40 CFR 75.75 - Additional ozone season calculation procedures for special circumstances.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 16 2010-07-01 2010-07-01 false Additional ozone season calculation... § 75.75 Additional ozone season calculation procedures for special circumstances. (a) The owner or operator of a unit that is required to calculate ozone season heat input for purposes of providing data...

40 CFR 75.75 - Additional ozone season calculation procedures for special circumstances.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 16 2011-07-01 2011-07-01 false Additional ozone season calculation... § 75.75 Additional ozone season calculation procedures for special circumstances. (a) The owner or operator of a unit that is required to calculate ozone season heat input for purposes of providing data...

40 CFR 75.75 - Additional ozone season calculation procedures for special circumstances.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 17 2012-07-01 2012-07-01 false Additional ozone season calculation... § 75.75 Additional ozone season calculation procedures for special circumstances. (a) The owner or operator of a unit that is required to calculate ozone season heat input for purposes of providing data...

40 CFR 75.75 - Additional ozone season calculation procedures for special circumstances.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 17 2013-07-01 2013-07-01 false Additional ozone season calculation... § 75.75 Additional ozone season calculation procedures for special circumstances. (a) The owner or operator of a unit that is required to calculate ozone season heat input for purposes of providing data...

40 CFR 75.75 - Additional ozone season calculation procedures for special circumstances.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 17 2014-07-01 2014-07-01 false Additional ozone season calculation... § 75.75 Additional ozone season calculation procedures for special circumstances. (a) The owner or operator of a unit that is required to calculate ozone season heat input for purposes of providing data...

40 CFR 79.22 - Determination of noncompliance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... (CONTINUED) REGISTRATION OF FUELS AND FUEL ADDITIVES Additive Registration Procedures § 79.22 Determination... fuel additive has failed to submit all of the information required by § 79.21, or determines within the... which is required prior to registration of the fuel additive by any provision of subpart F of this part...

40 CFR 79.22 - Determination of noncompliance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... (CONTINUED) REGISTRATION OF FUELS AND FUEL ADDITIVES Additive Registration Procedures § 79.22 Determination... fuel additive has failed to submit all of the information required by § 79.21, or determines within the... which is required prior to registration of the fuel additive by any provision of subpart F of this part...

40 CFR 79.22 - Determination of noncompliance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... (CONTINUED) REGISTRATION OF FUELS AND FUEL ADDITIVES Additive Registration Procedures § 79.22 Determination... fuel additive has failed to submit all of the information required by § 79.21, or determines within the... which is required prior to registration of the fuel additive by any provision of subpart F of this part...

40 CFR 79.22 - Determination of noncompliance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) REGISTRATION OF FUELS AND FUEL ADDITIVES Additive Registration Procedures § 79.22 Determination... fuel additive has failed to submit all of the information required by § 79.21, or determines within the... which is required prior to registration of the fuel additive by any provision of subpart F of this part...

40 CFR 79.22 - Determination of noncompliance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) REGISTRATION OF FUELS AND FUEL ADDITIVES Additive Registration Procedures § 79.22 Determination... fuel additive has failed to submit all of the information required by § 79.21, or determines within the... which is required prior to registration of the fuel additive by any provision of subpart F of this part...

Procedure: Ensuring EPA Public Content in the EPA Web Environment

EPA Pesticide Factsheets

This document outlines the procedures for ensuring access to EPA information by hosting EPA data and information on the epa.gov server. Additionally, it provides the procedures for obtaining waivers of this requirement.

24 CFR 4001.112 - Income verification.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Income verification. 4001.112... Requirements and Underwriting Procedures § 4001.112 Income verification. The mortgagee shall use FHA's procedures to verify the mortgagor's income and shall comply with the following additional requirements: (a...

Sampling and Analysis Plan for U.S. Department of Energy Office of Legacy Management Sites

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

None

2012-10-24

This plan incorporates U.S. Department of Energy (DOE) Office of Legacy Management (LM) standard operating procedures (SOPs) into environmental monitoring activities and will be implemented at all sites managed by LM. This document provides detailed procedures for the field sampling teams so that samples are collected in a consistent and technically defensible manner. Site-specific plans (e.g., long-term surveillance and maintenance plans, environmental monitoring plans) document background information and establish the basis for sampling and monitoring activities. Information will be included in site-specific tabbed sections to this plan, which identify sample locations, sample frequencies, types of samples, field measurements, and associatedmore » analytes for each site. Additionally, within each tabbed section, program directives will be included, when developed, to establish additional site-specific requirements to modify or clarify requirements in this plan as they apply to the corresponding site. A flowchart detailing project tasks required to accomplish routine sampling is displayed in Figure 1. LM environmental procedures are contained in the Environmental Procedures Catalog (LMS/PRO/S04325), which incorporates American Society for Testing and Materials (ASTM), DOE, and U.S. Environmental Protection Agency (EPA) guidance. Specific procedures used for groundwater and surface water monitoring are included in Appendix A. If other environmental media are monitored, SOPs used for air, soil/sediment, and biota monitoring can be found in the site-specific tabbed sections in Appendix D or in site-specific documents. The procedures in the Environmental Procedures Catalog are intended as general guidance and require additional detail from planning documents in order to be complete; the following sections fulfill that function and specify additional procedural requirements to form SOPs. Routine revision of this Sampling and Analysis Plan will be conducted annually at the beginning of each fiscal year when attachments in Appendix D, including program directives and sampling location/analytical tables, will be reviewed by project personnel and updated. The sampling location/analytical tables in Appendix D, however, may have interim updates according to project direction that are not reflected in this plan. Deviations from location/analytical tables in Appendix D prior to sampling will be documented in project correspondence (e.g., startup letters). If significant changes to other aspects of this plan are required before the annual update, then the plan will be revised as needed.« less

40 CFR 240.200-2 - Recommended procedures: Design.

Code of Federal Regulations, 2011 CFR

2011-07-01

....200-2 Section 240.200-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended Procedures § 240.200-2 Recommended procedures: Design. (a) In addition to the residential and commercial wastes...

40 CFR 240.200-2 - Recommended procedures: Design.

Code of Federal Regulations, 2010 CFR

2010-07-01

....200-2 Section 240.200-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended Procedures § 240.200-2 Recommended procedures: Design. (a) In addition to the residential and commercial wastes...

40 CFR 240.200-2 - Recommended procedures: Design.

Code of Federal Regulations, 2013 CFR

2013-07-01

... processing. These include: Certain bulky wastes (e.g., combustible demolition and construction debris, tree... WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended Procedures § 240.200-2 Recommended procedures: Design. (a) In addition to the residential and commercial wastes...

Project W-314 specific test and evaluation plan for transfer line SN-633 (241-AX-B to 241-AY-02A)

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

Hays, W.H.

1998-03-20

The purpose of this Specific Test and Evaluation Plan (STEP) is to provide a detailed written plan for the systematic testing of modifications made by the addition of the SN-633 transfer line by the W-314 Project. The STEP develops the outline for test procedures that verify the system`s performance to the established Project design criteria. The STEP is a lower tier document based on the W-314 Test and Evaluation Plan (TEP). This STEP encompasses all testing activities required to demonstrate compliance to the project design criteria as it relates to the addition of transfer line SN-633. The Project Design Specificationsmore » (PDS) identify the specific testing activities required for the Project. Testing includes Validations and Verifications (e.g., Commercial Grade Item Dedication activities), Factory Acceptance Tests (FATs), installation tests and inspections, Construction Acceptance Tests (CATs), Acceptance Test Procedures (ATPs), Pre-Operational Test Procedures (POTPs), and Operational Test Procedures (OTPs). It should be noted that POTPs are not required for testing of the transfer line addition. The STEP will be utilized in conjunction with the TEP for verification and validation.« less

33 CFR 203.83 - Additional requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 33 Navigation and Navigable Waters 3 2011-07-01 2011-07-01 false Additional requirements. 203.83 Section 203.83 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local Interests...

33 CFR 203.83 - Additional requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 33 Navigation and Navigable Waters 3 2014-07-01 2014-07-01 false Additional requirements. 203.83 Section 203.83 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local Interests...

33 CFR 203.83 - Additional requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 33 Navigation and Navigable Waters 3 2012-07-01 2012-07-01 false Additional requirements. 203.83 Section 203.83 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local Interests...

33 CFR 203.83 - Additional requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 33 Navigation and Navigable Waters 3 2013-07-01 2013-07-01 false Additional requirements. 203.83 Section 203.83 Navigation and Navigable Waters CORPS OF ENGINEERS, DEPARTMENT OF THE ARMY, DEPARTMENT OF DEFENSE EMERGENCY EMPLOYMENT OF ARMY AND OTHER RESOURCES, NATURAL DISASTER PROCEDURES Local Interests...

Impact of Postoperative Intravenous Acetaminophen on Opioid Requirements and Pain Scores Following Gynecologic Procedures.

PubMed

Stoudenmire, Laura G; Norman, Christy M; Latif, Erin Z

2016-10-01

This study aims to assess the impact of postoperative intravenous (IV) acetaminophen on opioid requirements and pain scores in patients following gynecologic procedures. A retrospective cohort study of patients undergoing gynecologic procedures was conducted to assess the impact of adding scheduled IV acetaminophen to postoperative analgesic regimens. The control group consisted of patients admitted prior to formulary addition of IV acetaminophen; the study group consisted of patients admitted after formulary addition of IV acetaminophen who received scheduled IV acetaminophen for at least the first 24 hours postoperatively. Opioid requirements 0 to 24 hours postoperatively served as the primary end point. Secondary end points included average pain score, cumulative acetaminophen dose, nonopioid analgesic requirements, and rate of adverse events 0 to 24 hours postoperatively. One hundred and thirty-seven patients who underwent a gynecologic procedure from January 2009 to April 2013 were included in this study. Baseline characteristics were similar between the groups. In the first 24 hours postoperatively, there was no difference in opioid requirements between the groups (21 mg [interquartile range, IQR, 15-39.8 mg] vs 32.6 mg [IQR, 16.75-41 mg], P = 0.150). The average pain score and incidence of adverse events did not differ between the 2 groups. Postoperative administration of IV acetaminophen did not provide a significant opioid-sparing effect in patients undergoing gynecologic procedures. © The Author(s) 2015.

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Reserve Select for certain members of the selected reserve; Transitional Assistance Management Program; early eligibility for TRICARE for certain reserve component members. Interim final rule with comment period.

PubMed

2005-03-16

This interim final rule establishes requirements and procedures for implementation of TRICARE Reserve Select. It also revises requirements and procedures for the Transitional Assistance Management Program. In addition, it establishes requirements and procedures for implementation of the earlier TRICARE eligibility for certain reserve component members. The rule is being published as an interim final rule with comment period in order to comply with statutory effective dates.

77 FR 59790 - General Services Administration Acquisition Regulation (GSAR); Rewrite of Part 504...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-01

....'' GSAR Subpart 504.11, Central Contractor Registration (CCR) and GSAR 504.1103, Procedures, to add the... Sec. 504.1103 Procedures. Subpart 504.11--Central Contractor Registration 504.1103 Procedures. In addition to the requirements found in FAR 4.1103, prior to awarding a contractual instrument the...

Diabetic retinopathy and complexity of retinal surgery in a general hospital.

PubMed

Mijangos-Medina, Laura Fanny; Hurtado-Noriega, Blanca Esmeralda; Lima-Gómez, Virgilio

2012-01-01

Usual retinal surgery (vitrectomy or surgery for retinal detachment) may require additional procedures to deal with complex cases, which increase time and resource use and delay access to treatment. We undertook this study to identify the proportion of primary retinal surgeries that required complex procedures and the associated causes. We carried out an observational, descriptive, cross-sectional, retrospective study. Patients with primary retinal surgery were evaluated (January 2007-December 2010). The proportion and 95% confidence intervals (CI) of preoperative diagnosis and cause of the disease requiring retinal surgery as well as the causes for complex retinal surgery were identified. Complex retinal surgery was defined as that requiring lens extraction, intraocular lens implantation, heavy perfluorocarbon liquids, silicone oil tamponade or intravitreal drugs, in addition to the usual surgical retinal procedure. The proportion of complex retinal surgeries was compared among preoperative diagnoses and among causes (χ(2), odds ratio [OR]). We studied 338 eyes. Mean age of subjects was 53.7 years, and there were 49% females. The most common diagnoses were vitreous hemorrhage (27.2%) and rhegmatogenous retinal detachment (24.6%). The most common cause was diabetes (50.6%); 273 eyes required complex surgery (80.8%, 95% CI: 76.6-85). The proportion did not differ among diagnoses but was higher in diabetic retinopathy (89%, p <0.001, OR 3.04, 95% CI: 1.63-5.7). Of the total sample, 80.8% of eyes required complex surgical procedures; diabetic retinopathy increased by 3-fold the probability of requiring these complex procedures. Early treatment of diabetic retinopathy may reduce the proportion of complex retinal surgery by 56%.

40 CFR 60.4176 - Additional requirements to provide heat input data.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 6 2011-07-01 2011-07-01 false Additional requirements to provide heat... requirements to provide heat input data. The owner or operator of a Hg Budget unit that monitors and reports Hg... monitor and report heat input rate at the unit level using the procedures set forth in part 75 of this...

40 CFR 80.165 - Certification test procedures and standards.

Code of Federal Regulations, 2013 CFR

2013-07-01

... PROGRAMS (CONTINUED) REGULATION OF FUELS AND FUEL ADDITIVES Detergent Gasoline § 80.165 Certification test... detergent additive is mixed in a test fuel meeting all relevant requirements of § 80.164, including the... for such records. (a) Fuel injector deposit control testing. (1) The required test fuel must produce...

40 CFR 80.165 - Certification test procedures and standards.

Code of Federal Regulations, 2012 CFR

2012-07-01

... PROGRAMS (CONTINUED) REGULATION OF FUELS AND FUEL ADDITIVES Detergent Gasoline § 80.165 Certification test... detergent additive is mixed in a test fuel meeting all relevant requirements of § 80.164, including the... for such records. (a) Fuel injector deposit control testing. (1) The required test fuel must produce...

12 CFR 1270.18 - Additional requirements; notice of attachment for Book-entry consolidated obligations.

Code of Federal Regulations, 2012 CFR

2012-01-01

... for Book-entry consolidated obligations. 1270.18 Section 1270.18 Banks and Banking FEDERAL HOUSING FINANCE AGENCY FEDERAL HOME LOAN BANKS LIABILITIES Book-Entry Procedure for Consolidated Obligations § 1270.18 Additional requirements; notice of attachment for Book-entry consolidated obligations. (a...

12 CFR 1270.18 - Additional requirements; notice of attachment for Book-entry consolidated obligations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... for Book-entry consolidated obligations. 1270.18 Section 1270.18 Banks and Banking FEDERAL HOUSING FINANCE AGENCY FEDERAL HOME LOAN BANKS LIABILITIES Book-Entry Procedure for Consolidated Obligations § 1270.18 Additional requirements; notice of attachment for Book-entry consolidated obligations. (a...

12 CFR 1270.18 - Additional requirements; notice of attachment for Book-entry consolidated obligations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... for Book-entry consolidated obligations. 1270.18 Section 1270.18 Banks and Banking FEDERAL HOUSING FINANCE AGENCY FEDERAL HOME LOAN BANKS LIABILITIES Book-Entry Procedure for Consolidated Obligations § 1270.18 Additional requirements; notice of attachment for Book-entry consolidated obligations. (a...

16 CFR 1014.4 - Requirements for identification of individuals making requests.

Code of Federal Regulations, 2010 CFR

2010-01-01

... GENERAL POLICIES AND PROCEDURES IMPLEMENTING THE PRIVACY ACT OF 1974 § 1014.4 Requirements for... addition to establishing the identity of the minor or other person he or she represents as required by...

16 CFR 1014.4 - Requirements for identification of individuals making requests.

Code of Federal Regulations, 2011 CFR

2011-01-01

... GENERAL POLICIES AND PROCEDURES IMPLEMENTING THE PRIVACY ACT OF 1974 § 1014.4 Requirements for... addition to establishing the identity of the minor or other person he or she represents as required by...

49 CFR 383.117 - Requirements for passenger endorsement.

Code of Federal Regulations, 2011 CFR

2011-10-01

... COMMERCIAL DRIVER'S LICENSE STANDARDS; REQUIREMENTS AND PENALTIES Required Knowledge and Skills § 383.117... following additional knowledge and skills test requirements. (a) Knowledge test. All applicants for the... procedures not otherwise specified. (b) Skills test. To obtain a passenger endorsement applicable to a...

40 CFR 79.23 - Registration.

Code of Federal Regulations, 2011 CFR

2011-07-01

... OF FUELS AND FUEL ADDITIVES Additive Registration Procedures § 79.23 Registration. (a) If the... additive which includes all of the information and assurances required by § 79.21 and has satisfactorily... the fuel additive and notify the fuel manufacturer of such registration. (b) The Administrator shall...

40 CFR 79.23 - Registration.

Code of Federal Regulations, 2014 CFR

2014-07-01

... OF FUELS AND FUEL ADDITIVES Additive Registration Procedures § 79.23 Registration. (a) If the... additive which includes all of the information and assurances required by § 79.21 and has satisfactorily... the fuel additive and notify the fuel manufacturer of such registration. (b) The Administrator shall...

40 CFR 79.23 - Registration.

Code of Federal Regulations, 2012 CFR

2012-07-01

... OF FUELS AND FUEL ADDITIVES Additive Registration Procedures § 79.23 Registration. (a) If the... additive which includes all of the information and assurances required by § 79.21 and has satisfactorily... the fuel additive and notify the fuel manufacturer of such registration. (b) The Administrator shall...

40 CFR 79.23 - Registration.

Code of Federal Regulations, 2013 CFR

2013-07-01

... OF FUELS AND FUEL ADDITIVES Additive Registration Procedures § 79.23 Registration. (a) If the... additive which includes all of the information and assurances required by § 79.21 and has satisfactorily... the fuel additive and notify the fuel manufacturer of such registration. (b) The Administrator shall...

40 CFR 79.23 - Registration.

Code of Federal Regulations, 2010 CFR

2010-07-01

... OF FUELS AND FUEL ADDITIVES Additive Registration Procedures § 79.23 Registration. (a) If the... additive which includes all of the information and assurances required by § 79.21 and has satisfactorily... the fuel additive and notify the fuel manufacturer of such registration. (b) The Administrator shall...

40 CFR 97.76 - Additional requirements to provide heat input data.

Code of Federal Regulations, 2010 CFR

2010-07-01

... heat input data. 97.76 Section 97.76 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Monitoring and Reporting § 97.76 Additional requirements to provide heat input data. The owner or operator of... a flow system shall also monitor and report heat input rate at the unit level using the procedures...

40 CFR 97.76 - Additional requirements to provide heat input data.

Code of Federal Regulations, 2011 CFR

2011-07-01

... heat input data. 97.76 Section 97.76 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Monitoring and Reporting § 97.76 Additional requirements to provide heat input data. The owner or operator of... a flow system shall also monitor and report heat input rate at the unit level using the procedures...

40 CFR 80.165 - Certification test procedures and standards.

Code of Federal Regulations, 2014 CFR

2014-07-01

... PROGRAMS (CONTINUED) REGULATION OF FUELS AND FUEL ADDITIVES Detergent Gasoline § 80.165 Certification test... additive is mixed in a test fuel meeting all relevant requirements of § 80.164, including the deposit... control testing. The required test fuel must produce no more than 5% flow restriction in any one injector...

40 CFR 97.76 - Additional requirements to provide heat input data.

Code of Federal Regulations, 2013 CFR

2013-07-01

... heat input data. 97.76 Section 97.76 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Monitoring and Reporting § 97.76 Additional requirements to provide heat input data. The owner or operator of... a flow system shall also monitor and report heat input rate at the unit level using the procedures...

40 CFR 97.76 - Additional requirements to provide heat input data.

Code of Federal Regulations, 2014 CFR

2014-07-01

... heat input data. 97.76 Section 97.76 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Monitoring and Reporting § 97.76 Additional requirements to provide heat input data. The owner or operator of... a flow system shall also monitor and report heat input rate at the unit level using the procedures...

40 CFR 97.76 - Additional requirements to provide heat input data.

Code of Federal Regulations, 2012 CFR

2012-07-01

... heat input data. 97.76 Section 97.76 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Monitoring and Reporting § 97.76 Additional requirements to provide heat input data. The owner or operator of... a flow system shall also monitor and report heat input rate at the unit level using the procedures...

A Web-based Multimedia Program Before Colonoscopy Increased Knowledge and Decreased Anxiety, Sedation Requirement, and Procedure Time.

PubMed

Parker, Siddhartha; Zipursky, Jonathan; Ma, Helen; Baumblatt, Geri-Lynn; Siegel, Corey A

2018-07-01

Assess the impact of a web-based multimedia patient engagement program on patient anxiety, perception and knowledge about the colonoscopy in addition to procedure outcomes. The success of patients coming for a colonoscopy for colorectal cancer screening is dependent in part on patients' understanding of the preparation and of the procedure. Patients were randomized to use either our institution's standard preprocedure colonoscopy packet or a web-based multimedia patient engagement program (Emmi Solutions) before their scheduled procedure. On the day of colonoscopy, all participants completed a survey including questions to assess knowledge and perception of colonoscopy, in addition to the State Trait Anxiety Inventory. We also collected procedure data including medication doses and procedure time. Patients in the experimental group correctly answered knowledge questions (82%) more often than the control group (74%) (P=0.0003). More than half (58%) of patients in the experimental group felt this intervention reduced their anxiety about the procedure, and the State Trait Anxiety Inventory anxiety score was lower in the experimental group (P=0.026). Patients who viewed the program required less midazolam (3.66 vs. 4.46 mg, P=0.0035) and total procedure time was shorter (24.8 vs. 29 min, P=0.024). A web-based multimedia patient engagement program watched before colonoscopy decreased patient anxiety, medication requirements, and procedure time while increasing knowledge. This intervention could help patients understand and feel more comfortable about colonoscopy leading to increased screening rates while increasing efficiency and decreasing recovery time.

Crew procedures development techniques

NASA Technical Reports Server (NTRS)

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

1975-01-01

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

CSPD Technical Manual: Procedures for Comprehensive Assessment of Educational Personnel Supply/Demand. 1990 Edition.

ERIC Educational Resources Information Center

Lauritzen, Paul; Friedman, Stephen

This manual presents procedures for collecting data to project personnel needs in the field of special education, addressing in part the Comprehensive System of Personnel Development requirements of Public Law 94-142. Implementation of the procedures identifies: areas of education that show need for additional teachers as well as areas of surplus;…

Verifying Dissolution Of Wax From Hardware Surfaces

NASA Technical Reports Server (NTRS)

Montoya, Benjamina G.

1995-01-01

Wax removed by cleaning solvent revealed by cooling solution with liquid nitrogen. Such improved procedure and test needed in case of hardware that must be protected by wax during machining or plating but required to be free of wax during subsequent use. Improved cleaning procedure and test take less than 5 minutes. Does not require special skill or equipment and performs at cleaning site. In addition, enables recovery of all cleaning solvent.

49 CFR 1155.23 - Additional requirements when filing after an unsatisfactory result from a State, local, or...

Code of Federal Regulations, 2010 CFR

2010-10-01

... Procedures Governing Applications for a Land-Use-Exemption Permit § 1155.23 Additional requirements when... the facility. (a) When an applicant has previously sought permission from the applicable state, local... siting of the facility, the applicant may petition the Board to accept an application for a land-use...

21 CFR 170.30 - Eligibility for classification as generally recognized as safe (GRAS).

Code of Federal Regulations, 2013 CFR

2013-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION (CONTINUED) FOOD ADDITIVES Food Additive... obtain approval of a food additive regulation for the ingredient. General recognition of safety through... of scientific procedures required for approval of a food additive regulation. General recognition of...

21 CFR 170.30 - Eligibility for classification as generally recognized as safe (GRAS).

Code of Federal Regulations, 2011 CFR

2011-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION (CONTINUED) FOOD ADDITIVES Food Additive... obtain approval of a food additive regulation for the ingredient. General recognition of safety through... of scientific procedures required for approval of a food additive regulation. General recognition of...

21 CFR 170.30 - Eligibility for classification as generally recognized as safe (GRAS).

Code of Federal Regulations, 2012 CFR

2012-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION (CONTINUED) FOOD ADDITIVES Food Additive... obtain approval of a food additive regulation for the ingredient. General recognition of safety through... of scientific procedures required for approval of a food additive regulation. General recognition of...

21 CFR 170.30 - Eligibility for classification as generally recognized as safe (GRAS).

Code of Federal Regulations, 2010 CFR

2010-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION (CONTINUED) FOOD ADDITIVES Food Additive... obtain approval of a food additive regulation for the ingredient. General recognition of safety through... of scientific procedures required for approval of a food additive regulation. General recognition of...

Long-term outcomes after primary failures of artificial urinary sphincter implantation.

PubMed

Wang, Rou; McGuire, Edward J; He, Chang; Faerber, Gary J; Latini, Jerilyn M

2012-04-01

To assess our institutional outcomes after primary artificial urinary sphincter (AUS) failures. From 1985 to 2010, a total of 149 patients underwent 318 primary and additional AUS procedures. We classified additional procedures as revisions, replacements, or explantations. At a median of 52 months (range, 6-250 months), 53% of patients had required at least 1 additional procedure beyond their initial implantation. These included 106 (63%) revisions, 42 (24.9%) explantations, and 21 (12.4%) replacements. The most common revision was reservoir upsizing (37/106). Reasons for first revision included recurrent incontinence (56.7%), mechanical malfunction (22%), and infection or erosion (18.6%). Explantations were performed primarily for infection and erosion (64.3%). Median time to first revision was 20.1 months (range, 0.1-173 months) after implantation, with a median of 9.5 months (range, 1-102 months) between revisions. Explantation occurred at a median of 22 months (range, 1-221 months) after implant, and subsequent replacement at a median of 33.6 months (range, 2-138 months). At 5 years, 28/83 (33.7%) patients had undergone no additional procedures. Patients with previous radiation were more likely to experience infection (P = .03; OR 3.99; 95% CI 1.03-15.42). Patients with previous myocardial infarction were more likely to experience erosion (P = .04; OR 2.29; 95% CI 1.05-5.02), and obese patients were more likely to experience mechanical malfunction (P = .04; OR 2.62; 95% CI 1.07-6.4). More than half of patients with an AUS will require additional procedures, most likely revision. Radiation, previous myocardial infarction, and obesity are linked to complications. Median time to first revision or explantation is slightly less than 2 years, indicating that long-term follow-up is required after initial implantation. Copyright © 2012 Elsevier Inc. All rights reserved.

5 CFR 838.721 - Application requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (CONTINUED) COURT ORDERS AFFECTING RETIREMENT BENEFITS Procedures for Processing Court Orders Awarding Former... former spouse survivor annuity based on a court order acceptable for processing. No special form is required to give OPM notice of the court order. (2) OPM may require an additional application after the...

40 CFR 600.509-12 - Voluntary submission of additional data.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) ENERGY POLICY FUEL ECONOMY AND GREENHOUSE GAS EXHAUST EMISSIONS OF MOTOR VEHICLES Procedures for Determining Manufacturer's Average Fuel Economy and Manufacturer's Average Carbon-Related Exhaust Emissions... addition to the data required by the Administrator. (b) Additional fuel economy and carbon-related exhaust...

40 CFR 600.509-12 - Voluntary submission of additional data.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) ENERGY POLICY FUEL ECONOMY AND GREENHOUSE GAS EXHAUST EMISSIONS OF MOTOR VEHICLES Procedures for Determining Manufacturer's Average Fuel Economy and Manufacturer's Average Carbon-Related Exhaust Emissions... addition to the data required by the Administrator. (b) Additional fuel economy and carbon-related exhaust...

12 CFR 574.6 - Procedural requirements.

Code of Federal Regulations, 2010 CFR

2010-01-01

... part: (i) By a savings and loan holding company for approval of acquisitions by a merger, consolidation... company; or (ii) By any company for approval of acquisitions by a merger, consolidation, or purchase of... means acceptable to the Office. (i) Additional procedures for acquisitions involving mergers...

7 CFR 1455.11 - Application procedure.

Code of Federal Regulations, 2012 CFR

2012-01-01

... PROGRAM § 1455.11 Application procedure. (a) Request for applications (RFA). CCC will issue periodic RFAs... following elements; additional required elements may be specified in the applicable RFA: (1) Title page; (2) Table of contents; (3) Executive summary, which includes; (i) Activities. Provide a summary of the...

7 CFR 1455.11 - Application procedure.

Code of Federal Regulations, 2011 CFR

2011-01-01

... PROGRAM § 1455.11 Application procedure. (a) Request for applications (RFA). CCC will issue periodic RFAs... following elements; additional required elements may be specified in the applicable RFA: (1) Title page; (2) Table of contents; (3) Executive summary, which includes; (i) Activities. Provide a summary of the...

7 CFR 1455.11 - Application procedure.

Code of Federal Regulations, 2013 CFR

2013-01-01

... PROGRAM § 1455.11 Application procedure. (a) Request for applications (RFA). CCC will issue periodic RFAs... following elements; additional required elements may be specified in the applicable RFA: (1) Title page; (2) Table of contents; (3) Executive summary, which includes; (i) Activities. Provide a summary of the...

7 CFR 1455.11 - Application procedure.

Code of Federal Regulations, 2014 CFR

2014-01-01

... PROGRAM § 1455.11 Application procedure. (a) Request for applications (RFA). CCC will issue periodic RFAs... following elements; additional required elements may be specified in the applicable RFA: (1) Title page; (2) Table of contents; (3) Executive summary, which includes; (i) Activities. Provide a summary of the...

Rocket propulsion hazard summary: Safety classification, handling experience and application to space shuttle payload

NASA Technical Reports Server (NTRS)

Pennington, D. F.; Man, T.; Persons, B.

1977-01-01

The DOT classification for transportation, the military classification for quantity distance, and hazard compatibility grouping used to regulate the transportation and storage of explosives are presented along with a discussion of tests used in determining sensitivity of propellants to an impact/shock environment in the absence of a large explosive donor. The safety procedures and requirements of a Scout launch vehicle, Western and Eastern Test Range, and the Minuteman, Delta, and Poseidon programs are reviewed and summarized. Requirements of the space transportation system safety program include safety reviews from the subsystem level to the completed payload. The Scout safety procedures will satisfy a portion of these requirements but additional procedures need to be implemented to comply with the safety requirements for Shuttle operation from the Eastern Test Range.

Evaluating the use of preoperative antibiotics in pediatric orthopaedic surgery.

PubMed

Formaini, Nathan; Jacob, Paul; Willis, Leisel; Kean, John R

2012-01-01

To evaluate the rate of infection after minimally invasive procedures on a consecutive series of pediatric orthopaedic patients. We hypothesized that the use of preoperative antibiotics for minimally invasive pediatric orthopaedic procedures does not significantly reduce the incidence of surgical site infection requiring surgical debridement within 30 days of the primary procedure. We retrospectively reviewed 2330 patients having undergone minimally invasive orthopaedic procedures at our institution between March 2008 and November 2010. Knee arthroscopy, closed reduction with percutaneous fixation, soft tissue releases, excision of bony or soft-tissue masses, and removal of hardware constituted the vast majority of included procedures. Two groups, based on whether prophylactic antibiotics were administered before surgery, were created and the incidence of a repeat procedure required for deep infection was recorded. Statistical analysis was performed to determine significance, if any, between the 2 groups. Chart review of the 2330 patients identified 1087 as having received preoperative antibiotics, whereas the remaining 1243 patients did not receive antibiotics before surgery. Only 1 patient out of the 1243 cases in which antibiotics were not given required additional surgery within 30 days of the primary procedure due to a complicated surgical site infection (an incidence of 0.0008%). No patients in the antibiotic group developed a postoperative infection within 30 days requiring a return to the operating room for management. Our data revealed no significant increase in the incidence of complicated infection requiring additional procedures when antibiotics were not administered before surgery. Though prophylactic antibiotics have been shown to confer numerous benefits for patients undergoing relatively major operations, their use in cases of minimally invasive and/or percutaneous orthopaedic surgery is not well defined. Our data suggest that the use of prophylactic antibiotics may not be indicated for many less invasive procedures when performed in a low-risk pediatric population. Future studies are warranted to help establish evidence-based guidelines regarding the routine use of prophylactic antibiotics in this specific population, hopefully resulting in improved cost-effectiveness and safety while slowing the emergence of new drug-resistant organisms. Level III, retrospective comparative.

Challenges in Interventional Radiology: The Pregnant Patient

PubMed Central

Moon, Eunice K.; Wang, Weiping; Newman, James S.; Bayona-Molano, Maria Del Pilar

2013-01-01

A pregnant patient presenting to interventional radiology (IR) has a different set of needs from any other patient requiring a procedure. Often, the patient's care can be in direct conflict with the growth and development of the fetus, whether it be optimal fluoroscopic imaging, adequate sedation of the mother, or the timing of the needed procedure. Despite the additional risks and complexities associated with pregnancy, IR procedures can be performed safely for the pregnant patient with knowledge of the special and general needs of the pregnant patient, use of acceptable medications and procedures likely to be encountered during pregnancy, in addition to strategies to protect the patient and her fetus from the hazards of radiation. PMID:24436567

40 CFR 600.509-08 - Voluntary submission of additional data.

Code of Federal Regulations, 2013 CFR

2013-07-01

... (CONTINUED) ENERGY POLICY FUEL ECONOMY AND GREENHOUSE GAS EXHAUST EMISSIONS OF MOTOR VEHICLES Procedures for Determining Manufacturer's Average Fuel Economy and Manufacturer's Average Carbon-Related Exhaust Emissions... data in addition to the data required by the Administrator. (b) Additional fuel economy data may be...

40 CFR 600.509-08 - Voluntary submission of additional data.

Code of Federal Regulations, 2012 CFR

2012-07-01

... (CONTINUED) ENERGY POLICY FUEL ECONOMY AND GREENHOUSE GAS EXHAUST EMISSIONS OF MOTOR VEHICLES Procedures for Determining Manufacturer's Average Fuel Economy and Manufacturer's Average Carbon-Related Exhaust Emissions... data in addition to the data required by the Administrator. (b) Additional fuel economy data may be...

Risk factors for an additional port in single-incision laparoscopic cholecystectomy in patients with cholecystitis.

PubMed

Araki, Kenichiro; Shirabe, Ken; Watanabe, Akira; Kubo, Norio; Sasaki, Shigeru; Suzuki, Hideki; Asao, Takayuki; Kuwano, Hiroyuki

2017-01-01

Although single-incision laparoscopic cholecystectomy is now widely performed in patients with cholecystitis, some cases require an additional port to complete the procedure. In this study, we focused on risk factor of additional port in this surgery. We performed single-incision cholecystectomy in 75 patients with acute cholecystitis or after cholecystitis between 2010 and 2014 at Gunma University Hospital. Surgical indications followed the TG13 guidelines. Our standard procedure for single-incision cholecystectomy routinely uses two needlescopic devices. We used logistic regression analysis to identify the risk factors associated with use of an additional full-size port (5 or 10 mm). Surgical outcome was acceptable without biliary injury. Nine patients (12.0%) required an additional port, and one patient (1.3%) required conversion to open cholecystectomy because of severe adhesions around the cystic duct and common bile duct. In multivariate analysis, high C-reactive protein (CRP) values (>7.0 mg/dl) during cholecystitis attacks were significantly correlated with the need for an additional port (P = 0.009), with a sensitivity of 55.6%, specificity of 98.5%, and accuracy of 93.3%. This study indicated that the severe inflammation indicated by high CRP values during cholecystitis attacks predicts the need for an additional port. J. Med. Invest. 64: 245-249, August, 2017.

Collective Protection (COLPRO) Novel Closures Testing

DTIC Science & Technology

2013-03-28

science and technology programs for future ColPro systems may include interfaces such as novel designs using zippers, hook-and-pile closures, and...necessitate new testing procedures. Additionally, stand- ards of performance must be adjusted as technologies advance. Test procedures and parameters...listed in this TOP may require updating to accommodate new technologies in test items or in test instrumentation. Any variation to the TOP procedures

76 FR 80226 - Technical Amendments

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-23

... final rule, effective upon publication. Generally, the Administrative Procedure Act (APA) requires a.... Additionally, the APA requires that a final rule must have a delayed effective date of 30 days from the date of... delayed effective date requirement under the APA. 5 U.S.C. 553(d)(3). Again the technical change conforms...

20 CFR 663.705 - What are the requirements for OJT contracts for employed workers?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the requirements for OJT contracts for employed workers? 663.705 Section 663.705 Employees' Benefits EMPLOYMENT AND TRAINING... production or service procedures, upgrading to new jobs that require additional skills, workplace literacy...

40 CFR 98.116 - Data reporting requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... information, analyses of representative samples you collected). (7) If you use the missing data procedures in... addition to the information required by § 98.3(c), each annual report must contain the information... you must report under this subpart the relevant information required by § 98.37 for the Tier 4...

21 CFR 570.30 - Eligibility for classification as generally recognized as safe (GRAS).

Code of Federal Regulations, 2014 CFR

2014-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS FOOD ADDITIVES Food... obtain approval of a food additive regulation for the ingredient. General recognition of safety through... scientific procedures required for approval of a food additive regulation. General recognition of safety...

21 CFR 570.30 - Eligibility for classification as generally recognized as safe (GRAS).

Code of Federal Regulations, 2011 CFR

2011-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS FOOD ADDITIVES Food... obtain approval of a food additive regulation for the ingredient. General recognition of safety through... scientific procedures required for approval of a food additive regulation. General recognition of safety...

21 CFR 570.30 - Eligibility for classification as generally recognized as safe (GRAS).

Code of Federal Regulations, 2012 CFR

2012-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS FOOD ADDITIVES Food... obtain approval of a food additive regulation for the ingredient. General recognition of safety through... scientific procedures required for approval of a food additive regulation. General recognition of safety...

21 CFR 570.30 - Eligibility for classification as generally recognized as safe (GRAS).

Code of Federal Regulations, 2013 CFR

2013-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS FOOD ADDITIVES Food... obtain approval of a food additive regulation for the ingredient. General recognition of safety through... scientific procedures required for approval of a food additive regulation. General recognition of safety...

21 CFR 570.30 - Eligibility for classification as generally recognized as safe (GRAS).

Code of Federal Regulations, 2010 CFR

2010-04-01

... HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS FOOD ADDITIVES Food... obtain approval of a food additive regulation for the ingredient. General recognition of safety through... scientific procedures required for approval of a food additive regulation. General recognition of safety...

Decimal Fraction Arithmetic: Logical Error Analysis and Its Validation.

ERIC Educational Resources Information Center

Standiford, Sally N.; And Others

This report illustrates procedures of item construction for addition and subtraction examples involving decimal fractions. Using a procedural network of skills required to solve such examples, an item characteristic matrix of skills analysis was developed to describe the characteristics of the content domain by projected student difficulties. Then…

Health Care Procedure Considerations and Individualized Health Care Plans

ERIC Educational Resources Information Center

Heller, Kathryn Wolff; Avant, Mary Jane Thompson

2011-01-01

Teachers need to maintain a safe, healthy environment for all their students in order to promote learning. However, there are additional considerations when students require health care procedures, such as tube feeding or clean intermittent catheterization. Teachers must effectively monitor their students and understand their roles and…

Theft Reversal: An Overcorrection Procedure for Eliminating Stealing by Retarded Persons

ERIC Educational Resources Information Center

Azrin, N. H.; Wesolowski, M. D.

1974-01-01

To deal with the problem of stealing among 34 severely and profoundly retarded institutionalized adults, an overcorrection procedure was designed in which the thief was required to give his victim an item identical to the stolen one in addition to returning the stolen item. (Author)

New gasoline regulations require annual attestations

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

Leger, M.W.; Lott, L.H.

1995-03-27

The US Environmental Protection Agency's new reformulated fuels regulations impose a myriad of new record keeping and reporting requirements, in addition to the new quality standards. These requirements include an annual procedures review, or attestation. The attestation is part of EPA's enforcement plan and is required of all refiners, importers, and oxygenate blenders. This annual report is due May 31 of the year following the covered period and must be performed by a certified public accountant or a certified internal auditor. The attestation procedure is too complicated and detailed to be explained fully here, but the main points covered bymore » the attestation are outlined to inform refiners who may be unaware of the requirements.« less

47 CFR 22.165 - Additional transmitters for existing systems.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 2 2010-10-01 2010-10-01 false Additional transmitters for existing systems. 22.165 Section 22.165 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) COMMON CARRIER SERVICES PUBLIC MOBILE SERVICES Licensing Requirements and Procedures Applications and Notifications § 22...

Scandinavian Total Ankle Replacement: 15-Year Follow-up.

PubMed

Palanca, Ariel; Mann, Roger A; Mann, Jeffrey A; Haskell, Andrew

2018-02-01

Over the past decade, total ankle arthroplasty (TAA) has become a mainstay in the treatment of end-stage ankle arthritis. Currently in its fourth generation, the Scandanavian Total Ankle Replacement (STAR) is the only 3-piece mobile bearing ankle prosthesis available in the United States. Our current study reports implant survivorship at 15 years and patient outcomes for a subset of these survivors available for study. Eighty-four TAAs were performed between 1998 and 2000. Metal component survivorship at 15 years was calculated with a Kaplan-Meier curve. Twenty-four (29%) of 84 patients were available for participation with a minimum 15-year follow-up. Any radiographic changes were documented. All additional procedures and complications were recorded. Clinical findings, self-reported performance and pain evaluations, and AOFAS ankle/hindfoot scores were noted. Metal implant survival was 73% at 15 years. Of the 24 patients available for clinical evaluation, 18 of 24 patients (70.7%) had no change in prosthetic alignment from the immediate postoperative radiograph. Only 1 subtalar fusion was required for symptomatic adjacent joint arthritis. Three patients sustained a broken polyethylene component. AOFAS scores improved from an average of 39.6 points preoperatively, to an average of 71.6. More than half (52.4%) of patients with retained implants required an additional surgical procedure; 3 required 2 additional procedures. The average time to subsequent procedure was 10.2 years. Our small cohort demonstrated STAR ankles with retention at 9 years were highly likely to survive to 15 years, and patients continued to have significant improvement in pain relief and minimal decrease in function. At 15 years from TAA, metal survivorship was 73%. As with all ankle replacements, supplementary procedures were common. Level IV, case series.

29 CFR 1926.1404 - Assembly/Disassembly-general requirements (applies to all assembly and disassembly operations).

Code of Federal Regulations, 2013 CFR

2013-07-01

...'s procedures must be followed. When lifting loads without using outriggers or stabilizers, the manufacturer's procedures must be met regarding truck wedges or screws. (r) Rigging. In addition to following...(o)(3) before assembly/disassembly begins. (5) Boom and jib pick points. The point(s) of attachment...

29 CFR 1926.1404 - Assembly/Disassembly-general requirements (applies to all assembly and disassembly operations).

Code of Federal Regulations, 2012 CFR

2012-07-01

...'s procedures must be followed. When lifting loads without using outriggers or stabilizers, the manufacturer's procedures must be met regarding truck wedges or screws. (r) Rigging. In addition to following...(o)(3) before assembly/disassembly begins. (5) Boom and jib pick points. The point(s) of attachment...

29 CFR 1926.1404 - Assembly/Disassembly-general requirements (applies to all assembly and disassembly operations).

Code of Federal Regulations, 2011 CFR

2011-07-01

...'s procedures must be followed. When lifting loads without using outriggers or stabilizers, the manufacturer's procedures must be met regarding truck wedges or screws. (r) Rigging. In addition to following...(o)(3) before assembly/disassembly begins. (5) Boom and jib pick points. The point(s) of attachment...

29 CFR 1926.1404 - Assembly/Disassembly-general requirements (applies to all assembly and disassembly operations).

Code of Federal Regulations, 2014 CFR

2014-07-01

...'s procedures must be followed. When lifting loads without using outriggers or stabilizers, the manufacturer's procedures must be met regarding truck wedges or screws. (r) Rigging. In addition to following...(o)(3) before assembly/disassembly begins. (5) Boom and jib pick points. The point(s) of attachment...

14 CFR 382.55 - May carriers impose security screening procedures for passengers with disabilities that go beyond...

Code of Federal Regulations, 2013 CFR

2013-01-01

... Accessibility of Airport Facilities § 382.55 May carriers impose security screening procedures for passengers..., including those with disabilities, are subject to TSA security screening requirements at U.S. airports. In addition, passengers at foreign airports, including those with disabilities, may be subject to security...

14 CFR 382.55 - May carriers impose security screening procedures for passengers with disabilities that go beyond...

Code of Federal Regulations, 2014 CFR

2014-01-01

... Accessibility of Airport Facilities § 382.55 May carriers impose security screening procedures for passengers..., including those with disabilities, are subject to TSA security screening requirements at U.S. airports. In addition, passengers at foreign airports, including those with disabilities, may be subject to security...

14 CFR 382.55 - May carriers impose security screening procedures for passengers with disabilities that go beyond...

Code of Federal Regulations, 2012 CFR

2012-01-01

... Accessibility of Airport Facilities § 382.55 May carriers impose security screening procedures for passengers..., including those with disabilities, are subject to TSA security screening requirements at U.S. airports. In addition, passengers at foreign airports, including those with disabilities, may be subject to security...

The work of the European Union Reference Laboratory for Food Additives (EURL) and its support for the authorisation process of feed additives in the European Union: a review

PubMed Central

von Holst, Christoph; Robouch, Piotr; Bellorini, Stefano; de la Huebra, María José González; Ezerskis, Zigmas

2016-01-01

ABSTRACT This paper describes the operation of the European Union Reference Laboratory for Feed Additives (EURL) and its role in the authorisation procedure of feed additives in the European Union. Feed additives are authorised according to Regulation (EC) No. 1831/2003, which introduced a completely revised authorisation procedure and also established the EURL. The regulations authorising feed additives contain conditions of use such as legal limits of the feed additives, which require the availability of a suitable method of analysis for official control purposes under real world conditions. It is the task of the EURL to evaluate the suitability of analytical methods as proposed by the industry for this purpose. Moreover, the paper shows that one of the major challenges is the huge variety of the methodology applied in feed additive analysis, thus requiring expertise in quite different analytical areas. In order to cope with this challenge, the EURL is supported by a network of national reference laboratories (NRLs) and only the merged knowledge of all NRLs allows for a scientifically sound assessment of the analytical methods. PMID:26540604

Study of the Decision-Making Procedures for the Acquisition of Science Library Materials and the Relation of These Procedures to the Requirements of College and University Library Patrons.

ERIC Educational Resources Information Center

Lane, David O.

The idea that there was a need for formal study of the methods by which titles are selected for addition to the collections of academic science libraries resulted in this investigation of the selection processes of these libraries. Specifically, the study concentrates on the selection procedures in three sciences: biology, chemistry, and physics.…

75 FR 62639 - Air Ambulance and Commercial Helicopter Operations, Part 91 Helicopter Operations, and Part 135...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-12

...This proposed rule addresses air ambulance and commercial helicopter operations, part 91 helicopter operations, and load manifest requirements for all part 135 aircraft. From 2002 to 2008, there has been an increase in fatal helicopter air ambulance accidents. To address these safety concerns, the FAA is proposing to implement operational procedures and require additional equipment on board helicopter air ambulances. Many of these proposed requirements currently are found in agency guidance publications and would address National Transportation Safety Board (NTSB) safety recommendations. Some of these safety concerns are not unique to the helicopter air ambulance industry and affect all commercial helicopter operations. Accordingly, the FAA also is proposing to amend regulations pertaining to all commercial helicopter operations conducted under part 135 to include equipment requirements, pilot training, and alternate airport weather minima. The changes are intended to provide certificate holders and pilots with additional tools and procedures that will aid in preventing accidents.

Medicaid program; Medicaid Management Information Systems; conditions of approval and reapproval and procedures for reduction of Federal financial participation--HCFA. Final rule.

PubMed

1985-07-30

This final rule provides the additional requirements to the conditions and procedures for initial approval and reapproval of Medicaid Management Information Systems (MMIS) that were added by section 1903(r) of the Social Security Act (as amended by section 901 of the Mental Health Systems Act of 1980, Pub. L. 96-398). These provisions are intended to improve States' MMIS, ensure efficient system operations, and make the procedures for detection of fraud, waste, and abuse more effective. In addition, this final rule specifies the procedures we follow in reducing the level of Federal financial participation in State administrative expenditures if a State fails to meet the conditions for initial operation, initial approval, or reapproval of an MMIS.

21 CFR 170.17 - Exemption for investigational use and procedure for obtaining authorization to market edible...

Code of Federal Regulations, 2014 CFR

2014-04-01

... authorization to market edible products from experimental animals. A food additive or food containing a food... information required by the act, the warning: Caution. Contains a new food additive for investigational use..., the warning: Caution. Contains a new food additive for use only in investigational animals. Not for...

40 CFR 98.186 - Data reporting procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... section (e.g., supplier provided information, analyses of representative samples you collected). (9) If... addition to the information required by § 98.3(c), each annual report must contain the information... the relevant information required by § 98.36 and the information specified in paragraphs (a)(1...

40 CFR 98.186 - Data reporting procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... section (e.g., supplier provided information, analyses of representative samples you collected). (9) If... addition to the information required by § 98.3(c), each annual report must contain the information... the relevant information required by § 98.36 and the information specified in paragraphs (a)(1...

40 CFR 98.186 - Data reporting procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... section (e.g., supplier provided information, analyses of representative samples you collected). (9) If... addition to the information required by § 98.3(c), each annual report must contain the information... the relevant information required by § 98.36 and the information specified in paragraphs (a)(1...

40 CFR 98.186 - Data reporting procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... section (e.g., supplier provided information, analyses of representative samples you collected). (9) If... addition to the information required by § 98.3(c), each annual report must contain the information... the relevant information required by § 98.36 and the information specified in paragraphs (a)(1...

40 CFR 98.186 - Data reporting procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... section (e.g., supplier provided information, analyses of representative samples you collected). (9) If... addition to the information required by § 98.3(c), each annual report must contain the information... the relevant information required by § 98.36 and the information specified in paragraphs (a)(1...

78 FR 17086 - Public Hearing Before a Public Advisory Committee; Technical Amendments

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-20

... Administrative practice and procedure, Advisory committees, Color additives, Drugs, Foods, Medical Devices... device good manufacturing practice advisory committees established under section 520(f)(3) of the FD&C...) Color additive advisory committees are required to be established under the circumstances specified in...

Current good manufacturing practices, quality control procedures, quality factors, notification requirements, and records and reports, for infant formula. Final rule.

PubMed

2014-06-10

The Food and Drug Administration (FDA or we) is issuing a final rule that adopts, with some modifications, the interim final rule (IFR) entitled "Current Good Manufacturing Practices, Quality Control Procedures, Quality Factors, Notification Requirements, and Records and Reports, for Infant Formula'' (February 10, 2014). This final rule affirms the IFR's changes to FDA's regulations and provides additional modifications and clarifications. The final rule also responds to certain comments submitted in response to the request for comments in the IFR.

Projector-based virtual reality dome environment for procedural pain and anxiety in young children with burn injuries: a pilot study.

PubMed

Khadra, Christelle; Ballard, Ariane; Déry, Johanne; Paquin, David; Fortin, Jean-Simon; Perreault, Isabelle; Labbe, David R; Hoffman, Hunter G; Bouchard, Stéphane; LeMay, Sylvie

2018-01-01

Virtual reality (VR) is a non-pharmacological method to distract from pain during painful procedures. However, it was never tested in young children with burn injuries undergoing wound care. We aimed to assess the feasibility and acceptability of the study process and the use of VR for procedural pain management. From June 2016 to January 2017, we recruited children from 2 months to 10 years of age with burn injuries requiring a hydrotherapy session in a pediatric university teaching hospital in Montreal. Each child received the projector-based VR intervention in addition to the standard pharmacological treatment. Data on intervention and study feasibility and acceptability in addition to measures on pain (Face, Legs, Activity, Cry, Consolability scale), baseline (Modified Smith Scale) and procedural (Procedure Behavior Check List) anxiety, comfort (OCCEB-BECCO [behavioral observational scale of comfort level for child burn victims]), and sedation (Ramsay Sedation Scale) were collected before, during, and after the procedure. Data analyses included descriptive and non-parametric inferential statistics. We recruited 15 children with a mean age of 2.2±2.1 years and a mean total body surface area of 5% (±4). Mean pain score during the procedure was low (2.9/10, ±3), as was the discomfort level (2.9/10, ±2.8). Most children were cooperative, oriented, and calm. Assessing anxiety was not feasible with our sample of participants. The prototype did not interfere with the procedure and was considered useful for procedural pain management by most health care professionals. The projector-based VR is a feasible and acceptable intervention for procedural pain management in young children with burn injuries. A larger trial with a control group is required to assess its efficacy.

Projector-based virtual reality dome environment for procedural pain and anxiety in young children with burn injuries: a pilot study

PubMed Central

Khadra, Christelle; Ballard, Ariane; Déry, Johanne; Paquin, David; Fortin, Jean-Simon; Perreault, Isabelle; Labbe, David R; Hoffman, Hunter G; Bouchard, Stéphane

2018-01-01

Background Virtual reality (VR) is a non-pharmacological method to distract from pain during painful procedures. However, it was never tested in young children with burn injuries undergoing wound care. Aim We aimed to assess the feasibility and acceptability of the study process and the use of VR for procedural pain management. Methods From June 2016 to January 2017, we recruited children from 2 months to 10 years of age with burn injuries requiring a hydrotherapy session in a pediatric university teaching hospital in Montreal. Each child received the projector-based VR intervention in addition to the standard pharmacological treatment. Data on intervention and study feasibility and acceptability in addition to measures on pain (Face, Legs, Activity, Cry, Consolability scale), baseline (Modified Smith Scale) and procedural (Procedure Behavior Check List) anxiety, comfort (OCCEB-BECCO [behavioral observational scale of comfort level for child burn victims]), and sedation (Ramsay Sedation Scale) were collected before, during, and after the procedure. Data analyses included descriptive and non-parametric inferential statistics. Results We recruited 15 children with a mean age of 2.2±2.1 years and a mean total body surface area of 5% (±4). Mean pain score during the procedure was low (2.9/10, ±3), as was the discomfort level (2.9/10, ±2.8). Most children were cooperative, oriented, and calm. Assessing anxiety was not feasible with our sample of participants. The prototype did not interfere with the procedure and was considered useful for procedural pain management by most health care professionals. Conclusion The projector-based VR is a feasible and acceptable intervention for procedural pain management in young children with burn injuries. A larger trial with a control group is required to assess its efficacy. PMID:29491717

33 CFR 154.1125 - Additional response plan requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Sound: (A) Valdez; (B) Tatitlek; (C) Cordova; (D) Whittier; (E) Chenega; and (F) Fish hatcheries located...) Address the responsibilities required in § 154.1035(b)(3)(iii). (2) Exercises. Identification of exercise procedures that must— (i) Provide for two exercises of the oil spill removal organization each year that test...

25 CFR 517.4 - Requirements for making requests.

Code of Federal Regulations, 2010 CFR

2010-04-01

... INFORMATION ACT PROCEDURES § 517.4 Requirements for making requests. (a) How to make a FOIA request. Requests... additional information. If the requester is making a request for records about another individual, the..., the requester will be notified of this decision and advised that fees associated with the processing...

Consideration of drainage ditches and sediment rating cure on SWAT model performance

USDA-ARS?s Scientific Manuscript database

Water quality models most often require a considerable amount of data to be properly configured and in some cases this requires additional procedural steps prior to model applications. We examined two different scenarios of such input issues in a small watershed using the Soil and Water Assessment ...

40 CFR 80.260 - What are the procedures and requirements for obtaining a hardship extension?

Code of Federal Regulations, 2011 CFR

2011-07-01

... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) REGULATION OF FUELS AND FUEL ADDITIVES Gasoline Sulfur... the refinery to produce gasoline meeting the requirements of § 80.195. Such an application must... appropriate sulfur reduction technology and other equipment procurements or improvements; and (ii) If...

Herbicidal drift control: aerial spray equipment, formulations, and supervision.

Treesearch

H. Gratkowski

1974-01-01

Public concern over environmental pollution requires increasingly sophisticated procedures when herbicides are used in silviculture. Many specialized aerial application systems and spray additives have been developed to reduce drift of herbicidal sprays. This publication provides forest-land managers with a brief description of these aerial spray systems and additives...

Acid Rain Analysis by Standard Addition Titration.

ERIC Educational Resources Information Center

Ophardt, Charles E.

1985-01-01

The standard addition titration is a precise and rapid method for the determination of the acidity in rain or snow samples. The method requires use of a standard buret, a pH meter, and Gran's plot to determine the equivalence point. Experimental procedures used and typical results obtained are presented. (JN)

24 CFR 582.330 - Nondiscrimination and equal opportunity requirements.

Code of Federal Regulations, 2010 CFR

2010-04-01

... diseases). However, other eligible disabled homeless persons must be considered for housing designed for... recipient must establish additional procedures that will ensure that interested persons can obtain...

24 CFR 582.330 - Nondiscrimination and equal opportunity requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... diseases). However, other eligible disabled homeless persons must be considered for housing designed for... recipient must establish additional procedures that will ensure that interested persons can obtain...

24 CFR 582.330 - Nondiscrimination and equal opportunity requirements.

Code of Federal Regulations, 2012 CFR

2012-04-01

... diseases). However, other eligible disabled homeless persons must be considered for housing designed for... recipient must establish additional procedures that will ensure that interested persons can obtain...

24 CFR 582.330 - Nondiscrimination and equal opportunity requirements.

Code of Federal Regulations, 2011 CFR

2011-04-01

... diseases). However, other eligible disabled homeless persons must be considered for housing designed for... recipient must establish additional procedures that will ensure that interested persons can obtain...

Weather Requirements and Procedures for Step 1: High Altitude Long Endurance (HALE) Unmanned Aircraft System (UAS) Flight Operations in the National Air Space (NAS)

NASA Technical Reports Server (NTRS)

2007-01-01

This cover sheet is for version 2 of the weather requirements document along with Appendix A. The purpose of the requirements document was to identify and to list the weather functional requirements needed to achieve the Access 5 vision of "operating High Altitude, Long Endurance (HALE) Unmanned Aircraft Systems (UAS) routinely, safely, and reliably in the National Airspace System (NAS) for Step 1." A discussion of the Federal Aviation Administration (FAA) references and related policies, procedures, and standards is provided as basis for the recommendations supported within this document. Additional procedures and reference documentation related to weather functional requirements is also provided for background. The functional requirements and related information are to be proposed to the FAA and various standards organizations for consideration and approval. The appendix was designed to show that sources of flight weather information are readily available to UAS pilots conducting missions in the NAS. All weather information for this presentation was obtained from the public internet.

Estimating force and power requirements for crosscut shearing of roundwood.

Treesearch

Rodger A. Arola

1972-01-01

Presents a procedure which, through the use of nomographs, permits rapid estimation of the force required to crosscut shear logs of various species and diameters with shear blades ranging in thickness from 1/4 to 7/8 inch. In addition, nomographs are included to evaluate hydraulic cylinder sizes, pump capacities, and motor horsepower requirements to effect the cut....

The Centers for Medicare and Medicaid Services (CMS) two midnight rule: policy at odds with reality.

PubMed

Huntington, Ciara R; Blair, Laurel J; Cox, Tiffany C; Prasad, Tanushree; Kercher, Kent W; Augenstein, Vedra A; Heniford, B Todd

2016-02-01

To reduce costs, the Centers for Medicare and Medicaid Services (CMS) implemented new policies governing which patients are automatically admitted as inpatients (staying greater than "two midnights") and which require additional justification with physician documentation to be admitted. This study examines procedures missing from the Medicare Inpatient Only (MIO) list and uses national data to evaluate its appropriateness. Non-MIO procedures were identified from the current MIO list. Utilizing relevant billing codes, procedures were queried in the National Surgery Quality Improvement Program database for length of stay (LOS), percentage requiring >2 day stay, and inpatient status from 2005 to 2012. In addition, a separate analysis was performed for patients 65 years old or older who would qualify for Medicare. A majority of patients stayed more than 2 days for several procedures not included on the MIO list (% staying >2 days, mean LOS), including component separation (79.1%, 5.9 ± 12.3 days), diagnostic laparoscopy (64.2%, 5.5 ± 11.9 days), laparoscopic splenectomy (60.0%, 9.0 ± 13.6 days), open recurrent ventral hernia repair (58.2%, 6.3 ± 9.0 days), laparoscopic esophageal surgery (46.4%, 5.3 ± 13.3 days), and laparoscopic ventral hernia repair (24.7%, 2.5 ± 8.8 days). In patients ≥65 years, the average LOS was longer than the general population; for example, 40.2% of laparoscopic appendectomies and 38.7% of laparoscopic cholecystectomies in this older group required more than two nights in the hospital. In 92.3% of procedures examined, patients ≥65 years required greater than two nights in the hospital with an average LOS of 2.5-10.7 days. Commonly encountered non-MIO surgical procedures have national precedents for inpatient status. Before enacting policy, CMS and other regulatory bodies should consider current data to ensure rules are evidence-based and applicable.

5 CFR 9901.406 - Setting and communicating performance expectations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... other work requirements, such as standard operating procedures, operating instructions, manuals... standards of conduct and behavior, such as civility and respect for others. (d) In addition to the...

Federal employees health benefits program; revision of contract cost principles and procedures, and miscellaneous changes. Final rule.

PubMed

2005-06-01

The U.S. Office of Personnel Management (OPM) is issuing a final regulation amending the Federal Employees Health Benefits (FEHB) Acquisition Regulation (FEHBAR). This regulation provides additional contract cost principles and procedures for FEHB Program experience-rated contracts and is intended to clarify our requirements and enhance our oversight of FEHB carriers.

Preparation of unsymmetrical ketones from tosylhydrazones and aromatic aldehydes via formyl C-H bond insertion.

PubMed

Allwood, Daniel M; Blakemore, David C; Ley, Steven V

2014-06-06

Preparation of ketones by insertion of diazo compounds into the formyl C-H bond of an aldehyde is an attractive procedure, but use of structurally diverse diazo compounds is hampered by preparation and safety issues. A convenient procedure for the synthesis of unsymmetrical ketones from bench-stable tosylhydrazones and aryl aldehydes is reported. The procedure can be performed in one pot from the parent carbonyl compound and needs only a base, with no additional promoters being required.

77 FR 49063 - Energy Conservation Program: Test Procedures for Residential Dishwashers and Cooking Products

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-15

...The U.S. Department of Energy (DOE) proposes to amend its test procedures for residential dishwashers to update certain obsolete dishware, flatware and food items, make minor amendments to the definition of the normal cycle, and update the ambient temperature and preconditioning requirements as well as the industry test method referenced in DOE's test procedure. DOE also proposes to add water pressure, drain height, rack position, loading, rinse aid container, and soil preparation specifications to the dishwasher test procedure. DOE additionally proposes to amend the test procedures for both dishwashers and conventional cooking products for the measurement of energy use in fan-only mode.

49 CFR 210.25 - Measurement criteria and procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... background noise requirements are prescribed in § 201.23 of the Standards. In addition, a measurement... measurement site; (4) Variations resulting from atmospheric conditions such as wind, ambient temperature, and...

The Fibroid Registry for outcomes data (FIBROID) for uterine embolization: short-term outcomes.

PubMed

Worthington-Kirsch, Robert; Spies, James B; Myers, Evan R; Mulgund, Jyotsna; Mauro, Matthew; Pron, Gaylene; Peterson, Eric D; Goodwin, Scott

2005-07-01

To investigate the short-term safety of uterine embolization for leiomyomata in a large cohort of patients treated in a variety of clinical settings. Examining the FIBROID Registry, a multicenter prospective voluntary registry of patients undergoing uterine embolization for leiomyomata, we studied the frequency of adverse events and predictors of adverse events within 30 days of the procedure. We also report on the technical aspects of the procedure, including details of periprocedural care, technique, and short-term recovery. All adverse events were recorded and classified using standard definitions, both in terms of type and severity. Summary statistics were used to describe the data set, and univariate and multivariate analyses were used to determine which factors might influence the incidence of adverse events. Of the 3,160 patients enrolled at 72 contributing sites, major in-hospital complications occurred in 0.66%, and postdischarge major events occurred in 4.8% within the first 30 days. The most common adverse event after discharge was inadequate pain relief requiring additional hospital treatment (2.4%). Thirty-one patients required additional surgical intervention within 30 days after treatment, 3 of whom required hysterectomy (0.1%). There were no deaths. Multivariate analysis showed modest increased odds for an adverse event for African Americans, smokers, and those with prior leiomyoma procedures. There were no differences in outcome based on the practice site experience, practice type, or any procedure-related factors. Uterine embolization for leiomyomata is a low-risk procedure with little variability in short-term outcome based on either patient demographics or practice setting. II-3.

12 CFR 747.607 - Statement of net worth.

Code of Federal Regulations, 2012 CFR

2012-01-01

... and Procedures Applicable to Recovery of Attorneys Fees and Other Expenses Under the Equal Access to... is an eligible party. The administrative law judge or the NCUA Board may require additional...

Information Requirements for Supervisory Air Traffic Controllers in Support of a Mid-Term Wake Vortex Departure System

NASA Technical Reports Server (NTRS)

Lohr, Gary W.; Williams, Daniel M.; Trujillo, Anna C.; Johnson, Edward J.; Domino, David A.

2008-01-01

A concept focusing on wind dependent departure operations has been developed the current version of this concept is called the Wake Turbulence Mitigation for Departures (WTMD). This concept takes advantage the fact that cross winds of sufficient velocity blow wakes generated by "heavy" and B757 category aircraft on the downwind runway away from the upwind runway. Supervisory Air Traffic Controllers would be responsible for authorization of the Procedure. An investigation of the information requirements necessary to for Supervisors to approve monitor and terminate the Procedure was conducted. Results clearly indicated that the requisite information is currently available in air traffic control towers and that additional information was not required.

40 CFR 63.95 - Additional approval criteria for accidental release prevention programs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... basis. (3) Procedures for reviewing risk management plans and providing technical assistance to... chapter; and (ii) A requirement that any source subject to the State's part 68 program submit a Risk Management Plan (RMP) that reports at least the same information in the same format as required under part 68...

26 CFR 1.7519-2T - Required payments-procedures and administration (temporary).

Code of Federal Regulations, 2010 CFR

2010-04-01

... payment under section 7519 for an applicable election year, the partnership or S corporation should type... termination of the section 444 election. (d) Negligence and fraud penalties made applicable. For purposes of section 6653, relating to additions to tax for negligence and fraud, any payment required by this section...

78 FR 3837 - Connect America Fund; A National Broadband Plan for Our Future; Establishing Just and Reasonable...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-01-17

... requires the auditor additionally to obtain an understanding of the internal controls environment for the company, which requires the development of certain documentation, such as internal controls procedures... detailed understanding of the internal controls environment, a CPA review generally is less costly than a...

49 CFR Appendix D to Part 218 - Requirements and Considerations for Implementing Technology Aided Point Protection

Code of Federal Regulations, 2011 CFR

2011-10-01

... for a remote control crew; however, several potential problems may result when non-crewmembers are... cameras or other technological means, provided that it and the procedures for use provide an equivalent... protection as well as specific additional requirements for those operations involving remote control...

49 CFR Appendix D to Part 218 - Requirements and Considerations for Implementing Technology Aided Point Protection

Code of Federal Regulations, 2012 CFR

2012-10-01

... for a remote control crew; however, several potential problems may result when non-crewmembers are... cameras or other technological means, provided that it and the procedures for use provide an equivalent... protection as well as specific additional requirements for those operations involving remote control...

49 CFR Appendix D to Part 218 - Requirements and Considerations for Implementing Technology Aided Point Protection

Code of Federal Regulations, 2014 CFR

2014-10-01

... for a remote control crew; however, several potential problems may result when non-crewmembers are... cameras or other technological means, provided that it and the procedures for use provide an equivalent... protection as well as specific additional requirements for those operations involving remote control...

49 CFR Appendix D to Part 218 - Requirements and Considerations for Implementing Technology Aided Point Protection

Code of Federal Regulations, 2013 CFR

2013-10-01

... for a remote control crew; however, several potential problems may result when non-crewmembers are... cameras or other technological means, provided that it and the procedures for use provide an equivalent... protection as well as specific additional requirements for those operations involving remote control...

49 CFR Appendix D to Part 218 - Requirements and Considerations for Implementing Technology Aided Point Protection

Code of Federal Regulations, 2010 CFR

2010-10-01

... for a remote control crew; however, several potential problems may result when non-crewmembers are... cameras or other technological means, provided that it and the procedures for use provide an equivalent... protection as well as specific additional requirements for those operations involving remote control...

40 CFR 63.95 - Additional approval criteria for accidental release prevention programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... basis. (3) Procedures for reviewing risk management plans and providing technical assistance to... chapter; and (ii) A requirement that any source subject to the State's part 68 program submit a Risk Management Plan (RMP) that reports at least the same information in the same format as required under part 68...

Metal- and additive-free photoinduced borylation of haloarenes.

PubMed

Mfuh, Adelphe M; Schneider, Brett D; Cruces, Westley; Larionov, Oleg V

2017-03-01

Boronic acids and esters have critical roles in the areas of synthetic organic chemistry, molecular sensors, materials science, drug discovery, and catalysis. Many of the current applications of boronic acids and esters require materials with very low levels of transition metal contamination. Most of the current methods for the synthesis of boronic acids, however, require transition metal catalysts and ligands that must be removed via additional purification procedures. This protocol describes a simple, metal- and additive-free method of conversion of haloarenes directly to boronic acids and esters. This photoinduced borylation protocol does not require expensive and toxic metal catalysts or ligands, and it produces innocuous and easy-to-remove by-products. Furthermore, the reaction can be carried out on multigram scales in common-grade solvents without the need for reaction mixtures to be deoxygenated. The setup and purification steps are typically accomplished within 1-3 h. The reactions can be run overnight, and the protocol can be completed within 13-16 h. Two representative procedures that are described in this protocol provide details for preparation of a boronic acid (3-cyanopheylboronic acid) and a boronic ester (1,4-benzenediboronic acid bis(pinacol)ester). We also discuss additional details of the method that will be helpful in the application of the protocol to other haloarene substrates.

77 FR 31443 - Energy Conservation Program: Test Procedures for Residential Dishwashers, Dehumidifiers, and...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-25

... dishwashers with a separate soil- sensing cycle, and the normal cycle definition, power supply and detergent... Soiling Requirements 5. Detergent Dosing Specifications E. Incorporation by Reference of an Updated AHAM...: (1) The addition of a method to rate the efficiency of soil-sensing products; (2) the addition of a...

13 CFR 115.65 - General PSB procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... information for the term of the bond, plus such additional time as may be required to settle any claims of the Surety for reimbursement from SBA and to attempt salvage or other recovery, plus an additional 3 years... the Surety has established or added to a claim reserve; of the recovery of any amounts on the...

13 CFR 115.65 - General PSB procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... information for the term of the bond, plus such additional time as may be required to settle any claims of the Surety for reimbursement from SBA and to attempt salvage or other recovery, plus an additional 3 years... the Surety has established or added to a claim reserve; of the recovery of any amounts on the...

Guide for Schoolhouse Planning and Construction 1969.

ERIC Educational Resources Information Center

New Jersey State Dept. of Education, Trenton. Bureau of School Planning Services.

This guide sets forth requirements common to all good school construction which must be met and recommends additional procedures which can lead to a still better facility. It covers the construction of new buildings, of additions to or remodeling of existing structures, and the acquisition of buildings occupied or to be occupied by pupils.…

Pain control requirements for percutaneous ablation of renal tumors: cryoablation versus radiofrequency ablation--initial observations.

PubMed

Allaf, Mohamad E; Varkarakis, Ioannis M; Bhayani, Sam B; Inagaki, Takeshi; Kavoussi, Louis R; Solomon, Stephen B

2005-10-01

To retrospectively compare the pain control requirements of patients undergoing computed tomography (CT)-guided percutaneous radiofrequency (RF) ablation with those of patients undergoing CT-guided percutaneous cryoablation of small (< or = 4-cm) renal tumors. The study was HIPAA compliant and received institutional review board exemption; informed consent was not required. Medical and procedure records of patients who underwent RF ablation and cryoablation of renal tumors from June 19, 2003, to February 28, 2004, were retrospectively reviewed for clinical data, tumor characteristics, and anesthesia information. During the study period, 10 men (mean age, 66.5 years) underwent cryoablation of 11 renal lesions, and 14 patients (11 men, four women; mean age, 68.1 years) underwent RF ablation of 15 renal tumors. Analgesic and sedative requirements during the procedure were compared. Standard anesthesia consisted of 5 mL of 1% lidocaine injected locally, and conscious sedation consisted of 50 microg of fentanyl and 1 mg of midazolam administered intravenously. The Fisher exact test and Student t test were used to compare clinical factors and drug requirements between the two groups. There was no difference in terms of patient demographics, tumor diameter, or distribution of central versus noncentral lesions between the two groups. Cryoablation was associated with a significantly lower dose of fentanyl (165.0 microg [RF group] vs 75.0 microg [cryoablation group]; P < .001) and midazolam (2.9 mg [RF group] vs 1.6 mg [cryoablation group]; P = .026). In the RF group, one patient required general anesthesia, one patient required supplemental narcotics (5 mg of oxycodone) and sedatives (1 mg lorezapam), and one patient became apneic for a brief interval after receiving additional narcotics for pain during the procedure. An additional RF session was terminated early in one patient because of pain, and further medication could not be administered owing to bradycardia. No patients in the cryoablation group required any additional or alternate anesthetics. Image-guided percutaneous cryoablation of small (< or = 4-cm) renal lesions appears to require less analgesia than RF ablation. Prospective trials with validated pain scales are needed to examine this further. RSNA, 2005

33 CFR 155.1125 - Additional response plan requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... of sufficient numbers of trained personnel with the necessary technical skills to remove, to the... recommended procedures, to include— (A) Start-up and running under load of all electrical motors, pumps, power...

Safety Assurance in NextGen

NASA Technical Reports Server (NTRS)

HarrisonFleming, Cody; Spencer, Melissa; Leveson, Nancy; Wilkinson, Chris

2012-01-01

The generation of minimum operational, safety, performance, and interoperability requirements is an important aspect of safely integrating new NextGen components into the Communication Navigation Surveillance and Air Traffic Management (CNS/ATM) system. These requirements are used as part of the implementation and approval processes. In addition, they provide guidance to determine the levels of design assurance and performance that are needed for each element of the new NextGen procedures, including aircraft, operator, and Air Navigation and Service Provider. Using the enhanced Airborne Traffic Situational Awareness for InTrail Procedure (ATSA-ITP) as an example, this report describes some limitations of the current process used for generating safety requirements and levels of required design assurance. An alternative process is described, as well as the argument for why the alternative can generate more comprehensive requirements and greater safety assurance than the current approach.

Thermal/Structural Tailoring of Engine Blades (T/STAEBL) User's manual

NASA Technical Reports Server (NTRS)

Brown, K. W.

1994-01-01

The Thermal/Structural Tailoring of Engine Blades (T/STAEBL) system is a computer code that is able to perform numerical optimizations of cooled jet engine turbine blades and vanes. These optimizations seek an airfoil design of minimum operating cost that satisfies realistic design constraints. This report documents the organization of the T/STAEBL computer program, its design and analysis procedure, its optimization procedure, and provides an overview of the input required to run the program, as well as the computer resources required for its effective use. Additionally, usage of the program is demonstrated through a validation test case.

Thermal/Structural Tailoring of Engine Blades (T/STAEBL): User's manual

NASA Astrophysics Data System (ADS)

Brown, K. W.

1994-03-01

The Thermal/Structural Tailoring of Engine Blades (T/STAEBL) system is a computer code that is able to perform numerical optimizations of cooled jet engine turbine blades and vanes. These optimizations seek an airfoil design of minimum operating cost that satisfies realistic design constraints. This report documents the organization of the T/STAEBL computer program, its design and analysis procedure, its optimization procedure, and provides an overview of the input required to run the program, as well as the computer resources required for its effective use. Additionally, usage of the program is demonstrated through a validation test case.

Miscoding and other user errors: importance of ongoing education for proper blood glucose monitoring procedures.

PubMed

Schrock, Linda E

2008-07-01

This article reviews the literature to date and reports on a new study that documented the frequency of manual code-requiring blood glucose (BG) meters that were miscoded at the time of the patient's initial appointment in a hospital-based outpatient diabetes education program. Between January 1 and May 31, 2007, the type of BG meter and the accuracy of the patient's meter code (if required) and procedure for checking BG were checked during the initial appointment with the outpatient diabetes educator. If indicated, reeducation regarding the procedure for the BG meter code entry and/or BG test was provided. Of the 65 patients who brought their meter requiring manual entry of a code number or code chip to the initial appointment, 16 (25%) were miscoded at the time of the appointment. Two additional problems, one of dead batteries and one of improperly stored test strips, were identified and corrected at the first appointment. These findings underscore the importance of checking the patient's BG meter code (if required) and procedure for testing BG at each encounter with a health care professional or providing the patient with a meter that does not require manual entry of a code number or chip to match the container of test strips (i.e., an autocode meter).

Ketamine versus alfentanil combined with propofol for sedation in colonoscopy procedures: a randomized prospective study.

PubMed

Türk, Hacer Şebnem; Aydoğmuş, Meltem; Ünsal, Oya; Işıl, Canan Tülay; Citgez, Bülent; Oba, Sibel; Açık, Mehmet Eren

2014-12-01

Different drug combinations are used for sedation in colonoscopy procedures. A ketamine-propofol (ketofol) mixture provides effective sedation and has minimal adverse effects. Alfentanil also provides anesthesia for short surgical procedures by incremental injection as an adjunct. However, no study has investigated the use of ketofol compared with an opioid-propofol combination in colonoscopic procedures. A total of 70 patients, ASA physical status I-II, scheduled to undergo elective colonoscopy, were enrolled in this prospective randomized study and allocated to two groups. After premedication, sedation induction was performed with 0.5 mg/kg ketamine +1 mg/kg propofol in Group KP, and 10 mg/kg alfentanil +1 mg/kg propofol in Group AP. Propofol was added when required. Demographic data, colonoscopy duration, recovery time, discharge time, mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation, Ramsey Sedation Scale values, colonoscopy patients' satisfaction scores, and complications were recorded. The need for additional propofol doses was significantly higher in Group AP than in Group KP. MAP at minute 1 and 5, Ramsey Sedation Scale at minute 5, and discharge time were significantly higher in Group KP than in Group AP. Additional propofol doses and total propofol dose were significantly lower in Group KP than in Group AP. Ketofol provided better hemodynamic stability and quality of sedation compared with alfentanil-propofol combination in elective colonoscopy, and required fewer additional propofol; however, it prolonged discharge time. Both combinations can safely be used in colonoscopy sedation.

Laparoendoscopic single site surgery in pediatric urology: does it require specialized tools?

PubMed Central

Patel, Nishant; Santomauro, Michael; Marietti, Sarah; Chiang, George

2016-01-01

ABSTRACT Purpose: To describe our experience utilizing Laparoendoscopic single site (LESS) surgery in pediatric urology. Materials and Methods: Retrospective chart review was performed on LESS urologic procedures from November 2009 through March 2013. A total of 44 patients underwent 54 procedures including: nephrectomy (23), orchiopexy (14), varicocelectomy (9), orchiectomy (2), urachal cyst excision (3), and antegrade continence enema (3) (ACE). Results: Median patient age was 6.9 years old. Estimated blood loss (EBL), ranged from less than 5cc to 47cc for a bilateral nephrectomy. Operative time varied from 56 mins for varicocelectomy to a median of 360 minutes for a bilateral nephroureterectomy. Incision length ranged between 2 and 2.5cm. In our initial experience we used a commercial port. However, as we progressed, we were able to perform the majority of our procedures via adjacent fascial punctures for instrumentation at the single incision site. One patient did require conversion to an open procedure as a result of bleeding. Three complications were noted (6.8%), with two Clavien Grade 3b complications. Two patients required additional procedures at 1-year follow-up. Conclusions: The use of LESS applies to many pediatric urologic procedures, ideally for ablative procedures or simple reconstructive efforts. The use of adjacent fascial puncture sites for instrumentation can obviate the need for a commercial port or multiple trocars. PMID:27256182

The Payer and Patient Cost Burden of Open Breast Conserving Procedures Following Percutaneous Breast Biopsy.

PubMed

Kimball, Chloe C; Nichols, Christine I; Vose, Joshua G

2018-01-01

Percutaneous core-needle biopsy (PCNB) is the standard of care to biopsy and diagnose suspicious breast lesions. Dependent on histology, many patients require additional open procedures for definitive diagnosis and excision. This study estimated the payer and patient out-of-pocket (OOP) costs, and complication risk, among those requiring at least 1 open procedure following PCNB. This retrospective study used the Truven Commercial database (2009-2014). Women who underwent PCNB, with continuous insurance, and no history of cancer, chemotherapy, radiation, or breast surgery in the prior year were included. Open procedures were defined as open biopsy or lumpectomy. Study follow-up ended at chemotherapy, radiation, mastectomy, or 90 days-whichever occurred first. In total, 143 771 patients (mean age 48) met selection criteria; 85.1% underwent isolated PCNB, 12.4% one open procedure, and 2.5% re-excision. Incidence of complications was significantly lower among those with PCNB alone (9.2%) vs 1 open procedure (15.6%) or re-excision (25.3%, P  < .001). Mean incremental commercial payments were US $13 190 greater among patients with 1 open procedure vs PCNB alone (US $17 125 vs US $3935, P  < .001), and US $4767 greater with re-excision (US $21 892) relative to 1 procedure. Mean patient OOP cost was US $858 greater for 1 open procedure vs PCNB alone (US $1527 vs US $669), and US $247 greater for re-excision vs 1 procedure. A meaningful proportion of patients underwent open procedure(s) following PCNB which was associated with increased complication risk and costs to both the payer and the patient. These results suggest a need for technologies to reduce the proportion of cases requiring open surgery and, in some cases, re-excision.

Robotic cardiac surgery: an anaesthetic challenge.

PubMed

Wang, Gang; Gao, Changqing

2014-08-01

Robotic cardiac surgery with the da Vinci robotic surgical system offers the benefits of a minimally invasive procedure, including a smaller incision and scar, reduced risk of infection, less pain and trauma, less bleeding and blood transfusion requirements, shorter hospital stay and decreased recovery time. Robotic cardiac surgery includes extracardiac and intracardiac procedures. Extracardiac procedures are often performed on a beating heart. Intracardiac procedures require the aid of peripheral cardiopulmonary bypass via a minithoracotomy. Robotic cardiac surgery, however, poses challenges to the anaesthetist, as the obligatory one-lung ventilation (OLV) and CO2 insufflation may reduce cardiac output and increase pulmonary vascular resistance, potentially resulting in hypoxaemia and haemodynamic compromise. In addition, surgery requires appropriate positioning of specialised cannulae such as an endopulmonary vent, endocoronary sinus catheter, and endoaortic clamp catheter under the guidance of transoesophageal echocardiography. Therefore, cardiac anaesthetists should have a working knowledge of these systems, OLV and haemodynamic support. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

40 CFR 80.50 - General test procedure requirements for augmentation of the emission models.

Code of Federal Regulations, 2014 CFR

2014-07-01

... § 80.45. (1) VOC, NOX, CO, and CO2 emissions must be measured for all fuel-vehicle combinations tested. (2) Toxics emissions must be measured when testing the extension fuels per the requirements of § 80... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) REGULATION OF FUELS AND FUEL ADDITIVES Reformulated...

40 CFR 80.50 - General test procedure requirements for augmentation of the emission models.

Code of Federal Regulations, 2010 CFR

2010-07-01

... § 80.45. (1) VOC, NOX, CO, and CO2 emissions must be measured for all fuel-vehicle combinations tested. (2) Toxics emissions must be measured when testing the extension fuels per the requirements of § 80... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) REGULATION OF FUELS AND FUEL ADDITIVES Reformulated...

40 CFR 80.50 - General test procedure requirements for augmentation of the emission models.

Code of Federal Regulations, 2012 CFR

2012-07-01

... § 80.45. (1) VOC, NOX, CO, and CO2 emissions must be measured for all fuel-vehicle combinations tested. (2) Toxics emissions must be measured when testing the extension fuels per the requirements of § 80... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) REGULATION OF FUELS AND FUEL ADDITIVES Reformulated...

40 CFR 80.50 - General test procedure requirements for augmentation of the emission models.

Code of Federal Regulations, 2011 CFR

2011-07-01

... § 80.45. (1) VOC, NOX, CO, and CO2 emissions must be measured for all fuel-vehicle combinations tested. (2) Toxics emissions must be measured when testing the extension fuels per the requirements of § 80... PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) REGULATION OF FUELS AND FUEL ADDITIVES Reformulated...

10 CFR 32.57 - Calibration or reference sources containing americium-241 or radium-226: Requirements for license...

Code of Federal Regulations, 2013 CFR

2013-01-01

... design; (3) Details of the method of incorporation and binding of the americium-241 or radium-226 in the source; (4) Procedures for and results of prototype testing of sources, which are designed to contain... additional information, including experimental studies and tests, required by the Commission to facilitate a...

10 CFR 32.57 - Calibration or reference sources containing americium-241 or radium-226: Requirements for license...

Code of Federal Regulations, 2012 CFR

2012-01-01

... design; (3) Details of the method of incorporation and binding of the americium-241 or radium-226 in the source; (4) Procedures for and results of prototype testing of sources, which are designed to contain... additional information, including experimental studies and tests, required by the Commission to facilitate a...

10 CFR 32.57 - Calibration or reference sources containing americium-241 or radium-226: Requirements for license...

Code of Federal Regulations, 2010 CFR

2010-01-01

... design; (3) Details of the method of incorporation and binding of the americium-241 or radium-226 in the source; (4) Procedures for and results of prototype testing of sources, which are designed to contain... additional information, including experimental studies and tests, required by the Commission to facilitate a...

10 CFR 32.57 - Calibration or reference sources containing americium-241 or radium-226: Requirements for license...

Code of Federal Regulations, 2014 CFR

2014-01-01

... design; (3) Details of the method of incorporation and binding of the americium-241 or radium-226 in the source; (4) Procedures for and results of prototype testing of sources, which are designed to contain... additional information, including experimental studies and tests, required by the Commission to facilitate a...

10 CFR 32.57 - Calibration or reference sources containing americium-241 or radium-226: Requirements for license...

Code of Federal Regulations, 2011 CFR

2011-01-01

... design; (3) Details of the method of incorporation and binding of the americium-241 or radium-226 in the source; (4) Procedures for and results of prototype testing of sources, which are designed to contain... additional information, including experimental studies and tests, required by the Commission to facilitate a...

26 CFR 1.7519-2T - Required payments-procedures and administration (temporary).

Code of Federal Regulations, 2011 CFR

2011-04-01

... should type or legibly print “zero” on the appropriate line of the prescribed form. (3) Time and place... termination of the section 444 election. (d) Negligence and fraud penalties made applicable. For purposes of section 6653, relating to additions to tax for negligence and fraud, any payment required by this section...

Running DNA Mini-Gels in 20 Minutes or Less Using Sodium Boric Acid Buffer

ERIC Educational Resources Information Center

Jenkins, Kristin P.; Bielec, Barbara

2006-01-01

Providing a biotechnology experience for students can be challenging on several levels, and time is a real constraint for many experiments. Many DNA based methods require a gel electrophoresis step, and although some biotechnology procedures have convenient break points, gel electrophoresis does not. In addition to the time required for loading…

Arcuate keratotomy on post-keratoplasty astigmatism is unpredictable and frequently needs repeat procedures to increase its success rate.

PubMed

Bayramlar, Huseyin; Karadag, Remzi; Cakici, Ozgur; Ozsoy, Isilay

2016-06-01

To evaluate the effectiveness and predictability of arcuate keratotomy (AK) for post-keratoplasty astigmatism and to present the complications and rate of repeat procedures. Sixteen eyes from 14 patients were included. Paired 70-80° arc length AKs centred on the steep axis were carried out 0.5 mm within the graft-host junction. The depth of the AKs was set at approximately 80-90% of the depth of the cornea, based on a topographic pachymeter at the incision location. The outcome measures included preoperative and postoperative topographic astigmatism, uncorrected and corrected visual acuity, surgical complications and repeat procedures. In 12 of the 16 eyes (75%), at least one additional surgical procedure was required to obtain the desired result: suturing for overcorrection or wound gape in six eyes (38%), lengthening of the incisions for undercorrection in four eyes (25%) and additional AKs for marked astigmatic axis displacement in three eyes (19%). The mean preoperative astigmatism was 10.45±3.82 dioptres (D); the postoperative astigmatism at the last visit was 2.99±1.14 D (in a mean follow-up of 17.6±5.55 months). The efficacy index was 0.83 and the safety index was 1.68. In treatment of post-keratoplasty astigmatism, AK does not have a good predictability. Additional procedures such as lengthening of the AK incisions for undercorrection or using compression sutures for overcorrection with significantly gaping wounds are frequently required to improve the final outcome. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Procedures Used in Narcotics Airbridge Denial Program in Peru, 1995-2001

DTIC Science & Technology

2008-08-25

success that played a key role in the significant decline in coca cultivation in Peru and as the linchpin of a successful strategy to disrupt the export...the US and Peruvian aircraft and their respective commands. Additionally, significant US resources were used to establish and maintain infrastructure...internal examination of the ABDP (unrelated to this OIG review) was documenting sustained and significant violations of the required intercept procedures

Validation of the grown-ups with congenital heart disease score.

PubMed

Hörer, Jürgen; Roussin, Régine; LeBret, Emanuel; Ly, Mohamed; Abdullah, Jarrah; Marzullo, Rafaella; Pabst von Ohain, Jelena; Belli, Emre

2018-06-01

Adults with congenital heart disease in need of heart surgery frequently present with significant comorbidity. Furthermore, additional technical difficulties often related to redo operations increase the risk for postoperative mortality and morbidity. Hence, next to the type of the procedure, additional procedure-dependent and procedure-independent factors have to be considered for risk evaluation. The recently proposed grown-ups with congenital heart disease (GUCH) mortality and morbidity scores account for these additional risk factors. We sought to validate their predictive power in a large population operated in a single centre. Data of all consecutive patients aged 18 years or more, who underwent surgery for congenital heart disease between 2005 and 2016, were collected. Mortality was defined as hospital mortality or mortality within 30 days following surgery. Morbidity was defined as occurrence of one or more of the following complications: renal failure requiring dialysis, neurologic deficit persisting at discharge, atrioventricular block requiring permanent pacemaker implantation, mechanical circulatory support, phrenic nerve injury and unplanned reoperation. The discriminatory power of the GUCH scores was assessed using the area under the receiver operating characteristics curve (c-index, including 95% CI). Eight hundred and twenty-four operations were evaluated. Additional procedure-dependent and procedure-independent factors, as defined in the GUCH scores, were present in 165 patients (20.0%) and 544 patients (66.0%), respectively. Hospital mortality and morbidity was 3.4% and 10.0%, respectively. C-index for GUCH mortality score was 0.809 (0.742-0.877). C-index for GUCH morbidity score was 0.676 (0.619-0.734). We could confirm the good predictive power of the GUCH mortality score for postoperative mortality in a large population of adults with congenital heart disease. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Classification and reporting of severity experienced by animals used in scientific procedures: FELASA/ECLAM/ESLAV Working Group report.

PubMed

Smith, David; Anderson, David; Degryse, Anne-Dominique; Bol, Carla; Criado, Ana; Ferrara, Alessia; Franco, Nuno Henrique; Gyertyan, Istvan; Orellana, Jose M; Ostergaard, Grete; Varga, Orsolya; Voipio, Hanna-Marja

2018-02-01

Directive 2010/63/EU introduced requirements for the classification of the severity of procedures to be applied during the project authorisation process to use animals in scientific procedures and also to report actual severity experienced by each animal used in such procedures. These requirements offer opportunities during the design, conduct and reporting of procedures to consider the adverse effects of procedures and how these can be reduced to minimize the welfare consequences for the animals. Better recording and reporting of adverse effects should also help in highlighting priorities for refinement of future similar procedures and benchmarking good practice. Reporting of actual severity should help inform the public of the relative severity of different areas of scientific research and, over time, may show trends regarding refinement. Consistency of assignment of severity categories across Member States is a key requirement, particularly if re-use is considered, or the safeguard clause is to be invoked. The examples of severity classification given in Annex VIII are limited in number, and have little descriptive power to aid assignment. Additionally, the examples given often relate to the procedure and do not attempt to assess the outcome, such as adverse effects that may occur. The aim of this report is to deliver guidance on the assignment of severity, both prospectively and at the end of a procedure. A number of animal models, in current use, have been used to illustrate the severity assessment process from inception of the project, through monitoring during the course of the procedure to the final assessment of actual severity at the end of the procedure (Appendix 1).

Classification and reporting of severity experienced by animals used in scientific procedures: FELASA/ECLAM/ESLAV Working Group report

PubMed Central

Smith, David; Anderson, David; Degryse, Anne-Dominique; Bol, Carla; Criado, Ana; Ferrara, Alessia; Gyertyan, Istvan; Orellana, Jose M; Ostergaard, Grete; Varga, Orsolya; Voipio, Hanna-Marja

2018-01-01

Directive 2010/63/EU introduced requirements for the classification of the severity of procedures to be applied during the project authorisation process to use animals in scientific procedures and also to report actual severity experienced by each animal used in such procedures. These requirements offer opportunities during the design, conduct and reporting of procedures to consider the adverse effects of procedures and how these can be reduced to minimize the welfare consequences for the animals. Better recording and reporting of adverse effects should also help in highlighting priorities for refinement of future similar procedures and benchmarking good practice. Reporting of actual severity should help inform the public of the relative severity of different areas of scientific research and, over time, may show trends regarding refinement. Consistency of assignment of severity categories across Member States is a key requirement, particularly if re-use is considered, or the safeguard clause is to be invoked. The examples of severity classification given in Annex VIII are limited in number, and have little descriptive power to aid assignment. Additionally, the examples given often relate to the procedure and do not attempt to assess the outcome, such as adverse effects that may occur. The aim of this report is to deliver guidance on the assignment of severity, both prospectively and at the end of a procedure. A number of animal models, in current use, have been used to illustrate the severity assessment process from inception of the project, through monitoring during the course of the procedure to the final assessment of actual severity at the end of the procedure (Appendix 1). PMID:29359995

Standardizing lightweight deflectometer modulus measurements for compaction quality assurance : research summary.

DOT National Transportation Integrated Search

2017-09-01

The mechanistic-empirical pavement design method requires the elastic resilient modulus as the key input for characterization of geomaterials. Current density-based QA procedures do not measure resilient modulus. Additionally, the density-based metho...

48 CFR 8.405-2 - Ordering procedures for services requiring a statement of work.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... (3) For proposed orders exceeding the maximum order threshold or when establishing a BPA. In addition... is reasonable. Place the order, or establish the BPA, with the schedule contractor that represents...

48 CFR 522.805 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

.../ofcpkeyp.htm. (c) The EEO poster required by FAR 22.805(b) can be found at: http://www.dol.gov/esa/regs/compliance/posters/pdf/eeopost.pdf. In addition to providing this poster to each non-exempt contractor, the...

48 CFR 522.805 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

.../ofcpkeyp.htm. (c) The EEO poster required by FAR 22.805(b) can be found at: http://www.dol.gov/esa/regs/compliance/posters/pdf/eeopost.pdf. In addition to providing this poster to each non-exempt contractor, the...

48 CFR 522.805 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

.../ofcpkeyp.htm. (c) The EEO poster required by FAR 22.805(b) can be found at: http://www.dol.gov/esa/regs/compliance/posters/pdf/eeopost.pdf. In addition to providing this poster to each non-exempt contractor, the...

48 CFR 522.805 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

.../ofcpkeyp.htm. (c) The EEO poster required by FAR 22.805(b) can be found at: http://www.dol.gov/esa/regs/compliance/posters/pdf/eeopost.pdf. In addition to providing this poster to each non-exempt contractor, the...

Carcinogen Control in the Chemical Laboratory.

ERIC Educational Resources Information Center

Johnson, James S.

1981-01-01

Presents general and specific guidelines for handling carcinogens. Additional topics include: definition of potential occupational carcinogens; classification of carcinogens; inventory requirements; signs and labels for materials and laboratories; decontamination and disposal procedures; medical surveillance for employees working with controlled…

Single-Incision Laparoscopic Cholecystectomy after Endoscopic Nasogallbladder Drainage: A Case Report

PubMed Central

Igami, Tsuyoshi; Ebata, Tomoki; Yokoyama, Yukihiro; Sugawara, Gen; Mizuno, Takashi; Yamaguchi, Junpei; Nagino, Masato

2015-01-01

Objective To report a single-incision laparoscopic cholecystectomy (SILC) for a patient with cholecystitis that required endoscopic nasogallbladder drainage (ENGBD). Clinical Presentation and Intervention A 75-year-old man was diagnosed with moderate acute cholecystitis and underwent antiplatelet therapy for a history of brain infarction. An ENGBD was performed as an initial treatment for his cholecystitis. After recovery from the cholecystitis, a SILC was performed using a SILS Port with an additional forceps. Because neither Rouviere's sulcus nor Calot's triangle could be identified with a favorable laparoscopic view, the fundus-first procedure was selected. The patient's postoperative course was uneventful, and he was discharged from the hospital on day 3 after surgery. Conclusion In this case of a patient who had cholecystitis that required ENGBD, a SILC was successful performed using a combination of SILS Port with additional forceps and fundus-first procedure. PMID:26022235

Using Discrete Event Simulation to Model the Economic Value of Shorter Procedure Times on EP Lab Efficiency in the VALUE PVI Study.

PubMed

Kowalski, Marcin; DeVille, J Brian; Svinarich, J Thomas; Dan, Dan; Wickliffe, Andrew; Kantipudi, Charan; Foell, Jason D; Filardo, Giovanni; Holbrook, Reece; Baker, James; Baydoun, Hassan; Jenkins, Mark; Chang-Sing, Peter

2016-05-01

The VALUE PVI study demonstrated that atrial fibrillation (AF) ablation procedures and electrophysiology laboratory (EP lab) occupancy times were reduced for the cryoballoon compared with focal radiofrequency (RF) ablation. However, the economic impact associated with the cryoballoon procedure for hospitals has not been determined. Assess the economic value associated with shorter AF ablation procedure times based on VALUE PVI data. A model was formulated from data from the VALUE PVI study. This model used a discrete event simulation to translate procedural efficiencies into metrics utilized by hospital administrators. A 1000-day period was simulated to determine the accrued impact of procedure time on an institution's EP lab when considering staff and hospital resources. The simulation demonstrated that procedures performed with the cryoballoon catheter resulted in several efficiencies, including: (1) a reduction of 36.2% in days with overtime (422 days RF vs 60 days cryoballoon); (2) 92.7% less cumulative overtime hours (370 hours RF vs 27 hours cryoballoon); and (3) an increase of 46.7% in days with time for an additional EP lab usage (186 days RF vs 653 days cryoballoon). Importantly, the added EP lab utilization could not support the time required for an additional AF ablation procedure. The discrete event simulation of the VALUE PVI data demonstrates the potential positive economic value of AF ablation procedures using the cryoballoon. These benefits include more days where overtime is avoided, fewer cumulative overtime hours, and more days with time left for additional usage of EP lab resources.

The pedicled internal pudendal artery perforator (PIPAP) flap for ischial pressure sore reconstruction: Technique and long-term outcome of a cohort study.

PubMed

Legemate, Catherine M; van der Kwaak, Monique; Gobets, David; Huikeshoven, Menno; van Zuijlen, Paul P M

2018-06-01

The ischial region is the site most affected by pressure sores and has the highest recurrence and complication rates compared to other affected sites. We developed a practical and safe pedicled flap for reconstruction of ischial pressure sores based on the rich available perforators from the internal pudendal artery and the surplus of skin at the infragluteal fold. A retrospective cohort study was conducted in all patients who underwent ischial pressure ulcer reconstruction using the PIPAP flap between March 2010 and March 2017. The skin flap was designed along the gluteal fold. The skin perforators of the pudendal artery were marked with a Doppler probe in the medial region of the gluteal fold. Surgery was performed in the jackknife position, and flaps were elevated in the suprafascial plane. Patients were assessed for minor (requiring no additional surgery) and major complications (requiring additional surgery). Twenty-seven patients (34 flaps) were identified. The median follow-up period was 38 months (IQR 37). Primary closure of the donor-site was achieved in all procedures, only one flap required muscle flap transposition in order to fill the dead space. The mean operating time was 60 ± 21 minutes. In six flaps (9%) wound healing problems were noted that did not require an additional operative procedure. Among the nine flaps (27%) that required a second procedure, 3 (9%) were necessary due to recurrent ulcers. The PIPAP flap is a safe and reliable alternative for ischial pressure sore reconstruction, certainly when compared to available techniques. Moreover, it has significant advantages over other techniques including minimal donor-site morbidity, preservation of posterior thigh skin, buttock-line integrity and reliable vascularity. Copyright © 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Standard addition with internal standardisation as an alternative to using stable isotope labelled internal standards to correct for matrix effects-Comparison and validation using liquid chromatography-​tandem mass spectrometric assay of vitamin D.

PubMed

Hewavitharana, Amitha K; Abu Kassim, Nur Sofiah; Shaw, Paul Nicholas

2018-06-08

With mass spectrometric detection in liquid chromatography, co-eluting impurities affect the analyte response due to ion suppression/enhancement. Internal standard calibration method, using co-eluting stable isotope labelled analogue of each analyte as the internal standard, is the most appropriate technique available to correct for these matrix effects. However, this technique is not without drawbacks, proved to be expensive because separate internal standard for each analyte is required, and the labelled compounds are expensive or require synthesising. Traditionally, standard addition method has been used to overcome the matrix effects in atomic spectroscopy and was a well-established method. This paper proposes the same for mass spectrometric detection, and demonstrates that the results are comparable to those with the internal standard method using labelled analogues, for vitamin D assay. As conventional standard addition procedure does not address procedural errors, we propose the inclusion of an additional internal standard (not co-eluting). Recoveries determined on human serum samples show that the proposed method of standard addition yields more accurate results than the internal standardisation using stable isotope labelled analogues. The precision of the proposed method of standard addition is superior to the conventional standard addition method. Copyright © 2018 Elsevier B.V. All rights reserved.

40 CFR 155.58 - Procedures for issuing a decision on a registration review case.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) State whether it believes that additional data are needed and, if so, describe what is needed. A FIFRA 3(c)(2)(B) notice requiring such data may be issued in conjunction with a proposed or final decision... remain open until all actions required in the final decision on the registration review case have been...

40 CFR 155.58 - Procedures for issuing a decision on a registration review case.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) State whether it believes that additional data are needed and, if so, describe what is needed. A FIFRA 3(c)(2)(B) notice requiring such data may be issued in conjunction with a proposed or final decision... remain open until all actions required in the final decision on the registration review case have been...

34 CFR 602.24 - Additional procedures certain institutional accreditors must have.

Code of Federal Regulations, 2013 CFR

2013-07-01

... change of ownership. (c) Teach-out plans and agreements. (1) The agency must require an institution it accredits or preaccredits to submit a teach-out plan to the agency for approval upon the occurrence of any... with section 487(c)(1)(F) of the HEA, and that a teach-out plan is required. (ii) The agency acts to...

34 CFR 602.24 - Additional procedures certain institutional accreditors must have.

Code of Federal Regulations, 2014 CFR

2014-07-01

... change of ownership. (c) Teach-out plans and agreements. (1) The agency must require an institution it accredits or preaccredits to submit a teach-out plan to the agency for approval upon the occurrence of any... with section 487(c)(1)(F) of the HEA, and that a teach-out plan is required. (ii) The agency acts to...

34 CFR 602.24 - Additional procedures certain institutional accreditors must have.

Code of Federal Regulations, 2012 CFR

2012-07-01

... change of ownership. (c) Teach-out plans and agreements. (1) The agency must require an institution it accredits or preaccredits to submit a teach-out plan to the agency for approval upon the occurrence of any... with section 487(c)(1)(F) of the HEA, and that a teach-out plan is required. (ii) The agency acts to...

34 CFR 602.24 - Additional procedures certain institutional accreditors must have.

Code of Federal Regulations, 2011 CFR

2011-07-01

... change of ownership. (c) Teach-out plans and agreements. (1) The agency must require an institution it accredits or preaccredits to submit a teach-out plan to the agency for approval upon the occurrence of any... with section 487(c)(1)(F) of the HEA, and that a teach-out plan is required. (ii) The agency acts to...

Reducing radiation exposure during CRT implant procedures: early experience with a sensor-based navigation system.

PubMed

Thibault, Bernard; Andrade, Jason G; Dubuc, Marc; Talajic, Mario; Guerra, Peter G; Dyrda, Katia; Macle, Laurent; Rivard, Léna; Roy, Denis; Mondésert, Blandine; Khairy, Paul

2015-01-01

Cardiac resynchronization therapy (CRT) implant procedures are often complex and prolonged, resulting in significant ionizing radiation (IR) exposure to the patient and operator. We report our early experience working with a novel sensor-based electromagnetic tracking system (MediGuide™, MDG, St. Jude Medical Inc., St. Paul, MN, USA), in terms of procedural IR exposure reduction. Information regarding patient demographics, procedural details, procedural duration, and IR exposure were prospectively collected on 130 consecutive CRT procedures performed between January 2013 and January 2014. Sixty procedures were performed with MDG guidance, and 70 were performed without MDG guidance. Despite a nonsignificant trend toward shorter procedure duration with the use of MDG (120 minutes vs 138 minutes with non-MDG, P = 0.088), a 66% reduction in total IR exposure (median 769 μGray · m(2) vs 2,608 μGray · m(2), P < 0.001) was found. This reduction was primarily driven by a >90% reduction in IR dose required to cannulate the coronary sinus (median 80 μGray · m(2) vs 922 μGray · m(2), P < 0.001), and to a lesser extent from a reduction in IR dose required for LV lead placement (median 330 μGray·m(2) vs 737 μGray · m(2), P = 0.059). In addition, a significant learning curve effect was observed with a significantly shorter procedural duration for the last 15 cases compared to the first 15 cases (median 98 minutes vs 175 minutes, P < 0.001). The nonfluoroscopic MDG positioning system is associated with a dramatic reduction in exposure to IR during CRT implant procedures, with a 90% decrease in the IR dose required to cannulate the coronary sinus. A steep learning curve was quantified. ©2014 Wiley Periodicals, Inc.

78 FR 28860 - Announcement of Requirements and Registration for: “Data Rx: Prescription Drug Abuse Infographic...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-16

... must be in English. All requested information must be provided for your application to be valid. All... solutions for meeting them. In addition to complying with appropriate policies, procedures, and protections...

5 CFR 1312.36 - Appeal procedure.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES CLASSIFICATION, DOWNGRADING... is declassified and otherwise releasable. If continued classification is required, the requestor... normally be made within 60 working days following receipt. If additional time is needed, the requestor will...

5 CFR 1312.36 - Appeal procedure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Administrative Personnel OFFICE OF MANAGEMENT AND BUDGET OMB DIRECTIVES CLASSIFICATION, DOWNGRADING... is declassified and otherwise releasable. If continued classification is required, the requestor... normally be made within 60 working days following receipt. If additional time is needed, the requestor will...

A Battery Certification Testbed for Small Satellite Missions

NASA Technical Reports Server (NTRS)

Cameron, Zachary; Kulkarni, Chetan S.; Luna, Ali Guarneros; Goebel, Kai; Poll, Scott

2015-01-01

A battery pack consisting of standard cylindrical 18650 lithium-ion cells has been chosen for small satellite missions based on previous flight heritage and compliance with NASA battery safety requirements. However, for batteries that transit through the International Space Station (ISS), additional certification tests are required for individual cells as well as the battery packs. In this manuscript, we discuss the development of generalized testbeds for testing and certifying different types of batteries critical to small satellite missions. Test procedures developed and executed for this certification effort include: a detailed physical inspection before and after experiments; electrical cycling characterization at the cell and pack levels; battery-pack overcharge, over-discharge, external short testing; battery-pack vacuum leak and vibration testing. The overall goals of these certification procedures are to conform to requirements set forth by the agency and identify unique safety hazards. The testbeds, procedures, and experimental results are discussed for batteries chosen for small satellite missions to be launched from the ISS.

[Radiation protection in medical research : Licensing requirement for the use of radiation and advice for the application procedure].

PubMed

Minkov, V; Klammer, H; Brix, G

2017-07-01

In Germany, persons who are to be exposed to radiation for medical research purposes are protected by a licensing requirement. However, there are considerable uncertainties on the part of the applicants as to whether licensing by the competent Federal Office for Radiation Protection is necessary, and regarding the choice of application procedure. The article provides explanatory notes and practical assistance for applicants and an outlook on the forthcoming new regulations concerning the law on radiation protection of persons in the field of medical research. Questions and typical mistakes in the application process were identified and evaluated. The qualified physicians involved in a study are responsible for deciding whether a license is required for the intended application of radiation. The decision can be guided by answering the key question whether the study participants would undergo the same exposures regarding type and extent if they had not taken part in the study. When physicians are still unsure about their decision, they can seek the advisory service provided by the professional medical societies. Certain groups of people are particularly protected through the prohibition or restriction of radiation exposure. A simplified licensing procedure is used for a proportion of diagnostic procedures involving radiation when all related requirements are met; otherwise, the regular licensing procedure should be used. The new radiation protection law, which will enter into force on the 31st of december 2018, provides a notification procedure in addition to deadlines for both the notification and the licensing procedures. In the article, the authors consider how eligible studies involving applications of radiation that are legally not admissible at present may be feasible in the future, while still ensuring a high protection level for study participants.

Photovoltaic Calibrations at the National Renewable Energy Laboratory and Uncertainty Analysis Following the ISO 17025 Guidelines

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

Emery, Keith

The measurement of photovoltaic (PV) performance with respect to reference conditions requires measuring current versus voltage for a given tabular reference spectrum, junction temperature, and total irradiance. This report presents the procedures implemented by the PV Cell and Module Performance Characterization Group at the National Renewable Energy Laboratory (NREL) to achieve the lowest practical uncertainty. A rigorous uncertainty analysis of these procedures is presented, which follows the International Organization for Standardization (ISO) Guide to the Expression of Uncertainty in Measurement. This uncertainty analysis is required for the team’s laboratory accreditation under ISO standard 17025, “General Requirements for the Competence ofmore » Testing and Calibration Laboratories.” The report also discusses additional areas where the uncertainty can be reduced.« less

Improved telescope focus using only two focus images

NASA Astrophysics Data System (ADS)

Barrick, Gregory; Vermeulen, Tom; Thomas, James

2008-07-01

In an effort to reduce the amount of time spent focusing the telescope and to improve the quality of the focus, a new procedure has been investigated and implemented at the Canada-France-Hawaii Telescope (CFHT). The new procedure is based on a paper by Tokovinin and Heathcote and requires only two out-of-focus images to determine the best focus for the telescope. Using only two images provides a great time savings over the five or more images required for a standard through-focus sequence. In addition, it has been found that this method is significantly less sensitive to seeing variations than the traditional through-focus procedure, so the quality of the resulting focus is better. Finally, the new procedure relies on a second moment calculation and so is computationally easier and more robust than methods using a FWHM calculation. The new method has been implemented for WIRCam for the past 18 months, for MegaPrime for the past year, and has recently been implemented for ESPaDOnS.

Sedation and monitoring for gastrointestinal endoscopy

PubMed Central

Amornyotin, Somchai

2013-01-01

The safe sedation of patients for diagnostic or therapeutic procedures requires a combination of properly trained physicians and suitable facilities. Additionally, appropriate selection and preparation of patients, suitable sedative technique, application of drugs, adequate monitoring, and proper recovery of patients is essential. The goal of procedural sedation is the safe and effective control of pain and anxiety as well as to provide an appropriate degree of memory loss or decreased awareness. Sedation practices for gastrointestinal endoscopy (GIE) vary widely. The majority of GIE patients are ambulatory cases. Most of this procedure requires a short time. So, short acting, rapid onset drugs with little adverse effects and improved safety profiles are commonly used. The present review focuses on commonly used regimens and monitoring practices in GIE sedation. This article is to discuss the decision making process used to determine appropriate pre-sedation assessment, monitoring, drug selection, dose of sedative agents, sedation endpoint and post-sedation care. It also reviews the current status of sedation and monitoring for GIE procedures in Thailand. PMID:23424050

Electronic data collection for clinical trials using tablet and handheld PCs

NASA Astrophysics Data System (ADS)

Alaoui, Adil; Vo, Minh; Patel, Nikunj; McCall, Keith; Lindisch, David; Watson, Vance; Cleary, Kevin

2005-04-01

This paper describes a system that uses electronic forms to collect patient and procedure data for clinical trials. During clinical trials, patients are typically required to provide background information such as demographics and medical history, as well as review and complete any consent forms. Physicians or their assistants then usually have additional forms for recording technical data from the procedure and for gathering follow-up information from patients after completion of the procedure. This approach can lead to substantial amounts of paperwork to collect and manage over the course of a clinical trial with a large patient base. By using e-forms instead, data can be transmitted to a single, centralized database, reducing the problem of managing paper forms. Additionally, the system can provide a means for relaying information from the database to the physician on his/her portable wireless device, such as to alert the physician when a patient has completed the pre-procedure forms and is ready to begin the procedure. This feature could improve the workflow in busy clinical practices. In the future, the system could be expanded so physicians could use their portable wireless device to pull up entire hospital records and view other pre-procedure data and patient images.

Framework conditions and requirements to ensure the technical functional safety of reprocessed medical devices.

PubMed

Kraft, Marc

2008-09-03

Testing and restoring technical-functional safety is an essential part of medical device reprocessing. Technical functional tests have to be carried out on the medical device in the course of the validation of reprocessing procedures. These ensure (in addition to the hygiene tests) that the reprocessing procedure is suitable for the medical device. Functional tests are, however, also a part of reprocessing procedures. As a stage in the reprocessing, they ensure for the individual medical device that no damage or other changes limit the performance. When determining which technical-functional tests are to be carried out, the current technological standard has to be taken into account in the form of product-specific and process-oriented norms. Product-specific norms primarily define safety-relevant requirements. The risk management method described in DIN EN ISO 14971 is the basis for recognising hazards; the likelihood of such hazards arising can be minimised through additional technical-functional tests, which may not yet have been standardised. Risk management is part of a quality management system, which must be bindingly certified for manufacturers and processors of critical medical devices with particularly high processing demands by a body accredited by the competent authority.

Framework conditions and requirements to ensure the technical functional safety of reprocessed medical devices

PubMed Central

Kraft, Marc

2008-01-01

Testing and restoring technical-functional safety is an essential part of medical device reprocessing. Technical functional tests have to be carried out on the medical device in the course of the validation of reprocessing procedures. These ensure (in addition to the hygiene tests) that the reprocessing procedure is suitable for the medical device. Functional tests are, however, also a part of reprocessing procedures. As a stage in the reprocessing, they ensure for the individual medical device that no damage or other changes limit the performance. When determining which technical-functional tests are to be carried out, the current technological standard has to be taken into account in the form of product-specific and process-oriented norms. Product-specific norms primarily define safety-relevant requirements. The risk management method described in DIN EN ISO 14971 is the basis for recognising hazards; the likelihood of such hazards arising can be minimised through additional technical-functional tests, which may not yet have been standardised. Risk management is part of a quality management system, which must be bindingly certified for manufacturers and processors of critical medical devices with particularly high processing demands by a body accredited by the competent authority. PMID:20204095

Development of an algorithm to plan and simulate a new interventional procedure.

PubMed

Fujita, Buntaro; Kütting, Maximilian; Scholtz, Smita; Utzenrath, Marc; Hakim-Meibodi, Kavous; Paluszkiewicz, Lech; Schmitz, Christoph; Börgermann, Jochen; Gummert, Jan; Steinseifer, Ulrich; Ensminger, Stephan

2015-07-01

The number of implanted biological valves for treatment of valvular heart disease is growing and a percentage of these patients will eventually undergo a transcatheter valve-in-valve (ViV) procedure. Some of these patients will represent challenging cases. The aim of this study was to develop a feasible algorithm to plan and in vitro simulate a new interventional procedure to improve patient outcome. In addition to standard diagnostic routine, our algorithm includes 3D printing of the annulus, hydrodynamic measurements and high-speed analysis of leaflet kinematics after simulation of the procedure in different prosthesis positions as well as X-ray imaging of the most suitable valve position to create a 'blueprint' for the patient procedure. This algorithm was developed for a patient with a degenerated Perceval aortic sutureless prosthesis requiring a ViV procedure. Different ViV procedures were assessed in the algorithm and based on these results the best option for the patient was chosen. The actual procedure went exactly as planned with help of this algorithm. Here we have developed a new technically feasible algorithm simulating important aspects of a novel interventional procedure prior to the actual procedure. This algorithm can be applied to virtually all patients requiring a novel interventional procedure to help identify risks and find optimal parameters for prosthesis selection and placement in order to maximize safety for the patient. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Coexistence Analysis of Civil Unmanned Aircraft Systems at Low Altitudes

NASA Astrophysics Data System (ADS)

Zhou, Yuzhe

2016-11-01

The requirement of unmanned aircraft systems in civil areas is growing. However, provisioning of flight efficiency and safety of unmanned aircraft has critical requirements on wireless communication spectrum resources. Current researches mainly focus on spectrum availability. In this paper, the unmanned aircraft system communication models, including the coverage model and data rate model, and two coexistence analysis procedures, i. e. the interference and noise ratio criterion and frequency-distance-direction criterion, are proposed to analyze spectrum requirements and interference results of the civil unmanned aircraft systems at low altitudes. In addition, explicit explanations are provided. The proposed coexistence analysis criteria are applied to assess unmanned aircraft systems' uplink and downlink interference performances and to support corresponding spectrum planning. Numerical results demonstrate that the proposed assessments and analysis procedures satisfy requirements of flexible spectrum accessing and safe coexistence among multiple unmanned aircraft systems.

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

Faye, S. A.; Shaughnessy, D. A.

The objective of this project is to provide a comprehensive study on the production routes and chemical separation requirements for activation products, fission products, and actinides required for the creation of realistic post-detonation surrogate debris. Isotopes that have been prioritized by debris diagnosticians will be examined for their ability to be produced at existing irradiation sources, production rates, and availability of target materials, and chemical separation procedures required to rapidly remove the products from the bulk target matrix for subsequent addition into synthetic debris samples. The characteristics and implications of the irradiation facilities on the isotopes of interest will bemore » addressed in addition to a summary of the isotopes that are already regularly produced. This is a planning document only.« less

Using Video Modeling with Voiceover Instruction Plus Feedback to Train Staff to Implement Direct Teaching Procedures.

PubMed

Giannakakos, Antonia R; Vladescu, Jason C; Kisamore, April N; Reeve, Sharon A

2016-06-01

Direct teaching procedures are often an important part of early intensive behavioral intervention for consumers with autism spectrum disorder. In the present study, a video model with voiceover (VMVO) instruction plus feedback was evaluated to train three staff trainees to implement a most-to-least direct (MTL) teaching procedure. Probes for generalization were conducted with untrained direct teaching procedures (i.e., least-to-most, prompt delay) and with an actual consumer. The results indicated that VMVO plus feedback was effective in training the staff trainees to implement the MTL procedure. Although additional feedback was required for the staff trainees to show mastery of the untrained direct teaching procedures (i.e., least-to-most and prompt delay) and with an actual consumer, moderate to high levels of generalization were observed.

16 CFR 1632.5 - Mattress pad test procedure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 1632.5 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FLAMMABLE FABRICS ACT REGULATIONS... substrate. (b) Flame resistant mattress pads. The following additional requirements shall be applicable to mattress pads which contain a chemical fire retardant. (1) These mattress pads shall be tested in...

Public Accountancy Handbook.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Office of the Professions.

A reference guide to laws, rules, and regulations that govern public accountancy practice in New York State is presented. In addition to identifying licensing requirements/procedures for certified public accountants, general provisions of Title VIII of the Education Law are covered, along with state management, professional misconduct, and…

16 CFR 1.26 - Procedure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... rule may be held within the discretion of the Commission, unless otherwise expressly required by law... rule and may suggest such amendments, revisions, and additions thereto as they may consider desirable..., after consideration of all relevant matters of fact, law, policy, and discretion, including all relevant...

Robonaut 2 - Building a Robot on the International Space Station

NASA Technical Reports Server (NTRS)

Diftler, Myron; Badger, Julia; Joyce, Charles; Potter, Elliott; Pike, Leah

2015-01-01

In 2010, the Robonaut Project embarked on a multi-phase mission to perform technology demonstrations on-board the International Space Station (ISS), showcasing state of the art robotics technologies through the use of Robonaut 2 (R2). This phased approach implements a strategy that allows for the use of ISS as a test bed during early development to both demonstrate capability and test technology while still making advancements in the earth based laboratories for future testing and operations in space. While R2 was performing experimental trials onboard the ISS during the first phase, engineers were actively designing for Phase 2, Intra-Vehicular Activity (IVA) Mobility, that utilizes a set of zero-g climbing legs outfitted with grippers to grasp handrails and seat tracks. In addition to affixing the new climbing legs to the existing R2 torso, it became clear that upgrades to the torso to both physically accommodate the climbing legs and to expand processing power and capabilities of the robot were required. In addition to these upgrades, a new safety architecture was also implemented in order to account for the expanded capabilities of the robot. The IVA climbing legs not only needed to attach structurally to the R2 torso on ISS, but also required power and data connections that did not exist in the upper body. The climbing legs were outfitted with a blind mate adapter and coarse alignment guides for easy installation, but the upper body required extensive rewiring to accommodate the power and data connections. This was achieved by mounting a custom adapter plate to the torso and routing the additional wiring through the waist joint to connect to the new set of processors. In addition to the power and data channels, the integrated unit also required updated electronics boards, additional sensors and updated processors to accommodate a new operating system, software platform, and custom control system. In order to perform the unprecedented task of building a robot in space, extensive practice sessions and meticulous procedures were required. Since crew training time is at a premium, the R2 team took a skills-based training approach to ensure the astronauts were proficient with a basic skill set while refining the detailed procedures over several practice sessions and simulations. In addition to the crew activities, meticulous ground procedures were required in order to upgrade firmware on the upper body motor drivers. The new firmware for the IVA mobility unit needed to be deployed using the old software system. This also provided an opportunity to upgrade the upper body joints with new software and allowed for limited insight into the success of the updates. Complete verification that the updated firmware was successfully loaded was not confirmed until the rewiring of the upper body torso was complete.

Single-ring ablation compared with standard circumferential pulmonary vein isolation using remote magnetic catheter navigation.

PubMed

Sohns, Christian; Bergau, Leonard; Seegers, Joachim; Lüthje, Lars; Vollmann, Dirk; Zabel, Markus

2014-10-01

In ablation of atrial fibrillation, the single-ring method aims for isolation of the posterior wall of the left atrium (LA) including the pulmonary veins (PVs) but avoiding posterior LA lesions. The aim of this randomized prospective study was to evaluate safety and efficacy of remote magnetic navigation (RMN)-guided single-ring ablation strategy as compared to standard RMN-guided circumferential PV ablation (PVA). Eighty consecutive patients undergoing PVA were enrolled prospectively and randomized equally into two study groups. RMN using the Stereotaxis system and open-irrigated 3.5-mm ablation catheters were used with a 3D mapping system in all procedures. Forty patients underwent RMN-guided single-ring ablation, and 40 patients received RMN-guided circumferential PVA. In the circumferential group, 3.3 ± 1.1 PVs were successfully isolated at the end of the procedure as compared to 3.1 ± 1.3 in the single-ring (box) group (p=0.38). All patients in the box group required additional posterior lesions in order to achieve electrical isolation of the PVs. Single-ring ablation was associated with longer procedure duration (p=0.01) and ablation time (p=0.001). After a single procedure, the proportion of patients free of any atrial tachycardia (AT)/atrial fibrillation (AF) episode at 12-month follow-up was 57 % in the box group and 58 % in the circ group. Using RMN, only minor complications have been observed. RMN-guided single-ring PVA provides comparable acute and long-term success rates as compared to RMN-guided circumferential PVA but requires additional posterior lesions to achieve PV isolation and increased procedure and ablation time. Procedural complication rates are low when using RMN.

Anticipating implementation of colorectal cancer screening in The Netherlands: a nation wide survey on endoscopic supply and demand

PubMed Central

2012-01-01

Background Colorectal cancer (CRC) screening requires sufficient endoscopic resources. The present study aims to determine the Dutch endoscopic production and manpower for 2009, evaluate trends since 2004, determine additional workload which would be caused by implementation of a CRC screening program, and inventory colonoscopy rates performed in other European countries. Methods All Dutch endoscopy units (N = 101) were surveyed for manpower and the numbers of endoscopy procedures performed in 2009. Based on calculations in the report issued by the Dutch Health Council, future additional workload caused by faecal immunochemical test (FIT) screening was estimated. The number of colonoscopies performed in Europe was evaluated by a literature search and an email-inquiry. Results Compared to 2004, there was a 24% increase in total endoscopies (N = 505,226 in 2009), and a 64% increase in colonoscopies (N = 191,339 in 2009) in The Netherlands. The number of endoscopists had increased by 4.6% (N = 583 in 2009). Five years after stepwise implementation of FIT-based CRC screening, endoscopic capacity needs to be increased an additional 15%. A lack of published data on the number of endoscopies performed in Europe was found. Based on our email-inquiry, the number of colonoscopies per 100,000 inhabitants ranged from 126 to 3,031 in 15 European countries. Conclusions Over the last years, endoscopic procedures increased markedly in The Netherlands without a corresponding increase in manpower. A FIT-based CRC screening program requires an estimated additional 15% increase in endoscopic procedures. It is very likely that current colonoscopy density varies widely across European countries. PMID:22280408

[Actual medical care situation and therapeutic needs in multiple sclerosis: Impact of the Pharmaceutical Market Restructuring Act (AMNOG)].

PubMed

Bittner, S; Meuth, S G

2016-04-01

The treatment of patients with multiple sclerosis (MS) is associated with constantly rising costs for the healthcare system and pharmaceuticals constitute 60 % of the direct medical costs. The Pharmaceutical Market Restructuring Act (Arzneimittelmarkt-Neuordnungsgesetz, AMNOG) came into force on 1 January 2011 with the aim of limiting the costs of pharmaceuticals by obligating newly approved products to be subjected to an early evaluation of the additional benefits by the Federal Joint Committee (FJC, Gemeinsamer Bundesausschuss, G‑BA). The majority of products evaluated up to October 2015 in neurology (5 out of 8) were approved for treatment of MS. Has the AMNOG been able to fulfill the original aims? Analysis of available information on MS therapies evaluated by the FJC between December 2010 and October 2015. For various reasons an additional benefit could be shown in only 2 out of 5 assessment procedures for MS drugs. It is obvious that some methodological shortcomings of the process have to be improved. Additionally requirements for pivotal clinical trials have to be harmonized with AMNOG requirements taking the best available evidence and real-life data into consideration (e.g. non-interventional studies) and a closer collaboration between the FJC, healthcare providers and the neurological societies is necessary. The AMNOG procedure currently only partially fulfills the original aims, which could be the reason why guidelines play a more important role for therapy decision-making than FJC decisions. As the early evaluation procedure is an adaptive process methodological shortcomings might be overcome in the future; however, this requires a much closer collaboration between the FJC and neurological societies.

The Efficacy of Simultaneous Breast Reconstruction and Contralateral Balancing Procedures in Reducing the Need for Second Stage Operations

PubMed Central

Clarke-Pearson, Emily M; Vornovitsky, Michael; Dayan, Joseph H; Samson, William; Sultan, Mark R

2014-01-01

Background Patients having unilateral breast reconstruction often require a second stage procedure on the contralateral breast to improve symmetry. In order to provide immediate symmetry and minimize the frequency and extent of secondary procedures, we began performing simultaneous contralateral balancing operations at the time of initial reconstruction. This study examines the indications, safety, and efficacy of this approach. Methods One-hundred and two consecutive breast reconstructions with simultaneous contralateral balancing procedures were identified. Data included patient age, body mass index (BMI), type of reconstruction and balancing procedure, specimen weight, transfusion requirement, complications and additional surgery under anesthesia. Unpaired t-tests were used to compare BMI, specimen weight and need for non-autologous transfusion. Results Average patient age was 48 years. The majority had autologous tissue-only reconstructions (94%) and the rest prosthesis-based reconstructions (6%). Balancing procedures included reduction mammoplasty (50%), mastopexy (49%), and augmentation mammoplasty (1%). Average BMI was 27 and average reduction specimen was 340 grams. Non-autologous blood transfusion rate was 9%. There was no relationship between BMI or reduction specimen weight and need for transfusion. We performed secondary surgery in 24% of the autologous group and 100% of the prosthesis group. Revision rate for symmetry was 13% in the autologous group and 17% in the prosthesis group. Conclusions Performing balancing at the time of breast reconstruction is safe and most effective in autologous reconstructions, where 87% did not require a second operation for symmetry. PMID:25276646

Specific arithmetic calculation deficits in children with Turner syndrome.

PubMed

Rovet, J; Szekely, C; Hockenberry, M N

1994-12-01

Study 1 compared arithmetic processing skills on the WRAT-R in 45 girls with Turner syndrome (TS) and 92 age-matched female controls. Results revealed significant underachievement by subjects with TS, which reflected their poorer performance on problems requiring the retrieval of addition and multiplication facts and procedural knowledge for addition and division operations. TS subjects did not differ qualitatively from controls in type of procedural error committed. Study 2, which compared the performance of 10 subjects with TS and 31 controls on the Keymath Diagnostic Arithmetic Test, showed that the TS group had less adequate knowledge of arithmetic, subtraction, and multiplication procedures but did not differ from controls on Fact items. Error analyses revealed that TS subjects were more likely to confuse component steps or fail to separate intermediate steps or to complete problems. TS subjects relied to a greater degree on verbal than visual-spatial abilities in arithmetic processing while their visual-spatial abilities were associated with retrieval of simple multidigit addition facts and knowledge of subtraction, multiplication, and division procedures. Differences between the TS and control groups increased with age for Keymath, but not WRAT-R, procedures. Discrepant findings are related to the different task constraints (timed vs. untimed, single vs. alternate versions, size of item pool) and the use of different strategies (counting vs. fact retrieval). It is concluded that arithmetic difficulties in females with TS are due to less adequate procedural skills, combined with poorer fact retrieval in timed testing situations, rather than to inadequate visual-spatial abilities.

Technical note: Design flood under hydrological uncertainty

NASA Astrophysics Data System (ADS)

Botto, Anna; Ganora, Daniele; Claps, Pierluigi; Laio, Francesco

2017-07-01

Planning and verification of hydraulic infrastructures require a design estimate of hydrologic variables, usually provided by frequency analysis, and neglecting hydrologic uncertainty. However, when hydrologic uncertainty is accounted for, the design flood value for a specific return period is no longer a unique value, but is represented by a distribution of values. As a consequence, the design flood is no longer univocally defined, making the design process undetermined. The Uncertainty Compliant Design Flood Estimation (UNCODE) procedure is a novel approach that, starting from a range of possible design flood estimates obtained in uncertain conditions, converges to a single design value. This is obtained through a cost-benefit criterion with additional constraints that is numerically solved in a simulation framework. This paper contributes to promoting a practical use of the UNCODE procedure without resorting to numerical computation. A modified procedure is proposed by using a correction coefficient that modifies the standard (i.e., uncertainty-free) design value on the basis of sample length and return period only. The procedure is robust and parsimonious, as it does not require additional parameters with respect to the traditional uncertainty-free analysis. Simple equations to compute the correction term are provided for a number of probability distributions commonly used to represent the flood frequency curve. The UNCODE procedure, when coupled with this simple correction factor, provides a robust way to manage the hydrologic uncertainty and to go beyond the use of traditional safety factors. With all the other parameters being equal, an increase in the sample length reduces the correction factor, and thus the construction costs, while still keeping the same safety level.

Midline submental intubation might be the preferred alternative to oral and nasal intubation in elective oral and craniomaxillofacial surgery when indicated.

PubMed

Jin, Huijun; Patil, Pavan Manohar

2015-01-01

No consensus exists to date regarding the best method of controlling the airway for oral or craniomaxillofacial surgery when orotracheal and nasotracheal intubations are unsuccessful or contraindicated. The most commonly used method of tracheostomy has been associated with a high degree of morbidity. Therefore, the present study was conducted to determine the indications, safety, efficacy, time required, drawbacks, complications, and costs of the midline submental intubation (SMI) approach in elective oral and craniomaxillofacial surgical procedures. A retrospective case series study was used to evaluate the surgical, financial, and photographic records of all patients who had undergone oral or craniomaxillofacial operations at Sharda University School of Dental Sciences, Greater Noida, from April 2006 to March 2014. The indications, drawbacks, time required for the procedure, ability to provide a secure airway, intra- and postoperative complications, and additional costs associated with SMI were analyzed. Of the 2,823 patients treated, the present study included 120 patients (97 men and 23 women, aged 19 to 60 years). The average time required for SMI was 10 ± 2 minutes. No episode of intraoperative oxygen desaturation was noted. One intraoperative complication, an injury to the ventral surface of the tongue, was encountered. Two patients developed infection at the skin incision site. No significant additional cost was incurred with the use of SMI. SMI has been successfully used in elective oral and craniomaxillofacial surgical procedures for which oral and nasal intubations were either not indicated or not possible. The advantages include a quick procedure, insignificant complications, the ability to provide a stable airway, and no added costs, making SMI a quick, safe, efficient, and cost-effective alternative in such cases. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

15 CFR 911.1 - Purpose.

Code of Federal Regulations, 2012 CFR

2012-01-01

... OF THE NOAA SPACE-BASED DATA COLLECTION SYSTEMS § 911.1 Purpose. These regulations set forth the procedural, informational and technical requirements for use of the NOAA Data Collection Systems (DCS). In addition, they establish the criteria NOAA will employ when making determinations as to whether to...

15 CFR 911.1 - Purpose.

Code of Federal Regulations, 2014 CFR

2014-01-01

... OF THE NOAA SPACE-BASED DATA COLLECTION SYSTEMS § 911.1 Purpose. These regulations set forth the procedural, informational and technical requirements for use of the NOAA Data Collection Systems (DCS). In addition, they establish the criteria NOAA will employ when making determinations as to whether to...

15 CFR 911.1 - Purpose.

Code of Federal Regulations, 2011 CFR

2011-01-01

... OF THE NOAA SPACE-BASED DATA COLLECTION SYSTEMS § 911.1 Purpose. These regulations set forth the procedural, informational and technical requirements for use of the NOAA Data Collection Systems (DCS). In addition, they establish the criteria NOAA will employ when making determinations as to whether to...

15 CFR 911.1 - Purpose.

Code of Federal Regulations, 2013 CFR

2013-01-01

... OF THE NOAA SPACE-BASED DATA COLLECTION SYSTEMS § 911.1 Purpose. These regulations set forth the procedural, informational and technical requirements for use of the NOAA Data Collection Systems (DCS). In addition, they establish the criteria NOAA will employ when making determinations as to whether to...

21 CFR 107.50 - Terms and conditions.

Code of Federal Regulations, 2012 CFR

2012-04-01

... Center for Food Safety and Applied Nutrition concludes that additional or modified quality control... also typically represented and labeled for use to provide dietary management for diseases or conditions... regulations promulgated under section 412(a)(2) of the act, the quality control procedure requirements of part...

Medicine Handbook.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Office of the Professions.

A reference guide to laws, rules, and regulations that govern medical practice in the State of New York is presented. In addition to identifying licensing requirements/procedures for physicians, general provisions of Title VIII of the Education Law are covered along with state management, professional misconduct, and authorized acts. Regulations…

15 CFR 911.1 - Purpose.

Code of Federal Regulations, 2010 CFR

2010-01-01

... OF THE NOAA SPACE-BASED DATA COLLECTION SYSTEMS § 911.1 Purpose. These regulations set forth the procedural, informational and technical requirements for use of the NOAA Data Collection Systems (DCS). In addition, they establish the criteria NOAA will employ when making determinations as to whether to...

A Novel Technique to Follow Consequences of Exogenous Factors, Including Therapeutic Drugs, on Living Human Breast Epithelial Cells

DTIC Science & Technology

1999-07-01

and lipid vectors, are being tested. Concurrent with the development of procedures for live - cell imaging , we are examining the distribution of proteins...dimensional matrix. These studies have not yet begun. There are a number of procedures that must be developed and perfected in the live - cell imaging , as...components of the Wnt signaling pathway are too preliminary and require additional research prior to publication. (9) CONCLUSIONS Live cell imaging of

[Requirements for CE-marking of apps and wearables].

PubMed

Berensmann, Michael; Gratzfeld, Markus

2018-03-01

Depending on the intended use, apps and wearables can be medical devices. In such cases, the manufacturer has to provide evidence that the requirements stated in directive 93/42/EWG are fulfilled. Depending on the classification of the medical device, several so-called conformity assessment procedures are possible. Once the conformity assessment procedure has been finished successfully, the manufacturer attaches the CE-marking to the product. This assures that all requirements of the directive have been fulfilled and the manufacturer is therefore authorized to put the product onto the market in all member states of the European union. In this article, the possible and practical conformity assessment procedures for apps and wearables are described and their implementation is outlined.For medical devices with sufficiently high-risk classification, the manufacturer has to involve a Notified Body. For the conformity assessment procedure according to annex II, the manufacturer implements a full quality management system and compiles technical documentation. These are supervised and evaluated by Notified Body audits. Especially for startups, it is important for the development of apps and wearables to implement a quality management system early and to fulfill the regulatory requirements, for example, related to the software life-cycle model. This also includes considering accompanying processes during development like risk management, usability engineering, and clinical evaluation.Additionally, it should be pointed out, that according to the new medical device regulation almost all apps will fall at least into class IIa. Thus, the involvement of a Notified Body in the related conformity assessment procedures would be required. Apps that have already been put onto the market as class I devices, and are now upgraded to a higher class, need the approval of a notified body starting from 26 May 2020.

Hypnosis for Acute Procedural Pain: A Critical Review.

PubMed

Kendrick, Cassie; Sliwinski, Jim; Yu, Yimin; Johnson, Aimee; Fisher, William; Kekecs, Zoltán; Elkins, Gary

2016-01-01

Clinical evidence for the effectiveness of hypnosis in the treatment of acute procedural pain was critically evaluated based on reports from randomized controlled clinical trials (RCTs). Results from the 29 RCTs meeting inclusion criteria suggest that hypnosis decreases pain compared to standard care and attention control groups and that it is at least as effective as comparable adjunct psychological or behavioral therapies. In addition, applying hypnosis in multiple sessions prior to the day of the procedure produced the highest percentage of significant results. Hypnosis was most effective in minor surgical procedures. However, interpretations are limited by considerable risk of bias. Further studies using minimally effective control conditions and systematic control of intervention dose and timing are required to strengthen conclusions.

HYPNOSIS FOR ACUTE PROCEDURAL PAIN: A Critical Review

PubMed Central

Kendrick, Cassie; Sliwinski, Jim; Yu, Yimin; Johnson, Aimee; Fisher, William; Kekecs, Zoltán; Elkins, Gary

2015-01-01

Clinical evidence for the effectiveness of hypnosis in the treatment of acute, procedural pain was critically evaluated based on reports from randomized controlled clinical trials (RCTs). Results from the 29 RCTs meeting inclusion criteria suggest that hypnosis decreases pain compared to standard care and attention control groups and that it is at least as effective as comparable adjunct psychological or behavioral therapies. In addition, applying hypnosis in multiple sessions prior to the day of the procedure produced the highest percentage of significant results. Hypnosis was most effective in minor surgical procedures. However, interpretations are limited by considerable risk of bias. Further studies using minimally effective control conditions and systematic control of intervention dose and timing are required to strengthen conclusions. PMID:26599994

Leveraging Past and Current Measurements to Probabilistically Nowcast Low Visibility Procedures at an Airport

NASA Astrophysics Data System (ADS)

Mayr, G. J.; Kneringer, P.; Dietz, S. J.; Zeileis, A.

2016-12-01

Low visibility or low cloud ceiling reduce the capacity of airports by requiring special low visibility procedures (LVP) for incoming/departing aircraft. Probabilistic forecasts when such procedures will become necessary help to mitigate delays and economic losses.We compare the performance of probabilistic nowcasts with two statistical methods: ordered logistic regression, and trees and random forests. These models harness historic and current meteorological measurements in the vicinity of the airport and LVP states, and incorporate diurnal and seasonal climatological information via generalized additive models (GAM). The methods are applied at Vienna International Airport (Austria). The performance is benchmarked against climatology, persistence and human forecasters.

Prospective evaluation of antibiotic treatment for urological procedure in patients presenting with neurogenic bladder.

PubMed

Weglinski, L; Rouzaud, C; Even, A; Bouchand, F; Davido, B; Duran, C; Salomon, J; Perronne, C; Denys, P; Chartier-Kastler, E; Dinh, A

2016-09-01

Patients presenting with neurogenic bladder often require urological procedures (urodynamic testing and botulinum toxin injections) and a preventive antibiotic therapy. We aimed to assess the efficacy of this little known strategy in a cohort of patients. All patients presenting with neurogenic bladder who underwent urological procedure were included in the study. They received an antibiotic therapy in accordance with the urine cytobacteriological examination results. The antibiotic therapy was initiated two days before the procedure and prolonged up until two days after the procedure if the culture was positive. Patients were treated with a single dose of fosfomycin-trometamol in case of a negative culture. The main study outcome was the occurrence of urinary tract infection (UTI), defined by a positive urine culture and symptoms, up until 14 days after the procedure. A total of 80 urological procedures were performed. Mean patient age was 47±13.1 years (sex ratio 1.22); 59 (73.8%) presented with asymptomatic bacteriuria before the procedure. Nine (11.1%) UTIs were recorded on Day 14, of which one (1.2%) was febrile. Two patients required an additional curative antibiotic therapy. No patient was hospitalized. Overall, 77.8% of UTIs were cured without antibiotic therapy. Screening and treating asymptomatic bacteriuria before urological procedures seems unnecessary and vainly exposes this population at high risk of infectious diseases to antibiotic therapies. This data should be confirmed by a randomized clinical trial. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Should Title 24 Ventilation Requirements Be Amended to include an Indoor Air Quality Procedure?

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

Dutton, Spencer M.; Mendell, Mark J.; Chan, Wanyu R.

Minimum outdoor air ventilation rates (VRs) for buildings are specified in standards, including California?s Title 24 standards. The ASHRAE ventilation standard includes two options for mechanically-ventilated buildings ? a prescriptive ventilation rate procedure (VRP) that specifies minimum VRs that vary among occupancy classes, and a performance-based indoor air quality procedure (IAQP) that may result in lower VRs than the VRP, with associated energy savings, if IAQ meeting specified criteria can be demonstrated. The California Energy Commission has been considering the addition of an IAQP to the Title 24 standards. This paper, based on a review of prior data and newmore » analyses of the IAQP, evaluates four future options for Title 24: no IAQP; adding an alternate VRP, adding an equivalent indoor air quality procedure (EIAQP), and adding an improved ASHRAE-like IAQP. Criteria were established for selecting among options, and feedback was obtained in a workshop of stakeholders. Based on this review, the addition of an alternate VRP is recommended. This procedure would allow lower minimum VRs if a specified set of actions were taken to maintain acceptable IAQ. An alternate VRP could also be a valuable supplement to ASHRAE?s ventilation standard.« less

Use of luciferase probes to measure ATP in living cells and animals.

PubMed

Morciano, Giampaolo; Sarti, Alba Clara; Marchi, Saverio; Missiroli, Sonia; Falzoni, Simonetta; Raffaghello, Lizzia; Pistoia, Vito; Giorgi, Carlotta; Di Virgilio, Francesco; Pinton, Paolo

2017-08-01

ATP, the energy exchange factor that connects anabolism and catabolism, is required for major reactions and processes that occur in living cells, such as muscle contraction, phosphorylation and active transport. ATP is also the key molecule in extracellular purinergic signaling mechanisms, with an established crucial role in inflammation and several additional disease conditions. Here, we describe detailed protocols to measure the ATP concentration in isolated living cells and animals using luminescence techniques based on targeted luciferase probes. In the presence of magnesium, oxygen and ATP, the protein luciferase catalyzes oxidation of the substrate luciferin, which is associated with light emission. Recombinantly expressed wild-type luciferase is exclusively cytosolic; however, adding specific targeting sequences can modify its cellular localization. Using this strategy, we have constructed luciferase chimeras targeted to the mitochondrial matrix and the outer surface of the plasma membrane. Here, we describe optimized protocols for monitoring ATP concentrations in the cytosol, mitochondrial matrix and pericellular space in living cells via an overall procedure that requires an average of 3 d. In addition, we present a detailed protocol for the in vivo detection of extracellular ATP in mice using luciferase-transfected reporter cells. This latter procedure may require up to 25 d to complete.

33 CFR 155.1125 - Additional response plan requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Prince William Sound— (A) Valdez; (B) Tatitlek; (C) Cordova; (D) Whittier; (E) Chenega; and (F) Fish... include exercise procedures that must— (i) Provide two exercises of the oil spill removal organization... effectively; (ii) Provide for both announced and unannounced exercises; and (iii) Provide for exercises that...

40 CFR 600.507-08 - Running change data requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... POLICY FUEL ECONOMY AND GREENHOUSE GAS EXHAUST EMISSIONS OF MOTOR VEHICLES Procedures for Determining Manufacturer's Average Fuel Economy and Manufacturer's Average Carbon-Related Exhaust Emissions § 600.507-08... manufacturer shall submit additional running change fuel economy data as specified in paragraph (b) of this...

28 CFR 34.4 - Additional competitive application requirements and procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... other eligible parties, including those in another State, and submit joint applications for assistance. (2) A joint application made by two or more applicants for assistance may have separate budgets... combined budget. If joint applications present separate budgets, the Administrator may make separate awards...

75 FR 50034 - Reports, Forms, and Record Keeping Requirements

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-16

... the Office of Management and Budget (OMB). Under procedures established by the Paperwork Reduction Act... riding skills tests, and archival records to examine the effect of entry-level motorcycle rider training... riding. Survey information will additionally supplement data from skills tests of riders' on-motorcycle...

Preparing a cost analysis for the section of medical physics-guidelines and methods.

PubMed

Mills, M D; Spanos, W J; Jose, B O; Kelly, B A; Brill, J P

2000-01-01

Radiation oncology is a highly complex medical specialty, involving many varied routine and special procedures. To assure cost-effectiveness and maintain support for the medical physics program, managers are obligated to analyze and defend all aspects of an institutional billing and cost-reporting program. Present standards of practice require that each patient's radiation treatments be customized to fit his/her particular condition. Since the use of personnel time and other resources is highly variable among patients, graduated levels of charges have been established to allow for more precise billing. Some radiation oncology special procedures have no specific code descriptors; so existing codes are modified or additional information attached in order to avoid payment denial. Recent publications have explored the manpower needs, salaries, and other resources required to perform radiation oncology "physics" procedures. This information is used to construct a model cost-based resource use profile for a radiation oncology center. This profile can be used to help the financial officer prepare a cost report for the institution. Both civil and criminal penalties for Medicare fraud and abuse (intentional or unintentional) are included in the False Claims Act and other statutes. Compliance guidelines require managers to train all personnel in correct billing procedures and to review continually billing performance.

Utilizing collagen membranes for guided tissue regeneration-based root coverage.

PubMed

Wang, Hom-Lay; Modarressi, Marmar; Fu, Jia-Hui

2012-06-01

Gingival recession is a common clinical problem that can result in hypersensitivity, pain, root caries and esthetic concerns. Conventional soft tissue procedures for root coverage require an additional surgical site, thereby causing additional trauma and donor site morbidity. In addition, the grafted tissues heal by repair, with formation of long junctional epithelium with some connective tissue attachment. Guided tissue regeneration-based root coverage was thus developed in an attempt to overcome these limitations while providing comparable clinical results. This paper addresses the biologic foundation of guided tissue regeneration-based root coverage, and describes the indications and contraindications for this technique, as well as the factors that influence outcomes. The step-by-step clinical techniques utilizing collagen membranes are also described. In comparison with conventional soft tissue procedures, the benefits of guided tissue regeneration-based root coverage procedures include new attachment formation, elimination of donor site morbidity, less chair-time, and unlimited availability and uniform thickness of the product. Collagen membranes, in particular, benefit from product biocompatibility with the host, while promoting chemotaxis, hemostasis, and exchange of gas and nutrients. Such characteristics lead to better wound healing by promoting primary wound coverage, angiogenesis, space creation and maintenance, and clot stability. In conclusion, collagen membranes are a reliable alternative for use in root coverage procedures. © 2012 John Wiley & Sons A/S.

An extension of incidental teaching procedures to reading instruction for autistic children.

PubMed Central

McGee, G G; Krantz, P J; McClannahan, L E

1986-01-01

In an extension of incidental teaching procedures to reading instruction, two autistic children acquired functional sight-word reading skills in the context of a play activity. Children gained access to preferred toys by selecting the label of the toy in tasks requiring increasingly complex visual discriminations. In addition to demonstrating rapid acquisition of 5-choice discriminations, they showed comprehension on probes requiring reading skills to locate toys stored in labeled boxes. Also examined was postteaching transfer across stimulus materials and response modalities. Implications are that extensions of incidental teaching to new response classes may produce the same benefits documented in communication training, in terms of producing generalization concurrent with skill acquisition in the course of child-preferred activities. PMID:3733586

Soft tissue augmentation in skin of color: market growth, available fillers, and successful techniques.

PubMed

Burgess, Cheryl M

2007-01-01

In recent years, people of color have become an increasingly important market force for the cosmetics industry. Product lines have been expanded to accommodate a broader spectrum of skin colors and marketing strategies have been specialized in order to target specific ethnic populations. In addition, it is predicted that people with pigmented skin will eventually comprise a majority of the domestic and international population during the 21st century. Not surprisingly, people of color are increasingly seeking out products and procedures to fight the effects of aging, including an increase in surgical and nonsurgical cosmetic procedures. Among nonsurgical procedures, soft tissue augmentation has experienced dramatic growth. Today, clinicians are performing more and more of these procedures in people of color. As a result of these shifts in the cosmetics industry, clinicians performing soft tissue augmentation require increased expertise in the treatment of ethnic skin. This article reviews the important differences that exist between the appearance of the aging faces of Caucasians and people of color. In addition, soft tissue augmentation strategies and injection techniques that are specific to skin of color are discussed.

16 CFR 1702.2 - Procedural requirements and recommendations.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Procedural requirements and recommendations...; PETITION PROCEDURES AND REQUIREMENTS § 1702.2 Procedural requirements and recommendations. (a) Requirements... recommendations. The following are procedural recommendations to help the Commission in its consideration of...

16 CFR 1702.2 - Procedural requirements and recommendations.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Procedural requirements and recommendations...; PETITION PROCEDURES AND REQUIREMENTS § 1702.2 Procedural requirements and recommendations. (a) Requirements... recommendations. The following are procedural recommendations to help the Commission in its consideration of...

Therapeutic Plasma Exchange in Critically Ill Children Requiring Intensive Care.

PubMed

Cortina, Gerard; McRae, Rosemary; Chiletti, Roberto; Butt, Warwick

2018-02-01

To characterize the clinical indications, procedural safety, and outcome of critically ill children requiring therapeutic plasma exchange. Retrospective observational study based on a prospective registry. Tertiary and quaternary referral 30-bed PICU. Forty-eight critically ill children who received therapeutic plasma exchange during an 8-year period (2007-2014) were included in the study. Therapeutic plasma exchange. A total of 48 patients underwent 244 therapeutic plasma exchange sessions. Of those, therapeutic plasma exchange was performed as sole procedure in 193 (79%), in combination with continuous renal replacement therapy in 40 (16.4%) and additional extracorporeal membrane oxygenation in 11 (4.6%) sessions. The most common admission diagnoses were hematologic disorders (30%), solid organ transplantation (20%), neurologic disorders (20%), and rheumatologic disorders (15%). Complications associated with the procedure occurred in 50 (21.2%) therapeutic plasma exchange sessions. Overall, patient survival from ICU was 82%. Although patients requiring therapeutic plasma exchange alone (n = 31; 64%) had a survival rate of 97%, those with additional continuous renal replacement therapy (n = 13; 27%) and extracorporeal membrane oxygenation (n = 4; 8%) had survival rates of 69% and 50%, respectively. Factors associated with increased mortality were lower Pediatric Index of Mortality 2 score, need for mechanical ventilation, higher number of failed organs, and longer ICU stay. Our results indicate that, in specialized centers, therapeutic plasma exchange can be performed relatively safely in critically ill children, alone or in combination with continuous renal replacement therapy and extracorporeal membrane oxygenation. Outcome in children requiring therapeutic plasma exchange alone is excellent. However, survival decreases with the number of failed organs and the need for continuous renal replacement therapy and extracorporeal membrane oxygenation.

13 CFR 134.402 - Appeal petition.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Appeal petition. 134.402 Section 134.402 Business Credit and Assistance SMALL BUSINESS ADMINISTRATION RULES OF PROCEDURE GOVERNING... § 134.402 Appeal petition. In addition to the requirements of § 134.203, an appeal petition must state...

78 FR 63019 - Safety Standard for Bassinets and Cradles

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-23

... directly attributable to product stability, the instability of the product, in many incidents, was to blame... stability test procedure, and (2) the addition of new provisions for a segmented mattress flatness test and a removable bed stability requirement. In this document, the Commission is issuing a safety standard...

32 CFR 231.10 - Financial institutions on DoD installations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... installations shall be provided logistic support as set forth in subpart A of this part. (vi) Military... financial services (to include in-store banking) requiring the outgrant of additional space or logistical... Logistics) (USD(AT&L)) shall monitor policies and procedures governing logistical support furnished to...

32 CFR 231.10 - Financial institutions on DoD installations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... installations shall be provided logistic support as set forth in subpart A of this part. (vi) Military... financial services (to include in-store banking) requiring the outgrant of additional space or logistical... Logistics) (USD(AT&L)) shall monitor policies and procedures governing logistical support furnished to...

32 CFR 231.10 - Financial institutions on DoD installations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... installations shall be provided logistic support as set forth in subpart A of this part. (vi) Military... financial services (to include in-store banking) requiring the outgrant of additional space or logistical... Logistics) (USD(AT&L)) shall monitor policies and procedures governing logistical support furnished to...

76 FR 31510 - Proposed Amendment of Class E Airspace; Rutherfordton, NC

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-01

...; Airspace Docket No. 10-ASO-41) and be submitted in triplicate to the Docket Management System (see... airspace required to support new standard instrument approach procedures for Rutherford County Airport. The... action proposes to amend Class E Airspace at Rutherfordton, NC, to accommodate the additional airspace...

25 CFR 273.18 - Additional requirements for education plan.

Code of Federal Regulations, 2011 CFR

2011-04-01

... total enrollment of school or district, by age and grade level. (l) State the eligible Indian enrollment—total and classification by tribal affiliation(s) and by age and grade level. (m) State the total number...) Program goals and objectives related to the learning needs of potential target students. (2) Procedures...

25 CFR 273.18 - Additional requirements for education plan.

Code of Federal Regulations, 2010 CFR

2010-04-01

... total enrollment of school or district, by age and grade level. (l) State the eligible Indian enrollment—total and classification by tribal affiliation(s) and by age and grade level. (m) State the total number...) Program goals and objectives related to the learning needs of potential target students. (2) Procedures...

7 CFR 58.731 - Closing and sealing containers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 3 2010-01-01 2010-01-01 false Closing and sealing containers. 58.731 Section 58.731... Procedures § 58.731 Closing and sealing containers. Pouches, liners, or containers having product contact... means, so as to assure against contamination. Each container in addition to other required labeling...

7 CFR 1709.124 - Grant award procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES RUS High Energy Cost Grant Program § 1709.124 Grant... additional information in order to complete the required environmental review under 7 CFR 1794 and to meet... must concur with any changes proposed to the letter of conditions by the applicant before the...

7 CFR 1709.124 - Grant award procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES RUS High Energy Cost Grant Program § 1709.124 Grant... additional information in order to complete the required environmental review under 7 CFR 1794 and to meet... must concur with any changes proposed to the letter of conditions by the applicant before the...

76 FR 68385 - Approval and Promulgation of Implementation Plans; New Mexico; Albuquerque/Bernalillo County...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-04

... NMAC) addition of in subsections methodology for (A) and (B). fugitive dust control permits, revised... fee Fee Calculations and requirements for Procedures. fugitive dust control permits. 9/7/2004 Section... schedule based on acreage, add and update calculation methodology used to calculate non- programmatic dust...

Three studies of biographical factors associated with success in air traffic control specialist screening/training at the FAA Academy.

DOT National Transportation Integrated Search

1983-04-01

The current Air Traffic Control Specialist (ATCS) selection procedure requires that all applicants pass the Office of Personnel Management (OPM) air traffic control aptitude test. In addition to the test scores, applicants may also receive points for...

75 FR 27561 - Agency Recordkeeping/Reporting Requirements Under Emergency Review by the Office of Management...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-17

... authorize emergency processing of its information collection clearance of the LIHEAP Program Integrity... approval for this information collection under procedures for emergency processing by May 30, 2010. A copy... has determined that additional information from each administering agency is necessary to assess...

A 'digital' technique for manual extraction of data from aerial photography

NASA Technical Reports Server (NTRS)

Istvan, L. B.; Bondy, M. T.

1977-01-01

The interpretation procedure described uses a grid cell approach. In addition, a random point is located in each cell. The procedure required that the cell/point grid be established on a base map, and identical grids be made to precisely match the scale of the photographic frames. The grid is then positioned on the photography by visual alignment to obvious features. Several alignments on one frame are sometimes required to make a precise match of all points to be interpreted. This system inherently corrects for distortions in the photography. Interpretation is then done cell by cell. In order to meet the time constraints, first order interpretation should be maintained. The data is put onto coding forms, along with other appropriate data, if desired. This 'digital' manual interpretation technique has proven to be efficient, and time and cost effective, while meeting strict requirements for data format and accuracy.

The Gap Procedure: for the identification of phylogenetic clusters in HIV-1 sequence data.

PubMed

Vrbik, Irene; Stephens, David A; Roger, Michel; Brenner, Bluma G

2015-11-04

In the context of infectious disease, sequence clustering can be used to provide important insights into the dynamics of transmission. Cluster analysis is usually performed using a phylogenetic approach whereby clusters are assigned on the basis of sufficiently small genetic distances and high bootstrap support (or posterior probabilities). The computational burden involved in this phylogenetic threshold approach is a major drawback, especially when a large number of sequences are being considered. In addition, this method requires a skilled user to specify the appropriate threshold values which may vary widely depending on the application. This paper presents the Gap Procedure, a distance-based clustering algorithm for the classification of DNA sequences sampled from individuals infected with the human immunodeficiency virus type 1 (HIV-1). Our heuristic algorithm bypasses the need for phylogenetic reconstruction, thereby supporting the quick analysis of large genetic data sets. Moreover, this fully automated procedure relies on data-driven gaps in sorted pairwise distances to infer clusters, thus no user-specified threshold values are required. The clustering results obtained by the Gap Procedure on both real and simulated data, closely agree with those found using the threshold approach, while only requiring a fraction of the time to complete the analysis. Apart from the dramatic gains in computational time, the Gap Procedure is highly effective in finding distinct groups of genetically similar sequences and obviates the need for subjective user-specified values. The clusters of genetically similar sequences returned by this procedure can be used to detect patterns in HIV-1 transmission and thereby aid in the prevention, treatment and containment of the disease.

Maximization of DRAM yield by control of surface charge and particle addition during high dose implantation

NASA Astrophysics Data System (ADS)

Horvath, J.; Moffatt, S.

1991-04-01

Ion implantation processing exposes semiconductor devices to an energetic ion beam in order to deposit dopant ions in shallow layers. In addition to this primary process, foreign materials are deposited as particles and surface films. The deposition of particles is a major cause of IC yield loss and becomes even more significant as device dimensions are decreased. Control of particle addition in a high-volume production environment requires procedures to limit beamline and endstation sources, control of particle transport, cleaning procedures and a well grounded preventative maintenance philosophy. Control of surface charge by optimization of the ion beam and electron shower conditions and measurement with a real-time charge sensor has been effective in improving the yield of NMOS and CMOS DRAMs. Control of surface voltages to a range between 0 and -20 V was correlated with good implant yield with PI9200 implanters for p + and n + source-drain implants.

Virtual Surgical Planning for Inferior Alveolar Nerve Reconstruction.

PubMed

Miloro, Michael; Markiewicz, Michael R

2017-11-01

The purpose of this study was to assess the outcomes after preoperative virtual surgical planning (VSP) for inferior alveolar nerve (IAN) reconstruction in ablative mandibular surgery. We performed a retrospective evaluation of consecutive surgical cases using standard VSP for hard tissue resection and reconstructive surgery in addition to IAN VSP performed simultaneously during surgery. Cases were assessed regarding the planning time, additional costs involved, surgeon's subjective impression of the process, accuracy of the prediction during surgery, and operative time during surgery compared with cases performed without VSP. The study sample was composed of 5 cases of mandibular resection for benign disease, with bony, soft tissue, and neural reconstruction with the use of VSP. The addition of IAN reconstruction to the VSP session added no additional expense to the planning session but resulted in an additional 22.5 minutes (±7.5 minutes) for the webinar session. From a subjective standpoint, IAN VSP provided the surgeon with a discreet plan for surgery. From an objective standpoint, IAN VSP provided the exact length and diameter of nerve graft required for surgery, facilitated the surgeon's ability to visualize the actual nerve graft procedure, and limited the additional time required for simultaneous nerve reconstruction. Despite perceived prejudice against simultaneous IAN reconstruction with complex mandibular resection and reconstruction, the use of IAN VSP may facilitate the actual surgical procedure and result in considerably improved patient outcomes without considerable additional time or cost associated with this protocol. Copyright © 2017 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Standardized technique for single-incision laparoscopic-assisted stoma creation.

PubMed

Miyoshi, Norikatsu; Fujino, Shiki; Ohue, Masayuki; Yasui, Masayoshi; Noura, Shingo; Wada, Yuma; Kimura, Ryuichiro; Sugimura, Keijiro; Tomokuni, Akira; Akita, Hirofumi; Kobayashi, Shogo; Takahashi, Hidenori; Omori, Takeshi; Fujiwara, Yoshiyuki; Yano, Masahiko

2016-08-10

To describe the procedure, efficacy, and utility of single-incision laparoscopic-assisted stoma creation (SILStoma) for transverse colostomy. Using single-incision laparoscopic surgery, we developed a standardized technique for SILStoma. Twelve consecutive patients underwent SILStoma for transverse colostomy at Osaka Medical Center for Cancer and Cardiovascular Diseases from April 2013 to March 2016. A single, intended stoma site was created with a 2.5-3.5 cm skin incision for primary access to the intra-abdominal space, and it functioned as the main port through which multi-trocars were placed. Clinical and operative factors and postoperative outcomes were evaluated. Patient demographics, including age, gender, body mass index, and surgical indications for intestinal diversion were evaluated. SILStoma was performed in nine cases without the requirement of additional ports. In the remaining three cases, 1-2 additional 5-mm ports were required for mobilization of the transverse colon and safe dissection of abdominal adhesions. No cases required conversion to open surgery. In all cases, SILStoma was completed at the initial stoma site marked preoperatively. No intraoperative or postoperative complications greater than Grade II (the Clavien-Dindo classification) were reported in the complication survey. Surgical site infection at stoma sites was observed in four cases; however, surgical interventions were not required and all infections were cured completely. In all cases, the resumption of bowel movements was observed between postoperative days 1 and 2. SILStoma for transverse loop colostomy represents a feasible surgical procedure that allows the creation of a stoma at the preoperatively marked site without any additional large skin incisions.

Development of methodologies for the estimation of thermal properties associated with aerospace vehicles

NASA Technical Reports Server (NTRS)

Scott, Elaine P.

1993-01-01

Thermal stress analyses are an important aspect in the development of aerospace vehicles such as the National Aero-Space Plane (NASP) and the High-Speed Civil Transport (HSCT) at NASA-LaRC. These analyses require knowledge of the temperature within the structures which consequently necessitates the need for thermal property data. The initial goal of this research effort was to develop a methodology for the estimation of thermal properties of aerospace structural materials at room temperature and to develop a procedure to optimize the estimation process. The estimation procedure was implemented utilizing a general purpose finite element code. In addition, an optimization procedure was developed and implemented to determine critical experimental parameters to optimize the estimation procedure. Finally, preliminary experiments were conducted at the Aircraft Structures Branch (ASB) laboratory.

Development of methodologies for the estimation of thermal properties associated with aerospace vehicles

NASA Astrophysics Data System (ADS)

Scott, Elaine P.

1993-12-01

Thermal stress analyses are an important aspect in the development of aerospace vehicles such as the National Aero-Space Plane (NASP) and the High-Speed Civil Transport (HSCT) at NASA-LaRC. These analyses require knowledge of the temperature within the structures which consequently necessitates the need for thermal property data. The initial goal of this research effort was to develop a methodology for the estimation of thermal properties of aerospace structural materials at room temperature and to develop a procedure to optimize the estimation process. The estimation procedure was implemented utilizing a general purpose finite element code. In addition, an optimization procedure was developed and implemented to determine critical experimental parameters to optimize the estimation procedure. Finally, preliminary experiments were conducted at the Aircraft Structures Branch (ASB) laboratory.

Bilateral effects of hospital patient-safety procedures on nurses' job satisfaction.

PubMed

Inoue, T; Karima, R; Harada, K

2017-09-01

The aim of this study was to examine how hospital patient-safety procedures affect the job satisfaction of hospital nurses. Additionally, we investigated the association between perceived autonomy and hospital patient-safety procedures and job satisfaction. Recently, measures for patient safety have been recognized as an essential requirement in hospitals. Hospital patient-safety procedures may enhance the job satisfaction of nurses by improving the quality of their work. However, such procedures may also decrease their job satisfaction by imposing excessive stress on nurses because they cannot make mistakes. The participants included 537 nurses at 10 private hospitals in Japan (The surveys were collected from March to July 2012). Factors related to hospital patient-safety procedures were demonstrated using factor analysis, and the associations between these factors and nurses' self-perceived autonomy and job satisfaction were examined using structural equation modelling. Five factors regarding hospital patient-safety procedures were extracted. Additionally, structural equation modelling revealed statistically significant associations between these factors and the nurses' self-perceived autonomy and job satisfaction. The findings showed that nurses' perceived autonomy of the workplace enhanced their job satisfaction and that their perceptions of hospital patient-safety procedures promoted their job satisfaction. However, some styles of chief nurses' leadership regarding patient safety restrict nurses' independent and autonomous decision-making and actions, resulting in a lowering of job satisfaction. This study demonstrated that hospital patient-safety procedures have ambiguous effects on nurses' job satisfaction. In particular, chief nurses' leadership relating to patient safety can have a positive or negative effect on nurses' job satisfaction. The findings indicated that hospital managers should demonstrate positive attitudes to improve patient safety for nurses' job satisfaction. In addition, policymakers in the hospitals should consider that chief nurses' leadership styles may reduce autonomy and suppress nurses' job satisfaction. © 2017 The Authors International Nursing Review published by John Wiley & Sons Ltd on behalf of International Council of Nurses.

Manufacturing implant supported auricular prostheses by rapid prototyping techniques.

PubMed

Karatas, Meltem Ozdemir; Cifter, Ebru Demet; Ozenen, Didem Ozdemir; Balik, Ali; Tuncer, Erman Bulent

2011-08-01

Maxillofacial prostheses are usually fabricated on the models obtained following the impression procedures. Disadvantages of conventional impression techniques used in production of facial prosthesis are deformation of soft tissues caused by impression material and disturbance of the patient due to. Additionally production of prosthesis by conventional methods takes longer time. Recently, rapid prototyping techniques have been developed for extraoral prosthesis in order to reduce these disadvantages of conventional methods. Rapid prototyping technique has the potential to simplify the procedure and decrease the laboratory work required. It eliminates the need for measurement impression procedures and preparation of wax model to be performed by prosthodontists themselves In the near future this technology will become a standard for fabricating maxillofacial prostheses.

Surgical harvesting of bone graft from the ilium: point of view.

PubMed

Russell, J L; Block, J E

2000-12-01

Autologous bone harvested from the ilium is commonly used as a grafting material in surgical reconstructive and arthrodesis procedures to ensure a satisfactory postoperative outcome. However, operative removal of bone from the iliac crest requires an additional surgical procedure with a distinct set of postoperative complications. We provide a comprehensive literature synthesis of the incidence and severity of complications reported to be associated with this commonly practiced procedure. Most severe complications are rare, but chronic pain at the donor site exceeding three months in duration occurs frequently and can be particularly bothersome to patients. Alternative grafting materials that are safe and effective are sorely needed. Copyright 2000 Harcourt Publishers Ltd.

LACIE large area acreage estimation. [United States of America

NASA Technical Reports Server (NTRS)

Chhikara, R. S.; Feiveson, A. H. (Principal Investigator)

1979-01-01

A sample wheat acreage for a large area is obtained by multiplying its small grains acreage estimate as computed by the classification and mensuration subsystem by the best available ratio of wheat to small grains acreages obtained from historical data. In the United States, as in other countries with detailed historical data, an additional level of aggregation was required because sample allocation was made at the substratum level. The essential features of the estimation procedure for LACIE countries are included along with procedures for estimating wheat acreage in the United States.

Using Concentration Curves to Assess Organization-Specific Relationships between Surgeon Volumes and Outcomes.

PubMed

Kanter, Michael H; Huang, Yii-Chieh; Kally, Zina; Gordon, Margo A; Meltzer, Charles

2018-06-01

A well-documented association exists between higher surgeon volumes and better outcomes for many procedures, but surgeons may be reluctant to change practice patterns without objective, credible, and near real-time data on their performance. In addition, published thresholds for procedure volumes may be biased or perceived as arbitrary; typical reports compare surgeons grouped into discrete procedure volume categories, even though the volume-outcomes relationship is likely continuous. The concentration curves methodology, which has been used to analyze whether health outcomes vary with socioeconomic status, was adapted to explore the association between procedure volume and outcomes as a continuous relationship so that data for all surgeons within a health care organization could be included. Using widely available software and requiring minimal analytic expertise, this approach plots cumulative percentages of two variables of interest against each other and assesses the characteristics of the resulting curve. Organization-specific relationships between surgeon volumes and outcomes were examined for three example types of procedures: uncomplicated hysterectomies, infant circumcisions, and total thyroidectomies. The concentration index was used to assess whether outcomes were equally distributed unrelated to volumes. For all three procedures, the concentration curve methodology identified associations between surgeon procedure volumes and selected outcomes that were specific to the organization. The concentration indices confirmed the higher prevalence of examined outcomes among low-volume surgeons. The curves supported organizational discussions about surgical quality. Concentration curves require minimal resources to identify organization- and procedure-specific relationships between surgeon procedure volumes and outcomes and can support quality improvement. Copyright © 2018 The Joint Commission. Published by Elsevier Inc. All rights reserved.

Quality control for federal clean water act and safe drinking water act regulatory compliance.

PubMed

Askew, Ed

2013-01-01

QC sample results are required in order to have confidence in the results from analytical tests. Some of the AOAC water methods include specific QC procedures, frequencies, and acceptance criteria. These are considered to be the minimum controls needed to perform the method successfully. Some regulatory programs, such as those in 40 CFR Part 136.7, require additional QC or have alternative acceptance limits. Essential QC measures include method calibration, reagent standardization, assessment of each analyst's capabilities, analysis of blind check samples, determination of the method's sensitivity (method detection level or quantification limit), and daily evaluation of bias, precision, and the presence of laboratory contamination or other analytical interference. The details of these procedures, their performance frequency, and expected ranges of results are set out in this manuscript. The specific regulatory requirements of 40 CFR Part 136.7 for the Clean Water Act, the laboratory certification requirements of 40 CFR Part 141 for the Safe Drinking Water Act, and the ISO 17025 accreditation requirements under The NELAC Institute are listed.

Control of asthma for reducing the risk of bronchospasm in asthmatics undergoing general anesthesia and/or intravascular administration of radiographic contrast media.

PubMed

Liccardi, Gennaro; Salzillo, Antonello; De Blasio, Francesco; D'Amato, Gennaro

2009-07-01

It is well known that patients suffering from bronchial asthma undergoing surgical procedures requiring general anesthesia (GA) or the administration of water soluble radiographic contrast media (RCM) have an increased risk of potentially severe bronchospasm. Nevertheless, little attention has been devoted to the possible preventive measures to reduce the occurrence of this potentially life-threatening event. It has been shown that the most important risk factor for bronchospasm during GA induction and/or the use of RCM is represented by a high degree of bronchial hyperreactivity with airway instability not adequately controlled by long-term anti-inflammatory treatment. The aim of this commentary is to underline the need for an accurate clinical and functional evaluation of asthmatics undergoing surgical procedures requiring GA or radiological procedures requiring the administration of RCM, as well as to suggest a stepwise preventive pharmacological approach for reducing the risk of bronchospasm. The authors' suggestions represent clinical experience of the respiratory section of an internal hospital-based working group whose aim is the prevention of asthmatic/anaphylactic/anaphylactoid reactions during the administration of anesthetics and/or RCM. The MEDLINE database was searched with a combination of keywords: general anesthesia, radio contrast media [and] bronchial asthma. The main limitation of this commentary is the scarcity of available literature on this topic. The authors suggest a therapeutic approach before surgical procedures requiring GA and/or RCM administration based on the degree of asthma control as assessed by clinical/functional criteria. In this setting, in addition to the necessity of obtaining the best control of airway reactivity, the authors suggest that an optimal control of asthma symptoms in 'real life' conditions might likely constitute a safety issue in asthmatic patients in the case of emergency procedures.

User's guide for ALEX: uncertainty propagation from raw data to final results for ORELA transmission measurements

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

Larson, N.M.

1984-02-01

This report describes a computer code (ALEX) developed to assist in AnaLysis of EXperimental data at the Oak Ridge Electron Linear Accelerator (ORELA). Reduction of data from raw numbers (counts per channel) to physically meaningful quantities (such as cross sections) is in itself a complicated procedure; propagation of experimental uncertainties through that reduction procedure has in the past been viewed as even more difficult - if not impossible. The purpose of the code ALEX is to correctly propagate all experimental uncertainties through the entire reduction procedure, yielding the complete covariance matrix for the reduced data, while requiring little additional inputmore » from the eperimentalist beyond that which is required for the data reduction itself. This report describes ALEX in detail, with special attention given to the case of transmission measurements (the code itself is applicable, with few changes, to any type of data). Application to the natural iron measurements of D.C. Larson et al. is described in some detail.« less

Endometrial ablation: normal appearance and complications.

PubMed

Drylewicz, Monica R; Robinson, Kathryn; Siegel, Cary Lynn

2018-03-14

Global endometrial ablation is a commonly performed, minimally invasive technique aimed at improving/resolving abnormal uterine bleeding and menorrhagia in women. As non-resectoscopic techniques have come into existence, endometrial ablation performance continues to increase due to accessibility and decreased requirements for operating room time and advanced technical training. The increased utilization of this method translates into increased imaging of patients who have undergone the procedure. An understanding of the expected imaging appearances of endometrial ablation using different modalities is important for the abdominal radiologist. In addition, the frequent usage of the technique naturally comes with complications requiring appropriate imaging work-up. We review the expected appearance of the post-endometrial ablated uterus on multiple imaging modalities and demonstrate the more common and rare complications seen in the immediate post-procedural time period and remotely.

Measure Guideline: Buried and/or Encapsulated Ducts

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

Shapiro, C.; Zoeller, W.; Mantha, P.

2013-08-01

Buried and/or encapsulated ducts (BEDs) are a class of advanced, energy-efficiency strategies intended to address the significant ductwork thermal losses associated with ducts installed in unconditioned attics. BEDs are ducts installed in unconditioned attics that are covered in loose-fill insulation and/or encapsulated in closed cell polyurethane spray foam insulation. This Measure Guideline covers the technical aspects of BEDs as well as the advantages, disadvantages, and risks of BEDs compared to other alternative strategies. This guideline also provides detailed guidance on installation of BEDs strategies in new and existing homes through step-by-step installation procedures. Some of the procedures presented here, however,more » require specialized equipment or expertise. In addition, some alterations to duct systems may require a specialized license.« less

A Self-Adaptive Model-Based Wi-Fi Indoor Localization Method.

PubMed

Tuta, Jure; Juric, Matjaz B

2016-12-06

This paper presents a novel method for indoor localization, developed with the main aim of making it useful for real-world deployments. Many indoor localization methods exist, yet they have several disadvantages in real-world deployments-some are static, which is not suitable for long-term usage; some require costly human recalibration procedures; and others require special hardware such as Wi-Fi anchors and transponders. Our method is self-calibrating and self-adaptive thus maintenance free and based on Wi-Fi only. We have employed two well-known propagation models-free space path loss and ITU models-which we have extended with additional parameters for better propagation simulation. Our self-calibrating procedure utilizes one propagation model to infer parameters of the space and the other to simulate the propagation of the signal without requiring any additional hardware beside Wi-Fi access points, which is suitable for real-world usage. Our method is also one of the few model-based Wi-Fi only self-adaptive approaches that do not require the mobile terminal to be in the access-point mode. The only input requirements of the method are Wi-Fi access point positions, and positions and properties of the walls. Our method has been evaluated in single- and multi-room environments, with measured mean error of 2-3 and 3-4 m, respectively, which is similar to existing methods. The evaluation has proven that usable localization accuracy can be achieved in real-world environments solely by the proposed Wi-Fi method that relies on simple hardware and software requirements.

A Self-Adaptive Model-Based Wi-Fi Indoor Localization Method

PubMed Central

Tuta, Jure; Juric, Matjaz B.

2016-01-01

This paper presents a novel method for indoor localization, developed with the main aim of making it useful for real-world deployments. Many indoor localization methods exist, yet they have several disadvantages in real-world deployments—some are static, which is not suitable for long-term usage; some require costly human recalibration procedures; and others require special hardware such as Wi-Fi anchors and transponders. Our method is self-calibrating and self-adaptive thus maintenance free and based on Wi-Fi only. We have employed two well-known propagation models—free space path loss and ITU models—which we have extended with additional parameters for better propagation simulation. Our self-calibrating procedure utilizes one propagation model to infer parameters of the space and the other to simulate the propagation of the signal without requiring any additional hardware beside Wi-Fi access points, which is suitable for real-world usage. Our method is also one of the few model-based Wi-Fi only self-adaptive approaches that do not require the mobile terminal to be in the access-point mode. The only input requirements of the method are Wi-Fi access point positions, and positions and properties of the walls. Our method has been evaluated in single- and multi-room environments, with measured mean error of 2–3 and 3–4 m, respectively, which is similar to existing methods. The evaluation has proven that usable localization accuracy can be achieved in real-world environments solely by the proposed Wi-Fi method that relies on simple hardware and software requirements. PMID:27929453

Valuing Equal Protection in Aviation Security Screening.

PubMed

Nguyen, Kenneth D; Rosoff, Heather; John, Richard S

2017-12-01

The growing number of anti-terrorism policies has elevated public concerns about discrimination. Within the context of airport security screening, the current study examines how American travelers value the principle of equal protection by quantifying the "equity premium" that they are willing to sacrifice to avoid screening procedures that result in differential treatments. In addition, we applied the notion of procedural justice to explore the effect of alternative selective screening procedures on the value of equal protection. Two-hundred and twenty-two respondents were randomly assigned to one of three selective screening procedures: (1) randomly, (2) using behavioral indicators, or (3) based on demographic characteristics. They were asked to choose between airlines using either an equal or a discriminatory screening procedure. While the former requires all passengers to be screened in the same manner, the latter mandates all passengers undergo a quick primary screening and, in addition, some passengers are selected for a secondary screening based on a predetermined selection criterion. Equity premiums were quantified in terms of monetary cost, wait time, convenience, and safety compromise. Results show that equity premiums varied greatly across respondents, with many indicating little willingness to sacrifice to avoid inequitable screening, and a smaller minority willing to sacrifice anything to avoid the discriminatory screening. The selective screening manipulation was effective in that equity premiums were greater under selection by demographic characteristics compared to the other two procedures. © 2017 Society for Risk Analysis.

25 CFR 224.65 - How may a tribe assume additional activities under a TERA?

Code of Federal Regulations, 2011 CFR

2011-04-01

...? 224.65 Section 224.65 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR ENERGY AND MINERALS TRIBAL ENERGY RESOURCE AGREEMENTS UNDER THE INDIAN TRIBAL ENERGY DEVELOPMENT AND SELF DETERMINATION ACT Procedures for Obtaining Tribal Energy Resource Agreements Tera Requirements § 224.65 How may a tribe assume...

Special features of the dayCent modeling package and additional procedures for parameterization, calibration, validation, and applications

USDA-ARS?s Scientific Manuscript database

DayCent (Daily Century) is a biogeochemical model of intermediate complexity used to simulate flows of carbon and nutrients for crop, grassland, forest, and savanna ecosystems. Required model inputs are: soil texture, current and historical land use, vegetation cover, and daily maximum/minimum tempe...

The Flame Spectrometric Determination of Calcium in Fruit Juice by Standard Addition.

ERIC Educational Resources Information Center

Strohl, Arthur N.

1985-01-01

Provides procedures to measure the calcium concentration in fruit juice by atomic absorption. Fruit juice is used because: (1) it is an important consumer product; (2) large samples are available; and (3) calcium exists in fruit juice at concentrations that do not require excessive dilution or preconcentration prior to measurement. (JN)

Assessment at North Carolina State University: Adapting to Change in the Workplace

ERIC Educational Resources Information Center

Bresciani, Marilee J.; Griffiths, Jane H.; Rust, Jon P.

2009-01-01

Effectively introducing change in job responsibilities, particularly when dealing with tenured faculty, can be challenging. More often, additions or changes to work tasks, such as integrating assessment procedures into existing work tasks, requires employees to apply new and/or more complex knowledge, skill, and ability. When compared to…

16 CFR 1501.4 - Size requirements and test procedure.

Code of Federal Regulations, 2014 CFR

2014-01-01

... part 1501 shall be small enough to fit entirely within a cylinder with the dimensions shown in Figure 1... compliance with this regulation, the dimensions of the Commission's test cylinder will be no greater than those shown in Figure 1. (In addition, for compliance purposes, the English dimensions shall be used...

16 CFR 1501.4 - Size requirements and test procedure.

Code of Federal Regulations, 2011 CFR

2011-01-01

... part 1501 shall be small enough to fit entirely within a cylinder with the dimensions shown in Figure 1... compliance with this regulation, the dimensions of the Commission's test cylinder will be no greater than those shown in Figure 1. (In addition, for compliance purposes, the English dimensions shall be used...

16 CFR 1501.4 - Size requirements and test procedure.

Code of Federal Regulations, 2012 CFR

2012-01-01

... part 1501 shall be small enough to fit entirely within a cylinder with the dimensions shown in Figure 1... compliance with this regulation, the dimensions of the Commission's test cylinder will be no greater than those shown in Figure 1. (In addition, for compliance purposes, the English dimensions shall be used...

40 CFR 51.302 - Implementation control strategies for reasonably attributable visibility impairment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... attributable visibility impairment. (a) Plan Revision Procedures. (1) Each State identified in § 51.300(b)(2... of this subpart pertaining to reasonably attributable visibility impairment. (2)(i) The State, prior.... (ii) In addition to the requirements in § 51.102, the State must provide written notification of such...

78 FR 41677 - Procedures for Bureau Debt Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-11

... Management (OPM), as required by 5 U.S.C. 5514. In addition, the administrative wage garnishment provisions... statute (5 U.S.C. 5514) and by regulations issued by the Office of Personnel Management (OPM) (5 CFR part... the United States by requesting that the Financial Management Service of the Department of the...

21 CFR 810.14 - Cease distribution and notification or mandatory recall strategy.

Code of Federal Regulations, 2011 CFR

2011-04-01

... addition to written communications as required by § 810.15, i.e., personal visits, telephone calls, or a... recall strategy. 810.14 Section 810.14 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH... Device Recall Procedures § 810.14 Cease distribution and notification or mandatory recall strategy. (a...

22 CFR 907.1 - General.

Code of Federal Regulations, 2010 CFR

2010-04-01

... FOREIGN SERVICE GRIEVANCE BOARD PROCEDURE WHEN HEARING IS NOT HELD § 907.1 General. (a) In a case in which a hearing is not required under § 906.1 of this chapter, the Board may request in writing that... obtain such additional documents or other evidence as may be necessary to understand and decide the case...

Dentistry and Dental Hygiene Handbook. 1988 Edition.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Office of the Professions.

The laws, rules and regulations of the New York State Education Department governing dentistry and dental hygiene practice in the state are presented. In addition, the requirements and procedures for obtaining licensure and first registration as a dentist and dental hygienist in New York are discussed. The following chapters are provided: (1)…

4 CFR 83.12 - Procedures for individual access to records.

Code of Federal Regulations, 2010 CFR

2010-01-01

... last place and dates of Federal employment, if appropriate; and (4) Social security number (for those... requester appears in person and cannot be identified by sight and signature, proof of identity is required... (c) of this section. In addition, the requester shall establish the identity of the data subject by...

Designing Flightdeck Procedures: Literature Resources

NASA Technical Reports Server (NTRS)

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

2017-01-01

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

Refinement of planetary protection policy for Mars missions

NASA Technical Reports Server (NTRS)

DeVincenzi, D. L.; Stabekis, P.; Barengoltz, J.

1996-01-01

Under existing COSPAR policy adopted in 1984, missions to Mars (landers, probes, and some orbiters) are designated as Category IV missions. As such, the procedures for implementing planetary protection requirements could include trajectory biasing, cleanrooms, bioload reduction, sterilization of hardware, and bioshields. In 1992, a U.S. National Research Council study recommended that controls on forward contamination of Mars be tied to specific mission objectives. The report recommended that Mars landers with life detection instruments be subject to at least Viking-level sterilization procedures for bioload reduction, while spacecraft (including orbiters) without life detection instruments be subject to at least Viking-level pre-sterilization procedures for bioload reduction but need not be sterilized. In light of this, it is proposed that the current policy's Category IV and its planetary protection requirements be divided into two sub-categories as follows: Category IVa, for missions comprising landers and probes without life detection experiments, which will meet a specified bioburden limit for exposed surfaces, and Category IVb, for landers and probes with life detection experiments, which will require sterilization of landed systems. In addition, Category III orbiter mission specifications are expanded to be consistent with these recommendations.

Use of Key Performance Indicators to Improve Milestone Assessment in Semi-Annual Clinical Competency Committee Meetings.

PubMed

Chen, Fei; Arora, Harendra; Martinelli, Susan M

2017-01-01

The Accreditation Council for Graduate Medical Education's Next Accreditation System requires residency programs to semiannually submit composite milestone data on each resident's performance. This report describes and evaluates a new assessment review procedure piloted in our departmental Clinical Competency Committee (CCC) semi-annual meeting in June 2016. A modified Delphi technique was utilized to develop key performance indicators (KPI) linking milestone descriptors to clinical practice. In addition, the CCC identified six specific milestone sub-competencies that would be prescored with objective data prior to the meeting. Each resident was independently placed on the milestones by 3 different CCC faculty members. Milestone placement data of the same cohort of 42 residents (Clinical Anesthesia Years 1-3) were collected to calculate inter-rater reliability of the assessment procedures before and after the implemented changes. A survey was administrated to collect CCC feedback on the new procedure. The procedure assisted in reducing meeting time from 8 to 3.5 hours. Survey of the CCC members revealed positive perception of the procedure. Higher inter-rater reliability of the milestone placement was obtained using the implemented KPIs (Intraclass correlation coefficient [ICC] single measure range: before=.53-.94, after=.74-.98). We found the new assessment procedure beneficial to the efficiency and transparency of the assessment process. Further improvement of the procedure involves refinement of KPIs and additional faculty development on KPIs to allow non-CCC faculty to provide more accurate resident evaluations.

Use of Key Performance Indicators to Improve Milestone Assessment in Semi-Annual Clinical Competency Committee Meetings

PubMed Central

Arora, Harendra; Martinelli, Susan M.

2017-01-01

Background: The Accreditation Council for Graduate Medical Education's Next Accreditation System requires residency programs to semiannually submit composite milestone data on each resident's performance. This report describes and evaluates a new assessment review procedure piloted in our departmental Clinical Competency Committee (CCC) semi-annual meeting in June 2016. Methods: A modified Delphi technique was utilized to develop key performance indicators (KPI) linking milestone descriptors to clinical practice. In addition, the CCC identified six specific milestone sub-competencies that would be prescored with objective data prior to the meeting. Each resident was independently placed on the milestones by 3 different CCC faculty members. Milestone placement data of the same cohort of 42 residents (Clinical Anesthesia Years 1–3) were collected to calculate inter-rater reliability of the assessment procedures before and after the implemented changes. A survey was administrated to collect CCC feedback on the new procedure. Results: The procedure assisted in reducing meeting time from 8 to 3.5 hours. Survey of the CCC members revealed positive perception of the procedure. Higher inter-rater reliability of the milestone placement was obtained using the implemented KPIs (Intraclass correlation coefficient [ICC] single measure range: before=.53–.94, after=.74–.98). Conclusion: We found the new assessment procedure beneficial to the efficiency and transparency of the assessment process. Further improvement of the procedure involves refinement of KPIs and additional faculty development on KPIs to allow non-CCC faculty to provide more accurate resident evaluations. PMID:29766033

Attention bias modification training under working memory load increases the magnitude of change in attentional bias.

PubMed

Clarke, Patrick J F; Branson, Sonya; Chen, Nigel T M; Van Bockstaele, Bram; Salemink, Elske; MacLeod, Colin; Notebaert, Lies

2017-12-01

Attention bias modification (ABM) procedures have shown promise as a therapeutic intervention, however current ABM procedures have proven inconsistent in their ability to reliably achieve the requisite change in attentional bias needed to produce emotional benefits. This highlights the need to better understand the precise task conditions that facilitate the intended change in attention bias in order to realise the therapeutic potential of ABM procedures. Based on the observation that change in attentional bias occurs largely outside conscious awareness, the aim of the current study was to determine if an ABM procedure delivered under conditions likely to preclude explicit awareness of the experimental contingency, via the addition of a working memory load, would contribute to greater change in attentional bias. Bias change was assessed among 122 participants in response to one of four ABM tasks given by the two experimental factors of ABM training procedure delivered either with or without working memory load, and training direction of either attend-negative or avoid-negative. Findings revealed that avoid-negative ABM procedure under working memory load resulted in significantly greater reductions in attentional bias compared to the equivalent no-load condition. The current findings will require replication with clinical samples to determine the utility of the current task for achieving emotional benefits. These present findings are consistent with the position that the addition of a working memory load may facilitate change in attentional bias in response to an ABM training procedure. Copyright © 2017 Elsevier Ltd. All rights reserved.

Factors influencing the commercialisation of cloning in the pork industry.

PubMed

Pratt, S L; Sherrer, E S; Reeves, D E; Stice, S L

2006-01-01

Production of cloned pigs using somatic cell nuclear transfer (SCNT) is a repeatable and predictable procedure and multiple labs around the world have generated cloned pigs and genetically modified cloned pigs. Due to the integrated nature of the pork production industry, pork producers are the most likely to benefit and are in the best position to introduce cloning in to production systems. Cloning can be used to amplify superior genetics or be used in conjunction with genetic modifications to produce animals with superior economic traits. Though unproven, cloning could add value by reducing pig-to-pig variability in economically significant traits such as growth rate, feed efficiency, and carcass characteristics. However, cloning efficiencies using SCNT are low, but predictable. The inefficiencies are due to the intrusive nature of the procedure, the quality of oocytes and/or the somatic cells used in the procedure, the quality of the nuclear transfer embryos transferred into recipients, pregnancy rates of the recipients, and neonatal survival of the clones. Furthermore, in commercial animal agriculture, clones produced must be able to grow and thrive under normal management conditions, which include attainment of puberty and subsequent capability to reproduce. To integrate SCNT into the pork industry, inefficiencies at each step of the procedure must be overcome. In addition, it is likely that non-surgical embryo transfer will be required to deliver cloned embryos, and/or additional methods to generate high health clones will need to be developed. This review will focus on the state-of-the-art for SCNT in pigs and the steps required for practical implementation of pig cloning in animal agriculture.

The introduction of capillary structures in 4D simulated vascular tree for ART 3.5D algorithm further validation

NASA Astrophysics Data System (ADS)

Barra, Beatrice; El Hadji, Sara; De Momi, Elena; Ferrigno, Giancarlo; Cardinale, Francesco; Baselli, Giuseppe

2017-03-01

Several neurosurgical procedures, such as Artero Venous Malformations (AVMs), aneurysm embolizations and StereoElectroEncephaloGraphy (SEEG) require accurate reconstruction of the cerebral vascular tree, as well as the classification of arteries and veins, in order to increase the safety of the intervention. Segmentation of arteries and veins from 4D CT perfusion scans has already been proposed in different studies. Nonetheless, such procedures require long acquisition protocols and the radiation dose given to the patient is not negligible. Hence, space is open to approaches attempting to recover the dynamic information from standard Contrast Enhanced Cone Beam Computed Tomography (CE-CBCT) scans. The algorithm proposed by our team is called ART 3.5 D. It is a novel algorithm based on the postprocessing of both the angiogram and the raw data of a standard Digital Subtraction Angiography from a CBCT (DSACBCT) allowing arteries and veins segmentation and labeling without requiring any additional radiation exposure for the patient and neither lowering the resolution. In addition, while in previous versions of the algorithm just the distinction of arteries and veins was considered, here the capillary phase simulation and identification is introduced, in order to increase further information useful for more precise vasculature segmentation.

Medicaid program; Medicaid Management Information Systems; conditions of approval and reapproval and procedures for reduction of federal financial participation--Health Care Financing Administration. Proposed rule.

PubMed

1983-03-03

This proposal adds to regulations new conditions and procedures for initial approval and for reapproval of Medicaid Management Information Systems (MMIS) to update the regulations to reflect additional requirements added by section 901 of the Mental Health Systems Act of 1980 (Pub. L. 96-398). The proposal specifies procedures for reducing the level of Federal financial participation in a State's administrative expenditures when a State fails to meet the conditions for initial operation, initial approval or reapproval of an MMIS. It also proposes procedures with respect to waivers of the conditions of approval and reapproval and to appeals of adverse decisions. These provisions are intended to improve States' MMIS, and to ensure efficient system operations, and to detect cases of fraud, waste, and abuse effectively.

Specific test and evaluation plan

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

Hays, W.H.

1998-03-20

The purpose of this Specific Test and Evaluation Plan (STEP) is to provide a detailed written plan for the systematic testing of modifications made to the 241-AX-B Valve Pit by the W-314 Project. The STEP develops the outline for test procedures that verify the system`s performance to the established Project design criteria. The STEP is a lower tier document based on the W-314 Test and Evaluation Plan (TEP). Testing includes Validations and Verifications (e.g., Commercial Grade Item Dedication activities), Factory Acceptance Tests (FATs), installation tests and inspections, Construction Acceptance Tests (CATs), Acceptance Test Procedures (ATPs), Pre-Operational Test Procedures (POTPs), andmore » Operational Test Procedures (OTPs). It should be noted that POTPs are not required for testing of the transfer line addition. The STEP will be utilized in conjunction with the TEP for verification and validation.« less

Scalable randomized benchmarking of non-Clifford gates

NASA Astrophysics Data System (ADS)

Cross, Andrew; Magesan, Easwar; Bishop, Lev; Smolin, John; Gambetta, Jay

Randomized benchmarking is a widely used experimental technique to characterize the average error of quantum operations. Benchmarking procedures that scale to enable characterization of n-qubit circuits rely on efficient procedures for manipulating those circuits and, as such, have been limited to subgroups of the Clifford group. However, universal quantum computers require additional, non-Clifford gates to approximate arbitrary unitary transformations. We define a scalable randomized benchmarking procedure over n-qubit unitary matrices that correspond to protected non-Clifford gates for a class of stabilizer codes. We present efficient methods for representing and composing group elements, sampling them uniformly, and synthesizing corresponding poly (n) -sized circuits. The procedure provides experimental access to two independent parameters that together characterize the average gate fidelity of a group element. We acknowledge support from ARO under Contract W911NF-14-1-0124.

Application of Additive Manufacturing in Oral and Maxillofacial Surgery.

PubMed

Farré-Guasch, Elisabet; Wolff, Jan; Helder, Marco N; Schulten, Engelbert A J M; Forouzanfar, Tim; Klein-Nulend, Jenneke

2015-12-01

Additive manufacturing is the process of joining materials to create objects from digital 3-dimensional (3D) model data, which is a promising technology in oral and maxillofacial surgery. The management of lost craniofacial tissues owing to congenital abnormalities, trauma, or cancer treatment poses a challenge to oral and maxillofacial surgeons. Many strategies have been proposed for the management of such defects, but autogenous bone grafts remain the gold standard for reconstructive bone surgery. Nevertheless, cell-based treatments using adipose stem cells combined with osteoconductive biomaterials or scaffolds have become a promising alternative to autogenous bone grafts. Such treatment protocols often require customized 3D scaffolds that fulfill functional and esthetic requirements, provide adequate blood supply, and meet the load-bearing requirements of the head. Currently, such customized 3D scaffolds are being manufactured using additive manufacturing technology. In this review, 2 of the current and emerging modalities for reconstruction of oral and maxillofacial bone defects are highlighted and discussed, namely human maxillary sinus floor elevation as a valid model to test bone tissue-engineering approaches enabling the application of 1-step surgical procedures and seeding of Good Manufacturing Practice-level adipose stem cells on computer-aided manufactured scaffolds to reconstruct large bone defects in a 2-step surgical procedure, in which cells are expanded ex vivo and seeded on resorbable scaffolds before implantation. Furthermore, imaging-guided tissue-engineering technologies to predetermine the surgical location and to facilitate the manufacturing of custom-made implants that meet the specific patient's demands are discussed. The potential of tissue-engineered constructs designed for the repair of large oral and maxillofacial bone defects in load-bearing situations in a 1-step surgical procedure combining these 2 innovative approaches is particularly emphasized. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Human Factors and ISS Medical Systems: Highlights of Procedures and Equipment Findings

NASA Technical Reports Server (NTRS)

Byrne, V. E.; Hudy, C.; Smith, D.; Whitmore, M.

2005-01-01

As part of the Space Human Factors Engineering Critical Questions Roadmap, a three year Technology Development Project (TDP) was funded by NASA Headquarters to examine emergency medical procedures on ISS. The overall aim of the emergency medical procedures project was to determine the human factors issues in the procedures, training, communications and equipment, and to recommend solutions that will improve the survival rate of crewmembers in the event of a medical emergency. Currently, each ISS crew remains on orbit for six month intervals. As there is not standing requirement for a physician crewmember, during such time, the maintenance of crew health is dependant on individual crewmembers. Further, in the event of an emergency, crew will need to provide prolonged maintenance care, as well as emergency treatment, to an injured crewmember while awaiting transport to Earth. In addition to the isolation of the crew, medical procedures must be carried out within the further limitations imposed by the physical environment of the space station. For example, in order to administer care on ISS without the benefit of gravity, the Crew Medical Officers (CMOs) must restrain the equipment required to perform the task, restrain the injured crewmember, and finally, restrain themselves. Both the physical environment and the physical space available further limit the technology that can be used onboard. Equipment must be compact, yet able to withstand high levels of radiation and function without gravity. The focus here is to highlight the human factors impacts from our three year project involving the procedures and equipment areas that have been investigated and provided valuable to ISS and provide groundwork for human factors requirements for medical applications for exploration missions.

Performance of advanced trauma life support procedures in microgravity

NASA Technical Reports Server (NTRS)

Campbell, Mark R.; Billica, Roger D.; Johnston, Smith L 3rd; Muller, Matthew S.

2002-01-01

BACKGROUND: Medical operations on the International Space Station will emphasize the stabilization and transport of critically injured personnel and so will need to be capable of advanced trauma life support (ATLS). METHODS: We evaluated the ATLS invasive procedures in the microgravity environment of parabolic flight using a porcine animal model. Included in the procedures evaluated were artificial ventilation, intravenous infusion, laceration closure, tracheostomy, Foley catheter drainage, chest tube insertion, peritoneal lavage, and the use of telemedicine methods for procedural direction. RESULTS: Artificial ventilation was performed and appeared to be unaltered from the 1-G environment. Intravenous infusion, laceration closure, percutaneous dilational tracheostomy, and Foley catheter drainage were achieved without difficulty. Chest tube insertion and drainage were performed with no more difficulty than in the 1-G environment due to the ability to restrain patient, operator and supplies. A Heimlich valve and Sorenson drainage system were both used to provide for chest tube drainage collection with minimal equipment, without the risk of atmospheric contamination, and with the capability to auto-transfuse blood drained from a hemothorax. The use of telemedicine in chest tube insertion was demonstrated to be useful and feasible. Peritoneal lavage using a percutaneous technique, although requiring less training to perform, was found to be dangerous in weightlessness due to the additional pressure of the bowel on the anterior abdominal wall creating a high risk of bowel perforation. CONCLUSIONS: The performance of ATLS procedures in microgravity appears to be feasible with the exception of diagnostic peritoneal lavage. Minor modifications to equipment and techniques are required in microgravity to effect surgical drainage in the presence of altered fluid dynamics, to prevent atmospheric contamination, and to provide for the restraint requirements. A parabolic simulation system was developed for equipment and procedure verification, physiological research, and possible crew medical officer training in the future.

Employee Retirement Income Security Act of 1974; rules and regulations for administration and enforcement; claims procedure. Final regulation; delay of applicability date.

PubMed

2001-07-09

This action delays for at least six months and not more than one year the applicability date for the regulation governing minimum requirements for benefit claims procedures of group health plans covered by Title I of the Employee Retirement Income Security Act. As published on November 21, 2000, the benefit claims procedure would be applicable to claims filed on or after January 1, 2002. The current action amends the regulation so that it will apply to group health claims filed on or after the first day of the first plan year beginning on or after July 1, 2002, but in no event later than January 1, 2003. This action provides a limited additional period within which group health plan sponsors, administrators, and service providers can bring their claims processing systems into compliance with the new requirements. A postponement of the applicability date with respect to group health claims will allow a more orderly transition to the new standards and will avoid the confusion and additional expense that would be caused if certain pending Congressional bills are enacted before or soon after the original applicability date. This action does not apply to pension plans or plans providing disability or welfare benefits (other than group health). For these plans, the regulation will continue to be applicable to claims filed on or after January 1, 2002.

Poster - Thur Eve - 10: Long term stability of VMAT quality assurance parameters using an EPID.

PubMed

Pekar, J; Diamond, K R

2012-07-01

The rapidly growing use of volumetric modulated arc therapy (VMAT) treatments in radiation therapy calls for a quantitative, automated, and reliable quality assurance (QA) procedure that can be used routinely in the clinical setting. In this work, we present a series VMAT QA procedures used to assess dynamic multi-leaf collimator (MLC) positional accuracy, variable dose-rate accuracy, and MLC leaf speed accuracy. The QA procedures were performed using amorphous silicon electronic portal imaging devices (EPID) to determine the long term stability of the measured parameters on two Varian linear accelerators. The measurements were repeated weekly on both linear accelerators for a period of three months and the EPID images were analyzed using custom Matlab software. The results of the picket fence tests indicate that MLC leaf positions can be identified to within 0.11 mm and 0.15 mm for static gantry delivery and VMAT delivery respectively. In addition, the dose-rate, gantry speed and MLC leaf speed tests both show very good stability over the measurement period. The measurements thus far, suggest that a number of the dosimetry tests may be suitable for quarterly QA for Varian iX and Trilogy linacs. However, additional measurements are required to confirm the frequency with which each test is required for safe and reliable VMAT delivery at our centre. © 2012 American Association of Physicists in Medicine.

Challenges in pediatric ambulatory anesthesia: kids are different.

PubMed

Collins, Corey E; Everett, Lucinda L

2010-06-01

The care of the child having ambulatory surgery presents a specific set of challenges to the anesthesia provider. This review focuses on areas of clinical distinction that support the additional attention children often require, and on clinical controversies that require providers to have up-to-date information to guide practice and address parental concerns. These include perioperative risk; obstructive sleep apnea; obesity; postoperative nausea and vomiting; neurocognitive outcomes; and specific concerns regarding common ear, nose, and throat procedures. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Cornea Optical Topographical Scan System (COTSS)

NASA Technical Reports Server (NTRS)

1986-01-01

The Cornea Optical Topographical Scan System (COTSS) is an instrument designed for use by opthalmologist to aid in performing surgical procedures such as radial keratotomy and to provide quick accurate data to aid in prescribing contact lenses and eyeglasses. A breadboard of the system was built and demonstrated in June of 1984. Additional refinements to the breadboard are needed to meet systems requirements prior to proceeding with prototype development. The present status of the COTSS instrument is given and the areas in which system refinements are required, are defined.

U.S. Southern Command Government Purchase Card Controls Need Improvement to Prevent Improper Purchases

DTIC Science & Technology

2014-12-19

track or maintain training records for ensuring A/BOs and cardholders received the initial and refresher trainings needed to properly use a GPC...required refresher training is completed. A/OPCs are also required to provide additional training on simplified acquisitions procedures to...Crystal Prestige, rectangle 8-3/4-inch 1 39.38 39.38 36 Crystal Service, Buffet 3186 1 40.00 40.00 37 Crystal Tray, Bread 2 25.00 50.00 38

Rapid non-enzymatic extraction method for isolating PCR-quality camelpox virus DNA from skin.

PubMed

Yousif, A Ausama; Al-Naeem, A Abdelmohsen; Al-Ali, M Ahmad

2010-10-01

Molecular diagnostic investigations of orthopoxvirus (OPV) infections are performed using a variety of clinical samples including skin lesions, tissues from internal organs, blood and secretions. Skin samples are particularly convenient for rapid diagnosis and molecular epidemiological investigations of camelpox virus (CMLV). Classical extraction procedures and commercial spin-column-based kits are time consuming, relatively expensive, and require multiple extraction and purification steps in addition to proteinase K digestion. A rapid non-enzymatic procedure for extracting CMLV DNA from dried scabs or pox lesions was developed to overcome some of the limitations of the available DNA extraction techniques. The procedure requires as little as 10mg of tissue and produces highly purified DNA [OD(260)/OD(280) ratios between 1.47 and 1.79] with concentrations ranging from 6.5 to 16 microg/ml. The extracted CMLV DNA was proven suitable for virus-specific qualitative and, semi-quantitative PCR applications. Compared to spin-column and conventional viral DNA extraction techniques, the two-step extraction procedure saves money and time, and retains the potential for automation without compromising CMLV PCR sensitivity. Copyright (c) 2010 Elsevier B.V. All rights reserved.

A technical report on video-assisted thoracoscopy in thoracic spinal surgery. Preliminary description.

PubMed

Regan, J J; Mack, M J; Picetti, G D

1995-04-01

This report is a preliminary description of the efficacy of video-assisted thoracoscopic surgery in thoracic spinal procedures that otherwise require open thoracotomy. This report sought to describe the efficacy of video-assisted thoracoscopic surgery in thoracic spinal procedures that otherwise require open thoracotomy. In a landmark study that compared video-assisted thoracoscopic surgery for peripheral lung lesions with thoracotomy, video-assisted thoracoscopic surgery reduced postoperative pain, improved early shoulder girdle function, and shortened hospital stay. Video-assisted thoracoscopic surgery was performed in 12 thoracic spinal patients (herniated nucleus pulposus, infection, tumor, or spinal deformity) and is described in detail in this report. Video-assisted thoracoscopic surgery in thoracic spinal surgery resulted in little postoperative pain, short intensive care unit and hospital stays, and little or no morbidity. In the short follow-up period, there was no post-thoracotomy pain syndrome nor neurologic sequelae in these patients. Operative time decreased dramatically as experience was gained with the procedure. Given consistently improving surgical skills, a number of thoracic spinal procedures using video-assisted thoracoscopic surgery, including thoracic discectomy, internal rib thoracoplasty, anterior osteotomy, corpectomy, and fusion, can be performed safely with no additional surgical time or risk to the patient.

[Basics of Ear Surgery].

PubMed

Lailach, S; Zahnert, T

2016-12-01

The present article about the basics of ear surgery is a short overview of current indications, the required diagnostics and surgical procedures of common otologic diseases. In addition to plastic and reconstructive surgery of the auricle, principles of surgery of the external auditory canal, basics of middle ear surgery and the tumor surgery of the temporal bone are shown. Additionally, aspects of the surgical hearing rehabilitation (excluding implantable hearing systems) are presented considering current study results. Georg Thieme Verlag KG Stuttgart · New York.

Quality assurance and training procedures for computer-aided detection and diagnosis systems in clinical usea)

PubMed Central

Huo, Zhimin; Summers, Ronald M.; Paquerault, Sophie; Lo, Joseph; Hoffmeister, Jeffrey; Armato, Samuel G.; Freedman, Matthew T.; Lin, Jesse; Ben Lo, Shih-Chung; Petrick, Nicholas; Sahiner, Berkman; Fryd, David; Yoshida, Hiroyuki; Chan, Heang-Ping

2013-01-01

Computer-aided detection/diagnosis (CAD) is increasingly used for decision support by clinicians for detection and interpretation of diseases. However, there are no quality assurance (QA) requirements for CAD in clinical use at present. QA of CAD is important so that end users can be made aware of changes in CAD performance both due to intentional or unintentional causes. In addition, end-user training is critical to prevent improper use of CAD, which could potentially result in lower overall clinical performance. Research on QA of CAD and user training are limited to date. The purpose of this paper is to bring attention to these issues, inform the readers of the opinions of the members of the American Association of Physicists in Medicine (AAPM) CAD subcommittee, and thus stimulate further discussion in the CAD community on these topics. The recommendations in this paper are intended to be work items for AAPM task groups that will be formed to address QA and user training issues on CAD in the future. The work items may serve as a framework for the discussion and eventual design of detailed QA and training procedures for physicists and users of CAD. Some of the recommendations are considered by the subcommittee to be reasonably easy and practical and can be implemented immediately by the end users; others are considered to be “best practice” approaches, which may require significant effort, additional tools, and proper training to implement. The eventual standardization of the requirements of QA procedures for CAD will have to be determined through consensus from members of the CAD community, and user training may require support of professional societies. It is expected that high-quality CAD and proper use of CAD could allow these systems to achieve their true potential, thus benefiting both the patients and the clinicians, and may bring about more widespread clinical use of CAD for many other diseases and applications. It is hoped that the awareness of the need for appropriate CAD QA and user training will stimulate new ideas and approaches for implementing such procedures efficiently and effectively as well as funding opportunities to fulfill such critical efforts. PMID:23822459

Cytochrome P450 2C9 gene polymorphism and warfarin maintenance dosage in pediatric patients: A systematic review and meta-analysis.

PubMed

Zhang, Jinhua; Tian, Lihong; Huang, Jinlong; Huang, Sihan; Chai, Tingting; Shen, Jianzhen

2017-02-01

To assess the effect of Cytochrome P450 2C9 (CYP2C9) gene polymorphism on pediatric warfarin maintenance dosage requirement. A previously developed search strategy was conducted in PubMed, EMBASE, and the Cochrane Library. Eligible studies published prior to January 27, 2016, were identified and compared against strict inclusion/exclusion criteria. Required data were extracted, and researchers were consulted for additional data if needed. Review Manager version 5.2.3 software was used to analyze the relationship between CYP2C9 polymorphisms and warfarin maintenance doses in pediatric patients. Eight articles with a combined total of 507 pediatric patients were included in the meta-analysis. Maintenance warfarin doses in patients with CYP2C9 *1/*2 genotype, CYP2C9 *1/*3 genotype, and CYP2C9 variant carriers which contain at least one variant allele (*2 or *3) were from 15% to 41% lower than doses in patients with the wild-type allele (CYP2C9 *1/*1): All differences were significant with P-values <.05. The Fontan procedure as a medical indication for anticoagulation was also associated with a lower warfarin maintenance dose; however, target INR range was not. We found that CYP2C9 gene polymorphism (referring to the presence of *1/*2, *1/*3, and variant genotypes in the population in addition to the wild type) was significantly associated with decreased warfarin maintenance dose requirements. Additionally, a specific indication for warfarin, the Fontan procedure, was associated with a lower daily warfarin dose. However, the results of our study require confirmation from more research with larger numbers of pediatric patients. © 2016 John Wiley & Sons Ltd.

The concurrent multiplicative-additive approach for gauge-radar/satellite multisensor precipitation estimates

NASA Astrophysics Data System (ADS)

Garcia-Pintado, J.; Barberá, G. G.; Erena Arrabal, M.; Castillo, V. M.

2010-12-01

Objective analysis schemes (OAS), also called ``succesive correction methods'' or ``observation nudging'', have been proposed for multisensor precipitation estimation combining remote sensing data (meteorological radar or satellite) with data from ground-based raingauge networks. However, opposite to the more complex geostatistical approaches, the OAS techniques for this use are not optimized. On the other hand, geostatistical techniques ideally require, at the least, modelling the covariance from the rain gauge data at every time step evaluated, which commonly cannot be soundly done. Here, we propose a new procedure (concurrent multiplicative-additive objective analysis scheme [CMA-OAS]) for operational rainfall estimation using rain gauges and meteorological radar, which does not require explicit modelling of spatial covariances. On the basis of a concurrent multiplicative-additive (CMA) decomposition of the spatially nonuniform radar bias, within-storm variability of rainfall and fractional coverage of rainfall are taken into account. Thus both spatially nonuniform radar bias, given that rainfall is detected, and bias in radar detection of rainfall are handled. The interpolation procedure of CMA-OAS is built on the OAS, whose purpose is to estimate a filtered spatial field of the variable of interest through a successive correction of residuals resulting from a Gaussian kernel smoother applied on spatial samples. The CMA-OAS, first, poses an optimization problem at each gauge-radar support point to obtain both a local multiplicative-additive radar bias decomposition and a regionalization parameter. Second, local biases and regionalization parameters are integrated into an OAS to estimate the multisensor rainfall at the ground level. The approach considers radar estimates as background a priori information (first guess), so that nudging to observations (gauges) may be relaxed smoothly to the first guess, and the relaxation shape is obtained from the sequential optimization. The procedure is suited to relatively sparse rain gauge networks. To show the procedure, six storms are analyzed at hourly steps over 10,663 km2. Results generally indicated an improved quality with respect to other methods evaluated: a standard mean-field bias adjustment, an OAS spatially variable adjustment with multiplicative factors, ordinary cokriging, and kriging with external drift. In theory, it could be equally applicable to gauge-satellite estimates and other hydrometeorological variables.

Burr Hole Washout versus Craniotomy for Chronic Subdural Hematoma: Patient Outcome and Cost Analysis

PubMed Central

Regan, Jacqueline M.; Worley, Emmagene; Shelburne, Christopher; Pullarkat, Ranjit; Watson, Joseph C.

2015-01-01

Chronic subdural hematomas (CSDH), which are frequently encountered in neurosurgical practice, are, in the majority of cases, ideally treated with surgical drainage. Despite this common practice, there is still controversy surrounding the best surgical procedure. With lack of clear evidence of a superior technique, surgeons are free to base the decision on other factors that are not related to patient care. A retrospective chart review of 119 patients requiring surgical drainage of CSDH was conducted at a large tertiary care center over a three-year period. Of the cases reviewed, 58 patients underwent craniotomy, while 61 patients underwent burr hole washout. The study focused on re-operation rates, mortality, and morbidity, as measured by Glasgow coma scores (GCS), discharge Rankin disability scores, and discharge disposition. Secondary endpoints included length of stay and cost of procedure. Burr hole washout was superior to craniotomy with respect to patient outcome, length of stay and recurrence rates. In both study groups, patients required additional surgical procedures (6.6% of burr hole patients and 24.1% of craniotomy patients) (P = 0.0156). Of the patients treated with craniotomy, 51.7% were discharged home, whereas 65.6% of the burr hole patients were discharged home. Patients who underwent burr hole washout spent a mean of 78.8 minutes in the operating suite while the patients undergoing craniotomy spent 129.4 minutes (P < 0.001). The difference in mean cost per patient, based solely on operating time, was $2,828 (P < 0.001). This does not include the further cost due to additional procedures and hospital stay. The mean length of stay after surgical intervention was 3 days longer for the craniotomy group (P = 0.0465). Based on this retrospective study, burr hole washout is superior for both patients’ clinical and financial outcome; however, prospective long-term multicenter clinical studies are required to verify these findings. PMID:25611468

Burr hole washout versus craniotomy for chronic subdural hematoma: patient outcome and cost analysis.

PubMed

Regan, Jacqueline M; Worley, Emmagene; Shelburne, Christopher; Pullarkat, Ranjit; Watson, Joseph C

2015-01-01

Chronic subdural hematomas (CSDH), which are frequently encountered in neurosurgical practice, are, in the majority of cases, ideally treated with surgical drainage. Despite this common practice, there is still controversy surrounding the best surgical procedure. With lack of clear evidence of a superior technique, surgeons are free to base the decision on other factors that are not related to patient care. A retrospective chart review of 119 patients requiring surgical drainage of CSDH was conducted at a large tertiary care center over a three-year period. Of the cases reviewed, 58 patients underwent craniotomy, while 61 patients underwent burr hole washout. The study focused on re-operation rates, mortality, and morbidity, as measured by Glasgow coma scores (GCS), discharge Rankin disability scores, and discharge disposition. Secondary endpoints included length of stay and cost of procedure. Burr hole washout was superior to craniotomy with respect to patient outcome, length of stay and recurrence rates. In both study groups, patients required additional surgical procedures (6.6% of burr hole patients and 24.1% of craniotomy patients) (P = 0.0156). Of the patients treated with craniotomy, 51.7% were discharged home, whereas 65.6% of the burr hole patients were discharged home. Patients who underwent burr hole washout spent a mean of 78.8 minutes in the operating suite while the patients undergoing craniotomy spent 129.4 minutes (P < 0.001). The difference in mean cost per patient, based solely on operating time, was $2,828 (P < 0.001). This does not include the further cost due to additional procedures and hospital stay. The mean length of stay after surgical intervention was 3 days longer for the craniotomy group (P = 0.0465). Based on this retrospective study, burr hole washout is superior for both patients' clinical and financial outcome; however, prospective long-term multicenter clinical studies are required to verify these findings.

Treatment options for Dandy-Walker malformation.

PubMed

Mohanty, Aaron; Biswas, Arundhati; Satish, Satyanarayana; Praharaj, Shanti Shankar; Sastry, Kolluri V R

2006-11-01

The aim of this study was to assess the efficacy of various treatment options available for children with Dandy-Walker malformation (DWM) and to evaluate the role of endoscopic procedures in the treatment of this disorder. The authors conducted a retrospective review of 72 children who underwent surgical treatment for DWM during a 16-year period. All patients underwent computed tomography scanning, and 26 underwent magnetic resonance (MR) imaging. The initial surgical treatment included ventriculoperitoneal (VP) shunt placement in 21 patients, cystoperitoneal (CP) shunt placement in 24, and combined VP and CP shunt insertion in three. Twenty-one patients underwent endoscopic procedures (endoscopic third ventriculostomy [ETV] alone in 16 patients, ETV with aqueductal stent placement in three, and ETV with fenestration of the occluding membrane in two). Three patients underwent membrane excision via a posterior fossa craniectomy. In the 26 patients who had undergone preoperative MR imaging, aqueductal patency was noted in 23 and aqueductal obstruction in three. These three patients underwent placement of a stent from the third ventricle to the posterior fossa cyst in addition to the ETV procedure. During the follow-up period, 12 patients with a CP shunt and four with a VP shunt experienced shunt malfunctions that required revision. Four patients with a CP shunt also required placement of a VP shunt. In addition, five of the 21 ETVs failed, requiring VP shunt insertion. A reduction in ventricle size noted on postoperative images occurred more frequently in patients with a VP shunt, whereas a reduction in cyst size was more appreciable in patients with a CP shunt. Successful ETV resulted in a slight decrease in ventricle size and varying degrees of reduction in cyst size. Endoscopic procedures may be considered an acceptable alternative in children with DWM. The authors propose a treatment protocol based on preoperative MR imaging findings of associated aqueductal stenosis.

Manufacturing Implant Supported Auricular Prostheses by Rapid Prototyping Techniques

PubMed Central

Karatas, Meltem Ozdemir; Cifter, Ebru Demet; Ozenen, Didem Ozdemir; Balik, Ali; Tuncer, Erman Bulent

2011-01-01

Maxillofacial prostheses are usually fabricated on the models obtained following the impression procedures. Disadvantages of conventional impression techniques used in production of facial prosthesis are deformation of soft tissues caused by impression material and disturbance of the patient due to. Additionally production of prosthesis by conventional methods takes longer time. Recently, rapid prototyping techniques have been developed for extraoral prosthesis in order to reduce these disadvantages of conventional methods. Rapid prototyping technique has the potential to simplify the procedure and decrease the laboratory work required. It eliminates the need for measurement impression procedures and preparation of wax model to be performed by prosthodontists themselves In the near future this technology will become a standard for fabricating maxillofacial prostheses. PMID:21912504

Laboratory requirements for in-situ and remote sensing of suspended material

NASA Technical Reports Server (NTRS)

Kuo, C. Y.; Cheng, R. Y. K.

1978-01-01

Recommendations for laboratory and in-situ measurements required for remote sensing of suspended material are presented. This study investigates the properties of the suspended materials, factors influencing the upwelling radiance, and the various types of remote sensing techniques. Calibration and correlation procedures are given to obtain the accuracy necessary to quantify the suspended materials by remote sensing. In addition, the report presents a survey of the national need for sediment data, the agencies that deal with and require the data of suspended sediment, and a summary of some recent findings of sediment measurements.

Laboratory requirements for in-situ and remote sensing of suspended material

NASA Technical Reports Server (NTRS)

Kuo, C. Y.; Cheng, R. Y. K.

1976-01-01

Recommendations for laboratory and in-situ measurements required for remote sensing of suspended material are presented. This study investigates the properties of the suspended materials, factors influencing the upwelling radiance, and the various types of remote sensing techniques. Calibration and correlation procedures are given to obtain the accuracy necessary to quantify the suspended materials by remote sensing. In addition, the report presents a survey of the national need for sediment data, the agencies that deal with and require the data of suspended sediment, and a summary of some recent findings of sediment measurements.

A randomized trial of vaginal misoprostol for cervical priming before hysteroscopy in postmenopausal women

PubMed Central

Kant, Anita; Divyakumar; Priyambada, Usha

2011-01-01

Objective: To perform hysteroscopy the cervix needs to be dilated and in nullipara and postmenopausal women this is sometimes difficult. Well-known, entry-related complications during hysteroscopy include cervical tear, creation of false tract, bleeding, uterine perforation, scarring, and subsequent anatomical stenosis. Materials and Methods: This study was done to investigate the priming effect of vaginal misoprostol on cervical dilatation in postmenopausal women, before hysteroscopy, to prevent such complications. Two hundred micrograms of misoprostol was inserted into the vagina at least 12 hours before the procedure and the control group did not receive any cervical priming agent. Pre-procedural dilatation, additional dilatation required, and time taken for dilatation was noted in each case. Observations: The study showed a significant difference between the study group (7.7 ± 1.7 mm) and the control group (4.5 ± 1.8 mm) in terms of pre-procedural cervical width and the number of women requiring a dditional dilatation (7 / 25 versus 22 / 25), and hence, the time required for dilatation (4.7 ± 8 seconds versus 20.6 ± 9.3 seconds). Conclusion: The pre-procedural cervical width was significantly more in the study group as compared to that in the control group. We found significant differences between the study and control groups with respect to the number of women who required cervical dilatation. To conclude, this study helps derive a conclusion that vaginal misoprostol as a cervical priming agent in postmenopausal women appears to be safe, effective, and inexpensive, with mild side effects. PMID:21897735

Word-Problem-Solving Strategy for Minority Students at Risk for Math Difficulties

ERIC Educational Resources Information Center

Kong, Jennifer E.; Orosco, Michael J.

2016-01-01

Minority students at risk for math difficulties (MD) struggle with word problems for various reasons beyond procedural or calculation challenges. As a result, these students require support in reading and language development in addition to math. The purpose of this study was to assess the effectiveness of a math comprehension strategy based on a…

40 CFR 96.76 - Additional requirements to provide heat input data for allocations purposes.

Code of Federal Regulations, 2011 CFR

2011-07-01

... heat input data for allocations purposes. 96.76 Section 96.76 Protection of Environment ENVIRONMENTAL... to provide heat input data for allocations purposes. (a) The owner or operator of a unit that elects... also monitor and report heat input at the unit level using the procedures set forth in part 75 of this...

75 FR 5248 - Requirements and Procedures for Consumer Assistance To Recycle and Save Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-02

... time will allow the public to benefit from the availability of lower cost used vehicle parts from... CARS program. The additional time would allow the public to benefit from the availability of lower cost... public benefit of having cheaper used vehicle parts from the vehicles traded in under the CARS program...

Reserve Officer Program

DTIC Science & Technology

1992-01-01

few went beyond the survey instrument to provide additional information. The surveys indicated a consensus among departments in the areas of policy ...uniforms, equipment, and weapons. All departments required their reserves to adhere to the policies and procedures that governed their regular...officers. Some agencies maintained separate policies on the operation and organization of their reserve force separate from that of the regular department

40 CFR 96.76 - Additional requirements to provide heat input data for allocations purposes.

Code of Federal Regulations, 2013 CFR

2013-07-01

... heat input data for allocations purposes. 96.76 Section 96.76 Protection of Environment ENVIRONMENTAL... to provide heat input data for allocations purposes. (a) The owner or operator of a unit that elects... also monitor and report heat input at the unit level using the procedures set forth in part 75 of this...

40 CFR 96.76 - Additional requirements to provide heat input data for allocations purposes.

Code of Federal Regulations, 2012 CFR

2012-07-01

... heat input data for allocations purposes. 96.76 Section 96.76 Protection of Environment ENVIRONMENTAL... to provide heat input data for allocations purposes. (a) The owner or operator of a unit that elects... also monitor and report heat input at the unit level using the procedures set forth in part 75 of this...

40 CFR 96.76 - Additional requirements to provide heat input data for allocations purposes.

Code of Federal Regulations, 2014 CFR

2014-07-01

... heat input data for allocations purposes. 96.76 Section 96.76 Protection of Environment ENVIRONMENTAL... to provide heat input data for allocations purposes. (a) The owner or operator of a unit that elects... also monitor and report heat input at the unit level using the procedures set forth in part 75 of this...

Educational Personnel Needs Assessment: CSPD Technical Manual, 1989. Critical Areas of Data Collection.

ERIC Educational Resources Information Center

Lauritzen, Paul

This manual addresses the Comprehensive System of Personnel Development (CSPD) requirement of Public Law 94-142. It presents model procedures for the collection of data necessary to project personnel needs in special education. Implementation of the model will identify: areas of education which show need for additional teachers as well as areas of…

78 FR 40351 - Procedural Rule To Establish Supervisory Authority Over Certain Nonbank Covered Persons Based on...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

...) Origination, brokerage, or servicing of loans secured by real estate for use by consumers primarily for... the construction of time limits, change of time limits, and effect of deadlines. Under the final rule... covered persons potentially subject to the final rule should not require additional time to come into...

78 FR 64394 - Airworthiness Directives; Lycoming Engines and Continental Motors, Inc. Reciprocating Engines

Federal Register 2010, 2011, 2012, 2013, 2014

2013-10-29

... approve AMOCs for this AD. Use the procedures found in 14 CFR 39.19 to make your request. (2) AMOCs... turbochargers from service before further flight. This AD also requires removing certain HET turbochargers from service before further flight. This AD was prompted by a report that an additional engine, the CMI LTSIO...

Multistep process to produce fermentable sugars and lignosulfonates from softwood enzymolysis residues

Treesearch

Yalan Liu; Jinwu Wang; Michael P. Wolcott

2016-01-01

The residual solids from enzymatic hydrolysis are usually burned to produce energy and have been explored as a feedstock for various products including activated carbon and lignin based polymers. These products require additional procedures unrelated to the existing biorefinery equipment. In the current study, we proposed successive sulfite treatments to utilize the...

14 CFR Appendix C to Part 27 - Criteria for Category A

Code of Federal Regulations, 2013 CFR

2013-01-01

... unless it meets the design installation and performance requirements contained in this appendix in... drive system: Design. 29.927(c)(1)—Additional tests. 29.953(a)—Fuel system independence. 29.1027(a)—Transmission and gearboxes: General. 29.1045(a)(1), (b), (c), (d), and (f)—Climb cooling test procedures. 29...

Interactive grid adaption

NASA Technical Reports Server (NTRS)

Abolhassani, Jamshid S.; Everton, Eric L.

1990-01-01

An interactive grid adaption method is developed, discussed and applied to the unsteady flow about an oscillating airfoil. The user is allowed to have direct interaction with the adaption of the grid as well as the solution procedure. Grid points are allowed to adapt simultaneously to several variables. In addition to the theory and results, the hardware and software requirements are discussed.

Obtaining NASA Approval for use of Non-Metallic Materials in Manned Space Flight

NASA Technical Reports Server (NTRS)

Davis, Samuel E.; Wise, Harry L.

2003-01-01

Material manufacturers and suppliers are often surprised when a material commonly provided to industry is not approved for use on manned spacecraft. Often the reason is a lack of test data in environments that simulate those encountered in space applications, especially oxygen-enriched conditions, which significantly increase both the likelihood of material combustion and the propagation of a fire. This paper introduces the requirements for flight approval of non-metallic materials, focusing on material testing for human-rated space flight programs; it reviews the history of flight materials requirements and provides the rationale for such and introduces specific requirements related to testing and to good material engineering and design practices. After describing the procedure for submitting materials to be tested, the paper outlines options available if a material fails testing. In addition, this treatise introduces the National Aeronautics and Space Administration's (NASA's) Materials and Processes Technical Information System (MAPTIS), a database housing all test data produced in accordance with NASA-STD-6001, Flammability, Odor, Offgassing, and Compatibility Requirements and Test Procedures for Materials in Environments that Support Combustion.

An Efficient Method for Hair Containment During Head and Neck Surgery.

PubMed

Zingaretti, Nicola; De Biasio, Fabrizio; Riccio, Michele; Marchesi, Andrea; Parodi, Pier Camillo

2017-11-01

The authors present a simple technique for operations around hair-bearing areas such as during a rhytidectomy. Hair surrounding the surgical field is twisted into bundles and clipped with duckbill clips. The authors repeat the procedure for each strand of hair. Between 5 and 7 duckbill clips may be required per surgery.The clippers are faster, easily applicable, and well performing. They can be used with different hair lengths, and they do not require any additional trimming or shaving; clips also keep the hair firmly in place, and they do not loosen up in the process.This technical note explains a very simple, economical, and less time-consuming method to control hair located around the surgical site. It may be applied to all procedures within the field of the hair-bearing scalp, including craniofacial and maxillofacial surgery.

Capabilities and applications of the Program to Optimize Simulated Trajectories (POST). Program summary document

NASA Technical Reports Server (NTRS)

Brauer, G. L.; Cornick, D. E.; Stevenson, R.

1977-01-01

The capabilities and applications of the three-degree-of-freedom (3DOF) version and the six-degree-of-freedom (6DOF) version of the Program to Optimize Simulated Trajectories (POST) are summarized. The document supplements the detailed program manuals by providing additional information that motivates and clarifies basic capabilities, input procedures, applications and computer requirements of these programs. The information will enable prospective users to evaluate the programs, and to determine if they are applicable to their problems. Enough information is given to enable managerial personnel to evaluate the capabilities of the programs and describes the POST structure, formulation, input and output procedures, sample cases, and computer requirements. The report also provides answers to basic questions concerning planet and vehicle modeling, simulation accuracy, optimization capabilities, and general input rules. Several sample cases are presented.

Environmental testing, official methods, and attitudes toward noncompliance

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

Krages, B.P. II

1999-08-01

The US Environmental Protection Agency (EPA) has established longstanding regulations that prescribe the analytical procedures to be followed when parties submit information pursuant to regulatory programs. However, problems associated with unnecessary or irrational testing requirements along with the difficulty in obtaining approval of alternate procedures, has resulted in widespread noncompliance with those regulations. For the most part, agencies have tolerated this attitude of noncompliance and have in some ways contributed to it by adopting testing requirements that make little or no sense. Unfortunately, this complacency leaves agencies and regulated parties vulnerable to legal problems, such as court challenges to environmentalmore » permits. Regulatory agencies should confront the problems that have led to pervasive noncompliance and amend regulations to reflect that concerns about having useful data frequently override concerns about the national uniformity of test methods. In addition, the regulated community should be more mindful of the legal enforceability of promulgated testing requirements and affirmatively address those concerns with the promulgating agencies.« less

The Myth, the Truth, the NASA IRB

NASA Technical Reports Server (NTRS)

Covington, M. D.; Flores, M. P.; Neutzler, V. P.; Schlegel, T. T.; Platts, S. H.; Lioyd, C. W.

2017-01-01

The purpose of the NASA Institutional Review Board (IRB) is to review research activities involving human subjects to ensure that ethical standards for the care and protection of human subjects have been met and research activities are in compliance with all pertinent federal, state and local regulations as well as NASA policies. NASA IRB's primary role is the protection of human subjects in research studies. Protection of human subjects is the shared responsibility of NASA, the IRB, and the scientific investigators. Science investigators who plan to conduct NASA-funded human research involving NASA investigators, facilities, or funds must submit and coordinate their research studies for review and approval by the NASA IRB prior to initiation. The IRB has the authority to approve, require changes in, or disapprove research involving human subjects. Better knowledge of the NASA IRB policies, procedures and guidelines should help facilitate research protocol applications and approvals. In this presentation, the myths and truths of NASA IRB policies and procedures will be discussed. We will focus on the policies that guide a protocol through the NASA IRB and the procedures that principal investigators must take to obtain required IRB approvals for their research studies. In addition, tips to help ensure a more efficient IRB review will be provided. By understanding the requirements and processes, investigators will be able to more efficiently prepare their protocols and obtain the required NASA IRB approval in a timely manner.

Residual tumor size and IGCCCG risk classification predict additional vascular procedures in patients with germ cell tumors and residual tumor resection: a multicenter analysis of the German Testicular Cancer Study Group.

PubMed

Winter, Christian; Pfister, David; Busch, Jonas; Bingöl, Cigdem; Ranft, Ulrich; Schrader, Mark; Dieckmann, Klaus-Peter; Heidenreich, Axel; Albers, Peter

2012-02-01

Residual tumor resection (RTR) after chemotherapy in patients with advanced germ cell tumors (GCT) is an important part of the multimodal treatment. To provide a complete resection of residual tumor, additional surgical procedures are sometimes necessary. In particular, additional vascular interventions are high-risk procedures that require multidisciplinary planning and adequate resources to optimize outcome. The aim was to identify parameters that predict additional vascular procedures during RTR in GCT patients. A retrospective analysis was performed in 402 GCT patients who underwent 414 RTRs in 9 German Testicular Cancer Study Group (GTCSG) centers. Overall, 339 of 414 RTRs were evaluable with complete perioperative data sets. The RTR database was queried for additional vascular procedures (inferior vena cava [IVC] interventions, aortic prosthesis) and correlated to International Germ Cell Cancer Collaborative Group (IGCCCG) classification and residual tumor volume. In 40 RTRs, major vascular procedures (23 IVC resections with or without prosthesis, 11 partial IVC resections, and 6 aortic prostheses) were performed. In univariate analysis, the necessity of IVC intervention was significantly correlated with IGCCCG (14.1% intermediate/poor vs 4.8% good; p=0.0047) and residual tumor size (3.7% size < 5 cm vs 17.9% size ≥ 5 cm; p < 0.0001). In multivariate analysis, IVC intervention was significantly associated with residual tumor size ≥ 5 cm (odds ratio [OR]: 4.61; p=0.0007). In a predictive model combining residual tumor size and IGCCCG classification, every fifth patient (20.4%) with a residual tumor size ≥ 5 cm and intermediate or poor prognosis needed an IVC intervention during RTR. The need for an aortic prosthesis showed no correlation to either IGCCCG (p=0.1811) or tumor size (p=0.0651). The necessity for IVC intervention during RTR is correlated to residual tumor size and initial IGCCCG classification. Patients with high-volume residual tumors and intermediate or poor risk features must initially be identified as high-risk patients for vascular procedures and therefore should be referred to specialized surgical centers with the ad hoc possibility of vascular interventions. Copyright © 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.

40 CFR 63.1549 - Recordkeeping and reporting requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

... recordkeeping required as part of the practices described in the standard operating procedures manual for... as part of the practices described in the standard operating procedures manual for baghouses required... procedures outlined in the standard operating procedures manual required by § 63.1544(a) were not followed...

40 CFR 63.1549 - Recordkeeping and reporting requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... recordkeeping required as part of the practices described in the standard operating procedures manual for... as part of the practices described in the standard operating procedures manual for baghouses required... procedures outlined in the standard operating procedures manual required by § 63.1544(a) were not followed...

40 CFR 63.1549 - Recordkeeping and reporting requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... recordkeeping required as part of the practices described in the standard operating procedures manual for... as part of the practices described in the standard operating procedures manual for baghouses required... procedures outlined in the standard operating procedures manual required by § 63.1544(a) were not followed...

High-Penetration Photovoltaic Planning Methodologies

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

Gao, David Wenzhong; Muljadi, Eduard; Tian, Tian

The main objective of this report is to provide an overview of select U.S. utility methodologies for performing high-penetration photovoltaic (HPPV) system planning and impact studies. This report covers the Federal Energy Regulatory Commission's orders related to photovoltaic (PV) power system interconnection, particularly the interconnection processes for the Large Generation Interconnection Procedures and Small Generation Interconnection Procedures. In addition, it includes U.S. state interconnection standards and procedures. The procedures used by these regulatory bodies consider the impacts of HPPV power plants on the networks. Technical interconnection requirements for HPPV voltage regulation include aspects of power monitoring, grounding, synchronization, connection tomore » the overall distribution system, back-feeds, disconnecting means, abnormal operating conditions, and power quality. This report provides a summary of mitigation strategies to minimize the impact of HPPV. Recommendations and revisions to the standards may take place as the penetration level of renewables on the grid increases and new technologies develop in future years.« less

Running SINDA '85/FLUINT interactive on the VAX

NASA Technical Reports Server (NTRS)

Simmonds, Boris

1992-01-01

Computer software as engineering tools are typically run in three modes: Batch, Demand, and Interactive. The first two are the most popular in the SINDA world. The third one is not so popular, due probably to the users inaccessibility to the command procedure files for running SINDA '85, or lack of familiarity with the SINDA '85 execution processes (pre-processor, processor, compilation, linking, execution and all of the file assignment, creation, deletions and de-assignments). Interactive is the mode that makes thermal analysis with SINDA '85 a real-time design tool. This paper explains a command procedure sufficient (the minimum modifications required in an existing demand command procedure) to run SINDA '85 on the VAX in an interactive mode. To exercise the procedure a sample problem is presented exemplifying the mode, plus additional programming capabilities available in SINDA '85. Following the same guidelines the process can be extended to other SINDA '85 residence computer platforms.

Recommended procedures for measuring aircraft noise and associated parameters

NASA Technical Reports Server (NTRS)

Marsh, A. H.

1977-01-01

Procedures are recommended for obtaining experimental values of aircraft flyover noise levels (and associated parameters). Specific recommendations are made for test criteria, instrumentation performance requirements, data-acquisition procedures, and test operations. The recommendations are based on state-of-the-art measurement capabilities available in 1976 and are consistent with the measurement objectives of the NASA Aircraft Noise Prediction Program. The recommendations are applicable to measurements of the noise produced by an airplane flying subsonically over (or past) microphones located near the surface of the ground. Aircraft types covered by the recommendations are fixed-wing airplanes powered by turbojet or turbofan engines and using conventional aerodynamic means for takeoff and landing. Various assumptions with respect to subsequent data processing and analysis were made (and are described) and the recommended measurement procedures are compatible with the assumptions. Some areas where additional research is needed relative to aircraft flyover noise measurement techniques are also discussed.

Characterization of the PTW SourceCheck ionization chamber with the Valencia lodgment for (125)I seed verification.

PubMed

Tornero-López, Ana M; Torres Del Río, Julia; Ruiz, Carmen; Perez-Calatayud, Jose; Guirado, Damián; Lallena, Antonio M

2015-12-01

In brachytherapy using (125)I seed implants, a verification of the air kerma strength of the sources used is required. Typically, between 40 and 100 seeds are implanted. Checking all of them is unaffordable, especially when seeds are disposed in sterile cartridges. Recently, a new procedure allowing the accomplishment of the international recommendations has been proposed for the seedSelectron system of Elekta Brachytherapy. In this procedure, the SourceCheck ionization chamber is used with a special lodgment (Valencia lodgment) that allows to measure up to 10 seeds simultaneously. In this work we analyze this procedure, showing the feasibility of the approximations required for its application, as well as the effect of the additional dependence with the air density that shows the chamber model used. Uncertainty calculations and the verification of the approximation needed to obtain a calibration factor for the Valencia lodgment are carried out. The results of the present work show that the chamber dependence with the air density is the same whether the Valencia lodgment is used or not. On the contrary, the chamber response profile is influenced by the presence of the lodgment. The determination of this profile requires various measurements due to the nonnegligible variability found between different experiments. If it is considered, the uncertainty in the determination of the air-kerma strength increases from 0.5% to 1%. Otherwise, a systematic additional uncertainty of 1% would occur. This could be relevant for the comparison between user and manufacturer measurements that is mandatory in the case studied here. Copyright © 2015 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Antibiotic prophylaxis for children with sickle cell disease: a survey of pediatric dentistry residency program directors and pediatric hematologists.

PubMed

Tate, Anupama Rao; Norris, Chelita Kaye; Minniti, Caterina P

2006-01-01

The purposes of this study were to: (1) investigate the current clinical practice regarding the use of antibiotic prophylaxis by pediatric dentistry residency program directors and pediatric hematologists for children with sickle cell disease (SCD) requiring dental treatment; and (2) evaluate the perceived relative risk of bacteremia following specific dental procedures, as defined by pediatric dentistry residency program directors and pediatric hematologists. A written survey depicting various clinical scenarios of SCD children requiring common dental procedures was mailed to directors of pediatric dental advanced education programs and distributed to pediatric hematologists attending the 2003 Annual Sickle Cell Disease Association of America conference in Washington, DC. Surveys were returned by 60% (N=34/57) of the pediatric dentistry residency program directors. The surveys were obtained from 51% of pediatric hematologists at the meeting (N=72/140). At least 50% of all respondents recommended prophylaxis for the following clinical situations: dental extractions, treatment under general anesthesia, and status post splenectomy. The perceived risk of infectious complication was highest for extractions, followed by restorative treatment and tooth polishing. Dental residency program directors were more likely (71%, N=24/34) to recommend additional antibiotic therapy for patients taking penicillin prophylaxis if they required an invasive oral surgical procedure. Conversely, only 38% (N=25/66) of pediatric hematologists recommended additional antibiotic therapy (P=.001). Eighty-six percent of dental residency program directors (N=25/29) chose amoxicillin for prophylaxis whereas only 62% of pediatric hematologists (N=36/58) recommended amoxicillin. (P<.05). There is a lack of consensus on the appropriate use of antibiotic prophylaxis in SCD children undergoing dental treatments. Further research and risk/benefit assessment is needed to create a unified approach.

Precession-nutation procedures consistent with IAU 2006 resolutions

NASA Astrophysics Data System (ADS)

Wallace, P. T.; Capitaine, N.

2006-12-01

Context: .The 2006 IAU General Assembly has adopted the P03 model of Capitaine et al. (2003a) recommended by the WG on precession and the ecliptic (Hilton et al. 2006) to replace the IAU 2000 model, which comprised the Lieske et al. (1977) model with adjusted rates. Practical implementations of this new "IAU 2006" model are therefore required, involving choices of procedures and algorithms. Aims: .The purpose of this paper is to recommend IAU 2006 based precession-nutation computing procedures, suitable for different classes of application and achieving high standards of consistency. Methods: .We discuss IAU 2006 based procedures and algorithms for generating the rotation matrices that transform celestial to terrestrial coordinates, taking into account frame bias (B), P03 precession (P), P03-adjusted IAU 2000A nutation (N) and Earth rotation. The NPB portion can refer either to the equinox or to the celestial intermediate origin (CIO), requiring either the Greenwich sidereal time (GST) or the Earth rotation angle (ERA) as the measure of Earth rotation. Where GST is used, it is derived from ERA and the equation of the origins (EO) rather than through an explicit formula as in the past, and the EO itself is derived from the CIO locator. Results: .We provide precession-nutation procedures for two different classes of full-accuracy application, namely (i) the construction of algorithm collections such as the Standards Of Fundamental Astronomy (SOFA) library and (ii) IERS Conventions, and in addition some concise procedures for applications where the highest accuracy is not a requirement. The appendix contains a fully worked numerical example, to aid implementors and to illustrate the consistency of the two full-accuracy procedures which, for the test date, agree to better than 1 μas. Conclusions: .The paper recommends, for case (i), procedures based on angles to represent the PB and N components and, for case (ii), procedures based on series for the CIP X,Y. The two methods are of similar efficiency, and both support equinox based as well as CIO based applications.

Ethical aspects of capsule endoscopy.

PubMed

Niv, Yaron

2008-01-01

Capsule endoscopy is the most recent innovation in gastrointestinal endoscopy. The capsule contains a video camera that photographs the bowel for 8 h after the capsule has been orally ingested and transmits the images for interpretation to a computerized workstation. Ethical considerations of the use of capsule endoscopy should cover the following main issues: justification of the procedure, its potential benefits and harm, and patient autonomy. Capsule endoscopy has several advantages over traditional endoscopy. The procedure is painless, does not require sedation, is easy to perform and for the first time enables exploration of the entire small bowel at high magnification. However, the clinician cannot control its passive advance along the bowel. In addition, the examination may be incomplete, as the capsule reaches the cecum in only 80% of cases. This paper discusses the problems related to the new endoscopic procedure, the diagnostic yield in comparison with other procedures, proper indications for the procedure, outcome and complications. Copyright 2008 S. Karger AG, Basel.

IS THERE ANY ROOM FOR TENDOSCOPY IN THE SURGICAL TREATMENT OF POSTERIOR TIBIAL TENDON INSUFFICIENCY?

PubMed

Bojanić, Ivan; Dimnjaković, Damjan; Mahnik, Alan; Smoljanović, Tomislav

2016-05-01

Posterior tibial tendon insufficiency (PTTI) is nowadays considered to be the main cause of adult-acquired flatfoot deformity (AAFD). The purpose of this study is to report the outcomes of tendoscopic treatment of tibialis poste- rior tendon (TP) in eleven patients with stage 1 or 2 PTTI and failed prior conservative treatment. Tendoscopy was carried out as a solitary procedure in 8 patients, while in 3 patients additional procedures such as ,,mini-open" tubularization of TP or anterior ankle arthroscopy were necessary. In a single patient transfer of flexor digitorum longus tendon was performed as a second stage surgery due to complete rupture of TP. Related with tendoscopic procedure, no complications were re- ported. TP tendoscopy is a useful and beneficial minimally invasive procedure to treat TP pathology at earlier stages of PTTI. It is a technically demanding procedure that requires extensive experience in arthroscopic management of small ioints and excellent knowledge of repional anatomy.

76 FR 302 - Pesticides; Satisfaction of Data Requirements; Procedures To Ensure Protection of Data Submitters...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-01-04

... Pesticides; Satisfaction of Data Requirements; Procedures To Ensure Protection of Data Submitters' Rights..., concerning the revision of its regulations which govern procedures for the satisfaction of data requirements... regulations which govern procedures for the satisfaction of data requirements under the Federal Insecticide...

40 CFR 124.42 - Additional procedures for PSD permits affecting Class I areas.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 21 2010-07-01 2010-07-01 false Additional procedures for PSD permits... (CONTINUED) WATER PROGRAMS PROCEDURES FOR DECISIONMAKING Specific Procedures Applicable to PSD Permits § 124.42 Additional procedures for PSD permits affecting Class I areas. (a) The Regional Administrator...

40 CFR 124.42 - Additional procedures for PSD permits affecting Class I areas.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 23 2013-07-01 2013-07-01 false Additional procedures for PSD permits... (CONTINUED) WATER PROGRAMS PROCEDURES FOR DECISIONMAKING Specific Procedures Applicable to PSD Permits § 124.42 Additional procedures for PSD permits affecting Class I areas. (a) The Regional Administrator...

40 CFR 124.42 - Additional procedures for PSD permits affecting Class I areas.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 22 2011-07-01 2011-07-01 false Additional procedures for PSD permits... (CONTINUED) WATER PROGRAMS PROCEDURES FOR DECISIONMAKING Specific Procedures Applicable to PSD Permits § 124.42 Additional procedures for PSD permits affecting Class I areas. (a) The Regional Administrator...

40 CFR 124.42 - Additional procedures for PSD permits affecting Class I areas.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 23 2012-07-01 2012-07-01 false Additional procedures for PSD permits... (CONTINUED) WATER PROGRAMS PROCEDURES FOR DECISIONMAKING Specific Procedures Applicable to PSD Permits § 124.42 Additional procedures for PSD permits affecting Class I areas. (a) The Regional Administrator...

40 CFR 124.42 - Additional procedures for PSD permits affecting Class I areas.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 22 2014-07-01 2013-07-01 true Additional procedures for PSD permits... (CONTINUED) WATER PROGRAMS PROCEDURES FOR DECISIONMAKING Specific Procedures Applicable to PSD Permits § 124.42 Additional procedures for PSD permits affecting Class I areas. (a) The Regional Administrator...

Hybrid Grid Techniques for Propulsion Applications

NASA Technical Reports Server (NTRS)

Koomullil, Roy P.; Soni, Bharat K.; Thornburg, Hugh J.

1996-01-01

During the past decade, computational simulation of fluid flow for propulsion activities has progressed significantly, and many notable successes have been reported in the literature. However, the generation of a high quality mesh for such problems has often been reported as a pacing item. Hence, much effort has been expended to speed this portion of the simulation process. Several approaches have evolved for grid generation. Two of the most common are structured multi-block, and unstructured based procedures. Structured grids tend to be computationally efficient, and have high aspect ratio cells necessary for efficently resolving viscous layers. Structured multi-block grids may or may not exhibit grid line continuity across the block interface. This relaxation of the continuity constraint at the interface is intended to ease the grid generation process, which is still time consuming. Flow solvers supporting non-contiguous interfaces require specialized interpolation procedures which may not ensure conservation at the interface. Unstructured or generalized indexing data structures offer greater flexibility, but require explicit connectivity information and are not easy to generate for three dimensional configurations. In addition, unstructured mesh based schemes tend to be less efficient and it is difficult to resolve viscous layers. Recently hybrid or generalized element solution and grid generation techniques have been developed with the objective of combining the attractive features of both structured and unstructured techniques. In the present work, recently developed procedures for hybrid grid generation and flow simulation are critically evaluated, and compared to existing structured and unstructured procedures in terms of accuracy and computational requirements.

Decoupled and linear quadratic regulator control of a large, flexible space antenna with an observer in the control loop

NASA Technical Reports Server (NTRS)

Hamer, H. A.; Johnson, K. G.; Young, J. W.

1985-01-01

An analysis is performed to compare decoupled and linear quadratic regulator (LQR) procedures for the control of a large, flexible space antenna. Control objectives involve: (1) commanding changes in the rigid-body modes, (2) nulling initial disturbances in the rigid-body modes, or (3) nulling initial disturbances in the first three flexible modes. Control is achieved with two three-axis control-moment gyros located on the antenna column. Results are presented to illustrate various effects on control requirements for the two procedures. These effects include errors in the initial estimates of state variables, variations in the type, number, and location of sensors, and deletions of state-variable estimates for certain flexible modes after control activation. The advantages of incorporating a time lag in the control feedback are also illustrated. In addition, the effects of inoperative-control situations are analyzed with regard to control requirements and resultant modal responses. Comparisons are included which show the effects of perfect state feedback with no residual modes (ideal case). Time-history responses are presented to illustrate the various effects on the control procedures.

Preliminary Human-in-the-Loop Assessment of Procedures for Very-Closely-Spaced Parallel Runways

NASA Technical Reports Server (NTRS)

Verma, Savita; Lozito, Sandra C.; Ballinger, Deborah S.; Trot, Greg; Hardy, Gordon H.; Panda, Ramesh C.; Lehmer, Ronald D.; Kozon, Thomas E.

2010-01-01

Demand in the future air transportation system concept is expected to double or triple by 2025 [1]. Increasing airport arrival rates will help meet the growing demand that could be met with additional runways but the expansion airports is met with environmental challenges for the surrounding communities when using current standards and procedures. Therefore, changes to airport operations can improve airport capacity without adding runways. Building additional runways between current ones, or moving them closer, is a potential solution to meeting the increasing demand, as addressed by the Terminal Area Capacity Enhancing Concept (TACEC). TACEC requires robust technologies and procedures that need to be tested such that operations are not compromised under instrument meteorological conditions. The reduction of runway spacing for independent simultaneous operations dramatically exacerbates the criticality of wake vortex incursion and the calculation of a safe and proper breakout maneuver. The study presented here developed guidelines for such operations by performing a real-time, human-in-the-loop simulation using precision navigation, autopilot-flown approaches, with the pilot monitoring aircraft spacing and the wake vortex safe zone during the approach.

The impact of multiple show-ups on eyewitness decision-making and innocence risk.

PubMed

Smith, Andrew M; Bertrand, Michelle; Lindsay, R C L; Kalmet, Natalie; Grossman, Deborah; Provenzano, Daniel

2014-09-01

If an eyewitness rejects a show-up, police may respond by finding a new suspect and conducting a second show-up with the same eyewitness. Police may continue finding suspects and conducting show-ups until the eyewitness makes an identification (Study 1). Relatively low criterion-setting eyewitnesses filter themselves out of the multiple show-ups procedure by choosing the first suspect with whom they are presented (Studies 2 and 3). Accordingly, response bias was more stringent on the second show-up when compared with the first, but became no more stringent with additional show-ups. Despite this stringent shift in response bias, innocence risk increased with additional show-ups, as false alarms cumulate (Studies 2 and 3). Although unbiased show-up instructions decreased innocent suspect identifications, the numbers were still discouraging (Study 4). Given the high number of innocent suspects who would be mistakenly identified through the use of multiple show-up procedures, using such identifications as evidence of guilt is questionable. Although evidence of guilt is limited to identifications from a single show-up, practical constraints might sometimes require police to use additional show-ups. Accordingly, we propose a stronger partition between evidentiary and investigative procedures. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Analysis of Slug Tests in Formations of High Hydraulic Conductivity

USGS Publications Warehouse

Butler, J.J.; Garnett, E.J.; Healey, J.M.

2003-01-01

A new procedure is presented for the analysis of slug tests performed in partially penetrating wells in formations of high hydraulic conductivity. This approach is a simple, spreadsheet-based implementation of existing models that can be used for analysis of tests from confined or unconfined aquifers. Field examples of tests exhibiting oscillatory and nonoscillatory behavior are used to illustrate the procedure and to compare results with estimates obtained using alternative approaches. The procedure is considerably simpler than recently proposed methods for this hydrogeologic setting. Although the simplifications required by the approach can introduce error into hydraulic-conductivity estimates, this additional error becomes negligible when appropriate measures are taken in the field. These measures are summarized in a set of practical field guidelines for slug tests in highly permeable aquifers.

Analysis of slug tests in formations of high hydraulic conductivity.

PubMed

Butler, James J; Garnett, Elizabeth J; Healey, John M

2003-01-01

A new procedure is presented for the analysis of slug tests performed in partially penetrating wells in formations of high hydraulic conductivity. This approach is a simple, spreadsheet-based implementation of existing models that can be used for analysis of tests from confined or unconfined aquifers. Field examples of tests exhibiting oscillatory and nonoscillatory behavior are used to illustrate the procedure and to compare results with estimates obtained using alternative approaches. The procedure is considerably simpler than recently proposed methods for this hydrogeologic setting. Although the simplifications required by the approach can introduce error into hydraulic-conductivity estimates, this additional error becomes negligible when appropriate measures are taken in the field. These measures are summarized in a set of practical field guidelines for slug tests in highly permeable aquifers.

An improved numerical procedure for the parametric optimization of three dimensional scramjet nozzles. [supersonic combustion ramjet engines - computer programs

NASA Technical Reports Server (NTRS)

Dash, S.; Delguidice, P. D.

1975-01-01

A parametric numerical procedure permitting the rapid determination of the performance of a class of scramjet nozzle configurations is presented. The geometric complexity of these configurations ruled out attempts to employ conventional nozzle design procedures. The numerical program developed permitted the parametric variation of cowl length, turning angles on the cowl and vehicle undersurface and lateral expansion, and was subject to fixed constraints such as the vehicle length and nozzle exit height. The program required uniform initial conditions at the burner exit station and yielded the location of all predominant wave zones, accounting for lateral expansion effects. In addition, the program yielded the detailed pressure distribution on the cowl, vehicle undersurface and fences, if any, and calculated the nozzle thrust, lift and pitching moments.

78 FR 53171 - Agency Information Collection Activities: Submission to OMB for Reinstatement, With Change, of a...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-28

... risks to FCU members or to an FCU's safety and soundness. Each FCU also must develop an Identity Theft... forms of activity that indicate the possible existence of identity theft. In addition, 12 CFR 717.90 requires each FCU to establish reasonable policies and procedures to address the risk of identity theft...

33 CFR 385.14 - Incorporation of NEPA and related considerations into the implementation process.

Code of Federal Regulations, 2013 CFR

2013-07-01

... requiring an EA, but not necessarily an EIS. In addition to the actions listed in § 230.7 of this chapter... invited to be cooperating agencies in the preparation of NEPA documentation pursuant to § 230.16 of this... implementation of the plan shall follow the NEPA procedures established in part 230 of this chapter. (b) Actions...

33 CFR 385.14 - Incorporation of NEPA and related considerations into the implementation process.

Code of Federal Regulations, 2014 CFR

2014-07-01

... requiring an EA, but not necessarily an EIS. In addition to the actions listed in § 230.7 of this chapter... invited to be cooperating agencies in the preparation of NEPA documentation pursuant to § 230.16 of this... implementation of the plan shall follow the NEPA procedures established in part 230 of this chapter. (b) Actions...

33 CFR 385.14 - Incorporation of NEPA and related considerations into the implementation process.

Code of Federal Regulations, 2010 CFR

2010-07-01

... requiring an EA, but not necessarily an EIS. In addition to the actions listed in § 230.7 of this chapter... invited to be cooperating agencies in the preparation of NEPA documentation pursuant to § 230.16 of this... implementation of the plan shall follow the NEPA procedures established in part 230 of this chapter. (b) Actions...

33 CFR 385.14 - Incorporation of NEPA and related considerations into the implementation process.

Code of Federal Regulations, 2011 CFR

2011-07-01

... requiring an EA, but not necessarily an EIS. In addition to the actions listed in § 230.7 of this chapter... invited to be cooperating agencies in the preparation of NEPA documentation pursuant to § 230.16 of this... implementation of the plan shall follow the NEPA procedures established in part 230 of this chapter. (b) Actions...

33 CFR 385.14 - Incorporation of NEPA and related considerations into the implementation process.

Code of Federal Regulations, 2012 CFR

2012-07-01

... requiring an EA, but not necessarily an EIS. In addition to the actions listed in § 230.7 of this chapter... invited to be cooperating agencies in the preparation of NEPA documentation pursuant to § 230.16 of this... implementation of the plan shall follow the NEPA procedures established in part 230 of this chapter. (b) Actions...

Shuttle on-orbit contamination and environmental effects

NASA Technical Reports Server (NTRS)

Leger, L. J.; Jacobs, S.; Ehlers, H. K. F.; Miller, E.

1985-01-01

Ensuring the compatibility of the space shuttle system with payloads and payload measurements is discussed. An extensive set of quantitative requirements and goals was developed and implemented by the space shuttle program management. The performance of the Shuttle system as measured by these requirements and goals was assessed partly through the use of the induced environment contamination monitor on Shuttle flights 2, 3, and 4. Contamination levels are low and generally within the requirements and goals established. Additional data from near-term payloads and already planned contamination measurements will complete the environment definition and allow for the development of contamination avoidance procedures as necessary for any payload.

Media influence on risk competence in self-medication and self-treatment

PubMed Central

Schweim, Harald; Ullmann, Marcela

2015-01-01

Media play an important role in the reception of health risks; thus, media competence is important for enhancing the risk competence of patients and consumers. In addition to life-long health education, risk competence particularly requires careful handling of health information because, at present, the key problem is not the lack of sufficient information on health topics but the quality of such information. Patients and consumers of health procedures and health products also require information which relates to their daily life and matches their life style. PMID:26195923

Template for updating regulations in QA manuals

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

White, M.G.; Banerjee, B.

1992-01-01

Recently, the U.S. Department of Energy (DOE) issued new quality assurance (QA) orders to reflect current policies for conduct and operation of DOE-authorized programs and facilities. Establishing traceability to new QA criteria and requirements from former multidraft orders, QA manuals, and guidance documentation for DOE-funded work can be confusing. Identified critical considerations still must be addressed. Most of the newly stated QA criteria can be cross referenced, where applicable, to former QA plans and manuals. Where additional criteria occur, new procedures may be required, together with revisions in QA plans and manuals.

Media influence on risk competence in self-medication and self-treatment.

PubMed

Schweim, Harald; Ullmann, Marcela

2015-01-01

Media play an important role in the reception of health risks; thus, media competence is important for enhancing the risk competence of patients and consumers. In addition to life-long health education, risk competence particularly requires careful handling of health information because, at present, the key problem is not the lack of sufficient information on health topics but the quality of such information. Patients and consumers of health procedures and health products also require information which relates to their daily life and matches their life style.

Draft Plan to Develop Non-Intrusive Load Monitoring Test Protocols

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

Mayhorn, Ebony T.; Sullivan, Greg P.; Petersen, Joseph M.

2015-09-29

This document presents a Draft Plan proposed to develop a common test protocol that can be used to evaluate the performance requirements of Non-Intrusive Load Monitoring. Development on the test protocol will be focused on providing a consistent method that can be used to quantify and compare the performance characteristics of NILM products. Elements of the protocols include specifications for appliances to be used, metrics, instrumentation, and a procedure to simulate appliance behavior during tests. In addition, three priority use cases for NILM will be identified and their performance requirements will specified.

Iliac Artery Stent Placement Relieves Claudication in Patients with Iliac and Superficial Femoral Artery Lesions

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

Ichihashi, Shigeo, E-mail: shigeoichihashi@yahoo.co.jp; Higashiura, Wataru; Itoh, Hirofumi

Purpose. To evaluate the efficacy of iliac artery stent placement for relief of claudication in patients with both iliac and superficial femoral artery (SFA) lesions. Methods. Stent placement for only iliac artery occlusive disease was performed in 94 limbs (74 patients) with both iliac and SFA occlusive disease on the same limb. All procedures were performed because intermittent claudication did not improve after continuation of antiplatelet medication therapy and home-based exercise for 3 months. Rutherford classification was 2 in 20 limbs and 3 in 74 limbs. Patients with critical limb ischemia were excluded. Median duration of follow-up was 40 months.more » Primary patency rates of the iliac stent, clinical improvement rates, and risk factors for requiring additional SFA procedures were evaluated. Results. Primary patency rates of the iliac stent at 1, 3, 5, and 7 years were 97, 93, 79, and 79 %, respectively. The initial clinical improvement rate was 87 %. Continued clinical improvement rates at 1, 3, 5, and 7 years were 87, 81, 69, and 66 %, respectively. SFA Trans-Atlantic Inter-Society Consensus (TASC) II C/D lesion was a significant risk factor for requiring additional SFA procedures. Conclusion. Intermittent claudication was relieved by iliac stent placement in most patients with both iliac and SFA lesions. Thus, the indications for treatment of the SFA intended for claudicants should be evaluated after treatment of the iliac lesion.« less

Investigation of parabolic computational techniques for internal high-speed viscous flows

NASA Technical Reports Server (NTRS)

Anderson, O. L.; Power, G. D.

1985-01-01

A feasibility study was conducted to assess the applicability of an existing parabolic analysis (ADD-Axisymmetric Diffuser Duct), developed previously for subsonic viscous internal flows, to mixed supersonic/subsonic flows with heat addition simulating a SCRAMJET combustor. A study was conducted with the ADD code modified to include additional convection effects in the normal momentum equation when supersonic expansion and compression waves were present. It is concluded from the present study that for the class of problems where strong viscous/inviscid interactions are present a global iteration procedure is required.

Short bowel mucosal morphology, proliferation and inflammation at first and repeat STEP procedures.

PubMed

Mutanen, Annika; Barrett, Meredith; Feng, Yongjia; Lohi, Jouko; Rabah, Raja; Teitelbaum, Daniel H; Pakarinen, Mikko P

2018-04-17

Although serial transverse enteroplasty (STEP) improves function of dilated short bowel, a significant proportion of patients require repeat surgery. To address underlying reasons for unsuccessful STEP, we compared small intestinal mucosal characteristics between initial and repeat STEP procedures in children with short bowel syndrome (SBS). Fifteen SBS children, who underwent 13 first and 7 repeat STEP procedures with full thickness small bowel samples at median age 1.5 years (IQR 0.7-3.7) were included. The specimens were analyzed histologically for mucosal morphology, inflammation and muscular thickness. Mucosal proliferation and apoptosis was analyzed with MIB1 and Tunel immunohistochemistry. Median small bowel length increased 42% by initial STEP and 13% by repeat STEP (p=0.05), while enteral caloric intake increased from 6% to 36% (p=0.07) during 14 (12-42) months between the procedures. Abnormal mucosal inflammation was frequently observed both at initial (69%) and additional STEP (86%, p=0.52) surgery. Villus height, crypt depth, enterocyte proliferation and apoptosis as well as muscular thickness were comparable at first and repeat STEP (p>0.05 for all). Patients, who required repeat STEP tended to be younger (p=0.057) with less apoptotic crypt cells (p=0.031) at first STEP. Absence of ileocecal valve associated with increased intraepithelial leukocyte count and reduced crypt cell proliferation index (p<0.05 for both). No adaptive mucosal hyperplasia or muscular alterations occurred between first and repeat STEP. Persistent inflammation and lacking mucosal growth may contribute to continuing bowel dysfunction in SBS children, who require repeat STEP procedure, especially after removal of the ileocecal valve. Level IV, retrospective study. Copyright © 2018 Elsevier Inc. All rights reserved.

The impact of obesity on pediatric procedural sedation-related outcomes: results from the Pediatric Sedation Research Consortium.

PubMed

Scherrer, Patricia D; Mallory, Michael D; Cravero, Joseph P; Lowrie, Lia; Hertzog, James H; Berkenbosch, John W

2015-07-01

To evaluate the impact of obesity on adverse events and required interventions during pediatric procedural sedation. The Pediatric Sedation Research Consortium database of prospectively collected procedural sedation encounters was queried to identify patients for whom body mass index (BMI) could be calculated. Obesity was defined as BMI ≥95th percentile for age and gender. Sedation-related outcomes, adverse events, and therapeutic interventions were compared between obese and nonobese patients. For analysis, 28,792 records were eligible. A total of 5,153 patients (17.9%) were obese; they were predominantly male and older and had a higher median American Society of Anesthesiologists Physical Status classification (P < 0.001). Total adverse events were more common in obese patients (odds ratio [OR] 1.49, 95% confidence interval [1.31, 1.70]). Respiratory events (airway obstruction OR 1.94 [1.54, 2.44], oxygen desaturation OR 1.99 [1.50, 2.63], secretions OR 1.48 [1.01, 2.15], laryngospasm OR 2.30 [1.30, 4.05]), inability to complete the associated procedure (OR 1.96 [1.16, 3.30]), and prolonged recovery (OR 2.66 [1.26, 5.59]) were increased in obese patients. Obese patients more frequently required airway intervention including repositioning, suctioning, jaw thrust, airway adjuncts, and bag-valve-mask ventilation. Multivariate regression analysis demonstrated obesity to be independently associated with minor and moderate but not major adverse events. Obesity is an independent risk factor for adverse respiratory events during procedural sedation and is associated with an increased frequency of airway interventions, suggesting that additional vigilance and expertise are required when sedating these patients. © 2015 John Wiley & Sons Ltd.

Elective change of surgeon during the OR day has an operationally negligible impact on turnover time.

PubMed

Austin, Thomas M; Lam, Humphrey V; Shin, Naomi S; Daily, Bethany J; Dunn, Peter F; Sandberg, Warren S

2014-08-01

To compare turnover times for a series of elective cases with surgeons following themselves with turnover times for a series of previously scheduled elective procedures for which the succeeding surgeon differed from the preceding surgeon. Retrospective cohort study. University-affiliated teaching hospital. The operating room (OR) statistical database was accessed to gather 32 months of turnover data from a large academic institution. Turnover time data for the same-surgeon and surgeon-swap groups were batched by month to minimize autocorrelation and achieve data normalization. Two-way analysis of variance (ANOVA) using the monthly batched data was performed with surgeon swapping and changes in procedure category as variables of turnover time. Similar analyses were performed using individual surgical services, hourly time intervals during the surgical day, and turnover frequency per OR as additional covariates to surgeon swapping. The mean (95% confidence interval [CI]) same-surgeon turnover time was 43.6 (43.2 - 44.0) minutes versus 51.0 (50.5 - 51.6) minutes for a planned surgeon swap (P < 0.0001). This resulted in a difference (95% CI) of 7.4 (6.8 - 8.1) minutes. The exact increase in turnover time was dependent on surgical service, change in subsequent procedure type, time of day when the turnover occurred, and turnover frequency. The investigated institution averages 2.5 cases per OR per day. The cumulative additional turnover time (far less than one hour per OR per day) for switching surgeons definitely does not allow the addition of another elective procedure if the difference could be eliminated. A flexible scheduling policy allowing surgeon swapping rather than requiring full blocks incurs minimal additional staffed time during the OR day while allowing the schedule to be filled with available elective cases. Copyright © 2014 Elsevier Inc. All rights reserved.

QA procedures and emissions from nonstandard sources in AQUIS, a PC-based emission inventory and air permit manager

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

Smith, A.E.; Tschanz, J.; Monarch, M.

1996-05-01

The Air Quality Utility Information System (AQUIS) is a database management system that operates under dBASE IV. It runs on an IBM-compatible personal computer (PC) with MS DOS 5.0 or later, 4 megabytes of memory, and 30 megabytes of disk space. AQUIS calculates emissions for both traditional and toxic pollutants and reports emissions in user-defined formats. The system was originally designed for use at 7 facilities of the Air Force Materiel Command, and now more than 50 facilities use it. Within the last two years, the system has been used in support of Title V permit applications at Department ofmore » Defense facilities. Growth in the user community, changes and additions to reference emission factor data, and changing regulatory requirements have demanded additions and enhancements to the system. These changes have ranged from adding or updating an emission factor to restructuring databases and adding new capabilities. Quality assurance (QA) procedures have been developed to ensure that emission calculations are correct even when databases are reconfigured and major changes in calculation procedures are implemented. This paper describes these QA and updating procedures. Some user facilities include light industrial operations associated with aircraft maintenance. These facilities have operations such as fiberglass and composite layup and plating operations for which standard emission factors are not available or are inadequate. In addition, generally applied procedures such as material balances may need special treatment to work in an automated environment, for example, in the use of oils and greases and when materials such as polyurethane paints react chemically during application. Some techniques used in these situations are highlighted here. To provide a framework for the main discussions, this paper begins with a description of AQUIS.« less

76 FR 69333 - Derivatives Clearing Organization General Provisions and Core Principles

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-08

...The Commodity Futures Trading Commission (Commission) is adopting final regulations to implement certain provisions of Title VII and Title VIII of the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank Act) governing derivatives clearing organization (DCO) activities. More specifically, the regulations establish the regulatory standards for compliance with DCO Core Principles A (Compliance), B (Financial Resources), C (Participant and Product Eligibility), D (Risk Management), E (Settlement Procedures), F (Treatment of Funds), G (Default Rules and Procedures), H (Rule Enforcement), I (System Safeguards), J (Reporting), K (Recordkeeping), L (Public Information), M (Information Sharing), N (Antitrust Considerations), and R (Legal Risk) set forth in Section 5b of the Commodity Exchange Act (CEA). The Commission also is updating and adding related definitions; adopting implementing rules for DCO chief compliance officers (CCOs); revising procedures for DCO applications including the required use of a new Form DCO; adopting procedural rules applicable to the transfer of a DCO registration; and adding requirements for approval of DCO rules establishing a portfolio margining program for customer accounts carried by a futures commission merchant (FCM) that is also registered as a securities broker-dealer (FCM/BD). In addition, the Commission is adopting certain technical amendments to parts 21 and 39, and is adopting certain delegation provisions under part 140.

Loop-mediated isothermal amplification with the Procedure for Ultra Rapid Extraction kit for the diagnosis of pneumocystis pneumonia.

PubMed

Kawano, Shuichi; Maeda, Takuya; Suzuki, Takefumi; Abe, Tatsuhiro; Mikita, Kei; Hamakawa, Yusuke; Ono, Takeshi; Sonehara, Wataru; Miyahira, Yasushi; Kawana, Akihiko

2015-03-01

Loop-mediated isothermal amplification (LAMP) is an innovative molecular technique requiring only a heating device and isothermal conditions to amplify a specific target gene. The results of current microscopic diagnostic tools for pneumocystis pneumonia are not sufficiently consistent for detecting infection with a low-density of Pneumocystis jirovecii. Although polymerase chain reaction (PCR) is highly sensitive, it is not suitable for resource-limited facilities. LAMP is a potential diagnostic replacement for PCR in such settings but a critical disadvantage of DNA extraction was still remained. Therefore, we employed the Procedure for Ultra Rapid Extraction (PURE) kit, which uses a porous material, to isolate the DNA from clinical samples in a simple way in combination with previously reported LAMP procedure for diagnosing PCP. The detection limit of the PURE-LAMP method applied to artificial bronchoalveolar lavage fluid samples was 100 copies/tube, even with the use of massive blood-contaminated solutions. In addition, we concluded the diagnostic procedure within 1 h without the need for additional equipment. PURE-LAMP coupled with suitable primers for specific pathogens has good potential for diagnosing various infectious diseases. Copyright © 2014 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Potential costs of breast augmentation mammaplasty.

PubMed

Schmitt, William P; Eichhorn, Mitchell G; Ford, Ronald D

2016-01-01

Augmentation mammaplasty is one of the most common surgical procedures performed by plastic surgeons. The aim of this study was to estimate the cost of the initial procedure and its subsequent complications, as well as project the cost of Food and Drug Administration (FDA)-recommended surveillance imaging. The potential costs to the individual patient and society were calculated. Local plastic surgeons provided billing data for the initial primary silicone augmentation and reoperative procedures. Complication rates used for the cost analysis were obtained from the Allergen Core study on silicone implants. Imaging surveillance costs were considered in the estimations. The average baseline initial cost of silicone augmentation mammaplasty was calculated at $6335. The average total cost of primary breast augmentation over the first decade for an individual patient, including complications requiring reoperation and other ancillary costs, was calculated at $8226. Each decade thereafter cost an additional $1891. Costs may exceed $15,000 over an averaged lifetime, and the recommended implant surveillance could cost an additional $33,750. The potential cost of a breast augmentation, which includes the costs of complications and imaging, is significantly higher than the initial cost of the procedure. Level III, economic and decision analysis study. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Rotation stability of a toric intraocular lens with a second capsular tension ring.

PubMed

Sagiv, Oded; Sachs, Dan

2015-05-01

An Acrysof toric intraocular lens (IOL) and a capsular tension ring (CTR) were implanted in the highly myopic eye of a 74-year-old white man during cataract surgery. On the first postoperative day, the IOL was found 90 degrees from the required position, with a consequent high amount of astigmatism. A second procedure was performed and because it was not possible to secure the toric IOL in the correct position, an additional in-the-bag CTR was inserted, with an immediate optimal outcome. The IOL remained stable up to the final follow-up examination. Co-implantation of a toric IOL and a single CTR has been reported. In our case, 2 CTRs were required to fixate the toric IOL in the correct position. This procedure is simple and safe and should be considered in cases of postoperatively misaligned toric IOLs. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Endoscopes with latest technology and concept.

PubMed

Gotoh

2003-09-01

Endoscopic imaging systems that perform as the "eye" of the operator during endoscopic surgical procedures have developed rapidly due to various technological developments. In addition, since the most recent turn of the century robotic surgery has increased its scope through the utilization of systems such as Intuitive Surgical's da Vinci System. To optimize the imaging required for precise robotic surgery, a unique endoscope has been developed, consisting of both a two dimensional (2D) image optical system for wider observation of the entire surgical field, and a three dimensional (3D) image optical system for observation of the more precise details at the operative site. Additionally, a "near infrared radiation" endoscopic system is under development to detect the sentinel lymph node more readily. Such progress in the area of endoscopic imaging is expected to enhance the surgical procedure from both the patient's and the surgeon's point of view.

Instrumentation and data analysis design for evaluating mechanic performance in decentralized I/M programs

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

Ashby, H.A.; Carlson, T.R.; Husson, L.

1986-01-01

Significant reductions in motor vehicle emissions are possible through the implementation of inspection and maintenance (I/M) programs. However, the potential benefits of I/M are obviously not achieved when specific inspection requirements are ignored or improperly performed. In addition, I/M benefits may be substantially reduced when improper repair procedures are used on vehicles which fail the test. In order for the ''theoretical'' benefits of I/M to be achieved, certain program design and enforcement procedures are necessary. The use of instrumentation and data analysis methods capable of identifying individuals who are improperly performing inspections and repairs is critical.

Post-procedural Care in Interventional Radiology: What Every Interventional Radiologist Should Know—Part I: Standard Post-procedural Instructions and Follow-Up Care

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

Taslakian, Bedros, E-mail: Bedros.Taslakian@nyumc.org; Sridhar, Divya

Interventional radiology (IR) has evolved into a full-fledged clinical specialty with attendant patient care responsibilities. Success in IR now requires development of a full clinical practice, including consultations, inpatient admitting privileges, and an outpatient clinic. In addition to technical excellence and innovation, maintaining a comprehensive practice is imperative for interventional radiologists to compete successfully for patients and referral bases. A structured approach to periprocedural care, including routine follow-up and early identification and management of complications, facilitates efficient and thorough management with an emphasis on quality and patient safety.

Method 1664: N-hexane extractable material (hem) and silica gel treated n-hexane extractable material (SGT-HEM) by extraction and gravimetry (oil and grease and total petroleum hydrocarbons), April 1995

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

NONE

Method 1664 was developed by the United States Environmental Protection Agency Office of Science and Technology to replace previously used gravimetric procedures that employed Freon-113, a Class I CFC, as the extraction solvent for the determination of oil and grease and petroleum hydrocarbons. Method 1664 is a performance-based method applicable to aqueous matrices that requires the use of n-hexane as the extraction solvent and gravimetry as the determinative technique. In addition, QC procedures designed to monitor precision and accuracy have been incorporated into Method 1664.

Post-procedural Care in Interventional Radiology: What Every Interventional Radiologist Should Know-Part I: Standard Post-procedural Instructions and Follow-Up Care.

PubMed

Taslakian, Bedros; Sridhar, Divya

2017-04-01

Interventional radiology (IR) has evolved into a full-fledged clinical specialty with attendant patient care responsibilities. Success in IR now requires development of a full clinical practice, including consultations, inpatient admitting privileges, and an outpatient clinic. In addition to technical excellence and innovation, maintaining a comprehensive practice is imperative for interventional radiologists to compete successfully for patients and referral bases. A structured approach to periprocedural care, including routine follow-up and early identification and management of complications, facilitates efficient and thorough management with an emphasis on quality and patient safety.

49 CFR 218.97 - Good faith challenge procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... the railroad's operating rules implementing the requirements of this subpart. (b) General procedures... requirements of this subpart. (1) Each railroad or employer shall adopt and implement written procedures which... fulfill the requirements of this subpart. Each railroad or employer's written procedures shall provide for...

49 CFR 218.97 - Good faith challenge procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... the railroad's operating rules implementing the requirements of this subpart. (b) General procedures... requirements of this subpart. (1) Each railroad or employer shall adopt and implement written procedures which... fulfill the requirements of this subpart. Each railroad or employer's written procedures shall provide for...

49 CFR 218.97 - Good faith challenge procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... the railroad's operating rules implementing the requirements of this subpart. (b) General procedures... requirements of this subpart. (1) Each railroad or employer shall adopt and implement written procedures which... fulfill the requirements of this subpart. Each railroad or employer's written procedures shall provide for...

49 CFR 218.97 - Good faith challenge procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... the railroad's operating rules implementing the requirements of this subpart. (b) General procedures... requirements of this subpart. (1) Each railroad or employer shall adopt and implement written procedures which... fulfill the requirements of this subpart. Each railroad or employer's written procedures shall provide for...

49 CFR 218.97 - Good faith challenge procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... the railroad's operating rules implementing the requirements of this subpart. (b) General procedures... requirements of this subpart. (1) Each railroad or employer shall adopt and implement written procedures which... fulfill the requirements of this subpart. Each railroad or employer's written procedures shall provide for...

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

PubMed

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

2015-03-01

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

Evaluation of 12 blood glucose monitoring systems for self-testing: system accuracy and measurement reproducibility.

PubMed

Freckmann, Guido; Baumstark, Annette; Schmid, Christina; Pleus, Stefan; Link, Manuela; Haug, Cornelia

2014-02-01

Systems for self-monitoring of blood glucose (SMBG) have to provide accurate and reproducible blood glucose (BG) values in order to ensure adequate therapeutic decisions by people with diabetes. Twelve SMBG systems were compared in a standardized manner under controlled laboratory conditions: nine systems were available on the German market and were purchased from a local pharmacy, and three systems were obtained from the manufacturer (two systems were available on the U.S. market, and one system was not yet introduced to the German market). System accuracy was evaluated following DIN EN ISO (International Organization for Standardization) 15197:2003. In addition, measurement reproducibility was assessed following a modified TNO (Netherlands Organization for Applied Scientific Research) procedure. Comparison measurements were performed with either the glucose oxidase method (YSI 2300 STAT Plus™ glucose analyzer; YSI Life Sciences, Yellow Springs, OH) or the hexokinase method (cobas(®) c111; Roche Diagnostics GmbH, Mannheim, Germany) according to the manufacturer's measurement procedure. The 12 evaluated systems showed between 71.5% and 100% of the measurement results within the required system accuracy limits. Ten systems fulfilled with the evaluated test strip lot minimum accuracy requirements specified by DIN EN ISO 15197:2003. In addition, accuracy limits of the recently published revision ISO 15197:2013 were applied and showed between 54.5% and 100% of the systems' measurement results within the required accuracy limits. Regarding measurement reproducibility, each of the 12 tested systems met the applied performance criteria. In summary, 83% of the systems fulfilled with the evaluated test strip lot minimum system accuracy requirements of DIN EN ISO 15197:2003. Each of the tested systems showed acceptable measurement reproducibility. In order to ensure sufficient measurement quality of each distributed test strip lot, regular evaluations are required.

Site Safety and Health Plan (Phase 3) for the treatability study for in situ vitrification at Seepage Pit 1 in Waste Area Grouping 7, Oak Ridge National Laboratory, Oak Ridge, TN

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

Spalding, B.P.; Naney, M.T.

1995-06-01

This plan is to be implemented for Phase III ISV operations and post operations sampling. Two previous project phases involving site characterization have been completed and required their own site specific health and safety plans. Project activities will take place at Seepage Pit 1 in Waste Area Grouping 7 at ORNL, Oak Ridge, Tennessee. Purpose of this document is to establish standard health and safety procedures for ORNL project personnel and contractor employees in performance of this work. Site activities shall be performed in accordance with Energy Systems safety and health policies and procedures, DOE orders, Occupational Safety and Healthmore » Administration Standards 29 CFR Part 1910 and 1926; applicable United States Environmental Protection Agency requirements; and consensus standards. Where the word ``shall`` is used, the provisions of this plan are mandatory. Specific requirements of regulations and orders have been incorporated into this plan in accordance with applicability. Included from 29 CFR are 1910.120 Hazardous Waste Operations and Emergency Response; 1910.146, Permit Required - Confined Space; 1910.1200, Hazard Communication; DOE Orders requirements of 5480.4, Environmental Protection, Safety and Health Protection Standards; 5480.11, Radiation Protection; and N5480.6, Radiological Control Manual. In addition, guidance and policy will be followed as described in the Environmental Restoration Program Health and Safety Plan. The levels of personal protection and the procedures specified in this plan are based on the best information available from reference documents and site characterization data. Therefore, these recommendations represent the minimum health and safety requirements to be observed by all personnel engaged in this project.« less

Droplet-Based Segregation and Extraction of Concentrated Samples

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

Buie, C R; Buckley, P; Hamilton, J

2007-02-23

Microfluidic analysis often requires sample concentration and separation techniques to isolate and detect analytes of interest. Complex or scarce samples may also require an orthogonal separation and detection method or off-chip analysis to confirm results. To perform these additional steps, the concentrated sample plug must be extracted from the primary microfluidic channel with minimal sample loss and dilution. We investigated two extraction techniques; injection of immiscible fluid droplets into the sample stream (''capping'''') and injection of the sample into an immiscible fluid stream (''extraction''). From our results we conclude that capping is the more effective partitioning technique. Furthermore, this functionalitymore » enables additional off-chip post-processing procedures such as DNA/RNA microarray analysis, realtime polymerase chain reaction (RT-PCR), and culture growth to validate chip performance.« less

Biatrial reduction plasty with reef imbricate technique as an adjunct to maze procedure for permanent atrial fibrillation associated with giant left atria.

PubMed

Wang, William; Guo, L Ray; Martland, Anne Marie; Feng, Xiao-Dong; Ma, Jie; Feng, Xi Qing

2010-04-01

Success of the modified maze procedure after valvular operation with giant atria and permanent atrial fibrillation (AF) remains suboptimal. We report an aggressive approach for these patients utilizing biatrial reduction plasty with a reef imbricate suture technique concomitantly with valvular and maze procedure for AF. From January 1999 to December 2006, 122 consecutive Chinese patients with permanent AF and biatrial enlargement who required mitral valve+/-tricuspid valve (TV) surgery underwent aggressive left atrial reduction combined with radiofrequency bipolar full maze procedure. Left atrial dimensions were measured by TTE or TEE. There were 71 women (58.1%) and 51 men (41.9%) and their mean age was 45+/-9.5 years. Mean duration of AF was 48.4+/-21.4 months. All patients underwent left atrial reduction plasty with reef imbricate suture technique and full maze procedure. Their preoperative left atria measured 64+/-12 mm in the enlarged left atria (ELA) group and 86+/-17 mm in the giant left atria (GLA). Mitral valve replacement (MVR) combined with TV repair was performed in 102 patients (83%) while 21 patients underwent MVRs combined with aortic valve replacements (17%). Sixty-six (54%) patients required additional procedures and 61 (50%) of the patients also underwent left atrial appendage clot evacuation. Postoperative left atrial size was reduced to 49+/-8 mm (ELA) and 51+/-11 mm (GLA), respectively (P<0.05). Ninety-three of 122 (76%) patients were restored in normal sinus rhythm after one year clinical follow-up. Aggressive biatrial reduction plasty combined with full maze procedure is an effective treatment for patients with permanent AF undergoing concomitant valvular surgery. Further studies utilizing the reef imbricate suture technique for atrial reduction need to subsequently be evaluated.

Significance of Urinary Tract Involvement in Patients Treated with Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC)

PubMed Central

Randle, Reese W.; Craven, Brandon; Swett, Katrina R.; Levine, Edward A.; Shen, Perry; Stewart, John H.; Mirzazadeh, Majid

2014-01-01

Background Urinary tract involvement in patients with peritoneal surface disease treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) often requires complex urologic resections and reconstruction to achieve optimal cytoreduction. The impact of these combined procedures on surgical outcomes is not well defined. Methods A prospective database of CRS/HIPEC procedures was analyzed retrospectively. Type of malignancy, performance status, resection status, hospital and intensive care unit stay, morbidity, mortality, and overall survival were reviewed. Results A total of 864 patients underwent 933 CRS/HI-PEC procedures, while 64 % (550) had preoperative ureteral stent placement. A total of 7.3 % had an additional urologic procedure without an increase in 30-day (p = 0.4) or 90-day (p = 1.0) mortality. Urologic procedures correlated with increased length of operating time (p < 0.001), blood loss (p < 0.001), and length of hospitalization (p = 0.003), yet were not associated with increased overall 30-day major morbidity (grade III/IV, p = 0.14). In multivariate analysis, independent predictors of additional urologic procedures were prior surgical score (p < 0.001), number of resected organs (p = 0.001), and low anterior resection (p = 0.03). Long-term survival was not statistically different between patients with and without urologic resection for low-grade appendiceal primary lesions (p = 0.23), high-grade appendiceal primary lesions (p = 0.40), or colorectal primary lesions (p = 0.14). Conclusions Urinary tract involvement in patients with peritoneal surface disease does not increase overall surgical morbidity. Patients with urologic procedures demonstrate survival patterns with meaningful prolongation of life. Urologic involvement should not be considered a contraindication for CRS/HIPEC in patients with resectable peritoneal surface disease. PMID:24217789

Significance of urinary tract involvement in patients treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

PubMed

Votanopoulos, Konstantinos I; Randle, Reese W; Craven, Brandon; Swett, Katrina R; Levine, Edward A; Shen, Perry; Stewart, John H; Mirzazadeh, Majid

2014-03-01

Urinary tract involvement in patients with peritoneal surface disease treated with cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) often requires complex urologic resections and reconstruction to achieve optimal cytoreduction. The impact of these combined procedures on surgical outcomes is not well defined. A prospective database of CRS/HIPEC procedures was analyzed retrospectively. Type of malignancy, performance status, resection status, hospital and intensive care unit stay, morbidity, mortality, and overall survival were reviewed. A total of 864 patients underwent 933 CRS/HIPEC procedures, while 64 % (550) had preoperative ureteral stent placement. A total of 7.3 % had an additional urologic procedure without an increase in 30-day (p = 0.4) or 90-day (p = 1.0) mortality. Urologic procedures correlated with increased length of operating time (p < 0.001), blood loss (p < 0.001), and length of hospitalization (p = 0.003), yet were not associated with increased overall 30-day major morbidity (grade III/IV, p = 0.14). In multivariate analysis, independent predictors of additional urologic procedures were prior surgical score (p < 0.001), number of resected organs (p = 0.001), and low anterior resection (p = 0.03). Long-term survival was not statistically different between patients with and without urologic resection for low-grade appendiceal primary lesions (p = 0.23), high-grade appendiceal primary lesions (p = 0.40), or colorectal primary lesions (p = 0.14). Urinary tract involvement in patients with peritoneal surface disease does not increase overall surgical morbidity. Patients with urologic procedures demonstrate survival patterns with meaningful prolongation of life. Urologic involvement should not be considered a contraindication for CRS/HIPEC in patients with resectable peritoneal surface disease.

Toxicity Minimized Cryoprotectant Addition and Removal Procedures for Adherent Endothelial Cells

PubMed Central

Davidson, Allyson Fry; Glasscock, Cameron; McClanahan, Danielle R.; Benson, James D.; Higgins, Adam Z.

2015-01-01

Ice-free cryopreservation, known as vitrification, is an appealing approach for banking of adherent cells and tissues because it prevents dissociation and morphological damage that may result from ice crystal formation. However, current vitrification methods are often limited by the cytotoxicity of the concentrated cryoprotective agent (CPA) solutions that are required to suppress ice formation. Recently, we described a mathematical strategy for identifying minimally toxic CPA equilibration procedures based on the minimization of a toxicity cost function. Here we provide direct experimental support for the feasibility of these methods when applied to adherent endothelial cells. We first developed a concentration- and temperature-dependent toxicity cost function by exposing the cells to a range of glycerol concentrations at 21°C and 37°C, and fitting the resulting viability data to a first order cell death model. This cost function was then numerically minimized in our state constrained optimization routine to determine addition and removal procedures for 17 molal (mol/kg water) glycerol solutions. Using these predicted optimal procedures, we obtained 81% recovery after exposure to vitrification solutions, as well as successful vitrification with the relatively slow cooling and warming rates of 50°C/min and 130°C/min. In comparison, conventional multistep CPA equilibration procedures resulted in much lower cell yields of about 10%. Our results demonstrate the potential for rational design of minimally toxic vitrification procedures and pave the way for extension of our optimization approach to other adherent cell types as well as more complex systems such as tissues and organs. PMID:26605546

Healthcare software assurance.

PubMed

Cooper, Jason G; Pauley, Keith A

2006-01-01

Software assurance is a rigorous, lifecycle phase-independent set of activities which ensure completeness, safety, and reliability of software processes and products. This is accomplished by guaranteeing conformance to all requirements, standards, procedures, and regulations. These assurance processes are even more important when coupled with healthcare software systems, embedded software in medical instrumentation, and other healthcare-oriented life-critical systems. The current Food and Drug Administration (FDA) regulatory requirements and guidance documentation do not address certain aspects of complete software assurance activities. In addition, the FDA's software oversight processes require enhancement to include increasingly complex healthcare systems such as Hospital Information Systems (HIS). The importance of complete software assurance is introduced, current regulatory requirements and guidance discussed, and the necessity for enhancements to the current processes shall be highlighted.

Healthcare Software Assurance

PubMed Central

Cooper, Jason G.; Pauley, Keith A.

2006-01-01

Software assurance is a rigorous, lifecycle phase-independent set of activities which ensure completeness, safety, and reliability of software processes and products. This is accomplished by guaranteeing conformance to all requirements, standards, procedures, and regulations. These assurance processes are even more important when coupled with healthcare software systems, embedded software in medical instrumentation, and other healthcare-oriented life-critical systems. The current Food and Drug Administration (FDA) regulatory requirements and guidance documentation do not address certain aspects of complete software assurance activities. In addition, the FDA’s software oversight processes require enhancement to include increasingly complex healthcare systems such as Hospital Information Systems (HIS). The importance of complete software assurance is introduced, current regulatory requirements and guidance discussed, and the necessity for enhancements to the current processes shall be highlighted. PMID:17238324

Identification of potential surgical site infections leveraging an enterprise clinical information warehouse.

PubMed

Santangelo, Jennifer; Erdal, Selnur; Wellington, Linda; Mekhjian, Hagop; Kamal, Jyoti

2008-11-06

At The Ohio State University Medical Center (OSUMC), infection control practitioners (ICPs) need an accurate list of patients undergoing defined operative procedures to track surgical site infections. Using data from the OSUMC Information Warehouse (IW), we have created an automated report detailing required data. This report also displays associated surgical and pathology text or dictated reports providing additional information to the ICPs.

20 CFR 645.315 - What actions are to be taken if a State fails to make the required matching expenditures?

Code of Federal Regulations, 2012 CFR

2012-04-01

... Additional Formula Grant Administrative Standards and Procedures § 645.315 What actions are to be taken if a... reduced by two (2) dollars for each one (1) dollar shortfall in State matching funds) when the grant is... based on the FY formula grant award amount, as reduced under paragraph (a) of this section. ...

How the Use of the International Classification of Functioning, Disability and Health for Children and Youth Changed the Individualized Education Programs in Portugal

ERIC Educational Resources Information Center

Silveira-Maia, Mónica; Lopes-dos-Santos, Pedro; Sanches-Ferreira, Manuela

2017-01-01

Current Portuguese Public Law No. 3/2008 requires the use of the International Classification of Functioning, Health and Disability for Children and Youth (ICF-CY) as a reference framework to guide assessment and intervention procedures for students with additional support needs. This study explores whether the ICF-CY use fostered multidimensional…

Kevlar Overwrap Study

DTIC Science & Technology

1992-04-01

Manager, ARDE, INC. as Prime Contractor/Principal Investigator, Physics International as subcontractor for failure modeling computer calculations and Air...Force Astronautics Laboratory (EAFB) for full scale composite vessel testing. In addition, important contributions were made by Dr. Yen Pan...34 0 AND 22" 0 PSC VESSEL TESTS E-i E.1 - FULL SCALE COMPOSITE VESSEL E-1 TESTS - INSTRUMENTATION REQUIREMENTS/PROCEDURES E.2 - 16" 0 AND 22" 0 PSC

JWST ISIM Primary Structure and Kinematic Mount Configuration

NASA Technical Reports Server (NTRS)

Bartoszyk, Andrew; Carnahan, Tim; Hendricks, Steve; Kaprielian, Charles; Kuhn, Jonathan; Kunt, Cengiz

2004-01-01

In this presentation we will review the evolution of the ISIM primary structure tube topology and kinematic mount configuration to the current baseline concept. We will also show optimization procedures used and challenges resulting from complex joints under launch loads. Two additional key ISIM structure challenges of meeting thermal distortion and stability requirements and metal-composite bonded joint survivability at cryogenic temperatures are covered in other presentations.

Limb lengthening in Turner syndrome.

PubMed Central

Noonan, K. J.; Leyes, M.; Forriol, F.

1997-01-01

We report the results and complications of eight consecutive patients who underwent bilateral tibial lengthenings for dwarfism associated with Turner syndrome. Lengthening was performed via distraction osteogenesis with monolateral external fixation. Tibias were lengthened an average distance of 9.2 centimeters or 33 percent of the original tibial length. The average total treatment time was 268 days. The overall complication rate was 169 percent for each tibia lengthened and each segment required an average of 1.7 additional procedures. Seven cases (44 percent) required Achilles tendon lengthening and nine cases (56 percent) developed angulation before or after fixator removal; six of these segments required corrective osteotomy for axial malalignment. Two cases (12.5 percent) developed distraction site nonunion and required plating and bone grafting. From this series we conclude that tibial lengthening via distraction osteogenesis can be used to treat disproportionate short stature in patients with Turner syndrome. However, the benefit of a cosmetic increase in height may not compensate for the high complication rate. Efforts to determine the psychosocial and functional benefits of limb lengthening in patients with short stature is necessary to determine the true cost-benefit ratio of this procedure. Images Figure 1a Figure 1b Figure 1c PMID:9234980

Pulsed Dose Radiofrequency Before Ablation of Medial Branch of the Lumbar Dorsal Ramus for Zygapophyseal Joint Pain Reduces Post-procedural Pain.

PubMed

Arsanious, David; Gage, Emmanuel; Koning, Jonathon; Sarhan, Mazin; Chaiban, Gassan; Almualim, Mohammed; Atallah, Joseph

2016-01-01

One of the potential side effects with radiofrequency ablation (RFA) includes painful cutaneous dysesthesias and increased pain due to neuritis or neurogenic inflammation. This pain may require the prescription of opioids or non-opioid analgesics to control post-procedural pain and discomfort. The goal of this study is to compare post-procedural pain scores and post-procedural oral analgesic use in patients receiving continuous thermal radiofrequency ablation versus patients receiving pulsed dose radiofrequency immediately followed by continuous thermal radiofrequency ablation for zygopophaseal joint disease. This is a prospective, double-blinded, randomized, controlled trial. Patients who met all the inclusion criteria and were not subject to any of the exclusion criteria were required to have two positive diagnostic medial branch blocks prior to undergoing randomization, intervention, and analysis. University hospital. Eligible patients were randomized in a 1:1 ratio to either receive thermal radiofrequency ablation alone (standard group) or pulsed dose radiofrequency (PDRF) immediately followed by thermal radiofrequency ablation (investigational group), all of which were performed by a single Board Certified Pain Medicine physician. Post-procedural pain levels between the two groups were assessed using the numerical pain Scale (NPS), and patients were contacted by phone on post-procedural days 1 and 2 in the morning and afternoon regarding the amount of oral analgesic medications used in the first 48 hours following the procedure. Patients who received pulsed dose radiofrequency followed by continuous radiofrequency neurotomy reported statistically significantly lower post-procedural pain scores in the first 24 hours compared to patients who received thermal radiofrequency neurotomy alone. These patients also used less oral analgesic medication in the post-procedural period. These interventions were carried out by one board accredited pain physician at one center. The procedures were exclusively performed using one model of radiofrequency generator, at one setting for the PDRF and RFA. The difference in the number of levels of ablation was not considered in the analysis of the results. Treating patients with pulsed dose radiofrequency prior to continuous thermal radiofrequency ablation can provide patients with less post-procedural pain during the first 24 hours and also reduce analgesic requirements. Furthermore, the addition of PDRF to standard thermal RFA did not prolong the time of standard thermal radiofrequency ablation procedures, as it was performed during the typically allotted time for local anesthetic action. Low back pain, facet joint disease, medial branch block, Radiofrequency ablation, thermal radiofrequency, pulsed dose radiofrequency, PDRF, zygapophyseal joint.

Prevailing Torque Locking Feature in Threaded Fasteners Using Anaerobic Adhesive

NASA Technical Reports Server (NTRS)

Hernandez, Alan; Hess, Daniel P.

2016-01-01

This paper presents results from tests to assess the use of anaerobic adhesive for providing a prevailing torque locking feature in threaded fasteners. Test procedures are developed and tests are performed on three fastener materials, four anaerobic adhesives, and both unseated assembly conditions. Five to ten samples are tested for each combination. Tests for initial use, reuse without additional adhesive, and reuse with additional adhesive are performed for all samples. A 48-hour cure time was used for all initial use and reuse tests. Test data are presented as removal torque versus removal angle with the specification required prevailing torque range added for performance assessment. Percent specification pass rates for the all combinations of fastener material, adhesive, and assembly condition are tabulated and reveal use of anaerobic adhesive as a prevailing torque locking feature is viable. Although not every possible fastener material and anaerobic adhesive combination provides prevailing torque values within specification, any combination can be assessed using the test procedures presented. Reuse without additional anaerobic adhesive generally provides some prevailing torque, and in some cases within specification. Reuse with additional adhesive often provides comparable removal torque data as in initial use.

21 CFR 14.145 - Procedures of a color additive advisory committee.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Procedures of a color additive advisory committee... SERVICES GENERAL PUBLIC HEARING BEFORE A PUBLIC ADVISORY COMMITTEE Color Additive Advisory Committees § 14.145 Procedures of a color additive advisory committee. (a) A color additive advisory committee is...

Interval Female Sterilization.

PubMed

Stuart, Gretchen S; Ramesh, Shanthi S

2018-01-01

Female sterilization is relied on by nearly one in three women aged 35-44 years in the United States. Sterilization procedures are among the most common procedures that obstetrician-gynecologists perform. The most frequent sterilization procedures include postpartum tubal ligation, laparoscopic tubal disruption or salpingectomy, and hysteroscopic tubal occlusion. The informed consent process for sterilization is crucial and requires shared decision-making between the patient and the health care provider. Counseling should include the specific risks and benefits of the specific surgical approaches. Additionally, women should be counseled on the alternatives to sterilization, including intrauterine contraceptives and subdermal contraceptive implants. Complications, including unplanned pregnancy after successful female sterilization, are rare. The objectives of this Clinical Expert Series are to describe the epidemiology of female sterilization, access to postpartum sterilization, advances in interval sterilization techniques, and clinical considerations in caring for women requesting sterilization.

Equipment management user's handbook for property custodians

NASA Technical Reports Server (NTRS)

1993-01-01

The NASA Equipment Management User's Handbook for Property Custodians is issued as an instructional guide for personnel designated as property custodians and technical personnel involved in the acquisition, management, and use of NASA-owned equipment. This handbook provides general information and basic operational procedures for processing equipment transactions through the agency-wide NASA Equipment Management System (NEMS). Each NASA installation must prepare supplementary instructions for local requirements beyond the scope of NASA-wide policies and procedures contained herein, or as specified for local implementation in NHB 4200.1, 'NASA Equipment Management Manual.' NHB 4200.1 sets forth policy, uniform performance standards, and procedural guidance to NASA personnel for the acquisition, management, and use of NASA-owned equipment. This handbook is a controlled document, issued in loose-leaf form and revised by page changes. Additional copies for internal use may be obtained through normal distribution.

Optical coherence tomography for an in-vivo study of posterior-capsule-opacification types and their influence on the total-pulse energy required for Nd:YAG capsulotomy: a case series.

PubMed

Hawlina, Gregor; Perovšek, Darko; Drnovšek-Olup, Brigita; MoŽina, Janez; Gregorčič, Peter

2014-11-18

Posterior capsule opacification (PCO) is the most common post-operative complication associated with cataract surgery and is mostly treated with Nd:YAG laser capsulotomy. Here, we demonstrate the use of high-resolution spectral-domain optical coherence tomography (OCT) as a technique for PCO analysis. Additionally, we evaluate the influence of PCO types and the distance between the intraocular lens (IOL) and the posterior capsule (PC), i.e., the IOL/PC distance, on the total-pulse energy required for the Nd:YAG laser posterior capsulotomy. 47 eyes with PCO scheduled for the Nd:YAG procedure were examined and divided into four categories: fibrosis, pearl, mixed type and late-postoperative capsular bag distension syndrome. Using custom-made computer software for OCT image analysis, the IOL/PC distances in two dimensions were measured. The IOL/PC distances were compared with those of a control group of 15 eyes without PCO. The influence of the different PCO types and the IOL/PC distance on the total-pulse energy required for the Nd:YAG procedure was analyzed. The total-pulse energy required for a laser capsulotomy differs significantly between PCO types (p = 0.005, Kruskal-Wallis test). The highest energy was required for the fibrosis PCO type, followed by mixed, pearl and late-postoperative capsular bag distension syndrome. The IOL/PC distance also significantly influenced the total-pulse energy required for laser capsulotomy (p = 0.028, linear regression). Lower total-pulse energy was expected for a larger IOL/PC distance. Our study indicates that the PCO types and the IOL/PC distance influence the total-pulse energy required for Nd:YAG capsulotomy. The presented OCT method has the potential to become an additional tool for PCO characterization. Our results are important for a better understanding of the photodisruptive mechanisms in Nd:YAG capsulotomy.

Retinal complications after aqueous shunt surgical procedures for glaucoma.

PubMed

Law, S K; Kalenak, J W; Connor, T B; Pulido, J S; Han, D P; Mieler, W F

1996-12-01

To assess retinal complications and to identify risk factors for retinal complications following aqueous shunt procedures. Records of 38 consecutive aqueous shunt procedures that were performed on 36 patients at the Eye Institute of the Medical College of Wisconsin, Milwaukee, from June 1993 to March 1995 (minimum follow-up, 6 months) were reviewed. The mean +/- SD follow-up was 11.4 +/- 5.2 months (median, 10.5 months). Twelve patients (32%) had the following retinal complications: 4 serous choroidal effusions (10%) that required drainage, 3 suprachoroidal hemorrhages (8%), 2 vitreous hemorrhages (5%), 1 rhegmatogenous retinal detachment (3%), 1 endophthalmitis (3%), and 1 scleral buckling extrusion (3%). Surgical procedures for retinal complications were required in 8 (67%) of these 12 patients. Visual acuity decreased 2 lines or more in 9 (75%) of these 12 patients. The median onset of a postoperative retinal complication was 12.5 days, with 10 patients (83%) experiencing complications within 35 days. Serous choroidal effusions developed in 10 other patients (26%), and these effusions resolved spontaneously. Visual acuity decreased 2 lines or more in 2 (20%) of these additional 10 patients. Patients who experienced serious retinal complications were significantly older, had a higher rate of hypertension, and postoperative ocular hypotony. Serious retinal complications were distributed evenly among patients with Krupin valves with discs and Molteno and Baerveldt devices. Experience with the Ahmed glaucoma valve implant was limited. Aqueous shunt procedures may be associated with significant retinal complications and subsequent visual loss.

Microbiological water methods: quality control measures for Federal Clean Water Act and Safe Drinking Water Act regulatory compliance.

PubMed

Root, Patsy; Hunt, Margo; Fjeld, Karla; Kundrat, Laurie

2014-01-01

Quality assurance (QA) and quality control (QC) data are required in order to have confidence in the results from analytical tests and the equipment used to produce those results. Some AOAC water methods include specific QA/QC procedures, frequencies, and acceptance criteria, but these are considered to be the minimum controls needed to perform a microbiological method successfully. Some regulatory programs, such as those at Code of Federal Regulations (CFR), Title 40, Part 136.7 for chemistry methods, require additional QA/QC measures beyond those listed in the method, which can also apply to microbiological methods. Essential QA/QC measures include sterility checks, reagent specificity and sensitivity checks, assessment of each analyst's capabilities, analysis of blind check samples, and evaluation of the presence of laboratory contamination and instrument calibration and checks. The details of these procedures, their performance frequency, and expected results are set out in this report as they apply to microbiological methods. The specific regulatory requirements of CFR Title 40 Part 136.7 for the Clean Water Act, the laboratory certification requirements of CFR Title 40 Part 141 for the Safe Drinking Water Act, and the International Organization for Standardization 17025 accreditation requirements under The NELAC Institute are also discussed.

Patterns and operative treatment of recurrent Crohn's disease: a prospective longitudinal study.

PubMed

Fichera, Alessandro; Lovadina, Stefano; Rubin, Michele; Cimino, Fabrizio; Hurst, Roger D; Michelassi, Fabrizio

2006-10-01

It is believed commonly that Crohn's recurrences always occur at the site of a previous intestinal anastomosis; yet this concept is probably inaccurate and not mindful of the panintestinal nature of the disease. Between October, 1984 and March, 2003, we carried out 1,132 procedures (464 for primary and 668 for recurrent disease) on 981 consecutive patients. Patients in whom we carried out both the original procedure as well as the procedure for recurrent disease constitute this study population. Operative procedures for perineal complications were excluded from this analysis. Data were accrued prospectively. Seventy-eight patients met the study inclusion criteria. They had a total of 149 sites of disease (duodenum, n = 3; jejunum/ileum, n = 53; terminal ileum/neo terminal ileum, n = 67; colon and rectum, n = 26). One hundred thirty-four sites required operative intervention (85 resections and 49 strictureplasties) and 15 did not. Crohn's disease recurred in 79 sites after a mean of 48.4 months (range, 1-161 months, median, 41 months). Site of operative intervention and operative technique influenced patterns of recurrence: when an anastomosis or strictureplasty was constructed with small bowel, the majority of recurrences were limited to the anastomotic line (17/29, 59%); when it was constructed with small bowel and colon, the majority of recurrences extended to the proximal limb (29/35, 83%). The difference in recurrence pattern is significant (P < .01). In addition, fewer recurrences occurred at strictureplasty than resection sites (22/49, 45%, vs 57/85, 70%, respectively, P < .05). At the time of the second procedure, 40 additional recurrences were identified distant from the original operative site. Four of these represented progression of disease at the 15 sites that did not originally need operative intervention. Of 119 total recurrences, 115 required 73 resections, 40 strictureplasties, and 2 other procedures. The site of the original operative intervention is the most common site for recurrence, although as many as one-third of recurrences occur separate from it. Pattern of recurrence is influenced by site of the operative intervention (anastomotic for small bowel, proximal limb for ileocolonic) and by operative technique (fewer recurrences occurred at strictureplasty than resection sites). Disease progression occurred in 25% of the sites not addressed operatively at the original procedure. The operative strategy applied to Crohn's complications in different intestinal sites was similar for primary and recurrent disease.

77 FR 72141 - Rules of Practice and Procedure for Hearings Before the Office of Administrative Law Judges

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-04

...The Department of Labor proposes to revise and reorganize the Rules of Practice and Procedure for Administrative Hearings Before the Office of Administrative Law Judges, from our regulations, which provide procedural guidance to administrative law judges, claimants, employers, and Department of Labor representatives seeking to resolve disputes under a variety of employment and labor laws. The Office of Administrative Law Judges promulgated these regulations in 1983. The regulations were modeled on the Federal Rules of Civil Procedure (FRCP) and have proved extraordinarily helpful in providing litigants with familiar rules governing hearing procedure. Since 1983, the FRCP have been amended many times. Moreover, in 2007 the FRCP were given a complete revision to improve style and clarity. The nature of litigation has also changed in the past 28 years, particularly in the areas of discovery and electronic records. Thus, OALJ has revised its regulations to make the rules more accessible and useful to parties, and to harmonize administrative hearing procedures with the current FRCP. The goal in amending the regulations is to provide clarity through the use of consistent terminology, structure and formatting so that parties have clear direction when pursuing or defending against a claim. In addition to revising the regulations to conform to modern legal procedure, the rules need to be modified to reflect the types of claims now heard by OALJ. When the rules were promulgated in 1983, OALJ primarily adjudicated occupational disease and injury cases. Presently, and looking ahead to the future, OALJ is and will be increasingly tasked with hearing whistleblower and other workplace retaliation claims, in addition to the occupational disease and injury cases. These types of cases require more structured management and oversight by the presiding administrative law judge and more sophisticated motions and discovery procedures than the current regulations provide. In order to best manage the complexities of whistleblower and discrimination claims, OALJ needs to update its rules to address the procedural questions that arise in these cases.

Spectroscopy applied to feed additives of the European Union Reference Laboratory: a valuable tool for traceability.

PubMed

Omar, Jone; Slowikowski, Boleslaw; Boix, Ana; von Holst, Christoph

2017-08-01

Feed additives need to be authorised to be placed on the market according to Regulation (EU) No. 1831/2003. Next to laying down the procedural requirements, the regulation creates the European Union Reference Laboratory for Feed Additives (EURL-FA) and requires that applicants send samples to the EURL-FA. Once authorised, the characteristics of the marketed feed additives should correspond to those deposited in the sample bank of the EURL-FA. For this purpose, the submitted samples were subjected to near-infrared (NIR) and Raman spectroscopy for spectral characterisation. These techniques have the valuable potential of characterising the feed additives in a non-destructive manner without any complicated sample preparation. This paper describes the capability of spectroscopy for a rapid characterisation of products to establish whether specific authorisation criteria are met. This study is based on the analysis of feed additive samples from different categories and functional groups, namely products containing (1) selenium, (2) zinc and manganese, (3) vitamins and (4) essential oils such as oregano and thyme oil. The use of chemometrics turned out to be crucial, especially in cases where the differentiation of spectra by visual inspection was very difficult.

A Hybrid Procedural/Deductive Executive for Autonomous Spacecraft

NASA Technical Reports Server (NTRS)

Pell, Barney; Gamble, Edward B.; Gat, Erann; Kessing, Ron; Kurien, James; Millar, William; Nayak, P. Pandurang; Plaunt, Christian; Williams, Brian C.; Lau, Sonie (Technical Monitor)

1998-01-01

The New Millennium Remote Agent (NMRA) will be the first AI system to control an actual spacecraft. The spacecraft domain places a strong premium on autonomy and requires dynamic recoveries and robust concurrent execution, all in the presence of tight real-time deadlines, changing goals, scarce resource constraints, and a wide variety of possible failures. To achieve this level of execution robustness, we have integrated a procedural executive based on generic procedures with a deductive model-based executive. A procedural executive provides sophisticated control constructs such as loops, parallel activity, locks, and synchronization which are used for robust schedule execution, hierarchical task decomposition, and routine configuration management. A deductive executive provides algorithms for sophisticated state inference and optimal failure recover), planning. The integrated executive enables designers to code knowledge via a combination of procedures and declarative models, yielding a rich modeling capability suitable to the challenges of real spacecraft control. The interface between the two executives ensures both that recovery sequences are smoothly merged into high-level schedule execution and that a high degree of reactivity is retained to effectively handle additional failures during recovery.

40 CFR 63.1549 - Recordkeeping and reporting requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the practices described in the standard operating procedures manual required under § 63.1544(a) for... described in the standard operating procedures manual for baghouses required under § 63.1547(a). (6) If an... in the standard operating procedures manual for baghouses required under § 63.1547(a), including an...

40 CFR 63.1549 - Recordkeeping and reporting requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... the practices described in the standard operating procedures manual required under § 63.1544(a) for... described in the standard operating procedures manual for baghouses required under § 63.1547(a). (6) If an... in the standard operating procedures manual for baghouses required under § 63.1547(a), including an...

40 CFR 63.550 - Recordkeeping and reporting requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

..., corrective action, report, or record, according to § 63.10(b)(1). (b) The standard operating procedures... standard operating procedures manual for baghouses required under § 63.548(a). (4) Electronic records of... required as part of the practices described in the standard operating procedures manual required under § 63...

40 CFR 63.550 - Recordkeeping and reporting requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

..., corrective action, report, or record, according to § 63.10(b)(1). (b) The standard operating procedures... standard operating procedures manual for baghouses required under § 63.548(a). (4) Electronic records of... required as part of the practices described in the standard operating procedures manual required under § 63...

40 CFR 63.550 - Recordkeeping and reporting requirements.

Code of Federal Regulations, 2014 CFR

2014-07-01

..., corrective action, report, or record, according to § 63.10(b)(1). (b) The standard operating procedures... standard operating procedures manual for baghouses required under § 63.548(a). (4) Electronic records of... required as part of the practices described in the standard operating procedures manual required under § 63...

75 FR 68297 - Pesticides; Satisfaction of Data Requirements; Procedures To Ensure Protection of Data Submitters...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-05

... Pesticides; Satisfaction of Data Requirements; Procedures To Ensure Protection of Data Submitters' Rights... regulations governing procedures for the satisfaction of data requirements under the Federal Insecticide... ground water. C. Satisfaction of Data Requirements EPA regulations in 40 CFR part 152, subpart E...

Standing sedation in African elephants (Loxodonta africana) using detomidine-butorphanol combinations.

PubMed

Neiffer, Donald L; Miller, Michele A; Weber, Martha; Stetter, Mark; Fontenot, Deidre K; Robbins, P K; Pye, Geoffrey W

2005-06-01

Standing sedation was provided for 14 clinical procedures in three African elephants (Loxodonta africana) managed by combined protected and modified-protected contact and trained through operant conditioning. An initial hand-injection of detomidine hydrochloride and butorphanol tartrate at a ratio of 1:1 on a microg:microg basis was administered intramuscularly, with a dosage range of 50-70 mg (12.9-19.7 microg/kg) for each drug. The initial injection resulted in adequate sedation for initiation and completion of eight procedures, whereas supplemental doses were required for the remaining procedures. The dosage range for the supplemental injections of each drug was 4.0-7.3 microg/kg. Initial effect was noted within 3.0-25 min (mean = 11.6 min, SD +/- 5.9 min), with maximal effect occurring at 25-30 min for those procedures not requiring supplementation. In all but one procedure, this effect was maintained until the end of the procedure, which ranged from 47 to 98 min (mean = 74.7 min, SD +/- 18.8 min). No cardiac or respiratory depression was appreciated. Recovery after administration of reversal agents was rapid and complete, ranging from 2 to 20 min (mean = 9.0 min, SD +/- 7.0 min). On the basis of the authors' experience, recommended dosage ranges for reversal agents would be intravenous yohimbine (73.4-98.5 microg/kg), intravenous naltrexone (48.9-98.5 microg/kg), and intramuscular naltrexone (73.4-98.5 microg/kg). Approximately one-third to one-half of the total naltrexone dose should be administered intravenously. Mild adverse side effects limited to the gastrointestinal tract were observed in association with five procedures including abdominal distention with or without transient anorexia. Administration of reversal agents, encouraging exercise and water consumption, and administration of flunixin meglumine were helpful in the resolution of signs. In addition to gastrointestinal signs, slight ataxia was observed before initiation of surgical stimulation during one procedure in which 19.7 microg/kg of each drug was administered. On the basis of the procedures that did not require supplementation to initiate treatment and taking into consideration the potential for ataxia at higher doses, a starting dosage range of 14.7-16.2 microg/kg of both detomidine and butorphanol in a ratio of 1:1 on a microg:microg basis administered i.m. simultaneously is recommended.

IEEE 1547 Standards Advancing Grid Modernization

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

Basso, Thomas; Chakraborty, Sudipta; Hoke, Andy

Technology advances including development of advanced distributed energy resources (DER) and grid-integrated operations and controls functionalities have surpassed the requirements in current standards and codes for DER interconnection with the distribution grid. The full revision of IEEE Standards 1547 (requirements for DER-grid interconnection and interoperability) and 1547.1 (test procedures for conformance to 1547) are establishing requirements and best practices for state-of-the-art DER including variable renewable energy sources. The revised standards will also address challenges associated with interoperability and transmission-level effects, in addition to strictly addressing the distribution grid needs. This paper provides the status and future direction of the ongoingmore » development focus for the 1547 standards.« less

Functional and Aesthetic Outcome Enhancement of Head and Neck Reconstruction through Secondary Procedures

PubMed Central

Hofer, Stefan O.P.; Payne, Caroline E.

2010-01-01

The foundation of head and neck reconstruction is based on two pillars: the restoration of function and the restoration of aesthetics. The objective of this article is to provide insight into how to prevent undesirable functional and aesthetic outcome after the initial procedure and also to provide solutions for enhancement of functional and aesthetic outcome with secondary procedures. Functional and aesthetic outcome enhancement is discussed in relation to the individual structures within the oral cavity, for the mandible, and for facial reconstruction. Normal prerequisites for all individual structures are described, and key points for restoration of these functional and aesthetic issues are proposed. In addition, further suggestions to improve suboptimal results after initial reconstructive surgery are presented. Understanding the function and aesthetics of the area to be reconstructed will allow appropriate planning and management of the initial reconstruction. Secondary enhancement should be attainable by minor procedures rather than a requirement to redo the initial reconstruction. PMID:22550452

Evaluation of modal pushover-based scaling of one component of ground motion: Tall buildings

USGS Publications Warehouse

Kalkan, Erol; Chopra, Anil K.

2012-01-01

Nonlinear response history analysis (RHA) is now increasingly used for performance-based seismic design of tall buildings. Required for nonlinear RHAs is a set of ground motions selected and scaled appropriately so that analysis results would be accurate (unbiased) and efficient (having relatively small dispersion). This paper evaluates accuracy and efficiency of recently developed modal pushover–based scaling (MPS) method to scale ground motions for tall buildings. The procedure presented explicitly considers structural strength and is based on the standard intensity measure (IM) of spectral acceleration in a form convenient for evaluating existing structures or proposed designs for new structures. Based on results presented for two actual buildings (19 and 52 stories, respectively), it is demonstrated that the MPS procedure provided a highly accurate estimate of the engineering demand parameters (EDPs), accompanied by significantly reduced record-to-record variability of the responses. In addition, the MPS procedure is shown to be superior to the scaling procedure specified in the ASCE/SEI 7-05 document.

Efficient placement of structural dynamics sensors on the space station

NASA Technical Reports Server (NTRS)

Lepanto, Janet A.; Shepard, G. Dudley

1987-01-01

System identification of the space station dynamic model will require flight data from a finite number of judiciously placed sensors on it. The placement of structural dynamics sensors on the space station is a particularly challenging problem because the station will not be deployed in a single mission. Given that the build-up sequence and the final configuration for the space station are currently undetermined, a procedure for sensor placement was developed using the assembly flights 1 to 7 of the rephased dual keel space station as an example. The procedure presented approaches the problem of placing the sensors from an engineering, as opposed to a mathematical, point of view. In addition to locating a finite number of sensors, the procedure addresses the issues of unobserved structural modes, dominant structural modes, and the trade-offs involved in sensor placement for space station. This procedure for sensor placement will be applied to revised, and potentially more detailed, finite element models of the space station configuration and assembly sequence.

39 CFR 230.26 - Do these rules affect the service of process requirements of the Federal Rules of Civil Procedure...

Code of Federal Regulations, 2011 CFR

2011-07-01

... requirements of the Federal Rules of Civil Procedure (28 U.S.C. Appendix)? 230.26 Section 230.26 Postal Service....26 Do these rules affect the service of process requirements of the Federal Rules of Civil Procedure... Rules of Civil Procedure regarding service of process. ...

IDSE Version 1 User's Manual

NASA Technical Reports Server (NTRS)

Mayer, Richard

1988-01-01

The integrated development support environment (IDSE) is a suite of integrated software tools that provide intelligent support for information modelling. These tools assist in function, information, and process modeling. Additional tools exist to assist in gathering and analyzing information to be modeled. This is a user's guide to application of the IDSE. Sections covering the requirements and design of each of the tools are presented. There are currently three integrated computer aided manufacturing definition (IDEF) modeling methodologies: IDEF0, IDEF1, and IDEF2. Also, four appendices exist to describe hardware and software requirements, installation procedures, and basic hardware usage.

Correction for intravascular activity in the oxygen-15 steady-state technique is independent of the regional hematocrit

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

Lammertsma, A.A.; Baron, J.C.; Jones, T.

1987-06-01

The oxygen-15 steady-state technique to measure the regional cerebral metabolic rate for oxygen requires a correction for the nonextracted intravascular molecular oxygen-15. To perform this correction, an additional procedure is carried out using RBCs labeled with /sup 11/CO or C/sup 15/O. The previously reported correction method, however, required knowledge of the regional cerebral to large vessel hematocrit ratio. A closer examination of the underlying model eliminated this ratio. Both molecular oxygen and carbon monoxide are carried by RBCs and are therefore similarly affected by a change in hematocrit.

48 CFR 6.102 - Use of competitive procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... ACQUISITION PLANNING COMPETITION REQUIREMENTS Full and Open Competition 6.102 Use of competitive procedures. The competitive procedures available for use in fulfilling the requirement for full and open... procedures (e.g., two-step sealed bidding). (d) Other competitive procedures. (1) Selection of sources for...

A Framework for Dynamic Constraint Reasoning Using Procedural Constraints

NASA Technical Reports Server (NTRS)

Jonsson, Ari K.; Frank, Jeremy D.

1999-01-01

Many complex real-world decision and control problems contain an underlying constraint reasoning problem. This is particularly evident in a recently developed approach to planning, where almost all planning decisions are represented by constrained variables. This translates a significant part of the planning problem into a constraint network whose consistency determines the validity of the plan candidate. Since higher-level choices about control actions can add or remove variables and constraints, the underlying constraint network is invariably highly dynamic. Arbitrary domain-dependent constraints may be added to the constraint network and the constraint reasoning mechanism must be able to handle such constraints effectively. Additionally, real problems often require handling constraints over continuous variables. These requirements present a number of significant challenges for a constraint reasoning mechanism. In this paper, we introduce a general framework for handling dynamic constraint networks with real-valued variables, by using procedures to represent and effectively reason about general constraints. The framework is based on a sound theoretical foundation, and can be proven to be sound and complete under well-defined conditions. Furthermore, the framework provides hybrid reasoning capabilities, as alternative solution methods like mathematical programming can be incorporated into the framework, in the form of procedures.

Calibration of 3D ultrasound to an electromagnetic tracking system

NASA Astrophysics Data System (ADS)

Lang, Andrew; Parthasarathy, Vijay; Jain, Ameet

2011-03-01

The use of electromagnetic (EM) tracking is an important guidance tool that can be used to aid procedures requiring accurate localization such as needle injections or catheter guidance. Using EM tracking, the information from different modalities can be easily combined using pre-procedural calibration information. These calibrations are performed individually, per modality, allowing different imaging systems to be mixed and matched according to the procedure at hand. In this work, a framework for the calibration of a 3D transesophageal echocardiography probe to EM tracking is developed. The complete calibration framework includes three required steps: data acquisition, needle segmentation, and calibration. Ultrasound (US) images of an EM tracked needle must be acquired with the position of the needles in each volume subsequently extracted by segmentation. The calibration transformation is determined through a registration between the segmented points and the recorded EM needle positions. Additionally, the speed of sound is compensated for since calibration is performed in water that has a different speed then is assumed by the US machine. A statistical validation framework has also been developed to provide further information related to the accuracy and consistency of the calibration. Further validation of the calibration showed an accuracy of 1.39 mm.

Context-driven Salt Seeking Test (Rats)

PubMed Central

Chang, Stephen E.; Smith, Kyle S.

2018-01-01

Changes in reward seeking behavior often occur through incremental learning based on the difference between what is expected and what actually happens. Behavioral flexibility of this sort requires experience with rewards as better or worse than expected. However, there are some instances in which behavior can change through non-incremental learning, which requires no further experience with an outcome. Such an example of non-incremental learning is the salt appetite phenomenon. In this case, animals such as rats will immediately seek out a highly-concentrated salt solution that was previously undesired when they are put in a novel state of sodium deprivation. Importantly, this adaptive salt-seeking behavior occurs despite the fact that the rats never tasted salt in the depleted state, and therefore never tasted it as a highly desirable reward. The following protocol is a method to investigate the neural circuitry mediating adaptive salt seeking using a conditioned place preference (CPP) procedure. The procedure is designed to provide an opportunity to discover possible dissociations between the neural circuitry mediating salt seeking and salt consumption to replenish the bodily deficit after sodium depletion. Additionally, this procedure is amenable to incorporating a number of neurobiological techniques for studying the brain basis of this behavior.

Fluoroscopic Placement of Double-Pigtail Ureteral Stents

PubMed Central

Chen, Gregory L.

2001-01-01

Purpose: Double-pigtail ureteral stent is placed cystoscopically after ureteroscopy. We describe a technique for fluoroscopic placement of ureteral stents and demonstrate its use in a non-randomized prospective study. Materials and methods: Double-pigtail stents were placed either fluoroscopically or cystoscopically in 121 consecutive patients. In the fluoroscopic method, the stent was placed over a guide wire using a stent pusher without the use of cystoscopy. Conversely, stents were placed through the working channel of the cystoscope under vision. The procedure, stent length, width, type, method, ureteral dilation, and use of a retrieval string were noted. Results: A wide range of stent sizes were used. The success with fluoroscopic placement of double-pigtail ureteral stents was 100% (89 of 89 cases). No stents migrated or required replacement. Stents were placed after ureteroscopic laser lithotripsy (53/89) and ureteroscopic tumor treatment (22/89). Cystoscopic visualization was used in 32 additional procedures requiring precise control (15 ureteral strictures and nine retrograde endopyelotomy). Conclusions: The fluoroscopic placement of ureteral stents is a safe and simple technique with a very high success rate. We have used cystoscopic placement only after incisional procedures such as retrograde endopyelotomy, stricture or ureterotomy. PMID:18493562

Ultra Pure Water Cleaning Baseline Study on NASA JSC Astromaterial Curation Gloveboxes

NASA Technical Reports Server (NTRS)

Calaway, Michael J.; Burkett, P. J.; Allton, J. H.; Allen, C. C.

2013-01-01

Future sample return missions will require strict protocols and procedures for reducing inorganic and organic contamination in isolation containment systems. In 2012, a baseline study was orchestrated to establish the current state of organic cleanliness in gloveboxes used by NASA JSC astromaterials curation labs [1, 2]. As part of this in-depth organic study, the current curatorial technical support procedure (TSP) 23 was used for cleaning the gloveboxes with ultra pure water (UPW) [3-5]. Particle counts and identification were obtained that could be used as a benchmark for future mission designs that require glovebox decontamination. The UPW baseline study demonstrates that TSP 23 works well for gloveboxes that have been thoroughly degreased. However, TSP 23 could be augmented to provide even better glovebox decontamination. JSC 03243 could be used as a starting point for further investigating optimal cleaning techniques and procedures. DuPont Vertrel XF or other chemical substitutes to replace Freon- 113, mechanical scrubbing, and newer technology could be used to enhance glovebox cleanliness in addition to high purity UPW final rinsing. Future sample return missions will significantly benefit from further cleaning studies to reduce inorganic and organic contamination.

Interventional procedures and future drug therapy for hypertension

PubMed Central

Lobo, Melvin D.; Sobotka, Paul A.; Pathak, Atul

2017-01-01

Hypertension management poses a major challenge to clinicians globally once non-drug (lifestyle) measures have failed to control blood pressure (BP). Although drug treatment strategies to lower BP are well described, poor control rates of hypertension, even in the first world, suggest that more needs to be done to surmount the problem. A major issue is non-adherence to antihypertensive drugs, which is caused in part by drug intolerance due to side effects. More effective antihypertensive drugs are therefore required which have excellent tolerability and safety profiles in addition to being efficacious. For those patients who either do not tolerate or wish to take medication for hypertension or in whom BP control is not attained despite multiple antihypertensives, a novel class of interventional procedures to manage hypertension has emerged. While most of these target various aspects of the sympathetic nervous system regulation of BP, an additional procedure is now available, which addresses mechanical aspects of the circulation. Most of these new devices are supported by early and encouraging evidence for both safety and efficacy, although it is clear that more rigorous randomized controlled trial data will be essential before any of the technologies can be adopted as a standard of care. PMID:27406184

Collection, quality control and delivery of ground-based magnetic data during ESA's Swarm mission

NASA Astrophysics Data System (ADS)

Macmillan, Susan; Humphries, Thomas; Flower, Simon; Swan, Anthony

2016-04-01

Ground-based magnetic data are used in a variety of ways when analysing satellite data. Selecting satellite data often involves the use of magnetic disturbance indices derived from ground-based stations and inverting satellite magnetic data for models of fields from various sources often requires ground-based data. Ground-based data can also be valuable independent data for validation purposes. We summarise data collection and quality control procedures in place at the British Geological Survey for global ground-based observatory and repeat station data. Whilst ongoing participation in the ICSU World Data System and INTERMAGNET facilitates this work, additional procedures have been specially developed for the Swarm mission. We describe these in detail.

Developing Characterization Procedures for Qualifying both Novel Selective Laser Sintering Polymer Powders and Recycled Powders

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

Bajric, Sendin

Selective laser sintering (SLS) is an additive technique which is showing great promise over conventional manufacturing techniques. SLS requires certain key material properties for a polymer powder to be successfully processed into an end-use part, and therefore limited selection of materials are available. Furthermore, there has been evidence of a powder’s quality deteriorating following each SLS processing cycle. The current investigation serves to build a path forward in identifying new SLS powder materials by developing characterization procedures for identifying key material properties as well as for detecting changes in a powder’s quality. Thermogravimetric analyses, differential scanning calorimetry, and bulk densitymore » measurements were investigated.« less

BEHAVIORAL COACHING TO IMPROVE OFFENSIVE LINE PASS-BLOCKING SKILLS OF HIGH SCHOOL FOOTBALL ATHLETES

PubMed Central

Stokes, John V; Luiselli, James K; Reed, Derek D; Fleming, Richard K

2010-01-01

We evaluated several behavioral coaching procedures for improving offensive line pass-blocking skills with 5 high school varsity football players. Pass blocking was measured during practice drills and games, and our intervention included descriptive feedback with and without video feedback and teaching with acoustical guidance (TAG). Intervention components and pass blocking were evaluated in a multiple baseline design, which showed that video feedback and TAG were the most effective procedures. For all players, improved pass blocking matched a standard derived by observing more experienced linemen and was evident in games. Additional intervention was required to maintain pass-blocking proficiency. Issues pertinent to behavioral coaching and sport psychology research are discussed. PMID:21358905

21 CFR 111.553 - What are the requirements under this subpart O for written procedures?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 2 2010-04-01 2010-04-01 false What are the requirements under this subpart O for... What are the requirements under this subpart O for written procedures? You must establish and follow written procedures to fulfill the requirements of this subpart O. ...

5 CFR 179.309 - Additional administrative procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Additional administrative procedures. 179.309 Section 179.309 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS CLAIMS COLLECTION STANDARDS Administrative Offset § 179.309 Additional administrative procedures. Nothing...

Ballistic Evaluation of 6055 Aluminum

DTIC Science & Technology

2015-09-01

impacts from various munitions including armor-piercing (AP) and fragment-simulating projectiles (FSPs). Additionally, Table 2 provides the required...percentage of the combination of silicon and iron cannot exceed 0.40%. 2. Experimental Procedure The V50 is defined as the impact velocity at which...152 mm (6 inches) behind the target to determine the outcome of each shot. An impact is regarded as a complete penetration (CP), or loss, if the

Dataset demonstrating effects of momentum transfer on sizing of current collector for lithium-ion batteries during laser cutting.

PubMed

Lee, Dongkyoung; Mazumder, Jyotirmoy

2018-04-01

Material properties of copper and aluminum required for the numerical simulation are presented. Electrodes used for the (paper) are depicted. This study describes the procedures of how penetration depth, width, and absorptivity are obtained from the simulation. In addition, a file format extracted from the simulation to visualize 3D distribution of temperature, velocity, and melt pool geometry is presented.

Leadership and Management of Medical Treatment Facilities: Case Study of Charleston Naval Hospital, 1988-1993

DTIC Science & Technology

1993-06-01

Additional preparations included conducting nurse training in trauma/combat casualty care , streamlining the patient admissions and tracking procedures...departments (i.e. surgery, ambulatory care , operating rooms, maternity ward, etc.) cooperation between the Director of Nursing and the directors of clinical...provide the 107 At quality care , staff support from nursing , administration, and ancillary services was required. s Director for Surgical Services The

Development of Methods for Carrier-Mediated Targeted Delivery of Antiviral Compounds Using Monoclonal Antibodies

DTIC Science & Technology

1987-04-01

2. Comparison of Immunofluorescent Staining in Formaldehyde-Fixed Pichlnde Virus-Infected Cells That Had Been either Dried prior to Reaction with...was undertaken. 37 &aa&&3&M ^.{m^mmsmmmmmmmmmiä B. Experimental Methods General Procedures and Instrumentation. When required, reactions and...period, the reaction mixture was red and efficient stirring became very difficult. After the addition was complete, the reaction mixture was allowed

A review of virtual reality based training simulators for orthopaedic surgery.

PubMed

Vaughan, Neil; Dubey, Venketesh N; Wainwright, Thomas W; Middleton, Robert G

2016-02-01

This review presents current virtual reality based training simulators for hip, knee and other orthopaedic surgery, including elective and trauma surgical procedures. There have not been any reviews focussing on hip and knee orthopaedic simulators. A comparison of existing simulator features is provided to identify what is missing and what is required to improve upon current simulators. In total 11 hip replacements pre-operative planning tools were analysed, plus 9 hip trauma fracture training simulators. Additionally 9 knee arthroscopy simulators and 8 other orthopaedic simulators were included for comparison. The findings are that for orthopaedic surgery simulators in general, there is increasing use of patient-specific virtual models which reduce the learning curve. Modelling is also being used for patient-specific implant design and manufacture. Simulators are being increasingly validated for assessment as well as training. There are very few training simulators available for hip replacement, yet more advanced virtual reality is being used for other procedures such as hip trauma and drilling. Training simulators for hip replacement and orthopaedic surgery in general lag behind other surgical procedures for which virtual reality has become more common. Further developments are required to bring hip replacement training simulation up to date with other procedures. This suggests there is a gap in the market for a new high fidelity hip replacement and resurfacing training simulator. Copyright © 2015 IPEM. Published by Elsevier Ltd. All rights reserved.

Certification of lightning protection for a full-authority digital engine control

NASA Technical Reports Server (NTRS)

Dargi, M.; Rupke, E.; Wiles, K.

1991-01-01

FADEC systems present many challenges to the lightning protection engineer. Verification of the protection-design adequacy for certification purposes presents additional challenges. The basic requirements of the certification plan of a FADEC is to demonstrate compliance with Federal Airworthiness Regulations (FAR) 25.1309 and 25.581. These FARs are intended for transport aircraft, but there are equivalent sections for general aviation aircraft, normal and transport rotorcraft. Military aircraft may have additional requirements. The criteria for demonstration of adequate lightning protection for a FADEC systems include the procedures outlined in FAA Advisory Circular (AC) 20-136, Protection of aircraft electrical/electronic systems against the indirect effects of lightning. As FADEC systems, including the interconnecting wiring, are generally not susceptible to direct attachment of lightning currents, the verification of protection against indirect effects is primarily described.

The DRIL procedure for arteriovenous access ischemic steal: a controversial approach.

PubMed

Davidson, Ingemar; Beathard, Gerald; Gallieni, Maurizio; Ross, John

2017-01-18

The DRIL procedure first described in 1988 has long been considered the preferred treatment for arteriovenous access ischemic steal (AVAIS). At the time it was a brilliant concept and breakthrough. In the last decade, the DRIL procedure has become less used. With the increasing age of the dialysis population, patients developing AVAIS are more likely to be elderly with advanced peripheral arterial disease, making the distal revascularization anastomosis difficult and risky if not impossible to perform. In addition, the distal ligation of the main artery to the arm is something most surgeons are reluctant to do. The occlusion of the arterial bypass over time is not uncommon with recurrence of hand ischemia. The multistep DRIL procedure requires general anesthesia and the need to harvest the saphenous vein for the bypass, add to the surgical risk in patients with multiple co-morbidities. For these reasons, some surgeons prefer to do only the DR (distal re-vascularization) portion of the procedure omitting the IL (interval ligation). Increasing the bypass distance from the original anastomosis, makes this modification similar to the less invasive proximal arterial inflow (PAI) procedure. Because of changes in the patient population clinical presentation, most notably forearm atherosclerosis and with new technologies, this editorial addresses the current validity of the DRIL procedure as a safe option in treating AVAIS.

Additional Samples: Where They Should Be Located

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

Pilger, G. G., E-mail: jfelipe@ufrgs.br; Costa, J. F. C. L.; Koppe, J. C.

2001-09-15

Information for mine planning requires to be close spaced, if compared to the grid used for exploration and resource assessment. The additional samples collected during quasimining usually are located in the same pattern of the original diamond drillholes net but closer spaced. This procedure is not the best in mathematical sense for selecting a location. The impact of an additional information to reduce the uncertainty about the parameter been modeled is not the same everywhere within the deposit. Some locations are more sensitive in reducing the local and global uncertainty than others. This study introduces a methodology to select additionalmore » sample locations based on stochastic simulation. The procedure takes into account data variability and their spatial location. Multiple equally probable models representing a geological attribute are generated via geostatistical simulation. These models share basically the same histogram and the same variogram obtained from the original data set. At each block belonging to the model a value is obtained from the n simulations and their combination allows one to access local variability. Variability is measured using an uncertainty index proposed. This index was used to map zones of high variability. A value extracted from a given simulation is added to the original data set from a zone identified as erratic in the previous maps. The process of adding samples and simulation is repeated and the benefit of the additional sample is evaluated. The benefit in terms of uncertainty reduction is measure locally and globally. The procedure showed to be robust and theoretically sound, mapping zones where the additional information is most beneficial. A case study in a coal mine using coal seam thickness illustrates the method.« less

Clinical efficacy of periodontal plastic surgery procedures: consensus report of Group 2 of the 10th European Workshop on Periodontology.

PubMed

Tonetti, Maurizio S; Jepsen, Søren

2014-04-01

The scope of the discussions of this consensus report was to assess the strength of the scientific evidence and make clinical and research recommendations for surgical interventions to cover exposed root surfaces and enhance soft tissues at implants. Discussions were informed by three systematic reviews covering single recessions, multiple recessions and soft-tissue deficiencies at implants. The strength of the evidence was assessed using a modification in GRADE. The group also emphasized the need to report the experience of the surgeon and the performance of the control intervention (CONSORT guidelines for non-pharmacological treatment). A moderate strength of evidence supported the following statements for single (moderately deep, mostly maxillary) recessions without inter-dental attachment loss: (i) The addition of a connective tissue graft (CTG) improved outcomes of coronally advanced flaps (CAF). (ii) The addition of enamel matrix derivative (EMD) improved the outcomes of CAF. For multiple recessions, preliminary data indicate that flaps specifically designed to treat this condition are worthy of additional attention. Emerging data indicate that it is possible to obtain complete root coverage at sites with some inter-dental attachment loss. With regards to soft-tissue deficiencies at implants, several procedures are available, but great heterogeneity among studies does not allow drawing conclusions at this time. The group highlighted that periodontal plastic procedures are complex, technique-sensitive interventions that require advanced skills and expertise. At single recessions, the addition of autologous CTG or EMD under CAF improves complete root coverage and may be considered the procedure of choice at maxillary anterior and premolar teeth. The adjunctive benefit needs to be put in the context of increased morbidity of the donor area or increased cost. Additional research is needed to: (i) assess the role of alternatives to autologous soft-tissue grafting in combination with CAF; (ii) identify the optimal surgical design and the need for additional soft-tissue grafting (or alternatives) at multiple recessions, recessions with inter-dental attachment loss and soft-tissue deficiencies at implants. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

A generic template for automated bioanalytical ligand-binding assays using modular robotic scripts in support of discovery biotherapeutic programs.

PubMed

Duo, Jia; Dong, Huijin; DeSilva, Binodh; Zhang, Yan J

2013-07-01

Sample dilution and reagent pipetting are time-consuming steps in ligand-binding assays (LBAs). Traditional automation-assisted LBAs use assay-specific scripts that require labor-intensive script writing and user training. Five major script modules were developed on Tecan Freedom EVO liquid handling software to facilitate the automated sample preparation and LBA procedure: sample dilution, sample minimum required dilution, standard/QC minimum required dilution, standard/QC/sample addition, and reagent addition. The modular design of automation scripts allowed the users to assemble an automated assay with minimal script modification. The application of the template was demonstrated in three LBAs to support discovery biotherapeutic programs. The results demonstrated that the modular scripts provided the flexibility in adapting to various LBA formats and the significant time saving in script writing and scientist training. Data generated by the automated process were comparable to those by manual process while the bioanalytical productivity was significantly improved using the modular robotic scripts.

21 CFR 821.25 - Device tracking system and content requirements: manufacturer requirements.

Code of Federal Regulations, 2014 CFR

2014-04-01

... accordance with its standard operating procedure of the information identified in paragraphs (a)(1), (a)(2... shall establish a written standard operating procedure for the collection, maintenance, and auditing of... standard operating procedure: (1) Data collection and recording procedures, which shall include a procedure...

Identification of factors associated with sedation tolerance in 5000 patients undergoing outpatient colonoscopy: Canadian tertiary center experience.

PubMed

Shingina, Alexandra; Ou, George; Takach, Oliver; Svarta, Sigrid; Kwok, Ricky; Tong, Jessica; Donaldson, Kieran; Lam, Eric; Enns, Robert

2016-12-16

To develop a prediction model aimed at identifying patients that may require higher than usual sedation doses during colonoscopy. A retrospective chart review on 5000 patients who underwent an outpatient colonoscopy at St. Paul's Hospital from 2009 to 2010 was conducted in order to develop a model for identifying patients who will require increased doses of sedatives. Potential predictor variables including age, gender, endoscopy indication, high sedation requirements during previous endoscopies, difficulty of the procedure, bowel preparation quality, interventions, findings as well as current use of benzodiazepines, opioids and alcohol were analyzed. The outcome of study was the use of high dose of sedation agents for the procedure. In particular, the high dose of sedation was defined as fentanyl greater than 50 mcg and midazolam greater than 3 mg. Analysis of 5282 patients (mean age 57 ± 12, 49% female) was performed. Most common indication for the procedure was screening colonoscopy (57%). Almost half of our patients received doses exceeding Fentanyl 50 mcg and Midazolam 3 mg. Logistic regression models identified the following variables associated with high sedation: Younger age (OR = 0.95 95%CI: 0.94-0.95; P < 0.0001); abdominal pain (OR = 1.45, 95%CI: 1.08-1.96); P = 0.01) and Inflammatory Bowel Disease (OR = 1.45, 95%CI: 1.04-2.03; P = 0.02) as indications for the procedure; difficult procedure as defined by gastroenterologist (OR = 1.73, 95%CI: 1.48-2.03; P < 0.0001); past history of abdominal surgery (OR = 1.33, 95%CI: 1.17-1.52; P <0.0001) and previous colonoscopy (OR = 1.39, 95%CI: 1.21-1.60; P = 0.0001) and alcohol use (OR = 1.26, 95%CI: 1.03-1.54; P = 0.02). Age and gender adjusted analysis yielded inflammatory bowel disease as an indication (OR = 3.17, 95%CI: 1.58-6.37; P = 0.002); difficult procedure as defined by an endoscopist (OR = 5.13 95%CI: 2.97-8.85; P = 0.0001) and current use of opioids, benzodiazepines or antidepressants (OR = 2.88, 95%CI: 1.74-4.77; P = 0.001) having the highest predictive value of high sedation requirements. Our prediction model using the following pre-procedural variables including age, gender, indication for the procedure, medication/substance use, previous surgeries, previous high sedation requirements for colonoscopy yielded an area under the curve of 0.76 for Fentanyl ≥ 100 mcg and Midazolam ≥ 3 mg. Pre-procedural planning is the key in conducting successful, efficient colonoscopy. Logistic regression analysis of 5000 patients who underwent out-patient colonoscopy revealed the following factors associated with increased sedation requirement: Younger age, female gender, difficult endoscopy, specific indications as well as cardiopulmonary complications and current use of opioids/benzodiazepines. Age and gender adjusted analysis yielded similar results. These patients are more likely to need a longer recovery periods post-endoscopy, which could result in additional time and personnel requirements. The final predictive model has good predictive ability for Fentanyl ≥ 100 mcg and Midazolam ≥ 3 mg and fair predictive ability for Fentanyl ≥ 50 mcg and Midazolam ≥ 2 mg. The external validity of this model is planned to be tested in another center.

10 CFR 1021.300 - General requirements.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 4 2013-01-01 2013-01-01 false General requirements. 1021.300 Section 1021.300 Energy DEPARTMENT OF ENERGY (GENERAL PROVISIONS) NATIONAL ENVIRONMENTAL POLICY ACT IMPLEMENTING PROCEDURES Implementing Procedures § 1021.300 General requirements. (a) DOE shall determine, under the procedures in the...

Quality-assurance plan for groundwater activities, U.S. Geological Survey, Washington Water Science Center

USGS Publications Warehouse

Kozar, Mark D.; Kahle, Sue C.

2013-01-01

This report documents the standard procedures, policies, and field methods used by the U.S. Geological Survey’s (USGS) Washington Water Science Center staff for activities related to the collection, processing, analysis, storage, and publication of groundwater data. This groundwater quality-assurance plan changes through time to accommodate new methods and requirements developed by the Washington Water Science Center and the USGS Office of Groundwater. The plan is based largely on requirements and guidelines provided by the USGS Office of Groundwater, or the USGS Water Mission Area. Regular updates to this plan represent an integral part of the quality-assurance process. Because numerous policy memoranda have been issued by the Office of Groundwater since the previous groundwater quality assurance plan was written, this report is a substantial revision of the previous report, supplants it, and contains significant additional policies not covered in the previous report. This updated plan includes information related to the organization and responsibilities of USGS Washington Water Science Center staff, training, safety, project proposal development, project review procedures, data collection activities, data processing activities, report review procedures, and archiving of field data and interpretative information pertaining to groundwater flow models, borehole aquifer tests, and aquifer tests. Important updates from the previous groundwater quality assurance plan include: (1) procedures for documenting and archiving of groundwater flow models; (2) revisions to procedures and policies for the creation of sites in the Groundwater Site Inventory database; (3) adoption of new water-level forms to be used within the USGS Washington Water Science Center; (4) procedures for future creation of borehole geophysics, surface geophysics, and aquifer-test archives; and (5) use of the USGS Multi Optional Network Key Entry System software for entry of routine water-level data collected as part of long-term water-level monitoring networks.

Patients with single ventricle physiology undergoing noncardiac surgery are at high risk for adverse events.

PubMed

Brown, Morgan L; DiNardo, James A; Odegard, Kirsten C

2015-08-01

Patients with single ventricle physiology are at increased anesthetic risk when undergoing noncardiac surgery. To review the outcomes of anesthetics for patients with single ventricle physiology undergoing noncardiac surgery. This study is a retrospective chart review of all patients who underwent a palliative procedure for single ventricle physiology between January 1, 2007 and January 31, 2014. Anesthetic and surgical records were reviewed for noncardiac operations that required sedation or general anesthesia. Any noncardiac operation occurring prior to completion of a bidirectional Glenn procedure was included. Diagnostic procedures, including cardiac catheterization, insertion of permanent pacemaker, and procedures performed in the ICU, were excluded. During the review period, 417 patients with single ventricle physiology had initial palliation. Of these, 70 patients (16.7%) underwent 102 anesthetics for 121 noncardiac procedures. The noncardiac procedures included line insertion (n = 23); minor surgical procedures such as percutaneous endoscopic gastrostomy or airway surgery (n = 38); or major surgical procedures including intra-abdominal and thoracic operations (n = 41). These interventions occurred on median day 60 of life (1-233 days). The procedures occurred most commonly in the operating room (n = 79, 77.5%). Patients' median weight was 3.4 kg (2.4-15 kg) at time of noncardiac intervention. In 102 anesthetics, 26 patients had an endotracheal tube or tracheostomy in situ, 57 patients underwent endotracheal intubation, and 19 patients had a natural or mask airway. An intravenous induction was performed in 77 anesthetics, an inhalational induction in 17, and a combination technique in 8. The median total anesthetic time was 126 min (14-594 min). In 22 anesthetics (21.6%), patients were on inotropic support upon arrival; an additional 24 patients required inotropic support (23.5%), of which dopamine was the most common medication. There were 10 intraoperative adverse events (9.8%) including: arrhythmias requiring treatment (n = 4), conversion from sedation to a general anesthetic (n = 2), difficult airway (n = 1), inadvertent extubation with desaturation and bradycardia (n = 1), hypotension and desaturation (n = 1), and cardiac arrest (n = 1). Postoperative events (<48 h) included ST segment changes requiring cardiac catheterization (n = 1), and cardiorespiratory arrest (n = 1). Age, size, gender, type of cardiac palliation, patient location, procedure location, and type of procedure were not associated with adverse outcome. After 62 anesthetics (60.8%), patients went postoperatively to the cardiac ICU. There were no deaths at 48 h. We observed no mortality during or after noncardiac surgery in a high-risk subgroup of palliated cardiac patients with single ventricle physiology. However, 11.8% of patients had an adverse event associated with their anesthetic. © 2015 John Wiley & Sons Ltd.

Compliance with infection control practices in an university hospital dental clinic

PubMed Central

Mutters, Nico T.; Hägele, Ulrike; Hagenfeld, Daniel; Hellwig, Elmar; Frank, Uwe

2014-01-01

Aim: Compliance with infection control practices is the key to quality care and excellence in dentistry. Infection control remains one of the most cost-beneficial interventions available. However, implementing control procedures requires full compliance of the whole dental team. The aim of our study was to measure the compliance in daily clinical practice. Methods: The compliance with infection control practices in dentistry by dental health care personnel (DHCP) in a German university dental clinic was observed during clinical work. In addition, a survey was conducted to assess the individual knowledge about infection control procedures. Contamination of the workplace during invasive dental procedures was tested, as well. Results: A total of 58 invasive dental treatments implying close contacts between HCWs and patients were scrutinized. All HCWs (100%) wore gloves during dental work, but in some cases (female dentists: 14.3%; dental assistants: 28.6%) gloves were neither changed nor hands were disinfected between different activities or patient contacts (female dentists: 68.6%; male dentists: 60.9%; dental assistants: 93%). Only 31.4% of female and 39.1% of male dentists carried out adequate hygienic hand disinfection after removing gloves. Male dentists wore significantly more often (100%) protective eyewear compared to 77.1% of female dentists (p<0.05). In addition, most of female dentists (62.9%) and dental assistants (80.7%) wore jewelry during dental procedures. Conclusion: Despite the knowledge of distinct hygiene procedures only a small percentage of dental staff performs hygiene practices according to recommended guidelines. Strict audit is clearly needed in the dental setting to ensure compliance with infection control guidelines to prevent transmission of pathogens. Our results provide insights for the development of a targeted education and training strategy to enhance compliance of dental staff especially of dental assistants with infection control procedures. PMID:25285262

Compliance with infection control practices in an university hospital dental clinic.

PubMed

Mutters, Nico T; Hägele, Ulrike; Hagenfeld, Daniel; Hellwig, Elmar; Frank, Uwe

2014-01-01

Compliance with infection control practices is the key to quality care and excellence in dentistry. Infection control remains one of the most cost-beneficial interventions available. However, implementing control procedures requires full compliance of the whole dental team. The aim of our study was to measure the compliance in daily clinical practice. The compliance with infection control practices in dentistry by dental health care personnel (DHCP) in a German university dental clinic was observed during clinical work. In addition, a survey was conducted to assess the individual knowledge about infection control procedures. Contamination of the workplace during invasive dental procedures was tested, as well. A total of 58 invasive dental treatments implying close contacts between HCWs and patients were scrutinized. All HCWs (100%) wore gloves during dental work, but in some cases (female dentists: 14.3%; dental assistants: 28.6%) gloves were neither changed nor hands were disinfected between different activities or patient contacts (female dentists: 68.6%; male dentists: 60.9%; dental assistants: 93%). Only 31.4% of female and 39.1% of male dentists carried out adequate hygienic hand disinfection after removing gloves. Male dentists wore significantly more often (100%) protective eyewear compared to 77.1% of female dentists (p<0.05). In addition, most of female dentists (62.9%) and dental assistants (80.7%) wore jewelry during dental procedures. Despite the knowledge of distinct hygiene procedures only a small percentage of dental staff performs hygiene practices according to recommended guidelines. Strict audit is clearly needed in the dental setting to ensure compliance with infection control guidelines to prevent transmission of pathogens. Our results provide insights for the development of a targeted education and training strategy to enhance compliance of dental staff especially of dental assistants with infection control procedures.

Analytic methods for design of wave cycles for wave rotor core engines

NASA Technical Reports Server (NTRS)

Resler, Edwin L., Jr.; Mocsari, Jeffrey C.; Nalim, M. R.

1993-01-01

A procedure to design a preliminary wave rotor cycle for any application is presented. To complete a cycle with heat addition there are two separate but related design steps that must be followed. The 'wave' boundary conditions determine the allowable amount of heat added in any case and the ensuing wave pattern requires certain pressure discharge conditions to allow the process to be made cyclic. This procedure, when applied, gives a first estimate of the cycle performance and the necessary information for the next step in the design process, namely the application of a characteristic based or other appropriate detailed one dimensional wave calculation that locates the proper porting around the periphery of the wave rotor. Four examples of the design procedure are given to demonstrate its utility and generality. These examples also illustrate the large gains in performance that could be realized with the use of wave rotor enhanced propulsion cycles.

Design of landfill daily cells.

PubMed

Panagiotakopoulos, D; Dokas, I

2001-08-01

The objective of this paper is to study the behaviour of the landfill soil-to-refuse (S/R) ratio when size, geometry and operating parameters of the daily cell vary over realistic ranges. A simple procedure is presented (1) for calculating the cell parameters values which minimise the S/R ratio and (2) for studying the sensitivity of this minimum S/R ratio to variations in cell size, final refuse density, working face length, lift height and cover thickness. In countries where daily soil cover is required, savings in landfill space could be realised following this procedure. The sensitivity of minimum S/R to variations in cell dimensions decreases with cell size. Working face length and lift height affect the S/R ratio significantly. This procedure also offers the engineer an additional tool for comparing one large daily cell with two or more smaller ones, at two different working faces within the same landfill.

Mechanisms of Optical Regression Following Corneal Laser Refractive Surgery: Epithelial and Stromal Responses

PubMed Central

MOSHIRFAR, Majid; DESAUTELS, Jordan D.; WALKER, Brian D.; MURRI, Michael S.; BIRDSONG, Orry C.; HOOPES, Phillip C. Sr

2018-01-01

Laser vision correction is a safe and effective method of reducing spectacle dependence. Photorefractive Keratectomy (PRK), Laser In Situ Keratomileusis (LASIK), and Small-Incision Lenticule Extraction (SMILE) can accurately correct myopia, hyperopia, and astigmatism. Although these procedures are nearing optimization in terms of their ability to produce a desired refractive target, the long term cellular responses of the cornea to these procedures can cause patients to regress from the their ideal postoperative refraction. In many cases, refractive regression requires follow up enhancement surgeries, presenting additional risks to patients. Although some risk factors underlying refractive regression have been identified, the exact mechanisms have not been elucidated. It is clear that cellular proliferation events are important mediators of optical regression. This review focused specifically on cellular changes to the corneal epithelium and stroma, which may influence postoperative visual regression following LASIK, PRK, and SMILE procedures. PMID:29644238

40 CFR 63.550 - Recordkeeping and reporting requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... recordkeeping required as part of the practices described in the standard operating procedures manual for... part of the practices described in the standard operating procedures manual for baghouses required... period, including an explanation of the periods when the procedures outlined in the standard operating...

40 CFR 63.550 - Recordkeeping and reporting requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... recordkeeping required as part of the practices described in the standard operating procedures manual for... part of the practices described in the standard operating procedures manual for baghouses required... period, including an explanation of the periods when the procedures outlined in the standard operating...

40 CFR 63.1547 - Monitoring requirements.

Code of Federal Regulations, 2010 CFR

2010-07-01

... standard operating procedures manual that describes in detail the procedures for inspection, maintenance...) The standard operating procedures manual for baghouses required by paragraph (a) of this section shall... specified in the standard operating procedures manual for inspections and routine maintenance shall, at a...

40 CFR 63.1547 - Monitoring requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... standard operating procedures manual that describes in detail the procedures for inspection, maintenance...) The standard operating procedures manual for baghouses required by paragraph (a) of this section shall... specified in the standard operating procedures manual for inspections and routine maintenance shall, at a...

Topical EMLA cream versus prilocaine infiltration for pediatric cardiac catheterization.

PubMed

Pirat, Arash; Karaaslan, Pelin; Candan, Selim; Zeyneloglu, Pinar; Varan, Birgul; Tokel, Kursat; Torgay, Adnan; Arslan, Gulnaz

2005-10-01

The aim of this study was to compare the anesthetic efficacy of prilocaine infiltration and a eutectic mixture of local anesthetics (EMLA) in cream for femoral vessel catheterization during pediatric cardiac catheterization and to evaluate whether EMLA cream application improves cannulation success. Prospective, randomized clinical trial. A university hospital. Forty American Society of Anesthesiologists class III and IV children scheduled for cardiac catheterization via the femoral route were included. The children were randomly assigned to 2 groups. The EMLA group (n = 20) had EMLA cream applied to the groin 60 minutes before the procedure, and the control group (n = 20) had prilocaine infiltrated at the site 5 minutes before the procedure. Boluses of intravenous midazolam, 0.1 mg/kg, and/or ketamine, 1 mg/kg, were given to achieve and maintain a predetermined sedation score of 2-3 (0 = deeply sedated, 5 = agitated) throughout the procedure (sedation monitored every 5 minutes). The groups were compared with respect to demographic data, hemodynamic and respiratory parameters/complications, amounts of additional sedative-analgesics required, cannulation time, and cannulation results (first-attempt success [right groin], second-attempt success [left groin], or failure on both attempts). Each group's "overall cannulation success rate" was calculated as the proportion of cases in which cannulation was achieved on the first or second attempt. The demographic data and the group findings for hemodynamic and respiratory parameters/complications, additional amounts of sedative-analgesics needed, cannulation times, and overall cannulation success rate were similar. The mean sedation score during femoral puncture in the EMLA group was significantly lower than that in the control group (3 +/- 1 v 4 +/- 1, respectively, p = 0.001). There were no other significant differences between the groups with respect to sedation scores during the procedure. The respective frequencies of first-attempt cannulation success in the EMLA and control groups were 75% and 45% (p = 0.05). The study showed that EMLA cream provides adequate topical anesthesia for femoral vessel cannulation during pediatric cardiac catheterization and may also increase the likelihood of cannulation success. However, use of this cream has no effect on sedative-analgesic requirements or on the risks of hemodynamic and respiratory complications during this procedure.

Physical and cognitive task analysis in interventional radiology.

PubMed

Johnson, S; Healey, A; Evans, J; Murphy, M; Crawshaw, M; Gould, D

2006-01-01

To identify, describe and detail the cognitive thought processes, decision-making, and physical actions involved in the preparation and successful performance of core interventional radiology procedures. Five commonly performed core interventional radiology procedures were selected for cognitive task analysis. Several examples of each procedure being performed by consultant interventional radiologists were videoed. The videos of those procedures, and the steps required for successful outcome, were analysed by a psychologist and an interventional radiologist. Once a skeleton algorithm of the procedures was defined, further refinement was achieved using individual interview techniques with consultant interventional radiologists. Additionally a critique of each iteration of the established algorithm was sought from non-participating independent consultant interventional radiologists. Detailed task descriptions and decision protocols were developed for five interventional radiology procedures (arterial puncture, nephrostomy, venous access, biopsy-using both ultrasound and computed tomography, and percutaneous transhepatic cholangiogram). Identical tasks performed within these procedures were identified and standardized within the protocols. Complex procedures were broken down and their constituent processes identified. This might be suitable for use as a training protocol to provide a universally acceptable safe practice at the most fundamental level. It is envisaged that data collected in this way can be used as an educational resource for trainees and could provide the basis for a training curriculum in interventional radiology. It will direct trainees towards safe practice of the highest standard. It will also provide performance objectives of a simulator model.

Impact of Rapid On-Site Cytological Evaluation (ROSE) on the Diagnostic Yield of Transbronchial Needle Aspiration During Mediastinal Lymph Node Sampling: Systematic Review and Meta-Analysis.

PubMed

Sehgal, Inderpaul Singh; Dhooria, Sahajal; Aggarwal, Ashutosh Nath; Agarwal, Ritesh

2018-04-01

Whether the use of rapid on-site cytologic evaluation (ROSE) increases the diagnostic yield of transbronchial needle aspiration (TBNA) remains unclear. This article is a systematic review of studies describing the utility of ROSE in subjects undergoing TBNA. The study included a systematic review of the PubMed, Embase, and Scopus databases for randomized controlled trials investigating the diagnostic yield of conventional transbronchial needle aspiration (c-TBNA) or endobronchial ultrasound (EBUS)-TBNA, with or without ROSE, in subjects with mediastinal lymphadenopathy. Five studies (618 subjects; two EBUS-TBNA, two c-TBNA, and one both) were identified. Overall, the studies were of good quality. The pooled risk difference (95% CI) of the diagnostic yield of EBUS-TBNA and c-TBNA was 0.04 (-0.01 to 0.09) and 0.12 (-0.08 to 0.33), respectively, suggesting no added benefit with ROSE. The use of ROSE during EBUS-TBNA (but not c-TBNA) resulted in significantly fewer needle passes (mean difference [95% CI], -1.1 [-2.2 to -0.005]; P < .001). There was no difference in the procedure time during EBUS-TBNA. The complication rate was significantly lower (OR [95% CI], 0.26 [0.10 to 0.71]; P = .009) when ROSE was used during c-TBNA due to fewer additional procedures required to make a diagnosis. There was evidence of heterogeneity in the studies involving c-TBNA but not EBUS-TBNA. There was no publication bias. The use of ROSE neither improved the diagnostic yield nor reduced the procedure time during TBNA. However, the use of ROSE was associated with fewer number of needle passes during EBUS-TBNA and overall lower requirement for additional bronchoscopy procedures during TBNA to make a final diagnosis. PROSPERO; No.: CRD42017058937; URL: www.crd.york.ac.uk/prospero/. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Incidence and treatment of procedural cardiovascular complications associated with trans-arterial and trans-apical interventional aortic valve implantation in 412 consecutive patients.

PubMed

Lange, Rüdiger; Bleiziffer, Sabine; Piazza, Nicolo; Mazzitelli, Domenico; Hutter, Andrea; Tassani-Prell, Peter; Laborde, Jean-Claude; Bauernschmitt, Robert

2011-11-01

Trans-catheter aortic valve implantation (TAVI) technology is rapidly evolving, with 412 procedures having been performed at our institution. Herein, we report a complete, prospective analysis of complications occurring during transvascular and trans-apical implantations with two different prostheses. Between June 2007 and June 2010, 412 patients (258 female, mean age 80.3±7.2 years, logistic EuroSCORE (European System for Cardiac Operative Risk Evaluation) 20.2%±13.0%) underwent TAVI through either a retrograde (n=252 transfemoral, n=28 transaxillary, and n=5 transaortic) or antegrade (n=127 trans-apical) approach at our institution. The trans-apical access was chosen only in cases where transvascular implantation was not possible. As many as 283 CoreValve and 129 Edwards Sapien prostheses were implanted. Thirty-day survival was 90.9%. Vascular complications occurred in 42 patients (10.2%). In four patients, lethal aortic root (n=3) or abdominal (n=1) aortic rupture occurred. Pericardial effusion developed in 53 patients (12.8%), which resulted in cardiac tamponade in 12 patients (2.9%). Twenty-three patients (5.6%) with valve malplacement were treated interventionally. In five patients (1.2%), emergency institution of cardiopulmonary bypass was required during the procedure for temporary support; all patients survived. Seventeen patients underwent re-intervention on the catheter valve (4.1%). With growing experience, complications with TAVI may be avoided by proper patient selection and skillful management. Other complications, when they occur, require a specific treatment algorithm to avoid delay in decision making. A considerable number of complications after TAVI require surgical treatment. Therefore, the ideal environment for TAVI procedures is a hybrid operating room, where a multidisciplinary team of surgeons, cardiologists, and anesthesiologists is best fitted to meet the current needs associated with TAVI technology. A reduction in complications was seen after 300 cases. This finding attests to the complexity of the procedure in addition to the experience required to reduce the incidence of complications. Copyright © 2011 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Rate of revisions or conversion after bariatric surgery over 10 years in the state of New York.

PubMed

Altieri, Maria S; Yang, Jie; Nie, Lizhou; Blackstone, Robin; Spaniolas, Konstantinos; Pryor, Aurora

2018-04-01

A primary measure of the success of a procedure is the whether or not additional surgery may be necessary. Multi-institutional studies regarding the need for reoperation after bariatric surgery are scarce. The purpose of this study is to evaluate the rate of revisions/conversions (RC) after 3 common bariatric procedures over 10 years in the state of New York. University Hospital, involving a large database in New York State. The Statewide Planning and Research Cooperative System database was used to identify all patients undergoing laparoscopic adjustable gastric banding (LAGB), sleeve gastrectomy (SG), and Roux-en-Y gastric bypass (RYGB) between 2004 and 2010. Patients were followed for RC to other bariatric procedures for at least 4 years (up to 2014). Multivariable cox proportional hazard regression analysis was performed to identify risk factors for additional surgery after each common bariatric procedure. Multivariable logistic regression was used to check the factors associated with having ≥2 follow-up procedures. There were 40,994 bariatric procedures with 16,444 LAGB, 22,769 RYGB, and 1781 SG. Rate of RC was 26.0% for LAGB, 9.8% for SG, and 4.9% for RYGB. Multiple RC ( = />2) were more common for LAGB (5.7% for LAGB, .5% for RYGB, and .2% for LSG). Band revision/replacements required further procedures compared with patients who underwent conversion to RYGB/SG (939 compared with 48 procedures). Majority of RC were not performed at initial institution (68.2% of LAGB patients, 75.9% for RYGB, 63.7% of SG). Risk factors for multiple procedures included surgery type, as LAGB was more likely to have multiple RC. Reoperation was common for LAGB, but less common for RYGB (4.9%) and SG (9.8%). RC rate are almost twice after SG than after RYGB. LAGB had the highest rate (5.7%) of multiple reoperations. Conversion was the procedure of choice after a failed LAGB. Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

9 CFR 2.25 - Requirements and procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Requirements and procedures. 2.25 Section 2.25 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Registration § 2.25 Requirements and procedures. (a) Each carrier and...

9 CFR 2.25 - Requirements and procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 1 2013-01-01 2013-01-01 false Requirements and procedures. 2.25 Section 2.25 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Registration § 2.25 Requirements and procedures. (a) Each carrier and...

9 CFR 2.25 - Requirements and procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 1 2011-01-01 2011-01-01 false Requirements and procedures. 2.25 Section 2.25 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Registration § 2.25 Requirements and procedures. (a) Each carrier and...

9 CFR 2.25 - Requirements and procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 1 2012-01-01 2012-01-01 false Requirements and procedures. 2.25 Section 2.25 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Registration § 2.25 Requirements and procedures. (a) Each carrier and...

9 CFR 2.25 - Requirements and procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 1 2014-01-01 2014-01-01 false Requirements and procedures. 2.25 Section 2.25 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL WELFARE REGULATIONS Registration § 2.25 Requirements and procedures. (a) Each carrier and...

42 CFR 493.47 - Requirements for a certificate for provider-performed microscopy (PPM) procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-performed microscopy (PPM) procedures. 493.47 Section 493.47 Public Health CENTERS FOR MEDICARE & MEDICAID... REQUIREMENTS Registration Certificate, Certificate for Provider-performed Microscopy Procedures, and Certificate of Compliance § 493.47 Requirements for a certificate for provider-performed microscopy (PPM...

42 CFR 493.47 - Requirements for a certificate for provider-performed microscopy (PPM) procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

...-performed microscopy (PPM) procedures. 493.47 Section 493.47 Public Health CENTERS FOR MEDICARE & MEDICAID... REQUIREMENTS Registration Certificate, Certificate for Provider-performed Microscopy Procedures, and Certificate of Compliance § 493.47 Requirements for a certificate for provider-performed microscopy (PPM...

42 CFR 493.47 - Requirements for a certificate for provider-performed microscopy (PPM) procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

...-performed microscopy (PPM) procedures. 493.47 Section 493.47 Public Health CENTERS FOR MEDICARE & MEDICAID... REQUIREMENTS Registration Certificate, Certificate for Provider-performed Microscopy Procedures, and Certificate of Compliance § 493.47 Requirements for a certificate for provider-performed microscopy (PPM...

42 CFR 493.47 - Requirements for a certificate for provider-performed microscopy (PPM) procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

...-performed microscopy (PPM) procedures. 493.47 Section 493.47 Public Health CENTERS FOR MEDICARE & MEDICAID... REQUIREMENTS Registration Certificate, Certificate for Provider-performed Microscopy Procedures, and Certificate of Compliance § 493.47 Requirements for a certificate for provider-performed microscopy (PPM...