Pituitary-adrenal axis in Prader Willi syndrome

Purpose: Prader Willi syndrome (PWS) is a rare genetic condition that has concurrent endocrinological insufficiencies. The presence of growth hormone deficiency has been well documented, but adrenal insufficiency (AI) is not widely reported. A review was conducted to investigate its prevalence and relevance in PWS in both adults and children. Methodology: A literature review was performed with the search terms “Prader-Willi syndrome” and “adrenal insufficiency”. Results: The review found studies disagree on the prevalence and method of investigation of AI in PWS. Case studies demonstrate that patients with PWS are at risk of premature death, often secondary to respiratory infections. The possibility that this may be the result of the inability to mount an effective cortisol response has been studied, with some evidence confirming AI in PWS patients. Most reports agreed AI is present in PWS, however, Farholt et al. showed no HPA axis dysfunction in adults, suggesting that perhaps it is rare in adults, and children should be the focus of further studies. Conclusion: AI is present in some patients with PWS. Further research is required to ensure optimal treatment can be implemented and to prevent premature deaths related to adrenal insufficiency. Clinicians should have a low threshold for testing the adrenal axis and considering treatment for adrenal insufficiency in PWS patients

Carbon-sulfur bond strength in methanesulfinate and benzenesulfinate ligands directs decomposition of Np(v) and Pu(v) coordination complexes.

Gas-phase coordination complexes of actinyl(v) cations, AnO2+, provide a basis to assess fundamental aspects of actinide chemistry. Electrospray ionization of solutions containing an actinyl cation and sulfonate anion CH3SO2- or C6H5SO2- generated complexes [(AnVO2)(CH3SO2)2]- or [(AnVO2)(C6H5SO2)2]- where An = Np or Pu. Collision induced dissociation resulted in C-S bond cleavage for methanesulfinate to yield [(AnVO2)(CH3SO2)(SO2)]-, whereas hydrolytic ligand elimination occurred for benzenesulfinate to yield [(AnVO2)(C6H5SO2)(OH)]-. These different fragmentation pathways are attributed to a stronger C6H5-SO2-versus CH3-SO2- bond, which was confirmed for both the bare and coordinating sulfinate anions by energies computed using a relativistic multireference perturbative approach (XMS-CASPT2 with spin-orbit coupling). The results demonstrate shutting off a ligand fragmentation channel by increasing the strength of a particular bond, here a sulfinate C-S bond. The [(AnVO2)(CH3SO2)(SO2)]- complexes produced by CID spontaneously react with O2 to eliminate SO2, yielding [(AnO2)(CH3SO2)(O2)]-, a process previously reported for An = U and found here for An = Np and Pu. Computations confirm that the O2/SO2 displacement reactions should be exothermic or thermoneutral for all three An, as was experimentally established. The computations furthermore reveal that the products are superoxides [(AnVO2)(CH3SO2)(O2)]- for An = Np and Pu, but peroxide [(UVIO2)(CH3SO2)(O2)]-. Distinctive reduction of O2- to O22- concomitant with oxidation of U(v) to U(vi) reflects the relatively higher stability of hexavalent uranium versus neptunium and plutonium

Polypharmacy And Fall Risk Education In Elderly Adults

The primary care office is often the setting for medication management and risk-reduction and PCPs frequently reconcile and manage the prescriptions of numerous specialists who see a patient separately. For patients \u3e65, one must consider the necessity of prescribed medications that may contribute to increased fall risk in this age group. Patients themselves may be uncertain of the types of medications they may be taking that potentially put them at increased risk for falls or adverse outcomes of falls. Thus, they may benefit from easily accessible educational materials on commonly-prescribed medications in these categories so that they may work with their physician to make informed decisions on their medication regimens.https://scholarworks.uvm.edu/fmclerk/1993/thumbnail.jp

Desain Sistem Penjualan Online Kaligrafi Berbasis Web pada Galeri Al-Wafa

Galeri Al-Wafa merupakan salah satu galeri yang bergerak dibidang penjualankaligrafi. Sistem penjualan yang ada di galeri ini masih dilakukan dengan cara pelanggandatang langsung ke galeri untuk melakukan transaksi, tentunya sistem penjualan yangseperti ini sangat kurang efektif. Selain itu, jangkauan pemasaran produk yang masihsempit dan kurangnya informasi kepada masyarakat luas, mengakibatkan tidak bisaberkembangnya galeri ini di lingkungan luar daerah.Dengan memanfaatkan penjualan online, Galeri Al-Wafa memberikankemudahan pada konsumen dalam memberikan informasi tentang barang yang akandibeli, kemudian konsumen dapat mencari informasi tentang semua produk yang ada,selain itu sistem penjualan ini juga dapat memperluas jangkauan pemasaran, karena dapatdi buka dimana saja oleh semua orang

Enhancement of Landfill Daily Cover in Minimizing the Migration of Heavy Metals in Landfill Leachate by Using Natural Soil, Pressmud Empty Fruit Bunch (EFB) in PulauBurung Landfill

This study emphasizes on the removal of heavy metals in landfill leachate by using natural soil mixed with agricultural wastes. The agricultural wastes used in this study werenatural soil or known as laterite soil, pressmud which is a waste from sugar refinery process and Empty Fruit Bunch (EFB), one of many forms of waste fromoil palm industry. The laterite soil was mixed with these wastes at different percentages of weight ratio namely 50S:40P:10E, 50S:30P:20E, 50S:25P:25E, 50S:10P:40E and 50S:20P:30E. The terms S, P and E each refers to soil, pressmud and empty fruit bunch respectively.Removal efficiency tests were also carried out and the results showed that the mixtures of laterite soil have the ability to remove concentrationsof As2+, Cd2+, Cr2+, Cu2+, Fe2+, Ni2+ and Zn2+between a range of 86% (minimum) and 99% (maximum) compared to removal via soil per se. Ergo, the laterite soil-pressmud-EFB mixtures signify great potential to be made as a daily cover material that minimizes heavy metals migration in landfill leachate, eliminates odor issues and providesadditional protection from further infiltration

COLLABORATIVE MULTI-LEVEL PLAN MONITORING

The recent worldwide connectivity and the net-centricity of military operations (coalition-based operations) are witnessing an increasing need for the monitoring of plan execution for enhanced resource management and decision making. Monitoring of ongoing operations is the process of continuous observation recording and reporting. In this process the plan becomes a resource that needs to be managed effi ciently. The centralized approach to plan monitoring soon reaches its limits when plan execution is distributed across different organizations/countries. We propose a new framework that would allow different monitoring nodes distributed across the network. An effi cient propagation mechanism that allows information exchange between the different nodes would also be needed. The main purpose of this mechanism is to present the right information, to the right person, at the right time. To cope with a rapid increase of information fl ow through the network, an effi cient alarm management mechanism allows the presentation of the information with an appropriate level of details

A Techno-economic Study of a Biomass Gasification Plant for the Production of Transport Biofuel for Small Communities

This is an open access article under the CC BY-NC-ND license. Link to publishers version:http://doi.org/10.1016/j.egypro.2017.03.1111A techno-economic feasibility study of liquid bio-fuel production from biomass to meet the demand for public transport in small communities is presented. The methodology adopted in this work is based on calculating the demand of fuels required by transport sector and then estimating the amount of available biomass from various sources which can be treated to produce biofuels to meet the demand within the region. Depending on demand and available biomass feedstock, size and type of the gasification plant are specified. Narvik, a town in the northern part of Norway, is considered as a case study. The current demand of diesel for public transport in Narvik was calculated. The main sources of biomass in the region under consideration come basically from forests and municipal solid waste. It was found out that the potential of producing biofuel is more than three times the fuel demand for public transport, which means that excess biofuel produced can be used in other sectors such as heating. A downdraft gasifier of 6.0 MW was considered adequate to produce the required amount of biofuel. Cost analysis was performed where capital cost, operational and maintenance (O&M) costs for the biomass pre-treatment processes, the gasification plant and the gas to liquid (GTL) plant were considered in the assessment. It was concluded that the payback period of the project could be achieved within four years. The study demonstrated that biomass gasification offers small communities a means to cover their energy demand for public transport using local biomass feedstock and fulfils environmental targets of the community

Theoretical studies of the phase transition in the anisotropic 2-D square spin lattice

The phase transition occurring in a square 2-D spin lattice governed by an anisotropic Heisenberg Hamiltonian has been studied according to two recently proposed methods. The first one, the Dressed Cluster Method, provides excellent evaluations of the cohesive energy, the discontinuity of its derivative around the critical (isotropic) value of the anisotropy parameter confirms the first-order character of the phase transition. Nevertheless the method introduces two distinct reference functions (either N\'eel or XY) which may in principle force the discontinuity. The Real Space Renormalization Group with Effective Interactions does not reach the same numerical accuracy but it does not introduce a reference function and the phase transition appears qualitatively as due to the existence of two domains, with specific fixed points. The method confirms the dependence of the spin gap on the anisotropy parameter occurring in the Heisenberg-Ising domain