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The Regional office shall provide the Adoption Assistance Program Manager detailed information regarding; 1 pregnancy zone protein generic clomiphene 25mg online. The type of requested expense 6203 Special Service Payments A special service payment may be pre approved on a time-limited or one-time only basis at the request of the adoptive parents if the child has a specific need which cannot be met through the Medicaid program women's health clinic va boise best clomiphene 50 mg, the monthly subsidy payment or other resources and address the special needs of the child pregnancy 27 weeks generic clomiphene 25 mg with visa. The special service payment should not be used to meet the ordinary needs of a child, or if the expense to State adoption assistance funds exceeds $1000 or is expected to last more than 6 months. Specify and document the service and length of time the service shall be purchased, or the goods to be purchased. If a need is identified at a later date, a new agreement shall be developed and signed. Time Limited Services Time limited services may be approved by regional staff for a six month period. One-Time Only Purchases Unique one-time only purchases are limited to $1000 per child. Beds and chest of drawers for families who adopt three or more children and the child has not been placed with the adoptive family as a foster care placement; 2. Special equipment for children with handicaps or development disabilities not covered by other resources; 3. Home modifications to make the house handicapped accessible, or meet the special needs of the child, i. Factors to consider when negotiating the amount of subsidy include but are not limited to: 1. Special equipment or other non-medical supplies needed by the child not covered through other resources or Medicaid; 4. Number of children in the sibling group to be adopted (In certain situations where families are adopting large sibling groups, the added cost of food, clothing, and shelter may be taken into consideration when arriving at a subsidy amount); 6. The current rate is posted on the Social Security Administration web site at: Children may be eligible for one or more of the following types of adoption assistance: Medicaid, monthly subsidy payment, special subsidy payment, and non-recurring expenses. To be eligible for adoption assistance a child shall meet the following criteria: 1. Establishing the Child Cannot Return to the Parents There shall be a judicial determination that the child cannot or should not be returned to the home of the parents and it is not in the best interest of the child to be returned to the parents. Case records shall contain documentation stating why the child cannot return to his/her parents. Establishing the Special Needs of the Child the child shall have one or more specific factors or conditions, which limits their adoptability without adoption assistance. There shall be a linkage between the specific factor or condition and the type of subsidy needed to enable the adoptive family to meet the needs of the child. The following conditions are factors used to determine if the child has special needs requiring professional treatment on an ongoing basis, which may make it reasonable to conclude the child cannot be placed without cash subsidy or Medicaid services. Physical Disability 612 Printed Documentation the child has a medically diagnosed disability, which requires professional treatment, impairs normal functioning, or requires assistance in self-care or the purchase of special equipment. The disability is to be diagnosed by a physician, hospital, clinic or other licensed medical practitioner qualified to make disability determinations. Developmental Disability the child has significant developmental disabilities and/or delays with demonstrated need for intensive adult supervision beyond chronological age, determined through an evaluation by a licensed psychologist, diagnostic center, special education services, or other qualified professional individual. Diagnosis and prognosis shall be established by a licensed physician, psychologist or clinical social worker. The child, parents genetic, social, and health history shall be documented in the case record. Membership in a Sibling Group Placed Together the child is a member of a sibling group of two or more children placed for adoption together. For a sibling group of two, one of the siblings shall have one of the special needs factors or conditions listed above. Sibling groups of three or more placed together do not need to meet any other special needs criteria. A determination shall be made that reasonable but unsuccessful efforts were made to place the child without assistance. Efforts shall be made to place the child without assistance and documented in the case file. It shall be documented in the staffing report why the family is the most appropriate choice for the child. Children Who Are Not Eligible for either State or Federally Funded Adoption Assistance: 1. Children who have been placed by the court, adoption brokers, parents and other individuals; even if the child was previously in the custody of the Secretary. The following shall be considered when determining the funding source for Adoption Assistance: A. Child has attained age 2 by the end of the fiscal year in which their adoption assistance agreement started. If no, is the child a sibling of a child placed at the same time in the same adoptive placement who meets the age requirement? Maintenance Eligibility Maintenance eligibility should be determined when adoption assistance begins. If child is determined state maintenance eligible, no further redeterminations are necessary. When federal maintenance eligibility is determined, a redetermination is necessary at each yearly review and before the child turns 18. Convicted for child abuse or neglect, spousal abuse, crimes against children, including child pornography; or crimes involving violence, including rape, sexual assault or homicide; and In the past 5 years, convicted for physical assault, battery, or a drug related offense. Is the child of the minimum age for compulsory school attendance under state law and enrolled, and attending, school per law? If yes, or if child is under the minimum age for compulsory school attendance, child is federally funded. Does the youth have a documented physical or mental disability (documented by a physician, hospital, clinic, or other qualified medical practitioner)? Child Abuse and Neglect Registry checks for all family members 18 years or older done within the past year and if residing out of state for the last five years, child abuse registry checks in the state (s) where they resided 5. The family shall have face-to-face contact with the Adoption Assistance Specialist executing the agreements whenever possible. Adoption assistance is intended to encourage the adoption of special needs children and minimize the financial barriers. It is different from foster care, as it does not reimburse the family for the total costs for caring for the child. Families shall receive this type of information before they make a decision to adopt and before the adoption agreements are signed. Eligibility is based on the needs of the child and not the resources of the family. The agency shall not use any universal form of a means test or use any type of grid or scale to determine the amount of assistance. Send the Regional Adoption Specialist at least two weeks prior to the date planned to sign the Adoption Placement Agreement a.
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Items used by two or more Military Services of similar manufacture or fabrication that may vary between the Services as to breast cancer 2 cm lump 25 mg clomiphene sale color or shape (as vehicles or clothing) menstruation ovulation period buy generic clomiphene 50 mg. Any part or component that is required in the assembly of two or more complete end-items womens health group enfield ct order clomiphene 25 mg without prescription. In logistics, a part or combination of parts having a specific function, which can be installed or replaced only as an entity. Those variables of an operational environment or situation in which a unit, system, or individual is expected to operate and may affect performance. A physical or behavioral state of a system that is required for the achievement of an objective. Examples of conduits include: foreign intelligence and security services, intelligence collection platforms, open-source intelligence, news media- foreign and domestic. In land warfare, a point on the terrain, easily identifiable, where two or more units are required to make contact. In air operations, the position at which a mission leader makes radio contact with an air control agency. In personnel recovery, a location where isolated personnel can establish contact with recovery forces. The deposit, absorption, or adsorption of radioactive material, or of biological or chemical agents on or by structures, areas, personnel, or objects. Food and/or water made unfit for consumption by humans or animals because of the presence of environmental chemicals, radioactive elements, bacteria or organisms, the byproduct of the growth of bacteria or organisms, the decomposing material or waste in the food or water. A maritime zone adjacent to the territorial sea that may not extend beyond 24 nautical miles from the baselines from which the breadth of the territorial sea is measured. The zone of the ocean extending 3-12 nautical miles from the United States coastline. See also external support contract; systems support contract; theater support contract. See also combat engineering; contingency; crisis action planning; geospatial engineering. Authority that may be less than full command exercised by a commander over part of the activities of subordinate or other organizations. In mapping, charting, and photogrammetry, a collective term for a system of marks or objects on the Earth or on a map or a photograph, whose positions or elevations (or both) have been or will be determined. Physical or psychological pressures exerted with the intent to assure that an agent or group will respond as directed. An indicator governing the distribution and use of documents, information, or material. Information conveyed to an adversary in a deception operation to evoke desired appreciations. A position along a route of march at which men are stationed to give information and instructions for the regulation of supply or traffic. A position marked by coordinates (latitude, longitude), a buoy, boat, aircraft, electronic device, conspicuous terrain feature, or other identifiable object which is given a name or number and used as an aid to navigation or control of ships, boats, or aircraft. In marking mosaics, a point located by ground survey with which a corresponding point on a photograph is matched as a check. A number of merchant ships and/or naval auxiliaries usually escorted by warships and/or aircraft - or a single merchant ship or naval auxiliary under surface escort - assembled and organized for the purpose of passage together. A naval ship(s) or aircraft in company with a convoy and responsible for its protection. An escort to protect a convoy of vehicles from being scattered, destroyed, or captured. Cooperative security locations provide contingency access, logistic support, and rotational use by operating forces and are a focal point for security cooperation activities. Counterdeception does not include the intelligence function of identifying foreign deception operations. Counterintelligence operational tasking authority is exercised through supporting components. Counterintelligence production is used in formulating security policy, plans, and operations. A product of the course-of-action development step of the joint operation planning process. In amphibious usage, fire delivered prior to the landing to cover preparatory operations such as underwater demolition or mine countermeasures. A force operating apart from the main force for the purpose of intercepting, engaging, delaying, disorganizing, and deceiving the enemy before the enemy can attack the force covered. Any body or detachment of troops which provides security for a larger force by observation, reconnaissance, attack, or defense, or by any combination of these methods. An element of an entity or object that enables it to perform its primary function. An element of a target, which if effectively engaged, will serve to support the achievement of an operational objective and/or mission task. Equivalent military specialties are those engaged in operational art in order to attain strategic goals in an operational area through the design, organization, and conduct of campaigns and major operations. The responsibility for the control of, transfer and movement of, access to, and maintenance of accountability for weapons and components. A determination of the effect of a compromise of classified information on national security. A basic unit of information built on standard structures having a unique meaning and distinct units or values. In electronic recordkeeping, a combination of characters or bytes referring to one separate item of information, such as name, address, or age. A reference surface consisting of five quantities: the latitude and longitude of an initial point, the azimuth of a line from that point, and the parameters of the reference ellipsoid. Activities and resources used to convey or deny selected information to a foreign power. Military material resources and their associated operating techniques used to convey or deny selected information to a foreign power. Resources, methods, and techniques to convey or deny oral, pictorial, documentary, or other physical evidence to a foreign power. United States Coast Guard - the light displays clearance for a helicopter to conduct a given evolution. In naval mine warfare, a minefield laid in international waters or international straits with the declared intention of controlling shipping in defense of sea communications. In land mine warfare, a minefield laid in accordance with an established plan to prevent a penetration between positions and to strengthen the defense of the positions themselves. Protection from hostile observation and fire provided by an obstacle such as a hill, ridge, or bank. To shield from enemy fire or observation by using natural or artificial obstacles. The Adaptive Planning and Execution system process involving the development of joint operation plans for contingencies identified in joint strategic planning documents. A planning process for the deployment and employment of apportioned forces and resources that occurs in response to a hypothetical situation.
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A death women's health issues depression generic 100mg clomiphene with amex, near death breast cancer 7mm buy clomiphene without prescription, attempted suicide women's health center rome ga buy clomiphene 50mg mastercard, or serious physical injury involving a child with an open service or foster care case, or a child is named in an open investigation or family assessment; 2. A death, near death, or serious physical injury of a child when child abuse or neglect is suspected; 3. The Critical Incident Review and Assessment process consists of the following parts: 1. When the Secretary has entered into a contract or memorandum of agreement or understanding the terms are binding on the entire agency. This requires communication among the various divisions, regions, contract agencies and individuals. Use of the courts to settle internal disputes diminishes, and perhaps destroys our ability to carry out our responsibility as an equal branch of government. The Family Based Assessment includes questions regarding substance use disorders to assist staff in determining the need for further screening and assessment services. Families with available insurance coverage should seek services first through the process established by that company. Addiction and Prevention Services provides funding for an array of programs across the state including these specialized services: 1. Social Detoxification for customers under the influence of drugs or alcohol or experiencing acute withdrawal. Residential and outpatient programs for pregnant women and women with dependent children. Work Program Services (job training, job search and related employment assistance) 6. Description of Penalties Penalties are utilized only when customers have clearly chosen not to cooperate and the consequences are understood. Consult the Rehabilitation Services Manual for information about eligibility and services. Coordinate the inclusion of Kansas Rehabilitation Services in the case conferences of potentially eligible youth, as needed. Home and Community Based Services include a variety of medical and non-medical services which meet the needs of those served by the waiver. For types of waivers, eligibility requirements and application information, see waiver overview chart at. These programs are intended to provide active treatment in a structured therapeutic environment for children and youth with significant functional impairments resulting from an identified mental health diagnosis, substance use diagnosis, sexual abuse disorders, and/or mental health diagnosis with co-occurring disorder. The residential treatment facility is expected to work actively with the family and other agencies to offer strengths-based, culturally competent, trauma-informed, medically appropriate treatment designed to meet the individual needs of the residents. It encourages parents and other care givers to obtain periodic well-child visits to the doctor for their children, thereby keeping immunizations up to date and treating medical conditions when they first appear. It promotes good health by identifying and treating medical, dental, developmental and emotional conditions. To participate in the program a child must have a health screening performed by their primary care provider (family practice physician, pediatrician, or the Health Department). Health screenings are required for children to be participants in the Kan Be Healthy Program and eligible to receive expanded services. The screenings are at specific intervals, which consist of, but not limited to a health history, developmental assessment, complete physical exam, vision screening, hearing test, urinalysis, blood test, immunizations, other tests as needed, and referrals for treatment. Refer to Kansas Department of Health and Environment/ Division of Health Care Finance website for more details). Orthodontia Services Orthodontia may be a Medicaid covered expense if deemed medically necessary. Medical Services through Public Schools Certain services provided by the school districts in Kansas are covered by Medicaid. These services are not available to those children who are home schooled or attend privately funded schools. There may be program limitation on the type, style and frequency of equipment provided. Investigation of Abuse/Neglect: Conduct investigations and make findings on alleged abuse and neglect of adjudicated juvenile offenders. The Indian Child Welfare Act supersedes the Multi-Ethnic Placement Act/Interethnic Adoption Provisions. If the child is of Native American and is a member of a federally recognized tribe or is eligible for membership in an Indian tribe and is the biological child of a member of an Indian tribe, the Indian Child Welfare Act controls. If the tribe has elected not to intervene in the child in need of care case, the agency is responsible to follow the placement preference as articulated in the Indian Child Welfare Act. Should a child or youth need to be placed in out of home care, the order of placement preference for Native American Children is as follows: A. Definitions: An Indian is any person who is a member of an Indian tribe, or who is an Alaska Native and a member of a Regional Corporation. An Indian child is any unmarried person under age 18, and either a member of an Indian tribe or the biological child of a member and eligible for membership. An Indian custodian is any Indian person who has legal custody of an Indian child under tribal law, custom or state law. Race or color or national origin may not be used as the basis for any denial of placement, nor may such factors be used as a reason to delay or deny any foster or adoptive placement. Kansas is required to provide for the diligent recruitment of potential foster and adoptive families that reflect the ethnic and racial diversity of children in the state for whom foster and adoptive homes are needed. It is the policy of the Department not to delay the placement of any child for adoption or foster care based on race, color or national origin of the adoptive parent, foster parent, or the child. The Department will not deny any person the opportunity to become an adoptive or foster parent on the basis of race, color or national origin. The Indian Child Welfare Act supersedes the Multi-Ethnic Placement Act/Interethnic Placement Act. If the identity or location of the parent or Indian custodian and the tribe cannot be determined, a letter shall be sent to the Secretary of Interior requesting assistance. The following tribes have reservations located within Kansas borders: the Iowa Tribe of Kansas and Nebraska, Sac and Fox Tribe of Missouri in Kansas, Prairie Band of Pottawatomi and Kickapoo. All Kansas tribes have agreed to assist with identifying Indian children and their tribal affiliation. When completing an assessment involving an Indian family, the family shall be informed that they may request an Indian interpreter. Assessment of the family must take into account the prevailing social and cultural conditions and way of life of the Indian community. If an out-of-home placement or loss of parental custody is being considered, the requirements of the Indian Child Welfare Act apply.
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When environmental conditions are favorable womens health 2014 beauty awards buy clomiphene discount, bacteria propagate and secrete polysaccharides to women's health center hudson ny cheap clomiphene online the extracellular environment pregnancy x medications clomiphene 25mg online. These polysaccharides form a slime, which is a loose amorphous material composed of a range of low and high molecular weight polymers associated in large part through ionic interactions. Extracellular polysaccharide is an important factor in the development and persistence of biomaterial-centered infections. This complex exopolysccaride is believed to act as an ion-exchange resin for enhanced nutrition, to interfere with phagocytosis, to influence response to antibodies, and to function in later stages of surface adhesion, aggregation, and polymicrobial interaction. Micro-organisms in colonies on surfaces form layers two to hundreds of organisms thick composed of cellular material, extracellular polysaccharides, environmental adsorbates, and debris. The biofilm mode of growth offers enhanced protection against natural host defenses and antibiotic therapy. Further, the microzones, metal ions required by pathogenic bacteria are not lost by diffusion and may be shielded from host protein-binding complexes. When environmental conditions become unfavorable, some bacteria detach and swim away to find a new surface in a more favorable environment. To avoid these complications, the design of many implants requires, in addition to general biocompatibility, that a sector of the prosthesis or artificial organ be colonized by host cells to provide secure fixation or integration. From a biomaterials point of view, the scaffolds are synthesized from materials that support the growth of cells and that are biodegradable. The scaffold can also be formulated to contain bioactive agents for more rapid tissue growth or compatibility. Regenerated tissues outside the body are also useful in toxicology tests, and understanding the progression of a pathological condition that is not clearly understood. Scaffolds of required shape are generated, which guide and support the in-growth of cells. While cells grow and synthesize their own matrix at the site of grafting or in vitro, the scaffold will degrade leaving only the necessary healthy tissue in a topologically required form. In many applications, where tissue functionality is critical, developing tissues outside the body via cell colonization prior to transplantation is the preferred modus operandi. For example, porous leaky materials cannot be grafted without cell colonization in the cardiovascular systems. The absence of cellular components typically leads to blood clotting, an overgrowth of cells that clog blood flow, and to the subsequent failure of the graft. If liver has to be replaced, the replaced tissue should have the ability to provide critical metabolic functions. For cells to colonize the scaffolds successfully, various molecular events have to be carefully programmed to regulate cellular bioactivity such as adhesion, spreading, migration, proliferation, and functionality, which are discussed in Chapter 7. Here, the importance of scaffold characteristics and processing techniques are discussed. Further, the degradation products define the biocompatibility of the material used, not necessarily the material itself. Scaffolds generated from natural and synthetic polymers or biological materials from xenogeneic sources have been used. The batch-to-batch variation in the properties of nature of biological materials limits the wide spread usage in clinical settings. Thus, synthesizing scaffolds using various polymer processing techniques (described in Section 6. The general criteria for selecting polymers are to match the mechanical properties and the time of degradation to the needs of the application. Synthetic and natural polymer-based scaffolds have been formed and used with and without prior cell-seeded configurations. Ideally, tissue engineering scaffolds should meet at least the following requirements: 1. Polymer and its degraded products should not either show cytotoxicity or initiate inflammation. The processing of material into a 3D scaffold should allow the formation of required pore sizes and pore orientations and should be reproducible. Scaffold should provide a mechanical property similar to the native tissue to be replaced. The scaffold should have interconnected open pores and high porosity to provide adequate space for cellular proliferation, transport of nutrients/ metabolic waste and de novo deposition of the matrix components. Scaffold should resorb gradually and should be replaced by cells and cellular components completely without leaving any material at the end of the tissue growth. Degradation rate should be amendable so that cell growth kinetics and biomaterial degradation rate can be synchronized to ensure no space restriction due to slower degradation or the loss of structural support due to faster degradation. However, formed degradation products are relatively strong acids, which raise concerns about possible inflammation; also, the scaffold microenvironment may not be ideal for tissue growth. Further, scaffolds may show structural instability due to swelling during degradation. Synthetic polymers do not possess a surface chemistry that is familiar to cells. Hence, many synthetic polymers lack biological activity suitable for cell colonization. A number of new materials are developed by abstracting good design from the natural world. Synthetic poly(amino acids) were developed, however, high crystallinity makes them difficult to process and results in relatively slow degradation. Further, concerns related to immune response towards polymers with more than three amino acids in the chain also makes them inappropriate for tissue regeneration. Modified "pseudo" poly(amino acids) have been synthesized by using a tyrosine derivative. Tyrosine-derived polycarbonates are high-strength materials that may be useful as orthopedic implants. Other natural polymers such as alginates, chitosan, and their various combinations have also been used as scaffolding materials. However, weak mechanical strength, inadequate tailorability options in altering mechanical and degradation properties limit their usage. Blending both synthetic and natural polymers is also an option to obtain polymers with tailorable mechanical and biological properties. Unlike prosthetic materials, these porous materials require a different set of processing conditions. Many cells are unable to completely colonize scaffolds with pore sizes larger than 300 m due to the difficulty in crossing large bridging distances. In addition to pore size, the topography of scaffold surfaces influences spreading characteristics and activity of cells. Scaffold formation techniques can be grouped into two categories: additive processes and subtractive processes. Additive processes include self-assembled monolayer techniques and free form fabrication where matrices are assembled using fundamental building blocks.
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If a phimotic prepuce is forcibly retracted over the glans penis menstruation euphemisms discount clomiphene 25mg fast delivery, a condition called paraphimosis may develop womens health quarterly exit christina diet secret articles buy clomiphene 50 mg visa. This condition is extremely painful and may cause obstruction of the urinary tract or blood flow menopause nutrition buy clomiphene 25mg line, which may lead to necrosis of the penis. Genital malformations may cause an abnormal location of the urethral opening, either on the ventral surface of the penis (hypospadias) or the dorsal surface (epispadias). Hypospadias is the result of failure of the urethral folds to close, while epispadias is the result of faulty positioning of the genital tubercle. This 399 400 Pathology type of invasion is in contrast to squamous cell carcinomas, which invade tissue as finger-like projections of atypical squamous epithelial cells. It is present in up to 1% of males after puberty and is unilateral in the majority of cases. The interstitial cells are usually prominent and occasional focal proliferations of Sertoli cells may be seen. The incidence of malignancy is increased 7- to 11-fold, and this risk is greater for abdominal than for inguinal locations. There is a smaller but definite risk of malignancy in the contralateral, correctly placed testis. Transillumination is helpful in differentiating between cysts (which transilluminate) and tumors (which do not). Examples of the latter include germ cell tumors and the adenomatoid tumor, a benign form of mesothelioma that histologically is composed of glandlike or slitlike spaces. Recall that the processus vaginalis is an outpouching of the peritoneum that enters into the scrotum. When the testis reaches the scrotum, the proximal portion of the processus vaginalis obliterates, but the distal portion persists and does not fuse. Examples of cysts that involve this tunica vaginalis include hydroceles, hematoceles, chyloceles, and spermatoceles. Hydroceles contain clear fluid and result from developmental abnormalities or inflammatory processes. Hematoceles result from hemorrhage into a hydrocele, while chyloceles result from the accumulation of lymph fluid within the tunica as a result of elephantiasis. Spermatoceles refer to cystic enlargements of the efferent ducts or the rete testis with numerous spermatocytes present. Seminomas typically spread via lymphatics after having remained localized for a long time. Embryonal carcinoma, choriocarcinoma, and mixed tumors with an element of choriocarcinoma tend to metastasize early via the blood. It may be secreted by either yolk sac tumors (endodermal sinus tumors) or embryonal carcinomas. Markedly elevated serum levels are most often associated with choriocarcinomas, which are characterized histologically by a mixture of malignant cytotrophoblasts and syncytiotrophoblasts. This is found in about 10% of classic seminomas, which are characterized histologically by large cells with distinct cell membranes and clear cytoplasm. It is characterized by being found in older individuals and by the fact that it does not metastasize. Histologically, a spermatocytic seminoma is characterized by maturation of the tumor cells, some of which histologically resemble secondary spermatocytes. But there are many areas of overlap between tumors, and many tumors are composed of multiple types of germ cell cancers. Patients with acute prostatitis present with the sudden onset of fever, chills, and dysuria. Acute prostatitis is usually caused by bacteria that cause urinary tract infections, such as Escherichia coli. Chronic prostatitis presents clinically as low back pain, dysuria, and suprapubic discomfort. Instead, chronic abacterial prostatitis is associated with infections with either Chlamydia trachomatis or Ureaplasma urealyticum. Histologically, the hyperplastic nodules are composed of a variable mixture of hyperplastic glands and hyperplastic stromal cells. Urinary obstruction results because the inner, periurethral portions of the prostate (the middle and lateral lobes) are affected most commonly. Histologically, these malignant glands are composed of a single layer of cuboidal epithelial cells, as the outer basal layer of epithelial cells, seen in normal and hyperplastic glands, is not present. Most adenocarcino- Reproductive Systems Answers 403 mas of the prostate originate in the peripheral zone, while hyperplastic nodules originate in the transition zone. This anatomic differentiation is the result of the physiologic fact that the transition zone is particularly estrogen-sensitive, while the peripheral zone is particularly androgensensitive. The mesonephric ducts in males, if stimulated by testosterone secreted by the Leydig cells, develop into the vas deferens, epididymis, and seminal vesicles. In contrast, because normal females do not secrete testosterone, the Wolffian ducts regress and form vestigial structures. They may, however, form mesonephric cysts in the cervix or vulva, or they may form Gartner duct cysts in the vagina. The cranial group of mesonephric tubules (the epoophoron) remains as vestigial structures in the broad ligament above the ovary, while the caudal group of mesonephric tubules (the paroophoron) forms vestigial structures in the broad ligament beside the ovary. The lower portion of the vagina and the vestibule develop from the urogenital sinus. The metanephric duct in both sexes forms the ureter, renal pelvis, calyces, and renal collecting tubules. Uterine agenesis may result from abnormal development or fusion of these paired paramesonephric ducts. Retarded growth of one of the paramesonephric ducts along with incomplete fusion to the other paramesonephric ducts results in the formation of a bicornuate uterus with a rudimentary horn. If these are obstructed, a cyst may form that is usually lined with transitional epithelium. Cysts derived from the same Wolffian duct may also be found on the lateral aspect of the vulva and are called mesonephric cysts. Obstruction of the ducts of the mucous glands in the endocervix may result in small mucous (Nabothian) cysts. These cysts, which contain white, cheesy material, are called keratinous (epithelial inclusion) cysts.
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Natural selection is the process that occurs in nature whereby strong and well-adapted plants survive while weak and poorly adapted plants eventually die out women's health issues in japan clomiphene 25 mg with amex. This process has taken place since the beginning of life on earth and it is still occurring in nature pregnancy 4 weeks 5 days buy generic clomiphene 100 mg online. Artificial selection is the process that humans use to women's health center wooster ohio order clomiphene 100mg line obtain more desirable types of plants. Thousands of years ago people learned that saving seed from the kind of plant they wanted to continue growing would increase the chances of getting a plant similar to the original. But enough is known so that we can select plants for breeding with considerably more assurance of success than our ancestors did. It is advisable to check for this before breeding, for although barriers can be overcome, some plants cannot be artificially pollinated. An example of a barrier that cannot be overcome is the selfpollination prohibitor of some orchids; the stigmas of certain orchids produce a substance, which kills the pollen of flowers of the same plant. In choosing a pollen parent (male parent), select one that has a heavy yellow powder on the anther. It should have either a glistening substance on it that is sticky to the touch or a "hairy" surface. It is this substance or surface that retains the pollen, thus making fertilization possible. Once the seed parents and pollen have been selected, you are ready to begin pollination. Hybridization the equipment required for plant breeding is relatively inexpensive and easy to use. Here are some useful items: n n n n n n n n n n n Magnifying glass (10 or 15 power) Tweezers Small sharp-pointed scissors Camel-hair brush Small containers or vials Alcohol Rubber bands or soft wire Paper or cellophane bags Paper clips Tags Notebook the first step is to mark those flowers that are to serve as pollen parents and those that are to serve as seed parents. This can be done with colored thread, one color for the male and another color for the female. Or paper labels can be used, covered with varnish to protect them from the weather. If the plant is to be cross-pollinated, the stamens will have to be removed to prevent the possibility of self-pollination or selfing. Emasculation can be accomplished by: (1) pinching off the stamens or anthers with tweezers, or (2) snipping off the stamens or anthers with sharp-pointed scissors, or (3) removing the petals to which the stamens are sometimes attached. Protecting the Plant from External Influence Both the seed and pollen parents should be protected from contamination by foreign pollen. This can be done by one of the following methods: Closing the flower In many flowers, such as morning-glories, petunias, and lilies, the petals can be closed around the floral organs with a piece of soft wire, string, or rubber band. The flower shown here is a perfect flower; that is, it has male and female reproductive organs. Or, if you wish to observe the flower at all times, you can cover it with a cellophane bag. If the stamens are too small or too difficult to grasp, you can cross-pollinate by transferring the pollen from the anthers with a brush into a container and then brushing the pollen on to the stigma. Shake the bagged pollen parent so that the pollen is collected in the bag that is covering it for protection. Remove the protector from the seed parent and place the bag containing the pollen over the seed parent and shake the bag so that pollen falls on the stigmatic surfaces. Each time you use different pollen, be sure to first wash with alcohol the camelhair brush, tweezers, and any other item that might have touched some pollen. This step is very important to prevent pollination of the seed parent with unwanted pollen that has adhered to the equipment. Selfing Procedures for self-pollinating flowers will depend on the type of flower. For perfect flowers, your job is done once you have closed or covered the flower, although shaking the flower once a day for several days after the pollen develops can help the pollen land on the stigma. Only those composite flowers containing both disc and ray florets can be self-pollinated. Since they have both pistils and stamens, they can be selfed in the same way as perfect flowers. In selfing imperfect flowers, the pollen from the staminate flower must be transferred to the stigma of the pistillate flower on the same plant. Write on the label in the following order: (a) the number that you have assigned or the variety name of the seed parent; (b) the letter X; (c) the number or variety name of the pollen parent; and (d) the date of the cross was made (Figure 13. Once the seed parent is labeled, the next step is to record the cross or self in a notebook. The recorded information should contain all essential facts regarding the cross or self so that you can refer to it at a later time and even do the job again from the beginning, if necessary. An easy way to keep track of the offspring is to assign consecutive numbers to each generation resulting from each crossing or selfing. Collection of Seeds the protector or the bag cover used to avoid unwanted pollens, can be used to collect the seeds if the seeds are very small. Screening Collected seeds are screened for the desired characters by generating seedlings. The new progeny crossed with the parental varieties until the desired characteristic that is present in one of the parents is achieved. The genetical, morphological, and biochemical methods can be adopted to evaluate the plant for stabilization of the desired characteristic. Hybrid Vigor the progenies produced by crossing two known, but different varieties of parents will perform better than both the parents. This phenomenon shown by the hybrid organisms is known as heterosis or hybrid vigor. Lots of crop plants and horticultural plants including the garden plants are exploiting this phenomenon of hybrid vigor. In practice, we humans actually share this characteristic with many long-lived organisms who delay first births. In short, it is not terribly convenient to perform experimental crosses if one has to wait 15 years between generations. However, for humans, one also has to add that our system of morality uniquely does not allow such experimentation on humans. This is an unfortunate state of affairs since there is no other organism for which practical knowledge of their genetics would be more useful, especially in the case of the genetics of heritable diseases. It has been found that human genetics may readily be inferred so long as good records have been kept within large families. In this section we will discuss many aspects of human genetics, in particular considering strategies of pedigree analysis whereby we will attempt to infer the genetics of human conditions based on knowledge of marriage (mating) and affliction in large extended families.
- Oligodactyly tetramelia postaxial
- Craniodiaphyseal dysplasia
- Septooptic dysplasia digital anomalies
- Visceral steatosis
- Hoyeraal Hreidarsson syndrome
- Thiele syndrome
- Larsen syndrome, dominant type
- Pai Levkoff syndrome
- Aarskog Ose Pande syndrome
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Transfer of genes from certain sources menopause sweating order 50 mg clomiphene visa, which is considered forbidden by certain religious groups breast cancer 4th stage symptoms buy clomiphene 100 mg amex, to pregnancy uterus size best clomiphene 50 mg food animals they normally use. Yeast is also used as a host organism to produce recombinant human proteins of therapeutic value. The spent recombinant yeast cells may be used as the component of the animal feed. Based on the above concerns and objections it was recommended by the concerned authorities to adopt some precautions or to discourage the use of transgenic organisms as food, when the normal foods with the same nutritive value are available. Food materials containing the foreign genes have to be properly labeled with all details such as the type of gene, its protein, and the source organism, so that people will have the choice of avoiding foods containing genes from the unethical sources according to their religious practices and beliefs. The advances made in cell-culture and tissue-culture technology could replace the animal models for specific experiments related to drug development and drug metabolism. This has resulted in substantial reduction in the use of different types of animals for studying cancer biology and other aspects of genetics and metabolism. But transgenic animals created for special purposes like production of vaccines or some other proteins or enzymes, which are normally not present in their system, may adversely affect the normal behavior and health of the organism. Considering these facts, there is severe moral opposition against the creation of transgenic animals as it may result in the suffering of animals. For example, there is a report that when animals were treated with transgenic growth hormones that enhance meat quality, they developed acute arthritis. All genetic engineering studies whether it involves animals, plants, or microbes should consider and evaluate the potential risk of its misuse or accidental faults and errors directly to humans, other animals, and also to the environment in a very systematic way. All the experiments and development of transgenic animals or gene therapy or cell culture should meet certain basic safety measures in the laboratory as well as with the organisms to minimize possible risk factors. Transgenic animals may escape into the environment and breed with the wild types, which can result in the transfer of that gene into other populations. Public concern over the possible risk to humans and other animals due to the consumption of genetically-modified food materials. Application of drug-resistant genes as markers of genetic transformation is a usual practice in genetic engineering. Uncontrolled production of disease-resistant organisms, both animals and plants, can create an imbalance in nature due to the destruction of other organisms. At times of scarcity of healthy human organs or tissue for transplantation, it is recommended to use the tissues and organs from suitable compatible animals such as pigs. This method of transplantation of organs or tissue grafting from animals is called xenotransplantation. It also poses concerns about the possible infection through the organs and tissues if the animals are infected or have disease in the dormant form. But, the use of healthy animals without any type of infections or diseases can solve this problem to a greater extent. Human blood, blood products, body fluids, and tissues are listed as potentially hazardous biological materials. Biosafety practices and procedures must be followed when handling human blood, blood products, body fluids, and tissues because of the infectious agents they may contain. Biosafety practices and procedures are consistent with the concept of "Universal Precautions," which requires all specimens of human blood, blood products, body fluids, and tissues to be treated as if they are infectious. Occupational exposure to blood-borne pathogens mandates a combination of work-practice controls and training for laboratory employees to prevent infection by pathogens and other risks. Vaccination against known pathogens such as hepatitis B has to be carried out among laboratory employees. They should be given proper information about the scientific facts related to the so-called danger and moral ethics in the practice of some of the techniques of modern biotechnology. It is very essential for the expansion and commercial application of biotechnology. What are the major ethical and moral issues related to animal cell culture and its various applications? What are the types of fermentors used for the large-scale cultivation of animal cells for industrial purposes? Certain therapeutic proteins, even though they are direct gene products, cannot be produced in. What are the difficulties and how can they interfere with the viability of the preserved cells? So far, these have included the harnessing of hydro, tidal, wave and wind power, the capture of solar and geothermal energy supplies, and nuclear power. There is now a growing appreciation of biological solar energy systems and biotechnological advances in this area will soon bring economic reality to selected processes. There are three main directions that can be followed to achieve biomass supplies: (1) cultivation of so-called energy crops, (2) harvesting of natural vegetation, and (3) utilization of agricultural and other organic wastes. The conversion of the resulting biomass to usable fuels can be accomplished by either biological or chemical means or by a combination of both. The two main end products that will be formed, will be either methane or ethanol although other products may arise depending on initial biomass and the processes utilized, for example, solid fuels, hydrogen, low-energy gases, methanol and longer-chain hydrocarbons. In some parts of the world, such as Brazil and countries of similar climatic conditions, biomass will surely attain wider exploitation and utilization. There may still be some disadvantages when comparing it with coal or oil, but the very fact that it is renewable and they are not must spur further research. In time, biomass will become much more easily available and economically useful as a source of energy for mankind. Conventional agriculture may not be able to provide sufficient supply of food and, in particular, protein. Today, new agricultural practices are widespread, high-protein cereals have been developed, the cultivation of soybeans and groundnuts is ever expanding, and so on. The use of microbes as protein producers has also gained wide experimental success. Some of the reasons include: (1) microorganisms can grow at remarkably rapid rates under optimum conditions (some microbes can double their mass every 0. Growth in human populations has generally been matched by a greater formation of a wider range of waste products, many of which cause serious environmental pollution if allowed to accumulate in the ecosystem. In rural communities, recycling of human, animal, and vegetable waste has been practiced for centuries, providing in many cases valuable fertilizers or fuel. In urban communities where most of the deleterious wastes accumulate, efficient waste collection and specific treatment processes have been developed because it is impractical to discharge high volumes of waste into natural land and waters. The development of these practices in the last century was one of the main reasons for the spectacular improvement in health and well being of humans. Mainly by empirical means, a variety of biological treatment systems have been developed, ranging from cesspits, septic tanks, and sewage farms to gravel beds, percolating filters, and activated sludge processes coupled with anaerobic digestion. The primary aim of all of these systems or biotreaters is to alleviate health hazards and to reduce the amount of oxidizable organic compounds and thus produce a final effluent or outflow, which can be discharged into the natural environment without producing any adverse affect. Bioreactors rely on the metabolic versatility of mixed microbial populations for their efficiency.
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A 67-year-old male long-term smoker presents with weight loss pregnancy gender quiz purchase clomiphene online from canada, a persistent cough women's health clinic savannah ga discount clomiphene 100 mg overnight delivery, fever women's health clinic san diego 100mg clomiphene for sale, chest pain, and hemoptysis. Physical examination reveals a cachectic male with clubbing of his fingers and dullness to percussion over his right lower lobe. Histologic examination of a transbronchial biopsy specimen reveals infiltrating groups of cells with scant cytoplasm. The nuclei of these cells are about twice the size of normal lymphocytes and do not appear to have nucleoli. Adenocarcinoma Hamartoma Large cell undifferentiated carcinoma Small cell undifferentiated carcinoma Squamous cell carcinoma 256. Bronchioloalveolar carcinoma Carcinoid Large cell carcinoma Small cell carcinoma Squamous cell carcinoma Respiratory System 275 257. Which one of the listed abnormalities is an example of a type of pleural effusion that is better classified as an exudate (inflammatory edema) rather than a transudate? A 19-year-old female presents with sudden, severe right-sided chest pain that developed shortly after she had been placing heavy boxes on shelves in her garage. Breath sounds are markedly decreased on the right, and the right lung is hyperresonant to percussion. Pneumoconiosis Pneumocystis infection Bacterial pneumonia Viral pneumonia Pneumothorax 276 Pathology 259. A 57-year-old male presents with a lesion similar to that seen in this gross photograph of a sagittal section of the lung. Which one of the listed characteristics, if present in this lesion, would favor the diagnosis of mesothelioma? Pulmonary edema can be classified based on the etiology into cardiogenic pulmonary edema and noncardiogenic pulmonary edema. Cardiogenic pulmonary edema results from abnormalities of hemodynamic (Starling) forces, while noncardiogenic pulmonary edema results from cellular injury. Causes of cardiogenic pulmonary edema include increased hydrostatic forces, as seen with congestive heart failure (the most common cause of pulmonary edema); decreased oncotic pressure, such as resulting from decreased albumin levels; and lymphatic obstruction. Noncardiogenic edema may be the result of either endothelial injury (infections, disseminated intravascular coagulopathy, or trauma) or alveolar injury (from inhaled toxins, aspiration, drowning, or near drowning). Microscopically, pulmonary edema reveals the alveoli to be filled with pale pink fluid. Cardiogenic edema may lead to alveolar hemorrhages and hemosiderin-laden macrophages (heart failure cells). Where cardiogenic edema is present, chest x-rays show an increase in the caliber of the blood vessels in the upper lobes, perivascular and peribronchial fluid ("cuffing"), and Kerley B lines (fluid in the interlobular septa). Absorptive (obstructive) atelectasis results from airway obstruction, such as occurs with mucus, tumors, or foreign bodies. The air within the lungs distal to the obstruction is absorbed, the lung collapses, and the mediastinum then shifts toward the collapsed lung. In contraction, atelectasis fibrosis causes collapse 277 278 Pathology of lung tissue. Patchy atelectasis may result from loss of pulmonary surfactant, which is seen in hyaline membrane disease of the newborn. In the acute edematous stage, the lungs are congested (pulmonary congestion) and show pulmonary edema with interstitial inflammation. In contrast, angioinvasive infiltrates of pleomorphic lymphoid cells are seen with lymphomatoid granulomatosis, a disease of middle-aged individuals that is characterized by an angiocentric and angioinvasive infiltrate of atypical lymphoid cells. Deposits of needle-like crystals from the membranes of eosinophils, called Charcot-Leyden crystals, can be seen in patients with asthma, while infiltrating groups of malignant cells having intercellular bridges characterize squamous cell carcinoma. Plexiform lesions within pulmonary arterioles are diagnostic of pulmonary hypertension. Pulmonary emboli are common and are found in about 10 to 20% of hospital autopsies. Typical settings for the development of deep vein thrombosis include increased venous stasis and hypercoagulable states, such as after surgery. Pulmonary emboli may produce other clinical Respiratory System Answers 279 symptoms, such as anxiety, pleuritic chest pain, dyspnea, fever, cough, hemoptysis, or sudden death. Hypoxemia results from increased A-a gradients, the result of increased alveolar dead space. The majority of pulmonary thromboemboli do no harm and eventually organize or lyse; however, depending on the size of the embolus and the hemodynamic status of the patient, a pulmonary infarct may be produced. Pulmonary infarcts grossly have an apex pointing toward the occluded vessel and a pyramidal base extending toward the pleural surface. Elevation of the mean pulmonary arterial pressure is the result of endothelial dysfunction and vascular changes. The main arteries have atheromas that are similar to systemic atherosclerosis, but are not as severe. Smaller arteries and arterioles show intimal thickening, medial hypertrophy, and reduplication of the internal and external elastic membranes. A distinctive arteriolar change, a plexiform lesion, consists of intraluminal angiomatous tufts that form webs. Secondary sclerosis may occur at any age, and symptoms depend on the underlying cause. Possible causes include certain types of heart disease, such as mitral valve disease, left ventricular failure, and congenital valvular disease with left-to-right shunt, as well as certain types of pulmonary disease, such as chronic obstructive or interstitial lung disease and recurrent pulmonary emboli. Pulmonary hypertension is also associated with diet pills (Redux and Fen-Phen), while "exotic" causes include Crotalaria spectabilis ("bush tea") and adulterated olive oil. Asthma, bronchiectasis, and chronic bronchitis affect primarily the bronchus, while emphysema affects primarily the aci- 280 Pathology nus. Asthma is a pulmonary disease that is caused by excessive bronchoconstriction secondary to airways that are hyperreactive to numerous stimuli. The extrinsic category includes atopic (allergic) asthma, occupational asthma, and allergic bronchopulmonary aspergillosis. The former is related to respiratory tract infections, while the latter is often related to aspirin sensitivity. In these patients the aspirin initiates an asthmatic attack by inhibiting the cyclooxygenase pathway of arachidonic acid metabolism without affecting the lipoxygenase pathway. This causes the relative excess production of the leukotrienes, which are bronchoconstrictors. The normal respiratory lobule is composed of three to five terminal bronchioles and their acini, which in turn are composed of a respiratory bronchiole, alveolar ducts, alveolar sacs, and alveoli. Emphysema may affect the proximal acinus (centrilobular emphysema), the distal acinus (paraseptal emphysema), or the entire acinus (panlobular emphysema).
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This dual-coverage scheme appears intended to pregnancy test order clomiphene cheap online recognize the separation of governmental authorities mensural notation order clomiphene canada. The lack of integration among stormwater permits and the absence of objective measures of compliance that are quantifiable is a glaring shortcoming in current stormwater permits and renders them difficult to womens health evanston buy clomiphene overnight delivery enforce for water quality protection. It also addresses a significant shortcoming of the current scheme, that is, failure to recognize the enormous staff resources that it would take at the federal and state level for successful implementation in the absence of the leadership of local governments. The criteria by which the outputs of the industries are judged could be either water quality- or technology-based criteria. If put in this position, municipalities will make intelligent choices and adopt effective strategies to identify which industries and sources to focus upon. The devolution of this responsibility to the municipality is sensible because the municipality, as the land-use authority, already conducts development review and issues industrial conditional-use permits. In addition, the permitting authority would inspect municipal facilities such as airports, ports, landfills, and waste storage facilities to avoid the situation of self-inspection. Methods for ranking industries according to risk are discussed in a subsequent section. This "pass through" of pollutants impacts the surrounding environment, occasionally causing fish kills or other detrimental alterations of the receiving waters. Through this guidance, the pretreatment program has maintained national consistency in interpretation of the regulations. Unlike other environmental programs that rely on federal or state governments to implement and enforce specific requirements, the Pretreatment Program places the majority of the responsibility on local municipalities. However, their lack of specific pollutant limitations creates the need for additional controls, namely categorical pretreatment standards and local limits. For example, the pretreatment standard for the electrical and electronic component manufacturing industry (40 C. Part 469, Subparts A-D) are concentration-based daily maximum and monthly average limits that vary by subpart and pollutant parameter. Local Limits Prohibited discharge standards are designed to protect against pass-through and interference generally. The net effect of this alternative is to pool the resources to come up with an optimal sampling strategy to replace what is now a stormwater monitoring strategy that is haphazard and not useful. It is thus expected to be more difficult to identify problem stormwater sources and to hold them accountable for discharges in excess of standards. There are few barriers to including water quality considerations in reauthorizing these connections and adding new ones. They would substantively improve the current industrial stormwater permitting program even if the integration recommendations were not acted upon. It is important that the permitting authority designate the basis for the determination of the water quality design storm, and explicitly state that it would form the criteria for evaluation of compliance with technology-based standards or water qualitybased standards. This is essential because the engineering design decisions that determine how much stormwater is to be treated to remove toxic pollutants that pose a risk to human health or aquatic life is more a policy matter than a scientific one (Schiff et al. Conceivably, unlike the technology limiting design storms that are set on rainfall recurrence intervals, the design storm to protect surface water quality and beneficial uses could be different for different eco-regions of the United States. Whereas flood control engineers design conveyance systems with return frequencies of two years (streets), ten years (detention basins), 50 years, and 100 years (channels), the water quality design storm event is for a return frequency of six months to a year. The water quality design implicitly focuses on treating the first flush of runoff, which contains the highest load and concentration of pollutants and which occurs in the first half to one inch of runoff. The water quality design storm and the best available technologies with their associated criteria can then form a basis for technology-based effluent limitations to be included in industrial stormwater permits. If the facility operator elects the identified presumptive technology, then compliance monitoring requirements can be scaled down to a minimum to ensure that the treatment systems are being properly maintained. In such a scheme, visual monitoring will serve to ensure that the treatment systems are being properly maintained, and compliance can be reported using the same procedures as required presently for the industrial wastewater permits. How to Identify a High-Risk Industry Both the watershed-based permitting approach described previously in this chapter and the integration approach call for municipal permittees, as part of their responsibilities, to identify high-risk industrial stormwater dischargers. This involves identifying the potential sources of concern, evaluating the extent of their potential impacts, and then prioritizing them for attention-a classic risk assessment. Municipalities would generally not be able to give equal and full attention to all sources, nor should they. Two methodologies for identifying industrial and commercial facilities that are considered high-risk for discharging pollutants in stormwater are presented below. Box 6-6 describes the "intensity of industrial activity" method devised for the City of Jacksonville (Duke, 2007). This method uses telephone queries and a point scale system to visually score each facility based on the intensity of the industrial activities exposed to stormwater, and groups the results into categories A, B, C, or D in increasing order of intensity (Cross and Duke, 2008). The categories are designed to distinguish high-risk facilities from low-risk facilities, and not to make fine distinctions among facilities with similar characteristics. This typology is sufficient to distinguish facilities with little or no potential for discharging pollutants associated with stormwater from facilities that might discharge those pollutants. Box 6-7 outlines an empirical methodology used by the County of Los Angeles to rank the risk of industrial facilities for stormwater pollution on the basis of pollution potential P. The pollution potential P was computed as a product of the number of on-site sources, percent imperviousness, pollutant toxicity, degree of exposure, and the number of facilities (Los Angeles County, 2001). Based on this ranking scheme, five top high-risk industries were selected: (1) automobile dismantlers, (2) automobile repair, (3) metal fabrication, (4) motor freight, and (5) automobile dealers. However, the monitoring was minimal, and so much of the prioritization was based on best professional judgment about pollutant discharges. Many industrial facilities reported repeated exceedances of benchmark values without action, and others have failed to report any monitoring data at all. In addition, the representativeness of single grab samples taken to characterize the discharge and less-thanrigorous sample collection and quality assurance procedures have resulted in monitoring data that are not very useful. The study showed no relationship between facility type and stormwater discharge quality. The cited reasons for the poor relationship included variability in sampling parameters, sampling time, and sampling strategy-that is, poor data. Duke (2007) proposed a 0- to 8-point scoring scheme (shown below) to rate the intensity of industrial activities exposed to stormwater. The system is based on the relative amount of exposure to precipitation and runoff by industrial materials, processes, wastes, and vehicles. Once municipalities gather the data and then classify their industries accordingly, they would have a very useful tool to program inspections and monitoring emphasizing the industries most risking their success in achieving established objectives. The initial list of candidate facilities was identified from their relative numbers and the extent of their outdoor activities. This list was then refined using an empirical equation for pollutant potential P: P=QxRxTxExN where Loading (Q) is the number of sources at a site and the likelihood of release; Imperviousness (R) of a site is the percent of paved area; Pollutant toxicity (T) denotes the number of toxic pollutants and the inherent toxicity of the mix; An exposure factor (E) signifies if activities are exposed to rainfall; and the Number (N) represents the total number of sites in the county. Each variable was assigned a qualitative number from 1 to 10, with 10 representing the worst condition.
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The process by which the Armed Forces of the United States or part of them are brought to womens health 5k buy clomiphene without prescription a state of readiness for war or other national emergency women's health big book of yoga pdf download discount 50 mg clomiphene with mastercard, whichincludes activating all or part of the Reserve Component as well as assembling and organizing personnel menopause 60 years buy genuine clomiphene line, supplies, and materiel. All preparations made in anticipation of an operation, including assembly in the mounting area, preparation and maintenance within the mounting area, movement to loading points, and subsequent embarkation into ships, craft, or aircraft if applicable. See also line of communications; movement control teams; non-unit cargo; non-unit-related personnel. Including the Maritime Administration Ready Reserve Force, a fleet composed of ships acquired and maintained by the Maritime Administration for use in mobilization or emergency. A defense posture capable of successfully resisting hostile or destructive action from within or without, overt or covert. The National Security Agency/Central Security Service representative serves as a special advisor to the combatant commander for cryptologic matters, to include signals intelligence, communications security, and computer security. See also logistic support; naval forward logistic site; support; theater of operations. A naval action (or the performance of a naval mission) that may be strategic, operational, tactical, logistic, or training. The process of carrying on or training for naval combat in order to gain the objectives of any battle or campaign. The actual weight in pounds of explosive mixtures or compounds, including the trinitrotoluene equivalent of energetic material, that is used in determination of explosive limits and explosive quantity data arcs. Remotely controlled, interconnected, weapons system designed to provide rapidly emplaced ground-based countermobility and protection capability through scalable application of lethal and nonlethal means. To render enemy personnel or materiel incapable of interfering with a particular operation. A location in a mobility system where a movement requirement is originated, processed for onward movement, or terminated. In communications and computer systems, the physical location that provides terminating, switching, and gateway access services to support information exchange. United States citizens who may be ordered to evacuate by competent authority, and who are civilian employees of all agencies of the United States Government and their dependents, excepting dependents who are residents in the country concerned of their own volition; military personnel of the Armed Forces of the United States specifically designated for evacuation as noncombatants; and dependents of members of the Armed Forces of the United States. United States citizens and nonUnited States citizens who may be authorized or assisted to evacuate by competent authority, and who are civilian employees of United States Government agencies and their dependents who are residents in the country concerned of their own volition, but express the willingness to be evacuated; private United States citizens and their dependents; military personnel of the Armed Forces of the United States and their dependents; and designated personnel, including dependents of persons ordered to evacuate, as prescribed by the Department of State. The clearly defined, decisive, and attainable goal toward which every operation is directed. The two types of offensive counterintelligence operations are double agent operation and controlled source operation. When underway, the officer designated by the commanding officer to be in charge of the ship, including its safe and proper operation. When in port or at anchor, the officer of the deck is designated by the command duty officer, has similar responsibilities, and may be enlisted. See also amphibious bulk liquid transfer system; offshore petroleum discharge system. A term used to signify that a prearranged concentration, air strike, or final protective fire may be called for. Preplanned, identified force or materiel requirements without designated time-phase and destination information. An individual in the immediate vicinity of an isolating event who temporarily assumes command of the incident. The federal officer designated to direct federal crisis and consequence management efforts at the scene of a terrorist or weapons of mass destruction incident. A military action or the carrying out of a strategic, operational, tactical, service, training, or administrative military mission. See also amphibious objective area; area of operations; area of responsibility; joint operations area; joint special operations area; theater of operations; theater of war. See also combatant command; combatant command (command authority); tactical control. Any plan for the conduct of military operations prepared in response to actual and potential contingencies. A complete and detailed joint plan containing a full description of the concept of operations, all annexes applicable to the plan, and a time-phased force and deployment data. See also operations security indicators; operations security measures; operations security planning guidance; operations security vulnerability. A procedure by which the number of United States Government personnel, their dependents, or both are reduced at a foreign service post. Mandatory departure of some or all categories of personnel and dependents to designated safe havens as directed by the Department of State, with the implementation of the theater evacuation plan. See also civilian internee; custody; detainee; prisoner of war; retained personnel. Large items of specific equipment such as a barge, side loadable warping tug, causeway section, powered, or causeway section, nonpowered that require transport by sea. Air cargo exceeding the usable dimension of a 463L pallet loaded to the design height of 96 inches, but equal to or less than 1,000 inches in length, 117 inches in width, and 105 inches in height. Overt information may be collected by observation, elicitation, or from knowledgeable human sources. Supplies are sufficient for a short-term deployment but do not include all material needed for every maintenance task. A mine whose anticountermining device has been operated preventing the firing mechanism from being actuated. Functions include medical regulating, patient evacuation, and en route medical care. Term used to represent any theater, joint or the Global Patient Movement Requirements Center function. See also combat search and rescue; evasion; personnel; recovery; search and rescue. That part of security concerned with physical measures designed to safeguard personnel; to prevent unauthorized access to equipment, installations, material, and documents; and to safeguard them against espionage, sabotage, damage, and theft. In communications security, the component that results from all physical measures necessary to safeguard classified equipment, material, and documents from access thereto or observation thereof by unauthorized persons. A command-unique four-digit number followed by a suffix indicating the Joint Strategic Capabilities Plan year for which the plan is written. A five-digit number representing the command-unique four-digit identifier, followed by a one-character, alphabetic suffix indicating the operation plan option, or a one-digit number numeric value indicating the Joint Strategic Capabilities Plan year for which the plan is written. In land mine warfare, a mine whose fuse responds to the direct pressure of a target. In naval mine warfare, a mine whose circuit responds to the hydrodynamic pressure field of a target. See also information requirements; intelligence; intelligence process; intelligence requirement.