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Interview | Charles Fréger
by Susanna Buffa
in focus, Interview
Since the beginning of his career as a photographer, Charles Fréger has established his own system of signs – a language through which he expresses his interest for human beings as part of a group, for their abilities of interaction when placed within a community and for their abilities of communication through outward signs such as clothing, masks or uniforms. This is the common denominator of all of his series of photographs which are always independent from the others and characterized by a clear cut spatio-temporal sphere. The other fundamental trait of his work is his strong flair for exoticism – which Fréger traces to civilizations that are far from us in terms of time and space as well as in contemporary European society.
His penultimate series Wilder Mann is a consideration of the tribal traditions and rituals of European populations. It is through research that the artist singled out the exotic and untamed attributes of our civilized societies. Nineteen countries were explored and Fréger re-created environmental sets for each one of them in an undefined, suspended temporal dimension. The image of the savage is reproduced in relation to a natural environment. The apparently static and motionless poses contrast fully with an internal dynamism which is also linked to the vitality of the outfitting and sets, colours and masks. From demonic to bestial and primitive, the wild man shows up again in our present with features that are even frightening at times but always destabilizing and deeply connected to an earthy dimension and all celebratory activities.
This series became a popular book and inspired Italian composer Teho Teardo to compose music based upon his own reactions to the wild masked men. The result was an album, Music for Wilder Mann (Spècula Records, 2013), which met with the enthusiastic approval of the public and critics from all over the world. On February 26, Teardo will put into play the value of interaction between musical and photographic art by performing the music he composed for «Wilder Mann» while images from Fréger's book are being projected. This event will take place at Rome's Cembalo Gallery and is a part of Fréger's solo exhibition that is being hosted there from 6 February to 28 March 2015. (by Susanna Buffa)
Where does your inspiration for portraying wild men wearing masks come from?
I have always been fascinated by the idea that Europeans also had deep-seated tribal traditions. Usually, when we speak of the tradition of masks or masked men exotic places like Africa come to mind. While researching this project I found proof that there are deep-rooted tribal traditions in Europe as well. I realize that the concept of «tribalism» might be too broad but my intention is to express the fact that we too have our own exoticism. I noticed that there are traditions observed in Austria with strong tribal features. The same applies to most of France with the exception of the areas bordering Spain and in the south-eastern portion of the country. My research began in Austria. After that I went to Hungary, Greece, Italy (Sardinia) and then I decided to expand my exploration to the entire European continent. After the book was completed in 2011 (with nineteen documented countries), I continued my travels and research. At the moment I have material from twenty-one different countries and my research continues because I have toured one or two countries per year.
Did you notice different perceptions of our past from one country to another while touring Europe and taking photographs?
Actually, I would say that there is a lot of common ground because all of these traditions are linked to similar systems and festivities – the holiday of Saint Nicholas, Christmas, New Year's celebrations and Carnival. There are different moments, usually in the winter, during which these traditions come to life in the Czech Republic, Austria or Italy and even if the distance between these countries is remarkable, the traditions are observed in a very similar manner.
After the book «Wilder Mann» was published, the Italian composer Teho Teardo had a chance to read it and was very impressed by your work. He immediately contacted you and offered to compose music to accompany your photographs. Was this the first time you had ever collaborated with a musician? How did your react to his offer?
Yes, in regards to my work as a photographer, this was the first time. When Teho spoke to me about this, I initially gave it some thought because what really interested me was the possibility of finding common ground between my photographs and music. We agreed on that right away. He was totally open and really great. He was very quick to finalize the work and compose the music. We haven't limited our collaboration to «Wilder Mann», however. Teho has also helped me with an installation project regarding the masks of theCommedia dell'Artebased on the video I did in Venice. There is something about his work that connects immediately with my photographs and this is something that doesn't happen very often. It was really a positive experience. Teho is always very effective. He has this really powerful energy and he's never tired. I could tell that the work was progressing quickly and that he was very inspired by the book and needed to keep active and not waste any time.
I think that your photographs are very powerful and that they have great strength – the subjects you portray, your outfitting and sets, your colours. Do you think that music has that same power?
I really hope so. I gave him a few suggestions for song titles – for example, I wanted a piece that described the awakening of a bear and he composed The Waking of the Bear and it really works! I like that weight we hear in the lower notes and sounds. It sounds as if it comes from some intimate place deep inside…the entire album has that kind of weight and I like it a lot. You can almost hear the roar of an animal in some spots.
Did you exchange ideas with the musician during the development of the musical project?
No, not at all. I would listen to the music and he would evaluate my reaction and work from there. I didn't want to influence his musical work because it was «his» work, his territory and I didn't want to suggest a thing. It was a great experience and I hope that there will be more of them. We are thinking about another collaboration, a new project.
That's wonderful news. How would you feel about taking photos based upon the music you hear? Doing a reverse process and letting yourself be inspired by music.
It never occurred to me because I never work that way. Come to think of it, I might be embarrassed. I think it's better that things work the other way around. That the images inspire the music. I am usually inspired by the life of a community or group. So that kind of change is improbable.
Your solo exhibition with the photographs from «Wilder Mann» was inaugurated at Rome's Cembalo Gallery on 6 February. You will be in Rome on the 26th for the concert where Teho Teardo will perform the music he composed for your photos which are also featured on his album. Your work takes you around the world all the time.
Yes, I have been doing this since I was eighteen years old. I keep doing it because creating these photographic series means moving around and interacting with places even though from time to time I have some problems when I find a new subject. Photographing whatever I want is not always possible or allowed. I usually take on more than one project at a time. At the moment I am working on a book which is coming out in two months.
What is the subject of this book?
It is called Bretonnes and it's being published in France by Actes Sud and in England by Thames&Hudson. It explores the women in Brittany and their clothing….It is a work that was primarily inspired by paintings and old photographs. In a way, it is the opposite of «Wilder Mann» which was about crude men. Although there actually is a common factor between the two photographic series because the communicative power of the groups emerges in both. In Bretonnes we see women interacting amongst themselves with a secret life, a system of secret signs that are not a language per se, but something linked to the instinctive part of relationships between women.
As far as I can tell, the people from Brittany seem to be very communicative.
It is a part of France that stands alone. It cultivates a strong tie with tradition, especially the Celtic one, but that culture also identifies strongly with modernity. This is a very energetic and vital portion of the country.
Charles Fréger, «The Wilder Mann», Galleria del Cembalo, Roma, 06.02 – 28.03.2015. Special concert by Teho Teardo on February 26th, perform ing the music he composed for Fréger photos
Charles Fréger | Teho Teardo
[youtube id="F33ayGx22lk" width="620″ height="360″]
Images and video
(1 cover) Teho Teardo, Music for Wilder Mann cover (2) Charles Freger, Wilder Mann, 2010-2011, Skoromati (3) Charles Freger, Wilder Mann, 2010-2011. Luzifer, Kleine, Teufel (4) Charles Freger, Wilder Mann, book cover (5) Teardo Live, PH Simona Caleo (6) Charles Freger, Shooting (7) Video with music by Teho Teardo
«The Future is now». Part II
VIDEO POST > «Laptop_Orchestra»


Name 7-FD-i Section number derived automatically from the wiki page. Move the page to change the section number.
The Integrated Licensing Process (ILP) is the default process used to license hydropower projects. However, developers may request use of the Traditional Licensing Process (TLP) for their project. The Office of Energy Projects within the [[Federal Energy Regulatory Commission]] (FERC) oversees the licensing process as authorized by the [[Federal Power Act]]. FERC may approve the use of TLP for projects with less complex issues, where involvement in the study plan development process may not be necessary. Developers often wish to use TLP to avoid the strict schedule of the ILP so that they can move through pre-filing quicker or have time to develop a settlement agreement with interested parties. The TLP is a notice-and-comment process that involves three stages of consultation with agencies implicated by the project.
==7-FD-i.1 – Notice of Intent, Pre-Application Documents, and Request for Traditional Licensing Process== The developer may file with FERC a request to use the Traditional Licensing Process (TLP) with the Notice of Intent. [[Title 18 CFR 5 Integrated License Application Process | 18 CFR 5.3(b)]]. An application for permission to use the TLP must include justification for the request and any existing written comments on the developer's proposal and any response provided. [[Title 18 CFR 5 Integrated License Application Process | 18 CFR 5.3(c)(1)(i)]]. The developer should address the following considerations when requesting to use the TLP: *Likelihood of timely license issuance; *Complexity of the resource issues; *Level of anticipated controversy; *Relative cost of the traditional process compared to the integrated process; *The amount of available information and potential for significant disputes over studies; and *Other factors believed by the developer to be pertinent. [[Title 18 CFR 5 Integrated License Application Process | 18 CFR 5.3(c)(1)(ii)]]. ==7-FD-i.2 – Provide Copy of Request to Affected Resource Agencies== The developer must provide a copy of the request to all affected resource agencies, Indian tribes, and members of the public likely to be interested in the proceeding. [[Title 18 CFR 5 Integrated License Application Process | 18 CFR 5.3(d)(1)]]. ==7-FD-i.3 – Initiate 401 Water Quality Certification== Under Section 401 of the [[Clean Water Act]] (CWA), a federal agency may not issue a license authorizing the construction or operation of a project unless the appropriate state agency first issues a water quality certification for the project or waives certification by failing or refusing to act on a request for certification within a reasonable period of time. 33 USC 1341(a)(1). In order to allow the state agency sufficient time to analyze the impacts of the project on water quality and to meet the deadline for demonstrating compliance with Section 401 of the CWA, the developer may request water quality certification from the appropriate state authority early on in the FERC licensing process.
 '''Alaska''' In Alaska, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[Alaska Department of Environmental Conservation]] for projects that require a FERC license or a USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-AK-d|401 Water Quality Certification:
14-AK-d]]

 '''Arkansas''' In Arkansas, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[Arkansas Department of Environmental Quality]] for projects that require a FERC license or a USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-AR-d|401 Water Quality Certification:
14-AR-d]]

 '''California''' In California, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[California State Water Resources Control Board]] and/or the regional water quality control for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-CA-d|401 Water Quality Certification:
14-CA-d]]

 '''Colorado''' In Colorado, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[Colorado Department of Public Health and Environment]] Water Quality Control Division for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-CO-d|401 Water Quality Certification:
14-CO-d]]

 '''Illinois''' In Illinois, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[Illinois Environmental Protection Agency]] for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-IL-d|401 Water Quality Certification:
14-IL-d]]

 '''Indiana''' In Indiana, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[Indiana Department of Environmental Management]] for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-IN-d|401 Water Quality Certification:
14-IN-d]]

 '''Iowa''' In Iowa, a hydropower developer needs a 401 Water Quality Certifications or waiver from the [[Iowa Department of Natural Resources]] for projects that require a FERC license or a USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-IA-d|401 Water Quality Certification:
14-IA-d]]

 '''Kentucky''' In Kentucky, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[Kentucky Department of Environmental Protection]] for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-KY-d|401 Water Quality Certification:
14-KY-d]]

 '''Louisiana''' In Louisiana, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[Louisiana Department of Environmental Quality]] for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-LA-d|401 Water Quality Certification:
14-LA-d]]

 '''Minnesota''' In Minnesota, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[Minnesota Pollution Control Agency]] for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-MN-d|401 Water Quality Certification:
14-MN-d]]

 '''Mississippi''' In Mississippi, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[Mississippi Department of Environmental Quality]] for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-MS-d|401 Water Quality Certification:
14-MS-d]]

 '''Missouri''' In Missouri, the hydropower developer needs a 401 Water Quality Certification or waiver from the [[Missouri Department of Natural Resources]] for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-MO-d|401 Water Quality Certification:
14-MO-d]]

 '''New York''' In New York, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[New York State Department of Environmental Conservation]] Division of Water Resources for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-NY-d|401 Water Quality Certification:
14-NY-d]]

 '''North Dakota''' In North Dakota, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[North Dakota Department of Health]] for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-ND-d|401 Water Quality Certification:
14-ND-d]]

 '''Ohio''' In Ohio, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[Ohio Environmental Protection Agency]] for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-OH-d|401 Water Quality Certification:
14-OH-d]]

 '''Pennsylvania''' In Pennsylvania, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[Pennsylvania Department of Environmental Protection DEP|Pennsylvania Department of Environmental Protection]] for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-PA-d|401 Water Quality Certification:
14-PA-d]]

 '''Tennessee''' In Tennessee, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[Tennessee Department of Environment and Conservation]] for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-TN-d|401 Water Quality Certification:
14-TN-d]]

 '''Vermont''' In Vermont, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[Vermont Department of Environmental Conservation]] for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. Vermont also requires a 401 Water Quality Certification or waiver for FERC exempt projects. For more information, see: [[RAPID/Roadmap/14-VT-d|401 Water Quality Certification:
14-VT-d]]

 '''Washington''' In Washington, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[Washington State Department of Ecology]] for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-WA-d|401 Water Quality Certification:
14-WA-d]]

 '''West Virginia''' In West Virginia, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[West Virginia Department of Environmental Protection]] for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-WV-d|401 Water Quality Certification:
14-WV-d]]

 '''Wisconsin''' In Wisconsin, a hydropower developer needs a 401 Water Quality Certification or waiver from the [[Wisconsin Department of Natural Resources]] for projects that require a FERC license or USACE approval and may result in any discharge into the navigable waters of the U.S. For more information, see: [[RAPID/Roadmap/14-WI-d|401 Water Quality Certification:
14-WI-d]]
 ==7-FD-i.4 – Publish Notice of NOI, Pre-Application Documents, and Request== The developer must publish notice of the filing of its NOI, the Pre-Application Document, and of the request to use the TLP no later than the filing date of the NOI in a daily or weekly newspaper of general circulation in each county in which the project is located. The notice must: *Disclose the filing date of the request to use the traditional process, and the NOI and Pre-Application Document; *Briefly summarize these documents and the basis for the request to use the traditional process; *Include the potential developer's name and address, and telephone number, the type of facility proposed to be applied for, its proposed location, the places where the Pre-Application document is available for inspection and reproduction; and *Include a statement that comments on the request to use the traditional process are due to FERC and the potential developer no later than 30 days following the filing date of that document and, if there is no project number, that responses must reference the developer's name and address. [[Title 18 CFR 5 Integrated License Application Process | 18 CFR 5.3(d)(2)]]. ==7-FD-i.5 – Comment on Request for Traditional Licensing Process== Any person may submit comments on the request for the TLP within 30 days of the filing date of the request. The notice will specify that comments on the request to use the TLP should address the likelihood of timely license issuance, complexity of the resource issues, level of anticipated controversy, relative cost compared to the integrated process and any other factors that the commenter believes are pertinent. [[FERC Handbook for Hydroelectric Project Licensing and 5 MW Exemptions from Licensing | FERC Handbook, page 4-3]]. ==7-FD-i.6 – Issue Decision on Request for Traditional Licensing Process== FERC usually issues a decision on any request to use the TLP within 60 days of the filing of the notice of intent. [[FERC Handbook for Hydroelectric Project Licensing and 5 MW Exemptions from Licensing | FERC Handbook, page 4-3]]. ==7-FD-i.7 to 7-FD-i.8 – Does FERC Approve the Request for Use of the Traditional Licensing Process?== FERC may grant requests to use the TLP if they find good cause shown by the developer. If FERC does not approve the request for use of the TLP, the developer will initiate the ILP. [[RAPID/Roadmap/7-FD-k|FERC Integrated Licensing Process:
7-FD-k]] ==7-FD-i.9 – Schedule Consultation Meeting== The developer must consult with the agencies, tribes, and public to schedule a joint meeting to discuss the notice of commencement and project details. [[FERC Handbook for Hydroelectric Project Licensing and 5 MW Exemptions from Licensing | FERC Handbook, page 4-4]]. The developer must provide to the resource agencies, Indian tribes and FERC the following information: *Detailed maps showing project boundaries, if any, proper land descriptions of the entire project area by township, range, and section, and also showing the specific location of all proposed project facilities, including roads, transmission lines, and any other appurtenant facilities; *A general engineering design of the proposed project, with a description of any proposed diversion of a stream through a canal or penstock; *A summary of the proposed operational mode of the project; *Identification of the environment to be affected, the significant resources present, and the developer's proposed environmental protection, mitigation, and enhancement plans, to the extent known at that time; *Streamflow and water regime information, including drainage area, natural flow periodicity, monthly flow rates and durations, mean flow figures illustrating the mean daily streamflow curve for each month of the year at the point of diversion or impoundment, with location of the stream gauging station; *A statement of whether or not the developer will seek benefits under section 210 of the [[Public Utility Regulatory Policies Act of 1978|Public Utility Regulatory Policies Act]] (PURPA); *Detailed descriptions of any proposed studies and the proposed methodologies to be employed; and *Any statement required by [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.301(a)]]. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(b)(2)]]. ==7-FD-i.10 – Publish Notice of Consultation Meeting and Site Visit== The developer must provide public notice of the consultation meeting and site visit. The developer must provide FERC with written notice of the meeting's time, place, and agenda at least 15 days before the scheduled joint meeting date. The developer must provide public notice of the meeting arrangements and agenda in a daily or weekly newspaper in each county in which the project is located. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(g)(2)(i)]]. ==7-FD-i.11 to 7-FD-i.12 – Hold Public Consultation Meeting== The developer must hold a public consultation meeting. Members of the public are invited to attend the meeting. The meeting must include an opportunity for a site visit. The objectives of the joint meeting are: *To develop a common understanding of the project; *Discuss current and potential resource needs and management objectives for the project area; and *Agree on a time frame and format for discussion of study results. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38]]. ==7-FD-i.13 – Conduct Endangered Species Act Section 7 Consultation Process== Under the [[Endangered Species Act]] (ESA) section 7(a)(2), FERC must ensure that any action it authorizes, funds, or implements is not likely to jeopardize the continued existence of listed species or result in the destruction or adverse modification of a designated critical habitat. If the project will adversely affect a threatened or endangered species of fish, wildlife, or plant, then the FWS or NMFS may establish reasonable and prudent alternatives (RPA) or measures (RPM). FERC is not required to include the measures in a license, but FERC and the developer may be held liable for any damage to a listed species that results from the license. Due to this, FERC treats RPA or RPM as mandatory conditions included in the license. [[FERC Handbook for Hydroelectric Project Licensing and 5 MW Exemptions from Licensing | FERC Handbook, page B-2]]. [[RAPID/Roadmap/12-FD-c|Endangered Species Act Section 7 Consultation Process:
12-FD-c]] ==7-FD-i.14 to 7-FD-i.16 – Comment on Meeting and Site Visit == Any interested resource agency, Indian tribe, and members of the public may provide the developer with written comments and study requests not later than 60 days after the joint meeting. The written comments should include: *Identifying its determination of necessary studies to be performed or information to be provided by the developer; *The basis for the agency's determination; *The agency's understanding of the resource issues involved, and its goals and objectives for these resources; *Justification of recommended study methodology; *Documentation that the use of each study method it recommends is a generally accepted practice; and *Explanation of how the studies and information requested will be useful to the agency, Indian tribe, or members of the public in furthering its resource goals and objectives as related to the project. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(b)(5)]]. ==7-FD-i.17 – Study Plans== Following the required consultations, the developer with the assistance of participating agencies will have completed a set of resource-by-resource study plans and detailed documentation of the consultations. [[FERC Handbook for Hydroelectric Project Licensing and 5 MW Exemptions from Licensing | FERC Handbook, page 4-7]]. ==7-FD-i.18 – Has a Study Dispute Been Filed?== Any participant and the developer may disagree on the need or method of a study. Any dispute may be referred to FERC for resolution. ==7-FD-i.19 – Has the Dispute Been Referred to FERC for Resolution?== If the developer and a resource agency or Indian tribe disagree as to any matter arising during the first stage of consultation or as to the need to conduct a study, then the dispute may be referred to FERC for resolution. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(b)(6)]]. ==7-FD-i.20 – Provide Notice of Referral== The entity referring the dispute to FERC must serve a copy of its written request for resolution on the disagreeing party and any affected resource agency or Indian tribe, which may submit a written response to the referral within 15 days of the referral's submission. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(b)(6)(ii)]]. ==7-FD-i.21 – Review and Provide Resolution to Dispute== FERC will resolve the disputes by letter provided to the developer and all affected resource agencies and Indian tribes. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(b)(6)(iv)]]. ==7-FD-i.22 – Implement Study Plans== The developer must implement the approved study plans once all disputes have been resolved. ==7-FD-i.23 to 7-FD-i.24 – Is an Additional Study Requested?== If a participant requests an additional study, then the developer must promptly initiate the study unless the study is unreasonable or unnecessary for an informed decision by FERC on the merits of the application or use of the methodology requested by a resource agency or Indian tribe for conducting the study is not a generally accepted practice. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(c)(2)]]. ==7-FD-i.25 - Draft License Application and Study Results== The developer may submit a Draft License Application and Study Results to FERC. A draft license application must: *Indicate the type of application the potential applicant intends to file; *Respond to any comments and recommendations made by any resource agency and Indian tribe during the first stage of consultation; *Contain the results of studies requested by the resource agencies and Indian tribes; and *Include a discussion of the study results and any proposed protection, mitigation, and enhancement measures. [[FERC Handbook for Hydroelectric Project Licensing and 5 MW Exemptions from Licensing | FERC Handbook, page 4-9]]. Note, FERC may review the Draft License Application and Study Results, pending on workload. ==7-FD-i.26 – Provide Copy of Draft Application== The developer must provide each resource agency and Indian tribe a copy of its draft application that: *Indicates the type of application the developer expects to file with FERC; *Responds to any comments and recommendations made by any resource agency and Indian tribe either during the consultation process. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(c)(4)]]. ==7-FD-i.27 – Comment on Draft Application== Resource agencies and Indian tribes will have 90 days from the date the developer provides the copy of the draft application to comment on the application. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(c)(5)]]. ==7-FD-i.28 to 7-FD-i.29 – Develop Preliminary License Conditions and Recommendations== Any agency responsible for developing mandatory terms, conditions or prescriptions for a FERC license, or issuing recommendations to FERC for a FERC license, must provide these terms, conditions, prescriptions or recommendations in the agency's initial comments filed on the draft application. Agencies and the public may comment no later than 60 days following public notice of the draft application. These agencies will include those acting pursuant to the following: '''FPA Section 4(e)''' Where the project will be located on a federal reservation, the federal agency responsible for managing that land can file conditions to protect the reservation, and these conditions are required to be included in any license issued. For example, The Forest Service (FS) may require that a license for a project occupying lands or waters of a National Forest include those conditions necessary to assure the protection and use of the affected resources. [[USDOI - Memorandum 37005 | United States Department of the Interior Memorandum M-37005]]. A national forest is considered a "reservation" for purposes of FPA Section 4(e), and FS is authorized to impose mandatory conditions on the project license. [[Title 16 USC 796 Regulation of the Development of Water Power and Resources Definitions | 16 USC 796(2)]]. '''FPA Section 10(a)''' FERC must ensure that the project is best adapted to a comprehensive plan for developing the waterway for beneficial public purposes. For example, The NPS has submitted the Nationwide Rivers Inventory as a comprehensive plan with FERC. NPS may then submit conditions to FERC for consideration under FPA Section 10(a) to ensure that the project is best adapted to the Nationwide Rivers Inventory. [[FERC List of Comprehensive Plans | FERC List of Comprehensive Plans]]. '''FPA Section 10(j)''' The [[Fish and Wildlife Service|U.S. Fish and Wildlife Service]] (FWS), the [[National Oceanic and Atmospheric Administration (NOAA)|National Oceanic and Atmospheric Administration's]] National Marine Fisheries Service (NOAA Fisheries), and state fish and wildlife agencies will develop preliminary conditions for inclusion in the license pursuant to section 10(j) of the [[Federal Power Act]]. The agencies are responsible for filing any preliminary fish and wildlife recommendations, prescriptions, conditions, and comments, to be submitted in final form after the filing of the application. [[FERC Handbook for Hydroelectric Project Licensing and 5 MW Exemptions from Licensing | FERC Handbook, page 5-5]]. FERC will include these measures unless it finds them inconsistent with the FPA or other applicable law. FERC likely could avoid 10(j) disputes if the ALP application contains consensus for the proposed protection, mitigation, and enhancement measures. [[FERC Handbook for Hydroelectric Project Licensing and 5 MW Exemptions from Licensing | FERC Handbook, page 4-14]]. '''FPA Section 18''' The Secretaries of Commerce and the Interior can prescribe mandatory fishways at licensed projects, and those conditions are required to be included in any license issued. For example, the NMFS may require acceptable fishway prescriptions to safeguard certain species of fish from changes in waterflow that degrade their habitat. [[NOAA Hydropower and Fish Passage webpage | NOAA Hydropower and Fish Passage webpage]]. [[FERC Handbook for Hydroelectric Project Licensing and 5 MW Exemptions from Licensing | FERC Handbook, page 1-4]]. The agency must specifically identify and explain the mandatory terms and conditions or prescriptions and their evidentiary and legal basis. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.34(b)(1)]]. With TLP, any agency must also submit the following by the due date: *Preliminary terms and conditions or prescriptions and a schedule showing the status of the agency proceedings and when the terms and conditions or prescriptions are expected to become final; or *A statement waiving the agency's right to file the terms and conditions or prescriptions or indicating the agency does not intend to file terms and conditions or prescriptions. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.34(b)(1)]]. '''Agency Conditions and Recommendations''' * '''Bureau of Indian Affairs''' **The Bureau of Indian Affairs (BIA) typically issues FPA section 4(e) conditions or 10(a) recommendations, as appropriate, where a project is located on tribal lands, a tribe has an interest in the area where the project is located, or a project may interfere with the purpose of a reservation. The BIA may also participate by engaging with fish and wildlife agencies responsible for developing section 10(j) recommendations. [[RAPID/Roadmap/7-FD-l|Bureau of Indian Affairs - FERC License Conditions and Recommendations-
7-FD-l ]] * '''Bureau of Reclamation''' **The Bureau of Reclamation (BOR) typically issues FPA section 4(e) conditions or 10(a) recommendations, as appropriate, for projects that are located on or may otherwise affect a BOR facility. [[RAPID/Roadmap/7-FD-n|Bureau of Reclamation - FERC License Conditions and Recommendations-
7-FD-n ]] * '''National Park Service''' **The National Park Service (NPS) typically issues FPA section 4(e) conditions or 10(a) recommendations, as appropriate, for projects that are located on federally-reserved NPS lands, projects that may affect NPS-managed lands, and projects that may affect recreational interests in non-NPS lands. [[RAPID/Roadmap/7-FD-q|National Park Service - FERC License Conditions and Recommendations-
7-FD-q ]] * '''U.S. Forest Service''' **The United States Forest Service (USFS) typically issues FPA section 4(e) conditions or 10(a) recommendations, as appropriate, where projects are located on National Forest Service lands or may adversely affect National Forest System resources. [[RAPID/Roadmap/7-FD-s|U.S. Forest Service - FERC License Conditions and Recommendations-
7-FD-s ]] '''State Fish and Wildlife Agencies'''
 '''Alaska''' In Alaska, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[Alaska Department of Fish and Game]] (ADF&G). ADF&G has primary responsibility for protecting, maintaining, and improving the fish, game, and aquatic plant resources of the state and to manage their use and development in the best interest of the economy and the well-being of the state, consistent with the sustained yield principle. [[Title 16 Alaska Statutes Chapter 5 Fish and Game|AS 16.05.020]]. For more information, see: [[RAPID/Roadmap/12-AK-a(1)|State Fish and Wildlife License Conditions and Recommendations:
12-AK-a(1)]]

 '''Arkansas''' In Arkansas, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[Arkansas Game and Fish Commission]] (AGFC). AGFC is charged with the "control, management, restoration, conservation and regulation of birds, fish, game and wildlife resources of the state." [[Arkansas – Constitution of the State of Arkansas Amendment 35 et seq., Wild Life – Conservation – Arkansas State Game and Fish Commission|Const. of Arkansas Amend. 35 §1]]. USACE hydropower projects are not eligible for a FERC exemption and therefore are not subject to mandatory terms and conditions pursuant to 30(c) of the [[Federal Power Act]], but AGFC may issue section 10(j) license recommendations. For more information, see: [[RAPID/Roadmap/12-AR-a|State Fish and Wildlife License Recommendations:
12-AR-a]]

 '''California''' In California, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[California Department of Fish & Wildlife]] (CDFW). CDFW is dedicated to the conservation, protection, and management of fish, wildlife, and native plant species, and the habitat necessary to support biologically sustainable populations of those species. [[California Department of Fish and Wildlife: Federal Energy Regulatory Commission (FERC) Hydroelectric Projects]]. For more information, see: [[RAPID/Roadmap/12-CA-a (1)|State Fish and Wildlife License Conditions and Recommendations:
12-CA-a (1)]]

 '''Colorado''' In Colorado, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[Colorado Division of Wildlife|Colorado Parks and Wildlife]] (CPW). CPW is the state agency charged with the management of Colorado's wildlife and wildlife areas. For more information, see: [[RAPID/Roadmap/12-CO-a (2)|State Fish and Wildlife License Conditions and Recommendations:
12-CO-a (2)]]

 '''Illinois''' The [[Illinois Department of Natural Resources]] (IDNR) is the state agency charged with managing the state's wildlife and natural resources. [[Illinois – 520 Illinois Comp. Stat. §§ 5 et seq., Wildlife Code|520 ILCS §5/1.3]]. IDNR participates in the FERC licensing process by (in addition to consulting with other federal, state, and tribal resource management agencies involved in the FERC licensing process) reviewing proposed hydropower projects at [[US Army Corps of Engineers]] (USACE) non-powered dams. IDNR may issue recommendations to FERC regarding the proposed project designed to protect, mitigate damage to, and enhance fish and wildlife resources. [[Federal Power Act|16 U.S.C. § 803(j)]]. USACE hydropower projects are not eligible for a FERC exemption and therefore are not subject to mandatory terms and conditions pursuant to section 30(c) of the [[Federal Power Act]], but IDNR may issue section 10(j) license recommendations. For more information, see: [[RAPID/Roadmap/12-IL-a|State Fish and Wildlife License Recommendations:
12-IL-a]]

 '''Indiana''' In Indiana, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[Indiana Department of Natural Resources]] ("IDNR"). IDNR is the state agency charged with protecting the state's environment and natural resources. [[Indiana - Ind. Code §§ 14-9 et seq., Department of Natural Resources|I.C. §14-9-1-1]]. USACE hydropower projects are not eligible for a FERC exemption and therefore are not subject to mandatory terms and conditions pursuant to section 30(c) of the [[Federal Power Act]], but IDNR may issue section 10(j) license recommendations. For more information, see: [[RAPID/Roadmap/12-IN-a|State Fish and Wildlife License Recommendations:
12-IN-a]]

 '''Iowa''' In Iowa, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[Iowa Department of Natural Resources]] (IDNR). IDNR is Iowa's state agency charged with "protecting the environment, and managing fish, wildlife, and land and water resources" in the state. [[Iowa – Iowa Code §§ 455A et seq., Department of Natural Resources|I.C. §455A.2]]. USACE hydropower projects are not eligible for a FERC exemption and therefore are not subject to mandatory terms and conditions pursuant to section 30(c) of the [[Federal Power Act]], but IDNR may issue section 10(j) license recommendations. For more information, see: [[RAPID/Roadmap/12-IA-a|State Fish and Wildlife License Recommendations:
12-IA-a]]

 '''Kentucky''' In Kentucky, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[Kentucky Department of Fish & Wildlife Resources]] (KDFWR). KDFWR is the state agency charged with the protection, conservation, and enhancement of the state's aquatic resources. [[Kentucky – Ky. Rev. Stat. §§ 150 et seq., Fish and Wildlife Resources|K.R.S. § 150]]; [[Kentucky – 301 Ky. Admin Reg. et seq., Tourism, Arts and Heritage Cabinet – Department of Fish and Wildlife Resources|301 K.A.R.]]. USACE hydropower projects are not eligible for a FERC exemption and therefore are not subject to mandatory terms and conditions pursuant to section 30(c) of the [[Federal Power Act]], but KDFWR may issue section 10(j) license recommendations. For more information, see: [[RAPID/Roadmap/12-KY-a|State Fish and Wildlife License Recommendations:
12-KY-a]]

 '''Louisiana''' In Louisiana, a hydropower developer may be subject to mandatory terms and conditions or recommendations from the [[Louisiana Department of Wildlife and Fisheries]] ("LDWF"). LDWF is charged with protecting, conserving, and replenishing wildlife and aquatic life in the state. [[Louisiana – La. Rev. Stat. §§ 56:1 et seq., Wildlife and Fisheries|L.R.S. § 56:1]]. USACE hydropower projects are not eligible for a FERC exemption and therefore are not subject to mandatory terms and conditions pursuant to section 30(c) of the [[Federal Power Act]], but LDWF may issue section 10(j) license recommendations. For more information, see: [[RAPID/Roadmap/12-LA-a|State Fish and Wildlife License Recommendations:
12-LA-a]]

 '''Minnesota''' In Minnesota, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[Minnesota Department of Natural Resources]] ("MNDNR"). MNDNR is the state agency charged with controlling the state's wildlife and natural resources. [[Minn. Stat. §§ 84.027 et seq., Powers and Duties|Minn. Stat. §84.027(2)]]. USACE hydropower projects are not eligible for a FERC exemption and therefore are not subject to mandatory terms and conditions pursuant to section 30(c) of the [[Federal Power Act]], but MNDNR may issue section 10(j) license recommendations. For more information, see: [[RAPID/Roadmap/12-MN-a|State Fish and Wildlife License Recommendations:
12-MN-a]]

 '''Mississippi''' In Mississippi, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[Mississippi Department of Wildlife, Fisheries and Parks]] (MDWFP). MDWFP is Mississippi's state agency charged with conserving, managing, developing and protecting the state's wildlife. [[Mississippi – Miss. Code §§ 49 et seq., Conservation and Ecology|Miss. Code §49-4-8]]. USACE hydropower projects are not eligible for a FERC exemption and therefore are not subject to mandatory terms and conditions pursuant to section 30(c) of the [[Federal Power Act]], but MDWFP may issue section 10(j) license recommendations. For more information, see: [[RAPID/Roadmap/12-MS-a|State Fish and Wildlife License Recommendations:
12-MS-a]]

 '''Missouri''' In Missouri, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[Missouri Department of Conservation]] ("MDC"). The MDC is Missouri's state agency "charged with the control, management, conservation, and regulation of the bird, fish, game, forestry, and all wildlife resources of the state." [[Missouri – Mo. Code of State Reg. §§ 3 C.S.R. 30-1.010 et seq., Wildlife Code: Organization|3 C.S.R. § 30-1.010(1)]]; [[Missouri – Mo. Rev. Stat. §§ 242.010 et seq., Missouri Wildlife and Forestry Law]]. USACE hydropower projects are not eligible for a FERC exemption and therefore are not subject to mandatory terms and conditions pursuant to section 30(c) of the [[Federal Power Act]], but MDC may issue section 10(j) license recommendations. For more information, see: [[RAPID/Roadmap/12-MO-a|State Fish and Wildlife License Recommendations:
12-MO-a]]

 '''New York''' In New York, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[New York State Department of Environmental Conservation]] (DEC). DEC is the state agency charged with the management of New York's fish, wildlife, and marine resources. For more information, see: [[RAPID/Roadmap/12-NY-a|State Fish and Wildlife License Conditions and Recommendations:
12-NY-a]]

 '''North Dakota''' In North Dakota, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[North Dakota Game and Fish Department]] (NDGF). NDGF is the state agency charged with protecting, propagating, increasing, preserving and conserving of the state's wildlife resources. [[North Dakota – N.D. Century Code §§ 20.1-02 et seq., Game and Fish Department|N.D. Century Code §20.1-02-04]]. USACE hydropower projects are not eligible for a FERC exemption and therefore are not subject to mandatory terms and conditions pursuant to section 30(c) of the [[Federal Power Act]], but NDGF may issue section 10(j) license recommendations. For more information, see: [[RAPID/Roadmap/12-ND-a|State Fish and Wildlife License Recommendations:
12-ND-a]]

 '''Ohio''' In Ohio, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[Ohio Division of Wildlife]] (Division of Wildlife) within the [[Ohio Department of Natural Resources]] (ODNR). The Division of Wildlife is Ohio's state agency charged with investigating, considering, and making recommendations "in all matters pertaining to the protection, preservation, propagation, possession, and management" of Ohio's wildlife. [[Ohio – Ohio Rev. Code §§ 1531.01 et seq., Division of Wildlife|O.R.C. § 1531.03(C)]]. USACE hydropower projects are not eligible for a FERC exemption and therefore are not subject to mandatory terms and conditions pursuant to section 30(c) of the [[Federal Power Act]], but ODNR may issue section 10(j) license recommendations. For more information, see: [[RAPID/Roadmap/12-OH-a|State Fish and Wildlife License Recommendations:
12-OH-a]]

 '''Pennsylvania''' In Pennsylvania, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[Pennsylvania Fish and Boat Commission]] (PFBC). PFBC is the state agency charged with the protection, conservation, and enhancement of the state's aquatic resources. [[Pennsylvania – 30 Pa Cons. Stat. §§ 3 et seq., Fish and Boat Commission| 30 Pa.C.S. § 3]]; [[Pennsylvania – Fish and Boat Commission – Policy Manual|PFBC Policy Manual]]. USACE hydropower projects are not eligible for a FERC exemption and therefore are not subject to mandatory terms and conditions pursuant to section 30(c) of the [[Federal Power Act]], but PFBC may issue section 10(j) license recommendations. For more information, see: [[RAPID/Roadmap/12-PA-a|State Fish and Wildlife License Recommendations:
12-PA-a]]

 '''Tennessee''' In Tennessee, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[Tennessee Wildlife Resources Agency]] (TWRA). TWRA is the state agency charged with protecting, propagating, increasing, preserving and conserving of the state's wildlife resources. [[Tennessee – Tenn. Code Ann. §§ 70-1-3 et seq., Wildlife Resources Agency|Tenn. Code Ann. §70-1-302]]. USACE hydropower projects are not eligible for a FERC exemption and therefore are not subject to mandatory terms and conditions pursuant to section 30(c) of the [[Federal Power Act]], but TWRA may issue section 10(j) license recommendations. For more information, see: [[RAPID/Roadmap/12-TN-a|State Fish and Wildlife License Recommendations:
12-TN-a]]

 '''Vermont''' In Vermont, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[Vermont Agency of Natural Resources]] (ANR). ANR is Vermont's state agency with primary responsibility for protecting Vermont's environment, natural resources and wildlife. For more information, see: [[RAPID/Roadmap/12-VT-a|State Fish and Wildlife License Conditions and Recommendations:
12-VT-a]]

 '''Washington''' In Washington, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[Washington State Department of Fish and Wildlife]] (WDFW). WDFW is the state agency charged with the preservation, protection, perpetuation, and management of the state's wildlife and fish resources. [[Washington – Title 77, Fish and Wildlife|RCW 77.04.012]]. For more information, see: [[RAPID/Roadmap/12-WA-a(1)|State Fish and Wildlife License Conditions and Recommendations:
12-WA-a(1)]]

 '''West Virginia''' In West Virginia, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[West Virginia Division of Natural Resources]] (WVDNR). WVDNR is the state agency charged with the protection, conservation, and enhancement of the state's aquatic resources. [[West Virginia – W.V. Code §§ 20-2 et seq., Wildlife Resources|W.V.C. §20-2]]. USACE hydropower projects are not eligible for a FERC exemption and therefore are not subject to mandatory terms and conditions pursuant to section 30(c) of the [[Federal Power Act]], but WVDNR may issue section 10(j) license recommendations. For more information, see: [[RAPID/Roadmap/12-WV-a|State Fish and Wildlife License Recommendations:
12-WV-a]]

 '''Wisconsin''' In Wisconsin, a hydropower project may be subject to mandatory terms and conditions or recommendations from the [[Wisconsin Department of Natural Resources]] (Wisconsin DNR). Wisconsin DNR is the state agency charged with controlling and conserving the state's plant and wildlife resources. [[Wisconsin – Wis. Stat. §§ 23 et seq., Conservation|Wis. Stat. §23]]; [[Wisconsin – Wis. Stat. §§ 29 et seq., Wild Animals and Plants|Wis. Stat. §29]]. USACE hydropower projects are not eligible for a FERC exemption and therefore are not subject to mandatory terms and conditions pursuant to 30(c) of the [[Federal Power Act]]. For more information, see: [[RAPID/Roadmap/12-WI-a|State Fish and Wildlife License Recommendations:
12-WI-a]]
 ==7-FD-i.30 – Is there a Substantive Dispute that Must be Resolved?== The developer will be required to participate in further review if the written comments provided in response to the draft application indicate that a resource agency or Indian tribe has a substantive disagreement with the developer's conclusions regarding resource impacts or its proposed protection, mitigation, or enhancement measures. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(c)(6)]]. If there is no dispute regarding the applicant's (developer) study results and draft application then go to: 7-FD-i.33 – Application for FERC License and Associated Documents. ==7-FD-i.31 to 7-FD-i.32 – Provide Notice of Joint Meeting== The developer must hold a joint meeting if there is a substantial dispute regarding the applicant's (developer) draft application and study results. The developer must hold the joint meeting with the disagreeing resource agency or Indian tribe and other agencies with similar or related areas of interest, expertise, or responsibility no later than 60 days from the date of the written comments of the disagreeing agency or Indian tribe. The meeting will allow all parties to discuss and to attempt to reach agreement on any plan for environmental protection, mitigation, or enhancement measures. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(c)(6)(i)]]. The developer must provide written notice of the meeting to FERC at least 15 days prior to the meeting. The notice must indicate the time, place, and agenda of the issues to be discussed at the meeting. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(c)(6)(iii)]].The developer and any disagreeing agency or Indian tribe may conclude a joint meeting with a document embodying any agreement among them regarding environmental protection, mitigation, or enhancement measures and any issues that are unresolved. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(c)(7)]]. ==7-FD-i.33 – Application for FERC License and Associated Documents== The developer must file an application with FERC, accompanied by a transmittal letter certifying that at the same time copies of the application are being mailed to the resource agencies, Indian tribes, other government offices, and consulted members of the public. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(d)(1)]]. A developer may submit an application for a FERC License if: *It has provided resources agencies with the documents required under [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(c)(4)]]; and *It has complied with meeting requirements in the event of a substantive disagreement with any resource agency. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(c)(9)]]. The developer must describe all disagreements with a resource agency or Indian tribe on technical or environmental protection, mitigation, or enhancement measures in the application. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(c)(10)]]. The developer must include an Exhibit E in the application that indicates they have met all consultation requirements, and it should include a summary of the consultation process and: *Any resource agency's or Indian tribe's letters containing comments, recommendations, and proposed terms and conditions; *Any letters from the public containing comments and recommendations; *Notice of any remaining disagreement with a resource agency or Indian tribe on the need for or manner of a study, and information on any environmental protection, mitigation, or enhancement measure, including the developer's reasons for disagreement; *Evidence of any waivers obtained from resource agencies; *Evidence of all attempts to consult with a resource agency or Indian tribe, copies of related documents showing the attempts, and documents showing the conclusion of the second stage of consultation; *An explanation of how and why the project would, would not, or should not, comply with any relevant comprehensive plan and a description of any relevant resource agency or Indian tribe determination regarding the consistency of the project with any such comprehensive plan; *A description of how the developer's proposal addresses the significant resource issues raised at the joint meeting; and *A list containing the name and address of every federal, state, and interstate resource agency and Indian tribe with which the developer consulted. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.38(f)]]. ==7-FD-i.34 – Provide Notice of Application== FERC must issue a tendering notice within 14 days of the filing of an application. [[FERC Handbook for Hydroelectric Project Licensing and 5 MW Exemptions from Licensing | FERC Handbook, page 4-11]]. This notice must solicit requests for additional studies. [[FERC Handbook for Hydroelectric Project Licensing and 5 MW Exemptions from Licensing | FERC Handbook, page 4-11]]. ==7-FD-i.35 – Initiate FERC - NEPA Process== FERC, with the assistance of the developer, must initiate environmental review under the [[National Environmental Policy Act]] (NEPA). FERC will issue a Notice of Ready for EA after the developer files the license application and FERC has accepted the application. [[RAPID/Roadmap/9-FD-i|FERC - NEPA Process:
9-FD-i]] ==7-FD-i.36 - Conduct National Historic Preservation Act Section 106 – Resource Survey== With the FERC-issued notice of application (see 7-FD-i.36), FERC initiates consultation with the State Historic Preservation Officer (SHPO), as required by section 106 of the [[National Historic Preservation Act]]. [[FERC Handbook for Hydroelectric Project Licensing and 5 MW Exemptions from Licensing | FERC Handbook, page 4-11]]. Section 106 of the [[National Historic Preservation Act]] requires FERC to consult with appropriate state and local officials, Indian tribes, applicants for federal assistance, and members of the public and to consider their views and concerns about the effect of licensing a hydropower project on historic properties within the affected area. For more information regarding the [[National Historic Preservation Act]] (NHPA) requirements, see: [[RAPID/Roadmap/11-FD-a|National Historic Preservation Act Section 106 – Resource Survey:
11-FD-a]] ==7-FD-i.37 – Provide any Necessary Additional Information== The developer must provide to the participants any: *Deficiency correction, revision, supplement, response to additional information request, or amendment to the application; and *Written correspondence from FERC requesting the correction of deficiencies or the submittal of additional information. [[FERC Handbook for Hydroelectric Project Licensing and 5 MW Exemptions from Licensing | FERC Handbook, page 4-11]]. ==7-FD-i.38 to 7-FD-i.40 – Review Application Materials for Completeness== FERC will review application materials to ensure that all required elements are present. FERC may request additional information or documents it considers relevant for an informed decision on the application even if the application complies with the regulations. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.32(e)(1)]]. ==7-FD-i.41 – Conduct Substantive Review of Application Materials== FERC will review the application materials to ensure that all applicable regulations have been followed. ==7-FD-i.42 – Is the Application Accepted?== FERC may accept or reject an application for a license. ==7-FD-i.43 – Letter of Acceptance== If FERC determines that the application is acceptable following adequacy review, then they will issue a Letter of Acceptance to the developer. [[FERC Handbook for Hydroelectric Project Licensing and 5 MW Exemptions from Licensing | FERC Handbook, page 4-11]]. ==7-FD-i.44 – Is the Application Patently Deficient?== If FERC determines, within 90 days of its filing date, that an application patently fails to substantially comply with the application requirements, then the application will be rejected as patently deficient. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.32(e)(2)]]. If FERC determines that the application is patently deficient, go to: 7-FD-i.47 to 7-FD-i.48 – Submit a Request for Rehearing. ==7-FD-i.45 – Deficiency Letter== FERC will issue a Deficiency Letter to the developer if the application is inadequate but not patently deficient. ==7-FD-i.46 – Provide Any Necessary Additional Information== The developer will be given a chance to provide the necessary additional information. However, if the 24-month filing deadline has passed, then the application must be rejected. ==7-FD-i.47 to 7-FD-i.48 – Submit a Request for Rehearing== The developer may request rehearing on any decision of FERC. The developer must submit the request no later than 30 days after issuance of the licensing denial. [[Title 18 CFR 385 Rules of Practice and Procedure | 18 CFR 385.713(b)]]. The request should outline the alleged error in the final decision or final order. [[Title 18 CFR 385 Rules of Practice and Procedure | 18 CFR 385.713(c)(1)]]. FERC may approve or deny any rehearing request. If FERC rejects or dismisses an application because it is patently deficient or because the developer fails to correct deficiencies, then the developer cannot refile its application if the 24-month filing deadline has passed. [[FERC Handbook for Hydroelectric Project Licensing and 5 MW Exemptions from Licensing | FERC Handbook, page 4-12]]. ==7-FD-i.49 – Consider Submitting Final Order for Judicial Review== The developer may obtain review of a final order in the United States Court of Appeals for any circuit in which the developer is located or has its principal place of business. The developer may obtain review through filing a written petition requesting that the final order be modified or set aside in whole within 60 days after the final action of FERC. [[Title 16 USC 825l Review of Orders|16 USC 8251(b)]]. ==7-FD-i.50 – Conduct Rehearing on Denial of Application== If the request for rehearing is approved, then FERC will review the decision to deny an application. See element 7-FD-i.33 — Application for FERC License and Associated Documents.. ==7-FD-i.51 to 7-FD-i.52 – Provide Public Notice of Acceptance of Application== FERC must provide public notice in the Federal Register, local newspapers, and directly to resources agencies and Indian tribes if the application is accepted. The notice will identify dates for comment, intervention, and protests. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.34(b)]]. The public and participating agencies may comment on the acceptance of the application. The time frame for comments will be included in the public notice. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.34(b)]]. ==7-FD-i.53 to 7-FD-i.54 – Scoping Document 1 (If Necessary)== FERC will typically issue a Scoping Document for public comment. [[FERC Handbook for Hydroelectric Project Licensing and 5 MW Exemptions from Licensing | FERC Handbook, page 4-13]]. The timeframe for public notice will be included in the Scoping Document. FERC may request additional information from the developer. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.32(g)]]. ==7-FD-i.55 to 7-FD-i.56 – Provide Notice of Readiness for Environmental Analysis (REA)== FERC will provide notice of Readiness for Environmental Analysis (REA) following the comment period for the Notice of Acceptance of Application or the Scoping Document. [[FERC Handbook for Hydroelectric Project Licensing and 5 MW Exemptions from Licensing | FERC Handbook, page 4-13]]. Agencies, tribes, and the public will have 60 days to file comments, recommendations, terms and conditions, and prescriptions. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.34(b)]]. ==7-FD-i.57 – Demonstrate Compliance with 401 Water Quality Certification== The developer must demonstrate compliance with the CWA's water quality certification requirements. Within 60 days from the date FERC issues the notice of readiness for environmental analysis, the developer must file: *A copy of the water quality certification; *A copy of the request for certification, including proof of the date on which the certifying agency received the request; or *Evidence of waiver of water quality certification. See element 7-FD-i.3. [[Title 18 CFR 4 Licenses, Permits, Exemptions, and Determination of Project Costs | 18 CFR 4.34(b)(5)(i)]]. ==7-FD-i.58 to 7-FD-i.60 – Is the License Approved?== FERC may approve or deny any request for a license. If the license is approved, then FERC will issue a Licensing Order. If the license is denied, then FERC will issue an order denying the license application. The developer may seek rehearing of the order denying the license application with FERC. FERC may issue an order either granting or denying rehearing of the license order. If FERC issues an order denying rehearing of the license order, then the developer may obtain review of the order denying rehearing in the United States Court of Appeals for the District of Columbia, or for any circuit in which the developer is located or where the developer has its principal place of business. The developer may obtain review through filing a written petition requesting that the rehearing order be modified or set aside in whole within 60 days after the final action of FERC. [[Title 16 USC 825l Review of Orders|16 USC 8251(b)]]. 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A Muslim man tried to execute A 33-year-old Philadelphia policeman him while he was sitting in his police vehicle late Thursday night.
The suspect said he had committed the attempted execution in the name of the Islamic State, the jihadi terrorist insurgent group that controls territory in the Middle East.
Shocking photos show the moment a crazed gunman wearing a white smock shot a Philadelphia police officer "in the name of Islam".
The incident happened last night in West Philadelphia. 33-year-old officer Jesse Hartnett was sat in his patrol vehicle when the gunman fired 13 shots through the driver side window.
"Shots fired! I'm shot! I'm bleeding heavily!" Hartnett is heard yelling on police radio.
According to a CBS News report, the gunman later confessed that he had carried out the attempted assassination "in the name of Islam".
Surveillance photos from the scene show the gunman wearing a white smock.
"When you look at the video — we have video that captured all of this — it's one of the scariest things I've ever seen," Philadelphia Police Commissioner Richard Ross said during a press conference.
The officer, who is in hospital but expected to recover, returned fire and hit the gunman three times.
An ABC News report about the incident contained no mention of the fact that the gunman attempted to kill the officer "in the name of Islam".
Democrats usually start talking about going after people who offend Muslims for hate speech after incidences like these and then blame the gun, not the Islamist extremist.


text:
Impact Factor 2.634 | CiteScore 2.6
Frontiers in Pediatrics
Pediatric Gastroenterology, Hepatology and Nutrition
Daniel A. Lemberg
Sydney Children's Hospital, Australia
Corentin Babakissa
Université de Sherbrooke, Canada
Nadeem O. Kaakoush
University of New South Wales, Australia
The editor and reviewers' affiliations are the latest provided on their Loop research profiles and may not reflect their situation at the time of review.
Case Report ARTICLE
Front. Pediatr., 29 January 2018 | https://doi.org/10.3389/fped.2018.00007
Extracellular Calcium Dictates Onset, Severity, and Recovery of Diarrhea in a Child with Immune-Mediated Enteropathy
Johnathan Fraebel, Regino Gonzalez-Peralta†, Maryann Maximos, Genie L. Beasley, Christopher Douglas Jolley and Sam Xianjun Cheng*
Department of Pediatrics, Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL, United States
Diarrhea causes monovalent and divalent ion losses that can influence clinical outcome. Unlike the losses of monovalent ions, such as Na+, K+, Cl−, and HCO3−, which are generally large in quantity (osmoles) and therefore determine the severity of diarrhea, the losses of divalent ions are relatively small in osmoles and are often overlooked during diarrheal treatment. Studies now suggest that despite divalent ions being small in osmoles, their effects are large due to the presence of divalent ion-sensing receptors and their amplifying effects in the gut. As a result, losses of these divalent ions without prompt replacement could also significantly affect the onset, severity, and/or recovery of diarrheal disease. Herein, we report a case of a malnourished child with an immune-mediated enteropathy who developed episodes of "breakthrough" diarrhea with concurrent hypocalcemia while on appropriate immunotherapy. Interestingly, during these periods of diarrhea, stool volume fluctuated with levels of blood Ca2+. When Ca2+ was low, diarrhea occurred; when Ca2+ levels normalized with replacement, diarrhea stopped. Based on this and other observations, a broader question arises as to whether the Ca2+ lost in diarrhea should be replaced promptly in these patients.
Diarrhea causes both monovalent and divalent ion losses (1, 2). Without prompt replacement, both affect the outcome of diarrheal disease. While losses of monovalent ions Na+, K+, Cl−, and HCO3− are large and therefore determine the severity of diarrhea, losses of divalent ions are small but large in biologic effect due to the presence of divalent ion-sensing receptor-mediated signal amplification (3, 4). As a result, without prompt replacement, the loss of divalent ions can also likely affect the onset, severity, and recovery of diarrheal disease. For example, Zn2+, acting via Zn2+-sensing receptor (ZnSR), can reduce the severity, duration, and recurrence rate of diarrhea (5). This Zn2+ effect is particularly important in mal- and undernourished children in whom an underlying negative balance of Zn2+ metabolism often exists. However, despite the recent advances in Ca2+ and Ca2+-sensing receptor (CaSR) research, limited information is available on the role and function of this important divalent ion in diarrhea.
In this communication, we report a malnourished child with an immune-mediated enteropathy. Despite adequate immunotherapy, he developed episodes of "breakthrough" diarrhea with concurrent hypocalcemia. Interestingly, during these disease flare-up episodes, diarrhea symptoms inversely fluctuated with levels of blood Ca2+. When blood (serum) Ca2+ was low, diarrhea occurred; when Ca2+ levels normalized with replacement, diarrhea quickly stopped. In light of this and other observations, we propose that, similar to Zn2+ deficiency, the loss of Ca2+ without prompt replacement may compromise the diarrhea-protective capability of Ca2+ and CaSR in the gut and lead to severe, protracted, and recurrent diarrhea.
The patient is a 6-year-old African-American male with autoimmune enteropathy (diagnosed 12 months prior to admission, based on the following criteria: intractable diarrhea, small bowel villous atrophy, presence of circulating anti-enterocyte antibodies, and responsiveness to immunosuppressive treatment) who was hospitalized for worsening non-bloody, watery diarrhea, severe malnutrition, and hypocalcemia. Initially, he responded well to glucocorticosteroid monotherapy. However, for the 6 months prior to this admission, social issues gradually led to interruption of this therapy with recurrence of diarrhea (Figure 1A) and weight loss. Despite re-initiation of glucocorticoids, diarrhea persisted, so tacrolimus was added to his treatment regimen. He responded well with combination therapy, but 6 weeks prior to admission, he developed recurrent diarrhea and weight loss (despite appropriate administration of medications and consistent therapeutic tacrolimus levels). He had no other medical problems and had no relatives with gastrointestinal or immunological disease. Findings on the initial physical examination revealed a moderately malnourished (height Z = −0.56, weight Z = −2.25, BMI Z = −2.85) child with hypothermia (temperature 97.5 °F), hypotension (blood pressure 83/54 mmHg), tachycardia (pulse 103 beats per minute), dry mucus membranes, sunken orbits, temporal wasting, and a protuberant but otherwise benign abdomen. His laboratory values are shown in Figures 1B–E.
Figure 1. Diarrhea response and fluctuation of laboratory values prior to and post calcium replacement. Stool output (A) does not vary with blood levels of tacrolimus (C) but fluctuates with blood concentrations of Ca2+ ([Ca2+]) (B) on three occasions and via two routes of administration. Upon switch to a dairy-free diet, [Ca2+] reduces and diarrhea occurs. With intravenous CaCl2, [Ca2+] rises and stool output declines. With oral CaCO3, [Ca2+] rises again and stool output yet declines again. The corresponding alterations in other laboratory values are shown in (D,E). The values between the upper lines (upper normal limits) and lower lines (lower normal limits) are normal, whereas the values above the upper lines are elevated and those below the lower lines are reduced. The two gray areas illustrate the periods in which the patient was receiving calcium therapies. The form of calcium salts and their doses administered are indicated in the black boxes. It is likely that under a negative status of calcium balance, the diarrhea-combating ability of the divalent mineral is compromised, and the responsiveness to immunomodulators is lost. As a result, disease is "flared up" and the patient becomes diarrheic. Diarrhea will temporarily be halted upon normalization of calcium level. However, the disease will relapse and will not enter a permanent remission state unless a normal positive calcium balance is restored.
He was initially resuscitated with intravenous fluids. However, his diarrhea (Figure 1A) and metabolic acidosis (Figure 1E) remained while hypokalemia (Figure 1D) worsened. All enteral intakes were withheld and total parenteral nutrition was initiated, while intravenous solumedrol and oral tacrolimus were continued. Despite good therapeutic blood levels of tacrolimus (Figure 1C), the diarrhea persisted (Figure 1A). Pan cultures of stool, urine, and blood revealed no abnormal growth. Stool ova and parasites analysis, viral, and Clostridium difficile toxin A/B studies were negative. On hospital day 4, he developed severe hypocalcemia with tetany (contractures of the hands and lower extremities), and worsening hypokalemia and metabolic acidosis. He was transferred to the intensive care unit for a closer monitoring and given three consecutive doses of q 3-h intravenous calcium chloride (0.5 mEq elemental Ca2+/kg/dose), in addition to intravenous fluids and other electrolyte replacements. Remarkably, as his serum-ionized Ca2+ normalized, his diarrhea resolved (Figure 1A). In fact, after 3 days of calcium therapy, he became constipated.
With weaning of calcium supplementation, there was a recurrence of diarrhea, hypocalcemia, and metabolic acidosis. Five days after discontinuing calcium, his daily stool output increased to more than 2 L—close to that before calcium supplementation. The diarrhea resolved within 2 days of administration of oral calcium carbonate suspension (1.3 mEq elemental Ca2+/kg/day) (Figure 1A). Of note, he received a combination of glucocorticoid-tacrolimus (at therapeutic levels) therapy during the entire hospitalization. At discharge, the patient was prescribed vitamin D in addition to calcium supplementation to restore normal Ca2+ balance. He was also placed on an unrestricted diet. At his recent 3-month follow-up clinic visit, he had no diarrhea, and the serum calcium levels remained normal.
Management of pediatric diarrhea remains challenging, particularly in children with malnutrition or undernutrition, in whom diarrheal episodes are often severe, protracted, and recurrent. Based on the previous Ca2+ metabolic balance studies in diarrhea (1, 2) and the recent work on the influence of Ca2+ and CaSR in reversing both secretory (6–10) and inflammatory diarrheas (11–13), we propose that the inadequate replacement of Ca2+ losses and the resultant inadequate activation of intestinal CaSR may be responsible for the severity and persistence of diarrhea symptoms in these malnourished patients.
According to earlier metabolic balance studies (1, 2), diarrhea results in losses of not only Na+, K+, Cl−, and HCO3−, which are normally replaced with oral rehydration solution (ORS), but also Ca2+, Mg2+, and Zn2+, which are not routinely included in these solutions, possibly because of their relatively small quantities compared to monovalent ion losses (see summary in Table 1).
Table 1. Total fluid, electrolyte, and mineral losses in normal infants and those with diarrhea and their consequences.
It is important to note that the absolute concentrations of divalent ion losses in diarrhea are smaller than those of monovalent ones, and they contribute less to the severity of dehydration. However, divalent mineral losses may greatly affect the course of diarrhea, leading to prolonged duration and frequent recurrence of the disease. Unlike monovalent ions, divalent ions such as Ca2+ are "functional" nutrients. In addition to their nutritional values, they also function as hormones or first messengers, binding to their corresponding divalent ion-sensing receptors (i.e., Ca2+ and Mg2+ binding to CaSR (3, 4, 13) and Zn2+ binding to ZnSR (5)) in the enterocytes of the gastrointestinal tract and inhibiting pathophysiologic processes that result in diarrhea. Indeed, as shown in this present case, diarrhea volume inversely correlated with serum levels of Ca2+ (Figure 1). Similar findings were also observed in children with infectious diarrheal diseases (14), as well as in healthy adult volunteers who were infected with enterotoxigenic Escherichia coli resulting in secretory diarrhea (15).
Considering the chronic nature of the diarrhea prior to admission and the absence of gastrointestinal infection, our patient's diarrhea was most likely related to the underlying autoimmune enteropathy. Indeed, the diarrhea responded well to appropriate immunotherapy while calcium levels were normal. However, it recurred with hypocalcemia and again resolved with normalization of this element's serum levels. The direct correlation between calcium concentration and stool volume (Figure 2) strongly implicates hypocalcemia as the cause of "breakthrough" diarrhea in this patient. The fact that the intensification of immunosuppression alone (with low calcium levels) early during his hospitalization failed to curtail diarrhea also lends support to this conclusion.
Figure 2. The correlation between serum Ca2+ concentrations ([Ca2+]) and daily stool outputs. The total serum [Ca2+] is shown. The linear regression was performed using Microsoft Excel 2016 for Windows, while the statistical analysis was performed using GraphPad Prism version 6.07 for Windows (GraphPad Software, San Diego, CA, USA). The fluctuation in stool output is correlated significantly with the change in total (r = −0.5818, P = 0.0181) and ionized (r = −0.8396, P = 0.0365, data not shown) serum [Ca2+] in a negative manner.
There are multiple reasons that our patient would have a negative balance of Ca2+ metabolism. First, he has malnutrition. It is common for children with malnutrition to have a negative calcium balance. Second, this child had a history of enteropathy that could impair Ca2+ absorption and induce Ca2+ loss. Third, he also has milk-dairy intolerance and was consuming a dairy-free diet. The long restriction of Ca2+-rich dairy intake could lead his Ca2+ metabolic balance to a further negative direction, precipitating hypocalcemia and diarrhea.
The mechanisms whereby hypocalcemia precipitates diarrhea in an inflammatory gut have been described in animal models and not in humans. Several studies have reported that Ca2+ is required for the maintenance of epithelial tight junction integrity, a critical determinant of intestinal barrier function and inflammatory diarrhea (16–25). Decreases in extracellular Ca2+ concentration caused cell–cell junction destruction and opening of the paracellular pathway (17, 18, 20–22, 25). As a result, animals on high Ca2+ diets were shown to be more resistant to the development of enterocolitis caused by barrier function disrupters, such as invading pathogens (26–29), chemical colitogens (30), and immune-mediated processes (31). By contrast, animals on reduced Ca2+ diets were more prone to induced intestinal inflammation, resulting in colitis and diarrhea (32). Emerging data are now linking this phenomenon to the activity of the CaSR, as activation of this special G-protein-coupled cell surface receptor increased the epithelial tight junction barrier (12, 25) while its inactivation [as in CaSR-deficient mice (11)] disrupted intestinal barrier, leading to increased gut inflammation. In these CaSR-deficient mice, diarrhea responses to induced gut inflammation were more severe and persisted longer than their wild-type littermates. Based on these experimental observations, we propose that Ca2+-therapeutic effects on inflammatory diarrhea are mediated via the CaSR, augmenting the epithelial barrier function that is so often disrupted in these conditions.
Of note, the localization of CaSR in the gut has been described on both the apical and the basolateral sides of the plasma membrane of the enterocyte (8), and receptors in both membrane domains of the polarized enterocyte are functionally active and can be activated by Ca2+, calcimimetics such as R568, and other polycations such as spermine with similar potency and EC50 values (7–9). It is therefore possible that the efficacy of oral Ca2+ supplementation results from the activation of the CaSR at the intestinal brush border, whereas the efficacy of intravenous Ca2+ supplementation results from the activation of the receptor at the blood side of the enterocyte. These observations demonstrate that the anti-diarrheal activity of Ca2+ can be readily achieved by either route. Thus, depending upon the severity of symptoms and the presence or absence of emergencies, the replacement of Ca2+ can be given either intravenously or orally, as in the case of this patient. However, it is worth noting that, while the repletion via intravenous route raises serum Ca2+ quickly, this quickly raised serum calcium is lost quickly due to its prompt activation of CaSR in parathyroid glands and kidneys (which increases Ca2+ excretion). By contrast, while oral replacement raises serum Ca2+ relatively slowly, it produces local therapeutic anti-diarrheal (and other) actions and helps restore Ca2+ balance without causing much unwanted systemic adverse effects. Given this, the oral route is considered both safer and more physiological. Whenever clinically allowed, prompt switching from intravenous to oral supplementation of Ca2+ is recommended.
Given the wealth of accumulating data on the role and importance of Ca2+ and CaSR in both secretory and inflammatory diarrheal conditions, we suggest that Ca2 stool losses should be routinely replaced as is currently done for Na+, K+, Cl−, HCO3−, and Zn2+. As summarized in Table 2, an ideal ORS composition would contain both monovalent ions and divalent minerals. The monovalent ions aim at replacing electrolyte losses, and correcting both hypovolemia and metabolic acidosis, thereby reducing diarrhea-associated mortality. By contrast, divalent ions would replace mineral losses, restoring the anti-diarrheal activities of CaSR and ZnSR, and thereby reducing the onset, duration, and recurrence of diarrhea. ORS use has been declining over the past decade, with fewer than 33% of children with diarrhea under the age of 5 using this therapy (33). Because it has little effects in decreasing stool volume, caregivers are reluctant to use ORS and instead prefer using anti-microbial agents, which increases the risk of developing drug resistance (3). If the findings presented in this and other studies are confirmed, adding divalent minerals to, or concurrently supplementing these ions along with ORS, would likely increase compliance with this oral therapy. Large randomized-controlled trials are warranted to further test the efficacy and safety of this therapeutic strategy.
Table 2. Rationale for suggested combined approach for treating diarrhea.
The written consent for publication was obtained from the child's parent.
This study was carried out in accordance with the recommendations of the University of Florida Health Center's IRB Guidelines and Privacy Rules about case reports, and it has been reviewed by UF IRB with written informed consent from the guardian of the studied subject.
SXC conceptualized and designed the work, JF and SXC collected and analyzed the data, RG, MM, GLB, CDJ, and SXC interpreted the data, JF and SXC drafted and RG, MM, GLB, and CDJ revised this manuscript, and all authors approved the final version and agreed to be accountable for the content of this work.
The authors declare that the submitted work was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
We thank Ms. Jane Harrell for reading this manuscript.
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Keywords: calcium, calcium metabolism, calcium-sensing receptor, diarrhea, immune-mediated enteropathy, inflammatory bowel disease, intestinal barrier function, ion transport
Citation: Fraebel J, Gonzalez-Peralta R, Maximos M, Beasley GL, Jolley CD and Cheng SX (2018) Extracellular Calcium Dictates Onset, Severity, and Recovery of Diarrhea in a Child with Immune-Mediated Enteropathy. Front. Pediatr. 6:7. doi: 10.3389/fped.2018.00007
Received: 10 November 2017; Accepted: 10 January 2018;
Daniel Avi Lemberg, Sydney Children's Hospital, Australia
Nadeem Omar Kaakoush, University of New South Wales, Australia
Corentin Babakissa, Université de Sherbrooke, Canada
Copyright: © 2018 Fraebel, Gonzalez-Peralta, Maximos, Beasley, Jolley and Cheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Sam Xianjun Cheng, sam.cheng@ufl.edu
†Present address: Regino Gonzalez-Peralta, Division of Pediatric Gastroenterology, Florida Hospital for Children, Orlando, FL, United States

redpajama_set_name: RedPajamaCommonCrawl


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