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Favorable wound healing was verified and he finished the monitorized protocol two weeks later medications requiring prior authorization cheap 100mg epivir-hbv otc. In order to exclude possible infection, we monitorized the C-reactive protein levels, which decreased gradually. Two months later, the X-ray and the Computed Tomography showed signals of malunion (Figure 3) and the external fixator was removed. In the postoperative period we noticed an important elbow instability and reduced mobility. We considered multiple treatment options and concluded that internal fixation would not be possible given the absence of adequate articular surfaces. In this sense, we decided to perform a total elbow arthroplasty three months after the accident. By a posterior approach, the triceps was externally reflected, the distal humeral extremity was regularized, the bone sequestra were removed and the ulna was prepared. In the postoperative period, we verified adequate healing and the X-ray revealed correct prosthesis implantation (Figure 5). Two weeks later, the patient began rehabilitation with passive elbow motion that gradually progressed to active motion. Six weeks after surgery, the patient was capable of feeding himself and began strength exercises. Six months after arthroplasty, the patient resumed his laboral activity and presented with no pain or sensory alterations. After initial fracture stabilization with an external fixator, it became mandatory to find a therapeutic alternative that permitted to restore elbow function and stability. Although osteosynthesis should be the first option, in this case, the huge bone loss (mainly articular) turned it unfeasible. Some last resort procedures have been described, such as immobilization with orthosis, arthrodesis or amputation [10]. However, these are associated with functional limitations and with worse aesthetic outcomes [11]. In this sense, a procedure that permits the reestablishment of the limb structural integrity, with pain remission and with strength and function improvement, is desirable. In contrast with previous reports, several authors have recently shown favorable results with this procedure in traumatic injuries [1114]. The Coonrad-Morrey total elbow arthroplasty allows to make up for the bone defects, to correct the limb structure and alignment and to stabilize the joint. Despite some pronation-supination limitations and strength deficits, satisfactory motion, that permits daily activities, can be obtained [15]. Historically, it was considered that elbow arthroplasty was related to low survival. However, using recently developed materials, a 5-year-survival rate of 97,7% and a 10-year-survival rate of 91,0% are described [16]. Other described complications include ulnar and radial nerve injury, infections, delayed wound healing and periprosthetic fractures [1618]. In this case, of an active young patient with a non- reconstructable fracture, last resort procedures would lead to an important functional loss with an associated worse quality of life. The elbow arthroplasty allowed pain remission and functional recovery with a high satisfaction index. We recommended the patient to avoid strength activities and plan to follow him on an annual basis, with clinical and radiological assessments. Kalicke T, Weber O, Backhaus M, Muhr G, Citak M (2010) Salvage procedures of the elbow: Alternatives to elbow arthroplasty. Franke A, Bieler D, Hentsh S, Johann M, Kollig E (2014) Reconstruction of an elbow joint after blast injury by arthroplasty with a custom-made modified total elbow prosthesis: a case report. Prasad N, Dent C (2008) Outcome of total elbow replacement for distal humeral fractures in the elderly. Pogliacomi F, Galavotti C, Cavaciocchi M, Corradi M, Rotini R (2014) Total elbow artroplasty following traumas: mid-term results. Chalidis B, Dimitrou C, Papadopoulos P (2009) Total elbow artrhoplasty for the treatment of insuficiente distal humeral fractures.

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Enterocytes of zinc-deficient rats in another experiment failed to form chylomicrons medications definition order epivir-hbv online pills, the principal carriers of dietary lipids including retinyl esters. Adding essential fatty acids to the diet did not counteract the adverse effect of zinc deficiency (13). These studies carefully controlled food intake, feeding patterns, and body weights in zinc-deficient, pair-fed control rats, suggesting that intestinal vitamin A malabsorption could be due to specific effects of zinc deficiency beyond any generalized effects of malnutrition. Changes in vitamin A intake have effects on zinc absorption, status, and function. In situ experiments in vitamin-deficient chicks showed that zinc absorption was depressed not only throughout the small intestine (by 40%), but particularly in the ileum (by 57%) (14). Administration of retinyl acetate increased ileal absorption of zinc nearly 3-fold. It must be noted that experimental chicks manifested severe hypovitaminosis A; their body weight was 60% of that of the controls and they had secondary zinc deficiency. A dramatic decline in zinc absorption is likely to occur in severe vitamin A deficiency, although the Downloaded from academic. The authors concluded that above a certain threshold of plasma zinc, vitamin A transport is not dependent on plasma zinc concentration, but below that threshold vitamin A release and transport from the liver is strongly influenced by plasma zinc concentration. A polynomial regression equation that included a squared term for zinc provided the optimum fit for the curvilinear relation between plasma zinc and vitamin A (18). Interaction via the visual cycle Animal data show that vitamin A and zinc interact during the conversion of retinol to retinal in the retina of the eye during the visual cycle (7), as well as in other tissues such as the liver and testes (9). Rhodopsin, a photosensitive pigment required for night vision, is synthesized from retinaldehyde and a membrane protein moiety, opsin. In zinc deficiency the formation of 13-cis-retinal is reduced, causing a decrease in rhodopsin formation and rod photosensitivity that can lead to poor dark adaptation or night blindness. Investigators measured the rate of rhodopsin regeneration in the following groups of rats: 1) zinc sufficient and ad libitum fed, 2) zinc deficient, and 3) zinc sufficient, pair fed, and weight matched. The initial rate of rhodopsin regeneration after 60 min of dark-adaptation, using the ocular concentration of 13-cisretinal as an indicator, was not different among the 3 groups. Rather, generalized malnutrition that results from markedly reduced food intake may have depressed opsin synthesis (although unassessed) in the rod photoreceptor cells, which in turn may have lowered rhodopsin concentrations in the eyes. Another study that examined electroretinogram changes in zinc and vitamin A deficiencies in rats showed that vitamin A deficiency could cause retinal degeneration that was not responsive to zinc (20). Vitamin A repletion, however, reversed the degeneration even in the presence of moderate zinc deficiency. Relation between plasma vitamin A and zinc concentrations in rhesus monkeys at 135 d of pregnancy. Cross-sectional studies have often failed to establish a consistent relation between vitamin A and zinc status; however, a positive association may exist in malnourished populations in which deficiencies of both micronutrients often coexist. In African children suffering from measles, serum zinc was significantly correlated with both serum vitamin A (r = 0. Mean serum zinc concentrations were lower in school-aged Bangladeshi children with serum retinol concentrations < 0. On the other hand, no correlation was found between serum zinc and vitamin A concentrations in 102 growth-retarded (third percentile for height, weight, or head circumference) Mexican American migrant children (21). In Brazil, only a very weak and nonsignificant correlation was observed between liver zinc and vitamin A content of fetuses and stillborn infants (r = 0. In contrast, amniotic fluid and maternal serum concentrations of zinc and vitamin A were more highly correlated (r = 0.

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Once the top-level (or parent) functional requirements and constraints have been established medications i can take while pregnant trusted 150mg epivir-hbv, the system designer uses functional analysis to begin to formulate a conceptual system architecture. The system architecture can be seen as the strategic organization of the functional elements of the system, laid out to enable the roles, relationships, dependencies, and interfaces between elements to be clearly defined and understood. It is strategic in its focus on the overarching structure of the system and how its elements fit together to contribute to the whole, instead of on the particular workings of the elements themselves. It enables the elements to be developed separately from each other while ensuring that they work together effectively to achieve the top-level (or parent) requirements. Each architecture concept involves specification of the functional elements (what the pieces do), their relationships to each other (interface definition), and the ConOps, i. Cost and schedule constraints will ultimately limit how long a program or project can maintain multiple architectural concepts. Architectural changes at higher levels occasionally occur as decomposition to lower levels produces complexity in design, cost, or schedule that necessitates such changes. These are primarily modeling and simulation tools, functional analysis tools, architecture frameworks, and trade studies. A search concept is developed, and analytical models of the architecture, its elements, and their operations are developed with increased fidelity as the project evolves. Functional decomposition, requirements development, and trade studies are subsequently undertaken. Multiple iterations of these activities feed back to the evolving architectural concept as the requirements flow down and the design matures. It is the systematic process of identifying, describing, and relating the functions a system should perform to fulfill its goals and objectives. Functional analysis identifies and links system functions, trade studies, interface characteristics, and rationales to requirements. Translate top-level requirements into functions that should be performed to accomplish the requirements. Decompose and allocate the functions to lower levels of the product breakdown structure. The process involves analyzing each system requirement to identify all of the functions that need to be performed to meet the requirement. Each function identified is described in terms of inputs, outputs, failure modes, consequence of failure, and interface requirements. The process is repeated from the top down so that sub-functions are recognized as part of larger functional areas. Functions are arranged in a logical sequence so that any specified operational usage of the system can be traced in an end-to-end path. Therefore, the outcome is highly dependent on the creativity, skills, and experience of the engineers doing the analysis. As the analysis proceeds to lower levels of the architecture and system, and the system is better understood, the systems engineer should keep an open mind and a willingness to go back and change previously established architecture and system requirements. These changes will then have to be decomposed down through the architecture and sub-functions again with the recursive process continuing until the system is fully defined with all of the requirements understood and known to be viable, verifiable, and internally consistent. Both the baselined and derived requirements are allocated to the system architecture and functions. The other work products generated during the Logical Decomposition Process should be captured along with key decisions made, supporting decision rationale and assumptions, and lessons learned in performing the activities. This involves transforming the defined logical decomposition models and their associated sets of derived technical requirements into alternative solutions. These alternative solutions are then analyzed through detailed trade studies that result in the selection of a preferred alternative. This preferred alternative is then fully defined into a final design solution that satisfies the technical requirements. They include the system architecture models that define the underlying structure and relationship of the elements of the system. If the alternatives are precisely defined and thoroughly understood to be well differentiated in the cost-effectiveness space, then the systems engineer can make choices among them with confidence. It should be realized, however, that this illustration represents neither the project life cycle, which encompasses the system development process from inception through disposal, nor the product development process by which the system design is developed and implemented. These three products should be consistent with each other and will require iterations and design decisions to achieve this consistency.

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San Mateo County Complex Litigation Court Judge Weiner is the only Complex Civil Litigation Judge in San Mateo County symptoms sleep apnea discount 100mg epivir-hbv overnight delivery. At any one time, Judge Weiner has about 100 lawsuits assigned to her, 45-50 of which are active at any one time (groups of related cases are counted as one of the 4550). Lawyers should be dressed professionally before coming into the courtroom (she has observed lawyers getting dressed in the courtroom before a hearing). Judge Weiner encourages stipulations, because if the parties cannot agree, then the judge may pick something both parties do not like. Failure to appear for a scheduled hearing or trial is the only conduct for which Judge Weiner has issued sanctions against attorneys. Judge Weiner advises lawyers to keep their objections short, especially in front of the jury. Judge Weiner will generally grant side bars until that privilege is abused by, for example, going on record of saying something contrary to what was said at side bar or using side bars too often. Also in jury 27 trials, lawyers should arrive early so they can raise any issues with the judge before the jury starts at 9 a. Judge Weiner often has to remind lawyers to speak more slowly, especially younger attorneys. She finds that younger lawyers tend to speak faster, so it is harder for court reporters and the judge to hear. She has been enthusiastic when senior partners ask junior attorneys to divide up voir dire, split witnesses, or argue motions. Judge Weiner also finds that less experienced lawyers who are given opportunities tend to be more well-prepared. Applicable Rules and Guidelines Attorneys appearing before Judge Weiner are required to follow the California Rules of Court, County Local Rules (including Local Rule 2. The website contains model protective orders for the ease of the parties and to assure compliance with California Rules of Court, Rules 2. Case Management Conferences Judge Weiner is very active in case management because she believes that it helps reduce the number of motions and keeps the case moving. Judge Weiner discourages parties from catching the other side off-guard with impromptu hearings. The philosophy is to work together as a team to set a schedule that meets the needs of the case and the schedule of counsel, even if the schedule veers from the statutory deadlines, usually by stipulation, given that complex cases are allowed flexibility. Judge 28 Weiner works with the parties as a team to resolve these types of phasing issues. Because people in the legal profession are procrastinators by nature, Judge Weiner works with the parties to pick logical deadlines to get things done. Judge Weiner also holds regular discovery conferences, as often as the case needs. If the parties are able to resolve the dispute, they can take the conference off calendar at that time. Judge Weiner believes it is easier to have periodic discovery conferences on calendar and remove them if necessary rather than keeping conferences unscheduled and having the parties scramble last minute to squeeze in a conference. Judge Weiner does not stay merits discovery pending class certification or formally bifurcate proceedings. Sometimes lawyers will stipulate to stay merits discovery, and Judge Weiner will caution the parties that doing so is at their peril because they may get to trial and have not had enough time to focus on merits discovery. Once class certification is complete, the parties will often know whether the case will go to trial or not. Once certified, Judge Weiner will set pretrial dates and deadlines and figure out what further discovery is needed. But her hope is they have been working on class discovery on the merits all along. Discovery As noted, Judge Weiner encourages the parties to prioritize what is needed at the current moment without formal phasing.

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So an equivalent question is: How many ways can a subset of three rays be chosen from six rays The point of intersection of the perpendicular bisectors is the center of the circle and the radius is the measure from the center to the arc medicine cabinets recessed cheap epivir-hbv 150 mg amex. It is not intended that the questions be given as a block, but that there be ample opportunities for discussion between questions. It is not necessary that all questions be asked or that they are asked in any particular order. The solution key includes a cross-reference to the Core Content for Assessment descriptor that is being addressed for each question. For some reason, the bank teller was confused and switched the dollars and cents; that is, what was written as cents on the check he gave to her in dollars, and what was written in dollars on the check he gave to her in cents. At that point, she actually had twice the amount of money that was written on the check. Also, explain why you believe there is only one possible answer, or why you believe there is more than one possible answer. At this rate, how much would it cost to purchase groceries now which would have cost $50 twenty years ago Kris lined cans in two rows on a shelf and had one left over; she tried again using three rows, and then four rows. What famous summation formula is being illustrated in this informal pictorial proof To win the prize of $2000, Kris had to solve the following problem: the sum of two numbers is 2, the product of the same two numbers is 3. Diana and Andrew each roll a standard die obtaining a number at random from 1 to 6. Find a positive integer that satisfies: 2 2 3n 3 = 81n 3 if Max wrote the right side and Phoebe wrote the left side. Determine all pairs of numbers x and y such that xy, x/y, and x - y are all equal. He replied, "If I had as many more, half as many more, and 1 1 more, I would have two dozen. Find the value of t and the digit symbolized by a such that [3(230 + t)]2 will equal 492, a04. Find three integers in geometric progression whose sum is 21 and such that the sum of their reciprocals is 7/12. If you are given the sum of the squares of three consecutive integers, what five digits can never occur in the ones place You are given a nine-inch diameter pie plate and you conduct an experiment in which the plate is dropped, upside down from about waist height, onto a floor of nine-inch square tiles. What is the probability that I will get a roll without my favorite color, chocolate Three straws are chosen from a set of nine straws whose lengths are 1 inch, 2 inches, 3 inches. What is the probability that the three straws placed end-to-end will form a triangle One circle divides a plane into two regions, two circles into four regions, three circles into regions, four circles into regions, and n circles into regions. You already know how to find the sum of the first n triangular numbers: 1 = 1 1+2 = 3 1+2+3 = 6 n(n + 1) 1+2+3+4 = 10, or Sn =. Solution of two variable linear equations; write and solve linear equations given reallife situations. With 100 choices for dollars and 100 choices for cents, I would have to check out 10,000 possibilities. With random guessing it soon becomes apparent that the amount of cents must be more than double the number of dollars, and the number of dollars must be less than 50.

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About the Security Industries Authority Staff

The Security Industies Authority is headed by a Registrar as the CEO and has thirteen (13) other staff members from all four (4) regions of the country working under him. These includes the Manager Finance and Administration, Manager Licensing and Compliance and four (4) Regional inspectors(MOMASE, Islands, Highland and Southern).

The Inspectors job are very challenging because they are at the front line of enforcement to ensure that private security companies are compliant with the provisions of the Security Protection Act to operate a security company. Most of them are former officers of the Royal PNG Constabulary. Apart from them we also have a efficient staff made up of the Executive Secretary, Accounts Officer, HR Officer , I.T Officer & an Office Janitor in Head Office Port Moresby while Admin Assistance/ Driver and an Office Admin/ Reception in Lae Momase & Highlands Region branch office.

Staff Profiles


Mr. Paul Kingston Isari

Registrar & CEO of PNG Security Industries Authority


Mr. Philip Gene, BAC, CPA PNG

Manager Finance & Administration


Mr. Spencer Gelo

Manager Licencing & Compliance

POM Office Staff

Front left – right Ms Margaret Biskum- Security Inspector New Guinea Islands, Ms Alicia Nana – Executive Secretary & Mrs Mackey Kembi Office Janitor

Back left – right Mr. Rinson Ngale – Security Inspector NCD/Southern Region, Mr. Emmanuel Tumbe HR Officer, Mr. Elijah Fave – Accounts Officer, Mr. Andrew Kaiap – I.T Officer


Lae Office Staff

Front left – right Ms Nelison Roberts – Office Secretary / Reception , Mr. Elvis Otare – Office Admin Assistance / Driver & Acting Momase Region Inspector

Back left – right Vacant – Office Manager & Security Inspector Momase Region, Mr. Pius Moi – Acting Office Manager Security Inspector Highlands Region

Security Industries Authority organizational chart


Vacancies for Council Representatives from the Security
Industry to sit in the Council

The Security Industries Authority currently does not have any vacant Council Representative position. There in total six (6) nominated representative from Security Industries in the council.(see SIA Council)

Qualified candidates will be made known here if there is a vacant in Council Representative positions.

Security Industries Authority Position Vacancies

SIA Currently has no vacancy positions available. Public will be notified for any positions available in the future.

Criteria for appointment to the Security Industries Council

  1. The candidates must have a sound knowledge in the operations of private security companies and are quite versed with the Security Protection Act 2004.
  2. The candidates shall not be currently employed in any licensed security companies that are currently registered with the Security Industries Authority or were not previously employed by any licensed security companies.
  3. The candidates shall not be a current owner or a shareholder of a licensed security company currently registered with the Security Industries Authority and the IPA (Investment promotion Authority).
  4. The candidates shall not be a previous owner or a shareholder of a licensed security company registered with the Security Industries Authority or with the IPA. (Investment promotion Authority).
  5. Interested persons may submit their application with a CV with three (3) references named and attached with their latest passport size photos.
  6. Both male and females are encouraged to participate.
  7. Only registered security companies and permitted security guards will participate in the nominations.
  8. All candidates shall be subjected to a fit and proper persons test before they are formally appointed for 3 years term by the Minister for Police & Internal Security.

For enquiries on this matter

Visit us at the Top floor of the Former Fraud Squad blue building, Gorobe Street, Badili, 2 Mile, Port Moresby NCD or Lae at Post Office Building, second street, top floor, suite # 14, Lae Morobe Province or write to the Chairman Security Industries Council PO BOX 80 Port Moresby National capital District. You can also contact Manager Licensing & Compliance – Mr. Spencer Gelo on telephone 3239851 / 3257930, or email executivesecretary@sia.gov.pg

Invitation to the Stake Holders and the Industry to make a submission on the amendments to current security Protection Act

The Registrar now invites all the registered security companies, service receivers and interested stake holders for their written submission to amend the current Security Protection Act to cover many grey areas of the law.

The submissions should clearly state what provisions of the current Security Protection Act 2004 and the Security Protection regulation 2012 are to be amended to enhance the growth of the industry. This is necessary in light of numerous complaints from the security companies and interested stake holders of the short falls in the current Act which is said to be hindering the growth of the industry.

All submissions must be dropped at The Authority Head Office: Former Fraud Squad Office, Top Floor, Gorobe Street, 2 Mile Drive, Badili,Boroko NCD in Port Moresby. They can also be posted or emailed using the address on the last page. Copies of the current Security Protection Act 2004 can be obtained at the Security Industries Authority office for K35 to use as a guide to prepare the submissions.

Appointment to the Board of Complaints

The Security Industries Authority in compliance with section 57 of the Security Protection Act 2004 has already advertised in the media in early February 2013 seeking for two (2) interested persons to sit on the Board of Complaints.

The purposes of the Board of Complaints is to hear allegations made against licensed security companies by the general public and to award appropriate disciplinary penalties to protect the integrity of the security industry. Several applications have already been received and the short listed candidates will be advised in writing by the chairman shortly before a final selection is made for their three (3) yeas appointments by the Minister for Police and Internal Security.