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Psychiatric problems also lead to increased stigmatization and present significant challenges to medication adherence erectile dysfunction organic causes generic top avana 80 mg fast delivery. In low-resource settings impotence injections buy top avana 80mg otc, specialized medical professionals are usually not available to perform comprehensive psychiatric evaluations impotent rage man buy 80mg top avana with visa. Dosing may have to be altered erectile dysfunction question generic top avana 80mg otc, however, because of the presence of interactions between certain psychotropic and antiretroviral medications. Effect of perinatally acquired human immunodeficiency virus infection on neurodevelopment in children during the first two years of life. Psychiatric diagnoses in adolescents seropositive for the human immunodeficiency virus. Early cognitive and motor development among infants born to women infected with human immunodeficiency virus. Identify the appropriate rehydration plan for use with patients experiencing dehydration. Others include vomiting, wasting, hepatitis, esophagitis, malabsorption, jaundice, and failure to thrive. Nausea and Vomiting Nausea and vomiting are common physical complaints with many causes. Many medications can also cause nausea and vomiting, including antiretroviral agents, drugs used to treat or prevent opportunistic infections, and antineoplastic (anticancer) drugs. Patients with diarrhea and/or vomiting should be monitored for signs and symptoms of dehydration. Assessment the assessment of a patient with nausea and vomiting should include both subjective and objective data. Some danger signs include bilious (dark green) emesis, hematemesis (vomit with blood), jaundice, severe headache, altered mental status, focal neurologic signs, and severe flank or abdominal tenderness on exam. Patients should be instructed to drink fluids frequently, small volumes at a time; eat five to six small meals a day; avoid greasy, highfat foods; and eat food at room temperature. In addition to restoring and maintaining adequate hydration, treatment should be directed at the underlying cause of nausea and vomiting if appropriate. Antiemetic medications can be sedating and may be harmful in the pediatric setting and are not recommended for children. Diarrhea Overview Diarrhea remains one of the most common causes of death worldwide among children younger than 5 years. Diarrhea is an excessive loss of fluid and electrolytes in the stool resulting in three or more loose stools in a 24-h period. The consistency of the stools is the most important factor, and frequent passage of soft or well-formed stools should not be considered diarrhea. Infections, toxins, medications, anatomic abnormalities such as tumors, and dietary intolerance can cause diarrhea. Infections can be classified as causing predominantly watery, large-volume diarrhea due to a small-bowel infection or bloody, small-volume dysentery due to a predominant colonic infection. Agents such as rotavirus, Norwalk virus, adenoviruses, enteroviruses, Vibrio cholerae, enterotoxigenic Escherichia coli, Giardia, and Cryptosporidium commonly cause watery diarrhea. The patient and family should be educated about the signs of dehydration and the importance of maintaining adequate fluid intake. Food- or waterborne pathogens may cause diarrheal infections in immunocompromised hosts at a smaller inoculum than that needed to infect healthy hosts; they may also cause opportunistic infections. Staphylococcus aureus, Bacillus cereus, and Clostridium perfringens can cause food poisoning. Other causes of diarrhea include medications, such as antiretrovirals, which may cause diarrhea as a side effect (refer to the chapter on antiretroviral treatment for a listing of specific medications associated with diarrhea). Many antibiotics also cause loose stools because of their effect on normal flora, and Clostridium difficile infection may occur in the setting of recent broad-spectrum antibiotic therapy. Inflammatory processes such as celiac sprue (malabsorption syndrome characterized by marked atrophy and loss of function of the small intestinal lining), surgical procedures, and tumors can change the anatomy and function of the intestines and result in diarrhea. Though diagnosis of the exact cause of diarrhea may be difficult, for treatment purposes one can usually divide diarrhea into four clinical types and then manage accordingly: 1. Diarrhea and severe acute malnutrition Assessment Assessment of a patient with diarrhea should include both subjective and objective information.
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Effect of Deck Support-The most common form of support against lateral deflection is a deck continuously attached to the top edge of the beam erectile dysfunction massage techniques discount top avana 80mg without a prescription. If this deck is rigid against shear in the plane of the deck and is attached to the compression edge of the beam erectile dysfunction doctors buffalo ny buy cheap top avana 80 mg online, the beam cannot buckle erectile dysfunction diagnosis quality top avana 80mg. In regions where the deck is attached to the tension edge of the beam impotence your 20s discount top avana 80mg fast delivery, as where a beam is continuous over a support, the deck cannot be counted on to prevent buckling and restraint against axial rotation should be provided at the support point. If the deck is not very rigid against in-plane shear, as for example standard 38-mm (nominal 2-in. Cantilevers with the deck on top have their tension edge supported and do not derive much support from the deck. LateralTorsional Buckling Because beams are compressed on the concave edge when bent under load, they can buckle by a combination of lateral deflection and twist. Because most wood beams are rectangular in cross section, the equations presented here are for rectangular members only. Beams of I, H, or other built-up cross section exhibit a more complex resistance to twisting and are more stable than the following equations would predict. The general case of a beam of unbraced length le includes a primary (edgewise) moment M1, a lateral (flatwise) moment M2, and axial load P. The axial load creates a secondary moment on both edgewise and flatwise moments due to the deflection under combined loading given by Equation (97). In addition, the edgewise moment has an effect like the secondary moment effect on the flatwise moment. The following equation contains two moment modification factors, one on the edgewise bending stress and one on the flatwise bending stress that includes the interaction of biaxial bending. A method of determining the buckling stress and the required cross-sectional area for centrally loaded straight columns in elastic and inelastic range. Hunt, Research Chemist Contents Surface Properties of Wood for Bonding 102 Lumber Surfaces 102 Veneer Surfaces 103 Chemical Interference to Bonding 104 Bonding of Wood Composite Products and Nonwood Materials 105 Physical Properties of Wood for Bonding 105 Density and Porosity 105 Moisture Content and Dimensional Changes 106 Adhesives 108 Composition 108 Strength and Durability 109 Selection 1010 Health and Safety 1014 Bonding Process 1014 Moisture Content Control 1014 Surface Preparation 1015 Spreading of Adhesive 1015 Assembly and Pressing 1016 Post-Cure Conditioning 1017 Bonded Joints 1018 Edge-Grain Joints 1018 End-Grain Joints 1018 End-to-Edge-Grain Joints 1018 Construction Joints 1019 Testing and Performance 1019 Analytical, Chemical, and Mechanical Testing of Polymers 1019 Mechanical Testing of Bonded Assemblies 1020 Short- and Long-Term Performance 1021 Product Quality Assurance 1022 Standards 1022 References 1023 Adhesive bonding of wood plays an increasing role in the forest products industry and is a key factor for efficiently utilizing our timber resource. The main use of adhesives is in the manufacture of building materials, including plywood, oriented strandboard, particleboard, fiberboard, structural composite lumber, doors, windows and frames, and factory-laminated wood products. Adhesives are also used in the assembly of furniture and cabinets, manufacture of engineered wood products, and construction of residential and commercial structures. Adhesives transfer and distribute loads between components, thereby increasing the strength and stiffness of wood products. Effective transfer of stress from one member to another depends on the strength of the links in an imaginary chain across the adhesive-bonded joint. Thus, the performance of a bonded joint depends on how well the complex factors that contribute to the properties of the individual links (wood, adhesive, and interphase regions of wood and adhesive) are controlled during product assembly, which ultimately determines the strength of the chain. Effective mechanical interlocking takes place when an adhesive penetrates beyond the surface debris and damaged fibers into sound wood two to six cells deep. Further penetration into the cell wall microstructure increases the mechanical interlocking and the surface area for adhesive contact with the wood. With many adhesives, the most durable, water-resistant bonds develop when the adhesive flows deeply into cell cavities and infiltrates inside the cell walls. The standard for excellent bonds is that the wood breaks away from the adhesive joint and that the bond strength is equal to the strength of the solid wood. Attractive forces between molecules of adhesive and wood contribute greatly to adhesion. Although covalent bonds- chemical bonds between the adhesive and wood-seem plausible with some adhesives, no evidence exists that they contribute to the strength of adhesive bonds. The wood surface should be smooth, flat, and free of machine marks and other surface irregularities, including planer skips and crushed, torn, or chipped grain. The surface should be free of burnishes, exudates, oils, dirt, and other debris that form a weak boundary between the adhesive and the wood. Imaginary links of adhesive bond between two pieces of wood using the schematic from Marra (1980). With some wood surfaces, such as teak, wood extractives can interfere with the direct adhesive contact, leading to a chemically weak boundary effect and poor bond strength. For maximum adhesive bond strength, the liquid adhesive must "wet" the wood surface, flowing over and penetrating into the wood.
Hardwood grading associations in United Statesa Name and address National Hardwood Lumber Association P impotence hypothyroidism buy top avana 80 mg otc. If the width is specified by purchase agreement coffee causes erectile dysfunction buy discount top avana 80mg line, S1E or S2E lumber is 10 mm (3/8 in erectile dysfunction 60784 generic top avana 80mg fast delivery. Dimension and Component Parts the term "dimension parts" for hardwoods signifies stock that is processed in specific thickness erectile dysfunction doctor san jose order 80 mg top avana amex, width, and length, or multiples thereof and ranges from semi-machined to completely machined component products. This stock is sometimes referred to as "hardwood dimension stock" or "hardwood lumber for dimension parts. These rules encompass three classes of material, each of which is classified into various grades: Hardwood dimension parts (flat stock) Clear two faces Clear one face Paint Core Sound Solid kiln-dried squares (rough) Clear Select Sound Solid kiln-dried squares (surfaced) Clear Select Paint Second Finished Market Products Some hardwood lumber products are graded in relatively finished form, with little or no further processing anticipated. Other examples are lath, siding, ties, planks, carstock, construction boards, timbers, trim, moulding, stair treads, and risers. Grading rules promulgated for flooring anticipate final consumer use and are summarized in this section. Details on grades of other finished products are found in appropriate association grading rules. Square-edge, square-endstrip flooring is also available as well as parquet flooring suitable for laying with mastic. The grading rules of the Maple Flooring Manufacturers Association cover flooring that is manufactured from hard maple, beech, and birch. Each species is graded into four categories: · First grade-one face practically free of all imperfections; variations in natural color of wood allowed Second grade-tight, sound knots (except on edges or ends) and other slight imperfections allowed; must be possible to lay flooring without waste Third grade-may contain all visual features common to hard maple, beech, and birch; will not admit voids on edges or ends, or holes over 10-mm (3/8-in. Surfaced semifabricated parts have been · 64 Chapter 6 Commercial Lumber, Round Timbers, and Ties Table 63. Nomenclature of commercial hardwood lumber Commercial name for lumber Alder, red Ash, black Ash, Oregon Ash, white Aspen (popple) Basswood Beech Birch Commercial name for lumber Maple, Oregon Maple, soft Oak, red Common tree name Red alder Black ash Oregon ash Blue ash Green ash White ash Bigtooth aspen Quaking aspen American basswood White basswood American beech Gray birch Paper birch River birch Sweet birch Yellow birch Boxelder Ohio buckeye Yellow buckeye Butternut Black cherry American chestnut Balsam poplar Eastern cottonwood Black cottonwood Cucumbertree Flowering dogwood Pacific dogwood Cedar elm Rock elm September elm Winged elm American elm Slippery elm Sweetgum Hackberry Sugarberry Mockernut hickory Pignut hickory Shagbark hickory Shellbark hickory American holly Eastern hophornbeam Black locust Honeylocust Pacific madrone Southern magnolia Sweetbay Black maple Sugar maple Botanical name Alnus rubra Fraxinus nigra Fraxinus latifolia Fraxinus quadrangulata Fraxinus pennsylvanica Fraxinus americana Populus grandidentata Populus tremuloides Tilia americana Tilia heterophylla Fagus grandifolia Betula populifolia Betula papyrifera Betula nigra Betula lenta Betula alleghaniensis Acer negundo Aesculus glabra Aesculus octandra Juglans cinerea Prunus serotina Castanea dentate Populus balsamifera Populus deltoids Populus trichocarpa Magnolia acuminata Cornus florida Cornus nuttallii Ulmus crassifolia Ulmus thomasii Ulmus serotina Ulmus alata Ulmus Americana Ulmus rubra Liquidambar styraciflua Celtis occidentalis Celtis laevigata Carya tomentosa Carya glabra Carya ovata Carya lacinosa Ilex opaca Ostrya virginiana Robinia pseudoacacia Gleditsia triacanthos Arbutus menziesii Magnolia grandiflora Magnolia virginiana Acer nigrum Acer saccharum Common tree name Big leaf maple Red maple Silver maple Black oak Blackjack oak California black oak Cherrybark oak Laurel oak Northern pin oak Northern red oak Nuttall oak Pin oak Scarlet oak Shumard oak Southern red oak Turkey oak Willow oak Arizona white oak Blue oak Bur oak Valley oak Chestnut oak Chinkapin oak Emory oak Gambel oak Mexican blue oak Live oak Oregon white oak Overcup oak Post oak Swamp chestnut oak Swamp white oak White oak California-laurel Osage-orange Bitternut hickory Nutmeg hickory Water hickory Pecan Common persimmon Yellow-poplar Sassafras Sycamore Tanoak Black tupelo, blackgum Ogeechee tupelo Water tupelo Black walnut Black willow Peachleaf willow Boxelder Buckeye Butternut Cherry Chestnut Cottonwood Cucumber Dogwood Elm, rock Oak, white Elm, soft Gum Hackberry Hickory Oregon myrtle Osage orange Pecan Persimmon Poplar Sassafras Sycamore Tanoak Tupelo Botanical name Acer macrophyllum Acer rubrum Acer saccharinum Quercus velutina Quercus marilandica Quercus kelloggi Quercus falcata var. Standard lengths are 610 mm (2 ft) and longer in First- and Secondgrade flooring and 381 mm (1-1/4 ft) and longer in Thirdgrade flooring. Oak is separated as red oak and white oak and by grain direction: plain sawn (all cuts), quartersawn (50% quartered character), rift sawn (75% rift character), and quarter/rift sawn (a combination). Standard thickness values for rough and surfaced (S2S) hardwood lumber Rough ((mm)(in. Lumber Species Names used by the trade to describe commercial lumber in the United States are not always the same as names of trees adopted as official by the U. United States agencies and associations that prepare rules for and supervise grading of hardwoods are given in Table 62. Softwood Lumber For many years, softwood lumber has demonstrated the versatility of wood by serving as a primary raw material for 66 Chapter 6 Commercial Lumber, Round Timbers, and Ties construction and manufacture. In this role, softwood lumber has been produced in a wide variety of products from many different species. The first industry-sponsored grading rules (product descriptions) for softwoods, which were established before 1900, were comparatively simple because sawmills marketed their lumber locally and grades had only local significance. As new timber sources were developed and lumber was transported to distant points, each producing region continued to establish its own grading rules; thus, lumber from various regions differed in size, grade name, and allowable grade characteristics. When different species were graded under different rules and competed in the same consuming areas, confusion and dissatisfaction were inevitable. To minimize unnecessary differences in the grading rules of softwood lumber and to improve and simplify these rules, a number of conferences were organized by the U. These meetings were attended by representatives of lumber manufacturers, distributors, wholesalers, retailers, engineers, architects, and contractors. The result was a relative standardization of sizes, definitions, and procedures for deriving allowable design properties, formulated as a voluntary American Lumber Standard. This standard has been modified several times, including addition of hardwood species to the standard beginning in 1970. Softwood lumber is classified for market use by form of manufacture, species, and grade.
The distinction between molding and staining is made primarily on the basis of the depth of discoloration erectile dysfunction age 29 80 mg top avana amex. With some molds and the lesser fungal stains health erectile dysfunction causes purchase 80 mg top avana free shipping, there is no clear-cut differentiation beta blocker causes erectile dysfunction buy top avana 80 mg with amex. Typical sap stain or blue stain penetrates into the sapwood and cannot be removed by surfacing erectile dysfunction medication free trial generic 80mg top avana with visa. Also, the discoloration as seen on a cross section of the wood often appears as pie-shaped wedges oriented radially, corresponding to the direction of the wood rays. The discoloration may completely cover the sapwood or may occur as specks, spots, streaks, or patches of various intensities of color. The so-called blue stains, which vary from bluish to bluish black and gray to brown, are the most common, although various shades of yellow, orange, purple, and red are sometimes encountered. The exact color of the stain depends on the infecting organisms and the species and moisture condition of the wood. The fungal brown stain mentioned here should not be confused with chemical brown stain. Mold discolorations usually become noticeable as fuzzy or powdery surface growths, with colors ranging from light shades to black. On softwoods, though the fungus may penetrate deeply, the discoloring surface growth often can easily be brushed or surfaced off. However, on large- Chemical Stains Nonmicrobial or chemical stains are difficult to control and represent substantial loss in wood quality. These stains, which should not be confused with fungal brown stain, include a variety of discolorations in wood that are often promoted by slow drying of lumber and warm to hot temperatures. Such conditions allow naturally occurring chemicals in wood to react with air (enzymatic oxidation) to form a new chemical that is typically dark in color. Common chemical stains include (a) interior sapwood graying, prevalent in oak, hackberry, ash, and maple, (b) brown stain in softwoods, and (c) pinking and browning in the interior of light-colored woods such as maple. Another common discoloration, iron stain, is caused by the interaction of iron with tannins in wood. Iron stain is more prevalent in hardwoods (for example, oak and many tropical hardwoods) and in some softwoods such as Douglas-fir. Most fungi that attack trees cease their activities after the trees have been cut, as do the fungi causing brown pocket (peck) in baldcypress or white pocket in Douglas-fir and other conifers. Relatively few fungi continue their destruction after the trees have been cut and worked into products and then only if conditions remain favorable for their growth. Although heartwood is more susceptible to decay than is sapwood in living trees, for many species, the sapwood of wood products is more susceptible to decay than is the heartwood. Most decay can progress rapidly at temperatures that favor growth of plant life in general. For the most part, decay is relatively slow at temperatures below 10 °C (50 °F) and above 35 °C (95 °F). Decay essentially ceases when the temperature drops as low as 2 °C (35 °F) or rises as high as 38 °C (100 °F). Serious decay occurs only when the moisture content of the wood is above the fiber saturation point (average 30%). Only when previously dried wood is contacted by water in the form of rain or condensation or is in contact with wet ground will the fiber saturation point be reached. By itself, the water vapor in humid air will not wet wood sufficiently to support significant decay, but it will permit development of some mold fungi. Fully air-dried wood usually will have a moisture content not exceeding 20% and should provide a reasonable margin of safety against fungal damage. Thus, wood will not decay if it is kept air dry, and decay already present from prior infection will not progress. If the wood is water-soaked, the supply of air to the interior of a piece may not be adequate to support development of typical decay fungi. For this reason, foundation piles buried beneath the water table and logs stored in a pond or under a suitable system of water sprays are not subject to decay by typical wood-decay fungi. Thousands of spores produced in a fungal fruiting body are distributed by wind or insects.
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