Hyperglycemia is a condition in which an excessive amount of glucose circulates in the blood plasma. This is a blood sugar level higher than 11.1 mmol/l, but symptoms may not start to become noticeable until higher values such as 13.9–16.7 mmol/l. A subject with a consistent range between ~5.6 and ~7 mmol/l is considered hyperglycemic, above 7 mmol/l is held to have diabetes. For diabetics, glucose levels that are considered to be too hyperglycemic can vary from person to person due to the person's renal threshold of glucose and overall glucose tolerance. On average, chronic levels above 10–12 mmol/L can produce noticeable organ damage over time; the degree of hyperglycemia can change over time depending on the metabolic cause, for example, impaired glucose tolerance or fasting glucose, it can depend on treatment. Temporary hyperglycemia is benign and asymptomatic. Blood glucose levels can rise well above normal and cause pathological and functional changes for significant periods without producing any permanent effects or symptoms.
During this asymptomatic period, an abnormality in carbohydrate metabolism can occur which can be tested by measuring plasma glucose. Chronic hyperglycemia at above normal levels can produce a wide variety of serious complications over a period of years, including kidney damage, neurological damage, cardiovascular damage, damage to the retina or damage to feet and legs. Diabetic neuropathy may be a result of long-term hyperglycemia. Impairment of growth and susceptibility to certain infection can occur as a result of chronic hyperglycemia. Acute hyperglycemia involving glucose levels that are high is a medical emergency and can produce serious complications, it is most seen in persons who have uncontrolled insulin-dependent diabetes. The following symptoms may be associated with acute or chronic hyperglycemia, with the first three composing the classic hyperglycemic triad: Polyphagia – frequent hunger pronounced hunger Polydipsia – frequent thirst excessive thirst Polyuria – increased volume of urination Blurred vision Fatigue Restlessness Weight loss Poor wound healing Dry mouth Dry or itchy skin Tingling in feet or heels Erectile dysfunction Recurrent infections, external ear infections Cardiac arrhythmia Stupor Coma SeizuresFrequent hunger without other symptoms can indicate that blood sugar levels are too low.
This may occur when people who have diabetes take too much oral hypoglycemic medication or insulin for the amount of food they eat. The resulting drop in blood sugar level to below the normal range prompts a hunger response. Polydipsia and polyuria occur when blood glucose levels rise high enough to result in excretion of excess glucose via the kidneys, which leads to the presence of glucose in the urine; this produces an osmotic diuresis. Signs and symptoms of diabetic ketoacidosis may include: Ketoacidosis Kussmaul hyperventilation Confusion or a decreased level of consciousness Dehydration due to glycosuria and osmotic diuresis Increased thirst'Fruity' smelling breath odor Nausea and vomiting Impairment of cognitive function, along with increased sadness and anxiety Weight lossHyperglycemia causes a decrease in cognitive performance in processing speed, executive function, performance. Decreased cognitive performance may cause forgetfulness and concentration loss. In untreated hyperglycemia, a condition called ketoacidosis may develop because decreased insulin levels increase the activity of hormone sensitive lipase.
The degradation of triacylglycerides by hormone-sensitive lipase produces free fatty acids that are converted to acetyl-coA by beta-oxidation. Ketoacidosis is a life-threatening condition. Symptoms include: shortness of breath, breath that smells fruity and vomiting, dry mouth. Chronic hyperglycemia injures the heart in patients without a history of heart disease or diabetes and is associated with heart attacks and death in subjects with no coronary heart disease or history of heart failure. Life-threatening consequences of hyperglycemia is nonketotic hyperosmolar syndrome. Perioperative hyperglycemia has been associated with immunosuppression, increased infections, osmotic diuresis, delayed wound healing, delayed gastric emptying, sympatho-adrenergic stimulation, increased mortality. In addition, it reduces skin graft success, exacerbates brain, spinal cord, renal damage by ischemia, worsens neurologic outcomes in traumatic head injuries, is associated with postoperative cognitive dysfunction following CABG.
Chronic hyperglycemia that persists in fasting states is most caused by diabetes mellitus. In fact, chronic hyperglycemia is the defining characteristic of the disease. Intermittent hyperglycemia may be present in prediabetic states. Acute episodes of hyperglycemia without an obvious cause may indicate developing diabetes or a predisposition to the disorder. In diabetes mellitus, hyperglycemia is caused by low insulin levels and/or by resistance to insulin at the cellular level, depending on the type and state of the disease. Low insulin levels and/or insulin resistance prevent the body from converting glucose into glycogen, which in turn makes it difficult or impossible to remove excess glucose from the blood. With normal glucose levels
The Parque Ibirapuera Conservação is a nonprofit organization that identifies and enhances the natural and cultural assets of Ibirapuera Park in São Paulo, Brazil. It assists other Brazilian local communities to care for their local urban parks; until 2017, the organization provided nearly $1.5 million in aid to support Ibirapuera Park through restoration and volunteer work by its members and donors, contributions from Park-area residents and foundations. In late 2010, the park’s management council started to realize that much of the support they wanted to Ibirapuera Park would take longer than expected by public sector. By 2014, Parque Ibirapuera Conservação was structured following the steps' of Central Park Conservancy focusing at engaging the parks neighborhood into a local and pioneering project to professionalize stewardship through civil society; until 2017, PIC major works in Ibirapuera Park included the Reading Grove restoration, upgraded a part of its irrigation system and conservation actions, volunteer engagement, created interpretive programs.
In 2017, the city of São Paulo announced that Ibirapuera Park would be part of a large municipal concession program, the organization Parque Ibirapuera Conservação became a key piece of the process, as the major private organization dedicated to care for urban parks. The bidding took longer the municipality envisaged, PIC was a key influencer at the city public policy for urban parks by requiring the a better governance as an update master plan, so that no matter what model the municipality would choose to adopted for its parks, the control could remain public. Official website
Carom billiards and pocket billiards are two types of cue sports or billiards-family games, which as a general class are played with a stick called a cue, used to strike billiard balls, moving them around a cloth-covered billiard table bounded by rubber cushions attached to the confining rails of the table. Carom or carambole billiards is a type of billiards in which the table is bounded by cushions, in which three balls are used. Pocket billiards, most called "pool", is a form of billiards equipped with sixteen balls, played on a pool table with six pockets built into the rails, splitting the cushions; the pockets provide targets for the balls. The two types of billiards have developed into a wide array of specific games with divergent rules, require equipment that differs in some key parameters. Skill at one type of billiards-family game is applicable to the other, but expertise requires at least a degree of specialisation. A few games such as English billiards are hybrids, using carom balls on large pocket tables, snooker, a non-pool-based pocket game uses such tables.
Cue sports evolved from ancient outdoor stick-and-ball games referred to as "ground billiards", a game similar in various respects, related to, modern croquet and hockey. Billiards has been a popular game since the 15th century. Carom billiards was long the most popular type of billiards, remains an important international sport. Carom games three-cushion, are intensely popular in many parts of Europe and the Pacific, Latin America. In former times complicated and difficult carom games such as 18.2 balkline were played in world championship bouts by players whose skill at fine manipulation of the balls in nurse shots was so great that the serious playing field consisted of only 4 major players for decades at a time. The carom world opened up in the latter half of the 20th century and grew to its current level of much broader international competition with the rise of three-cushion billiards, which had more action, simpler rules and easier basic play, but more difficult true mastery due to the elimination of nurse shots.
Along with snooker and nine-ball, three-cushion is expected to become an Olympic sport within a decade. Pocket tables are known from the earliest days of billiards, being adaptations of lawn holes and croquet-style hoops to the indoor version of the game; the most common modern pool game, eight-ball evolved around 1925, when it was played with seven yellow and seven red balls, a black ball, the cue ball. Today, numbered stripes and solids are preferred in most of the world, though the British-style variant uses the traditional colours. Eight-ball, in one variant or another, is played world-wide, is a pastime of millions of amateur league players, draws intense competition at professional and amateur tournaments using the WPA World Standardized Rules. However, the most intense competition in pool is in the game nine-ball, the professional game of choice since the 1970s, with the decline of straight pool. Nine-ball grew in popularity because of its speed, the increased role played by luck, its suitability for television.
Today there is some indication that the more difficult variant ten-ball may supplant nine-ball in pro play, but nine-ball is to remain the most popular gambling game for many years, eight-ball the most popular recreational and amateur team one. Billiard balls vary from game to game, area to area, in size and number. Though the dominant material in the making of quality balls was ivory until the late 1800s, there was a need to find a substitute for it, not only due to elephant endangerment but because of the high cost of the balls; this search led to the development of celluloid, the first industrial plastic, balls have been made of various plastic compounds since, from now-obsolete materials such as bakelite, to modern-day phenolic resin and acrylic. Carom billiards balls are larger in size than pool balls, come most as a set of two cue balls and a red object ball. Carom balls are 61.5–mm in diameter and weigh the same, between 205 and 220 g Internationally standardized pool balls, used in any pool game and found throughout the world, come in sets of 16, including two suits or groups of numbered object balls, seven solids and seven stripes, a black 8 ball and a white cue ball.
"British-style" balls are smaller, come in unnumbered suits of reds and yellows. The balls are arranged differently depending on the game; the pocket billiards offshoot snooker requires smaller balls, several additional balls with special point values. Some unusual pool games such as baseball require additional balls, while other rare variants like poker pocket billiards, use an alternative ball set. Standard pool balls are all of the same weight. British-styl