shinmoedake volcano : the shinmoedake cone on the kirishima mountain range erupted on sunday, the largest blast from the volcano in 52 years. when it comes to building a country, you ' d be hard - pressed to do it in a more volatile part of the world than japan. about 1, 500 earthquakes strike the island nation every year. minor tremors occur on a nearly daily basis. deadly quakes are a tragic part of the nation ' s past. the anniversary of the great kanto earthquake of 1923, for example, which killed more than 100, 000 people around tokyo, is now national disaster prevention day. more recently, a 6. 8 magnitude earthquake struck the city of kobe in 1995, killing more than 6, 000 people. japan has such a large potential for earthquakes — and disaster — because the nation sits atop four huge slabs of the earth ' s crust, called tectonic plates. these plates mash and grind together and trigger deadly earthquakes, like the 8. 9 - magnitude quake that struck on friday ( march 11 ). [ photos : japan earthquake and tsunami in pictures ] the tectonic activity has also created explosive volcanoes, like south japan ' s mount kirishima, which continued its recent eruptive streak today ( march 14 ). japan lies along the pacific ring of fire — a narrow zone around the pacific ocean where a large chunk of earth ' s earthquakes and volcanic eruptions occur. roughly 90 percent of all the world ' s earthquakes — and 80 percent of the largest ones — strike along the ring of fire. more than 150 aftershocks of magnitude 5 or greater have followed — including more than two dozen of magnitude 6 or greater. the number of aftershocks in japan is not uncommon for an earthquake of this size, said geologist eric geist, of the usgs, at a news conference last week, and the rumbling could last for a year or more. as a rule of thumb, an earthquake ' s largest aftershock is about one magnitude lower than the mainshock, said paul caruso, a geophysicist with the usgs. the largest aftershock from this earthquake has been a magnitude 7. 1. japan ' s tectonic shuffle earthquakes typically occur along faults, which are breaks in the rocky plates of the earth ' s crust. these faults accumulate strain over the years as two plates butt heads. japan ' s stretch of the ring of fire is where the north american, pacific, eurasian and philippine plates come together. northern japan


in the rocky plates of the earth ' s crust. these faults accumulate strain over the years as two plates butt heads. japan ' s stretch of the ring of fire is where the north american, pacific, eurasian and philippine plates come together. northern japan is largely on top of the western tip of the north american plate. southern japan sits mostly above the eurasian plate. friday ' s temblor struck 231 miles ( 373 kilometers ) northeast of tokyo and 80 miles ( 130 km ) east of sendai, honshu, in the pacific ocean near the japan trench. the japan trench, a subduction zone, is where the pacific plate — beneath the pacific ocean — dives underneath north american plate — beneath japan. this violent movement, called thrust faulting, forced the north american plate upward in this latest quake. on average, the pacific plate is moving west at about 3. 5 inches ( 8. 9 centimeters ) per year, and the movement has produced major earthquakes in the past — nine earthquakes of magnitude 7 or greater since 1973. the largest of these was a magnitude 7. 8 earthquake in december 1994, which caused three fatalities and almost 700 injuries, approximately 160 miles ( 260 km ) to the north of friday ' s quake. in june of 1978, a magnitude 7. 7 earthquake about 22 miles ( 35 km ) to the southwest caused 22 fatalities and over 400 injuries. the rupture during friday ' s quake was almost 200 miles ( 322 km ) long, on an underwater fault that is about 220 miles ( 354 km ) long by about 60 miles ( 97 km ) wide, said tom broker, of the usgs. earthquakes along that fault can affect the rest of the world — literally. " this is just a ginormous earthquake, " broker said. " it ' s really hard to grasp how big it is. " for one, the intense temblor accelerated earth ' s spin, shortening the length of the 24 - hour day by 1. 8 microseconds, according to geophysicist richard gross at nasa ' s jet propulsion laboratory in pasadena, calif. japan ' s earthquake research committee said the earthquake forced the north american plate eastward by about 66 feet ( 20 meters ), reported japan ' s national broadcast agency, nhk. the entire island of honshu was moved about 8 feet ( 2. 4 m ) east, according to usgs scientists. geologists in st. louis reported that their city moved up and down a fraction of an inch during the quake, but too slowly


entire island of honshu was moved about 8 feet ( 2. 4 m ) east, according to usgs scientists. geologists in st. louis reported that their city moved up and down a fraction of an inch during the quake, but too slowly for anyone to notice, reported the st. louis post - dispatch. friday ' s huge earthquake was about 15. 2 miles ( 24. 4 km ) deep, which was shallow enough to trigger a tsunami as the seafloor was pushed up and away from japan. as the energy from the quake rose, two waves were created. wave heights of more than 20 feet ( 6 m ) socked japan ' s coast, where the death toll is expected to exceed 10, 000, according to news reports. colliding tectonic plates not only trigger earthquakes — they also build volcanoes. about 10 percent of the world ' s active volcanoes are in japan, mostly where the pacific plate is diving below the philippine plate. about 950 miles ( 1, 500 km ) south of friday ' s earthquake, the shinmoedake cone on the kirishima mountain range erupted on sunday. the blast was the volcano ' s largest in 52 years, the bbc reported. the volcano had been active earlier in the year, and despite the renewed activity coinciding with last week ' s earthquake, any link between the two would be speculation at this time, reported the los angeles times. the pacific ring of fire is home to 452 volcanoes in total — that ' s 75 percent of the world ' s active and dormant volcanoes.


| this document is available in : english castellano chinesegb deutsch francais nederlands turkce | by georges tarbouriech about the author : georges is a long time unix user. he loves gnustep and the tools this great framework provides. gorm and projectcenter, the gnustep rad tools rad stands for rapid application development. at the end of the 80 ' s, when nextstep was released, it came with an incredible tool, called interfacebuilder. used in conjunction with another tool, named projectbuilder, it allowed to build graphical applications in a flash. gnustep offers a free version of these tools, called gorm. app and projectcenter. app. from the computers prehistory, software development has been a great challenge. computers were quite big in size despite their very little power. they were quite expensive, not really numerous and developers were unable to use them as often as they wished since they had to share them with other people. then, researchers tried to find a way to make computers execute more than one task at a time to improve efficiency. obviously, they had to design and create programming languages from scratch, taking into account the poor resources of the available machines. thus, during the 60 ' s various new programming languages appeared : lisp, fortran, basic, algol68, bcpl, etc. next came the b language derived from the above mentioned bcpl, which soon became the c language. this last changed the world of programming. the object oriented ( smalltalk, objective c, c + +, etc ) languages appeared later, with the " graphical era ". in the 80 ' s some machines were providing graphical oses ( apple macintosh, commodore amiga, atari st, etc ) and the x window system was in the works. at the same time, a company was working on a gui for ibm os2, called presentation manager. before finishing that job, this company released its " own " gui for its dos, called... windos. the first two versions were hardly usable, but... the third one started it all. the mvai ( microsoft very artificial intelligence ) was born! that is, every user became a computer scientist. since then we have seen " great " applications written using excel or word and visual basic : - ( never mind! fortunately, long before we reached the above situation, nextstep was born and with it, came interface buider. this tool allowed you


then we have seen " great " applications written using excel or word and visual basic : - ( never mind! fortunately, long before we reached the above situation, nextstep was born and with it, came interface buider. this tool allowed you to create a gui for your application in a very short lapse of time and with great ease. from there, this kind of tools has been spreading. among others, let us mention omnis, 4d, delphi, kylix, etc. a few of them are multiplatform while the vast majority is dedicated to windos. let us also mention that there are free toolkits using such a philosophy, gtk ( gimp tool kit ) for instance. proprietary unixes also provide these sort of tools. the most important feature of these tools is that you do not have to write the code for the 200 windows of your application, but only the one to manage the data. whether you like this sort of tools or not is not the point. the development time is short : it is a fact ( hence the name, " rapid application development " ). gnustep provides us with free rad tools. they are called gorm and projectcenter. of course, these tools are very " young " but they do work. let us have a look at them. to be able to use both gorm and projectcenter, you need to install gnustep. how to do this is beyond the scope of this article. you will find everything you need at the gnustep website. this includes source code, howtos, tutorials, etc. you can also have a look at these articles : gnustep, the open source openstep and gnumail. app, the portability evidence. the tests for the present article have been done under freebsd 4. 7 with window maker 0. 80. 1, using gnustep - make - 1. 5. 0, gnustep - base - 1. 5. 0, gnustep - gui - 0. 8. 2 and gnustep - back - 0. 8. 2. these last are the latest gnustep unstable versions. you can also use the stable versions if you wish. last but not least, we used the gcc 3. 0. 4 compiler. gorm stands for graphic object relationship modeler ( or perhaps gnustep object relationship modeler, as said in the readme file ). it is a clone of the above mentioned


, we used the gcc 3. 0. 4 compiler. gorm stands for graphic object relationship modeler ( or perhaps gnustep object relationship modeler, as said in the readme file ). it is a clone of the above mentioned nextstep interface builder ( or today ' s macos x ). gorm is the work of richard frith - macdonald who started the project. today gregory casamento is the current maintainer and he does most of the work with pierre - yves rivaille. the present version is 0. 1. 9. newer cvs snapshots are available from http : / / savannah. gnu. org / projects / gnustep. you can download the latest stable version from the gnustep website. the philosophy behind gorm ( and interface builder ) is to provide the user with objects found in palettes and drag these objects to empty windows to design the graphical components of your application. the objects can be buttons, fields, checkboxes, panels, etc. that is, everything you can add to a window to make it user - friendly. next, you can modify them using inspectors. from the inspectors, you can change the attributes, define connections, size, help and manipulate classes for the selected objects. after creating a class, you can add outlets and actions to the objects. next you instantiate the class, what creates a new object ( the instance ) in the gorm main window, and you connect the outlets and the actions to the corresponding components. you do this just by dragging the mouse from the instance to the selected object to connect outlets and from the object to the instance to connect actions. last, you create the skeleton of the class source files, and you ' re done. more on this later. projectcenter, as the name says, is the " heart " of a project. it is a clone of project builder found under nextstep and mac os x. projectcenter is the work of philippe c. d. robert and the present version is 0. 3. 0. like gorm, you can download it from gnustep website going to the developer apps section. of course you can get the latest cvs snapshot : we use it for this article and it is version 0. 3. 1. from projectcenter you can create a project, its interface ( using gorm ), write its source code ; you can build this project and run it ( debugging is not yet available ). in short, you


. 3. 1. from projectcenter you can create a project, its interface ( using gorm ), write its source code ; you can build this project and run it ( debugging is not yet available ). in short, you can manage all the resources required by the project : source code, documentation, libraries, subprojects, interfaces, etc. when you create a new project, you can choose its type. you can select between application, bundle, tool, library and gorm application. among other things, projectcenter provides you with an editor in which you will be able to complete the gorm skeleton code. how do gorm and projectcenter work together? very well, thank you! more seriously, we will use two examples to illustrate it. this article is not a tutorial. the idea is to show the ease of use of these tools while insisting on the fact that you will be able to use the same code for both gnustep ( that is, a lot of unix platforms... and, if you like " struggling ", under windos too ) and macos x. the only thing you will have to do is to design the interface on every platform, since the nib ( interfacebuilder or gorm ) files are not portable ( at least for now ). the above mentioned gnumail. app article showed the portability from a user ' s point of view. this one will focus on the developer ' s point of view, still with portability in mind. that is, in gnumail. app we used the work of ludovic and friends and here we do create a gui application for both gnustep and macos x. many tutorials are available, either for macos x or gnustep. you can reach most of the gnustep ' s ones from the gnustep website or from http : / / www. gnustep. net, but let us mention a few of them. - an application using gorm and projectcenter by pierre - yves rivaille. - the nicola pero ' s tutorial page - an older tutorial on how to create a htmleditor : http : / / stepwise. com / articles / technical / htmleditor / to learn more, you can also check the source code, the nib files, etc, of the existing gnustep applications ( gorm, projectcenter, gnumail, gworkspace, etc ) and of course,


the textview is selected ), choose size and change the values to make them match the editor window size values. these last are obtained in the same way, that is, selecting the window and checking the size in gormnswindow inspector. if you do not change the x and y values, for instance, you will not be able to use the full width of the editor, whether you resize the window or not. save all in the gorm document menu and quit to go back to projectcenter. select the build icon and click in the new build icon in the second horizontal half of the window. everything should go well if you defined the right preferences for your compiler, debugger, etc. for example, using freebsd, you must change make to gmake ( including the path ) clicking in the settings icon of projectcenter. check also the paths from the preferences menu in projectcenter. if the built succeeded ( it should have! ), just do the same with run and you will see the editor application. just play with it, writing, cutting, pasting, etc. obviously, you can restart it later using the openapp command. how long did it take? well, i should say a few minutes. nothing much to say since you will have to do the same as above. here is what it looks like while designing the gui : now we choose another example from mike beam. this time is a full working application, able to manage data : an address book. mike ' s tutorial about the address book ( like every other ) is recommended reading to understand how the " thing " works. also check the tutorial list since mike provides different steps of the developing process for one and the same application allowing to improve it. again we create and run the application on both gnustep and macos x. like you did for the editor example, start projectcenter. app. select a gorm application and call it addressbook. from projectcenter launch gorm by double - clicking in interfaces - > addressbook. gorm. drag a tableview from the palette to the default window. in other words, follow mike ' s tutorial like you would under macos x. you will have to adapt a few things since they work differently in gorm and in interfacebuilder. for example, the number of columns in the tableview cannot be defined from the attributes inspector in gorm. to keep things simple, just copy a column and paste it next to it


they work differently in gorm and in interfacebuilder. for example, the number of columns in the tableview cannot be defined from the attributes inspector in gorm. to keep things simple, just copy a column and paste it next to it to get the required number ( 4 in our case ). you should end with something like this : mike beam did the whole job : what else could i add? obviously, gnustep development tools cannot be as ahead as apple ' s. apple and next represent a 15 years old experience with hundreds of developers. gnustep is the work ( for free ) of a few individuals having to do something else for a living. accordingly, do not be surprised to find, for instance, much more available classes in interfacebuilder than in gorm. remember, gorm is at version 0. 1. 9 ( or 0. 2. 0 ). furthermore, we did the tests the " hard " way. that is, we " ported " from os x to gnustep. the other way round would have been easier because of the above mentioned differences between the tools. for example, porting applications developed under macos x 10. 2 would be much more difficult since the new apple development tools have much improved. as already said, there are many new available classes or more elaborated ones. however, the tools rely on the same philosophy whether they work under gnustep or macos x... and gnustep improves every day. one thing looks very nice to me : gnustep people really work together. they do help each other when individual projects are concerned and they also contribute in improving gnustep core. this is the free software way of working i like. congratulations for such a behavior mr. fedor and friends. the goal of this article was to show the power of the gnustep " rad " tools, gorm. app and projectcenter. app. despite their " youth " they can help you develop nice applications in a very easy way. futhermore, these tools provide a very pleasant way of working while being very efficient. objective c is a very compact language and, in my opinion, much easier to learn than c + + for someone with c knowledge ( i know, i already said so! ). this allows to design nice looking applications ( well, it is a matter of taste, but i do love this look and feel ) while keeping them rather small in size. i must admit that i never recovered from the shock


already said so! ). this allows to design nice looking applications ( well, it is a matter of taste, but i do love this look and feel ) while keeping them rather small in size. i must admit that i never recovered from the shock i received when i first met the next machine. the fact apple released a modern version of nextstep delights me. this is also why i am very fond of projects such as gnustep or window maker. however, if i love free software i am not a " fundamentalist " and accordingly, i am not against proprietary software ( well, maybe a bit against a specific editor... but, just a bit! ). gnustep can benefit from apple... but apple can benefit from gnustep too. gnustep is not an apple competitor, it is free software. as far as i know, free software is widely used in os x. this to say that bringing even more free software to apple cannot be a bad thing. what ludovic and friends did with gnumail. app is a very good example of what could happen. " i had a dream "... apple was providing most of its development tools source code to gnustep. gnustep and apple developers were working together to bring great applications to unix users. and slowly, people were realizing they could live without windos... unfortunately, it was a dream ; - ) anyway, if you do not know gnustep and its applications, feel free to give them a try. remember, gnustep is a framework and tools such as gorm and projectcenter provide you with everything to create, to invent. in other words, with a bit of imagination, you can develop " products " much different from what we can see nowadays : windos applications clones! we are living in a great time! to the gnustep people : a. fedor, n. pero, g. casamento, p. y. rivaille, n. roard, l. marcotte, r. frith - macdonald, p. c. d. robert, e. sersale, a. froloff, f. kiefer, m. viviani, m. guesdon and all those i forgot for the very great job either for the framework or for the applications. to window maker people : a. kojima, d. pascu and friends for bringing us a free nextstep interface for x. to


a titanic mistake? new research sinks the “ women and children first ” myth. the titanic sank 100 years ago today, and men ’ s rights activists are still pissed off about it. they ’ re not really pissed off that it sank. they ’ re pissed off that the men on board were more likely to go down with the ship than the women. you know, that whole “ women and children first ” thing. some mras were so pissed off about this that they were planning to march on washington on this very day in an attempt, as they put it, to “ sink misandry. ” you don ’ t know how much i would have loved to see this, a dozen angry dudes marching in circles on the national mall carrying signs protesting the sinking of the titanic and demanding that in all future sinkings of the titanic that women and men be equally likely to drown in the cold waters of the north atlantic. for that would be justice at last! but, alas, due to unspecified logistical problems this march was cancelled some months back, and so misandry remains unsunk. or does it? for you see, it turns out that the whole “ women and children first ” thing was not really a thing. oh, on the titanic it was. but women unfortunate enough to be passengers on sinking ships that weren ’ t the titanic ( or the hms birkenhead, which sunk off the coast of south africa in 1852 ) weren ’ t able to push ahead to the front of the line. that, at least, is the conclusion of a new swedish study ( link is to a pdf of it ). the chivalrous code “ women and children first ” appears to have sunk with the titanic 100 years ago. long believed to be the golden standard of conduct in a shipwreck, the noble edict is in fact “ a myth that has been nourished by the titanic disaster, ” economist mikael elinder of uppsala university, sweden, told discovery news. elinder and colleague oscar erixson analyzed a database of 18 peace - time shipwrecks over the period 1852 – 2011 in a new study into survival advantages at sea disasters. looking at the fate of over 15, 000 people of more than 30 nationalities, the researchers found that more women and children die than men in maritime disasters, while captains and crew have a greater chance of survival than any passengers. being a woman was an advantage on only two ships : on the birkenhead in 1852 and on the titanic in 1912. the


and children die than men in maritime disasters, while captains and crew have a greater chance of survival than any passengers. being a woman was an advantage on only two ships : on the birkenhead in 1852 and on the titanic in 1912. the notion of “ women and children first ” may have captured the popular imagination, but it ’ s never been an official policy for ship evacuations. it wouldn ’ t be fair, nor would it be an efficient way to get as many people as possible to safety. nor was “ women and children ” strictly enforced even on the titanic. true, my great - grandfather, the mystery writer jacques futrelle, was one of those who went down with the ship, while his wife and my great - grandmother, writer lily may futrelle made it off safely ( in the last lifeboat ). but there were many men who survived, and many women who died. if you want to get mad about the sinking of the titanic all those years ago, get mad at the white star line for not bothering to equip the ship with lifeboats enough for everyone on it. blame the captain, for ordering the ship to continue plowing ahead on a dark, foggy night into an area of the atlantic where numerous icebergs had just been sighted by a number of other ships. blame the crew for botching the evacuation – for the strange lack of urgency after the ship hit the iceberg, for the lifeboats leaving the sinking ship with half as many passengers as they could fit. much like the iceberg that sank the titanic, elinder and erixson ’ s research has poked a giant hole in the “ women and children first ” myth. of course, mras aren ’ t interested in historical accuracy. they ’ re looking for excuses to demonize women and feminists. so i imagine we ’ ll be hearing about the titanic from them for years to come. here ’ s another tragic sinking, of yet another ship without a sufficient number of lifeboats : edit : i added a couple of relevant links and fixed a somewhat egregious typo.


research is clear that there is an inextricable link between students ' emotional and mental health and their ability to learn. a student is not able to benefit from the educational program if the student is suicidal or if the student is preoccupied by concerns about someone who may be thinking about suicide. few events have greater impact than suicide upon students, parents, and staff. the student services and alternative programs branch staff is committed to providing technical assistance about effective youth suicide prevention, intervention, and postvention ( i. e., support and assistance for those affected by a completed suicide. ) suicide continues to be a leading cause of death in the united states and in maryland. according to the federal centers for disease control and prevention, suicide continues to be the third leading cause of death for youth in the united states and in maryland. during 2004, maryland lost 86 youth due to suicide. the results of the 2005 maryland youth risk behavior survey ( yrbs ) indicate that more than one in ten maryland high school students reported making a plan to commit suicide in the past twelve moths. the data demonstrate the importance of the statewide youth suicide prevention school program established in the annotated code of maryland § 7 - 503. the maryland program establishes a shared responsibility between educational programs at the state and local levels and community suicide prevention and crisis center agencies. the statewide program includes : - classroom instruction about warning signs of suicide and suicide prevention strategies - maryland youth crisis hotline at 1 - 800 - 422 - 0009 and local suicide and crisis hotlines - suicide intervention and postvention - data collection - teacher training


i have to determine all values of h for which a is invertible and i really don ' t know what should be my first step ( if anyone could guide me through this that would be awesome. here ' s the matrix : 1 1 0 1 1 0 0 1 0 1 2h + 1 0 1 1 h you mean then that the matrix is i see two ways to do that. one is to use the fact that a matrix is invertible if and only if its determinant is non - zero. the other is to row - reduce this to triangular form and use the fact that a matrix is invertible if and only if, reduced to triangular form, it has no zeros on its main diagonal. since a simple way of determining the determinant of a matrix is to reduce to triangular form, those are essentially the same. that will give you now you also need to note that 1 ) if you " add a multiple of one row to another " the determinant of a matrix 2 ) if you " multiply one row by a number ", the determinant of a matrix is multiplied by that number. 3 ) if you " swap two rows ", the determinant of a matrix is multiplied by - 1. since you have not " multiplied one row by a number ", the determinant of your original matrix must be the determinant of this matrix : that is,. the determinant of your original matrix is non - zero if and only if h is non - zero.


a bag contains n discs, made up of red and blue colours. two discs are removed from the bag. if the probability of selecting two discs of the same colour is 1 / 2, what can you say about the number of discs in the bag? let there be r red discs, so p ( rb ) = r / n ( nr ) / ( n1 ), similarly, p ( br ) = ( nr ) / n r / ( n1 ). therefore, p ( different ) = 2r ( nr ) / ( n ( n1 ) ) = 1 / 2. giving the quadratic, 4r2 4nr + n2 n = 0. solving, r = ( nn ) / 2. if n is an odd square, n will be odd, and similarly, when n is an even square, n will be even. hence their sum / difference will be even, and divisible by 2. in other words, n being a perfect square is both a sufficient and necessary condition for r to be integer and the probability of the discs being the same colour to be 1 / 2. prove that n ( n + 1 ) / 2 ( a triangle number ), must be square, for the probability of the discs being the same colour to be 3 / 4, and find the smallest n for which this is true. what does this tell us about n and n ( n + 1 ) / 2 both being square? can you prove this result directly?


human reproduction is a complex and remarkable process. women ’ s and men ’ s reproductive systems compliment one another, and each is essential for reproduction. there are two types of sex cells involved in human reproduction : the male ’ s sperm and the female ’ s egg. an egg that has been fertilized by a sperm cell grows and divides in a woman ’ s uterus ( womb ) throughout pregnancy until childbirth. the resulting child ’ s genetic makeup comes from the sperm and egg cells produced by the father and mother. the female reproductive system the female reproductive system includes the : - vagina — a muscular passage that connects the cervix with the external genitals - cervix — the lower part of the uterus that connects to the vagina - uterus — a hollow, muscular structure in which the fertilized egg implants and fetus grows during pregnancy - ovaries — two glands that produce eggs, as well as the female hormones estrogen and progesterone - fallopian tubes — two tubes that connect the ovaries with the uterus during a woman ’ s menstrual cycle, which usually lasts about 28 days, her body prepares for the possibility of a pregnancy. in the first half of the menstrual cycle, estrogen levels rise to thicken the lining of the uterus. at the same time, an egg begins to mature in one of the ovaries. around the midpoint of the menstrual cycle ( for example, day 14 of a 28 - day cycle ), a surge of luteinizing hormone ( lh ), which is produced by the pituitary gland in the brain, causes the mature egg to leave the ovary, a process called ovulation. in the second half of the menstrual cycle, fingerlike projections located at the opening of the fallopian tubes sweep the released egg into the tube toward the uterus. at the same time, rising levels of progesterone help prepare the lining of the uterus for pregnancy. if sperm cells are present at this time, the egg may become fertilized. if no sperm cells are present, the egg either dissolves or is absorbed into the body, no pregnancy occurs, hormone levels drop, and the thickened lining of the uterus is shed during the menstrual period. if fertilization does occur, the fertilized egg grows and divides until it becomes a blastocyst, which is a hollow ball of cells


, and the thickened lining of the uterus is shed during the menstrual period. if fertilization does occur, the fertilized egg grows and divides until it becomes a blastocyst, which is a hollow ball of cells. the blastocyst moves to the uterus, where it attaches itself to the lining, in a process called implantation. the blastocyst is nourished, and continues to grow and divide until it becomes an embryo, which eventually becomes a fetus. pregnancy lasts for an average of 280 days, or about nine months, until the baby is ready for birth and moves from the uterus through the cervix and out of the vagina. the male reproductive system the male reproductive system includes the : - testicles, or testes — two oval - shaped organs that produce and store millions of tiny sperm cells, as well as male hormones, including testosterone - epididymis — two coiled tubes that connect each testicle to the vas deferens - scrotum — a pouch of skin that hangs outside the pelvis to hold and regulate the temperature of the testes - vas deferens — a muscular tube that transports sperm from the testes to the ejaculatory ducts - seminal gland and prostate gland — glands that produce seminal fluid - urethra — the tube that passes urine and semen out of the body - penis — the organ in which muscular contractions force sperm - containing semen out of the urethra when a male is stimulated, sperm cells move out of the testes, through the epididymis, and into the vas deferens. they are mixed with the whitish seminal fluid produced by the seminal and prostate glands to form semen. the penis then fills with blood and becomes erect, and muscles contract, forcing semen through the urethra and out of the male ’ s body, a process called ejaculation. each ejaculation can contain up to 500 million sperm. when ejaculation occurs during intercourse, semen is deposited into the female ’ s vagina. sperm cells “ swim ” from the vagina through the cervix and uterus, toward the fallopian tubes. if a mature egg is present in one of the fallopian tubes, a sperm may penetrate and fertilize it. - reviewer : andrea chisholm, md - review date : 11 / 2012 - - update date : 11 / 26 / 2012 -


when you are pregnant, it is important to eat a well - balanced, healthful diet. this includes getting the right amount of calories and key nutrients to support both you and your baby. since the amount of calories you need will vary depending on age, weight, and physical activity among other things, talk with your doctor about a calorie plan that is right for you. along with talking about the amount of calories and types of foods you need to consume to achieve a well - balanced, healthy diet during pregnancy, your doctor may also discuss the kinds of nutrients you will need. there are some key nutrients, like folic acid and iron, which deserve extra attention during pregnancy. many women may also benefit from a vitamin supplement. women who are pregnant or may become pregnant should consume 600 micrograms of folic acid ( ie, folate ) every day. this mineral is most important during the first several weeks of pregnancy — often before a woman even knows she is pregnant. getting enough folic acid can help prevent neural tube defects, such as spina bifida. taking this vitamin may also help prevent birth defects like cleft lip and congenital heart disease you can meet this requirement by eating a variety of foods rich in folic acid. for extra insurance, you may also want to take a folic acid supplement before you become pregnant and through your first trimester. ( if you are taking a prenatal vitamin that contains folate, you do not need a separate folic acid supplement. ) foods rich in folic acid include : - fortified breakfast cereal - whole - wheat breads - orange juice and citrus fruits - green leafy vegetables ( eg, spinach, broccoli, and romaine lettuce ) iron is a mineral that helps red blood cells transport oxygen around the body. the recommended amount of iron for pregnant women is 27 milligrams ( mg ). not getting enough of this mineral can lead to iron - deficiency anemia and pregnancy complications. good sources of iron include : - lean red meat - dried fruits - fortified breakfast cereals eating vitamin c - rich foods along with iron - containing foods can help with iron absorption. on the other hand, drinking tea or coffee at the same time can inhibit iron absorption. because it can be difficult to get all the iron you need from food alone, it is often recommended that all pregnant women take a prenatal vitamin that contains the necessary iron amount. talk to your physician about iron supplementation. good sources of calcium include : -


be difficult to get all the iron you need from food alone, it is often recommended that all pregnant women take a prenatal vitamin that contains the necessary iron amount. talk to your physician about iron supplementation. good sources of calcium include : - low - fat or nonfat dairy products ( eg, milk, yogurt, cottage cheese ) - fish canned with bones - green leafy vegetables - fortified soy milk or rice milk - fortified orange juice - other calcium - fortified foods if you do not eat dairy products or enough foods fortified with calcium, talk to your physician about calcium and vitamin d supplementation. ( vitamin d is necessary for the body to absorb and use the calcium. ) during pregnancy the body becomes extra efficient at absorbing the nutrients in food. if you are eating a variety of healthful foods every day, you may not need a supplement. but many women may benefit from taking a prenatal multivitamin. some may need only an iron or folic acid supplement. talk to your doctor about your eating and lifestyle habits to determine if you should take a vitamin supplement. no safe amount of alcohol has been shown in pregnancy. therefore, it is recommended that you abstain from drinking until after your pregnancy. most experts agree that having one or two cups of coffee or tea per day is fine during pregnancy. however some research has linked high intakes of caffeine ( more than 300 mg per day ) with greater difficulty to conceive and a higher rate of miscarriages. one cup of brewed coffee contains about 135 mg of caffeine, one shot of espresso contains about 35 mg, one brewed tea bag contains about 50 mg, and a 16 - ounce serving of cola has about 50 mg. talk to your doctor about how much caffeine you drink. seafood is an excellent source of omega - 3 fatty acids, which are essential for the proper brain development of the fetus. therefore, it is recommended that pregnant women include seafood, particularly fatty fish such as salmon, as a regular part of their diet. however, some seafood contains high amounts of mercury, a contaminant that can be harmful to the developing baby. fish that should be avoided due to their high mercury content include : tilefish, king mackerel, swordfish, albacore tuna, and shark. good choices include salmon, sardines, catfish, canned light tuna, and shrimp. these are both high in omega - 3 fatty acids and low in mercury. to avoid the risk of foodborne


swordfish, albacore tuna, and shark. good choices include salmon, sardines, catfish, canned light tuna, and shrimp. these are both high in omega - 3 fatty acids and low in mercury. to avoid the risk of foodborne illness, which could harm you and your developing baby, it is important to pay close attention to food safety during pregnancy. here are some general guidelines : - wash your hands before eating or preparing food. - when preparing food, avoid cross - contamination of raw meats or poultry with other foods. - cook meat to recommended temperatures. - thoroughly reheat leftovers. - avoid luncheon meats and hot dogs unless reheated until steaming. - drink only pasteurized juice and milk. - avoid raw or soft cheeses. most artificial sweeteners are considered safe for use in moderation during pregnancy, including : acesulfame k ( sunett ), aspartame ( nutrasweet or equal ), and sucralose ( splenda ). but more research is needed on saccharin ( sweet ’ n low ) and stevia, these should, therefore, be avoided by pregnant women. staying well - hydrated is important for the health of you and your baby, so try to drink at least 6 - 8 glasses of water a day. other beverages, such as juice and soda, also contribute to hydration, but tend to be high in calories and low in nutritional value. - reviewer : dianne scheinberg rishikof ms, rd, ldn - review date : 03 / 2013 - - update date : 00 / 31 / 2013 -


dnr to study declining moose populationby curtis gilbert, minnesota public radio st. paul, minn. — the minnesota department of natural resources is embarking on what it calls the largest study of moose deaths ever conducted. the study will help determine why minnesota ' s moose population has declined almost 50 percent in the last six years. this month the dnr will attach tracking collars and implant devices in the digestive tracts of 100 moose. both the collars and devices will alert researchers when a moose has died. scientists also plan to use gps to track moose in the northeastern part of the state. wildlife veterinarian erika butler said the goal is to autopsy each moose as quickly as possible. " we ' re going to be doing everything we can to remove the carcass intact, " butler said. " and if that ' s not possible, we ' ll be doing extremely thorough field necropsies. " butler said the dnr wants to know why moose populations are declining. " one thing that ' s been very clear for me working for the state of minnesota is how much the state values moose as a species overall, " she said. " you know all you really have to do is go up to duluth or ely or grand marais, and you know walk around in the bars and the shops and see all the moose paraphernalia everywhere. we know it ' s an iconic species for minnesota, and we definitely have a connection with it. " butler said the $ 1. 2 million study should yield results in about two years. about half of the funding comes from state lottery proceeds.


rotary engines based on the wankel principle were developed with two fundamentally different approaches to cooling the rotor. mazda, audi, suzuki, ingersoll - rand and others used the oil - cooled rotor. it is an expensive, heavier and more complicated design, which achieved specific fuel consumption in the range of. 55 to. 6 lbs / hp hr. this is about 15 % to 20 % poorer than a typical four - stroke piston engine. the other approach taken by outboard marine corporation ( omc ), fichtel sachs and norton was to use the incoming air - fuel mixture ( “ charge ” ) to cool the rotor. this design was much lighter, less expensive and through the use of roller bearings and very low rotor cooling losses achieved a specific fuel consumption between. 45 and. 5 lb / hp hr, which was close to the 4 - stroke piston engine. historically all of the charge - cooled rotary engines that were developed used an arrangement where the fuel - air mixture passed through the rotor from one side to the other. this design cooled the rotor unevenly, which lowered engine rotor bearing life and increased friction between the rotor and the end housing. in 1985 moller international acquired the major rotary engine assets of omc. omc ’ s main product was the johnson and evinrude outboard engine and they were the world leader noted for their product ’ s reliability. omc reportedly spent over $ 200 million between 1970 and 1985 developing a number of different rotary engine models including a 530cc displacement model that went into volume production and used in a snowmobile as a test product. emissions requirements were one of the key motivators for this program. omc believed that they would not be able to meet the proposed emissions standards proposed for the late 1980 ’ s with their two - stroke engines and therefore chose to develop a lightweight low emission 4 - stroke rotary engine. fortunately for our company the proposed emission standards were not enacted as originally planned and omc stayed with their two - strokes, allowing moller international to purchase their rotary engine technology. since acquiring the omc charge - cooled rotary design, moller international has spent ~ $ 35 million on further development, testing and product integration efforts related to its rotary engine, preparing it for use in its aeronautical products as well as for use in a wide range of other suitable applications. freedom rotapower engine • high power to weight ratio - more than 2 hp per pound of installed weight in high - performance versions - compares with. 6 hp / lb. to 1 hp / lb. for 2


wide range of other suitable applications. freedom rotapower engine • high power to weight ratio - more than 2 hp per pound of installed weight in high - performance versions - compares with. 6 hp / lb. to 1 hp / lb. for 2 - strokes and. 3 hp / lb. to. 65 hp / lb. for 4 - stroke pistons. • high power to volume ratio - ( power output / volume ) > 100 hp per cubic foot of installed volume - compares with 36 hp / ft³ to 50 hp / ft³ for 2 - strokes and 10 hp / ft³ to 20 hp / ft³ for 4 - stroke piston engines. • few moving parts - moving parts - only 2 for single rotor engine. - compares to 7 parts for 2 - stroke and 25 parts for 4 - stroke piston with same nstantaneous output torque. • solid fuel economy - specific fuel consumption <. 45 lb. / hp - hr ~ ( stratified charge ). expect <. 4 lb. / hp - hr when both stratified charged and turbo - charged - compares to. 65 lb. / hp - hr for 2 - strokes and ~. 4 lb / hp - hr for the best 4 - stroke piston. • proven multi - fuel performer - demonstrated on gasoline, natural gas, alcohol and propane - spark - ignited diesel, kerosine and jet fuel • very low emissions levels - see emissions performance • enhanced energy at exhaust - exhaust temperatures > 1500 °f - acts like a naturally occuring thermal reactor - ideal for turbocharge / co - generation applications • low vibration levels - hard mounted engine can be used as part of the structure • modular design - stacking of rotors easily extends range of available power


hilbert ' s building blocks investigating space curves to construct 3 - d forms i have been interested in the area of computer generated forms, mostly from the architectural viewpoint, for a long time. most recently i have been investigating fractals as a way of generating 3 - d forms. not having a lot of luck in getting results that could suggest reasonable 3 - d forms, i moved back to some earlier work i did in 2 - d with hilbert curves, spirolaterals, space filling curves, and recursive designs. the image above on the left is the space filling curve designed by the german mathematician david hilbert. the adjacent image shows the three line segment " generator " for the hilbert curve. the generator is connected to another generator by a connecting line segment. by definition, this type of curve will always remain in a two dimensional plane. if you break the generator into forward moves and turns, and then modify the angle of the turn, the lines segments will cross each other. this crossing enables the curve to trigger a move to another " level ". this enables the determination of the curve height. variations can be developed by using a turning angle other than 90 degrees. two such variations are shown below. the second part of the this investigation is the interpretation of the curve once it is generated. each of the line segments and their vertices can be interpreted in three dimensional, architectural terms : select one the above variations to view these interpretations individually and in combination. walls, each line segment is constructed as a vertical plane floors, for each set of line segments, the minimum and maximum extends are found and constructed into a horizontal plane floor blocks, the horizontal floor plane is constructed into a volume extended walls, walls are constructed from the bottom and the top, starting at their beginning level, extending either to the bottom or top columns, volumes are constructed at the vertices of the line segments and the floor blocks beams, volumes are constructed along each line segment at the wall the more i worked with these variations and their interpretations, the more sculptural the forms became, further studies will continue in both the sculptural and architectural form possibilities. the next set of forms will use spirolaterals and more generalized recursive curves for the initial form generation. the forms currently only exist in this digital studio. my next goal is to generate stl files of the forms to send to a rapid prototyping system. another possible direction would be to rewrite the generation software in autolisp for use within autocad r13. this would also


the sumxu is also known as the chinese lop - eared cat, droop - eared cat, drop - eared cat, or hanging - ear cat. all the names refer to its main feature - pendulous ears. nowadays, the breed is considered extinct. it is thought that the pendulous ears were a result of mutation similar to that occurred in the scottish fold. all descriptions of the breed are based on reports of travellers. in 1976, a german naturalist gave rather a detailed description of the sumxu, when a droop - eared cat had been brought from china by a traveller. the breed was described as long - haired cats with glossy black, yellow or cream coats and pendulous ears. most probably, they looked like longhair scottish folds. the cat by lady cust ( 1870 ) has this brief description : bosman relates that in the province of pe - chily, in china, there are cats with long hair and drooping ears, which are in great favour with the chinese ladies ; others say this is not a cat but an animal called ' samxces '. georges louis leclerc, comte de buffon, described the cat in the natural history of the cat ( volume 4 of histoire naturelle c. 1767, translated by william smellie, 1781 ) : our domestic cats, though they differ in colour, form no distinct races. the climates of spain and syria have alone produced permanent varieties : to these may be added the climate of pe - chi - ly in china, where the cats have long hair and pendulous ears, and are the favourites of the ladies. these domestic cats with pendulous ears, of which we have full descriptions, are still farther removed from the wild and primitive race, than those whose ears are erect. i formerly remarked, that, in china, there were cats with pendulous ears. this variety is not found any where else, and perhaps it is an animal of a different species ; for travellers, when mentioning an animal called sumxu, which is entirely domestic, say, that they can compare it to nothing but the cat, with which it has a great resemblance. its colour is black or yellow, and its hair very bright and glittering. the chinese put silver collars about the necks of these animals, and render them extremely familiar. as they are not common, they give a high price, both on account of their beauty, and because they destroy rats. jean bungartz also described the chinese lo


silver collars about the necks of these animals, and render them extremely familiar. as they are not common, they give a high price, both on account of their beauty, and because they destroy rats. jean bungartz also described the chinese lop - eared cat or hanging - ear cat in his book die hauskatze, ihre rassen und varietaten ( housecats, their races and varieties ) from illustriertes katzenbuch ( an illustrated book of cats ) in berlin in 1896 : the chinese or lop - eared cat is most interesting, because it provides proof that by continual disuse of an organ, the organ withers. with the chinese cat the hearing and ears have deteriorated. michel says the chinese, not only admire the cat in porcelain, but also value it for culinary reasons. the cats are regarded as special morsels and enjoyed particularly with noodles or with rice. this cat is bred particularly for the purpose of meat production, and is a preferred chinese morsel ; this is not unusual if one considers that the chinese consume much the sight of which revolts the stomachs of europeans. the poor creature is confined in small bamboo cages and fattened like a goose on plentiful portions. there is extensive trade with other parts of asia and the canny chinese allow no tomcats to be exported so there is no interference in this lucrative source of income. due to the restrictive conditions that have deprived the cat of its actual use, its hearing has decreased because it is no longer needed for hunting its own food. with no need for watchfulness, it had no need of sharp hearing to listen for hidden things so its hearing became blunted and as a natural consequence its ears lost their upright nature, gradually becoming lower and becoming the hanging ear that is now the characteristic feature of the chinese cat. at first impression this is a surprising and amusing look, but this impression is lost with closer examination. if one ignores the characteristic of the ears, one sees a beauty similar to the angora cat : a long, close coat of hair, albeit less rich, covers the body. the hair is silky - soft and shining and the colour is usually isabelline or a dirty white yellow, although some have the usual colouring of the common house - cat. in size it is considerably larger and stronger than a housecat. the ears hang completely, as with our hunting dogs and are large in relation to the cat. although the chinese cat is found in considerable numbers in its homeland, it is


- cat. in size it is considerably larger and stronger than a housecat. the ears hang completely, as with our hunting dogs and are large in relation to the cat. although the chinese cat is found in considerable numbers in its homeland, it is rarely found at european animal markets. only one such cat has reached us in the flesh ; we acquired this years ago when a sailor returning from china brought it into hamburg. the accompanying illustration is based on this cat. in character it is like the angora cat and somewhat languid. it prefer to live by a warm fire, is rather sensitive to flattery, hears badly and is at its most animated when given milk or food. apart from its unusual ears, it has no really attractive characteristics and is a curious specimen of housecat. in frances simpson ' s the book of the cat ( 1903 ), contributing author h. c. brooke wrote : there is said to be a variety of chinese cat which is remarkable for its pendent ears. we have never been able to ascertain anything definite with regard to this variety. some years back a class was provided for them at a certain continental cat show, and we went across in the hope of seeing, and if possible acquiring, some specimens ; but alas the class was empty! we have seen a stuffed specimen in a continental museum, which was a half long - haired cat, the ears being pendent down the sides of the head instead of erect ; but do not attach much value to this. in 1926, h. c. brooke wrote in the magazine cat gossip that for many years continental cat shows had offered prizes for the drop - eared chinese cat. on each occasion, the cat failed to materialise and brooke considered it to be mythical. other writers suggested the folded or crumpled ears were the result of damage or haematomas. brooke wrote that although no - one ever saw the cat itself, one always met “ someone who knows someone whose friends has often seen them ”. brooke himself had been assured by a chinese gentleman he had met only once that “ he knew them well ”. hc brooke, and several other cat fanciers, contacted the chinese embassy and carl hagenbeck ' s animal exchange in hamburg and also a “ certain well known author, who has lived for years in china and knows that country well ”, but their enquiries bore no fruit. the search for this cat became so intense in the 1920s that the american express company instructed their representatives at shanghai and peking to make enquiries with the wild


●the more budgets are cut and taxes increased, the weaker an economy becomes. ●austerity is the government ’ s method for widening the gap between rich and poor, which leads to civil disorder. ●until the 99 % understand the need for federal deficits, the upper 1 % will rule. ●to survive long term, a monetarily non - sovereign government must have a positive balance of payments. ●those, who do not understand the differences between monetary sovereignty and monetary non - sovereignty, do not understand economics. unless you ’ re an ultra right - winger, you probably agree with the scientific consensus : we are in a period of global warming, which at least in part, is caused by humans but that brings us to the question ( s ) : is global warming negative for the world and the life on it – including humans – and should we should do everything possible to slow it, if not stop it, altogether? the media have answered, “ yes, ” and have focused on the claimed negatives, which as a result, are well known. increases in : 1. number and severity of storms – hurricanes, tornadoes, blizzards, rain, lightning, tsumanis 2. droughts, heat waves and ( ironically ) cold waves, desertification 3. flooding, pollution 4. volcanic activity 6. food shortages 7. species extinction 8. spread of tropical diseases but global warming is more than a simple recitation of presumed negatives. the world is enormously complex, and not only are these negatives far from certain, but perhaps too little attention has been paid to the potential positives of global warming. for instance, global warming could help prevent future glaciation periods and could open millions of acres to agriculture. maybe. tellingly, few people know that today, we live in an ice age : an ice age, or more precisely, a glacial age, is a period of long - term reduction in the temperature of the earth ’ s surface and atmosphere, resulting in the presence or expansion of continental ice sheets, polar ice sheets and alpine glaciers. glaciologically, ice age implies the presence of extensive ice sheets in the northern and southern hemispheres. by this definition, we are still in the ice age that began 2. 6 million years ago at the start of the pleistocene epoch, because the greenland and antarctic ice sheets still exist. much of the earth ’ s history has been warmer than today. discussions of global warming often begin with the arctic. here are excerpts from an article in news


ago at the start of the pleistocene epoch, because the greenland and antarctic ice sheets still exist. much of the earth ’ s history has been warmer than today. discussions of global warming often begin with the arctic. here are excerpts from an article in newscientist magazine : industries make a dash for the arctic 03 october 2012 by fred pearce, sara reardon and catherine brahic last week, the inuit - owned nunavut resources corporation hit wall street asking for $ 18 million to help prospect half - a - million square kilometres of the kitikmeot region in northern canada. they expect to find gold, diamonds, platinum and lithium.... the shrinking ice cap will have profound consequences for the rest of the planet – including changed weather patterns and water distribution – and the region ’ s biota has undergone vast transformation. most commentators expect the arctic to play a key role in meeting the world ’ s energy needs in the 21st century. the us geological survey ( usgs ) says the continental shelves are the largest area on the planet not yet explored for oil and gas. it estimates that the arctic contains 30 per cent of the world ’ s undiscovered natural gas, more than 80 per cent of it offshore. from the geology, the usgs reckons that the biggest oil and gas reserves will be off the north shore of alaska, and beneath the kara and barents seas. russia ’ s yamal peninsula already supplies around a fifth of the world ’ s natural gas. exploration and mining activities are booming, bringing infrastructure such as roads, ports and new settlements. london - based insurers lloyd ’ s earlier this year forecast that up to $ 100 billion of investment would pour into the arctic in the next decade. extracting hydrocarbons in the arctic is scarcely new. coal has been mined there for more than a century. but a combination of global shortages, rising prices, technical advances and the exposure of wide areas of the arctic ocean during summer melts, are triggering an explosion of activity. inevitably, as global warming melts the ice, industry will enter – and pollute. on balance, will this prove to be beneficial? and, “ beneficial to whom? ” nearly a million visitors go to the arctic each year. they account for more than 80, 000 hotel - nights on the norwegian island of svalbard. even greater numbers visit greenland, where they easily outnumber the local population of just 55, 000 people. canada ’ s cambridge bay – a stop on the north - west passage – has seen


- nights on the norwegian island of svalbard. even greater numbers visit greenland, where they easily outnumber the local population of just 55, 000 people. canada ’ s cambridge bay – a stop on the north - west passage – has seen a 30 per cent jump in tourists visiting the town in the past five years, with six cruise ships dropping anchor annually. the world – a giant residential vessel calling itself the world ’ s largest private mega - yacht – sailed through the north - west passage for the first time in august. it was the largest passenger vessel to make the trip without an icebreaker to escort it. as the sea ice melts, sailing passages open, and more people not only will visit, but live in today ’ s remote northern climes. warmer waters and a 20 per cent increase over the past decade in the volume of algae that sustain the marine food chain means there are more fish in the arctic than ever before. and less ice means more open ocean in which to catch them. the number of voyages by fishing vessels in the canadian arctic increased sevenfold, to 221, between 2005 and 2010. the inuit of nunavut now run six factory ships trawling for turbot and other species in baffin bay and the davis strait, up from none 10 years ago. climate change is altering the region ’ s fish population, as warmer water temperatures further south push commercial fish stocks into the arctic circle. according to the us national oceanic and atmospheric administration ’ s fisheries service, six species of fish have recently extended their range north through the bering straits into the beaufort sea in the arctic. they include the pacific cod, walleye pollock and bering flounder. new fishing waters will open, providing relief to currently overfished areas. burning oil helped melt arctic ice in the first place. now the estimated 90 billion barrels beneath it – 13 per cent of the world ’ s remaining total – promise profit to anyone able to reach them. oil companies have operated onshore in every arctic nation for decades, but the new frontier is offshore... a melted arctic pushes back the date on which we will “ run out of ” energy, giving us more time to develop new sources. mining is big business in the arctic. russia ’ s norilsk mine is the world ’ s largest producer of nickel and palladium, and alaska ’ s red dog mine is the world ’ s largest source of zinc. more record - beaters are set to break ground. last month, the nunavut environmental assessment


the world ’ s largest producer of nickel and palladium, and alaska ’ s red dog mine is the world ’ s largest source of zinc. more record - beaters are set to break ground. last month, the nunavut environmental assessment agency gave the green light for the indian metals giant arcelormittal to dig an open pit iron - ore mine on 170 square kilometres of tundra at mary river on baffin bay, canada. the $ 4 billion project will be connected to a port in baffin bay by the world ’ s most northerly railway. the south - west coast, around kvanefjeld ( greenland ), probably holds the world ’ s second largest deposit of rare earth elements and huge reserves of uranium and zinc – all together valued at almost half - a - trillion dollars. last month, greenland minerals of perth, australia, announced plans to carry out a feasibility study. the project could keep miners busy for 100 years. it seems like only yesterday when we read about shortages of rare earths threatening computer development. receding sea ice is opening up the arctic to shipping. the north - east passage, linking the north atlantic to the pacific via the arctic waters north of russia, was open for five months in 2011. more than 30 ships passed through, including a 120, 000 - tonne russian gas tanker and nordic and japanese iron ore carriers taking arctic minerals to china. the shortcut to asia halves the shipping time from northern europe to china to roughly 20 days, and avoids pirate - infested shipping lanes in the indian ocean. russia expects a 40 - fold increase in shipping along the route by 2020. american analysts say it could be carrying 5 per cent of world ’ s shipping by 2050. bottom line : no one knows what the long term effects of global warming will be, and not knowing, no one can say whether on balance they will be beneficial or not. even the concept of “ on balance... beneficial ” is shaky. “ beneficial ” for whom and for what? even if we focus on “ beneficial for humans, ” are we talking about long term or short term? survival? life span? society? progress? happiness? is there something about global warming that will help humans to better health in the short term, but give us less ability to survive in the long term? will it assist tribal society at the expense of “ modern ” society? and what do we mean by “ progress ” and “ happiness ”? robert burns wrote : “... foresight may be vain


less ability to survive in the long term? will it assist tribal society at the expense of “ modern ” society? and what do we mean by “ progress ” and “ happiness ”? robert burns wrote : “... foresight may be vain : the best - laid schemes o ’ mice an ’ men, gang aft agley, ” and the longer we try to peer into the future, the more “ agley ” our best - laid schemes become. the universe and our world in it, are victims of chaos, where : “ small differences in initial conditions ( such as those due to rounding errors in numerical computation ) yield widely diverging outcomes for chaotic systems, rendering long - term prediction impossible in general. ( wikipedia ) we can ’ t predict what volcanoes will erupt, nor what wars will be fought, nor the status of the stock market, nor the next coronal mass ejection, nor the next pandemic, nor scientific progress in a thousand areas. and we can ’ t predict the effects of global warming. at best, we can try to address our immediate problems and hope our efforts will bode well for the long term. we can and should try to reduce air, water and ground pollution. we can and should try to find cures for diseases. we can and should try to prevent wars and to make cars safer to drive, and to improve the education of our children and to explore the solar system and to save our forests. but, i suspect our efforts to reduce global warming are misplaced. we simply do not know what we are doing. global warming very well could be what saves the human species. rodger malcolm mitchell nine steps to prosperity : 1. eliminate fica ( click here ) 2. medicare — parts a, b & d — for everyone 3. send every american citizen an annual check for $ 5, 000 or give every state $ 5, 000 per capita ( click here ) 4. long - term nursing care for everyone 5. free education ( including post - grad ) for everyone 6. salary for attending school ( click here ) 7. eliminate corporate taxes 8. increase the standard income tax deduction annually 9. increase federal spending on the myriad initiatives that benefit america ’ s 99 % no nation can tax itself into prosperity, nor grow without money growth. monetary sovereignty : cutting federal deficits to grow the economy is like applying leeches to cure anemia. two key equations in economics : federal deficits – net imports = net private savings gross domestic product = federal spending +


on november 26, 1941, a white house aide named henry field was summoned to the office of franklin roosevelt ’ s secretary, grace tully, for what seemed like a bizarre assignment. tully instructed field, one of the president ’ s bright young staffers, to produce, as quickly as possible, the names and addresses of all japanese americans, whether born in japan or america. the assignment was " of the utmost urgency, " said tully, adding, " use your own judgment to achieve results causing the least possible chance of a breach in security. " this was eleven days before pearl harbor. that same day secretary of state cordell hull issued what amounted to an ultimatum to two top japanese diplomats, ambassador to the u. s. kichisaburo nomura and special envoy saburo kurusu. " nomuru, " writes john toland in his book infamy : pearl harbor and its aftermath, " was too stunned to talk, " while kurusu instantly saw that this would be regarded in tokyo as " an insult. " having placed japan under strain of severe economic sanctions, the united states now was showing no willingness to negotiate a way out of the impasse short of a japanese humiliation. this was the day roosevelt both ensured war with japan and began preparing for the incarceration of japanese - americans when the war came. america today is once again on a path to war — this time with iran — and the road is dotted with many of the same signposts seen in roosevelt ’ s path to war seventy years ago. like roosevelt in his dealings with japan, president barack obama has helped place iran under severe strain of economic sanctions. like roosevelt, he has received from the adversary signals of flexibility in the search for a mutually satisfactory solution. like roosevelt, obama has rebuffed those overtures. roosevelt was under pressure from britain ’ s prime minister winston churchill to hang tough, and obama is under similar pressure from israel ’ s benjamin netanyahu. there may be one big difference, but we can ’ t know for sure. while the historical record shows clearly that roosevelt actually wanted war with japan, it isn ’ t clear this is obama ’ s desired outcome. if it is, his actions make sense. if not, his approach seems reckless. for there should be no mistaking the reality that the united states and iran are on a collision course, as reflected in the ongoing negotiations between the so - called p5 + 1 ( the united states, britain, france, china, russia and germany ) and iran.


no mistaking the reality that the united states and iran are on a collision course, as reflected in the ongoing negotiations between the so - called p5 + 1 ( the united states, britain, france, china, russia and germany ) and iran. the next session is set for june 18 – 19 in moscow, and this session isn ’ t likely to lead to a blowup, not least because obama has a large political incentive to keep the talks going at least through the november election. but the last session in baghdad seemed to indicate that, if there is indeed any prospect for a negotiated settlement, obama and the other p5 + 1 powers aren ’ t demonstrating any interest in exploring it. to understand this dynamic, it is helpful to review events leading up to the next negotiating session. any such review should take into account the recent writings of seyed hossein mousavian. the former spokesman for iran ’ s nuclear negotiations team and also iranian ambassador to germany for seven years, mousavian now is a research fellow at princeton. he was arrested by iranian president mahmoud ahmadinejad on charges of espionage in 2007 but was acquitted by the country ’ s judiciary. he is the author of a recently published book called the iranian nuclear crisis : a memoir. in his writings and public speaking, mousavian disputes those in the west who declare iran is bent on developing nuclear weapons. as he said in an interview with the middle east institute, " i am confident that iran is not seeking to have nuclear weapons. " indeed, in the spring of 2005, iran, in negotiations with european powers, offered to convert its enriched uranium to fuel rods, which would have precluded the country from using it for nuclear weapons. that was rejected by britain at america ’ s insistence, says mousavian. later, in 2010 and 2011, iran offered to limit its enrichment to 5 percent if the west would provide fuel rods for peaceful nuclear uses. shortly thereafter, russia put forth a " step - by - step " plan designed to break the impasse. both times the united states balked, leading russia ’ s then prime minister vladimir putin to suggest publicly that the west ’ s real design was regime change in iran ( a prospect guaranteed to generate powerful nuclear incentives in tehran ). against this backdrop, mousavian sees a possible avenue of peace. iran is willing to curtail its nuclear program and accept transparency measures, he says, so long as the west recognizes iran ’ s right to enrich uranium up to 5 percent, which is allowed under the


having a colonoscopy might be pretty low on latino adults ’ to - do lists. even hearing the term “ colonoscopy ” might make some people a bit squeamish. but it can also save your life. just take it from armida flores, a promotora — a trained community health worker — at the institute for health promotion research ( ihpr ) at the ut health science center at san antonio. flores spends her days helping latinos confront cancers and illness. she knows first - hand that latinos don ’ t get colon cancer screening enough. in fact, a new study found that only 28 percent of u. s. latinos have had colon cancer screening, compared to 36 percent of african - americans and 44 percent of whites. because of these things, she began to worry about her own health and decided to schedule a colonoscopy, which can help identify colon cancer. “ i was a little bit nervous about it but, to my surprise, the procedure was not too bad, ” flores said. “ i was asleep, so i did not feel any pain or discomfort. ” after explaining the procedure using simple medical terms, the doctor even offered to pray with her, an extra comfort that flores welcomed. “ the procedure was fast and the staff was caring. ” the night before the procedure, flores had trouble sleeping because of the liquid laxative solution she had to drink. however, she was surprised to discover that the liquid laxative, usually known for its horrible taste, actually wasn ’ t bad. “ the taste was okay, it was kind of salty and sweet, ” she recalled. the doctor found two small polyps in flores ’ colon that he was able to remove easily. flores eliminated potential dangers to her health just by deciding to take action. she urges latinos not to put themselves at risk just because of fear. “ i think people are scared because of the word or because they heard something negative about it, ” flores said. “ but a colonoscopy could save their life. ” amelie g. ramirez, drph, directs the institute for health promotion research at the ut health science center at san antonio, which researches latino health issues and founded the saludtoday latino health blog, twitter and facebook. dr. ramirez, an internationally recognized cancer health disparities researcher, has spent 30 years directing research on human and organizational communication to reduce chronic disease and cancer health disparities affecting latinos, including cancer risk factors, clinical trial recruitment, tobacco prevention, obesity


paternalism, the controlling of all aspects of an employee ' s life by the employer, was characteristic of many nineteenth - and early twentieth - century north carolina mills and factories. the roots of paternalism were evident in an earlier era, when southern slaveholders came to regard taking good care of their slaves as of primary importance. although partly a humanitarian concern, this focus on slaves ' welfare derived mostly from business considerations ; sufficient food, housing, medical care, and clothing kept slaves at least outwardly content and enabled them to work more efficiently. this understanding of the importance of the quality of life of one ' s workforce continued to motivate owners in the tenancy system and later in the creation of mill villages. paternalism was the philosophical and fiscal underpinning of many north carolina cotton mill villages, which were organized as " company towns " to keep workers and their families satisfied and thus loyal and more productive. paternalistic mill owners also claimed the right to discipline employees. violators of specific rules and laws were first warned, then fired and made to vacate their house after a second offense. drunkenness, spouse abuse, sexual immorality, and stealing were some of the most serious offenses, and only a small legal force, usually one man, was needed for the entire village. world war ii essentially brought an end to paternalism, as most north carolina mill villages and all of their homes, hospitals, libraries, and even community buildings were incorporated into neighboring towns. jacquelyn dowd hall and others, like a family : the making of a southern cotton mill world ( 1987 ). harriet l. herring, passing of the mill village : revolution in a southern institution ( 1949 ). oral histories of the american south - piedmont industrialization - employer paternalism. doc south, unc libraries : http : / / docsouth. unc. edu / sohp / browse / themes. html? theme _ id = 4 & category _ id = 15 & subcategory _ id = 131 free dental dispensary for school children, erlanger mills, lexington, nc, davidson county, october 1918. from the dr. george m. cooper photograph collection, north carolina state archives, call # : phc _ 41 _ 161 _ 4. available from http : / / www. flickr. com / photos / north - carolina - state - archives / 3059000658 / ( accessed october 12, 2012 ). 1 january 2006 | purcell, gene


cobalamin is a family of complex molecules, consisting of a cobalt - containing tetrapyrrole ring and side nucleotide chains attached to the cobalt atom. 4 it is synthesized by anaerobic bacteria and is found in foods of animal origin ( e. g., fish, meat, dairy products, and eggs ), as well as fortified cereals. 5 – 7 the recommended daily allowance ( rda ) of vitamin b12 is 2. 4 μg per day ( mcg / day ) for persons over the age of 14 years. in the united states, the average daily adult dietary intake of vitamin b12 is about 5 mcg – 30 mcg, of which only 1 mcg – 5 mcg are effectively absorbed, given its complex absorption process. it is estimated that only 50 % of dietary vitamin b12 is absorbed by healthy adults. 7 defects at any step of the absorption process can cause cobalamin deficiencies of varying degrees ; 50 % – 90 % of cobalamin stores in the body ( 3 mg – 5 mg ) are located in the liver. these stores help delay, often for up to 5 years, the onset of clinical symptoms due to insufficient cobalamin absorption. dietary cobalamin is bound to animal proteins. in the stomach, hydrochloric acid ( hcl ) and pepsin are critical for the release of free cobalamin from the proteins. glycoproteins called r - proteins ( r ) secreted from salivary glands and parietal cells bind free cobalamin in the stomach. intrinsic factor ( if ), a weak binder of cobalamin in the presence of r, is also released by parietal cells in the stomach. in the duodenum, dietary - and bile - secreted cobalamin - r complexes are cleaved by pancreatic enzymes, and free cobalamin is then bound to if with more affinity. cobalamin – if complexes are taken up by endocytosis, by adhering to cubilin receptors located on the distal ileal mucosa. once inside the cell, cobalamin dissociates from if. free cobalamin is then bound to transporter proteins : transcobalamin ( tc ) i, ii, and iii, and transported to the liver. tc ii represents about 10 % of total transcobalamin and is the only cobalamin - transport protein that reaches target cell receptors. this biologically - active form of the vitamin


i, ii, and iii, and transported to the liver. tc ii represents about 10 % of total transcobalamin and is the only cobalamin - transport protein that reaches target cell receptors. this biologically - active form of the vitamin can be taken up by cells via endocytosis for metabolic purposes. up to 1 % – 5 % of free cobalamin is also absorbed throughout the intestinal mucosa, via passive diffusion. 1 this enables the absorption of high doses ( at least 1 mg daily ) of oral supplemental cobalamin, despite absorption - disease processes. enterohepatic cobalamin absorption is another important source of vitamin b12. cobalamin released through bile is reabsorbed in the ileum on a daily basis. 8 the active forms of cobalamin ( methylcobalamin and adenosylcobalamin ) serve as co - factors for enzymes and exert their physiologic effects in the cytoplasm and the mitochondria. in the cytoplasm, methylcobalamin is a co - factor for methionine synthase, an enzyme necessary for two major cellular processes : 1 ) the conversion of homocysteine to methionine ; and 2 ) the conversion of methyl - tetrahydrofolate ( mthf ), the major circulating form of folate, to tetrahydrofolate ( thf ), the active form of folate, which is important for nucleotide and dna synthesis. in the mitochondria, adenosylcobalamin catalyzes the conversion of methylmalonyl coenzyme a ( coa ) to succinyl - coa, for lipid and protein metabolism. 6 disruptions in these pathways produce elevated levels of homocysteine ( hcy ) and methylmalonic acid ( mma ), respectively. hcy is known to be neurotoxic, through overstimulation of the n - methyl - d - aspartate ( nmda ) receptors, and toxic to the vasculature because of activation of the coagulation system and adverse effects on the vascular endothelium. 9 mma, a product of methylmalonyl - coa, can cause abnormal fatty - acid synthesis, affecting the neuronal membrane. 8 mma and hcy levels are elevated before any clinical manifestations of vitamin b12 deficiency and often precede low serum vitamin b12 levels. 5 neuropsychia


, can cause abnormal fatty - acid synthesis, affecting the neuronal membrane. 8 mma and hcy levels are elevated before any clinical manifestations of vitamin b12 deficiency and often precede low serum vitamin b12 levels. 5 neuropsychiatric symptoms usually precede hematologic signs and are often the presenting manifestation of cobalamin deficiency. 10 – 12 vitamin b12 deficiency definitions vary and usually rely on population statistics to establish normal serum - level thresholds ( normal range : 180 pg / ml – 900 pg / ml ). this can be problematic because individual metabolic requirements may vary, and active disease can be present despite a “ normal level. ” false - negative results can also be explained because vitamin b12 levels are altered by the concentration of its binding proteins, and radioimmunoassays may detect inactive forms of cobalamin that may mask tissue deficiencies of active cobalamin. studies have found that relying on the serum levels of vitamin b12 underestimated the prevalence of elevated metabolites that indicate tissue - deficiency by as much as 50 %. 13 as deficiency develops, serum values may be maintained at the expense of tissue cobalamin. thus, a serum - cobalamin value above the lower normal cutoff point does not necessarily indicate adequate cobalamin status. a deficiency spectrum ranging from subclinical metabolic abnormalities to clinical symptoms could be better delineated by measuring hcy and mma levels2, 4, 14, 15 or by measuring cobalamin bound to tc ii ( holo - transcobalamin ) levels, which represent the active form of the vitamin. 16, 17 a recent study in elderly persons ( n = 700 ) found holo - transcobalamin ( holo - tc ) to be the best predictor for determining cobalamin deficiency, when compared with other measures ( serum cobalamin, hcy, and mma ) and was recommended as the first - line measure in assessing cobalamin status, 18 but results have been inconsistent, 19 and further research is warranted. it is estimated that between 3 % and 40 % of older adults have vitamin b12 deficiencies, where lower rates are seen in the community and higher rates in institutional settings. 1, 8, 20 – 22 prevalence rates vary according to economic status, age, and dietary choices. 5, 23 in a multi - ethnic study, elderly white men had higher deficiency prevalence rates than elderly black or asian american women. 24 the elderly population is especially at risk for cobalamin deficiency,


to economic status, age, and dietary choices. 5, 23 in a multi - ethnic study, elderly white men had higher deficiency prevalence rates than elderly black or asian american women. 24 the elderly population is especially at risk for cobalamin deficiency, given their higher prevalence of atrophic gastritis and other gi pathology, as well as the use of medications that can interfere with b12 ' s absorption and / or metabolism : 10 % to 30 % of older people are unable to adequately absorb vitamin b12 from foods. 23 currently, it is estimated that food - cobalamin malabsorption syndrome causes most vitamin b12 deficiency, accounting for 60 % – 70 % of cases, followed by pernicious anemia ( pa ), an autoimmune loss of secretion of intrinsic factor, which accounts for 15 % – 20 % of cases. 1 in food - cobalamin malabsorption, there is an inability to release cobalamin from food or transport proteins, thus affecting absorption, even though unbound cobalamin can be adequately absorbed. vitamin b12 status relies not only on maintaining an adequate nutritional intake, but also ensuring an appropriate absorption process. many different factors and conditions can interfere with this process, leading to deficiency states. the following are causes / risk factors for cobalamin deficiency : 1, 25 – 29 1. food - cobalamin malabsorption : atrophic gastritis ( > 40 % in elderly persons ) ; chronic gastritis ; and drug interactions, including metformin or commonly - prescribed drugs that can increase gastric ph, such as histamine receptor - 2 antagonists ( h2 - blockers ), proton - pump inhibitors ( ppi ), and antacids. these drugs may also increase small - intestinal bacterial overgrowth ( sibo ), which is present in 15 % – 50 % of elderly patients, which may also increase the risk of vitamin b12 deficiency. 2. autoimmune : pernicious anemia, sjogren ' s syndrome. 3. surgical : post - gastrectomy syndrome, ileal resection. 4. decreased intake or malnutrition : vegetarians ; chronic alcoholism ; elderly people. 5. intestinal malabsorption : chronic pancreatitis ( exocrine insufficiency ), crohn ' s disease, whipple ' s disease, celiac disease, amyloidosis, scleroderma, intestinal lymphoma


vitamin b12 deficiency. a previous association has not been consistently documented, as some cohort studies have shown that low vitamin b12 level increases the risk for cognitive impairment or dementia, 65, 71 – 76 whereas other studies have not demonstrated an increased risk. 37, 76 – 84 the evidence is more consistent when hhcy is present, and vitamin b12 deficiency can lead to hhcy, a risk factor for cognitive impairment and dementia. 37 the reversibility of this dementia syndrome has also been questioned, given that studies reviewing large series of cases or decades of literature have yielded one and three cases of vitamin b12 reversibility, respectively. 39, 85 the evidence for response to treatment is better when pernicious anemia has been identified as the cause of vitamin b12 deficiency and it has been treated early in the course of the disease, before irreversible damage occurs. 37 we acknowledge that the severity and chronicity of symptoms, as well as comorbid conditions and adequacy of treatment, are all important factors affecting response and reversal of symptoms. current guidelines suggest assessing vitamin b12 levels in patients with cognitive impairment, or as part of a workup for dementia. we believe this remains a sound clinical judgment until newer evidence can clarify the issue, as vitamin b12 deficiency can lead to hhcy, a known risk factor for dementia. if vitamin b12 deficiency is diagnosed and treated early in the course of the disease, neuropsychiatric symptoms may be prevented or even reversed. the hallmark of delirium remains a fluctuating level of consciousness, with attention deficits. vitamin b12 deficiency has been associated with attention deficits, acute mental - status changes, and acute cognitive changes, with eeg abnormalities. 13, 86 case reports describe associations of vitamin b12 deficiency and delirium with or without other risk factors such as dementia and infection. 87, 88 in a prospective study of patients with mild - to - moderate dementia with low vitamin b12 levels that were supplemented, delirium risk was reduced significantly ; however, no long - term improvement was seen in cognition or behavioral problems. 89 screening for vitamin b12 deficiency should start by developing a clinical awareness of the population at risk. these include elderly persons, vegans, alcoholics, malnourished persons, and patients with gi pathology, neuropsychiatric symptoms, or autoimmune diseases. common suggestive laboratory findings include macrocytosis with or without anemia and hypersegmented neutrophil


, malnourished persons, and patients with gi pathology, neuropsychiatric symptoms, or autoimmune diseases. common suggestive laboratory findings include macrocytosis with or without anemia and hypersegmented neutrophils. special attention should also be given to patients on medications such as ppis, h2 - receptor antagonists, antacids, metformin, colchicine, cholestyramine, and patients chronically on anticonvulsants or antibiotics. serum cobalamin levels are unreliable when assessing vitamin b12 status, and there has been a lack of scientific consensus defining cutoff values to diagnose deficiency states. 3, 90 however, until better diagnostic tools are available, initial screening should start with assessing a serum cobalamin level. an adequate supply is suggested by levels above 350 pg / ml. 22, 29 we recommend assessment of mma in elderly patients when cobalamin levels are below 350 pg / ml. 20, 26 if mma levels are elevated, rule out other possible causes of elevated mma, including renal insufficiency or intravascular volume depletion. 25 patients taking antibiotics may have low levels of mma despite vitamin b12 deficiency, as propionic acid, a precursor of mma, 14, 25 is generated by the anaerobic gut flora, which are depleted by the chronic use of antibiotics. hhcy can be more sensitive to cobalamin deficiency, but it can also reflect folate deficiency, whereas elevated mma has a similar sensitivity, but more specificity to metabolic vitamin b12 deficiency. 15 assessment of holo - tc, the active fraction of cobalamin, may also provide reliable information to evaluate vitamin b12 status, 18 but further research is warranted. vitamin b12 deficiency is suspected when serum cobalamin levels are low ( < 350 pg / ml ) and when both mma and hcy are elevated, or when mma is elevated in the absence of renal disease or volume depletion, or when hcy is elevated in the absence of folate deficiency. several conditions can falsely elevate or decrease serum cobalamin levels, but a normal mma and hcy level suggest the absence of vitamin b12 deficiency. 2 however, clinical judgment is warranted, as it has been reported that some patients may improve clinically when supplemented with vitamin b12, despite normal levels of vitamin b12, hcy, and mma, especially when pa is present. 91 when pa is suspected, or if patients fail


, as it has been reported that some patients may improve clinically when supplemented with vitamin b12, despite normal levels of vitamin b12, hcy, and mma, especially when pa is present. 91 when pa is suspected, or if patients fail to respond to oral, transnasal, or buccal cobalamin preparations, antiparietal cell and anti - intrinsic factor antibodies should be tested. alternatively, if the cost of assessing mma levels ( e. g., availability, financial, time ) exceeds the diagnostic benefit, we recommend doing a risk / benefit analysis to consider supplementing vitamin b12, without further testing, in patients where deficiency is suspected, and serum cobalamin levels are less than 350 pg / ml. efficacy in the treatment of vitamin b12 deficiency due to food - cobalamin malabsorption with both parenteral and oral routes has been demonstrated. a systematic review of randomized, controlled trials of oral ( po ) versus intramuscular ( im ) vitamin b12 for the treatment of cobalamin deficiency found adequate efficacy with both routes of administration ; 92 po supplementation is usually more cost - effective and convenient, and is therefore the preferred route of initial therapy. the recommended doses for po administration vary from 125 mcg / day – 1, 000 mcg / day of crystalline cyanocobalamin to 1, 000 mcg / day – 2, 000 mcg / day, 28, 93, 94 with a mean dose of 1, 000 mcg / day being common practice. it is reasonable to initiate therapy with vitamin b12 or a multivitamin or b - complex supplement containing at least 1, 000 mcg of cobalamin daily. transnasal and buccal cobalamin preparations are also available. the im route of replacement should be initiated in cases where po, transnasal, or buccal preparations are ineffective or compliance is limited. the parenteral treatment for most cases of vitamin b12 deficiency, where a dietary deficiency is not implicated, involves im administration of cyanocobalamin in doses of 100 mcg / month – 1, 000 mcg / month, indefinitely. 8, 28, 95, 96 an alternate scheme recommends administering 1, 000 mcg / day im for 1 week, then weekly for 1 month, and then monthly thereafter. 28 once treatment has been initiated, obtain repeat plasma vitamin b12, mma, and hcy levels in 4 - to - 6 weeks to assess response to treatment. once stable mid - normal co


then weekly for 1 month, and then monthly thereafter. 28 once treatment has been initiated, obtain repeat plasma vitamin b12, mma, and hcy levels in 4 - to - 6 weeks to assess response to treatment. once stable mid - normal cobalamin levels are achieved, monitoring of vitamin b12 levels should be performed every 6 - to - 12 months. even though supplementation with vitamin b12 has been proven safe, hypokalemia has been reported when treating patients with severe anemia. 33, 64 evidence for the improvement or reversal of neuropsychiatric symptoms varies according to symptom severity, duration, and clinical diagnosis. it has been proposed that treating deficiencies in the early stages yields better results, as structural and irreversible changes in the brain may occur if left untreated. vitamin b12 status has been associated with severity of white - matter lesions, especially periventricular in some, 97 but not all studies. 98 the partial reversal of white - matter lesions has been documented with cobalamin treatment, 32, 91 emphasizing the importance of early detection and treatment of vitamin b12 deficiency. a correlation of vitamin b12 treatment and decreases in mma and total hcy has been shown, 10 suggesting a reversal of metabolic abnormalities. some evidence suggests that eeg, visual and somatosensory evoked potentials, and p300 latency abnormalities readily improve with treatment even if no clinical benefits are observed. 13, 33 vitamin b12 deficiency is a common and often missed problem in geriatric patients. neuropsychiatric manifestations can be the presenting and only sign of this deficiency even in the absence of hematologic abnormalities. vitamin b12 deficiency can occur despite “ normal ” serum cobalamin levels ; therefore, measuring hcy and mma can decrease false - negative findings. early detection and treatment are important to prevent structural and irreversible damage leading to treatment - resistant symptoms. oral treatment can be as efficacious as parenteral treatment even in the presence of pernicious anemia. because the neurologic damage caused by cobalamin deficiency is often irreversible, and progression of disease can be abated by cobalamin replacement, it is important to maintain plasma cobalamin levels in the mid - normal range among elderly persons. 1. screen annually for vitamin b12 deficiency in at - risk patients by measuring serum cobalamin levels. 2. measure mma levels in patients with serum cobalamin levels < 350 pg /


levels in the mid - normal range among elderly persons. 1. screen annually for vitamin b12 deficiency in at - risk patients by measuring serum cobalamin levels. 2. measure mma levels in patients with serum cobalamin levels < 350 pg / ml. high levels, in the absence of renal insufficiency or volume depletion, are suggestive of vitamin b12 deficiency. 3. if there is no access to mma or the cost outweighs the diagnostic benefit, a clinical approach can be to supplement after a risk / benefit analysis and monitor for response when low serum cobalamin levels are present ( < 350 pg / ml ) in the context of suggestive clinical findings. 4. administer cyanocobalamin 1, 000 mcg po daily, even if pernicious anemia has been identified. an alternative parenteral treatment includes cyanocobalamin 1, 000 mcg im daily for 1 week, then weekly for 1 month, and then monthly thereafter. 5. evaluate for pernicious anemia by requesting antiparietal cell and anti - intrinsic factor antibodies in patients with clinical symptoms of subacute combined degeneration of the spinal cord and suggestive hematological manifestations ( e. g., macrocytic anemia ). patients with pernicious anemia require lifetime cobalamin supplementation. 6. monitor vitamin b12 serum levels at least yearly in patients who have stopped supplementation after symptoms have improved or cobalamin levels have been replenished. 7. maintain plasma vitamin b12 levels in the mid - normal range ( 400 pg / ml – 500 pg / ml ) to reduce risk of developing vitamin b12 - related neuropsychiatric disorders.