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AEI currently utilizes a RIEGL VZ400 Terrestrial Laser Scanner on various job sites.  This proecss utilizes a high accuracy 3D terrestrial LiDAR unit.  The data collected will be brought into a feature extraction software, TopoDOT.  TopoDOT utilizes a variety of tools to identify adn quickly extrapolate features within pointcloud data.  All features can then be imported into an AutoCAD drawing file.  AEI can provide an accurate 3D pointcloud of terrain plus any existing building or structures.  The pointcloud can also be converted for Building Information Models.

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Allen Engineering is involved with the civil design and surveying for the new park in Palm Bay, Flordia.  This Regional Park will feature 150 full service campsite hookups and is scheduled to break ground in 2018.  We are extremely proud to be involved in this project.

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Allen Engineering is beginning its 21st year associated with the Space Coast Post of the Society of American Military Engineers (SAME).  During our 21 years, we have helped raise over $350,000 in scholarships and endowments.  We are extremely proud to be associated with SAME and its continued commitment to offer opportunities for students pursuing careers in the engineering field.


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Check with the manufacturer of the gown to ratio between cholesterol generic 10 mg crestor mastercard determine what level of protection the gown is designated and/or provides blood cholesterol definition cheap 5 mg crestor otc. It may be helpful to cholesterol weight loss purchase crestor 20mg without a prescription monitor gown use to is cholesterol in eggs harmful buy discount crestor 10 mg on-line assure appropriate use, based on this guidance and in the event of shortages, conduct a risk assessment for allocating gowns for highest risk procedures. The need for and type of isolation gown selected is based on the nature of the patient interaction, including the anticipated degree of contact with infectious material and potential for blood and body fluid penetration of the barrier. This document indicates the following: "Gown and gloves - Wear a standard isolation gown and pair of nonsterile patient-care gloves for all patient contacts. Chapter 121- "Infectious Disease Disasters: Bioterrorism, Emerging Infections, and Pandemics. Planning Assumptions In accordance with these recommendations, laboratories must develop facility specific policies and procedures that take into account local capabilities and regulations. Specimens should be double bagged with the specimen placed in the first bag in the collection room. Point of Care Testing Point of care instrumentation should be left in the isolation room with the patient. Organization and Assignment of Responsibilities For Laboratory Directors Laboratory directors are responsible for all laboratory testing (including Point of Care testing) that occurs in their facilities (outlined in the Pathology Handbook 1106. Directors should be prepared to manage short term blood shortages if restriction on movement or quarantine effect the rate of blood donation. Direction, Control, and Coordination Pathology and Laboratory Medicine Services (10P11P) · Provide technical guidance for laboratory collection, examination and disposition of samples; · · · Provide guidance on internal and external specimen collection, preparation, chain of custody, and transportation to identified laboratory; Identify appropriate analytical laboratories for specimen analysis and guidelines for any in-house lab work; and Provide guidance for mortuary protocols and policies. The results are used to establish prevalence, or monitor and control a situation. If these site/specimens are not existing in your file 61 then new entry needs to be created. If sites need to generate a Critical View Alert the following Delta Check can be created in File 62. This mechanism is case-sensitive so the Set of Codes should match the following if this specific coding is utilized. Note: Laboratories may choose to use the State Health Dept suffix code created specifically for their state, for example. Situation Overview To ensure the planning environment remains organized, information provided must be unquestionable and properly analyzed. Tasks performed by position and organization: · Office of Procurement: Administer the full range of emergency procurement services through the effective and innovative use of procurement policies, procedures, and processes to provide the best possible care to Veterans. Additionally, Direction, Control, and Coordination is in coordination with Standard Operating Procedures. Metrics & Analytics (M&A): Ensures continuity of logistics and supply chain system enablers. Critical supply, equipment, and procurement resources need to be prioritized and directed to meet evolving demands and to maximize mission effectiveness. Administration, Finance, and Logistics All in accordance with Standard Operating Procedures and Emergency Operations. Scope the scope of this plan includes all communications to staff, patients, volunteers, visitors, and the general public. The workgroup has adopted a centralized, communications strategy that relies heavily on digital tools such as a Website and social media apps. To prepare for eventual decentralization of communications, the workgroup has developed and continues to expand a tool kit of templated materials for use by facility public affairs officers and other communicators to maintain a single voice and a coordinated, unified message. The tool kit contains guidance to the field, communications contacts, key messages, and both templated and sample communications tools, including press statements, signage, social media posts, and blog posts. Additionally, a Joint Task Force has been established to formalize the clearance process and enhanced tracking ability. The Task Force comprises four communications subgroups: Veteran, Field, External, and Congressional. Develop content for Veteran-, Field-, External-, and Congressional-facing communications. Review and comment on field generated products and offer determinations of what constitutes operational communications. Assist in response to questions from the field, which help drive development of the tool kit. Interface with the White House Coronavirus Task Force and obtain necessary approvals. Any operational messages (patient and employee health and safety communications, facility instructions, signage, etc. Previously approved materials are approved for use unless they are updated or withdrawn. Speak factually about topics that facility leadership can discuss with confidence. When it comes to testing, we are taking samples on-site and getting them processed [insert name of lab]. This may lengthen entry times, so patients are advised to allow for that when arriving for their appointments. Do you have a fever or worsening cough or shortness of breath or flu-like symptoms? Veterans and staff are encouraged to take everyday preventive actions to avoid being exposed to the virus: · · · · · Wash your hands often with soap and water for at least 20 seconds.

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No further information is given; it is unknown if the patient refused surgery or if there were co-morbid conditions that prevented the surgical procedure cholesterol age chart uk 20 mg crestor for sale. Assign code 6 when Note: Coding Reason for No Surgery of Primary Site as "refused" does not affect the coding of the other treatment fields cholesterol medication glass generic crestor 5 mg on-line. Code 7 means surgery is exactly what was recommended by the physician and the patient refused cholesterol levels post mi buy crestor 10mg with mastercard. If two treatment alternatives were offered and surgery was not chosen cholesterol in dried shrimp cheap crestor 20mg otc, code Reason no surgery of primary site as 1 [Surgery of the primary site was not performed because it was not part of the planned first-course treatment]. Assign code 8 when surgery is recommended, but it is unknown if the patient actually had the surgery Example: There is documentation in the medical record that the primary care physician referred the patient to a surgical oncologist. Follow-back to the surgical oncologist and primary care physician yields no further information. Assign code 8, it is known that surgery was recommended but there is no information on whether or not the patient actually had the surgical procedure. Determination of the date radiation started may require assistance from the radiation oncologist for consistent coding. Record the date of the first/earliest radiation treatment if radiation was given and recorded as part of the first course of therapy Radiation date should be the same as the Date Therapy Initiated when radiation is the only treatment administered There may be times when the first course of treatment information is incomplete. Therefore, it is important to continue follow-up efforts to be certain the complete treatment information is collected. Code 10 11 12 Label Blank No information Not applicable Unknown Definition A valid date value is provided in Date Radiation Started No information whatsoever can be inferred from this exceptional value (that is, unknown whether any radiation therapy was given) No proper value is applicable in this context. This event occurred, but the date is unknown (that is, radiation therapy administered but the date is unknown). Information is not available at this time, but it is expected that it will be available later. Leave this item blank if Date Radiation Started has a full or partial date recorded Assign code 10 when it is unknown whether any treatment was administered a. If radiation was expected to be given or was planned as part of the first course of therapy, but information was not known if the radiation had been started or had not been started at the time of the most recent follow-up, attempt to follow-up to assure complete information is collected. As information is learned, update this item, Date Radiation Started, and all other radiation items. These data items identify the radiation modality administered during the first, second, and third phase, respectively, of radiation treatment delivered during the first course of treatment. Radiation modality reflects whether a treatment was external beam, brachytherapy, a radioisotope as well as their major subtypes, or a combination of modalities. These data items identify the external beam radiation planning technique used to administer the first, second, and third phase, respectively, of radiation treatment during the first course of treatment. These type of treatments are sometimes referred to as electronic brachytherapy or orthovoltage or superficial therapy. Clinical notes may refer to the brand names of low energy x-ray delivery devices. An external beam planning technique using 2-D imaging, such as plain film x-rays or fluoroscopic images, to define the location and size of the treatment beams. An external beam planning technique using multiple, fixed beams shaped to conform to a defined target volume. An external beam planning technique where the shape or energy of beams is optimized using software algorithms. Any external beam modality can be modulated but these generally refer to photon or proton beams. Treatment planning using stereotactic radiotherapy/radiosurgery techniques, but the treatment is not described as CyberKnife or Gamma Knife. If a treatment is described as stereotactic radiotherapy or radiosurgery with online re-optimization/re-planning, then it should be categorized as online re-optimization or re-planning. If a treatment is described as "adaptive" but does not include the descriptor "online," this code should not be used. Determination of the external beam planning technique may require assistance from the radiation oncologist to ensure consistent coding. Any one of these changes will generally mean that a new radiation plan will be generated in the treatment planning system and should be coded as a new phase of radiation therapy. Note: "Online adaptive therapy" refers to treatment where radiation treatment plans are adapted or updated while a patient is on the treatment table. When treatment plans are adapted, the shape of the target volume may change from day to day but, for registry purposes, the volume that is being targeted will not change. An adapted plan should not be coded as though a new phase of treatment has been initiated unless, as above, the radiation oncologist documents it as a new phase in the radiation treatment summary. Code 0 2 3 4 5 6 7 9 Description No radiation and/or surgery as defined above; Unknown if surgery and/or radiation given Radiation before surgery Radiation after surgery Radiation both before and after surgery Intraoperative radiation therapy Intraoperative radiation with other radiation given before and/or after surgery Surgery both before and after radiation (for cases diagnosed 01/01/2012 and later) Sequence unknown, but both surgery and radiation were given Coding Instructions 1. The patient did not have either surgery or radiation the patient had surgery but not radiation the patient had radiation but not surgery It is unknown whether or not the patient had surgery and/or radiation i. Assign code 4 when there are at least two courses, episodes, or fractions of radiation therapy given before and at least two more after surgery to the primary site, scope of regional lymph node surgery, surgery to other regional site(s), distant site(s), or distant lymph node(s) Example 1. Preoperative radiation therapy was administered to shrink a large, bulky lesion Resection was performed Postoperative radiation therapy was administered after resection Assign code 7 when there are at least two surgeries; radiation was administered between one surgical procedure and a subsequent surgical procedure Example 1 1. Surgery of primary site Code Radiation Sequence with Surgery as 7 (surgery both before and after radiation). Lymph node aspiration Radiation Surgery of primary site Code Radiation Sequence with Surgery as 7 (surgery both before and after radiation) because lymph node aspiration is coded in Scope of Regional Lymph Node Surgery. This data item captures the reason the patient did not receive radiation treatment as part of first course of therapy. Code 0 1 2 5 6 7 Description Radiation therapy was administered Radiation therapy was not administered because it was not part of the planned first-course treatment.

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Recording that a patient refused the treatment modality means that the patient refused recommended therapy cholesterol job cheap crestor 5mg visa. Radiation therapy was not administered because it was contraindicated due to cholesterol test lloyds pharmacy purchase crestor 5mg without a prescription patient risk factors (comorbid conditions cholesterol test for diabetes cheap 10 mg crestor otc, advanced age cholesterol in shrimp good or bad crestor 20 mg mastercard, progression of tumor prior to planned radiation, etc. Radiation therapy was recommended, but it is unknown if it was administered It is unknown if radiation therapy was recommended or administered. Assign Code 0 if the patient received regional radiation as part of first course of therapy Assign Code 1 if the treatment plan offered multiple alternative treatment options but the patient selected treatment that did not include radiation therapy Assign Code 7 if the patient refused recommended radiation therapy, made a blanket refusal of all recommended treatment, or refused all treatment before any was recommended Assign Code 8 a. If it is known that a physician recommended radiation treatment, but no further documentation is available to confirm it was given To indicate referral to a radiation oncologist was made and the registry should follow to determine whether radiation was administered If follow-up to the specialist or facility determines the patient was never there and no other documentation can be found, assign Code 1 Note: Cases coded 8 should be followed and updated to a more definitive code as appropriate. Code 10 11 12 15 Label Blank No information Not applicable Unknown Planned Definition A valid date value is provided in Date Systemic Therapy Started No information whatsoever can be inferred No proper value is applicable in this context A proper value is applicable but not known Treatment planned but not yet started Coding Instructions 1. Leave this item blank if Date Systemic Therapy Started has a full or partial date recorded a. If systemic therapy was expected to be given or was planned as part of the first course of therapy, but information was not known if the systemic therapy had been started or had not been started at the time of the most recent follow-up, attempt to followup to assure complete information is collected. Record the date of the first/earliest chemotherapy if chemotherapy was given and recorded as part of the first course of therapy a. Code 10 11 12 15 Label Blank No information Not applicable Unknown Planned Definition A valid date value is provided in Date Chemotherapy Started No information whatsoever can be inferred No proper value is applicable in this context A proper value is applicable but not known Treatment planned but not yet started Coding Instructions 1. Leave this item blank if Date Chemotherapy Started has a full or partial date recorded Assign code 10 when it is unknown whether any treatment was administered a. If chemotherapy was expected to be given or was planned as part of the first course of therapy, but information was not known if the chemotherapy had been started or had not been started at the time of the most recent follow-up, attempt to follow-up to assure complete information is collected. As information is learned, update this item, Date Chemotherapy Started, and Chemotherapy. Code 00 01 02 03 82 85 86 87 Description None, chemotherapy was not part of the planned first course of therapy; diagnosed at autopsy Chemotherapy administered as first course therapy, but the type and number of agents is not documented in the patient record Single agent chemotherapy administered as first course therapy Multi-agent chemotherapy administered as first course therapy Chemotherapy was not recommended/administered because it was contraindicated due to patient risk factors (comorbid conditions, advanced age, etc. Example 2: Patient diagnosed with breast cancer November 1, 2012, and begins receiving Rituximab January 30, 2013, as part of first course therapy. Code the Rituximab in the chemotherapy data field because the patient was diagnosed prior to January 1, 2013. Definitions Chemotherapy recommended: A consult recommended chemotherapy, or the attending physician documented that chemotherapy was recommended. Multiple agent chemotherapy: Planned first course of therapy included two or more chemotherapeutic agents and those agents were administered. The planned first course of therapy may or may not have included other agents such as hormone therapy, immunotherapy, or other treatment in addition to the chemotherapeutic agents. Single agent chemotherapy: Only one chemotherapeutic agent was administered to destroy cancer tissue during the first course of therapy. The chemotherapeutic agent may or may not have been administered with other drugs classified as immunotherapy, hormone therapy, ancillary, or other treatment. Code the chemotherapeutic agents whose actions are chemotherapeutic only; do not code the method of administration When chemotherapeutic agents are used as radiosensitizers or radioprotectants, they are given at a much lower dosage and do not affect the cancer. Review the radiation-oncology progress notes for information about radiosensitizing chemotherapy. Note: Do not assume that a chemo agent given with radiation therapy is a radiosensitizer. Code as treatment for both primaries when the patient receives chemotherapy for invasive carcinoma in one breast and also has in situ carcinoma in the other breast. There is no reason to suspect that the patient would have had chemotherapy If the treatment plan offered multiple treatment options and the patient selected treatment that did not include chemotherapy Patient elects to pursue no treatment following the discussion of chemotherapy. Assign code 00 since there is no reason to suspect that the patient had been treated. Do not code combination of ancillary drugs administered with single agent chemotherapeutic agents as multiple chemotherapy. Assign code 82 when chemotherapy is a customary option for the primary site/histology but it was not administered due to patient risk factors, such as a. Advanced age Comorbid condition(s) (heart disease, kidney failure, other cancer, etc. Insertion of port-a-cath Note: Review cases coded 88 periodically for later confirmation of chemotherapy. Assign code 99 when there is no documentation that chemotherapy was recommended or administered a. Although they are toxic to all cells, they are most active in the resting phase of the cell. Alkylating agents are used to treat many different cancers including acute and chronic leukemia, lymphoma, Hodgkin disease, multiple myeloma, sarcoma, and cancers of the lung, breast, and ovary. When the cells incorporate these substances into the cellular metabolism, they are unable to divide. Antimetabolites are classified according to the substances with which they interfere. Plant Alkaloids are cell-cycle specific which means they attack the cells during various phases of division. Vinca alkaloids: vincristine, vinblastine, and vinorelbine Taxanes: paclitaxel and docetaxel Podophyllotoxins: etoposide and teniposide Camptothecan analogs: irinotecan and topotecan Antitumor antibiotics are also cell-cycle specific and act during multiple phases of the cell cycle. They are made from natural products and were first produced by the soil fungus Streptomyces. Targeted cancer therapies are sometimes called "molecularly targeted drugs," "molecularly targeted therapies," "precision medicines," or similar names. Examples of molecularly targeted therapy are imatinib (Gleevec), lapatinib (Tykerb), erlotinib (Tarceva), sunitinib (Sutent). This permits a higher concentration of drug to be in contact with the tumor for a longer period of time.

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However cholesterol japanese food buy discount crestor 5 mg online, yield increase depends on the manure and crop types considered (Wang et al cholesterol medication debate crestor 10 mg line. Despite their potential benefit for agriculture cholesterol know your numbers crestor 5mg with mastercard, there is sufficient scientific evidence of the increase in heavy metals content cholesterol test glucose order 20 mg crestor overnight delivery, pathogens, and veterinary antibiotics residues, which may lead to antimicrobial-resistant bacteria proliferation in soils amended with livestock manure. After atmospheric deposition, which is the main source, livestock manures and sewage sludge were identified as important sources of contamination. These were especially important for Zn, Cu, Ni, Pb and Cr contamination (Nicholson et al. Negative effects on soil organisms have been widely studied (Bьnemann, Schwenke and Van Zwieten, 2006; Jacobsen and Hjelmsш, 2014; Komбrek et al. Considering the need to have coordinated efforts regarding hazardous chemicals, the Rotterdam Convention was adopted on 10 September 1998. It aims to promote shared responsibility and cooperative efforts among Parties in the international trade of hazardous chemicals and pesticides in order to protect human health and the environment from potential harm. The Convention contributes to the environmentally sound use of such chemicals, by facilitating information exchange about their characteristics, by providing for a national decision-making process on their import and export and by disseminating these decisions to Parties. It enables member governments to alert each other to potential dangers by exchanging information on banned or severely restricted chemicals and to take informed decisions on them. It makes the international trade in hazardous chemicals more transparent and less vulnerable to abuse through its export notification provisions and by encouraging harmonized labelling of exported chemicals. The Convention also calls for the provision of technical assistance to help establish the infrastructure and capacity necessary to safely manage chemicals. The Code is directed primarily at government authorities and the pesticide industry but is also relevant for other stakeholders. The Code is supported by technical guidelines and toolkits, for example the Registration Toolkit. Stocks of obsolete, unwanted and banned pesticides continue to represent a threat to human health, the environment and the sustainable development of the regions in which they are found. The reasons for the accumulation of obsolete pesticide stocks are well documented. They include poor storage and management of pesticide stocks, international bans on the use of harmful pesticides, untimely donations of pesticides, over-ordering and supply and procurement of strategic stocks of pesticides for migratory pest control, which are then not used completely or not needed. Volume 6 is intended to provide practical methods to assist countries in the formulation of strategies for the management of pesticide contaminated land. Even if some elements and compounds occur naturally in soils, human interventions are the main drivers of soil pollution. The following sections discuss only a small subset of the most common pollutants affecting agricultural areas, and the properties that make these compounds pollutants. Pollutants have been divided by their chemical characteristics, but some of the categories presented here overlap. Swartjes proposed a systematic categorization of pollutants (Figure 5) that may be useful in better understanding them (Swartjes, 2011). Other non-metals that are often considered together with heavy metals include As, antimony (Sb) and selenium (Se) (Kemp, 1998). Many of them are essential micronutrients for plants, animals and humans, but at high concentrations may cause phytotoxicity and harm human health because of their non-biodegradable nature, which causes them to readily accumulate in tissues and living organisms. The main anthropogenic sources of heavy metals are industrial areas, mine tailings, disposal of high metal wastes, leaded gasoline and paints, application of fertilizers, animal manures, sewage sludge, pesticides, wastewater irrigation, coal combustion residues, spillage of petrochemicals, and atmospheric deposition from varied sources (Alloway, 2013). Heavy metals are the most persistent and complex kind of pollutants to remediate in nature. They not only degrade the quality of the atmosphere, water bodies, and food crops, but also threaten the health and well-being of animals and human beings. Metals accumulate in the tissues of living organisms because unlike most organic compounds they are not subject to metabolic breakdown. Among the heavy metals, Zn, Ni, Co, and Cu are relatively more toxic to plants, and As, Cd, Pb, Cr and Hg are relatively more toxic to higher animals (McBride, 1994). The most important elements to consider in terms of food-chain contamination are As, Cd, Hg, Pb and Se (McLaughlin, Parker and Clarke, 1999). The main sources of As in soils are agrochemical compounds and mining and smelting activities, but they can also be introduced in manure originating from livestock feed with As-rich additives. Some parent materials are rich in As and therefore their weathering can also be a source of As in high concentrations. Trace metals from inorganic (Cu-based) and organic pesticides represent a major environmental and toxicological concern (Komбrek et al. However, fungicide-derived Cu has been found in large amounts in the potentially available fraction of the soil (Pietrzak and McPhail, 2004). It occurs in both organic and inorganic forms, and in many different oxidation states. Unreactive forms such as gaseous nitrogen (N2) can be assimilated through microbial activity. Fertilizer demand has increased globally (Figure 6), supported by global economic growth, leading to an excessive application of fertilizers following the idea "the more, the better. However, there is not a linear correlation between an increase in the amount of fertilizer applied to agricultural soils and an increase in crop production; on the contrary, increases may result in low nutrient use efficiency and in turn lower crop yields (Hossain et al. Many heavy metals have also been documented in phosphate and nitrate fertilizers including As, Cd, Cr, Hg, Pb, and Zn (Brevik, 2013). While nutrients are essential to crop production, when they are applied in excess they can have negative effects on yields. Nitrogen increases chlorophyll production, and energy for flower growth and root elongation is redirected to foliage proliferation, causing disorders in plants and making them more vulnerable to pathogen attacks.

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