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out any preceding complaint. Decerebrate rigidity and brief clonic jerking of the limbs may occur at the onset of the hemorrhage, in association with unconsciousness. If the hemorrhage is massive, death may ensue in a matter of minutes or hours, so that ruptured aneurysm must be considered in the differential diagnosis of sudden death. A considerable proportion of such patients probably never reach a hospital. Persistent deep coma is accompanied by irregular respirations, attacks of extensor rigidity, and nally respiratory arrest and circulatory collapse. In these rapidly fatal cases, the subarachnoid blood has greatly increased the intracranial pressure to a level that approaches arterial pressure and caused a marked reduction in cerebral perfusion. In some instances the hemorrhage has dissected intracerebrally and entered the ventricular system. Rupture of the aneurysm usually occurs while the patient is active rather than during sleep, and in a few instances during sexual intercourse, straining at stool, lifting heavy objects, or other sustained exertion (see page 160). Momentary Valsalva maneuvers, as in coughing or sneezing, have generally not caused aneurysmal rupture (they may cause arterial dissection). In patients who survive the initial rupture, the most feared complication is rerupture, an event that may occur at any time from minutes up to 2 or 3 weeks. In less severe cases, consciousness, if lost, may be regained within a few minutes or hours, but a residuum of drowsiness, confusion, and amnesia accompanied by severe headache and stiff neck persists for several days. It is not uncommon for the drowsiness and confusion to last 10 days or longer. Since the hemorrhage is con ned to the subarachnoid space, there are few if any focal neurologic signs. That is to say, gross lateralizing signs in the form of hemiplegia, hemiparesis, homonymous hemianopia, or aphasia are absent in the majority of cases. On occasion, a jet of blood emanating from an aneurysm may rupture into the adjacent brain or clot in the insular cistern and produce a hemiparesis or other focal syndrome. There may also be a focal syndrome from acute or delayed ischemia in the territory of the aneurysm-bearing artery. Usually this occurs several days after a large subarachnoid hemorrhage. The pathogenesis of such manifestations is not fully understood, but a transitory fall in pressure in the circulation distal to the aneurysm is postulated in early cases and vasospasm is responsible for the later focal signs. Transient de cits are not common, but they do constitute reliable indicators of the site of the ruptured aneurysm (see below). Convulsive seizures, usually brief and generalized, occur in 10 to 25 percent of cases according to Hart et al (but far less often in our experience) in relation to acute bleeding or rebleeding. These early seizures do not correlate with the location of the aneurysm and do not appear to alter the prognosis. Prior to rupture, saccular aneurysms are usually asymptomatic. Exceptionally, if large enough to compress pain-sensitive structures, they may cause localized cranial pain. With a cavernous or anterolaterally situated aneurysm on the rst part of the middle cerebral artery, the pain may be projected to the orbit. An aneurysm on the posteroinferior or anteroinferior cerebellar artery may cause unilateral occipital or cervical pain. The presence of a partial oculomotor palsy with dilated pupil may be indicative of an aneurysm of the posterior communicating internal carotid junction (less often posterior communicating posterior cerebral junction). Occasionally, large aneurysms just anterior to the cavernous sinus may compress the optic nerves or chiasm, third nerve, hypothalamus, or pituitary gland. In the cavernous sinus they may compress the third, fourth, or sixth nerve or the ophthalmic division of the fth nerve. A monocular visual eld defect may also develop with a
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The rst term on the right accounts for the relative instantaneous linear velocity of the two reference frames. The second term is the instantaneous
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Liz Wetzel, a senior designer for Cadillac, once thought she would be designing blenders for a living. As an art student at the University of Michigan, she majored in project design. Teapots and appliances were her forte, but a summer job at General Motors Truck and Bus Group ended her product-design aspirations. She returned to the University of Michigan and concentrated on marketing and engineering. Wetzel eventually returned to GM and worked her way up to a design slot in the prestigious Cadillac studios. Wetzel strives to understand the attitudes of buyers twice her age. I m designing for a specific market, Wetzel says about interpreting the needs and preferences of Cadillac customers. One of the areas she pays close attention to is the Cadillac interior, and it s no coincidence that the roominess and appointments are reminiscent of first-class accommodations on a jetliner. Julie Geldelman Dolan works on Chrysler cars ergonomics, solving people puzzles, such as how passengers fit most comfortably into a car. She had elected architecture as her major at Michigan State University when she quickly realized that the field lacked kicks. She transferred to CCS and felt instantly comfortable with automobile design. At Chrysler, Dolan designed the interior of the Neon concept car and captured top honors at the North American Auto Show in Detroit. The preproduction Neon was the ultimate Lego car add, subtract, expand, reduce. This idea car even had removable seats that users could take to the beach. As is so often the case, Dolan s extremist ideas were not used on the production Neon. She didn t mind this because these progressive ideas can appear years later when studio heads, production people, and the public are more receptive to them. Still, the aura of friendliness she worked into her designs was retained in the production Neon. The executives had picked up some of the fun of it, she says.
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The homogeneous part of eqn. (3.43) is x(t) = F(t)x(t). (3.53)
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Here s a challenge!
With the new era of Governance, Risk Management, and Compliance (GRC) firmly upon us, security and auditing excuses are quickly evaporating. As the custodians of data, IT professionals are being asked to protect personally identifiable information (PII), personal health information (PHI), and an assortment of other valuable data such as credit card numbers or bank account information used in electronic banking transactions. We must now comply with the cadre of new legal requirements: Sarbanes-Oxley (SOX), state privacy laws, the Payment Card Industry s Data Security Standard, EU privacy directives, Corporate Law Economic Reform Program Act (CLERP9), and Basel II to name just a few. In this emerging GRC and privacy era, these requirements are just that requirements. They are no longer optional and are now part of company business plans. They are not considered extra overhead, or a luxury item that is, if we have spare time, money, and computing cycles, then we ll audit. Some consider auditing a tax, but as with all taxes, they still have to be paid. An emerging view of auditing is now gaining popularity, however. From a GRC perspective, auditing provides an additional layer of oversight to existing access and physical controls. You can think of auditing as a safety net that catches things that fall through the protection controls. In these instances, while you cannot prevent a security compromise (because if you could have, you would have), you can detect them when they occur. This allows you to respond to and remediate any data breaches or other negative events. The timeliness of the detection and response is critical and crucial to preserving public image and setting up prevention techniques that will protect against future attacks.
In this example, you create a subroutine for trimming any leading spaces or trailing spaces off a string of text. As mentioned in 5, trimming off spaces is useful when you need to make sure that a string of text you use doesn t start or end with a space for example, to avoid layout problems in documents or errors in sorting. To create the subroutine, follow these steps:
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