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AEI currently utilizes a RIEGL VZ400 Terrestrial Laser Scanner on various job sites.  This proecss utilizes a high accuracy 3D terrestrial LiDAR unit.  The data collected will be brought into a feature extraction software, TopoDOT.  TopoDOT utilizes a variety of tools to identify adn quickly extrapolate features within pointcloud data.  All features can then be imported into an AutoCAD drawing file.  AEI can provide an accurate 3D pointcloud of terrain plus any existing building or structures.  The pointcloud can also be converted for Building Information Models.

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Allen Engineering is involved with the civil design and surveying for the new park in Palm Bay, Flordia.  This Regional Park will feature 150 full service campsite hookups and is scheduled to break ground in 2018.  We are extremely proud to be involved in this project.

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Allen Engineering is beginning its 21st year associated with the Space Coast Post of the Society of American Military Engineers (SAME).  During our 21 years, we have helped raise over $350,000 in scholarships and endowments.  We are extremely proud to be associated with SAME and its continued commitment to offer opportunities for students pursuing careers in the engineering field.

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Follow food safety guidelines when preparing and eating foods to muscle relaxant definition purchase pyridostigmine 60mg free shipping reduce the risk of foodborne illnesses infantile spasms 8 month old buy pyridostigmine 60mg on-line. For example back spasms 33 weeks pregnant buy pyridostigmine 60mg amex, exposure to muscle spasms 37 weeks pregnant purchase pyridostigmine 60 mg online chemicals or toxins in the environment can cause some types of anemia. If you have hemolytic anemia, reduce your chances of getting an infection by washing your hands often, avoiding people who have colds, and staying away from crowds. Work With Your Doctor Visit your doctor if you develop signs or symptoms of anemia. Visit your doctor regularly for checkups and ongoing care, and tell him or her about any new or changing symptoms. Your Guide to Anemia Older children and teens who have severe anemia may have an increased risk for injury or infection. Talk with your doctor about ways to keep them as healthy as possible and whether they need to avoid certain activities. Talk To Your Family Some types of anemia-such as pernicious anemia, Fanconi anemia, or thalassemia-can be inherited. Suggest they visit their doctors for a checkup to see whether they also might have anemia. If you have children or teens who have anemia, talk to them about how they can take an active role in their own care by learning about their condition and making decisions with their doctor. This can help young people feel more in control and have a more positive outlook about their health. The tips above can help you prevent or cope with anemia and improve your overall health and well-being. In addition, Executive Order 11141 prohibits discrimination on the basis of age by contractors and subcontractors in the performance of Federal contracts, and Executive Order 11246 states that no federally funded con tractor may discriminate against any employee or applicant for employment because of race, color, religion, sex, or national origin. Therefore, the National Heart, Lung, and Blood Institute must be operated in compliance with these laws and Executive Orders. The regimen is the administration of 1 mg of vitamin B12 daily for one week, weekly thereafter for one month and, then, every 2-3 months for life. Hablamos de macrocitosis cuando el volumen corpuscular medio estб elevado (> 100) y se observan por tanto hematнes de gran tamaсo en sangre perifйrica. La causa Correspondencia: Raquel de Paz Servicio de Hematologнa y Hemoterapia Hospital Universitario La Paz P. Produce astenia, palpitaciones, sudoraciуn, mareo e insuficiencia cardiaca de instauraciуn lenta, con buena tolerancia por parte del paciente. Entre las alteraciones digestivas destaca la anorexia, diarrea, estomatitis angular, lengua lisa depapilada, dolorosa al tacto y de color rojo intenso denominada glositis de Hunter. Las alteraciones neurolуgicas pueden aparecer sin que exista anemia ni macrocitosis, y hay que distinguir entre: 1. Degeneraciуn combinada subaguda medular como Mielosis Funicular y que consiste en una alteraciуn de los cordones posteriores produce parestesias, ataxia, y tendencia a caнdas en la oscuridad siendo el signo mбs precoz en la exploraciуn fнsica la disminuciуn de la sensibilidad vibratoria en las extremidades inferiores. Alteraciуn de la vнa piramidal que consiste en paresia, espasticidad, hiperreflexia, alteraciуn de los esfнnteres, Romberg y Babinsky positivos y alteraciones mentales (irritabilidad, demencia, depresiуn). Las pruebas de interйs diagnуstico son, los niveles sйricos de vitamina B12 (< 100 pg/ml) y бcido fуlico (> 4 ng/ml). Anticuerpos anti-cйlulas parietales (sensibilidad: 80%; especificidad: baja, y entre un 3-10% de las personas sin anemia perniciosa lo tienen elevado). Los niveles de бcido metilmalуnico y homocisteнna plasmбticos, ambos aumentan precozmente cuando existe un dйficit de vitamina B12, incluso antes de la apariciуn del sнndrome anйmico, por lo que su determinaciуn podrнa estar indicada en situaciones dudosas donde existen cifras lнmites de esta vitamina. El Test de Schilling es el patrуn de oro en el diagnуstico de la anemia perniciosa. Y por ъltimo el estudio gastroscуpico permite valorar la atrofia de la mucosa gбstrica (que caracterнsticamente suele respetar el antro) asн como las lesiones gбstricas (pуlipos y/o carcinoma asociados a la anemia perniciosa). Otras pruebas ъtiles en el seguimiento y de interйs para un diagnуstico diferencial son la hematimetrнa y la determinaciуn de hormonas tiroideas. Ademбs podemos observar leucopenia, y en el frotis de sangre perifйrica se observarбn neutrуfilos polisegmentados, envejecidos y con desviaciуn a la derecha. En el caso de realizarse estudio de la funciуn tiroidea, puede observarse asociaciones con patologнas tipo tiroiditis autoinmune. Con la anemia megaloblбstica por dйficit de бcido fуlico: debido a una ingesta inadecuada de йste (las reservas de fуlico cubren las necesidades durante 4 meses); con el alcoholismo; con los sнndromes malabsortivos como la enfermedad de Crohn o la enfermedad celнaca; con la ingesta de determinados fбrmacos (barbitъricos, difenilhidantoina, etanol, sulfasalazina, colestiramina, zidovudina, hidroxiurea, anticonceptivos orales, metotrexate, pentamidina); o con aumento de las necesidades como ocurre en el embarazo, durante la lactancia, durante el periodo de crecimiento, ante la existencia de neoplasias, hipertiroidismo, hemodiбlisis o trastornos exfoliativos de la piel y finalmente por aumento de la excreciуn en las situaciones de insuficiencia cardiaca congestiva o hepatitis aguda5. Debemos hacer el diagnуstico diferencial con la anemia megaloblбstica por dйficit/ alteraciуn de la vitamina B12. La causa mбs comъn es una disminuciуn de la absorciуn, observada fundamentalmente en pacientes gastrectomizados, o en aquellas situaciones de ausencia congйnita o anomalнa funcional. Hernбndez-Navarro mente por sobrecrecimiento bacteriano o por la interacciуn de determinados fбrmacos como la colchicina, neomicina, etc. Existen ademбs otras causas de macrocitosis no megaloblбsticas como son el alcoholismo, las hepatopatнas, el hipotiroidismo, el hipopituitarismo, la anemia aplбsica у determinados sнndromes mielodisplasicos6. El tratamiento tiene como objetivos, por un lado corregir la anemia y sus posibles alteraciones epiteliales y por otro reducir los trastornos neurolуgicos asн como prevenir su apariciуn, normalizando los depуsitos de vitamina B12. Si la causa es carencial, es necesario asociar una dieta con 50-150 mg de vitamina B12 al dнa. El tratamiento vнa intramuscular es de primera elecciуn una vez confirmada la existencia de malabsorciуn. Existen varias pautas, la mбs adecuada consiste en administrar 1 mg de Vitamina B12, intramuscularmente, diariamente durante 1 semana, posteriormente semanal durante un mes y despuйs mensualmente durante toda la vida.

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Interestingly spasms just under rib cage order pyridostigmine 60mg with visa, when comparing 3rdyear to spasms posterior knee buy pyridostigmine 60mg on line 4thyear podiatric medical students the "felt adequately trained" percentage rose from 16 muscle relaxant cvs order pyridostigmine 60 mg with mastercard. Likewise spasms of the stomach buy cheap pyridostigmine 60mg online, when comparing "wanting more formal training" the percentage declined from 93. However, these results were expected, as one get more clinical experience one get more confident. Questionnaires and surveys from previous literature publications were utilized as an outline to compile our comprehensive vascular education student survey. The survey combined questions to form an inclusive questionnaire (29 questions) pertaining to vascular surgery as well as an attached survey at the end (5 questions). Answers were combined and calculated as a percentage correct and incorrect and tallied at the end for completeness. The survey was distributed to all third and fourth year podiatric students by means of electronic and paper methods. A total of 30 third year podiatric students and 20 fourth year podiatric students completed the survey, totaling 50 completed surveys for final data collection. Table 2: Graphical illustration of percentage of correct response for ankle-brachial index interpretation, measurement, and calculation knowledge. Table 3: Graphical illustration of most common error when performing ankle-brachial index calculations. When comparing third and fourth year podiatric students with vascular knowledge, fourth year podiatric students scored higher with prevalence (45% v. Vascular Educational Needs in the "Real World" and Teaching of Vascular Surgery in Medical Schools: Evidence and Suggestions. Training to Measure Ankle-Brachial Index at the Undergraduate Leve: Can It Be Successful? Knowledge about ankle-brachial index procedure among residents: being experienced is beneficial but is not enough. Expectations for the Skills of Final Year Medical Students in Examining Lower Limb Arteries and Veins. Table 5: Graphical illustration of percentage of correct response for anklebrachial index interpretation, measurement, and calculation knowledge, comparing third and fourth year students. Table 6: Graphical illustration of most common error when performing ankle-brachial index calculations, comparing third and fourth year podiatric students. Common medical terms for cardiology Angina - Medical term for chest pain or discomfort due to coronary heart disease. Stable angina (or chronic stable angina) refers to "predictable" chest discomfort such as that associated with physical exertion or mental or emotional stress. It is typically more severe and prolonged and is due to a reduced blood flow to the heart caused by the narrowing of the coronary arteries in atherosclerosis. Unstable angina is an acute coronary syndrome and should be treated as an emergency. Atherosclerosis - A form of arteriosclerosis in which the inner layers of artery walls become thick and irregular due to deposits of fat, cholesterol and other substances. Eventually the plaque can erode the wall of the artery and diminish its elasticity. Plaque deposits can also rupture, causing blood clots to form that can block blood flow or break off and travel to another part of the body. If a clot blocks the blood supply to the arms or legs, it can cause difficulty walking and eventually gangrene if not treated. Cardiomyopathy - Cardiomyopathy is a chronic disease of the heart muscle (myocardium), in which the muscle is abnormally enlarged, thickened, and/or stiffened. Dilated cardiomyopathy, in which the heart muscle becomes weak and the heart chambers subsequently dilate. Hypertrophic cardiomyopathy, in which the heart muscle itself is much thicker than normal. Restrictive cardiomyopathy, in which the heart becomes stiff and cannot fill efficiently during diastole, the period of the heartbeat when the chambers fill with blood. Carotid bruit - An abnormal sound in the neck of a person with carotid artery disease, created by the blood as it flows through the diseased artery. They have to be transported to and from the cells by special carriers called lipoproteins. Edema ­ Swelling due to an abnormally large amount of fluid in the intracellular body tissue spaces. Heart murmur - An abnormal sound in the heart caused by defective heart valves or holes in the heart walls. High blood pressure, or hypertension, is a condition in which blood pressure levels are consistently above the normal range. Ischemia ­ Insufficiency blood supply Myocardial infarction - Medical term for heart attack. It is the damaging or death of an area of the heart muscle (myocardium) resulting from a blocked blood supply to that area. Pericarditis - A disorder caused by inflammation of the pericardium, which is the sac-like covering of the heart. The symptoms of peripheral artery disease depend upon the location and extent of the blocked arteries. The most common symptom of peripheral artery disease is intermittent claudication, manifested by pain (usually in the calf) that occurs while walking and dissipates at rest. A stenotic valve does not open completely and therefore it obstructs or blocks blood from moving through it normally. A stenotic artery results in an obstruction of blood flow through it to the organs of the body. Ultimately most causes of syncope produce a dramatic fall in blood pressure which leads to fainting.

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The brain stem begins where the spinal cord enters the skull and forms the medulla spasms caused by anxiety pyridostigmine 60 mg without prescription, the area of the brain stem that controls heart rate and breathing xanax spasms pyridostigmine 60mg low cost. In many cases the medulla alone is sufficient to spasms left shoulder blade generic 60mg pyridostigmine maintain life as animals that have the remainder of their brains above the medulla severed are still able to spasms nose order 60 mg pyridostigmine with mastercard eat, breathe and move. Medical, science, and nature things Photography and digital imagery by Scott Camazine. Humans have a very large and highly developed outer brain layer known as the cerebral cortex. The cortex provides humans with excellent memory, outstanding cognitive skills, and the ability to experience complex emotions. Running through the medulla and the pons is a long, narrow network of neurons known as the reticular formation. The job of the reticular formation is to filter out some of the stimuli that are coming into the brain from the spinal cord and to relay the remainder of the signals to other areas of the brain. The reticular formation also plays important roles in reflexes, muscle tone, arousal, and sleeping. When electrical stimulation is applied to the reticular formation of an animal, it immediately becomes fully awake, and when the reticular formation is severed from the higher brain regions, the animal falls into a deep coma. Cerebellum: the cerebellum, literally, "little brain", consists of two wrinkled ovals behind the brain stem and its main function is to coordinate voluntry movement. People who have damage to the cerebellum have difficulty walking, keeping their balance, and holding their hands steady. Consuming alcohol influences the cerebellum, which is why people who are drunk have more difficulty walking in a straight line. Also, the cerebellum contributes to emotional responses, helps us discriminate between different sounds and textures, and is important in learning (Bower & Parsons, 2003). Thalamus: Above the brain stem are other older parts of the brain that also are involved in the processing of behavior and emotions. The thalamus is the egg-shaped structure above the brain stem that applies still more filtering to the sensory information that is coming up from the spinal cord and through the reticular formation, and it relays some of these remaining signals to the appropriate areas of the cortex or higher brain levels (Sherman & Guillery, 2002). The thalamus is also important in sleep because it shuts off incoming signals from the senses, allowing us to rest. Limbic System: Whereas the primary function of the brain stem is to regulate the most basic aspects of life, including motor functions, the limbic system is a brain region largely responsible for memory and emotions, including our responses to reward and punishment. The limbic system is located between the brain stem and the two cerebral hemispheres. The amygdala consists of two almond-shaped clusters that is primarily responsible for regulating our perceptions of, and reactions to, aggression and fear. The amygdala has connections to other bodily systems related to fear, including the sympathetic nervous system, which is important in fear responses, facial responses, the processing of smells, and the release of 73 Figure 3. In one early study, Klьver and Bucy (1939) damaged the amygdala of an aggressive rhesus monkey. They found that the once angry animal immediately became passive and no longer responded to fearful situations with aggressive behavior. Electrical stimulation of the amygdala in other animals also influences aggression. In addition to helping us experience fear, the amygdala also helps us learn from situations that create fear. When we experience events that are dangerous, the amygdala stimulates the brain to remember the details of the situation so that we learn to avoid it in the future (Sigurdsson, Doyиre, Cain, & LeDoux, 2007). Located just under the thalamus and just above the brain stem, the hypothalamus links the nervous system to the endocrine system via the pituitary gland, and thus regulates body temperature, hunger, thirst, and sex. It also responds to the satisfaction of these needs by creating feelings of pleasure. Olds and Milner (1954) discovered these reward centers accidentally after they had momentarily stimulated the hypothalamus of a rat. The researchers noticed that after being stimulated, the rat continued to move to the exact spot in its cage where the stimulation had occurred, as if it were trying to recreate the circumstances surrounding its original experience. Upon further research into these reward centers, Olds (1958) discovered that animals would do almost anything to re-create enjoyable stimulation, including crossing a painful electrified grid to receive it. In one experiment a rat was given the opportunity to electrically stimulate its own hypothalamus by pressing a pedal. The rat enjoyed the experience so much that it pressed the pedal more than 7,000 times per hour until it collapsed from sheer exhaustion. The hippocampus is important in forming and storing information in long-term memory and consists of two horns that curve back from the amygdala. If the hippocampus is damaged, a person cannot build new memories, living instead in a strange world where everything he or she experiences just fades away, even while older memories from the time before the damage are untouched. Cerebrum: From an evolutionary perspective, the newest part of our brain is the cerebrum, which consists of the cerebral cortex and the corpus callosum. The key to the advanced intelligence of humans is not found in the size of our brains. What sets humans apart from other animals is our larger cerebral cortex, which is the outer bark-like layer of our cerebrum that allows us to so successfully use language, acquire complex skills, create tools, and live in social groups (Gibson, 2002). In humans, the cerebral cortex is wrinkled and folded, rather than smooth as it is in most other animals. This creates a much greater surface area and size, and allows increased capacities for learning, remembering, and thinking.

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Anesthesiology 110:22 spasms temporal area discount pyridostigmine 60 mg overnight delivery, 2009 American Society of Anesthesiologists Task Force on Perioperative Management of Patients with Cardiac Rhythm Management Devices: Practice advisory for the perioperative management of patients with cardiac rhythm management devices: pacemakers and implantable cardioverter-defibrillators 303 muscle relaxant reviews pyridostigmine 60mg without a prescription. Anesthesiology 103:186 spasms down there effective 60 mg pyridostigmine, 2005 American Society of Anesthesiologists Task Force on Postanesthetic Care: Practice guidelines for postanesthetic care infantile spasms 6 months old discount pyridostigmine 60mg online. Anesthesiology 96:742, 2002 American Society of Anesthesiologists Task Force on Preanesthesia Evaluation: Practice advisory for preanesthesia evaluation. Anesthesiology 116:522, 2012 Ansari R: Fever work-up and management in postsurgical oral and maxillofacial surgery patients. J Oral Maxillofac Surg 68:2955, 2010 Arvidsson S: Preparation of adult patients for anaesthesia and surgery. Can J Anaesth 45:87, 1998 Bailey J, Depaulo S: Prophylaxis for invasive dental procedures in at-risk patients. Arch Ophthalmol 113:1248, 1995 Bates B: A Guide to Physical Examination and History Taking (ed. Cardiol Clin 13:149, 1995 Blery C, Charpak Y, Szatan M, et al: Evaluation of a protocol for selective ordering of preoperative tests. Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester. Best Pract Res Clin Anaesthesiol 21:241, 2007 Chung F: Discharge criteria ­ a new trend. Can J Anaesth 42:1056, 1995 Chung F, Yuan H, Yin L, et al: Elimination of preoperative testing in ambulatory surgery. Anesth Analg 108:467, 2009 Clarkson E, Raj Bhatia S: Perioperative management of the patient with liver disease and management of the chronic alcoholic. Adv Dermatol 18:1, 2002 Criteria Committee of the New York Heart Association: Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels (ed. Arthritis Rheum 41:725, 1998 Edrich T, Sadovnikoff N: Anesthesia for patients with severe chronic obstructive pulmonary disease. Oral Maxillofac Surg Clin North Am 18:115, 2006 Fattahi T: Perioperative laboratory and diagnostic testing-what is needed and when? Am J Surg 172:21, 1996 Gupta A: Preoperative screening and risk assessment in the ambulatory surgery patient. Anesthesiol Clin 24:823, 2006 Isono S: Obstructive sleep apnea of obese adults: pathophysiology and perioperative airway management. Surgery 104:639, 1988 Joint Commission: Comprehensive Accreditation Manual for Hospitals 2011. Am J Cardiol 75:42D, 1995 Lessard E, Glick M, Ahmed S, et al: the patient with a heart murmur: evaluation, assessment, and dental considerations. J Am Dent Assoc 136:347, 2005 Lieb K, Selim M: Preoperative evaluation of patients with neurological disease. Emerg Med Clin North Am 18:565, 2000 Munro J, Nicholl J, Booth A: Routine preoperative testing: a systematic review of the evidence. J Trauma 41:21, 1996 National Asthma Education and Prevention Program, National Heart, Lung, and Blood Institute: Expert Panel Report 3: Guidelines for the diagnosis and management of asthma. J Calif Dent Assoc 23:14, 1995 Peters A, Kerner W: Perioperative management of the diabetic patient. Circulation 120:86, 2009 Potyk D, Raudaskoski P: Preoperative cardiac evaluation for elective noncardiac surgery. Anesthesiol Clin North America 5:15, 1987 Rose M, Wilkerson L: Widening the lens on standardized patient assessment: What the encounter can reveal about the development of clinical competence. Dent Clin North Am 43:383, 1999 Shearer W, Michaels M, Managle J: A model of community based, preadmission management for elective surgical patients. A guideline from the American Heart Association Rheumatic Fever, Endocarditis, and Kawasaki Disease Committee, Council on Cardiovascular Disease in the Young, and the Council on Clinical Cardiology, Council on Cardiovascular Surgery and Anesthesia, and the Quality of Care and Outcomes Research Interdisciplinary Working Group. The Oral and Maxillofacial Surgeon is referred to for the Special Considerations of Pediatric Cleft and Craniofacial Surgery section for the management of pediatric patients with cleft and craniofacial deformities. Parameters of care for cleft lip and palate deformities and for craniofacial deformities are described separately. The management of cleft lip and palate deformities is divided into the following conditions: Primary Cleft Lip Deformities Primary Cleft Palate Deformities Velopharyngeal Dysfunction Residual Cleft Lip and/or Nasal Deformities Requiring Secondary Management Maxillary Alveolar Cleft Deformities Residual Maxillofacial Skeletal Deformities Requiring Secondary Management the craniofacial surgery section is divided into the following conditions: Craniofacial Deformities: Those Not Requiring an Intracranial Approach for Repair Craniofacial Deformities: Primary Cranial Deformities Requiring Treatment Through an Intracranial Approach Craniofacial Deformities: Secondary Cranial Deformities Requiring Treatment Through an Intracranial Approach Orbital and/or Naso-orbital Deformities these parameters were prepared with the appreciation that there is more than one approach to treating certain clinical problems; consequently, flexibility has been allowed so that the practitioner may select different therapeutic options. Future changes in this area of Oral and Maxillofacial Surgery, resulting from new research findings and evolving technologic developments, will undoubtedly extend and expand the capabilities for treatment and enable even a higher quality of patient care. The surgical correction of these deformities requires a clear understanding, by the surgeon and patient and/or family, of the therapeutic goals. In turn, the Oral and Maxillofacial Surgeon should determine through careful dialogue that the patient and/or family have realistic expectations regarding the proposed therapy. Unplanned Caldwell-Luc, bronchoscopy, or other exploratory procedures associated with surgery H. Readmission for complications or incomplete management of problems during previous hospitalization Comments and Exceptions: Complication or incomplete management occurring at another hospital or involving a physician who is not on the medical staff. In the pediatric patient with cleft/maxillofacial anomalies, particular attention must be paid to the interaction among the primary deformity, treatment, and facial growth. The Oral and Maxillofacial Surgeon must determine whether the treatment will adversely affect growth and then ascertain the ideal time for treatment. It is not uncommon for the family to push for treatment at a time that may not be ideal, and the surgeon must resist this pressure. On the other hand, timing may be altered for a child with significant psychosocial problems and the surgery undertaken at a time that is not ideal relative to facial growth. Especially in these cases, clear documentation of treatment decisions and indications must be included within the informed consent recordings. In the pediatric patient with cleft lip/palate, the Oral and Maxillofacial Surgeon must be aware of the effects of the deformity and its treatment on middle ear function, speech-airway, and facial growth.

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References:

  • https://pediatrics.aappublications.org/content/pediatrics/early/2019/08/23/peds.2018-2065.full.pdf
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  • https://botgarden.uga.edu/wp-content/uploads/2020/04/healingmedicinal.pdf
  • https://www.osha.gov/OshDoc/data_General_Facts/hexavalent_chromium.pdf