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Sample records for myeloablative megatherapy procedures

  1. 1070 myeloablative megatherapy procedures followed by stem cell rescue for neuroblastoma: 17 years of European experience and conclusions. European Group for Blood and Marrow Transplant Registry Solid Tumour Working Party.

    PubMed

    Philip, T; Ladenstein, R; Lasset, C; Hartmann, O; Zucker, J M; Pinkerton, R; Pearson, A D; Klingebiel, T; Garaventa, A; Kremens, B; Bernard, J L; Rosti, G; Chauvin, F

    1997-10-01

    1070 myeloablative procedures followed by stem cell rescue for neuroblastoma are reviewed. These 1070 procedures are part of the European Group for Blood and Marrow Transplant (EBMTG) registry from the last 17 years (in 4536 patients). In 1070 neuroblastoma patients, survival at 2 years was 49%, at 5 years, 33% and relapses were observed as late as 7 years post-BMT (bone marrow transplant). However, 5-year survivors after megatherapy with BMT for stage 4 disease do have an 80% chance of becoming a long-term survivor. When BMT had been used in first complete response (CR1) no salvage was possible, whereas 15% survivors may be seen if BMT is used for the first time at relapse. Infants with stage 4 neuroblastoma had a 17% toxic death rate and indication in this group is exceptional and not recommended. In a matched cohort (17 allogeneic and 34 autologous), autologous stem cell rescue (SCR) was shown to be at least equal to allogeneic SCR. Multivariate analysis of clinical prognostic factors in children with stage 4 disease over 1 year showed that event-free survival was mainly influenced by two adverse factors before the megatherapy procedure: persisting skeleton lesions (99Tc and/or mIBG scan positive) as well as persisting bone marrow (BM) involvement.

  2. Myeloablative therapy and bone marrow rescue in advanced neuroblastoma. Report from the Italian Bone Marrow Transplant Registry. Italian Association of Pediatric Hematology-Oncology, BMT Group.

    PubMed

    Garaventa, A; Rondelli, R; Lanino, E; Dallorso, S; Dini, G; Bonetti, F; Arrighini, A; Santoro, N; Rossetti, F; Miniero, R; Andolina, M; Amici, A; Indolfi, P; Lo Curto, M; Favre, C; Paolucci, P; Pession, A; De Bernardi, B

    1996-07-01

    This study reports a large cooperative experience in myeloablative therapy and bone marrow rescue undertaken to define better the outcome of children with disseminated neuroblastoma after megatherapy. Between 1984 and 1993, 135 children underwent myeloablative therapy with bone marrow transplantation (BMT) in nine Italian Centres. One hundred and seventeen children received unpurged autologous BMT, five allogeneic BMT and 13 peripheral blood progenitor cells as rescue. Of these 135 children, 57 were in 1st CR, 11 in 2nd or subsequent CR, 42 in 1st PR, and 25 had more advanced disease. Twelve children (9%) died of toxicity, 86 relapsed or progressed at 1-68 months (median 7 months) and 80 of these subsequently died of progressive disease. Forty-three children are still alive with 37 in continuous remission at a median of 65 months (30-123 months) after BMT. Overall and disease-free survival at 8 years are 28.5% (s.e. 4.3) and 26% (s.e. 4), respectively. Disease-free survival is 34.6% (s.e. 6.7) for the patients grafted in 1st complete remission, 23.6% (s.e. 6.6) for patients grafted in 1st partial remission, 36.4% (s.e. 14.5) for patients grafted in 2nd or subsequent CR, and 8% (5.4) for patients with advanced disease. We conclude these data confirm that early toxicity of myeloablative therapy is manageable and that myeloablative therapy with bone marrow rescue may contribute to an improved long-term survival of children with disseminated neuroblastoma but the objective of cure of all patients remains distant.

  3. Impact of TBI on late effects in children treated by megatherapy for Stage IV neuroblastoma. A study of the French Society of Pediatric oncology

    SciTech Connect

    Flandin, Isabelle; Michon, Jean; Pinkerton, Ross; Coze, Carole; Stephan, Jean Louis; Fourquet, Bernard; Valteau-Couanet, Dominique; Bergeron, Christophe; Philip, Thierry; Carrie, Christian . E-mail: carrie@lyon.fnclcc.fr

    2006-04-01

    Purpose: To determine the contribution of total body irradiation (TBI) to late sequelae in children treated with high-dose chemotherapy and autologous bone marrow transplantation for Stage IV neuroblastoma. Patients and Methods: We compared two populations that were similar with regard to age, stage, pre-autologous bone marrow transplantation chemotherapy (CT) regimen, period of treatment, and follow-up (12 years). The TBI group (n = 32) received TBI as part of the megatherapy procedure (1982-1993), whereas the CT group (n 30) received conditioning without TBI (1985-1992). Analysis 12 years later focused on growth, weight and corpulence (body mass index) delay; hormonal deficiencies; liver, kidney, heart, ear, eye, and dental sequelae; school performance; and the incidence of secondary tumors. Results: Impact of TBI was most marked in relation to growth and weight delay, although the mean delay was not severe, probably because of treatment with growth hormones. Other consequences of TBI were thyroid insufficiency, cataracts, and a high incidence of secondary tumors. Hearing loss and dental agenesis were more prominent in the group treated with CT alone. No differences were observed in school performance. Conclusion: The most frequent side effects of TBI were cataracts, thyroid insufficiency, and growth delay, but more worrying is the risk of secondary tumors. Because of the young mean age of patients and the toxicity of TBI regimens without any survival advantage, regimens without TBI are preferable in the management of Stage IV neuroblastoma.

  4. Splenocytes seed bone marrow of myeloablated mice: implication for atherosclerosis.

    PubMed

    Wang, Lai; Yang, Mingjie; Arias, Ana; Song, Lei; Li, Fuqiang; Tian, Fang; Qin, Minghui; Yukht, Ada; Williamson, Ian K; Shah, Prediman K; Sharifi, Behrooz G

    2015-01-01

    Extramedullary hematopoiesis has been shown to contribute to the pathogenesis of a variety of diseases including cardiovascular diseases. In this process, the spleen is seeded with mobilized bone marrow cells that augment its hematopoietic ability. It is unclear whether these immigrant cells that are produced/reprogrammed in spleen are similar or different from those found in the bone marrow. To begin to understand this, we investigated the relative potency of adult splenocytes per se to repopulate bone marrow of lethally-irradiated mice and its functional consequences in atherosclerosis. The splenocytes were harvested from GFP donor mice and transplanted into myeloablated wild type recipient mice without the inclusion of any bone marrow helper cells. We found that adult splenocytes repopulated bone marrow of myeloablated mice and the transplanted cells differentiated into a full repertoire of myeloid cell lineages. The level of monocytes/macrophages in the bone marrow of recipient mice was dependent on the cell origin, i.e., the donor splenocytes gave rise to significantly more monocytes/macrophages than the donor bone marrow cells. This occurred despite a significantly lower number of hematopoietic stem cells being present in the donor splenocytes when compared with donor bone marrow cells. Atherosclerosis studies revealed that donor splenocytes displayed a similar level of atherogenic and atheroprotective activities to those of donor bone marrow cells. Cell culture studies showed that the phenotype of macrophages derived from spleen is different from those of bone marrow. Together, these results demonstrate that splenocytes can seed bone marrow of myeloablated mice and modulate atherosclerosis. In addition, our study shows the potential of splenocytes for therapeutic interventions in inflammatory disease.

  5. Comparison of Non-myeloablative Conditioning Regimens for Lymphoproliferative Disorders

    PubMed Central

    Hong, Sanghee; Le-Rademacher, Jennifer; Artz, Andrew; McCarthy, Philip L.; Logan, Brent R.; Pasquini, Marcelo C.

    2014-01-01

    Hematopoietic cell transplantation (HCT) with non-myeloablative conditioning (NMA) for lymphoproliferative diseases (LD) includes fludarabine with and without low-dose total body irradiation (TBI). Transplant outcomes were compared among patients ≥40 years with LD who received a HCT with TBI (N=382) and no-TBI (N=515) NMA from 2001 to 2011. The groups were comparable except for donor, graft, prophylaxis for graft-versus-host disease (GVHD), disease status and year of HCT. Cumulative incidences of grades II–IV GVHD at 100 days, were 29% and 20% (p=0.001), and chronic GVHD at 1 year were 54% and 44% (p=0.004) for TBI and no-TBI, respectively. Multivariate analysis of progression/relapse, treatment failure and mortality showed no outcome differences by conditioning. Full donor chimerism at day 100 was observed in 82% vs. 64% in the TBI and no-TBI groups, respectively (p=0.006). Subset of four most common conditioning/ GVHD prophylaxis combinations demonstrated higher rates of grades II–IV acute (p<0.001) and chronic GVHD (p<0.001) among recipients of TBI-mycophenolate mofetil (MMF) compared to other combinations. TBI-based NMA conditioning induces faster full donor chimerism but overall survival outcomes are comparable to no-TBI regimens. Combination of TBI and MMF are associated with higher rates of GVHD without impact on survival outcomes in patients with LD. PMID:25437248

  6. Severe Pulmonary Toxicity After Myeloablative Conditioning Using Total Body Irradiation: An Assessment of Risk Factors

    SciTech Connect

    Kelsey, Chris R.; Horwitz, Mitchell E.; Chino, Junzo P.; Craciunescu, Oana; Steffey, Beverly; Folz, Rodney J.; Chao, Nelson J.; Rizzieri, David A.; Marks, Lawrence B.

    2011-11-01

    Purpose: To assess factors associated with severe pulmonary toxicity after myeloablative conditioning using total body irradiation (TBI) followed by allogeneic stem cell transplantation. Methods and Materials: A total of 101 adult patients who underwent TBI-based myeloablative conditioning for hematologic malignancies at Duke University between 1998 and 2008 were reviewed. TBI was combined with high-dose cyclophosphamide, melphalan, fludarabine, or etoposide, depending on the underlying disease. Acute pulmonary toxicity, occurring within 90 days of transplantation, was scored using Common Terminology Criteria for Adverse Events version 3.0. Actuarial overall survival and the cumulative incidence of acute pulmonary toxicity were calculated via the Kaplan-Meier method and compared using a log-rank test. A binary logistic regression analysis was performed to assess factors independently associated with acute severe pulmonary toxicity. Results: The 90-day actuarial risk of developing severe (Grade 3-5) pulmonary toxicity was 33%. Actuarial survival at 90 days was 49% in patients with severe pulmonary toxicity vs. 94% in patients without (p < 0.001). On multivariate analysis, the number of prior chemotherapy regimens was the only factor independently associated with development of severe pulmonary toxicity (odds ratio, 2.7 per regimen). Conclusions: Severe acute pulmonary toxicity is prevalent after TBI-based myeloablative conditioning regimens, occurring in approximately 33% of patients. The number of prior chemotherapy regimens appears to be an important risk factor.

  7. Decreased transfusion requirements in patients given stem cell allografts using a non-myeloablative conditioning regimen: a single institution experience.

    PubMed

    Ruiz-Argüelles, Guillermo J; López-Martínez, Briceida; Gómez-Rangel, David; Estrada, Erick; Marín-López, Antonio; Bravo-Hernández, Gerardo; Manuel Hernández, Juan

    2003-06-01

    We report our experience of allogeneic peripheral blood stem cell transplantation using non-myeloablative conditioning regimens delivered and supported on an outpatient basis. A group of 44 patients underwent 47 allograft procedures using peripheral blood stem cells. Approximately one third of the individuals did not require red blood cells transfusions: the median of transfused red blood cells units was 1 (range 0-10). In addition one out of three did not require platelet transfusions either, the median of platelet transfusions being 1 (range 0-6). In fourteen allografts (30%) neither red blood cells nor platelet transfusions were used. An inverse correlation was found between the number of CD34 cells infused and the PRBC and PLT transfusion requirements, those patients receiving high numbers of CD34 cells needing fewer transfusions of both PRBC and platelets. The possibility of conducting allografts without transfusion of blood products in some patients may result in a decrease in both cost and the risks stemming from exposure to human blood derivatives.

  8. Pilot experience with opebacan/rBPI 21 in myeloablative hematopoietic cell transplantation

    PubMed Central

    Guinan, Eva; Avigan, David E; Soiffer, Robert J; Bunin, Nancy J; Brennan, Lisa L; Bergelson, Ilana; Brightman, Spencer; Ozonoff, Al; Scannon, Patrick J; Levy, Ofer

    2015-01-01

    Bacterial infection and inflammation contribute significantly to the morbidity and mortality of myeloablative allogeneic hematopoietic cell transplantation (HCT). Endotoxin, a component of the outer membrane of Gram-negative bacteria, is a potent inflammatory stimulus in humans. Bactericidal/permeability increasing protein (BPI), a constituent of human neutrophil granules, binds endotoxin thereby precluding endotoxin-induced inflammation and also has direct anti-infective properties against bacteria. As a consequence of myeloablative therapy used in preparation for hematopoietic cell infusion, patients experience gastrointestinal leak of bacteria and bacterial toxins into the systemic circulation and a period of inflammatory cytokine elevation associated with subsequent regimen-related toxicities.  Patients frequently become endotoxemic and febrile as well as BPI-deficient due to sustained neutropenia. To examine whether enhancing endotoxin-neutralizing and anti-infective activity by exogenous administration of a recombinant N-terminal fragment of BPI (rBPI 21, generic name opebacan) might ameliorate regimen-related toxicities including infection, we recruited patients scheduled to undergo myeloablative HCT to participate in a proof-of-concept prospective phase I/II trial. After the HCT preparative regimen was completed, opebacan was initiated 18-36 hours prior to administration of allogeneic hematopoietic stem cells (defined as Day 0) and continued for 72 hours. The trial was to have included escalation of rBPI 21 dose and duration but was stopped prematurely due to lack of further drug availability.  Therefore, to better understand the clinical course of opebacan-treated patients (n=6), we compared their outcomes with a comparable cohort meeting the same eligibility criteria and enrolled in a non-interventional myeloablative HCT observational study (n = 35).  Opebacan-treated participants had earlier platelet engraftment (p=0.005), mirroring beneficial effects

  9. Survival improvements in adolescents and young adults after myeloablative allogeneic transplantation for acute lymphoblastic leukemia.

    PubMed

    Wood, William A; Lee, Stephanie J; Brazauskas, Ruta; Wang, Zhiwei; Aljurf, Mahmoud D; Ballen, Karen K; Buchbinder, David K; Dehn, Jason; Freytes, Cesar O; Lazarus, Hillard M; Lemaistre, Charles F; Mehta, Paulette; Szwajcer, David; Joffe, Steven; Majhail, Navneet S

    2014-06-01

    Adolescents and young adults (AYAs, ages 15 to 40 years) with cancer have not experienced survival improvements to the same extent as younger and older patients. We compared changes in survival after myeloablative allogeneic hematopoietic cell transplantation (HCT) for acute lymphoblastic leukemia (ALL) among children (n = 981), AYAs (n = 1218), and older adults (n = 469) who underwent transplantation over 3 time periods: 1990 to 1995, 1996 to 2001, and 2002 to 2007. Five-year survival varied inversely with age group. Survival improved over time in AYAs and paralleled that seen in children; however, overall survival did not change over time for older adults. Survival improvements were primarily related to lower rates of early treatment-related mortality in the most recent era. For all cohorts, relapse rates did not change over time. A subset of 222 AYAs between the ages of 15 and 25 at 46 pediatric or 49 adult centers were also analyzed to describe differences by center type. In this subgroup, there were differences in transplantation practices among pediatric and adult centers, although HCT outcomes did not differ by center type. Survival for AYAs undergoing myeloablative allogeneic HCT for ALL improved at a similar rate as survival for children. PMID:24607554

  10. Myeloablative therapy against high risk Ewing's sarcoma: A single institution experience and literature review

    PubMed Central

    Lopez, Jose Luis; Pérez, Concepcion; Marquez, Catalina; Cabrera, Patricia; Perez, Jose Maria; Ramirez, Gema Lucia; Ordoñez, Rafael; Praena-Fernandez, Juan Manuel; Ortiz, Maria Jose

    2011-01-01

    Background Attempts to improve survival outcomes of patients with high risk Ewing's sarcoma (ES) have focused on chemotherapy dose intensification strategies. Aim The objective of this study is to retrospectively evaluate clinical characteristics and outcome of pediatric patients with high risk ES treated at a single institution. Materials and methods From 1995 to 2008, seventeen patients (male:female, 14:3) were treated with dose-intensive therapy in our institution. Median age at diagnosis was 10 years (range: 2–15). Seven patients had metastases at diagnosis (lung in 6 cases and bone in one case). Eleven patients presented with unresectable disease. Fifteen (88.2%) received the Spanish Society of Pediatric Oncology protocol which includes six cycles of vincristine, doxorubicin, ifosfamide and etoposide. Two out of the six cases that were resectable received postoperative radiation. In addition, eleven patients received definitive radiation therapy. Finally, twelve (70.5%) out of 17 patients received myeloablative therapy with melphalan/etoposide. The rest of patients (N = 5) received busulfan/melphalan. Results Median follow-up was 78 months (range: 15–155 months). Initial responses were complete in all patients, but 9 of them developed progression disease. Seven patients became long-term event-free survivors. No patient died of toxicity after transplantation. The 2- and 5-year overall survival rates for all patients were 93% and 73%, respectively. Event-free survival rates were 74% and 54% at 2 and 5 years, respectively. Conclusion This single-institution experience suggests that myeloablative therapy against high risk ES is effective and safe. PMID:24376974

  11. Chemoselection of Allogeneic HSC After Murine Neonatal Transplantation Without Myeloablation or Post-transplant Immunosuppression

    PubMed Central

    Falahati, Rustom; Zhang, Jianqing; Flebbe-Rehwaldt, Linda; Shi, Yimin; Gerson, Stanton L; Gaensler, Karin ML

    2012-01-01

    The feasibility of allogeneic transplantation, without myeloablation or post-transplant immunosuppression, was tested using in vivo chemoselection of allogeneic hematopoietic stem cells (HSCs) after transduction with a novel tricistronic lentiviral vector (MGMTP140K-2A-GFP-IRES-TK (MAGIT)). This vector contains P140K-O6-methylguanine-methyltransferase (MGMTP140K), HSV-thymidine kinase (TKHSV), and enhanced green fluorescent protein (eGFP) enabling (i) in vivo chemoselection of HSC by conferring resistance to benzylguanine (BG), an inhibitor of endogenous MGMT, and to chloroethylating agents such as 1,3-bis(2-chloroethyl)nitrosourea (BCNU) and, (ii) depletion of proliferating cells such as malignant clones or transduced donor T cells mediating graft versus host disease (GVHD), by expression of the suicide gene TKHSV and Ganciclovir (GCV) administration. Non-myeloablative transplantation of transduced, syngeneic, lineage-depleted (Lin−) BM in neonates resulted in 0.67% GFP+ mononuclear cells in peripheral blood. BG/BCNU chemoselection, 4 and 8 weeks post-transplant, produced 50-fold donor cell enrichment. Transplantation and chemoselection of major histocompatibility complex (MHC)-mismatched MAGIT-transduced Lin− BM also produced similar expansion for >40 weeks. The efficacy of this allotransplant approach was validated in Hbbth3 heterozygous mice by correction of β-thalassemia intermedia, without toxicity or GVHD. Negative selection, by administration of GCV resulted in donor cell depletion without graft ablation, as re-expansion of donor cells was achieved with BG/BCNU treatment. These studies show promise for developing non-ablative allotransplant approaches using in vivo positive/negative selection. PMID:22871662

  12. The Myeloablative Drug Busulfan Converts Cysteine to Dehydroalanine and Lanthionine in Redoxins.

    PubMed

    Scian, Michele; Guttman, Miklos; Bouldin, Samantha D; Outten, Caryn E; Atkins, William M

    2016-08-23

    The myeloablative agent busulfan (1,4-butanediol dimethanesulfonate) is an old drug that is used routinely to eliminate cancerous bone marrow prior to hematopoietic stem cell transplant. The myeloablative activity and systemic toxicity of busulfan have been ascribed to its ability to cross-link DNA. In contrast, here we demonstrate that incubation of busulfan with the thiol redox proteins glutaredoxin or thioredoxin at pH 7.4 and 37 °C results in the formation of putative S-tetrahydrothiophenium adducts at their catalytic Cys residues, followed by β-elimination to yield dehydroalanine. Both proteins contain a second Cys, in their catalytic C-X-X-C motif, which reacts with the dehydroalanine, the initial Cys adduct with busulfan, or the S-tetrahydrothiophenium, to form novel intramolecular cross-links. The reactivity of the dehydroalanine (DHA) formed is further demonstrated by adduction with glutathione to yield a lanthionine and by a novel reaction with the reducing agent tris(2-carboxyethyl)phosphine (TCEP), which yields a phosphine adduct via Michael addition to the DHA. Formation of a second quaternary organophosphonium salt via nucleophilic substitution with TCEP on the initial busulfan-protein adduct or on the THT(+)-Redoxin species is also observed. These results reveal a rich potential for reactions of busulfan with proteins in vitro, and likely in vivo. It is striking that several of the chemically altered protein products retain none of the atoms of busulfan, in contrast to typical drug-protein adducts or traditional protein modification reagents. In particular, the ability of a clinically used drug to convert Cys to dehydrolanine in intact proteins, and its subsequent reaction with biological thiols, is unprecedented. PMID:27490699

  13. Outcomes after allogeneic hematopoietic cell transplantation with nonmyeloablative or myeloablative conditioning regimens for treatment of lymphoma and chronic lymphocytic leukemia

    PubMed Central

    Storer, Barry E.; Maloney, David G.; Sandmaier, Brenda M.; Martin, Paul J.; Storb, Rainer

    2008-01-01

    Allogeneic conventional hematopoietic cell transplantation (HCT) can be curative treatment for lymphoid malignancies, but it has been characterized by high nonrelapse mortality (NRM). Here, we compared outcomes among patients with lymphoma or chronic lymphocytic leukemia given either nonmyeloablative (n = 152) or myeloablative (n = 68) conditioning. Outcomes were stratified by the HCT-specific comorbidity index. Patients in the nonmyeloablative group were older, had more previous treatment and more comorbidities, more frequently had unrelated donors, and more often had malignancy in remission compared with patients in the myeloablative group. Patients with indolent versus aggressive malignancies were equally distributed among both cohorts. After HCT, patients without comorbidities both in the nonmyeloablative and myeloablative cohorts had comparable NRM (P = .74), overall survival (P = .75), and progression-free survival (P = .40). No significant differences were observed (P = .91, P = .89, and P = .40, respectively) after adjustment for pretransplantation variables. Patients with comorbidities experienced lower NRM (P = .009) and better survival (P = .04) after nonmyeloablative conditioning. These differences became more significant (P < .001 and .007, respectively) after adjustment for other variables. Further, nonmyeloablative patients with comorbidities had favorable adjusted progression-free survival (P = .01). Patients without comorbidities could be enrolled in prospective randomized studies comparing different conditioning intensities. Younger patients with comorbidities might benefit from reduced conditioning intensity. PMID:17916744

  14. Does total body irradiation conditioning improve outcomes of myeloablative human leukocyte antigen-identical sibling transplantations for chronic lymphocytic leukemia?

    PubMed

    Sabloff, Mitchell; Sobecks, Ronald M; Ahn, Kwang Woo; Zhu, Xiaochun; de Lima, Marcos; Brown, Jennifer R; Inamoto, Yoshihiro; Holland, H Kent; Aljurf, Mahmoud D; Laughlin, Mary J; Kamble, Rammurti T; Hsu, Jack W; Wirk, Baldeep M; Seftel, Matthew; Lewis, Ian D; Arora, Mukta; Alyea, Edwin P; Kalaycio, Matt E; Cortes, Jorge; Maziarz, Richard T; Gale, Robert Peter; Saber, Wael

    2014-03-01

    An allogeneic hematopoietic cell transplantation from an HLA-identical donor after high-dose (myeloablative) pretransplantation conditioning is an effective therapy for some people with chronic lymphocytic leukemia (CLL). Because CLL is a highly radiosensitive cancer, we hypothesized that total body irradiation (TBI) conditioning regimens may be associated with better outcomes than those without TBI. To answer this, we analyzed data from 180 subjects with CLL receiving myeloablative doses of TBI (n = 126) or not (n = 54), who received transplants from an HLA-identical sibling donor between 1995 and 2007 and reported to the Center for International Blood & Marrow Transplant Research. At 5 years, treatment-related mortality was 48% (95% confidence interval [CI], 39% to 57%) versus 50% (95% CI, 36% to 64%); P = NS. Relapse rates were 17% (95% CI, 11% to 25%) versus 22% (95% CI, 11% to 35%); P = NS. Five-year progression-free survival and overall survival were 34% (95% CI, 26% to 43%) versus 28% (95% CI, 15% to 42%); P = NS and 42% (95% CI, 33% to 51%) versus 33% (95% CI, 19% to 48%); P = NS, respectively. The single most common cause of death in both cohorts was recurrent/progressive CLL. No variable tested in the multivariate analysis was found to significantly affect these outcomes, including having failed fludarabine. Within the limitations of this study, we found no difference in HLA-identical sibling transplantation outcomes between myeloablative TBI and chemotherapy pretransplantation conditioning in persons with CLL.

  15. Significance of Persistent Cytogenetic Abnormalities at Myeloablative Allogeneic Stem Cell Transplantation in First Complete Remission

    PubMed Central

    Oran, Betul; Popat, Uday; Rondon, Gabriella; Ravandi, Farhad; Garcia-Manero, Guillermo; Abruzzo, Lynn; Andersson, Borje S.; Bashir, Qaiser; Chen, Julianne; Kebriaei, Partow; Khouri, Issa F.; Koca, Ebru; Qazilbash, Muzaffar H.; Champlin, Richard; de Lima, Marcos

    2014-01-01

    Risk stratification is important to identify acute myeloid leukemia (AML) patients that might benefit from allogeneic hematopoietic stem cell transplantation (allo-HCT) in first complete remission (CR1). We retrospectively studied 150 AML patients with diagnostic cytogenetic abnormalities receiving myeloablative allo-HCT in CR1 to determine the prognostic impact of persistent cytogenetic abnormalities at allo-HCT. Three risk groups were identified: First group of patients with favorable/intermediate cytogenetics at diagnosis (n=49) and the second group with unfavorable cytogenetics at diagnosis but without the presence of persistent abnormal clone at allo-HCT (n=83) had similar 3-year leukemia free survival (LFS) of 58%-60% despite increased 3-year relapse incidence (RI) of 32.3% observed in the second risk group versus 16.8% in the first group. Third group of patients with unfavorable cytogenetics at diagnosis and persistence of that clone at allo-HCT (n=15) represented the worst prognostic group with 3-year RI of 57.5% and 3-year LFS of 29.2%. These data suggest that AML patients with unfavorable cytogenetics at diagnosis and persistence of abnormal clone at allo-HCT have high risk of relapse after allo-HCT. These patients should be considered for clinical trials designed to optimize conditioning regimens and/or to use preemptive strategies in the post-transplant setting to decrease the relapse incidence. PMID:22982533

  16. Effect of cord blood processing on transplantation outcomes after single myeloablative umbilical cord blood transplantation.

    PubMed

    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

    2015-04-01

    Variations in cord blood manufacturing and administration are common, and the optimal practice is not known. We compared processing and banking practices at 16 public cord blood banks (CBB) in the United States and assessed transplantation outcomes on 530 single umbilical cord blood (UCB) myeloablative transplantations for hematologic malignancies facilitated by these banks. UCB banking practices were separated into 3 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 with 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, .19; P = .001) or plasma and red cell reduced (odds ratio, .54; P = .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 with the "no wash" or "dilution only" techniques (odds ratio, 1.82; P = .04). In conclusion, CBB processing has no significant effect on early (day 100) survival despite differences in kinetics of neutrophil recovery. PMID:25543094

  17. Primary Graft Failure after Myeloablative Allogeneic Hematopoietic Cell Transplantation for Hematologic Malignancies

    PubMed Central

    Olsson, Richard F.; Logan, Brent R.; Chaudhury, Sonali; Zhu, Xiaochun; Akpek, Görgün; Bolwell, Brian J.; Bredeson, Christopher N.; Dvorak, Christopher C.; Gupta, Vikas; Ho, Vincent T.; Lazarus, Hillard M.; Marks, David I.; Ringdén, Olle T.H.; Pasquini, Marcelo C.; Schriber, Jeffrey R.; Cooke, Kenneth R.

    2015-01-01

    Clinical outcomes after primary graft failure (PGF) remain poor. Here we present a large retrospective analysis (n=23,272) which investigates means to prevent PGF and early detection of patients at high risk. In patients with hematologic malignancies, who underwent their first myeloablative allogeneic hematopoietic cell transplantation, PGF was reported in 1,278 (5.5%), and there was a marked difference in PGFs using peripheral blood stem cell compared to bone marrow grafts (2.5 vs. 7.3%; P<0.001). A 4-fold increase of PGF was observed in myeloproliferative disorders compared to acute leukemia (P<0.001). Other risk factors for PGF included recipient age below 30, HLA-mismatch, male recipients of female donor grafts, ABO-incompatibility, busulfan/cyclophosphamide conditioning, and cryopreservation. In bone marrow transplants, total nucleated cell doses ≤2.4 × 108/kg were associated with PGF (OR 1.39; P<0.001). The use of tacrolimus-based immunosuppression and granulocyte colony-stimulating factor were associated with decreased PGF risk. These data, allow clinicians to do more informed choices with respect to graft source, donor selection, conditioning and immunosuppressive regimens to reduce the risk of PGF. Moreover, a novel risk score determined on day 21 post-transplant may provide the rationale for an early request for additional hematopoietic stem cells. PMID:25772027

  18. 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

  19. Nonpermissive HLA-DPB1 mismatch increases mortality after myeloablative unrelated allogeneic hematopoietic cell transplantation

    PubMed Central

    Lee, Stephanie J.; Ahn, Kwang Woo; Spellman, Stephen; Wang, Hai-Lin; Aljurf, Mahmoud; Askar, Medhat; Dehn, Jason; Fernandez Viña, Marcelo; Gratwohl, Alois; Gupta, Vikas; Hanna, Rabi; Horowitz, Mary M.; Hurley, Carolyn K.; Inamoto, Yoshihiro; Kassim, Adetola A.; Nishihori, Taiga; Mueller, Carlheinz; Oudshoorn, Machteld; Petersdorf, Effie W.; Prasad, Vinod; Robinson, James; Saber, Wael; Schultz, Kirk R.; Shaw, Bronwen; Storek, Jan; Wood, William A.; Woolfrey, Ann E.; Anasetti, Claudio

    2014-01-01

    We examined current outcomes of unrelated donor allogeneic hematopoietic cell transplantation (HCT) to determine the clinical implications of donor-recipient HLA matching. Adult and pediatric patients who had first undergone myeloablative-unrelated bone marrow or peripheral blood HCT for acute myelogenous leukemia, acute lymphoblastic leukemia, chronic myelogenous leukemia, and myelodysplastic syndrome between 1999 and 2011 were included. All had high-resolution typing for HLA-A, -B, -C, and -DRB1. Of the total (n = 8003), cases were 8/8 (n = 5449), 7/8 (n = 2071), or 6/8 (n = 483) matched. HLA mismatch (6-7/8) conferred significantly increased risk for grades II to IV and III to IV acute graft vs host disease (GVHD), chronic GVHD, transplant-related mortality (TRM), and overall mortality compared with HLA-matched cases (8/8). Type (allele/antigen) and locus (HLA-A, -B, -C, and -DRB1) of mismatch were not associated with overall mortality. Among 8/8 matched cases, HLA-DPB1 and -DQB1 mismatch resulted in increased acute GVHD, and HLA-DPB1 mismatch had decreased relapse. Nonpermissive HLA-DPB1 allele mismatch was associated with higher TRM compared with permissive HLA-DPB1 mismatch or HLA-DPB1 match and increased overall mortality compared with permissive HLA-DPB1 mismatch in 8/8 (and 10/10) matched cases. Full matching at HLA-A, -B, -C, and -DRB1 is required for optimal unrelated donor HCT survival, and avoidance of nonpermissive HLA-DPB1 mismatches in otherwise HLA-matched pairs is indicated. PMID:25161269

  20. Double Umbilical Cord Blood Transplantation after Novel Myeloablative Conditioning Using FluBu4/TLI

    PubMed Central

    Abedin, Sameem; Levine, John E.; Choi, Sung; Yanik, Gregory; Couriel, Daniel R.

    2015-01-01

    We conducted a pilot study evaluating double umbilical cord blood transplantation (dCBT) after myeloablative (MA) conditioning with Fludarabine/Busulfan 3.2mg/kg IV × 4, followed by Total Lymphoid Irradiation at 400cGy (FluBu4/TLI) for any indicated hematological disorder without a suitable donor. Twenty patients with predominantly high-risk disease underwent dCBT according to protocol. The regimen was well tolerated, with mucositis as the primary observed toxicity (n=19). The cumulative incidence of neutrophil engraftment was 89% (95% C.I., 64-97%), with a median time to recovery of 16 days (range: 12-31 days). All evaluable patients with neutrophil engraftment achieved complete donor chimerism by day 40. The cumulative incidence of grade III/IV acute GVHD at day 100 was 10% (95% C.I., 2-27%), and the cumulative incidence of chronic GVHD was 35% (95% C.I. 16-55%) by the end of the study. At one year, the cumulative incidence of treatment related mortality (TRM) was 35% (95% C.I. 16-55%). The leading cause of non-relapse mortality was acute GVHD (n=4), followed by graft failure (n=2), and chronic GVHD (n=1). Treatment-related mortality was significantly associated with a pre-transplant HCT-CI score ≥3 (p=0.005). At one year, disease relapse occurred in six patients, and overall survival was 40% (95% C.I. 19-60%). We conclude that MA FluBu4/TLI is an adequate preparative regiment prior to dCBT, providing high engraftment rates, and relatively early neutrophil recovery. The best survival outcomes were seen in patients without significant comorbidities pre-transplant, and are comparable to previously published dCBT studies. PMID:25046834

  1. Successful Treatment of Extra-Renal Noncerebral Rhabdoid Tumors with VIDE.

    PubMed

    Yasui, Naoko; Yoshida, Akihiko; Kobayashi, Eisuke; Nakatani, Fumihiko; Kawamoto, Hiroshi

    2016-02-01

    Extra-renal noncerebral rhabdoid tumors (ERRTs) are highly aggressive and often lethal. An optimal chemotherapy regimen for ERRT remains undetermined. We report on three pediatric patients successfully treated with vincristine, ifosfamide, doxorubicin, and etoposide (VIDE). Two of our patients who had metastatic or refractory disease have survived more than 2 years, one disease free without myeloablative megatherapy. The treatment with high-dose alkylator therapy is reported to have a beneficial effect on survival. A VIDE regimen containing high-dose ifosfamide is feasible and appears to prolong the survival of patients with ERRT. This regimen may be a promising option for ERRT treatment without myeloablative megatherapy. PMID:26469354

  2. Successful Treatment of Extra-Renal Noncerebral Rhabdoid Tumors with VIDE.

    PubMed

    Yasui, Naoko; Yoshida, Akihiko; Kobayashi, Eisuke; Nakatani, Fumihiko; Kawamoto, Hiroshi

    2016-02-01

    Extra-renal noncerebral rhabdoid tumors (ERRTs) are highly aggressive and often lethal. An optimal chemotherapy regimen for ERRT remains undetermined. We report on three pediatric patients successfully treated with vincristine, ifosfamide, doxorubicin, and etoposide (VIDE). Two of our patients who had metastatic or refractory disease have survived more than 2 years, one disease free without myeloablative megatherapy. The treatment with high-dose alkylator therapy is reported to have a beneficial effect on survival. A VIDE regimen containing high-dose ifosfamide is feasible and appears to prolong the survival of patients with ERRT. This regimen may be a promising option for ERRT treatment without myeloablative megatherapy.

  3. A paediatric case of successful non-myeloablative bone marrow transplantation after azacitidine therapy for non-Down syndrome acute megakaryoblastic leukaemia with monosomy 7.

    PubMed

    Koga, Yuhki; Oba, Utako; Kato, Wakako; Ono, Hiroaki; Nakashima, Kentaro; Takada, Hidetoshi

    2016-09-01

    We report a patient with non-Down syndrome AML, also known as AMKL, with monosomy 7, who was also obese and had a hearing impairment and mental retardation. Non-myeloablative bone marrow transplantation was performed successfully after the patient received less aggressive azacitidine treatment, without the usual intensive induction chemotherapy regimen for AML. PMID:27384975

  4. High-dose total body irradiation and myeloablative conditioning before allogeneic hematopoietic cell transplantation: time to rethink?

    PubMed

    Mohty, Mohamad; Malard, Florent; Savani, Bipin N

    2015-04-01

    Over the last decade, the care of patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) has significantly improved, leading to a decrease in deaths related to allo-HCT as well as improved long-term survival. However, for many patients, long-term survivorship is associated with a substantial burden of chronic morbidities. Indeed, malignant and nonmalignant late complications after allo-HCT are numerous and usually multifactorial, with all organs and tissues a potential target. In many cases, these long-term side effects are associated with the use of high-dose total body irradiation, myeloablative conditioning regimens, and the onset of chronic graft-versus-host disease. It appears to be essential to change the natural history of these late effects. This requires the introduction of improved conditioning regimens and the development of lifelong monitoring controls, patient counseling, and preventative treatment measures. This approach will allow us to pursue our efforts to improve patient outcome.

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

    SciTech Connect

    Mikell, John L.; Waller, Edmund K.; Switchenko, Jeffrey M.; Rangaraju, Sravanti; Ali, Zahir; Graiser, Michael; Hall, William A.; Langston, Amelia A.; Esiashvili, Natia; Khoury, H. Jean; Khan, Mohammad K.

    2014-06-01

    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 of 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 between

  6. The impact of pre-transplant minimal residual disease on outcome of intensified myeloablative cord blood transplant for acute myeloid leukemia in first or second complete remission.

    PubMed

    Zheng, Changcheng; Zhu, Xiaoyu; Tang, Baolin; Zhang, Lei; Geng, Liangquan; Liu, Huilan; Sun, Zimin

    2016-01-01

    The impact of pretransplant minimal residual disease (MRD) on outcome of myeloablative cord blood transplant (CBT) for acute myeloid leukemia (AML) in complete remission (CR) has not been reported. Seventy-two AML patients were assessed for MRD before CBT, and the majority (84.7%) of these patients received single-unit CBT. All patients received intensified myeloablative conditioning with BUCY2 or TBICY plus high-dose cytarabine, and graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and mycophenolate mofetil. The cumulative incidences of neutrophil and platelet engraftment, acute or chronic GVHD were comparable between MRD-negative and MRD-positive groups. The cumulative incidence of transplant-related mortality (TRM) and relapse did not differ significantly between the two cohorts (25.6% vs. 32.5%, 16.1% vs. 19.2%; p = 0.52, 0.61). There were no apparent differences in 3-year overall survival (OS) (68.9% in MRD-negative group and 57.9% in MRD-positive group, p = 0.31) and 3-year leukemia-free survival (LFS) (62.5% in MRD-negative group and 52.7% in MRD-positive group, p = 0.42) between both groups. The current study suggests that AML patients in morphological CR1 or CR2 who have detectable MRD might benefit from unrelated CBT with intensified myeloablative conditioning. PMID:26690538

  7. The impact of pre-transplant minimal residual disease on outcome of intensified myeloablative cord blood transplant for acute myeloid leukemia in first or second complete remission.

    PubMed

    Zheng, Changcheng; Zhu, Xiaoyu; Tang, Baolin; Zhang, Lei; Geng, Liangquan; Liu, Huilan; Sun, Zimin

    2016-01-01

    The impact of pretransplant minimal residual disease (MRD) on outcome of myeloablative cord blood transplant (CBT) for acute myeloid leukemia (AML) in complete remission (CR) has not been reported. Seventy-two AML patients were assessed for MRD before CBT, and the majority (84.7%) of these patients received single-unit CBT. All patients received intensified myeloablative conditioning with BUCY2 or TBICY plus high-dose cytarabine, and graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and mycophenolate mofetil. The cumulative incidences of neutrophil and platelet engraftment, acute or chronic GVHD were comparable between MRD-negative and MRD-positive groups. The cumulative incidence of transplant-related mortality (TRM) and relapse did not differ significantly between the two cohorts (25.6% vs. 32.5%, 16.1% vs. 19.2%; p = 0.52, 0.61). There were no apparent differences in 3-year overall survival (OS) (68.9% in MRD-negative group and 57.9% in MRD-positive group, p = 0.31) and 3-year leukemia-free survival (LFS) (62.5% in MRD-negative group and 52.7% in MRD-positive group, p = 0.42) between both groups. The current study suggests that AML patients in morphological CR1 or CR2 who have detectable MRD might benefit from unrelated CBT with intensified myeloablative conditioning.

  8. Reduced toxicity, myeloablative conditioning with BU, fludarabine, alemtuzumab and SCT from sibling donors in children with sickle cell disease.

    PubMed

    Bhatia, M; Jin, Z; Baker, C; Geyer, M B; Radhakrishnan, K; Morris, E; Satwani, P; George, D; Garvin, J; Del Toro, G; Zuckerman, W; Lee, M T; Licursi, M; Hawks, R; Smilow, E; Baxter-Lowe, L A; Schwartz, J; Cairo, M S

    2014-07-01

    BU and CY (BU/CY; 200 mg/kg) before HLA-matched sibling allo-SCT in children with sickle cell disease (SCD) is associated with ~85% EFS but is limited by the acute and late effects of BU/CY myeloablative conditioning. Alternatives include reduced toxicity but more immunosuppressive conditioning. We investigated in a prospective single institutional study, the safety and efficacy of a reduced-toxicity conditioning (RTC) regimen of BU 12.8-16 mg/kg, fludarabine 180 mg/m(2), alemtuzumab 54 mg/m(2) (BFA) before HLA-matched sibling donor transplantation in pediatric recipients with symptomatic SCD. Eighteen patients, median age 8.9 years (2.3-20.2), M/F 15/3, 15 sibling BM and 3 sibling cord blood (CB) were transplanted. Mean whole blood and erythroid donor chimerism was 91% and 88%, at days +100 and +365, respectively. Probability of grade II-IV acute GVHD was 17%. Two-year EFS and OS were both 100%. Neurological, pulmonary and cardiovascular function were stable or improved at 2 years. BFA RTC and HLA-matched sibling BM and CB allo-SCT in pediatric recipients result in excellent EFS, long-term donor chimerism, low incidence of GVHD and stable/improved organ function.

  9. 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.

  10. Non-myeloablative conditioning is sufficient to induce mixed chimerism and subsequent acceptance of donor specific cardiac and skin grafts.

    PubMed

    Liu, Chi; Zhu, Ping; Saito, Taro; Isaka, Yoshitaka; Nagahara, Yukitoshi; Zhuang, Jian; Li, Xiao-Kang

    2013-07-01

    Organ transplant recipients have elevated cancer and viral infection risks due to immunosuppression and long-term results of organ transplantation remain unsatisfactory, mainly because of chronic rejection. The purpose of the current study is to establish a nonmyeloablative perioperative regimen, able to induce mixed chimerism and tolerance of allografts. To establish a nonmyeloablative perioperative regimen, we used Busulfan, an important component of many bone marrow transplantation preparative regimens for a variety of non-neoplastic diseases as an alternative to total body irradiation (TBI), and FTY720, a unique immunosuppression agent, inhibition lymphocyte homing. We found that creating a lymphohematopoietic chimera in which donor and recipient hematopoiesis coexist resulted in prolongation of the donor specific heart and skin allografts. Consistent with graft survival, pathological analysis indicated that the allografts from tolerant recipients were free of myocardial injury and had only a few interstitial infiltrates, and obliterative vasculopathy was not observed. Furthermore, we found that Treg cells were increased in the long-term graft acceptance recipients. Our data revealed that the therapeutic potential for using hematopoietic chimerism in non-myeloablated recipients hope the advances in rodent models described above in the development of minimal, nontoxic host conditioning regimens for mixed chimerism induction and subsequent acceptance of donor specific grafts. PMID:23428909

  11. Outcome of myeloablative allogeneic peripheral blood hematopoietic stem cell transplantation for refractory/relapsed AML patients in NR status.

    PubMed

    Liu, Na; Ning, Hong-Mei; Hu, Liang-Ding; Jiang, Min; Xu, Chen; Hu, Jiang-Wei; Wang, Jun; Li, Yu-Hang; Li, Bo-Tao; Lou, Xiao; Yang, Fan; Chen, Jian-Lin; Su, Yong-Feng; Li, Meng; Wang, Hong-Ye; Ren, Jing; Feng, Yue-Qian; Zhang, Bin; Wang, Dan-Hong; Chen, Hu

    2015-12-01

    To further find effective method to improve the long term survival of refractory or relapsed acute myeloid leukemia (AML) patients, we retrospectively analyzed the outcomes of myeloablative hematopoietic stem cell transplantation (HSCT) for 133 consecutive patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS) therapy related AML(t-AML) in not remission status. The overall 3-year OS and DFS were 40.9% and 35.6% respectively. The variables associated with improved long term DFS were a bone marrow blast cell count less than 20% and an intensified conditioning regimen. In addition, the t-AML group had higher rates of relapse and III-IV acute GVHD than the primary AML group. The unrelated donor group had similar OS and DFS with sibling groups. Our study suggested that decreasing bone marrow blast cell counts before HSCT and strengthening the conditioning regimen may improve long-term DFS for refractory/relapsed AML patients, and unrelated donor group can get similar effect when compared to the sibling group. PMID:26530539

  12. Single-agent GVHD prophylaxis with posttransplantation cyclophosphamide after myeloablative, HLA-matched BMT for AML, ALL, and MDS

    PubMed Central

    Kanakry, Christopher G.; Tsai, Hua-Ling; Bolaños-Meade, Javier; Smith, B. Douglas; Gojo, Ivana; Kanakry, Jennifer A.; Kasamon, Yvette L.; Gladstone, Douglas E.; Matsui, William; Borrello, Ivan; Huff, Carol Ann; Swinnen, Lode J.; Powell, Jonathan D.; Pratz, Keith W.; DeZern, Amy E.; Showel, Margaret M.; McDevitt, Michael A.; Brodsky, Robert A.; Levis, Mark J.; Ambinder, Richard F.; Fuchs, Ephraim J.; Rosner, Gary L.; Jones, Richard J.

    2014-01-01

    High-dose, posttransplantation cyclophosphamide (PTCy) reduces severe graft-versus-host disease (GVHD) after allogeneic blood or marrow transplantation (alloBMT), but the impact of PTCy on long-term, disease-specific outcomes is unclear. We conducted a retrospective study of 209 consecutive adult patients transplanted for acute myeloid leukemia (AML, n = 138), myelodysplastic syndrome (n = 28), or acute lymphoblastic leukemia (ALL, n = 43) using PTCy as sole GVHD prophylaxis after myeloablative conditioning and HLA-matched–related or –unrelated T-cell–replete allografting. At alloBMT, 30% of patients were not in morphologic complete remission. The cumulative incidences of grades II to IV and III to IV acute GVHD at 100 days and chronic GVHD at 2 years were 45%, 11%, and 13%, respectively. Forty-three percent of patients did not require immunosuppression for any reason beyond PTCy. At 3 years, relapse cumulative incidence was 36%, disease-free survival was 46%, survival free of disease and chronic GVHD was 39%, and overall survival was 58%. Lack of remission at alloBMT, adverse cytogenetics, and low allograft nucleated cell dose were associated with inferior survival for AML patients. Minimal residual disease but not t(9;22) was associated with inferior outcomes for ALL patients. The ability to limit posttransplantation immunosuppression makes PTCy a promising transplantation platform for the integration of postgrafting strategies to prevent relapse. PMID:25316679

  13. 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. PMID:25840335

  14. Recovery of ovarian function and pregnancy in a patient with AML after myeloablative busulphan-based conditioning regimen.

    PubMed

    Balashov, Dmitry N; Papusha, Ludmila I; Nazarenko, Tatiana A; Trakhtman, Pavel E; Revishvili, Nino A; Maschan, Alexei A; Persiantseva, Marina I; Andriutsa, Anna V; Skorobogatova, Elena V; Skvortsova, Yulia V; Rumiantsev, Alexander G

    2011-05-01

    We report a rare case of ovarian function recovery and pregnancy after hormone-replacement therapy (HRT) in the acute myeloblastic leukemia (AML) patient in third complete remission received hematopoietic stem cell transplantation (HSCT) with busulphan-based conditioning regimen. Successful engraftment of the donor cells and full donor's chimerism was achieved without the signs of leukemia. One year after HSCT the patient received a course of HRT as a treatment of hypergonadotropic hypogonadism. After 12 months of HRT the recovery of ovarian function was confirmed. Eight years after the HSCT spontaneous pregnancy occurred; heartbeat of the fetus was registered on week 7. Three weeks later a nonsevere vaginal bleeding occurred and the ultrasound examination showed a nondeveloping pregnancy. Genetic examination of the abortion material showed a full triploid genotype (69 XXX). To our knowledge this is a first case of ovarian function restoration and spontaneous pregnancy in a AML patient after multiple courses of high-dose chemotherapy and busulphan-based myeloablative conditioning for HSCT. PMID:21423042

  15. 131I-tositumomab myeloablative radioimmunotherapy for non-Hodgkin’s lymphoma: radiation dose to the testes

    SciTech Connect

    Hattori, Naoya; Gopal, Ajay K.; Shields, Andrew T.; Fisher, Darrell R.; Gooley, Ted; Pagel, John M.; Press, Oliver W.; Rajendran, Joseph G.

    2012-12-01

    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 considerable 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.

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

    PubMed Central

    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.

    2015-01-01

    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 (HCT) who received TBI (1200-1500cGY) for acute leukemia from 2003 to 2010. The two cohorts were comparable for median age, performance score, type of leukemia, first complete remission, Ph+ ALL, HLA matched siblings, stem cell source, anti-thymocyte globulin use, TBI dose, and type of graft-versus-host disease (GVHD) prophylaxis. The sequence of TBI did not significantly affect TRM (24% vs. 23% at 3y, p=0.67; relative risk [RR] 1.01, p=0.91), leukemia relapse (27% vs. 29% at 3y, p=0.34; RR 0.89, p=0.18), leukemia-free survival (49% vs. 48% at3y, p=0.27; RR 0.93, p=0.29), chronic GVHD (45% vs. 47% at 1y, p=0.39; RR 0.9, p=0.11) or overall survival (53% vs. 52% at 3y, p=0.62; RR 0.96, p=0.57) for CyTBI and TBICy respectively. Corresponding cumulative incidences of sinusoidal obstruction syndrome were 4% and 6% at 100 days (p=0.08). This study demonstrates that the sequence of Cy and TBI does not impact transplant outcomes and complications in patients with acute leukemia undergoing HCT with myeloablative conditioning. PMID:25840335

  17. Late Effects after Umbilical Cord Blood Transplantation in Very Young Children after Busulfan-Based, Myeloablative Conditioning.

    PubMed

    Allewelt, Heather; El-Khorazaty, Jill; Mendizabal, Adam; Taskindoust, Mahsa; Martin, Paul L; Prasad, Vinod; Page, Kristin; Sanders, Jean; Kurtzberg, Joanne

    2016-09-01

    Infants and young children who undergo allogeneic cord blood transplantation (CBT) are at increased risk for late effects because of exposure of developing organs to chemotherapy and radiation therapy typically used in transplant conditioning regimens. Busulfan (Bu)-based myeloablative regimens were developed to eliminate radiation exposure in these young children with the hope that late effects would be minimized. We now describe the late effects in 102 consecutive patients surviving a minimum of 5 years (median follow-up, 12.9 years) post-CBT. Patients were conditioned with high-dose chemotherapy using Bu-containing regimens. No patient received total body irradiation. The median age at transplant was 1 year (range, .1 to 2). Diagnoses included inherited metabolic diseases (59.8%), leukemia (17.6%), congenital immune deficiency (20.2%), bone marrow failure/myelodysplastic syndrome (3.9%), and hemoglobinopathy (2%). Among patients surviving 5 years, the overall survival rate at 10 years post-CBT was 93% (95% CI, 84.9 to 96.8). Virtually all patients (98%) experienced at least 1 significant late effect. Most (83.3%) experienced 2 or more late effects, and more than half of the patients (64.7%) experienced 3 or more late effects. The most commonly observed late effects included dental problems (92.2%), short stature (55.9%), cognitive deficits (53.6%), pulmonary dysfunction (18.6%), and abnormal pubertal development (27.9%). This is the first report of late effects of Bu-based conditioning in a cohort of very young patients at the time of transplant. These results will inform clinical care guidelines for long-term follow-up and add to the growing information regarding outcomes of hematopoietic stem cell transplantation. PMID:27264632

  18. Allogeneic transplantation with myeloablative FluBu4 conditioning improves survival compared to reduced intensity FluBu2 conditioning for acute myeloid leukemia in remission.

    PubMed

    Magenau, John M; Braun, Thomas; Reddy, Pavan; Parkin, Brian; Pawarode, Attaphol; Mineishi, Shin; Choi, Sung; Levine, John; Li, Yumeng; Yanik, Gregory; Kitko, Carrie; Churay, Tracey; Frame, David; Riwes, Mary Mansour; Harris, Andrew; Bixby, Dale; Couriel, Daniel R; Goldstein, Steven C

    2015-06-01

    The optimal intensity of conditioning for allogeneic hematopoietic stem cell transplantation (HCT) in acute myeloid leukemia (AML) remains undefined. Traditionally, myeloablative conditioning regimens improve disease control, but at the risk of greater nonrelapse mortality. Because fludarabine with myeloablative doses of intravenous busulfan using pharmacokinetic monitoring has excellent tolerability, we reasoned that this regimen would limit relapse without substantially elevating toxicity when compared to reduced intensity conditioning. We retrospectively analyzed 148 consecutive AML patients in remission receiving T cell replete HCT conditioned with fludarabine and intravenous busulfan at doses defined as reduced (6.4 mg/kg; FluBu2, n = 63) or myeloablative (12.8 mg/kg; FluBu4, n = 85). Early and late nonrelapse mortality (NRM) was similar among FluBu4 and FluBu2 recipients, respectively (day + 100: 4 vs 0 %; 5 years: 19 vs 22 %; p = 0.54). NRM did not differ between FluBu4 and FluBu2 in patients >50 years of age (24 vs 22 %, p = 0.75). Relapse was lower in recipients of FluBu4 (5 years: 30 vs 49 %; p = 0.04), especially in patients with poor risk cytogenetics (22 vs 59 %; p = 0.02) and those >50 years of age (28 vs 51 %; p = 0.02). Overall survival favored FluBu4 recipients at 5 years (53 vs 34 %, p = 0.02), a finding confirmed in multivariate analysis (HR: 0.57; 95 % CI: 0.34-0.95; p = 0.03). These data suggest that myeloablative FluBu4 may provide equivalent NRM, reduced relapse, and improved survival compared to FluBu2, emphasizing the importance of busulfan dose in conditioning for AML.

  19. Cardiopulmonary exercise testing prior to myeloablative allo-SCT: a feasibility study

    PubMed Central

    Kelsey, CR; Scott, JM; Lane, A; Schwitzer, E; West, MJ; Thomas, S; Herndon, JE; Michalski, MG; Horwitz, ME; Hennig, T; Jones, LW

    2015-01-01

    The feasibility of symptom-limited cardiopulmonary exercise testing (CPET) prior to allo-SCT was assessed in addition to the prognostic value of CPET-derived measures. CPET was performed prospectively on 21 patients with hematologic malignancies, with assessments of peak (for example, peak oxygen consumption, VO2peak) and submaximal (for example, ventilatory threshold (VT)) measures of cardiopulmonary function. No serious adverse events were observed during CPET procedures, with 95% of patients achieving criteria for a peak test. Mean VO2peak was 24.7±6.4 mL kg−1min−1 (range: 10.9–35.5), equivalent to 29%±17% below that of age-matched healthy controls. All patients proceeded with the conditioning regimen followed by allo-SCT. Median follow-up was 25 months. During this period, 11 (52.4%) patients died (n = 6, relapsed disease; n = 5, non-relapse mortality (NRM)); 9 patients (43%) developed pulmonary toxicity. In univariate analyses, both peak and submaximal markers of cardiopulmonary function were predictors of OS, pulmonary toxicity and NRM. For OS, the HR for VO2peak and VT were 0.89 (95% CI, 0.8–0.99, P = 0.04) and 0.84 (95% CI, 0.71–0.98, P = 0.03), respectively. In conclusion, CPET is safe and feasible prior to allo-SCT. Patients have marked impairments in cardiopulmonary function prior to allo-SCT. CPET-derived metrics may complement conventional measures to improve risk stratification. PMID:25068429

  20. Lineage-specific chimerism analysis in nucleated cells, T cells and natural killer cells after myeloablative allogeneic hematopoietic stem cell transplantation

    PubMed Central

    Goh, Ri-Young; Kim, Sung-Hyun

    2011-01-01

    Background Chimerism analysis is an important tool for assessing the origin of hematopoietic cells after allogeneic stem cell transplantation (allo-SCT) and can be used to detect impending graft rejection and the recurrence of underlying malignant or nonmalignant diseases. Methods This study included 24 patients who underwent myeloablative allo-SCT. DNA was extracted from nucleated cells (NCs), T cells, and natural killer (NK) cells, and the chimerism status of these cell fractions was determined by STR-PCR performed using an automated fluorescent DNA analyzer. Results Twenty-three out of the 24 patients achieved engraftment. Mixed chimerism (MC) in NCs, but not in T cells and NK cells, was significantly correlated with disease relapse. MC in all cell fractions was correlated with mortality. Ten patients (41.6%) developed extensive chronic GVHD. Six patients had MC in T cells, and 3 of them had chronic GVHD. Four patients with MC and relapse received donor lymphocyte infusion (DLI), and among them, 3 had secondary relapse. Further, the chimerism status differed among different cell lineages in 6 patients with myeloid malignancies. Conclusion The implications of MC in lymphocyte subsets are an important area for future research. Chimerism analysis in lineage-specific cells permits detection of relapse and facilitates the monitoring of therapeutic interventions. These results can provide the basic data for chimerism analysis after myeloablative SCT. PMID:21461299

  1. Outcomes of HLA Matched Sibling Donor Hematopoietic Cell Transplantation in Chronic Lymphocytic Leukemia: Myeloablative vs. Reduced-Intensity Conditioning Regimens

    PubMed Central

    Sobecks, Ronald M.; Leis, Jose F.; Gale, Robert Peter; Ahn, Kwang Woo; Zhu, Xiaochun; Sabloff, Mitchell; de Lima, Marcos; Brown, Jennifer R.; Inamoto, Yoshihiro; Hale, Gregory A.; Aljurf, Mahmoud D.; Kamble, Rammurti T.; Hsu, Jack W.; Pavletic, Steven Z.; Wirk, Baldeep; Seftel, Matthew D.; Lewis, Ian D.; Alyea, Edwin P.; Cortes, Jorge; Kalaycio, Matt E.; Maziarz, Richard T.; Saber, Wael

    2014-01-01

    Purpose Allogeneic hematopoietic cell transplantation (HCT) can cure some chronic lymphocytic leukemia (CLL) subjects. This study compared outcomes of myeloablative (MA) and reduced-intensity conditioning (RIC) transplants from HLA-matched sibling donors (MSD) for CLL. Patients and Methods From 1995–2007 there were 297 CLL subjects reported to the CIBMTR who received MA (N=163) and RIC (N=134) MSD HCT. The MA subjects were less often transplanted after 2000 and less commonly received anti-thymocyte globulin (4% vs. 13%, p=0.004) or prior antibody therapy (14% vs. 53%; p<0.001). Results RIC was associated with a greater likelihood of platelet recovery and less grade 2–4 acute GvHD compared to MA conditioning. 1 and 5-year treatment related mortality (TRM) were 24% (95% confidence intervals (CI), 16–33%) vs. 37% (95% CI, 30–45%; p=0.023), and 40% (95% CI, 29–51%) vs. 54% (95% CI, 46–62%; p=0.036), and the relapse/progression rates were 21% (95% CI, 14–29%) vs. 10% (95% CI, 6–15%; p=0.020), and 35% (95% CI, 26–46%) vs. 17% (95% CI, 12–24%; p=0.003). MA conditioning was associated with better progression-free (PFS) (relative risk (RR) 0.60; 95% CI, 0.37–0.97, p=0.038) and 3-year survival in transplants before 2001, but for subsequent years RIC was associated with better PFS and survival (RR 1.49 (95% CI, 0.92–2.42), p=0.10; and RR 1.86 (95% CI, 1.11–3.13), p=0.019). Pre-transplant disease status was the most important predictor of relapse (p=0.003) and PFS (p=0.0007) for both forms of transplant conditioning. Conclusion MA and RIC MSD transplants are effective for CLL. Future strategies to decrease TRM and reduce relapses are warranted. PMID:24880021

  2. Myeloablative transplantation using either cord blood or bone marrow leads to immune recovery, high long-term donor chimerism and excellent survival in chronic granulomatous disease.

    PubMed

    Tewari, Priti; Martin, Paul L; Mendizabal, Adam; Parikh, Suhag H; Page, Kristin M; Driscoll, Timothy A; Malech, Harry L; Kurtzberg, Joanne; Prasad, Vinod K

    2012-09-01

    The curative potential of hematopoietic stem cell transplantation in patients with chronic granulomatous disease depends on availability of a suitable donor, successful donor engraftment, and maintenance of long-term donor chimerism. Twelve consecutive children (median age, 59.5 months; range, 8-140 months) with severe chronic granulomatous disease (serious bacterial/fungal infections pretransplantation; median, 3; range, 2-9) received myeloablative hematopoietic stem cell transplantation using sibling bone marrow ([SibBM]; n = 5), unrelated cord blood (UCB; n = 6), and sibling cord blood (n = 1) at our center between 1997 and 2010. SibBM and sibling cord blood were HLA matched at 6/6, whereas UCB were 5/6 (n = 5) or 6/6 (n = 1). Recipients of SibBM were conditioned with busulfan and cyclophosphamide ± anti-thymocyte globulin (ATG), whereas 6 of 7 cord blood recipients received fludarabine/busulfan/cyclophosphamide/ATG. Seven patients received granulocyte-colony stimulating factor-mobilized granulocyte transfusions from directed donors. The first 2 UCB recipients had primary graft failure but successfully underwent retransplantation with UCB. Highest acute graft-versus-host disease was grade III (n = 1). Extensive chronic graft-vs-host disease developed in 3 patients. All patients are alive with median follow-up of 70.5 months (range, 12-167 months) with high donor chimerism (>98%, n = 10; 94%, n = 1; and 92%, n = 1). Myeloablative hematopoietic stem cell transplantation led to correction of neutrophil dysfunction, durable donor chimerism, excellent survival, good quality of life, and low incidence of graft-vs-host disease regardless of graft source.

  3. Comparison of Radiation Dose Estimation for Myeloablative Radioimmunotherapy for Relapsed or Recurrent Mantle Cell Lymphoma using 131I Tositumomab to that of Other Types of Non-Hodgkin's Lymphoma

    SciTech Connect

    Rajendran, Joseph G.; Gopal, Ajay K.; Durack, Larry; Fisher, Darrell R.; Press, Oliver W.; Eary, Janet F.

    2004-12-01

    Patients with relapsed or refractory mantle cell lymphoma (MCL) demonstrate poor survival after standard treatment. Myeloablative radioimmunotherapy (RIT) using 131I tositumomab (anti-CD20) has the ability to deliver specific radiation absorbed dose to antigen bearing tumor. We reviewed normal organ radiation absorbed doses in MCL patients. METHODS: Records of patients with MCL (n = 25), who received myeloablative RIT between January 1996 and December 2003 were reviewed. Individual patient radiation dosimetry was performed on all patients after a trace labeled infusion of 131I tositumomab (mean = 348 MBq), to calculate the required amount of radioactivity for therapy, based on MIRD schema. RESULTS: Mean organ residence times (hr) corrected for CT derived organ volumes for MCL, were as follows: Lungs:9.0; Liver:12.4; Kidneys:1.7; Spleen:2.17; Whole Body:62.4 and mean radiation absorbed doses mGy/Mbq were: Lungs:1.2; Liver:1.1; Kidneys:0.85; Spleen:1.7; Whole Body: 0.21. This is similar to patients with other NHL. Patients received a mean activity of 21 GBq of 131I (range = 11.5 - 41.4) for therapy estimated to deliver 25 Gy to the normal organ receiving the highest radiation absorbed dose. CONCLUSION: Myeloablative RIT using 131I tositumomab results in normal organ radiation absorbed doses similar to those in patients with other non-Hodgkin's lymphoma, and is suitable for treating patients with relapsed or refractory MCL.

  4. Total Body Irradiation-Based Myeloablative Haploidentical Stem Cell Transplantation Is a Safe and Effective Alternative to Unrelated Donor Transplantation in Patients Without Matched Sibling Donors.

    PubMed

    Solomon, Scott R; Sizemore, Connie A; Sanacore, Melissa; Zhang, Xu; Brown, Stacey; Holland, H Kent; Morris, Lawrence E; Bashey, Asad

    2015-07-01

    We enrolled 30 patients on a prospective phase II trial utilizing a total body irradiation (TBI)-based myeloablative preparative regimen (fludarabine 30 mg/m2/day × 3 days and TBI 150 cGy twice per day on day -4 to -1 [total dose 1200 cGy]) followed by infusion of unmanipulated peripheral blood stem cells from a haploidentical family donor (haplo). Postgrafting immunosuppression consisted of cyclophosphamide 50 mg/kg/day on days 3 and 4, mycophenolate mofetil through day 35, and tacrolimus through day 180. Median patient age was 46.5 years (range, 24 to 60). Transplantation diagnosis included acute myelogenous leukemia (n = 16), acute lymphoblastic leukemia (n = 6), chronic myelogenous leukemia (n = 5), myelodysplastic syndrome (n = 1), and non-Hodgkin's lymphoma (n = 2). Using the Dana Farber/Center for International Blood and Marrow Transplant Research/Disease Risk Index (DRI), patients were classified as low (n = 4), intermediate (n = 12), high (n = 11), and very high (n = 3) risk. All patients engrafted with a median time to neutrophil and platelet recovery of 16 and 25 days, respectively. All evaluable patients achieved sustained complete donor T cell and myeloid chimerism by day +30. Acute graft-versus-host disease (GVHD) grades II to IV and III and IV was seen in 43% and 23%, respectively. The cumulative incidence of chronic GVHD was 56% (severe in 10%). After a median follow-up of 24 months, the estimated 2-year overall survival (OS), disease-free survival (DFS), nonrelapse mortality, and relapse rate were 78%, 73%, 3%, and 24%, respectively. Two-year DFS and relapse rate in patients with low/intermediate risk disease was 100% and 0%, respectively, compared with 39% and 53% for patients with high/very high risk disease. When compared with a contemporaneously treated cohort of patients at our institution receiving myeloablative HLA-matched unrelated donor (MUD) transplantation (acute myelogenous leukemia [n = 17], acute lymphoblastic leukemia [n = 15

  5. Evaluation of immunomodulatory treatment based on conventional and lineage-specific chimerism analysis in patients with myeloid malignancies after myeloablative allogeneic hematopoietic cell transplantation.

    PubMed

    Zeiser, R; Spyridonidis, A; Wäsch, R; Ihorst, G; Grüllich, C; Bertz, H; Finke, J

    2005-05-01

    Both conventional chimerism analysis (CCA) and lineage-specific chimerism analysis (LCA) have potential pitfalls as diagnostic means for the detection of minimal residual disease after allogeneic hematopoietic cell transplantation (aHCT). Therefore, the present study examines the results of both methods in order to determine how predictive consecutive evaluations were, with respect to the risk that the patient would relapse during post-transplant follow-up and with respect to responsiveness to immunomodulatory treatment. A total of 168 individuals with acute myeloid leukemia (AML) (n = 137) and myelo dysplastic syndrome (n = 31) were investigated with CCA and LCA at mean intervals of 24 days (range: 11-116). The median follow-up after myeloablative aHCT was 22 months (range: 4-49). Of 168 patients, 65 experienced a clinical relapse after aHCT. CCA and LCA were comparatively sensitive and specific for relapse at the intervals of chimerism testing employed in this study. Of 32 patients, 10 who were offered donor lymphocyte infusions (DLI) treatment for increasing (n = 29) or stable (n = 3) mixed chimerism (MC) achieved at least transitory CC. The observation that all patients with increasing MC relapsed despite DLI treatment (54%) or withdrawal of immune suppression (24%) indicates that novel strategies to deal with rapidly evolving relapse in AML patients, such as shortening of chimerism monitoring intervals, need to be evaluated.

  6. 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

  7. 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.

  8. Non-myeloablative Allogeneic Hematopoietic Stem Cell Transplantation for Adults with Relapsed and Refractory Mantle Cell Lymphoma: A Single Center Analysis in the Rituximab Era

    PubMed Central

    Mussetti, Alberto; Devlin, Sean M.; Castro-Malaspina, Hugo R; Barker, Juliet N.; Giralt, Sergio A.; Zelenetz, Andrew D.

    2015-01-01

    Relapsed and refractory (rel/ref) mantle cell lymphoma (MCL) portends a dismal prognosis. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) represents the only potentially curative therapy in this setting. We analyzed survival outcomes of 29 recipients of non-myeloablative allo-HSCT for rel/ref MCL, and studied possible prognostic factors in this setting. The cumulative incidence of disease progression and non-relapse mortality at 3 years were 28% (95% confidence interval [CI]: 13-46%) and 29% (95%CI: 13-47%), respectively. The cumulative incidence of grade II-IV acute graft-versus-host disease (GVHD) at days +100 and +180 were 34% (95%CI: 18-52%) and 45% (95%CI: 26-62%), respectively. With a median follow-up in survivors of 53 (range 24-83) months, the 3-year overall survival (OS) and progression-free survival (PFS) were 54% (95%CI: 38-76%) and 41% (95%CI: 26-64%), respectively. In vivo T-cell depletion with alemtuzumab (n=6) was associated with inferior 3-year PFS (0% vs. 51%, p=0.007) and OS (17% vs. 64%, p=0.014). Conversely, a second line international prognostic index (sIPI) at transplantation equal to 0 (no risk factors) was associated with an improved 3-year PFS (52% vs. 22%, p=0.020) and OS (71% vs. 22%, p=0.006) compared to sIPI ≥1. Performing an allo-HSCT before 2007 was associated with a decreased 3-year OS (25% vs. 76%, p=0.015) but not with a significantly inferior PFS (17% vs. 59%, p=0.058). In this single center series, we report encouraging results with allo-HSCT for patients with rel/ref MCL. High alemtuzumab doses should probably be avoided in this context. PMID:26146802

  9. 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.

  10. Low relapse without excessive transplant related mortality following myeloablative cord blood transplantation for acute leukemia in complete remission: a matched cohort analysis

    PubMed Central

    Gutman, Jonathan A; Leisenring, Wendy; Appelbaum, Frederick R; Woolfrey, Ann E; Delaney, Colleen

    2009-01-01

    Growing evidence supports the efficacy of cord blood transplantation (CBT), and the number of CBTs is increasing. Numerous studies confirm the presence of a graft-versus-leukemia effect following CBT, and preliminary data suggests that double unit CBT may be associated with a decreased risk of relapse. We have observed a low relapse rate following CBT among patients with acute leukemias in morphologic CR at the time of myeloablative transplant. To further assess this observation we conducted a matched cohort analysis comparing relapse rates and outcomes for patients receiving CBTs versus patients receiving matched unrelated donor (MURD) and mismatched unrelated donor (MMURD) transplants at our center. Thirty-one consecutive CBT patients (ages 0.6–42, median 22) transplanted between April 2006 and June 2008 were compared to matched subjects selected on the basis of disease type and remission number, cytogenetic risk status, minimal residual disease status (MRD), time from diagnosis to first relapse (for patients beyond CR1), use of imatinib for CML and Philadelphia chromosome positive ALL patients, age, and date of transplant. With a median follow-up among surviving CBT patients of 21.1 months (range 6.6–32.6), there has been one relapse among cord patients versus eight relapses among MURD patients (p=0.018) and seven relapses among MMURD patients (p=0.019). Transplant related mortality (TRM) between cohorts is comparable. Though we have observed a high incidence of acute graft-versus-host disease (GVHD) following CBT, the incidence of National Institutes of Health (NIH) consensus criteria chronic GVHD has been low. These data support increased investigation of the use of CBT. PMID:19660726

  11. 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 Central

    Bachanova, Veronika; Marks, David I.; Zhang, Mei-Jie; Wang, Hailin; de Lima, Marcos; Aljurf, Mahmoud D.; Arellano, Martha; Artz, Andrew S.; Bacher, Ulrike; Cahn, Jean-Yves; Chen, Yi-Bin; Copelan, Edward A.; Drobyski, William R.; Gale, Robert Peter; Greer, John P; Gupta, Vikas; Hale, Gregory A.; Kebriaei, Partow; Lazarus, Hillard M.; Lewis, Ian D.; Lewis, Victor A.; Liesveld, Jane L.; Litzow, Mark R.; Loren, Alison W.; Miller, Alan M.; Norkin, Maxim; Oran, Betul; Pidala, Joseph; Rowe, Jacob M.; Savani, Bipin N.; Saber, Wael; Vij, Ravi; Waller, Edmund K.; Wiernik, Peter H.; Weisdorf, Daniel J.

    2014-01-01

    The efficacy of reduced intensity conditioning (RIC) allogeneic hematopoietic cell transplantation (HCT) for 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 (TKI), mostly imatinib; 39% (RIC) and 49% (MAC) were MRDneg 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 was similar (RIC 39% [95% CI:27–52] vs. 35% [95% CI:270–44];p=0.62). Patients MRDpos pre-HCT had higher risk of relapse with RIC versus MAC (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 to a similar MRDneg 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 MRDpos (HR 1.6; p=0.070) increased relapse risk. RIC is a valid alternative strategy for Ph+ ALL patients ineligible for MAC and MRDneg status is preferred pre-HCT. PMID:23989431

  12. A Bortezomib-Based Regimen Offers Promising Survival and Graft-versus-Host Disease Prophylaxis in Myeloablative HLA-Mismatched and Unrelated Donor Transplantation: A Phase II Trial.

    PubMed

    Koreth, John; Kim, Haesook T; Lange, Paulina B; Bindra, Bhavjot; Reynolds, Carol G; Chammas, Marie J; Armand, Philippe; Cutler, Corey S; Ho, Vincent T; Glotzbecker, Brett; Nikiforow, Sarah; Ritz, Jerome; Blazar, Bruce R; Soiffer, Robert J; Antin, Joseph H; Alyea, Edwin P

    2015-11-01

    Hematopoietic stem cell transplantation (HSCT) recipients lacking HLA-matched related donors have increased graft-versus-host disease (GVHD) and nonrelapse mortality (NRM). Bortezomib added to reduced-intensity conditioning can offer benefit in T cell-replete HLA-mismatched HSCT and may also benefit myeloablative conditioning (MAC) transplants. We conducted a phase II trial of short-course bortezomib plus standard tacrolimus/methotrexate after busulfan/fludarabine MAC in 34 patients with predominantly myeloid malignancies. Fourteen (41%) received 8/8 HLA-matched unrelated donor (MUD) and 20 (59%) received 7/8 HLA-mismatched related/unrelated donor peripheral blood stem cell grafts. Median age was 49 years (range, 21 to 60), and median follow-up was 25 months (range, 11 to 36). The regimen was well tolerated. No dose modifications were required. Neutrophil and platelet engraftment occurred at a median of 14 (range, 10 to 33) and 17 (range, 10 to 54) days, respectively. Median 30-day donor chimerism was 99% (range, 90 to 100), and 100-day grades II to IV and III to IV acute GVHD incidence was 32% and 12% respectively. One-year chronic GVHD incidence was 50%. Two-year cumulative incidence of both NRM and relapse was 16%. Two-year progression-free and overall survival rates were 70% and 71%, respectively. Outcomes were comparable to an 8/8 MUD MAC cohort (n = 45). Immune reconstitution was robust. Bortezomib-based MAC HSCT is well tolerated, with HLA-mismatched outcomes comparable with 8/8 MUD MAC HSCT, and is suitable for randomized evaluation. (clinicaltrials.gov: NCT01323920.).

  13. Myeloablative Anti-CD20 Radioimmunotherapy +/- High-Dose Chemotherapy Followed by Autologous Stem Cell Support for Relapsed/Refractory B-Cell Lymphoma Results in Excellent Long-Term Survival

    PubMed Central

    Schreiber, Susanne; Schmidt, Burkhard; Wester, Hans-Jürgen; Schwaiger, Markus; Peschel, Christian; von Schilling, Christoph

    2013-01-01

    Background Radioimmunotherapy (RIT) has been used to treat relapsed/refractory CD20+ Non-Hodgkin lymphoma (NHL). Myeloablative anti-CD20 RIT followed by autologous stem cell infusion (ASCT) enables high radiation doses to lymphoma sites. We performed a phase I/II trial to assess feasibility and survival. Methods Twenty-three patients with relapsed/refractory NHL without complete remission (CR) to salvage chemotherapy were enrolled to evaluate RIT with Iodine-131 labelled rituximab (131I-rituximab) in a myeloablative setting. Biodistribution and dosimetric studies were performed to determine 131I activity required to induce a total body dose of 21-27Gy to critical organs. In 6/23 patients RIT was combined with high-dose chemotherapy. 8/23 patients received a sequential high-dose chemotherapy with a second ASCT. The median follow-up is 9.5 years. Results 6.956-19.425GBq of 131I was delivered to achieve the limiting organ dose to lungs or kidneys. No grade III/IV non-hematologic toxicity was seen with RIT alone. Significant grade III/IV toxicity (mucositis, fever, infection, one therapy related death) was observed in patients treated with RIT combined with high-dose chemotherapy. The overall response rate was 87% (64% CR). The median progression-free (PFS) and overall survival (OS) is 47.5 and 101.5 months. An international prognostic index score >1 was predictive for OS. Conclusion Myeloablative RIT with 131I-rituximab followed by ASCT is feasible, well-tolerated and effective in high risk CD20+ NHL. Combination of RIT and high-dose chemotherapy increased toxicity significantly. Long-term results for PFS and OS are encouraging. PMID:23765188

  14. Impact of outpatient non-myeloablative haematopoietic stem cell transplantation in quality of life vs. conventional therapy.

    PubMed

    Cantú-Rodríguez, Olga Graciela; Sánchez-Cárdenas, Mónica; Treviño-Montemayor, Oscar Rubén; Gutiérrez-Aguirre, Cesar Homero; Tarín-Arzaga, Luz; Jaime-Pérez, José Carlos; Gómez-Almaguer, David

    2016-01-01

    The role of outpatient hematopoietic stem cell transplantation (HSCT) as a therapeutic tool has been strengthened significantly because of the increasing number of patients undergoing this treatment. Due the very nature of this procedure, one of the aspects that should not be overlooked is the quality of life (QOL) of patients undergoing HSCT. Thus, one must consider not only health status after treatment, but also, the psychosocial implications for the patient. This is an observational, longitudinal, and prospective study to assess QOL in patients undergoing outpatient HSCT vs. similar patients receiving medical treatment (MxTx). By applying the COOP/WONKA charts on five occasions (pre-HSCT/initial, post-HSCT/first month, and at 3, 6, and 9 months), thirty-eight patients were analysed, 19 with HSCT and 19 with MxTx with no differences in age, gender or diagnosis. The initial survey found significant differences only in pain perception, which was higher in the HSCT group (p = .08); at the first month, there was a greater tendency for feelings of depression or anxiety in the HSCT group (p = .016), with more limitations in social (p = .003) and daily (p = .044) activities. From 3 months post-HSCT, the results were very similar. The differences persisted only in the area of social activities. Four patients developed graft-versus-host disease with no significant difference in the scores obtained compared to other transplant patients at 3, 6, and 9 months (p = .26) of follow-up. PMID:26125120

  15. 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. PMID:26618548

  16. Assessment of the ovarian reserve with anti-Müllerian hormone in women who underwent allogeneic hematopoietic stem cell transplantation using reduced-intensity conditioning regimens or myeloablative regimens with ovarian shielding.

    PubMed

    Nakano, Hirofumi; Ashizawa, Masahiro; Akahoshi, Yu; Ugai, Tomotaka; Wada, Hidenori; Yamasaki, Ryoko; Ishihara, Yuko; Kawamura, Koji; Sakamoto, Kana; Sato, Miki; Terasako-Saito, Kiriko; Kimura, Shun-Ichi; Kikuchi, Misato; Nakasone, Hideki; Kako, Shinichi; Kanda, Junya; Yamazaki, Rie; Tanihara, Aki; Nishida, Junji; Kanda, Yoshinobu

    2016-07-01

    Conditioning regimens that include cyclophosphamide (CY) and total body irradiation (TBI) induce severe gonadal toxicity and permanent infertility in approximately 90 % of female patients who undergo hematopoietic stem cell transplantation (HSCT). However, the use of ovarian shielding or non-myeloablative regimens may preserve ovarian function. To evaluate the ovarian reserve, serum anti-Müllerian hormone (AMH) levels were retrospectively measured in 11 female HSCT recipients aged less than 40 years, including seven with acute leukemia (AL) and four with aplastic anemia (AA), who received a myeloablative conditioning regimen with ovarian shielding or a reduced-intensity conditioning regimen. In most patients, menstruation had stopped and AMH level had decreased to an undetectable level (<0.1 ng/ml) after HSCT. Most patients showed a recovery of regular menstruation, but AMH levels did not increase immediately after the resumption of menstruation. However, in three AL patients and two AA patients who were evaluable for long-term recovery, AMH level increased gradually beyond 1 year after HSCT. In conclusion, recovery of the serum AMH level may be delayed after HSCT, and the AMH level early after HSCT may not accurately reflect ovarian reserve. A prospective study is required to address the usefulness of measuring the AMH level in HSCT recipients.

  17. Improved survival of children with advanced neuroblastoma treated by intensified therapy including myeloablative chemotherapy with stem cell transplantation: a retrospective analysis from the Tohoku Neuroblastoma Study Group.

    PubMed

    Imaizumi, M; Watanabe, A; Kikuta, A; Takano, T; Ito, E; Shimizu, T; Tsuchiya, S; Iinuma, K; Konno, T; Ohi, R; Hayashi, Y

    2001-10-01

    In the hospitals of the Tohoku Neuroblastoma Study Group (TNBSG), treatment for children with advanced neuroblastoma (NB) was intensified in the mid-1990's with the introduction of myeloablative therapy (MT) with stem cell transplantation (SCT) including the use of autologous peripheral blood stem cells (PBSC) and bone marrow transplantation (BMT). In this report, we examined whether the intensified therapy improved the outcome of children with advanced NB (age> 12 months) who were diagnosed between 1991 and 1997. Patients were 36 children (23 boys and 13 girls) with an average age of 3.4 years (range; 1 to 14 years). Six of them had stage III disease, and the other 30 had stage IV. They were treated initially with induction chemotherapy, surgery, and post-operative chemoradiotherapy, after which 17 of them continued further chemotherapy and the other 19 received MT/SCT (18 with PBSCT and 1 with BMT). Progression-free survival (PFS) rate at seven years from diagnosis was 43.5% for all patients, 66.7% for stage III patients and 38.2% for stage IV patients. The difference between stage III and IV patients was not significant. Among the 30 patients with stage IV disease, PFS at seven years was significantly higher in the 19 patients who received MT/SCT (55.6%) than in the 11 patients who did not receive it (12.5%). There was no difference in clinical and biological risk factors between these two groups, except for the proportion of patients with favorable response to initial therapy (36% and 80% for patients without and with MT/SCT, respectively). Furthermore, the proportion of patients with N-myc amplification was significantly higher in patients with progressive disease (PD) after MT/SCT than in those in CR after MT/SCT. The results of this retrospective study of children with advanced NB suggest that therapy intensification involving MT/SCT might result in lengthened survival time for patients with stage IV disease, and that post-transplant PD remains a risk for

  18. Multi-Institutional Study of Post-Transplantation Cyclophosphamide As Single-Agent Graft-Versus-Host Disease Prophylaxis After Allogeneic Bone Marrow Transplantation Using Myeloablative Busulfan and Fludarabine Conditioning

    PubMed Central

    Kanakry, Christopher G.; O'Donnell, Paul V.; Furlong, Terry; de Lima, Marcos J.; Wei, Wei; Medeot, Marta; Mielcarek, Marco; Champlin, Richard E.; Jones, Richard J.; Thall, Peter F.; Andersson, Borje S.; Luznik, Leo

    2014-01-01

    Purpose The clinical safety and efficacy of intravenous busulfan and fludarabine (IV Bu/Flu) myeloablative conditioning as well as graft-versus-host disease (GVHD) prophylaxis with high-dose, post-transplantation cyclophosphamide (PTCy) have been demonstrated independently in several single-institutional studies. We hypothesized that combining these two promising approaches in a multi-institutional study of human leukocyte antigen (HLA) -matched bone marrow transplantation would provide low rates of severe acute and chronic GVHD, low toxicity, and effective disease control. Patients and Methods Ninety-two adult patients (median age, 49 years; range, 21 to 65 years) with high-risk hematologic malignancies were enrolled at three centers (clinical trial No. NCT00809276). Forty-five patients received related allografts, and 47 received unrelated allografts. GVHD prophylaxis was solely with PTCy at 50 mg/kg/day on post-transplantation days +3 and +4. Results The cumulative incidences of grades 2 to 4 acute, grades 3 to 4 acute, and chronic GVHD were 51%, 15%, and 14%, respectively. Nonrelapse mortality (NRM) at 100 days and 1 year were 9% and 16%, respectively. With a median follow-up period of 2.2 years, the 2-year disease-free survival (DFS) and overall survival (OS) rates were 62% and 67%, respectively. Donor relatedness did not affect NRM, DFS, or OS. Patients in complete remission (CR) without evidence of minimal residual disease (MRD) had markedly better DFS (80%) and OS (80%) than patients in CR with MRD or with active disease at the time of transplantation (DFS, P = .0005; OS, P = .019). Conclusion This multi-institutional study demonstrates that PTCy can be safely and effectively combined with IV Bu/Flu myeloablative conditioning and confirms PTCy's efficacy as single-agent, short-course GVHD prophylaxis for both acute and chronic GVHD after bone marrow transplantation from HLA-matched donors. PMID:25267759

  19. Improved Outcome of Refractory/Relapsed Acute Myeloid Leukemia after Post-Transplantation Cyclophosphamide-Based Haploidentical Transplantation with Myeloablative Conditioning and Early Prophylactic Granulocyte Colony-Stimulating Factor-Mobilized Donor Lymphocyte Infusions.

    PubMed

    Jaiswal, Sarita Rani; Zaman, Shamsuz; Chakrabarti, Aditi; Sen, Subrata; Mukherjee, Shashwata; Bhargava, Sneh; Ray, Kunal; O'Donnell, Paul V; Chakrabarti, Suparno

    2016-10-01

    We carried out post-transplantation cyclophosphamide (PTCy)-based haploidentical peripheral blood stem cell transplantation in 51 patients with refractory/relapsed acute myeloid leukemia not in remission. The first 10 patients received nonmyeloablative conditioning followed by planned granulocyte colony-stimulating factor (G-CSF)-mobilized donor lymphocyte infusions (DLIs) on days 35, 60, and 90. No patient developed graft-versus-host disease (GVHD), but 90% had disease progression between 3 and 6 months. A subsequent 41 patients received myeloablative conditioning (MAC); the first 20 patients did not receive DLIs (MAC group) and the next 21 patients received G-CSF-mobilized DLIs (G-DLI) on days 21, 35, and 60 (MAC-DLI group). The incidence of disease progression and progression-free survival at 18 months were 66% and 25% in the MAC group compared with 21.4% and 61.9% in the MAC-DLI group (P = .01). Chronic GVHD but not acute GVHD was increased in the MAC-DLI group (41.2% versus 11%, P = .05). Natural killer cell alloreactive donor was associated with lower incidence of disease progression in the MAC but not in MAC-DLI group. The only factor favorably influencing disease progression and progression-free survival was administration of G-DLI after myeloablative conditioning. Our study shows that early administration of G-DLI is feasible after PTCy-based haploidentical hematopoietic stem cell transplantation for refractory/relapsed acute myeloid leukemia and might be associated with improved survival after MAC. PMID:27470289

  20. Myeloablative 131I-Tositumomab Radioimmunotherapy in Treating Non-Hodgkin’s Lymphoma: Comparison of Dosimetry Based on Whole-Body Retention and Dose to Critical Organ Receiving the Highest Dose

    SciTech Connect

    Rajendran, Joseph G.; Gopal, Ajay K.; Fisher, Darrell R.; Durack, L. D.; Gooley, Ted; Press, Oliver W.

    2008-05-01

    Objectives: Myeloablative radioimmunotherapy (RIT) using 131I tositumomab (anti-CD 20) monoclonal antibodies is an effective new therapy for B-cell non-Hodgkins lymphoma (NHL). The goal of this work is to determine optimum methods to deliver maximal myeloablative radioactivity without exceeding the radiation tolerance of critical normal organs such as liver and lungs, and avoiding serious toxicity. Methods: We reviewed dosimetry records for 100 consecutive patients who underwent biodistribution and dosimetry after a test infusion of 131I- tositumomab. Serial gamma camera images were used to determine organ and tissue activities over time and to calculate radiation-absorbed doses. Volumes of critical normal organs were determined from CT scans to adjust the dose estimates for the individual patient. These dose estimates helped us determine an appropriate therapy based on projected dose to the critical normal organ receiving a maximum tolerable radiation dose. We compared our method of organ-specific dosimetry for treatment planning with the standard clinical approaches using a whole-body dose-assessment method by assessing the difference in projected amounts of radiation-absorbed doses, as well as the ratios of projected amounts, that would be prescribed for therapy by each of these two strategies. Results: The mean organ doses (mGy/MBq) estimated by both methods were (1) Whole body method: liver = 0.33 and lungs = 0.33; and (2) Organ-specific method: liver 1.52 and lungs 1.72 (p = .0001). The median difference between the radiation-absorbed dose estimates was 3.40 (range of 1.37 to 7.96) for the lungs, 3.05 (range of 1.04 to 6.20) for the liver, and –0.05 for whole body (range of –0.18 to 0.16). The median ratio (OS divided by WB method) of radiation-absorbed dose estimates was 5.12 (range of 2.33 to 10.01) for the lungs, 4.14 (range of 2.16 to 6.67) for the liver, and 0.94 (range of 0.79 to 1.22) for whole body. There was significant difference between the

  1. Dental Procedures.

    PubMed

    Ramponi, Denise R

    2016-01-01

    Dental problems are a common complaint in emergency departments in the United States. There are a wide variety of dental issues addressed in emergency department visits such as dental caries, loose teeth, dental trauma, gingival infections, and dry socket syndrome. Review of the most common dental blocks and dental procedures will allow the practitioner the opportunity to make the patient more comfortable and reduce the amount of analgesia the patient will need upon discharge. Familiarity with the dental equipment, tooth, and mouth anatomy will help prepare the practitioner for to perform these dental procedures. PMID:27482994

  2. Thiotepa-based versus total body irradiation-based myeloablative conditioning prior to allogeneic stem cell transplantation for acute myeloid leukaemia in first complete remission: a retrospective analysis from the Acute Leukemia Working Party of the European Group for Blood and Marrow Transplantation.

    PubMed

    Eder, Sandra; Labopin, Myriam; Arcese, William; Or, Reuven; Majolino, Ignazio; Bacigalupo, Andrea; de Rosa, Gennaro; Volin, Liisa; Beelen, Dietrich; Veelken, Hendrik; Schaap, Nicolaas P M; Kuball, Jurgen; Cornelissen, Jan; Nagler, Arnon; Mohty, Mohamad

    2016-01-01

    Thiotepa is an alkylating compound with an antineoplastic and myeloablative activity and can mimic the effect of radiation. However, it is unknown whether this new regimen could safely replace the long-established ones. This retrospective matched-pair analysis evaluated the outcome of adults with acute myeloid leukaemia in first complete remission who received myeloablative conditioning either with a thiotepa-based (n = 121) or a cyclophosphamide/total body irradiation-based (TBI; n = 358) regimen for allogeneic hematopoietic stem cell transplantation from an HLA-matched sibling or an unrelated donor. With a median follow-up of 44 months, the outcome was similar in both groups. Acute graft-versus-host disease grade II-IV was observed in 25% after thiotepa-containing regimen versus 35% after TBI (P = 0.06). The 2-yr cumulative incidence of chronic graft-versus-host disease was 40.5% for thiotepa and 41% for TBI (P = 0.98). At 2 yrs, the cumulative incidences of non-relapse mortality and relapse incidence were 23.9% (thiotepa) vs. 22.4% (TBI; P = 0.66) and 17.2% (thiotepa) vs. 23.3% (TBI; P = 0.77), respectively. The probabilities of leukaemia-free and overall survival at 2 yrs were not significantly different between the thiotepa and TBI groups, at 58.9% vs. 54.2% (P = 0.95) and 61.4% vs. 58% (P = 0.72), respectively. Myeloablative regimens using combinations including thiotepa can provide satisfactory outcomes, but the optimal conditioning remains unclear for the individual patient in this setting.

  3. Procedural knowledge

    SciTech Connect

    Georgeff, M.P.; Lansky, A.L.

    1986-10-01

    Much of commonsense knowledge about the real world is in the form of procedures or sequences of actions for achieving particular goals. In this paper, a formalism is presented for representing such knowledge using the notion of process. A declarative semantics for the representation is given, which allows a user to state facts about the effects of doing things in the problem domain of interest. An operational semantics is also provided, which shows how this knowledge can be used to achieve particular goals or to form intentions regarding their achievement. Given both semantics, our formalism additionally serves as an executable specification language suitable for constructing complex systems. A system based on this formalism is described, and examples involving control of an autonomous robot and fault diagnosis for NASA's space shuttle are provided.

  4. Human leukocyte antigen supertype matching after myeloablative hematopoietic cell transplantation with 7/8 matched unrelated donor allografts: a report from the Center for International Blood and Marrow Transplant Research

    PubMed Central

    Lazaryan, Aleksandr; Wang, Tao; Spellman, Stephen R.; Wang, Hai-Lin; Pidala, Joseph; Nishihori, Taiga; Askar, Medhat; Olsson, Richard; Oudshoorn, Machteld; Abdel-Azim, Hisham; Yong, Agnes; Gandhi, Manish; Dandoy, Christopher; Savani, Bipin; Hale, Gregory; Page, Kristin; Bitan, Menachem; Reshef, Ran; Drobyski, William; Marsh, Steven GE; Schultz, Kirk; Müller, Carlheinz R.; Fernandez-Viña, Marcelo A.; Verneris, Michael R.; Horowitz, Mary M.; Arora, Mukta; Weisdorf, Daniel J.; Lee, Stephanie J.

    2016-01-01

    The diversity of the human leukocyte antigen (HLA) class I and II alleles can be simplified by consolidating them into fewer supertypes based on functional or predicted structural similarities in epitope-binding grooves of HLA molecules. We studied the impact of matched and mismatched HLA-A (265 versus 429), -B (230 versus 92), -C (365 versus 349), and -DRB1 (153 versus 51) supertypes on clinical outcomes of 1934 patients with acute leukemias or myelodysplasia/myeloproliferative disorders. All patients were reported to the Center for International Blood and Marrow Transplant Research following single-allele mismatched unrelated donor myeloablative conditioning hematopoietic cell transplantation. Single mismatched alleles were categorized into six HLA-A (A01, A01A03, A01A24, A02, A03, A24), six HLA-B (B07, B08, B27, B44, B58, B62), two HLA-C (C1, C2), and five HLA-DRB1 (DR1, DR3, DR4, DR5, DR9) supertypes. Supertype B mismatch was associated with increased risk of grade II–IV acute graft-versus-host disease (hazard ratio =1.78, P=0.0025) compared to supertype B match. Supertype B07-B44 mismatch was associated with a higher incidence of both grade II–IV (hazard ratio=3.11, P=0.002) and III–IV (hazard ratio=3.15, P=0.01) acute graft-versus-host disease. No significant associations were detected between supertype-matched versus -mismatched groups at other HLA loci. These data suggest that avoiding HLA-B supertype mismatches can mitigate the risk of grade II–IV acute graft-versus-host disease in 7/8-mismatched unrelated donor hematopoietic cell transplantation when multiple HLA-B supertype-matched donors are available. Future studies are needed to define the mechanisms by which supertype mismatching affects outcomes after alternative donor hematopoietic cell transplantation. PMID:27247320

  5. 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, Richard; Doocey, R; 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.

  6. Comparison of Outcomes for Pediatric Patients With Acute Myeloid Leukemia in Remission and Undergoing Allogeneic Hematopoietic Cell Transplantation With Myeloablative Conditioning Regimens Based on Either Intravenous Busulfan or Total Body Irradiation: A Report From the Japanese Society for Hematopoietic Cell Transplantation.

    PubMed

    Ishida, Hiroyuki; Kato, Motohiro; Kudo, Kazuko; Taga, Takashi; Tomizawa, Daisuke; Miyamura, Takako; Goto, Hiroaki; Inagaki, Jiro; Koh, Katsuyoshi; Terui, Kiminori; Ogawa, Atsushi; Kawano, Yoshifumi; Inoue, Masami; Sawada, Akihisa; Kato, Koji; Atsuta, Yoshiko; Yamashita, Takuya; Adachi, Souichi

    2015-12-01

    Pediatric patients with acute myeloid leukemia (AML) mainly receive myeloablative conditioning regimens based on busulfan (BU) or total body irradiation (TBI) before allogeneic hematopoietic cell transplantation (allo-HCT); however, the optimal conditioning regimen remains unclear. To identify which of these regimens is better for pediatric patients, we performed a retrospective analysis of nationwide registration data collected in Japan between 2006 and 2011 to assess the outcomes of patients receiving these regimens before a first allo-HCT. Myeloablative conditioning regimens based on i.v. BU (i.v. BU-MAC) (n = 69) or TBI (TBI-MAC) (n = 151) were compared in pediatric AML patients in first or second complete remission (CR1/CR2). The incidences of sinusoid obstruction syndrome, acute and chronic graft-versus-host disease, and early nonrelapse mortality (NRM) before day 100 were similar for both conditioning groups; however, the incidence of bacterial infection during the acute period was higher in the TBI-MAC group (P = .008). Both groups showed a similar incidence of NRM, and there was no significant difference in the incidence of relapse between the groups. Univariate and multivariate analyses revealed no significant differences in the 2-year relapse-free survival rates for the i.v. BU-MAC and TBI-MAC groups in the CR1/CR2 setting (71% versus 67%, P = .36; hazard ratio, .73; 95% CI, .43 to 1.24, respectively). TBI-MAC was no better than i.v. BU-MAC for pediatric AML patients in remission. Although this retrospective registry-based analysis has several limitations, i.v. BU-MAC warrants further evaluation in a prospective trial. PMID:26271192

  7. Comparison of Outcomes for Pediatric Patients With Acute Myeloid Leukemia in Remission and Undergoing Allogeneic Hematopoietic Cell Transplantation With Myeloablative Conditioning Regimens Based on Either Intravenous Busulfan or Total Body Irradiation: A Report From the Japanese Society for Hematopoietic Cell Transplantation.

    PubMed

    Ishida, Hiroyuki; Kato, Motohiro; Kudo, Kazuko; Taga, Takashi; Tomizawa, Daisuke; Miyamura, Takako; Goto, Hiroaki; Inagaki, Jiro; Koh, Katsuyoshi; Terui, Kiminori; Ogawa, Atsushi; Kawano, Yoshifumi; Inoue, Masami; Sawada, Akihisa; Kato, Koji; Atsuta, Yoshiko; Yamashita, Takuya; Adachi, Souichi

    2015-12-01

    Pediatric patients with acute myeloid leukemia (AML) mainly receive myeloablative conditioning regimens based on busulfan (BU) or total body irradiation (TBI) before allogeneic hematopoietic cell transplantation (allo-HCT); however, the optimal conditioning regimen remains unclear. To identify which of these regimens is better for pediatric patients, we performed a retrospective analysis of nationwide registration data collected in Japan between 2006 and 2011 to assess the outcomes of patients receiving these regimens before a first allo-HCT. Myeloablative conditioning regimens based on i.v. BU (i.v. BU-MAC) (n = 69) or TBI (TBI-MAC) (n = 151) were compared in pediatric AML patients in first or second complete remission (CR1/CR2). The incidences of sinusoid obstruction syndrome, acute and chronic graft-versus-host disease, and early nonrelapse mortality (NRM) before day 100 were similar for both conditioning groups; however, the incidence of bacterial infection during the acute period was higher in the TBI-MAC group (P = .008). Both groups showed a similar incidence of NRM, and there was no significant difference in the incidence of relapse between the groups. Univariate and multivariate analyses revealed no significant differences in the 2-year relapse-free survival rates for the i.v. BU-MAC and TBI-MAC groups in the CR1/CR2 setting (71% versus 67%, P = .36; hazard ratio, .73; 95% CI, .43 to 1.24, respectively). TBI-MAC was no better than i.v. BU-MAC for pediatric AML patients in remission. Although this retrospective registry-based analysis has several limitations, i.v. BU-MAC warrants further evaluation in a prospective trial.

  8. 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.

  9. 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.

  10. Public Sector Impasse Procedures.

    ERIC Educational Resources Information Center

    Vadakin, James C.

    The subject of collective bargaining negotiation impasse procedures in the public sector, which includes public school systems, is a broad one. In this speech, the author introduces the various procedures, explains how they are used, and lists their advantages and disadvantages. Procedures discussed are mediation, fact-finding, arbitration,…

  11. Developing policies and procedures.

    PubMed

    Randolph, Susan A

    2006-11-01

    The development of policies and procedures is an integral part of the occupational health nurse's role. Policies and procedures serve as the foundation for the occupational health service and are based on its vision, mission, culture, and values. The design and layout selected for the policies and procedures should be simple, consistent, and easy to use. The same format should be used for all existing and new policies and procedures. Policies and procedures should be reviewed periodically based on a specified time frame (i.e., annually). However, some policies may require a more frequent review if they involve rapidly changing external standards, ethical issues, or emerging exposures. PMID:17124968

  12. 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.

  13. Procedural pediatric dermatology.

    PubMed

    Metz, Brandie J

    2013-04-01

    Due to many factors, including parental anxiety, a child's inability to understand the necessity of a procedure and a child's unwillingness to cooperate, it can be much more challenging to perform dermatologic procedures in children. This article reviews pre-procedural preparation of patients and parents, techniques for minimizing injection-related pain and optimal timing of surgical intervention. The risks and benefits of general anesthesia in the setting of pediatric dermatologic procedures are discussed. Additionally, the surgical approach to a few specific types of birthmarks is addressed.

  14. 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…

  15. Useful Procedures of Inquiry.

    ERIC Educational Resources Information Center

    Handy, Rollo; Harwood, E. C.

    This book discusses and analyzes the many different procedures of inquiry, both old and new, which have been used in an attempt to solve the problems men encounter. Section A examines some outmoded procedures of inquiry, describes scientific inquiry, and presents the Dewey-Bentley view of scientific method. Sections B and C, which comprise the…

  16. Minimally invasive procedures

    PubMed Central

    Baltayiannis, Nikolaos; Michail, Chandrinos; Lazaridis, George; Anagnostopoulos, Dimitrios; Baka, Sofia; Mpoukovinas, Ioannis; Karavasilis, Vasilis; Lampaki, Sofia; Papaiwannou, Antonis; Karavergou, Anastasia; Kioumis, Ioannis; Pitsiou, Georgia; Katsikogiannis, Nikolaos; Tsakiridis, Kosmas; Rapti, Aggeliki; Trakada, Georgia; Zissimopoulos, Athanasios; Zarogoulidis, Konstantinos

    2015-01-01

    Minimally invasive procedures, which include laparoscopic surgery, use state-of-the-art technology to reduce the damage to human tissue when performing surgery. Minimally invasive procedures require small “ports” from which the surgeon inserts thin tubes called trocars. Carbon dioxide gas may be used to inflate the area, creating a space between the internal organs and the skin. Then a miniature camera (usually a laparoscope or endoscope) is placed through one of the trocars so the surgical team can view the procedure as a magnified image on video monitors in the operating room. Specialized equipment is inserted through the trocars based on the type of surgery. There are some advanced minimally invasive surgical procedures that can be performed almost exclusively through a single point of entry—meaning only one small incision, like the “uniport” video-assisted thoracoscopic surgery (VATS). Not only do these procedures usually provide equivalent outcomes to traditional “open” surgery (which sometimes require a large incision), but minimally invasive procedures (using small incisions) may offer significant benefits as well: (I) faster recovery; (II) the patient remains for less days hospitalized; (III) less scarring and (IV) less pain. In our current mini review we will present the minimally invasive procedures for thoracic surgery. PMID:25861610

  17. Short Nuss bar procedure

    PubMed Central

    2016-01-01

    The Nuss procedure is now the preferred operation for surgical correction of pectus excavatum (PE). It is a minimally invasive technique, whereby one to three curved metal bars are inserted behind the sternum in order to push it into a normal position. The bars are left in situ for three years and then removed. This procedure significantly improves quality of life and, in most cases, also improves cardiac performance. Previously, the modified Ravitch procedure was used with resection of cartilage and the use of posterior support. This article details the new modified Nuss procedure, which requires the use of shorter bars than specified by the original technique. This technique facilitates the operation as the bar may be guided manually through the chest wall and no additional stabilizing sutures are necessary. PMID:27747185

  18. Dynamic alarm response procedures

    SciTech Connect

    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 Graphics (SVG), such as Netscape{sup R}, Microsoft Internet Explorer{sup R}, Mozilla Firefox{sup R}, Opera{sup R}, and others. (authors)

  19. Cardiac ablation procedures

    MedlinePlus

    ... the heart. During the procedure, small wires called electrodes are placed inside your heart to measure your ... is in place, your doctor will place small electrodes in different areas of your heart. These electrodes ...

  20. Common Interventional Radiology Procedures

    MedlinePlus

    ... of common interventional techniques is below. Common Interventional Radiology Procedures Angiography An X-ray exam of the ... into the vertebra. Copyright © 2016 Society of Interventional Radiology. All rights reserved. 3975 Fair Ridge Drive • Suite ...

  1. 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. PMID:3349241

  2. Safety referral procedures clarified.

    PubMed

    2014-12-01

    Two types of referrals are available for the purpose of harmonising pharmacovigilance decisions across the EU: the urgent procedure and the "normal" procedure. In both cases, the Pharmacovigilance Risk Assessment Committee (PRAC) issues a recommendation that the marketing authorisation committees concerned must take into account when formulating their opinions. If Member States disagree in their decisions, a final referral is available, although it lacks transparency. The European Commission's final decision is binding on all Member States. PMID:25629154

  3. 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.

  4. Megatherapy combining I(131) metaiodobenzylguanidine and high-dose chemotherapy with haematopoietic progenitor cell rescue for neuroblastoma.

    PubMed

    Miano, M; Garaventa, A; Pizzitola, M R; Piccolo, M S; Dallorso, S; Villavecchia, G P; Bertolazzi, C; Cabria, M; De Bernardi, B

    2001-03-01

    Despite the use of aggressive chemotherapy, stage 4 high risk neuroblastoma still has very poor prognosis which is estimated at 25%. Metabolic radiotherapy with I(131) MIBG appears a feasible option to enhance the effects of chemotherapy. Seventeen patients having MIBG-positive residual disease received 4.1-11.1 mCi/kg of I(131) MIBG 7-10 days before initiating the high-dose chemotherapy cycle consisting of busulphan 16 mg/kg and melphalan 140 mg/m(2) followed by PBSC infusion. We compared the toxicity in these patients to that seen in 15 control subjects with neuroblastoma who underwent a PBSC transplant without MIBG therapy. We observed greater toxic involvement of the gastrointestinal system in children treated with I(131) MIBG: grade 2 or 3 mucositis developed in 13/17 patients treated with I(131) MIBG and in 9/15 treated without it. Grade 1-2 gastrointestinal toxicity occurred in 12/17 children given MIBG and in 5/15 of the controls. One child receiving I(131) MIBG developed transient interstitial pneumonia. Another child who also received I(131) MIBG after PBSC rescue developed fatal pneumonia after the third course of metabolic radiotherapy. Our experience indicates that MIBG can be included in the high-dose chemotherapy regimens followed by PBSC rescue for children with residual neuroblastoma taking up MIBG. Attention should be paid to avoiding lung complications. Prospective studies are needed to demonstrate the real efficacy of this treatment.

  5. Mobile Energy Laboratory Procedures

    SciTech Connect

    Armstrong, P.R.; Batishko, C.R.; Dittmer, A.L.; Hadley, D.L.; Stoops, J.L.

    1993-09-01

    Pacific Northwest Laboratory (PNL) has been tasked to plan and implement a framework for measuring and analyzing the efficiency of on-site energy conversion, distribution, and end-use application on federal facilities as part of its overall technical support to the US Department of Energy (DOE) Federal Energy Management Program (FEMP). The Mobile Energy Laboratory (MEL) Procedures establish guidelines for specific activities performed by PNL staff. PNL provided sophisticated energy monitoring, auditing, and analysis equipment for on-site evaluation of energy use efficiency. Specially trained engineers and technicians were provided to conduct tests in a safe and efficient manner with the assistance of host facility staff and contractors. Reports were produced to describe test procedures, results, and suggested courses of action. These reports may be used to justify changes in operating procedures, maintenance efforts, system designs, or energy-using equipment. The MEL capabilities can subsequently be used to assess the results of energy conservation projects. These procedures recognize the need for centralized NM administration, test procedure development, operator training, and technical oversight. This need is evidenced by increasing requests fbr MEL use and the economies available by having trained, full-time MEL operators and near continuous MEL operation. DOE will assign new equipment and upgrade existing equipment as new capabilities are developed. The equipment and trained technicians will be made available to federal agencies that provide funding for the direct costs associated with MEL use.

  6. 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.

  7. Arianespace streamlines launch procedures

    NASA Astrophysics Data System (ADS)

    Lenorovitch, Jeffrey M.

    1992-06-01

    Ariane has entered a new operational phase in which launch procedures have been enhanced to reduce the length of launch campaigns, lower mission costs, and increase operational availability/flexibility of the three-stage vehicle. The V50 mission utilized the first vehicle from a 50-launcher production lot ordered by Arianespace, and was the initial flight with a stretched third stage that enhances Ariane's performance. New operational procedures were introduced gradually over more than a year, starting with the V42 launch in January 1991.

  8. Mini-Bentall procedure

    PubMed Central

    2015-01-01

    An important goal in cardiovascular and thoracic surgery is reducing surgical trauma to achieve faster recovery for our patients. Mini-Bentall procedure encompasses aortic root and ascending aortic replacement with re-implantation of coronary buttons, performed via a mini-sternotomy. The skin incision extends from the angle of Louis to the third intercostal space, usually measuring 5-7 cm in length. Through this incision, it is possible to perform isolated aortic root surgery and/or hemi-arch replacement. The present illustrated article describes the technical details on how I perform a Mini-Bentall procedure with hemi-arch replacement. PMID:25870816

  9. 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 ...

  10. Preschooler test or procedure preparation

    MedlinePlus

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

  11. Simulating Laboratory Procedures.

    ERIC Educational Resources Information Center

    Baker, J. E.; And Others

    1986-01-01

    Describes the use of computer assisted instruction in a medical microbiology course. Presents examples of how computer assisted instruction can present case histories in which the laboratory procedures are simulated. Discusses an authoring system used to prepare computer simulations and provides one example of a case history dealing with fractured…

  12. Numerical Boundary Condition Procedures

    NASA Technical Reports Server (NTRS)

    1981-01-01

    Topics include numerical procedures for treating inflow and outflow boundaries, steady and unsteady discontinuous surfaces, far field boundaries, and multiblock grids. In addition, the effects of numerical boundary approximations on stability, accuracy, and convergence rate of the numerical solution are discussed.

  13. Least Squares Procedures.

    ERIC Educational Resources Information Center

    Hester, Yvette

    Least squares methods are sophisticated mathematical curve fitting procedures used in all classical parametric methods. The linear least squares approximation is most often associated with finding the "line of best fit" or the regression line. Since all statistical analyses are correlational and all classical parametric methods are least square…

  14. Advanced intrarenal ureteroscopic procedures.

    PubMed

    Monga, Manoj; Beeman, William W

    2004-02-01

    The role of flexible ureteroscopy in the management of intrarenal pathology has undergone a dramatic evolution, powered by improvements in flexible ureteroscope design; deflection and image quality; diversification of small, disposable instrumentation; and the use of holmium laser lithotripsy. This article reviews the application of flexible ureteroscopy for advanced intrarenal procedures.

  15. Visual Screening: A Procedure.

    ERIC Educational Resources Information Center

    Williams, Robert T.

    Vision is a complex process involving three phases: physical (acuity), physiological (integrative), and psychological (perceptual). Although these phases cannot be considered discrete, they provide the basis for the visual screening procedure used by the Reading Services of Colorado State University and described in this document. Ten tests are…

  16. Student Loan Collection Procedures.

    ERIC Educational Resources Information Center

    National Association of College and University Business Officers, Washington, DC.

    This manual on the collection of student loans is intended for the use of business officers and loan collection personnel of colleges and universities of all sizes. The introductory chapter is an overview of sound collection practices and procedures. It discusses the making of a loan, in-school servicing of the accounts, the exit interview, the…

  17. PLATO Courseware Development Procedures.

    ERIC Educational Resources Information Center

    Mahler, William A.; And Others

    This is an exploratory study of methods for the preparation of computer curriculum materials. It deals with courseware development procedures for the PLATO IV computer-based education system, and draws on interviews with over 100 persons engaged in courseware production. The report presents a five stage model of development: (1) planning, (2)…

  18. Parliamentary Procedure Made Easy.

    ERIC Educational Resources Information Center

    Hayden, Ellen T.

    Based on the newly revised "Robert's Rules of Order," these self-contained learning activities will help students successfully and actively participate in school, social, civic, political, or professional organizations. There are 13 lessons. Topics studied include the what, why, and history of parliamentary procedure; characteristics of the ideal…

  19. Grievance Procedure Problems.

    ERIC Educational Resources Information Center

    Green, Gary J.

    This paper presents two actual problems involving grievance procedures. Both problems involve pending litigation and one of them involves pending arbitration. The first problem occurred in a wealthy Minnesota school district and involved a seniority list. Because of changes in the financial basis for supporting public schools, it became necessary…

  20. Procedures and Policies Manual

    ERIC Educational Resources Information Center

    Davis, Jane M.

    2006-01-01

    This document was developed by the Middle Tennessee State University James E. Walker Library Collection Management Department to provide policies and procedural guidelines for the cataloging and processing of bibliographic materials. This document includes policies for cataloging monographs, serials, government documents, machine-readable data…

  1. Educational Accounting Procedures.

    ERIC Educational Resources Information Center

    Tidwell, Sam B.

    This chapter of "Principles of School Business Management" reviews the functions, procedures, and reports with which school business officials must be familiar in order to interpret and make decisions regarding the school district's financial position. Among the accounting functions discussed are financial management, internal auditing, annual…

  2. Terrestrial photovoltaic measurement procedures

    NASA Technical Reports Server (NTRS)

    1977-01-01

    Procedures for obtaining cell and array current-voltage measurements both outdoors in natural sunlight and indoors in simulated sunlight are presented. A description of the necessary apparatus and equipment is given for the calibration and use of reference solar cells. Some comments relating to concentration cell measurements, and a revised terrestrial solar spectrum for use in theoretical calculations, are included.

  3. Procedural Quantum Programming

    NASA Astrophysics Data System (ADS)

    Ömer, Bernhard

    2002-09-01

    While classical computing science has developed a variety of methods and programming languages around the concept of the universal computer, the typical description of quantum algorithms still uses a purely mathematical, non-constructive formalism which makes no difference between a hydrogen atom and a quantum computer. This paper investigates, how the concept of procedural programming languages, the most widely used classical formalism for describing and implementing algorithms, can be adopted to the field of quantum computing, and how non-classical features like the reversibility of unitary transformations, the non-observability of quantum states or the lack of copy and erase operations can be reflected semantically. It introduces the key concepts of procedural quantum programming (hybrid target architecture, operator hierarchy, quantum data types, memory management, etc.) and presents the experimental language QCL, which implements these principles.

  4. Standards of neurosurgical procedures.

    PubMed

    Steiger, H J

    2001-01-01

    Written specifications with regard to procedures performed, equipment used, and training of the involved personnel are widely used in the industry and aviation to guarantee constant quality. Similar systems are progressively being introduced to medicine. We have made an effort to standardize surgical procedures by introducing step-by-step guidelines and checklists. The current experience shows that a system of written standards is applicable to neurosurgery and that the use of checklists contributes to the prevention of forgetting essential details. Written standards and checklists are also a useful training tool within a university hospital and facilitate communication of essentials to the residents. Comparison with aviation suggests that standardization leads to a remarkable but nonetheless limited reduction of adverse incidents. PMID:11840739

  5. Practical procedures: oxygen therapy.

    PubMed

    Olive, Sandra

    Knowing when to start patients on oxygen therapy can save lives, but ongoing assessment and evaluation must be carried out to ensure the treatment is safe and effective. This article outlines when oxygen therapy should be used and the procedures to follow. It also describes the delivery methods applicable to different patient groups, along with the appropriate target saturation ranges, and details relevant nurse competencies.

  6. The Superintendent and Grievance Procedures.

    ERIC Educational Resources Information Center

    Kleinmann, Jack H.

    Grievance adjustment between teachers and administrators is viewed as a misunderstood process. The problem is treated under four main headings: (1) Purposes and characteristics of an effective grievance procedure, (2) status of grievance procedures in education, (3) relationship of grievance procedures to professional negotiation procedures, and…

  7. Pipe Cleaning Operating Procedures

    SciTech Connect

    Clark, D.; Wu, J.; /Fermilab

    1991-01-24

    This cleaning procedure outlines the steps involved in cleaning the high purity argon lines associated with the DO calorimeters. The procedure is broken down into 7 cycles: system setup, initial flush, wash, first rinse, second rinse, final rinse and drying. The system setup involves preparing the pump cart, line to be cleaned, distilled water, and interconnecting hoses and fittings. The initial flush is an off-line flush of the pump cart and its plumbing in order to preclude contaminating the line. The wash cycle circulates the detergent solution (Micro) at 180 degrees Fahrenheit through the line to be cleaned. The first rinse is then intended to rid the line of the majority of detergent and only needs to run for 30 minutes and at ambient temperature. The second rinse (if necessary) should eliminate the remaining soap residue. The final rinse is then intended to be a check that there is no remaining soap or other foreign particles in the line, particularly metal 'chips.' The final rinse should be run at 180 degrees Fahrenheit for at least 90 minutes. The filters should be changed after each cycle, paying particular attention to the wash cycle and the final rinse cycle return filters. These filters, which should be bagged and labeled, prove that the pipeline is clean. Only distilled water should be used for all cycles, especially rinsing. The level in the tank need not be excessive, merely enough to cover the heater float switch. The final rinse, however, may require a full 50 gallons. Note that most of the details of the procedure are included in the initial flush description. This section should be referred to if problems arise in the wash or rinse cycles.

  8. Interventional radiology neck procedures.

    PubMed

    Zabala Landa, R M; Korta Gómez, I; Del Cura Rodríguez, J L

    2016-05-01

    Ultrasonography has become extremely useful in the evaluation of masses in the head and neck. It enables us to determine the anatomic location of the masses as well as the characteristics of the tissues that compose them, thus making it possible to orient the differential diagnosis toward inflammatory, neoplastic, congenital, traumatic, or vascular lesions, although it is necessary to use computed tomography or magnetic resonance imaging to determine the complete extension of certain lesions. The growing range of interventional procedures, mostly guided by ultrasonography, now includes biopsies, drainages, infiltrations, sclerosing treatments, and tumor ablation. PMID:27138033

  9. Common rodent procedures.

    PubMed

    Klaphake, Eric

    2006-05-01

    Rodents are commonly owned exotic animal pets that may be seen by veterinary practitioners. Although most owners presenting their animals do care about their pets, they may not be aware of the diagnostic possibilities and challenges that can be offered by rodents to the veterinarian. Understanding clinical anatomy, proper hand-ling technique, realistic management of emergency presentations,correct and feasible diagnostic sampling, anesthesia, and humane euthanasia procedures is important to enhancing the doctor-client-patient relationship, especially when financial constraints may be imposed by the owner. PMID:16759953

  10. Surface cleanliness measurement procedure

    DOEpatents

    Schroder, Mark Stewart; Woodmansee, Donald Ernest; Beadie, Douglas Frank

    2002-01-01

    A procedure and tools for quantifying surface cleanliness are described. Cleanliness of a target surface is quantified by wiping a prescribed area of the surface with a flexible, bright white cloth swatch, preferably mounted on a special tool. The cloth picks up a substantial amount of any particulate surface contamination. The amount of contamination is determined by measuring the reflectivity loss of the cloth before and after wiping on the contaminated system and comparing that loss to a previous calibration with similar contamination. In the alternative, a visual comparison of the contaminated cloth to a contamination key provides an indication of the surface cleanliness.

  11. Radiometric correction procedure study

    NASA Technical Reports Server (NTRS)

    Colby, C.; Sands, R.; Murphrey, S.

    1978-01-01

    A comparison of MSS radiometric processing techniques identified as a preferred radiometric processing technique a procedure which equalizes the mean and standard deviation of detector-specific histograms of uncalibrated scene data. Evaluation of MSS calibration data demonstrated that the relationship between detector responses is essentially linear over the range of intensities typically observed in MSS data, and that the calibration wedge data possess a high degree of temporal stability. An analysis of the preferred radiometric processing technique showed that it could be incorporated into the MDP-MSS system without a major redesign of the system, and with minimal impact on system throughput.

  12. CELT optics Alignment Procedure

    NASA Astrophysics Data System (ADS)

    Mast, Terry S.; Nelson, Jerry E.; Chanan, Gary A.; Noethe, Lothar

    2003-01-01

    The California Extremely Large Telescope (CELT) is a project to build a 30-meter diameter telescope for research in astronomy at visible and infrared wavelengths. The current optical design calls for a primary, secondary, and tertiary mirror with Ritchey-Chretién foci at two Nasmyth platforms. The primary mirror is a mosaic of 1080 actively-stabilized hexagonal segments. This paper summarizes a CELT report that describes a step-by-step procedure for aligning the many degrees of freedom of the CELT optics.

  13. Interventional radiology neck procedures.

    PubMed

    Zabala Landa, R M; Korta Gómez, I; Del Cura Rodríguez, J L

    2016-05-01

    Ultrasonography has become extremely useful in the evaluation of masses in the head and neck. It enables us to determine the anatomic location of the masses as well as the characteristics of the tissues that compose them, thus making it possible to orient the differential diagnosis toward inflammatory, neoplastic, congenital, traumatic, or vascular lesions, although it is necessary to use computed tomography or magnetic resonance imaging to determine the complete extension of certain lesions. The growing range of interventional procedures, mostly guided by ultrasonography, now includes biopsies, drainages, infiltrations, sclerosing treatments, and tumor ablation.

  14. 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.

  15. Designing Flight Deck Procedures

    NASA Technical Reports Server (NTRS)

    Degani, Asaf; Wiener, Earl

    2005-01-01

    Three reports address the design of flight-deck procedures and various aspects of human interaction with cockpit systems that have direct impact on flight safety. One report, On the Typography of Flight- Deck Documentation, discusses basic research about typography and the kind of information needed by designers of flight deck documentation. Flight crews reading poorly designed documentation may easily overlook a crucial item on the checklist. The report surveys and summarizes the available literature regarding the design and typographical aspects of printed material. It focuses on typographical factors such as proper typefaces, character height, use of lower- and upper-case characters, line length, and spacing. Graphical aspects such as layout, color coding, fonts, and character contrast are discussed; and several cockpit conditions such as lighting levels and glare are addressed, as well as usage factors such as angular alignment, paper quality, and colors. Most of the insights and recommendations discussed in this report are transferable to paperless cockpit systems of the future and computer-based procedure displays (e.g., "electronic flight bag") in aerospace systems and similar systems that are used in other industries such as medical, nuclear systems, maritime operations, and military systems.

  16. Astigmatism and diagnostic procedures.

    PubMed

    Visnjić, Mirna Belovari; Zrinsćak, Ognjen; Barisić, Freja; Iveković, Renata; Laus, Katia Novak; Mandić, Zdravko

    2012-06-01

    Astigmatism represents an inability of the cornea and lens to provide a sharp image onto the retina. Correcting astigmatic errors, whether congenital, contact lens induced or surgically induced, is now an integral part of modern cataract and refractive procedures. Development of modern technology has enabled accurate diagnosis and perfect opportunities for correction; however, while cataract and keratorefractive surgery have come a long way in the last decade, the treatment and diagnosis of astigmatism continue to challenge ophthalmologists. There are several diagnostic procedures and tools available today, some standard and some contemporary that include keratometry, corneal topography, apparatus using wavefront or Scheimpflug analysis like Orbscan, Pentacam, Wavescan, etc. With the introduction of several new diagnostic tools, measurements of astigmatism have become less of an issue, but in some cases it is still difficult to obtain consistent results. What remains still unanswered is the question of the best diagnostic tool on the market. Further research is needed to evaluate both tools as well as their clinical application for optimal use. PMID:23115957

  17. Surgical Procedures for Vestibular Dysfunction

    MedlinePlus

    ... Rated Nonprofit! Volunteer. Donate. Review. Surgical Procedures for Vestibular Dysfunction When is surgery necessary? When medical treatment ... organ (cochlea) is also sacrificed with this procedure. Vestibular nerve section A vestibular nerve section is a ...

  18. Policy and Procedures Manual. Revised.

    ERIC Educational Resources Information Center

    Mississippi State Board for Community and Junior Colleges, Jackson.

    The Mississippi State Board for Community and Junior College Policy and Procedures Manual has been established by the State Board to govern its actions and activities and those of the staff. It describes polices and procedures regarding board operations, staff employment, staff workplace, employee performance/grievance procedure, staff positions,…

  19. 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.

  20. [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. PMID:15886748

  1. Inflight IFR procedures simulator

    NASA Technical Reports Server (NTRS)

    Parker, L. C. (Inventor)

    1984-01-01

    An inflight IFR procedures simulator for generating signals and commands to conventional instruments provided in an airplane is described. The simulator includes a signal synthesizer which generates predetermined simulated signals corresponding to signals normally received from remote sources upon being activated. A computer is connected to the signal synthesizer and causes the signal synthesizer to produce simulated signals responsive to programs fed into the computer. A switching network is connected to the signal synthesizer, the antenna of the aircraft, and navigational instruments and communication devices for selectively connecting instruments and devices to the synthesizer and disconnecting the antenna from the navigational instruments and communication device. Pressure transducers are connected to the altimeter and speed indicator for supplying electrical signals to the computer indicating the altitude and speed of the aircraft. A compass is connected for supply electrical signals for the computer indicating the heading of the airplane. The computer upon receiving signals from the pressure transducer and compass, computes the signals that are fed to the signal synthesizer which, in turn, generates simulated navigational signals.

  2. The procedure safety system

    NASA Technical Reports Server (NTRS)

    Obrien, Maureen E.

    1990-01-01

    Telerobotic operations, whether under autonomous or teleoperated control, require a much more sophisticated safety system than that needed for most industrial applications. Industrial robots generally perform very repetitive tasks in a controlled, static environment. The safety system in that case can be as simple as shutting down the robot if a human enters the work area, or even simply building a cage around the work space. Telerobotic operations, however, will take place in a dynamic, sometimes unpredictable environment, and will involve complicated and perhaps unrehearsed manipulations. This creates a much greater potential for damage to the robot or objects in its vicinity. The Procedural Safety System (PSS) collects data from external sensors and the robot, then processes it through an expert system shell to determine whether an unsafe condition or potential unsafe condition exists. Unsafe conditions could include exceeding velocity, acceleration, torque, or joint limits, imminent collision, exceeding temperature limits, and robot or sensor component failure. If a threat to safety exists, the operator is warned. If the threat is serious enough, the robot is halted. The PSS, therefore, uses expert system technology to enhance safety thus reducing operator work load, allowing him/her to focus on performing the task at hand without the distraction of worrying about violating safety criteria.

  3. MUSE optical alignment procedure

    NASA Astrophysics Data System (ADS)

    Laurent, Florence; Renault, Edgard; Loupias, Magali; Kosmalski, Johan; Anwand, Heiko; Bacon, Roland; Boudon, Didier; Caillier, Patrick; Daguisé, Eric; Dubois, Jean-Pierre; Dupuy, Christophe; Kelz, Andreas; Lizon, Jean-Louis; Nicklas, Harald; Parès, Laurent; Remillieux, Alban; Seifert, Walter; Valentin, Hervé; Xu, Wenli

    2012-09-01

    MUSE (Multi Unit Spectroscopic Explorer) is a second generation VLT integral field spectrograph (1x1arcmin² Field of View) developed for the European Southern Observatory (ESO), operating in the visible wavelength range (0.465-0.93 μm). A consortium of seven institutes is currently assembling and testing MUSE in the Integration Hall of the Observatoire de Lyon for the Preliminary Acceptance in Europe, scheduled for 2013. MUSE is composed of several subsystems which are under the responsibility of each institute. The Fore Optics derotates and anamorphoses the image at the focal plane. A Splitting and Relay Optics feed the 24 identical Integral Field Units (IFU), that are mounted within a large monolithic instrument mechanical structure. Each IFU incorporates an image slicer, a fully refractive spectrograph with VPH-grating and a detector system connected to a global vacuum and cryogenic system. During 2011, all MUSE subsystems were integrated, aligned and tested independently in each institute. After validations, the systems were shipped to the P.I. institute at Lyon and were assembled in the Integration Hall This paper describes the end-to-end optical alignment procedure of the MUSE instrument. The design strategy, mixing an optical alignment by manufacturing (plug and play approach) and few adjustments on key components, is presented. We depict the alignment method for identifying the optical axis using several references located in pupil and image planes. All tools required to perform the global alignment between each subsystem are described. The success of this alignment approach is demonstrated by the good results for the MUSE image quality. MUSE commissioning at the VLT (Very Large Telescope) is planned for 2013.

  4. Myeloablative Umbilical Cord Blood Transplantation in Hematological Diseases

    ClinicalTrials.gov

    2016-01-21

    Acute Myeloid Leukemia; Acute Lymphocytic Leukemia; Chronic Myelogenous Leukemia; Myelofibrosis; MDS; Refractory Anemia; Chronic Lymphocytic Leukemia; Prolymphocytic Leukemia; Non-Hodgkin's Lymphoma; Leukemia; Lymphoma; Multiple Myeloma; Myelodysplastic Syndromes

  5. UCB Transplant for Hematological Diseases Using a Non Myeloablative Prep

    ClinicalTrials.gov

    2016-04-08

    Acute Leukemia; Acute Myeloid Leukemia; Acute Lymphoblastic Leukemia/Lymphoma; Burkitt's Lymphoma; Natural Killer Cell Malignancies; Chronic Myelogenous Leukemia; Myelodysplastic Syndrome; Large-cell Lymphoma; Hodgkin Lymphoma; Multiple Myeloma; Chronic Lymphocytic Leukemia; Small Lymphocytic Lymphoma; Marginal Zone B-cell Lymphoma; Follicular Lymphoma; Lymphoplasmacytic Lymphoma; Mantle-cell Lymphoma; Prolymphocytic Leukemia; Bone Marrow Failure Syndromes; Myeloproliferative Syndromes

  6. Documenting Laboratory Procedures with Video

    PubMed Central

    Wyttenbach, Robert A.

    2015-01-01

    Demonstrating laboratory procedures in person during class time can be time-consuming. When procedures are done under a microscope, live demonstration is also impractical because of the limited number of students who can view the demonstration at once. Creating videos beforehand, which students can watch before class and review during lab sessions, solves both of these problems. This article suggests ways to make and distribute high quality video of microscopic procedures. PMID:26240520

  7. Practical pearls for oral procedures.

    PubMed

    Davari, Parastoo; Fazel, Nasim

    2016-01-01

    We provide an overview of clinically relevant principles of oral surgical procedures required in the workup and management of oral mucosal diseases. An understanding of the fundamental concepts of how to perform safely and effectively minor oral procedures is important to the practicing dermatologist and can minimize the need for patient referrals. This chapter reviews the principles of minor oral procedures, including incisional, excisional, and punch biopsies, as well as minor salivary gland excision. Pre- and postoperative patient care is also discussed.

  8. 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.

  9. Laboratory Procedures for Medical Assistants.

    ERIC Educational Resources Information Center

    Johnson, Pauline

    The purpose of the manual is to provide the medical assisting student a text which presents the common laboratory procedures in use today in physician's offices. The procedures for performing a complete urinalysis are outlined, along with those for carrying out various hematological tests. Information is also presented to help the student learn to…

  10. Characteristics of Multiple Comparison Procedures.

    ERIC Educational Resources Information Center

    Yusuf, Mian Muhammad; And Others

    Multiple comparison procedures (MCPs), in the context of analysis of variance, are becoming more popular than the overall F tests. An attempt is made to clarify confusion among the different MCPs by systematically comparing and contrasting the procedures in terms of their purposes, restrictions, robustness to assumptions, and other special…

  11. 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…

  12. 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)

  13. Current procedural terminology coding of nuclear medicine procedures.

    PubMed

    McKusick, K A; Quaife, M A

    1993-01-01

    The future of nuclear medicine is dependent on payment for new procedures. Today, the basis of payment by the federal government is a relative value unit (RVU) system; the RVUS employed in this system are for medical services and procedures listed and described in Physicians' Current Procedural Terminology, fourth edition. Current procedural terminology (CPT) is maintained by the AMA; annual revisions include adding new codes or revised or deleted old codes. This process involves all national medical specialty societies. Starting in 1992 a new process, the Relative Updating Committee, which was initiated by the AMA, organized medicine to formalize a method for recommending relative values for physician procedures and services. In this rapidly changing scenario, all nuclear medicine procedure codes are under review by the coding and nomenclature committees of the medical societies interested in imaging. Significant CPT changes and additions were made in the cardiovascular nuclear medicine codes in 1992, reflecting the current imaging protocols and pharmacological agents for performing cardiac stress testing and new codes that recognize combinations of ventricular function measurements in patients undergoing myocardial perfusion imaging with technetium-99m agents.

  14. Apexum: A Minimum Invasive Procedure

    PubMed Central

    2011-01-01

    The new Apexum procedure (Apexum Ltd, Or-Yehuda, Israel) is based on a minimally invasive removal of periapical chronically inflamed tissues through a root canal access. Apexum procedure (a novel method that allows for the removal or debulking of periapical tissues without using scalpels, periosteal elevators, or sutures) results in significant less postoperative discomfort or pain than conventional root canal treatment or than reported for conventional apical surgery. The removal or debulking of the periapical inflamed tissues, using the Apexum procedure, seems to enhance healing kinetics with no adverse events.

  15. Practical pearls for oral procedures.

    PubMed

    Davari, Parastoo; Fazel, Nasim

    2016-01-01

    We provide an overview of clinically relevant principles of oral surgical procedures required in the workup and management of oral mucosal diseases. An understanding of the fundamental concepts of how to perform safely and effectively minor oral procedures is important to the practicing dermatologist and can minimize the need for patient referrals. This chapter reviews the principles of minor oral procedures, including incisional, excisional, and punch biopsies, as well as minor salivary gland excision. Pre- and postoperative patient care is also discussed. PMID:27343958

  16. Surface Environmental Surveillance Procedures Manual

    SciTech Connect

    Hanf, RW; Dirkes, RL

    1990-02-01

    This manual establishes the procedures for the collection of environmental samples and the performance of radiation surveys and other field measurements. Responsibilities are defined for those personnel directly involved in the collection of samples and the performance of field measurements.

  17. Loop Electrosurgical Excision Procedure (LEEP)

    MedlinePlus

    ... that acts like a scalpel (surgical knife). An electric current is passed through the loop, which cuts away ... A procedure in which an instrument works with electric current to destroy tissue. Local Anesthesia: The use of ...

  18. Interventional procedures in the chest.

    PubMed

    Vollmer Torrubiano, I; Sánchez González, M

    2016-05-01

    Many thoracic conditions will require an interventional procedure for diagnosis and/or treatment. For this reason, radiologists need to know the indications and the technique for each procedure. In this article, we review the various interventional procedures that radiologists should know and the indications for each procedure. We place special emphasis on the potential differences in the diagnostic results and complications between fine-needle aspiration and biopsy. We also discuss the indications for radiofrequency ablation of lung tumors and review the concepts related to the drainage of pulmonary abscesses. We devote special attention to the management of pleural effusion, covering the indications for thoracocentesis and when to use imaging guidance, and to the protocol for pleural drainage. We also discuss the indications for percutaneous treatment of pericardial effusion and the possible complications of this treatment. Finally, we discuss the interventional management of mediastinal lesions and provide practical advice about how to approach these lesions to avoid serious complications.

  19. Adolescent test or procedure preparation

    MedlinePlus

    ... someone else) during the procedure Playing hand-held video games Using guided imagery Trying other distractions, such as ... Ask that anesthesia be used, if appropriate, to reduce any discomfort. Assure your adolescent that his or her reactions are normal.

  20. Quarantine document system indexing procedure

    NASA Technical Reports Server (NTRS)

    1972-01-01

    The Quarantine Document System (QDS) is described including the indexing procedures and thesaurus of indexing terms. The QDS consists of these functional elements: acquisition, cataloging, indexing, storage, and retrieval. A complete listing of the collection, and the thesaurus are included.

  1. Collected radiochemical and geochemical procedures

    SciTech Connect

    Kleinberg, J

    1990-05-01

    This revision of LA-1721, 4th Ed., Collected Radiochemical Procedures, reflects the activities of two groups in the Isotope and Nuclear Chemistry Division of the Los Alamos National Laboratory: INC-11, Nuclear and radiochemistry; and INC-7, Isotope Geochemistry. The procedures fall into five categories: I. Separation of Radionuclides from Uranium, Fission-Product Solutions, and Nuclear Debris; II. Separation of Products from Irradiated Targets; III. Preparation of Samples for Mass Spectrometric Analysis; IV. Dissolution Procedures; and V. Geochemical Procedures. With one exception, the first category of procedures is ordered by the positions of the elements in the Periodic Table, with separate parts on the Representative Elements (the A groups); the d-Transition Elements (the B groups and the Transition Triads); and the Lanthanides (Rare Earths) and Actinides (the 4f- and 5f-Transition Elements). The members of Group IIIB-- scandium, yttrium, and lanthanum--are included with the lanthanides, elements they resemble closely in chemistry and with which they occur in nature. The procedures dealing with the isolation of products from irradiated targets are arranged by target element.

  2. 21 CFR 1270.31 - Written procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Written procedures. 1270.31 Section 1270.31 Food... FOR TRANSPLANTATION Procedures and Records § 1270.31 Written procedures. (a) There shall be written... the procedures are performed unless impractical. Any deviation from the written procedures shall...

  3. 21 CFR 1270.31 - Written procedures.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Written procedures. 1270.31 Section 1270.31 Food... FOR TRANSPLANTATION Procedures and Records § 1270.31 Written procedures. (a) There shall be written... the procedures are performed unless impractical. Any deviation from the written procedures shall...

  4. 21 CFR 1270.31 - Written procedures.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Written procedures. 1270.31 Section 1270.31 Food... FOR TRANSPLANTATION Procedures and Records § 1270.31 Written procedures. (a) There shall be written... the procedures are performed unless impractical. Any deviation from the written procedures shall...

  5. 21 CFR 1270.31 - Written procedures.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Written procedures. 1270.31 Section 1270.31 Food... FOR TRANSPLANTATION Procedures and Records § 1270.31 Written procedures. (a) There shall be written... the procedures are performed unless impractical. Any deviation from the written procedures shall...

  6. 21 CFR 1270.31 - Written procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Written procedures. 1270.31 Section 1270.31 Food... FOR TRANSPLANTATION Procedures and Records § 1270.31 Written procedures. (a) There shall be written... the procedures are performed unless impractical. Any deviation from the written procedures shall...

  7. 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...

  8. 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...

  9. 32 CFR 70.5 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... BOARD (DRB) PROCEDURES AND STANDARDS § 70.5 Procedures. (a) Discharge review procedures are prescribed... Procedures about decisional documents are prescribed in § 70.10. ... 32 National Defense 1 2011-07-01 2011-07-01 false Procedures. 70.5 Section 70.5 National...

  10. 18 CFR 301.3 - Filing procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 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... 18 Conservation of Power and Water Resources 1 2011-04-01 2011-04-01 false Filing procedures....

  11. 32 CFR 70.5 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... BOARD (DRB) PROCEDURES AND STANDARDS § 70.5 Procedures. (a) Discharge review procedures are prescribed... Procedures about decisional documents are prescribed in § 70.10. ... 32 National Defense 1 2010-07-01 2010-07-01 false Procedures. 70.5 Section 70.5 National...

  12. [Clamping procedures in hepatic surgery].

    PubMed

    Frangov, T; Dimitrova, V; Kasten, D; Bismiut, A

    2005-01-01

    The advance of liver surgery and transplantation offers a new procedures--vascular clamping. Results of hepatic resections depends essentially on proper control of intraoperative hemorrhage. We present here the different procedures for vascular clamping and discussing their indications. Four parametres can be used to define the type of clamping: 1) place of application--control of arterial or glisson pedicles and portal veins (pedicles, selective hilar, suprahilar and intrahepatic clamps), suprahepatic veins or vena cava; 2) selectivity--partial or total clamp of hepatic blood supply; 3) duration--continuous or intermittent; 4) association measures to favor tolerence to ischemia (cooling, preservation fluids) or to limit downstream consequences (extracorporal circulaton, derivation). The clamping procedures depends on the localisation of the lesion and its relationships with the great vessels, presence of liver desease and the patients general and cardiovascular status. The aim is to use clamp moderate, favoring selective clamps to avoid ischemia. PMID:18693516

  13. Cognitive procedural learning in amnesia.

    PubMed

    Schmidtke, K; Handschu, R; Vollmer, H

    1996-12-01

    This group study examined the role of residual declarative memory and task-specific cognitive abilities for cognitive procedural learning in amnesia. 20 amnesic patients and 40 control subjects were studied, using four new cognitive tasks, as well as the Tower of Hanoi and a Mirror Reading task. On the cognitive tasks, but not on Mirror Reading, the learning of amnesic patients was significantly impaired relative to controls. Between- and within-group differences in learning were found to be statistically related to cognitive abilities that are involved in the processing of the procedural tasks. In amnesic patients, significant effects of residual declarative memory on learning scores were not observed, but there was indirect evidence for a role of memory in two tasks. The analysis of the correlative relationship between absolute procedural task performances and cognitive abilities indicated a prolonged dependence on nonspecific intellectual abilities in amnesic patients, suggesting a retarded transition to more advanced stages of skill acquisition.

  14. Complications of the Latarjet procedure.

    PubMed

    Gupta, Ashish; Delaney, Ruth; Petkin, Kalojan; Lafosse, Laurent

    2015-03-01

    The Latarjet procedure is an operation performed either arthroscopically or open for recurrent anterior shoulder instability, in the setting of glenoid bone loss; with good to excellent functional results. Despite excellent clinical results, the complication rates are reported between 15 and 30 %. Intraoperative complications such as graft malpositioning, neurovascular injury, and graft fracture can all be mitigated with meticulous surgical technique and understanding of the local anatomy. Nonunion and screw breakage are intermediate-term complications that occur in less than 5 % of patients. The long-term complications such as graft osteolysis are still an unsolved problem, and future research is required to understand the etiology and best treatment option. Recurrent instability after the Latarjet procedure can be managed with iliac crest bone graft reconstruction of the anterior glenoid. Shoulder arthritis is another complication reported after the Latarjet procedure, which poses additional challenges to both the surgeon and patient.

  15. Authentication Procedures - The Procedures and Integration Working Group

    SciTech Connect

    Kouzes, Richard T.; Bratcher, Leigh; Gosnell, Tom; Langner, Diana; MacArthur, D.; Mihalczo, John T.; Pura, Carolyn; Riedy, Alex; Rexroth, Paul; Scott, Mary; Springarn, Jay

    2001-05-31

    Authentication is how we establish trust in monitoring systems and measurements to verify compliance with, for example, the storage of nuclear weapons material. Authentication helps assure the monitoring party that accurate and reliable information is provided by any measurement system and that any irregularities are detected. The U.S. is developing its point of view on the procedures for authentication of monitoring systems now planned or contemplated for arms reduction and control applications. The authentication of a system utilizes a set of approaches, including: functional testing using trusted calibration sources, evaluation of documentation, evaluation of software, evaluation of hardware, random selection of hardware and software, tamper-indicating devices, and operational procedures. Authentication of measurement systems should occur throughout their lifecycles, starting with the elements of design, and moving to off-site authentication, on-siste authentication, and continuing with authentication following repair. The most important of these is the initial design of systems. Hardware and software design criteria and procurement decisions can make future authentication relatively straightforward or conversely very difficult. Facility decisions can likewise ease the procedures for authentication since reliable and effective monitoring systems and tampering indicating devices can help provide the assurance needed in the integrity of such items as measurement systems, spare equipment, and reference sources. This paper will summarize the results of the U.S. Authentication Task Force discussion on the role of procedures in authentication.

  16. 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.

  17. Landsat classification accuracy assessment procedures

    USGS Publications Warehouse

    Mead, R. R.; Szajgin, John

    1982-01-01

    A working conference was held in Sioux Falls, South Dakota, 12-14 November, 1980 dealing with Landsat classification Accuracy Assessment Procedures. Thirteen formal presentations were made on three general topics: (1) sampling procedures, (2) statistical analysis techniques, and (3) examples of projects which included accuracy assessment and the associated costs, logistical problems, and value of the accuracy data to the remote sensing specialist and the resource manager. Nearly twenty conference attendees participated in two discussion sessions addressing various issues associated with accuracy assessment. This paper presents an account of the accomplishments of the conference.

  18. Palliative Procedures in Lung Cancer

    PubMed Central

    Masuda, Emi; Sista, Akhilesh K.; Pua, Bradley B.; Madoff, David C.

    2013-01-01

    Palliative care aims to optimize comfort and function when cure is not possible. Image-guided interventions for palliative treatment of lung cancer is aimed at local control of advanced disease in the affected lung, adjacent mediastinal structures, or distant metastatic sites. These procedures include endovascular therapy for superior vena cava syndrome, bronchial artery embolization for hemoptysis associated with lung cancer, and ablation of osseous metastasis. Pathophysiology, clinical presentation, indications of these palliative treatments, procedural techniques, complications, and possible future interventions are discussed in this article. PMID:24436537

  19. Anesthetic consideration for neurointerventional procedures.

    PubMed

    Joung, Kyung Woon; Yang, Ku Hyun; Shin, Won Jung; Song, Myung Hee; Ham, Kyungdon; Jung, Seung Chul; Lee, Deok Hee; Suh, Dae Chul

    2014-09-01

    Interventional neuroradiology (INR) has been a rapidly expanding and advancing clinical area during the past few decades. As the complexity and diversity of INR procedures increases, the demand for anesthesia also increases. Anesthesia for interventional neuroradiology is a challenge for the anesthesiologist due to the unfamiliar working environment which the anesthesiologist must consider, as well as the unique neuro-interventional components. This review provides an overview of the anesthetic options and specific consideration of the anesthesia requirements for each procedure. We also introduce the anesthetic management for interventional neuroradiology performed in our medical institution.

  20. Tsallis’ entropy maximization procedure revisited

    NASA Astrophysics Data System (ADS)

    Martínez, S.; Nicolás, F.; Pennini, F.; Plastino, A.

    2000-11-01

    The proper way of averaging is an important question with regards to Tsallis’ Thermostatistics. Three different procedures have been thus far employed in the pertinent literature. The third one, i.e., the Tsallis-Mendes-Plastino (TMP) (Physica A 261 (1998) 534) normalization procedure, exhibits clear advantages with respect to earlier ones. In this work, we advance a distinct (from the TMP-one) way of handling the Lagrange multipliers involved in the extremization process that leads to Tsallis’ statistical operator. It is seen that the new approach considerably simplifies the pertinent analysis without losing the beautiful properties of the Tsallis-Mendes-Plastino formalism.

  1. 1995 Procedure for nominating Fellows

    NASA Astrophysics Data System (ADS)

    In 1994, there was a new procedure for nominating members of AGU for Fellowship for 1995. The new procedure was intended to increase the number of nominees. It required an initial nomination consisting only of a one-page letter and one-page cv. The Sections could make their selections prior to developing complete nomination packages for those candidates to be forwarded to the Union Committee. The timing of the process was changed so that Section committees would have more time to develop complete packages prior to forwarding their recommendations to the Union Committee.

  2. 28 CFR 42.530 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Section 504 of the Rehabilitation Act of 1973 Procedures § 42.530 Procedures. (a) The procedural provisions applicable to title VI of the Civil Rights Act of 1964 (28 CFR 42.106-42.110) apply to...

  3. 28 CFR 42.530 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Section 504 of the Rehabilitation Act of 1973 Procedures § 42.530 Procedures. (a) The procedural provisions applicable to title VI of the Civil Rights Act of 1964 (28 CFR 42.106-42.110) apply to...

  4. 28 CFR 42.530 - Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Section 504 of the Rehabilitation Act of 1973 Procedures § 42.530 Procedures. (a) The procedural provisions applicable to title VI of the Civil Rights Act of 1964 (28 CFR 42.106-42.110) apply to...

  5. 28 CFR 42.530 - Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Section 504 of the Rehabilitation Act of 1973 Procedures § 42.530 Procedures. (a) The procedural provisions applicable to title VI of the Civil Rights Act of 1964 (28 CFR 42.106-42.110) apply to...

  6. 28 CFR 42.530 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Section 504 of the Rehabilitation Act of 1973 Procedures § 42.530 Procedures. (a) The procedural provisions applicable to title VI of the Civil Rights Act of 1964 (28 CFR 42.106-42.110) apply to...

  7. Concepts & Procedures. [SITE 2001 Section].

    ERIC Educational Resources Information Center

    Bauder, Deborah Y., Ed.; Mullick, Rosemary, Ed.; Sarner, Ronald, Ed.

    This document contains the following papers on concepts and procedures from the SITE (Society for Information Technology & Teacher Education) 2001 conference: "Using School District Standards To Develop Thematic Lessons for Electronic Portfolios" (Cindy L. Anderson and others); "Using Adobe Acrobat for Electronic Portfolio Development" (Helen C.…

  8. Network-Based Management Procedures.

    ERIC Educational Resources Information Center

    Buckner, Allen L.

    Network-based management procedures serve as valuable aids in organizational management, achievement of objectives, problem solving, and decisionmaking. Network techniques especially applicable to educational management systems are the program evaluation and review technique (PERT) and the critical path method (CPM). Other network charting…

  9. 77 FR 34186 - Appeal Procedures

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-11

    ... potential civil rights issues. The review reveals no factors indicating the NRCS Appeal Procedures would... final rule (71 FR 28239). Section 275 of the 1994 Act, 7 U.S.C. 6995, requires USDA agencies to hold... agency level. This final rule amends the interim final rule published May 16, 2006 (71 FR 28239),...

  10. Some Forerunners of Cloze Procedure.

    ERIC Educational Resources Information Center

    Harris, David P.

    1985-01-01

    Looks at some of the methods of testing foreign language learning which are closely related to, yet pre-date, Wilson Taylor's cloze procedure. These include the Ebbinghaus Completion Method, which was first reported in 1897 and was used to test mental ability. Describes later modifications of the Ebbinghaus Method. (SED)

  11. Academic Tenure Policies and Procedures.

    ERIC Educational Resources Information Center

    Shaw, Biswanath

    The purpose of this study was to determine the policies for the acquisition and termination of academic tenure and the procedures used to implement these policies in the member institutions of the National Association of State Universities and Land Grant Colleges (NASULGC). The study was also designed to present and analyze data related to the…

  12. Software Verification and Validation Procedure

    SciTech Connect

    Olund, Thomas S.

    2008-09-15

    This Software Verification and Validation procedure provides the action steps for the Tank Waste Information Network System (TWINS) testing process. The primary objective of the testing process is to provide assurance that the software functions as intended, and meets the requirements specified by the client. Verification and validation establish the primary basis for TWINS software product acceptance.

  13. Arkansas' Office Procedures Curriculum Guide.

    ERIC Educational Resources Information Center

    Clayton, Dean

    This curriculum guide provides teachers of office procedures classes with unit lesson plans and information about resource materials that can be examined, selected, and integrated into the instructional program. Contents are mainly established for the following two types of secondary-level programs: cooperative office education and intensive…

  14. Handbook on: Rights, Responsibilities, Procedures.

    ERIC Educational Resources Information Center

    Illinois State Dept. of Rehabilitation Services, Springfield.

    This handbook presents policies and procedures that affect three schools operated by the Illinois Department of Rehabilitation Services to serve students with disabilities: the Illinois Center for Rehabilitation and Education-Roosevelt, Illinois School for the Deaf, and the Illinois School for the Visually Impaired. The handbook includes…

  15. Reference Policies and Procedures Manual.

    ERIC Educational Resources Information Center

    George Mason Univ., Fairfax, VA.

    This guide to services of the reference department of Fenwick Library, George Mason University, is intended for use by staff in the department, as well as the general public. Areas covered include (1) reference desk services to users; (2) reference desk support procedures; (3) off desk services; (4) collection development, including staff…

  16. Evaluating Prevention and Intervention Procedures.

    ERIC Educational Resources Information Center

    Sullivan, Arthur P.; And Others

    1986-01-01

    States the process-outcome research and evaluation paradigm applied to alcohol and substance abuse prevention and intervention programs. Shows its application to efforts to improve students' and patients' self-esteem to be deficient in certain aspects and advocates additions to the evaluation procedures, most notably analysis of in-session change.…

  17. Motivational Procedures in School Settings.

    ERIC Educational Resources Information Center

    Klausmeier, Herbert J.

    Two concerns in education are student lack of motivation for achieving subject-matter knowledge and skills, and a high incidence of both disruptive and withdrawal behavior. The state of the art with respect to the motivational procedures teachers employ with students is in question. This paper attempts to answer by dealing with these related…

  18. Concepts & Procedures. [SITE 2002 Section].

    ERIC Educational Resources Information Center

    Sarner, Ronald, Ed.; Mullick, Rosemary J., Ed.; Bauder, Deborah Y., Ed.

    This document contains the following full and short papers on concepts and procedures from the SITE (Society for Information Technology & Teacher Education) 2002 conference: "Exploring Minds Network" (Marino C. Alvarez and others); "Learning Communities: A Kaleidoscope of Ecological Designs" (Alain Breuleux and others); "PDA's and Research: A…

  19. A coding procedure for teachers.

    PubMed

    Kubany, E S; Sloggett, B B

    1973-01-01

    An observational technique for reliably estimating the per cent of time a student engages in appropriate and inappropriate classroom behavior is described. The regular classroom teacher can utilize the procedure without deviating from regular routine, and the obtained data can serve as a basis for dispensing token reinforcement. PMID:16795415

  20. Grievance Procedures. SPEC Kit 23.

    ERIC Educational Resources Information Center

    Association of Research Libraries, Washington, DC. Office of Management Studies.

    This collection of grievance procedures from member libraries of the Association of Research Libraries (ARL) contains: (1) documents on committee approaches to grievances from University of British Columbia, Center for Research Libraries, University of Connecticut, Harvard University, Michigan State University, and University of Nebraska; (2)…

  1. Environmental Impact Assessment: A Procedure.

    ERIC Educational Resources Information Center

    Stover, Lloyd V.

    Prepared by a firm of consulting engineers, this booklet outlines the procedural "whys and hows" of assessing environmental impact, particularly for the construction industry. Section I explores the need for environmental assessment and evaluation to determine environmental impact. It utilizes a review of the National Environmental Policy Act and…

  2. Token Systems: A Procedural Guide

    ERIC Educational Resources Information Center

    Sattler, Howard E.; Swoope, Karen S.

    1970-01-01

    A primary purpose of the token system is to expand the operant model in order to provide a broader reinforcement base. The ten procedural considerations necessary for implementing a token system are presented. Beyond this, fundamental knowledge of operant principles remains essential in order to apply the token system correctly. (Author/KJ)

  3. Current procedural terminology; a primer.

    PubMed

    Hirsch, Joshua A; Leslie-Mazwi, Thabele M; Nicola, Gregory N; Barr, Robert M; Bello, Jacqueline A; Donovan, William D; Tu, Raymond; Alson, Mark D; Manchikanti, Laxmaiah

    2015-04-01

    In 1966, The American Medical Association (AMA) working with multiple major medical specialty societies developed an iterative coding system for describing medical procedures and services using uniform language, the Current Procedural Terminology (CPT) system. The current code set, CPT IV, forms the basis of reporting most of the services performed by healthcare providers, physicians and non-physicians as well as facilities allowing effective, reliable communication among physician and other providers, third parties and patients. This coding system and its maintenance has evolved significantly since its inception, and now goes well beyond its readily perceived role in reimbursement. Additional roles include administrative management, tracking new and investigational procedures, and evolving aspects of 'pay for performance'. The system also allows for local, regional and national utilization comparisons for medical education and research. Neurointerventional specialists use CPT category I codes regularly--for example, 36,215 for first-order cerebrovascular angiography, 36,216 for second-order vessels, and 37,184 for acute stroke treatment by mechanical means. Additionally, physicians add relevant modifiers to the CPT codes, such as '-26' to indicate 'professional charge only,' or '-59' to indicate a distinct procedural service performed on the same day. PMID:24589819

  4. Cloze Procedure. An Historical Review.

    ERIC Educational Resources Information Center

    Wardell, David

    Cloze procedure, a testing method which systematically deletes words in written prose and then measures the accuracy of the information is reviewed from a historical viewpoint. Redundancy is placed in a verbal context and can be noted on three separate levels of language: (1) surface syntactic structure; (2) deep syntactic structure; and (3)…

  5. Budgetary Control Procedures for Institutions.

    ERIC Educational Resources Information Center

    Powell, Ray M.

    Budgetary control procedures for not-for-profit institutions are presented in this compilation of budgetary materials and ideas gathered at the Program for Institutional Administrators at the University of Notre Dame. Budgetary reporting and control are suggested as the most effective tools for coordinating and controlling the acquisition and use…

  6. 12 CFR 303.63 - Filing procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE FILING PROCEDURES... transactions. Applications for approval of interim merger transactions and any related deposit insurance... deposit insurance....

  7. 12 CFR 303.63 - Filing procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE FILING PROCEDURES... transactions. Applications for approval of interim merger transactions and any related deposit insurance... deposit insurance....

  8. 32 CFR 635.35 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... INVESTIGATIONS LAW ENFORCEMENT REPORTING Victim and Witness Assistance Procedures § 635.35 Procedures. (a) As... to support victims of spouse abuse. Victim Advocacy services include crisis intervention,...

  9. 32 CFR 635.35 - Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... INVESTIGATIONS LAW ENFORCEMENT REPORTING Victim and Witness Assistance Procedures § 635.35 Procedures. (a) As... to support victims of spouse abuse. Victim Advocacy services include crisis intervention,...

  10. 32 CFR 635.35 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... INVESTIGATIONS LAW ENFORCEMENT REPORTING Victim and Witness Assistance Procedures § 635.35 Procedures. (a) As... to support victims of spouse abuse. Victim Advocacy services include crisis intervention,...

  11. 32 CFR 635.35 - Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... INVESTIGATIONS LAW ENFORCEMENT REPORTING Victim and Witness Assistance Procedures § 635.35 Procedures. (a) As... to support victims of spouse abuse. Victim Advocacy services include crisis intervention,...

  12. 32 CFR 635.35 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... INVESTIGATIONS LAW ENFORCEMENT REPORTING Victim and Witness Assistance Procedures § 635.35 Procedures. (a) As... to support victims of spouse abuse. Victim Advocacy services include crisis intervention,...

  13. 76 FR 56969 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-15

    ... Procedures (44 FR 11034; February 26, 1979); and (3) does not warrant preparation of a regulatory evaluation... Minimums and Obstacle Departure Procedures; Miscellaneous Amendments AGENCY: Federal Aviation... Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures...

  14. Laparoscopic reversal of Hartmann's procedure.

    PubMed

    Fiscon, Valentino; Portale, Giuseppe; Mazzeo, Antonio; Migliorini, Giovanni; Frigo, Flavio

    2014-12-01

    Reestablishing continuity after a Hartmann's procedure is considered a major surgical procedure with high morbidity/mortality. The aim of this study was to assess the short-/long-term outcome of laparoscopic restoration of bowel continuity after HP. A prospectively collected database of colorectal laparoscopic procedures (>800) performed between June 2005 and June 2013 was used to identify 20 consecutive patients who had undergone laparoscopic reversal of Hartmann's procedure (LHR). Median age was 65.4. Ten patients (50 %) had undergone surgery for perforated diverticulitis, 3 (15 %) for cancer, and 7 (35 %) for other reasons (volvulus, posttraumatic perforation, and sigmoid perforation from foreign body). Previous HP had been performed laparoscopically in only 3 patients. Median operative time was 162.5 min. All the procedures were completed laparoscopically. Intraoperative complication rate was nil. Post-operative mortality and morbidity were respectively 0 and 10 % (1 pneumonia, 1 bowel obstruction from post-anastomotic stenosis which required resection and redo of the anastomosis). Median time to first flatus was 3 days, to normal diet 5 days. Median hospital stay was 9 days without readmissions. We followed up the patients for a median of 44 months: when asked, all 20 (100 %) said they would undergo the operation (LHR) again; 3 (15 %) had been re-operated of laparoscopic mesh repair for incisional hernia. When performed by experienced surgeons, LHR is a feasible, safe, reproducible operation, which allows early return of bowel function, early discharge and fast return to work for the patient. It has a low morbidity rate.

  15. Structured programming: Principles, notation, procedure

    NASA Technical Reports Server (NTRS)

    JOST

    1978-01-01

    Structured programs are best represented using a notation which gives a clear representation of the block encapsulation. In this report, a set of symbols which can be used until binding directives are republished is suggested. Structured programming also allows a new method of procedure for design and testing. Programs can be designed top down, that is, they can start at the highest program plane and can penetrate to the lowest plane by step-wise refinements. The testing methodology also is adapted to this procedure. First, the highest program plane is tested, and the programs which are not yet finished in the next lower plane are represented by so-called dummies. They are gradually replaced by the real programs.

  16. Invasive procedures with questionable indications

    PubMed Central

    Jargin, Sergei V.

    2014-01-01

    Insufficient coordination of medical research and partial isolation from the international scientific community can result in application of invasive methods without sufficient indications. Here is presented an overview of renal and pancreatic biopsy studies performed in the course of the operations of pancreatic blood shunting into the systemic blood flow in type 1 diabetic patients. Furthermore a surgical procedure of lung denervation as a treatment method of asthma as well as the use of bronchoscopy for research in asthmatics are discussed here. Today, the upturn in Russian economy enables acquisition of modern equipment; and medical research is on the increase. Under these circumstances, the purpose of this letter was to remind that, performing surgical or other invasive procedures, the risk-to-benefit ratio should be kept as low as possible. PMID:25568799

  17. Aesthetic Surgical Crown Lengthening Procedure.

    PubMed

    de Oliveira, Pablo Santos; Chiarelli, Fabio; Rodrigues, José A; Shibli, Jamil A; Zizzari, Vincenzo Luca; Piattelli, Adriano; Iezzi, Giovanna; Perrotti, Vittoria

    2015-01-01

    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most habitual surgical periodontal treatment.

  18. Diagnostic Procedures in Parasitic Diseases

    PubMed Central

    Seah, S. K. K.

    1976-01-01

    This article offers some guidelines for investigating patients with suspected tropical and parasitic diseases. The common symptoms of tropical diseases as seen in Canadians returning from the tropics are discussed and diagnostic approaches suggested. Simple office laboratory procedures for the diagnosis of the common intestinal and blood parasites are outlined. The value and pitfalls of serological tests in parasitic diseases are discussed. ImagesFigure 1Figure 2 PMID:21308049

  19. Aesthetic Surgical Crown Lengthening Procedure

    PubMed Central

    de Oliveira, Pablo Santos; Chiarelli, Fabio; Rodrigues, José A.; Shibli, Jamil A.; Zizzari, Vincenzo Luca; Piattelli, Adriano; Iezzi, Giovanna; Perrotti, Vittoria

    2015-01-01

    The aim of this case report was to describe the surgical sequence of crown lengthening to apically reposition the dentogingival complex, in addition to an esthetic restorative procedure. Many different causes can be responsible for short clinical crown. In these cases, the correct execution of a restorative or prosthetic rehabilitation requires an increasing of the crown length. According to the 2003 American Academy of Periodontology (Practice Profile Survey), crown lengthening is the most habitual surgical periodontal treatment. PMID:26609452

  20. Cytoreductive Surgery and Peritonectomy Procedures.

    PubMed

    Mehta, Sanket S; Bhatt, Aditi; Glehen, Olivier

    2016-06-01

    Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has become widely accepted as an effective method of treating peritoneal metastases (PM) from various cancers. CRS performed with the goal of removing all the macroscopic disease and comprises of peritonectomy procedures and visceral resections. CRS is a technically challenging surgery that requires a considerable amount of skill and appropriate patient selection. This article is a review of the techniques and current recommendations for performing CRS. PMID:27065704

  1. Surface Environmental Surveillance Procedures Manual

    SciTech Connect

    RW Hanf; TM Poston

    2000-09-20

    Environmental surveillance data are used in assessing the impact of current and past site operations on human health and the environment, demonstrating compliance with applicable local, state, and federal environmental regulations, and verifying the adequacy of containment and effluent controls. SESP sampling schedules are reviewed, revised, and published each calendar year in the Hanford Site Environmental Surveillance Master Sampling Schedule. Environmental samples are collected by SESP staff in accordance with the approved sample collection procedures documented in this manual.

  2. Cost analysis for procedure comparisons.

    PubMed

    Trowers, E A; Batra, S C; Buessler, J; Anderson, L K

    1995-01-01

    Using the methodology of activity-based costing as a conceptual framework, the authors present the potential cost reduction of a new office routine and a medical procedure. The costs of a new instrument for colorectal cancer screening and a new surveying and follow-up of at-risk patients show that time and relevant costs in the G.I Clinic and G.I Endoscopy Lab were significantly reduced.

  3. 16 CFR 1.2 - Procedure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 1 2012-01-01 2012-01-01 false Procedure. 1.2 Section 1.2 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL PROCEDURES Industry Guidance Advisory Opinions § 1.2 Procedure. (a) Application. The request for advice...

  4. 12 CFR 303.201 - Filing procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 12 Banks and Banking 4 2011-01-01 2011-01-01 false Filing procedures. 303.201 Section 303.201 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE FILING PROCEDURES Prompt Corrective Action § 303.201 Filing procedures. Applications shall be filed with...

  5. 12 CFR 303.201 - 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. 303.201 Section 303.201 Banks and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE FILING PROCEDURES Prompt Corrective Action § 303.201 Filing procedures. Applications shall be filed with...

  6. 20 CFR 435.44 - Procurement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Procurement procedures. 435.44 Section 435.44... ORGANIZATIONS Post-Award Requirements Procurement Standards § 435.44 Procurement procedures. (a) All recipients must establish written procurement procedures. These procedures must provide, at a minimum,...

  7. 14 CFR 1274.505 - Procurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Procurement procedures. 1274.505 Section... WITH COMMERCIAL FIRMS Procurement Standards § 1274.505 Procurement procedures. (a) All recipients shall establish written procurement procedures. These procedures shall provide at a minimum, that the...

  8. 10 CFR 600.144 - Procurement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 4 2010-01-01 2010-01-01 false Procurement procedures. 600.144 Section 600.144 Energy... Nonprofit Organizations Post-Award Requirements § 600.144 Procurement procedures. (a) All recipients shall establish written procurement procedures. These procedures shall provide for, at a minimum, that...

  9. 49 CFR 19.44 - Procurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 1 2011-10-01 2011-10-01 false Procurement procedures. 19.44 Section 19.44... Requirements Procurement Standards § 19.44 Procurement procedures. (a) All recipients shall establish written procurement procedures. These procedures shall provide for, at a minimum, that the conditions in paragraphs...

  10. 22 CFR 518.44 - Procurement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 2 2010-04-01 2010-04-01 true Procurement procedures. 518.44 Section 518.44... Requirements Procurement Standards § 518.44 Procurement procedures. (a) All recipients shall establish written procurement procedures. These procedures shall provide for, at a minimum, that the conditions in paragraphs...

  11. 28 CFR 70.44 - Procurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 false Procurement procedures. 70.44 Section 70... NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 70.44 Procurement procedures. (a) All recipients must establish written procurement procedures. These procedures must provide...

  12. 49 CFR 601.47 - Review Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 7 2011-10-01 2011-10-01 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 Transportation Systems § 601.47 Review Procedures....

  13. 47 CFR 2.1041 - Measurement procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Measurement procedure. 2.1041 Section 2.1041... RULES AND REGULATIONS Equipment Authorization Procedures Certification § 2.1041 Measurement procedure. For equipment operating under parts 15 and 18, the measurement procedures are specified in the...

  14. 2 CFR 215.44 - Procurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 2 Grants and Agreements 1 2011-01-01 2011-01-01 false Procurement procedures. 215.44 Section 215... A-110) Post Award Requirements Procurement Standards § 215.44 Procurement procedures. (a) All recipients shall establish written procurement procedures. These procedures shall provide for, at a...

  15. 22 CFR 518.44 - Procurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 2 2011-04-01 2009-04-01 true Procurement procedures. 518.44 Section 518.44... Requirements Procurement Standards § 518.44 Procurement procedures. (a) All recipients shall establish written procurement procedures. These procedures shall provide for, at a minimum, that the conditions in paragraphs...

  16. 22 CFR 226.44 - Procurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 22 Foreign Relations 1 2011-04-01 2011-04-01 false Procurement procedures. 226.44 Section 226.44...-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Procurement Standards § 226.44 Procurement procedures. (a) All recipients shall establish written procurement procedures. These procedures shall provide, at...

  17. 45 CFR 2543.44 - Procurement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Procurement procedures. 2543.44 Section 2543.44... ORGANIZATIONS Post-Award Requirements Property Standards § 2543.44 Procurement procedures. (a) All recipients shall establish written procurement procedures. These procedures shall provide for, at a minimum,...

  18. 45 CFR 2543.44 - Procurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Procurement procedures. 2543.44 Section 2543.44... ORGANIZATIONS Post-Award Requirements Property Standards § 2543.44 Procurement procedures. (a) All recipients shall establish written procurement procedures. These procedures shall provide for, at a minimum,...

  19. 28 CFR 40.8 - Emergency procedure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Emergency procedure. 40.8 Section 40.8... for Inmate Grievance Procedures § 40.8 Emergency procedure. The grievance procedure shall contain special provision for responding to grievances of an emergency nature. Emergency grievances shall...

  20. 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...

  1. 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...

  2. 40 CFR 89.508 - Test procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 21 2013-07-01 2013-07-01 false 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...

  3. 9 CFR 318.311 - Recall procedure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Recall procedure. 318.311 Section 318... Products § 318.311 Recall procedure. Establishments shall prepare and maintain a current procedure for the recall of all canned product covered by this subpart. Upon request, the recall procedure shall be...

  4. 9 CFR 318.311 - Recall procedure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Recall procedure. 318.311 Section 318... Products § 318.311 Recall procedure. Establishments shall prepare and maintain a current procedure for the recall of all canned product covered by this subpart. Upon request, the recall procedure shall be...

  5. 9 CFR 318.311 - Recall procedure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Recall procedure. 318.311 Section 318... Products § 318.311 Recall procedure. Establishments shall prepare and maintain a current procedure for the recall of all canned product covered by this subpart. Upon request, the recall procedure shall be...

  6. 9 CFR 318.311 - Recall procedure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Recall procedure. 318.311 Section 318... Products § 318.311 Recall procedure. Establishments shall prepare and maintain a current procedure for the recall of all canned product covered by this subpart. Upon request, the recall procedure shall be...

  7. 47 CFR 2.1041 - Measurement procedure.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Measurement procedure. 2.1041 Section 2.1041... RULES AND REGULATIONS Equipment Authorization Procedures Certification § 2.1041 Measurement procedure. For equipment operating under parts 15 and 18, the measurement procedures are specified in the...

  8. 47 CFR 2.1041 - Measurement procedure.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Measurement procedure. 2.1041 Section 2.1041... RULES AND REGULATIONS Equipment Authorization Procedures Certification § 2.1041 Measurement procedure. For equipment operating under parts 15 and 18, the measurement procedures are specified in the...

  9. 47 CFR 2.1041 - Measurement procedure.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Measurement procedure. 2.1041 Section 2.1041... RULES AND REGULATIONS Equipment Authorization Procedures Certification § 2.1041 Measurement procedure. For equipment operating under parts 15 and 18, the measurement procedures are specified in the...

  10. 47 CFR 2.1041 - Measurement procedure.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false Measurement procedure. 2.1041 Section 2.1041... RULES AND REGULATIONS Equipment Authorization Procedures Certification § 2.1041 Measurement procedure. For equipment operating under parts 15 and 18, the measurement procedures are specified in the...

  11. 22 CFR 226.44 - Procurement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 22 Foreign Relations 1 2010-04-01 2010-04-01 false Procurement procedures. 226.44 Section 226.44...-GOVERNMENTAL ORGANIZATIONS Post-award Requirements Procurement Standards § 226.44 Procurement procedures. (a) All recipients shall establish written procurement procedures. These procedures shall provide, at...

  12. 14 CFR 1274.505 - Procurement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Procurement procedures. 1274.505 Section... WITH COMMERCIAL FIRMS Procurement Standards § 1274.505 Procurement procedures. (a) All recipients shall establish written procurement procedures. These procedures shall provide at a minimum, that the...

  13. 28 CFR 70.44 - Procurement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Procurement procedures. 70.44 Section 70... NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 70.44 Procurement procedures. (a) All recipients must establish written procurement procedures. These procedures must provide...

  14. 14 CFR 21.441 - Procedure manual.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Procedure manual. 21.441 Section 21.441... of, a procedure manual containing— (1) The procedures for issuing STCs; and (2) The names, signatures... procedure manual; and (ii) Are to conduct inspections (including conformity and compliance inspections)...

  15. 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...

  16. 10 CFR 766.105 - Payment procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 4 2013-01-01 2013-01-01 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...

  17. 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 154.34 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS SPECIAL REVIEW PROCEDURES Procedures § 154.34 Expedited procedures. (a) The Agency may elect to issue...

  18. 40 CFR 154.34 - Expedited procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Expedited procedures. 154.34 Section 154.34 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS SPECIAL REVIEW PROCEDURES Procedures § 154.34 Expedited procedures. (a) The Agency may elect to issue...

  19. 40 CFR 154.34 - Expedited procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Expedited procedures. 154.34 Section 154.34 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS SPECIAL REVIEW PROCEDURES Procedures § 154.34 Expedited procedures. (a) The Agency may elect to issue...

  20. 40 CFR 1507.3 - Agency procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... from applicants. The procedures shall be adopted only after an opportunity for public review and after... own procedures. Agencies shall continue to review their policies and procedures and in consultation... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Agency procedures. 1507.3 Section...

  1. 19 CFR 351.221 - Review procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 19 Customs Duties 3 2011-04-01 2011-04-01 false Review procedures. 351.221 Section 351.221 Customs... Antidumping and Countervailing Duty Procedures § 351.221 Review procedures. (a) Introduction. The procedures for reviews are similar to those followed in investigations. This section details the...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 48 CFR 2813.7002 - Procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Contract Types SIMPLIFIED ACQUISITION PROCEDURES Certified Invoice Procedure 2813.7002 Procedure. (a) Purchases utilizing the certified invoice procedure shall be effected only in accordance with FAR part 13...; (3) Appropriate invoices can be obtained from the supplier; and, (4) The items to be purchased...

  7. 48 CFR 2813.7002 - Procedure.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... CONTRACT TYPES SIMPLIFIED ACQUISITION PROCEDURES Certified Invoice Procedure 2813.7002 Procedure. (a) Purchases utilizing the certified invoice procedure shall be effected only in accordance with FAR part 13...; (3) Appropriate invoices can be obtained from the supplier; and, (4) The items to be purchased...

  8. 48 CFR 2813.7002 - Procedure.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... CONTRACT TYPES SIMPLIFIED ACQUISITION PROCEDURES Certified Invoice Procedure 2813.7002 Procedure. (a) Purchases utilizing the certified invoice procedure shall be effected only in accordance with FAR part 13...; (3) Appropriate invoices can be obtained from the supplier; and, (4) The items to be purchased...

  9. 48 CFR 2813.7002 - Procedure.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... CONTRACT TYPES SIMPLIFIED ACQUISITION PROCEDURES Certified Invoice Procedure 2813.7002 Procedure. (a) Purchases utilizing the certified invoice procedure shall be effected only in accordance with FAR part 13...; (3) Appropriate invoices can be obtained from the supplier; and, (4) The items to be purchased...

  10. 48 CFR 2813.7002 - Procedure.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... CONTRACT TYPES SIMPLIFIED ACQUISITION PROCEDURES Certified Invoice Procedure 2813.7002 Procedure. (a) Purchases utilizing the certified invoice procedure shall be effected only in accordance with FAR part 13...; (3) Appropriate invoices can be obtained from the supplier; and, (4) The items to be purchased...

  11. The 'obsolescence' of assessment procedures.

    PubMed

    Russell, Elbert W

    2010-01-01

    The concept that obsolescence or being "out of date" makes a test or procedure invalid ("inaccurate," "inappropriate," "not useful," "creating wrong interpretations," etc.) has been widely accepted in psychology and neuropsychology. Such obsolescence, produced by publishing a new version of a test, has produced an extensive nullification of research effort (probably 10,000 Wechsler studies). The arguments, attempting to justify obsolescence, include the Flynn Effect, the creation of a new version of a test or simply time. However, the Flynn Effect appears to have plateaued. In psychometric theory, validated tests do not lose their validity due to the creation of newer versions. Time does not invalidate tests due to the improvement of neurological methodology, such as magnetic resonance imaging. This assumption is unscientific, unproven, and if true, would discredit all older neuropsychological and neurological knowledge. In science, no method, theory, or information, once validated, loses that validation merely due to time or the creation of another test or procedure. Once validated, a procedure is only disproved or replaced by means of new research. PMID:20146123

  12. Disclosure analysis procedures: reliability issues.

    PubMed

    Hux, K; Sanger, D; Reid, R; Maschka, A

    1997-01-01

    Performing disclosure analyses to supplement assessment procedures and facilitate intervention planning is only valuable if the observations are reliable. The purpose of the present study was to evaluate and compare four methods of assessing reliability on one discourse analysis procedure--a modified version of Damico's Clinical Discourse Analysis (1985a, 1985b, 1992). The selected methods were: (a) Pearson product-moment correlations, (b) interobserver agreement, (c) Cohen's kappa, and (d) generalizability coefficients. Results showed high correlation coefficients and high percentages of interobserver agreement when error type was not taken into account. However, interobserver agreement percentages obtained solely for target behavior occurrences and Cohen's kappa revealed that much of the agreement between rates was due to chance and the high frequency of target behavior non-occurrence. Generalizability coefficients revealed that the procedure was fair to good for discriminating among persons with differing levels of language competency for some aspects of communication performance but was less than desirable for others; the aggregate score was below recommended standards for differentiating among people for diagnostic purposes.

  13. Compound estimation procedures in reliability

    NASA Technical Reports Server (NTRS)

    Barnes, Ron

    1990-01-01

    At NASA, components and subsystems of components in the Space Shuttle and Space Station generally go through a number of redesign stages. While data on failures for various design stages are sometimes available, the classical procedures for evaluating reliability only utilize the failure data on the present design stage of the component or subsystem. Often, few or no failures have been recorded on the present design stage. Previously, Bayesian estimators for the reliability of a single component, conditioned on the failure data for the present design, were developed. These new estimators permit NASA to evaluate the reliability, even when few or no failures have been recorded. Point estimates for the latter evaluation were not possible with the classical procedures. Since different design stages of a component (or subsystem) generally have a good deal in common, the development of new statistical procedures for evaluating the reliability, which consider the entire failure record for all design stages, has great intuitive appeal. A typical subsystem consists of a number of different components and each component has evolved through a number of redesign stages. The present investigations considered compound estimation procedures and related models. Such models permit the statistical consideration of all design stages of each component and thus incorporate all the available failure data to obtain estimates for the reliability of the present version of the component (or subsystem). A number of models were considered to estimate the reliability of a component conditioned on its total failure history from two design stages. It was determined that reliability estimators for the present design stage, conditioned on the complete failure history for two design stages have lower risk than the corresponding estimators conditioned only on the most recent design failure data. Several models were explored and preliminary models involving bivariate Poisson distribution and the

  14. Overview of current treatment of neuroblastoma.

    PubMed

    Philip, T

    1992-05-01

    Neuroblastoma is the second most common solid tumor in infants and children. Improvement of therapy for stage IV patients remains the major goal of research in treatment of neuroblastoma. New approaches under study are focused in four main areas: (a) phase II studies; (b) mega-therapy procedures; (c) targeted therapy; and (d) immunotherapy. Future approaches will be closely linked to progress in laboratory investigation and more efficient use of currently available drugs. Of all the childhood malignancies, this is the one tumor where such an approach is most likely to be effective.

  15. Revised Unfilling Procedure for Solid Lithium Lenses

    SciTech Connect

    Leveling, A.; /Fermilab

    2003-06-03

    A procedure for unfilling used lithium lenses to has been described in Pbar Note 664. To date, the procedure has been used to disassemble lenses 20, 21, 17, 18, and 16. As a result of this work, some parts of the original procedure were found to be time consuming and ineffective. Modifications to the original procedure have been made to streamline the process and are discussed in this note. The revised procedure is included in this note.

  16. Entangled entanglement: A construction procedure

    NASA Astrophysics Data System (ADS)

    Uchida, Gabriele; Bertlmann, Reinhold A.; Hiesmayr, Beatrix C.

    2015-10-01

    The familiar Greenberger-Horne-Zeilinger (GHZ) states can be rewritten by entangling the Bell states for two qubits with a third qubit state, which is dubbed entangled entanglement. We show that in a constructive way we obtain all eight independent GHZ states that form the simplex of entangled entanglement, the magic simplex. The construction procedure allows a generalization to higher dimensions both, in the degrees of freedom (considering qudits) as well as in the number of particles (considering n-partite states). Such bases of GHZ-type states exhibit a cyclic geometry, a Merry Go Round, that is relevant for experimental and quantum information theoretic applications.

  17. Inspection system performance test procedure

    SciTech Connect

    Jensen, C.E.

    1995-01-17

    This procedure establishes requirements to administer a performance demonstration test. The test is to demonstrate that the double-shell tank inspection system (DSTIS) supplied by the contractor performs in accordance with the WHC-S-4108, Double-Shell Tank Ultrasonic Inspection Performance Specification, Rev. 2-A, January, 1995. The inspection system is intended to provide ultrasonic (UT) and visual data to determine integrity of the Westinghouse Hanford Company (WHC) site underground waste tanks. The robotic inspection system consists of the following major sub-systems (modules) and components: Mobile control center; Deployment module; Cable management assembly; Robot mechanism; Ultrasonic testing system; Visual testing system; Pneumatic system; Electrical system; and Control system.

  18. Procedures for precap visual inspection

    NASA Technical Reports Server (NTRS)

    1984-01-01

    Screening procedures for the final precap visual inspection of microcircuits used in electronic system components are described as an aid in training personnel unfamiliar with microcircuits. Processing techniques used in industry for the manufacture of monolithic and hybrid components are presented and imperfections that may be encountered during this inspection are discussed. Problem areas such as scratches, voids, adhesions, and wire bonding are illustrated by photomicrographs. This guide can serve as an effective tool in training personnel to perform precap visual inspections efficiently and reliably.

  19. Ultrasound-Guided Elbow Procedures.

    PubMed

    Sussman, Walter I; Williams, Christopher J; Mautner, Ken

    2016-08-01

    High-resolution ultrasonography can help clinicians visualize key anatomic structures of the elbow and guide periarticular and intra-articular injections. Historically, most procedures done around the elbow have been done using landmark guidance, and few studies have reported the accuracy of ultrasonography-guided injections in the elbow region. This article reviews common musculoskeletal disorders about the elbow that can be evaluated with ultrasonography, reviews the literature on ultrasonography-guided injections of the elbow region, and describes the senior author's preferred approach for the most commonly performed elbow region injections. PMID:27468667

  20. Hemispherectomy Procedure in Proteus Syndrome

    PubMed Central

    GUNAWAN, PrastiyaIndra; LUSIANA, Lusiana; SAHARSO, Darto

    2016-01-01

    Objective Proteus syndrome is a rare overgrowth disorder including bone, soft tissue, and skin. Central nervous system manifestations were reported in about 40% of the patients including hemimegalencephaly and the resultant hemicranial hyperplasia, convulsions and mental deficiency. We report a 1-month-old male baby referred to Pediatric Neurology Clinic Soetomo Hospital, Surabaya, Indonesia in 2014 presented recurrent seizures since birth with asymmetric dysmorphic face with the right side larger than the left, subcutaneous mass and linear nevi. Craniocervical MRI revealed hemimegalencephaly right cerebral hemisphere. Triple antiepileptic drugs were already given as well as the ketogenic diet, but the seizures persisted. The seizure then was resolved after hemispherectomy procedure. PMID:27375761

  1. Procedures for evaluating technical specifications

    SciTech Connect

    Boccio, J.L.; Robinson, R.C.; Samanta, P.K.; Vesely, W.E.

    1987-01-01

    The Procedures for Evaluating Technical Specifications (PETS) Program being conducted by Brookhaven National Laboratory for the Office of Research, US Nuclear Regulatory Commission (NRC), is developing various risk-based approaches for modifying Technical Specifications (TS). This paper highlights the various risk-based issues being addressed by the program and presents examples that exemplify the use of PRA models for modifying TS, primarily elements of the Limiting Condition of Operation (LCOs) and Surveillance Requirements (SRs). PETS approaches to TS modification using more detailed analysis are presented in a companion paper.

  2. 40 CFR 90.120 - Certification procedure-use of special test procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... specified procedures. (3) A manufacturer may elect to use the test procedures in 40 CFR part 1065 as an... certification that the engines were tested using the procedures in 40 CFR part 1065. For any EPA testing with... procedures of 40 CFR part 1065, manufacturers may elect to use the procedures specified in 40 CFR part...

  3. 40 CFR 90.120 - Certification procedure-use of special test procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... specified procedures. (3) A manufacturer may elect to use the test procedures in 40 CFR part 1065 as an... certification that the engines were tested using the procedures in 40 CFR part 1065. For any EPA testing with... procedures of 40 CFR part 1065, manufacturers may elect to use the procedures specified in 40 CFR part...

  4. Procedures for computing site seismicity

    NASA Astrophysics Data System (ADS)

    Ferritto, John

    1994-02-01

    This report was prepared as part of the Navy's Seismic Hazard Mitigation Program. The Navy has numerous bases located in seismically active regions throughout the world. Safe effective design of waterfront structures requires determining expected earthquake ground motion. The Navy's problem is further complicated by the presence of soft saturated marginal soils that can significantly amplify the levels of seismic shaking as evidenced in the 1989 Loma Prieta earthquake. The Naval Facilities Engineering Command's seismic design manual, NAVFAC P355.l, requires a probabilistic assessment of ground motion for design of essential structures. This report presents the basis for the Navy's Seismic Hazard Analysis procedure that was developed and is intended to be used with the Seismic Hazard Analysis computer program and user's manual. This report also presents data on geology and seismology to establish the background for the seismic hazard model developed. The procedure uses the historical epicenter data base and available geologic data, together with source models, recurrence models, and attenuation relationships to compute the probability distribution of site acceleration and an appropriate spectra. This report discusses the developed stochastic model for seismic hazard evaluation and the associated research.

  5. Taguchi optimisation of ELISA procedures.

    PubMed

    Jeney, C; Dobay, O; Lengyel, A; Adám, E; Nász, I

    1999-03-01

    We propose a new method in the field of ELISA optimization using an experimental design called the Taguchi method. This can be used to compare the net effects of different conditions which can be both qualitative and quantitative in nature. The method reduces the effects of the interactions of the optimized variables making it possible to access the optimum conditions even in cases where there are large interactions between the variables of the assay. Furthermore, the proposed special assignment of factors makes it possible to calculate the biochemical parameters of the ELISA procedure carried out under optimum conditions. Thus, the calibration curve, the sensitivity of the optimum assay, the intra-assay and inter-assay variability can be estimated. The method is fast, accessing the results in one step, compared to the traditional, time-consuming 'one-step-at-a-time' method. We exemplify the procedure with a method to optimize the detection of ScFv (single chain fragment of variable) phages by ELISA. All the necessary calculations can be carried out by a spreadsheet program without any special statistical knowledge. PMID:10089092

  6. Design procedures for compressor blades

    NASA Technical Reports Server (NTRS)

    Starken, H.

    1983-01-01

    The conventional methods for the design of the blades in the case of axial turbomachines are considered, taking into account difficulties concerning the determination of optimal blade profiles. These difficulties have been partly overcome as a consequence of the introduction of new numerical methods during the last few years. It is pointed out that, in the case of the subsonic range, a new procedure is now available for the determination of the form of blade profile on the basis of a given velocity distribution on the profile surface. The search for a profile form with favorable characteristics is consequently transformed into a search for a favorable velocity or pressure distribution on the blade. The distribution of velocities depends to a large degree on the characteristics of the profile boundary layers. The considered concept is not new. However, its practical implementation has only recently become possible. The employment of the new design procedure is illustrated with the aid of an example involving a concrete design problem.

  7. Ice anaesthesia in procedural dermatology.

    PubMed

    Dixit, Shreya; Lowe, Patricia; Fischer, Gayle; Lim, Adrian

    2013-11-01

    This article presents findings from a survey of Australian dermatologists who were questioned about their preferred pain control methods when carrying out injectable procedures. We also present, what is to the best of our knowledge, the first proof-of-concept experiment exploring the relationship between ice-to-skin contact time and skin surface temperature, using both ice wrapped in latex and ice wrapped in aluminium foil. Of 79 dermatologists 32 responded to the survey (41% response rate): 31 (97%) injected botulinum toxin type A (BTA) for dynamic lines, 26 (81%) injected BTA for hyperhidrosis, and 24 (75%) injected skin fillers. Ice anaesthesia was the most common method of pain control (75%) followed by use of topical anaesthesia (50%) such as EMLA, compound agents and lignocaine 4%. Ice wrapped in latex or latex-like material was the most common ice packaging used by those surveyed and the median ice-to-skin contact time was 10 s. The ice experiment results indicated that ice wrapped with aluminium foil was equivalent to ice wrapped in latex for short contact times (< 20 s), but more effective at reducing skin temperature with longer contact times (> 20 s). These findings will be of relevance to cosmetic and paediatric dermatologists or any area of procedural medicine where effective non-injectable pain control is required.

  8. Cardiovascular procedures/diagnostic techniques and therapeutic procedures

    SciTech Connect

    Tilkian, A.G.; Daily, E.K.

    1986-01-01

    This book covers the technical and therapeutic aspects of cardiovascular procedures in immense detail. There are large and appropriate diagrams and tables. The topics of the chapters are tools for catheterization, venous access, arterial access, hemodynamic monitoring, cardiac catheterization and coronary arteriography, ergonovine provocation testing for coronary artery spasm, pulmonary angiography, endomyocredial biopsy, electrophysiologic studies, pericardiocentesis and drainage, intraaortic balloon pumping, direct current cardioversion and defibrilaltion, pacemaker implantation of the automatic implantable cardioverter/defibrillator, coronary angioplasty, thrombolytic therapy, transluminal catheter extraction and resolution of intracardiac catheter knots, cardiopulmonary resuscitation, contrast media toxicity and allergic reactions, radiation hazards, and medicolegal concerns. An appendix and index follow these chapters. In general, each chapter covers historical aspects, indications, complications, techniques, and preoperative and postoperative care.

  9. 76 FR 16686 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-25

    ... Policies and Procedures (44 FR 11034; February 26, 1979); and (3) does not warrant preparation of a... Minimums and Obstacle Departure Procedures; Miscellaneous Amendments AGENCY: Federal Aviation... Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle...

  10. Hartmann's procedure or primary anastomosis?

    PubMed

    Kreis, Martin E; Mueller, Mario H; Thasler, Wolfgang H

    2012-01-01

    Perforation following acute diverticulitis is a typical scenario during the first attack. Different classification systems exist to classify acute perforated diverticulitis. While the Hinchey classification, which is based on intraoperative findings, is internationally best known, the German Hansen-Stock classification which is based on CT scan is widely accepted within Germany. When surgery is necessary, sigmoid colectomy is the standard of care. An important question is whether patients should receive primary anastomosis or a Hartmann procedure subsequently. A priori there are several arguments for both procedures. Hartmann's operation is extremely safe and, therefore, represents the best option in severely ill patients and/or extensive peritonitis. However, this operation carries a high risk of stoma nonreversal, or, when reversal is attempted, a high risk in terms of morbidity and mortality. In contrast, primary anastomosis with or without loop ileostoma is a slightly more lengthy procedure as normally the splenic flexure needs to be mobilized and construction of the anastomosis may consume more time than the Hartmann operation. The big advantage of primary anastomosis, however, is that there is no need for the potentially risky stoma reversal operation. The most interesting question is when to do the Hartmann operation or primary anastomosis. Several comparative case series were published showing that primary anastomosis is feasible in many patients. However, no randomized trial is available to date. It is of note, that all non-randomized case series are biased, i.e. that patients in better condition received anastomosis and those with severe peritonitis underwent Hartmann's operation. This bias is undoubtedly likely to be present, even if not obvious, in the published papers! Our own data suggest that this decision should not be based on the extent of peritonitis but rather on patient condition and comorbidity. In conclusion, sigmoid colectomy and primary

  11. 40 CFR 96.308 - Appeal procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... Ozone Season Trading Program General Provisions § 96.308 Appeal procedures. The appeal procedures for decisions of the Administrator under the CAIR NOX Ozone Season Trading Program are set forth in part 78...

  12. 40 CFR 96.308 - Appeal procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Ozone Season Trading Program General Provisions § 96.308 Appeal procedures. The appeal procedures for decisions of the Administrator under the CAIR NOX Ozone Season Trading Program are set forth in part 78...

  13. 40 CFR 96.308 - Appeal procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... Ozone Season Trading Program General Provisions § 96.308 Appeal procedures. The appeal procedures for decisions of the Administrator under the CAIR NOX Ozone Season Trading Program are set forth in part 78...

  14. 40 CFR 96.308 - Appeal procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Ozone Season Trading Program General Provisions § 96.308 Appeal procedures. The appeal procedures for decisions of the Administrator under the CAIR NOX Ozone Season Trading Program are set forth in part 78...

  15. 40 CFR 96.308 - Appeal procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... Ozone Season Trading Program General Provisions § 96.308 Appeal procedures. The appeal procedures for decisions of the Administrator under the CAIR NOX Ozone Season Trading Program are set forth in part 78...

  16. 40 CFR 89.508 - Test procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... procedure as adopted in the California Regulations for New 1996 and Later Heavy-Duty Off-Road Diesel Cycle... exhaust emission standard (or applicable FEL) for oxides of nitrogen. If alternate procedures were used...

  17. 40 CFR 89.508 - Test procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... procedure as adopted in the California Regulations for New 1996 and Later Heavy-Duty Off-Road Diesel Cycle... exhaust emission standard (or applicable FEL) for oxides of nitrogen. If alternate procedures were used...

  18. 40 CFR 89.508 - Test procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... procedure as adopted in the California Regulations for New 1996 and Later Heavy-Duty Off-Road Diesel Cycle... exhaust emission standard (or applicable FEL) for oxides of nitrogen. If alternate procedures were used...

  19. 48 CFR 315.606 - Agency procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 315.606 Agency procedures. (a) The HCA is responsible for establishing procedures to comply with FAR 15.606(a). (b) The HCA or designee shall be...

  20. 48 CFR 315.606 - Agency procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 315.606 Agency procedures. (a) The HCA is responsible for establishing procedures to comply with FAR 15.606(a). (b) The HCA or designee shall be...

  1. 48 CFR 315.606 - Agency procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 315.606 Agency procedures. (a) The HCA is responsible for establishing procedures to comply with FAR 15.606(a). (b) The HCA or designee shall be...

  2. 48 CFR 315.606 - Agency procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 315.606 Agency procedures. (a) The HCA is responsible for establishing procedures to comply with FAR 15.606(a). (b) The HCA or designee shall be...

  3. 48 CFR 315.606 - Agency procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 315.606 Agency procedures. (a) The HCA is responsible for establishing procedures to comply with FAR 15.606(a). (b) The HCA or designee shall be...

  4. 15 CFR 971.1001 - Assessment procedure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR COMMERCIAL RECOVERY PERMITS Enforcement § 971.1001 Assessment procedure. Subpart B of 15 CFR part 904 governs the procedures for assessing a civil penalty...

  5. 15 CFR 971.1001 - Assessment procedure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR COMMERCIAL RECOVERY PERMITS Enforcement § 971.1001 Assessment procedure. Subpart B of 15 CFR part 904 governs the procedures for assessing a civil penalty...

  6. 15 CFR 971.1001 - Assessment procedure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR COMMERCIAL RECOVERY PERMITS Enforcement § 971.1001 Assessment procedure. Subpart B of 15 CFR part 904 governs the procedures for assessing a civil penalty...

  7. 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...

  8. 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...

  9. 48 CFR 208.7403 - Acquisition procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... SYSTEM, DEPARTMENT OF DEFENSE ACQUISITION PLANNING REQUIRED SOURCES OF SUPPLIES AND SERVICES Enterprise Software Agreements 208.7403 Acquisition procedures. Follow the procedures at PGI 208.7403 when acquiring commercial software and related services....

  10. 48 CFR 208.7403 - Acquisition procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... SYSTEM, DEPARTMENT OF DEFENSE ACQUISITION PLANNING REQUIRED SOURCES OF SUPPLIES AND SERVICES Enterprise Software Agreements 208.7403 Acquisition procedures. Follow the procedures at PGI 208.7403 when acquiring commercial software and related services....

  11. 40 CFR 140.5 - Analytical procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...) MARINE SANITATION DEVICE STANDARD § 140.5 Analytical procedures. In determining the composition and quality of effluent discharge from marine sanitation devices, the procedures contained in 40 CFR part...

  12. 12 CFR 303.221 - Filing procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... PROCEDURES Section 19 of the FDI Act (Consent to Service of Persons Convicted of Certain Criminal Offenses) § 303.221 Filing procedures. (a) Where to file. An application under section 19 of the FDI Act shall...

  13. 50 CFR 697.11 - Civil procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ....11 Civil procedures. The civil procedure regulations at 15 CFR part 904 apply to civil penalties, permit sanctions, seizures, and forfeitures under the Atlantic Striped Bass Conservation Act and...

  14. 50 CFR 697.11 - Civil procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ....11 Civil procedures. The civil procedure regulations at 15 CFR part 904 apply to civil penalties, permit sanctions, seizures, and forfeitures under the Atlantic Striped Bass Conservation Act and...

  15. 50 CFR 697.11 - Civil procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ....11 Civil procedures. The civil procedure regulations at 15 CFR part 904 apply to civil penalties, permit sanctions, seizures, and forfeitures under the Atlantic Striped Bass Conservation Act and...

  16. 50 CFR 697.11 - Civil procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ....11 Civil procedures. The civil procedure regulations at 15 CFR part 904 apply to civil penalties, permit sanctions, seizures, and forfeitures under the Atlantic Striped Bass Conservation Act and...

  17. 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.

  18. Sandia Satellite Program summary of operational procedures

    SciTech Connect

    Not Available

    1989-08-01

    Operational procedures for the Space Systems Department and Space Sensors Department are described. Departmental policies and procedures from design of systems for space applications through qualification for spaceflight are summarized. 1 fig.

  19. 32 CFR 57.6 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... this part. (b) The procedures for educational programs and services for children with disabilities... INTERVENTION AND SPECIAL EDUCATION SERVICES TO ELIGIBLE DOD DEPENDENTS § 57.6 Procedures. (a) The...

  20. 32 CFR 197.6 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... RESEARCH IN THE FILES OF THE OFFICE OF THE SECRETARY OF DEFENSE (OSD) § 197.6 Procedures. The procedures for processing and/or researching for access to OSD Component files are in appendices B, C, and D...

  1. 32 CFR 154.56 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... procedures prescribed by 32 CFR part 253. (b) Unfavorable administrative action procedures. Except as... Personnel Manual, chapter 732, subchapter 1, paragraph 1-6b. The signature authority must be as provided...

  2. 32 CFR 154.56 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... procedures prescribed by 32 CFR part 253. (b) Unfavorable administrative action procedures. Except as... Personnel Manual, chapter 732, subchapter 1, paragraph 1-6b. The signature authority must be as provided...

  3. 15 CFR 971.1001 - Assessment procedure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR COMMERCIAL RECOVERY PERMITS Enforcement § 971.1001 Assessment procedure. Subpart B of 15 CFR part 904 governs the procedures for assessing a civil penalty...

  4. 15 CFR 971.1001 - Assessment procedure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... ENVIRONMENTAL DATA SERVICE DEEP SEABED MINING REGULATIONS FOR COMMERCIAL RECOVERY PERMITS Enforcement § 971.1001 Assessment procedure. Subpart B of 15 CFR part 904 governs the procedures for assessing a civil penalty...

  5. 49 CFR 244.17 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... with the procedures enumerated at 49 CFR 209.11. ... TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.17 Procedures. (a) Each applicant shall file...

  6. 49 CFR 244.17 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... with the procedures enumerated at 49 CFR 209.11. ... TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.17 Procedures. (a) Each applicant shall file...

  7. 49 CFR 244.17 - Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... with the procedures enumerated at 49 CFR 209.11. ... TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.17 Procedures. (a) Each applicant shall file...

  8. 49 CFR 244.17 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... with the procedures enumerated at 49 CFR 209.11. ... TRANSPORTATION REGULATIONS ON SAFETY INTEGRATION PLANS GOVERNING RAILROAD CONSOLIDATIONS, MERGERS, AND ACQUISITIONS OF CONTROL Safety Integration Plans § 244.17 Procedures. (a) Each applicant shall file...

  9. Surgical procedures for voice restoration

    PubMed Central

    Nawka, Tadeus; Hosemann, Werner

    2005-01-01

    Surgical procedures for voice restoration serve to improve oral communication by better vocal function. They comprise of phonomicrosurgery, with direct and indirect access to the larynx; laryngoplasty; laryngeal injections; and surgical laryngeal reinnervation. The basis for modern surgical techniques for voice disorders is the knowledge about the ultrastructure of the vocal folds and the increasing experience of surgeons in voice surgery, while facing high social and professional demands on the voice. Vocal activity limitation and participation restriction has become more important in the artistic and social areas. A number of surgical methods that have been developed worldwide for this reason, are presented in this article. Functional oriented surgery has to meet high standards. The diagnostics of vocal function has to be multi-dimensional in order to determine the indication and the appropriate surgical intervention. PMID:22073062

  10. Comparison of energy calculation procedures

    SciTech Connect

    Kusuda, T.

    1981-08-01

    ASHRAE has developed a simplified energy-calculation procedure suitable for small calculators that applied to nonresidential buildings and includes all the essential calculation elements - climatic data, buildings construction, operational characteristics, utility system and equipment performance, and internal heat gain due to lighting, occupancy, cooking, etc. A comparison of the results predicted by the proposed method for four typical HVAC (heating, ventilation, and air conditioning) systems in an office building in Washington, DC, against the predictions of seven detailed computer-simulation programs - AXCESS, BLAST, BLDSIM, DOE-2, E-CUBE, ESAS, and TRACE - revealed that the similarity of the results depended more on which analyst employed the methods than on which methods were used.

  11. [Current diagnosis and procedure classification].

    PubMed

    Graubner, B

    2000-01-01

    Classifications of diagnoses and medical procedures support structurized medical documentation and make it accessible to computerized evaluation. Important figures of performance of in- and outpatient medical care can be derived from these data. Actually the importance of medical classifications increases in Germany because of the decision for introducing a new accounting system for hospitals on the basis of Australian AR-DRGs. The following review describes in detail these medical classifications which are prescribed by law in Germany (ICD-10 respectively ICD-10-SGBV and OP-301 [ICPM]). Some of their most important predecessors are also being referred to and discussed in the context of medical documentation. Some ideas are given about the further development of these medical classifications (e.g. PCS) and the medical documentation, taking into account especially the future DRG situation in hospitals.

  12. 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.

  13. 39 CFR 776.9 - Review procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 39 Postal Service 1 2012-07-01 2012-07-01 false Review procedures. 776.9 Section 776.9 Postal Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Wetlands Protection § 776.9 Review procedures. (a) Early public notice. If a facility action at the contending...

  14. 39 CFR 776.9 - Review procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 39 Postal Service 1 2014-07-01 2014-07-01 false Review procedures. 776.9 Section 776.9 Postal Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Wetlands Protection § 776.9 Review procedures. (a) Early public notice. If a facility action at the contending...

  15. 39 CFR 776.9 - Review procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 39 Postal Service 1 2011-07-01 2011-07-01 false Review procedures. 776.9 Section 776.9 Postal Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Wetlands Protection § 776.9 Review procedures. (a) Early public notice. If a facility action at the contending...

  16. 39 CFR 776.9 - Review procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 39 Postal Service 1 2013-07-01 2013-07-01 false Review procedures. 776.9 Section 776.9 Postal Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Wetlands Protection § 776.9 Review procedures. (a) Early public notice. If a facility action at the contending...

  17. 39 CFR 776.9 - Review procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Review procedures. 776.9 Section 776.9 Postal Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Wetlands Protection § 776.9 Review procedures. (a) Early public notice. If a facility action at the contending...

  18. 39 CFR 954.16 - Procedure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 39 Postal Service 1 2010-07-01 2010-07-01 false Procedure. 954.16 Section 954.16 Postal Service UNITED STATES POSTAL SERVICE PROCEDURES RULES OF PRACTICE IN PROCEEDINGS RELATIVE TO THE DENIAL, SUSPENSION, OR REVOCATION OF PERIODICALS MAIL PRIVILEGES § 954.16 Procedure. (a) Evidence. The general...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 12 CFR 303.21 - Filing procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE FILING PROCEDURES Deposit Insurance § 303.21 Filing procedures. (a) Applications for deposit insurance shall be filed with.... (b) An application for deposit insurance for an interim depository institution shall be filed...

  4. 12 CFR 303.21 - Filing procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... and Banking FEDERAL DEPOSIT INSURANCE CORPORATION PROCEDURE AND RULES OF PRACTICE FILING PROCEDURES Deposit Insurance § 303.21 Filing procedures. (a) Applications for deposit insurance shall be filed with.... (b) An application for deposit insurance for an interim depository institution shall be filed...

  5. 50 CFR 12.51 - Return procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 50 Wildlife and Fisheries 1 2010-10-01 2010-10-01 false Return procedure. 12.51 Section 12.51 Wildlife and Fisheries UNITED STATES FISH AND WILDLIFE SERVICE, DEPARTMENT OF THE INTERIOR TAKING... SEIZURE AND FORFEITURE PROCEDURES Return of Property § 12.51 Return procedure. If, at the conclusion...

  6. 5 CFR 2423.21 - Motions procedure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 5 Administrative Personnel 3 2011-01-01 2011-01-01 false Motions procedure. 2423.21 Section 2423... Procedures § 2423.21 Motions procedure. (a) General requirements. All motions, except those made during a prehearing conference or hearing, shall be in writing. Motions for an extension of time, postponement of...

  7. 43 CFR 12.944 - Procurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 43 Public Lands: Interior 1 2011-10-01 2011-10-01 false Procurement procedures. 12.944 Section 12... Requirements § 12.944 Procurement procedures. (a) All recipients shall establish written procurement procedures... would be the most economical and practical procurement for the Federal Government; and (3)...

  8. 14 CFR 1260.144 - Procurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 5 2011-01-01 2010-01-01 true Procurement procedures. 1260.144 Section... Higher Education, Hospitals, and Other Non-Profit Organizations Procurement Standards § 1260.144 Procurement procedures. (a) All recipients shall establish written procurement procedures. These...

  9. 24 CFR 84.44 - Procurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 1 2011-04-01 2011-04-01 false Procurement procedures. 84.44... EDUCATION, HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 84.44 Procurement procedures. (a) All recipients shall establish written procurement procedures....

  10. 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...

  11. 49 CFR 601.47 - Review Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 7 2013-10-01 2013-10-01 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...

  12. 49 CFR 601.47 - Review Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 7 2012-10-01 2012-10-01 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...

  13. 49 CFR 601.47 - Review Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 7 2014-10-01 2014-10-01 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...

  14. 34 CFR 76.672 - Bypass procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false Bypass procedures. 76.672 Section 76.672 Education Office of the Secretary, Department of Education STATE-ADMINISTERED PROGRAMS What Conditions Must Be Met by the State and Its Subgrantees? Procedures for Bypass § 76.672 Bypass procedures. Sections...

  15. 21 CFR 16.60 - Hearing procedure.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Hearing procedure. 16.60 Section 16.60 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL REGULATORY HEARING BEFORE THE FOOD AND DRUG ADMINISTRATION Procedures for Regulatory Hearing § 16.60 Hearing procedure....

  16. 21 CFR 16.60 - Hearing procedure.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Hearing procedure. 16.60 Section 16.60 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL REGULATORY HEARING BEFORE THE FOOD AND DRUG ADMINISTRATION Procedures for Regulatory Hearing § 16.60 Hearing procedure....

  17. 10 CFR 218.31 - Incorporated procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 3 2010-01-01 2010-01-01 false Incorporated procedures. 218.31 Section 218.31 Energy DEPARTMENT OF ENERGY OIL STANDBY MANDATORY INTERNATIONAL OIL ALLOCATION Procedures § 218.31 Incorporated procedures. The following subparts of part 205 of this chapter are, as appropriate, hereby made applicable...

  18. Procedural Learning and Individual Differences in Language

    ERIC Educational Resources Information Center

    Lee, Joanna C.; Tomblin, J. Bruce

    2015-01-01

    The aim of the current study was to examine different aspects of procedural memory in young adults who varied with regard to their language abilities. We selected a sample of procedural memory tasks, each of which represented a unique type of procedural learning, and has been linked, at least partially, to the functionality of the corticostriatal…

  19. 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...

  20. 47 CFR 15.313 - Measurement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 47 Telecommunication 1 2010-10-01 2010-10-01 false Measurement procedures. 15.313 Section 15.313... Communications Service Devices § 15.313 Measurement procedures. Measurements must be made in accordance with... measurement procedure must be in accordance with good engineering practice....

  1. 31 CFR 538.500 - Licensing procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Licensing procedures. 538.500 Section..., and Statements of Licensing Policy § 538.500 Licensing procedures. For provisions relating to licensing procedures, see part 501, subpart E, of this chapter. Licensing actions taken pursuant to part...

  2. 31 CFR 585.500 - Licensing procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Licensing procedures. 585.500 Section... Licenses, Authorizations, and Statements of Licensing Policy § 585.500 Licensing procedures. For provisions relating to licensing procedures, see part 501, subpart E, of this chapter. Licensing actions...

  3. 31 CFR 575.500 - Licensing procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Licensing procedures. 575.500 Section..., and Statements of Licensing Policy § 575.500 Licensing procedures. For provisions relating to licensing procedures, see part 501, subpart E, of this chapter. Licensing actions taken pursuant to part...

  4. 31 CFR 595.500 - Licensing procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Licensing procedures. 595.500 Section..., Authorizations, and Statements of Licensing Policy § 595.500 Licensing procedures. For provisions relating to licensing procedures, see part 501, subpart E, of this chapter. Licensing actions taken pursuant to part...

  5. 31 CFR 560.500 - Licensing procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Licensing procedures. 560.500 Section..., Authorizations and Statements of Licensing Policy § 560.500 Licensing procedures. For provisions relating to licensing procedures, see part 501, subpart E, of this chapter. Licensing actions taken pursuant to part...

  6. 31 CFR 540.500 - Licensing procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Licensing procedures. 540.500 Section... REGULATIONS Licenses, Authorizations, and Statements of Licensing Policy § 540.500 Licensing procedures. For provisions relating to licensing procedures, see part 501, subpart E, of this chapter. Licensing...

  7. 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...

  8. 12 CFR 615.5130 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Procedures. 615.5130 Section 615.5130 Banks and Banking FARM CREDIT ADMINISTRATION FARM CREDIT SYSTEM FUNDING AND FISCAL AFFAIRS, LOAN POLICIES AND OPERATIONS, AND FUNDING OPERATIONS Other Funding § 615.5130 Procedures. Procedures relating to...

  9. 14 CFR 21.441 - Procedure manual.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 1 2010-01-01 2010-01-01 false Procedure manual. 21.441 Section 21.441... manual. (a) No DAS may exercise any authority under this subpart unless it submits, and obtains approval of, a procedure manual containing— (1) The procedures for issuing STCs; and (2) The names,...

  10. 40 CFR 791.31 - Expedited procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 33 2012-07-01 2012-07-01 false Expedited procedures. 791.31 Section 791.31 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) DATA REIMBURSEMENT Hearing Procedures § 791.31 Expedited procedures. Unless...

  11. 40 CFR 791.31 - Expedited procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 33 2013-07-01 2013-07-01 false Expedited procedures. 791.31 Section 791.31 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) DATA REIMBURSEMENT Hearing Procedures § 791.31 Expedited procedures. Unless...

  12. 40 CFR 791.30 - Hearing procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 33 2013-07-01 2013-07-01 false Hearing procedures. 791.30 Section 791.30 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) DATA REIMBURSEMENT Hearing Procedures § 791.30 Hearing procedures. (a) Representation by...

  13. 40 CFR 791.31 - Expedited procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Expedited procedures. 791.31 Section 791.31 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) DATA REIMBURSEMENT Hearing Procedures § 791.31 Expedited procedures. Unless...

  14. 40 CFR 791.30 - Hearing procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 33 2012-07-01 2012-07-01 false Hearing procedures. 791.30 Section 791.30 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) DATA REIMBURSEMENT Hearing Procedures § 791.30 Hearing procedures. (a) Representation by...

  15. 40 CFR 791.30 - Hearing procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 31 2010-07-01 2010-07-01 true Hearing procedures. 791.30 Section 791.30 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) TOXIC SUBSTANCES CONTROL ACT (CONTINUED) DATA REIMBURSEMENT Hearing Procedures § 791.30 Hearing procedures. (a) Representation by...

  16. 20 CFR 422.130 - Claim procedure.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 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...

  17. 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...

  18. Cloze Procedure and the Teaching of Reading.

    ERIC Educational Resources Information Center

    Rye, James

    By examining the full range of uses of the cloze procedure, this book intends to help teachers use the procedure to better understand the reading behavior of their students and to assist their students in making reading progress. Chapter 1 defines the cloze procedure and discusses the similarities and differences in reading processes when using…

  19. 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...

  20. 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…

  1. 45 CFR 1309.52 - Procurement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... Renovation § 1309.52 Procurement procedures. (a) All facility construction and major renovation transactions must comply with the procurement procedure in 45 CFR parts 74 or 92, and must be conducted in a manner... 45 Public Welfare 4 2010-10-01 2010-10-01 false Procurement procedures. 1309.52 Section...

  2. 40 CFR 30.44 - Procurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Procurement procedures. 30.44 Section..., HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 30.44 Procurement procedures. (a) All recipients shall establish written procurement procedures. These...

  3. 38 CFR 49.44 - Procurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Procurement procedures..., HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 49.44 Procurement procedures. (a) All recipients shall establish written procurement procedures. These...

  4. 45 CFR 1309.52 - Procurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Renovation § 1309.52 Procurement procedures. (a) All facility construction and major renovation transactions must comply with the procurement procedure in 45 CFR parts 74 or 92, and must be conducted in a manner... 45 Public Welfare 4 2011-10-01 2011-10-01 false Procurement procedures. 1309.52 Section...

  5. 44 CFR 206.436 - Application procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... of the measure; (5) Cost estimate for the measure; (6) Analysis of the measure's cost-effectiveness... 44 Emergency Management and Assistance 1 2014-10-01 2014-10-01 false Application procedures. 206... Program § 206.436 Application procedures. (a) General. This section describes the procedures to be used...

  6. 44 CFR 206.436 - Application procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... of the measure; (5) Cost estimate for the measure; (6) Analysis of the measure's cost-effectiveness... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Application procedures. 206... Program § 206.436 Application procedures. (a) General. This section describes the procedures to be used...

  7. 44 CFR 206.436 - Application procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... of the measure; (5) Cost estimate for the measure; (6) Analysis of the measure's cost-effectiveness... 44 Emergency Management and Assistance 1 2013-10-01 2013-10-01 false Application procedures. 206... Program § 206.436 Application procedures. (a) General. This section describes the procedures to be used...

  8. 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...

  9. 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...

  10. Administrative Procedures for Small Institutions. Second Edition.

    ERIC Educational Resources Information Center

    Mathews, Keith W., Ed.

    This guide offers sample administrative procedures and policies that can be used by small colleges and universities to prepare or revise administrative procedures manuals. The sample procedures and policies offered here have been compiled from a review of many manuals from many different institutions, and vary from the general to the specific.…

  11. 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 §...

  12. 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...

  13. 4 CFR 28.9 - Procedures; general.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 4 Accounts 1 2012-01-01 2012-01-01 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...

  14. 4 CFR 28.9 - Procedures; general.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 4 Accounts 1 2011-01-01 2011-01-01 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...

  15. 4 CFR 28.9 - Procedures; general.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 4 Accounts 1 2013-01-01 2013-01-01 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...

  16. 20 CFR 363.3 - Procedure.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 20 Employees' Benefits 1 2010-04-01 2010-04-01 false Procedure. 363.3 Section 363.3 Employees' Benefits RAILROAD RETIREMENT BOARD INTERNAL ADMINISTRATION, POLICY AND PROCEDURES GARNISHMENT OF REMUNERATION OF BOARD PERSONNEL § 363.3 Procedure. (a) Service of legal process brought for the enforcement...

  17. 40 CFR 231.7 - Emergency procedure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... may ask the Chief of Engineers to suspend the permit under 33 CFR 325.7, or the state, pending... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Emergency procedure. 231.7 Section 231...) PROCEDURES § 231.7 Emergency procedure. Where a permit has already been issued, and the Administrator...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 16 CFR 1610.6 - Test procedure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... accordance with 5 U.S.C. 552(a) and 1 CFR part 51. You may obtain a copy from the American Association of... 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...

  3. 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...

  4. 9 CFR 381.311 - Recall procedure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Recall procedure. 381.311 Section 381... CERTIFICATION POULTRY PRODUCTS INSPECTION REGULATIONS Canning and Canned Products § 381.311 Recall procedure. Establishments shall prepare and maintain a current procedure for the recall of all canned product covered...

  5. 38 CFR 18.546 - Compliance procedure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Compliance procedure. 18.546 Section 18.546 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... Enforcement Procedures § 18.546 Compliance procedure. (a) VA may enforce the Act and these regulations...

  6. 38 CFR 18.546 - Compliance procedure.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2014-07-01 2014-07-01 false Compliance procedure. 18.546 Section 18.546 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... Enforcement Procedures § 18.546 Compliance procedure. (a) VA may enforce the Act and these regulations...

  7. 38 CFR 18.546 - Compliance procedure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Compliance procedure. 18.546 Section 18.546 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... Enforcement Procedures § 18.546 Compliance procedure. (a) VA may enforce the Act and these regulations...

  8. 38 CFR 18.546 - Compliance procedure.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2013-07-01 2013-07-01 false Compliance procedure. 18.546 Section 18.546 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... Enforcement Procedures § 18.546 Compliance procedure. (a) VA may enforce the Act and these regulations...

  9. 38 CFR 18.546 - Compliance procedure.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2012-07-01 2012-07-01 false Compliance procedure. 18.546 Section 18.546 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED... Enforcement Procedures § 18.546 Compliance procedure. (a) VA may enforce the Act and these regulations...

  10. 47 CFR 15.523 - Measurement procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 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...

  11. 47 CFR 15.313 - Measurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 false Measurement procedures. 15.313 Section 15.313... Communications Service Devices § 15.313 Measurement procedures. Measurements must be made in accordance with... measurement procedure must be in accordance with good engineering practice....

  12. 47 CFR 2.947 - Measurement procedure.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Measurement procedure. 2.947 Section 2.947... Authorization § 2.947 Measurement procedure. (a) The Commission will accept data which have been measured in accordance with the following standards or measurement procedures: (1) Those set forth in bulletins...

  13. 47 CFR 15.523 - Measurement procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 47 Telecommunication 1 2011-10-01 2011-10-01 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...

  14. 47 CFR 15.313 - Measurement procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 false Measurement procedures. 15.313 Section 15.313... Communications Service Devices § 15.313 Measurement procedures. Measurements must be made in accordance with... measurement procedure must be in accordance with good engineering practice....

  15. 47 CFR 15.313 - Measurement procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 false Measurement procedures. 15.313 Section 15.313... Communications Service Devices § 15.313 Measurement procedures. Measurements must be made in accordance with... measurement procedure must be in accordance with good engineering practice....

  16. 47 CFR 15.523 - Measurement procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 47 Telecommunication 1 2012-10-01 2012-10-01 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...

  17. 47 CFR 15.523 - Measurement procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 47 Telecommunication 1 2013-10-01 2013-10-01 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...

  18. 47 CFR 15.313 - Measurement procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 47 Telecommunication 1 2014-10-01 2014-10-01 false Measurement procedures. 15.313 Section 15.313... Communications Service Devices § 15.313 Measurement procedures. Measurements must be made in accordance with... measurement procedure must be in accordance with good engineering practice....

  19. 38 CFR 49.44 - Procurement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Procurement procedures..., HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 49.44 Procurement procedures. (a) All recipients shall establish written procurement procedures. These...

  20. 40 CFR 30.44 - Procurement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Procurement procedures. 30.44 Section..., HOSPITALS, AND OTHER NON-PROFIT ORGANIZATIONS Post-Award Requirements Procurement Standards § 30.44 Procurement procedures. (a) All recipients shall establish written procurement procedures. These...

  1. 14 CFR 1260.144 - Procurement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 5 2010-01-01 2010-01-01 false Procurement procedures. 1260.144 Section... Higher Education, Hospitals, and Other Non-Profit Organizations Procurement Standards § 1260.144 Procurement procedures. (a) All recipients shall establish written procurement procedures. These...

  2. 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...

  3. 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...

  4. 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...

  5. 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...

  6. 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...

  7. 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...

  8. 28 CFR 902.5 - Hearing procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 2 2013-07-01 2013-07-01 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...

  9. 28 CFR 902.5 - Hearing procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 2 2011-07-01 2011-07-01 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...

  10. 28 CFR 902.5 - Hearing procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 2 2012-07-01 2012-07-01 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...

  11. 28 CFR 902.5 - Hearing procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 2 2014-07-01 2014-07-01 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...

  12. TMACS Test Procedure TP007: System administration

    SciTech Connect

    Scanlan, P.; Washburn, S.; Seghers, R.

    1994-05-24

    The TMACS Software Project Test Procedures translate the project`s acceptance criteria into test steps. Software releases are certified when the affected Test Procedures are successfully performed and the customers authorize installation of these changes. This Test Procedure tests the TMACS System Administration functions.

  13. 45 CFR 96.66 - Hearing procedure.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 45 Public Welfare 1 2013-10-01 2013-10-01 false Hearing procedure. 96.66 Section 96.66 Public Welfare DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION BLOCK GRANTS Hearing Procedure § 96.66 Hearing procedure. (a) A hearing is public, except when the Secretary or the presiding officer determines that all or part of a hearing...

  14. 49 CFR 199.5 - DOT procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 3 2010-10-01 2010-10-01 false DOT procedures. 199.5 Section 199.5 Transportation... DOT procedures. The anti-drug and alcohol programs required by this part must be conducted according to the requirements of this part and DOT Procedures. Terms and concepts used in this part have...

  15. 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...

  16. 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...

  17. 36 CFR 908.32 - Review procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 36 Parks, Forests, and Public Property 3 2012-07-01 2012-07-01 false Review procedures. 908.32... DEVELOPMENT AREA Review Procedure § 908.32 Review procedures. (a) Upon receipt of a request for review, the... applicable regulations; (2) Information submitted by the applicant including the request for review and...

  18. Procedures for Peer Review of Grant Applications

    ERIC Educational Resources Information Center

    US Department of Education, 2006

    2006-01-01

    This guide presents information on the procedures for peer review of grant applications. It begins with an overview of the review process for grant application submission and review. The review process includes: (1) pre-submission procedures that enable the Institute to plan for specific review sessions; (2) application processing procedures; (3)…

  19. 12 CFR 1704.42 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Procedures. 1704.42 Section 1704.42 Banks and... ORGANIZATION AND FUNCTIONS DEBT COLLECTION Administrative Offset § 1704.42 Procedures. Unless the procedures... are not exempt from disclosure; (c) An opportunity for review within OFHEO of the determination...

  20. 45 CFR 1623.4 - Suspension procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Suspension procedures. 1623.4 Section 1623.4 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION SUSPENSION PROCEDURES § 1623.4 Suspension procedures. (a) When the Corporation has made a proposed determination,...

  1. 45 CFR 1623.4 - Suspension procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 45 Public Welfare 4 2011-10-01 2011-10-01 false Suspension procedures. 1623.4 Section 1623.4 Public Welfare Regulations Relating to Public Welfare (Continued) LEGAL SERVICES CORPORATION SUSPENSION PROCEDURES § 1623.4 Suspension procedures. (a) When the Corporation has made a proposed determination,...

  2. 36 CFR 14.77 - Procedures. [Reserved

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 36 Parks, Forests, and Public Property 1 2014-07-01 2014-07-01 false Procedures. 14.77 Section 14.77 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR RIGHTS-OF-WAY Principles and Procedures, Power Transmission Lines § 14.77 Procedures....

  3. 36 CFR 14.77 - Procedures. [Reserved

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 36 Parks, Forests, and Public Property 1 2013-07-01 2013-07-01 false Procedures. 14.77 Section 14.77 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR RIGHTS-OF-WAY Principles and Procedures, Power Transmission Lines § 14.77 Procedures....

  4. 36 CFR 14.77 - Procedures. [Reserved

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Procedures. 14.77 Section 14.77 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR RIGHTS-OF-WAY Principles and Procedures, Power Transmission Lines § 14.77 Procedures....

  5. 36 CFR 14.77 - Procedures. [Reserved

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 36 Parks, Forests, and Public Property 1 2011-07-01 2011-07-01 false Procedures. 14.77 Section 14.77 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR RIGHTS-OF-WAY Principles and Procedures, Power Transmission Lines § 14.77 Procedures....

  6. 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...

  7. 48 CFR 45.202 - Evaluation procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 48 Federal Acquisition Regulations System 1 2011-10-01 2011-10-01 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...

  8. 48 CFR 45.202 - Evaluation procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 1 2014-10-01 2014-10-01 false Evaluation procedures. 45... MANAGEMENT GOVERNMENT PROPERTY Solicitation and Evaluation Procedures 45.202 Evaluation procedures. (a) The... applying, for evaluation purposes only, a rental equivalent evaluation factor as specified in FAR...

  9. 40 CFR 90.514 - Hearing procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 20 2011-07-01 2011-07-01 false Hearing procedures. 90.514 Section 90.514 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... Auditing § 90.514 Hearing procedures. The procedures provided in § 86.1014-84 (i) to (s) apply for...

  10. 40 CFR 90.514 - Hearing procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 20 2010-07-01 2010-07-01 false Hearing procedures. 90.514 Section 90.514 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED... Auditing § 90.514 Hearing procedures. The procedures provided in § 86.1014-84 (i) to (s) apply for...

  11. 50 CFR 697.11 - Civil procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ....11 Civil procedures. The civil procedure regulations at 15 CFR part 904 apply to civil penalties... 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...

  12. 36 CFR 908.32 - Review procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false Review procedures. 908.32... DEVELOPMENT AREA Review Procedure § 908.32 Review procedures. (a) Upon receipt of a request for review, the... applicable regulations; (2) Information submitted by the applicant including the request for review and...

  13. 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...

  14. 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...

  15. 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...

  16. 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...

  17. 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...

  18. 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...

  19. 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...

  20. 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...

  1. 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...

  2. 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...

  3. 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...

  4. 40 CFR 140.5 - Analytical procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...) MARINE SANITATION DEVICE STANDARD § 140.5 Analytical procedures. In determining the composition and quality of effluent discharge from marine sanitation devices, the procedures contained in 40 CFR part 136... 40 Protection of Environment 22 2010-07-01 2010-07-01 false Analytical procedures. 140.5...

  5. 10 CFR 26.127 - Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 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...

  6. 10 CFR 26.127 - Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 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...

  7. 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...

  8. Procedures for restoring vestibular disorders

    PubMed Central

    Walther, Leif Erik

    2005-01-01

    This paper will discuss therapeutic possibilities for disorders of the vestibular organs and the neurons involved, which confront ENT clinicians in everyday practice. Treatment of such disorders can be tackled either symptomatically or causally. The possible strategies for restoring the body's vestibular sense, visual function and co-ordination include medication, as well as physical and surgical procedures. Prophylactic or preventive measures are possible in some disorders which involve vertigo (bilateral vestibulopathy, kinetosis, height vertigo, vestibular disorders when diving (Tables 1 (Tab. 1) and 2 (Tab. 2)). Glucocorticoid and training therapy encourage the compensation of unilateral vestibular loss. In the case of a bilateral vestibular loss, it is important to treat the underlying disease (e.g. Cogan's disease). Although balance training does improve the patient's sense of balance, it will not restore it completely. In the case of Meniere's disease, there are a number of medications available to either treat bouts or to act as a prophylactic (e.g. dimenhydrinate or betahistine). In addition, there are non-ablative (sacculotomy) as well as ablative surgical procedures (e.g. labyrinthectomy, neurectomy of the vestibular nerve). In everyday practice, it has become common to proceed with low risk therapies initially. The physical treatment of mild postural vertigo can be carried out quickly and easily in outpatients (repositioning or liberatory maneuvers). In very rare cases it may be necessary to carry out a semicircular canal occlusion. Isolated disturbances of the otolith function or an involvement of the otolith can be found in roughly 50% of labyrinth disturbances. A specific surgical procedure to selectively block the otolith organs is currently being studied. When an external perilymph fistula involving loss of perilymph is suspected, an exploratory tympanotomy involving also the round and oval window niches must be carried out. A traumatic rupture of

  9. HUMAN RELIABILITY ANALYSIS FOR COMPUTERIZED PROCEDURES

    SciTech Connect

    Ronald L. Boring; David I. Gertman; Katya Le Blanc

    2011-09-01

    This paper provides a characterization of human reliability analysis (HRA) issues for computerized procedures in nuclear power plant control rooms. It is beyond the scope of this paper to propose a new HRA approach or to recommend specific methods or refinements to those methods. Rather, this paper provides a review of HRA as applied to traditional paper-based procedures, followed by a discussion of what specific factors should additionally be considered in HRAs for computerized procedures. Performance shaping factors and failure modes unique to computerized procedures are highlighted. Since there is no definitive guide to HRA for paper-based procedures, this paper also serves to clarify the existing guidance on paper-based procedures before delving into the unique aspects of computerized procedures.

  10. Writer`s guide for technical procedures

    SciTech Connect

    1998-12-01

    A primary objective of operations conducted in the US Department of Energy (DOE) complex is safety. Procedures are a critical element of maintaining a safety envelope to ensure safe facility operation. This DOE Writer`s Guide for Technical Procedures addresses the content, format, and style of technical procedures that prescribe production, operation of equipment and facilities, and maintenance activities. The DOE Writer`s Guide for Management Control Procedures and DOE Writer`s Guide for Emergency and Alarm Response Procedures are being developed to assist writers in developing nontechnical procedures. DOE is providing this guide to assist writers across the DOE complex in producing accurate, complete, and usable procedures that promote safe and efficient operations that comply with DOE orders, including DOE Order 5480.19, Conduct of Operations for DOE Facilities, and 5480.6, Safety of Department of Energy-Owned Nuclear Reactors.

  11. Radiological Work Planning and Procedure

    SciTech Connect

    KURTZ, J.E.

    2000-01-01

    Each facility is tasked with maintaining personnel radiation exposure as low as reasonably achievable (ALARA). A continued effort is required to meet this goal by developing and implementing improvements to technical work documents (TWDs) and work performance. A review of selected TWDs from most facilities shows there is a need to incorporate more radiological control requirements into the TWD. The Radioactive Work Permit (RWP) provides a mechanism to place some of the requirements but does not provide all the information needed by the worker as he/she is accomplishing the steps of the TWD. Requiring the engineers, planners and procedure writers to put the radiological control requirements in the work steps would be very easy if all personnel had a strong background in radiological work planning and radiological controls. Unfortunately, many of these personnel do not have the background necessary to include these requirements without assistance by the Radiological Control organization at each facility. In addition, there seems to be confusion as to what should be and what should not be included in the TWD.

  12. New material for Nuss procedure.

    PubMed

    Osawa, Hisayoshi; Mawatari, Tohru; Watanabe, Atsushi; Abe, Tomio

    2004-10-01

    The Nuss procedure for pectus excavatum repair has been considered an acceptable method in terms of its decreased invasiveness and excellent cosmetic results. Although a steel bar is usually used for elevating the sternum, we used a titanium alloy plate for pectus excavatum repair for the first time. The characteristics of this plate are that 1) it comes out translucently on X-rays, 2) MRI examination is possible because titanium will not be magnetized, and 3) it is possible to go through the security checkpoint at the airport without setting off the metal detector. Furthermore, the titanium alloy is highly elastic, which reduces complications such as dislocation, and it excels in the conformity to organization. Patients who have received the Nuss operation are forced to somewhat limit their daily life for two or three years until the bar is removed. A plate made from titanium alloy resolves this problem because of its material and it is thought to be an ideal candidate for elevating the sternum during the Nuss operation. PMID:15563267

  13. Augmented reality in surgical procedures

    NASA Astrophysics Data System (ADS)

    Samset, E.; Schmalstieg, D.; Vander Sloten, J.; Freudenthal, A.; Declerck, J.; Casciaro, S.; Rideng, Ø.; Gersak, B.

    2008-02-01

    Minimally invasive therapy (MIT) is one of the most important trends in modern medicine. It includes a wide range of therapies in videoscopic surgery and interventional radiology and is performed through small incisions. It reduces hospital stay-time by allowing faster recovery and offers substantially improved cost-effectiveness for the hospital and the society. However, the introduction of MIT has also led to new problems. The manipulation of structures within the body through small incisions reduces dexterity and tactile feedback. It requires a different approach than conventional surgical procedures, since eye-hand co-ordination is not based on direct vision, but more predominantly on image guidance via endoscopes or radiological imaging modalities. ARIS*ER is a multidisciplinary consortium developing a new generation of decision support tools for MIT by augmenting visual and sensorial feedback. We will present tools based on novel concepts in visualization, robotics and haptics providing tailored solutions for a range of clinical applications. Examples from radio-frequency ablation of liver-tumors, laparoscopic liver surgery and minimally invasive cardiac surgery will be presented. Demonstrators were developed with the aim to provide a seamless workflow for the clinical user conducting image-guided therapy.

  14. 40 CFR 91.119 - Certification procedure-use of special test procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    .... (3) A manufacturer may elect to use the test procedures in 40 CFR part 1065 as an alternate test... engines were tested using the procedures in 40 CFR part 1065. For any EPA testing with engines subject to... procedures of 40 CFR part 1065, manufacturers may elect to use the procedures specified in 40 CFR part...

  15. 40 CFR 91.119 - Certification procedure-use of special test procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    .... (3) A manufacturer may elect to use the test procedures in 40 CFR part 1065 as an alternate test... engines were tested using the procedures in 40 CFR part 1065. For any EPA testing with engines subject to... procedures of 40 CFR part 1065, manufacturers may elect to use the procedures specified in 40 CFR part...

  16. 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. PMID:11541101

  17. A procedural analysis of correspondence training techniques

    PubMed Central

    Paniagua, Freddy A.

    1990-01-01

    A variety of names have been given to procedures used in correspondence training, some more descriptive than others. In this article I argue that a terminology more accurately describing actual procedures, rather than the conceptual function that those procedures are assumed to serve, would benefit the area of correspondence training. I identify two documented procedures during the reinforcement of verbalization phase and five procedures during the reinforcement of correspondence phase and suggest that those procedures can be classified, or grouped into nonoverlapping categories, by specifying the critical dimensions of those procedures belonging to a single category. I suggest that the names of such nonoverlapping categories should clearly specify the dimensions on which the classification is based in order to facilitate experimental comparison of procedures, and to be able to recognize when a new procedure (as opposed to a variant of one already in existence) is developed. Future research involving comparative analysis across and within procedures is discussed within the framework of the proposed classification. PMID:22478059

  18. Procedure Intensity and the Cost of Care

    PubMed Central

    Chen, Serene I.; Dharmarajan, Kumar; Kim, Nancy; Strait, Kelly M.; Li, Shu-Xia; Safavi, Kyan C.; Lindenauer, Peter K.; Krumholz, Harlan M.; Lagu, Tara

    2012-01-01

    Background Costs of care in high-procedure hospitals may be related to factors beyond procedures. We sought to determine how costs for patients with heart failure (HF) not receiving procedures compare between hospital groups defined by their overall use of procedures. Methods and Results We identified all 2009–2010 adult HF hospitalizations in hospitals capable of performing invasive procedures that had at least 25 HF hospitalizations in the Perspective® database from Premier, Inc. We divided hospitals into 2 groups by the proportion of HF patients receiving invasive percutaneous or surgical procedures: low (>0–10%) and high (at least 10%). The standard costs of hospitalizations at each hospital were risk adjusted using patient demographics and comorbidities. We used the Wilcoxon Rank Sum test to assess cost, length of stay, and mortality outcome differences between the 2 groups. Median risk-standardized standard costs among low-procedural HF hospitalizations were $5,259 ($4,683, $6,814) versus $6,965 ($5,981, $8,235) for hospitals with high procedure use (p<0.001). Median length of stay was 4 days for both groups. Risk-standardized mortality rates were 5.4% (low-procedure) and 5.0% (high-procedure) (p=0.009). We did not identify any single service area that explained the difference in costs between hospital groups, but these hospitals had higher costs for most service areas. Conclusion Among patients who do not receive invasive procedures, the cost of HF hospitalization is higher in more procedure-intense hospitals compared with hospitals that perform fewer procedures. PMID:22576844

  19. Endoscopic ultrasound guided interventional procedures

    PubMed Central

    Sharma, Vishal; Rana, Surinder S; Bhasin, Deepak K

    2015-01-01

    Endoscopic ultrasound (EUS) has emerged as an important diagnostic and therapeutic modality in the field of gastrointestinal endoscopy. EUS provides access to many organs and lesions which are in proximity to the gastrointestinal tract and thus giving an opportunity to target them for therapeutic and diagnostic purposes. This modality also provides a real time opportunity to target the required area while avoiding adjacent vascular and other structures. Therapeutic EUS has found role in management of pancreatic fluid collections, biliary and pancreatic duct drainage in cases of failed endoscopic retrograde cholangiopancreatography, drainage of gallbladder, celiac plexus neurolysis/blockage, drainage of mediastinal and intra-abdominal abscesses and collections and in targeted cancer chemotherapy and radiotherapy. Infact, therapeutic EUS has emerged as the therapy of choice for management of pancreatic pseudocysts and recent innovations like fully covered removable metallic stents have improved results in patients with organised necrosis. Similarly, EUS guided drainage of biliary tract and pancreatic duct helps drainage of these systems in patients with failed cannulation, inaccessible papilla as with duodenal/gastric obstruction or surgically altered anatomy. EUS guided gall bladder drainage is a useful emergent procedure in patients with acute cholecystitis who are not fit for surgery. EUS guided celiac plexus neurolysis and blockage is more effective and less morbid vis-à-vis the percutaneous technique. The field of interventional EUS is rapidly advancing and many more interventions are being continuously added. This review focuses on the current status of evidence vis-à-vis the established indications of therapeutic EUS. PMID:26078831

  20. Assumptions of the QALY procedure.

    PubMed

    Carr-Hill, R A

    1989-01-01

    The Quality Adjusted Life Year (QALY) has been proposed as a useful index for those managing the provision of health care because it enables the decision-maker to compare the 'value' of different health care programmes and in a way which, potentially at least, reflects social preferences about the appropriate pattern of provision. The index depends on a combination of a measure of morbidity and the risk of mortality. Methodological debate has tended to concentrate on the technicalities of producing a scale of health; and philosophical argument has concentrated on the ethics of interpersonal comparison. There is little recognition of the fragility of the theoretical assumptions underpinning the proposed combination of morbidity and risk of mortality. The context in which the proposed indices are being developed is examined in Section 2. Whilst most working in the field of health measurement eschew over-simplification, it is clear that the application of micro-economics to management is greatly facilitated if a single index can be agreed. The various approaches to combining morbidity and mortality are described in Section 3. The crucial assumptions concern the measurement and valuation of morbidity; the procedures used for scaling morbidity with mortality; and the role of risk. The nature of the valuations involved are examined in Section 4. It seems unlikely that they could ever be widely acceptable; the combination with death and perfect health poses particular problems; and aggregation across individuals compounds the problem. There are also several technical difficulties of scaling and of allowing for risk which have been discussed elsewhere and so are only considered briefly in Section 5 of this paper.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2762872

  1. A general design for energy test procedures

    SciTech Connect

    Meier, Alan

    2000-06-15

    Appliances are increasingly controlled by microprocessors. Unfortunately, energy test procedures have not been modified to capture the positive and negative contributions of the microprocessor to the appliance's energy use. A new test procedure is described which captures both the mechanical and logical features present in many new appliances. We developed an energy test procedure for refrigerators that incorporates most aspects of the proposed new approach. Some of the strengths and weaknesses of the new test are described.

  2. The computational structural mechanics testbed procedures manual

    NASA Technical Reports Server (NTRS)

    Stewart, Caroline B. (Compiler)

    1991-01-01

    The purpose of this manual is to document the standard high level command language procedures of the Computational Structural Mechanics (CSM) Testbed software system. A description of each procedure including its function, commands, data interface, and use is presented. This manual is designed to assist users in defining and using command procedures to perform structural analysis in the CSM Testbed User's Manual and the CSM Testbed Data Library Description.

  3. 32 CFR 159.6 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... as country information and cultural training, and guidance on working with host country nationals and... Chief of Mission, will issue guidance and procedures implementing the standing combatant...

  4. 45 CFR 605.36 - Procedural safeguards.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... regarding the identification, evaluation, or educational placement of persons who, because of handicap, need or are believed to need special instruction or related services, a system of procedural...

  5. 45 CFR 605.36 - Procedural safeguards.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... regarding the identification, evaluation, or educational placement of persons who, because of handicap, need or are believed to need special instruction or related services, a system of procedural...

  6. 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.

  7. 7 CFR 1485.17 - Reimbursement procedures.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... OF AGRICULTURE LOANS, PURCHASES, AND OTHER OPERATIONS COOPERATIVE AGREEMENTS FOR THE DEVELOPMENT OF FOREIGN MARKETS FOR AGRICULTURAL COMMODITIES Market Access Program § 1485.17 Reimbursement procedures....

  8. 32 CFR 242.5 - Admission procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... HEALTH SCIENCES § 242.5 Admission procedures. (a) Application—(1) Civilians. Civilians seeking admission to the School of Medicine shall make direct application following instructions published in...

  9. 7 CFR 3022.2 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AGRICULTURE RESEARCH INSTITUTIONS CONDUCTING USDA-FUNDED EXTRAMURAL RESEARCH; RESEARCH MISCONDUCT § 3022.2 Procedures. Research institutions that conduct extramural research funded by USDA must foster an...

  10. 7 CFR 3022.2 - Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AGRICULTURE RESEARCH INSTITUTIONS CONDUCTING USDA-FUNDED EXTRAMURAL RESEARCH; RESEARCH MISCONDUCT § 3022.2 Procedures. Research institutions that conduct extramural research funded by USDA must foster an...

  11. 7 CFR 3022.2 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AGRICULTURE RESEARCH INSTITUTIONS CONDUCTING USDA-FUNDED EXTRAMURAL RESEARCH; RESEARCH MISCONDUCT § 3022.2 Procedures. Research institutions that conduct extramural research funded by USDA must foster an...

  12. 48 CFR 422.1308 - Complaint procedures.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... Vietnam Era, and Other Eligible Veterans 422.1308 Complaint procedures. The contracting officer shall forward complaints received about the administration of the Vietnam Era Veterans Readjustment...

  13. 48 CFR 422.1308 - Complaint procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... Vietnam Era, and Other Eligible Veterans 422.1308 Complaint procedures. The contracting officer shall forward complaints received about the administration of the Vietnam Era Veterans Readjustment...

  14. 48 CFR 422.1308 - Complaint procedures.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Vietnam Era, and Other Eligible Veterans 422.1308 Complaint procedures. The contracting officer shall forward complaints received about the administration of the Vietnam Era Veterans Readjustment...

  15. 48 CFR 422.1308 - Complaint procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... Vietnam Era, and Other Eligible Veterans 422.1308 Complaint procedures. The contracting officer shall forward complaints received about the administration of the Vietnam Era Veterans Readjustment...

  16. 21 CFR 640.120 - Alternative procedures.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... Alternative procedures. (a) The Director, Center for Biologics Evaluation and Research, may approve an... Regulations regarding blood, blood components, or blood products. Requests for such exceptions or...

  17. 48 CFR 307.104 - General procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    .... As appropriate, the discussions shall include— (1) Determining the intended acquisition strategy and... maximizing the use of, competitive procedures; (4) Performing market research, identifying potential...

  18. 7 CFR 1207.325 - Procedure.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan National Potato Promotion Board § 1207.325 Procedure. (a) Each...

  19. 7 CFR 1207.325 - Procedure.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan National Potato Promotion Board § 1207.325 Procedure. (a) Each...

  20. 7 CFR 1207.325 - Procedure.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan National Potato Promotion Board § 1207.325 Procedure. (a) Each...

  1. 7 CFR 1207.325 - Procedure.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan National Potato Promotion Board § 1207.325 Procedure. (a) Each...

  2. 7 CFR 1207.325 - Procedure.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... AND ORDERS; MISCELLANEOUS COMMODITIES), DEPARTMENT OF AGRICULTURE POTATO RESEARCH AND PROMOTION PLAN Potato Research and Promotion Plan National Potato Promotion Board § 1207.325 Procedure. (a) Each...

  3. Laparoscopic Gynecology Procedures: Avoid the Risk

    PubMed Central

    1996-01-01

    Laparoscopic approaches to gynecological surgery have been developed by an elite group of highly skilled surgeons. As these procedures become more prevalent in the general gynecological approach to disease and the general gynecologist's approach to treatment, the complication rate for these procedures is likely to increase. In an effort to assist in avoiding these complications, guidelines for the performance of laparoscopic gynecological procedures need to be established. This article presents approaches to the most common gynecological procedures that can assist in the prevention of complications. PMID:18493397

  4. 43 CFR 3601.62 - Cancellation procedure.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINERAL MATERIALS DISPOSAL Mineral Materials Disposal; General Provisions Contract and Permit Cancellation § 3601.62 Cancellation procedure....

  5. 43 CFR 3601.62 - Cancellation procedure.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) MINERAL MATERIALS DISPOSAL Mineral Materials Disposal; General Provisions Contract and Permit Cancellation § 3601.62 Cancellation procedure....

  6. Pollutant Assessments Group Procedures Manual: Volume 1, Administrative and support procedures

    SciTech Connect

    Not Available

    1992-03-01

    This manual describes procedures currently in use by the Pollutant Assessments Group. The manual is divided into two volumes: Volume 1 includes administrative and support procedures, and Volume 2 includes technical procedures. These procedures are revised in an ongoing process to incorporate new developments in hazardous waste assessment technology and changes in administrative policy. Format inconsistencies will be corrected in subsequent revisions of individual procedures. The purpose of the Pollutant Assessments Groups Procedures Manual is to provide a standardized set of procedures documenting in an auditable manner the activities performed by the Pollutant Assessments Group (PAG) of the Health and Safety Research Division (HASRD) of the Environmental Measurements and Applications Section (EMAS) at Oak Ridge National Laboratory (ORNL). The Procedures Manual ensures that the organizational, administrative, and technical activities of PAG conform properly to protocol outlined by funding organizations. This manual also ensures that the techniques and procedures used by PAG and other contractor personnel meet the requirements of applicable governmental, scientific, and industrial standards. The Procedures Manual is sufficiently comprehensive for use by PAG and contractor personnel in the planning, performance, and reporting of project activities and measurements. The Procedures Manual provides procedures for conducting field measurements and includes program planning, equipment operation, and quality assurance elements. Successive revisions of this manual will be archived in the PAG Document Control Department to facilitate tracking of the development of specific procedures.

  7. 40 CFR 35.920-2 - Procedure.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 40 Protection of Environment 1 2012-07-01 2012-07-01 false Procedure. 35.920-2 Section 35.920-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.920-2 Procedure....

  8. 40 CFR 35.920-2 - Procedure.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 40 Protection of Environment 1 2011-07-01 2011-07-01 false Procedure. 35.920-2 Section 35.920-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.920-2 Procedure....

  9. 40 CFR 35.920-2 - Procedure.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Procedure. 35.920-2 Section 35.920-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.920-2 Procedure....

  10. 40 CFR 35.920-2 - Procedure.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 40 Protection of Environment 1 2013-07-01 2013-07-01 false Procedure. 35.920-2 Section 35.920-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.920-2 Procedure....

  11. 40 CFR 35.920-2 - Procedure.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 40 Protection of Environment 1 2014-07-01 2014-07-01 false Procedure. 35.920-2 Section 35.920-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE STATE AND LOCAL ASSISTANCE Grants for Construction of Treatment Works-Clean Water Act § 35.920-2 Procedure....

  12. 31 CFR 536.801 - Procedures.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 31 Money and Finance:Treasury 3 2011-07-01 2011-07-01 false Procedures. 536.801 Section 536.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NARCOTICS TRAFFICKING SANCTIONS REGULATIONS Procedures §...

  13. 31 CFR 536.801 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 31 Money and Finance: Treasury 3 2010-07-01 2010-07-01 false Procedures. 536.801 Section 536.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NARCOTICS TRAFFICKING SANCTIONS REGULATIONS Procedures §...

  14. 31 CFR 536.801 - Procedures.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 31 Money and Finance:Treasury 3 2012-07-01 2012-07-01 false Procedures. 536.801 Section 536.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NARCOTICS TRAFFICKING SANCTIONS REGULATIONS Procedures §...

  15. 31 CFR 536.801 - Procedures.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 31 Money and Finance:Treasury 3 2013-07-01 2013-07-01 false Procedures. 536.801 Section 536.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NARCOTICS TRAFFICKING SANCTIONS REGULATIONS Procedures §...

  16. 31 CFR 536.801 - Procedures.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 31 Money and Finance:Treasury 3 2014-07-01 2014-07-01 false Procedures. 536.801 Section 536.801 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) OFFICE OF FOREIGN ASSETS CONTROL, DEPARTMENT OF THE TREASURY NARCOTICS TRAFFICKING SANCTIONS REGULATIONS Procedures §...

  17. 48 CFR 1532.805 - Procedure.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Procedure. 1532.805 Section 1532.805 Federal Acquisition Regulations System ENVIRONMENTAL PROTECTION AGENCY GENERAL CONTRACTING REQUIREMENTS CONTRACT FINANCING Assignment of Claims 1532.805 Procedure....

  18. 48 CFR 1509.105 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Procedures. 1509.105 Section 1509.105 Federal Acquisition Regulations System ENVIRONMENTAL PROTECTION AGENCY ACQUISITION PLANNING CONTRACTOR QUALIFICATIONS Responsible Prospective Contractors 1509.105 Procedures....

  19. 48 CFR 1509.407-3 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Procedures. 1509.407-3 Section 1509.407-3 Federal Acquisition Regulations System ENVIRONMENTAL PROTECTION AGENCY ACQUISITION PLANNING CONTRACTOR QUALIFICATIONS Debarment, Suspension and Ineligibility 1509.407-3 Procedures....

  20. 48 CFR 2805.503-70 - Procedures.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Procedures. 2805.503-70 Section 2805.503-70 Federal Acquisition Regulations System DEPARTMENT OF JUSTICE Competition and... Title 7, Chapter 5-25.2, General Accounting Office Policy and Procedures Manual for Guidance of...