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Archive for October 22, 2013

Project Manager’s Journal

projectmanagerjournal

Project Manager’s Journal ( stars with Ratings) 
iPad App
$2.99 Free

 

Whether you’re in the throes of creating your own company or managing someone else’s, chances are you have a number of projects you have to keep in mind and track along the way. With today’s app, Project Manager’s Journal, you’ll be able to do all that on your iPad lickity split.

Project Manager’s Journal is exactly what it sounds like: a way for you to keep your projects in line and stay on top of things as they progress. You’ll be able to manage multiple projects, and label things like actions, risks, meetings, issues, and more. You can create notes for all items, and even analyze risks and determine a risk profile for the project at hand. Everything can be sorted by details, actions, and other labels, and your items can be exports in XML, XLS format for Excel compatibility. If you need to send out a calendar event meeting invitation, you can do so from within the app, and even assign contact info to certain projects. If you’re in the world of business, it’s worth checking out Project Manager’s Journal.

App Screenshots

via Project Manager’s Journal: Track multiple projects and take advantage of a litany of features | AppSaga.

Caramel Chicken

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INGREDIENTS

2 tablespoons vegetable oil

2½ pounds skin-on, bone-in chicken legs and thighs

Kosher salt

8 garlic cloves, peeled

⅓ cup (packed) light brown sugar

¼ cup (or more) unseasoned rice vinegar

2 slices ¼”-thick slices peeled ginger

1 cup low-sodium chicken broth

¼ cup reduced-sodium soy sauce

2 scallions, thinly sliced

Cooked white rice (for serving)

 

PREPARATION

Heat oil in a large wide heavy pot over medium-high heat. Season chicken with salt and, working in 2 batches, cook until golden brown and crisp, 6–8 minutes per side; transfer to a plate. Add garlic to pot and cook, stirring often, until golden, about 2 minutes; transfer to plate with chicken. Pour off fat from pot.

Return pot to medium-high heat and add ½ cup water, scraping up browned bits. Add brown sugar; stir to dissolve, then cook, stirring, until mixture thickens and turns a deep amber color, about 4 minutes. Carefully add vinegar (it may bubble up; sugar will crystallize); stir to dissolve sugar.

Add ginger, broth, and soy sauce, then add chicken, skin side up, and garlic. Bring to a boil, reduce heat, and simmer gently until chicken is cooked through, 20–25 minutes. Transfer chicken to a plate.

Bring cooking liquid to a boil and cook until thick enough to coat a spoon, about 10 minutes. Return chicken to pot; turn to coat. Top with scallions and serve with rice.

via Caramel Chicken – Bon Appétit.

Polio outbreak fears in war-ravaged Syria

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Polio can be prevented but not cured

 

Experts are concerned that polio may have made a return to war-torn Syria.

The World Health Organization says it has received reports of the first suspected outbreak in the country in 14 years.

Syrian’s Ministry of Public Health is launching an urgent response, but experts fear the disease will be hard to control amid civil unrest.

Immunisation is almost impossible to carry out in regions under intense shellfire.

As a result, vaccination rates have been waning – from 95% in 2010 to an estimated 45% in 2013.

At least a third of the country’s public hospitals are out of service, and in some areas, up to 70% of the health workforce has fled.

Outbreak risks have also increased due to overcrowding, poor sanitation and deterioration in water supply.


Polio

  • Caused by a highly-infectious virus
  • Mainly affects children under five years
  • Can lead to irreversible muscle paralysis
  • A course of vaccines against polio can protect a child for life
  • Global eradication efforts continue
  • The disease remains endemic in only a few countries – Afghanistan, Nigeria and Pakistan
  • Mass vaccination is needed to eradicate polio

More than four million Syrians who have relocated to less volatile areas of the country are mostly living in overcrowded, unsanitary conditions.

The WHO says it is already seeing increased cases of measles, typhoid and hepatitis A in Syria.

Dr Jaouad Mahjour, director of the department for communicable diseases at WHO’s regional office for the Eastern Mediterranean, said: “Given the scale of population movement both inside Syria and across borders, together with deteriorating environmental health conditions, outbreaks are inevitable.”

The cluster of suspected polio cases was detected in early October 2013 in Deir al-Zour province.

Initial results from a laboratory in Damascus indicate that at least two of the cases could indeed be polio.

A surveillance alert has been issued for the region to actively search for additional potential cases. Supplementary immunisation activities in neighbouring countries are currently being planned.

WHO’s International Travel and Health recommends that all travellers to and from polio-infected areas be fully vaccinated against polio.

Most people infected with the poliovirus have no signs of illness and are never aware they have been infected. These symptomless people carry the virus in their intestines and can “silently” spread the infection to thousands of others before the first case of polio paralysis emerges.

Polio is spread by eating food or drink contaminated with faeces or, more rarely, directly from person-to-person via saliva.

via BBC News – Polio outbreak fears in war-ravaged Syria.

Baldness treatment a ‘step closer’

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Scientists say they have moved a step closer to banishing bald spots and reversing receding hairlines after human hair was grown in the laboratory.

 

A joint UK and US team was able to create new hairs from tissue samples.

Far more research is needed, but the group said its technique had the “potential to transform” the treatment of hair loss.

The study results were published in the journal Proceedings of the National Academy of Sciences.

There are baldness therapies including drugs to slow the loss of hairs, and transplants, which move hair from the back of the head to cover bald spots.


“Yeah I think it [baldness] will eventually be treatable, absolutely.”

Prof Colin Jahoda,Durham University

The scientists at the University of Durham, in the UK, and Columbia University Medical Centre, in the US, were trying to actually grow new hairs.

Their plan was to start with material taken from the base of a hair and use it to grow many new hairs.

Tricky feat

But human hair has been tricky to grow despite successes in animal studies.

Whenever human tissue was taken from the dermal papillae, the cells which form the base of each hair follicle, the cells would transform into skin instead of growing new hairs.

However, the group found that by clumping the cells together in “3D spheroids” they would keep their hairy identity.

Tissue was taken from seven people and grown in 3D spheroids. These were then transplanted into human skin which had been grafted on to the backs of mice.

Hair follicle
Cells were taken from the base of a follicle and used to grow new hairs

After six weeks, new hair follicles formed in five out of the seven cases and some new tiny hairs began to form.

Prof Colin Jahoda, from Durham University, told the BBC a cure for baldness was possible but it was too soon for men to be hanging up the toupee.

“It’s closer, but it’s still some way away because in terms of what people want cosmetically they’re looking for re-growth of hair that’s the same shape, the same size, as long as before, the same angle. Some of these are almost engineering solutions.

“Yeah I think it [baldness] will eventually be treatable, absolutely.”

He added: “It’s hard to say exactly how long that would take, but the fact that we’ve done it now should reawaken interest.”

Any future therapy would involve transplanting cells which have been grown in the laboratory so safety is a concern.

There would be a risk of infection and the cells could become abnormal, or even cancerous, while being grown.

Baldness cures may not be the first application of the research. Prof Jahoda believes the findings will be used to improve the quality of skin grafts used after severe burns.

Prof Angela Christiano, from Columbia University, said: “This approach has the potential to transform the medical treatment of hair loss.

“Current hair-loss medications tend to slow the loss of hair follicles or potentially stimulate the growth of existing hairs, but they do not create new hair follicles.

“Our method, in contrast, has the potential to actually grow new follicles using a patient’s own cells.”

via BBC News – Baldness treatment a ‘step closer’.

Exercise ‘boosts academic performance’ of teenagers

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Those who did the most exercise did better academically according to the research

 

Intensive exercise improves the academic performance of teenagers, according to new research.

The study, of about 5,000 children, found links between exercise and exam success in English, maths and science.

It found an increase in performance for every extra 17 minutes boys exercised, and 12 minutes for girls.

The study by the universities of Strathclyde and Dundee found physical activity particularly benefited girls’ performance at science.

The authors said this could be a chance finding or reflect gender differences in the impact of physical activity on the brain.

Children who carried out regular exercise, not only did better academically at 11 but also at 13 and in their exams at 16, the study suggested.

‘Low exercise levels’

Most of the teenagers’ exercise levels were found to be well below the recommended 60 minutes a day.

The authors speculated what might happen to academic performance if children got the recommended amount.

They claimed that since every 15 minutes of exercise improved performance by an average of about a quarter of a grade, it was possible children who carried out 60 minutes of exercise every day could improve their academic performance by a full grade – for example, from a C to a B, or a B to an A.

However, the authors admitted this was speculation given that very few children did anywhere near this amount of exercise.

Dr Josie Booth, one of the leaders of the study, from Dundee University said: “Physical activity is more than just important for your physical health.

“There are other benefits and that is something that should be especially important to parents, policy-makers and people involved in education.”

The authors of the study, published in the British Journal of Sports Medicine, said further research backing the findings could have implications fore public health and education policy.

The study was funded by a grant from the BUPA Foundation to the University of Strathclyde.

via BBC News – Exercise ‘boosts academic performance’ of teenagers.

First human trial of new bone-marrow transplant method

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Mohammed started going to school in September

 

Doctors at London’s Great Ormond Street Hospital have carried out a pioneering bone-marrow transplant technique.

They say the method should help with donor shortages since it does not require a perfect cell match.

Mohammed Ahmed, who is nearly five years old, was among the first three children in the world to try out the new treatment.

He has severe combined immunodeficiency syndrome and had been waiting for a suitable donor for years.

Mohammed, who lives in Milton Keynes, was referred to Great Ormond Street Hospital when he was a year old.


We waited for a full match but it did not come. By the grace of God, we took the decision to have the treatment”

Jamil Ahmed, Mohammed’s dad

His condition – a weak immune system – makes him more susceptible to infections than most, and a bone marrow transplant is the only known treatment.

While Mohammed was on the transplant waiting list, he became extremely sick with swine flu.

At that time, his doctors decided Mohammed’s only real hope was to have a mismatched bone-marrow transplant, with his father acting as the donor.

Mohammed’s dad, Jamil, agreed to give the experimental therapy a go.

Before giving his donation, Jamil was first vaccinated against swine flu so that his own bone-marrow cells would know how to fight the infection.

Mohammed’s doctors then modified these donated immune cells, called “T-cells”, in the lab to engineer a safety switch – a self-destruct message that could be activated if Mohammed’s body should start to reject them once transplanted.

Safety net

Rejection or graft-v-host disease is a serious complication of bone-marrow transplants, particularly where tissue matching between donor and recipient is not perfect, and is one of the most difficult challenges faced by patients and their doctors.

Mismatched transplants in children – where the donor is not a close match for the child – are usually depleted of T-cells to prevent graft-v-host disease, but this causes problems in terms of virus infections and leukaemia relapse.

Blood cells
White blood cells protect the body against infections

The safety switch gets round this – plenty of T-cells to be transfused and later killed off if problems do arise.

Thankfully, the transplant carried out in 2011 was a success – Mohammed’s doctors did not need to use the safety switch.

Although Mohammed still has to take a number of medicines to ward off future infections, his immune system is now in better shape.

Jamil said: “We waited for a full match but it did not come. By the grace of God, we took the decision to have the treatment.

“Now he is all right. Sometimes we forget what he has been through. We are just so grateful.”

He said Mohammed would still need close monitoring and regular health checks over the coming years, but his outlook was good.

Dr Waseem Qasim, ‎consultant in paediatric immunology at Great Ormond Street Hospital and lead author for the study, said the new approach should hopefully mean children who received a mismatched transplant could enjoy the same chance of success as those given a fully matched transplant.

“We think Mohammed is cured of his disorder. He should be able to lead a fairly normal life now.”

A full report about Mohammed’s therapy and the research by Great Ormond Street Hospital, King’s College London and the Institute of Child Health has just been published in PLoS One journal.

There are currently about 1,600 people in the UK waiting for a bone-marrow transplant and 37,000 worldwide.

Just 30% of people will find a matching donor from within their families.

Donations involve collecting blood from a vein or aspirating bone marrow from the pelvis using a needle and syringe.

via BBC News – First human trial of new bone-marrow transplant method.

甘露消毒丹‧治疫病效果佳

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甘露消毒丹的組方考量是用滑石、茵陳等從下焦排出濕熱,以石菖蒲、藿香等芳香化掉中焦的濕邪及用連翹、射干、貝母和薄荷等清熱解毒,對治上焦的熱毒。因此是治療三焦濕熱的名方之一。(圖:光明日報)

 

(吉隆坡訊)根據歷史的記載,歷代都有溫疫,即從西元前369年算起到1644年的明朝末年,僅正史就記載95次疾病大流行。經醫家與學者觀察,這些疾病的流行與氣候的變化有密切關係。而《黃帝內經》的五運六氣學說,就是根據氣候的變化來推斷疾病的流行度,據此採取預防和治療措施,從而減少其破壞力,挽救健康和生命。好比在2003年SARS時期,中醫運用溫病理論及五運六氣理論為SARS擬定治療方案,成功對證用藥並緩解病況。當時,中醫應用的處方以溫病學方劑為主,其中包含甘露消毒丹,該方為清代醫家葉天士針對清代流行的溫疫,依據五運六氣理論配伍出來的處方,時至今日猶有用武之地。

中醫師李凱亮說,甘露消毒丹清熱而不甚寒,化濕而不香燥,對於濕溫症熱盛於濕者,頗為適合。此外,患者癒後也要調養身體方能預防本病再犯。

傳統上,甘露消毒丹素是治療濕溫時疫的主方,適應於邪在氣分,濕熱並重的證型。他說,患者會出現發熱、倦怠、喉嚨或腮腺或淋巴結等腫痛、胸悶腹脹、尿黃、或便秘或泄瀉等症狀。倦怠、四肢酸痛困重等都是濕邪困身的表現。

他解釋,患者喉嚨腫痛,顯示熱邪侵犯上焦,胸悶腹脹為中焦氣機受阻,小便黃,或便秘或泄瀉,顯示濕邪客居於腸胃。簡言之,就是濕熱邪合併侵襲三焦,得用處方來驅除病邪,在辨證論治的原則下,甘露消毒丹是其中一個選擇。

“臨床上,本病患者熱象是比較明顯的,就是咽喉、腮腺、淋巴等腫痛的表現,顯示上焦的熱毒壅盛,要用清熱解毒藥來消除。患者若泄瀉也是瀉而不爽,大便呈粘膩,肛門有灼熱感。還有,醫者在辨證濕熱病時要很注意舌象,因為濕邪最容易從舌象中表現出來。如果舌苔顯得白而厚膩或黃而厚膩,就適合以本方調理。一般上,患者服藥後,熱象減輕了,但濕邪還未盡除,可以改用別的處方如三仁湯調理,跫固療效。”

濕熱挾雜較棘手

不過,李凱亮披露,前人形容濕熱挾雜就如食油混入麵粉中,很難分開。同時,在治療上也不好拿捏,容易傷及陽氣,加重濕邪。反過來說,若祛濕太重,芳香祛濕藥像藿香、蒼朮等是溫藥,會加重熱象。

“清熱和祛濕用藥的比例不能拘泥原方,需要隨著患者的情況而改變,療效就會比較明顯。”

此外,他指出,臨床顯示,服用本方者以實證居多,發病較快,熱象明顯。因此,病癒後的調養很重要,好祛除體內尚存的一點濕邪,可用赤小豆薏苡仁湯來緩解。

相對的,若是有氣虛者,宜用參苓白朮散,血虛者則用當歸芍藥散。

依患者熱像程度用藥
甘露消毒丹祛熱較全面

中醫師李凱亮透露,通常,臨床上,濕溫病初期多用三仁湯與甘露消毒丹,兩者均是清熱利濕的處方,可以治療濕熱流滯在氣分的證型。在選用方劑時,得依據患者熱像的程度來決定。因為濕溫病可以表現為濕重於熱,也可以表現為濕熱並重。

咳嗽因素多複雜

“也有醫家認為,甘露消毒丹是濕熱並重的處方,甘露消毒丹與三仁湯的相同點為邪在氣分,均屬感受濕熱病邪而發病。惟甘露消毒丹方證的熱毒症候比較嚴重,發熱及咽喉、腮腺、淋巴等腫痛的表現突出,這些是三仁湯不足以應付的,三仁湯適用於濕多熱少的情況,其方重在祛濕,清熱解毒的藥比較少。”

提及時疫病者伴有咳嗽的情況時,他說,咳嗽的原因很多複雜,包括病邪犯肺、中焦氣機樞紐不暢、六淫等。清代著名醫家徐靈胎有句名言謂:“諸病中,惟咳嗽之病因各殊而最難癒,治或稍誤,即遺害無窮。余以此證考求四十餘年,而後始能措手。”說的就是咳嗽的原因繁多而難治,只要一不小心就可能耽誤病情。淺言之,咳嗽只是一個證狀,不是一個疾病。而許多疾病都可能導致咳嗽。因此,醫者臨證時不能見咳止咳,必須審證求因,辨證論治,加以治療。

“近代傷寒名家劉渡舟獨具慧眼,曾用甘露消毒丹治癒濕熱型的頑咳及百日咳,體現出抓準病機辨證用藥的精神。”

疫病傳染快流傳廣
甘露消毒丹可應急

中醫師李凱亮指出,從前,疫病是地方性疾病,因為交通不發達、方便,流傳度不廣泛。如今,由於交通方便,尤其是廉價航空當道,疫病很容易透過航空路線發展為世界性疾病,流傳度甚廣及多。例如2003年SARS時期即是典型的疫病。當時廣東名老中醫鄧鐵濤認為,SARS是時疫病,並以五運六氣來推斷本病過了夏天就會消失,開出一些中醫處方包括甘露消毒飲應急。

臨床證實,這些處方可達到一定的療效,緩解病況。

“據此可見,本方雖誕於清代,卻經得起時代與臨床考驗,拯救不少患者。”

他直言,時疫不像一般外感病逐步漸進地發病,俱有發病迅速、傳染快、流行廣、臨床症狀相似的特征常常令人措手不及,好比SARS、H1N1等。

同時,李凱亮披露,甘露消毒丹有不同的版本,多引述自《溫熱經緯》,但在《續名醫類案》、《醫效秘傳》等醫書均可尋到其芳蹤。據目前考證為《醫效秘傳》最早收錄,別名普濟解疫丹。這類考證有助於我們瞭解方劑的原型和創方者的用意。

避免機能受影響
防病須適應大自然變化

人與自然界的四時氣候,晝夜明晦、日夜星辰,地理環境和水土風雨等息息相關,不可分割。意思是說,人體的內在機能會受到外在環境變化包括天氣變化的影響,引發健康問題。

所以,應當採取恰當的應對措施,以適應自然,不可輕視。

中醫師李凱亮說,本地氣候長年是夏,屬於熱帶雨林季候,天氣炎熱、多雨和多風。每逢雨季空氣濕度增加,寒濕邪容易侵入人體,影響健康,尤其是腸胃疾病或腸胃型感冒。這使人陸續出現嘔吐、泄瀉和身體困重的表現,以辨證論治的前提下,可用藿香正氣散、柴胡平胃散等調理。

“本地的天氣常在炎熱、多雨和多風之間交替。炎熱如夏,故暑熱之邪偏盛;多雨多風,故濕邪易挾風而犯人體。所以,民眾在天氣轉換時宜小心防範,以避免健康受波及,影響生活。”(光明日報/良醫‧報導:黃秀儀)

via 2013年10月22日 – 甘露消毒丹‧治疫病效果佳 – 良醫 – 光明日報.

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