A 52-year-old man with chronic hepatitis C presented with painless, bilateral, simultaneous non-arteritic anterior ischemic optic neuropathy (NAION) and peripheral neuropathy. Symptoms began 19 weeks after starting peginterferon alpha-2a. The peripheral neuropathy and vision of the right eye improved, but the vision of the left eye worsened after stopping interferon. We identified 23 additional cases of NAION during interferon alpha therapy. At least 12 of these patients suffered bilateral NAION. Patients lost vision 1–40 weeks after initiating therapy. Of 21 eyes that had documented initial and follow-up acuities, 8 improved, 1 worsened, and the rest remained stable. One patient had a painful peripheral neuropathy. Treatment with interferon alpha may result in NAION. Discontinuation of therapy deserves consideration after weighing individual risks and benefits.
Product standards for residential thermal insulation were authorized by the Minnesota Legislature in response to the marketing of substandard insulation. In 1985 administrative rules established minimum standards for all residential insulation products sold or installed in the State. When possible, these requirements were based on industry consensus standards. The rules require manufacturers to file annual reports with the State, indicating that their products have been tested and meet the minimum standards. Manufacturers must also provide installation instructions to purchasers. Special testing provisions and installation instructions are required for insulations intended for use exterior below ground. Manufacturers of insulation marketed in the State have been notified of this regulation. Filings of products are acknowledged by the State as being complete, or incomplete, with explanations as necessary. The State has published lists including products of 36 companies with completed filings and of those with filings in preparation. Four areas have been particularly difficult in the design and implementation of this program. The first is deciding on equitable quality assurance requirements for manufacturers of insulation. A second is determining what products are acceptable for exterior foundation wall applications. Third is how consumers can identify which insulation products meet the standards. Finally, and probably most important, is how the installation of material can be improved so as to realize its full potential energy saving benefits. The insulation manufacturing industry has been-very supportive of this program. In the first two years of its existence, the program has benefited both consumers and industry.
Rules governing the design of rowing shells do not restrict basic hull parameters. In designing a new eight-oared rowing shell for international ard Olympic competition, the authors sought a high speed, minimum drag hull form, subject only to the constraints on minimum displacement and roll stability. An investigation of optimum hull parameters using analytically determined resistance curves was made. Optimum hull parameters for both deep and shallow water racing are presented. Using the hull parameters determined for minimum resistance at racing speeds in shallow water, several new hull forms were created and analyzed in both deep and shallow water. Two promising final design candidates were proposed for model-scale testing. Results of both steady and unsteady towing tests are presented.
The Province of Ontario developed the Critical Infrastructure Assurance Program based upon risk management, business continuity process, and the collaboration of three levels of government and the private sector. It addresses the resiliency of systems and networks and their ability to function at some level throughout a threat. It is an all‐hazards approach that concentrates its efforts in the prevention and mitigation pillars of emergency management. The systems are addressed by sectors and their information sharing networks are an integral part of the program. The program includes a modeling program that is fed by the work of the sectors and addresses the strength of relationships amongst the sectors’ dependencies and interdependencies. The program's work is validated through an annual interdependency exercise involving all sectors and smaller exercises on particular threats or identified vulnerabilities between sectors. The most valuable part of the program is the sharing of knowledge throught the information‐sharing network.
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