Cholera is an infection of the small intestine by some strains of the bacterium Vibrio cholerae. Symptoms may range to mild, to severe; the classic symptom is large amounts of watery diarrhea. Vomiting and muscle cramps may occur. Diarrhea can be so severe that it leads within hours to severe dehydration and electrolyte imbalance; this may result in sunken eyes, cold skin, decreased skin elasticity, wrinkling of the hands and feet. Dehydration can cause the skin to turn bluish. Symptoms start two hours to five days after exposure. Cholera is caused by a number of types of Vibrio cholerae, with some types producing more severe disease than others, it is spread by unsafe water and unsafe food, contaminated with human feces containing the bacteria. Undercooked seafood is a common source. Humans are the only animal affected. Risk factors for the disease include poor sanitation, not enough clean drinking water, poverty. There are concerns. Cholera can be diagnosed by a stool test. A rapid dipstick test is not as accurate.
Prevention methods against cholera include improved access to clean water. Cholera vaccines that are given by mouth provide reasonable protection for about six months, they have the added benefit of protecting against another type of diarrhea caused by E. coli. The primary treatment is oral rehydration therapy—the replacement of fluids with sweet and salty solutions. Rice-based solutions are preferred. Zinc supplementation is useful in children. In severe cases, intravenous fluids, such as Ringer's lactate, may be required, antibiotics may be beneficial. Testing to see which antibiotic the cholera is susceptible to can help guide the choice. Cholera causes 28,800 -- 130,000 deaths a year. Although it is classified as a pandemic as of 2010, it is rare in the developed world. Children are affected. Cholera occurs as both outbreaks and chronically in certain areas. Areas with an ongoing risk of disease include Southeast Asia; the risk of death among those affected is less than 5% but may be as high as 50%.
No access to treatment results in a higher death rate. Descriptions of cholera are found as early as the 5th century BC in Sanskrit; the study of cholera in England by John Snow between 1849 and 1854 led to significant advances in the field of epidemiology. Seven large outbreaks have occurred over the last 200 years with millions of deaths; the primary symptoms of cholera are profuse vomiting of clear fluid. These symptoms start half a day to five days after ingestion of the bacteria; the diarrhea is described as "rice water" in nature and may have a fishy odor. An untreated person with cholera may produce 10 to 20 litres of diarrhea a day. Severe cholera, without treatment, kills about half of affected individuals. If the severe diarrhea is not treated, it can result in life-threatening dehydration and electrolyte imbalances. Estimates of the ratio of asymptomatic to symptomatic infections have ranged from 3 to 100. Cholera has been nicknamed the "blue death" because a person's skin may turn bluish-gray from extreme loss of fluids.
Fever should raise suspicion for secondary infection. Patients can be lethargic, might have sunken eyes, dry mouth, cold clammy skin, or wrinkled hands and feet. Kussmaul breathing, a deep and labored breathing pattern, can occur because of acidosis from stool bicarbonate losses and lactic acidosis associated with poor perfusion. Blood pressure drops due to dehydration, peripheral pulse is rapid and thready, urine output decreases with time. Muscle cramping and weakness, altered consciousness, seizures, or coma due to electrolyte imbalances are common in children. Cholera bacteria have been found in plankton. Transmission is through the fecal-oral route of contaminated food or water caused by poor sanitation. Most cholera cases in developed countries are a result of transmission by food, while in the developing world it is more water. Food transmission can occur when people harvest seafood such as oysters in waters infected with sewage, as Vibrio cholerae accumulates in planktonic crustaceans and the oysters eat the zooplankton.
People infected with cholera have diarrhea, disease transmission may occur if this liquid stool, colloquially referred to as "rice-water", contaminates water used by others. A single diarrheal event can cause a one-million fold increase in numbers of V. cholerae in the environment. The source of the contamination is other cholera sufferers when their untreated diarrheal discharge is allowed to get into waterways, groundwater or drinking water supplies. Drinking any contaminated water and eating any foods washed in the water, as well as shellfish living in the affected waterway, can cause a person to contract an infection. Cholera is spread directly from person to person. V. Cholerae exists outside the human body in natural water sources, either by itself or through interacting with phytoplankton, zooplankton, or biotic and abiotic detritus. Drinking such water can result in the disease without prior contamination through fecal matter. Selective pressures exist however in the aquatic environment that may reduce the virulence of V. cholerae.
Animal models indicate that the transcriptional profile of the pathogen changes as it prepares to enter an aquatic environment. This transcriptional change results in a loss of ability of V. cholerae to be cultured on standard media, a phenotype referred to as'viable but non-culturable' or more conservatively'active but non-culturable'. One study indicates
The Billboard Top Latin albums chart, published in Billboard magazine, is a record chart that features Latin music sales information. This data are compiled by Nielsen SoundScan from a sample that includes music stores, music departments at electronics and department stores, internet sales and verifiable sales from concert venues in United States. There were fifteen number-one albums in 2002, including Libre by Marc Anthony, which received a nomination for Best Salsa album at the Latin Grammy Awards of 2002, MTV Unplugged by Alejandro Sanz—the winner of the Latin Grammy Award for Album of the Year. Spanish singer-songwriter Enrique Iglesias peaked at number one for the fifth time on this chart with Quizás, while Colombian performer Shakira, Mexican norteño band Los Tigres del Norte, rock band Maná released their third chart topper, respectively. Los Temerarios became the fourth act to release two number-one albums in the same year, after Selena, Enrique Iglesias and Grupo Bryndis. Intocable, Thalía, Las Ketchup, Banda el Recodo and Luis Fonsi peaked at number one for the first time.
One compilation album hit the top of this chart in 2002, Las 30 Cumbias Más Pegadas, which includes performances by Angeles Azules, Grupo Carabo, Los Askis, Rayito Colombiano, Chon Arauza y La Furia Colombiana, Aaron y Su Grupo Illusion, Grupo Perla Colombiana and Tropa Vallenata
ATI TruForm was a brand by ATI for a SIP block capable of doing a graphics procedure called tessellation in computer hardware. ATI TruForm was included into newer products; the successor of the SIP block branded "ATI TruForm" was included into Radeon HD 2000 series and newer products: hardware tessellation with TeraScale. Support for hardware tessellation only became mandatory in Direct3D 11 and OpenGL 4. Tessellation as defined in those APIs is only supported by newer TeraScale 2 products introduced in September 2009 and GCN-based products; the GCN SIP block carrying out the tessellation is the "Geometric processor". Before the adoption of pixel shader-enhanced bump mapping methods such as normal and parallax mapping that simulate higher mesh detail, curved 3D shapes in games were created with large numbers of triangles; the more triangles are used, the more detailed and thus less polygonal the surface appears. TruForm creates a curved surface using the existing triangles, tessellates this surface to make a new, more detailed polygonal model.
It is designed to increase visual quality, without impacting frame rates, by utilizing hardware processing of geometry. TruForm was not accepted by game developers because it ideally required the models to be designed with TruForm in mind. To enable the feature without causing visual problems, such as ballooned-up weapons, the models had to have flags identifying which areas were to be tessellated; the lack of industry-wide support of the technique from the competition caused developers to ignore the technology. In version of Catalyst drivers, the TruForm feature is removed. Beginning with Radeon X1000 series, TruForm was no longer advertised as a hardware feature. However, Radeon 9500 and higher include Render to Vertex Buffer feature, which can be used for tessellation applications. In the case of Radeon X1000 series, it supports binding up to 5 R2VB buffers simultaneously. Tessellation as dedicated hardware has returned in Xenos and Radeon R600 GPUs. Counter-Strike Tom Clancy's Rainbow Six Soldier of Fortune Soldier of Fortune II: Double Helix Quake Quake 2 Hexen II Unreal Tournament The Elder Scrolls III: Morrowind Madden NFL 2004 Bugdom Return to Castle Wolfenstein Serious Sam Unreal Tournament 2003 and 2004 Wolfenstein: Enemy Territory Command & Conquer: Renegade Neverwinter Nights FTEQW Quake III Arena Official ATI's List of TruForm Enabled Game Titles ATI Press release ATI TruForm Developer FAQ page TruForm whitepaper R2VB Programming Render to Vertex Buffer with D3D9 area3d.net: NitroGL Demos - home of TruQuake, TruQuake2 & TruUT