Classically, HAPE occurs in persons normally living at low altitude who travel to an altitude above 2, meters 8, feet. There are many factors that can make a person more susceptible to developing HAPE, including genetic factors, but detailed understanding is lacking and currently under investigation. HAPE remains the major cause of death related to high-altitude exposure, with a high mortality rate in the absence of adequate emergency treatment. Physiological and symptomatic changes often vary according to the altitude involved.
Acute mountain sickness and high altitude cerebral edema may also be present in conjunction with HAPE, however these symptoms may be subtle or not present at all. The most reliable sign of HAPE is severe fatigue or exercise intolerance, especially in a climber that was previously not displaying this symptom. There are multiple factors that can contribute to the development of HAPE, including sex malegenetic factors, prior development of HAPE, ascent rate, cold exposure, peak altitude, intensity of physical exertion, and certain underlying medical conditions eg, pulmonary hypertension.
In studies performed at sea level, HAPE-s people were found to have exaggerated circulatory response to both hypoxia at rest and during exercise. Endothelial tissue dysfunction has also been linked to development of HAPE, including reduced synthesis of NO a potent vasodilatorincreased levels of endothelin a potent vasconstrictorand an impaired ability to transport sodium and water across the epithelium and out of the alveoli.
Data on the genetic basis for HAPE susceptibility is conflicting and interpretation is difficult. Though it remains a topic of intense investigation, multiple studies and reviews over the last several years have helped to elucidate the proposed mechanism of HAPE. The inciting factor of HAPE is the decrease in partial pressure of arterial oxygen caused by the lower air pressure at high altitudes pulmonary gas pressures.
Hypoxic pulmonary vasoconstriction HPV occurs diffusely, leading to arterial vasoconstriction in all areas of the lung. This is evidenced by the appearance of "diffuse," "fluffy," and "patchy" infiltrates described on imaging studies of climbers with known HAPE. Although higher pulmonary arterial pressures are associated with the development of HAPE, the presence of pulmonary hypertension may not in itself be sufficient to explain the development of edema ; severe pulmonary hypertension can exist in the absence of clinical HAPE in subjects at high altitude.
The diagnosis of HAPE is entirely based on symptoms and many of the symptoms overlap with other diagnoses. Another cardinal feature of HAPE is the rapid progression to dyspnea at rest. On physical exam, increased breathing rates, increased heart rates, and a low-grade fever People typically do not appear as ill as SpO 2 and chest X-ray films would suggest. The severity of HAPE is graded.
C (musical note)
The grades of mild, moderate, or severe HAPE are assigned based upon symptoms, clinical signs, and chest x-ray results for individuals.
On physical exam of a suspected HAPE patient the exam findings used to grade the severity are the heart rate, respiratory rate, signs of cyanosis, and severity of lung sounds.The level of C-reactive protein CRPwhich can be measured in your blood, increases when there's inflammation in your body. Your doctor might check your C-reactive protein level for infections or for other medical conditions.
A high-sensitivity C-reactive protein hs-CRP test, which is more sensitive than a standard test, also can be used to evaluate your risk of developing coronary artery disease, a condition in which the arteries of your heart are narrowed. Coronary artery disease can lead to a heart attack.
Your doctor might order a CRP test to check for inflammation, which can indicate infection or a chronic inflammatory disease, such as rheumatoid arthritis or lupus, as well as risk of heart disease. It's thought that a high level of hs-CRP in your blood is associated with an increased risk of heart attacks. A CRP test doesn't indicate the cause of inflammation, though, so it's possible that a high hs-CRP level could mean there's inflammation caused by something besides your heart.
Rather, the test is most useful for people who have a 5 to 10 percent chance of having a heart attack within the next 10 years. This intermediate risk level is determined by the global risk assessment, which is based on lifestyle choices, family history and current health status. The test also helps determine the risk of a second heart attack, as people with a high level of hs-CRP who had a heart attack are more likely to have another event than those with a normal level.
People who have a low risk of having a heart attack are less likely to benefit from having an hs-CRP test. People who have a known high risk of having a heart attack should seek treatment and preventive measures regardless of how high their hs-CRP level is. As with any blood draw, you might have some soreness or bruising around the draw site. The site can become infected, but that's rare. However, if your blood is being drawn for other tests, as well, you might need to fast or follow other instructions.
Ask your doctor if you're having other tests at the same time. Blood is drawn from a vein, usually from your arm. Before the needle is inserted, an elastic band around your upper arm causes the veins in that arm to fill with blood, and the puncture site is cleaned with antiseptic.
After the needle is inserted, a small amount of blood is collected into a vial or syringe. The band is then removed to restore circulation, and blood continues to flow into the vial. Once enough blood is collected, the needle is removed and the puncture site is covered with a pressure wrap. It can take a few days to get your results. Your doctor should explain to you what the results of your test mean.
If you're having an hs-CRP test is to help find out your heart disease risk, remember that your CRP level is only one risk factor for coronary artery disease. If you have a high CRP level, it doesn't necessarily mean you're at a higher risk of developing heart disease.
Talk to your doctor about your other risk factors and ways you can try to prevent coronary artery disease and a heart attack. If you're having an hs-CRP test to evaluate your risk of heart disease, current risk levels used include:. These risk levels aren't a definitive measure of your risk because the ideal indicator of high CRP isn't clearly defined.
Also, because a person's CRP levels vary over time, it's recommended that the average of two tests, ideally taken two weeks apart, be used to determine coronary artery disease risk. If you're having an hs-CRP test to check for heart disease, your doctor is likely to request a cholesterol test at the same time.
Other tests might be done to further evaluate your risk. Your doctor might also recommend lifestyle changes or medications to decrease your risk of a heart attack.C or Do is the first note of the C major scalethe third note of the A minor scale the relative minor of C majorand the fourth note F, A, B, C of the Guidonian handcommonly pitched around The actual frequency has depended on historical pitch standardsand for transposing instruments a distinction is made between written and sounding or concert pitch.
Historically, concert pitch has varied. For an instrument in equal temperament tuned to the A pitch standard widely adopted inmiddle C has a frequency around After the A pitch standard was adopted by musicians, the Acoustical Society of America published new frequency tables for scientific use. A movement to restore the older A standard has used the banners "Verdi tuning", "philosophical pitch" or the easily confused scientific pitch.
On the Grand Staffmiddle-C is notated with a ledger line above the top line of the bass staff or below the bottom line of the treble staff. Alternatively, it is written on the centre line of a staff using the alto clefor on the fourth line from the bottom, or the second line from the top, of staves using the tenor clef.
In vocal music, the term High C sometimes less ambiguously called Top C  can refer to either the soprano's C 6 The term Low C is sometimes used in vocal music to refer to C 2 because this is considered the divide between true basses and bass-baritones: a basso can sing this note easily, whereas other male voices, including bass-baritones, typically cannot.
Tenor C is an organ builder 's term for small C or C 3 In stoplists it usually means that a rank is not full compass, omitting the bottom octave. From Wikipedia, the free encyclopedia. Several terms redirect here. Music Educators Journal. Schonberg November 4, The New York Times. Notes of the chromatic scale.
Categories : Musical notes. Hidden categories: Articles with hAudio microformats All articles with unsourced statements Articles with unsourced statements from February Namespaces Article Talk. Views Read Edit View history. Help Learn to edit Community portal Recent changes Upload file. Download as PDF Printable version. Low C, cello C, 8' C see organ pipe length. Treble C, high C written an octave higher for tenor voices .
Double high C [ citation needed ].In four-part chorale style harmony, the soprano takes the highest part, which often encompasses the melody. The word "soprano" comes from the Italian word sopra above, over, on top of as the soprano is the highest pitch human voice, often given to the leading female roles in operas.
The term "soprano" is also based on the Latin word superius which, like soprano, referred to the highest pitch vocal range of all human voice types. The soprano has the highest vocal range of all voice typeswith the highest tessitura.
A soprano and a mezzo-soprano have a similar range, but their tessituras will lie in different parts of that range. Often low notes in higher voices will project less, lack timbre, and tend to "count less" in roles although some Verdi, Strauss and Wagner roles call for stronger singing below the staff. However, rarely is a soprano simply unable to sing a low note in a song within a soprano role. While not necessarily within the tessitura, a good soprano will be able to sing her top notes full-throated, with timbre and dynamic control.
In SATB four-part mixed chorus, the soprano is the highest vocal range, above the altotenorand bass. Sopranos commonly sing in the tessitura G4-A5. When the composer calls for divisi, sopranos can be separated into Soprano I highest part and Soprano II lower soprano part.
In contrast to choral singing, in classical solo singing a person is classified through the identification of several vocal traits, including range, vocal timbrevocal weightvocal tessituravocal resonanceand vocal transition points lifts or " passaggio " within the singer's voice. Within operaparticular roles are written with specific kinds of soprano voices in mind, causing certain roles to be associated with certain kinds of voices. Within the soprano voice type category are five generally recognized subcategories: coloratura sopranosoubrettelyric sopranospinto sopranoand dramatic soprano.
Pitch Notation & Octave Naming
The coloratura soprano may be a lyric coloratura or a dramatic coloratura. The lyric coloratura soprano is a very agile light voice with a high upper extension capable of fast vocal coloratura. Light coloraturas have a range of approximately middle C C 4 to "high F" in alt F 6 with some coloratura sopranos being able to sing somewhat lower or higher,  e.
The dramatic coloratura soprano is a coloratura soprano with great flexibility in high-lying velocity passages, yet with great sustaining power comparable to that of a full spinto or dramatic soprano. Dramatic coloraturas have a range of approximately "low B" B 3 to "high F" F 6 with some coloratura sopranos being able to sing somewhat higher or lower. In classical music and opera, a soubrette soprano refers to both a voice type and a particular type of opera role.
A soubrette voice is light with a bright, sweet timbre, a tessitura in the mid-range, and with no extensive coloratura. The soubrette voice is not a weak voice, for it must carry over an orchestra without a microphone like all voices in opera.
The voice, however, has a lighter vocal weight than other soprano voices with a brighter timbre. Many young singers start out as soubrettes, but, as they grow older and the voice matures more physically, they may be reclassified as another voice type, usually either a light lyric soprano, a lyric coloratura soprano, or a coloratura mezzo-soprano. Rarely does a singer remain a soubrette throughout her entire career. The lyric soprano is a warm voice with a bright, full timbre, which can be heard over a big orchestra.
Lyric sopranos have a range from approximately below middle C C 4 to "high D" D 6. The lyric soprano may be a light lyric soprano or a full lyric soprano. Also lirico- spintoItalian for "pushed lyric", the spinto soprano has the brightness and height of a lyric soprano, but can be "pushed" to dramatic climaxes without strain, and may have a somewhat darker timbre.
Spinto sopranos have a range from approximately from B B 3 to "high D" D 6. A dramatic soprano or soprano robusto has a powerful, rich, emotive voice that can sing over a full orchestra. Usually but not always this voice has a lower tessitura than other sopranos, and a darker timbre. Dramatic sopranos have a range from approximately A A 3 to "high C" C 6. Some dramatic sopranos, known as Wagnerian sopranos, have a very big voice that can assert itself over an exceptionally large orchestra over eighty pieces.
These voices are substantial and very powerful and ideally even throughout the registers. Two other types of soprano are the Dugazon and the Falconwhich are intermediate voice types between the soprano and the mezzo-soprano: a Dugazon is a darker-colored soubrette, a Falcon a darker-colored soprano drammatico.This fingering chart includes both basic fingerings and alternatives that are more appropriate in some passages. Some alternate fingerings are designed for fast passages, while others modify the tone, color, or pitch at normal and extreme dynamic levels.
These fingerings are the same on oboes and English horns unless specified otherwise. Note Written Fingering Description Src. D 6 C Basic. Good intonation. For full conservatory models without the Philadelphia key. Use in combination with Eb 5 or D 6. Works on some models. I G Eb Basic. I B G Eb Basic. I Basic. Use in combination with similar G 6 and Bb 6 fingerings. II ——— G ———. Use in combination with C 5. Use in combination with C 5 or alternate C 6.
Smooth slur with D6.Singers Hit The High \
Sharp, but useful in many high register combinations, such as: chromatic passages including notes Eb 6 through F 6 ; combinations of Eb 6 to F 6D 6 to F 6 to Eb 6Eb 5 to E 6 to Eb 6and Db 5 to F 6 to Eb 6 ; scales of thirds; combinations of Eb 6 and fingerings involving the RH little finger. II G Eb. Use in combination with similar A 6 and Bb 6 fingerings. In tune, requires lots of air support. Use in combination with similar A 6 fingering. Easy transition with G 6.
Submit a fingering for this note or for a higher note.We also provide Dubai Carnival tips every Thursday and Australian racing tips every evening, updated at 8pm. Both are supplied by dedicated tipsters with extensive knowledge and experience. As we with the rest of our tips, these are provided completely free of charge.
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Website owner is not responsible for any loss due to your own decision or judgement.However, if you try to delete a model that is being used at the moment, then BigML.
To list all the models, you can use the model base URL. By default, only the 20 most recent models will be returned. You can get your list of models directly in your browser using your own username and API key with the following links. You can also paginate, filter, and order your models. This is valid for both regression and classification models. Objective Weights: submitting a specific weight for each class in classification models. Automatic Balancing: setting the balance argument to true to let BigML automatically balance all the classes evenly.
Let's see each method in more detail. We can use it as an input to create a model that will use to weight each instance accordingly. In this case, fraudulent transactions will weigh 10 times more than valid transactions in the model building computations.
You can just use one of the rows and add the corresponding count as a weight field. This will reduce the size of your sources enormously. Objective Weights The second method for adding weights only applies to classification models. Each instance will be weighted according to its class weight. This means the example below is equivalent to the example above. If every weight does end up zero (this is possible with sampled datasets), then the resulting model will have a single node with a nil output.
Each instance will be weighted individually according to the weight field's value.
High-altitude pulmonary edema
Confidence, importance, and pruning calculations also take weights into account. You can create an ensemble just as you would create a model with the following three basic machine learning techniques: bagging, random decision forests, and gradient tree boosting.
Bagging, also known as bootstrap aggregating, is one of the simplest ensemble-based strategies but often outperforms strategies that are more complex. The basic idea is to use a different random subset of the original dataset for each model in the ensemble.
You can read more about bagging here. Random decision forests is the second ensemble-based strategy that BigML provides. It consists, essentially, in selecting a new random set of the input fields at each split while an individual model is being built instead of considering all the input fields.
To create a random decision forest you just need to set the randomize argument to true.