Scurvy is a disease resulting from a lack of vitamin C. Early symptoms of deficiency include weakness, feeling tired and sore legs. Without treatment, decreased red blood cells, gum disease, changes to hair, bleeding from the skin may occur; as scurvy worsens there can be poor wound healing, personality changes, death from infection or bleeding. It takes at least a month of little to no vitamin C in the diet. In modern times, scurvy occurs most in people with mental disorders, unusual eating habits and older people who live alone. Other risk factors include intestinal dialysis. While many animals produce their own vitamin C, humans and a few others do not. Vitamin C is required to make the building blocks for collagen. Diagnosis is based on physical signs, X-rays, improvement after treatment. Treatment is with vitamin C supplements taken by mouth. Improvement begins in a few days with complete recovery in a few weeks. Sources of vitamin C in the diet include a number of vegetables such as tomatoes.
Cooking decreases vitamin C in foods. Scurvy is rare, it occurs more in the developing world in association with malnutrition. Rates among refugees are reported at 5 to 45 percent. Scurvy was described as early as the time of ancient Egypt, it was a limiting factor in long-distance sea travel killing large numbers of people. During the Age of Sail, it was assumed that 50 percent of the sailors would die of scurvy on a given trip. A Scottish surgeon in the Royal Navy, James Lind, is credited with proving that scurvy can be treated with citrus fruit in 1753. Nonetheless, it would be 1795 before health reformers such as Gilbert Blane persuaded the British Royal Navy to give lemon juice to its sailors. Early symptoms are lethargy. After one to three months, patients develop shortness of bone pain. Myalgias may occur because of reduced carnitine production. Other symptoms include skin changes with roughness, easy bruising and petechiae, gum disease, loosening of teeth, poor wound healing, emotional changes.
Dry mouth and dry eyes similar to Sjögren's syndrome may occur. In the late stages, generalised edema, neuropathy, fever and eventual death are seen. Scurvy, including subclinical scurvy, is caused by a deficiency of dietary vitamin C since humans are unable to metabolically make this chemical. Provided diet contains sufficient vitamin C, the lack of working L-gulonolactone oxidase enzyme has no significance, in modern Western societies, scurvy is present in adults, although infants and elderly people are affected. All commercially available baby formulas contain added vitamin C, preventing infantile scurvy. Human breast milk contains sufficient vitamin C. Commercial milk is pasteurized, a heating process that destroys the natural vitamin C content of the milk. Scurvy is one of the accompanying diseases of malnutrition and thus is still widespread in areas of the world depending on external food aid. Although rare, there are documented cases of scurvy due to poor dietary choices by people living in industrialized nations.
Vitamins are essential to the production and use of enzymes that are involved in ongoing processes throughout the human body. Ascorbic acid is needed for a variety of biosynthetic pathways, by accelerating hydroxylation and amidation reactions. In the synthesis of collagen, ascorbic acid is required as a cofactor for prolyl hydroxylase and lysyl hydroxylase; these two enzymes are responsible for the hydroxylation of the proline and lysine amino acids in collagen. Hydroxyproline and hydroxylysine are important for stabilizing collagen by cross-linking the propeptides in collagen. Collagen is a primary structural protein in the human body, necessary for healthy blood vessels, skin, bone and other connective tissues. Defective connective tissue leads to fragile capillaries, resulting in abnormal bleeding and internal hemorrhaging. Collagen is an important part of bone, so bone formation is affected. Teeth loosen, bones break more and once-healed breaks may recur. Defective collagen fibrillogenesis impairs wound healing.
Untreated scurvy is invariably fatal. Diagnosis is based on physical signs, X-rays, improvement after treatment. Various childhood onset disorders can mimic the clinical and X-ray picture of scurvy such as: Rickets Osteochondrodysplasias osteogenesis imperfecta Blount's disease Osteomyelitis Scurvy can be prevented by a diet that includes vitamin C-rich foods such as amla, bell peppers, broccoli, chili peppers, guava and parsley. Other sources rich in vitamin C are fruits such as lemons, oranges and strawberries, it is found in vegetables, such as brussels sprouts, cabbage and spinach. Some fruits and vegetables not high in vitamin C may be pickled in lemon juice, high in vitamin C. Though redundant in the presence of a balanced diet, various nutritional supplements are available, which provide ascorbic acid well in excess of that required to prevent scurvy; some animal products, including liver, muktuk and parts of the central nervous system, including the adrenal medulla and spinal cord, contain large amounts of vitamin C, can be used to treat scurvy.
Fresh meat from animals which make their own vitamin C contains enough vitamin C to prevent scurvy, partly treat it. In some cases (notably French
San Severo al Pendino is a former Roman Catholic church, located on Via Duomo, just south of San Giorgio Maggiore and adjacent to the Museo Civico Gaetano Filangieri, in central Naples, Italy. The church was founded in 1448 at the same time as the hospital of Pietro Caracciolo, the abbot of the nearby church of San Giorgio Maggiore; the original name was Santa Maria a Selice. In 1550 the church was ceded to the Dominican Order which in 1587 acquired the nearby Palazzo Como to use as a convent. From 1599 to 1620 the church underwent major reconstruction by Giovan Giacomo Di Conforto, which give the building a late-mannerist style. In the 18th century, it was decorated with Baroque touches, including the staircase with finely sculpted balustrade. In 1818 the building became the first home of the State Archives of Naples with the return of the Dominicans, the complex was rebuilt in 1845 by Filippo Botta, but in 1863 the convent was suppressed and building was used as a retirement home; the reworking of the Via Duomo shortened the nave, deprived the church of its baroque facade and its first two chapels.
The front now has a simpler Renaissance style facade. During the Second World War, the church was used as a bomb shelter, but it was damaged by the 1980 earthquake; the church has been though deconsecrated and used for exhibitions and conferences. The interior has a Greek plan, 17th century decoration; the altar is made of polychrome marble, while the transept to the right has the funereal monument of Giovanni Alfonso Bisvallo, sculpted by Girolamo D'Auria in 1617, which had a canvas by Luca Giordano. Churches in Naples Vincenzo Regina, Le chiese di Napoli. Viaggio indimenticabile attraverso la storia artistica, letteraria, civile e spirituale della Napoli sacra and Compton editor, Naples 2004. Francesco Domenico Moccia e Dante Caporali, NapoliGuida-Tra Luoghi e Monumenti della città storica, Clean Edition, 2001 Gennaro Aspreno Galante, Le Chiese di Napoli. Guida Sacra della Città di Napoli, Naples, 19th century
The AP International English Language is an AP Examinations course managed by Educational Testing Service with the sponsorship of the College Board in New York. It is designed for non-native speakers to prepare for studying in an English-speaking university in North America; the course gives students a chance to earn college credit. The three-hour exam assesses four language skills: listening, reading and speaking; the test paper has two sections: free-response questions. The current APIEL committee consists of high school and university English teachers from Belgium, France, Germany and the United States. Since 1955, the Advanced Placement program of the College Board has offered college-level curriculum and examinations to high school students; the APIEL examination was conceived in 1995 and was first implemented in 1997. It was first tested in Germany in 1997, there were about 2500 examinees at that time; the examination was tested in France in the second year, further extended to Australia, Sweden and India in 1999 and 2000.
The test was offered in China in 2002 for the first time. For a designated high school course, the course must be reviewed by the University Board to determine that it is compliant with the AP course. If the course is approved, the school can use the AP designation and the course will be publicly listed on the AP course ledger. At present, more than 700 universities in the United Kingdom, the United States, other countries have adopted the APIEL as an admission criteria for undergraduates and scholarships and bursaries; some multinational companies regard APIEL grades as an essential credential for recruited employees and they are sometimes used in credit decisions. The APIEL is open to any student, in the final stage of secondary school or attending a university; the subject matter of the APIEL examination is chosen from a wide range of subjects, including current events, the arts, literature and technology, other topics of general interest. The content of the APIEL is not tied to a particular curriculum, so there are no additional coursework or materials required for preparation, other than general secondary school study.
The College Board website provides test details and sample questions for the examination. The APIEL measures the English fluency of non-native speakers; the test is designed to indicate that high-scoring students will be able to participate in the English-speaking academic community on an equal basis with native English speakers. APIEL students should demonstrate the following skills: Comprehension of spoken English in academic contexts. Like the other AP language exams, the three-hour APIEL exam assesses four language skills: listening, reading and speaking; each section is worth 25% of the total examination grade. Listening consists of short talks; the multiple-choice section has two parts -- reading. Both are machine-scored; the listening part of the exam has around 40 multiple-choice questions, students have around 35 minutes to answer them. The test consists of short monologues, presentations, or dialogues between two speakers who discuss a variety of subjects. For the test, native speakers of standard North American English are recorded on cassette tapes.
The recordings test "comprehension of spoken English". Students answer all the questions based on the recording. Note-taking in the examination booklet is allowed; the test booklet only has the answer choices and the questions are not printed in the test booklet. The reading part of the exam has around 40 multiple-choice questions, students have around 50 minutes to answer them; this part of the exam consists of several prose passages, each followed by multiple-choice questions about their content and meaning. The readings vary in length and complexity, they are chosen from twentieth-century materials; the free-response section has two parts -- speaking. Both of these sections are scored by the International Schools team and university English teachers at the Central Rating Center each June; the writing element consists of two essays. Students are required to write both in 80 minutes. Students are asked to present their ideas about major issues, they should be able to understand and explain their opinions by providing evidence from their own experiences.
The speaking part of the exam has five tasks that need to be completed in 15 minutes. The tasks demonstrate substantive issues. For example, in one exam, a set of pictures was given to students that showed the stages of development for towns in three countries. Students had to describe how the town changed and what type of daily life they might expect in each stage of the development. During the exam, students are given thirty seconds to prepare their speech, they have one minute to adequately respond to each task. Students record their responses on individual cassette tapes, each response is scored holistically; the APIEL, like other AP exams, is scored on a 1 to 5 scale as f