Congestion potential

One precaution is that, especially with congested molecules, these potential energy loci should not be taken too literally because rotated atoms or groups (within the model) can stick during rotation, then suddenly snap into place , giving a potential energy discontinuity that has no counterpart in the real molecule. 

Artificial Hearts. Congestive heart failure (CHF) is a common cause of disabiHty and death. It is estimated that three to four million Americans suffer from this condition. Medical therapy in the form of inotropic agents, diuretics (qv), and vasofilators is commonly used to treat this disorder (see Cardiovascularagents). Cardiac transplantation has become the treatment of choice for medically intractable CHF. Although the results of heart transplantation are impressive, the number of patients who might benefit far exceeds the number of potential donors. Long-term circulatory support systems may become an alternative to transplantation (5). 

Most of the occurrences mentioned above maybe related to the location of tlie plant. Natural hazards, waste disposal liazards, and avoidance of congested areas, particularly tliose with inadequate emergency facilities, may eliminate or minimize the potential hazards of the phuit itself. It is important to set an efficient and appropriate environment for the plant site, as was discussed in Chapter 5. 

Adler, K. Grant, M. and Scliroeer, W. (1998). Emissions Reduction Potential of the Congestion Mitigation and Air Ciuahty Improvement Program A Preliminary Assessment. Transportation Research Record 1641. Transportation Research Board. Washington, ITC National Research Council. 

Traffic and material movement is a major consideration, and should be arranged so that cross flows are minimized and the potential for congestion and accidents reduced. Much useful information on both the analysis and practice of movements is contained in the References. 

Under certain circumstances, and very rarely, the inhibition of gluconeogenesis by metformin may suppress lactic acid metabolism and precipitate a potentially fatal lactic acidosis. Impairment of renal function, liver disease, alcoholism, conditions that give rise to increased lactate production (e.g. congestive heart failure, infections) are therefore contraindications for the application of metformin. 

Figure 12.4 A series of SFG spectra in the CO stretch region of chemisorbed CO on polycrystalline Pt in a CO-free 0.1 M H2SO4 electrolyte. The atop spectra were fit to (12.5) (see text) to extract the amplitude, frequency, and width [Lu et al., 2005 Lagutchev et al, 2006] (each displayed data point is the average of three or five spectra). The electrode potential was swept at a rate of 5 mV/s, and SFG spectra were obtained every 200 ms. Spectra were obtained at 1 mV intervals, but, to avoid congestion in the plot, averaged spectra are displayed at 10 mV intervals in the pre-oxidation region (V < 0.43 V) and at 3.3 mV intervals in the oxidation region (V > 0.43 V) [Lu et al., 2005].

Cardiotoxicity is a serious, rare adverse effect of mitox-antrone. The incidence of congestive heart failure was 0.15% in patients with normal left ventricular ejection fraction and 2.18% in those who had asymptomatic left ventricular ejection fraction of less than 50% at baseline.46 Therefore, mitoxantrone should not be used in patients with baseline cardiomyopathy, even if asymptomatic. The risk of cardiotoxicity is dose-related. The maximum lifetime dose of mitoxantrone is 140 mg/m2, or about 3 years of MS therapy. The use of cyclooxygenase-2 inhibitors should be avoided in patients receiving mitoxantrone because of a potential for worsening cardiac toxicity.46... 

For example, referring to Table 3.4, significant blast resulting in near-total destmction of the plant buildings has occurred with releases of fewer than 20,000 lb. (9,000 kg) of flammable material (Ref. 15). On the other hand, depending upon the materials handled, the process conditions, and the plant layout (with no confinement or congestion), releases of greater than 20,000 lb. (9,000 kg) of such material may have little potential for blast effects. 

The inherent properties of Class 1B liquids, under the storage and release conditions specified (lack of confinement, congestion, and release of material at low pressure), preclude formation of a well-mixed, turbulent vapor cloud that can support rapid flame propagation. Thus, the potential for VCE is low. 

Other techniques that take into account some site-specific conditions, such as the Dow Fire and Explosion Index (Ref. 34) and the Mond Index (Ref. 39), have been used to prioritize buildings for evaluation. The results of these indices should be used in conjunction with consideration of other factors, rather than as stand-alone criteria. These other factors might include an evaluation of the effects of confinement and/or congestion-induced turbulence on the potential for blast. 

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