Gotowa bibliografia na temat „Leyton transfer”

Microscopic, non-gem quality, grains of blue sapphire (corundum) have been identified in a small (1–2 cm wide), discontinuous, dike of nelsonite hosted by aluminous feldspathic gneiss. The gneiss was excavated during the construction of a hydroelectric plant on the Black River at Port Leyden, NY (western Adirondack Highlands). The sapphire location is 250 m NE of the Port Leyden nelsonite deposit. The small dike may represent a separate intrusion of nelsonite or one sheared from the main nelsonite orebody during Ottawan (circa 1050 Ma) deformation and metamorphism. The sapphires range in size from 0.1 to 2.0 mm, and commonly show parting, pleochroism, and hexagonal oscillatory zoning (from deep blue to clear). Electron microprobe analysis shows comparable levels of Fe in both clear (0.71–0.75 wt. %) and blue (0.38–0.77 wt. %) portions of grains, but clear sections have significantly lower TiO2 levels (0.002–0.011 wt.%) compared to blue sections (0.219–0.470 wt. %). Cr2O3 abundances range from 0.006 to 0.079 wt. % whereas V2O3 abundances range from 0.010 to 0.077 wt. % in blue sapphires. Small amounts of MgO were detected in one of the clear corundum grains (0.013 wt. %) and two of the six blue grains (0.001–0.015 wt. %), but the remaining five grains were below the limit of detection. Ga2O3, however, was detected in five out of six blue-colored grains (0.026–0.097 wt. %) but was below the limits of detection for clear grains. Optical spectroscopic data collected on the blue sapphire grains show broad absorbance in the yellow, orange, and red part of the spectrum (~565–740 nm) consistent with intervalence charge transfer between the next nearest neighbor Fe2+ and Ti4+. A magmatic origin of the sapphire grains is supported by petrologic and trace element data from the blue sapphires, but Cr abundances are inconsistent with this interpretation. Sapphire in a nelsonite host rock represents a new type of occurrence.

The climate policy of the European Union became the key priority for the European Commission, headed by Ursula von der Leyen. This article analyses both its internal and external dimensions, while concentrating on the finances of the European Green Deal, the multiyear strategy for the EU socio-economic development. The methods are demonstrated which the EC employs to mobilize public and private capital for the realization of the green transit, including the financial instruments designed to assist businesses when investing in clean energy and industry. The notion of ‘sustainable’ investment is specified that Brussels is guided by when working out its financial decisions. The EU taxonomy, a green classification system that translates the EU's climate and environmental objectives into criteria for specific economic activities for investment purposes, is presented. The research reveals how the market and regulatory powers of the EU are brought to bear in rolling out its controversial Carbon Border Adjustment Mechanism. By means of this transnational taxation Brussels hopes to avoid carbon leakage: the situation that allegedly may occur if European carbon-intensive businesses were to transfer production to other jurisdictions with laxer emission constraints. Yet a lack of flexibility in applying the CBAM is causing concern in many countries of the world, including the USA, Brazil, South Africa and China. In EU-Russia relations in particular, it risks increasing political tensions and/or causing trade retaliation due to low levels of mutual trust. Russia developing energy transition plans of her own, her efforts in this respect are now visibly stimulated by the declared EU intention to externalize its regulatory practices. At the same time, Moscow perceives this externalization as an imposition which is most unwelcome and hurts Russia disproportionally. Presumably, the European Union could put more effort in negotiating and developing this latest European initiative with international partners to win new willing ears for it.

Carbon credits, carbon taxes, and emissions trading systems are familiar terms in discussions about limiting global warming, the Paris Agreement, and net-zero emissions goals. A more recent addition to the glossary of climate policy is “carbon tariff.” While the concept is not new, it recently surfaced in nascent policymaking in the EU. In 2019, European Commission President Ursula von der Leyen proposed a “carbon border adjustment mechanism (CBAM)” as part of a proposed green deal. In March, the European Parliament adopted a resolution on a World Trade Organization (WTO)-compatible CBAM. A carbon tariff, or the EU’s CBAM, is a tax applied to carbon-intensive imports. Countries that have pledged to be more ambitious in reducing emissions—and in some cases have implemented binding targets—may impose carbon costs on their own businesses. Being eyed now are cross-border or overseas businesses that make products in countries in which no costs are imposed for emissions, resulting in cheaper carbon-intensive goods. Those products are exported to the countries aiming for reduced emissions. The concern lies in the risk of locally made goods becoming unfairly disadvantaged against competitors that are not taking similar steps to deal with climate change. A carbon tariff is being considered to level the playing field: local businesses in countries applying a tariff can better compete as climate policies evolve and are adopted around the world. Complying with WTO rules to ensure fair treatment, the CBAM will be imposed only on high-emitting industries that compete directly with local industries paying a carbon price. In the short term, these are likely to be steel, chemicals, fertilizers, and cement. The Parliament’s statement introduced another term to the glossary of climate policy: carbon leakage. “To raise global climate ambition and prevent ‘carbon leakage,’ the EU must place a carbon price on imports from less climate-ambitious countries.” It refers to the situation that may occur if businesses were to transfer production to other countries with laxer emission constraints to avoid costs related to climate policies. This could lead to an increase in total emissions in the higher-emitting countries. “The resolution underlines that the EU’s increased ambition on climate change must not lead to carbon leakage as global climate efforts will not benefit if EU production is just moved to non-EU countries that have less ambitious emissions rules,” the Parliament said. It also emphasized the tariff “must not be misused to further protectionism.” A member of the environment committee, Yannick Jadot, said, “It is a major political and democratic test for the EU, which must stop being naïve and impose the same carbon price on products, whether they are produced in or outside the EU, to ensure the most polluting sectors also take part in fighting climate change and innovate towards zero carbon. This will give us the best chance of remaining below the 1.5°C warming limit, whilst also pushing our trading partners to be equally ambitious in order to enter the EU market.” The Commission is expected to present a legislative proposal on a CBAM in the second quarter of 2021 as part of the European Green Deal.

Medicinal plants, especially those that are grown and cultivated in heavily polluted soils, are one source of lead toxicity in humans. This study assessed the Pb accumulation capacity of two commonly used medicinal plants, Artemisia vulgaris and Plectranthus amboinicus. Bioaccumulation factor, translocation factor and metal extraction ratio of each plant species were also determined. The plants were planted in pots in a controlled experiment and subjected to different concentrations of Pb (0–600ppm) for 4 weeks. Both plants showed no visual signs of Pb toxicity at the end of the study. The growth of A. vulgaris was not significantly affected by the different levels of Pb added to the soil. The increase in height of P. amboinicus was significantly affected by the Pb in the soil. The roots accumulated more Pb, followed by the leaves and the stems. Pb level in plant tissues increased with increased addition of Pb to the soil. Bioaccumulation factor (BAF) of A. vulgaris and P. amboinicus was above 1 which means these plants are accumulators of Pb. With a translocation factor (TF) > 1, A. vulgaris can effectively transfer Pb from the stems to the shoots while P. amboinicus cannot. Of the two plants, P. amboinicus was most effective in removing lead from the soil even at high concentrations (600ppm).

The prevalence of advanced dementia (AD) is expected to increase dramatically over the next few decades. Patients with AD suffer from recurrent episodic illnesses that frequently result in transfers to acute care hospitals. The default pathway followed by some emergency physicians, internists and intensivists who see those patients is to prioritize disease-directed therapies over attention to the larger picture of AD. While this strategy is desired by many families, some families prefer a different approach. This essay examines the reason why there can be a failure to focus on the over-arching issue of AD and offers suggestions for improvement. Gaps in information and physician workload are important factors, but we argue that until physicians who see patients in emergency departments learn to pause first and ask “Why are we doing this?” they will revert to their comfort zone of ordering tests and therapies that may be unwanted. A separate emergency palliative care pathway may be one solution. Shifting the focus back to the larger picture of AD and away from the physiologic disturbance of the moment may alter the trajectory of care in ways that truly respect the wishes of some patients and their families. On s’attend à ce que la prévalence de la démence avancée (DA) augmente de façon extrêmement importante au cours des prochaines décennies. Or, il arrive que des patients atteints de DA soient aux prises avec des maladies épisodiques récurrentes qui entraînent fréquemment un transfert dans un hôpital de soins actifs. La voie suivie par défaut par certains urgentologues, internistes et intensivistes qui reçoivent ces patients consiste à donner la priorité à l’application de traitements axés sur la maladie plutôt qu’à aborder le problème plus large de la DA. Cette stratégie satisfait bien des familles, mais certaines préfèrent une autre approche. Cet article examine pourquoi on semble vouloir éviter de s’attarder au problème récurrent de la DA et offre des suggestions d’amélioration. Des lacunes en matière d’information ainsi que la charge de travail des médecins sont sûrement des facteurs importants qui mènent à cette situation. Toutefois, nous soutenons que tant que les médecins qui voient ces patients au service des urgences ne prendront pas le temps de s’arrêter et de se questionner sur leur choix d’actions, ils se limiteront à se retirer dans leur zone de confort qui consiste à prescrire des tests et des traitements qui risquent d’être inopportuns. Une voie distincte en matière de soins palliatifs d’urgence peut s’avérer être une solution. En déplaçant l’accent mis sur les troubles physiologiques du moment pour le mettre sur le problème plus large de la DA, la trajectoire des soins pourrait être modifiée de façon à mieux respecter les désirs de certains patients et de leur famille.An 84-year-old bed-bound man with severe Alzheimer’s dementia presents to the emergency department with pneumonia, accompanied by his 3 daughters. He has been hospitalized 4 times in the past 2 years for antibiotic-associated Clostridium difficile diarrhea. Antibiotics and intravenous fluids were started by the first physicians who saw him. An internist was consulted to take over his care.In 2016, 564,000 Canadians were living with dementia. Each year 25,000 new cases of dementia are diagnosed, and it is expected that by 2030 there will be close to 1 million Canadians who have dementia.1 People with advanced dementia (AD) suffer with cognitive deficits and are unable to communicate, ambulate and have incontinence. They are at high risk for imminent death,2,3 an under-recognized fact even among health care professionals.4 In contrast to patients with terminal cancer and end stage heart disease, most patients with AD do not die from devastating acute events (like bowel obstruction, or heart failure) that result from the progression of their primary disease. Instead, they die from recurrent episodic illnesses that can be treated with relatively simple therapeutic responses (like intravenous fluids or antibiotics). 3 These include pneumonias, urinary tract and skin infections, influenza, problems with eating (including aspiration) and dehydration. It is not surprising that in the United States that 19% of nursing home residents with cognitive impairment experience at least one transfer to a hospital in the last 120 days of life.5When these patients arrive in the emergency department (ED), the default pathway is to prioritize disease-directed therapies (e.g., intravenous fluid and antibiotics) over attention to the larger picture of AD. The physiologic disturbances receive intense focus and the AD is seemingly forgotten. These patients often suffer from treatable symptoms, including pain and shortness of breath.3 In some (but not all) cases, patients may receive care they don’t really want, families may be afraid to express their true wishes, and health care professionals may deliver care they suspect is unnecessary, or even harmful. This essay examines the reasons why this phenomenon occurs and offers suggestions for improvement by encouraging acute care clinicians to pause and ask themselves, “Why are we doing this?” and by engage family members in focused goals of care discussions that include outcomes of aggressive disease-directed treatments and palliative approaches.There are many reasons why the physicians who treat these patients in acute care hospitals (primarily emergency physicians, internists/hospitalists and intensivists) prioritize life-sustaining therapies over relief of burdensome symptoms as the default strategy. Information gaps affect the process of care. These physicians likely assume that a transfer to an acute care facility indicates the (sometimes mistaken) desire for life-sustaining interventions by the patient’s relatives. Transfer decisions are a human endeavour, and thus are subject to error6 especially when personnel worry about blame. While nearly half of all transfers from nursing homes to the ED are for cardiovascular and respiratory problems, 7 key factors influencing decisions to transfer as reported by family physicians include medico-legal concerns, family pressure, the capability of nursing home staff and the physician’s workload.8Even in Ontario, where nursing home residents are legally required to have annually updated instructions about whether transfer to acute care hospitals is indicated, the process only works as well as the nature of the counselling and discussion (which is often perfunctory) that takes place before the patients or their legal substitutes sign that document. In the United States, it is unclear how and whether the rapid uptake of Physician Orders for Life-Sustaining Treatment in nursing homes has affected end-of-life care in AD.9 From an economic and medico-legal perspective, there is no incentive for nursing homes or their staff to manage the acutely ill nursing home patient themselves, and every incentive to transfer care to an ED even when “no transfer” instructions are clearly recorded. The physician who meets the patient for the first time in the ED often lacks familiarity with the patient’s clinical course and his or her family, which coupled with a lack of communication training for these circumstances, inhibits addressing goals of care directly.10Physician workload is also an important factor. In a busy ED, an empathetic conversation that elucidates patients’ goals of care, educates families about the outcomes of care11 and offers the option of prioritizing attention to symptoms takes time and requires a higher cognitive load than ordering tests, intravenous fluids and antibiotics. In addition, the process of acute care, once initiated, may be a contributing factor. Family members see that life-prolonging therapies can be given, making it more difficult for them to decide to forgo disease-directed therapies once started without being overwhelmed by a sense of guilt. Finally, precise prognostication in a patient with AD is fraught with hazards.12 All of these factors play a role, but overall, until the physicians who see patients in the ED acquire the expertise to routinely address goals of care, and experience the rewards and sense of professional fulfillment that can be derived from sparing patients unwanted invasive care, the opportunity to prioritize comfort may not be offered. Those physicians will revert to their comfort zone of checking the electrolytes, obtaining a chest x-ray and urine culture which then results in a discussion that starts by asking families questions like, “Do you want us to treat the hypernatremia?” When phrased that way, few family members (even those who are physicians) are prepared to say “No.”While assessing goals of care for patients with AD may currently be viewed as impractical in the busy ED, perhaps the right models have not been proposed. Complexity has not deterred the rapid response in EDs for patients with acute strokes and ST-elevation myocardial infarctions. One solution may be to develop a separate “emergency palliative care pathway” where the primary task is prioritizing relief of burdensome symptoms and eliciting true preferences.13 thus avoiding stressful lengthy stays in the chaotic ED where patients with AD are often of low priority. Interventions aimed upstream from the ED may include increasing resources for training of nursing home staff along with the provision of decision aids to assist caregivers in the clarification of goals of care prior to transfer to the ED.14Some patients with AD and their families may prefer prioritizing comfort above all else but may not be offered the chance to make that choice. In a survey of elderly hospitalized Canadians, 70% reported wanting to focus on providing comfort rather than life-prolonging treatment, yet 54% of these patients are admitted to intensive care units at the end of life. 15 Even if this circumstance occurs in a minority of the dementia patients who are sent to EDs, the substantial rise in the number of people with dementia means that it will occur much more commonly in the future. In these cases, emergency physicians and the consultants that they approach for help can play a critical role if they push the pause button before beginning empiric disease-directed therapies, and simply ask patients’ families, “What is your understanding of your loved one’s prognosis?” and, “ What are you hoping for?” On the one hand, these conversations take time. On the other, they can be efficient, focus on these simple questions, and describe outcomes of care including potential discomforts associated with treatments. By shifting the focus back to the larger picture of AD and away from the physiologic disturbance of the moment, they may alter the trajectory of care, ultimately reducing the burden to patients and their families. We can facilitate patients’ wishes and honour the truly vital role that family members play as members of the health care team.Returning to the case, after a 7-minute discussion of the goals and options for care, led by the internist, the patient’s daughters were unable to decide upon the best course of treatment. A phone call to his wife was made, and she indicated that comfort measures were “what he would want.” After initiating oxygen and subcutaneous morphine for relief of pain and dyspnea in the ED, the patient was transferred to the ward with palliative care physicians. He received comfort-directed care and died peacefully 4 days later surrounded by his family. Competing InterestsNone declared AcknowledgementsWe thank S. Ryan Greysen MD, Gurpreet Dhaliwal (both of University of California San Francisco), Lewis A. Lipsitz MD (Harvard), Howard Ovens MD and Barry J. Goldlist MD (both of University of Toronto) for comments on an earlier draft.References1. Alzheimer Society of Canada. Report summary Prevalence and monetary costs of dementia in Canada (2016): a report by the Alzheimer Society of Canada. Health promotion and chronic disease prevention in Canada: research, policy and practice. October 2016:231–32.2. Morrison RS, Siu AL. Survival in end-stage dementia following acute illness. JAMA 2000;284(1):47–52.3. Mitchell SL, Teno JM, Kiely DK, et al. The clinical course of AD. N Engl J Med 2009;361(16):1529–38. doi:10.1056/NEJMoa0902234.4. Chang A, Walter LC. Recognizing dementia as a terminal illness in nursing home residents: Comment on "Survival and comfort after treatment of pneumonia in AD." Arch Intern Med 2010;170(13):1107–1109. doi:10.1001/archinternmed.2010.166.5. Gozalo P, Teno JM, Mitchell SL, et al. End-of-life transitions among nursing home residents with cognitive issues. N Engl J Med 2011;365(13):1212–21. doi:10.1056/NEJMsa1100347.6. Stephens CE, Newcomer R, Blegen M, Miller B, Harrington C. Emergency department use by nursing home residents: effect of severity of cognitive impairment. Gerontologist 2012;52(3):383–93. doi:10.1093/geront/gnr109.7. Jensen PM, Fraser F, Shankardass K, Epstein R, Khera J. Are long-term care residents referred appropriately to hospital emergency departments? Can Fam Physician 2009;55(5):500–505.8. McDermott C, Coppin R, Little P, Leydon G. Hospital admissions from nursing homes: a qualitative study of GP decision making. Br J Gen Pract 2012;62(601):e538–e545. doi:10.3399/bjgp12X653589.9. Halpern SD. Toward evidence-based end-of-life care. N Engl J Med 2015;373(21):2001-2003. doi:10.1056/NEJMp1509664.10. Lamba S, Nagurka R, Zielinski A, Scott SR. Palliative care provision in the emergency department: barriers reported by emergency physicians. J Palliat Med 2013;16(2):143–47. doi:10.1089/jpm.2012.0402.11. Givens JL, Jones RN, Shaffer ML, et al. Survival and comfort after treatment of pneumonia in AD. Arch Intern Med 2010;170(13):1102–107. doi:10.1001/archinternmed.2010.181.12. Mitchell SL, Miller SC, Teno JM, et al. Prediction of 6-month survival of nursing home residents with advanced dementia using ADEPT vs hospice eligibility guidelines. JAMA 2010;304(17):1929–35. doi:10.1001/jama.2010.1572.13. Grudzen CR, Stone SC, Morrison RS. The palliative care model for emergency department patients with advanced illness. J Palliat Med 2011;14(8):945–50. doi:10.1089/jpm.2011.0011.14. Hanson LC, Zimmerman S, Song M-K, et al. Effect of the goals of care intervention for AD. JAMA Intern Med 2017;177(1):24–28. doi:10.1001/jamainternmed.2016.7031.15. Fowler R, Hammer M. End-of-life care in Canada. Clin Invest Med 2013;36(3):E127–E132.

The aim of this thesis is to illustrate the phenomenon of the transfer of the transalpine landscape motifs in graphic art into the works of Italian engravers at the beginning of the six- teenth century, and by using detailed analysis of these prints lead to a decision as to why these transfers occur so frequently, mainly in the years 1500-1520. Because only brief mentions of these transfers are found in the available literature on this topic, and then often only as a statement, I decided to tackle this phenomenon in the context of landscape specifications. In the introductory chapter there will be a concise overview of the cultural situation of the humanistic society, including its assumptions and a brief evolution of depiction of landscape art. Additionally there will be a chapter about the terminology used, which in addition to clarifying the terminology also helps to further the description of the proce- ss itself. The main part will of course be a chapter dedicated into selected items. There will also be descriptions of the graphic works of selected Italian engravers, especially in the comparison of transferred landscape motifs from works by Albrecht Dürer and Lucas van Leyden. Analy- sis of the individual prints will focus on elements transmitted in the background of the works. Iconography...

This article revisits the problem of indirect combustion noise in nozzles of finite length. The analytical model proposed by Moase et al. (JFM 2007) for indirect combustion noise is red-erived and applied to subcritical nozzles having shapes of increasing complexity. This model is based on the equations formulated by Marble & Candel (JSV 1977) for which an explicit solution is obtained in the subsonic framework. The discretization of the nozzle into n elementary units of finite length implies the determination of 2n integration constants for which a set of linear equations is provided in this article. The analytical method is applied to configurations of increasing complexity. Analytical solutions are compared to numerical results obtained using SUNDAY (a 1D non linear Euler solver in temporal space) and CEDRE (3D Navier-Stokes flow solver). An excellent agreement is found for all configurations thereby showing that acceleration discontinuities at the boundaries between adjacent elements do not influence the actual acoustic transfer functions. The issue of nozzle compactness is addressed. It is found that in the subcritical domain, spectral results should be nondimensionalized using the flow-through-time of the entire nozzle. Doing so, transfer functions of nozzles of different lengths are successfully compared and a compactness criterion is proposed that writes ω*∫0Ldζ/uζ<1 where L is the axial length of the nozzle. Finally, the EWG experimental setup of Bake et al. (JSV 2009) is considered. Analytical results are compared to the results reported by Howe (JFM 2010). Both models give similar trends and show the important role of the rising time of the fluctuating temperature front on the amplitude of the indirect acoustic emission. The experimental temperature profile and the impedance coefficients at the inlet and outlet provided by Bake et al. (JSV 2009) and Leyko et al. (JSV 2011) are introduced into the analytical formulation. Results show that the indirect combustion noise mechanism cannot be held responsible alone for the acoustic emission in the subcritical case.