victor; Rajalingam, Raja; Berka, Noureddine; Storek, Jan; Masood Khan, Faisal

2016-01-01

Background Allogeneic hematopoietic cell transplantation (HCT) can be curative for many hematologic diseases. However, complications such as graft-versus-host disease (GVHD) and relapse of primary malignancy remain significant and are the leading causes of morbidity and mortality. Effects of killer Ig-like receptors (KIR)-influenced NK cells on HCT outcomes have been extensively pursued over the last decade. However, the relevance of the reported algorithms on HLA matched myeloablative HCT with rabbit antithymocyte globulin (ATG) is used for GVHD prophylaxis remains elusive. Here we examined the role of KIR and KIR-ligands of donor-recipient pairs in modifying the outcomes of ATG conditioned HLA matched sibling and unrelated donor HCT Methods and Findings The study cohort consisted of 281 HLA matched sibling and unrelated donor-recipient pairs of first allogeneic marrow or blood stem cell transplantation allocated into ‘discovery’ (135 pairs) and ‘validation’ (146 pairs) cohorts. High resolution HLA typing was obtained from the medical charts and KIR gene repertoires were obtained by a Luminex® based SSO method. All surviving patients were followed-up for a minimum of two years. KIR and HLA class I distributions of HCT pairs were stratified as per applicable definitions and were tested for their association with cause specific outcomes [acute GVHD grade II-IV (aGVHD), chronic GVHD needing systemic therapy (cGVHD) and relapse] using a multivariate competing risks regression model as well as with survival outcomes [relapse-free survival (RFS), cGVHD & relapse free survival (cGRFS) and overall survival (OS)] by multivariate Cox proportional hazards regression model. A significant association between KIR genotype mismatching (KIR-B/x donor into KIR-AA recipient or vice versa) and cGVHD was found in both discovery (p = 0.001; SHR = 2.78; 95%CI: 1.50–5.17) and validation cohorts (p = 0.005; SHR = 2.61; 95%CI: 1.33–5.11). High incidence of cGVHD associated

Donor-Recipient Matching for KIR Genotypes Reduces Chronic GVHD and Missing Inhibitory KIR Ligands Protect against Relapse after Myeloablative, HLA Matched Hematopoietic Cell Transplantation.

PubMed

Faridi, Rehan Mujeeb; Kemp, Taylor J; Dharmani-Khan, Poonam; Lewis, Victor; Tripathi, Gaurav; Rajalingam, Raja; Daly, Andrew; Berka, Noureddine; Storek, Jan; Masood Khan, Faisal

2016-01-01

Allogeneic hematopoietic cell transplantation (HCT) can be curative for many hematologic diseases. However, complications such as graft-versus-host disease (GVHD) and relapse of primary malignancy remain significant and are the leading causes of morbidity and mortality. Effects of killer Ig-like receptors (KIR)-influenced NK cells on HCT outcomes have been extensively pursued over the last decade. However, the relevance of the reported algorithms on HLA matched myeloablative HCT with rabbit antithymocyte globulin (ATG) is used for GVHD prophylaxis remains elusive. Here we examined the role of KIR and KIR-ligands of donor-recipient pairs in modifying the outcomes of ATG conditioned HLA matched sibling and unrelated donor HCT. The study cohort consisted of 281 HLA matched sibling and unrelated donor-recipient pairs of first allogeneic marrow or blood stem cell transplantation allocated into 'discovery' (135 pairs) and 'validation' (146 pairs) cohorts. High resolution HLA typing was obtained from the medical charts and KIR gene repertoires were obtained by a Luminex® based SSO method. All surviving patients were followed-up for a minimum of two years. KIR and HLA class I distributions of HCT pairs were stratified as per applicable definitions and were tested for their association with cause specific outcomes [acute GVHD grade II-IV (aGVHD), chronic GVHD needing systemic therapy (cGVHD) and relapse] using a multivariate competing risks regression model as well as with survival outcomes [relapse-free survival (RFS), cGVHD & relapse free survival (cGRFS) and overall survival (OS)] by multivariate Cox proportional hazards regression model. A significant association between KIR genotype mismatching (KIR-B/x donor into KIR-AA recipient or vice versa) and cGVHD was found in both discovery (p = 0.001; SHR = 2.78; 95%CI: 1.50-5.17) and validation cohorts (p = 0.005; SHR = 2.61; 95%CI: 1.33-5.11). High incidence of cGVHD associated with KIR genotype mismatching was applicable

High incidence of chronic graft-versus-host disease after myeloablative allogeneic stem cell transplantation for chronic lymphocytic leukemia in Sweden: graft-versus-leukemia effect protects against relapse.

PubMed

Machaczka, Maciej; Johansson, Jan-Erik; Remberger, Mats; Hallböök, Helene; Lazarevic, Vladimir Lj; Wahlin, Björn Engelbrekt; Omar, Hamdy; Wahlin, Anders; Juliusson, Gunnar; Kimby, Eva; Hägglund, Hans

2013-12-01

Allogeneic hematopoietic stem cell transplantation (allo-SCT) is a potentially curative treatment option for eligible patients with chronic lymphocytic leukemia (CLL). However, it is known that cure of CLL is only possible if a graft-versus-leukemia effect is present. Between 1994 and 2007, 48 adults underwent allo-SCT for poor-risk CLL in Sweden. Of these, ten (21%) patients aged 24-53 years (median: 46 years) received myeloablative conditioning (MAC), based on TBI and cyclophosphamide. All MAC patients had refractory, poorly controlled CLL before allo-SCT (partial remission in 9/10 patients and progressive disease in one). The cumulative incidence of acute graft-versus-host disease (GVHD) grades II-IV was 30%. Nine patients developed chronic GVHD; extensive in four. Rates of nonrelapse mortality at 1, 3 and 10 years were 0, 10 and 20%, respectively. Two patients relapsed 36 and 53 months after transplantation. Six patients were still alive after a median follow-up time of 11.5 years (range 5.9-13.7). The probabilities of relapse-free and overall survival from 1, 3 and 5 years after transplantation were 100, 90 and 70%, and 100, 90 and 80%, respectively. Nevertheless, our analysis of long-term outcome after MAC allo-SCT for CLL suggests that younger patients with poorly controlled CLL may benefit from MAC allo-SCT.

Reduced-intensity versus reduced-toxicity myeloablative fludarabine/busulfan-based conditioning regimens for allografted non-Hodgkin lymphoma adult patients: a retrospective study on behalf of the Société Francophone de Greffe de Moelle et de Thérapie Cellulaire.

PubMed

Le Bourgeois, A; Labopin, M; Blaise, D; Ceballos, P; Vigouroux, S; Peffault de Latour, R; Marçais, A; Bulabois, C E; Bay, J O; Chantepie, S; Deconinck, E; Daguindau, E; Contentin, N; Yakoub-Agha, I; Cornillon, J; Mercier, M; Turlure, P; Charbonnier, A; Rorhlich, P S; N'Guyen, S; Maillard, N; Marchand, T; Mohty, M; Chevallier, P

2017-09-01

Fludarabine/busulfan-based conditioning regimens are widely used to perform allogeneic stem-cell transplantation (allo-SCT) in high-risk non-Hodgkin lymphoma (NHL) patients. The impact of the dose intensity of busulfan on outcomes has not been reported yet. This was a retrospective with the aim to compare the outcomes of NHL patients who received before allo-SCT a fludarabine/busulfan conditioning regimen, either of reduced intensity (FB2, 2 days of busulfan at 4 mg/kg/day oral or 3.2 mg/kg/day i.v.) (n = 277) or at a myeloablative reduced-toxicity dose (FB3/FB4, 3 or 4 days of busulfan at 4 mg/kg/day oral or 3.2 mg/kg/day i.v.) (n = 101). In univariate analysis, the 2-year overall survival (FB2 66.5% versus 60.3%, P = 0.33), lymphoma-free survival (FB2 57.9% versus 49.8%, P = 0.26), and non-relapse mortality (FB2 19% versus 21.1%, P = 0.91) were similar between both groups. Cumulative incidence of grade III-IV acute graft versus host disease (GVHD) (FB2 11.2% versus 18%, P = 0.08), extensive chronic GVHD (FB2: 17.3% versus 10.7%, P = 0.18) and 2-year GVHD free-relapse free survival (FB2: 44.4% versus 42.8%, P = 0.38) were also comparable. In multivariate analysis there was a trend for a worse outcome using FB3/FB4 regimens (overall survival: HR 1.47, 95% CI: 0.96-2.24, P = 0.08; lymphoma-free survival: HR: 1.43, 95% CI: 0.99-2.06, P = 0.05; relapse incidence: HR 1.54; 95% CI: 0.96-2.48, P = 0.07). These results were confirmed using a propensity score-matching strategy. We conclude that reduced toxicity myeloablative conditioning with fludarabine/busulfan does not improve the outcomes compared with reduced-intensity conditioning in adults receiving allo-SCT for NHL. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Impact of Thymoglobulin by Stem Cell Source (Peripheral Blood Stem Cell or Bone Marrow) After Myeloablative Stem Cell Transplantation From HLA 10/10-Matched Unrelated Donors: A Report From the Société Française de Greffe de Moelle et de Thérapie Cellulaire.

PubMed

Ravinet, Aurelie; Cabrespine, Aurelie; Socié, Gerard; Milpied, Noël; Yakoub Agha, Ibrahim; Nguyen, Stephanie; Michallet, Mauricette; Menard, Anne Lise; Maillard, Natacha; Mohty, Mohamad; Suarez, Felipe; Huynh, Anne; Marchand, Tony; Deteix, Clémence; Cassuto, Jill Patrice; Maury, Sebastien; Chevallier, Patrice; Reman, Oumedaly; Peffault de Latour, Régis; Bay, Jacques Olivier

2016-08-01

The impact of antithymocyte globulin (ATG) in the setting of a myeloablative conditioning transplantation remains controversial, especially when using bone marrow (BM) as the stem cell source. We therefore conducted a retrospective analysis to investigate the impact of ATG in patients with acute myeloid leukemia or myelodysplastic syndrome receiving myeloablative conditioning followed by a matched 10 of 10 unrelated donor transplant from BM or peripheral blood stem cells (PBSCs). Our study included 356 patients conditioned with cyclophosphamide associated with fractionated total body irradiation or busulfan. Median follow-up was 17.6 months (range, 0-156). The ATG and PBSCs were the only variables that independently decreased the cumulative incidence (CI) of chronic graft-versus-host disease (GvHD) (hazards ratio [HR], 0.4; 95% CI, 0.21-0.73; P < 0.01; and HR, 0.53; 95% CI, 0.30-0.90; P = 0.02, respectively). The ATG had no impact on overall survival, disease-free survival, relapse, and nonrelapse mortality. In the PBSC group (n = 139), ATG was associated with a lower CI of both grades III to IV acute GvHD (HR, 0.17; 95% CI, 0.03-0.91; P = 0.04), chronic GvHD (HR, 0.31; 95% CI, 0.11-0.87; P = 0.03), and GvHD-free/relapse-free survival (HR, 0.48; 95% CI, 0.29-0.80; P < 0.01), whereas these correlations were not significant in the group of patients (n = 217) receiving BM (HR, 0.36; 95% CI, 0.11-1.93; P = 0.06 for grade III-IV acute GvHD; HR, 0.49; 95% CI, 0.22-1.06; P = 0.08 for chronic GvHD; and HR, 0.69; 95% CI, 0.46-1.01; P = 0.06 for GvHD-free/relapse-free survival). Although our results confirm the recommendation for ATG to be added after PBSC transplantation, no obvious benefit was identified using this approach in the setting of BM transplantation. Only prospective studies may yield definitive answers to this question.

The Johns Hopkins RTR Consortium: A Collaborative Approach to Advance Translational Science and Standardize Clinical Monitoring of Restorative Transplantation

DTIC Science & Technology

2016-10-01

received non-myeloablative conditioning with 50cGy total body and 350cGy thymic irradiation for induction. Aim1: Group I was treated with high-dose...regimen of non-myeloablative irradiation and peritransplant tacrolimus. The long-term graft survival off of immunosuppression for animals treated

Induction of transplantation tolerance to fully mismatched cardiac allografts by T cell mediated delivery of alloantigen

PubMed Central

Tian, Chaorui; Yuan, Xueli; Jindra, Peter T.; Bagley, Jessamyn; Sayegh, Mohamed H.; Iacomini, John

2010-01-01

Induction of transplantation tolerance has the potential to allow for allograft acceptance without the need for life-long immunosuppression. Here we describe a novel approach that uses delivery of alloantigen by mature T cells to induce tolerance to fully allogeneic cardiac grafts. Adoptive transfer of mature alloantigen-expressing T cells into myeloablatively conditioned mice results in long-term acceptance of fully allogeneic heart transplants without evidence of chronic rejection. Since myeloablative conditioning is clinically undesirable we further demonstrated that adoptive transfer of mature alloantigen-expressing T cells alone into mice receiving non-myeloablative conditioning resulted in long-term acceptance of fully allogeneic heart allografts with minimal evidence of chronic rejection. Mechanistically, tolerance induction involved both deletion of donor-reactive host T cells and the development of regulatory T cells. Thus, delivery of alloantigen by mature T cells induces tolerance to fully allogeneic organ allografts in non-myeloablatively conditioned recipients, representing a novel approach for tolerance induction in transplantation. PMID:20452826

Ph+ ALL patients in first complete remission have similar survival after reduced intensity and myeloablative allogeneic transplantation: impact of tyrosine kinase inhibitor and minimal residual disease.

PubMed

Bachanova, V; Marks, D I; Zhang, M-J; Wang, H; de Lima, M; Aljurf, M D; Arellano, M; Artz, A S; Bacher, U; Cahn, J-Y; Chen, Y-B; Copelan, E A; Drobyski, W R; Gale, R P; Greer, J P; Gupta, V; Hale, G A; Kebriaei, P; Lazarus, H M; Lewis, I D; Lewis, V A; Liesveld, J L; Litzow, M R; Loren, A W; Miller, A M; Norkin, M; Oran, B; Pidala, J; Rowe, J M; Savani, B N; Saber, W; Vij, R; Waller, E K; Wiernik, P H; Weisdorf, D J

2014-03-01

The efficacy of reduced intensity conditioning (RIC) allogeneic hematopoietic cell transplantation (HCT) for Philadelphia chromosome positive (Ph+) acute lymphoblastic leukemia (ALL) is uncertain. We analyzed 197 adults with Ph+ ALL in first complete remission; 67 patients receiving RIC were matched with 130 receiving myeloablative conditioning (MAC) for age, donor type and HCT year. Over 75% received pre-HCT tyrosine kinase inhibitors (TKIs), mostly imatinib; 39% (RIC) and 49% (MAC) were minimal residual disease (MRD)(neg) pre-HCT. At a median 4.5 years follow-up, 1-year transplant-related mortality (TRM) was lower in RIC (13%) than MAC (36%; P=0.001) while the 3-year relapse rate was 49% in RIC and 28% in MAC (P=0.058). Overall survival (OS) was similar (RIC 39% (95% confidence interval (CI) 27-52) vs 35% (95% CI 27-44); P=0.62). Patients MRD(pos) pre-HCT had higher risk of relapse with RIC vs MAC (hazard ratio (HR) 1.97; P=0.026). However, patients receiving pre-HCT TKI in combination with MRD negativity pre-RIC HCT had superior OS (55%) compared with a similar MRD population after MAC (33%; P=0.0042). In multivariate analysis, RIC lowered TRM (HR 0.6; P=0.057), but absence of pre-HCT TKI (HR 1.88; P=0.018), RIC (HR 1.891; P=0.054) and pre-HCT MRD(pos) (HR 1.6; P=0.070) increased relapse risk. RIC is a valid alternative strategy for Ph+ ALL patients ineligible for MAC and MRD(neg) status is preferred pre-HCT.

Haploidentical transplant with posttransplant cyclophosphamide vs matched unrelated donor transplant for acute myeloid leukemia

PubMed Central

Zhang, Mei-Jie; Bacigalupo, Andrea A.; Bashey, Asad; Appelbaum, Frederick R.; Aljitawi, Omar S.; Armand, Philippe; Antin, Joseph H.; Chen, Junfang; Devine, Steven M.; Fowler, Daniel H.; Luznik, Leo; Nakamura, Ryotaro; O’Donnell, Paul V.; Perales, Miguel-Angel; Pingali, Sai Ravi; Porter, David L.; Riches, Marcie R.; Ringdén, Olle T. H.; Rocha, Vanderson; Vij, Ravi; Weisdorf, Daniel J.; Champlin, Richard E.; Horowitz, Mary M.; Fuchs, Ephraim J.; Eapen, Mary

2015-01-01

We studied adults with acute myeloid leukemia (AML) after haploidentical (n = 192) and 8/8 HLA-matched unrelated donor (n = 1982) transplantation. Haploidentical recipients received calcineurin inhibitor (CNI), mycophenolate, and posttransplant cyclophosphamide for graft-versus-host disease (GVHD) prophylaxis; 104 patients received myeloablative and 88 received reduced intensity conditioning regimens. Matched unrelated donor transplant recipients received CNI with mycophenolate or methotrexate for GVHD prophylaxis; 1245 patients received myeloablative and 737 received reduced intensity conditioning regimens. In the myeloablative setting, day 30 neutrophil recovery was lower after haploidentical compared with matched unrelated donor transplants (90% vs 97%, P = .02). Corresponding rates after reduced intensity conditioning transplants were 93% and 96% (P = .25). In the myeloablative setting, 3-month acute grade 2-4 (16% vs 33%, P < .0001) and 3-year chronic GVHD (30% vs 53%, P < .0001) were lower after haploidentical compared with matched unrelated donor transplants. Similar differences were observed after reduced intensity conditioning transplants, 19% vs 28% (P = .05) and 34% vs 52% (P = .002). Among patients receiving myeloablative regimens, 3-year probabilities of overall survival were 45% (95% CI, 36-54) and 50% (95% CI, 47-53) after haploidentical and matched unrelated donor transplants (P = .38). Corresponding rates after reduced intensity conditioning transplants were 46% (95% CI, 35-56) and 44% (95% CI, 0.40-47) (P = .71). Although statistical power is limited, these data suggests that survival for patients with AML after haploidentical transplantation with posttransplant cyclophosphamide is comparable with matched unrelated donor transplantation. PMID:26130705

A Phase IIb, Multicenter, Open-Label, Safety, and Efficacy Study of High-Dose, Propylene Glycol-Free Melphalan Hydrochloride for Injection (EVOMELA) for Myeloablative Conditioning in Multiple Myeloma Patients Undergoing Autologous Transplantation.

PubMed

Hari, Parameswaran; Aljitawi, Omar S; Arce-Lara, Carlos; Nath, Rajneesh; Callander, Natalie; Bhat, Gajanan; Allen, Lee F; Stockerl-Goldstein, Keith

2015-12-01

Autologous stem cell transplantation (ASCT) after high-dose melphalan conditioning is considered a standard of care procedure for patients with multiple myeloma (MM). Current formulations of melphalan (eg, Alkeran for Injection [melphalan hydrochloride]; GlaxoSmithKline, Research Triangle Park, NC, USA) have marginal solubility and limited chemical stability upon reconstitution. Alkeran requires the use of propylene glycol as a co-solvent, which itself has been reported to cause such complications as metabolic/renal dysfunction and arrhythmias. EVOMELA (propylene glycol-free melphalan HCl; Spectrum Pharmaceuticals, Inc., Irvine, CA, USA) is a new i.v. melphalan formulation that incorporates Captisol (Ligand Pharmaceuticals, Inc., La Jolla, CA, USA), a specially modified cyclodextrin that improves the solubility and stability of melphalan and eliminates the need for propylene glycol. This new formulation has been shown to be bioequivalent to Alkeran. EVOMELA (200 mg/m(2)) was administered as 2 doses of 100 mg/m(2) each in a phase IIb, open-label, multicenter study to confirm its safety and efficacy as a high-dose conditioning regimen for patients with MM undergoing ASCT. At 5 centers, 61 patients (26 women) with a median age of 62 years (range, 32-73) were enrolled. All patients achieved myeloablation with a median time of 5 days post-ASCT, and all successfully achieved neutrophil and platelet engraftment with median times of 12 days post-ASCT and 13 days post-ASCT, respectively; treatment-related mortality on day 100 was 0%. Overall response rate (according to independent, blinded review) was high (100%), with an overall complete response rate of 21% (13% stringent complete response; 8% complete response) and overall partial response rate of 79% (61% very good partial response; 18% partial response). The incidence of grade 3 mucositis and stomatitis was low (10% and 5%, respectively) with no grade 4 mucositis or stomatitis reported (graded according to National

Depleting dietary valine permits nonmyeloablative mouse hematopoietic stem cell transplantation.

PubMed

Taya, Yuki; Ota, Yasunori; Wilkinson, Adam C; Kanazawa, Ayano; Watarai, Hiroshi; Kasai, Masataka; Nakauchi, Hiromitsu; Yamazaki, Satoshi

2016-12-02

A specialized bone marrow microenvironment (niche) regulates hematopoietic stem cell (HSC) self-renewal and commitment. For successful donor-HSC engraftment, the niche must be emptied via myeloablative irradiation or chemotherapy. However, myeloablation can cause severe complications and even mortality. Here we report that the essential amino acid valine is indispensable for the proliferation and maintenance of HSCs. Both mouse and human HSCs failed to proliferate when cultured in valine-depleted conditions. In mice fed a valine-restricted diet, HSC frequency fell dramatically within 1 week. Furthermore, dietary valine restriction emptied the mouse bone marrow niche and afforded donor-HSC engraftment without chemoirradiative myeloablation. These findings indicate a critical role for valine in HSC maintenance and suggest that dietary valine restriction may reduce iatrogenic complications in HSC transplantation. Copyright © 2016, American Association for the Advancement of Science.

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

Massimino, Maura; Gandola, Lorenza; Spreafico, Filippo

Purpose: Myeloablative regimens were frequently used for medulloblastoma relapsing after craniospinal irradiation (CSI): in 1997-2002, we used repeated surgery, standard-dose and myeloablative chemotherapy, and reirradiation. Methods and Materials: In 10 patients, reinduction included sequential high-dose etoposide, high-dose cyclophosphamide/vincristine, and high-dose carboplatin/vincristine, then two myeloablative courses with high-dose thiotepa ({+-} carboplatin); 6 other patients received two of four courses of cisplatin/etoposide. Hematopoietic precursor mobilization followed high-dose etoposide or high-dose cyclophosphamide or cisplatin/etoposide therapy. After the overall chemotherapy program, reirradiation was prescribed when possible. Results: Seventeen patients were treated: previous treatment included CSI of 19.5-36 Gy with posterior fossa/tumor boost and chemotherapymore » in 16 patients. Fifteen patients were in their first and 2 in their second and third relapses, respectively. First progression-free survival had lasted a median of 26 months. Relapse sites included leptomeninges in 9 patients, spine in 4 patients, posterior fossa in 3 patients, and brain in 1 patient. Three patients underwent complete resection of recurrence, and 10 underwent reirradiation. Twelve of 14 patients with assessable tumor had an objective response after reinduction; 2 experienced progression and were not given the myeloablative courses. Remission lasted a median of 16 months. Additional relapses appeared in 13 patients continuing the treatment. Fifteen patients died of progression and 1 died of pneumonia 13 months after relapse. The only survivor at 93 months had a single spinal metastasis that was excised and irradiated. Survival for the series as a whole was 11-93 months, with a median of 41 months. Conclusions: Despite responses being obtained and ample use of surgery and reirradiation, second-line therapy with myeloablative schedules was not curative, barring a few

The Genotype of the Donor for the (GT)n Polymorphism in the Promoter/Enhancer of FOXP3 Is Associated with the Development of Severe Acute GVHD but Does Not Affect the GVL Effect after Myeloablative HLA-Identical Allogeneic Stem Cell Transplantation

PubMed Central

Buces, Elena; Pion, Marjorie; Sánchez-Hernández, Noemí; Martín-Antonio, Beatriz; Guillem, Vicent; Bosch-Vizcaya, Anna; Bento, Leyre; González-Rivera, Milagros; Balsalobre, Pascual; Kwon, Mi; Serrano, David; Gayoso, Jorge; de la Cámara, Rafael; Brunet, Salut; Rojas-Contreras, Rafael; Nieto, José B.; Martínez, Carmen; Gónzalez, Marcos; Espigado, Ildefonso; Vallejo, Juan C.; Sampol, Antonia; Jiménez-Velasco, Antonio; Urbano-Ispizua, Alvaro; Solano, Carlos; Gallardo, David; Díez-Martín, José L.; Buño, Ismael

2015-01-01

The FOXP3 gene encodes for a protein (Foxp3) involved in the development and functional activity of regulatory T cells (CD4+/CD25+/Foxp3+), which exert regulatory and suppressive roles over the immune system. After allogeneic stem cell transplantation, regulatory T cells are known to mitigate graft versus host disease while probably maintaining a graft versus leukemia effect. Short alleles (≤(GT)15) for the (GT)n polymorphism in the promoter/enhancer of FOXP3 are associated with a higher expression of FOXP3, and hypothetically with an increase of regulatory T cell activity. This polymorphism has been related to the development of auto- or alloimmune conditions including type 1 diabetes or graft rejection in renal transplant recipients. However, its impact in the allo-transplant setting has not been analyzed. In the present study, which includes 252 myeloablative HLA-identical allo-transplants, multivariate analysis revealed a lower incidence of grade III-IV acute graft versus host disease (GVHD) in patients transplanted from donors harboring short alleles (OR = 0.26, CI 0.08–0.82, p = 0.021); without affecting chronic GVHD or graft versus leukemia effect, since cumulative incidence of relapse, event free survival and overall survival rates are similar in both groups of patients. PMID:26473355

The Genotype of the Donor for the (GT)n Polymorphism in the Promoter/Enhancer of FOXP3 Is Associated with the Development of Severe Acute GVHD but Does Not Affect the GVL Effect after Myeloablative HLA-Identical Allogeneic Stem Cell Transplantation.

PubMed

Noriega, Víctor; Martínez-Laperche, Carolina; Buces, Elena; Pion, Marjorie; Sánchez-Hernández, Noemí; Martín-Antonio, Beatriz; Guillem, Vicent; Bosch-Vizcaya, Anna; Bento, Leyre; González-Rivera, Milagros; Balsalobre, Pascual; Kwon, Mi; Serrano, David; Gayoso, Jorge; de la Cámara, Rafael; Brunet, Salut; Rojas-Contreras, Rafael; Nieto, José B; Martínez, Carmen; Gónzalez, Marcos; Espigado, Ildefonso; Vallejo, Juan C; Sampol, Antonia; Jiménez-Velasco, Antonio; Urbano-Ispizua, Alvaro; Solano, Carlos; Gallardo, David; Díez-Martín, José L; Buño, Ismael

2015-01-01

The FOXP3 gene encodes for a protein (Foxp3) involved in the development and functional activity of regulatory T cells (CD4+/CD25+/Foxp3+), which exert regulatory and suppressive roles over the immune system. After allogeneic stem cell transplantation, regulatory T cells are known to mitigate graft versus host disease while probably maintaining a graft versus leukemia effect. Short alleles (≤(GT)15) for the (GT)n polymorphism in the promoter/enhancer of FOXP3 are associated with a higher expression of FOXP3, and hypothetically with an increase of regulatory T cell activity. This polymorphism has been related to the development of auto- or alloimmune conditions including type 1 diabetes or graft rejection in renal transplant recipients. However, its impact in the allo-transplant setting has not been analyzed. In the present study, which includes 252 myeloablative HLA-identical allo-transplants, multivariate analysis revealed a lower incidence of grade III-IV acute graft versus host disease (GVHD) in patients transplanted from donors harboring short alleles (OR = 0.26, CI 0.08-0.82, p = 0.021); without affecting chronic GVHD or graft versus leukemia effect, since cumulative incidence of relapse, event free survival and overall survival rates are similar in both groups of patients.

Reduced-intensity conditioning for the treatment of malignant and life-threatening non-malignant disorders.

PubMed

Slavin, Shimon; Aker, Mehmet; Shapira, Michael Y; Resnick, Igor; Bitan, Menachem; Or, Reuven

2003-01-01

Allogeneic bone marrow or blood stem cell transplantation (BMT) represents an important therapeutic tool for the treatment of an otherwise incurable broad spectrum of malignant and non-malignant diseases. Until recently, BMT was used primarily to replace a malignant, genetically abnormal or deficient immunohematopoietic compartment and therefore, highly toxic myeloablative regimens were considered mandatory for more effective eradication of all undesirable host-derived hematopoietic cells, including stem cells and their progeny. Our preclinical and ongoing clinical studies indicated that much more effective eradication of host immunohematopoietic system cells can be mediated by donor lymphocytes in the process of adoptive allogeneic cell therapy following BMT. Thus, eradication of all malignant cells, especially in patients with CML and, to a lesser extent, in patients with other hematologic malignancies can be accomplished despite complete resistance of puch tumor cells to maximally tolerated doses of chemoradiotherapy. Our cumulative experience suggested that graft-versus-malignancy effects might be used as a tool for eradication of otherwise resistant tumor cells of host origin. We speculated that the therapeutic benefit of BMT may be improved by using safer conditioning for engraftment of donor stem cells induce host-versus-graft unresponsiveness to enable engraftment of donor lymphocytes for subsequent induction of graft-versus-malignancy effects, or even graft-versus-autoimmunity and graft-versus-genetically abnormal cells. In other words, focusing on more selective and smarter rather than stronger modalities. Effective BMT procedures may be accomplished without lethal conditioning of the host, using a new, well-tolerated and user-friendly non-myeloablative regimen, thus eliminating or minimizing immediate and late procedure-related toxicity and mortality. It appears that initial induction of graft tolerance, mediated by engraftment of donor stem cells, leads

Filgrastim-Stimulated Bone Marrow Compared with Filgrastim-Mobilized Peripheral Blood in Myeloablative Sibling Allografting for Patients with Hematologic Malignancies: A Randomized Canadian Blood and Marrow Transplant Group Study.

PubMed

Couban, Stephen; Aljurf, Mahmoud; Lachance, Sylvie; Walker, Irwin; Toze, Cynthia; Rubinger, Morel; Lipton, Jeffrey H; Lee, Stephanie J; Szer, Jeff; Doocey, Richard; Lewis, Ian D; Huebsch, Lothar; Howson-Jan, Kang; Lalancette, Michel; Almohareb, Fahad; Chaudhri, Nadeem; Ivison, Sabine; Broady, Raewyn; Levings, Megan; Fairclough, Diane; Devins, Gerald; Szwajcer, David; Foley, Ronan; Smith, Clayton; Panzarella, Tony; Kerr, Holly; Kariminia, Amina; Schultz, Kirk R

2016-08-01

In adult hematopoietic cell transplantation (HCT), filgrastim-mobilized peripheral blood (G-PB) has largely replaced unstimulated marrow for allografting. Although the use of G-PB results in faster hematopoietic recovery, it is also associated with more chronic graft-versus-host disease (cGVHD). A potential alternative allograft is filgrastim-stimulated marrow (G-BM), which we hypothesized may be associated with prompt hematopoietic recovery but with less cGVHD. We conducted a phase 3, open-label, multicenter randomized trial of 230 adults with hematologic malignancies receiving allografts from siblings after myeloablative conditioning to compare G-PB with G-BM. The primary endpoint was time to treatment failure, defined as a composite of extensive cGVHD, relapse/disease progression, and death. With a median follow-up of 36 months (range, 9.6 to 48), comparing G-BM with G-PB, there was no difference between the 2 arms with respect to the primary outcome of this study (hazard ratio [HR], .91; 95% confidence interval [CI], .68 to 1.22; P = .52). However, the cumulative incidence of overall cGVHD was lower with G-BM (HR, .66; 95% CI, .46 to .95; P = .007) and there was no difference in the risk of relapse or progression (P = .35). The median times to neutrophil recovery (P = .0004) and platelet recovery (P = .012) were 3 days shorter for recipients allocated to G-PB compared with those allocated to G-BM, but there were no differences in secondary engraftment-related outcomes, such as time to first hospital discharge (P = .17). In addition, there were no graft failures in either arm. This trial demonstrates that, compared with G-PB, the use of G-BM allografts leads to a significantly lower rate of overall cGVHD without a loss of the graft-versus-tumor effect and comparable overall survival. Our findings suggest that further study of this type of allograft is warranted. Copyright © 2016 American Society for Blood and Marrow Transplantation. Published by

[Role of stem cell transplantation in treatment of primary cutaneous T‑cell lymphoma].

PubMed

Stranzenbach, R; Theurich, S; Schlaak, M

2017-09-01

Within the heterogeneous group of cutaneous T‑cell lymphomas (CTCL) the therapeutic options for advanced and progressive forms are particularly limited. The therapeutic value of hematopoietic stem cell transplantation in CTCL was analyzed. A literature search using the keywords "hematopoietic stem cell transplantation" and "cutaneous T‑cell lymphoma" was performed in PubMed. Studies between 1990 and 2017 were taken into account. The studies identified were analyzed for relevance and being up to date. After reviewing the currently available literature no prospective randomized studies were found. Wu et al. showed a superiority of allogeneic transplantation in a comparison of autologous and allogeneic stem cell transplantation for cutaneous lymphoma. The graft-versus-lymphoma effect plays a significant role in a prolonged progression-free survival after allogeneic transplantation. By using a non-myeloablative conditioning regimen, stem cell transplantation can also be an option for elderly patients. The most extensive long-term data after allogeneic stem cell transplantation were reported by Duarte et al. in 2014. Autologous stem cell transplantation does not currently represent a therapeutic option, whereas allogeneic stem cell transplantation for advanced cutaneous T‑cell lymphoma, using a non-myeloablative conditioning scheme, does represent a therapeutic option. However, there is no consensus on the appropriate patients and the right timing. Morbidity and mortality of complications should be taken into account. Thus, this procedure is currently subject to an individual case decision.

Avascular necrosis of bone following allogeneic hematopoietic cell transplantation in children and adolescents

PubMed Central

Li, Xiaxin; Brazauskas, Ruta; Wang, Zhiwei; Al-Seraihy, Amal; Baker, K. Scott; Cahn, Jean-Yves; Frangoul, Haydar A.; Gajewski, James L.; Hale, Gregory A.; Hsu, Jack W.; Kamble, Rammurti T.; Lazarus, Hillard M.; Marks, David I.; Maziarz, Richard T.; Savani, Bipin N.; Shah, Ami J.; Shah, Nirali; Sorror, Mohamed L.; Wood, William A.; Majhail, Navneet S.

2014-01-01

We conducted a nested case-control study within a cohort of 6,244 patients to assess risk factors for avascular necrosis (AVN) of bone in children and adolescents following allogeneic transplantation. Eligible patients were ≤21 years of age, received their first allogeneic transplant between 1990 and 2008 in the United States and had survived ≥ 6 months from transplantation. Overall, 160 cases with AVN and 478 controls matched by year of transplant, length of followup and transplant center were identified. Cases and controls were confirmed via central review of radiology, pathology and/or surgical procedure reports. Median time from transplant to diagnosis of AVN was 14 months. On conditional logistic regression, increasing age at transplant (≥5 years), female gender and chronic graft-versus-host disease (GVHD) were significantly associated with increased risks of AVN. Compared to patients receiving myeloablative regimens for malignant diseases, lower risks of AVN were seen in patients with non-malignant diseases and those who had received reduced intensity conditioning regimens for malignant diseases. Children at high risk for AVN include those within the age group where rapid bone growth occurs as well as those who experience exposure to myeloablative conditioning regimens and immunosuppression post-HCT for the treatment of GVHD. More research is needed to determine whether screening strategies specifically for patients at high risk for developing AVN with early interventions may mitigate the morbidity associated with this complication. PMID:24388803

Safety and Tolerability of HSC835 in Patients With Hematological Malignancies Undergoing Single Umbilical Cord Blood Transplant

ClinicalTrials.gov

2017-08-31

Single Umbilical Cord Blood Transplantation; Non-myeloablative Conditioning; Acute Lymphocytic Leukemia; Myelodysplastic Syndrome; Non-Hodgkin's Lymphoma; Multiple Myeloma; Chronic Lymphocytic Leukemia

131I-MIBG followed by consolidation with busulfan, melphalan and autologous stem cell transplantation for refractory neuroblastoma.

PubMed

French, Sarah; DuBois, Steven G; Horn, Biljana; Granger, Meaghan; Hawkins, Randall; Pass, Amy; Plummer, Ellen; Matthay, Katherine

2013-05-01

(131) I-metaiodobenzylguanidine (MIBG) produces a 37% response rate in relapsed/refractory neuroblastoma, and could be used to improve remission status prior to myeloablative chemotherapy with autologous stem cell transplant (ASCT). The purpose of our report was to evaluate safety and response with MIBG therapy followed by myeloablative busulfan and melphalan (BuMel) with ASCT in patients with refractory neuroblastoma. Retrospective chart review was done on patients treated with MIBG (18 mCi/kg) on Day 1 and ASCT on day 14. Six to eight weeks after MIBG, patients without progressive disease received IV busulfan on days -6 to -2 (target Css 700-900), melphalan (140 mg/m2 IV) on day -1, and ASCT on Day 0. Response and toxicity were evaluated after MIBG and again after myeloablative therapy. Eight patients completed MIBG/ASCT followed by BuMel/ASCT. MIBG was well tolerated, with grade 3 or 4 non-hematologic toxicity limited to one patient with sepsis. Grade 3 mucositis occurred in six patients after BuMel/ASCT. One patient developed sinusoidal obstructive syndrome (SOS) and died 50 days post-ASCT following myeloablative conditioning. All patients engrafted neutrophils (median 16.5 days) and platelets (median 32 days) after BuMel, excluding the patient with SOS. After all therapy, there were three complete, two partial, and one minor response in seven evaluable patients. MIBG at doses up to 18 mCi/kg can be safely administered 6 weeks prior to a BuMel consolidative regimen for refractory neuroblastoma. Preceding MIBG did not impair engraftment following BuMel. This regimen is being further evaluated in a Children's Oncology Group (COG) trial. Copyright © 2012 Wiley Periodicals, Inc.

Thiotepa-based conditioning versus total body irradiation as myeloablative conditioning prior to allogeneic stem cell transplantation for acute lymphoblastic leukemia: A matched-pair analysis from the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation.

PubMed

Eder, Sandra; Canaani, Jonathan; Beohou, Eric; Labopin, Myriam; Sanz, Jaime; Arcese, William; Or, Reuven; Finke, Juergen; Cortelezzi, Agostino; Beelen, Dietrich; Passweg, Jakob; Socié, Gerard; Gurman, Gunhan; Aljurf, Mahmoud; Stelljes, Matthias; Giebel, Sebastian; Mohty, Mohamad; Nagler, Arnon

2017-10-01

The optimal conditioning regimen to employ before hematopoietic stem cell transplantation in acute lymphoblastic leukemia (ALL) is still undecided, and while cyclophosphamide/total body irradiation (Cy/TBI) is the most commonly used myeloablative regimen, there are concerns regarding long-term toxicity for patients conditioned with this regimen. Thiotepa-based conditioning is an emerging radiation-free regimen with recent publications indicative of comparable clinical outcomes to TBI-based conditioning. In this analysis of the acute leukemia working party of the EBMT, we performed a retrospective matched-pair analysis, evaluating the outcome of adult patients with ALL who received thiotepa-based conditioning (n = 180) with those receiving Cy/TBI conditioning (n = 540). The 2-year leukemia-free survival and overall survival (OS) rates of both conditioning regimens were comparable, 33% for thiotepa [95% confidence interval (CI): 26.4-42.8] versus 39% for Cy/TBI (95% CI: 34.8-44.5] (P = .33) and 46.5% [95% CI: 38.6-56.1] versus 48.8% [95% CI: 44.2-54] (P = .9), respectively. There was no significant difference between the two regimens in the incidence of either acute graft versus host disease (GVHD) or chronic GVHD. Multivariate analysis demonstrated increased relapse incidence for thiotepa conditioning compared to Cy/TBI (HR = 1.78, 95% CI, 1.07-2.95; P = .03) which did not affect OS. Our results indicate that thiotepa-based conditioning may not be inferior to Cy/TBI for adult patients with ALL. © 2017 Wiley Periodicals, Inc.

Acute myeloid leukemia developing in a granulocyte colony-stimulating factor-mobilized stem cell donor: A case report and review of the literature.

PubMed

Haddad, Housam; Wungjiranirun, Manida; Gergis, Usama

2016-09-01

We describe the first case of a FLT-3 mutated AML in a healthy donor, 3years after recombinant human granulocyte colony stimulating factor (rhG-CSF)-mobilized peripheral blood stem cell (PBSC) harvest. The patient had a myeloablative (MA) matched unrelated donor (MUD) stem cell transplant (SCT) for refractory AML. However, he experienced a secondary graft failure. He had a second non myeloablative (NMA) on day +75 from a second MUD. He achieved a complete neutrophil and platelet engraftment. After 4years of follow up, he is alive in complete remission with full second donor chimerism. Copyright © 2015 King Faisal Specialist Hospital & Research Centre. Published by Elsevier Ltd. All rights reserved.

Bone marrow transplant - discharge

MedlinePlus

Transplant - bone marrow - discharge; Stem cell transplant - discharge; Hematopoietic stem cell transplant - discharge; Reduced intensity; Non-myeloablative transplant - discharge; Mini transplant - discharge; Allogenic bone marrow transplant - discharge; ...

Avascular necrosis of bone after allogeneic hematopoietic cell transplantation in children and adolescents.

PubMed

Li, Xiaxin; Brazauskas, Ruta; Wang, Zhiwei; Al-Seraihy, Amal; Baker, K Scott; Cahn, Jean-Yves; Frangoul, Haydar A; Gajewski, James L; Hale, Gregory A; Hsu, Jack W; Kamble, Rammurti T; Lazarus, Hillard M; Marks, David I; Maziarz, Richard T; Savani, Bipin N; Shah, Ami J; Shah, Nirali; Sorror, Mohamed L; Wood, William A; Majhail, Navneet S

2014-04-01

We conducted a nested case-control study within a cohort of 6244 patients to assess risk factors for avascular necrosis (AVN) of bone in children and adolescents after allogeneic transplantation. Eligible patients were ≤21 years of age, received their first allogeneic transplant between 1990 and 2008 in the United States, and had survived ≥ 6 months from transplantation. Overall, 160 patients with AVN and 478 control subjects matched by year of transplant, length of follow-up and transplant center were identified. Patients and control subjects were confirmed via central review of radiology, pathology, and/or surgical procedure reports. Median time from transplant to diagnosis of AVN was 14 months. On conditional logistic regression, increasing age at transplant (≥5 years), female gender, and chronic graft-versus-host disease (GVHD) were significantly associated with increased risks of AVN. Compared with patients receiving myeloablative regimens for malignant diseases, lower risks of AVN were seen in patients with nonmalignant diseases and those who had received reduced-intensity conditioning regimens for malignant diseases. Children at high risk for AVN include those within the age group where rapid bone growth occurs as well as those who experience exposure to myeloablative conditioning regimens and immunosuppression after hematopoietic cell transplantation for the treatment of GVHD. More research is needed to determine whether screening strategies specifically for patients at high risk for developing AVN with early interventions may mitigate the morbidity associated with this complication. Copyright © 2014 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Efficiency of performing pulmonary procedures in a shared endoscopy unit: procedure time, turnaround time, delays, and procedure waiting time.

PubMed

Verma, Akash; Lee, Mui Yok; Wang, Chunhong; Hussein, Nurmalah B M; Selvi, Kalai; Tee, Augustine

2014-04-01

The purpose of this study was to assess the efficiency of performing pulmonary procedures in the endoscopy unit in a large teaching hospital. A prospective study from May 20 to July 19, 2013, was designed. The main outcome measures were procedure delays and their reasons, duration of procedural steps starting from patient's arrival to endoscopy unit, turnaround time, total case durations, and procedure wait time. A total of 65 procedures were observed. The most common procedure was BAL (61%) followed by TBLB (31%). Overall procedures for 35 (53.8%) of 65 patients were delayed by ≥ 30 minutes, 21/35 (60%) because of "spillover" of the gastrointestinal and surgical cases into the time block of pulmonary procedure. Time elapsed between end of pulmonary procedure and start of the next procedure was ≥ 30 minutes in 8/51 (16%) of cases. In 18/51 (35%) patients there was no next case in the room after completion of the pulmonary procedure. The average idle time of the room after the end of pulmonary procedure and start of next case or end of shift at 5:00 PM if no next case was 58 ± 53 minutes. In 17/51 (33%) patients the room's idle time was >60 minutes. A total of 52.3% of patients had the wait time >2 days and 11% had it ≥ 6 days, reason in 15/21 (71%) being unavailability of the slot. Most pulmonary procedures were delayed due to spillover of the gastrointestinal and surgical cases into the block time allocated to pulmonary procedures. The most common reason for difficulty encountered in scheduling the pulmonary procedure was slot unavailability. This caused increased procedure waiting time. The strategies to reduce procedure delays and turnaround times, along with improved scheduling methods, may have a favorable impact on the volume of procedures performed in the unit thereby optimizing the existing resources.

Bone marrow transplant – children - discharge

MedlinePlus

Transplant - bone marrow - children - discharge; Stem cell transplant - children - discharge; Hematopoietic stem cell transplant -children - discharge; Reduced intensity, non-myeloablative transplant - children - discharge; Mini transplant - children - discharge; Allogenic bone ...

Designing Flightdeck Procedures

NASA Technical Reports Server (NTRS)

Barshi, Immanuel; Mauro, Robert; Degani, Asaf; Loukopoulou, Loukia

2016-01-01

The primary goal of this document is to provide guidance on how to design, implement, and evaluate flight deck procedures. It provides a process for developing procedures that meet clear and specific requirements. This document provides a brief overview of: 1) the requirements for procedures, 2) a process for the design of procedures, and 3) a process for the design of checklists. The brief overview is followed by amplified procedures that follow the above steps and provide details for the proper design, implementation and evaluation of good flight deck procedures and checklists.

Role of Pharmacogenetics in Hematopoietic Stem Cell Transplantation Outcome in Children

PubMed Central

Franca, Raffaella; Stocco, Gabriele; Favretto, Diego; Giurici, Nagua; Decorti, Giuliana; Rabusin, Marco

2015-01-01

Hematopoietic stem cell transplantation (HSCT) is an established therapeutic procedure for several congenital and acquired disorders, both malignant and nonmalignant. Despite the great improvements in HSCT clinical practices over the last few decades, complications, such as graft vs. host disease (GVHD) and sinusoidal obstructive syndrome (SOS), are still largely unpredictable and remain the major causes of morbidity and mortality. Both donor and patient genetic background might influence the success of bone marrow transplantation and could at least partially explain the inter-individual variability in HSCT outcome. This review summarizes some of the recent studies on candidate gene polymorphisms in HSCT, with particular reference to pediatric cohorts. The interest is especially focused on pharmacogenetic variants affecting myeloablative and immunosuppressive drugs, although genetic traits involved in SOS susceptibility and transplant-related mortality are also reviewed. PMID:26266406

Computerized procedures system

DOEpatents

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

2010-10-12

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

Effects of two doses of anti-T lymphocyte globulin-Fresenius given after full-match sibling stem cell transplantation in acute myeloblastic leukemia patients who underwent myeloablative fludarabine/busulfan conditioning.

PubMed

Boga, Can; Yeral, Mahmut; Gereklioglu, Ciğdem; Asma, Suheyl; Maytalman, Erkan; Aytan, Pelin; Kozanoglu, Ilknur; Sariturk, Cagla; Ozdogu, Hakan

2018-02-20

rATG-F did not influence survival parameters; however, increasing the dose to 30 mg/kg seems to be effective for reducing cGVHD with an increase in infection rate requiring close monitoring of infections in AML patients who received myeloablative fludarabine/busulfan conditioning. Copyright © 2018 King Faisal Specialist Hospital & Research Centre. Published by Elsevier B.V. All rights reserved.

Requirements for emergent neurosurgical procedures among patients undergoing neuroendovascular procedures in contemporary practice.

PubMed

Khatri, R; Ansar, M; Sultan, F; Chaudhry, S A; Khan, A A; Rodriguez, G J; Tummala, R P; Qureshi, A I

2012-03-01

Provisions for an emergent neurosurgical procedure have been a mandatory component of centers that perform neuroendovascular procedures. We sought to determine the need for emergent neurosurgical procedures following neuroendovascular interventions in 2 comprehensive stroke centers in settings with such provisions. Analysis of retrospectively collected data from procedure logs and patient charts was performed to identify patients who required immediate (before the termination of the intervention) or adjunctive (within 24 hours of the intervention) neurosurgical procedures related to a neuroendovascular intervention complication. The types of neurosurgical procedures and in-hospital outcomes of identified patients are reported as an aggregate and per endovascular procedure-type analyses. We reviewed a total of 933 neuroendovascular procedures performed during 3.5 years (2006-2010). A total of 759 intracranial procedures were performed. There was a need for emergent neurosurgical procedures in 8 patients (0.85% cumulative incidence and 1.05% for major intracranial procedures) (mean age, 46 years; 7 were women); the procedures were categorized as 3 immediate and 5 adjunctive procedures. There were 5 in-hospital deaths (62.5%) among these 8 patients. Neurosurgical procedures performed were external ventricular drainage placement in 6 (6 of 8, 75%) patients, decompressive craniectomy in 1 (12.5%) patient, and both surgical procedures in 1 (12.5%) patient. The need for emergent neurosurgical procedures is very low among patients undergoing intracranial neuroendovascular procedures. Survival in such patients despite emergent neurosurgical procedures is quite low.

Palifermin: new drug. Prevention of oral mucositis: inappropriate evaluation.

PubMed

2007-08-01

(1) Patients treated with high-dose chemotherapy combined with total body irradiation (myeloablative therapy) often develop oral mucositis. Prevention is based mainly on sucking ice during chemotherapy. (2) Palifermin is a growth factor marketed for the prevention of severe oral mucositis in adults with malignant haemopathies who are receiving myeloablative therapy followed by peripheral stem cell autografting. (3) Palifermin has not been compared with sucking ice, despite the efficacy of this simple treatment. (4) In a randomised placebo-controlled double-blind trial involving 212 adult patients treated with high-dose chemotherapy and total body irradiation, palifermin reduced the incidence of severe oral mucositis (63% versus 98%) and its duration (about 3 days versus 9 days). The myeloablative regimen used in this trial is not that commonly used in Europe. The efficacy of palifermin during less aggressive regimens, which cause less severe oral mucositis, is not known. (5) The main adverse events noted in clinical trials were erythema and cutaneous oedema. It is not known whether palifermin increases the long-term risk of cancer. (6) Treatment with palifermin is expensive, 4800.00 euros in France); the optimal dosing schedule is not known and the unit dose chosen by the manufacturer is wastefully large. (7) In practice, it remains to be demonstrated that palifermin is more effective than simply sucking ice.

Teaching procedural skills to medical students: A pilot procedural skills lab.

PubMed

Katz, Laurence M; Finch, Alexander; McKinnish, Tyler; Gilliland, Kurt; Tolleson-Rinehart, Sue; Marks, Bonita L

2017-01-01

Medical students have limited confidence in performing procedural skills. A pilot study was conducted to evaluate the effect of a multifaceted Procedural Skills Lab (PSL) on the confidence of medical students to perform procedural skills. Twelve 2nd year medical students were randomly selected to participate in a pilot PSL. The PSL students met with an instructor for 2 h once a week for 4 weeks. Students participated in a flipped classroom and spaced education program before laboratory sessions that included a cadaver laboratory. Procedural skills included a focused assessment with sonography in trauma (FAST) scan, cardiac echocardiogram, lumbar puncture, arthrocentesis, and insertion of intraosseous and intravenous catheters. Students in the PSL were asked to rank their confidence in performing procedural skills before and after completion of the laboratory sessions (Wilcoxon ranked-sum test). A web-based questionnaire was also emailed to all 2nd year medical students to establish a baseline frequency for observing, performing, and confidence performing procedural skills (Mann-Whitney U-test). Fifty-nine percent (n = 106) of 180 2nd year medical students (n = 12 PSL students [treatment group], n = 94 [control group]) completed the survey. Frequency of observation, performance, and confidence in performing procedural skills was similar between the control and treatment groups at baseline. There was an increased confidence level (p < 0.001) for performing all procedural skills for the treatment group after completion of the PSL. An innovative PSL may increase students' confidence to perform procedural skills. Future studies will examine competency after a PSL.

Civil Procedure.

ERIC Educational Resources Information Center

Byer, Robert

1997-01-01

Briefly reviews the historical development of civil procedure (the rules that dictate how a civil case can proceed through the courts) and identifies some of its main components. Discusses procedures such as subject matter jurisdiction, personal jurisdiction, venue, discovery, motions practice, pleadings, pretrial conference, and trials. (MJP)

Are minimally invasive procedures harder to acquire than conventional surgical procedures?

PubMed

Hiemstra, Ellen; Kolkman, Wendela; le Cessie, Saskia; Jansen, Frank Willem

2011-01-01

It is frequently suggested that minimally invasive surgery (MIS) is harder to acquire than conventional surgery. To test this hypothesis, residents' learning curves of both surgical skills are compared. Residents had to be assessed using a general global rating scale of the OSATS (Objective Structured Assessment of Technical Skills) for every procedure they performed as primary surgeon during a 3-month clinical rotation in gynecological surgery. Nine postgraduate-year-4 residents collected a total of 319 OSATS during the 2 years and 3 months investigation period. These assessments concerned 129 MIS (laparoscopic and hysteroscopic) and 190 conventional (open abdominal and vaginal) procedures. Learning curves (in this study defined as OSATS score plotted against procedure-specific caseload) for MIS and conventional surgery were compared using a linear mixed model. The MIS curve revealed to be steeper than the conventional curve (1.77 vs. 0.75 OSATS points per assessed procedure; 95% CI 1.19-2.35 vs. 0.15-1.35, p < 0.01). Basic MIS procedures do not seem harder to acquire during residency than conventional surgical procedures. This may have resulted from the incorporation of structured MIS training programs in residency. Hopefully, this will lead to a more successful implementation of the advanced MIS procedures. Copyright © 2010 S. Karger AG, Basel.

Costing imaging procedures.

PubMed

Bretland, P M

1988-01-01

The existing National Health Service financial system makes comprehensive costing of any service very difficult. A method of costing using modern commercial methods has been devised, classifying costs into variable, semi-variable and fixed and using the principle of overhead absorption for expenditure not readily allocated to individual procedures. It proved possible to establish a cost spectrum over the financial year 1984-85. The cheapest examinations were plain radiographs outside normal working hours, followed by plain radiographs, ultrasound, special procedures, fluoroscopy, nuclear medicine, angiography and angiographic interventional procedures in normal working hours. This differs from some published figures, particularly those in the Körner report. There was some overlap between fluoroscopic interventional and the cheaper nuclear medicine procedures, and between some of the more expensive nuclear medicine procedures and the cheaper angiographic ones. Only angiographic and the few more expensive nuclear medicine procedures exceed the cost of the inpatient day. The total cost of the imaging service to the district was about 4% of total hospital expenditure. It is shown that where more procedures are undertaken, the semi-variable and fixed (including capital) elements of the cost decrease (and vice versa) so that careful study is required to assess the value of proposed economies. The method is initially time-consuming and requires a computer system with 512 Kb of memory, but once the basic costing system is established in a department, detailed financial monitoring should become practicable. The necessity for a standard comprehensive costing procedure of this nature, based on sound cost accounting principles, appears inescapable, particularly in view of its potential application to management budgeting.

Relationship of procedural numbers with meaningful procedural autonomy in general surgery residents.

PubMed

Stride, Herbert P; George, Brian C; Williams, Reed G; Bohnen, Jordan D; Eaton, Megan J; Schuller, Mary C; Zhao, Lihui; Yang, Amy; Meyerson, Shari L; Scully, Rebecca; Dunnington, Gary L; Torbeck, Laura; Mullen, John T; Mandell, Samuel P; Choti, Michael; Foley, Eugene; Are, Chandrakanth; Auyang, Edward; Chipman, Jeffrey; Choi, Jennifer; Meier, Andreas; Smink, Douglas; Terhune, Kyla P; Wise, Paul; DaRosa, Debra; Soper, Nathaniel; Zwischenberger, Jay B; Lillemoe, Keith; Fryer, Jonathan P

2018-03-01

Concerns exist regarding the competency of general surgery graduates with performing core general surgery procedures. Current competence assessment incorporates minimal procedural numbers requirements. Based on the Zwisch scale we evaluated the level of autonomy achieved by categorical PGY1-5 general surgery residents at 14 U.S. general surgery resident training programs between September 1, 2015 and December 31, 2016. With 5 of the most commonly performed core general surgery procedures, we correlated the level of autonomy achieved by each resident with the number of procedures they had performed before the evaluation period, with the intent of identifying specific target numbers that would correlate with the achievement of meaningful autonomy for each procedure with most residents. Whereas a definitive target number was identified for laparoscopic appendectomy (i.e. 25), for the other 4 procedures studied (i.e. laparoscopic cholecystectomy, 52; open inguinal hernia repair, 42; ventral hernia repair, 35; and partial colectomy, 60), target numbers identified were less definitive and/or were higher than many residents will experience during their surgical residency training. We conclude that procedural target numbers are generally not effective in predicting procedural competence and should not be used as the basis for determining residents' readiness for independent practice. Copyright © 2017. Published by Elsevier Inc.

Advanced crew procedures development techniques: Procedures and performance program description

NASA Technical Reports Server (NTRS)

Arbet, J. D.; Mangiaracina, A. A.

1975-01-01

The Procedures and Performance Program (PPP) for operation in conjunction with the Shuttle Procedures Simulator (SPS) is described. The PPP user interface, the SPS/PPP interface, and the PPP applications software are discussed.

Crew procedures development techniques

NASA Technical Reports Server (NTRS)

Arbet, J. D.; Benbow, R. L.; Hawk, M. L.; Mangiaracina, A. A.; Mcgavern, J. L.; Spangler, M. C.

1975-01-01

The study developed requirements, designed, developed, checked out and demonstrated the Procedures Generation Program (PGP). The PGP is a digital computer program which provides a computerized means of developing flight crew procedures based on crew action in the shuttle procedures simulator. In addition, it provides a real time display of procedures, difference procedures, performance data and performance evaluation data. Reconstruction of displays is possible post-run. Data may be copied, stored on magnetic tape and transferred to the document processor for editing and documentation distribution.

A Phase I study of gemtuzumab ozogamicin (GO) in combination with busulfan and cyclophosphamide (Bu/Cy) and allogeneic stem cell transplantation in children with poor-risk CD33+ AML: a new targeted immunochemotherapy myeloablative conditioning (MAC) regimen.

PubMed

Satwani, Prakash; Bhatia, Monica; Garvin, James H; George, Diane; Dela Cruz, Filemon; Le Gall, John; Jin, Zhezhen; Schwartz, Joseph; Duffy, Deirdre; van de Ven, Carmella; Foley, Sandra; Hawks, Ria; Morris, Erin; Baxter-Lowe, Lee Ann; Cairo, Mitchell S

2012-02-01

Children with high-risk acute myelogenous leukemia (AML) (induction failure [IF], refractory relapse [RR], third complete remission [CR3]) have dismal outcomes. Over 80% of AML patients express CD33, a target of gemtuzumab ozogamicin (GO). GO is an active drug in childhood AML but has not been studied in a myeloablative conditioning regimen. We sought to determine the safety of GO in combination with busulfan/cyclophosphamide (Bu/Cy) conditioning before allogeneic hematopoietic stem cell transplantation (alloSCT). GO was administered on day -14 at doses of 3.0, 4.5, 6.0, and 7.5 mg/m(2), busulfan on days -7, -6, -5, -4 (12.8-16.0 mg/kg), and cyclophosphamide on days -3 and -2 (60 mg/kg/day). GVHD prophylaxis consisted of tacrolimus and mycophenolate mofetil. We enrolled 12 patients: 8 IF, 3 RR, 1 CR3; median age: 3 years (1-17); median follow-up: 1379 days (939-2305). Nine received umbilical cord blood (UCB), 2 matched unrelated donors (MUDs) and 1 HLA-matched sibling donor: 3 patients each at GO doses of 3.0, 4.5, 6.0, or 7.5 mg/m(2). No dose-limiting toxicities secondary to GO were observed. Day 100 treatment-related mortality (TRM) was 0%. Myeloid and platelet engraftment was observed in 92% and 75% of patients at median day 22 (12-40) and 42 (21-164), respectively. Median day +30 donor chimerism was 99% (85%-100%). The probability of grade II-IV acute graft-versus-host disease (aGVHD) was 42% and chronic GVHD (cGVHD) was 28%. One-year overall survival (OS) and event-free survival (EFS) was 50% (95% confidence interval [CI], 20.8-73.6). GO combined with Bu/Cy regimen followed by alloSCT is well tolerated in children with poor-risk AML. GO at 7.5 mg/m(2) in combination with Bu/Cy is currently being tested in a phase II study. Copyright © 2012 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Pollutant Assessments Group procedures manual: Volume 2, Technical procedures

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

Not Available

1992-03-01

This is volume 2 of the manuals that describes the technical procedures currently in use by the Pollution Assessments Group. This manual incorporates new developments in hazardous waste assessment technology and administrative policy. Descriptions of the equipment, procedures and operations of such things as radiation detection, soil sampling, radionuclide monitoring, and equipment decontamination are included in this manual. (MB)

Adoptive cell therapy with autologous tumor-infiltrating lymphocytes and high-dose interleukin-2 for metastatic melanoma: The surgeon’s perspective

PubMed Central

ZIPPEL, DOUGLAS B.; BESSER, MICHAL; SHAPIRA, RONI; BEN-NUN, ALON; GOITEIN, DAVID; DAVIDSON, TIMA; TREVES, ABRAHAM J.; MARKEL, GAL; SCHACHTER, JACOB; PAPA, MOSHE Z.

2012-01-01

Tumor-infiltrating lymphocytes (TILs) are produced by resecting tumor tissue and growing and expanding ex vivo large quantities of autologous T cells. Once the TILs are ready for infusion, the patient undergoes a non-myeloablative lympho-depleting course of chemotherapy and subsequent TIL infusion with high-dose bolus IL-2. This study reviews the surgical experience of the TIL program at the Chaim Sheba Cancer Research Center in Israel. Eligible patients underwent surgical consultation to determine what tumorectomy would be beneficial for harvesting appropriate tissue. Factors involved in the decision included tumor mass size, location and morbidity of the procedure. Between January 2006 and May 2010, 44 patients underwent 47 procedures of adoptive transfer of TILs. Three patients underwent the procedure twice for recurrence after initial good responses, including an additional surgical procedure to produce fresh tumor. Thirty-seven excisions were with general anesthesia and 10 were with local anesthesia. Of the 37 general anesthesia procedures, 27 were open procedures involving a thoracotomy, a laparotomy or dissection of a major lymph node basin. Ten used minimally invasive techniques such as thorascopy or laparoscopy. Tumorectomy sites included 18 lymph node metastasis, 13 subcutaneous nodules, 11 lung specimens and 5 abdominal visceral metastasis including 2 liver lesions. Surgical mortality and major morbidity was 0%. Minor morbidity included only wound complications. Maximal number of TILs were derived from lymph node specimens, while liver metastasis procured the fewest TILs. Adoptive cell transfer technology affords a maximal tumor response with minimal surgical morbidity in metastatic patients. PMID:22969990

Information Exchange Procedures. Outcomes Study Procedures. Technical Report No. 66.

ERIC Educational Resources Information Center

Byers, Maureen

The Information Exchange Procedures (IEP) developed by the National Center for Higher Education Management Systems (NCHEMS) are a set of standard definitions and procedures for collecting information about disciplines and student degree programs, outcomes of instructional programs, and general institutional characteristics. A fundamental purpose…

Hematopoietic Stem Cell Transplantation in Thalassemia and Sickle Cell Anemia

PubMed Central

Lucarelli, Guido; Isgrò, Antonella; Sodani, Pietro; Gaziev, Javid

2012-01-01

The globally widespread single-gene disorders β-thalassemia and sickle cell anemia (SCA) can only be cured by allogeneic hematopoietic stem cell transplantation (HSCT). HSCT treatment of thalassemia has substantially improved over the last two decades, with advancements in preventive strategies, control of transplant-related complications, and preparative regimens. A risk class–based transplantation approach results in disease-free survival probabilities of 90%, 84%, and 78% for class 1, 2, and 3 thalassemia patients, respectively. Because of disease advancement, adult thalassemia patients have a higher risk for transplant-related toxicity and a 65% cure rate. Patients without matched donors could benefit from haploidentical mother-to-child transplantation. There is a high cure rate for children with SCA who receive HSCT following myeloablative conditioning protocols. Novel non-myeloablative transplantation protocols could make HSCT available to adult SCA patients who were previously excluded from allogeneic stem cell transplantation. PMID:22553502

Hemorrhagic cystitis after allogeneic hematopoietic stem cell transplants is the complex result of BK virus infection, preparative regimen intensity and donor type

PubMed Central

de Padua Silva, Leandro; Patah, Poliana A.; Saliba, Rima M.; Szewczyk, Nicholas A.; Gilman, Lisa; Neumann, Joyce; Han, Xiang-Yang; Tarrand, Jeffrey; Ribeiro, Rachel; Gulbis, Alison; Shpall, Elizabeth J.; Jones, Roy; Popat, Uday; Walker, Julia A.; Petropoulos, Demetrios; Chiattone, Alexandre; Stewart, John; El-Zimaity, Maha; Anderlini, Paolo; Giralt, Sergio; Champlin, Richard E; de Lima, Marcos

2010-01-01

Background Hemorrhagic cystitis is a common cause of morbidity after allogeneic stem cell transplantation, frequently associated with BK virus infection. We hypothesized that patients with positive BK viruria before unrelated or mismatched related donor allogeneic hematopoietic stem cell transplantation have a higher incidence of hemorrhagic cystitis. Design and Methods To test this hypothesis, we prospectively studied 209 patients (median age 49 years, range 19–71) with hematologic malignancies who received bone marrow (n=78), peripheral blood (n=108) or umbilical cord blood (n=23) allogeneic hematopoietic stem cell transplantation after myeloablative (n=110) or reduced intensity conditioning (n=99). Donors were unrelated (n=201) or haploidentical related (n=8). Results Twenty-five patients developed hemorrhagic cystitis. Pre-transplant BK viruria detected by quantitative PCR was positive in 96 patients. The one-year cumulative incidence of hemorrhagic cystitis was 16% in the PCR-positive group versus 9% in the PCR-negative group (P=0.1). The use of umbilical cord blood or a haploidentical donor was the only significant predictor of the incidence of hemorrhagic cystitis on univariate analysis. There was also a trend for a higher incidence after myeloablative conditioning. Multivariate analysis showed that patients who had a positive PCR pre-transplant and received haploidentical or cord blood grafts with myeloablative conditioning had a significantly higher risk of developing hemorrhagic cystitis (58%) than all other recipients (7%, P<0.001). Conclusions Hemorrhagic cystitis is the result of a complex interaction of donor type, preparative regimen intensity, and BK viruria. PMID:20410183

An Improved Protocol for Efficient Engraftment in NOD/LTSZ-SCIDIL-2RγNULL Mice Allows HIV Replication and Development of Anti-HIV Immune Responses

PubMed Central

Singh, Maneesh; Singh, Pratibha; Gaudray, Gilles; Musumeci, Lucia; Thielen, Caroline; Vaira, Dolores; Vandergeeten, Claire; Delacroix, Laurence; Van Gulck, Ellen; Vanham, Guido; de Leval, Laurence; Rahmouni, Souad; Moutschen, Michel

2012-01-01

Cord blood hematopoietic progenitor cells (CB-HPCs) transplanted immunodeficient NOD/LtsZ-scidIL2Rγnull (NSG) and NOD/SCID/IL2Rγnull (NOG) mice need efficient human cell engraftment for long-term HIV-1 replication studies. Total body irradiation (TBI) is a classical myeloablation regimen used to improve engraftment levels of human cells in these humanized mice. Some recent reports suggest the use of busulfan as a myeloablation regimen to transplant HPCs in neonatal and adult NSG mice. In the present study, we further ameliorated the busulfan myeloablation regimen with fresh CB-CD34+cell transplantation in 3–4 week old NSG mice. In this CB-CD34+transplanted NSG mice engraftment efficiency of human CD45+cell is over 90% in peripheral blood. Optimal engraftment promoted early and increased CD3+T cell levels, with better lymphoid tissue development and prolonged human cell chimerism over 300 days. These humanized NSG mice have shown long-lasting viremia after HIV-1JRCSF and HIV-1Bal inoculation through intravenous and rectal routes. We also saw a gradual decline of the CD4+T cell count, widespread immune activation, up-regulation of inflammation marker and microbial translocation after HIV-1 infection. Humanized NSG mice reconstituted according to our new protocol produced, moderate cellular and humoral immune responses to HIV-1 postinfection. We believe that NSG mice reconstituted according to our easy to use protocol will provide a better in vivo model for HIV-1 replication and anti-HIV-1 therapy trials. PMID:22675567

Electronic Procedures for Medical Operations

NASA Technical Reports Server (NTRS)

2015-01-01

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

31 CFR 598.801 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Procedures. 598.801 Section 598.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN... § 598.801 Procedures. For license application procedures and procedures relating to amendments...

31 CFR 598.801 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Procedures. 598.801 Section 598.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN... § 598.801 Procedures. For license application procedures and procedures relating to amendments...

31 CFR 598.801 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Procedures. 598.801 Section 598.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN... § 598.801 Procedures. For license application procedures and procedures relating to amendments...

31 CFR 598.801 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Procedures. 598.801 Section 598.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN... § 598.801 Procedures. For license application procedures and procedures relating to amendments...

31 CFR 598.801 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Procedures. 598.801 Section 598.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN... § 598.801 Procedures. For license application procedures and procedures relating to amendments...

77 FR 57196 - Proposed Collection; Comment Request for Revenue Procedure 2011-4, Revenue Procedure 2011-5...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-09-17

...) of the Internal Revenue Service to give advice on filing letter ruling, determination letter, and... Procedure 2011-4 (Letter Rulings), Revenue Procedure 2011-5 (Technical Advice), Revenue Procedure 2011-6... Advice), Revenue Procedure 2011-6 (Determination Letters), and Revenue Procedure 2011-8 (User Fees). OMB...

Model of Procedure Usage – Results from a Qualitative Study to Inform Design of Computer-Based Procedures

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

Johanna H Oxstrand; Katya L Le Blanc

The nuclear industry is constantly trying to find ways to decrease the human error rate, especially the human errors associated with procedure use. As a step toward the goal of improving procedure use performance, researchers, together with the nuclear industry, have been looking at replacing the current paper-based procedures with computer-based procedure systems. The concept of computer-based procedures is not new by any means; however most research has focused on procedures used in the main control room. Procedures reviewed in these efforts are mainly emergency operating procedures and normal operating procedures. Based on lessons learned for these previous efforts wemore » are now exploring a more unknown application for computer based procedures - field procedures, i.e. procedures used by nuclear equipment operators and maintenance technicians. The Idaho National Laboratory, the Institute for Energy Technology, and participants from the U.S. commercial nuclear industry are collaborating in an applied research effort with the objective of developing requirements and specifications for a computer-based procedure system to be used by field operators. The goal is to identify the types of human errors that can be mitigated by using computer-based procedures and how to best design the computer-based procedures to do this. The underlying philosophy in the research effort is “Stop – Start – Continue”, i.e. what features from the use of paper-based procedures should we not incorporate (Stop), what should we keep (Continue), and what new features or work processes should be added (Start). One step in identifying the Stop – Start – Continue was to conduct a baseline study where affordances related to the current usage of paper-based procedures were identified. The purpose of the study was to develop a model of paper based procedure use which will help to identify desirable features for computer based procedure prototypes. Affordances such as note taking

[Costing nuclear medicine diagnostic procedures].

PubMed

Markou, Pavlos

2005-01-01

To the Editor: Referring to a recent special report about the cost analysis of twenty-nine nuclear medicine procedures, I would like to clarify some basic aspects for determining costs of nuclear medicine procedure with various costing methodologies. Activity Based Costing (ABC) method, is a new approach in imaging services costing that can provide the most accurate cost data, but is difficult to perform in nuclear medicine diagnostic procedures. That is because ABC requires determining and analyzing all direct and indirect costs of each procedure, according all its activities. Traditional costing methods, like those for estimating incomes and expenses per procedure or fixed and variable costs per procedure, which are widely used in break-even point analysis and the method of ratio-of-costs-to-charges per procedure may be easily performed in nuclear medicine departments, to evaluate the variability and differences between costs and reimbursement - charges.

Civilizing Civil Procedure.

ERIC Educational Resources Information Center

Ticcioni, Daniel A.

1981-01-01

A "Civil Litigation Exercise" (a litigation simulation) conducted during the second semester of a first year procedure course at the New England School of Law is described. The purpose of the exercise is to simulate the real world of adversary pleading and practice. The Civil Procedure Litigation exercises are appended. (MLW)

In-Trail Procedure Air Traffic Control Procedures Validation Simulation Study

NASA Technical Reports Server (NTRS)

Chartrand, Ryan C.; Hewitt, Katrin P.; Sweeney, Peter B.; Graff, Thomas J.; Jones, Kenneth M.

2012-01-01

In August 2007, Airservices Australia (Airservices) and the United States National Aeronautics and Space Administration (NASA) conducted a validation experiment of the air traffic control (ATC) procedures associated with the Automatic Dependant Surveillance-Broadcast (ADS-B) In-Trail Procedure (ITP). ITP is an Airborne Traffic Situation Awareness (ATSA) application designed for near-term use in procedural airspace in which ADS-B data are used to facilitate climb and descent maneuvers. NASA and Airservices conducted the experiment in Airservices simulator in Melbourne, Australia. Twelve current operational air traffic controllers participated in the experiment, which identified aspects of the ITP that could be improved (mainly in the communication and controller approval process). Results showed that controllers viewed the ITP as valid and acceptable. This paper describes the experiment design and results.

Monitor for Sterilization Procedures

DTIC Science & Technology

2001-10-25

were tested using ampules of Bacillus stearothermophilus spores commercially manufactured by Barnstead/Thermolyne for testing sterilization procedures...Monitor for Sterilization Procedures F. Cleary1,2, H.-Y. Mason2, C. Estes2, A. Duncan2, W. Ellis, Jr.2 and L. Powers2 1Moses Brown High School...accurate determination of the efficacy of sterilization procedures is demonstrated using a hand-held instrument based on the intrinsic fluorescence of

Candidate CDTI procedures study

NASA Technical Reports Server (NTRS)

Ace, R. E.

1981-01-01

A concept with potential for increasing airspace capacity by involving the pilot in the separation control loop is discussed. Some candidate options are presented. Both enroute and terminal area procedures are considered and, in many cases, a technologically advanced Air Traffic Control structure is assumed. Minimum display characteristics recommended for each of the described procedures are presented. Recommended sequencing of the operational testing of each of the candidate procedures is presented.

Developing Procedural Flexibility: Are Novices Prepared to Learn from Comparing Procedures?

ERIC Educational Resources Information Center

Rittle-Johnson, Bethany; Star, Jon R.; Durkin, Kelley

2012-01-01

Background: A key learning outcome in problem-solving domains is the development of procedural flexibility, where learners know multiple procedures and use them appropriately to solve a range of problems (e.g., Verschaffel, Luwel, Torbeyns, & Van Dooren, 2009). However, students often fail to become flexible problem solvers in mathematics. To…

Connectionist Learning Procedures.

ERIC Educational Resources Information Center

Hinton, Geoffrey E.

A major goal of research on networks of neuron-like processing units is to discover efficient learning procedures that allow these networks to construct complex internal representations of their environment. The learning procedures must be capable of modifying the connection strengths in such a way that internal units which are not part of the…

Modified arthroscopic Brostrom procedure.

PubMed

Lui, Tun Hing

2015-09-01

The open modified Brostrom anatomic repair technique is widely accepted as the reference standard for lateral ankle stabilization. However, there is high incidence of intra-articular pathologies associated with chronic lateral ankle instability which may not be addressed by an isolated open Brostrom procedure. Arthroscopic Brostrom procedure with suture anchor has been described for anatomic repair of chronic lateral ankle instability and management of intra-articular lesions. However, the complication rates seemed to be higher than open Brostrom procedure. Modification of the arthroscopic Brostrom procedure with the use of bone tunnel may reduce the risk of certain complications. Copyright © 2015 European Foot and Ankle Society. Published by Elsevier Ltd. All rights reserved.

Preschooler test or procedure preparation

MedlinePlus

Preparing preschoolers for test/procedure; Test/procedure preparation - preschooler ... Preparing children for medical tests can reduce their anxiety. It can also make them less likely to cry and resist the procedure. Research shows that ...

Enucleation Procedure Manual.

ERIC Educational Resources Information Center

Davis, Kevin; Poston, George

This manual provides information on the enucleation procedure (removal of the eyes for organ banks). An introductory section focuses on the anatomy of the eye and defines each of the parts. Diagrams of the eye are provided. A list of enucleation materials follows. Other sections present outlines of (1) a sterile procedure; (2) preparation for eye…

Toddler test or procedure preparation

MedlinePlus

Preparing toddler for test/procedure; Test/procedure preparation - toddler; Preparing for a medical test or procedure - toddler ... Before the test, know that your child will probably cry. Even if you prepare, your child may feel some discomfort or ...

Pelvic denervation procedures for dysmenorrhea.

PubMed

Ramirez, Christina; Donnellan, Nicole

2017-08-01

Chronic pelvic pain and dysmenorrhea are common conditions affecting reproductive-age women. Surgical pelvic denervation procedures may be a treatment option for women with midline dysmenorrhea, in which medical management is declined by the patient, ineffective at managing symptoms, or medically contraindicated. This review describes the surgical techniques and complications associated with pelvic denervation procedures as well as the current evidence for these procedures in women with primary dysmenorrhea and dysmenorrhea secondary to endometriosis. Presacral neurectomy is the preferred pelvic denervation procedure in patients with primary dysmenorrhea and midline chronic pelvic pain associated with endometriosis. In patients with endometriosis presacral neurectomy is a useful adjunct to excision or ablation of all endometrial lesions to improve postoperative pain relief. There is no additional patient benefit of performing combined presacral neurectomy and uterine nerve ablation procedures. Pelvic denervation procedures can be performed safely and quickly with a low risk of complication if the surgeon is knowledgeable and skilled in operating in the presacral space. Patients should be adequately counseled on expected success rates and potential complications associated with pelvic denervation procedures.

The impact of a medical procedure service on patient safety, procedure quality and resident training opportunities.

PubMed

Tukey, Melissa H; Wiener, Renda Soylemez

2014-03-01

At some academic hospitals, medical procedure services are being developed to provide supervision for residents performing bedside procedures in hopes of improving patient safety and resident education. There is limited knowledge of the impact of such services on procedural complication rates and resident procedural training opportunities. To determine the impact of a medical procedure service (MPS) on patient safety and resident procedural training opportunities. Retrospective cohort analysis comparing characteristics and outcomes of procedures performed by the MPS versus the primary medical service. Consecutive adults admitted to internal medicine services at a large academic hospital who underwent a bedside medical procedure (central venous catheterization, thoracentesis, paracentesis, lumbar puncture) between 1 July 2010 and 31 December 2011. The primary outcome was a composite rate of major complications. Secondary outcomes included resident participation in bedside procedures and use of "best practice" safety process measures. We evaluated 1,707 bedside procedures (548 by the MPS, 1,159 by the primary services). There were no differences in the composite rate of major complications (1.6 % vs. 1.9 %, p = 0.71) or resident participation in bedside procedures (57.0 % vs. 54.3 %, p = 0.31) between the MPS and the primary services. Procedures performed by the MPS were more likely to be successfully completed (95.8 % vs. 92.8 %, p = 0.02) and to use best practice safety process measures, including use of ultrasound guidance when appropriate (96.8 % vs. 90.0 %, p = 0.0004), avoidance of femoral venous catheterization (89.5 vs. 82.7 %, p = 0.02) and involvement of attending physicians (99.3 % vs. 57.0 %, p < 0.0001). Although use of a MPS did not significantly affect the rate of major complications or resident opportunities for training in bedside procedures, it was associated with increased use of best practice safety process measures.

Advanced crew procedures development techniques

NASA Technical Reports Server (NTRS)

Arbet, J. D.; Benbow, R. L.; Mangiaracina, A. A.; Mcgavern, J. L.; Spangler, M. C.; Tatum, I. C.

1975-01-01

The development of an operational computer program, the Procedures and Performance Program (PPP), is reported which provides a procedures recording and crew/vehicle performance monitoring capability. The PPP provides real time CRT displays and postrun hardcopy of procedures, difference procedures, performance, performance evaluation, and training script/training status data. During post-run, the program is designed to support evaluation through the reconstruction of displays to any point in time. A permanent record of the simulation exercise can be obtained via hardcopy output of the display data, and via magnetic tape transfer to the Generalized Documentation Processor (GDP). Reference procedures data may be transferred from the GDP to the PPP.

Diagnosis of sinusoidal obstruction syndrome by positron emission tomography/computed tomography: report of two cases treated by defibrotide.

PubMed

Gauthé, Mathieu; Bozec, Laurence; Bedossa, Pierre

2014-11-01

Sinusoidal obstruction syndrome (SOS) is a potentially fatal liver injury that mainly occurs after myeloablative chemotherapy. We report two cases of SOS investigated by 18F-fluorodeoxyglucose positron emission tomography/computed tomography and treated with defibrotide. © 2014 by the American Association for the Study of Liver Diseases.

40 CFR 1033.315 - Test procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Test procedures. 1033.315 Section 1033... Programs § 1033.315 Test procedures. (a) Test procedures. Use the test procedures described in subpart F of this part, except as specified in this section. (1) You may ask to use other test procedures. We will...

40 CFR 1033.315 - Test procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 34 2012-07-01 2012-07-01 false Test procedures. 1033.315 Section 1033... Programs § 1033.315 Test procedures. (a) Test procedures. Use the test procedures described in subpart F of this part, except as specified in this section. (1) You may ask to use other test procedures. We will...

40 CFR 1033.315 - Test procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 33 2014-07-01 2014-07-01 false Test procedures. 1033.315 Section 1033... Programs § 1033.315 Test procedures. (a) Test procedures. Use the test procedures described in subpart F of this part, except as specified in this section. (1) You may ask to use other test procedures. We will...

76 FR 62092 - Filing Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-06

... INTERNATIONAL TRADE COMMISSION Filing Procedures AGENCY: International Trade Commission. ACTION: Notice of issuance of Handbook on Filing Procedures. SUMMARY: The United States International Trade Commission (``Commission'') is issuing a Handbook on Filing Procedures to replace its Handbook on Electronic...

10 CFR 26.127 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

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

10 CFR 26.127 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

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

10 CFR 26.127 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

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

78 FR 22546 - Hearing Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-16

... FINANCIAL STABILITY OVERSIGHT COUNCIL Hearing Procedures AGENCY: Financial Stability Oversight... Council (Council) has adopted amendments to its hearing procedures (Council Hearing Procedures) for hearings conducted by the Council under Title I and Title VIII of the Dodd-Frank Wall Street Reform and...

CATS EYES Adjustment Procedures

DTIC Science & Technology

1993-04-01

AL-TR-1 993-0025 AD-A264 069 CATS EYES ADJUSTMENT PROCEDURES A R M Joseph C. Antonio DTIC S ELECTET University of Dayton Research Institute MAY 13...Final November 1992 - January 1993 4. TITLE AND SUBTITLE S. FUNDING NUMBERS C F33615-90-C-0005 CATS EYES Adjustment Procedures PE - 62205F 6. AUTHOR(S) PR...the loss of NVG performance resulting from improper goggle adjustments. This report describes correct adjustment procedures for the CATS EYES NVG system

Dynamic alarm response procedures

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

Martin, J.; Gordon, P.; Fitch, K.

2006-07-01

The Dynamic Alarm Response Procedure (DARP) system provides a robust, Web-based alternative to existing hard-copy alarm response procedures. This paperless system improves performance by eliminating time wasted looking up paper procedures by number, looking up plant process values and equipment and component status at graphical display or panels, and maintenance of the procedures. Because it is a Web-based system, it is platform independent. DARP's can be served from any Web server that supports CGI scripting, such as Apache{sup R}, IIS{sup R}, TclHTTPD, and others. DARP pages can be viewed in any Web browser that supports Javascript and Scalable Vector Graphicsmore » (SVG), such as Netscape{sup R}, Microsoft Internet Explorer{sup R}, Mozilla Firefox{sup R}, Opera{sup R}, and others. (authors)« less

28 CFR 42.530 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND... Section 504 of the Rehabilitation Act of 1973 Procedures § 42.530 Procedures. (a) The procedural... section 803(a) of title I of the Omnibus Crime Control and Safe Streets Act, as amended by the Justice...

28 CFR 42.530 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND... Section 504 of the Rehabilitation Act of 1973 Procedures § 42.530 Procedures. (a) The procedural... section 803(a) of title I of the Omnibus Crime Control and Safe Streets Act, as amended by the Justice...

28 CFR 42.530 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND... Section 504 of the Rehabilitation Act of 1973 Procedures § 42.530 Procedures. (a) The procedural... section 803(a) of title I of the Omnibus Crime Control and Safe Streets Act, as amended by the Justice...

28 CFR 42.530 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND... Section 504 of the Rehabilitation Act of 1973 Procedures § 42.530 Procedures. (a) The procedural... section 803(a) of title I of the Omnibus Crime Control and Safe Streets Act, as amended by the Justice...

28 CFR 42.530 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY; POLICIES AND... Section 504 of the Rehabilitation Act of 1973 Procedures § 42.530 Procedures. (a) The procedural... section 803(a) of title I of the Omnibus Crime Control and Safe Streets Act, as amended by the Justice...

34 CFR 104.61 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Procedures § 104.61 Procedures. The procedural provisions applicable to title VI of the Civil Rights Act of...

34 CFR 104.61 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Procedures § 104.61 Procedures. The procedural provisions applicable to title VI of the Civil Rights Act of...

34 CFR 104.61 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Procedures § 104.61 Procedures. The procedural provisions applicable to title VI of the Civil Rights Act of...

34 CFR 104.61 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Procedures § 104.61 Procedures. The procedural provisions applicable to title VI of the Civil Rights Act of...

34 CFR 104.61 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... of the Offices of the Department of Education OFFICE FOR CIVIL RIGHTS, DEPARTMENT OF EDUCATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Procedures § 104.61 Procedures. The procedural provisions applicable to title VI of the Civil Rights Act of...

10 CFR 26.127 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Procedures. 26.127 Section 26.127 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.127 Procedures. (a) Licensee testing facilities shall develop, implement, and maintain clear and well-documented procedures for...

10 CFR 26.127 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Procedures. 26.127 Section 26.127 Energy NUCLEAR REGULATORY COMMISSION FITNESS FOR DUTY PROGRAMS Licensee Testing Facilities § 26.127 Procedures. (a) Licensee testing facilities shall develop, implement, and maintain clear and well-documented procedures for...

22 CFR 305.5 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Procedures. 305.5 Section 305.5 Foreign Relations PEACE CORPS ELIGIBILITY AND STANDARDS FOR PEACE CORPS VOLUNTEER SERVICE § 305.5 Procedures. Procedures for filing, investigating, and determining allegations of discrimination on the basis of race...

31 CFR 546.801 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Procedures. 546.801 Section 546.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY DARFUR SANCTIONS REGULATIONS Procedures § 546.801 Procedures...

22 CFR 305.5 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Procedures. 305.5 Section 305.5 Foreign Relations PEACE CORPS ELIGIBILITY AND STANDARDS FOR PEACE CORPS VOLUNTEER SERVICE § 305.5 Procedures. Procedures for filing, investigating, and determining allegations of discrimination on the basis of race...

22 CFR 305.5 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Procedures. 305.5 Section 305.5 Foreign Relations PEACE CORPS ELIGIBILITY AND STANDARDS FOR PEACE CORPS VOLUNTEER SERVICE § 305.5 Procedures. Procedures for filing, investigating, and determining allegations of discrimination on the basis of race...

22 CFR 305.5 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Procedures. 305.5 Section 305.5 Foreign Relations PEACE CORPS ELIGIBILITY AND STANDARDS FOR PEACE CORPS VOLUNTEER SERVICE § 305.5 Procedures. Procedures for filing, investigating, and determining allegations of discrimination on the basis of race...

22 CFR 305.5 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Procedures. 305.5 Section 305.5 Foreign Relations PEACE CORPS ELIGIBILITY AND STANDARDS FOR PEACE CORPS VOLUNTEER SERVICE § 305.5 Procedures. Procedures for filing, investigating, and determining allegations of discrimination on the basis of race...

31 CFR 537.801 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Procedures. 537.801 Section 537.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY BURMESE SANCTIONS REGULATIONS Procedures § 537.801 Procedures...

10 CFR 26.157 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of standard operating procedures for each assay performed for licensees and other entities for drug... 10 Energy 1 2010-01-01 2010-01-01 false Procedures. 26.157 Section 26.157 Energy NUCLEAR... Services § 26.157 Procedures. (a) HHS-certified laboratories shall develop, implement, and maintain clear...

10 CFR 26.157 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... of standard operating procedures for each assay performed for licensees and other entities for drug... 10 Energy 1 2013-01-01 2013-01-01 false Procedures. 26.157 Section 26.157 Energy NUCLEAR... Services § 26.157 Procedures. (a) HHS-certified laboratories shall develop, implement, and maintain clear...

10 CFR 26.157 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... of standard operating procedures for each assay performed for licensees and other entities for drug... 10 Energy 1 2011-01-01 2011-01-01 false Procedures. 26.157 Section 26.157 Energy NUCLEAR... Services § 26.157 Procedures. (a) HHS-certified laboratories shall develop, implement, and maintain clear...

10 CFR 26.157 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... of standard operating procedures for each assay performed for licensees and other entities for drug... 10 Energy 1 2014-01-01 2014-01-01 false Procedures. 26.157 Section 26.157 Energy NUCLEAR... Services § 26.157 Procedures. (a) HHS-certified laboratories shall develop, implement, and maintain clear...

10 CFR 26.157 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... of standard operating procedures for each assay performed for licensees and other entities for drug... 10 Energy 1 2012-01-01 2012-01-01 false Procedures. 26.157 Section 26.157 Energy NUCLEAR... Services § 26.157 Procedures. (a) HHS-certified laboratories shall develop, implement, and maintain clear...

18 CFR 401.23 - Procedure.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 2 2014-04-01 2014-04-01 false Procedure. 401.23 Section 401.23 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL RULES OF PRACTICE AND PROCEDURE Water Resources Program § 401.23 Procedure. Each project included...

18 CFR 401.23 - Procedure.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Procedure. 401.23 Section 401.23 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL RULES OF PRACTICE AND PROCEDURE Water Resources Program § 401.23 Procedure. Each project included...

18 CFR 401.23 - Procedure.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 18 Conservation of Power and Water Resources 2 2012-04-01 2012-04-01 false Procedure. 401.23 Section 401.23 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL RULES OF PRACTICE AND PROCEDURE Water Resources Program § 401.23 Procedure. Each project included...

18 CFR 401.23 - Procedure.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 2 2013-04-01 2012-04-01 true Procedure. 401.23 Section 401.23 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL RULES OF PRACTICE AND PROCEDURE Water Resources Program § 401.23 Procedure. Each project included...

18 CFR 401.23 - Procedure.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 18 Conservation of Power and Water Resources 2 2011-04-01 2011-04-01 false Procedure. 401.23 Section 401.23 Conservation of Power and Water Resources DELAWARE RIVER BASIN COMMISSION ADMINISTRATIVE MANUAL RULES OF PRACTICE AND PROCEDURE Water Resources Program § 401.23 Procedure. Each project included...

10 CFR 766.105 - Payment procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Payment procedures. 766.105 Section 766.105 Energy DEPARTMENT OF ENERGY URANIUM ENRICHMENT DECONTAMINATION AND DECOMMISSIONING FUND; PROCEDURES FOR SPECIAL ASSESSMENT OF DOMESTIC UTILITIES Procedures for Special Assessment § 766.105 Payment procedures. DOE shall...

10 CFR 766.105 - Payment procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Payment procedures. 766.105 Section 766.105 Energy DEPARTMENT OF ENERGY URANIUM ENRICHMENT DECONTAMINATION AND DECOMMISSIONING FUND; PROCEDURES FOR SPECIAL ASSESSMENT OF DOMESTIC UTILITIES Procedures for Special Assessment § 766.105 Payment procedures. DOE shall...

10 CFR 766.105 - Payment procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Payment procedures. 766.105 Section 766.105 Energy DEPARTMENT OF ENERGY URANIUM ENRICHMENT DECONTAMINATION AND DECOMMISSIONING FUND; PROCEDURES FOR SPECIAL ASSESSMENT OF DOMESTIC UTILITIES Procedures for Special Assessment § 766.105 Payment procedures. DOE shall...

10 CFR 766.105 - Payment procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Payment procedures. 766.105 Section 766.105 Energy DEPARTMENT OF ENERGY URANIUM ENRICHMENT DECONTAMINATION AND DECOMMISSIONING FUND; PROCEDURES FOR SPECIAL ASSESSMENT OF DOMESTIC UTILITIES Procedures for Special Assessment § 766.105 Payment procedures. DOE shall...

18 CFR 301.3 - Filing procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... FOR SALES FROM UTILITIES TO BONNEVILLE POWER ADMINISTRATION UNDER NORTHWEST POWER ACT § 301.3 Filing procedures. (a) Bonneville's ASC review procedures. The procedures established by Bonneville's Administrator... Bonneville's ASC review procedures. (b) Exchange Period. The Exchange Period will be equal to the term of...

15 CFR 904.402 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS CIVIL PROCEDURES Written Warnings § 904.402 Procedures. (a) Any person authorized to enforce the laws listed in § 904.1(c) or Agency... 15 Commerce and Foreign Trade 3 2010-01-01 2010-01-01 false Procedures. 904.402 Section 904.402...

15 CFR 904.402 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE GENERAL REGULATIONS CIVIL PROCEDURES Written Warnings § 904.402 Procedures. (a) Any person authorized to enforce the laws listed in § 904.1(c) or Agency... 15 Commerce and Foreign Trade 3 2011-01-01 2011-01-01 false Procedures. 904.402 Section 904.402...

22 CFR 911.3 - Procedure.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Procedure. 911.3 Section 911.3 Foreign Relations FOREIGN SERVICE GRIEVANCE BOARD IMPLEMENTATION DISPUTES § 911.3 Procedure. Implementation disputes shall be handled by the Board in accordance with the procedures set forth in parts 901-910 of this chapter. ...

22 CFR 911.3 - Procedure.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 22 Foreign Relations 2 2013-04-01 2009-04-01 true Procedure. 911.3 Section 911.3 Foreign Relations FOREIGN SERVICE GRIEVANCE BOARD IMPLEMENTATION DISPUTES § 911.3 Procedure. Implementation disputes shall be handled by the Board in accordance with the procedures set forth in parts 901-910 of this chapter. ...

22 CFR 911.3 - Procedure.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 22 Foreign Relations 2 2012-04-01 2009-04-01 true Procedure. 911.3 Section 911.3 Foreign Relations FOREIGN SERVICE GRIEVANCE BOARD IMPLEMENTATION DISPUTES § 911.3 Procedure. Implementation disputes shall be handled by the Board in accordance with the procedures set forth in parts 901-910 of this chapter. ...

22 CFR 911.3 - Procedure.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Procedure. 911.3 Section 911.3 Foreign Relations FOREIGN SERVICE GRIEVANCE BOARD IMPLEMENTATION DISPUTES § 911.3 Procedure. Implementation disputes shall be handled by the Board in accordance with the procedures set forth in parts 901-910 of this chapter. ...

22 CFR 911.3 - Procedure.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 22 Foreign Relations 2 2014-04-01 2014-04-01 false Procedure. 911.3 Section 911.3 Foreign Relations FOREIGN SERVICE GRIEVANCE BOARD IMPLEMENTATION DISPUTES § 911.3 Procedure. Implementation disputes shall be handled by the Board in accordance with the procedures set forth in parts 901-910 of this...

32 CFR 57.6 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... INTERVENTION AND SPECIAL EDUCATION SERVICES TO ELIGIBLE DOD DEPENDENTS § 57.6 Procedures. (a) The procedures..., ages 3 through 21 years, inclusive, on IEPs are prescribed in appendix B of this part. (c) The..., inclusive, are prescribed in appendix C of this part (d) Procedural safeguards and parent and student rights...

32 CFR 57.6 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... INTERVENTION AND SPECIAL EDUCATION SERVICES TO ELIGIBLE DOD DEPENDENTS § 57.6 Procedures. (a) The procedures..., ages 3 through 21 years, inclusive, on IEPs are prescribed in appendix B of this part. (c) The..., inclusive, are prescribed in appendix C of this part (d) Procedural safeguards and parent and student rights...

Nursing Procedures. NAVMED P-5066.

ERIC Educational Resources Information Center

Bureau of Medicine and Surgery (Navy), Washington, DC.

The revised manual of nursing procedures covers fundamental nursing care, admission and discharge of the patient, assisting with therapeutic measures, pre- and postoperative care, diagnostic tests and procedures, and isolation technique. Each of the over 300 topics includes the purpose, equipment, and procedure to be used and, where relevant, such…

32 CFR 162.6 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 1 2011-07-01 2011-07-01 false Procedures. 162.6 Section 162.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DEFENSE CONTRACTING PRODUCTIVITY ENHANCING CAPITAL INVESTMENT (PECI) § 162.6 Procedures. The following procedures shall be followed by the DoD Components in the...

32 CFR 162.6 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Procedures. 162.6 Section 162.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DEFENSE CONTRACTING PRODUCTIVITY ENHANCING CAPITAL INVESTMENT (PECI) § 162.6 Procedures. The following procedures shall be followed by the DoD Components in the...

32 CFR 162.6 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 1 2013-07-01 2013-07-01 false Procedures. 162.6 Section 162.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DEFENSE CONTRACTING PRODUCTIVITY ENHANCING CAPITAL INVESTMENT (PECI) § 162.6 Procedures. The following procedures shall be followed by the DoD Components in the...

32 CFR 162.6 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 1 2012-07-01 2012-07-01 false Procedures. 162.6 Section 162.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE DEFENSE CONTRACTING PRODUCTIVITY ENHANCING CAPITAL INVESTMENT (PECI) § 162.6 Procedures. The following procedures shall be followed by the DoD Components in the...

32 CFR 635.35 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Procedures. 635.35 Section 635.35 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY (CONTINUED) LAW ENFORCEMENT AND CRIMINAL INVESTIGATIONS LAW ENFORCEMENT REPORTING Victim and Witness Assistance Procedures § 635.35 Procedures. (a) As required by Federal law, Army personnel...

40 CFR 154.34 - Expedited procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Expedited procedures. 154.34 Section... SPECIAL REVIEW PROCEDURES Procedures § 154.34 Expedited procedures. (a) The Agency may elect to issue a Notice of Special Review and a Notice of Preliminary Determination simultaneously; or, to initiate...

49 CFR 193.2903 - Security procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Security procedures. 193.2903 Section 193.2903...: FEDERAL SAFETY STANDARDS Security § 193.2903 Security procedures. Each operator shall prepare and follow one or more manuals of written procedures to provide security for each LNG plant. The procedures must...

49 CFR 193.2903 - Security procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Security procedures. 193.2903 Section 193.2903...: FEDERAL SAFETY STANDARDS Security § 193.2903 Security procedures. Each operator shall prepare and follow one or more manuals of written procedures to provide security for each LNG plant. The procedures must...

49 CFR 193.2903 - Security procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false Security procedures. 193.2903 Section 193.2903...: FEDERAL SAFETY STANDARDS Security § 193.2903 Security procedures. Each operator shall prepare and follow one or more manuals of written procedures to provide security for each LNG plant. The procedures must...

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

DTIC Science & Technology

2016-04-04

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

Standardized Procedure Content And Data Structure Based On Human Factors Requirements For Computer-Based Procedures

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

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

2015-02-01

Most activities that involve human interaction with systems in a nuclear power plant are guided by procedures. Traditionally, the use of procedures has been a paper-based process that supports safe operation of the nuclear power industry. However, the nuclear industry is constantly trying to find ways to decrease the human error rate, especially the human errors associated with procedure use. Advances in digital technology make computer-based procedures (CBPs) a valid option that provides further enhancement of safety by improving human performance related to procedure use. The transition from paper-based procedures (PBPs) to CBPs creates a need for a computer-based proceduremore » system (CBPS). A CBPS needs to have the ability to perform logical operations in order to adjust to the inputs received from either users or real time data from plant status databases. Without the ability for logical operations the procedure is just an electronic copy of the paper-based procedure. In order to provide the CBPS with the information it needs to display the procedure steps to the user, special care is needed in the format used to deliver all data and instructions to create the steps. The procedure should be broken down into basic elements and formatted in a standard method for the CBPS. One way to build the underlying data architecture is to use an Extensible Markup Language (XML) schema, which utilizes basic elements to build each step in the smart procedure. The attributes of each step will determine the type of functionality that the system will generate for that step. The CBPS will provide the context for the step to deliver referential information, request a decision, or accept input from the user. The XML schema needs to provide all data necessary for the system to accurately perform each step without the need for the procedure writer to reprogram the CBPS. The research team at the Idaho National Laboratory has developed a prototype CBPS for field workers as well as

31 CFR 4.1 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 1 2010-07-01 2010-07-01 false Procedures. 4.1 Section 4.1 Money and Finance: Treasury Office of the Secretary of the Treasury EMPLOYEES' PERSONAL PROPERTY CLAIMS § 4.1 Procedures. The procedures for filing a claim with the Treasury Department for personal property that is lost...

32 CFR 105.6 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 1 2014-07-01 2014-07-01 false Procedures. 105.6 Section 105.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN SEXUAL ASSAULT PREVENTION AND RESPONSE PROGRAM PROCEDURES § 105.6 Procedures. See § 105.7 through § 105.16 of this part. ...

32 CFR 105.6 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 1 2013-07-01 2013-07-01 false Procedures. 105.6 Section 105.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN SEXUAL ASSAULT PREVENTION AND RESPONSE PROGRAM PROCEDURES § 105.6 Procedures. See § 105.7 through § 105.16 of this part. ...

31 CFR 4.1 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance: Treasury 1 2011-07-01 2011-07-01 false Procedures. 4.1 Section 4.1 Money and Finance: Treasury Office of the Secretary of the Treasury EMPLOYEES' PERSONAL PROPERTY CLAIMS § 4.1 Procedures. The procedures for filing a claim with the Treasury Department for personal property that is lost...

31 CFR 4.1 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance: Treasury 1 2012-07-01 2012-07-01 false Procedures. 4.1 Section 4.1 Money and Finance: Treasury Office of the Secretary of the Treasury EMPLOYEES' PERSONAL PROPERTY CLAIMS § 4.1 Procedures. The procedures for filing a claim with the Treasury Department for personal property that is lost...

31 CFR 4.1 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance: Treasury 1 2013-07-01 2013-07-01 false Procedures. 4.1 Section 4.1 Money and Finance: Treasury Office of the Secretary of the Treasury EMPLOYEES' PERSONAL PROPERTY CLAIMS § 4.1 Procedures. The procedures for filing a claim with the Treasury Department for personal property that is lost...

31 CFR 4.1 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance: Treasury 1 2014-07-01 2014-07-01 false Procedures. 4.1 Section 4.1 Money and Finance: Treasury Office of the Secretary of the Treasury EMPLOYEES' PERSONAL PROPERTY CLAIMS § 4.1 Procedures. The procedures for filing a claim with the Treasury Department for personal property that is lost...

16 CFR 1.20 - Alternative procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Alternative procedures. 1.20 Section 1.20 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL PROCEDURES Rules and Rulemaking Under Section 18(a)(1)(B) of the FTC Act § 1.20 Alternative procedures. If...

40 CFR 92.506 - Test procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Test procedures. 92.506 Section 92.506... and Audit Programs § 92.506 Test procedures. (a)(1) For locomotives and locomotive engines subject to the provisions of this subpart, the prescribed test procedures are those procedures described in...

40 CFR 90.508 - Test procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Test procedures. 90.508 Section 90.508....508 Test procedures. (a) For nonroad engines subject to the provisions of this subpart, the prescribed test procedures are the appropriate small SI engine test procedures as described in subpart E of this...

40 CFR 89.508 - Test procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Test procedures. 89.508 Section 89.508... Test procedures. (a)(1) For nonroad engines subject to the provisions of this subpart, the prescribed test procedures are the nonroad engine 8-mode test procedure as described in subpart E of this part...

10 CFR 431.154 - Test procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 3 2011-01-01 2011-01-01 false Test procedures. 431.154 Section 431.154 Energy DEPARTMENT... EQUIPMENT Commercial Clothers Washers Test Procedures § 431.154 Test procedures. The test procedures for residential clothes washers in Appendix J1 to subpart B of part 430 of this title shall be used to test...

An XML Representation for Crew Procedures

NASA Technical Reports Server (NTRS)

Simpson, Richard C.

2005-01-01

NASA ensures safe operation of complex systems through the use of formally-documented procedures, which encode the operational knowledge of the system as derived from system experts. Crew members use procedure documentation on the ground for training purposes and on-board space shuttle and space station to guide their activities. Investigators at JSC are developing a new representation for procedures that is content-based (as opposed to display-based). Instead of specifying how a procedure should look on the printed page, the content-based representation will identify the components of a procedure and (more importantly) how the components are related (e.g., how the activities within a procedure are sequenced; what resources need to be available for each activity). This approach will allow different sets of rules to be created for displaying procedures on a computer screen, on a hand-held personal digital assistant (PDA), verbally, or on a printed page, and will also allow intelligent reasoning processes to automatically interpret and use procedure definitions. During his NASA fellowship, Dr. Simpson examined how various industries represent procedures (also called business processes or workflows), in areas such as manufacturing, accounting, shipping, or customer service. A useful method for designing and evaluating workflow representation languages is by determining their ability to encode various workflow patterns, which depict abstract relationships between the components of a procedure removed from the context of a specific procedure or industry. Investigators have used this type of analysis to evaluate how well-suited existing workflow representation languages are for various industries based on the workflow patterns that commonly arise across industry-specific procedures. Based on this type of analysis, it is already clear that existing workflow representations capture discrete flow of control (i.e., when one activity should start and stop based on when other

Procedural learning and dyslexia.

PubMed

Nicolson, R I; Fawcett, A J; Brookes, R L; Needle, J

2010-08-01

Three major 'neural systems', specialized for different types of information processing, are the sensory, declarative, and procedural systems. It has been proposed (Trends Neurosci., 30(4), 135-141) that dyslexia may be attributable to impaired function in the procedural system together with intact declarative function. We provide a brief overview of the increasing evidence relating to the hypothesis, noting that the framework involves two main claims: first that 'neural systems' provides a productive level of description avoiding the underspecificity of cognitive descriptions and the overspecificity of brain structural accounts; and second that a distinctive feature of procedural learning is its extended time course, covering from minutes to months. In this article, we focus on the second claim. Three studies-speeded single word reading, long-term response learning, and overnight skill consolidation-are reviewed which together provide clear evidence of difficulties in procedural learning for individuals with dyslexia, even when the tasks are outside the literacy domain. The educational implications of the results are then discussed, and in particular the potential difficulties that impaired overnight procedural consolidation would entail. It is proposed that response to intervention could be better predicted if diagnostic tests on the different forms of learning were first undertaken. 2010 John Wiley & Sons, Ltd.

Surgeon-patient communication during awake procedures.

PubMed

Smith, Claire S; Guyton, Kristina; Pariser, Joseph J; Siegler, Mark; Schindler, Nancy; Langerman, Alexander

2017-06-01

Surgeons are increasingly performing procedures on awake patients. Communication during such procedures is complex and underexplored in the literature. Surgeons were recruited from the faculty of 2 hospitals to participate in an interview regarding their approaches to communication during awake procedures. Three researchers used the constant comparative method to transcribe, code, and review interviews until saturation was reached. Twenty-three surgeons described the advantages and disadvantages of awake procedures, their communication with the awake patient, their interactions with staff and with trainees, the environment of awake procedures, and how communication in this context is taught and learned. Surgeons recognized communication during awake procedures as important and reported varied strategies for ensuring patient comfort in this context. However, they also acknowledged challenges with multiparty communication during awake procedures, especially in balancing commitments to teaching with their duty to comfort the patient. Copyright © 2016 Elsevier Inc. All rights reserved.

Robot-assisted procedures in pediatric neurosurgery.

PubMed

De Benedictis, Alessandro; Trezza, Andrea; Carai, Andrea; Genovese, Elisabetta; Procaccini, Emidio; Messina, Raffaella; Randi, Franco; Cossu, Silvia; Esposito, Giacomo; Palma, Paolo; Amante, Paolina; Rizzi, Michele; Marras, Carlo Efisio

2017-05-01

OBJECTIVE During the last 3 decades, robotic technology has rapidly spread across several surgical fields due to the continuous evolution of its versatility, stability, dexterity, and haptic properties. Neurosurgery pioneered the development of robotics, with the aim of improving the quality of several procedures requiring a high degree of accuracy and safety. Moreover, robot-guided approaches are of special interest in pediatric patients, who often have altered anatomy and challenging relationships between the diseased and eloquent structures. Nevertheless, the use of robots has been rarely reported in children. In this work, the authors describe their experience using the ROSA device (Robotized Stereotactic Assistant) in the neurosurgical management of a pediatric population. METHODS Between 2011 and 2016, 116 children underwent ROSA-assisted procedures for a variety of diseases (epilepsy, brain tumors, intra- or extraventricular and tumor cysts, obstructive hydrocephalus, and movement and behavioral disorders). Each patient received accurate preoperative planning of optimal trajectories, intraoperative frameless registration, surgical treatment using specific instruments held by the robotic arm, and postoperative CT or MR imaging. RESULTS The authors performed 128 consecutive surgeries, including implantation of 386 electrodes for stereo-electroencephalography (36 procedures), neuroendoscopy (42 procedures), stereotactic biopsy (26 procedures), pallidotomy (12 procedures), shunt placement (6 procedures), deep brain stimulation procedures (3 procedures), and stereotactic cyst aspiration (3 procedures). For each procedure, the authors analyzed and discussed accuracy, timing, and complications. CONCLUSIONS To the best their knowledge, the authors present the largest reported series of pediatric neurosurgical cases assisted by robotic support. The ROSA system provided improved safety and feasibility of minimally invasive approaches, thus optimizing the surgical

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

ERIC Educational Resources Information Center

West, Alfred W.

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

Procedural Learning and Dyslexia

ERIC Educational Resources Information Center

Nicolson, R. I.; Fawcett, A. J.; Brookes, R. L.; Needle, J.

2010-01-01

Three major "neural systems", specialized for different types of information processing, are the sensory, declarative, and procedural systems. It has been proposed ("Trends Neurosci.",30(4), 135-141) that dyslexia may be attributable to impaired function in the procedural system together with intact declarative function. We provide a brief…

Science Safety Procedure Handbook.

ERIC Educational Resources Information Center

Lynch, Mervyn A.; Offet, Lorna

This booklet outlines general safety procedures in the areas of: (1) student supervision; (2) storage safety regulations, including lists of incompatible chemicals, techniques of disposal and storage; (3) fire; and (4) first aid. Specific sections exist for elementary, junior high school, senior high school, in which special procedures are…

Coding for urologic office procedures.

PubMed

Dowling, Robert A; Painter, Mark

2013-11-01

This article summarizes current best practices for documenting, coding, and billing common office-based urologic procedures. Topics covered include general principles, basic and advanced urologic coding, creation of medical records that support compliant coding practices, bundled codes and unbundling, global periods, modifiers for procedure codes, when to bill for evaluation and management services during the same visit, coding for supplies, and laboratory and radiology procedures pertinent to urology practice. Detailed information is included for the most common urology office procedures, and suggested resources and references are provided. This information is of value to physicians, office managers, and their coding staff. Copyright © 2013 Elsevier Inc. All rights reserved.

8 CFR 1003.40 - Local operating procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

8 CFR 1003.40 - Local operating procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

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

40 CFR 600.111-80 - Test procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Test procedures. 600.111-80 Section... Model Year Automobiles-Test Procedures § 600.111-80 Test procedures. (a) The test procedures to be...-78 of this chapter, as applicable. (The evaporative and refueling loss portions of the test procedure...

40 CFR 600.111-93 - Test procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Test procedures. 600.111-93 Section... Model Year Automobiles-Test Procedures § 600.111-93 Test procedures. (a) The test procedures to be... loss portion of the test procedure may be omitted unless specifically required by the Administrator...

Polarization of perceived Procedural Justice.

PubMed

Flint, Douglas H; Hernandez-Marrero, Pablo; Wielemaker, Martin

2006-02-01

This study examined polarization of perceptions of Procedural Justice. Two polarization mechanisms are examined, Persuasive Arguments and Social Comparisons. Participants were students enrolled in a first-year introductory business class. There were 216 participants in the Persuasive Arguments study, 429 in the Social Comparisons study. The average age of all participants was 22.3 yr. (SD = 2.1); 56% were women. Fields of study represented were business, engineering, information technology, and sports. Analysis showed under conditions of low Procedural Justice, polarization effects were only found with the Persuasive Arguments mechanism. Under conditions of high Procedural Justice, polarization effects were only found with Social Comparisons. Implications for group polarization and Procedural Justice theories are considered.

40 CFR 60.648 - Optional procedure for measuring hydrogen sulfide in acid gas-Tutwiler Procedure. 1

Code of Federal Regulations, 2011 CFR

2011-07-01

... hydrogen sulfide in acid gas-Tutwiler Procedure. 1 60.648 Section 60.648 Protection of Environment... procedure for measuring hydrogen sulfide in acid gas—Tutwiler Procedure. 1 1 Gas Engineers Handbook, Fuel.... In principle, this method consists of titrating hydrogen sulfide in a gas sample directly with a...

40 CFR 60.648 - Optional procedure for measuring hydrogen sulfide in acid gas-Tutwiler Procedure. 1

Code of Federal Regulations, 2010 CFR

2010-07-01

... hydrogen sulfide in acid gas-Tutwiler Procedure. 1 60.648 Section 60.648 Protection of Environment... procedure for measuring hydrogen sulfide in acid gas—Tutwiler Procedure. 1 1 Gas Engineers Handbook, Fuel.... In principle, this method consists of titrating hydrogen sulfide in a gas sample directly with a...

40 CFR 60.648 - Optional procedure for measuring hydrogen sulfide in acid gas-Tutwiler Procedure. 1

Code of Federal Regulations, 2012 CFR

2012-07-01

... hydrogen sulfide in acid gas-Tutwiler Procedure. 1 60.648 Section 60.648 Protection of Environment... procedure for measuring hydrogen sulfide in acid gas—Tutwiler Procedure. 1 1 Gas Engineers Handbook, Fuel.... In principle, this method consists of titrating hydrogen sulfide in a gas sample directly with a...

Coding of procedures documented by general practitioners in Swedish primary care-an explorative study using two procedure coding systems

PubMed Central

2012-01-01

Background Procedures documented by general practitioners in primary care have not been studied in relation to procedure coding systems. We aimed to describe procedures documented by Swedish general practitioners in electronic patient records and to compare them to the Swedish Classification of Health Interventions (KVÅ) and SNOMED CT. Methods Procedures in 200 record entries were identified, coded, assessed in relation to two procedure coding systems and analysed. Results 417 procedures found in the 200 electronic patient record entries were coded with 36 different Classification of Health Interventions categories and 148 different SNOMED CT concepts. 22.8% of the procedures could not be coded with any Classification of Health Interventions category and 4.3% could not be coded with any SNOMED CT concept. 206 procedure-concept/category pairs were assessed as a complete match in SNOMED CT compared to 10 in the Classification of Health Interventions. Conclusions Procedures documented by general practitioners were present in nearly all electronic patient record entries. Almost all procedures could be coded using SNOMED CT. Classification of Health Interventions covered the procedures to a lesser extent and with a much lower degree of concordance. SNOMED CT is a more flexible terminology system that can be used for different purposes for procedure coding in primary care. PMID:22230095

49 CFR 601.47 - Review Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 7 2010-10-01 2010-10-01 false Review Procedures. 601.47 Section 601.47 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL TRANSIT ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ORGANIZATION, FUNCTIONS, AND PROCEDURES Emergency Procedures for Public...

Designing Flight-Deck Procedures

NASA Technical Reports Server (NTRS)

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

1995-01-01

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

40 CFR 60.648 - Optional procedure for measuring hydrogen sulfide in acid gas-Tutwiler Procedure. 1

Code of Federal Regulations, 2013 CFR

2013-07-01

... hydrogen sulfide in acid gas-Tutwiler Procedure. 1 60.648 Section 60.648 Protection of Environment..., 2011 § 60.648 Optional procedure for measuring hydrogen sulfide in acid gas—Tutwiler Procedure. 1 1 Gas... dilute solutions are used. In principle, this method consists of titrating hydrogen sulfide in a gas...

40 CFR 60.648 - Optional procedure for measuring hydrogen sulfide in acid gas-Tutwiler Procedure. 1

Code of Federal Regulations, 2014 CFR

2014-07-01

... hydrogen sulfide in acid gas-Tutwiler Procedure. 1 60.648 Section 60.648 Protection of Environment..., 2011 § 60.648 Optional procedure for measuring hydrogen sulfide in acid gas—Tutwiler Procedure. 1 1 Gas... dilute solutions are used. In principle, this method consists of titrating hydrogen sulfide in a gas...

Cryotherapy effect on oral mucositis severity among recipients of bone marrow transplantation: a literature review.

PubMed

Tayyem, Abdel-Qader Mahmoud

2014-08-01

Oral mucositis is a distressing toxic effect of cancer therapy and one of the major side effects of the myeloablative conditioning used to prepare patients for bone marrow transplantation (BMT). Oral cryotherapy is one of the recent modalities used to prevent and manage oral mucositis. The purpose of this review is to clarify the cryotherapy effect on oral mucositis severity among patients receiving myeloablative conditioning followed by BMT. A literature search was performed using six different electronic databases: CINAHL®, MEDLINE®, Nursing Ovid, PubMed, Springer, and Science Direct. Six articles were deemed relevant and included in this review. Oral mucositis increases mortality rate, length of hospital stay, opioid use, and the need for parenteral nutrition usage. It also decreases patient's quality of life and his or her desire to complete treatment. However, oral cryotherapy significantly minimizes the incidence and severity of oral mucositis and decreases secondary oral mucositis complications. Using oral cryotherapy concurrently with a regular oral care protocol can improve its efficacy for preventing and managing oral mucositis. Additional studies should be conducted to create standard oral cryotherapy protocols.

Post-procedure bleeding in interventional radiology.

PubMed

Mayer, J; Tacher, V; Novelli, L; Djabbari, M; You, K; Chiaradia, M; Deux, J-F; Kobeiter, H

2015-01-01

Following interventional radiology procedures, bleeding can occur in 0.5 to 4% of the cases. Risk factors are related to the patient, to the procedure, and to the end organ. Bleeding is treated usually by interventional radiologists and consists mainly of embolization. Bleeding complications are preventable: before the procedure by checking hemostasis, during the procedure by ensuring the accurate puncture site (with ultrasound or fluoroscopy guidance) or by treating the puncture path using gelatin sponge, curaspon(®), biological glue or thermocoagulation, and after the procedure by carefully monitoring the patients. Copyright © 2015 Éditions françaises de radiologie. Published by Elsevier Masson SAS. All rights reserved.

Environmental Test Screening Procedure

NASA Technical Reports Server (NTRS)

Zeidler, Janet

2000-01-01

This procedure describes the methods to be used for environmental stress screening (ESS) of the Lightning Mapper Sensor (LMS) lens assembly. Unless otherwise specified, the procedures shall be completed in the order listed, prior to performance of the Acceptance Test Procedure (ATP). The first unit, S/N 001, will be subjected to the Qualification Vibration Levels, while the remainder will be tested at the Operational Level. Prior to ESS, all units will undergo Pre-ESS Functional Testing that includes measuring the on-axis and plus or minus 0.95 full field Modulation Transfer Function and Back Focal Length. Next, all units will undergo ESS testing, and then Acceptance testing per PR 460.

4 CFR 28.9 - Procedures; general.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 4 Accounts 1 2010-01-01 2010-01-01 false Procedures; general. 28.9 Section 28.9 Accounts GOVERNMENT ACCOUNTABILITY OFFICE GENERAL PROCEDURES GOVERNMENT ACCOUNTABILITY OFFICE PERSONNEL APPEALS BOARD; PROCEDURES APPLICABLE TO CLAIMS CONCERNING EMPLOYMENT PRACTICES AT THE GOVERNMENT ACCOUNTABILITY OFFICE...

Dropout Count Procedural Handbook.

ERIC Educational Resources Information Center

Nevada State Dept. of Education, Carson City. Planning, Research and Evaluation Branch.

This manual outlines the procedure for counting dropouts from the Nevada schools. The State Department of Education instituted a new dropout counting procedure to its student accounting system in January 1988 as part of its response to recommendations of a task force on at-risk youth. The count is taken from each secondary school and includes…

Procedures For Microbial-Ecology Laboratory

NASA Technical Reports Server (NTRS)

Huff, Timothy L.

1993-01-01

Microbial Ecology Laboratory Procedures Manual provides concise and well-defined instructions on routine technical procedures to be followed in microbiological laboratory to ensure safety, analytical control, and validity of results.

Procedural justice in children: Preschoolers accept unequal resource distributions if the procedure provides equal opportunities.

PubMed

Grocke, Patricia; Rossano, Federico; Tomasello, Michael

2015-12-01

When it is not possible to distribute resources equitably to everyone, people look for an equitable or just procedure. In the current study, we investigated young children's sense of procedural justice. We tested 32 triads of 5-year-olds in a new resource allocation game. Triads were confronted with three unequal reward packages and then agreed on a procedure to allocate them among themselves. To allocate the rewards, they needed to use a "wheel of fortune." Half of the groups played with a fair wheel (where each child had an equal chance of obtaining each reward package), and the other half played with an unfair wheel. We analyzed children's interactions when using the wheel and conducted an interview with each child after the game was over. Children using the unfair wheel often decided to change the rules of the game, and they also rated it as an unfair procedure in the interview. In contrast, children who played with the fair wheel were mostly accepting of both the outcome and the procedure. Overall, we found that children as young as preschool age are already sensitive not only to distributive justice but to procedural justice as well. Copyright © 2015 Elsevier Inc. All rights reserved.

Oculoplastic procedures

MedlinePlus

... eye doctors (ophthalmologists) who have special training in plastic or reconstructive surgery. Conditions Treated Oculoplastic procedures may ... Editorial team. Related MedlinePlus Health Topics Eyelid Disorders Plastic and Cosmetic Surgery Browse the Encyclopedia A.D. ...

28 CFR 42.733 - Enforcement procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Enforcement procedures. 42.733 Section 42.733 Judicial Administration DEPARTMENT OF JUSTICE NONDISCRIMINATION; EQUAL EMPLOYMENT OPPORTUNITY...; Implementation of the Age Discrimination Act of 1975 Compliance Procedures § 42.733 Enforcement procedures. (a...

20 CFR 633.316 - Closeout procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Closeout procedures. 633.316 Section 633.316 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR MIGRANT AND SEASONAL FARMWORKER PROGRAMS Program Design and Administrative Procedures § 633.316 Closeout procedures. Grant...

40 CFR 152.164 - Classification procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Classification procedures. 152.164... PESTICIDE REGISTRATION AND CLASSIFICATION PROCEDURES Classification of Pesticides § 152.164 Classification procedures. (a) Grouping of products for classification purposes. In its discretion, the Agency may identify...

40 CFR 152.164 - Classification procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Classification procedures. 152.164... PESTICIDE REGISTRATION AND CLASSIFICATION PROCEDURES Classification of Pesticides § 152.164 Classification procedures. (a) Grouping of products for classification purposes. In its discretion, the Agency may identify...

40 CFR 152.164 - Classification procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Classification procedures. 152.164... PESTICIDE REGISTRATION AND CLASSIFICATION PROCEDURES Classification of Pesticides § 152.164 Classification procedures. (a) Grouping of products for classification purposes. In its discretion, the Agency may identify...

44 CFR 206.202 - Application procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 44 Emergency Management and Assistance 1 2011-10-01 2011-10-01 false Application procedures. 206.202 Section 206.202 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY... Administration § 206.202 Application procedures. (a) General. This section describes the policies and procedures...

20 CFR 422.130 - Claim procedure.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Employees' Benefits SOCIAL SECURITY ADMINISTRATION ORGANIZATION AND PROCEDURES General Procedures § 422.130 Claim procedure. (a) General. The Social Security Administration provides facilities for the public to... station of the Social Security Administration, from the Division of Foreign Claims, Post Office Box 1756...

40 CFR 1066.10 - Other procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 33 2014-07-01 2014-07-01 false Other procedures. 1066.10 Section 1066.10 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS VEHICLE-TESTING PROCEDURES Applicability and General Provisions § 1066.10 Other procedures. (a) Your...

40 CFR 1066.10 - Other procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 34 2012-07-01 2012-07-01 false Other procedures. 1066.10 Section 1066.10 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS VEHICLE-TESTING PROCEDURES Applicability and General Provisions § 1066.10 Other procedures. (a) Your...

40 CFR 1066.10 - Other procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 34 2013-07-01 2013-07-01 false Other procedures. 1066.10 Section 1066.10 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR POLLUTION CONTROLS VEHICLE-TESTING PROCEDURES Applicability and General Provisions § 1066.10 Other procedures. (a) Your...

40 CFR 152.164 - Classification procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Classification procedures. 152.164... PESTICIDE REGISTRATION AND CLASSIFICATION PROCEDURES Classification of Pesticides § 152.164 Classification procedures. (a) Grouping of products for classification purposes. In its discretion, the Agency may identify...

40 CFR 152.164 - Classification procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Classification procedures. 152.164... PESTICIDE REGISTRATION AND CLASSIFICATION PROCEDURES Classification of Pesticides § 152.164 Classification procedures. (a) Grouping of products for classification purposes. In its discretion, the Agency may identify...

Improving Performance During Image-Guided Procedures

PubMed Central

Duncan, James R.; Tabriz, David

2015-01-01

Objective Image-guided procedures have become a mainstay of modern health care. This article reviews how human operators process imaging data and use it to plan procedures and make intraprocedural decisions. Methods A series of models from human factors research, communication theory, and organizational learning were applied to the human-machine interface that occupies the center stage during image-guided procedures. Results Together, these models suggest several opportunities for improving performance as follows: 1. Performance will depend not only on the operator’s skill but also on the knowledge embedded in the imaging technology, available tools, and existing protocols. 2. Voluntary movements consist of planning and execution phases. Performance subscores should be developed that assess quality and efficiency during each phase. For procedures involving ionizing radiation (fluoroscopy and computed tomography), radiation metrics can be used to assess performance. 3. At a basic level, these procedures consist of advancing a tool to a specific location within a patient and using the tool. Paradigms from mapping and navigation should be applied to image-guided procedures. 4. Recording the content of the imaging system allows one to reconstruct the stimulus/response cycles that occur during image-guided procedures. Conclusions When compared with traditional “open” procedures, the technology used during image-guided procedures places an imaging system and long thin tools between the operator and the patient. Taking a step back and reexamining how information flows through an imaging system and how actions are conveyed through human-machine interfaces suggest that much can be learned from studying system failures. In the same way that flight data recorders revolutionized accident investigations in aviation, much could be learned from recording video data during image-guided procedures. PMID:24921628

Relations among conceptual knowledge, procedural knowledge, and procedural flexibility in two samples differing in prior knowledge.

PubMed

Schneider, Michael; Rittle-Johnson, Bethany; Star, Jon R

2011-11-01

Competence in many domains rests on children developing conceptual and procedural knowledge, as well as procedural flexibility. However, research on the developmental relations between these different types of knowledge has yielded unclear results, in part because little attention has been paid to the validity of the measures or to the effects of prior knowledge on the relations. To overcome these problems, we modeled the three constructs in the domain of equation solving as latent factors and tested (a) whether the predictive relations between conceptual and procedural knowledge were bidirectional, (b) whether these interrelations were moderated by prior knowledge, and (c) how both constructs contributed to procedural flexibility. We analyzed data from 2 measurement points each from two samples (Ns = 228 and 304) of middle school students who differed in prior knowledge. Conceptual and procedural knowledge had stable bidirectional relations that were not moderated by prior knowledge. Both kinds of knowledge contributed independently to procedural flexibility. The results demonstrate how changes in complex knowledge structures contribute to competence development.

Laboratory Analytical Procedures | Bioenergy | NREL

Science.gov Websites

analytical procedures (LAPs) to provide validated methods for biofuels and pyrolysis bio-oils research . Biomass Compositional Analysis These lab procedures provide tested and accepted methods for performing

48 CFR 1827.304 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Procedures. 1827.304 Section 1827.304 Federal Acquisition Regulations System NATIONAL AERONAUTICS AND SPACE ADMINISTRATION... 1827.304 Procedures. ...

Designing Flightdeck Procedures: Literature Resources

NASA Technical Reports Server (NTRS)

Feldman, Jolene; Barshi, Immanuel; Degani, Asaf; Loukopoulou, Loukia; Mauro, Robert

2017-01-01

This technical publication contains the titles, abstracts, summaries, descriptions, and/or annotations of available literature sources on procedure design and development, requirements, and guidance. It is designed to provide users with an easy access to available resources on the topic of procedure design, and with a sense of the contents of these sources. This repository of information is organized into the following publication sources: Research (e.g., journal articles, conference proceedings), Manufacturers' (e.g., operation manuals, newsletters), and Regulatory and/or Government (e.g., advisory circulars, reports). An additional section contains synopses of Accident/Incident Reports involving procedures. This work directly supports a comprehensive memorandum by Barshi, Mauro, Degani, & Loukopoulou (2016) that summarizes the results of a multi-year project, partially funded by the FAA, to develop technical reference materials that support guidance on the process of developing cockpit procedures (see "Designing Flightdeck Procedures" https://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/20160013263.pdf). An extensive treatment of this topic is presented in a forthcoming book by the same authors.

28 CFR 54.605 - Enforcement procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Enforcement procedures. 54.605 Section 54.605 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) NONDISCRIMINATION ON THE BASIS OF SEX IN... procedures. The investigative, compliance, and enforcement procedural provisions of Title VI of the Civil...

28 CFR 54.605 - Enforcement procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Enforcement procedures. 54.605 Section 54.605 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) NONDISCRIMINATION ON THE BASIS OF SEX IN... procedures. The investigative, compliance, and enforcement procedural provisions of Title VI of the Civil...

28 CFR 54.605 - Enforcement procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Enforcement procedures. 54.605 Section 54.605 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) NONDISCRIMINATION ON THE BASIS OF SEX IN... procedures. The investigative, compliance, and enforcement procedural provisions of Title VI of the Civil...

28 CFR 54.605 - Enforcement procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Enforcement procedures. 54.605 Section 54.605 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) NONDISCRIMINATION ON THE BASIS OF SEX IN... procedures. The investigative, compliance, and enforcement procedural provisions of Title VI of the Civil...

28 CFR 54.605 - Enforcement procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Enforcement procedures. 54.605 Section 54.605 Judicial Administration DEPARTMENT OF JUSTICE (CONTINUED) NONDISCRIMINATION ON THE BASIS OF SEX IN... procedures. The investigative, compliance, and enforcement procedural provisions of Title VI of the Civil...

Medical Service Clinical Laboratory Procedures--Bacteriology.

ERIC Educational Resources Information Center

Department of the Army, Washington, DC.

This manual presents laboratory procedures for the differentiation and identification of disease agents from clinical materials. Included are procedures for the collection of specimens, preparation of culture media, pure culture methods, cultivation of the microorganisms in natural and simulated natural environments, and procedures in…

49 CFR 25.605 - Enforcement procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 1 2010-10-01 2010-10-01 false Enforcement procedures. 25.605 Section 25.605 Transportation Office of the Secretary of Transportation NONDISCRIMINATION ON THE BASIS OF SEX IN EDUCATION PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Procedures § 25.605 Enforcement procedures...

48 CFR 45.202 - Evaluation procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Evaluation procedures. 45... MANAGEMENT GOVERNMENT PROPERTY Solicitation and Evaluation Procedures 45.202 Evaluation procedures. (a) The... evaluation purposes only, a rental equivalent evaluation factor. (b) The contracting officer shall ensure the...

47 CFR 15.523 - Measurement procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Measurement procedures. 15.523 Section 15.523 Telecommunication FEDERAL COMMUNICATIONS COMMISSION GENERAL RADIO FREQUENCY DEVICES Ultra-Wideband Operation § 15.523 Measurement procedures. Measurements shall be made in accordance with the procedures specified by...

10 CFR 835.104 - Written procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Written procedures. 835.104 Section 835.104 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.104 Written procedures. Written procedures shall be developed and implemented as necessary to ensure...

10 CFR 835.104 - Written procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Written procedures. 835.104 Section 835.104 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.104 Written procedures. Written procedures shall be developed and implemented as necessary to ensure...

10 CFR 835.104 - Written procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Written procedures. 835.104 Section 835.104 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.104 Written procedures. Written procedures shall be developed and implemented as necessary to ensure...

10 CFR 835.104 - Written procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Written procedures. 835.104 Section 835.104 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.104 Written procedures. Written procedures shall be developed and implemented as necessary to ensure...

10 CFR 835.104 - Written procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Written procedures. 835.104 Section 835.104 Energy DEPARTMENT OF ENERGY OCCUPATIONAL RADIATION PROTECTION Management and Administrative Requirements § 835.104 Written procedures. Written procedures shall be developed and implemented as necessary to ensure...

Continuation of advanced crew procedures development techniques

NASA Technical Reports Server (NTRS)

Arbet, J. D.; Benbow, R. L.; Evans, M. E.; Mangiaracina, A. A.; Mcgavern, J. L.; Spangler, M. C.; Tatum, I. C.

1976-01-01

An operational computer program, the Procedures and Performance Program (PPP) which operates in conjunction with the Phase I Shuttle Procedures Simulator to provide a procedures recording and crew/vehicle performance monitoring capability was developed. A technical synopsis of each task resulting in the development of the Procedures and Performance Program is provided. Conclusions and recommendations for action leading to the improvements in production of crew procedures development and crew training support are included. The PPP provides real-time CRT displays and post-run hardcopy output of procedures, difference procedures, performance data, parametric analysis data, and training script/training status data. During post-run, the program is designed to support evaluation through the reconstruction of displays to any point in time. A permanent record of the simulation exercise can be obtained via hardcopy output of the display data and via transfer to the Generalized Documentation Processor (GDP). Reference procedures data may be transferred from the GDP to the PPP. Interface is provided with the all digital trajectory program, the Space Vehicle Dynamics Simulator (SVDS) to support initial procedures timeline development.

Common office procedures and analgesia considerations.

PubMed

Baxter, Amy

2013-10-01

This article reviews common office procedures and analgesia considerations for pediatric outpatients. Layer times of onset of analgesics to coincide with procedures. Pediatric procedural distress is multimodal. Always address parent and child fear and attention, along with pain. Copyright © 2013 Elsevier Inc. All rights reserved.

46 CFR 272.14 - Survey procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

46 CFR 272.14 - Survey procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

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

46 CFR 272.14 - Survey procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

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

46 CFR 272.14 - Survey procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

46 CFR 272.14 - Survey procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

7 CFR 356.8 - Return procedure.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 7 Agriculture 5 2012-01-01 2012-01-01 false Return procedure. 356.8 Section 356.8 Agriculture Regulations of the Department of Agriculture (Continued) ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE FORFEITURE PROCEDURES § 356.8 Return procedure. If, at the conclusion of...

49 CFR 192.225 - Welding procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Welding procedures. 192.225 Section 192.225... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Welding of Steel in Pipelines § 192.225 Welding procedures. (a) Welding must be performed by a qualified welder in accordance with welding procedures...

46 CFR 154.665 - Welding procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 5 2010-10-01 2010-10-01 false Welding procedures. 154.665 Section 154.665 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY STANDARDS... Construction § 154.665 Welding procedures. Welding procedure tests for cargo tanks for a design temperature...

49 CFR 581.7 - Test procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 7 2013-10-01 2013-10-01 false Test procedures. 581.7 Section 581.7... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) BUMPER STANDARD § 581.7 Test procedures. (a) Longitudinal impact test procedures. (1) Impact the vehicle's front surface and its rear surface two times each...

49 CFR 581.7 - Test procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 7 2011-10-01 2011-10-01 false Test procedures. 581.7 Section 581.7... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) BUMPER STANDARD § 581.7 Test procedures. (a) Longitudinal impact test procedures. (1) Impact the vehicle's front surface and its rear surface two times each...

19 CFR 122.173 - Application procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... that it has developed and will continue to maintain standard operating procedures (SOP) which are... 19 Customs Duties 1 2014-04-01 2014-04-01 false Application procedures. 122.173 Section 122.173... TREASURY AIR COMMERCE REGULATIONS Air Carrier Smuggling Prevention Program § 122.173 Application procedures...

19 CFR 122.173 - Application procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... that it has developed and will continue to maintain standard operating procedures (SOP) which are... 19 Customs Duties 1 2011-04-01 2011-04-01 false Application procedures. 122.173 Section 122.173... TREASURY AIR COMMERCE REGULATIONS Air Carrier Smuggling Prevention Program § 122.173 Application procedures...

19 CFR 122.173 - Application procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... that it has developed and will continue to maintain standard operating procedures (SOP) which are... 19 Customs Duties 1 2010-04-01 2010-04-01 false Application procedures. 122.173 Section 122.173... TREASURY AIR COMMERCE REGULATIONS Air Carrier Smuggling Prevention Program § 122.173 Application procedures...

19 CFR 122.173 - Application procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... that it has developed and will continue to maintain standard operating procedures (SOP) which are... 19 Customs Duties 1 2012-04-01 2012-04-01 false Application procedures. 122.173 Section 122.173... TREASURY AIR COMMERCE REGULATIONS Air Carrier Smuggling Prevention Program § 122.173 Application procedures...

19 CFR 122.173 - Application procedures.

Code of Federal Regulations, 2013 CFR

2013-04-01

... that it has developed and will continue to maintain standard operating procedures (SOP) which are... 19 Customs Duties 1 2013-04-01 2013-04-01 false Application procedures. 122.173 Section 122.173... TREASURY AIR COMMERCE REGULATIONS Air Carrier Smuggling Prevention Program § 122.173 Application procedures...

40 CFR 1065.10 - Other procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... meet all applicable emission standards. (b) Our testing. These procedures generally apply for testing... importance of pursuing changes to the procedures: (i) Whether supplemental emission standards or other... procedures. For example, this may apply if your engine cannot operate on the specified duty cycle. In this...

40 CFR 1065.10 - Other procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... meet all applicable emission standards. (b) Our testing. These procedures generally apply for testing... importance of pursuing changes to the procedures: (i) Whether supplemental emission standards or other... procedures. For example, this may apply if your engine cannot operate on the specified duty cycle. In this...

40 CFR 1065.10 - Other procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... meet all applicable emission standards. (b) Our testing. These procedures generally apply for testing... importance of pursuing changes to the procedures: (i) Whether supplemental emission standards or other... procedures. For example, this may apply if your engine cannot operate on the specified duty cycle. In this...

40 CFR 1065.10 - Other procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... meet all applicable emission standards. (b) Our testing. These procedures generally apply for testing... importance of pursuing changes to the procedures: (i) Whether supplemental emission standards or other... procedures. For example, this may apply if your engine cannot operate on the specified duty cycle. In this...

40 CFR 1065.10 - Other procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... meet all applicable emission standards. (b) Our testing. These procedures generally apply for testing... importance of pursuing changes to the procedures: (i) Whether supplemental emission standards or other... procedures. For example, this may apply if your engine cannot operate on the specified duty cycle. In this...

40 CFR 205.54 - Test procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Test procedures. 205.54 Section 205.54 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) NOISE ABATEMENT PROGRAMS TRANSPORTATION EQUIPMENT NOISE EMISSION CONTROLS Medium and Heavy Trucks § 205.54 Test procedures. The procedures described...

46 CFR 154.665 - Welding procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 5 2011-10-01 2011-10-01 false Welding procedures. 154.665 Section 154.665 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY STANDARDS... Construction § 154.665 Welding procedures. Welding procedure tests for cargo tanks for a design temperature...

46 CFR 154.665 - Welding procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 5 2012-10-01 2012-10-01 false Welding procedures. 154.665 Section 154.665 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY STANDARDS... Construction § 154.665 Welding procedures. Welding procedure tests for cargo tanks for a design temperature...

49 CFR 192.225 - Welding procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false Welding procedures. 192.225 Section 192.225... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Welding of Steel in Pipelines § 192.225 Welding procedures. (a) Welding must be performed by a qualified welder in accordance with welding procedures...

46 CFR 154.665 - Welding procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 5 2014-10-01 2014-10-01 false Welding procedures. 154.665 Section 154.665 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY STANDARDS... Construction § 154.665 Welding procedures. Welding procedure tests for cargo tanks for a design temperature...

46 CFR 154.665 - Welding procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 5 2013-10-01 2013-10-01 false Welding procedures. 154.665 Section 154.665 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) CERTAIN BULK DANGEROUS CARGOES SAFETY STANDARDS... Construction § 154.665 Welding procedures. Welding procedure tests for cargo tanks for a design temperature...

49 CFR 192.225 - Welding procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 3 2014-10-01 2014-10-01 false Welding procedures. 192.225 Section 192.225... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Welding of Steel in Pipelines § 192.225 Welding procedures. (a) Welding must be performed by a qualified welder in accordance with welding procedures...

49 CFR 192.225 - Welding procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false Welding procedures. 192.225 Section 192.225... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Welding of Steel in Pipelines § 192.225 Welding procedures. (a) Welding must be performed by a qualified welder in accordance with welding procedures...

49 CFR 192.225 - Welding procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Welding procedures. 192.225 Section 192.225... BY PIPELINE: MINIMUM FEDERAL SAFETY STANDARDS Welding of Steel in Pipelines § 192.225 Welding procedures. (a) Welding must be performed by a qualified welder in accordance with welding procedures...

50 CFR 697.11 - Civil procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 13 2013-10-01 2013-10-01 false Civil procedures. 697.11 Section 697.11 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION....11 Civil procedures. The civil procedure regulations at 15 CFR part 904 apply to civil penalties...

50 CFR 697.11 - Civil procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 13 2014-10-01 2014-10-01 false Civil procedures. 697.11 Section 697.11 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION....11 Civil procedures. The civil procedure regulations at 15 CFR part 904 apply to civil penalties...

50 CFR 697.11 - Civil procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 11 2011-10-01 2011-10-01 false Civil procedures. 697.11 Section 697.11 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION....11 Civil procedures. The civil procedure regulations at 15 CFR part 904 apply to civil penalties...

50 CFR 697.11 - Civil procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Civil procedures. 697.11 Section 697.11 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION....11 Civil procedures. The civil procedure regulations at 15 CFR part 904 apply to civil penalties...

50 CFR 697.11 - Civil procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 13 2012-10-01 2012-10-01 false Civil procedures. 697.11 Section 697.11 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION....11 Civil procedures. The civil procedure regulations at 15 CFR part 904 apply to civil penalties...

49 CFR 581.7 - Test procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 7 2012-10-01 2012-10-01 false Test procedures. 581.7 Section 581.7... ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) BUMPER STANDARD § 581.7 Test procedures. (a) Longitudinal impact test procedures. (1) Impact the vehicle's front surface and its rear surface two times each...

40 CFR 89.413 - Raw sampling procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Raw sampling procedures. 89.413 Section 89.413 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Test Procedures § 89.413 Raw sampling procedures. Follow these procedures when sampling for gaseous...

40 CFR 89.413 - Raw sampling procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Raw sampling procedures. 89.413 Section 89.413 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... Test Procedures § 89.413 Raw sampling procedures. Follow these procedures when sampling for gaseous...

14 CFR 1251.400 - Procedures for compliance.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Procedures for compliance. 1251.400 Section 1251.400 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION NONDISCRIMINATION ON BASIS OF HANDICAP Procedures § 1251.400 Procedures for compliance. The procedural provisions applicable to...

14 CFR 1251.400 - Procedures for compliance.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 5 2012-01-01 2012-01-01 false Procedures for compliance. 1251.400 Section 1251.400 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION NONDISCRIMINATION ON BASIS OF HANDICAP Procedures § 1251.400 Procedures for compliance. The procedural provisions applicable to...

14 CFR 1251.400 - Procedures for compliance.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Procedures for compliance. 1251.400 Section 1251.400 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION NONDISCRIMINATION ON BASIS OF HANDICAP Procedures § 1251.400 Procedures for compliance. The procedural provisions applicable to...

14 CFR 1251.400 - Procedures for compliance.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 5 2013-01-01 2013-01-01 false Procedures for compliance. 1251.400 Section 1251.400 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION NONDISCRIMINATION ON BASIS OF HANDICAP Procedures § 1251.400 Procedures for compliance. The procedural provisions applicable to...

Fusion Imaging for Procedural Guidance.

PubMed

Wiley, Brandon M; Eleid, Mackram F; Thaden, Jeremy J

2018-05-01

The field of percutaneous structural heart interventions has grown tremendously in recent years. This growth has fueled the development of new imaging protocols and technologies in parallel to help facilitate these minimally-invasive procedures. Fusion imaging is an exciting new technology that combines the strength of 2 imaging modalities and has the potential to improve procedural planning and the safety of many commonly performed transcatheter procedures. In this review we discuss the basic concepts of fusion imaging along with the relative strengths and weaknesses of static vs dynamic fusion imaging modalities. This review will focus primarily on echocardiographic-fluoroscopic fusion imaging and its application in commonly performed transcatheter structural heart procedures. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

NHEXAS PHASE I REGION 5 STUDY--STANDARD OPERATING PROCEDURE--SAMPLE SHIPPING PROCEDURES (RTI/ACS-AP-209-083)

EPA Science Inventory

This procedure summarizes the sample shipping procedures that have been described in the individual NHEXAS sample collection protocols. This procedure serves as a quick reference tool for the field staff when samples are prepared for shipment at the field lab/staging area. For ea...

5 CFR 9701.521 - Grievance procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... paragraphs (d), (f), and (g) of this section, the procedures must be the exclusive administrative procedures... simple, provide for expeditious processing, and include procedures that— (i) Assure an exclusive representative the right, in its own behalf or on behalf of any employee in the unit represented by the exclusive...

10 CFR 765.22 - Appeals procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Appeals procedures. 765.22 Section 765.22 Energy DEPARTMENT OF ENERGY REIMBURSEMENT FOR COSTS OF REMEDIAL ACTION AT ACTIVE URANIUM AND THORIUM PROCESSING SITES Procedures for Submitting and Processing Reimbursement Claims § 765.22 Appeals procedures. (a) Any...

10 CFR 765.22 - Appeals procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Appeals procedures. 765.22 Section 765.22 Energy DEPARTMENT OF ENERGY REIMBURSEMENT FOR COSTS OF REMEDIAL ACTION AT ACTIVE URANIUM AND THORIUM PROCESSING SITES Procedures for Submitting and Processing Reimbursement Claims § 765.22 Appeals procedures. (a) Any...

10 CFR 765.22 - Appeals procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Appeals procedures. 765.22 Section 765.22 Energy DEPARTMENT OF ENERGY REIMBURSEMENT FOR COSTS OF REMEDIAL ACTION AT ACTIVE URANIUM AND THORIUM PROCESSING SITES Procedures for Submitting and Processing Reimbursement Claims § 765.22 Appeals procedures. (a) Any...

10 CFR 765.22 - Appeals procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Appeals procedures. 765.22 Section 765.22 Energy DEPARTMENT OF ENERGY REIMBURSEMENT FOR COSTS OF REMEDIAL ACTION AT ACTIVE URANIUM AND THORIUM PROCESSING SITES Procedures for Submitting and Processing Reimbursement Claims § 765.22 Appeals procedures. (a) Any...

12 CFR 303.221 - Filing procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Filing procedures. 303.221 Section 303.221 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE FILING PROCEDURES Section 19 of the FDI Act (Consent to Service of Persons Convicted of Certain Criminal Offenses...

49 CFR 193.2503 - Operating procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

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

42 CFR 422.202 - Participation procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... Participation procedures. (a) Notice and appeal rights. An MA organization that operates a coordinated care plan... 42 Public Health 3 2013-10-01 2013-10-01 false Participation procedures. 422.202 Section 422.202... and members of groups of physicians, through reasonable procedures that include the following: (1...

42 CFR 422.202 - Participation procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... procedures. (a) Notice and appeal rights. An MA organization that operates a coordinated care plan or network... of groups of physicians, through reasonable procedures that include the following: (1) Written notice... 42 Public Health 3 2011-10-01 2011-10-01 false Participation procedures. 422.202 Section 422.202...

49 CFR 193.2503 - Operating procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

42 CFR 422.202 - Participation procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Participation procedures. (a) Notice and appeal rights. An MA organization that operates a coordinated care plan... 42 Public Health 3 2012-10-01 2012-10-01 false Participation procedures. 422.202 Section 422.202... and members of groups of physicians, through reasonable procedures that include the following: (1...

49 CFR 193.2503 - Operating procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

49 CFR 193.2503 - Operating procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

42 CFR 422.202 - Participation procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Participation procedures. (a) Notice and appeal rights. An MA organization that operates a coordinated care plan... 42 Public Health 3 2014-10-01 2014-10-01 false Participation procedures. 422.202 Section 422.202... and members of groups of physicians, through reasonable procedures that include the following: (1...

10 CFR 2.1304 - Hearing procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Hearing procedures. 2.1304 Section 2.1304 Energy NUCLEAR... for Hearings on License Transfer Applications § 2.1304 Hearing procedures. The procedures in this subpart will constitute the exclusive basis for hearings on license transfer applications for all NRC...

10 CFR 2.1304 - Hearing procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Hearing procedures. 2.1304 Section 2.1304 Energy NUCLEAR... for Hearings on License Transfer Applications § 2.1304 Hearing procedures. The procedures in this subpart will constitute the exclusive basis for hearings on license transfer applications for all NRC...

28 CFR 902.5 - Hearing procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Hearing procedures. 902.5 Section 902.5 Judicial Administration NATIONAL CRIME PREVENTION AND PRIVACY COMPACT COUNCIL DISPUTE ADJUDICATION PROCEDURES § 902.5 Hearing procedures. (a) The hearing shall be open to the public pursuant to Article VI (d...

10 CFR 765.22 - Appeals procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Appeals procedures. 765.22 Section 765.22 Energy DEPARTMENT OF ENERGY REIMBURSEMENT FOR COSTS OF REMEDIAL ACTION AT ACTIVE URANIUM AND THORIUM PROCESSING SITES Procedures for Submitting and Processing Reimbursement Claims § 765.22 Appeals procedures. (a) Any...

40 CFR 231.7 - Emergency procedure.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Emergency procedure. 231.7 Section 231.7 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING SECTION 404(c) PROCEDURES § 231.7 Emergency procedure. Where a permit has already been issued, and the Administrator has...

40 CFR 791.30 - Hearing procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... officer may deem necessary to an understanding and determination of the dispute. The hearing officer shall... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Hearing procedures. 791.30 Section 791... (CONTINUED) DATA REIMBURSEMENT Hearing Procedures § 791.30 Hearing procedures. (a) Representation by counsel...

5 CFR 550.204 - Agency procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... following information to the employee in writing: (1) A statement indicating how the advance in pay will be... ADMINISTRATION (GENERAL) Advances in Pay § 550.204 Agency procedures. (a) Each agency shall establish written procedures governing advance payments. These procedures shall include— (1) Criteria to be considered before...

Grant Competition Dispute Resolution Procedures

EPA Pesticide Factsheets

Notice of the availability of a Class Deviation from EPA’s assistance agreement dispute procedures and alsosets forth the procedures that will apply to the resolution of competition-related disputes and disagreements that may arise.

23 CFR 630.803 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... PROCEDURES Bridges on Federal Dams § 630.803 Procedures. A State's application to qualify a project under... part of the agency constructing the dam to provide such bridge or approach roads to satisfy a legal...

23 CFR 630.803 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... PROCEDURES Bridges on Federal Dams § 630.803 Procedures. A State's application to qualify a project under... part of the agency constructing the dam to provide such bridge or approach roads to satisfy a legal...

The NASA Constellation Program Procedure System

NASA Technical Reports Server (NTRS)

Phillips, Robert G.; Wang, Lui

2010-01-01

NASA has used procedures to describe activities to be performed onboard vehicles by astronaut crew and on the ground by flight controllers since Apollo. Starting with later Space Shuttle missions and the International Space Station, NASA moved forward to electronic presentation of procedures. For the Constellation Program, another large step forward is being taken - to make procedures more interactive with the vehicle and to assist the crew in controlling the vehicle more efficiently and with less error. The overall name for the project is the Constellation Procedure Applications Software System (CxPASS). This paper describes some of the history behind this effort, the key concepts and operational paradigms that the work is based upon, and the actual products being developed to implement procedures for Constellation

16 CFR 1.95 - Procedures upon election.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Procedures upon election. 1.95 Section 1.95 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL PROCEDURES Penalties for Violation of Appliance Labeling Rules § 1.95 Procedures upon election. (a) After...

10 CFR 824.14 - Special procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Special procedures. 824.14 Section 824.14 Energy DEPARTMENT OF ENERGY PROCEDURAL RULES FOR THE ASSESSMENT OF CIVIL PENALTIES FOR CLASSIFIED INFORMATION SECURITY VIOLATIONS § 824.14 Special procedures. A person receiving a final notice of violation under § 824...

29 CFR 102.93 - Alternative procedure.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 2 2010-07-01 2010-07-01 false Alternative procedure. 102.93 Section 102.93 Labor Regulations Relating to Labor NATIONAL LABOR RELATIONS BOARD RULES AND REGULATIONS, SERIES 8 Procedure To Hear and Determine Disputes Under Section 10(k) of the Act § 102.93 Alternative procedure. If, either...

45 CFR 1156.19 - Compliance procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 3 2010-10-01 2010-10-01 false Compliance procedure. 1156.19 Section 1156.19..., and Enforcement Procedures § 1156.19 Compliance procedure. (a) The Endowment may enforce the Act and... compliance cannot be obtained. (2) Thirty days have elapsed after the Chairperson has sent a written report...

40 CFR 792.81 - Standard operating procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

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

40 CFR 792.81 - Standard operating procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

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

40 CFR 792.81 - Standard operating procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

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

Pre-procedural antibiotics for endoscopic urological procedures: Initial experience in individuals with spinal cord injury and asymptomatic bacteriuria.

PubMed

Chong, Julio T; Klausner, Adam P; Petrossian, Albert; Byrne, Michael D; Moore, Jewel R; Goetz, Lance L; Gater, David R; Grob, B Mayer

2015-03-01

The objective of this study was to compare the safety, efficacy, quality-of-life impact, and costs of a single dose or a longer course of pre-procedural antibiotics prior to elective endoscopic urological procedures in individuals with spinal cord injury and disorders (SCI/D) and asymptomatic bacteriuria. A prospective observational study. Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA. Sixty persons with SCI/D and asymptomatic bacteriuria scheduled to undergo elective endoscopic urological procedures. A single pre-procedural dose of antibiotics vs. a 3-5-day course of pre-procedural antibiotics. Objective and subjective measures of health, costs, and quality of life. There were no significant differences in vital signs, leukocytosis, adverse events, and overall satisfaction in individuals who received short-course vs. long-course antibiotics. There was a significant decrease in antibiotic cost (33.1 ± 47.6 vs. 3.6 ± 6.1 US$, P = 0.01) for individuals in the short-course group. In addition, there was greater pre-procedural anxiety (18 vs. 0%, P < 0.05) for individuals who received long-course antibiotics. SCI/D individuals with asymptomatic bacteriuria may be able to safely undergo most endoscopic urological procedures with a single dose of pre-procedural antibiotics. However, further research is required and even appropriate pre-procedural antibiotics may not prevent severe infections.

40 CFR 86.425-78 - Test procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 19 2013-07-01 2013-07-01 false Test procedures. 86.425-78 Section 86... Later New Motorcycles, General Provisions § 86.425-78 Test procedures. (a) Motorcycle emission test procedures are found in subpart F. (b) The Administrator may prescribe emission test procedures for any...

40 CFR 86.425-78 - Test procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 19 2014-07-01 2014-07-01 false Test procedures. 86.425-78 Section 86... Later New Motorcycles, General Provisions § 86.425-78 Test procedures. (a) Motorcycle emission test procedures are found in subpart F. (b) The Administrator may prescribe emission test procedures for any...

40 CFR 86.425-78 - Test procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 19 2012-07-01 2012-07-01 false Test procedures. 86.425-78 Section 86... Later New Motorcycles, General Provisions § 86.425-78 Test procedures. (a) Motorcycle emission test procedures are found in subpart F. (b) The Administrator may prescribe emission test procedures for any...

Bio-Oil Analysis Laboratory Procedures | Bioenergy | NREL

Science.gov Websites

Bio-Oil Analysis Laboratory Procedures Bio-Oil Analysis Laboratory Procedures NREL develops standard procedures have been validated and allow for reliable bio-oil analysis. Procedures Determination different hydroxyl groups (-OH) in pyrolysis bio-oil: aliphatic-OH, phenolic-OH, and carboxylic-OH. Download

40 CFR 1515.1 - FOIA procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY FREEDOM OF INFORMATION ACT PROCEDURES Purpose § 1515.1 FOIA procedures. The Freedom of Information Act (5 U.S.C. 552), as amended, commonly known as... Section 552(b) of the Act. These procedures explain how the Council on Environmental Quality (CEQ)—one of...

40 CFR 1515.1 - FOIA procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY FREEDOM OF INFORMATION ACT PROCEDURES Purpose § 1515.1 FOIA procedures. The Freedom of Information Act (5 U.S.C. 552), as amended, commonly known as... Section 552(b) of the Act. These procedures explain how the Council on Environmental Quality (CEQ)—one of...

40 CFR 1515.1 - FOIA procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY FREEDOM OF INFORMATION ACT PROCEDURES Purpose § 1515.1 FOIA procedures. The Freedom of Information Act (5 U.S.C. 552), as amended, commonly known as... Section 552(b) of the Act. These procedures explain how the Council on Environmental Quality (CEQ)—one of...

40 CFR 1515.1 - FOIA procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Protection of Environment COUNCIL ON ENVIRONMENTAL QUALITY FREEDOM OF INFORMATION ACT PROCEDURES Purpose § 1515.1 FOIA procedures. The Freedom of Information Act (5 U.S.C. 552), as amended, commonly known as... Section 552(b) of the Act. These procedures explain how the Council on Environmental Quality (CEQ)—one of...

49 CFR 195.214 - Welding procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 49 Transportation 3 2010-10-01 2010-10-01 false Welding procedures. 195.214 Section 195.214... PIPELINE Construction § 195.214 Welding procedures. (a) Welding must be performed by a qualified welder in accordance with welding procedures qualified under Section 5 of API 1104 or Section IX of the ASME Boiler and...

Intake Procedures in College Counseling Centers.

ERIC Educational Resources Information Center

Pappas, James P.; And Others

Intake procedures is the common subject of four papers presented in this booklet. James P. Pappas discusses trends, a decision theory model, information and issues in his article "Intake Procedures in Counseling Centers--Trends and Theory." In the second article "The Utilization of Standardized Tests in Intake Procedures or 'Where's the Post…

12 CFR 269.8 - Grievance procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Grievance procedures. 269.8 Section 269.8 Banks... ON LABOR RELATIONS FOR THE FEDERAL RESERVE BANKS § 269.8 Grievance procedures. (a) Subject to the... resolution of a grievance arising under such agreement. (b) Grievance procedures established by a labor...

49 CFR 195.214 - Welding procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 3 2014-10-01 2014-10-01 false Welding procedures. 195.214 Section 195.214... PIPELINE Construction § 195.214 Welding procedures. (a) Welding must be performed by a qualified welder in accordance with welding procedures qualified under Section 5 of API 1104 or Section IX of the ASME Boiler and...

49 CFR 195.214 - Welding procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 49 Transportation 3 2011-10-01 2011-10-01 false Welding procedures. 195.214 Section 195.214... PIPELINE Construction § 195.214 Welding procedures. (a) Welding must be performed by a qualified welder in accordance with welding procedures qualified under Section 5 of API 1104 or Section IX of the ASME Boiler and...

49 CFR 195.214 - Welding procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 3 2013-10-01 2013-10-01 false Welding procedures. 195.214 Section 195.214... PIPELINE Construction § 195.214 Welding procedures. (a) Welding must be performed by a qualified welder in accordance with welding procedures qualified under Section 5 of API 1104 or Section IX of the ASME Boiler and...

49 CFR 195.214 - Welding procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 3 2012-10-01 2012-10-01 false Welding procedures. 195.214 Section 195.214... PIPELINE Construction § 195.214 Welding procedures. (a) Welding must be performed by a qualified welder in accordance with welding procedures qualified under Section 5 of API 1104 or Section IX of the ASME Boiler and...

WSSDA's Guide to Parliamentary Procedures. Revised

ERIC Educational Resources Information Center

Randolph, Mary

2004-01-01

This guide to parliamentary procedures is presented by the Washington State School Directors' Association (WSSDA) for use by local school boards within the State of Washington. Parliamentary law and parliamentary procedure is the key to order and to provide justice and fairness to all. Through both formal and informal parliamentary procedures,…

40 CFR 205.54 - Test procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Test procedures. 205.54 Section 205.54... EQUIPMENT NOISE EMISSION CONTROLS Medium and Heavy Trucks § 205.54 Test procedures. The procedures described in this and subsequent sections will be the test program to determine the conformity of vehicles with...

40 CFR 205.54 - Test procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Test procedures. 205.54 Section 205.54... EQUIPMENT NOISE EMISSION CONTROLS Medium and Heavy Trucks § 205.54 Test procedures. The procedures described in this and subsequent sections will be the test program to determine the conformity of vehicles with...

Relative value of dental procedures.

PubMed

Tuominen, R; Tuominen, M

1994-10-01

This study was conducted to develop a relative value method for dental procedures, and to evaluate the differences in values assigned by private and public sector dentists. Samples of 90 general practitioners and 120 clinical specialists were systematically drawn to represent all actively working Finnish dentists. The dentists were asked to assess the required time and know-how for performing various procedures compared to performing a two-surface amalgam filling (AF2). At the end, the dentists were asked to divide the value of 200 between time and know-how for the reference procedure (AF2). These figures were then utilized to calculate the average relative value for each procedure. Private practitioners' weighted relative values were 55.3% higher than the prices, and among public sector dentists they were 27.9% higher. Overall, know-how constituted more of the total value of the procedures than did time. Private practitioners' time assessments correlated well (r = 0.72-0.95) with the recommended prices. However, significant differences were often observed both in time and know-how assessments of individual procedures. Both time and know-how seem to be important factors when determining values for dental services. For evaluation of the value of output in the private sector, the use of prices is justified. However, when the productivity of non-profit dental offices is evaluated, a value system which is not based on market prices is needed.

48 CFR 2842.1503 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Procedures. 2842.1503 Section 2842.1503 Federal Acquisition Regulations System DEPARTMENT OF JUSTICE Contract Management CONTRACT ADMINISTRATION Contractor Performance Information 2842.1503 Procedures. Past performance...

Procedures in complex systems: the airline cockpit.

PubMed

Degani, A; Wiener, E L

1997-05-01

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

40 CFR 86.884-5 - Test procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 20 2012-07-01 2012-07-01 false Test procedures. 86.884-5 Section 86... New Diesel Heavy-Duty Engines; Smoke Exhaust Test Procedure § 86.884-5 Test procedures. The procedures described in this and subsequent sections will be the test program to determine the conformity of engines...

40 CFR 600.111-08 - Test procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 30 2014-07-01 2014-07-01 false Test procedures. 600.111-08 Section... Emission Test Procedures § 600.111-08 Test procedures. This section describes test procedures for the FTP, highway fuel economy test (HFET), US06, SC03, and the cold temperature FTP tests. Perform testing...

40 CFR 600.111-08 - Test procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 31 2012-07-01 2012-07-01 false Test procedures. 600.111-08 Section... Emission Test Procedures § 600.111-08 Test procedures. This section provides test procedures for the FTP, highway, US06, SC03, and the cold temperature FTP tests. Testing shall be performed according to test...

40 CFR 600.111-08 - Test procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Test procedures. 600.111-08 Section... Model Year Automobiles-Test Procedures § 600.111-08 Test procedures. This section provides test procedures for the FTP, highway, US06, SC03, and the cold temperature FTP tests. Testing shall be performed...

40 CFR 600.111-93 - Test procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Test procedures. 600.111-93 Section... Emission Regulations for 1978 and Later Model Year Automobiles-Test Procedures § 600.111-93 Test procedures. (a) The test procedures to be followed for generation of the city fuel economy data are those...

40 CFR 600.111-08 - Test procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Test procedures. 600.111-08 Section... Emission Regulations for 1978 and Later Model Year Automobiles-Test Procedures § 600.111-08 Test procedures. This section provides test procedures for the FTP, highway, US06, SC03, and the cold temperature FTP...

40 CFR 600.111-80 - Test procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 30 2011-07-01 2011-07-01 false Test procedures. 600.111-80 Section... Emission Regulations for 1978 and Later Model Year Automobiles-Test Procedures § 600.111-80 Test procedures. (a) The test procedures to be followed for generation of the city fuel economy data are those...

40 CFR 86.884-5 - Test procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 19 2014-07-01 2014-07-01 false Test procedures. 86.884-5 Section 86... Heavy-Duty Engines; Smoke Exhaust Test Procedure § 86.884-5 Test procedures. The procedures described in this and subsequent sections will be the test program to determine the conformity of engines with the...

48 CFR 19.1007 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Procedures. 19.1007 Section 19.1007 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Small Business Competitiveness Demonstration Program 19.1007 Procedures...

48 CFR 932.304 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Procedures. 932.304 Section 932.304 Federal Acquisition Regulations System DEPARTMENT OF ENERGY GENERAL CONTRACTING REQUIREMENTS CONTRACT FINANCING Loan Guarantees for Defense Production 932.304 Procedures. ...

48 CFR 32.304 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Procedures. 32.304 Section 32.304 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS CONTRACT FINANCING Loan Guarantees for Defense Production 32.304 Procedures. ...

48 CFR 642.1503 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Procedures. 642.1503 Section 642.1503 Federal Acquisition Regulations System DEPARTMENT OF STATE CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Contractor Performance Information 642.1503 Procedures. ...

40 CFR 90.707 - Test procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 20 2014-07-01 2013-07-01 true Test procedures. 90.707 Section 90.707... Program § 90.707 Test procedures. (a)(1) For small SI engines subject to the provisions of this subpart, the prescribed test procedures are specified in subpart E of this part. (2) The Administrator may, on...

40 CFR 90.707 - Test procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Test procedures. 90.707 Section 90.707... Program § 90.707 Test procedures. (a)(1) For small SI engines subject to the provisions of this subpart, the prescribed test procedures are specified in subpart E of this part. (2) The Administrator may, on...

45 CFR 91.46 - Compliance procedure.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 1 2011-10-01 2011-10-01 false Compliance procedure. 91.46 Section 91.46 Public..., Conciliation, and Enforcement Procedures § 91.46 Compliance procedure. (a) HHS may enforce the Act and these... compliance cannot be obtained. (2) Thirty days have elapsed after the Secretary has sent a written report of...

Series expansion of the modified Einstein Procedure

Treesearch

Seema Chandrakant Shah-Fairbank

2009-01-01

This study examines calculating total sediment discharge based on the Modified Einstein Procedure (MEP). A new procedure based on the Series Expansion of the Modified Einstein Procedure (SEMEP) has been developed. This procedure contains four main modifications to MEP. First, SEMEP solves the Einstein integrals quickly and accurately based on a series expansion. Next,...

40 CFR 86.608-98 - Test procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 19 2014-07-01 2014-07-01 false Test procedures. 86.608-98 Section 86... New Light-Duty Vehicles, Light-Duty Trucks, and Heavy-Duty Vehicles § 86.608-98 Test procedures. (a) The prescribed test procedures are the Federal Test Procedure, as described in subpart B of this part...

40 CFR 86.608-98 - Test procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 20 2012-07-01 2012-07-01 false Test procedures. 86.608-98 Section 86... Auditing of New Light-Duty Vehicles, Light-Duty Trucks, and Heavy-Duty Vehicles § 86.608-98 Test procedures. (a) The prescribed test procedures are the Federal Test Procedure, as described in subpart B and/or...

48 CFR 619.602 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Procedures. 619.602 Section 619.602 Federal Acquisition Regulations System DEPARTMENT OF STATE SOCIOECONOMIC PROGRAMS SMALL BUSINESS PROGRAMS Certificates of Competency and Determinations of Eligibility 619.602 Procedures. ...

48 CFR 2819.602 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Procedures. 2819.602 Section 2819.602 Federal Acquisition Regulations System DEPARTMENT OF JUSTICE Socioeconomic Programs SMALL BUSINESS PROGRAMS Certificates of Competency and Determinations of Eligibility 2819.602 Procedures. ...

48 CFR 42.1503 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... CONTRACT ADMINISTRATION AND AUDIT SERVICES Contractor Performance Information 42.1503 Procedures. (a) Agency procedures for the past performance evaluation system shall generally provide for input to the.... Those individuals identified may obtain information for the evaluation of performance from the program...

48 CFR 1432.304 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Procedures. 1432.304 Section 1432.304 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR GENERAL CONTRACTING REQUIREMENTS CONTRACT FINANCING Loan Guarantees for Defense Production 1432.304 Procedures. ...

48 CFR 1227.304 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Procedures. 1227.304 Section 1227.304 Federal Acquisition Regulations System DEPARTMENT OF TRANSPORTATION GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Patent Rights Under Government Contracts 1227.304 Procedures. ...

48 CFR 1327.304 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Procedures. 1327.304 Section 1327.304 Federal Acquisition Regulations System DEPARTMENT OF COMMERCE GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Patent Rights Under Government Contracts 1327.304 Procedures. ...

48 CFR 27.304 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Procedures. 27.304 Section 27.304 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Patent Rights under Government Contracts 27.304 Procedures. ...

48 CFR 627.304 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Procedures. 627.304 Section 627.304 Federal Acquisition Regulations System DEPARTMENT OF STATE GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Patent Rights Under Government Contracts 627.304 Procedures. ...

48 CFR 742.1503 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Procedures. 742.1503 Section 742.1503 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT CONTRACT MANAGEMENT CONTRACT ADMINISTRATION Contractor Performance Information 742.1503 Procedures. (a) [Reserved] (b...

48 CFR 742.1503 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 5 2011-10-01 2011-10-01 false Procedures. 742.1503 Section 742.1503 Federal Acquisition Regulations System AGENCY FOR INTERNATIONAL DEVELOPMENT CONTRACT MANAGEMENT CONTRACT ADMINISTRATION Contractor Performance Information 742.1503 Procedures. (a) [Reserved] (b...

Condemnation procedure alternatives for Virginia.

DOT National Transportation Integrated Search

1972-01-01

Fifty-four judges were interviewed and at least one judge in each of the forty judicial circuits was questioned. Some of the observations on the present procedure were as follows: (1) a substantial number of judges were dissatisfied with the procedur...

76 FR 78810 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-20

... region in which the affected airport is located; 3. The National Flight Procedures Office, 6500 South... Policies and Procedures (44 FR 11034; February 26, 1979); and (3) does not warrant preparation of a... This NOTAM, published in TL 12-01, is hereby rescinded in its entirety. 12-Jan-12......... CQ Rota...

16 CFR 1610.6 - Test procedure.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Test procedure. 1610.6 Section 1610.6... FLAMMABILITY OF CLOTHING TEXTILES The Standard § 1610.6 Test procedure. The test procedure is divided into two... according to paragraph (b)(1) of this section. (a) Step 1—Testing in the original state. (1) Tests shall be...

16 CFR 1610.6 - Test procedure.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 16 Commercial Practices 2 2014-01-01 2014-01-01 false Test procedure. 1610.6 Section 1610.6... FLAMMABILITY OF CLOTHING TEXTILES The Standard § 1610.6 Test procedure. The test procedure is divided into two... according to paragraph (b)(1) of this section. (a) Step 1—Testing in the original state. (1) Tests shall be...

16 CFR 1610.6 - Test procedure.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Test procedure. 1610.6 Section 1610.6... FLAMMABILITY OF CLOTHING TEXTILES The Standard § 1610.6 Test procedure. The test procedure is divided into two... according to paragraph (b)(1) of this section. (a) Step 1—Testing in the original state. (1) Tests shall be...

Apollo experience report: Systems and flight procedures development

NASA Technical Reports Server (NTRS)

Kramer, P. C.

1973-01-01

This report describes the process of crew procedures development used in the Apollo Program. The two major categories, Systems Procedures and Flight Procedures, are defined, as are the forms of documentation required. A description is provided of the operation of the procedures change control process, which includes the roles of man-in-the-loop simulations and the Crew Procedures Change Board. Brief discussions of significant aspects of the attitude control, computer, electrical power, environmental control, and propulsion subsystems procedures development are presented. Flight procedures are subdivided by mission phase: launch and translunar injection, rendezvous, lunar descent and ascent, and entry. Procedures used for each mission phase are summarized.

Beyond procedure's content: the role of accessibility experiences and personal uncertainty in procedural justice judgements.

PubMed

Greifeneder, Rainer; Müller, Patrick; Stahlberg, Dagmar; Van den Bos, Kees; Bless, Herbert

2011-01-01

Procedural justice concerns play a critical role in economic settings, politics, and other domains of human life. Despite the vast evidence corroborating their relevance, considerably less is known about how procedural justice judgments are formed. Whereas earlier theorizing focused on the systematic integration of content information, the present contribution provides a new perspective on the formation of justice judgments by examining the influence of accessibility experiences. Specifically, we hypothesize that procedural justice judgments may be formed based on the ease or difficulty with which justice-relevant information comes to mind. Three experiments corroborate this prediction in that procedures were evaluated less positively when the retrieval of associated unfair aspects was easy compared to difficult. Presumably this is because when it feels easy (difficult) to retrieve unfair aspects, these are perceived as frequent (infrequent), and hence the procedure as unjust (just). In addition to demonstrating that ease-of-retrieval may influence justice judgments, the studies further revealed that reliance on accessibility experiences is high in conditions of personal certainty. We suggest that this is because personal uncertainty fosters systematic processing of content information, whereas personal certainty may invite less taxing judgmental strategies such as reliance on ease-of-retrieval.

48 CFR 2909.506 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 7 2011-10-01 2011-10-01 false Procedures. 2909.506 Section 2909.506 Federal Acquisition Regulations System DEPARTMENT OF LABOR ACQUISITION PLANNING CONTRACTOR QUALIFICATIONS Organizational and Consultant Conflicts of Interest 2909.506 Procedures. (a) If a...

5 CFR 2601.202 - Procedure.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 3 2013-01-01 2013-01-01 false Procedure. 2601.202 Section 2601.202 Administrative Personnel OFFICE OF GOVERNMENT ETHICS ORGANIZATION AND PROCEDURES IMPLEMENTATION OF OFFICE OF GOVERNMENT ETHICS STATUTORY GIFT ACCEPTANCE AUTHORITY Guidelines for Solicitation and Acceptance of Gifts...

5 CFR 2601.202 - Procedure.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 3 2014-01-01 2014-01-01 false Procedure. 2601.202 Section 2601.202 Administrative Personnel OFFICE OF GOVERNMENT ETHICS ORGANIZATION AND PROCEDURES IMPLEMENTATION OF OFFICE OF GOVERNMENT ETHICS STATUTORY GIFT ACCEPTANCE AUTHORITY Guidelines for Solicitation and Acceptance of Gifts...

5 CFR 2601.202 - Procedure.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Procedure. 2601.202 Section 2601.202 Administrative Personnel OFFICE OF GOVERNMENT ETHICS ORGANIZATION AND PROCEDURES IMPLEMENTATION OF OFFICE OF GOVERNMENT ETHICS STATUTORY GIFT ACCEPTANCE AUTHORITY Guidelines for Solicitation and Acceptance of Gifts...

5 CFR 2601.202 - Procedure.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 3 2012-01-01 2012-01-01 false Procedure. 2601.202 Section 2601.202 Administrative Personnel OFFICE OF GOVERNMENT ETHICS ORGANIZATION AND PROCEDURES IMPLEMENTATION OF OFFICE OF GOVERNMENT ETHICS STATUTORY GIFT ACCEPTANCE AUTHORITY Guidelines for Solicitation and Acceptance of Gifts...

48 CFR 42.902 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Procedures. 42.902 Section 42.902 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACT MANAGEMENT CONTRACT ADMINISTRATION AND AUDIT SERVICES Bankruptcy 42.902 Procedures. (a) When notified of bankruptcy...

48 CFR 927.304 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Procedures. 927.304 Section 927.304 Federal Acquisition Regulations System DEPARTMENT OF ENERGY GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Patent Rights Under Government Contracts 927.304 Procedures. Where...

48 CFR 1427.304 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Procedures. 1427.304 Section 1427.304 Federal Acquisition Regulations System DEPARTMENT OF THE INTERIOR GENERAL CONTRACTING REQUIREMENTS PATENTS, DATA, AND COPYRIGHTS Patent Rights Under Government Contracts. 1427.304 Procedures. ...

48 CFR 410.002 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 4 2011-10-01 2011-10-01 false Procedures. 410.002 Section 410.002 Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE COMPETITION AND ACQUISITION PLANNING MARKET RESEARCH 410.002 Procedures. Market research must include obtaining information on...

48 CFR 410.002 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Procedures. 410.002 Section 410.002 Federal Acquisition Regulations System DEPARTMENT OF AGRICULTURE COMPETITION AND ACQUISITION PLANNING MARKET RESEARCH 410.002 Procedures. Market research must include obtaining information on...

48 CFR 36.303 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Procedures. 36.303 Section 36.303 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SPECIAL CATEGORIES OF CONTRACTING CONSTRUCTION AND ARCHITECT-ENGINEER CONTRACTS Two-Phase Design-Build Selection Procedures 36.303...

32 CFR 142.4 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... AND VIDEO RECORDINGS § 142.4 Procedures. (a) Permission or licenses from copyright owners shall be obtained for public performance of copyrighted sound and video recordings. (b) Component procedures... would be considered a public performance. (c) Government audio and video duplicating equipment and...

Failure to Follow Written Procedures

DOT National Transportation Integrated Search

2017-12-01

Most tasks in aviation have a mandated written procedure to be followed specifically under the Code of Federal Regulations (CFR) Part 14, Section 43.13(a). However, the incidence of Failure to Follow Procedure (FFP) events continues to be a major iss...

Pathophysiology of renal denervation procedures: from renal nerve anatomy to procedural parameters.

PubMed

Ammar, Sonia; Ladich, Elena; Steigerwald, Kristin; Deisenhofer, Isabel; Joner, Michael

2013-05-01

Endovascular renal denervation techniques have been clinically adopted for the treatment of resistant arterial hypertension with great success. Despite the favourable early results achieved with this technology, a clear understanding of the pathophysiology underlying this novel treatment is lacking. In addition, non-responsiveness to renal denervation remains a nidus for treatment failure in distinct patients. In search of meaningful surrogate parameters relating to treatment responsiveness, the current article reviews the existing knowledge on renal nerve anatomy, changes occurring after denervation and procedural parameters collected during denervation. From preclinical experience, the most reliable morphological parameter reflecting successful renal denervation is the presence of axonal degeneration. Most procedural and clinical parameters need extended investigation before adopting them as potential surrogate parameters for successful renal denervation. As a consequence, there is an imperative need for dedicated research revealing the pathophysiology of renal denervation procedures. In this regard, close co-operation of engineers, researchers and clinicians is warranted to turn renal denervation into a milestone treatment of arterial hypertension.

Restorative Procedures in Colonic Crohn Disease

PubMed Central

Martin, Sean T.; Vogel, Jon D.

2013-01-01

Surgical management for refractory Crohn colitis often involves creation of a temporary or permanent stoma. Traditionally, the procedure of choice has been a total proctocolectomy with permanent ileostomy. However, restorative procedures that help to avoid a permanent stoma are being used with more frequency. In this article, the authors will address these procedures, including colocolonic anastomosis, ileorectal anastomosis, ileal pouch rectal anastomosis, and ileal pouch anal anastomosis. Factors that may influence one's decision to perform these procedures, such as patient age and nutritional status, medical comorbidities, sphincter function, desire to avoid a permanent ostomy, and prior medical therapy, will be discussed. Functional outcomes regarding these procedures will also be described. One should keep in mind that surgery does not cure Crohn disease and that postoperative long-term management is essential in preventing progression or recurrence of disease. PMID:24436657

77 FR 22477 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-16

..., Col. Bud Day published in Field. TL 12-09, is hereby rescinded in its entirety. 3-May-12 CA San... region in which the affected airport is located; 3. The National Flight Procedures Office, 6500 South... Policies and Procedures (44 FR 11034; February 26, 1979); and (3) does not warrant preparation of a...

76 FR 65951 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-25

... region in which the affected airport is located; 3. The National Flight Procedures Office, 6500 South... Policies and Procedures (44 FR 11034; February 26, 1979); and (3) does not warrant preparation of a..., Harbor Intl. published in TL 11-23, is hereby rescinded in its entirety. 17-Nov-11 GQ Agana Guam Intl...

75 FR 60305 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-30

... the affected airport is located; 3. The National Flight Procedures Office, 6500 South MacArthur Blvd... Policies and Procedures (44 FR 11034; February 26, 1979); and (3) does not warrant preparation of a......... LOUISVILLE INTL- 0/8285 9/7/10 THIS NOTAM, PUBLISHED IN TL STANDIFORD 10-21, IS HEREBY RESCINDED FIELD. IN...

Reasoning about procedural knowledge

NASA Technical Reports Server (NTRS)

Georgeff, M. P.

1985-01-01

A crucial aspect of automated reasoning about space operations is that knowledge of the problem domain is often procedural in nature - that is, the knowledge is often in the form of sequences of actions or procedures for achieving given goals or reacting to certain situations. In this paper a system is described that explicitly represents and reasons about procedural knowledge. The knowledge representation used is sufficiently rich to describe the effects of arbitrary sequences of tests and actions, and the inference mechanism provides a means for directly using this knowledge to reach desired operational goals. Furthermore, the representation has a declarative semantics that provides for incremental changes to the system, rich explanatory capabilities, and verifiability. The approach also provides a mechanism for reasoning about the use of this knowledge, thus enabling the system to choose effectively between alternative courses of action.

ANAESTHESIA FOR OPHTHALMIC SURGICAL PROCEDURES.

PubMed

Onakpoya, O H; Asudo, F D; Adeoye, A O

2014-03-01

Ophthalmic surgical procedures are performed under anaesthesia to enhance comfort and cooperation of patient. To review factors influencing the choice of anaesthesia for ophthalmic surgical procedures. Restrospective descriptive study. Eye unit of a tertiary hospital. All patients who had ophthalmic surgeries in the operating theatre from January 2002 to December 2009. Two hundred and ninety ophthalmic surgeries were carried out during the study period. Age range was 1-95 years and mean of 61.0 ± 1.9; most (55%) were elderly while 4.8% were children. One hundred and fourty seven (50.7%) were males, 143(49.3%) females; male:female of 1.03:1. Local anaesthesia was the more commonly (92.1%) employed while general anaesthesia was used in 23(7.9%) patients. General anaesthesia was used more frequently (71.4%) in children compared to other age groups; the mean age and standard error of means for patients who had general anaesthesia (27.2 /5.4 years) is smaller compared to 63.9/0.93 years for patients who had local anaesthesia (p < 0.0001). Regional anaesthesia was the most frequently used for all types of procedures except for eye wall repairs in which general anaesthesia was used for 71.4% of patients (p < 0.0001). General anaesthesia was indicated in seven (41.2%) of emergency ophthalmic surgical procedures as compared to 16 (5.9%) of elective ophthalmic procedures P < 0.0001. General anaesthesia was more commonly employed in children, eye wall repairs and emergency ophthalmic surgical procedures.

38 CFR 17.133 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2014-07-01 2014-07-01 false Procedures. 17.133 Section 17.133 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Reconsideration of Denied Claims § 17.133 Procedures. (a) Scope. This section sets forth reconsideration...

38 CFR 17.133 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2010-07-01 2010-07-01 false Procedures. 17.133 Section 17.133 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Reconsideration of Denied Claims § 17.133 Procedures. (a) Scope. This section sets forth reconsideration...

38 CFR 17.133 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2011-07-01 2011-07-01 false Procedures. 17.133 Section 17.133 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Reconsideration of Denied Claims § 17.133 Procedures. (a) Scope. This section sets forth reconsideration...

77 FR 33085 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-05

... the affected airport is located; 3. The National Flight Procedures Office, 6500 South MacArthur Blvd... Policies and Procedures (44 FR 11034; February 26, 1979); and (3) does not warrant preparation of a........ 2/6965 5/8/12 This NOTAM, published in TL 12-13, is hereby rescinded in its entirety. 28-Jun-12 IA...

76 FR 64006 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-17

... Office of the region in which the affected airport is located; 3. The National Flight Procedures Office... Policies and Procedures (44 FR 11034; February 26, 1979); and (3) does not warrant preparation of a... Milwaukee/Lawrence 1/4410 9/1/11 This NOTAM, published in TL 11-22, is J. Timmerman. hereby rescinded in its...

78 FR 18803 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-28

... region in which the affected airport is located; 3. The National Flight Procedures Office, 6500 South... Policies and Procedures (44 FR 11034; February 26, 1979); and (3) does not warrant preparation of a... City Airport FDC No. FDC date Subject 2-May-13 IL Decatur Decatur 3/8961 2/25/13 This NOTAM, published...

Increasingly automated procedure acquisition in dynamic systems

NASA Technical Reports Server (NTRS)

Mathe, Nathalie; Kedar, Smadar

1992-01-01

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

Procedures for sampling radium-contaminated soils

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

Fleischhauer, H.L.

Two procedures for sampling the surface layer (0 to 15 centimeters) of radium-contaminated soil are recommended for use in remedial action projects. Both procedures adhere to the philosophy that soil samples should have constant geometry and constant volume in order to ensure uniformity. In the first procedure, a ''cookie cutter'' fashioned from pipe or steel plate, is driven to the desired depth by means of a slide hammer, and the sample extracted as a core or plug. The second procedure requires use of a template to outline the sampling area, from which the sample is obtained using a trowel ormore » spoon. Sampling to the desired depth must then be performed incrementally. Selection of one procedure over the other is governed primarily by soil conditions, the cookie cutter being effective in nongravelly soils, and the template procedure appropriate for use in both gravelly and nongravelly soils. In any event, a minimum sample volume of 1000 cubic centimeters is recommended. The step-by-step procedures are accompanied by a description of the minimum requirements for sample documentation. Transport of the soil samples from the field is then addressed in a discussion of the federal regulations for shipping radioactive materials. Interpretation of those regulations, particularly in light of their application to remedial action soil-sampling programs, is provided in the form of guidance and suggested procedures. Due to the complex nature of the regulations, however, there is no guarantee that our interpretations of them are complete or entirely accurate. Preparation of soil samples for radium-226 analysis by means of gamma-ray spectroscopy is described.« less

Total laparoscopic reversal of Hartmann's procedure.

PubMed

Masoni, Luigi; Mari, Francesco Saverio; Nigri, Giuseppe; Favi, Francesco; Pindozzi, Fioralba; Dall'Oglio, Anna; Pancaldi, Alessandra; Brescia, Antonio

2013-01-01

Hartmann's procedure is still performed in those cases in which colorectal anastomosis might be unsafe. Reversal of Hartmann's procedure (HR) is considered a major surgical procedure with a high morbidity (55 to 60%) and mortality rate (0 to 4%). To decrease these rates, laparoscopic Hartmann's reversal procedure was successfully experienced. We report our totally laparoscopic Hartmann's reversal technique. Between 2004 and 2010 we performed 27 HRs with a totally laparoscopic approach. The efficacy and safety of this technique were demonstrated evaluating the operative data, postoperative complications, and the outcome of the patients. There were no open conversions or major intraoperative complications. Anastomotic leaking occurred in one patient requiring an ileostomy; one patient needed a blood transfusion and one had a nosocomial pneumonia. The mean postoperative hospitalization was 5.7 days. Laparoscopic HR is a feasible and safe procedure and can be considered a valid alternative to open HR.

31 CFR 592.701 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Procedures. 592.701 Section 592.701 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY ROUGH DIAMONDS CONTROL REGULATIONS Procedures § 592.701...

31 CFR 592.701 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Procedures. 592.701 Section 592.701 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY ROUGH DIAMONDS CONTROL REGULATIONS Procedures § 592.701...

31 CFR 592.701 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Procedures. 592.701 Section 592.701 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY ROUGH DIAMONDS CONTROL REGULATIONS Procedures § 592.701...

31 CFR 592.701 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Procedures. 592.701 Section 592.701 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY ROUGH DIAMONDS CONTROL REGULATIONS Procedures § 592.701...

31 CFR 592.701 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Procedures. 592.701 Section 592.701 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY ROUGH DIAMONDS CONTROL REGULATIONS Procedures § 592.701...

32 CFR 1292.5 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 6 2010-07-01 2010-07-01 false Procedures. 1292.5 Section 1292.5 National Defense Other Regulations Relating to National Defense DEFENSE LOGISTICS AGENCY MISCELLANEOUS SECURITY OF DLA ACTIVITIES AND RESOURCES § 1292.5 Procedures. (a) Security regulations and orders will be...

31 CFR 594.801 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Procedures. 594.801 Section 594.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY GLOBAL TERRORISM SANCTIONS REGULATIONS Procedures § 594.801...

48 CFR 25.408 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 1 2010-10-01 2010-10-01 false Procedures. 25.408 Section 25.408 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Trade Agreements 25.408 Procedures. (a) If the WTO GPA or an FTA applies (see 25.401...

45 CFR 605.61 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 3 2014-10-01 2014-10-01 false Procedures. 605.61 Section 605.61 Public Welfare Regulations Relating to Public Welfare (Continued) NATIONAL SCIENCE FOUNDATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN PROGRAMS OR ACTIVITIES RECEIVING FEDERAL FINANCIAL ASSISTANCE Procedures § 605.61...

31 CFR 545.801 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Procedures. 545.801 Section 545.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY TALIBAN (AFGHANISTAN) SANCTIONS REGULATIONS Procedures § 545...

31 CFR 510.801 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Procedures. 510.801 Section 510.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NORTH KOREA SANCTIONS REGULATIONS Procedures § 510.801...

32 CFR 1292.5 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 6 2011-07-01 2011-07-01 false Procedures. 1292.5 Section 1292.5 National Defense Other Regulations Relating to National Defense DEFENSE LOGISTICS AGENCY MISCELLANEOUS SECURITY OF DLA ACTIVITIES AND RESOURCES § 1292.5 Procedures. (a) Security regulations and orders will be...

32 CFR 1292.5 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 6 2014-07-01 2014-07-01 false Procedures. 1292.5 Section 1292.5 National Defense Other Regulations Relating to National Defense DEFENSE LOGISTICS AGENCY MISCELLANEOUS SECURITY OF DLA ACTIVITIES AND RESOURCES § 1292.5 Procedures. (a) Security regulations and orders will be...

32 CFR 1292.5 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 6 2013-07-01 2013-07-01 false Procedures. 1292.5 Section 1292.5 National Defense Other Regulations Relating to National Defense DEFENSE LOGISTICS AGENCY MISCELLANEOUS SECURITY OF DLA ACTIVITIES AND RESOURCES § 1292.5 Procedures. (a) Security regulations and orders will be...

32 CFR 1292.5 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 6 2012-07-01 2012-07-01 false Procedures. 1292.5 Section 1292.5 National Defense Other Regulations Relating to National Defense DEFENSE LOGISTICS AGENCY MISCELLANEOUS SECURITY OF DLA ACTIVITIES AND RESOURCES § 1292.5 Procedures. (a) Security regulations and orders will be...

23 CFR 620.203 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 23 Highways 1 2011-04-01 2011-04-01 false Procedures. 620.203 Section 620.203 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS ENGINEERING Relinquishment of Highway Facilities § 620.203 Procedures. (a) After final acceptance of a project on the Federal...

23 CFR 620.203 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 23 Highways 1 2010-04-01 2010-04-01 false Procedures. 620.203 Section 620.203 Highways FEDERAL HIGHWAY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION ENGINEERING AND TRAFFIC OPERATIONS ENGINEERING Relinquishment of Highway Facilities § 620.203 Procedures. (a) After final acceptance of a project on the Federal...

48 CFR 25.408 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 48 Federal Acquisition Regulations System 1 2012-10-01 2012-10-01 false Procedures. 25.408 Section 25.408 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Trade Agreements 25.408 Procedures. (a) If the WTO GPA or an FTA applies (see 25.401...

48 CFR 25.408 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 48 Federal Acquisition Regulations System 1 2013-10-01 2013-10-01 false Procedures. 25.408 Section 25.408 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Trade Agreements 25.408 Procedures. (a) If the WTO GPA or an FTA applies (see 25.401...

48 CFR 25.408 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 false Procedures. 25.408 Section 25.408 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Trade Agreements 25.408 Procedures. (a) If the WTO GPA or an FTA applies (see 25.401...

48 CFR 25.408 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Procedures. 25.408 Section 25.408 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION SOCIOECONOMIC PROGRAMS FOREIGN ACQUISITION Trade Agreements 25.408 Procedures. (a) If the WTO GPA or an FTA applies (see 25.401...

31 CFR 510.801 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Procedures. 510.801 Section 510.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NORTH KOREA SANCTIONS REGULATIONS Procedures § 510.801...

31 CFR 510.801 - Procedures

Code of Federal Regulations, 2011 CFR

2011-07-01

... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Procedures 510.801 Section 510.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NORTH KOREA SANCTIONS REGULATIONS Procedures § 510.801...

31 CFR 510.801 - Procedures

Code of Federal Regulations, 2012 CFR

2012-07-01

... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Procedures 510.801 Section 510.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NORTH KOREA SANCTIONS REGULATIONS Procedures § 510.801...

28 CFR 527.31 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Procedures. 527.31 Section 527.31 Judicial Administration BUREAU OF PRISONS, DEPARTMENT OF JUSTICE INMATE ADMISSION, CLASSIFICATION, AND TRANSFER TRANSFERS Transfer of Inmates to State Agents for Production on State Writs § 527.31 Procedures...

76 FR 16686 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-25

... region in which the affected airport is located; 3. The National Flight Procedures Office, 6500 South... Policies and Procedures (44 FR 11034; February 26, 1979); and (3) does not warrant preparation of a... Field. 1/3779 2/7/11 This NOTAM, Published in TL 11-07, is hereby rescinded in its entirety 7-Apr-11 MS...

MetaMapping the nursing procedure manual.

PubMed

Peace, Jane; Brennan, Patricia Flatley

2006-01-01

Nursing procedure manuals are an important resource for practice, but ensuring that the correct procedure can be located when needed is an ongoing challenge. This poster presents an approach used to automatically index nursing procedures with standardized nursing terminology. Although indexing yielded a low number of mappings, examination of successfully mapped terms, incorrect mappings, and unmapped terms reveals important information about the reasons automated indexing fails.

Consensus criteria for sensitive detection of minimal neuroblastoma cells in bone marrow, blood and stem cell preparations by immunocytology and QRT-PCR: recommendations by the International Neuroblastoma Risk Group Task Force

PubMed Central

Beiske, K; Burchill, S A; Cheung, I Y; Hiyama, E; Seeger, R C; Cohn, S L; Pearson, A D J; Matthay, K K

2009-01-01

Disseminating disease is a predictive and prognostic indicator of poor outcome in children with neuroblastoma. Its accurate and sensitive assessment can facilitate optimal treatment decisions. The International Neuroblastoma Risk Group (INRG) Task Force has defined standardised methods for the determination of minimal disease (MD) by immunocytology (IC) and quantitative reverse transcriptase-polymerase chain reaction (QRT-PCR) using disialoganglioside GD2 and tyrosine hydroxylase mRNA respectively. The INRG standard operating procedures (SOPs) define methods for collecting, processing and evaluating bone marrow (BM), peripheral blood (PB) and peripheral blood stem cell harvest by IC and QRT-PCR. Sampling PB and BM is recommended at diagnosis, before and after myeloablative therapy and at the end of treatment. Peripheral blood stem cell products should be analysed at the time of harvest. Performing MD detection according to INRG SOPs will enable laboratories throughout the world to compare their results and thus facilitate quality-controlled multi-centre prospective trials to assess the clinical significance of MD and minimal residual disease in heterogeneous patient groups. PMID:19401690

14 CFR 1245.304 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Procedures. 1245.304 Section 1245.304 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION PATENTS AND OTHER INTELLECTUAL PROPERTY RIGHTS NASA Foreign Patent Program § 1245.304 Procedures. (a) The patent counsel at each NASA field...

14 CFR 1245.304 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Procedures. 1245.304 Section 1245.304 Aeronautics and Space NATIONAL AERONAUTICS AND SPACE ADMINISTRATION PATENTS AND OTHER INTELLECTUAL PROPERTY RIGHTS NASA Foreign Patent Program § 1245.304 Procedures. (a) The patent counsel at each NASA field...

32 CFR 504.2 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 3 2010-07-01 2010-07-01 true Procedures. 504.2 Section 504.2 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND PUBLIC RELATIONS OBTAINING INFORMATION FROM FINANCIAL INSTITUTIONS § 504.2 Procedures. (a) General. A law enforcement...

Accounting Procedures for Student Organizations.

ERIC Educational Resources Information Center

California State Dept. of Education, Sacramento.

This two-part handbook presents information on accounting procedures for student organizations, with a focus on the laws, policies, and procedures that affect student body organizations. Part 1 contains information about: (1) legal status of a school's student body organization; (2) principles governing student body finance; (3) administration of…

32 CFR 77.6 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 1 2012-07-01 2012-07-01 false Procedures. 77.6 Section 77.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN PROGRAM TO ENCOURAGE PUBLIC AND COMMUNITY SERVICE § 77.6 Procedures. (a) Military personnel offices shall advise...

32 CFR 77.6 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 1 2011-07-01 2011-07-01 false Procedures. 77.6 Section 77.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN PROGRAM TO ENCOURAGE PUBLIC AND COMMUNITY SERVICE § 77.6 Procedures. (a) Military personnel offices shall advise...

32 CFR 77.6 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 1 2014-07-01 2014-07-01 false Procedures. 77.6 Section 77.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN PROGRAM TO ENCOURAGE PUBLIC AND COMMUNITY SERVICE § 77.6 Procedures. (a) Military personnel offices shall advise...

32 CFR 77.6 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 1 2013-07-01 2013-07-01 false Procedures. 77.6 Section 77.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN PROGRAM TO ENCOURAGE PUBLIC AND COMMUNITY SERVICE § 77.6 Procedures. (a) Military personnel offices shall advise...

15 CFR 768.7 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... DETERMINATION PROCEDURES AND CRITERIA § 768.7 Procedures. (a) Initiation of an assessment. (1) Once BIS accepts... initiating the assessment. (2) BIS will publish a Federal Register notice of the initiation of any assessment... initiated an assessment. Each such department, agency, and contractor shall provide BIS all relevant...

15 CFR 768.7 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... DETERMINATION PROCEDURES AND CRITERIA § 768.7 Procedures. (a) Initiation of an assessment. (1) Once BIS accepts... initiating the assessment. (2) BIS will publish a Federal Register notice of the initiation of any assessment... initiated an assessment. Each such department, agency, and contractor shall provide BIS all relevant...

15 CFR 768.7 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... DETERMINATION PROCEDURES AND CRITERIA § 768.7 Procedures. (a) Initiation of an assessment. (1) Once BIS accepts... initiating the assessment. (2) BIS will publish a Federal Register notice of the initiation of any assessment... initiated an assessment. Each such department, agency, and contractor shall provide BIS all relevant...

15 CFR 768.7 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... DETERMINATION PROCEDURES AND CRITERIA § 768.7 Procedures. (a) Initiation of an assessment. (1) Once BIS accepts... initiating the assessment. (2) BIS will publish a Federal Register notice of the initiation of any assessment... initiated an assessment. Each such department, agency, and contractor shall provide BIS all relevant...

48 CFR 219.1007 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 48 Federal Acquisition Regulations System 3 2010-10-01 2010-10-01 false Procedures. 219.1007 Section 219.1007 Federal Acquisition Regulations System DEFENSE ACQUISITION REGULATIONS SYSTEM, DEPARTMENT... Demonstration Program 219.1007 Procedures. (a)(2) When it is not practical to mark the face page of an award...

19 CFR 191.142 - Procedure.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 19 Customs Duties 2 2010-04-01 2010-04-01 false Procedure. 191.142 Section 191.142 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) DRAWBACK Foreign-Built Jet Aircraft Engines Processed in the United States § 191.142 Procedure...

19 CFR 191.142 - Procedure.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 19 Customs Duties 2 2011-04-01 2011-04-01 false Procedure. 191.142 Section 191.142 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF THE TREASURY (CONTINUED) DRAWBACK Foreign-Built Jet Aircraft Engines Processed in the United States § 191.142 Procedure...

40 CFR 108.5 - Procedure.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 22 2011-07-01 2011-07-01 false Procedure. 108.5 Section 108.5 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS EMPLOYEE PROTECTION HEARINGS § 108.5 Procedure. Any hearing held pursuant to this part shall be of record and shall be...

40 CFR 108.5 - Procedure.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 23 2012-07-01 2012-07-01 false Procedure. 108.5 Section 108.5 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS EMPLOYEE PROTECTION HEARINGS § 108.5 Procedure. Any hearing held pursuant to this part shall be of record and shall be...

40 CFR 108.5 - Procedure.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Procedure. 108.5 Section 108.5 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) WATER PROGRAMS EMPLOYEE PROTECTION HEARINGS § 108.5 Procedure. Any hearing held pursuant to this part shall be of record and shall be...

National Marrow Donor Program

DTIC Science & Technology

2008-08-05

Research in HLA Typing, Hematopoietic Stem Cell Transplantation and Clinical Studies to Improve Outcomes 16. SECURITY CLASSIFICATION OF: 19a. NAME...new action item was added to Workflow Management screen for the SCTOD ( Stem Cell Therapeutic Outcomes Data) Data Form. The information will be passed...Improvement Amendment NRP National Response Plan CME Continuing Medical Education NST Non-myeloablative Allogeneic Stem Cell Transplantation COG

Grievance Procedures.

ERIC Educational Resources Information Center

Eisenhower, R. Warren

Because grievances are unavoidable, it is essential for organizations, such as the schools, to utilize an efficient, effective procedure to handle friction between employers and employees. Through successive steps, representatives of labor and management attempt to resolve the grievance, first with meetings of lower level representatives (such as…

40 CFR 60.5408 - What is an optional procedure for measuring hydrogen sulfide in acid gas-Tutwiler Procedure?

Code of Federal Regulations, 2013 CFR

2013-07-01

... measuring hydrogen sulfide in acid gas-Tutwiler Procedure? 60.5408 Section 60.5408 Protection of Environment... § 60.5408 What is an optional procedure for measuring hydrogen sulfide in acid gas—Tutwiler Procedure... of titrating hydrogen sulfide in a gas sample directly with a standard solution of iodine. (b...

40 CFR 60.5408 - What is an optional procedure for measuring hydrogen sulfide in acid gas-Tutwiler Procedure?

Code of Federal Regulations, 2014 CFR

2014-07-01

... measuring hydrogen sulfide in acid gas-Tutwiler Procedure? 60.5408 Section 60.5408 Protection of Environment... § 60.5408 What is an optional procedure for measuring hydrogen sulfide in acid gas—Tutwiler Procedure... of titrating hydrogen sulfide in a gas sample directly with a standard solution of iodine. (b...

Robotic vascular resections during Whipple procedure.

PubMed

Allan, Bassan J; Novak, Stephanie M; Hogg, Melissa E; Zeh, Herbert J

2018-01-01

Indications for resection of pancreatic cancers have evolved to include selected patients with involvement of peri-pancreatic vascular structures. Open Whipple procedures have been the standard approach for patients requiring reconstruction of the portal vein (PV) or superior mesenteric vein (SMV). Recently, high-volume centers are performing minimally invasive Whipple procedures with portovenous resections. Our institution has performed seventy robotic Whipple procedures with concomitant vascular resections. This report outlines our technique.

Motives for cosmetic procedures in Saudi women.

PubMed

Al-Natour, Sahar H

2014-01-01

The media-fuelled obsession with beauty in modern society has led more women to seek elective cosmetic procedures to meet the portrayed ideals of beauty in different cultures. This study gives insights into incentives and desires to undergo cosmetic procedures in a conservative society with strict religious practices where women are veiled. Questionnaire data were obtained from 509 Saudi women who responded to a survey distributed randomly to a sample of Saudi women aged 17 to 72 years. At least 1 elective cosmetic procedure was performed in 42% of the women, of whom 77.8% wore a veil. Another 33% considered having a procedure. The motives for seeking a cosmetic procedure were to improve self-esteem in 83.7%, attract a husband in 63.3%, or prevent a husband from seeking another wife in 36.2%. The decision to seek a procedure was affected by the media, with high peer influence. Motivation for elective cosmetic procedures in Saudi women is influenced by a combination of emotional and cultural factors, level of education, marital status, and religious beliefs. The veil is not an impediment for seeking such procedures. The limitation of the study was missing data analysis as some items in the questionnaire were completed inaccurately or left unanswered.

32 CFR 155.6 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 1 2013-07-01 2013-07-01 false Procedures. 155.6 Section 155.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE SECURITY DEFENSE INDUSTRIAL PERSONNEL SECURITY... Secretary of Defense or the head of another Department or Agency determines that the hearing procedures and...

32 CFR 155.6 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 1 2011-07-01 2011-07-01 false Procedures. 155.6 Section 155.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE SECURITY DEFENSE INDUSTRIAL PERSONNEL SECURITY... Secretary of Defense or the head of another Department or Agency determines that the hearing procedures and...

32 CFR 155.6 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 1 2012-07-01 2012-07-01 false Procedures. 155.6 Section 155.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE SECURITY DEFENSE INDUSTRIAL PERSONNEL SECURITY... Secretary of Defense or the head of another Department or Agency determines that the hearing procedures and...

32 CFR 86.6 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 1 2013-07-01 2013-07-01 false Procedures. 86.6 Section 86.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN CRIMINAL HISTORY BACKGROUND CHECKS ON INDIVIDUALS IN CHILD CARE SERVICES § 86.6 Procedures. The records of all existing...

32 CFR 96.6 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 1 2014-07-01 2014-07-01 false Procedures. 96.6 Section 96.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN ACQUISITION AND USE OF CRIMINAL HISTORY RECORD INFORMATION BY THE MILITARY SERVICES § 96.6 Procedures. (a) Under section...

32 CFR 86.6 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Procedures. 86.6 Section 86.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN CRIMINAL HISTORY BACKGROUND CHECKS ON INDIVIDUALS IN CHILD CARE SERVICES § 86.6 Procedures. The records of all existing...

32 CFR 96.6 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 1 2012-07-01 2012-07-01 false Procedures. 96.6 Section 96.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN ACQUISITION AND USE OF CRIMINAL HISTORY RECORD INFORMATION BY THE MILITARY SERVICES § 96.6 Procedures. (a) Under section...

32 CFR 86.6 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 1 2011-07-01 2011-07-01 false Procedures. 86.6 Section 86.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN CRIMINAL HISTORY BACKGROUND CHECKS ON INDIVIDUALS IN CHILD CARE SERVICES § 86.6 Procedures. The records of all existing...

32 CFR 86.6 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 1 2014-07-01 2014-07-01 false Procedures. 86.6 Section 86.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN CRIMINAL HISTORY BACKGROUND CHECKS ON INDIVIDUALS IN CHILD CARE SERVICES § 86.6 Procedures. The records of all existing...

32 CFR 96.6 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 1 2011-07-01 2011-07-01 false Procedures. 96.6 Section 96.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN ACQUISITION AND USE OF CRIMINAL HISTORY RECORD INFORMATION BY THE MILITARY SERVICES § 96.6 Procedures. (a) Under section...

32 CFR 86.6 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 1 2012-07-01 2012-07-01 false Procedures. 86.6 Section 86.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN CRIMINAL HISTORY BACKGROUND CHECKS ON INDIVIDUALS IN CHILD CARE SERVICES § 86.6 Procedures. The records of all existing...

32 CFR 96.6 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 1 2010-07-01 2010-07-01 false Procedures. 96.6 Section 96.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN ACQUISITION AND USE OF CRIMINAL HISTORY RECORD INFORMATION BY THE MILITARY SERVICES § 96.6 Procedures. (a) Under section...

32 CFR 96.6 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 1 2013-07-01 2013-07-01 false Procedures. 96.6 Section 96.6 National Defense Department of Defense OFFICE OF THE SECRETARY OF DEFENSE PERSONNEL, MILITARY AND CIVILIAN ACQUISITION AND USE OF CRIMINAL HISTORY RECORD INFORMATION BY THE MILITARY SERVICES § 96.6 Procedures. (a) Under section...

Developing Competency in Payroll Procedures

ERIC Educational Resources Information Center

Jackson, Allen L.

1975-01-01

The author describes a sequence of units that provides for competency in payroll procedures. The units could be the basis for a four to six week minicourse and are adaptable, so that the student, upon completion, will be able to apply his learning to any payroll procedures system. (Author/AJ)

10 CFR 1706.7 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false Procedures. 1706.7 Section 1706.7 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD ORGANIZATIONAL AND CONSULTANT CONFLICTS OF INTERESTS § 1706.7 Procedures. (a) Pre... the same defense nuclear facility that is the subject of the proposed new work (including overlap...

10 CFR 1706.7 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 4 2011-01-01 2011-01-01 false Procedures. 1706.7 Section 1706.7 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD ORGANIZATIONAL AND CONSULTANT CONFLICTS OF INTERESTS § 1706.7 Procedures. (a) Pre... the same defense nuclear facility that is the subject of the proposed new work (including overlap...

10 CFR 1706.7 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 4 2014-01-01 2014-01-01 false Procedures. 1706.7 Section 1706.7 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD ORGANIZATIONAL AND CONSULTANT CONFLICTS OF INTERESTS § 1706.7 Procedures. (a) Pre... the same defense nuclear facility that is the subject of the proposed new work (including overlap...

10 CFR 1706.7 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 4 2012-01-01 2012-01-01 false Procedures. 1706.7 Section 1706.7 Energy DEFENSE NUCLEAR FACILITIES SAFETY BOARD ORGANIZATIONAL AND CONSULTANT CONFLICTS OF INTERESTS § 1706.7 Procedures. (a) Pre... the same defense nuclear facility that is the subject of the proposed new work (including overlap...

32 CFR 250.5 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... UNCLASSIFIED TECHNICAL DATA FROM PUBLIC DISCLOSURE § 250.5 Procedures. All determinations to disseminate or withhold technical data subject to this part shall be consistent both with the policies set forth in § 250.4 of this part, and with the following procedures: (a) Requests for technical data shall be...

46 CFR 309.1 - Procedure.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 46 Shipping 8 2014-10-01 2014-10-01 false Procedure. 309.1 Section 309.1 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS VALUES FOR WAR RISK INSURANCE § 309.1 Procedure... vessels upon which interim binders for war risk hull insurance have been issued. Such values shall be...

46 CFR 309.1 - Procedure.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 8 2011-10-01 2011-10-01 false Procedure. 309.1 Section 309.1 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS VALUES FOR WAR RISK INSURANCE § 309.1 Procedure... vessels upon which interim binders for war risk hull insurance have been issued. Such values shall be...

46 CFR 309.1 - Procedure.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 8 2013-10-01 2013-10-01 false Procedure. 309.1 Section 309.1 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS VALUES FOR WAR RISK INSURANCE § 309.1 Procedure... vessels upon which interim binders for war risk hull insurance have been issued. Such values shall be...

46 CFR 309.1 - Procedure.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 8 2010-10-01 2010-10-01 false Procedure. 309.1 Section 309.1 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS VALUES FOR WAR RISK INSURANCE § 309.1 Procedure... vessels upon which interim binders for war risk hull insurance have been issued. Such values shall be...

46 CFR 309.1 - Procedure.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 8 2012-10-01 2012-10-01 false Procedure. 309.1 Section 309.1 Shipping MARITIME ADMINISTRATION, DEPARTMENT OF TRANSPORTATION EMERGENCY OPERATIONS VALUES FOR WAR RISK INSURANCE § 309.1 Procedure... vessels upon which interim binders for war risk hull insurance have been issued. Such values shall be...

XML syntax for clinical laboratory procedure manuals.

PubMed

Saadawi, Gilan; Harrison, James H

2003-01-01

We have developed a document type description (DTD) in Extensable Markup Language (XML) for clinical laboratory procedures. Our XML syntax can adequately structure a variety of procedure types across different laboratories and is compatible with current procedure standards. The combination of this format with an XML content management system and appropriate style sheets will allow efficient procedure maintenance, distributed access, customized display and effective searching across a large body of test information.

45 CFR 84.61 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... provisions applicable to title VI of the Civil Rights Act of 1964 apply to this part. These procedures are... 45 Public Welfare 1 2013-10-01 2013-10-01 false Procedures. 84.61 Section 84.61 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN...

45 CFR 84.61 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... provisions applicable to title VI of the Civil Rights Act of 1964 apply to this part. These procedures are... 45 Public Welfare 1 2011-10-01 2011-10-01 false Procedures. 84.61 Section 84.61 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN...

45 CFR 84.61 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... provisions applicable to title VI of the Civil Rights Act of 1964 apply to this part. These procedures are... 45 Public Welfare 1 2012-10-01 2012-10-01 false Procedures. 84.61 Section 84.61 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN...

45 CFR 84.61 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... provisions applicable to title VI of the Civil Rights Act of 1964 apply to this part. These procedures are... 45 Public Welfare 1 2014-10-01 2014-10-01 false Procedures. 84.61 Section 84.61 Public Welfare Department of Health and Human Services GENERAL ADMINISTRATION NONDISCRIMINATION ON THE BASIS OF HANDICAP IN...

12 CFR 367.12 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Procedures. 367.12 Section 367.12 Banks and... EXCLUSION OF CONTRACTOR AND TERMINATION OF CONTRACTS § 367.12 Procedures. (a) FDIC shall process suspension... reconsideration, the provisions relating to the construction of time limits in 12 CFR 308.12 will control. ...

12 CFR 3.12 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 1 2010-01-01 2010-01-01 false Procedures. 3.12 Section 3.12 Banks and Banking COMPTROLLER OF THE CURRENCY, DEPARTMENT OF THE TREASURY MINIMUM CAPITAL RATIOS; ISSUANCE OF DIRECTIVES Establishment of Minimum Capital Ratios for an Individual Bank § 3.12 Procedures. (a) Notice. When the OCC...

25 CFR 143.3 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Procedures. 143.3 Section 143.3 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR FINANCIAL ACTIVITIES CHARGES FOR GOODS AND SERVICES PROVIDED TO NON-FEDERAL USERS § 143.3 Procedures. (a) All non-Federal users who receive the above listed goods/services...

12 CFR 611.501 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Procedures. 611.501 Section 611.501 Banks and... Procedures. (a) The boards of directors of a bank and an association which seek to transfer authorities may adopt appropriate resolutions approving such transfer and providing for the submission of such a...

21 CFR 1270.31 - Written procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... procedures prepared and followed for all significant steps in the infectious disease testing process under... procedures prepared, validated, and followed for prevention of infectious disease contamination or cross...