Finite Element Equations & Poisson Equation
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Questions and Answers

What is the primary immunological function that should be restored and preserved in HIV management?

  • Enhancing the production of non-neutralizing antibodies.
  • Stimulating the exhaustion of hyperactivated T-cells.
  • Decreasing viral reservoirs in immune cells.
  • Restoring and preserving immune function. (correct)

Which situation presents the most challenging barrier to adherence to antiretroviral therapy (ART)?

  • Co-existing mental health issues, substance abuse, and high medication costs. (correct)
  • Stable housing and consistent access to healthcare services.
  • Use of a simplified, once-daily ART regimen.
  • Strong social support network and understanding of treatment benefits.

What laboratory test is most useful in evaluating the effectiveness of antiretroviral therapy (ART)?

  • Comprehensive metabolic panel (CMP).
  • Viral load testing to measure HIV RNA levels. (correct)
  • Complete blood count (CBC) with differential.
  • CD4+ T-lymphocyte count.

What is the most critical initial step in preventing HIV transmission?

<p>Maximally and durably suppressing plasma HIV viral load through ART. (C)</p> Signup and view all the answers

In the context of HIV infection, what change indicates progression from HIV to AIDS?

<p>Development of opportunistic infections or cancers. (D)</p> Signup and view all the answers

Why is early family planning education essential for patients with primary immunodeficiency?

<p>To ensure proper genetic counseling and prevent transmission of immunodeficiency to offspring. (A)</p> Signup and view all the answers

What is the primary rationale for avoiding live vaccines in patients with antibody deficiency disorders?

<p>Live vaccines pose a risk of causing infection due to impaired immune response. (C)</p> Signup and view all the answers

What is the underlying mechanism by which ART achieves a sustained reduction in HIV-associated morbidity and prolonged survival?

<p>Suppressing HIV replication and restoring immune function. (B)</p> Signup and view all the answers

In older adults with HIV/AIDS, which factor contributes most significantly to delayed diagnosis and initiation of treatment?

<p>Lower perceived risk of infection and provider bias. (D)</p> Signup and view all the answers

Which statement accurately describes the 'viral set point' in HIV infection?

<p>The stable level of virus in the body after the initial immune response. (A)</p> Signup and view all the answers

What is the primary goal of post-exposure prophylaxis (PEP) following a high-risk exposure to HIV?

<p>To prevent the establishment of HIV infection by inhibiting viral replication. (A)</p> Signup and view all the answers

Which component of nursing care is most critical when managing a patient receiving intravenous immunoglobulin (IVIG) therapy?

<p>Closely monitoring for signs and symptoms of infection. (B)</p> Signup and view all the answers

In managing HIV, what is the significance of understanding HIV's life cycle?

<p>It informs the development of targeted interventions to disrupt viral replication. (A)</p> Signup and view all the answers

What is the clinical significance of identifying Reed-Sternberg cells in a lymph node biopsy?

<p>Confirms the diagnosis of Hodgkin lymphoma. (D)</p> Signup and view all the answers

What is a key difference between Hodgkin lymphoma and non-Hodgkin lymphoma regarding the spread of the disease?

<p>Hodgkin lymphoma often spreads in an orderly, contiguous manner. (A)</p> Signup and view all the answers

What is typically the initial clinical presentation of Hodgkin lymphoma?

<p>Localized, painless enlargement of a single group of lymph nodes. (B)</p> Signup and view all the answers

What is the most likely etiology of Kaposi's sarcoma in an individual with HIV/AIDS?

<p>Herpes Human Virus. (B)</p> Signup and view all the answers

Which of the following diagnostic findings would most strongly suggest HIV-associated neurocognitive disorder (HAND) in a patient with HIV?

<p>Gradual decline in cognitive function, slowed thinking, and behavioral changes. (C)</p> Signup and view all the answers

A patient living with HIV presents with a persistent cough, fever, and night sweats. Which opportunistic infection should be the primary concern?

<p>Tuberculosis. (C)</p> Signup and view all the answers

Which of the following manifestations of tuberculosis is particularly concerning in individuals with HIV infection?

<p>Reactivation of latent tuberculosis infection. (A)</p> Signup and view all the answers

Which body fluids are considered to have a high risk of HIV transmission?

<p>Blood, seminal fluid, and vaginal secretions. (C)</p> Signup and view all the answers

What is the typical duration of antiretroviral medications prescribed for post-exposure prophylaxis (PEP)?

<p>28 days. (D)</p> Signup and view all the answers

In the context of HIV prevention, what is the primary focus of education regarding needle stick injuries?

<p>Promoting immediate reporting and risk reduction strategies. (D)</p> Signup and view all the answers

Which intervention is most appropriate when caring for a patient with primary immunodeficiency?

<p>Maintaining strict aseptic technique during invasive procedures. (C)</p> Signup and view all the answers

A patient is diagnosed with toxoplasmosis. Which route of transmission is most likely?

<p>Ingestion of undercooked meat or exposure to cat feces. (D)</p> Signup and view all the answers

What is the significance of monitoring CD4 counts in a patient with HIV?

<p>CD4 counts are useful for predicting risk of opportunistic infection. (C)</p> Signup and view all the answers

Which of the following statements best describes the significance of viral load testing in the management of HIV infection?

<p>Viral load testing is an indicator of the amount of virus in the blood. (B)</p> Signup and view all the answers

What is the recommended approach to managing latent tuberculosis infection in an individual newly diagnosed with HIV?

<p>Treat the latent TB infection concurrently with initiating ART. (A)</p> Signup and view all the answers

Which factor has the greatest impact on adherence to ART in adults?

<p>Socioeconomic factors and comorbid conditions. (C)</p> Signup and view all the answers

Why is education regarding adherence to ART essential?

<p>Prevents development of drug resistance. (B)</p> Signup and view all the answers

Which action is the priority if a patient is suspected of having toxoplasmosis?

<p>Confirming the diagnosis via serology or brain biopsy. (D)</p> Signup and view all the answers

What is the most appropriate initial intervention for a patient experiencing peripheral neuropathy as a complication of HIV?

<p>Assess and manage pain with appropriate analgesics. (A)</p> Signup and view all the answers

In stage 1(early HIV infection 2-6 weeks, Clinical evidence of acute infection) when is the CD4%?

<blockquote> <p>=26% (A)</p> </blockquote> Signup and view all the answers

A person has a documented AIDS-defining condition, what stage is it under the CDC case definition for HIV infection among adults and adolescents?

<p>Stage 3 (D)</p> Signup and view all the answers

Identify the first step in the HIV Life Cycle?

<p>HIV attaches itself to CD4 cell and enters (E)</p> Signup and view all the answers

What is not a domain that can be affected by HIV Encephalopathy?

<p>Increased Concentration (E)</p> Signup and view all the answers

Why is it important to education patients on Pre-exposure Prophylaxis (PrEP)?

<p>It minimizes risk of acquiring HIV (A)</p> Signup and view all the answers

What is the mechanism of action to ART(Antiretroviral therapy)?

<p>Decrease HIV replication and restore immune function (B)</p> Signup and view all the answers

In managing a patient with HIV-associated neurocognitive disorder (HAND), which intervention would have the greatest impact on improving their cognitive function and daily living skills?

<p>Initiating a structured cognitive rehabilitation program in conjunction with optimized antiretroviral therapy (ART). (A)</p> Signup and view all the answers

A patient with HIV is diagnosed with Kaposi's sarcoma. Which of the following treatment approaches is most likely to provide targeted therapy against the underlying cause of this malignancy?

<p>Initiating chemotherapy with agents such as doxorubicin or paclitaxel in combination with antiretroviral therapy (ART). (B)</p> Signup and view all the answers

In a patient with HIV and suspected Pneumocystis pneumonia (PCP), what diagnostic test provides the most definitive confirmation of the infection?

<p>Bronchoalveolar lavage with microscopic examination for Pneumocystis cysts. (D)</p> Signup and view all the answers

An older adult with HIV presents with new-onset confusion, memory loss, and gait disturbances without fever. What is the priority diagnostic consideration to differentiate HIV-associated neurocognitive disorder (HAND) from other potential causes?

<p>Initiating a comprehensive neurological workup, including brain imaging and cerebrospinal fluid analysis. (A)</p> Signup and view all the answers

A patient with HIV is diagnosed with non-Hodgkin's lymphoma (NHL). What is the most crucial aspect of care coordination to optimize treatment outcomes?

<p>Ensuring seamless communication and collaboration between the oncologist, infectious disease specialist, and primary care physician to manage both the malignancy and the underlying HIV infection. (B)</p> Signup and view all the answers

Flashcards

Disease Progression

Ranges from cutaneous lesions to disseminated disease in multiple systems.

Lymphoma

Cancer that originates in the lymphatic system.

Hodgkin Lymphoma

Localized to a single group of nodes, contiguous spread, characterized by Reed-Sternberg cells, bimodal distribution, and associated with EBV.

Non-Hodgkin Lymphoma

Involves multiple lymph nodes, extranodal involvement is common, noncontiguous spread, majority involve B cells, and may be associated with HIV and autoimmune diseases.

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Toxoplasmosis

Infection caused by parasites.

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HIV Encephalopathy

Symptoms generally develop over weeks to months in the cognitive domains.

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Domains affected in HIV Encephalopathy

Forgetfulness, slowed thinking, global dementia, confusion, organic psychosis.

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Tuberculosis & CD4 Level

Can occur at any CD4 level.

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Latent TB Treatment

Latent TB with HIV infection is treated.

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Manifestations of Tuberculosis

Manifestations can be seen in the lungs or can also be seen in CNS, bone, pericardium, stomach, or peritoneum.

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Kaposi's Sarcoma Cause

Caused by Herpes Human Virus.

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ART Goals

Restore and preserve immunologic function; maximally and durably suppress plasma HIV viral load; prevent HIV transmission.

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Barriers to Adherence

Substance use, costs, mental health, stigma, beliefs.

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ART Mechanism of Action

To suppress HIV replication, reduce morbidity, prolong quality of life, restore immune function, suppress viral load, and prevent transmission.

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ART Start

Use at least 2 (3 preferred) active drugs from 2 or more drug classes. Should occur within the first 12 to 24 weeks of therapy.

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Patient Education with ART

Education regarding promoting adherence to ART. Lab tests will evaluate whether ART is effective.

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Complication of ART

Peripheral neuropathy.

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Viral Load

The amount of HIV in blood.

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Viral Set Point

The amount of virus in the body after equilibrium between HIV levels and immune response during stage 1.

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Antiretroviral Therapy Goals

Reduce HIV-associated morbidity and prolong the duration and quality of survival.

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Prevention for HIV

Standard precautions and hand hygiene.

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Post-Exposure Prophylaxis (PEP)

Antiretroviral medications as soon as possible, 2–3 drugs prescribed for 28 days.

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HIV Prevention Education

Behavioral interventions, condoms, healthy behaviors, Pre-exposure Prophylaxis (PrEP), HIV Testing, linkage to treatment and care, education needs.

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HIV in older adults

Growing number of HIV/AIDS in adults over 50, low perceived risk of infection, HCP bias, co-morbidities.

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HIV Transmission

Transmitted through bodily fluids such as blood, seminal fluid, vaginal secretions, amniotic fluid and breast milk.

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Humoral Immunity

Characterized by the production of antibodies by B lymphocytes in response to a specific antigen

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Cellular Immunity

T lymphocytes are primarily responsible, stem cells migrate from bone marrow to thymus gland, designated roles in defense, attack foreign invaders directly

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Primary Immunodeficiency Education

Live vaccines are contraindicated; assess family planning needs; caregiver taught how to administer medications; hand hygiene.

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Medical Care for Immunodeficiency

Treatment of infection; intravenous immunoglobulin (IVIG) or stem cell transplants.

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Nursing for Immunodeficiency

Appropriate hand hygiene, infection prevention precautions, medication administration, lifestyle modification, nutrition, and diet.

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Study Notes

Derivation of Finite Element Equations

  • Focuses on the Poisson equation.

Strong Form for the Poisson Equation

  • Seeks $u$ satisfying $-\nabla \cdot (c \nabla u) = f$ in $\Omega$.
  • Boundary condition: $u = g$ on $\Gamma_D$.
  • Neumann boundary condition: $c \nabla u \cdot \mathbf{n} = h$ on $\Gamma_N$.

Weak Form for the Poisson Equation

  • Find $u \in V$ where $u = g$ on $\Gamma_D$.
  • Integral equation: $\int_\Omega c \nabla u \cdot \nabla v d\Omega = \int_\Omega f v d\Omega + \int_{\Gamma_N} h v dS$ for all $v \in V_0$.
  • $V$ is defined as ${v \mid v \in H^1(\Omega) }$.
  • $V_0$ is defined as ${v \mid v \in H^1(\Omega), v = 0 \text{ on } \Gamma_D }$.

Finite Element Approximation

  • Approximates $u$ as $u_h = \sum_{j=1}^{n} N_j u_j$.
  • Approximates $v$ as $v_h = \sum_{i=1}^{n} N_i v_i$.
  • Weak form approximation: $\int_\Omega c \nabla u_h \cdot \nabla v_h d\Omega = \int_\Omega f v_h d\Omega + \int_{\Gamma_N} h v_h dS$ for all $v_h \in V_{0h}$.
  • Equation becomes: $\int_\Omega c \nabla (\sum_{j=1}^{n} N_j u_j) \cdot \nabla N_i d\Omega = \int_\Omega f N_i d\Omega + \int_{\Gamma_N} h N_i dS$.
  • Simplified summation: $\sum_{j=1}^{n} (\int_\Omega c \nabla N_j \cdot \nabla N_i d\Omega) u_j = \int_\Omega f N_i d\Omega + \int_{\Gamma_N} h N_i dS$.

Matrix Form

  • Expressed as $\mathbf{K u} = \mathbf{f}$.
  • $K_{ij}$ is defined as $\int_\Omega c \nabla N_i \cdot \nabla N_j d\Omega$.
  • $f_i$ is defined as $\int_\Omega f N_i d\Omega + \int_{\Gamma_N} h N_i dS$.

Dijkstra's Algorithm

  • Used for finding the shortest paths in a graph.

Initialization Steps

  • Set the distance $d[v] = \infty$ for each node $v$.
  • Set $d[s] = 0$ for the starting node $s$.
  • Add all nodes to a priority queue $Q$, prioritized by their distances $d[v]$.

Main Loop

  • Loop while $Q$ is not empty.
    • Remove node $u$ with the smallest distance $d[u]$ from $Q$.
    • For each neighbor $v$ of $u$:
      • Calculate the alternative distance $alt = d[u] + w(u, v)$, where $w(u, v)$ is the weight of the edge from $u$ to $v$.
      • If $alt < d[v]$:
        • Update the distance: $d[v] = alt$.
        • Set the predecessor of $v$ to $u$.
        • Update the priority of $v$ in $Q$.

Output

  • Returns the shortest distance from the start node $s$ to each node.

Notes

  • Works for graphs having non-negative edge weights.
  • Uses a Fibonacci heap for the priority queue to achieve a time complexity of $O(E + V \log V)$.

Search Algorithms

  • Expands the node based on heuristic function $h(n)$.
  • Not complete; can enter loops.
  • Not optimal.
  • Time Complexity: $O(b^m)$.
  • Space Complexity: $O(b^m)$.
  • Minimizes $f(n) = g(n) + h(n)$.
  • $g(n)$: The cost to reach the node.
  • $h(n)$: Estimated cost from node to goal.
  • Complete unless there are infinitely many nodes with $f \le f(G)$.
  • Optimal.
  • Time Complexity: Exponential.
  • Space Complexity: Keeps all nodes in memory.

Admissible Heuristics

  • $h(n) \le h^*(n)$ for each node $n$.
  • $h^*(n)$: Actual cost to reach the goal from $n$.
  • Never overestimates the cost to reach the goal.
  • Straight-line distance to goal is an example.

Consistent Heuristics

  • $h(n) \le c(n, a, n') + h(n')$ for each node $n$ and successor $n'$.
  • More restrictive than admissibility.
  • If $h(n)$ is consistent, A* using GRAPH-SEARCH is optimal.

Dominance

  • $h_2(n) \ge h_1(n)$ for all $n$ (both are admissible).
  • $h_2$ dominates $h_1$.
  • A* expands fewer nodes with $h_2$.

Heuristics from Relaxation

  • Systematic way to invent admissible heuristics.
  • Exact solution cost for a relaxed problem is an admissible heuristic for the original.
  • Relaxed problem rules result in a directed acyclic graph (DAG).
  • Can be generated automatically from problem description.

8-Puzzle Example

  • $h_1(n)$: Number of misplaced tiles.
  • $h_2(n)$: Sum of distances of tiles to correct positions (Manhattan distance).
  • Example State:
    • $h_1(n) = 7$.
    • $h_2(n) = 4 + 0 + 3 + 3 + 1 + 0 + 2 + 4 = 17$.
  • Typical search cost values ​​for depth $d=14$:
    • A* with $h_1$: 539 nodes expanded.
    • A* with $h_2$: 113 nodes expanded.
  • Typical search cost values ​​for depth $d=24$:
    • A* with $h_1$: 39135 nodes expanded.
    • A* with $h_2$: 1641 nodes expanded.

Machine Learning

Traditional vs. Machine Learning

  • Traditional: Data + Program $\rightarrow$ Computer $\rightarrow$ Output.
  • Machine Learning: Data + Output $\rightarrow$ Computer $\rightarrow$ Program, learning from data.

Types of Machine Learning

  • Supervised Learning
  • Unsupervised Learning
  • Reinforcement Learning

Supervised Learning

  • Learns from labeled data (input + output).
  • Learns function that maps input output.

Types of Supervised Learning

  • Regression: Predicts continuous value (ex. house price).
  • Classification: Predicts discrete value (ex. spam detection).

Unsupervised Learning

  • Learns from unlebeled data (input).
  • Learns to discover patterns.

Types of Unsupervised Learning

  • Clutering: groups similar data points
  • Dimensionality Reduction: Reduces number of variables.
  • Association Rules Learning: Finds relationships between variables.

Reinforcement Learning

  • Learns to make decisions by "trial and error".
  • Receives reward/penalty; maximizes reward.
  • ex, Robot training / Game playing.

Linear Algebra

Vector Space Definition

  • A set $E$ with addition ($E \times E \rightarrow E$) and scalar multiplication ($\mathbb{K} \times E \rightarrow E$) operations.
  • $\mathbb{K}$ is a field (e.g., $\mathbb{R}$ or $\mathbb{C}$).

Vector Space Axioms

  • Associativity: $(u+v)+w = u+(v+w)$.
  • Commutativity: $u+v = v+u$.
  • Identity element: $\exists 0 \in E$ such that $u+0 = u$.
  • Inverse element: $\exists -u \in E$ such that $u + (-u) = 0$.
  • Compatibility: $\lambda(\mu u) = (\lambda \mu)u$.
  • Vector addition distributivity: $\lambda(u+v) = \lambda u + \lambda v$.
  • Scalar addition distributivity: $(\lambda + \mu)u = \lambda u + \mu u$.
  • Scalar multiplication identity: $1u = u$.

Vector Subspace Requirements

  • Non-empty.
  • Closed under addition: $u, v \in F$ implies $u+v \in F$.
  • Closed under scalar multiplication: $u \in F, \lambda \in \mathbb{K}$ implies $\lambda u \in F$.

Linear Combination

  • Expression of the form $\lambda_1 v_1 + \lambda_2 v_2 +... + \lambda_n v_n$.

Span

  • Set of all possible linear combinations of vectors.

Linear Independence

  • Vectors are linearly independent if $\lambda_1 v_1 + \lambda_2 v_2 +... + \lambda_n v_n = 0$ implies $\lambda_1 = \lambda_2 =... = \lambda_n = 0$.

Basis

  • Linearly independent set of vectors that spans the vector space.

Dimension

  • Number of vectors in a basis of the vector space.

Definition of Linear Transformation

  • A function $f: E \rightarrow F$ such that:
    • $f(u+v) = f(u) + f(v)$.
    • $f(\lambda u) = \lambda f(u)$.

Kernel

  • The set of vectors in $E$ that map to the zero vector in $F$.

Image

  • The set of vectors in $F$ that are the image of at least one vector in $E$.

Rank Theorem

  • States: $dim(E) = dim(ker(f)) + dim(im(f))$ for $f: E \rightarrow F$.

Matrices Definition

  • A matrix is a table of numbers. An $m \times n$ matrix has $m$ rows and $n$ columns.

Matrix Operations

  • Addition is element-wise.
  • Scalar multiplication is element-wise.
  • Matrix Multiplication: Element $C_{ij} = \sum_{k=1}^{n} A_{ik}B_{kj}$

Transpose

  • Obtained exchanging between rows and columns

Inverse

  • Matrix $A^{-1}$ such that $AA^{-1} = A^{-1}A = I$.

Determinant

  • Scalar indicating matrix properties.

Eigenvalues and Eigenvectors

  • A nonzero vector $v$ such that $Av = \lambda v$. Where $\lambda$ = eigenvalue

Research

Categorizing Student Ideas

  • Noticing: Ability to direct attention to detail.
  • Interpreting: Articulate the significance of observations.
  • Deciding: Choosing an appropriate course of action.

Framework for Attending to Student Thinking

Unproductive Productive
Description of Ideas Accuracy: Inaccurate, imprecise, or unclear. Completeness: Disconnected or incomplete. Accuracy: Accurate and precise. Completeness: Clearly expressed and well-connected
Explanations of Ideas Justification: Unsupported claims. Understanding: Unclear reasoning. Generality: Limited domain validity Justification: Claims supported by warrants. Understanding: Clear reasoning. Generality: Appropriate generalizations
Usefulness of Ideas Flexibility: Inflexible approach. Significance: Limited insights. Flexibility: Flexible approach applicable to the problem. Significance: Broader applications and insights.
Mathematical Language Formality: Informal language, imprecise notation. Connections: Isolates ideas. Representations: Inaccurate Formality: Formal language, precise notation, and clear definitions. Connections: Appropriate. Representations: Accurate

Assessing Student Thinking

  • Prompts: At what point did you struggle? How did you check your work? Can you show me another way? How is this related to X? What assumptions are you making?

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Description

Explanation of Poisson equation strong and weak forms. Includes finite element approximation, seeking solutions satisfying conditions in $\Omega$ with boundary and Neumann conditions. Focuses on integral equation derivation.

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