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Nebulizer

In medicine, a nebulizer or nebuliser is a drug delivery device used to administer medication in the form of a mist inhaled into the lungs. Nebulizers are used for the treatment of asthma, cystic fibrosis, COPD and other respiratory diseases or disorders, they use oxygen, compressed air or ultrasonic power to break up solutions and suspensions into small aerosol droplets that can be directly inhaled from the mouthpiece of the device. An aerosol is solid or liquid particles. Various asthma guidelines, such as the Global Initiative for Asthma Guidelines, the British Guidelines on the management of Asthma, The Canadian Pediatric Asthma Consensus Guidelines, United States Guidelines for Diagnosis and Treatment of Asthma each recommend metered dose inhalers in place of nebulizer-delivered therapies; the European Respiratory Society acknowledge that although nebulizers are used in hospitals and at home they suggest much of this use may not be evidence-based. Recent evidence shows. An MDI with a spacer may offer advantages to children.

Those findings refer to the treatment of asthma and not to the efficacy of nebulisers as for COPD for example. For COPD when assessing exacerbations or lung attacks, there is no evidence to indicate that MDI delivered medicine is more effective than administration of the same medicine with a nebulizer; the European Respiratory Society highlighted a risk relating to droplet size reproducibility caused by selling nebulizer devices separately from nebulized solution. They found this practice could vary droplet size 10-fold or more by changing from an inefficient nebulizer system to a efficient one. Two advantages attributed to nebulizers, compared to MDIs with spacers, were their ability to deliver larger dosages at a faster rate in acute asthma. In addition, another trial found that a MDI had a lower required dose for clinical result compared to a nebulizer. Beyond use in chronic lung disease, nebulizers may be used to treat acute issues like the inhalation of toxic substances. One such example is the treatment of inhalation of toxic hydroflouric acid vapors.

Calcium gluconate is a first-line treatment for HF exposure to the skin. By using a nebulizer, calcium gluconate can be delivered to the lungs as an aerosol to counteract the toxicity of inhaled HF vapors; the lung deposition characteristics and efficacy of an aerosol depend on the particle or droplet size. The smaller the particle the greater its chance of peripheral penetration and retention. However, for fine particles below 0.5 μm in diameter there is a chance of avoiding deposition altogether and being exhaled. In 1966 the Task Group on Lung Dynamics, concerned with the hazards of inhalation of environmental toxins, proposed a model for deposition of particles in the lung; this suggested that particles of more than 10 μm in diameter are most to deposit in the mouth and throat, for those of 5–10 μm diameter a transition from mouth to airway deposition occurs, particles smaller than 5 μm in diameter deposit more in the lower airways and are appropriate for pharmaceutical aerosols. The medical company Boehringer Ingelheim invented a new device named Respimat Soft Mist Inhaler in 1997.

This new technology provides a metered dose to the user, as the liquid bottom of the inhaler is rotated clockwise 180 degrees by hand, adding a build up tension into a spring around the flexible liquid container. When the user activates the bottom of the inhaler, the energy from the spring is released and imposes pressure on the flexible liquid container, causing liquid to spray out of 2 nozzles, thus forming a soft mist to be inhaled; the device features no need for battery/power to operate. The average droplet size in the mist was measured to 5.8 micrometers, which could indicate some potential efficiency problems for the inhaled medicine to reach the lungs. Subsequent trials have proven. Due to the low velocity of the mist, the Soft Mist Inhaler in fact has a higher efficiency compared to a conventional pMDI. In 2000, arguments were launched towards the European Respiratory Society to clarify/expand their definition of a nebulizer, as the new Soft Mist Inhaler in technical terms both could be classified as a "hand driven nebulizer" and a "hand driven pMDI".

The most used nebulizers are jet nebulizers, which are called "atomizers". Jet nebulizers are connected by tubing to a compressor, that causes compressed air or oxygen to flow at high velocity through a liquid medicine to turn it into an aerosol, inhaled by the patient. There seems to be a tendency among physicians to prefer prescription of a pressurized Metered Dose Inhaler for their patients, instead of a jet nebulizer that generates a lot more noise and is less portable due to a greater weight. However, jet nebulizers are used for patients in hospitals who have difficulty using inhalers, such as in serious cases of respiratory disease, or severe asthma attacks; the main advantage of the jet nebulizer is related to its low operational cost. If the patient needs to inhale medicine on a daily basis the use of a pMDI can be rather expensive. Today several manufacturers have managed to lower the weight of the jet nebulizer down to 635 grams, thereby started to label it as a portable device. Compared to all the competing inhalers and nebulizers, the noise and heavy weight is

2011 Vancouver municipal election

The City of Vancouver held a municipal election on November 19, 2011, along with other municipalities and regional districts in British Columbia. All local government elections were for a three-year period; the ballot elected one mayor, 10 councillors, nine school board trustees and seven park board commissioners. A $180 million capital borrowing plan was put to a vote. Incumbent Mayor Gregor Robertson and the Vision Vancouver Party sought and won their second term in office following their victory in the 2008 election. All Vision Vancouver candidates won seats in their respective categories. Suzanne Anton lost her bid as mayor but the NPA team gained seats in council, Park Board and School Board. COPE was nearly wiped out this election, its only elected official was School Board trustee incumbent Allan Wong. On December 8, 2013, Wong resigned from the Coalition of Progressive Electors and joined Vision as a sitting trustee; the Green Party of Vancouver had its first elected city councillor with Adriane Carr, but lost its incumbent seat in the Park Board.

New party Neighbourhoods for a Sustainable Vancouver did not win any seats in council. NSV leader Randy Helten placed a distant third in the mayoral race; the nomination period opened on October 4, 2011, closed on October 14, 2011. This was the second election where Vision Vancouver and COPE signed an electoral agreement to support each other's candidates for election. Denotes incumbents. Twelve candidates sought election to the position of mayor. Four were affiliated with a political party and eight were independents. Incumbent mayor Gregor Robertson of Vision Vancouver was re-elected. Ten councillors were elected out of 41 candidates. Of the candidates, 28 were affiliated with a political party, 13 were independent. Seven incumbent councillors sought re-election: six from Vision Vancouver and one from COPE. Of those subsequently elected, Vision Vancouver held seven seats, the NPA two and the Green Party of Vancouver one. Seven commissioners were elected out of 21 candidates. Of the candidates, 15 were affiliated with a political party, six were independent.

Four incumbent commissioners sought re-election: three from Vision Vancouver and one from the Green Party of Vancouver. Of the elected commissioners, Vision held the NPA two. Nine school board trustees were elected out of 20 candidates. Of the candidates, 15 were affiliated with a political party, five were independent. Seven incumbent trustees were seeking re-election: three from Vision Vancouver, three from COPE, one from the NPA. Of the elected trustees, five were from Vision Vancouver, three from the NPA and one from COPE. 1. Are you in favour of Council having the authority, without further assent of the electors, to pass by-laws between January 1, 2012, December 31, 2014, to borrow an aggregate $65,800,000 for the following purposes? Community Facilities at $58,600,000 Parks at $7,200,0002. Are you in favour of Council having the authority, without further assent of the electors, to pass by-laws between January 1, 2012, December 31, 2014, to borrow an aggregate $66,300,000 for the following purposes?

Street and Bridge Infrastructure at $41,150,000 Transit and Safety Improvements at $8,500,000 Street Lighting, Traffic Signals and Communications Systems at $16,650,0003. Are you in favour of Council having the authority, without further assent of the electors, to pass by-laws between January 1, 2012, December 31, 2014, to borrow an aggregate $47,700,000 for the following purposes? Public Safety Facilities at $13,200,000 Civic Facilities at $34,500,000 Of the 418,878 registered voters, there were 144,823 recorded ballots, marking the voter turnout at 34.57%. This is an increase from the 30.79% turnout during the previous municipal election in 2008. Of the parties represented, only Vision Vancouver had its entire slate of candidates elected in all fields. Vancouver Votes on city website

Yūki Ōtsu

Yūki Ōtsu is a Japanese professional footballer who plays for Japanese J1 League club Yokohama F. Marinos as an attacking midfielder. On 21 July 2011, Ōtsu was signed by German Bundesliga side Borussia Mönchengladbach on a three-year contract, he made his league debut on 22 October 2011, coming on as a late substitute for Mike Hanke, in a 1–0 away defeat against 1899 Hoffenheim. After having lost prospect with Borussia Mönchengladbach, Ōtsu signed with Dutch Eredivisie side VVV-Venlo until the summer of 2014 on 31 August 2012, he was supposed to succeed his countryman Keisuke Honda who had impressed and made a transfer to AC Milan half a year earlier. However, on 15 December 2013, Ōtsu badly injured his achilles tendon. After a long time rehabilitation, Ōtsu became fit again with the result VVV-Venlo extended his expiring contract until the summer of 2015. On 13 December 2014, it was announced, he had signed a deal with his former team Kashiwa Reysol. On 2 July 2012, Ōtsu was included in the 2012 Summer Olympics squad by Japan under-23s manager Takashi Sekizuka.

He made his debut in their opening match on 26 July 2012 against Spain at Hampden Park, where he scored the opening and winning goal. He went on to score in both Japan's quarter-final and semi-final against Egypt and Mexico respectively. On 31 January 2013, Ōtsu was included in the Japan senior national team squad in a friendly against Latvia by head coach Alberto Zaccheroni. On 6 February 2013, Ōtsu made his debut for the national team, replacing Shinji Okazaki in the 82nd minute; as of 24 April 20191Includes Emperor's DFB-Pokal and KNVB Cup. 2Includes J. League Cup. 3Includes AFC Champions League. As of 10 August 2012

Jaime Bonilla Valdez

Jaime Bonilla Valdez is a politician and entrepreneur with both Mexican and American nationalities. He is a member of the National Regeneration Movement party, he has been a Senator of the Republic. On June 2 he became the winner of the electoral contest for the governorship of Baja California by the "Together We Will Make History" coalition in the 2019 state elections. On June 11, 2019 he was given the majority certificate with which he is credited as Governor-elect of Baja California for 2019-2021 term. Bonilla was born in San Diego and obtained his degree in business administration from the UNAM in 1983, he worked in a variety of companies, including Electrol de México, CONESA, COVIMEX de México. Between 1982 and 1985, he directed the Potros de Tijuana baseball club, which played in the Liga Mexicana del Pacífico. In 1984, he became the director general and a columnist of the Diario de Baja California newspaper, which began a career in media ownership for Bonilla. Through his company PSN, he directly operates XESS-AM XESDD-AM 1030 in Tijuana.

He owned XHENB-TV channel 29 in Ensenada, now a cable-only outlet, his company Media Sports de México holds the concessions for two radio stations operated under brokerage agreements by American programmers, XEPE-AM 1700 and XHPRS-FM 105.7. Bonilla acquired cable systems in Ensenada and Tecate. Bonilla owned radio station KURS 1040 in San Diego through his company Quetzal Bilingual Communications. In 2000, Bonilla a dual citizen of Mexico and the United States, joined the board of the Otay Water District in Otay Mesa, California. While in the US, he was a donor to Republican causes and was on the California finance committee for John McCain's 2008 presidential campaign. In March 2012, he announced his resignation from the water board in order to run for federal deputy and join the 2012 presidential campaign of Andrés Manuel López Obrador. At the same time, he renounced his dual citizenship, a move necessary to meet the constitutional requirements to run for office, he became a proportional representation deputy on the PT list, during which time he served as the president of the Northern Border Matters Commission and was the state campaign coordinator for the PT in the 2013 Baja California state elections.

Bonilla left the post in 2014 in order to become the state party director for the then-new Morena party. His relationship with López Obrador remained close. Party members and leaders say that in Bonilla's media holdings, López Obrador saw a "gold mine" to gain media exposure in Baja California. On 31 January 2018, López Obrador announced that Bonilla would be the primary Senate candidate in Baja California for the Juntos Haremos Historia coalition, forming a ticket with Alejandra León Gastélum; the Juntos Haremos Historia ticket took first place in the election, securing both candidates seats in the Senate. However, Bonilla has stated that he will only remain in office three months and will become the state development coordinator in Baja California

Patricia Longo

Patricia Longo known as Jimena Benìtez, is a fictional character in the 2012 Argentine telenovela Graduados. She is played by Isabel Macedo, both as an adult and, in flashbacks, as a teenager. Jimena Benìtez attended high school in the 1980s, graduating in 1989; as a obese girl, she was victim of school bullying, but fell in love with the main bully, Pablo Catáneo. She took part in a fitness program after graduation, used cosmetic surgery to change her face, she changed her name to Patricia Longo, got a job in Mc Can, ignoring that Pablo worked there as well. In time, she never revealed her secret identity. María Laura Falsini, Pablo's wife, was the first to figure it out, she had a romance with Pablo, got pregnant from him, stayed with him when Pablo and Marìa got divorced. Macedo, a thin actress, had to be made up to become obese for the flashback scenes, she was the villain of the telenovela. Isabel Macedo has played villains including Floricienta, she took the role of Patricia Longo/Jimena Benitez character because it was something she had not done before.

Patricia's past identity as Jimena was intended to remain secret for only ten episodes, but Macedo insisted that the mystery should be maintained for longer. She read about the experiences of victims of school bullying to inform her character and declined other work during the year to stay focused on the series becoming attached to her character. Isabel Macedo was nominated for the 2012 Tato Award as best supporting actress in daily fiction for her work as the character, but did not receive the award, she received the Martín Fierro Awards in a ceremony, as lead actress of daily fiction

Victor Zagainov

Victor Zagainov was a hot air balloon pilot and astronomer from Kazakhstan. He was the first and only hot air balloon champion of the USSR, Hot Air Balloon champion of the Republic of Kazakhstan, the winner of the International Balloon Grand Prix Todi, the champion of the CIS, he organized Grand Prix of Zagainov and was awarded Fédération Aéronautique Internationale Diploma for Outstanding Airmanship and the FAI Air Sport Medal in 2003. Victor Zagainov was born in the family of a military pilot Alexander Zagainov in Tsulukidze of the Georgian Soviet Socialist Republic, where at that time the military unit of his father was based, his father retired in Ukraine where Victor grew up. From his early years, Victor had two passions, both related to the sky - he wanted to fly like his father, he was in love with the stars; however due to partial colour blindness Victor was not accepted to the flight school. Therefore stars became his main future profession. From the 7th grade, he spent lots of time in Lugansk Pedagogical Institute, where there was a small telescope.

He read a lot. He was a winner of the Republican Astronomy Olympiad in grade 10th, he entered Odessa University in 1971 with Astronomy major. After graduation he worked as an astronomer at the limited access observatory in Uzbekistan and in Kazakhstan near Alma-Ata. In 1980, Victor decided to settle in Kazakhstan. For several years Mr. Zagainov led a club of amateur astronomers at the National Palace of Pioneers of the Republic of Kazakhstan. Among his students are well-known physicists, journalists working in Almaty and abroad. Many of them flew with Victor on his legendary balloon "Altair". For many of them he was not only a teacher but a father, his heart and home were always open to them. After 13 years of not running the club they came to him for advice. In 1989, Victor was first introduced to ballooning - long cherished dream of a flight in the sky. In 1990 he had built his first hot air balloon; the envelope was made in Feodosiya, the burner was done by well-known designer D. Bimbat in Sverdlovsk and the basket he weaved himself.

The name and design of the balloon reflected his two passions. A proudly soaring eagle and the inscription "Altair" - the name of Alpha Aquilae; the first inflation of "Altair" happened in December 1990 in Sverdlovsk. In February 1991 he flew this balloon in Norway. In August it was in Ukraine. In September 1991 Victor Zagainov on the Hot Air Balloon "Altair" become the first champion of the USSR. In the same year the Soviet Union collapsed, so Victor Zagainov was the only one to receive this title, his astronomy club students were not only his first passengers, but members of his crew. Three out of the four members of his crew at the National Championship of USSR in 1991 were his former students. Victor was one of the biggest promoters of Hot Air Ballooning; as part of this work in his new home country Kazakhstan he organized Hot Air Balloon competition - Grand Prix of Zagainov. For the first time it took place in 1992; such event offered opportunity for novice pilots to improve their skills, while introducing international standards to them.

To help Kazakh pilots improve their level, Victor invited pilots from Pakistan, Switzerland, Scotland, United States and Russia. Main goal of Grand Prix of Zagainov was to rise new generation of pilots; as part of Grand Prix of Zagainov in 1996 Victor organized national records setting flight for Hot Air Balloons of different classes. This was a first time any Hot Air Balloon record registration request was submitted to FAI. On October 3, 2002, taking part in a ballooning event in the town of Zheleznovodsk, Victor Zagainov's balloon was involved in a mid-air collision between his balloon's envelope and a descending balloon's basket. Victor's envelope was torn open at a height of 300 m, initiating a fast and uncontrolled descent. Despite his best efforts to keep the balloon inflated with continuous heating, the envelope caught fire and the balloon plunged to the ground. On board with Victor, as the only passenger, was his best friend's and crew-member's 19 years old daughter. Realizing that he could not stop or slow the balloon's descent, just before impact Victor lifted the girl in his arms and placed himself underneath her, thus acting as a living cushion on impact.

Both occupants survived the crash and the girl was released from hospital after a routine check, with just a few scratches and concussion. Victor Zagainov succumbed to severe internal injuries two days later