Standardizing care and monitoring for anesthesia or procedural sedation delivered outside the operating room.

PubMed

Eichhorn, Volker; Henzler, Dietrich; Murphy, Michael F

2010-08-01

The purpose of this review is to summarize recommendations for the safe and efficient conductance of sedation and anesthesia at remote locations; and to define safety standards, monitoring techniques, quality of care and procedural eligibility. Anesthesia outside of the operating room is rapidly increasing in numbers, which has seen a growth of older and sicker patients. These circumstances have created a need for guidelines, for both specialist anesthesia providers and nonanesthesia-trained practitioners, that define patient selection, minimum monitoring (hemodynamics and respiration), facility design and equipment, policy framework, recovery facilities and policies. The patient's safety throughout all stages of sedation and/or anesthesia is the most pertinent goal. Recent data emphasize the importance of monitoring pulse oximetry and end-tidal carbon dioxide for any sedating or anesthetic procedure. Substandard monitoring combined with oversedation and subsequent respiratory depression are implicated as the main reasons for catastrophic sedation and anesthetic outcomes at remote locations. Patient selection, procedure appropriateness and location appropriateness are the key elements defining the provision of safe anesthesia care outside the operating room. Titratable, short-acting intravenous drugs are preferred such as propofol and remifentanil.

49 CFR 193.2503 - Operating procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

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

49 CFR 193.2503 - Operating procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

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

49 CFR 193.2503 - Operating procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

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

49 CFR 193.2503 - Operating procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

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

Hybrid procedure for orbital venous malformation in the endovascular operation room.

PubMed

Cheng, A C O; Li, E Y M; Chan, T C Y; Wong, A C W; Chan, P C M; Poon, W W L; Fung, D H S; Yuen, H K L

2015-08-01

To describe a hybrid procedure for orbital venous malformation in the endovascular operating room (EVOR). Five consecutive patients with venous malformation in the periocular and orbital region were included. All patients received a one-stage direct puncture venogram, image-guided glue injection, and surgical resection in the EVOR equipped with a biplane digital subtraction angiography system (BDSAS). The mean age at the time of operation was 37.4 years (range, 22-69 years). The mean operative time was 193 min (range, 138-324 min). No intraoperative complications were noted. The mean follow-up duration was 18.8 months (range, 10-24 months). Three patients had complete removal of the vascular lesions. At the latest follow-up, no recurrence of symptoms related to the lesions was noted. All patients had an uneventful recovery and satisfactory outcome. The hybrid procedure of orbital venous malformation in the EVOR is a novel application in ophthalmology. It is a safe and well-controlled procedure with real-time high-quality BDSAS surveillance to facilitate surgical resection. Its success requires collaboration between the interventional radiologist, the surgeon, and the ophthalmologist.

MRI-guided stereotactic neurosurgical procedures in a diagnostic MRI suite: Background and safe practice recommendations.

PubMed

Larson, Paul S; Willie, Jon T; Vadivelu, Sudhakar; Azmi-Ghadimi, Hooman; Nichols, Amy; Fauerbach, Loretta Litz; Johnson, Helen Boehm; Graham, Denise

2017-07-01

The development of navigation technology facilitating MRI-guided stereotactic neurosurgery has enabled neurosurgeons to perform a variety of procedures ranging from deep brain stimulation to laser ablation entirely within an intraoperative or diagnostic MRI suite while having real-time visualization of brain anatomy. Prior to this technology, some of these procedures required multisite workflow patterns that presented significant risk to the patient during transport. For those facilities with access to this technology, safe practice guidelines exist only for procedures performed within an intraoperative MRI. There are currently no safe practice guidelines or parameters available for facilities looking to integrate this technology into practice in conventional MRI suites. Performing neurosurgical procedures in a diagnostic MRI suite does require precautionary measures. The relative novelty of technology and workflows for direct MRI-guided procedures requires consideration of safe practice recommendations, including those pertaining to infection control and magnet safety issues. This article proposes a framework of safe practice recommendations designed for assessing readiness and optimization of MRI-guided neurosurgical interventions in the diagnostic MRI suite in an effort to mitigate patient risk. The framework is based on existing clinical evidence, recommendations, and guidelines related to infection control and prevention, health care-associated infections, and magnet safety, as well as the clinical and practical experience of neurosurgeons utilizing this technology. © 2017 American Society for Healthcare Risk Management of the American Hospital Association.

49 CFR 392.62 - Safe operation, buses.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Transportation Other Regulations Relating to Transportation (Continued) FEDERAL MOTOR CARRIER SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION FEDERAL MOTOR CARRIER SAFETY REGULATIONS DRIVING OF COMMERCIAL MOTOR VEHICLES Prohibited Practices § 392.62 Safe operation, buses. No person shall drive a bus and a motor...

Formalizing procedures for operations automation, operator training and spacecraft autonomy

NASA Technical Reports Server (NTRS)

Lecouat, Francois; Desaintvincent, Arnaud

1994-01-01

The generation and validation of operations procedures is a key task of mission preparation that is quite complex and costly. This has motivated the development of software applications providing support for procedures preparation. Several applications have been developed at MATRA MARCONI SPACE (MMS) over the last five years. They are presented in the first section of this paper. The main idea is that if procedures are represented in a formal language, they can be managed more easily with a computer tool and some automatic verifications can be performed. One difficulty is to define a formal language that is easy to use for operators and operations engineers. From the experience of the various procedures management tools developed in the last five years (including the POM, EOA, and CSS projects), MMS has derived OPSMAKER, a generic tool for procedure elaboration and validation. It has been applied to quite different types of missions, ranging from crew procedures (PREVISE system), ground control centers management procedures (PROCSU system), and - most relevant to the present paper - satellite operation procedures (PROCSAT developed for CNES, to support the preparation and verification of SPOT 4 operation procedures, and OPSAT for MMS telecom satellites operation procedures).

Unmanned Aerial Systems Traffic Management (UTM): Safely Enabling UAS Operations in Low-Altitude Airspace

NASA Technical Reports Server (NTRS)

Rios, Joseph

2016-01-01

Currently, there is no established infrastructure to enable and safely manage the widespread use of low-altitude airspace and UAS flight operations. Given this, and understanding that the FAA faces a mandate to modernize the present air traffic management system through computer automation and significantly reduce the number of air traffic controllers by FY 2020, the FAA maintains that a comprehensive, yet fully automated UAS traffic management (UTM) system for low-altitude airspace is needed. The concept of UTM is to begin by leveraging concepts from the system of roads, lanes, stop signs, rules and lights that govern vehicles on the ground today. Building on its legacy of work in air traffic management (ATM), NASA is working with industry to develop prototype technologies for a UAS Traffic Management (UTM) system that would evolve airspace integration procedures for enabling safe, efficient low-altitude flight operations that autonomously manage UAS operating in an approved low-altitude airspace environment. UTM is a cloud-based system that will autonomously manage all traffic at low altitudes to include UASs being operated beyond visual line of sight of an operator. UTM would thus enable safe and efficient flight operations by providing fully integrated traffic management services such as airspace design, corridors, dynamic geofencing, severe weather and wind avoidance, congestion management, terrain avoidance, route planning re-routing, separation management, sequencing spacing, and contingency management. UTM removes the need for human operators to continuously monitor aircraft operating in approved areas. NASA envisions concepts for two types of UTM systems. The first would be a small portable system, which could be moved between geographical areas in support of operations such as precision agriculture and public safety. The second would be a Persistent system, which would support low-altitude operations in an approved area by providing continuous automated

Objective assessment of operator performance during ultrasound-guided procedures.

PubMed

Tabriz, David M; Street, Mandie; Pilgram, Thomas K; Duncan, James R

2011-09-01

Simulation permits objective assessment of operator performance in a controlled and safe environment. Image-guided procedures often require accurate needle placement, and we designed a system to monitor how ultrasound guidance is used to monitor needle advancement toward a target. The results were correlated with other estimates of operator skill. The simulator consisted of a tissue phantom, ultrasound unit, and electromagnetic tracking system. Operators were asked to guide a needle toward a visible point target. Performance was video-recorded and synchronized with the electromagnetic tracking data. A series of algorithms based on motor control theory and human information processing were used to convert raw tracking data into different performance indices. Scoring algorithms converted the tracking data into efficiency, quality, task difficulty, and targeting scores that were aggregated to create performance indices. After initial feasibility testing, a standardized assessment was developed. Operators (N = 12) with a broad spectrum of skill and experience were enrolled and tested. Overall scores were based on performance during ten simulated procedures. Prior clinical experience was used to independently estimate operator skill. When summed, the performance indices correlated well with estimated skill. Operators with minimal or no prior experience scored markedly lower than experienced operators. The overall score tended to increase according to operator's clinical experience. Operator experience was linked to decreased variation in multiple aspects of performance. The aggregated results of multiple trials provided the best correlation between estimated skill and performance. A metric for the operator's ability to maintain the needle aimed at the target discriminated between operators with different levels of experience. This study used a highly focused task model, standardized assessment, and objective data analysis to assess performance during simulated

40 CFR 792.81 - Standard operating procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

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

40 CFR 792.81 - Standard operating procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

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

40 CFR 792.81 - Standard operating procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

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

8 CFR 1003.40 - Local operating procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

8 CFR 1003.40 - Local operating procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

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

Representing operations procedures using temporal dependency networks

NASA Technical Reports Server (NTRS)

Fayyad, Kristina E.; Cooper, Lynne P.

1993-01-01

DSN Link Monitor & Control (LMC) operations consist primarily of executing procedures to configure, calibrate, test, and operate a communications link between an interplanetary spacecraft and its mission control center. Currently the LMC operators are responsible for integrating procedures into an end-to-end series of steps. The research presented in this paper is investigating new ways of specifying operations procedures that incorporate the insight of operations, engineering, and science personnel to improve mission operations. The paper describes the rationale for using Temporal Dependency Networks (TDN's) to represent the procedures, a description of how the data is acquired, and the knowledge engineering effort required to represent operations procedures. Results of operational tests of this concept, as implemented in the LMC Operator Assistant Prototype (LMCOA), are also presented.

End-to-End Demonstrator of the Safe Affordable Fission Engine (SAFE) 30: Power Conversion and Ion Engine Operation

NASA Technical Reports Server (NTRS)

Hrbud, Ivana; VanDyke, Melissa; Houts, Mike; Goodfellow, Keith; Schafer, Charles (Technical Monitor)

2001-01-01

The Safe Affordable Fission Engine (SAFE) test series addresses Phase 1 Space Fission Systems issues in particular non-nuclear testing and system integration issues leading to the testing and non-nuclear demonstration of a 400-kW fully integrated flight unit. The first part of the SAFE 30 test series demonstrated operation of the simulated nuclear core and heat pipe system. Experimental data acquired in a number of different test scenarios will validate existing computational models, demonstrated system flexibility (fast start-ups, multiple start-ups/shut downs), simulate predictable failure modes and operating environments. The objective of the second part is to demonstrate an integrated propulsion system consisting of a core, conversion system and a thruster where the system converts thermal heat into jet power. This end-to-end system demonstration sets a precedent for ground testing of nuclear electric propulsion systems. The paper describes the SAFE 30 end-to-end system demonstration and its subsystems.

40 CFR 160.81 - Standard operating procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Standard operating procedures. 160.81... GOOD LABORATORY PRACTICE STANDARDS Testing Facilities Operation § 160.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting forth study...

40 CFR 160.81 - Standard operating procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Standard operating procedures. 160.81... GOOD LABORATORY PRACTICE STANDARDS Testing Facilities Operation § 160.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting forth study...

40 CFR 160.81 - Standard operating procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Standard operating procedures. 160.81... GOOD LABORATORY PRACTICE STANDARDS Testing Facilities Operation § 160.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting forth study...

Transient Approximation of SAFE-100 Heat Pipe Operation

NASA Technical Reports Server (NTRS)

Bragg-Sitton, Shannon M.; Reid, Robert S.

2005-01-01

Engineers at Los Alamos National Laboratory (LANL) have designed several heat pipe cooled reactor concepts, ranging in power from 15 kWt to 800 kWt, for both surface power systems and nuclear electric propulsion systems. The Safe, Affordable Fission Engine (SAFE) is now being developed in a collaborative effort between LANL and NASA Marshall Space Flight Center (NASA/MSFC). NASA is responsible for fabrication and testing of non-nuclear, electrically heated modules in the Early Flight Fission Test Facility (EFF-TF) at MSFC. In-core heat pipes must be properly thawed as the reactor power starts. Computational models have been developed to assess the expected operation of a specific heat pipe design during start-up, steady state operation, and shutdown. While computationally intensive codes provide complete, detailed analyses of heat pipe thaw, a relatively simple. concise routine can also be applied to approximate the response of a heat pipe to changes in the evaporator heat transfer rate during start-up and power transients (e.g., modification of reactor power level) with reasonably accurate results. This paper describes a simplified model of heat pipe start-up that extends previous work and compares the results to experimental measurements for a SAFE-100 type heat pipe design.

Electronic Procedures for Medical Operations

NASA Technical Reports Server (NTRS)

2015-01-01

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

Open lung biopsy performed in idiopathic pulmonary fibrosis is a safe procedure

PubMed Central

Halman, Joanna; Taniewska, Sonia; Burzyńska, Natalia; Piekarska, Anna; Sawicka, Wioletta

2017-01-01

Introduction Idiopathic pulmonary fibrosis (IPF) is an interstitial lung disease with a fatal prognosis. The diagnosis is made on the basis of high-resolution computed tomography and histological examination in selected cases. Aim To determine the risk of complications of open lung biopsy performed in patients with IPF. Material and methods We performed a retrospective analysis of 51 patients who underwent diagnostic excision of pulmonary parenchyma due to IPF in the period 1995–2014. We assessed the complication rate, length of drainage, postoperative period and 30-day mortality. We compared the results of treatment in the groups of patients operated on with thoracotomy and videothoracoscopy. Results The mean age of patients was 58 (47% female, 53% male) forced vital capacity (FVC) was 81%, forced expiratory volume in 1 s (FEV1) was 80% and body mass index (BMI) was 27 kg/m2. Thoracotomies (lateral, muscle sparing or anterior) were performed in 20 patients between 1995 and 2012 and videothoracoscopy in 31 patients operated on in the years 2009–2014. Patients in study groups did not differ considering age (p = 0.40), gender (p = 0.81), FVC (p = 0.08), FEV1 (p = 0.13) or BMI (p = 0.75). Postoperative complications occurred in 3.9% of patients (atrial arrhythmia 1.9% and recurrent pneumothorax 1.9%) with equal incidence in both study groups (p = 0.75). Median stay after thoracotomy was 4 days while after videothoracoscopy it was 3 days (p = 0.04). Conclusions Open lung biopsy performed on patients with IPF is a safe procedure. Open lung biopsy performed through thoracotomy could be as safe as through VATS, however is characterized by longer postoperative stay. PMID:29354175

Representing Operations Procedures Using Temporal Dependency Algorithms

NASA Technical Reports Server (NTRS)

Fayyad, K.; Cooper, L.

1992-01-01

The research presented in this paper is investigating new ways of specifying operations procedures that incorporate the insight of operations, engineering, and science personnel to improve mission operations. The paper describes the rationale for using Temporal Dependency Networks to represent the procedures, a description of how the data is acquired, and the knowledge engineering effort required to represent operations procedures.

78 FR 32088 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-29

...This rule establishes, amends, suspends, or revokes Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures for operations at certain airports. These regulatory actions are needed because of the adoption of new or revised criteria, or because of changes occurring in the National Airspace System, such as the commissioning of new navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide safe and efficient use of the navigable airspace and to promote safe flight operations under instrument flight rules at the affected airports.

75 FR 69331 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-12

...This establishes, amends, suspends, or revokes Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures for operations at certain airports. These regulatory actions are needed because of the adoption of new or revised criteria, or because of changes occurring in the National Airspace System, such as the commissioning of new navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide safe and efficient use of the navigable airspace and to promote safe flight operations under instrument flight rules at the affected airports.

77 FR 12454 - Standard Instrument Approach Procedures, and Takeoff Minimums and Obstacle Departure Procedures...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-01

...This rule establishes, amends, suspends, or revokes Standard Instrument Approach Procedures (SIAPs) and associated Takeoff Minimums and Obstacle Departure Procedures for operations at certain airports. These regulatory actions are needed because of the adoption of new or revised criteria, or because of changes occurring in the National Airspace System, such as the commissioning of new navigational facilities, adding new obstacles, or changing air traffic requirements. These changes are designed to provide safe and efficient use of the navigable airspace and to promote safe flight operations under instrument flight rules at the affected airports.

Safe operating conditions for NSLS-II Storage Ring Frontends commissioning

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

Seletskiy, S.; Amundsen, C.; Ha, K.

2015-04-02

The NSLS-II Storage Ring Frontends are designed to safely accept the synchrotron radiation fan produced by respective insertion device when the electron beam orbit through the ID is locked inside the predefined Active Interlock Envelope. The Active Interlock is getting enabled at a particular beam current known as AI safe current limit. Below such current the beam orbit can be anywhere within the limits of the SR beam acceptance. During the FE commissioning the beam orbit is getting intentionally disturbed in the particular ID. In this paper we explore safe operating conditions for the Frontends commissioning.

Laparoscopic appendicectomy: safe and useful for training.

PubMed Central

Duff, S. E.; Dixon, A. R.

2000-01-01

Debate exists about the benefits of laparoscopic appendicectomy when compared to a conventional open procedure. The majority of appendices are removed by the open route in the UK. We report a series of 132 cases of suspected appendicitis managed laparoscopically: 112 (85%) of the patients had acute appendicitis, the remaining 20 (15%) had non-appendiceal pathology. The median operative time was 30 min and there were no conversions to an open operative procedure. The median postoperative stay was two days. Complications were seen in two patients. The published evidence comparing laparoscopic and open appendicectomy is contradictory. Our series shows that laparoscopic appendicectomy is a safe procedure with low morbidity; it is also an excellent training tool in laparoscopic technique and, with sufficient experience, takes no longer than an open procedure. Negative appendicocecotomies are most common in women of fertile age and can be associated with significant morbidity; therefore, laparoscopy should be used to make the diagnosis and, if appendicitis is the cause, the appendix could safely be removed laparoscopically. However, the choice between open and laparoscopic procedure is a subjective decision for the patient and their surgeon. Laparoscopic appendicectomy cannot be regarded as the gold standard. PMID:11103154

Operationalizing safe operating space for regional social-ecological systems.

PubMed

Hossain, Md Sarwar; Dearing, John A; Eigenbrod, Felix; Johnson, Fiifi Amoako

2017-04-15

This study makes a first attempt to operationalize the safe operating space concept at a regional scale by considering the complex dynamics (e.g. non-linearity, feedbacks, and interactions) within a systems dynamic model (SD). We employ the model to explore eight 'what if' scenarios based on well-known challenges (e.g. climate change) and current policy debates (e.g. subsidy withdrawal). The findings show that the social-ecological system in the Bangladesh delta may move beyond a safe operating space when a withdrawal of a 50% subsidy for agriculture is combined with the effects of a 2°C temperature increase and sea level rise. Further reductions in upstream river discharge in the Ganges would push the system towards a dangerous zone once a 3.5°C temperature increase was reached. The social-ecological system in Bangladesh delta may be operated within a safe space by: 1) managing feedback (e.g. by reducing production costs) and the slow biophysical variables (e.g. temperature, rainfall) to increase the long-term resilience, 2) negotiating for transboundary water resources, and 3) revising global policies (e.g. withdrawal of subsidy) that negatively impact at regional scales. This study demonstrates how the concepts of tipping points, limits to adaptations, and boundaries for sustainable development may be defined in real world social-ecological systems. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

76 FR 37014 - Expedited Approval of Alternative Test Procedures for the Analysis of Contaminants Under the Safe...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-24

...; Analysis and Sampling Procedures AGENCY: Environmental Protection Agency (EPA). ACTION: Final rule. SUMMARY... Contaminants Under the Safe Drinking Water Act; Analysis and Sampling Procedures. 75 FR 32295. June 8, 2010...

14 CFR 23.1585 - Operating procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 1 2011-01-01 2011-01-01 false Operating procedures. 23.1585 Section 23.1585 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT... Information Airplane Flight Manual and Approved Manual Material § 23.1585 Operating procedures. (a) For all...

21 CFR 58.81 - Standard operating procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling...

21 CFR 58.81 - Standard operating procedures.

Code of Federal Regulations, 2013 CFR

2013-04-01

... LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling...

21 CFR 58.81 - Standard operating procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling...

21 CFR 58.81 - Standard operating procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Testing Facilities Operation § 58.81 Standard operating procedures. (a) A testing facility shall have standard operating procedures in writing setting... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling...

32 CFR 700.857 - Safe navigation and regulations governing operation of ships and aircraft.

Code of Federal Regulations, 2013 CFR

2013-07-01

... OFFICIAL RECORDS The Commanding Officer Commanding Officers Afloat § 700.857 Safe navigation and regulations governing operation of ships and aircraft. (a) The commanding officer is responsible for the safe... Operations or the Commandant of the Marine Corps, as appropriate. (d) The Commanding Officer is responsible...

32 CFR 700.857 - Safe navigation and regulations governing operation of ships and aircraft.

Code of Federal Regulations, 2010 CFR

2010-07-01

... OFFICIAL RECORDS The Commanding Officer Commanding Officers Afloat § 700.857 Safe navigation and regulations governing operation of ships and aircraft. (a) The commanding officer is responsible for the safe... Operations or the Commandant of the Marine Corps, as appropriate. (d) The Commanding Officer is responsible...

32 CFR 700.857 - Safe navigation and regulations governing operation of ships and aircraft.

Code of Federal Regulations, 2011 CFR

2011-07-01

... OFFICIAL RECORDS The Commanding Officer Commanding Officers Afloat § 700.857 Safe navigation and regulations governing operation of ships and aircraft. (a) The commanding officer is responsible for the safe... Operations or the Commandant of the Marine Corps, as appropriate. (d) The Commanding Officer is responsible...

32 CFR 700.857 - Safe navigation and regulations governing operation of ships and aircraft.

Code of Federal Regulations, 2014 CFR

2014-07-01

... OFFICIAL RECORDS The Commanding Officer Commanding Officers Afloat § 700.857 Safe navigation and regulations governing operation of ships and aircraft. (a) The commanding officer is responsible for the safe... Operations or the Commandant of the Marine Corps, as appropriate. (d) The Commanding Officer is responsible...

32 CFR 700.857 - Safe navigation and regulations governing operation of ships and aircraft.

Code of Federal Regulations, 2012 CFR

2012-07-01

... OFFICIAL RECORDS The Commanding Officer Commanding Officers Afloat § 700.857 Safe navigation and regulations governing operation of ships and aircraft. (a) The commanding officer is responsible for the safe... Operations or the Commandant of the Marine Corps, as appropriate. (d) The Commanding Officer is responsible...

[Prevention of adverse effects in latex allergic patients: organizing a latex safe operating theatre].

PubMed

Bonalumi, Sabrina; Barbonaglia, Patrizia; Bertocchi, Carmen

2006-01-01

In 2001 the General Health Direction of Region Lombardia approved (decree n. 22303) a guideline for the prevention of latex allergic reactions in patients and health care workers. This document provides general recommendations in order to standardize behaviors in regional health care facilities. The reason is due to a rise in the incident of reactions to latex products in the last 20 years. Nowadays the prevalence is higher in certain risk groups (subjected to frequent and repeated exposures) rather than the general population. The aim of the project was to organize a latex safe operating theatre in the Ospedale Maggiore Policlinico, Mangiagalli e Regina Elena of Milan (Fondazione) and to standardize behaviors in order to prevent adverse effects in latex allergic patients. Thanks to the literature review and the creation of a multidisciplinar team, we produced a protocol. Therefore, we requested manufacturers the certification of the latex content of their products. Results and conclusion. When latex allergic patients need to undergone surgery in our hospital, a latex safe operating theatre is organized by personnel following a multidisciplinar protocol. No allergic reactions were experienced during surgical procedures after the creation of an environment as free as possible from latex contamination. The project will involve an emergency room, one room or more of a ward and of the outpatients department.

29 CFR 1926.1080 - Safe practices manual.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Regulations Relating to Labor (Continued) OCCUPATIONAL SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR (CONTINUED) SAFETY AND HEALTH REGULATIONS FOR CONSTRUCTION Diving General Operations Procedures § 1926.1080 Safe practices manual. Note: The requirements applicable to construction work under this section are...

Simple Automatic File Exchange (SAFE) to Support Low-Cost Spacecraft Operation via the Internet

NASA Technical Reports Server (NTRS)

Baker, Paul; Repaci, Max; Sames, David

1998-01-01

Various issues associated with Simple Automatic File Exchange (SAFE) are presented in viewgraph form. Specific topics include: 1) Packet telemetry, Internet IP networks and cost reduction; 2) Basic functions and technical features of SAFE; 3) Project goals, including low-cost satellite transmission to data centers to be distributed via an Internet; 4) Operations with a replicated file protocol; 5) File exchange operation; 6) Ground stations as gateways; 7) Lessons learned from demonstrations and tests with SAFE; and 8) Feedback and future initiatives.

Operation Safe Border: The Ecuador-Peru Crisis

DTIC Science & Technology

1996-01-01

52 JFQ / Spring 1996 In January 1995, the hemisphere was shocked by an outbreak of fighting between Ecuador and Peru over a long-festering border...Weidner, USA, is commander of the U.S. Military Group-Honduras and served as commander of the U.S. Contingent, Military Observer Mission, Ecuador ...Peru. Operation Safe Border: The Ecuador -Peru Crisis By G L E N N R. W E I D N E R Santiago River (fore- ground) and Yaupi River on Ecuador -Peru

Improving the safety and quality of nursing care through standardized operating procedures in Bosnia and Herzegovina.

PubMed

Ausserhofer, Dietmar; Rakic, Severin; Novo, Ahmed; Dropic, Emira; Fisekovic, Eldin; Sredic, Ana; Van Malderen, Greet

2016-06-01

We explored how selected 'positive deviant' healthcare facilities in Bosnia and Herzegovina approach the continuous development, adaptation, implementation, monitoring and evaluation of nursing-related standard operating procedures. Standardized nursing care is internationally recognized as a critical element of safe, high-quality health care; yet very little research has examined one of its key instruments: nursing-related standard operating procedures. Despite variability in Bosnia and Herzegovina's healthcare and nursing care quality, we assumed that some healthcare facilities would have developed effective strategies to elevate nursing quality and safety through the use of standard operating procedures. Guided by the 'positive deviance' approach, we used a multiple-case study design to examine a criterion sample of four facilities (two primary healthcare centres and two hospitals), collecting data via focus groups and individual interviews. In each studied facility, certification/accreditation processes were crucial to the initiation of continuous development, adaptation, implementation, monitoring and evaluation of nursing-related SOPs. In one hospital and one primary healthcare centre, nurses working in advanced roles (i.e. quality coordinators) were responsible for developing and implementing nursing-related standard operating procedures. Across the four studied institutions, we identified a consistent approach to standard operating procedures-related processes. The certification/accreditation process is enabling necessary changes in institutions' organizational cultures, empowering nurses to take on advanced roles in improving the safety and quality of nursing care. Standardizing nursing procedures is key to improve the safety and quality of nursing care. Nursing and Health Policy are needed in Bosnia and Herzegovina to establish a functioning institutional framework, including regulatory bodies, educational systems for developing nurses' capacities or the

Experience with fluorine and its safe use as a propellant

NASA Technical Reports Server (NTRS)

Bond, D. L.; Guenther, M. E.; Stimpson, L. D.; Toth, L. R.; Young, D. L.

1979-01-01

The industrial and the propulsion experience with fluorine and its derivatives is surveyed. The hazardous qualities of fluorine and safe handling procedures for the substance are emphasized. Procedures which fulfill the safety requirements during ground operations for handling fluorinated propulsion systems are discussed. Procedures to be implemented for use onboard the Space Transportation System are included.

A Procedure for Setting Environmentally Safe Total Maximum Daily Loads (TMDLs) for Selenium

Treesearch

A. Dennis Lemly

2002-01-01

This article presents a seven-step procedure for developing environmentally safe total maximum daily loads (TMDLs) for selenium. The need for this information stems from recent actions taken by the U.S. Environmental Protection Agency (EPA) that may require TMDLs for selenium and other contaminants that are impairing water bodies. However, there is no technical...

Developing standard operating procedures for gene drive research in disease vector mosquitoes.

PubMed

Adelman, Zach N; Pledger, David; Myles, Kevin M

2017-12-01

Numerous arthropod species represent potential targets for gene-drive-based population suppression or replacement, including those that transmit diseases, damage crops, or act as deleterious invasive species. Containment measures for gene drive research in arthropods have been discussed in the literature, but the importance of developing safe and effective standard operating procedures (SOPs) for these types of experiments has not been adequately addressed. Concisely written SOPs link safe work practices, containment measures, institutional training, and research-specific protocols. Here we discuss information to be considered by principal investigators, biosafety officers, and institutional biosafety committees as they work together to develop SOPs for experiments involving gene drive in arthropods, and describe various courses of action that can be used to maintain the effectiveness of SOPs through evaluation and revision. The information provided herein will be especially useful to investigators and regulatory personnel who may lack extensive experience working with arthropods under containment conditions.

NHEXAS PHASE I MARYLAND STUDY--STANDARD OPERATING PROCEDURE FOR PREPARATION OF STANDARD OPERATING PROCEDURES (G01)

EPA Science Inventory

The purpose of this SOP is to develop a consistent method and style for all Emory University/Harvard University/Johns Hopkins University standard operating procedures. SOPs are necessary to document all procedures, methods, and techniques used in the NHEXAS investigations. Deve...

40 CFR 243.201-2 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... waste handling techniques, and in the proper operation of collection equipment, such as those presented in Operation Responsible: Safe Refuse Collection. (b) Personal protective equipment such as gloves... Standards for Subpart I—Personal Protective Equipment (29 CFR 1910.132 through 1910.137). (c) Scavenging...

40 CFR 243.201-2 - Recommended procedures: Operations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... waste handling techniques, and in the proper operation of collection equipment, such as those presented in Operation Responsible: Safe Refuse Collection. (b) Personal protective equipment such as gloves... Standards for Subpart I—Personal Protective Equipment (29 CFR 1910.132 through 1910.137). (c) Scavenging...

Planetary boundaries: exploring the safe operating space for humanity

Treesearch

Johan Rockström; Will Steffen; Kevin Noone; Asa Persson; F. Stuart Chapin; Eric Lambin; Timothy M. Lenton; Marten Scheffer; Carl Folke; Hans Joachim Schellnhuber; Björn Nykvist; Cynthia A. de Wit; Terry Hughes; Sander van der Leeuw; Henning Rodhe; Sverker Sörlin; Peter K. Snyder; Robert Costanza; Uno Svedin; Malin Falkenmark; Louise Karlberg; Robert W. Corell; Victoria J. Fabry; James Hansen; Brian Walker; Diana Liverman; Katherine Richardson; Paul Crutzen; Jonathan Foley

2009-01-01

Anthropogenic pressures on the Earth System have reached a scale where abrupt global environmental change can no longer be excluded. We propose a new approach to global sustainability in which we define planetary boundaries within which we expect that humanity can operate safely. Transgressing one or more planetary boundaries may be deleterious or even catastrophic due...

[Standard operating procedures in ethic committees].

PubMed

Czarkowski, Marek

2006-02-01

Polish ethic committees should have to work together in order to maintain and develop high quality standards in the protection of human subjects. Exchanging knowledge, know-how and information polish ethic committees should have to implement standard operating procedures. Procedures should improve quality and proficiency of all types of ethic committee's activities. Standard operating procedures should cover as important problems as conflict of interest, trial's insurance or elections of ethic committees. The opinions of experts who have been reviewing medical research projects for several years may prove to be especially valuable in this setting. Governmental initiatives and creation of forum for polish ethic committees are essential in the effective standardisation, coordination and implementation of procedures in regional ethic committees. These projects need support via public funding from our authorities.

Laparoscopy is safe among patients with congestive heart failure undergoing general surgery procedures.

PubMed

Speicher, Paul J; Ganapathi, Asvin M; Englum, Brian R; Vaslef, Steven N

2014-08-01

Over the past 2 decades, laparoscopy has been established as a superior technique in many general surgery procedures. Few studies, however, have examined the impact of the use of a laparoscopic approach in patients with symptomatic congestive heart failure (CHF). Because pneumoperitoneum has known effects on cardiopulmonary physiology, patients with CHF may be at increased risk. This study examines current trends in approaches to patients with CHF and effects on perioperative outcomes. The 2005-2011 National Surgical Quality Improvement Program Participant User File was used to identify patients who underwent the following general surgery procedures: Appendectomy, segmental colectomy, small bowel resection, ventral hernia repair, and splenectomy. Included for analysis were those with newly diagnosed CHF or chronic CHF with new signs or symptoms. Trends of use of laparoscopy were assessed across procedure types. The primary endpoint was 30-day mortality. The independent effect of laparoscopy in CHF was estimated with a multiple logistic regression model. A total of 265,198 patients were included for analysis, of whom 2,219 were identified as having new or recently worsened CHF. Of these patients, there were 1,300 (58.6%) colectomies, 486 (21.9%) small bowel resections, 216 (9.7%) ventral hernia repairs, 141 (6.4%) appendectomies, and 76 (3.4%) splenectomies. Laparoscopy was used less frequently in patients with CHF compared with their non-CHF counterparts, particularly for nonelective procedures. Baseline characteristics were similar for laparoscopy versus open procedures with the notable exception of urgent/emergent case status (36.4% vs 71.3%; P < .001). After multivariable adjustment, laparoscopy seemed to have a protective effect against mortality (adjusted odds ratio, 0.45; P = .04), but no differences in other secondary endpoints. For patients with CHF, an open operative approach seems to be utilized more frequently in general surgery procedures, particularly

Laparoscopy is safe among patients with congestive heart failure undergoing general surgery procedures

PubMed Central

Speicher, Paul J.; Ganapathi, Asvin M.; Englum, Brian R.; Vaslef, Steven N.

2015-01-01

Background Over the past 2 decades, laparoscopy has been established as a superior technique in many general surgery procedures. Few studies, however, have examined the impact of the use of a laparoscopic approach in patients with symptomatic congestive heart failure (CHF). Because pneumoperitoneum has known effects on cardiopulmonary physiology, patients with CHF may be at increased risk. This study examines current trends in approaches to patients with CHF and effects on perioperative outcomes. Methods The 2005–2011 National Surgical Quality Improvement Program Participant User File was used to identify patients who underwent the following general surgery procedures: Appendectomy, segmental colectomy, small bowel resection, ventral hernia repair, and splenectomy. Included for analysis were those with newly diagnosed CHF or chronic CHF with new signs or symptoms. Trends of use of laparoscopy were assessed across procedure types. The primary endpoint was 30-day mortality. The independent effect of laparoscopy in CHF was estimated with a multiple logistic regression model. Results A total of 265,198 patients were included for analysis, of whom 2,219 were identified as having new or recently worsened CHF. Of these patients, there were 1,300 (58.6%) colectomies, 486 (21.9%) small bowel resections, 216 (9.7%) ventral hernia repairs, 141 (6.4%) appendectomies, and 76 (3.4%) splenectomies. Laparoscopy was used less frequently in patients with CHF compared with their non-CHF counterparts, particularly for nonelective procedures. Baseline characteristics were similar for laparoscopy versus open procedures with the notable exception of urgent/emergent case status (36.4% vs 71.3%; P < .001). After multivariable adjustment, laparoscopy seemed to have a protective effect against mortality (adjusted odds ratio, 0.45; P = .04), but no differences in other secondary endpoints. Conclusion For patients with CHF, an open operative approach seems to be utilized more frequently in

The Resident-Run Minor Surgery Clinic: A Pilot Study to Safely Increase Operative Autonomy.

PubMed

Wojcik, Brandon M; Fong, Zhi Ven; Patel, Madhukar S; Chang, David C; Petrusa, Emil; Mullen, John T; Phitayakorn, Roy

General surgery training has evolved to align with changes in work hour restrictions, supervision regulations, and reimbursement practices. This has culminated in a lack of operative autonomy, leaving residents feeling inadequately prepared to perform surgery independently when beginning fellowship or practice. A resident-run minor surgery clinic increases junior resident autonomy, but its effects on patient outcomes have not been formally established. This pilot study evaluated the safety of implementing a resident-run minor surgery clinic within a university-based general surgery training program. Single institution case-control pilot study of a resident-run minor surgery clinic from 9/2014 to 6/2015. Rotating third-year residents staffed the clinic once weekly. Residents performed operations independently in their own procedure room. A supervising attending surgeon staffed each case prior to residents performing the procedure and viewed the surgical site before wound closure. Postprocedure patient complications and admissions to the hospital because of a complication were analyzed and compared with an attending control cohort. Massachusetts General Hospital General in Boston, MA; an academic tertiary care general surgery residency program. Ten third-year general surgery residents. Overall, 341 patients underwent a total of 399 procedures (110 in the resident clinic vs. 289 in the attending clinic). Minor surgeries included soft tissue mass excision (n = 275), abscess incision and drainage (n = 66), skin lesion excision (n = 37), skin tag removal (n = 15), and lymph node excision (n = 6). There was no significant difference in the overall rate of patients developing a postprocedure complication within 30 days (3.6% resident vs. 2.8% attending; p = 0.65); which persisted on multivariate analysis. Similar findings were observed for the rate of hospital admission resulting from a complication. Resident evaluations overwhelmingly supported the rotation, citing

Transfascial vaginal tape (TFT): a simple, safe and cost-effective procedure for stress urinary incontinence. A preliminary study.

PubMed

Foglia, Giovanni; Mistrangelo, Emanuela; Lijoi, Davide; Alessandri, Franco; Ragni, Nicola

2007-07-01

To analyse prospectively the effectiveness of a new simple, minimally invasive, and cost-effective technique for the treatment of female urinary stress incontinence: the transfascial vaginal tape (TFT). In a prospective study, we enrolled 45 women undergoing TFT with or without hysterectomy and/or another pelvic reconstructive procedure between 1st December 2003 and 31st December. TFT consists of a tension-free urethrosuspension using a sling located at the mid-urethral level and placed laterally in the endopelvic fascia previously perforated. Follow-up evaluations were established at 3 and 6 months and at 1 year after the operation. During each follow-up, women underwent cough stress test and they answered to the "Incontinence quality of life questionnaire" (I-QOL), to the Patient Global Impression of Severity (PGI-S) and of Improvement (PGI-I) questions. Thirty-nine patients (88.9%) had a follow-up examination 1 year after surgery. Of these, 30 (76.9%) were defined cured, 6 (15.4%) improved and 3 (7.7%) failed. TFT procedure can be considered a simple, safe and cost-effective procedure for the treatment of stress urinary incontinence and can be an alternative to tension-free vaginal tape or transobturator route for sub-urethral tape procedures.

49 CFR 325.39 - Measurement procedure; highway operations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 49 Transportation 5 2014-10-01 2014-10-01 false Measurement procedure; highway operations. 325.39... MOTOR CARRIER NOISE EMISSION STANDARDS Measurement of Noise Emissions; Highway Operations § 325.39 Measurement procedure; highway operations. (a) In accordance with the rules in this subpart, a measurement...

49 CFR 325.39 - Measurement procedure; highway operations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 49 Transportation 5 2012-10-01 2012-10-01 false Measurement procedure; highway operations. 325.39... MOTOR CARRIER NOISE EMISSION STANDARDS Measurement of Noise Emissions; Highway Operations § 325.39 Measurement procedure; highway operations. (a) In accordance with the rules in this subpart, a measurement...

49 CFR 325.39 - Measurement procedure; highway operations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 49 Transportation 5 2013-10-01 2013-10-01 false Measurement procedure; highway operations. 325.39... MOTOR CARRIER NOISE EMISSION STANDARDS Measurement of Noise Emissions; Highway Operations § 325.39 Measurement procedure; highway operations. (a) In accordance with the rules in this subpart, a measurement...

Design for Assured Safe Jettison Operations

NASA Astrophysics Data System (ADS)

Herd, Andrew; Shea, Matt

2010-09-01

The International Space Station is coming toward the end of the assembly process and will enter "steady state" operations. During this time and also in the future, there arises the need for removing items from station, and in some instances this is achieved through jettison, either robotic or crew initiated. To control this practice at the ISS Partner level, a policy document has been developed. The policy states: "While there are risks inherent in jettisoning objects, the ISS Program recognizes that there may be significant benefits in terms of operational flexibility, crew safety, etc. A thorough assessment of the risks vs. the benefits will be conducted whenever a proposal to jettison an object is made. It is the intent of the ISS Program to limit the number of objects that are jettisoned from the ISS ...". The policy addresses hardware that: "may fall into one or more of the following categories: 1. Items that pose a safety issue for the ISS or for return onboard a visiting vehicle(contamination, materials degradation, etc.) 2. Items that negatively impact ISS utilization, return or on-orbit stowage manifests 3. Items that represent an Extravehicular Activity(EVA) timeline savings large enough to reduce the sum of the risks of EVA exposure time and the orbital environment’s hazardous debris population, compared to the sum of such risks without a jettison. 4. Items that are designed for jettison ". [1] Through the use of jettison to date, as a disposal means, operational experiences have been gained during and as a result of post-disposal event analysis. The data collected has allowed a generic assessment of issues(and best practices) and the proposal of ways in which process corrective action can be taken to assure future safe jettison operations. The improvements proposed emphasize the ways in which design can offer key interface and hardware response characteristics to the jettison event and the subsequent orbital and re-entry profile. There exist simple

14 CFR 93.309 - General operating procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 2 2011-01-01 2011-01-01 false General operating procedures. 93.309... Vicinity of Grand Canyon National Park, AZ § 93.309 General operating procedures. Except in an emergency... authorized in writing by the Flight Standards District Office: (1) Northbound. 11,500 or 13,500 feet MSL. (2...

14 CFR 93.309 - General operating procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 2 2014-01-01 2014-01-01 false General operating procedures. 93.309... Vicinity of Grand Canyon National Park, AZ § 93.309 General operating procedures. Except in an emergency... authorized in writing by the Flight Standards District Office: (1) Northbound. 11,500 or 13,500 feet MSL. (2...

14 CFR 93.309 - General operating procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false General operating procedures. 93.309... Vicinity of Grand Canyon National Park, AZ § 93.309 General operating procedures. Except in an emergency... authorized in writing by the Flight Standards District Office: (1) Northbound. 11,500 or 13,500 feet MSL. (2...

14 CFR 93.309 - General operating procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 14 Aeronautics and Space 2 2013-01-01 2013-01-01 false General operating procedures. 93.309... Vicinity of Grand Canyon National Park, AZ § 93.309 General operating procedures. Except in an emergency... authorized in writing by the Flight Standards District Office: (1) Northbound. 11,500 or 13,500 feet MSL. (2...

14 CFR 93.309 - General operating procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 14 Aeronautics and Space 2 2012-01-01 2012-01-01 false General operating procedures. 93.309... Vicinity of Grand Canyon National Park, AZ § 93.309 General operating procedures. Except in an emergency... authorized in writing by the Flight Standards District Office: (1) Northbound. 11,500 or 13,500 feet MSL. (2...

Surgical resident involvement is safe for common elective general surgery procedures.

PubMed

Tseng, Warren H; Jin, Leah; Canter, Robert J; Martinez, Steve R; Khatri, Vijay P; Gauvin, Jeffrey; Bold, Richard J; Wisner, David; Taylor, Sandra; Chen, Steven L

2011-07-01

Outcomes of surgical resident training are under scrutiny with the changing milieu of surgical education. Few have investigated the effect of surgical resident involvement (SRI) on operative parameters. Examining 7 common general surgery procedures, we evaluated the effect of SRI on perioperative morbidity and mortality and operative time (OpT). The American College of Surgeons National Surgical Quality Improvement Program database (2005 to 2007) was used to identify 7 cases of nonemergent operations. Cases with simultaneous procedures were excluded. Logistic regression was performed across all procedures and within each procedure incorporating SRI, OpT, and risk-stratifying American College of Surgery National Surgical Quality Improvement Program morbidity and mortality probability scores, which incorporate multiple prognostic individual patient factors. Procedure-specific, SRI-stratified OpTs were compared using Wilcoxon rank-sum tests. A total of 71.3% of the 37,907 cases had SRI. Absolute 30-day morbidity for all cases with SRI and without SRI were 3.0% and 1.0%, respectively (p < 0.001); absolute 30-day mortality for all cases with SRI and without SRI were 0.1% and 0.08%, respectively (p < 0.001). After multivariate analysis by specific procedure, SRI was not associated with increased morbidity but was associated with decreased mortality during open right colectomy (odds ratio 0.32; p = 0.01). Across all procedures, SRI was associated with increased morbidity (odds ratio 1.14; p = 0.048) but decreased mortality (odds ratio 0.42; p < 0.001). Mean OpT for all procedures was consistently lower for cases without SRI. SRI has a measurable impact on both 30-day morbidity and mortality and OpT. These data have implications to the impact associated with surgical graduate medical education. Further studies to identify causes of patient morbidity and prevention strategies in surgical teaching environments are warranted. Copyright © 2011 American College of Surgeons

Ultrashort-Pulse Laser System: Theory of Operation and Operating Procedures

DTIC Science & Technology

1992-07-01

Nov 89 - Jul 92 4. TITLE AND SUBTITLE 5. FUNDING NUMBERS Ultrashort-Pulse Laser System : Theory of Operation and C - F33615-88-C-0631 Operating...i ’IR~A&, D2;" T.&B [E] al uicod [] j 0 Avhi lp.bilty C: oded’ Avail i Qiv ULTRASHORT-PULSE LASER SYSTEM : THEORY OF OPERATION AND OPERATING PROCEDURES

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

ERIC Educational Resources Information Center

West, Alfred W.

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

34 CFR 602.23 - Operating procedures all agencies must have.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 34 Education 3 2011-07-01 2011-07-01 false Operating procedures all agencies must have. 602.23... Criteria for Recognition Required Operating Policies and Procedures § 602.23 Operating procedures all... that is related to the agency's standards or procedures. The agency may not complete its review and...

34 CFR 602.23 - Operating procedures all agencies must have.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 34 Education 3 2013-07-01 2013-07-01 false Operating procedures all agencies must have. 602.23... Criteria for Recognition Required Operating Policies and Procedures § 602.23 Operating procedures all... that is related to the agency's standards or procedures. The agency may not complete its review and...

34 CFR 602.23 - Operating procedures all agencies must have.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 34 Education 3 2012-07-01 2012-07-01 false Operating procedures all agencies must have. 602.23... Criteria for Recognition Required Operating Policies and Procedures § 602.23 Operating procedures all... that is related to the agency's standards or procedures. The agency may not complete its review and...

34 CFR 602.23 - Operating procedures all agencies must have.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 34 Education 3 2010-07-01 2010-07-01 false Operating procedures all agencies must have. 602.23... Criteria for Recognition Required Operating Policies and Procedures § 602.23 Operating procedures all... that is related to the agency's standards or procedures. The agency may not complete its review and...

Ethanol sclerotherapy of ovarian endometrioma: a safe and effective minimal invasive procedure. Preliminary results.

PubMed

García-Tejedor, Amparo; Castellarnau, Marta; Ponce, Jordi; Fernández, Ma Eulalia; Burdio, Fernando

2015-04-01

To study if ultrasound-guided aspiration with ethanol sclerosis is a safe and effective treatment for endometriomas. We conducted a prospective study of 25 women with 27 endometriomas (two bilateral) measuring 4-10cm in diameter with no suspected malignancy, who underwent ultrasound-guided aspiration and ethanol sclerosis between August 2010 and July 2014. Patients were followed up by ultrasound at 6, 12, 24, and 36 months to identify rates of complication and recurrence. Clinical characteristics of the patients (age, history of infertility, previous surgery, and abdominal pain), the cysts (location, diameter, and volume) and the procedure (duration and complications) were recorded. Kaplan-Meier survival curves were used to analyze the recurrence rates by SPSS statistical software. The recurrence rate after sclerosis was 12%. The mean length of follow-up was 17 (SD 9.9) months. Although no major procedure-related complications were recorded, minor complications included three cases of low abdominal pain during the procedure (10.7%) and two cases of abdominal ethanol extravasation (7.1%). Ultrasound-guided aspiration and ethanol sclerotherapy are a safe and effective treatment for endometriomas measuring 4-10cm in diameter with no evidence of malignancy. This conservative treatment could possibly achieve a symptomatic cure while preserving healthy ovarian tissue, thereby improving fertility outcomes and avoiding early menopause. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Recommended Practices for the Safe Design and Operation of Flywheels

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

Bender, Donald Arthur

2015-12-01

Flywheel energy storage systems are in use globally in increasing numbers . No codes pertaining specifically to flywheel energy storage exist. A number of industrial incidents have occurred. This protocol recommends a technical basis for safe flywheel de sign and operation for consideration by flywheel developers, users of flywheel systems and standards setting organizations.

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

DTIC Science & Technology

2016-04-04

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

In-office vs. operating room procedures for recurrent respiratory papillomatosis.

PubMed

Miller, Anya J; Gardner, Glendon M

2017-01-01

We conducted a study to analyze hospital and patient costs, outcomes, and patient satisfaction among adults undergoing in-office and operating room procedures for the treatment of recurrent respiratory papillomatosis. Our final study population was made up of 17 patients-1 man and 16 women, aged 30 to 86 years (mean: 62). The mean number of in-office laser procedures per patient was 4.2, and the mean interval between procedures was 5.4 months (although 10 patients underwent only 1 office procedure); the mean number of operating room procedures was 13.5, and the mean interval between procedures was 14.3 months. An equal number of patients reported complications or adverse events with the two types of procedures-5 each. The difference in cost between the office procedure (mean: $3,413.00) and the operating room procedure (mean: $12,382.59) was almost $9,000, but these savings were offset by the fact that the office procedures needed to be performed three times as often. Patients reported slightly more anxiety and discomfort during the office procedures and, overall, they appeared to prefer the operating room procedure. We conclude that office procedures are significantly more cost-effective than operating room procedures, but their use may be limited by patient tolerance and the increased frequency of the procedure.

46 CFR 130.480 - Test procedure and operations manual.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Test procedure and operations manual. 130.480 Section... VESSEL CONTROL, AND MISCELLANEOUS EQUIPMENT AND SYSTEMS Automation of Unattended Machinery Spaces § 130.480 Test procedure and operations manual. (a) A procedure for tests to be conducted on automated...

42 CFR 35.15 - Consent to operative procedures.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 1 2014-10-01 2014-10-01 false Consent to operative procedures. 35.15 Section 35.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.15 Consent to operative procedures. Except in...

42 CFR 35.15 - Consent to operative procedures.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 1 2012-10-01 2012-10-01 false Consent to operative procedures. 35.15 Section 35.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.15 Consent to operative procedures. Except in...

42 CFR 35.15 - Consent to operative procedures.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 1 2013-10-01 2013-10-01 false Consent to operative procedures. 35.15 Section 35.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.15 Consent to operative procedures. Except in...

42 CFR 35.15 - Consent to operative procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Consent to operative procedures. 35.15 Section 35.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.15 Consent to operative procedures. Except in...

42 CFR 35.15 - Consent to operative procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 1 2011-10-01 2011-10-01 false Consent to operative procedures. 35.15 Section 35.15 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES MEDICAL CARE AND EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.15 Consent to operative procedures. Except in...

Unmanned Aerial Systems Traffic Management (UTM): Safely Enabling UAS Operations in Low-Altitude Airspace

NASA Technical Reports Server (NTRS)

Jung, Jaewoo; Kopardekar, Parimal H.

2016-01-01

Flexibility where possible, and structure where necessary. Consider the needs of national security, safe airspace operations, economic opportunities, and emerging technologies. Risk-based approach based on population density, assets on the ground, density of operations, etc. Digital, virtual, dynamic, and as needed UTM services to manage operations.

Unmanned Aerial Systems Traffic Management (UTM): Safely Enabling UAS Operations in Low-Altitude Airspace

NASA Technical Reports Server (NTRS)

Kopardekar, Parimal H.; Cavolowsky, John

2015-01-01

Flexibility where possible, and structure where necessary. Consider the needs of national security, safe airspace operations, economic opportunities, and emerging technologies. Risk-based approach based on population density, assets on the ground, density of operations, etc. Digital, virtual, dynamic, and as needed UTM services to manage operations.

14 CFR 23.1585 - Operating procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... multiengine airplanes, information identifying each operating condition in which the fuel system independence... fuel system in a configuration used to show compliance with that section. (h) For each airplane showing compliance with § 23.1353 (g)(2) or (g)(3), the operating procedures for disconnecting the battery from its...

Microbial ecology laboratory procedures manual NASA/MSFC

NASA Technical Reports Server (NTRS)

Huff, Timothy L.

1990-01-01

An essential part of the efficient operation of any microbiology laboratory involved in sample analysis is a standard procedures manual. The purpose of this manual is to provide concise and well defined instructions on routine technical procedures involving sample analysis and methods for monitoring and maintaining quality control within the laboratory. Of equal importance is the safe operation of the laboratory. This manual outlines detailed procedures to be followed in the microbial ecology laboratory to assure safety, analytical control, and validity of results.

Mayo Clinic experience with modified Vecchietti procedure for vaginal agenesis: it is easy, safe, and effective.

PubMed

Nahas, Samar; Yi, Johnny; Magrina, Javier

2013-01-01

To evaluate the surgical outcome and the anatomic and sexual function in 10 women with Rokitansky syndrome who underwent the laparoscopic Vecchietti procedure at our center. Retrospective analysis. Data were analyzed on the basis of short-term and long-term surgical outcome and sexual function. All patients underwent clinical follow-up at 1, 2, and 6 months after surgery. In all 10 patients, the procedure produced anatomic and functional success. The laparoscopic Vecchietti technique is safe, simple, and effective for treatment of vaginal agenesis. Results are comparable to those of all European studies, and the procedure should gain more popularity in North America. Copyright © 2013 AAGL. All rights reserved.

Office-based endovascular suite is safe for most procedures.

PubMed

Jain, Krishna; Munn, John; Rummel, Mark C; Johnston, Dan; Longton, Chris

2014-01-01

This study was conducted to identify the safety of endovascular procedures in the office endovascular suite and to assess patient satisfaction in this setting. Between May 22, 2007, and December 31, 2012, 2822 patients underwent 6458 percutaneous procedures in an office-based endovascular suite. Demographics of the patients, complications, hospital transfers, and 30-day mortality were documented in a prospective manner. Follow-up calls were made, and a satisfaction survey was conducted. Almost all dialysis procedures were done under local anesthesia and peripheral arterial procedures under conscious sedation. All patients, except those undergoing catheter removals, received hydrocodone and acetaminophen (5/325 mg), diazepam (5-10 mg), and one dose of an oral antibiotic preprocedure and three doses postprocedure. Patients who required conscious sedation received fentanyl and midazolam. Conscious sedation was used almost exclusively in patients having an arterial procedure. Measurements of blood urea nitrogen, creatinine, international normalized ratio, and partial thromboplastin time were performed before peripheral arteriograms. All other patients had no preoperative laboratory tests. Patients considered high risk (American Society of Anesthesiologists Physical Status Classification 4), those who could not tolerate the procedure with mild to moderate conscious sedation, patients with a previous bad experience, or patients who weighed >400 pounds were not candidates for office based procedures. There were 54 total complications (0.8%): venous, 2.2%; aortogram without interventions, 1%; aortogram with interventions, 2.7%; fistulogram, 0.5%; catheters, 0.3%; and venous filter-related, 2%. Twenty-six patients required hospital transfer from the office. Ten patients needed an operative intervention because of a complication. No procedure-related deaths occurred. There were 18 deaths in a 30-day period. Of patients surveyed, 99% indicated that they would come back to the

OCCUPATIONAL RADIATION DOSES TO OPERATORS PERFORMING FLUOROSCOPICALLY-GUIDED PROCEDURES

PubMed Central

Kim, Kwang Pyo; Miller, Donald L.; de Gonzalez, Amy Berrington; Balter, Stephen; Kleinerman, Ruth A.; Ostroumova, Evgenia; Simon, Steven L.; Linet, Martha S.

2012-01-01

In the past 30 years, the numbers and types of fluoroscopically-guided (FG) procedures have increased dramatically. The objective of the present study is to provide estimated radiation doses to physician specialists, other than cardiologists, who perform FG procedures. We searched Medline to identify English-language journal articles reporting radiation exposures to these physicians. We then identified several primarily therapeutic FG procedures that met specific criteria: well-defined procedures for which there were at least five published reports of estimated radiation doses to the operator, procedures performed frequently in current medical practice, and inclusion of physicians from multiple medical specialties. These procedures were percutaneous nephrolithotomy (PCNL), vertebroplasty, orthopedic extremity nailing for treatment of fractures, biliary tract procedures, transjugular intrahepatic portosystemic shunt creation (TIPS), head/neck endovascular therapeutic procedures, and endoscopic retrograde cholangiopancreatography (ERCP). We abstracted radiation doses and other associated data, and estimated effective dose to operators. Operators received estimated doses per patient procedure equivalent to doses received by interventional cardiologists. The estimated effective dose per case ranged from 1.7 – 56μSv for PCNL, 0.1 – 101 μSv for vertebroplasty, 2.5 – 88μSv for orthopedic extremity nailing, 2.0 – 46μSv for biliary tract procedures, 2.5 – 74μSv for TIPS, 1.8 – 53μSv for head/neck endovascular therapeutic procedures, and 0.2 – 49μSv for ERCP. Overall, mean operator radiation dose per case measured over personal protective devices at different anatomic sites on the head and body ranged from 19 – 800 (median = 113) μSv at eye level, 6 – 1180 (median = 75)μSv at the neck, and 2 – 1600 (median = 302) μSv at the trunk. Operators’ hands often received greater doses than the eyes, neck or trunk. Large variations in operator doses

Safe and accurate midcervical pedicle screw insertion procedure with the patient-specific screw guide template system.

PubMed

Kaneyama, Shuichi; Sugawara, Taku; Sumi, Masatoshi

2015-03-15

Clinical trial for midcervical pedicle screw insertion using a novel patient-specific intraoperative screw guiding device. To evaluate the availability of the "Screw Guide Template" (SGT) system for insertion of midcervical pedicle screws. Despite many efforts for accurate midcervical pedicle screw insertion, there still remain unacceptable rate of screw malpositioning that might cause neurovascular injuries. We developed patient-specific SGT system for safe and accurate intraoperative screw navigation tool and have reported its availability for the screw insertion to C2 vertebra and thoracic spine. Preoperatively, the bone image on computed tomography was analyzed and the trajectories of the screws were designed in 3-dimensional format. Three types of templates were created for each lamina: location template, drill guide template, and screw guide template. During the operations, after engaging the templates directly with the laminae, drilling, tapping, and screwing were performed with each template. We placed 80 midcervical pedicle screws for 20 patients. The accuracy and safety of the screw insertion by SGT system were evaluated using postoperative computed tomographic scan by calculation of screw deviation from the preplanned trajectory and evaluation of screw breach of pedicle wall. All templates fitted the laminae and screw navigation procedures proceeded uneventfully. All screws were inserted accurately with the mean screw deviation from planned trajectory of 0.29 ± 0.31 mm and no neurovascular complication was experienced. We demonstrated that our SGT system could support the precise screw insertion in midcervical pedicle. SGT prescribes the safe screw trajectory in a 3-dimensional manner and the templates fit and lock directly to the target laminae, which prevents screwing error along with the change of spinal alignment during the surgery. These advantages of the SGT system guarantee the high accuracy in screw insertion, which allowed surgeons to insert

A cadaveric procedural anatomy course enhances operative competence.

PubMed

Sharma, Gaurav; Aycart, Mario A; Najjar, Peter A; van Houten, Trudy; Smink, Douglas S; Askari, Reza; Gates, Jonathan D

2016-03-01

Inadequate anatomy training has been cited as a major contributor to declines in surgical resident operative competence and confidence. We report the impact of a procedurally oriented general surgery cadaveric dissection course on trainee-operative confidence and competence. After obtaining institutional review board approval, postgraduate year 2 and 3 general surgery residents were prospectively enrolled into two cohorts: (1) an intervention group (n = 7) participating in an 8-wk procedurally oriented cadaver course and (2) controls (n = 7) given access to course materials without participation in cadaver dissection. At both the beginning and end of the study, we used two evaluation instruments: (1) an oral examination using standardized templates and (2) a questionnaire assessing operative confidence. There were no intergroup differences in baseline characteristics, including number of operative procedures performed to date. Residents who took the anatomy course had significantly higher improvements in examination scores on common bile duct exploration (mean ± standard error, 33 ± 8% versus 10 ± 7%, P = 0.04), femoral endarterectomy (43 ± 5% versus 11 ± 7%, P = 0.003), fasciotomies (55 ± 10% versus 22 ± 9%, P = 0.04), inguinal hernia repair (20 ± 9% versus -14 ± 5%, P = 0.005), superior mesenteric artery embolectomy (38 ± 10% versus 2 ± 11%, P = 0.04), and in overall examination scores (31 ± 4% versus 8% ± 3%, P = 0.0006). In addition, they reported higher operative confidence on common bile duct exploration (P = 0.008) and superior mesenteric artery embolectomy (P = 0.02), and a trend toward higher overall operative confidence (P = 0.06). In this study, we demonstrate that a procedurally oriented cadaver course covering a wide range of essential general surgery procedures resulted in significant improvements in self-reported operative confidence and competence as assessed by oral examination. Copyright © 2016 Elsevier Inc. All rights reserved.

Safe Autonomous Flight Environment (SAFE50) for the Notional Last 50 ft of Operation of 55 lb Class of UAS

NASA Technical Reports Server (NTRS)

Krishnakumar, Kalmanje; Kopardekar, Parimal; Ippolito, Corey; Melton, John E.; Stepanyan, Vahram; Sankararaman, Shankar; Nikaido, Ben

2017-01-01

The most difficult phase of small Unmanned Aerial System (sUAS) deployment is autonomous operations below the notional 50 ft in urban landscapes. Understanding the feasibility of safely flying sUAS autonomously below 50 ft is a game changer for many civilian applications. This paper outlines three areas of research currently underway which address key challenges for flight in the urban landscape. These are: (1) Off-line and On-board wind estimation and accommodation; (2) Real-time trajectory planning via characterization of obstacles using a LIDAR; (3) On-board information fusion for real-time decision-making and safe trajectory generation.

Advanced laparoscopic bariatric surgery Is safe in general surgery training.

PubMed

Kuckelman, John; Bingham, Jason; Barron, Morgan; Lallemand, Michael; Martin, Matthew; Sohn, Vance

2017-05-01

Bariatric surgery makes up an increasing percentage of general surgery training. The safety of resident involvement in these complex cases has been questioned. We evaluated patient outcomes in resident performed laparoscopic bariatric procedures. Retrospective review of patients undergoing a laparoscopic bariatric procedure over seven years at a tertiary care single center. Procedures were primarily performed by a general surgery resident and proctored by an attending surgeon. Primary outcomes included operative volume, operative time and leak rate with perioperative outcomes evaluated as secondary outcomes. A total of 1649 bariatric procedures were evaluated. Operations included laparoscopic bypass (690) and laparoscopic sleeve gastrectomy (959). Average operating time was 136 min. Eighteen leaks (0.67%) were identified. Graduating residents performed an average of 89 laparoscopic bariatric cases during their training. There were no significant differences between resident levels with concern to operative time or leak rate (p 0.97 and p = 0.54). General surgery residents can safely perform laparoscopic bariatric surgery. When proctored by a staff surgeon, a resident's level of training does not significantly impact leak rate. Published by Elsevier Inc.

Operator procedure verification with a rapidly reconfigurable simulator

NASA Technical Reports Server (NTRS)

Iwasaki, Yumi; Engelmore, Robert; Fehr, Gary; Fikes, Richard

1994-01-01

Generating and testing procedures for controlling spacecraft subsystems composed of electro-mechanical and computationally realized elements has become a very difficult task. Before a spacecraft can be flown, mission controllers must envision a great variety of situations the flight crew may encounter during a mission and carefully construct procedures for operating the spacecraft in each possible situation. If, despite extensive pre-compilation of control procedures, an unforeseen situation arises during a mission, the mission controller must generate a new procedure for the flight crew in a limited amount of time. In such situations, the mission controller cannot systematically consider and test alternative procedures against models of the system being controlled, because the available simulator is too large and complex to reconfigure, run, and analyze quickly. A rapidly reconfigurable simulation environment that can execute a control procedure and show its effects on system behavior would greatly facilitate generation and testing of control procedures both before and during a mission. The How Things Work project at Stanford University has developed a system called DME (Device Modeling Environment) for modeling and simulating the behavior of electromechanical devices. DME was designed to facilitate model formulation and behavior simulation of device behavior including both continuous and discrete phenomena. We are currently extending DME for use in testing operator procedures, and we have built a knowledge base for modeling the Reaction Control System (RCS) of the space shuttle as a testbed. We believe that DME can facilitate design of operator procedures by providing mission controllers with a simulation environment that meets all these requirements.

14 CFR 93.71 - General operating procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... of Niagara Falls, New York § 93.71 General operating procedures. (a) Flight restrictions are in effect below 3,500 feet MSL in the airspace above Niagara Falls, New York, west of a line from latitude..., aircraft operating on an ATC-approved IFR flight plan, aircraft operating the Scenic Falls Route pursuant...

14 CFR 93.71 - General operating procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... of Niagara Falls, New York § 93.71 General operating procedures. (a) Flight restrictions are in effect below 3,500 feet MSL in the airspace above Niagara Falls, New York, west of a line from latitude..., aircraft operating on an ATC-approved IFR flight plan, aircraft operating the Scenic Falls Route pursuant...

14 CFR 93.71 - General operating procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... of Niagara Falls, New York § 93.71 General operating procedures. (a) Flight restrictions are in effect below 3,500 feet MSL in the airspace above Niagara Falls, New York, west of a line from latitude..., aircraft operating on an ATC-approved IFR flight plan, aircraft operating the Scenic Falls Route pursuant...

Beyond climate-smart agriculture: toward safe operating spaces for global food systems

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

Gulledge, Jay; Neufeldt, Heinrich; Jahn, Margaret M

Agriculture is considered to be climate-smart when it contributes to increasing food security, adaptation and mitigation in a sustainable way. This new concept now dominates current discussions in agricultural development because of its capacity to unite the agendas of the agriculture, development and climate change communities under one brand. In this opinion piece authored by scientists from a variety of international agricultural and climate research communities, we argue that the concept needs to be evaluated critically because the relationship between the three dimensions is poorly understood, such that practically any improved agricultural practice can be considered climate-smart. This lack ofmore » clarity may have contributed to the broad appeal of the concept. From the understanding that we must hold ourselves accountable to demonstrably better meet human needs in the short and long term within foreseeable local and planetary limits, we develop a conceptualization of climate-smart agriculture as agriculture that can be shown to bring us closer to safe operating spaces for agricultural and food systems across spatial and temporal scales. Improvements in the management of agricultural systems that bring us significantly closer to safe operating spaces will require transformations in governance and use of our natural resources, underpinned by enabling political, social and economic conditions beyond incremental changes. Establishing scientifically credible indicators and metrics of long-term safe operating spaces in the context of a changing climate and growing social-ecological challenges is critical to creating the societal demand and political will required to motivate deep transformations. Answering questions on how the needed transformational change can be achieved will require actively setting and testing hypotheses to refine and characterize our concepts of safer spaces for social-ecological systems across scales. This effort will demand prioritizing

Safely Conducting Airport Surface Trajectory-Based Operations

NASA Technical Reports Server (NTRS)

Jones, Denise R.; Prinzel, Lawrence J., III; Bailey, Randall E.; Arthur, Jarvis J., III; Barnes, James R.

2014-01-01

A piloted simulation study was conducted at the National Aeronautics and Space Administration (NASA) Langley Research Center (LaRC) to evaluate the ability to safely conduct surface trajectory-based operations (STBO) by assessing the impact of providing traffic intent information, conflict detection and resolution (CD&R) system capability, and the display of STBO guidance to the flight crew on both head-down and head-up displays (HUD). Nominal and off-nominal conflict scenarios were conducted using 12 airline crews operating in a simulated Memphis International Airport terminal environment. The flight crews met their required time-of-arrival at route end within 10 seconds on 98 percent of the trials, well within the acceptable performance bounds of 15 seconds. Traffic intent information was found to be useful in determining the intent of conflict traffic, with graphical presentation preferred. The CD&R system was only minimally effective during STBO because the prevailing visibility was sufficient for visual detection of incurring traffic. Overall, the pilots indicated STBO increased general situation awareness but also negatively impacted workload, reduced the ability to watch for other traffic, and increased head-down time.

The procedure execution manager and its application to Advanced Photon Source operation

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

Borland, M.

1997-06-01

The Procedure Execution Manager (PEM) combines a complete scripting environment for coding accelerator operation procedures with a manager application for executing and monitoring the procedures. PEM is based on Tcl/Tk, a supporting widget library, and the dp-tcl extension for distributed processing. The scripting environment provides support for distributed, parallel execution of procedures along with join and abort operations. Nesting of procedures is supported, permitting the same code to run as a top-level procedure under operator control or as a subroutine under control of another procedure. The manager application allows an operator to execute one or more procedures in automatic, semi-automatic,more » or manual modes. It also provides a standard way for operators to interact with procedures. A number of successful applications of PEM to accelerator operations have been made to date. These include start-up, shutdown, and other control of the positron accumulator ring (PAR), low-energy transport (LET) lines, and the booster rf systems. The PAR/LET procedures make nested use of PEM`s ability to run parallel procedures. There are also a number of procedures to guide and assist tune-up operations, to make accelerator physics measurements, and to diagnose equipment. Because of the success of the existing procedures, expanded use of PEM is planned.« less

47 CFR 80.116 - Radiotelephone operating procedures for ship stations.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Radiotelephone operating procedures for ship... Procedures-Ship Stations § 80.116 Radiotelephone operating procedures for ship stations. (a) Calling coast stations. (1) Use by ship stations of the frequency 2182 kHz for calling coast stations and for replying to...

47 CFR 80.116 - Radiotelephone operating procedures for ship stations.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Radiotelephone operating procedures for ship... Procedures-Ship Stations § 80.116 Radiotelephone operating procedures for ship stations. (a) Calling coast stations. (1) Use by ship stations of the frequency 2182 kHz for calling coast stations and for replying to...

47 CFR 80.116 - Radiotelephone operating procedures for ship stations.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 47 Telecommunication 5 2013-10-01 2013-10-01 false Radiotelephone operating procedures for ship... Procedures-Ship Stations § 80.116 Radiotelephone operating procedures for ship stations. (a) Calling coast stations. (1) Use by ship stations of the frequency 2182 kHz for calling coast stations and for replying to...

47 CFR 80.116 - Radiotelephone operating procedures for ship stations.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 47 Telecommunication 5 2014-10-01 2014-10-01 false Radiotelephone operating procedures for ship... Procedures-Ship Stations § 80.116 Radiotelephone operating procedures for ship stations. (a) Calling coast stations. (1) Use by ship stations of the frequency 2182 kHz for calling coast stations and for replying to...

47 CFR 80.116 - Radiotelephone operating procedures for ship stations.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 47 Telecommunication 5 2012-10-01 2012-10-01 false Radiotelephone operating procedures for ship... Procedures-Ship Stations § 80.116 Radiotelephone operating procedures for ship stations. (a) Calling coast stations. (1) Use by ship stations of the frequency 2182 kHz for calling coast stations and for replying to...

40 CFR 240.200-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended Procedures § 240.200-3 Recommended procedures: Operations. (a) Storage areas for special wastes should be... acceptance of Special Wastes. ...

40 CFR 240.200-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended Procedures § 240.200-3 Recommended procedures: Operations. (a) Storage areas for special wastes should be... acceptance of Special Wastes. ...

Philosophy, policies, and procedures - The three P's of flight-deck operations

NASA Technical Reports Server (NTRS)

Degani, Asaf; Wiener, Earl L.

1991-01-01

Standard operating procedures are drafted and provided to flightcrews to dictate the manner in which tasks are carried out. Failure to conform to Standard Operating Procedures (SOP) is frequently listed as the cause of violations, incidents, and accidents. However, procedures are often designed piecemeal, rather than being based on a sound philosophy of operations and policies that follow from such a philosophy. A framework of philosophy, policies, and procedures is proposed.

Disinfection of aircraft : Appropriate disinfectants and standard operating procedures for highly infectious diseases.

PubMed

Klaus, Joachim; Gnirs, Peter; Hölterhoff, Sabine; Wirtz, Angela; Jeglitza, Matthias; Gaber, Walter; Gottschalk, Rene

2016-12-01

For infectious diseases caused by highly pathogenic agents (e. g., Ebola/Lassa fever virus, SARS-/MERS-CoV, pandemic influenza virus) which have the potential to spread over several continents within only a few days, international Health Protection Authorities have taken appropriate measures to limit the consequences of a possible spread. A crucial point in this context is the disinfection of an aircraft that had a passenger on board who is suspected of being infected with one of the mentioned diseases. Although, basic advice on hygiene and sanitation on board an aircraft is given by the World Health Organization, these guidelines lack details on available and effective substances as well as standardized operating procedures (SOP). The purpose of this paper is to give guidance on the choice of substances that were tested by a laboratory of Lufthansa Technik and found compatible with aircraft components, as well as to describe procedures which ensure a safe and efficient disinfection of civil aircrafts. This guidance and the additional SOPs are made public and are available as mentioned in this paper.

[The transrectus sheath preperitoneal procedure: a safe, effective and cheap surgical approach to inguinal hernia?].

PubMed

Prins, M W Wiesje; Voropai, D A Dasha; van Laarhoven, C J H M Kees; Akkersdijk, Willem L

2013-01-01

The main complication of surgery for inguinal hernia is chronic postoperative pain. This is often reported following the Lichtenstein procedure. A new, open surgical technique for the repair of inguinal hernia has been developed. This procedure is called the transrectus sheath preperitoneal procedure (TREPP). At TREPP a lightweight mesh with a ring made of memory metal is introduced into the preperitoneal space through the transrectus sheath. The first results of this operative technique are very promising: short operation time, short learning curve and not many patients with chronic postoperative pain. In a randomised, multi-centre study which will start mid-2013 (ISRCTN18591339), the TREPP procedure is compared with the transinguinal preperitoneal procedure. The primary outcome measure of this study is chronic postoperative pain.

Colorectal endoscopic submucosal dissection: Recent technical advances for safe and successful procedures

PubMed Central

Yamamoto, Katsumi; Michida, Tomoki; Nishida, Tsutomu; Hayashi, Shiro; Naito, Masafumi; Ito, Toshifumi

2015-01-01

Endoscopic submucosal dissection (ESD) is very useful in en bloc resection of large superficial colorectal tumors but is a technically difficult procedure because the colonic wall is thin and endoscopic maneuverability is poor because of colonic flexure and extensibility. A high risk of perforation has been reported in colorectal ESD. To prevent complications such as perforation and unexpected bleeding, it is crucial to ensure good visualization of the submucosal layer by creating a mucosal flap, which is an exfoliated mucosa for inserting the tip of the endoscope under it. The creation of a mucosal flap is often technically difficult; however, various types of equipment, appropriate strategy, and novel procedures including our clip-flap method, appear to facilitate mucosal flap creation, improving the safety and success rate of ESD. Favorable treatment outcomes with colorectal ESD have already been reported in many advanced institutions, and appropriate understanding of techniques and development of training systems are required for world-wide standardization of colorectal ESD. Here, we describe recent technical advances for safe and successful colorectal ESD. PMID:26468335

What is the safety of nonemergent operative procedures performed at night? A study of 10,426 operations at an academic tertiary care hospital using the American College of Surgeons national surgical quality program improvement database.

PubMed

Turrentine, Florence E; Wang, Hongkun; Young, Jeffrey S; Calland, James Forrest

2010-08-01

Ever-increasing numbers of in-house acute care surgeons and competition for operating room time during normal daytime business hours have led to an increased frequency of nonemergent general and vascular surgery procedures occurring at night when there are fewer residents, consultants, nurses, and support staff available for assistance. This investigation tests the hypothesis that patients undergoing such procedures after hours are at increased risk for postoperative morbidity and mortality. Clinical data for 10,426 operative procedures performed over a 5-year period at a single academic tertiary care hospital were obtained from the American College of Surgeons National Surgical Quality Improvement Program Database. The prevalence of preoperative comorbid conditions, postoperative length of stay, morbidity, and mortality was compared between two cohorts of patients: one who underwent nonemergent operative procedures at night and other who underwent similar procedures during the day. Subsequent statistical comparisons utilized chi tests for comparisons of categorical variables and F-tests for continuous variables. Patients undergoing procedures at night had a greater prevalence of serious preoperative comorbid conditions. Procedure complexity as measured by relative value unit did not differ between groups, but length of stay was longer after night procedures (7.8 days vs. 4.3 days, p < 0.0001). Patients undergoing nonemergent general and vascular surgery procedures at night in an academic medical center do not seem to be at increased risk for postoperative morbidity or mortality. Performing nonemergent procedures at night seems to be a safe solution for daytime overcrowding of operating rooms.

Critical issues in assuring long lifetime and fail-safe operation of optical communications network

NASA Astrophysics Data System (ADS)

Paul, Dilip K.

1993-09-01

Major factors in assuring long lifetime and fail-safe operation in optical communications networks are reviewed in this paper. Reliable functionality to design specifications, complexity of implementation, and cost are the most critical issues. As economics is the driving force to set the goals as well as priorities for the design, development, safe operation, and maintenance schedules of reliable networks, a balance is sought between the degree of reliability enhancement, cost, and acceptable outage of services. Protecting both the link and the network with high reliability components, hardware duplication, and diversity routing can ensure the best network availability. Case examples include both fiber optic and lasercom systems. Also, the state-of-the-art reliability of photonics in space environment is presented.

Improved Quick Disconnect (QD) Interface Through Fail Safe Parts Identification

NASA Technical Reports Server (NTRS)

Blanch-Payne, Evelyn

2001-01-01

An extensive review of existing Quick Disconnects (QDs) mating and demating operations was performed to determine which shuttle part interface identifications and procedures contribute to human factor errors. The research methods used consisted of interviews with engineers and technicians, examination of incident reports, critiques of video and audio tapes of QD operations, and attendance of a Hyper QD operational course. The data strongly suggests that there are inherit human factor errors involved in QD operations. To promote fail-safe operations, QD interface problem areas and recommendations were outlined and reviewed. It is suggested that dialogue, investigations and recommendations continue.

Designing Flight-Deck Procedures

NASA Technical Reports Server (NTRS)

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

1995-01-01

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

Is Office-Based Surgery Safe? Comparing Outcomes of 183,914 Aesthetic Surgical Procedures Across Different Types of Accredited Facilities.

PubMed

Gupta, Varun; Parikh, Rikesh; Nguyen, Lyly; Afshari, Ashkan; Shack, R Bruce; Grotting, James C; Higdon, K Kye

2017-02-01

There has been a dramatic rise in office-based surgery. However, due to wide variations in regulatory standards, the safety of office-based aesthetic surgery has been questioned. This study compares complication rates of cosmetic surgery performed at office-based surgical suites (OBSS) to ambulatory surgery centers (ASCs) and hospitals. A prospective cohort of patients undergoing cosmetic surgery between 2008 and 2013 were identified from the CosmetAssure database (Birmingham, AL). Patients were grouped by type of accredited facility where the surgery was performed: OBSS, ASC, or hospital. The primary outcome was the incidence of major complication(s) requiring emergency room visit, hospital admission, or reoperation within 30 days postoperatively. Potential risk factors including age, gender, body mass index (BMI), smoking, diabetes, type of procedure, and combined procedures were reviewed. Of the 129,007 patients (183,914 procedures) in the dataset, the majority underwent the procedure at ASCs (57.4%), followed by hospitals (26.7%) and OBSS (15.9%). Patients operated in OBSS were less likely to undergo combined procedures (30.3%) compared to ASCs (31.8%) and hospitals (35.3%, P < .01). Complication rates in OBSS, ASCs, and hospitals were 1.3%, 1.9%, and 2.4%, respectively. On multivariate analysis, there was a lower risk of developing a complication in an OBSS compared to an ASC (RR 0.67, 95% CI 0.59-0.77, P < .01) or a hospital (RR 0.59, 95% CI 0.52-0.68, P < .01). Accredited OBSS appear to be a safe alternative to ASCs and hospitals for cosmetic procedures. Plastic surgeons should continue to triage their patients carefully based on other significant comorbidities that were not measured in this present study. LEVEL OF EVIDENCE 3. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

Procedures in complex systems: the airline cockpit.

PubMed

Degani, A; Wiener, E L

1997-05-01

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

40 CFR 68.69 - Operating procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.69 Operating procedures. (a) The... presented by, the chemicals used in the process; (ii) Precautions necessary to prevent exposure, including engineering controls, administrative controls, and personal protective equipment; (iii) Control measures to be...

40 CFR 68.69 - Operating procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.69 Operating procedures. (a) The... presented by, the chemicals used in the process; (ii) Precautions necessary to prevent exposure, including engineering controls, administrative controls, and personal protective equipment; (iii) Control measures to be...

40 CFR 68.69 - Operating procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.69 Operating procedures. (a) The... presented by, the chemicals used in the process; (ii) Precautions necessary to prevent exposure, including engineering controls, administrative controls, and personal protective equipment; (iii) Control measures to be...

40 CFR 68.69 - Operating procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.69 Operating procedures. (a) The... presented by, the chemicals used in the process; (ii) Precautions necessary to prevent exposure, including engineering controls, administrative controls, and personal protective equipment; (iii) Control measures to be...

40 CFR 68.69 - Operating procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

...) CHEMICAL ACCIDENT PREVENTION PROVISIONS Program 3 Prevention Program § 68.69 Operating procedures. (a) The... presented by, the chemicals used in the process; (ii) Precautions necessary to prevent exposure, including engineering controls, administrative controls, and personal protective equipment; (iii) Control measures to be...

Initial Investigations of Controller Tools and Procedures for Schedule-Based Arrival Operations with Mixed Flight-Deck Interval Management Equipage

NASA Technical Reports Server (NTRS)

Callantine, Todd J.; Cabrall, Christopher; Kupfer, Michael; Omar, Faisal G.; Prevot, Thomas

2012-01-01

NASA?s Air Traffic Management Demonstration-1 (ATD-1) is a multi-year effort to demonstrate high-throughput, fuel-efficient arrivals at a major U.S. airport using NASA-developed scheduling automation, controller decision-support tools, and ADS-B-enabled Flight-Deck Interval Management (FIM) avionics. First-year accomplishments include the development of a concept of operations for managing scheduled arrivals flying Optimized Profile Descents with equipped aircraft conducting FIM operations, and the integration of laboratory prototypes of the core ATD-1 technologies. Following each integration phase, a human-in-the-loop simulation was conducted to evaluate and refine controller tools, procedures, and clearance phraseology. From a ground-side perspective, the results indicate the concept is viable and the operations are safe and acceptable. Additional training is required for smooth operations that yield notable benefits, particularly in the areas of FIM operations and clearance phraseology.

TVT and TVT-Obturator: comparison of two operative procedures.

PubMed

Neuman, Menahem

2007-03-01

To compare two anti-incontinence operations: the tension-free vaginal tape (TVT) and the TVT-Obturator for the first two 75-patient groups. One surgeon operated on two patient groups with urodynamically proven urinary stress incontinence. The first 75-patient group in 1998 included the first TVT procedures performed according to Ulmsten [Ulmsten U, Henriksson L, Johnson P, Varhos G. An ambulatory surgical procedure under local anesthesia for treatment of female urinary incontinence. Int Urogynecol J 1996;7:81-6]. Follow-up lasted for 5-6 years. The second 75-patient group in 2004 included the first TVT-Obturator operations performed according to [De Leval J. Novel surgical technique for the treatment of female stress urinary incontinence: transobturator vaginal tape inside-out. Eur. Urol. 2003;44:724-30]. Follow-up lasted for 6-13 months. The two patient groups were similar from the demographic and therapeutic points of view. The TVT-Obturator procedure required neither bladder catheterization nor intra-operative diagnostic cystoscopy. TVT-related bladder penetration (8.0%), post-operative voiding difficulties (5.0%), intra-operative bleeding (4.0%), post-operative field infection (2.7%), and post-operative pelvic floor relaxation (1.3%) were not noted with the TVT-Obturator. The early therapeutic failure rates were 2.7% for the TVT and 1.3% for the TVT-Obturator, and neither bowel nor urethral injuries were recorded. The surgeons' learning curves of these two minimally invasive surgical procedures for the treatment of female urinary stress incontinence are comparable. The safety and cost-effectiveness of the TVT are well-established. The TVT-Obturator, a novel mid-urethral sling, was designed to overcome some of the TVT-related operative complications. The TVT-Obturator patients seem to have less intra-operative and post-operative surgical complications than the TVT patients. However, long-term comparative data collection is required prior to drawing solid

D0 Central Tracking Solenoid Energization, Controls, Interlocks and Quench Protection Operating Procedures

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

Hance, R.; /Fermilab

1998-08-26

This procedure is used when it is necessary to operate the solenoid energization, controls, interlocks and quench detection system. Note that a separate procedure exists for operating the solenoid 'cryogenic' systems. Only D0 Control Room Operators or the Project Electrical Engineer are qualified to execute these procedures or operate the solenoid system. This procedure assumes that the operator is familiar with using the Distributed Manufacturing Automation and Control Software (DMACS).

Exploring the safe and just operating space in an inhomogeneous world

NASA Astrophysics Data System (ADS)

Barfuss, Wolfram; Beronov, Boyan; Wiedermann, Marc; Donges, Jonathan

2015-04-01

The Anthropocene has become reality during the 20th century, implying that our species is pressuring the Earth's ecosystems on a global scale. In the meantime, the challenge of eradicating poverty has not yet ceased to exist. Effectively dealing with these issues requires us to better understand the driving forces, feedback loops and tipping elements in the whole Earth system, constituted by natural and social components. To take a step forward in this direction, we refine an existing conceptual coevolutionary model of social and ecological domains (COPAN:EXPLOIT) by introducing inhomogeneities in the properties of local renewable resource stocks that are abstracted from real-world data. We then propose an analytical framework, 'the safe and just space'- plot, which aligns with the current debate on how to simultaneously stay within planetary boundaries (Rockström et al., 2009) and at the same time ensure that social foundations are met (Raworth, 2012). This plot presents a practical tool for jointly studying global socio-ecological models as well as real-world observations. First results from comparing the model outputs with real-world data indicate that the current state of the world is neither particularly safe nor particularly just. References: Rockström, Johan, et al. "A safe operating space for humanity." Nature 461.7263 (2009): 472-475. Raworth, Kate. "A safe and just space for humanity: can we live within the doughnut?" Oxfam Discussion Papers (2012): 1-26.

STS-38 Atlantis, OV-104, during safing operations after KSC SLF landing

NASA Image and Video Library

1990-11-20

Spotlights illuminate Atlantis, Orbiter Vehicle (OV) 104, during safing operations at the Kennedy Space Center's (KSC's) Shuttle Landing Facility (SLF). OV-104 parked on runway 33 is serviced by KSC ground crews. STS-38, a Department of Defense (DOD)-devoted mission, came to an end (with complete wheel stop) at 4:43:37 pm (Eastern Standard Time (EST)).

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

STOL Traffic environment and operational procedures

NASA Technical Reports Server (NTRS)

Schlundt, R. W.; Dewolf, R. W.; Ausrotas, R. A.; Curry, R. E.; Demaio, D.; Keene, D. W.; Speyer, J. L.; Weinreich, M.; Zeldin, S.

1972-01-01

The expected traffic environment for an intercity STOL transportation system is examined, and operational procedures are discussed in order to identify problem areas which impact STOL avionics requirements. Factors considered include: traffic densities, STOL/CTOL/VTOL traffic mix, the expect ATC environment, aircraft noise models and community noise models and community noise impact, flight paths for noise abatement, wind considerations affecting landing, approach and landing considerations, STOLport site selection, runway capacity, and STOL operations at jetports, suburban airports, and separate STOLports.

Unmanned Aircraft Systems Traffic Management (UTM) Safely Enabling UAS Operations in Low-Altitude Airspace

NASA Technical Reports Server (NTRS)

Kopardekar, Parimal H.

2016-01-01

Unmanned Aircraft System (UAS) Traffic Management (UTM) Enabling Civilian Low-Altitude Airspace and Unmanned Aircraft System Operations What is the problem? Many beneficial civilian applications of UAS have been proposed, from goods delivery and infrastructure surveillance, to search and rescue, and agricultural monitoring. Currently, there is no established infrastructure to enable and safely manage the widespread use of low-altitude airspace and UAS operations, regardless of the type of UAS. A UAS traffic management (UTM) system for low-altitude airspace may be needed, perhaps leveraging concepts from the system of roads, lanes, stop signs, rules and lights that govern vehicles on the ground today, whether the vehicles are driven by humans or are automated. What system technologies is NASA exploring? Building on its legacy of work in air traffic management for crewed aircraft, NASA is researching prototype technologies for a UAS Traffic Management (UTM) system that could develop airspace integration requirements for enabling safe, efficient low-altitude operations. While incorporating lessons learned from the today's well-established air traffic management system, which was a response that grew out of a mid-air collision over the Grand Canyon in the early days of commercial aviation, the UTM system would enable safe and efficient low-altitude airspace operations by providing services such as airspace design, corridors, dynamic geofencing, severe weather and wind avoidance, congestion management, terrain avoidance, route planning and re-routing, separation management, sequencing and spacing, and contingency management. One of the attributes of the UTM system is that it would not require human operators to monitor every vehicle continuously. The system could provide to human managers the data to make strategic decisions related to initiation, continuation, and termination of airspace operations. This approach would ensure that only authenticated UAS could operate

Towards Verification of Operational Procedures Using Auto-Generated Diagnostic Trees

NASA Technical Reports Server (NTRS)

Kurtoglu, Tolga; Lutz, Robyn; Patterson-Hine, Ann

2009-01-01

The design, development, and operation of complex space, lunar and planetary exploration systems require the development of general procedures that describe a detailed set of instructions capturing how mission tasks are performed. For both crewed and uncrewed NASA systems, mission safety and the accomplishment of the scientific mission objectives are highly dependent on the correctness of procedures. In this paper, we describe how to use the auto-generated diagnostic trees from existing diagnostic models to improve the verification of standard operating procedures. Specifically, we introduce a systematic method, namely the Diagnostic Tree for Verification (DTV), developed with the goal of leveraging the information contained within auto-generated diagnostic trees in order to check the correctness of procedures, to streamline the procedures in terms of reducing the number of steps or use of resources in them, and to propose alternative procedural steps adaptive to changing operational conditions. The application of the DTV method to a spacecraft electrical power system shows the feasibility of the approach and its range of capabilities

Standard operating procedures for serum and plasma collection: early detection research network consensus statement standard operating procedure integration working group.

PubMed

Tuck, Melissa K; Chan, Daniel W; Chia, David; Godwin, Andrew K; Grizzle, William E; Krueger, Karl E; Rom, William; Sanda, Martin; Sorbara, Lynn; Stass, Sanford; Wang, Wendy; Brenner, Dean E

2009-01-01

Specimen collection is an integral component of clinical research. Specimens from subjects with various stages of cancers or other conditions, as well as those without disease, are critical tools in the hunt for biomarkers, predictors, or tests that will detect serious diseases earlier or more readily than currently possible. Analytic methodologies evolve quickly. Access to high-quality specimens, collected and handled in standardized ways that minimize potential bias or confounding factors, is key to the "bench to bedside" aim of translational research. It is essential that standard operating procedures, "the how" of creating the repositories, be defined prospectively when designing clinical trials. Small differences in the processing or handling of a specimen can have dramatic effects in analytical reliability and reproducibility, especially when multiplex methods are used. A representative working group, Standard Operating Procedures Internal Working Group (SOPIWG), comprised of members from across Early Detection Research Network (EDRN) was formed to develop standard operating procedures (SOPs) for various types of specimens collected and managed for our biomarker discovery and validation work. This report presents our consensus on SOPs for the collection, processing, handling, and storage of serum and plasma for biomarker discovery and validation.

40 CFR 63.7733 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2013 CFR

2013-07-01

... Foundries Initial Compliance Requirements § 63.7733 What procedures must I use to establish operating limits... site-specific operating limits in your operation and maintenance plan according to the procedures in... site-specific operating limit according to the procedures specified in paragraphs (c)(1) and (2) of...

40 CFR 63.7733 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2012 CFR

2012-07-01

... Initial Compliance Requirements § 63.7733 What procedures must I use to establish operating limits? (a...-specific operating limits in your operation and maintenance plan according to the procedures in paragraphs... site-specific operating limit according to the procedures specified in paragraphs (c)(1) and (2) of...

40 CFR 63.7733 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2011 CFR

2011-07-01

... Foundries Initial Compliance Requirements § 63.7733 What procedures must I use to establish operating limits... site-specific operating limits in your operation and maintenance plan according to the procedures in... site-specific operating limit according to the procedures specified in paragraphs (c)(1) and (2) of...

40 CFR 63.7733 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2014 CFR

2014-07-01

... Foundries Initial Compliance Requirements § 63.7733 What procedures must I use to establish operating limits... site-specific operating limits in your operation and maintenance plan according to the procedures in... site-specific operating limit according to the procedures specified in paragraphs (c)(1) and (2) of...

Recommendations For The Safe Design, Operation And Use Of Commercial Sun Tanning Equipment

NASA Astrophysics Data System (ADS)

Cox, E. A.

1982-02-01

HSE Guidance Notes are being prepared to give recommendations to the designers, manufacturers, operators and users of commercial sun tanning equipment on the various health and safety aspects associated with the safe construction, siting and use of such equipment. Medically prescribed ultraviolet treatments are excluded from the guidance.

Operational Implementation of Space Debris Mitigation Procedures

NASA Astrophysics Data System (ADS)

Gicquel, Anne-Helene; Bonaventure, Francois

2013-08-01

During the spacecraft lifetime, Astrium supports its customers to manage collision risks alerts from the Joint Space Operations Center (JSpOC). This was previously done with hot-line support and a manual operational procedure. Today, it is automated and integrated in QUARTZ, the Astrium Flight Dynamics operational tool. The algorithms and process details for this new 5- step functionality are provided in this paper. To improve this functionality, some R&D activities such as the study of dilution phenomenon and low relative velocity encounters are going on. Regarding end of life disposal, recent operational experiences as well as studies results are presented.

14 CFR 27.1585 - Operating procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

....1585 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT... Manual and Approved Manual Material § 27.1585 Operating procedures. (a) Parts of the manual containing... 605 of the Federal Aviation Act of 1958 (49 U.S.C. 1354(a), 1421, 1423, 1424, and 1425); and sec. 6(c...

14 CFR 27.1585 - Operating procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

....1585 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT... Manual and Approved Manual Material § 27.1585 Operating procedures. (a) Parts of the manual containing... 605 of the Federal Aviation Act of 1958 (49 U.S.C. 1354(a), 1421, 1423, 1424, and 1425); and sec. 6(c...

14 CFR 27.1585 - Operating procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

....1585 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT... Manual and Approved Manual Material § 27.1585 Operating procedures. (a) Parts of the manual containing... 605 of the Federal Aviation Act of 1958 (49 U.S.C. 1354(a), 1421, 1423, 1424, and 1425); and sec. 6(c...

14 CFR 27.1585 - Operating procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

....1585 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION AIRCRAFT... Manual and Approved Manual Material § 27.1585 Operating procedures. (a) Parts of the manual containing... 605 of the Federal Aviation Act of 1958 (49 U.S.C. 1354(a), 1421, 1423, 1424, and 1425); and sec. 6(c...

SOME PROBLEMS OF "SAFE DOSE" ESTIMATION

EPA Science Inventory

In environmental carcinogenic risk assessment, the usually defined "safe doses" appear subjective in some sense. n this paper a method of standardizing "safe doses" based on some objective parameters is introduced and a procedure of estimating safe doses under the competing risks...

Radiation exposure to operator and patients during cardiac electrophysiology study, radiofrequency catheter ablation and cardiac device implantation procedures

NASA Astrophysics Data System (ADS)

Lee, C. H.; Cho, J. H.; Park, S. J.; Kim, J. S.; On, Y. K.; Huh, J.

2015-10-01

The purpose of this study was to measure the radiation exposure to operator and patient during cardiac electrophysiology study, radiofrequency catheter ablation and cardiac device implantation procedures and to calculate the allowable number of cases per year. We carried out 9 electrophysiology studies, 40 radiofrequency catheter ablation and 11 cardiac device implantation procedures. To measure occupational radiation dose and dose-area product (DAP), 13 photoluminescence glass dosimeters were placed at eyes (inside and outside lead glass), thyroids (inside and outside thyroid collar), chest (inside and outside lead apron), wrists, genital of the operator (inside lead apron), and 6 of photoluminescence glass dosimeters were placed at eyes, thyroids, chest and genital of the patient. Exposure time and DAP values were 11.7 ± 11.8 min and 23.2 ± 26.2 Gy cm2 for electrophysiology study; 36.5 ± 42.1 min and 822.4 ± 125.5 Gy cm2 for radiofrequency catheter ablation; 16.2 ± 9.3 min and 27.8 ± 16.5 Gy cm2 for cardiac device implantation procedure, prospectively. 4591 electrophysiology studies can be conducted within the occupational exposure limit for the eyes (150 mSv), and 658-electrophysiology studies with radiofrequency catheter ablation can be carried out within the occupational exposure limit for the hands (500 mSv). 1654 cardiac device implantation procedure can be conducted within the occupational exposure limit for the eyes (150 mSv). The amounts of the operator and patient's radiation exposure were comparatively small. So, electrophysiology study, radio frequency catheter ablation and cardiac device implantation procedures are safe when performed with modern equipment and optimized protective radiation protect equipment.

14 CFR 29.1585 - Operating procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... condition in which the fuel system independence prescribed in § 29.953 is necessary for safety must be furnished, together with instructions for placing the fuel system in a configuration used to show compliance... compliance with § 29.1353 (c)(6)(ii) or (c)(6)(iii), the operating procedures for disconnecting the battery...

10 CFR 36.53 - Operating and emergency procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Operating and emergency procedures. 36.53 Section 36.53 Energy NUCLEAR REGULATORY COMMISSION LICENSES AND RADIATION SAFETY REQUIREMENTS FOR IRRADIATORS Operation... the source storage pool; (6) A prolonged loss of electrical power; (7) A fire alarm or explosion in...

10 CFR 36.53 - Operating and emergency procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Operating and emergency procedures. 36.53 Section 36.53 Energy NUCLEAR REGULATORY COMMISSION LICENSES AND RADIATION SAFETY REQUIREMENTS FOR IRRADIATORS Operation... the source storage pool; (6) A prolonged loss of electrical power; (7) A fire alarm or explosion in...

10 CFR 36.53 - Operating and emergency procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Operating and emergency procedures. 36.53 Section 36.53 Energy NUCLEAR REGULATORY COMMISSION LICENSES AND RADIATION SAFETY REQUIREMENTS FOR IRRADIATORS Operation... the source storage pool; (6) A prolonged loss of electrical power; (7) A fire alarm or explosion in...

14 CFR 93.71 - General operating procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... of Niagara Falls, New York § 93.71 General operating procedures. (a) Flight restrictions are in effect below 3,500 feet MSL in the airspace above Niagara Falls, New York, west of a line from latitude...

Procedure-Authoring Tool Improves Safety on Oil Rigs

NASA Technical Reports Server (NTRS)

2014-01-01

Dark, cold, and dangerous environments are plentiful in space and on Earth. To ensure safe operations in difficult surroundings, NASA relies heavily on procedures written well ahead of time. Houston-based TRACLabs Inc. worked with Ames Research Center through the SBIR program to create an electronic procedure authoring tool, now used by NASA and companies in the oil and gas industry.

Extended Aging Theories for Predictions of Safe Operational Life of Critical Airborne Structural Components

NASA Technical Reports Server (NTRS)

Ko, William L.; Chen, Tony

2006-01-01

The previously developed Ko closed-form aging theory has been reformulated into a more compact mathematical form for easier application. A new equivalent loading theory and empirical loading theories have also been developed and incorporated into the revised Ko aging theory for the prediction of a safe operational life of airborne failure-critical structural components. The new set of aging and loading theories were applied to predict the safe number of flights for the B-52B aircraft to carry a launch vehicle, the structural life of critical components consumed by load excursion to proof load value, and the ground-sitting life of B-52B pylon failure-critical structural components. A special life prediction method was developed for the preflight predictions of operational life of failure-critical structural components of the B-52H pylon system, for which no flight data are available.

Test Operations Procedure (TOP) 08-2-188 Chemical Point Detector Vapor Testing

DTIC Science & Technology

2018-04-27

Evaluation Command 6617 Aberdeen Boulevard Aberdeen Proving Ground, MD 21005-5001 10. SPONSOR/MONITOR’S ACRONYM(S) 11. SPONSOR/MONITOR’S REPORT NUMBER(S...AND EVALUATION COMMAND TEST OPERATIONS PROCEDURE *Test Operations Procedure 08-2-188 27 April 2018 DTIC AD No. CHEMICAL POINT DETECTOR VAPOR...188 27 April 2018 2 1. SCOPE. This Test Operations Procedure (TOP), which has been endorsed by the Test and Evaluation Capabilities and

Safe Operation of Mobile Unmanned Ground Vehicle (UGV) Systems

DTIC Science & Technology

2010-07-13

vehicle could go during uncommanded movement and full throttle acceleration. 4. TEST PROCEDURES. 4.1 Vehicle Subsystem Tests. These tests identify...time required to go from straight ahead to full deflection in one direction. (sec) i. Observations on ability of the remote operator to maintain...were well below the lateral acceleration limits of the vehicle resulting in very predictable handling traits. The primary concern , albeit subjective

[Hybrid operating rooms: only for advanced endovascular procedures?].

PubMed

Verhoeven, E; Katsargyris, A; Töpel, I; Steinbauer, M

2013-10-01

The evolution of endovascular techniques has led to the concept of the "hybrid operating room" (hybrid OR). A hybrid OR combines the sterility of an OR in an operating theatre environment with a high-quality fixed imaging system. On the basis of these advantages it would be desirable that an angio-hybrid OR becomes a standard requirement for endovascular surgery. In Great Britain guidelines have already been published that require a hybrid OR even for normal endovascular management of the infrarenal aorta. However, in Germany there are no guidelines from professional societies or formal rules from the federal joint committee, thus in this article a classification of endovascular procedures according to their complexity and the necessary infrastructures are proposed in order to define particular procedures that should only be performed in an angio-hybrid OR. According to our experience, endovascular procedures can be classified into four categories based on their complexity and the requirements regarding fluoroscopy: level 1: standard EVAR, TEVAR, iliac and popliteal artery procedures; level 2: iliac branched (IBD) and standard (2 fenestrations for the renal arteries and a scallop for the superior mesenteric artery) fenestrated stent-grafting; level 3: more complex fenestrated procedures (three or four fenestrations); and level 4: branched stent-grafting for TAAA. At this moment it is still acceptable to perform level 1 and level 2 procedures outside of a hybrid OR. In our opinion, it is not recommended to perform level 3 and level 4 endovascular procedures without a hybrid OR. Georg Thieme Verlag KG Stuttgart · New York.

Obtaining accreditation by the pharmacy compounding accreditation board, part 2: developing essential standard operating procedures.

PubMed

Cabaleiro, Joe

2007-01-01

A key component of qualifying for accreditation with the Pharmacy Compounding Accreditation Board is having a set of comprehensive standard operating procedures that are being used by the pharmacy staff. The three criteria in standard operating procedures for which the Pharmacy Compounding Accreditation Board looks are: (1)written standard operating procedures; (2)standard operating procedures that reflect what the organization actualy does; and (3) whether the written standard operating procedures are implemented. Following specified steps in the preparation of standard operating procedures will result in procedures that meet Pharmacy Compounding Accreditation Board Requirements, thereby placing pharmacies one step closer to qualifying for accreditation.

How Safe Are Kid-Safe Search Engines?

ERIC Educational Resources Information Center

Masterson-Krum, Hope

2001-01-01

Examines search tools available to elementary and secondary school students, both human-compiled and crawler-based, to help direct them to age-appropriate Web sites; analyzes the procedures of search engines labeled family-friendly or kid safe that use filters; and tests the effectiveness of these services to students in school libraries. (LRW)

40 CFR 63.7323 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2011 CFR

2011-07-01

... operating limit according to the procedures in paragraphs (c)(1), (2), or (3) of this section. (1) If you... establish a site-specific operating limit for pressure drop according to the procedures in paragraphs (d)(1... § 63.7290(a). (3) Establish revised operating limits according to the applicable procedures in...

40 CFR 63.7323 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2010 CFR

2010-07-01

... operating limit according to the procedures in paragraphs (c)(1), (2), or (3) of this section. (1) If you... establish a site-specific operating limit for pressure drop according to the procedures in paragraphs (d)(1... § 63.7290(a). (3) Establish revised operating limits according to the applicable procedures in...

40 CFR 63.7323 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2014 CFR

2014-07-01

... operating limit according to the procedures in paragraphs (c)(1), (2), or (3) of this section. (1) If you... establish a site-specific operating limit for pressure drop according to the procedures in paragraphs (d)(1... § 63.7290(a). (3) Establish revised operating limits according to the applicable procedures in...

40 CFR 63.7323 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2013 CFR

2013-07-01

... operating limit according to the procedures in paragraphs (c)(1), (2), or (3) of this section. (1) If you... establish a site-specific operating limit for pressure drop according to the procedures in paragraphs (d)(1... § 63.7290(a). (3) Establish revised operating limits according to the applicable procedures in...

Operating room waste: disposable supply utilization in neurointerventional procedures.

PubMed

Rigante, Luigi; Moudrous, Walid; de Vries, Joost; Grotenhuis, André J; Boogaarts, Hieronymus D

2017-12-01

Operating rooms account for 70% of hospital waste, increasing healthcare costs and creating environmental hazards. Endovascular treatment of cerebrovascular pathologies has become prominent, and associated products highly impact the total cost of care. We investigated the costs of endovascular surgical waste at our institution. Data from 53 consecutive endovascular procedures at the Radboud UMC Nijmegen from May to December 2016 were collected. "Unused disposable supply" was defined as one-time use items opened but not used during the procedure. Two observers cataloged the unused disposable supply for each case. The cost of each item was determined from the center supply catalog, and these costs were summed to determine the total cost of unused supply per case. Thirteen diagnostic cerebral digital subtraction angiographies (DSA) (24.5%) and 40 endovascular procedures (75.5%) were analyzed. Total interventional waste was 27,299.53 € (mean 515.09 € per procedure). While total costs of unused disposable supply were almost irrelevant for DSAs, they were consistent for interventional procedures (mean 676.49 € per case). Aneurysm standard coiling had the highest impact on total interventional waste (mean 1061.55 €). Disposable interventional products had a very high impact on the surgical waste costs in the series of the neurointerventional procedures (95% of total waste). This study shows the impact of neurointerventional waste on the total care costs for cerebrovascular patients. This might reflect the tendency to anticipate needs and emergencies in neurointervention. Responsible use of disposable material can be achieved by educating operators and nurses and creating operator preference cards.

Safe procedure in endoscopic submucosal dissection for colorectal tumors focused on preventing complications

PubMed Central

Yoshida, Naohisa; Yagi, Nobuaki; Naito, Yuji; Yoshikawa, Toshikazu

2010-01-01

Endoscopic submucosal dissection (ESD) is efficient for en bloc resection of large colorectal tumors. However, it has several technical difficulties, because the wall of the colon is thin and due to the winding nature of the colon. The main complications of ESD comprise postoperative perforation and hemorrhage, similar to endoscopic mucosal resection (EMR). In particular, the rate of perforation in ESD is higher than that in EMR. Perforation of the colon can cause fatal peritonitis. Endoscopic clipping is reported to be an efficient therapy for perforation. Most cases with perforation are treated conservatively without urgent surgical intervention. However, the rate of postoperative hemorrhage in ESD is similar to that in EMR. Endoscopic therapy including endoscopic clipping is performed and most of the cases are treated conservatively without blood transfusion. In blood examination, some degree of inflammation is detected after ESD. For the standardization of ESD, it is most important to decrease the rate of perforation. Adopting a safe strategy for ESD and a suitable choice of knife are both important ways of preventing perforation. Moreover, appropriate training and increasing experience can improve the endoscopic technique and can decrease the rate of perforation. In this review, we describe safe procedures in ESD to prevent complications, the complications of ESD and their management. PMID:20379999

40 CFR 63.7323 - What procedures must I use to establish operating limits?

Code of Federal Regulations, 2012 CFR

2012-07-01

... to the procedures in paragraphs (c)(1), (2), or (3) of this section. (1) If you elect the operating...-specific operating limit for pressure drop according to the procedures in paragraphs (d)(1) and (2) of this... § 63.7290(a). (3) Establish revised operating limits according to the applicable procedures in...

Operational procedures for ground station operation: ATS-3 Hawaii-Ames satellite link experiment

NASA Technical Reports Server (NTRS)

Nishioka, K.; Gross, E. H.

1979-01-01

Hardware description and operational procedures for the ATS-3 Hawaii-Ames satellite computer link are presented in basic step-by-step instructions. Transmit and receive channels and frequencies are given. Details such as switch settings for activating the station to the sequence of turning switches on are provided. Methods and procedures for troubleshooting common problems encountered with communication stations are also provided.

9 CFR 354.243 - Operations and procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Section 354.243 Animals and Animal Products FOOD SAFETY AND INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE... Sanitary Conditions and Precautions Against Contamination of Products § 354.243 Operations and procedures... product against contamination by any foreign substance (including, but not being limited to, dust, dirt...

21 CFR 58.81 - Standard operating procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... quality and integrity of the data generated in the course of a study. All deviations in a study from... data. Significant changes in established standard operating procedures shall be properly authorized in... following: (1) Animal room preparation. (2) Animal care. (3) Receipt, identification, storage, handling...

Guidance regarding voluntary compliance with international management code for the safe operation of ships and for pollution prevention

DOT National Transportation Integrated Search

1994-03-15

The purpose of this Circular is to advise owners and operators of U.S. flag merchant vessels regarding voluntary compliance with the International Management Code for the Safe Operation of Ships and for Pollution Prevention.

Safely Enabling Civilian Unmanned Aerial System (UAS) Operations In Low-Altitude Airspace By Unmanned Aerial System Traffic Management (UTM)

NASA Technical Reports Server (NTRS)

Kopardekar, Parimal H.

2015-01-01

Many UAS will operate at lower altitude (Class G, below 2000 feet)There is urgent need for a system for civilian low-altitude airspace and UAS operations. Stakeholders want to work with NASA to enable safe operations.

76 FR 9853 - Parts and Accessories Necessary for Safe Operation; Brakes; Application for Exemption From...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-22

... Innovative Electronics; Correction AGENCY: Federal Motor Carrier Safety Administration (FMCSA), DOT. ACTION... Accessories Necessary for Safe Operation; Brakes; Application for Exemption From Innovative Electronics... Innovative Electronics; Notice of application for exemption; request for comments (76 FR 7623, February 10...

Safely Enabling Civilian Unmanned Aerial System (UAS) Operations in Low-Altitude Airspace by Unmanned Aerial System Traffic Management (UTM)

NASA Technical Reports Server (NTRS)

Kopardekar, Parimal Hemchandra

2015-01-01

Many UAS will operate at lower altitude (Class G, below 2000 feet). There is an urgent need for a system for civilian low-altitude airspace and UAS operations. Stakeholders want to work with NASA to enable safe operations.

Allocation of surgical procedures to operating rooms.

PubMed

Ozkarahan, I

1995-08-01

Reduction of health care costs is of paramount importance in our time. This paper is a part of the research which proposes an expert hospital decision support system for resource scheduling. The proposed system combines mathematical programming, knowledge base, and database technologies, and what is more, its friendly interface is suitable for any novice user. Operating rooms in hospitals represent big investments and must be utilized efficiently. In this paper, first a mathematical model similar to job shop scheduling models is developed. The model loads surgical cases to operating rooms by maximizing room utilization and minimizing overtime in a multiple operating room setting. Then a prototype expert system which replaces the expertise of the operations research analyst for the model, drives the modelbase, database, and manages the user dialog is developed. Finally, an overview of the sequencing procedures for operations within an operating room is also presented.

47 CFR 80.97 - Radiotelegraph operating procedures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 5 2010-10-01 2010-10-01 false Radiotelegraph operating procedures. 80.97 Section 80.97 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO... signals, all transmissions must cease within the band 485-515 kHz during each 500 kHz silence period. (b...

47 CFR 80.97 - Radiotelegraph operating procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 47 Telecommunication 5 2011-10-01 2011-10-01 false Radiotelegraph operating procedures. 80.97 Section 80.97 Telecommunication FEDERAL COMMUNICATIONS COMMISSION (CONTINUED) SAFETY AND SPECIAL RADIO... signals, all transmissions must cease within the band 485-515 kHz during each 500 kHz silence period. (b...

40 CFR 792.81 - Standard operating procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... data generated in the course of a study. All deviations in a study from standard operating procedures shall be authorized by the study director and shall be documented in the raw data. Significant changes...) Test system room preparation. (2) Test system care. (3) Receipt, identification, storage, handling...

40 CFR 792.81 - Standard operating procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... data generated in the course of a study. All deviations in a study from standard operating procedures shall be authorized by the study director and shall be documented in the raw data. Significant changes...) Test system room preparation. (2) Test system care. (3) Receipt, identification, storage, handling...

On the design of flight-deck procedures

NASA Technical Reports Server (NTRS)

Degani, Asaf; Wiener, Earl L.

1994-01-01

In complex human-machine systems, operations, training, and standardization depend on a elaborate set of procedures which are specified and mandated by the operational management of the organization. The intent is to provide guidance to the pilots, to ensure a logical, efficient, safe, and predictable means of carrying out the mission objectives. In this report the authors examine the issue of procedure use and design from a broad viewpoint. The authors recommend a process which we call 'The Four P's:' philosophy, policies, procedures, and practices. We believe that if an organization commits to this process, it can create a set of procedures that are more internally consistent, less confusing, better respected by the flight crews, and that will lead to greater conformity. The 'Four-P' model, and the guidelines for procedural development in appendix 1, resulted from cockpit observations, extensive interviews with airline management and pilots, interviews and discussion at one major airframe manufacturer, and an examination of accident and incident reports. Although this report is based on airline operations, we believe that the principles may be applicable to other complex, high-risk systems, such as nuclear power production, manufacturing process control, space flight, and military operations.

Who's Got the Bridge? - Towards Safe, Robust Autonomous Operations at NASA Langley's Autonomy Incubator

NASA Technical Reports Server (NTRS)

Allen, B. Danette; Cross, Charles D.; Motter, Mark A.; Neilan, James H.; Qualls, Garry D.; Rothhaar, Paul M.; Tran, Loc; Trujillo, Anna C.; Crisp, Vicki K.

2015-01-01

NASA aeronautics research has made decades of contributions to aviation. Both aircraft and air traffic management (ATM) systems in use today contain NASA-developed and NASA sponsored technologies that improve safety and efficiency. Recent innovations in robotics and autonomy for automobiles and unmanned systems point to a future with increased personal mobility and access to transportation, including aviation. Automation and autonomous operations will transform the way we move people and goods. Achieving this mobility will require safe, robust, reliable operations for both the vehicle and the airspace and challenges to this inevitable future are being addressed now in government labs, universities, and industry. These challenges are the focus of NASA Langley Research Center's Autonomy Incubator whose R&D portfolio includes mission planning, trajectory and path planning, object detection and avoidance, object classification, sensor fusion, controls, machine learning, computer vision, human-machine teaming, geo-containment, open architecture design and development, as well as the test and evaluation environment that will be critical to prove system reliability and support certification. Safe autonomous operations will be enabled via onboard sensing and perception systems in both data-rich and data-deprived environments. Applied autonomy will enable safety, efficiency and unprecedented mobility as people and goods take to the skies tomorrow just as we do on the road today.

Apollo-Soyuz test project. Operations handbook command/service/docking modules (CSM 119/DM 1): Operational procedures reference issue

NASA Technical Reports Server (NTRS)

1974-01-01

Operational and configuration checks for the Apollo-Soyuz Test Project are presented. The checks include: backup crew prelaunch, prime crew prelaunch, boost and insertion, G and C reference data, G and N reference modes, rendezvous, navigation, Apollo-Soyuz operations, abort procedures, and emergency procedures.

Operational Control Procedures for the Activated Sludge Process: Appendix.

ERIC Educational Resources Information Center

West, Alfred W.

This document is the appendix for a series of documents developed by the National Training and Operational Technology Center describing operational control procedures for the activated sludge process used in wastewater treatment. Categories discussed include: control test data, trend charts, moving averages, semi-logarithmic plots, probability…

49 CFR 192.605 - Procedural manual for operations, maintenance, and emergencies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... operations and maintenance activities are conducted. (b) Maintenance and normal operations. The manual... personnel to determine the effectiveness, and adequacy of the procedures used in normal operation and... or flow rate outside normal operating limits; (iii) Loss of communications; (iv) Operation of any...

Target Trailing With Safe Navigation With Colregs for Maritime Autonomous Surface Vehicles

NASA Technical Reports Server (NTRS)

Kuwata, Yoshiaki (Inventor); Aghazarian, Hrand (Inventor); Huntsberger, Terrance L. (Inventor); Howard, Andrew B. (Inventor); Wolf, Michael T. (Inventor); Zarzhitsky, Dimitri V. (Inventor)

2014-01-01

Systems and methods for operating autonomous waterborne vessels in a safe manner. The systems include hardware for identifying the locations and motions of other vessels, as well as the locations of stationary objects that represent navigation hazards. By applying a computational method that uses a maritime navigation algorithm for avoiding hazards and obeying COLREGS using Velocity Obstacles to the data obtained, the autonomous vessel computes a safe and effective path to be followed in order to accomplish a desired navigational end result, while operating in a manner so as to avoid hazards and to maintain compliance with standard navigational procedures defined by international agreement. The systems and methods have been successfully demonstrated on water with radar and stereo cameras as the perception sensors, and integrated with a higher level planner for trailing a maneuvering target.

Imaging Flash Lidar for Autonomous Safe Landing and Spacecraft Proximity Operation

NASA Technical Reports Server (NTRS)

Amzajerdian, Farzin; Roback, Vincent E.; Brewster, Paul F.; Hines, Glenn D.; Bulyshev, Alexander E.

2016-01-01

3-D Imaging flash lidar is recognized as a primary candidate sensor for safe precision landing on solar system bodies (Moon, Mars, Jupiter and Saturn moons, etc.), and autonomous rendezvous proximity operations and docking/capture necessary for asteroid sample return and redirect missions, spacecraft docking, satellite servicing, and space debris removal. During the final stages of landing, from about 1 km to 500 m above the ground, the flash lidar can generate 3-Dimensional images of the terrain to identify hazardous features such as craters, rocks, and steep slopes. The onboard fli1ght computer can then use the 3-D map of terrain to guide the vehicle to a safe location. As an automated rendezvous and docking sensor, the flash lidar can provide relative range, velocity, and bearing from an approaching spacecraft to another spacecraft or a space station from several kilometers distance. NASA Langley Research Center has developed and demonstrated a flash lidar sensor system capable of generating 16k pixels range images with 7 cm precision, at a 20 Hz frame rate, from a maximum slant range of 1800 m from the target area. This paper describes the lidar instrument design and capabilities as demonstrated by the closed-loop flight tests onboard a rocket-propelled free-flyer vehicle (Morpheus). Then a plan for continued advancement of the flash lidar technology will be explained. This proposed plan is aimed at the development of a common sensor that with a modest design adjustment can meet the needs of both landing and proximity operation and docking applications.

Are the surgeons safe during UV-A radiation exposure in collagen cross-linking procedure?

PubMed

Shetty, Rashmi; Shetty, Rohit; Mahendradas, Padmamalini; Shetty, Bhujang K

2012-02-01

To quantify the effect of scattered UV-A radiation used in the collagen cross-linking (CXL) procedure and the amount of radiation reaching the surgeon and the surrounding area and to estimate the dampening effect by various protective devices. In this case series, 3 patients [aged 25-30 (±2.5) years] with keratoconus underwent a CXL procedure with UV-A light and riboflavin. Irradiance was measured using a spectrometer (Model USB2000; Ocean Optics, Inc) for various distances from the source, at various angles, and for different durations of radiation. The spectrometer was also used to measure the dampening effect produced by gown, latex gloves, and UV-protective glasses. Maximum UV-A radiation (1.4 × 10(-9) mW/cm(2)) was measured at 2 cm from the limbus, when the probe was held at a 45-degree angle to the floor. UV-A radiation reaching the surgeon's eye and the abdomen was 3.403 × 10(-11) and 2.36 × 10(-11) mW/cm(2), respectively. Gown, latex gloves, and UV-protective glasses showed dampening effects of 99.58%, 95.01%, and 99.73%, respectively. CXL appears to be a safe procedure with respect to UV-A radiation exposure to the surgeon. Further safety can be ensured by UV-protective devices.

Operating room environment and surgical site infections in arthroplasty procedures.

PubMed

Cristina, M L; Sartini, M; Schinca, E; Ottria, G; Spagnolo, A M

2016-09-01

The rate of surgical site infections (SSI) is strongly influenced by operating room quality, which is determined by the structural features of the facility and its systems and by the management and behavior of healthcare workers. The aim of the present study was to assess microbial contamination in the operating room during hip- and knee-replacement procedures, the behavior of operating room staff and the incidence of SSI through postdischarge surveillance. Microbial contamination was evaluated by active and passive sampling at rest and in operating conditions. Organizational and behavioral characteristics were collected through observational assessment. The incidence of SSI was evaluated in 255 patients, and follow-up examinations were carried out 30 and 365 days after the procedure. The mean values of the airborne and sedimenting microbial loads were 12.90 CFU/m 3 and 0.02 CFU/cm2/h, respectively. With regard to outcome, the infection rate proved to be 0.89% and was associated with knee-replacement procedures. The microorganism responsible for this superficial infection was Staphylococcus aureus. Clinical outcomes proved to be satisfactory, owing to the limited microbial load (in both at-rest and operating conditions), the appropriate behavior of the staff, compliance with the guidelines on preoperative antibiotic prophylaxis, and efficient management of the ventilation system.

Empirical models for use in designing decompression procedures for space operations

NASA Technical Reports Server (NTRS)

Conkin, Johnny; Edwards, Benjamin F.; Waligora, James M.; Horrigan, David J., Jr.

1987-01-01

Empirical models for predicting the incidence of Type 1 altitude decompression sickness (DCS) and venous gas emboli (VGE) during space extravehicular activity (EVA), and for use in designing safe denitrogenation decompression procedures are developed. The models are parameterized using DCS and VGE incidence data from NASA and USAF manned altitude chamber decompression tests using 607 male and female subject tests. These models, and procedures for their use, consist of: (1) an exponential relaxation model and procedure for computing tissue nitrogen partial pressure resulting from a specified prebreathing and stepped decompression sequence; (2) a formula for calculating Tissue Ratio (TR), a tissue decompression stress index; (3) linear and Hill equation models for predicting the total incidence of VGE and DCS attendant with a particular TR; (4) graphs of cumulative DCS and VGE incidence (risk) versus EVA exposure time at any specified TR; and (5) two equations for calculating the average delay period for the initial detection of VGE or indication of Type 1 DCS in a group after a specific denitrogenation decompression procedure. Several examples of realistic EVA preparations are provided.

Strategies for Countering Terrorist Safe Havens

DTIC Science & Technology

2014-02-20

within safe havens, tactical containment, pseudo operations, and surrogate security forces. The thesis draws from four historical case studies to...leadership targeting within safe havens, tactical containment, pseudo operations, and surrogate security forces. The thesis draws from four historical case ...surrogate forces and pseudo operations—provide viable potential options for USSOF to counter the complex problem of safe havens. Overall, the case

What influences youth to operate all-terrain vehicles safely?

PubMed Central

Grummon, A. H.; Heaney, C. A.; Dellinger, W. A.; Wilkins, J. R.

2014-01-01

The operation of all-terrain vehicles (ATVs) by youth has contributed to the incidence of serious and fatal injuries among children. This study explored factors related to the frequency with which youth wore a helmet and refrained from engaging in three risky driving behaviors (driving at risky speeds, on paved roads and on unfamiliar terrain) while operating an ATV. Youth (n = 248) aged 9–14 from central Ohio and one of their parents completed self-report measures of ATV safety behaviors, youth general propensity for risk taking, protection motivation and parental behaviors to facilitate youth safety. Data from two focus groups provided insight on quantitative results. Analyses revealed considerable variation in the frequency with which youth performed the safety behaviors, with 13- and 14-year-olds reporting less frequent safe behavior than 9- to 12-year-olds. Multiple regression analyses suggested that parental behaviors, such as providing reminders to wear a helmet, were associated with more frequent helmet use but were not associated with risky driving behaviors. Youth’s general propensity toward risk taking was not associated with helmet use and only associated with riskydriving behaviors among the 13- and 14-year-olds. Self-efficacy was an important predictor across both age groups and behaviors. Implications for injury prevention are discussed. PMID:24740837

Minimally Invasive Catheter Procedures to Assist Complicated Pacemaker Lead Extraction and Implantation in the Operating Room

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

Kroepil, Patric; Lanzman, Rotem S., E-mail: rotemshlomo@yahoo.de; Miese, Falk R.

2011-04-15

We report on percutaneous catheter procedures in the operating room (OR) to assist complicated manual extraction or insertion of pacemaker (PM) and implantable cardioverter defibrillator leads. We retrospectively reviewed complicated PM revisions and implantations performed between 2004 and 2009 that required percutaneous catheter procedures performed in the OR. The type of interventional procedure, catheter and retrieval system used, venous access, success rates, and procedural complications were analyzed. In 41 (12 female and 29 male [mean age 62 {+-} 17 years]) of 3021 (1.4%) patients, standard manual retrieval of old leads or insertion of new leads was not achievable and thusmore » required percutaneous catheter intervention for retrieval of misplaced leads and/or recanalisation of occluded central veins. Thirteen of 18 (72.2%) catheter-guided retrieval procedures for misplaced (right atrium [RA] or ventricle [RV; n = 3], superior vena cava [n = 2], brachiocephalic vein [n = 5], and subclavian vein [n = 3]) lead fragments in 16 patients were successful. Percutaneous catheter retrieval failed in five patients because there were extremely fixed or adhered lead fragments. Percutaneous transluminal angiography (PTA) of central veins for occlusion or high-grade stenosis was performed in 25 patients. In 22 of 25 patients (88%), recanalization of central veins was successful, thus enabling subsequent lead replacement. Major periprocedural complications were not observed. In the case of complicated manual PM lead implantation or revision, percutaneous catheter-guided extraction of misplaced lead fragments or recanalisation of central veins can be performed safely in the OR, thus enabling subsequent implantation or revision of PM systems in the majority of patients.« less

How to develop a Standard Operating Procedure for sorting unfixed cells

PubMed Central

Schmid, Ingrid

2012-01-01

Written Standard Operating Procedures (SOPs) are an important tool to assure that recurring tasks in a laboratory are performed in a consistent manner. When the procedure covered in the SOP involves a high-risk activity such as sorting unfixed cells using a jet-in-air sorter, safety elements are critical components of the document. The details on sort sample handling, sorter set-up, validation, operation, troubleshooting, and maintenance, personal protective equipment (PPE), and operator training, outlined in the SOP are to be based on careful risk assessment of the procedure. This review provides background information on the hazards associated with sorting of unfixed cells and the process used to arrive at the appropriate combination of facility design, instrument placement, safety equipment, and practices to be followed. PMID:22381383

How to develop a standard operating procedure for sorting unfixed cells.

PubMed

Schmid, Ingrid

2012-07-01

Written standard operating procedures (SOPs) are an important tool to assure that recurring tasks in a laboratory are performed in a consistent manner. When the procedure covered in the SOP involves a high-risk activity such as sorting unfixed cells using a jet-in-air sorter, safety elements are critical components of the document. The details on sort sample handling, sorter set-up, validation, operation, troubleshooting, and maintenance, personal protective equipment (PPE), and operator training, outlined in the SOP are to be based on careful risk assessment of the procedure. This review provides background information on the hazards associated with sorting of unfixed cells and the process used to arrive at the appropriate combination of facility design, instrument placement, safety equipment, and practices to be followed. Copyright © 2012 Elsevier Inc. All rights reserved.

Preliminary Investigation of Time Remaining Display on the Computer-based Emergency Operating Procedure

NASA Astrophysics Data System (ADS)

Suryono, T. J.; Gofuku, A.

2018-02-01

One of the important thing in the mitigation of accidents in nuclear power plant accidents is time management. The accidents should be resolved as soon as possible in order to prevent the core melting and the release of radioactive material to the environment. In this case, operators should follow the emergency operating procedure related with the accident, in step by step order and in allowable time. Nowadays, the advanced main control rooms are equipped with computer-based procedures (CBPs) which is make it easier for operators to do their tasks of monitoring and controlling the reactor. However, most of the CBPs do not include the time remaining display feature which informs operators of time available for them to execute procedure steps and warns them if the they reach the time limit. Furthermore, the feature will increase the awareness of operators about their current situation in the procedure. This paper investigates this issue. The simplified of emergency operating procedure (EOP) of steam generator tube rupture (SGTR) accident of PWR plant is applied. In addition, the sequence of actions on each step of the procedure is modelled using multilevel flow modelling (MFM) and influenced propagation rule. The prediction of action time on each step is acquired based on similar case accidents and the Support Vector Regression. The derived time will be processed and then displayed on a CBP user interface.

Systematic review of operative outcomes of robotic surgical procedures performed with endoscopic linear staplers or robotic staplers.

PubMed

Gutierrez, Mario; Ditto, Richard; Roy, Sanjoy

2018-05-09

A comprehensive review of operative outcomes of robotic surgical procedures performed with the da Vinci robotic system using either endoscopic linear staplers (ELS) or robotic staplers is not available in the published literature. We conducted a literature search to identify publications of robotic surgical procedures in all specialties performed with either ELS or robotic staplers. Twenty-nine manuscripts and six abstracts with relevant information on operative outcomes published from January 2011 to September 2017 were identified. Given the relatively recent market release of robotic staplers in 2014, comparative perioperative clinical outcomes data on the performance of ELS vs. robotic staplers in robotic surgery is very sparse in the published literature. Only three comparative studies of surgeries with the da Vinci robotic system plus ELS vs. da Vinci plus robotic staplers were identified; two in robotic colorectal surgery and the other in robotic gastric bypass surgery. These comparative studies illustrate some nuances in device design and usability, which may impact outcomes and cost, and therefore may be important to consider when selecting the appropriate stapling technologies/technique for different robotic surgeries. Comparative perioperative data on the use of ELS vs. robotic staplers in robotic surgery is scarce (three studies), and current literature identifies both types of devices as safe and effective. Given the longer clinical history of ELS and its relatively more robust evidence base, there may be trade-offs to consider before switching to robotic staplers in certain robotic procedures. However, this literature review may serve as an initial reference for future research.

Conducting Safe and Efficient Airport Surface Operations in a NextGen Environment

NASA Technical Reports Server (NTRS)

Jones, Denise R.; Prinzel, Lawrence J., III; Bailey, Randall E.; Arthur, Jarvis J., III; Barnes, James R.

2016-01-01

The Next Generation Air Transportation System (NextGen) vision proposes many revolutionary operational concepts, such as surface trajectory-based operations (STBO) and technologies, including display of traffic information and movements, airport moving maps (AMM), and proactive alerts of runway incursions and surface traffic conflicts, to deliver an overall increase in system capacity and safety. A piloted simulation study was conducted at the National Aeronautics and Space Administration (NASA) Langley Research Center to evaluate the ability of a flight crew to conduct safe and efficient airport surface operations while utilizing an AMM. Position accuracy of traffic was varied, and the effect of traffic position accuracy on airport conflict detection and resolution (CD&R) capability was measured. Another goal was to evaluate the crew's ability to safely conduct STBO by assessing the impact of providing traffic intent information, CD&R system capability, and the display of STBO guidance to the flight crew on both head-down and head-up displays (HUD). Nominal scenarios and off-nominal conflict scenarios were conducted using 12 airline crews operating in a simulated Memphis International Airport terminal environment. The data suggest that all traffic should be shown on the airport moving map, whether qualified or unqualified, and conflict detection and resolution technologies provide significant safety benefits. Despite the presence of traffic information on the map, collisions or near-collisions still occurred; when indications or alerts were generated in these same scenarios, the incidents were averted. During the STBO testing, the flight crews met their required time-of-arrival at route end within 10 seconds on 98 percent of the trials, well within the acceptable performance bounds of 15 seconds. Traffic intent information was found to be useful in determining the intent of conflicting traffic, with graphical presentation preferred. The CD&R system was only

[Standard Operating Procedures in Clinical Medicine].

PubMed

Miljak, Tomislav; Zaar, Peter

2017-09-01

Standard operating procedures (SOP) in hospital care have the potential to improve treatment quality and transparency. However, after arriving at the decision to generate a SOP for the own hospital or ward, the upcoming question is often, how to start?The present article tries to give some interdisciplinary guidance about reasonable structures and contents of SOPs that could be understood as a basic matrix for individual work. © Georg Thieme Verlag KG Stuttgart · New York.

47 CFR 1.957 - Procedure with respect to amateur radio operator license.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 47 Telecommunication 1 2010-10-01 2010-10-01 false Procedure with respect to amateur radio... AND PROCEDURE Wireless Radio Services Applications and Proceedings Application Requirements and Procedures § 1.957 Procedure with respect to amateur radio operator license. Each candidate for an amateur...

47 CFR 1.957 - Procedure with respect to amateur radio operator license.

Code of Federal Regulations, 2013 CFR

2013-10-01

... AND PROCEDURE Grants by Random Selection Wireless Radio Services Applications and Proceedings Application Requirements and Procedures § 1.957 Procedure with respect to amateur radio operator license. Each... 47 Telecommunication 1 2013-10-01 2013-10-01 false Procedure with respect to amateur radio...

47 CFR 1.957 - Procedure with respect to amateur radio operator license.

Code of Federal Regulations, 2011 CFR

2011-10-01

... AND PROCEDURE Wireless Radio Services Applications and Proceedings Application Requirements and Procedures § 1.957 Procedure with respect to amateur radio operator license. Each candidate for an amateur... 47 Telecommunication 1 2011-10-01 2011-10-01 false Procedure with respect to amateur radio...

47 CFR 1.957 - Procedure with respect to amateur radio operator license.

Code of Federal Regulations, 2014 CFR

2014-10-01

... AND PROCEDURE Grants by Random Selection Wireless Radio Services Applications and Proceedings Application Requirements and Procedures § 1.957 Procedure with respect to amateur radio operator license. Each... 47 Telecommunication 1 2014-10-01 2014-10-01 false Procedure with respect to amateur radio...

47 CFR 1.957 - Procedure with respect to amateur radio operator license.

Code of Federal Regulations, 2012 CFR

2012-10-01

... AND PROCEDURE Grants by Random Selection Wireless Radio Services Applications and Proceedings Application Requirements and Procedures § 1.957 Procedure with respect to amateur radio operator license. Each... 47 Telecommunication 1 2012-10-01 2012-10-01 false Procedure with respect to amateur radio...

Prospective study of glove perforation in obstetrical and gynecological operations: are we safe enough?

PubMed

Malhotra, Monika; Sharma, Jai Bhagwan; Wadhwa, Leena; Arora, Raksha

2004-08-01

To assess the glove perforation rate, efficacy of double gloving, effect of duration of surgery, expertise of surgeon and operative urgency on the glove perforation rate in obstetrical and gynecologic operations. From February to September 2002, double glove protocol was made necessary for all major obstetrical and gynecologic procedures. The operating surgeon, first and second assistant were included in the study. Gloves damage was noted (overt by inspection, occult by hydroinsufflation technique). Of the 156 procedures included in study, 32 procedures were performed (all emergency operations) single-gloved because surgeons found double gloving clumsy (56%), made it difficult to tie knots due to lack of dexterity (24%), or were too tight (20%). One thousand one hundred and twenty single gloves were examined after each procedure by hydroinsufflation. The overall perforation rate was 13.6% (single versus double outer gloves, 13.8% versus l3.2%, P > 0.05). Matching perforations were found in six cases (4.6%). Thus, the protection offered by double gloves was 95.4% even if the outer gloves were perforated. Four inner gloves had preexisting perforations. Sixty unused gloves checked similarly revealed a perforation rate of 1.6%. Emergency cases had higher perforation rate compared to elective surgeries (16.6% versus 10.8%, P < 0.00 1). Surgeries lasting for more than 40 min had a higher perforation rate compared to those finished in less than or equal to 40 min (18.6% versus 7.6%, P < 0.001). The middle finger of the left hand was the most commonly involved. The surgeon, first assistant and second assistant were involved in 73.6, 23.3 and 3.2% cases, respectively. Double gloving offers considerable protection against exposure to contaminants in the blood and body fluids of the patient and should be made routine, especially in developing countries where HIV, hepatitis B and C are widely prevalent. Double gloving should be made mandatory in emergency procedures, which

Learning curve in transradial cardiac catheterization: procedure-related parameters stratified by operators' transradial volume.

PubMed

Kasasbeh, Ehab S; Parvez, Babar; Huang, Robert L; Hasselblad, Michele Marie; Glazer, Mark D; Salloum, Joseph G; Cleator, John H; Zhao, David X

2012-11-01

To determine whether radial artery access is associated with a reduction in fluoroscopy time, procedure time, and other procedural variables over a 27-month period during which the radial artery approach was incorporated in a single academic Medical Center. Although previous studies have demonstrated a relationship between increased volume and decreased procedural time, no studies have looked at the integration of radial access over time. Data were collected from consecutive patients who presented to the Vanderbilt University Medical Center cardiac catheterization laboratory from January 1, 2009 to April 1, 2011. Patients who underwent radial access diagnostic catheterization with and without percutaneous coronary intervention were included in this study. A total of 1112 diagnostic cardiac catheterizations through the radial access site were analyzed. High-volume, intermediate-volume, and low-volume operators were grouped based on the percentage of procedures performed through a radial approach. From 2009 to 2011, there was a significant decrease in fluoroscopy time in all operator groups for diagnostic catheterization (P=.035). The high-volume operator group had 1.88 and 3.66 minute reductions in fluoroscopy time compared to the intermediate- and low-volume operator groups, respectively (both P<.001). Likewise, the intermediate-volume operator group had a 1.77 minute improvement compared to the low-volume operator group, but this did not reach statistical significance (P=.102). The improvement in fluoroscopy time and other procedure-related parameters was seen after approximately 25 cases with further improvement after 75 cases. The incorporation of the radial access approach in the cardiac catheterization laboratory led to a decrease in fluoroscopy time for each operator and operator group over the last 3 years. Our data demonstrated that higher-volume radial operators have better procedure, room, and fluoroscopy times when compared to intermediate- and low

Safe Hazmat Storage Tips.

ERIC Educational Resources Information Center

Neville, Angela

1996-01-01

Provides a list of recommendations for safely managing hazardous waste containers. Encourages training of employees on the hazards of the wastes they handle and the correct procedures for managing containers. (DDR)

Estimation of safe exposure time from an ophthalmic operating microscope with regard to ultraviolet radiation and blue-light hazards to the eye

NASA Astrophysics Data System (ADS)

Michael, Ralph; Wegener, Alfred

2004-08-01

Hazards from the optical radiation of an operating microscope that cause damage at the corneal, lenticular, and retinal levels were investigated; we considered, in particular, ultraviolet radiation (UVR) and blue light. The spectral irradiance from a Zeiss operation microscope OPMI VISU 200 was measured in the corneal plane between 300 and 1100 nm. Effective irradiance and radiance were calculated with relative spectral effectiveness data from the American Conference for Governmental and Industrial Hygienists. Safe exposure time to avoid UVR injury to the lens and cornea was found to be 2 h without a filter, 4 h with a UVR filter, 200 h with a yellow filter, and 400 h with a filter combination. Safe exposure time to avoid retinal photochemical injury was found to be 3 min without a filter and with a UVR filter, 10 min with a yellow filter, and 49 min with a filter combination. The effective radiance limit for retinal thermal injury was not exceeded. The hazard due to the UVR component from the operating microscope is not critical, and operation time can be safely prolonged with the use of appropriate filters. The retinal photochemical hazard appears critical without appropriate filters, permitting only some minutes of safe exposure time. The calculated safe exposure times are for worst-case conditions and maximal light output and include a safety factor.

Estimation of safe exposure time from an ophthalmic operating microscope with regard to ultraviolet radiation and blue-light hazards to the eye.

PubMed

Michael, Ralph; Wegener, Alfred

2004-08-01

Hazards from the optical radiation of an operating microscope that cause damage at the corneal, lenticular, and retinal levels were investigated; we considered, in particular, ultraviolet radiation (UVR) and blue light. The spectral irradiance from a Zeiss operation microscope OPMI VISU 200 was measured in the corneal plane between 300 and 1100 nm. Effective irradiance and radiance were calculated with relative spectral effectiveness data from the American Conference for Governmental and Industrial Hygienists. Safe exposure time to avoid UVR injury to the lens and cornea was found to be 2 h without a filter, 4 h with a UVR filter, 200 a yellow filter, and 400 h with a filter combination. Safe exposure time to avoid retinal photochemical injury was found to be 3 min without a filter and with a UVR filter, 10 min with a yellow filter, and 49 min with a filter combination. The effective radiance limit for retinal thermal injury was not exceeded. The hazard due to the UVR component from the operating microscope is not critical, and operation time can be safely prolonged with the use of appropriate filters. The retinal photochemical hazard appears critical without appropriate filters, permitting only some minutes of safe exposure time. The calculated safe exposure times are for worst-case conditions and maximal light output and include a safety factor.

Acquisition of Formal Operations: The Effects of Two Training Procedures.

ERIC Educational Resources Information Center

Rosenthal, Doreen A.

1979-01-01

A study of 11- and 12-year-old girls indicates that either of two training procedures, method training or dimension training, can aid in the transition from concrete operational to formal operational thought by promoting a hypothesis-testing attitude. (BH)

Unsupervised laparoscopic appendicectomy by surgical trainees is safe and time-effective.

PubMed

Wong, Kenneth; Duncan, Tristram; Pearson, Andrew

2007-07-01

Open appendicectomy is the traditional standard treatment for appendicitis. Laparoscopic appendicectomy is perceived as a procedure with greater potential for complications and longer operative times. This paper examines the hypothesis that unsupervised laparoscopic appendicectomy by surgical trainees is a safe and time-effective valid alternative. Medical records, operating theatre records and histopathology reports of all patients undergoing laparoscopic and open appendicectomy over a 15-month period in two hospitals within an area health service were retrospectively reviewed. Data were analysed to compare patient features, pathology findings, operative times, complications, readmissions and mortality between laparoscopic and open groups and between unsupervised surgical trainee operators versus consultant surgeon operators. A total of 143 laparoscopic and 222 open appendicectomies were reviewed. Unsupervised trainees performed 64% of the laparoscopic appendicectomies and 55% of the open appendicectomies. There were no significant differences in complication rates, readmissions, mortality and length of stay between laparoscopic and open appendicectomy groups or between trainee and consultant surgeon operators. Conversion rates (laparoscopic to open approach) were similar for trainees and consultants. Unsupervised senior surgical trainees did not take significantly longer to perform laparoscopic appendicectomy when compared to unsupervised trainee-performed open appendicectomy. Unsupervised laparoscopic appendicectomy by surgical trainees is safe and time-effective.

40 CFR 243.201-2 - Recommended procedures: Operations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... equipment should meet the applicable provisions of the Occupational Safety and Health Administration... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Recommended procedures: Operations. 243.201-2 Section 243.201-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

40 CFR 243.202-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Recommended procedures: Operations. 243.202-3 Section 243.202-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... receive periodic vehicle safety checks, including, but not limited to, inspection of brakes, windshield...

40 CFR 240.209-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Occupational Respiratory Disease, National Institute for Occupational Safety and Health, Morgantown, W. Va. (c... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Recommended procedures: Operations. 240.209-3 Section 240.209-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

40 CFR 243.202-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Recommended procedures: Operations. 243.202-3 Section 243.202-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... receive periodic vehicle safety checks, including, but not limited to, inspection of brakes, windshield...

40 CFR 240.209-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Occupational Respiratory Disease, National Institute for Occupational Safety and Health, Morgantown, W. Va. (c... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Recommended procedures: Operations. 240.209-3 Section 240.209-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

40 CFR 243.202-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Recommended procedures: Operations. 243.202-3 Section 243.202-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... receive periodic vehicle safety checks, including, but not limited to, inspection of brakes, windshield...

40 CFR 240.209-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Occupational Respiratory Disease, National Institute for Occupational Safety and Health, Morgantown, W. Va. (c... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Recommended procedures: Operations. 240.209-3 Section 240.209-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

40 CFR 243.203-2 - Recommended procedures: Operations.

Code of Federal Regulations, 2013 CFR

2013-07-01

...) The minimum collection frequency consistent with public health and safety should be adopted to... 40 Protection of Environment 26 2013-07-01 2013-07-01 false Recommended procedures: Operations. 243.203-2 Section 243.203-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

40 CFR 243.203-2 - Recommended procedures: Operations.

Code of Federal Regulations, 2014 CFR

2014-07-01

...) The minimum collection frequency consistent with public health and safety should be adopted to... 40 Protection of Environment 25 2014-07-01 2014-07-01 false Recommended procedures: Operations. 243.203-2 Section 243.203-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

40 CFR 243.203-2 - Recommended procedures: Operations.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) The minimum collection frequency consistent with public health and safety should be adopted to... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Recommended procedures: Operations. 243.203-2 Section 243.203-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...

40 CFR 243.202-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 25 2011-07-01 2011-07-01 false Recommended procedures: Operations. 243.202-3 Section 243.202-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... receive periodic vehicle safety checks, including, but not limited to, inspection of brakes, windshield...

10 CFR 39.63 - Operating and emergency procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... Energy NUCLEAR REGULATORY COMMISSION LICENSES AND RADIATION SAFETY REQUIREMENTS FOR WELL LOGGING Radiation Safety Requirements § 39.63 Operating and emergency procedures. Each licensee shall develop and... radiation surveys, including surveys for detecting contamination, as required by § 39.67(c)-(e); (d...

10 CFR 39.63 - Operating and emergency procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... Energy NUCLEAR REGULATORY COMMISSION LICENSES AND RADIATION SAFETY REQUIREMENTS FOR WELL LOGGING Radiation Safety Requirements § 39.63 Operating and emergency procedures. Each licensee shall develop and... radiation surveys, including surveys for detecting contamination, as required by § 39.67(c)-(e); (d...

10 CFR 39.63 - Operating and emergency procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... Energy NUCLEAR REGULATORY COMMISSION LICENSES AND RADIATION SAFETY REQUIREMENTS FOR WELL LOGGING Radiation Safety Requirements § 39.63 Operating and emergency procedures. Each licensee shall develop and... radiation surveys, including surveys for detecting contamination, as required by § 39.67(c)-(e); (d...

10 CFR 39.63 - Operating and emergency procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Energy NUCLEAR REGULATORY COMMISSION LICENSES AND RADIATION SAFETY REQUIREMENTS FOR WELL LOGGING Radiation Safety Requirements § 39.63 Operating and emergency procedures. Each licensee shall develop and... radiation surveys, including surveys for detecting contamination, as required by § 39.67(c)-(e); (d...

10 CFR 39.63 - Operating and emergency procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... Energy NUCLEAR REGULATORY COMMISSION LICENSES AND RADIATION SAFETY REQUIREMENTS FOR WELL LOGGING Radiation Safety Requirements § 39.63 Operating and emergency procedures. Each licensee shall develop and... radiation surveys, including surveys for detecting contamination, as required by § 39.67(c)-(e); (d...

40 CFR 240.208-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Recommended procedures: Operations. 240.208-3 Section 240.208-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended...

40 CFR 240.210-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Recommended procedures: Operations. 240.210-3 Section 240.210-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended...

40 CFR 240.202-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Recommended procedures: Operations. 240.202-3 Section 240.202-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended...

40 CFR 240.203-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Recommended procedures: Operations. 240.203-3 Section 240.203-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES GUIDELINES FOR THE THERMAL PROCESSING OF SOLID WASTES Requirements and Recommended...

Effect of Traffic Position Accuracy for Conducting Safe Airport Surface Operations

NASA Technical Reports Server (NTRS)

Jones, Denise R.; Prinzel, Lawrence J., III; Bailey, Randall E.; Arthur, Jarvis J., III; Barnes, James R.

2014-01-01

The Next Generation Air Transportation System (NextGen) concept proposes many revolutionary operational concepts and technologies, such as display of traffic information and movements, airport moving maps (AMM), and proactive alerts of runway incursions and surface traffic conflicts, to deliver an overall increase in system capacity and safety. A piloted simulation study was conducted at the National Aeronautics and Space Administration (NASA) Langley Research Center to evaluate the ability to conduct safe and efficient airport surface operations while utilizing an AMM displaying traffic of various position accuracies as well as the effect of traffic position accuracy on airport conflict detection and resolution (CD&R) capability. Nominal scenarios and off-nominal conflict scenarios were conducted using 12 airline crews operating in a simulated Memphis International Airport terminal environment. The data suggest that all traffic should be shown on the airport moving map, whether qualified or unqualified, and conflict detection and resolution technologies provide significant safety benefits. Despite the presence of traffic information on the map, collisions or near collisions still occurred; when indications or alerts were generated in these same scenarios, the incidences were averted.

Eye Safe, Visible Wavelength Lidar Systems: Design and Operational Advances, Results and Potential

NASA Technical Reports Server (NTRS)

Spinhirne, James; Welton, Ellsworth J.; Berkoff, Timothy; Campbell, James

2007-01-01

In the early nineties the first of the eye safe visible wavelength lidar systems known now as Micro Pulse Lidar (MPL) became operational. The important advance of the design was a system that, unlike most existing lidar, operated at eye safe energy densities and could thus operate unattended for full time monitoring. Since that time there have been many dozens of these systems produced and applied for full time profiling of atmospheric cloud and aerosol structure. There is currently an observational network of MPL sites to support global climate research. In thc course of application of these instruments there have been significant improvements in the, design and performance of the systems. In the last half decade particularly there has been significant application and technical development of MPL systems. In this paper we review progress. The current MPL systems in use are all single wavelength systems designed for cloud and aerosol applications. For the cloud and aerosol applications, both lidar depolarization and multi wavelength measurements have significant applications. These can be accomplished with the MPL, approach. The main current challenge for the lidar network activity are in the area of the reliability, repeatability and efficiency of data processing. The network makes use of internet data downloads and automated processing. The heights of all cloud and aerosol layers are needed. The recent emphasis has been in operationally deriving aerosol extinction cross section. Future emphasis will include adding cirrus optical parameters. For operational effectiveness, improvements to simplify routine data signal calibration are being researched. Overall the MPL systems have proven very effective. A large data base of results from globally distributed sites can be easily accessed through the internet. Applications have included atmospheric model development. Validation of current global satellite observations of aerosol and clouds, including now orbital lidar

49 CFR 240.207 - Procedures for making the determination on vision and hearing acuity.

Code of Federal Regulations, 2014 CFR

2014-10-01

... writing that the person can safely operate without using the device. [56 FR 28254, June 19, 1991, as... 49 Transportation 4 2014-10-01 2014-10-01 false Procedures for making the determination on vision... CERTIFICATION OF LOCOMOTIVE ENGINEERS Implementation of the Certification Process § 240.207 Procedures for...

49 CFR 240.207 - Procedures for making the determination on vision and hearing acuity.

Code of Federal Regulations, 2012 CFR

2012-10-01

... writing that the person can safely operate without using the device. [56 FR 28254, June 19, 1991, as... 49 Transportation 4 2012-10-01 2012-10-01 false Procedures for making the determination on vision... CERTIFICATION OF LOCOMOTIVE ENGINEERS Implementation of the Certification Process § 240.207 Procedures for...

49 CFR 240.207 - Procedures for making the determination on vision and hearing acuity.

Code of Federal Regulations, 2013 CFR

2013-10-01

... writing that the person can safely operate without using the device. [56 FR 28254, June 19, 1991, as... 49 Transportation 4 2013-10-01 2013-10-01 false Procedures for making the determination on vision... CERTIFICATION OF LOCOMOTIVE ENGINEERS Implementation of the Certification Process § 240.207 Procedures for...

Risk of Venous Thromboembolism and Operative Duration in Patients Undergoing Neurosurgical Procedures.

PubMed

Bekelis, Kimon; Labropoulos, Nicos; Coy, Shannon

2017-05-01

The association of operative duration with the risk of venous thromboembolism (VTE) has not been quantified in neurosurgery. To investigate the association of surgical duration for several neurosurgical procedures and the incidence of VTE. We performed a retrospective cohort study involving patients who underwent neurosurgical procedures from 2005 to 2012 and were registered in the American College of Surgeons National Quality Improvement Project registry. In order to control for confounding, we used multivariable regression models, and propensity score conditioning. During the study period, there were 94 747 patients, who underwent neurosurgical procedures, and met the inclusion criteria. Of these, 1358 (1.0%) developed VTE within 30 days postoperatively. Multivariable logistic regression demonstrated an association of longer operative duration with higher 30-day incidence of VTE (odds ratio [OR], 1.22; 95% confidence interval [CI], 1.19-1.25). Compared with procedures of moderate duration (third quintile, 40-60th percentile), patients undergoing the longest procedures (>80th percentile) had higher odds (OR, 3.15; 95% CI, 2.49-3.99) of developing VTE. The shortest procedures (<20th percentile) were associated with a decreased incidence of VTE (OR, 0.51; 95% CI, 0.27-0.76) in comparison to those of moderate duration. The same associations were present in propensity score-adjusted models, and models stratified by subgroups of cranial, spinal, peripheral nerve, and carotid procedures. In a cohort of patients from a national prospective surgical registry, increased operative duration was associated with increased incidence of VTE for neurosurgical procedures. These results can be used by neurosurgeons to inform operative management, and to stratify patients with regard to VTE risk. Copyright © 2016 by the Congress of Neurological Surgeons

The Role of Well Control Training in Developing Safe Onshore and Offshore Oil Drilling Operations

ERIC Educational Resources Information Center

Abulhassn, Aber

2016-01-01

This research investigates the role of the International Well Control Forum (IWCF) Rotary Drilling Well Control Training Program in developing safe oil drilling operations from the perspective of onshore and offshore drilling crews. The research methodology is a qualitative case study. A total of 40 IWCF candidates were interviewed, with 10 from…

40 CFR 243.202-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Recommended procedures: Operations. 243.202-3 Section 243.202-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID... receive periodic vehicle safety checks, including, but not limited to, inspection of brakes, windshield...

40 CFR 243.201-2 - Recommended procedures: Operations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... should meet the applicable provisions of the Occupational Safety and Health Administration Standards for... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Recommended procedures: Operations. 243.201-2 Section 243.201-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID...

40 CFR 240.209-3 - Recommended procedures: Operations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Occupational Respiratory Disease, National Institute for Occupational Safety and Health, Morgantown, W. Va. (c... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Recommended procedures: Operations. 240.209-3 Section 240.209-3 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID...

40 CFR 243.203-2 - Recommended procedures: Operations.

Code of Federal Regulations, 2012 CFR

2012-07-01

... minimum collection frequency consistent with public health and safety should be adopted to minimize... 40 Protection of Environment 26 2012-07-01 2011-07-01 true Recommended procedures: Operations. 243.203-2 Section 243.203-2 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID...

21 CFR 120.6 - Sanitation standard operating procedures.

Code of Federal Regulations, 2010 CFR

2010-04-01

... garments; (3) Prevention of cross contamination from insanitary objects to food, food packaging material... health conditions that could result in the microbiological contamination of food, food packaging... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Sanitation standard operating procedures. 120.6...

Suggested Guide for Fire Service Standard Operating Procedures.

ERIC Educational Resources Information Center

Gillett, Merl; Hertzler, Simon L.

Suggested guidelines for the development of fire service standard operating procedures are presented in this document. Section topics are as follow: chain of command; communications; emergency response; apparatus; fire service training; disaster response; aircraft fire safety; mutual aid; national reporting system (example reporting forms);…

Supporting the future nuclear workforce with computer-based procedures

DOE PAGES

Oxstrand, Johanna; Le Blanc, Katya

2016-05-01

Here we see that computer-based tools have dramatically increased ease and efficiency of everyday tasks. Gone are the days of paging through a paper catalog, transcribing product numbers, and calculating totals. Today, a consumer can find a product online with a simple search engine, and then purchase it in a matter of a few clicks. Paper catalogs have their place, but it is hard to imagine life without on-line shopping sites. All tasks conducted in a nuclear power plant are guided by procedures, which helps ensure safe and reliable operation of the plants. One prominent goal of the nuclear industrymore » is to minimize the risk of human errors. To achieve this goal one has to ensure tasks are correctly and consistently executed. This is partly achieved by training and by a structured approach to task execution, which is provided by procedures and work instructions. Procedures are used in the nuclear industry to direct workers' actions in a proper sequence. The governing idea is to minimize the reliance on memory and choices made in the field. However, the procedure document may not contain sufficient information to successfully complete the task. Therefore, the worker might have to carry additional documents such as turnover sheets, operation experience, drawings, and other procedures to the work site. The nuclear industry is operated with paper procedures like paper catalogs of the past. A field worker may carry a large stack of documents needed to complete a task to the field. Even though the paper process has helped keep the industry safe for decades, there are limitations to using paper. Paper procedures are static (i.e., the content does not change after the document is printed), difficult to search, and rely heavily on the field worker’s situational awareness and ability to consistently meet the high expectation of human performance excellence. With computer-based procedures (CBPs) that stack of papers may be reduced to the size of a small tablet or even

Supporting the future nuclear workforce with computer-based procedures

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

Oxstrand, Johanna; Le Blanc, Katya

Here we see that computer-based tools have dramatically increased ease and efficiency of everyday tasks. Gone are the days of paging through a paper catalog, transcribing product numbers, and calculating totals. Today, a consumer can find a product online with a simple search engine, and then purchase it in a matter of a few clicks. Paper catalogs have their place, but it is hard to imagine life without on-line shopping sites. All tasks conducted in a nuclear power plant are guided by procedures, which helps ensure safe and reliable operation of the plants. One prominent goal of the nuclear industrymore » is to minimize the risk of human errors. To achieve this goal one has to ensure tasks are correctly and consistently executed. This is partly achieved by training and by a structured approach to task execution, which is provided by procedures and work instructions. Procedures are used in the nuclear industry to direct workers' actions in a proper sequence. The governing idea is to minimize the reliance on memory and choices made in the field. However, the procedure document may not contain sufficient information to successfully complete the task. Therefore, the worker might have to carry additional documents such as turnover sheets, operation experience, drawings, and other procedures to the work site. The nuclear industry is operated with paper procedures like paper catalogs of the past. A field worker may carry a large stack of documents needed to complete a task to the field. Even though the paper process has helped keep the industry safe for decades, there are limitations to using paper. Paper procedures are static (i.e., the content does not change after the document is printed), difficult to search, and rely heavily on the field worker’s situational awareness and ability to consistently meet the high expectation of human performance excellence. With computer-based procedures (CBPs) that stack of papers may be reduced to the size of a small tablet or even

[Handling modern imaging procedures in a high-tech operating room].

PubMed

Hüfner, T; Citak, M; Imrecke, J; Krettek, C; Stübig, T

2012-03-01

Operating rooms are the central unit in the hospital network in trauma centers. In this area, high costs but also high revenues are generated. Modern operating theater concepts as an integrated model have been offered by different companies since the early 2000s. Our hypothesis is that integrative concepts for operating rooms, in addition to improved operating room ergonomics, have the potential for measurable time and cost savings. In our clinic, an integrated operating room concept (I-Suite, Stryker, Duisburg) was implemented after analysis of the problems. In addition to the ceiling-mounted arrangement, the system includes an endoscopy unit, a navigation system, and a voice control system. In the first 6 months (9/2005 to 2/2006), 112 procedures were performed in the integrated operating room: 34 total knee arthroplasties, 12 endoscopic spine surgeries, and 66 inpatient arthroscopic procedures (28 shoulder and 38 knee reconstructions). The analysis showed a daily saving of 22-45 min, corresponding to 15-30% of the daily changeover times, calculated to account for potential savings in the internal cost allocation of 225-450 EUR. A commercial operating room concept was evaluated in a pilot phase in terms of hard data, including time and cost factors. Besides the described effects further savings might be achieved through the effective use of voice control and the benefit of the sterile handle on the navigation camera, since waiting times for an additional nurse are minimized. The time of the procedure of intraoperative imaging is also reduced due to the ceiling-mounted concept, as the C-arm can be moved freely in the operating theater without hindering cables. By these measures and ensuing improved efficiency, the initial high costs for the implementation of the system may be cushioned over time.

Technical Operating Procedures for Resource Documentation Under the Oil Pollution Act of 1990

DOT National Transportation Integrated Search

1996-06-01

Technical Operating Procedures (TOPs) for Resource Documentation under the Oil Pollution Act of 1990 (P.L.101-380) have been developed to provide guidance to users operating as, or in support of, the Federal On-Scene Coordinator(FOSC). The procedures...

Evaluating North Carolina Food Pantry Food Safety-Related Operating Procedures.

PubMed

Chaifetz, Ashley; Chapman, Benjamin

2015-11-01

Almost one in seven American households were food insecure in 2012, experiencing difficulty in providing enough food for all family members due to a lack of resources. Food pantries assist a food-insecure population through emergency food provision, but there is a paucity of information on the food safety-related operating procedures used in the pantries. Food pantries operate in a variable regulatory landscape; in some jurisdictions, they are treated equivalent to restaurants, while in others, they operate outside of inspection regimes. By using a mixed methods approach to catalog the standard operating procedures related to food in 105 food pantries from 12 North Carolina counties, we evaluated their potential impact on food safety. Data collected through interviews with pantry managers were supplemented with observed food safety practices scored against a modified version of the North Carolina Food Establishment Inspection Report. Pantries partnered with organized food bank networks were compared with those that operated independently. In this exploratory research, additional comparisons were examined for pantries in metropolitan areas versus nonmetropolitan areas and pantries with managers who had received food safety training versus managers who had not. The results provide a snapshot of how North Carolina food pantries operate and document risk mitigation strategies for foodborne illness for the vulnerable populations they serve. Data analysis reveals gaps in food safety knowledge and practice, indicating that pantries would benefit from more effective food safety training, especially focusing on formalizing risk management strategies. In addition, new tools, procedures, or policy interventions might improve information actualization by food pantry personnel.

A simulation facility for testing Space Station assembly procedures

NASA Technical Reports Server (NTRS)

Hajare, Ankur R.; Wick, Daniel T.; Shehad, Nagy M.

1994-01-01

NASA plans to construct the Space Station Freedom (SSF) in one of the most hazardous environments known to mankind - space. It is of the utmost importance that the procedures to assemble and operate the SSF in orbit are both safe and effective. This paper describes a facility designed to test the integration of the telerobotic systems and to test assembly procedures using a real-world robotic arm grappling space hardware in a simulated microgravity environment.

Acute normovolemic hemodilution is safe in neurosurgery.

PubMed

Oppitz, Paulo P; Stefani, Marco A

2013-01-01

To determine the safety of acute normovolemic hemodilution (ANH) for patients undergoing neurosurgical procedures. A group of 100 patients undergoing neurosurgical procedures was assigned prospectively to receive ANH. A group of 47 patients who underwent craniotomy for aneurysm clipping and standard anesthetic management was used as a control. Procedures conducted under ANH were performed without significant variations in physiologic parameters. Compared with controls, intraoperative blood loss, operative time, incidence and grade of complications, and length of hospital stay were similar between the two groups. Although the ANH group showed a difference in prothrombin levels before and after hemodilution procedures, the levels were still considered within physiologic parameters. Platelet counts and partial thromboplastin time (PTT) levels indicated no significant variations in either group. During the ANH procedure, a considerable reduction of brain oxygen extraction was observed in individuals with worse preoperative neurologic status (P < 0.05), indicating potential benefit. Among patients with cerebral aneurysm, patients with good initial clinical grades had better clinical results as indicated by Glasgow Outcome Scale scores (P < 0.02). ANH is a safe procedure for patients undergoing neurosurgical procedures. Further studies are necessary to confirm the improvement in brain oxygen extraction and the clinical impact. Nonetheless, patients undergoing aneurysm clipping with good clinical grades seem to profit from ANH. Copyright © 2013 Elsevier Inc. All rights reserved.

10 CFR 34.81 - Copies of operating and emergency procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Copies of operating and emergency procedures. 34.81 Section 34.81 Energy NUCLEAR REGULATORY COMMISSION LICENSES FOR INDUSTRIAL RADIOGRAPHY AND RADIATION SAFETY REQUIREMENTS FOR INDUSTRIAL RADIOGRAPHIC OPERATIONS Recordkeeping Requirements § 34.81 Copies of...

10 CFR 34.81 - Copies of operating and emergency procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Copies of operating and emergency procedures. 34.81 Section 34.81 Energy NUCLEAR REGULATORY COMMISSION LICENSES FOR INDUSTRIAL RADIOGRAPHY AND RADIATION SAFETY REQUIREMENTS FOR INDUSTRIAL RADIOGRAPHIC OPERATIONS Recordkeeping Requirements § 34.81 Copies of...

10 CFR 34.81 - Copies of operating and emergency procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Copies of operating and emergency procedures. 34.81 Section 34.81 Energy NUCLEAR REGULATORY COMMISSION LICENSES FOR INDUSTRIAL RADIOGRAPHY AND RADIATION SAFETY REQUIREMENTS FOR INDUSTRIAL RADIOGRAPHIC OPERATIONS Recordkeeping Requirements § 34.81 Copies of...

10 CFR 34.81 - Copies of operating and emergency procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Copies of operating and emergency procedures. 34.81 Section 34.81 Energy NUCLEAR REGULATORY COMMISSION LICENSES FOR INDUSTRIAL RADIOGRAPHY AND RADIATION SAFETY REQUIREMENTS FOR INDUSTRIAL RADIOGRAPHIC OPERATIONS Recordkeeping Requirements § 34.81 Copies of...

10 CFR 34.81 - Copies of operating and emergency procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 10 Energy 1 2012-01-01 2012-01-01 false Copies of operating and emergency procedures. 34.81 Section 34.81 Energy NUCLEAR REGULATORY COMMISSION LICENSES FOR INDUSTRIAL RADIOGRAPHY AND RADIATION SAFETY REQUIREMENTS FOR INDUSTRIAL RADIOGRAPHIC OPERATIONS Recordkeeping Requirements § 34.81 Copies of...

Safe Energy Source in Battery-operated Toys for Children.

PubMed

Rossi, Alfredo; Vignola, Silvia; Nason, Francesca; Boschetti, Federica; Bramerio, Manuela; Bailini, Alessandro; Pinarello, Giordano

2017-11-01

Serious and even fatal consequences of disk batteries ingestion in children are well known. Among other applications, disk batteries are used to power small toys, from which they can be unexpectedly extracted and swallowed. We tested a new cell intended for little toys (green cell [GC]), after 6 and 12 hours of in vitro close contact with esophageal swine mucosa. The GC was compared with lithium and silver button batteries under the same experimental conditions. Tissues in contact with the GC did not show pH variations nor histological alterations after 6 and 12 hours. In such conditions, statistically significant differences were found between the GC and the lithium and silver batteries. So far, multidisciplinary medical effort has been driven to both emergency approach and subsequent operative strategies in children with ingested batteries. Our trial demonstrates the possibility to primarily prevent battery-induced damages by designing new-generation safe cells with no tissue toxicity to power little toys intended for children.

OPERANT PROCEDURES IN REMEDIAL SPEECH AND LANGUAGE TRAINING.

ERIC Educational Resources Information Center

MACAULAY, BARBARA D., ED.; SLOANE, HOWARD N., JR., ED.

INTENDED FOR SPEECH THERAPISTS, THEACHERS OF THE MENTALLY RETARDED, AND OTHERS IN SPECIAL EDUCATION, THE COLLECTION CONTAINS REPORTS BY VARIOUS AUTHORS ON SPEECH AND LANGUAGE MODIFICATION ATTEMPTS THAT HAVE UTILIZED OPERANT CONDITIONING PROCEDURES, AS WELL AS SEVERAL PAPERS ON BACKGROUND TOPICS. BACKGROUND PAPERS ON TEACHING TREAT ENVIRONMENTAL…

The Small Aircraft Transportation System (SATS), Higher Volume Operations (HVO) Off-Nominal Operations

NASA Technical Reports Server (NTRS)

Baxley, B.; Williams, D.; Consiglio, M.; Conway, S.; Adams, C.; Abbott, T.

2005-01-01

The ability to conduct concurrent, multiple aircraft operations in poor weather, at virtually any airport, offers an important opportunity for a significant increase in the rate of flight operations, a major improvement in passenger convenience, and the potential to foster growth of charter operations at small airports. The Small Aircraft Transportation System, (SATS) Higher Volume Operations (HVO) concept is designed to increase traffic flow at any of the 3400 nonradar, non-towered airports in the United States where operations are currently restricted to one-in/one-out procedural separation during Instrument Meteorological Conditions (IMC). The concept's key feature is pilots maintain their own separation from other aircraft using procedures, aircraft flight data sent via air-to-air datalink, cockpit displays, and on-board software. This is done within the Self-Controlled Area (SCA), an area of flight operations established during poor visibility or low ceilings around an airport without Air Traffic Control (ATC) services. The research described in this paper expands the HVO concept to include most off-nominal situations that could be expected to occur in a future SATS environment. The situations were categorized into routine off-nominal operations, procedural deviations, equipment malfunctions, and aircraft emergencies. The combination of normal and off-nominal HVO procedures provides evidence for an operational concept that is safe, requires little ground infrastructure, and enables concurrent flight operations in poor weather.

14 CFR 93.352 - Hudson River Exclusion specific operating procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Hudson River Exclusion specific operating procedures. 93.352 Section 93.352 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES SPECIAL AIR TRAFFIC RULES New York Class B...

14 CFR 93.353 - East River Exclusion specific operating procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false East River Exclusion specific operating procedures. 93.353 Section 93.353 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) AIR TRAFFIC AND GENERAL OPERATING RULES SPECIAL AIR TRAFFIC RULES New York Class B...

Sequential robot-assisted radical right nephrectomy and cholecystectomy: a safe combined procedure.

PubMed

Spinoit, Anne-Françoise; Stravodimos, Konstantinos; Nikiteas, Nikolaos; Ploumidis, Antonios; Lumen, Nicolaas; Ploumidis, Achilles

2015-06-01

Kidney tumours are often found incidentally in the work-up of abdominal pain. We are reporting, to the best of our knowledge, the first series of robot-assisted radical nephrectomy (RARN) combined with cholecystectomy (RACH) in patients with organ-confined right kidney tumour and gallbladder stones. A solid organ-confined tumour of the right kidney, along with gallbladder stones, was demonstrated on CT in three patients following evaluation of colic-like abdominal pain. The tumours were deemed unsuitable for nephron-sparing surgery. A combined RARN with RACH in a single session was proposed for all the patients. Mean console time was 187 min. Estimated blood loss was minimal and all three patients had an uneventful recovery. The pathology reports confirmed complete excision of renal cell carcinoma with negative surgical margins and the gallbladders showed no signs of malignancy. Concomitant RARN-RACH for tumour in the right kidney and gallstones is a safe and effective procedure with excellent oncological and functional results. Copyright © 2014 John Wiley & Sons, Ltd.

21 CFR 120.6 - Sanitation standard operating procedures.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 2 2014-04-01 2014-04-01 false Sanitation standard operating procedures. 120.6 Section 120.6 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION HAZARD ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS General...

21 CFR 120.6 - Sanitation standard operating procedures.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 2 2012-04-01 2012-04-01 false Sanitation standard operating procedures. 120.6 Section 120.6 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION HAZARD ANALYSIS AND CRITICAL CONTROL POINT (HACCP) SYSTEMS General...

The End-To-End Safety Verification Process Implemented to Ensure Safe Operations of the Columbus Research Module

NASA Astrophysics Data System (ADS)

Arndt, J.; Kreimer, J.

2010-09-01

The European Space Laboratory COLUMBUS was launched in February 2008 with NASA Space Shuttle Atlantis. Since successful docking and activation this manned laboratory forms part of the International Space Station(ISS). Depending on the objectives of the Mission Increments the on-orbit configuration of the COLUMBUS Module varies with each increment. This paper describes the end-to-end verification which has been implemented to ensure safe operations under the condition of a changing on-orbit configuration. That verification process has to cover not only the configuration changes as foreseen by the Mission Increment planning but also those configuration changes on short notice which become necessary due to near real-time requests initiated by crew or Flight Control, and changes - most challenging since unpredictable - due to on-orbit anomalies. Subject of the safety verification is on one hand the on orbit configuration itself including the hardware and software products, on the other hand the related Ground facilities needed for commanding of and communication to the on-orbit System. But also the operational products, e.g. the procedures prepared for crew and ground control in accordance to increment planning, are subject of the overall safety verification. In order to analyse the on-orbit configuration for potential hazards and to verify the implementation of the related Safety required hazard controls, a hierarchical approach is applied. The key element of the analytical safety integration of the whole COLUMBUS Payload Complement including hardware owned by International Partners is the Integrated Experiment Hazard Assessment(IEHA). The IEHA especially identifies those hazardous scenarios which could potentially arise through physical and operational interaction of experiments. A major challenge is the implementation of a Safety process which owns quite some rigidity in order to provide reliable verification of on-board Safety and which likewise provides enough

Evaluation of combinations of procedures in cesarean section.

PubMed

Stark, M; Chavkin, Y; Kupfersztain, C; Guedj, P; Finkel, A R

1995-03-01

To evaluate a procedure for cesarean section, consisting of a number of surgical techniques adopted from various sources and further developed. The principal elements of the cesarean section procedure followed were: the Joel-Cohen method for opening the abdomen, suturing the uterus in one layer, and non-closure of the visceral and parietal peritoneal layers. The postoperative recovery of women who underwent this procedure (JCl--group) was compared with that of women who had undergone a Pfannenstiel incision, in which the uterus is sutured in two layers, and both peritoneal layers sutured (Pf2++ group). The incidence of postoperative febrile morbidity was 7.7% in the JCl--group compared with 19.8% in the Pf2++ group (P < 0.05). Adhesions were found in 6.3% of repeat operations after the JCl--operation compared with 28.8% after the Pf2++ operation (P < 0.05), and there was a non-significant trend toward fewer postoperative analgesics in the JCl--group. The cesarean section procedure we have devised is not only safe, but has a lower risk of long- and short-term complications.

Crew procedures for microwave landing system operations

NASA Technical Reports Server (NTRS)

Summers, Leland G.

1987-01-01

The objective of this study was to identify crew procedures involved in Microwave Landing System (MLS) operations and to obtain a preliminary assessment of crew workload. The crew procedures were identified for three different complements of airborne equipment coupled to an autopilot. Using these three equipment complements, crew tasks were identified for MLS approaches and precision departures and compared to an ILS approach and a normal departure. Workload comparisons between the approaches and departures were made by using a task-timeline analysis program that obtained workload indexes, i.e., the radio of time required to complete the tasks to the time available. The results showed an increase in workload for the MLS scenario for one of the equipment complements. However, even this workload was within the capacity of two crew members.

Safe Disposal of Highly Reactive Chemicals.

ERIC Educational Resources Information Center

Lunn, George; Sansone, Eric B.

1994-01-01

Provides specific procedures for the disposal of a variety of highly reactive chemicals and reports the results of a study of their safe disposal. Disposal of some problematic sulfur-containing compounds are included. Procedures are based on a combination of literature review and author development. (LZ)

Situation awareness and trust in computer-based procedures in nuclear power plant operations

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

Throneburg, E. B.; Jones, J. M.

2006-07-01

Situation awareness and trust are two issues that need to be addressed in the design of computer-based procedures for nuclear power plants. Situation awareness, in relation to computer-based procedures, concerns the operators' knowledge of the plant's state while following the procedures. Trust concerns the amount of faith that the operators put into the automated procedures, which can affect situation awareness. This paper first discusses the advantages and disadvantages of computer-based procedures. It then discusses the known aspects of situation awareness and trust as applied to computer-based procedures in nuclear power plants. An outline of a proposed experiment is then presentedmore » that includes methods of measuring situation awareness and trust so that these aspects can be analyzed for further study. (authors)« less

Modern problems concerned with ensuring safe operation of heat-generating and mechanical equipment in extending its lifetime

NASA Astrophysics Data System (ADS)

Rezinskikh, V. F.; Grin', E. A.

2013-01-01

The problem concerned with safe and reliable operation of ageing heat-generating and mechanical equipment of thermal power stations is discussed. It is pointed out that the set of relevant regulatory documents serves as the basis for establishing an efficient equipment diagnostic system. In this connection, updating the existing regulatory documents with imparting the required status to them is one of top-priority tasks. Carrying out goal-oriented scientific research works is a necessary condition for solving this problem as well as other questions considered in the paper that are important for ensuring reliable performance of equipment operating for a long period of time. In recent years, the amount of such works has dropped dramatically, although the need for them is steadily growing. Unbiased assessment of the technical state of equipment that has been in operation for a long period of time is an important aspect in solving the problem of ensuring reliable and safe operation of thermal power stations. Here, along with the quality of diagnostic activities, monitoring of technical state performed on the basis of an analysis of statistical field data and results of operational checks plays an important role. The need to concentrate efforts taken in the mentioned problem areas is pointed out, and it is indicated that successful implementation of the outlined measures requires proper organization and efficient operation of a system for managing safety in the electric power industry.

14 CFR 431.39 - Mission rules, procedures, contingency plans, and checklists.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Mission rules, procedures, contingency plans, and checklists. 431.39 Section 431.39 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION... safe conduct of mission operations during nominal and non-nominal vehicle flight. (b) Mission rules...

14 CFR 431.39 - Mission rules, procedures, contingency plans, and checklists.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Mission rules, procedures, contingency plans, and checklists. 431.39 Section 431.39 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION... safe conduct of mission operations during nominal and non-nominal vehicle flight. (b) Mission rules...

Model Checking Satellite Operational Procedures

NASA Astrophysics Data System (ADS)

Cavaliere, Federico; Mari, Federico; Melatti, Igor; Minei, Giovanni; Salvo, Ivano; Tronci, Enrico; Verzino, Giovanni; Yushtein, Yuri

2011-08-01

We present a model checking approach for the automatic verification of satellite operational procedures (OPs). Building a model for a complex system as a satellite is a hard task. We overcome this obstruction by using a suitable simulator (SIMSAT) for the satellite. Our approach aims at improving OP quality assurance by automatic exhaustive exploration of all possible simulation scenarios. Moreover, our solution decreases OP verification costs by using a model checker (CMurphi) to automatically drive the simulator. We model OPs as user-executed programs observing the simulator telemetries and sending telecommands to the simulator. In order to assess feasibility of our approach we present experimental results on a simple meaningful scenario. Our results show that we can save up to 90% of verification time.

Radiation exposure to eye lens and operator hands during endovascular procedures in hybrid operating rooms.

PubMed

Attigah, Nicolas; Oikonomou, Kyriakos; Hinz, Ulf; Knoch, Thomas; Demirel, Serdar; Verhoeven, Eric; Böckler, Dittmar

2016-01-01

The purpose of this study was to evaluate the radiation exposure of vascular surgeons' eye lens and fingers during complex endovascular procedures in modern hybrid operating rooms. Prospective, nonrandomized multicenter study design. One hundred seventy-one consecutive patients (138 male; median age, 72.5 years [interquartile range, 65-77 years]) underwent an endovascular procedure in a hybrid operating room between March 2012 and July 2013 in two vascular centers. The dose-area product (DAP), fluoroscopy time, operating time, and amount of contrast dye were registered prospectively. For radiation dose recordings, single-use dosimeters were attached at eye level and to the ring finger of the hand next to the radiation field of the operator for each endovascular procedure. Dose recordings were evaluated by an independent institution. Before the study, precursory investigations were obtained to simulate the radiation dose to eye lens and fingers with an Alderson phantome (RSD, Long Beach, Calif). Interventions were classified into six treatment categories: endovascular repair of infrarenal abdominal aneurysm (n = 65), thoracic endovascular aortic repair (n = 32), branched endovascular aortic repair for thoracoabdominal aneurysms (n = 17), fenestrated endovascular aortic repair for complex abdominal aortic aneurysm, (n = 25), iliac branched device (n = 8), and peripheral interventions (n = 24). There was a significant correlation in DAP between both lens (P < .01; r = 0.55) and finger (P < .01; r = 0.56) doses. The estimated fluoroscopy time to reach a radiation threshold of 20 mSv/y was 1404.10 minutes (90% confidence limit, 1160, 1650 minutes). According to correlation of the lens dose with the DAP an estimated cumulative DAP of 932,000 mGy/m(2) (90% confidence limit, 822,000, 1,039,000) would be critical for a threshold of 20 mSv/y for the eyes. Radiation protection is a serious issue for vascular surgeons because most complex endovascular procedures are delivering

Safe Manual Jettison

NASA Technical Reports Server (NTRS)

Barton, Jay

2008-01-01

In space, the controlled release of certain cargoes is no less useful than the maritime jettisons from which they take their name but is also much more dangerous. Experience has shown that jettisons can be performed safely, but the process is complicated with the path to performing a jettison taking months or even years. In the background, time is also required to write procedures, train the crew, configure the vehicle, and many other activities. This paper outlines the current process used by the National Aeronautics and Space Administration (NASA) for manual jettisons, detailing the methods used to assure that the jettisons and the jettisoned objects are as safe as achievable and that the crew is adequately trained to be able to affect the safe jettison. The goal of this paper is not only to capture what it takes to perform safe jettisons in the near Earth environment but to extrapolate this knowledge to future space exploration scenarios that will likely have Extravehicular Activity (EVA) and International Partner (IP) interfaces.

49 CFR Appendix E to Part 240 - Recommended Procedures for Conducting Skill Performance Tests

Code of Federal Regulations, 2010 CFR

2010-10-01

... tailor their testing procedures to the specific operational realities. This appendix contains FRA's..., headlight? —Couple to cars at a safe speed? —Properly control in train slack and buff forces? —Properly use...

Pelvic denervation procedures for dysmenorrhea.

PubMed

Ramirez, Christina; Donnellan, Nicole

2017-08-01

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

Terminal Area Procedures for Paired Runways

NASA Technical Reports Server (NTRS)

Lozito, Sandra; Verma, Savita Arora

2011-01-01

Parallel runway operations have been found to increase capacity within the National Airspace but poor visibility conditions reduce the use of these operations. The NextGen and SESAR Programs have identified the capacity benefits from increased use of closely-space parallel runway. Previous research examined the concepts and procedures related to parallel runways however, there has been no investigation of the procedures associated with the strategic and tactical pairing of aircraft for these operations. This simulation study developed and examined the pilot and controller procedures and information requirements for creating aircraft pairs for parallel runway operations. The goal was to achieve aircraft pairing with a temporal separation of 15s (+/- 10s error) at a coupling point that was about 12 nmi from the runway threshold. Two variables were explored for the pilot participants: two levels of flight deck automation (current-day flight deck automation and auto speed control future automation) as well as two flight deck displays that assisted in pilot conformance monitoring. The controllers were also provided with automation to help create and maintain aircraft pairs. Results show the operations in this study were acceptable and safe. Subjective workload, when using the pairing procedures and tools, was generally low for both controllers and pilots, and situation awareness was typically moderate to high. Pilot workload was influenced by display type and automation condition. Further research on pairing and off-nominal conditions is required however, this investigation identified promising findings about the feasibility of closely-spaced parallel runway operations.

Total laparoscopic reversal of Hartmann's procedure.

PubMed

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

2013-01-01

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

ARM Operations and Engineering Procedure Mobile Facility Site Startup

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

Voyles, Jimmy W

2015-05-01

This procedure exists to define the key milestones, necessary steps, and process rules required to commission and operate an Atmospheric Radiation Measurement (ARM) Mobile Facility (AMF), with a specific focus toward on-time product delivery to the ARM Data Archive. The overall objective is to have the physical infrastructure, networking and communications, and instrument calibration, grooming, and alignment (CG&A) completed with data products available from the ARM Data Archive by the Operational Start Date milestone.

Interprofessional and interdisciplinary simulation-based training leads to safe sedation procedures in the emergency department.

PubMed

Sauter, Thomas C; Hautz, Wolf E; Hostettler, Simone; Brodmann-Maeder, Monika; Martinolli, Luca; Lehmann, Beat; Exadaktylos, Aristomenis K; Haider, Dominik G

2016-08-02

Sedation is a procedure required for many interventions in the Emergency department (ED) such as reductions, surgical procedures or cardioversions. However, especially under emergency conditions with high risk patients and rapidly changing interdisciplinary and interprofessional teams, the procedure caries important risks. It is thus vital but difficult to implement a standard operating procedure for sedation procedures in any ED. Reports on both, implementation strategies as well as their success are currently lacking. This study describes the development, implementation and clinical evaluation of an interprofessional and interdisciplinary simulation-based sedation training concept. All physicians and nurses with specialised training in emergency medicine at the Berne University Department of Emergency Medicine participated in a mandatory interdisciplinary and interprofessional simulation-based sedation training. The curriculum consisted of an individual self-learning module, an airway skill training course, three simulation-based team training cases, and a final practical learning course in the operating theatre. Before and after each training session, self-efficacy, awareness of emergency procedures, knowledge of sedation medication and crisis resource management were assessed with a questionnaire. Changes in these measures were compared via paired tests, separately for groups formed based on experience and profession. To assess the clinical effect of training, we collected patient and team satisfaction as well as duration and complications for all sedations in the ED within the year after implementation. We further compared time to beginning of procedure, time for duration of procedure and time until discharge after implementation with the one year period before the implementation. Cohen's d was calculated as effect size for all statistically significant tests. Fifty staff members (26 nurses and 24 physicians) participated in the training. In all subgroups

Operational Control Procedures for the Activated Sludge Process, Part III-B: Calculation Procedures for Step-Feed Process Responses and Addendum No. 1.

ERIC Educational Resources Information Center

West, Alfred W.

This is the third in a series of documents developed by the National Training and Operational Technology Center describing operational control procedures for the activated sludge process used in wastewater treatment. This document deals with the calculation procedures associated with a step-feed process. Illustrations and examples are included to…

Strategies for Countering Terrorist Safe Havens

DTIC Science & Technology

2013-12-01

tactical containment, pseudo operations, and surrogate security forces. The thesis draws from four historical case studies to examine these strategies...safe havens, tactical containment, pseudo operations, and surrogate security forces. The thesis draws from four historical case studies to examine...pseudo operations—provide viable potential options for USSOF to counter the complex problem of safe havens. Overall, the case studies will demonstrate

Asymptotically safe standard model extensions?

NASA Astrophysics Data System (ADS)

Pelaggi, Giulio Maria; Plascencia, Alexis D.; Salvio, Alberto; Sannino, Francesco; Smirnov, Juri; Strumia, Alessandro

2018-05-01

We consider theories with a large number NF of charged fermions and compute the renormalization group equations for the gauge, Yukawa and quartic couplings resummed at leading order in 1 /NF. We construct extensions of the standard model where SU(2) and/or SU(3) are asymptotically safe. When the same procedure is applied to the Abelian U(1) factor, we find that the Higgs quartic can not be made asymptotically safe and stay perturbative at the same time.

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.

Oral Surgical Procedures Performed Safely in Patients With Head and Neck Arteriovenous Malformations: A Retrospective Case Series of 12 Patients.

PubMed

Karim, Abdul Basit; Lindsey, Sean; Bovino, Brian; Berenstein, Alejandro

2016-02-01

This case series describes patients with head and neck arteriovenous malformations who underwent oral and maxillofacial surgical procedures combined with interventional radiology techniques to minimize blood loss. Twelve patients underwent femoral cerebral angiography to visualize the extent of vascular malformation. Before the surgical procedures, surgical sites were devascularized by direct injection of hemostatic or embolic agents. Direct puncture sclerotherapy at the base of surgical sites was performed using Surgiflo or n-butylcyanoacrylate glue. Surgical procedures were carried out in routine fashion. A hemostatic packing of FloSeal, Gelfoam, and Avitene was adapted to the surgical sites. Direct puncture sclerotherapy with Surgiflo or n-butylcyanoacrylate glue resulted in minimal blood loss intraoperatively. Local application of the FloSeal, Gelfoam, and Avitene packing sustained hemostasis and produced excellent healing postoperatively. Patients with arteriovenous malformations can safely undergo routine oral and maxillofacial surgical procedures with minimal blood loss when appropriate endovascular techniques and local hemostatic measures are used by the interventional radiologist and oral and maxillofacial surgeon. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Quantifying Nanoparticle Release from Nanotechnology: Scientific Operating Procedure Series: SOP C 3

DTIC Science & Technology

2017-02-01

Operating Procedure Series : SOP-C-3 En vi ro nm en ta l L ab or at or y David P. Martin, Aimee R. Poda, and Anthony J. Bednar February 2017...Operating Procedure Series : SOP-C-3 David P. Martin, Aimee R. Poda, and Anthony J. Bednar Environmental Laboratory U.S. Army Engineer Research and...so designated by other authorized documents. DESTROY THIS REPORT WHEN NO LONGER NEEDED. DO NOT RETURN IT TO THE ORIGINATOR. ERDC/EL SR-17-1 iii

Operative vaginal delivery and invasive procedures in pregnancy among women living with HIV.

PubMed

Peters, Helen; Francis, Kate; Harding, Kate; Tookey, Pat A; Thorne, Claire

2017-03-01

To describe the use and outcomes of operative delivery and invasive procedures in pregnancy amongst women living with HIV. The National Study of HIV in Pregnancy and Childhood (NSHPC) is a comprehensive population-based surveillance study in the UK and Ireland. The NSHPC has collected data on operative delivery since 2008, and invasive procedures in pregnancy (amniocentesis, cordocentesis, chorionic villus sampling) from 2012. Descriptive analyses were conducted on 278 pregnancies expected to deliver from 1 January 2008 with outcome reported to the NSHPC by 31 March 2016. Among 9372 pregnancies in 2008-2016, there were 9072 livebirths with 251 operative deliveries and 27 invasive procedures in pregnancy reported. Information was available for 3023/3490 vaginal deliveries, and use of forceps or vacuum reported in 251deliveries (8.2%), increasing over calendar time to almost 10% by 2014-16. Forceps were used twice as often as vacuum delivery, and forceps use increased over time. One infant delivered operatively is known to have acquired HIV. From 2012 there were 4063 pregnancies resulting in 3952 livebirths, 83 terminations and 28 stillbirths. 2163/4063 had information on use (or not) of invasive procedures in pregnancy. Amniocentesis was reported in 25/2163 pregnancies, there was one report of chorionic villus sampling and one of cordocentesis. There were no reported transmissions following invasive procedures in pregnancy. This is the largest study to date to report on operative delivery in women living with HIV on combined antiretroviral therapy (cART), and provides an up-to-date picture of invasive procedures during pregnancy in this group. Findings from this comprehensive national study are reassuring but numbers are currently low; on-going monitoring is crucial as obstetric care of women with HIV becomes normalised. Copyright © 2017 Elsevier B.V. All rights reserved.

Guidewire retention following central venous catheterisation: a human factors and safe design investigation.

PubMed

Horberry, Tim; Teng, Yi-Chun; Ward, James; Patil, Vishal; Clarkson, P John

2014-01-01

Central Venous Catheterisation (CVC) has occasionally been associated with cases of retained guidewires in patients after surgery. In theory, this is a completely avoidable complication; however, as with any human procedure, operator error leading to guidewires being occasionally retained cannot be fully eliminated. The work described here investigated the issue in an attempt to better understand it both from an operator and a systems perspective, and to ultimately recommend appropriate safe design solutions that reduce guidewire retention errors. Nine distinct methods were used: observations of the procedure, a literature review, interviewing CVC end-users, task analysis construction, CVC procedural audits, two human reliability assessments, usability heuristics and a comprehensive solution survey with CVC end-users. The three solutions that operators rated most highly, in terms of both practicality and effectiveness, were: making trainees better aware of the potential guidewire complications and strongly emphasising guidewire removal in CVC training, actively checking that the guidewire is present in the waste tray for disposal, and standardising purchase of central line sets so that differences that may affect chances of guidewire loss is minimised. Further work to eliminate/engineer out the possibility of guidewires being retained is proposed.

Impact of Anatomical, Procedural, and Operator Skill Factors on the Success and Duration of Fluoroscopy-Guided Transjugular Intrahepatic Portosystemic Shunt

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

Marquardt, Steffen, E-mail: marquardt.steffen@mh-hannover.de; Rodt, Thomas, E-mail: rodt.thomas@mh-hannover.de; Rosenthal, Herbert, E-mail: rosenthal.herbert@mh-hannover.de

PurposeTo assess the impact of anatomical, procedural, and operator skill factors on the success and duration of fluoroscopy-guided transjugular intrahepatic portoystemic shunt following standard operating procedure (SOP).Material and MethodsDuring a 32-month period, 102 patients underwent transjugular intrahepatic portosystemic shunt creation (TIPS) by two interventional radiologists (IR) following our institutional SOP based on fluoroscopy guidance. Both demographic and procedural data were assessed. The duration of the intervention (D{sub Int}) and of the portal vein puncture (D{sub Punct}) was analyzed depending on the skill level of the IR as well as the anatomic or procedural factors.ResultsIn 99 of the 102 patients, successfulmore » TIPS without peri-procedural complications was performed. The mean D{sub Int} (IR1: 77 min; IR2: 51 min, P < 0.005) and the mean D{sub Punct} (IR1: 19 min; IR2: 13 min, P < 0.005) were significantly higher in TIPS performed by IR1 (with 2 years of clinical experience performing TIPS, n = 38) than by IR2 (>10 years of clinical experience performing TIPS, n = 61), (P < 0.005 both, Mann–Whitney U test). D{sub Int} showed a higher correlation with D{sub Punct} for IR2 (R{sup 2} = 0.63) than for IR1 (R{sup 2} = 0.13). There was no significant difference in the D{sub Punct} for both IRs with regard to the success of the wedged portography (P = 0.90), diameter of the portal vein (P = 0.60), central right portal vein length (P = 0.49), or liver function (MELD-Score before the TIPS procedure; P = 0.14).ConclusionTIPS following SOP is safe, fast, and reliable. The only significant factor for shorter D{sub Punct} and D{sub Int} was the clinical experience of the IR. Anatomic variability, successful portography, or liver function did not alter the duration or technical success of TIPS.« less

Terminal Area Procedures for Paired Runways

NASA Technical Reports Server (NTRS)

Lozito, Sandy

2011-01-01

Parallel Runway operations have been found to increase capacity within the National Airspace (NAS) however, poor visibility conditions reduce this capacity [1]. Much research has been conducted to examine the concepts and procedures related to parallel runways however, there has been no investigation of the procedures associated with the strategic and tactical pairing of aircraft for these operations. This study developed and examined the pilot and controller procedures and information requirements for creating aircraft pairs for parallel runway operations. The goal was to achieve aircraft pairing with a temporal separation of 15s(+/- 10s error) at a coupling point that is about 12 nmi from the runway threshold. Two variables were explored for the pilot participants: Two levels of flight deck automation (current-day flight deck automation, and a prototype future automation) as well as two flight deck displays that assisted in pilot conformance monitoring. The controllers were also provided with automation to help create and maintain aircraft pairs. Data showed that the operations in this study were found to be acceptable and safe. Workload when using the pairing procedures and tools was generally low for both controllers and pilots, and situation awareness (SA) was typically moderate to high. There were some differences based upon the display and automation conditions for the pilots. Future research should consider the refinement of the concepts and tools for pilot and controller displays and automation for parallel runway concepts.

EPA Library Disaster Response and Continuity of Operations (COOP) Procedures

EPA Pesticide Factsheets

To establish Agency-wide procedures for the EPA National Library Network libraries to mitigate, prepare for, respond to, and recover from disasters in EPA libraries and provide continuing operations during and after a disaster.

Safe handling of antineoplastic drugs.

PubMed

Harrison, B R

1994-07-01

Managers should be aware of the hazardous properties of antineoplastic drugs and of the procedures and equipment commonly recommended to provide a safe working environment for employees, patients, and visitors. Compliance with the many published guidelines should help ensure passage of the inevitable Occupational Safety and Health Administration (OSHA) or Joint Commission inspection. Acute and chronic toxicities of the antineoplastic drugs, the potential for exposure in the workplace, and the basic guidelines for safe handling of these agents are reviewed.

National CPS Certification | A Program of Safe Kids Worldwide

Science.gov Websites

the Tech! ABOUT THE PROGRAM National CPS Certification Training is a program of Safe Kids Worldwide ; E-Vouchers FAQS/HELP FAQs Fees Forms Policies & Procedures Who We Are NHTSA Safe Kids CPS-board State Farm Follow us on Facebook Copyright © 2017 by Safe Kids Worldwide - Child Passenger Safety

RECOMMENDED OPERATING PROCEDURE NO. 45: ANALYSIS OF NITROUS OXIDE FROM COMBUSTION SOURCES

EPA Science Inventory

The recommended operating procedure (ROP) has been prepared for use in research activities conducted by EPA's Air and Energy Engineering Research Laboratory (AEERL). he procedure applies to the measurement of nitrous oxide (N2O) in dry gas samples extracted from gas streams where...

Defining a Safe Operating Space for inland recreational fisheries

USGS Publications Warehouse

Carpenter, Stephen R.; Brock, William A.; Hansen, Gretchen J. A.; Hansen, Jonathan F.; Hennessy, Joseph M.; Isermann, Daniel A.; Pedersen, Eric J.; Perales, K. Martin; Rypel, Andrew L.; Sass, Greg G.; Tunney, Tyler D.; Vander Zanden, M. Jake

2017-01-01

The Safe Operating Space (SOS) of a recreational fishery is the multidimensional region defined by levels of harvest, angler effort, habitat, predation and other factors in which the fishery is sustainable into the future. SOS boundaries exhibit trade-offs such that decreases in harvest can compensate to some degree for losses of habitat, increases in predation and increasing value of fishing time to anglers. Conversely, high levels of harvest can be sustained if habitat is intact, predation is low, and value of fishing effort is moderate. The SOS approach recognizes limits in several dimensions: at overly high levels of harvest, habitat loss, predation, or value of fishing effort, the stock falls to a low equilibrium biomass. Recreational fisheries managers can influence harvest and perhaps predation, but they must cope with trends that are beyond their control such as changes in climate, loss of aquatic habitat or social factors that affect the value of fishing effort for anglers. The SOS illustrates opportunities to manage harvest or predation to maintain quality fisheries in the presence of trends in climate, social preferences or other factors that are not manageable.

User's operating procedures. Volume 1: Scout project information programs

NASA Technical Reports Server (NTRS)

Harris, C. G.; Harris, D. K.

1985-01-01

A review of the user's operating procedures for the Scout Project Automatic Data System, called SPADS is given. SPADS is the result of the past seven years of software development on a Prime minicomputer located at the Scout Project Office. SPADS was developed as a single entry, multiple cross reference data management and information retrieval system for the automation of Project office tasks, including engineering, financial, managerial, and clerical support. The instructions to operate the Scout Project Information programs in data retrieval and file maintenance via the user friendly menu drivers is presented.

User's operating procedures. Volume 3: Projects directorate information programs

NASA Technical Reports Server (NTRS)

Haris, C. G.; Harris, D. K.

1985-01-01

A review of the user's operating procedures for the scout project automatic data system, called SPADS is presented. SPADS is the results of the past seven years of software development on a prime mini-computer. SPADS was developed as a single entry, multiple cross-reference data management and information retrieval system for the automation of Project office tasks, including engineering, financial, managerial, and clerical support. This volume, three of three, provides the instructions to operate the projects directorate information programs in data retrieval and file maintenance via the user friendly menu drivers.

Improving the review of standard operating procedures: a novel electronic system for compounding pharmacies.

PubMed

Brensel, Robert; Brensel, Scott; Ng, Amy

2013-01-01

Since the New England Compounding Center disaster in 2012, the importance of following correct procedures during every phase of customized pharmacy has been a focus of governmental interest and action as well as public scrutiny. Many pharmacies rely on the rote review of standard operating procedures to ensure that staff members understand and follow protocols that ensure the safety and potency of all compounds prepared, but that approach to continuing education can be cumbersome and needlessly time-consuming. In addition, documenting and retrieving evidence of employee competence can be difficult. In this article, we describe our use of online technology to improve our methods of educating staff about the full range of standard operating procedures that must be followed in our pharmacy. The system we devised and implemented has proven to be effective, easy to update and maintain, very inexpensive, and user friendly. Its use has reduced the time previously required for a read-over review of standard operating procedures from 30 or 40 minutes to 5 or 10 minutes in weekly staff meetings, and we can now easily document and access proof of employees' comprehension of that content. It is our hope that other small compounding pharmacies will also find this system of online standard operating procedure review helpful.

VISIR: technological infrastructure of an operational service for safe and efficient navigation in the Mediterranean Sea

NASA Astrophysics Data System (ADS)

Mannarini, Gianandrea; Turrisi, Giuseppe; D'Anca, Alessandro; Scalas, Mario; Pinardi, Nadia; Coppini, Giovanni; Palermo, Francesco; Carluccio, Ivano; Scuro, Matteo; Cretì, Sergio; Lecci, Rita; Nassisi, Paola; Tedesco, Luca

2016-08-01

VISIR (discoVerIng Safe and effIcient Routes) is an operational decision support system (DSS) for optimal ship routing designed and implemented in the frame of the TESSA (TEchnology for Situational Sea Awareness) project. The system is aimed to increase safety and efficiency of navigation through the use of forecast environmental fields and route optimization. VISIR can be accessed through a web interface (www.visir-nav.com) and mobile applications for both iOS and Android devices. This paper focuses on the technological infrastructure developed for operating VISIR as a DSS. Its main components are described, the performance of the operational system is assessed through experimental measurements, and a few case studies are presented.

Standard operating procedures for clinical research departments.

PubMed

Kee, Ashley Nichole

2011-01-01

A set of standard operating procedures (SOPs) provides a clinical research department with clear roles, responsibilities, and processes to ensure compliance, accuracy, and timeliness of data. SOPs also serve as a standardized training program for new employees. A practice may have an employee that can assist in the development of SOPs. There are also consultants that specialize in working with a practice to develop and write practice-specific SOPs. Making SOPs a priority will save a practice time and money in the long run and make the research practice more attractive to corporate study sponsors.

An operational procedure for rapid flood risk assessment in Europe

NASA Astrophysics Data System (ADS)

Dottori, Francesco; Kalas, Milan; Salamon, Peter; Bianchi, Alessandra; Alfieri, Lorenzo; Feyen, Luc

2017-07-01

The development of methods for rapid flood mapping and risk assessment is a key step to increase the usefulness of flood early warning systems and is crucial for effective emergency response and flood impact mitigation. Currently, flood early warning systems rarely include real-time components to assess potential impacts generated by forecasted flood events. To overcome this limitation, this study describes the benchmarking of an operational procedure for rapid flood risk assessment based on predictions issued by the European Flood Awareness System (EFAS). Daily streamflow forecasts produced for major European river networks are translated into event-based flood hazard maps using a large map catalogue derived from high-resolution hydrodynamic simulations. Flood hazard maps are then combined with exposure and vulnerability information, and the impacts of the forecasted flood events are evaluated in terms of flood-prone areas, economic damage and affected population, infrastructures and cities.An extensive testing of the operational procedure has been carried out by analysing the catastrophic floods of May 2014 in Bosnia-Herzegovina, Croatia and Serbia. The reliability of the flood mapping methodology is tested against satellite-based and report-based flood extent data, while modelled estimates of economic damage and affected population are compared against ground-based estimations. Finally, we evaluate the skill of risk estimates derived from EFAS flood forecasts with different lead times and combinations of probabilistic forecasts. Results highlight the potential of the real-time operational procedure in helping emergency response and management.

Operating Policies and Procedures of Computer Data-Base Systems.

ERIC Educational Resources Information Center

Anderson, David O.

Speaking on the operating policies and procedures of computer data bases containing information on students, the author divides his remarks into three parts: content decisions, data base security, and user access. He offers nine recommended practices that should increase the data base's usefulness to the user community: (1) the cost of developing…

Managing Cassini Safe Mode Attitude at Saturn

NASA Technical Reports Server (NTRS)

Burk, Thomas A.

2010-01-01

The Cassini spacecraft was launched on October 15, 1997 and arrived at Saturn on June 30, 2004. It has performed detailed observations and remote sensing of Saturn, its rings, and its satellites since that time. In the event safe mode interrupts normal orbital operations, Cassini has flight software fault protection algorithms to detect, isolate, and recover to a thermally safe and commandable attitude and then wait for further instructions from the ground. But the Saturn environment is complex, and safety hazards change depending on where Cassini is in its orbital trajectory around Saturn. Selecting an appropriate safe mode attitude that insures safe operation in the Saturn environment, including keeping the star tracker field of view clear of bright bodies, while maintaining a quiescent, commandable attitude, is a significant challenge. This paper discusses the Cassini safe table management strategy and the key criteria that must be considered, especially during low altitude flybys of Titan, in deciding what spacecraft attitude should be used in the event of safe mode.

Effective and efficient learning in the operating theater with intraoperative video-enhanced surgical procedure training.

PubMed

van Det, M J; Meijerink, W J H J; Hoff, C; Middel, B; Pierie, J P E N

2013-08-01

INtraoperative Video Enhanced Surgical procedure Training (INVEST) is a new training method designed to improve the transition from basic skills training in a skills lab to procedural training in the operating theater. Traditionally, the master-apprentice model (MAM) is used for procedural training in the operating theater, but this model lacks uniformity and efficiency at the beginning of the learning curve. This study was designed to investigate the effectiveness and efficiency of INVEST compared to MAM. Ten surgical residents with no laparoscopic experience were recruited for a laparoscopic cholecystectomy training curriculum either by the MAM or with INVEST. After a uniform course in basic laparoscopic skills, each trainee performed six cholecystectomies that were digitally recorded. For 14 steps of the procedure, an observer who was blinded for the type of training determined whether the step was performed entirely by the trainee (2 points), partially by the trainee (1 point), or by the supervisor (0 points). Time measurements revealed the total procedure time and the amount of effective procedure time during which the trainee acted as the operating surgeon. Results were compared between both groups. Trainees in the INVEST group were awarded statistically significant more points (115.8 vs. 70.2; p < 0.001) and performed more steps without the interference of the supervisor (46.6 vs. 18.8; p < 0.001). Total procedure time was not lengthened by INVEST, and the part performed by trainees was significantly larger (69.9 vs. 54.1 %; p = 0.004). INVEST enhances effectiveness and training efficiency for procedural training inside the operating theater without compromising operating theater time efficiency.

49 CFR 240.129 - Criteria for monitoring operational performance of certified engineers.

Code of Federal Regulations, 2010 CFR

2010-10-01

... railroad's rules and practices for the safe operation of locomotives and trains; (2) Be designed so that... service. (c) The procedures shall: (1) Be designed to determine that the person possesses and routinely... operational performance monitoring will be conducted; (3) Be designed so that the locomotive engineer is...

Prioritizing essential surgery and safe anesthesia for the Post-2015 Development Agenda: operative capacities of 78 district hospitals in 7 low- and middle-income countries.

PubMed

LeBrun, Drake G; Chackungal, Smita; Chao, Tiffany E; Knowlton, Lisa M; Linden, Allison F; Notrica, Michelle R; Solis, Carolina V; McQueen, K A Kelly

2014-03-01

Surgery has been neglected in low- and middle-income countries for decades. It is vital that the Post-2015 Development Agenda reflect that surgery is an important part of a comprehensive global health care delivery model. We compare the operative capacities of multiple low- and middle-income countries and identify critical gaps in surgical infrastructure. The Harvard Humanitarian Initiative survey tool was used to assess the operative capacities of 78 government district hospitals in Bangladesh (n = 7), Bolivia (n = 11), Ethiopia (n = 6), Liberia (n = 11), Nicaragua (n = 10), Rwanda (n = 21), and Uganda (n = 12) from 2011 to 2012. Key outcome measures included infrastructure, equipment availability, physician and nonphysician surgical providers, operative volume, and pharmaceutical capacity. Seventy of 78 district hospitals performed operations. There was fewer than one surgeon or anesthesiologist per 100,000 catchment population in all countries except Bolivia. There were no physician anesthesiologists in any surveyed hospitals in Rwanda, Liberia, Uganda, or in the majority of hospitals in Ethiopia. Mean annual operations per hospital ranged from 374 in Nicaragua to 3,215 in Bangladesh. Emergency operations and obstetric operations constituted 57.5% and 40% of all operations performed, respectively. Availability of pulse oximetry, essential medicines, and key infrastructure (water, electricity, oxygen) varied widely between and within countries. The need for operative procedures is not being met by the limited operative capacity in numerous low- and middle-income countries. It is of paramount importance that this gap be addressed by prioritizing essential surgery and safe anesthesia in the Post-2015 Development Agenda. Copyright © 2014 Mosby, Inc. All rights reserved.

Medical Operations Console Procedure Evaluation: BME Response to Crew Call Down for an Emergency

NASA Technical Reports Server (NTRS)

Johnson-Troop; Pettys, Marianne; Hurst, Victor, IV; Smaka, Todd; Paul, Bonnie; Rosenquist, Kevin; Gast, Karin; Gillis, David; McCulley, Phyllis

2006-01-01

International Space Station (ISS) Mission Operations are managed by multiple flight control disciplines located at the lead Mission Control Center (MCC) at NASA-Johnson Space Center (JSC). ISS Medical Operations are supported by the complementary roles of Flight Surgeons (Surgeon) and Biomedical Engineer (BME) flight controllers. The Surgeon, a board certified physician, oversees all medical concerns of the crew and the BME provides operational and engineering support for Medical Operations Crew Health Care System. ISS Medical Operations is currently addressing the coordinated response to a crew call down for an emergent medical event, in particular when the BME is the only Medical Operations representative in MCC. In this case, the console procedure BME Response to Crew Call Down for an Emergency will be used. The procedure instructs the BME to contact a Surgeon as soon as possible, coordinate with other flight disciplines to establish a Private Medical Conference (PMC) for the crew and Surgeon, gather information from the crew if time permits, and provide Surgeon with pertinent console resources. It is paramount that this procedure is clearly written and easily navigated to assist the BME to respond consistently and efficiently. A total of five BME flight controllers participated in the study. Each BME participant sat in a simulated MCC environment at a console configured with resources specific to the BME MCC console and was presented with two scripted emergency call downs from an ISS crew member. Each participant used the procedure while interacting with analog MCC disciplines to respond to the crew call down. Audio and video recordings of the simulations were analyzed and each BME participant's actions were compared to the procedure. Structured debriefs were conducted at the conclusion of both simulations. The procedure was evaluated for its ability to elicit consistent responses from each BME participant. Trials were examined for deviations in procedure task

Pediatric Drowning: A Standard Operating Procedure to Aid the Prehospital Management of Pediatric Cardiac Arrest Resulting From Submersion.

PubMed

Best, Rebecca R; Harris, Benjamin H L; Walsh, Jason L; Manfield, Timothy

2017-05-08

Drowning is one of the leading causes of death in children. Resuscitating a child following submersion is a high-pressure situation, and standard operating procedures can reduce error. Currently, the Resuscitation Council UK guidance does not include a standard operating procedure on pediatric drowning. The objective of this project was to design a standard operating procedure to improve outcomes of drowned children. A literature review on the management of pediatric drowning was conducted. Relevant publications were used to develop a standard operating procedure for management of pediatric drowning. A concise standard operating procedure was developed for resuscitation following pediatric submersion. Specific recommendations include the following: the Heimlich maneuver should not be used in this context; however, prolonged resuscitation and therapeutic hypothermia are recommended. This standard operating procedure is a potentially useful adjunct to the Resuscitation Council UK guidance and should be considered for incorporation into its next iteration.

Radiation exposure from fluoroscopy during orthopedic surgical procedures

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

Riley, S.A.

1989-11-01

The use of fluoroscopy has enabled orthopedic surgeons to become technically more proficient. In addition, these surgical procedures tend to have less associated patient morbidity by decreasing operative time and minimizing the area of the operative field. The trade-off, however, may be an increased risk of radiation exposure to the surgeon on an annual or lifetime basis. The current study was designed to determine the amount of radiation received by the primary surgeon and the first assistant during selected surgical procedures involving the use of fluoroscopy. Five body sites exposed to radiation were monitored for dosage. The results of thismore » study indicate that with appropriate usage, (1) radiation exposure from fluoroscopy is relatively low; (2) the surgeon's dominant hand receives the most exposure per case; and (3) proper maintenance and calibration of fluoroscopic machines are important factors in reducing exposure risks. Therefore, with proper precautions, the use of fluoroscopy in orthopedic procedures can remain a safe practice.« less

The European Stroke Organisation Guidelines: a standard operating procedure.

PubMed

Ntaios, George; Bornstein, Natan M; Caso, Valeria; Christensen, Hanne; De Keyser, Jacques; Diener, Hans-Christoph; Diez-Tejedor, Exuperio; Ferro, Jose M; Ford, Gary A; Grau, Armin; Keller, Emanuella; Leys, Didier; Russell, David; Toni, Danilo; Turc, Guillaume; Van der Worp, Bart; Wahlgren, Nils; Steiner, Thorsten

2015-10-01

In 2008, the recently founded European Stroke Organisation published its guidelines for the management of ischemic stroke and transient ischemic attack. This highly cited document was translated in several languages and was updated in 2009. Since then, the European Stroke Organisation has published guidelines for the management of intracranial aneurysms and subarachnoidal hemorrhage, for the establishment of stroke units and stroke centers, and recently for the management of intracerebral hemorrhage. In recent years, the methodology for the development of guidelines has evolved significantly. To keep pace with this progress and driven by the strong determination of the European Stroke Organisation to further promote stroke management, education, and research, the European Stroke Organisation decided to delineate a detailed standard operating procedure for its guidelines. There are two important cornerstones in this standard operating procedure: The first is the implementation of the Grading of Recommendations Assessment, Development, and Evaluation methodology for the development of its Guideline Documents. The second one is the decision of the European Stroke Organisation to move from the classical model of a single Guideline Document about a major topic (e.g. management of ischemic stroke) to focused modules (i.e. subdivisions of a major topic). This will enable the European Stroke Organisation to react faster when new developments in a specific stroke field occur and update its recommendations on the related module rather swiftly; with the previous approach of a single large Guideline Document, its entire revision had to be completed before an updated publication, delaying the production of up-to-date guidelines. After discussion within the European Stroke Organisation Guidelines Committee and significant input from European Stroke Organisation members as well as methodologists and analysts, this document presents the official standard operating procedure for

From Planetary Boundaries to national fair shares of the global safe operating space - How can the scales be bridged?

NASA Astrophysics Data System (ADS)

Häyhä, Tiina; Cornell, Sarah; Lucas, Paul; van Vuuren, Detlef; Hoff, Holger

2016-04-01

The planetary boundaries framework proposes precautionary quantitative global limits to the anthropogenic perturbation of crucial Earth system processes. In this way, it marks out a planetary 'safe operating space' for human activities. However, decisions regarding resource use and emissions are mostly made at much smaller scales, mostly by (sub-)national and regional governments, businesses, and other local actors. To operationalize the planetary boundaries, they need to be translated into and aligned with targets that are relevant at these smaller scales. In this paper, we develop a framework that addresses the three dimension of bridging across scales: biophysical, socio-economic and ethical, to provide a consistent universally applicable approach for translating the planetary boundaries into national level context-specific and fair shares of the safe operating space. We discuss our findings in the context of previous studies and their implications for future analyses and policymaking. In this way, we help link the planetary boundaries framework to widely- applied operational and policy concepts for more robust strong sustainability decision-making.

NHEXAS PHASE I ARIZONA STUDY--LIST OF STANDARD OPERATING PROCEDURES

EPA Science Inventory

This document lists available protocols and SOPs for the NHEXAS Phase I Arizona study. It identifies protocols and SOPs for the following study components: (1) Sample collection and field operations, (2) Sample analysis, (3) General laboratory procedures, (4) Quality Assurance, (...

Computer Based Procedures for Field Workers - FY16 Research Activities

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

Oxstrand, Johanna; Bly, Aaron

The Computer-Based Procedure (CBP) research effort is a part of the Light-Water Reactor Sustainability (LWRS) Program, which provides the technical foundations for licensing and managing the long-term, safe, and economical operation of current nuclear power plants. One of the primary missions of the LWRS program is to help the U.S. nuclear industry adopt new technologies and engineering solutions that facilitate the continued safe operation of the plants and extension of the current operating licenses. One area that could yield tremendous savings in increased efficiency and safety is in improving procedure use. A CBP provides the opportunity to incorporate context-driven jobmore » aids, such as drawings, photos, and just-in-time training. The presentation of information in CBPs can be much more flexible and tailored to the task, actual plant condition, and operation mode. The dynamic presentation of the procedure will guide the user down the path of relevant steps, thus minimizing time spent by the field worker to evaluate plant conditions and decisions related to the applicability of each step. This dynamic presentation of the procedure also minimizes the risk of conducting steps out of order and/or incorrectly assessed applicability of steps. This report provides a summary of the main research activities conducted in the Computer-Based Procedures for Field Workers effort since 2012. The main focus of the report is on the research activities conducted in fiscal year 2016. The activities discussed are the Nuclear Electronic Work Packages – Enterprise Requirements initiative, the development of a design guidance for CBPs (which compiles all insights gained through the years of CBP research), the facilitation of vendor studies at the Idaho National Laboratory (INL) Advanced Test Reactor (ATR), a pilot study for how to enhance the plant design modification work process, the collection of feedback from a field evaluation study at Plant Vogtle, and path forward to

Review of Issues Associated with Safe Operation and Management of the Space Shuttle Program

NASA Technical Reports Server (NTRS)

Johnstone, Paul M.; Blomberg, Richard D.; Gleghorn, George J.; Krone, Norris J.; Voltz, Richard A.; Dunn, Robert F.; Donlan, Charles J.; Kauderer, Bernard M.; Brill, Yvonne C.; Englar, Kenneth G.;

76 FR 17367 - National Voluntary Laboratory Accreditation Program; Operating Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-29

... DEPARTMENT OF COMMERCE National Institute of Standards and Technology 15 CFR Part 285 [Docket No: 110125063-1062-02] RIN 0693-AB61 National Voluntary Laboratory Accreditation Program; Operating Procedures AGENCY: National Institute of Standards and Technology (NIST), Commerce. ACTION: Notice of proposed...

9 CFR 354.210 - Minimum standards for sanitation, facilities, and operating procedures in official plants.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 9 Animals and Animal Products 2 2012-01-01 2012-01-01 false Minimum standards for sanitation, facilities, and operating procedures in official plants. 354.210 Section 354.210 Animals and Animal Products... sanitation, facilities, and operating procedures in official plants. The provisions of §§ 354.210 to 354.247...

9 CFR 354.210 - Minimum standards for sanitation, facilities, and operating procedures in official plants.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 9 Animals and Animal Products 2 2011-01-01 2011-01-01 false Minimum standards for sanitation, facilities, and operating procedures in official plants. 354.210 Section 354.210 Animals and Animal Products... sanitation, facilities, and operating procedures in official plants. The provisions of §§ 354.210 to 354.247...

9 CFR 354.210 - Minimum standards for sanitation, facilities, and operating procedures in official plants.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 9 Animals and Animal Products 2 2014-01-01 2014-01-01 false Minimum standards for sanitation, facilities, and operating procedures in official plants. 354.210 Section 354.210 Animals and Animal Products... sanitation, facilities, and operating procedures in official plants. The provisions of §§ 354.210 to 354.247...

9 CFR 354.210 - Minimum standards for sanitation, facilities, and operating procedures in official plants.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 9 Animals and Animal Products 2 2010-01-01 2010-01-01 false Minimum standards for sanitation, facilities, and operating procedures in official plants. 354.210 Section 354.210 Animals and Animal Products... sanitation, facilities, and operating procedures in official plants. The provisions of §§ 354.210 to 354.247...

9 CFR 354.210 - Minimum standards for sanitation, facilities, and operating procedures in official plants.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 9 Animals and Animal Products 2 2013-01-01 2013-01-01 false Minimum standards for sanitation, facilities, and operating procedures in official plants. 354.210 Section 354.210 Animals and Animal Products... sanitation, facilities, and operating procedures in official plants. The provisions of §§ 354.210 to 354.247...

12 CFR 234.5 - Changes to rules, procedures, or operations.

Code of Federal Regulations, 2013 CFR

2013-01-01

... risk-management techniques. (4) A designated financial market utility shall not implement a change to...) Participant eligibility or access criteria; (ii) Product eligibility; (iii) Risk management; (iv) Settlement..., procedures, or operations that could materially affect the nature or level of risks presented by the...

12 CFR 234.5 - Changes to rules, procedures, or operations.

Code of Federal Regulations, 2014 CFR

2014-01-01

... risk-management techniques. (4) A designated financial market utility shall not implement a change to...) Participant eligibility or access criteria; (ii) Product eligibility; (iii) Risk management; (iv) Settlement..., procedures, or operations that could materially affect the nature or level of risks presented by the...

Operational Improvements From the In-Trail Procedure in the North Atlantic Organized Track System

NASA Technical Reports Server (NTRS)

Chartrand, Ryan C.; Bussink, Frank J. L.; Graff, Thomas J.; Murdoch, Jennifer L.; Jones, Kenneth M.

2008-01-01

This paper explains the computerized batch processing experiment examining the operational impacts of the introduction of Automatic Dependent Surveillance-Broadcast (ADS-B) equipment and the In-Trail Procedure (ITP) to the North Atlantic Organized Track System (NATOTS). This experiment was conducted using the Traffic Manager (TMX), a desktop simulation capable of simulating airspace environments and aircraft operations. ADS-B equipment can enable the use of new ground and airborne procedures, such as the ITP. The ITP is among the first of these new procedures, which will make use of improved situation awareness in the local surrounding airspace of ADS-B equipped aircraft to enable more efficient oceanic flight level changes. The data collected were analyzed with respect to multiple operationally relevant parameters including fuel burn, request approval rates, and the distribution of fuel savings. This experiment showed that through the use of ADS-B or ADS-B and the ITP that operational improvements and benefits could be achieved.

Outcomes of PCI in Relation to Procedural Characteristics and Operator Volumes in the United States.

PubMed

Fanaroff, Alexander C; Zakroysky, Pearl; Dai, David; Wojdyla, Daniel; Sherwood, Matthew W; Roe, Matthew T; Wang, Tracy Y; Peterson, Eric D; Gurm, Hitinder S; Cohen, Mauricio G; Messenger, John C; Rao, Sunil V

2017-06-20

Professional guidelines have reduced the recommended minimum number to an average of 50 percutaneous coronary intervention (PCI) procedures performed annually by each operator. Operator volume patterns and associated outcomes since this change are unknown. The authors describe herein PCI operator procedure volumes; characteristics of low-, intermediate-, and high-volume operators; and the relationship between operator volume and clinical outcomes in a large, contemporary, nationwide sample. Using data from the National Cardiovascular Data Registry collected between July 1, 2009, and March 31, 2015, we examined operator annual PCI volume. We divided operators into low- (<50 PCIs per year), intermediate- (50 to 100 PCIs per year), and high- (>100 PCIs per year) volume groups, and determined the adjusted association between annual PCI volume and in-hospital outcomes, including mortality. The median annual number of procedures performed per operator was 59; 44% of operators performed <50 PCI procedures per year. Low-volume operators more frequently performed emergency and primary PCI procedures and practiced at hospitals with lower annual PCI volumes. Unadjusted in-hospital mortality was 1.86% for low-volume operators, 1.73% for intermediate-volume operators, and 1.48% for high-volume operators. The adjusted risk of in-hospital mortality was higher for PCI procedures performed by low- and intermediate-volume operators compared with those performed by high-volume operators (adjusted odds ratio: 1.16 for low versus high; adjusted odds ratio: 1.05 for intermediate vs. high volume) as was the risk for new dialysis post PCI. No volume relationship was observed for post-PCI bleeding. Many PCI operators in the United States are performing fewer than the recommended number of PCI procedures annually. Although absolute risk differences are small and may be partially explained by unmeasured differences in case mix between operators, there remains an inverse relationship

Evolution of the Hubble Space Telescope Safing Systems

NASA Technical Reports Server (NTRS)

Pepe, Joyce; Myslinski, Michael

2006-01-01

The Hubble Space Telescope (HST) was launched on April 24 1990, with an expected lifespan of 15 years. Central to the spacecraft design was the concept of a series of on-orbit shuttle servicing missions permitting astronauts to replace failed equipment, update the scientific instruments and keep the HST at the forefront of astronomical discoveries. One key to the success of the Hubble mission has been the robust Safing systems designed to monitor the performance of the observatory and to react to keep the spacecraft safe in the event of equipment anomaly. The spacecraft Safing System consists of a range of software tests in the primary flight computer that evaluate the performance of mission critical hardware, safe modes that are activated when the primary control mode is deemed inadequate for protecting the vehicle, and special actions that the computer can take to autonomously reconfigure critical hardware. The HST Safing System was structured to autonomously detect electrical power system, data management system, and pointing control system malfunctions and to configure the vehicle to ensure safe operation without ground intervention for up to 72 hours. There is also a dedicated safe mode computer that constantly monitors a keep-alive signal from the primary computer. If this signal stops, the safe mode computer shuts down the primary computer and takes over control of the vehicle, putting it into a safe, low-power configuration. The HST Safing system has continued to evolve as equipment has aged, as new hardware has been installed on the vehicle, and as the operation modes have matured during the mission. Along with the continual refinement of the limits used in the safing tests, several new tests have been added to the monitoring system, and new safe modes have been added to the flight software. This paper will focus on the evolution of the HST Safing System and Safing tests, and the importance of this evolution to prolonging the science operations of the

76 FR 54528 - Standard Operating Procedures (SOP) of the Aircraft Certification Service (AIR) Process for the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-01

...) of the Aircraft Certification Service (AIR) Process for the Sequencing of Certification and... on the Aircraft Certification Service (AIR) standard operating procedure (SOP) describing the process... comments on the SOP : AIR-100-001; Standard Operating Procedure--Aircraft Certification Service Project...

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CALIBRATION, MAINTENANCE AND OPERATION OF ELECTRONIC BALANCES (BCO-L-23.0)

EPA Science Inventory

The purpose of this SOP is to describe the general procedures to be followed for the operation, calibration and maintenance of electronic balances. This procedure was followed to ensure consistent data retrieval during the Arizona NHEXAS project and the "Border" study. Keywords: ...

Laparoscopic Whipple procedure: review of the literature.

PubMed

Gagner, Michel; Palermo, Mariano

2009-01-01

Laparoscopic pancreatic surgery represents one of the most advanced applications for laparoscopic surgery currently in use. In the past, minimally invasive techniques were only used for diagnostic laparoscopy, staging of pancreatic cancer, and palliative procedures for unresectable pancreatic cancer. With new advances in technology and instrumentation, some sophisticated procedures are currently available, such as the Whipple procedure, one of the most sophisticated applications of minimally invasive surgery. A review of the literature shows that 146 laparoscopic Whipple procedures have been published worldwide since 1994. The authors analyzed blood loss, mean operating time, hospital stay, conversion rate, mean age, mortality rate, lymph nodes in the pathologic findings, follow up, and complications. Mean age was 59.1 years; mean operating time was 439 min. The average blood loss for the reviewed literature was 143 mL; median hospital stay was 18 days; conversion rate was 46%; number of lymph nodes in the pathologic findings was 19; and mortalities related to the procedure was low, 2 patients (1.3%) and the complication rate was 16% (23/46 patients). Complications included 2 hemorrhages, 4 bowel obstructions, 1 stress ulcer, 1 delay of gastric emptying, 4 pneumonias, and 11 leaks. This review demonstrates that the laparoscopic Whipple procedure is not only feasible but also safe, with low mortality and acceptable rates of complications.

[MINIMALLY INVASIVE PROCEDURE FOR CORRECTION OF PECTUS CARINATUM].

PubMed

Xu, Bing; Liu, Wenying

2015-04-01

To explore the method and experience in correction of pectus carinatum with minimally invasive procedure. Between June 2010 and January 2014, 30 patients with pectus carinatum were corrected by minimally invasive procedure. There were 21 boys and 9 girls whose average age was 13 years and 2 months (range, from 8 years and 10 months to 18 years and 9 months), including 24 cases of first operation, 2 recurrence after traditional pectus carinatum correction, and 4 cases secondary to median thoracotomy. Thirty patients had symmetric and asymmetric mild pectus carinatum. The operation was performed successfully in all patients, and no severe complication occurred. The operation time was 42-95 minutes (mean, 70 minutes). The bleeding volume during operation was 4-30 mL (mean, 10 mL). The time from operation to discharge was 6-10 days (mean, 7 days). The average time of follow-up was 25 months (range, 9-54 months). All surgical wound healed primarily with no infection. The X-ray films showed slight pneumothorax in 7 cases, and it was absorbed after 1 month without treatment. Loosening of internal fixation was found in 1 patient because of trauma at 6 months, and operation was performed again. The bar was removed at 2 years in 21 patients. The patients had good thoracic contour and normal activity. Minimally invasive procedure for correction of pectus carinatum is safe and will get satisfactory effect in maintaining thoracic contour. It has also less trauma and shorter operation time.

Evaluation of Winter Operational Runway Friction Measurement Equipment, Procedures, and Research

NASA Technical Reports Server (NTRS)

1995-01-01

This document produced by the FAA/Industry Winter Runway Friction Measurement and Reporting Working Group, is designed to provide an overview of current information on the present guidance, practices, and procedures for reporting runway pavement surface conditions during winter operations at airports. It contains recommendations on the desirability of providing the best procedural consistency and standardization and discusses the available means to implement the guidance that will result in improved aviation safety at airports during hazardous winter conditions.

JJ Stent Removal under Ultrasound Guidance in Women: It is Simple and Safe.

PubMed

Amer, Bernard; Gupta, Sandeep; Kanwar, Vijayendra S; Lodh, Bijit; Khumukcham, Somarendra; Akoijam, Kaku Singh

2014-12-01

With the increase in number of patients treated for urological problems with endoscopic procedures, the number of patients with JJ stent is also increasing. The amount of workload thus incurred multiplies, even to the point that, sometimes we waste more time in the operating room removing JJ stents than the actual endourological procedures. Here in our institute, we have devised a very simple and effective way of removing JJ stents in women and also determined the efficacy, safety and cost of JJ stent removal under ultrasound guidance in women in comparison to cystoscopic removal. Two hundred women attending the Department of Urology from July 2012 to July 2013 at RIMS hospital were randomly divided into two arms. One hundred women had their JJ stent removed with cystoscope and another 100 women had their JJ stent removed under ultrasound guidance using simple surgical tools available at the hospital. The primary comparative points were waiting time for operating room appointment date, cost of the procedure, time taken for the procedure, discomfort or pain felt by the patient and urethral injuries. In all the parameters, stent removal under ultrasound guidance was significantly better except for urethral injuries where both the procedures had similar outcomes. We concluded that JJ stent removal under ultrasound guidance in women was simple, effective and safe.

Bootstrap-based procedures for inference in nonparametric receiver-operating characteristic curve regression analysis.

PubMed

Rodríguez-Álvarez, María Xosé; Roca-Pardiñas, Javier; Cadarso-Suárez, Carmen; Tahoces, Pablo G

2018-03-01

Prior to using a diagnostic test in a routine clinical setting, the rigorous evaluation of its diagnostic accuracy is essential. The receiver-operating characteristic curve is the measure of accuracy most widely used for continuous diagnostic tests. However, the possible impact of extra information about the patient (or even the environment) on diagnostic accuracy also needs to be assessed. In this paper, we focus on an estimator for the covariate-specific receiver-operating characteristic curve based on direct regression modelling and nonparametric smoothing techniques. This approach defines the class of generalised additive models for the receiver-operating characteristic curve. The main aim of the paper is to offer new inferential procedures for testing the effect of covariates on the conditional receiver-operating characteristic curve within the above-mentioned class. Specifically, two different bootstrap-based tests are suggested to check (a) the possible effect of continuous covariates on the receiver-operating characteristic curve and (b) the presence of factor-by-curve interaction terms. The validity of the proposed bootstrap-based procedures is supported by simulations. To facilitate the application of these new procedures in practice, an R-package, known as npROCRegression, is provided and briefly described. Finally, data derived from a computer-aided diagnostic system for the automatic detection of tumour masses in breast cancer is analysed.

Flywheel Rotor Safe-Life Technology

NASA Technical Reports Server (NTRS)

Ratner, J. K. H.; Chang, J. B.; Christopher, D. A.; McLallin, Kerry L. (Technical Monitor)

2002-01-01

Since the 1960s, research has been conducted into the use of flywheels as energy storage systems. The-proposed applications include energy storage for hybrid and electric automobiles, attitude control and energy storage for satellites, and uninterruptible power supplies for hospitals and computer centers. For many years, however, the use of flywheels for space applications was restricted by the total weight of a system employing a metal rotor. With recent technological advances in the manufacturing of composite materials, however, lightweight composite rotors have begun to be proposed for such applications. Flywheels with composite rotors provide much higher power and energy storage capabilities than conventional chemical batteries. However, the failure of a high speed flywheel rotor could be a catastrophic event. For this reason, flywheel rotors are classified by the NASA Fracture Control Requirements Standard as fracture critical parts. Currently, there is no industry standard to certify a composite rotor for safe and reliable operation forth( required lifetime of the flywheel. Technical problems hindering the development of this standard include composite manufacturing inconsistencies, insufficient nondestructive evaluation (NDE) techniques for detecting defects and/or impact damage, lack of standard material test methods for characterizing composite rotor design allowables, and no unified proof (over-spin) test for flight rotors. As part of a flywheel rotor safe-life certification pro-ram funded b the government, a review of the state of the art in composite rotors is in progress. The goal of the review is to provide a clear picture of composite flywheel rotor technologies. The literature review has concentrated on the following topics concerning composites and composite rotors: durability (fatigue) and damage tolerance (safe-life) analysis/test methods, in-service NDE and health monitoring techniques, spin test methods/ procedures, and containment options

The impact of intra-operative interruptions on surgeons' perceived workload: an observational study in elective general and orthopedic surgery.

PubMed

Weigl, Matthias; Antoniadis, Sophia; Chiapponi, Costanza; Bruns, Christiane; Sevdalis, Nick

2015-01-01

Surgeons' intra-operative workload is critical for effective and safe surgical performance. Detrimental conditions in the operating room (OR) environment may add to perceived workload and jeopardize surgical performance and outcomes. This study aims to evaluate the impact of different intra-operative workflow interruptions on surgeons' capacity to manage their workload safely and efficiently. This was an observational study of intra-operative interruptions and self-rated workload in two surgical specialties (general, orthopedic/trauma surgery). Intra-operative interruptions were assessed via expert observation using a well-validated observation tool. Surgeons, nurses, and anesthesiologists assessed their intra-operative workload directly after case completion based on three items of the validated Surgery Task Load Index (mental demand, situational stress, distraction). A total of 56 elective cases (35 open, 21 laparoscopic) with 94 workload ratings were included. Mean intra-operative duration was 1 h 37 min. Intra-operative interruptions were on average observed 9.78 times per hour. People who entered/exited the OR (30.6 %) as well as telephone-/beeper-related disruptions (23.6 %) occurred most often. Equipment and OR environment-related interruptions were associated with highest interference with team functioning particularly in laparoscopic procedures. After identifying task and procedural influences, partial correlational analyses revealed that case-irrelevant communications were negatively associated with surgeons' mental fatigue and situational stress, whereas surgeons' reported distraction was increased by case-irrelevant communication and procedural disruptions. OR nurses' and anesthesiologists' perceived workload was also related to intra-operative interruption events. Our study documents the unique contribution of different interruptions on surgeons' workload; whereas case-irrelevant communications may be beneficial for mental fatigue and stress in routine

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.

The importance of production standard operating procedure in a family business company

NASA Astrophysics Data System (ADS)

Hongdiyanto, C.

2017-12-01

Plastic industry is a growing sector, therefore UD X which engage in this business has a great potential to grow as well. The problem faced by this family business company is that no standard operating procedure is used and it lead to problem in the quality and quantity produced. This research is aim to create a production standard operating procedure for UD X. Semistructure interview is used to gather information from respondent to help writer create the SOP. There are four SOP’s created, namely: classifying SOP, sorting SOP, milling SOP and packing SOP. Having SOP will improve the effectiveness of production because employees already know how to work in each stages of production process.

Standard operating procedure changed pre-hospital critical care anaesthesiologists’ behaviour: a quality control study

PubMed Central

2013-01-01

Introduction The ability of standard operating procedures to improve pre-hospital critical care by changing pre-hospital physician behaviour is uncertain. We report data from a prospective quality control study of the effect on pre-hospital critical care anaesthesiologists’ behaviour of implementing a standard operating procedure for pre-hospital controlled ventilation. Materials and methods Anaesthesiologists from eight pre-hospital critical care teams in the Central Denmark Region prospectively registered pre-hospital advanced airway-management data according to the Utstein-style template. We collected pre-intervention data from February 1st 2011 to January 31st 2012, implemented the standard operating procedure on February 1st 2012 and collected post intervention data from February 1st 2012 until October 31st 2012. We included transported patients of all ages in need of controlled ventilation treated with pre-hospital endotracheal intubation or the insertion of a supraglottic airways device. The objective was to evaluate whether the development and implementation of a standard operating procedure for controlled ventilation during transport could change pre-hospital critical care anaesthesiologists’ behaviour and thereby increase the use of automated ventilators in these patients. Results The implementation of a standard operating procedure increased the overall prevalence of automated ventilator use in transported patients in need of controlled ventilation from 0.40 (0.34-0.47) to 0.74 (0.69-0.80) with a prevalence ratio of 1.85 (1.57-2.19) (p = 0.00). The prevalence of automated ventilator use in transported traumatic brain injury patients in need of controlled ventilation increased from 0.44 (0.26-0.62) to 0.85 (0.62-0.97) with a prevalence ratio of 1.94 (1.26-3.0) (p = 0.0039). The prevalence of automated ventilator use in patients transported after return of spontaneous circulation following pre-hospital cardiac arrest increased from 0.39 (0

Abstract Model of the SATS Concept of Operations: Initial Results and Recommendations

NASA Technical Reports Server (NTRS)

Dowek, Gilles; Munoz, Cesar; Carreno, Victor A.

2004-01-01

An abstract mathematical model of the concept of operations for the Small Aircraft Transportation System (SATS) is presented. The Concept of Operations consist of several procedures that describe nominal operations for SATS, Several safety properties of the system are proven using formal techniques. The final goal of the verification effort is to show that under nominal operations, aircraft are safely separated. The abstract model was written and formally verified in the Prototype Verification System (PVS).

Writing standard operating procedures (SOPs) for cryostorage protocols: using shoot meristem cryopreservation as an example.

PubMed

Harding, Keith; Benson, Erica E

2015-01-01

Standard operating procedures are a systematic way of making sure that biopreservation processes, tasks, protocols, and operations are correctly and consistently performed. They are the basic documents of biorepository quality management systems and are used in quality assurance, control, and improvement. Methodologies for constructing workflows and writing standard operating procedures and work instructions are described using a plant cryopreservation protocol as an example. This chapter is pertinent to other biopreservation sectors because how methods are written, interpreted, and implemented can affect the quality of storage outcomes.

Radiation dose of nurses during IR procedures: a controlled trial evaluating operator alerts before nursing tasks.

PubMed

Komemushi, Atsushi; Suzuki, Satoshi; Sano, Akira; Kanno, Shohei; Kariya, Shuji; Nakatani, Miyuki; Yoshida, Rie; Kono, Yumiko; Ikeda, Koshi; Utsunomiya, Keita; Harima, Yoko; Komemushi, Sadao; Tanigawa, Noboru

2014-08-01

To compare radiation exposure of nurses when performing nursing tasks associated with interventional procedures depending on whether or not the nurses called out to the operator before approaching the patient. In a prospective study, 93 interventional radiology procedures were randomly divided into a call group and a no-call group; there were 50 procedures in the call group and 43 procedures in the no-call group. Two monitoring badges were used to calculate effective dose of nurses. In the call group, the nurse first told the operator she was going to approach the patient each time she was about to do so. In the no-call group, the nurse did not say anything to the operator when she was about to approach the patient. In all the nursing tasks, the equivalent dose at the umbilical level inside the lead apron was below the detectable limit. The equivalent dose at the sternal level outside the lead apron was 0.16 μSv ± 0.41 per procedure in the call group and 0.51 μSv ± 1.17 per procedure in the no-call group. The effective dose was 0.018 μSv ± 0.04 per procedure in the call group and 0.056 μSv ± 0.129 per procedure in the no-call group. The call group had a significantly lower radiation dose (P = .034). Radiation doses of nurses were lower in the group in which the nurse called to the operator before she approached the patient. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

30 CFR 250.408 - May I use alternative procedures or equipment during drilling operations?

Code of Federal Regulations, 2010 CFR

2010-07-01

... during drilling operations? 250.408 Section 250.408 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations General Requirements § 250.408 May I use alternative procedures or equipment...

Resident involvement in laparoscopic procedures does not worsen clinical outcomes but may increase operative times and length of hospital stay.

PubMed

Jolley, Jennifer; Lomelin, Daniel; Simorov, Anton; Tadaki, Carl; Oleynikov, Dmitry

2016-09-01

Surgical procedures have a learning curve regarding the number of cases required for proficiency. Consequently, involvement of less experienced resident surgeons may impact patients and the healthcare system. This study examines basic and advanced laparoscopic procedures performed between 2010 and 2011 and evaluates the resident surgeon participation effect. Basic laparoscopic procedures (BL), appendectomy (LA), cholecystectomy (LC), and advanced Nissen fundoplication (LN) were queried from the American College of Surgeons National Surgical Quality Improvement Program database. Cases were identified using Current Procedural Terminology codes. Analyses were performed using IBM SPSS Statistics v.22, α-level = 0.05. Multiple logistic regression was used, accounting for age, race, gender, admission status, wound classification, and ASA classification. In total, 71,819 surgeries were reviewed, 66,327 BL (37,636 LC and 28,691 LA) and 5492 LN. Median age was 48 years for LC and 37 years for LA. In sum, 72.2 % of LC and 49.5 % of LA patients were female. LN median age was 59 years, and 67.7 % of patients were female. For BL, resident involvement was not significantly associated with mortality, morbidity, and return to the OR. Readmission was not related to resident involvement in LC. In LA, resident-involved surgeries had increased readmission and longer OR time, but decreased LOS. In LC, resident involvement was associated with longer LOS and OR time. Resident involvement was not a significant factor in the odds of mortality, morbidity, return to OR, or readmission in LN. Surgeries involving residents had increased odds of having longer LOS, and of lengthier surgery time. We demonstrate resident involvement is safe and does not result in poorer patient outcomes. Readmissions and LOS were higher in BL, and operative times were longer in all surgeries. Resident operations do appear to have real consequences for patients and may impact the healthcare system

Development of use of an Operational Procedure Information System (OPIS) for future space missions

NASA Technical Reports Server (NTRS)

Illmer, N.; Mies, L.; Schoen, A.; Jain, A.

1994-01-01

A MS-Windows based electronic procedure system, called OPIS (Operational Procedure Information System), was developed. The system consists of two parts, the editor, for 'writing' the procedure and the notepad application, for the usage of the procedures by the crew during training and flight. The system is based on standardized, structured procedure format and language. It allows the embedding of sketches, photos, animated graphics and video sequences and the access to off-nominal procedures by linkage to an appropriate database. The system facilitates the work with procedures of different degrees of detail, depending on the training status of the crew. The development of a 'language module' for the automatic translation of the procedures, for example into Russian, is planned.

Retroperitoneal endoscopic adrenalectomy is safe and effective.

PubMed

Schreinemakers, J M J; Kiela, G J; Valk, G D; Vriens, M R; Rinkes, I H M Borel

2010-11-01

The aim of this study was to review an experience with retroperitoneal endoscopic adrenalectomy (REA). This is the procedure of choice for adrenal tumours at this institution. Between 1997 and 2008, 112 REAs were performed in a single university centre. Data were retrieved retrospectively from a prospectively collected database, including information on patient demographics, surgical procedure, complications and hospital stay. One hundred and twelve REAs were carried out successfully in 105 patients, including seven bilateral adrenalectomies. Thirty-nine patients with unilateral adrenal disease had a phaeochromocytoma, of whom 16 had multiple endocrine neoplasia syndrome type 2, 21 patients had Cushing's disease and 20 had Conn's disease. Median body mass index was 27 (interquartile range 23-29) kg/m(2). The median duration of unilateral operations was 100 (90-130) min with a median blood loss of 5 ml. Median tumour size was 3.1 (2.0-4.4) cm. Conversion from REA to open surgery was needed in two patients. Seven patients experienced postoperative complications (2 major, 5 minor). One patient needed a reoperation. The median postoperative hospital stay was 3 days. A learning curve with a significant decrease in operating time was observed over the years. REA appears to be a safe and effective surgical technique for adrenal gland tumours up to 6 cm in diameter, with a minimal complication rate. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

Redo Laparoscopic Gastric Bypass: One-Step or Two-Step Procedure?

PubMed

Theunissen, Caroline M J; Guelinckx, Nele; Maring, John K; Langenhoff, Barbara S

2016-11-01

The adjustable gastric band (AGB) is a bariatric procedure that used to be widely performed. However, AGB failure-signifying band-related complications or unsatisfactory weight loss, resulting in revision surgery (redo operations)-frequently occurs. Often this entails a conversion to a laparoscopic Roux-en-Y gastric bypass (LRYGB). This can be performed as a one-step or two-step (separate band removal) procedure. Data were collected from patients operated from 2012 to 2014 in a single bariatric centre. We compared 107 redo LRYGB after AGB failure with 1020 primary LRYGB. An analysis was performed of the one-step vs. two-step redo procedures. All redo procedures were performed by experienced bariatric surgeons. No difference in major complication rate was seen (2.8 vs. 2.3 %, p = 0.73) between redo and primary LRYGB, and overall complication severity for redos was low (mainly Clavien-Dindo 1 or 2). Weight loss results were comparable for primary and redo procedures. The one-step and two-step redos were comparable regarding complication rates and readmissions. The operating time for the one-step redo LRYGB was 136 vs. 107.5 min for the two-step (median, p < 0.001), excluding the operating time of separate AGB removal (mean 61 min, range 36-110). Removal of a failed AGB and LRYGB in a one-step procedure is safe when performed by experienced bariatric surgeons. However, when erosion or perforation of the AGB occurs, we advise caution and would perform the redo LRYGB as a two-step procedure. Equal weights can be achieved at 1 year post redo LRYGB as after primary LRYGB procedures.

Outpatient radioiodine therapy for thyroid cancer: a safe nuclear medicine procedure.

PubMed

Willegaignon, José; Sapienza, Marcelo; Ono, Carla; Watanabe, Tomoco; Guimarães, Maria Inês; Gutterres, Ricardo; Marechal, Maria Helena; Buchpiguel, Carlos

2011-06-01

To evaluate the dosimetric effect of outpatient radioiodine therapy for thyroid cancer in members of a patient's family and their living environment, when using iodine-131 doses reaching 7.4 GBq. The following parameters were thus defined: (a) whole-body radiation doses to caregivers, (b) the production of contaminated solid waste, and (c) radiation potential and surface contamination within patients' living quarters. In total, 100 patients were treated on an outpatient basis, taking into consideration their acceptable living conditions, interests, and willingness to comply with medical and radiation safety guidelines. Both the caregivers and the radiation dose potentiality inside patients' residences were monitored by using thermoluminescent dosimeters. Surface contamination and contaminated solid wastes were identified and measured with a Geiger-Müller detector. A total of 90 monitored individuals received a mean dose of 0.27 (±0.28) mSv, and the maximum dose registered was 1.6 mSv. The mean value for the potential dose within all living quarters was 0.31 (±0.34) mSv, and the mean value per monitored surface was 5.58 Bq/cm(2) for all the 1659 points measured. The overall production of contaminated solid wastes was at a low level, being about 3 times less than the exemption level indicated by the International Atomic Energy Agency. This study indicates that the treatment of thyroid cancer by applying radioiodine activities up to 7.4 GBq, on an outpatient basis, is a safe procedure, especially when supervised by qualified professionals. This alternative therapy should be a topic for careful discussion considering the high potential for reducing costs in healthcare and improving patient acceptance.

After-hour Versus Daytime Shifts in Non-Operating Room Anesthesia Environments: National Distribution of Case Volume, Patient Characteristics, and Procedures.

PubMed

Gabriel, Rodney A; Burton, Brittany N; Tsai, Mitchell H; Ehrenfeld, Jesse M; Dutton, Richard P; Urman, Richard D

2017-09-01

The objective of this study was to characterize workload during all hours of the day in the non-operating room anesthesia (NORA) environment and identify what type of patients and procedures were more likely to occur during after-hours. By investigating data from the National Anesthesia Clinical Outcomes Registry, we characterized the total number of ongoing NORA cases per hour of the day (0 - 23 h). Results were presented as the mean hour and standard error (SE). Multivariable logistic regression was applied to assess the association of various patient, procedural, and facility characteristics with time of day (after-hours = 17:01-06:59 local time versus day-time). Included in this analysis, there were a total of 4,948,634 cases performed on non-holiday weekdays. The mean hour for ongoing cases for gastroenterology, cardiac, radiology and "other" were: 10.8 with standard error (SE) of 0.002, 11.5 (SE of 0.005), 11.2 (SE of 0.005), and 10.8 (SE of 0.002), respectively. Pairwise differences between means for each NORA specialty were all statistically significant (p < 0.0001). During after-hour shifts (4.3% of cases), patients with higher American Society of Anesthesiologists physical status classification scores had increased odds for undergoing a NORA procedure, while procedures that were more physiologically complex had decreased odds. With the increasing demand for NORA services, it is prudent that we fully understand the challenges of providing safe and efficient anesthetic services particularly in locations where fewer resources are available.

Laparoscopic retroperitoneal lymph-node dissection with the waterjet is technically feasible and safe in testis-cancer patient.

PubMed

Corvin, Stefan; Sturm, Wolfgang; Schlatter, Evelin; Anastasiadis, Aristotelis; Kuczyk, Markus; Stenzl, Arnulf

2005-09-01

The acceptance of open retroperitoneal lymph node dissection (RPLND) for stage I and II nonseminomatous testicular cancer has decreased because of the intraoperative and postoperative morbidity of the procedure. Laparoscopic RPLND is a minimally invasive and safe alternative for low-stage germ-cell tumors. It is, however, technically demanding and should therefore be performed only in experienced centers. The purpose of the present study was to evaluate the waterjet technique for laparoscopic RPLND. A series of 18 patients with clinical stage I testis cancer (group A) and 7 patients who had received chemotherapy for stage II disease (group B) underwent laparoscopic RPLND at our institution. The procedure was performed identically to the open approach using the modified template according to Weissbach and associates. The waterjet was used for removal of lymphatic tissue from the aorta and the vena cava, as well as from the sympathetic trunk. The operation was completed in all patients without conversion to open surgery. The mean operating time was 232 +/- 48 minutes. The waterjet was able to remove lymphatic tissue easily and atraumatically. At pressures of 20 bar, the lymph-node capsule remained completely intact, thus avoiding tumor-cell spread. Antegrade ejaculation could be preserved in all patients, who, to date, show no evidence of disease. The waterjet allows the safe and complete removal of lymphatic tissue, leaving vulnerable anatomic structures intact. It can decrease the learning curve of laparoscopic RPLND and contribute to better acceptance of this procedure.

Operational Improvements From Using the In-Trail Procedure in the North Atlantic Organized Track System

NASA Technical Reports Server (NTRS)

Chartrand, Ryan C.; Bussink, Frank J.; Graff, Thomas J.; Jones, Kenneth M.

2009-01-01

This paper explains the computerized batch processing experiment examining the operational impacts of the introduction of Automatic Dependent Surveillance-Broadcast (ADS-B) equipment and the In-Trail Procedure (ITP) to the North Atlantic Organized Track System. This experiment was conducted using the Traffic Manager (TMX), a desktop simulation capable of simulating airspace environments and aircraft operations. ADS-B equipment can enable the use of new ground and airborne procedures, such as the ITP. ITP is among the first of these new procedures, which will make use of improved situation awareness in the local surrounding airspace of ADS-B equipped aircraft to enable more efficient oceanic flight level changes. The collected data were analyzed with respect to multiple operationally relevant parameters including fuel burn, request approval rates, and the distribution of fuel savings. This experiment showed that through the use of ADS-B or ADS-B and the ITP that operational improvements and benefits could be achieved.

Task-shifting of orthopaedic surgery to non-physician clinicians in Malawi: effective and safe?

PubMed

Wilhelm, Torsten J; Dzimbiri, Kondwani; Sembereka, Victoria; Gumeni, Martin; Bach, Olaf; Mothes, Henning

2017-10-01

There is a shortage of orthopaedic surgeons in Malawi. Orthopaedic clinical officers (OCOs) treat trauma patients and occasionally perform major orthopaedic surgery. No studies have assessed the efficacy and safety of their work. The aim of this study was to evaluate their contribution to major orthopaedic surgery at Zomba Central Hospital. Data about orthopaedic procedures during 2006-2010 were collected from theatre books. We selected major amputations and open reductions and plating for outcome analysis and collected details from files. We compared patients operated by OCOs alone ('OCOs alone' group) and by surgeons or OCOs assisted by surgeons ('Surgeon present' group). OCOs performed 463/1010 major (45.8%) and 1600/1765 minor operations (90.7%) alone. There was no difference in perioperative outcome between both groups. OCOs carry out a large proportion of orthopaedic procedures with good clinical results. Shifting of clinical tasks including major orthopaedic surgery can be safe. Further prospective studies are recommended.

Generalized peritonitis due to perforated diverticulitis: Hartmann's procedure or primary anastomosis?

PubMed

Trenti, Loris; Biondo, Sebastiano; Golda, Thomas; Monica, Millan; Kreisler, Esther; Fraccalvieri, Domenico; Frago, Ricardo; Jaurrieta, Eduardo

2011-03-01

Hartmann's procedure (HP) still remains the most frequently performed procedure for diffuse peritonitis due to perforated diverticulitis. The aims of this study were to assess the feasibility and safety of resection with primary anastomosis (RPA) in patients with purulent or fecal diverticular peritonitis and review morbidity and mortality after single stage procedure and Hartmann in our experience. From January 1995 through December 2008, patients operated for generalized diverticular peritonitis were studied. Patients were classified into two main groups: RPA and HP. A total of 87 patients underwent emergency surgery for diverticulitis complicated with purulent or diffuse fecal peritonitis. Sixty (69%) had undergone HP while RPA was performed in 27 patients (31%). At the multivariate analysis, RPA was associated with less post-operative complications (P < 0.05). Three out of the 27 patients with RPA (11.1%) developed a clinical anastomotic leakage and needed re-operation. RPA can be safely performed without adding morbidity and mortality in cases of diffuse diverticular peritonitis. HP should be reserved only for hemodynamically unstable or high-risk patients. Specialization in colorectal surgery improves mortality and raises the percentage of one-stage procedures.

30 CFR 250.408 - May I use alternative procedures or equipment during drilling operations?

Code of Federal Regulations, 2013 CFR

2013-07-01

... during drilling operations? 250.408 Section 250.408 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations General Requirements § 250.408 May I use alternative procedures or...

30 CFR 250.408 - May I use alternative procedures or equipment during drilling operations?

Code of Federal Regulations, 2014 CFR

2014-07-01

... during drilling operations? 250.408 Section 250.408 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations General Requirements § 250.408 May I use alternative procedures or...

30 CFR 250.408 - May I use alternative procedures or equipment during drilling operations?

Code of Federal Regulations, 2012 CFR

2012-07-01

... during drilling operations? 250.408 Section 250.408 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Drilling Operations General Requirements § 250.408 May I use alternative procedures or...

Test Operations Procedure (TOP) 10-2-400 Open End Compressed Gas Driven Shock Tube

DTIC Science & Technology

gas-driven shock tube. Procedures are provided for instrumentation, test item positioning, estimation of key test parameters, operation of the shock...tube, data collection, and reporting. The procedures in this document are based on the use of helium gas and Mylar film diaphragms.

Nanomaterial Dispersion/Dissolution Characterization: Scientific Operating Procedure SOP-F-1

DTIC Science & Technology

2016-05-01

ER D C/ EL S R- 16 -1 Environmental Consequences of Nanotechnologies Nanomaterial Dispersion/Dissolution Characterization Scientific...Nanotechnologies ERDC/EL SR-16-1 May 2016 Nanomaterial Dispersion/Dissolution Characterization Scientific Operating Procedure SOP-F-1 Lesley Miller...diagnostic application. While microscopy represents the only available method for measuring particle size, this is very labor intensive and prone to

EDRN Standard Operating Procedures (SOP) — EDRN Public Portal

Cancer.gov

The NCI’s Early Detection Research Network is developing a number of standard operating procedures for assays, methods, and protocols for collection and processing of biological samples, and other reference materials to assist investigators to conduct experiments in a consistent, reliable manner. These SOPs are established by the investigators of the Early Detection Research Network to maintain constancy throughout the Network. These SOPs represent neither a consensus, nor are the recommendations of NCI.

Safety Precautions and Operating Procedures in an (A)BSL-4 Laboratory: 2. General Practices.

PubMed

Mazur, Steven; Holbrook, Michael R; Burdette, Tracey; Joselyn, Nicole; Barr, Jason; Pusl, Daniela; Bollinger, Laura; Coe, Linda; Jahrling, Peter B; Lackemeyer, Matthew G; Wada, Jiro; Kuhn, Jens H; Janosko, Krisztina

2016-10-03

Work in a biosafety level 4 (BSL-4) containment laboratory requires time and great attention to detail. The same work that is done in a BSL-2 laboratory with non-high-consequence pathogens will take significantly longer in a BSL-4 setting. This increased time requirement is due to a multitude of factors that are aimed at protecting the researcher from laboratory-acquired infections, the work environment from potential contamination and the local community from possible release of high-consequence pathogens. Inside the laboratory, movement is restricted due to air hoses attached to the mandatory full-body safety suits. In addition, disinfection of every item that is removed from Class II biosafety cabinets (BSCs) is required. Laboratory specialists must be trained in the practices of the BSL-4 laboratory and must show high proficiency in the skills they are performing. The focus of this article is to outline proper procedures and techniques to ensure laboratory biosafety and experimental accuracy using a standard viral plaque assay as an example procedure. In particular, proper techniques to work safely in a BSL-4 environment when performing an experiment will be visually emphasized. These techniques include: setting up a Class II BSC for experiments, proper cleaning of the Class II BSC when finished working, waste management and safe disposal of waste generated inside a BSL-4 laboratory, and the removal of inactivated samples from inside a BSL-4 laboratory to the BSL-2 laboratory.

Evolution of the Whipple procedure at the Massachusetts General Hospital.

PubMed

Fernández-del Castillo, Carlos; Morales-Oyarvide, Vicente; McGrath, Deborah; Wargo, Jennifer A; Ferrone, Cristina R; Thayer, Sarah P; Lillemoe, Keith D; Warshaw, Andrew L

2012-09-01

Since Allen O. Whipple published his seminal paper in 1935, the procedure that bears his name has been performed widely throughout the world and is now a common operation in major medical centers. The goal of this study was to investigate the evolution of pancreatoduodenectomy at the Massachusetts General Hospital (MGH). We sought to identify all pancreatoduodenectomies performed at the MGH since 1935. Cases were obtained from a computerized database, hospital medical records, and the MGH historical archive. Demographics, diagnosis, intraoperative variables and short-term surgical outcomes were recorded. The first pancreatoduodenectomy at the MGH was carried out in 1941; since then, 2,050 Whipple procedures have been performed. Pancreatic ductal adenocarcinoma was the most frequent indication (36%). Pylorus preservation has been the most important variation in technique, accounting for 45% of Whipple procedures in the 1980s; observation of frequent delayed gastric emptying after this procedure led to decline in its use. Pancreatic fistula was the most frequent complication (13%). Operative blood replacement and reoperation rates have decreased markedly over time; the most frequent indication for reoperation was intra-abdominal bleeding. Mortality has decreased from 45% to 0.8%, with sepsis and hypovolemic shock being the most frequent causes of death. Mean duration of hospital stay has decreased from >30 to 9.5 days, along with an increasing readmission rate (currently 19%). The Whipple procedure in the 21st century is a well-established operation. Improvements in operative technique and perioperative care have contributed in making it a safe operation that continues evolving. Copyright © 2012 Mosby, Inc. All rights reserved.

Microelectromechanical safe arm device

DOEpatents

Roesler, Alexander W [Tijeras, NM

2012-06-05

Microelectromechanical (MEM) apparatus and methods for operating, for preventing unintentional detonation of energetic components comprising pyrotechnic and explosive materials, such as air bag deployment systems, munitions and pyrotechnics. The MEM apparatus comprises an interrupting member that can be moved to block (interrupt) or complete (uninterrupt) an explosive train that is part of an energetic component. One or more latching members are provided that engage and prevent the movement of the interrupting member, until the one or more latching members are disengaged from the interrupting member. The MEM apparatus can be utilized as a safe and arm device (SAD) and electronic safe and arm device (ESAD) in preventing unintentional detonations. Methods for operating the MEM apparatus include independently applying drive signals to the actuators coupled to the latching members, and an actuator coupled to the interrupting member.

A Guide for Developing Standard Operating Job Procedures for the Pump Station Process Wastewater Treatment Facility. SOJP No. 3.

ERIC Educational Resources Information Center

Perley, Gordon F.

This is a guide for standard operating job procedures for the pump station process of wastewater treatment plants. Step-by-step instructions are given for pre-start up inspection, start-up procedures, continuous routine operation procedures, and shut-down procedures. A general description of the equipment used in the process is given. Two…

Curiosity's Autonomous Surface Safing Behavior Design

NASA Technical Reports Server (NTRS)

Neilson, Tracy A.; Manning, Robert M.

2013-01-01

The safing routines on all robotic deep-space vehicles are designed to put the vehicle in a power and thermally safe configuration, enabling communication with the mission operators on Earth. Achieving this goal is made a little more difficult on Curiosity because the power requirements for the core avionics and the telecommunication equipment exceed the capability of the single power source, the Multi-Mission Radioisotope Thermoelectric Generator. This drove the system design to create an operational mode, called "sleep mode", where the vehicle turns off most of the loads in order to charge the two Li-ion batteries. The system must keep the vehicle safe from over-heat and under-heat conditions, battery cell failures, under-voltage conditions, and clock failures, both while the computer is running and while the system is sleeping. The other goal of a safing routine is to communicate. On most spacecraft, this simply involves turning on the receiver and transmitter continuously. For Curiosity, Earth is above the horizon only a part of the day for direct communication to the Earth, and the orbiter overpass opportunities only occur a few times a day. The design must robustly place the Rover in a communicable condition at the correct time. This paper discusses Curiosity's autonomous safing behavior and describes how the vehicle remains power and thermally safe while sleeping, as well as a description of how the Rover communicates with the orbiters and Earth at specific times.

Percutaneous tracheostomy in patients with cervical spine fractures--feasible and safe.

PubMed

Ben Nun, Alon; Orlovsky, Michael; Best, Lael Anson

2006-08-01

The aim of this study is to evaluate the short and long-term results of percutaneous tracheostomy in patients with documented cervical spine fracture. Between June 2000 and September 2005, 38 consecutive percutaneous tracheostomy procedures were performed on multi-trauma patients with cervical spine fracture. Modified Griggs technique was employed at the bedside in the general intensive care department. Staff thoracic surgeons and anesthesiologists performed all procedures. Demographics, anatomical conditions, presence of co-morbidities and complication rates were recorded. The average operative time was 10 min (6-15). Two patients had minor complications. One patients had minor bleeding (50 cc) and one had mild cellulitis. Nine patients had severe paraparesis or paraplegia prior to the PCT procedure and 29 were without neurological damage. There was no PCT related neurological deterioration. Twenty-eight patients were discharged from the hospital, 21 were decannulated. The average follow-up period was 18 months (1-48). There was no delayed, procedure related, complication. These results demonstrate that percutaneous tracheostomy is feasible and safe in patients with cervical spine fracture with minimal short and long-term morbidity. We believe that percutaneous tracheostomy is the procedure of choice for patients with cervical spine fracture who need prolonged ventilatory support.

Allowing variance may enlarge the safe operating space for exploited ecosystems.

PubMed

Carpenter, Stephen R; Brock, William A; Folke, Carl; van Nes, Egbert H; Scheffer, Marten

2015-11-17

Variable flows of food, water, or other ecosystem services complicate planning. Management strategies that decrease variability and increase predictability may therefore be preferred. However, actions to decrease variance over short timescales (2-4 y), when applied continuously, may lead to long-term ecosystem changes with adverse consequences. We investigated the effects of managing short-term variance in three well-understood models of ecosystem services: lake eutrophication, harvest of a wild population, and yield of domestic herbivores on a rangeland. In all cases, actions to decrease variance can increase the risk of crossing critical ecosystem thresholds, resulting in less desirable ecosystem states. Managing to decrease short-term variance creates ecosystem fragility by changing the boundaries of safe operating spaces, suppressing information needed for adaptive management, cancelling signals of declining resilience, and removing pressures that may build tolerance of stress. Thus, the management of variance interacts strongly and inseparably with the management of resilience. By allowing for variation, learning, and flexibility while observing change, managers can detect opportunities and problems as they develop while sustaining the capacity to deal with them.

Allowing variance may enlarge the safe operating space for exploited ecosystems

PubMed Central

Carpenter, Stephen R.; Brock, William A.; Folke, Carl; van Nes, Egbert H.; Scheffer, Marten

2015-01-01

Variable flows of food, water, or other ecosystem services complicate planning. Management strategies that decrease variability and increase predictability may therefore be preferred. However, actions to decrease variance over short timescales (2–4 y), when applied continuously, may lead to long-term ecosystem changes with adverse consequences. We investigated the effects of managing short-term variance in three well-understood models of ecosystem services: lake eutrophication, harvest of a wild population, and yield of domestic herbivores on a rangeland. In all cases, actions to decrease variance can increase the risk of crossing critical ecosystem thresholds, resulting in less desirable ecosystem states. Managing to decrease short-term variance creates ecosystem fragility by changing the boundaries of safe operating spaces, suppressing information needed for adaptive management, cancelling signals of declining resilience, and removing pressures that may build tolerance of stress. Thus, the management of variance interacts strongly and inseparably with the management of resilience. By allowing for variation, learning, and flexibility while observing change, managers can detect opportunities and problems as they develop while sustaining the capacity to deal with them. PMID:26438857

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

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

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

2015-02-01

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

TVT-Exact and midurethral sling (SLING-IUFT) operative procedures: a randomized study.

PubMed

Aniuliene, Rosita; Aniulis, Povilas; Skaudickas, Darijus

2015-01-01

The aim of the study is to compare results, effectiveness and complications of TVT exact and midurethral sling (SLING-IUFT) operations in the treatment of female stress urinary incontinence (SUI). A single center nonblind, randomized study of women with SUI who were randomized to TVT-Exact and SLING-IUFT was performed by one surgeon from April 2009 to April 2011. SUI was diagnosed on coughing and Valsalva test and urodynamics (cystometry and uroflowmetry) were assessed before operation and 1 year after surgery. This was a prospective randomized study. The follow up period was 12 months. 76 patients were operated using the TVT-Exact operation and 78 patients - using the SLING-IUFT operation. There was no statistically significant differences between groups for BMI, parity, menopausal status and prolapsed stage (no patients had cystocele greater than stage II). Mean operative time was significantly shorter in the SLING-IUFT group (19 ± 5.6 min.) compared with the TVT-Exact group (27 ± 7.1 min.). There were statistically significant differences in the effectiveness of both procedures: TVT-Exact - at 94.5% and SLING-IUFT - at 61.2% after one year. Hospital stay was statistically significantly shorter in the SLING-IUFT group (1. 2 ± 0.5 days) compared with the TVT-Exact group (3.5 ± 1.5 days). Statistically significantly fewer complications occurred in the SLING-IUFT group. the TVT-Exact and SLING-IUFT operations are both effective for surgical treatment of female stress urinary incontinence. The SLING-IUFT involved a shorter operation time and lower complications rate., the TVT-Exact procedure had statistically significantly more complications than the SLING-IUFT operation, but a higher effectiveness.

Compliant Task Execution and Learning for Safe Mixed-Initiative Human-Robot Operations

NASA Technical Reports Server (NTRS)

Dong, Shuonan; Conrad, Patrick R.; Shah, Julie A.; Williams, Brian C.; Mittman, David S.; Ingham, Michel D.; Verma, Vandana

2011-01-01

We introduce a novel task execution capability that enhances the ability of in-situ crew members to function independently from Earth by enabling safe and efficient interaction with automated systems. This task execution capability provides the ability to (1) map goal-directed commands from humans into safe, compliant, automated actions, (2) quickly and safely respond to human commands and actions during task execution, and (3) specify complex motions through teaching by demonstration. Our results are applicable to future surface robotic systems, and we have demonstrated these capabilities on JPL's All-Terrain Hex-Limbed Extra-Terrestrial Explorer (ATHLETE) robot.

EMS providers' perceptions of safety climate and adherence to safe work practices.

PubMed

Eliseo, Laura J; Murray, Kate A; White, Laura F; Dyer, Sophia; Mitchell, Patricia A; Fernandez, William G

2012-01-01

Occupational injuries are an important source of morbidity for emergency medical services (EMS) providers. Previous work has shown that employee perceptions of an organization's commitment to safety (i.e., safety climate) correlate with adherence to safe practices. To assess the association between perceived safety climate and compliance with safety procedures in an urban EMS system with >100,000 calls/year. EMS providers were issued a self-administered survey that included questions on demographics, years of experience, perceived safety climate, and adherence to safety procedures. Safety climate was assessed with a 20-item validated instrument. Adherence to safety procedures was assessed with a nine-item list of safety behaviors. Strict adherence to safety procedures was defined as endorsing "agree" or "strongly agree" on 80% of items. The effect of safety climate on compliance with safe practices was estimated using multiple logistic regression. One hundred ninety-six of 221 providers (89%) completed surveys; 74% were male; the median age was 36-40 years; and the median amount of experience was 8 years. One hundred twenty-seven of 196 respondents (65%) reported strict adherence to safe work practice. Factor analysis confirmed the original six-factor grouping of questions; frequent safety-related feedback/training was significantly associated with safe practices (odds ratio [OR] = 2.14, 95% confidence interval [CI] = 1.01-4.51). EMS workers perceiving a high degree of perceived safety climate was associated with twofold greater odds of self-reported level of strict adherence to safe work practices. Frequent safety-related feedback/training was the one dimension of safety climate that had the strongest association with adherence to safe workplace behaviors.

Safety Precautions and Operating Procedures in an (A)BSL-4 Laboratory: 4. Medical Imaging Procedures.

PubMed

Byrum, Russell; Keith, Lauren; Bartos, Christopher; St Claire, Marisa; Lackemeyer, Matthew G; Holbrook, Michael R; Janosko, Krisztina; Barr, Jason; Pusl, Daniela; Bollinger, Laura; Wada, Jiro; Coe, Linda; Hensley, Lisa E; Jahrling, Peter B; Kuhn, Jens H; Lentz, Margaret R

2016-10-03

Medical imaging using animal models for human diseases has been utilized for decades; however, until recently, medical imaging of diseases induced by high-consequence pathogens has not been possible. In 2014, the National Institutes of Health, National Institute of Allergy and Infectious Diseases, Integrated Research Facility at Fort Detrick opened an Animal Biosafety Level 4 (ABSL-4) facility to assess the clinical course and pathology of infectious diseases in experimentally infected animals. Multiple imaging modalities including computed tomography (CT), magnetic resonance imaging, positron emission tomography, and single photon emission computed tomography are available to researchers for these evaluations. The focus of this article is to describe the workflow for safely obtaining a CT image of a live guinea pig in an ABSL-4 facility. These procedures include animal handling, anesthesia, and preparing and monitoring the animal until recovery from sedation. We will also discuss preparing the imaging equipment, performing quality checks, communication methods from "hot side" (containing pathogens) to "cold side," and moving the animal from the holding room to the imaging suite.

Safely Enabling Low-Altitude Airspace Operations

NASA Technical Reports Server (NTRS)

Kopardekar, Parimal

2015-01-01

Near-term Goal: Enable initial low-altitude airspace and UAS operations with demonstrated safety as early as possible, within 5 years. Long-term Goal: Accommodate increased UAS operations with highest safety, efficiency, and capacity as much autonomously as possible (10-15 years).

The National Aeronautics and Space Administration Nondestructive Evaluation Program for Safe and Reliable Operations

NASA Technical Reports Server (NTRS)

Generazio, Ed

2005-01-01

The National Aeronautics and Space Administration (NASA) Nondestructive Evaluation (NDE) Program is presented. As a result of the loss of seven astronauts and the Space Shuttle Columbia on February 1, 2003, NASA has undergone many changes in its organization. NDE is one of the key areas that are recognized by the Columbia Accident Investigation Board (CAIB) that needed to be strengthened by warranting NDE as a discipline with Independent Technical Authority (iTA). The current NASA NDE system and activities are presented including the latest developments in inspection technologies being applied to the Space Transportation System (STS). The unfolding trends and directions in NDE for the future are discussed as they apply to assuring safe and reliable operations.

49 CFR 192.605 - Procedural manual for operations, maintenance, and emergencies.

Code of Federal Regulations, 2011 CFR

2011-10-01

... maintenance activities and for emergency response. For transmission lines, the manual must also include... and effective manner. (5) Starting up and shutting down any part of the pipeline in a manner designed... control room management procedures required by § 192.631. (c) Abnormal operation. For transmission lines...

Using Goal Setting, Task Clarification, and Feedback to Increase the Use of the Hands-Free Technique by Hospital Operating Room Staff

ERIC Educational Resources Information Center

Cunningham, Thomas R.; Austin, John

2007-01-01

We evaluated the effects of a behavioral treatment on the safe passing of sharp instruments using the hands-free technique among hospital operating room personnel during surgical procedures. Treatment consisted of participative goal setting, task clarification, and feedback. The average percentage of sharp instruments passed safely increased from…

An XML Representation for Crew Procedures

NASA Technical Reports Server (NTRS)

Simpson, Richard C.

2005-01-01

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

Reactive, Safe Navigation for Lunar and Planetary Robots

NASA Technical Reports Server (NTRS)

Utz, Hans; Ruland, Thomas

2008-01-01

When humans return to the moon, Astronauts will be accompanied by robotic helpers. Enabling robots to safely operate near astronauts on the lunar surface has the potential to significantly improve the efficiency of crew surface operations. Safely operating robots in close proximity to astronauts on the lunar surface requires reactive obstacle avoidance capabilities not available on existing planetary robots. In this paper we present work on safe, reactive navigation using a stereo based high-speed terrain analysis and obstacle avoidance system. Advances in the design of the algorithms allow it to run terrain analysis and obstacle avoidance algorithms at full frame rate (30Hz) on off the shelf hardware. The results of this analysis are fed into a fast, reactive path selection module, enforcing the safety of the chosen actions. The key components of the system are discussed and test results are presented.

Ketamine. A solution to procedural pain in burned children.

PubMed

Groeneveld, A; Inkson, T

1992-09-01

Our experience has shown ketamine to be a safe and effective method of providing pain relief during specific procedures in burned children. It renders high doses of narcotics unnecessary and offers children the benefit of general anesthesia without the requirement of endotracheal intubation and a trip to the operating room. The response of parents and staff to the use of ketamine has been positive. Parents often experience feelings of guilt following injury to a child and are eager to employ methods that reduce their child's pain. So far, no parent has refused the administration of ketamine; some have even asked that it be used during subsequent procedures on their child. With adequate pre-procedure teaching, parents are prepared for the possible occurrence of emergent reactions and can assist in reorienting the child during recovery. Staff have found that the stress of doing painful procedures on children is reduced when ketamine is used. The procedures tend to be quicker and the predicament of working on a screaming, agitated child is eliminated. At the same time, nursing staff have had to get used to the nystagmic gaze of the children and accept that these patients are truly anesthetized even though they might move and talk. Despite the success we and others have had with ketamine, several questions about its use in burn patients remain unanswered. The literature does not answer such questions as: Which nursing measures reduce the incidence of emergent reactions? How many ketamine anesthetics can safely be administered to one individual? How does the frequency of administration relate to tolerance in a burn patient? Are there detrimental effects of frequent or long-term use? Clearly, an understanding of these questions is necessary to determine the safe boundaries of ketamine use in burn patients. Ketamine is not a panacea for the problem of pain in burned children. But it is one means of managing procedural pain, which is, after all, a significant clinical

The South Australian Safe Drinking Water Act: summary of the first year of operation.

PubMed

Froscio, Suzanne M; Bolton, Natalie; Cooke, Renay; Wittholz, Michelle; Cunliffe, David

2016-06-01

The Safe Drinking Water Act 2011 was introduced in South Australia to provide clear direction to drinking water providers on how to achieve water safety. The Act requires drinking water providers to register with SA Health and develop a risk management plan (RMP) for their water supply that includes operational and verification monitoring plans and an incident notification and communication protocol. During the first year of operation, 212 drinking water providers registered under the Act, including one major water utility and a range of small to medium sized providers in regional and remote areas of the State. Information was captured on water source(s) used and water treatment. Rainwater was the most frequently reported drinking water source (66%), followed by bore water (13%), on-supply or carting of mains water (13%), mixed source (rainwater with bore water backup) (6%) and surface water (3%). The majority of providers (91%) treated the water supply, 87% used disinfection. During the first year of operation, 16 water quality incidents were formally reported to SA Health. These included both microbial and chemical incidents. Case studies presented highlight how the RMPs are assisting drinking water providers to identify incidents of potential health concern and implement corrective actions.

28 CFR 42.530 - Procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

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

28 CFR 42.530 - Procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

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

28 CFR 42.530 - Procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

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

28 CFR 42.530 - Procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

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

28 CFR 42.530 - Procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

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

Robot-assisted laparoscopic (RAL) procedures in general surgery.

PubMed

Alimoglu, Orhan; Sagiroglu, Julide; Atak, Ibrahim; Kilic, Ali; Eren, Tunc; Caliskan, Mujgan; Bas, Gurhan

2016-09-01

Robotics was introduced in clinical practice more than two decades ago, and it has gained remarkable popularity for a wide variety of laparoscopic procedures. We report our results of robot-assisted laparoscopic surgery (RALS) in the most commonly applied general surgical procedures. Ninety seven patients underwent RALS from 2009 to 2012. Indications for RALS were cholelithiasis, gastric carcinoma, splenic tumors, colorectal carcinoma, benign colorectal diseases, non-toxic nodular goiter and incisional hernia. Records of patients were analyzed for demographic features, intraoperative and postoperative complications and conversion to open surgery. Forty six female and 51 male patients were operated and mean age was 58,4 (range: 25-88). Ninety three out of 97 procedures (96%) were completed robotically, 4 were converted to open surgery and there were 15 postoperative complications. There was no mortality. Wide variety of procedures of general surgery can be managed safely and effectively by RALS. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Blood loss in the space of Retzius and pelvis with tension-free vaginal tape and trans-obturator tape procedures.

PubMed

Huffaker, R Keith; Copas, Pleas

2006-11-01

The purpose of this study was to evaluate the space of Retzius and pelvis for hematoma formation and blood loss following placement of tension-free vaginal tapes (TVT) and transobturator tapes (TOT). 25 women were examined with ultrasonography on post-operative days one, two, three, four or five. One patient underwent TVT while the other 24 underwent TOT. Additional procedures were performed on most patients. No hematomas or collections of free fluid were identified post-operatively. TVT and TOT procedures are relatively safe procedures. We encountered no vascular complications in this small series of patients. Review of literature has yielded reports of infrequent complications.

Accurate, safe, and rapid method of intraoperative tumor identification for totally laparoscopic distal gastrectomy: injection of mixed fluid of sodium hyaluronate and patent blue.

PubMed

Nakagawa, Masatoshi; Ehara, Kazuhisa; Ueno, Masaki; Tanaka, Tsuyoshi; Kaida, Sachiko; Udagawa, Harushi

2014-04-01

In totally laparoscopic distal gastrectomy, determining the resection line with safe proximal margins is often difficult, particularly for tumors located in a relatively upper area. This is because, in contrast to open surgery, identifying lesions by palpating or opening the stomach is essentially impossible. This study introduces a useful method of tumor identification that is accurate, safe, and rapid. On the operation day, after inducing general anesthesia, a mixture of sodium hyaluronate and patent blue is injected into the submucosal layer of the proximal margin. When resecting stomach, all marker spots should be on the resected side. In all cases, the proximal margin is examined histologically by using frozen sections during the operation. From October 2009 to September 2011, a prospective study that evaluated this method was performed. A total of 34 patients who underwent totally laparoscopic distal gastrectomy were enrolled in this study. Approximately 5 min was required to complete the procedure. Proximal margins were negative in all cases, and the mean ± standard deviation length of the proximal margin was 23.5 ± 12.8 mm. No side effects, such as allergy, were encountered. As a method of tumor identification for totally laparoscopic distal gastrectomy, this procedure appears accurate, safe, and rapid.

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR OPERATION AND INITIALIZATION OF THE MAGELLAN GPS SATELLITE NAVIGATOR (UA-F-22.1)

EPA Science Inventory

The purpose of this SOP is to describe the general procedures for the operation and initialization of the Magellan Global Positioning System (GPS) Satellite Navigator. This procedure was followed to ensure consistent data retrieval during the Arizona NHEXAS project and the "Bord...

User's operating procedures. Volume 2: Scout project financial analysis program

NASA Technical Reports Server (NTRS)

Harris, C. G.; Haris, D. K.

1985-01-01

A review is presented of the user's operating procedures for the Scout Project Automatic Data system, called SPADS. SPADS is the result of the past seven years of software development on a Prime mini-computer located at the Scout Project Office, NASA Langley Research Center, Hampton, Virginia. SPADS was developed as a single entry, multiple cross-reference data management and information retrieval system for the automation of Project office tasks, including engineering, financial, managerial, and clerical support. This volume, two (2) of three (3), provides the instructions to operate the Scout Project Financial Analysis program in data retrieval and file maintenance via the user friendly menu drivers.

Transhepatic Hilar Approach for Perihilar Cholangiocarcinoma: Significance of Early Judgment of Resectability and Safe Vascular Reconstruction.

PubMed

Kuriyama, Naohisa; Isaji, Shuji; Tanemura, Akihiro; Iizawa, Yusuke; Kato, Hiroyuki; Murata, Yasuhiro; Azumi, Yoshinori; Kishiwada, Masashi; Mizuno, Shugo; Usui, Masanobu; Sakurai, Hiroyuki

2017-03-01

In the most common surgical procedure for perihilar cholangiocarcinoma, the margin status of the proximal bile duct is determined at the final step. Our procedure, the transhepatic hilar approach, confirms a cancer-negative margin status of the proximal bile duct first. We first performed a partial hepatic parenchymal transection to expose the hilar plate, and then transected the proximal bile duct to confirm margin status. Then, divisions of the hepatic artery and portal vein of the future resected liver are performed, followed by the residual hepatic parenchymal transection. The transhepatic hilar approach offers a wide surgical field for safe resection and reconstruction of the portal vein in the middle of the hepatectomy. We reviewed 23 patients with perihilar cholangiocarcinoma who underwent major hepatectomy using our procedure from 2011 to 2015. A combined vascular resection and reconstruction was carried out in 14 patients (60.9%). R0 resection was achieved in 17 patients (73.9%), and the overall 3-year survival rate was 52.9% (median survival time 52.4 months). The transhepatic hilar approach is useful and practicable regardless of local tumor extension, enabling us to determine tumor resectability and perform safe resection and reconstruction of the portal vein early in the operation.

Safe percutaneous suprapubic catheterisation.

PubMed

Goyal, N K; Goel, A; Sankhwar, S N

2012-11-01

We describe our technique of percutaneous suprapubic catheter insertion with special reference to steps that help to avoid common complications of haematuria and catheter misplacement. The procedure is performed using a stainless steel reusable trocar under local infiltrative anaesthesia, usually at the bedside. After clinical confirmation of a full bladder, the trocar is advanced into the bladder through a skin incision. Once the bladder is entered, the obturator is removed and the assistant inserts a Foley catheter followed by rapid balloon inflation. Slight traction is applied to the catheter for about five minutes. Patients with previous lower abdominal surgery, an inadequately distended bladder or acute pelvic trauma do not undergo suprapubic catheterisation using this method. The procedure was performed in 72 men (mean age: 42.4 years, range: 18-78 years) with urinary retention with a palpable bladder. The average duration of the procedure was less than five minutes. No complications were noted in any of the patients. Trocar suprapubic catheter insertion is a safe and effective bedside procedure for emergency bladder drainage and can be performed by resident surgeons. The common complications associated with the procedure can be avoided with a few careful steps.

TVT-Exact and midurethral sling (SLING-IUFT) operative procedures: a randomized study

PubMed Central

Aniulis, Povilas; Skaudickas, Darijus

2015-01-01

Objectives The aim of the study is to compare results, effectiveness and complications of TVT exact and midurethral sling (SLING-IUFT) operations in the treatment of female stress urinary incontinence (SUI). Methods A single center nonblind, randomized study of women with SUI who were randomized to TVT-Exact and SLING-IUFT was performed by one surgeon from April 2009 to April 2011. SUI was diagnosed on coughing and Valsalva test and urodynamics (cystometry and uroflowmetry) were assessed before operation and 1 year after surgery. This was a prospective randomized study. The follow up period was 12 months. 76 patients were operated using the TVT-Exact operation and 78 patients – using the SLING-IUFT operation. There was no statistically significant differences between groups for BMI, parity, menopausal status and prolapsed stage (no patients had cystocele greater than stage II). Results Mean operative time was significantly shorter in the SLING-IUFT group (19 ± 5.6 min.) compared with the TVT-Exact group (27 ± 7.1 min.). There were statistically significant differences in the effectiveness of both procedures: TVT-Exact – at 94.5% and SLING-IUFT – at 61.2% after one year. Hospital stay was statistically significantly shorter in the SLING-IUFT group (1. 2 ± 0.5 days) compared with the TVT-Exact group (3.5 ± 1.5 days). Statistically significantly fewer complications occurred in the SLING-IUFT group. Conclusion the TVT-Exact and SLING-IUFT operations are both effective for surgical treatment of female stress urinary incontinence. The SLING-IUFT involved a shorter operation time and lower complications rate., the TVT-Exact procedure had statistically significantly more complications than the SLING-IUFT operation, but a higher effectiveness. PMID:28352711

Safe and efficacious use of procedural sedation and analgesia by nonanesthesiologists in a pediatric emergency department.

PubMed

Pitetti, Raymond D; Singh, Sonia; Pierce, Mary Clyde

2003-11-01

(23.6%); and intramuscular ketamine, midazolam, and atropine in 82 (6.6%). Procedural sedation and analgesia was successfully provided in 1177 (98.6%) of 1194 sedation events. Complications occurred in 207 (17.8%) of 1161 events. The most common complication was hypoxia (79.1% of patients), followed by vomiting (6.2% of patients). No patient required intubation. One patient had an oral airway placed, 3 patients received flumazenil, 3 patients received naloxone hydrochloride, and 1 patient received naloxone and bag-valve-mask ventilation. Seventy (9.8%) of 717 patients, following discharge from the ED, reported minor complications related to PSA. The most common complication was vomiting (76.7% of patients), followed by persistent dizziness (6.8% of patients). Patients who received IV fentanyl and midazolam were significantly more likely to experience a complication during PSA (P<.001), while patients sedated using IV ketamine, midazolam, and atropine (P =.006) or IV midazolam alone (P =.005) were less likely. No difference in success of sedation or incidence of complications at follow-up was found between the types of PSA provided. Complications related to PSA occurred in 17.9% of patients, but most commonly consisted of hypoxia that was easily treated. Sedation was successful in 98.6% of patients. Procedural sedation and analgesia can be safely and effectively provided by nonanesthesiologists in a pediatric ED.

Mental workload measurement for emergency operating procedures in digital nuclear power plants.

PubMed

Gao, Qin; Wang, Yang; Song, Fei; Li, Zhizhong; Dong, Xiaolu

2013-01-01

Mental workload is a major consideration for the design of emergency operation procedures (EOPs) in nuclear power plants. Continuous and objective measures are desired. This paper compares seven mental workload measurement methods (pupil size, blink rate, blink duration, heart rate variability, parasympathetic/sympathetic ratio, total power and (Goals, Operations, Methods, and Section Rules)-(Keystroke Level Model) GOMS-KLM-based workload index) with regard to sensitivity, validity and intrusiveness. Eighteen participants performed two computerised EOPs of different complexity levels, and mental workload measures were collected during the experiment. The results show that the blink rate is sensitive to both the difference in the overall task complexity and changes in peak complexity within EOPs, that the error rate is sensitive to the level of arousal and correlate to the step error rate and that blink duration increases over the task period in both low and high complexity EOPs. Cardiac measures were able to distinguish tasks with different overall complexity. The intrusiveness of the physiological instruments is acceptable. Finally, the six physiological measures were integrated using group method of data handling to predict perceived overall mental workload. The study compared seven measures for evaluating the mental workload with emergency operation procedure in nuclear power plants. An experiment with simulated procedures was carried out, and the results show that eye response measures are useful for assessing temporal changes of workload whereas cardiac measures are useful for evaluating the overall workload.

The Food-Safe Schools Action Guide

ERIC Educational Resources Information Center

Centers for Disease Control and Prevention, 2007

2007-01-01

"The Food-Safe School Needs Assessment and Planning Guide" is a tool that can help schools assess their food safety policies, procedures, and programs and develop plans for improvement. This tool includes a simple, straightforward questionnaire, score card, and planning guide that give administrators, school staff, families, and students a chance…

Surface Area Analysis Using the Brunauer-Emmett-Teller (BET) Method: Standard Operating Procedure Series: SOP-C

DTIC Science & Technology

2016-09-01

Method Scientific Operating Procedure Series : SOP-C En vi ro nm en ta l L ab or at or y Jonathon Brame and Chris Griggs September 2016...BET) Method Scientific Operating Procedure Series : SOP-C Jonathon Brame and Chris Griggs Environmental Laboratory U.S. Army Engineer Research and...response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing

Design Guidance for Computer-Based Procedures for Field Workers

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

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

Nearly all activities that involve human interaction with nuclear power plant systems are guided by procedures, instructions, or checklists. Paper-based procedures (PBPs) currently used by most utilities have a demonstrated history of ensuring safety; however, improving procedure use could yield significant savings in increased efficiency, as well as improved safety through human performance gains. The nuclear industry is constantly trying to find ways to decrease human error rates, especially human error rates associated with procedure use. As a step toward the goal of improving field workers’ procedure use and adherence and hence improve human performance and overall system reliability, themore » U.S. Department of Energy Light Water Reactor Sustainability (LWRS) Program researchers, together with the nuclear industry, have been investigating the possibility and feasibility of replacing current paper-based procedures with computer-based procedures (CBPs). PBPs have ensured safe operation of plants for decades, but limitations in paper-based systems do not allow them to reach the full potential for procedures to prevent human errors. The environment in a nuclear power plant is constantly changing, depending on current plant status and operating mode. PBPs, which are static by nature, are being applied to a constantly changing context. This constraint often results in PBPs that are written in a manner that is intended to cover many potential operating scenarios. Hence, the procedure layout forces the operator to search through a large amount of irrelevant information to locate the pieces of information relevant for the task and situation at hand, which has potential consequences of taking up valuable time when operators must be responding to the situation, and potentially leading operators down an incorrect response path. Other challenges related to use of PBPs are management of multiple procedures, place-keeping, finding the correct procedure for a task, and

Surveillance of Environmental and Procedural Measures of Infection Control in the Operating Theatre Setting

PubMed Central

Raggi, Alessandra; Sanna, Tiziana; Mazzetti, Magda; Orsi, Alessandra; Zanni, Angela; Farruggia, Patrizia

2017-01-01

The microbiological contamination of operating theatres and the lack of adherence to best practices by surgical staff represent some of the factors affecting Surgical Site Infections (SSIs). The aim of the present study was to assess the microbiological quality of operating settings and the staff compliance to the SSI evidence-based control measures. Ten operating rooms were examined for microbiological contamination of air and surfaces, after cleaning procedures, in “at rest” conditions. Furthermore, 10 surgical operations were monitored to assess staff compliance to the recommended practices. None of the air samples exceeded microbiological reference standards and only six of the 200 surface samples (3.0%) were slightly above recommended levels. Potentially pathogenic bacteria and moulds were never detected. Staff compliance to best practices varied depending on the type of behaviour investigated and the role of the operator. The major not compliant behaviours were: pre-operative skin antisepsis, crowding of the operating room and hand hygiene of the anaesthetist. The good environmental microbiological quality observed is indicative of the efficacy of the cleaning-sanitization procedures adopted. The major critical point was staff compliance to recommended practices. Awareness campaigns are therefore necessary, aimed at improving the organisation of work so as to facilitate compliance to operative protocols. PMID:29283367

NHEXAS PHASE I ARIZONA STUDY--STANDARD OPERATING PROCEDURE FOR CALIBRATION AND OPERATION OF BALANCES (UA-L-1.2)

EPA Science Inventory

The purpose of this SOP is to describe the procedures used when calibrating and operating balances during the Arizona NHEXAS project and the "Border" study. Keywords: lab; equipment; balances.

The National Human Exposure Assessment Survey (NHEXAS) is a federal interagency rese...

Separation, Aspiration, and Fat Equalization: SAFE Liposuction Concepts for Comprehensive Body Contouring.

PubMed

Wall, Simeon H; Lee, Michael R

2016-12-01

Separation, aspiration, and fatty equilibration (SAFE) liposuction uses a process approach to body contouring and minimizes injury to surrounding structures. The multistep process allows for (1) fat separation, (2) lipoaspiration, and (3) fat equalization. The purpose of this study was to review both outcomes and complications of primary SAFE liposuction. Retrospective chart review was completed of patients undergoing SAFE liposuction from January of 2006 to January of 2011. Patient selection was limited to those undergoing liposuction alone with no adjuvant excisional procedures. Data were collected regarding demographics, body mass index, operative details, and outcomes. Seven hundred thirty-four patients were identified as having undergone SAFE liposuction. One hundred twenty-nine patients were found to have been treated with liposuction alone. Patient age ranged from 18 to 42 years and body mass index ranged from 18 to 42 kg/m (mean, 26.3 kg/m). Seven patients (5.4 percent) underwent treatment of the face and neck, six patients (4.7 percent) underwent treatment of upper extremities, 13 patients (10.1 percent) underwent treatment of the chest, 20 patients (15.5 percent) underwent treatment of lower extremities, 32 patients (24.8 percent) underwent treatment of the circumferential trunk, and 51 patients (39.5 percent) underwent treatment of circumferential trunk and additional area(s). No major complications occurred. Five of the 129 patients (3.87 percent) developed the minor complication of seroma formation. SAFE liposuction is a multistep process approach to body contouring consisting of (1) fat separation, (2) lipoaspiration, and (3) fat equalization. The results of this study show such technique to be safe and effective. Therapeutic, IV.

Safe abortion: WHO technical and policy guidance.

PubMed

Cook, R J; Dickens, B M; Horga, M

2004-07-01

In 2003, the World Health Organization published its well referenced handbook Safe Abortion: Technical and Policy Guidance for Health Systems to address the estimated almost 20 million induced abortions each year that are unsafe, imposing a burden of approximately 67 thousand deaths annually. It is a global injustice that 95% of unsafe abortions occur in developing countries. The focus of guidance is on abortion procedures that are lawful within the countries in which they occur, noting that in almost all countries, the law permits abortion to save a woman's life. The guidance treats unsafe abortion as a public health challenge, and responds to the problem through strategies concerning improved clinical care for women undergoing procedures, and the appropriate placement of necessary services. Legal and policy considerations are explored, and annexes present guidance to further reading, international consensus documents on safe abortion, and on manual vacuum aspiration and post-abortion contraception.

Nonspecific abdominal pain is a safe diagnosis.

PubMed

Pennel, David John Laurie; Goergen, Nina; Driver, Chris P

2014-11-01

The aim of this study is to assess if a clinical diagnosis of nonspecific abdominal pain (NSAP) is safe and if patients with this initial diagnosis are likely to require further investigation or surgical intervention. 3323 patients admitted with NSAP from July 1990 to September 2012 utilizing a prospective database of all surgical admissions were included. Readmission over the period of the study and specifically within 30 days of their initial presentation was identified together with any invasive investigation or surgical intervention. 319 children (9.6%) were subsequently readmitted with abdominal pain at some point during the study period. Of these, 78 (2.3%) were readmitted within 30 days. 118 (3.5%) children subsequently had an operation or invasive investigation some point following their initial admission. Of these 33 (0.6%) had the procedure within 3 months of the initial admission. 13 patients had an appendicectomy within 3 months of the initial presentation. Of these histology confirmed appendicitis in 8 patients. This gives an overall incidence of "missed" appendicitis of 0.2 % (8/3323). This study confirms that a clinical diagnosis of nonspecific abdominal pain (NSAP) is safe in a pediatric population and the risk of "missing" appendicitis is only 0.2%. Patients and/or parents can be confidently reassured that the risk of missing organic pathology is very low. Copyright © 2014 Elsevier Inc. All rights reserved.

US EPA Base Study Standard Operating Procedure for Preliminary Visits to Buildings

EPA Pesticide Factsheets

The objective of this standard operation procedure is to give the preliminary visit (PV) field investigator a description of how to conduct a BASE PV, as well as to detail the informational requirements that are gathered as part of this investigation.

Robot-assisted rectopexy is a safe and feasible option for treatment of rectal prolapse.

PubMed

Haahr, Camilla; Jakobsen, Henrik Loft; Gögenur, Ismail

2014-05-01

Rectal prolapse is seen in up to one in 100 elderly women and results in symptoms such as incontinence, mucus secretion and constipation. The aim of this study was to present short- and longterm outcomes after robot-assisted rectopexy in patients with rectal prolapse. All patients diagnosed with rectal prolapse at our institution underwent robot-assisted rectopexy. Data regarding the surgical procedure and post-operative morbidity were collected retrospectively. Patients were contacted to register long-term results regarding recurrence, incontinence and satisfaction. A total of 24 consecutive patients underwent robot-assisted rectopexy from October 2010 to July 2012. Data regarding their long-term outcome was available for 18 patients at follow-up (average ten months). 50% of the patients suffered from faecal incontinence before surgery (n = 9/18, 50%). The mean age at surgery was 72 years (28-93 years). The mean duration of surgery was 123 min. (70-245 min.). The median length of stay in hospital was 4.1 days (0-15 days). There was one procedure-related complication (small-bowel obstruction) resulting in reoperation. At the time of follow-up, two patients (11%) had a subjective recurrence of rectal prolapse, and three patients (17%) had faecal incontinence. 89% were satisfied with the operation, and 94% would recommend this operation to other patients with the same condition. Robot-assisted rectopexy is a safe procedure for patients with rectal prolapse and is associated with acceptable functional outcomes and recurrence rates. There is no evidence in the literature of advantages compared with the corresponding laparoscopic procedure. not relevant. not relevant.

Modeling Relevant to Safe Operations of U.S. Navy Vessels in Arctic Conditions: Physical Modeling of Ice Loads

DTIC Science & Technology

2016-06-01

zones with ice concentrations up to 40%. To achieve this goal, the Navy must determine safe operational speeds as a function of ice concen- tration...and full-scale experience with ice-capable hull forms that have shallow entry angles to promote flexural ice failure preferentially over crushing...plan view) of the proposed large-scale ice–hull impact experiment to be conducted in CRREL’s refrigerated towing basin. Shown here is a side-panel

A review of evidence for safe abortion care.

PubMed

Kapp, Nathalie; Whyte, Patti; Tang, Jennifer; Jackson, Emily; Brahmi, Dalia

2013-09-01

The provision of safe abortion services to women who need them has the potential to drastically reduce or eliminate maternal deaths due to unsafe abortion. The World Health Organization recently updated its evidence-based guidance for safe and effective clinical practices using data from systematic reviews of the literature. Systematic reviews pertaining to the evidence for safe abortion services, from pre-abortion care, medical and surgical methods of abortion and post-abortion care were evaluated for relevant outcomes, primarily those relating to safety, effectiveness and women's preference. Sixteen systematic reviews were identified and evaluated. The available evidence does not support the use of pre-abortion ultrasound to increase safety. Routine use of cervical preparation with osmotic dilators, mifepristone or misoprostol after 14 weeks gestation reduces complications; at early gestational ages, surgical abortions have very few complications. Prophylactic antibiotics result in lower rates of post-surgical abortion infection. Pain medication such as non-steroidal anti-inflammatories should be offered to women undergoing abortion procedures; acetaminophen, however, is not effective in reducing pain. Women who are eligible should be offered a choice between surgical (vacuum aspiration or dilation and evacuation) and medical methods (mifepristone and misoprostol) of abortion when possible. Modern methods of contraception can be safely initiated immediately following abortion procedures. Evidence-based guidelines assist health care providers and policymakers to utilize the best data available to provide safe abortion care and prevent the millions of deaths and disabilities that result from unsafe abortion. Copyright © 2013 Elsevier Inc. All rights reserved.

Electrocautery skin incision for neurosurgery procedures--technical note.

PubMed

Nitta, Naoki; Fukami, Tadateru; Nozaki, Kazuhiko

2011-01-01

The reluctance to incise skin with electrocautery is partly attributable to concerns about excessive scarring and poor wound healing. However, recently no difference was reported in wound complications between the cold scalpel and electrocautery scalpel. We assessed the safety and efficacy of electrocautery skin incision in 22 scalp incisions, including 4 cases of reoperation. Electrocautery skin incisions were created using a sharp needle electrode. The generator unit was set on cutting mode, with power of 6 W and 330 kHz sinusoid waveform. Subcutaneous dissections also used the sharp needle electrode, set on coagulating mode, with power of 10 W and 1 MHz pulse-modulated waveform. Galea incisions used a standard blade tip, set on coagulating mode, with power of 20 W and 1 MHz pulse-modulated waveform. Skin incision with the sharp needle electrode caused no charring of the wound. Little bleeding or oozing were observed and skin clips were not necessary. No wound complication such as necrosis or infection occurred. Electrocautery skin incisions for re-operations were also performed safely without complications. Electrocautery skin incision is sufficiently safe procedure not only for first operation but also for re-operation. Electrocautery skin incision is efficacious, especially for extended operation times, because of little blood loss from the edges of skin incision and possible avoidance of skin edge necrosis or alopecia caused by skin clips.

Impact of operator experience and training strategy on procedural outcomes with leadless pacing: Insights from the Micra Transcatheter Pacing Study.

PubMed

El-Chami, Mikhael; Kowal, Robert C; Soejima, Kyoko; Ritter, Philippe; Duray, Gabor Z; Neuzil, Petr; Mont, Lluis; Kypta, Alexander; Sagi, Venkata; Hudnall, John Harrison; Stromberg, Kurt; Reynolds, Dwight

2017-07-01

Leadless pacemaker systems have been designed to avoid the need for a pocket and transvenous lead. However, delivery of this therapy requires a new catheter-based procedure. This study evaluates the role of operator experience and different training strategies on procedural outcomes. A total of 726 patients underwent implant attempt with the Micra transcatheter pacing system (TPS; Medtronic, Minneapolis, MN, USA) by 94 operators trained in a teaching laboratory using a simulator, cadaver, and large animal models (lab training) or locally at the hospital with simulator/demo model and proctorship (hospital training). Procedure success, procedure duration, fluoroscopy time, and safety outcomes were compared between training methods and experience (implant case number). The Micra TPS procedure was successful in 99.2% of attempts and did not differ between the 55 operators trained in the lab setting and the 39 operators trained locally at the hospital (P = 0.189). Implant case number was also not a determinant of procedural success (P = 0.456). Each operator performed between one and 55 procedures. Procedure time and fluoroscopy duration decreased by 2.0% (P = 0.002) and 3.2% (P < 0.001) compared to the previous case. Major complication rate and pericardial effusion rate were not associated with case number (P = 0.755 and P = 0.620, respectively). There were no differences in the safety outcomes by training method. Among a large group of operators, implantation success was high regardless of experience. While procedure duration and fluoroscopy times decreased with implant number, complications were low and not associated with case number. Procedure and safety outcomes were similar between distinct training methodologies. © 2017 Wiley Periodicals, Inc.

Synthetic Vision Enhanced Surface Operations and Flight Procedures Rehearsal Tool

NASA Technical Reports Server (NTRS)

Arthur, Jarvis J., III; Prinzel, Lawrence J., III; Williams, Steven P.; Kramer, Lynda J.

2006-01-01

Limited visibility has been cited as predominant causal factor for both Controlled-Flight-Into-Terrain (CFIT) and runway incursion accidents. NASA is conducting research and development of Synthetic Vision Systems (SVS) technologies which may potentially mitigate low visibility conditions as a causal factor to these accidents while replicating the operational benefits of clear day flight operations, regardless of the actual outside visibility condition. Two experimental evaluation studies were performed to determine the efficacy of two concepts: 1) head-worn display application of SVS technology to enhance transport aircraft surface operations, and 2) three-dimensional SVS electronic flight bag display concept for flight plan preview, mission rehearsal and controller-pilot data link communications interface of flight procedures. In the surface operation study, pilots evaluated two display devices and four display modes during taxi under unlimited and CAT II visibility conditions. In the mission rehearsal study, pilots flew approaches and departures in an operationally-challenged airport environment, including CFIT scenarios. Performance using the SVS concepts was compared to traditional baseline displays with paper charts only or EFB information. In general, the studies evince the significant situation awareness and enhanced operational capabilities afforded from these advanced SVS display concepts. The experimental results and conclusions from these studies are discussed along with future directions.

Soil Sampling Operating Procedure

EPA Pesticide Factsheets

EPA Region 4 Science and Ecosystem Support Division (SESD) document that describes general and specific procedures, methods, and considerations when collecting soil samples for field screening or laboratory analysis.

Sediment Sampling Operating Procedure

EPA Pesticide Factsheets

EPA Region 4 Science and Ecosystem Support Division (SESD) document that describes general and specific procedures, methods, and considerations when collecting sediment samples for field screening or laboratory analysis.

A cost and time analysis of laryngology procedures in the endoscopy suite versus the operating room.

PubMed

Hillel, Alexander T; Ochsner, Matthew C; Johns, Michael M; Klein, Adam M

2016-06-01

To assess the costs, charges, reimbursement, and efficiency of performing awake laryngology procedures in an endoscopy suite (ES) compared with like procedures performed in the operating room (OR). Retrospective review of billing records. Cost, charges, and reimbursements for the hospital, surgeon, and anesthesiologist were compared between ES injection laryngoplasty and laser excision procedures and matched case controls in the OR. Time spent in 1) the preoperative unit, 2) the operating or endoscopy suite, and 3) recovery unit were compared between OR and ES procedures. Hospital expenses were significantly less for ES procedures when compared to OR procedures. Reimbursement was similar for ES and OR injection laryngoplasty, though greater for OR laser excisions. Net balance (reimbursement-expenses) was greater for ES procedures. A predictive model of payer costs over a 3-year period showed similar costs for ES and OR laser procedures and reduced costs for ES compared to OR injection laryngoplasty. Times spent preoperatively and the procedure were significantly less for ES procedures. For individual laryngology procedures, the ES reduces time and costs compared to the OR, increasing otolaryngologist and hospital efficiency. This reveals cost and time savings of ES injection laryngoplasty, which occurs at a similar frequency as OR injection laryngoplasty. Given the increased frequency for ES laser procedures, total costs are similar for ES and OR laser excision of papilloma, which usually require repeated procedures. When regulated office space is unavailable, endoscopy rooms represent an alternative setting for unsedated laryngology procedures. NA Laryngoscope, 126:1385-1389, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

A 2-microm continuous-wave laser system for safe and high-precision dissection during NOTES procedures.

PubMed

Dray, Xavier; Donatelli, Gianfranco; Krishnamurty, Devi Mukkai; Dubcenco, Elena; Wroblewski, Ronald J; Assumpcao, Lia; Giday, Samuel A; Buscaglia, Jonathan M; Shin, Eun J; Magno, Priscilla; Pipitone, Laurie J; Marohn, Michael R; Kantsevoy, Sergey V; Kalloo, Anthony N

2010-09-01

Lasers 2-microm in wavelength offer efficient tissue cutting with limited thermal damage in biological tissue. To evaluate the dissection capabilities of a 2-microm continuous-wave laser for NOTES procedures. We conducted 18 acute animal experiments. Group 1 (three animals): transcolonic access to the peritoneal cavity (15-W transcolonic laser puncture, balloon dilation over the laser probe). Group 2 (six animals): transcolonic access with needle-knife puncture and balloon dilation. Group 3 (three animals): transgastric access to the peritoneal cavity (similar technique as group 1) followed by laser-assisted dissection of the kidney. In one animal of group 3, a therapeutic target (hematoma) was created by percutaneous puncture of the kidney. Group 4 (six animals): transgastric access (similar to the technique of group 2). Translumenal access to the peritoneal cavity was achieved in 2-3 min in group 1 (significantly shorter than with the needle-knife-assisted technique, 4-5 min, p=0.02) and in 7-10 min in group 3 (compared to 6-17 min in group 4, p=0.88). In group 3, laser dissection of the parietal peritoneum and of perinephric connective tissue allowed access to the retroperitoneum with complete removal of a blood collection in the animal with puncture trauma. Laser dissection demonstrated good maneuverability, clean and rapid cutting, and excellent hemostasis. Peritoneoscopy and necropsy showed no damage of targeted tissue and surrounding organs. The 2-microm continuous-wave laser system showed promising capabilities for highly precise and safe dissection during NOTES procedures.

RECOMMENDED OPERATING PROCEDURE NO. 51: GLASS SOURCE ASSESSMENT SAMPLING SYSTEM (GLASS SASS)

EPA Science Inventory

The report is a recommended operating procedure (ROP), prepared for use in research activities conducted by EPA's Air and Energy Engineering Research Laboratory (AEERL). he method described is applicable to the stack sampling of flue gas from a rotary kiln and to associated equip...