Benjamin Franklin was one of the Founding Fathers of the United States. Franklin was a polymath and a leading author, political theorist, freemason, scientist, civic activist, statesman. As a scientist, he was a figure in the American Enlightenment. As an inventor, he is known for the rod, bifocals. He facilitated many civic organizations, including Philadelphias fire department and the University of Pennsylvania, Franklin earned the title of The First American for his early and indefatigable campaigning for colonial unity, initially as an author and spokesman in London for several colonies. As the first United States Ambassador to France, he exemplified the emerging American nation, in the words of historian Henry Steele Commager, In a Franklin could be merged the virtues of Puritanism without its defects, the illumination of the Enlightenment without its heat. To Walter Isaacson, this makes Franklin the most accomplished American of his age, Franklin became a successful newspaper editor and printer in Philadelphia, the leading city in the colonies, publishing the Pennsylvania Gazette at the age of 23.
He became wealthy publishing this and Poor Richards Almanack, which he authored under the pseudonym Richard Saunders, after 1767, he was associated with the Pennsylvania Chronicle, a newspaper that was known for its revolutionary sentiments and criticisms of the British policies. He pioneered and was first president of The Academy and College of Philadelphia which opened in 1751 and he organized and was the first secretary of the American Philosophical Society and was elected president in 1769. Franklin became a hero in America as an agent for several colonies when he spearheaded an effort in London to have the Parliament of Great Britain repeal the unpopular Stamp Act. An accomplished diplomat, he was widely admired among the French as American minister to Paris and was a figure in the development of positive Franco-American relations. His efforts proved vital for the American Revolution in securing shipments of crucial munitions from France, during the Revolution, he became the first US Postmaster General.
He was active in community affairs and colonial and state politics, from 1785 to 1788, he served as governor of Pennsylvania. He initially owned and dealt in slaves but, by the 1750s, he argued against slavery from an economic perspective, Franklins father, Josiah Franklin, was a tallow chandler, a soap-maker and a candle-maker. Josiah was born at Ecton, England on December 23,1657, the son of Thomas Franklin, a blacksmith-farmer, and Jane White. His mother, Abiah Folger, was born in Nantucket, Massachusetts, on August 15,1667, to Peter Folger, a miller and schoolteacher, and his wife, Mary Morrill, Josiah Franklin had seventeen children with his two wives. He married his first wife, Anne Child, in about 1677 in Ecton and emigrated with her to Boston in 1683, after her death, Josiah was married to Abiah Folger on July 9,1689 in the Old South Meeting House by Samuel Willard. Benjamin, their child, was Josiah Franklins fifteenth child and tenth
Syrias capital and largest city is Damascus. Religious groups include Sunnis, Alawites, Mandeans, Salafis, Sunni Arabs make up the largest religious group in Syria. Its capital Damascus and largest city Aleppo are among the oldest continuously inhabited cities in the world, in the Islamic era, Damascus was the seat of the Umayyad Caliphate and a provincial capital of the Mamluk Sultanate in Egypt. The post-independence period was tumultuous, and a number of military coups. In 1958, Syria entered a union with Egypt called the United Arab Republic. Syria was under Emergency Law from 1963 to 2011, effectively suspending most constitutional protections for citizens, Bashar al-Assad has been president since 2000 and was preceded by his father Hafez al-Assad, who was in office from 1970 to 2000. Mainstream modern academic opinion strongly favours the argument that the Greek word is related to the cognate Ἀσσυρία, Assyria, in the past, others believed that it was derived from Siryon, the name that the Sidonians gave to Mount Hermon.
However, the discovery of the inscription in 2000 seems to support the theory that the term Syria derives from Assyria. The area designated by the word has changed over time, since approximately 10,000 BC, Syria was one of centers of Neolithic culture where agriculture and cattle breeding appeared for the first time in the world. The following Neolithic period is represented by houses of Mureybet culture. At the time of the pre-pottery Neolithic, people used vessels made of stone, finds of obsidian tools from Anatolia are evidences of early trade relations. Cities of Hamoukar and Emar played an important role during the late Neolithic, archaeologists have demonstrated that civilization in Syria was one of the most ancient on earth, perhaps preceded by only those of Mesopotamia. The earliest recorded indigenous civilisation in the region was the Kingdom of Ebla near present-day Idlib, gifts from Pharaohs, found during excavations, confirm Eblas contact with Egypt. One of the earliest written texts from Syria is an agreement between Vizier Ibrium of Ebla and an ambiguous kingdom called Abarsal c.2300 BC.
The Northwest Semitic language of the Amorites is the earliest attested of the Canaanite languages, Mari reemerged during this period, and saw renewed prosperity until conquered by Hammurabi of Babylon. Ugarit arose during this time, circa 1800 BC, close to modern Latakia, Ugaritic was a Semitic language loosely related to the Canaanite languages, and developed the Ugaritic alphabet. The Ugarites kingdom survived until its destruction at the hands of the marauding Indo-European Sea Peoples in the 12th century BC, Yamhad was described in the tablets of Mari as the mightiest state in the near east and as having more vassals than Hammurabi of Babylon. Yamhad imposed its authority over Alalakh, the Hurrians states, the army of Yamhad campaigned as far away as Dēr on the border of Elam
Reed is a common name for several tall, grass-like plants of wetlands. Thatching reed, another restio species originating from the geographic region. Phragmites australis, the reed, is used in many areas for thatching roofs. In the United Kingdom, common reed used for purpose is known as Norfolk reed or water reed. However, wheat reed and Devon reed are not in fact reed at all, constructed wetland Reed bed Reed boat Reed fields Thatching
Peripherally inserted central catheter
It is a catheter that enters the body through the skin at a peripheral site, extends to the superior vena cava, and stays in place for days or weeks. In those who are very unwell PICC lines are appropriate when more than two weeks of treatment is needed, side effects include blood clots and infection. Other complications may include catheter occlusion and bleeding, urokinase or low-dose tPA may be used to break down obstructions. The type of occlusion may determine which drug will be used in an attempt to clear the line, to decrease the risk of infection, particularly a blood stream infection, those involved in the management of the PICC must adhere to strict infection control procedures. PICC insertion is a procedure, but does not require the use of an operating room. When done at bedside, a suitable sterile field must be established and maintained throughout the procedure, for this reason, visitors are normally requested to leave the room until the insertion is complete, and some form of skin preparation should be used to clean the patients skin.
The insertable portion of a PICC varies from 25 to 60 cm in length, some lines are designed to be trimmed to the desired length before insertion, others are simply inserted to the needed depth with the excess left outside. As supplied, the line has a guide wire inside and this wire is provided to stiffen the line so it can be threaded through the veins. The wire is removed and discarded after insertion, the PICC is provided with a wing having holes for either sutures or an adhesive securing device. Securing the catheter prevents post-insertion movements of the line, which otherwise could place the tip in an unsafe position, PICCs can remain in situ for extended periods of time, from seven days to 12 months, although little information is available with respect to viability timeframes. They are used in both the hospital and community settings, to maintain patency, PICC management should include regular flushing with normal saline and locking with Heparin or normal saline when not in use. In comparison, Arrow PICCs have clamps on the exterior line, the use of heparin to maintain line patency, though, is questionable, and currently randomized clinical control trials are investigating this further.
Heparin locks have been associated with complications, including heparin-induced thrombocytopaenia, blood pressure readings on legs are often 10–20% higher than those on the brachial artery. Certain types of PICCs have recently been approved by the FDA for use in power injection and these types, often referred to as power-injectable PICCs, are designed to withstand the high pressures associated with radiocontrast studies. PICCs can be used to measure central venous pressure, which is an estimate of the right atrial pressures of the heart. In most cases, removal of a PICC is a simple procedure, the catheter line can be safely and quickly removed by a trained nurse, even in the patients own home, in a matter of minutes. After removal, the site is normally bandaged with sterile gauze and kept dry for a few days, during which the wound can close. Usually, an adhesive bandage can be placed over the wound site after the gauze is removed if the wound is slow to heal
Insulin is a peptide hormone produced by beta cells of the pancreatic islets. It regulates the metabolism of carbohydrates and protein by promoting the absorption of, glucose from the blood into fat and skeletal muscle cells. In these tissues the absorbed glucose is converted into either glycogen via glycogenesis or fats via lipogenesis, or, in the case of the liver, Glucose production by the liver is strongly inhibited by high concentrations of insulin in the blood. Circulating insulin affects the synthesis of proteins in a variety of tissues. It is therefore an anabolic hormone, promoting the conversion of small molecules in the blood into large molecules inside the cells, low insulin levels in the blood have the opposite effect by promoting widespread catabolism. Pancreatic beta cells are known to be sensitive to concentrations in the blood. When glucose concentrations in the blood are high, the pancreatic β cells secrete insulin into the blood, through stimulating the liver to release glucose by glycogenolysis and gluconeogenesis, has the opposite effect of insulin.
If pancreatic beta cells are destroyed by an reaction, insulin can no longer be synthesized or be secreted into the blood. This results in type 1 diabetes mellitus, which is characterized by high blood glucose concentrations. In type 2 diabetes mellitus the destruction of cells is less pronounced than in type 1 diabetes. Instead there is an accumulation of amyloid in the pancreatic islets, Type 2 diabetes is characterized by high rates of glucagon secretion into the blood which are unaffected by, and unresponsive to the concentration of glucose in the blood glucose. Insulin is still secreted into the blood in response to the blood glucose, as a result, the insulin levels, even when the blood sugar level is normal, are much higher than they are in healthy persons. There are a variety of treatment regimens, none of which is entirely satisfactory, when the pancreas’s capacity to secrete insulin can no longer keep the blood sugar level within normal bounds, insulin injections are given. The human insulin protein is composed of 51 amino acids, and has a mass of 5808 Da.
It is a dimer of an A-chain and a B-chain, which are linked together by disulfide bonds, insulins structure varies slightly between species of animals. Insulin from animal sources differs somewhat in effectiveness from human insulin because of these variations, porcine insulin is especially close to the human version, and was widely used to treat type 1 diabetics before human insulin could be produced in large quantities by recombinant DNA technologies. The crystal structure of insulin in the state was determined by Dorothy Hodgkin. It is on the WHO Model List of Essential Medicines, the most important medications needed in a health system
Oxygen is a chemical element with symbol O and atomic number 8. It is a member of the group on the periodic table and is a highly reactive nonmetal. By mass, oxygen is the third-most abundant element in the universe, after hydrogen, at standard temperature and pressure, two atoms of the element bind to form dioxygen, a colorless and odorless diatomic gas with the formula O2. This is an important part of the atmosphere and diatomic oxygen gas constitutes 20. 8% of the Earths atmosphere, additionally, as oxides the element makes up almost half of the Earths crust. Most of the mass of living organisms is oxygen as a component of water, oxygen is continuously replenished by photosynthesis, which uses the energy of sunlight to produce oxygen from water and carbon dioxide. Oxygen is too reactive to remain a free element in air without being continuously replenished by the photosynthetic action of living organisms. Another form of oxygen, strongly absorbs ultraviolet UVB radiation, but ozone is a pollutant near the surface where it is a by-product of smog.
At low earth orbit altitudes, sufficient atomic oxygen is present to cause corrosion of spacecraft, the name oxygen was coined in 1777 by Antoine Lavoisier, whose experiments with oxygen helped to discredit the then-popular phlogiston theory of combustion and corrosion. One of the first known experiments on the relationship between combustion and air was conducted by the 2nd century BCE Greek writer on mechanics, Philo of Byzantium. In his work Pneumatica, Philo observed that inverting a vessel over a burning candle, Philo incorrectly surmised that parts of the air in the vessel were converted into the classical element fire and thus were able to escape through pores in the glass. Many centuries Leonardo da Vinci built on Philos work by observing that a portion of air is consumed during combustion and respiration, Oxygen was discovered by the Polish alchemist Sendivogius, who considered it the philosophers stone. In the late 17th century, Robert Boyle proved that air is necessary for combustion, English chemist John Mayow refined this work by showing that fire requires only a part of air that he called spiritus nitroaereus.
From this he surmised that nitroaereus is consumed in both respiration and combustion, Mayow observed that antimony increased in weight when heated, and inferred that the nitroaereus must have combined with it. Accounts of these and other experiments and ideas were published in 1668 in his work Tractatus duo in the tract De respiratione. Robert Hooke, Ole Borch, Mikhail Lomonosov, and Pierre Bayen all produced oxygen in experiments in the 17th and the 18th century but none of them recognized it as a chemical element. This may have been in part due to the prevalence of the philosophy of combustion and corrosion called the phlogiston theory, which was the favored explanation of those processes. Established in 1667 by the German alchemist J. J. Becher, one part, called phlogiston, was given off when the substance containing it was burned, while the dephlogisticated part was thought to be its true form, or calx. The fact that a substance like wood gains overall weight in burning was hidden by the buoyancy of the combustion products
The Seldinger technique, known as Seldinger wire technique, is a medical procedure to obtain safe access to blood vessels and other hollow organs. It is named after Dr. Sven Ivar Seldinger, a Swedish radiologist who introduced the procedure in 1953, the desired vessel or cavity is punctured with a sharp hollow needle called a trocar, with ultrasound guidance if necessary. A round-tipped guidewire is advanced through the lumen of the trocar, a sheath or blunt cannula can now be passed over the guidewire into the cavity or vessel. Alternatively, drainage tubes are passed over the guidewire, after passing a sheath or tube, the guidewire is withdrawn. An introducer sheath can be used to introduce catheters or other devices to perform endoluminal procedures, fluoroscopy may be used to confirm the position of the catheter and to manoeuvre it to the desired location. Injection of radiocontrast may be used to visualize organs, interventional procedures, such as thermoablation, embolisation or biopsy, may be performed.
Upon completion of the procedure, the sheath is withdrawn. In certain settings, a device may be used to close the hole made by the procedure. The initial puncture is with an instrument, and this may lead to hemorrhage or perforation of the organ in question. Infection is a complication, and hence asepsis is practiced during most Seldinger procedures. Loss of the guidewire into the cavity or blood vessel is a significant, prior to the description of the Seldinger technique, sharp trocars were used to create lumens through which devices could be passed. This had a rate of complications. However, with the introduction of the Seldinger technique, angiography became a relatively risk-free procedure, building on the work of Seldinger, Charles Dotter and Andreas Gruentzig developed angioplasty. Flash animation of the Seldinger technique
Civil wars and executions continued, culminating in the victory of Octavian, Caesars adopted son, over Mark Antony and Cleopatra at the Battle of Actium in 31 BC and the annexation of Egypt. Octavians power was unassailable and in 27 BC the Roman Senate formally granted him overarching power, the imperial period of Rome lasted approximately 1,500 years compared to the 500 years of the Republican era. The first two centuries of the empires existence were a period of unprecedented political stability and prosperity known as the Pax Romana, following Octavians victory, the size of the empire was dramatically increased. After the assassination of Caligula in 41, the senate briefly considered restoring the republic, under Claudius, the empire invaded Britannia, its first major expansion since Augustus. Vespasian emerged triumphant in 69, establishing the Flavian dynasty, before being succeeded by his son Titus and his short reign was followed by the long reign of his brother Domitian, who was eventually assassinated.
The senate appointed the first of the Five Good Emperors, the empire reached its greatest extent under Trajan, the second in this line. A period of increasing trouble and decline began with the reign of Commodus, Commodus assassination in 192 triggered the Year of the Five Emperors, of which Septimius Severus emerged victorious. The assassination of Alexander Severus in 235 led to the Crisis of the Third Century in which 26 men were declared emperor by the Roman Senate over a time span. It was not until the reign of Diocletian that the empire was fully stabilized with the introduction of the Tetrarchy, which saw four emperors rule the empire at once. This arrangement was unsuccessful, leading to a civil war that was finally ended by Constantine I. Constantine subsequently shifted the capital to Byzantium, which was renamed Constantinople in his honour and it remained the capital of the east until its demise. Constantine adopted Christianity which became the state religion of the empire. However, Augustulus was never recognized by his Eastern colleague, and separate rule in the Western part of the empire ceased to exist upon the death of Julius Nepos.
The Eastern Roman Empire endured for another millennium, eventually falling to the Ottoman Turks in 1453, the Roman Empire was among the most powerful economic, cultural and military forces in the world of its time. It was one of the largest empires in world history, at its height under Trajan, it covered 5 million square kilometres. It held sway over an estimated 70 million people, at that time 21% of the entire population. Throughout the European medieval period, attempts were made to establish successors to the Roman Empire, including the Empire of Romania, a Crusader state. Rome had begun expanding shortly after the founding of the republic in the 6th century BC, then, it was an empire long before it had an emperor
An inhalational anaesthetic is a chemical compound possessing general anaesthetic properties that can be delivered via inhalation. They are administered by anaesthetists through a mask, laryngeal mask airway or tracheal tube connected to an anaesthetic vaporiser. All of these share the property of being quite hydrophobic. The ideal volatile anaesthetic agent offers smooth and reliable induction and maintenance of general anaesthesia with minimal effects on other organ systems. In addition it is odourless or pleasant to inhale, safe for all ages and in pregnancy, not metabolised, rapid in onset and offset, none of the agents currently in use are ideal, although many have some of the desirable characteristics. For example, sevoflurane is pleasant to inhale and is rapid in onset and offset and it is safe for all ages. However, it is expensive, and approximately half as potent as isoflurane, other gases or vapors which produce general anaesthesia by inhalation include nitrous oxide and xenon. These are stored in gas cylinders and administered using flowmeters, rather than vaporisers, cyclopropane is explosive and is no longer used for safety reasons, although otherwise it was found to be an excellent anaesthetic.
Xenon is odourless and rapid in onset, but is expensive and requires specialized equipment to administer, under hyperbaric conditions, other gases such as nitrogen, and noble gases such as argon and xenon become anaesthetics. When inhaled at high pressures, nitrogen begins to act as an anaesthetic agent. However, the minimum alveolar concentration for nitrogen is not achieved until pressures of about 20 to 30 atm are attained, argon is slightly more than twice as anaesthetic as nitrogen per unit of partial pressure. Xenon however is an anaesthetic at 80% concentration and normal atmospheric pressure. The full mechanism of action of volatile anaesthetic agents is unknown and has been the subject of intense debate. Anesthetics have been used for 160 years, and how work is one of the great mysteries of neuroscience, says anaesthesiologist James Sonner of the University of California. Anaesthesia research has been for a time a science of untestable hypotheses, notes Neil L. Harrison of Cornell University.
Most of the injectable anesthetics appear to act on a molecular target. It looks like inhaled anesthetics act on multiple molecular targets and that makes it a more difficult problem to pick apart. However, the agent may bind to a receptor with a weak interaction, a physical interaction such as swelling of nerve cell membranes from gas solution in the lipid bilayer may be operative
Ancient Greek includes the forms of Greek used in ancient Greece and the ancient world from around the 9th century BC to the 6th century AD. It is often divided into the Archaic period, Classical period. It is antedated in the second millennium BC by Mycenaean Greek, the language of the Hellenistic phase is known as Koine. Koine is regarded as a historical stage of its own, although in its earliest form it closely resembled Attic Greek. Prior to the Koine period, Greek of the classic and earlier periods included several regional dialects, Ancient Greek was the language of Homer and of fifth-century Athenian historians and philosophers. It has contributed many words to English vocabulary and has been a subject of study in educational institutions of the Western world since the Renaissance. This article primarily contains information about the Epic and Classical phases of the language, Ancient Greek was a pluricentric language, divided into many dialects. The main dialect groups are Attic and Ionic, Arcadocypriot, some dialects are found in standardized literary forms used in literature, while others are attested only in inscriptions.
There are several historical forms, homeric Greek is a literary form of Archaic Greek used in the epic poems, the Iliad and Odyssey, and in poems by other authors. Homeric Greek had significant differences in grammar and pronunciation from Classical Attic, the origins, early form and development of the Hellenic language family are not well understood because of a lack of contemporaneous evidence. Several theories exist about what Hellenic dialect groups may have existed between the divergence of early Greek-like speech from the common Proto-Indo-European language and the Classical period and they have the same general outline, but differ in some of the detail. The invasion would not be Dorian unless the invaders had some relationship to the historical Dorians. The invasion is known to have displaced population to the Attic-Ionic regions, the Greeks of this period believed there were three major divisions of all Greek people—Dorians and Ionians, each with their own defining and distinctive dialects.
Often non-west is called East Greek, Arcadocypriot apparently descended more closely from the Mycenaean Greek of the Bronze Age. Boeotian had come under a strong Northwest Greek influence, and can in some respects be considered a transitional dialect, thessalian likewise had come under Northwest Greek influence, though to a lesser degree. Most of the dialect sub-groups listed above had further subdivisions, generally equivalent to a city-state and its surrounding territory, Doric notably had several intermediate divisions as well, into Island Doric, Southern Peloponnesus Doric, and Northern Peloponnesus Doric. The Lesbian dialect was Aeolic Greek and this dialect slowly replaced most of the older dialects, although Doric dialect has survived in the Tsakonian language, which is spoken in the region of modern Sparta. Doric has passed down its aorist terminations into most verbs of Demotic Greek, by about the 6th century AD, the Koine had slowly metamorphosized into Medieval Greek
An infusion set is used with an insulin pump as part of intensive insulin therapy. The purpose of a set is to deliver insulin under the skin. It is a tubing system to connect an insulin pump to the pump user, it includes a subcutaneous cannula, adhesive mount, quick-disconnect. Firstly, the user must attach a reservoir of insulin to the set, the set is primed - the pump pushes insulin quickly through the tubing and the cannula to ensure no air is in the system before insertion. Note that it is vital that the set is not inserted into the skin when the set is being primed. The user peels off the paper protecting the adhesive pad, the cannula is usually made of flexible plastic, which allows it to move without causing discomfort to the patient. The needle is pushed into the layer of fat below the skin, the needle is removed, leaving the cannula in place below the skin. Insertion should be done in a swift movement to avoid the cannula bunching up around the needle. A few pump users prefer an infusion set with a steel needle instead of a cannula, the cannula surrounds a steel needle similar to that found on a hypodermic syringe.
The same used device cant be reused for the other patient, as it is not a surgical instrument. It is for use only. Some pump users prefer to use a device to insert their sets. These are spring-loaded and are designed to push the needle into the skin quickly and painlessly, the user simply loads the primed set into the insertion device, peels off the paper protecting the adhesive pad, places the device against the skin and presses a button. This may be an advantage for those with needle phobia, many pump users site their infusion sets on the abdomen, in a roughly semicircular area around and below the navel. Other sites include the upper leg, upper buttocks, upper arms, insulin absorption may vary from site to site, so it is important that patients are advised of the most effective sites to use by their diabetes adviser. The infusion set must be replaced regularly, usually every 2–3 days, insulin absorption becomes less effective the longer the set is left in place, leading to poorer control of blood glucose.
For this reason, the site of the set is moved when the set is changed. Often a number of sites for the infusion set are used on a rotation basis
Peripheral venous catheter
In medicine, a peripheral venous catheter, peripheral venous line or peripheral venous access catheter is a catheter placed into a peripheral vein in order to administer medication or fluids. Upon insertion, the line can be used to draw blood, the catheter is introduced into the vein by a needle, which is subsequently removed while the small tube of the cannula remains in place. The catheter is fixed by taping it to the patients skin, newer catheters have been equipped with additional safety features to avoid needlestick injuries. Modern catheters consist of polymers such as teflon. In 1950 they consisted of PVC plastic, a peripheral venous catheter is the most commonly used vascular access in medicine. It is given to most emergency room and surgical patients, and before some radiological imaging techniques using radiocontrast, in the United States, more than 25 million patients get a peripheral venous line each year. A peripheral venous catheter is placed in a vein on the hand or arm. It should be distinguished from a central venous catheter which is inserted in a central vein, in children, a local anaesthetic gel is applied to the insertion site to facilitate placement.
Insertion of a venous cannula is a procedure that can lead to anxiety. Use of a vapocoolant immediately before cannulation reduces pain during the procedure, phlebitis, infiltration, air embolism and formation of a hematoma may occur. Because of the risk of infection the CDC advises in their guideline that the catheter needs to be replaced every 96 hours. Although these catheters can best not be left in place longer than necessary, expert management has been shown to reduce the complications of peripheral lines. National Cancer Institute, peripheral venous catheter Recommended practices for the insertion and management of peripheral intravenous catheters