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I. Narkam, M.A., M.D., M.P.H.

Co-Director, University of Puerto Rico School of Medicine

Maintenance Required: No maintenance is required during storage Sizes Available: One size fits all. Independent Testing: Edgewood Chemical Biological Center Test Conducted: Air-Permeable Charcoal Impregnated Suits to Challenge by Chemical and Biological Warfare Agents and Simulants Test Dates: September 2002 Material Technology: the Lanx Chemical Protective Boot Liner is an air permeable, vapor protective boot liner for wear beneath shoes and duty boots. Design 1-flat sock with one seam running from front to back (beneath the sole of the foot). Design 2-sock with a sole and Velcro closures which open at the top and run down to the ankle. Stretchable fabric so half-sizes not needed; stretchable fabric contends with width variation. All goods received that are damaged or out of specification will be replaced at no charge if manufacturer is at fault. The foot form ("last") used to build these boots has been optimized for comfort and fit. Innersole system: Next to your foot, a medium density footbed further cushions impact and creates a rebound effect to return walking energy. Lightweight, up to 20 % lighter than standard rubber fire boots, the boot "The Boss" Ultimate Fit provides superior protection in a compact design. The 36 data fields are comprised of data fields from the market survey vendor questionnaire requesting information about their protective gloves. All data fields were developed using input from the emergency responder community. General Product Information Product information, including name, model, and/or stock number, is used to identify the protective gloves. The stock and/or model number indicates the number(s) that are used to uniquely identify the item. It should include the stock identification or national stock number, if the item has one. Traditional hazardous materials response gloves are constructed from nonpermeable barrier films, membranes or rubber materials. Military chemical protective gloves couple inner adsorptive carbon layers with liquid resistant outer shell textiles. The data field also includes whether the glove is in stock or if it is manufactured on demand. References must be verified with consent from the users before including the contact information. Attributes may include textured gripping, rounded fingertips, and comparable performance under wet and dry conditions. These tests are based on a set performance reduction compared to bare hand control. It is assumed that the thickness of the glove material will influence this criterion. Shelf life for sealed packages under normal storage conditions can typically be 5 yr, 10 yr, or as long as 15 yr. In some cases, gloves are stored in extraordinary storage conditions, which could shorten the shelf life. Shelf life for gloves removed from their package (to be carried by the user) would likely be shorter than those remaining in the package.

This means software can read them; but if software writes to them, only all zeros is allowed. The second capability permits a machine-check exception handler written to run on a Pentium processor to be run on a Pentium 4, Intel Xeon, Intel Atom, or P6 family processor. There is a limitation in that information returned by the Pentium 4, Intel Xeon, Intel Atom, and P6 family processors is encoded differently than information returned by the Pentium processor. In earlier Intel processors, cache status was based on the number of correction events that occurred in a cache. A processor that supports enhanced cache error reporting contains hardware that tracks the operating status of certain caches and provides an indicator of their "health". The hardware reports a "green" status when the number of lines that incur repeated corrections is at or below a pre-defined threshold, and a "yellow" status when the number of affected lines exceeds the threshold. Yellow status means that the cache reporting the event is operating correctly, but you should schedule the system for servicing within a few weeks. Intel recommends that you rely on this mechanism for structures supported by threshold-base error reporting. An uncorrected error means that a serious error has actually occurred, whereas the yellow condition is a warning that the number of affected lines has exceeded the threshold but is not, in itself, a serious event: the error was corrected and system state was not compromised. Such a failure can occur and cause an uncorrected error before the yellow threshold is reached. However, the chance of an uncorrected error increases as the number of affected lines increases. It provides capabilities beyond those of threshold-based error reporting (Section 15. To detect the existence of thresholding for a given bank, software writes only bits 14:0 with the threshold value. The initialization of per-thread data structure must be done serially on each logical processor in the system. The sequencing order to start the per-thread initialization between different logical processor is arbitrary. Increase the threshold to a value below the maximum value discovered using step a. Ownership is determined at initialization time which is described in Section [Cross Reference to 14. This allow system software to perform recovery action on certain class of uncorrected errors and continue execution. When this bit is clear, this indicates that there is no support for error recovery from the processor and the primary responsibility of the machine check handler is logging the machine check error information and shutting down the system. This recovery action must be completed successfully before any additional work is scheduled for this processor. System software recovery action is optional and not required to continue execution from this machine check exception. Table 15-7 lists overwrite rules for uncorrected errors, corrected errors, and uncorrected recoverable errors. This pseudocode checks for the existence of the machine-check architecture and exception; it then enables machine-check exception and the error-reporting register banks. The pseudocode shown is compatible with the Pentium 4, Intel Xeon, Intel Atom, P6 family, and Pentium processors. These sub-fields describe the type of access, level in the cache hierarchy, and type of request. The name is constructed by substituting mnemonics for the sub-field names given within curly braces. For more information on the "Form" and "Interpretation" columns, see Sections Section 15. Filtering means that some or all of the subsequent corrections to this entry (in this structure) will not be posted. The enhanced error reporting introduced with the Intel Core Duo processors is based on tracking the lines affected by repeated corrections (see Section 15. Only the first few correction events for a line are posted; subsequent redundant correction events to the same line are not posted.

Cervix moves significantly more than previously thought during radiation for cancer. Impact of improved irradiation technique, age, and lymph node sampling on the severe complication rate of surgically staged endometrial cancer patients: a multivariate analysis. Prospective clinical trial of positron emission tomography/computed tomography image-guided intensity-modulated radiation therapy for cervical carcinoma with positive para-aortic lymph nodes. Consensus guidelines for delineation of clinical target volume for intensity-modulated pelvic radiotherapy for the definitive treatment of cervix cancer. Pelvic external beam photon radiation therapy (alone) is considered medically necessary for either of the following: A. Postoperative pelvic external beam photon radiation therapy and brachytherapy are considered medically necessary for any of the following: A. Para-aortic lymph node radiation treatment with pelvic external beam photon radiation therapy with or without brachytherapy is considered medically necessary for either of the following: A. Tumor directed radiation therapy is considered medically necessary for any of the following: A. The treatment options for treatment of cancer of the endometrium are defined by stage of disease, grade of the cancer, completeness of surgical staging and the presence of adverse risk factors. In advanced disease, the increased utilization of adjuvant chemotherapy has called into question the magnitude of the added benefit of adjuvant radiation therapy. We are awaiting the results of some recent trials that may help to answer some of these questions. For all other stages and those with positive radiologic imaging, surgical restaging or pathologic confirmation of more advanced disease is recommended (image directed biopsy). Brachytherapy should be initiated as soon as the vaginal cuff has healed or no later than 12 weeks following surgery a. The use of chemotherapy and radiation treatment in the management of endometrial cancer either concurrently or sequentially remains for the most part the object of clinical study and investigation B. If imaging results are negative, they should be treated according to their assigned stage. If positive or suspicious, however, an attempt should be made to either restage surgically or document the presence of metastatic disease. Individuals who have been surgically restaged should be treated according to their appropriate new Stage and findings. Postoperative external irradiation and prognostic parameters in stage I endometrial carcinoma: clinical and histiopathologic study of 540 patients. Randomized Trial of Radiation Therapy With or Without Chemotherapy for Endometrial Cancer Leiden University Medical Center. Postoperative pelvic intensity-modulated radiotherapy in high risk endometrial cancer Gynecol Oncol. American Brachytherapy Society survey regarding practice patterns of postoperative irradiation for endometrial cancer: current status of vaginal brachytherapy. Vaginal brachytherapy alone is sufficient adjuvant treatment of surgical stage I endometrial cancer. Two hundred and thirty-six (236) patients with T1-4, N0-1 squamous cell carcinoma or adenocarcinoma were randomized to 50. For example, in the treatment of esophageal carcinoma, several studies have confirmed an association between cardiac dose and toxicity. Symptomatic toxicity was not observed if the whole heart V20, V30 and V40 was kept below 70%, 65% or 60%, respectively. Effect of concurrent radiation therapy and chemotherapy on pulmonary function in patients with esophageal cancer: dose-volume histogram analysis. Combined chemotherapy and radiotherapy compared with radiotherapy alone in patients with cancer of the esophagus. Propensity score-based comparison of long-term outcomes with 3-dimensional conformal radiotherapy vs. Survival after neoadjuvant chemotherapy or chemoradiotherapy for resectable oesophageal carcinoma: an updated meta-analysis.

Therefore the ecology of each species needs to be understood in order to identify those that are most vulnerable (Chessman, 2011). Spring rainfall is not expected to change, while winter rainfall is expected to decrease slightly. Despite projected increases in rainfall in summer and autumn, soil conditions are likely to be drier for most of the year, particularly in spring and winter, as a result of increased temperatures and evaporation Average annual run-off will likely increase slightly as a result of substantial increases in summer run-off. Substantial increases in run-off depths and the magnitude of high flows are very likely in summer. A moderate decrease in run-off depths is likely in spring Short-term hydrological droughts are likely to become more severe Flooding behaviour is likely to change. The combination of rising sea levels and catchmentdriven flooding is likely to increase flood frequency, height and extent in the lower portions of coastal floodplains. Increases in the intensity of flood-producing rainfall events are likely to change flood behaviour everywhere, but catchment conditions at the time of each rainfall 52 event (soil moisture conditions and levels in major water storages) will affect the degree of change. Higher summer rainfall and rainfall intensity in the region are also likely to increase sheet and rill erosion on the steeper slopes of the hinterland. Sediment inundation of coastal and hinterland floodplains is likely where major erosion occurs. Higher temperatures, altered fire regimes and altered hydrology (with wetter summers and drier winters) are likely to bring about changes to many ecosystems including changes to structure, species composition and species abundances. Ecosystems most at risk include high-altitude and firesensitive species, wetlands and those ecosystems which have a reduced resilience to disturbance due to fragmentation or isolation. Iridovirus in chelonians can be a highly fatal disease with upper respiratory, oral, and skin lesions. There is some evidence of a cross-taxon infection of ranavirus from amphibians to reptiles Herpesviruses have been isolated from freshwater turtles, tortoises, and marine turtles. Herpesvirus infection may be accompanied by lethargy, anorexia, subcutaneous oedema of the neck, nasal discharge, necrotising to diphtheritic stomatitis and neurological dysfunction (The Merck Vet Manual, 2015; Marschang, 2011a; Divers, S. Snakes (gaboon vipers, ball pythons, boa constrictors, rosy boas, and rat snakes), Globally, ranavirus diseases in amphibians have been diagnosed in North and South America, Europe, Asia, and Australia (U. Iridoviruses are reported in European tortoises, American turtles and tortoises, and Chinese softshelled turtles Severe Potentially severe See summary later in document (Gibbons & Steffes, 2013) Hepatic necrosis, Lung-eye-trachea disease, Gray patch disease, Herpesvirus, Fibropapillomatosis Herpesviruses: Gray patch disease in marine turtles (chelonian herpesvirus 1) (The Merck Vet Manual, 2015) Fibropapillomas in marine turtles Viraemia and death in a range or turtles and tortoises Global. Increasingly reported in terrestrial chelonians as a cause of individual and mass mortality, with signs of dermatitis, diphtheritic stomatitis and enteritis, myocarditis, fibrinous splenitis, renal tubular necrosis, and multifocal bone marrow necrosis. Fewer reports in chelonians, but documented to cause raised oral lesions in marine and terrestrial turtles Broad range of reptiles including many chelonians. No clinical illness detected in nature and experimental infection, but uncertain impacts for unusual viral incursions variety of reptiles. In Australia adenovirus detection in reptiles is increasing in step with increased diagnostic capacity. Often associated with poor husbandry and/or nutrition Aeromonas septicaemia Aeromonas hydrophila A. Several mass mortality events reported in terrestrial and freshwater turtles emerging from estivation A broad range of Mycoplasmosis is a disease of high concern for terrestrial chelonian conservation, particularly wild and free-ranging gopher and desert tortoises. Infection may be inapparent or associated with upper respiratory tract infection, particularly in coinfection with other reptile pathogens Broad host range, including all reptiles and mammals. Worldwide, common Potentially Severe Mild to severe (The Merck Vet Manual, 2015) Chlamydiosis Chlamydophila pneumonia and newly described "Chlamydia-like" microorganisms Parachlamydia acanthamoebae and Simkania negevensis these organisms are emerging as potential pathogens in reptiles, predominantly snakes, but a smaller number of others, including chelonians. The organisms have been identified in granulomatous inflammation, necrotising to Worldwide Mild/ Moderate Mild to severe (Bodetti, et al.