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The phases of fertilization include Phase 1 pain treatment center in franklin tn cheap artane 2 mg on-line, penetration of the corona radiata Phase 2 treatment pain post shingles generic 2 mg artane, penetration of the zona pellucida Phase 3 pain relief treatment center fairfax generic artane 2 mg overnight delivery, fusion of the oocyte and sperm cell membranes Phase 1: Penetration of the Corona Radiata Of the 200 to 300 million spermatozoa normally deposited in the female genital tract pacific pain treatment center san francisco order artane with visa, only 300 to 500 reach the site of fertilization. It is thought that the others aid the fertilizing sperm in penetrating the barriers protecting the female gamete. Permeability of the zona pellucida changes when the head of the sperm comes in contact with the oocyte surface. This contact results in release of lysosomal enzymes from cortical granules lining the plasma membrane of the oocyte. In turn, these enzymes alter properties of the zona pellucida (zona reaction) to prevent sperm penetration and inactivate species-specific receptor sites for spermatozoa on the zona surface. Other spermatozoa have been found embedded in the zona pellucida, but only one seems to be able to penetrate the oocyte. Phase 3: Fusion of the Oocyte and Sperm Cell Membranes the initial adhesion of sperm to the oocyte is mediated in part by the interaction of integrins on the oocyte and their ligands, disintegrins, on sperm. Because the plasma membrane covering the acrosomal head cap disappears during the acrosome reaction, actual fusion is accomplished between the oocyte membrane and the membrane that covers the posterior region of the sperm head. In the human, both the head and the tail of the spermatozoon enter the cytoplasm of the oocyte, but Phase 2: Penetration of the Zona Pellucida the zona is a glycoprotein shell surrounding the egg that facilitates and maintains sperm binding and induces the acrosome reaction. Release of acrosomal A B Chapter 3 First Week of Development: Ovulation to Implantation 37 Figure 3. The two-cell stage is reached approximately 30 hours after fertilization; the four-cell stage is reached at approximately 40 hours; the 12- to 16-cell stage is reached at approximately 3 days; and the late morula stage is reached at approximately 4 days. During this period, blastomeres are surrounded by the zona pellucida, which disappears at the end of the fourth day. The main results of fertilization are as follows: Restoration of the diploid number of chromosomes, half from the father and half from the mother. Hence, the zygote contains a new combination of chromosomes different from both parents. After the third cleavage, however, blastomeres maximize their contact with each other, forming a compact ball of cells held together by tight junctions. This process, compaction, segregates inner cells, which communicate extensively by gap junctions, from outer cells. Approximately 3 days after fertilization, cells of the compacted embryo divide again to form a 16-cell morula (mulberry). Inner cells of the morula constitute the inner cell mass, and surrounding cells compose the outer cell mass. The inner cell mass gives rise to tissues of the embryo proper, and the outer cell mass forms the trophoblast, which later contributes to the placenta. Section of a 107-cell human blastocyst showing inner cell mass and trophoblast cells. Schematic representation of a human blastocyst recovered from the uterine cavity at approximately 4. Schematic representation of a blastocyst at the sixth day of development showing trophoblast cells at the embryonic pole of the blastocyst penetrating the uterine mucosa. The human blastocyst begins to penetrate the uterine mucosa by the sixth day of development. Cells of the inner cell mass, now called the embryoblast, are at one pole, and those of the outer cell mass, or trophoblast, flatten and form the epithelial wall of the blastocyst. In the human, trophoblastic cells over the embryoblast pole begin to penetrate between the epithelial cells of the uterine mucosa on about the sixth day. New studies suggest that L selectin on trophoblast cells and its carbohydrate receptors on the uterine epithelium mediate initial attachment of the blastocyst to the uterus. Selectins are carbohydrate-binding proteins involved in interactions between leukocytes and endothelial cells that allow leukocyte "capture" from flowing blood. A similar mechanism is now proposed for "capture" of the blastocyst from the uterine cavity by the uterine epithelium. Following capture by selectins, further attachment and invasion by the trophoblast involve integrins, expressed by the trophoblast and the extracellular matrix molecules laminin and fibronectin.

Such loss of life comes at a cost to society pain management for dogs with arthritis purchase artane us, both directly pain treatment center artane 2 mg visa, through the expense of treatment pain management during shingles order artane discount, and indirectly knee pain treatment ligament cheap artane line, through the loss of adults in their prime; viral hepatitis culls most heavily from the 45 to 64 age group. It is therefore surprising how relatively little public or scientific attention viral hepatitis has garnered. Such developments inspired the World Health Assembly resolution in June 2016 to eliminate viral hepatitis as a major public health problem by 2030. In the first phase of this project,3 the sponsors4 asked the committee to 1 References are not included in the summary; please see the body of the report for references and the bulk of the discussion and justification. Global health sector strategy on viral hepatitis, 2016-2021: Towards ending viral hepatitis. In this report, the second of two, the committee lays out appropriate goals for disease reduction and a path to achieve these goals. Modelers were chosen for their prior work in the field; only models that have been extensively validated and peer reviewed were considered. Given the differences in biology, epidemiology, and treatment options for hepatitis B and C, the models presented are not directly comparable, but both consider the reduction in morbidity and mortality that might be expected from different strategies for diagnosis, care, and treatment. It found that diagnosing two-thirds of hepatitis B cases in the United States, almost doubling the current diagnosis rate, but changing nothing else, would reduce deaths by only 4. In order to see a meaningful reduction in deaths, simultaneous improvements would have to be made in care and treatment of chronic infection. Diagnosing 90 percent of cases, bringing 90 percent of those to care, and treating 80 percent of those for whom treatment is indicated, on the other hand, would, assuming highly motivated patients with good adherence to treatment, result in a cumulative 50 percent reducphase of this report. The same level of diagnosis, care, and treatment would reduce incident cirrhosis by about 45 percent and new cases of hepatocellular carcinoma by a third. The model cohort does not include the roughly 23,370 new cases of chronic hepatitis B that enter the United States every year from immigration (about 1 percent of the total cases) or the relatively small number of chronic infections acquired domestically. These additional cases would not, however, affect the estimated percent reduction in cumulative risk if they follow the same diagnosis, care, and treatment patterns. Hepatitis C Models the hepatitis C model compared four scenarios of diagnosis and treatment coverage on incidence and prevalence of hepatitis C and on liverrelated deaths, liver cancer, and cirrhosis. It suggested considerable public health benefit to combining aggressive case finding with unrestricted treatment for chronic hepatitis C. The same level of treatment and case finding would reduce incident infections by 90 percent (relative to 2015) by 2030. There is no reason why this number could not increase, especially if the capacity of primary care providers to treat hepatitis C were expanded. The model also assumes diagnosis of 110,000 new cases a year until 2020 and roughly 70,000 to 90,000 a year between 2020 and 2030. Case finding will be more challenging as time passes; the people in contact with the health system will have already been cured. Meeting these targets depends on considerable improvements in testing, diagnosis, and care, as well as increased preventive measures and focused research. The actions recommended in this report all advance some part of the larger goal: eliminating the public health problem of hepatitis B and C in the United States by 2030. This program will require the cooperation of various federal and state government agencies, as well as professional societies, legislators, and private companies. With work spread among so many organizations, the opportunity for distraction is real. The leadership of a single office would help ensure efficient and harmonious work. Strong central leadership is a characteristic of successful disease elimination programs. The elimination strategy described in this report may have particular need for such leadership, given its emphasis on reaching people who inject drugs and novel strategies to finance medicines for Medicaid beneficiaries and prisoners. Serious symptoms may not emerge for decades, and the root infection is often unrecorded on death certificates. This long latency is part of the reason why morbidity and mortality from viral hepatitis are undercounted. A better understanding of the true burden of disease will be essential when tracking progress toward elimination.

Effemimania encourages those who are socialized male to mystify femininity and to dehumanize those who are considered feminine who pain treatment guidelines buy 2mg artane overnight delivery, and thus forms the foundation of virtually all male expressions of misogyny shoulder pain treatment guidelines buy artane 2mg with amex. Until now pain treatment for psoriatic arthritis discount artane 2 mg mastercard, the typical feminist response to men who fear being associated with the "feminine realm" can be paraphrased as "Get over it! If femininity in women is already seen as "artificial" and "contrived treatment pain during menstruation artane 2mg otc," then oppositional sexism ensures that femininity in men appears exponentially "artificial" and "contrived. The greatest barrier preventing us from fully challenging sexism is the pervasive antifeminine sentiment that runs wild in both the straight and queer communities, targeting people of all genders and sexualities. The only realistic way to address this issue is to work toward empowering femininity itself. We must rightly recognize that feminine expression is strong, daring, and brave- that it is powerful-and not in an enchanting, enticing, or supernatural sort of way, but in a tangible, practical way that facilitates openness, creativity, and honest expression. By embracing femininity, feminism will finally be able to reach out to the vast majority of feminine women who have felt alienated by the movement in the past. The movement would also be able to reach those who are not female (whether male and/or transgender) who regularly face effemimania or trans-misogyny, but who have not been able to seek refuge or have a voice in the feminist movements of the past. Indeed, a feminist movement that encompasses both those who are female and those who are feminine has the potential to become a majority, one with the strength in numbers to finally challenge and overturn both traditional and oppositional sexism. Its politics are generally antiassimilationist, particularly with regard to gender and sexual expression. Subversivism is the practice of extolling certain gender and sexual expressions and identities simply because they are unconventional or nonconforming. In the parlance of subversivism, these atypical genders and sexualities are "good" because they "transgress" or "subvert" oppressive binary gender norms. To briefly summarize this popularized account: All forms of sexism arise from the binary gender system. Since this binary gender system is everywhere -in our thoughts, language, traditions, behaviors, etc. Thus, in order to challenge sexism, people must "perform" their genders in ways that bend, break, and blur all of the imaginary distinctions that exist between male and female, heterosexual and homosexual, and so on, presumably leading to a systemwide binary meltdown. Another way that one can be "transgressively gendered" is by identifying as genderqueer or genderfluid- i. The notion that certain gender identities and expressions are inherently "subversive" or "transgressive" can be seen throughout the queer/trans community, where drag and gender-bending are routinely celebrated, where binary-confounding identities such as "boy-identified-dyke" and "pansexual trannyfag" have become rather commonplace. On the surface, subversivism gives the appearance of accommodating a seemingly infinite array of genders and sexualities, but this is not quite the case. Not surprisingly, this often-unspoken category of bad, conservative genders is predominantly made up of feminine women and masculine men who are attracted to the "opposite" sex. One routinely sees this "dark side" of subversivism rear its head in the queer/trans community, where it is not uncommon to hear individuals critique or call into question other queers or trans folks because their gender presentation, behaviors, or sexual preferences are not deemed "subversive" enough. Indeed, if one fails to sufficiently distinguish oneself from heterosexual feminine women and masculine men, one runs the risk of being accused of "reinforcing the gender binary," an indictment that is tantamount to being called a sexist. One of the most common targets of such critiques are transsexuals, and particularly those who are heterosexual and gender-normative post-transition. Indeed, because such transsexuals (in the eyes of others) transition from a seemingly "transgressive" queer identity to a "conservative" straight one, subversivists may even claim that they have transitioned in order to purposefully "assimilate" themselves into straight culture. While these days, such accusations are often couched in the rhetoric of current queer theory, they rely on many of the same mistaken assumptions that plagued the work of cissexist feminists like Janice Raymond and sociologists like Thomas Kando decades ago. After all, in our culture, the meanings of "bold," "rebellious," and "dangerous"-adjectives that often come to mind when considering subversiveness-are practically built into our understanding of masculinity. In contrast, femininity conjures up antonyms like "timid," "conventional," and "safe," which seem entirely incompatible with subversion. It is sadly ironic that people who claim to be gender-fucking in the name of "shattering the gender binary," and who criticize people whose identities fail to adequately challenge our societal notions of femaleness and maleness, cannot see that they have just created a new gender binary, one in which subversive genders are "good" and conservative genders are "bad. So now, gendernonconforming folks are on top and gender-normative people are on the bottom -how revolutionary! While subversivism reverses oppositional sexism, cultural feminism sought to reverse traditional sexism by claiming that women were naturally creative and cooperative and therefore superior to men, who were seen as inherently destructive and oppressive. While it is always difficult to draw comparisons between different social/political movements for fear of oversimplifying them, there are other striking parallels between subversivism and cultural feminism that are worth bearing out. As historian Alice Echols describes in her book Daring to Be Bad: Radical Feminism in America, 1967-1975, cultural feminism evolved from its more outwardly focused predecessor, radical feminism.

Resonance can occur inside a food for spe cific combinations of size lower back pain treatment exercise purchase artane from india, shape shoulder pain treatment options order genuine artane on line, and food property pain management utica new york purchase online artane. A cycle of increasing temperature in food causing increasing rate of enegy (microwave/ ohmic) absorption that further increases the rate of temperature rise treatment for pain with shingles purchase 2 mg artane with amex. Treatment ofliquiform products using one or more chambers fitted with a free piston to allow compres sion, hold, and decompression with discharge under clean or sterile conditions. In X-rays technology, solid state opening switch that can deliver pulses in the gigawatt range. Described technically as the amount of energy required to raise the tem perature of unit mass of an object by a unit increment in temper ature. Magnetic fields that have constant in tensity (Bl over time and whose field direction is constant. The intensity varies periodically according to the frequency and type of wave in the magnet. Any process, physical or chemical, which will de stroy all forms of life; applied especially to microorganisms, includ ing bacterial and mold spores and the inactivation of viruses. A non-pathogenic species and strain responding to a particular treatment in a manner equivalent to a pathogenic species and strain. The surrogate allows bio logical verification of the treatment without introducing pathogens into a food processing area. Examples of thermophysical proper ties are thermal conductivity (the ability of the material to con duct heat), specific heat (the ability of the material to store heat), and density (the mass per unit volume of the material). Term used to describe a vibrating wave of a fre quency above that of the upper frequency limit of the human ear; it generally embraces all frequencies above 16 kilocycles/ second. Heating by internal energy generation throughout the volume of a material (see also internal energy generation). Qualitatively, 8w is a measure of unbound, free water in a system, available to support biological and chemi cal reactions. Water activity affects microorganisms survival and reproduction, enzymes, and chemical reactions. The water activi ty of a substance is quantitatively equal to the vapor pressure of the substance divided by the vapor pressure of pure water (both measured at the same temperature). The physical component of a microwave system that guides the microwaves from magnetron to the cavity where the food is heated. When applied in the form of pulses, it revers es the charge for each pulse and pulse intensity gradually de creases. Inhibition ofSaccharomyces cerevislae by combination of hydrostatic pressure and monoterpenes. Effect of viscosity and salt concentration on microwave heating of model non-Newtonian liquid foods in cylindrical containers. Effect of shielding on Dow proOles in water In a cylindrical container during microwave heating. Canned Foods: principles ofthermal process control, acidification and container closure evaluation. State of the art technologies for the stablllzatlon of foods by non-therrnal processes: physical methods. The electric current (apart from the heat generated) A bacteriological agent in the sterilization of milk and other fluids. Variation in resis tance of natural Isolates of Escherichia coll O 157 to high hydrostatic pressure, mild heat, and other stresses. Microwave cooking and processing: Engineering fundamentals for the food scientist. Effects of high pressure and bacteriostatlc agents on the destruction of citrobacter freundll in minced beefmuscle. Pulsed electrical field modification ofactlvlty and denaturation ofalkaline phosphatase. Incidence of foodborne Illnesses: preliminary data from the food borne diseases active surveillance network [Foodnet]-Unlted States, 1998.

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