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If they had never been tested, they were asked whether they knew a place where they could go to be tested. Patterns by background characteristics Knowledge of where to get tested was lowest among women age 40-49 (27%) and men age 15-19 (41%) (Table 13. Knowledge regarding where to get tested was lower among women and men in rural areas (27% and 54%, respectively) than among those in urban areas (38% and 60%). Knowledge on where to get tested was lowest among women in Province 2 (15%) and men in Province 5 (49%). Similarly, women (19%) are more likely than men (12%) to know where to seek treatment. Patterns by background characteristics Knowledge on where to seek treatment is lower among men in Province 2 (8%) than among men in other provinces (Table 13. The percentage among men has remained relatively constant, at around 2% to 3%, since 2006. Similarly, the percentage of young men with comprehensive knowledge decreased from 44% in 2006 and 34% in 2011 to 27% in 2016 (Figure 13. Five percent of young women and 3% of young men age 15-24 had sexual intercourse before age 15 (Table 13. A greater proportion of young women (38%) than young men (27%) age 18-24 had sexual intercourse before age 18. The percentage of young women who had sexual intercourse before age 15 drastically decreased from 24% in 1996 to 8% in 2006 and has stabilized since. Likewise, the proportion of young women who had sexual intercourse before age 18 drastically decreased from 72% in 1996 to 40% in 2011 and has since remained constant. The proportion of young men who had sexual intercourse before age 15 decreased from 11% in 2001 to 3% in 2011 before stabilizing between 2011 and 2016. The percentage of young men who had sexual intercourse before age 18 decreased dramatically from 56% in 2001 to 24% in 2011 and has changed only minimally over the past 5 years. Patterns by background characteristics Young women and men in rural areas (48% and 35%, respectively) are more likely than those in urban areas (32% and 23%) to initiate sexual intercourse before age 18 (Table 13. One percent of never-married young women and 25% of never-married young men age 15-24 have had premarital sexual intercourse. Trends: the proportion of never-married young women who have had premarital sexual intercourse has been stable (1%) since 2006, while the proportion among never-married young men increased from 17% in 2006 to 22% in 2011 and 25% in 2016. Patterns by background characteristics By age, premarital sex is higher among never-married young men age 23-24 (48%) than among their younger counterparts (Table 13. A greater proportion of never-married young men age 15-24 in rural areas (30%) than in urban areas (23%) have had premarital sexual intercourse. Four percent of men age 15-24 had two or more partners in the 12 months prior to the survey. Sixteen percent of young men had sexual intercourse with a non-marital, non-cohabiting partner in the last 12 months, of whom 69% reported using a condom during the most recent sexual intercourse with such a partner. Trends: the proportion of men age 15-24 with two or more partners in the 12 months preceding the survey has remained unchanged since 2011 (4%). Among household population in the 15-69 age group, 15% of women and 22% of men had hypertension. Hypertension is more prevalent in Province 4 (24% among women and 31% among men age 15 and older) than in other provinces. Rates of hypertension are higher among tobacco users (16% of women and 20% of men) than among those who do not use tobacco (10% of women and 13% of men). Rates of hypertension are about twice the national average among obese women (38%) and men (54%) age 15 or older. This chapter presents information on blood pressure screening and blood pressure status. Among those who have had their blood pressure measured, 13% of women and 18% of men were told on two or more occasions that they had high blood pressure. Among those who had high blood pressure, one-third of both women (34%) and men (33%) are taking prescribed medicines to lower their blood pressure. The proportion of women who were told that they had high blood pressure increases with increasing wealth, from 9% among those in the lowest wealth quintile to 22% among those in the highest quintile. The proportion among men increases as well, from 15% among those in the lowest wealth quintile to 23% among those in the highest quintile.

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Population served are individuals 21 and older with a dual diagnosis of a serious mental illness and a developmental disability. Make sure medical equipment such as wheelchairs and prosthetic devices "fit" properly. Keep a list of concerns or questions in between appointments and bring it with you to your appointments. The child must have been 21 years old or younger when the medical bills were incurred. Participants are asked to partner with the program to develop and carry out a household energy savings Action Plan. The benefit is also available to customers who have electric and gas costs included in their rent. Benefits appear as a credit on the household electric and/or gas bill (capped at $1,800 per year). You cannot apply for Fresh Start, but if you are eligible you will be enrolled by your utility company and receive information about the program in the mail. Eligibility is determined based on your income or participation in other assistance programs. It covers emergency treatment immediately following an accident, and treatment of serious brain and spinal cord injuries up to $250,000. The ultimate goal is for children to maximize their potential to lead full, productive lives with their families and within their own communities. A State Interagency Coordinating Council, appointed by the governor, advises and assists the Department of Health as the lead agency in the development and implementation of early intervention for infants and toddlers with developmental delays or disabilities, and their families. If the child is not eligible for early intervention, recommendations may be made for referral to other appropriate resources. The service coordinator will arrange evaluation for eligibility at no cost to the family. The collaboratives are responsible for child find, public awareness, initial referral, service coordination, training and technical assistance and family support. The New Jersey Department of Education administers state and federally funded aid programs for more than 1. For children age three to five, the child study team includes a speech correctionist or speech-language specialist. Upon completion of the evaluation and prior to placement in special education, an Individualized Education Program, with stated goals and objectives, is written with the participation of the parents. According to New Jersey Administrative Code, a full continuum of alternative placements shall be available to meet the needs of children with educational disabilities. Services for people with disabilities include vocational evaluation and assessment, training, counseling, education, job placement assistance, supported employment and support for entrepreneurs with disabilities. Vocational rehabilitation counselors work with individuals and their families to develop and carry out a plan for training and placement. If financial need is established, the division will purchase other rehabilitative services from private providers, such as further evaluation or counseling, training at a vocational center or technical school and on-the-job training. The goals of the program are to offer beneficiaries with disabilities expanded choices when seeking service and supports to enter, re-enter, and/or maintain employment; to increase the financial independence and self-sufficiency of beneficiaries with disabilities; and to reduce and, whenever possible, eliminate reliance on disability benefits. While participating in the Ticket to Work Program, beneficiaries can get the help they need to safely explore their work options without immediately losing their benefits. Beneficiaries also can use a combination of work incentives to maximize their income until they begin earning enough to support themselves. Individuals with an interest in becoming self-employed should present this option to their vocational rehabilitation counselor. If a solid business plan is put together, there may be capital investment available for a variety of start-up needs. Support primarily consists of training in business management and assistance in establishing vending locations. People with disabilities who are employed and are between the ages of 16 to 64 can qualify for the program with an annual gross earned income of up to approximately $61,500. Its Community Development Division administers several programs targeted to people with special needs. New Jersey Housing Resource Center the Housing Resource Center provides individuals with information on accessible and affordable housing throughout the state.

Diseases

  • Engelhard Yatziv syndrome
  • Maxillary double lip
  • Exudative retinopathy, familial
  • Kenny Caffey syndrome
  • Iminoglycinuria
  • Rutledge Friedman Harrod syndrome
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To provide a foundation for the decision-making in the environment-based urban management. Between 1950 and 2000, the air temperature in Indonesia has increased as much as Moreover, the data Data Analysis Procedure acquisition was conducted in several offices, department stores, and housing complex around the locations of the research. Tools and Materials the tools and materials used in the research are air conditioners, rooms, thermometers, cameras, calculators, measuring instruments, raffias, ladders, compasses, and stationery. Quantitative description (calculation of the room air conditioner) (Handoko, 1979) b. Vegetation Potential Ability of Urban Forest the potential ability of urban forest in decreasing the temperature is known through the estimation using the secondary data, which are the rate of surface latent heat, sunlight intensity, albedo, the rate of evapotranspiration, and the evapotranspiration latent heat. Nonetheless, a calculation on the heat flux density in the vegetation should be conducted initially. H = -k A T Z Description: H = heat flux density (W/m2) in the vegetation A = canopy area (m2) T = temperature (0C) Z = height (meter) k = Air conductance (-5,7 x 10-5 Cal/cm. According to the principle of energy balance on the vegetation surface which shows the input, output, or storage energy using equation 3 (Campbell and Norman, 2000). G = Rn ­ H ­ E Description: = the rate of thermal storage in vegetation and soil, = radiation absorption flux density by the surface or sunlight net intensity received by the tree = the rate of heat release (heat flow through the convection or conduction determined by temperature difference), = the rate of the surface latent heat, = the rate of water evapotranspiration, = the evapotranspiration latent heat (the heat absorbed 1 gram of water evaporated). Based on the measurement using Room Air Conditioner method, the air conditioning requirements varied for each room. Whereas, the room which requires the least air conditioning is the room in Soil Science Department of the Faculty of Agriculture, that is 22. In Surabaya, the ground floor of the Moslem Department Store "Bibah Dibah" requires the most air conditioning, that is 156316. Whereas, the bedroom in the Rungkut Harapan Housing Complex G/31 requires the least air conditioning, that is 4738. It shows that the measurement of air conditioning requirement of a room is determined by the size of the room, walls, the quantity and area of window(s), room capacity, and the electrical devices used. The Ability of Trees to Absorb Heat Sunlight is one of factors that trigger overwarming, including the ambient air. The trees in urban forest are able to absorb heat through the sunlight absorption mechanism which is applied in the process of photosynthesis. Thereby, the heat radiation of the sun does not warm up the ambient air in the coverage of the trees. The air conditioning effect occurs due to the heat (radiation of the sun) absorption, often namely as endothermic (absorbing heat). Based on the measurement and secondary data, as well the analysis using the equation presented by Campbell and Norman (2000), the vegetation ability in absorbing heat is revealed (Table 1 and Table 2). The density of the vegetation, variant, and the rate of evapotranspiration of the trees will affect the individual ability of a tree. Urban Forest Efficiency the calculation of the value on the urban forest efficiency is analyzed by comparing and finding the difference between the costs needed to use air conditioner and the cost of urban forest development on air conditioning fulfillment of the same room. Location Arboretum in Faculty of Forestry Tropical Forest Germ Plasm Arboretum Canopy area 400 m2 400 m2 Based on the calculation, the values of heat absorption among the urban forest vegetation have differences depends on the density of the vegetation. The ability of heat absorption that belongs to the trees in the Arboretum in the Faculty of Forestry is lesser than the trees in the Tropical Forest Germ Plasm Arboretum. It is due to the trees in the Arboretum of Faculty of Forestry have the lesser canopy areal, that is 21 m2/tree, whereas the trees in the Tropical Forest Germ Plasm Arboretum have the approximately greater canopy areal, that is 28 m2/tree. The ability of heat absorption belongs to the trees in the Bratang Urban Forest is greater than of the trees in Wonorejo Urban Forest. The difference is because the trees in Bratang Urban Forest have greater approximate canopy areal, that is 28.

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With new forms of media emerging and the convergence of media technology, the patterns of media usage will inevitably undergo rapid changes. The beginning of the 21st century is marked by the rise of ubiquitous technology in everyday life. Consequently, individual citizens are becoming more focused on the opportunities and risks electronic devices pose. Among these include the risk of indecent exposure, enculturation, pornography, and anti-social behaviors among others. Littlejohn and Foss (2008) highlighted the idea of the "Second Media Age", as propounded by Mark Poster in his book "The Second Media Age", which signal important changes in media theory. Three key assumptions of the second media age include: firstly, that the concept of "media" is loosened from primarily "mass" communication to a variety of media ranging from broad to personal in scope. Secondly, the concept evaluates new forms of media use ranging from individualized information and knowledge acquisition to interaction. Thirdly, the power of media comes back into focus including a renewed interest in characteristics of dissemination and broadcast media. The first media age was said to be characterized by "(a) centralized production (one to many); (b) one-way communication; (c) state control for the most part; (d) the reproduction of social stratification and inequality through media; (e) fragmented mass audiences; and (f) the shaping of social consciousness" (Littlejohn & Foss, 2008, p. The second media age, in contrast, and which is the focus of this study is described as being "(a) decentralized; (b) two-way; (c) beyond state control; (d) democratizing; (e) promoting individual consciousness; and (f) individually oriented" (Littlejohn & Foss, 2008, p. Littlejohn and Foss therefore add that "the Internet provides virtual meeting places that expand social worlds, creates new possibilities for knowledge, and provide for a sharing of perspectives worldwide" (p. Examples include: provision of openness and flexibility of use, can lead to confusion and chaos. Diversity is one of the great values of new media, but can lead to division and separation. New media may also allow flexibility in how we use time but also create new time demands. For example, Facebook and MySpace report in excess of 70 and 50 million visitors, respectively on a monthly basis to their sites (Dunne & Lawlor, 2010). Although the situation is rapidly changing, scholars still have a limited understanding of who is and who is not using these sites, why, and for what purposes, especially outside the U. This is attributed to their self-sustaining nature and ever growing audience size (Shao, 2009). Over time, "they have evolved to encompass blogs, wikis, picture-sharing, video-sharing, social networking, and other user-generated web sites" (p. The challenge here is in relating the gratifications sought and those obtained through the choice of these new forms of media. They further defined a social network site as; A networked communication platform in which participants 1) have uniquely identifiable profiles that consist of user-supplied content provided by other users, and/ or system-provided data; 2) can publicly articulate connections that can be viewed and traversed by others; and 3) can consume, produce, and/ or interact with streams of user-generated content provided by their connections on the site (Ellison & Boyd, 2013, p. Willems (2011) described Facebook as "a social utility which connects people with friends and others" (p. The uses and gratifications (U&G) theory is based on the notion that media cannot influence an individual unless that person has some use for that media or its messages (Rubin, 2002). Quan-Haase and Young (2010) argued that in U&G theory a key distinction is made between gratifications obtained and gratifications sought. Song, Larose, Eastin and Lin (2004) found seven gratification factors specific to the Internet. These are; virtual community, information seeking, aesthetic experience, monetary compensation, diversion, personal status, and relationship maintenance. The uses and gratifications (U&G) theory According to Littlejohn and Foss (2008) one of the most popular theories of mass communication is the U&G approach. This approach focuses on the consumer-the audience member rather than the message. The media are considered to be only one factor contributing to how needs get met, and the audience members are assumed to have considerable agency or in essence know their need and how to gratify those needs. The underlying assumption is that audiences are active and they seek out that content which provides the most gratification (Fawkes & Gregory, 2001). Fawkes and Gregory further added that "the level of gratification depends on the level of need or interest of the individual" (p.

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Number of Deaths for Leadings Causes of Death, by Race and Ethnicity: is the total number of deaths registered with the State of Connecticut for a health event that resulted in death for conditions that contributed to the most deaths in Connecticut aggregated over the 2006 to 2010 period. Age-Specific Death Rates Age-Specific Death Rates, With Average Annual Percent Change Estimates: is the death rate per 100,000 population for each age group, for threeyear time intervals, from 1991-2011. Mortality and Premature Mortality Across Connecticut All-Cause Mortality: this map indicates the distribution of all-cause mortality aggregated over the 2006-2010 period, by town. Towns where the all-cause mortality rate per 100,000 population was the highest for the State are indicated in dark blue. In this graph, it is the years of potential life lost before 75 years of age, adjusting for age for deaths in Connecticut in 2010. Life Expectancy Life Expectancy at Birth, by Sex: is an estimate of the average number of years that would be expected for a baby to live, assuming that current mortality rates remain stable. Data are presented for three-year time intervals for the 1991 to 2011 period, by sex. Life Expectancy at Birth, by Sex and Race and Ethnicity: is an estimate of the average number of years that would be expected for a baby to live, assuming that current mortality rates remain stable. Data are presented for two-year time intervals, from 1997 to 2011, by sex and race and ethnicity. Hospitalizations and Emergency Department Visits Number of Hospitalizations: indicates the number of hospitalizations in 2011 for a given cause of hospitalizations. This includes discharges from nonfederal, short-stay, acute-care, and general hospitals in Connecticut. This includes discharges from non-federal, short-stay, acute-care, and general hospitals in Connecticut. Rate of Emergency Department Visits: is the number of emergency department visits in 2011 for a given cause of emergency department visit, per 100,000 population. Births to Teen Mothers Birth Rate to Teen Mothers (15-19 Years of Age) and Annual Percent Change, by Race and Ethnicity: is the number of births per 1,000 women 15 to 19 years of age, from 2000 to 2011. The annual percent change is the average annual percent change in the birth rate among women 15 to 19 years of age from 181 2000 to 2011. This indicator is presented for the total population and also by race and ethnicity. Birth Rate to Teen Mothers (15-19 Years of Age), by Race and Ethnicity: indicates the number of births to women 15 to 19 years of age, per 1,000 women in this age group in Connecticut in 2011. Births to Teen Mothers Across Connecticut Birth Rate to Teen Mothers (15-19 Years of Age), by Town: this map shows the birth rate to women 15 to 19 years of age, aggregated for the 2007-2011 period for each town in Connecticut. Towns with the highest birth rate to teen mothers are shaded in dark blue; towns with the lowest highest teen birth rate are shaded in yellow. Preterm Birth and Low Birthweight Births Percent of Singleton Preterm Births, by Race and Ethnicity: is the proportion of live born infants who were younger than 37 completed weeks of gestation when they were born in 2011. Percent of Low Birthweight Births, by Plurality and Race and Ethnicity: is the percent of live born infants whose birthweight was less than 2,500 grams (5. Percent of Low Birthweight Births, by Low Birthweight Status and Race and Ethnicity: is the percent of low (<2,500 grams), moderately low (1,500-2,499 grams), and very low birthweight (2271,499 grams) births in Connecticut in 2011. Preterm Birth and Low Birthweight Births Across Connecticut Percent of Preterm Births, By Town: this map indicates the proportion of preterm births (<37 weeks gestation), by town, aggregated over the 2007 to 2011 period. Percent of Low Birthweight Births, by Town: this map shows the proportion of low birthweight births (<2,500 g), by town, aggregated over the 2007 to 2011 period. Towns with the highest proportion of low birthweight births are indicated in dark blue. Preconception Health, Unplanned Pregnancies, and Cesarean Sections Percent of Women Who Discussed Preconception Health with a Health Care Provider Prior to Pregnancy, by Race and Ethnicity: is the proportion of women who discussed with a doctor, nurse, or other health care provider ways to prepare for a healthy pregnancy and baby prior to getting pregnant with their new baby. Percent of Unplanned Pregnancies, by Race and Ethnicity: is the percent of women who indicated that thinking back to just before they got pregnant with their new baby felt that they did not want to be pregnant then or at any time in the future (unwanted pregnancy) or wanted to be pregnant later (mistimed pregnancy). Cesarean Section (C-Section) Rates, by Plurality: is the number births delivered by cesarean section (Csection) per 100 births in Connecticut from 2000 to 2011. This indicator is presented for all births, singleton births, and multiple births in 2011. Late Prenatal Care Across Connecticut Percent of Mothers Who Received Late Prenatal Care, by Town: this map indicates the proportion of pregnant women who experienced late initiation of prenatal care, meaning their prenatal care began in the second or third trimester.

Syndromes

  • Easy bruising
  • Unusual posture, with the head and neck arched backwards (opisthotonos)
  • Is the feeding getting harder?
  • Salicylate: greater than 300 mcg/mL
  • Not being able to urinate
  • Porphyria
  • Electrocardiogram (ECG)
  • Personality change
  • Constant hunger and need to eat often

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The authors performed realignment procedures, if they were necessary, in the latter 14 patients in the study, which resulted in good to excellent results in 11 of the 14 patients (79%). The authors reported that an unloading osteotomy may improve the outcomes of select patients who have normal patellofemoral biomechanics; however, both of the groups in the study included a substantial number of patients who had lateral patellar facet defects, which would be expected to respond positively to an unloading osteotomy, thus amplifying the differences the authors reported between the groups. Patellar instability must be addressed in patients with patellofemoral chondral defects who undergo cartilage restoration. Historically, a high failure rate and mediocre results were associated with patellofemoral arthroplasty; however, newer implant designs and techniques have substantially improved patient outcomes and implant survivorship. The meniscus is a critically important structure that minimizes joint contact stresses by providing maximum contact area. In a loaded knee, the medial meniscus transmits 50% of the medial compartment load, and the lateral meniscus transmits 70% of the lateral compartment load. Contact forces have been reported to increase by as much as 65% after partial meniscectomy and 235% after total meniscectomy. In a prospective 40-year follow-up study of 53 patients who underwent total meniscectomy as adolescents, Pengas et al132 reported that meniscectomy led to symptomatic knee osteoarthritis later in all of the patients, with a 132-fold increase in the rate of total knee replacement compared with that of age-matched control patients. Many other studies have reported a strong association between meniscectomy and radiographic and symptomatic osteoarthritis. The surgeon should obtain a thorough history, including the time from previous surgery, the duration of current symptoms, and the activities or factors that precipitate pain. Some patients experience pain only with high-impact activities; other patients may experience pain with normal weight-bearing activities. The physical examination begins with a gait analysis followed by an assessment for effusion, deformity, contracture, ligamentous instability, malalignment, and patellar maltracking. The radiographs are evaluated for fractures, loose bodies, osteophytes, and joint space narrowing. B, Arthroscopic image of a knee taken after suture fixation of the meniscal allograft. An unloader brace can be effective in patients who have unilateral compartment overload as a result of malalignment or meniscal deficiency. Nonsurgical treatment may help alleviate symptoms; however, in many patients, nonsurgical treatment is only palliative in nature. Younger patients, especially those younger than 30 years, who have meniscal deficiency should be monitored closely because joint degeneration can occur quickly, especially after lateral meniscectomy. Factors such as patient age, goals, and activity level as well as the extent of the disease process should be considered in the development of the surgical plan. Younger patients who have realistic expectations and are willing to comply with a rigorous postoperative rehabilitation are ideal. If multiple procedures are indicated, a staged procedure in which extra-articular and intra-articular procedures are grouped together based on surgeon comfort level may be considered. A varusproducing distal femoral osteotomy is indicated in patients who have lateral compartment disease, and a valgusproducing proximal tibial osteotomy is indicated in patients who have medial compartment disease (Figure 9). Osteotomy is advantageous for younger patients because long-term activities are not restricted, and the need for joint arthroplasty may be delayed or prevented. Opening and closing wedge osteotomies have been described in the literature; however, a paucity of studies support one technique over another. In a recent systematic review of 21 studies, which included 1,065 patients who were treated for unicompartmental knee osteoarthritis, Brouwer et al153 reported that valgus high tibial osteotomy reduced pain and improved knee function in patients who had medial compartment knee osteoarthritis. Although less commonly used, varus-producing distal femoral osteotomy has resulted in encouraging outcomes in patients who have lateral compartment disease and genu valgus alignment. The decision on which repair technique to use depends on both patient factors and the characteristics of the chondral lesion. The authors reported that, before the 2-year follow-up, the procedure failed in four patients, all of whom required revision surgery. The authors reported statistically significant improvements in all outcome scores of the patients who had grafts that were still in place at the last follow-up.

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According to Raghuram Rajan, minimum support price, rural wage rate including female wage rate, food prices and inflation expectations are the crucial variables that may determine Indian inflation although he confessed that interest rate cut would not able to come down inflation rate in India in recent times. But he was not in favour of target rate of inflation which require financial stability in the economy. Therefore, medium term or long term inflation targets will be suitable policy measures to control inflation for India. Basir,Furrukh,et all,2011,Determinants of inflation in Pakistan:An Econometric analysis using Johansen Cointegration Approach. Econometric Reviews,13, 205-229 [2] [3] [4] [5] [6] [7] [8] [9] [10] [11] [16] Johansen S. Debesh Bhowmik, International Institute for Development Studies, Kolkata [15] Irzaman ** * Department Forest Resources Conservation and Ecotourism, Faculty of Forestry, Bogor Agricultural University ** Department of Physics, Faculty of Mathematics and Natural Science, Bogor Agricultural University *** Abstract- Most of the societies used the air conditioners to reduce overwarming. The purpose of this research was to assess the ability of urban forest vegetation in absorbing heat in replacing air conditioner, hence the efficiency of urban forest. The research were conducted in Bogor Agricultural University Darmaga Campus and the city of Surabaya. The research was initiated by performing measurements at room with Room Air Conditioner methods. The potential of urban forest made through measuring the heat flux density on vegetation. The efficiency of urban forest for the room that is 2-9 times cheaper than the use of air conditioning. Then in Surabaya, the result show that the heat absorption ability of the trees was 2958. Thus, the development of urban forests to replace air conditioner is rational because it could significantly save the cost of a room spending. The benefit gained is limited to size and room (indoor), while the heat blown will raise the temperature outside of the room. One attempt to control the temperature in urban areas is by developing an urban forest. To provide information regarding the ability of trees in the urban forest as a substitution for the room air conditioner, in order to decrease the usage level of the air conditioner. To provide information for the society about the values of the urban forest, in order to open their minds to participate in keeping and improving the forest. Regarding on that fact, the greater canopy area is able to absorb greater radiation heat of the sun. The result of the research shows that the existence of the urban forest vegetation is able to substitute or decrease the usage of air conditioner. Based on the data analysis result, the trees have the ability of heat absorption for as much as 3. The quantity of trees to fulfill the requirement of a room is based on this calculation should be adjusted with the density of the vegetation in the urban forest measured. In addition, trees that are able to well absorb heat generally are the ones which aged 10 years or more, with a shady and dense canopy. To fulfill the air conditioning requirement of a room, the trees should be planted around the area. It is due to the fact that the approximate age of the tree is 20-30 years old (Widiarti, 2003). Urban Forest Development Cost the trees which are able to decrease air temperature, does not grow by itself, although there are these trees that does. The variants of cost for a tree to grow are the seedling provision cost, planting cost, replantation cost, fertilization cost, watering and monitoring cost adjusted with the Gerhan Standard which is referred by Asyravy (2008) (Table 7 and Table 8). Based on the calculation on tree(s) provision cost above, therefore the cost to spend for the air conditioning requirement for a room can be revealed. The Auditorium 1 in the Faculty of Forestry which requires 27 trees spends Rp27,562,410, the Silva Thesis Defence Room in the Faculty of Forestry which requires 34 trees spends Rp34,708,220, the Soil Science Department Room in the Faculty of Agriculture which Rp 1.

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Elie et al 59 Study Design and Demographics Patients 16 to 85 years of age with insomnia Sample Size and Study Duration Duration varied (2 nights to 4 weeks) End Points adverse events, rebound insomnia Secondary: Not reported of zolpidem (P=0. One study reported that patients taking zaleplon were less likely to suffer withdrawal symptoms on the first night of the placebo run-out phase than those on zolpidem (1. The number of patients treated with zaleplon showing rebound insomnia was not significantly different from placebo on the first night after discontinuation of four weeks of treatment. On the second night after discontinuation of treatment, there were significantly more patients (P<0. There was no evidence of withdrawal symptoms after discontinuation of four weeks of zaleplon treatment. Significantly more patients who had received zolpidem than placebo reported withdrawal effects on the first night after treatment was discontinued; however, there was no statistically significant difference on the second or third night between the two groups. The frequency of adverse events in the active treatment groups did not differ significantly from that in the placebo group. Primary: There were no significant differences in psychometric tests between either dose of zolpidem modified release and placebo (P<0. Ease of falling asleep and sleep quality were significantly improved with both doses of zolpidem modified release and with flurazepam (all P<0. Neither zolpidem modified release nor flurazepam modified perception of well-being on awakening (P values not reported). Both groups experienced improvements in depression treatment remission and Page 35 of 76 Copyright 2012 · Review Completed on 09/02/2012 Therapeutic Class Review: sedative hypnotics Study and Drug Regimen Study Design and Demographics Sample Size and Study Duration End Points Results depression symptoms; however, these improvements were not significantly different between groups (P value not reported). Ratings of severity and mental illness by clinicians were comparable between the two groups throughout phase 2. The most frequently reported events among both treatment groups include headache, diarrhea, and nasopharyngitis. There were statistically significant differences between groups at one or both of the time points for three of seven items. By week six, there was a difference in favor of the placebo group that as also present at week eight. Laboratory values, vital signs, and physical examination findings revealed no meaningful changes or clinically relevant differences between groups. Results Secondary: At week four, scores for the Output Scale and the Time Management Scale were significantly lower than at baseline (P value not reported). No serious adverse events occurred and no subject discontinued the study due to an adverse event. Similar differences were demonstrated for sleep initiation parameters between zolpidem 5 mg and 10 mg sublingual tablets (7. There were no significant differences in the three sleep initiation parameters between zolpidem 5 mg and 10 mg sublingual tablets. There were no differences in sleep maintenance between zolpidem 5 mg and 10 mg Page 39 of 76 Copyright 2012 · Review Completed on 09/02/2012 Therapeutic Class Review: sedative hypnotics Study and Drug Regimen Study Design and Demographics Sample Size and Study Duration End Points sublingual tablets. There were no differences in sleep architecture between zolpidem 5 mg and 10 mg sublingual tablets. Vigilance, psychomotor performances, attention and concentration were comparable between treatments. The difference found for time spent in stage 2 reached statistical significance (P<0. There were no significant differences in the way patients rated their subjective feelings of alertness, contentedness and calmness on the visual analog scale. Both routes of administration were well tolerated with a similar overall incidence of adverse events. The most common adverse events with zolpidem sublingual were somnolence and dysgeusia. Nausea, dysgeusia, somnolence and dizziness were the most common adverse events with zolpidem. Primary: On weekly telephone interviews, patients reported taking 73 to 89% of the single nightly capsules each month while at home.

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Patients must have undergone lymph node dissection and, if indicated, radiotherapy within 13 weeks prior to starting treatment. Assessment of tumor status was performed at Week 6, Week 12, and then every 9 weeks thereafter. Patients were randomized (1:1) to one of the following treatment arms; all study medications were administered via intravenous infusion. Assessment of tumor status was performed every 6 weeks through Week 18, every 9 weeks through Week 45 and every 12 weeks thereafter. The study population characteristics were: median age of 63 years (range: 25 to 90), 45% age 65 or older; 71% male; 64% White, 30% Asian, and 2% Black. Patients with autoimmune disease; a medical condition that required immunosuppression; or who had received more than 30 Gy of thoracic radiation within the prior 26 weeks were ineligible. All patients had received prior therapy with a platinumdoublet regimen, 29% received two or more prior therapies for their metastatic disease. Treatment with pembrolizumab could be reinitiated for subsequent disease progression and administered for up to 1 additional year. Among the 28 responding patients, the median duration of response had not been reached (range: 2. Fifty-eight percent were refractory to the last prior therapy, including 35% with primary refractory disease and 14% whose disease was chemo-refractory to all prior regimens. Thirty-six percent had primary refractory disease, 49% had relapsed disease refractory to the last prior therapy, and 15% had untreated relapse. For the 24 responders, the median time to first objective response (complete or partial response) was 2. Tumor response assessments were performed at 9 weeks after the first dose, then every 6 weeks for the first year, and then every 12 weeks thereafter. The study population characteristics were: median age was 74 years, 77% were male, and 89% were White. Eighty-one percent had a primary tumor in the lower tract, and 19% of patients had a primary tumor in the upper tract. Eighty-five percent of patients had visceral metastases, including 21% with liver metastases. Ninety percent of patients were treatment naпve, and 10% received prior adjuvant or neoadjuvant platinum-based chemotherapy. The study population characteristics of these 110 patients were: median age 73 years, 68% male, and 87% White. Eighty-one percent had a primary tumor in the lower tract, and 18% of patients had a primary tumor in the upper tract. Seventy-six percent of patients had visceral metastases, including 11% with liver metastases. Ninety percent of patients were treatment naпve, and 10% received prior adjuvant or neoadjuvant platinumbased chemotherapy. The trial excluded patients with autoimmune disease or a medical condition that required immunosuppression. Assessment of tumor status was performed at 9 weeks after randomization, then every 6 weeks through the first year, followed by every 12 weeks thereafter. Eighty-seven percent of patients had visceral metastases, including 34% with liver metastases. Eighty-six percent had a primary tumor in the lower tract and 14% had a primary tumor in the upper tract. Fifteen percent of patients had disease progression following prior platinum-containing neoadjuvant or adjuvant chemotherapy. Twenty-one percent had received 2 or more prior systemic regimens in the metastatic setting. Patients with active autoimmune disease or a medical condition that required immunosuppression were ineligible across the five trials. Treatment continued until unacceptable toxicity or disease progression that was either symptomatic, rapidly progressive, required urgent intervention, or occurred with a decline in performance status. Ninety-eight percent of patients had metastatic disease and 2% had locally advanced, unresectable disease. The median number of prior therapies for metastatic or unresectable disease was two.

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Patients usually maintained on oral therapy may require temporary conversion to i. In addition, the medical and interventional treatments for more advanced cases are still invasive and prone to significant side effects. In any of these steps, the knowledge and experience of the responsible physician are critical to optimize the available resources. Physical activity and supervised rehabilitation Patients should be encouraged to be active within symptom limits. Mild breathlessness is acceptable but patients should avoid exertion that leads to severe breathlessness, exertional dizziness, or chest pain. A recent study has shown the value of a training programme in improving exercise performance. There is less consensus relating to the most appropriate methods of birth control. Diuretics Decompensated right heart failure leads to fluid retention, raised central venous pressure, hepatic congestion, ascites, and peripheral oedema. It is important to monitor renal function and blood biochemistry in patients to avoid hypokalaemia and the effects of decreased intravascular volume leading to pre-renal failure. The optimal dose varies between individual patients, ranging in the majority between 20 and 40 ng/kg/min. Guidelines for the prevention of central venous catheter bloodstream infections have recently been proposed. Treprostinil is a tricyclic benzidine analogue of epoprostenol, with sufficient chemical stability to be administered at ambient temperature. Infusion site pain was the most common adverse effect of treprostinil, leading to discontinuation of the treatment in 8% of cases on active drug and limiting dose increase in an additional proportion of patients. The optimal dose varies between individual patients, ranging in the majority between 20 and 80 ng/kg/min. Limiting factors for dose increase are usually systemic hypotension and lower limb peripheral oedema. This compound is the most potent endogenous inhibitor of platelet aggregation and it also appears to have both cytoprotective and antiproliferative activities. Epoprostenol (synthetic prostacyclin) is available as a stable freeze-dried preparation that needs to be dissolved in alkaline buffer for i. Epoprostenol has a short half-life (3­5 min) and is stable at room temperature for only 8 h. This explains why it needs to be administered continuously by means of an infusion pump and a permanent tunnelled catheter. The current approved dose is 5 mg once daily which can be increased to 10 mg once daily when the drug is tolerated at the initial dose. In a small group of patients in which treatment with either bosentan or sitaxentan was discontinued due to liver function test abnormalities, ambrisentan at a dose of 5 mg was well tolerated. An increased incidence of peripheral oedema has been reported with ambrisentan use. Sildenafil is an orally active, potent, and selective inhibitor of phosphodiesterase type-5. Tadalafil is a once-daily dispensed, selective phosphodiesterase type-5 inhibitor, currently approved for the treatment of erectile dysfunction. The most frequent adverse events were headache, flushing, jaw pain, and diarrhoea. Bosentan is an oral active dual endothelin-A and endothelin-B receptor antagonist and the first molecule of its class that was synthesized. For these reasons, liver function test should be performed monthly in patients receiving bosentan. Reductions on haemoglobin levels and impaired spermatogenesis have also been observed. A 1-year, open-label observational study has demonstrated the durability of the effects of sitaxentan over time. There were no significant differences in Borg dyspnoea index, functional class, and time to clinical worsening. The co-administration of both substances results in a decline of sildenafil plasma levels and in an increase in bosentan plasma levels.

References:

  • https://www.theacpa.org/wp-content/uploads/2019/02/ACPA_Resource_Guide_2019.pdf
  • https://www.msh.org/sites/default/files/mds3-jan2014.pdf
  • http://www.cpd.utoronto.ca/organimaging/files/2015/09/MIM1502S1-2709-1015-Machnowska-Head-and-Neck-Tumors.pdf
  • http://vlm.ub.ac.id/pluginfile.php/42642/mod_resource/content/1/Antigen%20dan%20Antibodi.pdf
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