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Kitzinger, Ernst
Byzantine (culture or style)
Medieval (European)
Influential Harvard Byzantinist and medievalist art historian. Kitzinger's father, Wilhelm Nathan Kitzinger (1870-1945) was a Munich lawyer and his mother Elisabeth Rahel Merzbacher (1881-1966), a woman devoted to social causes connected with Judaism. Kitzinger's cousin, Richard Krautheimer would also become a distinguished medievalist in Europe and the United States. Kitzinger attended the Max-Gymnasium in Munich, graduating in 1931. Between 1931-34 he studied art history, archaeology, and philosophy at the universities in Munich where his professors included Ernst Buschor and Wilhelm Pinder. Pinder's ideological thrust emphasized the "Germanness" of medieval art, a characteristic Kitzinger never adopted. His dissertation, written under Pinder, was on the topic of Roman painting between the 7th and 8th centuries A.D. The tiny forty-plus page thesis, completed when Kitzinger was only 21, persuasively argued against the prevailing notion of a hegemonic "Alexandrian" style in favor of eastern Mediterranean influences. Kitzinger left Germany in 1935 when it became ever clearer that academic careers would be barred to Jews by the Nazis. He first went to Rome, where did post-doctorate studies with Pietro Toesca, and then to England where accepted a position at the British Museum under the brilliant Keeper, T. D. Kendrick. Kitzinger's research on Anglo-Saxon arts of northern England and southern Scotland in the Department of British and Mediaeval Antiquities resulted in one of his most enduring books, the 1940 Early Medieval Art at the British Museum. It is still a standard introduction to medieval art. While at the museum, the great 7th-century ship burial site at Sutton Hoo was excavated in 1939 and Kitzinger was responsible for the first assessment of this extraordinary late-Roman and early Byzantine silver plate discovery. When England entered the war against Germany, Kitzinger was interned as an enemy alien and evacuated to Australia. After his release in 1941, he emigrated to the United States where he was appointed a junior fellow at the newly founded Center for Byzantine Studies, Dumbarton Oaks, Harvard's medieval research center in Washgington, D. C., whose director was the great Carolingian manuscript scholar Wilhelm Reinhold Walter Koehler. His security clearance reinstated, Kitzinger served as a research analyst for the Office of Strategic Services in Washington and London between 1943 and 1945. He married [Margaret] Susan Theobald Ranby (1915-2000), a devoted Quaker and painter in 1944. Kitzinger returned to Harvard and Dumbarton Oaks in 1946 where he was named assistant professor of Byzantine art and archaeology. As a 1950-1951 Fulbright Scholar, he was engaged in research on the Byzantine mosaics of the Norman kingdom of Sicily, a topic concomitantly investigated by fellow Byzantinist Otto Demus. Kitzinger's review of Demus's The Mosaics of Norman Sicily (1950) was itself a work of scholarship and fairness on the topic. His own monograph on the topic, The Mosaics of Monreale appeared in 1960. He was appointed associate professor at Harvard in 1951. As a Guggenheim Fellow, 1953-1954, he continued his field research, traveling to Italy, Greece, Yugoslavia and Turkey. Between 1955 and 1966 Kitzinger was Director of Byzantine Studies at Dumbarton Oaks, transforming that institution into the world's premiere Byzantine studies center. He was appointed full professor at Harvard in 1956. In 1966, he accepted an appointment at the Institute for Advanced Study, Princeton, N. J. Wishing to devote more time to teaching, he returned to Harvard in 1967, this time the campus in Cambridge, MA, as the first A. Kingsley Porter University Professor. A series of lectures Kitzinger gave as Slade Professor at Cambridge University between 1974 and 1975 resulted in the 1977 book, Byzantine Art in the Making. His collected articles appeared in 1976 as The Art of Byzantium and the Medieval West: Selected Studies. In 1979 he retired from Harvard and moved to Oxford, a city he had developed an affinity for during his first stay in England. In the 1980s, Kitzinger researched and wrote a six-volume survey of the Norman mosaics of Sicily. Surprising to many, however, Oxford failed to make use of Kitzinger's presence and expertise. During his final years, he divided his retirement time between Princeton and Oxford. Kitzinger's many distinguished students included Irving Lavin. His papers are held at the Getty Research Center.
Kitzinger was among the generation of German art historians who fled Nazi persecution and brought to the United States a methodologically rigorous and intellectually ambitious brand of art scholarship. The virtue of Kitzinger's work was its ability "to connect what was happening visually to what was happening conceptually; the history of art [of Kitzinger] became a history of ideas" (Lavin). Kitzinger rejected the conventional term "Early Christian" for the area of his research, insisting that it failed to encompass monuments as different as the Hagia Sophia or the encaustic icons preserved at St. Catherine's monastery of Mount Sinai. He also pioneered the concept of "modes" of artistic representation. These modes or distinct styles linked to specific subject matter were first used by Kitzinger to characterize the differing appearances of angels at Santa Maria Antiqua, Rome. Likewise, the 1958 paper "Byzantine Art in the Period Between Justinian and Iconoclasm," presented in Munich, remains the most perceptive construct of the arts of the Mediterranean before the destruction of images. Kitzinger's reliance on style as an element of analysis had detractors. Some voiced concern that his reliance on formal structure was employed even when the object's provenance and date were under question. Among medievalists, it has been noted that he practiced his craft in research institutions more than in the field. Kitzinger was a skilled promoter of budding art historical talent without imposing a particular school of thought.
[dissertation:] Römische Malerei vom Beginn des 7. bis zur Mitte 8. Jahrhunderts. Munich, 1936; [collected essays:] The Art of Byzantium and the Medieval West: Selected Studies. Edited by W. Eugene Kleinbauer. Bloomington, IN: Indiana University Press, 1976; [papers] Ernst Kitzinger papers, 1931-1995, Getty Research Institute link; Early Medieval Art in the British Museum. London: The British Museum, 1940; and Senior, Elizabeth. Portraits of Christ. Harmondsworth: Penguin, 1940; "A Survey of the Early Christian Town of Stobi." Dumbarton Oaks Papers 3 (1946): 81-162; "The Horse and Lion Tapestry at Dumbarton Oaks" Dumbarton Oaks Papers 3 (1946):1-72; The Coffin of Saint Cuthbert. Oxford: Printed for the Dean and Chapter of Durham Cathedral at the University Press, 1950; "Studies on Late Antique and Early Byzantine Floor Mosaics: I. Mosaics at Nikopolis." Dumbarton Oaks Papers 6 (1951); "The Cult of Images in the Age Before Iconoclasm." Dumbarton Oaks Papers 8 (1954); "The Cult of Images in the Age before Iconoclasm." Dumbarton Oaks Papers 8 (1954): 83-150; "On Some Icons of the Seventh Century." Late Classical and Medieval Studies in Honor of Albert Mathias Friend, Jr. Edited by Kurt Weitzmann. Princeton: Princeton University Press, 1955: 132-50; I mosaici di Monreale. 6 vols. Palermo: S. F. Flaccovio,1960; English: The Mosaics of Monreale. Palermo: 1960; Israeli Mosaics of the Byzantine Period. New York: New American Library/UNESCO, 1965; "On the Interpretation of Stylistic Changes in Antique Art." Bucknell Review 15 (December, 1967): ; Byzantine Art in the Making: Main Lines of Stylistic Development in Mediterranean Art, 3rd-7th Century. Cambridge, MA: Harvard University Press, 1977; The Mosaics of St. Mary's of the Admiral in Palermo. Dumbarton Oaks Papers 27 (1990); I mosaici del periodo normanno in Sicilia. Palermo: Istituto siciliano di studi bizantini e neoellenici, 1992-2000.
Kleinbauer, W. Eugene. Modern Perspectives in Western Art History: An Anthology of 20th-Century Writings on the Visual Arts. New York: Holt, Rinehart and Winston, 1971, p. 59 mentioned, 85; Kleinbauer, W. Eugene. Research Guide to the History of Western Art. Sources of Information in the Humanities, no. 2. Chicago: American Library Association, 1982, p. 125; Wendland, Ulrike. Biographisches Handbuch deutschsprachiger Kunsthistoriker im Exil: Leben und Werk der unter dem Nationalsozialismus verfolgten und vertriebenen Wissenschaftler. Munich: Saur, 1999, vol. 1, pp. 365-71; [transcribed interview and CV,] "Style and its Meaning in Early Medieval Art." Ernst Kitzinger interviewed by Richard Cándida Smith. Interviews with Art Historians, 1991-2002. Getty Research Institute, Santa Monica, CA no. 940109, 1994; [obituaries:] New York Times, February 9, 2003, p. 44; The Independent (London), February 8, 2003, p. 20; The Times (London), February 7, 2003, p. 41; The Guardian (London), January 29, 2003, p. 26.
Sorensen, Lee, ed. "Kitzinger, Ernst." Dictionary of Art Historians (website). https://arthistorians.info/kitzingere.
Sorensen, Lee, ed. "Kitzinger, Ernst." Dictionary of Art Historians. 30 Jan 2023 https://arthistorians.info/
/kitzingere.
Sorensen, Lee, ed. "Kitzinger, Ernst." In Dictionary of Art Historians. Retrieved January 30, 2023, Web site: https://arthistorians.info/
Sorensen, Lee, ed. "Kitzinger, Ernst." Dictionary of Art Historians (30 Jan 2023)


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Q: how to calculate the sum of two fields in Django model? store value (a + b) in the c field
class R(models.Model):
a = models.IntegerField(null=True)
b = models.IntegerField(null=True)
c = models.IntegerField(null=True)

A: I would advise not to store the sum in a field. Since c simply depends on a and b, we can use a property that calculates this on demand. For example:
lass R(models.Model):
    a = models.IntegerField(null=True)
    b = models.IntegerField(null=True)

    @property
    def c(self):
        if self.a is not None and self.b is not None:
            return self.a + self.b
You can also annotate a QuerySet and filter the QuerySet based on the sum, for example:
from django.db.models import F

R.objects.annotate(
    my_c=F('a')+F('b')
).filter(my_c__gt=10)
Since django-3.2, we can work with .alias(…) instead:
from django.db.models import F

R.objects.alias(
    my_c=F('a')+F('b')
).filter(my_c__gt=10)

redpajama_set_name: RedPajamaStackExchange


text:
RESOURCES > Publications & Manuals > Manuals > Pharmacist's Manual > SECTION I-VIII
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Pharmacist's Manual - SECTION I-VIII
SECTION I – INTRODUCTION
This pharmacist's manual is intended to summarize and explain the basic requirements for prescribing, administering, and dispensing controlled substances under the Controlled Substances Act (CSA), Title 21 United States Code (21 U.S.C.) 801-971 and the DEA regulations, Title 21, Code of Federal Regulations (21 C.F.R.), Parts 1300 to End. Pertinent citations to the law and regulations are included in this manual.
Printed copies of the complete regulations implementing the CSA (21 C.F.R. Part 1300 to End) may be obtained from:
Superintendent of Documents
U.S. Government Printing Office
Both the C.F.R. and the Federal Register (which includes proposed and final rules implementing the CSA) are available on the internet through the U.S. Government Printing Office website. This website, which provides information by section, citation, and keywords, can be accessed at:
www.gpo.gov
Unofficial copies of pertinent C.F.R. citations and this pharmacist's manual may be found on the internet at DEA's Diversion website (under "Manuals"):
www.DEAdiversion.usdoj.gov
Should any pertinent provisions of the law or regulations be modified in the future, DEA will issue a revised electronic version of this document, which will be posted on the DEA Diversion website.
If you encounter errors in this document, please notify:
Attn: Liaison and Policy Section/DRL
8701 Morrissette Drive
Springfield, Virginia 22152
Inquiries regarding topics within this document may be addressed to your local DEA Diversion Field Office (Appendix K) or the address above.
Authorization for Public Dissemination
All material in this publication is in the public domain and may be reproduced without the express permission of the Drug Enforcement Administration.
Message from the Administrator
The Drug Enforcement Administration is pleased to provide you with the 2010 edition of the Pharmacist's Manual to assist you in understanding the provisions of the Controlled Substances Act (CSA) and its implementing regulations. This manual will answer questions you may encounter in the practice of pharmacy and provide guidance in complying with the CSA regulations. This edition has been updated to include information on the provisions of the Combat Methamphetamine Epidemic Act of 2005, the Ryan Haight Online Pharmacy Consumer Protection Act of 2008, and the Interim Final Rule entitled Electronic Prescriptions for Controlled Substances.
Your role in the proper dispensing of controlled substances is critical to the health of patients and helps protect society against drug abuse and diversion. Your adherence to the CSA, together with its objectives and your compliance, is a powerful resource for protecting the public health, assuring patient safety, and preventing the diversion of controlled substances and drug products containing listed chemicals.
The Drug Enforcement Administration (DEA) was established in 1973 to serve as the primary agency responsible for the enforcement of federal drug laws. The Controlled Substances Act (CSA) and its implementing regulations establish federal requirements regarding both illicit and licit controlled substances. With respect to pharmaceutical controlled substances, DEA's responsibility is twofold: to prevent diversion and abuse of these substances while ensuring an adequate and uninterrupted supply is available to meet the country's legitimate medical, scientific, and research needs. In carrying out this mission, DEA works closely with state and local authorities and other federal agencies.
Under the framework of the CSA, all controlled substance transactions take place within a "closed system" of distribution established by Congress. Within this "closed system" all legitimate handlers of controlled substances – manufacturers, distributors, physicians, pharmacies, and others, must be registered with DEA (unless exempt) and maintain strict accounting for all controlled substance transactions.
To carry out this mission effectively, DEA seeks to educate its registrants regarding their legal obligations. It is DEA's goal to maintain a positive working relationship with all of its registrants, including pharmacies. DEA understands that it can best serve the public interest by working with the pharmacy community to prevent the diversion of pharmaceutical controlled substances and scheduled listed chemical products (SLCPs) into the illicit market.
Federal controlled substance laws are designed to function in tandem with state controlled substance laws. DEA works in cooperation with state professional licensing boards and state and local law enforcement officials to make certain that pharmaceutical controlled substances are prescribed, administered, and dispensed for a legitimate medical purpose in the usual course of professional practice. Within this framework, the majority of investigations into possible violations of controlled substance laws are carried out by state authorities. DEA focuses its investigations on cases involving violators of the highest level or most significant impact.
In the event a state board revokes the license of a pharmacy, DEA will request a voluntary surrender of the pharmacy's DEA registration. If the pharmacy refuses to surrender its registration, DEA will seek administrative action to revoke its DEA registration based on lack of state authorization. Additional administrative remedies that may be utilized to correct a lack of compliance include a letter of admonition or an administrative hearing. DEA may also pursue civil or criminal sanctions if there is sufficient evidence to justify a prosecution. All such actions are designed to protect the public health and safety.
In addition to the diversion of controlled substances, DEA is concerned with the diversion of certain chemicals used in the clandestine manufacture of controlled substances. Chemicals such as ephedrine and pseudoephedrine contained in over the counter and prescription substances are immediate precursors used in the illicit manufacture of methamphetamine and amphetamine. These products may be purchased or stolen from retail outlets, including pharmacies, for use in clandestine laboratories.
Pharmacies that sell over the counter products containing ephedrine and pseudoephedrine must be "self-certified" as required by the Combat Methamphetamine Epidemic Act of 2005 (CMEA). The CMEA created a new category of products designated as SLCPs. SLCPs are products containing ephedrine, pseudoephedrine, or phenylpropanolamine that may be marketed or distributed lawfully in the United States as a non-prescription drug under the Food, Drug, and Cosmetic Act. The retail provisions of the CMEA went into effect on September 30, 2006 and require, among other things, employee training, self certification, placement of SLCPs out of customer reach, required identification, sales logbooks, sales and purchase limits, and others.
DEA and the pharmacy profession have strong common interests in the appropriate use of controlled substances and SLCPs. An effective working relationship to ensure compliance with CSA requirements will continue to produce lasting benefits on a national scale.
SECTION II – SCHEDULES OF CONTROLLED SUBSTANCES
The drugs and other substances that are considered controlled substances under the CSA are divided into five schedules. A listing of the substances and their schedules is found in the DEA regulations, 21 C.F.R. Sections 1308.11 through 1308.15. A controlled substance is placed in its respective schedule based on whether it has a currently accepted medical use in treatment in the United States and its relative abuse potential and likelihood of causing dependence. Some examples of controlled substances in each schedule are outlined below.
NOTE: Drugs listed in schedule I have no currently accepted medical use in treatment in the United States and, therefore, may not be prescribed, administered, or dispensed for medical use. In contrast, drugs listed in schedules II-V have some accepted medical use and may be prescribed, administered, or dispensed for medical use.
Schedule I Controlled Substances
Substances in this schedule have a high potential for abuse, have no currently accepted medical use in treatment in the United States, and there is a lack of accepted safety for use of the drug or other substance under medical supervision.
Some examples of substances listed in schedule I are: heroin, lysergic acid diethylamide (LSD), marijuana (cannabis), peyote, methaqualone, and 3,4-methylenedioxymethamphetamine ("ecstasy").
Schedule II Controlled Substances
Substances in this schedule have a high potential for abuse which may lead to severe psychological or physical dependence.
Examples of single entity schedule II narcotics include morphine and opium. Other schedule II narcotic substances and their common name brand products include: hydromorphone (Dilaudid®), methadone (Dolophine®), meperidine (Demerol®), oxycodone (OxyContin®), and fentanyl (Sublimaze® or Duragesic®).
Examples of schedule II stimulants include: amphetamine (Dexedrine®, Adderall®), methamphetamine (Desoxyn®), and methylphenidate (Ritalin®). Other schedule II substances include: cocaine, amobarbital, glutethimide, and pentobarbital.
Schedule III Controlled Substances
Substances in this schedule have a potential for abuse less than substances in schedules I or II and abuse may lead to moderate or low physical dependence or high psychological dependence.
Examples of schedule III narcotics include combination products containing less than 15 milligrams of hydrocodone per dosage unit (Vicodin®) and products containing not more than 90 milligrams of codeine per dosage unit (Tylenol with codeine®). Also included are buprenorphine products (Suboxone® and Subutex®) used to treat opioid addiction.
Examples of schedule III non-narcotics include benzphetamine (Didrex®), phendimetrazine, ketamine, and anabolic steroids such as oxandrolone (Oxandrin®).
Schedule IV Controlled Substances
Substances in this schedule have a low potential for abuse relative to substances in schedule III.
An example of a schedule IV narcotic is propoxyphene (Darvon® and Darvocet-N 100®).
Other schedule IV substances include: alprazolam (Xanax®), clonazepam (Klonopin®), clorazepate (Tranxene®), diazepam (Valium®), lorazepam (Ativan®), midazolam (Versed®), temazepam (Restoril®), and triazolam (Halcion®).
Schedule V Controlled Substances
Substances in this schedule have a low potential for abuse relative to substances listed in schedule IV and consist primarily of preparations containing limited quantities of certain narcotics. These are generally used for antitussive, antidiarrheal, and analgesic purposes.
Examples include cough preparations containing not more than 200 milligrams of codeine per 100 milliliters or per 100 grams (Robitussin AC® and Phenergan with Codeine®).
Scheduled Listed Chemical Product (SLCP)
An SLCP is defined as a product that contains ephedrine, pseudoephedrine, or phenylpropanolamine and may be marketed or distributed lawfully in the United States under the Federal Food, Drug, and Cosmetic Act as a nonprescription drug.
SECTION III – REGISTRATION REQUIREMENTS
New Pharmacy Registration
Every pharmacy that dispenses a controlled substance must be registered with the DEA. First, a state license must be obtained.
To register as a new pharmacy, the DEA Form 224 must be completed. The cost of the application fee is indicated on the application form. The certificate of registration must be maintained at the registered location and kept available for official inspection. If a person owns and operates more than one pharmacy, each place of business must be registered.
The DEA Form 224 should be completed online (www.DEAdiversion.usdoj.gov).
A paper version of the DEA Form 224 may be requested by writing to:
Attn: Registration Section/DRR
Springfield, Virginia 22152-2639
If a pharmacy needs a duplicate Certificate of Registration (DEA Form 223), a copy may be requested online via DEA's Diversion website, www.DEAdiversion.usdoj.gov, or contact DEA Headquarters at 1-800-882-9539 or via e-mail at DEA.Registration.Help@usdoj.gov.
Renewal of Pharmacy Registration
A pharmacy registration must be renewed every three years utilizing DEA Form 224a, Renewal Application for DEA Registration. The cost of the application fee is indicated on the application form.
To renew a registration, the most current information from the pharmacy's existing registration must be utilized. A registrant can renew online no more than 60 days prior to the current expiration date. The DEA Form 224a should be completed online and can be found at www.DEAdiversion.usdoj.gov.
If the registrant has not renewed online approximately 50 days before the registration expiration date, a renewal application is sent to the registrant at the mailing address listed on the current registration. If the renewal form is not received by the 30th day before the expiration date of the current registration, the pharmacy should contact the local DEA Registration Specialist (Appendix J) or DEA Headquarters at 1-800-882-9539 and request a renewal registration form.
NOTE: Once the expiration date has passed and no renewal has been received by DEA, the pharmacy has no authority to handle controlled substances.
Affidavit for Renewal of Retail Chain Pharmacy Registration
Corporations that own or operate a chain of pharmacies may submit a single DEA Form 224b, Retail Pharmacy Registration Affidavit for Chain Renewal. This affidavit, along with a list of the corporation's registrations, is provided in lieu of a separate registration application for each pharmacy registration. No registration may be issued unless the completed affidavit is received by DEA. The corporation should retain a copy of this affidavit with their readily retrievable records for the duration of the registrations covered by the affidavit. A responsible individual must answer the questions listed on the affidavit on behalf of the corporation as they pertain to each registrant.
The original affidavit along with the registration application fee and the list of registrations should be mailed to:
Registration Chain Renewal
Change of Business Address
A pharmacy that moves to a new physical location must request a modification of registration. Modifications are handled in the same manner as applications and must be approved by DEA.
A modification of registration can be requested online at www.DEAdiversion.usdoj.gov or in writing to the local DEA Registration Specialist (Appendix J) responsible for the area in which the pharmacy is located. If the change of address involves a change in state, the proper state issued license and, if applicable, controlled substances registration must be obtained prior to the approval of modification of the federal registration. If the modification is approved, DEA will issue a new certificate of registration and, if requested, new schedule II order forms (DEA Form 222). The registrant should maintain the new certificate with the old certificate until expiration. A Renewal Application for Registration (DEA Form 224a) will only be sent to the mailing address on file with DEA. It will not be forwarded.
Termination of Registration
A pharmacy that discontinues business activities either completely or only regarding controlled substances must return its DEA registration certificate and unused official order forms (DEA Form 222) to the local DEA Registration Specialist (Appendix J). In addition, DEA may ask for the location of where inventories, prescriptions, and other required controlled substance records will be stored during the requisite two-year retention period.
Unwanted controlled substances in the pharmacy's possession must be disposed of in accordance with DEA regulations (see Section IV, Transfer or Disposal of Controlled Substances).
Transfer of Business
A pharmacy registrant that transfers its business operations to another pharmacy registrant must submit in person or by registered or certified mail, return receipt requested, to the Special Agent in Charge in his/her area, at least 14 days in advance of the date of the proposed transfer (unless the Special Agent in Charge waives this time limitation in individual instances), the following information:
The name, address, registration number, and authorized business activity of the registrant discontinuing the business (registrant-transferor);
The name, address, registration number, and authorized business activity of the person acquiring the business (registrant-transferee);
Whether the business activities will be continued at the location registered by the person discontinuing business, or moved to another location (if the latter, the address of the new location should be listed); and
The date on which the transfer of controlled substances will occur.
On the day the controlled substances are transferred, a complete inventory must be taken and a copy of the inventory must be included in the records of both the person transferring the business and the person acquiring the business. This inventory will serve as the final inventory for the registrant going out of business and transferring the controlled substances. It will also serve as the initial inventory for the registrant acquiring the controlled substances. It is not necessary to send a copy of the inventory to the DEA unless requested by the Special Agent in Charge.
To transfer schedule II controlled substances, the receiving registrant must issue an official order form (DEA Form 222) or an electronic equivalent to the registrant transferring the drugs. The transfer of schedules III-V controlled substances must be documented in writing to show the drug name, dosage form, strength, quantity, and date transferred. The document must include the names, addresses, and DEA registration numbers of the parties involved in the transfer of the controlled substances.
All controlled substance records required to be kept by the registrant-transferor shall be transferred to the registrant-transferee. Responsibility for the accuracy of records prior to the date of transfer remains with the transferor, but responsibility for custody and maintenance shall be upon the transferee.
If the registrant acquiring the pharmacy owns at least one other pharmacy licensed in the same state as the pharmacy being transferred, the registrant may apply for a new DEA registration prior to the date of transfer. DEA will issue a registration which will authorize the registrant to obtain controlled substances at the time of transfer, but the registrant may not dispense controlled substances until the pharmacy has been issued a valid state pharmacy license.
A DEA registration application to transfer ownership of an existing pharmacy can be facilitated if the applicant includes an affidavit verifying that the pharmacy has been registered by the state licensing agency. The affidavit verifying the existence of the state license should be attached to the initial application for registration.
Denial, Suspension, or Revocation of Registration
Under the CSA (21 U.S.C. § 824 (a)), DEA has the authority to deny, suspend, or revoke a DEA registration upon a finding that the registrant:
Has materially falsified the application;
Has been convicted of a felony relating to a controlled substance or a List I chemical;
Had a State license or registration suspended, revoked, or denied by a competent State authority and is no longer authorized by State law to engage in the manufacturing, distribution, or dispensing of controlled substances or List I chemicals or has had the suspension, revocation, or denial of a registration recommended by competent State authority;
Has committed an act which would render the DEA registration inconsistent with the public interest; or
Has been excluded (or directed to be excluded) from participation in a program pursuant to Title 42 U.S.C. § 1320a-7(a), that is, a Medicaid or Medicare program.
Denial of Registration in the Public Interest
In determining the public interest, the CSA states the following factors are to be considered (21 U.S.C. § 823 (f)):
The recommendation of the appropriate State licensing board or professional disciplinary authority.
The applicant's experience in dispensing or conducting research with respect to controlled substances.
The applicant's conviction record under federal or state laws relating to the manufacture, distribution, or dispensing of controlled substances.
Compliance with applicable State, Federal, or local laws relating to controlled substances.
Such other conduct which may threaten the public health and safety.
Chemical Registration Requirements
Registration is not required for regulated sellers of SLCPs. However, a regulated seller must self-certify with DEA pursuant to federal law (see Section XIV, Self-Certification). A regulated seller is defined as a grocery store, general merchandise store, drug store, or other entity engaged in over-the-counter sales of ephedrine (both single-entity and combination products), pseudoephedrine, or phenylpropanolamine products, directly to walk-in customers or in face-to-face transactions by direct sales. A mobile retail vendor is defined as a person or entity that makes sales at retail from a stand that is intended to be temporary or is capable of being moved from one location to another.
Federal law requires any person who is engaged in the wholesale distribution of an SLCP to obtain a registration as a chemical distributor. A distributor who does not meet all the requirements for a regulated seller of SLCPs, or who does not meet the requirements for distributors required to submit "mail-order" reports, is a wholesale distributor.
Note: this would include those pharmacies that sell quantities of SLCPs to institutions, including long term care facilities, jails, and other institutional-type settings for non-patient specific use. Such pharmacies are often referred to as "closed door" pharmacies.
Retail pharmacies that are registered to handle controlled substances need not obtain a separate DEA chemical registration for retail distribution of SLCPs. If a pharmacy desires to engage in the wholesale distribution of bulk quantities of SLCPs, the pharmacy is required to register with DEA as a chemical distributor because these activities fall outside the definition of a regulated seller. Therefore, the pharmacy would be subject to the registration requirements that apply to wholesale distributors for those distribution activities, and subject to the pharmacy requirements for its pharmacy activities. To obtain a DEA chemical distributor registration, a pharmacy may complete the DEA Form 510 online at www.DEAdiversion.usdoj.gov. A paper version may be requested by writing to:
SECTION IV – TRANSFER OR DISPOSAL OF CONTROLLED SUBSTANCES
Transfer of Controlled Substances
A pharmacy may hire an outside firm to inventory, package, and arrange for the transfer of its controlled substances to another pharmacy, the original supplier, or the original manufacturer. The pharmacy is responsible for the actual transfer of the controlled substances and for the accuracy of the inventory and records. The records involving the transfer of controlled substances must be kept readily available by the pharmacy for two years for inspection by the DEA.
To transfer schedule II substances, the receiving registrant must issue an official order form (DEA Form 222) or an electronic equivalent to the registrant transferring the drugs. The transfer of schedules III-V controlled substances must be documented in writing to show the drug name, dosage form, strength, quantity, and date transferred. The document must include the names, addresses, and DEA registration numbers of the parties involved in the transfer of the controlled substances.
Transfer to a Pharmacy
If a pharmacy goes out of business or is acquired by a new pharmacy, it may transfer the controlled substances to another pharmacy. On the day the controlled substances are transferred, a complete inventory must be taken which documents the drug name, dosage form, strength, quantity, and date transferred. In addition, DEA Form 222 or the electronic equivalent must be prepared to document the transfer of schedule II controlled substances. This inventory will serve as the final inventory for the registrant going out of business and transferring the controlled substances. It will also serve as the initial inventory for the registrant acquiring the controlled substances. A copy of the inventory must be included in the records of each pharmacy. It is not necessary to send a copy of the inventory to the DEA. The pharmacy acquiring the controlled substances must maintain all records involved in the transfer of the controlled substances for two years.
Transfer to the Original Supplier or Original Manufacturer
Any pharmacy may transfer controlled substances to the original supplier or the original manufacturer that is appropriately registered with the DEA. The pharmacist must maintain a written record showing:
The date of the transaction.
The name, strength, dosage form, and quantity of the controlled substance.
The supplier or manufacturer's name, address, and registration number.
The DEA Form 222 or the electronic equivalent will be the official record for the transfer of schedule II controlled substances.
Disposal of Controlled Substances
A pharmacy may transfer controlled substances to a DEA registered reverse distributor who handles the disposal of controlled substances. The pharmacy should contact the local DEA Diversion Field Office (Appendix K) for an updated list of DEA registered reverse distributors. In no case should drugs be forwarded to the DEA unless the registrant has received prior approval from the DEA. The DEA procedures established for the disposal of controlled substances must not be construed as altering in any way the state laws or regulations for the disposal of controlled substances.
Reverse Distributors Authorized to Dispose Controlled Substances
A pharmacy may forward controlled substances to a DEA registered reverse distributor who handles the disposal of controlled substances. When a pharmacy transfers schedule II controlled substances to a reverse distributor for destruction, the reverse distributor must issue an official order form (DEA Form 222) or the electronic equivalent to the pharmacy. When schedules III-V controlled substances are transferred to a reverse distributor for destruction, the pharmacy must maintain a record of distribution that lists the drug name, dosage form, strength, quantity, and date transferred. The DEA registered reverse distributor who will destroy the controlled substances is responsible for submitting a DEA Form 41 (Registrants Inventory of Drugs Surrendered) to the DEA when the controlled substances have been destroyed. A DEA Form 41 should not be used to record the transfer of controlled substances between the pharmacy and the reverse distributor disposing of the drugs.
A paper version of the DEA Form 41 may be requested by writing to:
Disposal of Controlled Substances by Persons Not Registered with DEA
On January 21, 2009, DEA published in the Federal Register an Advance Notice of Proposed Rulemaking (ANPRM), Disposal of Controlled Substances by Persons Not Registered with the Drug Enforcement Administration. This ANPRM sought comments on how to address the issue of disposal of dispensed controlled substances held by DEA nonregistrants (i.e., ultimate users, long term care facilities). DEA was interested in the possible options that would enable nonregistrants to dispose of unwanted controlled substances, while also protecting public health and public safety, and minimizing the possibility of diversion. The public comment period for this ANPRM ended on March 23, 2009.
SECTION V – SECURITY REQUIREMENTS
Requests for Employment Waivers for Certain Pharmacy Employees
Under 21 C.F.R. § 1301.76(a), a registrant must not employ in a position which allows access to controlled substances any person who has been convicted of a felony relating to controlled substances, or who, at any time, has had an application for DEA registration denied, revoked, or surrendered for cause. "For cause" means surrendering a registration in lieu of, or as a consequence of, any federal or state administrative, civil, or criminal action resulting from an investigation of the individual's handling of controlled substances.
However, 21 C.F.R. § 1307.03 does permit registrants desiring to employ an individual who meets this definition to request an exception to this requirement. The employer must have a waiver approved before allowing such an employee or prospective employee to have access to controlled substances. A waiver request should be sent by the employer to the following address:
Attn: Administrator
A registrant that applies for such a waiver should understand that the following factors will be considered by the DEA in the approval process and should provide details relevant to each factor as part of the waiver request submitted, since a waiver will not be considered unless there are valid reasons to believe that diversion is unlikely to occur:
A detailed description of the nature and extent of the individual's past controlled substances violations, including all pertinent documentation;
Current status of the individual's state licensure;
Extent of individual's proposed access to controlled substances. "Access" is not limited to only physical access to controlled substances, but includes any influence over the handling of controlled substances;
Registrant's proposed physical and professional safeguards to prevent diversion by the individual;
Status of employing registrant regarding handling of controlled substances;
Other pertinent information uncovered by DEA in its investigation of the individual's or registrant's handling of controlled substances; and
All other relevant factors or materials.
Controlled Substance Theft or Significant Loss
Should a theft or significant loss of any controlled substance occur at a pharmacy, the following procedures must be implemented within one business day of the discovery of the theft or loss.
A. Notify DEA and Local Police
The theft of controlled substances from a registrant is a criminal act and a source of diversion that requires notification to DEA. A pharmacy must notify in writing the local DEA Diversion Field Office (Appendix K) within one business day of discovery of a theft or significant loss of a controlled substance. Although not specifically required by federal law or regulations, the registrant should also notify local law enforcement and state regulatory agencies. Prompt notification to enforcement agencies will allow them to investigate the incident and prosecute those responsible for the diversion. If there is a question as to whether a theft has occurred or a loss is significant, a registrant should err on the side of caution and report it to DEA and local law enforcement authorities.
DEA must be notified directly. This requirement is not satisfied by reporting the theft or significant loss in any other manner. For example, a corporation which owns or operates multiple registered sites and wishes to channel all notifications through corporate management or any other internal department responsible for security, must still provide notice directly to DEA in writing within one business day upon discovery and keep a copy of that notice for its records. The notice must be signed by an authorized individual of the registrant.
B. Complete DEA Form 106
A pharmacy must also complete a DEA Form 106 (Report of Theft or Loss of Controlled Substances) which can be found online at www.DEAdiversion.usdoj.gov under the Quick Links section. The DEA Form 106 is used to document the actual circumstances of the theft or significant loss and the quantities of controlled substances involved. A paper version of the form can be obtained by writing to:
If completing the paper version, the pharmacy should send the original DEA Form 106 to the local DEA Diversion Field Office (Appendix K) and keep a copy for its records. Please see the Guidelines for Completing the DEA Form 106 (Appendix I) for additional guidance.
The DEA Form 106 must include the following information:
Name and address of the firm (pharmacy),
DEA registration number,
Date of theft or loss (or when discovered if not known),
Name and telephone number of local police department (if notified),
Type of theft (e.g., night break-in, armed robbery),
List of identifying marks, symbols, or price codes (if any) used by the pharmacy on the labels of the containers, and
A listing of controlled substances missing, including the strength, dosage form, and size of container (in milliliters if liquid form) or corresponding National Drug Code numbers.
C. If Investigation Finds No Theft or Loss
If, after the initial notification to DEA, the investigation of the theft or loss determines no such theft or loss of controlled substances occurred, a DEA Form 106 does not need to be filed. However, the registrant must notify DEA in writing of this fact in order to resolve the initial report and explain why no DEA Form 106 was filed regarding the incident.
D. Registrant's Responsibility for Identifying "Significant Loss"
Although the CSA regulations do not define the term "significant loss," it is the responsibility of the registrant to use his/her best judgment to take appropriate action. Whether a "significant loss" has occurred depends, in large part, on the business of the pharmacy and the likelihood of a rational explanation for a particular occurrence. What would constitute a significant loss for a pharmacy may be viewed as comparatively insignificant for a hospital or manufacturer.
Further, the loss of a small quantity of controlled substances, repeated over a period of time, may indicate a significant problem for a registrant, which must be reported. The burden of responsibility is on the registrant to identify what is a significant loss and make the required report to DEA.
When determining whether a loss is significant, a registrant should consider, among others, the following factors:
The actual quantity of controlled substances lost in relation to the type of business;
The specific controlled substances;
Whether the loss of the controlled substances can be associated with access to those controlled substances by specific individuals, or whether the loss can be attributed to unique activities that may take place involving the controlled substances;
A pattern of losses over a specific time period, whether the losses appear to be random, and the results of efforts taken to resolve the losses; and, if known
Whether the specific controlled substances are likely candidates for diversion; and
Local trends and other indicators of the diversion potential of the missing controlled substances.
If it is determined that the loss is not significant, the registrant should place a record of the occurrence in a theft and loss file for future reference. Miscounts or adjustments to inventory involving clerical errors on the part of the pharmacy should not be reported on a DEA Form 106, but rather should be noted in a separate log at the pharmacy management's discretion.
In-Transit Loss
When all or part of an in-transit shipment of controlled substances fails to reach its intended destination, the supplier is responsible for reporting the in-transit loss of controlled substances to DEA. The purchaser is responsible for reporting any loss of controlled substances after he/she has signed for or taken custody of a shipment. If it is discovered after that point that an in-transit loss or theft has occurred; the purchaser must then submit a DEA Form 106. If the purchaser does not take custody of the shipment and instead returns it to the supplier, it is the supplier's responsibility for reporting any loss of controlled substances in the original shipment.
In-Transit Loss from Central Fill Pharmacy
Central fill pharmacies must comply with 21 C.F.R. § 1301.74(e) when selecting private, common or contract carriers to transport filled prescriptions to a retail pharmacy for delivery to an ultimate user. Pursuant to 21 C.F.R. § 1301.76(d), when a central fill pharmacy contracts with private, common or contract carriers to transport filled prescriptions to a retail pharmacy, the central fill pharmacy is responsible for reporting the in-transit loss upon discovery of such loss by use of a DEA Form 106. In addition, when a retail pharmacy contracts with private, common or contract carriers to retrieve filled prescriptions from a central fill pharmacy, the retail pharmacy is responsible for reporting in-transit losses upon discovery using a DEA Form 106.
Breakage and Spillage
The breakage or spillage of controlled substances does not constitute a "loss" of controlled substances. When there is breakage, damage, or spillage or some other form of destruction, any recoverable controlled substances must be disposed of according to DEA requirements. When this disposal occurs, it must be reported to DEA on a DEA Form 41 (Registrants Inventory of Drugs Surrendered). Damaged goods may also be disposed of through shipment to a reverse distributor or by a DEA approved process as defined in Section IV, Transfer or Disposal of Controlled Substances.
Robberies and Burglaries Involving Controlled Substances
The Controlled Substance Registrant Protection Act of 1984 (CSRPA) was enacted to protect DEA registrants against certain crimes (see Title 18 U.S.C. § 2118 for a complete text of CSRPA). The CSRPA provides for the federal investigation of controlled substances thefts and robberies if any of the following conditions are met:
The replacement cost of the controlled substances taken is $500 or more.
Interstate or foreign commerce was involved in the execution of the crime.
A person was killed or suffered significant bodily injury as a result of the crime.
Penalties Upon Conviction - The perpetrator(s) convicted of violating CSRPA's provisions may be subject to the following penalties:
Burglary or robbery - a maximum $25,000 fine and/or 20 years imprisonment.
If a dangerous weapon was used to carry out the crime - a maximum $35,000 fine and/or 25 years imprisonment.
If death resulted from the crime - a maximum $50,000 fine and/or life imprisonment.
SECTION VI – RECORDKEEPING REQUIREMENTS
Every pharmacy must maintain complete and accurate records on a current basis for each controlled substance purchased, received, stored, distributed, dispensed, or otherwise disposed of. These records are required to provide accountability of all controlled substances from the manufacturing process through the dispensing pharmacy and to the ultimate user. The closed system reduces the potential for diversion of controlled substances.
All required records concerning controlled substances must be maintained for at least two years for inspection and copying by duly authorized DEA officials. Records and inventories of schedule II controlled substances must be maintained separately from all other records of the registrant. All records and inventories of schedules III, IV, and V controlled substances must be maintained either separately from all other records or in such a form that the information required is readily retrievable from the ordinary business records. Recordkeeping requirements for prescriptions are detailed in Section VI, Prescription Records.
Readily retrievable is defined as:
Records kept by automatic data processing systems or other electronic or mechanized recordkeeping systems in such a manner that they can be separated out from all other records in a reasonable time, and/or
Records kept in such a manner that certain items are asterisked, redlined, or in some other manner visually identifiable apart from other items appearing on the records.
Required Records
The records which must be maintained by a pharmacy are:
Executed and unexecuted official order forms (DEA Form 222) or the electronic equivalent
Power of Attorney authorization to sign order forms
Receipts and/or invoices for schedules III, IV, and V controlled substances
All inventory records of controlled substances, including the initial and biennial inventories, dated as of beginning or close of business
Records of controlled substances distributed (i.e., sales to other registrants, returns to vendors, distributions to reverse distributors)
Records of controlled substances dispensed (i.e., prescriptions, schedule V logbook)
Reports of Theft or Significant Loss (DEA Form 106), if applicable
Inventory of Drugs Surrendered for Disposal (DEA Form 41), if applicable
Records of transfers of controlled substances between pharmacies
DEA registration certificate
Self-certification certificate and logbook (or electronic equivalent) as required under the Combat Methamphetamine Epidemic Act of 2005
Central Recordkeeping
A registrant desiring to maintain shipping and financial records (but not executed official order forms) at a central location rather than the registered location must submit written notification of his/her intention by registered or certified mail, return receipt requested, in triplicate, to the Special Agent in Charge of the local DEA Diversion Field Office in which the registrant is located (Appendix K). Unless the registrant is informed by the DEA that the permission to keep central records is denied, the registrant may begin maintaining central records 14 days after DEA receives this notification. Central recordkeeping requirements are described in 21 C.F.R. § 1304.04. Central recordkeeping permits are no longer issued by the DEA.
Prescription Records
Pharmacies have two options for filing prescription records under the C.F.R. If there is a conflict between federal and state requirements for filing prescriptions, DEA recognizes that the pharmacy must choose a filing system that would comply with both federal and state law. All prescription records must be readily retrievable for DEA inspection. Controlled substance prescriptions must be filed in one of the following ways:
Paper Prescriptions Records Option 1 (Three separate files):
A file for schedule II controlled substances dispensed.
A file for schedules III, IV and V controlled substances dispensed.
A file for all noncontrolled drugs dispensed.
Paper Prescriptions Records Option 2 (Two separate files):
A file for all schedule II controlled substances dispensed.
A file for all other drugs dispensed (noncontrolled and those in schedules III, IV and V). If this method is used, a prescription for a schedule III, IV or V drug must be made readily retrievable by use of a red "C" stamp not less than one inch high. If a pharmacy has an electronic recordkeeping system for prescriptions which permits identification by prescription number and retrieval of original documents by prescriber's name, patient's name, drug dispensed, and date filled, the requirement to mark the hard copy with a red "C" is waived.
Electronic Prescription Records
If a prescription is created, signed, transmitted, and received electronically, all records related to that prescription must be retained electronically.
Electronic records must be maintained electronically for two years from the date of their creation or receipt. However, this record retention requirement shall not pre-empt any longer period of retention which may be required now or in the future, by any other Federal or State law or regulation, applicable to pharmacists or pharmacies.
Records regarding controlled substances must be readily retrievable from all other records. Electronic records must be easily readable or easily rendered into a format that a person can read.
Records of electronic prescriptions for controlled substances shall be maintained in an application that meets the requirements of 21 C.F.R. §1311. The computers on which the records are maintained may be located at another location, but the records must be readily retrievable at the registered location if requested by the DEA or other law enforcement agent. The electronic application must be capable of printing out or transferring the records in a format that is readily understandable to an Administration or other law enforcement agent at the registered location. Electronic copies of prescription records must be sortable by prescriber name, patient name, drug dispensed, and date filled.
SECTION VII – INVENTORY REQUIREMENTS
An "inventory" is a complete and accurate list of all stocks and forms of controlled substances in the possession of the registrant as determined by an actual physical count for schedule II controlled substances and an estimated count or measure of the contents of a schedule III, IV, or V controlled substance (unless the container holds more than 1,000 tablets or capsules in which case an exact count of the contents must be made). The CSA also requires that all inventory records be maintained at the registered location in a readily retrievable manner for at least two years for copying and inspection. In addition, the inventory records of schedule II controlled substances must be kept separate from all other controlled substances.
When issued a DEA registration, a registrant must take an initial inventory, which is an actual physical count of all controlled substances in their possession. If there are no stocks of controlled substances on hand, the registrant should make a record showing a zero inventory. There is no requirement to submit a copy of the inventory to the DEA. The C.F.R. requires that the inventory include:
The date of the inventory,
Whether the inventory was taken at the beginning or close of business,
The name of each controlled substance inventoried,
The finished form of each of the substances (e.g., 10 milligram tablet),
The number of dosage units of each finished form in the commercial container (e.g., 100 tablet bottle),
The number of commercial containers of each finished form (e.g., four 100 tablet bottles), and
A count of the substance - if the substance is listed in schedule II, an exact count or measure of the contents or if the substance is listed in schedules III, IV, or V, an estimated count or measure of the contents, unless the container holds more than 1,000 tablets or capsules in which case, an exact count of the contents is required.
DEA recommends, but does not require, an inventory record include the name, address, and DEA registration number of the registrant, and the signature of the person or persons responsible for taking the inventory.
Biennial Inventory
Following the initial inventory, the registrant is required to take a biennial inventory (every two years), which requires the same information as the initial inventory (see list above) of all controlled substances on hand. The biennial inventory may be taken on any date which is within two years of the previous inventory date. There is no requirement to submit a copy of the inventory to DEA.
Newly Scheduled Controlled Substance Inventory
When a drug not previously listed as a controlled substance is scheduled or a drug is rescheduled, the drug must be inventoried as of the effective date of scheduling or change in scheduling.
SECTION VIII – ORDERING CONTROLLED SUBSTANCES
Ordering Schedule II Controlled Substances
Only schedules I and II controlled substances are ordered with an official order form, DEA Form 222, or the electronic equivalent (see below, Controlled Substance Ordering System (CSOS) – Electronic Order Forms). A DEA Form 222 is required for each distribution, purchase, or transfer of a schedule II controlled substance.
When a controlled substance has been moved by DEA from schedule II to another schedule at the federal level, in many states it may remain a schedule II controlled substance pending any legislative or administrative action that may result from the federal action. Many states require transactions that involve substances they classify as schedule II be made via official order forms (DEA Form 222) or the electronic equivalent. When federal law or regulations differ from state law or regulations, a pharmacy is required to abide by the more stringent aspects of both the federal and state requirements. When the use of DEA Form 222 or the electronic equivalent for the transfer of a controlled substance is not required under federal law, its use as mandated by these states does not violate federal law and is therefore permitted.
Requesting Official Order Forms
The unexecuted DEA Form 222 can be requested initially by checking "block 3" on the application for a new registration (DEA Form 224). The DEA Form 224 can be found online at www.DEAdiversion.usdoj.gov.
Once a registrant has received a DEA registration number, additional DEA Forms 222 may be ordered online at www.DEAdiversion.usdoj.gov. When requesting additional DEA Forms 222 online, a valid DEA registration number, business name, and contact telephone number are required. The registrant may also request DEA Forms 222 by calling the DEA Headquarters Registration Section at 1-800-882-9539 or by contacting the local DEA Registration Specialist (Appendix J).
Each book of DEA Form 222 consists of seven sets of forms. Each pharmacy is provided a maximum of six books at one time unless its needs exceed this limit. In such a case, the pharmacy should contact the local DEA Registration Specialist (Appendix J) to request additional books.
Completing Official Order Forms
When ordering schedule II controlled substances, the purchaser is responsible for filling in the number of packages, the size of the package, and the name of the item. Each DEA Form 222 must be signed and dated by a person authorized to sign a registration application or a person granted power of attorney (see below, Power of Attorney to Sign an Official Order Form). When the items are received, the pharmacist must document on the purchaser's copy (copy three) the actual number of packages received and the date received.
The executed DEA Form 222 must be maintained separately from the pharmacy's other business records. However, this does not preclude a registrant from attaching a copy of the supplier's invoice to the related DEA Form 222.
Title 21 C.F.R. § 1305.15(a)(1) requires that, for orders using the DEA Form 222, an order must not be filled if the order is not complete, legible, or properly prepared, executed, or endorsed, or if the order shows any alteration, erasure, or change of any description. For a discussion of the circumstances in which an electronic order must not be filled see below, Controlled Substance Ordering System (CSOS) – Electronic Order Forms.
A supplier may refuse to accept an order for any reason as set forth under 21 C.F.R. § 1305.15(c). If a supplier refuses to accept an order, a statement that the order is not accepted is sufficient. If an order is refused, the supplier must return copies one and two of the DEA Form 222 to the purchaser with a statement explaining the reason the order was refused. For electronic orders, the supplier must notify the purchaser and provide a statement as to the reason (see below, Controlled Substance Ordering System (CSOS) – Electronic Order Forms).
DEA policy does not preclude the substitution of identical products differing in packaging size from those initially ordered, provided that the actual quantity received does not exceed the amount initially ordered and that the National Drug Code number reflected is that of the actual product shipped. For example, a distributor may substitute five bottles of 100, 2 milligram tablets for one bottle of 500, 2 milligram tablets or any variation thereof.
Cancellation and Voiding an Official Order Form
A purchaser may cancel an order (or partial order) on a DEA Form 222 by notifying the supplier in writing. The supplier must indicate the cancellation on Copies 1 and 2 of the DEA Form 222 by drawing a line through the cancelled item(s) and printing "cancelled" in the space provided for the number of items shipped.
A supplier may void part or all of an order on a DEA Form 222 by notifying the purchaser in writing. The supplier must indicate the voiding in Copies 1 and 2 of the DEA Form 222 by drawing a line through the cancelled item(s) and printing "void" in the space provided for the number of items shipped. For information regarding cancelled electronic orders, see below, Controlled Substance Ordering System (CSOS) – Electronic Order Forms.
Power of Attorney to Sign an Official Order Form
Any registrant (pharmacy) may authorize one or more individuals, whether or not they are located at the registered location, to obtain and execute DEA Forms 222 by granting a power of attorney to each such individual. The power of attorney must be signed by the same person who signed the most recent application for registration or renewal registration, as well as the individual being authorized to obtain and execute the DEA Forms 222.
The power of attorney may be revoked at any time by the person who granted and signed the power of attorney. Only if the renewal application is signed by a different person is it necessary to grant a new power of attorney when the pharmacy completes a renewal registration. The power of attorney should be filed with executed DEA Forms 222 as a readily retrievable record. The power of attorney is not submitted to DEA.
Suggested formats for granting and revoking a power of attorney follow:
Power of Attorney for DEA Forms 222 and Electronic Orders
_________________________ (Name of registrant)
_________________________(Address of registrant)
_________________________(DEA registration number)
I, _______________________________________________(name of person granting power), the undersigned, who is authorized to sign the current application for registration of the above named registrant under the Controlled Substances Act or Controlled Substances Import and Export Act, have made, constituted, and appointed, and by these presents, do make, constitute, and appoint _________________________________(name of attorney-in-fact), my true and lawful attorney for me in my name, place, and stead, to execute applications for books of official order forms and to sign such order forms in requisition for schedule I and II controlled substances, in accordance with Section 308 of the Controlled Substances Act (21 U.S.C. 828) and part 1305 of Title 21 of the Code of Federal Regulations. I hereby ratify and confirm all that said attorney shall lawfully do or cause to be done by virtue hereof.
(Signature of person granting power)
I, _______________________(name of attorney-in-fact), hereby affirm that I am the person named herein as attorney-in-fact and that the signature affixed hereto is my signature.
(Signature of attorney-in-fact)
1. _______________________
Signed and dated on the ___ day of ____________in the year____ at
Notice of Revocation
The foregoing power of attorney is hereby revoked by the undersigned, who is authorized to sign the current application for registration of the above-named registrant under the Controlled Substances Act. Written notice of this revocation has been given to the attorney-in-fact ____________________________ this same day.
(Signature of person revoking power)
1. ______________________
Lost or Stolen Order Forms
When a pharmacist has not received an expected shipment of controlled substances, he/she should first contact the supplier to determine whether the original DEA Form 222 was received. If the original order form has been lost or stolen, the pharmacist must complete a second order form so the supplier can fill the original order. The pharmacist must also prepare a statement which includes the first order form's serial number and date, and verify that the drugs ordered were never received. The pharmacy must attach a copy of the statement to the second order form that is sent to the supplier. In addition, the pharmacist must keep a copy of the statement with copy three from the first and second order forms.
A pharmacy, upon discovery of the loss or theft of used or unused order forms, must immediately report the loss to the local DEA Diversion Field Office (Appendix K) and provide the serial numbers of each lost or stolen order form. If an entire book or multiple books of order forms are lost or stolen, and the serial numbers of the missing forms cannot be identified, the pharmacist must report the approximate date of issuance (in lieu of the serial numbers) to the DEA. If an unused order form reported stolen or lost is later recovered or found, the pharmacy must immediately notify the local DEA Diversion Field Office.
Controlled Substance Ordering System (CSOS) – Electronic Order Forms
Any registrant permitted to order schedule II controlled substances may do so electronically via the DEA Controlled Substance Ordering System (CSOS) and maintain the records of these orders electronically for two years. The use of electronic orders is optional; registrants may continue to issue orders on a paper DEA Form 222. CSOS allows for secure electronic transmission of controlled substance orders without the supporting paper DEA Form 222. The adoption of the CSOS standards is the only allowance for the electronic transmission of schedule II controlled substance orders between controlled substance manufacturers, distributors, pharmacies, and other DEA authorized entities. CSOS uses Public Key Infrastructure (PKI) technology, which requires CSOS users to obtain a CSOS digital certificate for electronic ordering. The electronic orders must be signed using a digital signature issued by a Certification Authority (CA) run by the DEA.
Digital certificates can be obtained only by registrants and individuals granted power of attorney by registrants to sign orders. A registrant must appoint a CSOS coordinator who will serve as that registrant's recognized agent regarding issues pertaining to issuance of, revocation of, and changes to, digital certificates issued under that registrant's DEA registration. A CSOS digital certificate will be valid until the DEA registration under which it is issued expires or until the CSOS CA is notified that the certificate should be revoked. Certificates will be revoked if the certificate holder is no longer authorized to sign schedule II orders for the registrant, if the information on which the certificate is based changes, or if the digital certificate used to sign electronic orders has been compromised, stolen, or lost.
A "Questions and Answers" page about the CSOS certificate is available on the DEA E-Commerce Program website at www.DEAecom.gov. Applicants can download the Diversion PKI CSOS Enrollment document and the CSOS Subscriber's Manual for assistance on the enrollment process. DEA maintains a support line to assist applicants and subscribers with issues pertaining to certificate enrollment, issuance, revocation, and renewal. Staff is available from 8:00 a.m. to 6:00 p.m. (Eastern Time), Monday through Friday at 1-877-332-3266 if further assistance is needed.
Unaccepted and Defective Electronic Orders
An electronic order for controlled substances may not be filled if any of the following occurs:
1. The required data fields have not been completed.
2. The order is not signed using a digital certificate issued by DEA.
3. The digital certificate used has expired or been revoked prior to signature.
4. The purchaser's public key will not validate the digital certificate.
5. The validation of the order shows that the order is invalid for any reason.
If an order cannot be filled, the supplier must notify the purchaser and provide a statement as to the reason (e.g., improperly prepared or altered). A supplier may, for any reason, refuse to accept any order. If a supplier refuses, a statement that the order is not accepted is sufficient.
When a purchaser receives an unaccepted electronic order from the supplier, the purchaser must electronically link the statement of nonacceptance to the original order. The original statement must be retained for two years. Neither a purchaser nor a supplier may correct a defective order. The purchaser must issue a new order for the order to be filled.
Cancellation and Voiding of Electronic Orders
A supplier may void all (or part) of an electronic order by notifying the purchaser of the voiding. If the entire order is voided, the supplier must make an electronic copy of the order and indicate "Void" on the copy and return it to the purchaser. The supplier is not required to retain a record of orders that are not filled. The purchaser must retain an electronic copy of the voided order. Should a supplier partially void an order, the supplier must indicate in the linked record that nothing was shipped for each item voided.
Lost Electronic Orders
If a purchaser determines that an unfilled electronic order has been lost before or after receipt, the purchaser must provide, to the supplier, a signed statement. This statement must include the unique tracking number and date of the lost order and state that the goods covered by the first order were not received through loss of that order. If the purchaser executes a new order to replace the lost order, the purchaser must electronically link an electronic record of the second order and a copy of the statement with the record of the first order and retain them both. If the supplier to whom the order was directed subsequently receives the first order, the supplier must indicate that it is "not accepted" and return it to the purchaser. The purchaser must link the returned order to the record of that order and the statement.
Ordering Schedules III-V Controlled Substances
The registrant must keep a receipt (invoice or packing slip) on which it records the date the drugs were received and confirm that the order is accurate. These receipts must also contain the name of each controlled substance, the finished form, the number of dosage units of finished form in each commercial container, and the number of commercial containers ordered and received. In addition, these receipts must be maintained in a readily retrievable manner for inspection by the DEA.
Pharmacist's Manual (PDF)
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redpajama_set_name: RedPajamaCommonCrawl


PS: i didn't start changing textures yet, plan to do it in the next build.
I am almost thinking black trim for some reason, or a really dark gray.
in other words not rust colors.
Red_Fist wrote: I am almost thinking black trim for some reason, or a really dark gray.
Can I ask what is this mess ? This is Pathing definition ? Using Editor ?
You know, until this map will be NORMAL, I'll keep that Rv19 version - of course, modified with glass tubes routes turned to the right direction.
You can forget command for auto-generating paths, it's useless... 342 PathNodes for this area ?
I'm waiting re-textured version. Keep up good work .
Yes. Unfortunately, I don't have enough time to do "pixel bot pathing job", because I am not sure that somebody really needs "perfect" bot support in 2019. But anyway this map has at least some bot support.
Last edited by stat_I_k on Sun Apr 21, 2019 6:50 am, edited 2 times in total.
He is just saying there is way too many pathnodes, and you should clean it up by placing them one at a t time with minimal paths.
I also think he was saying that if you use the editor to automatically build the path network, if you click and raise a pathnode there will be another one there at the exact same spot, a bad thing. If that is the case, clean up the map because all those paths those paths take computing time and will confuse bots and bad for servers.
It really don't take that long to path, unless you want to study the sticky spots for bots on an extensive complicated map.
stat_I_k wrote: I don't have enough time to do "pixel bot pathing job"
Neither me... (but you had enough time for editing 3 beta here) else it took 10-15 minutes in previous map Rv19 which you ask me to remove. You could be more smart and copy-pasting nodes from there because new actors copied are not creating duplicates... and paths are done to support original Editor building using "paths define" command and not "paths build" from any kind. There is a single map known to me where Editor creates paths almost perfect - it's a testing Level which I did very small and simple, but here Editor will spend time for making garbage not paths due to geometry which need human eye not auto-bot type guessing from a poorly coded Script which Polge did.


text:
Future Directions in Distance Learning and Communication Technologies
Author(s)/Editor(s): Timothy K. Shih (Tamkang University, Taiwan) and Jason Hung (Northern Taiwan Institute of Science and Technology, Taiwan)
DOI: 10.4018/978-1-59904-376-0
EISBN13: 9781599043784
View Future Directions in Distance Learning and Communication Technologies on the publisher's website for pricing and purchasing information.
Distance education technology combines communication with educational and intelligent methods to develop software and hardware systems that support learning activities with spatiotemporal flexibilities.
Future Directions in Distance Learning and Communication Technologies presents theoretical studies and practical solutions for engineers, educational professionals, and graduate students in the research areas of e-learning, distance education, and instructional design. This book provides readers with cutting-edge solutions and research directions pertinent to these evolving fields.
#1. A Survey of Distance Education Challenges and Technologies
#2. An E-Learning System Based on the Top Down Method and the Cellular Models
#3. Privacy and Security in E-Learning
#4. Bluetooth Scatternet Using an Ad Hoc Bridge Node Routing Protocal for Outdoor Distance Education
#5. Ubiquitous Agent-Based Campus Information Providing System for Cellular Phones
#6. An XML-Based Approach to Multimedia Engineering for Distance Learning
#7. Open Multi-Agent Systems for Collaborative Web-Based Learning
#8. Concept Effect Model: An Effective Approach to Developing Adaptive Hypermedia Systems
#9. A Virtual Laboratory for Digital Signal Processing
#10. Interactive E-Learning
#11. Using Ontology as Scaffolding for Authoring Teaching Materials
#12. The Next Generation of E-Learning: Strategies for Media Rich Online Teaching and Engaged Learning
#13. A SCORM-Compliant U-Learning Grid by Emplying CC/PP
#14. A Distance Learning System for Teaching the Writing of Chinese Characters Over the Internet
#15. Future Directions of Multimedia Technologies in E-Learning
The book provides us a glimpse of what kinds of distance learning we may see in future.
– British Journal of Educational Technology, Volume 38, Number 4 (2007)
Future Directions in Deistance Learning and Communication Technologies presents theoretical studies and practical solutions for engineers, educational professionals, and graduate students in the research areas of e-learning, distance education, and instructional design. This book provides readers with cutting-edge solutions and research directions pertinent to these evolving fields.
– TechTrends, Volume 51, Number 4 (July/August 2007)
Author's/Editor's Biography
Timothy Shih (Ed.)
Timothy K. Shih is a Professor and the Chairman of Department of Computer Science and Information Engineering at Tamkang University, Taiwan, R.O.C. His research interests include Multimedia Computing and Networking, Distance Learning, Software Engineering, and Formal Specification and Verification. He was a faculty of the Computer Engineering Department at Tamkang University in 1986. In 1993 and 1994, he was a part time faculty of the Computer Engineering Department at Santa Clara University. He was also a visiting professor at the University of Aizu, Japan in summer 1999. Dr. Shih received his BS and MS degrees in Computer Engineering from Tamkang University and California State University, Chico, in 1983 and 1985, respectively. He also received his Ph.D. in Computer Engineering from Santa Clara University in 1993. Dr. Shih has published over 240 papers and participated in many international academic activities, including the organization of DMS'98, SEMA'99, IMMCN'2000, IEEE ICPADS'2000, ICCLC'2000, IEEE MNS'2000, SEMA'2000, CAIIC'2000, IEEE MNS'2001, DMS'2001, Human.Society@Internet'2001, IEEE PCM'2001, IEEE ICDCS-22, and IMMCN'2002. Dr. Shih has received many research awards, including Tamkang University research awards, NSC research awards (National Science Council of Taiwan), and IIAS research award of Germany. He also received many funded research grants from NSC, from the Institute of Information Industry, Taiwan, from the University of Aizu, Japan, and from the University of Hong Kong, Hong Kong. Dr. Shih has been invited frequently to give keynote speeches, tutorials, panels, and talks at international conferences and overseas research organizations, including ICCIMADE'01, CAIIC'2000, PDCAT'2001, IEEE PCM'2001, DMS'99, ICCLC'2000, IEEE COMPSAC'2000, MSE'2000, and DDMA'2001, Santa Clara University (USA), Hiroshima City University (Japan), Iwate Prefecture University (Japan), University of Aizu (Japan), City University of Hong Kong (Hong Kong), Hosei University (Japan), and the University of Hong Kong (Hong Kong).
Jason Hung (Ed.)
Jason Hung is an assistant professor in the Department of Information Management at Northern Taiwan Institute of Science and Technology, Taiwan. He is also a part-time faculty of the Computer Science and Information Engineering Department at Tamkang University. Dr. Hung received Ph.D. in computer science and information engineering from Tamkang University in 2001. Dr. Hung has published over 50 papers and book chapters, as well as participated in many international academic activities, including the organization of many international conferences. He is the founder and workshop chair of the International Workshop on Mobile Systems, E-commerce, and Agent Technology. He is also the executive manager of the International Journal of Distance Education Technologies, published by Idea Group Publishing, USA.


United States' Food and Drug Administration (FDA).
of the SAAVI DNA-C2 vaccine.
housed within big pharmaceutical companies to UCT.
neglected diseases of particular relevance to Africa.
translate other UCT inventions into other future innovations.
Researchers in the H-3D Drug Discovery laboratory.


text:
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Bundesautobahn 17 (em português: Auto-estrada Federal 17) ou A 17, é uma auto-estrada na Alemanha.
A Bundesautobahn 17 tem 44,75 km de comprimento.

Estados
Estados percorridos por esta auto-estrada:
Saxônia

Ver também
Autoestradas da Alemanha
Auto-estradas

Bundesautobahn 17

redpajama_set_name: RedPajamaWikipedia


text:
import { Component, OnInit, Input } from '@angular/core';
import { FactsService } from '../facts.service';
import { MatDialog, MatSnackBar } from '@angular/material';
import { Router } from '@angular/router';
import { Fact } from '../../shared/entities';
import { FactDetailsComponent } from '../fact-details/fact-details.component';

@Component({
  selector: 'app-facts-list',
  templateUrl: './facts-list.component.html',
  styleUrls: ['./facts-list.component.css']
})
export class FactsListComponent implements OnInit {

    facts: Fact[];

    @Input() personId: number;

    constructor(private factsService: FactsService, public dialog: MatDialog, private router: Router, public snackBar: MatSnackBar) { }

    ngOnInit() {
        this.getFacts();
    }

    getFacts(): void {
        this.factsService.getFacts().subscribe(p => this.refreshDataSource(p));
    }

    refreshDataSource(facts: Fact[]): void {
        if (this.personId > 0) {
            this.facts = facts.filter(fact => fact.personId == this.personId);
        }
        else {
            this.facts = facts;
        }
    }

    onRemoved() {
        this.getFacts();
    }

    addNewFact() {
        let newFact = new Fact();
        newFact.personId = this.personId;

        let dialogRef = this.dialog.open(FactDetailsComponent, {
            width: '750px',
            data: newFact
        });

        dialogRef.afterClosed().subscribe(result => {
            console.log('The dialog was closed');
            if (result) {
                this.factsService.saveTask(result).subscribe(i => {
                    this.getFacts();
                    this.openSnackBar("Pomyślnie zapisano wydarzenie");
                });

            }

        });
    }

    openSnackBar(message: string) {
        this.snackBar.open(message, "", {
            duration: 1500,
        });
    }

}

redpajama_set_name: RedPajamaGithub


text:
John S. (Seargeant) Kloppenborg (born 1951) is a Canadian professor of Religious Studies with expertise in Greco-Roman culture, Judean culture and Christian Origins, particularly the synoptic gospels and Q-source.  He is presently at the University of Toronto (since 2007), where he holds the distinguished title of "University Professor." He was elected a member of the Studiorum Novi Testamenti Societas in 1990, and was elected as a Fellow of the Royal Society of Canada in 2014. In 2019-2020 he served as the president of the Studiorum Novi Testamenti Societas. He is also a member of The Context Group, the Society of Biblical Literature, and the Canadian Society of Biblical Studies. He was awarded honorary doctorates from the University of Lethbridge (2011) and the University of Pretoria (2018)

Biography
Kloppenborg received his M.A. (1977) and his Ph.D. (1984)  at the University of St. Michael's College (a constituent college of the University of Toronto). He has taught and conducted research in Toronto, Windsor, United Kingdom, Helsinki, Jerusalem, Cambridge, Calgary, and the United States in Claremont, California.  He is one of the general editors of the International Q Project.

Research Contributions
John Kloppenborg studies the origins of Christianity, early Christian documents and the history of Second Temple Judaism. He has researched and written most substantially about the Q document, also known as the Sayings Gospel Q. This hypothetical document would be one of the oldest circulating sources of the sayings of Jesus. It is hypothesized as prior to, and known to the authors of The Gospel of Matthew, The Gospel of Luke, and is similar in some ways to the (non-synoptic) The Gospel of Thomas. He has also worked extensively on the Synoptic problem and co-edited a major collection in 2011 on the centenary of the publication of William Sanday's Oxford Studies in the Synoptic Problem (1911).

Kloppenborg has also done original research and written on the social world of the early Jesus movement in Jewish Palestine, cultic associations and occupational guilds in the eastern Roman Empire and the social significance of the parables of Jesus. Other areas of interest have been the letters of the New Testament, especially the Letter of James, and the culture of the Graeco-Roman world as relates to such matters as: religion, spirituality, cultic associations, ethnic sub-groups and their ancient organization, professional societies and the general conditions of the societies in the Near East during the time of Second Temple Judaism, the time of Jesus and the formation of the Bible as we know it.

Tenants in the Vineyard
Published in 2006, Kloppenborg's book, The Tenants in the Vineyard: Ideology, Economics, and Agrarian Conflict in Jewish Palestine, titled after the "tenants in the vineyard" parable attributed to Jesus by the New Testament, provides an analysis for the critical reader of the Bible of this very difficult parable. The bible citation for the parable is Mark 12:1-12 and it is also recorded in the apocryphal Gospel of Thomas (65). In his book, Kloppenborg models a new approach to the parables of Jesus. He discusses the ideological interests engaged by the parable in modern times and over the history of the Christian Church. Next, he explains the conditions of the society in which the parable was first laid out, especially in regards to ancient viticulture. In his conclusions, Kloppenborg notes that the parable has ironically been interpreted from the viewpoint of those in power in politics and society rather than as a literary parable or as an "anti-power" parable, as it may have read in the original texts.  He shows that the editing in Mark's version of the story takes it beyond the useful idiom common to Jesus' other parables. Kloppenborg also includes a second volume documenting historical papyrus dealing with ancient viticulture and agrarian conflict.

Critical Edition of Q
Published in 2000, by James M. Robinson, Paul Hoffmann, and John S. Kloppenborg, The Critical Edition of Q: Synopsis including the Gospels of Matthew and Luke, Mark and Thomas with English, German, and French Translations of Q and Thomas is a groundbreaking, though still controversial, work of scholarship.

Containing a lengthy introduction by bible scholar James M. Robinson and a foreword by the three editor scholars: Robinson, John S. Kloppenborg and Paul Hoffmann, this hefty volume provides a redacted version of what the original Q document might have looked like whether it was written in Greek or Aramaic. The Critical Edition of Q is the product of the International Q Project (IQP), a program inaugurated at the Society of Biblical Literature in 1985 that has sought to establish an accessible critical edition of the source shared by Matthew and Luke.

Their work also seeks to "document the major turning points in the history of Q research, with particular attention to the problem of establishing a critical text of Q" (xix). Putting aside "a purely hypothetical Aramaic source" of Matthew and Luke, which would mean that "Q would never be more than a hypothesis," Robinson claims, in the introduction, that such approaches have been "completely replaced by objective criteria, based on empirical observation of Matthean
and Lukan redactional traits" (xix). The bulk of the text is the critical text of Q (1-561), which concludes with a concordance of Q (Greek words [563-81]). The volume also contains a discussion of divergences from the Lukan sequence (lxxxix), text-critical notes (xc-cvi), and end-pages (cvii). The critical text itself is formatted with eight columns on facing pages presenting by column: 1) any Markan parallel to Matthew, 2) any doublets found in Matthew, 3) the text in Matthew that is deemed to be derived from Q, 4) the critical text of Q, 5) the text in Luke that is deemed to be derived from Q, 6) Luke's doublets, 7) any Markan parallel to Luke, and 8) any parallel from the Gospel of Thomas, the Coptic of which is provided but also retroverted into Greek. As footnotes, the Thomas and Q texts are translated into English, French and German.

The editors intend this volume to be functional as a standard research tool for the study of Q despite the continuing controversy over the validity of the text actually existing; this is the most comprehensive effort to provide such a tool nonetheless.

Publications
 The Sayings Gospel Q in Greek and English with Parallels from the Gospels of Mark and Thomas, Contributions to Biblical Exegesis & Theology vol. 30 with James M. Robinson and Paul Hoffmann
 Documenta Q edited by James M. Robinson, John S. Kloppenborg, and Paul Hoffmann, with contributions from the International Q Project
 Christ's Associations: Connecting and Belonging in the Ancient City (Yale University Press, 2019)
 Luke on Jesus, Paul, and Earliest Christianity: What Did He Really Know? with Joseph Verheyden (Leuven: Peeters, 2017)
 The Jesus tradition in the Catholic Epistles with Alicia Batten (Bloomsbury Academic, 2014)
 Synoptic Problems: Collected Essays (Tübingen: Mohr Siebeck, 2014)
 Associations in the Greco-Roman World: A Sourcebook (with Richard S. Ascough and Philip A. Harland) (Baylor University Press, 2012)
 Attica, Central Greece  Macedonia, Thrace. Vol. 1 of Greco-Roman Associations: Texts, Translations, and Commentary (with Richard S. Ascough) (Walter de Gruyter, 2011)
 Q: The Earliest Gospel (Westminster/John Knox, 2008)
 The Tenants in the Vineyard: Ideology, Economics, and Agrarian Conflict in Jewish Palestine (Tübingen: Mohr Siebeck, 2006)
 Apocalypticism, Antisemitism and the Historical Jesus: Subtexts in Criticism Journal for the Study of the New Testament, Supplement Series, vol. 275 with John W. Marshall (2005)
 Excavating Q: The History and Setting of the Sayings Gospel (Minneapolis: Fortress Press, 2000)
 The Critical Edition of Q with James M. Robinson and Paul Hoffmann (Hermeneia; Minneapolis: Fortress; Leuven: Peeters, 2000)
 Voluntary Associations in the Graeco-Roman World with Stephen Wilson (1996)
 Conflict and Invention (Valley Forge, Pa.: Trinity Press Int'l, 1995)
 The Shape of Q: Signal Essays on the Sayings Gospel (Minneapolis: Fortress, 1994)
 Scriptures and Cultural Conversations: Essays for Heinz Guenther at Sixty-five Pp. 211 (1992)
 Early Christianity, Q and Jesus Ed. with Leif E. Vaage Pp. 265 (1991)
 Q-Thomas Reader (1988) with Michael G. Steinhauser, Stephen Patterson, and Marvin W. Meyer
 Q Parallels: Synopsis, Critical Notes & Concordance (1988)
 The Formation of Q: Trajectories in Ancient Wisdom Collections (Minneapolis, 1987)
 Numerous articles by John S. Kloppenborg are found on his academia.edu site: https://utoronto.academia.edu/JohnKloppenborg

References

1951 births
Living people
Synoptic problem
New Testament scholars
University of Toronto alumni
Academic staff of the University of Toronto
Members of the Jesus Seminar


text:
Should You Wear a Surgical Mask On Top of an N95?
COVID-19 Vaccines:
Caroline Shannon Karasik
Caroline Shannon Karasik is a writer based in Pittsburgh, PA. In addition to Verywell, her work has appeared in several publications, including Good Housekeeping, Women's Health and Well+Good.
Wearing a surgical mask on top of an N95 mask may be the key to preserving an N95 for further use, says one doctor in a tweet earlier this month.
N95s are crucial to the healthcare field and regularly in short supply, so this method is one worth considering, some experts say.
An N95 standard mask is different than an N95 surgical mask, the latter of which is reserved for operative or procedural settings (e.g. during surgery).
The more, the better, or so the saying goes. But when it comes to mask-wearing, is it true that doubling up on masks can help protect, say, a highly-sought-after N95 mask, allowing it to be used again in the future? It's a conversation initiated earlier this month on Twitter, and it sparked a debate about whether or not double mask-wearing does indeed pull double duty.
"This preserves the N95 with a cheaper mask," Esther Choo, MD, wrote on Twitter about a picture of Joe Biden wearing a surgical mask over an N95 mask. "So you can swap out the top mask and keep using the N95. The VP is helping us conserve our precious PPE!"
But is wearing a cheaper or less-protective mask over an N95 actually a method for preserving an N95? Or is it just another coronavirus mask myth? Here, experts weigh in on the ins and outs of double mask-wearing, as well as a few tried and true rules you'll want to keep sticking by.
For starters, it's important to know the difference between an N95 and your standard cloth or surgical mask.
There are actually two types of N95 masks, a standard N95 (particulate respirator) and a surgical-grade N95 (also known as a medical respirator). A June 2020 report from 3M Company classified standard N95 masks as the following:
[These masks] are designed to help reduce the wearer's exposure to airborne particulate hazards. In the U.S., respirators are tested and certified by the U.S. National Institute of Occupational Safety and Health (NIOSH). N95-rated filtering facepiece respirators have a filtration efficiency of at least 95% against non-oily particles when tested using the NIOSH criteria.
On the other hand, a surgical N95 mask is recommended for use by healthcare professionals who need protection from both airborne and fluid hazards (e.g., splashes, sprays), according to the Centers for Disease Control and Prevention (CDC).
What Does PPE Mean?
In her tweet, Choo mentions that Biden's mask-wearing method is "helping us conserve our precious PPE!"
PPE simply stands for personal protective equipment, a term used to encompass a number of personal protection in healthcare settings, including gloves, gowns or aprons and, yes, masks.
Theda C. Kontis, MD
[At the office], I wear an N95 mask with another surgical mask covering it. This protects both my patient and me, as well as allows me to re-use my N95.
— Theda C. Kontis, MD
So Is the Tweet Accurate?
While you certainly can't believe everything you read on Twitter, Theda C. Kontis, MD, says Choo's suggested method is one she uses in her own practice.
"At the office, I see patients with their face masks removed, so I wear an N95 mask with another surgical mask covering it," she tells Verywell. "This protects both my patient and me, as well as allows me to re-use my N95."
But Jay Woody, MD, chief medical officer of Intuitive Health and a co-founder of Legacy ER & Urgent Care, says it's important to note the difference between doubling up on masks to protect an N95 and wearing two masks for extra protection. As for the latter, Woody says it's simply not the case.
"As the name implies—the N95 filters out 95% of all particles," he tells Verywell, noting that healthcare personnel must be properly fitted to ensure the mask's effectiveness. "N95 masks are the strongest face masks available and do not need additional coverings."
Woody adds, "The only reason I can think of for adding an additional mask to the N95 would be if it had a valve that allowed for unfiltered air that the wearer breathes out."
Your Instant Pot May Sanitize N95 Masks
When she's not at work, Kontis says she sheds the N95, opting instead for a spandex mask, a style she finds the most comfortable for everyday mask-wearing.
"Of all the styles I have tried, it is the most comfortable because the ear openings are not elastic straps but actually are cut out of the spandex," Kontis says. "The mask is breathable, doesn't fog my glasses, and fits snugly over my face."
Kontis says the key to mask-wearing in public is continued adherence to social distancing to "prevent aerosolized particles from exiting and/or entering."
Which is another way of saying, the same safety precautions are still in place, which means continued adherence to safety precautions like mask-wearing, maintaining social distance, regular hand-washing, and avoiding large gatherings, especially indoors.
The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.
3M. Surgical N95 vs. standard N95 – which to consider?. Technical Bulletin.
Centers for Disease Control and Prevention. Coronavirus disease 2019 (COVID-19)
Centers for Disease Control and Prevention. Guidance for the selection and use of personal protective equipment in healthcare settings.
A Definitive Guide to Face Masks
How to Tell if Your Face Mask Is Real and Not a Counterfeit
How Effective Is a Face Mask Against COVID-19 if You're the Only One Wearing It?
Should You Wear Your Mask at the Gym?
Can You Apply for Disability With an At-home Rapid COVID-19 Test?
How to Protect Yourself Against COVID-19 During the Winter Surge
Will We Wear Face Masks Forever?
Over 100 Scientists Call for 'Vaccines-Plus' COVID-19 Strategy
How to Protect Yourself From Wildfire Smoke
Does Double-Masking Help Curb the Spread of COVID-19?
Humidity From Face Masks May Lessen the Severity of COVID-19
Will Your COVID-19 Mask Protect You From Wildfire Smoke?
Have Spring Allergies? Your Face Mask Can Help
Can Medical Masks Prevent Viral Infections?