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The diagnosis of pain in these parts of the body often requires the assistance of a neurologist The task is largely to determine whether a disease of the spine has implicated the spinal cord or the spinal roots and to identify an injury of a peripheral nerve To do this effectively, a clear understanding of the structures involved and some knowledge of orthopedics and rheumatology is necessary We include a chapter on this subject in recognition of the fact that back pain is among the most frequent of medical complaints Up to 80 percent of adults have low back pain at some time in their lives, and according to Kelsey and White an even larger percentage will be found at autopsy to have degenerative disc disease Similar changes are disclosed by imaging studies of the lower spine Our purpose in this chapter is to focus on the neurologic implications of back and neck pain and to help the clinician develop a systematic approach to patients with such complaints Since pains in the lower part of the spine and legs are caused by rather different types of disease than those in the neck, shoulder, and arms, they are considered separately

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feature is available when performing backups to disk, and also to tape but only when Oracle Secure Backup (OSB) is the media manager RMAN is also capable of performing binary compression of backup sets using industry-standard compression algorithms Binary compression will compress the backup sets before they are written to disk The compression can be performed using different algorithms (BZIP2, LZO, and ZLIB) and the appropriate algorithm is selected when you set the compression level (BASIC, LOW, MEDIUM, or HIGH) before initiating the backups Based upon the compression-level settings, you get different compression ratios and backup performance NOTE Compression levels of LOW, MEDIUM, and HIGH requires you to be licensed for the Advanced Compression Option for the Oracle database The BASIC level is included with the Oracle database license If you are using database compression features such as OLTP compression and Exadata Hybrid Columnar Compression, you are already reducing the overall disk footprint of database files The best practice in such a case is not to compress the data again using RMAN Compressing the same data twice does not provide any measurable savings, and in fact in some cases, might even be an overhead RMAN Best Practices Follow the RMAN best practices specified here to get higher performance and availability with the Database Machine

The lower parts of the spine and pelvis, with their massive muscular attachments, are relatively inaccessible to palpation and inspection Although some physical signs and radiographs are helpful, diagnosis often depends on the patient s description of the pain and his behavior during the execution of certain maneuvers Seasoned clinicians, for these reasons, have come to appreciate the need for a systematic inquiry and method of examination, the descriptions of which are preceded here by a brief consideration of the anatomy and physiology of the spine

The bony spine is a complex structure, roughly divisible into an anterior and a posterior part The former consists of a series of cylindric vertebral bodies, articulated by the intervertebral discs and held together by the anterior and posterior longitudinal ligaments The posterior elements are more delicate and extend from the bodies as pedicles and laminae, which form the spinal canal by joining with the posterior aspects of the vertebral bodies and ligaments Stout transverse and spinous processes project laterally and posteriorly, respectively, and serve as the origins and insertions of the muscles that support and protect the spinal column The bony processes are also held together by sturdy ligaments, the most important being the ligamentum avum The posterior parts of the vertebrae articulate with one another at the diarthrodal facet joints (also called apophysial or zygoapophysial joints), each of which is composed of the inferior facet of the vertebra above and the superior facet of the one below These anatomic features are illustrated in Figs 11-1 and 11-2 The facet and sacroiliac joints covered by synovia, the compressible intervertebral discs, and the 168

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Another danger with a blackout is what happens to the computer when the power suddenly comes on again Most newer computers are designed to come back on only if the power button is pushed again However, older computers might automatically come back on when the power is restored, resulting in a harmful power surge When the power goes out, you should always turn the computer and monitor off, or better yet, unplug them Power surges or power spikes don t just occur when the power is restored; even the regular supply of electricity can contain temporary dips and increases Like brownouts, power surges are temporary and are not typically very extreme In fact, you might not even notice when a power surge occurs However, if the lights become brighter or if electrical devices begin to make more noise than usual, these issues could be due to a power surge Power surges can be very harmful to computer components Recall that the power supply not only converts electricity from AC to DC, but it also drops the overall voltage from 110 120 to only 3 12 volts The power supply does this by using resistors to shield a certain amount of excess voltage If there is a power surge, however, the total voltage could be more than the resistors can shield, resulting in a higher voltage within the computer itself A power spike is more extreme than a power surge and typically does not last as long Due to their extreme nature, power spikes are much more likely to damage computer components The electrical supply can also contain interference due to the presence of high-voltage equipment in the area or very long cables (The longer a cable, the more susceptible it is to EMI) Current that contains EMI is referred to as noisy or dirty and can cause problems in the computer because the noise can result in dips and increases in the amount of electricity reaching the computer Noisy power lines can also create magnetic fields, which can be damaging to magnetically stored data.

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