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...

NGA-West 2 GMPE average site coefficients for use in earthquake-resistant design

USGS Publications Warehouse

Borcherdt, Roger D.

2015-01-01

Site coefficients corresponding to those in tables 11.4–1 and 11.4–2 of Minimum Design Loads for Buildings and Other Structures published by the American Society of Civil Engineers (Standard ASCE/SEI 7-10) are derived from four of the Next Generation Attenuation West2 (NGA-W2) Ground-Motion Prediction Equations (GMPEs). The resulting coefficients are compared with those derived by other researchers and those derived from the NGA-West1 database. The derivation of the NGA-W2 average site coefficients provides a simple procedure to update site coefficients with each update in the Maximum Considered Earthquake Response MCER maps. The simple procedure yields average site coefficients consistent with those derived for site-specific design purposes. The NGA-W2 GMPEs provide simple scale factors to reduce conservatism in current simplified design procedures.

Hellsgate Big Game Winter Range Wildlife Mitigation Site Specific Management Plan for the Hellsgate Project.

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

Berger, Matthew T.; Judd, Steven L.

This report contains a detailed site-specific management plan for the Hellsgate Winter Range Wildlife Mitigation Project. The report provides background information about the mitigation process, the review process, mitigation acquisitions, Habitat Evaluation Procedures (HEP) and mitigation crediting, current habitat conditions, desired future habitat conditions, restoration/enhancements efforts and maps.

A site specific model and analysis of the neutral somatic mutation rate in whole-genome cancer data.

PubMed

Bertl, Johanna; Guo, Qianyun; Juul, Malene; Besenbacher, Søren; Nielsen, Morten Muhlig; Hornshøj, Henrik; Pedersen, Jakob Skou; Hobolth, Asger

2018-04-19

Detailed modelling of the neutral mutational process in cancer cells is crucial for identifying driver mutations and understanding the mutational mechanisms that act during cancer development. The neutral mutational process is very complex: whole-genome analyses have revealed that the mutation rate differs between cancer types, between patients and along the genome depending on the genetic and epigenetic context. Therefore, methods that predict the number of different types of mutations in regions or specific genomic elements must consider local genomic explanatory variables. A major drawback of most methods is the need to average the explanatory variables across the entire region or genomic element. This procedure is particularly problematic if the explanatory variable varies dramatically in the element under consideration. To take into account the fine scale of the explanatory variables, we model the probabilities of different types of mutations for each position in the genome by multinomial logistic regression. We analyse 505 cancer genomes from 14 different cancer types and compare the performance in predicting mutation rate for both regional based models and site-specific models. We show that for 1000 randomly selected genomic positions, the site-specific model predicts the mutation rate much better than regional based models. We use a forward selection procedure to identify the most important explanatory variables. The procedure identifies site-specific conservation (phyloP), replication timing, and expression level as the best predictors for the mutation rate. Finally, our model confirms and quantifies certain well-known mutational signatures. We find that our site-specific multinomial regression model outperforms the regional based models. The possibility of including genomic variables on different scales and patient specific variables makes it a versatile framework for studying different mutational mechanisms. Our model can serve as the neutral null model for the mutational process; regions that deviate from the null model are candidates for elements that drive cancer development.

40 CFR 63.7824 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

Code of Federal Regulations, 2014 CFR

2014-07-01

... establish site-specific operating limits according to the procedures in paragraphs (b)(1) and (2) of this.... (3) Establish revised operating limits according to the applicable procedures in paragraphs (a) and... 40 Protection of Environment 14 2014-07-01 2014-07-01 false What test methods and other procedures...

40 CFR 63.7824 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

Code of Federal Regulations, 2012 CFR

2012-07-01

... establish site-specific operating limits according to the procedures in paragraphs (b)(1) and (2) of this.... (3) Establish revised operating limits according to the applicable procedures in paragraphs (a) and... 40 Protection of Environment 14 2012-07-01 2011-07-01 true What test methods and other procedures...

Procedure-specific Surgical Site Infection Incidence Varies Widely within Certain National Healthcare Safety Network Surgery Groups

PubMed Central

Saeed, Mohammed J; Dubberke, Erik R; Fraser, Victoria J; Olsen, Margaret A

2015-01-01

Background The National Healthcare Safety Network (NHSN) classifies surgical procedures into 40 categories. The objective of this study was to determine surgical site infection (SSI) incidence for clinically defined subgroups within 5 heterogeneous NHSN surgery categories. Methods This is a retrospective cohort study using the longitudinal State Inpatient Database. We identified 5 groups of surgical procedures (amputation; biliary, liver and pancreas [BILI]; breast; colon and hernia) using ICD-9-CM procedure codes in community hospitals in California, Florida and New York from January 2009 through September 2011 in persons aged ≥18 years. Each of these 5 categories was classified to more specific surgical procedures within the group. 90-day SSI rates were calculated using ICD-9-CM diagnosis codes. Results There were 62,901 amputation, 33,358 BILI, 72,058 breast, 125,689 colon and 85,745 hernia surgeries in 349,298 people. 90-day SSI rates varied significantly within each of the 5 subgroups. Within the BILI category, bile duct, pancreas and laparoscopic liver procedures had SSI rates of 7.2%, 17.2%, and 2.2%, respectively (p<0.0001 for each) compared to open liver procedures (11.1% SSI). Conclusion 90-day SSI rates varied widely within certain NHSN categories. Risk adjustment for specific surgery type is needed in order to make valid comparisons between hospitals. PMID:25818024

40 CFR 60.2095 - What site-specific documentation is required?

Code of Federal Regulations, 2010 CFR

2010-07-01

.... (5) Procedures for operating the incinerator and associated air pollution control systems within the... incinerator operating limits. (7) Reporting and recordkeeping procedures. (8) The waste management plan... required? 60.2095 Section 60.2095 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR...

Final report: survey and removal of radioactive surface contamination at environmental restoration sites, Sandia National Laboratories/New Mexico. Volume 2

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

Lambert, K.A.; Mitchell, M.M.; Jean, D.

1997-09-01

This report contains the Appendices A-L including Voluntary Corrective Measure Plans, Waste Management Plans, Task-Specific Health and Safety Plan, Analytical Laboratory Procedures, Soil Sample Results, In-Situ Gamma Spectroscopy Results, Radionuclide Activity Summary, TCLP Soil Sample Results, Waste Characterization Memoranda, Waste Drum Inventory Data, Radiological Risk Assessment, and Summary of Site-Specific Recommendations.

40 CFR 62.14620 - What site-specific documentation is required?

Code of Federal Regulations, 2011 CFR

2011-07-01

... POLLUTANTS Federal Plan Requirements for Commercial and Industrial Solid Waste Incineration Units That...) Procedures for receiving, handling, and charging waste. (3) Incinerator startup, shutdown, and malfunction... limits. (7) Reporting and recordkeeping procedures. (8) The waste management plan required under §§ 62...

A tiered approach for the human health risk assessment for consumption of vegetables from with cadmium-contaminated land in urban areas.

PubMed

Swartjes, Frank A; Versluijs, Kees W; Otte, Piet F

2013-10-01

Consumption of vegetables that are grown in urban areas takes place worldwide. In developing countries, vegetables are traditionally grown in urban areas for cheap food supply. In developing and developed countries, urban gardening is gaining momentum. A problem that arises with urban gardening is the presence of contaminants in soil, which can be taken up by vegetables. In this study, a scientifically-based and practical procedure has been developed for assessing the human health risks from the consumption of vegetables from cadmium-contaminated land. Starting from a contaminated site, the procedure follows a tiered approach which is laid out as follows. In Tier 0, the plausibility of growing vegetables is investigated. In Tier 1 soil concentrations are compared with the human health-based Critical soil concentration. Tier 2 offers the possibility for a detailed site-specific human health risk assessment in which calculated exposure is compared to the toxicological reference dose. In Tier 3, vegetable concentrations are measured and tested following a standardized measurement protocol. To underpin the derivation of the Critical soil concentrations and to develop a tool for site-specific assessment the determination of the representative concentration in vegetables has been evaluated for a range of vegetables. The core of the procedure is based on Freundlich-type plant-soil relations, with the total soil concentration and the soil properties as variables. When a significant plant-soil relation is lacking for a specific vegetable a geometric mean of BioConcentrationFactors (BCF) is used, which is normalized according to soil properties. Subsequently, a 'conservative' vegetable-group-consumption-rate-weighted BioConcentrationFactor is calculated as basis for the Critical soil concentration (Tier 1). The tool to perform site-specific human health risk assessment (Tier 2) includes the calculation of a 'realistic worst case' site-specific vegetable-group-consumption-rate-weighted BioConcentrationFactor. © 2013 Elsevier Inc. All rights reserved.

Plastic surgeons’ self-reported operative infection rates at a Canadian academic hospital

PubMed Central

Ng, Wendy KY; Kaur, Manraj Nirmal; Thoma, Achilleas

2014-01-01

BACKGROUND: Surgical site infection rates are of great interest to patients, surgeons, hospitals and third-party payers. While previous studies have reported hospital-acquired infection rates that are nonspecific to all surgical services, there remain no overall reported infection rates focusing specifically on plastic surgery in the literature. OBJECTIVE: To estimate the reported surgical site infection rate in plastic surgery procedures over a 10-year period at an academic hospital in Canada. METHODS: A review was conducted on reported plastic surgery surgical site infection rates from 2003 to 2013, based on procedures performed in the main operating room. For comparison, prospective infection surveillance data over an eight-year period (2005 to 2013) for nonplastic surgery procedures were reviewed to estimate the overall operative surgical site infection rates. RESULTS: A total of 12,183 plastic surgery operations were performed from 2003 to 2013, with 96 surgical site infections reported, corresponding to a net operative infection rate of 0.79%. There was a 0.49% surgeon-reported infection rate for implant-based procedures. For non-plastic surgery procedures, surgical site infection rates ranged from 0.04% for cataract surgery to 13.36% for high-risk abdominal hysterectomies. DISCUSSION: The plastic surgery infection rate at the study institution was found to be <1%. This rate was equal to, or somewhat less than, surgical site infection rates. However, these results do not report patterns of infection rates germane to procedures, season, age groups or sex. To provide more in-depth knowledge of this topic, multicentre studies should be conducted. PMID:25535460

VERIFICATION OF SIMPLIFIED PROCEDURES FOR SITE- SPECIFIC SO2 AND NOX CONTROL COST ESTIMATES

EPA Science Inventory

The report documents results of an evaluation to verify the accuracy of simplified procedures for estimating sulfur dioxide (S02) and nitrogen oxides (NOx) retrofit control costs and performance for 200 502-emitting coal-fired power plants in the 31-state eastern region. nitially...

31 CFR 552.501 - General and specific licensing procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... provisions relating to licensing procedures, see part 501, subpart E of this chapter. Licensing actions taken... actions taken pursuant to this part. General licenses and statements of licensing policy relating to this part also may be available through the Yemen sanctions page on OFAC's Web site: www.treasury.gov/ofac. ...

31 CFR 552.501 - General and specific licensing procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... provisions relating to licensing procedures, see part 501, subpart E of this chapter. Licensing actions taken... actions taken pursuant to this part. General licenses and statements of licensing policy relating to this part also may be available through the Yemen sanctions page on OFAC's Web site: www.treasury.gov/ofac. ...

Obsidian dating and East african archeology.

PubMed

Michels, J W; Tsong, I S; Nelson, C M

1983-01-28

New experimental procedures have made it possible to establish specific hydration rates for the numerous compositional types of obsidian to be found at archeological sites in Kenya. Two rates are applied to artifacts from the Prospect Farm site, revealing a history of occupation extending back 120,000 years.

Synthesis and Labeling of RNA In Vitro

PubMed Central

Huang, Chao; Yu, Yi-Tao

2013-01-01

This unit discusses several methods for generating large amounts of uniformly labeled, end-labeled, and site-specifically labeled RNAs in vitro. The methods involve a number of experimental procedures, including RNA transcription, 5′ dephosphorylation and rephosphorylation, 3′ terminal nucleotide addition (via ligation), site-specific RNase H cleavage directed by 2′-O-methyl RNA-DNA chimeras, and 2-piece splint ligation. The applications of these RNA radiolabeling approaches are also discussed. PMID:23547015

Engineering applications of strong ground motion simulation

NASA Astrophysics Data System (ADS)

Somerville, Paul

1993-02-01

The formulation, validation and application of a procedure for simulating strong ground motions for use in engineering practice are described. The procedure uses empirical source functions (derived from near-source strong motion recordings of small earthquakes) to provide a realistic representation of effects such as source radiation that are difficult to model at high frequencies due to their partly stochastic behavior. Wave propagation effects are modeled using simplified Green's functions that are designed to transfer empirical source functions from their recording sites to those required for use in simulations at a specific site. The procedure has been validated against strong motion recordings of both crustal and subduction earthquakes. For the validation process we choose earthquakes whose source models (including a spatially heterogeneous distribution of the slip of the fault) are independently known and which have abundant strong motion recordings. A quantitative measurement of the fit between the simulated and recorded motion in this validation process is used to estimate the modeling and random uncertainty associated with the simulation procedure. This modeling and random uncertainty is one part of the overall uncertainty in estimates of ground motions of future earthquakes at a specific site derived using the simulation procedure. The other contribution to uncertainty is that due to uncertainty in the source parameters of future earthquakes that affect the site, which is estimated from a suite of simulations generated by varying the source parameters over their ranges of uncertainty. In this paper, we describe the validation of the simulation procedure for crustal earthquakes against strong motion recordings of the 1989 Loma Prieta, California, earthquake, and for subduction earthquakes against the 1985 Michoacán, Mexico, and Valparaiso, Chile, earthquakes. We then show examples of the application of the simulation procedure to the estimatation of the design response spectra for crustal earthquakes at a power plant site in California and for subduction earthquakes in the Seattle-Portland region. We also demonstrate the use of simulation methods for modeling the attenuation of strong ground motion, and show evidence of the effect of critical reflections from the lower crust in causing the observed flattening of the attenuation of strong ground motion from the 1988 Saguenay, Quebec, and 1989 Loma Prieta earthquakes.

A tiered approach for the human health risk assessment for consumption of vegetables from with cadmium-contaminated land in urban areas

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

Swartjes, Frank A., E-mail: frank.swartjes@rivm.nl; Versluijs, Kees W.; Otte, Piet F.

Consumption of vegetables that are grown in urban areas takes place worldwide. In developing countries, vegetables are traditionally grown in urban areas for cheap food supply. In developing and developed countries, urban gardening is gaining momentum. A problem that arises with urban gardening is the presence of contaminants in soil, which can be taken up by vegetables. In this study, a scientifically-based and practical procedure has been developed for assessing the human health risks from the consumption of vegetables from cadmium-contaminated land. Starting from a contaminated site, the procedure follows a tiered approach which is laid out as follows. Inmore » Tier 0, the plausibility of growing vegetables is investigated. In Tier 1 soil concentrations are compared with the human health-based Critical soil concentration. Tier 2 offers the possibility for a detailed site-specific human health risk assessment in which calculated exposure is compared to the toxicological reference dose. In Tier 3, vegetable concentrations are measured and tested following a standardized measurement protocol. To underpin the derivation of the Critical soil concentrations and to develop a tool for site-specific assessment the determination of the representative concentration in vegetables has been evaluated for a range of vegetables. The core of the procedure is based on Freundlich-type plant–soil relations, with the total soil concentration and the soil properties as variables. When a significant plant–soil relation is lacking for a specific vegetable a geometric mean of BioConcentrationFactors (BCF) is used, which is normalized according to soil properties. Subsequently, a ‘conservative’ vegetable-group-consumption-rate-weighted BioConcentrationFactor is calculated as basis for the Critical soil concentration (Tier 1). The tool to perform site-specific human health risk assessment (Tier 2) includes the calculation of a ‘realistic worst case’ site-specific vegetable-group-consumption-rate-weighted BioConcentrationFactor. -- Highlights: • A scientifically-based and practical procedure has been developed for assessing the human health risks from the consumption of vegetables. • Uptake characteristics of cadmium in a series of vegetables is represented by a vegetable-group-consumption-rate-weighted BioConcentrationFactor. • Calculations and measurement steps are combined.« less

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

NONE

The study was conducted to determine the pollutants of concern in the Istanbul metropolitan area, monitoring equipment specifications and monitoring and data analysis procedures for an air quality and meteorological monitoring program. This volume consists of: (1) Introduction; (2) Selection of Pollutants of Concern; (3) Selection of Monitoring Locations; (4) Equipment Specifications; (5) Site Preparation and Security; (6) Standard Operating Procedures; (7) Data Reduction and Analysis; (8) Future Phases; (9) References. Also included are Attachments A through G and List of Tables and List of Figures.

Multi-Site Quality Assurance Project Plan for Wisconsin Public Service Corporation, Peoples Gas Light and Coke Company, and North Shore Gas

EPA Pesticide Factsheets

This Multi-Site QAPP presents the organization, data quality objectives (DQOs), a set of anticipated activities, sample analysis, data handling and specific Quality Assurance/Quality Control (QA/QC) procedures associated with Studies done in EPA Region 5

40 CFR Appendix C to Part 58 - Ambient Air Quality Monitoring Methodology

Code of Federal Regulations, 2013 CFR

2013-07-01

..., National Exposure Research Laboratory (MD-D205-03), U.S. Environmental Protection Agency, Research Triangle....2.3For which a quantitative relationship to a reference or equivalent method for PM 10 has been established at the use site. Procedures for establishing a quantitative site-specific relationship are...

40 CFR Appendix C to Part 58 - Ambient Air Quality Monitoring Methodology

Code of Federal Regulations, 2014 CFR

2014-07-01

..., National Exposure Research Laboratory (MD-D205-03), U.S. Environmental Protection Agency, Research Triangle....2.3For which a quantitative relationship to a reference or equivalent method for PM 10 has been established at the use site. Procedures for establishing a quantitative site-specific relationship are...

40 CFR 131.43 - Florida.

Code of Federal Regulations, 2011 CFR

2011-07-01

... a copy of all materials submitted to EPA, at the time of submittal to EPA, to facilitate the State... time for a specific lake in lieu of the site-specific alternative criteria procedure described in...: Waccasassa Coastal Drainage Area, Withlacoochee Coastal Drainage Area, Crystal/Pithlachascotee Coastal...

Da Vinci single site© surgical platform in clinical practice: a systematic review.

PubMed

Morelli, Luca; Guadagni, Simone; Di Franco, Gregorio; Palmeri, Matteo; Di Candio, Giulio; Mosca, Franco

2016-12-01

The Da Vinci single-site© surgical platform (DVSSP) is a set of single-site instruments and accessories specifically dedicated to robot-assisted single-site surgery. The PubMed database from inception to June 2015 was searched for English literature on the clinical use of DVSSP in general surgery, urology and gynecology. Twenty-nine articles involving the clinical application of DVSSP were identified; 15 articles on general surgery (561 procedures), four articles on urology (48 procedures) and 10 articles on gynecology (212 procedures). All studies have proven the safety and feasibility of the use of DVSSP. The principal reported advantage is the restoration of intra-abdominal triangulation, while the main reported limitation is the lack of the endowrist. Da Vinci systems have proven to be valuable assets in single-site surgery, owing to the combination of robot use with the dedicated single-incision platform. However, case-control or prospective trials are warranted to draw more definitive conc lusions. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Periodontal soft tissue root coverage procedures: a consensus report from the AAP Regeneration Workshop.

PubMed

Tatakis, Dimitris N; Chambrone, Leandro; Allen, Edward P; Langer, Burton; McGuire, Michael K; Richardson, Christopher R; Zabalegui, Ion; Zadeh, Homayoun H

2015-02-01

Management of gingival recession defects, a common periodontal condition, using root coverage procedures is an important aspect of periodontal regenerative therapy. The goal of the periodontal soft tissue root coverage procedures group was to develop a consensus report based on the accompanying systematic review of root coverage procedures, including priorities for future research and identification of the best evidence available to manage different clinical scenarios. The group reviewed and discussed the accompanying systematic review, which covered treatment of single-tooth recession defects, multiple-tooth recession defects, and additional focused questions on relevant clinical topics. The consensus group members submitted additional material for consideration by the group in advance and at the time of the meeting. The group also identified priorities for future research. All reviewed root coverage procedures provide significant reduction in recession depth, especially for Miller Class I and II recession defects. Subepithelial connective tissue graft (SCTG) procedures provide the best root coverage outcomes. Acellular dermal matrix graft (ADMG) or enamel matrix derivative (EMD) in conjunction with a coronally advanced flap (CAF) can serve as alternatives to autogenous donor tissue. Additional research is needed to do the following: 1) assess the treatment outcomes for multiple-tooth recession defects, oral sites other than maxillary canine and premolar teeth, and Miller Class III and IV defects; 2) assess the role of patient- and site-specific factors on procedure outcomes; and 3) obtain evidence on patient-reported outcomes. Predictable root coverage is possible for single-tooth and multiple-tooth recession defects, with SCTG procedures providing the best root coverage outcomes. Alternatives to SCTG are supported by evidence of varying strength. Additional research is needed on treatment outcomes for specific oral sites. Clinical Recommendation: For Miller Class I and II single-tooth recession defects, SCTG procedures provide the best outcomes, whereas ADMG or EMD in conjunction with CAF may be used as an alternative.

WAG 2 remedial investigation and site investigation site-specific work plan/health and safety checklist for the sediment transport modeling task

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

Holt, V.L.; Baron, L.A.

1994-05-01

This site-specific Work Plan/Health and Safety Checklist (WP/HSC) is a supplement to the general health and safety plan (HASP) for Waste Area Grouping (WAG) 2 remedial investigation and site investigation (WAG 2 RI&SI) activities [Health and Safety Plan for the Remedial Investigation and Site Investigation of Waste Area Grouping 2 at the Oak Ridge National Laboratory, Oak Ridge, Tennessee (ORNL/ER-169)] and provides specific details and requirements for the WAG 2 RI&SI Sediment Transport Modeling Task. This WP/HSC identifies specific site operations, site hazards, and any recommendations by Oak Ridge National Laboratory (ORNL) health and safety organizations [i.e., Industrial Hygiene (IH),more » Health Physics (HP), and/or Industrial Safety] that would contribute to the safe completion of the WAG 2 RI&SI. Together, the general HASP for the WAG 2 RI&SI (ORNL/ER-169) and the completed site-specific WP/HSC meet the health and safety planning requirements specified by 29 CFR 1910.120 and the ORNL Hazardous Waste Operations and Emergency Response (HAZWOPER) Program Manual. In addition to the health and safety information provided in the general HASP for the WAG 2 RI&SI, details concerning the site-specific task are elaborated in this site-specific WP/HSC, and both documents, as well as all pertinent procedures referenced therein, will be reviewed by all field personnel prior to beginning operations.« less

Applications of a Next-Generation MDAC Discrimination Procedure Using Two-Dimensional Grids of Regional P/S Spectral Ratios

DTIC Science & Technology

2008-09-01

explosions (UNEs) at the Semipalatinsk Test Site and regional earthquakes recorded by station WMQ (Urumchi, China). Measurements from the grids are... Semipalatinsk , Lop Nor, Novaya Zemlya, and Nevada Test Sites (STS, LNTS, NZTS, NTS, respectively) and regional earthquakes. We used phase-specific window...stations (triangles) within 2000 km of STS and LNTS. Semipalatinsk Test Site Figure 2 shows Pn/Lg spectral ratios, corrected for site and distance

40 CFR 98.176 - Data reporting requirements.

Code of Federal Regulations, 2013 CFR

2013-07-01

... weight of gaseous fuels. (5) If you used the missing data procedures in § 98.175(b), you must report how the monthly mass for each process input or output with missing data was determined and the number of months the missing data procedures were used. (f) If you used the site-specific emission factor method in...

40 CFR 98.176 - Data reporting requirements.

Code of Federal Regulations, 2011 CFR

2011-07-01

... weight of gaseous fuels. (5) If you used the missing data procedures in § 98.175(b), you must report how the monthly mass for each process input or output with missing data was determined and the number of months the missing data procedures were used. (f) If you used the site-specific emission factor method in...

40 CFR 98.176 - Data reporting requirements.

Code of Federal Regulations, 2012 CFR

2012-07-01

... weight of gaseous fuels. (5) If you used the missing data procedures in § 98.175(b), you must report how the monthly mass for each process input or output with missing data was determined and the number of months the missing data procedures were used. (f) If you used the site-specific emission factor method in...

The procedures manual of the Environmental Measurements Laboratory. Volume 2, 28. edition

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

Chieco, N.A.

1997-02-01

This report contains environmental sampling and analytical chemistry procedures that are performed by the Environmental Measurements Laboratory. The purpose of environmental sampling and analysis is to obtain data that describe a particular site at a specific point in time from which an evaluation can be made as a basis for possible action.

Ultrasound-guided steroid tendon sheath injections in juvenile idiopathic arthritis: a 10-year single-center retrospective study.

PubMed

Peters, Shannon E; Laxer, Ronald M; Connolly, Bairbre L; Parra, Dimitri A

2017-04-11

The aims of this study were to: (a) Identify tendon sheaths most commonly treated with steroid injections in a pediatric patient population with Juvenile Idiopathic Arthritis (JIA); (b) Describe technical aspects of the procedure; (c) Characterize sonographic appearance of tenosynovitis in JIA; (d) Assess agreement between clinical request and sites injected. This was a 10 year single-center retrospective study (May 2006-April 2016) of patients with JIA referred by Rheumatology for ultrasound-guided tendon sheath injections. Patient demographics, clinical referral information, sonographic appearance of the tendon sheaths and technical aspects of the procedure were analyzed. There were 308 procedures of 244 patients (75% female, mean age 9.6 years) who underwent a total of 926 tendon sheath injections. Ankle tendons were most commonly injected (84.9%), specifically the tendon sheaths of tibialis posterior (22.3%), peroneus longus (20%) and brevis (19.7%). The majority of treated sites (91.9%) showed peritendinous fluid and sheath thickening on ultrasound. There were 2 minor intra-procedure complications without sequelae. A good agreement between clinical request and sites injected was observed. Ultrasound-guided tendon sheath injections with steroids are used frequently to treat patients with JIA. It is a safe intervention with a high technical success rate. The ankle region, specifically the medial compartment, is the site most commonly injected in this group of patients. The most common sonographic finding is peritendinous fluid and sheath thickening. These findings might assist clinicians and radiologists to characterize and more effectively manage tenosynovitis in patients with JIA.

Evaluation of chemical data from selected sites in the Surface-Water Ambient Monitoring Program (SWAMP) in Florida

USGS Publications Warehouse

Katz, B.G.; Collins, J.J.

1998-01-01

A cooperative study between the Florida Department of Environmental Protection (FDEP) and the U.S. Geological Survey was conducted to assess the integrity of selected water-quality data collected at 150 sites in the FDEP Surface-Water Ambient Monitoring Program (SWAMP) in Florida. The assessment included determining the consistency of the water-quality data collected statewide, including commonality of monitoring procedures and analytes, screening of the gross validity of a chemical analysis, and quality assurance and quality control (QA/QC) procedures. Four tests were used to screen data at selected SWAMP sites to estimate the gross validity of selected chemical data: (1) the ratio of dissolved solids (in milligrams per liter) to specific conductance (in microsiemens per centimeter); (2) the ratio of total cations (in milliequivalents per liter) multiplied by 100 to specific conductance (in microsiemens per centimeter); (3) the ratio of total anions (in milliequivalents per liter) multiplied by 100 to specific conductance (in microsiemens per centimeter); and (4) the ionic charge-balance error. Although the results of the four screening tests indicate that the chemical data generally are quite reliable, the extremely small number of samples (less than 5 percent of the total number of samples) with sufficient chemical information to run the tests may not provide a representative indication of the analytical accuracy of all laboratories in the program. In addition to the four screening tests, unusually low or high values were flagged for field and laboratory pH (less than 4.0 and greater than 9.0) and specific conductance (less than 10 and greater than 10,000 microsiemens per centimeter). The numbers of flagged data were less than 1 percent of the 19,937 water samples with pH values and less than 0.6 percent of the 16,553 water samples with specific conductance values. Thirty-four agencies responded to a detailed questionnaire that was sent to more than 60 agencies involved in the collection and analysis of surface-water-quality data for SWAMP. The purpose of the survey was to evaluate quality assurance methods and consistency of methods statewide. Information was compiled and summarized on monitoring network design, data review and upload procedures, laboratory and field sampling methods, and data practices. Currently, most agencies that responded to the survey follow FDEP-approved QA/QC protocol for sampling and have quality assurance practices for recording and reporting data. Also, most agencies responded that calibration procedures were followed in the laboratory for analysis of data, but no responses were given about the specific procedures. Approximately 50 percent of the respondents indicated that laboratory analysis methods have changed over time. With so many laboratories involved in analyzing samples for SWAMP, it is difficult to compare water quality from one site to another due to different reporting conventions for chemical constituents and different analytical methods over time. Most agencies responded that calibration methods are followed in the field, but no specific details were provided. Grab samples are the most common method of collection. Other data screening procedures are necessary to further evaluate the validity of chemical data collected at SWAMP sites. High variability in the concentration of targeted constituents may signal analytical problems, but more likely changes in concentration are related to hydrologic conditions. This underscores the need for accurate measurements of discharge, lake stage, tidal stage at the time of sampling so that changes in constituent concentrations can be properly evaluated and fluxes (loads) of nutrients or metals, for example, can be calculated and compared over time.

Site-specific integration of Streptomyces PhiC31 integrase-based vectors in the chromosome of Rhodococcus equi.

PubMed

Hong, Yang; Hondalus, Mary K

2008-10-01

Streptomyces PhiC31-based site-specific integration was used to transform the facultative intracellular pathogen Rhodococcus equi. The transformation efficiency of vectors incorporating the PhiC31 integrase and attP sites was comparable to that of replication plasmids using the same electroporation procedure. A single attB integration site was identified within an ORF encoding a pirin-like protein, which deviates slightly from the consensus sequence of Streptomyces attB sites. Vector integration was stably maintained in the R. equi chromosome for as many as 100 generations during unselected passage in vitro. In addition, integration does not appear to affect the replication of bacteria inside macrophages. Finally, this integration system was also used to successfully complement an R. equi mutant.

Highly Concurrent Scalar Processing.

DTIC Science & Technology

1986-01-01

rearrangement arise from data dependencies between instructions, hence it is critical that artificial - dependencies are eliminated whenever possible...An important class of artificial depen- *. dencies arise due to register reuse. In the following example, no parallelism can be • . exploited in the...specific procedure call site. The use of inteligent procedure expansion techniques is expected to be crucial to the achievement of high performance

Immunogold staining procedure for the localisation of regulatory peptides.

PubMed

Varndell, I M; Tapia, F J; Probert, L; Buchan, A M; Gu, J; De Mey, J; Bloom, S R; Polak, J M

1982-01-01

The use of protein A- and IgG-conjugated colloidal gold staining methods for the immuno-localisation of peptide hormones and neurotransmitters at light- and electron microscope level are described and discussed. Bright-field and dark-ground illumination modes have been used to visualise the gold-labelled antigenic sites at the light microscope level. Immunogold staining procedures at the ultrastructural level using region-specific antisera have been adopted to localise specific molecular forms of peptides including gastrin (G17 and G34), glucagon and pro-glucagon, insulin and pro-insulin, in normal tissue and in tumours of the gastroenteropancreatic system. Similar methods have been used to demonstrate the heterogeneity of p-type nerves in the enteric nervous system. Vasoactive intestinal polypeptide (VIP) has been localised to granular sites (mean +/- S.D. granule diameter = 98 +/- 19 nm) in nerve terminals of the enteric plexuses and in tumour cells of diarrhoeogenic VIP-producing neoplasias (mean +/- S.D. granule diameter = 126 +/- 37 nm) using immunogold procedures applied to ultraviolet-cured ultrathin sections. Co-localisation of amines and peptides in carotid body type I cells and in chromaffin cells of normal adrenal medulla and phaeochromocytomas has also been demonstrated. Advantages of the immunogold procedures over alternative immunocytochemical techniques are discussed.

Agricultural areas in potentially contaminated sites: characterization, risk, management.

PubMed

Vanni, Fabiana; Scaini, Federica; Beccaloni, Eleonora

2016-01-01

In Italy, the current legislation for contaminants in soils provides two land uses: residential/public or private gardens and commercial/industrial; there are not specific reference values for agricultural soils, even if a special decree has been developed and is currently going through the legislative approval process. The topic of agricultural areas is relevant, also in consideration of their presence near potentially contaminated sites. Aim and results. In this paper, contamination sources and transport modes of contaminants from sources to the target in agricultural areas are examined and a suitable "conceptual model" to define appropriate characterization methods and risk assessment procedures is proposed. These procedures have already been used by the National Institute of Health in various Italian areas characterized by different agricultural settings. Finally, specific remediation techniques are suggested to preserve soil resources and, if possible, its particular land use.

WIPP waste characterization program sampling and analysis guidance manual

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

Not Available

1991-01-01

The Waste Isolation Pilot Plant (WIPP) Waste Characterization Program Sampling and Analysis Guidance Manual (Guidance Manual) provides a unified source of information on the sampling and analytical techniques that enable Department of Energy (DOE) facilities to comply with the requirements established in the current revision of the Quality Assurance Program Plan (QAPP) for the WIPP Experimental-Waste Characterization Program (the Program). This Guidance Manual includes all of the sampling and testing methodologies accepted by the WIPP Project Office (DOE/WPO) for use in implementing the Program requirements specified in the QAPP. This includes methods for characterizing representative samples of transuranic (TRU) wastesmore » at DOE generator sites with respect to the gas generation controlling variables defined in the WIPP bin-scale and alcove test plans, as well as waste container headspace gas sampling and analytical procedures to support waste characterization requirements under the WIPP test program and the Resource Conservation and Recovery Act (RCRA). The procedures in this Guidance Manual are comprehensive and detailed and are designed to provide the necessary guidance for the preparation of site specific procedures. The use of these procedures is intended to provide the necessary sensitivity, specificity, precision, and comparability of analyses and test results. The solutions to achieving specific program objectives will depend upon facility constraints, compliance with DOE Orders and DOE facilities' operating contractor requirements, and the knowledge and experience of the TRU waste handlers and analysts. With some analytical methods, such as gas chromatography/mass spectrometry, the Guidance Manual procedures may be used directly. With other methods, such as nondestructive/destructive characterization, the Guidance Manual provides guidance rather than a step-by-step procedure.« less

Site-specific protein labeling with PRIME and chelation-assisted Click chemistry

PubMed Central

Uttamapinant, Chayasith; Sanchez, Mateo I.; Liu, Daniel S.; Yao, Jennifer Z.; White, Katharine A.; Grecian, Scott; Clarke, Scott; Gee, Kyle R.; Ting, Alice Y.

2016-01-01

This protocol describes an efficient method to site-specifically label cell-surface or purified proteins with chemical probes in two steps: PRobe Incorporation Mediated by Enzymes (PRIME) followed by chelation-assisted copper-catalyzed azide-alkyne cycloaddition (CuAAC). In the PRIME step, Escherichia coli lipoic acid ligase site-specifically attaches a picolyl azide derivative to a 13-amino acid recognition sequence that has been genetically fused onto the protein of interest. Proteins bearing picolyl azide are chemoselectively derivatized with an alkyne-probe conjugate by chelation-assisted CuAAC in the second step. We describe herein the optimized protocols to synthesize picolyl azide, perform PRIME labeling, and achieve CuAAC derivatization of picolyl azide on live cells, fixed cells, and purified proteins. Reagent preparations, including synthesis of picolyl azide probes and expression of lipoic acid ligase, take 12 d, while the procedure to perform site-specific picolyl azide ligation and CuAAC on cells or on purified proteins takes 40 min-3 h. PMID:23887180

Guidelines and standard procedures for continuous water-quality monitors: Site selection, field operation, calibration, record computation, and reporting

USGS Publications Warehouse

Wagner, Richard J.; Mattraw, Harold C.; Ritz, George F.; Smith, Brett A.

2000-01-01

The U.S. Geological Survey uses continuous water-quality monitors to assess variations in the quality of the Nation's surface water. A common system configuration for data collection is the four-parameter water-quality monitoring system, which collects temperature, specific conductance, dissolved oxygen, and pH data, although systems can be configured to measure other properties such as turbidity or chlorophyll. The sensors that are used to measure these water properties require careful field observation, cleaning, and calibration procedures, as well as thorough procedures for the computation and publication of final records. Data from sensors can be used in conjunction with collected samples and chemical analyses to estimate chemical loads. This report provides guidelines for site-selection considerations, sensor test methods, field procedures, error correction, data computation, and review and publication processes. These procedures have evolved over the past three decades, and the process continues to evolve with newer technologies.

48 CFR 307.104 - General procedures.

Code of Federal Regulations, 2011 CFR

2011-10-01

... regarding the specific acquisition method the contracting activity plans to use. (5) HHS requires use of a standard format for an AAP. The template for the plan is available on the ASFR/OGAPA/DA Internet Web site...

Association of Airborne Microorganisms in the Operating Room With Implant Infections: A Randomized Controlled Trial.

PubMed

Darouiche, Rabih O; Green, David M; Harrington, Melvyn A; Ehni, Bruce L; Kougias, Panagiotis; Bechara, Carlos F; O'Connor, Daniel P

2017-01-01

OBJECTIVE To evaluate the association of airborne colony-forming units (CFU) at incision sites during implantation of prostheses with the incidence of either incisional or prosthesis-related surgical site infections. DESIGN Randomized, controlled trial. SETTING Primary, public institution. PATIENTS Three hundred patients undergoing total hip arthroplasty, instrumented spinal procedures, or vascular bypass graft implantation. METHODS Patients were randomly assigned in a 1:1 ratio to either the intervention group or the control group. A novel device (Air Barrier System), previously shown to reduce airborne CFU at incision sites, was utilized in the intervention group. Procedures assigned to the control group were performed without the device, under routine operating room atmospheric conditions. Patients were followed up for 12 months to determine whether airborne CFU levels at the incision sites predicted the incidence of incisional or prosthesis-related infection. RESULTS Data were available for 294 patients, 148 in the intervention group and 146 in the control group. CFU density at the incision site was significantly lower in the intervention group than in the control group (P<.001). The density of airborne CFU at the incision site during the procedures was significantly related to the incidence of implant infection (P=.021). Airborne CFU densities were 4 times greater in procedures with implant infection versus no implant infection. All 4 of the observed prosthesis infections occurred in the control group. CONCLUSION Reduction of airborne CFU specifically at the incision site during operations may be an effective strategy to reduce prosthesis-related infections. clinicaltrials.gov Identifier: NCT01610271 Infect Control Hosp Epidemiol 2016;1-8.

Treatment of RDX and/or HMX Using Mulch Biowalls

DTIC Science & Technology

2008-04-01

industrial classification TAL target analyte list TCE trichloroethene TCLP toxicity characteristic leachate procedure TNB 1,3,5-Trinitobenzene TNT... leachate procedure (TCLP) testing results for the mulch fill in the site-specific treatability phase confirmed no leaching of the target...0.01% 1 ɘ.001% 0.1% * i. Presence of other remediation technologies in the immediate vicinity No 4 No Yes, active phytoremediation in Pink Water

Association of postdischarge complications with reoperation and mortality in general surgery.

PubMed

Kazaure, Hadiza S; Roman, Sanziana A; Sosa, Julie A

2012-11-01

To describe procedure-specific types, rates, and risk factors for postdischarge (PD) complications occurring within 30 days after 21 groups of inpatient general surgery procedures. Retrospective cohort study. American College of Surgeons National Surgical Quality Improvement Program 2005 through 2010 Participant Use Data Files. A total of 551,510 adult patients who underwent one of 21 groups of general surgery procedures in the inpatient setting. Postdischarge complications, reoperation, and mortality. Of 551,510 patients (mean age, 54.6 years), 16.7% experienced a complication; 41.5% occurred PD. Of the PD complications, 75.0% occurred within 14 days PD. Proctectomy (14.5%), enteric fistula repair (12.6%), and pancreatic procedures (11.4%) had the highest PD complication rates. Breast, bariatric, and ventral hernia repair procedures had the highest proportions of complications that occurred PD (78.7%, 69.4%, and 62.0%, respectively). For all procedures, surgical site complications, infections, and thromboembolic events were the most common. Occurrence of an inpatient complication increased the likelihood of a PD complication (12.5% vs 6.2% without an inpatient complication; P < .001). Compared with patients without a PD complication, those with a PD complication had higher rates of reoperation (4.6% vs 17.9%, respectively; P < .001) and death (2.0% vs 6.9%, respectively; P < .001) within 30 days after surgery; those whose PD complication was preceded by an inpatient complication had the highest rates of reoperation (33.7%) and death (24.7%) (all P < .001). After adjustment, PD complications were associated with procedure type, American Society of Anesthesiologists class higher than 3, and steroid use. The PD complication rates vary by procedure, are commonly surgical site related, and are associated with mortality. Fastidious, procedure-specific patient triage at discharge as well as expedited patient follow-up could improve PD outcomes.

Filtration of water-sediment samples for the determination of organic compounds

USGS Publications Warehouse

Sandstrom, Mark W.

1995-01-01

This report describes the equipment and procedures used for on-site filtration of surface-water and ground-water samples for determination of organic compounds. Glass-fiber filters and a positive displacement pumping system are suitable for processing most samples for organic analyses. An optional system that uses disposable in-line membrane filters is suitable for a specific gas chromatography/mass spectrometry, selected-ion monitoring analytical method for determination of organonitrogen herbicides. General procedures to minimize contamination of the samples include preparing a clean workspace at the site, selecting appropriate sample-collection materials, and cleaning of the equipment with detergent, tap water, and methanol.

Fall Protection Procedures for Sealing Bulk Waste Shipments by Rail Cars at Formerly Utilized Sites Remedial Action Program (FUSRAP) Sites - 13509

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

Boyle, J.D.; Fort, E. Joseph; Lorenz, William

2013-07-01

Rail-cars loaded with radioactive materials must be closed and fastened to comply with United States Department of Transportation (DOT) requirements before they shipped. Securing waste shipments in a manner that meets these regulations typically results in the use of a sealable rail-car liner. Workers accessing the tops of the 2.74 m high rail-cars to seal and inspect liners for compliance prior to shipment may be exposed to a fall hazard. Relatively recent revisions to the Fall Protection requirements in the Safety and Health Requirements Manual (EM385-1-1, U.S. Army Corps of Engineers) have necessitated modifications to the fall protection systems previouslymore » employed for rail-car loading at Formerly Utilized Sites Remedial Action Program (FUSRAP) sites. In response these projects have developed site-specific procedures to protect workers and maintain compliance with the improved fall protection regulations. (authors)« less

Administrative goals and safety standards for hazard control on forested recreation sites

Treesearch

Lee A. Paine

1973-01-01

For efficient control of tree hazard on recreation sites, a specific administrative goal must be selected. A safety standard designed to achieve the selected goal and a uniform hazard-rating procedure will then promote a consistent level of safety at an acceptable cost. Safety standards can be established with the aid of data for past years, and dollar evaluations are...

The modified stepwise ablation guided by low-dose ibutilide in chronic atrial fibrillation trial (The MAGIC-AF Study).

PubMed

Singh, Sheldon M; d'Avila, Andre; Kim, Young-Hoon; Aryana, Arash; Mangrum, J Michael; Michaud, Gregory F; Dukkipati, Srinivas R; Barrett, Conor D; Heist, E Kevin; Parides, Michael K; Thorpe, Kevin E; Reddy, Vivek Y

2016-05-21

Complex fractionated atrial electrograms (CFAE) are targeted during persistent atrial fibrillation (AF) ablation. However, many CFAE sites are non-specific resulting in extensive ablation. Ibutilide has been shown to reduce left atrial surface area exhibiting CFAE. We hypothesized that ibutilide administration prior to CFAE ablation would identify sites critical for persistent AF maintenance allowing for improved procedural efficacy and long-term freedom from atrial arrhythmias. Two hundred patients undergoing a first-ever persistent AF catheter ablation procedure were randomly assigned to receive either 0.25 mg of intravenous ibutilide or saline placebo upon completion of pulmonary vein isolation. Complex fractionated atrial electrogram sites were then targeted with ablation. The primary efficacy endpoint was the 1-year single procedure freedom from atrial arrhythmia off anti-arrhythmic drugs. Similar procedural characteristics (procedure, fluoroscopy, and ablation times) were observed with both strategies despite a greater reduction in left atrial surface area with CFAE sites (8 vs. 1%, P < 0.0001) and AF termination during CFAE ablation with ibutilide compared with placebo (75 vs. 57%, P = 0.007). The primary efficacy endpoint was achieved in 56% of patients receiving ibutilide and 49% receiving placebo (P = 0.35). No significant differences in peri-procedural complications were observed in both groups. Despite a reduction in CFAE area and greater AF termination during CFAE ablation, procedural characteristics and clinical outcomes were unchanged when CFAE ablation was guided by ibutilide administration. ClinicalTrials.gov number: NCT01014741. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

Site-Specific Pyrolysis Induced Cleavage at Aspartic Acid Residue in Peptides and Proteins

PubMed Central

Zhang, Shaofeng; Basile, Franco

2011-01-01

A simple and site-specific non-enzymatic method based on pyrolysis has been developed to cleave peptides and proteins. Pyrolytic cleavage was found to be specific and rapid as it induced a cleavage at the C-terminal side of aspartic acid in the temperature range of 220–250 °C in 10 seconds. Electrospray Ionization (ESI) mass spectrometry (MS) and tandem-MS (MS/MS) were used to characterize and identify pyrolysis cleavage products, confirming that sequence information is conserved after the pyrolysis process in both peptides and protein tested. This suggests that pyrolysis-induced cleavage at aspartyl residues can be used as a rapid protein digestion procedure for the generation of sequence specific protein biomarkers. PMID:17388620

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

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

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

1995-06-01

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

Time-saving impact of an algorithm to identify potential surgical site infections.

PubMed

Knepper, B C; Young, H; Jenkins, T C; Price, C S

2013-10-01

To develop and validate a partially automated algorithm to identify surgical site infections (SSIs) using commonly available electronic data to reduce manual chart review. Retrospective cohort study of patients undergoing specific surgical procedures over a 4-year period from 2007 through 2010 (algorithm development cohort) or over a 3-month period from January 2011 through March 2011 (algorithm validation cohort). A single academic safety-net hospital in a major metropolitan area. Patients undergoing at least 1 included surgical procedure during the study period. Procedures were identified in the National Healthcare Safety Network; SSIs were identified by manual chart review. Commonly available electronic data, including microbiologic, laboratory, and administrative data, were identified via a clinical data warehouse. Algorithms using combinations of these electronic variables were constructed and assessed for their ability to identify SSIs and reduce chart review. The most efficient algorithm identified in the development cohort combined microbiologic data with postoperative procedure and diagnosis codes. This algorithm resulted in 100% sensitivity and 85% specificity. Time savings from the algorithm was almost 600 person-hours of chart review. The algorithm demonstrated similar sensitivity on application to the validation cohort. A partially automated algorithm to identify potential SSIs was highly sensitive and dramatically reduced the amount of manual chart review required of infection control personnel during SSI surveillance.

Simple Protein Modification Using Zwitterionic Polymer to Mitigate the Bioactivity Loss of Conjugated Insulin.

PubMed

Xie, Jinbing; Lu, Yang; Wang, Wei; Zhu, Hui; Wang, Zhigang; Cao, Zhiqiang

2017-06-01

Polymer-protein conjugation has been extensively explored toward a better protein drug with improved pharmacokinetics. However, a major problem with polymer-protein conjugation is that the polymers drastically reduce the bioactivity of the modified protein. There is no perfect solution to prevent the bioactivity loss, no matter the polymer is conjugated in a non-site specific way, or a more complex site-specific procedure. Here the authors report for the first time that when zwitterionic carboxybetaine polymer (PCB) is conjugated to insulin through simple conventional coupling chemistry. The resulting PCB-insulin does not show a significant reduction of in vitro bioactivity. The obtained PCB-insulin shows two significant advantages as a novel pharmaceutical agent. First, its therapeutic performance is remarkable. For PCB-insulin, there is a 24% increase of in vivo pharmacological activity of lowering blood glucose compared with native insulin. Such uncommonly seen increase has rarely been reported and is expected to be due to both the improved pharmacokinetics and retained bioactivity of PCB-insulin. Second, the production is simple from manufacturing standpoints. Conjugation procedure involves only one-step coupling reaction without complex site-specific linkage technique. The synthesized PCB-insulin conjugates do not require chromatographic separation to purify and obtain particular isoforms. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Introduction to the Centers for Disease Control and Prevention and the Healthcare Infection Control Practices Advisory Committee Guideline for the Prevention of Surgical Site Infections.

PubMed

Solomkin, Joseph S; Mazuski, John; Blanchard, Joan C; Itani, Kamal M F; Ricks, Philip; Dellinger, E Patchen; Allen, George; Kelz, Rachel; Reinke, Caroline E; Berríos-Torres, Sandra I

Surgical site infection (SSI) is a common type of health-care-associated infection (HAI) and adds considerably to the individual, social, and economic costs of surgical treatment. This document serves to introduce the updated Guideline for the Prevention of SSI from the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC). The Core section of the guideline addresses issues relevant to multiple surgical specialties and procedures. The second procedure-specific section focuses on a high-volume, high-burden procedure: Prosthetic joint arthroplasty. While many elements of the 1999 guideline remain current, others warrant updating to incorporate new knowledge and changes in the patient population, operative techniques, emerging pathogens, and guideline development methodology.

Improving patient safety during insertion of peripheral venous catheters: an observational intervention study.

PubMed

Kampf, Günter; Reise, Gesche; James, Claudia; Gittelbauer, Kirsten; Gosch, Jutta; Alpers, Birgit

2013-01-01

Peripheral venous catheters are frequently used in hospitalized patients but increase the risk of nosocomial bloodstream infection. Evidence-based guidelines describe specific steps that are known to reduce infection risk. However, the degree of guideline implementation in clinical practice is not known. The aim of this study was to determine the use of specific steps for insertion of peripheral venous catheters in clinical practice and to implement a multimodal intervention aimed at improving both compliance and the optimum order of the steps. The study was conducted at University Hospital Hamburg. An optimum procedure for inserting a peripheral venous catheter was defined based on three evidence-based guidelines (WHO, CDC, RKI) including five steps with 1A or 1B level of evidence: hand disinfection before patient contact, skin antisepsis of the puncture site, no palpation of treated puncture site, hand disinfection before aseptic procedure, and sterile dressing on the puncture site. A research nurse observed and recorded procedures for peripheral venous catheter insertion for healthcare workers in four different departments (endoscopy, central emergency admissions, pediatrics, and dermatology). A multimodal intervention with 5 elements was established (teaching session, dummy training, e-learning tool, tablet and poster, and direct feedback), followed by a second observation period. During the last observation week, participants evaluated the intervention. In the control period, 207 insertions were observed, and 202 in the intervention period. Compliance improved significantly for four of five steps (e.g., from 11.6% to 57.9% for hand disinfection before patient contact; p<0.001, chi-square test). Compliance with skin antisepsis of the puncture site was high before and after intervention (99.5% before and 99.0% after). Performance of specific steps in the correct order also improved (e.g., from 7.7% to 68.6% when three of five steps were done; p<0.001). The intervention was described as helpful by 46.8% of the participants, as neutral by 46.8%, and as disruptive by 6.4%. A multimodal strategy to improve both compliance with safety steps for peripheral venous catheter insertion and performance of an optimum procedure was effective and was regarded helpful by healthcare workers.

WAG 2 remedial investigation and site investigation site-specific work plan/health and safety checklist for the soil and sediment task. Environmental Restoration Program

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

Holt, V.L.; Burgoa, B.B.

1993-12-01

This document is a site-specific work plan/health and safety checklist (WP/HSC) for a task of the Waste Area Grouping 2 Remedial Investigation and Site Investigation (WAG 2 RI&SI). Title 29 CFR Part 1910.120 requires that a health and safety program plan that includes site- and task-specific information be completed to ensure conformance with health- and safety-related requirements. To meet this requirement, the health and safety program plan for each WAG 2 RI&SI field task must include (1) the general health and safety program plan for all WAG 2 RI&SI field activities and (2) a WP/HSC for that particular field task.more » These two components, along with all applicable referenced procedures, must be kept together at the work site and distributed to field personnel as required. The general health and safety program plan is the Health and Safety Plan for the Remedial Investigation and Site Investigation of Waste Area Grouping 2 at the Oak Ridge National Laboratory, Oak Ridge, Tennessee (ORNL/ER-169). The WP/HSCs are being issued as supplements to ORNL/ER-169.« less

Caring Letters for Military Suicide Prevention: A Randomized Controlled Trial

DTIC Science & Technology

2014-02-01

Scale (Wright, Cabrera, Bliese, Adler, Hoge, & Castro, 2009) in order to examine how thwarted belongingness , perceived burdensomeness, capability for... belongingness , perceived burdensomeness, capability for lethal self-injury, and suicidal behavior will also be examined. We will use latent variable...specific safety rules and procedures to follow in order to maintain a safe 23 environment for the participants and employees . Site specific

40 CFR 62.14620 - What site-specific documentation is required?

Code of Federal Regulations, 2010 CFR

2010-07-01

... the incinerator and associated air pollution control systems within the standards established under... required? 62.14620 Section 62.14620 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED...) Procedures for receiving, handling, and charging waste. (3) Incinerator startup, shutdown, and malfunction...

PHL7/441: Fixing a Broken Line between the Perceived "Anarchy" of the Web and a Process-Comfortable Pharmaceutical Company

PubMed Central

Vercellesi, L

1999-01-01

Introduction In 1998 a pharmaceutical company published its Web site to provide: an institutional presence multifunctional information to primary customers and general public a new way of access to the company a link to existing company-sponsored sites a platform for future projects Since the publication, some significant integration have been added; in particular one is a primary interactive service, addressed to a selected audience. The need has been felt to foster new projects and establish the idea of routinely considering the site as a potential tool in the marketing mix, to provide advanced services to customers. Methods Re-assessment of the site towards objectives. Assessment of its perception with company potential suppliers. Results The issue "web use" was discussed in various management meetings; the trend of use of Internet among the primary customers was known; major concerns expressed were about staffing and return of investment for activities run in the Web. These perceptions are being addressed by making the company more comfortable by: Running the site through a detailed process and clear procedures, defining A new process of maintenance of the site, involving representatives of all the functions. Procedures and guidelines. A master file of approved answers and company contacts. Categories of activities (information, promotion, education, information to investors, general services, target-specific services). Measures for all the activities run in the Web site Specifically for the Web site a concise periodical report is being assessed, covering 1. Statistics about hits and mails, compared to the corporate data. Indication of new items published. Description by the "supplier" of new or ongoing innovative projects, to transfer best practice. Basic figures on the Italian trend in internet use and specifically in the pharmaceutical and medical fields. Comments to a few competitor sites. Examples of potential uses deriving from other Web sites. Discussion The comparatively low use of Internet in Italy has affected the systematic professional exploitation of the company site. The definition of "anarchic" commonly linked to the Web by local media has lead to the attempt to "master" and "normalize" the site with a stricter approach than usual: most procedures and guidelines have been designed from scratch as not available for similar activities traditionally run. A short set of information has been requested for inclusion in the report: its wide coverage will help to receive a flavour of the global parallel new world developing in the net. Hopefully this approach will help to create a comfortable attitude towards the medium in the whole organisation and to acquire a working experience with the net.

Sampling protocol for monitoring abiotic and biotic characteristics of mountain ponds and lakes

USGS Publications Warehouse

Hoffman, Robert L.; Tyler, Torrey J.; Larson, Gary L.; Adams, Michael J.; Wente, Wendy; Galvan, Stephanie

2005-01-01

This document describes field techniques and procedures used for sampling mountain ponds and lakes. These techniques and procedures will be used primarily to monitor, as part of long-term programs in National Parks and other protected areas, the abiotic and biotic characteristics of naturally occurring permanent montane lentic systems up to 75 ha in surface area. However, the techniques and procedures described herein also can be used to sample temporary or ephemeral montane lentic sites. Each Standard Operating Procedure (SOP) section addresses a specific component of the limnological investigation, and describes in detail field sampling methods pertaining to parameters to be measured for each component.

Using MCDA and GIS for hazardous waste landfill siting considering land scarcity for waste disposal.

PubMed

De Feo, Giovanni; De Gisi, Sabino

2014-11-01

The main aim of this study was to develop a procedure that minimizes the wasting of space for the siting of hazardous waste landfills as part of a solid waste management system. We wanted to tackle the shortage of land for waste disposal that is a serious and growing problem in most large urban regions. The procedure combines a multi-criteria decision analysis (MCDA) approach with a geographical information system (GIS). The GIS was utilised to obtain an initial screening in order to eliminate unsuitable areas, whereas the MCDA was developed to select the most suitable sites. The novelty of the proposed siting procedure is the introduction of a new screening phase before the macro-siting step aimed at producing a "land use map of potentially suitable areas" for the siting of solid waste facilities which simultaneously takes into consideration all plant types. The issue of obtaining sites evaluations of a specific facility was coupled with the issue of not wasting land appropriate to facilitate other types of waste management options. In the developed case study, the use of an innovative criteria weighting tool (the "Priority Scale") in combination with the Analytic Hierarchy Process was useful to easier define the priorities of the evaluation criteria in comparison with other classic methods such as the Paired Comparison Technique in combination with the Simple Additive Weighting method. Copyright © 2014 Elsevier Ltd. All rights reserved.

Using MCDA and GIS for hazardous waste landfill siting considering land scarcity for waste disposal

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

Feo, Giovanni De, E-mail: g.defeo@unisa.it; Gisi, Sabino De

Highlights: • Wasting land for the siting of hazardous waste landfills must be avoided. • The siting procedure is based on a land use map of potentially suitable areas. • All the waste facilities of the management system are simultaneously considered. • A case study is developed considering two multi-criteria techniques. • An innovative criteria weighting tool (PSW) is used in combination with the AHP. - Abstract: The main aim of this study was to develop a procedure that minimizes the wasting of space for the siting of hazardous waste landfills as part of a solid waste management system. Wemore » wanted to tackle the shortage of land for waste disposal that is a serious and growing problem in most large urban regions. The procedure combines a multi-criteria decision analysis (MCDA) approach with a geographical information system (GIS). The GIS was utilised to obtain an initial screening in order to eliminate unsuitable areas, whereas the MCDA was developed to select the most suitable sites. The novelty of the proposed siting procedure is the introduction of a new screening phase before the macro-siting step aimed at producing a “land use map of potentially suitable areas” for the siting of solid waste facilities which simultaneously takes into consideration all plant types. The issue of obtaining sites evaluations of a specific facility was coupled with the issue of not wasting land appropriate to facilitate other types of waste management options. In the developed case study, the use of an innovative criteria weighting tool (the “Priority Scale”) in combination with the Analytic Hierarchy Process was useful to easier define the priorities of the evaluation criteria in comparison with other classic methods such as the Paired Comparison Technique in combination with the Simple Additive Weighting method.« less

Epidemiology of Surgical Site Infections With Staphylococcus aureus in Europe: Protocol for a Retrospective, Multicenter Study.

PubMed

Mellinghoff, Sibylle C; Vehreschild, Jörg Janne; Liss, Blasius J; Cornely, Oliver A

2018-03-12

Surgical site infections (SSIs) are among the most common hospital acquired infections. While the incidence of SSI in certain indicator procedures is the subject of ongoing surveillance efforts in hospitals and health care systems around the world, SSI rates vary markedly within surgical categories and are poorly represented by routinely monitored indicator procedures (eg, mastectomy or hernia surgery). Therefore, relying on indicator procedures to estimate the burden of SSI is imprecise and introduces bias as hospitals may take special precautions to achieve lower SSI rates. The most common cause of SSI is Staphylococcus aureus (S. aureus), as recently confirmed by a Europe-wide point-prevalence study conducted by the European Centre for Disease Prevention and Control (ECDC). The primary objective of this study is to determine the overall and procedure-specific incidence of S. aureus SSI in Europe. Secondary objectives are the overall and procedure-specific outcomes as well as the economic burden of S. aureus SSI in Europe. Explorative objectives are to characterize the composition of the surgical patient population and to estimate the number of patients at risk for S. aureus SSI. A retrospective, multinational, multicenter cohort study (Staphylococcus aureus Surgical Site Infection Multinational Epidemiology in Europe [SALT] study) with a nested case-control part will be conducted. The study will include all surgical procedures at a participating center in order to prevent selection bias and strengthen the understanding of SSI risk by determining the incidence for all common surgical procedures. Data will be assessed in the cohort population, including 150,000 adult patients who underwent any surgical procedure in 2016, and the case-control population. We will match patients establishing S. aureus SSI 1:1 with controls from the same center. Data on demographics, surgery, and microbiology will be exported from electronic files. More detailed data will be captured from the case-control population. The SALT study will include 13 major or academic surgical centers in Europe, comprising 3 in France, 4 in Germany, 2 in Italy, 3 in Spain, and 1 in the United Kingdom. Sites were selected using a feasibility questionnaire. The SALT study is currently recruiting patients. The aim is to complete recruitment in February 2018 and to close the database in September 2018. The final results are expected by the end of 2018. Results of the SALT study will help to better understand the precise risk of certain procedures. They will also provide insight into the overall and procedure-specific incidence and outcome as well as the economic burden of S. aureus SSI in Europe. Findings of the study may help guide the design of clinical trials for S. aureus vaccines. ClinicalTrials.gov NCT03353532; https://clinicaltrials.gov/ct2/show/NCT03353532 (Archived by WebCite at http://www.webcitation.org/6xAK3gVmO). ©Sibylle C Mellinghoff, Jörg Janne Vehreschild, Blasius J Liss, Oliver A Cornely. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 12.03.2018.

31 CFR 589.501 - General and specific licensing procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... chapter. Licensing actions taken pursuant to part 501 of this chapter with respect to the prohibitions contained in this part are considered actions taken pursuant to this part. General licenses and statements... page on OFAC's Web site: www.treasury.gov/ofac. ...

18 CFR 50.5 - Pre-filing procedures.

Code of Federal Regulations, 2011 CFR

2011-04-01

... to prepare the environmental documentation for the project and the specifications for the applicant's... showing all major components, including a description of zoning and site availability for any permanent... environmental reviews and authorizations for the project, including contact names and telephone numbers, and a...

7 CFR 1726.404 - Non-site specific construction contract closeout.

Code of Federal Regulations, 2014 CFR

2014-01-01

... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Contract... equipment is supplied under a construction contract, the borrower (acting through its engineer, if... equipment. The borrower (acting through its engineer, if applicable) will schedule such inspection and...

7 CFR 1726.404 - Non-site specific construction contract closeout.

Code of Federal Regulations, 2010 CFR

2010-01-01

... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Contract... equipment is supplied under a construction contract, the borrower (acting through its engineer, if... equipment. The borrower (acting through its engineer, if applicable) will schedule such inspection and...

7 CFR 1726.404 - Non-site specific construction contract closeout.

Code of Federal Regulations, 2011 CFR

2011-01-01

... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Contract... equipment is supplied under a construction contract, the borrower (acting through its engineer, if... equipment. The borrower (acting through its engineer, if applicable) will schedule such inspection and...

7 CFR 1726.404 - Non-site specific construction contract closeout.

Code of Federal Regulations, 2012 CFR

2012-01-01

... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Contract... equipment is supplied under a construction contract, the borrower (acting through its engineer, if... equipment. The borrower (acting through its engineer, if applicable) will schedule such inspection and...

7 CFR 1726.404 - Non-site specific construction contract closeout.

Code of Federal Regulations, 2013 CFR

2013-01-01

... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ELECTRIC SYSTEM CONSTRUCTION POLICIES AND PROCEDURES Contract... equipment is supplied under a construction contract, the borrower (acting through its engineer, if... equipment. The borrower (acting through its engineer, if applicable) will schedule such inspection and...

40 CFR 60.2910 - What site-specific documentation is required?

Code of Federal Regulations, 2010 CFR

2010-07-01

... the incinerator and associated air pollution control systems within the standards established under... required? 60.2910 Section 60.2910 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR...) Procedures for receiving, handling, and charging waste. (3) Incinerator startup, shutdown, and malfunction...

Site-specific seismic ground motion analyses for transportation infrastructure in the New Madrid seismic zone.

DOT National Transportation Integrated Search

2012-11-01

Generic, code-based design procedures cannot account for the anticipated short-period attenuation and long-period amplification of earthquake ground motions in the deep, soft sediments of the Mississippi Embayment within the New Madrid Seismic Zone (...

Biosecurity procedures for the environmental management of carcasses burial sites in Korea.

PubMed

Kim, Geon-Ha; Pramanik, Sudipta

2016-12-01

Avian influenza and foot-and-mouth disease are two main contagious pathogenic viral disease which are responsible for the massive burials of livestock in Korea since burial is the primary measure to control these outbreaks. Biosecurity is a set of preventive measures designed to prevent the risk of spreading of these infectious diseases. The main objective of this paper is to discuss about the requirements of biosecurity and develop protocol outlines for environmental management of burial sites in Korea. Current practice prescribes to minimize the potential for on-farm pollution and the spread of the infectious diseases. Specific biosecurity procedures such as proper assessment of leachate quality, safe handling and disposal of leachate, adequate leachate pollution monitoring, necessary seasonal management of burial site, and appropriate sterilization process must be carried out to prevent the indirect transmission of pathogens from the burial sites. Policy makers should acquire robust knowledge of biosecurity for establishing more effective future legislation for carcasses disposal in Korea.

Cleanup protocol for 226Ra-contaminated cobbly soil at UMTRA Project sites

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

Gonzales, D.E.; Millard, J.B.; Miller, M.L.

The nonuniform distribution of 226Ra and other radiological contamination of cobbly soil encountered on several Uranium Mill Tailings Remedial Action Project sites is presented and discussed, and the concomitant challenges to the intent and implementation of the U.S. Environmental Protection Agency's soil cleanup standards are noted. In response to technical assessments and information presented to the U.S. Nuclear Regulatory Commission by the U.S. Department of Energy, the Nuclear Regulatory Commission has recently resolved the dilemma by concluding that compliance with Environmental Protection Agency soil cleanup standards for cobby soil at Uranium Mill Tailings Remedial Action Project sites would be adequatelymore » attained using bulk radionuclide concentrations, instead of requiring that the radionuclide concentration of the finer soil fraction passing a No. 4 mesh sieve met the standards. A Nuclear Regulatory Commission-approved procedure developed for cobbly soil remediation is outlined and discussed. The site-specific implementation of this procedure at Uranium Mill Tailings Remedial Action Project sites containing cobbly soil is estimated to save millions of dollars.« less

Nevada Applied Ecology Group procedures handbook for environmental transuranics

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

White, M.G.; Dunaway, P.B.

The activities of the Nevada Applied Ecology Group (NAEG) integrated research studies of environmental plutonium and other transuranics at the Nevada Test Site have required many standardized field and laboratory procedures. These include sampling techniques, collection and preparation, radiochemical and wet chemistry analysis, data bank storage and reporting, and statistical considerations for environmental samples of soil, vegetation, resuspended particles, animals, and others. This document, printed in two volumes, includes most of the Nevada Applied Ecology Group standard procedures, with explanations as to the specific applications involved in the environmental studies. Where there is more than one document concerning a procedure,more » it has been included to indicate special studies or applications perhaps more complex than the routine standard sampling procedures utilized.« less

Nevada Applied Ecology Group procedures handbook for environmental transuranics

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

White, M.G.; Dunaway, P.B.

The activities of the Nevada Applied Ecology Group (NAEG) integrated research studies of environmental plutonium and other transuranics at the Nevada Test Site have required many standardized field and laboratory procedures. These include sampling techniques, collection and preparation, radiochemical and wet chemistry analysis, data bank storage and reporting, and statistical considerations for environmental samples of soil, vegetation, resuspended particles, animals, and other biological material. This document, printed in two volumes, includes most of the Nevada Applied Ecology Group standard procedures, with explanations as to the specific applications involved in the environmental studies. Where there is more than one document concerningmore » a procedure, it has been included to indicate special studies or applications more complex than the routine standard sampling procedures utilized.« less

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.

The Development of Statistical Models for Predicting Surgical Site Infections in Japan: Toward a Statistical Model-Based Standardized Infection Ratio.

PubMed

Fukuda, Haruhisa; Kuroki, Manabu

2016-03-01

To develop and internally validate a surgical site infection (SSI) prediction model for Japan. Retrospective observational cohort study. We analyzed surveillance data submitted to the Japan Nosocomial Infections Surveillance system for patients who had undergone target surgical procedures from January 1, 2010, through December 31, 2012. Logistic regression analyses were used to develop statistical models for predicting SSIs. An SSI prediction model was constructed for each of the procedure categories by statistically selecting the appropriate risk factors from among the collected surveillance data and determining their optimal categorization. Standard bootstrapping techniques were applied to assess potential overfitting. The C-index was used to compare the predictive performances of the new statistical models with those of models based on conventional risk index variables. The study sample comprised 349,987 cases from 428 participant hospitals throughout Japan, and the overall SSI incidence was 7.0%. The C-indices of the new statistical models were significantly higher than those of the conventional risk index models in 21 (67.7%) of the 31 procedure categories (P<.05). No significant overfitting was detected. Japan-specific SSI prediction models were shown to generally have higher accuracy than conventional risk index models. These new models may have applications in assessing hospital performance and identifying high-risk patients in specific procedure categories.

[Microbiological surveillance in an intensive care unit of a large Roman hospital].

PubMed

Franchi, Cristiana; Venditti, Mario; Rocco, Monica; Spadetta, Gustavo; Vullo, Vincenzo; Raponi, Massimiliano; Orsi, Giovanni Battista

2002-06-01

Infection surveillance in ICU is fundamental to monitor endemic rates, to identify outbreaks on-time in order to activate control procedures implementing a correct empirical antibiotic treatment. The data collection surveillance software CIN-20002 was established in the Teaching Hospital Umberto I ICU to monitor the following site-specific infection rates: urinary tract infections (UTI), pneumonia (PNE), blood stream infections (BSI), surgical site infections (SSI). According to CDC definitions all patients developing infection 48 hours or more after ward admission were included. Furthermore risk factors (i.e. age, sex, SAPS II), invasive procedures (i.e. endotracheal intubation, vascular and urinary catheterisation), microbiological isolates and their antibiotic susceptibility were screened. Overall 279 patients (183 men and 96 women) were admitted; age 54,8 20,3 years (mean), SAPS II 44,4 17,1 (mean) and average ward stay 13,3 17,8 days. Results showed a total of 121 infection episodes (56 PNE, 51 BSI, 10 UTI e 4 SSI) in 80 patients (28,7%). Standardized infection rates associated to invasive procedures were: Urinary catheter-associated UTI rate (2.9/1000), Ventilator-associated PNE rate (20.4/1000), Vascular catheter-associated BSI rate (19.1/1000). Among the infected patients the most common microrganisms isolated were P. aeruginosa (31,8%), MRSA (14,8%), A. baumanni (12,5%) e S. maltophilia (8,5%). Considering site-specific infections: PNE (P. aeruginosa 38,3% and MRSA 18,1%), BSI (MR CNS 21,9% and P. aeruginosa 17,2%), UTI (P. aeruginosa 70,0%). The surveillance software CIN-2000 proved to be very accurate, usefull and easy to use. The results showed a high incidence of infections associated to invasive procedures and the presence of multiresistant bacteria

A revisitation of TRIX for trophic status assessment in the light of the European Water Framework Directive: application to Italian coastal waters.

PubMed

Pettine, Maurizio; Casentini, Barbara; Fazi, Stefano; Giovanardi, Franco; Pagnotta, Romano

2007-09-01

The trophic status classification of coastal waters at the European scale requires the availability of harmonised indicators and procedures. The composite trophic status index (TRIX) provides useful metrics for the assessment of the trophic status of coastal waters. It was originally developed for Italian coastal waters and then applied in many European seas (Adriatic, Tyrrhenian, Baltic, Black and Northern seas). The TRIX index does not fulfil the classification procedure suggested by the WFD for two reasons: (a) it is based on an absolute trophic scale without any normalization to type-specific reference conditions; (b) it makes an ex ante aggregation of biological (Chl-a) and physico-chemical (oxygen, nutrients) quality elements, instead of an ex post integration of separate evaluations of biological and subsequent chemical quality elements. A revisitation of the TRIX index in the light of the European Water Framework Directive (WFD, 2000/60/EC) and new TRIX derived tools are presented in this paper. A number of Italian coastal sites were grouped into different types based on a thorough analysis of their hydro-morphological conditions, and type-specific reference sites were selected. Unscaled TRIX values (UNTRIX) for reference and impacted sites have been calculated and two alternative UNTRIX-based classification procedures are discussed. The proposed procedures, to be validated on a broader scale, provide users with simple tools that give an integrated view of nutrient enrichment and its effects on algal biomass (Chl-a) and on oxygen levels. This trophic evaluation along with phytoplankton indicator species and algal blooms contribute to the comprehensive assessment of phytoplankton, one of the biological quality elements in coastal waters.

78 FR 25097 - Notice of Realty Action: Competitive, Sealed-Bid, Spring SNPLMA Sale of Public Lands in Clark...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-29

... Determination of National Environmental Policy Act Adequacy (DNA). DATES: Interested parties may submit written... December 23, 2004, and a site specific DNA document numbered DOI-BLM-NV-S010-2012-0106-DNA. Sale procedures...

INITIAL SCREENING OF THERMAL DESORPTION FOR SOIL REMEDIATION

EPA Science Inventory

The purpose of the paper is to present procedures for collecting and evaluating key data that affect the potential application of thermal desorption for a specific site. These data are defined as 'criticalsuccess factors'. The screening prodcedure can be used to peerform an ini...

40 CFR 62.14620 - What site-specific documentation is required?

Code of Federal Regulations, 2013 CFR

2013-07-01

... POLLUTANTS Federal Plan Requirements for Commercial and Industrial Solid Waste Incineration Units That Commenced Construction On or Before November 30, 1999 Operator Training and Qualification § 62.14620 What...) Procedures for receiving, handling, and charging waste. (3) Incinerator startup, shutdown, and malfunction...

Mössbauer investigations to characterize Fe lattice sites in sheet silicates and Peru Basin deep-sea sediments

NASA Astrophysics Data System (ADS)

Lougear, André; König, Iris; Trautwein, Alfred X.; Suess, Erwin

A procedure to classify different Fe lattice sites, i.e., OH-group geometries, in the clay mineral content of deep-sea sediments was developed using Mössbauer spectroscopy at low temperature (77 K). This speciation is of interest with regard to the redox behavior, reactivity and color of marine sediments, since substantial iron redox transitions (associated with sediment color change) have been documented for the structural sheet silicate iron. Lattice site classification was achieved for the Fe(II) fraction, all of which is structural clay Fe(II) in the sediments under investigation. Whereas the major part of the Fe(III) is structural clay iron as well, there is a small Fe(III) fraction in oxide minerals. Therefore, further elaboration of the procedure would be required to also achieve lattice site classification for the Fe(III) fraction. Analysis of the Mössbauer spectra is based on computer fits, the input parameters of which were derived from a separate study of Fe(II)-rich pure chlorites. The procedure of classification is qualified to investigate, e.g., in laboratory experiments, the site-specific reaction rates and the effects on sediment color of iron redox transitions in the sheet silicate content of sediments. The new skills were successfully applied in environmental impact studies on the mining of polymetallic nodules from the Peru Basin deep-sea floor.

Western energy related overhead monitoring project. Phase 2: Summary. [Campbell County, Wyoming and coal strip mines in Montana and New Mexico

NASA Technical Reports Server (NTRS)

Anderson, J. E. (Principal Investigator)

1979-01-01

Assistance by NASA to EPA in the establishment and maintenance of a fully operational energy-related monitoring system included: (1) regional analysis applications based on LANDSAT and auxiliary data; (2) development of techniques for using aircraft MSS data to rapidly monitor site specific surface coal mine activities; and (3) registration of aircraft MSS data to a map base. The coal strip mines used in the site specific task were in Campbell County, Wyoming; Big Horn County, Montana; and the Navajo mine in San Juan County, New Mexico. The procedures and software used to accomplish these tasks are described.

Certification of highly complex safety-related systems.

PubMed

Reinert, D; Schaefer, M

1999-01-01

The BIA has now 15 years of experience with the certification of complex electronic systems for safety-related applications in the machinery sector. Using the example of machining centres this presentation will show the systematic procedure for verifying and validating control systems using Application Specific Integrated Circuits (ASICs) and microcomputers for safety functions. One section will describe the control structure of machining centres with control systems using "integrated safety." A diverse redundant architecture combined with crossmonitoring and forced dynamization is explained. In the main section the steps of the systematic certification procedure are explained showing some results of the certification of drilling machines. Specification reviews, design reviews with test case specification, statistical analysis, and walk-throughs are the analytical measures in the testing process. Systematic tests based on the test case specification, Electro Magnetic Interference (EMI), and environmental testing, and site acceptance tests on the machines are the testing measures for validation. A complex software driven system is always undergoing modification. Most of the changes are not safety-relevant but this has to be proven. A systematic procedure for certifying software modifications is presented in the last section of the paper.

78 FR 66388 - Applications and Amendments to Facility Operating Licenses and Combined Licenses Involving...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-11-05

... NUCLEAR REGULATORY COMMISSION [NRC-2013-0231] Applications and Amendments to Facility Operating... Sensitive Unclassified Non-Safeguards Information and Order Imposing Procedures for Access to Sensitive... describes a different method for submitting comments on a specific subject): Federal Rulemaking Web site: Go...

16 CFR 0.2 - Official address.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 1 2011-01-01 2011-01-01 false Official address. 0.2 Section 0.2 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.2... 20580, unless otherwise specifically directed. The Commission's Web site address is www.ftc.gov. [63 FR...

16 CFR 0.2 - Official address.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Official address. 0.2 Section 0.2 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE ORGANIZATION § 0.2... 20580, unless otherwise specifically directed. The Commission's Web site address is www.ftc.gov. [63 FR...

[Features of skin graft in pediatric plastic surgery].

PubMed

Depoortère, C; François, C; Belkhou, A; Duquennoy-Martinot, V; Guerreschi, P

2016-10-01

Skin graft is a skin tissue fragment transferred from a donor site to a receiving site with a spontaneous revascularization. Basic process of plastic surgery, skin graft known in children, specific, warnings and refinements. It finds its indication in many pediatric cases: integumental diseases (neavus, hamartoma), acute burns and scars, traumatic loss of substance or surgically induced, congenital malformations of the hands and feet, etc. Specific skin graft techniques in children are developed: donor sites, sampling technique and procedure, early postoperative care. Especially in children, the scalp is a perfect site for split skin graft and technique is actively developed. Refinements and special cases are discussed: use of dermal matrices, allografts, xenografts, negative pressure therapy, prior skin expansion of the donor site. Results of skin graft in children are exposed: taking of graft, growth and shrinkage, pigmentation. Skin graft sometimes allows to stay the complex movement and get the best final benefit, permanent or at least temporary, in a growing being. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Improving patient safety during insertion of peripheral venous catheters: an observational intervention study

PubMed Central

Kampf, Günter; Reise, Gesche; James, Claudia; Gittelbauer, Kirsten; Gosch, Jutta; Alpers, Birgit

2013-01-01

Background: Peripheral venous catheters are frequently used in hospitalized patients but increase the risk of nosocomial bloodstream infection. Evidence-based guidelines describe specific steps that are known to reduce infection risk. However, the degree of guideline implementation in clinical practice is not known. The aim of this study was to determine the use of specific steps for insertion of peripheral venous catheters in clinical practice and to implement a multimodal intervention aimed at improving both compliance and the optimum order of the steps. Methods: The study was conducted at University Hospital Hamburg. An optimum procedure for inserting a peripheral venous catheter was defined based on three evidence-based guidelines (WHO, CDC, RKI) including five steps with 1A or 1B level of evidence: hand disinfection before patient contact, skin antisepsis of the puncture site, no palpation of treated puncture site, hand disinfection before aseptic procedure, and sterile dressing on the puncture site. A research nurse observed and recorded procedures for peripheral venous catheter insertion for healthcare workers in four different departments (endoscopy, central emergency admissions, pediatrics, and dermatology). A multimodal intervention with 5 elements was established (teaching session, dummy training, e-learning tool, tablet and poster, and direct feedback), followed by a second observation period. During the last observation week, participants evaluated the intervention. Results: In the control period, 207 insertions were observed, and 202 in the intervention period. Compliance improved significantly for four of five steps (e.g., from 11.6% to 57.9% for hand disinfection before patient contact; p<0.001, chi-square test). Compliance with skin antisepsis of the puncture site was high before and after intervention (99.5% before and 99.0% after). Performance of specific steps in the correct order also improved (e.g., from 7.7% to 68.6% when three of five steps were done; p<0.001). The intervention was described as helpful by 46.8% of the participants, as neutral by 46.8%, and as disruptive by 6.4%. Conclusions: A multimodal strategy to improve both compliance with safety steps for peripheral venous catheter insertion and performance of an optimum procedure was effective and was regarded helpful by healthcare workers. PMID:24327944

Draft Site Treatment Plan (DSTP), Volumes I and II

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

D`Amelio, J.

1994-08-30

Site Treatment Plans (STP) are required for facilities at which the DOE generates or stores mixed waste. This Draft Site Treatment Plan (DSTP) the second step in a three-phase process, identifies the currently preferred options for treating mixed waste at the Savannah River Site (SRS) or for developing treatment technologies where technologies do not exist or need modification. The DSTP reflects site-specific preferred options, developed with the state`s input and based on existing available information. To the extent possible, the DSTP identifies specific treatment facilities for treating the mixed waste and proposes schedules. Where the selection of specific treatment facilitiesmore » is not possible, schedules for alternative activities such as waste characterization and technology assessment are provided. All schedule and cost information presented is preliminary and is subject to change. The DSTP is comprised of two volumes: this Compliance Plan Volume and the Background Volume. This Compliance Plan Volume proposes overall schedules with target dates for achieving compliance with the land disposal restrictions (LDR) of RCRA and procedures for converting the target dates into milestones to be enforced under the Order. The more detailed discussion of the options contained in the Background Volume is provided for informational purposes only.« less

A revised logistic regression equation and an automated procedure for mapping the probability of a stream flowing perennially in Massachusetts

USGS Publications Warehouse

Bent, Gardner C.; Steeves, Peter A.

2006-01-01

A revised logistic regression equation and an automated procedure were developed for mapping the probability of a stream flowing perennially in Massachusetts. The equation provides city and town conservation commissions and the Massachusetts Department of Environmental Protection a method for assessing whether streams are intermittent or perennial at a specific site in Massachusetts by estimating the probability of a stream flowing perennially at that site. This information could assist the environmental agencies who administer the Commonwealth of Massachusetts Rivers Protection Act of 1996, which establishes a 200-foot-wide protected riverfront area extending from the mean annual high-water line along each side of a perennial stream, with exceptions for some urban areas. The equation was developed by relating the observed intermittent or perennial status of a stream site to selected basin characteristics of naturally flowing streams (defined as having no regulation by dams, surface-water withdrawals, ground-water withdrawals, diversion, wastewater discharge, and so forth) in Massachusetts. This revised equation differs from the equation developed in a previous U.S. Geological Survey study in that it is solely based on visual observations of the intermittent or perennial status of stream sites across Massachusetts and on the evaluation of several additional basin and land-use characteristics as potential explanatory variables in the logistic regression analysis. The revised equation estimated more accurately the intermittent or perennial status of the observed stream sites than the equation from the previous study. Stream sites used in the analysis were identified as intermittent or perennial based on visual observation during low-flow periods from late July through early September 2001. The database of intermittent and perennial streams included a total of 351 naturally flowing (no regulation) sites, of which 85 were observed to be intermittent and 266 perennial. Stream sites included in the database had drainage areas that ranged from 0.04 to 10.96 square miles. Of the 66 stream sites with drainage areas greater than 2.00 square miles, 2 sites were intermittent and 64 sites were perennial. Thus, stream sites with drainage areas greater than 2.00 square miles were assumed to flow perennially, and the database used to develop the logistic regression equation included only those stream sites with drainage areas less than 2.00 square miles. The database for the equation included 285 stream sites that had drainage areas less than 2.00 square miles, of which 83 sites were intermittent and 202 sites were perennial. Results of the logistic regression analysis indicate that the probability of a stream flowing perennially at a specific site in Massachusetts can be estimated as a function of four explanatory variables: (1) drainage area (natural logarithm), (2) areal percentage of sand and gravel deposits, (3) areal percentage of forest land, and (4) region of the state (eastern region or western region). Although the equation provides an objective means of determining the probability of a stream flowing perennially at a specific site, the reliability of the equation is constrained by the data used in its development. The equation is not recommended for (1) losing stream reaches or (2) streams whose ground-water contributing areas do not coincide with their surface-water drainage areas, such as many streams draining the Southeast Coastal Region-the southern part of the South Coastal Basin, the eastern part of the Buzzards Bay Basin, and the entire area of the Cape Cod and the Islands Basins. If the equation were used on a regulated stream site, the estimated intermittent or perennial status would reflect the natural flow conditions for that site. An automated mapping procedure was developed to determine the intermittent or perennial status of stream sites along reaches throughout a basin. The procedure delineates the drainage area boundaries, determines values for the four explanatory variables, and solves the equation for estimating the probability of a stream flowing perennially at two locations on a headwater (first-order) stream reach-one near its confluence or end point and one near its headwaters or start point. The automated procedure then determines the intermittent or perennial status of the reach on the basis of the calculated probability values and a probability cutpoint (a stream is considered to flow perennially at a cutpoint of 0.56 or greater for this study) for the two locations or continues to loop upstream or downstream between locations less than and greater than the cutpoint of 0.56 to determine the transition point from an intermittent to a perennial stream. If the first-order stream reach is determined to be intermittent, the procedure moves to the next downstream reach and repeats the same process. The automated procedure then moves to the next first-order stream and repeats the process until the entire basin is mapped. A map of the intermittent and perennial stream reaches in the Shawsheen River Basin is provided on a CD-ROM that accompanies this report. The CD-ROM also contains ArcReader 9.0, a freeware product, that allows a user to zoom in and out, set a scale, pan, turn on and off map layers (such as a USGS topographic map), and print a map of the stream site with a scale bar. Maps of the intermittent and perennial stream reaches in Massachusetts will provide city and town conservation commissions and the Massachusetts Department of Environmental Protection with an additional method for assessing the intermittent or perennial status of stream sites.

10 CFR 73.55 - Requirements for physical protection of licensed activities in nuclear power reactors against...

Code of Federal Regulations, 2011 CFR

2011-01-01

... integration of systems, technologies, programs, equipment, supporting processes, and implementing procedures...-in-depth methodologies to minimize the potential for an insider to adversely affect, either directly... protection of digital computer and communication systems and networks. (ii) Site-specific conditions that...

40 CFR 131.43 - Florida.

Code of Federal Regulations, 2012 CFR

2012-07-01

... a copy of all materials submitted to EPA, at the time of submittal to EPA, to facilitate the State... all CWA purposes. The State may use this procedure one time for a specific lake in lieu of the site... Coastal Drainage Area, Crystal/Pithlachascotee Coastal Drainage Area, small, direct Tampa Bay tributary...

40 CFR 131.43 - Florida.

Code of Federal Regulations, 2014 CFR

2014-07-01

... all CWA purposes. The State may use this procedure one time for a specific lake in lieu of the site... Coastal Drainage Area, Crystal/Pithlachascotee Coastal Drainage Area, small, direct Tampa Bay tributary... a copy of all materials submitted to EPA, at the time of submittal to EPA, to facilitate the State...

Schools as Open Social Systems: A Study of Site Specific Restructuring.

ERIC Educational Resources Information Center

Dellar, Graham B.

This paper revisits the literature on the nature of school organizations and presents a view of secondary schools as complex social systems, as opposed to bureaucratic-rational structures. Research was conducted into three Western Australia secondary schools planning to implement school-based decision making and planning procedures. The…

32 CFR 22.315 - Merit-based, competitive procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... This OMB policy directive is available at the Internet site http://www.whitehouse.gov/omb/grants/grants... accordance with that OMB policy directive, DoD Components also must post on the Internet any notice under... Component issues a specific notice with limited distribution (e.g., for national security considerations...

32 CFR 22.315 - Merit-based, competitive procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... This OMB policy directive is available at the Internet site http://www.whitehouse.gov/omb/grants/grants... accordance with that OMB policy directive, DoD Components also must post on the Internet any notice under... Component issues a specific notice with limited distribution (e.g., for national security considerations...

32 CFR 22.315 - Merit-based, competitive procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... This OMB policy directive is available at the Internet site http://www.whitehouse.gov/omb/grants/grants... accordance with that OMB policy directive, DoD Components also must post on the Internet any notice under... Component issues a specific notice with limited distribution (e.g., for national security considerations...

78 FR 78402 - Applications and Amendments to Facility Operating Licenses and Combined Licenses Involving...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

... NUCLEAR REGULATORY COMMISSION [NRC-2013-0272] Applications and Amendments to Facility Operating... Sensitive Unclassified Non-Safeguards Information and Order Imposing Procedures for Access to Sensitive... submitting comments on a specific subject): Federal Rulemaking Web site: Go to http://www.regulations.gov and...

75 FR 59143 - Magnuson-Stevens Fishery Conservation and Management Act; Regional Fishery Management Councils...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-27

... Coordinating Committee (CCC), require that the Councils' science and statistical committee (SSC) members... Council's Internet site, with alternative methods of retrieval for specific documents. The words ``to the... restrictions on lobbying; the procedures for Council member nomination, including timing for submission of...

Project PARTnership: Instructional Kit. A Model Program for Encouraging Self-Determination through Access to the Arts.

ERIC Educational Resources Information Center

Harris, Carolyn DeMeyer, Ed.; McKinney, David D., Ed.

This instructional kit outlines procedures for implementing Project PARTnership, a program for teaching students with disabilities greater self-determination skills through specifically designed arts experiences. An introductory section describes key project activities, including establishing a site steering committee comprised of teachers,…

Ancient DNA in human bone remains from Pompeii archaeological site.

PubMed

Cipollaro, M; Di Bernardo, G; Galano, G; Galderisi, U; Guarino, F; Angelini, F; Cascino, A

1998-06-29

aDNA extraction and amplification procedures have been optimized for Pompeian human bone remains whose diagenesis has been determined by histological analysis. Single copy genes amplification (X and Y amelogenin loci and Y specific alphoid repeat sequences) have been performed and compared with anthropometric data on sexing.

42 CFR 73.14 - Incident response.

Code of Federal Regulations, 2013 CFR

2013-10-01

... under this part must develop and implement a written incident response plan based upon a site specific risk assessment.2 The incident response plan must be coordinated with any entity-wide plans, kept in... response plan must fully describe the entity's response procedures for the theft, loss, or release of a...

42 CFR 73.14 - Incident response.

Code of Federal Regulations, 2014 CFR

2014-10-01

... under this part must develop and implement a written incident response plan based upon a site specific risk assessment.2 The incident response plan must be coordinated with any entity-wide plans, kept in... response plan must fully describe the entity's response procedures for the theft, loss, or release of a...

Catastrophic Icefall Hazard Assessment, Avoidance Procedures & Mitigations Strategies, Phase II Site-Specific Studies

DOT National Transportation Integrated Search

2018-02-01

The incidence of icefall is one of the most underrepresented and likely underappreciated of all the natural hazards. Falling pieces of ice are subject to melting and sublimation, and evidence of such events may be gone in a matter of days or even hou...

Canadian Health Measures Survey pre-test: design, methods, results.

PubMed

Tremblay, Mark; Langlois, Renée; Bryan, Shirley; Esliger, Dale; Patterson, Julienne

2007-01-01

The Canadian Health Measures Survey (CHMS) pre-test was conducted to provide information about the challenges and costs associated with administering a physical health measures survey in Canada. To achieve the specific objectives of the pre-test, protocols were developed and tested, and methods for household interviewing and clinic testing were designed and revised. The cost, logistics and suitability of using fixed sites for the CHMS were assessed. Although data collection, transfer and storage procedures are complex, the pre-test experience confirmed Statistics Canada's ability to conduct a direct health measures survey and the willingness of Canadians to participate in such a health survey. Many operational and logistical procedures worked well and, with minor modifications, are being employed in the main survey. Fixed sites were problematic, and survey costs were higher than expected.

European Council of Legal Medicine (ECLM) principles for on-site forensic and medico-legal scene and corpse investigation.

PubMed

Cusack, D; Ferrara, S D; Keller, E; Ludes, B; Mangin, P; Väli, M; Vieira, N

2017-07-01

Forensic medical practitioners need to define the general principles governing procedures to be used for the on-site examination of a body where the death has occurred in unnatural, violent or suspicious circumstances. These principles should be followed whenever a medical expert is required to perform an on-site corpse inspection and should be utilised as a set of general guidelines to be adapted to the specific situation in hand and interpreted using common sense and scientific knowledge of the relevant procedures and facts of the case. The aim of these principles is to ensure that forensic evidence at the scene of a death is properly observed and assessed and all necessary relevant evidence gathered in order to ensure that a comprehensive report is available to the judicial authority (investigating judge or coroner) in the justice system. The on-site corpse inspection by a forensic practitioner is a mandatory and essential stage of the forensic and medico-legal autopsy, as it may provide important information for subsequent investigation stages.

CRISM Hyperspectral Data Filtering with Application to MSL Landing Site Selection

NASA Astrophysics Data System (ADS)

Seelos, F. P.; Parente, M.; Clark, T.; Morgan, F.; Barnouin-Jha, O. S.; McGovern, A.; Murchie, S. L.; Taylor, H.

2009-12-01

We report on the development and implementation of a custom filtering procedure for Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) IR hyperspectral data that is suitable for incorporation into the CRISM Reduced Data Record (RDR) calibration pipeline. Over the course of the Mars Reconnaissance Orbiter (MRO) Primary Science Phase (PSP) and the ongoing Extended Science Phase (ESP) CRISM has operated with an IR detector temperature between ~107 K and ~127 K. This ~20 K range in operational temperature has resulted in variable data quality, with observations acquired at higher detector temperatures exhibiting a marked increase in both systematic and stochastic noise. The CRISM filtering procedure consists of two main data processing capabilities. The primary systematic noise component in CRISM IR data appears as along track or column oriented striping. This is addressed by the robust derivation and application of an inter-column ratio correction frame. The correction frame is developed through the serial evaluation of band specific column ratio statistics and so does not compromise the spectral fidelity of the image cube. The dominant CRISM IR stochastic noise components appear as isolated data spikes or column oriented segments of variable length with erroneous data values. The non-systematic noise is identified and corrected through the application of an iterative-recursive kernel modeling procedure which employs a formal statistical outlier test as the iteration control and recursion termination criterion. This allows the filtering procedure to make a statistically supported determination between high frequency (spatial/spectral) signal and high frequency noise based on the information content of a given multidimensional data kernel. The governing statistical test also allows the kernel filtering procedure to be self regulating and adaptive to the intrinsic noise level in the data. The CRISM IR filtering procedure is scheduled to be incorporated into the next augmentation of the CRISM IR calibration (version 3). The filtering algorithm will be applied to the I/F data (IF) delivered to the Planetary Data System (PDS), but the radiance on sensor data (RA) will remain unfiltered. The development of CRISM hyperspectral analysis products in support of the Mars Science Laboratory (MSL) landing site selection process has motivated the advance of CRISM-specific data processing techniques. The quantitative results of the CRISM IR filtering procedure as applied to CRISM observations acquired in support of MSL landing site selection will be presented.

Developing Terrestrial Trophic Models for Petroleum and Natural Gas Exploration and Production Sites: The Oklahoma Tallgrass Prairie Preserve Example

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

Stevenson, M; Coty, J; Stewart, J

This document details procedures to be used when constructing a conceptual terrestrial trophic model for natural gas and oil exploration and production sites. A site conceptual trophic model is intended for use in evaluating ecological impacts of oil and brine releases at E&P sites from a landscape or ecosystem perspective. The terrestrial trophic model protocol was developed using an example site, the Tallgrass Prairie Preserve (TPP) in Oklahoma. The procedure focuses on developing a terrestrial trophic model using information found in the primary literature, and augmented using site-specific research where available. Although the TPP has been the subject of considerablemore » research and public interest since the high-profile reintroduction of bison (Bison bison) in 1993, little formal work has been done to develop a food web for the plant and animal communities found at the preserve. We describe how to divide species into guilds using explicit criteria on the basis of resource use and spatial distribution. For the TPP, sixteen guilds were developed for use in the trophic model, and the relationships among these guilds were analyzed. A brief discussion of the results of this model is provided, along with considerations for its use and areas for further study.« less

Ten Steps to Conducting a Large, Multi-Site, Longitudinal Investigation of Language and Reading in Young Children

PubMed Central

Farquharson, Kelly; Murphy, Kimberly A.

2016-01-01

Purpose: This paper describes methodological procedures involving execution of a large-scale, multi-site longitudinal study of language and reading comprehension in young children. Researchers in the Language and Reading Research Consortium (LARRC) developed and implemented these procedures to ensure data integrity across multiple sites, schools, and grades. Specifically, major features of our approach, as well as lessons learned, are summarized in 10 steps essential for successful completion of a large-scale longitudinal investigation in early grades. Method: Over 5 years, children in preschool through third grade were administered a battery of 35 higher- and lower-level language, listening, and reading comprehension measures (RCM). Data were collected from children, their teachers, and their parents/guardians at four sites across the United States. Substantial and rigorous effort was aimed toward maintaining consistency in processes and data management across sites for children, assessors, and staff. Conclusion: With appropriate planning, flexibility, and communication strategies in place, LARRC developed and executed a successful multi-site longitudinal research study that will meet its goal of investigating the contribution and role of language skills in the development of children's listening and reading comprehension. Through dissemination of our design strategies and lessons learned, research teams embarking on similar endeavors can be better equipped to anticipate the challenges. PMID:27064308

Checklists in Neurosurgery to Decrease Preventable Medical Errors: A Review

PubMed Central

Enchev, Yavor

2015-01-01

Neurosurgery represents a zero tolerance environment for medical errors, especially preventable ones like all types of wrong site surgery, complications due to the incorrect positioning of patients for neurosurgical interventions and complications due to failure of the devices required for the specific procedure. Following the excellent and encouraging results of the safety checklists in intensive care medicine and in other surgical areas, the checklist was naturally introduced in neurosurgery. To date, the reported world experience with neurosurgical checklists is limited to 15 series with fewer than 20,000 cases in various neurosurgical areas. The purpose of this review was to study the reported neurosurgical checklists according to the following parameters: year of publication; country of origin; area of neurosurgery; type of neurosurgical procedure-elective or emergency; person in charge of the checklist completion; participants involved in completion; whether they prevented incorrect site surgery; whether they prevented complications due to incorrect positioning of the patients for neurosurgical interventions; whether they prevented complications due to failure of the devices required for the specific procedure; their specific aims; educational preparation and training; the time needed for checklist completion; study duration and phases; number of cases included; barriers to implementation; efforts to implementation; team appreciation; and safety outcomes. Based on this analysis, it could be concluded that neurosurgical checklists represent an efficient, reliable, cost-effective and time-saving tool for increasing patient safety and elevating the neurosurgeons’ self-confidence. Every neurosurgical department must develop its own neurosurgical checklist or adopt and modify an existing one according to its specific features and needs in an attempt to establish or develop its safety culture. The world, continental, regional and national neurosurgical societies could promote safety checklists and their benefits. PMID:26740891

Design and evaluation guidelines for Department of Energy facilities subjected to natural phenomena hazards

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

Kennedy, R.P.; Short, S.A.; McDonald, J.R.

1990-06-01

The Department of Energy (DOE) and the DOE Natural Phenomena Hazards Panel have developed uniform design and evaluation guidelines for protection against natural phenomena hazards at DOE sites throughout the United States. The goal of the guidelines is to assure that DOE facilities can withstand the effects of natural phenomena such as earthquakes, extreme winds, tornadoes, and flooding. The guidelines apply to both new facilities (design) and existing facilities (evaluation, modification, and upgrading). The intended audience is primarily the civil/structural or mechanical engineers conducting the design or evaluation of DOE facilities. The likelihood of occurrence of natural phenomena hazards atmore » each DOE site has been evaluated by the DOE Natural Phenomena Hazard Program. Probabilistic hazard models are available for earthquake, extreme wind/tornado, and flood. Alternatively, site organizations are encouraged to develop site-specific hazard models utilizing the most recent information and techniques available. In this document, performance goals and natural hazard levels are expressed in probabilistic terms, and design and evaluation procedures are presented in deterministic terms. Design/evaluation procedures conform closely to common standard practices so that the procedures will be easily understood by most engineers. Performance goals are expressed in terms of structure or equipment damage to the extent that: (1) the facility cannot function; (2) the facility would need to be replaced; or (3) personnel are endangered. 82 refs., 12 figs., 18 tabs.« less

Evaluation of the Eberline AMS-3A and AMS-4 Beta continuous air monitors

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

Johnson, M.L.; Sisk, D.R.

1996-03-01

Eberline AMS-3A-1 and AMS-4 beta continuous air monitors were tested against the criteria set forth in the ANSI Standards N42.18, Specification and Performance of On-site Instrumentation for Continuously Monitoring Radioactivity in Effluents, and ANSI N42.17B, Performance Specification for Health Physics Instrumentation - Occupational Airborne Radioactivity Monitoring Instrumentation. ANSI N42.18 does not, in general, specify testing procedures for demonstrating compliance with the criteria set forth in the standard; therefore, wherever possible, the testing procedures given in ANSI N42.17B were adopted. In all cases, the more restrictive acceptance criteria and/or the more demanding test conditions of the two standards were used.

Developing and Validating a Rapid Small-Scale Column Test Procedure for GAC Selection using Reconstituted Lyophilized NOM

EPA Science Inventory

Cost effective design and operation of Granular Activated Carbon (GAC) facilities requires the selection of GAC that is optimal for a specific site. Rapid small-scale column tests (RSSCTs) are widely used for GAC assessment due to several advantages, including the ability to simu...

40 CFR 278.3 - Criteria for use of chat in Federally funded transportation projects.

Code of Federal Regulations, 2010 CFR

2010-07-01

... funded transportation projects. 278.3 Section 278.3 Protection of Environment ENVIRONMENTAL PROTECTION... Leaching Procedure (SPLP) tests are conducted on the proposed material using EPA SW-846 Method 1312...) EPA (or a State environmental Agency, if it chooses to do so) has determined, based on a site-specific...

Detailed Concepts in Performing Oversight on an Army Radiographic Inspection Site

DTIC Science & Technology

2017-03-01

number of facilities that perform various nondestructive tests , inspections, and evaluations. The U.S. Army Armament Research, Development and...procedures, and documentation in place to conform to nationally recognized standards. This report specifically reviews the radiographic testing ...X-ray Nondestructive testing (NDT) Radiographic testing (RT) Computed tomography (CT) 16. SECURITY

Developing and Validating a Rapid Small-Scale Column Test Procedure for GAC Selection using Reconstituted Lyophilized NOM - Portland, OR

EPA Science Inventory

Cost effective design and operation of Granular Activated Carbon (GAC) facilities requires the selection of GAC that is optimal for a specific site. Rapid small-scale column tests (RSSCTs) are widely used for GAC assessment due to several advantages, including the ability to simu...

Effects of aging procedures on the molecular, biochemical, morphological, and mechanical properties of vacuum-formed retainers.

PubMed

Ahn, Hyo-Won; Ha, Hye-Ryun; Lim, Ho-Nam; Choi, Samjin

2015-11-01

The influence of intraoral exposure procedures on the physical characteristics of thermoplastic vacuum-formed retainers (VFRs) is still unclear. The effects of thermoforming and intraoral use on the molecular, chemical, morphological, and mechanical properties of thermoplastic VFRs were investigated. VFRs with a 0.8-mm-thick thermoplastic PETG sheet acquired from 48 patients were investigated with two aging procedures, including vacuum forming and intraoral exposure, for 2-week and 6-month. Eight evaluating sites for thermoplastic VFRs were assessed with seven analytical techniques. LM, SEM, and AFM microscopic findings showed that the surface characteristics increased with increasing in vivo exposure time (a four-fold increase) and varied depending on the sites evaluated (an occlusal surface). Raman and EDX spectroscopic findings showed that aging procedures led to a significant change in the molecular composition of VFRs, leading to a decrease in the composition rate of carbon (C) and the presence of silicon (Si), phosphorus (P), and calcium (Ca). Compressive strength and tensile tests showed that aging procedures led to a significant increase (P<0.01) in ultimate tensile strength, elastic modulus, the stored energy at a 6-mm deflection (u6 mm), and the compressed load at a 3-mm deflection (σ3 mm). Thermoforming led to a smoother surface and no crystallization of PETG sheets. Intraoral exposure accelerated changes in surface morphology, tensile strength, and elastic modulus of VFRs. This change was site-specific and enhanced with an increase in intraoral exposure time. Therefore, thermoforming and in vivo oral exposure procedures led to the molecular, morphological, and mechanical properties of thermoplastic VFRs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Chemoenzymatic Labeling of Proteins: Techniques and Approaches

PubMed Central

Rashidian, Mohammad; Dozier, Jonathan K.; Distefano, Mark D.

2013-01-01

Site-specific modification of proteins is a major challenge in modern chemical biology due to the large number of reactive functional groups typically present in polypeptides. Because of its importance in biology and medicine, the development of methods for site-specific modification of proteins is an area of intense research. Selective protein modification procedures have been useful for oriented protein immobilization, for studies of naturally-occurring post-translational modifications, for creating antibody-drug conjugates, for the introduction of fluorophores and other small molecules on to proteins, for examining protein structure, folding, dynamics and protein-protein interactions and for the preparation of protein-polymer conjugates. One of the most important approaches for protein labeling is to incorporate bioorthogonal functionalities into proteins at specific sites via enzymatic reactions. The incorporated tags then enable reactions that are chemoselective, whose functional groups are not only inert in biological media, but also do not occur natively in proteins or other macromolecules. This review article summarizes the enzymatic strategies, which enable site-specific functionalization of proteins with a variety of different functional groups. The enzymes covered in this review include formylglycine generating enzyme, sialyltransferases, phosphopantetheinyltransferases, O-GlcNAc post-translational modification, sortagging, transglutaminase, farnesyltransferase, biotin ligase, lipoic acid ligase and N-myristoyl transferase. PMID:23837885

Implications of NGA for NEHRP site coefficients

USGS Publications Warehouse

Borcherdt, Roger D.

2012-01-01

Three proposals are provided to update tables 11.4-1 and 11.4-2 of Minimum Design Loads for Buildings and Other Structures (7-10), by the American Society of Civil Engineers (2010) (ASCE/SEI 7-10), with site coefficients implied directly by NGA (Next Generation Attenuation) ground motion prediction equations (GMPEs). Proposals include a recommendation to use straight-line interpolation to infer site coefficients at intermediate values of ̅vs (average shear velocity). Site coefficients are recommended to ensure consistency with ASCE/SEI 7-10 MCER (Maximum Considered Earthquake) seismic-design maps and simplified site-specific design spectra procedures requiring site classes with associated tabulated site coefficients and a reference site class with unity site coefficients. Recommended site coefficients are confirmed by independent observations of average site amplification coefficients inferred with respect to an average ground condition consistent with that used for the MCER maps. The NGA coefficients recommended for consideration are implied directly by the NGA GMPEs and do not require introduction of additional models.

Identifying 5-methylcytosine sites in RNA sequence using composite encoding feature into Chou's PseKNC.

PubMed

Sabooh, M Fazli; Iqbal, Nadeem; Khan, Mukhtaj; Khan, Muslim; Maqbool, H F

2018-05-01

This study examines accurate and efficient computational method for identification of 5-methylcytosine sites in RNA modification. The occurrence of 5-methylcytosine (m 5 C) plays a vital role in a number of biological processes. For better comprehension of the biological functions and mechanism it is necessary to recognize m 5 C sites in RNA precisely. The laboratory techniques and procedures are available to identify m 5 C sites in RNA, but these procedures require a lot of time and resources. This study develops a new computational method for extracting the features of RNA sequence. In this method, first the RNA sequence is encoded via composite feature vector, then, for the selection of discriminate features, the minimum-redundancy-maximum-relevance algorithm was used. Secondly, the classification method used has been based on a support vector machine by using jackknife cross validation test. The suggested method efficiently identifies m 5 C sites from non- m 5 C sites and the outcome of the suggested algorithm is 93.33% with sensitivity of 90.0 and specificity of 96.66 on bench mark datasets. The result exhibits that proposed algorithm shown significant identification performance compared to the existing computational techniques. This study extends the knowledge about the occurrence sites of RNA modification which paves the way for better comprehension of the biological uses and mechanism. Copyright © 2018 Elsevier Ltd. All rights reserved.

Site Safety Plan for Lawrence Livermore National Laboratory CERCLA investigations

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

Bainer, R.; Duarte, J.

1993-07-01

The safety policy of LLNL is to take every reasonable precaution in the performance of work to protect the environment and the health and safety of employees and the public, and to prevent property damage. With respect to hazardous agents, this protection is provided by limiting human exposures, releases to the environment, and contamination of property to levels that are as low as reasonably achievable (ALARA). It is the intent of this Plan to supply the broad outline for completing environmental investigations within ALARA guidelines. It may not be possible to determine actual working conditions in advance of the work;more » therefore, planning must allow the opportunity to provide a range of protection based upon actual working conditions. Requirements will be the least restrictive possible for a given set of circumstances, such that work can be completed in an efficient and timely fashion. Due to the relatively large size of the LLNL Site and the different types of activities underway, site-specific Operational Safety Procedures (OSPs) will be prepared to supplement activities not covered by this Plan. These site-specific OSPs provide the detailed information for each specific activity and act as an addendum to this Plan, which provides the general plan for LLNL Main Site operation.« less

Redesigning the specificity of protein-DNA interactions with Rosetta.

PubMed

Thyme, Summer; Baker, David

2014-01-01

Building protein tools that can selectively bind or cleave specific DNA sequences requires efficient technologies for modifying protein-DNA interactions. Computational design is one method for accomplishing this goal. In this chapter, we present the current state of protein-DNA interface design with the Rosetta macromolecular modeling program. The LAGLIDADG endonuclease family of DNA-cleaving enzymes, under study as potential gene therapy reagents, has been the main testing ground for these in silico protocols. At this time, the computational methods are most useful for designing endonuclease variants that can accommodate small numbers of target site substitutions. Attempts to engineer for more extensive interface changes will likely benefit from an approach that uses the computational design results in conjunction with a high-throughput directed evolution or screening procedure. The family of enzymes presents an engineering challenge because their interfaces are highly integrated and there is significant coordination between the binding and catalysis events. Future developments in the computational algorithms depend on experimental feedback to improve understanding and modeling of these complex enzymatic features. This chapter presents both the basic method of design that has been successfully used to modulate specificity and more advanced procedures that incorporate DNA flexibility and other properties that are likely necessary for reliable modeling of more extensive target site changes.

[3H]aniracetam binds to specific recognition sites in brain membranes.

PubMed

Fallarino, F; Genazzani, A A; Silla, S; L'Episcopo, M R; Camici, O; Corazzi, L; Nicoletti, F; Fioretti, M C

1995-08-01

[3H]Aniracetam bound to specific and saturable recognition sites in membranes prepared from discrete regions of rat brain. In crude membrane preparation from rat cerebral cortex, specific binding was Na+ independent, was still largely detectable at low temperature (4 degrees C), and underwent rapid dissociation. Scatchard analysis of [3H]aniracetam binding revealed a single population of sites with an apparent KD value of approximately 70 nM and a maximal density of 3.5 pmol/mg of protein. Specifically bound [3H]aniracetam was not displaced by various metabolites of aniracetam, nor by other pyrrolidinone-containing nootropic drugs such as piracetam or oxiracetam. Subcellular distribution studies showed that a high percentage of specific [3H]aniracetam binding was present in purified synaptosomes or mitochondria, whereas specific binding was low in the myelin fraction. The possibility that at least some [3H]aniracetam binding sites are associated with glutamate receptors is supported by the evidence that specific binding was abolished when membranes were preincubated at 37 degrees C under fast shaking (a procedure that substantially reduced the amount of glutamate trapped in the membranes) and could be restored after addition of either glutamate or alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA) but not kainate. The action of AMPA was antagonized by DNQX, which also reduced specific [3H]aniracetam binding in unwashed membranes. High levels of [3H]aniracetam binding were detected in hippocampal, cortical, or cerebellar membranes, which contain a high density of excitatory amino acid receptors.(ABSTRACT TRUNCATED AT 250 WORDS)

Purification and Kinetics of Higher Plant NADH:Nitrate Reductase.

PubMed

Campbell, W H; Smarrelli, J

1978-04-01

Squash cotyledon (Cucurbita pepo L.) NADH:nitrate reductase (NR) was purified 150-fold with 50% recovery by a single step procedure based on the affinity of the NR for blue-Sepharose. Blue-Sepharose, which is prepared by direct coupling of Cibacron blue to Sepharose, appears to bind squash NR at the NADH site. The NR can be purified in 2 to 3 hours to a specific activity of 2 mumol of NADH oxidized/minute * milligram of protein. Corn (Zea mays L.) leaf NR was also purified to a specific activity of 6.9 mumol of NADH oxidized/minute * milligram of protein using a blue-Sepharose affinity step. The blue-Sepharose method offers the advantages of a rapid purification of plant NR to a high specific activity with reasonable recovery of total activity.The kinetic mechanism of higher plant NR was investigated using these highly purified squash and corn NR preparations. Based on initial velocity and product inhibition studies utilizing both enzymes, a two-site ping-pong mechanism is proposed for NR. This kinetic mechanism incorporates the concept of the reduced NR transferring electrons from the NADH site to a physically separated nitrate site.

Concept analysis: wrong-site surgery.

PubMed

Watson, Donna S

2015-06-01

A concept analysis was conducted on the concept of wrong-site surgery (WSS) using the principle-based method by Penrod and Hupcey. It included analysis of WSS within the context of epistemological, pragmatic, linguistic, and logical principles. The analysis found that WSS is an important concept that is universally accepted, but the definition could be improved with inclusion of comprehensive labeling for types of WSS that may occur, such as wrong patient, wrong site, wrong level/part, wrong procedure, and wrong side. Wrong-site surgery falls into the domains of both nursing and medicine, and there is limited research on the topic specific to nursing interventions, perceptions, and contributions to prevent WSS. Copyright © 2015 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Techniques for Large-Scale Bacterial Genome Manipulation and Characterization of the Mutants with Respect to In Silico Metabolic Reconstructions.

PubMed

diCenzo, George C; Finan, Turlough M

2018-01-01

The rate at which all genes within a bacterial genome can be identified far exceeds the ability to characterize these genes. To assist in associating genes with cellular functions, a large-scale bacterial genome deletion approach can be employed to rapidly screen tens to thousands of genes for desired phenotypes. Here, we provide a detailed protocol for the generation of deletions of large segments of bacterial genomes that relies on the activity of a site-specific recombinase. In this procedure, two recombinase recognition target sequences are introduced into known positions of a bacterial genome through single cross-over plasmid integration. Subsequent expression of the site-specific recombinase mediates recombination between the two target sequences, resulting in the excision of the intervening region and its loss from the genome. We further illustrate how this deletion system can be readily adapted to function as a large-scale in vivo cloning procedure, in which the region excised from the genome is captured as a replicative plasmid. We next provide a procedure for the metabolic analysis of bacterial large-scale genome deletion mutants using the Biolog Phenotype MicroArray™ system. Finally, a pipeline is described, and a sample Matlab script is provided, for the integration of the obtained data with a draft metabolic reconstruction for the refinement of the reactions and gene-protein-reaction relationships in a metabolic reconstruction.

SIMS prototype system 1: Design data brochure. [solar heating system

NASA Technical Reports Server (NTRS)

1978-01-01

A prototype solar heating and hot water system using air as the collector fluid and a pebble bed for heat storage was designed for installation into a single family dwelling. The system, subsystem, and installation requirements are described. System operation and performance are discussed, and procedures for sizing the system to a specific site are presented.

29 CFR 37.7 - What specific discriminatory actions based on disability are prohibited by this part?

Code of Federal Regulations, 2010 CFR

2010-07-01

... WIA or this part. (g) A recipient, in the selection of contractors, must not use criteria that subject..., licensing, or other arrangements, use standards, procedures, criteria, or administrative methods: (1) That... site or location of facilities, a grant applicant or recipient must not make selections that have any...

Chapter 8. Medical procedures. Recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster.

PubMed

Zimmerman, Janice L; Sprung, Charles L

2010-04-01

To provide recommendations and standard operating procedures for intensive care unit and hospital preparations for an influenza pandemic or mass disaster with a specific focus on ensuring that adequate resources are available and appropriate protocols are developed to safely perform procedures in patients with and without influenza illness. Based on a literature review and expert opinion, a Delphi process was used to define the essential topics including performing medical procedures. Key recommendations include: (1) specify high-risk procedures (aerosol generating-procedures); (2) determine if certain procedures will not be performed during a pandemic; (3) develop protocols for safe performance of high-risk procedures that include appropriateness, qualifications of personnel, site, personal protection equipment, safe technique and equipment needs; (4) ensure adequate training of personnel in high-risk procedures; (5) procedures should be performed at the bedside whenever possible; (6) ensure safe respiratory therapy practices to avoid aerosols; (7) provide safe respiratory equipment; and (8) determine criteria for cancelling and/or altering elective procedures. Judicious planning and adoption of protocols for safe performance of medical procedures are necessary to optimize outcomes during a pandemic.

Assessing, mapping and validating site-specific ecotoxicological risk for pesticide mixtures: a case study for small scale hot spots in aquatic and terrestrial environments.

PubMed

Vaj, Claudia; Barmaz, Stefania; Sørensen, Peter Borgen; Spurgeon, David; Vighi, Marco

2011-11-01

Mixture toxicity is a real world problem and as such requires risk assessment solutions that can be applied within different geographic regions, across different spatial scales and in situations where the quantity of data available for the assessment varies. Moreover, the need for site specific procedures for assessing ecotoxicological risk for non-target species in non-target ecosystems also has to be recognised. The work presented in the paper addresses the real world effects of pesticide mixtures on natural communities. Initially, the location of risk hotspots is theoretically estimated through exposure modelling and the use of available toxicity data to predict potential community effects. The concept of Concentration Addition (CA) is applied to describe responses resulting from exposure of multiple pesticides The developed and refined exposure models are georeferenced (GIS-based) and include environmental and physico-chemical parameters, and site specific information on pesticide usage and land use. As a test of the risk assessment framework, the procedures have been applied on a suitable study areas, notably the River Meolo basin (Northern Italy), a catchment characterised by intensive agriculture, as well as comparative area for some assessments. Within the studied areas, the risks for individual chemicals and complex mixtures have been assessed on aquatic and terrestrial aboveground and belowground communities. Results from ecological surveys have been used to validate these risk assessment model predictions. Value and limitation of the approaches are described and the possibilities for larger scale applications in risk assessment are also discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

Evaluation of site plan review procedures.

DOT National Transportation Integrated Search

1988-01-01

The site plan review procedures of the Virginia Department of Transportation (VDOT) were evaluated. The objectives of the evaluation were to recommend (1) a set of site plan review procedures including a checklist, (2) definitions of the roles and re...

The sequence specificity of UV-induced DNA damage in a systematically altered DNA sequence.

PubMed

Khoe, Clairine V; Chung, Long H; Murray, Vincent

2018-06-01

The sequence specificity of UV-induced DNA damage was investigated in a specifically designed DNA plasmid using two procedures: end-labelling and linear amplification. Absorption of UV photons by DNA leads to dimerisation of pyrimidine bases and produces two major photoproducts, cyclobutane pyrimidine dimers (CPDs) and pyrimidine(6-4)pyrimidone photoproducts (6-4PPs). A previous study had determined that two hexanucleotide sequences, 5'-GCTC*AC and 5'-TATT*AA, were high intensity UV-induced DNA damage sites. The UV clone plasmid was constructed by systematically altering each nucleotide of these two hexanucleotide sequences. One of the main goals of this study was to determine the influence of single nucleotide alterations on the intensity of UV-induced DNA damage. The sequence 5'-GCTC*AC was designed to examine the sequence specificity of 6-4PPs and the highest intensity 6-4PP damage sites were found at 5'-GTTC*CC nucleotides. The sequence 5'-TATT*AA was devised to investigate the sequence specificity of CPDs and the highest intensity CPD damage sites were found at 5'-TTTT*CG nucleotides. It was proposed that the tetranucleotide DNA sequence, 5'-YTC*Y (where Y is T or C), was the consensus sequence for the highest intensity UV-induced 6-4PP adduct sites; while it was 5'-YTT*C for the highest intensity UV-induced CPD damage sites. These consensus tetranucleotides are composed entirely of consecutive pyrimidines and must have a DNA conformation that is highly productive for the absorption of UV photons. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

Improved Tandem Affinity Purification Tag and Methods for Isolation of Proteins and Protein Complexes from Schizosaccharomyces pombe.

PubMed

Zilio, Nicola; Boddy, Michael N

2017-03-01

The tandem affinity purification (TAP) method uses an epitope that contains two different affinity purification tags separated by a site-specific protease site to isolate a protein rapidly and easily. Proteins purified via the TAP tag are eluted under mild conditions, allowing them to be used for structural and biochemical analyses. The original TAP tag contains a calmodulin-binding peptide and the IgG-binding domain from protein A separated by a tobacco etch virus (TEV) protease cleavage site. After capturing the Protein A epitope on an IgG resin, bound proteins are released by incubation with the TEV protease and then isolated on a calmodulin matrix in the presence of calcium; elution from this resin is achieved by chelating calcium with EGTA. However, because the robustness of the calmodulin-binding step in this procedure is highly variable, we replaced the calmodulin-binding peptide with three copies of the FLAG epitope, (3× FLAG)-TEV-Protein A, which can be isolated using an anti-FLAG resin. Elution from this matrix is achieved in the presence of an excess of a 3× FLAG peptide. In addition to allowing proteins to be released under mild conditions, elution by the 3× FLAG peptide adds an extra layer of specificity to the TAP procedure, because it liberates only FLAG-tagged proteins. © 2017 Cold Spring Harbor Laboratory Press.

Safety rules and regulations on mine sites - the problem and a solution.

PubMed

Laurence, David

2005-01-01

Many accidents and incidents on mine sites have a causal factor in the rules and regulations that supposedly are in place to prevent the incident from occurring. The causes involve a lack of awareness or understanding, ignorance, or deliberate violations. The issue of mine rules, procedures, and regulations is a central focus of this paper, highlighted by this recent comment - "very few people have accidents for which there is no procedure in place..." An attitudinal survey was conducted at 33 mines throughout NSW, Queensland and international mine sites involving almost 500 mineworkers. The survey was in the form of a self-completing questionnaire, consisting of approximately 65 questions. It aimed to seek the opinions of the mining workforce on safety rules and regulations generally, as well as how they apply to their specific jobs on a mine site. The research also aimed to investigate: (a) the level of awareness and understanding of mine rules and procedures such as manager's rules and safe work procedures (SWPs); (b) the level of awareness and understanding of mine safety regulations and legislation; (c) the extent of communication of and commitment to rules and regulations; (d) the extent of compliance with rules and regulations; and (e) attitudes regarding errors, risk-taking, and accidents and their interaction with rules and regulations. The sample consisted of a random selection of underground and open pit mines, extracting coal, metals, or industrial minerals. The insights provided by the mineworkers enabled a set of principles to be developed to guide mine management and regulators in the development of more effective rules and regulations. CONCLUSIONS AND IMPACT ON THE MINING INDUSTRY: (a) Management and regulators should not continue to produce more and more rules and regulations to cover every aspect of mining. (b) Detailed prescriptive regulations, detailed safe work procedures, and voluminous safety management plans will not "connect" with a miner. (c) Achieving more effective rules and regulations is not the only answer to a safer workplace.

Phenology satellite experiment

NASA Technical Reports Server (NTRS)

Dethier, B. E. (Principal Investigator)

1973-01-01

The author has identified the following significant results. The detection of a phenological event (the Brown Wave-vegetation sensescence) for specific forest and crop types using ERTS-1 imagery is described. Data handling techniques including computer analysis and photointerpretation procedures are explained. Computer analysis of multspectral scanner digital tapes in all bands was used to give the relative changes of spectral reflectance with time of forests and specified crops. These data were obtained for a number of the twenty-four sites located within four north-south corridors across the United States. Analysis of ground observation photography and ERTS-1 imagery for sites in the Appalachian Corridor and Mississippi Valley Corridor indicates that the recession of vegetation development can be detected very well. Tentative conclusions are that specific phenological events such as crop maturity or leaf fall can be mapped for specific sites and possible for different regions. Preliminary analysis based on a number of samples in mixed deciduous hardwood stands indicates that as senescence proceeds both the rate of change and differences in color among species can be detected. The results to data show the feasibility of the development and refinement of phenoclimatic models.

Interaction of SR 33557 with skeletal muscle calcium channel blocker receptors in the baboon: characterization of its binding sites

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

Sol-Rolland, J.; Joseph, M.; Rinaldi-Carmona, M.

1991-05-01

A procedure for the isolation of primate skeletal microsomal membranes was initiated. Membranes exhibited specific enzymatic markers such as 5'-nucleotidase, Ca{sup 2}{sup +},Mg({sup 2}{sup +})-adenosine triphosphatase and an ATP-dependent calcium uptake. Baboon skeletal microsomes bound specifically with high-affinity potent Ca{sup 2}{sup +} channel blockers such as dihydropyridine, phenylalkylamine and benzothiazepine derivatives. Scatchard analysis of equilibrium binding assays with ({sup 3}H)(+)-PN 200-110, ({sup 3}H)(-)-desmethoxyverapamil (( {sup 3}H)(-)-D888) and ({sup 3}H)-d-cis-dilitiazem were consistent with a single class of binding sites for the three radioligands. The pharmacological profile of SR 33557, an original compound with calcium antagonist properties, was investigated using radioligand bindingmore » studies. SR 33557 totally inhibited the specific binding of the three main classes of Ca{sup 2}{sup +} channel effectors and interacted allosterically with them. In addition, SR 33557 bound with high affinity to a homogeneous population of binding sites in baboon skeletal muscle.« less

Advanced computer architecture specification for automated weld systems

NASA Technical Reports Server (NTRS)

Katsinis, Constantine

1994-01-01

This report describes the requirements for an advanced automated weld system and the associated computer architecture, and defines the overall system specification from a broad perspective. According to the requirements of welding procedures as they relate to an integrated multiaxis motion control and sensor architecture, the computer system requirements are developed based on a proven multiple-processor architecture with an expandable, distributed-memory, single global bus architecture, containing individual processors which are assigned to specific tasks that support sensor or control processes. The specified architecture is sufficiently flexible to integrate previously developed equipment, be upgradable and allow on-site modifications.

A survey of tuberculosis infection control practices at the NIH/NIAID/DAIDS-supported clinical trial sites in low and middle income countries.

PubMed

Godfrey, Catherine; Tauscher, Gail; Hunsberger, Sally; Austin, Melissa; Scott, Lesley; Schouten, Jeffrey T; Luetkemeyer, Anne F; Benson, Constance; Coombs, Robert; Swindells, Susan

2016-06-10

Health care associated transmission of Mycobacterium tuberculosis (TB) is well described. A previous survey of infection control (IC) practices at clinical research sites in low and middle income countries (LMIC) funded by the National Institute of Allergy and Infectious Diseases (NIAID) conducting HIV research identified issues with respiratory IC practices. A guideline for TB IC based on international recommendations was developed and promulgated. This paper reports on adherence to the guideline at sites conducting or planning to conduct TB studies with the intention of supporting improvement. A survey was developed that assessed IC activities in three domains: facility level measures, administrative control measures and environmental measures. An external site monitor visited each site in 2013-2014, to complete the audit. A central review committee evaluated the site-level survey and results were tabulated. Fisher's exact test was performed to determine whether there were significant differences in practices at sites that had IC officers versus sites that did not have IC officers. Significance was assessed at p

Optimal mapping of site-specific multivariate soil properties.

PubMed

Burrough, P A; Swindell, J

1997-01-01

This paper demonstrates how geostatistics and fuzzy k-means classification can be used together to improve our practical understanding of crop yield-site response. Two aspects of soil are important for precision farming: (a) sensible classes for a given crop, and (b) their spatial variation. Local site classifications are more sensitive than general taxonomies and can be provided by the method of fuzzy k-means to transform a multivariate data set with i attributes measured at n sites into k overlapping classes; each site has a membership value mk for each class in the range 0-1. Soil variation is of interest when conditions vary over patches manageable by agricultural machinery. The spatial variation of each of the k classes can be analysed by computing the variograms of mk over the n sites. Memberships for each of the k classes can be mapped by ordinary kriging. Areas of class dominance and the transition zones between them can be identified by an inter-class confusion index; reducing the zones to boundaries gives crisp maps of dominant soil groups that can be used to guide precision farming equipment. Automation of the procedure is straightforward given sufficient data. Time variations in soil properties can be automatically incorporated in the computation of membership values. The procedures are illustrated with multi-year crop yield data collected from a 5 ha demonstration field at the Royal Agricultural College in Cirencester, UK.

Alkaline Comet Assay for Assessing DNA Damage in Individual Cells.

PubMed

Pu, Xinzhu; Wang, Zemin; Klaunig, James E

2015-08-06

Single-cell gel electrophoresis, commonly called a comet assay, is a simple and sensitive method for assessing DNA damage at the single-cell level. It is an important technique in genetic toxicological studies. The comet assay performed under alkaline conditions (pH >13) is considered the optimal version for identifying agents with genotoxic activity. The alkaline comet assay is capable of detecting DNA double-strand breaks, single-strand breaks, alkali-labile sites, DNA-DNA/DNA-protein cross-linking, and incomplete excision repair sites. The inclusion of digestion of lesion-specific DNA repair enzymes in the procedure allows the detection of various DNA base alterations, such as oxidative base damage. This unit describes alkaline comet assay procedures for assessing DNA strand breaks and oxidative base alterations. These methods can be applied in a variety of cells from in vitro and in vivo experiments, as well as human studies. Copyright © 2015 John Wiley & Sons, Inc.

Analysis of the Factors Affecting Men's Attitudes Toward Cosmetic Surgery: Body Image, Media Exposure, Social Network Use, Masculine Gender Role Stress and Religious Attitudes.

PubMed

Abbas, Ozan Luay; Karadavut, Ufuk

2017-12-01

Cosmetic surgery is no longer just for females. More men are opting for cosmetic procedures, with marked increases seen in both minimally invasive and surgical options over the last decade. Compared to females, relatively little work has specifically focused on factors predicting males' attitudes toward cosmetic surgery. Therefore, we evaluated a number of variables that may predict some facet of men's attitudes toward cosmetic surgery according to evidence reported in the literature METHODS: A total of 151 male patients who applied for a surgical or minimally invasive cosmetic surgery procedure (patient group) and 151 healthy male volunteers who do not desire any type of cosmetic procedure (control group) were asked to fill out questionnaires about measures of body image, media exposure (television and magazine), social network site use, masculine gender role stress and religious attitudes. Our findings showed that lower ratings of body image satisfaction, increased time spent watching television, more frequent social network site use and higher degrees of masculine gender role stress were all significant predictors of attitudes toward cosmetic surgery among males. The current study confirmed the importance of body image dissatisfaction as a predictor of the choice to undergo cosmetic procedure. More importantly, a new predictor of cosmetic procedure attitudes was identified, namely masculine gender role stress. Finally, we demonstrated the effects television exposure and social network site use in promoting acceptance of surgical and nonsurgical routes to appearance enhancement. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

CO2CARE - Site Closure Assessment Research - Recent Results

NASA Astrophysics Data System (ADS)

Wipki, Mario; Liebscher, Axel; Kühn, Michael; Lüth, Stefan; Durucan, Sevket; Deflandre, Jean-Pierre; Wollenweber, Jens; Chadwick, Andy; Böhm, Gualtiero

2013-04-01

The EU project CO2CARE, which started in January 2011, supports the large scale demonstration of CCS technology by addressing requirements of operators and regulators face in terms of CO2 storage site abandonment. The CO2CARE consortium, consisting of 24 project partners from universities, research institutes, and the industry, investigate technologies and procedures for abandonment and post-closure safety, satisfying the regulatory requirements for the transfer of responsibility. Nine key injections sites in Europe, USA, Japan, and Australia, each with a specific (hydro) geological and environmental character, were selected for investigations. These sites can be divided into the CO2 storage types on-shore, off-shore, natural CO2 reservoir, depleted gas reservoirs, and saline aquifers. The project mainly focuses on three key areas: - well abandonment and long-term integrity; - reservoir management and prediction from closure to the long-term; - risk management methodologies for long-term safety. These key areas are in turn closely linked to the three high-level requirements of the EU Directive 2009/31/EC, Article 18 for CO2 storage which are: (i) absence of any detectable leakage, (ii) conformity of actual behaviour of the injected CO2 with the modeled behaviour, and (iii) the storage site is evolving towards a situation of long-term stability. The identification of criteria and the development of site abandonment procedures and technologies, which guarantee the fulfillment of the high-level requirements, are the major objectives in CO2CARE. These criteria have to be fulfilled prior to subsequent transfer of responsibility to the competent authorities, typically 20 or 30 years after site closure. Finally, the essential results of the different working groups in CO2CARE will feed into overall guidelines for regulatory compliance and "Best Practice" for site abandonment. Dissemination of the results will show policy makers and the general public how site abandonment procedures for CO2 storage sites can be undertaken sustainably, cost-effectively and with no adverse effect to the local population and the natural environment. After more than two-thirds of the project`s lifetime, an overview of the project`s goals and the most relevant research findings are presented.

Supraorbital Rim Syndrome: Definition, Surgical Treatment, and Outcomes for Frontal Headache

PubMed Central

Fallucco, Michael A.; Janis, Jeffrey E.

2016-01-01

Background: Supraorbital rim syndrome (SORS) is a novel term attributed to a composite of anatomically defined peripheral nerve entrapment sites of the supraorbital rim region. The SORS term establishes a more consistent nomenclature to describe the constellation of frontal peripheral nerve entrapment sites causing frontal headache pain. In this article, we describe the anatomical features of SORS and evidence to support its successful treatment using the transpalpebral approach that allows direct vision of these sites and the intraconal space. Methods: A retrospective review of 276 patients who underwent nerve decompression or neurectomy procedures for frontal or occipital headache was performed. Of these, treatment of 96 patients involved frontal surgery, and 45 of these patients were pure SORS patients who underwent this specific frontal trigger site deactivation surgery only. All procedures involved direct surgical approach through the upper eyelid to address the nerves of the supraorbital rim at the bony rim and myofascial sites. Results: Preoperative and postoperative data from the Migraine Disability Assessment Questionnaire were analyzed with paired t test. After surgical intervention, Migraine Disability Assessment Questionnaire scores decreased significantly at 12 months postoperatively (P < 0.0001). Conclusions: SORS describes the totality of compression sites both at the bony orbital rim and the corrugator myofascial unit for the supraorbital rim nerves. Proper diagnosis, full anatomical site knowledge, and complete decompression allow for consistent treatment. Furthermore, the direct, transpalpebral surgical approach provides significant benefit to allow complete decompression. PMID:27536474

Phase I Investigations at the Former CCC/USDA Grain Storage Facility in Montgomery City, Missouri, in 2010-2011

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

LaFreniere, Lorraine M.

This report presents the technical findings of Phase I of Argonne’s studies. The Phase I field investigation was initiated on October 18, 2010. The work was conducted in accord with (1) the final site-specific Phase I Work Plan for Montgomery City (Argonne 2010; approved by the MDNR [2010]); (2) applicable Missouri regulations; and (3) the standard operating procedures, quality assurance/quality control (QA/QC) measures, and general health and safety policies outlined in the Master Work Plan (Argonne 2002) for operations in Kansas, which was reviewed by the MDNR and accepted for current use. A draft master plan specific to work inmore » Missouri and a set of draft standard operating procedures are in review with the MDNR. The site-specific Work Plan for Montgomery City (Argonne 2010) (1) summarizes the pre-existing knowledge base for the Montgomery City investigation site compiled by Argonne and (2) describes the site-specific technical objectives and the intended scope of work developed for the first phase of the investigation. Three primary technical objectives were identified for the Phase I studies, as follows: 1. Update the presently identified inventory and status of private and public drinking water wells in the immediate vicinity of the former CCC/USDA grain storage facility, and sample the identified wells for volatile organic compounds (VOCs) and geochemical analyses. In conjunction with this effort, determine the present sources(s) of drinking water for all residents in an approximate 0.5-mi radius of the former CCC/USDA facility. 2. Investigate for possible evidence of a soil source of carbon tetrachloride contamination in the unconsolidated sediments beneath the former CCC/USDA facility that might affect the underlying bedrock aquifer units. 3. Obtain preliminary information on the site-specific lithologic and hydrologic characteristics of the unconsolidated sediments overlying bedrock at the former CCC/USDA grain storage location. Section 2 of this report describes the investigative methods used in the 2010-2011 studies and provides a chronological summary of the field events conducted. Section 3 presents a summary of the resulting field and laboratory data. These data, together with information presented in the site-specific Work Plan (Argonne 2010), are interpreted and integrated in Section 4 to (1) develop a preliminary conceptual model of the hydrogeologic framework affecting groundwater and potential contaminant migration in the vicinity of the former CCC/USDA facility and (2) serve as a basis for the initial consideration of contaminant levels and potential exposure pathways that might be of concern in the evaluation of risks to human health, public welfare, and the environment. The working conclusions drawn from the 2010-2011 studies are presented, along with recommendations, in Section 5.« less

Replication and Comparison of the Newly Proposed ADOS-2, Module 4 Algorithm in ASD Without ID: A Multi-site Study.

PubMed

Pugliese, Cara E; Kenworthy, Lauren; Bal, Vanessa Hus; Wallace, Gregory L; Yerys, Benjamin E; Maddox, Brenna B; White, Susan W; Popal, Haroon; Armour, Anna Chelsea; Miller, Judith; Herrington, John D; Schultz, Robert T; Martin, Alex; Anthony, Laura Gutermuth

2015-12-01

Recent updates have been proposed to the Autism Diagnostic Observation Schedule-2 Module 4 diagnostic algorithm. This new algorithm, however, has not yet been validated in an independent sample without intellectual disability (ID). This multi-site study compared the original and revised algorithms in individuals with ASD without ID. The revised algorithm demonstrated increased sensitivity, but lower specificity in the overall sample. Estimates were highest for females, individuals with a verbal IQ below 85 or above 115, and ages 16 and older. Best practice diagnostic procedures should include the Module 4 in conjunction with other assessment tools. Balancing needs for sensitivity and specificity depending on the purpose of assessment (e.g., clinical vs. research) and demographic characteristics mentioned above will enhance its utility.

Respiratory Protection Program medical clearance for respirator use

NASA Technical Reports Server (NTRS)

1993-01-01

Background on occupational exposure to various inhalents is discussed including on-site hazard control measures, procedures, physiological effects, and interpretation of results for the medical clearance of employee for use of personal respiratory protection devices. The purpose of the Respiratory Protection Program at LeRC is outlined, and the specifics of the Medical Surveillance Program for Respiratory Protection at LeRC are discussed.

High Throughput Determination of Ricinine Abrine and Alpha ...

EPA Pesticide Factsheets

Analytical Method This document provides the standard operating procedure for determination of ricinine (RIC), abrine (ABR), and α-amanitin (AMAN) in drinking water by isotope dilution liquid chromatography tandem mass spectrometry (LC/MS/MS). This method is designed to support site-specific cleanup goals of environmental remediation activities following a homeland security incident involving one or a combination of these analytes.

Sampling protocol for post-landfall Deepwater Horizon oil release, Gulf of Mexico, 2010

USGS Publications Warehouse

Wilde, F.D.; Skrobialowski, S.C.; Hart, J.S.

2010-01-01

The protocols and procedures described in this report are designed to be used by U.S. Geological Survey (USGS) field teams for the collection of environmental data and samples in coastal areas affected by the 2010 Deepwater Horizon oil spill in the Gulf of Mexico. This sampling protocol focuses specifically on sampling for water, sediments, benthic invertebrates, and microorganisms (ambient bacterial populations) after shoreline arrival of petroleum-associated product on beach, barrier island, and wetland environments of the Gulf of Mexico coastal states. Deployment to sampling sites, site setup, and sample collection in these environments necessitates modifications to standard USGS sampling procedures in order to address the regulatory, logistical, and legal requirements associated with samples collected in oil-impacted coastal areas. This document, therefore, has been written as an addendum to the USGS National Field Manual for the Collection of Water-Quality Data (NFM) (http://pubs.water.usgs.gov/twri9A/), which provides the basis for training personnel in the use of standard USGS sampling protocols. The topics covered in this Gulf of Mexico oil-spill sampling protocol augment NFM protocols for field-deployment preparations, health and safety precautions, sampling and quality-assurance procedures, and decontamination requirements under potentially hazardous environmental conditions. Documentation procedures and maintenance of sample integrity by use of chain-of-custody procedures also are described in this protocol.

LAMP assay and rapid sample preparation method for on-site detection of flavescence dorée phytoplasma in grapevine

PubMed Central

Kogovšek, P; Hodgetts, J; Hall, J; Prezelj, N; Nikolić, P; Mehle, N; Lenarčič, R; Rotter, A; Dickinson, M; Boonham, N; Dermastia, M; Ravnikar, M

2015-01-01

In Europe the most devastating phytoplasma associated with grapevine yellows (GY) diseases is a quarantine pest, flavescence dorée (FDp), from the 16SrV taxonomic group. The on-site detection of FDp with an affordable device would contribute to faster and more efficient decisions on the control measures for FDp. Therefore, a real-time isothermal LAMP assay for detection of FDp was validated according to the EPPO standards and MIQE guidelines. The LAMP assay was shown to be specific and extremely sensitive, because it detected FDp in all leaf samples that were determined to be FDp infected using quantitative real-time PCR. The whole procedure of sample preparation and testing was designed and optimized for on-site detection and can be completed in one hour. The homogenization procedure of the grapevine samples (leaf vein, flower or berry) was optimized to allow direct testing of crude homogenates with the LAMP assay, without the need for DNA extraction, and was shown to be extremely sensitive. PMID:26146413

Physician training protocol within the WEB Intrasaccular Therapy (WEB-IT) study.

PubMed

Arthur, Adam; Hoit, Daniel; Coon, Alexander; Delgado Almandoz, Josser E; Elijovich, Lucas; Cekirge, Saruhan; Fiorella, David

2018-05-01

The WEB Intra-saccular Therapy (WEB-IT) trial is an investigational device exemption study to demonstrate the safety and effectiveness of the WEB device for the treatment of wide-neck bifurcation aneurysms. The neurovascular replicator (Vascular Simulations, Stony Brook, New York, USA) creates a physical environment that replicates patient-specific neurovascular anatomy and hemodynamic physiology, and allows devices to be implanted under fluoroscopic guidance. To report the results of a unique neurovascular replicator-based training program, which was incorporated into the WEB-IT study to optimize technical performance and patient safety. US investigators participated in a new training program that incorporated full surgical rehearsals on a neurovascular replicator. No roll-in cases were permitted within the trial. Custom replicas of patient-specific neurovascular anatomy were created for the initial cases treated at each center, as well as for cases expected to be challenging. On-site surgical rehearsals were performed before these procedures. A total of 48 participating investigators at 25 US centers trained using the replicator. Sessions included centralized introductory training, on-site training, and patient-specific full surgical rehearsal. Fluoroscopy and procedure times in the WEB-IT study were not significantly different from those seen in two European trials where participating physicians had significant WEB procedure experience before study initiation. A new program of neurovascular-replicator-based physician training was employed within the WEB-IT study. This represents a new methodology for education and training that may be an effective means to optimize technical success and patient safety during the introduction of a new technology. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Plastic freezer bags: a cost-effective method to protect extraction sites in laparoscopic colorectal procedures?

PubMed

Huynh, Hai P; Musselman, Reilly P; Trottier, Daniel C; Soto, Claudia M; Poulin, Eric C; Mamazza, Joseph; Boushey, Robin P; Auer, Rebecca C; Moloo, Husein

2013-10-01

To review surgical-site infection (SSI) and retrieval-site tumor recurrence rates in laparoscopic colorectal procedures when using a plastic freezer bag as a wound protector. Laparoscopic colorectal procedures where a plastic freezer bag used as a wound protector at the extraction site were reviewed between 1991 and 2008 from a prospectively collected database. χ test was used to compare SSI and tumor recurrence rates between groups. Costing data were obtained from the operating room supplies department. A total of 936 cases with 51 (5.45%) surgical-site infections were identified. SSI rates did not differ when comparing groups based on demographic factors, diagnosis, or location of procedure. Retrieval-site tumor recurrence rate was 0.21% (1/474). Cost of plastic freezer bags including sterilization ranged from $0.25 to $3. Plastic freezer bags as wound protectors in laparoscopic colorectal procedures are cost effective and have SSI and retrieval-site tumor recurrence rates that compare favorably to published data.

MO-E-18C-01: Open Access Web-Based Peer-To-Peer Training and Education in Radiotherapy

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

Pawlicki, T; Brown, D; Dunscombe, P

Purpose: Current training and education delivery models have limitations which result in gaps in clinical proficiency with equipment, procedures, and techniques. Educational and training opportunities offered by vendors and professional societies are by their nature not available at point of need or for the life of clinical systems. The objective of this work is to leverage modern communications technology to provide peer-to-peer training and education for radiotherapy professionals, in the clinic and on demand, as they undertake their clinical duties. Methods: We have developed a free of charge web site ( https://i.treatsafely.org ) using the Google App Engine and datastoremore » (NDB, GQL), Python with AJAX-RPC, and Javascript. The site is a radiotherapy-specific hosting service to which user-created videos illustrating clinical or physics processes and other relevant educational material can be uploaded. Efficient navigation to the material of interest is provided through several RT specific search tools and videos can be scored by users, thus providing comprehensive peer review of the site content. The site also supports multilingual narration\\translation of videos, a quiz function for competence assessment and a library function allowing groups or institutions to define their standard operating procedures based on the video content. Results: The website went live in August 2013 and currently has over 680 registered users from 55 countries; 27.2% from the United States, 9.8% from India, 8.3% from the United Kingdom, 7.3% from Brazil, and 47.5% from other countries. The users include physicists (57.4%), Oncologists (12.5%), therapists (8.2%) and dosimetrists (4.8%). There are 75 videos to date including English, Portuguese, Mandarin, and Thai. Conclusion: Based on the initial acceptance of the site, we conclude that this open access web-based peer-to-peer tool is fulfilling an important need in radiotherapy training and education. Site functionality should expand in the future to include document sharing and continuing education credits.« less

Effectiveness of the addition of Lidocaine to a hemostatic, bioresorbable putty in the treatment of iliac crest donor site pain.

PubMed

Müller, Marc Andreas; Mehrkens, Arne; Zürcher, Roman; Vavken, Patrick; Valderrabano, Victor

2014-12-08

The harvest of iliac crest bone grafts (ICBG) is associated with relevant donor site pain, but may be lowered by the application of lidocaine loaded on biodegradable, hemostatic putty for sustained local analgesic release. The goal of this double-blind controlled trial was to assess the efficacy of adding lidocaine to a hemostatic putty (Orthostat ™) to treat donor site pain following harvest of ICBG in foot and ankle procedures. After ICBG harvest during a foot and ankle procedure, the resulting bone defect was either filled with Orthostat™ (n = 7) or with the same hemostatic putty loaded with lidocaine (Orthostat-L™, n = 7). During the first 72 postoperative hours, donor site and surgical site pain were managed by patient controlled morphine delivery and a peripheral nerve block. Donor site pain was periodically quantified on a Visual Analog (VAS) and a Wong Baker FACES scale. Pain scores were plotted over time to calculate the area under the curve (AUC) to quantify the overall pain experienced in specific time intervals. Orthostat-L™ significantly reduced donor site pain over the first 12 hours postoperatively as evidenced by a significant decrease of the AUC in both VAS (p = 0.0366) and Wong Baker FACES pain score plots (p = 0.0024). Cumulated morphine uses were not significantly decreased with Orthostat-L™. The addition of lidocaine to a hemostatic putty offers a significant ICBG donor site pain reduction over the first 12 postoperative hours. ClinicalTrials.gov NCT01504035. Registered January 2nd 2012.

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

Bower, J.C.; Burford, M.J.; Downing, T.R.

The Integrated Baseline System (IBS) is an emergency management planning and analysis tool that is being developed under the direction of the US Army Nuclear and Chemical Agency (USANCA). The IBS Data Management Guide provides the background, as well as the operations and procedures needed to generate and maintain a site-specific map database. Data and system managers use this guide to manage the data files and database that support the administrative, user-environment, database management, and operational capabilities of the IBS. This document provides a description of the data files and structures necessary for running the IBS software and using themore » site map database.« less

The precision of wet atmospheric deposition data from national atmospheric deposition program/national trends network sites determined with collocated samplers

USGS Publications Warehouse

Nilles, M.A.; Gordon, J.D.; Schroder, L.J.

1994-01-01

A collocated, wet-deposition sampler program has been operated since October 1988 by the U.S. Geological Survey to estimate the overall sampling precision of wet atmospheric deposition data collected at selected sites in the National Atmospheric Deposition Program and National Trends Network (NADP/NTN). A duplicate set of wet-deposition sampling instruments was installed adjacent to existing sampling instruments at four different NADP/NTN sites for each year of the study. Wet-deposition samples from collocated sites were collected and analysed using standard NADP/NTN procedures. Laboratory analyses included determinations of pH, specific conductance, and concentrations of major cations and anions. The estimates of precision included all variability in the data-collection system, from the point of sample collection through storage in the NADP/NTN database. Sampling precision was determined from the absolute value of differences in the analytical results for the paired samples in terms of median relative and absolute difference. The median relative difference for Mg2+, Na+, K+ and NH4+ concentration and deposition was quite variable between sites and exceeded 10% at most sites. Relative error for analytes whose concentrations typically approached laboratory method detection limits were greater than for analytes that did not typically approach detection limits. The median relative difference for SO42- and NO3- concentration, specific conductance, and sample volume at all sites was less than 7%. Precision for H+ concentration and deposition ranged from less than 10% at sites with typically high levels of H+ concentration to greater than 30% at sites with low H+ concentration. Median difference for analyte concentration and deposition was typically 1.5-2-times greater for samples collected during the winter than during other seasons at two northern sites. Likewise, the median relative difference in sample volume for winter samples was more than double the annual median relative difference at the two northern sites. Bias accounted for less than 25% of the collocated variability in analyte concentration and deposition from weekly collocated precipitation samples at most sites.A collocated, wet-deposition sampler program has been operated since OCtober 1988 by the U.S Geological Survey to estimate the overall sampling precision of wet atmospheric deposition data collected at selected sites in the National Atmospheric Deposition Program and National Trends Network (NADP/NTN). A duplicate set of wet-deposition sampling instruments was installed adjacent to existing sampling instruments four different NADP/NTN sites for each year of the study. Wet-deposition samples from collocated sites were collected and analysed using standard NADP/NTN procedures. Laboratory analyses included determinations of pH, specific conductance, and concentrations of major cations and anions. The estimates of precision included all variability in the data-collection system, from the point of sample collection through storage in the NADP/NTN database.

Access site complications and puncture site pain following transradial coronary procedures: a correlational study.

PubMed

Cheng, Ka Yan; Chair, Sek Ying; Choi, Kai Chow

2013-10-01

Transradial coronary angiography (CA) and percutaneous coronary intervention (PCI) are gaining worldwide popularity due to the low incidence of major vascular complications and early mobilization of patients post procedures. Although post transradial access site complications are generally considered as minor in nature, they are not being routinely recorded in clinical settings. To evaluate the incidence of access site complications and level of puncture site pain experienced by patients undergoing transradial coronary procedures and to examine factors associated with access site complications occurrence and puncture site pain severity. A cross-sectional correlational study of 85 Chinese speaking adult patients scheduled for elective transradial CA and or PCI. Ecchymosis, bleeding, hematoma and radial artery occlusion (RAO) were assessed through observation, palpation and plethysmographic signal of pulse oximetry after coronary procedures. Puncture site pain was assessed with a 100mm Visual Analogue Scale. Factors that were related to access site complications and puncture site pain were obtained from medical records. Ecchymosis was the most commonly reported transradial access site complication in this study. Paired t-test showed that the level of puncture site pain at 24 h was significantly (p<0.001) lower than that at 3 h after the procedure. Stepwise multivariable regression showed that female gender and shorter sheath time were found to be significantly associated with bleeding during gradual deflation of compression device. Only longer sheath time was significantly associated with RAO. Female gender and larger volume of compression air were associated with the presence of ecchymosis and puncture site pain at 3 h after procedure, respectively. The study findings suggest that common access site complications post transradial coronary procedures among Chinese population are relatively minor in nature. Individual puncture site pain assessment during the period of hemostasis is important. Nurses should pay more attention to factors such as female gender, sheath time and volume of compression that are more likely to be associated with transradial access site complications and puncture site pain. Copyright © 2013 Elsevier Ltd. All rights reserved.

Determination of colonoscopy indication from administrative claims data.

PubMed

Ko, Cynthia W; Dominitz, Jason A; Neradilek, Moni; Polissar, Nayak; Green, Pam; Kreuter, William; Baldwin, Laura-Mae

2014-04-01

Colonoscopy outcomes, such as polyp detection or complication rates, may differ by procedure indication. To develop methods to classify colonoscopy indications from administrative data, facilitating study of colonoscopy quality and outcomes. We linked 14,844 colonoscopy reports from the Clinical Outcomes Research Initiative, a national repository of endoscopic reports, to the corresponding Medicare Carrier and Outpatient File claims. Colonoscopy indication was determined from the procedure reports. We developed algorithms using classification and regression trees and linear discriminant analysis (LDA) to classify colonoscopy indication. Predictor variables included ICD-9CM and CPT/HCPCS codes present on the colonoscopy claim or in the 12 months prior, patient demographics, and site of colonoscopy service. Algorithms were developed on a training set of 7515 procedures, then validated using a test set of 7329 procedures. Sensitivity was lowest for identifying average-risk screening colonoscopies, varying between 55% and 86% for the different algorithms, but specificity for this indication was consistently over 95%. Sensitivity for diagnostic colonoscopy varied between 77% and 89%, with specificity between 55% and 87%. Algorithms with classification and regression trees with 7 variables or LDA with 10 variables had similar overall accuracy, and generally lower accuracy than the algorithm using LDA with 30 variables. Algorithms using Medicare claims data have moderate sensitivity and specificity for colonoscopy indication, and will be useful for studying colonoscopy quality in this population. Further validation may be needed before use in alternative populations.

Introduction to the Centers for Disease Control and Prevention and Healthcare Infection Control Practices Advisory Committee Guideline for Prevention of Surgical Site Infection: Prosthetic Joint Arthroplasty Section.

PubMed

Segreti, John; Parvizi, Javad; Berbari, Elie; Ricks, Philip; Berríos-Torres, Sandra I

Peri-prosthetic joint infection (PJI) is a severe complication of total joint arthroplasty that appears to be increasing as more of these procedures are performed. Numerous risk factors for incisional (superficial and deep) and organ/space (e.g., PJI) surgical site infections (SSIs) have been identified. A better understanding and reversal of modifiable risk factors may lead to a reduction in the incidence of incisional SSI and PJI. The Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC) recently updated the national Guideline for Prevention of Surgical Site Infection. The updated guideline applies evidence-based methodology, presents recommendations for potential strategies to reduce the risk of SSI, and includes an arthroplasty-specific section. This article serves to introduce the guideline development process and to complement the Prosthetic Joint Arthroplasty section with background information on PJI-specific economic burden, epidemiology, pathogenesis and microbiology, and risk factor information.

Probing site-exclusive binding of aqueous QDs and their organelle-dependent dynamics in live cells by single molecule spectroscopy.

PubMed

Dong, Chaoqing; Chowdhury, Basudev; Irudayaraj, Joseph

2013-05-21

Understanding the biophysical and chemical interactions of nanoprobes and their fate upon entering live cells is critical for developing fundamental insights related to intracellular diagnostics, drug delivery and targeting. In this article we report herein a single molecule analysis procedure to quantitate site-specific exclusive membrane binding of N-acetyl-L-cysteine (NAC)-capped cadmium telluride (CdTe) quantum dots (QDs) in A-427 lung carcinoma cells (k(eq) = 0.075 ± 0.011 nM(-1)), its relative intracellular distribution and dynamics using fluorescence correlation spectroscopy (FCS) combined with scanning confocal fluorescence lifetime imaging (FLIM). In particular, we demonstrate that the binding efficacy of QDs to the cell membrane is directly related to their size and the targeting of QDs to specific membrane sites is exclusive. We also show that QDs are efficiently internalized by endocytosis and enclosed within the endosome and organelle-dependent diffusion dynamics can be monitored in live cells.

Health and Safety Plan for Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee. Environmental Restoration Program

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

Van Hoesen, S.D.; Clark, C. Jr.; Burman, S.N.

1993-12-01

The Martin Marietta Energy Systems, Inc. (Energy Systems), policy is to provide a safe and healthful workplace for all employees and subcontractors. The accomplishment of this policy requires that operations at Waste Area Grouping (WAG) 6 at the Department of Energy (DOE) Oak Ridge National Laboratory are guided by an overall plan and consistent proactive approach to safety and health (S&H) issues. The plan is written to utilize past experience and best management practices to minimize hazards to human health or the environment from events such as fires, explosions, falls, mechanical hazards, or any unplanned release of hazardous or radioactivemore » materials to air, soil, or surface water This plan explains additional site-specific health and safety requirements such as Site Specific Hazards Evaluation Addendums (SSHEAs) to the Site Safety and Health Plan which should be used in concert with this plan and existing established procedures.« less

Species-Level Identification of Orthopoxviruses with an Oligonucleotide Microchip

PubMed Central

Lapa, Sergey; Mikheev, Maxim; Shchelkunov, Sergei; Mikhailovich, Vladimir; Sobolev, Alexander; Blinov, Vladimir; Babkin, Igor; Guskov, Alexander; Sokunova, Elena; Zasedatelev, Alexander; Sandakhchiev, Lev; Mirzabekov, Andrei

2002-01-01

A method for species-specific detection of orthopoxviruses pathogenic for humans and animals is described. The method is based on hybridization of a fluorescently labeled amplified DNA specimen with the oligonucleotide DNA probes immobilized on a microchip (MAGIChip). The probes identify species-specific sites within the crmB gene encoding the viral analogue of tumor necrosis factor receptor, one of the most important determinants of pathogenicity in this genus of viruses. The diagnostic procedure takes 6 h and does not require any sophisticated equipment (a portable fluorescence reader can be used). PMID:11880388

Can PET-CT imaging and radiokinetic analyses provide useful clinical information on atypical femoral shaft fracture in osteoporotic patients?

PubMed

Chesnut, C Haile; Chesnut, Charles H

2012-03-01

Atypical femoral shaft fractures are associated with the extended usage of nitrogen-containing bisphosphonates as therapy for osteoporosis. For such fractures, the positron emission tomography (PET) procedure, coupled with computerized tomography (CT), provides a potential imaging modality for defining aspects of the pathogenesis, site specificity, and possible prodromal abnormalities prior to fracture. PET-CT may assess the radiokinetic variables K1 (a putative marker for skeletal blood flow) and Ki (a putative marker for skeletal bone formation), and when combined with PET imaging modalities and CT skeletal site localization, may define the site of such radiokinetic findings. Further studies into the clinical usage of PET-CT in patients with atypical femoral shaft fractures are warranted.

40 CFR 63.9916 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

Code of Federal Regulations, 2011 CFR

2011-07-01

... compliance with the operating limits? For a wet scrubber subject to operating limits for pressure drop and scrubber water flow rate in § 63.9890(b), you must establish site-specific operating limits according to... monitoring system (CPMS) required in § 63.9920, measure and record the pressure drop and scrubber water flow...

40 CFR 63.9916 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

Code of Federal Regulations, 2010 CFR

2010-07-01

... compliance with the operating limits? For a wet scrubber subject to operating limits for pressure drop and scrubber water flow rate in § 63.9890(b), you must establish site-specific operating limits according to... monitoring system (CPMS) required in § 63.9920, measure and record the pressure drop and scrubber water flow...

40 CFR 63.9916 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

Code of Federal Regulations, 2012 CFR

2012-07-01

... compliance with the operating limits? For a wet scrubber subject to operating limits for pressure drop and scrubber water flow rate in § 63.9890(b), you must establish site-specific operating limits according to... monitoring system (CPMS) required in § 63.9920, measure and record the pressure drop and scrubber water flow...

40 CFR 63.9916 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

Code of Federal Regulations, 2013 CFR

2013-07-01

... compliance with the operating limits? For a wet scrubber subject to operating limits for pressure drop and scrubber water flow rate in § 63.9890(b), you must establish site-specific operating limits according to... monitoring system (CPMS) required in § 63.9920, measure and record the pressure drop and scrubber water flow...

40 CFR 63.9916 - What test methods and other procedures must I use to establish and demonstrate initial compliance...

Code of Federal Regulations, 2014 CFR

2014-07-01

... compliance with the operating limits? For a wet scrubber subject to operating limits for pressure drop and scrubber water flow rate in § 63.9890(b), you must establish site-specific operating limits according to... monitoring system (CPMS) required in § 63.9920, measure and record the pressure drop and scrubber water flow...

28 CFR Appendix E to Part 61 - United States Marshals Service Procedures Relating to the Implementation of the National...

Code of Federal Regulations, 2010 CFR

2010-07-01

... disposal of equipment or property, (3) Leases or entitlement for use, including donation or exchange, (4... facility is a site-specific determination based on the extent to which an entire project will be within the... decisions based on it, will or will not achieve the goals of NEPA to prevent damage to the environment and...

Identification of site frequencies from building records

USGS Publications Warehouse

Celebi, M.

2003-01-01

A simple procedure to identify site frequencies using earthquake response records from roofs and basements of buildings is presented. For this purpose, data from five different buildings are analyzed using only spectral analyses techniques. Additional data such as free-field records in close proximity to the buildings and site characterization data are also used to estimate site frequencies and thereby to provide convincing evidence and confirmation of the site frequencies inferred from the building records. Furthermore, simple code-formula is used to calculate site frequencies and compare them with the identified site frequencies from records. Results show that the simple procedure is effective in identification of site frequencies and provides relatively reliable estimates of site frequencies when compared with other methods. Therefore the simple procedure for estimating site frequencies using earthquake records can be useful in adding to the database of site frequencies. Such databases can be used to better estimate site frequencies of those sites with similar geological structures.

Prompting one low-fat, high-fiber selection in a fast-food restaurant.

PubMed

Wagner, J L; Winett, R A

1988-01-01

Evidence increasingly links a high-fat, low-fiber diet to coronary heart disease and certain site cancers, indicating a need for large-scale dietary change. Studies showing the effectiveness of particular procedures in specific settings are important at this point. The present study, using an A-B-A-B design and sales data from computerized cash registers, replicated and extended previous work by showing that inexpensive prompts (i.e., signs and fliers) in a national fast-food restaurant could increase the sales of salads, a low-fat, high-fiber menu selection. Suggestions also are made pertinent to more widespread use of the procedures.

SSET Project: Cost-effectiveness Analysis of Surgical Specialty Emergency Trays in the Emergency Department.

PubMed

Humphries, Laura S; Shenaq, Deana S; Teven, Chad M; Park, Julie E; Song, David H

2018-01-01

We hypothesize that reusable, on-site specialty instrument trays available to plastic surgery residents in the emergency department (ED) for bedside procedures are more cost-effective than disposable on-site and remote re-usable operating room (OR) instruments at our institution. We completed a cost-effectiveness analysis comparing the use of disposable on-site kits and remote OR trays to a hypothetical, custom, reusable tray for ED procedures completed by PRS residents. Material costs of existing OR trays were used to estimate the purchasing and use-cost of a custom on-site tray for the same procedures. Cost of per procedure 'consult time' was estimated using procedure and resident salary. Sixteen bedside procedures were completed over a 4.5 month period. A mean of 2.14 disposable kits were used per-procedure. Mean consultation time was 1.66 hours. Procedures that used OR trays took 3 times as long as procedures that used on-site kits (4 vs. 1.1 hours). Necessary, additional instruments were unavailable for 75% of procedures. Mean cost of using disposable kits and OR trays was $115.03/procedure versus an estimated $26.67/procedure cost of using a custom tray, yielding $88.36/procedure cost-savings. Purchase of a single custom tray ($1,421.55) would be redeemed after 2.3 weeks at 1 procedure/day. Purchasing 4 trays has projected annual cost-savings of $26,565.20. The purchase of specialized procedure trays will yield valuable time and cost-savings while providing quality patient care. Improving time efficiency will help achieve the Accreditation Council of Graduate Medical Education (ACGME) goals of maintaining resident well-being and developing quality improvement competency.

Replication and Comparison of the Newly Proposed ADOS-2, Module 4 Algorithm in ASD without ID: A Multi-site Study

PubMed Central

Pugliese, Cara E.; Kenworthy, Lauren; Bal, Vanessa Hus; Wallace, Gregory L; Yerys, Benjamin E; Maddox, Brenna B.; White, Susan W.; Popal, Haroon; Armour, Anna Chelsea; Miller, Judith; Herrington, John D.; Schultz, Robert T.; Martin, Alex; Anthony, Laura Gutermuth

2015-01-01

Recent updates have been proposed to the Autism Diagnostic Observation Schedule-2 Module 4 diagnostic algorithm. This new algorithm, however, has not yet been validated in an independent sample without intellectual disability (ID). This multi-site study compared the original and revised algorithms in individuals with ASD without ID. The revised algorithm demonstrated increased sensitivity, but lower specificity in the overall sample. Estimates were highest for females, individuals with a verbal IQ below 85 or above 115, and ages 16 and older. Best practice diagnostic procedures should include the Module 4 in conjunction with other assessment tools. Balancing needs for sensitivity and specificity depending on the purpose of assessment (e.g., clinical vs. research) and demographic characteristics mentioned above will enhance its utility. PMID:26385796

43 CFR 3833.10 - Procedures for recording mining claims and sites.

Code of Federal Regulations, 2011 CFR

2011-10-01

...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) RECORDING MINING CLAIMS AND SITES Recording Process § 3833.10 Procedures for recording mining claims and sites. ...

43 CFR 3833.10 - Procedures for recording mining claims and sites.

Code of Federal Regulations, 2013 CFR

2013-10-01

...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) RECORDING MINING CLAIMS AND SITES Recording Process § 3833.10 Procedures for recording mining claims and sites. ...

43 CFR 3833.10 - Procedures for recording mining claims and sites.

Code of Federal Regulations, 2014 CFR

2014-10-01

...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) RECORDING MINING CLAIMS AND SITES Recording Process § 3833.10 Procedures for recording mining claims and sites. ...

43 CFR 3833.10 - Procedures for recording mining claims and sites.

Code of Federal Regulations, 2012 CFR

2012-10-01

...) BUREAU OF LAND MANAGEMENT, DEPARTMENT OF THE INTERIOR MINERALS MANAGEMENT (3000) RECORDING MINING CLAIMS AND SITES Recording Process § 3833.10 Procedures for recording mining claims and sites. ...

Standardized patient walkthroughs in the National Drug Abuse Treatment Clinical Trials Network: common challenges to protocol implementation.

PubMed

Fussell, Holly E; Kunkel, Lynn E; McCarty, Dennis; Lewy, Colleen S

2011-09-01

Training research staff to implement clinical trials occurring in community-based addiction treatment programs presents unique challenges. Standardized patient walkthroughs of study procedures may enhance training and protocol implementation. Examine and discuss cross-site and cross-study challenges of participant screening and data collection procedures identified during standardized patient walkthroughs of multi-site clinical trials. Actors portrayed clients and "walked through" study procedures with protocol research staff. The study completed 57 walkthroughs during implementation of 4 clinical trials. Observers and walkthrough participants identified three areas of concern (consent procedures, screening and assessment processes, and protocol implementation) and made suggestions for resolving the concerns. Standardized patient walkthroughs capture issues with study procedures previously unidentified with didactic training or unscripted rehearsals. Clinical trials within the National Drug Abuse Treatment Clinical Trials Network are conducted in addiction treatment centers that vary on multiple dimensions. Based on walkthrough observations, the national protocol team and local site leadership modify standardized operating procedures and resolve cross-site problems prior to recruiting study participants. The standardized patient walkthrough improves consistency across study sites and reduces potential site variation in study outcomes.

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

None

The purpose of this document is to provide the technical requirements for operation, inspection and maintenance of a TRUPACT-II Shipping Package and directly related components. This document shall supply the minimum requirements as specified in the TRUPACT-II Safety Analysis Report for Packaging (SARP) and Certificate of Compliance (C of C) 9218. In the event there is a conflict between this document and the TRUPACT-II SARP (NRC Certificate of Compliance No. 9218), the TRUPACT-II SARP shall govern. This document details the operations, maintenance, repair, replacement of components, as well as the documentation required and the procedures to be followed to maintainmore » the integrity of the TRUPACT-II container. These procedures may be modified for site use, but as a minimum all parameters and format listed herein must be included in any site modified version. For convenience and where applicable steps may be performed out of sequence. Packaging and payload handling equipment and transport trailers have been specifically designed for use with the TRUPACT-II Packaging. This document discusses the minimum required procedures for use of the adjustable center of gravity lift fixture and the TRUPACT-II transport trailer in conjunction with the TRUPACT-II Packaging.« less

A decision support tool to prioritize risk management options for contaminated sites.

PubMed

Sorvari, Jaana; Seppälä, Jyri

2010-03-15

The decisions on risk management (RM) of contaminated sites in Finland have typically been driven by practical factors such as time and money. However, RM is a multifaceted task that generally involves several additional determinants, e.g. performance and environmental effects of remediation methods, psychological and social factors. Therefore, we adopted a multi-criteria decision analysis approach and developed a decision support tool (DST) that is viable in decision-making in such a complex situation. The basic components of the DST are based on the Dutch REC system. However, our DST is more case-specific and allows the consideration of the type, magnitude and scale of contamination, land use, environmental conditions and socio-cultural aspects (e.g. loss of cultural heritage, image aspects). The construction of the DST was started by structuring the decision problem using a value tree. Based on this work we adopted the Multi-Attribute Value Theory (MAVT) for data aggregation. The final DST was demonstrated by two model sites for which the RM alternatives and site-specific data were created on the basis of factual remediation projects and by interviewing experts. The demonstration of the DST was carried out in a workshop where representatives of different stakeholders were requested to rank and weight the decision criteria involved. To get information on the consistency of the ranking of the RM alternatives, we used different weighting techniques (ratio estimation and pair-wise weighting) and alternative ways to treat individual respondents' weights in calculating the preference scores for each RM alternative. These dissimilar approaches resulted in some differences in the preference order of the RM alternatives. The demonstration showed that attention has to be paid to the proper description of the site, the principles of the procedure and the decision criteria. Nevertheless, the procedure proved to enable efficient communication between different stakeholders and the identification of the preferred RM option.

Distributions of Magnetic Field Variations, Differences and Residuals

DTIC Science & Technology

1999-02-01

differences and residuals between two neighbouring sites (1997 data, Monte - cristo area). Each panel displays the results from a specific vector...This means, in effect, counting the number of times the absolute value increased past one of a series of regularly spaced thresholds, and tally the...results. Crossings of the zero level were not counted . Fig. 7 illustrates the binning procedure for a fictitious data set and four bin thresholds on

Determination of Optimum Tropic Storage and Exposure Sites. Report 1: Survey of Programs in Tropic Materials Research

DTIC Science & Technology

1973-04-01

of fungicidal varnish. Differences in specifications and procedures between the two countries were largely due to differences in available materials...the Japanese were aware of the problems of tropic deterioration of improperly protected materiel, neither fungicides nor radioactive materials were...used to prevent fungus growth. Emphasis was placed on moisture proofing the material rather than incorporating fungicides . The wartime state of

Australia ground data collection 1981-82 crop year, volume 1

NASA Technical Reports Server (NTRS)

Quinones, C. R.

1982-01-01

Under AgRISTARS management, ground data were collected at 20 agricultural sites within Australia during the crop year 1981-82. The data collection activity is summarized. Specifically, the following information is provided: discussion of data procedures, methods, and products; crop production results; photographs of the Australia agriculture scene, map sheets of segments, LANDSAT full frames, and aerial photographs of data collection areas; and summarizations of district agronomist reports.

40 CFR 63.1450 - What test methods and other procedures must I use to demonstrate initial compliance with the...

Code of Federal Regulations, 2010 CFR

2010-07-01

... emissions from an affected source and subject to operating limits in § 63.1444(g) or § 63.1446(d) for... applied to emissions from an affected source and subject to site-specific operating limit(s) in § 63.1444... two or more segments performed on the same day or on different days if conditions prevent the required...

40 CFR 63.1450 - What test methods and other procedures must I use to demonstrate initial compliance with the...

Code of Federal Regulations, 2011 CFR

2011-07-01

... emissions from an affected source and subject to operating limits in § 63.1444(g) or § 63.1446(d) for... applied to emissions from an affected source and subject to site-specific operating limit(s) in § 63.1444... two or more segments performed on the same day or on different days if conditions prevent the required...

Decontamination and management of human remains following incidents of hazardous chemical release.

PubMed

Hauschild, Veronique D; Watson, Annetta; Bock, Robert

2012-01-01

To provide specific guidance and resources for systematic and orderly decontamination of human remains resulting from a chemical terrorist attack or accidental chemical release. A detailed review and health-based decision criteria protocol is summarized. Protocol basis and logic are derived from analyses of compound-specific toxicological data and chemical/physical characteristics. Guidance is suitable for civilian or military settings where human remains potentially contaminated with hazardous chemicals may be present, such as sites of transportation accidents, terrorist operations, or medical examiner processing points. Guidance is developed from data-characterizing controlled experiments with laboratory animals, fabrics, and materiel. Logic and specific procedures for decontamination and management of remains, protection of mortuary affairs personnel, and decision criteria to determine when remains are sufficiently decontaminated are presented. Established procedures as well as existing materiel and available equipment for decontamination and verification provide reasonable means to mitigate chemical hazards from chemically exposed remains. Unique scenarios such as those involving supralethal concentrations of certain liquid chemical warfare agents may prove difficult to decontaminate but can be resolved in a timely manner by application of the characterized systematic approaches. Decision criteria and protocols to "clear" decontaminated remains for transport and processing are also provided. Once appropriate decontamination and verification have been accomplished, normal procedures for management of remains and release can be followed.

A facile reflux procedure to increase active surface sites form highly active and durable supported palladium@platinum bimetallic nanodendrites

NASA Astrophysics Data System (ADS)

Wang, Qin; Li, Yingjun; Liu, Baocang; Xu, Guangran; Zhang, Geng; Zhao, Qi; Zhang, Jun

2015-11-01

A series of well-dispersed bimetallic Pd@Pt nanodendrites uniformly supported on XC-72 carbon black are fabricated by using different capping agents. These capping agents are essential for the branched morphology control. However, the surfactant adsorbed on the nanodendrites surface blocks the access of reactant molecules to the active surface sites, and the catalytic activities of these bimetallic nanodendrites are significantly restricted. Herein, a facile reflux procedure to effectively remove the capping agent molecules without significantly affecting their sizes is reported for activating supported nanocatalysts. More significantly, the structure and morphology of the nanodendrites can also be retained, enhancing the numbers of active surface sites, catalytic activity and stability toward methanol and ethanol electro-oxidation reactions. The as-obtained hot water reflux-treated Pd@Pt/C catalyst manifests superior catalytic activity and stability both in terms of surface and mass specific activities, as compared to the untreated catalysts and the commercial Pt/C and Pd/C catalysts. We anticipate that this effective and facile removal method has more general applicability to highly active nanocatalysts prepared with various surfactants, and should lead to improvements in environmental protection and energy production.

A procedure to select ground-motion time histories for deterministic seismic hazard analysis from the Next Generation Attenuation (NGA) database

NASA Astrophysics Data System (ADS)

Huang, Duruo; Du, Wenqi; Zhu, Hong

2017-10-01

In performance-based seismic design, ground-motion time histories are needed for analyzing dynamic responses of nonlinear structural systems. However, the number of ground-motion data at design level is often limited. In order to analyze seismic performance of structures, ground-motion time histories need to be either selected from recorded strong-motion database or numerically simulated using stochastic approaches. In this paper, a detailed procedure to select proper acceleration time histories from the Next Generation Attenuation (NGA) database for several cities in Taiwan is presented. Target response spectra are initially determined based on a local ground-motion prediction equation under representative deterministic seismic hazard analyses. Then several suites of ground motions are selected for these cities using the Design Ground Motion Library (DGML), a recently proposed interactive ground-motion selection tool. The selected time histories are representatives of the regional seismic hazard and should be beneficial to earthquake studies when comprehensive seismic hazard assessments and site investigations are unavailable. Note that this method is also applicable to site-specific motion selections with the target spectra near the ground surface considering the site effect.

An efficient procedure for marker-free mutagenesis of S. coelicolor by site-specific recombination for secondary metabolite overproduction.

PubMed

Zhang, Bo; Zhang, Lin; Dai, Ruixue; Yu, Meiying; Zhao, Guoping; Ding, Xiaoming

2013-01-01

Streptomyces bacteria are known for producing important natural compounds by secondary metabolism, especially antibiotics with novel biological activities. Functional studies of antibiotic-biosynthesizing gene clusters are generally through homologous genomic recombination by gene-targeting vectors. Here, we present a rapid and efficient method for construction of gene-targeting vectors. This approach is based on Streptomyces phage φBT1 integrase-mediated multisite in vitro site-specific recombination. Four 'entry clones' were assembled into a circular plasmid to generate the destination gene-targeting vector by a one-step reaction. The four 'entry clones' contained two clones of the upstream and downstream flanks of the target gene, a selectable marker and an E. coli-Streptomyces shuttle vector. After targeted modification of the genome, the selectable markers were removed by φC31 integrase-mediated in vivo site-specific recombination between pre-placed attB and attP sites. Using this method, part of the calcium-dependent antibiotic (CDA) and actinorhodin (Act) biosynthetic gene clusters were deleted, and the rrdA encoding RrdA, a negative regulator of Red production, was also deleted. The final prodiginine production of the engineered strain was over five times that of the wild-type strain. This straightforward φBT1 and φC31 integrase-based strategy provides an alternative approach for rapid gene-targeting vector construction and marker removal in streptomycetes.

Recognition of RNA Editing Sites Is Directed by Unique Proteins in Chloroplasts: Biochemical Identification of cis-Acting Elements and trans-Acting Factors Involved in RNA Editing in Tobacco and Pea Chloroplasts

PubMed Central

Miyamoto, Tetsuya; Obokata, Junichi; Sugiura, Masahiro

2002-01-01

RNA editing in higher-plant chloroplasts involves C-to-U conversions at specific sites. Although in vivo analyses have been performed, little is known about the biochemical aspects of chloroplast editing reactions. Here we improved our original in vitro system and devised a procedure for preparing active chloroplast extracts not only from tobacco plants but also from pea plants. Using our tobacco in vitro system, cis-acting elements were defined for psbE and petB mRNAs. Distinct proteins were found to bind specifically to each cis-element, a 56-kDa protein to the psbE site and a 70-kDa species to the petB site. Pea chloroplasts lack the corresponding editing site in psbE since T is already present in the DNA. Parallel in vitro analyses with tobacco and pea extracts revealed that the pea plant has no editing activity for psbE mRNAs and lacks the 56-kDa protein, whereas petB mRNAs are edited and the 70-kDa protein is also present. Therefore, coevolution of an editing site and its cognate trans-factor was demonstrated biochemically in psbE mRNA editing between tobacco and pea plants. PMID:12215530

Teaching Geography and History through GIS: Application on Greek cultural sites

NASA Astrophysics Data System (ADS)

Skentos, Athanasios; Pavlopoulos, Kosmas; Galani, Apostolia; Theodorakopoulou, Katerina; Kritikos, Giorgos

2013-04-01

This study deals with the presentation of cultural succession in Greek space-time through a GIS application, associated with core concepts of geographic and historical education. Through the specific application students will be able to develop five distinct skills: sense of time-scale, historical and geographic comprehension, spatial analysis and interpretation, ability to perform geo-historical research, and procedure of geo-historical decision-making. The methodology is based on the calibration of a set of criteria for each cultural site that covers the topics of economy, geomorphology, society, religion, art and science. Further analysis of these data forms a geodatabase. In addition, palaeogeographic and historical maps of the cultural sites derived by the geodatabase provide information about temporal and spatial changes. As result, students will be able to develop a multidimensional and interdisciplinary approach, in order to reconstruct the evolution of the site.

Documenting the location of systematic transrectal ultrasound-guided prostate biopsies: correlation with multi-parametric MRI.

PubMed

Turkbey, Baris; Xu, Sheng; Kruecker, Jochen; Locklin, Julia; Pang, Yuxi; Shah, Vijay; Bernardo, Marcelino; Baccala, Angelo; Rastinehad, Ardeshir; Benjamin, Compton; Merino, Maria J; Wood, Bradford J; Choyke, Peter L; Pinto, Peter A

2011-03-29

During transrectal ultrasound (TRUS)-guided prostate biopsies, the actual location of the biopsy site is rarely documented. Here, we demonstrate the capability of TRUS-magnetic resonance imaging (MRI) image fusion to document the biopsy site and correlate biopsy results with multi-parametric MRI findings. Fifty consecutive patients (median age 61 years) with a median prostate-specific antigen (PSA) level of 5.8 ng/ml underwent 12-core TRUS-guided biopsy of the prostate. Pre-procedural T2-weighted magnetic resonance images were fused to TRUS. A disposable needle guide with miniature tracking sensors was attached to the TRUS probe to enable fusion with MRI. Real-time TRUS images during biopsy and the corresponding tracking information were recorded. Each biopsy site was superimposed onto the MRI. Each biopsy site was classified as positive or negative for cancer based on the results of each MRI sequence. Sensitivity, specificity, and receiver operating curve (ROC) area under the curve (AUC) values were calculated for multi-parametric MRI. Gleason scores for each multi-parametric MRI pattern were also evaluated. Six hundred and 5 systemic biopsy cores were analyzed in 50 patients, of whom 20 patients had 56 positive cores. MRI identified 34 of 56 positive cores. Overall, sensitivity, specificity, and ROC area values for multi-parametric MRI were 0.607, 0.727, 0.667, respectively. TRUS-MRI fusion after biopsy can be used to document the location of each biopsy site, which can then be correlated with MRI findings. Based on correlation with tracked biopsies, T2-weighted MRI and apparent diffusion coefficient maps derived from diffusion-weighted MRI are the most sensitive sequences, whereas the addition of delayed contrast enhancement MRI and three-dimensional magnetic resonance spectroscopy demonstrated higher specificity consistent with results obtained using radical prostatectomy specimens.

Options to avoid the second surgical site: a review of literature.

PubMed

Ramachandra, Srinivas Sulugodu; Rana, Ritu; Reetika, Singhal; Jithendra, K D

2014-09-01

As esthetics gain importance, periodontal plastic surgical procedures involving soft tissue grafts are becoming commoner both around natural teeth as well as around implants. Periodontal soft tissue grafts are primarily used for the purpose of root coverage and in pre-prosthetic surgery to thicken a gingival site or to improve the crestal volume. Soft tissue grafts are usually harvested from the palate. Periodontal plastic surgical procedures involving soft tissue grafts harvested from the palate have two surgical sites; a recipient site and another donor site. Many patients are apprehensive about the soft tissue graft procedures, especially the creation of the second/donor surgical site in the palate. In the past decade, newer techniques and products have emerged which provide an option for the periodontist/patient to avoid the second surgical site. MucoMatrixX, Alloderm(®), Platelet rich fibrin, Puros(®) Dermis and Mucograft(®) are the various options available to the practicing periodontist to avoid the second surgical site. Use of these soft tissue allografts in an apprehensive patient would decrease patient morbidity and increase patient's acceptance towards periodontal plastic surgical procedures.

Single molecule tracking of Ace1p in Saccharomyces cerevisiae defines a characteristic residence time for non-specific interactions of transcription factors with chromatin

PubMed Central

Ball, David A.; Mehta, Gunjan D.; Salomon-Kent, Ronit; Mazza, Davide; Morisaki, Tatsuya; Mueller, Florian; McNally, James G.; Karpova, Tatiana S.

2016-01-01

In vivo single molecule tracking has recently developed into a powerful technique for measuring and understanding the transient interactions of transcription factors (TF) with their chromatin response elements. However, this method still lacks a solid foundation for distinguishing between specific and non-specific interactions. To address this issue, we took advantage of the power of molecular genetics of yeast. Yeast TF Ace1p has only five specific sites in the genome and thus serves as a benchmark to distinguish specific from non-specific binding. Here, we show that the estimated residence time of the short-residence molecules is essentially the same for Hht1p, Ace1p and Hsf1p, equaling 0.12–0.32 s. These three DNA-binding proteins are very different in their structure, function and intracellular concentration. This suggests that (i) short-residence molecules are bound to DNA non-specifically, and (ii) that non-specific binding shares common characteristics between vastly different DNA-bound proteins and thus may have a common underlying mechanism. We develop new and robust procedure for evaluation of adverse effects of labeling, and new quantitative analysis procedures that significantly improve residence time measurements by accounting for fluorophore blinking. Our results provide a framework for the reliable performance and analysis of single molecule TF experiments in yeast. PMID:27566148

Identifying diabetes knowledge network nodes as sites for a diabetes prevention program.

PubMed

Gesler, Wilbert M; Arcury, Thomas A; Skelly, Anne H; Nash, Sally; Soward, April; Dougherty, Molly

2006-12-01

This paper reports on the methods used and results of a study that identified specific places within a community that have the potential to be sites for a diabetes prevention program. These sites, termed diabetes knowledge network nodes (DKNNs), are based on the concept of socio-spatial knowledge networks (SSKNs), the web of social relationships within which people obtain knowledge about type 2 diabetes. The target population for the study was working poor African Americans, Latinos, and European Americans of both sexes in a small rural southern town who had not been diagnosed with diabetes. Information was collected from a sample of 121 respondents on the places they visited in carrying out their daily activities. Data on number of visits to specific sites, degree of familiarity with these sites, and ratings of sites as places to receive diabetes information were used to develop three categories of DKNNs for six subgroups based on ethnicity and sex. Primary potential sites of importance to one or more subgroups included churches, grocery stores, drugstores, the local library, a beauty salon, laundromats, a community service agency, and a branch of the County Health Department. Secondary potential sites included gas stations, restaurants, banks, and post offices. Latent potential sites included three medical facilities. Most of the DKNNs were located either in the downtown area or in one of two shopping areas along the most used highway that passed through the town. The procedures used in this study can be generalized to other communities and prevention programs for other chronic diseases.

Biliary tract obstruction secondary to cancer: management guidelines and selected literature review.

PubMed

Lokich, J J; Kane, R A; Harrison, D A; McDermott, W V

1987-06-01

Malignant biliary tract obstruction (MBTO) due to either primary biliary tract cancer or metastasis to the porta hepatis is a common clinical problem. The most common metastatic tumors causing MBTO in order of frequency are gastric, colon, breast, and lung cancers. Radiographic diagnostic procedures should proceed in a cost-effective sequence from ultrasonography, computerized tomography (CT), percutaneous transhepatic cholangiography (PTHC), and endoscopic retrograde pancreatography with the goal of establishing the site of the biliary tract obstruction. The identification of the site of obstruction could be established by ultrasound 70% to 80%, CT scan 80% to 90%, PTHC 100%, and endoscopic retrograde cholangiography (ERCP) 85%. Therapeutic intervention by radiographic decompression (PTHC or endoscopic prosthesis), surgical bypass, or radiation therapy with or without chemotherapy may be selectively used based on (1) the site of obstruction; (2) the type of primary tumor; and (3) the presence of specific symptoms related to the obstruction. ("Prophylactic" biliary tract decompression to prevent ascending cholangitis is not supported by the literature in that the frequency of sepsis in the face of malignant obstruction is small (in contrast to sepsis associated with stone disease). Furthermore, PTHC with drainage as a long-term procedure is associated with a substantial frequency of sepsis and is unnecessary and possibly problematic as a preoperative procedure simply to reduce the bilirubin level. The use of radiation therapy in conjunction with chemotherapy for patients not deemed suitable for a surgical bypass because of the presence of proximal obstruction is an important alternative to PTHC.

Measuring the patient perspective on latissimus dorsi donor site outcomes following breast reconstruction.

PubMed

Browne, John P; Jeevan, Ranjeet; Pusic, Andrea L; Klassen, Anne F; Gulliver-Clarke, Carmel; Pereira, Jerome; Caddy, Christopher M; Cano, Stefan J

2018-03-01

There is little evidence about the long-term donor site outcome of latissimus dorsi breast reconstruction and no patient-reported outcome measures designed specifically for the procedure. A prospective cohort of breast cancer patients having latissimus dorsi reconstruction after a mastectomy was recruited from 270 hospitals in the United Kingdom. An 18-month follow up questionnaire containing two novel scales was sent to consenting patients. The prevalence of aesthetic and functional morbidity at the donor site was described. The two new scales were refined using the Rasch measurement model and subsequently validated. 1,096 women completed the new scales. 78% of patients reported that no back appearance issues had bothered them "most of the time" or "all of the time" in the past two weeks. The equivalent figure for functional morbidity was 60%. Four items were eliminated following initial psychometric testing. This produced an 8-item Back Appearance scale and an 11-item Back and Shoulder Function scale. Both scales showed adequate fit to the Rasch measurement model. Higher levels of aesthetic and functional bother were observed for completely autologous procedures versus those where latissimus dorsi reconstruction was used to cover an implant (p <0.05). Higher levels of aesthetic bother were observed in women who had suffered a perioperative complication at the donor site (p = 0.003). These results can inform patients of the morbidity associated with latissimus dorsi reconstruction. The new scales can be used to compare groups undergoing different variations of the procedure and to monitor individual patients. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Patterns and operative treatment of recurrent Crohn's disease: a prospective longitudinal study.

PubMed

Fichera, Alessandro; Lovadina, Stefano; Rubin, Michele; Cimino, Fabrizio; Hurst, Roger D; Michelassi, Fabrizio

2006-10-01

It is believed commonly that Crohn's recurrences always occur at the site of a previous intestinal anastomosis; yet this concept is probably inaccurate and not mindful of the panintestinal nature of the disease. Between October, 1984 and March, 2003, we carried out 1,132 procedures (464 for primary and 668 for recurrent disease) on 981 consecutive patients. Patients in whom we carried out both the original procedure as well as the procedure for recurrent disease constitute this study population. Operative procedures for perineal complications were excluded from this analysis. Data were accrued prospectively. Seventy-eight patients met the study inclusion criteria. They had a total of 149 sites of disease (duodenum, n = 3; jejunum/ileum, n = 53; terminal ileum/neo terminal ileum, n = 67; colon and rectum, n = 26). One hundred thirty-four sites required operative intervention (85 resections and 49 strictureplasties) and 15 did not. Crohn's disease recurred in 79 sites after a mean of 48.4 months (range, 1-161 months, median, 41 months). Site of operative intervention and operative technique influenced patterns of recurrence: when an anastomosis or strictureplasty was constructed with small bowel, the majority of recurrences were limited to the anastomotic line (17/29, 59%); when it was constructed with small bowel and colon, the majority of recurrences extended to the proximal limb (29/35, 83%). The difference in recurrence pattern is significant (P < .01). In addition, fewer recurrences occurred at strictureplasty than resection sites (22/49, 45%, vs 57/85, 70%, respectively, P < .05). At the time of the second procedure, 40 additional recurrences were identified distant from the original operative site. Four of these represented progression of disease at the 15 sites that did not originally need operative intervention. Of 119 total recurrences, 115 required 73 resections, 40 strictureplasties, and 2 other procedures. The site of the original operative intervention is the most common site for recurrence, although as many as one-third of recurrences occur separate from it. Pattern of recurrence is influenced by site of the operative intervention (anastomotic for small bowel, proximal limb for ileocolonic) and by operative technique (fewer recurrences occurred at strictureplasty than resection sites). Disease progression occurred in 25% of the sites not addressed operatively at the original procedure. The operative strategy applied to Crohn's complications in different intestinal sites was similar for primary and recurrent disease.

User's manual for the national water information system of the U.S. Geological Survey: Ground-water site-inventory system

USGS Publications Warehouse

,

2004-01-01

The Ground-Water Site-Inventory (GWSI) System is a ground-water data storage and retrieval system that is part of the National Water Information System (NWIS) developed by the U.S. Geological Survey (USGS). The NWIS is a distributed water database in which data can be processed over a network of workstations and file servers at USGS offices throughout the United States. This system comprises the GWSI, the Automated Data Processing System (ADAPS), the Water-Quality System (QWDATA), and the Site-Specific Water-Use Data System (SWUDS). The GWSI System provides for entering new sites and updating existing sites within the local database. In addition, the GWSI provides for retrieving and displaying ground-water and sitefile data stored in the local database. Finally, the GWSI provides for routine maintenance of the local and national data records. This manual contains instructions for users of the GWSI and discusses the general operating procedures for the programs found within the GWSI Main Menu.

User's Manual for the National Water Information System of the U.S. Geological Survey: Ground-water site-inventory system

USGS Publications Warehouse

,

2005-01-01

The Ground-Water Site-Inventory (GWSI) System is a ground-water data storage and retrieval system that is part of the National Water Information System (NWIS) developed by the U.S. Geological Survey (USGS). The NWIS is a distributed water database in which data can be processed over a network of workstations and file servers at USGS offices throughout the United States. This system comprises the GWSI, the Automated Data Processing System (ADAPS), the Water-Quality System (QWDATA), and the Site- Specific Water-Use Data System (SWUDS). The GWSI System provides for entering new sites and updating existing sites within the local database. In addition, the GWSI provides for retrieving and displaying groundwater and Sitefile data stored in the local database. Finally, the GWSI provides for routine maintenance of the local and national data records. This manual contains instructions for users of the GWSI and discusses the general operating procedures for the programs found within the GWSI Main Menu.

39 CFR 776.9 - Review procedures.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Wetlands Protection § 776.9 Review procedures. (a) Early public notice. If a facility action at the contending site(s) could require construction in a wetland, public notice must be provided. (b) Finding of no practicable...

39 CFR 776.9 - Review procedures.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Wetlands Protection § 776.9 Review procedures. (a) Early public notice. If a facility action at the contending site(s) could require construction in a wetland, public notice must be provided. (b) Finding of no practicable...

39 CFR 776.9 - Review procedures.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Wetlands Protection § 776.9 Review procedures. (a) Early public notice. If a facility action at the contending site(s) could require construction in a wetland, public notice must be provided. (b) Finding of no practicable...

39 CFR 776.9 - Review procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Wetlands Protection § 776.9 Review procedures. (a) Early public notice. If a facility action at the contending site(s) could require construction in a wetland, public notice must be provided. (b) Finding of no practicable...

39 CFR 776.9 - Review procedures.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Service UNITED STATES POSTAL SERVICE ENVIRONMENTAL REGULATIONS FLOODPLAIN AND WETLAND PROCEDURES Wetlands Protection § 776.9 Review procedures. (a) Early public notice. If a facility action at the contending site(s) could require construction in a wetland, public notice must be provided. (b) Finding of no practicable...

Ultrasound-guided percutaneous fine-needle aspiration of 545 focal pancreatic lesions.

PubMed

Zamboni, Giulia A; D'Onofrio, Mirko; Idili, Antonio; Malagò, Roberto; Iozzia, Roberta; Manfrin, Erminia; Mucelli, Roberto Pozzi

2009-12-01

The purpose of this study was to assess the accuracy and short-term complication rate of ultrasound-guided fine-needle aspiration cytologic sampling of focal pancreatic lesions. We reviewed 545 consecutive ultrasound-guided fine-needle aspiration cytologic sampling procedures for focal pancreatic lesions from January 2004 through June 2008. The procedures were performed with a 20- or 21-gauge needle. The onsite cytopathologist evaluated the appropriateness of the sample and made a diagnosis. We reviewed the final diagnosis and the radiologic and medical records of all patients for onset of complications during or within 7 days of the procedure. The study sample included 262 women and 283 men (mean age, 62 years; range, 25-86 years). The head or uncinate process of the pancreas was the location of 63.0% of the lesions, and 35.2% of the lesions were located in the body or tail of the pancreas. The site of 10 lesions (1.8%) was not specified. Sampling was diagnostic in 509 of the 545 cases (93.4%). Excluding the 36 nondiagnostic samples, ultrasound-guided fine-needle aspiration cytologic sampling had 99.4% sensitivity, 100% specificity, and 99.4% accuracy. In 537 of the 545 cases (98.5%), the procedure was uneventful. In two cases, abdominal fluid was found after the procedure that was not present before the procedure. Six patients experienced postprocedural pain without abnormal findings at subsequent imaging. No major complications occurred. Ultrasound-guided cytologic sampling is safe and accurate for the diagnosis and planning of management of focal pancreatic lesions. With a cytologist on site, the rate of acquisition of samples adequate for diagnosis is high, reducing the need for patient recall.

Tar sand extraction by steam stimulation and steam drive: measurement of physical properties

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

Linberg, W.R.

The measurement of the following thermophysical properties of Utah tar sands is in progress: thermal conductivity, specific heat relative permeability, and viscosity (of the recovered bitumen). During the report period (October 1, 1978 to November 1, 1979), experimental procedures have been developed and a basic data set has been measured. Additionally, standard core analysis has been performed for four drill sites in the Asphalt Ridge, Utah area.

Community Relations Plan: Galena Airport and Campion Air Force Station, Alaska

DTIC Science & Technology

1994-11-11

toxic 0k Corporations that are not wastes at any facility listed or proposed for incorporated for the specific listing on the NPL and where site work ... working toward for awarding a TAG, and how to obtain incorporation under state laws. additional information are described. The Applications are...for similar work in the area. Notification Procedures and In special cases, where an applicant Evaluation Criteria group intends to apply for a single

In search for a gold-standard procedure to count motor neurons in the spinal cord.

PubMed

Ferrucci, Michela; Lazzeri, Gloria; Flaibani, Marina; Biagioni, Francesca; Cantini, Federica; Madonna, Michele; Bucci, Domenico; Limanaqi, Fiona; Soldani, Paola; Fornai, Francesco

2018-03-14

Counting motor neurons within the spinal cord and brainstem represents a seminal step to comprehend the anatomy and physiology of the final common pathway sourcing from the CNS. Motor neuron loss allows to assess the severity of motor neuron disorders while providing a tool to assess disease modifying effects. Counting motor neurons at first implies gold standard identification methods. In fact, motor neurons may occur within mixed nuclei housing a considerable amount of neurons other than motor neurons. In the present review, we analyse various approaches to count motor neurons emphasizing both the benefits and bias of each protocol. A special emphasis is placed on discussing automated stereology. When automated stereology does not take into account site-specificity and does not distinguish between heterogeneous neuronal populations, it may confound data making such a procedure a sort of "guide for the perplex". Thus, if on the one hand automated stereology improves our ability to quantify neuronal populations, it may also hide false positives/negatives in neuronal counts. For instance, classic staining for antigens such as SMI-32, SMN and ChAT, which are routinely considered to be specific for motor neurons, may also occur in other neuronal types of the spinal cord. Even site specificity within Lamina IX may be misleading due to neuronal populations having a size and shape typical of motor neurons. This is the case of spinal border cells, which often surpass the border of Lamina VII and intermingle with motor neurons of Lamina IX. The present article discusses the need to join automated stereology with a dedicated knowledge of each specific neuroanatomical setting.

Guidelines and standard procedures for continuous water-quality monitors: Station operation, record computation, and data reporting

USGS Publications Warehouse

Wagner, Richard J.; Boulger, Robert W.; Oblinger, Carolyn J.; Smith, Brett A.

2006-01-01

The U.S. Geological Survey uses continuous water-quality monitors to assess the quality of the Nation's surface water. A common monitoring-system configuration for water-quality data collection is the four-parameter monitoring system, which collects temperature, specific conductance, dissolved oxygen, and pH data. Such systems also can be configured to measure other properties, such as turbidity or fluorescence. Data from sensors can be used in conjunction with chemical analyses of samples to estimate chemical loads. The sensors that are used to measure water-quality field parameters require careful field observation, cleaning, and calibration procedures, as well as thorough procedures for the computation and publication of final records. This report provides guidelines for site- and monitor-selection considerations; sensor inspection and calibration methods; field procedures; data evaluation, correction, and computation; and record-review and data-reporting processes, which supersede the guidelines presented previously in U.S. Geological Survey Water-Resources Investigations Report WRIR 00-4252. These procedures have evolved over the past three decades, and the process continues to evolve with newer technologies.

Development of a 3D ultrasound-guided prostate biopsy system

NASA Astrophysics Data System (ADS)

Cool, Derek; Sherebrin, Shi; Izawa, Jonathan; Fenster, Aaron

2007-03-01

Biopsy of the prostate using ultrasound guidance is the clinical gold standard for diagnosis of prostate adenocarinoma. However, because early stage tumors are rarely visible under US, the procedure carries high false-negative rates and often patients require multiple biopsies before cancer is detected. To improve cancer detection, it is imperative that throughout the biopsy procedure, physicians know where they are within the prostate and where they have sampled during prior biopsies. The current biopsy procedure is limited to using only 2D ultrasound images to find and record target biopsy core sample sites. This information leaves ambiguity as the physician tries to interpret the 2D information and apply it to their 3D workspace. We have developed a 3D ultrasound-guided prostate biopsy system that provides 3D intra-biopsy information to physicians for needle guidance and biopsy location recording. The system is designed to conform to the workflow of the current prostate biopsy procedure, making it easier for clinical integration. In this paper, we describe the system design and validate its accuracy by performing an in vitro biopsy procedure on US/CT multi-modal patient-specific prostate phantoms. A clinical sextant biopsy was performed by a urologist on the phantoms and the 3D models of the prostates were generated with volume errors less than 4% and mean boundary errors of less than 1 mm. Using the 3D biopsy system, needles were guided to within 1.36 +/- 0.83 mm of 3D targets and the position of the biopsy sites were accurately localized to 1.06 +/- 0.89 mm for the two prostates.

Drilling and completion specifications for CA series multilevel piezometers

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

Clawson, T.S.

1986-08-01

CX Series multilevel piezometer boreholes will provide information on hydraulic heads in the Rosalia, Sentinel Gap, Ginkgo, Rocky Coulee, Cohassett, Birkett, and Umtanum flow tops. The borehole sites will be located adjacent to the reference repository location. In addition, information from the boreholes will provide input data used to determine horizontal and vertical flow rates, and identify possible geologic structures. This specification includes details for drilling, piezometer design, hydrologic testing, and hydrochemical sampling of the boreholes. It includes drilling requirements, design, and installation procedures for the series piezometer nests, intervals selected for head monitoring and schedules for drilling and piezometermore » installation. Specific drilling and piezometer installation specifications for boreholes DC-24CX and DC-25CX are also included. 27 refs., 5 figs., 3 tabs.« less

Standardizing Nasal Nitric Oxide Measurement as a Test for Primary Ciliary Dyskinesia

PubMed Central

Hazucha, Milan J.; Chawla, Kunal K.; Baker, Brock R.; Shapiro, Adam J.; Brown, David E.; LaVange, Lisa M.; Horton, Bethany J.; Qaqish, Bahjat; Carson, Johnny L.; Davis, Stephanie D.; Dell, Sharon D.; Ferkol, Thomas W.; Atkinson, Jeffrey J.; Olivier, Kenneth N.; Sagel, Scott D.; Rosenfeld, Margaret; Milla, Carlos; Lee, Hye-Seung; Krischer, Jeffrey; Zariwala, Maimoona A.; Knowles, Michael R.

2013-01-01

Rationale: Several studies suggest that nasal nitric oxide (nNO) measurement could be a test for primary ciliary dyskinesia (PCD), but the procedure and interpretation have not been standardized. Objectives: To use a standard protocol for measuring nNO to establish a disease-specific cutoff value at one site, and then validate at six other sites. Methods: At the lead site, nNO was prospectively measured in individuals later confirmed to have PCD by ciliary ultrastructural defects (n = 143) or DNAH11 mutations (n = 6); and in 78 healthy and 146 disease control subjects, including individuals with asthma (n = 37), cystic fibrosis (n = 77), and chronic obstructive pulmonary disease (n = 32). A disease-specific cutoff value was determined, using generalized estimating equations (GEEs). Six other sites prospectively measured nNO in 155 consecutive individuals enrolled for evaluation for possible PCD. Measurements and Main Results: At the lead site, nNO values in PCD (mean ± standard deviation, 20.7 ± 24.1 nl/min; range, 1.5–207.3 nl/min) only rarely overlapped with the nNO values of healthy control subjects (304.6 ± 118.8; 125.5–867.0 nl/min), asthma (267.8 ± 103.2; 125.0–589.7 nl/min), or chronic obstructive pulmonary disease (223.7 ± 87.1; 109.7–449.1 nl/min); however, there was overlap with cystic fibrosis (134.0 ± 73.5; 15.6–386.1 nl/min). The disease-specific nNO cutoff value was defined at 77 nl/minute (sensitivity, 0.98; specificity, >0.999). At six other sites, this cutoff identified 70 of the 71 (98.6%) participants with confirmed PCD. Conclusions: Using a standardized protocol in multicenter studies, nNO measurement accurately identifies individuals with PCD, and supports its usefulness as a test to support the clinical diagnosis of PCD. PMID:24024753

Spatial effect of new municipal solid waste landfill siting using different guidelines.

PubMed

Ahmad, Siti Zubaidah; Ahamad, Mohd Sanusi S; Yusoff, Mohd Suffian

2014-01-01

Proper implementation of landfill siting with the right regulations and constraints can prevent undesirable long-term effects. Different countries have respective guidelines on criteria for new landfill sites. In this article, we perform a comparative study of municipal solid waste landfill siting criteria stated in the policies and guidelines of eight different constitutional bodies from Malaysia, Australia, India, U.S.A., Europe, China and the Middle East, and the World Bank. Subsequently, a geographic information system (GIS) multi-criteria evaluation model was applied to determine new suitable landfill sites using different criterion parameters using a constraint mapping technique and weighted linear combination. Application of Macro Modeler provided in the GIS-IDRISI Andes software helps in building and executing multi-step models. In addition, the analytic hierarchy process technique was included to determine the criterion weight of the decision maker's preferences as part of the weighted linear combination procedure. The differences in spatial results of suitable sites obtained signifies that dissimilarity in guideline specifications and requirements will have an effect on the decision-making process.

Establishment and operation of the National Accident Sampling System (NASS) team within the cities of Ft. Lauderdale/Hollywood, Florida

NASA Astrophysics Data System (ADS)

Beddow, B.; Roberts, C.; Rankin, J.; Bloch, A.; Peizer, J.

1981-01-01

The National Accident Sampling System (NASS) is described. The study area discussed is one of the original ten sites selected for NASS implementation. In addition to collecting data from the field, the original ten sites address questions of feasibility of the plan, projected results of the data collection effort, and specific operational topics, e.g., team size, sampling requirements, training approaches, quality control procedures, and field techniques. Activities and results of the first three years of the project, for both major tasks (establishment and operation) are addressed. Topics include: study area documentation; team description, function and activities; problems and solutions; and recommendations.

Strategies for detection of floodplain inundation with multi-frequency polarimetric SAR

NASA Technical Reports Server (NTRS)

Hess, Laura L.; Melack, John M.

1992-01-01

Mapping of floodplain inundation patterns is a key element in developing hydrological and biogeochemical models for large tropical river basins such as the Amazon. Knowledge of the time sequence of inundation is necessary to determine both water routing and biogenic gas fluxes. Synthetic Aperture Radar (SAR) is uniquely suited for this application because of its ability to penetrate cloud cover and, in many cases, to detect flooding beneath a forest or herbaceous canopy. A procedure for discriminating flooded forest, flooded herbaceous vegetation, and open water from other cover types for a coastal wetland site on the lower Altamaha floodplain, Georgia, emphasizing robust classifiers that are not site-specific is currently being developed.

On the use of drift bottle and seabed drifter data in coastal management

NASA Technical Reports Server (NTRS)

Welch, C. S.; Norcross, J. J.

1973-01-01

The use of drift bottle and seabed drifter information for use in coastal management is discussed. The drift bottle/seabed drifter portion of VIMS project MACONS (Mid Atlantic Continental Shelf) is described as an example of how a comprehensive survey using drift bottles and seabed drifters provides data useful for coastal management. The data from MACONS are analyzed to answer specific questions of interest to several different coastal managers: a manager siting a deep oil port, one siting a sewage outfall, a manager responsible for setting up emergency beach protection procedures before an accident occurs, and a manager responsible for the environmental quality of a particular small section of coastline.

Rapid one-step recombinational cloning

PubMed Central

Fu, Changlin; Wehr, Daniel R.; Edwards, Janice; Hauge, Brian

2008-01-01

As an increasing number of genes and open reading frames of unknown function are discovered, expression of the encoded proteins is critical toward establishing function. Accordingly, there is an increased need for highly efficient, high-fidelity methods for directional cloning. Among the available methods, site-specific recombination-based cloning techniques, which eliminate the use of restriction endonucleases and ligase, have been widely used for high-throughput (HTP) procedures. We have developed a recombination cloning method, which uses truncated recombination sites to clone PCR products directly into destination/expression vectors, thereby bypassing the requirement for first producing an entry clone. Cloning efficiencies in excess of 80% are obtained providing a highly efficient method for directional HTP cloning. PMID:18424799

An alternative approach to account for patient organ doses from imaging guidance procedures.

PubMed

Nelson, Alan P; Ding, George X

2014-07-01

To investigate the feasibility of an alternative method of accounting for additional organ doses resulting from image guidance procedures during patient treatment planning through tabulated values based on scan protocol and scan site. Patient-specific imaging dose to 30 patients resulting from Varian OBI kV-CBCT scans using the Standard Head (17 patients), Low-dose Thorax (8 patients), and Pelvic (5 patients) scan protocols were retrospectively calculated using Monte Carlo methods. Dose dependence on scan location and patient geometry was explored. Patient organ doses were analyzed by using dose-volume histograms and expressed by the mean, minimum dose delivered to 50% of the organ volume, D50. The reported doses are dose-to-medium instead of dose-to-water. The organ doses from all patient-specific calculations show predictable and limited ranges across patients. For brain isocenters using Standard Head Scans: Bone: 0.7-1.1 cGy, Brain: 0.2-0.3 cGy, Brainstem: 0.2-0.3 cGy, Skin: 0.3-0.4 cGy, Eye: 0.03-0.3 cGy. For head and neck patients using the Standard Head Scan: Bone: 0.3-0.6 cGy, Parotids: 0.3-0.4 cGy, Spinal Cord: 0.15-0.25 cGy, Thyroid: 0.1-0.25 cGy, Skin: 0.2-0.3 cGy, Trachea-Esophagus: 0.1-0.2 cGy. For chest using Thorax Scans: Bone: 1.1-1.8 cGy, Soft tissue organs (Bowel, Lung, Heart, Kidney, Esophagus, and Spinal Cord): 0.3-0.6 cGy. For abdominal site using Pelvic Scans: Bone: 3.2-4.2 cGy. Soft tissue organs (Bladder, Bowel, Rectum, Prostate, and Skin) D50s fell between 1.2 and 2.2 cGy. Femoral Heads: 2.5-3.4 cGy. It is adequate to estimate and account for organ dose by using tabulated values based on scan procedure and site because organ doses from imaging procedures are only modestly dependent upon scan location and body size. Considering the dose variation and magnitude of dose from each scan protocol in comparison to therapeutic doses, this approach provides a simple alternative to account for additional imaging guidance doses during patient treatment planning. Clinicians can use these tabulated values to make informed decisions in selecting the appropriate imaging procedures and imaging frequency during radiotherapy treatment. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Past and present work practices of European interventional cardiologists in the context of radiation protection of the eye lens-results of the EURALOC study.

PubMed

Domienik-Andrzejewska, Joanna; Ciraj-Bjelac, Olivera; Askounis, Panagiotis; Covens, Peter; Dragusin, Octavian; Jacob, Sophie; Farah, Jad; Gianicolo, Emilio; Padovani, Renato; Teles, Pedro; Widmark, Anders; Struelens, Lara

2018-05-21

This paper investigates over five decades of work practices in interventional cardiology, with an emphasis on radiation protection. The analysis is based on data from more than 400 cardiologists from various European countries recruited for a EURALOC study and collected in the period from 2014 to 2016. Information on the types of procedures performed and their annual mean number, fluoroscopy time, access site choice, x-ray units and radiation protection means used was collected using an occupational questionnaire. Based on the specific European data, changes in each parameter have been analysed over decades, while country-specific data analysis has allowed us to determine the differences in local practices. In particular, based on the collected data, the typical workload of a European cardiologist working in a haemodynamic room and an electrophysiology room was specified for various types of procedures. The results showed that when working in a haemodynamic room, a transparent ceiling-suspended lead shield or lead glasses are necessary in order to remain below the recommended eye lens dose limit of 20 mSv. Moreover, the analysis revealed that new, more complex cardiac procedures such as chronic total occlusion, valvuloplasty and pulmonary vein isolation for atrial fibrillation ablation might contribute substantially to annual doses, although they are relatively rarely performed. The results revealed that considerable progress has been made in the use of radiation protection tools. While their use in electrophysiology procedures is not generic, the situation in haemodynamic procedures is rather encouraging, as ceiling-suspended shields are used in 90% of cases, while the combination of ceiling shield and lead glasses is noted in more than 40% of the procedures. However, we find that still 7% of haemodynamic procedures are performed without any radiation protection tools.

Secondary school accident reporting in one education authority.

PubMed

Williams, W R; Latif, A H A; Sibert, J

2002-01-01

Secondary schools appear to have very different accident rates when they are compared on the basis of accident report returns. The variation may be as a result of real differences in accident rates or different reporting procedures. This study investigates accident reporting from secondary schools and, in particular, the role of the school nurse. Accident form returns covering a 2-year period were collected for statistical analysis from 13 comprehensive schools in one local education authority in Wales. School sites were visited in the following school year to obtain information about accident records held on site and accident reporting procedures. The main factors determining the number of school accident reports submitted to the education authority relate to differences in recording and reporting procedures, such as the employment of a nurse and the policy of the head teacher/safety officer on submitting accident returns. Accident and emergency department referrals from similar schools may show significant differences in specific injuries and their causes. The level of school accident activity cannot be gauged from reports submitted to the education authority. Lack of incentives for collecting good accident data, in conjunction with the degree of complacency in the current system, suggest that future accident rates and reporting activity are unlikely to change.

Impact of specific postoperative complications on the outcomes of emergency general surgery patients.

PubMed

McCoy, Christopher Cameron; Englum, Brian R; Keenan, Jeffrey E; Vaslef, Steven N; Shapiro, Mark L; Scarborough, John E

2015-05-01

The relative contribution of specific postoperative complications on mortality after emergency operations has not been previously described. Identifying specific contributors to postoperative mortality following acute care surgery will allow for significant improvement in the care of these patients. Patients from the 2005 to 2011 American College of Surgeons' National Surgical Quality Improvement Program database who underwent emergency operation by a general surgeon for one of seven diagnoses (gallbladder disease, gastroduodenal ulcer disease, intestinal ischemia, intestinal obstruction, intestinal perforation, diverticulitis, and abdominal wall hernia) were analyzed. Postoperative complications (pneumonia, myocardial infarction, incisional surgical site infection, organ/space surgical site infection, thromboembolic process, urinary tract infection, stroke, or major bleeding) were chosen based on surgical outcome measures monitored by national quality improvement initiatives and regulatory bodies. Regression techniques were used to determine the independent association between these complications and 30-day mortality, after adjustment for an array of patient- and procedure-related variables. Emergency operations accounted for 14.6% of the approximately 1.2 million general surgery procedures that are included in American College of Surgeons' National Surgical Quality Improvement Program but for 53.5% of the 19,094 postoperative deaths. A total of 43,429 emergency general surgery patients were analyzed. Incisional surgical site infection had the highest incidence (6.7%). The second most common complication was pneumonia (5.7%). Stroke, major bleeding, myocardial infarction, and pneumonia exhibited the strongest associations with postoperative death. Given its disproportionate contribution to surgical mortality, emergency surgery represents an ideal focus for quality improvement. Of the potential postoperative targets for quality improvement, pneumonia, myocardial infarction, stroke, and major bleeding have the strongest associations with subsequent mortality. Since pneumonia is both relatively common after emergency surgery and strongly associated with postoperative death, it should receive priority as a target for surgical quality improvement initiatives. Prognostic and epidemiologic study, level III.

[Current Perceptions of Lipofilling on the Basis of the New Guideline on "Autologous Fat Grafting"].

PubMed

Prantl, L; Rennekampff, H O; Giunta, R E; Harder, Y; von Heimburg, D; Heine, N; Herold, C; Kneser, U; Lampert, F; Machens, H G; Mirastschijski, U; Müller, D; Pallua, N; Schantz, T; Schönborn, A; Ueberreiter, K; Witzel, C H; Bull, G; Rezek, D; Sattler, G; Vogt, P M; Horch, R E

2016-12-01

Introduction: Autologous fat transfer has recently become an increasingly popular surgical procedure and comprises harvesting, processing and transplantation of adipose tissue, as well as professional follow-up care. This method, as a surgical procedure, can be utilised for trauma-, disease- or age-related soft tissue volume deficits and soft tissue augmentation. As usage is increasing, but the variables of fat harvest, specific indications and fashion of fat transfer are poorly defined, there is a great demand for development of a guideline in the field of reconstructive and aesthetic surgery. Methods: All relevant points were discussed within the scope of a consensus conference including a nominal group process of all societies involved in the procedure and ratified with a strong consensus (>95%). Literature from the standard medical databases over the last 10 years was retrieved, studied and specific guidelines were concluded. Results: Consensus was achieved among all professionals involved on the following points: 1. definition 2. indication/contraindication, 3. preoperative measures 4. donor sites 5. techniques of processing 6. transplantation 7. follow-up care 8. storage 9. efficacy 10. documentation 11. evaluation of patient safety. Conclusion: Definite indications and professional expertise are paramount for autologous fat tissue transfer. Successful transfers are based on the use of correct methods as well as specific instruments and materials. Autologous adipose tissue transplantation is considered to be a safe procedure in reconstructive and aesthetic surgery, due to the low rate of postoperative complications and sequelae. © Georg Thieme Verlag KG Stuttgart · New York.

A simple Gateway-assisted construction system of TALEN genes for plant genome editing.

PubMed

Kusano, Hiroaki; Onodera, Hitomi; Kihira, Miho; Aoki, Hiromi; Matsuzaki, Hikaru; Shimada, Hiroaki

2016-07-25

TALEN is an artificial nuclease being applied for sequence-specific genome editing. For the plant genome editing, a pair of TALEN genes is expressed in the cells, and a binary plasmid for Agrobacterium-mediated transformation should be assembled. We developed a novel procedure using the Gateway-assisted plasmids, named Emerald-Gateway TALEN system. We constructed entry vectors, pPlat plasmids, for construction of a desired TALEN gene using Platinum Gate TALEN kit. We also created destination plasmid, pDual35SGw1301, which allowed two TALEN genes to both DNA strands to recruit using Gateway technology. Resultant TALEN genes were evaluated by the single-strand annealing (SSA) assay in E. coli cells. By this assay, the TALENs recognized the corresponding targets in the divided luciferase gene, and induced a specific recombination to generate an active luciferase gene. Using the TALEN genes constructed, we created a transformant potato cells in which a site-specific mutation occurred at the target site of the GBSS gene. This suggested that our system worked effectively and was applicable as a convenient tool for the plant genome editing.

Site-specific chemical conjugation of human Fas ligand extracellular domain using trans-cyclooctene - methyltetrazine reactions.

PubMed

Muraki, Michiro; Hirota, Kiyonori

2017-07-03

Fas ligand plays a key role in the human immune system as a major cell death inducing protein. The extracellular domain of human Fas ligand (hFasLECD) triggers apoptosis of malignant cells, and therefore is expected to have substantial potentials in medical biotechnology. However, the current application of this protein to clinical medicine is hampered by a shortage of the benefits relative to the drawbacks including the side-effects in systemic administration. Effective procedures for the engineering of the protein by attaching useful additional functions are required to overcome the problem. A procedure for the site-specific chemical conjugation of hFasLECD with a fluorochrome and functional proteins was devised using an inverse-electron-demand Diels-Alder reaction between trans-cyclooctene group and methyltetrazine group. The conjugations in the present study were attained by using much less molar excess amounts of the compounds to be attached as compared with the conventional chemical modification reactions using maleimide derivatives in the previous study. The isolated conjugates of hFasLECD with sulfo-Cy3, avidin and rabbit IgG Fab' domain presented the functional and the structural integrities of the attached molecules without impairing the specific binding activity toward human Fas receptor extracellular domain. The present study provided a new fundamental strategy for the production of the engineered hFasLECDs with additional beneficial functions, which will lead to the developments of the improved diagnostic systems and the effective treatment methods of serious diseases by using this protein as a component of novel molecular tools.

Advanced Materials by Atom Transfer Radical Polymerization.

PubMed

Matyjaszewski, Krzysztof

2018-06-01

Atom transfer radical polymerization (ATRP) has been successfully employed for the preparation of various advanced materials with controlled architecture. New catalysts with strongly enhanced activity permit more environmentally benign ATRP procedures using ppm levels of catalyst. Precise control over polymer composition, topology, and incorporation of site specific functionality enables synthesis of well-defined gradient, block, comb copolymers, polymers with (hyper)branched structures including stars, densely grafted molecular brushes or networks, as well as inorganic-organic hybrid materials and bioconjugates. Examples of specific applications of functional materials include thermoplastic elastomers, nanostructured carbons, surfactants, dispersants, functionalized surfaces, and biorelated materials. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Pregnancy after tubal sterilization with silicone rubber band and spring clip application.

PubMed

Peterson, H B; Xia, Z; Wilcox, L S; Tylor, L R; Trussell, J

2001-02-01

To determine risk factors for pregnancy after tubal sterilization with silicone rubber bands or spring clips. A total of 3329 women sterilized using silicone rubber bands and 1595 women sterilized using spring clips were followed for up to 14 years as part of a prospective cohort study conducted in medical centers in nine US cities. We assessed the risk of pregnancy by cumulative life-table probabilities and proportional hazards analysis. The risk of pregnancy for women who had silicone rubber band application differed by location of band application and study site. The 10-year cumulative probabilities of pregnancy varied from a low of 0.0 per 1000 procedures at one study site to a high of 42.5 per 1000 procedures in the four combined sites in which fewer than 100 procedures per site were performed. The risk of pregnancy for women who had spring clip application varied by location of clip application, study site, race or ethnicity, tubal disease, and history of abdominal or pelvic surgery. The probabilities across study sites ranged from 7.1 per 1000 procedures at 10 years to 78.0 per 1000 procedures at 5 years (follow-up was limited to 5 years at that site). The 10-year cumulative probability of pregnancy after silicone rubber band and spring clip application is low but varies substantially by both clinical and demographic characteristics.

Burnout and Scope of Practice in New Family Physicians.

PubMed

Weidner, Amanda K H; Phillips, Robert L; Fang, Bo; Peterson, Lars E

2018-05-01

Family physicians report some of the highest levels of burnout, but no published work has considered whether burnout is correlated with the broad scope of care that family physicians may provide. We examined the associations between family physician scope of practice and self-reported burnout. Secondary analysis of the 2016 National Family Medicine Graduate Survey respondents who provided outpatient continuity care (N = 1,617). We used bivariate analyses and logistic regression to compare self-report of burnout and measures of scope of practice including: inpatient medicine, obstetrics, pediatric ambulatory care, number of procedures and/or clinical content areas, and providing care outside the principal practice site. Forty-two percent of respondents reported feeling burned out from their work once a week or more. In bivariate analysis, elements of scope of practice associated with higher burnout rates included providing more procedures/clinical content areas (mean procedures/clinical areas: 7.49 vs 7.02; P = .02) and working in more settings than the principal practice site (1+ additional settings: 57.6% vs 48.4%: P = .001); specifically in the hospital (31.4% vs 24.2%; P = .002) and patient homes (3.3% vs 1.5%; P = .02). In adjusted analysis, practice characteristics significantly associated with lower odds of burnout were practicing inpatient medicine (OR = 0.70; 95% CI, 0.56-0.87; P = .0017) and obstetrics (OR = 0.64; 95% CI, 0.47-0.88; P = .0058). Early career family physicians who provide a broader scope of practice, specifically, inpatient medicine, obstetrics, or home visits, reported significantly lower rates of burnout. Our findings suggest that comprehensiveness is associated with less burnout, which is critical in the context of improving access to good quality, affordable care while maintaining physician wellness. © 2018 Annals of Family Medicine, Inc.

A quality assessment tool for markup-based clinical guidelines.

PubMed

Shalom, Erez; Shahar, Yuval; Taieb-Maimon, Meirav; Lunenfeld, Eitan

2008-11-06

We introduce a tool for quality assessment of procedural and declarative knowledge. We developed this tool for evaluating the specification of mark-up-based clinical GLs. Using this graphical tool, the expert physician and knowledge engineer collaborate to perform scoring, using pre-defined scoring scale, each of the knowledge roles of the mark-ups, comparing it to a gold standard. The tool enables scoring the mark-ups simultaneously at different sites by different users at different locations.

Site Plan Safety Submission for Sampling, Monitoring, and Decontamination of Mustard Agent - South Plant, Rocky Mountain Arsenal. Volume 1

DTIC Science & Technology

1988-10-01

sample these ducts. This judgement was based on the following factors : 1. The ducts were open to the atmosphere. 2. RMA records of building area samples...selected based on several factors including piping arrangements, volume to be sampled, sampling equipment flow rates, and the flow rate necessary for...effective sampling. Therefore, each sampling point strategy and procedure was customized based on these factors . The individual specific sampling

Site characterization at the Rabbit Valley Geophysical Performance Evaluation Range

NASA Astrophysics Data System (ADS)

Koppenjan, S.,; Martinez, M.

The United States Department of Energy (US DOE) is developing a Geophysical Performance Evaluation Range (GPER) at Rabbit Valley located 30 miles west of Grand Junction, Colorado. The purpose of the range is to provide a test area for geophysical instruments and survey procedures. Assessment of equipment accuracy and resolution is accomplished through the use of static and dynamic physical models. These models include targets with fixed configurations and targets that can be re-configured to simulate specific specifications. Initial testing (1991) combined with the current tests at the Rabbit Valley GPER will establish baseline data and will provide performance criteria for the development of geophysical technologies and techniques. The US DOE's Special Technologies Laboratory (STL) staff has conducted a Ground Penetrating Radar (GPR) survey of the site with its stepped FM-CW GPR. Additionally, STL contracted several other geophysical tests. These include an airborne GPR survey incorporating a 'chirped' FM-CW GPR system and a magnetic survey with a surfaced-towed magnetometer array unit Ground-based and aerial video and still frame pictures were also acquired. STL compiled and analyzed all of the geophysical maps and created a site characterization database. This paper discusses the results of the multi-sensor geophysical studies performed at Rabbit Valley and the future plans for the site.

Site characterization at the Rabbit Valley Geophysical Performance Evaluation Range

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

Koppenjan, S,; Martinez, M.

1994-06-01

The United States Department of Energy (US DOE) is developing a Geophysical Performance Evaluation Range (GPER) at Rabbit Valley located 30 miles west of Grand Junction, Colorado. The purpose of the range is to provide a test area for geophysical instruments and survey procedures. Assessment of equipment accuracy and resolution is accomplished through the use of static and dynamic physical models. These models include targets with fixed configurations and targets that can be re-configured to simulate specific specifications. Initial testing (1991) combined with the current tests at the Rabbit Valley GPER will establish baseline data and will provide performance criteriamore » for the development of geophysical technologies and techniques. The US DOE`s Special Technologies Laboratory (STL) staff has conducted a Ground Penetrating Radar (GPR) survey of the site with its stepped FM-CW GPR. Additionally, STL contracted several other geophysical tests. These include an airborne GPR survey incorporating a ``chirped`` FM-CW GPR system and a magnetic survey with a surfaced-towed magnetometer array unit Ground-based and aerial video and still frame pictures were also acquired. STL compiled and analyzed all of the geophysical maps and created a site characterization database. This paper discusses the results of the multi-sensor geophysical studies performed at Rabbit Valley and the future plans for the site.« less

Viral proteases: an emerging therapeutic target.

PubMed

Korant, B D

1988-01-01

Only a few viral diseases are presently treatable because of our limited knowledge of specific viral target molecules. An attractive class of viral molecules toward which chemotherapeutic agents could be aimed are proteases coded by some virus groups such as retro- or picornaviruses (poliomyelitis, common cold virus). The picornavirus enzymes were discovered first, and they have now been characterized by a combination of molecular-genetic and biochemical approaches. Several laboratories have expressed the picornaviral enzymes in heterologous systems and have reported proteolytic activity, as well as the high cleavage fidelity diagnostic of the viral proteases. After dealing with several technical difficulties often encountered in standard genetic engineering approaches, one viral protease is now available to us in quantity and is amendable to mutagenic procedures. The initial outcome of the mutagenesis studies has been the confirmation of our earlier work with inhibitors, which suggested a cysteine active-site class. There is a clustering of active-site residues which may be unique to these viruses. The requirement for an active-site cysteine-histidine pair in combination with detailed information on the viral cleavage sites has permitted design of selective inhibitors with attractive antiviral properties. Future goals include investigation of the structural basis for selective processing and application of the cleavage specificity to general problems in genetic engineering.

Onboard Determination of Vehicle Glide Capability for Shuttle Abort Flight Managment (SAFM)

NASA Technical Reports Server (NTRS)

Straube, Timothy; Jackson, Mark; Fill, Thomas; Nemeth, Scott

2002-01-01

When one or more main engines fail during ascent, the flight crew of the Space Shuttle must make several critical decisions and accurately perform a series of abort procedures. One of the most important decisions for many aborts is the selection ofa landing site. Several factors influence the ability to reach a landing site, including the spacecraft point of atmospheric entry, the energy state at atmospheric entry, the vehicle glide capability from that energy state, and whether one or more suitable landing sites are within the glide capability. Energy assessment is further complicated by the fact that phugoid oscillations in total energy influence glide capability. Once the glide capability is known, the crew must select the "best" site option based upon glide capability and landing site conditions and facilities. Since most of these factors cannot currently be assessed by the crew in flight, extensive planning is required prior to each mission to script a variety of procedures based upon spacecraft velocity at the point of engine failure (or failures). The results of this preflight planning are expressed in tables and diagrams on mission-specific cockpit checklists. Crew checklist procedures involve leafing through several pages of instructions and navigating a decision tree for site selection and flight procedures - all during a time critical abort situation. With the advent of the Cockpit Avionics Upgrade (CAU), the Shuttle will have increased on-board computational power to help alleviate crew workload during aborts and provide valuable situational awareness during nominal operations. One application baselined for the CAU computers is Shuttle Abort Flight Management (SAFM), whose requirements have been designed and prototyped. The SAFM application includes powered and glided flight algorithms. This paper describes the glided flight algorithm which is dispatched by SAFM to determine the vehicle glide capability and make recommendations to the crew for site selection as well as to monitor glide capability while in route to the selected site. Background is provided on Shuttle entry guidance as well as the various types of Shuttle aborts. SAFM entry requirements and cockpit disp lays are discussed briefly to provide background for Glided Flight algorithm design considerations. The central principal of the Glided Flight algorithm is the use of energy-over-weight (EOW) curves to determine range and crossrange boundaries. The major challenges of this technique are exo-atmospheric flight, and phugoid oscillations in energy. During exo-atmospheric flight, energy is constant, so vehicle EOW is not sufficient to determine glide capability. The paper describes how the exo-atmospheric problem is solved by propagating the vehicle state to an "atmospheric pullout" state defined by Shuttle guidance parameters.

Robotic Single-Site Sacrocolpopexy Using Barbed Suture Anchoring and Peritoneal Tunneling Technique: Tips and Tricks.

PubMed

Guan, Xiaoming; Ma, Yingchun; Gisseman, Jordan; Kleithermes, Christopher; Liu, Juan

2017-01-01

To demonstrate the tips and tricks of a simpler technique for single-site sacrocolpopexy using barbed suture anchoring and retroperitoneal tunneling to make the procedure more efficient and reproducible. Step-by-step description of surgical tutorial using a narrated video (Canadian Task Force classification III). Academic tertiary care hospital. Patient with Stage III uterine prolapse. Sacrocolpopexy is increasing utilized since the FDA warning about complications of vaginal mesh surgery. It is the gold standard for repair of apical prolapse. However, there is great variation in the sacrocolpopexy procedure techniques and they have not been standardized. Traditional single-site laparoscopic sacrocolpopexy is very challenging as the procedure time is long and suturing is difficult. The advantages of suturing with wristed needle drivers in robotic single-site surgery simplify this complex procedure. Furthermore, using barbed suture anchoring and peritoneal tunneling technique potentially decreases the surgeon's learning curve and makes the procedure reproducible. In this video, we demonstrate a supracervial hysterectomy with a stepwise explanation of the correct technique for performing a robotic single incision sacrocolpopexy. Sacrocolpopexy is increasing used since the US Food and Drug Administration warning about complications of vaginal mesh surgery. It is the gold standard for repair of apical prolapse. However, a great variation exists in the sacrocolpopexy procedure techniques that need to be standardized. Traditional single-site laparoscopic sacrocolpopexy is very challenging because the procedure time is long and suturing is difficult. The advantages of suturing with wristed needle drivers in robotic single-site surgery simplify this complex procedure. Furthermore, using the barbed suture anchoring and peritoneal tunneling technique potentially decreases the surgeon's learning curve and makes the procedure reproducible. In this video, we demonstrate a supracervical hysterectomy with a stepwise explaation of the correct technique for performing a robotic single-incision sacrocolpopexy. The possibility of using the barbed suture and peritoneal tunneling technique with wristed needle drivers in robotic single-site sacrocolpopexy offers the possibility of an effective, safe, reproducible, and cosmetic surgical option. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

Rapid-estimation method for assessing scour at highway bridges

USGS Publications Warehouse

Holnbeck, Stephen R.

1998-01-01

A method was developed by the U.S. Geological Survey for rapid estimation of scour at highway bridges using limited site data and analytical procedures to estimate pier, abutment, and contraction scour depths. The basis for the method was a procedure recommended by the Federal Highway Administration for conducting detailed scour investigations, commonly referred to as the Level 2 method. Using pier, abutment, and contraction scour results obtained from Level 2 investigations at 122 sites in 10 States, envelope curves and graphical relations were developed that enable determination of scour-depth estimates at most bridge sites in a matter of a few hours. Rather than using complex hydraulic variables, surrogate variables more easily obtained in the field were related to calculated scour-depth data from Level 2 studies. The method was tested by having several experienced individuals apply the method in the field, and results were compared among the individuals and with previous detailed analyses performed for the sites. Results indicated that the variability in predicted scour depth among individuals applying the method generally was within an acceptable range, and that conservatively greater scour depths generally were obtained by the rapid-estimation method compared to the Level 2 method. The rapid-estimation method is considered most applicable for conducting limited-detail scour assessments and as a screening tool to determine those bridge sites that may require more detailed analysis. The method is designed to be applied only by a qualified professional possessing knowledge and experience in the fields of bridge scour, hydraulics, and flood hydrology, and having specific expertise with the Level 2 method.

Framing medical tourism: an analysis of persuasive appeals, risks and benefits, and new media features of medical tourism broker websites.

PubMed

Lee, Hyunmin; Wright, Kevin B; O'Connor, Michaela; Wombacher, Kevin

2014-01-01

This study explores the benefits and risks featured in medical tourism broker websites, as well as the types of persuasive appeals that these websites use to attract potential customers, from a framing theory perspective. In addition, it examines relationships among types of appeals and specific types of health-related services offered by medical facilities abroad and the role of new media modalities within medical tourism broker sites. A content analysis of 91 medical tourism broker websites was conducted. The results indicate that the websites highly emphasized benefits while downplaying the risks. Specifically, despite offering consumers complicated and risky medical procedures, the websites failed to report any procedural, postoperative, or legal concerns associated with them. Moreover, the results indicated that the websites relied on heavy use of new media features to enhance the appeal of the medical services that were offered. The implications of these findings, future directions for research, and limitations of the study are discussed.

Site Data Acquisition Subsystem (SDAS) Mod 1, installation, operation, and maintenance manual

NASA Technical Reports Server (NTRS)

1977-01-01

The Site Data Acquisition Subsystem (SDAS) Mod 1 was designed to collect sensor measurement data from solar energy demonstration site. This report provides a brief description of the SDAS and defines the installation requirements and procedures, the operations description and the procedures for field maintenance of the subsystem.

Topology of the membrane protein LamB by epitope tagging and a comparison with the X-ray model.

PubMed

Newton, S M; Klebba, P E; Michel, V; Hofnung, M; Charbit, A

1996-06-01

We previously developed a genetic approach to study, with a single antibody, the topology of the outer membrane protein LamB, an Escherichia coli porin with specificity towards maltodextrins and a receptor for bacteriophage lambda. Our initial procedure consisted of inserting at random the same reporter epitope (the C3 neutralization epitope from poliovirus) into permissive sites of LamB (i.e., sites which tolerate insertions without deleterious effects on the protein activities or the cell). A specific monoclonal antibody was then used to examine the position of the inserted epitope with respect to the protein and the membrane. In the present work, we set up a site-directed procedure to insert the C3 epitope at new sites in order to distinguish between two-dimensional folding models. This allowed us to identify two new surface loops of LamB and to predict another periplasmic exposed region. The results obtained by random and directed epitope tagging are analyzed in light of the recently published X-ray structure of the LamB protein. Study of 23 hybrid LamB-C3 proteins led to the direct identification of five of the nine external loops (L4, L5, L6, L7, and L9) and led to the prediction of four periplasmic loops (I1, I4, I5, and I8) of LamB. Nine of the hybrid proteins did not lead to topological conclusions, and none led to the wrong predictions or conclusions. The comparison indicates that parts of models based on secondary structure predictions alone are not reliable and points to the importance of experimental data in the establishment of outer membrane protein topological models. The advantages and limitations of genetic foreign epitope insertion for the study of integral membrane proteins are discussed.

Impact of steerable sheaths on contact forces and reconnection sites in ablation for persistent atrial fibrillation.

PubMed

Ullah, Waqas; Hunter, Ross J; McLean, Ailsa; Dhinoja, Mehul; Earley, Mark J; Sporton, Simon; Schilling, Richard J

2015-03-01

In preclinical studies, catheter contact force (CF) during radiofrequency ablation correlates with the subsequent lesion size. We investigated the impact of steerable sheaths on ablation CF, its consistency, and wide area circumferential ablation (WACA) line reconnection sites. Five thousand and sixty-four ablations were analyzed across 60 patients undergoing first-time ablation for persistent AF using a CF-sensing catheter: 19 manual nonsteerable sheath (Manual-NSS), 11 manual steerable sheath, and 30 robotic steerable sheath (Sensei, Hansen Medical Inc.) procedures were studied. Ablation CFs were higher in the steerable sheath groups for all left atrial ablations and also WACA ablations specifically (P < 0.006), but less consistent per WACA segment (P < 0.005). There were significant differences in the CFs around both WACAs by group: in the left WACA CFs were lower with Manual-NSS, other than at the anterior-inferior and posterior-superior regions, and lower in the right WACA, other than the anterior-superior region. There was a difference in the proportion of segments chronically reconnecting across groups: Manual-NSS 26.5%, manual steerable sheath 4.6%, robotic 12% (P < 0.0005). The left atrial appendage/PV ridge and right posterior wall were common sites of reconnection in all groups. Steerable sheaths increased ablation CF; however, there were region-specific heterogeneities in the extent of increment, with some segments where they failed to increase CF. Steerable sheath use was associated with reduced WACA-segment reconnection. It may be that the benefits of steerable sheath use in terms of higher CFs could be translated to improved clinical outcomes if regional weaknesses of this technology are taken into account during ablation procedures. © 2014 Wiley Periodicals, Inc.

Sandia National Laboratories, California Environmental Management System program manual.

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

Larsen, Barbara L.

2012-03-01

The Sandia National Laboratories, California (SNL/CA) Environmental Management System (EMS) Program Manual documents the elements of the site EMS Program. The SNL/CA EMS Program conforms to the International Standard on Environmental Management Systems, ISO 14001:2004and Department of Energy (DOE) Order 436.1. Sandia National Laboratories, California (SNL/CA) has maintained functional environmental programs to assist with regulatory compliance for more than 30 years. During 2005, these existing programs were rolled into a formal environmental management system (EMS) that expands beyond the traditional compliance focus to managing and improving environmental performance and stewardship practices for all site activities. An EMS is a setmore » of inter-related elements that represent a continuing cycle of planning, implementing, evaluating, and improving processes and actions undertaken to achieve environmental policy and goals. The SNL/CA EMS Program conforms to the International Standard for Environmental Management Systems, ISO 14001:2004 (ISO 2004). The site first received ISO 14001 certification in September 2006 and recertification in 2009. SNL/CA's EMS Program is applicable to the Sandia, Livermore site only. Although SNL/CA operates as one organizational division of the overall Sandia National Laboratories, the EMS Program is site-specific, with site-specific objectives and targets. SNL/CA (Division 8000) benefits from the organizational structure as it provides corporate level policies, procedures, and standards, and established processes that connect to and support elements of the SNL/CA EMS Program. Additionally, SNL/CA's EMS Program benefits from two corporate functional programs (Facilities Energy and Water Resource Management and Fleet Services programs) that maintain responsibility for energy management and fleet services for all Sandia locations. Each EMS element is further enhanced with site-specific processes and standards. Division 8000 has several groups operating at Sandia National Laboratories, New Mexico (SNL/NM). Although these groups, from an organizational perspective, are part of Division 8000, they are managed locally and fall under the environmental requirements specific to their New Mexico location. The New Mexico groups in Division 8000 follow the corporate EMS Program for New Mexico operations.« less

A Partial Least Squares Based Procedure for Upstream Sequence Classification in Prokaryotes.

PubMed

Mehmood, Tahir; Bohlin, Jon; Snipen, Lars

2015-01-01

The upstream region of coding genes is important for several reasons, for instance locating transcription factor, binding sites, and start site initiation in genomic DNA. Motivated by a recently conducted study, where multivariate approach was successfully applied to coding sequence modeling, we have introduced a partial least squares (PLS) based procedure for the classification of true upstream prokaryotic sequence from background upstream sequence. The upstream sequences of conserved coding genes over genomes were considered in analysis, where conserved coding genes were found by using pan-genomics concept for each considered prokaryotic species. PLS uses position specific scoring matrix (PSSM) to study the characteristics of upstream region. Results obtained by PLS based method were compared with Gini importance of random forest (RF) and support vector machine (SVM), which is much used method for sequence classification. The upstream sequence classification performance was evaluated by using cross validation, and suggested approach identifies prokaryotic upstream region significantly better to RF (p-value < 0.01) and SVM (p-value < 0.01). Further, the proposed method also produced results that concurred with known biological characteristics of the upstream region.

Evaluating the use of preoperative antibiotics in pediatric orthopaedic surgery.

PubMed

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

2012-01-01

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

Mapping multiple potential ATP binding sites on the matrix side of the bovine ADP/ATP carrier by the combined use of MD simulation and docking.

PubMed

Di Marino, Daniele; Oteri, Francesco; della Rocca, Blasco Morozzo; D'Annessa, Ilda; Falconi, Mattia

2012-06-01

The mitochondrial adenosine diphosphate/adenosine triphosphate (ADP/ATP) carrier-AAC-was crystallized in complex with its specific inhibitor carboxyatractyloside (CATR). The protein consists of a six-transmembrane helix bundle that defines the nucleotide translocation pathway, which is closed towards the matrix side due to sharp kinks in the odd-numbered helices. In this paper, we describe the interaction between the matrix side of the AAC transporter and the ATP(4-) molecule using carrier structures obtained through classical molecular dynamics simulation (MD) and a protein-ligand docking procedure. Fifteen structures were extracted from a previously published MD trajectory through clustering analysis, and 50 docking runs were carried out for each carrier conformation, for a total of 750 runs ("MD docking"). The results were compared to those from 750 docking runs performed on the X-ray structure ("X docking"). The docking procedure indicated the presence of a single interaction site in the X-ray structure that was conserved in the structures extracted from the MD trajectory. MD docking showed the presence of a second binding site that was not found in the X docking. The interaction strategy between the AAC transporter and the ATP(4-) molecule was analyzed by investigating the composition and 3D arrangement of the interaction pockets, together with the orientations of the substrate inside them. A relationship between sequence repeats and the ATP(4-) binding sites in the AAC carrier structure is proposed.

76 FR 50414 - National Oil and Hazardous Substances Pollution Contingency Plan; National Priorities List...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-15

...://www.regulations.gov Web site is an ``anonymous access'' system, which means EPA will not know your... hazard ranking system. III. Deletion Procedures The following procedures apply to deletion of this Site... Delete the Site from the NPL. (4) The EPA placed copies of documents supporting the proposed deletion in...

Cost Effective, Ultra Sensitive Groundwater Monitoring for Site Remediation and Management: Standard Operating Procedures with QA/QC

DTIC Science & Technology

2015-05-01

in consultation with the site management . 4.0 DATA TYPES AND QUALITY CONTROL A sampling plan must account for the collection, handling, and...GUIDANCE DOCUMENT Cost-Effective, Ultra-Sensitive Groundwater Monitoring for Site Remediation and Management : Standard Operating Procedures...Groundwater Monitoring for Site Remediation and Management 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Halden, R.U., Roll, I.B. 5d

Autoradiographic demonstration of oxytocin-binding sites in the macula densa

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

Stoeckel, M.E.; Freund-Mercier, M.J.

1989-08-01

Specific oxytocin (OT)-binding sites were localized in the rat kidney with use of a selective {sup 125}I-labeled OT antagonist ({sup 125}I-OTA). High concentrations of OT binding sites were detected on the juxtaglomerular apparatus with use of the conventional film autoradiographic technique. No labeling occurred on other renal structures. The cellular localization of the OT binding sites within the juxtaglomerular apparatus was studied in light microscope autoradiography, on semithin sections from paraformaldehyde-fixed kidney slices incubated in the presence of {sup 125}I-OTA. These preparations revealed selective labeling of the macula densa, mainly concentrated at the basal pole of the cells. Control experimentsmore » showed first that {sup 125}I-OTA binding characteristics were not noticeably altered by prior paraformaldehyde fixation of the kidneys and second that autoradiographic detection of the binding sites was not impaired by histological treatments following binding procedures. In view of the role of the macula densa in the tubuloglomerular feedback, the putative OT receptors of this structure might mediate the stimulatory effect of OT on glomerular filtration.« less

National hydroelectric power resources study. Preliminary inventory of hydropower resources. Volume 1. Pacific Northwest region

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

None

1979-07-01

The preliminary inventory and analysis procedures provide a comprehensive assessment of the undeveloped hydroelectric power potential in the US and determines which sites merit more thorough investigation. Over 5400 existing structures have been identified as having the physical potential to add hydropower plants or increase hydropower output thereby increasing our present hydropower capacity from a total of 64,000 MW to 158,000 MW and our energy from 280,000 GWH to 503,000 GWH. While the physical potential for this increase is clearly available, some of these projects will undoubtedly not satisfy more-detailed economic analysis as well as the institutional and environmental criteriamore » which will be imposed upon them. Summary tables include estimates of the potential capacity and energy at each site in the inventory. In some cases, individual projects may be site alternatives to others in the same general location, when only one can be considered for hydropower development. The number of sites per state is identified, but specific information is included for only the sites in Alaska, Idaho, Oregon, and Washington in this first volume.« less

Empirical evidence for acceleration-dependent amplification factors

USGS Publications Warehouse

Borcherdt, R.D.

2002-01-01

Site-specific amplification factors, Fa and Fv, used in current U.S. building codes decrease with increasing base acceleration level as implied by the Loma Prieta earthquake at 0.1g and extrapolated using numerical models and laboratory results. The Northridge earthquake recordings of 17 January 1994 and subsequent geotechnical data permit empirical estimates of amplification at base acceleration levels up to 0.5g. Distance measures and normalization procedures used to infer amplification ratios from soil-rock pairs in predetermined azimuth-distance bins significantly influence the dependence of amplification estimates on base acceleration. Factors inferred using a hypocentral distance norm do not show a statistically significant dependence on base acceleration. Factors inferred using norms implied by the attenuation functions of Abrahamson and Silva show a statistically significant decrease with increasing base acceleration. The decrease is statistically more significant for stiff clay and sandy soil (site class D) sites than for stiffer sites underlain by gravely soils and soft rock (site class C). The decrease in amplification with increasing base acceleration is more pronounced for the short-period amplification factor, Fa, than for the midperiod factor, Fv.

Perioperative outcomes for pediatric neurosurgical procedures: analysis of the National Surgical Quality Improvement Program-Pediatrics.

PubMed

Kuo, Benjamin J; Vissoci, Joao Ricardo N; Egger, Joseph R; Smith, Emily R; Grant, Gerald A; Haglund, Michael M; Rice, Henry E

2017-03-01

OBJECTIVE Existing studies have shown a high overall rate of adverse events (AEs) following pediatric neurosurgical procedures. However, little is known regarding the morbidity of specific procedures or the association with risk factors to help guide quality improvement (QI) initiatives. The goal of this study was to describe the 30-day mortality and AE rates for pediatric neurosurgical procedures by using the American College of Surgeons (ACS) National Surgical Quality Improvement Program-Pediatrics (NSQIP-Peds) database platform. METHODS Data on 9996 pediatric neurosurgical patients were acquired from the 2012-2014 NSQIP-Peds participant user file. Neurosurgical cases were analyzed by the NSQIP-Peds targeted procedure categories, including craniotomy/craniectomy, defect repair, laminectomy, shunts, and implants. The primary outcome measure was 30-day mortality, with secondary outcomes including individual AEs, composite morbidity (all AEs excluding mortality and unplanned reoperation), surgical-site infection, and unplanned reoperation. Univariate analysis was performed between individual AEs and patient characteristics using Fischer's exact test. Associations between individual AEs and continuous variables (duration from admission to operation, work relative value unit, and operation time) were examined using the Student t-test. Patient characteristics and continuous variables associated with any AE by univariate analysis were used to develop category-specific multivariable models through backward stepwise logistic regression. RESULTS The authors analyzed 3383 craniotomy/craniectomy, 242 defect repair, 1811 laminectomy, and 4560 shunt and implant cases and found a composite overall morbidity of 30.2%, 38.8%, 10.2%, and 10.7%, respectively. Unplanned reoperation rates were highest for defect repair (29.8%). The mortality rate ranged from 0.1% to 1.2%. Preoperative ventilator dependence was a significant predictor of any AE for all procedure groups, whereas admission from outside hospital transfer was a significant predictor of any AE for all procedure groups except craniotomy/craniectomy. CONCLUSIONS This analysis of NSQIP-Peds, a large risk-adjusted national data set, confirms low perioperative mortality but high morbidity for pediatric neurosurgical procedures. These data provide a baseline understanding of current expected clinical outcomes for pediatric neurosurgical procedures, identify the need for collecting neurosurgery-specific risk factors and complications, and should support targeted QI programs and clinical management interventions to improve care of children.

Specification for procurement of water-level sensing instrumentation, specification number HIF-I-1

USGS Publications Warehouse

Rapp, D.H.

1982-01-01

This specification is to communicate to instrument manufacturers the U.S. Geological Survey 's requirements. It covers systems for sensing the elevation of the water surface on open channels, rivers, lakes, reservoirs, storm-sewer pipes, and observation wells at Survey data-collection sites. The signal output (mechanical or electrical) must meet the signal input requirements of analog to digital and digital input recorders in use by the Survey. A classification of stage-sensing systems by common characteristics is used to aid Survey people making system selections. These characteristics are (1) system type (contact or noncontact), (2) sensor type and sensing distance, (3) accuracy, (4) range, (5) power requirements, (6) system size and weight, and (7) data output signal. Acceptable system requirements cover system configurations, signal outputs, materials, operation manuals, detailed environmental conditions, calibration procedures, system accuracy, power requirements, installation limitations, maintainability, safety, and workmanship. An outline of the qualification test procedures and failure criteria are also given. The Hydrologic Instrumentation Facility at NSTL Station, Mississippi will test available systems to determine if they meet the specification in this report for inclusion in the Survey 's 'Qualified Products List'. This list will be used for future procurement of water-level sensing systems by the Survey. (USGS)

SNP2TFBS - a database of regulatory SNPs affecting predicted transcription factor binding site affinity.

PubMed

Kumar, Sunil; Ambrosini, Giovanna; Bucher, Philipp

2017-01-04

SNP2TFBS is a computational resource intended to support researchers investigating the molecular mechanisms underlying regulatory variation in the human genome. The database essentially consists of a collection of text files providing specific annotations for human single nucleotide polymorphisms (SNPs), namely whether they are predicted to abolish, create or change the affinity of one or several transcription factor (TF) binding sites. A SNP's effect on TF binding is estimated based on a position weight matrix (PWM) model for the binding specificity of the corresponding factor. These data files are regenerated at regular intervals by an automatic procedure that takes as input a reference genome, a comprehensive SNP catalogue and a collection of PWMs. SNP2TFBS is also accessible over a web interface, enabling users to view the information provided for an individual SNP, to extract SNPs based on various search criteria, to annotate uploaded sets of SNPs or to display statistics about the frequencies of binding sites affected by selected SNPs. Homepage: http://ccg.vital-it.ch/snp2tfbs/. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

Current status and future directions of robotic single-site surgery: a systematic review.

PubMed

Autorino, Riccardo; Kaouk, Jihad H; Stolzenburg, Jens-Uwe; Gill, Inderbir S; Mottrie, Alex; Tewari, Ash; Cadeddu, Jeffrey A

2013-02-01

Despite the increasing interest in laparoendoscopic single-site surgery (LESS) worldwide, the actual role of this novel approach in the field of minimally invasive urologic surgery remains to be determined. It has been postulated that robotic technology could be applied to LESS to overcome the current constraints. To summarize and critically analyze the available evidence on the current status and future of robotic applications in single-site surgery. A systematic literature review was performed in April 2011 using PubMed and the Thomson-Reuters Web of Science. In the free-text protocol, the following terms were applied: robotic single site surgery, robotic single port surgery, robotic single incision surgery, and robotic laparoendoscopic single site surgery. Review articles, editorials, commentaries, and letters to the editor were included only if deemed to contain relevant information. In addition, cited references from the selected articles and from review articles retrieved in the search were assessed for significant manuscripts not previously included. The authors selected 55 articles according to the search strategy based on Preferred Reporting Items for Systematic Reviews and Meta-analysis criteria. The volume of available clinical outcomes of robotic LESS (R-LESS) has considerably grown since the pioneering description of the first successful clinical series of single-port robotic procedures. So far, a cumulative number of roughly 150 robotic urologic LESS cases have been reported by different institutions across the globe with a variety of techniques and port configurations. The feasibility of robot-assisted single-incision colorectal procedures, as well as of many gynecologic procedures, has also been demonstrated. A novel set of single-site instruments specifically dedicated to LESS is now commercially available for use with the da Vinci Si surgical system, and both experimental and clinical use have been reported. However, the current robotic systems were specifically designed for LESS. The ideal robotic platform should have a low external profile, the possibility of being deployed through a single access site, and the possibility of restoring intra-abdominal triangulation while maintaining the maximum degree of freedom for precise maneuvers and strength for reliable traction. Several purpose-built robotic prototypes for single-port surgery are being tested. Significant advances have been achieved in the field of R-LESS since the first reported clinical series in 2009. Given the several advantages offered by current the da Vinci system, it is likely that its adoption in this field will increase. The recent introduction of purpose-built instrumentation is likely to further foster the application of robotics to LESS. However, we are still far from the ideal robotic platform. Significant improvements are needed before this technique might reach widespread adoption beyond selected centers. Further advances in the field of robotic technology are expected to provide the optimal interface to facilitate LESS. Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.

NREL/University of Delaware Offshore Wind R&D Collaboration: Cooperative Research and Development Final Report, CRADA Number CRD-10-393

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

Musial, Walt

2015-11-12

Specifically, the work under this CRADA includes, but is not limited to, the development of test procedures for an offshore test site in Delaware waters; testing of installed offshore wind turbines; performance monitoring of those turbines; and a program of research and development on offshore wind turbine blades, components, coatings, foundations, installation and construction of bottom-fixed structures, environmental impacts, policies, and more generally on means to enhance the reliability, facilitate permitting, and reduce costs for offshore wind turbines. This work will be conducted both at NREL's National Wind Technology Center and participant facilities, as well as the established offshore windmore » test sites.« less

Improving the S-Shape Solar Radiation Estimation Method for Supporting Crop Models

PubMed Central

Fodor, Nándor

2012-01-01

In line with the critical comments formulated in relation to the S-shape global solar radiation estimation method, the original formula was improved via a 5-step procedure. The improved method was compared to four-reference methods on a large North-American database. According to the investigated error indicators, the final 7-parameter S-shape method has the same or even better estimation efficiency than the original formula. The improved formula is able to provide radiation estimates with a particularly low error pattern index (PIdoy) which is especially important concerning the usability of the estimated radiation values in crop models. Using site-specific calibration, the radiation estimates of the improved S-shape method caused an average of 2.72 ± 1.02 (α = 0.05) relative error in the calculated biomass. Using only readily available site specific metadata the radiation estimates caused less than 5% relative error in the crop model calculations when they were used for locations in the middle, plain territories of the USA. PMID:22645451

Prediction of cancer incidence and mortality in Korea, 2014.

PubMed

Jung, Kyu-Won; Won, Young-Joo; Kong, Hyun-Joo; Oh, Chang-Mo; Lee, Duk Hyoung; Lee, Jin Soo

2014-04-01

We studied and reported on cancer incidence and mortality rates as projected for the year 2014 in order to estimate Korea's current cancer burden. Cancer incidence data from 1999 to 2011 were obtained from the Korea National Cancer Incidence Database, and cancer mortality data from 1993 to 2012 were acquired from Statistics Korea. Cancer incidence in 2014 was projected by fitting a linear regression model to observed age-specific cancer incidence rates against observed years, then multiplying the projected age-specific rates by the age-specific population. For cancer mortality, a similar procedure was employed, except that a Joinpoint regression model was used to determine at which year the linear trend changed significantly. A total of 265,813 new cancer cases and 74,981 cancer deaths are expected to occur in Korea in 2014. Further, the crude incidence rate per 100,000 of all sites combined will likely reach 524.7 and the age-standardized incidence rate, 338.5. Meanwhile, the crude mortality rate of all sites combined and age-standardized rate are projected to be 148.0 and 84.6, respectively. Given the rapid rise in prostate cancer cases, it is anticipated to be the fourth most frequently occurring cancer site in men for the first time. Cancer has become the most prominent public health concern in Korea, and as the population ages, the nation's cancer burden will continue to increase.

Global Analysis of Transcription Factor-Binding Sites in Yeast Using ChIP-Seq

PubMed Central

Lefrançois, Philippe; Gallagher, Jennifer E. G.; Snyder, Michael

2016-01-01

Transcription factors influence gene expression through their ability to bind DNA at specific regulatory elements. Specific DNA-protein interactions can be isolated through the chromatin immunoprecipitation (ChIP) procedure, in which DNA fragments bound by the protein of interest are recovered. ChIP is followed by high-throughput DNA sequencing (Seq) to determine the genomic provenance of ChIP DNA fragments and their relative abundance in the sample. This chapter describes a ChIP-Seq strategy adapted for budding yeast to enable the genome-wide characterization of binding sites of transcription factors (TFs) and other DNA-binding proteins in an efficient and cost-effective way. Yeast strains with epitope-tagged TFs are most commonly used for ChIP-Seq, along with their matching untagged control strains. The initial step of ChIP involves the cross-linking of DNA and proteins. Next, yeast cells are lysed and sonicated to shear chromatin into smaller fragments. An antibody against an epitope-tagged TF is used to pull down chromatin complexes containing DNA and the TF of interest. DNA is then purified and proteins degraded. Specific barcoded adapters for multiplex DNA sequencing are ligated to ChIP DNA. Short DNA sequence reads (28–36 base pairs) are parsed according to the barcode and aligned against the yeast reference genome, thus generating a nucleotide-resolution map of transcription factor-binding sites and their occupancy. PMID:25213249

Double-label immunofluorescence method for simultaneous detection of adenovirus and herpes simplex virus from the eye.

PubMed

Walpita, P; Darougar, S

1989-07-01

The development and application of a double-label immunofluorescence method which has the potential to screen for single or dual infections from any site, in single shell vial cultures, is described. In this study, a total of 1,141 ocular specimens were inoculated in shell vials, centrifuged at 15,000 X g for 1 h, incubated at 37 degrees C for 48 h, and fixed in methanol at room temperature for 15 min. The virus inclusions were detected by staining with a double-label indirect immunofluorescence procedure using mixtures of appropriate first antibodies, followed by fluorescein- and rhodamine-conjugated second antibodies. Each specimen was also inoculated in parallel by the conventional virus isolation method. The sensitivity and specificity of the double-label shell vial procedure were comparable to those with the conventional method, and the former test took only 48 h to complete. The test offers a rapid and simple single-vial procedure which allows for individual or simultaneous detection of multiple pathogens. It results in savings in time and cost over the conventional virus isolation method and other shell vial procedures.

Decontamination and Management of Human Remains Following Incidents of Hazardous Chemical Release

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

Hauschild, Veronique; Watson, Annetta Paule; Bock, Robert Eldon

2012-01-01

Abstract Objective: To provide specific procedural guidance and resources for identification, assessment, control, and mitigation of compounds that may contaminate human remains resulting from chemical attack or release. Design: A detailed technical, policy, and regulatory review is summarized. Setting: Guidance is suitable for civilian or military settings where human remains potentially contaminated with hazardous chemicals may be present. Settings would include sites of transportation accidents, natural disasters, terrorist or military operations, mortuary affairs or medical examiner processing and decontamination points, and similar. Patients, Participants: While recommended procedures have not been validated with actual human remains, guidance has been developed frommore » data characterizing controlled experiments with fabrics, materiel, and laboratory animals. Main Outcome Measure(s): Presentation of logic and specific procedures for remains management, protection and decontamination of mortuary affairs personnel, as well as decision criteria for determining when remains are sufficiently decontaminated so as to pose no chemical health hazard. Results: Established procedures and existing equipment/materiel available for decontamination and verification provide appropriate and reasonable means to mitigate chemical hazards from remains. Extensive characterization of issues related to remains decontamination indicates that supra-lethal concentrations of liquid chemical warfare agent VX may prove difficult to decontaminate and verify in a timely fashion. Specialized personnel can and should be called upon to assist with monitoring necessary to clear decontaminated remains for transport and processing. Conclusions: Once appropriate decontamination and verification have been accomplished, normal procedures for remains processing and transport to the decedent s family and the continental United States can be followed.« less

Automated statistical matching of multiple tephra records exemplified using five long maar sequences younger than 75 ka, Auckland, New Zealand

NASA Astrophysics Data System (ADS)

Green, Rebecca M.; Bebbington, Mark S.; Cronin, Shane J.; Jones, Geoff

2014-09-01

Detailed tephrochronologies are built to underpin probabilistic volcanic hazard forecasting, and to understand the dynamics and history of diverse geomorphic, climatic, soil-forming and environmental processes. Complicating factors include highly variable tephra distribution over time; difficulty in correlating tephras from site to site based on physical and chemical properties; and uncertain age determinations. Multiple sites permit construction of more accurate composite tephra records, but correctly merging individual site records by recognizing common events and site-specific gaps is complex. We present an automated procedure for matching tephra sequences between multiple deposition sites using stochastic local optimization techniques. If individual tephra age determinations are not significantly different between sites, they are matched and a more precise age is assigned. Known stratigraphy and mineralogical or geochemical compositions are used to constrain tephra matches. We apply this method to match tephra records from five long sediment cores (≤ 75 cal ka BP) in Auckland, New Zealand. Sediments at these sites preserve basaltic tephras from local eruptions of the Auckland Volcanic Field as well as distal rhyolitic and andesitic tephras from Okataina, Taupo, Egmont, Tongariro, and Tuhua (Mayor Island) volcanic centers. The new correlated record compiled is statistically more likely than previously published arrangements from this area.

10 CFR 2.604 - Notice of hearing on application for early review of site suitability issues in construction...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Notice of hearing on application for early review of site... AGENCY RULES OF PRACTICE AND PROCEDURE Additional Procedures Applicable to Early Partial Decisions on... Early Partial Decisions on Site Suitability-Construction Permit § 2.604 Notice of hearing on application...

10 CFR 2.623 - Notice of hearing on application for early review of site suitability issues in combined license...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 10 Energy 1 2013-01-01 2013-01-01 false Notice of hearing on application for early review of site... AGENCY RULES OF PRACTICE AND PROCEDURE Additional Procedures Applicable to Early Partial Decisions on... Early Partial Decisions on Site Suitability-Combined License Under 10 Cfr Part 52 § 2.623 Notice of...

10 CFR 2.604 - Notice of hearing on application for early review of site suitability issues in construction...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Notice of hearing on application for early review of site... AGENCY RULES OF PRACTICE AND PROCEDURE Additional Procedures Applicable to Early Partial Decisions on... Early Partial Decisions on Site Suitability-Construction Permit § 2.604 Notice of hearing on application...

10 CFR 2.623 - Notice of hearing on application for early review of site suitability issues in combined license...

Code of Federal Regulations, 2014 CFR

2014-01-01

... 10 Energy 1 2014-01-01 2014-01-01 false Notice of hearing on application for early review of site... AGENCY RULES OF PRACTICE AND PROCEDURE Additional Procedures Applicable to Early Partial Decisions on... Early Partial Decisions on Site Suitability-Combined License Under 10 Cfr Part 52 § 2.623 Notice of...

Competency-Based Education in Low Resource Settings: Development of a Novel Surgical Training Program.

PubMed

McCullough, Meghan; Campbell, Alex; Siu, Armando; Durnwald, Libby; Kumar, Shubha; Magee, William P; Swanson, Jordan

2018-03-01

The unmet burden of surgical disease represents a major global health concern, and a lack of trained providers is a critical component of the inadequacy of surgical care worldwide. Competency-based training has been advanced in high-income countries, improving technical skills and decreasing training time, but it is poorly understood how this model might be applied to low- and middle-income countries. We describe the development of a competency-based program to accelerate specialty training of in-country providers in cleft surgery techniques. The program was designed and piloted among eight trainees at five international cleft lip and palate surgical mission sites in Latin America and Africa. A competency-based evaluation form, designed for the program, was utilized to grade general technical and procedure-specific competencies, and pre- and post-training scores were analyzed using a paired t test. Trainees demonstrated improvement in average procedure-specific competency scores for both lip repairs (60.4-71.0%, p < 0.01) and palate (50.6-66.0%, p < 0.01). General technical competency scores also improved (63.6-72.0%, p < 0.01). Among the procedural competencies assessed, surgical markings showed the greatest improvement (19.0 and 22.8% for lip and palate, respectively), followed by nasal floor/mucosal approximation (15.0%) and hard palate dissection (17.1%). Surgical delivery models in LMICs are varied, and trade-offs often exist between goals of case throughput, quality and training. Pilot program results show that procedure-specific and general technical competencies can be improved over a relatively short time and demonstrate the feasibility of incorporating such a training program into surgical outreach missions.

Milestones for Selection, Characterization, and Analysis of the Performance of a Repository for Spent Nuclear Fuel and High-Level Radioactive Waste at Yucca Mountain.

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

Rechard, Robert P.

This report presents a concise history in tabular form of events leading up to site identification in 1978, site selection in 1987, subsequent characterization, and ongoing analysis through 2008 of the performance of a repository for spent nuclear fuel and high-level radioactive waste at Yucca Mountain in southern Nevada. The tabulated events generally occurred in five periods: (1) commitment to mined geologic disposal and identification of sites; (2) site selection and analysis, based on regional geologic characterization through literature and analogous data; (3) feasibility analysis demonstrating calculation procedures and importance of system components, based on rough measures of performance usingmore » surface exploration, waste process knowledge, and general laboratory experiments; (4) suitability analysis demonstrating viability of disposal system, based on environment-specific laboratory experiments, in-situ experiments, and underground disposal system characterization; and (5) compliance analysis, based on completed site-specific characterization. Because the relationship is important to understanding the evolution of the Yucca Mountain Project, the tabulation also shows the interaction between four broad categories of political bodies and government agencies/institutions: (a) technical milestones of the implementing institutions, (b) development of the regulatory requirements and related federal policy in laws and court decisions, (c) Presidential and agency directives and decisions, and (d) critiques of the Yucca Mountain Project and pertinent national and world events related to nuclear energy and radioactive waste.« less

Development of [3H]2-Carboxy-4,6-dichloro-1H-indole-3-propionic Acid ([3H]PSB-12150): A Useful Tool for Studying GPR17

PubMed Central

2014-01-01

The recently described synthetic GPR17 agonist 2-carboxy-4,6-dichloro-1H-indole-3-propionic acid (1) was prepared in tritium-labeled form by catalytic hydrogenation of the corresponding propenoic acid derivative 8 with tritium gas. The radioligand [3H]PSB-12150 (9) was obtained with a specific activity of 17 Ci/mmol (629 GBq/mmol). It showed specific and saturable binding to a single binding site in membrane preparations from Chinese hamster ovary cells recombinantly expressing the human GPR17. A competition assay procedure was established, which allows the determination of ligand binding affinities. PMID:24900835

Development of [(3)H]2-Carboxy-4,6-dichloro-1H-indole-3-propionic Acid ([(3)H]PSB-12150): A Useful Tool for Studying GPR17.

PubMed

Köse, Meryem; Ritter, Kirsten; Thiemke, Katharina; Gillard, Michel; Kostenis, Evi; Müller, Christa E

2014-04-10

The recently described synthetic GPR17 agonist 2-carboxy-4,6-dichloro-1H-indole-3-propionic acid (1) was prepared in tritium-labeled form by catalytic hydrogenation of the corresponding propenoic acid derivative 8 with tritium gas. The radioligand [(3)H]PSB-12150 (9) was obtained with a specific activity of 17 Ci/mmol (629 GBq/mmol). It showed specific and saturable binding to a single binding site in membrane preparations from Chinese hamster ovary cells recombinantly expressing the human GPR17. A competition assay procedure was established, which allows the determination of ligand binding affinities.

Developing a Web-Based Mechanism for Assessing Teacher Science Content Knowledge

NASA Astrophysics Data System (ADS)

Byers, Al; Koba, Susan; Sherman, Greg; Scheppke, Joan; Bolus, Roger

2011-04-01

The National Science Teachers Association (NSTA) recently launched a comprehensive electronic professional development (e-PD) online portal, the NSTA Learning Center. This support site for educators currently includes over 6,000 e-PD resources and opportunities available on-demand, as well as various tools designed to help educators maximize the effectiveness of using NSTA resources. One tool, the PD Indexer, helps teachers identify their own areas of content strengths and weaknesses by selecting content-specific assessments. Individual NSTA resources are recommended based on assessment outcomes. This paper presents a detailed description of the procedures employed by NSTA to develop valid and reliable PD Indexer content-specific multiple-choice assessment items.

Should gram stains have a role in diagnosing hip arthroplasty infections?

PubMed

Johnson, Aaron J; Zywiel, Michael G; Stroh, D Alex; Marker, David R; Mont, Michael A

2010-09-01

The utility of Gram stains in diagnosing periprosthetic infections following total hip arthroplasty has recently been questioned. Several studies report low sensitivity of the test, and its poor ability to either confirm or rule out infection in patients undergoing revision total hip arthroplasty. Despite this, many institutions including that of the senior author continue to perform Gram stains during revision total hip arthroplasty. We assessed the sensitivity, specificity, accuracy, and positive and negative predictive values of Gram stains from surgical-site samplings taken from procedures on patients with both infected and aseptic revision total hip arthroplasties. A review was performed on patients who underwent revision total hip arthroplasty between 2000 and 2007. Eighty-two Gram stains were performed on patients who had infected total hip arthroplasties and underwent revision procedures. Additionally, of the 410 revision total hip arthroplasties performed on patients who were confirmed infection-free, 120 Gram stains were performed. Patients were diagnosed as infected using multiple criteria at the time of surgery. Sensitivity, specificity, positive and negative predictive values, and accuracy were calculated from these Gram stain results. The Gram stain demonstrated a sensitivity and specificity of 9.8% and 100%, respectively. In this series, the Gram stain had a negative predictive value of 62%, a positive predictive value of 100%, and an accuracy of 63%. Gram stains obtained from surgical-site samples had poor sensitivity and poor negative predictive value. Based on these findings, as well as those of other authors, we believe that Gram stains should no longer be considered for diagnosing infections in revision total hip arthroplasty. Level III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.

Concepts & Procedures. [SITE 2002 Section].

ERIC Educational Resources Information Center

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

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

Concepts & Procedures. [SITE 2001 Section].

ERIC Educational Resources Information Center

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

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

Influence of intraoral temperature and relative humidity on the dentin bond strength: an in situ study.

PubMed

Saraiva, Letícia O; Aguiar, Thaiane R; Costa, Leonardo; Cavalcanti, Andrea N; Giannini, Marcelo; Mathias, Paula

2015-01-01

The effect of the intraoral environment during adhesive restorative procedures remains a concern, especially in the absence of rubber dam isolation. To evaluate the temperature and relative humidity (RH) at anterior and posterior intraoral sites and their effects on the dentin bond strength of two-step etch-and-rinse adhesive systems. Sixty human molars were assigned to six groups according to the adhesive systems (Adper Single Bond Plus and One Step Plus) and intraoral sites (incisor and molar sites). The room condition was used as a control group. Dentin fragments were individually placed in custom-made acetate trays and direct composite restorations were performed. The intraoral temperature and RH were recorded during adhesive procedures. Then, specimens were removed from the acetate trays and sectioned to obtain multiple beams for the microtensile bond strength test. In addition, the adhesive interface morphology was evaluated through scanning electron microscopy. Intraoral conditions were statistically analyzed by paired Students' t-tests and the bond strength data by two-way analysis of variance and Tukey test (α = 0.05). The posterior intraoral site showed a significant increase in the temperature and RH when compared with the anterior site. However, both intraoral sites revealed higher temperatures and RH than the room condition. In regards to the adhesive systems, the intraoral environment did not affect the bond strength, and the One Step Plus system showed the highest bond strength means. Despite the fact that remarkable changes in the intraoral conditions were observed for both anterior and posterior sites, the intraoral environment was not able to compromise the immediate dentin bond strength. Some conditions of intraoral temperature and relative humidity may not impair the dentin bond strength of two-step etch-and-rinse adhesive systems. Thus, an adequate relative isolation seems to be a good alternative under the specific clinical conditions in which rubber dam isolation is either impossible or very difficult to perform. © 2014 Wiley Periodicals, Inc.

Guidelines for asbestos remediation at Italian superfund sites.

PubMed

Paglietti, F; Malinconico, S; Di Molfetta, V; Giangrasso, M

2012-01-01

Asbestos is now banned in 52 countries. Although Italy banned asbestos in 1992, up until that date it had been one of the main producer nations of asbestos and asbestos-containing materials, and asbestos-related contamination is still widespread in the country. To reduce asbestos-related health effects, Italy has adopted many laws and regulations regarding exposure thresholds and remediation tools. Even so, there are legislative gaps that are making it difficult to manage related risks especially in the operative phase. The lack of standard procedures at a national level regarding emergency shutdown and remediation as well as reference thresholds for specific risk situations creates difficulties and different actions when dealing with the cleanup of Italian asbestos superfund sites. The authors propose operative guidelines for asbestos remediation at Italian superfund sites. INAIL, the reference national organization for asbestos-related matters, acting as an advisor to a number of state, regional, and local authorities, examined the main asbestos-related risk situations in Italy and proposed the most appropriate actions to take. The detailed analysis of many actual cases of risk, in part through inspections and the management of cleanup actions at asbestos Italian superfund sites, resulted in proposals to modify existing procedures and thresholds, which were subsequently discussed with all national, regional, and local scientific bodies. After more than two years of work and discussion at a national level, INAIL-DIPIA-Asbestos Group drafted new Guidelines for Asbestos Remediation at Italian Superfund sites, and officially submitted them to the Environment Ministry. The Ministry then adopted the document in regard to all asbestos Italian superfunds. This recently released document is also a useful reference for contaminated sites at a regional and local level. The operative Guidelines for Asbestos Remediation at Italian Superfund sites may also be of use at an international level for countries that have already banned asbestos and are engaged in remediation activity and for countries that have not yet banned asbestos but wish to adopt risk prevention measures.

Empirical evidence for site coefficients in building code provisions

USGS Publications Warehouse

Borcherdt, R.D.

2002-01-01

Site-response coefficients, Fa and Fv, used in U.S. building code provisions are based on empirical data for motions up to 0.1 g. For larger motions they are based on theoretical and laboratory results. The Northridge earthquake of 17 January 1994 provided a significant new set of empirical data up to 0.5 g. These data together with recent site characterizations based on shear-wave velocity measurements provide empirical estimates of the site coefficients at base accelerations up to 0.5 g for Site Classes C and D. These empirical estimates of Fa and Fnu; as well as their decrease with increasing base acceleration level are consistent at the 95 percent confidence level with those in present building code provisions, with the exception of estimates for Fa at levels of 0.1 and 0.2 g, which are less than the lower confidence bound by amounts up to 13 percent. The site-coefficient estimates are consistent at the 95 percent confidence level with those of several other investigators for base accelerations greater than 0.3 g. These consistencies and present code procedures indicate that changes in the site coefficients are not warranted. Empirical results for base accelerations greater than 0.2 g confirm the need for both a short- and a mid- or long-period site coefficient to characterize site response for purposes of estimating site-specific design spectra.

Orthopaedic surgery in natural disaster and conflict settings: how can quality care be ensured?

PubMed

Alvarado, Oscar; Trelles, Miguel; Tayler-Smith, Katie; Joseph, Holdine; Gesline, Rodné; Wilna, Thélusma Eli; Mohammad Omar, Mohammad Karim; Faiz Mohammad, Niaz Mohammad; Muhima Mastaki, John; Chingumwa Buhu, Richard; Caluwaerts, An; Dominguez, Lynette

2015-10-01

Médecins sans Frontières (MSF) is one of the main providers of orthopaedic surgery in natural disaster and conflict settings and strictly imposes a minimum set of context-specific standards before any surgery can be performed. Based on MSF's experience of performing orthopaedic surgery in a number of such settings, we describe: (a) whether it was possible to implement the minimum standards for one of the more rigorous orthopaedic procedures--internal fixation--and when possible, the time frame, (b) the volume and type of interventions performed and (c) the intra-operative mortality rates and postoperative infection rates. We conducted a retrospective review of routine programme data collected between 2007 and 2014 from three MSF emergency surgical interventions in Haiti (following the 2010 earthquake) and three ongoing MSF projects in Kunduz (Afghanistan), Masisi (Democratic Republic of the Congo) and Tabarre (Haiti). The minimum standards for internal fixation were achieved in one emergency intervention site in Haiti, and in Kunduz and Tabarre, taking up to 18 months to implement in Kunduz. All sites achieved the minimum standards to perform amputations, reductions and external fixations, with a total of 9,409 orthopaedic procedures performed during the study period. Intraoperative mortality rates ranged from 0.6 to 1.9 % and postoperative infection rates from 2.4 to 3.5 %. In settings affected by natural disaster or conflict, a high volume and wide repertoire of orthopaedic surgical procedures can be performed with good outcomes when minimum standards are in place. More demanding procedures like internal fixation may not always be feasible.

Development of a surgical site infection (SSI) surveillance system, calculation of SSI rates and specification of important factors affecting SSI in a digestive organ surgical department.

PubMed

Kimura, Koji; Sawa, Akihiro; Akagi, Shinji; Kihira, Kenji

2007-06-01

We have developed an original system to conduct surgical site infection (SSI) surveillance. This system accumulates SSI surveillance information based on the National Nosocomial Infections Surveillance (NNIS) System and the Japanese Nosocomial Infections Surveillance (JNIS) System. The features of this system are as follows: easy input of data, high generality, data accuracy, SSI rate by operative procedure and risk index category (RIC) can be promptly calculated and compared with the current NNIS SSI rate, and the SSI rates and accumulated data can be exported electronically. Using this system, we monitored 798 patients in 24 operative procedure categories in the Digestive Organs Surgery Department of Mazda Hospital, Mazda Motor Corporation, from January 2004 through December 2005. The total number and rate of SSI were 47 and 5.89%, respectively. The SSI rates of 777 patients were calculated based on 15 operative procedure categories and Risk Index Categories (RIC). The highest SSI rate was observed in the rectum surgery of RIC 1 (30%), followed by the colon surgery of RIC3 (28.57%). About 30% of the isolated infecting bacteria were Enterococcus faecalis, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli. Using quantification theory type 2, the American Society of Anesthesiology score (4.531), volume of hemorrhage under operation (3.075), wound classification (1.76), operation time (1.352), and history of diabetes (0.989) increased to higher ranks as factors for SSI. Therefore, we evaluated this system as a useful tool in safety control for operative procedures.

Single molecule tracking of Ace1p in Saccharomyces cerevisiae defines a characteristic residence time for non-specific interactions of transcription factors with chromatin.

PubMed

Ball, David A; Mehta, Gunjan D; Salomon-Kent, Ronit; Mazza, Davide; Morisaki, Tatsuya; Mueller, Florian; McNally, James G; Karpova, Tatiana S

2016-12-01

In vivo single molecule tracking has recently developed into a powerful technique for measuring and understanding the transient interactions of transcription factors (TF) with their chromatin response elements. However, this method still lacks a solid foundation for distinguishing between specific and non-specific interactions. To address this issue, we took advantage of the power of molecular genetics of yeast. Yeast TF Ace1p has only five specific sites in the genome and thus serves as a benchmark to distinguish specific from non-specific binding. Here, we show that the estimated residence time of the short-residence molecules is essentially the same for Hht1p, Ace1p and Hsf1p, equaling 0.12-0.32 s. These three DNA-binding proteins are very different in their structure, function and intracellular concentration. This suggests that (i) short-residence molecules are bound to DNA non-specifically, and (ii) that non-specific binding shares common characteristics between vastly different DNA-bound proteins and thus may have a common underlying mechanism. We develop new and robust procedure for evaluation of adverse effects of labeling, and new quantitative analysis procedures that significantly improve residence time measurements by accounting for fluorophore blinking. Our results provide a framework for the reliable performance and analysis of single molecule TF experiments in yeast. Published by Oxford University Press on behalf of Nucleic Acids Research 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Towards objective hand hygiene technique assessment: validation of the ultraviolet-dye-based hand-rubbing quality assessment procedure.

PubMed

Lehotsky, Á; Szilágyi, L; Bánsághi, S; Szerémy, P; Wéber, G; Haidegger, T

2017-09-01

Ultraviolet spectrum markers are widely used for hand hygiene quality assessment, although their microbiological validation has not been established. A microbiology-based assessment of the procedure was conducted. Twenty-five artificial hand models underwent initial full contamination, then disinfection with UV-dyed hand-rub solution, digital imaging under UV-light, microbiological sampling and cultivation, and digital imaging of the cultivated flora were performed. Paired images of each hand model were registered by a software tool, then the UV-marked regions were compared with the pathogen-free sites pixel by pixel. Statistical evaluation revealed that the method indicates correctly disinfected areas with 95.05% sensitivity and 98.01% specificity. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

A comparison of regional flood frequency analysis approaches in a simulation framework

NASA Astrophysics Data System (ADS)

Ganora, D.; Laio, F.

2016-07-01

Regional frequency analysis (RFA) is a well-established methodology to provide an estimate of the flood frequency curve at ungauged (or scarcely gauged) sites. Different RFA approaches exist, depending on the way the information is transferred to the site of interest, but it is not clear in the literature if a specific method systematically outperforms the others. The aim of this study is to provide a framework wherein carrying out the intercomparison by building up a virtual environment based on synthetically generated data. The considered regional approaches include: (i) a unique regional curve for the whole region; (ii) a multiple-region model where homogeneous subregions are determined through cluster analysis; (iii) a Region-of-Influence model which defines a homogeneous subregion for each site; (iv) a spatially smooth estimation procedure where the parameters of the regional model vary continuously along the space. Virtual environments are generated considering different patterns of heterogeneity, including step change and smooth variations. If the region is heterogeneous, with the parent distribution changing continuously within the region, the spatially smooth regional approach outperforms the others, with overall errors 10-50% lower than the other methods. In the case of a step-change, the spatially smooth and clustering procedures perform similarly if the heterogeneity is moderate, while clustering procedures work better when the step-change is severe. To extend our findings, an extensive sensitivity analysis has been performed to investigate the effect of sample length, number of virtual stations, return period of the predicted quantile, variability of the scale parameter of the parent distribution, number of predictor variables and different parent distribution. Overall, the spatially smooth approach appears as the most robust approach as its performances are more stable across different patterns of heterogeneity, especially when short records are considered.

A ruggedness evaluation of procedures for damage threshold testing optical materials

NASA Technical Reports Server (NTRS)

Hooker, Matthew W.; Thomas, Milfred E.; Wise, Stephanie A.; Tappan, Nina D.

1995-01-01

A ruggedness evaluation of approaches to damage threshold testing was performed to determine the influence of three procedural variables on damage threshold data. The differences between the number of test sites evaluated at an applied fluence level (1 site versus 10 sites), the number of laser pulses at each test site (1 pulse versus 200 pulses), and the beam diameter (0.35 mm versus 0.70 mm) were all found to significantly influence the damage threshold data over a 99-percent confidence interval.

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

PubMed Central

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

2016-01-01

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

SU-E-T-420: Failure Effects Mode Analysis for Trigeminal Neuralgia Frameless Radiosurgery

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

Howe, J

2015-06-15

Purpose: Functional radiosurgery has been used successfully in the treatment of trigeminal neuralgia but presents significant challenges to ensuring the high prescription dose is delivered accurately. A review of existing practice should help direct the focus of quality improvement for this treatment regime. Method: Failure modes and effects analysis was used to identify the processes in preparing radiosurgery treatment for TN. The map was developed by a multidisciplinary team including: neurosurgeon, radiation oncology, physicist and therapist. Potential failure modes were identified for each step in the process map as well as potential causes and end effect. A risk priority numbermore » was assigned to each cause. Results: The process map identified 66 individual steps (see attached supporting document). Corrective actions were developed for areas of high risk priority number. Wrong site treatment is at higher risk for trigeminal neuralgia treatment due to the lack of site specific pathologic imaging on MR and CT – additional site specific checks were implemented to minimize the risk of wrong site treatment. Failed collision checks resulted from an insufficient collision model in the treatment planning system and a plan template was developed to address this problem. Conclusion: Failure modes and effects analysis is an effective tool for developing quality improvement in high risk radiotherapy procedures such as functional radiosurgery.« less

Water-compatible 'aspartame'-imprinted polymer grafted on silica surface for selective recognition in aqueous solution.

PubMed

Singh, Meenakshi; Kumar, Abhishek; Tarannum, Nazia

2013-05-01

Molecularly imprinted polymers selective for aspartame have been prepared using N-[2-ammonium-ethyl-piperazinium) maleimidopropane sulfonate copolymer bearing zwitterionic centres along the backbone via a surface-confined grafting procedure. Aspartame, a dipeptide, is commonly used as an artificial sweetener. Polymerisation on the surface was propagated by means of Michael addition reaction on amino-grafted silica surface. Electrostatic interactions along with complementary H-bonding and other hydrophobic interactions inducing additional synergetic effect between the template (aspartame) and the imprinted surface led to the formation of imprinted sites. The MIP was able to selectively and specifically take up aspartame from aqueous solution and certain pharmaceutical samples quantitatively. Hence, a facile, specific and selective technique using surface-grafted specific molecular contours developed for specific and selective uptake of aspartame in the presence of various interferrants, in different kinds of matrices is presented.

Visible, Durable, Enforceable Institutional Controls: Weldon Spring Site - A 10-Year Journey - 13190

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

Uhlmeyer, Terri; Thompson, Randy; Starr, Ken

2013-07-01

The DOE Office of Legacy Management's (LM's) mission is to manage the DOE's post-closure responsibilities and ensure the future protection of human health and the environment. LM has control and custody of legacy land, structures, and facilities and is responsible for maintaining them at levels suitable for their long-term use. This includes all engineered and institutional controls (ICs) designed as another level of assurance to prevent exposure to residual contamination and waste. The development and management of ICs has been, and continues to be, a critical component to the success of LM surveillance and maintenance activities. Many major federal laws,more » Executive Orders, regulations, and various other drivers influence the establishment and use of ICs at LM sites. LM uses a wide range of ICs to appropriately limit access to, or uses of, land, facilities, and other real and personal properties; protect the environment; maintain the physical safety and security of DOE facilities; and prevent or limit inadvertent human and environmental exposure to residual contaminants and other hazards. The ICs at the Weldon Spring, Missouri, Site were developed in close coordination with federal and state regulators. An Explanation of Significant Differences (ESD) was issued in February 2005, which clarified the use restrictions necessary for the remedial actions specified in the Records of Decision for the separate operable units to remain protective over the long-term. The operable units included the Chemical Plant Operable Unit, the Chemical Plant Groundwater Operable Unit, and the Quarry Residuals Operable Unit. The ESD clarified specific requirements for each site area that needed use restrictions and established how DOE would implement, maintain, and monitor the specific requirements. DOE developed the Long-Term Surveillance and Maintenance Plan for the U.S. Department of Energy Weldon Spring, Missouri, Site (LTS and M Plan) that addressed the full scope of the site management activities necessary to ensure that the Weldon Spring Site remains protective over the long-term. The LTS and M Plan is revised periodically to ensure its applicability to changing site, regulatory, or procedural conditions. In addition to addressing such activities as long-term groundwater monitoring and disposal cell maintenance, the LTS and M Plan was developed and issued to ensure that the use restrictions identified in the ESD were properly imposed and maintained. The LTS and M Plan included a detailed IC Implementation Plan, which includes a process for evaluating and identifying specific IC mechanisms that best accomplish the objectives set out in the ESD. Consistent with EPA guidance on selecting ICs, various IC mechanisms were evaluated, including government controls, proprietary controls, enforcement tools, and informational devices. Where appropriate, redundant mechanisms were employed to increase the effectiveness of the ICs. Information in the IC Implementation Plan includes: (1) a discussion of current site conditions (reflecting post-remedial action conditions for the Chemical Plant and Quarry Areas and the risk-basis for why use restrictions are needed); (2) the objectives of, or performance expectations for, the use restrictions; (3) specific ICs already in place and additional mechanisms identified for implementation; (4) a schedule for implementing additional ICs; (5) procedures for maintaining the ICs and for conducting periodic inspections; and (6) general provisions for the implementing ICs for the site. The actual agreements and documentation of the various ICs are included in an appendix of the LTS and M Plan. These documents are also available via the internet from the authorizing agencies (County, Missouri Department of Natural Resources, EPA, etc.) The Weldon Spring Site personnel have been successful in finalizing each of the ICs that were established for the site. The planning, establishment, and implementation of the ICs was a long and detailed process with several lessons-learned that were identified along the way. (authors)« less

Proceedings of the tenth annual DOE low-level waste management conference: Session 2: Site performance assessment

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

Not Available

1988-12-01

This document contains twelve papers on various aspects of low-level radioactive waste management. Topics of this volume include: performance assessment methodology; remedial action alternatives; site selection and site characterization procedures; intruder scenarios; sensitivity analysis procedures; mathematical models for mixed waste environmental transport; and risk assessment methodology. Individual papers were processed separately for the database. (TEM)

Surgical site infections following coronary artery bypass graft procedures: 10 years of surveillance data.

PubMed

Si, Damin; Rajmokan, Mohana; Lakhan, Prabha; Marquess, John; Coulter, Christopher; Paterson, David

2014-06-10

Surgical site infections following coronary artery bypass graft (CABG) procedures pose substantial burden on patients and healthcare systems. This study aims to describe the incidence of surgical site infections and causative pathogens following CABG surgery over the period 2003-2012, and to identify risk factors for complex sternal site infections. Routine computerised surveillance data were collected from three public hospitals in Queensland, Australia in which CABG surgery was performed between 2003 and 2012. Surgical site infection rates were calculated by types of infection (superficial/complex) and incision sites (sternal/harvest sites). Patient and procedural characteristics were evaluated as risk factors for complex sternal site infections using a logistic regression model. There were 1,702 surgical site infections (518 at sternal sites and 1,184 at harvest sites) following 14,546 CABG procedures performed. Among 732 pathogens isolated, Methicillin-sensitive Staphylococcus aureus accounted for 28.3% of the isolates, Pseudomonas aeruginosa 18.3%, methicillin-resistant Staphylococcus aureus 14.6%, and Enterobacter species 6.7%. Proportions of Gram-negative bacteria elevated from 37.8% in 2003 to 61.8% in 2009, followed by a reduction to 42.4% in 2012. Crude rates of complex sternal site infections increased over the reporting period, ranging from 0.7% in 2004 to 2.6% in 2011. Two factors associated with increased risk of complex sternal site infections were identified: patients with an ASA (American Society of Anaesthesiologists) score of 4 or 5 (reference score of 3, OR 1.83, 95% CI 1.36-2.47) and absence of documentation of antibiotic prophylaxis (OR 2.03, 95% CI 1.12-3.69). Compared with previous studies, our data indicate the importance of Gram-negative organisms as causative agents for surgical site infections following CABG surgery. An increase in complex sternal site infection rates can be partially explained by the increasing proportion of patients with more severe underlying disease.

Diabetes and Risk of Surgical Site Infection: A systematic review and meta-analysis

PubMed Central

Kaye, Keith S.; Knott, Caitlin; Nguyen, Huong; Santarossa, Maressa; Evans, Richard; Bertran, Elizabeth; Jaber, Linda

2016-01-01

Objective To determine the independent association between diabetes and SSI across multiple surgical procedures. Design Systematic review and meta-analysis. Methods Studies indexed in PubMed published between December 1985 and through July 2015 were identified through the search terms “risk factors” or “glucose” and “surgical site infection”. A total of 3,631 abstracts were identified through the initial search terms. Full texts were reviewed for 522 articles. Of these, 94 articles met the criteria for inclusion. Standardized data collection forms were used to extract study-specific estimates for diabetes, blood glucose levels, and body mass index (BMI). Random-effects meta-analysis was used to generate pooled estimates and meta-regression was used to evaluate specific hypothesized sources of heterogeneity. Results The primary outcome was SSI, as defined by the Centers for Disease Control and Prevention surveillance criteria. The overall effect size for the association between diabetes and SSI was OR=1.53 (95% Predictive Interval 1.11, 2.12, I2: 57.2%). SSI class, study design, or patient BMI did not significantly impact study results in a meta-regression model. The association was higher for cardiac surgery 2.03 (95% Predictive Interval 1.13, 4.05) compared to surgeries of other types (p=0.001). Conclusion These results support the consideration of diabetes as an independent risk factor for SSIs for multiple surgical procedure types. Continued efforts are needed to improve surgical outcomes for diabetic patients. PMID:26503187

Report: EPA Has Made Progress in Assessing Historical Lead Smelter Sites But Needs to Strengthen Procedures

EPA Pesticide Factsheets

Report #14-P-0302, June 17, 2014. Improvements in guidance and procedures for managing contaminated sites could result in more efficient and effective use of limited resources and result in public health and economic benefits.

Phase 2 environmental site investigation procedures and technologies for property transfer and PS and E development

DOT National Transportation Integrated Search

1999-05-01

The purpose of this project is to provide TxDOT with an improved procedure for conducting environmental site investigations at various stages during transportation infrastructure development. The project seeks to identify modern assessment technologi...

ENVIRONMENTAL METHODS TESTING SITE PROJECT: DATA MANAGEMENT PROCEDURES PLAN

EPA Science Inventory

The Environmental Methods Testing Site (EMTS) Data Management Procedures Plan identifies the computer hardware and software resources used in the EMTS project. It identifies the major software packages that are available for use by principal investigators for the analysis of data...

Localization of premature ventricular contractions from the papillary muscles using the standard 12-lead electrocardiogram: a feasibility study using a novel cardiac isochrone positioning system.

PubMed

van Dam, Peter M; Boyle, Noel G; Laks, Michael M; Tung, Roderick

2016-12-01

The precise localization of the site of origin of a premature ventricular contraction (PVC) prior to ablation can facilitate the planning and execution of the electrophysiological procedure. In clinical practice, the targeted ablation site is estimated from the standard 12-lead ECG. The accuracy of this qualitative estimation has limitations, particularly in the localization of PVCs originating from the papillary muscles. Clinical available electrocardiographic imaging (ECGi) techniques that incorporate patient-specific anatomy may improve the localization of these PVCs, but require body surface maps with greater specificity for the epicardium. The purpose of this report is to demonstrate that a novel cardiac isochrone positioning system (CIPS) program can accurately detect the specific location of the PVC on the papillary muscle using only a 12-lead ECG. Cardiac isochrone positioning system uses three components: (i) endocardial and epicardial cardiac anatomy and torso geometry derived from MRI, (ii) the patient-specific electrode positions derived from an MRI model registered 3D image, and (iii) the 12-lead ECG. CIPS localizes the PVC origin by matching the anatomical isochrone vector with the ECG vector. The predicted PVC origin was compared with the site of successful ablation or stimulation. Three patients who underwent electrophysiological mapping and ablation of PVCs originating from the papillary muscles were studied. CIPS localized the PVC origin for all three patients to the correct papillary muscle and specifically to the base, mid, or apical region. A simplified form of ECGi utilizing only 12 standard electrocardiographic leads may facilitate accurate localization of the origin of papillary muscle PVCs. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For Permissions, please email: journals.permissions@oup.com.

Modeling Training Site Vegetation Coverage Probability with a Random Optimizing Procedure: An Artificial Neural Network Approach.

DTIC Science & Technology

1998-05-01

Coverage Probability with a Random Optimization Procedure: An Artificial Neural Network Approach by Biing T. Guan, George Z. Gertner, and Alan B...Modeling Training Site Vegetation Coverage Probability with a Random Optimizing Procedure: An Artificial Neural Network Approach 6. AUTHOR(S) Biing...coverage based on past coverage. Approach A literature survey was conducted to identify artificial neural network analysis techniques applicable for

Fluorescent labeling of tetracysteine-tagged proteins in intact cells.

PubMed

Hoffmann, Carsten; Gaietta, Guido; Zürn, Alexander; Adams, Stephen R; Terrillon, Sonia; Ellisman, Mark H; Tsien, Roger Y; Lohse, Martin J

2010-09-01

In this paper, we provide a general protocol for labeling proteins with the membrane-permeant fluorogenic biarsenical dye fluorescein arsenical hairpin binder-ethanedithiol (FlAsH-EDT₂). Generation of the tetracysteine-tagged protein construct by itself is not described, as this is a protein-specific process. This method allows site-selective labeling of proteins in living cells and has been applied to a wide variety of proteins and biological problems. We provide here a generally applicable labeling procedure and discuss the problems that can occur as well as general considerations that must be taken into account when designing and implementing the procedure. The method can even be applied to proteins with expression below 1 pmol mg⁻¹ of protein, such as G protein-coupled receptors, and it can be used to study the intracellular localization of proteins as well as functional interactions in fluorescence resonance energy transfer experiments. The labeling procedure using FlAsH-EDT₂ as described takes 2-3 h, depending on the number of samples to be processed.

Tele-surgery simulation with a patient organ model for robotic surgery training.

PubMed

Suzuki, S; Suzuki, N; Hattori, A; Hayashibe, M; Konishi, K; Kakeji, Y; Hashizume, M

2005-12-01

Robotic systems are increasingly being incorporated into general laparoscopic and thoracoscopic surgery to perform procedures such as cholecystectomy and prostatectomy. Robotic assisted surgery allows the surgeon to conduct minimally invasive surgery with increased accuracy and with potential benefits for patients. However, current robotic systems have their limitations. These include the narrow operative field of view, which can make instrument manipulation difficult. Current robotic applications are also tailored to specific surgical procedures. For these reasons, there is an increasing demand on surgeons to master the skills of instrument manipulation and their surgical application within a controlled environment. This study describes the development of a surgical simulator for training and mastering procedures performed with the da Vinci surgical system. The development of a tele-surgery simulator and the construction of a training center are also described, which will enable surgeons to simulate surgery from or in remote places, to collaborate over long distances, and for off-site expert assistance. Copyright 2005 John Wiley & Sons, Ltd.

Prediction of lysine ubiquitylation with ensemble classifier and feature selection.

PubMed

Zhao, Xiaowei; Li, Xiangtao; Ma, Zhiqiang; Yin, Minghao

2011-01-01

Ubiquitylation is an important process of post-translational modification. Correct identification of protein lysine ubiquitylation sites is of fundamental importance to understand the molecular mechanism of lysine ubiquitylation in biological systems. This paper develops a novel computational method to effectively identify the lysine ubiquitylation sites based on the ensemble approach. In the proposed method, 468 ubiquitylation sites from 323 proteins retrieved from the Swiss-Prot database were encoded into feature vectors by using four kinds of protein sequences information. An effective feature selection method was then applied to extract informative feature subsets. After different feature subsets were obtained by setting different starting points in the search procedure, they were used to train multiple random forests classifiers and then aggregated into a consensus classifier by majority voting. Evaluated by jackknife tests and independent tests respectively, the accuracy of the proposed predictor reached 76.82% for the training dataset and 79.16% for the test dataset, indicating that this predictor is a useful tool to predict lysine ubiquitylation sites. Furthermore, site-specific feature analysis was performed and it was shown that ubiquitylation is intimately correlated with the features of its surrounding sites in addition to features derived from the lysine site itself. The feature selection method is available upon request.

Wrong-Site Surgery, Retained Surgical Items, and Surgical Fires : A Systematic Review of Surgical Never Events.

PubMed

Hempel, Susanne; Maggard-Gibbons, Melinda; Nguyen, David K; Dawes, Aaron J; Miake-Lye, Isomi; Beroes, Jessica M; Booth, Marika J; Miles, Jeremy N V; Shanman, Roberta; Shekelle, Paul G

2015-08-01

Serious, preventable surgical events, termed never events, continue to occur despite considerable patient safety efforts. To examine the incidence and root causes of and interventions to prevent wrong-site surgery, retained surgical items, and surgical fires in the era after the implementation of the Universal Protocol in 2004. We searched 9 electronic databases for entries from 2004 through June 30, 2014, screened references, and consulted experts. Two independent reviewers identified relevant publications in June 2014. One reviewer used a standardized form to extract data and a second reviewer checked the data. Strength of evidence was established by the review team. Data extraction was completed in January 2015. Incidence of wrong-site surgery, retained surgical items, and surgical fires. We found 138 empirical studies that met our inclusion criteria. Incidence estimates for wrong-site surgery in US settings varied by data source and procedure (median estimate, 0.09 events per 10,000 surgical procedures). The median estimate for retained surgical items was 1.32 events per 10,000 procedures, but estimates varied by item and procedure. The per-procedure surgical fire incidence is unknown. A frequently reported root cause was inadequate communication. Methodologic challenges associated with investigating changes in rare events limit the conclusions of 78 intervention evaluations. Limited evidence supported the Universal Protocol (5 studies), education (4 studies), and team training (4 studies) interventions to prevent wrong-site surgery. Limited evidence exists to prevent retained surgical items by using data-matrix-coded sponge-counting systems (5 pertinent studies). Evidence for preventing surgical fires was insufficient, and intervention effects were not estimable. Current estimates for wrong-site surgery and retained surgical items are 1 event per 100,000 and 1 event per 10,000 procedures, respectively, but the precision is uncertain, and the per-procedure prevalence of surgical fires is not known. Root-cause analyses suggest the need for improved communication. Despite promising approaches and global Universal Protocol evaluations, empirical evidence for interventions is limited.

Using Temporal Modulation Sensitivity to Select Stimulation Sites for Processor MAPs in Cochlear Implant Listeners

PubMed Central

Garadat, Soha N.; Zwolan, Teresa A.; Pfingst, Bryan E.

2013-01-01

Previous studies in our laboratory showed that temporal acuity as assessed by modulation detection thresholds (MDTs) varied across activation sites and that this site-to-site variability was subject specific. Using two 10-channel MAPs, the previous experiments showed that processor MAPs that had better across-site mean (ASM) MDTs yielded better speech recognition than MAPs with poorer ASM MDTs tested in the same subject. The current study extends our earlier work on developing more optimal fitting strategies to test the feasibility of using a site-selection approach in the clinical domain. This study examined the hypothesis that revising the clinical speech processor MAP for cochlear implant (CI) recipients by turning off selected sites that have poorer temporal acuity and reallocating frequencies to the remaining electrodes would lead to improved speech recognition. Twelve CI recipients participated in the experiments. We found that site selection procedure based on MDTs in the presence of a masker resulted in improved performance on consonant recognition and recognition of sentences in noise. In contrast, vowel recognition was poorer with the experimental MAP than with the clinical MAP, possibly due to reduced spectral resolution when sites were removed from the experimental MAP. Overall, these results suggest a promising path for improving recipient outcomes using personalized processor-fitting strategies based on a psychophysical measure of temporal acuity. PMID:23881208

2013 Annual Site Inspection and Monitoring Report for Uranium Mill Tailings Radiation Control Act Title II Disposal Sites

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

None

This report, in fulfillment of a license requirement, presents the results of long-term surveillance and maintenance activities conducted by the U.S. Department of Energy (DOE) Office of Legacy Management in 2013 at six uranium mill tailings disposal sites reclaimed under Title II of the Uranium Mill Tailings Radiation Control Act (UMTRCA) of 1978. These activities verified that the UMTRCA Title II disposal sites remain in compliance with license requirements. DOE manages six UMTRCA Title II disposal sites under a general license granted by the U.S. Nuclear Regulatory Commission (NRC) established at Title 10 Code of Federal Regulations Part 40.28. Reclamationmore » and site transition activities continue at other sites, and DOE ultimately expects to manage approximately 27 Title II disposal sites. Long-term surveillance and maintenance activities and services for these disposal sites include inspecting and maintaining the sites; monitoring environmental media and institutional controls; conducting any necessary corrective action; and performing administrative, records, stakeholder services, and other regulatory functions. Annual site inspections and monitoring are conducted in accordance with site-specific long-term surveillance plans (LTSPs) and procedures established by DOE to comply with license requirements. Each site inspection is performed to verify the integrity of visible features at the site; to identify changes or new conditions that may affect the long-term performance of the site; and to determine the need, if any, for maintenance, follow-up inspections, or corrective action. LTSPs and site compliance reports are available online at http://www.lm.doe.gov« less

Laparoendoscopic single site in pelvic surgery

PubMed Central

Sanchez-Salas, Rafael; Clavijo, Rafael; Barret, Eric; Sotelo, Rene

2012-01-01

Laparoendoscopic single site (LESS) has recently gained momentum as feasible techniques for minimal access surgery. Our aim is to describe the current status of laparoendoscopic single site (LESS) in pelvic surgery. A comprehensive revision of the literature in LESS pelvic surgery was performed. References for this manuscript were obtained by performing a review of the available literature in PubMed from 01-01-01 to 30-11-11. References outside the search period were obtained selected manuscript΄s bibliography. Search terms included: pelvic anatomy, less in gynecology, single port colectomy, urological less, single port, single site, NOTES, LESS and single incision. 314 manuscripts were initially identified. Out of these, 46 manuscripts were selected based in their pelvic anatomy or surgical content; including experimental experience, clinical series and literature reviews. LESS drastically limit the surgeon's ability to perform in the operative field and the latter becomes hardened by the lack of space in anatomical location like the pelvis. Potential advantages of LESS are gained with the understanding that the surgical procedure is more technically challenging. Pelvic surgical procedures related to colorectal surgery, gynecology and urology have been performed with LESS technique and information available is mostly represented by case reports and short case series. Comparative series remain few. LESS pelvic surgery remain in its very beginning and due to the very specific anatomical conditions further development of LESS surgery in the mentioned area can be clearly be facilitated by using robotic technology. Standardization ad reproducibility of techniques are mandatory to further develop LESS in the surgical arena.. PMID:22557719

Assessing the availability of the teratogenic drug isotretinoin outside the pregnancy prevention programme: a survey of e-pharmacies†

PubMed Central

Lagan, Briege M; Dolk, Helen; White, Bronagh; Uges, Donald R A; Sinclair, M

2014-01-01

Purpose The increase in online purchasing of medications raises safety concerns regarding teratogenic drugs. The use of the teratogenic drug ‘isotretinoin’ for women of childbearing age requires strict adherence to the Pregnancy Prevention Programme (PPP), a risk minimisation measure imposed on prescribers and users. We sought to determine how readily consumers can purchase isotretinoin online and the associated safety procedures and information. Methods A descriptive cross-sectional survey was conducted of 50 e-pharmacies identified from commonly used search engines. E-pharmacy characteristics and isotretinoin PPP specific criteria were evaluated. Purchases of isotretinoin from seven e-pharmacies not bearing authentication logos and not requiring a prescription were assessed for PPP policy adherence, purchasing procedures and compound quality. Results Forty-three (86%) of the e-pharmacies did not have an authentication seal/logo. Isotretinoin could be purchased from 42 sites without a valid prescription. Information on isotretinoin causing birth defects was lacking in 25 of the 50 sites, on not taking isotretinoin in pregnancy in 24 sites and not taking isotretinoin if planning or at risk of a pregnancy in 33 sites. Of the eight attempted purchases, seven arrived, all without any patient information leaflet. All were verified as isotretinoin. Conclusion The Internet provides a loophole for purchasing of medications known to cause congenital abnormalities, which needs to be addressed by medicines regulatory agencies worldwide. The current PPP for isotretinoin may be failing to protect mothers and babies from preventable harm—clinicians need to be aware of this, and the public needs to be educated about the potential risks. PMID:24493556

Antibiotic prophylaxis in dermatologic surgery: advisory statement 2008.

PubMed

Wright, Tina I; Baddour, Larry M; Berbari, Elie F; Roenigk, Randall K; Phillips, P Kim; Jacobs, M Amanda; Otley, Clark C

2008-09-01

Antibiotic prophylaxis is an important component of dermatologic surgery, and recommendations in this area should reflect the updated 2007 guidelines of the American Heart Association, the American Dental Association with the American Academy of Orthopaedic Surgeons guidelines, and recent prospective studies on surgical site infection. To provide an update on the indications for antibiotic prophylaxis in dermatologic surgery for the prevention of infective endocarditis, hematogenous total joint infection, and surgical site infection. A literature review was performed, expert consensus was obtained, and updated recommendations were created, consistent with the most current authoritative guidelines from the American Heart Association and the American Dental Association with the American Academy of Orthopaedic Surgeons. For patients with high-risk cardiac conditions, and a defined group of patients with prosthetic joints at high risk for hematogenous total joint infection, prophylactic antibiotics are recommended when the surgical site is infected or when the procedure involves breach of the oral mucosa. For the prevention of surgical site infections, antibiotics may be indicated for procedures on the lower extremities or groin, for wedge excisions of the lip and ear, skin flaps on the nose, skin grafts, and for patients with extensive inflammatory skin disease. These recommendations are not based on multiple, large-scale, prospective trials. There is a strong shift away from administration of prophylactic antibiotics in many dermatologic surgery settings, based on updated authoritative guidelines. These recommendations provide guidance to comply with the most current guidelines, modified to address dermatology-specific considerations. Managing physicians may utilize these guidelines while individualizing their approach based on all clinical considerations.

An innovative implementation of LCA within the EIA procedure: Lessons learned from two Wastewater Treatment Plant case studies

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

Larrey-Lassalle, Pyrène, E-mail: pyrene.larrey-lassalle@irstea.fr; LGEI, Ecole des mines d'Alès, 6 avenue de Clavières, 30319 Alès Cedex; Catel, Laureline

Life Cycle Assessment (LCA) has been identified in the literature as a promising tool to increase the performance of environmental assessments at different steps in the Environmental Impact Assessment (EIA) procedure. However, few publications have proposed a methodology for an extensive integration, and none have compared the results with existing EIA conclusions without LCA. This paper proposes a comprehensive operational methodology for implementing an LCA within an EIA. Based on a literature review, we identified four EIA steps that could theoretically benefit from LCA implementation, i.e., (a) the environmental comparison of alternatives, (b) the identification of key impacts, (c) themore » impact assessment, and (d) the impact of mitigation measures. For each of these steps, an LCA was implemented with specific goal and scope definitions that resulted in a specific set of indicators. This approach has been implemented in two contrasting Wastewater Treatment Plant (WWTP) projects and compared to existing EIA studies. The results showed that the two procedures, i.e., EIAs with or without inputs from LCA, led to different conclusions. The environmental assessments of alternatives and mitigation measures were not carried out in the original studies and showed that other less polluting technologies could have been chosen. Regarding the scoping step, the selected environmental concerns were essentially different. Global impacts such as climate change or natural resource depletion were not taken into account in the original EIA studies. Impacts other than those occurring on the project site (off-site impacts) were not assessed, either. All these impacts can be significant compared to those initially considered. On the other hand, unlike current LCA applications, EIAs usually address natural and technological risks and neighbourhood disturbances such as noises or odours, which are very important for the public acceptability of projects. Regarding the impact assessment, even if the conclusions of the EIAs with or without LCA were partially common for local on-site impacts, LCA gives crucial additional information on global and off-site impacts and highlights the processes responsible for them. Finally, for all EIA steps investigated, interest in LCA was demonstrated for both WWTP case studies. The feasibility in terms of skills, time and cost of such implementation has also been assessed. - Highlights: • An innovative methodology for a first-stage implementation of LCA in EIA is proposed. • Its applicability is demonstrated on two Wastewater Treatment Plant case studies. • The conclusions for the four EIA steps investigated differ with or without LCA. • LCA provides valuable additional information on 1) global and 2) off-site impacts. • LCA identifies pollution transfers towards a life cycle perspective.« less

Human health risk assessment for nanoparticle-contaminated aquifer systems.

PubMed

Tosco, Tiziana; Sethi, Rajandrea

2018-08-01

Nanosized particles (NPs), such as TiO 2 , Silver, graphene NPs, nanoscale zero-valent iron, carbon nanotubes, etc., are increasingly used in industrial processes, and releases at production plants and from landfills are likely scenarios for the next years. As a consequence, appropriate procedures and tools to quantify the risks for human health associated to these releases are needed. The tiered approach of the standard ASTM procedure (ASTM-E2081-00) is today the most applied for human health risk assessment at sites contaminated by chemical substances, but it cannot be directly applied to nanoparticles: NP transport along migration pathways follows mechanisms significantly different from those of chemicals; moreover, also toxicity indicators (namely, reference dose and slope factor) are NP-specific. In this work a risk assessment approach modified for NPs is proposed, with a specific application at Tier 2 to migration in groundwater. The standard ASTM equations are modified to include NP-specific transport mechanisms. NPs in natural environments are typically characterized by a heterogeneous set of NPs having different size, shape, coating, etc. (all properties having a significant impact on both mobility and toxicity). To take into account this heterogeneity, the proposed approach divides the NP population into classes, each having specific transport and toxicity properties, and simulates them as independent species. The approach is finally applied to a test case simulating the release of heterogeneous Silver NPs from a landfill. The results show that taking into account the size-dependent mobility of the particles provides a more accurate result compared to the direct application of the standard ASTM procedure. In particular, the latter tends to underestimate the overall toxic risk associated to the nP release. Copyright © 2018 Elsevier Ltd. All rights reserved.

Subcellular localization of pituitary enzymes

NASA Technical Reports Server (NTRS)

Smith, R. E.

1970-01-01

A cytochemical procedure is reported for identifying subcellular sites of enzymes hydrolyzing beta-naphthylamine substrates, and to study the sites of reaction product localization in cells of various tissues. Investigations using the substrate Leu 4-methoxy-8-naphthylamine, a capture with hexonium pararosaniline, and the final chelation of osmium have identified the hydrolyzing enzyme of rat liver cells; this enzyme localized on cell membranes with intense deposition in the areas of the parcanaliculi. The study of cells in the anterior pituitary of the rat showed the deposition of reaction product on cell membrane; and on the membranes of secretion granules contained within the cell. The deposition of reaction product on the cell membrane however showed no increase or decrease with changes in the physiological state of the gland and release of secretion granules from specific cells.

Grafting both acute wound site and adjacent donor site with the same graft: an easy and safe procedure to improve healing and minimize pain in elderly and bedridden patients.

PubMed

Keilani, C; Agard, D; Duhoux, A; Lakhel, A; Giraud, O; Brachet, M; Duhamel, P; Bey, E

2017-03-31

In harvesting skin to cover the defect caused by a burn, a second wound is created, the donor site wound. We propose an alternative method to manage the donor site: taking a split-thickness skin graft (STSG) from a donor site adjacent to the burn wound to be treated, and meshing at a 3:1 ratio to cover both sites at once. The main objective of this study is to evaluate the effectiveness of covering both burn wound and adjacent donor site with the same STSG in elderly and bedridden patients. We retrospectively reviewed the medical records of 6 patients over 60 years old or/and bedridden presenting with a small burn wound who underwent STSG of both burn wound and adjacent donor site between April 2016 and November 2016 in the Department of Plastic Surgery and Burn Treatment at Percy Military Hospital (France). Their data were compared with data of five patients who had undergone the usual STSG procedure during the same period. There was a statistically significant difference between patients who underwent adjacent STSG procedure and those who underwent usual STSG procedure in healing time (days) mean (SD) (7,33 ± 1,03 vs. 16,2 ± 0,83; p = 0,007) and Numeric Rating Scale pain mean (SD) at day 2 (0,33 ± 0,33 vs. 2,4 ± 1,35; p = 0,04). Grafting both acute burn wound and adjacent donor site with the same graft seems to be an easy method to improve healing and minimize pain in the STSG donor site in elderly and bedridden patients.

Grafting both acute wound site and adjacent donor site with the same graft: an easy and safe procedure to improve healing and minimize pain in elderly and bedridden patients

PubMed Central

Keilani, C.; Agard, D.; Duhoux, A.; Lakhel, A.; Giraud, O.; Brachet, M.; Duhamel, P.; Bey, E.

2017-01-01

Summary In harvesting skin to cover the defect caused by a burn, a second wound is created, the donor site wound. We propose an alternative method to manage the donor site: taking a split-thickness skin graft (STSG) from a donor site adjacent to the burn wound to be treated, and meshing at a 3:1 ratio to cover both sites at once. The main objective of this study is to evaluate the effectiveness of covering both burn wound and adjacent donor site with the same STSG in elderly and bedridden patients. We retrospectively reviewed the medical records of 6 patients over 60 years old or/and bedridden presenting with a small burn wound who underwent STSG of both burn wound and adjacent donor site between April 2016 and November 2016 in the Department of Plastic Surgery and Burn Treatment at Percy Military Hospital (France). Their data were compared with data of five patients who had undergone the usual STSG procedure during the same period. There was a statistically significant difference between patients who underwent adjacent STSG procedure and those who underwent usual STSG procedure in healing time (days) mean (SD) (7,33 ± 1,03 vs. 16,2 ± 0,83; p = 0,007) and Numeric Rating Scale pain mean (SD) at day 2 (0,33 ± 0,33 vs. 2,4 ± 1,35; p = 0,04). Grafting both acute burn wound and adjacent donor site with the same graft seems to be an easy method to improve healing and minimize pain in the STSG donor site in elderly and bedridden patients. PMID:28592936

Analytical control test plan and microbiological methods for the water recovery test

NASA Technical Reports Server (NTRS)

Traweek, M. S. (Editor); Tatara, J. D. (Editor)

1994-01-01

Qualitative and quantitative laboratory results are important to the decision-making process. In some cases, they may represent the only basis for deciding between two or more given options or processes. Therefore, it is essential that handling of laboratory samples and analytical operations employed are performed at a deliberate level of conscientious effort. Reporting erroneous results can lead to faulty interpretations and result in misinformed decisions. This document provides analytical control specifications which will govern future test procedures related to all Water Recovery Test (WRT) Phase 3 activities to be conducted at the National Aeronautics and Space Administration/Marshall Space Flight Center (NASA/MSFC). This document addresses the process which will be used to verify analytical data generated throughout the test period, and to identify responsibilities of key personnel and participating laboratories, the chains of communication to be followed, and ensure that approved methodology and procedures are used during WRT activities. This document does not outline specifics, but provides a minimum guideline by which sampling protocols, analysis methodologies, test site operations, and laboratory operations should be developed.

An Efficient Method for High-Fidelity BAC/PAC Retrofitting with a Selectable Marker for Mammalian Cell Transfection

PubMed Central

Wang, Zunde; Engler, Peter; Longacre, Angelika; Storb, Ursula

2001-01-01

Large-scale genomic sequencing projects have provided DNA sequence information for many genes, but the biological functions for most of them will only be known through functional studies. Bacterial artificial chromosomes (BACs) and P1-derived artificial chromosomes (PACs) are large genomic clones stably maintained in bacteria and are very important in functional studies through transfection because of their large size and stability. Because most BAC or PAC vectors do not have a mammalian selection marker, transfecting mammalian cells with genes cloned in BACs or PACs requires the insertion into the BAC/PAC of a mammalian selectable marker. However, currently available procedures are not satisfactory in efficiency and fidelity. We describe a very simple and efficient procedure that allows one to retrofit dozens of BACs in a day with no detectable deletions or unwanted recombination. We use a BAC/PAC retrofitting vector that, on transformation into competent BAC or PAC strains, will catalyze the specific insertion of itself into BAC/PAC vectors through in vivo cre/loxP site-specific recombination. PMID:11156622

Verbal autopsy: current practices and challenges.

PubMed Central

Soleman, Nadia; Chandramohan, Daniel; Shibuya, Kenji

2006-01-01

Cause-of-death data derived from verbal autopsy (VA) are increasingly used for health planning, priority setting, monitoring and evaluation in countries with incomplete or no vital registration systems. In some regions of the world it is the only method available to obtain estimates on the distribution of causes of death. Currently, the VA method is routinely used at over 35 sites, mainly in Africa and Asia. In this paper, we present an overview of the VA process and the results of a review of VA tools and operating procedures used at demographic surveillance sites and sample vital registration systems. We asked for information from 36 field sites about field-operating procedures and reviewed 18 verbal autopsy questionnaires and 10 cause-of-death lists used in 13 countries. The format and content of VA questionnaires, field-operating procedures, cause-of-death lists and the procedures to derive causes of death from VA process varied substantially among sites. We discuss the consequences of using varied methods and conclude that the VA tools and procedures must be standardized and reliable in order to make accurate national and international comparisons of VA data. We also highlight further steps needed in the development of a standard VA process. PMID:16583084

Cranial Bone Graft Donor Site Reconstruction.

PubMed

Çelik, Muzaffer

2017-01-01

My most important concern, in my entire experience with cranial bone grafting procedures, is managing the bone graft donor site such as donor site cavity from harvesting and weakness of the cranium. The most common patient complaint, following cranial bone grafting for aesthetic indications, is the presence of a cavity at the donor site. The authors have managed more than 200 patients since 2001, wherein the cranial bone graft-donor sites were reconstructed with tiny bone chip lamellae harvested from the area adjacent to the donor site. This procedure was associated with a low incidence of patient complaints, thereby suggesting higher patient satisfaction. This approach for cranial bone grafting appears to have a high patient acceptance.

From conceptual model to remediation: bioavailability, a key to clean up heavy metal contaminated soils.

NASA Astrophysics Data System (ADS)

Petruzzelli, Gianniantonio; Pedron, Francesca; Pezzarossa, Beatrice

2013-04-01

Processes of metal bioavailability in the soil To know the bioavailability processes at site specific levels is essential to understand in detail the risks associated with pollution, and to support the decision-making process, i.e. description of the conceptual model and choice of clean up technologies. It is particularly important to assess how chemical, physical and biological processes in the soil affect the reactions leading to adsorption, precipitation or release of contaminants. The measurement of bioavailability One of the main difficulties in the practical application of the bioavailability concept in soil remediation is the lack of consensus on the method to be used to measure bioavailability. The best strategy is to apply a series of tests to assess bioavailability, since no applicable method is universally valid under all conditions. As an example, bioavailability tests for phytotechnology application should consider two distinct aspects: a physico-chemical driven solubilization process and a physiologically driven uptake process. Soil and plant characteristics strongly influence bioavailability. Bioavailability as a tool in remediation strategies Bioavailability can be used at all stages in remediation strategies: development of the conceptual model, evaluation of risk assessment, and selection of the best technology, considering different scenarios and including different environmental objectives. Two different strategies can be followed: the reduction and the increase of bioavailability. Procedures that reduce bioavailability aim to prevent the movement of pollutants from the soil to the living organisms, essentially by: i) removal of the labile phase of the contaminant, i.e. the fraction which is intrinsic to the processes of bioavailability (phytostabilization); ii) conversion of the labile fraction into a stable fraction (precipitation or adsorption); iii) increase of the resistance to mass transfer of the contaminants (inertization). Procedures that aim to increase the bioavailability of pollutants are used in technologies which remove or destroy the solubilized contaminants. These procedures can increase mass transfer from the absorbed phase by means of sieving in order to decrease the diffusion processes (soil washing), by increasing the temperature (low temperature thermal desorption), or through the addition of chemical additives, such as chelating agents (Phytoextraction Elektrokinetic remediation). Concluding remarks Bioavailability should be a key component of the exposure evaluation in order to develop the conceptual model and to select the technology, in particular when: • only some chemical forms of contaminants are a source of risk for the site; • default assumptions regarding bioavailability are not suitable because of the site's specific characteristics; • the final destination of the site will not be modified at least in the near future.

Predicting the difficulty of a lead extraction procedure: the LED index.

PubMed

Bontempi, Luca; Vassanelli, Francesca; Cerini, Manuel; D'Aloia, Antonio; Vizzardi, Enrico; Gargaro, Alessio; Chiusso, Francesco; Mamedouv, Rashad; Lipari, Alessandro; Curnis, Antonio

2014-08-01

According to recent surveys, many sites performing permanent lead extractions do not meet the minimum prerequisites concerning personnel training, procedures' volume, or facility requirements. The current Heart Rhythm Society consensus on lead extractions suggests that patients should be referred to more experienced sites when a better outcome could be achieved. The purpose of this study was to develop a score aimed at predicting the difficulty of a lead extraction procedure through the analysis of a high-volume center database. This score could help to discriminate patients who should be sent to a referral site. A total of 889 permanent leads were extracted from 469 patients. All procedures were performed from January 2009 to May 2012 by two expert electrophysiologists, at the University Hospital of Brescia. Factors influencing the difficulty of a procedure were assessed using a univariate and a multivariate logistic regression model. The fluoroscopy time of the procedure was taken as an index of difficulty. A Lead Extraction Difficulty (LED) score was defined, considering the strongest predictors. Overall, 873 of 889 (98.2%) leads were completely removed. Major complications were reported in one patient (0.2%) who manifested cardiac tamponade. Minor complications occurred in six (1.3%) patients. No deaths occurred. Median fluoroscopic time was 8.7 min (3.3-17.3). A procedure was classified as difficult when fluoroscopy time was more than 31.2 min [90th percentile (PCTL)].At a univariate analysis, the number of extracted leads and years from implant were significantly associated with an increased risk of fluoroscopy time above 90th PCTL [odds ratio (OR) 1.51, 95% confidence interval (CI) 1.08-2.11, P = 0.01; and OR 1.19, 95% CI 1.12-1.25, P < 0.001, respectively). After adjusting for patient age and sex, and combining with other covariates potentially influencing the extraction procedure, a multivariate analysis confirmed a 71% increased risk of fluoroscopy time above 90th PCTL for each additional lead extracted (OR 1.71, 95% CI 1.06-2.77, P = 0.028) and a 23% increased risk for each year of lead age (OR 1.23, 95% CI 1.15-1.31, P < 0.001). Further nonindependent factors increasing the risk were the presence of active fixation leads and dual-coil implantable cardiac defibrillator leads. Conversely, vegetations significantly favored lead extraction.The LED score was defined as: number of extracted leads within a procedure + lead age (years from implant) + 1 if dual-coil - 1 if vegetation. The LED score independently predicted complex procedure (with fluoroscopic time >90th PCTL) both at univariate and multivariate analysis. A receiver-operating characteristic analysis showed an area under the curve of 0.81. A LED score greater than 10 could predict fluoroscopy time above 90th PCTL with a sensitivity of 78.3% and a specificity of 76.7%. The LED score is easy to compute and potentially predicts fluoroscopy time above 90th PCTL with a relatively high accuracy.

Virologic and Immunologic Evidence of Multifocal Genital Herpes Simplex Virus 2 Infection

PubMed Central

Zhu, Jia; Jing, Lichen; Laing, Kerry J.; McClurkan, Christopher M.; Klock, Alexis; Diem, Kurt; Jin, Lei; Stanaway, Jeffrey; Tronstein, Elizabeth; Kwok, William W.; Huang, Meei-li; Selke, Stacy; Fong, Youyi; Magaret, Amalia; Koelle, David M.; Wald, Anna; Corey, Lawrence

2014-01-01

ABSTRACT Genital herpes simplex virus (HSV) reactivation is thought to be anatomically and temporally localized, coincident with limited ganglionic infection. Short, subclinical shedding episodes are the most common form of HSV-2 reactivation, with host clearance mechanisms leading to rapid containment. The anatomic distribution of shedding episodes has not been characterized. To precisely define patterns of anatomic reactivation, we divided the genital tract into a 22-region grid and obtained daily swabs for 20 days from each region in 28 immunocompetent, HSV-2-seropositive persons. HSV was detected via PCR, and sites of asymptomatic HSV shedding were subjected to a biopsy procedure within 24 h. CD4+ and CD8+ T cells were quantified by immunofluorescence, and HSV-specific CD4+ T cells were identified by intracellular cytokine cytometry. HSV was detected in 868 (7%) of 11,603 genital swabs at a median of 12 sites per person (range, 0 to 22). Bilateral HSV detection occurred on 83 (67%) days with shedding, and the median quantity of virus detected/day was associated with the number of sites positive (P < 0.001). In biopsy specimens of asymptomatic shedding sites, we found increased numbers of CD8+ T cells compared to control tissue (27 versus 13 cells/mm2, P = 0.03) and identified HSV-specific CD4+ T cells. HSV reactivations emanate from widely separated anatomic regions of the genital tract and are associated with a localized cellular infiltrate that was demonstrated to be HSV specific in 3 cases. These data provide evidence that asymptomatic HSV-2 shedding contributes to chronic inflammation throughout the genital tract. IMPORTANCE This detailed report of the anatomic patterns of genital HSV-2 shedding demonstrates that HSV-2 reactivation can be detected at multiple bilateral sites in the genital tract, suggesting that HSV establishes latency throughout the sacral ganglia. In addition, genital biopsy specimens from sites of asymptomatic HSV shedding have increased numbers of CD8+ T cells compared to control tissue, and HSV-specific CD4+ T cells are found at sites of asymptomatic shedding. These findings suggest that widespread asymptomatic genital HSV-2 shedding is associated with a targeted host immune response and contributes to chronic inflammation throughout the genital tract. PMID:24554666

Virologic and immunologic evidence of multifocal genital herpes simplex virus 2 infection.

PubMed

Johnston, Christine; Zhu, Jia; Jing, Lichen; Laing, Kerry J; McClurkan, Christopher M; Klock, Alexis; Diem, Kurt; Jin, Lei; Stanaway, Jeffrey; Tronstein, Elizabeth; Kwok, William W; Huang, Meei-Li; Selke, Stacy; Fong, Youyi; Magaret, Amalia; Koelle, David M; Wald, Anna; Corey, Lawrence

2014-05-01

Genital herpes simplex virus (HSV) reactivation is thought to be anatomically and temporally localized, coincident with limited ganglionic infection. Short, subclinical shedding episodes are the most common form of HSV-2 reactivation, with host clearance mechanisms leading to rapid containment. The anatomic distribution of shedding episodes has not been characterized. To precisely define patterns of anatomic reactivation, we divided the genital tract into a 22-region grid and obtained daily swabs for 20 days from each region in 28 immunocompetent, HSV-2-seropositive persons. HSV was detected via PCR, and sites of asymptomatic HSV shedding were subjected to a biopsy procedure within 24 h. CD4(+) and CD8(+) T cells were quantified by immunofluorescence, and HSV-specific CD4(+) T cells were identified by intracellular cytokine cytometry. HSV was detected in 868 (7%) of 11,603 genital swabs at a median of 12 sites per person (range, 0 to 22). Bilateral HSV detection occurred on 83 (67%) days with shedding, and the median quantity of virus detected/day was associated with the number of sites positive (P < 0.001). In biopsy specimens of asymptomatic shedding sites, we found increased numbers of CD8(+) T cells compared to control tissue (27 versus 13 cells/mm(2), P = 0.03) and identified HSV-specific CD4(+) T cells. HSV reactivations emanate from widely separated anatomic regions of the genital tract and are associated with a localized cellular infiltrate that was demonstrated to be HSV specific in 3 cases. These data provide evidence that asymptomatic HSV-2 shedding contributes to chronic inflammation throughout the genital tract. This detailed report of the anatomic patterns of genital HSV-2 shedding demonstrates that HSV-2 reactivation can be detected at multiple bilateral sites in the genital tract, suggesting that HSV establishes latency throughout the sacral ganglia. In addition, genital biopsy specimens from sites of asymptomatic HSV shedding have increased numbers of CD8(+) T cells compared to control tissue, and HSV-specific CD4(+) T cells are found at sites of asymptomatic shedding. These findings suggest that widespread asymptomatic genital HSV-2 shedding is associated with a targeted host immune response and contributes to chronic inflammation throughout the genital tract.

Use of Data Libraries for IAEA Nuclear Security Assessment Methodologies (NUSAM) [section 5.4

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

Shull, D.; Lane, M.

2015-06-23

Data libraries are essential for the characterization of the facility and provide the documented input which enables the facility assessment results and subsequent conclusions. Data Libraries are historical, verifiable, quantified, and applicable collections of testing data on different types of barriers, sensors, cameras, procedures, and/or personnel. Data libraries are developed and maintained as part of any assessment program or process. Data is collected during the initial stages of facility characterization to aid in the model and/or simulation development process. Data library values may also be developed through the use of state testing centers and/or site resources by testing different typesmore » of barriers, sensors, cameras, procedures, and/or personnel. If no data exists, subject matter expert opinion and manufacturer's specifications/ testing values can be the basis for initially assigning values, but are generally less reliable and lack appropriate confidence measures. The use of existing data libraries that have been developed by a state testing organization reduces the assessment costs by establishing standard delay, detection and assessment values for use by multiple sites or facilities where common barriers and alarms systems exist.« less

Solid Lipid Nanoparticles as Efficient Drug and Gene Delivery Systems: Recent Breakthroughs

PubMed Central

Ezzati Nazhad Dolatabadi, Jafar; Valizadeh, Hadi; Hamishehkar, Hamed

2015-01-01

In recent years, nanomaterials have been widely applied as advanced drug and gene delivery nanosystems. Among them, solid lipid nanoparticles (SLNs) have attracted great attention as colloidal drug delivery systems for incorporating hydrophilic or lipophilic drugs and various macromolecules as well as proteins and nucleic acids. Therefore, SLNs offer great promise for controlled and site specific drug and gene delivery. This article includes general information about SLN structures and properties, production procedures, characterization. In addition, recent progress on development of drug and gene delivery systems using SLNs was reviewed. PMID:26236652

Capturing birds with mist nets: A review

USGS Publications Warehouse

Keyes, B.E.; Grue, C.E.

1982-01-01

Herein we have tried to provide a comprehensive review of mist-netting techniques suitable for both novice and experienced netters. General mist-netting procedures and modifications developed by netters for particular bird species and habitats are included. Factors which influence capture success, including site selection, net specifications and placement, weather, and time of day, are discussed. Guidelines are presented for the care of netted birds and the use of mist-net data in the study of bird communities. The advantages of the use of mist nets over other methods of capturing birds are also discussed.

32 CFR 516.39 - Duties and procedures.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 3 2011-07-01 2009-07-01 true Duties and procedures. 516.39 Section 516.39 National Defense Department of Defense (Continued) DEPARTMENT OF THE ARMY AID OF CIVIL AUTHORITIES AND... response at civil works facilities, at former defense sites or at other sites where the Army is a...

ENERGY FACILITY SITING PROCEDURES, CRITERIA, AND PUBLIC PARTICIPATION IN THE OHIO RIVER BASIN ENERGY STUDY REGION

EPA Science Inventory

The report was prepared in support of the Ohio River Basin Energy Study (ORBES), a multidisciplinary policy research program. Findings are presented on the adequacy of current review procedures, criteria, and public participation in energy facility siting (EFS) for nuclear and co...

Proceedings of the workshop for exchange of technology for CWC inspections

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

McGuire, R.R.

1993-04-01

With the signing of the Chemical Weapons Convention (CWC), the work of the Preparatory Commission in defining the modalities of on-site verification inspections will begin early in 1993. One of the methods for increasing the effectiveness of inspections is the collection of samples for chemical analysis. The CWC allows for this analysis to be performed either at the site of the inspection or in a dedicated off-site laboratory. The decision as to where samples are to be analyzed in any specific instance may involve a consideration of the threat, real or perceived, to the compromise of legitimate sensitive host-party information.more » The ability to perform efficient chemical analysis at the inspection site, where samples remain in joint (host-inspector) custody and the analytical procedures can be observed by the host, can alleviate much of the concern over possible loss of confidential information in both government and industry. This workshop was designed to encourage the exchange of information among participants with experience in the use of analytical equipment for on-site sample collection and analysis. Individual projects are processed separately for the databases.« less

ModBack - simplified contaminant source zone delineation using backtracking

NASA Astrophysics Data System (ADS)

Thielsch, K.; Herold, M.; Ptak, T.

2012-12-01

Contaminated groundwater poses a serious threat to drinking water resources all over the world. Even though contaminated water might be detected in observation wells, a proper clean up is often only successful if the source of the contamination is detected and subsequently removed, contained or remediated. The high costs of groundwater remediation could be possibly significantly reduced if, from the outset, a focus is placed on source zone detection. ModBack combines several existing modelling tools in one easy to use GIS-based interface helping to delineate potential contaminant source zones in the subsurface. The software is written in Visual Basic 3.5 and uses the ArcObjects library to implement all required GIS applications. It can run without modification on any Microsoft Windows based PC with sufficient RAM and at least Microsoft .NET Framework 3.5. Using ModBack requires additional installation of the following software: Processing Modflow Pro 7.0, ModPath, CSTREAM (Bayer-Raich et al., 2003), Golden Software Surfer and Microsoft Excel. The graphical user interface of ModBack is separated into four blocks of procedures dealing with: data input, groundwater modelling, backtracking and analyses. Geographical data input includes all georeferenced information pertaining to the study site. Information on subsurface contamination is gathered either by conventional sampling of monitoring wells or by conducting integral pumping tests at control planes with a specific sampling scheme. Hydraulic data from these pumping tests together with all other available information are then used to set up a groundwater flow model of the study site, which provides the flow field for transport simulations within the subsequent contamination backtracking procedures, starting from the defined control planes. The backtracking results are then analysed within ModBack. The potential areas of contamination source presence or absence are determined based on the procedure used by Jarsjö et al. (2005). The contaminant plume length can be estimated using plume length statistics, first order rate degradation equations or calculations based on site specific hydraulic and chemical parameters. Furthermore, an analytical tool is included to identify the distribution of contaminants across a control plane. All relevant output can be graphically displayed and saved as vector data to be later used in GIS software. ModBack has been already used to delimit the zones of source presence or absence at several test sites. With ModBack, a tool is now available which enables environmental consultants, engineers and environmental agencies to delineate possible sources of contamination already at the planning stage of site investigation and remediation measures, helping to significantly reduce costs of contaminated site management. Bayer-Raich, M., Jarsjö, J., Holder, T. and Ptak, T. (2003): "Numerical estimations of contaminant mass flow rate based on concentration measurements in pumping wells", ModelCare 2002: A Few Steps Closer to Reality, IAHS Publication No. 277, 10-16. Jarsjö, J., Bayer-Raich, M., Ptak, T. (2005): "Monitoring groundwater contamination and delineating source zones at industrial sites: Uncertainty analyses using integral pumping tests", Journal of Contaminant Hydrology, 79, 107-134

VITAL NMR: Using Chemical Shift Derived Secondary Structure Information for a Limited Set of Amino Acids to Assess Homology Model Accuracy

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

Brothers, Michael C; Nesbitt, Anna E; Hallock, Michael J

2011-01-01

Homology modeling is a powerful tool for predicting protein structures, whose success depends on obtaining a reasonable alignment between a given structural template and the protein sequence being analyzed. In order to leverage greater predictive power for proteins with few structural templates, we have developed a method to rank homology models based upon their compliance to secondary structure derived from experimental solid-state NMR (SSNMR) data. Such data is obtainable in a rapid manner by simple SSNMR experiments (e.g., (13)C-(13)C 2D correlation spectra). To test our homology model scoring procedure for various amino acid labeling schemes, we generated a library ofmore » 7,474 homology models for 22 protein targets culled from the TALOS+/SPARTA+ training set of protein structures. Using subsets of amino acids that are plausibly assigned by SSNMR, we discovered that pairs of the residues Val, Ile, Thr, Ala and Leu (VITAL) emulate an ideal dataset where all residues are site specifically assigned. Scoring the models with a predicted VITAL site-specific dataset and calculating secondary structure with the Chemical Shift Index resulted in a Pearson correlation coefficient (-0.75) commensurate to the control (-0.77), where secondary structure was scored site specifically for all amino acids (ALL 20) using STRIDE. This method promises to accelerate structure procurement by SSNMR for proteins with unknown folds through guiding the selection of remotely homologous protein templates and assessing model quality.« less

Ensuring treatment fidelity in a multi-site behavioral intervention study: implementing NIH Behavior Change Consortium recommendations in the SMART trial.

PubMed

Robb, Sheri L; Burns, Debra S; Docherty, Sharron L; Haase, Joan E

2011-11-01

The Stories and Music for Adolescent/Young Adult Resilience during Transplant (SMART) study (R01NR008583; U10CA098543; U10CA095861) is an ongoing multi-site Children's Oncology Group randomized clinical trial testing the efficacy of a therapeutic music video intervention for adolescents/young adults (11-24 years of age) with cancer undergoing stem cell transplant. Treatment fidelity strategies from our trial are consistent with the National Institutes of Health (NIH) Behavior Change Consortium Treatment Fidelity Workgroup (BCC) recommendations and provide a successful working model for treatment fidelity implementation in a large, multi-site behavioral intervention study. In this paper, we summarize 20 specific treatment fidelity strategies used in the SMART trial and how these strategies correspond with NIH BCC recommendations in five specific areas: (1) study design, (2) training providers, (3) delivery of treatment, (4) receipt of treatment, and (5) enactment of treatment skills. Increased use and reporting of treatment fidelity procedures is essential in advancing the reliability and validity of behavioral intervention research. The SMART trial provides a strong model for the application of fidelity strategies to improve scientific findings and addresses the absence of published literature, illustrating the application of BCC recommendations in behavioral intervention studies. Copyright © 2010 John Wiley & Sons, Ltd.

Mission objectives for geological exploration of the Apollo 16 landing site

NASA Technical Reports Server (NTRS)

Muehlberger, W. R.; Horz, F.; Sevier, J. R.; Ulrich, G. E.

1980-01-01

The objectives of the Apollo 16 mission to delineate the nature and origin of two major physiographic units of the central lunar highlands are discussed. Surface exploration plans, specific sampling procedures, operational constraints, and suites of samples that were collected for specific local objectives are described. Pre-mission hypotheses that favored a volcanic origin for the Cayley plains as well as the Descartes mountains were proved to be wrong by the mission results, but not enough samples have been studied to draw any other definite conclusions. Two contrasting schools of thought about the origin of the Apollo fragmental impact deposits are described: one maintains that the samples are predominantly of local origin, while the other suggests more distant, basin-related sources.

Determination of strontium-90 in deer bones by liquid scintillation spectrometry after separation on Sr-specific ion exchange columns.

PubMed

Landstetter, Claudia; Wallner, Gabriele

2006-01-01

The activity concentration of (90)Sr was determined in several deer bones from Austria. Strontium specific ion exchange columns with 4',4''(5'')-di-t-butylcyclohexane-18-crown-6 from Eichrom Industries, Inc. were used for separation. The yield of the chemical procedure was quantified with AAS. Directly after column separation, the solution containing (90)Sr was mixed with the scintillation cocktail HiSafe III and measured by liquid scintillation counting. Prevention of (210)Pb contamination and reusability of the separation columns was investigated as well as the activity distribution within the bones. Results were compared with pre-Chernobyl measurements in Austria; a correlation between activity concentration of (90)Sr and site altitude was found.

Identifying and assessing ecotourism visitor impacts at selected protected areas in Costa Rica and Belize

USGS Publications Warehouse

Farrell, T.A.; Marion, J.L.

2001-01-01

Protected area visitation is an important component of ecotourism, and as such, must be sustainable. However, protected area visitation may degrade natural resources, particularly in areas of concentrated visitor activities like trails and recreation sites. This is an important concern in ecotourism destinations such as Belize and Costa Rica, because they actively promote ecotourism and emphasize the pristine qualities of their natural resources. Research on visitor impacts to protected areas has many potential applications in protected area management, though it has not been widely applied in Central and South America. This study targeted this deficiency through manager interviews and evaluations of alternative impact assessment procedures at eight protected areas in Belize and Costa Rica. Impact assessment procedures included qualitative condition class systems, ratings systems, and measurement-based systems applied to trails and recreation sites. The resulting data characterize manager perceptions of impact problems, document trail and recreation site impacts, and provide examples of inexpensive, efficient and effective rapid impact assessment procedures. Interview subjects reported a variety of impacts affecting trails, recreation sites, wildlife, water, attraction features and other resources. Standardized assessment procedures were developed and applied to record trail and recreation site impacts. Impacts affecting the study areas included trail proliferation, erosion and widening, muddiness on trails, vegetation cover loss, soil and root exposure, and tree damage on recreation sites. The findings also illustrate the types of assessment data yielded by several alternative methods and demonstrate their utility to protected area managers. The need for additional rapid assessment procedures for wildlife, water, attraction feature and other resource impacts was also identified.

Location Distribution Optimization of Photographing Sites for Indoor Panorama Modeling

NASA Astrophysics Data System (ADS)

Zhang, S.; Wu, J.; Zhang, Y.; Zhang, X.; Xin, Z.; Liu, J.

2017-09-01

Generally, panoramas image modeling is costly and time-consuming because of photographing continuously to capture enough photos along the routes, especially in complicated indoor environment. Thus, difficulty follows for a wider applications of panoramic image modeling for business. It is indispensable to make a feasible arrangement of panorama sites locations because the locations influence the clarity, coverage and the amount of panoramic images under the condition of certain device. This paper is aim to propose a standard procedure to generate the specific location and total amount of panorama sites in indoor panoramas modeling. Firstly, establish the functional relationship between one panorama site and its objectives. Then, apply the relationship to panorama sites network. We propose the Distance Clarity function (FC and Fe) manifesting the mathematical relationship between panoramas and objectives distance or obstacle distance. The Distance Buffer function (FB) is modified from traditional buffer method to generate the coverage of panorama site. Secondly, transverse every point in possible area to locate possible panorama site, calculate the clarity and coverage synthetically. Finally select as little points as possible to satiate clarity requirement preferentially and then the coverage requirement. In the experiments, detailed parameters of camera lens are given. Still, more experiments parameters need trying out given that relationship between clarity and distance is device dependent. In short, through the function FC, Fe and FB, locations of panorama sites can be generated automatically and accurately.

FATE 5: A natural attenuation calibration tool for groundwater fate and transport modeling

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

Nevin, J.P.; Connor, J.A.; Newell, C.J.

1997-12-31

A new groundwater attenuation modeling tool (FATE 5) has been developed to assist users with determining site-specific natural attenuation rates for organic constituents dissolved in groundwater. FATE 5 is based on and represents an enhancement to the Domenico analytical groundwater transport model. These enhancements include use of an optimization routine to match results from the Domenico model to actual measured site concentrations, an extensive database of chemical property data, and calculation of an estimate of the length of time needed for a plume to reach steady state conditions. FATE 5 was developed in Microsoft{reg_sign} Excel and is controlled by meansmore » of a simple, user-friendly graphical interface. Using the Solver routine built into Excel, FATE 5 is able to calibrate the attenuation rate used by the Domenico model to match site-specific data. By calibrating the decay rate to site-specific measurements, FATE 5 can yield accurate predictions of long-term natural attenuation processes within a groundwater within a groundwater plume. In addition, FATE 5 includes a formulation of the transient Domenico solution used to help the user determine if the steady-state assumptions employed by the model are appropriate. The calibrated groundwater flow model can then be used either to (i) predict upper-bound constituent concentrations in groundwater, based on an observed source zone concentration, or (ii) back-calculate a lower-bound SSTL value, based on a user-specified exposure point concentration at the groundwater point of exposure (POE). This paper reviews the major elements of the FATE 5 model - and gives results for real-world applications. Key modeling assumptions and summary guidelines regarding calculation procedures and input parameter selection are also addressed.« less

Ground Truth Sampling and LANDSAT Accuracy Assessment

NASA Technical Reports Server (NTRS)

Robinson, J. W.; Gunther, F. J.; Campbell, W. J.

1982-01-01

It is noted that the key factor in any accuracy assessment of remote sensing data is the method used for determining the ground truth, independent of the remote sensing data itself. The sampling and accuracy procedures developed for nuclear power plant siting study are described. The purpose of the sampling procedure was to provide data for developing supervised classifications for two study sites and for assessing the accuracy of that and the other procedures used. The purpose of the accuracy assessment was to allow the comparison of the cost and accuracy of various classification procedures as applied to various data types.

TargetM6A: Identifying N6-Methyladenosine Sites From RNA Sequences via Position-Specific Nucleotide Propensities and a Support Vector Machine.

PubMed

Li, Guang-Qing; Liu, Zi; Shen, Hong-Bin; Yu, Dong-Jun

2016-10-01

As one of the most ubiquitous post-transcriptional modifications of RNA, N 6 -methyladenosine ( [Formula: see text]) plays an essential role in many vital biological processes. The identification of [Formula: see text] sites in RNAs is significantly important for both basic biomedical research and practical drug development. In this study, we designed a computational-based method, called TargetM6A, to rapidly and accurately target [Formula: see text] sites solely from the primary RNA sequences. Two new features, i.e., position-specific nucleotide/dinucleotide propensities (PSNP/PSDP), are introduced and combined with the traditional nucleotide composition (NC) feature to formulate RNA sequences. The extracted features are further optimized to obtain a much more compact and discriminative feature subset by applying an incremental feature selection (IFS) procedure. Based on the optimized feature subset, we trained TargetM6A on the training dataset with a support vector machine (SVM) as the prediction engine. We compared the proposed TargetM6A method with existing methods for predicting [Formula: see text] sites by performing stringent jackknife tests and independent validation tests on benchmark datasets. The experimental results show that the proposed TargetM6A method outperformed the existing methods for predicting [Formula: see text] sites and remarkably improved the prediction performances, with MCC = 0.526 and AUC = 0.818. We also provided a user-friendly web server for TargetM6A, which is publicly accessible for academic use at http://csbio.njust.edu.cn/bioinf/TargetM6A.

Comparison of 1997 Medicare relative value units for gender-specific procedures: is Adam still worth more than Eve?

PubMed

Goff, B A; Muntz, H G; Cain, J M

1997-08-01

On January 1, 1992, Congress implemented a Medicare payment system based on relative value units (RVUs). The total RVU (which is made up of work, practice, and malpractice RVUs) is multiplied by a dollar conversion factor to set the reimbursement for all procedures covered by Medicare. In a previous study, we found that significant gender bias exists in Medicare reimbursement for female-specific services. Recently, HCFA approved increases (beginning January 1997) in the work RVU for many gynecologic procedures. This study was undertaken to compare work and total RVUs for gender-specific procedures effective January 1, 1997. Using the May 1996 Federal Register, we compared work and total RVUs for 24 pairs of gender-specific procedures. The groups were matched so that the amount of work and level of difficulty would be similar, if not identical. We validated our selection of procedures for comparison by also evaluating the average time required to perform these procedures. Comparison of work RVUs for the 24 paired procedures revealed that in 19 cases (80%), male-specific procedures had a higher RVU; in 3 cases (12%), female-specific procedures were higher; and in 2 cases, there was no difference. On average, work RVUs were 49% higher for urologic procedures than for gynecologic procedures. Comparison of total RVUs revealed that in 20 cases (83%), urologic procedures had a higher total RVU and in 3 cases (12%), gynecologic procedures were higher. On average, male-specific surgeries are reimbursed at an amount which is 37% higher than that for female-specific surgeries. Recent increases in work RVUs for many gynecologic procedures have resulted in improved reimbursement. However, even with these improvements, significant gender bias still exists in the Medicare reimbursement of female-specific procedures. This gender bias is further magnified as more private insurance carriers use the system to set reimbursement.

Health technology assessment of medical devices: a survey of non-European union agencies.

PubMed

Ciani, Oriana; Wilcher, Britni; Blankart, Carl Rudolf; Hatz, Maximilian; Rupel, Valentina Prevolnik; Erker, Renata Slabe; Varabyova, Yauheniya; Taylor, Rod S

2015-01-01

The aim of this study was to review and compare current health technology assessment (HTA) activities for medical devices across non-European Union HTA agencies. HTA activities for medical devices were evaluated from three perspectives: organizational structure, processes, and methods. Agencies were primarily selected upon membership of existing HTA networks. The data collection was performed in two stages: stage 1-agency Web-site assessment using a standardized questionnaire, followed by review and validation of the collected data by a representative of the agency; and stage 2-semi-structured telephone interviews with key informants of a sub-sample of agencies. In total, thirty-six HTA agencies across twenty non-EU countries assessing medical devices were included. Twenty-seven of thirty-six (75 percent) agencies were judged at stage 1 to have adopted HTA-specific approaches for medical devices (MD-specific agencies) that were largely organizational or procedural. There appeared to be few differences in the organization, process and methods between MD-specific and non-MD-specific agencies. Although the majority (69 percent) of both categories of agency had specific methods guidance or policy for evidence submission, only one MD-specific agency had developed methodological guidelines specific to medical devices. In stage 2, many MD-specific agencies cited insufficient resources (budget, skilled employees), lack of coordination (between regulator and reimbursement bodies), and the inability to generalize findings from evidence synthesis to be key challenges in the HTA of medical devices. The lack of evidence for differentiation in scientific methods for HTA of devices raises the question of whether HTA needs to develop new methods for medical devices but rather adapt existing methodological approaches. In contrast, organizational and/or procedural adaptation of existing HTA agency frameworks to accommodate medical devices appear relatively commonplace.

Optimizing Travel Time to Outpatient Interventional Radiology Procedures in a Multi-Site Hospital System Using a Google Maps Application.

PubMed

Mandel, Jacob E; Morel-Ovalle, Louis; Boas, Franz E; Ziv, Etay; Yarmohammadi, Hooman; Deipolyi, Amy; Mohabir, Heeralall R; Erinjeri, Joseph P

2018-02-20

The purpose of this study is to determine whether a custom Google Maps application can optimize site selection when scheduling outpatient interventional radiology (IR) procedures within a multi-site hospital system. The Google Maps for Business Application Programming Interface (API) was used to develop an internal web application that uses real-time traffic data to determine estimated travel time (ETT; minutes) and estimated travel distance (ETD; miles) from a patient's home to each a nearby IR facility in our hospital system. Hypothetical patient home addresses based on the 33 cities comprising our institution's catchment area were used to determine the optimal IR site for hypothetical patients traveling from each city based on real-time traffic conditions. For 10/33 (30%) cities, there was discordance between the optimal IR site based on ETT and the optimal IR site based on ETD at non-rush hour time or rush hour time. By choosing to travel to an IR site based on ETT rather than ETD, patients from discordant cities were predicted to save an average of 7.29 min during non-rush hour (p = 0.03), and 28.80 min during rush hour (p < 0.001). Using a custom Google Maps application to schedule outpatients for IR procedures can effectively reduce patient travel time when more than one location providing IR procedures is available within the same hospital system.

WE-H-207B-03: MRI Guidance in the Radiation Therapy Clinic: Site-Specific Discussions

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

Shang, C.

2016-06-15

In recent years, steady progress has been made towards the implementation of MRI in external beam radiation therapy for processes ranging from treatment simulation to in-room guidance. Novel procedures relying mostly on MR data are currently implemented in the clinic. This session will cover topics such as (a) commissioning and quality control of the MR in-room imagers and simulators specific to RT, (b) treatment planning requirements, constraints and challenges when dealing with various MR data, (c) quantification of organ motion with an emphasis on treatment delivery guidance, and (d) MR-driven strategies for adaptive RT workflows. The content of the sessionmore » was chosen to address both educational and practical key aspects of MR guidance. Learning Objectives: Good understanding of MR testing recommended for in-room MR imaging as well as image data validation for RT chain (e.g. image transfer, filtering for consistency, spatial accuracy, manipulation for task specific); Familiarity with MR-based planning procedures: motivation, core workflow requirements, current status, challenges; Overview of the current methods for the quantification of organ motion; Discussion on approaches for adaptive treatment planning and delivery. T. Stanescu - License agreement with Modus Medical Devices to develop a phantom for the quantification of MR image system-related distortions.; T. Stanescu, N/A.« less

RH Packaging Program Guidance

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

Washington TRU Solutions, LLC

The purpose of this program guidance document is to provide technical requirements for use, operation, inspection, and maintenance of the RH-TRU 72-B Waste Shipping Package and directly related components. This document complies with the requirements as specified in the RH-TRU 72-B Safety Analysis Report for Packaging (SARP), and Nuclear Regulatory Commission (NRC) Certificate of Compliance (C of C) 9212. If there is a conflict between this document and the SARP and/or C of C, the SARP and/or C of C shall govern. The C of C states: ''...each package must be prepared for shipment and operated in accordance with themore » procedures described in Chapter 7.0, ''Operating Procedures,'' of the application.'' It further states: ''...each package must be tested and maintained in accordance with the procedures described in Chapter 8.0, ''Acceptance Tests and Maintenance Program of the Application.'' Chapter 9.0 of the SARP tasks the Waste Isolation Pilot Plant (WIPP) Management and Operating (M&O) contractor with assuring the packaging is used in accordance with the requirements of the C of C. Because the packaging is NRC approved, users need to be familiar with 10 CFR {section} 71.11, ''Deliberate Misconduct.'' Any time a user suspects or has indications that the conditions of approval in the C of C were not met, the Carlsbad Field Office (CBFO) shall be notified immediately. CBFO will evaluate the issue and notify the NRC if required. This document details the instructions to be followed to operate, maintain, and test the RH-TRU 72-B packaging. This Program Guidance standardizes instructions for all users. Users shall follow these instructions. Following these instructions assures that operations are safe and meet the requirements of the SARP. This document is available on the Internet at: ttp://www.ws/library/t2omi/t2omi.htm. Users are responsible for ensuring they are using the current revision and change notices. Sites may prepare their own document using the word-for-word steps in th is document, in sequence, including Notes and cautions. Site specific information may be included as necessary. The document, and revisions, must then be submitted to CBFO at sitedocuments@wipp.ws for approval. A copy of the approval letter from CBFO shall be available for audit purposes. Users may develop site-specific procedures addressing preoperational activities, quality assurance (QA), hoisting and rigging, and radiation health physics to be used with the instructions contained in this document. Users may recommend changes to this document by submitting their recommendations (in writing) to the WIPP M&O Contractor RH Packaging Maintenance Engineer for evaluation. If approved, the change(s) will be incorporated into this document for use by ALL users. Before first use and every 12 months after, user sites will be audited to this document to ensure compliance. They will also be audited within one year from the effective date of revisions to this document.« less

Virus-Clip: a fast and memory-efficient viral integration site detection tool at single-base resolution with annotation capability.

PubMed

Ho, Daniel W H; Sze, Karen M F; Ng, Irene O L

2015-08-28

Viral integration into the human genome upon infection is an important risk factor for various human malignancies. We developed viral integration site detection tool called Virus-Clip, which makes use of information extracted from soft-clipped sequencing reads to identify exact positions of human and virus breakpoints of integration events. With initial read alignment to virus reference genome and streamlined procedures, Virus-Clip delivers a simple, fast and memory-efficient solution to viral integration site detection. Moreover, it can also automatically annotate the integration events with the corresponding affected human genes. Virus-Clip has been verified using whole-transcriptome sequencing data and its detection was validated to have satisfactory sensitivity and specificity. Marked advancement in performance was detected, compared to existing tools. It is applicable to versatile types of data including whole-genome sequencing, whole-transcriptome sequencing, and targeted sequencing. Virus-Clip is available at http://web.hku.hk/~dwhho/Virus-Clip.zip.

The application of consequence models in risk assessment: A regulator`s view

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

Nussey, C.; Carter, D.A.; Cassidy, K.

1995-12-31

Quantified risk assessment (QRA) is a technique for aiding decision making. The UK Health and Safety Executive (HSE) uses QRA in the Major Hazards (MH) area to formulate advice to Local Planning Authorities (LPAs) on the siting of MH installations and the development of land in the vicinity of existing MH installations. The region around UK MH sites within which LPAs are required to consult HSE on land-use planning matters (i.e. the Consultation Distance (CD)) is increasingly being redefined by adopting a risk based approach. The authors are now in the process of conducting or updated site specific QRAs tomore » redefine CDs. This process enables them to identify risk reduction measures and discuss them with companies, taking into consideration the ALARP--as low as is reasonably practicable--philosophy. The paper outlines the basis of the QRAs and the role of consequence assessment models and procedures in this process, and illustrates by examples the setting of CDs and the application of the ALARP philosophy.« less

Integrating Radar Image Data with Google Maps

NASA Technical Reports Server (NTRS)

Chapman, Bruce D.; Gibas, Sarah

2010-01-01

A public Web site has been developed as a method for displaying the multitude of radar imagery collected by NASA s Airborne Synthetic Aperture Radar (AIRSAR) instrument during its 16-year mission. Utilizing NASA s internal AIRSAR site, the new Web site features more sophisticated visualization tools that enable the general public to have access to these images. The site was originally maintained at NASA on six computers: one that held the Oracle database, two that took care of the software for the interactive map, and three that were for the Web site itself. Several tasks were involved in moving this complicated setup to just one computer. First, the AIRSAR database was migrated from Oracle to MySQL. Then the back-end of the AIRSAR Web site was updated in order to access the MySQL database. To do this, a few of the scripts needed to be modified; specifically three Perl scripts that query that database. The database connections were then updated from Oracle to MySQL, numerous syntax errors were corrected, and a query was implemented that replaced one of the stored Oracle procedures. Lastly, the interactive map was designed, implemented, and tested so that users could easily browse and access the radar imagery through the Google Maps interface.

Development and evaluation of a species diagnostic polymerase chain reaction-restriction fragment-length polymorphism procedure for cryptic members of the Culex sitiens (Diptera: Culicidae) subgroup in Australia and the southwest Pacific.

PubMed

Beebe, N W; van den Hurk, A F; Chapman, H F; Frances, S P; Williams, C R; Cooper, R D

2002-03-01

Members of the Culex sitiens subgroup are important vectors of arboviruses, including Japanese encephalitis virus, Murray Valley encephalitis virus and Ross River virus. Of the eight described species, Cx. annulirostris Skuse, Cx. sitiens Wiedemann, and Cx. palpalis Taylor appear to be the most abundant and widespread throughout northern Australia and Papua New Guinea (PNG). Recent investigations using allozymes have shown this subgroup to contain cryptic species that possess overlapping adult morphology. We report the development of a polymerase chain reaction-restriction fragment-length polymorphism (PCR-RFLP) procedure that reliably separates these three species. This procedure utilizes the sequence variation in the ribosomal DNA ITS1 and demonstrates species-specific PCR-RFLP profiles from both colony and field collected material. Assessment of the consistency of this procedure was undertaken on mosquitoes sampled from a wide geographic area including Australia, PNG, and the Solomon Islands. Overlapping adult morphology was observed for Cx. annulirostris and Cx. palpalis in both northern Queensland and PNG and for all three species at one site in northwest Queensland.

Comparison of discrete Fourier transform (DFT) and principal component analysis/DFT as forecasting tools for absorbance time series received by UV-visible probes installed in urban sewer systems.

PubMed

Plazas-Nossa, Leonardo; Torres, Andrés

2014-01-01

The objective of this work is to introduce a forecasting method for UV-Vis spectrometry time series that combines principal component analysis (PCA) and discrete Fourier transform (DFT), and to compare the results obtained with those obtained by using DFT. Three time series for three different study sites were used: (i) Salitre wastewater treatment plant (WWTP) in Bogotá; (ii) Gibraltar pumping station in Bogotá; and (iii) San Fernando WWTP in Itagüí (in the south part of Medellín). Each of these time series had an equal number of samples (1051). In general terms, the results obtained are hardly generalizable, as they seem to be highly dependent on specific water system dynamics; however, some trends can be outlined: (i) for UV range, DFT and PCA/DFT forecasting accuracy were almost the same; (ii) for visible range, the PCA/DFT forecasting procedure proposed gives systematically lower forecasting errors and variability than those obtained with the DFT procedure; and (iii) for short forecasting times the PCA/DFT procedure proposed is more suitable than the DFT procedure, according to processing times obtained.

Attachment narratives in refugee children: interrater reliability and qualitative analysis in pilot findings from a two-site study.

PubMed

De Haene, Lucia; Dalgaard, Nina Thorup; Montgomery, Edith; Grietens, Hans; Verschueren, Karine

2013-06-01

Although forced migration research on refugee family functioning clearly points to the potential breakdown of parental availability and responsiveness in the context of cumulative migration stressors, studies exploring attachment security in refugee children are surprisingly lacking so far. The authors report their findings from a 2-site, small-scale administration of an attachment measure, adapted for use with refugee children aged between 4 and 9 years from a reliable and validated doll-play procedure. We evaluated interrater reliability and conducted a qualitative analysis of refugee children's narrative response to identify migration-specific representational markers of attachment quality. The level of agreement among 3 independent coders ranged between .54 to 1.00 for both study samples, providing initial psychometric evidence of the measure's value in assessing child attachment security in this population. The exploratory analysis of migration-related narrative markers pointed to specific parameters to be used in parent-child observational assessments in future validation of the attachment measure, such as parental withdrawal or trauma-communication within the parent-child dyad. Copyright © 2013 International Society for Traumatic Stress Studies.

A Multi-Site Study on Medical School Selection, Performance, Motivation and Engagement

ERIC Educational Resources Information Center

Wouters, A.; Croiset, G.; Schripsema, N. R.; Cohen-Schotanus, J.; Spaai, G. W.; Hulsman, R. L.; Kusurkar, R. A.

2017-01-01

Medical schools seek ways to improve their admissions strategies, since the available methods prove to be suboptimal for selecting the best and most motivated students. In this multi-site cross-sectional questionnaire study, we examined the value of (different) selection procedures compared to a weighted lottery procedure, which includes direct…

40 CFR 65.158 - Performance test procedures for control devices.

Code of Federal Regulations, 2010 CFR

2010-07-01

... regulated material or as TOC (minus methane and ethane) according to the procedures specified. (1) Method 1... material or TOC, sampling sites shall be located at the inlet of the control device as specified in the... sampling sites shall ensure the measurement of total regulated material or TOC (minus methane and ethane...

18 CFR 16.6 - Notification procedures under section 15 of the Federal Power Act.

Code of Federal Regulations, 2012 CFR

2012-04-01

... filing procedures posted on the Commission's Web site at http://www.ferc.gov a letter, that contains the following information: (1) The licensee's name and address. (2) The project number. (3) The license... installed plant capacity. (9) The location or locations of all the sites where the information required...

18 CFR 16.6 - Notification procedures under section 15 of the Federal Power Act.

Code of Federal Regulations, 2011 CFR

2011-04-01

... filing procedures posted on the Commission's Web site at http://www.ferc.gov a letter, that contains the following information: (1) The licensee's name and address. (2) The project number. (3) The license... installed plant capacity. (9) The location or locations of all the sites where the information required...

18 CFR 16.6 - Notification procedures under section 15 of the Federal Power Act.

Code of Federal Regulations, 2013 CFR

2013-04-01

... filing procedures posted on the Commission's Web site at http://www.ferc.gov a letter, that contains the following information: (1) The licensee's name and address. (2) The project number. (3) The license... installed plant capacity. (9) The location or locations of all the sites where the information required...

The Importance of Perioperative Prophylaxis with Cefuroxime or Ceftriaxone in the Surgical Site Infections Prevention after Cranial and Spinal Neurosurgical Procedures.

PubMed

Dimovska-Gavrilovska, Aleksandra; Chaparoski, Aleksandar; Gavrilovski, Andreja; Milenkovikj, Zvonko

2017-09-01

Introduction Surgical site infections pose a significant problem in the treatment of neurosurgical procedures, regardless of the application of perioperative prophylaxis with systemic antibiotics. The infection rate in these procedures ranges from less than 1% to above 15%. Different antibiotics and administration regimes have been used in the perioperative prophylaxis so far, and there are numerous comparative studies regarding their efficiency, however, it is generally indicated that the choice thereof should be based on information and local specifics connected to the most probable bacterial causers, which would possibly contaminate the surgical site and cause infection, and moreover, the mandatory compliance with the principles of providing adequate concentration of the drug at the time of the anticipated contamination. Objective Comparing the protective effect of two perioperative prophylactic antibiotic regimes using cefuroxime (second generation cephalosporin) and ceftriaxone (third generation cephalosporin) in the prevention of postoperative surgical site infections after elective and urgent cranial and spinal neurosurgical procedures at the University Clinic for Neurosurgery in Skopje in the period of the first three months of 2016. Design of the study Prospective randomized comparative study. Outcome measures Establishing the clinical outcome represented as prevalence of superficial and deep incision and organ/space postoperative surgical site infections. Material and method We analyzed prospectively 40 patients who received parenteral antibiotic prophylaxis with two antibiotic regimes one hour before the routine neurosurgical cranial and spinal surgical procedures; the patients were randomized in two groups, according to the order of admission and participation in the study, alternately, non-selectively, those persons who fulfilled inclusion criteria were placed in one of the two programmed regimes with cefuroxime in the first, and cefotaxime in the second compared group. All relevant demographic and perioperative patient data were analyzed for both comparative groups, especially the factors known to cause disposition (predisposition) to infections. The prevalence of postoperative infections was evaluated as the primary outcome in both comparative groups, while the secondary outcome was the postoperative infection rate after cranial and spinal neurosurgical procedures at the Neurosurgical clinic in Skopje (having in consideration that so far no data have been published in this context), as well as the prevalence of the risk factors for occurrence of postoperative infections, pre-surgically in patients undergoing neurosurgical interventions locally in the Republic of Macedonia. Results A total of three cases of postoperative infections were registered, two of which classified as superficial incisional, while one case organ/space infection - meningitis (elective intervention) without etiological confirmation. Both comparative groups were statistically similar, without any statistically significant differences in the basic demographic and perioperative characteristics, especially in relation to the incidence of the factors, which, regardless of the antibiotic prophylaxis, show predisposition to postoperative infections. All three cases with infections were registered in the group of persons who received prophylaxis with ceftriaxone preoperatively, with isolated etiological S. aureus agent (elective intervention) in one of them, and methicillin resistant staphylococcus aureus (MRSA) in another (urgent intervention) with superficial incisional SSI. There was no case of SSI in the group of patients who received cefuroxime before surgery. Conclusion Administration of parenteral antibiotics before surgery reduces the incidence of postoperative infections after neurosurgical procedures, especially in cases with increased risk factors for SSI, such as ACA score of ≥ 2/3, the duration of the surgical intervention ≥ 4 hours, contaminated wound and comorbidities. Perioperative antibiotic prophylaxis should be directed to better coverage of the S.aureus arrays.

Representation of spatial cross correlations in large stochastic seasonal streamflow models

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

Oliveira, G.C.; Kelman, J.; Pereira, M.V.F.

1988-05-01

Pereira et al. (1984) presented a special disaggregation procedure for generating cross-correlated monthly flows at many sites while using what are essentially univariate disaggregation models for the flows at each site. This was done by using a nonparametric procedure for constructing residual innovations or noise vectors with cross-correlated components. This note considers the theoretical underpinnings of that streamflow disaggregation procedure and a proposed variation and their ability to reproduce the observed historical cross correlations among concurrent monthly flows at nine Brazilian stations.

WHO Expert Committee on Specifications for Pharmaceutical Preparations.

PubMed

2011-01-01

The Expert Committee on Specifications for Pharmaceutical Preparations works towards clear, independent and practical standards and guidelines for the quality assurance of medicines. Standards are developed by the Committee through worldwide consultation and an international consensus-building process. The following new guidelines were adopted and recommended for use: procedure for adoption of International Chemical Reference Substances; WHO good practices for pharmaceutical microbiology laboratories; good manufacturing practices: main principles for pharmaceutical products; good manufacturing practices for blood establishments (jointly with the Expert Committee on Biological Standardization); guidelines on good manufacturing practices for heating, ventilation and air-conditioning systems for non-sterile pharmaceutical dosage forms; good manufacturing practices for sterile pharmaceutical products; guidelines on transfer of technology in pharmaceutical manufacturing; good pharmacy practice: standards for quality of pharmacy services (joint FIP/WHO); model guidance for the storage and transport of time- and temperature-sensitive pharmaceutical products (jointly with the Expert Committee on Biological Standardization); procedure for prequalification of pharmaceutical products; guide on submission of documentation for prequalification of innovator finished pharmaceutical products approved by stringent regulatory authorities; prequalification of quality control laboratories: procedure for assessing the acceptability, in principle, of quality control laboratories for use by United Nations agencies; guidelines for preparing a laboratory information file; guidelines for drafting a site master file; guidelines on submission of documentation for a multisource (generic) finished product: general format: preparation of product dossiers in common technical document format.

Estimation of the annual production and composition of C&D Debris in Galicia (Spain).

PubMed

Martínez Lage, Isabel; Martínez Abella, Fernando; Herrero, Cristina Vázquez; Ordóñez, Juan Luis Pérez

2010-04-01

One of the key aspects that must be taken into consideration within the framework of Sustainable Construction is the management of Construction and Demolition (C&D) Debris. As for other types of waste, specific handling procedures are required to manage C&D Debris; these include reduction, reuse, recycling, and if all other possibilities fail, recovery or disposal. For public planning strategies aimed at the management of C&D Debris to be effective, it is first necessary to have specific knowledge of the type of waste materials generated in a particular region. After verifying that the methods available to determine the production and composition of C&D Debris are limited, this paper presents a procedure to ascertain the production and composition of C&D Debris, in any region. The procedure utilizes data on the surface areas of newly constructed buildings, renovations and demolitions, which are estimated from available data for recent years, as well as information on the quantity of debris generated per surface area in any type of construction site, which is obtained from recently executed constructions or from the ground plans of older buildings. The method proposed here has been applied to Galicia, one of Spain's autonomous communities, for which the quantity and composition of C&D Debris have been estimated for the horizon year 2011. Copyright 2009 Elsevier Ltd. All rights reserved.

Specificity of O-glycosylation in enhancing the stability and cellulose binding affinity of Family 1 carbohydrate-binding modules

PubMed Central

Chen, Liqun; Drake, Matthew R.; Resch, Michael G.; Greene, Eric R.; Himmel, Michael E.; Chaffey, Patrick K.; Beckham, Gregg T.; Tan, Zhongping

2014-01-01

The majority of biological turnover of lignocellulosic biomass in nature is conducted by fungi, which commonly use Family 1 carbohydrate-binding modules (CBMs) for targeting enzymes to cellulose. Family 1 CBMs are glycosylated, but the effects of glycosylation on CBM function remain unknown. Here, the effects of O-mannosylation are examined on the Family 1 CBM from the Trichoderma reesei Family 7 cellobiohydrolase at three glycosylation sites. To enable this work, a procedure to synthesize glycosylated Family 1 CBMs was developed. Subsequently, a library of 20 CBMs was synthesized with mono-, di-, or trisaccharides at each site for comparison of binding affinity, proteolytic stability, and thermostability. The results show that, although CBM mannosylation does not induce major conformational changes, it can increase the thermolysin cleavage resistance up to 50-fold depending on the number of mannose units on the CBM and the attachment site. O-Mannosylation also increases the thermostability of CBM glycoforms up to 16 °C, and a mannose disaccharide at Ser3 seems to have the largest themostabilizing effect. Interestingly, the glycoforms with small glycans at each site displayed higher binding affinities for crystalline cellulose, and the glycoform with a single mannose at each of three positions conferred the highest affinity enhancement of 7.4-fold. Overall, by combining chemical glycoprotein synthesis and functional studies, we show that specific glycosylation events confer multiple beneficial properties on Family 1 CBMs. PMID:24821760

Calibration of semi-stochastic procedure for simulating high-frequency ground motions

USGS Publications Warehouse

Seyhan, Emel; Stewart, Jonathan P.; Graves, Robert

2013-01-01

Broadband ground motion simulation procedures typically utilize physics-based modeling at low frequencies, coupled with semi-stochastic procedures at high frequencies. The high-frequency procedure considered here combines deterministic Fourier amplitude spectra (dependent on source, path, and site models) with random phase. Previous work showed that high-frequency intensity measures from this simulation methodology attenuate faster with distance and have lower intra-event dispersion than in empirical equations. We address these issues by increasing crustal damping (Q) to reduce distance attenuation bias and by introducing random site-to-site variations to Fourier amplitudes using a lognormal standard deviation ranging from 0.45 for Mw < 7 to zero for Mw 8. Ground motions simulated with the updated parameterization exhibit significantly reduced distance attenuation bias and revised dispersion terms are more compatible with those from empirical models but remain lower at large distances (e.g., > 100 km).

Assessment of Quality and Content of Online Information About Hip Arthroscopy.

PubMed

Ellsworth, Bridget; Patel, Hiren; Kamath, Atul F

2016-10-01

The purpose of this study was to assess the quality of information available to patients on the Internet when using popular search engines to search the term "hip arthroscopy." We analyzed the quality and content of information about hip arthroscopy (HA) on the first 50 websites returned by the search engines Google and Bing for the search term "hip arthroscopy." The sites were categorized by type, and quality and content were measured using the DISCERN score, along with an HA-specific content score. The HA-specific content score was used to assess each website for the presence or absence of 19 topics about HA determined to be important for a patient seeking information about the procedure. The Health on the Net Code (HONcode) status of each website was also noted. The mean DISCERN score for all websites analyzed was 39.5, considered "poor," while only 44.6% of sites were considered "fair" or "good." Governmental and nonprofit organization (NPO) websites had the highest average DISCERN score. The mean HA-specific content score was 8.6 (range, 2 to 16). The commercial website category had the highest average HA-specific content score, followed by the governmental and NPO category. Sites that bore the HONcode certification obtained significantly higher DISCERN scores than those without the certification (P = .0032) but did not obtain significantly higher HA-specific content scores. "Hip arthroscopy" is a fairly general term, and there is significant variability in the quality of HA information available online. The HONcode is useful to identify quality patient information websites; however, it is not commonly used in HA-specific websites and does not encompass all quality websites about HA. This study increases awareness of the quality of information on HA available online. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Soil Viral Communities Vary Temporally and along a Land Use Transect as Revealed by Virus-Like Particle Counting and a Modified Community Fingerprinting Approach (fRAPD)

PubMed Central

Narr, Anja; Nawaz, Ali; Wick, Lukas Y.; Harms, Hauke; Chatzinotas, Antonis

2017-01-01

Environmental surveys on soil viruses are still rare and mostly anecdotal, i. e., they mostly report on viruses at one location or for only a few sampling dates. Detailed time-series analysis with multiple samples can reveal the spatio-temporal dynamics of viral communities and provide important input as to how viruses interact with their potential hosts and the environment. Such surveys, however, require fast, easy-to-apply and reliable methods. In the present study we surveyed monthly across 13 months the abundance of virus-like particles (VLP) and the structure of the viral communities in soils along a land use transect (i.e., forest, pasture, and cropland). We evaluated 32 procedures to extract VLP from soil using different buffers and mechanical methods. The most efficient extraction was achieved with 1× saline magnesium buffer in combination with 20 min vortexing. For community structure analysis we developed an optimized fingerprinting approach (fluorescent RAPD-PCR; fRAPD) by combining RAPD-PCR with fluorescently labeled primers in order to size the obtained fragments on a capillary sequencing machine. With the concomitantly collected data of soil specific factors and weather data, we were able to find correlations of viral abundance and community structure with environmental variables and sampling site. More specifically, we found that soil specific factors such as pH and total nitrogen content played a significant role in shaping both soil viral abundance and community structure. The fRAPD analysis revealed high temporal changes and clustered the viral communities according to sampling sites. In particular we observed that temperature and rainfall shaped soil viral communities in non-forest sites. In summary our findings suggest that sampling site was a key factor for shaping the abundance and community structure of soil viruses, and when site vegetation was reduced, temperature and rainfall were also important factors. PMID:29067022

How important is hydrotherapy? Effects of dynamic action of hot spring water as a rehabilitative treatment for burn patients in Switzerland.

PubMed

Moufarrij, S; Deghayli, L; Raffoul, W; Hirt-Burri, N; Michetti, M; de Buys Roessingh, A; Norberg, M; Applegate, L A

2014-12-31

Burn rehabilitation using hydrotherapy can have multiple benefits for the burn patient. The therapy uses specific mineral enriched hot spring water and water jets with varied hydro-pressure to combat hypertrophy, inflammatory reaction signs, abnormal pigmentation, and, more specifically, redness and scarring. Standard operating procedures for burn rehabilitation have been developed and integrated into the Standard of Care at the CHUV hospital using localized hydro-mechanical stimulation of burn sites (20 minutes of alternating anatomical sites) followed by constant pressure large-bore and filiform showers targeting specific scarred areas. These therapeutic regimens are repeated daily for 2 to 3 weeks. Patients showed lasting effects from this regimen (up to 3-6 months), the results becoming permanent with more uniform skin structure, color and visco-elasticity in addition to a decrease in pruritus. The specifications of clinical protocols are described herein along with the virtues of hot spring hydro-pressure therapy for burn rehabilitation. The use of hydrotherapy, which has been a controversial topic among burn units across the world, is also discussed. In North America, hydrotherapy is defined only within the scope of in-patient wound cleansing and is thought to lead to microbial auto-contamination and bacterial resistance. In Switzerland and France the emphasis of hydrotherapy is on rehabilitation after the wound has closed.

How important is hydrotherapy? Effects of dynamic action of hot spring water as a rehabilitative treatment for burn patients in Switzerland

PubMed Central

Moufarrij, S.; Deghayli, L.; Raffoul, W.; Hirt-Burri, N.; Michetti, M.; de Buys Roessingh, A.; Norberg, M.; Applegate, L.A.

2014-01-01

Summary Burn rehabilitation using hydrotherapy can have multiple benefits for the burn patient. The therapy uses specific mineral enriched hot spring water and water jets with varied hydro-pressure to combat hypertrophy, inflammatory reaction signs, abnormal pigmentation, and, more specifically, redness and scarring. Standard operating procedures for burn rehabilitation have been developed and integrated into the Standard of Care at the CHUV hospital using localized hydro-mechanical stimulation of burn sites (20 minutes of alternating anatomical sites) followed by constant pressure large-bore and filiform showers targeting specific scarred areas. These therapeutic regimens are repeated daily for 2 to 3 weeks. Patients showed lasting effects from this regimen (up to 3-6 months), the results becoming permanent with more uniform skin structure, color and visco-elasticity in addition to a decrease in pruritus. The specifications of clinical protocols are described herein along with the virtues of hot spring hydro-pressure therapy for burn rehabilitation. The use of hydrotherapy, which has been a controversial topic among burn units across the world, is also discussed. In North America, hydrotherapy is defined only within the scope of in-patient wound cleansing and is thought to lead to microbial auto-contamination and bacterial resistance. In Switzerland and France the emphasis of hydrotherapy is on rehabilitation after the wound has closed. PMID:26336365

Numerical study of a novel procedure for installing the tower and Rotor Nacelle Assembly of offshore wind turbines based on the inverted pendulum principle

NASA Astrophysics Data System (ADS)

Guachamin Acero, Wilson; Gao, Zhen; Moan, Torgeir

2017-09-01

Current installation costs of offshore wind turbines (OWTs) are high and profit margins in the offshore wind energy sector are low, it is thus necessary to develop installation methods that are more efficient and practical. This paper presents a numerical study (based on a global response analysis of marine operations) of a novel procedure for installing the tower and Rotor Nacelle Assemblies (RNAs) on bottom-fixed foundations of OWTs. The installation procedure is based on the inverted pendulum principle. A cargo barge is used to transport the OWT assembly in a horizontal position to the site, and a medium-size Heavy Lift Vessel (HLV) is then employed to lift and up-end the OWT assembly using a special upending frame. The main advantage of this novel procedure is that the need for a huge HLV (in terms of lifting height and capacity) is eliminated. This novel method requires that the cargo barge is in the leeward side of the HLV (which can be positioned with the best heading) during the entire installation. This is to benefit from shielding effects of the HLV on the motions of the cargo barge, so the foundations need to be installed with a specific heading based on wave direction statistics of the site and a typical installation season. Following a systematic approach based on numerical simulations of actual operations, potential critical installation activities, corresponding critical events, and limiting (response) parameters are identified. In addition, operational limits for some of the limiting parameters are established in terms of allowable limits of sea states. Following a preliminary assessment of these operational limits, the duration of the entire operation, the equipment used, and weather- and water depth-sensitivity, this novel procedure is demonstrated to be viable.

Peripheral nerve catheters and local anesthetic infiltration in perioperative analgesia.

PubMed

Merritt, Christopher K; Mariano, Edward R; Kaye, Alan David; Lissauer, Jonathan; Mancuso, Kenneth; Prabhakar, Amit; Urman, Richard D

2014-03-01

Peripheral nerve catheters (PNCs) and local infiltration analgesia (LIA) represent valuable options for controlling perioperative pain. PNCs have been increasingly utilized to provide both surgical anesthesia and prolonged postoperative analgesia for a wide variety of procedures. PNCs can be more technically challenging to place than typical single-injection nerve blocks (SINB), and familiarity with the indications, contraindications, relevant anatomy, and appropriate technical skills is a prerequisite for the placement of any PNC. PNCs include risks of peripheral nerve injury, damage to adjacent anatomic structures, local anesthetic toxicity, intravascular injection, risks associated with motor block, risks of unnoticed injury to the insensate limb, and risks of sedation associated with PNC placement. In addition to these common risks, there are specific risks unique to each PNC insertion site. LIA strategies have emerged that seek to provide the benefit of targeted local anesthesia while minimizing collateral motor block and increasing the applicability of durable local anesthesia beyond the extremities. LIA involves the injection and/or infusion of a local anesthetic near the site of surgical incision to provide targeted analgesia. A wide variety of techniques have been described, including single-injection intraoperative wound infiltration, indwelling wound infusion catheters, and the recent high-volume LIA technique associated with joint replacement surgery. The efficacy of these techniques varies depending on specific procedures and anatomic locations. The recent incorporation of ultra-long-acting liposomal bupivacaine preparations has the potential to dramatically increase the utility of single-injection LIA. LIA represents a promising yet under-investigated method of postoperative pain control. Copyright © 2014 Elsevier Ltd. All rights reserved.

Prioritizing stream types according to their potential risk to receive crop plant material--A GIS-based procedure to assist in the risk assessment of genetically modified crops and systemic insecticide residues.

PubMed

Bundschuh, Rebecca; Kuhn, Ulrike; Bundschuh, Mirco; Naegele, Caroline; Elsaesser, David; Schlechtriemen, Ulrich; Oehen, Bernadette; Hilbeck, Angelika; Otto, Mathias; Schulz, Ralf; Hofmann, Frieder

2016-03-15

Crop plant residues may enter aquatic ecosystems via wind deposition or surface runoff. In the case of genetically modified crops or crops treated with systemic pesticides, these materials may contain insecticidal Bt toxins or pesticides that potentially affect aquatic life. However, the particular exposure pattern of aquatic ecosystems (i.e., via plant material) is not properly reflected in current risk assessment schemes, which primarily focus on waterborne toxicity and not on plant material as the route of uptake. To assist in risk assessment, the present study proposes a prioritization procedure of stream types based on the freshwater network and crop-specific cultivation data using maize in Germany as a model system. To identify stream types with a high probability of receiving crop materials, we developed a formalized, criteria-based and thus transparent procedure that considers the exposure-related parameters, ecological status--an estimate of the diversity and potential vulnerability of local communities towards anthropogenic stress--and availability of uncontaminated reference sections. By applying the procedure to maize, ten stream types out of 38 are expected to be the most relevant if the ecological effects from plant-incorporated pesticides need to be evaluated. This information is an important first step to identifying habitats within these stream types with a high probability of receiving crop plant material at a more local scale, including accumulation areas. Moreover, the prioritization procedure developed in the present study may support the selection of aquatic species for ecotoxicological testing based on their probability of occurrence in stream types having a higher chance of exposure. Finally, this procedure can be adapted to any geographical region or crop of interest and is, therefore, a valuable tool for a site-specific risk assessment of crop plants carrying systemic pesticides or novel proteins, such as insecticidal Bt toxins, expressed in genetically modified crops. Copyright © 2015 Elsevier B.V. All rights reserved.

Operating manual for the R200 downhole recorder with husky hunter retriever

USGS Publications Warehouse

Johnson, Roy A.; Rorabaugh, James I.

1988-01-01

The R200 Downhole Recorder is a battery-powered device that, when placed in a well casing, monitors water levels for a period of up to 1 year. This instrument measures a 1- to 70-foot range of water levels. These water-level data can be retrieved through use of a commercially available portable microcomputer. The R200 Downhole Recorder was developed at the U.S. Geological Survey 's Hydrologic Instrumentation Facility, Stennis Space Center, Mississippi. This operating manual describes the R200 Downhole Recorder, provides initial set-up instructions, and gives directions for on-site operation. Design specifications and routine maintenance steps are included. The R200 data-retriever program is a user-friendly, menu-driven program. The manual guides the user through the procedures required to perform specific operations. Numerous screens are reproduced in the text with a discussion of user input for desired responses. Help is provided for specific problems. (USGS)

Operating manual for the R200 downhole recorder with Tandy 102 retriever

USGS Publications Warehouse

Johnson, Roy A.; Rorabaugh, James I.

1988-01-01

The R200 Downhole Recorder is a battery-powered device that, when placed in a well casing, monitors water levels for a period of up to 1 year. This instrument measures a 1- to 70-ft range of water levels. These water level data can be retrieved through use of a commercially available portable microcomputer. The R200 Downhole Recorder was developed at the U. S. Geological Survey 's Hydrologic Instrumentation Facility, Stennis Space Center, Mississippi. This operating manual describes the R200 Downhole Recorder, provides initial set-up instructions, and gives directions for on-site operation. Design specifications and routine maintenance steps are included. The R200 data-retriever program is a user-friendly, menu-driven program. The manual guides the user through the procedures required to perform specific operations. Numerous screens are reproduced in the text with a discussion of user input for desired responses. Help is provided for specific problems. (USGS)

Final Work Plan: Targeted Investigation at York, Nebraska

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

LaFreniere, Lorraine M.

The targeted investigation at York will be implemented in phases, so that data collected and interpretations developed at each stage of the program can be evaluated to guide subsequent phases most effectively. Section 2 of this Work Plan presents a brief overview of the York site, its geologic and hydrologic setting, and the previous CCC/USDA investigations. Section 3, outlines the proposed technical program for the targeted investigation, and Section 4 describes the investigative methods to be employed. A community relations plan is in Section 5, and Section 6 includes health and safety information. In addition to this site-specific Work Plan,more » the Master Work Plan (Argonne 2002) developed by Argonne for CCC/USDA investigations in Nebraska should be consulted for complete details of the methods and procedures to be used at York.« less

Test site suitability assessment for radiation measurements

NASA Astrophysics Data System (ADS)

Borsero, M.; Nano, E.

1980-04-01

Field and attenuation methods for site suitability assessment for radiation measurements are presented. Attention is given to the IEC procedure for checking the suitability of radiation measurement site.

NEEMO 20: Science Training, Operations, and Tool Development

NASA Technical Reports Server (NTRS)

Graff, T.; Miller, M.; Rodriguez-Lanetty, M.; Chappell, S.; Naids, A.; Hood, A.; Coan, D.; Abell, P.; Reagan, M.; Janoiko, B.

2016-01-01

The 20th mission of the National Aeronautics and Space Administration (NASA) Extreme Environment Mission Operations (NEEMO) was a highly integrated evaluation of operational protocols and tools designed to enable future exploration beyond low-Earth orbit. NEEMO 20 was conducted from the Aquarius habitat off the coast of Key Largo, FL in July 2015. The habitat and its surroundings provide a convincing analog for space exploration. A crew of six (comprised of astronauts, engineers, and habitat technicians) lived and worked in and around the unique underwater laboratory over a mission duration of 14-days. Incorporated into NEEMO 20 was a diverse Science Team (ST) comprised of geoscientists from the Astromaterials Research and Exploration Science (ARES/XI) Division from the Johnson Space Center (JSC), as well as marine scientists from the Department of Biological Sciences at Florida International University (FIU). This team trained the crew on the science to be conducted, defined sampling techniques and operational procedures, and planned and coordinated the science focused Extra Vehicular Activities (EVAs). The primary science objectives of NEEMO 20 was to study planetary sampling techniques and tools in partial gravity environments under realistic mission communication time delays and operational pressures. To facilitate these objectives two types of science sites were employed 1) geoscience sites with available rocks and regolith for testing sampling procedures and tools and, 2) marine science sites dedicated to specific research focused on assessing the photosynthetic capability of corals and their genetic connectivity between deep and shallow reefs. These marine sites and associated research objectives included deployment of handheld instrumentation, context descriptions, imaging, and sampling; thus acted as a suitable proxy for planetary surface exploration activities. This abstract briefly summarizes the scientific training, scientific operations, and tool development conducted during NEEMO 20 with an emphasis on the primary lessons learned.

Assessing the availability of the teratogenic drug isotretinoin outside the pregnancy prevention programme: a survey of e-pharmacies.

PubMed

Lagan, Briege M; Dolk, Helen; White, Bronagh; Uges, Donald R A; Sinclair, M

2014-04-01

The increase in online purchasing of medications raises safety concerns regarding teratogenic drugs. The use of the teratogenic drug 'isotretinoin' for women of childbearing age requires strict adherence to the Pregnancy Prevention Programme (PPP), a risk minimisation measure imposed on prescribers and users. We sought to determine how readily consumers can purchase isotretinoin online and the associated safety procedures and information. A descriptive cross-sectional survey was conducted of 50 e-pharmacies identified from commonly used search engines. E-pharmacy characteristics and isotretinoin PPP specific criteria were evaluated. Purchases of isotretinoin from seven e-pharmacies not bearing authentication logos and not requiring a prescription were assessed for PPP policy adherence, purchasing procedures and compound quality. Forty-three (86%) of the e-pharmacies did not have an authentication seal/logo. Isotretinoin could be purchased from 42 sites without a valid prescription. Information on isotretinoin causing birth defects was lacking in 25 of the 50 sites, on not taking isotretinoin in pregnancy in 24 sites and not taking isotretinoin if planning or at risk of a pregnancy in 33 sites. Of the eight attempted purchases, seven arrived, all without any patient information leaflet. All were verified as isotretinoin. The Internet provides a loophole for purchasing of medications known to cause congenital abnormalities, which needs to be addressed by medicines regulatory agencies worldwide. The current PPP for isotretinoin may be failing to protect mothers and babies from preventable harm-clinicians need to be aware of this, and the public needs to be educated about the potential risks. © 2014 The Authors. Pharmacoepidemiology and Drug Safety published by John Wiley & Sons, Ltd.

An Application of the SSHAC Level 3 Process to the Probabilistic Seismic Hazard Analysis for Nuclear Facilities at the Hanford Site, Eastern Washington, USA

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

Coppersmith , Kevin J.; Bommer, Julian J.; Bryce, Robert W.

Under the sponsorship of the US Department of Energy (DOE) and the electric utility Energy Northwest, the Pacific Northwest National Laboratory (PNNL) is conducting a probabilistic seismic hazard analysis (PSHA) within the framework of a SSHAC Level 3 procedure (Senior Seismic Hazard Analysis Committee; Budnitz et al., 1997). Specifically, the project is being conducted following the guidelines and requirements specified in NUREG-2117 (USNRC, 2012b) and consistent with approach given in the American Nuclear Standard ANSI/ANS-2.29-2008 Probabilistic Seismic Hazard Analysis. The collaboration between DOE and Energy Northwest is spawned by the needs of both organizations for an accepted PSHA with highmore » levels of regulatory assurance that can be used for the design and safety evaluation of nuclear facilities. DOE committed to this study after performing a ten-year review of the existing PSHA, as required by DOE Order 420.1C. The study will also be used by Energy Northwest as a basis for fulfilling the NRC’s 10CFR50.54(f) requirement that the western US nuclear power plants conduct PSHAs in conformance with SSHAC Level 3 procedures. The study was planned and is being carried out in conjunction with a project Work Plan, which identifies the purpose of the study, the roles and responsibilities of all participants, tasks and their associated schedules, Quality Assurance (QA) requirements, and project deliverables. New data collection and analysis activities are being conducted as a means of reducing the uncertainties in key inputs to the PSHA. It is anticipated that the results of the study will provide inputs to the site response analyses at multiple nuclear facility sites within the Hanford Site and at the Columbia Generating Station.« less

Sentinel lymph node biopsy in periocular merkel cell carcinoma: a case report.

PubMed

Filitis, Dan C; Paragh, Gyorgy; Samie, Faramarz H; Zeitouni, Nathalie C

2017-09-20

The National Comprehensive Cancer Network guidelines for Merkel cell carcinoma recommend performance of the sentinel lymph node biopsy in all patients with clinically negative nodal disease for staging and treatment. Nevertheless, sentinel lymph node biopsy in the periocular region is debated as tumors are typically smaller and lymphatic variability can make performance procedurally problematic. We present a case of a Caucasian patient in their seventies who presented with a 1.0 cm periocular Merkel cell carcinoma, who underwent Mohs surgery with a Tenzel flap repair, that was found to have a positive sentinel lymph node biopsy, but who, despite parotidectomy, selective neck dissection, and radiation, succumbed to the disease. Evidence in both the site-specific and non-specific literature demonstrates: (1) Worsening prognosis with extent of lymph node burden, (2) improvements in our abilities to perform lymphoscintigraphy, (3) locoregional and distant metastatic disease in patients with tumor sizes ≤1 cm, and (4) significant rates of sentinel lymph node positivity in patients with tumor sizes ≤1 cm. Our case supports that sentinel lymph node biopsy should be considered in all clinically nodal negative periocular Merkel cell carcinoma, regardless of size, and despite limited site-specific studies on the subject.

Targeted enzyme prodrug therapies.

PubMed

Schellmann, N; Deckert, P M; Bachran, D; Fuchs, H; Bachran, C

2010-09-01

The cure of cancer is still a formidable challenge in medical science. Long-known modalities including surgery, chemotherapy and radiotherapy are successful in a number of cases; however, invasive, metastasized and inaccessible tumors still pose an unresolved and ongoing problem. Targeted therapies designed to locate, detect and specifically kill tumor cells have been developed in the past three decades as an alternative to treat troublesome cancers. Most of these therapies are either based on antibody-dependent cellular cytotoxicity, targeted delivery of cytotoxic drugs or tumor site-specific activation of prodrugs. The latter is a two-step procedure. In the first step, a selected enzyme is accumulated in the tumor by guiding the enzyme or its gene to the neoplastic cells. In the second step, a harmless prodrug is applied and specifically converted by this enzyme into a cytotoxic drug only at the tumor site. A number of targeting systems, enzymes and prodrugs were investigated and improved since the concept was first envisioned in 1974. This review presents a concise overview on the history and latest developments in targeted therapies for cancer treatment. We cover the relevant technologies such as antibody-directed enzyme prodrug therapy (ADEPT), gene-directed enzyme prodrug therapy (GDEPT) as well as related therapies such as clostridial- (CDEPT) and polymer-directed enzyme prodrug therapy (PDEPT) with emphasis on prodrug-converting enzymes, prodrugs and drugs.

Optimization of a CRISPR/Cas9-mediated Knock-in Strategy at the Porcine Rosa26 Locus in Porcine Foetal Fibroblasts.

PubMed

Xie, Zicong; Pang, Daxin; Wang, Kankan; Li, Mengjing; Guo, Nannan; Yuan, Hongming; Li, Jianing; Zou, Xiaodong; Jiao, Huping; Ouyang, Hongsheng; Li, Zhanjun; Tang, Xiaochun

2017-06-08

Genetically modified pigs have important roles in agriculture and biomedicine. However, genome-specific knock-in techniques in pigs are still in their infancy and optimal strategies have not been extensively investigated. In this study, we performed electroporation to introduce a targeting donor vector (a non-linearized vector that did not contain a promoter or selectable marker) into Porcine Foetal Fibroblasts (PFFs) along with a CRISPR/Cas9 vector. After optimization, the efficiency of the EGFP site-specific knock-in could reach up to 29.6% at the pRosa26 locus in PFFs. Next, we used the EGFP reporter PFFs to address two key conditions in the process of achieving transgenic pigs, the limiting dilution method and the strategy to evaluate the safety and feasibility of the knock-in locus. This study demonstrates that we establish an efficient procedures for the exogenous gene knock-in technique and creates a platform to efficiently generate promoter-less and selectable marker-free transgenic PFFs through the CRISPR/Cas9 system. This study should contribute to the generation of promoter-less and selectable marker-free transgenic pigs and it may provide insights into sophisticated site-specific genome engineering techniques for additional species.

Wrong-site nerve blocks: A systematic literature review to guide principles for prevention.

PubMed

Deutsch, Ellen S; Yonash, Robert A; Martin, Donald E; Atkins, Joshua H; Arnold, Theresa V; Hunt, Christina M

2018-05-01

Wrong-site nerve blocks (WSBs) are a significant, though rare, source of perioperative morbidity. WSBs constitute the most common type of perioperative wrong-site procedure reported to the Pennsylvania Patient Safety Authority. This systematic literature review aggregates information about the incidence, patient consequences, and conditions that contribute to WSBs, as well as evidence-based methods to prevent them. A systematic search of English-language publications was performed, using the PRISMA process. Seventy English-language publications were identified. Analysis of four publications reporting on at least 10,000 blocks provides a rate of 0.52 to 5.07 WSB per 10,000 blocks, unilateral blocks, or "at risk" procedures. The most commonly mentioned potential consequence was local anesthetic toxicity. The most commonly mentioned contributory factors were time pressure, personnel factors, and lack of site-mark visibility (including no site mark placed). Components of the block process that were addressed include preoperative nerve-block verification, nerve-block site marking, time-outs, and the healthcare facility's structure and culture of safety. A lack of uniform reporting criteria and divergence in the data and theories presented may reflect the variety of circumstances affecting when and how nerve blocks are performed, as well as the infrequency of a WSB. However, multiple authors suggest three procedural steps that may help to prevent WSBs: (1) verify the nerve-block procedure using multiple sources of information, including the patient; (2) identify the nerve-block site with a visible mark; and (3) perform time-outs immediately prior to injection or instillation of the anesthetic. Hospitals, ambulatory surgical centers, and anesthesiology practices should consider creating site-verification processes with clinician input and support to develop sustainable WSB-prevention practices. Copyright © 2017 Elsevier Inc. All rights reserved.

Single-site multiport combined splenectomy and cholecystectomy with conventional laparoscopic instruments: Case series and review of literature

PubMed Central

Ozemir, Ibrahim Ali; Bayraktar, Baris; Bayraktar, Onur; Tosun, Salih; Bilgic, Cagri; Demiral, Gokhan; Ozturk, Erman; Yigitbasi, Rafet; Alimoglu, Orhan

2015-01-01

Introduction Conventional laparoscopic procedures have been used for splenic diseases and concomitant gallbladder stones, frequently in patients with hereditary spherocytosis since 1990’s. The aim of this study is to evaluate the feasibility of single-site surgery with conventional instruments in combined procedures. Presentation of case series Six consecutive patients who scheduled for combined cholecystectomy and splenectomy because of hereditary spherocytosis or autoimmune hemolytic anemia were included this study. Both procedures were performed via trans-umbilical single-site multiport approach using conventional instruments. All procedures completed successfully without conversion to open surgery or conventional laparoscopic surgery. An additional trocar was required for only one patient. The mean operation time was 190 min (150–275 min). The mean blood loss was 185 ml (70–300 ml). Median postoperative hospital stay was two days. No perioperative mortality or major complications occurred in our series. Recurrent anemia, hernia formation or wound infection was not observed during the follow-up period. Discussion Nowadays, publications are arising about laparoscopic or single site surgery for combined diseases. Surgery for combined diseases has some difficulties owing to the placement of organs and position of the patient during laparoscopic surgery. Single site laparoscopic surgery has been proposed to have better cosmetic outcome, less postoperative pain, greater patient satisfaction and faster recovery compared to standard laparoscopy. Conclusion We consider that single-site multiport laparoscopic approach for combined splenectomy and cholecystectomy is a safe and feasible technique, after gaining enough experience on single site surgery. PMID:26708949

Local antimicrobial administration for prophylaxis of surgical site infections.

PubMed

Huiras, Paul; Logan, Jill K; Papadopoulos, Stella; Whitney, Dana

2012-11-01

Despite a lack of consensus guidelines, local antibiotic administration for prophylaxis of surgical site infections is used during many surgical procedures. The rationale behind this practice is to provide high antibiotic concentrations at the site of surgery while minimizing systemic exposure and adverse effects. Local antibiotic administration for surgical site prophylaxis has inherent limitations in that antibiotics are applied after the incision is made, rather than the current standard for surgical site prophylaxis that recommends providing adequate antibiotic concentrations at the site before the incision. The efficacy and safety of local application of antibiotics for surgical site prophylaxis have been assessed in different types of surgery with a variety of antibiotic agents and methods of application. We identified 22 prospective, randomized, controlled trials that evaluated local application of antibiotics for surgical site prophylaxis. These trials were subsequently divided and analyzed based on the type of surgical procedure: dermatologic, orthopedic, abdominal, colorectal, and cardiothoracic. Methods of local application analyzed included irrigations, powders, ointments, pastes, beads, sponges, and fleeces. Overall, there is a significant lack of level I evidence supporting this practice for any of the surgical genres evaluated. In addition, the literature spans several decades, and changes in surgical procedures, systemic antibiotic prophylaxis, and microbial flora make conclusions difficult to determine. Based on available data, the efficacy of local antibiotic administration for the prophylaxis of surgical site infections remains uncertain, and recommendations supporting this practice for surgical site prophylaxis cannot be made. © 2012 Pharmacotherapy Publications, Inc.

Data Quality Assurance and Control for AmeriFlux Network at CDIAC, ORNL

NASA Astrophysics Data System (ADS)

Shem, W.; Boden, T.; Krassovski, M.; Yang, B.

2014-12-01

The Carbon Dioxide Information Analysis Center (CDIAC) at the Oak Ridge National Laboratory (ORNL) serves as the long-term data repository for the AmeriFlux network. Datasets currently available include hourly or half-hourly meteorological and flux observations, biological measurement records, and synthesis data products. Currently there is a lack of standardized nomenclature and specifically designed procedures for data quality assurance/control in processing and handling micrometeorological and ecological data at individual flux sites. CDIAC's has bridged this gap by providing efficient and accurate procedures for data quality control and standardization of the results for easier assimilation by the models used in climate science. In this presentation we highlight the procedures we have put in place to scrutinize continuous flux and meteorological data within Ameriflux network. We itemize some basic data quality issues that we have observed over the past years and include some examples of typical data quality issues. Such issues, e.g., incorrect time-stamping, poor calibration or maintenance of instruments, missing or incomplete metadata and others that are commonly over-looked by PI's, invariably impact the time-series observations.

Fluorescent labeling of tetracysteine-tagged proteins in intact cells

PubMed Central

Hoffmann, Carsten; Gaietta, Guido; Zürn, Alexander; Adams, Stephen R; Terrillon, Sonia; Ellisman, Mark H; Tsien, Roger Y; Lohse, Martin J

2011-01-01

In this paper, we provide a general protocol for labeling proteins with the membrane-permeant fluorogenic biarsenical dye fluorescein arsenical hairpin binder–ethanedithiol (FlAsH-EDT2). Generation of the tetracysteine-tagged protein construct by itself is not described, as this is a protein-specific process. This method allows site-selective labeling of proteins in living cells and has been applied to a wide variety of proteins and biological problems. We provide here a generally applicable labeling procedure and discuss the problems that can occur as well as general considerations that must be taken into account when designing and implementing the procedure. The method can even be applied to proteins with expression below 1 pmol mg−1 of protein, such as G protein–coupled receptors, and it can be used to study the intracellular localization of proteins as well as functional interactions in fluorescence resonance energy transfer experiments. The labeling procedure using FlAsH-EDT2 as described takes 2–3 h, depending on the number of samples to be processed. PMID:20885379

The history of sentinel node biopsy in head and neck cancer: From visualization of lymphatic vessels to sentinel nodes.

PubMed

de Bree, Remco; Nieweg, Omgo E

2015-09-01

The aim of this report is to describe the history of sentinel node biopsy in head and neck cancer. Sentinel node biopsy is a minimally invasive technique to select patients for treatment of metastatic lymph nodes in the neck. Although this procedure has only recently been accepted for early oral cancer, the first studies on visualization of the cervical lymphatic vessels were reported in the 1960s. In the 1980s mapping of lymphatic drainage from specific head and neck sites was introduced. Sentinel node biopsy was further developed in the 1990s and after validation in this century the procedure is routinely performed in early oral cancer in several head and neck centers. New techniques may improve the accuracy of sentinel node biopsy further, particularly in difficult subsites like the floor of mouth. Copyright © 2015 Elsevier Ltd. All rights reserved.

Cerebrospinal Fluid Shunting Complications in Children

PubMed Central

Hanak, Brian W.; Bonow, Robert H.; Harris, Carolyn A.; Browd, Samuel R.

2018-01-01

Although cerebrospinal fluid (CSF) shunt placement is the most common procedure performed by pediatric neurosurgeons, shunts remain among the most failure-prone life-sustaining medical devices implanted in modern medical practice. This article provides an overview of the mechanisms of CSF shunt failure for the 3 most commonly employed definitive CSF shunts in the practice of pediatric neurosurgery: ventriculoperitoneal, ventriculopleural, and ventriculoatrial. The text has been partitioned into the broad modes of shunt failure: obstruction, infection, mechanical shunt failure, overdrainage, and distal catheter site-specific failures. Clinical management strategies for the various modes of shunt failure are discussed as are research efforts directed towards reducing shunt complication rates. As it is unlikely that CSF shunting will become an obsolete procedure in the foreseeable future, it is incumbent on the pediatric neurosurgery community to maintain focused efforts to improve our understanding of and management strategies for shunt failure and shunt-related morbidity. PMID:28249297

10 CFR 765.22 - Appeals procedures.

Code of Federal Regulations, 2013 CFR

2013-01-01

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

10 CFR 765.22 - Appeals procedures.

Code of Federal Regulations, 2011 CFR

2011-01-01

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

10 CFR 765.22 - Appeals procedures.

Code of Federal Regulations, 2014 CFR

2014-01-01

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

10 CFR 765.22 - Appeals procedures.

Code of Federal Regulations, 2012 CFR

2012-01-01

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

10 CFR 765.22 - Appeals procedures.

Code of Federal Regulations, 2010 CFR

2010-01-01

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

An alternative method for processing northern blots after capillary transfer.

PubMed

Nilsen, Timothy W

2015-03-02

Different laboratories use different methods for the prehybridization, hybridization, and washing steps of the northern blotting procedure. In this protocol, a northern blot is pretreated with Church and Gilbert hybridization buffer to block nonspecific probe-binding sites. The immobilized RNA is then hybridized to a DNA probe specific for the RNA of interest. Finally, the membrane is washed and subjected to autoradiography or phosphorimaging. The solutions and conditions described here may be ideal for those who prefer to use fewer ingredients in their solutions. This protocol is designed to achieve the same goals as other northern blotting approaches. It minimizes background (nonspecific adherence of probe to membrane and nonspecific hybridization) and maximizes specific hybridization to RNAs immobilized on a membrane. © 2015 Cold Spring Harbor Laboratory Press.

Post-surgical infections and perioperative antibiotics usage in pediatric genitourinary procedures.

PubMed

Ellett, Justin; Prasad, Michaella M; Purves, J Todd; Stec, Andrew A

2015-12-01

Post-surgical infections (PSIs) are a source of preventable perioperative morbidity. No guidelines exist for the use of perioperative antibiotics in pediatric urologic procedures. This study reports the rate of PSIs in non-endoscopic pediatric genitourinary procedures at our institution. Secondary aims evaluate the association of PSI with other perioperative variables, including wound class (WC) and perioperative antibiotic administration. Data from consecutive non-endoscopic pediatric urologic procedures performed between August 2011 and April 2014 were examined retrospectively. The primary outcome was the rate of PSIs. PSIs were classified as superficial skin (SS) and deep/organ site (D/OS) according to Centers for Disease Control and Prevention guidelines, and urinary tract infection (UTI). PSIs were further stratified by WC1 and WC2 and perioperative antibiotic usage. A relative risk and chi-square analysis compared PSI rates between WC1 and WC2 procedures. A total of 1185 unique patients with 1384 surgical sites were reviewed; 1192 surgical sites had follow-up for inclusion into the study. Ten total PSIs were identified, for an overall infection rate of 0.83%. Of these, six were SS, one was D/OS, and three were UTIs. The PSI rate for WC1 (885 sites) and WC2 (307 sites) procedures was 0.34% and 2.28%, respectively, p < 0.01. Relative risk of infection in WC2 procedures was 6.7 (CI 1.75-25.85, p = 0.0055). The rate of infections in WC1 procedures was similar between those receiving and not receiving perioperative antibiotics (0.35% vs. 0.33%). All WC2 procedures received antibiotics. Post-surgical infections are associated with significant perioperative morbidity. In some studies, PSI can double hospital costs, and contribute to hospital length of stay, admission to intensive care units, and impact patient mortality. Our study demonstrates that the rate of PSI in WC1 operations is low, irrespective of whether the patient received perioperative antibiotics (0.35%) or no antibiotics (0.33%). WC2 operations were the larger source of morbidity with an infection rate of 2.28% and a 6.7 fold higher increase in relative risk. WC1 procedures have a rate of infection around 0.3%, which is independent of the use of perioperative antibiotics. WC2 procedures have a higher rate of infection, with a relative risk of 6.7 for the development of PSI, and should be the target of guidelines for periprocedural prophylaxis. Copyright © 2015 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.

Ngram time series model to predict activity type and energy cost from wrist, hip and ankle accelerometers: implications of age

PubMed Central

Strath, Scott J; Kate, Rohit J; Keenan, Kevin G; Welch, Whitney A; Swartz, Ann M

2016-01-01

To develop and test time series single site and multi-site placement models, we used wrist, hip and ankle processed accelerometer data to estimate energy cost and type of physical activity in adults. Ninety-nine subjects in three age groups (18–39, 40–64, 65 + years) performed 11 activities while wearing three triaxial accelereometers: one each on the non-dominant wrist, hip, and ankle. During each activity net oxygen cost (METs) was assessed. The time series of accelerometer signals were represented in terms of uniformly discretized values called bins. Support Vector Machine was used for activity classification with bins and every pair of bins used as features. Bagged decision tree regression was used for net metabolic cost prediction. To evaluate model performance we employed the jackknife leave-one-out cross validation method. Single accelerometer and multi-accelerometer site model estimates across and within age group revealed similar accuracy, with a bias range of −0.03 to 0.01 METs, bias percent of −0.8 to 0.3%, and a rMSE range of 0.81–1.04 METs. Multi-site accelerometer location models improved activity type classification over single site location models from a low of 69.3% to a maximum of 92.8% accuracy. For each accelerometer site location model, or combined site location model, percent accuracy classification decreased as a function of age group, or when young age groups models were generalized to older age groups. Specific age group models on average performed better than when all age groups were combined. A time series computation show promising results for predicting energy cost and activity type. Differences in prediction across age group, a lack of generalizability across age groups, and that age group specific models perform better than when all ages are combined needs to be considered as analytic calibration procedures to detect energy cost and type are further developed. PMID:26449155

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 suggest that optimizing procedure protocols and proper use of protective devices and shields might reduce occupational radiation dose substantially. PMID:22647920

Operational Procedures for Collecting Water-Quality Samples at Monitoring Sites on Maple Creek Near Nickerson and the Platte River at Louisville, Eastern Nebraska

USGS Publications Warehouse

Johnson, Steven M.; Swanson, Robert B.

1994-01-01

Prototype stream-monitoring sites were operated during part of 1992 in the Central Nebraska Basins (CNBR) and three other study areas of the National Water-Quality Assessment (NAWQ) Program of the U.S. Geological Survey. Results from the prototype project provide information needed to operate a net- work of intensive fixed station stream-monitoring sites. This report evaluates operating procedures for two NAWQA prototype sites at Maple Creek near Nickerson and the Platte River at Louisville, eastern Nebraska. Each site was sampled intensively in the spring and late summer 1992, with less intensive sampling in midsummer. In addition, multiple samples were collected during two high- flow periods at the Maple Creek site--one early and the other late in the growing season. Water-samples analyses included determination of pesticides, nutrients, major ions, suspended sediment, and measurements of physical properties. Equipment and protocols for the water-quality sampling procedures were evaluated. Operation of the prototype stream- monitoring sites included development and comparison of onsite and laboratory sample-processing proce- dures. Onsite processing was labor intensive but allowed for immediate preservation of all sampled constituents. Laboratory processing required less field labor and decreased the risk of contamination, but allowed for no immediate preservation of the samples.

Analysis of Internet information on the controversial X-Stop device.

PubMed

Anderson, Joshua T; Sullivan, T Barrett; Ahn, Uri M; Ahn, Nicholas U

2014-10-01

The Internet is frequently used by patients to aid in medical decision making. Multiple studies display the Internet's ineffectiveness in presenting high-quality information regarding surgical procedures and devices. With recent reports of unacceptably high complication rates and poor outcomes with the X-Stop device, it is important that online information is comprehensive and accurate. This study is the first to examine Internet information on the controversial X-Stop. To determine how accurately public information over the Internet portrays the existing primary literature on the X-Stop, how extensively the X-Stop is characterized online, and how patient decision making could foreseeably be affected. This cross-sectional study analyzed publicly available Internet information, including videos on the web site YouTube regarding the X-Stop device. No patients were involved in this study. No specific outcome measures were used. Search engines Google, Yahoo, and Bing were used to identify 105 web sites providing information on the X-Stop. Videos on the web site YouTube were included. Web sites were categorized based on the authorship. Each site was analyzed for the provision of appropriate patient inclusion and exclusion criteria, surgical and nonsurgical treatment alternatives, purported benefits, common complications, peer-reviewed literature citations, and descriptions/diagrams of the procedure. Data were evaluated for each authorship subgroup and the entire group of sites. Forty-three percent of sites were authored by a private medical group, 4% by an academic medical group, 16% by an insurance company, 9% by a biomedical industry, 10% by news sources, and 19% by other. Thirty-one percent of web sites and 11% of sites authored by private medical groups contained references to peer-reviewed literature. Fifty-six percent of web sites reported patient inclusion criteria, whereas 33% reported exclusion criteria. Benefits and complications were reported within 91% and 23% of sites, respectively. Surgical and nonsurgical treatment options were mentioned within 59% and 61% of web sites, respectively. Our study demonstrates the Internet's ineffectiveness in reporting quality information on the X-Stop. Information was often incomplete and potentially misleading. Significant controversy exists within primary literature regarding the safety and efficacy of the X-Stop. Yet, publicly available Internet information largely provided misinformation and did not reflect any such controversy. This raises the concern that such information lends itself more toward patient recruitment than patient education. Medical professionals need to know how this may affect their patients' decision making. Copyright © 2014 Elsevier Inc. All rights reserved.

Quality assurance of research protocols conducted in the community: the National Institute on Drug Abuse Clinical Trials Network experience.

PubMed

Rosa, Carmen; Campbell, Aimee; Kleppinger, Cynthia; Sampson, Royce; Tyson, Clare; Mamay-Gentilin, Stephanie

2009-04-01

Quality assurance (QA) of clinical trials is essential to protect the welfare of trial participants and the integrity of the data collected. However, there is little detailed information available on specific procedures and outcomes of QA monitoring for clinical trials. This article describes the experience of the National Institute on Drug Abuse's (NIDA) National Drug Abuse Treatment Clinical Trials Network (CTN) in devising and implementing a three-tiered QA model for rigorous multi-site randomized clinical trials implemented in community-based substance abuse treatment programs. The CTN QA model combined local and national resources and was developed to address the unique needs of clinical trial sites with limited research experience. The authors reviewed internal records maintained by the sponsor, a coordinating site (Lead Nodes), and a local site detailing procedural development, training sessions, protocol violation monitoring, and site visit reporting. Between January 2001 and September 2005, the CTN implemented 21 protocols, of which 18 were randomized clinical trials, one was a quality improvement study and two were surveys. Approximately 160 community-based treatment programs participated in the 19 studies that were monitored, with a total of 6560 participants randomized across the sites. During this time 1937 QA site visits were reported across the three tiers of monitoring and the cost depended on the location of the sites and the salaries of the staff involved. One study reported 109 protocol violations (M = 15.6). Examples are presented to highlight training, protocol violation monitoring, site visit frequency and intensity and cost considerations. : QA data from the entire network were not easily available for review as much of the data were not electronically accessible. The authors reviewed and discussed a representative sample of internal data from the studies and participating sites. The lessons learned from the CTN's experience include the need for balancing thoroughness with efficiency, monitoring early, assessing research staff abilities in order to judge the need for proactive, focused attention, providing targeted training sessions, and developing flexible tools. The CTN model can work for sponsors overseeing studies at sites with limited research experience that require more frequent, in-depth monitoring. We recommend that sponsors not develop a rigid monitoring approach, but work with the study principal investigators to determine the intensity of monitoring needed depending on trial complexity, the risks of the intervention(s), and the experience of the staff with clinical research. After careful evaluation, sponsors should then determine the best approach to site monitoring and what resources will be needed.

Quality assurance of research protocols conducted in the community: The National Institute on Drug Abuse Clinical Trials Network Experience

PubMed Central

Rosa, Carmen; Campbell, Aimee; Kleppinger, Cynthia; Sampson, Royce; Tyson, Clare; Mamay-Gentilin, Stephanie

2009-01-01

Background: Quality assurance (QA) of clinical trials is essential to protect the welfare of trial participants and the integrity of the data collected. However, there is little detailed information available on specific procedures and outcomes of QA monitoring for clinical trials. Purpose: This article describes the experience of the National Institute on Drug Abuse's (NIDA) National Drug Abuse Treatment Clinical Trials Network (CTN) in devising and implementing a three-tiered QA model for rigorous multi-site randomized clinical trials implemented in community-based substance abuse treatment programs. The CTN QA model combined local and national resources and was developed to address the unique needs of clinical trial sites with limited research experience. Methods: The authors reviewed internal records maintained by the sponsor, a coordinating site (Lead Nodes), and a local site detailing procedural development, training sessions, protocol violation monitoring, and site visit reporting. Results: Between January 2001 and September 2005, the CTN implemented 21 protocols, of which 18 were randomized clinical trials, one was a quality improvement study and two were surveys. Approximately 160 community-based treatment programs participated in the 19 studies that were monitored, with a total of 6560 participants randomized across the sites. During this time 1937 QA site visits were reported across the three tiers of monitoring and the cost depended on the location of the sites and the salaries of the staff involved. One study reported 109 protocol violations (M = 15.6). Examples are presented to highlight training, protocol violation monitoring, site visit frequency and intensity and cost considerations. Limitations: QA data from the entire network were not easily available for review as much of the data were not electronically accessible. The authors reviewed and discussed a representative sample of internal data from the studies and participating sites. Conclusions: The lessons learned from the CTN's experience include the need for balancing thoroughness with efficiency, monitoring early, assessing research staff abilities in order to judge the need for proactive, focused attention, providing targeted training sessions, and developing flexible tools. The CTN model can work for sponsors overseeing studies at sites with limited research experience that require more frequent, in-depth monitoring. We recommend that sponsors not develop a rigid monitoring approach, but work with the study principal investigators to determine the intensity of monitoring needed depending on trial complexity, the risks of the intervention(s), and the experience of the staff with clinical research. After careful evaluation, sponsors should then determine the best approach to site monitoring and what resources will be needed. PMID:19342468

High Throughput Determination of VX in Drinking Water by ...

EPA Pesticide Factsheets

Methods Report This document provides the standard operating procedure for determination of the chemical warfare agent VX (O-Ethyl S-2-Diisopropylamino-Ethyl Methylphosphonothioate) in drinking water by isotope dilution liquid chromatography tandem mass spectrometer (LC/MS/MS). This method was adapted from one that was initially developed by the Centers for Disease Control and Prevention, in the National Center for Environmental Health for the determination and quantitation of VX in aqueous matrices. This method is designed to support site-specific cleanup goals of environmental remediation activities following a homeland security incident involving this analyte.

Seismic site coefficients and acceleration design response spectra based on conditions in South Carolina : final report.

DOT National Transportation Integrated Search

2014-11-15

The simplified procedure in design codes for determining earthquake response spectra involves : estimating site coefficients to adjust available rock accelerations to site accelerations. Several : investigators have noted concerns with the site coeff...

The National Institute on Disability, Independent Living, and Rehabilitation Research Burn Model System: Twenty Years of Contributions to Clinical Service and Research.

PubMed

Goverman, Jeremy; Mathews, Katie; Holavanahalli, Radha K; Vardanian, Andrew; Herndon, David N; Meyer, Walter J; Kowalske, Karen; Fauerbach, Jim; Gibran, Nicole S; Carrougher, Gretchen J; Amtmann, Dagmar; Schneider, Jeffrey C; Ryan, Colleen M

The National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) established the Burn Model System (BMS) in 1993 to improve the lives of burn survivors. The BMS program includes 1) a multicenter longitudinal database describing the functional and psychosocial recovery of burn survivors; 2) site-specific burn-related research; and 3) a knowledge dissemination component directed toward patients and providers. Output from each BMS component was analyzed. Database structure, content, and access procedures are described. Publications using the database were identified and categorized to illustrate the content area of the work. Unused areas of the database were identified for future study. Publications related to site-specific projects were cataloged. The most frequently cited articles are summarized to illustrate the scope of these projects. The effectiveness of dissemination activities was measured by quantifying website hits and information downloads. There were 25 NIDILRR-supported publications that utilized the database. These articles covered topics related to psychological outcomes, functional outcomes, community reintegration, and burn demographics. There were 172 site-specific publications; highly cited articles demonstrate a wide scope of study. For information dissemination, visits to the BMS website quadrupled between 2013 and 2014, with 124,063 downloads of educational material in 2014. The NIDILRR BMS program has played a major role in defining the course of burn recovery, and making that information accessible to the general public. The accumulating information in the database serves as a rich resource to the burn community for future study. The BMS is a model for collaborative research that is multidisciplinary and outcome focused.

Identification of opportunities for quality improvement and outcome measurement in pediatric otolaryngology.

PubMed

Shah, Rahul K; Stey, Anne M; Jatana, Kris R; Rangel, Shawn J; Boss, Emily F

2014-11-01

Despite increased emphasis on measuring safety outcomes and quality indicators for surgical care, little is known regarding which operative procedures should be prioritized for quality-improvement initiatives in pediatric otolaryngology. To describe the 30-day adverse event rates and relative contributions to morbidity for procedures in pediatric otolaryngology surgery using data from the American College of Surgeons' National Surgical Quality Improvement Program Pediatric database (ACS-NSQIP-P). Analysis of records contained in the ACS-NSQIP-P 2011-2012 clinical database. The ACS-NSQIP-P is a nationwide risk-adjusted, clinical outcomes-based program aimed at measuring and improving pediatric surgical care. Fifty hospitals participated in the 2011-2012 ACS-NSQIP-P program. Medical records of patients who underwent tracked otolaryngologic procedures were accrued in the ACS-NSQIP-P database. These were inclusive of specific otolaryngologic surgical procedures and do not represent the entire spectrum of pediatric otolaryngology surgical procedures. Individual 30-day adverse events, composite morbidity, composite serious adverse events, and composite hospital-acquired infections were compiled. Clinically related procedure groups were used to broadly evaluate outcomes. Procedures and groups were evaluated according to their relative contribution to otolaryngologic morbidity and their incidence of major complications. A total of 8361 patients underwent 1 of 40 selected otolaryngology procedures; 90% were elective; 76% were performed on an outpatient or ambulatory basis; and 46% were American Society of Anesthesiologists (ASA) class 2 cases. Individual 30-day adverse event rates were highest for return to the operating room (4%), surgical site infection (2%), pneumonia (1%), sepsis (1%), and reintubation (1%). The highest rates of composite morbidity were seen for tracheostomy in patients younger than 2 years (23%), airway reconstruction (19%), and tympanoplasty with mastoidectomy (2%). Airway reconstruction procedures had the highest rates of composite serious adverse events (16%), followed by tracheostomy (13%) and abscess drainage (5%). Tracheostomy (31%) and airway reconstruction (16%) made the largest relative contributions to composite morbidity rate of the procedures studied. Tracheostomy in patients younger than 2 years had the highest composite hospital-acquired infection rate (14%), followed by airway reconstruction procedures (11%) and tympanoplasty with mastoidectomy (2%). While the overall rate of major postoperative morbidity in pediatric otolaryngology is low, areas for targeted quality-improvement interventions include tracheostomy, airway reconstruction, mastoidectomy, and abscess drainage. Measurement of outcomes specific to otolaryngologic procedures will be necessary to further identify and measure the impact of quality-improvement initiatives in pediatric otolaryngology.

Framing medical tourism: an examination of appeal, risk, convalescence, accreditation, and interactivity in medical tourism web sites.

PubMed

Mason, Alicia; Wright, Kevin B

2011-02-01

This exploratory study analyzed the content of medical tourism Web sites in an attempt to examine how they convey information about benefits and risks of medical procedures, how they frame credibility, and the degree to which these Web sites include interactive features for consumers. Drawing upon framing theory, the researchers content analyzed a sample of 66 medical tourism Web sites throughout the world. The results indicated that medical tourism Web sites largely promote the benefits of medical procedures while downplaying the risks, and relatively little information regarding the credibility of these services appears. In addition, the presentation of benefits/risks, credibility, and Web site interactivity were found to differ by region and type of facility. The authors discuss the implications of these findings concerning the framing of medical tourism Web site content, future directions for research, and limitations.

40 CFR 63.645 - Test methods and procedures for miscellaneous process vents.

Code of Federal Regulations, 2010 CFR

2010-07-01

... TOC emission rate, as specified under paragraph (f) of this section, the sampling site shall be after... process vent TOC mass flow rate is less than 33 kilograms per day for an existing source or less than 6.8... shall determine the TOC mass flow rate by the following procedures: (1) The sampling site shall be...

40 CFR 228.4 - Procedures for designation of sites.

Code of Federal Regulations, 2011 CFR

2011-07-01

... environmental studies of each site, regions adjacent to the site, and on historical knowledge of the impact of waste disposal on areas similar to such sites in physical, chemical, and biological characteristics. All studies for the evaluation and potential selection of dumping sites will be conducted in accordance with...

40 CFR 228.4 - Procedures for designation of sites.

Code of Federal Regulations, 2013 CFR

2013-07-01

... environmental studies of each site, regions adjacent to the site, and on historical knowledge of the impact of waste disposal on areas similar to such sites in physical, chemical, and biological characteristics. All studies for the evaluation and potential selection of dumping sites will be conducted in accordance with...

40 CFR 228.4 - Procedures for designation of sites.

Code of Federal Regulations, 2010 CFR

2010-07-01

... environmental studies of each site, regions adjacent to the site, and on historical knowledge of the impact of waste disposal on areas similar to such sites in physical, chemical, and biological characteristics. All studies for the evaluation and potential selection of dumping sites will be conducted in accordance with...

40 CFR 228.4 - Procedures for designation of sites.

Code of Federal Regulations, 2014 CFR

2014-07-01

... environmental studies of each site, regions adjacent to the site, and on historical knowledge of the impact of waste disposal on areas similar to such sites in physical, chemical, and biological characteristics. All studies for the evaluation and potential selection of dumping sites will be conducted in accordance with...

40 CFR 228.4 - Procedures for designation of sites.

Code of Federal Regulations, 2012 CFR

2012-07-01

... environmental studies of each site, regions adjacent to the site, and on historical knowledge of the impact of waste disposal on areas similar to such sites in physical, chemical, and biological characteristics. All studies for the evaluation and potential selection of dumping sites will be conducted in accordance with...

The VA Ostomy Health-Related Quality of Life Study: objectives, methods, and patient sample.

PubMed

Krouse, Robert S; Mohler, M Jane; Wendel, Christopher S; Grant, Marcia; Baldwin, Carol M; Rawl, Susan M; McCorkle, Ruth; Rosenfeld, Kenneth E; Ko, Clifford Y; Schmidt, C Max; Coons, Stephen Joel

2006-04-01

To present the design and methods of a multisite study of health-related quality of life (HR-QOL) in veterans living with ostomies. Veterans from Tucson, Indianapolis, and Los Angeles VA Medical Centers were surveyed using the validated City of Hope ostomy-specific tool (mCOH-QOL-Ostomy) and the SF-36V. Cases (ostomates) had a major gastrointestinal procedure that required an intestinal stoma, while controls had similar procedures for which an ostomy was not required. Ostomy subjects were recruited for four focus groups in each of two sites divided by ostomy type (colostomy versus ileostomy) and overall mCOH-QOL-Ostomy HR-QOL score (highest versus lowest quartile). The focus groups further evaluated barriers, concerns, and adaptation methods and skills. This report presents recruitment results, reliability of survey instruments, and demographic characteristics of the sample. The overall response (i.e., recruitment) rate across all sites was 48% and by site was 53%, 57%, and 37%, respectively (p < 0.001). Internal consistency reliability estimates indicated that both instruments remain reliable in this population (Cronbach's alpha for HR-QOL domains/scales: 0.71-0.96). Cases and controls were similar in demographic characteristics. Proportions of minority subjects matched projections from the site patient populations. Subjects with ostomies had significantly longer time since surgery than controls (p < 0.001). Focus groups were comprised of two to six subjects per group and demonstrated racial diversity at the Los Angeles site. The unique design of our study of VA patients with ostomies is an illustration of a successful mixed methods approach to HR-QOL research. We collected meaningful quantitative and qualitative data that will be used in the development of new approaches to care that will lead to improved functioning and well-being in persons living with ostomies. Subsequent reports will provide the results of this research project.

Detection of new HIV infections in a multicentre HIV antiretroviral pre-exposure prophylaxis trial.

PubMed

Fransen, Katrien; de Baetselier, Irith; Rammutla, Elizabeth; Ahmed, Khatija; Owino, Frederick; Agingu, Walter; Venter, Gustav; Deese, Jen; Van Damme, Lut; Crucitti, Tania

2017-08-01

Monthly specimens collected from FEM-PrEP-a Phase III trial [1] were investigated for the detection of acute HIV (AHI) infection. To evaluate the efficiency of the study-specific HIV algorithm in detecting AHI, and the performance of each of the serological and molecular tests used in diagnosing new infections, and their contribution to narrowing the window period. A total of 83 pre-seroconversion specimens from 61 seroconverters from the FEM-PrEP trial were further analyzed in a sub-study. During the trial, HIV seroconversion was diagnosed on site using a testing algorithm with simple/rapid tests (SRTs) and confirmed with a gold standard testing algorithm (see short communication: Fig. 1). The infection date was determined more accurately by the use of standard ELISAs and Nucleic Acid Amplification Tests (NAAT) in a look-back procedure. For this sub-study, the international central laboratory repeated the study algorithm using SRTs. A total of 83 pre-seroconversions specimens from 61 seroconverters were analyzed in a look-back procedure. RNA was detected in 35/61 seroconverters at the visit before the seroconversion visit as determined at the study sites. Four seroconversion dates were inaccurate at one study site as the international central laboratory detected the HIV infection one visit earlier using the same test algorithm. Using the gold standard, an additional seroconversion was detected at an earlier visit. The combined antigen/antibody and the single antigen test had a higher sensitivity compared to the SRTs in detecting acute infections. In the FEM-PrEP trial, the international central laboratory detected a small number of seroconversions one month earlier than the study sites using the same study algorithm. Standard tests are still the most sensitive tests in detecting pre-seroconversion or acute HIV infection, but they are costly, time consuming and not recommended for use on-site in a clinical trial. Copyright © 2017 Elsevier B.V. All rights reserved.

Topical simvastatin gel as a novel therapeutic modality for palatal donor site wound healing following free gingival graft procedure.

PubMed

Madi, Marwa; Kassem, Abeer

2018-04-01

Autogenous soft-tissue grafting is a commonly used procedure nowadays in dentistry. However, the prolonged healing time needed for the donor site leads to increase the patient's pain and discomfort. Statin has been observed to be beneficial in reducing bacterial burden, improving epithelization and wound healing. The aim of this study was to evaluate intra-oral topical application of simvastatin/chitosan gel (10 mg/mL) over the palatal donor site following free gingival graft (FGG) procedure. Subjects indicated for FGG procedure were divided into four groups. Group I: Simvastatin suspension (S), group II: simvastatin/chitosan gel (SC), group III: chitosan gel (C), group IV: petroleum gel (P). Treatment was applied three times/day for the following 7 days. Wound healing was evaluated at day 3, 7 and 14 post-surgery. A visual analogue scale (VAS) was used to measure the experienced discomfort at 1, 3, 5, 7 and 14 days. Statistical significant reduction in wound-healing scores was observed after 3 and 7 days for group II compared to other groups (p  = .015). A significant reduction was also observed in VAS score for group II compared to other groups at day 1, 3, 5 and 7. Topical application of S/C gel could be used as a novel therapeutic modality that improved healing and reduced pain in the palatal donor site following FGG procedure.

Quality control and assurance for validation of DOS/I measurements

NASA Astrophysics Data System (ADS)

Cerussi, Albert; Durkin, Amanda; Kwong, Richard; Quang, Timothy; Hill, Brian; Tromberg, Bruce J.; MacKinnon, Nick; Mantulin, William W.

2010-02-01

Ongoing multi-center clinical trials are crucial for Biophotonics to gain acceptance in medical imaging. In these trials, quality control (QC) and assurance (QA) are key to success and provide "data insurance". Quality control and assurance deal with standardization, validation, and compliance of procedures, materials and instrumentation. Specifically, QC/QA involves systematic assessment of testing materials, instrumentation performance, standard operating procedures, data logging, analysis, and reporting. QC and QA are important for FDA accreditation and acceptance by the clinical community. Our Biophotonics research in the Network for Translational Research in Optical Imaging (NTROI) program for breast cancer characterization focuses on QA/QC issues primarily related to the broadband Diffuse Optical Spectroscopy and Imaging (DOS/I) instrumentation, because this is an emerging technology with limited standardized QC/QA in place. In the multi-center trial environment, we implement QA/QC procedures: 1. Standardize and validate calibration standards and procedures. (DOS/I technology requires both frequency domain and spectral calibration procedures using tissue simulating phantoms and reflectance standards, respectively.) 2. Standardize and validate data acquisition, processing and visualization (optimize instrument software-EZDOS; centralize data processing) 3. Monitor, catalog and maintain instrument performance (document performance; modularize maintenance; integrate new technology) 4. Standardize and coordinate trial data entry (from individual sites) into centralized database 5. Monitor, audit and communicate all research procedures (database, teleconferences, training sessions) between participants ensuring "calibration". This manuscript describes our ongoing efforts, successes and challenges implementing these strategies.

Analysis of three tests of the unconfined aquifer in southern Nassau County, Long Island, New York

USGS Publications Warehouse

Lindner, J.B.; Reilly, T.E.

1982-01-01

Drawdown and recovery data from three 2-day aquifer tests (OF) the unconfined (water-table) aquifer in southern Nassau County, N.Y., during the fall of 1979, were analyzed. Several simple analytical solutions, a typecurve-matching procedure, and a Galerkin finite-element radial-flow model were used to determine hydraulic conductivity, ratio of horizontal to vertical hydraulic conductivity, and specific yield. Results of the curve-matching procedure covered a broad range of values that could be narrowed through consideration of data from other sources such as published reports, drillers ' logs, or values determined by analytical solutions. Analysis by the radial-flow model was preferred because it allows for vertical variability in aquifer properties and solves the system for all observation points simultaneously, whereas the other techniques treat the aquifer as homogeneous and must treat each observation well separately. All methods produced fairly consistent results. The ranges of aquifer values at the three sites were: horizontal hydraulic conductivity, 140 to 380 feet per day; transmissivity 11,200 to 17,100 feet squared per day; ratio of horizontal to vertical hydraulic conductivity 2.4:1 to 7:1, and specific yield , 0.13 to 0.23. (USGS)

Standardizing Flow Cytometry Immunophenotyping Analysis from the Human ImmunoPhenotyping Consortium

PubMed Central

Finak, Greg; Langweiler, Marc; Jaimes, Maria; Malek, Mehrnoush; Taghiyar, Jafar; Korin, Yael; Raddassi, Khadir; Devine, Lesley; Obermoser, Gerlinde; Pekalski, Marcin L.; Pontikos, Nikolas; Diaz, Alain; Heck, Susanne; Villanova, Federica; Terrazzini, Nadia; Kern, Florian; Qian, Yu; Stanton, Rick; Wang, Kui; Brandes, Aaron; Ramey, John; Aghaeepour, Nima; Mosmann, Tim; Scheuermann, Richard H.; Reed, Elaine; Palucka, Karolina; Pascual, Virginia; Blomberg, Bonnie B.; Nestle, Frank; Nussenblatt, Robert B.; Brinkman, Ryan Remy; Gottardo, Raphael; Maecker, Holden; McCoy, J Philip

2016-01-01

Standardization of immunophenotyping requires careful attention to reagents, sample handling, instrument setup, and data analysis, and is essential for successful cross-study and cross-center comparison of data. Experts developed five standardized, eight-color panels for identification of major immune cell subsets in peripheral blood. These were produced as pre-configured, lyophilized, reagents in 96-well plates. We present the results of a coordinated analysis of samples across nine laboratories using these panels with standardized operating procedures (SOPs). Manual gating was performed by each site and by a central site. Automated gating algorithms were developed and tested by the FlowCAP consortium. Centralized manual gating can reduce cross-center variability, and we sought to determine whether automated methods could streamline and standardize the analysis. Within-site variability was low in all experiments, but cross-site variability was lower when central analysis was performed in comparison with site-specific analysis. It was also lower for clearly defined cell subsets than those based on dim markers and for rare populations. Automated gating was able to match the performance of central manual analysis for all tested panels, exhibiting little to no bias and comparable variability. Standardized staining, data collection, and automated gating can increase power, reduce variability, and streamline analysis for immunophenotyping. PMID:26861911

DNA-mediated self-assembly of artificial vesicles.

PubMed

Hadorn, Maik; Eggenberger Hotz, Peter

2010-03-26

Although multicompartment systems made of single unilamellar vesicles offer the potential to outperform single compartment systems widely used in analytic, synthetic, and medical applications, their use has remained marginal to date. On the one hand, this can be attributed to the binary character of the majority of the current tethering protocols that impedes the implementation of real multicomponent or multifunctional systems. On the other hand, the few tethering protocols theoretically providing multicompartment systems composed of several distinct vesicle populations suffer from the readjustment of the vesicle formation procedure as well as from the loss of specificity of the linking mechanism over time. In previous studies, we presented implementations of multicompartment systems and resolved the readjustment of the vesicle formation procedure as well as the loss of specificity by using linkers consisting of biotinylated DNA single strands that were anchored to phospholipid-grafted biotinylated PEG tethers via streptavidin as a connector. The systematic analysis presented herein provides evidences for the incorporation of phospholipid-grafted biotinylated PEG tethers to the vesicle membrane during vesicle formation, providing specific anchoring sites for the streptavidin loading of the vesicle membrane. Furthermore, DNA-mediated vesicle-vesicle self-assembly was found to be sequence-dependent and to depend on the presence of monovalent salts. This study provides a solid basis for the implementation of multi-vesicle assemblies that may affect at least three distinct domains. (i) Analysis. Starting with a minimal system, the complexity of a bottom-up system is increased gradually facilitating the understanding of the components and their interaction. (ii) Synthesis. Consecutive reactions may be implemented in networks of vesicles that outperform current single compartment bioreactors in versatility and productivity. (iii) Personalized medicine. Transport and targeting of long-lived, pharmacologically inert prodrugs and their conversion to short-lived, active drug molecules directly at the site of action may be accomplished if multi-vesicle assemblies of predefined architecture are used.

Laparoendoscopic single-site Heller myotomy with anterior fundoplication for achalasia.

PubMed

Barry, Linda; Ross, Sharona; Dahal, Sujat; Morton, Connor; Okpaleke, Chinyere; Rosas, Melissa; Rosemurgy, Alexander S

2011-06-01

Laparoendoscopic single-site (LESS) surgery is beginning to include advanced laparoscopic operations such as Heller myotomy with anterior fundoplication. However, the efficacy of LESS Heller myotomy has not been established. This study aimed to evaluate the authors' initial experience with LESS Heller myotomy for achalasia. Transumbilical LESS Heller myotomy with concomitant anterior fundoplication for achalasia was undertaken for 66 patients after October 2007. Outcomes including operative time, complications, and length of hospital stay were recorded and compared with those for an earlier contiguous group of 66 consecutive patients undergoing conventional multi-incision laparoscopic Heller myotomy with anterior fundoplication. Symptoms before and after myotomy were scored by the patients using a Likert scale ranging from 0 (never/not severe) to 10 (always/very severe). Data were analyzed using the Mann-Whitney U test, the Wilcoxon matched-pairs test, and Fisher's exact test where appropriate. Patients undergoing LESS Heller myotomy were similar to those undergoing conventional laparoscopic Heller myotomy in gender, age, body mass index (BMI), blood loss, and length of hospital stay. However, the patients undergoing LESS Heller myotomies had operations of significantly longer duration (median, 117 vs. 93 min with the conventional laparoscopic approach) (p<0.003). For 11 patients (16%) undergoing LESS Heller myotomy, additional ports/incisions were required. No patients were converted to "open" operations, and no patients had procedure-specific complications. Symptom reduction was dramatic and satisfying after both LESS and conventional laparoscopic myotomy with fundoplication. The symptom reduction was similar with the two procedures. The LESS approach left no apparent umbilical scar. Heller myotomy with anterior fundoplication effectively treats achalasia. The findings showed LESS Heller myotomy with anterior fundoplication to be feasible, safe, and efficacious. Although the LESS approach increases operative time, it does not increase procedure-related morbidity or hospital length of stay and avoids apparent umbilical scarring. Laparoendoscopic single-site surgery represents a paradigm shift to more minimally invasive surgery and is applicable to advanced laparoscopic operations such as Heller myotomy and anterior fundoplication.

Towards computer-assisted TTTS: Laser ablation detection for workflow segmentation from fetoscopic video.

PubMed

Vasconcelos, Francisco; Brandão, Patrick; Vercauteren, Tom; Ourselin, Sebastien; Deprest, Jan; Peebles, Donald; Stoyanov, Danail

2018-06-27

Intrauterine foetal surgery is the treatment option for several congenital malformations. For twin-to-twin transfusion syndrome (TTTS), interventions involve the use of laser fibre to ablate vessels in a shared placenta. The procedure presents a number of challenges for the surgeon, and computer-assisted technologies can potentially be a significant support. Vision-based sensing is the primary source of information from the intrauterine environment, and hence, vision approaches present an appealing approach for extracting higher level information from the surgical site. In this paper, we propose a framework to detect one of the key steps during TTTS interventions-ablation. We adopt a deep learning approach, specifically the ResNet101 architecture, for classification of different surgical actions performed during laser ablation therapy. We perform a two-fold cross-validation using almost 50 k frames from five different TTTS ablation procedures. Our results show that deep learning methods are a promising approach for ablation detection. To our knowledge, this is the first attempt at automating photocoagulation detection using video and our technique can be an important component of a larger assistive framework for enhanced foetal therapies. The current implementation does not include semantic segmentation or localisation of the ablation site, and this would be a natural extension in future work.

Reasons for non-participation in an international multicenter trial of a new drug for tuberculosis treatment.

PubMed

Lamunu, D; Chapman, K N; Nsubuga, P; Muzanyi, G; Mulumba, Y; Mugerwa, M A; Goldberg, S; Bozeman, L; Engle, M; Saukkonen, J; Mastranunzio, S; Mayanja-Kizza, H; Johnson, J L

2012-04-01

Clinical trials can provide a high standard of patient care and contribute to scientific knowledge; however, only a fraction of the patients screened participate and receive treatment as part of a trial. To explore reasons why patients were not enrolled in an international tuberculosis (TB) treatment trial and to compare experiences among study sites. An analysis of reasons why patients were not enrolled was conducted among patients screened for a TB clinical trial at 26 sites in North and South America, Africa, and Europe. Staff at study sites screened 1119 potential candidates for the trial: 61% (n = 686) were not enrolled due to 1) failure to meet eligibility criteria (n = 405, 59%), 2) site's decision (n = 168, 24%), or 3) candidate's choice (n = 113, 16%). Study staff recorded a total of 144 reasons for why they believed patients chose not to participate, including concerns over research (28%), conflicts with work or school (21%), and lifestyle and family issues (20%). Socio-demographic and geographic factors also influenced participation. Increased evaluation of screening outcomes and of specific interventions, such as improved education and communication about trial procedures, may increase the efficiency of screening and enrollment in clinical trials.

Immobilization of metals in contaminated soil from E-waste recycling site by dairy-manure-derived biochar.

PubMed

Chen, Zhiliang; Zhang, Jianqiang; Liu, Minchao; Wu, Yingxin; Yuan, Zhihui

2017-08-24

E-waste is a growing concern around the world and varieties of abandoned E-waste recycling sites, especially in urban area, need to remediate immediately. The impacts of dairy-manure-derived biochars (BCs) on the amelioration of soil properties, the changes in the morphologies as well as the mobility of metals were studied to test their efficacy in immobilization of metals for a potential restoration of vegetation landscape in abandoned E-waste recycling site. The amendment with BCs produced positive effects on bioavailability and mobility reduction for Pb, Cd, Zn and Cu depending on BC ratio and incubation time. The BCs promoted the transformation of species of heavy metals to a more stable fraction, and the metals concentrations in Toxicity Characteristic Leaching Procedure extract declined significantly, especially Pb and Cu. Besides, the BCs ameliorated the substrate with increasing the soil pH, cations exchangeable capacity and available phosphorous, which suggested BC as a potential amendment material for abandoned E-waste recycling sites before restoration of vegetation landscape. Generally, the BC modified by alkaline treatment has a higher efficacy, probably due to increase of specific surface area and porosity as well as the functional groups after alkaline treatment.

Technical approach to groundwater restoration. Final report

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

Not Available

1993-11-01

The Technical Approach to Groundwater Restoration (TAGR) provides general technical guidance to implement the groundwater restoration phase of the Uranium Mill Tailings Remedial Action (UMTRA) Project. The TAGR includes a brief overview of the surface remediation and groundwater restoration phases of the UMTRA Project and describes the regulatory requirements, the National Environmental Policy Act (NEPA) process, and regulatory compliance. A section on program strategy discusses program optimization, the role of risk assessment, the observational approach, strategies for meeting groundwater cleanup standards, and remedial action decision-making. A section on data requirements for groundwater restoration evaluates the data quality objectives (DQO) andmore » minimum data required to implement the options and comply with the standards. A section on sits implementation explores the development of a conceptual site model, approaches to site characterization, development of remedial action alternatives, selection of the groundwater restoration method, and remedial design and implementation in the context of site-specific documentation in the site observational work plan (SOWP) and the remedial action plan (RAP). Finally, the TAGR elaborates on groundwater monitoring necessary to evaluate compliance with the groundwater cleanup standards and protection of human health and the environment, and outlines licensing procedures.« less

Water dissociating on rigid Ni(100): A quantum dynamics study on a full-dimensional potential energy surface

NASA Astrophysics Data System (ADS)

Liu, Tianhui; Chen, Jun; Zhang, Zhaojun; Shen, Xiangjian; Fu, Bina; Zhang, Dong H.

2018-04-01

We constructed a nine-dimensional (9D) potential energy surface (PES) for the dissociative chemisorption of H2O on a rigid Ni(100) surface using the neural network method based on roughly 110 000 energies obtained from extensive density functional theory (DFT) calculations. The resulting PES is accurate and smooth, based on the small fitting errors and the good agreement between the fitted PES and the direct DFT calculations. Time dependent wave packet calculations also showed that the PES is very well converged with respect to the fitting procedure. The dissociation probabilities of H2O initially in the ground rovibrational state from 9D quantum dynamics calculations are quite different from the site-specific results from the seven-dimensional (7D) calculations, indicating the importance of full-dimensional quantum dynamics to quantitatively characterize this gas-surface reaction. It is found that the validity of the site-averaging approximation with exact potential holds well, where the site-averaging dissociation probability over 15 fixed impact sites obtained from 7D quantum dynamics calculations can accurately approximate the 9D dissociation probability for H2O in the ground rovibrational state.

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

Jacob, Reed B.; Ding, Feng; Ye, Dongmei

Organophosphates are widely used for peaceful (agriculture) and military purposes (chemical warfare agents). The extraordinary toxicity of organophosphates and the risk of deployment, make it critical to develop means for their rapid and efficient deactivation. Organophosphate hydrolase (OPH) already plays an important role in organophosphate remediation, but is insufficient for therapeutic or prophylactic purposes primarily due to low substrate affinity. Current efforts focus on directly modifying the active site to differentiate substrate specificity and increase catalytic activity. Here, we present a novel strategy for enhancing the general catalytic efficiency of OPH through computational redesign of the residues that are allostericallymore » coupled to the active site and validated our design by mutagenesis. Specifically, we identify five such hot-spot residues for allosteric regulation and assay these mutants for hydrolysis activity against paraoxon, a chemical-weapons simulant. A high percentage of the predicted mutants exhibit enhanced activity over wild-type (k cat =16.63 s -1), such as T199I/T54I (899.5 s -1) and C227V/T199I/T54I (848 s -1), while the Km remains relatively unchanged in our high-throughput cell-free expression system. Further computational studies of protein dynamics reveal four distinct distal regions coupled to the active site that display significant changes in conformation dynamics upon these identified mutations. These results validate a computational design method that is both efficient and easily adapted as a general procedure for enzymatic enhancement.« less

COUP-TF (chicken ovalbumin upstream promoter transcription factor)-interacting protein 1 (CTIP1) is a sequence-specific DNA binding protein.

PubMed Central

Avram, Dorina; Fields, Andrew; Senawong, Thanaset; Topark-Ngarm, Acharawan; Leid, Mark

2002-01-01

Chicken ovalbumin upstream promoter transcription factor (COUP-TF)-interacting proteins 1 and 2 [CTIP1/Evi9/B cell leukaemia (Bcl) l1a and CTIP2/Bcl11b respectively] are highly related C(2)H(2) zinc finger proteins that are abundantly expressed in brain and the immune system, and are associated with immune system malignancies. A selection procedure was employed to isolate high-affinity DNA binding sites for CTIP1. The core binding site on DNA identified in these studies, 5'-GGCCGG-3' (upper strand), is highly related to the canonical GC box and was bound by a CTIP1 oligomeric complex(es) in vitro. Furthermore, both CTIP1 and CTIP2 repressed transcription of a reporter gene harbouring a multimerized CTIP binding site, and this repression was neither reversed by trichostatin A (an inhibitor of known class I and II histone deacetylases) nor stimulated by co-transfection of a COUP-TF family member. These results demonstrate that CTIP1 is a sequence-specific DNA binding protein and a bona fide transcriptional repressor that is capable of functioning independently of COUP-TF family members. These findings may be relevant to the physiological and/or pathological action(s) of CTIPs in cells that do not express COUP-TF family members, such as cells of the haematopoietic and immune systems. PMID:12196208

Resistance to Biocides in Listeria monocytogenes Collected in Meat-Processing Environments

PubMed Central

Conficoni, Daniele; Losasso, Carmen; Cortini, Enzo; Di Cesare, Andrea; Cibin, Veronica; Giaccone, Valerio; Corno, Gianluca; Ricci, Antonia

2016-01-01

The emergence of microorganisms exerting resistance to biocides is a challenge to meat-processing environments. Bacteria can be intrinsically resistant to biocides but resistance can also be acquired by adaptation to their sub-lethal concentrations. Moreover, the presence of biocide resistance determinants, which is closely linked to antibiotic resistance determinants, could lead to co-selection during disinfection practices along the food chain, and select cross-resistant foodborne pathogens. The purpose of this work was to test the resistance of wild strains of Listeria monocytogenes, isolated from pork meat processing plants, toward benzalkonium chloride (BC), used as proxy of quaternary ammonium compounds. Furthermore, the expression of two non-specific efflux pumps genes (lde and mdrL) under biocide exposure was evaluated. L. monocytogenes were isolated from five processing plants located in the Veneto region (northeast of Italy) before and after cleaning and disinfection (C&D) procedures. A total of 45 strains were collected: 36 strains before and nine after the C&D procedures. Collected strains were typed according to MLST and ERIC profiles. Strains sampled in the same site, isolated before, and after the C&D procedures and displaying the same MLST and ERIC profiles were tested for their sensitivity to different concentrations of BC, in a time course assay. The expression of non-specific efflux pumps was evaluated at each time point by qPCR using tufA gene as housekeeping. A differential expression of the two investigated genes was observed: lde was found to be more expressed by the strains isolated before C&D procedures while its expression was dose-dependent in the case of the post C&D procedures strain. On the contrary, the expression of mdrL was inhibited under low biocidal stress (10 ppm BC) and enhanced in the presence of high stress (100 ppm BC). These findings suggests a possible role for C&D procedures to select L. monocytogenes persisters, pointing out the importance of dealing with the identification of risk factors in food plants sanification procedures that might select more tolerant strains. PMID:27807430

Is Adam worth more than Eve? The financial impact of gender bias in the federal reimbursement of gynecological procedures.

PubMed

Goff, B A; Muntz, H G; Cain, J M

1997-03-01

On January 1, 1992, Congress implemented a Medicare payment system based on relative value units (RVU). The RVU multiplied by a dollar conversion factor sets the reimbursement for all procedures covered by Medicare and many other private insurers. This study was undertaken to evaluate discrepancies in federal reimbursement for gender-specific procedures. Using the December 1995 Federal Register and the regional Medicare conversion factor ($40.08/RVU), we compared the work RVU and total reimbursement of 24 groups of gender-specific surgical procedures. The groups were matched as carefully as possible so that the amount of work and level of difficulty would be similar, if not identical. Some examples of comparisons are as follows: biopsy of male vs female genitals, hysterectomy vs prostatectomy, staging for ovarian vs testicular cancer, and exenteration for cervical vs prostate cancer. In the 24 matched procedures, the male-specific procedures were reimbursed at a higher amount in 19 (79%) cases. The female-specific procedures were reimbursed at a higher amount in 3 (12%) cases (P = 0.004). There was no difference in reimbursement for two of the comparisons. Overall, we found that male-specific procedures are reimbursed at an amount which is 44% higher than female-specific procedures. Comparison of work RVU revealed that male-specific procedures were assigned higher values in 19 cases and, overall, male gender-related surgeries had work RVU that were 50% higher than female gender-related surgeries. There is significant gender bias against the Medicare reimbursement of female-specific services. This results in a lower net reimbursement for gynecologic procedures. In addition, since many private sector insurance carriers now use the resource-based relative value scale system, this gender bias is further potentiated.

Scientific evaluation and pricing of medical devices and associated procedures in France.

PubMed

Gilard, Martine; Debroucker, Frederique; Dubray, Claude; Allioux, Yves; Aper, Eliane; Barat-Leonhardt, Valérie; Brami, Michèle; Carbonneil, Cédric; Chartier-Kastler, Emmanuel; Coqueblin, Claire; Fare, Sandrine; Giri, Isabelle; Goehrs, Jean-Marie; Levesque, Karine; Maugendre, Philippe; Parquin, François; Sales, Jean-Patrick; Szwarcensztein, Karine

2013-01-01

Medical devices are many and various, ranging from tongue spatulas to implantable or invasive devices and imaging machines; their lifetimes are short, between 18 months and 5 years, due to incessant incremental innovation; and they are operator-dependent: in general, the clinical user performs a fitting procedure (hip implant or pacemaker), a therapeutic procedure using a non-implantable invasive device (arrhythmic site ablation probe, angioplasty balloon, extension spondyloplasty system, etc.) or follow-up of an active implanted device (long-term follow-up of an implanted cardiac defibrillator or of a deep brain stimulator in Parkinson's patients). A round-table held during the XXVIII(th) Giens Workshops meeting focused on the methodology of scientific evaluation of medical devices and the associated procedures with a view to their pricing and financing by the French National Health Insurance system. The working hypothesis was that the available data-set was sufficient for and compatible with scientific evaluation with clinical benefit. Post-registration studies, although contributing to the continuity of assessment, were not dealt with. Moreover, the focus was restricted to devices used in health establishments, where the association between devices and technical medical procedures is optimally representative. An update of the multiple regulatory protocols governing medical devices and procedures is provided. Issues more specifically related to procedures as such, to non-implantable devices and to innovative devices are then dealt with, and the proposals and discussion points raised at the round-table for each of these three areas are presented. © 2013 Société Française de Pharmacologie et de Thérapeutique.

Site-selective and stereoselective functionalization of non-activated tertiary C-H bonds

NASA Astrophysics Data System (ADS)

Liao, Kuangbiao; Pickel, Thomas C.; Boyarskikh, Vyacheslav; Bacsa, John; Musaev, Djamaladdin G.; Davies, Huw M. L.

2017-11-01

The synthesis of complex organic compounds usually relies on controlling the reactions of the functional groups. In recent years, it has become possible to carry out reactions directly on the C-H bonds, previously considered to be unreactive. One of the major challenges is to control the site-selectivity because most organic compounds have many similar C-H bonds. The most well developed procedures so far rely on the use of substrate control, in which the substrate has one inherently more reactive C-H bond or contains a directing group or the reaction is conducted intramolecularly so that a specific C-H bond is favoured. A more versatile but more challenging approach is to use catalysts to control which site in the substrate is functionalized. p450 enzymes exhibit C-H oxidation site-selectivity, in which the enzyme scaffold causes a specific C-H bond to be functionalized by placing it close to the iron-oxo haem complex. Several studies have aimed to emulate this enzymatic site-selectivity with designed transition-metal catalysts but it is difficult to achieve exceptionally high levels of site-selectivity. Recently, we reported a dirhodium catalyst for the site-selective functionalization of the most accessible non-activated (that is, not next to a functional group) secondary C-H bonds by means of rhodium-carbene-induced C-H insertion. Here we describe another dirhodium catalyst that has a very different reactivity profile. Instead of the secondary C-H bond, the new catalyst is capable of precise site-selectivity at the most accessible tertiary C-H bonds. Using this catalyst, we modify several natural products, including steroids and a vitamin E derivative, indicating the applicability of this method of synthesis to the late-stage functionalization of complex molecules. These studies show it is possible to achieve site-selectivity at different positions within a substrate simply by selecting the appropriate catalyst. We hope that this work will inspire the design of even more sophisticated catalysts, such that catalyst-controlled C-H functionalization becomes a broadly applied strategy for the synthesis of complex molecules.

Characteristics of the patient with an ostomy.

PubMed

Pittman, Joyce

2011-01-01

Complications following intestinal and urinary diversion (OSTOMY) surgery are a significant problem for many individuals. Patient characteristics or risk factors have been associated with the development of ostomy complications, but research in this area is limited. To examine the demographic and clinical characteristics of new ostomy patients. Descriptive, cross-sectional study. A convenience sample of 144 new ostomy patients was recruited from a large midwest urban level i trauma teaching hospital system. A descriptive, cross-sectional design was used to examine the demographic and clinical characteristics in persons with a new ostomy. demographic and clinical characteristics included were age, gender, disposition, diagnosis, ostomy type, type of procedure (emergent or elective), stoma type (temporary or permanent), technique of stoma creation (loop or end), stoma site marked preoperatively, body type, stoma height, and complicating factors. Data were collected through a medical record review and direct observation by the WOC nurse. Significant differences were found among demographic and clinical characteristics and ostomy type and disposition. Age, type of procedure, reason for surgery, stoma type, stoma site marking, and complicating factors were significantly different by ostomy type. The majority of stomas were not marked preoperatively (67%). Sixty-eight percent of persons with a stoma above skin level versus 38% with a stoma below skin level were discharged to their home. Statistically significant relationships were found among disposition and type of procedure (P = .036), stoma height (P = .003), reason for surgery (P = .000), and age (P = .005). This study provides additional information regarding specific patient characteristics (demographic and clinical) and their relationship to ostomy type and disposition.

Statistical and Economic Techniques for Site-specific Nematode Management.

PubMed

Liu, Zheng; Griffin, Terry; Kirkpatrick, Terrence L

2014-03-01

Recent advances in precision agriculture technologies and spatial statistics allow realistic, site-specific estimation of nematode damage to field crops and provide a platform for the site-specific delivery of nematicides within individual fields. This paper reviews the spatial statistical techniques that model correlations among neighboring observations and develop a spatial economic analysis to determine the potential of site-specific nematicide application. The spatial econometric methodology applied in the context of site-specific crop yield response contributes to closing the gap between data analysis and realistic site-specific nematicide recommendations and helps to provide a practical method of site-specifically controlling nematodes.

Context-dependent environmental quality standards of soil nitrate for terrestrial plant communities.

PubMed

van Goethem, Thomas M W J; Schipper, Aafke M; Wamelink, G W Wieger; Huijbregts, Mark A J

2016-10-01

Environmental quality standards (EQS) specify the maximum permissible concentration or level of a specific environmental stressor. Here, a procedure is proposed to derive EQS that are specific to a representative species pool and conditional on confounding environmental factors. To illustrate the procedure, a dataset was used with plant species richness observations of grasslands and forests and accompanying soil nitrate-N and pH measurements collected from 981 sampling sites in the Netherlands. Species richness was related to soil nitrate-N and pH with quantile regression allowing for interaction effects. The resulting regression models were used to derive EQS for nitrate conditional on pH, quantified as the nitrate-N concentrations at a specific pH level corresponding with a species richness equal to 95% of the species pool, for both grasslands and forest communities. The EQS varied between 1.8 mg/kg nitrate-N at pH 9-65 mg/kg nitrate-N at pH 4. EQS for forests and grasslands were similar, but EQS based on Red List species richness were considerably lower (more stringent) than those based on overall species richness, particularly at high pH levels. The results indicate that both natural background pH conditions and Red List species are important factors to consider in the derivation of EQS for soil nitrate-N for terrestrial ecosystems. Copyright © 2016 Elsevier Ltd. All rights reserved.

FAIRE (Formaldehyde-Assisted Isolation of Regulatory Elements) isolates active regulatory elements from human chromatin

PubMed Central

Giresi, Paul G.; Kim, Jonghwan; McDaniell, Ryan M.; Iyer, Vishwanath R.; Lieb, Jason D.

2007-01-01

DNA segments that actively regulate transcription in vivo are typically characterized by eviction of nucleosomes from chromatin and are experimentally identified by their hypersensitivity to nucleases. Here we demonstrate a simple procedure for the isolation of nucleosome-depleted DNA from human chromatin, termed FAIRE (Formaldehyde-Assisted Isolation of Regulatory Elements). To perform FAIRE, chromatin is crosslinked with formaldehyde in vivo, sheared by sonication, and phenol-chloroform extracted. The DNA recovered in the aqueous phase is fluorescently labeled and hybridized to a DNA microarray. FAIRE performed in human cells strongly enriches DNA coincident with the location of DNaseI hypersensitive sites, transcriptional start sites, and active promoters. Evidence for cell-type–specific patterns of FAIRE enrichment is also presented. FAIRE has utility as a positive selection for genomic regions associated with regulatory activity, including regions traditionally detected by nuclease hypersensitivity assays. PMID:17179217

A novel SPECT camera for molecular imaging of the prostate

NASA Astrophysics Data System (ADS)

Cebula, Alan; Gilland, David; Su, Li-Ming; Wagenaar, Douglas; Bahadori, Amir

2011-10-01

The objective of this work is to develop an improved SPECT camera for dedicated prostate imaging. Complementing the recent advancements in agents for molecular prostate imaging, this device has the potential to assist in distinguishing benign from aggressive cancers, to improve site-specific localization of cancer, to improve accuracy of needle-guided prostate biopsy of cancer sites, and to aid in focal therapy procedures such as cryotherapy and radiation. Theoretical calculations show that the spatial resolution/detection sensitivity of the proposed SPECT camera can rival or exceed 3D PET and further signal-to-noise advantage is attained with the better energy resolution of the CZT modules. Based on photon transport simulation studies, the system has a reconstructed spatial resolution of 4.8 mm with a sensitivity of 0.0001. Reconstruction of a simulated prostate distribution demonstrates the focal imaging capability of the system.

Merlin: Computer-Aided Oligonucleotide Design for Large Scale Genome Engineering with MAGE.

PubMed

Quintin, Michael; Ma, Natalie J; Ahmed, Samir; Bhatia, Swapnil; Lewis, Aaron; Isaacs, Farren J; Densmore, Douglas

2016-06-17

Genome engineering technologies now enable precise manipulation of organism genotype, but can be limited in scalability by their design requirements. Here we describe Merlin ( http://merlincad.org ), an open-source web-based tool to assist biologists in designing experiments using multiplex automated genome engineering (MAGE). Merlin provides methods to generate pools of single-stranded DNA oligonucleotides (oligos) for MAGE experiments by performing free energy calculation and BLAST scoring on a sliding window spanning the targeted site. These oligos are designed not only to improve recombination efficiency, but also to minimize off-target interactions. The application further assists experiment planning by reporting predicted allelic replacement rates after multiple MAGE cycles, and enables rapid result validation by generating primer sequences for multiplexed allele-specific colony PCR. Here we describe the Merlin oligo and primer design procedures and validate their functionality compared to OptMAGE by eliminating seven AvrII restriction sites from the Escherichia coli genome.

A survey of whitewater recreation impacts along five West Virginia rivers

USGS Publications Warehouse

Leung, Y.-F.; Marion, J.L.

1998-01-01

Results are reported from an assessment of whitewater river recreation impacts at river accesses and recreation sites along five West Virginia rivers: the New, Gauley, Cheat, Tygart, and Shenandoah. Procedures were developed and applied to assess resource conditions on 24 river access roads, 68 river accesses, and 151 recreation sites. The majority of river accesses and recreation sites are located on the New and Gauley rivers, which account for most of the state?s whitewater recreation use. Site conditions are variable. While some river accesses and sites are situated on resistant rocky substrates, many are poorly designed and/or located on erodible soil and sand substrates. Recreation site sizes and other areal measures of site disturbance are quite large, coincident with the large group sizes associated with commercially outfitted whitewater rafting trips. Recommendations are offered for managing river accesses and sites and whitewater visitation and the selection of indicators and standards as part of a Limits of Acceptable Change management process. Procedures and recommendations for continued visitor impact monitoring are also offered.

Guidance on Initial Site Assessment at Corrective Action Sites

EPA Pesticide Factsheets

Guidance to be used to conduct Corrective Action site assessment efforts. Informs Resource Conservation and Recovery Act (RCRA) permit writers and enforcement officials of procedures to be used in conducting RCRA Facility Assessments.

Clustering and Bayesian hierarchical modeling for the definition of informative prior distributions in hydrogeology

NASA Astrophysics Data System (ADS)

Cucchi, K.; Kawa, N.; Hesse, F.; Rubin, Y.

2017-12-01

In order to reduce uncertainty in the prediction of subsurface flow and transport processes, practitioners should use all data available. However, classic inverse modeling frameworks typically only make use of information contained in in-situ field measurements to provide estimates of hydrogeological parameters. Such hydrogeological information about an aquifer is difficult and costly to acquire. In this data-scarce context, the transfer of ex-situ information coming from previously investigated sites can be critical for improving predictions by better constraining the estimation procedure. Bayesian inverse modeling provides a coherent framework to represent such ex-situ information by virtue of the prior distribution and combine them with in-situ information from the target site. In this study, we present an innovative data-driven approach for defining such informative priors for hydrogeological parameters at the target site. Our approach consists in two steps, both relying on statistical and machine learning methods. The first step is data selection; it consists in selecting sites similar to the target site. We use clustering methods for selecting similar sites based on observable hydrogeological features. The second step is data assimilation; it consists in assimilating data from the selected similar sites into the informative prior. We use a Bayesian hierarchical model to account for inter-site variability and to allow for the assimilation of multiple types of site-specific data. We present the application and validation of the presented methods on an established database of hydrogeological parameters. Data and methods are implemented in the form of an open-source R-package and therefore facilitate easy use by other practitioners.

Efficacy and Safety of a Hyaluronic Acid Filler to Correct Aesthetically Detracting or Deficient Features of the Asian Nose: A Prospective, Open-Label, Long-Term Study

PubMed Central

Liew, Steven; Scamp, Terrence; de Maio, Mauricio; Halstead, Michael; Johnston, Nicole; Silberberg, Michael; Rogers, John D.

2016-01-01

Background There is increasing interest among patients and plastic surgeons for alternatives to rhinoplasty, a common surgical procedure performed in Asia. Objectives To evaluate the safety, efficacy, and longevity of a hyaluronic acid filler in the correction of aesthetically detracting or deficient features of the Asian nose. Methods Twenty-nine carefully screened Asian patients had their noses corrected with the study filler (Juvéderm VOLUMA [Allergan plc, Dublin, Ireland] with lidocaine injectable gel), reflecting individualized treatment goals and utilizing a standardized injection procedure, and were followed for over 12 months. Results A clinically meaningful correction (≥1 grade improvement on the Assessment of Aesthetic Improvement Scale) was achieved in 27 (93.1%) patients at the first follow-up visit. This was maintained in 28 (96.6%) patients at the final visit, based on the independent assessments of a central non-injecting physician and the patients. At this final visit, 23 (79.3%) patients were satisfied or very satisfied with the study filler and 25 (86.2%) would recommend it to others. In this small series of patients, there were no serious adverse events (AEs), with all treatment-related AEs being mild to moderate, transient injection site reactions, unrelated to the study filler. Conclusions Using specific eligibility criteria, individualized treatment goals, and a standardized injection procedure, the study filler corrected aesthetically detracting or deficient features of the Asian nose, with the therapeutic effects lasting for over 12 months, consistent with a high degree of patient satisfaction. This study supports the safety and efficacy of this HA filler for specific nose augmentation procedures in selected Asian patients. Level of Evidence: 3 Therapeutic PMID:27301371

Inverse load calculation procedure for offshore wind turbines and application to a 5-MW wind turbine support structure: Inverse load calculation procedure for offshore wind turbines

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

Pahn, T.; Rolfes, R.; Jonkman, J.

A significant number of wind turbines installed today have reached their designed service life of 20 years, and the number will rise continuously. Most of these turbines promise a more economical performance if they operate for more than 20 years. To assess a continued operation, we have to analyze the load-bearing capacity of the support structure with respect to site-specific conditions. Such an analysis requires the comparison of the loads used for the design of the support structure with the actual loads experienced. This publication presents the application of a so-called inverse load calculation to a 5-MW wind turbine supportmore » structure. The inverse load calculation determines external loads derived from a mechanical description of the support structure and from measured structural responses. Using numerical simulations with the software fast, we investigated the influence of wind-turbine-specific effects such as the wind turbine control or the dynamic interaction between the loads and the support structure to the presented inverse load calculation procedure. fast is used to study the inverse calculation of simultaneously acting wind and wave loads, which has not been carried out until now. Furthermore, the application of the inverse load calculation procedure to a real 5-MW wind turbine support structure is demonstrated. In terms of this practical application, setting up the mechanical system for the support structure using measurement data is discussed. The paper presents results for defined load cases and assesses the accuracy of the inversely derived dynamic loads for both the simulations and the practical application.« less

Quantification of source uncertainties in Seismic Probabilistic Tsunami Hazard Analysis (SPTHA)

NASA Astrophysics Data System (ADS)

Selva, J.; Tonini, R.; Molinari, I.; Tiberti, M. M.; Romano, F.; Grezio, A.; Melini, D.; Piatanesi, A.; Basili, R.; Lorito, S.

2016-06-01

We propose a procedure for uncertainty quantification in Probabilistic Tsunami Hazard Analysis (PTHA), with a special emphasis on the uncertainty related to statistical modelling of the earthquake source in Seismic PTHA (SPTHA), and on the separate treatment of subduction and crustal earthquakes (treated as background seismicity). An event tree approach and ensemble modelling are used in spite of more classical approaches, such as the hazard integral and the logic tree. This procedure consists of four steps: (1) exploration of aleatory uncertainty through an event tree, with alternative implementations for exploring epistemic uncertainty; (2) numerical computation of tsunami generation and propagation up to a given offshore isobath; (3) (optional) site-specific quantification of inundation; (4) simultaneous quantification of aleatory and epistemic uncertainty through ensemble modelling. The proposed procedure is general and independent of the kind of tsunami source considered; however, we implement step 1, the event tree, specifically for SPTHA, focusing on seismic source uncertainty. To exemplify the procedure, we develop a case study considering seismic sources in the Ionian Sea (central-eastern Mediterranean Sea), using the coasts of Southern Italy as a target zone. The results show that an efficient and complete quantification of all the uncertainties is feasible even when treating a large number of potential sources and a large set of alternative model formulations. We also find that (i) treating separately subduction and background (crustal) earthquakes allows for optimal use of available information and for avoiding significant biases; (ii) both subduction interface and crustal faults contribute to the SPTHA, with different proportions that depend on source-target position and tsunami intensity; (iii) the proposed framework allows sensitivity and deaggregation analyses, demonstrating the applicability of the method for operational assessments.

Basin F Overburden and Soil Sampling and Analysis Study, Rocky Mountain Arsenal

DTIC Science & Technology

1982-05-01

boring sites will be es:ablished via standard :and surveyinS procedures. 3.3 Bor-ng/ Samaling Procidures Upon staking/marking of the bore holes, the folloi...procedure until the interferences have been eliminated. 3.2.2 Samale Testing Step OC (6) (Procedure Blank) The procedure blank consists of the

Periodontal regeneration around natural teeth.

PubMed

Garrett, S

1996-11-01

1. Evidence is conclusive (Table 2) that periodontal regeneration in humans is possible following the use of bone grafts, guided tissue regeneration procedures, both without and in combination with bone grafts, and root demineralization procedures. 2. Clinically guided tissue regeneration procedures have demonstrated significant positive clinical change beyond that achieved with debridement alone in treating mandibular and maxillary (buccal only) Class II furcations. Similar data exist for intraosseous defects. Evidence suggests that the use of bone grafts or GTR procedures produce equal clinical benefit in treating intraosseous defects. Further research is necessary to evaluate GTR procedures compared to, or combined with, bone grafts in treating intraosseous defects. 3. Although there are some data suggesting hopeful results in Class II furcations, the clinical advantage of procedures combining present regenerative techniques remains to be demonstrated. Additional randomized controlled trials with sufficient power are needed to demonstrate the potential usefulness of these techniques. 4. Outcomes following regenerative attempts remain somewhat variable with differences in results between studies and individual subjects. Some of this variability is likely patient related in terms of compliance with plaque control and maintenance procedures, as well as personal habits; e.g., smoking. Variations in the defects selected for study may also affect predictability of outcomes along with other factors. 5. There is evidence to suggest that present regenerative techniques lead to significant amounts of regeneration at localized sites on specific teeth. However, if complete regeneration is to become a reality, additional stimuli to enhance the regenerative process are likely needed. Perhaps this will be accomplished in the future, with combined procedures that include appropriate polypeptide growth factors or tissue factors to provide additional stimulus.

Estimating design-flood discharges for streams in Iowa using drainage-basin and channel-geometry characteristics

USGS Publications Warehouse

Eash, D.A.

1993-01-01

Procedures provided for applying the drainage-basin and channel-geometry regression equations depend on whether the design-flood discharge estimate is for a site on an ungaged stream, an ungaged site on a gaged stream, or a gaged site. When both a drainage-basin and a channel-geometry regression-equation estimate are available for a stream site, a procedure is presented for determining a weighted average of the two flood estimates. The drainage-basin regression equations are applicable to unregulated rural drainage areas less than 1,060 square miles, and the channel-geometry regression equations are applicable to unregulated rural streams in Iowa with stabilized channels.

A policy system for Grid Management and Monitoring

NASA Astrophysics Data System (ADS)

Stagni, Federico; Santinelli, Roberto; LHCb Collaboration

2011-12-01

Organizations using a Grid computing model are faced with non-traditional administrative challenges: the heterogeneous nature of the underlying resources requires professionals acting as Grid Administrators. Members of a Virtual Organization (VO) can use a subset of available resources and services in the grid infrastructure and in an ideal world, the more resoures are exploited the better. In the real world, the less faulty services, the better: experienced Grid administrators apply procedures for adding and removing services, based on their status, as it is reported by an ever-growing set of monitoring tools. When a procedure is agreed and well-exercised, a formal policy could be derived. For this reason, using the DIRAC framework in the LHCb collaboration, we developed a policy system that can enforce management and operational policies, in a VO-specific fashion. A single policy makes an assessment on the status of a subject, relative to one or more monitoring information. Subjects of the policies are monitored entities of an established Grid ontology. The status of a same entity is evaluated against a number of policies, whose results are then combined by a Policy Decision Point. Such results are enforced in a Policy Enforcing Point, which provides plug-ins for actions, like raising alarms, sending notifications, automatic addition and removal of services and resources from the Grid mask. Policy results are shown in the web portal, and site-specific views are provided also. This innovative system provides advantages in terms of procedures automation, information aggregation and problem solving.

Orbital Reconstruction: Patient-Specific Orbital Floor Reconstruction Using a Mirroring Technique and a Customized Titanium Mesh.

PubMed

Tarsitano, Achille; Badiali, Giovanni; Pizzigallo, Angelo; Marchetti, Claudio

2016-10-01

Enophthalmos is a severe complication of primary reconstruction of orbital floor fractures. The goal of secondary reconstruction procedures is to restore symmetrical globe positions to recover function and aesthetics. The authors propose a new method of orbital floor reconstruction using a mirroring technique and a customized titanium mesh, printed using a direct metal laser-sintering method. This reconstructive protocol involves 4 steps: mirroring of the healthy orbit at the affected site, virtual design of a patient-specific orbital floor mesh, CAM procedures for direct laser-sintering of the customized titanium mesh, and surgical insertion of the device. Using a computed tomography data set, the normal, uninjured side of the craniofacial skeleton was reflected onto the contralateral injured side, and a reconstructive orbital floor mesh was designed virtually on the mirrored orbital bone surface. The solid-to-layer files of the mesh were then manufactured using direct metal laser sintering, which resolves the shaping and bending biases inherent in the indirect method. An intraoperative navigation system ensured accuracy of the entire procedure. Clinical outcomes were assessed using 3dMD photogrammetry and computed tomography data in 7 treated patients. The technique described here appears to be a viable method to correct complex orbital floor defects needing delayed reconstruction. This study represents the first step in the development of a wider experimental protocol for orbital floor reconstruction using computer-assisted design-computer-assisted manufacturing technology.

Can Internet information on vertebroplasty be a reliable means of patient self-education?

PubMed

Sullivan, T Barrett; Anderson, Joshua T; Ahn, Uri M; Ahn, Nicholas U

2014-05-01

Studies of the quality and accuracy of health and medical information available on the Internet have shown that many sources provide inadequate information. However, to our knowledge, there are no published studies analyzing the quality of information available online regarding vertebroplasty. Because this has been a high-volume procedure with highly debated efficacy, it is critical that patients receive complete, accurate, and well-balanced information before deciding a treatment course. Additionally, few studies have evaluated the merit of academic site authorship or site certification on information quality, but some studies have used measurements of quality that are based primarily on subjective criteria or information accuracy rather than information completeness. The purposes of our study were (1) to evaluate and analyze the information on vertebroplasty available to the general public through the Internet; (2) to see if sites sponsored by academic institutions offered a higher quality of information; and (3) to determine whether quality of information varied according to site approval by a certification body. Three search engines were used to identify 105 web sites (35 per engine) offering information regarding vertebroplasty. Sites were evaluated for authorship/sponsorship, content, and references cited. Information quality was rated as "excellent," "high," "moderate," "low," or "unacceptable." Sites also were evaluated for contact information to set up an appointment. Data were analyzed as a complete set, then compared between authorship types, and finally evaluated by certification status. Academic sites were compared with other authorship groups and certified sites were compared with noncertified sites using Student's t-test. Appropriate indications were referenced in 74% of sites, whereas only 45% discussed a contraindication to the procedure. Benefits were expressed by 100% of sites, but risks were outlined in only 53% (p < 0.001). Ninety-nine percent of sites provided step-by-step descriptions of the procedure, and 44% of sites also included images. Alternative treatments were mentioned by 51% of sites. Twenty-seven percent of sites referenced peer-reviewed literature, 41% offered experiential or noncited data based on American populations, and 7% offered analogous data from international populations. Thirty percent of sites provided contact information for patient appointment scheduling. Seven percent of sites were classified as excellent quality, 6% as high quality, 11% as moderate quality, 19% as poor quality, and 57% as unacceptable. Sixteen percent of sites were sponsored by academic institutions, 62% by private groups, 8% by biomedical device companies, and 14% were sponsored otherwise. Academic sites reported fewer risks of the procedure than private sites or other sites (p = 0.05 and p = 0.04), but reported more risks than industry sites (p = 0.007). Academic sites were more likely than sites classified as other to offer contact information for patient appointment scheduling (p = 0.004). Nine percent of sites evaluated were Health on the Net Foundation (HONCode) certified. No association with improved information quality was observed in these sites relative to noncertified sites (all p > 0.05). Internet information regarding vertebroplasty is not only inadequate for proper patient education, but also potentially misleading as sites are more likely to present benefits of the procedure than risks. Although academic sites might be expected to offer higher-quality information than private, industry, or other sites, our data would suggest that they do not. HONCode certification cannot be used reliably as a means of qualifying website information quality. Academic sites should be expected to set a high standard and alter their Internet presence with adequate information distribution. Certification bodies also should alter their standards to necessitate provision of complete information in addition to emphasizing accurate information. Treating physicians may want to counsel their patients regarding the limitations of information present on the Internet and the pitfalls of current certification systems. Level IV, economic and decision analyses. See the Instructions for Authors for a complete description of levels of evidence.

New Site Coefficients and Site Classification System Used in Recent Building Seismic Code Provisions

USGS Publications Warehouse

Dobry, R.; Borcherdt, R.D.; Crouse, C.B.; Idriss, I.M.; Joyner, W.B.; Martin, G.R.; Power, M.S.; Rinne, E.E.; Seed, R.B.

2000-01-01

Recent code provisions for buildings and other structures (1994 and 1997 NEHRP Provisions, 1997 UBC) have adopted new site amplification factors and a new procedure for site classification. Two amplitude-dependent site amplification factors are specified: Fa for short periods and Fv for longer periods. Previous codes included only a long period factor S and did not provide for a short period amplification factor. The new site classification system is based on definitions of five site classes in terms of a representative average shear wave velocity to a depth of 30 m (V?? s). This definition permits sites to be classified unambiguously. When the shear wave velocity is not available, other soil properties such as standard penetration resistance or undrained shear strength can be used. The new site classes denoted by letters A - E, replace site classes in previous codes denoted by S1 - S4. Site classes A and B correspond to hard rock and rock, Site Class C corresponds to soft rock and very stiff / very dense soil, and Site Classes D and E correspond to stiff soil and soft soil. A sixth site class, F, is defined for soils requiring site-specific evaluations. Both Fa and Fv are functions of the site class, and also of the level of seismic hazard on rock, defined by parameters such as Aa and Av (1994 NEHRP Provisions), Ss and S1 (1997 NEHRP Provisions) or Z (1997 UBC). The values of Fa and Fv decrease as the seismic hazard on rock increases due to soil nonlinearity. The greatest impact of the new factors Fa and Fv as compared with the old S factors occurs in areas of low-to-medium seismic hazard. This paper summarizes the new site provisions, explains the basis for them, and discusses ongoing studies of site amplification in recent earthquakes that may influence future code developments.

Connecting Projects to Complete the In Situ Resource Utilization Paradigm

NASA Technical Reports Server (NTRS)

Linne, Diane L.; Sanders, Gerald B.

2017-01-01

Terrain Identify specifics such as slope, rockiness, traction parameters Identify what part of ISRU needs each Physical Geotechnical Hardness, density, cohesion, etc. Identify what part of ISRU needs each (e.g., excavation needs to know hardness, density; soil processing needs to know density, cohesion; etc.)Mineral Identify specifics Identify what part of ISRU needs each Volatile Identify specifics Identify what part of ISRU needs each Atmosphere Identify specifics Identify what part of ISRU needs each Environment Identify specifics Identify what part of ISRU needs each Resource Characterization What: Develop an instrument suite to locate and evaluate the physical, mineral, and volatile resources at the lunar poles Neutron Spectrometer Near Infrared (IR) to locate subsurface hydrogen surface water Near IR for mineral identification Auger drill for sample removal down to 1 m Oven with Gas Chromatograph Mass Spectrometer to quantify volatiles present ISRU relevance: Water volatile resource characterization and subsurface material access removal Site Evaluation Resource Mapping What: Develop and utilize new data products and tools for evaluating potential exploration sites for selection and overlay mission data to map terrain, environment, and resource information e.g., New techniques applied to generate Digital Elevation Map (DEMs) at native scale of images (1mpxl)ISRU relevance: Resource mapping and estimation with terrain and environment information is needed for extraction planning Mission Planning and Operations What: Develop and utilize tools and procedures for planning mission operations and real time changes Planning tools include detailed engineering models (e.g., power and data) of surface segment systems allows evaluation of designs ISRU relevance: Allows for iterative engineering as a function of environment and hardware performance.

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.

Readability of ASPS and ASAPS educational web sites: an analysis of consumer impact.

PubMed

Aliu, Oluseyi; Chung, Kevin C

2010-04-01

Patients use the Internet to educate themselves about health-related topics, and learning about plastic surgery is a common activity for enthusiastic consumers in the United States. How to educate consumers regarding plastic surgical procedures is a continued concern for plastic surgeons when faced with the growing portion of the American population having relatively low health care literacy. The usefulness of health-related education materials on the Internet depends largely on their comprehensibility and understandability for all who visit the Web sites. The authors studied the readability of patient education materials related to common plastic surgery procedures from the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS) Web sites and compared them with materials on similar topics from 10 popular health information-providing sites. The authors found that all analyzed documents on the ASPS and ASAPS Web sites targeted to the consumers were rated to be more difficult than the recommended reading grade level for most American adults, and these documents were consistently among the most difficult to read when compared with the other health information Web sites. The Internet is an increasingly popular avenue for patients to educate themselves about plastic surgery procedures. Patient education material provided on ASPS and ASAPS Web sites should be written at recommended reading grade levels to ensure that it is readable and comprehensible to the targeted audience.

Mars exobiology landing sites for future exploration

NASA Technical Reports Server (NTRS)

Landheim, Ragnhild; Greeley, Ronald; Desmarais, David; Farmer, Jack D.; Klein, Harold

1993-01-01

The selection of landing sites for Exobiology is an important issue for planning for future Mars missions. Results of a recent site selection study which focused on potential landing sites described in the Mars Landing Site Catalog are presented. In addition, basic Exobiology science objectives in Mars exploration are reviewed, and the procedures used in site evaluation and prioritization are outlined.

Between Site Reliability of Startle Prepulse Inhibition Across Two Early Psychosis Consortia

PubMed Central

Addington, Jean; Cannon, Tyrone D.; Cornblatt, Barbara A.; de la Fuente-Sandoval, Camilo; Mathalon, Dan H.; Perkins, Diana O.; Seidman, Larry J.; Tsuang, Ming; Walker, Elaine F.; Woods, Scott W.; Bachman, Peter; Belger, Ayse; Carrión, Ricardo E.; Donkers, Franc C.L.; Duncan, Erica; Johannesen, Jason; León-Ortiz, Pablo; Light, Gregory; Mondragón, Alejandra; Niznikiewicz, Margaret; Nunag, Jason; Roach, Brian J.; Solís-Vivanco, Rodolfo

2014-01-01

Prepulse inhibition (PPI) and reactivity of the acoustic startle response are widely used biobehavioral markers in psychopathology research. Previous studies have demonstrated that PPI and startle reactivity exhibit substantial within-site stability; between-site stability, however, has not been established. In two separate consortia investigating biomarkers of early psychosis, traveling subjects studies were performed as part of quality assurance procedures in order to assess the fidelity of data across sites. In the North American Prodromal Longitudinal Studies (NAPLS) Consortium, 8 normal subjects traveled to each of the 8 NAPLS sites and were tested twice at each site on the startle PPI paradigm. In preparation for a binational study, 10 healthy subjects were assessed twice in both San Diego and Mexico City. Intraclass correlations between and within sites were significant for PPI and startle response parameters, confirming the reliability of startle measures across sites in both consortia. There were between site differences in startle magnitude in the NAPLS study that did not appear to be related to methods or equipment. In planning multi-site studies, it is essential to institute quality assurance procedures early and establish between site reliability to assure comparable data across sites. PMID:23799460

Odor analysis of decomposing buried human remains

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

Vass, Arpad Alexander; Smith, Rob R; Thompson, Cyril V

2008-01-01

This study, conducted at the University of Tennessee's Anthropological Research Facility (ARF), lists and ranks the primary chemical constituents which define the odor of decomposition of human remains as detected at the soil surface of shallow burial sites. Triple sorbent traps were used to collect air samples in the field and revealed eight major classes of chemicals which now contain 478 specific volatile compounds associated with burial decomposition. Samples were analyzed using gas chromatography-mass spectrometry (GC-MS) and were collected below and above the body, and at the soil surface of 1.5-3.5 ft. (0.46-1.07 m) deep burial sites of four individualsmore » over a 4-year time span. New data were incorporated into the previously established Decompositional Odor Analysis (DOA) Database providing identification, chemical trends, and semi-quantitation of chemicals for evaluation. This research identifies the 'odor signatures' unique to the decomposition of buried human remains with projected ramifications on human remains detection canine training procedures and in the development of field portable analytical instruments which can be used to locate human remains in shallow burial sites.« less

Impact of a Saharan dust intrusion over southern Spain on DNI estimation with sky cameras

NASA Astrophysics Data System (ADS)

Alonso-Montesinos, J.; Barbero, J.; Polo, J.; López, G.; Ballestrín, J.; Batlles, F. J.

2017-12-01

To operate Central Tower Solar Power (CTSP) plants properly, solar collector systems must be able to work under varied weather conditions. Therefore, knowing the state of the atmosphere, and more specifically the level of incident radiation, is essential operational information to adapt the electricity production system to atmospheric conditions. In this work, we analyze the impact of a strong Saharan dust intrusion on the Direct normal irradiance (DNI) registered at two sites 35 km apart in southeastern Spain: the University of Almería (UAL) and the Plataforma Solar de Almería (PSA). DNI can be inputted into the European Solar Radiation Atlas (ESRA) clear sky procedure to derive Linke turbidity values, which proved to be extremely high at the UAL. By using the Simple Model of the Atmospheric Radiative Transfer of Sunshine (SMARTS) at the PSA site, AERONET data from PSA and assuming dust dominated aerosol, DNI estimations agreed strongly with the measured DNI values. At the UAL site, a SMARTS simulation of the DNI values also seemed to be compatible with dust dominated aerosol.

Environmental analysis for development planning in Chambers County, Texas, land use policy component, interim summary of federal influence over land use

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

Mixon, J.

1973-11-21

This summary covers major Federal programs that affect land use and indicates some of the influence which these programs may have on Chambers County, Texas. The first part is divided into specific areas of study and includes the history of Federal assistance programs to date. These areas are housing and urban development, the Rural Development Act of 1972, transportation, mass transit, energy, air pollution controls, the National Environmental Policy Act of 1969; power plant siting, the Environmental Protection Agency (EPA), Coastal Zone Management (CZM), the National Land Use Policy (NLUP) and Planning Assistance Act, and the interrelation of EPA, CZM,more » and NLUP. The second part deals with constitutional power in relation to transportation, housing and slum clearance, urban renewal, Federal assistance for new communities and open space acquisition, the Rural Development Act of 1972, the EPA, CZM, NLUP and Planning Assistance Act, and power plant siting bills. Included are the legislative history of these land use acts and their actual terminology, control and enforcement procedures and research and developing funding. Specific references to Texas, and especially Chambers County, in relation to these programs are made throughout the report.« less

Identifying the Infection Control Areas Requiring Modifications in Thoracic Surgery Units: Results of a Two-Year Surveillance of Surgical Site Infections in Hospitals in Southern Poland.

PubMed

Dubiel, Grzegorz; Rogoziński, Paweł; Żaloudik, Elżbieta; Bruliński, Krzysztof; Różańska, Anna; Wójkowska-Mach, Jadwiga

2017-10-01

Surgical site infection (SSI) is considered to be a priority in infection control. The objective of this study is the analysis of results of active targeted surveillance conducted over a two-year period in the Department of Thoracic Surgery at the Pulmonology and Thoracic Surgery Center in Bystra, in southern Poland. The retrospective analysis was carried out on the basis of results of active monitoring of SSI in the 45-bed Department of Thoracic Surgery at the Pulmonology and Thoracic Surgery Center in Bystra between April 1, 2014 and April 30, 2016. Surgical site infections were identified based on the definitions of the European Centre for Disease Prevention and Control (ECDC) taking into account the time of symptom onset, specifically, whether the symptoms occurred within 30 d after the surgical procedure. Detection of SSI relied on daily inspection of incisions by a trained nurse, analysis of medical and nursing entries in the computer system, and analysis of all results of microbiologic tests taken in the unit and in the operating room. In the study period, data were collected regarding 1,387 treatment procedures meeting the registration criteria. Forty cases of SSI were detected yielding an incidence rate of 3%. Most cases (55%) were found in the course of hospitalization and 45% were detected after the patient's discharge. The SSIs were classified as follows: superficial, 37.5%; deep infections, 7.5%; and organ/space infection, 55%. Among patients who were diagnosed with SSI, most were male (77.5%). For patients with an American Society of Anesthesiologists (ASA) score I-II the incidence rate was 2%; ASA score III or more, 3.7%. The incidence rate varied from 0.3% in clean surgical site to 6.5% in clean-contaminated site. The study validated the usefulness of targeted surveillance in monitoring SSIs in patients hospitalized in thoracic surgery departments. Surgical site infection surveillance identified areas of care requiring modifications, namely, organization of post-discharge and microbiologic diagnostics of infection cases.

2013 Annual Site Inspection and Monitoring Report for Uranium Mill Tailings Radiation Control Act Title I Disposal Sites

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

None, None

This report, in fulfillment of a license requirement, presents the results of long-term surveillance and maintenance activities conducted by the U.S. Department of Energy (DOE) Office of Legacy Management (LM) in 2013 at 19 uranium mill tailings disposal sites established under Title I of the Uranium Mill Tailings Radiation Control Act (UMTRCA) of 1978.1 These activities verified that the UMTRCA Title I disposal sites remain in compliance with license requirements. DOE operates 18 UMTRCA Title I sites under a general license granted by the U.S. Nuclear Regulatory Commission (NRC) in accordance with Title 10 Code of Federal Regulations Part 40.27more » (10 CFR 40.27). As required under the general license, a long-term surveillance plan (LTSP) for each site was prepared by DOE and accepted by NRC. The Grand Junction, Colorado, Disposal Site, one of the 19 Title I sites, will not be included under the general license until the open, operating portion of the cell is closed. The open portion will be closed either when it is filled or in 2023. This site is inspected in accordance with an interim LTSP. Long-term surveillance and maintenance services for these disposal sites include inspecting and maintaining the sites; monitoring environmental media and institutional controls; conducting any necessary corrective actions; and performing administrative, records, stakeholder relations, and other regulatory stewardship functions. Annual site inspections and monitoring are conducted in accordance with site-specific LTSPs and procedures established by DOE to comply with license requirements. Each site inspection is performed to verify the integrity of visible features at the site; to identify changes or new conditions that may affect the long-term performance of the site; and to determine the need, if any, for maintenance, follow-up or contingency inspections, or corrective action in accordance with the LTSP. LTSPs and site compliance reports are available on the Internet at http://www.lm.doe.gov/.« less

Relational databases: a transparent framework for encouraging biology students to think informatically.

PubMed

Rice, Michael; Gladstone, William; Weir, Michael

2004-01-01

We discuss how relational databases constitute an ideal framework for representing and analyzing large-scale genomic data sets in biology. As a case study, we describe a Drosophila splice-site database that we recently developed at Wesleyan University for use in research and teaching. The database stores data about splice sites computed by a custom algorithm using Drosophila cDNA transcripts and genomic DNA and supports a set of procedures for analyzing splice-site sequence space. A generic Web interface permits the execution of the procedures with a variety of parameter settings and also supports custom structured query language queries. Moreover, new analytical procedures can be added by updating special metatables in the database without altering the Web interface. The database provides a powerful setting for students to develop informatic thinking skills.

Relational Databases: A Transparent Framework for Encouraging Biology Students To Think Informatically

PubMed Central

2004-01-01

We discuss how relational databases constitute an ideal framework for representing and analyzing large-scale genomic data sets in biology. As a case study, we describe a Drosophila splice-site database that we recently developed at Wesleyan University for use in research and teaching. The database stores data about splice sites computed by a custom algorithm using Drosophila cDNA transcripts and genomic DNA and supports a set of procedures for analyzing splice-site sequence space. A generic Web interface permits the execution of the procedures with a variety of parameter settings and also supports custom structured query language queries. Moreover, new analytical procedures can be added by updating special metatables in the database without altering the Web interface. The database provides a powerful setting for students to develop informatic thinking skills. PMID:15592597

Using Decision Procedures to Build Domain-Specific Deductive Synthesis Systems

NASA Technical Reports Server (NTRS)

VanBaalen, Jeffrey; Roach, Steven; Lau, Sonie (Technical Monitor)

1998-01-01

This paper describes a class of decision procedures that we have found useful for efficient, domain-specific deductive synthesis. These procedures are called closure-based ground literal satisfiability procedures. We argue that this is a large and interesting class of procedures and show how to interface these procedures to a theorem prover for efficient deductive synthesis. Finally, we describe some results we have observed from our implementation. Amphion/NAIF is a domain-specific, high-assurance software synthesis system. It takes an abstract specification of a problem in solar system mechanics, such as 'when will a signal sent from the Cassini spacecraft to Earth be blocked by the planet Saturn?', and automatically synthesizes a FORTRAN program to solve it.

Global Tobacco Surveillance System (GTSS): purpose, production, and potential.

PubMed

2005-01-01

The World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), and Canadian Public Health Association (CPHA) developed the Global Tobacco Surveillance System (GTSS) to assist all 192 WHO Member States in collecting data on youth and adult tobacco use. The flexible GTSS system includes common data items but allows countries to include important unique information at their discretion. It uses a common survey methodology, similar field procedures for data collection, and similar data management and processing techniques. The GTSS includes collection of data through three surveys: the Global Youth Tobacco Survey (GYTS) for youth, and the Global School Personnel Survey (GSPS) and the Global Health Professional Survey (GHPS) for adults. GTSS data potentially can be applied in four ways. First, countries and research partners can disseminate data through publications, presentations, and an active GTSS web site. Second, countries can use GTSS data to inform politicians about the tobacco problem in their country, leading to new policy decisions to prevent and control tobacco use. Third, GTSS can provide countries with valuable feedback to evaluate and improve Country National Action Plans or develop new plans. Fourth, in response to the WHO FCTC call for countries to use consistent methods and procedures in their surveillance efforts, GTSS offers such consistency in sampling procedures, core questionnaire items, training infield procedures, and analysis of data across all survey sites. The GTSS represents the most comprehensive tobacco surveillance system ever developed and implemented. As an example, this paper describes development of the GYTS and discusses potential uses of the data. Sample data were drawn from 38 sites in 24 countries in the African Region, 82 sites in 35 countries in the Americas Region, 20 sites in 17 countries and the Gaza Strip/West Bank region in the Eastern Mediterranean Region, 25 sites in 22 countries in the European Region, 34 sites in six countries in the Southeast Asia Region, and 25 sites in 14 countries in the Western Pacific Region.

14 CFR 420.59 - Launch site accident investigation plan.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Launch site accident investigation plan... Licensee § 420.59 Launch site accident investigation plan. (a) General. A licensee shall develop and implement a launch site accident investigation plan that contains the licensee's procedures for reporting...

14 CFR 420.59 - Launch site accident investigation plan.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Launch site accident investigation plan... Licensee § 420.59 Launch site accident investigation plan. (a) General. A licensee shall develop and implement a launch site accident investigation plan that contains the licensee's procedures for reporting...

Guidelines for Site Supervisors: A Tool Kit

ERIC Educational Resources Information Center

Caldwell, Charmaine D.; Geltner, Jill A.; Cunningham, Teddi J.

2012-01-01

Site supervisors rarely receive training at the master's level in the supervisory skills required for the supervision of intern students. General guidelines for site supervisors are presented in this article. The article suggests steps for a site supervisor to take prior to accepting an intern, procedures to follow during the internship, and…

40 CFR 761.250 - Sample site selection for pipeline section abandonment.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 30 2010-07-01 2010-07-01 false Sample site selection for pipeline... Disposal of Natural Gas Pipeline: Selecting Sample Sites, Collecting Surface Samples, and Analyzing Standard PCB Wipe Samples § 761.250 Sample site selection for pipeline section abandonment. This procedure...

40 CFR 761.250 - Sample site selection for pipeline section abandonment.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 31 2011-07-01 2011-07-01 false Sample site selection for pipeline... Disposal of Natural Gas Pipeline: Selecting Sample Sites, Collecting Surface Samples, and Analyzing Standard PCB Wipe Samples § 761.250 Sample site selection for pipeline section abandonment. This procedure...

Step by Step: Biology Undergraduates’ Problem-Solving Procedures during Multiple-Choice Assessment

PubMed Central

Prevost, Luanna B.; Lemons, Paula P.

2016-01-01

This study uses the theoretical framework of domain-specific problem solving to explore the procedures students use to solve multiple-choice problems about biology concepts. We designed several multiple-choice problems and administered them on four exams. We trained students to produce written descriptions of how they solved the problem, and this allowed us to systematically investigate their problem-solving procedures. We identified a range of procedures and organized them as domain general, domain specific, or hybrid. We also identified domain-general and domain-specific errors made by students during problem solving. We found that students use domain-general and hybrid procedures more frequently when solving lower-order problems than higher-order problems, while they use domain-specific procedures more frequently when solving higher-order problems. Additionally, the more domain-specific procedures students used, the higher the likelihood that they would answer the problem correctly, up to five procedures. However, if students used just one domain-general procedure, they were as likely to answer the problem correctly as if they had used two to five domain-general procedures. Our findings provide a categorization scheme and framework for additional research on biology problem solving and suggest several important implications for researchers and instructors. PMID:27909021

Spatial Statistical Models and Optimal Survey Design for Rapid Geophysical characterization of UXO Sites

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

G. Ostrouchov; W.E.Doll; D.A.Wolf

2003-07-01

Unexploded ordnance(UXO)surveys encompass large areas, and the cost of surveying these areas can be high. Enactment of earlier protocols for sampling UXO sites have shown the shortcomings of these procedures and led to a call for development of scientifically defensible statistical procedures for survey design and analysis. This project is one of three funded by SERDP to address this need.

A hydrochemical data base for the Hanford Site, Washington

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

Early, T.O.; Mitchell, M.D.; Spice, G.D.

1986-05-01

This data package contains a revision of the Site Hydrochemical Data Base for water samples associated with the Basalt Waste Isolation Project (BWIP). In addition to the detailed chemical analyses, a summary description of the data base format, detailed descriptions of verification procedures used to check data entries, and detailed descriptions of validation procedures used to evaluate data quality are included. 32 refs., 21 figs., 3 tabs.

75 FR 47817 - Notice of Availability: Test Tools and Test Procedures Approved for the Office of the National...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-09

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Notice of Availability: Test Tools and Test Procedures.... SUMMARY: This notice announces the availability of test tools and test procedures approved by the National... certification program. The approved test tools and test procedures are identified on the ONC Web site at: http...

77 FR 64343 - Notice of Availability: Test Tools and Test Procedures Approved for the Office of the National...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-19

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Notice of Availability: Test Tools and Test Procedures.... SUMMARY: This notice announces the availability of test tools and test procedures approved by the National... test tools and test procedures are identified on the ONC Web site at: http://www.healthit.gov/policy...

TU-D-209-04: How Useful Are Indirect Dose Metrics for Estimating Peak Skin Dose in Interventional Cardiology?

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

Jones, A; Pasciak, A

Purpose: The purpose of this study was to determine if a relationship between indirect dose metrics and PSD could be established for fluoroscopically-guided interventional cardiology procedures. Methods: PSD were measured directly using XR-RV3 radiochromic film for 94 consecutive fluoroscopically guided interventional cardiology procedures performed at two sites. Procedures were both diagnostic and therapeutic in nature. Radiation dose structured reports (RDSR) were collected for each procedure and used to calculate indirect estimates of PSD which were compared to the measured PSD. Reference air kerma (Ka,r) was also compared to the measured PSD. Pearson’s correlation coefficient was calculated for each metric andmore » metrics were compared to measured PSD using a two-tailed t-test. Data were log transformed prior to statistical analysis. Results: Both Ka,r and the calculated PSD were closely correlated with measured PSD at each sites (Ka,r: 0.92 and 0.86, indirect PSD: 0.91 and 0.88). At one site, neither Ka,r nor indirect PSD was significantly different from the measured PSD (p = 0.22 and p=0.054, respectively), while at the second site both Ka,r and indirect PSD were significantly higher than measured PSD (p<0.0001 and p<0.0001, respectively). In almost all cases, both Ka,r and indirect PSD overestimated the true PSD. Conclusions: The use of a range of gantry angles and table positions, along with variation in procedural imaging requirements, limits the utility of indirect dose metrics for predicting PSD for interventional cardiology procedures. A. Kyle Jones and Alexander S. Pasciak are owners of Fluoroscopic Safety, LLC.« less

Trends in the survival of patients diagnosed with cancer in the Nordic countries 1964-2003 followed up to the end of 2006. Material and methods.

PubMed

Engholm, Gerda; Gislum, Mette; Bray, Freddie; Hakulinen, Timo

2010-06-01

Comparable data on cancer incidence and mortality in Denmark, Finland, Iceland, Norway, and Sweden are available for analysis through a collaboration of the national Cancer Registries via the NORDCAN website (http://ancr.nu). In the continued spirit of Nordic collaborative research, a number of studies examining trends in cancer survival are published in this journal. The data were divided into eight 5-year periods by sex in five Nordic countries. Age-standardised 5-year relative survival ratios and excess mortality rates in the short-term (first month and 1-3 months following diagnosis), and the long-term (2-5 years after diagnosis) were calculated, as were age-specific 5-year relative survival using cohort-survival methods. A hybrid method combining the cohort and period methods was used for the period 1999-2003 as not all patients were followed for five years. Age-standardisation used the International Cancer Survival Standard, and calculation of expected deaths used country-specific population mortality rates. The data series constitutes 3 360 397 tumours among 3 160 802 patients followed up for death through 2006 for 39 different cancer sites diagnosed in the years 1964-2003. The paper describes the data, exclusions and imputations, design and analysis, age structure and standardisation procedures, follow-up, and case-mix adjustment methods. The strengths of this study include the overall comparability and quality of the data, the national coverage, and the length of the time series. Collecting and analysing data from the five Nordic countries for 39 different cancer sites over 40 years in a systematised and comparable way is a major undertaking. A thorough description of the analyses, definitions and exclusions in the survival study, supplemented with corresponding information on cancer incidence and mortality is needed for appropriate interpretation and comparison between countries, and between and within cancer sites. This information must be made available to provide appropriate interpretation of the site-specific results.

Development, Application, and Implementation of RAMCAP to Characterize Nuclear Power Plant Risk From Terrorism

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

Gaertner, John P.; Teagarden, Grant A.

2006-07-01

In response to increased interest in risk-informed decision making regarding terrorism, EPRI and ERIN Engineering were selected by U.S. DHS and ASME to develop and demonstrate the RAMCAP method for nuclear power plant (NPP) risk assessment. The objective is to characterize plant-specific NPP risk for risk management opportunities and to provide consistent information for DHS decision making. This paper is an update of this project presented at the American Nuclear Society (ANS) International Topical Meeting on Probabilistic Safety Analysis (PSA05) in September, 2005. The method uses a characterization of risk as a function of Consequence, Vulnerability, and Threat. For eachmore » site, worst case scenarios are developed for each of sixteen benchmark threats. Nuclear RAMCAP hypothesizes that the intent of the perpetrator is to cause offsite radiological consequences. Specific targets are the reactor core, the spent fuel pool, and nuclear spent fuel in a dry storage facility (ISFSI). Results for each scenario are presented as conditional risk for financial loss, early fatalities and early injuries. Expected consequences for each scenario are quantified, while vulnerability is estimated on a relative likelihood scale. Insights for other societal risks are provided. Although threat frequencies are not provided, target attractiveness and threat deterrence are estimated. To assure efficiency, completeness, and consistency; results are documented using standard RAMCAP Evaluator software. Trial applications were successfully performed at four plant sites. Implementation at all other U.S. commercial sites is underway, supported by the Nuclear Sector Coordinating Council (NSCC). Insights from RAMCAP results at 23 U.S. plants completed to date have been compiled and presented to the NSCC. Results are site-specific. Physical security barriers, an armed security force, preparedness for design-basis threats, rugged design against natural hazards, multiple barriers between fuel and environment, accident mitigation capability, severe accident management procedures, and offsite emergency plans are risk-beneficial against all threat types. (authors)« less

Characterization and machine learning prediction of allele-specific DNA methylation.

PubMed

He, Jianlin; Sun, Ming-an; Wang, Zhong; Wang, Qianfei; Li, Qing; Xie, Hehuang

2015-12-01

A large collection of Single Nucleotide Polymorphisms (SNPs) has been identified in the human genome. Currently, the epigenetic influences of SNPs on their neighboring CpG sites remain elusive. A growing body of evidence suggests that locus-specific information, including genomic features and local epigenetic state, may play important roles in the epigenetic readout of SNPs. In this study, we made use of mouse methylomes with known SNPs to develop statistical models for the prediction of SNP associated allele-specific DNA methylation (ASM). ASM has been classified into parent-of-origin dependent ASM (P-ASM) and sequence-dependent ASM (S-ASM), which comprises scattered-S-ASM (sS-ASM) and clustered-S-ASM (cS-ASM). We found that P-ASM and cS-ASM CpG sites are both enriched in CpG rich regions, promoters and exons, while sS-ASM CpG sites are enriched in simple repeat and regions with high frequent SNP occurrence. Using Lasso-grouped Logistic Regression (LGLR), we selected 21 out of 282 genomic and methylation related features that are powerful in distinguishing cS-ASM CpG sites and trained the classifiers with machine learning techniques. Based on 5-fold cross-validation, the logistic regression classifier was found to be the best for cS-ASM prediction with an ACC of 0.77, an AUC of 0.84 and an MCC of 0.54. Lastly, we applied the logistic regression classifier on human brain methylome and predicted 608 genes associated with cS-ASM. Gene ontology term enrichment analysis indicated that these cS-ASM associated genes are significantly enriched in the category coding for transcripts with alternative splicing forms. In summary, this study provided an analytical procedure for cS-ASM prediction and shed new light on the understanding of different types of ASM events. Published by Elsevier Inc.

Comparison of 2015 Medicare relative value units for gender-specific procedures: Gynecologic and gynecologic-oncologic versus urologic CPT coding. Has time healed gender-worth?

PubMed

Benoit, M F; Ma, J F; Upperman, B A

2017-02-01

In 1992, Congress implemented a relative value unit (RVU) payment system to set reimbursement for all procedures covered by Medicare. In 1997, data supported that a significant gender bias existed in reimbursement for gynecologic compared to urologic procedures. The present study was performed to compare work and total RVU's for gender specific procedures effective January 2015 and to evaluate if time has healed the gender-based RVU worth. Using the 2015 CPT codes, we compared work and total RVU's for 50 pairs of gender specific procedures. We also evaluated 2015 procedure related provider compensation. The groups were matched so that the procedures were anatomically similar. We also compared 2015 to 1997 RVU and fee schedules. Evaluation of work RVU's for the paired procedures revealed that in 36 cases (72%), male vs female procedures had a higher wRVU and tRVU. For total fee/reimbursement, 42 (84%) male based procedures were compensated at a higher rate than the paired female procedures. On average, male specific surgeries were reimbursed at an amount that was 27.67% higher for male procedures than for female-specific surgeries. Female procedure based work RVU's have increased minimally from 1997 to 2015. Time and effort have trended towards resolution of some gender-related procedure worth discrepancies but there are still significant RVU and compensation differences that should be further reviewed and modified as surgical time and effort highly correlate. Copyright © 2016. Published by Elsevier Inc.

Non-observance of guidelines for surgical antimicrobial prophylaxis and surgical-site infections.

PubMed

Lallemand, S; Thouverez, M; Bailly, P; Bertrand, X; Talon, D

2002-06-01

A prospective multicentre study was conducted to assess major aspects of surgical prophylaxis and to determine whether inappropriate antimicrobial prophylaxis was a factor associated (risk or protective factor) with surgical site infection (SSI). Surgical prophylaxis practices were assessed by analysing four variables: indication, antimicrobial agent, timing and duration. Univariate and multivariate analyses were carried out to identify predictors of SSI among patient-specific, operation-specific and antimicrobial prophylaxis-specific factors. The frequency of SSI was 2.7% (13 SSI in 474 observations). Total compliance of the prescription with guidelines was observed in 41.1% of cases (195 prescriptions). Of the 139 patients who received an inappropriate drug, 126 (90.6%) received a drug with a broader spectrum than the recommended drug. Prophylaxis was prolonged in 71 (87.7%) of the 81 patients who received prophylaxis for inappropriate lengths of time and 43 (61.4%) of the 70 patients who did not receive prophylaxis at the optimal moment were treated too late. Multivariate analysis clearly demonstrated that SSI was associated with multiple procedures (relative risk 8.5), short duration of prophylaxis (relative risk 12.7) and long-term therapy with antimicrobial agents during the previous year (relative risk 8.8). The ecological risk of the emergence of resistance associated with the frequent use of broad-spectrum antibiotics and prophylaxis for longer periods was not offset by individual benefit to the patients who received inappropriate prophylaxis.

Improved characterization of the botanical origin of sugar by carbon-13 SNIF-NMR applied to ethanol.

PubMed

Thomas, Freddy; Randet, Celia; Gilbert, Alexis; Silvestre, Virginie; Jamin, Eric; Akoka, Serge; Remaud, Gerald; Segebarth, Nicolas; Guillou, Claude

2010-11-24

Until now, no analytical method, not even isotopic ones, had been able to differentiate between sugars coming from C4-metabolism plants (cane, maize, etc.) and some crassulacean acid metabolism plants (e.g., pineapple, agave) because in both cases the isotope distributions of the overall carbon-13/carbon-12 and site-specific deuterium/hydrogen isotope ratios are very similar. Following recent advances in the field of quantitative isotopic carbon-13 NMR measurements, a procedure for the analysis of the positional carbon-13/carbon-12 isotope ratios of ethanol derived from the sugars of pineapples and agave using the site-specific natural isotopic fractionation-nuclear magnetic resonance (SNIF-NMR) method is presented. It is shown that reproducible results can be obtained when appropriate analytical conditions are used. When applied to pineapple juice, this new method demonstrates a unique ability to detect cane and maize sugar, which are major potential adulterants, with a detection limit in the order of 15% of the total sugars, which provides an efficient mean of controlling the authenticity of juices made from this specific fruit. When applied to tequila products, this new method demonstrates a unique ability to unambiguously differentiate authentic 100% agave tequila, as well as misto tequila (made from at least 51% agave), from products made from a larger proportion of cane or maize sugar and therefore not complying with the legal definition of tequila.

76 FR 80261 - National Emission Standards for Hazardous Air Pollutants: Area Source Standards for Prepared...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-23

... specifications and operating instructions, if available, or standard operating procedures must be developed by... manufacturer's specifications and operating instructions, if available, or standard operating procedures must... operating specifications or standard operating procedures developed by the prepared feeds manufacturer be...

10 CFR 32.110 - Acceptance sampling procedures under certain specific licenses.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 10 Energy 1 2011-01-01 2011-01-01 false Acceptance sampling procedures under certain specific licenses. 32.110 Section 32.110 Energy NUCLEAR REGULATORY COMMISSION SPECIFIC DOMESTIC LICENSES TO MANUFACTURE OR TRANSFER CERTAIN ITEMS CONTAINING BYPRODUCT MATERIAL Quality Control Sampling Procedures § 32...

10 CFR 32.110 - Acceptance sampling procedures under certain specific licenses.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 10 Energy 1 2010-01-01 2010-01-01 false Acceptance sampling procedures under certain specific licenses. 32.110 Section 32.110 Energy NUCLEAR REGULATORY COMMISSION SPECIFIC DOMESTIC LICENSES TO MANUFACTURE OR TRANSFER CERTAIN ITEMS CONTAINING BYPRODUCT MATERIAL Quality Control Sampling Procedures § 32...

Utility of rapid on-site cytologic evaluation during endobronchial ultrasound with a guide sheath for peripheral pulmonary lesions.

PubMed

Izumo, Takehiro; Matsumoto, Yuji; Sasada, Shinji; Chavez, Christine; Nakai, Toshiyuki; Tsuchida, Takaaki

2017-03-01

The utility of rapid on-site evaluation during endobronchial ultrasound with a guide sheath for peripheral pulmonary lesions is unclear. The aim of this study was to evaluate the role of rapid on-site evaluation during endobronchial ultrasound with a guide sheath for peripheral pulmonary lesions. Consecutive patients who underwent endobronchial ultrasound with a guide sheath for the diagnosis of peripheral pulmonary lesions at our hospital between September 2012 and July 2014 were included in this retrospective study. Cytology slides were air-dried, and modified Giemsa (Diff-Quik) staining was used for rapid on-site evaluation. Additional smears were prepared for Papanicolaou staining and tissue samples were placed in formalin for histologic evaluation. The results of rapid on-site evaluation were compared with the final diagnoses of endobronchial ultrasound with a guide sheath. A total of 718 cases were included in the study population. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of rapid on-site evaluation during endobronchial ultrasound with a guide sheath for peripheral pulmonary lesions was 88.6%, 65.9%, 81.2%, 77.7% and 80.1%, respectively. There were no procedure-related deaths. Rapid on-site evaluation during endobronchial ultrasound with a guide sheath had high sensitivity for peripheral pulmonary lesions. When carrying out rapid on-site evaluation of transbronchial biopsy samples from peripheral pulmonary lesions, careful interpretation and clinical correlation are necessary. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Social but safe? Quality and safety of diabetes-related online social networks.

PubMed

Weitzman, Elissa R; Cole, Emily; Kaci, Liljana; Mandl, Kenneth D

2011-05-01

To foster informed decision-making about health social networking (SN) by patients and clinicians, the authors evaluated the quality/safety of SN sites' policies and practices. Multisite structured observation of diabetes-focused SN sites. Measurements 28 indicators of quality and safety covering: (1) alignment of content with diabetes science and clinical practice recommendations; (2) safety practices for auditing content, supporting transparency and moderation; (3) accessibility of privacy policies and the communication and control of privacy risks; and (4) centralized sharing of member data and member control over sharing. Quality was variable across n=10 sites: 50% were aligned with diabetes science/clinical practice recommendations with gaps in medical disclaimer use (30% have) and specification of relevant glycosylated hemoglobin levels (0% have). Safety was mixed with gaps in external review approaches (20% used audits and association links) and internal review approaches (70% use moderation). Internal safety review offers limited protection: misinformation about a diabetes 'cure' was found on four moderated sites. Of nine sites with advertising, transparency was missing on five; ads for unfounded 'cures' were present on three. Technological safety was poor with almost no use of procedures for secure data storage and transmission; only three sites support member controls over personal information. Privacy policies' poor readability impedes risk communication. Only three sites (30%) demonstrated better practice. Limitations English-language diabetes sites only. The quality/safety of diabetes SN is variable. Observed better practice suggests improvement is feasible. Mechanisms for improvement are recommended that engage key stakeholders to balance autonomy, community ownership, conditions for innovation, and consumer protection.