Euglycemic diabetic ketoacidosis secondary to Sodium Glucose 2 Transport Inhibitor: a case report

The purpose of this case report is to highlight the emergence of a rare adverse drug reaction (ADR), euglycemic diabetic ketoacidosis (EDKA), associated with the use of sodium glucose transport 2 (SGLT2) inhibitors.EDKA is a rare and often misdiagnosed condition, due to the absence of hyperglycemia, but represents a life-threatening emergency. We present a unique case of a 35-year-old female patient with a past medical history of diabetes and recent diagnosis of Hashimoto’s thyroiditis. The primary objective is to provide valuable insights and education to the medical community regarding this infrequent yet significant complication. Ultimately, the goal is to enhance future patient care by improving awareness and promoting informed decision-making in EDKA cases involving SGLT2 inhibitors

Assessment and identification of concrete box-girder bridges properties using surrogate model calibration: case study: El Tablazo bridge

Dissertação de mestrado integrado em Engenharia CivilThis work consists in identifying and assessing the properties in a pre-stressed concrete bridge related to material, geometry and physic sources, through a surrogate model. The participation of this mathematical model allows to generate a relationship between bridge properties and its dynamic response, with the purpose of creating a tool to predict the analytical values of the studied properties from measured eigenfrequencies; in this case, it is introduced the identification of damage scenarios, giving the application for validate the generated metamodel (Artificial Neural Network - ANN). A FE model is developed to simulate the studied structure, a Colombian bridge called El Tablazo, one of the higher in the country of this type (box-girder bridge), with a total length of 560 meters, located on the Sogamoso riverbed in the region of Santander - Colombia. Once the damage scenarios are defined, this work allows to indicate the basis for futures plans of structural health monitoring.Este trabalho consiste em identificar e avaliar as propriedades de uma ponte em betão pré-esforçado em relação ao material, geometria e características físicas através de um metamodelo. A participação deste modelo matemático permite gerar uma relação entre as propriedades da ponte e sua resposta dinâmica, com o objetivo de criar uma ferramenta para prever os valores analíticos das propriedades estudadas a partir de frequências próprias medidas; neste caso, é introduzida a identificação de cenários de dano, dando uma aplicação para validar o metamodelo (Rede Neural Artificial - ANN). Um modelo de elemento finito é desenvolvido para simular a estrutura estudada, uma ponte colombiana chamada El Tablazo, uma das que apresenta maior altura do país em seu tipo (pontes em viga-caixão), com um comprimento total de 560 metros, localizada no rio Sogamoso, na região de Santander - Colômbia. Uma vez que os cenários de dano são definidos, a tese permite indicar a base para os planos futuros de monitoramento da saúde estrutural

Profiles in Parole Release and Revocation Nevada

Felony sentences in Nevada have both a minimum and a maximum term, unless a definite term is required by statute. In 2017, legislation was passed creating the Nevada Sentencing Commission. The Commission hasmany statutory duties, including formulating statutory sentencing guidelines to be enacted by the legislature. Nevada's first Pardons Board was created in 1867. The Board was granted the power to parole inmates in 1909. In 1989, Nevada passed legislation that required the Board to create standards for parole release and revocation.Nevada also signed justice reinvestment legislation in 2007, which increased incentives for parolees to comply with supervision and expanded alternatives to incarceration

Profiles in Parole Release and Revocation Maryland

The Maryland Parole Commission (MPC) was created in 1976 to replace the Board of Parole, which had been established in 1968. The first Advisory Board of Parole was founded in 1914. Maryland has had advisory sentencing guidelines since 1983. A sentence pronounced under the guidelines represents the maximum time an offender may serve and the parole commission then determines when an inmate will be considered for release

Profiles in Parole Release and Revocation Idaho

Idaho has had a parole release authority since 1899. Idaho's sentencing framework requires judges to impose a minimum length of incarceration in each felony case; judges may also impose a subsequent indeterminate term of incarceration, during which an inmate may be eligible for parole. Idaho law also imposes mandatory minimum sentences for some crimes. Idaho does not have a sentencing commission or sentencing guidelines

Profiles in Parole Release and Revocation Hawaii

Hawaii has an indeterminate sentencing system in which the sentencing court sets only the maximum, but not the minimum sentence to be served. The sentencing court chooses from only five possible maximum prison sentences when imposing a sentence (life without parole, life, 20 years, 10 years, or 5 years). While some paroling discretion has been curbed by mandatory minimum sentencing laws, in many cases the parole board still plays a large role in incarceration length. There is no sentencing commission or sentencing guidelines; and while there are no parole release guidelines, guidelines do play a role in setting the date of parole eligibility

Plume Diagnostics of the RSRM Static Firings for the Pressure Perturbation Studies

During the STS-54 launch (RSRM-29), the right hand solid rocket motor experienced a 13.9 psi chamber pressure perturbation at 67 seconds into the motor operation. This pressure augmentation equated to a thrust change of 51 klb. Concerns were raised regarding the adverse effects of this thrust imbalance on the shuttle system and the overall thrust into the external tank structural elements. Pressure perturbations have been observed in solid rocket motors due to expulsion of igniter or insulation materials; the motor thrust during such events drop abruptly before rising. However, the RSRM motors do not exhibit such behavior during the large chamber pressure perturbation events. Several scenarios were investigated to explain these pressure perturbations in the RSRM motors based on a fault tree developed after STS-54. Of these, the expulsion of the slag accumulated in the submerged nozzle region appeared to be the most plausible scenario to explain the observations. Slag is a natural combustion product of aluminized solid rocket motors. The RSRM propellant contains 16% by weight of aluminum. Any ejection of this slag mass during nozzle vectoring or other side loads on the motor will result in the chamber pressure perturbation. Two RSRM static firings were instrumented extensively to further understand the slag expulsion phenomenon in the RSRM and the associated pressure perturbations

Correlation of Slag Expulsion with Ballistic Anomalies in Shuttle Solid Rocket Motors

During the Shuttle launches, the solid rocket motors (SRM) occasionally experience pressure perturbations (8-13 psi) between 65-75 s into the motor burn time. The magnitudes of these perturbations are very small in comparison with the operating motor chamber pressure, which is over 600 psi during this time frame. These SRM pressure perturbations are believed to he caused primarily by the expulsion of slag (aluminum oxide). Two SRM static tests, TEM-11 and FSM-4, were instrumented extensively for the study of the phenomena associated with pressure perturbations. The test instrumentation used included nonintrusive optical and infrared diagnostics of the plume, such as high-speed photography, radiometers, and thermal image cameras. Results from all of these nonintrusive observations provide substantial circumstantial evidence to support the scenario that the pressure perturbation event in the Shuttle SRM is caused primarily by the expulsion of molten slag. In the static motor tests, the slag was also expelled preferentially near the bottom of the nozzle because of slag accumulation at the bottom of the aft end of the horizontally oriented motor