42 CFR 409.85 - Skilled nursing facility (SNF) care coinsurance.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Skilled nursing facility (SNF) care coinsurance. 409.85 Section 409.85 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Coinsurance § 409.85 Skilled nursing facility (SNF) care coinsurance. (a) General provisions. (1) SNF care...

42 CFR 409.85 - Skilled nursing facility (SNF) care coinsurance.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Skilled nursing facility (SNF) care coinsurance. 409.85 Section 409.85 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Coinsurance § 409.85 Skilled nursing facility (SNF) care coinsurance. (a) General provisions. (1) SNF care...

42 CFR 409.85 - Skilled nursing facility (SNF) care coinsurance.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Skilled nursing facility (SNF) care coinsurance. 409.85 Section 409.85 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Coinsurance § 409.85 Skilled nursing facility (SNF) care coinsurance. (a) General provisions. (1) SNF care...

42 CFR 409.85 - Skilled nursing facility (SNF) care coinsurance.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Skilled nursing facility (SNF) care coinsurance. 409.85 Section 409.85 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Coinsurance § 409.85 Skilled nursing facility (SNF) care coinsurance. (a) General provisions. (1) SNF care...

42 CFR 409.85 - Skilled nursing facility (SNF) care coinsurance.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Skilled nursing facility (SNF) care coinsurance. 409.85 Section 409.85 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND... Coinsurance § 409.85 Skilled nursing facility (SNF) care coinsurance. (a) General provisions. (1) SNF care...

Environmental Radiation Monitoring at the Areas of the Former Military Technical Bases at the Russian Far East - 12445

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

Kiselev, Sergey M.; Shandala, Nataliya K.; Titov, Alexey V.

After termination of operation at the serviced facilities of the nuclear fleet of the former Soviet Union, the Military Technical Base in Sysoeva Bay has been reorganized to the site for SNF and RW temporary storage (STS). The main activities of STS are receipt, storage and transmission to radioactive waste reprocessing. Establishment of the RW management regional centre in the Far-Eastern region at the STS in Sysoeva Bay implies intensification of SNF and RW management in this region that can result in increasing ecological load to the adjacent areas and settlements. Regulatory supervision of the radiation safety at the areasmore » of the Former Military Technical Bases at the Russian Far East is one of the regulatory functions of the Federal Medical Biological Agency (FMBA of Russia). To regulate SNF an RW management and provide the effective response to changing radiation situation, the environmental radiation monitoring system is arranged. For this purpose, wide range of environmental media examinations at the Sysoeva Bay STS was performed by Burnasyan Federal Medical Biophysical Centre - a technical support organization of FMBA of Russia in collaboration with the Federal State Geological Enterprise 'Hydrospecgeology' (Federal Agency for Entrails). Regulation during the RW and SNF management is continuous process, which the FMBA of Russia implements in close cooperation with other Russian responsible authorities - the State Atomic Energy Corporation 'Rosatom' and Federal Agency for Entrails. The Environmental radiation monitoring findings served as a basis for the associated databank arrangement. The radio ecological monitoring system was arranged at the facilities under inspection for the purpose of the dynamic control of the radiation situation. It presupposes regular radiometry inspections in-situ, their analysis and assessment of the radiation situation forecast in the course of the STS remediation main stages. Some new data on the radiation situation at the facilities will appear in future and the prognostic assessment will become more precise. The mentioned natural, practical and theoretical works is a base for the development of the set of regulatory documents to assure radiation protection and safety of workers, public and environment, as well as development of documents to regulate SNF and RW management at the STS facilities. (authors)« less

Development of a novel ultrasonic temperature probe for long-term monitoring of dry cask storage systems

NASA Astrophysics Data System (ADS)

Bakhtiari, S.; Wang, K.; Elmer, T. W.; Koehl, E.; Raptis, A. C.

2013-01-01

With the recent cancellation of the Yucca Mountain repository and the limited availability of wet storage utilities for spent nuclear fuel (SNF), more attention has been directed toward dry cask storage systems (DCSSs) for long-term storage of SNF. Consequently, more stringent guidelines have been issued for the aging management of dry storage facilities that necessitate monitoring of the conditions of DCSSs. Continuous health monitoring of DCSSs based on temperature variations is one viable method for assessing the integrity of the system. In the present work, a novel ultrasonic temperature probe (UTP) is being tested for long-term online temperature monitoring of DCSSs. Its performance was evaluated and compared with type N thermocouple (NTC) and resistance temperature detector (RTD) using a small-scale dry storage canister mockup. Our preliminary results demonstrate that the UTP system developed at Argonne is able to achieve better than 0.8 °C accuracy, tested at temperatures of up to 400 °C. The temperature resolution is limited only by the sampling rate of the current system. The flexibility of the probe allows conforming to complex geometries thus making the sensor particularly suited to measurement scenarios where access is limited.

Is There Extra Cost of Institutional Care for MS Patients?

PubMed Central

Noyes, Katia; Bajorska, Alina; Weinstock-Guttman, Bianca

2013-01-01

Throughout life, patients with multiple sclerosis (MS) require increasing levels of support, rehabilitative services, and eventual skilled nursing facility (SNF) care. There are concerns that access to SNF care for MS patients is limited because of perceived higher costs of their care. This study compares costs of caring for an MS patient versus those of a typical SNF patient. We merged SNF cost report data with the 2001–2006 Nursing Home Minimum Data Set (MDS) to calculate percentage of MS residents-days and facility case-mix indices (CMIs). We estimated the average facility daily cost using hybrid cost functions, adjusted for facility ownership, average facility wages, CMI-adjusted number of SNF days, and percentage of MS residents-days. We describe specific characteristics of SNF with high and low MS volumes and examine any sources of variation in cost. MS patients were no longer more costly than typical SNF patients. A greater proportion of MS patients had no significant effect on facility daily costs (P = 0.26). MS patients were more likely to receive care in government-owned facilities (OR = 1.904) located in the Western (OR = 2.133) and Midwestern (OR = 1.3) parts of the USA (P < 0.05). Cost of SNF care is not a likely explanation for the perceived access barriers that MS patients face. PMID:24163769

Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2017, SNF Value-Based Purchasing Program, SNF Quality Reporting Program, and SNF Payment Models Research. Final rule.

PubMed

2016-08-05

This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2017. In addition, it specifies a potentially preventable readmission measure for the Skilled Nursing Facility Value-Based Purchasing Program (SNF VBP), and implements requirements for that program, including performance standards, a scoring methodology, and a review and correction process for performance information to be made public, aimed at implementing value-based purchasing for SNFs. Additionally, this final rule includes additional polices and measures in the Skilled Nursing Facility Quality Reporting Program (SNF QRP). This final rule also responds to comments on the SNF Payment Models Research (PMR) project.

Novel Nuclear Powered Photocatalytic Energy Conversion

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

White,John R.; Kinsmen,Douglas; Regan,Thomas M.

2005-08-29

The University of Massachusetts Lowell Radiation Laboratory (UMLRL) is involved in a comprehensive project to investigate a unique radiation sensing and energy conversion technology with applications for in-situ monitoring of spent nuclear fuel (SNF) during cask transport and storage. The technology makes use of the gamma photons emitted from the SNF as an inherent power source for driving a GPS-class transceiver that has the ability to verify the position and contents of the SNF cask. The power conversion process, which converts the gamma photon energy into electrical power, is based on a variation of the successful dye-sensitized solar cell (DSSC)more » design developed by Konarka Technologies, Inc. (KTI). In particular, the focus of the current research is to make direct use of the high-energy gamma photons emitted from SNF, coupled with a scintillator material to convert some of the incident gamma photons into photons having wavelengths within the visible region of the electromagnetic spectrum. The high-energy gammas from the SNF will generate some power directly via Compton scattering and the photoelectric effect, and the generated visible photons output from the scintillator material can also be converted to electrical power in a manner similar to that of a standard solar cell. Upon successful implementation of an energy conversion device based on this new gammavoltaic principle, this inherent power source could then be utilized within SNF storage casks to drive a tamper-proof, low-power, electronic detection/security monitoring system for the spent fuel. The current project has addressed several aspects associated with this new energy conversion concept, including the development of a base conceptual design for an inherent gamma-induced power conversion unit for SNF monitoring, the characterization of the radiation environment that can be expected within a typical SNF storage system, the initial evaluation of Konarka's base solar cell design, the design and fabrication of a range of new cell materials and geometries at Konarka's manufacturing facilities, and the irradiation testing and evaluation of these new cell designs within the UML Radiation Laboratory. The primary focus of all this work was to establish the proof of concept of the basic gammavoltaic principle using a new class of dye-sensitized photon converter (DSPC) materials based on KTI's original DSSC design. In achieving this goal, this report clearly establishes the viability of the basic gammavoltaic energy conversion concept, yet it also identifies a set of challenges that must be met for practical implementation of this new technology.« less

Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities (SNFs) for FY 2016, SNF Value-Based Purchasing Program, SNF Quality Reporting Program, and Staffing Data Collection. Final Rule.

PubMed

2015-08-04

This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2016. In addition, it specifies a SNF all-cause all-condition hospital readmission measure, as well as adopts that measure for a new SNF Value-Based Purchasing (VBP) Program, and includes a discussion of SNF VBP Program policies we are considering for future rulemaking to promote higher quality and more efficient health care for Medicare beneficiaries. Additionally, this final rule will implement a new quality reporting program for SNFs as specified in the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act). It also amends the requirements that a long-term care (LTC) facility must meet to qualify to participate as a skilled nursing facility (SNF) in the Medicare program, or a nursing facility (NF) in the Medicaid program, by establishing requirements that implement the provision in the Affordable Care Act regarding the submission of staffing information based on payroll data.

Medicaid Bed-Hold Policy and Medicare Skilled Nursing Facility Rehospitalizations

PubMed Central

Grabowski, David C; Feng, Zhanlian; Intrator, Orna; Mor, Vincent

2010-01-01

Objective To analyze the effect of states' Medicaid bed-hold policies on the 30-day rehospitalization of Medicare postacute skilled nursing facility (SNF) residents. Data Sources Minimum data set assessments were merged with Medicare claims and eligibility files for all first-time SNF admissions (N = 3,322,088) over the period 2000 through 2005; states' Medicaid bed-hold policies were obtained via survey. Study Design Regression specification incorporating facility fixed effects to examine changes in Medicaid bed-hold policies on the likelihood of a 30-day SNF rehospitalization. Principal Findings Using a continuous measure of bed-hold generosity, state Medicaid bed-hold was positively related to Medicare SNF rehospitalization. Specifically, the introduction of a bed-hold policy with average generosity increases Medicare rehospitalizations by 1.8 percent, representing roughly 12,000 SNF rehospitalizations at a cost to Medicare of approximately U.S.$100 million over our study period. Conclusions Although facilities do not receive a Medicaid bed-hold payment for Medicare SNF stays, we found that the adoption of more generous policies led to greater SNF rehospitalizations. This type of spillover is largely ignored in current discussions of Medicare payment reforms such as bundled payment. Neither Medicare nor Medicaid has an incentive to internalize the risks and benefits of its actions as they affect the other. PMID:20403059

In-Situ Characterization of Underwater Radioactive Sludge

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

Simpson, A.P.; Clapham, M.J.; Swinson, B.

2008-07-01

A fundamental requirement underpinning safe clean-up technologies for legacy spent nuclear fuel (SNF) ponds, pools and wet silos is the ability to characterize the radioactive waste form prior to retrieval. The corrosion products resulting from the long term underwater storage of spent nuclear fuel, reactor components and reprocessing debris present a major hazard to facility decontamination and decommissioning in terms of their radioactive content and physical / chemical reactivity. The ability to perform in-situ underwater non-destructive characterization of sludge and debris in a safe and cost-effective manner offers significant benefits over traditional destructive sampling methods. Several techniques are available formore » underwater measurements including (i) Gross gamma counting, (ii) Low-, Medium- and High- Resolution Gamma Spectroscopy, (iii) Passive neutron counting and (iv) Active Neutron Interrogation. The optimum technique depends on (i) the radioactive inventory (ii) mechanical access restrictions for deployment of the detection equipment, interrogation sources etc. (iii) the integrity of plant records and (iv) the extent to which Acceptable Knowledge which may be used for 'fingerprinting' the radioactive contents to a marker nuclide. Prior deployments of underwater SNF characterization equipment around the world have been reviewed with respect to recent developments in gamma and neutron detection technologies, digital electronics advancements, data transfer techniques, remote operation capabilities and improved field ruggedization. Modeling and experimental work has been performed to determine the capabilities, performance envelope and operational limitations of the future generation of non-destructive underwater sludge characterization techniques. Recommendations are given on the optimal design of systems and procedures to provide an acceptable level of confidence in the characterization of residual sludge content of legacy wet storage facilities such that retrieval and repackaging of SNF sludges may proceed safely and efficiently with support of the regulators and the public. (author)« less

Spent fuel measurements. passive neutron albedo reactivity (PNAR) and photon signatures

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

Eigenbrodt, Julia; Menlove, Howard Olsen

2016-03-29

The International Atomic Energy Agency’s (IAEA) safeguards technical objective is the timely detection of a diversion of a significant quantity of nuclear material from peaceful activities to the manufacture of nuclear weapons or of other nuclear explosive devices or for purposes unknown, and deterrence of such diversion by the risk of early detection. An important IAEA task towards meeting this objective is the ability to accurately and reliably measure spent nuclear fuel (SNF) to verify reactor operating parameters and verify that the fuel has not been removed from reactors or SNF storage facilities. This dissertation analyzes a method to improvemore » the state-of-the-art of nuclear material safeguards measurements using two combined measurement techniques: passive neutron albedo reactivity (PNAR) and passive spectral photon measurements.« less

Criticality Safety Evaluation Report CSER-96-019 for Spent Nuclear Fuel (SNF) Processing and Storage Facilities Multi Canister Overpack (MCO)

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

KESSLER, S.F.

This criticality evaluation is for Spent N Reactor fuel unloaded from the existing canisters in both KE and KW Basins, and loaded into multiple canister overpack (MCO) containers with specially built baskets containing a maximum of either 54 Mark IV or 48 Mark IA fuel assemblies. The criticality evaluations include loading baskets into the cask-MCO, operation at the Cold Vacuum Drying Facility,a nd storage in the Canister Storage Building. Many conservatisms have been built into this analysis, the primary one being the selection of the K{sub eff} = 0.95 criticality safety limit. This revision incorporates the analyses for the sampling/weldmore » station in the Canister Storage Building and additional analysis of the MCO during the draining at CVDF. Additional discussion of the scrap basket model was added to show why the addition of copper divider plates was not included in the models.« less

42 CFR 413.53 - Determination of cost of services to beneficiaries.

Code of Federal Regulations, 2010 CFR

2010-10-01

... DISEASE SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES... paragraph (d) of this section.) Nursing facility (NF)-type services, formerly known as ICF and SNF-type...)(1) of the Act. Skilled nursing facility (SNF)-type services are routine services furnished by a...

Do Hospital-Owned Skilled Nursing Facilities Provide Better Post-Acute Care Quality?

PubMed Central

Norton, Edward C.; Grabowski, David C.

2016-01-01

As hospitals are increasingly held accountable for patients' post-discharge outcomes under new payment models, hospitals may choose to acquire skilled nursing facilities (SNFs) to better manage these outcomes. This raises the question of whether patients discharged to hospital-based SNFs have better outcomes. In unadjusted comparisons, hospital-based SNF patients have much lower Medicare utilization in the 180 days following discharge relative to freestanding SNF patients. We solved the problem of differential selection into hospital-based and freestanding SNFs by using differential distance from home to the nearest hospital with a SNF relative to the distance from home to the nearest hospital without a SNF as an instrument. We found that hospital-based SNF patients spent roughly 5 more days in the community and 6 fewer days in the SNF in the 180 days following their original hospital discharge with no significant effect on mortality or hospital readmission. PMID:27661738

Submittal for 2003 Project of the Year K Basins Fuel Transfer System Project

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

GERBER, M.S.

2003-01-29

Fluor Hanford, Inc. is pleased to submit the K Basins Fuel Transfer System (FTS) for consideration by the Project Management Institute as Project of the Year for 2003. The FTS involved installing a unique, unproven system in an inhospitable and deteriorating radiological and hazardous environment, under very stringent requirements and within an extremely condensed schedule, just 19 months, from authorization to full operations. The FTS, therefore, is an excellent example of effective project management, and the dynamic involvement of an integrated team representing a broad spectrum of personnel, disciplines, and services. The FTS is an integral and critical part ofmore » a larger project at Hanford -the Spent Nuclear Fuel Project (SNF). The mission of the SNF Project is to relocate used, or spent, nuclear fuel to safe interim storage, permanently dispose of radioactive debris in the K-Basins, and deactivate all related facilities and prepare them for demolition. Today, the FTS is being used to remove highly radioactive nuclear fuel from an aging, and potentially unstable storage in underground pools of water--the K-Basins--and safely transport it to a processing area to be cleaned, dried and sent to safe storage. The role the FTS plays in successfully completing the mission of the SNF Project is concrete evidence of the intrinsic value of project management and a testimonial to the innovation, ingenuity, and teamwork of many--from workers to management and subcontractors, and regulators to stakeholders. It's a true success story and one that will have a happy ending, safely eliminating the risk of potentially contaminating one of Washington state's most valuable natural resources, the Columbia River. This nomination is dedicated to that Project Team.« less

Length of Stay in Skilled Nursing Facilities Following Total Joint Arthroplasty.

PubMed

Haghverdian, Brandon A; Wright, David J; Schwarzkopf, Ran

2017-02-01

The most commonly used postacute care facility after total joint arthroplasty is a skilled nursing facility (SNF). However, little is known regarding the role of physical therapy achievements and insurance status on the decision to discharge from an SNF. In this study, we aim to compare functional outcomes and length of stay (LOS) at an SNF among patients with Medicare vs private health coverage. We retrospectively collected physical therapy data for 114 patients who attended an SNF following acute hospitalization for total joint arthroplasty. Medicare beneficiaries were compared with patients covered by Managed Care (MC) policies (health maintenance organization [HMO] and preferred provider organization [PPO]) using several SNF discharge outcomes, including LOS, distance ambulated, and functional independence in gait, transfers, and bed mobility. LOS at the SNF was significantly longer for Medicare patients (Medicare: 24 ± 22 days, MC: 12 ± 7 days, P = .007). After adjusting for LOS and covariates, MC patients had significantly greater achievements in all functional outcomes measured. In a study subanalysis, Medicare patients were found to achieve similar functional outcomes by SNF day 14 as MC patients achieved by their day of discharge on approximately day 12. Yet, the Medicare group was not discharged until several days later. Medicare status is associated with poor functional outcomes, long LOS, and slow progress in the SNF. Our results suggest that insurance reimbursement may be a primary factor in the decision to discharge, rather than the achievement of functional milestones. Copyright © 2016 Elsevier Inc. All rights reserved.

Defining skilled nursing facility residents' dining style preferences.

PubMed

Adams, Katy; Anderson, Janet B; Archuleta, Martha; Smith Kudin, Janette

2013-01-01

The desire of skilled nursing facilities to increase quality of service to meet changes in residents' expectations, improve marketability, and adhere to regulations warrant a new look at culture change and homelike dining as defined by residents in skilled nursing facilities (SNF). The objectives of this study were to determine residents' home dining practices, to define residents' desired dining style practices in the SNF, and to determine the relationship between home dining practices and dining preferences in SNF. One hundred and four residents in three SNF in the central Texas area who met the cognition criteria and consumed facility-provided food were engaged in a standardized interview using the Resident Dining Style Preferences Survey. Data were analyzed to determine the degree to which home practices determine SNF dining preferences. Our findings showed that the majority of the participants want hot, home cooked meals served in the dining room. They want to be seated at the table with friends and neighbors and served on every day plates in a quiet atmosphere, with food served restaurant or table service style. Length of stay and generational group were not significant predictors of dining style preferences. Study limitations included small sample size and lack of ethnic diversity. Our study results show that removing dining time restrictions may be the most valuable adaptation for a SNF looking to initiate culture change.

First-dollar cost-sharing for skilled nursing facility care in medicare advantage plans.

PubMed

Keohane, Laura M; Grebla, Regina C; Rahman, Momotazur; Mukamel, Dana B; Lee, Yoojin; Mor, Vincent; Trivedi, Amal

2017-08-29

The initial days of a Medicare-covered skilled nursing facility (SNF) stay may have no cost-sharing or daily copayments depending on beneficiaries' enrollment in traditional Medicare or Medicare Advantage. Some policymakers have advocated imposing first-dollar cost-sharing to reduce post-acute expenditures. We examined the relationship between first-dollar cost-sharing for a SNF stay and use of inpatient and SNF services. We identified seven Medicare Advantage plans that introduced daily SNF copayments of $25-$150 in 2009 or 2010. Copays began on the first day of a SNF admission. We matched these plans to seven matched control plans that did not introduce first-dollar cost-sharing. In a difference-in-differences analysis, we compared changes in SNF and inpatient utilization for the 172,958 members of intervention and control plans. In intervention plans the mean annual number of SNF days per 100 continuously enrolled inpatients decreased from 768.3 to 750.6 days when cost-sharing changes took effect. Control plans experienced a concurrent increase: 721.7 to 808.1 SNF days per 100 inpatients (adjusted difference-in-differences: -87.0 days [95% CI (-112.1,-61.9)]). In intervention plans, we observed no significant changes in the probability of any SNF service use or the number of inpatient days per hospitalized member relative to concurrent trends among control plans. Among several strategies Medicare Advantage plans can employ to moderate SNF use, first-dollar SNF cost-sharing may be one influential factor. Not applicable.

Unexplained Variation for Hospitals' Use of Inpatient Rehabilitation and Skilled Nursing Facilities After an Acute Ischemic Stroke.

PubMed

Xian, Ying; Thomas, Laine; Liang, Li; Federspiel, Jerome J; Webb, Laura E; Bushnell, Cheryl D; Duncan, Pamela W; Schwamm, Lee H; Stein, Joel; Fonarow, Gregg C; Hoenig, Helen; Montalvo, Cris; George, Mary G; Lutz, Barbara J; Peterson, Eric D; Bettger, Janet Prvu

2017-10-01

Rehabilitation is recommended after a stroke to enhance recovery and improve outcomes, but hospital's use of inpatient rehabilitation facilities (IRFs) or skilled nursing facility (SNF) and the factors associated with referral are unknown. We analyzed clinical registry and claims data for 31 775 Medicare beneficiaries presenting with acute ischemic stroke from 918 Get With The Guidelines-Stroke hospitals who were discharged to either IRF or SNF between 2006 and 2008. Using a multilevel logistic regression model, we evaluated patient and hospital characteristics, as well as geographic availability, in relation to discharge to either IRF or SNF. After accounting for observed factors, the median odds ratio was reported to quantify hospital-level variation in the use of IRF versus SNF. Of 31 775 patients, 17 662 (55.6%) were discharged to IRF and 14 113 (44.4%) were discharged to SNF. Compared with SNF patients, IRF patients were younger, more were men, had less health-service use 6 months prestroke, and had fewer comorbid conditions and in-hospital complications. Use of IRF or SNF varied significantly across hospitals (median IRF use, 55.8%; interquartile range, 34.8%-75.0%; unadjusted median odds ratio, 2.59; 95% confidence interval, 2.44-2.77). Hospital-level variation in discharge rates to IRF or SNF persisted after adjustment for patient, clinical, and geographic variables (adjusted median odds ratio, 2.87; 95% confidence interval, 2.68-3.11). There is marked unexplained variation among hospitals in their use of IRF versus SNF poststroke even after accounting for clinical characteristics and geographic availability. URL: https://clinicaltrials.gov. Unique identifier: NCT02284165. © 2017 American Heart Association, Inc.

Improving medication information transfer between hospitals, skilled-nursing facilities, and long-term-care pharmacies for hospital discharge transitions of care: A targeted needs assessment using the Intervention Mapping framework.

PubMed

Kerstenetzky, Luiza; Birschbach, Matthew J; Beach, Katherine F; Hager, David R; Kennelty, Korey A

2018-02-01

Patients transitioning from the hospital to a skilled nursing home (SNF) are susceptible to medication-related errors resulting from fragmented communication between facilities. Through continuous process improvement efforts at the hospital, a targeted needs assessment was performed to understand the extent of medication-related issues when patients transition from the hospital into a SNF, and the gaps between the hospital's discharge process, and the needs of the SNF and long-term care (LTC) pharmacy. We report on the development of a logic model that will be used to explore methods for minimizing patient care medication delays and errors while further improving handoff communication to SNF and LTC pharmacy staff. Applying the Intervention Mapping (IM) framework, a targeted needs assessment was performed using quantitative and qualitative methods. Using the hospital discharge medication list as reference, medication discrepancies in the SNF and LTC pharmacy lists were identified. SNF and LTC pharmacy staffs were also interviewed regarding the continuity of medication information post-discharge from the hospital. At least one medication discrepancy was discovered in 77.6% (n = 45/58) of SNF and 76.0% (n = 19/25) of LTC pharmacy medication lists. A total of 191 medication discrepancies were identified across all SNF and LTC pharmacy records. Of the 69 SNF staff interviewed, 20.3% (n = 14) reported patient care delays due to omitted documents during the hospital-to-SNF transition. During interviews, communication between the SNF/LTC pharmacy and the discharging hospital was described by facility staff as unidirectional with little opportunity for feedback on patient care concerns. The targeted needs assessment guided by the IM framework has lent to several planned process improvements initiatives to help reduce medication discrepancies during the hospital-to-SNF transition as well as improve communication between healthcare entities. Opening lines of communication along with aligning healthcare entity goals may help prevent medication-related errors. Copyright © 2017 Elsevier Inc. All rights reserved.

Issues relating to spent nuclear fuel storage on the Oak Ridge Reservation

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

Klein, J.A.; Turner, D.W.

1994-12-31

Currently, about 2,800 metric tons of spent nuclear fuel (SNF) is stored in the US, 1,000 kg of SNF (or about 0.03% of the nation`s total) are stored at the US Department of Energy (DOE) complex in Oak Ridge, Tennessee. However small the total quantity of material stored at Oak Ridge, some of the material is quite singular in character and, thus, poses unique management concerns. The various types of SNF stored at Oak Ridge will be discussed including: (1) High-Flux Isotope Reactor (HFIR) and future Advanced Neutron Source (ANS) fuels; (2) Material Testing Reactor (MTR) fuels, including Bulk Shieldingmore » Reactor (BSR) and Oak Ridge Research Reactor (ORR) fuels; (3) Molten Salt Reactor Experiment (MSRE) fuel; (4) Homogeneous Reactor Experiment (HRE) fuel; (5) Miscellaneous SNF stored in Oak Ridge National Laboratory`s (ORNL`s) Solid Waste Storage Areas (SWSAs); (6) SNF stored in the Y-12 Plant 9720-5 Warehouse including Health. Physics Reactor (HPRR), Space Nuclear Auxiliary Power (SNAP-) 10A, and DOE Demonstration Reactor fuels.« less

A Cluster of Group A Streptococcal Infections in a Skilled Nursing Facility-the Potential Role of Healthcare Worker Presenteeism.

PubMed

Kobayashi, Miwako; Lyman, Meghan M; Francois Watkins, Louise K; Toews, Karrie-Ann; Bullard, Leon; Radcliffe, Rachel A; Beall, Bernard; Langley, Gayle; Beneden, Chris Van; Stone, Nimalie D

2016-12-01

To determine the extent of a group A streptococcus (GAS) cluster (2 residents with invasive GAS (invasive case-patients), 2 carriers) caused by a single strain (T antigen type 2 and M protein gene subtype 2.0 (T2, emm 2.0)), evaluate factors contributing to transmission, and provide recommendations for disease control. Cross-sectional analysis and retrospective review. Skilled nursing facility (SNF). SNF residents and staff. The initial cluster was identified through laboratory notification and screening of SNF residents with wounds. Laboratory and SNF administrative records were subsequently reviewed to identify additional residents with GAS, oropharyngeal and wound (if present) swabs were collected from SNF staff and residents to examine GAS colonization, staff were surveyed to assess infection control practices and risk factors for GAS colonization, epidemiologic links between case-patients and persons colonized with GAS were determined, and facility infection control practices were assessed. No additional invasive case-patients were identified. Oropharyngeal swabs obtained from all 167 SNF residents were negative; one wound swab grew GAS that was the same as the outbreak strain (T2, emm 2.0). The outbreak strain was not identified in any of the 162 staff members. One of six staff members diagnosed with GAS pharyngitis worked while ill and had direct contact with invasive case-patients within a few weeks before their onset of symptoms. Additional minor breaches in infection control were noted. Sick healthcare workers may have introduced GAS into the SNF, with propagation by infection control lapses. "Presenteeism," or working while ill, may introduce and transmit GAS to vulnerable in SNF populations. Identification of an invasive GAS case-patient should trigger a prompt response by facilities to prevent further transmission and workplace culture, and policies should be in place to discourage presenteeism in healthcare settings. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Process Evaluation of a Quality Improvement Project to Decrease Hospital Readmissions From Skilled Nursing Facilities.

PubMed

Meehan, Thomas P; Qazi, Daniel J; Van Hoof, Thomas J; Ho, Shih-Yieh; Eckenrode, Sheila; Spenard, Ann; Pandolfi, Michelle; Johnson, Florence; Quetti, Deborah

2015-08-01

To describe and evaluate the impact of quality improvement (QI) support provided to skilled nursing facilities (SNFs) by a Quality Improvement Organization (QIO). Retrospective, mixed-method, process evaluation of a QI project intended to decrease preventable hospital readmissions from SNFs. Five SNFs in Connecticut. SNF Administrators, Directors of Nursing, Assistant Directors of Nursing, Admissions Coordinators, Registered Nurses, Certified Nursing Assistants, Receptionists, QIO Quality Improvement Consultant. QIO staff provided training and technical assistance to SNF administrative and clinical staff to establish or enhance QI infrastructure and implement an established set of QI tools [Interventions to Reduce Acute Care Transfers (INTERACT) tools]. Baseline SNF demographic, staffing, and hospital readmission data; baseline and follow-up SNF QI structure (QI Committee), processes (general and use of INTERACT tools), and outcome (30-day all-cause hospital readmission rates); details of QIO-provided training and technical assistance; QIO-perceived barriers to quality improvement; SNF leadership-perceived barriers, accomplishments, and suggestions for improvement of QIO support. Success occurred in establishing QI Committees and targeting preventable hospital readmissions, as well as implementing INTERACT tools in all SNFs; however, hospital readmission rates decreased in only 2 facilities. QIO staff and SNF leaders noted the ongoing challenge of engaging already busy SNF staff and leadership in QI activities. SNF leaders reported that they appreciated the training and technical assistance that their institutions received, although most noted that additional support was needed to bring about improvement in readmission rates. This process evaluation documented mixed clinical results but successfully identified opportunities to improve recruitment of and provision of technical support to participating SNFs. Recommendations are offered for others who wish to conduct similar projects. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. All rights reserved.

Using antibiograms to improve antibiotic prescribing in skilled nursing facilities.

PubMed

Furuno, Jon P; Comer, Angela C; Johnson, J Kristie; Rosenberg, Joseph H; Moore, Susan L; MacKenzie, Thomas D; Hall, Kendall K; Hirshon, Jon Mark

2014-10-01

Antibiograms have effectively improved antibiotic prescribing in acute-care settings; however, their effectiveness in skilled nursing facilities (SNFs) is currently unknown. To develop SNF-specific antibiograms and identify opportunities to improve antibiotic prescribing. Cross-sectional and pretest-posttest study among residents of 3 Maryland SNFs. Antibiograms were created using clinical culture data from a 6-month period in each SNF. We also used admission clinical culture data from the acute care facility primarily associated with each SNF for transferred residents. We manually collected all data from medical charts, and antibiograms were created using WHONET software. We then used a pretest-posttest study to evaluate the effectiveness of an antibiogram on changing antibiotic prescribing practices in a single SNF. Appropriate empirical antibiotic therapy was defined as an empirical antibiotic choice that sufficiently covered the infecting organism, considering antibiotic susceptibilities. We reviewed 839 patient charts from SNF and acute care facilities. During the initial assessment period, 85% of initial antibiotic use in the SNFs was empirical, and thus only 15% of initial antibiotics were based on culture results. Fluoroquinolones were the most frequently used empirical antibiotics, accounting for 54.5% of initial prescribing instances. Among patients with available culture data, only 35% of empirical antibiotic prescribing was determined to be appropriate. In the single SNF in which we evaluated antibiogram effectiveness, prevalence of appropriate antibiotic prescribing increased from 32% to 45% after antibiogram implementation; however, this was not statistically significant ([Formula: see text]). Implementation of antibiograms may be effective in improving empirical antibiotic prescribing in SNFs.

REGIONAL BINNING FOR CONTINUED STORAGE OF SPENT NUCLEAR FUEL AND HIGH-LEVEL WASTES

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

W. Lee Poe, Jr

1998-10-01

In the Continued Storage Analysis Report (CSAR) (Reference 1), DOE decided to analyze the environmental consequences of continuing to store the commercial spent nuclear fuel (SNF) at 72 commercial nuclear power sites and DOE-owned spent nuclear fuel and high-level waste at five Department of Energy sites by region rather than by individual site. This analysis assumes that three commercial facilities pairs--Salem and Hope Creek, Fitzpatrick and Nine-Mile Point, and Dresden and Moms--share common storage due to their proximity to each other. The five regions selected for this analysis are shown on Figure 1. Regions 1, 2, and 3 are themore » same as those used by the Nuclear Regulatory Commission in their regulatory oversight of commercial power reactors. NRC Region 4 was subdivided into two regions to more appropriately define the two different climates that exist in NRC Region 4. A single hypothetical site in each region was assumed to store all the SNF and HLW in that region. Such a site does not exist and has no geographic location but is a mathematical construct for analytical purposes. To ensure that the calculated results for the regional analyses reflect appropriate inventory, facility and material degradation, and radionuclide transport, the waste inventories, engineered barriers, and environmental conditions for the hypothetical sites were developed from data for each of the existing sites within the given region. Weighting criteria to account for the amount and types of SNF and HLW at each site were used in the development of the environmental data for the regional site, such that the results of the analyses for the hypothetical site were representative of the sum of the results of each actual site if they had been modeled independently. This report defines the actual site data used in development of this hypothetical site, shows how the individual site data was weighted to develop the regional site, and provides the weighted data used in the CSAR analysis. It is divided into Part 1 that defines time-dependent releases from each regional site, Part 2 that defines transport conditions through the groundwater, and Part 3 that defines transport through surface water and populations using the surface waters for drinking.« less

Utilization of acute care among patients with ESRD discharged home from skilled nursing facilities.

PubMed

Hall, Rasheeda K; Toles, Mark; Massing, Mark; Jackson, Eric; Peacock-Hinton, Sharon; O'Hare, Ann M; Colón-Emeric, Cathleen

2015-03-06

Older adults with ESRD often receive care in skilled nursing facilities (SNFs) after an acute hospitalization; however, little is known about acute care use after SNF discharge to home. This study used Medicare claims for North and South Carolina to identify patients with ESRD who were discharged home from a SNF between January 1, 2010 and August 31, 2011. Nursing Home Compare data were used to ascertain SNF characteristics. The primary outcome was time from SNF discharge to first acute care use (hospitalization or emergency department visit) within 30 days. Cox proportional hazards models were used to identify patient and facility characteristics associated with the outcome. Among 1223 patients with ESRD discharged home from a SNF after an acute hospitalization, 531 (43%) had at least one rehospitalization or emergency department visit within 30 days. The median time to first acute care use was 37 days. Characteristics associated with a shorter time to acute care use were black race (hazard ratio [HR], 1.25; 95% confidence interval [95% CI], 1.04 to 1.51), dual Medicare-Medicaid coverage (HR, 1.24; 95% CI, 1.03 to 1.50), higher Charlson comorbidity score (HR, 1.07; 95% CI, 1.01 to 1.12), number of hospitalizations during the 90 days before SNF admission (HR, 1.12; 95% CI, 1.03 to 1.22), and index hospital discharge diagnoses of cellulitis, abscess, and/or skin ulcer (HR, 2.59; 95% CI, 1.36 to 4.45). Home health use after SNF discharge was associated with a lower rate of acute care use (HR, 0.72; 95% CI, 0.59 to 0.87). There were no statistically significant associations between SNF characteristics and time to first acute care use. Almost one in every two older adults with ESRD discharged home after a post-acute SNF stay used acute care services within 30 days of discharge. Strategies to reduce acute care utilization in these patients are needed. Copyright © 2015 by the American Society of Nephrology.

Amplicon Sequencing Reveals Microbiological Signatures in Spent Nuclear Fuel Storage Basins

DOE PAGES

Bagwell, Christopher E.; Noble, Peter A.; Milliken, Charles E.; ...

2018-03-09

Water quality is an important determinant for the structural integrity of alloy cladded fuels and assemblies during long-term wet storage. Detailed characterization of a water filled storage basin for spent nuclear reactor fuel was performed following the formation and proliferation of an amorphous white flocculent. White precipitant was sampled throughout the storage basin for chemical and spectroscopic characterization, and environmental DNA was extracted for 454 pyrosequencing of bacterial 16S rRNA gene diversity. Accordingly, spectroscopic analyses indicated the precipitant to be primarily amorphous to crystalline aluminum (oxy) hydroxides with minor associated elemental components including Fe, Si, Ti, and U. High levelsmore » of organic carbon were co-localized with the precipitant relative to bulk dissolved organic concentrations. Bacterial densities were highly variable between sampling locations and with depth within the water filled storage basin; cell numbers ranged from 4 × 10 3to 4 × 104 cells/mL. Bacterial diversity that was physically associated with the aluminum (oxy) hydroxide complexes exceeded an estimated 4,000 OTUs/amplicon library (3% cutoff) and the majority of sequences were aligned to the families Burkholderiaceae (23%), Nitrospiraceae (23%), Hyphomicrobiaceae (17%), and Comamonadaceae (6%). We surmise that episodic changes in the physical and chemical properties of the basin contribute to the polymerization of aluminum (oxy) hydroxides, which in turn can chemisorb nutrients, carbon ligands and bacterial cells from the surrounding bulk aqueous phase. As such, these precipitants should establish favorable microhabitats for bacterial colonization and growth. Comparative analyses of 16S rRNA gene amplicon libraries across a selection of natural and engineered aquatic ecosystems were performed and microbial community and taxonomic signatures unique to the spent nuclear fuel (SNF) storage basin environment were revealed. These insights could spur the development of tractable bio-indicators that are specific of and diagnostic for water quality at discrete locations and finer scales of resolution, marking an important contribution for improved water quality and management of SNF storage facilities.« less

Amplicon Sequencing Reveals Microbiological Signatures in Spent Nuclear Fuel Storage Basins

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

Bagwell, Christopher E.; Noble, Peter A.; Milliken, Charles E.

Water quality is an important determinant for the structural integrity of alloy cladded fuels and assemblies during long-term wet storage. Detailed characterization of a water filled storage basin for spent nuclear reactor fuel was performed following the formation and proliferation of an amorphous white flocculent. White precipitant was sampled throughout the storage basin for chemical and spectroscopic characterization, and environmental DNA was extracted for 454 pyrosequencing of bacterial 16S rRNA gene diversity. Accordingly, spectroscopic analyses indicated the precipitant to be primarily amorphous to crystalline aluminum (oxy) hydroxides with minor associated elemental components including Fe, Si, Ti, and U. High levelsmore » of organic carbon were co-localized with the precipitant relative to bulk dissolved organic concentrations. Bacterial densities were highly variable between sampling locations and with depth within the water filled storage basin; cell numbers ranged from 4 × 10 3to 4 × 104 cells/mL. Bacterial diversity that was physically associated with the aluminum (oxy) hydroxide complexes exceeded an estimated 4,000 OTUs/amplicon library (3% cutoff) and the majority of sequences were aligned to the families Burkholderiaceae (23%), Nitrospiraceae (23%), Hyphomicrobiaceae (17%), and Comamonadaceae (6%). We surmise that episodic changes in the physical and chemical properties of the basin contribute to the polymerization of aluminum (oxy) hydroxides, which in turn can chemisorb nutrients, carbon ligands and bacterial cells from the surrounding bulk aqueous phase. As such, these precipitants should establish favorable microhabitats for bacterial colonization and growth. Comparative analyses of 16S rRNA gene amplicon libraries across a selection of natural and engineered aquatic ecosystems were performed and microbial community and taxonomic signatures unique to the spent nuclear fuel (SNF) storage basin environment were revealed. These insights could spur the development of tractable bio-indicators that are specific of and diagnostic for water quality at discrete locations and finer scales of resolution, marking an important contribution for improved water quality and management of SNF storage facilities.« less

Amplicon Sequencing Reveals Microbiological Signatures in Spent Nuclear Fuel Storage Basins.

PubMed

Bagwell, Christopher E; Noble, Peter A; Milliken, Charles E; Li, Dien; Kaplan, Daniel I

2018-01-01

Water quality is an important determinant for the structural integrity of alloy cladded fuels and assemblies during long-term wet storage. Detailed characterization of a water filled storage basin for spent nuclear reactor fuel was performed following the formation and proliferation of an amorphous white flocculent. White precipitant was sampled throughout the storage basin for chemical and spectroscopic characterization, and environmental DNA was extracted for 454 pyrosequencing of bacterial 16S rRNA gene diversity. Accordingly, spectroscopic analyses indicated the precipitant to be primarily amorphous to crystalline aluminum (oxy) hydroxides with minor associated elemental components including Fe, Si, Ti, and U. High levels of organic carbon were co-localized with the precipitant relative to bulk dissolved organic concentrations. Bacterial densities were highly variable between sampling locations and with depth within the water filled storage basin; cell numbers ranged from 4 × 10 3 to 4 × 10 4 cells/mL. Bacterial diversity that was physically associated with the aluminum (oxy) hydroxide complexes exceeded an estimated 4,000 OTUs/amplicon library (3% cutoff) and the majority of sequences were aligned to the families Burkholderiaceae (23%), Nitrospiraceae (23%), Hyphomicrobiaceae (17%), and Comamonadaceae (6%). We surmise that episodic changes in the physical and chemical properties of the basin contribute to the polymerization of aluminum (oxy) hydroxides, which in turn can chemisorb nutrients, carbon ligands and bacterial cells from the surrounding bulk aqueous phase. As such, these precipitants should establish favorable microhabitats for bacterial colonization and growth. Comparative analyses of 16S rRNA gene amplicon libraries across a selection of natural and engineered aquatic ecosystems were performed and microbial community and taxonomic signatures unique to the spent nuclear fuel (SNF) storage basin environment were revealed. These insights could spur the development of tractable bio-indicators that are specific of and diagnostic for water quality at discrete locations and finer scales of resolution, marking an important contribution for improved water quality and management of SNF storage facilities.

Amplicon Sequencing Reveals Microbiological Signatures in Spent Nuclear Fuel Storage Basins

PubMed Central

Bagwell, Christopher E.; Noble, Peter A.; Milliken, Charles E.; Li, Dien; Kaplan, Daniel I.

2018-01-01

Water quality is an important determinant for the structural integrity of alloy cladded fuels and assemblies during long-term wet storage. Detailed characterization of a water filled storage basin for spent nuclear reactor fuel was performed following the formation and proliferation of an amorphous white flocculent. White precipitant was sampled throughout the storage basin for chemical and spectroscopic characterization, and environmental DNA was extracted for 454 pyrosequencing of bacterial 16S rRNA gene diversity. Accordingly, spectroscopic analyses indicated the precipitant to be primarily amorphous to crystalline aluminum (oxy) hydroxides with minor associated elemental components including Fe, Si, Ti, and U. High levels of organic carbon were co-localized with the precipitant relative to bulk dissolved organic concentrations. Bacterial densities were highly variable between sampling locations and with depth within the water filled storage basin; cell numbers ranged from 4 × 103to 4 × 104 cells/mL. Bacterial diversity that was physically associated with the aluminum (oxy) hydroxide complexes exceeded an estimated 4,000 OTUs/amplicon library (3% cutoff) and the majority of sequences were aligned to the families Burkholderiaceae (23%), Nitrospiraceae (23%), Hyphomicrobiaceae (17%), and Comamonadaceae (6%). We surmise that episodic changes in the physical and chemical properties of the basin contribute to the polymerization of aluminum (oxy) hydroxides, which in turn can chemisorb nutrients, carbon ligands and bacterial cells from the surrounding bulk aqueous phase. As such, these precipitants should establish favorable microhabitats for bacterial colonization and growth. Comparative analyses of 16S rRNA gene amplicon libraries across a selection of natural and engineered aquatic ecosystems were performed and microbial community and taxonomic signatures unique to the spent nuclear fuel (SNF) storage basin environment were revealed. These insights could spur the development of tractable bio-indicators that are specific of and diagnostic for water quality at discrete locations and finer scales of resolution, marking an important contribution for improved water quality and management of SNF storage facilities. PMID:29593667

Implementing an Internet-based communication network for use during skilled nursing facility to emergency department care transitions: challenges and opportunities for improvement.

PubMed

Hustey, Fredric M; Palmer, Robert M

2012-03-01

To explore the feasibility of implementing an Internet-based communication network for communication of health care information during skilled nursing facility (SNF)-to-ED care transitions, and to identify potential barriers to system implementation. Qualitative. The largest SNF affiliated with the ED of an urban tertiary care center. Consecutive sample of all patients transferred from SNF to ED over 8 months between June 2007 and January 2008; ED and SNF care providers. The development and implementation of an Internet-based communication network for use during SNF-to-ED care transitions. This network was developed by adapting a preexisting Internet-based system that is widely used to facilitate placement of hospitalized patients into SNFs. Internet-based SNF and ED surveys were used to help identify barriers to implementation. There were 276/276 care transitions reviewed. The Internet-based communication network was used in 76 (28%) care transitions, with usage peaking at 40% near the end of the study. Barriers to success that were identified included lack of an electronic medical record (EMR) at the SNF; pervasive negative attitudes between ED and SNF personnel; time necessary for network use during care transitions; frustration by emergency physicians at low system usage rates by SNF personnel; and additional login requirements by ED personnel. Although implementing an Internet-based network for nursing home to ED communication may be feasible, significant barriers were identified in this study that are likely generalizable to other health care settings. Understanding such barriers is an essential first step toward building successful electronic communication networks in the future. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Testing a diagnosis-related group index for skilled nursing facilities

PubMed Central

Cotterill, Philip G.

1986-01-01

Interest in case-mix measures for use in nursing home payment systems has been stimulated by the Medicare prospective payment system (PPS) for short-term acute-care hospitals. Appropriately matching payment with care needs is important to equitably compensate providers and to encourage them to admit patients who are most in need of nursing home care. The skilled nursing facility (SNF) Medicare benefit covers skilled convalescent or rehabilitative care following a hospital stay. Therefore, it might appear that diagnosis-related groups (DRG's), the basis for patient classification in PPS, could also be used for the Medicare SNF program. In this study, a DRG-based case-mix index (CMI) was developed and tested to determine how well it explains cost differences among SNF's. The results suggest that a DRG-based SNF payment system would be highly problematic. Incentives of this system would appear to discourage placement of patients who require relatively expensive care. PMID:10311674

Testing a diagnosis-related group index for skilled nursing facilities.

PubMed

Cotterill, P G

1986-01-01

Interest in case-mix measures for use in nursing home payment systems has been stimulated by the Medicare prospective payment system (PPS) for short-term acute-care hospitals. Appropriately matching payment with care needs is important to equitably compensate providers and to encourage them to admit patients who are most in need of nursing home care. The skilled nursing facility (SNF) Medicare benefit covers skilled convalescent or rehabilitative care following a hospital stay. Therefore, it might appear that diagnosis-related groups (DRG's), the basis for patient classification in PPS, could also be used for the Medicare SNF program. In this study, a DRG-based case-mix index (CMI) was developed and tested to determine how well it explains cost differences among SNF's. The results suggest that a DRG-based SNF payment system would be highly problematic. Incentives of this system would appear to discourage placement of patients who require relatively expensive care.

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

Scaglione, John M; Montgomery, Rose; Bevard, Bruce Balkcom

This test plan describes the experimental work to be implemented by the U.S. Department of Energy (DOE) Office of Nuclear Energy (NE) to characterize high burnup (HBU) spent nuclear fuel (SNF) in conjunction with the High Burnup Dry Storage Cask Research and Development Project and serves to coordinate and integrate the multi-year experimental program to collect and develop data regarding the continued storage and eventual transport of HBU (i.e., >45 GWd/MTU) SNF. The work scope involves the development, performance, technical integration, and oversight of measurements and collection of relevant data, guided by analyses and demonstration of need.

Modelling of radiation field around spent fuel container.

PubMed

Kryuchkov, E F; Opalovsky, V A; Tikhomirov, G V

2005-01-01

Operation of nuclear reactors leads to the production of spent nuclear fuel (SNF). There are two basic strategies of SNF management: ultimate disposal of SNF in geological formations and recycle or repeated utilisation of reprocessed SNF. In both options, there is an urgent necessity to study radiation properties of SNF. Information about SNF radiation properties is required at all stages of SNF management. In order to reach more effective utilisation of nuclear materials, new fuel cycles are under development based on uranium-plutonium, uranium-thorium and some other types of nuclear fuel. These promising types of nuclear fuel are characterised by quite different radiation properties at all the stages of nuclear fuel cycle (NFC) listed above. So, comparative analysis is required for radiation properties of different nuclear fuel types at different NFC stages. The results presented here were obtained from the numerical analysis of the radiation field around transport containers of different SNF types and in SNF storage. The calculations are carried out with the application of the computer code packages SCALE-4.3 and MCNP-4C. Comparison of the dose parameters obtained for different models of the transport container with experimental data allowed us to make certain conclusions about the errors of numerical results caused by the approximate geometrical description of the transport container.

The role of seasonal sediment storage in tidal channels on a mesotidal delta

NASA Astrophysics Data System (ADS)

Hale, R. P.; Wilson, C.; Bomer, J.; Goodbred, S. L., Jr.; Bain, R. L.

2017-12-01

The Sundarbans National Forest (SNF), located on the modern topset of the Ganges-Brahmaputra-Meghna (GBM) Delta, is the world's largest mangrove stand ( 10,000 km2), and provides a wide range of cultural, environmental, and economic benefits to the nation of Bangladesh. At present, sediment accretion in the SNF occurs at a rate comparable to that of the locally accelerated sea-level rise ( 1.1 cm/yr), despite substantial modification of the regional hydrodynamics via the construction of channel embankments to prevent inundation of agricultural areas. Approximately 50% of the sediment deposited in the SNF each year is recently delivered (<6 mos) from the GBM. As such, reducing sediment supply by an estimated 60-80% as a result of sediment and water diversions associated with India's National River Linking Project raises serious concerns over the SNF's continued sustainability. Here, we examine: 1) the capacity for short-term sediment storage within tidal channels of varying dimensions, and 2) the hydrodynamic conditions responsible for resuspending this material and delivering it to the mangrove platform. We compare textural and radiochemical characteristics from short cores (<50 cm) collected along the intertidal channel banks, with those from the mangrove platform, to assess seasonal storage of GBM sediment within tidal channels, and the timeframe of its delivery to the SNF platform. We also present instrument data from multiple locations within a confined basin of the SNF, using an upward-looking acoustic Doppler current profiler, pressure sensors, and optical backscatter sensors, to document how transport conditions vary with distance away from the primary tidal inlet, and across the platform. This collection of physical and instrumental observations is then compared to an existing dataset of platform inundation hydroperiods and deposition rates, allowing us to address the threat of a reduced sediment supply to this region, as well as the capacity for this system to self-supply sediment to the platform.

Walk the Line: The Development of Route Selection Standards for Spent Nuclear Fuel and High-level Radioactive Waste in the United States - 13519

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

Dilger, Fred; Halstead, Robert J.; Ballard, James D.

2013-07-01

Although storage facilities for spent nuclear fuel (SNF) and high-level radioactive waste (HLRW) are widely dispersed throughout the United States, these materials are also relatively concentrated in terms of geographic area. That is, the impacts of storage occur in a very small geographic space. Once shipments begin to a national repository or centralized interim storage facility, the impacts of SNF and HLRW will become more geographically distributed, more publicly visible, and almost certainly more contentious. The selection of shipping routes will likely be a major source of controversy. This paper describes the development of procedures, regulations, and standards for themore » selection of routes used to ship spent nuclear fuel and high-level radioactive waste in the United States. The paper begins by reviewing the circumstances around the development of HM-164 routing guidelines. The paper discusses the significance of New York City versus the Department of Transportation and application of HM-164. The paper describes the methods used to implement those regulations. The paper will also describe the current HM-164 designated routes and will provide a summary data analysis of their characteristics. This analysis will reveal the relatively small spatial scale of the effects of HM 164. The paper will then describe subsequent developments that have affected route selection for these materials. These developments include the use of 'representative routes' found in the Department of Energy (DOE) 2008 Supplemental Environmental Impact Statement for the formerly proposed Yucca Mountain geologic repository. The paper will describe recommendations related to route selection found in the National Academy of Sciences 2006 report Going the Distance, as well as recommendations found in the 2012 Final Report of the Blue Ribbon Commission on America's Nuclear Future. The paper will examine recently promulgated federal regulations (HM-232) for selection of rail routes for hazardous materials transport. The paper concludes that while the HM 164 regime is sufficient for certain applications, it does not provide an adequate basis for a national plan to ship spent nuclear fuel and high-level radioactive waste to centralized storage and disposal facilities over a period of 30 to 50 years. (authors)« less

An internet-based communication network for information transfer during patient transitions from skilled nursing facility to the emergency department.

PubMed

Hustey, Fredric M; Palmer, Robert M

2010-06-01

To determine whether the implementation of an Internet-based communication system improves the amount of essential information conveyed between a skilled nursing facility (SNF) and the emergency department (ED) during patient care transitions. Interventional; before and after. ED of an urban teaching hospital with approximately 55,000 visits per year and a 55-bed subacute free-standing rehabilitation facility (the SNF). All patients transferred from the SNF to the ED over 16 months. An Internet-based communication network with SNF-ED transfer form for communication during patient care transitions. Nine elements of patient information assessed before and after intervention through chart review. changes in efficiency of information transfer and staff satisfaction. Two hundred thirty-four of 237 preintervention and all 276 postintervention care transitions were reviewed. The Internet communication network was used in 78 (26%) of all care transitions, peaking at 40% by the end of the study. There was more critical patient information (1.85 vs 4.29 of 9 elements; P<.001) contained within fewer pages of transfer documents (24.47 vs 5.15; P<.001) after the intervention. Staff satisfaction with communication was higher among ED physicians after the intervention. The use of an Internet-based system increased the amount of information communicated during SNF-ED care transitions and significantly reduced the number of pages in which this information was contained.

Medicare program; prospective payment system and consolidated billing for skilled nursing facilities for FY 2015. Final rule.

PubMed

2014-08-05

This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2015. In addition, it adopts the most recent Office of Management and Budget (OMB) statistical area delineations to identify a facility's urban or rural status for the purpose of determining which set of rate tables will apply to the facility, and to determine the SNF PPS wage index including a 1-year transition with a blended wage index for all providers for FY 2015. This final rule also contains a revision to policies related to the Change of Therapy (COT) Other Medicare Required Assessment (OMRA). This final rule includes a discussion of a provision related to the Affordable Care Act involving Civil Money Penalties. Finally, this final rule discusses the SNF therapy payment research currently underway within CMS, observed trends related to therapy utilization among SNF providers, and the agency's commitment to accelerating health information exchange in SNFs.

Storage and treatment of SNF of Alfa class nuclear submarines: current status and problems

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

Ignatiev, Sviatoslav; Zabudko, Alexey; Pankratov, Dmitry

Available in abstract form only. Full text of publication follows: The current status and main problems associated with storage, defueling and following treatment of spent nuclear fuel (SNF) of Nuclear Submarines (NS) with heavy liquid metal cooled reactors are considered. In the final analysis these solutions could be realized in the form of separate projects to be funded through national and bi- and multilateral funding in the framework of the international collaboration of the Russian Federation on complex utilization of NS and rehabilitation of contaminated objects allocated in the North-West region of Russia. (authors)

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

W. L. Poe, Jr.; P.F. Wise

The U.S. Department of Energy (DOE) is preparing a proposal to construct, operate 2nd monitor, and eventually close a repository at Yucca Mountain in Nye County, Nevada, for the geologic disposal of spent nuclear fuel (SNF) and high-level radioactive waste (HLW). As part of this effort, DOE has prepared a viability assessment and an assessment of potential consequences that may exist if the repository is not constructed. The assessment of potential consequences if the repository is not constructed assumes that all SNF and HLW would be left at the generator sites. These include 72 commercial generator sites (three commercial facilitymore » pairs--Salem and Hope Creek, Fitzpatrick and Nine Mile Point, and Dresden and Morris--would share common storage due to their close proximity to each other) and five DOE sites across the country. DOE analyzed the environmental consequences of the effects of the continued storage of these materials at these sites in a report titled Continued Storage Analysis Report (CSAR; Reference 1 ) . The CSAR analysis includes a discussion of the degradation of these materials when exposed to the environment. This document describes the environmental parameters that influence the degradation analyzed in the CSAR. These include temperature, relative humidity, precipitation chemistry (pH and chemical composition), annual precipitation rates, annual number of rain-days, and annual freeze/thaw cycles. The document also tabulates weather conditions for each storage site, evaluates the degradation of concrete storage modules and vaults in different regions of the country, and provides a thermal analysis of commercial SNF in storage.« less

Efficient rehabilitation care for joint replacement patients: skilled nursing facility or inpatient rehabilitation facility?

PubMed

Tian, Wenqiang; DeJong, Gerben; Horn, Susan D; Putman, Koen; Hsieh, Ching-Hui; DaVanzo, Joan E

2012-01-01

There has been lengthy debate as to which setting, skilled nursing facility (SNF) or inpatient rehabilitation facility (IRF), is more efficient in treating joint replacement patients. This study aims to determine the efficiency of rehabilitation care provided by SNF and IRF to joint replacement patients with respect to both payment and length of stay (LOS). This study used a prospective multisite observational cohort design. Tobit models were used to examine the association between setting of care and efficiency. The study enrolled 948 knee replacement patients and 618 hip replacement patients from 11 IRFs and 7 SNFs between February 2006 and February 2007. Output was measured by motor functional independence measure (FIM) score at discharge. Efficiency was measured in 3 ways: payment efficiency, LOS efficiency, and stochastic frontier analysis efficiency. IRF patients incurred higher expenditures per case but also achieved larger motor FIM gains in shorter LOS than did SNF patients. Setting of care was not a strong predictor of overall efficiency of rehabilitation care. Great variation in characteristics existed within IRFs or SNFs and severity groups. Medium-volume facilities among both SNFs and IRFs were most efficient. Early rehabilitation was consistently predictive of efficient treatment. The advantage of either setting is not clear-cut. Definition of efficiency depends in part on preference between cost and time. SNFs are more payment efficient; IRFs are more LOS efficient. Variation within SNFs and IRFs blurred setting differences; a simple comparison between SNF and IRF may not be appropriate.

Intensified rehabilitation therapy and transitions to skilled nursing facilities in community-living seniors with acute medical illnesses.

PubMed

Yoo, Ji Won; Kim, Sulgi; Choi, Jai Hyun; Ryu, Woo Sang

2013-07-01

To examine whether rehabilitation therapy type would be associated with transitions to skilled nursing facilities (SNF) in community-living seniors with acute medical illnesses. Using administrative and clinical data, multivariate regression analysis examined the relationship between the extent of rehabilitation therapy and transitions to SNF in all participants, as well as participants by physical function at admission. In all participants (n=929), the intensified rehabilitation therapy was associated with a lower probability of transitions to SNF (14% vs 21%; odds ratio [OR] 0.59; 95% confidence intervals [CI] 0.22-0.96; P=0.02). In participants with mild physical limitations (n=270), less frequent transitions to SNF occurred when patients received intensified rehabilitation therapy [16% vs 23%; OR 0.46; 95% CI 0.17-0.94; P=0.01]. In participants with moderate to severe physical limitations (n=265), the decreased frequency of transitions to SNF associated with rehabilitation therapy became more pronounced (18% vs 28%; OR 0.34; 95% CI 0.07-0.89; P=0.004). By contrast, in participants without physical limitation (n=394), the number of transitions to SNF did not change significantly when they received intensified rehabilitation therapy (P=0.53). We found a significant relationship between intensified rehabilitation therapy and the decrease of transitions to SNF in community-living seniors with acute medical illness. The magnitude of this relationship increased in participants with more physical limitations, but not in participants without physical limitations at admission. © 2012 Japan Geriatrics Society.

Spent nuclear fuel project cold vacuum drying facility operations manual

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

IRWIN, J.J.

This document provides the Operations Manual for the Cold Vacuum Drying Facility (CVDF). The Manual was developed in conjunction with HNF-SD-SNF-SAR-002, Safety Analysis Report for the Cold Vacuum Drying Facility, Phase 2, Supporting Installation of Processing Systems (Garvin 1998) and, the HNF-SD-SNF-DRD-002, 1997, Cold Vacuum Drying Facility Design Requirements, Rev. 3a. The Operations Manual contains general descriptions of all the process, safety and facility systems in the CVDF, a general CVD operations sequence, and has been developed for the SNFP Operations Organization and shall be updated, expanded, and revised in accordance with future design, construction and startup phases of themore » CVDF until the CVDF final ORR is approved.« less

Prioritizing partners across the continuum.

PubMed

Maly, Mary Beth; Lawrence, Susan; Jordan, M Kim; Davies, William J; Weiss, Michael J; Deitrick, Lynn; Salas-Lopez, Debbie

2012-11-01

With the advent of accountable care organizations, bundled payments, value-based purchasing, and penalties for preventable hospital readmission, tight connections and collaboration across the care continuum will become critical to achieve successful patient outcomes and to reduce the cost of care delivery. Lehigh Valley Health Network (LVHN), the largest provider of health services in eastern Pennsylvania, set out on a journey to build collaborative relationships with skilled nursing facilities (SNFs) in their eastern Pennsylvania community. LVHN desired SNF partners with mutual interests in improving quality of care and lowering costs of delivery where possible. Recognizing that not all SNFs are alike, LVHN developed a Collaborative Partner Prioritization Tool to assess and prioritize skilled nursing facilities in an effort to determine those that would make the best collaborators. SNFs were reviewed based on their volume of mutual patients, quality of care delivery, and their perceived willingness to align with LVHN. Six variables were used to assess these facilities, including (1) patient discharge destination volume by SNF; (2) 30-day all-cause readmission rate to an LVHN hospital; (3) Medicare's Nursing Home Compare 5-Star Overall Rating; (4) the health network affiliation of the SNF's medical director; (5) the level of LVHN-employed or -affiliated physician presence at the SNF; and (6) the SNF's current participation in LVHN-sponsored programs and meetings. Through use of the Collaborative Partner Prioritization Tool, it was discovered that roughly 70% of LVHN patients who required skilled nursing care following their inpatient stay received care at 1 of 20 SNFs. Of these, 5 facilities performed well on the 6-variable assessment, deeming them the "Tier 1 Facilities" to initially focus collaborative efforts. LVHN has strategically deployed physician resources and has increased physician presence at these "Tier 1 SNFs." These facilities have also gained remote read-only access to LVHN's inpatient electronic medical record and have had opportunity to participate in LVHN-sponsored programs. Special projects have been co-developed with several SNFs, including a telemedicine-based Parkinson's disease program to increase patient access to a neurologist specially trained in movement disorders. The Collaborative Partner Prioritization Tool has become a powerful tool when used for prioritization of relationships and allocation of LVHN physicians and resources. Collaboration with strong SNF partners has offered a shared opportunity to improve quality of care, reduce costs, and prepare for the many policies affecting the health care industry. Future outcomes of this work will include quality metrics, such as readmissions, patient satisfaction with care, time for decision to admit, and overall costs of care. The data and metrics used to define the prioritization tool will continue to be adapted as the post-acute market and hospital-SNF relationships continue to evolve. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

SNF Interim Storage Canister Corrosion and Surface Environment Investigations

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

Bryan, Charles R.; Enos, David G.

2015-09-01

This progress report describes work being done at Sandia National Laboratories (SNL) to assess the localized corrosion performance of container/cask materials used in the interim storage of spent nuclear fuel (SNF). Of particular concern is stress corrosion cracking (SCC), by which a through-wall crack could potentially form in a canister outer wall over time intervals that are shorter than possible dry storage times. In order for SCC to occur, three criteria must be met. A corrosive environment must be present on the canister surface, the metal must susceptible to SCC, and sufficient tensile stress to support SCC must be presentmore » through the entire thickness of the canister wall. SNL is currently evaluating the potential for each of these criteria to be met.« less

Review of Technical Studies in the United States in Support of Burnup Credit Regulatory Guidance

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

Wagner, John C; Parks, Cecil V; Mueller, Don

2010-01-01

Taking credit for the reduction in reactivity associated with fuel depletion can enable more cost-effective, higher-density storage, transport, disposal, and reprocessing of spent nuclear fuel (SNF) while maintaining sufficient subcritical margin to establish an adequate safety basis. Consequently, there continues to be considerable interest in the United States (U.S.), as well as internationally, in the increased use of burnup credit in SNF operations, particularly related to storage, transport, and disposal of commercial SNF. This interest has motivated numerous technical studies related to the application of burnup credit, both domestically and internationally, as well as the design of SNF storage, transportmore » and disposal systems that rely on burnup credit for maintaining subcriticality. Responding to industry requests and needs, the U.S. Nuclear Regulatory Commission (NRC) initiated a burnup credit research program in 1999, with support from the Oak Ridge National Laboratory (ORNL), to develop regulatory guidance and the supporting technical bases for allowing and expanding the use of burnup credit in pressurized-water reactor SNF storage and transport applications. Although this NRC research program has not been continuous since its inception, considerable progress has been achieved in many key areas in terms of increased understanding of relevant phenomena and issues, availability of relevant information and data, and subsequently updated regulatory guidance for expanded use of burnup credit. This paper reviews technical studies performed by ORNL for the U.S. NRC burnup credit research program. Examples of topics include reactivity effects associated with reactor operating characteristics, fuel assembly characteristics, burnable absorbers, control rods, spatial burnup distributions, cooling time, and assembly misloading; methods and data for validation of isotopic composition predictions; methods and data for validation of criticality calculations; and operational issues and data related to assembly burnup confirmation. The objective of this paper is to summarize the work and significant accomplishments, with references to the technical reports and publications for complete details, and provide a useful resource to others in the burnup credit community.« less

Radiolytic and Thermal Process Relevant to Dry Storage of Spent Nuclear Fuels

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

Marschman, Steven C.; Haustein, Peter E.; Madey, Theodore E.

1999-06-01

This project involves basic research in chemistry and physics aimed at providing information pertinent to the safe long-term dry storage of spent nuclear fuel (SNF), thousands of tons of which remain in water storage across the DOE complex. The Hanford Site K-Basins alone hold 2300 tons of spent fuel, much of it severely corroded, and similar situations exist at Savannah River and Idaho National Engineering and Environmental Laboratory. DOE plans to remove this fuel and seal it in overpack canisters for ''dry'' interim storage for up to 75 years while awaiting permanent disposition. Chemically bound water will remain in thismore » fuel even after the proposed drying steps, leading to possible long-term corrosion of the containers and/or fuel rods themselves, generation of H2 and O2 gas via radiolysis (which could lead to deflagration or detonation), and reactions of pyrophoric uranium hydrides. No thoroughly tested model is now available to predict fuel behavior during preprocessing, processing, or storage. In a collaborative effort among Rutgers University, Pacific Northwest National Laboratory, and Brookhaven National Laboratory, we are studying the radiolytic reaction, drying processes, and corrosion behavior of actual SNF materials and of pure and mixed-phase samples. We propose to determine what is omitted from current models: radiolysis of water adsorbed on or in hydrates or hydroxides, thermodynamics of interfacial phases, and kinetics of drying. A model will be developed and tested against actual fuel rod behavior to ensure validity and applicability to the problems associated with developing dry storage strategies for DOE-owned SNF.« less

Preliminary Evaluation of Removing Used Nuclear Fuel from Shutdown Sites

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

Maheras, Steven J.; Best, Ralph E.; Ross, Steven B.

A preliminary evaluation of removing spent nuclear fuel (SNF) from 13 shutdown nuclear power plant sites was performed. At these shutdown sites the nuclear power reactors have been permanently shut down and the sites have been decommissioned or are undergoing decommissioning. The shutdown sites were Maine Yankee, Yankee Rowe, Connecticut Yankee, Humboldt Bay, Big Rock Point, Rancho Seco, Trojan, La Crosse, Zion, Crystal River, Kewaunee, San Onofre, and Vermont Yankee. The evaluation was divided into four components: Characterization of the SNF and greater-than-Class C low-level radioactive waste (GTCC waste) inventory A description of the on-site infrastructure at the shutdown sitesmore » An evaluation of the near-site transportation infrastructure and transportation experience at the shutdown sites An evaluation of the actions necessary to prepare for and remove SNF and GTCC waste. The primary sources for the inventory of SNF and GTCC waste were the U.S. Department of Energy (DOE) spent nuclear fuel inventory database, industry publications such as StoreFUEL, and government sources such as the U.S. Nuclear Regulatory Commission. The primary sources for information on the conditions of on-site infrastructure and near-site transportation infrastructure and experience included information collected during site visits, information provided by managers at the shutdown sites, Facility Interface Data Sheets compiled for DOE in 2005, Services Planning Documents prepared for DOE in 1993 and 1994, industry publications such as Radwaste Solutions, and Google Earth. State staff, State Regional Group representatives, a Tribal representative, and a Federal Railroad Administration representative have participated in nine of the shutdown site visits. Every shutdown site was found to have at least one off-site transportation mode option for removing its SNF and GTCC waste; some have multiple options. Experience removing large components during reactor decommissioning provided an important source of information used to identify the transportation mode options for the sites. Especially important in conducting the evaluation were site visits, through which information was obtained that would not have been available otherwise. Extensive photographs taken during the site visits proved to be particularly useful in documenting the current conditions at or near the sites. Additional conclusions from this evaluation include: The 13 shutdown sites use designs from 4 different suppliers involving 11 different (horizontal and vertical) dry storage systems that would require the use of 9 different transportation cask designs to remove the SNF and GTCC waste from the shutdown sites. Although some changes to transportation certificates of compliance will be required, the SNF at the initial 9 shutdown sites (Maine Yankee, Yankee Rowe, Connecticut Yankee, Humboldt Bay, Big Rock Point, Rancho Seco, Trojan, La Crosse, and Zion) is in dual purpose dry storage canisters that can be transported, including a small amount of high-burnup fuel. Most sites indicated that 2-3 years of advance time would be required for its preparations before shipments could begin. Some sites could be ready in less time. As additional sites such as Fort Calhoun, Clinton, Quad Cities, Pilgrim, Oyster Creek, and Diablo Canyon shut down, these sites will be included in updates to the evaluation.« less

The impact of a skilled nursing facility on the cost of surgical treatment of major head and neck tumors.

PubMed

Seikaly, H; Calhoun, K H; Stonestreet, J S; Rassekh, C H; Driscoll, B P; Averyt, P

2001-09-01

The finite resources available for health care and the proliferation of managed care in the United States have forced the head and neck surgeon to critically evaluate the cost of tumor treatment. To determine whether the cost of treating patients with head and neck tumors would be reduced if the patients were to spend a portion of what would otherwise be acute care hospital days in a hospital-based skilled nursing facility (HB/SNF). Retrospective cost-benefit analysis. Tertiary referral center. Twenty-four consecutive hospital admissions for definitive surgical treatment of head and neck tumors were retrospectively reviewed. The postoperative day on which the patient theoretically could have been transferred to the HB/SNF was determined. The charges and cost of each patient's actual hospital stay were compared with the theoretical counterparts had the patient been transferred to the HB/SNF on the determined day. Cost savings. The total hospital stay for the 24 patients was 524 days. One hundred eighty-two of those days could have been spent in the HB/SNF. The total charge and cost savings with the use of an HB/SNF were $201,045 and $84,238, respectively (15% of the total charge and cost). This represents an average charge and cost savings of $8377 and $3510, respectively, per patient. The difference was statistically significant (P<.005). An HB/SNF could reduce the cost of head and neck tumor treatment without compromising patient care.

A Randomized Trial of Heart Failure Disease Management in Skilled Nursing Facilities: Design and Rationale

PubMed Central

Boxer, Rebecca S.; Dolansky, Mary A.; Bodnar, Christine A.; Singer, Mendel E.; Albert, Jeffery M.; Gravenstein, Stefan

2013-01-01

Background Heart failure disease management can improve health outcomes for older community dwelling patients with heart failure. Heart failure disease management has not been studied in skilled nursing facilities, a major site of transitional care for older adults. Methods and Anticipated Results The objective of this trial is to investigate if a heart failure disease management program (HF-DMP) in skilled nursing facilities (SNF) will decrease all-cause rehospitalizations for the first 60 days post SNF admission. The trial is a randomized cluster trial to be conducted in 12 for-profit SNF in the greater Cleveland area. The study population is inclusive of patients with heart failure regardless of ejection fraction but excludes those patients on dialysis and with a life expectancy of 6 months or less. The HF-DMP includes 7 elements considered standard of care for patients with heart failure: documentation of left ventricular function, tracking of weight and symptoms, medication titration, discharge instructions, 7 day follow up appointment post SNF discharge, patient education. The HF-DMP is conducted by a research nurse tasked with adhering to each element of the program and regularly audited to maintain fidelity of the program. Additional outcomes include health status, self-care management, and discharge destination. Conclusion The SNF-Connect Trial is the first trial of its kind to assess if a HF-DMP will improve outcomes for patients in SNFs. This trial will provide evidence on the effectiveness of HF-DMP to improve outcomes for older frail heart failure patients undergoing post-acute rehabilitation. PMID:23871475

A randomized trial of heart failure disease management in skilled nursing facilities: design and rationale.

PubMed

Boxer, Rebecca S; Dolansky, Mary A; Bodnar, Christine A; Singer, Mendel E; Albert, Jeffery M; Gravenstein, Stefan

2013-09-01

Heart failure (HF) disease management can improve health outcomes for older community dwelling patients with heart failure. HF disease management has not been studied in skilled nursing facilities, a major site of transitional care for older adults. The objective of this trial is to investigate if a HF- disease management program (HF-DMP) in skilled nursing facilities (SNF)s will decrease all-cause rehospitalizations for the first 60 days post-SNF admission. The trial is a randomized cluster trial to be conducted in 12 for-profit SNF in the greater Cleveland area. The study population is inclusive of patients with HF regardless of ejection fraction but excludes those patients on dialysis and with a life expectancy of 6 months or less. The HF-DMP includes 7 elements considered standard of care for patients with HF documentation of left ventricular function, tracking of weight and symptoms, medication titration, discharge instructions, 7-day follow-up appointment post-SNF discharge, and patient education. The HF-DMP is conducted by a research nurse tasked with adhering to each element of the program and regularly audited to maintain fidelity of the program. Additional outcomes include health status, self-care management, and discharge destination. The SNF-Connect Trial is the first trial of its kind to assess if a HF-DMP will improve outcomes for patients in SNFs. This trial will provide evidence on the effectiveness of HF-DMP to improve outcomes for older frail HF patients undergoing postacute rehabilitation. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Effects of Caps on Cost Sharing for Skilled Nursing Facility Services in Medicare Advantage Plans.

PubMed

Keohane, Laura M; Rahman, Momotazur; Thomas, Kali S; Trivedi, Amal N

2018-03-12

To evaluate a federal regulation effective in 2011 that limited how much that Medicare Advantage (MA) plans could charge for the first 20 days of care in a skilled nursing facility (SNF). Difference-in-differences retrospective analysis comparing SNF utilization trends from 2008-2012. Select MA plans. Members of 27 plans with mandatory cost sharing reductions (n=132,000) and members of 21 plans without such reductions (n=138,846). Mean monthly number of SNF admissions and days per 1,000 members; annual proportion of MA enrollees exiting the plan. In plans with mandated cost sharing reductions, cost sharing for the first 20 days of SNF care decreased from an average of $2,039 in 2010 to $992 in 2011. In adjusted analyses, plans with mandated cost-sharing reductions averaged 158.1 SNF days (95% confidence interval (CI)=153.2-163.1 days) per 1,000 members per month before the cost sharing cap. This measure increased by 14.3 days (95% CI=3.8-24.8 days, p=0.009) in the 2 years after cap implementation. However, increases in SNF utilization did not significantly differ between plans with and without mandated cost-sharing reductions (adjusted between-group difference: 7.1 days per 1,000 members, 95% CI=-6.5-20.8, p=.30). Disenrollment patterns did not change after the cap took effect. When a federal regulation designed to protect MA members from high out-of-pocket costs for postacute care took effect, the use of SNF services did not change. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

78 FR 16632 - Medicare Program; Part B Inpatient Billing in Hospitals

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-18

...-hospital Skilled Nursing Facility (SNF) care, because section 1861(i) of the Act requires a prior 3-day... outpatients rather than inpatients or expanding the number of payable Part B inpatient services could impact... an inpatient in a hospital, SNF, hospice, or nursing home.'' Therefore, under our proposal these...

The glucose sensor Snf1 and the transcription factors Msn2 and Msn4 regulate transcription of the vacuolar iron importer gene CCC1 and iron resistance in yeast.

PubMed

Li, Liangtao; Kaplan, Jerry; Ward, Diane M

2017-09-15

The budding yeast Saccharomyces cerevisiae stores iron in the vacuole, which is a major resistance mechanism against iron toxicity. One key protein involved in vacuolar iron storage is the iron importer Ccc1, which facilitates iron entry into the vacuole. Transcription of the CCC1 gene is largely regulated by the binding of iron-sulfur clusters to the activator domain of the transcriptional activator Yap5. Additional evidence, however, suggests that Yap5-independent transcriptional activation of CCC1 also contributes to iron resistance. Here, we demonstrate that components of the signaling pathway involving the low-glucose sensor Snf1 regulate CCC1 transcription and iron resistance. We found that SNF1 deletion acts synergistically with YAP5 deletion to regulate CCC1 transcription and iron resistance. A kinase-dead mutation of Snf1 lowered iron resistance as did deletion of SNF4 , which encodes a partner protein of Snf1. Deletion of all three alternative partners of Snf1 encoded by SIT1 , SIT2 , and GAL83 decreased both CCC1 transcription and iron resistance. The Snf1 complex is known to activate the general stress transcription factors Msn2 and Msn4. We show that Msn2 and Msn4 contribute to Snf1-mediated CCC1 transcription. Of note, SNF1 deletion in combination with MSN2 and MSN4 deletion resulted in additive effects on CCC1 transcription, suggesting that other activators contribute to the regulation of CCC1 transcription. In conclusion, we show that yeast have developed multiple transcriptional mechanisms to regulate Ccc1 expression and to protect against high cytosolic iron toxicity. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.

The Impact of Operating Parameters and Correlated Parameters for Extended BWR Burnup Credit

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

Ade, Brian J.; Marshall, William B. J.; Ilas, Germina

Applicants for certificates of compliance for spent nuclear fuel (SNF) transportation and dry storage systems perform analyses to demonstrate that these systems are adequately subcritical per the requirements of Title 10 of the Code of Federal Regulations (10 CFR) Parts 71 and 72. For pressurized water reactor (PWR) SNF, these analyses may credit the reduction in assembly reactivity caused by depletion of fissile nuclides and buildup of neutron-absorbing nuclides during power operation. This credit for reactivity reduction during depletion is commonly referred to as burnup credit (BUC). US Nuclear Regulatory Commission (NRC) staff review BUC analyses according to the guidancemore » in the Division of Spent Fuel Storage and Transportation Interim Staff Guidance (ISG) 8, Revision 3, Burnup Credit in the Criticality Safety Analyses of PWR Spent Fuel in Transportation and Storage Casks.« less

Current state of nuclear fuel cycles in nuclear engineering and trends in their development according to the environmental safety requirements

NASA Astrophysics Data System (ADS)

Vislov, I. S.; Pischulin, V. P.; Kladiev, S. N.; Slobodyan, S. M.

2016-08-01

The state and trends in the development of nuclear fuel cycles in nuclear engineering, taking into account the ecological aspects of using nuclear power plants, are considered. An analysis of advantages and disadvantages of nuclear engineering, compared with thermal engineering based on organic fuel types, was carried out. Spent nuclear fuel (SNF) reprocessing is an important task in the nuclear industry, since fuel unloaded from modern reactors of any type contains a large amount of radioactive elements that are harmful to the environment. On the other hand, the newly generated isotopes of uranium and plutonium should be reused to fabricate new nuclear fuel. The spent nuclear fuel also includes other types of fission products. Conditions for SNF handling are determined by ecological and economic factors. When choosing a certain handling method, one should assess these factors at all stages of its implementation. There are two main methods of SNF handling: open nuclear fuel cycle, with spent nuclear fuel assemblies (NFAs) that are held in storage facilities with their consequent disposal, and closed nuclear fuel cycle, with separation of uranium and plutonium, their purification from fission products, and use for producing new fuel batches. The development of effective closed fuel cycles using mixed uranium-plutonium fuel can provide a successful development of the nuclear industry only under the conditions of implementation of novel effective technological treatment processes that meet strict requirements of environmental safety and reliability of process equipment being applied. The diversity of technological processes is determined by different types of NFA devices and construction materials being used, as well as by the composition that depends on nuclear fuel components and operational conditions for assemblies in the nuclear power reactor. This work provides an overview of technological processes of SNF treatment and methods of handling of nuclear fuel assemblies. Based on analysis of modern engineering solutions on SNF regeneration, it has been concluded that new reprocessing technologies should meet the ecological safety requirements, provide a more extensive use of the resource base of nuclear engineering, allow the production of valuable and trace elements on an industrial scale, and decrease radioactive waste release.

Predictors of Functional Change in a Skilled Nursing Facility Population.

PubMed

Gustavson, Allison M; Falvey, Jason R; Forster, Jeri E; Stevens-Lapsley, Jennifer E

2017-06-21

Inability to obtain sufficient gains in function during a skilled nursing facility (SNF) stay impacts patients' functional trajectories and susceptibility to adverse events. The purpose of this study was to identify predictors of functional change in patients temporarily residing in an SNF following hospitalization. One hundred forty patients admitted to a single SNF from the hospital who had both evaluation and discharge measures of physical function documented were included. Data from the Minimum Data Set 3.0 and electronic medical record were extracted to record clinical and demographic characteristics. The Short Physical Performance Battery (SPPB) was administered by rehabilitation therapists at evaluation and discharge. The SPPB consists of balance tests, gait speed, and a timed 5-time sit-to-stand test. The Patient Health Questionnaire (PHQ-9) Screening Tool for Depression was the only significant predictor of change in gait speed over an SNF stay. Eighty-seven percent of patients achieved a clinically meaningful change in the SPPB of 1 point or greater from evaluation to discharge, with 78% demonstrating a clinically meaningful change of 0.1 m/s or greater on gait speed. However, 69% of patients demonstrated SPPB scores of 6 points or less and 57% ambulated less than 0.65 m/s at the time of discharge from the SNF, which indicates severe disability. Poor physical function following an SNF stay places older adult at significant risk for adverse events including rehospitalization, future disability, and institutionalization. Understanding the predictors of functional change from evaluation to discharge may direct efforts toward developing innovative and effective interventions to improve function trajectories for older adults following an acute hospitalization.

42 CFR 488.431 - Civil money penalties imposed by CMS and independent informal dispute resolution: for SNFS...

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Civil money penalties imposed by CMS and independent informal dispute resolution: for SNFS, dually-participating SNF/NFs, and NF-only facilities. 488... imposed by CMS and independent informal dispute resolution: for SNFS, dually-participating SNF/NFs, and NF...

42 CFR 488.431 - Civil money penalties imposed by CMS and independent informal dispute resolution: for SNFS...

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Civil money penalties imposed by CMS and independent informal dispute resolution: for SNFS, dually-participating SNF/NFs, and NF-only facilities. 488... imposed by CMS and independent informal dispute resolution: for SNFS, dually-participating SNF/NFs, and NF...

42 CFR 488.431 - Civil money penalties imposed by CMS and independent informal dispute resolution: for SNFS...

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Civil money penalties imposed by CMS and independent informal dispute resolution: for SNFS, dually-participating SNF/NFs, and NF-only facilities. 488... imposed by CMS and independent informal dispute resolution: for SNFS, dually-participating SNF/NFs, and NF...

42 CFR 488.431 - Civil money penalties imposed by CMS and independent informal dispute resolution: for SNFS...

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Civil money penalties imposed by CMS and independent informal dispute resolution: for SNFS, dually-participating SNF/NFs, and NF-only facilities. 488... imposed by CMS and independent informal dispute resolution: for SNFS, dually-participating SNF/NFs, and NF...

Radiolytic and thermal process relevant to dry storage of spent nuclear fuels. 1998 annual progress report

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

Marschman, S.C.; Cowin, J.P.; Orlando, T.M.

1998-06-01

'This project involves basic research in chemistry and physics aimed at providing information pertinent to the safe long-term dry storage of spent nuclear fuel (SNF), thousands of tons of which remain in water storage across the DOE complex. The Hanford Site K-Basins alone hold 2,300 tons of spent fuel, much of it severely corroded, and similar situations exist at Savannah River and Idaho National Engineering and Environmental Laboratory. The DOE plans to remove this fuel and seal it in overpack canisters for dry interim storage for up to 75 years while awaiting permanent disposition. Chemically-bound water will remain in thismore » fuel even following proposed drying steps, leading to possible long-term corrosion of the containers and/or fuel rods themselves, generation of H{sub 2} and O{sub 2} gas via radiolysis (which could lead to deflagration or detonation), and reactions of pyrophoric uranium hydrides. No thoroughly tested model is currently available to predict fuel behavior during pre-processing, processing, or storage. In a collaboration between Rutgers University, Pacific Northwest National Laboratory, and Brookhaven National Laboratory, the authors are studying the radiolytic reaction, drying processes, and corrosion behavior of actual SNF materials, and of pure and mixed-phase samples. The authors propose to determine what is omitted from current models: radiolysis of water adsorbed on or in hydrates or hydroxides, thermodynamics of interfacial phases, and kinetics of drying. A model will be developed and tested against actual fuel rod behavior to insure validity and applicability to the problems associated with developing dry storage strategies for DOE-owned SNF. This report summarizes work after eight months of a three-year project.'« less

Can Shale Safely Host U.S. Nuclear Waste?

NASA Astrophysics Data System (ADS)

Neuzil, C. E.

2013-07-01

Even as cleanup efforts after Japan's Fukushima disaster offer a stark reminder of the spent nuclear fuel (SNF) stored at nuclear plants worldwide, the decision in 2009 to scrap Yucca Mountain as a permanent disposal site has dimmed hope for a repository for SNF and other high-level nuclear waste (HLW) in the United States anytime soon. About 70,000 metric tons of SNF are now in pool or dry cask storage at 75 sites across the United States [Government Accountability Office, 2012], and uncertainty about its fate is hobbling future development of nuclear power, increasing costs for utilities, and creating a liability for American taxpayers [Blue Ribbon Commission on America's Nuclear Future, 2012].

Analysis of Ignition Testing on K-West Basin Fuel

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

J. Abrefah; F.H. Huang; W.M. Gerry

Approximately 2100 metric tons of spent nuclear fuel (SNF) discharged from the N-Reactor have been stored underwater at the K-Basins in the 100 Area of the Hanford Site. The spent fuel has been stored in the K-East Basin since 1975 and in the K-West Basin since 1981. Some of the SNF elements in these basins have corroded because of various breaches in the Zircaloy cladding that occurred during fuel discharge operations and/or subsequent handling and storage in the basins. Consequently, radioactive material in the fuel has been released into the basin water, and water has leaked from the K-East Basinmore » into the soil below. To protect the Columbia River, which is only 380 m from the basins, the SNF is scheduled to be removed and transported for interim dry storage in the 200 East Area, in the central portion of the Site. However, before being shipped, the corroded fuel elements will be loaded into Multi-Canister OverPacks and conditioned. The conditioning process will be selected based on the Integrated Process Strategy (IPS) (WHC 1995), which was prepared on the basis of the dry storage concept developed by the Independent Technical Assessment (ITA) team (ITA 1994).« less

Getting Beyond Yucca Mountain - 12305

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

Halstead, Robert J.; Williams, James M.

2012-07-01

The U.S. Department of Energy has terminated the Yucca Mountain repository project. The U.S. Nuclear Regulatory Commission has indefinitely suspended the Yucca Mountain licensing proceeding. The presidentially-appointed Blue Ribbon Commission (BRC) on America's Nuclear Future is preparing a report, due in January 2012, to the Secretary of Energy on recommendations for a new national nuclear waste management and disposal program. The BRC Draft Report published in July 2011 provides a compelling critique of the past three decades failed efforts in the United States to site storage and disposal facilities for spent nuclear fuel (SNF) and high-level radioactive waste (HLW). However,more » the BRC Draft Report fails to provide detailed guidance on how to implement an alternative, successful approach to facility site selection. The comments submitted to the BRC by the State of Nevada Agency for Nuclear Projects provide useful details on how the US national nuclear waste program can get beyond the failed Yucca Mountain repository project. A detailed siting process, consisting of legislative elements, procedural elements, and 'rules' for volunteer sites, could meet the objectives of the BRC and the Western Governors Association (WGA), while promoting and protecting the interests of potential host states. The recent termination of the proposed Yucca Mountain repository provides both an opportunity and a need to re-examine the United States' nuclear waste management program. The BRC Draft Report published in July 2011 provides a compelling critique of the past three decades failed efforts in the United States to site storage and disposal facilities for SNF and HLW. It is anticipated that the BRC Final report in January 2012 will recommend a new general course of action, but there will likely continue to be a need for detailed guidance on how to implement an alternative, successful approach to facility site selection. Getting the nation's nuclear waste program back on track requires, among other things, new principles for siting-principles based on partnership between the federal implementing agency and prospective host states. These principles apply to the task of developing an integrated waste management strategy, to interactions between the federal government and prospective host states for consolidated storage and disposal facilities, and to the logistically and politically complicated task of transportation system design. Lessons from the past 25 years, in combination with fundamental parameters of the nuclear waste management task in the US, suggest new principles for partnership outlined in this paper. These principles will work better if well-grounded and firm guidelines are set out beforehand and if the challenge of maintaining competence, transparency and integrity in the new organization is treated as a problem to be addressed rather than a result to be expected. (authors)« less

Temperature-package power correlations for open-mode geologic disposal concepts.

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

Hardin, Ernest.

2013-02-01

Logistical simulation of spent nuclear fuel (SNF) management in the U.S. combines storage, transportation and disposal elements to evaluate schedule, cost and other resources needed for all major operations leading to final geologic disposal. Geologic repository reference options are associated with limits on waste package thermal power output at emplacement, in order to meet limits on peak temperature for certain key engineered and natural barriers. These package power limits are used in logistical simulation software such as CALVIN, as threshold requirements that must be met by means of decay storage or SNF blending in waste packages, before emplacement in amore » repository. Geologic repository reference options include enclosed modes developed for crystalline rock, clay or shale, and salt. In addition, a further need has been addressed for open modes in which SNF can be emplaced in a repository, then ventilated for decades or longer to remove heat, prior to permanent repository closure. For each open mode disposal concept there are specified durations for surface decay storage (prior to emplacement), repository ventilation, and repository closure operations. This study simulates those steps for several timing cases, and for SNF with three fuel-burnup characteristics, to develop package power limits at which waste packages can be emplaced without exceeding specified temperature limits many years later after permanent closure. The results are presented in the form of correlations that span a range of package power and peak postclosure temperature, for each open-mode disposal concept, and for each timing case. Given a particular temperature limit value, the corresponding package power limit for each case can be selected for use in CALVIN and similar tools.« less

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

Eric Larsen; Art Watkins; Timothy R. McJunkin

The U.S. Department of Energy (DOE) created the National Spent Nuclear Fuel Program (NSNFP) to manage DOE’s spent nuclear fuel (SNF). One of the NSNFP’s tasks is to prepare spent nuclear fuel for storage, transportation, and disposal at the national repository. As part of this effort, the NSNFP developed a standardized canister for interim storage and transportation of SNF. These canisters will be built and sealed to American Society of Mechanical Engineers (ASME) Section III, Division 3 requirements. Packaging SNF usually is a three-step process: canister loading, closure welding, and closure weld verification. After loading SNF into the canisters, themore » canisters must be seal welded and the welds verified using a combination of visual, surface eddy current, and ultrasonic inspection or examination techniques. If unacceptable defects in the weld are detected, the defective sections of weld must be removed, re-welded, and re-inspected. Due to the high contamination and/or radiation fields involved with this process, all of these functions must be performed remotely in a hot cell. The prototype apparatus to perform these functions is a floor-mounted carousel that encircles the loaded canister; three stations perform the functions of welding, inspecting, and repairing the seal welds. A welding operator monitors and controls these functions remotely via a workstation located outside the hot cell. The discussion describes the hardware and software that have been developed and the results of testing that has been done to date.« less

Medicare: Comparison of Catastropic Health Insurance Proposals--an Update.

DTIC Science & Technology

1987-10-01

Accounting Office ICF intermediate care facility SNF skilled nursing facility VA Veterans Administration d4 ....... ’. - --- MEDICARE: COMPARISON OF...optional woe services, such as home and community-based services; services in an intermediate care facility (ICF); and prescribed drugs, dentures

Medicare: Comparison of Catastrophic Health Insurance Proposals.

DTIC Science & Technology

1987-06-01

GAO General Accounting Office ICF intermediate care facility SNF skilled nursing facility VA Veterans Administration -4 MEDICARE: COMPARISON OF...community-based services; services in an intermediate care facility (ICF); and prescribed drugs, dentures, and eyeglasses. In recent years, the number of

A retrospective comparison of clinical outcomes and Medicare expenditures in skilled nursing facility residents with chronic wounds.

PubMed

DaVanzo, Joan E; El-Gamil, Audrey M; Dobson, Allen; Sen, Namrata

2010-09-01

Medicare skilled nursing facility (SNF) residents with chronic wounds require more resources and have relatively high healthcare expenditures compared to Medicare patients without wounds. A retrospective cohort study was conducted using 2006 Medicare Chronic Condition Warehouse claims data for SNF, inpatient, outpatient hospital, and physician supplier settings along with 2006 Long-Term Care Minimum Data Set (MDS) information to compare Medicare expenditures between two groups of SNF residents with a diagnosis of pressure, venous, ischemic, or diabetic ulcers whose wounds healed during the 10-month study period. The study group (n = 372) was managed using a structured, comprehensive wound management protocol provided by an external wound management team. The matched comparison group consisted of 311 SNF residents who did not receive care from the wound management team. Regression analyses indicate that after controlling for resident comorbidities and wound severity, study group residents experienced lower rates of wound-related hospitalization per day (0.08% versus 0.21%, P < 0.01) and shorter wound episodes (94 days versus 115 days, P < 0.01) than comparison group patients. Total Medicare costs were $21,449.64 for the study group and $40,678.83 for the comparison group (P < 0.01) or $229.07 versus $354.26 (P < 0.01) per resident episode day. Additional studies including wounds that do not heal are warranted. Increasing the number of SNF residents receiving the care described in this study could lead to significant Medicare cost savings. Incorporating wound clinical outcomes into a pay-for-performance measures for SNFs could increase broader SNF adoption of comprehensive wound care programs to treat chronic wounds.

Skilled Nursing Facility Partnerships May Decrease 90-Day Costs in a Total Joint Arthroplasty Episode Under the Bundled Payments for Care Improvement Initiative.

PubMed

Behery, Omar A; Kouk, Shalen; Chen, Kevin K; Mullaly, Kathleen A; Bosco, Joseph A; Slover, James D; Iorio, Richard; Schwarzkopf, Ran

2018-03-01

The Bundled Payments for Care Improvement initiative was developed to reduce costs associated with total joint arthroplasty through a single payment for all patient care from index admission through a 90-day post-discharge period, including care at skilled nursing facilities (SNFs). The aim of this study is to investigate whether forming partnerships between hospitals and SNFs could lower the post-discharge costs. We hypothesize that institutionally aligned SNFs have lower post-discharge costs than non-aligned SNFs. A cohort of 615 elective, primary total hip and knee arthroplasty subjects discharged to an SNF under the Bundled Payments for Care Improvement from 2014 to 2016 were included in our analysis. Patients were grouped into one of the 3 categories of SNF alignment: group 1: non-partners; group 2: agreement-based partners; group 3: institution-owned partners. Demographics, comorbidities, length of stay (LOS) at SNF, and associated costs during the 90-day post-operative period were compared between the 3 groups. Mean index hospital LOS was statistically shortest in group 3 (mean 2.7 days vs 3.5 for groups 1 and 2, P = .001). SNF LOS was also shortest in group 3 (mean 11 days vs 19 and 21 days in groups 2 and 1 respectively, P < .001). Total SNF costs and total 90-day costs were both significantly lower in group 3 compared with groups 1 and 2 (P < .001 for all), even after controlling for medical comorbidities. Institution-owned partner SNFs demonstrated the shortest patient LOS, and the lowest SNF and total 90-day costs, without increased risk of readmissions, compared with other SNFs. Copyright © 2017 Elsevier Inc. All rights reserved.

Transitions From Hospitals to Skilled Nursing Facilities for Persons With Dementia: A Challenging Convergence of Patient and System-Level Needs.

PubMed

Gilmore-Bykovskyi, Andrea L; Roberts, Tonya J; King, Barbara J; Kennelty, Korey A; Kind, Amy J H

2017-10-01

To describe skilled nursing facility (SNF) nurses' perspectives on the experiences and needs of persons with dementia (PwD) during hospital-to-SNF transitions and to identify factors related to the quality of these transitions. Grounded dimensional analysis study using individual and focus group interviews with nurses (N = 40) from 11 SNFs. Hospital-to-SNF transitions were largely described as distressing for PwD and their caregivers and dominated by dementia-related behavioral symptoms that were perceived as being purposely under-communicated by hospital personnel in discharge communications. SNF nurses described PwD as having unique transitional care needs, which primarily involved needing additional discharge preplanning to enable preparation of a tailored behavioral/social care plan and physical environment prior to transfer. SNF nurses identified inaccurate/limited hospital discharge communication regarding behavioral symptoms, short discharge timeframes, and limited nursing control over SNF admission decisions as factors that contributed to poorer-quality transitions producing increased risk for resident harm, rehospitalization, and negative resident/caregiver experiences. Engaged caregivers throughout the transition and the presence of high-quality discharge communication were identified as factors that improved the quality of transitions for PwD. Findings from this study provide important insight into factors that may influence transitional care quality during this highly vulnerable transition. Additional research is needed to explore the association between these factors and transitional care outcomes such as rehospitalization and caregiver stress. Future work should also explore strategies to improve inter-setting communication and care coordination for PwD exhibiting challenging behavioral symptoms. Published by Oxford University Press on behalf of the Gerontological Society of America 2016.

Association between Reported Elder Abuse and Rates of Admission to the Skilled Nursing Facilities: Findings from a Longitudinal Population-Based Cohort Study

PubMed Central

Dong, XinQi; Simon, Melissa A.

2013-01-01

Background Elder abuse is common and is a frank violation of an older adult’s fundamental rights to be safe and free of violence. Our prior study indicates elder abuse is independently associated with mortality. This study aims to quantify the relationship between overall elder abuse and specific subtypes of elder abuse and rate of admission to skilled nursing facilities (SNF). Methods A prospective population-based study is conducted in Chicago of community-dwelling older adults who participated in the Chicago Health and Aging Project (CHAP). Of the 6,674 participants in the CHAP study, 106 participants were reported to social services agency for elder abuse. The primary predictor was elder abuse reported to social services agency. The outcome of interest was the annual rate of admission to SNF obtained from the Center for Medicare and Medicaid Services. Poisson regression models were used to assess these longitudinal relationships. Results The average annual rate of SNF for those without elder abuse was 0.14(0.58) and for those with elder abuse was 0.66(1.63). After adjusting for sociodemographic, socioeconomic variables, medical commorbidities, cognitive and physical function, and psychosocial wellbeing, older adults who have been abused had higher rates of SNF admission (RR, 4.60 (2.85–7.42)). Psychological abuse (RR, 2.31(1.17–4.56)), physical abuse (RR, 2.36(1.19–4.66)), financial exploitation (RR, 2.81(1.53–5.17)) and caregiver neglect (RR, 4.73(3.03–7.40)) were associated with increased rates of admission to SNF, after considering the same confounders. Elder abuse is associated with higher rate of SNF stay of great than 30 days (RR, 6.27(3.68–10.69). Conclusion Elder abuse was associated with increased rates of admission to SNF in this community population. Specific subtypes of elder abuse had differential association with increased rate of admission to SNF. PMID:23816799

77 FR 26050 - Burnup Credit in the Criticality Safety Analyses of Pressurized Water Reactor Spent Fuel in...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-02

... Pressurized Water Reactor Spent Fuel in Transportation and Storage Casks AGENCY: Nuclear Regulatory Commission... of pressurized water reactor spent nuclear fuel (SNF) in transportation packages and storage casks... for the licensing basis, (b) provide recommendations regarding advanced isotopic depletion and...

U.S. Commercial Spent Nuclear Fuel Assembly Characteristics - 1968-2013

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

Hu, Jianwei; Peterson, Joshua L.; Gauld, Ian C.

2016-09-01

Activities related to management of spent nuclear fuel (SNF) are increasing in the US and many other countries. Over 240,000 SNF assemblies have been discharged from US commercial reactors since the late 1960s. The enrichment and burnup of SNF have changed significantly over the past 40 years, and fuel assembly designs have also evolved. Understanding the general characteristics of SNF helps regulators and other stakeholders form overall strategies towards the final disposal of US SNF. This report documents a survey of all US commercial SNF assemblies in the GC-859 database and provides reference SNF source terms (e.g., nuclide inventories, decaymore » heat, and neutron/photon emission) at various cooling times up to 200 years after fuel discharge. This study reviews the distribution and evolution of fuel parameters of all SNF assemblies discharged over the past 40 years. Assemblies were categorized into three groups based on discharge year, and the median burnups and enrichments of each group were used to establish representative cases. An extended burnup case was created for boiling water reactor (BWR) fuels, and another was created for the pressurized water reactor (PWR) fuels. Two additional cases were developed to represent the eight mixed oxide (MOX) fuel assemblies in the database. Burnup calculations were performed for each representative case. Realistic parameters for fuel design and operations were used to model the SNF and to provide reference fuel characteristics representative of the current inventory. Burnup calculations were performed using the ORIGEN code, which is part of the SCALE nuclear modeling and simulation code system. Results include total activity, decay heat, photon emission, neutron flux, gamma heat, and plutonium content, as well as concentrations for 115 significant nuclides. These quantities are important in the design, regulation, and operations of SNF storage, transportation, and disposal systems.« less

ICPP tank farm closure study. Volume 1

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

Spaulding, B.C.; Gavalya, R.A.; Dahlmeir, M.M.

1998-02-01

The disposition of INEEL radioactive wastes is now under a Settlement Agreement between the DOE and the State of Idaho. The Settlement Agreement requires that existing liquid sodium bearing waste (SBW), and other liquid waste inventories be treated by December 31, 2012. This agreement also requires that all HLW, including calcined waste, be disposed or made road ready to ship from the INEEL by 2035. Sodium bearing waste (SBW) is produced from decontamination operations and HLW from reprocessing of SNF. SBW and HLW are radioactive and hazardous mixed waste; the radioactive constituents are regulated by DOE and the hazardous constituentsmore » are regulated by the Resource Conservation and Recovery Act (RCRA). Calcined waste, a dry granular material, is produced in the New Waste Calcining Facility (NWCF). Two primary waste tank storage locations exist at the ICPP: Tank Farm Facility (TFF) and the Calcined Solids Storage Facility (CSSF). The TFF has the following underground storage tanks: four 18,400-gallon tanks (WM 100-102, WL 101); four 30,000-gallon tanks (WM 103-106); and eleven 300,000+ gallon tanks. This includes nine 300,000-gallon tanks (WM 182-190) and two 318,000 gallon tanks (WM 180-181). This study analyzes the closure and subsequent use of the eleven 300,000+ gallon tanks. The 18,400 and 30,000-gallon tanks were not included in the work scope and will be closed as a separate activity. This study was conducted to support the HLW Environmental Impact Statement (EIS) waste separations options and addresses closure of the 300,000-gallon liquid waste storage tanks and subsequent tank void uses. A figure provides a diagram estimating how the TFF could be used as part of the separations options. Other possible TFF uses are also discussed in this study.« less

A Military Hospice Model

DTIC Science & Technology

1983-05-06

that apply) A. A hospice inpatient facility; B. An inpatient unit in a a. Hospital; b. Intermediate Care Facility ; c. Skilled Nursing facility; C. A...Care Hospital Intermediate Care Facility SNF Hospice Other No License Page 3 V. "WEIGHTED" STANDARDS Please feel free to indicate with a "W" in the

Point-of-use membrane filtration and hyperchlorination to prevent patient exposure to rapidly growing mycobacteria in the potable water supply of a skilled nursing facility.

PubMed

Williams, Margaret M; Chen, Tai-Ho; Keane, Tim; Toney, Nadege; Toney, Sean; Armbruster, Catherine R; Butler, W Ray; Arduino, Matthew J

2011-09-01

Healthcare-associated outbreaks and pseudo-outbreaks of rapidly growing mycobacteria (RGM) are frequently associated with contaminated tap water. A pseudo-outbreak of Mycobacterium chelonae-M. abscessus in patients undergoing bronchoscopy was identified by 2 acute care hospitals. RGM was identified in bronchoscopy specimens of 28 patients, 25 of whom resided in the same skilled nursing facility (SNF). An investigation ruled out bronchoscopy procedures, specimen collection, and scope reprocessing at the hospitals as sources of transmission. To identify the reservoir for RGM within the SNF and evaluate 2 water system treatments, hyperchlorination and point-of-use (POU) membrane filters, to reduce RGM. A comparative in situ study of 2 water system treatments to prevent RGM transmission. An SNF specializing in care of patients requiring ventilator support. RGM and heterotrophic plate count (HPC) bacteria were examined in facility water before and after hyperchlorination and in a subsequent 24-week assessment of filtered water by colony enumeration on Middlebrook and R2A media. Mycobacterium chelonae was consistently isolated from the SNF water supply. Hyperchlorination reduced RGM by 1.5 log(10) initially, but the population returned to original levels within 90 days. Concentration of HPC bacteria also decreased temporarily. RGM were reduced below detection level in filtered water, a 3-log(10) reduction. HPC bacteria were not recovered from newly installed filters, although low quantities were found in water from 2-week-old filters. POU membrane filters may be a feasible prevention measure for healthcare facilities to limit exposure of sensitive individuals to RGM in potable water systems.

Concrete Materials with Ultra-High Damage Resistance and Self- Sensing Capacity for Extended Nuclear Fuel Storage Systems

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

Li, Mo; Nakshatrala, Kalyana; William, Kasper

The objective of this project is to develop a new class of multifunctional concrete materials (MSCs) for extended spent nuclear fuel (SNF) storage systems, which combine ultra-high damage resistance through strain-hardening behavior with distributed multi-dimensional damage self-sensing capacity. The beauty of multifunctional concrete materials is two-fold: First, it serves as a major material component for the SNF pool, dry cask shielding and foundation pad with greatly improved resistance to cracking, reinforcement corrosion, and other common deterioration mechanisms under service conditions, and prevention from fracture failure under extreme events (e.g. impact, earthquake). This will be achieved by designing multiple levels ofmore » protection mechanisms into the material (i.e., ultrahigh ductility that provides thousands of times greater fracture energy than concrete and normal fiber reinforced concrete; intrinsic cracking control, electrochemical properties modification, reduced chemical and radionuclide transport properties, and crack-healing properties). Second, it offers capacity for distributed and direct sensing of cracking, strain, and corrosion wherever the material is located. This will be achieved by establishing the changes in electrical properties due to mechanical and electrochemical stimulus. The project will combine nano-, micro- and composite technologies, computational mechanics, durability characterization, and structural health monitoring methods, to realize new MSCs for very long-term (greater than 120 years) SNF storage systems.« less

77 FR 60479 - Burnup Credit in the Criticality Safety Analyses of Pressurized Water Reactor Spent Fuel in...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-03

... Pressurized Water Reactor Spent Fuel in Transportation and Storage Casks AGENCY: Nuclear Regulatory Commission... 3, entitled, ``Burnup Credit in the Criticality Safety Analyses of PWR [Pressurized Water Reactor... water reactor spent nuclear fuel (SNF) in transportation packages and storage casks. SFST-ISG-8...

DCDS: A Real-time Data Capture and Personalized Decision Support System for Heart Failure Patients in Skilled Nursing Facilities.

PubMed

Zhu, Wei; Luo, Lingyun; Jain, Tarun; Boxer, Rebecca S; Cui, Licong; Zhang, Guo-Qiang

2016-01-01

Heart disease is the leading cause of death in the United States. Heart failure disease management can improve health outcomes for elderly community dwelling patients with heart failure. This paper describes DCDS, a real-time data capture and personalized decision support system for a Randomized Controlled Trial Investigating the Effect of a Heart Failure Disease Management Program (HF-DMP) in Skilled Nursing Facilities (SNF). SNF is a study funded by the NIH National Heart, Lung, and Blood Institute (NHLBI). The HF-DMP involves proactive weekly monitoring, evaluation, and management, following National HF Guidelines. DCDS collects a wide variety of data including 7 elements considered standard of care for patients with heart failure: documentation of left ventricular function, tracking of weight and symptoms, medication titration, discharge instructions, 7 day follow up appointment post SNF discharge and patient education. We present the design and implementation of DCDS and describe our preliminary testing results.

76 FR 9503 - Medicare and Medicaid Programs; Requirements for Long-Term Care (LTC) Facilities; Notice of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-18

... nursing facility (SNF) in the Medicare program, or a nursing facility (NF) in the Medicaid program. These..., as of April 2010, there are 15,713 long-term care (LTC) facilities (commonly referred to as nursing homes) in the U.S. LTC facilities are also referred to as skilled nursing facilities (SNFs) in the...

42 CFR 488.301 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... requirements under § 483.13, Resident behavior and facility practices, § 483.15, Quality of life, or § 483.25... participation requirements subsequent to finding substandard quality of care during a standard survey. Facility... substandard quality of care during an abbreviated standard survey. Skilled nursing facility (SNF) means a...

42 CFR 488.301 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... requirements under § 483.13, Resident behavior and facility practices, § 483.15, Quality of life, or § 483.25... participation requirements subsequent to finding substandard quality of care during a standard survey. Facility... substandard quality of care during an abbreviated standard survey. Skilled nursing facility (SNF) means a...

42 CFR 488.301 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... requirements under § 483.13, Resident behavior and facility practices, § 483.15, Quality of life, or § 483.25... participation requirements subsequent to finding substandard quality of care during a standard survey. Facility... substandard quality of care during an abbreviated standard survey. Skilled nursing facility (SNF) means a...

42 CFR 488.301 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... requirements under § 483.13, Resident behavior and facility practices, § 483.15, Quality of life, or § 483.25... participation requirements subsequent to finding substandard quality of care during a standard survey. Facility... substandard quality of care during an abbreviated standard survey. Skilled nursing facility (SNF) means a...

42 CFR 488.301 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... requirements under § 483.13, Resident behavior and facility practices, § 483.15, Quality of life, or § 483.25... participation requirements subsequent to finding substandard quality of care during a standard survey. Facility... substandard quality of care during an abbreviated standard survey. Skilled nursing facility (SNF) means a...

Pain and Satisfaction With Pain Management Among Older Patients During the Transition From Acute to Skilled Nursing Care.

PubMed

Simmons, Sandra F; Schnelle, John F; Saraf, Avantika A; Simon Coelho, Chris; Jacobsen, J Mary Lou; Kripalani, Sunil; Bell, Susan; Mixon, Amanda; Vasilevskis, Eduard E

2016-12-01

Approximately 20% of hospitalized Medicare beneficiaries are discharged from the hospital to skilled nursing facilities (SNFs); and up to 23% of SNF patients return to the hospital within 30 days of hospital discharge, with pain as one of the most common symptoms precipitating hospital readmission. We sought to examine the prevalence of moderate to severe pain at hospital discharge to SNF, the incidence of new moderate to severe pain (relative to prehospitalization), and satisfaction with pain management among older acute care patients discharged to SNF. Structured patient interviews were conducted with 188 Medicare beneficiaries discharged to 23 area SNFs from an academic medical center. Pain level (0-10) and satisfaction with pain management were assessed upon hospital admission, discharge, and within 1 week after transition to SNF. There was a high prevalence of moderate to severe pain at each time point including prehospital (51%), hospital discharge (38%), and following SNF admission (53%). Twenty-eight percent of participants reported new moderate to severe pain at hospital discharge, whereas 44% reported new moderate to severe pain following SNF admission. Most participants reported being "satisfied" with their pain treatment, even in the context of moderate to severe pain. Moderate to severe pain is a common problem among hospitalized older adults discharged to SNF and continues during their SNF stay. Pain assessment and management should involve a specific, planned process between hospital and SNF clinicians at the point of care transition, even if patients express "satisfaction" with current pain management. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

FY17 Status Report: Research on Stress Corrosion Cracking of SNF Interim Storage Canisters.

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

Schindelholz, Eric John; Bryan, Charles R.; Alexander, Christopher L.

This progress report describes work done in FY17 at Sandia National Laboratories (SNL) to assess the localized corrosion performance of container/cask materials used in the interim storage of spent nuclear fuel (SNF). Of particular concern is stress corrosion cracking (SCC), by which a through-wall crack could potentially form in a canister outer wall over time intervals that are shorter than possible dry storage times. Work in FY17 refined our understanding of the chemical and physical environment on canister surfaces, and evaluated the relationship between chemical and physical environment and the form and extent of corrosion that occurs. The SNL corrosionmore » work focused predominantly on pitting corrosion, a necessary precursor for SCC, and process of pit-to-crack transition; it has been carried out in collaboration with university partners. SNL is collaborating with several university partners to investigate SCC crack growth experimentally, providing guidance for design and interpretation of experiments.« less

Stability of Geriatric Syndromes in Hospitalized Medicare Patients Discharged to Skilled Nursing Facilities

PubMed Central

Simmons, Sandra F.; Bell, Susan; Saraf, Avantika A.; Coelho, Chris Simon; Long, Emily A.; Jacobsen, J. Mary Lou; Schnelle, John F.; Vasilevskis, Eduard E.

2016-01-01

Objectives The purpose of this study was to assess multiple geriatric syndromes in a sample of older hospitalized patients discharged to skilled nursing facilities and, subsequently, to home to determine the prevalence and stability of each geriatric syndrome at the point of these care transitions. Design Descriptive, prospective study. Setting One large university-affiliated hospital and four area SNFs. Participants Fifty-eight hospitalized Medicare beneficiaries discharged to SNF. Measurements Research personnel conducted standardized assessments of the following geriatric syndromes at hospital discharge and two weeks following SNF discharge to home: cognitive impairment, depression, incontinence, unintentional weight loss, loss of appetite, pain, pressure ulcers, history of falls, mobility impairment and polypharmacy. Results The average number of geriatric syndromes per patient was 4.4 (± 1.2) at hospital discharge and 3.8 (±1.5) following SNF discharge. There was low to moderate stability for most syndromes. On average, participants had 2.9 syndromes that persisted across both care settings, 1.4 syndromes that resolved, and 0.7 new syndromes that developed between hospital and SNF discharge. Conclusion Geriatric syndromes were prevalent at the point of each care transition but also reflected significant within-individual variability. These findings suggest that multiple geriatric syndromes present during a hospital stay are not transient nor are most syndromes resolved prior to SNF discharge. These results underscore the importance of conducting standardized screening assessments at the point of each care transition and effectively communicating this information to the next provider to support the management of geriatric conditions. PMID:27590032

78 FR 20564 - Medicare and Medicaid Programs; Survey, Certification and Enforcement Procedures

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-05

... Providers Act of 2008 NF--Nursing Facility OIG--Office of the Inspector General OPT--Provider of outpatient... Act SNF--Skilled Nursing Facility TJC--The Joint Commission I. Background To participate in the... participation (CoPs) for most providers, requirements for skilled nursing facilities (SNFs), conditions for...

Spent Nuclear Fuel (SNF) Project Canister Storage Building (CSB) Process Flow Diagram Mass Balance Calculations

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

KLEM, M.J.

2000-05-11

The purpose of these calculations is to develop the material balances for documentation of the Canister Storage Building (CSB) Process Flow Diagram (PFD) and future reference. The attached mass balances were prepared to support revision two of the PFD for the CSB. The calculations refer to diagram H-2-825869.

Estimation of Inherent Safety Margins in Loaded Commercial Spent Nuclear Fuel Casks

DOE PAGES

Banerjee, Kaushik; Robb, Kevin R.; Radulescu, Georgeta; ...

2016-06-15

We completed a novel assessment to determine the unquantified and uncredited safety margins (i.e., the difference between the licensing basis and as-loaded calculations) available in as-loaded spent nuclear fuel (SNF) casks. This assessment was performed as part of a broader effort to assess issues and uncertainties related to the continued safety of casks during extended storage and transportability following extended storage periods. Detailed analyses crediting the actual as-loaded cask inventory were performed for each of the casks at three decommissioned pressurized water reactor (PWR) sites to determine their characteristics relative to regulatory safety criteria for criticality, thermal, and shielding performance.more » These detailed analyses were performed in an automated fashion by employing a comprehensive and integrated data and analysis tool—Used Nuclear Fuel-Storage, Transportation & Disposal Analysis Resource and Data System (UNF-ST&DARDS). Calculated uncredited criticality margins from 0.07 to almost 0.30 Δk eff were observed; calculated decay heat margins ranged from 4 to almost 22 kW (as of 2014); and significant uncredited transportation dose rate margins were also observed. The results demonstrate that, at least for the casks analyzed here, significant uncredited safety margins are available that could potentially be used to compensate for SNF assembly and canister structural performance related uncertainties associated with long-term storage and subsequent transportation. The results also suggest that these inherent margins associated with how casks are loaded could support future changes in cask licensing to directly or indirectly credit the margins. Work continues to quantify the uncredited safety margins in the SNF casks loaded at other nuclear reactor sites.« less

An investigation of quality improvement initiatives in decreasing the rate of avoidable 30-day, skilled nursing facility-to-hospital readmissions: a systematic review.

PubMed

Mileski, Michael; Topinka, Joseph Baar; Lee, Kimberly; Brooks, Matthew; McNeil, Christopher; Jackson, Jenna

2017-01-01

The main objective was to investigate the applicability and effectiveness of quality improvement initiatives in decreasing the rate of avoidable 30-day, skilled nursing facility (SNF)-to-hospital readmissions. The rate of rehospitalizations from SNF within 30 days of original discharge has increased within the last decade. The research team participants conducted a literature review via Cumulative Index of Nursing and Allied Health Literature and PubMed to collect data about quality improvement implemented in SNFs. The most common facilitator was the incorporation of specialized staff. The most cited barriers were quality improvement tracking and implementation. These strategy examples can be useful to acute care hospitals attempting to lower bounce back from subacute care providers and long-term care facilities seeking quality improvement initiatives to reduce hospital readmissions.

76 FR 59265 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-26

... Skilled Nursing Facilities for FY 2012; Correction AGENCY: Centers for Medicare & Medicaid Services (CMS... Nursing Facilities for FY 2012'' that appeared in the August 8, 2011 Federal Register. DATES: Effective... October 1, 2011. II. Summary of Errors The Addendum to the Skilled Nursing Facility (SNF) Prospective...

Necessity is the mother of invention: an innovative hospitalist-resident initiative for improving quality and reducing readmissions from skilled nursing facilities.

PubMed

Petigara, Sunny; Krishnamurthy, Mahesh; Livert, David

2017-03-01

Background : Hospital readmissions have been a major challenge to the US health system. Medicare data shows that approximately 25% of Medicare skilled nursing facility (SNF) residents are readmitted back to the hospital within 30 days. Some of the major reasons for high readmission rates include fragmented information exchange during transitions of care and limited access to physicians round-the-clock in SNFs. These represent safety, quality, and health outcome concerns. Aim : The goal of the project was to reduce hospital readmission rates from SNFs by improving transition of care and increasing physician availability in SNFs (five to seven days a week physical presence with 24/7 accessibility by phone). Methods : We proposed a model whereby a hospitalist-led team, including the resident on the geriatrics rotation, followed patients discharged from the hospital to one SNF. Readmission rates pre- and post-implementation were compared. Study results : The period between January 2014 and June 2014 served as the baseline and showed readmission rate of 32.32% from the SNF back to the hospital. After we implemented the new hospitalist SNF model in June 2014, readmission rates decreased to 23.96% between July 2014 and December 2014. From January 2015 to June 2015, the overall readmission rate from the SNF reduced further to 16.06%. Statistical analysis revealed a post-intervention odds ratio of 0.403 (p < 0.001). Conclusion : The government is piloting several care models that incentivize value- based behavior. Our study strongly suggests that the hospitalist-resident continuity model of following patients to the SNFs can significantly decrease 30-days hospital readmission rates.

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

Li, Mo; Nakshatrala, Kalyana; William, Kasper

The objective of this project is to develop a new class of multifunctional concrete materials (MSCs) for extended spent nuclear fuel (SNF) storage systems, which combine ultra-high damage resistance through strain-hardening behavior with distributed multi-dimensional damage self-sensing capacity. The beauty of multifunctional concrete materials is two-fold: First, it serves as a major material component for the SNF pool, dry cask shielding and foundation pad with greatly improved resistance to cracking, reinforcement corrosion, and other common deterioration mechanisms under service conditions, and prevention from fracture failure under extreme events (e.g. impact, earthquake). This will be achieved by designing multiple levels ofmore » protection mechanisms into the material (i.e., ultrahigh ductility that provides thousands of times greater fracture energy than concrete and normal fiber reinforced concrete; intrinsic cracking control, electrochemical properties modification, reduced chemical and radionuclide transport properties, and crack-healing properties). Second, it offers capacity for distributed and direct sensing of cracking, strain, and corrosion wherever the material is located. This will be achieved by establishing the changes in electrical properties due to mechanical and electrochemical stimulus. The project will combine nano-, micro- and composite technologies, computational mechanics, durability characterization, and structural health monitoring methods, to realize new MSCs for very long-term (greater than 120 years) SNF storage systems.« less

Why are hospital-based nursing homes so costly? Relative importance of acuity and treatment setting.

PubMed

Pizer, Steven D; White, Alan J; White, Chapin

2002-05-01

To determine the extent to which higher costs in hospital-based skilled nursing facilities (HBSNF) can be explained by observable resident characteristics and unobservable selection effects, implying a design shortcoming of the skilled nursing facility prospective payment system (SNF PPS) implemented for Medicare-covered stays by the Balanced Budget Act of 1997 (BBA 1997). Data on resident characteristics from the Minimum Data Set (MDS) are combined with staff time costs from the Centers for Medicare and Medicaid Services' (CMS, formerly HCFA) 1995 and 1997 SNF Staff Time Measurement (STM) studies and nontherapy ancillary claim costs extracted from CMS SNF claim records. An endogenous switching model was estimated to measure the effect on costs of the relatively high acuity of HBSNF residents, net of differences purely attributable to the treatment setting. It was found that virtually the entire HBSNF differential is attributable to setting effects with resident characteristics and selection effects playing a negligible role. In addition, it was found that marginal costs associated with particular services and conditions are often lower in hospital-based than in freestanding facilities. HBSNFs incur high costs regardless of the characteristics of their residents. Their high fixed costs accompany relatively low marginal costs associated with admitting high-acuity residents. Consequently, a PPS casemix system that depends on resident characteristics and excludes consideration of facility characteristics (as mandated by BBA 1997) need not unfairly penalize HBSNFs, provided a powerful casemix system is used and HBSNFs specialize in the care of high-acuity residents.

Medicaid: Methods for Setting Nursing Home Rates Should be Improved.

DTIC Science & Technology

1986-05-01

care facility SNF skilled nursing facility Page 7 GAO/HRJD.W626 Medicaid Nursing Home Rate Setting A,, I-?A -WI...consumer price index GNP Gross National Product HCFA Health Care Financing Administration HHS Department of Health and Human Services ICF intermediate

78 FR 26437 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-06

...This proposed rule would update the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs) for fiscal year (FY) 2014, would revise and rebase the SNF market basket, and would make certain technical and conforming revisions in the regulations text. This proposed rule also includes a proposed policy for reporting the SNF market basket forecast error correction in certain limited circumstances and a proposed new item for the Minimum Data Set (MDS), Version 3.0.

78 FR 38594 - Medicare and Medicaid Programs; Requirements for Long Term Care Facilities; Hospice Services

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-27

..., and in view of the slight differences between these rules, we requested public comment on whether the...: This final rule will revise the requirements that an institution will have to meet in order to qualify to participate as a skilled nursing facility (SNF) in the Medicare program, or as a nursing facility...

75 FR 65282 - Medicare and Medicaid Programs; Requirements for Long Term Care Facilities; Hospice Services

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-22

... to qualify to participate as a skilled nursing facility (SNF) in the Medicare program, or as a nursing facility (NF) in the Medicaid program. We are proposing these requirements to ensure that long... According to CMS data, at any point in time, approximately 1.4 million elderly and disabled nursing home...

Assessment of Activity of Daily Living among Older Adult Patients in Home Health Care and Skilled Nursing Facilities: An Integrative Review

PubMed Central

Osakwe, Zainab Toteh; Larson, Elaine; Agrawal, Mansi; Shang, Jinjing

2017-01-01

Older adult’s ability to self-manage illness is dependent on their ability to perform activities of daily living (ADL). Forty-five percent of those older than 65 years will have ongoing clinical needs after hospital discharge and require post-acute care (PAC) services in settings such as home health care (HHC) and skilled nursing facilities (SNF). The Improving Medicare Post-Acute Care Transformation Act (IMPACT) of 2014 requires PAC providers to begin collecting and reporting ADL data to build a coordinated approach to payment and standardize patient assessments and quality measurement. The aim of this integrative review was to compare the methods of assessing ADLs in HHC to SNF. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was used to ensure results were reported systematically. A scientific literature search without date restriction within the PubMed and Cumulative Index of Nursing and Allied Health Literature (CINAHL) databases was conducted. Two independent investigators assessed study quality using the quality appraisal instrument developed by Kmet and colleagues. Study quality ranged from 94.5% to 100%. Of the 18749 articles identified by the search, eight met inclusion criteria and four tools were identified that are used to assess ADLs in SNF and HHC. Although SNF and HHC collect similar ADL information, the range of content covered, item definitions, scoring, and psychometrics are not comparable across settings. PMID:28471793

Consolidated Storage Facilities: Camel's Nose or Shared Burden? - 13112

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

Williams, James M.

2013-07-01

The Blue Ribbon Commission (BRC) made a strong argument why the reformulated nuclear waste program should make prompt efforts to develop one or more consolidated storage facilities (CSFs), and recommended the amendment of NWPA Section 145(b) 2 (linking 'monitored retrievable storage' to repository development) as an essential means to that end. However, other than recommending that the siting of CSFs should be 'consent-based' and that spent nuclear fuel (SNF) at stranded sites should be first-in-line for removal, the Commission made few recommendations regarding how CSF development should proceed. Working with three other key Senators, Jeff Bingaman attempted in the 112.more » Congress to craft legislation (S. 3469) to put the BRC recommendations into legislative language. The key reason why the Nuclear Waste Administration Act of 2012 did not proceed was the inability of the four senators to agree on whether and how to amend NWPA Section 145(b). A brief review of efforts to site consolidated storage since the Nuclear Waste Policy Amendments Act of 1987 suggests a strong and consistent motivation to shift the burden to someone (anyone) else. This paper argues that modification of NWPA Section 145(b) should be accompanied by guidelines for regional development and operation of CSFs. After review of the BRC recommendations regarding CSFs, and the 'camel's nose' prospects if implementation is not accompanied by further guidelines, the paper outlines a proposal for implementation of CSFs on a regional basis, including priorities for removal from reactor sites and subsequently from CSFs to repositories. Rather than allowing repository siting to be prejudiced by the location of a single remote CSF, the regional approach limits transport for off-site acceptance and storage, increases the efficiency of removal operations, provides a useful basis for compensation to states and communities that accept CSFs, and gives states with shared circumstances a shared stake in storage and disposal in an integrated national program. (authors)« less

75 FR 55801 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-14

... 0938-AP87 Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing... Payment System and Consolidated Billing for Skilled Nursing Facilities for FY 2011.'' DATES: Effective... illustrate the skilled nursing facility (SNF) prospective payment system (PPS) payment rate computations for...

Development of New Transportation/Storage Cask System for Use by DOE Russian Research Reactor Fuel Return Program

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

Michael Tyacke; Frantisek Svitak; Jiri Rychecky

2010-04-01

The United States, the Russian Federation, and the International Atomic Energy Agency (IAEA) have been working together on a program called the Russian Research Reactor Fuel Return (RRRFR) Program. The purpose of this program is to return Soviet or Russian supplied high-enriched uranium (HEU) fuel currently stored at Russian-designed research reactors throughout the world to Russia. To accommodate transport of the HEU spent nuclear fuel (SNF), a new large-capacity transport/storage cask system was specially designed for handling and operations under the unique conditions for these research reactor facilities. This new cask system is named the ŠKODA VPVR/M cask. The design,more » licensing, testing, and delivery of this new cask system are the results of a significant international cooperative effort by several countries and involved numerous private and governmental organizations. This paper contains the following sections: (1) Introduction/Background; (2) VPVR/M Cask Description; (3) Ancillary Equipment, (4) Cask Licensing; (5) Cask Demonstration and Operations; (6) IAEA Procurement, Quality Assurance Inspections, Fabrication, and Delivery; and, (7) Summary and Conclusions.« less

Development of a New Transportation/Storage Cask System for Use by the DOE Russian Research Reactor Fuel Return Program

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

Michael J. Tyacke; Frantisek Svitak; Jiri Rychecky

2007-10-01

The United States, the Russian Federation, and the International Atomic Energy Agency (IAEA) have been working together on a program called the Russian Research Reactor Fuel Return (RRRFR) Program. The purpose of this program is to return Soviet or Russian-supplied high-enriched uranium (HEU) fuel, currently stored at Russian-designed research reactors throughout the world, to Russia. To accommodate transport of the HEU spent nuclear fuel (SNF), a new large-capacity transport/storage cask system was specially designed for handling and operations under the unique conditions at these research reactor facilities. This new cask system is named the ŠKODA VPVR/M cask. The design, licensing,more » testing, and delivery of this new cask system result from a significant international cooperative effort by several countries and involved numerous private and governmental organizations. This paper contains the following sections: 1) Introduction; 2) VPVR/M Cask Description; 3) Ancillary Equipment, 4) Cask Licensing; 5) Cask Demonstration and Operations; 6) IAEA Procurement, Quality Assurance Inspections, Fabrication, and Delivery; and, 7) Conclusions.« less

Vertical integration and optimal reimbursement policy.

PubMed

Afendulis, Christopher C; Kessler, Daniel P

2011-09-01

Health care providers may vertically integrate not only to facilitate coordination of care, but also for strategic reasons that may not be in patients' best interests. Optimal Medicare reimbursement policy depends upon the extent to which each of these explanations is correct. To investigate, we compare the consequences of the 1997 adoption of prospective payment for skilled nursing facilities (SNF PPS) in geographic areas with high versus low levels of hospital/SNF integration. We find that SNF PPS decreased spending more in high integration areas, with no measurable consequences for patient health outcomes. Our findings suggest that integrated providers should face higher-powered reimbursement incentives, i.e., less cost-sharing. More generally, we conclude that purchasers of health services (and other services subject to agency problems) should consider the organizational form of their suppliers when choosing a reimbursement mechanism.

Vertical integration and optimal reimbursement policy

PubMed Central

Afendulis, Christopher C.

2011-01-01

Health care providers may vertically integrate not only to facilitate coordination of care, but also for strategic reasons that may not be in patients’ best interests. Optimal Medicare reimbursement policy depends upon the extent to which each of these explanations is correct. To investigate, we compare the consequences of the 1997 adoption of prospective payment for skilled nursing facilities (SNF PPS) in geographic areas with high versus low levels of hospital/SNF integration. We find that SNF PPS decreased spending more in high integration areas, with no measurable consequences for patient health outcomes. Our findings suggest that integrated providers should face higher-powered reimbursement incentives, i.e., less cost-sharing. More generally, we conclude that purchasers of health services (and other services subject to agency problems) should consider the organizational form of their suppliers when choosing a reimbursement mechanism. PMID:21850551

Implementation of a Person-Centered Medical Care Model in a Skilled Nursing Facility: A Pilot Evaluation.

PubMed

Abrahamson, Kathleen; Myers, Jaclyn; Nazir, Arif

2017-06-01

The objective of this study was to evaluate the feasibility and impact of implementing a person-centered medical care model for post-acute care residents within a skilled nursing facility (SNF). A mixed-method (qualitative and quantitative) pilot evaluation. An 89-bed SNF located within a large midwestern city. Forty SNF post-acute patients admitted to the facility during a 6-month period were enrolled in the pilot evaluation. The patients were 75% women, 57% African American, and had an average age of 73. To meet inclusion criteria, patients must have been admitted to the facility for rehabilitation with a plan for community discharge, and be cognitively able to consent as indicated by a cognitive screening tool or assent to participation with family member consent. The person-centered medical care model included (1) biweekly interdisciplinary care plan meetings, scheduled at a time of patients' preference and held in the patient's room; (2) patient selection of health-related goals that guide team discussions; (3) use of lay-language that facilitated patient understanding; (4) team accountability to the patient for patient care preferences; and (5) monthly care-team meetings to exchange feedback regarding the team's performance and the model. Evaluation data included admission and discharge Patient Activation Measure surveys; admission and discharge Care of Chronic Conditions surveys; admission and biweekly modified Castle Satisfaction Surveys; admission and discharge Patient and Caregiver Engagement surveys; and semistructured interviews with a sample of staff, family members, and patients. A significant (P < .01) improvement was noted between admission and discharge on both the Care for Chronic Conditions and the Patient Activation Measure surveys. Patient satisfaction surveys trended toward higher ratings over time on most questions, with significant improvement in 2 questions addressing satisfaction with their medical provider. Interviews revealed a perception that the model encouraged an environment of respect and honesty in patient communications, and an overall positive experience. The challenges of scheduling and time were noted by respondents. Implementation of person-centered medical care within an SNF was feasible, yet required changing care processes to better address individual goals and facilitate communication among patients, providers, and SNF staff. Overall pilot results indicated that patients and staff members viewed the person-centered care experience positively. Further research is needed to examine long-term effects of the model on resident outcomes. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Goals and Characteristics of Long-Term Care Programs: An Analytic Model.

ERIC Educational Resources Information Center

Braun, Kathryn L.; Rose, Charles L.

1989-01-01

Used medico-social analytic model to compare five long-term care programs: Skilled Nursing Facility-Intermediate Care Facility (SNF-ICF) homes, ICF homes, foster homes, day hospitals, and home care. Identified similarities and differences among programs. Preliminary findings suggest that model is useful in the evaluation and design of long-term…

Reversible Bending Fatigue Test System for Investigating Vibration Integrity of Spent Nuclear Fuel during Transportation

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

Wang, Jy-An John; Wang, Hong; Bevard, Bruce Balkcom

Transportation packages for spent nuclear fuel (SNF) must meet safety requirements under normal and accident conditions as specified by federal regulations. During transportation, SNF experiences unique conditions and challenges to cladding integrity due to the vibrational and impact loading during road or rail shipment. Oak Ridge National Laboratory (ORNL) has been developing testing capabilities that can be used to improve the understanding of the impacts on SNF integrity due to vibration loading, especially for high burn-up SNF in normal transportation operation conditions. This information can be used to meet the nuclear industry and U.S. Nuclear Regulatory Commission needs in themore » area of safety and security of spent nuclear fuel storage and transport operations. The ORNL developed test system can perform reversible-bending fatigue testing to evaluate both the static and dynamic mechanical response of SNF rods under simulated loads. The testing apparatus is also designed to meet the challenges of hot-cell operation, including remote installation and detachment of the SNF test specimen, in-situ test specimen deformation measurement, and implementation of a driving system suitable for use in a hot cell. The system contains a U-frame set-up equipped with uniquely designed grip rigs, to protect SNF rod and to ensure valid test results, and use of 3 specially designed LVDTs to obtain the in-situ curvature measurement. A variety of surrogate test rods have been used to develop and calibrate the test system as well as in performing a series of systematic cyclic fatigue tests. The surrogate rods include stainless steel (SS) cladding, SS cladding with cast epoxy, and SS cladding with alumina pellets inserts simulating fuel pellets. Testing to date has shown that the interface bonding between the SS cladding and the alumina pellets has a significant impact on the bending response of the test rods as well as their fatigue strength. The failure behaviors observed from tested surrogate rods provides a fundamental understanding of the underlying failure mechanisms of the SNF surrogate rod under vibration which has not been achieved previously. The newly developed device is scheduled to be installed in the hot-cell in summer 2013 to test high burnup SNF.« less

Approach for validating actinide and fission product compositions for burnup credit criticality safety analyses

DOE PAGES

Radulescu, Georgeta; Gauld, Ian C.; Ilas, Germina; ...

2014-11-01

This paper describes a depletion code validation approach for criticality safety analysis using burnup credit for actinide and fission product nuclides in spent nuclear fuel (SNF) compositions. The technical basis for determining the uncertainties in the calculated nuclide concentrations is comparison of calculations to available measurements obtained from destructive radiochemical assay of SNF samples. Probability distributions developed for the uncertainties in the calculated nuclide concentrations were applied to the SNF compositions of a criticality safety analysis model by the use of a Monte Carlo uncertainty sampling method to determine bias and bias uncertainty in effective neutron multiplication factor. Application ofmore » the Monte Carlo uncertainty sampling approach is demonstrated for representative criticality safety analysis models of pressurized water reactor spent fuel pool storage racks and transportation packages using burnup-dependent nuclide concentrations calculated with SCALE 6.1 and the ENDF/B-VII nuclear data. Furthermore, the validation approach and results support a recent revision of the U.S. Nuclear Regulatory Commission Interim Staff Guidance 8.« less

Early malnutrition screening and low cost protein supplementation in elderly patients admitted to a skilled nursing facility.

PubMed

Harding, Krystal M; Dyo, Melissa; Goebel, Joy R; Gorman, Nik; Levine, Julia

2016-08-01

Malnutrition among skilled nursing facility (SNF) patients can lead to hospital readmissions and multiple complications. To evaluate the effect of an existing malnutrition screening and management program on prealbumin levels of patients in skilled nursing facilities. A retrospective design was used to evaluate baseline admission data including a prealbumin level. Patients with malnutrition received an oral protein supplement according to protocol. A comparison prealbumin level was obtained at 30days. Nearly half of the patients were severely malnourished on admission. Patients receiving the prescribed protocol had significantly increased prealbumin levels at 30days than those patients that did not receive the protocol as prescribed. A prealbumin level upon admission at a SNF could represent a reliable tool to evaluate malnutrition. Initiation of an early malnutrition screening and protein supplement program in this setting is essential to identifying and treating at-risk patients before complications occur. Copyright © 2015 Elsevier Inc. All rights reserved.

Medicare and Medicaid programs; rural hospitals: provision of long-term care services (swing-bed provision); flexibility in application of standards--Health Care Financing Administration. Interim final rule with comment period.

PubMed

1982-07-20

These regulations implement sections 904 and 949 of Pub. L. 96-499, the Omnibus Reconciliation Act of 1980. Under section 904 (the swing-bed provision), certain small, rural hospitals may use their inpatient facilities to furnish skilled nursing facility (SNF) services to Medicare and Medicaid beneficiaries, and intermediate care facility (ICF) services to Medicaid beneficiaries. These hospitals will be reimbursed at rates appropriate for those services, which are generally lower than hospital rates. This statutory provision is intended to encourage the most efficient and effective use of inpatient hospital beds for delivery of either hospital or SNF and ICF services. Under section 949, rural hospitals of 50 or fewer beds may be exempted from certain personnel standards in the conditions of participation for hospitals. This exemption applies only to the extent that it does not jeopardize or adversely affect the health and safety of patients.

Relationship of patient volume and service concentration with outcome in geriatric rehabilitation.

PubMed

Holstege, Marije S; Zekveld, Ineke G; Caljouw, Monique A A; Peerenboom, Peter Bob; van Balen, Romke; Gussekloo, Jacobijn; Achterberg, Wilco P

2013-10-01

Although geriatric rehabilitation (GR) is beneficial for restoration of activities and participation after hospitalization of vulnerable older persons, little is known about the optimal organization of care of these postacute facilities. This study examines the relationship of patient volume and service concentration with successful GR (short length of stay and discharge home) in skilled nursing facilities (SNFs). A national multicenter retrospective cohort study. All patients indicated for GR in a Dutch SNF. Nurses filled out digital registration forms from patient records. Patients were studied in 3 predefined diagnostic groups: total joint replacement, traumatic injuries, and stroke. Facility characteristics were obtained by structured telephone interviews with facility managers. Volume was based on the number of discharges in a 3-month period and categorized in low-, medium-, and high-volume facilities. Concentration was defined at the organizational level in which the population consists of 80% or more of 1 or 2 diagnostic groups, with the prerequisite of having a minimum of 10 rehabilitation beds. From 88 facilities, 2269 GR patients (mean age 78.2 years [SD 9.7]; 68.2% female) were included. The median length of stay in the SNF was 45 days (interquartile range 23-81), 57% of the patients were discharged home, and 9.8% died during GR. Of patients with total joint replacement (n = 501), concentration was related to successful rehabilitation (odds ratio 5.7; 95% confidence interval 1.3-24.3; P = .020, adjusted for age and gender); this relationship was not found for patients with traumatic injuries or stroke. Volume showed no relation with successful rehabilitation in any of the 3 diagnostic groups. This study may indicate that concentration in an SNF, as a proxy for specialization, favors successful GR in total joint replacement. This relationship was not found for the traumatic injuries or stroke groups, or for volume. The relation on functional outcome in GR needs further investigation. Copyright © 2013 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

Stability of Geriatric Syndromes in Hospitalized Medicare Beneficiaries Discharged to Skilled Nursing Facilities.

PubMed

Simmons, Sandra F; Bell, Susan; Saraf, Avantika A; Coelho, Chris S; Long, Emily A; Jacobsen, J M L; Schnelle, John F; Vasilevskis, Eduard E

2016-10-01

To assess multiple geriatric syndromes in a sample of older hospitalized adults discharged to skilled nursing facilities (SNFs) and subsequently to home to determine the prevalence and stability of each geriatric syndrome at the point of these care transitions. Descriptive, prospective study. One large university-affiliated hospital and four area SNFs. Fifty-eight hospitalized Medicare beneficiaries discharged to SNFs (N = 58). Research personnel conducted standardized assessments of the following geriatric syndromes at hospital discharge and 2 weeks after SNF discharge to home: cognitive impairment, depression, incontinence, unintentional weight loss, loss of appetite, pain, pressure ulcers, history of falls, mobility impairment, and polypharmacy. The average number of geriatric syndromes per participant was 4.4 ± 1.2 at hospital discharge and 3.8 ± 1.5 after SNF discharge. There was low to moderate stability for most syndromes. On average, participants had 2.9 syndromes that persisted across both care settings, 1.4 syndromes that resolved, and 0.7 new syndromes that developed between hospital and SNF discharge. Geriatric syndromes were prevalent at the point of each care transition but also reflected significant within-individual variability. These findings suggest that multiple geriatric syndromes present during a hospital stay are not transient and that most syndromes are not resolved before SNF discharge. These results underscore the importance of conducting standardized screening assessments at the point of each care transition and effectively communicating this information to the next provider to support the management of geriatric conditions. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Coupling fuel cycles with repositories: how repository institutional choices may impact fuel cycle design

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

Forsberg, C.; Miller, W.F.

2013-07-01

The historical repository siting strategy in the United States has been a top-down approach driven by federal government decision making but it has been a failure. This policy has led to dispatching fuel cycle facilities in different states. The U.S. government is now considering an alternative repository siting strategy based on voluntary agreements with state governments. If that occurs, state governments become key decision makers. They have different priorities. Those priorities may change the characteristics of the repository and the fuel cycle. State government priorities, when considering hosting a repository, are safety, financial incentives and jobs. It follows that statesmore » will demand that a repository be the center of the back end of the fuel cycle as a condition of hosting it. For example, states will push for collocation of transportation services, safeguards training, and navy/private SNF (Spent Nuclear Fuel) inspection at the repository site. Such activities would more than double local employment relative to what was planned for the Yucca Mountain-type repository. States may demand (1) the right to take future title of the SNF so if recycle became economic the reprocessing plant would be built at the repository site and (2) the right of a certain fraction of the repository capacity for foreign SNF. That would open the future option of leasing of fuel to foreign utilities with disposal of the SNF in the repository but with the state-government condition that the front-end fuel-cycle enrichment and fuel fabrication facilities be located in that state.« less

Initial Assessment of the Risk Assessment and Prediction Tool in a Heterogeneous Neurosurgical Patient Population.

PubMed

Piazza, Matthew; Sharma, Nikhil; Osiemo, Benjamin; McClintock, Scott; Missimer, Emily; Gardiner, Diana; Maloney, Eileen; Callahan, Danielle; Smith, J Lachlan; Welch, William; Schuster, James; Grady, M Sean; Malhotra, Neil R

2018-05-21

Bundled care payments are increasingly being explored for neurosurgical interventions. In this setting, skilled nursing facility (SNF) is less desirable from a cost perspective than discharge to home, underscoring the need for better preoperative prediction of postoperative disposition. To assess the capability of the Risk Assessment and Prediction Tool (RAPT) and other preoperative variables to determine expected disposition prior to surgery in a heterogeneous neurosurgical cohort, through observational study. Patients aged 50 yr or more undergoing elective neurosurgery were enrolled from June 2016 to February 2017 (n = 623). Logistic regression was used to identify preoperative characteristics predictive of discharge disposition. Results from multivariate analysis were used to create novel grading scales for the prediction of discharge disposition that were subsequently compared to the RAPT Score using Receiver Operating Characteristic analysis. Higher RAPT Score significantly predicted home disposition (P < .001). Age 65 and greater, dichotomized RAPT walk score, and spinal surgery below L2 were independent predictors of SNF discharge in multivariate analysis. A grading scale utilizing these variables had superior discriminatory power between SNF and home/rehab discharge when compared with RAPT score alone (P = .004). Our analysis identified age, lower lumbar/lumbosacral surgery, and RAPT walk score as independent predictors of discharge to SNF, and demonstrated superior predictive power compared with the total RAPT Score when combined in a novel grading scale. These tools may identify patients who may benefit from expedited discharge to subacute care facilities and decrease inpatient hospital resource utilization following surgery.

Effects of skilled nursing facility structure and process factors on medication errors during nursing home admission.

PubMed

Lane, Sandi J; Troyer, Jennifer L; Dienemann, Jacqueline A; Laditka, Sarah B; Blanchette, Christopher M

2014-01-01

Older adults are at greatest risk of medication errors during the transition period of the first 7 days after admission and readmission to a skilled nursing facility (SNF). The aim of this study was to evaluate structure- and process-related factors that contribute to medication errors and harm during transition periods at a SNF. Data for medication errors and potential medication errors during the 7-day transition period for residents entering North Carolina SNFs were from the Medication Error Quality Initiative-Individual Error database from October 2006 to September 2007. The impact of SNF structure and process measures on the number of reported medication errors and harm from errors were examined using bivariate and multivariate model methods. A total of 138 SNFs reported 581 transition period medication errors; 73 (12.6%) caused harm. Chain affiliation was associated with a reduction in the volume of errors during the transition period. One third of all reported transition errors occurred during the medication administration phase of the medication use process, where dose omissions were the most common type of error; however, dose omissions caused harm less often than wrong-dose errors did. Prescribing errors were much less common than administration errors but were much more likely to cause harm. Both structure and process measures of quality were related to the volume of medication errors.However, process quality measures may play a more important role in predicting harm from errors during the transition of a resident into an SNF. Medication errors during transition could be reduced by improving both prescribing processes and transcription and documentation of orders.

Medicare program; prospective payment system and consolidated billing for skilled nursing facilities for FY 2014. Final rule.

PubMed

2013-08-06

This final rule updates the payment rates used under the prospective payment system for skilled nursing facilities (SNFs) for fiscal year (FY) 2014. In addition, it revises and rebases the SNF market basket, revises and updates the labor related share, and makes certain technical and conforming revisions in the regulations text. This final rule also includes a policy for reporting the SNF market basket forecast error in certain limited circumstances and adds a new item to the Minimum Data Set (MDS), Version 3.0 for reporting the number of distinct therapy days. Finally, this final rule adopts a change to the diagnosis code used to determine which residents will receive the AIDS add-on payment, effective for services provided on or after the October 1, 2014 implementation date for conversion to ICD-10-CM.

Functional Outcomes of Persons Undergoing Dysvascular Lower Extremity Amputations

PubMed Central

Sauter, Carley N.; Pezzin, Liliana E.; Dillingham, Timothy R.

2012-01-01

Objective To examine the effect of post-acute rehabilitation setting on functional outcomes among patients undergoing major lower extremity dysvascular amputations. Design A population-based, prospective cohort study conducted in Maryland and Wisconsin. Data collected from medical records and patient interviews conducted during acute hospitalization following amputation and at six-month following the acute care discharge were analyzed using multivariate models and instrumental variable techniques. Results A total of 297 patients were analyzed based on post-acute care rehabilitation setting: acute inpatient rehabilitation (IRF), skilled nursing facility (SNF) or home. The majority (43.4%) received care in IRF, 32% in SNF, and 24.6% at home. On SF-36 subscales, significantly improved outcomes were observed for patients receiving post-acute care at an IRF relative to those cared for at a SNF in physical function (PF), role physical (RF) and physical component score (PCS). Patients receiving post-acute care in IRFs also experienced better RF and PCS outcomes compared to those discharged directly home. In addition, patients receiving post-acute care at an IRF were significantly more likely to score in the top quartile for general health in IRF compared to SNF or home, and less likely to score in the lowest quartile for PF, RF and PCS in IRF compared to SNF. Lower ADL impairment was observed in IRF compared to SNF. Conclusions Among this large and diverse cohort of patients undergoing major dysvascular lower limb amputations, receipt of interdisciplinary rehabilitation services at an IRF yielded improved functional outcomes six months after amputation relative to care received at SNFs or home. PMID:23291599

A randomized trial of heart failure disease management in skilled nursing facilities (SNF Connect): Lessons learned.

PubMed

Daddato, Andrea; Wald, Heidi L; Horney, Carolyn; Fairclough, Diane L; Leister, Erin C; Coors, Marilyn; Capell, Warren H; Boxer, Rebecca S

2017-06-01

Conducting clinical trials in skilled nursing facilities is particularly challenging. This manuscript describes facility and patient recruitment challenges and solutions for clinical research in skilled nursing facilities. Lessons learned from the SNF Connect Trial, a randomized trial of a heart failure disease management versus usual care for patients with heart failure receiving post-acute care in skilled nursing facilities, are discussed. Description of the trial design and barriers to facility and patient recruitment along with regulatory issues are presented. The recruitment of Denver-metro skilled nursing facilities was facilitated by key stakeholders of the skilled nursing facilities community. However, there were still a number of barriers to facility recruitment including leadership turnover, varying policies regarding research, fear of litigation and of an increased workload. Engagement of facilities was facilitated by their strong interest in reducing hospital readmissions, marketing potential to hospitals, and heart failure management education for their staff. Recruitment of patients proved difficult and there were few facilitators. Identified patient recruitment challenges included patients being unaware of their heart failure diagnosis, patients overwhelmed with their illness and care, and frequently there was no available proxy for cognitively impaired patients. Flexibility in changing the recruitment approach and targeting skilled nursing facilities with higher rates of admissions helped to overcome some barriers. Recruitment of skilled nursing facilities and patients in skilled nursing facilities for clinical trials is challenging. Strategies to attract both facilities and patients are warranted. These include aligning study goals with facility incentives and flexible recruitment protocols to work with patients in "transition crisis."

Reducing Hospital Readmissions Through Preferred Networks Of Skilled Nursing Facilities.

PubMed

McHugh, John P; Foster, Andrew; Mor, Vincent; Shield, Renée R; Trivedi, Amal N; Wetle, Terrie; Zinn, Jacqueline S; Tyler, Denise A

2017-09-01

Establishing preferred provider networks of skilled nursing facilities (SNFs) is one approach hospital administrators are using to reduce excess thirty-day readmissions and avoid Medicare penalties or to reduce beneficiaries' costs as part of value-based payment models. However, hospitals are also required to provide patients at discharge with a list of Medicare-eligible providers and cannot explicitly restrict patient choice. This requirement complicates the development of a SNF network. Furthermore, there is little evidence about the effectiveness of network development in reducing readmission rates. We used a concurrent mixed-methods approach, combining Medicare claims data for the period 2009-13 with qualitative data gathered from interviews during site visits to hospitals in eight US markets in March-October 2015, to examine changes in rehospitalization rates and differences in practices between hospitals that did and did not develop formal SNF networks. Four hospitals had developed formal SNF networks as part of their care management efforts. These hospitals saw a relative reduction from 2009 to 2013 in readmission rates for patients discharged to SNFs that was 4.5 percentage points greater than the reduction for hospitals without formal networks. Interviews revealed that those with networks expanded existing relationships with SNFs, effectively managed patient data, and exercised a looser interpretation of patient choice. Project HOPE—The People-to-People Health Foundation, Inc.

Reducing Hospital Readmissions Through Preferred Networks Of Skilled Nursing Facilities

PubMed Central

Foster, Andrew; Mor, Vincent; Shield, Renée R.; Trivedi, Amal N.; Wetle, Terrie; Zinn, Jacqueline S.; Tyler, Denise A.

2017-01-01

Establishing preferred provider networks of skilled nursing facilities (SNFs) is one approach hospital administrators are using to reduce excess thirty-day readmissions and avoid Medicare penalties or to reduce beneficiaries’ costs as part of value-based payment models. However, hospitals are also required to provide patients at discharge with a list of Medicare-eligible providers and cannot explicitly restrict patient choice. This requirement complicates the development of a SNF network. Furthermore, there is little evidence about the effectiveness of network development in reducing readmission rates. We used a concurrent mixed-methods approach, combining Medicare claims data for the period 2009–13 with qualitative data gathered from interviews during site visits to hospitals in eight US markets in March–October 2015, to examine changes in rehospitalization rates and differences in practices between hospitals that did and did not develop formal SNF networks. Four hospitals had developed formal SNF networks as part of their care management efforts. These hospitals saw a relative reduction from 2009 to 2013 in readmission rates for patients discharged to SNFs that was 4.5 percentage points greater than the reduction for hospitals without formal networks. Interviews revealed that those with networks expanded existing relationships with SNFs, effectively managed patient data, and exercised a looser interpretation of patient choice. PMID:28874486

76 FR 10805 - Dan Kane; Denial of Petition for Rulemaking

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-28

... of no significant environmental impact, also known as the Waste Confidence Rule. (ADAMS Accession No... safely and without significant environmental impacts for at least 60 years after the licensed life of... supported by an Environmental Impact Statement) to assess the long-term storage of SNF and HLW. (ADAMS...

Initial Radionuclide Inventories

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

Miller, H

The purpose of this analysis is to provide an initial radionuclide inventory (in grams per waste package) and associated uncertainty distributions for use in the Total System Performance Assessment for the License Application (TSPA-LA) in support of the license application for the repository at Yucca Mountain, Nevada. This document is intended for use in postclosure analysis only. Bounding waste stream information and data were collected that capture probable limits. For commercially generated waste, this analysis considers alternative waste stream projections to bound the characteristics of wastes likely to be encountered using arrival scenarios that potentially impact the commercial spent nuclearmore » fuel (CSNF) waste stream. For TSPA-LA, this radionuclide inventory analysis considers U.S. Department of Energy (DOE) high-level radioactive waste (DHLW) glass and two types of spent nuclear fuel (SNF): CSNF and DOE-owned (DSNF). These wastes are placed in two groups of waste packages: the CSNF waste package and the codisposal waste package (CDSP), which are designated to contain DHLW glass and DSNF, or DHLW glass only. The radionuclide inventory for naval SNF is provided separately in the classified ''Naval Nuclear Propulsion Program Technical Support Document'' for the License Application. As noted previously, the radionuclide inventory data presented here is intended only for TSPA-LA postclosure calculations. It is not applicable to preclosure safety calculations. Safe storage, transportation, and ultimate disposal of these wastes require safety analyses to support the design and licensing of repository equipment and facilities. These analyses will require radionuclide inventories to represent the radioactive source term that must be accommodated during handling, storage and disposition of these wastes. This analysis uses the best available information to identify the radionuclide inventory that is expected at the last year of last emplacement, currently identified as 2030 and 2033, depending on the type of waste. TSPA-LA uses the results of this analysis to decay the inventory to the year of repository closure projected for the year of 2060.« less

The influence of financial incentives and racial status on the use of post-hospital care.

PubMed

Robertson, Madeline J; Broyles, Robert W; Khaliq, Amir

2004-01-01

This study examines the influence of financial incentives and the racial status of the patient on the use of extended care following an episode of hospitalization. Post-hospital care (PHC) is defined as the services provided by a skilled nursing facility (SNF) or intermediate care facility (ICF) following discharge. The focus of the analysis is on the use or nonuse of PHC, the presence or absence of a delay in transfer to an ICF or SNF and, limited to those who experienced a postponement, the length of the delayed discharge. After controlling for multiple factors, the results indicate that Medicare beneficiaries were more likely to use PHC, less likely to experience a delay in discharge, and used fewer days of prolonged care. Medicaid recipients and uninsured patients experienced reduced access to PHC. The results also indicated that the access of Native Americans and Americans to PHC was impeded.

Perceived Benefits, Barriers, and Drivers of Telemedicine From the Perspective of Skilled Nursing Facility Administrative Staff Stakeholders.

PubMed

Driessen, Julia; Castle, Nicholas G; Handler, Steven M

2018-01-01

Potentially avoidable hospitalizations (PAHs) of skilled nursing facility (SNF) patients are common and costly. Telemedicine represents a unique approach to manage and potentially reduce PAHs in SNFs, having been used in a variety of settings to improve coordination of care and enhance access to providers. Nonetheless, broad implementation and use of telemedicine lags in SNFs relative to other health care settings. To understand why, we surveyed SNF administrative staff attending a 1-day telemedicine summit. Participants saw the highest value of telemedicine in improving the quality of care and reducing readmissions. They identified hospital and managed care telemedicine requirements as primary drivers of adoption. The most significant barrier to adoption was the initial investment required. A joint research-policy effort to improve the evidence base around telemedicine in SNFs and introduce incentives may improve adoption and continued use of telemedicine in this setting.

Impact of Neuromuscular Electrical Stimulation (NMES) on 90-Day Episode Costs and Post-Acute Care Utilization in Total Knee Replacement Patients with Disuse Atrophy.

PubMed

Pal, Sarmistha; Chughtai, Morad; Sultan, Assem A; Khlopas, Anton; Sodhi, Nipun; George, Nicole E; Etcheson, Jennifer I; Gwam, Chukwuweike U; Newman, Jared M; Samuel, Linsen T; Bhave, Anil; DaVanzo, Joan E; Mont, Michael A

2017-12-22

This study evaluated differences in: 1) total episode payments, 2) probability of hospital readmission, 3) probability of inpatient rehab facility (IRF) and utilization, and 4) probability of skilled nursing care facility (SNF) utilization in patients who had disuse atrophy and underwent a total knee arthroplasty (TKA) and either did, or did not, receive preoperative home-based neuromuscular electrical stimulation (NMES) therapy. We used the Medicare limited dataset for a 5% sample of beneficiaries from 2014 and 2015 to construct episodes-of-care for TKA (DRG-470) patients with disuse atrophy who underwent a TKA during the 30 days prior to hospital admission and 90 days post-discharge. Patients were stratified into those who either did or did not receive pre- and postoperative NMES therapy. An ordinary least square (OLS) model was used to estimate the impact of NMES on total episode. Linear probability models were used to estimate the impact of NMES on SNF or IRF utilization and readmission. A $3,274 reduction in episode payments for patients who used preoperative NMES versus those who did not (p<0.001) was demonstrated. The probability of readmission was 12.7% lower for those who used preoperative NMES therapy versus those who did not (p=0.609). The probability of utilizing IRF and SNF was 56.7% (p=0.061) and 46.4% (p=<0.001) lower for those who used pre- and postoperative NMES versus those who did not, respectively. Significant reduction in total episode payments and SNF utilization for TKA patients with disuse atrophy who had NMES therapy was demonstrated.

Challenges for Nurses Caring for Patients With Peripherally Inserted Central Catheters in Skilled Nursing Facilities

PubMed Central

Harrod, Molly; Montoya, Ana; Mody, Lona; McGuirk, Helen; Winter, Suzanne; Chopra, Vineet

2016-01-01

Objectives To understand frontline nurses’ (registered nurses and licensed practical nurses), unit nurse managers’ and skilled nursing facility (SNF) administrators’ perceived preparedness in providing care for patients with peripherally inserted central catheters (PICCs) in SNFs. Design An exploratory, qualitative pilot study. Setting Two community based SNFs. Participants Patients, frontline nurses (registered nurses and licensed practical nurses), unit nurse managers and SNF administrators. Methods Over 36-weeks, we observed and conducted informal interviews with 56 patients with PICCs and their nurses focusing on PICC care practices and documentation. In addition, we collected baseline PICC data including placement indication (e.g., antimicrobial administration), placement setting (hospital vs. SNF), and dwell time. We then conducted focus groups with frontline nurses and unit nurse managers and semi-structured interviews with SNF administrators to evaluate perceived preparedness for PICC care. Data were analyzed using a descriptive analysis approach. Results During weekly informal interviews and observations variations in documentation were observed. Differences between patient-reported PICC concerns (quality-of-life) and those described by frontline nurses were noted. Deficiencies in communication between hospitals and SNFs with respect to device care, date of last dressing change and PICC removal time were also noted. During focus group sessions, perceived inadequacy of information at the time of care transitions, limited availability of resources to care for PICCs and gaps in training and education were highlighted as barriers in improving practice and safety. Conclusion Our study suggests that practices for PICC care in SNFs can be improved. Multimodal strategies that enhance staff education, improve information exchange during care transitions and increase resource availability in SNFs appear necessary to enhance PICC care and patient safety. PMID:27603747

Challenges for Nurses Caring for Individuals with Peripherally Inserted Central Catheters in Skilled Nursing Facilities.

PubMed

Harrod, Molly; Montoya, Ana; Mody, Lona; McGuirk, Helen; Winter, Suzanne; Chopra, Vineet

2016-10-01

To understand the perceived preparedness of frontline nurses (registered nurses (RNs), licensed practical nurses (LPNs)), unit nurse managers, and skilled nursing facility (SNF) administrators in providing care for residents with peripherally inserted central catheters (PICCs) in SNFs. Exploratory, qualitative pilot study. Two community based SNFs. Residents with PICCs, frontline nurses (RNs, LPNs), unit nurse managers, and SNF administrators. Over 36 weeks, 56 residents with PICCs and their nurses were observed and informally interviewed, focusing on PICC care practices and documentation. In addition, baseline PICC data were collected on placement indication (e.g., antimicrobial administration), placement setting (hospital vs SNF), and dwell time. Focus groups were then conducted with frontline nurses and unit nurse managers, and semistructured interviews were conducted with SNF administrators to evaluate perceived preparedness for PICC care. Data were analyzed using a descriptive analysis approach. Variations in documentation were observed during weekly informal interviews and observations. Differences were noted between resident self-reported PICC concerns (quality of life) and those described by frontline nurses. Deficiencies in communication between hospitals and SNFs with respect to device care, date of last dressing change, and PICC removal time were also noted. During focus group sessions, perceived inadequacy of information at the time of care transitions, limited availability of resources to care for PICCs, and gaps in training and education were highlighted as barriers to improving practice and safety. Practices for PICC care in SNFs can be improved. Multimodal strategies that enhance staff education, improve information exchange during care transitions, and increase resource availability in SNFs appear necessary to enhance PICC care and safety. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

Mechanical Fatigue Testing of High Burnup Fuel for Transportation Applications

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

Wang, Jy-An John; Wang, Hong

This report describes testing designed to determine the ability of high burnup (HBU) (>45 GWd/MTU) spent fuel to maintain its integrity under normal conditions of transportation. An innovative system, Cyclic Integrated Reversible-bending Fatigue Tester (CIRFT), has been developed at Oak Ridge National Laboratory (ORNL) to test and evaluate the mechanical behavior of spent nuclear fuel (SNF) under conditions relevant to storage and transportation. The CIRFT system is composed of a U-frame equipped with load cells for imposing the pure bending loads on the SNF rod test specimen and measuring the in-situ curvature of the fuel rod during bending using amore » set up with three linear variable differential transformers (LVDTs).« less

Mechanical Fatigue Testing of High-Burnup Fuel for Transportation Applications

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

Wang, Jy-An; Wang, Hong

This report describes testing designed to determine the ability of high burnup (HBU) (>45 GWd/MTU) spent fuel to maintain its integrity under normal conditions of transportation. An innovative system, Cyclic Integrated Reversible-bending Fatigue Tester (CIRFT), has been developed at Oak Ridge National Laboratory (ORNL) to test and evaluate the mechanical behavior of spent nuclear fuel (SNF) under conditions relevant to storage and transportation. The CIRFT system is composed of a U-frame equipped with load cells for imposing the pure bending loads on the SNF rod test specimen and measuring the in-situ curvature of the fuel rod during bending using amore » set up with three linear variable differential transformers (LVDTs).« less

42 CFR 409.47 - Place of service requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

...'s home is any place in which a beneficiary resides that is not a hospital, SNF, or nursing facility as defined in sections 1861(e)(1), 1819(a)(1), of 1919(a)(1) of the Act, respectively. (b) Outpatient...

42 CFR 409.47 - Place of service requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

...'s home is any place in which a beneficiary resides that is not a hospital, SNF, or nursing facility as defined in sections 1861(e)(1), 1819(a)(1), of 1919(a)(1) of the Act, respectively. (b) Outpatient...

42 CFR 409.47 - Place of service requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

...'s home is any place in which a beneficiary resides that is not a hospital, SNF, or nursing facility as defined in sections 1861(e)(1), 1819(a)(1), of 1919(a)(1) of the Act, respectively. (b) Outpatient...

42 CFR 409.47 - Place of service requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

...'s home is any place in which a beneficiary resides that is not a hospital, SNF, or nursing facility as defined in sections 1861(e)(1), 1819(a)(1), of 1919(a)(1) of the Act, respectively. (b) Outpatient...

The Arabidopsis BRAHMA Chromatin-Remodeling ATPase Is Involved in Repression of Seed Maturation Genes in Leaves1[W][OA

PubMed Central

Tang, Xurong; Hou, Anfu; Babu, Mohan; Nguyen, Vi; Hurtado, Lidia; Lu, Qing; Reyes, Jose C.; Wang, Aiming; Keller, Wilfred A.; Harada, John J.; Tsang, Edward W.T.; Cui, Yuhai

2008-01-01

Synthesis and accumulation of seed storage proteins (SSPs) is an important aspect of the seed maturation program. Genes encoding SSPs are specifically and highly expressed in the seed during maturation. However, the mechanisms that repress the expression of these genes in leaf tissue are not well understood. To gain insight into the repression mechanisms, we performed a genetic screen for mutants that express SSPs in leaves. Here, we show that mutations affecting BRAHMA (BRM), a SNF2 chromatin-remodeling ATPase, cause ectopic expression of a subset of SSPs and other embryogenesis-related genes in leaf tissue. Consistent with the notion that such SNF2-like ATPases form protein complexes in vivo, we observed similar phenotypes for mutations of AtSWI3C, a BRM-interacting partner, and BSH, a SNF5 homolog and essential SWI/SNF subunit. Chromatin immunoprecipitation experiments show that BRM is recruited to the promoters of a number of embryogenesis genes in wild-type leaves, including the 2S genes, expressed in brm leaves. Consistent with its role in nucleosome remodeling, BRM appears to affect the chromatin structure of the At2S2 promoter. Thus, the BRM-containing chromatin-remodeling ATPase complex involved in many aspects of plant development mediates the repression of SSPs in leaf tissue. PMID:18508955

Changes in Post-acute Care in the Medicare Shared Savings Program

PubMed Central

McWilliams, J. Michael; Gilstrap, Lauren G.; Stevenson, David G.; Chernew, Michael E.; Huskamp, Haiden A.; Grabowski, David C.

2017-01-01

Importance Post-acute care is thought to be a major source of wasteful spending. The extent to which accountable care organizations (ACOs) can limit post-acute spending has implications for the importance and design of other payment models that include post-acute care. Objective To assess changes in post-acute spending and utilization associated with provider participation as ACOs in the Medicare Shared Savings Program (MSSP) and the pathways by which they occurred. Design and Setting Using fee-for-service Medicare claims from 2009–2014, we conducted difference-in-difference comparisons of beneficiaries served by ACOs with beneficiaries served by local non-ACO providers (control group) before vs. after entry into the MSSP. We estimated differential changes separately for cohorts of ACOs entering the MSSP in 2012, 2013, and 2014. Participants Random 20% sample of beneficiaries with 25,544,650 patient-years, 8,395,426 hospital admissions, and 1,595,352 SNF stays from 2009–2014. Exposure Patient attribution to an ACO in the MSSP. Main Outcomes and Measures Post-acute spending, discharge to a facility, length of SNF stays, readmissions, use of highly-rated SNFs, and mortality, adjusted for patient characteristics. Results For the 2012 cohort of ACOs, MSSP participation was associated with an overall reduction in post-acute spending (differential change in 2014 for ACOs vs. control group: −$106/beneficiary or −9.0%; P=0.003) that was driven by differential reductions in inpatient utilization, discharges to facilities rather than home (−0.6 percentage points or −2.7%; P=0.03), and length of SNF stays (−0.60 days/stay or −2.2%; P=0.002). Reductions in SNF use and length of stay were due largely to within-hospital or within-SNF changes in care specifically for ACO patients. MSSP participation was associated with smaller significant reductions in SNF spending in 2014 for the 2013 ACO cohort but not in the 2013 or 2014 cohort’s first year of participation. Estimates were similar for ACOs with and without financial ties to hospitals. MSSP participation was not associated with significant changes in 30-day readmissions, use of highly-rated SNFs, or mortality. Conclusion and Relevance Participation in the MSSP has been associated with significant reductions in post-acute spending without ostensible deterioration in quality. Spending reductions were more consistent with clinicians working within hospitals and SNFs to influence care for ACO patients than with hospital-wide initiatives by ACOs or use of preferred SNFs. PMID:28192556

Does More Therapy in Skilled Nursing Facilities Lead to Better Outcomes in Patients With Hip Fracture?

PubMed Central

Trivedi, Amal N.; Grabowski, David C.; Mor, Vincent

2016-01-01

Background Skilled nursing facilities (SNFs) have increasingly been providing more therapy hours to beneficiaries of Medicare. It is not known whether these increases have improved patient outcomes. Objective The study objectives were: (1) to examine temporal trends in therapy hour volumes and (2) to evaluate whether more therapy hours are associated with improved patient outcomes. Design This was a retrospective cohort study. Methods Data sources included the Minimum Data Set, Medicare inpatient claims, and the Online Survey, Certification, and Reporting System. The study population consisted of 481,908 beneficiaries of Medicare fee-for-service who were admitted to 15,496 SNFs after hip fracture from 2000 to 2009. Linear regression models with facility and time fixed effects were used to estimate the association between the quantity of therapy provided in SNFs and the likelihood of discharge to home. Results The average number of therapy hours increased by 52% during the study period, with relatively little change in case mix at SNF admission. An additional hour of therapy per week was associated with a 3.1-percentage-point (95% confidence interval=3.0, 3.1) increase in the likelihood of discharge to home. The effect of additional therapy decreased as the Resource Utilization Group category increased, and additional therapy did not benefit patients in the highest Resource Utilization Group category. Limitations Minimum Data Set assessments did not cover details of therapeutic interventions throughout the entire SNF stay and captured only a 7-day retrospective period for measures of the quantity of therapy provided. Conclusions Increases in the quantity of therapy during the study period cannot be explained by changes in case mix at SNF admission. More therapy hours in SNFs appear to improve outcomes, except for patients with the greatest need. PMID:26586858

Does More Therapy in Skilled Nursing Facilities Lead to Better Outcomes in Patients With Hip Fracture?

PubMed

Jung, Hye-Young; Trivedi, Amal N; Grabowski, David C; Mor, Vincent

2016-01-01

Skilled nursing facilities (SNFs) have increasingly been providing more therapy hours to beneficiaries of Medicare. It is not known whether these increases have improved patient outcomes. The study objectives were: (1) to examine temporal trends in therapy hour volumes and (2) to evaluate whether more therapy hours are associated with improved patient outcomes. This was a retrospective cohort study. Data sources included the Minimum Data Set, Medicare inpatient claims, and the Online Survey, Certification, and Reporting System. The study population consisted of 481,908 beneficiaries of Medicare fee-for-service who were admitted to 15,496 SNFs after hip fracture from 2000 to 2009. Linear regression models with facility and time fixed effects were used to estimate the association between the quantity of therapy provided in SNFs and the likelihood of discharge to home. The average number of therapy hours increased by 52% during the study period, with relatively little change in case mix at SNF admission. An additional hour of therapy per week was associated with a 3.1-percentage-point (95% confidence interval=3.0, 3.1) increase in the likelihood of discharge to home. The effect of additional therapy decreased as the Resource Utilization Group category increased, and additional therapy did not benefit patients in the highest Resource Utilization Group category. Minimum Data Set assessments did not cover details of therapeutic interventions throughout the entire SNF stay and captured only a 7-day retrospective period for measures of the quantity of therapy provided. Increases in the quantity of therapy during the study period cannot be explained by changes in case mix at SNF admission. More therapy hours in SNFs appear to improve outcomes, except for patients with the greatest need. © 2016 American Physical Therapy Association.

Factors associated with discharge to home versus discharge to institutional care after inpatient stroke rehabilitation.

PubMed

Nguyen, Vu Q C; PrvuBettger, Janet; Guerrier, Tami; Hirsch, Mark A; Thomas, J George; Pugh, Terrence M; Rhoads, Charles F

2015-07-01

To examine sociodemographic and clinical characteristics independently associated with discharge home compared with discharge to a skilled nursing facility (SNF) after acute inpatient rehabilitation. Retrospective cohort study. Three tertiary accredited acute care rehabilitation facilities. Adult patients with stroke (N=2085). Not applicable. Not applicable. Of 2085 patients with stroke treated at 3 centers over a 4-year period, 78.2% (n=1631) were discharged home and 21.8% (n=454) discharged to an SNF. Findings from a multivariable logistic regression analysis indicated that patients were less likely to be discharged home if they were older (odds ratio [OR], .98; 95% confidence interval [CI], .96-.99), separated or divorced (compared with married; OR, .61; 95% CI, .48-.79), or with Medicare health insurance (compared with private insurance; OR, .69; 95% CI, .55-.88), or had dysphagia (OR, .83; 95% CI, .71-.98) or cognitive deficits (OR, .79; 95% CI, .77-.81). The odds of being discharged home were higher for those admitted with a higher motor FIM score (OR, 1.10; 95% CI, 1.09-1.11). The following were not associated with discharge disposition: sex, race, prestroke vocational status, availability of secondary health insurance, number of days from stroke onset to rehabilitation facility admission, stroke type, impairment group, cognitive FIM on admission, other stroke deficits (aphasia, ataxia, neglect, or speech disturbance), stroke complications of hyponatremia or urinary tract infection, or comorbid conditions. One in 5 patients with stroke were discharged to an SNF after inpatient rehabilitation. On admission, several sociodemographic and clinical characteristics were identified that could be considered as important factors in early discussions for discharge planning. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Thrombolysis with Intravenous Tissue Plasminogen Activator (rt-PA) Predicts Favorable Discharge Disposition in Patients with Acute Ischemic Stroke

PubMed Central

Ifejika-Jones, Nneka L.; Harun, Nusrat; Mohammed-Rajput, Nareesa A.; Noser, Elizabeth A.; Grotta, James C.

2011-01-01

Background and Purpose Acute ischemic stroke patients receiving IV tissue plasminogen activator (rt-PA) within 3 hours of symptom onset are 30% more likely to have minimal disability at three months. During hospitalization, short-term disability is subjectively measured by discharge disposition, whether to home, Inpatient Rehabilitation (IR), Skilled Nursing Facility (SNF) or Subacute Care (Sub). There are no studies assessing the role of rt-PA use as a predictor of post-stroke disposition. Methods Retrospective analysis of all ischemic stroke patients admitted to the University of Texas Houston Medical School (UTHMS) Stroke Service between Jan 2004 and Oct 2009. Baseline demographics and National Institute of Health Stroke Scale (NIHSS) score were collected. Cerebrovascular disease risk factors were used for risk stratification. Results Home vs. IR, SNF, Sub Of 2225 acute ischemic stroke patients, 1019 were discharged home, 1206 to another level of care. Patients who received rt-PA therapy were 1.9 times more likely to be discharged home (P = <0.0001; OR 1.945, 95% CI 1.538 to 2.459). IR vs. SNF, Sub / SNF vs. Sub Of 1206 acute ischemic stroke patients, 719 patients were discharged to acute IR, 371 were discharged to SNF, 116 to Sub. There were no differences in disposition between patients who received rt-PA therapy. Conclusions Stroke patients who receive IV rt-PA for acute ischemic stroke are more 1.9 times more likely to be discharged directly home after hospitalization. This study is limited by its retrospective nature and the undetermined role of psychosocial factors related to discharge. PMID:21293014

Medicare and Medicaid: long-term care survey--HCFA. Final rule.

PubMed

1988-06-17

This final rule amends the Medicare and Medicaid regulations to require that the State survey agencies use the survey methods and procedures prescribed by HCFA and forms contained in regulations. The regulations define the principles on which Medicare and Medicaid survey methodologies are based and the required elements of a skilled nursing facility (SNF) or intermediate care facility (ICF) survey. This rule is in response to a court order.

US NRC-Sponsored Research on Stress Corrosion Cracking Susceptibility of Dry Storage Canister Materials in Marine Environments - 13344

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

Oberson, Greg; Dunn, Darrell; Mintz, Todd

2013-07-01

At a number of locations in the U.S., spent nuclear fuel (SNF) is maintained at independent spent fuel storage installations (ISFSIs). These ISFSIs, which include operating and decommissioned reactor sites, Department of Energy facilities in Idaho, and others, are licensed by the U.S. Nuclear Regulatory Commission (NRC) under Title 10 of the Code of Federal Regulations, Part 72. The SNF is stored in dry cask storage systems, which most commonly consist of a welded austenitic stainless steel canister within a larger concrete vault or overpack vented to the external atmosphere to allow airflow for cooling. Some ISFSIs are located inmore » marine environments where there may be high concentrations of airborne chloride salts. If salts were to deposit on the canisters via the external vents, a chloride-rich brine could form by deliquescence. Austenitic stainless steels are susceptible to chloride-induced stress corrosion cracking (SCC), particularly in the presence of residual tensile stresses from welding or other fabrication processes. SCC could allow helium to leak out of a canister if the wall is breached or otherwise compromise its structural integrity. There is currently limited understanding of the conditions that will affect the SCC susceptibility of austenitic stainless steel exposed to marine salts. NRC previously conducted a scoping study of this phenomenon, reported in NUREG/CR-7030 in 2010. Given apparent conservatisms and limitations in this study, NRC has sponsored a follow-on research program to more systematically investigate various factors that may affect SCC including temperature, humidity, salt concentration, and stress level. The activities within this research program include: (1) measurement of relative humidity (RH) for deliquescence of sea salt, (2) SCC testing within the range of natural absolute humidity, (3) SCC testing at elevated temperatures, (4) SCC testing at high humidity conditions, and (5) SCC testing with various applied stresses. Results to date indicate that the deliquescence RH for sea salt is close to that of MgCl{sub 2} pure salt. SCC is observed between 35 and 80 deg. C when the ambient (RH) is close to or higher than this level, even for a low surface salt concentration. (authors)« less

Summary of available data for estimating chloride-induced SCC crack growth rates for 304/316 stainless steel.

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

Bryan, Charles R.; Enos, David

The majority of existing dry storage systems used for spent nuclear fuel (SNF) consist of a welded 304 stainless steel container placed within a passively-ventilated concrete or steel overpack. More recently fielded systems are constructed with dual certified 304/304L and in some cases, 316 or 316L. In service, atmospheric salts, a portion of which will be chloride bearing, will be deposited on the surface of these containers. Initially, the stainless steel canister surface temperatures will be high (exceeding the boiling point of water in many cases) due to decay heat from the SNF. As the SNF cools over time, themore » container surface will also cool, and deposited salts will deliquesce to form potentially corrosive chloride-rich brines. Because austenitic stainless steels are prone to chloride-induced stress corrosion cracking (CISCC), the concern has been raised that SCC may significantly impact long-term canister performance. While the susceptibility of austenitic stainless steels to CISCC in the general sense is well known, the behavior of SCC cracks (i.e., initiation and propagation behavior) under the aforementioned atmospheric conditions is poorly understood.« less

Evaluating the Quality of Patient Decision-Making Regarding Post-Acute Care.

PubMed

Burke, Robert E; Jones, Jacqueline; Lawrence, Emily; Ladebue, Amy; Ayele, Roman; Leonard, Chelsea; Lippmann, Brandi; Matlock, Daniel D; Allyn, Rebecca; Cumbler, Ethan

2018-05-01

Despite a national focus on post-acute care brought about by recent payment reforms, relatively little is known about how hospitalized older adults and their caregivers decide whether to go to a skilled nursing facility (SNF) after hospitalization. We sought to understand to what extent hospitalized older adults and their caregivers are empowered to make a high-quality decision about utilizing an SNF for post-acute care and what contextual or process elements led to satisfaction with the outcome of their decision once in SNF. Qualitative inquiry using the Ottawa Decision Support Framework (ODSF), a conceptual framework that describes key components of high-quality decision-making. Thirty-two previously community-dwelling older adults (≥ 65 years old) and 22 caregivers interviewed at three different hospitals and three skilled nursing facilities. We used key components of the ODSF to identify elements of context and process that affected decision-making and to what extent the outcome was characteristic of a high-quality decision: informed, values based, and not associated with regret or blame. The most important contextual themes were the presence of active medical conditions in the hospital that made decision-making difficult, prior experiences with hospital readmission or SNF, relative level of caregiver support, and pressure to make a decision quickly for which participants felt unprepared. Patients described playing a passive role in the decision-making process and largely relying on recommendations from the medical team. Patients commonly expressed resignation and a perceived lack of choice or autonomy, leading to dissatisfaction with the outcome. Understanding and intervening to improve the quality of decision-making regarding post-acute care supports is essential for improving outcomes of hospitalized older adults. Our results suggest that simply providing information is not sufficient; rather, incorporating key contextual factors and improving the decision-making process for both patients and clinicians are also essential.

Uncertainty quantification methodologies development for stress corrosion cracking of canister welds

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

Dingreville, Remi Philippe Michel; Bryan, Charles R.

2016-09-30

This letter report presents a probabilistic performance assessment model to evaluate the probability of canister failure (through-wall penetration) by SCC. The model first assesses whether environmental conditions for SCC – the presence of an aqueous film – are present at canister weld locations (where tensile stresses are likely to occur) on the canister surface. Geometry-specific storage system thermal models and weather data sets representative of U.S. spent nuclear fuel (SNF) storage sites are implemented to evaluate location-specific canister surface temperature and relative humidity (RH). As the canister cools and aqueous conditions become possible, the occurrence of corrosion is evaluated. Corrosionmore » is modeled as a two-step process: first, pitting is initiated, and the extent and depth of pitting is a function of the chloride surface load and the environmental conditions (temperature and RH). Second, as corrosion penetration increases, the pit eventually transitions to a SCC crack, with crack initiation becoming more likely with increasing pit depth. Once pits convert to cracks, a crack growth model is implemented. The SCC growth model includes rate dependencies on both temperature and crack tip stress intensity factor, and crack growth only occurs in time steps when aqueous conditions are predicted. The model suggests that SCC is likely to occur over potential SNF interim storage intervals; however, this result is based on many modeling assumptions. Sensitivity analyses provide information on the model assumptions and parameter values that have the greatest impact on predicted storage canister performance, and provide guidance for further research to reduce uncertainties.« less

Development of Technical Basis for Burnup Credit Regulatory Guidance in the United States

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

Parks, Cecil V; Wagner, John C; Mueller, Don

2011-01-01

In the United States (U.S.) there has been and continues to be considerable interest in the increased use of burnup credit as part of the safety basis for SNF systems and this interest has motivated numerous technical studies related to the application of burnup credit for maintaining subcriticality. Responding to industry requests and needs, the U.S. Nuclear Regulatory Commission initiated a burnup credit research program, with support from the Oak Ridge National Laboratory, to develop regulatory guidance and the supporting technical basis for allowing and expanding the use of burnup credit in pressurized-water reactor SNF storage and transport applications. Themore » objective of this paper is to summarize the work and significant accomplishments, with references to the technical reports and publications for complete details.« less

The Centers for Medicare and Medicaid Services' Nursing Home Case-Mix and Quality Demonstration: a descriptive overview.

PubMed

Reilly, Karen E; Mueller, Christine; Zimmerman, David R

2007-01-01

This paper presents the first comprehensive account of a major national demonstration designed to integrate skilled nursing facilities (SNF) prospective case-mix payment and quality of care. It describes the Centers for Medicare and Medicaid Services' Nursing Home Case-Mix and Quality (NHCMQ) Demonstration-the template for Medicare's SNF Prospective Payment System (PPS) implemented July 1998. The NHCMQ Demonstration provided the basis for one of the most significant changes in SNF reimbursement and quality monitoring policies to date. Prospective reimbursement policies created positive incentive for providers to admit Medicare residents under more equitable payment rates. However, controversy regarding unanticipated perverse provider incentives remains. The quality management system designed under the NHCMQDemonstration is currently used in over 17,000 nursing homes. Furthermore, under the NHCMQ Demonstration, one standardized assessment tool-the MDS-was used to assess a resident's clinical condition, to monitor quality, and to calculate provider reimbursement. Experiences from the NHCMQ Demonstration and continued evaluation of the current national PPS, along with state systems, provide a rich information source regarding prospective, case-mix reimbursement, and provider incentives.

Ultra-High Rate Measurements of Spent Fuel Gamma-Ray Emissions

NASA Astrophysics Data System (ADS)

Rodriguez, Douglas; Vandevender, Brent; Wood, Lynn; Glasgow, Brian; Taubman, Matthew; Wright, Michael; Dion, Michael; Pitts, Karl; Runkle, Robert; Campbell, Luke; Fast, James

2014-03-01

Presently there are over 200,000 irradiated spent nuclear fuel (SNF) assemblies in the world, each containing a concerning amount of weapons-usable material. Both facility operators and safeguards inspectors want to improve composition determination. Current measurements are expensive and difficult so new methods are developed through models. Passive measurements are limited since a few specific decay products and the associated down-scatter overwhelm the gamma rays of interest. Active interrogation methods produce gamma rays beyond 3 MeV, minimizing the impact of the passive emissions that drop off sharply above this energy. New devices like the Ultra-High Rate Germanium (UHRGe) detector are being developed to advance these novel measurement methods. Designed for reasonable resolution at 106 s-1 output rates (compared to ~ 1 - 10 e 3 s-1 standards), SNF samples were directly measured using UHRGe and compared to models. Model verification further enables using Los Alamos National Laboratory SNF assembly models, developed under the Next Generation Safeguards Initiative, to determine emission and signal expectations. Measurement results and future application requirements for UHRGe will be discussed.

42 CFR 488.305 - Standard surveys.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 5 2013-10-01 2013-10-01 false Standard surveys. 488.305 Section 488.305 Public...) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES Survey and Certification of Long-Term Care Facilities § 488.305 Standard surveys. (a) For each SNF and NF, the State survey agency...

42 CFR 488.305 - Standard surveys.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 5 2011-10-01 2011-10-01 false Standard surveys. 488.305 Section 488.305 Public...) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES Survey and Certification of Long-Term Care Facilities § 488.305 Standard surveys. (a) For each SNF and NF, the State survey agency...

42 CFR 488.305 - Standard surveys.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Standard surveys. 488.305 Section 488.305 Public...) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES Survey and Certification of Long-Term Care Facilities § 488.305 Standard surveys. (a) For each SNF and NF, the State survey agency...

42 CFR 488.305 - Standard surveys.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 5 2012-10-01 2012-10-01 false Standard surveys. 488.305 Section 488.305 Public...) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES Survey and Certification of Long-Term Care Facilities § 488.305 Standard surveys. (a) For each SNF and NF, the State survey agency...

42 CFR 488.305 - Standard surveys.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 5 2014-10-01 2014-10-01 false Standard surveys. 488.305 Section 488.305 Public...) STANDARDS AND CERTIFICATION SURVEY, CERTIFICATION, AND ENFORCEMENT PROCEDURES Survey and Certification of Long-Term Care Facilities § 488.305 Standard surveys. (a) For each SNF and NF, the State survey agency...

78 FR 16713 - Board Meeting; April 16, 2013; Richland, WA

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-18

... in a repository. Pursuant to its authority under section 5051 of Public Law 100-203, Nuclear Waste... facility in preparation for eventual disposal in a deep geologic repository. State, local, and regional... DOE's work related to the potential direct disposal in a deep geologic repository of existing SNF...

Benchmarking transportation logistics practices for effective system planning

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

Thrower, A.W.; Dravo, A.N.; Keister, M.

2007-07-01

This paper presents preliminary findings of an Office of Civilian Radioactive Waste Management (OCRWM) benchmarking project to identify best practices for logistics enterprises. The results will help OCRWM's Office of Logistics Management (OLM) design and implement a system to move spent nuclear fuel (SNF) and high-level radioactive waste (HLW) to the Yucca Mountain repository for disposal when that facility is licensed and built. This report suggests topics for additional study. The project team looked at three Federal radioactive material logistics operations that are widely viewed to be successful: (1) the Waste Isolation Pilot Plant (WIPP) in Carlsbad, New Mexico; (2)more » the Naval Nuclear Propulsion Program (NNPP); and (3) domestic and foreign research reactor (FRR) SNF acceptance programs. (authors)« less

Validation Test Report For The CRWMS Analysis and Logistics Visually Interactive Model Calvin Version 3.0, 10074-Vtr-3.0-00

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

S. Gillespie

2000-07-27

This report describes the tests performed to validate the CRWMS ''Analysis and Logistics Visually Interactive'' Model (CALVIN) Version 3.0 (V3.0) computer code (STN: 10074-3.0-00). To validate the code, a series of test cases was developed in the CALVIN V3.0 Validation Test Plan (CRWMS M&O 1999a) that exercises the principal calculation models and options of CALVIN V3.0. Twenty-five test cases were developed: 18 logistics test cases and 7 cost test cases. These cases test the features of CALVIN in a sequential manner, so that the validation of each test case is used to demonstrate the accuracy of the input to subsequentmore » calculations. Where necessary, the test cases utilize reduced-size data tables to make the hand calculations used to verify the results more tractable, while still adequately testing the code's capabilities. Acceptance criteria, were established for the logistics and cost test cases in the Validation Test Plan (CRWMS M&O 1999a). The Logistics test cases were developed to test the following CALVIN calculation models: Spent nuclear fuel (SNF) and reactivity calculations; Options for altering reactor life; Adjustment of commercial SNF (CSNF) acceptance rates for fiscal year calculations and mid-year acceptance start; Fuel selection, transportation cask loading, and shipping to the Monitored Geologic Repository (MGR); Transportation cask shipping to and storage at an Interim Storage Facility (ISF); Reactor pool allocation options; and Disposal options at the MGR. Two types of cost test cases were developed: cases to validate the detailed transportation costs, and cases to validate the costs associated with the Civilian Radioactive Waste Management System (CRWMS) Management and Operating Contractor (M&O) and Regional Servicing Contractors (RSCs). For each test case, values calculated using Microsoft Excel 97 worksheets were compared to CALVIN V3.0 scenarios with the same input data and assumptions. All of the test case results compare with the CALVIN V3.0 results within the bounds of the acceptance criteria. Therefore, it is concluded that the CALVIN V3.0 calculation models and options tested in this report are validated.« less

76 FR 26363 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-06

... previous case-mix classification system. It also includes a discussion of a Non-Therapy Ancillary component... facilities. Finally, it proposes certain changes relating to the payment of group therapy services and... Payment for SNF Non-Therapy Ancillary Costs 1. Previous Research 2. Conceptual Analysis 3. Analytic Sample...

Interaction of DOE SNF and Packaging Materials

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

P. A. Anderson

1998-09-01

A sensitivity analysis was conducted to identify and evaluate potential destructive interactions between the materials in US Department of Energy (USDOE) spent nuclear fuels (SNFs) and their storage/disposal canisters. The technical assessment was based on the thermodynamic properties as well as the chemical and physical characteristics of the materials expected inside the canisters. No chemical reactions were disclosed that could feasibly corrode stainless steel canisters to the point of failure. However, the possibility of embrittlement (loss of ductility) of the stainless steel through contact with liquid metal fission products or hydrogen inside the canisters cannot be dismissed. Higher-than-currently-permitted internal gasmore » pressures must also be considered. These results, based on the assessment of two representative 90-year-cooled fuels that are stored at 200°C in stainless steel canisters with internal blankets of helium, may be applied to most of the fuels in the USDOE's SNF inventory.« less

Advanced Fuel Cycle Cost Basis – 2017 Edition

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

Dixon, B. W.; Ganda, F.; Williams, K. A.

This report, commissioned by the U.S. Department of Energy (DOE) Office of Nuclear Energy (NE), provides a comprehensive set of cost data supporting a cost analysis for the relative economic comparison of options for use in the DOE Nuclear Technology Research and Development (NTRD) Program (previously the Fuel Cycle Research and Development (FCRD) and the Advanced Fuel Cycle Initiative (AFCI)). The report describes the NTRD cost basis development process, reference information on NTRD cost modules, a procedure for estimating fuel cycle costs, economic evaluation guidelines, and a discussion on the integration of cost data into economic computer models. This reportmore » contains reference cost data for numerous fuel cycle cost modules (modules A-O) as well as cost modules for a number of reactor types (R modules). The fuel cycle cost modules were developed in the areas of natural uranium mining and milling, thorium mining and milling, conversion, enrichment, depleted uranium disposition, fuel fabrication, interim spent fuel storage, reprocessing, waste conditioning, spent nuclear fuel (SNF) packaging, long-term monitored retrievable storage, managed decay storage, recycled product storage, near surface disposal of low-level waste (LLW), geologic repository and other disposal concepts, and transportation processes for nuclear fuel, LLW, SNF, transuranic, and high-level waste. Since its inception, this report has been periodically updated. The last such internal document was published in August 2015 while the last external edition was published in December of 2009 as INL/EXT-07-12107 and is available on the Web at URL: www.inl.gov/technicalpublications/Documents/4536700.pdf. This current report (Sept 2017) is planned to be reviewed for external release, at which time it will replace the 2009 report as an external publication. This information is used in the ongoing evaluation of nuclear fuel cycles by the NE NTRD program.« less

Association of Nondisease-Specific Problems with Mortality, Long-Term Care, and Functional Impairment among Older Adults Who Require Skilled Nursing Care after Dialysis Initiation

PubMed Central

Plantinga, Laura; Hall, Rasheeda K.; Mirk, Anna; Zhang, Rebecca; Kutner, Nancy

2016-01-01

Background and objectives The majority of older adults who initiate dialysis do so during a hospitalization, and these patients may require post-acute skilled nursing facility (SNF) care. For these patients, a focus on nondisease-specific problems, including cognitive impairment, depressive symptoms, exhaustion, falls, impaired mobility, and polypharmacy, may be more relevant to outcomes than the traditional disease-oriented approach. However, the association of the burden of nondisease-specific problems with mortality, transition to long-term care (LTC), and functional impairment among older adults receiving SNF care after dialysis initiation has not been studied. Design, setting, participants, & measurements We identified 40,615 Medicare beneficiaries ≥65 years old who received SNF care after dialysis initiation between 2000 and 2006 by linking renal disease registry data with the Minimum Data Set. Nondisease-specific problems were ascertained from the Minimum Data Set. We defined LTC as ≥100 SNF days and functional impairment as dependence in all four essential activities of daily living at SNF discharge. Associations of the number of nondisease-specific problems (≤1, 2, 3, and 4–6) with 6-month mortality, LTC, and functional impairment were examined. Results Overall, 39.2% of patients who received SNF care after dialysis initiation died within 6 months. Compared with those with ≤1 nondisease-specific problems, multivariable adjusted hazard ratios (95% confidence interval) for mortality were 1.26 (1.19 to 1.32), 1.40 (1.33 to 1.48), and 1.66 (1.57 to 1.76) for 2, 3, and 4–6 nondisease-specific problems, respectively. Among those who survived, 37.1% required LTC; of those remaining who did not require LTC, 74.7% had functional impairment. A higher likelihood of transition to LTC (among those who survived 6 months) and functional impairment (among those who survived and did not require LTC) was seen with a higher number of problems. Conclusions Identifying nondisease-specific problems may help patients and families anticipate LTC needs and functional impairment after dialysis initiation. PMID:27733436

Association of Nondisease-Specific Problems with Mortality, Long-Term Care, and Functional Impairment among Older Adults Who Require Skilled Nursing Care after Dialysis Initiation.

PubMed

Bowling, C Barrett; Plantinga, Laura; Hall, Rasheeda K; Mirk, Anna; Zhang, Rebecca; Kutner, Nancy

2016-12-07

The majority of older adults who initiate dialysis do so during a hospitalization, and these patients may require post-acute skilled nursing facility (SNF) care. For these patients, a focus on nondisease-specific problems, including cognitive impairment, depressive symptoms, exhaustion, falls, impaired mobility, and polypharmacy, may be more relevant to outcomes than the traditional disease-oriented approach. However, the association of the burden of nondisease-specific problems with mortality, transition to long-term care (LTC), and functional impairment among older adults receiving SNF care after dialysis initiation has not been studied. We identified 40,615 Medicare beneficiaries ≥65 years old who received SNF care after dialysis initiation between 2000 and 2006 by linking renal disease registry data with the Minimum Data Set. Nondisease-specific problems were ascertained from the Minimum Data Set. We defined LTC as ≥100 SNF days and functional impairment as dependence in all four essential activities of daily living at SNF discharge. Associations of the number of nondisease-specific problems (≤1, 2, 3, and 4-6) with 6-month mortality, LTC, and functional impairment were examined. Overall, 39.2% of patients who received SNF care after dialysis initiation died within 6 months. Compared with those with ≤1 nondisease-specific problems, multivariable adjusted hazard ratios (95% confidence interval) for mortality were 1.26 (1.19 to 1.32), 1.40 (1.33 to 1.48), and 1.66 (1.57 to 1.76) for 2, 3, and 4-6 nondisease-specific problems, respectively. Among those who survived, 37.1% required LTC; of those remaining who did not require LTC, 74.7% had functional impairment. A higher likelihood of transition to LTC (among those who survived 6 months) and functional impairment (among those who survived and did not require LTC) was seen with a higher number of problems. Identifying nondisease-specific problems may help patients and families anticipate LTC needs and functional impairment after dialysis initiation. Copyright © 2016 by the American Society of Nephrology.

Characterization of SNF472 pharmacokinetics and efficacy in uremic and non-uremic rats models of cardiovascular calcification

PubMed Central

Ferrer, Miguel D.; Ketteler, Markus; Tur, Fernando; Tur, Eva; Isern, Bernat; Salcedo, Carolina; Joubert, Pieter H.; Behets, Geert J.; Neven, Ellen; D’Haese, Patrick C.

2018-01-01

End-stage renal disease is strongly associated with progressive cardiovascular calcification (CVC) and there is currently no therapy targeted to treat CVC. SNF472 is an experimental formulation under development for treatment of soft tissue calcification. We have investigated the pharmacokinetics of SNF472 administration in rats and its inhibitory effects on CVC. SNF472 was studied in three rat models: (1) prevention of vitamin D3-induced CVC with an intravenous SNF472 bolus of 1 mg/kg SNF472, (2) inhibition of progression of vitamin D3-induced CVC with a subcutaneous SNF472 bolus of 10 or 60 mg/kg SNF472, starting after calcification induction, (3) CVC in adenine-induced uremic rats treated with 50 mg/kg SNF472 via i.v. 4h -infusion. Uremic rats presented lower plasma levels of SNF472 than control animals after i.v. infusion. CVC in non-uremic rats was inhibited by 60–70% after treatment with SNF472 and progression of cardiac calcification completely blocked. Development of CVC in uremic rats was inhibited by up to 80% following i.v. infusion of SNF472. SNF472 inhibits the development and progression of CVC in uremic and non-uremic rats in the same range of SNF472 plasma levels but using in each case the required dose to obtain those levels. These results collectively support the development of SNF472 as a novel therapeutic option for treatment of CVC in humans. PMID:29742152

Reconstruction of the yeast Snf1 kinase regulatory network reveals its role as a global energy regulator

PubMed Central

Usaite, Renata; Jewett, Michael C; Oliveira, Ana Paula; Yates, John R; Olsson, Lisbeth; Nielsen, Jens

2009-01-01

Highly conserved among eukaryotic cells, the AMP-activated kinase (AMPK) is a central regulator of carbon metabolism. To map the complete network of interactions around AMPK in yeast (Snf1) and to evaluate the role of its regulatory subunit Snf4, we measured global mRNA, protein and metabolite levels in wild type, Δsnf1, Δsnf4, and Δsnf1Δsnf4 knockout strains. Using four newly developed computational tools, including novel DOGMA sub-network analysis, we showed the benefits of three-level ome-data integration to uncover the global Snf1 kinase role in yeast. We for the first time identified Snf1's global regulation on gene and protein expression levels, and showed that yeast Snf1 has a far more extensive function in controlling energy metabolism than reported earlier. Additionally, we identified complementary roles of Snf1 and Snf4. Similar to the function of AMPK in humans, our findings showed that Snf1 is a low-energy checkpoint and that yeast can be used more extensively as a model system for studying the molecular mechanisms underlying the global regulation of AMPK in mammals, failure of which leads to metabolic diseases. PMID:19888214

Advantages of Production of New Fissionable Nuclides for the Nuclear Power Industry in Hybrid Fusion-Fission Reactors

NASA Astrophysics Data System (ADS)

Tsibulskiy, V. F.; Andrianova, E. A.; Davidenko, V. D.; Rodionova, E. V.; Tsibulskiy, S. V.

2017-12-01

A concept of a large-scale nuclear power engineering system equipped with fusion and fission reactors is presented. The reactors have a joint fuel cycle, which imposes the lowest risk of the radiation impact on the environment. The formation of such a system is considered within the framework of the evolution of the current nuclear power industry with the dominance of thermal reactors, gradual transition to the thorium fuel cycle, and integration into the system of the hybrid fusion-fission reactors for breeding nuclear fuel for fission reactors. Such evolution of the nuclear power engineering system will allow preservation of the existing structure with the dominance of thermal reactors, enable the reprocessing of the spent nuclear fuel (SNF) with low burnup, and prevent the dangerous accumulation of minor actinides. The proposed structure of the nuclear power engineering system minimizes the risk of radioactive contamination of the environment and the SNF reprocessing facilities, decreasing it by more than one order of magnitude in comparison with the proposed scheme of closing the uranium-plutonium fuel cycle based on the reprocessing of SNF with high burnup from fast reactors.

Organizational context associated with time spent evaluating language and cognitive-communicative impairments in skilled nursing facilities: Survey results within an implementation science framework.

PubMed

Douglas, Natalie F

2016-01-01

The Consolidated Framework for Implementation Research (CFIR) was developed to merge research and practice in healthcare by accounting for the many elements that influence evidence-based treatment implementation. These include characteristics of the individuals involved, features of the treatment itself, and aspects of the organizational culture where the treatment is being provided. The purpose of this study was to apply the CFIR to a measurement of current practice patterns of speech-language pathologists (SLPs) working in the skilled nursing facility (SNF) environment. In an effort to inform future evidence-based practice implementation interventions, research questions addressed current practice patterns, clinician treatment use and preferences, and perceptions of the organizational context including leadership, resources, and other staff. Surveys were mailed to each SLP working in a SNF in the state of Michigan. Participants (N=77, 19% response rate) completed a survey mapping on to CFIR components impacting evidence-based practice implementation. Quantitative descriptive and nonparametric correlational analyses were completed. Use of evidence-based treatments by SLPs in SNFs was highly variable. Negative correlations between treating speech and voice disorders and treating swallowing disorders (rs=-.35, p<.01), evaluating language and cognitive-communicative disorders and treating swallowing disorders (rs=-.30, p<.01), treating language and cognitive-communicative disorders and treating swallowing disorders (rs=-.67, p<.01), and evaluating swallowing disorders and treating language and cognitive-communicative disorders (rs=-.37, p<.01) were noted. A positive correlation between the SLPs' perception of organizational context and time spent evaluating language and other cognitive-communicative disorders (rs=.27, p<.05) was also present. Associative data suggest that the more an SLP in the SNF evaluates and treats swallowing disorders, the less he or she will evaluate speech, voice, language or other cognitive-communicative disorders. Further, SLPs in this sample spent more time evaluating language and cognitive-communicative impairments if they perceived their organizational context in a more positive way. The CFIR may guide treatment and implementation research to increase the uptake of evidence-based practices for SLPs working in the SNF setting. Copyright © 2015 Elsevier Inc. All rights reserved.

Outcomes of Laparoscopic Colectomy in Younger and Older Patients: An Analysis of Nationwide Readmission Database.

PubMed

Mehta, Hemalkumar B; Hughes, Byron D; Sieloff, Eric; Sura, Sneha O; Shan, Yong; Adhikari, Deepak; Senagore, Anthony

2018-04-01

Prior studies report safety and effectiveness of laparoscopic colectomy in older patients. The study aimed to examine the impact of laparoscopic colectomy on 30-day readmissions, discharge destination, hospital length of stay, and cost in younger (19-65 years) and older adults (>65 years). We used the nationwide readmission database from 2013 to study adults undergoing elective colectomy. The outcomes were 30-day readmissions, discharge destination for the index hospitalization (routine, skilled nursing facility [SNF]/intermediate care facility [ICF], home healthcare), length of stay, and cost. Multivariable analyses were conducted to determine the association of laparoscopic colectomy on outcome; logistic regression for 30-day readmission, multinomial logistic regression for discharge destination, and linear regression for length of stay and cost. An interaction between age and colectomy approach was included, and all models controlled gender, income, insurance status, All Patients Refined Diagnosis Related Groups (APR-DRG), Elixhauser comorbidities, hospital bed size, ownership, and teaching status. Of 79,581 colectomies, 40.2% were laparoscopic. Laparoscopic colectomy was more frequent in younger patients (41.9% versus 38.5%, p < .0001). Regardless of age, patients undergoing laparoscopic colectomy were 20% less likely to be readmitted within 30 days (odds ratio [OR] 0.80, confidence interval [95% CI] 0.75-0.85). For postdischarge destination, laparoscopic colectomy offered higher benefits to younger patients (SNF/ICF: OR 0.42, 95% CI 0.36-0.49; home health: OR 0.32, 95% CI 0.30-0.35) than older patients (SNF/ICF: OR 0.50, 95% CI 0.47-0.54; home health: OR 0.59, 95% CI 0.55-0.62). Regardless of age, laparoscopic colectomy resulted in 1.46 days (p < .0001) shorter hospital stays compared to open colectomy. Laparoscopic colectomy had significantly lower cost compared to open approach, particularly in younger ($1,466) versus older ($632) patients. Laparoscopic colectomy is superior to an open approach, with fewer 30-day readmissions, fewer discharges to SNF/ICF or home health, shorter hospital stays, and less overall cost; younger patients benefit more than older patients.

Use of Medical Orders for Scope of Treatment for Heart Failure Patients During Postacute Care in Skilled Nursing Facilities

PubMed Central

Lum, Hillary; Obafemi, Oluyomi; Dukes, Joanna; Nowels, Molly; Samon, Kristina; Boxer, Rebecca S.

2017-01-01

Background Individuals with heart failure (HF) who are hospitalized and admitted to skilled nursing facilities (SNFs) are at high risk for rehospitalization and death. The care preferences of this high-risk population have not been studied. Objectives To describe care preferences of patients with HF admitted to SNFs for rehabilitation based on Medical Orders for Scope of Treatment (MOST) documentation, and evaluate goal-concordant care based on MOST documentation, emergency department (ED) visits, and hospitalization. Design, setting, and participants Retrospective study of patients with HF in 35 SNFs enrolled in a randomized controlled trial of HF-disease management versus usual care between July 2014 and May 2016. Measurements Validity of MOST forms, care preference documentation, and ED visits/hospitalizations within 60 days of SNF admission. Results Of 370 patients (mean age 78.6 years, 58% women, 25% systolic HF), 278 (75%) had a MOST form in the SNF chart, of which 96 forms (35%) were invalid. The most common reason for an invalid MOST form was missing date accompanying patient or provider signature. Of 182 valid MOST forms, 47% of patients chose no cardiopulmonary resuscitation (“No CPR”), 58% selected “Full Treatment,” 17% chose “Selective Treatment,” and 23% chose “Comfort-Focused Treatment.” Patients who were older [odds ratio (OR) = 1.50, 95% confidence interval (CI) = 1.25, 1.81] and female (OR = 2.33, 95% CI = 1.18, 4.59) had higher odds of choosing “No CPR.” Sixty-six of 182 patients (36%) with valid MOST forms had an ED/hospital visit within 60 days of SNF admission; only 3 patients received medical care that was potentially discordant: all 3 chose “Comfort-Focused Treatment” and were hospitalized for more than symptom management. Conclusion Seventy-five percent of patients with HF admitted to SNFs had care preferences documented using the MOST form, and 95% received goal-concordant care based on care preferences documented during the SNF admission. Clinicaltrials.gov # NCT01822912. PMID:28688730

Assessment of the Measurement Properties of the NHCAHPS Family Survey: A Rasch Scaling Approach

ERIC Educational Resources Information Center

O'Connor, Matthew S.

2013-01-01

The introduction of the Consumer Assessment of Healthcare Providers and Systems (CAHPS), a family of survey instruments designed to capture and report people's experiences obtaining health care could soon add satisfaction as a consistent dimension of quality that skilled nursing facilities (SNFs) are required to assess and report. The SNF setting…

Predicting Risk Factors for 30-Day Readmissions Following Discharge From Post-Acute Care.

PubMed

Flanagan, Nina M; Rizzo, Victoria M; James, Gary D; Spegman, Adele; Barnawi, Najla A

The specific aims of this descriptive study were to (1) examine the relationships between individual-level determinants of health using standard care admission assessments of residents admitted to a skilled nursing facility (SNF) and those residents readmitted to the hospital within 30 days from discharge from the same SNF; (2) identify and describe the risk factors of the residents readmitted to the hospital within 30 days; and (3) use the findings to inform and refine current practice to target the mutable risk factors correlated with 30-day hospital readmission. A 180-bed skilled nursing center in Northeastern Pennsylvania. A retrospective paper medical record review of patients discharged from an SNF to community living was conducted to examine the relationship between individual determinants of health behaviors and 30-day hospital readmissions. The study sample (N = 221) included adults 65 years and older who were admitted to the SNF from January to December 2014 for subacute physical rehabilitation following an acute care hospital stay with a discharge plan to community living. The 30-day readmission rate was 11%. The results of the logistic regression including diagnosis at readmission showed that the odds of readmission before 30 days were nearly three times greater in patients who had congestive heart failure (p < .02). Patients who were at "very high risk" on the Braden Scale were 20 times more likely to be readmitted before 30 days compared with those at low risk. Age and gender were not predictors. None of the other standard screening assessments for delirium, depression, functional status, and fall risk were predictive of 30-day readmission. (1) Care coordination and communication with residents, caregivers, and home health can have an impact on 30-day readmissions post-SNF discharge. (2) Chronic respiratory diseases continue to be a challenge in prevention of hospital readmissions.

Purification and characterization of the three Snf1-activating kinases of Saccharomyces cerevisiae.

PubMed

Elbing, Karin; McCartney, Rhonda R; Schmidt, Martin C

2006-02-01

Members of the Snf1/AMPK family of protein kinases are activated by distinct upstream kinases that phosphorylate a conserved threonine residue in the Snf1/AMPK activation loop. Recently, the identities of the Snf1- and AMPK-activating kinases have been determined. Here we describe the purification and characterization of the three Snf1-activating kinases of Saccharomyces cerevisiae. The identities of proteins associated with the Snf1-activating kinases were determined by peptide mass fingerprinting. These kinases, Sak1, Tos3 and Elm2 do not appear to require the presence of additional subunits for activity. Sak1 and Snf1 co-purify and co-elute in size exclusion chromatography, demonstrating that these two proteins form a stable complex. The Snf1-activating kinases phosphorylate the activation loop threonine of Snf1 in vitro with great specificity and are able to do so in the absence of beta and gamma subunits of the Snf1 heterotrimer. Finally, we showed that the Snf1 kinase domain isolated from bacteria as a GST fusion protein can be activated in vitro and shows substrate specificity in the absence of its beta and gamma subunits.

Purification and characterization of the three Snf1-activating kinases of Saccharomyces cerevisiae

PubMed Central

2005-01-01

Members of the Snf1/AMPK family of protein kinases are activated by distinct upstream kinases that phosphorylate a conserved threonine residue in the Snf1/AMPK activation loop. Recently, the identities of the Snf1- and AMPK-activating kinases have been determined. Here we describe the purification and characterization of the three Snf1-activating kinases of Saccharomyces cerevisiae. The identities of proteins associated with the Snf1-activating kinases were determined by peptide mass fingerprinting. These kinases, Sak1, Tos3 and Elm2 do not appear to require the presence of additional subunits for activity. Sak1 and Snf1 co-purify and co-elute in size exclusion chromatography, demonstrating that these two proteins form a stable complex. The Snf1-activating kinases phosphorylate the activation loop threonine of Snf1 in vitro with great specificity and are able to do so in the absence of β and γ subunits of the Snf1 heterotrimer. Finally, we showed that the Snf1 kinase domain isolated from bacteria as a GST fusion protein can be activated in vitro and shows substrate specificity in the absence of its β and γ subunits. PMID:16201971

TEST SYSTEM FOR EVALUATING SPENT NUCLEAR FUEL BENDING STIFFNESS AND VIBRATION INTEGRITY

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

Wang, Jy-An John; Wang, Hong; Bevard, Bruce Balkcom

2013-01-01

Transportation packages for spent nuclear fuel (SNF) must meet safety requirements specified by federal regulations. For normal conditions of transport, vibration loads incident to transport must be considered. This is particularly relevant for high-burnup fuel (>45 GWd/MTU). As the burnup of the fuel increases, a number of changes occur that may affect the performance of the fuel and cladding in storage and during transportation. The mechanical properties of high-burnup de-fueled cladding have been previously studied by subjecting defueled cladding tubes to longitudinal (axial) tensile tests, ring-stretch tests, ring-compression tests, and biaxial tube burst tests. The objective of this study ismore » to investigate the mechanical properties and behavior of both the cladding and the fuel in it under vibration/cyclic loads similar to the sustained vibration loads experienced during normal transport. The vibration loads to SNF rods during transportation can be characterized by dynamic, cyclic, bending loads. The transient vibration signals in a specified transport environment can be analyzed, and frequency, amplitude and phase components can be identified. The methodology being implemented is a novel approach to study the vibration integrity of actual SNF rod segments through testing and evaluating the fatigue performance of SNF rods at defined frequencies. Oak Ridge National Laboratory (ORNL) has developed a bending fatigue system to evaluate the response of the SNF rods to vibration loads. A three-point deflection measurement technique using linear variable differential transformers is used to characterize the bending rod curvature, and electromagnetic force linear motors are used as the driving system for mechanical loading. ORNL plans to use the test system in a hot cell for SNF vibration testing on high burnup, irradiated fuel to evaluate the pellet-clad interaction and bonding on the effective lifetime of fuel-clad structure bending fatigue performance. Technical challenges include pure bending implementation, remote installation and detachment of the SNF test specimen, test specimen deformation measurement, and identification of a driving system suitable for use in a hot cell. Surrogate test specimens have been used to calibrate the test setup and conduct systematic cyclic tests. The calibration and systematic cyclic tests have been used to identify test protocol issues prior to implementation in the hot cell. In addition, cyclic hardening in unidirectional bending and softening in reverse bending were observed in the surrogate test specimens. The interface bonding between the surrogate clad and pellets was found to impact the bending response of the surrogate rods; confirming this behavior in the actual spent fuel segments will be an important aspect of the hot cell test implementation,« less

Medicare Episodes of Illness: A Study of Hospital, Skilled Nursing Facility, and Home Health Agency Care

PubMed Central

Young, Karen M.; Fisher, Charles R.

1980-01-01

This paper analyzes charges incurred under the Medicare program for inpatient hospital, skilled nursing facility (SNF), and home health agency (HHA) care for 1976. This research was made possible through the construction of a new data set which links a beneficiary's use of these three services. Summary highlights reveal that an overwhelming majority of the 7.5 million Medicare episodes of illness do not involve post-hospital SNF or HHA care. Those episodes of illness that use only hospital care are substantially (53%) cheaper than all other episodes. A large percentage of these charge differences reflect the greater number of hospital days of care associated with post-hospital care services. However, an analysis of the beneficiaries' demographic characteristics suggests that persons who use post-hospital care generally differ from those who receive only hospital care. We found that persons who use post-hospital SNF or HHA, or both types of care are likely to be female, to have cancer, diabetes, fractured bones or a central nervous or vascular system disease, and to be older than persons who do not use these types of care. The data also show that a beneficiary's area of residence greatly influences the amount and types of care received. Persons who reside in the New England, Middle Atlantic, and Pacific Divisions are more likely to receive post-hospital care services than persons who live elsewhere in the United States. These persons also incur among the highest per capita institutional charges in the United States. Part of this variation in institutional charges per capita is explained by the high input price index found in these areas, and in some cases by the high quantity of services index. PMID:10309327

Glucose de-repression by yeast AMP-activated protein kinase SNF1 is controlled via at least two independent steps.

PubMed

García-Salcedo, Raúl; Lubitz, Timo; Beltran, Gemma; Elbing, Karin; Tian, Ye; Frey, Simone; Wolkenhauer, Olaf; Krantz, Marcus; Klipp, Edda; Hohmann, Stefan

2014-04-01

The AMP-activated protein kinase, AMPK, controls energy homeostasis in eukaryotic cells but little is known about the mechanisms governing the dynamics of its activation/deactivation. The yeast AMPK, SNF1, is activated in response to glucose depletion and mediates glucose de-repression by inactivating the transcriptional repressor Mig1. Here we show that overexpression of the Snf1-activating kinase Sak1 results, in the presence of glucose, in constitutive Snf1 activation without alleviating glucose repression. Co-overexpression of the regulatory subunit Reg1 of the Glc-Reg1 phosphatase complex partly restores glucose regulation of Snf1. We generated a set of 24 kinetic mathematical models based on dynamic data of Snf1 pathway activation and deactivation. The models that reproduced our experimental observations best featured (a) glucose regulation of both Snf1 phosphorylation and dephosphorylation, (b) determination of the Mig1 phosphorylation status in the absence of glucose by Snf1 activity only and (c) a regulatory step directing active Snf1 to Mig1 under glucose limitation. Hence it appears that glucose de-repression via Snf1-Mig1 is regulated by glucose via at least two independent steps: the control of activation of the Snf1 kinase and directing active Snf1 to inactivating its target Mig1. © 2014 FEBS.

BWR Spent Nuclear Fuel Integrity Research and Development Survey for UKABWR Spent Fuel Interim Storage

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

Bevard, Bruce Balkcom; Mertyurek, Ugur; Belles, Randy

The objective of this report is to identify issues and support documentation and identify and detail existing research on spent fuel dry storage; provide information to support potential R&D for the UKABWR (United Kingdom Advanced Boiling Water Reactor) Spent Fuel Interim Storage (SFIS) Pre-Construction Safety Report; and support development of answers to questions developed by the regulator. Where there are gaps or insufficient data, Oak Ridge National Laboratory (ORNL) has summarized the research planned to provide the necessary data along with the schedule for the research, if known. Spent nuclear fuel (SNF) from nuclear power plants has historically been storedmore » on site (wet) in spent fuel pools pending ultimate disposition. Nuclear power users (countries, utilities, vendors) are developing a suite of options and set of supporting analyses that will enable future informed choices about how best to manage these materials. As part of that effort, they are beginning to lay the groundwork for implementing longer-term interim storage of the SNF and the Greater Than Class C (CTCC) waste (dry). Deploying dry storage will require a number of technical issues to be addressed. For the past 4-5 years, ORNL has been supporting the U.S. Department of Energy (DOE) in identifying these key technical issues, managing the collection of data to be used in issue resolution, and identifying gaps in the needed data. During this effort, ORNL subject matter experts (SMEs) have become expert in understanding what information is publicly available and what gaps in data remain. To ensure the safety of the spent fuel under normal and frequent conditions of wet and subsequent dry storage, intact fuel must be shown to: 1.Maintain fuel cladding integrity; 2.Maintain its geometry for cooling, shielding, and subcriticality; 3.Maintain retrievability, and damaged fuel with pinhole or hairline cracks must be shown not to degrade further. Where PWR (pressurized water reactor) information is utilized or referenced, justification has been provided as to why the data can be utilized for BWR fuel.« less

High burn-up spent nuclear fuel transport reliability investigation

DOE PAGES

Wang, Jy-An; Wang, Hong; Jiang, Hao; ...

2018-04-15

Transportation packages for spent nuclear fuel (SNF) must meet safety requirements under normal and accident conditions as specified by federal regulations. During road or rail transportation, SNF will experience unique conditions that could affect the structural integrity of the cladding due to vibrational and impact loading. Lack of SNF inertia-induced dynamic fatigue data, especially for the high burn-up (HBU) SNF systems, has brought significant challenges to quantify the reliability of SNF during transportation with a high degree of confidence. To address this shortcoming, Oak Ridge National Laboratory (ORNL) developed a SNF vibration testing protocol without fuel pellets removal, which hasmore » provided significant insight regarding the dynamics of mechanical interactions between pellet and cladding. This research has provided a detailed understanding about the effect of loading rate and loading mode on the fatigue damage evolution of HBU SNF under normal conditions of transport (NCT). Static and dynamic loading experimental data were generated for SNF under simulated transportation environments using a cyclic integrated reversible-bending fatigue tester (CIRFT), an enabling hot-cell testing technology developed at ORNL. SNF flexural tensile strength and fatigue S-N data from pressurized water reactors (PWRs) and boiling water reactor (BWR) HBU SNF are presented in this paper, including the potential effects of pellet-cladding interface bonding, hydride reorientation, and thermal annealing to SNF vibration reliability. The data presented here can be used to meet the nuclear industry and U.S. Nuclear Regulatory Commission needs in safety of SNF transportation operations.« less

High burn-up spent nuclear fuel transport reliability investigation

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

Wang, Jy-An; Wang, Hong; Jiang, Hao

Transportation packages for spent nuclear fuel (SNF) must meet safety requirements under normal and accident conditions as specified by federal regulations. During road or rail transportation, SNF will experience unique conditions that could affect the structural integrity of the cladding due to vibrational and impact loading. Lack of SNF inertia-induced dynamic fatigue data, especially for the high burn-up (HBU) SNF systems, has brought significant challenges to quantify the reliability of SNF during transportation with a high degree of confidence. To address this shortcoming, Oak Ridge National Laboratory (ORNL) developed a SNF vibration testing protocol without fuel pellets removal, which hasmore » provided significant insight regarding the dynamics of mechanical interactions between pellet and cladding. This research has provided a detailed understanding about the effect of loading rate and loading mode on the fatigue damage evolution of HBU SNF under normal conditions of transport (NCT). Static and dynamic loading experimental data were generated for SNF under simulated transportation environments using a cyclic integrated reversible-bending fatigue tester (CIRFT), an enabling hot-cell testing technology developed at ORNL. SNF flexural tensile strength and fatigue S-N data from pressurized water reactors (PWRs) and boiling water reactor (BWR) HBU SNF are presented in this paper, including the potential effects of pellet-cladding interface bonding, hydride reorientation, and thermal annealing to SNF vibration reliability. The data presented here can be used to meet the nuclear industry and U.S. Nuclear Regulatory Commission needs in safety of SNF transportation operations.« less

Accident analysis and control options in support of the sludge water system safety analysis

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

HEY, B.E.

A hazards analysis was initiated for the SWS in July 2001 (SNF-8626, K Basin Sludge and Water System Preliminary Hazard Analysis) and updated in December 2001 (SNF-10020 Rev. 0, Hazard Evaluation for KE Sludge and Water System - Project A16) based on conceptual design information for the Sludge Retrieval System (SRS) and 60% design information for the cask and container. SNF-10020 was again revised in September 2002 to incorporate new hazards identified from final design information and from a What-if/Checklist evaluation of operational steps. The process hazards, controls, and qualitative consequence and frequency estimates taken from these efforts have beenmore » incorporated into Revision 5 of HNF-3960, K Basins Hazards Analysis. The hazards identification process documented in the above referenced reports utilized standard industrial safety techniques (AIChE 1992, Guidelines for Hazard Evaluation Procedures) to systematically guide several interdisciplinary teams through the system using a pre-established set of process parameters (e.g., flow, temperature, pressure) and guide words (e.g., high, low, more, less). The teams generally included representation from the U.S. Department of Energy (DOE), K Basins Nuclear Safety, T Plant Nuclear Safety, K Basin Industrial Safety, fire protection, project engineering, operations, and facility engineering.« less

The natural history of spinal neurofibromatosis: a critical review of clinical and genetic features.

PubMed

Ruggieri, M; Polizzi, A; Spalice, A; Salpietro, V; Caltabiano, R; D'Orazi, V; Pavone, P; Pirrone, C; Magro, G; Platania, N; Cavallaro, S; Muglia, M; Nicita, F

2015-05-01

Spinal neurofibromatosis (SNF) is a related form of neurofibromatosis 1 (NF1), characterized by bilateral neurofibromas (histologically proven) of all spinal roots (and, eventually, of all the major peripheral nerve branches) with or without other manifestations of classical NF1. By rigorous application of these criteria to the 98 SNF cases published, we developed: (i) a cohort of 49 SNF patients (21 males and 28 females; aged 4-74 years]: 9 SNF families (21/49), 1 mixed SNF/NF1 family (1/49) and 27 of 49 sporadic SNF patients (including 5 unpublished patients in this report); and (ii) a group of 49 non-SNF patients including: (a) 32 patients with neurofibromas of multiple but not all spinal roots (MNFSR): 4 mixed SNF/MNFSR families (6/32); (b) 14 patients with NF1 manifestations without spinal neurofibromas, belonging to SNF (8/49) or MNFSR families (6/32); (c) 3 patients with neurofibromas in one spinal root. In addition to reduced incidence of café-au-lait spots (67% in SNF vs 56% in MNFSR), other NF1 manifestations were less frequent in either cohort. Molecular testing showed common NF1 gene abnormalities in both groups. The risk of developing SNF vs NF1 was increased for missense mutations [p = 0.0001; odds ratio (OR) = 6.16; confidence interval (CI) = 3.14-13.11], which were more frequent in SNF vs MNFSR (p = 0.0271). © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

High Burn-Up Spent Nuclear Fuel Vibration Integrity Study

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

Wang, Jy-An John; Wang, Hong; Jiang, Hao

2015-01-01

The Oak Ridge National Laboratory (ORNL) has developed the cyclic integrated reversible-bending fatigue tester (CIRFT) approach to successfully demonstrate the controllable fatigue fracture on high burnup (HBU) spent nuclear fuel (SNF) in a normal vibration mode. CIRFT enables examination of the underlying mechanisms of SNF system dynamic performance. Due to the inhomogeneous composite structure of the SNF system, the detailed mechanisms of the pellet-pellet and pellet-clad interactions and the stress concentration effects at the pellet-pellet interface cannot be readily obtained from a CIRFT system measurement. Therefore, finite element analyses (FEAs) are used to translate the global moment-curvature measurement into localmore » stress-strain profiles for further investigation. The major findings of CIRFT on the HBU SNF are as follows: SNF system interface bonding plays an important role in SNF vibration performance. Fuel structure contributes to SNF system stiffness. There are significant variations in stress and curvature of SNF systems during vibration cycles resulting from segment pellets and clad interactions. SNF failure initiates at the pellet-pellet interface region and appears to be spontaneous.« less

Subcellular localization of the Snf1 kinase is regulated by specific β subunits and a novel glucose signaling mechanism

PubMed Central

Vincent, Olivier; Townley, Robert; Kuchin, Sergei; Carlson, Marian

2001-01-01

The Snf1/AMP-activated protein kinase family has broad roles in transcriptional, metabolic, and developmental regulation in response to stress. In Saccharomyces cerevisiae, Snf1 is required for the response to glucose limitation. Snf1 kinase complexes contain the α (catalytic) subunit Snf1, one of the three related β subunits Gal83, Sip1, or Sip2, and the γ subunit Snf4. We present evidence that the β subunits regulate the subcellular localization of the Snf1 kinase. Green fluorescent protein fusions to Gal83, Sip1, and Sip2 show different patterns of localization to the nucleus, vacuole, and/or cytoplasm. We show that Gal83 directs Snf1 to the nucleus in a glucose-regulated manner. We further identify a novel signaling pathway that controls this nuclear localization in response to glucose phosphorylation. This pathway is distinct from the glucose signaling pathway that inhibits Snf1 kinase activity and responds not only to glucose but also to galactose and sucrose. Such independent regulation of the localization and the activity of the Snf1 kinase, combined with the distinct localization of kinases containing different β subunits, affords versatility in regulating physiological responses. PMID:11331606

Medicaid program; appeals from cancellation of approval of Medicaid long-term care facilities--HCFA. Final rule.

PubMed

1988-08-18

This rule corrects an oversight by setting forth time limits for new issues that may be considered by an Administrative Law Judge (ALJ) during a hearing afforded a Medicaid skilled nursing facility (SNF) or intermediate care facility (ICF) because the Secretary proposes to cancel its approval under section 1910(c)(1) of the Social Security Act (the Act). This amendment is necessary because current rules do not take account of the fact that hearings under section 1910(c) of the Act (unlike Medicare hearings) may take place before the cancellation is put into effect. The purpose is to establish time limits appropriate to section 1910(c) situations.

Subunits of the Snf1 kinase heterotrimer show interdependence for association and activity.

PubMed

Elbing, Karin; Rubenstein, Eric M; McCartney, Rhonda R; Schmidt, Martin C

2006-09-08

The Snf1 kinase and its mammalian orthologue, the AMP-activated protein kinase (AMPK), function as heterotrimers composed of a catalytic alpha-subunit and two non-catalytic subunits, beta and gamma. The beta-subunit is thought to hold the complex together and control subcellular localization whereas the gamma-subunit plays a regulatory role by binding to and blocking the function of an auto-inhibitory domain (AID) present in the alpha-subunit. In addition, catalytic activity requires phosphorylation by a distinct upstream kinase. In yeast, any one of three Snf1-activating kinases, Sak1, Tos3, or Elm1, can fulfill this role. We have previously shown that Sak1 is the only Snf1-activating kinase that forms a stable complex with Snf1. Here we show that the formation of the Sak1.Snf1 complex requires the beta- and gamma-subunits in vivo. However, formation of the Sak1.Snf1 complex is not necessary for glucose-regulated phosphorylation of the Snf1 activation loop. Snf1 kinase purified from cells lacking the beta-subunits do not contain any gamma-subunit, indicating that the Snf1 kinase does not form a stable alphagamma dimer in vivo. In vitro kinase assays using purified full-length and truncated Snf1 proteins demonstrate that the kinase domain, which lacks the AID, is significantly more active than the full-length Snf1 protein. Addition of purified beta- and gamma-subunits could stimulate the kinase activity of the full-length alpha-subunit but only when all three subunits were present, suggesting an interdependence of all three subunits for assembly of a functional complex.

SWI/SNF Protein Expression Status in Fumarate Hydratase-deficient Renal Cell Carcinoma: Immunohistochemical Analysis of 32 Tumors from 28 Patients.

PubMed

Agaimy, Abbas; Amin, Mahul B; Gill, Anthony J; Popp, Bernt; Reis, André; Berney, Daniel M; Magi-Galluzzi, Cristina; Sibony, Mathilde; Smith, Steven C; Suster, Saul; Trpkov, Kiril; Hes, Ondřej; Hartmann, Arndt

2018-04-21

Fumarate hydratase-deficient renal cell carcinoma (FH-RCC) is a rare, aggressive RCC type, originally described in the setting of hereditary leiomyomatosis and renal cell carcinoma (HLRCC) syndrome which is defined by germline FH gene inactivation. Inactivation of components of the SWI/SNF chromatin remodelling complex is involved in renal medullary carcinoma (SMARCB1/INI1 loss), clear cell RCC (PBRM1 loss) and in subsets of dedifferentiated RCC of clear cell, chromophobe and papillary types (loss of different SWI/SNF components). FH-RCC and SWI/SNF-deficient RCC share anaplastic nuclear features and highly aggressive course. We analysed 32 FH-RCCs from 28 patients using seven commercially available SWI/SNF antibodies (SMARCB1/INI1, SMARCA2, SMARCA4, SMARCC1, SMARCC2, PBRM1 and ARID1A). Variable loss of SMARCB1, ARID1A and SMARCC1 was observed in 1/31, 2/31 and 1/29 evaluable cases, respectively; three of these four SWI/SNF-deficient tumors had confirmed FH mutations. No correlation of SWI/SNF loss with solid or sarcomatoid features was observed. Two tumors with SMARCB1 and ARID1A deficiency had available SWI/SNF molecular data; both lacked SMARCB1 and ARID1A mutations. The remaining five SWI/SNF components were intact in all cases. Especially PBRM1 seems not to be involved in the pathogenesis or progression of FH-deficient RCC. Our data showed that, a subset of FH-RCC (12%) have a variable loss of SWI/SNF complex subunits, likely as secondary genetic events. This should not be confused with SWI/SNF-deficient RCC of other types. Evaluation of FH and SWI/SNF together with comprehensive molecular-genetic profiling is needed to explore possible prognostic implications of FH/SWI-SNF double deficiency and to better understand the somatic mutation landscape in high-grade RCC. Copyright © 2018. Published by Elsevier Inc.

Molecular principles underlying dual RNA specificity in the Drosophila SNF protein.

PubMed

Weber, Gert; DeKoster, Gregory T; Holton, Nicole; Hall, Kathleen B; Wahl, Markus C

2018-06-07

The first RNA recognition motif of the Drosophila SNF protein is an example of an RNA binding protein with multi-specificity. It binds different RNA hairpin loops in spliceosomal U1 or U2 small nuclear RNAs, and only in the latter case requires the auxiliary U2A' protein. Here we investigate its functions by crystal structures of SNF alone and bound to U1 stem-loop II, U2A' or U2 stem-loop IV and U2A', SNF dynamics from NMR spectroscopy, and structure-guided mutagenesis in binding studies. We find that different loop-closing base pairs and a nucleotide exchange at the tips of the loops contribute to differential SNF affinity for the RNAs. U2A' immobilizes SNF and RNA residues to restore U2 stem-loop IV binding affinity, while U1 stem-loop II binding does not require such adjustments. Our findings show how U2A' can modulate RNA specificity of SNF without changing SNF conformation or relying on direct RNA contacts.

Improving heart failure disease management in skilled nursing facilities: lessons learned.

PubMed

Dolansky, Mary A; Hitch, Jeanne A; Piña, Ileana L; Boxer, Rebecca S

2013-11-01

The purpose of the study was to design and evaluate an improvement project that implemented HF management in four skilled nursing facilities (SNFs). Kotter's Change Management principles were used to guide the implementation. In addition, half of the facilities had an implementation coach who met with facility staff weekly for 4 months and monthly for 5 months. Weekly and monthly audits were performed that documented compliance with eight key aspects of the protocol. Contextual factors were captured using field notes. Adherence to the HF management protocols was variable ranging from 17% to 82%. Facilitators of implementation included staff who championed the project, an implementation coach, and physician involvement. Barriers were high staff turnover and a hierarchal culture. Opportunities exist to integrate HF management protocols to improve SNF care.

Differential Roles of the Glycogen-Binding Domains of β Subunits in Regulation of the Snf1 Kinase Complex▿

PubMed Central

Mangat, Simmanjeet; Chandrashekarappa, Dakshayini; McCartney, Rhonda R.; Elbing, Karin; Schmidt, Martin C.

2010-01-01

Members of the AMP-activated protein kinase family, including the Snf1 kinase of Saccharomyces cerevisiae, are activated under conditions of nutrient stress. AMP-activated protein kinases are heterotrimeric complexes composed of a catalytic α subunit and regulatory β and γ subunits. In this study, the role of the β subunits in the regulation of Snf1 activity was examined. Yeasts express three isoforms of the AMP-activated protein kinase consisting of Snf1 (α), Snf4 (γ), and one of three alternative β subunits, either Sip1, Sip2, or Gal83. The Gal83 isoform of the Snf1 complex is the most abundant and was analyzed in the greatest detail. All three β subunits contain a conserved domain referred to as the glycogen-binding domain. The deletion of this domain from Gal83 results in a deregulation of the Snf1 kinase, as judged by a constitutive activity independent of glucose availability. In contrast, the deletion of this homologous domain from the Sip1 and Sip2 subunits had little effect on Snf1 kinase regulation. Therefore, the different Snf1 kinase isoforms are regulated through distinct mechanisms, which may contribute to their specialized roles in different stress response pathways. In addition, the β subunits are subjected to phosphorylation. The responsible kinases were identified as being Snf1 and casein kinase II. The significance of the phosphorylation is unclear since the deletion of the region containing the phosphorylation sites in Gal83 had little effect on the regulation of Snf1 in response to glucose limitation. PMID:19897735

Differential roles of the glycogen-binding domains of beta subunits in regulation of the Snf1 kinase complex.

PubMed

Mangat, Simmanjeet; Chandrashekarappa, Dakshayini; McCartney, Rhonda R; Elbing, Karin; Schmidt, Martin C

2010-01-01

Members of the AMP-activated protein kinase family, including the Snf1 kinase of Saccharomyces cerevisiae, are activated under conditions of nutrient stress. AMP-activated protein kinases are heterotrimeric complexes composed of a catalytic alpha subunit and regulatory beta and gamma subunits. In this study, the role of the beta subunits in the regulation of Snf1 activity was examined. Yeasts express three isoforms of the AMP-activated protein kinase consisting of Snf1 (alpha), Snf4 (gamma), and one of three alternative beta subunits, either Sip1, Sip2, or Gal83. The Gal83 isoform of the Snf1 complex is the most abundant and was analyzed in the greatest detail. All three beta subunits contain a conserved domain referred to as the glycogen-binding domain. The deletion of this domain from Gal83 results in a deregulation of the Snf1 kinase, as judged by a constitutive activity independent of glucose availability. In contrast, the deletion of this homologous domain from the Sip1 and Sip2 subunits had little effect on Snf1 kinase regulation. Therefore, the different Snf1 kinase isoforms are regulated through distinct mechanisms, which may contribute to their specialized roles in different stress response pathways. In addition, the beta subunits are subjected to phosphorylation. The responsible kinases were identified as being Snf1 and casein kinase II. The significance of the phosphorylation is unclear since the deletion of the region containing the phosphorylation sites in Gal83 had little effect on the regulation of Snf1 in response to glucose limitation.

Impact investigation of reactor fuel operating parameters on reactivity for use in burnup credit applications

NASA Astrophysics Data System (ADS)

Sloma, Tanya Noel

When representing the behavior of commercial spent nuclear fuel (SNF), credit is sought for the reduced reactivity associated with the net depletion of fissile isotopes and the creation of neutron-absorbing isotopes, a process that begins when a commercial nuclear reactor is first operated at power. Burnup credit accounts for the reduced reactivity potential of a fuel assembly and varies with the fuel burnup, cooling time, and the initial enrichment of fissile material in the fuel. With regard to long-term SNF disposal and transportation, tremendous benefits, such as increased capacity, flexibility of design and system operations, and reduced overall costs, provide an incentive to seek burnup credit for criticality safety evaluations. The Nuclear Regulatory Commission issued Interim Staff Guidance 8, Revision 2 in 2002, endorsing burnup credit of actinide composition changes only; credit due to actinides encompasses approximately 30% of exiting pressurized water reactor SNF inventory and could potentially be increased to 90% if fission product credit were accepted. However, one significant issue for utilizing full burnup credit, compensating for actinide and fission product composition changes, is establishing a set of depletion parameters that produce an adequately conservative representation of the fuel's isotopic inventory. Depletion parameters can have a significant effect on the isotopic inventory of the fuel, and thus the residual reactivity. This research seeks to quantify the reactivity impact on a system from dominant depletion parameters (i.e., fuel temperature, moderator density, burnable poison rod, burnable poison rod history, and soluble boron concentration). Bounding depletion parameters were developed by statistical evaluation of a database containing reactor operating histories. The database was generated from summary reports of commercial reactor criticality data. Through depletion calculations, utilizing the SCALE 6 code package, several light water reactor assembly designs and in-core locations are analyzed in establishing a combination of depletion parameters that conservatively represent the fuel's isotopic inventory as an initiative to take credit for fuel burnup in criticality safety evaluations for transportation and storage of SNF.

Watkins: Store spent fuel at federal sites

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

Tompkins, B.

If the Department of Energy under the Clinton Administration decides to follow the strategy of departing Energy Secretary James Watkins, spent nuclear fuel (SNF) from utilities would be stored at federal sites starting in 1998. In what amounts to an admission that a monitored retrievable storage (MRS) facility will not be ready to accept SNF by 1998, Watkins proposed in a December 17 letter to Senator J. Bennett Johnston that current work on an MRS be terminated, and that efforts be redirected toward standardized spent-fuel container design. According to the DOE's Samantha Williams, however, the Waste Negotiator's Office will continuemore » its activities, and the new strategy is intended to supplement the ongoing MRS work. She also said that DOE Undersecretary Hugo Pomrehn confirmed this in a statement to the Nuclear Waste TEchnical Review Board during its meeting on January 5. The motivation for the new strategic actions is in part related to the passage of the National Energy Policy Act of 1992, which envisions the continued use of nuclear power in the overall US energy plan. Watkins points out, however, that in order for nuclear power to remain a viable alternative, the management and disposal of spent commercial nuclear fuel is essential to avoid premature and unwarranted shutdowns of operating nuclear plants, to permit renewals of existing plant licenses to provide life extensions from 40 to 60 years, and to enable new orders of advanced-design nuclear plants. In addition, the new strategy is required, according to Watkins, because the Office of the Nuclear Waste Negotiator has been unsuccessful in identifying a voluntary host site for an MRS after two years of efforts to that end. David Leroy, the Negotiator, disagrees with this statement, and has noted that it still may be possible to present a candidate host site for the MRS to Congress by June 1993.« less

Co-evolution of SNF spliceosomal proteins with their RNA targets in trans-splicing nematodes.

PubMed

Strange, Rex Meade; Russelburg, L Peyton; Delaney, Kimberly J

2016-08-01

Although the mechanism of pre-mRNA splicing has been well characterized, the evolution of spliceosomal proteins is poorly understood. The U1A/U2B″/SNF family (hereafter referred to as the SNF family) of RNA binding spliceosomal proteins participates in both the U1 and U2 small interacting nuclear ribonucleoproteins (snRNPs). The highly constrained nature of this system has inhibited an analysis of co-evolutionary trends between the proteins and their RNA binding targets. Here we report accelerated sequence evolution in the SNF protein family in Phylum Nematoda, which has allowed an analysis of protein:RNA co-evolution. In a comparison of SNF genes from ecdysozoan species, we found a correlation between trans-splicing species (nematodes) and increased phylogenetic branch lengths of the SNF protein family, with respect to their sister clade Arthropoda. In particular, we found that nematodes (~70-80 % of pre-mRNAs are trans-spliced) have experienced higher rates of SNF sequence evolution than arthropods (predominantly cis-spliced) at both the nucleotide and amino acid levels. Interestingly, this increased evolutionary rate correlates with the reliance on trans-splicing by nematodes, which would alter the role of the SNF family of spliceosomal proteins. We mapped amino acid substitutions to functionally important regions of the SNF protein, specifically to sites that are predicted to disrupt protein:RNA and protein:protein interactions. Finally, we investigated SNF's RNA targets: the U1 and U2 snRNAs. Both are more divergent in nematodes than arthropods, suggesting the RNAs have co-evolved with SNF in order to maintain the necessarily high affinity interaction that has been characterized in other species.

The protective effect of SnF2 containing toothpastes and solution on enamel surfaces subjected to erosion and abrasion in situ.

PubMed

Hove, L H; Stenhagen, K R; Holme, B; Tveit, A B

2014-08-01

Stannous fluoride solutions have shown promising protective effect against erosion/abrasion, but the effect of SnF2 toothpastes is uncertain. The aim of the study was to test the inhibiting effect of two SnF2 toothpastes and a SnF2 solution against erosive/abrasive wear in a single-blind, randomised in situ study, using a white light interferometer. Sixteen human molars were each divided into four specimens, mounted on mouth appliances and worn by 8 volunteers for 9 days. Specimens were brushed with toothpaste twice each day for 30 s either with fluoride-free toothpaste or toothpastes including SnF2. Toothpaste was left on the surface for 90 additional seconds. Group 1, fluoride-free toothpaste; Group 2, toothpaste A (0.4% SnF2, Solidox); Group 3, toothpaste B (0.454 % SnF2, Oral-B(®)); Group 4, brushed with fluoride-free toothpaste (30 s) and treated for 2 min with a 0.4 % SnF2 solution (1,000 ppm F). To mimic gastric reflux/vomit, specimens were etched for 2 min twice a day (0.01 M HCl). Procedures were performed extra-orally. The mean enamel wear (in μm) for the control specimens was: -29.2 ± SD 10.5; for group 2 -14.5 SD ± 9.3; for group 3 -33.3 SD ± 7.4, and for group 4 +0.4 SD ± 1.3. The specimens treated with SnF2 solution and toothpaste A showed significantly lower enamel wear than the control group. Toothpaste B gave no significant reduction in enamel wear. The SnF2 solution fully protected the enamel surface against erosive and abrasive challenges. The SnF2 toothpaste A (Solidox) showed less, but significant protection of the enamel, while no statistically significant protection was demonstrated by SnF2 toothpaste B (Oral-B(®) Pro-Expert).

The pathway by which the yeast protein kinase Snf1p controls acquisition of sodium tolerance is different from that mediating glucose regulation.

PubMed

Ye, Tian; Elbing, Karin; Hohmann, Stefan

2008-09-01

It recently became apparent that the highly conserved Snf1p protein kinase plays roles in controlling different cellular processes in the yeast Saccharomyces cerevisiae, in addition to its well-known function in glucose repression/derepression. We have previously reported that Snf1p together with Gis4p controls ion homeostasis by regulating expression of ENA1, which encodes the Ena1p Na(+) extrusion system. In this study we found that Snf1p is rapidly phosphorylated when cells are exposed to NaCl and this phosphorylation is required for the role of Snf1p in Na(+) tolerance. In contrast to activation by low glucose levels, the salt-induced phosphorylation of Snf1p promoted neither phosphorylation nor nuclear export of the Mig1p repressor. The mechanism that prevents Mig1p phosphorylation by active Snf1p under salt stress does not involve either hexokinase PII or the Gis4p regulator. Instead, Snf1p may mediate upregulation of ENA1 expression via the repressor Nrg1p. Activation of Snf1p in response to glucose depletion requires any of the three upstream protein kinases Sak1p, Tos3p and Elm1p, with Sak1p playing the most prominent role. The same upstream kinases were required for salt-induced Snf1p phosphorylation, and also under these conditions Sak1p played the most prominent role. Unexpectedly, however, it appears that Elm1p plays a dual role in acquisition of salt tolerance by activating Snf1p and in a presently unknown parallel pathway. Together, these results indicate that under salt stress Snf1p takes part in a different pathway from that during glucose depletion and this role is performed together as well as in parallel with its upstream kinase Elm1p. Snf1p appears to be part of a wider functional network than previously anticipated and the full complexity of this network remains to be elucidated.

Insight from Public Surveys Related to Siting of Nuclear Waste Facilities: An Overview of Findings from a 2015 Nationwide Survey of US Residents

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

Jenkins-Smith, Hank C.; Gupta, Kuhika; Silva, Carol L.

The results described in this report are an analysis of nationwide surveys, administered between 2006 and 2015, which measure preferences of US residents concerning the environment and energy sources. The Energy & Environment (EE) survey series is conducted annually by the Center for Energy, Security & Society (CES&S), a joint research collaboration of the University of Oklahoma and Sandia National Laboratories. The annual EE survey series is designed to track evolving public views on nuclear materials management in the US. The 2015 wave of the Energy and Environment survey (EE15) was implemented using a web-based questionnaire, and was completed bymore » 2,021 respondents using an Internet sample that matches the characteristics of the adult US population as estimated in the US Census. A special focus of the EE15 survey is how survey respondents understand and evaluate “consent” in the context of the storage and transportation of spent nuclear fuel (SNF). This report presents an overview of key results from analyses of questions related to consent-based siting and other elements of the nuclear energy fuel cycle.« less

Springing into Action: Reg2 Negatively Regulates Snf1 Protein Kinase and Facilitates Recovery from Prolonged Glucose Starvation in Saccharomyces cerevisiae.

PubMed

Maziarz, Marcin; Shevade, Aishwarya; Barrett, LaKisha; Kuchin, Sergei

2016-07-01

Glucose is the preferred carbon source for the yeast Saccharomyces cerevisiae Glucose limitation activates Snf1 protein kinase, a key regulator of energy homeostasis that promotes utilization of alternative carbon sources and enforces energy conservation. Snf1 activation requires phosphorylation of its T-loop threonine (Thr210) by upstream kinases. When glucose is abundant, Snf1 is inhibited by Thr210 dephosphorylation. This involves the function of the type 1 protein phosphatase Glc7, which is targeted to Snf1 by a regulatory subunit, Reg1. The reg1 mutation causes increased Snf1 activity and mimics various aspects of glucose limitation, including slower growth. Reg2 is another Glc7 regulatory subunit encoded by a paralogous gene, REG2 Previous evidence indicated that the reg2 mutation exacerbates the Snf1-dependent slow-growth phenotype caused by reg1, suggesting a link between Reg2 and Snf1. Here, we explore this link in more detail and present evidence that Reg2 contributes to Snf1 Thr210 dephosphorylation. Consistent with this role, Reg2 interacts with wild-type Snf1 but not with nonphosphorylatable Snf1-T210A. Reg2 accumulation increases in a Snf1-dependent manner during prolonged glucose deprivation, and glucose-starved cells lacking Reg2 exhibit delayed Snf1 Thr210 dephosphorylation and slower growth recovery upon glucose replenishment. Accordingly, cells lacking Reg2 are outcompeted by wild-type cells in the course of several glucose starvation/replenishment cycles. Collectively, our results support a model in which Reg2-Glc7 contributes to the negative control of Snf1 in response to glucose refeeding after prolonged starvation. The competitive growth advantage provided by Reg2 underscores the evolutionary significance of this paralog for S. cerevisiae The ability of microorganisms to respond to stress is essential for their survival. However, rapid recovery from stress could be equally crucial in competitive environments. Therefore, a wise stress response program should prepare cells for quick recovery upon reexposure to favorable conditions. Glucose is the preferred carbon source for the yeast S. cerevisiae Glucose depletion activates the stress response protein kinase Snf1, which functions to limit energy-consuming processes, such as growth. We show that prolonged glucose deprivation also leads to Snf1-dependent accumulation of Reg2 and that this protein helps to inhibit Snf1 and to accelerate growth recovery upon glucose replenishment. Cells lacking Reg2 are readily outcompeted by wild-type cells during glucose depletion/replenishment cycles. Thus, while prolonged glucose deprivation might seem to put yeast cells "on their knees," concomitant accumulation of Reg2 helps configure the cells into a "sprinter's crouch start position" to spring into action once glucose becomes available. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Springing into Action: Reg2 Negatively Regulates Snf1 Protein Kinase and Facilitates Recovery from Prolonged Glucose Starvation in Saccharomyces cerevisiae

PubMed Central

Maziarz, Marcin; Shevade, Aishwarya; Barrett, LaKisha

2016-01-01

ABSTRACT Glucose is the preferred carbon source for the yeast Saccharomyces cerevisiae. Glucose limitation activates Snf1 protein kinase, a key regulator of energy homeostasis that promotes utilization of alternative carbon sources and enforces energy conservation. Snf1 activation requires phosphorylation of its T-loop threonine (Thr210) by upstream kinases. When glucose is abundant, Snf1 is inhibited by Thr210 dephosphorylation. This involves the function of the type 1 protein phosphatase Glc7, which is targeted to Snf1 by a regulatory subunit, Reg1. The reg1 mutation causes increased Snf1 activity and mimics various aspects of glucose limitation, including slower growth. Reg2 is another Glc7 regulatory subunit encoded by a paralogous gene, REG2. Previous evidence indicated that the reg2 mutation exacerbates the Snf1-dependent slow-growth phenotype caused by reg1, suggesting a link between Reg2 and Snf1. Here, we explore this link in more detail and present evidence that Reg2 contributes to Snf1 Thr210 dephosphorylation. Consistent with this role, Reg2 interacts with wild-type Snf1 but not with nonphosphorylatable Snf1-T210A. Reg2 accumulation increases in a Snf1-dependent manner during prolonged glucose deprivation, and glucose-starved cells lacking Reg2 exhibit delayed Snf1 Thr210 dephosphorylation and slower growth recovery upon glucose replenishment. Accordingly, cells lacking Reg2 are outcompeted by wild-type cells in the course of several glucose starvation/replenishment cycles. Collectively, our results support a model in which Reg2-Glc7 contributes to the negative control of Snf1 in response to glucose refeeding after prolonged starvation. The competitive growth advantage provided by Reg2 underscores the evolutionary significance of this paralog for S. cerevisiae. IMPORTANCE The ability of microorganisms to respond to stress is essential for their survival. However, rapid recovery from stress could be equally crucial in competitive environments. Therefore, a wise stress response program should prepare cells for quick recovery upon reexposure to favorable conditions. Glucose is the preferred carbon source for the yeast S. cerevisiae. Glucose depletion activates the stress response protein kinase Snf1, which functions to limit energy-consuming processes, such as growth. We show that prolonged glucose deprivation also leads to Snf1-dependent accumulation of Reg2 and that this protein helps to inhibit Snf1 and to accelerate growth recovery upon glucose replenishment. Cells lacking Reg2 are readily outcompeted by wild-type cells during glucose depletion/replenishment cycles. Thus, while prolonged glucose deprivation might seem to put yeast cells “on their knees,” concomitant accumulation of Reg2 helps configure the cells into a “sprinter's crouch start position” to spring into action once glucose becomes available. PMID:27107116

A matched-cohort study of health services utilization and financial outcomes for a heart failure disease-management program in elderly patients.

PubMed

Berg, Gregory D; Wadhwa, Sandeep; Johnson, Alan E

2004-10-01

To investigate the utilization and financial outcomes of a telephonic nursing disease-management program for elderly patients with heart failure. A 1-year concurrent matched-cohort study employing propensity score matching. Medicare+Choice recipients residing in Ohio, Kentucky, and Indiana. A total of 533 program participants aged 65 and older matched to nonparticipants. Disease-management heart failure program employing a structured, evidence-based, telephonic nursing intervention designed to provide patient education, counseling, and monitoring services. Medical service utilization, including hospitalizations, emergency department visits, medical doctor visits, skilled nursing facility (SNF) days, selected clinical indicators, and financial effect. The intervention group had considerably and significantly lower rates of acute service utilization than the control group, including 23% fewer hospitalizations, 26% fewer inpatient bed days, 22% fewer emergency department visits, 44% fewer heart failure hospitalizations, 70% fewer 30-day readmissions, and 45% fewer SNF bed days. Claims costs were 1,792 dollars per person lower in the intervention group than in the control group (inclusive of intervention costs), and the return on investment was calculated to be 2.31. The study demonstrates that a commercially delivered heart failure disease-management program significantly reduced hospitalizations, emergency department visits, and SNF days. The intervention group had 17% lower costs than the control group; when intervention costs were included, the intervention group had 10% lower costs.

Is there value in retrospective 90-day bundle payment models for shoulder arthroplasty procedures?

PubMed

Odum, Susan M; Hamid, Nady; Van Doren, Bryce A; Spector, Leo R

2018-05-01

The Centers for Medicare & Medicaid Services Bundled Payments for Care Improvement (BPCI) initiative was implemented as part of the Affordable Care Act. We implemented a retrospective payment model 2 for a 90-day total shoulder arthroplasty (TSA) episode to assess the value of TSA BPCI at our private practice. Expenditures and postacute event rates of 132 fee-for-service (FFS) patients who underwent a TSA operation between 2009 and 2012 were compared with 333 BPCI patients who had a TSA operation in 2015. The 90-day postacute events included an inpatient rehabilitation facility (IRF), skilled nursing facility (SNF), and home health (HH) admissions and readmissions. Expenditures were converted to 2016 dollars using the Consumer Price Index. Wilcoxon tests and multivariate generalized estimating equation were used to assess independent cost-drivers. The median FFS expenditure was $21,157 (interquartile range, $16,894-$30,748) compared with $17,894 (interquartile range, $15,796-$20,894) for BPCI (P < .0001). The BPCI patients had significantly lower rates of SNF admissions (34% FFS vs. 16% BPCI; P < .001), IRF admissions (3% FFS vs. 0.6% BPCI; P = .05), HH utilization (49% FFS vs. 41% BPCI; P = .05), and readmissions (14% FFS vs. 7% BPCI; P = .01). After controlling for postacute events in the multivariate regression model, we found BPCI had a 4% decrease in expenditures (P = .08). All postacute events were independently associated with higher expenditures. Our private practice implemented cost-containment practices, including clinical guidelines, patient navigators, and a BPCI management team. IRF and SNF utilization and the 90-day readmission rate significantly decreased. As a result, we were able to control the postacute spending, which resulted in decreased costs of performing TSA surgery. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Snf2 family gene distribution in higher plant genomes reveals DRD1 expansion and diversification in the tomato genome.

PubMed

Bargsten, Joachim W; Folta, Adam; Mlynárová, Ludmila; Nap, Jan-Peter

2013-01-01

As part of large protein complexes, Snf2 family ATPases are responsible for energy supply during chromatin remodeling, but the precise mechanism of action of many of these proteins is largely unknown. They influence many processes in plants, such as the response to environmental stress. This analysis is the first comprehensive study of Snf2 family ATPases in plants. We here present a comparative analysis of 1159 candidate plant Snf2 genes in 33 complete and annotated plant genomes, including two green algae. The number of Snf2 ATPases shows considerable variation across plant genomes (17-63 genes). The DRD1, Rad5/16 and Snf2 subfamily members occur most often. Detailed analysis of the plant-specific DRD1 subfamily in related plant genomes shows the occurrence of a complex series of evolutionary events. Notably tomato carries unexpected gene expansions of DRD1 gene members. Most of these genes are expressed in tomato, although at low levels and with distinct tissue or organ specificity. In contrast, the Snf2 subfamily genes tend to be expressed constitutively in tomato. The results underpin and extend the Snf2 subfamily classification, which could help to determine the various functional roles of Snf2 ATPases and to target environmental stress tolerance and yield in future breeding.

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

Wang, Jy-An John; Wang, Hong; Jiang, Hao

The objective of this research is to collect dynamic experimental data on spent nuclear fuel (SNF) under simulated transportation environments using the Cyclic Integrated Reversible-Bending Fatigue Tester (CIRFT), the hot-cell testing technology developed at Oak Ridge National Laboratory (ORNL). The collected CIRFT data will be utilized to support ongoing spent fuel modeling activities, and support SNF transportation related licensing issues. Recent testing to understand the effects of hydride reorientation on SNF vibration integrity is also being evaluated. CIRFT results have provided insight into the fuel/clad system response to transportation related loads. The major findings of CIRFT on the HBU SNFmore » are as follows: SNF system interface bonding plays an important role in SNF vibration performance, Fuel structure contributes to the SNF system stiffness, There are significant variations in stress and curvature of SNF systems during vibration cycles resulting from segment pellets and clad interaction, and SNF failure initiates at the pellet-pellet interface region and appears to be spontaneous. Because of the non-homogeneous composite structure of the SNF system, finite element analyses (FEA) are needed to translate the global moment-curvature measurement into local stress-strain profiles. The detailed mechanisms of the pellet-pellet and pellet-clad interactions and the stress concentration effects at the pellet-pellet interface cannot be readily obtained directly from a CIRFT system measurement. Therefore, detailed FEA is used to understand the global test response, and that data will also be presented.« less

Snf1 Phosphorylates Adenylate Cyclase and Negatively Regulates Protein Kinase A-dependent Transcription in Saccharomyces cerevisiae.

PubMed

Nicastro, Raffaele; Tripodi, Farida; Gaggini, Marco; Castoldi, Andrea; Reghellin, Veronica; Nonnis, Simona; Tedeschi, Gabriella; Coccetti, Paola

2015-10-09

In eukaryotes, nutrient availability and metabolism are coordinated by sensing mechanisms and signaling pathways, which influence a broad set of cellular functions such as transcription and metabolic pathways to match environmental conditions. In yeast, PKA is activated in the presence of high glucose concentrations, favoring fast nutrient utilization, shutting down stress responses, and boosting growth. On the contrary, Snf1/AMPK is activated in the presence of low glucose or alternative carbon sources, thus promoting an energy saving program through transcriptional activation and phosphorylation of metabolic enzymes. The PKA and Snf1/AMPK pathways share common downstream targets. Moreover, PKA has been reported to negatively influence the activation of Snf1/AMPK. We report a new cross-talk mechanism with a Snf1-dependent regulation of the PKA pathway. We show that Snf1 and adenylate cyclase (Cyr1) interact in a nutrient-independent manner. Moreover, we identify Cyr1 as a Snf1 substrate and show that Snf1 activation state influences Cyr1 phosphorylation pattern, cAMP intracellular levels, and PKA-dependent transcription. © 2015 by The American Society for Biochemistry and Molecular Biology, Inc.

Cry3Bb1-Resistant Western Corn Rootworm, Diabrotica virgifera virgifera (LeConte) Does Not Exhibit Cross-Resistance to DvSnf7 dsRNA.

PubMed

Moar, William; Khajuria, Chitvan; Pleau, Michael; Ilagan, Oliver; Chen, Mao; Jiang, Changjian; Price, Paula; McNulty, Brian; Clark, Thomas; Head, Graham

2017-01-01

There is a continuing need to express new insect control compounds in transgenic maize against western corn rootworm, Diabrotica virgifera virgifera (LeConte) (WCR). In this study three experiments were conducted to determine cross-resistance between the new insecticidal DvSnf7 dsRNA, and Bacillus thuringiensis (Bt) Cry3Bb1; used to control WCR since 2003, with field-evolved resistance being reported. Laboratory susceptible and Cry3Bb1-resistant WCR were evaluated against DvSnf7 dsRNA in larval diet-incorporation bioassays. Additionally, the susceptibility of seven field and one field-derived WCR populations to DvSnf7 (and Cry3Bb1) was assessed in larval diet-overlay bioassays. Finally, beetle emergence of laboratory susceptible and Cry3Bb1-resistant WCR was evaluated with maize plants in the greenhouse expressing Cry3Bb1, Cry34Ab1/Cry35Ab1, or DvSnf7 dsRNA singly, or in combination. The Cry3Bb1-resistant colony had slight but significantly (2.7-fold; P<0.05) decreased susceptibility to DvSnf7 compared to the susceptible colony, but when repeated using a field-derived WCR population selected for reduced Cry3Bb1 susceptibility, there was no significant difference (P<0.05) in DvSnf7 susceptibility compared to that same susceptible population. Additionally, this 2.7-fold difference in susceptibility falls within the range of DvSnf7 susceptibility among the seven field populations tested. Additionally, there was no correlation between susceptibility to DvSnf7 and Cry3Bb1 for all populations evaluated. In greenhouse studies, there were no significant differences (P<0.05) between beetle emergence of susceptible and Cry3Bb1-resistant colonies on DvSnf7 and Cry34Ab1/Cry35Ab1, and between DvSnf7 and MON 87411 (DvSnf7 + Cry3Bb1) for the Cry3Bb1-resistant colony. These results demonstrate no cross-resistance between DvSnf7 and Cry3Bb1 against WCR. Therefore, pyramiding DvSnf7 with Bt proteins such as Cry3Bb1 and Cry34Ab1/Cry35Ab1 will provide a valuable IRM tool against WCR that will increase the durability of these Bt proteins. These results also illustrate the importance of using appropriate bioassay methods when characterizing field-evolved resistant WCR populations.

Cry3Bb1-Resistant Western Corn Rootworm, Diabrotica virgifera virgifera (LeConte) Does Not Exhibit Cross-Resistance to DvSnf7 dsRNA

PubMed Central

Khajuria, Chitvan; Pleau, Michael; Ilagan, Oliver; Chen, Mao; Jiang, Changjian; Price, Paula; McNulty, Brian; Clark, Thomas; Head, Graham

2017-01-01

Background and Methodology There is a continuing need to express new insect control compounds in transgenic maize against western corn rootworm, Diabrotica virgifera virgifera (LeConte) (WCR). In this study three experiments were conducted to determine cross-resistance between the new insecticidal DvSnf7 dsRNA, and Bacillus thuringiensis (Bt) Cry3Bb1; used to control WCR since 2003, with field-evolved resistance being reported. Laboratory susceptible and Cry3Bb1-resistant WCR were evaluated against DvSnf7 dsRNA in larval diet-incorporation bioassays. Additionally, the susceptibility of seven field and one field-derived WCR populations to DvSnf7 (and Cry3Bb1) was assessed in larval diet-overlay bioassays. Finally, beetle emergence of laboratory susceptible and Cry3Bb1-resistant WCR was evaluated with maize plants in the greenhouse expressing Cry3Bb1, Cry34Ab1/Cry35Ab1, or DvSnf7 dsRNA singly, or in combination. Principal Findings and Conclusions The Cry3Bb1-resistant colony had slight but significantly (2.7-fold; P<0.05) decreased susceptibility to DvSnf7 compared to the susceptible colony, but when repeated using a field-derived WCR population selected for reduced Cry3Bb1 susceptibility, there was no significant difference (P<0.05) in DvSnf7 susceptibility compared to that same susceptible population. Additionally, this 2.7-fold difference in susceptibility falls within the range of DvSnf7 susceptibility among the seven field populations tested. Additionally, there was no correlation between susceptibility to DvSnf7 and Cry3Bb1 for all populations evaluated. In greenhouse studies, there were no significant differences (P<0.05) between beetle emergence of susceptible and Cry3Bb1-resistant colonies on DvSnf7 and Cry34Ab1/Cry35Ab1, and between DvSnf7 and MON 87411 (DvSnf7 + Cry3Bb1) for the Cry3Bb1-resistant colony. These results demonstrate no cross-resistance between DvSnf7 and Cry3Bb1 against WCR. Therefore, pyramiding DvSnf7 with Bt proteins such as Cry3Bb1 and Cry34Ab1/Cry35Ab1 will provide a valuable IRM tool against WCR that will increase the durability of these Bt proteins. These results also illustrate the importance of using appropriate bioassay methods when characterizing field-evolved resistant WCR populations. PMID:28060922

42 CFR 413.114 - Payment for posthospital SNF care furnished by a swing-bed hospital.

Code of Federal Regulations, 2010 CFR

2010-10-01

...— Availability date means with respect to a posthospital SNF care patient in a swing-bed hospital, the later of— (i) Any date on which a bed is available for the patient in a Medicare-participating SNF located... inaccessible to its patients. In the event of a dispute as to whether an SNF is within a hospital's geographic...

DESIGN ANALYSIS FOR THE NAVAL SNF WASTE PACKAGE

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

T.L. Mitchell

2000-05-31

The purpose of this analysis is to demonstrate the design of the naval spent nuclear fuel (SNF) waste package (WP) using the Waste Package Department's (WPD) design methodologies and processes described in the ''Waste Package Design Methodology Report'' (CRWMS M&O [Civilian Radioactive Waste Management System Management and Operating Contractor] 2000b). The calculations that support the design of the naval SNF WP will be discussed; however, only a sub-set of such analyses will be presented and shall be limited to those identified in the ''Waste Package Design Sensitivity Report'' (CRWMS M&O 2000c). The objective of this analysis is to describe themore » naval SNF WP design method and to show that the design of the naval SNF WP complies with the ''Naval Spent Nuclear Fuel Disposal Container System Description Document'' (CRWMS M&O 1999a) and Interface Control Document (ICD) criteria for Site Recommendation. Additional criteria for the design of the naval SNF WP have been outlined in Section 6.2 of the ''Waste Package Design Sensitivity Report'' (CRWMS M&O 2000c). The scope of this analysis is restricted to the design of the naval long WP containing one naval long SNF canister. This WP is representative of the WPs that will contain both naval short SNF and naval long SNF canisters. The following items are included in the scope of this analysis: (1) Providing a general description of the applicable design criteria; (2) Describing the design methodology to be used; (3) Presenting the design of the naval SNF waste package; and (4) Showing compliance with all applicable design criteria. The intended use of this analysis is to support Site Recommendation reports and assist in the development of WPD drawings. Activities described in this analysis were conducted in accordance with the technical product development plan (TPDP) ''Design Analysis for the Naval SNF Waste Package (CRWMS M&O 2000a).« less

Symbiotic N2 fixation activity in relation to C economy of Pisum sativum L. as a function of plant phenology.

PubMed

Voisin, A S; Salon, C; Jeudy, C; Warembourg, F R

2003-12-01

The relationships between symbiotic nitrogen fixation (SNF) activity and C fluxes were investigated in pea plants (Pisum sativum L. cv. Baccara) using simultaneous 13C and 15N labelling. Analysis of the dynamics of labelled CO2 efflux from the nodulated roots allowed the different components associated with SNF activity to be calculated, together with root and nodule synthetic and maintenance processes. The carbon costs for the synthesis of roots and nodules were similar and decreased with time. Carbon lost by turnover, associated with maintenance processes, decreased with time for nodules while it increased in the roots. Nodule turnover remained higher than root turnover until flowering. The effect of the N source on SNF was investigated using plants supplied with nitrate or plants only fixing N2. SNF per unit nodule biomass (nodule specific activity) was linearly related to the amount of carbon allocated to the nodulated roots regardless of the N source, with regression slopes decreasing across the growth cycle. These regression slopes permitted potential values of SNF specific activity to be defined. SNF activity decreased as the plants aged, presumably because of the combined effects of both increasing C costs of SNF (from 4.0 to 6.7 g C g-1 N) and the limitation of C supply to the nodules. SNF activity competed for C against synthesis and maintenance processes within the nodulated roots. Synthesis was the main limiting factor of SNF, but its importance decreased as the plant aged. At seed-filling, SNF was probably more limited by nodule age than by C supply to the nodulated roots.

The murine SNF5/INI1 chromatin remodeling factor is essential for embryonic development and tumor suppression.

PubMed

Klochendler-Yeivin, A; Fiette, L; Barra, J; Muchardt, C; Babinet, C; Yaniv, M

2000-12-01

The assembly of eukaryotic DNA into nucleosomes and derived higher order structures constitutes a barrier for transcription, replication and repair. A number of chromatin remodeling complexes, as well as histone acetylation, were shown to facilitate gene activation. To investigate the function of two closely related mammalian SWI/SNF complexes in vivo, we inactivated the murine SNF5/INI1 gene, a common subunit of these two complexes. Mice lacking SNF5 protein stop developing at the peri-implantation stage, showing that the SWI/SNF complex is essential for early development and viability of early embryonic cells. Furthermore, heterozygous mice develop nervous system and soft tissue sarcomas. In these tumors the wild-type allele was lost, providing further evidence that SNF5 functions as a tumor suppressor gene in certain cell types.

The murine SNF5/INI1 chromatin remodeling factor is essential for embryonic development and tumor suppression

PubMed Central

Klochendler-Yeivin, Agnes; Fiette, Laurence; Barra, Jaqueline; Muchardt, Christian; Babinet, Charles; Yaniv, Moshe

2000-01-01

The assembly of eukaryotic DNA into nucleosomes and derived higher order structures constitutes a barrier for transcription, replication and repair. A number of chromatin remodeling complexes, as well as histone acetylation, were shown to facilitate gene activation. To investigate the function of two closely related mammalian SWI/SNF complexes in vivo, we inactivated the murine SNF5/INI1 gene, a common subunit of these two complexes. Mice lacking SNF5 protein stop developing at the peri-implantation stage, showing that the SWI/SNF complex is essential for early development and viability of early embryonic cells. Furthermore, heterozygous mice develop nervous system and soft tissue sarcomas. In these tumors the wild-type allele was lost, providing further evidence that SNF5 functions as a tumor suppressor gene in certain cell types. PMID:11263494

Trehalose-6-phosphate synthesis controls yeast gluconeogenesis downstream and independent of SNF1.

PubMed

Deroover, Sofie; Ghillebert, Ruben; Broeckx, Tom; Winderickx, Joris; Rolland, Filip

2016-06-01

Trehalose-6-P (T6P), an intermediate of trehalose biosynthesis, was identified as an important regulator of yeast sugar metabolism and signaling. tps1Δ mutants, deficient in T6P synthesis (TPS), are unable to grow on rapidly fermentable medium with uncontrolled influx in glycolysis, depletion of ATP and accumulation of sugar phosphates. However, the exact molecular mechanisms involved are not fully understood. We show that SNF1 deletion restores the tps1Δ growth defect on glucose, suggesting that lack of TPS hampers inactivation of SNF1 or SNF1-regulated processes. In addition to alternative, non-fermentable carbon metabolism, SNF1 controls two major processes: respiration and gluconeogenesis. The tps1Δ defect appears to be specifically associated with deficient inhibition of gluconeogenesis, indicating more downstream effects. Consistently, Snf1 dephosphorylation and inactivation on glucose medium are not affected, as confirmed with an in vivo Snf1 activity reporter. Detailed analysis shows that gluconeogenic Pck1 and Fbp1 expression, protein levels and activity are not repressed upon glucose addition to tps1Δ cells, suggesting a link between the metabolic defect and persistent gluconeogenesis. While SNF1 is essential for induction of gluconeogenesis, T6P/TPS is required for inactivation of gluconeogenesis in the presence of glucose, downstream and independent of SNF1 activity and the Cat8 and Sip4 transcription factors. © FEMS 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Design and fabrication of highly open nickel cobalt sulfide nanosheets on Ni foam for asymmetric supercapacitors with high energy density and long cycle-life

NASA Astrophysics Data System (ADS)

Zha, Daosong; Fu, Yongsheng; Zhang, Lili; Zhu, Junwu; Wang, Xin

2018-02-01

Nickel cobalt sulfides (NiCo-S) are promising electrode materials for high-performance supercapacitors but normally show poor rate capability and unsatisfactory long-term endurance. To overcome these disadvantages, a properly constructed electrode architecture with abundant electron transport channels, excellent electronic conductivity and robust structural stability is required. Herein, considering that in situ transformation can mostly retain the specific structural advantages of the precursors, a two-step strategy is purposefully developed to construct a binder-free electrode composed of interconnected NiCo-S nanosheets on Ni foam (NiCo-S/NF), in which NiCo-S/NF is synthesized via the in situ sulfuration of networked acetate anion-intercalated nickel cobalt layered double hydroxide nanosheets loaded on Ni foam (A-NiCo-LDH/NF). Noticeably, the optimized Ni1Co1-S/NF exhibits an ultrahigh specific capacitance of 2553.9 F g-1 at 0.5 A g-1, excellent rate capability (1898.1 F g-1 at 50 A g-1) and superior cycling stability (nearly 90% capacitance retention after 10,000 cycles). Furthermore, the assembled asymmetric supercapacitor based on Ni1Co1-S/NF demonstrates a high energy density of 58.1 Wh kg-1 at a power density of 796 W kg-1 and impressive long-term durability even after a repeated charge/discharge process as long as 70,000 cycles (∼92% capacitance retention). The attractive properties endow the Ni1Co1-S/NF electrode with significant potential for high-performance energy storage devices.

Intrasteric control of AMPK via the gamma1 subunit AMP allosteric regulatory site.

PubMed

Adams, Julian; Chen, Zhi-Ping; Van Denderen, Bryce J W; Morton, Craig J; Parker, Michael W; Witters, Lee A; Stapleton, David; Kemp, Bruce E

2004-01-01

AMP-activated protein kinase (AMPK) is a alphabetagamma heterotrimer that is activated in response to both hormones and intracellular metabolic stress signals. AMPK is regulated by phosphorylation on the alpha subunit and by AMP allosteric control previously thought to be mediated by both alpha and gamma subunits. Here we present evidence that adjacent gamma subunit pairs of CBS repeat sequences (after Cystathionine Beta Synthase) form an AMP binding site related to, but distinct from the classical AMP binding site in phosphorylase, that can also bind ATP. The AMP binding site of the gamma(1) CBS1/CBS2 pair, modeled on the structures of the CBS sequences present in the inosine monophosphate dehydrogenase crystal structure, contains three arginine residues 70, 152, and 171 and His151. The yeast gamma homolog, snf4 contains a His151Gly substitution, and when this is introduced into gamma(1), AMP allosteric control is substantially lost and explains why the yeast snf1p/snf4p complex is insensitive to AMP. Arg70 in gamma(1) corresponds to the site of mutation in human gamma(2) and pig gamma(3) genes previously identified to cause an unusual cardiac phenotype and glycogen storage disease, respectively. Mutation of any of AMP binding site Arg residues to Gln substantially abolishes AMP allosteric control in expressed AMPK holoenzyme. The Arg/Gln mutations also suppress the previously described inhibitory properties of ATP and render the enzyme constitutively active. We propose that ATP acts as an intrasteric inhibitor by bridging the alpha and gamma subunits and that AMP functions to derepress AMPK activity.

Can shale safely host US nuclear waste?

USGS Publications Warehouse

Neuzil, C.E.

2013-01-01

"Even as cleanup efforts after Japan’s Fukushima disaster offer a stark reminder of the spent nuclear fuel (SNF) stored at nuclear plants worldwide, the decision in 2009 to scrap Yucca Mountain as a permanent disposal site has dimmed hope for a repository for SNF and other high-level nuclear waste (HLW) in the United States anytime soon. About 70,000 metric tons of SNF are now in pool or dry cask storage at 75 sites across the United States [Government Accountability Office, 2012], and uncertainty about its fate is hobbling future development of nuclear power, increasing costs for utilities, and creating a liability for American taxpayers [Blue Ribbon Commission on America’s Nuclear Future, 2012].However, abandoning Yucca Mountain could also result in broadening geologic options for hosting America’s nuclear waste. Shales and other argillaceous formations (mudrocks, clays, and similar clay-rich media) have been absent from the U.S. repository program. In contrast, France, Switzerland, and Belgium are now planning repositories in argillaceous formations after extensive research in underground laboratories on the safety and feasibility of such an approach [Blue Ribbon Commission on America’s Nuclear Future, 2012; Nationale Genossenschaft für die Lagerung radioaktiver Abfälle (NAGRA), 2010; Organisme national des déchets radioactifs et des matières fissiles enrichies, 2011]. Other nations, notably Japan, Canada, and the United Kingdom, are studying argillaceous formations or may consider them in their siting programs [Japan Atomic Energy Agency, 2012; Nuclear Waste Management Organization (NWMO), (2011a); Powell et al., 2010]."

Fibroblast growth factor receptors as novel therapeutic targets in SNF5-deleted malignant rhabdoid tumors.

PubMed

Wöhrle, Simon; Weiss, Andreas; Ito, Moriko; Kauffmann, Audrey; Murakami, Masato; Jagani, Zainab; Thuery, Anne; Bauer-Probst, Beatrice; Reimann, Flavia; Stamm, Christelle; Pornon, Astrid; Romanet, Vincent; Guagnano, Vito; Brümmendorf, Thomas; Sellers, William R; Hofmann, Francesco; Roberts, Charles W M; Graus Porta, Diana

2013-01-01

Malignant rhabdoid tumors (MRTs) are aggressive pediatric cancers arising in brain, kidney and soft tissues, which are characterized by loss of the tumor suppressor SNF5/SMARCB1. MRTs are poorly responsive to chemotherapy and thus a high unmet clinical need exists for novel therapies for MRT patients. SNF5 is a core subunit of the SWI/SNF chromatin remodeling complex which affects gene expression by nucleosome remodeling. Here, we report that loss of SNF5 function correlates with increased expression of fibroblast growth factor receptors (FGFRs) in MRT cell lines and primary tumors and that re-expression of SNF5 in MRT cells causes a marked repression of FGFR expression. Conversely, siRNA-mediated impairment of SWI/SNF function leads to elevated levels of FGFR2 in human fibroblasts. In vivo, treatment with NVP-BGJ398, a selective FGFR inhibitor, blocks progression of a murine MRT model. Hence, we identify FGFR signaling as an aberrantly activated oncogenic pathway in MRTs and propose pharmacological inhibition of FGFRs as a potential novel clinical therapy for MRTs.

Fibroblast Growth Factor Receptors as Novel Therapeutic Targets in SNF5-Deleted Malignant Rhabdoid Tumors

PubMed Central

Wöhrle, Simon; Jagani, Zainab; Thuery, Anne; Bauer-Probst, Beatrice; Reimann, Flavia; Stamm, Christelle; Pornon, Astrid; Romanet, Vincent; Guagnano, Vito; Brümmendorf, Thomas; Sellers, William R.; Hofmann, Francesco; Roberts, Charles W. M.; Graus Porta, Diana

2013-01-01

Malignant rhabdoid tumors (MRTs) are aggressive pediatric cancers arising in brain, kidney and soft tissues, which are characterized by loss of the tumor suppressor SNF5/SMARCB1. MRTs are poorly responsive to chemotherapy and thus a high unmet clinical need exists for novel therapies for MRT patients. SNF5 is a core subunit of the SWI/SNF chromatin remodeling complex which affects gene expression by nucleosome remodeling. Here, we report that loss of SNF5 function correlates with increased expression of fibroblast growth factor receptors (FGFRs) in MRT cell lines and primary tumors and that re-expression of SNF5 in MRT cells causes a marked repression of FGFR expression. Conversely, siRNA-mediated impairment of SWI/SNF function leads to elevated levels of FGFR2 in human fibroblasts. In vivo, treatment with NVP-BGJ398, a selective FGFR inhibitor, blocks progression of a murine MRT model. Hence, we identify FGFR signaling as an aberrantly activated oncogenic pathway in MRTs and propose pharmacological inhibition of FGFRs as a potential novel clinical therapy for MRTs. PMID:24204904

FRED: an innovative approach to nursing home level-of-care assignments.

PubMed

Morris, J N; Sherwood, S; May, M I; Bernstein, E

1987-04-01

A clear need currently exists to consider new approaches for classifying nursing home residents. The traditional intermediate care facility/skilled nursing facility (ICF/SNF) dichotomy cannot provide adequate information on the type of care required by any one individual, and it provides only the most limited information required to address the care and quality-of-life needs of the total patient population within a facility, as well as the level of reimbursement appropriate for their care. This article describes an alternative procedure for allocating nursing home residents according to a more comprehensive array of internally homogeneous categories. This system is based on an operational perspective focused on the total nursing and staffing requirements for types of nursing home residents. The tool is titled "Functionally Ranked Explanatory Designations," or FRED.

FRED: an innovative approach to nursing home level-of-care assignments.

PubMed Central

Morris, J N; Sherwood, S; May, M I; Bernstein, E

1987-01-01

A clear need currently exists to consider new approaches for classifying nursing home residents. The traditional intermediate care facility/skilled nursing facility (ICF/SNF) dichotomy cannot provide adequate information on the type of care required by any one individual, and it provides only the most limited information required to address the care and quality-of-life needs of the total patient population within a facility, as well as the level of reimbursement appropriate for their care. This article describes an alternative procedure for allocating nursing home residents according to a more comprehensive array of internally homogeneous categories. This system is based on an operational perspective focused on the total nursing and staffing requirements for types of nursing home residents. The tool is titled "Functionally Ranked Explanatory Designations," or FRED. PMID:3570811

Prolonged acute mechanical ventilation and hospital bed utilization in 2020 in the United States: implications for budgets, plant and personnel planning

PubMed Central

Zilberberg, Marya D; Shorr, Andrew F

2008-01-01

Background Adult patients on prolonged acute mechanical ventilation (PAMV) comprise 1/3 of all adult MV patients, consume 2/3 of hospital resources allocated to MV population, and are nearly twice as likely to require a discharge to a skilled nursing facility (SNF). Their numbers are projected to double by year 2020. To aid in planning for this growth, we projected their annualized days and costs of hospital use and SNF discharges in year 2020 in the US. Methods We constructed a model estimating the relevant components of hospital utilization. We computed the total days and costs for each component; we also applied the risk for SNF discharge to the total 2020 PAMV population. The underlying assumption was that process of care does not change over the time horizon. We performed Monte Carlo simulations to establish 95% confidence intervals (CI) for the point estimates. Results Given 2020 projected PAMV volume of 605,898 cases, they will require 3.6 (95% CI 2.7–4.8) million MV, 5.5 (95% CI 4.3–7.0) million ICU and 10.3 (95% CI 8.1–13.0) million hospital days, representing an absolute increase of 2.1 million MV, 3.2 million ICU and 6.5 million hospital days over year 2000, at a total inflation-adjusted cost of over $64 billion. Expected discharges to SNF are 218,123 (95% CI 177,268–266,739), compared to 90,928 in 2000. Conclusion Our model suggest that the projected growth in the US in PAMV population by 2020 will result in annualized increases of more than 2, 3, and 6 million MV, ICU and hospital days, respectively, over year 2000. Such growth requires careful planning efforts and attention to efficiency of healthcare delivery. PMID:19032766

The American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator Has a Role in Predicting Discharge to Post-Acute Care in Total Joint Arthroplasty.

PubMed

Goltz, Daniel E; Baumgartner, Billy T; Politzer, Cary S; DiLallo, Marcus; Bolognesi, Michael P; Seyler, Thorsten M

2018-01-01

Patient demand and increasing cost awareness have led to the creation of surgical risk calculators that attempt to predict the likelihood of adverse events and to facilitate risk mitigation. The American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator is an online tool available for a wide variety of surgical procedures, and has not yet been fully evaluated in total joint arthroplasty. A single-center, retrospective review was performed on 909 patients receiving a unilateral primary total knee (496) or hip (413) arthroplasty between January 2012 and December 2014. Patient characteristics were entered into the risk calculator, and predicted outcomes were compared with observed results. Discrimination was evaluated using the receiver-operator area under the curve (AUC) for 90-day readmission, return to operating room (OR), discharge to skilled nursing facility (SNF)/rehab, deep venous thrombosis (DVT), and periprosthetic joint infection (PJI). The risk calculator demonstrated adequate performance in predicting discharge to SNF/rehab (AUC 0.72). Discrimination was relatively limited for DVT (AUC 0.70, P = .2), 90-day readmission (AUC 0.63), PJI (AUC 0.67), and return to OR (AUC 0.59). Risk score differences between those who did and did not experience discharge to SNF/rehab, 90-day readmission, and PJI reached significance (P < .01). Predicted length of stay performed adequately, only overestimating by 0.2 days on average (rho = 0.25, P < .001). The American College of Surgeons National Surgical Quality Improvement Program Surgical Risk Calculator has fair utility in predicting discharge to SNF/rehab, but limited usefulness for 90-day readmission, return to OR, DVT, and PJI. Although length of stay predictions are similar to actual outcomes, statistical correlation remains relatively weak. Copyright © 2017 Elsevier Inc. All rights reserved.

SWI/SNF Chromatin-remodeling Factors: Multiscale Analyses and Diverse Functions*

PubMed Central

Euskirchen, Ghia; Auerbach, Raymond K.; Snyder, Michael

2012-01-01

Chromatin-remodeling enzymes play essential roles in many biological processes, including gene expression, DNA replication and repair, and cell division. Although one such complex, SWI/SNF, has been extensively studied, new discoveries are still being made. Here, we review SWI/SNF biochemistry; highlight recent genomic and proteomic advances; and address the role of SWI/SNF in human diseases, including cancer and viral infections. These studies have greatly increased our understanding of complex nuclear processes. PMID:22952240

SNF472, a novel inhibitor of vascular calcification, could be administered during hemodialysis to attain potentially therapeutic phytate levels.

PubMed

Perelló, Joan; Gómez, M; Ferrer, M D; Rodríguez, N Y; Salcedo, C; Buades, J M; Pérez, M M; Torregrosa, J V; Martín, E; Maduell, F

2018-04-01

Cardiovascular calcification (CVC) is a major concern in hemodialysis (HD) and the loss of endogenous modulators of calcification seems involved in the process. Phytate is an endogenous crystallization inhibitor and its low molecular mass and high water solubility make it potentially dialyzable. SNF472 (the hexasodium salt of phytate) is being developed for the treatment of calciphylaxis and CVC in HD patients. We aimed to verify if phytate is lost during dialysis, and evaluate SNF472's behaviour during dialysis. Dialyzability was assessed in vitro using online-hemodiafiltration and high-flux HD systems in blood and saline. SNF472 was infused for 20 min and quantified at different time points. Phytate completely dialyzed in 1 h at low concentrations (10 mg/l) but not when added at 30 or 66.67 mg/l SNF472. In bypass conditions, calcium was slightly chelated during SNF472 infusion but when the system was switched to dialysis mode the calcium in the bath compensated this chelation. Phytate dialyses with a low clearance. The administration of SNF472 as an exogenous source of phytate allows to attain supra-physiological levels required for its potential therapeutic properties. As SNF472 is infused during the whole dialysis session, the low clearance would not affect the drug's systemic exposure.

Estimation of phenotypic variability in symbiotic nitrogen fixation ability of common bean under drought stress using 15N natural abundance in grain.

PubMed

Polania, Jose; Poschenrieder, Charlotte; Rao, Idupulapati; Beebe, Stephen

2016-09-01

Common bean ( Phaseolus vulgaris L.) is the most important food legume, cultivated by small farmers and is usually exposed to unfavorable conditions with minimum use of inputs. Drought and low soil fertility, especially phosphorus and nitrogen (N) deficiencies, are major limitations to bean yield in smallholder systems. Beans can derive part of their required N from the atmosphere through symbiotic nitrogen fixation (SNF). Drought stress severely limits SNF ability of plants. The main objectives of this study were to: (i) test and validate the use of 15 N natural abundance in grain to quantify phenotypic differences in SNF ability for its implementation in breeding programs of common bean with bush growth habit aiming to improve SNF, and (ii) quantify phenotypic differences in SNF under drought to identify superior genotypes that could serve as parents. Field studies were conducted at CIAT-Palmira, Colombia using a set of 36 bean genotypes belonging to the Middle American gene pool for evaluation in two seasons with two levels of water supply (irrigated and drought stress). We used 15 N natural abundance method to compare SNF ability estimated from shoot tissue sampled at mid-pod filling growth stage vs. grain tissue sampled at harvest. Our results showed positive and significant correlation between nitrogen derived from the atmosphere (%Ndfa) estimated using shoot tissue at mid-pod filling and %Ndfa estimated using grain tissue at harvest. Both methods showed phenotypic variability in SNF ability under both drought and irrigated conditions and a significant reduction in SNF ability was observed under drought stress. We suggest that the method of estimating Ndfa using grain tissue (Ndfa-G) could be applied in bean breeding programs to improve SNF ability. Using this method of Ndfa-G, we identified four bean lines (RCB 593, SEA 15, NCB 226 and BFS 29) that combine greater SNF ability with greater grain yield under drought stress and these could serve as potential parents to further improve SNF ability of common bean.

New mutations of Saccharomyces cerevisiae that partially relieve both glucose and galactose repression activate the protein kinase Snf1.

PubMed

Rodríguez, Cristina; Sanz, Pascual; Gancedo, Carlos

2003-03-01

We isolated from Saccharomyces cerevisiae two mutants, esc1-1 and ESC3-1, in which genes FBP1, ICL1 or GDH2 were partially derepressed during growth in glucose or galactose. The isolation was done starting with a triple mutant pyc1 pyc2 mth1 unable to grow in glucose-ammonium medium and selecting for mutants able to grow in the non-permissive medium. HXT1 and HXT2 which encode glucose transporters were expressed at high glucose concentrations in both esc1-1 and ESC3-1 mutants, while derepression of invertase at low glucose concentrations was impaired. REG1, cloned as a suppressor of ESC3-1, was not allelic to ESC3-1. Two-hybrid analysis showed an increased interaction of the protein kinase Snf1 with Snf4 in the ESC3-1 mutant; this was not due to mutations in SNF1 or SNF4. ESC3-1 did not bypass the requirement of Snf1 for derepression. We hypothesize that ESC3-1 either facilitates activation of Snf1 or interferes with its glucose-dependent inactivation.

The AMP-Activated Protein Kinase Homolog Snf1 Concerts Carbon Utilization, Conidia Production and the Biosynthesis of Secondary Metabolites in the Taxol-Producer Pestalotiopsis microspora.

PubMed

Wang, Dan; Li, Yingying; Wang, Haichuan; Wei, Dongsheng; Akhberdi, Oren; Liu, Yanjie; Xiang, Biyun; Hao, Xiaoran; Zhu, Xudong

2018-01-24

Highly conserved, the Snf1/AMPK is a central regulator of carbon metabolism and energy production in the eukaryotes. However, its function in filamentous fungi has not been well established. In this study, we reported functional characterization of Snf1/AMPK in the growth, development and secondary metabolism in the filamentous fungus Pestalotiopsis microspora . By deletion of the yeast SNF1 homolog, we found that it regulated the utilization of carbon sources, e.g., sucrose, demonstrating a conserved function of this kinase in filamentous fungus. Importantly, several novel functions of SNF1 were unraveled. For instance, the deletion strain displayed remarkable retardation in vegetative growth and pigmentation and produced a diminished number of conidia, even in the presence of the primary carbon source glucose. Deletion of the gene caused damages in the cell wall as shown by its hypersensitivities to Calcofluor white and Congo red, suggesting a critical role of Snf1 in maintaining cell wall integrity. Furthermore, the mutant strain Δ snf1 was hypersensitive to stress, e.g., osmotic pressure (1 M sorbitol), drug G418 and heat shock, though the mechanism remains to be illustrated. Significantly, disruption of the gene altered the production of secondary metabolites. By high-performance liquid chromatography (HPLC) profiling, we found that Δ snf1 barely produced secondary metabolites, e.g., the known product pestalotiollide B. This study suggests that Snf1 is a key regulator in filamentous fungus Pestalotiopsis microspora concerting carbon metabolism and the filamentous growth, conidiation, cell wall integrity, stress tolerance and the biosynthesis of secondary metabolites.

The AMP-Activated Protein Kinase Homolog Snf1 Concerts Carbon Utilization, Conidia Production and the Biosynthesis of Secondary Metabolites in the Taxol-Producer Pestalotiopsis microspora

PubMed Central

Wang, Dan; Li, Yingying; Wang, Haichuan; Wei, Dongsheng; Akhberdi, Oren; Liu, Yanjie; Xiang, Biyun; Hao, Xiaoran; Zhu, Xudong

2018-01-01

Highly conserved, the Snf1/AMPK is a central regulator of carbon metabolism and energy production in the eukaryotes. However, its function in filamentous fungi has not been well established. In this study, we reported functional characterization of Snf1/AMPK in the growth, development and secondary metabolism in the filamentous fungus Pestalotiopsis microspora. By deletion of the yeast SNF1 homolog, we found that it regulated the utilization of carbon sources, e.g., sucrose, demonstrating a conserved function of this kinase in filamentous fungus. Importantly, several novel functions of SNF1 were unraveled. For instance, the deletion strain displayed remarkable retardation in vegetative growth and pigmentation and produced a diminished number of conidia, even in the presence of the primary carbon source glucose. Deletion of the gene caused damages in the cell wall as shown by its hypersensitivities to Calcofluor white and Congo red, suggesting a critical role of Snf1 in maintaining cell wall integrity. Furthermore, the mutant strain Δsnf1 was hypersensitive to stress, e.g., osmotic pressure (1 M sorbitol), drug G418 and heat shock, though the mechanism remains to be illustrated. Significantly, disruption of the gene altered the production of secondary metabolites. By high-performance liquid chromatography (HPLC) profiling, we found that Δsnf1 barely produced secondary metabolites, e.g., the known product pestalotiollide B. This study suggests that Snf1 is a key regulator in filamentous fungus Pestalotiopsis microspora concerting carbon metabolism and the filamentous growth, conidiation, cell wall integrity, stress tolerance and the biosynthesis of secondary metabolites. PMID:29364863

Spontaneous mutations in CYC8 and MIG1 suppress the short chronological lifespan of budding yeast lacking SNF1/AMPK

PubMed Central

Maqani, Nazif; Fine, Ryan D.; Shahid, Mehreen; Li, Mingguang; Enriquez-Hesles, Elisa; Smith, Jeffrey S.

2018-01-01

Chronologically aging yeast cells are prone to adaptive regrowth, whereby mutants with a survival advantage spontaneously appear and re-enter the cell cycle in stationary phase cultures. Adaptive regrowth is especially noticeable with short-lived strains, including those defective for SNF1, the homolog of mammalian AMP-activated protein kinase (AMPK). SNF1 becomes active in response to multiple environmental stresses that occur in chronologically aging cells, including glucose depletion and oxidative stress. SNF1 is also required for the extension of chronological lifespan (CLS) by caloric restriction (CR) as defined as limiting glucose at the time of culture inoculation. To identify specific downstream SNF1 targets responsible for CLS extension during CR, we screened for adaptive regrowth mutants that restore chronological longevity to a short-lived snf1∆ parental strain. Whole genome sequencing of the adapted mutants revealed missense mutations in TPR motifs 9 and 10 of the transcriptional co-repressor Cyc8 that specifically mediate repression through the transcriptional repressor Mig1. Another mutation occurred in MIG1 itself, thus implicating the activation of Mig1-repressed genes as a key function of SNF1 in maintaining CLS. Consistent with this conclusion, the cyc8 TPR mutations partially restored growth on alternative carbon sources and significantly extended CLS compared to the snf1∆ parent. Furthermore, cyc8 TPR mutations reactivated multiple Mig1-repressed genes, including the transcription factor gene CAT8, which is responsible for activating genes of the glyoxylate and gluconeogenesis pathways. Deleting CAT8 completely blocked CLS extension by the cyc8 TPR mutations on CLS, identifying these pathways as key Snf1-regulated CLS determinants.

Effect of NaF, SnF(2), and TiF(4) Toothpastes on Bovine Enamel and Dentin Erosion-Abrasion In Vitro.

PubMed

Comar, Lívia Picchi; Gomes, Marina Franciscon; Ito, Naiana; Salomão, Priscila Aranda; Grizzo, Larissa Tercília; Magalhães, Ana Carolina

2012-01-01

The aim of this study was to compare the effect of toothpastes containing TiF(4), NaF, and SnF(2) on tooth erosion-abrasion. Bovine enamel and dentin specimens were distributed into 10 groups (n = 12): experimental placebo toothpaste (no F); NaF (1450 ppm F); TiF(4) (1450 ppm F); SnF(2) (1450 ppm F); SnF(2) (1100 ppm F) + NaF (350 ppm F); TiF(4) (1100 ppm F) + NaF (350 ppm F); commercial toothpaste Pro-Health (SnF(2)-1100 ppm F + NaF-350 ppm F, Oral B); commercial toothpaste Crest (NaF-1.500 ppm F, Procter & Gamble); abrasion without toothpaste and only erosion. The erosion was performed 4 × 90 s/day (Sprite Zero). The toothpastes' slurries were applied and the specimens abraded using an electric toothbrush 2 × 15 s/day. Between the erosive and abrasive challenges, the specimens remained in artificial saliva. After 7 days, the tooth wear was evaluated using contact profilometry (μm). The experimental toothpastes with NaF, TiF(4), SnF(2), and Pro-Health showed a significant reduction in enamel wear (between 42% and 54%). Pro-Health also significantly reduced the dentin wear. The toothpastes with SnF(2)/NaF and TiF(4)/NaF showed the best results in the reduction of enamel wear (62-70%) as well as TiF(4), SnF(2), SnF(2)/NaF, and TiF(4)/NaF for dentin wear (64-79%) (P < 0.05). Therefore, the experimental toothpastes containing both conventional and metal fluoride seem to be promising in reducing tooth wear.

SWI/SNF Associates with Nascent Pre-mRNPs and Regulates Alternative Pre-mRNA Processing

PubMed Central

Tyagi, Anu; Ryme, Jessica; Brodin, David; Östlund Farrants, Ann Kristin; Visa, Neus

2009-01-01

The SWI/SNF chromatin remodeling complexes regulate the transcription of many genes by remodeling nucleosomes at promoter regions. In Drosophila, SWI/SNF plays an important role in ecdysone-dependent transcription regulation. Studies in human cells suggest that Brahma (Brm), the ATPase subunit of SWI/SNF, regulates alternative pre-mRNA splicing by modulating transcription elongation rates. We describe, here, experiments that study the association of Brm with transcribed genes in Chironomus tentans and Drosophila melanogaster, the purpose of which was to further elucidate the mechanisms by which Brm regulates pre-mRNA processing. We show that Brm becomes incorporated into nascent Balbiani ring pre-mRNPs co-transcriptionally and that the human Brm and Brg1 proteins are associated with RNPs. We have analyzed the expression profiles of D. melanogaster S2 cells in which the levels of individual SWI/SNF subunits have been reduced by RNA interference, and we show that depletion of SWI/SNF core subunits changes the relative abundance of alternative transcripts from a subset of genes. This observation, and the fact that a fraction of Brm is not associated with chromatin but with nascent pre-mRNPs, suggest that SWI/SNF affects pre-mRNA processing by acting at the RNA level. Ontology enrichment tests indicate that the genes that are regulated post-transcriptionally by SWI/SNF are mostly enzymes and transcription factors that regulate postembryonic developmental processes. In summary, the data suggest that SWI/SNF becomes incorporated into nascent pre-mRNPs and acts post-transcriptionally to regulate not only the amount of mRNA synthesized from a given promoter but also the type of alternative transcript produced. PMID:19424417

FACILITY LAYOUT OF FUEL STORAGE BUILDING (CPP603) SHOWING STORAGE BASINS, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

FACILITY LAYOUT OF FUEL STORAGE BUILDING (CPP-603) SHOWING STORAGE BASINS, FUEL ELEMENT CUTTING FACILITY, AND DRY GRAPHITE STORAGE FACILITY. INL DRAWING NUMBER 200-0603-00-030-056329. - Idaho National Engineering Laboratory, Idaho Chemical Processing Plant, Fuel Reprocessing Complex, Scoville, Butte County, ID

ADP Regulates SNF1, the Saccharomyces cerevisiae Homolog of AMP-Activated Protein Kinase

PubMed Central

Mayer, Faith V.; Heath, Richard; Underwood, Elizabeth; Sanders, Matthew J.; Carmena, David; McCartney, Rhonda R.; Leiper, Fiona C.; Xiao, Bing; Jing, Chun; Walker, Philip A.; Haire, Lesley F.; Ogrodowicz, Roksana; Martin, Stephen R.; Schmidt, Martin C.; Gamblin, Steven J.; Carling, David

2011-01-01

Summary The SNF1 protein kinase complex plays an essential role in regulating gene expression in response to the level of extracellular glucose in budding yeast. SNF1 shares structural and functional similarities with mammalian AMP-activated protein kinase. Both kinases are activated by phosphorylation on a threonine residue within the activation loop segment of the catalytic subunit. Here we show that ADP is the long-sought metabolite that activates SNF1 in response to glucose limitation by protecting the enzyme against dephosphorylation by Glc7, its physiologically relevant protein phosphatase. We also show that the regulatory subunit of SNF1 has two ADP binding sites. The tighter site binds AMP, ADP, and ATP competitively with NADH, whereas the weaker site does not bind NADH, but is responsible for mediating the protective effect of ADP on dephosphorylation. Mutagenesis experiments suggest that the general mechanism by which ADP protects against dephosphorylation is strongly conserved between SNF1 and AMPK. PMID:22019086

27 CFR 19.19 - Discontinuance of storage facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Discontinuance of storage... Provisions § 19.19 Discontinuance of storage facilities. If TTB determines that a proprietor's bonded storage... spirits stored in the facility to another storage facility. The transfer will take place at such time and...

27 CFR 19.19 - Discontinuance of storage facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Discontinuance of storage... Provisions § 19.19 Discontinuance of storage facilities. If TTB determines that a proprietor's bonded storage... spirits stored in the facility to another storage facility. The transfer will take place at such time and...

Impact of Superstorm Sandy on Medicare Patients' Utilization of Hospitals and Emergency Departments.

PubMed

Stryckman, Benoit; Walsh, Lauren; Carr, Brendan G; Hupert, Nathaniel; Lurie, Nicole

2017-10-01

National health security requires that healthcare facilities be prepared to provide rapid, effective emergency and trauma care to all patients affected by a catastrophic event. We sought to quantify changes in healthcare utilization patterns for an at-risk Medicare population before, during, and after Superstorm Sandy's 2012 landfall in New Jersey (NJ). This study is a retrospective cohort study of Medicare beneficiaries impacted by Superstorm Sandy. We compared hospital emergency department (ED) and healthcare facility inpatient utilization in the weeks before and after Superstorm Sandy landfall using a 20% random sample of Medicare fee-for-service beneficiaries continuously enrolled in 2011 and 2012 (N=224,116). Outcome measures were pre-storm discharges (or transfers), average length of stay, service intensity weight, and post-storm ED visits resulting in either discharge or hospital admission. In the pre-storm week, hospital transfers from skilled nursing facilities (SNF) increased by 39% and inpatient discharges had a 0.3 day decreased mean length of stay compared to the prior year. In the post-storm week, ED visits increased by 14% statewide; of these additional "surge" patients, 20% were admitted to the hospital. The increase in ED demand was more than double the statewide average in the most highly impacted coastal regions (35% versus 14%). Superstorm Sandy impacted both pre- and post-storm patient movement in New Jersey; post-landfall ED surge was associated with overall storm impact, which was greatest in coastal counties. A significant increase in the number and severity of pre-storm transfer patients, in particular from SNF, as well as in post-storm ED visits and inpatient admissions, draws attention to the importance of collaborative regional approaches to healthcare in large-scale events.

Effect of Fluoride-Containing Toothpastes on Enamel Demineralization and Streptococcus mutans Biofilm Architecture.

PubMed

Fernández, Constanza E; Fontana, Margherita; Samarian, Derek; Cury, Jaime A; Rickard, Alexander H; González-Cabezas, Carlos

This study aimed to explore the effect of fluoridated toothpastes on biofilm architecture and enamel demineralization in an in vitro biofilm model. Streptococcus mutans was grown on enamel and treated with slurries of commercial toothpastes, containing SnF2 or NaF. Water and chlorhexidine were used as negative and positive controls, respectively. The developed biofilms were imaged and enamel demineralization was measured. SnF2 and NaF toothpaste treatments significantly reduced enamel demineralization, but SnF2 toothpaste was more effective. Only SnF2 toothpaste and chlorhexidine treatments caused reductions on biofilm mass and thickness. In conclusion, this biofilm model was able to differentiate the effects of the SnF2 and NaF toothpastes on biofilm architecture and enamel demineralization. © 2016 S. Karger AG, Basel.

The N-CoR complex enables chromatin remodeler SNF2H to enhance repression by thyroid hormone receptor

PubMed Central

Alenghat, Theresa; Yu, Jiujiu; Lazar, Mitchell A

2006-01-01

Unliganded thyroid hormone receptor (TR) actively represses transcription via the nuclear receptor corepressor (N-CoR)/histone deacetylase 3 (HDAC3) complex. Although transcriptional activation by liganded receptors involves chromatin remodeling, the role of ATP-dependent remodeling in receptor-mediated repression is unknown. Here we report that SNF2H, the mammalian ISWI chromatin remodeling ATPase, is critical for repression of a genomically integrated, TR-regulated reporter gene. N-CoR and HDAC3 are both required for recruitment of SNF2H to the repressed gene. SNF2H does not interact directly with the N-CoR/HDAC3 complex, but binds to unacetylated histone H4 tails, suggesting that deacetylase activity of the corepressor complex is critical to SNF2H function. Indeed, HDAC3 as well as SNF2H are required for nucleosomal organization on the TR target gene. Consistent with these findings, reduction of SNF2H induces expression of an endogenous TR-regulated gene, dio1, in liver cells. Thus, although not apparent from studies of transiently transfected reporter genes, gene repression by TR involves the targeting of chromatin remodeling factors to repressed genes by the HDAC activity of nuclear receptor corepressors. PMID:16917504

Uranium Pyrophoricity Phenomena and Prediction (FAI/00-39)

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

PLYS, M.G.

2000-10-10

The purpose of this report is to provide a topical reference on the phenomena and prediction of uranium pyrophoricity for the Hanford Spent Nuclear Fuel (SNF) Project with specific applications to SNF Project processes and situations. Spent metallic uranium nuclear fuel is currently stored underwater at the K basins in the Hanford 100 area, and planned processing steps include: (1) At the basins, cleaning and placing fuel elements and scrap into stainless steel multi-canister overpacks (MCOs) holding about 6 MT of fuel apiece; (2) At nearby cold vacuum drying (CVD) stations, draining, vacuum drying, and mechanically sealing the MCOs; (3)more » Shipping the MCOs to the Canister Storage Building (CSB) on the 200 Area plateau; and (4) Welding shut and placing the MCOs for interim (40 year) dry storage in closed CSB storage tubes cooled by natural air circulation through the surrounding vault. Damaged fuel elements have exposed and corroded fuel surfaces, which can exothermically react with water vapor and oxygen during normal process steps and in off-normal situations, A key process safety concern is the rate of reaction of damaged fuel and the potential for self-sustaining or runaway reactions, also known as uranium fires or fuel ignition. Uranium metal and one of its corrosion products, uranium hydride, are potentially pyrophoric materials. Dangers of pyrophoricity of uranium and its hydride have long been known in the U.S. Department of Energy (Atomic Energy Commission/DOE) complex and will be discussed more below; it is sufficient here to note that there are numerous documented instances of uranium fires during normal operations. The motivation for this work is to place the safety of the present process in proper perspective given past operational experience. Steps in development of such a perspective are: (1) Description of underlying physical causes for runaway reactions, (2) Modeling physical processes to explain runaway reactions, (3) Validation of the method against experimental data, (4) Application of the method to plausibly explain operational experience, and (5) Application of the method to present process steps to demonstrate process safety and margin. Essentially, the logic above is used to demonstrate that runaway reactions cannot occur during normal SNF Project process steps, and to illustrate the depth of the technical basis for such a conclusion. Some off-normal conditions are identified here that could potentially lead to runaway reactions. However, this document is not intended to provide an exhaustive analysis of such cases. In summary, this report provides a ''toolkit'' of models and approaches for analysis of pyrophoricity safety issues at Hanford, and the technical basis for the recommended approaches. A summary of recommended methods appears in Section 9.0.« less

Postacute rehabilitation care for hip fracture: who gets the most care?

PubMed

Freburger, Janet K; Holmes, George M; Ku, Li-Jung E

2012-10-01

To determine the extent to which demographic and geographic disparities exist in postacute rehabilitation care (PARC) use after hip fracture. Cross-sectional analysis of 2 years (2005-06) of population-based hospital discharge data. All short-term acute care hospitals in four demographically and geographically diverse states (AZ, FL, NJ, WI). Individuals aged 65 and older (mean 82.9) admitted to the hospital with a hip fracture who survived their inpatient stay (N = 64,065). The sample was 75.1% female and 91.5% white, 5.8% Hispanic, and 2.7% black. Whether the participant received institutional PARC; for participants who did not receive institutional care, whether they received home health (HH) care; and for participants who received institutional care, whether they received skilled nursing facility (SNF) or inpatient rehabilitation facility (IRF) care. Multilevel logistic regression analyses were conducted to identify demographic and geographic disparities in PARC use. Considering PARC on a continuum from more to fewer hours of care per day (IRF→SNF→HH→no HH), minorities and individuals of lower socioeconomic status (SES) generally received a lower volume of care. Individuals on Medicaid or who were uninsured were less likely to receive institutional care (odds ratio (OR) = 0.23, 95% confidence interval (CI) = 0.18-0.30) and to receive HH (OR = 0.46, 95% CI = 0.30-0.70) and more likely to receive SNF than IRF care (OR = 2.03, 95% CI = 1.36-3.05). Hispanics were less likely to receive institutional care (OR = 0.70, 95% CI = 0.62-0.79), and Hispanics (OR = 1.31) and blacks (OR = 1.49) were more likely to receive SNF than IRF care. There were also geographic differences in PARC. Several demographic and geographic disparities in PARC use were identified. Future research should confirm these findings and further elucidate factors that contribute to the observed disparities. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

Quality improvement through implementation of discharge order reconciliation.

PubMed

Lu, Yun; Clifford, Pamela; Bjorneby, Andreas; Thompson, Bruce; VanNorman, Samuel; Won, Katie; Larsen, Kevin

2013-05-01

A coordinated multidisciplinary process to reduce medication errors related to patient discharges to skilled-nursing facilities (SNFs) is described. After determining that medication errors were a frequent cause of readmission among patients discharged to SNFs, a medical center launched a two-phase quality-improvement project focused on cardiac and medical patients. Phase one of the project entailed a three-month failure modes and effects analysis of existing procedures discharge, followed by the development and pilot testing of a multidisciplinary, closed-loop workflow process involving staff and resident physicians, clinical nurse coordinators, and clinical pharmacists. During pilot testing of the new workflow process, the rate of discharge medication errors involving SNF patients was tracked, and data on medication-related readmissions in a designated intervention group (n = 87) and a control group of patients (n = 1893) discharged to SNFs via standard procedures during a nine-month period were collected, with the data stratified using severity of illness (SOI) classification. Analysis of the collected data indicated a cumulative 30-day medication-related readmission rate for study group patients in the minor, moderate, and major SOI categories of 5.4% (4 of 74 patients), compared with a rate of 9.5% (169 of 1780 patients) in the control group. In phase 2 of the project, the revised SNF discharge medication reconciliation procedure was implemented throughout the hospital; since hospitalwide implementation of the new workflow, the readmission rate for SNF patients has been maintained at about 6.7%. Implementing a standardized discharge order reconciliation process that includes pharmacists led to decreased readmission rates and improved care for patients discharged to SNFs.

Frequent loss of claudin-4 expression in dedifferentiated and undifferentiated endometrial carcinomas.

PubMed

Tessier-Cloutier, Basile; Soslow, Robert A; Stewart, Colin J R; Köbel, Martin; Lee, Cheng-Han

2018-04-19

Dedifferentiated endometrial carcinomas (DDECs)/undifferentiated endometrial carcinomas (UECs) are aggressive endometrial cancers with frequent genomic inactivation of core components of switch/sucrose non-fermentable (SWI/SNF) complex proteins. Claudin-4, an epithelial intercellular tight junction protein, was recently found to be expressed in SWI/SNF-deficient undifferentiated carcinomas but not in SWI/SNF-deficient sarcomas. The aim of this study was to examine claudin-4 expression in UECs/DDECs and other high-grade uterine carcinomas. We examined claudin-4 expression by immunohistochemistry (clone 3E2C1) on tissue microarrays that contained 44 UECs/DDECs (24 SWI/SNF-deficient), 50 carcinosarcomas, 164 grade 3 endometrioid carcinomas, 57 serous carcinomas, and 20 clear cell carcinomas. Tumours with <5% claudin-4 expression were considered to be negative. Nearly all SWI/SNF-deficient, and most SWI/SNF-proficient, UECs/DDECs showed a complete absence of claudin-4 expression in the undifferentiated component, whereas the differentiated component in DDECs showed consistent and diffuse claudin-4 expression. Only one SWI/SNF-deficient DDEC showed focal expression of claudin-4 in the undifferentiated component, as compared with diffuse expression in the corresponding differentiated component. Claudin-4 expression was consistently absent in the sarcomatous component of carcinosarcoma, and it was absent in 24% of grade 3 endometrioid carcinomas and serous carcinomas. Claudin-4 expression can be absent or very focal in a subset of high-grade endometrial carcinomas, and is almost always absent in the undifferentiated components of SWI/SNF-deficient UECs/DDECs, despite the apparent epithelial origin in the case of DDECs. Therefore, claudin-4 expression cannot be used to infer mesenchymal or epithelial tumour origin in the endometrium. The consistent loss or down-regulation of claudin-4, a tight junction protein, in SWI/SNF-deficient UECs/DDECs further supports the undifferentiated nature of these tumours. © 2018 John Wiley & Sons Ltd.

27 CFR 22.92 - Storage facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Storage facilities. 22.92... Storage facilities. (a) Storerooms or compartments shall be so constructed and secured as to prevent unauthorized access and will be equipped for locking. These storage facilities shall be of sufficient capacity...

27 CFR 22.92 - Storage facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Storage facilities. 22.92... Storage facilities. (a) Storerooms or compartments shall be so constructed and secured as to prevent unauthorized access and will be equipped for locking. These storage facilities shall be of sufficient capacity...

27 CFR 22.92 - Storage facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Storage facilities. 22.92... Storage facilities. (a) Storerooms or compartments shall be so constructed and secured as to prevent unauthorized access and will be equipped for locking. These storage facilities shall be of sufficient capacity...

27 CFR 22.92 - Storage facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Storage facilities. 22.92... Storage facilities. (a) Storerooms or compartments shall be so constructed and secured as to prevent unauthorized access and will be equipped for locking. These storage facilities shall be of sufficient capacity...

27 CFR 22.92 - Storage facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Storage facilities. 22.92... Storage facilities. (a) Storerooms or compartments shall be so constructed and secured as to prevent unauthorized access and will be equipped for locking. These storage facilities shall be of sufficient capacity...

Separation of mixtures of chemical elements in plasma

NASA Astrophysics Data System (ADS)

Dolgolenko, D. A.; Muromkin, Yu A.

2017-10-01

This paper reviews proposals on the plasma processing of radioactive waste (RW) and spent nuclear fuel (SNF). The chemical processing of SNF based on the extraction of its components from water solutions is rather expensive and produces new waste. The paper considers experimental research on plasma separation of mixtures of chemical elements and isotopes, whose results can help evaluate the plasma methods of RW and SNF reprocessing. The analysis identifies the difference between ionization levels of RW and SNF components at their transition to the plasma phase as a reason why all plasma methods are difficult to apply.

Purification and biochemical heterogeneity of the mammalian SWI-SNF complex.

PubMed Central

Wang, W; Côté, J; Xue, Y; Zhou, S; Khavari, P A; Biggar, S R; Muchardt, C; Kalpana, G V; Goff, S P; Yaniv, M; Workman, J L; Crabtree, G R

1996-01-01

We have purified distinct complexes of nine to 12 proteins [referred to as BRG1-associated factors (BAFs)] from several mammalian cell lines using an antibody to the SWI2-SNF2 homolog BRG1. Microsequencing revealed that the 47 kDa BAF is identical to INI1. Previously INI1 has been shown to interact with and activate human immunodeficiency virus integrase and to be homologous to the yeast SNF5 gene. A group of BAF47-associated proteins were affinity purified with antibodies against INI1/BAF47 and were found to be identical to those co-purified with BRG1, strongly indicating that this group of proteins associates tightly and is likely to be the mammalian equivalent of the yeast SWI-SNF complex. Complexes containing BRG1 can disrupt nucleosomes and facilitate the binding of GAL4-VP16 to a nucleosomal template similar to the yeast SWI-SNF complex. Purification of the complex from several cell lines demonstrates that it is heterogeneous with respect to subunit composition. The two SWI-SNF2 homologs, BRG1 and hbrm, were found in separate complexes. Certain cell lines completely lack BRG1 and hbrm, indicating that they are not essential for cell viability and that the mammalian SWI-SNF complex may be tailored to the needs of a differentiated cell type. Images PMID:8895581

46 CFR 108.237 - Fuel storage facilities.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 46 Shipping 4 2013-10-01 2013-10-01 false Fuel storage facilities. 108.237 Section 108.237... AND EQUIPMENT Construction and Arrangement Helicopter Facilities § 108.237 Fuel storage facilities. (a) Helicopter fuel storage tanks must be installed as far as practicable from— (1) The landing area; and (2...

46 CFR 108.237 - Fuel storage facilities.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 46 Shipping 4 2012-10-01 2012-10-01 false Fuel storage facilities. 108.237 Section 108.237... AND EQUIPMENT Construction and Arrangement Helicopter Facilities § 108.237 Fuel storage facilities. (a) Helicopter fuel storage tanks must be installed as far as practicable from— (1) The landing area; and (2...

46 CFR 108.237 - Fuel storage facilities.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 46 Shipping 4 2010-10-01 2010-10-01 false Fuel storage facilities. 108.237 Section 108.237... AND EQUIPMENT Construction and Arrangement Helicopter Facilities § 108.237 Fuel storage facilities. (a) Helicopter fuel storage tanks must be installed as far as practicable from— (1) The landing area; and (2...

46 CFR 108.237 - Fuel storage facilities.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 46 Shipping 4 2011-10-01 2011-10-01 false Fuel storage facilities. 108.237 Section 108.237... AND EQUIPMENT Construction and Arrangement Helicopter Facilities § 108.237 Fuel storage facilities. (a) Helicopter fuel storage tanks must be installed as far as practicable from— (1) The landing area; and (2...

40 CFR 160.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Specimen and data storage facilities... PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Facilities § 160.51 Specimen and data storage facilities. Space shall be provided for archives, limited to access by authorized personnel only, for the storage and...

40 CFR 160.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Specimen and data storage facilities... PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Facilities § 160.51 Specimen and data storage facilities. Space shall be provided for archives, limited to access by authorized personnel only, for the storage and...

40 CFR 160.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Specimen and data storage facilities... PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Facilities § 160.51 Specimen and data storage facilities. Space shall be provided for archives, limited to access by authorized personnel only, for the storage and...

40 CFR 160.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Specimen and data storage facilities... PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Facilities § 160.51 Specimen and data storage facilities. Space shall be provided for archives, limited to access by authorized personnel only, for the storage and...

Risk assessment of CST-7 proposed waste treatment and storage facilities Volume I: Limited-scope probabilistic risk assessment (PRA) of proposed CST-7 waste treatment & storage facilities. Volume II: Preliminary hazards analysis of proposed CST-7 waste storage & treatment facilities

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

Sasser, K.

1994-06-01

In FY 1993, the Los Alamos National Laboratory Waste Management Group [CST-7 (formerly EM-7)] requested the Probabilistic Risk and Hazards Analysis Group [TSA-11 (formerly N-6)] to conduct a study of the hazards associated with several CST-7 facilities. Among these facilities are the Hazardous Waste Treatment Facility (HWTF), the HWTF Drum Storage Building (DSB), and the Mixed Waste Receiving and Storage Facility (MWRSF), which are proposed for construction beginning in 1996. These facilities are needed to upgrade the Laboratory`s storage capability for hazardous and mixed wastes and to provide treatment capabilities for wastes in cases where offsite treatment is not availablemore » or desirable. These facilities will assist Los Alamos in complying with federal and state requlations.« less

Drying results of K-Basin fuel element 1990 (Run 1)

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

Marschman, S.C.; Abrefah, J.; Klinger, G.S.

1998-06-01

The water-filled K-Basins in the Hanford 100-Area have been used to store N-Reactor spent nuclear fuel (SNF) since the 1970s. Because some leaks in the basins have been detected and some of the fuel is breached due to handling damage and corrosion, efforts are underway to remove the fuel elements from wet storage. An Integrated Process Strategy (IPS) has been developed to package, dry, transport, and store these metallic uranium fuels in an interim storage facility on the Hanford Site (WHC 1995). Information required to support the development of the drying processes, and the required safety analyses, is being obtainedmore » from characterization tests conducted on fuel elements removed from the K-Basins. A series of whole element drying tests (reported in separate documents, see Section 8.0) have been conducted by Pacific Northwest National Laboratory (PNNL) on several intact and damaged fuel elements recovered from both the K-East and K-West Basins. This report documents the results of the first of those tests (Run 1), which was conducted on an N-Reactor inner fuel element (1990) that had been stored underwater in the K-West Basin (see Section 2.0). This fuel element was subjected to a combination of low- and high-temperature vacuum drying treatments that were intended to mimic, wherever possible, the fuel treatment strategies of the IPS. The testing was conducted in the Whole Element Furnace Testing System, described in Section 3.0, located in the Postirradiation Testing Laboratory (PTL, 327 Building). The test conditions and methodology are given in Section 4.0, and the experimental results provided in Section 5.0. These results are further discussed in Section 6.0.« less

ORIGAMI Automator Primer. Automated ORIGEN Source Terms and Spent Fuel Storage Pool Analysis

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

Wieselquist, William A.; Thompson, Adam B.; Bowman, Stephen M.

2016-04-01

Source terms and spent nuclear fuel (SNF) storage pool decay heat load analyses for operating nuclear power plants require a large number of Oak Ridge Isotope Generation and Depletion (ORIGEN) calculations. SNF source term calculations also require a significant amount of bookkeeping to track quantities such as core and assembly operating histories, spent fuel pool (SFP) residence times, heavy metal masses, and enrichments. The ORIGEN Assembly Isotopics (ORIGAMI) module in the SCALE code system provides a simple scheme for entering these data. However, given the large scope of the analysis, extensive scripting is necessary to convert formats and process datamore » to create thousands of ORIGAMI input files (one per assembly) and to process the results into formats readily usable by follow-on analysis tools. This primer describes a project within the SCALE Fulcrum graphical user interface (GUI) called ORIGAMI Automator that was developed to automate the scripting and bookkeeping in large-scale source term analyses. The ORIGAMI Automator enables the analyst to (1) easily create, view, and edit the reactor site and assembly information, (2) automatically create and run ORIGAMI inputs, and (3) analyze the results from ORIGAMI. ORIGAMI Automator uses the standard ORIGEN binary concentrations files produced by ORIGAMI, with concentrations available at all time points in each assembly’s life. The GUI plots results such as mass, concentration, activity, and decay heat using a powerful new ORIGEN Post-Processing Utility for SCALE (OPUS) GUI component. This document includes a description and user guide for the GUI, a step-by-step tutorial for a simplified scenario, and appendices that document the file structures used.« less

The SWI/SNF Subunit INI1 Contains an N-Terminal Winged Helix DNA Binding Domain that Is a Target for Mutations in Schwannomatosis

PubMed Central

Allen, Mark D.; Freund, Stefan M.V.; Zinzalla, Giovanna; Bycroft, Mark

2015-01-01

Summary SWI/SNF complexes use the energy of ATP hydrolysis to remodel chromatin. In mammals they play a central role in regulating gene expression during differentiation and proliferation. Mutations in SWI/SNF subunits are among the most frequent gene alterations in cancer. The INI1/hSNF5/SMARCB1 subunit is mutated in both malignant rhabdoid tumor, a highly aggressive childhood cancer, and schwannomatosis, a tumor-predisposing syndrome characterized by mostly benign tumors of the CNS. Here, we show that mutations in INI1 that cause schwannomatosis target a hitherto unidentified N-terminal winged helix DNA binding domain that is also present in the BAF45a/PHF10 subunit of the SWI/SNF complex. The domain is structurally related to the SKI/SNO/DAC domain, which is found in a number of metazoan chromatin-associated proteins. PMID:26073604

7 CFR 301.89-16 - Compensation for grain storage facilities, flour millers, National Survey participants, and...

Code of Federal Regulations, 2010 CFR

2010-01-01

... 7 Agriculture 5 2010-01-01 2010-01-01 false Compensation for grain storage facilities, flour... DOMESTIC QUARANTINE NOTICES Karnal Bunt § 301.89-16 Compensation for grain storage facilities, flour... the 1999-2000 and subsequent crop seasons. Owners of grain storage facilities, flour millers, and...

30 CFR 56.6800 - Storage facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Storage facilities. 56.6800 Section 56.6800... § 56.6800 Storage facilities. When repair work which could produce a spark or flame is to be performed on a storage facility— (a) The explosive material shall be moved to another facility, or moved at...

30 CFR 56.6800 - Storage facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Storage facilities. 56.6800 Section 56.6800... § 56.6800 Storage facilities. When repair work which could produce a spark or flame is to be performed on a storage facility— (a) The explosive material shall be moved to another facility, or moved at...

30 CFR 56.6800 - Storage facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Storage facilities. 56.6800 Section 56.6800... § 56.6800 Storage facilities. When repair work which could produce a spark or flame is to be performed on a storage facility— (a) The explosive material shall be moved to another facility, or moved at...

30 CFR 56.6800 - Storage facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Storage facilities. 56.6800 Section 56.6800... § 56.6800 Storage facilities. When repair work which could produce a spark or flame is to be performed on a storage facility— (a) The explosive material shall be moved to another facility, or moved at...

30 CFR 56.6800 - Storage facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Storage facilities. 56.6800 Section 56.6800... § 56.6800 Storage facilities. When repair work which could produce a spark or flame is to be performed on a storage facility— (a) The explosive material shall be moved to another facility, or moved at...

30 CFR 56.4430 - Storage facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Storage facilities. 56.4430 Section 56.4430... Control Flammable and Combustible Liquids and Gases § 56.4430 Storage facilities. (a) Storage tanks for... changes. Vents for storage of Class I, II, or IIIA liquids shall be isolated or separated from ignition...

30 CFR 56.4430 - Storage facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Storage facilities. 56.4430 Section 56.4430... Control Flammable and Combustible Liquids and Gases § 56.4430 Storage facilities. (a) Storage tanks for... changes. Vents for storage of Class I, II, or IIIA liquids shall be isolated or separated from ignition...

30 CFR 56.4430 - Storage facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Storage facilities. 56.4430 Section 56.4430... Control Flammable and Combustible Liquids and Gases § 56.4430 Storage facilities. (a) Storage tanks for... changes. Vents for storage of Class I, II, or IIIA liquids shall be isolated or separated from ignition...

30 CFR 56.4430 - Storage facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Storage facilities. 56.4430 Section 56.4430... Control Flammable and Combustible Liquids and Gases § 56.4430 Storage facilities. (a) Storage tanks for... changes. Vents for storage of Class I, II, or IIIA liquids shall be isolated or separated from ignition...

42 CFR § 512.610 - Waiver of SNF 3-day rule.

Code of Federal Regulations, 2010 CFR

2017-10-01

... (CONTINUED) HEALTH CARE INFRASTRUCTURE AND MODEL PROGRAMS EPISODE PAYMENT MODEL Waivers § 512.610 Waiver of... is— (1) Waived for the AMI model; (2) Not waived for the CABG model; and (3) Not waived for the SHFFT model. (b) Waiver of the SNF 3-day rule. For episodes being tested in those EPMs where the SNF 3-day...

Main Principles of the Perspective System of SNF Management in Russia - 13333

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

Baryshnikov, Mikhail

For the last several years the System of the Spent Nuclear Fuel management in Russia was seriously changed. The paper describes the main principles of the changes and the bases of the Perspective System of SNF Management in Russia. Among such the bases there are the theses with the interesting names like 'total knowledge', 'pollutant pays' and 'pay and forget'. There is also a brief description of the modern Russian SNF Management Infrastructure. And an outline of the whole System. The System which is - in case of Russia - is quite necessary to adjust SNF accumulation and to utilizemore » the nuclear heritage. (authors)« less

Mechanisms of regulation of SNF1/AMPK/SnRK1 protein kinases.

PubMed

Crozet, Pierre; Margalha, Leonor; Confraria, Ana; Rodrigues, Américo; Martinho, Cláudia; Adamo, Mattia; Elias, Carlos A; Baena-González, Elena

2014-01-01

The SNF1 (sucrose non-fermenting 1)-related protein kinases 1 (SnRKs1) are the plant orthologs of the budding yeast SNF1 and mammalian AMPK (AMP-activated protein kinase). These evolutionarily conserved kinases are metabolic sensors that undergo activation in response to declining energy levels. Upon activation, SNF1/AMPK/SnRK1 kinases trigger a vast transcriptional and metabolic reprograming that restores energy homeostasis and promotes tolerance to adverse conditions, partly through an induction of catabolic processes and a general repression of anabolism. These kinases typically function as a heterotrimeric complex composed of two regulatory subunits, β and γ, and an α-catalytic subunit, which requires phosphorylation of a conserved activation loop residue for activity. Additionally, SNF1/AMPK/SnRK1 kinases are controlled by multiple mechanisms that have an impact on kinase activity, stability, and/or subcellular localization. Here we will review current knowledge on the regulation of SNF1/AMPK/SnRK1 by upstream components, post-translational modifications, various metabolites, hormones, and others, in an attempt to highlight both the commonalities of these essential eukaryotic kinases and the divergences that have evolved to cope with the particularities of each one of these systems.

Mechanisms of regulation of SNF1/AMPK/SnRK1 protein kinases

PubMed Central

Crozet, Pierre; Margalha, Leonor; Confraria, Ana; Rodrigues, Américo; Martinho, Cláudia; Adamo, Mattia; Elias, Carlos A.; Baena-González, Elena

2014-01-01

The SNF1 (sucrose non-fermenting 1)-related protein kinases 1 (SnRKs1) are the plant orthologs of the budding yeast SNF1 and mammalian AMPK (AMP-activated protein kinase). These evolutionarily conserved kinases are metabolic sensors that undergo activation in response to declining energy levels. Upon activation, SNF1/AMPK/SnRK1 kinases trigger a vast transcriptional and metabolic reprograming that restores energy homeostasis and promotes tolerance to adverse conditions, partly through an induction of catabolic processes and a general repression of anabolism. These kinases typically function as a heterotrimeric complex composed of two regulatory subunits, β and γ, and an α-catalytic subunit, which requires phosphorylation of a conserved activation loop residue for activity. Additionally, SNF1/AMPK/SnRK1 kinases are controlled by multiple mechanisms that have an impact on kinase activity, stability, and/or subcellular localization. Here we will review current knowledge on the regulation of SNF1/AMPK/SnRK1 by upstream components, post-translational modifications, various metabolites, hormones, and others, in an attempt to highlight both the commonalities of these essential eukaryotic kinases and the divergences that have evolved to cope with the particularities of each one of these systems. PMID:24904600

SWI/SNF interacts with cleavage and polyadenylation factors and facilitates pre-mRNA 3' end processing.

PubMed

Yu, Simei; Jordán-Pla, Antonio; Gañez-Zapater, Antoni; Jain, Shruti; Rolicka, Anna; Östlund Farrants, Ann-Kristin; Visa, Neus

2018-05-31

SWI/SNF complexes associate with genes and regulate transcription by altering the chromatin at the promoter. It has recently been shown that these complexes play a role in pre-mRNA processing by associating at alternative splice sites. Here, we show that SWI/SNF complexes are involved also in pre-mRNA 3' end maturation by facilitating 3' end cleavage of specific pre-mRNAs. Comparative proteomics show that SWI/SNF ATPases interact physically with subunits of the cleavage and polyadenylation complexes in fly and human cells. In Drosophila melanogaster, the SWI/SNF ATPase Brahma (dBRM) interacts with the CPSF6 subunit of cleavage factor I. We have investigated the function of dBRM in 3' end formation in S2 cells by RNA interference, single-gene analysis and RNA sequencing. Our data show that dBRM facilitates pre-mRNA cleavage in two different ways: by promoting the association of CPSF6 to the cleavage region and by stabilizing positioned nucleosomes downstream of the cleavage site. These findings show that SWI/SNF complexes play a role also in the cleavage of specific pre-mRNAs in animal cells.

Prevalence of sorbitol non-fermenting Shiga toxin-producing Escherichia coli in Black Bengal goats on smallholdings.

PubMed

Das Gupta, M; Das, A; Islam, M Z; Biswas, P K

2016-09-01

A cross-sectional survey was carried out in Bangladesh with the sampling of 514 Black Bengal goats on smallholdings to determine the presence of sorbitol non-fermenting (SNF) Shiga toxin-producing E. coli (STEC). Swab samples collected from the recto-anal junction were plated onto cefixime and potassium tellurite added sorbitol MacConkey (CT-SMAC) agar, a selective medium for STEC O157 serogroup, where this serogroup and other SNF STEC produce colourless colonies. The SNF E. coli (SNF EC) isolates obtained from the survey were investigated by PCR for the presence of Shiga toxin-producing genes, stx1 and stx2, and two other virulence genes, eae and hlyA that code for adherence factor (intimin protein) and pore-forming cytolysin, respectively. The SNF EC isolates were also assessed for the presence of the rfbO157 gene to verify their identity to O157 serogroup. The results revealed that the proportions of goats carrying SNF EC isolates and stx1 and stx2 genes were 6·2% (32/514) [95% confidence interval (CI) 4·4-8·7)], 1·2% (95% CI 0·5-2·6) and 1·2% (95% CI 0·5-2·6), respectively. All the SNF STEC tested negative for rfbO157, hlyA and eae genes. The risk for transmission of STEC from Black Bengal goats to humans is low.

SNF5 Mutation Leads to Intractable Pain in Schwannomatosis Patients

DTIC Science & Technology

2012-07-01

AD_________________ Award Number: W81XWH-11-1-0143 TITLE: SNF5 mutation leads to intractable pain in schwannomatosis patients...DATES COVERED 15-June-2011 to 14-June-2012 4. TITLE AND SUBTITLE SNF5 mutation leads to intractable pain in schwannomatosis patients 5a. CONTRACT...6 Introduction. Schwannomatosis does not affect longevity but it has profound effects on the patient’s quality of

STORAGE/SEDIMENTATION FACILITIES FOR CONTROL OF STORM AND COMBINED SEWER OVERFLOW: DESIGN MANUAL

EPA Science Inventory

This manual describes applications of storage facilities in wet-weather flow management and presents step-by-step procedures for analysis and design of storage-treatment facilities. Retention, detention, and sedimentation storage information is classified and described. Internati...

Parametric Study of the Effect of Burnable Poison Rods for PWR Burnup Credit

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

Wagner, J.C.

2001-09-28

The Interim Staff Guidance on burnup credit (ISG-8) issued by the United States Nuclear Regulatory Commission's (U.S. NRC) Spent Fuel Project Office recommends restricting the use of burnup credit to assemblies that have not used burnable absorbers. This recommended restriction eliminates a large portion of the currently discharged spent fuel assemblies from cask loading, and thus severely limits the practical usefulness of burnup credit. In the absence of readily available information on burnable poison rod (BPR) design specifications and usage in U.S. pressurized-water-reactors (PWRs), and the subsequent reactivity effect of BPR exposure on discharged spent nuclear fuel (SNF), NRC staffmore » has indicated a need for additional information in these areas. In response, this report presents a parametric study of the effect of BPR exposure on the reactivity of SNF for various BPR designs, fuel enrichments, and exposure conditions, and documents BPR design specifications. Trends in the reactivity effects of BPRs are established with infinite pin-cell and assembly array calculations with the SCALE and HELIOS code packages, respectively. Subsequently, the reactivity effects of BPRs for typical initial enrichment and burnup combinations are quantified based on three-dimensional (3-D) KENO V.a Monte Carlo calculations with a realistic rail-type cask designed for burnup credit. The calculations demonstrate that the positive reactivity effect due to BPR exposure increases nearly linearly with burnup and is dependent on the number, poison loading, and design of the BPRs and the initial fuel enrichment. Expected typical reactivity increases, based on one-cycle BPR exposure, were found to be less than 1% {Delta}k. Based on the presented analysis, guidance is offered on an appropriate approach for calculating bounding SNF isotopic data for assemblies exposed to BPRs. Although the analyses do not address the issue of validation of depletion methods for assembly designs with BPRs, they do demonstrate that the effect of BPRs is generally well behaved and that independent codes and cross-section libraries predict similar results. The report concludes with a discussion of the issues for consideration and recommendations for inclusion of SNF assemblies exposed to BPRs in criticality safety analyses using burnup credit for dry cask storage and transport.« less

7 CFR 1436.4 - Application for loans.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., except loans for renewable biomass storage facilities and cold storage facilities for fruits and... the administrative county office. (2) For loans for renewable biomass storage facilities and cold...

7 CFR 1436.4 - Application for loans.

Code of Federal Regulations, 2012 CFR

2012-01-01

..., except loans for renewable biomass storage facilities and cold storage facilities for fruits and... the administrative county office. (2) For loans for renewable biomass storage facilities and cold...

7 CFR 1436.4 - Application for loans.

Code of Federal Regulations, 2013 CFR

2013-01-01

..., except loans for renewable biomass storage facilities and cold storage facilities for fruits and... the administrative county office. (2) For loans for renewable biomass storage facilities and cold...

7 CFR 1436.4 - Application for loans.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., except loans for renewable biomass storage facilities and cold storage facilities for fruits and... the administrative county office. (2) For loans for renewable biomass storage facilities and cold...

7 CFR 1436.4 - Application for loans.

Code of Federal Regulations, 2010 CFR

2010-01-01

..., except loans for renewable biomass storage facilities and cold storage facilities for fruits and... the administrative county office. (2) For loans for renewable biomass storage facilities and cold...

36 CFR 1232.14 - What requirements must an agency meet before it transfers records to a records storage facility?

Code of Federal Regulations, 2010 CFR

2010-07-01

... agency meet before it transfers records to a records storage facility? 1232.14 Section 1232.14 Parks... RECORDS TO RECORDS STORAGE FACILITIES § 1232.14 What requirements must an agency meet before it transfers records to a records storage facility? An agency must meet the following requirements before it transfers...

Melton Valley Storage Tanks Capacity Increase Project, Oak Ridge National Laboratory, Oak Ridge, Tennessee

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

NONE

1995-04-01

The US Department of Energy (DOE) proposes to construct and maintain additional storage capacity at Oak Ridge National Laboratory (ORNL), Oak Ridge, Tennessee, for liquid low-level radioactive waste (LLLW). New capacity would be provided by a facility partitioned into six individual tank vaults containing one 100,000 gallon LLLW storage tank each. The storage tanks would be located within the existing Melton Valley Storage Tank (MVST) facility. This action would require the extension of a potable water line approximately one mile from the High Flux Isotope Reactor (HFIR) area to the proposed site to provide the necessary potable water for themore » facility including fire protection. Alternatives considered include no-action, cease generation, storage at other ORR storage facilities, source treatment, pretreatment, and storage at other DOE facilities.« less

77 FR 31841 - Notice of Applications for Authorization To Abandon Facilities and Services and To Acquire...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-30

... To Abandon Facilities and Services and To Acquire Facilities by Merger Steuben Gas Storage Company... Field Storage Facilities (Adrian Field) which Steuben operates pursuant to certificates of public... authorization to charge market based rates following its acquisition of the Adrian Field Storage Facility. The...

Application of federal indicators in nursing-home drug-regimen review.

PubMed

Shannon, R C; De Muth, J E

1984-05-01

Numbers of medications per patient and rate of drug administration errors were compared in Wisconsin long-term care facilities that used federal indicators in conducting drug-regimen review versus facilities that did not use the indicators. Data were collected from 1132 charts in 24 facilities randomly selected from a state survey schedule for June-October 1982. Both prescription and nonprescription drugs that patients received during the 30-day period preceding the survey were counted. Medication use was compared by facility type--skilled-nursing facility (SNF), intermediate-care facility (ICF), or ICF for the mentally retarded. The federal indicators were used in 10 facilities. Mean number of medications used per patient where indicators were applied (5.4 versus 6.6 for SNFs and 3.4 versus 5.8 for ICFs ) was not significantly different. In SNFs using the indicators, patients received 5.6 medications where the consultant pharmacist was also the provider and 5.2 where the consultant was not the provider. Medication use was not significantly different by facility type. The number of drug administration irregularities per 100 residents was significantly greater where indicators were not applied. Further study is needed to determine whether use of federal indicators encourages more efficient and appropriate drug therapy for patients in long-term care facilities.

A Nucleotide-Driven Switch Regulates Flanking DNA Length Sensing by a Dimeric Chromatin Remodeler

PubMed Central

Leonard, John D.; Narlikar, Geeta J.

2015-01-01

SUMMARY The ATP-dependent chromatin assembly factor (ACF) is a dimeric motor that spaces nucleosomes to promote formation of silent chromatin. Two copies of its ATPase subunit SNF2h bind opposite sides of a nucleosome, but how these protomers avoid competition is unknown. SNF2h senses the length of DNA flanking a nucleosome via its HAND-SANT-SLIDE (HSS) domain, yet it is unclear how this interaction enhances remodeling. Using covalently connected SNF2h dimers we show that dimerization accelerates remodeling and that the HSS contributes to communication between protomers. We further identify a nucleotide-dependent conformational change in SNF2h. In one conformation the HSS binds flanking DNA, and in another conformation the HSS engages the nucleosome core. Based on these results, we propose a model in which DNA length sensing and translocation are performed by two distinct conformational states of SNF2h. Such separation of function suggests that these activities could be independently regulated to affect remodeling outcomes. PMID:25684208

Formation of a Snf1-Mec1-Atg1 Module on Mitochondria Governs Energy Deprivation-Induced Autophagy by Regulating Mitochondrial Respiration.

PubMed

Yi, Cong; Tong, Jingjing; Lu, Puzhong; Wang, Yizheng; Zhang, Jinxie; Sun, Chen; Yuan, Kangning; Xue, Renyu; Zou, Bing; Li, Nianzhong; Xiao, Shuhua; Dai, Chong; Huang, Yuwei; Xu, Liling; Li, Lin; Chen, She; Miao, Di; Deng, Haiteng; Li, Hongliang; Yu, Li

2017-04-10

Autophagy is essential for maintaining glucose homeostasis, but the mechanism by which energy deprivation activates autophagy is not fully understood. We show that Mec1/ATR, a member of the DNA damage response pathway, is essential for glucose starvation-induced autophagy. Mec1, Atg13, Atg1, and the energy-sensing kinase Snf1 are recruited to mitochondria shortly after glucose starvation. Mec1 is recruited through the adaptor protein Ggc1. Snf1 phosphorylates Mec1 on the mitochondrial surface, leading to recruitment of Atg1 to mitochondria. Furthermore, the Snf1-mediated Mec1 phosphorylation and mitochondrial recruitment of Atg1 are essential for maintaining mitochondrial respiration during glucose starvation, and active mitochondrial respiration is required for energy deprivation-activated autophagy. Thus, formation of a Snf1-Mec1-Atg1 module on mitochondria governs energy deprivation-induced autophagy by regulating mitochondrial respiration. Copyright © 2017 Elsevier Inc. All rights reserved.

The SWI/SNF Subunit INI1 Contains an N-Terminal Winged Helix DNA Binding Domain that Is a Target for Mutations in Schwannomatosis.

PubMed

Allen, Mark D; Freund, Stefan M V; Zinzalla, Giovanna; Bycroft, Mark

2015-07-07

SWI/SNF complexes use the energy of ATP hydrolysis to remodel chromatin. In mammals they play a central role in regulating gene expression during differentiation and proliferation. Mutations in SWI/SNF subunits are among the most frequent gene alterations in cancer. The INI1/hSNF5/SMARCB1 subunit is mutated in both malignant rhabdoid tumor, a highly aggressive childhood cancer, and schwannomatosis, a tumor-predisposing syndrome characterized by mostly benign tumors of the CNS. Here, we show that mutations in INI1 that cause schwannomatosis target a hitherto unidentified N-terminal winged helix DNA binding domain that is also present in the BAF45a/PHF10 subunit of the SWI/SNF complex. The domain is structurally related to the SKI/SNO/DAC domain, which is found in a number of metazoan chromatin-associated proteins. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

The effects of a Pilates-based exercise rehabilitation program on functional outcome and fall risk reduction in an aging adult status-post traumatic hip fracture due to a fall.

PubMed

Stivala, Adam; Hartley, Greg

2014-01-01

Currently, little information describing the relationship of Pilates-based strength and stability exercises with fall risk in the geriatric population exists. The purpose of this report was to examine the impact of a Pilates-based rehabilitation (PBR) program on reducing fall risk in an aging adult status postfall with resulting hip fracture and open reduction and internal fixation. The patient was an 84-year-old woman admitted to a skilled nursing facility (SNF) after a right hip fracture resulting from a fall at home. The patient's relevant medical history included frequent falls due to loss of balance, a previous left hip fracture with resultant arthroplasty, and a stroke roughly 20 years prior. The patient received physical therapy and occupational therapy 6 days per week for 26 days in an SNF. The physical therapy intervention consisted of gait and transfer training, neuromuscular reeducation, and an adjunct of specialized PBR exercises for the following impairments: decreased core strength and awareness and poor dynamic stabilization during functional activities. The patient demonstrated increases in lower extremity strength and active range of motion, ambulation distance and speed, and transfer ability. The patient was able to return home and live with her husband while requiring only incidental assistance with activities of daily living. She was able to independently ambulate around her home with her rolling walker. Her fall risk was also reduced from initial evaluation based on several fall risk assessments, including the Four Square Step Test, the Berg Balance Scale, and the Timed Up and Go. This case illustrates the benefit of integrating PBR exercises into a standard SNF rehabilitation program, which may contribute to decreased fall risk.

30 CFR 57.6130 - Explosive material storage facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Explosive material storage facilities. 57.6130 Section 57.6130 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Storage-Surface Only § 57.6130 Explosive material storage facilities. (a) Detonators and explosives shall...

30 CFR 57.6130 - Explosive material storage facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Explosive material storage facilities. 57.6130 Section 57.6130 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Storage-Surface Only § 57.6130 Explosive material storage facilities. (a) Detonators and explosives shall...

27 CFR 20.165 - Storage facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2011-04-01 2011-04-01 false Storage facilities. 20.165... Users of Specially Denatured Spirits Premises and Equipment § 20.165 Storage facilities. (a) Storerooms... for locking. (b) Each stationary tank used for the storage of specially denatured spirits shall be...

27 CFR 20.165 - Storage facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Storage facilities. 20.165... Users of Specially Denatured Spirits Premises and Equipment § 20.165 Storage facilities. (a) Storerooms... for locking. (b) Each stationary tank used for the storage of specially denatured spirits shall be...

18 CFR 157.213 - Underground storage field facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 18 Conservation of Power and Water Resources 1 2013-04-01 2013-04-01 false Underground storage... of the Natural Gas Act for Certain Transactions and Abandonment § 157.213 Underground storage field... operate facilities for the remediation and maintenance of an existing underground storage facility...

27 CFR 20.165 - Storage facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2012-04-01 2012-04-01 false Storage facilities. 20.165... Users of Specially Denatured Spirits Premises and Equipment § 20.165 Storage facilities. (a) Storerooms... for locking. (b) Each stationary tank used for the storage of specially denatured spirits shall be...

27 CFR 20.165 - Storage facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2013-04-01 2013-04-01 false Storage facilities. 20.165... Users of Specially Denatured Spirits Premises and Equipment § 20.165 Storage facilities. (a) Storerooms... for locking. (b) Each stationary tank used for the storage of specially denatured spirits shall be...

18 CFR 157.213 - Underground storage field facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 18 Conservation of Power and Water Resources 1 2014-04-01 2014-04-01 false Underground storage... of the Natural Gas Act for Certain Transactions and Abandonment § 157.213 Underground storage field... operate facilities for the remediation and maintenance of an existing underground storage facility...

27 CFR 20.165 - Storage facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2014-04-01 2014-04-01 false Storage facilities. 20.165... Users of Specially Denatured Spirits Premises and Equipment § 20.165 Storage facilities. (a) Storerooms... for locking. (b) Each stationary tank used for the storage of specially denatured spirits shall be...

Incidental (malignancy) and coincidental (idiopathic polydactylous longitudinal erythronychia) conditions in patients with segmental neurofibromatosis.

PubMed

Cohen, Philip R

2013-04-01

Segmental neurofibromatosis (SNF) is an uncommon presentation of neurofibromatosis type 1 (NF-1). Although patients with SNF are at a lower risk for developing NF-l-associated complications, the estimated occurrence of related malignancies may be approaching the frequency observed in patients with NF-1. Idiopathic polydactylous longitudinal erythronychia also may be associated with SNF, though the frequency of this association remains to be determined.

Transcriptome analysis of two recombinant inbred lines of common bean contrasting for symbiotic nitrogen fixation

PubMed Central

Kamfwa, Kelvin; Zhao, Dongyan; Kelly, James D.

2017-01-01

Common bean (Phaseolus vulgaris L.) fixes atmospheric nitrogen (N2) through symbiotic nitrogen fixation (SNF) at levels lower than other grain legume crops. An understanding of the genes and molecular mechanisms underlying SNF will enable more effective strategies for the genetic improvement of SNF traits in common bean. In this study, transcriptome profiling was used to identify genes and molecular mechanisms underlying SNF differences between two common bean recombinant inbred lines that differed in their N-fixing abilities. Differential gene expression and functional enrichment analyses were performed on leaves, nodules and roots of the two lines when grown under N-fixing and non-fixing conditions. Receptor kinases, transmembrane transporters, and transcription factors were among the differentially expressed genes identified under N-fixing conditions, but not under non-fixing conditions. Genes up-regulated in the stronger nitrogen fixer, SA36, included those involved in molecular functions such as purine nucleoside binding, oxidoreductase and transmembrane receptor activities in nodules, and transport activity in roots. Transcription factors identified in this study are candidates for future work aimed at understanding the functional role of these genes in SNF. Information generated in this study will support the development of gene-based markers to accelerate genetic improvement of SNF in common bean. PMID:28192540

A Prospective, Multicenter Study to Compare a Disposable, High-fluid Capacity Underpad to Nonpermeable, Disposable, Reusable Containment Products on Incontinence-associated Dermatitis Rates Among Skilled Nursing Facility Residents.

PubMed

Motta, Glenda; Milne, Catherine T

2017-12-01

Due to the high prevalence of incontinence among skilled nursing facility (SNF) residents, incontinence-associated derma- titis (IAD) is a common occurrence. In addition, facility staff may mistakenly identify IAD as a pressure injury. A prospective, descriptive, multicenter study was conducted in 3 Connecticut facilities to evaluate the effect of substituting a disposable, high- uid capacity underpad for nonpermeable disposable and reusable containment products on the rate of IADs. Residents with and without IAD but with high IAD risk scores who were bed- or chairbound or ambulatory and used disposable nonpermeable briefs and underpads or reusable, laundered containment products when in bed longer than 2 hours were randomly enrolled and observed for a 4-week period. Facility staff were trained on the importance of differentiating between IAD and pressure injury; they substituted the study product (a disposable, high- uid capacity underpad) for all previously used containment products. Patient risk for IAD and skin condition were assessed using the Perineal Assessment Tool (PAT) and the Skin Condition Assessment Tool (SAT), respectively, at 5 time points: baseline, week 1, week 2, week 3, and week 4. The PAT is a 4-item instrument based conceptually on the 4 determinants in perineal skin breakdown; subscales are rated from 1 (least risk) to 3 (most risk), with a total score range of 4 to 12. The SAT is used to evaluate IAD speci cally, generating a cumulative severity score ranging from 0 to 3 on area of skin affected, degree of redness, and depth of ero- sion. Final data analysis was conducted on 40 residents: 25 had IAD present at enrollment and 15 were deemed high risk for developing IAD. Mean SAT scores in the 25 participants with IAD decreased with signi cance at week 1 (P = .0016), week 2 (P = .0023), week 3 (P = .0005), and week 4 (P <.0001). Baseline IAD severity scores averaged 3.3 ± 1.7. Overall IAD average severity scores in this group decreased from baseline mean of 3.3 ± 1.7 to 0.7 ± 1.4 at week 4 (P <.001). The 15 participants with intact, nondamaged skin at enrollment did not develop IAD from baseline to week 4, and PAT score risk levels decreased from high (7 or greater) to low (6 or less) as a result of a speci c reduction in the duration of irritant exposure category for 11 (73%) of this group of participants by week 4. PAT risk level scores for both IAD and non-IAD participants at baseline averaged 8.1 ± 1.4; after 4 weeks, they averaged 7.0 ± 1.5). Although change was not significant, results suggest the use of a disposable, high- uid capacity underpad improved SAT scores over time. IAD rates increased in each facility, but pressure injury incidence rates decreased for the study duration. Replacing a nonpermeable, reusable containment product with a disposable, high- uid capacity underpad when SNF residents are in bed longer than 2 hours may impact the severity of IAD and reduce its incidence. The inverse impact reported on IAD and pressure injury incidence rates 1 month after training suggest study educational efforts had a short-lasting effect. Future research is indicated to determine the most effective method to improve nurses' ability to identify and distinguish IAD from pressure injury in the SNF setting.

A novel signal transduction pathway in Saccharomyces cerevisiae defined by Snf3-regulated expression of HXT6.

PubMed Central

Liang, H; Gaber, R F

1996-01-01

We show that cells deleted for SNF3, HXT1, HXT2, HXT3, HXT4, HXT6, and HXT7 do not take up glucose and cannot grow on media containing glucose as a sole carbon source. The expression of Hxt1, Hxt2, Hxt3, Hxt6, or Gal2 in these cells resulted in glucose transport and allowed growth on glucose media. In contrast, the expression of Snf3 failed to confer glucose uptake or growth on glucose. HXT6 is highly expressed on raffinose, low glucose, or nonfermentable carbon sources but is repressed in the presence of high concentrations of glucose. The maintenance of HXT6 glucose repression is strictly dependent on Snf3 and not on intracellular glucose. In snf3 delta cells expression of HXT6 is constitutive even when the entire repertoire of HXT genes is present and glucose uptake is abundant. In addition, glucose repression of HXT6 does not require glucose uptake by HXT1, HXT2, HXT3 or HXT4. We show that a signal transduction pathway defined by the Snf3-dependent hexose regulation of HXT6 is distinct from but also overlaps with general glucose regulation pathways in Saccharomyces cerevisiae. Finally, glucose repression of ADH2 and SUC2 is intact in snf3 delta hxt1 delta hxt2 delta hxt3 delta hxt4 delta hxt6 delta hxt7 delta gal2 cells, suggesting that the sensing and signaling mechanism for general glucose repression is independent from glucose uptake. Images PMID:8970157

46 CFR 108.237 - Fuel storage facilities.

Code of Federal Regulations, 2014 CFR

2014-10-01

... AND EQUIPMENT Construction and Arrangement Helicopter Facilities § 108.237 Fuel storage facilities. (a) Helicopter fuel storage tanks must be installed as far as practicable from— (1) The landing area; and (2...

PAS kinase is activated by direct SNF1-dependent phosphorylation and mediates inhibition of TORC1 through the phosphorylation and activation of Pbp1.

PubMed

DeMille, Desiree; Badal, Bryan D; Evans, J Brady; Mathis, Andrew D; Anderson, Joseph F; Grose, Julianne H

2015-02-01

We describe the interplay between three sensory protein kinases in yeast: AMP-regulated kinase (AMPK, or SNF1 in yeast), PAS kinase 1 (Psk1 in yeast), and the target of rapamycin complex 1 (TORC1). This signaling cascade occurs through the SNF1-dependent phosphorylation and activation of Psk1, which phosphorylates and activates poly(A)- binding protein binding protein 1 (Pbp1), which then inhibits TORC1 through sequestration at stress granules. The SNF1-dependent phosphorylation of Psk1 appears to be direct, in that Snf1 is necessary and sufficient for Psk1 activation by alternate carbon sources, is required for altered Psk1 protein mobility, is able to phosphorylate Psk1 in vitro, and binds Psk1 via its substrate-targeting subunit Gal83. Evidence for the direct phosphorylation and activation of Pbp1 by Psk1 is also provided by in vitro and in vivo kinase assays, including the reduction of Pbp1 localization at distinct cytoplasmic foci and subsequent rescue of TORC1 inhibition in PAS kinase-deficient yeast. In support of this signaling cascade, Snf1-deficient cells display increased TORC1 activity, whereas cells containing hyperactive Snf1 display a PAS kinase-dependent decrease in TORC1 activity. This interplay between yeast SNF1, Psk1, and TORC1 allows for proper glucose allocation during nutrient depletion, reducing cell growth and proliferation when energy is low. © 2015 DeMille et al. This article is distributed by The American Society for Cell Biology under license from the author(s). Two months after publication it is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

An Approach for Validating Actinide and Fission Product Burnup Credit Criticality Safety Analyses-Isotopic Composition Predictions

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

Radulescu, Georgeta; Gauld, Ian C; Ilas, Germina

2011-01-01

The expanded use of burnup credit in the United States (U.S.) for storage and transport casks, particularly in the acceptance of credit for fission products, has been constrained by the availability of experimental fission product data to support code validation. The U.S. Nuclear Regulatory Commission (NRC) staff has noted that the rationale for restricting the Interim Staff Guidance on burnup credit for storage and transportation casks (ISG-8) to actinide-only is based largely on the lack of clear, definitive experiments that can be used to estimate the bias and uncertainty for computational analyses associated with using burnup credit. To address themore » issues of burnup credit criticality validation, the NRC initiated a project with the Oak Ridge National Laboratory to (1) develop and establish a technically sound validation approach for commercial spent nuclear fuel (SNF) criticality safety evaluations based on best-available data and methods and (2) apply the approach for representative SNF storage and transport configurations/conditions to demonstrate its usage and applicability, as well as to provide reference bias results. The purpose of this paper is to describe the isotopic composition (depletion) validation approach and resulting observations and recommendations. Validation of the criticality calculations is addressed in a companion paper at this conference. For isotopic composition validation, the approach is to determine burnup-dependent bias and uncertainty in the effective neutron multiplication factor (keff) due to bias and uncertainty in isotopic predictions, via comparisons of isotopic composition predictions (calculated) and measured isotopic compositions from destructive radiochemical assay utilizing as much assay data as is available, and a best-estimate Monte Carlo based method. This paper (1) provides a detailed description of the burnup credit isotopic validation approach and its technical bases, (2) describes the application of the approach for representative pressurized water reactor and boiling water reactor safety analysis models to demonstrate its usage and applicability, (3) provides reference bias and uncertainty results based on a quality-assurance-controlled prerelease version of the Scale 6.1 code package and the ENDF/B-VII nuclear cross section data.« less

30 CFR 56.6130 - Explosive material storage facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Explosive material storage facilities. 56.6130 Section 56.6130 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Storage § 56.6130 Explosive material storage facilities. (a) Detonators and explosives shall be stored in...

30 CFR 57.4430 - Surface storage facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Surface storage facilities. 57.4430 Section 57... and Control Flammable and Combustible Liquids and Gases § 57.4430 Surface storage facilities. The requirements of this standard apply to surface areas only. (a) Storage tanks for flammable or combustible...

30 CFR 57.6800 - Storage facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Storage facilities. 57.6800 Section 57.6800...-Surface and Underground § 57.6800 Storage facilities. When repair work which could produce a spark or flame is to be performed on a storage facility— (a) The explosive material shall be moved to another...

27 CFR 19.79 - Discontinuance of storage facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 27 Alcohol, Tobacco Products and Firearms 1 2010-04-01 2010-04-01 false Discontinuance of storage... Provisions Activities Not Subject to This Part § 19.79 Discontinuance of storage facilities. When the appropriate TTB officer finds that any facilities for the storage of spirits on bonded premises are unsafe or...

30 CFR 57.6800 - Storage facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Storage facilities. 57.6800 Section 57.6800...-Surface and Underground § 57.6800 Storage facilities. When repair work which could produce a spark or flame is to be performed on a storage facility— (a) The explosive material shall be moved to another...

30 CFR 57.4430 - Surface storage facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Surface storage facilities. 57.4430 Section 57... and Control Flammable and Combustible Liquids and Gases § 57.4430 Surface storage facilities. The requirements of this standard apply to surface areas only. (a) Storage tanks for flammable or combustible...

30 CFR 57.6800 - Storage facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Storage facilities. 57.6800 Section 57.6800...-Surface and Underground § 57.6800 Storage facilities. When repair work which could produce a spark or flame is to be performed on a storage facility— (a) The explosive material shall be moved to another...

30 CFR 57.6800 - Storage facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Storage facilities. 57.6800 Section 57.6800...-Surface and Underground § 57.6800 Storage facilities. When repair work which could produce a spark or flame is to be performed on a storage facility— (a) The explosive material shall be moved to another...

30 CFR 56.6130 - Explosive material storage facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Explosive material storage facilities. 56.6130 Section 56.6130 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR METAL AND... Storage § 56.6130 Explosive material storage facilities. (a) Detonators and explosives shall be stored in...

30 CFR 57.6800 - Storage facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Storage facilities. 57.6800 Section 57.6800...-Surface and Underground § 57.6800 Storage facilities. When repair work which could produce a spark or flame is to be performed on a storage facility— (a) The explosive material shall be moved to another...

40 CFR 160.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 23 2010-07-01 2010-07-01 false Specimen and data storage facilities. 160.51 Section 160.51 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) PESTICIDE PROGRAMS GOOD LABORATORY PRACTICE STANDARDS Facilities § 160.51 Specimen and data storage facilities. Space...

Wongabel rhabdovirus accessory protein U3 targets the SWI/SNF chromatin remodeling complex.

PubMed

Joubert, D Albert; Rodriguez-Andres, Julio; Monaghan, Paul; Cummins, Michelle; McKinstry, William J; Paradkar, Prasad N; Moseley, Gregory W; Walker, Peter J

2015-01-15

Wongabel virus (WONV) is an arthropod-borne rhabdovirus that infects birds. It is one of the growing array of rhabdoviruses with complex genomes that encode multiple accessory proteins of unknown function. In addition to the five canonical rhabdovirus structural protein genes (N, P, M, G, and L), the 13.2-kb negative-sense single-stranded RNA (ssRNA) WONV genome contains five uncharacterized accessory genes, one overlapping the N gene (Nx or U4), three located between the P and M genes (U1 to U3), and a fifth one overlapping the G gene (Gx or U5). Here we show that WONV U3 is expressed during infection in insect and mammalian cells and is required for efficient viral replication. A yeast two-hybrid screen against a mosquito cell cDNA library identified that WONV U3 interacts with the 83-amino-acid (aa) C-terminal domain of SNF5, a component of the SWI/SNF chromatin remodeling complex. The interaction was confirmed by affinity chromatography, and nuclear colocalization was established by confocal microscopy. Gene expression studies showed that SNF5 transcripts are upregulated during infection of mosquito cells with WONV, as well as West Nile virus (Flaviviridae) and bovine ephemeral fever virus (Rhabdoviridae), and that SNF5 knockdown results in increased WONV replication. WONV U3 also inhibits SNF5-regulated expression of the cytokine gene CSF1. The data suggest that WONV U3 targets the SWI/SNF complex to block the host response to infection. The rhabdoviruses comprise a large family of RNA viruses infecting plants, vertebrates, and invertebrates. In addition to the major structural proteins (N, P, M, G, and L), many rhabdoviruses encode a diverse array of accessory proteins of largely unknown function. Understanding the role of these proteins may reveal much about host-pathogen interactions in infected cells. Here we examine accessory protein U3 of Wongabel virus, an arthropod-borne rhabdovirus that infects birds. We show that U3 enters the nucleus and interacts with SNF5, a component of the chromatin remodeling complex that is upregulated in response to infection and restricts viral replication. We also show that U3 inhibits SNF5-regulated expression of the cytokine colony-stimulating factor 1 (CSF1), suggesting that it targets the chromatin remodeling complex to block the host response to infection. This study appears to provide the first evidence of a virus targeting SNF5 to inhibit host gene expression. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Wongabel Rhabdovirus Accessory Protein U3 Targets the SWI/SNF Chromatin Remodeling Complex

PubMed Central

Joubert, D. Albert; Rodriguez-Andres, Julio; Monaghan, Paul; Cummins, Michelle; McKinstry, William J.; Paradkar, Prasad N.; Moseley, Gregory W.

2014-01-01

ABSTRACT Wongabel virus (WONV) is an arthropod-borne rhabdovirus that infects birds. It is one of the growing array of rhabdoviruses with complex genomes that encode multiple accessory proteins of unknown function. In addition to the five canonical rhabdovirus structural protein genes (N, P, M, G, and L), the 13.2-kb negative-sense single-stranded RNA (ssRNA) WONV genome contains five uncharacterized accessory genes, one overlapping the N gene (Nx or U4), three located between the P and M genes (U1 to U3), and a fifth one overlapping the G gene (Gx or U5). Here we show that WONV U3 is expressed during infection in insect and mammalian cells and is required for efficient viral replication. A yeast two-hybrid screen against a mosquito cell cDNA library identified that WONV U3 interacts with the 83-amino-acid (aa) C-terminal domain of SNF5, a component of the SWI/SNF chromatin remodeling complex. The interaction was confirmed by affinity chromatography, and nuclear colocalization was established by confocal microscopy. Gene expression studies showed that SNF5 transcripts are upregulated during infection of mosquito cells with WONV, as well as West Nile virus (Flaviviridae) and bovine ephemeral fever virus (Rhabdoviridae), and that SNF5 knockdown results in increased WONV replication. WONV U3 also inhibits SNF5-regulated expression of the cytokine gene CSF1. The data suggest that WONV U3 targets the SWI/SNF complex to block the host response to infection. IMPORTANCE The rhabdoviruses comprise a large family of RNA viruses infecting plants, vertebrates, and invertebrates. In addition to the major structural proteins (N, P, M, G, and L), many rhabdoviruses encode a diverse array of accessory proteins of largely unknown function. Understanding the role of these proteins may reveal much about host-pathogen interactions in infected cells. Here we examine accessory protein U3 of Wongabel virus, an arthropod-borne rhabdovirus that infects birds. We show that U3 enters the nucleus and interacts with SNF5, a component of the chromatin remodeling complex that is upregulated in response to infection and restricts viral replication. We also show that U3 inhibits SNF5-regulated expression of the cytokine colony-stimulating factor 1 (CSF1), suggesting that it targets the chromatin remodeling complex to block the host response to infection. This study appears to provide the first evidence of a virus targeting SNF5 to inhibit host gene expression. PMID:25392228

3D simulation as a tool for improving the safety culture during remediation work at Andreeva Bay.

PubMed

Chizhov, K; Sneve, M K; Szőke, I; Mazur, I; Mark, N K; Kudrin, I; Shandala, N; Simakov, A; Smith, G M; Krasnoschekov, A; Kosnikov, A; Kemsky, I; Kryuchkov, V

2014-12-01

Andreeva Bay in northwest Russia hosts one of the former coastal technical bases of the Northern Fleet. Currently, this base is designated as the Andreeva Bay branch of Northwest Center for Radioactive Waste Management (SevRAO) and is a site of temporary storage (STS) for spent nuclear fuel (SNF) and other radiological waste generated during the operation and decommissioning of nuclear submarines and ships. According to an integrated expert evaluation, this site is the most dangerous nuclear facility in northwest Russia. Environmental rehabilitation of the site is currently in progress and is supported by strong international collaboration. This paper describes how the optimization principle (ALARA) has been adopted during the planning of remediation work at the Andreeva Bay STS and how Russian-Norwegian collaboration greatly contributed to ensuring the development and maintenance of a high level safety culture during this process. More specifically, this paper describes how integration of a system, specifically designed for improving the radiological safety of workers during the remediation work at Andreeva Bay, was developed in Russia. It also outlines the 3D radiological simulation and virtual reality based systems developed in Norway that have greatly facilitated effective implementation of the ALARA principle, through supporting radiological characterisation, work planning and optimization, decision making, communication between teams and with the authorities and training of field operators.

Spent Nuclear Fuel Alternative Technology Decision Analysis

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

Shedrow, C.B.

1999-11-29

The Westinghouse Savannah River Company (WSRC) made a FY98 commitment to the Department of Energy (DOE) to recommend a technology for the disposal of aluminum-based spent nuclear fuel (SNF) at the Savannah River Site (SRS). The two technologies being considered, direct co-disposal and melt and dilute, had been previously selected from a group of eleven potential SNF management technologies by the Research Reactor Spent Nuclear Fuel Task Team chartered by the DOE''s Office of Spent Fuel Management. To meet this commitment, WSRC organized the SNF Alternative Technology Program to further develop the direct co-disposal and melt and dilute technologies andmore » ultimately provide a WSRC recommendation to DOE on a preferred SNF alternative management technology.« less

40 CFR 60.5417 - What are the continuous control device monitoring requirements for my storage vessel or...

Code of Federal Regulations, 2013 CFR

2013-07-01

... monitoring requirements for my storage vessel or centrifugal compressor affected facility? 60.5417 Section 60... requirements for my storage vessel or centrifugal compressor affected facility? You must meet the applicable... standards for your storage vessel or centrifugal compressor affected facility. (a) You must install and...

40 CFR 60.5417 - What are the continuous control device monitoring requirements for my storage vessel or...

Code of Federal Regulations, 2014 CFR

2014-07-01

... monitoring requirements for my storage vessel or centrifugal compressor affected facility? 60.5417 Section 60... requirements for my storage vessel or centrifugal compressor affected facility? You must meet the applicable... standards for your storage vessel or centrifugal compressor affected facility. (a) For each control device...

Physicochemical and sensory characteristics of fat-free goat milk yogurt with added stabilizers and skim milk powder fortification.

PubMed

Bruzantin, F P; Daniel, J L P; da Silva, P P M; Spoto, M H F

2016-05-01

Goat milk yogurt has a less consistent coagulum compared with cow milk yogurt; furthermore, the presence of goat milk in foodstuffs imparts a characteristic flavor that can restrict its acceptance by consumers. This study aimed to assess and compare the physicochemical and sensory characteristics of fat-free goat milk yogurts with added stabilizers or bovine skim milk powder to improve the final product. Four treatment additions were evaluated: (1) a mixture of 0.1% (wt/vol) carrageenan and 0.1% (wt/vol) pectin (treatment CR); (2) 0.5% (wt/vol) pectin (treatment PE); (3) 4.65% (wt/vol) bovine skim milk powder (treatment BM); and (4) control (no stabilizer; treatment CT). The physicochemical parameters were investigated at on d 1 and 5 of storage. The BM treatment presented higher pH and titratable acidity values, resulting in a buffering capacity effect. The total crude protein (CP) and solids-not-fat (SNF) contents were also higher in BM compared with the other evaluated treatments because of the addition of bovine skim milk powder. We detected a reduction in pH values for all treatments. Lower SNF contents were present in the CR and CT treatments, which might be related to a syneresis process during storage; moreover, an increase in total CP was observed for all treatments due to the proteolytic action of the starter culture. Sensory attributes, including appearance (color, consistency, and presence of lumps), texture (consistency, viscosity, and presence of lumps), flavor (bitter, sweet, and characteristic of commercial plain nonfat yogurt), and overall impression were evaluated by quantitative descriptive analysis. The addition of 0.5% (wt/vol) of pectin (PE treatment) strengthened the curd; however, the visual and oral presence of lumps and a higher bitterness score were noted by trained panelists, which resulted in the lowest overall impression score for the PE treatment. In several sensory attributes, the CR treatment was considered similar to the control; the mixture of 0.1% (wt/vol) carrageenan and 0.1% (wt/vol) pectin was not as effective as expected. Goat milk yogurt containing added bovine skim milk powder (BM) had improved consistency, viscosity, and flavor due to its higher SNF and total CP contents, which are particularly important for the desirable texture of plain nonfat yogurt. In addition, the BM yogurt was considered to have characteristics most similar to that of available commercial brands and achieved the best score for overall impression. Copyright © 2016 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

78 FR 15712 - Arlington Storage Company, LLC; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-12

... Storage Company, LLC; Notice of Application Take notice that on February 26, 2013, Arlington Storage... Commission's regulations, requesting authorization to expand its Seneca Lake natural gas storage facility... ``Gallery 2''), previously used for propane storage, and related facilities to natural gas storage. The...

A public health initiative for reducing access to pesticides as a means to committing suicide: findings from a qualitative study.

PubMed

Mohanraj, Rani; Kumar, Shuba; Manikandan, Sarojini; Kannaiyan, Veerapandian; Vijayakumar, Lakshmi

2014-08-01

Widespread use of pesticides among farmers in rural India, provides an easy means for suicide. A public health initiative involving storage of pesticides in a central storage facility could be a possible strategy for reducing mortality and morbidity related to pesticide poisoning. This qualitative study explored community perceptions towards a central pesticide storage facility in villages in rural South India. Sixteen focus group discussions held with consenting adults from intervention and control villages were followed by eight more a year after initiation of the storage facility. Analysis revealed four themes, namely, reasons for committing suicide and methods used, exposure to pesticides and first-aid practices, storage and disposal of pesticides, and perceptions towards the storage facility. The facility was appreciated as a means of preventing suicides and for providing a safe haven for pesticide storage. The participatory process that guided its design, construction and location ensured its acceptability. Use of qualitative methods helped provide deep insights into the phenomenon of pesticide suicide and aided the understanding of community perceptions towards the storage facility. The study suggests that communal storage of pesticides could be an important step towards reducing pesticide suicides in rural areas.

40 CFR 122.3 - Exclusions.

Code of Federal Regulations, 2012 CFR

2012-07-01

... an energy or mining facility, a storage facility or a seafood processing facility, or when secured to a storage facility or a seafood processing facility, or when secured to the bed of the ocean...

40 CFR 122.3 - Exclusions.

Code of Federal Regulations, 2011 CFR

2011-07-01

... an energy or mining facility, a storage facility or a seafood processing facility, or when secured to a storage facility or a seafood processing facility, or when secured to the bed of the ocean...

40 CFR 122.3 - Exclusions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... an energy or mining facility, a storage facility or a seafood processing facility, or when secured to a storage facility or a seafood processing facility, or when secured to the bed of the ocean...

40 CFR 122.3 - Exclusions.

Code of Federal Regulations, 2013 CFR

2013-07-01

... an energy or mining facility, a storage facility or a seafood processing facility, or when secured to a storage facility or a seafood processing facility, or when secured to the bed of the ocean...

40 CFR 122.3 - Exclusions.

Code of Federal Regulations, 2014 CFR

2014-07-01

... an energy or mining facility, a storage facility or a seafood processing facility, or when secured to a storage facility or a seafood processing facility, or when secured to the bed of the ocean...

Quantifying transient binding of ISWI chromatin remodelers in living cells by pixel-wise photobleaching profile evolution analysis.

PubMed

Erdel, Fabian; Rippe, Karsten

2012-11-20

Interactions between nuclear proteins and chromatin frequently occur on the time scale of seconds and below. These transient binding events are important for the fast identification of target sites as concluded from our previous analysis of the human chromatin remodelers Snf2H and Snf2L from the imitation switch (ISWI) family. Both ATP-driven molecular motor proteins are able to translocate nucleosomes along the DNA and appear to exert this activity only on a small number of nucleosomes to which they bind more tightly. For mechanistic studies, one needs to distinguish such translocation reactions or other long-lived interactions associated with conformational changes and/or ATP hydrolysis from nonproductive chromatin sampling during target search. These processes can be separated by measuring the duration of nucleosome binding with subsecond time resolution. To reach this goal, we have developed a fluorescence bleaching technique termed pixel-wise photobleaching profile evolution analysis (3PEA). It exploits the inherent time structure of confocal microscopy images and yields millisecond resolution. 3PEA represents a generally applicable approach to quantitate transient chromatin interactions in the 2- to 500-ms time regime within only ∼1 s needed for a measurement. The green autofluorescent protein (GFP)-tagged Snf2H and Snf2L and the inactive Snf2L+13 splice variant were studied by 3PEA in comparison to the isolated GFP or red autofluorescent protein and a GFP pentamer. Our results reveal that the residence time for transient chromatin binding of Snf2H and Snf2L is <2 ms, and strongly support the view that ISWI-type remodelers are only rarely active in unperturbed cells during G1 phase.

The β subunit of yeast AMP-activated protein kinase directs substrate specificity in response to alkaline stress.

PubMed

Chandrashekarappa, Dakshayini G; McCartney, Rhonda R; O'Donnell, Allyson F; Schmidt, Martin C

2016-12-01

Saccharomyces cerevisiae express three isoforms of Snf1 kinase that differ by which β subunit is present, Gal83, Sip1 or Sip2. Here we investigate the abundance, activation, localization and signaling specificity of the three Snf1 isoforms. The relative abundance of these isoforms was assessed by quantitative immunoblotting using two different protein extraction methods and by fluorescence microscopy. The Gal83 containing isoform is the most abundant in all assays while the abundance of the Sip1 and Sip2 isoforms is typically underestimated especially in glass-bead extractions. Earlier studies to assess Snf1 isoform function utilized gene deletions as a means to inactivate specific isoforms. Here we use point mutations in Gal83 and Sip2 and a 17 amino acid C-terminal truncation of Sip1 to inactivate specific isoforms without affecting their abundance or association with the other subunits. The effect of low glucose and alkaline stresses was examined for two Snf1 phosphorylation substrates, the Mig1 and Mig2 proteins. Any of the three isoforms was capable of phosphorylating Mig1 in response to glucose stress. In contrast, the Gal83 isoform of Snf1 was both necessary and sufficient for the phosphorylation of the Mig2 protein in response to alkaline stress. Alkaline stress led to the activation of all three isoforms yet only the Gal83 isoform translocates to the nucleus and phosphorylates Mig2. Deletion of the SAK1 gene blocked nuclear translocation of Gal83 and signaling to Mig2. These data strongly support the idea that Snf1 signaling specificity is mediated by localization of the different Snf1 isoforms. Copyright © 2016 Elsevier Inc. All rights reserved.

The β subunit of yeast AMP-activated protein kinase directs substrate specificity in response to alkaline stress

PubMed Central

Chandrashekarappa, Dakshayini G.; McCartney, Rhonda R.; O’Donnell, Allyson F.; Schmidt, Martin C.

2016-01-01

Saccharomyces cerevisiae express three isoforms of Snf1 kinase that differ by which β subunit is present, Gal83, Sip1 or Sip2. Here we investigate the abundance, activation, localization and signaling specificity of the three Snf1 isoforms. The relative abundance of these isoforms was assessed by quantitative immunoblotting using two different protein extraction methods and by fluorescence microscopy. The Gal83 containing isoform is the most abundant in all assays while the abundance of the Sip1 and Sip2 isoforms is typically underestimated especially in glass-bead extractions. Earlier studies to assess Snf1 isoform function utilized gene deletions as a means to inactivate specific isoforms. Here we use point mutations in Gal83 and Sip2 and a 17 amino acid C-terminal truncation of Sip1 to inactivate specific isoforms without affecting their abundance or association with the other subunits. The effect of low glucose and alkaline stresses was examined for two Snf1 phosphorylation substrates, the Mig1 and Mig2 proteins. Any of the three isoforms was capable of phosphorylating Mig1 in response to glucose stress. In contrast, the Gal83 isoform of Snf 1 was both necessary and sufficient for the phosphorylation of the Mig2 protein in response to alkaline stress. Alkaline stress led to the activation of all three isoforms yet only the Gal83 isoform translocates to the nucleus and phosphorylates Mig2. Deletion of the SAK1 gene blocked nuclear translocation of Gal83 and signaling to Mig2. These data strongly support the idea that Snf1 signaling specificity is mediated by localization of the different Snf1 isoforms. PMID:27592031

SNF3 as High Affinity Glucose Sensor and Its Function in Supporting the Viability of Candida glabrata under Glucose-Limited Environment.

PubMed

Ng, Tzu Shan; Chew, Shu Yih; Rangasamy, Premmala; Mohd Desa, Mohd N; Sandai, Doblin; Chong, Pei Pei; Than, Leslie Thian Lung

2015-01-01

Candida glabrata is an emerging human fungal pathogen that has efficacious nutrient sensing and responsiveness ability. It can be seen through its ability to thrive in diverse range of nutrient limited-human anatomical sites. Therefore, nutrient sensing particularly glucose sensing is thought to be crucial in contributing to the development and fitness of the pathogen. This study aimed to elucidate the role of SNF3 (Sucrose Non Fermenting 3) as a glucose sensor and its possible role in contributing to the fitness and survivability of C. glabrata in glucose-limited environment. The SNF3 knockout strain was constructed and subjected to different glucose concentrations to evaluate its growth, biofilm formation, amphotericin B susceptibility, ex vivo survivability and effects on the transcriptional profiling of the sugar receptor repressor (SRR) pathway-related genes. The CgSNF3Δ strain showed a retarded growth in low glucose environments (0.01 and 0.1%) in both fermentation and respiration-preferred conditions but grew well in high glucose concentration environments (1 and 2%). It was also found to be more susceptible to amphotericin B in low glucose environment (0.1%) and macrophage engulfment but showed no difference in the biofilm formation capability. The deletion of SNF3 also resulted in the down-regulation of about half of hexose transporters genes (four out of nine). Overall, the deletion of SNF3 causes significant reduction in the ability of C. glabrata to sense limited surrounding glucose and consequently disrupts its competency to transport and perform the uptake of this critical nutrient. This study highlighted the role of SNF3 as a high affinity glucose sensor and its role in aiding the survivability of C. glabrata particularly in glucose limited environment.

Enhanced Proton Conductivity of Sulfonated Hybrid Poly(arylene ether ketone) Membranes by Incorporating an Amino-Sulfo Bifunctionalized Metal-Organic Framework for Direct Methanol Fuel Cells.

PubMed

Ru, Chunyu; Li, Zhenhua; Zhao, Chengji; Duan, Yuting; Zhuang, Zhuang; Bu, Fanzhe; Na, Hui

2018-03-07

Novel side-chain-type sulfonated poly(arylene ether ketone) (SNF-PAEK) containing naphthalene and fluorine moieties on the main chain was prepared in this work, and a new amino-sulfo-bifunctionalized metal-organic framework (MNS, short for MIL-101-NH 2 -SO 3 H) was synthesized via a hydrothermal technology and postmodification. Then, MNS was incorporated into a SNF-PAEK matrix as an inorganic nanofiller to prepare a series of organic-inorganic hybrid membranes (MNS@SNF-PAEK-XX). The mechanical property, methanol resistance, electrochemistry, and other properties of MNS@SNF-PAEK-XX hybrid membranes were characterized in detail. We found that the mechanical strength and methanol resistances of these hybrid membranes were improved by the formation of an ionic cross-linking structure between -NH 2 of MNS and -SO 3 H on the side chain of SNF-PAEK. Particularly, the proton conductivity of these hybrid membranes increased obviously after the addition of MNS. MNS@SNF-PAEK-3% exhibited the proton conductivity of 0.192 S·cm -1 , which was much higher than those of the pristine membrane (0.145 S·cm -1 ) and recast Nafion (0.134 S·cm -1 ) at 80 °C. This result indicated that bifunctionalized MNS rearranged the microstructure of hybrid membranes, which could accelerate the transfer of protons. The hybrid membrane (MNS@SNF-PAEK-3%) showed a better direct methanol fuel cell performance with a higher peak power density of 125.7 mW/cm 2 at 80 °C and a higher open-circuit voltage (0.839 V) than the pristine membrane.

SNF4Agamma, the Drosophila AMPK gamma subunit is required for regulation of developmental and stress-induced autophagy.

PubMed

Lippai, Mónika; Csikós, György; Maróy, Péter; Lukácsovich, Tamás; Juhász, Gábor; Sass, Miklós

2008-05-01

In holometabolous insects including Drosophila melanogaster a wave of autophagy triggered by 20-hydroxyecdysone is observed in the larval tissues during the third larval stage of metamorphosis. We used this model system to study the genetic regulation of autophagy. We performed a genetic screen to select P-element insertions that affect autophagy in the larval fat body. Light and electron microscopy of one of the isolated mutants (l(3)S005042) revealed the absence of autophagic vesicles in their fat body cells during the third larval stage. We show that formation of autophagic vesicles cannot be induced by 20-hydroxyecdysone in the tissues of mutant flies and represent evidence demonstrating that the failure to form autophagic vesicles is due to the insertion of a P-element into the gene coding SNF4Agamma, the Drosophila homologue of the AMPK (AMP-activated protein kinase) gamma subunit. The ability to form autophagic vesicles (wild-type phenotype) can be restored by remobilization of the P-element in the mutant. Silencing of SNF4Agamma by RNAi suppresses autophagic vesicle formation in wild-type flies. We raised an antibody against SNF4Agamma and showed that this gene product is constitutively present in the wild-type larval tissues during postembryonal development. SNF4Agamma is nearly absent from the cells of homozygous mutants. SNF4Agamma translocates into the nuclei of fat body cells at the onset of the wandering stage concurrently with the beginning of the autophagic process. Our results demonstrate that SNF4Agamma has an essential role in the regulation of autophagy in Drosophila larval fat body cells.

Undifferentiated Endometrial Carcinomas Show Frequent Loss of Core Switch/Sucrose Nonfermentable Complex Proteins.

PubMed

Köbel, Martin; Hoang, Lien N; Tessier-Cloutier, Basile; Meng, Bo; Soslow, Robert A; Stewart, Colin J R; Lee, Cheng-Han

2018-01-01

Undifferentiated endometrial carcinoma is an aggressive type of endometrial carcinoma that typically presents with advanced stage disease and rapid clinical progression. In contrast to dedifferentiated endometrial carcinoma, undifferentiated carcinoma lacks a concurrent differentiated (typically low-grade endometrioid) carcinoma component, though the undifferentiated component of dedifferentiated carcinoma is similar histologically and immunophenotypically to pure undifferentiated carcinoma. We recently identified 3 mutually exclusive mechanisms of switch/sucrose nonfermentable (SWI/SNF) complex inactivation (BRG1 inactivation, INI1 inactivation or ARID1A/ARID1B co-inactivation) that are associated with histologic dedifferentiation in the majority of dedifferentiated endometrial carcinoma. In the current study, we aimed to determine by immunohistochemistry whether these patterns of SWI/SNF inactivation also occur in undifferentiated endometrial carcinomas. Of the 34 undifferentiated carcinomas examined, 17 (50%) exhibited SWI/SNF complex inactivation, with 11 tumors showing complete loss of both ARID1A and ARID1B, 5 showing complete loss of BRG1 and 1 showing complete loss of INI1. Ten of the remaining 17 undifferentiated carcinomas showed the following alterations: 5 tumors (15%) showed loss of ARID1A only with intact ARID1B, BRG1, and INI1 expression, 4 tumors (12%) showed mutated patterns of p53 staining with intact SWI/SNF protein expression, and 1 tumor (3%) harbored a POLE exonuclease domain mutation (P286R). SWI/SNF complex-inactivated tumors presented more frequently with extrauterine disease spread than those with intact expression (88% vs. 41%, respectively). In addition, patients with SWI/SNF complex-inactivated tumors had a significantly worse disease-specific survival (P=0.02). The findings here demonstrate frequent SWI/SNF complex inactivation in undifferentiated endometrial carcinomas, which has future implications regarding therapies that target chromatin remodelling and epigenetic control.

Conditions inside Water Pooled in a Failed Nuclear Waste Container and its Effect on Radionuclide Release

NASA Astrophysics Data System (ADS)

Hamdan, L. K.; Walton, J. C.; Woocay, A.

2009-12-01

Nuclear power use is expected to expand in the future, as part of the global clean energy initiative, to meet the world’s surging energy demand, and attenuate greenhouse gas emissions, which are mainly caused by fossil fuels. As a result, it is estimated that hundreds of thousands of metric tons of spent nuclear fuel (SNF) will accumulate. SNF disposal has major environmental (radiation exposure) and security (nuclear proliferation) concerns. Storage in unsaturated zone geological repositories is a reasonable solution for dealing with SNF. One of the key factors that determine the performance of the geological repository is the release of radionuclides from the engineered barrier system. Over time, the nuclear waste containers are expected to fail gradually due to general and localized corrosions and eventually infiltrating water will have access to the nuclear waste. Once radionuclides are released, they will be transported by water, and make their way to the accessible environment. Physical and chemical disturbances in the environment over the container will lead to different corrosion rates, causing different times and locations of penetration. One possible scenario for waste packages failure is the bathtub model, where penetrations occur on the top of the waste package and water pools inside it. In this paper the bathtub-type failed waste container is considered. We shed some light on chemical and physical processes that take place in the pooled water inside a partially failed waste container (bathtub category), and the effects of these processes on radionuclide release. Our study considers two possibilities: temperature stratification of the pooled water versus mixing process. Our calculations show that temperature stratification of the pooled water is expected when the waste package is half (or less) filled with water. On the other hand, when the waste package is fully filled (or above half) there will be mixing in the upper part of water. The effect of these cases on oxygen availability and consequently spent fuel alteration and radionuclide release will be considered.

Evaluation of Neutron Poison Materials for DOE SNF Disposal Systems

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

Vinson, D.W.; Caskey, G.R. Jr.; Sindelar, R.L.

1998-09-01

Aluminum-based spent nuclear fuel (Al-SNF) from foreign and domestic research reactors is being consolidated at the Savannah River Site (SRS) for ultimate disposal in the Mined Geologic Disposal System (MGDS). Most of the aluminum-based fuel material contains highly enriched uranium (HEU) (more than 20 percent 235U), which challenges the preclusion of criticality events for disposal periods exceeding 10,000 years. Recent criticality analyses have shown that the addition of neutron absorbing materials (poisons) is needed in waste packages containing DOE SNF canisters fully loaded with Al-SNF under flooded and degraded configurations to demonstrate compliance with the requirement that Keff less thanmore » 0.95. Compatibility of poison matrix materials and the Al-SNF, including their relative degradation rate and solubility, are important to maintain criticality control. An assessment of the viability of poison and matrix materials has been conducted, and an experimental corrosion program has been initiated to provide data on degradation rates of poison and matrix materials and Al-SNF materials under repository relevant vapor and aqueous environments. Initial testing includes Al6061, Type 316L stainless steel, and A516Gr55 in synthesized J-13 water vapor at 50 degrees C, 100 degrees C, and 200 degrees C and in condensate water vapor at 100 degrees C. Preliminary results are presented herein.« less

Integrated analysis of transcriptome and lipid profiling reveals the co-influences of inositol-choline and Snf1 in controlling lipid biosynthesis in yeast.

PubMed

Chumnanpuen, Pramote; Zhang, Jie; Nookaew, Intawat; Nielsen, Jens

2012-07-01

In the yeast Saccharomyces cerevisiae many genes involved in lipid biosynthesis are transcriptionally controlled by inositol-choline and the protein kinase Snf1. Here we undertook a global study on how inositol-choline and Snf1 interact in controlling lipid metabolism in yeast. Using both a reference strain (CEN.PK113-7D) and a snf1Δ strain cultured at different nutrient limitations (carbon and nitrogen), at a fixed specific growth rate of 0.1 h(-1), and at different inositol choline concentrations, we quantified the expression of genes involved in lipid biosynthesis and the fluxes towards the different lipid components. Through integrated analysis of the transcriptome, the lipid profiling and the fluxome, it was possible to obtain a high quality, large-scale dataset that could be used to identify correlations and associations between the different components. At the transcription level, Snf1 and inositol-choline interact either directly through the main phospholipid-involving transcription factors (i.e. Ino2, Ino4, and Opi1) or through other transcription factors e.g. Gis1, Mga2, and Hac1. However, there seems to be flux regulation at the enzyme levels of several lipid involving enzymes. The analysis showed the strength of using both transcriptome and lipid profiling analysis for mapping the co-influence of inositol-choline and Snf1 on phospholipid metabolism.

SWI/SNF regulates half of its targets without the need of ATP-driven nucleosome remodeling by Brahma.

PubMed

Jordán-Pla, Antonio; Yu, Simei; Waldholm, Johan; Källman, Thomas; Östlund Farrants, Ann-Kristin; Visa, Neus

2018-05-18

Brahma (BRM) is the only catalytic subunit of the SWI/SNF chromatin-remodeling complex of Drosophila melanogaster. The function of SWI/SNF in transcription has long been attributed to its ability to remodel nucleosomes, which requires the ATPase activity of BRM. However, recent studies have provided evidence for a non-catalytic function of BRM in the transcriptional regulation of a few specific genes. Here we have used RNA-seq and ChIP-seq to identify the BRM target genes in S2 cells, and we have used a catalytically inactive BRM mutant (K804R) that is unable to hydrolyze ATP to investigate the magnitude of the non-catalytic function of BRM in transcription regulation. We show that 49% of the BRM target genes in S2 cells are regulated through mechanisms that do not require BRM to have an ATPase activity. We also show that the catalytic and non-catalytic mechanisms of SWI/SNF regulation operate on two subsets of genes that differ in promoter architecture and are linked to different biological processes. This study shows that the non-catalytic role of SWI/SNF in transcription regulation is far more prevalent than previously anticipated and that the genes that are regulated by SWI/SNF through ATPase-dependent and ATPase-independent mechanisms have specialized roles in different cellular and developmental processes.

36 CFR 1238.28 - What must agencies do when sending permanent microform records to a records storage facility?

Code of Federal Regulations, 2012 CFR

2012-07-01

... sending permanent microform records to a records storage facility? 1238.28 Section 1238.28 Parks, Forests... MANAGEMENT Storage, Use, and Disposition of Microform Records § 1238.28 What must agencies do when sending permanent microform records to a records storage facility? Agencies must: (a) Follow the procedures in part...

36 CFR 1238.28 - What must agencies do when sending permanent microform records to a records storage facility?

Code of Federal Regulations, 2014 CFR

2014-07-01

... sending permanent microform records to a records storage facility? 1238.28 Section 1238.28 Parks, Forests... MANAGEMENT Storage, Use, and Disposition of Microform Records § 1238.28 What must agencies do when sending permanent microform records to a records storage facility? Agencies must: (a) Follow the procedures in part...

Fanconi anemia protein, FANCA, associates with BRG1, a component of the human SWI/SNF complex.

PubMed

Otsuki, T; Furukawa, Y; Ikeda, K; Endo, H; Yamashita, T; Shinohara, A; Iwamatsu, A; Ozawa, K; Liu, J M

2001-11-01

Fanconi anemia (FA) is a genetic disorder that predisposes to hematopoietic failure, birth defects and cancer. We identified an interaction between the FA protein, FANCA and brm-related gene 1 (BRG1) product. BRG1 is a subunit of the SWI/SNF complex, which remodels chromatin structure through a DNA-dependent ATPase activity. FANCA was demonstrated to associate with the endogenous SWI/SNF complex. We also found a significant increase in the molecular chaperone, glucose-regulated protein 94 (GRP94) among BRG1-associated factors isolated from a FANCA-mutant cell line, which was not seen in either a normal control cell line or the mutant line complemented by wild-type FANCA. Despite this specific difference, FANCA did not appear to be absolutely required for in vitro chromatin remodeling. Finally, we demonstrated co-localization in the nucleus between transfected FANCA and BRG1. The physiological action of FANCA on the SWI/SNF complex remains to be clarified, but our work suggests that FANCA may recruit the SWI/SNF complex to target genes, thereby enabling coupled nuclear functions such as transcription and DNA repair.

Function and selectivity of bromodomains in anchoring chromatin-modifying complexes to promoter nucleosomes.

PubMed

Hassan, Ahmed H; Prochasson, Philippe; Neely, Kristen E; Galasinski, Scott C; Chandy, Mark; Carrozza, Michael J; Workman, Jerry L

2002-11-01

The functions of the SAGA and SWI/SNF complexes are interrelated and can form stable "epigenetic marks" on promoters in vivo. Here we show that stable promoter occupancy by SWI/SNF and SAGA in the absence of transcription activators requires the bromodomains of the Swi2/Snf2 and Gcn5 subunits, respectively, and nucleosome acetylation. This acetylation can be brought about by either the SAGA or NuA4 HAT complexes. The bromodomain in the Spt7 subunit of SAGA is dispensable for this activity but will anchor SAGA if it is swapped into Gcn5, indicating that specificity of bromodomain function is determined in part by the subunit it occupies. Thus, bromodomains within the catalytic subunits of SAGA and SWI/SNF anchor these complexes to acetylated promoter nucleosomes.

36 CFR 1254.28 - What items are not allowed in research rooms?

Code of Federal Regulations, 2011 CFR

2011-07-01

... papers. (b) You may store personal items at no cost in lockers or other storage facilities in the NARA facility. These lockers or other storage facilities are available on a first-come-first-served basis. (c) You must remove your personal belongings each night from the lockers or other storage facilities we...

36 CFR 1254.28 - What items are not allowed in research rooms?

Code of Federal Regulations, 2014 CFR

2014-07-01

... papers. (b) You may store personal items at no cost in lockers or other storage facilities in the NARA facility. These lockers or other storage facilities are available on a first-come-first-served basis. (c) You must remove your personal belongings each night from the lockers or other storage facilities we...

36 CFR 1254.28 - What items are not allowed in research rooms?

Code of Federal Regulations, 2010 CFR

2010-07-01

... papers. (b) You may store personal items at no cost in lockers or other storage facilities in the NARA facility. These lockers or other storage facilities are available on a first-come-first-served basis. (c) You must remove your personal belongings each night from the lockers or other storage facilities we...

36 CFR 1254.28 - What items are not allowed in research rooms?

Code of Federal Regulations, 2012 CFR

2012-07-01

... papers. (b) You may store personal items at no cost in lockers or other storage facilities in the NARA facility. These lockers or other storage facilities are available on a first-come-first-served basis. (c) You must remove your personal belongings each night from the lockers or other storage facilities we...

77 FR 4807 - Revised Fee Policy for Acceptance of Foreign Research Reactor Spent Nuclear Fuel From High-Income...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-01-31

...This notice announces a change in the fee policy by the Department of Energy (DOE) for receipt and management of spent nuclear fuel (SNF) from foreign research reactors (FRR) containing uranium enriched in the U.S. in countries with high-income economies, as identified in the World Bank Development Report. The fee will increase in three phases (See Table 1) for all future SNF shipments (including Training, Research, Isotopes, General Atomics (TRIGA) from high-income economy countries. The first phase will take effect immediately and the fee will increase from no higher than $3,750 per kg total mass (not heavy metal mass) to $5,625 per kg total mass for SNF containing low enriched uranium (LEU). The second phase will be implemented automatically on January 1, 2014, and the fees will increase from $5,625 per kg total mass to $7,500 per kg total mass for shipments of SNF containing LEU and from no higher than $4,500 per kg total mass to $6,750 per kg total mass for SNF containing highly enriched uranium (HEU). The third phase will be implemented automatically on January 1, 2016, and the fee will increase from $6,750 per kg total mass to $9,000 per kg total mass for shipments of SNF containing HEU. DOE is also implementing a new minimum fee of $200,000 per shipment of any type and amount of eligible SNF to reflect a minimum cost of providing acceptance services. This minimum fee will take effect immediately. In the case where a reactor operator already has a signed and executed contract with DOE, DOE intends to negotiate an equitable adjustment to the fee in accordance with this revised fee policy. Under this revised fee policy, the fee for return of TRIGA fuel will be the same as that of aluminum based fuel. All other aspects of the fee policy are unaffected by this Notice. This is the first fee increase since the fee policy was established in 1996, and will help DOE offset a portion of the increase in operation costs of managing SNF. DOE will continue to pay the costs for shipping, receipt and management of SNF from other than high-income economy countries. All other conditions and policies as previously established for acceptance of FRR SNF will continue to apply. DOE reserves the right to revise the fee policy at any time to respond to changed circumstances. DOE also reserves the right to adjust the fee set in an acceptance contract if there are unique and compelling circumstances that make it in DOE's best interest to do so.

Post Irradiation Examination for Advanced Materials at Burnups Exceeding the Current Limit

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

John H. Strumpell

2004-12-31

Permitting fuel to be irradiated to higher burnups limits can reduce the amount of spent nuclear fuel (SNF) requiring storage and/or disposal and enable plants to operate with longer more economical cycle lengths and/or at higher power levels. Therefore, Framatome ANP (FANP) and the B&W Owner's Group (BWOG) have introduced a new fuel rod design with an advanced M5 cladding material and have irradiated several test fuel rods through four cycles. The U.S. Department of Energy (DOE) joined FANP and the BWOG in supporting this project during its final phase of collecting and evaluating high burnup data through post irradiationmore » examination (PIE).« less

Log transfer and storage facilities in Southeast Alaska: a review.

Treesearch

Tamra L. Faris; Kenneth D. Vaughan

1985-01-01

The volume of timber harvested in southeast Alaska between 1909 and 1983 was 14,689 million board feet; nearly all was transported on water to various destinations for processing. In 1971 there were 69 active log transfer and storage facilities and 38 raft collecting and storage facilities in southeast Alaska. In 1983 there were 90 log transfer sites, 49 log storage...

36 CFR § 1238.28 - What must agencies do when sending permanent microform records to a records storage facility?

Code of Federal Regulations, 2013 CFR

2013-07-01

... sending permanent microform records to a records storage facility? § 1238.28 Section § 1238.28 Parks... RECORDS MANAGEMENT Storage, Use, and Disposition of Microform Records § 1238.28 What must agencies do when sending permanent microform records to a records storage facility? Agencies must: (a) Follow the...

How the University of Texas system responded to the need for interim storage of low-level radioactive waste materials.

PubMed

Emery, Robert J

2012-11-01

Faced with the prospect of being unable to permanently dispose of low-level radioactive wastes (LLRW) generated from teaching, research, and patient care activities, component institutions of the University of Texas System worked collaboratively to create a dedicated interim storage facility to be used until a permanent disposal facility became available. Located in a remote section of West Texas, the University of Texas System Interim Storage Facility (UTSISF) was licensed and put into operation in 1993, and since then has provided safe and secure interim storage for up to 350 drums of dry solid LLRW at any given time. Interim storage capability provided needed relief to component institutions, whose on-site waste facilities could have possibly become overburdened. Experiences gained from the licensing and operation of the site are described, and as a new permanent LLRW disposal facility emerges in Texas, a potential new role for the storage facility as a surge capacity storage site in times of natural disasters and emergencies is also discussed.

Mutants of Yeast Defective in Sucrose Utilization

PubMed Central

Carlson, Marian; Osmond, Barbara C.; Botstein, David

1981-01-01

Utilization of sucrose as a source of carbon and energy in yeast (Saccharomyces) is controlled by the classical SUC genes, which confer the ability to produce the sucrose-degrading enzyme invertase (Mortimer and Hawthorne 1969). Mutants of S. cerevisiae strain S288C (SUC2+) unable to grow anaerobically on sucrose, but still able to use glucose, were isolated. Two major complementation groups were identified: twenty-four recessive mutations at the SUC2 locus (suc2-); and five recessive mutations defining a new locus, SNF1 (for sucrose nonfermenting), essential for sucrose utilization. Two minor complementation groups, each comprising a single member with a leaky sucrose-nonfermenting phenotype, were also identified. The suc2 mutations isolated include four suppressible amber mutations and five mutations apparently exhibiting intragenic complementation; complementation analysis and mitotic mapping studies indicated that all of the suc2 mutations are alleles of a single gene. These results suggest that SUC2 encodes a protein, probably a dimer or multimer. No invertase activity was detected in suc2 mutants.—The SNF1 locus is not tightly linked to SUC2. The snf1 mutations were found to be pleiotropic, preventing sucrose utilization by SUC2+ and SUC7+ strains, and also preventing utilization of galactose, maltose and several nonfermentable carbon sources. Although snf1 mutants thus display a petite phenotype, classic petite mutations do not interfere with utilization of sucrose, galactose or maltose. A common feature of all the carbon utilization systems affected by SNF1 is that all are regulated by glucose repression. The snf1 mutants were found to produce the constitutive nonglycosylated form of invertase, but failed to produce the glucose-repressible, glycosylated, secreted invertase. This failure cannot be attributed to a general defect in production of glycosylated and secreted proteins because synthesis of acid phosphatase, a glycosylated secreted protein not subject to glucose repression, was not affected by snf1 mutations. These findings suggest that the SNF1 locus is involved in the regulation of gene expression by glucose repression. PMID:7040163

Feasibility study for a transportation operations system cask maintenance facility

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

Rennich, M.J.; Medley, L.G.; Attaway, C.R.

The US Department of Energy (DOE), Office of Civilian Radioactive Waste Management (OCRWM) is responsible for the development of a waste management program for the disposition of spent nuclear fuel (SNF) and high-level waste (HLW). The program will include a transportation system for moving the nuclear waste from the sources to a geologic repository for permanent disposal. Specially designed casks will be used to safely transport the waste. The cask systems must be operated within limits imposed by DOE, the Nuclear Regulatory Commission (NRC), and the Department of Transportation (DOT). A dedicated facility for inspecting, testing, and maintaining the caskmore » systems was recommended by the General Accounting Office (in 1979) as the best means of assuring their operational effectiveness and safety, as well as regulatory compliance. In November of 1987, OCRWM requested a feasibility study be made of a Cask Maintenance Facility (CMF) that would perform the required functions. 46 refs., 16 figs., 13 tabs.« less

Developing a concept for a national used fuel interim storage facility in the United States

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

Lewis, Donald Wayne

2013-07-01

In the United States (U.S.) the nuclear waste issue has plagued the nuclear industry for decades. Originally, spent fuel was to be reprocessed but with the threat of nuclear proliferation, spent fuel reprocessing has been eliminated, at least for now. In 1983, the Nuclear Waste Policy Act of 1982 [1] was established, authorizing development of one or more spent fuel and high-level nuclear waste geological repositories and a consolidated national storage facility, called a 'Monitored Retrievable Storage' facility, that could store the spent nuclear fuel until it could be placed into the geological repository. Plans were under way to buildmore » a geological repository, Yucca Mountain, but with the decision by President Obama to terminate the development of Yucca Mountain, a consolidated national storage facility that can store spent fuel for an interim period until a new repository is established has become very important. Since reactor sites have not been able to wait for the government to come up with a storage or disposal location, spent fuel remains in wet or dry storage at each nuclear plant. The purpose of this paper is to present a concept developed to address the DOE's goals stated above. This concept was developed over the past few months by collaboration between the DOE and industry experts that have experience in designing spent nuclear fuel facilities. The paper examines the current spent fuel storage conditions at shutdown reactor sites, operating reactor sites, and the type of storage systems (transportable versus non-transportable, welded or bolted). The concept lays out the basis for a pilot storage facility to house spent fuel from shutdown reactor sites and then how the pilot facility can be enlarged to a larger full scale consolidated interim storage facility. (authors)« less

Analysis of Samples Collected from the Surface of Interim Storage Canisters at Calvert Cliffs in June 2017: Revision 01.

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

Bryan, Charles R.; Schindelholz, Eric John

In June 2017, dust and salt samples were collected from the surface of Spent Nuclear Fuel (SNF) dry storage canisters at the Calvert Cliffs Nuclear Power Plant. The samples were delivered to Sandia National laboratories for analysis. Two types of samples were collected: filter-backed Scotch-Brite TM pads were used to collect dry dust samples for characterization of salt and dust morphologies and distributions; and Saltsmart TM test strips were used to collect soluble salts for determining salt surface loadings per unit area. After collection, the samples were sealed into plastic sleeves for shipping. Condensation within the sleeves containing the Scotch-Britemore » TM samples remobilized the salts, rendering them ineffective for the intended purpose, and also led to mold growth, further compromising the samples; for these reasons, the samples were not analyzed. The SaltSmart TM samples were unaffected and were analyzed by ion chromatography for major anions and cations. The results of those analyses are presented here.« less

Medicare Advantage Members' Expected Out-Of-Pocket Spending For Inpatient And Skilled Nursing Facility Services.

PubMed

Keohane, Laura M; Grebla, Regina C; Mor, Vincent; Trivedi, Amal N

2015-06-01

Inpatient and skilled nursing facility (SNF) cost sharing in Medicare Advantage (MA) plans may reduce unnecessary use of these services. However, large out-of-pocket expenses potentially limit access to care and encourage beneficiaries at high risk of needing inpatient and postacute care to avoid or leave MA plans. In 2011 new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in MA plans. After these regulations, MA members in plans with low premiums averaged $1,758 in expected out-of-pocket spending for an episode of seven hospital days and twenty skilled nursing facility days. Among members with the same low-premium plan in 2010 and 2011, 36 percent of members belonged to plans that added an out-of-pocket spending limit in 2011. However, these members also had a $293 increase in average cost sharing for an inpatient and skilled nursing facility episode, possibly to offset plans' expenses in financing out-of-pocket limits. Some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing. Project HOPE—The People-to-People Health Foundation, Inc.

Medicare program; prospective payment system and consolidated billing for skilled nursing facilities for FY 2010; minimum data set, version 3.0 for skilled nursing facilities and Medicaid nursing facilities. Final rule.

PubMed

2009-08-11

This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs), for fiscal year (FY) 2010. In addition, it recalibrates the case-mix indexes so that they more accurately reflect parity in expenditures related to the implementation of case-mix refinements in January 2006. It also discusses the results of our ongoing analysis of nursing home staff time measurement data collected in the Staff Time and Resource Intensity Verification project, as well as a new Resource Utilization Groups, version 4 case-mix classification model for FY 2011 that will use the updated Minimum Data Set 3.0 resident assessment for case-mix classification. In addition, this final rule discusses the public comments that we have received on these and other issues, including a possible requirement for the quarterly reporting of nursing home staffing data, as well as on applying the quality monitoring mechanism in place for all other SNF PPS facilities to rural swing-bed hospitals. Finally, this final rule revises the regulations to incorporate certain technical corrections.

Medicare Advantage Members’ Expected Out-Of-Pocket Spending For Inpatient And Skilled Nursing Facility Services

PubMed Central

Keohane, Laura M.; Grebla, Regina C.; Mor, Vincent; Trivedi, Amal N.

2015-01-01

Inpatient and skilled nursing facility (SNF) cost sharing in Medicare Advantage (MA) plans may reduce unnecessary use of these services. However, large out-of-pocket expenses potentially limit access to care and encourage beneficiaries at high risk of needing inpatient and postacute care to avoid or leave MA plans. In 2011 new federal regulations restricted inpatient and skilled nursing facility cost sharing and mandated limits on out-of-pocket spending in MA plans. After these regulations, MA members in plans with low premiums averaged $1,758 in expected out-of-pocket spending for an episode of seven hospital days and twenty skilled nursing facility days. Among members with the same low-premium plan in 2010 and 2011, 36 percent of members belonged to plans that added an out-of-pocket spending limit in 2011. However, these members also had a $293 increase in average cost sharing for an inpatient and skilled nursing facility episode, possibly to offset plans’ expenses in financing out-of-pocket limits. Some MA beneficiaries may still have difficulty affording acute and postacute care despite greater regulation of cost sharing. PMID:26056208

78 FR 47935 - Medicare Program; Prospective Payment System and Consolidated Billing for Skilled Nursing...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-06

... corresponding terms in alphabetical order below: AIDS Acquired Immune Deficiency Syndrome ARD Assessment... resource-intensive than SNF residents, especially SNF post-acute care patients. These commenters stated...

Simulation of mass storage systems operating in a large data processing facility

NASA Technical Reports Server (NTRS)

Holmes, R.

1972-01-01

A mass storage simulation program was written to aid system designers in the design of a data processing facility. It acts as a tool for measuring the overall effect on the facility of on-line mass storage systems, and it provides the means of measuring and comparing the performance of competing mass storage systems. The performance of the simulation program is demonstrated.

The yeast Hsp70 homolog Ssb: a chaperone for general de novo protein folding and a nanny for specific intrinsically disordered protein domains.

PubMed

Hübscher, Volker; Mudholkar, Kaivalya; Rospert, Sabine

2017-02-01

Activation of the heterotrimeric kinase SNF1 via phosphorylation of a specific residue within the α subunit is essential for the release from glucose repression in the yeast Saccharomyces cerevisiae. When glucose is available, SNF1 is maintained in the dephosphorylated, inactive state by the phosphatase Glc7-Reg1. Recent findings suggest that Bmh and Ssb combine their unique client-binding properties to interact with the regulatory region of the SNF1 α subunit and by that stabilize a conformation of SNF1, which is accessible for Glc7-Reg1-dependent dephosphorylation. Together, the 14-3-3 protein Bmh and the Hsp70 homolog Ssb comprise a novel chaperone module, which is required to maintain proper glucose repression in the yeast S. cerevisiae.

SNF5 Is an Essential Executor of Epigenetic Regulation during Differentiation

PubMed Central

You, Jueng Soo; De Carvalho, Daniel D.; Dai, Chao; Liu, Minmin; Pandiyan, Kurinji; Zhou, Xianghong J.; Liang, Gangning; Jones, Peter A.

2013-01-01

Nucleosome occupancy controls the accessibility of the transcription machinery to DNA regulatory regions and serves an instructive role for gene expression. Chromatin remodelers, such as the BAF complexes, are responsible for establishing nucleosome occupancy patterns, which are key to epigenetic regulation along with DNA methylation and histone modifications. Some reports have assessed the roles of the BAF complex subunits and stemness in murine embryonic stem cells. However, the details of the relationships between remodelers and transcription factors in altering chromatin configuration, which ultimately affects gene expression during cell differentiation, remain unclear. Here for the first time we demonstrate that SNF5, a core subunit of the BAF complex, negatively regulates OCT4 levels in pluripotent cells and is essential for cell survival during differentiation. SNF5 is responsible for generating nucleosome-depleted regions (NDRs) at the regulatory sites of OCT4 repressed target genes such as PAX6 and NEUROG1, which are crucial for cell fate determination. Concurrently, SNF5 closes the NDRs at the regulatory regions of OCT4-activated target genes such as OCT4 itself and NANOG. Furthermore, using loss- and gain-of-function experiments followed by extensive genome-wide analyses including gene expression microarrays and ChIP-sequencing, we highlight that SNF5 plays dual roles during differentiation by antagonizing the expression of genes that were either activated or repressed by OCT4, respectively. Together, we demonstrate that SNF5 executes the switch between pluripotency and differentiation. PMID:23637628

SNF5 is an essential executor of epigenetic regulation during differentiation.

PubMed

You, Jueng Soo; De Carvalho, Daniel D; Dai, Chao; Liu, Minmin; Pandiyan, Kurinji; Zhou, Xianghong J; Liang, Gangning; Jones, Peter A

2013-04-01

Nucleosome occupancy controls the accessibility of the transcription machinery to DNA regulatory regions and serves an instructive role for gene expression. Chromatin remodelers, such as the BAF complexes, are responsible for establishing nucleosome occupancy patterns, which are key to epigenetic regulation along with DNA methylation and histone modifications. Some reports have assessed the roles of the BAF complex subunits and stemness in murine embryonic stem cells. However, the details of the relationships between remodelers and transcription factors in altering chromatin configuration, which ultimately affects gene expression during cell differentiation, remain unclear. Here for the first time we demonstrate that SNF5, a core subunit of the BAF complex, negatively regulates OCT4 levels in pluripotent cells and is essential for cell survival during differentiation. SNF5 is responsible for generating nucleosome-depleted regions (NDRs) at the regulatory sites of OCT4 repressed target genes such as PAX6 and NEUROG1, which are crucial for cell fate determination. Concurrently, SNF5 closes the NDRs at the regulatory regions of OCT4-activated target genes such as OCT4 itself and NANOG. Furthermore, using loss- and gain-of-function experiments followed by extensive genome-wide analyses including gene expression microarrays and ChIP-sequencing, we highlight that SNF5 plays dual roles during differentiation by antagonizing the expression of genes that were either activated or repressed by OCT4, respectively. Together, we demonstrate that SNF5 executes the switch between pluripotency and differentiation.

Global assessment of limitation to symbiotic nitrogen fixation by phosphorus availability in terrestrial ecosystems using a meta-analysis approach

NASA Astrophysics Data System (ADS)

Augusto, Laurent; Delerue, Florian; Gallet-Budynek, Anne; Achat, David L.

2013-09-01

nitrogen fixation (SNF) is the main natural source of nitrogen (N) in terrestrial ecosystems worldwide. Previous studies have shown that fixation of N by plants can be limited by the availability of phosphorus (P) in soils. We used global meta-analysis to investigate how P availability controls SNF. In experiments in which plants were grown in an artificial medium, severe P deficiencies in the nutritive solution ([PO4] < 5-42 μM) depressed SNF flux through both a direct decrease in the plant fixation rate (i.e., decreased N fixed per unit of plant biomass) and an indirect effect (i.e., through plant biomass). In most experiments with plants grown in soils, SNF was proportional to plant biomass and was consequently only indirectly limited by P. Some cases using unfertilized and weathered soils (ultisols or oxisols), where plants were particularly P stressed, were an exception with both direct and indirect P limitations. Our global analysis of the P-SNF relationship indicated that P bioavailability commonly limited SNF flux. We conclude that the main driver of in situ P limitation is indirect via limitation of plant growth, except in certain cases where both indirect and direct constraints may play a role. These cases of severe P deficiency may be mainly found in weathered tropical soils of Africa and South America, probably in unfertilized croplands which are depleted in P due to repeated biomass harvests.

Corn rootworm-active RNA DvSnf7: Repeat dose oral toxicology assessment in support of human and mammalian safety.

PubMed

Petrick, Jay S; Frierdich, Gregory E; Carleton, Stephanie M; Kessenich, Colton R; Silvanovich, Andre; Zhang, Yuanji; Koch, Michael S

2016-11-01

Genetically modified (GM) crops have been developed and commercialized that utilize double stranded RNAs (dsRNA) to suppress a target gene(s), producing virus resistance, nutritional and quality traits. MON 87411 is a GM maize variety that leverages dsRNAs to selectively control corn rootworm through production of a 240 base pair (bp) dsRNA fragment targeting for suppression the western corn rootworm (Diabrotica virgifera virgifera) Snf7 gene (DvSnf7). A bioinformatics assessment found that endogenous corn small RNAs matched ∼450 to 2300 unique RNA transcripts that likely code for proteins in rat, mouse, and human, demonstrating safe dsRNA consumption by mammals. Mice were administered DvSnf7 RNA (968 nucleotides, including the 240 bp DvSnf7 dsRNA) at 1, 10, or 100 mg/kg by oral gavage in a 28-day repeat dose toxicity study. No treatment-related effects were observed in body weights, food consumption, clinical observations, clinical chemistry, hematology, gross pathology, or histopathology endpoints. Therefore, the No Observed Adverse Effect Level (NOAEL) for DvSnf7 RNA was 100 mg/kg, the highest dose tested. These results demonstrate that dsRNA for insect control does not produce adverse health effects in mammals at oral doses millions to billions of times higher than anticipated human exposures and therefore poses negligible risk to mammals. Copyright © 2016 Monsanto Company. Published by Elsevier Inc. All rights reserved.

40 CFR 792.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 33 2013-07-01 2013-07-01 false Specimen and data storage facilities..., for the storage and retrieval of all raw data and specimens from completed studies. ... SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Facilities § 792.51 Specimen and data...

40 CFR 792.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 32 2014-07-01 2014-07-01 false Specimen and data storage facilities..., for the storage and retrieval of all raw data and specimens from completed studies. ... SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Facilities § 792.51 Specimen and data...

40 CFR 792.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 32 2011-07-01 2011-07-01 false Specimen and data storage facilities..., for the storage and retrieval of all raw data and specimens from completed studies. ... SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Facilities § 792.51 Specimen and data...

40 CFR 792.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 33 2012-07-01 2012-07-01 false Specimen and data storage facilities..., for the storage and retrieval of all raw data and specimens from completed studies. ... SUBSTANCES CONTROL ACT (CONTINUED) GOOD LABORATORY PRACTICE STANDARDS Facilities § 792.51 Specimen and data...

18 CFR 157.213 - Underground storage field facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... storage reservoir and within the buffer area; (4) A detailed description of present storage operations and..., provided the storage facility's certificated physical parameters—including total inventory, reservoir pressure, reservoir and buffer boundaries, and certificated capacity remain unchanged—and provided...

Depleted uranium dioxide melting in cold crucible melter and production of granules from the melt for use in casks for spent nuclear fuel and radioactive wastes

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

Gotovchikov, V.T.; Seredenko, V.A.; Shatalov, V.V.

2007-07-01

This paper describes the results of a joint research program between the Russian Research Institute of Chemical Technology and Oak Ridge National Laboratory in the United States to develop new radiation shielding materials for use in the construction of casks for spent nuclear fuel (SNF) and radioactive wastes. Research and development is underway to develop SNF storage, transport, and disposal casks using shielding made with two new depleted uranium dioxide (DUO{sub 2}) materials: a DUO{sub 2}-steel cermet, and, DUCRETE with DUAGG (DUO{sub 2} aggregate). Melting the DUO{sub 2} and allowing it to freeze will produce a near 100% theoretical densitymore » product and assures that the product produces no volatile materials upon subsequent heating. Induction cold-crucible melters (ICCM) are being developed for this specific application. An ICCM is, potentially, a high throughput low-cost process. Schematics of a pilot facility were developed for the production of molten DUO{sub 2} from DU{sub 3}O{sub 8} to produce granules <1 mm in diameter in a continuous mode of operation. Thermodynamic analysis was conducted for uranium-oxygen system in the temperature range from 300 to 4000 K in various gas mediums. Temperature limits of stability for various uranium oxides were determined. Experiments on melting DUO{sub 2} were carried out in a high frequency ICCM in a cold crucible with a 120 mm in diameter. The microstructure of molten DUO{sub 2} was studied and lattice parameters were determined. It was experimentally proved, and validated by X-ray analysis, that an opportunity exists to produce molten DUO{sub 2} from mixed oxides (primarily DU{sub 3}O{sub 8}) by reduction melting in ICCM. This will allow using DU{sub 3}O{sub 8} directly to make DUO{sub 2}-a separate unit operation to produce UO{sub 2} feed material is not needed. Experiments were conducted concerning the addition of alloying components, gadolinium et al. oxides, into the DUO{sub 2} melt while in the crucible. These additives improve neutron and gamma radiation shielding and operation properties of the final solids. Cermet samples of 50 wt % DUO{sub 2} were produced. (authors)« less

Wolf (Canis lupus) Generation Time and Proportion of Current Breeding Females by Age.

PubMed

Mech, L David; Barber-Meyer, Shannon M; Erb, John

2016-01-01

Information is sparse about aspects of female wolf (Canis lupus) breeding in the wild, including age of first reproduction, mean age of primiparity, generation time, and proportion of each age that breeds in any given year. We studied these subjects in 86 wolves (113 captures) in the Superior National Forest (SNF), Minnesota (MN), during 1972-2013 where wolves were legally protected for most of the period, and in 159 harvested wolves from throughout MN wolf range during 2012-2014. Breeding status of SNF wolves were assessed via nipple measurements, and wolves from throughout MN wolf range, by placental scars. In the SNF, proportions of currently breeding females (those breeding in the year sampled) ranged from 19% at age 2 to 80% at age 5, and from throughout wolf range, from 33% at age 2 to 100% at age 7. Excluding pups and yearlings, only 33% to 36% of SNF females and 58% of females from throughout MN wolf range bred in any given year. Generation time for SNF wolves was 4.3 years and for MN wolf range, 4.7 years. These findings will be useful in modeling wolf population dynamics and in wolf genetic and dog-domestication studies.

A chromatin remodelling complex that loads cohesin onto human chromosomes

NASA Astrophysics Data System (ADS)

Hakimi, Mohamed-Ali; Bochar, Daniel A.; Schmiesing, John A.; Dong, Yuanshu; Barak, Orr G.; Speicher, David W.; Yokomori, Kyoko; Shiekhattar, Ramin

2002-08-01

Nucleosomal DNA is arranged in a higher-order structure that presents a barrier to most cellular processes involving protein DNA interactions. The cellular machinery involved in sister chromatid cohesion, the cohesin complex, also requires access to the nucleosomal DNA to perform its function in chromosome segregation. The machineries that provide this accessibility are termed chromatin remodelling factors. Here, we report the isolation of a human ISWI (SNF2h)-containing chromatin remodelling complex that encompasses components of the cohesin and NuRD complexes. We show that the hRAD21 subunit of the cohesin complex directly interacts with the ATPase subunit SNF2h. Mapping of hRAD21, SNF2h and Mi2 binding sites by chromatin immunoprecipitation experiments reveals the specific association of these three proteins with human DNA elements containing Alu sequences. We find a correlation between modification of histone tails and association of the SNF2h/cohesin complex with chromatin. Moreover, we show that the association of the cohesin complex with chromatin can be regulated by the state of DNA methylation. Finally, we present evidence pointing to a role for the ATPase activity of SNF2h in the loading of hRAD21 on chromatin.

Wolf (Canis lupus) generation time and proportion of current breeding females by age

USGS Publications Warehouse

Mech, L. David; Barber-Meyer, Shannon M.; Erb, John

2016-01-01

Information is sparse about aspects of female wolf (Canis lupus) breeding in the wild, including age of first reproduction, mean age of primiparity, generation time, and proportion of each age that breeds in any given year. We studied these subjects in 86 wolves (113 captures) in the Superior National Forest (SNF), Minnesota (MN), during 1972–2013 where wolves were legally protected for most of the period, and in 159 harvested wolves from throughout MN wolf range during 2012–2014. Breeding status of SNF wolves were assessed via nipple measurements, and wolves from throughout MN wolf range, by placental scars. In the SNF, proportions of currently breeding females (those breeding in the year sampled) ranged from 19% at age 2 to 80% at age 5, and from throughout wolf range, from 33% at age 2 to 100% at age 7. Excluding pups and yearlings, only 33% to 36% of SNF females and 58% of females from throughout MN wolf range bred in any given year. Generation time for SNF wolves was 4.3 years and for MN wolf range, 4.7 years. These findings will be useful in modeling wolf population dynamics and in wolf genetic and dog-domestication studies.

21 CFR 58.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 1 2012-04-01 2012-04-01 false Specimen and data storage facilities. 58.51..., for the storage and retrieval of all raw data and specimens from completed studies. ... GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Facilities § 58.51 Specimen and data...

21 CFR 58.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 1 2014-04-01 2014-04-01 false Specimen and data storage facilities. 58.51..., for the storage and retrieval of all raw data and specimens from completed studies. ... GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Facilities § 58.51 Specimen and data...

21 CFR 58.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Specimen and data storage facilities. 58.51..., for the storage and retrieval of all raw data and specimens from completed studies. ... GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Facilities § 58.51 Specimen and data...

21 CFR 58.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 1 2013-04-01 2013-04-01 false Specimen and data storage facilities. 58.51..., for the storage and retrieval of all raw data and specimens from completed studies. ... GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Facilities § 58.51 Specimen and data...

21 CFR 58.51 - Specimen and data storage facilities.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 1 2011-04-01 2011-04-01 false Specimen and data storage facilities. 58.51..., for the storage and retrieval of all raw data and specimens from completed studies. ... GOOD LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Facilities § 58.51 Specimen and data...

Geriatric Syndromes in Hospitalized Older Adults Discharged to Skilled Nursing Facilities

PubMed Central

Bell, Susan P.; Vasilevskis, Eduard E.; Saraf, Avantika A.; Jacobsen, J. Mary Lou; Kripalani, Sunil; Mixon, Amanda S.; Schnelle, John F.; Simmons, Sandra F.

2016-01-01

Background Geriatric syndromes are common in older adults and associated with adverse outcomes. The prevalence, recognition, co-occurrence and recent onset of geriatric syndromes in patients transferred from hospital to skilled nursing facilities (SNFs) are largely unknown. Design Quality improvement project. Setting Acute care academic medical center and 23 regional partner SNFs. Participants 686 Medicare beneficiaries hospitalized between January 2013 and April 2014 and referred to SNFs. Measurements Nine geriatric syndromes were measured by project staff -- weight loss, decreased appetite, incontinence and pain (standardized interview), depression (Geriatric Depression Scale), delirium (Brief-Confusion Assessment Method), cognitive impairment (Brief Interview for Mental Status), falls and pressure ulcers (hospital medical record utilizing hospital-implemented screening tools). Estimated prevalence, new-onset prevalence and common coexisting clusters were determined. The extent that syndromes were commonly recognized by treating physicians and communicated to SNFs in hospital discharge documentation was evaluated. Results Geriatric syndromes were prevalent in more than 90% of hospitalized adults referred to SNFs; 55% met criteria for 3 or more co-existing syndromes. Overall the most prevalent syndromes were falls (39%), incontinence (39%), decreased appetite (37%) and weight loss (33%). Of individuals that met criteria for 3 or more syndromes, the most common triad clusters included nutritional syndromes (weight loss, loss of appetite), incontinence and depression. Treating hospital physicians commonly did not recognize and document geriatric syndromes in discharge summaries, missing 33–95% of syndromes present as assessed by research personnel. Conclusion Geriatric syndromes in hospitalized older adults transferred to SNF are prevalent and commonly co-exist with the most frequent clusters including nutritional syndromes, depression and incontinence. Despite the high prevalence, this clinical information is rarely communicated to the SNF on discharge. PMID:27059831

Contemporary Trends and Predictors of Postacute Service Use and Routine Discharge Home After Stroke

PubMed Central

Prvu Bettger, Janet; McCoy, Lisa; Smith, Eric E.; Fonarow, Gregg C.; Schwamm, Lee H.; Peterson, Eric D.

2015-01-01

Background Returning home after the hospital is a primary aim for healthcare; however, additional postacute care (PAC) services are sometimes necessary for returning stroke patients to their pre‐event status. Recent trends in hospital discharge disposition specifying PAC use have not been examined across age groups or health insurance types. Methods and Results We examined trends in discharge to inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), home with home health (HH), and home without services for 849 780 patients ≥18 years of age with ischemic or hemorrhagic stroke at 1687 hospitals participating in Get With The Guidelines—Stroke. Multivariable analysis was used to identify factors associated with discharge to any PAC (IRF, SNF, or HH) versus discharge home without services. From 2003 to 2011, there was a 2.1% increase (unadjusted P=0.001) in PAC use after a stroke hospitalization. Change was greatest in SNF use, an 8.3% decrease over the period. IRF and HH increased 6.9% and 3.6%, respectively. The 2 strongest clinical predictors of PAC use after acute care were patients not ambulating on the second day of their hospital stay (ambulation odds ratio [OR], 3.03; 95% confidence interval [CI], 2.86 to 3.23) and those who failed a dysphagia screen or had an order restricting oral intake (OR, 2.48; 95% CI, 2.37 to 2.59). Conclusions Four in 10 stroke patients are discharged home without services. Although little has changed overall in PAC use since 2003, further research is needed to explain the shift in service use by type and its effect on outcomes. PMID:25713291

Contemporary trends and predictors of postacute service use and routine discharge home after stroke.

PubMed

Prvu Bettger, Janet; McCoy, Lisa; Smith, Eric E; Fonarow, Gregg C; Schwamm, Lee H; Peterson, Eric D

2015-02-23

Returning home after the hospital is a primary aim for healthcare; however, additional postacute care (PAC) services are sometimes necessary for returning stroke patients to their pre-event status. Recent trends in hospital discharge disposition specifying PAC use have not been examined across age groups or health insurance types. We examined trends in discharge to inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), home with home health (HH), and home without services for 849 780 patients ≥18 years of age with ischemic or hemorrhagic stroke at 1687 hospitals participating in Get With The Guidelines-Stroke. Multivariable analysis was used to identify factors associated with discharge to any PAC (IRF, SNF, or HH) versus discharge home without services. From 2003 to 2011, there was a 2.1% increase (unadjusted P=0.001) in PAC use after a stroke hospitalization. Change was greatest in SNF use, an 8.3% decrease over the period. IRF and HH increased 6.9% and 3.6%, respectively. The 2 strongest clinical predictors of PAC use after acute care were patients not ambulating on the second day of their hospital stay (ambulation odds ratio [OR], 3.03; 95% confidence interval [CI], 2.86 to 3.23) and those who failed a dysphagia screen or had an order restricting oral intake (OR, 2.48; 95% CI, 2.37 to 2.59). Four in 10 stroke patients are discharged home without services. Although little has changed overall in PAC use since 2003, further research is needed to explain the shift in service use by type and its effect on outcomes. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Neuropsychiatric symptoms in geriatric patients admitted to skilled nursing facilities in nursing homes for rehabilitation after stroke: a longitudinal multicenter study.

PubMed

Buijck, Bianca I; Zuidema, Sytse U; Spruit-van Eijk, Monica; Geurts, Alexander C H; Koopmans, Raymond T C M

2012-07-01

To investigate the prevalence and course of neuropsychiatric symptoms (NPS) in geriatric patients admitted to skilled nursing facilities (SNFs) for rehabilitation after stroke. This was a longitudinal multicenter study within 15 SNFs in the Netherlands. NPS were assessed in 145 patients with stroke through the Neuropsychiatric Inventory-Nursing Home version (NPI-NH) with measurements on admission and at discharge. The prevalence and course of NPS were described in terms of cumulative prevalence (symptoms either on admission or at discharge), conversion (only symptoms at discharge), remission (only symptoms on admission), and persistence (symptoms both on admission and at discharge) for patients who were discharged to an independent living situation within one year after admission and patients who had to stay in the SNF for long term care. Eighty percent had a first-ever stroke and 74% could be successfully discharged. Overall, the most common NPS were depression (33%), eating changes (18%), night-time disturbances (19%), anxiety (15%), irritability (12%), and disinhibition (12%). One year after admission, the patients who were still in the SNF showed significantly more hallucinations (p = 0.016), delusions (p = 0.016), agitation (p = 0.004), depression (p = 0.000), disinhibition (p = 0.004), irritability (p = 0.018), and night-time disturbances (p = 0.001) than those who had been discharged. The overall prevalence of NPS in this study was lower than reported by other studies in different settings. There was a high prevalence of NPS in patients that could not be successfully discharged. The findings suggest that NPS should be optimally treated to improve outcome of rehabilitation. Copyright © 2011 John Wiley & Sons, Ltd.

Bias estimates used in lieu of validation of fission products and minor actinides in MCNP K eff calculations for PWR burnup credit casks

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

Mueller, Don E.; Marshall, William J.; Wagner, John C.

The U.S. Nuclear Regulatory Commission (NRC) Division of Spent Fuel Storage and Transportation recently issued Interim Staff Guidance (ISG) 8, Revision 3. This ISG provides guidance for burnup credit (BUC) analyses supporting transport and storage of PWR pressurized water reactor (PWR) fuel in casks. Revision 3 includes guidance for addressing validation of criticality (k eff) calculations crediting the presence of a limited set of fission products and minor actinides (FP&MA). Based on previous work documented in NUREG/CR-7109, recommendation 4 of ISG-8, Rev. 3, includes a recommendation to use 1.5 or 3% of the FP&MA worth to conservatively cover the biasmore » due to the specified FP&MAs. This bias is supplementary to the bias and bias uncertainty resulting from validation of k eff calculations for the major actinides in SNF and does not address extension to actinides and fission products beyond those identified herein. The work described in this report involves comparison of FP&MA worths calculated using SCALE and MCNP with ENDF/B-V, -VI, and -VII based nuclear data and supports use of the 1.5% FP&MA worth bias when either SCALE or MCNP codes are used for criticality calculations, provided the other conditions of the recommendation 4 are met. The method used in this report may also be applied to demonstrate the applicability of the 1.5% FP&MA worth bias to other codes using ENDF/B V, VI or VII based nuclear data. The method involves use of the applicant s computational method to generate FP&MA worths for a reference SNF cask model using specified spent fuel compositions. The applicant s FP&MA worths are then compared to reference values provided in this report. The applicants FP&MA worths should not exceed the reference results by more than 1.5% of the reference FP&MA worths.« less

40 CFR 280.220 - Ownership of an underground storage tank or underground storage tank system or facility or...

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 26 2010-07-01 2010-07-01 false Ownership of an underground storage tank or underground storage tank system or facility or property on which an underground storage tank or underground storage tank system is located. 280.220 Section 280.220 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID...

Similarity network fusion for aggregating data types on a genomic scale.

PubMed

Wang, Bo; Mezlini, Aziz M; Demir, Feyyaz; Fiume, Marc; Tu, Zhuowen; Brudno, Michael; Haibe-Kains, Benjamin; Goldenberg, Anna

2014-03-01

Recent technologies have made it cost-effective to collect diverse types of genome-wide data. Computational methods are needed to combine these data to create a comprehensive view of a given disease or a biological process. Similarity network fusion (SNF) solves this problem by constructing networks of samples (e.g., patients) for each available data type and then efficiently fusing these into one network that represents the full spectrum of underlying data. For example, to create a comprehensive view of a disease given a cohort of patients, SNF computes and fuses patient similarity networks obtained from each of their data types separately, taking advantage of the complementarity in the data. We used SNF to combine mRNA expression, DNA methylation and microRNA (miRNA) expression data for five cancer data sets. SNF substantially outperforms single data type analysis and established integrative approaches when identifying cancer subtypes and is effective for predicting survival.

Spent nuclear fuel system dynamic stability under normal conditions of transportation

DOE PAGES

Jiang, Hao; Wang, Jy-An John

2016-10-14

In a horizontal layout of a spent nuclear fuel (SNF) assembly under normal conditions of transportation (NCT), the fuel assembly’s skeleton formed by guide tubes and spacer grids is the primary load bearing structure for carrying and transferring the vibration loads within an SNF assembly. Therefore, the integrity of guide tubes and spacer grids will dictate the vibration amplitude/intensity of the fuel assembly during transport, and must be considered when designing multipurpose purpose canister (MPC) for safe SNF transport. This paper investigates the SNF assembly deformation dynamics during normal vibration mode, as well as the transient shock mode inside themore » cask during NCT. In conclusion, dynamic analyses were performed in the frequency domain to study frequency characteristic of the fuel assembly system and in the time domain to simulate the transient dynamic response of the fuel assembly.« less

Spent nuclear fuel system dynamic stability under normal conditions of transportation

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

Jiang, Hao; Wang, Jy-An John

In a horizontal layout of a spent nuclear fuel (SNF) assembly under normal conditions of transportation (NCT), the fuel assembly’s skeleton formed by guide tubes and spacer grids is the primary load bearing structure for carrying and transferring the vibration loads within an SNF assembly. Therefore, the integrity of guide tubes and spacer grids will dictate the vibration amplitude/intensity of the fuel assembly during transport, and must be considered when designing multipurpose purpose canister (MPC) for safe SNF transport. This paper investigates the SNF assembly deformation dynamics during normal vibration mode, as well as the transient shock mode inside themore » cask during NCT. In conclusion, dynamic analyses were performed in the frequency domain to study frequency characteristic of the fuel assembly system and in the time domain to simulate the transient dynamic response of the fuel assembly.« less

Characterization of Actinides Complexed to Nuclear Fuel Constituents Using ESI-MS.

PubMed

McDonald, Luther W; Campbell, James A; Vercouter, Thomas; Clark, Sue B

2016-03-01

Electrospray ionization-mass spectrometry (ESI-MS) was tested for its use in monitoring spent nuclear fuel (SNF) constituents including U, Pu, dibutyl phosphate (DBP), and tributyl phosphate (TBP). Both positive and negative ion modes were used to evaluate the speciation of U and Pu with TBP and DBP. Furthermore, apparent stability constants were determined for U complexed to TBP and DBP. In positive ion mode, TBP produced a strong signal with and without complexation to U or Pu, but, in negative ion mode, no TBP, U-TBP, or Pu-TBP complexes were observed. Apparent stability constants were determined for [UO2(NO3)2(TBP)2], [UO2(NO3)2(H2O)(TBP)2], and [UO2(NO3)2(TBP)3]. In contrast DBP, U-DBP, and Pu-DBP complexes were observed in both positive and negative ion modes. Apparent stability constants were determined for the species [UO2(DBP)], [UO2(DBP)3], and [UO2(DBP)4]. Analyzing mixtures of U or Pu with TBP and DBP yielded the formation of ternary complexes whose stoichiometry was directly related to the ratio of TBP to DBP. The ESI-MS protocols used in this study will further demonstrate the utility of ESI-MS and its applicability to process control monitoring in SNF reprocessing facilities.

2-Deoxyglucose impairs Saccharomyces cerevisiae growth by stimulating Snf1-regulated and α-arrestin-mediated trafficking of hexose transporters 1 and 3.

PubMed

O'Donnell, Allyson F; McCartney, Rhonda R; Chandrashekarappa, Dakshayini G; Zhang, Bob B; Thorner, Jeremy; Schmidt, Martin C

2015-03-01

The glucose analog 2-deoxyglucose (2DG) inhibits the growth of Saccharomyces cerevisiae and human tumor cells, but its modes of action have not been fully elucidated. Yeast cells lacking Snf1 (AMP-activated protein kinase) are hypersensitive to 2DG. Overexpression of either of two low-affinity, high-capacity glucose transporters, Hxt1 and Hxt3, suppresses the 2DG hypersensitivity of snf1Δ cells. The addition of 2DG or the loss of Snf1 reduces HXT1 and HXT3 expression levels and stimulates transporter endocytosis and degradation in the vacuole. 2DG-stimulated trafficking of Hxt1 and Hxt3 requires Rod1/Art4 and Rog3/Art7, two members of the α-arrestin trafficking adaptor family. Mutations in ROD1 and ROG3 that block binding to the ubiquitin ligase Rsp5 eliminate Rod1- and Rog3-mediated trafficking of Hxt1 and Hxt3. Genetic analysis suggests that Snf1 negatively regulates both Rod1 and Rog3, but via different mechanisms. Snf1 activated by 2DG phosphorylates Rod1 but fails to phosphorylate other known targets, such as the transcriptional repressor Mig1. We propose a novel mechanism for 2DG-induced toxicity whereby 2DG stimulates the modification of α-arrestins, which promote glucose transporter internalization and degradation, causing glucose starvation even when cells are in a glucose-rich environment. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

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

Maheras, Steven J.; Best, Ralph E.; Ross, Steven B.

A preliminary evaluation of removing spent nuclear fuel (SNF) from 13 shutdown nuclear power reactor sites was conducted. At these shutdown sites the nuclear power reactors have been permanently shut down and the sites have been decommissioned or are undergoing decommissioning. The shutdown sites were Maine Yankee, Yankee Rowe, Connecticut Yankee, Humboldt Bay, Big Rock Point, Rancho Seco, Trojan, La Crosse, Zion, Crystal River, Kewaunee, San Onofre, and Vermont Yankee. The evaluation was divided into four components: (1) characterization of the SNF and greater-than-Class C low-level radioactive waste (GTCC waste) inventory, (2) a description of the on-site infrastructure and conditionsmore » relevant to transportation of SNF and GTCC waste, (3) an evaluation of the near-site transportation infrastructure and experience relevant to shipping transportation casks containing SNF and GTCC waste, including identification of gaps in information, and (4) an evaluation of the actions necessary to prepare for and remove SNF and GTCC waste. Every site was found to have at least one off-site transportation mode option for removing its SNF and GTCC waste; some have multiple options. Experience removing large components during reactor decommissioning provided an important source of information used to identify the transportation mode options for the sites. Especially important in conducting the evaluation were site visits, through which information was obtained that would not have been available otherwise. Extensive photographs taken during the site visits proved to be particularly useful in documenting the current conditions at or near the sites. It is expected that additional site visits will be conducted to add to the information presented in the evaluation.« less

Thermal Storage Materials Laboratory | Energy Systems Integration Facility

Science.gov Websites

| NREL Materials Laboratory Thermal Storage Materials Laboratory In the Energy Systems Integration Facility's Thermal Storage Materials Laboratory, researchers investigate materials that can be used as high-temperature heat transfer fluids or thermal energy storage media in concentrating solar

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

J. Bisset

This calculation documents the design of the Spent Nuclear Fuel (SNF) and High-Level Waste (HLW) Cask storage slab for the Aging Area. The design is based on the weights of casks that may be stored on the slab, the weights of vehicles that may be used to move the casks, and the layout shown on the sketch for a 1000 Metric Ton of Heavy Metal (MTHM) storage pad on Attachment 2, Sht.1 of the calculation 170-C0C-C000-00100-000-00A (BSC 2004a). The analytical model used herein is based on the storage area for 8 vertical casks. To simplify the model, the storage areamore » of the horizontal concrete modules and their related shield walls is not included. The heavy weights of the vertical storage casks and the tensile forces due to pullout at the anchorages will produce design moments and shear forces that will envelope those that would occur in the storage area of the horizontal modules. The design loadings will also include snow and live loads. In addition, the design will also reflect pertinent geotechnical data. This calculation will document the preliminary thickness and general reinforcing steel requirements for the slab. This calculation also documents the initial design of the cask anchorage. Other slab details are not developed in this calculation. They will be developed during the final design process. The calculation also does not include the evaluation of the effects of cask drop loads. These will be evaluated in this or another calculation when the exact cask geometry is known.« less

Rhabdoid and Undifferentiated Phenotype in Renal Cell Carcinoma: Analysis of 32 Cases Indicating a Distinctive Common Pathway of Dedifferentiation Frequently Associated With SWI/SNF Complex Deficiency.

PubMed

Agaimy, Abbas; Cheng, Liang; Egevad, Lars; Feyerabend, Bernd; Hes, Ondřej; Keck, Bastian; Pizzolitto, Stefano; Sioletic, Stefano; Wullich, Bernd; Hartmann, Arndt

2017-02-01

Undifferentiated (anaplastic) and rhabdoid cell features are increasingly recognized as adverse prognostic findings in renal cell carcinoma (RCC), but their molecular pathogenesis has not been studied sufficiently. Recent studies identified alterations in the Switch Sucrose nonfermentable (SWI/SNF) chromatin remodeling complex as molecular mechanisms underlying dedifferentiation and rhabdoid features in carcinomas of different organs. We herein have analyzed 32 undifferentiated RCCs having in common an undifferentiated (anaplastic) phenotype, prominent rhabdoid features, or both, irrespective of the presence or absence of conventional RCC component. Cases were stained with 6 SWI/SNF pathway members (SMARCB1, SMARCA2, SMARCA4, ARID1A, SMARCC1, and SMARCC2) in addition to conventional RCC markers. Patients were 20 males and 12 females aged 32 to 85 years (mean, 59). A total of 22/27 patients with known stage presented with ≥pT3. A differentiated component varying from microscopic to major component was detected in 20/32 cases (16 clear cell and 2 cases each chromophobe and papillary RCC). The undifferentiated component varied from rhabdoid dyscohesive cells to large epithelioid to small monotonous anaplastic cells. Variable loss of at least 1 SWI/SNF complex subunit was noted in the undifferentiated/rhabdoid component of 21/32 cases (65%) compared with intact or reduced expression in the differentiated component. A total of 15/17 patients (88%) with follow-up died of metastatic disease (mostly within 1 y). Only 2 patients were disease free at last follow-up (1 and 6 y). No difference in survival, age distribution, or sex was observed between the SWI/SNF-deficient and the SWI/SNF-intact group. This is the first study exploring the role of SWI/SNF deficiency as a potential mechanism underlying undifferentiated and rhabdoid phenotype in RCC. Our results highlight the association between the aggressive rhabdoid phenotype and the SWI/SNF complex deficiency, consistent with studies on similar neoplasms in other organs. Thorough sampling of such tumors that are usually huge and locally advanced is necessary for recognizing the clone of origin and hence for proper subtyping and also for differentiating them from undifferentiated urothelial carcinoma.

Subacute care, Medicare benefits, and nursing home behavior.

PubMed

Aaronson, W E; Zinn, J S; Rosko, M D

1995-09-01

Two policy changes in 1988, one administrative and one legislative, allowed greater Medicare coverage of subacute care in skilled nursing facilities (SNFs). The Medicare Catastrophic Coverage Act (MCCA) of 1988, in conjunction with an administrative directive, or transmittal, from the Health Care Financing Administration (HCFA), changed the Medicare SNF benefit structure substantially. In this study, we specified a simultaneous equation system to explain the effects of the benefit changes on Medicare use. The results suggest that the two policy changes increased Medicare use in Pennsylvania SNFs substantially; however, the increase was associated with facility and case mix characteristics, which suggest that the increase was largely attributable to reclassification of current patients from other payer categories, Medicaid and self-pay, rather than new admissions. The effects of the MCCA and the HCFA transmittal on increased Medicare use were unanticipated and have important implications for the way in which subacute care is defined and financed in future benefit discussions.

Medicare program; prospective payment system and consolidated billing for skilled nursing facilities for FY 2012. Final rule.

PubMed

2011-08-08

This final rule updates the payment rates used under the prospective payment system for skilled nursing facilities (SNFs) for fiscal year 2012. In addition, it recalibrates the case-mix indexes so that they more accurately reflect parity in expenditures between RUG-IV and the previous case-mix classification system. It also includes a discussion of a Non-Therapy Ancillary component currently under development within CMS. In addition, this final rule discusses the impact of certain provisions of the Affordable Care Act, and reduces the SNF market basket percentage by the multi-factor productivity adjustment. This rule also implements certain changes relating to the payment of group therapy services and implements new resident assessment policies. Finally, this rule announces that the proposed provisions regarding the ownership disclosure requirements set forth in section 6101 of the Affordable Care Act will be finalized at a later date.

Storage for greater-than-Class C low-level radioactive waste

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

Beitel, G.A.

1991-12-31

EG and G Idaho, Inc., at the Idaho National Engineering Laboratory (INEL) is actively pursuing technical storage alternatives for greater-than-Class C low-level radioactive waste (GTCC LLW) until a suitable licensed disposal facility is operating. A recently completed study projects that between 2200 and 6000 m{sup 3} of GTCC LLW will be generated by the year 2035; the base case estimate is 3250 m{sup 3}. The current plan envisions a disposal facility available as early as the year 2010. A long-term dedicated storage facility could be available in 1997. In the meantime, it is anticipated that a limited number of sealedmore » sources that are no longer useful and have GTCC concentrations of radionuclides will require storage. Arrangements are being made to provide this interim storage at an existing DOE waste management facility. All interim stored waste will subsequently be moved to the dedicated storage facility once it is operating. Negotiations are under way to establish a host site for interim storage, which may be operational, at the earliest, by the second quarter of 1993. Two major activities toward developing a long-term dedicated storage facility are ongoing. (a) An engineering study, which explores costs for alternatives to provide environmentally safe storage and satisfy all regulations, is being prepared. Details of some of the findings of that study will be presented. (b) There is also an effort under way to seek the assistance of one or more private companies in providing dedicated storage. Alternatives and options will be discussed.« less

Feasibility study: Assess the feasibility of siting a monitored retrievable storage facility. Phase 1

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

King, J.W.

1993-08-01

The purpose of phase one of this study are: To understand the waste management system and a monitored retrievable storage facility; and to determine whether the applicant has real interest in pursuing the feasibility assessment process. Contents of this report are: Generating electric power; facts about exposure to radiation; handling storage, and transportation techniques; description of a proposed monitored retrievable storage facility; and benefits to be received by host jurisdiction.

36 CFR § 1254.28 - What items are not allowed in research rooms?

Code of Federal Regulations, 2013 CFR

2013-07-01

... for papers. (b) You may store personal items at no cost in lockers or other storage facilities in the NARA facility. These lockers or other storage facilities are available on a first-come-first-served basis. (c) You must remove your personal belongings each night from the lockers or other storage...

36 CFR 1232.16 - What documentation must an agency create before it transfers records to a records storage facility?

Code of Federal Regulations, 2011 CFR

2011-07-01

... agency create before it transfers records to a records storage facility? 1232.16 Section 1232.16 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT TRANSFER OF RECORDS TO RECORDS STORAGE FACILITIES § 1232.16 What documentation must an agency create before it...

36 CFR 1232.16 - What documentation must an agency create before it transfers records to a records storage facility?

Code of Federal Regulations, 2014 CFR

2014-07-01

... agency create before it transfers records to a records storage facility? 1232.16 Section 1232.16 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT TRANSFER OF RECORDS TO RECORDS STORAGE FACILITIES § 1232.16 What documentation must an agency create before it...

36 CFR 1232.16 - What documentation must an agency create before it transfers records to a records storage facility?

Code of Federal Regulations, 2012 CFR

2012-07-01

... agency create before it transfers records to a records storage facility? 1232.16 Section 1232.16 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT TRANSFER OF RECORDS TO RECORDS STORAGE FACILITIES § 1232.16 What documentation must an agency create before it...

Long-term storage facility for reactor compartments in Sayda Bay - German support for utilization of nuclear submarines in Russia

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

Wolff, Dietmar; Voelzke, Holger; Weber, Wolfgang

2007-07-01

The German-Russian project that is part of the G8 initiative on Global Partnership Against the Spread of Weapons and Materials of Mass Destruction focuses on the speedy construction of a land-based interim storage facility for nuclear submarine reactor compartments at Sayda Bay near Murmansk. This project includes the required infrastructure facilities for long-term storage of about 150 reactor compartments for a period of about 70 years. The interim storage facility is a precondition for effective activities of decommissioning and dismantlement of almost all nuclear-powered submarines of the Russian Northern Fleet. The project also includes the establishment of a computer-assisted wastemore » monitoring system. In addition, the project involves clearing Sayda Bay of other shipwrecks of the Russian navy. On the German side the project is carried out by the Energiewerke Nord GmbH (EWN) on behalf of the Federal Ministry of Economics and Labour (BMWi). On the Russian side the Kurchatov Institute holds the project management of the long-term interim storage facility in Sayda Bay, whilst the Nerpa Shipyard, which is about 25 km away from the storage facility, is dismantling the submarines and preparing the reactor compartments for long-term interim storage. The technical monitoring of the German part of this project, being implemented by BMWi, is the responsibility of the Federal Institute for Materials Research and Testing (BAM). This paper gives an overview of the German-Russian project and a brief description of solutions for nuclear submarine disposal in other countries. At Nerpa shipyard, being refurbished with logistic and technical support from Germany, the reactor compartments are sealed by welding, provided with biological shielding, subjected to surface treatment and conservation measures. Using floating docks, a tugboat tows the reactor compartments from Nerpa shipyard to the interim storage facility at Sayda Bay where they will be left on the on-shore concrete storage space to allow the radioactivity to decay. For transport of reactor compartments at the shipyard, at the dock and at the storage facility, hydraulic keel blocks, developed and supplied by German subcontractors, are used. In July 2006 the first stage of the reactor compartment storage facility was commissioned and the first seven reactor compartments have been delivered from Nerpa shipyard. Following transports of reactor compartments to the storage facility are expected in 2007. (authors)« less

Mössbauer Studies of Stannous Fluoride Reactivity with Synthetic Tooth Enamel - A Model for the Tooth Cavity Protection Actions of Novel Dentifrices

NASA Astrophysics Data System (ADS)

Dénès, Georges; Muntasar, Abdualhafeed; Kozak, Kathy M.; Baig, Arif A.; White, Donald J.

2002-06-01

SnF2 is an important toothpaste ingredient, added for the provision of clinical efficacy for hard and soft tissue diseases and in breath protection. Synthetic calcium hydroxyapatite powders were exposed to liquid supernates (25 w/w% toothpaste water slurries, centrifuged) of Crest Gum Care® (SnF2) dentifrice. One-minute treatments were followed by 3x water washing, centrifugation and lyophilization. Post treatment, powders were analyzed by Mössbauer spectroscopy with 0.5-1 gram of treated apatite powder. Results show that tooth mineral stannous fluoride interactions include: (1) formation of surface reaction products with both Sn(II) and Sn(IV) oxidation states; (2) Sn-F binding on mineral surfaces with no evidence of SnO. The surface binding is, however, not pure Sn-F but contains contributions of other ligands, probably oxygens from surface phosphates or hydroxyl groups. Results also suggest that surface reacted stannous tin is oxidized with time, even when bound as a layer on the tooth surface. This study demonstrates for the first time the presence of Sn-F on tooth enamel post treatment and the contribution of passivation to long term stannous chemistry on tooth surfaces. The study also illustrates the practical applications of the Mössbauer technique.

Wolf (Canis lupus) Generation Time and Proportion of Current Breeding Females by Age

PubMed Central

2016-01-01

Information is sparse about aspects of female wolf (Canis lupus) breeding in the wild, including age of first reproduction, mean age of primiparity, generation time, and proportion of each age that breeds in any given year. We studied these subjects in 86 wolves (113 captures) in the Superior National Forest (SNF), Minnesota (MN), during 1972–2013 where wolves were legally protected for most of the period, and in 159 harvested wolves from throughout MN wolf range during 2012–2014. Breeding status of SNF wolves were assessed via nipple measurements, and wolves from throughout MN wolf range, by placental scars. In the SNF, proportions of currently breeding females (those breeding in the year sampled) ranged from 19% at age 2 to 80% at age 5, and from throughout wolf range, from 33% at age 2 to 100% at age 7. Excluding pups and yearlings, only 33% to 36% of SNF females and 58% of females from throughout MN wolf range bred in any given year. Generation time for SNF wolves was 4.3 years and for MN wolf range, 4.7 years. These findings will be useful in modeling wolf population dynamics and in wolf genetic and dog-domestication studies. PMID:27258193

The chromatin remodeling complex Swi/Snf regulates splicing of meiotic transcripts in Saccharomyces cerevisiae

PubMed Central

Douglass, Stephen; Galivanche, Anoop R.

2017-01-01

Abstract Despite its relatively streamlined genome, there are important examples of regulated RNA splicing in Saccharomyces cerevisiae, such as splicing of meiotic transcripts. Like other eukaryotes, S. cerevisiae undergoes a dramatic reprogramming of gene expression during meiosis, including regulated splicing of a number of crucial meiosis-specific RNAs. Splicing of a subset of these is dependent upon the splicing activator Mer1. Here we show a crucial role for the chromatin remodeler Swi/Snf in regulation of splicing of meiotic genes and find that the complex affects meiotic splicing in two ways. First, we show that Swi/Snf regulates nutrient-dependent downregulation of ribosomal protein encoding RNAs, leading to the redistribution of spliceosomes from this abundant class of intron-containing RNAs (the ribosomal protein genes) to Mer1-regulated transcripts. We also demonstrate that Mer1 expression is dependent on Snf2, its acetylation state and histone H3 lysine 9 acetylation at the MER1 locus. Hence, Snf2 exerts systems level control of meiotic gene expression through two temporally distinct mechanisms, demonstrating that it is a key regulator of meiotic splicing in S. cerevisiae. We also reveal an evolutionarily conserved mechanism whereby the cell redirects its energy from maintaining its translational capacity to the process of meiosis. PMID:28637241

Tolerance or avoidance: drought frequency determines the response of an N2 -fixing tree.

PubMed

Minucci, Jeffrey M; Miniat, Chelcy Ford; Teskey, Robert O; Wurzburger, Nina

2017-07-01

Climate change is increasing drought frequency, which may affect symbiotic N 2 fixation (SNF), a process that facilitates ecosystem recovery from disturbance. Here, we assessed the effect of drought frequency on the ecophysiology and SNF rate of a common N 2 -fixing tree in eastern US forests. We grew Robinia pseudoacacia seedlings under the same mean soil moisture, but with different drought frequency caused by wet-dry cycles of varying periodicity. We found no effect of drought frequency on final biomass or mean SNF rate. However, seedlings responded differently to wet and dry phases depending on drought frequency. Under low-frequency droughts, plants fixed carbon (C) and nitrogen (N) at similar rates during wet and dry phases. Conversely, under high-frequency droughts, plants fixed C and N at low rates during dry phases and at high rates during wet phases. Our findings suggest that R. pseudoacacia growth is resistant to increased drought frequency because it employs two strategies - drought tolerance or drought avoidance, followed by compensation. SNF may play a role in both by supplying N to leaf tissues for acclimation and by facilitating compensatory growth following drought. Our findings point to SNF as a mechanism for plants and ecosystems to cope with drought. © 2017 The Authors. New Phytologist © 2017 New Phytologist Trust.

SWI/SNF chromatin remodeling complex is critical for the expression of microphthalmia-associated transcription factor in melanoma cells

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

Vachtenheim, Jiri, E-mail: jivach@upn.anet.cz; Ondrusova, Lubica; Borovansky, Jan

2010-02-12

The microphthalmia-associated transcription factor (MITF) is required for melanocyte development, maintenance of the melanocyte-specific transcription, and survival of melanoma cells. MITF positively regulates expression of more than 25 genes in pigment cells. Recently, it has been demonstrated that expression of several MITF downstream targets requires the SWI/SNF chromatin remodeling complex, which contains one of the two catalytic subunits, Brm or Brg1. Here we show that the expression of MITF itself critically requires active SWI/SNF. In several Brm/Brg1-expressing melanoma cell lines, knockdown of Brg1 severely compromised MITF expression with a concomitant dowregulation of MITF targets and decreased cell proliferation. Although Brmmore » was able to substitute for Brg1 in maintaining MITF expression and melanoma cell proliferation, sequential knockdown of both Brm and Brg1 in 501mel cells abolished proliferation. In Brg1-null SK-MEL-5 melanoma cells, depletion of Brm alone was sufficient to abrogate MITF expression and cell proliferation. Chromatin immunoprecipitation confirmed the binding of Brg1 or Brm to the promoter of MITF. Together these results demonstrate the essential role of SWI/SNF for expression of MITF and suggest that SWI/SNF may be a promissing target in melanoma therapy.« less

Functional Silver-Silicone-Nanofilament-Composite Material for Water Disinfection.

PubMed

Meier, Margrith; Suppiger, Angela; Eberl, Leo; Seeger, Stefan

2017-01-01

The roughness of superhydrophobic silicone nanofilaments (SNFs) is exploited to enlarge the contact area of conventional filter material. As an efficient wetting of the filter material is crucial for water treatment, the wettability of SNFs is readily modified from superhydrophobic to hydrophilic during the functionalization process. SNFs are coated on glass beads and subsequently modified with biocidal silver nanoparticles (AgNPs). The enlarged surface area of SNFs allows a 30 times higher loading of AgNPs in comparison to glass beads without SNF coating. Thus, in column experiments, the AgNP-SNF-nanocomposite-modified glass beads exert superior antibacterial activity towards suspensions of E. coli K12 compared to AgNP functionalized glass beads without SNFs. Additionally, reusing the AgNP-SNF-nanocomposite-coated glass beads with fresh bacteria contaminated medium increases their efficacy and reduces the colony forming units by ≈6 log units. Thereby, the silver loss during percolation is below 0.1 μg mL -1 . These results highlight, first, the potential of AgNP-SNF-nanocomposite-modified glass beads as an effective filter substrate for water disinfection, and second, the efficiency of SNF coating in increasing the contact area of conventional filter material. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Chromatin-remodeling SWI/SNF complex regulates coenzyme Q6 synthesis and a metabolic shift to respiration in yeast.

PubMed

Awad, Agape M; Venkataramanan, Srivats; Nag, Anish; Galivanche, Anoop Raj; Bradley, Michelle C; Neves, Lauren T; Douglass, Stephen; Clarke, Catherine F; Johnson, Tracy L

2017-09-08

Despite its relatively streamlined genome, there are many important examples of regulated RNA splicing in Saccharomyces cerevisiae Here, we report a role for the chromatin remodeler SWI/SNF in respiration, partially via the regulation of splicing. We find that a nutrient-dependent decrease in Snf2 leads to an increase in splicing of the PTC7 transcript. The spliced PTC7 transcript encodes a mitochondrial phosphatase regulator of biosynthesis of coenzyme Q 6 (ubiquinone or CoQ 6 ) and a mitochondrial redox-active lipid essential for electron and proton transport in respiration. Increased splicing of PTC7 increases CoQ 6 levels. The increase in PTC7 splicing occurs at least in part due to down-regulation of ribosomal protein gene expression, leading to the redistribution of spliceosomes from this abundant class of intron-containing RNAs to otherwise poorly spliced transcripts. In contrast, a protein encoded by the nonspliced isoform of PTC7 represses CoQ 6 biosynthesis. Taken together, these findings uncover a link between Snf2 expression and the splicing of PTC7 and establish a previously unknown role for the SWI/SNF complex in the transition of yeast cells from fermentative to respiratory modes of metabolism. © 2017 by The American Society for Biochemistry and Molecular Biology, Inc.

Is Personality Associated with Health Care Use by Older Adults?

PubMed Central

Friedman, Bruce; Veazie, Peter J; Chapman, Benjamin P; Manning, Willard G; Duberstein, Paul R

2013-01-01

Context The patterns of health care utilization in the United States pose well-established challenges for public policy. Although economic and sociological research has resulted in considerable knowledge about what influences the use of health services, the psychological literature in this area is underdeveloped. Importantly, it is not known whether personality traits are associated with older adults’ use of acute and long-term care services. Methods Data were collected from 1,074 community-dwelling seniors participating in a Medicare demonstration. First they completed a self-report questionnaire measuring the “Big Five” personality traits: Neuroticism, Extraversion, Openness to Experience, Agreeableness, and Conscientiousness. During the next two years, the participants maintained daily journals of their use of health care services. We used regression models based on the Andersen behavioral model of health care utilization to test for associations. Findings Our hypothesis that higher Neuroticism would be associated with greater health care use was confirmed for three services—probability of any emergency department (ED) use, likelihood of any custodial nursing home use, and more skilled nursing facility (SNF) days for SNF users—but was disconfirmed for hospital days for those hospitalized. Higher Openness to Experience was associated with a greater likelihood of custodial home care use, and higher Agreeableness and lower Conscientiousness with a higher probability of custodial nursing home use. For users, lower Openness was associated with more ED visits and SNF days, and lower Conscientiousness with more ED visits. For many traits with significant associations, the predicted use was 16 to 30 percent greater for people high (low) versus low (high) in specific traits. Conclusions Personality traits are associated with Medicare beneficiaries’ use of many expensive health care services, findings that have implications for health services research and policy. Accordingly, person-centered interventions, population-based translational effectiveness programs, and other personalized approaches that leverage the profound advances in personality psychology in recent decades should be considered. PMID:24028697

Serious fall injury history and adverse health outcomes after initiating hemodialysis among older U.S. adults.

PubMed

Bowling, C Barrett; Hall, Rasheeda; Khakharia, Anjali; Franch, Harold A; Plantinga, Laura C

2018-01-16

Although older adults with pre-dialysis chronic kidney disease (CKD) are at higher risk for falls, the prognostic significance of a serious fall injury prior to dialysis initiation has not been well described in the end-stage renal disease population. We examined the association between a serious fall injury in the year prior to starting hemodialysis and adverse health outcomes in the year following dialysis initiation using a retrospective cohort study of U.S. Medicare beneficiaries ≥ 67 years old who initiated dialysis in 2010-2012. Serious fall injuries were defined using diagnostic codes for falls plus an injury (fracture, joint dislocation, or head injury). Health outcomes, defined as time-to-event variables within the first year of dialysis, included four outcomes: a subsequent serious fall injury, hospital admission, post-acute skilled nursing facility (SNF) utilization, and mortality. Among this cohort of 81,653 initiating hemodialysis, 2,958 (3.6%) patients had a serious fall injury in the year prior to hemodialysis initiation. In the first year of dialysis, 7.6% had a subsequent serious fall injury, 67.6% a hospitalization, 30.7% a SNF claim and 26.1% died. Those with vs. without a serious fall injury in the year prior to hemodialysis initiation were at higher risk (hazard ratio, 95% confidence interval) for a subsequent serious fall injury (2.65, 2.41-2.91), hospitalization (1.11, 1.06-1.16), SNF claim (1.40, 1.30-1.50), and death (1.14, 1.06-1.22). For older adults initiating dialysis, a history of a serious fall injury may provide prognostic information to support decision-making and establish expectations for life after dialysis initiation. Published by Oxford University Press on behalf of The Gerontological Society of America 2018. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Self-rated health predicts healthcare utilization in heart failure.

PubMed

Chamberlain, Alanna M; Manemann, Sheila M; Dunlay, Shannon M; Spertus, John A; Moser, Debra K; Berardi, Cecilia; Kane, Robert L; Weston, Susan A; Redfield, Margaret M; Roger, Véronique L

2014-05-28

Heart failure (HF) patients experience impaired functional status, diminished quality of life, high utilization of healthcare resources, and poor survival. Yet, the identification of patient-centered factors that influence prognosis is lacking. We determined the association of 2 measures of self-rated health with healthcare utilization and skilled nursing facility (SNF) admission in a community cohort of 417 HF patients prospectively enrolled between October 2007 and December 2010 from Olmsted County, MN. Patients completed a 12-item Short Form Health Survey (SF-12). Low self-reported physical functioning was defined as a score ≤ 25 on the SF-12 physical component. The first question of the SF-12 was used as a measure of self-rated general health. After 2 years, 1033 hospitalizations, 1407 emergency department (ED) visits, and 19,780 outpatient office visits were observed; 87 patients were admitted to a SNF. After adjustment for confounding factors, an increased risk of hospitalizations (1.52 [1.17 to 1.99]) and ED visits (1.48 [1.04 to 2.11]) was observed for those with low versus moderate-high self-reported physical functioning. Patients with poor and fair self-rated general health also experienced an increased risk of hospitalizations (poor: 1.73 [1.29 to 2.32]; fair: 1.46 [1.14 to 1.87]) and ED visits (poor: 1.73 [1.16 to 2.56]; fair: 1.48 [1.13 to 1.93]) compared with good-excellent self-rated general health. No association between self-reported physical functioning or self-rated general health with outpatient visits and SNF admission was observed. In community HF patients, self-reported measures of physical functioning predict hospitalizations and ED visits, indicating that these patient-reported measures may be useful in risk stratification and management in HF. © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Milk processed by pulsed electric fields: evaluation of microbial quality, physicochemical characteristics, and selected nutrients at different storage conditions.

PubMed

Bermúdez-Aguirre, Daniela; Fernández, Sulmer; Esquivel, Heracleo; Dunne, Patrick C; Barbosa-Cánovas, Gustavo V

2011-01-01

Pulsed electric fields (PEF) technology was used to pasteurize raw milk under selected treatments. Processing conditions were: temperature 20, 30, and 40 °C, electric field 30.76 to 53.84 kV/cm, and pulse numbers 12, 24, and 30 for skim milk (SM), and 12, 21, and 30 for whole milk (WM) (2 μs pulse width, monopolar). Physicochemical parameters (pH, electrical conductivity, density, color, solids nonfat [SNF]) and composition (protein and fat content) were measured after processing. Shelf life of SM and WM was assessed after processing at 46.15 kV/cm, combined with temperature (20 to 60 °C) and 30 pulses. Mesophilic and psychrophilic loads and pH were evaluated during storage at 4 and 21 °C. Results showed minor variations in physicochemical properties after processing. There was an interesting trend in SM in SNF, which decreased as treatment became stronger; similar behavior was observed for fat and protein, showing a 0.18% and 0.17% decrease, respectively, under the strongest conditions. Protein and fat content decreased in WM samples treated at 40 °C, showing a decrease in protein (0.11%), and an even higher decrease in fat content. During storage, PEF-treated milk samples showed higher stability at 4 °C with minor variations in pH; after 33 d, pH was higher than 6. However samples at 21 °C showed faster spoilage and pH dropped to 4 after 5 d. Growth of mesophilic bacteria was delayed in both milks after PEF processing, showing a 6- and 7-log cycles for SM and WM, respectively, after day 25 (4 °C); however, psychrophilic bacteria grew faster in both cases. Pulsed electric fields (PEF) technology in the pasteurization of liquid food products has shown positive results. Processing times can be reduced considerably, which in turn reduces the loss of nutrients and offers important savings in energy. PEF has been used successfully to pasteurize some liquid foods, but it is still not used commercially in milk pasteurization, although several trials have shown the positive effects of PEF milk pasteurization, which could allow for its future use at the industrial level. © 2011 Institute of Food Technologists®

Alaska SAR Facility mass storage, current system

NASA Technical Reports Server (NTRS)

Cuddy, David; Chu, Eugene; Bicknell, Tom

1993-01-01

This paper examines the mass storage systems that are currently in place at the Alaska SAR Facility (SAF). The architecture of the facility will be presented including specifications of the mass storage media that are currently used and the performances that we have realized from the various media. The distribution formats and media are also discussed. Because the facility is expected to service future sensors, the new requirements and possible solutions to these requirements are also discussed.

Space Station tethered refueling facility operations

NASA Technical Reports Server (NTRS)

Kiefel, E. R.; Rudolph, L. K.; Fester, D. A.

1986-01-01

The space-based orbital transfer vehicle will require a large cryogenic fuel storage facility at the Space Station. An alternative to fuel storage onboard the Space Station, is on a tethered orbital refueling facility (TORF) which is separated from the Space Station by a sufficient distance to induce a gravity gradient to settle the propellants. Facility operations are a major concern associated with a tethered LO2/LH2 storage depot. A study was carried out to analyze these operations so as to identify the preferred TORF deployment direction (up or down) and whether the TORF should be permanently or intermittently deployed. The analyses considered safety, contamination, rendezvous, servicing, transportation rate, communication, and viewing. An upwardly, intermittently deployed facility is the preferred configuration for a tethered cryogenic fuel storage.

Financial Assurance Requirements for Hazardous Waste Treatment, Storage and Disposal Facilities

EPA Pesticide Factsheets

The Resource Conservation and Recovery Act (RCRA) requires all treatment, storage and disposal facilities (TSDFs) to demonstrate that they will have the financial resources to properly close the facility

40 CFR 94.509 - Maintenance of records; submittal of information.

Code of Federal Regulations, 2013 CFR

2013-07-01

... disk, or some other method of data storage, depending upon the manufacturer's record retention..., associated storage facility or port facility, and the date the engine was received at the testing facility...

40 CFR 94.509 - Maintenance of records; submittal of information.

Code of Federal Regulations, 2011 CFR

2011-07-01

... disk, or some other method of data storage, depending upon the manufacturer's record retention..., associated storage facility or port facility, and the date the engine was received at the testing facility...

40 CFR 94.509 - Maintenance of records; submittal of information.

Code of Federal Regulations, 2012 CFR

2012-07-01

... disk, or some other method of data storage, depending upon the manufacturer's record retention..., associated storage facility or port facility, and the date the engine was received at the testing facility...

40 CFR 94.509 - Maintenance of records; submittal of information.

Code of Federal Regulations, 2014 CFR

2014-07-01

... disk, or some other method of data storage, depending upon the manufacturer's record retention..., associated storage facility or port facility, and the date the engine was received at the testing facility...

36 CFR 1232.16 - What documentation must an agency create before it transfers records to a records storage facility?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 36 Parks, Forests, and Public Property 3 2010-07-01 2010-07-01 false What documentation must an agency create before it transfers records to a records storage facility? 1232.16 Section 1232.16 Parks... RECORDS TO RECORDS STORAGE FACILITIES § 1232.16 What documentation must an agency create before it...

40 CFR 63.11087 - What requirements must I meet for gasoline storage tanks if my facility is a bulk gasoline...

Code of Federal Regulations, 2012 CFR

2012-07-01

... gasoline storage tanks if my facility is a bulk gasoline terminal, pipeline breakout station, or pipeline... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Source Category: Gasoline... § 63.11087 What requirements must I meet for gasoline storage tanks if my facility is a bulk gasoline...

40 CFR 63.11087 - What requirements must I meet for gasoline storage tanks if my facility is a bulk gasoline...

Code of Federal Regulations, 2014 CFR

2014-07-01

... gasoline storage tanks if my facility is a bulk gasoline terminal, pipeline breakout station, or pipeline... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Source Category: Gasoline... § 63.11087 What requirements must I meet for gasoline storage tanks if my facility is a bulk gasoline...

40 CFR 63.11087 - What requirements must I meet for gasoline storage tanks if my facility is a bulk gasoline...

Code of Federal Regulations, 2010 CFR

2010-07-01

... gasoline storage tanks if my facility is a bulk gasoline terminal, pipeline breakout station, or pipeline... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Source Category: Gasoline... § 63.11087 What requirements must I meet for gasoline storage tanks if my facility is a bulk gasoline...

40 CFR 63.11087 - What requirements must I meet for gasoline storage tanks if my facility is a bulk gasoline...

Code of Federal Regulations, 2013 CFR

2013-07-01

... gasoline storage tanks if my facility is a bulk gasoline terminal, pipeline breakout station, or pipeline... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Source Category: Gasoline... § 63.11087 What requirements must I meet for gasoline storage tanks if my facility is a bulk gasoline...

40 CFR 63.11087 - What requirements must I meet for gasoline storage tanks if my facility is a bulk gasoline...

Code of Federal Regulations, 2011 CFR

2011-07-01

... gasoline storage tanks if my facility is a bulk gasoline terminal, pipeline breakout station, or pipeline... CATEGORIES (CONTINUED) National Emission Standards for Hazardous Air Pollutants for Source Category: Gasoline... § 63.11087 What requirements must I meet for gasoline storage tanks if my facility is a bulk gasoline...

36 CFR § 1232.14 - What requirements must an agency meet before it transfers records to a records storage facility?

Code of Federal Regulations, 2013 CFR

2013-07-01

... agency meet before it transfers records to a records storage facility? § 1232.14 Section § 1232.14 Parks, Forests, and Public Property NATIONAL ARCHIVES AND RECORDS ADMINISTRATION RECORDS MANAGEMENT TRANSFER OF RECORDS TO RECORDS STORAGE FACILITIES § 1232.14 What requirements must an agency meet before it...

303-K Storage Facility closure plan. Revision 2

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

Not Available

1993-12-15

Recyclable scrap uranium with zircaloy-2 and copper silicon alloy, uranium-titanium alloy, beryllium/zircaloy-2 alloy, and zircaloy-2 chips and fines were secured in concrete billets (7.5-gallon containers) in the 303-K Storage Facility, located in the 300 Area. The beryllium/zircaloy-2 alloy and zircaloy-2 chips and fines are designated as mixed waste with the characteristic of ignitability. The concretion process reduced the ignitability of the fines and chips for safe storage and shipment. This process has been discontinued and the 303-K Storage Facility is now undergoing closure as defined in the Resource Conservation and Recovery Act (RCRA) of 1976 and the Washington Administrative Codemore » (WAC) Dangerous Waste Regulations, WAC 173-303-040. This closure plan presents a description of the 303-K Storage Facility, the history of materials and waste managed, and the procedures that will be followed to close the 303-K Storage Facility. The 303-K Storage Facility is located within the 300-FF-3 (source) and 300-FF-5 (groundwater) operable units, as designated in the Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) (Ecology et al. 1992). Contamination in the operable units 300-FF-3 and 300-FF-5 is scheduled to be addressed through the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) of 1980 remedial action process. Therefore, all soil remedial action at the 304 Facility will be conducted as part of the CERCLA remedial action of operable units 300-FF-3 and 300-FF-5.« less

Interplay between chromatin modulators and histone acetylation regulates the formation of accessible chromatin in the upstream regulatory region of fission yeast fbp1.

PubMed

Adachi, Akira; Senmatsu, Satoshi; Asada, Ryuta; Abe, Takuya; Hoffman, Charles S; Ohta, Kunihiro; Hirota, Kouji

2018-05-03

Numerous noncoding RNA transcripts are detected in eukaryotic cells. Noncoding RNAs transcribed across gene promoters are involved in the regulation of mRNA transcription via chromatin modulation. This function of noncoding RNA transcription was first demonstrated for the fission yeast fbp1 gene, where a cascade of noncoding RNA transcription events induces chromatin remodeling to facilitate transcription factor binding. We recently demonstrated that the noncoding RNAs from the fbp1 upstream region facilitate binding of the transcription activator Atf1 and thereby promote histone acetylation. Histone acetylation by histone acetyl transferases (HATs) and ATP-dependent chromatin remodelers (ADCRs) are implicated in chromatin remodeling, but the interplay between HATs and ADCRs in this process has not been fully elucidated. Here, we examine the roles played by two distinct ADCRs, Snf22 and Hrp3, and by the HAT Gcn5 in the transcriptional activation of fbp1. Snf22 and Hrp3 redundantly promote disassembly of chromatin in the fbp1 upstream region. Gcn5 critically contributes to nucleosome eviction in the absence of either Snf22 or Hrp3, presumably by recruiting Hrp3 in snf22∆ cells and Snf22 in hrp3∆ cells. Conversely, Gcn5-dependent histone H3 acetylation is impaired in snf22∆/hrp3∆ cells, suggesting that both redundant ADCRs induce recruitment of Gcn5 to the chromatin array in the fbp1 upstream region. These results reveal a previously unappreciated interplay between ADCRs and histone acetylation in which histone acetylation facilitates recruitment of ADCRs, while ADCRs are required for histone acetylation.

Yeast Carbon Catabolite Repression†

PubMed Central

Gancedo, Juana M.

1998-01-01

Glucose and related sugars repress the transcription of genes encoding enzymes required for the utilization of alternative carbon sources; some of these genes are also repressed by other sugars such as galactose, and the process is known as catabolite repression. The different sugars produce signals which modify the conformation of certain proteins that, in turn, directly or through a regulatory cascade affect the expression of the genes subject to catabolite repression. These genes are not all controlled by a single set of regulatory proteins, but there are different circuits of repression for different groups of genes. However, the protein kinase Snf1/Cat1 is shared by the various circuits and is therefore a central element in the regulatory process. Snf1 is not operative in the presence of glucose, and preliminary evidence suggests that Snf1 is in a dephosphorylated state under these conditions. However, the enzymes that phosphorylate and dephosphorylate Snf1 have not been identified, and it is not known how the presence of glucose may affect their activity. What has been established is that Snf1 remains active in mutants lacking either the proteins Grr1/Cat80 or Hxk2 or the Glc7 complex, which functions as a protein phosphatase. One of the main roles of Snf1 is to relieve repression by the Mig1 complex, but it is also required for the operation of transcription factors such as Adr1 and possibly other factors that are still unidentified. Although our knowledge of catabolite repression is still very incomplete, it is possible in certain cases to propose a partial model of the way in which the different elements involved in catabolite repression may be integrated. PMID:9618445

Yeast carbon catabolite repression.

PubMed

Gancedo, J M

1998-06-01

Glucose and related sugars repress the transcription of genes encoding enzymes required for the utilization of alternative carbon sources; some of these genes are also repressed by other sugars such as galactose, and the process is known as catabolite repression. The different sugars produce signals which modify the conformation of certain proteins that, in turn, directly or through a regulatory cascade affect the expression of the genes subject to catabolite repression. These genes are not all controlled by a single set of regulatory proteins, but there are different circuits of repression for different groups of genes. However, the protein kinase Snf1/Cat1 is shared by the various circuits and is therefore a central element in the regulatory process. Snf1 is not operative in the presence of glucose, and preliminary evidence suggests that Snf1 is in a dephosphorylated state under these conditions. However, the enzymes that phosphorylate and dephosphorylate Snf1 have not been identified, and it is not known how the presence of glucose may affect their activity. What has been established is that Snf1 remains active in mutants lacking either the proteins Grr1/Cat80 or Hxk2 or the Glc7 complex, which functions as a protein phosphatase. One of the main roles of Snf1 is to relieve repression by the Mig1 complex, but it is also required for the operation of transcription factors such as Adr1 and possibly other factors that are still unidentified. Although our knowledge of catabolite repression is still very incomplete, it is possible in certain cases to propose a partial model of the way in which the different elements involved in catabolite repression may be integrated.

Candida albicans Swi/Snf and Mediator Complexes Differentially Regulate Mrr1-Induced MDR1 Expression and Fluconazole Resistance.

PubMed

Liu, Zhongle; Myers, Lawrence C

2017-11-01

Long-term azole treatment of patients with chronic Candida albicans infections can lead to drug resistance. Gain-of-function (GOF) mutations in the transcription factor Mrr1 and the consequent transcriptional activation of MDR1 , a drug efflux coding gene, is a common pathway by which this human fungal pathogen acquires fluconazole resistance. This work elucidates the previously unknown downstream transcription mechanisms utilized by hyperactive Mrr1. We identified the Swi/Snf chromatin remodeling complex as a key coactivator for Mrr1, which is required to maintain basal and induced open chromatin, and Mrr1 occupancy, at the MDR1 promoter. Deletion of snf2 , the catalytic subunit of Swi/Snf, largely abrogates the increases in MDR1 expression and fluconazole MIC observed in MRR1 GOF mutant strains. Mediator positively and negatively regulates key Mrr1 target promoters. Deletion of the Mediator tail module med3 subunit reduces, but does not eliminate, the increased MDR1 expression and fluconazole MIC conferred by MRR1 GOF mutations. Eliminating the kinase activity of the Mediator Ssn3 subunit suppresses the decreased MDR1 expression and fluconazole MIC of the snf2 null mutation in MRR1 GOF strains. Ssn3 deletion also suppresses MDR1 promoter histone displacement defects in snf2 null mutants. The combination of this work with studies on other hyperactive zinc cluster transcription factors that confer azole resistance in fungal pathogens reveals a complex picture where the induction of drug efflux pump expression requires the coordination of multiple coactivators. The observed variations in transcription factor and target promoter dependence of this process may make the search for azole sensitivity-restoring small molecules more complicated. Copyright © 2017 American Society for Microbiology.

30 CFR 57.4130 - Surface electric substations and liquid storage facilities.

Code of Federal Regulations, 2013 CFR

2013-07-01

... liquid storage tanks. (3) Any group of containers used for storage of more than 60 gallons of flammable... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Surface electric substations and liquid storage facilities. 57.4130 Section 57.4130 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF...

30 CFR 57.4130 - Surface electric substations and liquid storage facilities.

Code of Federal Regulations, 2012 CFR

2012-07-01

... liquid storage tanks. (3) Any group of containers used for storage of more than 60 gallons of flammable... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Surface electric substations and liquid storage facilities. 57.4130 Section 57.4130 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF...

30 CFR 57.4130 - Surface electric substations and liquid storage facilities.

Code of Federal Regulations, 2011 CFR

2011-07-01

... liquid storage tanks. (3) Any group of containers used for storage of more than 60 gallons of flammable... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Surface electric substations and liquid storage facilities. 57.4130 Section 57.4130 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF...

30 CFR 57.4130 - Surface electric substations and liquid storage facilities.

Code of Federal Regulations, 2014 CFR

2014-07-01

... liquid storage tanks. (3) Any group of containers used for storage of more than 60 gallons of flammable... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Surface electric substations and liquid storage facilities. 57.4130 Section 57.4130 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF...

75 FR 52937 - Turtle Bayou Gas Storage Company, LLC; Notice of Application

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-30

...] Turtle Bayou Gas Storage Company, LLC; Notice of Application August 20, 2010. Take notice that on August 6, 2010, Turtle Bayou Gas Storage Company, LLC (Turtle Bayou), One Office Park Circle, Suite 300..., operate, and maintain a new salt dome natural gas storage facility in two caverns and related facilities...

77 FR 37036 - Williston Basin Interstate Pipeline Company; Notice of Request Under Blanket Authorization

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-20

... operation of natural gas facilities in Sheridan County and Campbell County, Wyoming and modification of underground storage facilities at its Baker Storage Reservoir in Fallon County, Montana. The details of... firm storage deliverability from its Baker Storage Reservoir that it will use to make up for declining...

Lessons learned from the Siting Process of an Interim Storage Facility in Spain - 12024

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

Lamolla, Meritxell Martell

2012-07-01

On 29 December 2009, the Spanish government launched a site selection process to host a centralised interim storage facility for spent fuel and high-level radioactive waste. It was an unprecedented call for voluntarism among Spanish municipalities to site a controversial facility. Two nuclear municipalities, amongst a total of thirteen municipalities from five different regions, presented their candidatures to host the facility in their territories. For two years the government did not make a decision. Only in November 30, 2011, the new government elected on 20 November 2011 officially selected a non-nuclear municipality, Villar de Canas, for hosting this facility. Thismore » paper focuses on analysing the factors facilitating and hindering the siting of controversial facilities, in particular the interim storage facility in Spain. It demonstrates that involving all stakeholders in the decision-making process should not be underestimated. In the case of Spain, all regional governments where there were candidate municipalities willing to host the centralised interim storage facility, publicly opposed to the siting of the facility. (author)« less

Spent Nuclear Fuel Transportation: An Examination of Potential Lessons Learned From Prior Shipping Campaigns

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

Marsha Keister; Kathryn McBride

The Nuclear Waste Policy Act of 1982 (NWPA), as amended, assigned the Department of Energy (DOE) responsibility for developing and managing a Federal system for the disposal of spent nuclear fuel (SNF) and high-level radioactive waste (HLW). The Office of Civilian Radioactive Waste Management (OCRWM) is responsible for accepting, transporting, and disposing of SNF and HLW at the Yucca Mountain repository in a manner that protects public health, safety, and the environment; enhances national and energy security; and merits public confidence. OCRWM faces a near-term challenge—to develop and demonstrate a transportation system that will sustain safe and efficient shipments ofmore » SNF and HLW to a repository. To better inform and improve its current planning, OCRWM has extensively reviewed plans and other documents related to past high-visibility shipping campaigns of SNF and other radioactive materials within the United States. This report summarizes the results of this review and, where appropriate, lessons learned.« less

A SWI/SNF Chromatin Remodelling Protein Controls Cytokinin Production through the Regulation of Chromatin Architecture

PubMed Central

Jégu, Teddy; Domenichini, Séverine; Blein, Thomas; Ariel, Federico; Christ, Aurélie; Kim, Soon-Kap; Crespi, Martin; Boutet-Mercey, Stéphanie; Mouille, Grégory; Bourge, Mickaël; Hirt, Heribert; Bergounioux, Catherine; Raynaud, Cécile; Benhamed, Moussa

2015-01-01

Chromatin architecture determines transcriptional accessibility to DNA and consequently gene expression levels in response to developmental and environmental stimuli. Recently, chromatin remodelers such as SWI/SNF complexes have been recognized as key regulators of chromatin architecture. To gain insight into the function of these complexes during root development, we have analyzed Arabidopsis knock-down lines for one sub-unit of SWI/SNF complexes: BAF60. Here, we show that BAF60 is a positive regulator of root development and cell cycle progression in the root meristem via its ability to down-regulate cytokinin production. By opposing both the deposition of active histone marks and the formation of a chromatin regulatory loop, BAF60 negatively regulates two crucial target genes for cytokinin biosynthesis (IPT3 and IPT7) and one cell cycle inhibitor (KRP7). Our results demonstrate that SWI/SNF complexes containing BAF60 are key factors governing the equilibrium between formation and dissociation of a chromatin loop controlling phytohormone production and cell cycle progression. PMID:26457678

The BAF60 Subunit of the SWI/SNF Chromatin-Remodeling Complex Directly Controls the Formation of a Gene Loop at FLOWERING LOCUS C in Arabidopsis[W

PubMed Central

Jégu, Teddy; Latrasse, David; Delarue, Marianne; Hirt, Heribert; Domenichini, Séverine; Ariel, Federico; Crespi, Martin; Bergounioux, Catherine; Raynaud, Cécile; Benhamed, Moussa

2014-01-01

SWI/SNF complexes mediate ATP-dependent chromatin remodeling to regulate gene expression. Many components of these complexes are evolutionarily conserved, and several subunits of Arabidopsis thaliana SWI/SNF complexes are involved in the control of flowering, a process that depends on the floral repressor FLOWERING LOCUS C (FLC). BAF60 is a SWI/SNF subunit, and in this work, we show that BAF60, via a direct targeting of the floral repressor FLC, induces a change at the high-order chromatin level and represses the photoperiod flowering pathway in Arabidopsis. BAF60 accumulates in the nucleus and controls the formation of the FLC gene loop by modulation of histone density, composition, and posttranslational modification. Physiological analysis of BAF60 RNA interference mutant lines allowed us to propose that this chromatin-remodeling protein creates a repressive chromatin configuration at the FLC locus. PMID:24510722

FY 2016 Status Report: Documentation of All CIRFT Data including Hydride Reorientation Tests (Draft M2)

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

Wang, Jy-An John; Wang, Hong; Jiang, Hao

The first portion of this report provides a detailed description of fiscal year (FY) 2015 test result corrections and analysis updates based on FY 2016 updates to the Cyclic Integrated Reversible-Bending Fatigue Tester (CIRFT) program methodology, which is used to evaluate the vibration integrity of spent nuclear fuel (SNF) under normal conditions of transport (NCT). The CIRFT consists of a U-frame test setup and a real-time curvature measurement method. The three-component U-frame setup of the CIRFT has two rigid arms and linkages connecting to a universal testing machine. The curvature SNF rod bending is obtained through a three-point deflection measurementmore » method. Three linear variable differential transformers (LVDTs) are clamped to the side connecting plates of the U-frame and used to capture deformation of the rod. The second portion of this report provides the latest CIRFT data, including data for the hydride reorientation test. The variations in fatigue life are provided in terms of moment, equivalent stress, curvature, and equivalent strain for the tested SNFs. The equivalent stress plot collapsed the data points from all of the SNF samples into a single zone. A detailed examination revealed that, at the same stress level, fatigue lives display a descending order as follows: H. B. Robinson Nuclear Power Station (HBR), LMK, and mixed uranium-plutonium oxide (MOX). Just looking at the strain, LMK fuel has a slightly longer fatigue life than HBR fuel, but the difference is subtle. The third portion of this report provides finite element analysis (FEA) dynamic deformation simulation of SNF assemblies . In a horizontal layout under NCT, the fuel assembly’s skeleton, which is formed by guide tubes and spacer grids, is the primary load bearing apparatus carrying and transferring vibration loads within an SNF assembly. These vibration loads include interaction forces between the SNF assembly and the canister basket walls. Therefore, the integrity of the guide tubes and spacer grids critically affects the vibration intensity of the fuel assembly during transport and must be considered when developing the multipurpose purpose canister (MPC) design for safe SNF transport.« less

40 CFR 90.704 - Maintenance of records; submission of information.

Code of Federal Regulations, 2014 CFR

2014-07-01

... paper) or reduced to microfilm, floppy disk, or some other method of data storage, depending upon the..., associated storage facility or port facility, and the date the engine was received at the testing facility...

40 CFR 90.704 - Maintenance of records; submission of information.

Code of Federal Regulations, 2013 CFR

2013-07-01

... paper) or reduced to microfilm, floppy disk, or some other method of data storage, depending upon the..., associated storage facility or port facility, and the date the engine was received at the testing facility...

40 CFR 90.704 - Maintenance of records; submission of information.

Code of Federal Regulations, 2011 CFR

2011-07-01

... paper) or reduced to microfilm, floppy disk, or some other method of data storage, depending upon the..., associated storage facility or port facility, and the date the engine was received at the testing facility...

40 CFR 90.704 - Maintenance of records; submission of information.

Code of Federal Regulations, 2012 CFR

2012-07-01

... paper) or reduced to microfilm, floppy disk, or some other method of data storage, depending upon the..., associated storage facility or port facility, and the date the engine was received at the testing facility...

Error estimates of Lagrange interpolation and orthonormal expansions for Freud weights

NASA Astrophysics Data System (ADS)

Kwon, K. H.; Lee, D. W.

2001-08-01

Let Sn[f] be the nth partial sum of the orthonormal polynomials expansion with respect to a Freud weight. Then we obtain sufficient conditions for the boundedness of Sn[f] and discuss the speed of the convergence of Sn[f] in weighted Lp space. We also find sufficient conditions for the boundedness of the Lagrange interpolation polynomial Ln[f], whose nodal points are the zeros of orthonormal polynomials with respect to a Freud weight. In particular, if W(x)=e-(1/2)x2 is the Hermite weight function, then we obtain sufficient conditions for the inequalities to hold:andwhere and k=0,1,2...,r.

CIRFT Data Update and Data Analyses for Spent Nuclear Fuel Vibration Reliability Study

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

Wang, Jy-An John; Wang, Hong

The objective of this research is to collect experimental data on spent nuclear fuel (SNF) from pressurized water reactors (PWRs), including the H. B. Robinson Nuclear Power Station (HBR), Catawba Nuclear Station, North Anna Nuclear Power Station (NA), and the Limerick Nuclear Power Station (LMK) boiling water reactor (BWR). Data will be collected under simulated transportation environments using the cyclic integrated reversible-bending fatigue tester (CIRFT), an enabling hot-cell testing technology developed at Oak Ridge National Laboratory (ORNL). These data will be used to support ongoing SNF modeling activities and to address regulatory issues associated with SNF transport.

Effects of payment changes on trends in post-acute care.

PubMed

Buntin, Melinda Beeuwkes; Colla, Carrie Hoverman; Escarce, José J

2009-08-01

To test how the implementation of new Medicare post-acute payment systems affected the use of inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), and home health agencies. Medicare acute hospital, IRF, and SNF claims; provider of services file; enrollment file; and Area Resource File data. We used multinomial logit models to measure realized access to post-acute care and to predict how access to alternative sites of care changed in response to prospective payment systems. A file was constructed linking data for elderly Medicare patients discharged from acute care facilities between 1996 and 2003 with a diagnosis of hip fracture, stroke, or lower extremity joint replacement. Although the effects of the payment systems on the use of post-acute care varied, most reduced the use of the site of care they directly affected and boosted the use of alternative sites of care. Payment system changes do not appear to have differentially affected the severely ill. Payment system incentives play a significant role in determining where Medicare beneficiaries receive their post-acute care. Changing these incentives results in shifting of patients between post-acute sites.

Behavioral problems among patients in skilled nursing facilities.

PubMed Central

Zimmer, J G; Watson, N; Treat, A

1984-01-01

This survey of a 33 per cent random sample (1,139) of 3,456 patients in 42 skilled nursing facilities (SNFs) in upstate New York yielded 64.2 per cent with significant behavioral problems. Of these, 257 (22.6 per cent) of the total sample had what were defined as "serious" problems (i.e., excluding those with only impaired judgment and/or physical restraint orders). Details of the problem behaviors of this group, their previous history, current management, frequency of psychiatric consultation, and adequacy of documentation were analyzed. Median age was the same as the general SNF population, a slightly lower proportion was female, and, while 66.5 per cent had diagnoses indicating organic brain syndrome, very few had specific psychiatric diagnoses, and only 4.7 per cent had been admitted from a psychiatric facility. The attending physician had noted the behavioral problem in the record in only 9.7 per cent and had requested psychiatric consultation in 14.8 per cent of these "serious" cases. The need for more staff training in mental health care, and more physician and psychiatric consultative assistance are discussed. PMID:6476166

A Pilot Health Information Technology-Based Effort to Increase the Quality of Transitions From Skilled Nursing Facility to Home: Compelling Evidence of High Rate of Adverse Outcomes.

PubMed

Donovan, Jennifer L; Kanaan, Abir O; Gurwitz, Jerry H; Tjia, Jennifer; Cutrona, Sarah L; Garber, Lawrence; Preusse, Peggy; Field, Terry S

2016-04-01

Older adults are often transferred from hospitals to skilled nursing facilities (SNFs) for post-acute care. Patients may be at risk for adverse outcomes after SNF discharges, but little research has focused on this period. Assessment of the feasibility of a transitional care intervention based on a combination of manual information transmission and health information technology to provide automated alert messages to primary care physicians and staff; pre-post analysis to assess potential impact. A multispecialty group practice. Adults aged 65 and older, discharged from SNFs to home; comparison group drawn from SNF discharges during the previous 1.5 years, matched on facility, patient age, and sex. For the pre-post analysis, we tracked rehospitalization within 30 days after discharge and adverse drug events within 45 days. The intervention was developed and implemented with manual transmission of information between 8 SNFs and the group practice followed by entry into the electronic health record. The process required a 5-day delay during which a large portion of the adverse events occurred. Over a 1-year period, automated alert messages were delivered to physicians and staff for the 313 eligible patients discharged from the 8 SNFs to home. We compared outcomes to those of individually matched discharges from the previous 1.5 years and found similar percentages with 30-day rehospitalizations (31% vs 30%, adjusted HR 1.06, 95% CI 0.80-1.4). Within the adverse drug event (ADE) study, 30% of the discharges during the intervention period and 30% of matched discharges had ADEs within 45 days. Older adults discharged from SNFs are at high risk of adverse outcomes immediately following discharge. Simply providing alerts to outpatient physicians, especially if delivered multiple days after discharge, is unlikely to have any impact on reducing these rates. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

36 CFR 1234.14 - What are the requirements for environmental controls for records storage facilities?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 36 Parks, Forests, and Public Property 3 2011-07-01 2011-07-01 false What are the requirements for environmental controls for records storage facilities? 1234.14 Section 1234.14 Parks, Forests, and Public... storage space that is designed to preserve them for their full retention period. New records storage...

Standardization of Fat:SNF ratio of milk and addition of sprouted wheat fada (semolina) for the manufacture of halvasan.

PubMed

Chaudhary, Apurva H; Patel, H G; Prajapati, P S; Prajapati, J P

2015-04-01

Traditional Indian Dairy Products such as Halvasan are manufactured in India using an age old practice. For manufacture of such products industrially, a standard formulation is required. Halvasan is a region specific, very popular heat desiccated milk product but has not been studied scientifically. Fat and Solids-not-fat (SNF) plays an important role in physico-chemical, sensory, textural characteristics and also the shelf life of any milk sweet. Hence for process standardization of Halvasan manufacture, different levels of Fat:SNF ratios i.e. 0.44, 0.55, 0.66 and 0.77 of milk were studied so that an optimum level yielding best organoleptic characteristics in final product can be selected. The product was made from milk standardized to these ratios of Fat:SNF and the product was manufactured as per the method tentatively employed on the basis of characterization of market samples of the product in laboratory. Based on the sensory results obtained, a Fat:SNF ratio of 0.66 for the milk has been selected. In the similar way, for standardizing the rate of addition of fada (semolina); 30, 40, 50 and 60 g fada (semolina) per kg of milk were added and based on the sensory observations, the level of fada (semolina) addition @50 gm/kg of milk was adjudged the best for Halvasan manufacture and hence selected.

Biofilm community diversity after exposure to 0·4% stannous fluoride gels.

PubMed

Reilly, C; Rasmussen, K; Selberg, T; Stevens, J; Jones, R S

2014-12-01

To test the effect of 0·4% stannous fluoride (SnF2 ) glycerine-based gels on specific portions of the bacterial community in both a clinical observational study and in vitro multispecies plaque-derived (MSPD) biofilm model. Potential changes to specific portions of the bacterial community were determined through the Human Oral Microbial Identification Microarray (HOMIM). Both the observational clinical study and the biofilm model showed that short-term use of 0·4% SnF2 gel has little effect on the bacterial community depicted by hierarchical cluster analysis. The amount of plaque accumulation on a subject's teeth, which was measured by plaque index scores, failed to show statistical significant changes over the two baselines or after treatment (P = 0·9928). The in vitro results were similar when examining the effect of 0·4% SnF2 gels on biofilm adherence through a crystal violet assay (P = 0·1157). The bacteria within the dental biofilms showed resilience in maintaining the overall community diversity after exposure to 0·4% SnF2 topical gels. The study supports that the immediate benefits of using 0·4% SnF2 gels in children may be strictly from fluoride ions inhibiting tooth demineralization rather than delivering substantial antimicrobial effects. © 2014 The Society for Applied Microbiology.

Functional Differentiation of SWI/SNF Remodelers in Transcription and Cell Cycle Control▿ †

PubMed Central

Moshkin, Yuri M.; Mohrmann, Lisette; van Ijcken, Wilfred F. J.; Verrijzer, C. Peter

2007-01-01

Drosophila BAP and PBAP represent two evolutionarily conserved subclasses of SWI/SNF chromatin remodelers. The two complexes share the same core subunits, including the BRM ATPase, but differ in a few signature subunits: OSA defines BAP, whereas Polybromo (PB) and BAP170 specify PBAP. Here, we present a comprehensive structure-function analysis of BAP and PBAP. An RNA interference knockdown survey revealed that the core subunits BRM and MOR are critical for the structural integrity of both complexes. Whole-genome expression profiling suggested that the SWI/SNF core complex is largely dysfunctional in cells. Regulation of the majority of target genes required the signature subunit OSA, PB, or BAP170, suggesting that SWI/SNF remodelers function mostly as holoenzymes. BAP and PBAP execute similar, independent, or antagonistic functions in transcription control and appear to direct mostly distinct biological processes. BAP, but not PBAP, is required for cell cycle progression through mitosis. Because in yeast the PBAP-homologous complex, RSC, controls cell cycle progression, our finding reveals a functional switch during evolution. BAP mediates G2/M transition through direct regulation of string/cdc25. Its signature subunit, OSA, is required for directing BAP to the string/cdc25 promoter. Our results suggest that the core subunits play architectural and enzymatic roles but that the signature subunits determine most of the functional specificity of SWI/SNF holoenzymes in general gene control. PMID:17101803

Referenced-site environmental document for a Monitored Retrievable Storage facility: backup waste management option for handling 1800 MTU per year

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

Silviera, D.J.; Aaberg, R.L.; Cushing, C.E.

This environmental document includes a discussion of the purpose of a monitored retrievable storage facility, a description of two facility design concepts (sealed storage cask and field drywell), a description of three reference sites (arid, warm-wet, and cold-wet), and a discussion and comparison of the impacts associated with each of the six site/concept combinations. This analysis is based on a 15,000-MTU storage capacity and a throughput rate of up to 1800 MTU per year.

Acute hepatitis B outbreaks in 2 skilled nursing facilities and possible sources of transmission: North Carolina, 2009-2010.

PubMed

Seña, Arlene C; Moorman, Anne; Njord, Levi; Williams, Roxanne E; Colborn, James; Khudyakov, Yury; Drobenuic, Jan; Xia, Guo-Liang; Wood, Hattie; Moore, Zack

2013-07-01

Acute hepatitis B virus (HBV) infections have been reported in long-term care facilities (LTCFs), primarily associated with infection control breaks during assisted blood glucose monitoring. We investigated HBV outbreaks that occurred in separate skilled nursing facilities (SNFs) to determine factors associated with transmission. Outbreak investigation with case-control studies. Two SNFs (facilities A and B) in Durham, North Carolina, during 2009-2010. Residents with acute HBV infection and controls randomly selected from HBV-susceptible residents during the outbreak period. After initial cases were identified, screening was offered to all residents, with repeat testing 3 months later for HBV-susceptible residents. Molecular testing was performed to assess viral relatedness. Infection control practices were observed. Case-control studies were conducted to evaluate associations between exposures and acute HBV infection in each facility. Six acute HBV cases were identified in each SNF. Viral phylogenetic analysis revealed a high degree of HBV relatedness within, but not between, facilities. No evaluated exposures were significantly associated with acute HBV infection in facility A; those associated with infection in facility B (all odds ratios >20) included injections, hospital or emergency room visits, and daily blood glucose monitoring. Observations revealed absence of trained infection control staff at facility A and suboptimal hand hygiene practices during blood glucose monitoring and insulin injections at facility B. These outbreaks underscore the vulnerability of LTCF residents to acute HBV infection, the importance of surveillance and prompt investigation of incident cases, and the need for improved infection control education to prevent transmission.

42 CFR 409.24 - Medical social services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 42 Public Health 2 2011-10-01 2011-10-01 false Medical social services. 409.24 Section 409.24... PROGRAM HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.24 Medical social services. Medicare pays for medical social services as posthospital SNF care, including— (a) Assessment of the social and...

42 CFR 413.30 - Limitations on payable costs.

Code of Federal Regulations, 2010 CFR

2010-10-01

... fluctuating populations. The SNF meets the following conditions: (i) Is located in an area (for example, a resort area) that has a population that varies significantly during the year. (ii) Is furnishing similar... and economy of the SNF's or the HHA's operations. If recommendations are made, any future exceptions...

42 CFR 409.24 - Medical social services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 42 Public Health 2 2014-10-01 2014-10-01 false Medical social services. 409.24 Section 409.24... PROGRAM HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.24 Medical social services. Medicare pays for medical social services as posthospital SNF care, including— (a) Assessment of the social and...

42 CFR 409.24 - Medical social services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 42 Public Health 2 2013-10-01 2013-10-01 false Medical social services. 409.24 Section 409.24... PROGRAM HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.24 Medical social services. Medicare pays for medical social services as posthospital SNF care, including— (a) Assessment of the social and...

42 CFR 409.24 - Medical social services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Medical social services. 409.24 Section 409.24... PROGRAM HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.24 Medical social services. Medicare pays for medical social services as posthospital SNF care, including— (a) Assessment of the social and...

42 CFR 409.24 - Medical social services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Medical social services. 409.24 Section 409.24... PROGRAM HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.24 Medical social services. Medicare pays for medical social services as posthospital SNF care, including— (a) Assessment of the social and...

Transcriptome analysis of two recombinant inbred lines of common bean contrasting for symbiotic nitrogen fixation

USDA-ARS?s Scientific Manuscript database

Common bean (Phaseolus vulgaris L.) is able to fix atmospheric nitrogen (N2) through symbiotic nitrogen fixation (SNF). Effective utilization of existing variability for SNF in common bean for genetic improvement requires an understanding of underlying genes and molecular mechanisms. The utility of ...

Genome-wide association analysis of symbiotic nitrogen fixation in common bean

USDA-ARS?s Scientific Manuscript database

A genome-wide association study (GWAS) was conducted to explore the genetic basis of variation for symbiotic nitrogen fixation (SNF) and related traits in the Andean diversity panel (ADP) comprised of 259 common bean (Phaseolus vulgaris) genotypes. The ADP was evaluated for SNF and related traits in...

42 CFR 409.21 - Nursing care.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Nursing care. 409.21 Section 409.21 Public Health... HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.21 Nursing care. (a) Basic rule. Medicare pays for nursing care as posthospital SNF care when provided by or under the supervision of a registered...

42 CFR 409.21 - Nursing care.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 42 Public Health 2 2012-10-01 2012-10-01 false Nursing care. 409.21 Section 409.21 Public Health... HOSPITAL INSURANCE BENEFITS Posthospital SNF Care § 409.21 Nursing care. (a) Basic rule. Medicare pays for nursing care as posthospital SNF care when provided by or under the supervision of a registered...