Drum-Boiler Dynamics

This paper describes a nonlinear dynamic model for natural circulation drum-boilers. The nonlinear model which is intended for model based control focuses on the complicated dynamics ofthe drum, downcomer, and riser components. A strong effort has been made to strike a balance between fidelity and simplicity. The model is derived from first principles, and is characterized by a few physical parameters. Results from validation of the model against unique plant data are presented. The model captures the shrink and swell effect very well. It also describes the behavior of the system over a wide operating range

Older adults with disability in extreme poverty in Peru: How is their access to health care?

Background Disability rates increase with age. In 2012, Peruvian older adults ( 65 years) represented 9% of the population. Additionally, older population reported disabilities at about 5 times the rate of Peruvians between 36 and 64 years old, and 30% of older population lived in poverty. Peruvian seniors living in extreme poverty experience disabilities and the extent of their access to healthcare is unknown. Objective This study assesses associations between disability and access to healthcare among Peruvians older individuals living in extreme poverty. Methods Secondary analysis of a national representative population based survey that utilizes information from Peru’s 2012 survey Health and Wellbeing in Older Adults (ESBAM), which includes older adults living in extreme poverty. We define disability in terms of the Activities of Daily Living (ADL disability) framework. Healthcare access was assessed as having any of Peru’s available health insurance schemes combined with preventive health services (vision assessment, influenza vaccination, blood pressure assessment, diabetes screening, and cholesterol assessment). Poisson robust regression models were used to evaluate the associations among relevant variables. Prevalence Ratios and 95% confidence intervals (95%CI) were reported. Results Data from 3869 individuals (65 to 80 years old), of whom 1760 (45.5%) were females, were analyzed. The prevalence of ADL disability was 17.3% (95%CI: 16.0%-18.4%). In addition, more than 60% had never received any of the preventive measures evaluated, except for the blood pressure assessment. In the adjusted model, people with ADL disability had 63% less probability of having extensive insurance, compared to those without disability (p<0.05). Conclusions This study shows that this Peruvian older population living in extreme poverty has limited access to healthcare services. Although there was no consistent association between ADL disability and the healthcare access, there is an urgent need to reduce the inequitable access to healthcare of this poor Peruvian older population.Wellcome TrustRevisión por pare

Secondary membranous nephropathy associated with guillain-barré syndrome.

Membranous nephropathy (MN) is one of the most common causes of nephrotic syndrome (NS) in adults. It may be primary, usually mediated by IgG4 anti-phospholipase A2 autoantibodies or secondary to various other conditions. Guillain- Barré syndrome (GBS) has been associated with MN, but a cause and effect relation has not been proven. We present a case of concurrent development of GBS and severe NS, with renal biopsy demonstrating MN. IgG4 stain was negative, indicating that most likely, the MN was secondary and probably caused by the underlying GBS

Cerebral Arteriovenous Malformations: Evaluation and Management.

There has been increased detection of incidental AVMs as result of the frequent use of advanced imaging techniques. The natural history of AVM is poorly understood and its management is controversial. This review provides an overview of the epidemiology, pathophysiology, natural history, clinical presentation, diagnosis, and management of AVMs. The authors discussed the imaging techniques available for detecting AVMs with regard to the advantages and disadvantages of each imaging modality. Furthermore, this review paper discusses the factors that must be considered for the most appropriate management strategy (based on the current evidence in the literature) and the risks and benefits of each management option

Biology and Biological Control of Exotic True Thistles

“Thistle” is an old English name for a large variety of weedy, prickly plants that grow throughout the world. The most notable characteristics of thistles are the prickly stems and leaves and the bracts around the flower head. While many different plants have “thistle” in their common name, only certain plant species fit the taxonomic requirements of being considered “true thistles.” True thistle species fall within the family Asteraceae, the tribe Cardueae, and the subtribe Carduinae. Examples of plants that are not true thistles include yellow starthistle (subtribe Centaureinae), sow thistle (subtribe Sonchinae), and Russian thistle (family Chenopodiaceae). Only true thistles in the subtribe Carduinae are discussed in this manual

Biology and Biological Control of Exotic True Thistles

“Thistle” is an old English name for a large variety of weedy, prickly plants that grow throughout the world. The most notable characteristics of thistles are the prickly stems and leaves and the bracts around the flower head. While many different plants have “thistle” in their common name, only certain plant species fit the taxonomic requirements of being considered “true thistles.” True thistle species fall within the family Asteraceae, the tribe Cardueae, and the subtribe Carduinae. Examples of plants that are not true thistles include yellow starthistle (subtribe Centaureinae), sow thistle (subtribe Sonchinae), and Russian thistle (family Chenopodiaceae). Only true thistles in the subtribe Carduinae are discussed in this manual

Sacred communities: contestations and connections

This article discusses a project whose purpose was to review existing qualitative and quantitative data from two separate studies to provide new insights about everyday religion and belonging. Researchers engaged in knowledge exchange and dialogue with new and former research participants, with other researchers involved in similar research, and with wider academic networks beyond the core disciplines represented here, principally anthropology and geography. Key concluding themes related to the ambivalent nature of ‘faith’, connections over place and time, and the contested nature of community. Implicit in terms like ‘faith’, ‘community’, and ‘life course’ are larger interwoven narratives of space, time, place, corporeality, and emotion. The authors found that understanding how places, communities, and faiths differ and intersect requires an understanding of social relatedness and boundaries

Novel partial anomalous pulmonary venous connection associated with brain abscess.

BACKGROUND: Right-to-left vascular shunts are associated with brain abscess. CASE REPORT: We present a 47-year-old female with a cryptogenic left thalamic abscess on which Streptococcus mitis grew upon aspiration. Computed tomography of the chest with contrast agent revealed an anomalous connection between the left superior pulmonary and brachiocephalic veins. A right-to-left shunt was confirmed in a transthoracic echocardiogram study in which bubbles were injected into the left arm; this shunt had not previously been noted upon right-arm injection. CONCLUSIONS: We recommend aggressive evaluation for right-to-left shunts in patients who present with cryptogenic brain abscesses. In addition to imaging, this should include a bubble-based study with left-arm saline injection