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Background: Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) is a validated instrument used to predict morbidity. The aim of our study was to evaluate the performance of the POSSUM score system on predicting perioperative frailty and quality of life (QOL) in elderly surgical patients. Patients and Methods: An observational prospective study was conducted during 3 months. POSSUM was used to determine operative morbidity risk. Patients with a POSSUM score ≥26 were considered as having a high POSSUM (PHP). WHODAS 2.0, EuroQOL-5 dimensions (EQ-5D), Charlson score, and the Clinical Frailty Scale were used to assess the QOL and frailty. Chi-square, Fisher's exact, or Mann–Whitney tests were used for comparisons. Results: Two hundred and thirty-five patients were included. Median age was 69 years; 58% were ASA I/II and 42% ASA III/IV. Frailty was present in 53 patients (23%). Median POSSUM score was 26. Patients PHP were older (median age 71 vs. 68, P = 0.008), more frequently ASA III/IV (P = 0.001), had higher median Charlson scores (7 vs. 5, P = 0.006) and were more frail (49% vs. 26%, P < 0.001). PHP presented more problems in EQ-5D dimensions preoperatively (mobility: 59% vs 41%, P = 0.008; care: 41% vs. 25%, P = 0.013; activity: 52% vs. 32%, P = 0.002; pain: 59% vs. 45%, P = 0.041) but not anxiety (P = 0.137). Three months after surgery, PHP patients presented more problems in mobility: 63% vs. 38%, P < 0.001; care: 48% vs. 31%, P = 0.009; activity: 58% vs. 44%, P = 0.036; pain 59% vs. 37%, P = 0.001 and anxiety: 54% vs. 50%, P = 0.025. Conclusions: Patients PHP were frailer and had worse perioperative QOL.
Background: Whether intraoperative use of hydroxyethyl starch (HES) solutions is associated with postoperative acute kidney injury (AKI) continues to be researched. Urinary neutrophil gelatinase-associated lipocalin (NGAL) is validated for early detection of AKI. Previous studies are limited and use empirically predefined volumes of HES solutions with serum creatinine as marker for AKI. Materials and Methods: Adults scheduled for orthopedic surgery under general anesthesia with >200–300 mL blood loss expected were included; 40 were randomized to receive 6% HES 130/0.4 (tetrastarch) (group HES) or Ringer's lactate (group RL) boluses when stroke volume variation (SVV) >10% in supine or lateral position, or >14% in prone position. Incidence of early postoperative AKI using urinary NGAL (>100 ng/mL) was the primary outcome, and using derangement of serum creatinine was the secondary measure. Results: In 38 patients, intervention was completed, and incidence of AKI (postoperative urinary NGAL >100 ng/mL) among them was 0% in both groups. Patients with urinary NGAL >50 ng/mL were insignificantly higher for group RL versus group HES (6/19 vs. 4/19) (P = 0.461), as were those with incidence of AKI as per creatinine values (5/19 vs. 4/19) (P = 1.000). Group RL had significantly higher requirement of fluid (1211 ± 758 mL vs. 689 ± 394 mL) (P = 0.013) and lower cardiac index (P < 0.05) versus group HES. Conclusion: SVV-guided tetrastarch and Ringer's lactate do not result in postoperative AKI diagnosed by urinary NGAL >100 ng/mL; however, an insignificant trend for better renal functions as well as significantly more efficacious volume expansion and hemodynamic stability were seen with tetrastarch instead.
Background: Hyperhidrosis is a functional disorder identified by excessive sweating. Its incidence is approximately 1% in any population. Bilateral endoscopic thoracic sympathectomy (BETS) intervention is the definitive treatment of choice for palmar and axillary hyperhidrosis. Aims and Objectives: The purpose of this study is to evaluate and compare the quality of life (QOL) and satisfaction rate of patients with upper limb hyperhidrosis before and after BETS surgery and the influence of compensatory hyperhidrosis (CH) on patients' QOL after surgery. Settings and Design: This study is a cross-sectional study designed to generate longitudinal data. Subjects and Methods: This study is a cross-sectional study designed to generate longitudinal data pre- and postbilateral BETS prospectively. This study was conducted in the surgery department of University Hospital in Riyadh, Saudi Arabia. Hundred patients with upper limb hyperhidrosis who underwent BETS from 2014 to 2017 were included. A modified and validated QOL questionnaire for hyperhidrosis was completed by the patients themselves in order to compare the QOL for patients both before and after BETS. Patients' satisfaction and the occurrence of CH were obtained postoperatively. Statistical Analysis Used: Data were analyzed using the SPSS® statistical package for social studies, version 22.0 (SPSS 22; IBM Corp., New York, NY, USA) for Windows®. Results: A total of 100 patients completed the questionnaire; 94% of patients had a positive QOL outcome after the surgery. The mean decrease in QOL scores was −42.0 points toward better QOL. The site of sweating had a significant effect on the patients' QOL before and after the surgery (P value < 0.001). Moreover, 76% of patients reported a high satisfaction rate. Conclusion: Primary hyperhidrosis can negatively impair patients' QOL in different domains. BETS showed to be an effective option for improving the QOL of patients and it provided both short- and long-term effectiveness in treating upper limb hyperhidrosis. CH did not interfere with the rate of patient satisfaction or their QOL postoperatively.
Background: Naso/Orogastric tube (NOGT) misplacement can lead to significant complications. Therefore, the assessment of tube position is essential to ensure patient safety. Although radiography is considered the gold standard for determining NOGT location, new methods may be helpful in reducing repetitive radiation exposure, especially for neonates. In this study, we sought to investigate if bedside ultrasonography (BUSG) can be used to verify NOGT placement in neonatal intensive care patients. Materials and Methods: Infants requiring NOGT placement were enrolled. After insertion of the NOGT, the location was first identified using BUSG and then confirmed using abdominal radiography for comparison. Results: The study cohort included 51 infants with an average gestational age of 34 ± 4.9 weeks. BUSG determined the NOGT location correctly with a sensitivity of 92.2%. The location of the NOGT could not be determined by BUSG in four neonates (7.8%). In one infant, the NOGT was positioned in the esophagus, as determined both by BUSG and radiography. Conclusion: BUSG is a promising diagnostic tool for determining NOGT location in neonates, thereby eliminating the need for abdominal radiography.
Background and Objective: Anesthesiologists encounter difficulties during laryngoscopy and tracheal intubation of neonates with myelodysplasia. Tracheal intubation in lateral position in such cases deemed profitable but not easy because of the compromised laryngeal view. We compared GlideScope video laryngoscope (GVL) versus conventional Miller direct laryngoscope (DL) for tracheal intubation in laterally positioned neonates with myelodysplasia. Materials and Methods: Sixty neonates scheduled for elective surgical repair of meningeocele or meningeomyelocele under general anesthesia were allocated randomly for endotracheal intubation using GVL or DL. Percentage of glottis opening (POGO) scores, time to best glottis view (TBGV), endotracheal tube passage time (TPT), intubation time (IT), intubation attempts, and overall success rate of intubation were recorded. Results: TBGV was significantly shorter in GVL group (median = 6.8 s, range = 3.5–28.2 s) in comparison with DL group (median = 8.4 s, range = 4.8–32.7 s) (P = 0.01); however, TPT and IT were comparable. POGO scores were significantly higher with GVL group than DL group (median = 93.8, range = 45–100 and median = 82.4, range 10–100, respectively) (P = 0.001). Overall success of intubation was the same; however, three patients in GVL group required a second attempt for intubation in comparison with five patients in DL group. One patient in DL group required a third attempt. Conclusion: In laterally positioned neonates, GVL is easier than DL with a similar intubation time, comparable time required for tube passage, better views of the glottis, shorter times to obtain the best glottic view, and high success rate as compared with DL. GlideScope seems to be an effective approach for endotracheal intubation of laterally positioned neonates with myelodysplasia.
Aim: We aimed to investigate the changes in respiratory mechanics in adult patients undergoing open heart surgery (OHS) while using volume-controlled auto-flow (VCAF) ventilation mode. Materials and Methods: After obtaining ethics committee's approval and informed consent, 30 patients (17 males and 13 females; mean age: 57.3 ± 17.0 years; mean weight; 74.9 ± 13.6 kg) scheduled for OHS were enrolled. Mechanical ventilation was carried out using VCAF mode (VT: 5–8 mL/kg, I/E: 1/2, 10 ± 2 fr/min). Values of dynamic compliance (Cdyn) and resistance (R) were obtained at six time points (TPs). Normally distributed variables were analyzed with repeated measure of analysis of variance and Bonferroni tests. For abnormally distributed variables, Friedman variance analysis and Wilcoxon signed-rank tests were used. Values were expressed as mean ± standard deviation. P value <0.05 was considered significant. Results: Cdyn (mL/mbar) and R (mbar/L/s) values were as follows – (1) before sternotomy (S): 49.9 ± 17.1 and 7.8 ± 3.6; (2) after S: 56.7 ± 18.3 and 7.1 ± 3.7; (3) after S and after sternal retractor placement: 48.7 ± 16.1 and 8.3 ± 4.4; (4) after weaning from cardiopulmonary bypass and following decannulation while retractor was in place: 49.6 ± 16.5 and 8.1 ± 4.0; (5) after retractor removal: 56.5 ± 19.6 and 7.4 ± 3.7; and (6) after sternal closure: 43.1 ± 14.2 and 9.6 ± 9.1, respectively. Significant differences were observed in Cdynand R between; first and second TPs, second and third TPs, fourth and fifth TPs, and fifth and sixth TPs. Also, significant difference in Cdynwas found between first and sixth TPs, but it was not found in R. Conclusion: Cdyndecreases, but R remains the same in cardiac surgical patients when mechanical ventilation is performed with VCAF ventilation mode. Additionally, Cdynis negatively affected by the presence of sternal retractor and the sternal closure in OHS.
Context: Elderly patients have a higher risk of complications and 30-day mortality than younger patients. Population is aging and this is an emergent preoccupation. Aims: The aim of this study was to evaluate the performance of Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (POSSUM) system on 30-day mortality in elderly patients submitted to elective surgery. Additionally, the correlation of WHODAS 2.0 and Clinical Frailty Score (CFS) with mortality was evaluated. Settings and Design: An observational prospective study was conducted between May and July 2017. Methods and Material: Patients submitted to elective orthopedic, gynecologic, urologic, vascular, plastic, and general surgery were included. Exclusion criteria were as follows: age <60 years old; inability to give informed consent; emergency/urgency surgery, inability to understand Portuguese; patients admitted in the ICU after surgery. POSSUM was used to estimate postoperative mortality risk. WHODAS 2.0 and CFS were used to assess quality of life and health status. Mortality was evaluated during hospital stay and 30 days after surgery. area under the receiver operating characteristic (AUROC) was analyzed to test the discrimination of P-POSSUM, WHODAS 2.0 and CFS scale. Statistical Analysis Used: Statistical analysis was done using the SPSS Software (version 24.0). Results: POSSUM-predicted mortality was 3.0% with a standardized mortality ratio = 0.87; 95% CI 0.62–0.93; and a good calibration (H–L: P = 0.646); however, the AUROC was poor (0.563). We identified an association between mortality and a higher CFS grade (P = 0.000 and AUROC = 0.859) and a higher WHODAS 2.0 score (P = 0.000 and AUROC = 0.808). Conclusions: WHODAS and CFS appear to be a better assessment tolls for predicting postoperative mortality with a good discrimination comparing with P-POSSUM system.
Background: The aim of this randomized controlled study is to compare the safety and efficacy of thoracic spinal versus thoracic epidural anesthesia for open nephrectomy in patients with obstructive/restrictive lung disease. Methods: Sixty patients with mild to moderate chronic obstructive/restrictive lung disease undergoing open nephrectomy were randomized into two groups, 30 patients each. The thoracic spinal group (TSA) group received ultrasound guided mid-thoracic spinal anesthesia, and the thoracic epidural group (TEA) group received thoracic epidural anesthesia. All blocks were performed at the T7-T8. Hemodynamics, visual analogue scale score, sensory and motor block profile as well as any adverse events, and patient satisfaction were all reported. Results: Both blocks were successfully performed and were effective for surgery in all patients, with the exception of only one patient in TSA group who needed to receive general anesthesia even after IV midazolam because of extreme anxiety and was excluded from the study analysis. The sensory block ranges were quiet close, with T2-T5 for the TSA group and T3-T6 for the TEA group as the upper level and L3-L5 as the same lower level. The values for the onset time and the duration of sensory and motor blocks were lower in TSA group. There were no statistically significant differences existed in intraoperative VAS, and hemodynamics between the two groups. Postoperative adverse effects were negligible and insignificant, with no case reporting any neurological sequel. Conclusion: Ultrasound guided thoracic spinal anesthesia can be performed safely and effectively for open nephrectomy in patients with obstructive/restrictive lung disease with the potential for an early ambulation and great patient satisfaction.
Purpose: Safety and feasibility of distal radial artery cannulation at the anatomic snuffbox in the perioperative settings in adult patients have been assessed in this study. Methods: Adult patients undergoing elective surgery requiring arterial cannulation were recruited in this retrospective cohort study. Results: Data of 55 patients have been reviewed here; among which in 21 patients, arterial puncture was performed ultrasound guidance and in 34 patients puncture was guided by the pulsation of the distal radial artery at the anatomical snuffbox. First attempt success rate of distal radial arterial cannulation was 76.3% (42 of 55 patients) and it was similar between ultrasound guided (USG) and palpation technique (P = 0.53, Chi-square test). Overall, cannulation success rate was 87.3% (48 of 55 patients) and it was also similar between USG and palpation technique (P = 0.79, Chi-square test). Conclusion: Distal radial artery cannulation is technically feasible in patients undergoing elective surgery. However, further randomized controlled trials are required to establish its clinical utility and safety profile in comparison to conventional radial artery cannulation.
We report a case of intravenous ephedrine administration that abolished suspected bronchoconstriction during general anesthesia in a patient undergoing beta-adrenergic blocker therapy for hypertension and who was subsequently diagnosed postoperatively as having bronchial asthma. A 54-year-old man who had childhood asthma was scheduled for laparoscopic cholecystectomy at our institution. The preanesthetic interview suggested full resolution of his childhood asthma. His capnogram showed an airway obstructive pattern immediately after the initiation of mechanical ventilation. However, after administration of ephedrine due to low blood pressure during surgery, his obstructive capnogram reverted to normal. On postoperative day 3, he was diagnosed as having bronchial asthma. Furthermore, we found that small airway obstruction as indicated in his preoperative pulmonary function test (PFT) had been overlooked. Two important points arise from this case. First, the use of beta-blockers for the treatment of hypertension in patients potentially having obstructive lung disease should be avoided. Second, clinicians should carefully check the preoperative PFT results in detail to ensure that nothing has been overlooked.
The erector spinae plane block (ESP) is a novel interfascial block described in 2016 by Forero. Although it has been used to provide analgesia for planned abdominal and thoracic surgery, it has never been used as a rescue technique for abdominal surgery. Pain control can be a challenge for anaesthesiologists in laparotomic surgery when epidural analgesia is contraindicated. We report two cases in which the ESP block has been successfully used as a rescue technique to provide pain relief after laparotomic surgery.
Preoperative blood transfusion is sometimes controversial. We describe a case of a 43-year-old woman who developed sudden pulmonary congestion during surgery despite a small amount of intravenous crystalloid administration. She had no allergic disorders. Preoperative examination revealed that her hemoglobin was 5.6 g/dl, and she was diagnosed as folate-deficiency anemia although she never felt any symptoms before. Therefore, blood transfusion was performed and her hemoglobin increased to 9.4 g/dl. Amid surgery, airway pressure increased suddenly and pulsed oxygen saturation dropped. Chest roentgenogram revealed that the lungs were congested and her heart was markedly enlarged indicating the state of circulatory overload. We suggest that preoperative transfusion in a patient with chronic anemia should be carefully considered, and strongly recommend the confirmation with chest roentgenogram.
Postoperative pain after breast surgery is difficult to manage owing to its complex innervation. Recently, erector spinae plane (ESP) block, an interfacial block, has been described to provide pain relief after thoracic and abdominal surgeries, multiple rib fractures, and neuropathic thoracic pain. Local anesthetic injected in the erector spinae muscle sheath at the level of the 5th thoracic transverse process is distributed cranially and caudally along the sheath, and to the paravertebral space through apertures in the anterior sheath wall. This may block the dorsal and ventral rami of the thoracic spinal nerves at multiple vertebral levels and the rami communicantes transmitting autonomic fibers to and from the sympathetic ganglia, causing multidermatomal somatic and visceral analgesia. The present case report demonstrates the adequate perioperative analgesia provided by the ultrasound-guided ESP block in patients undergoing various breast surgeries.
Cocoon abdomen is a rare condition in which abdominal structures are surrounded by thick encapsulating peritoneum resulting in dense adhesions. Liver transplant is a high risk surgery with an already increased risk of massive blood loss due to the pre-existing coagulopathy and portal hypertension. Presence of cocoon abdomen with severe dense adhesions can either lead to difficult hepatectomy with massive intra-operative blood loss or failure to proceed with the surgery. This becomes even more important in live donor liver transplantation where it may not be possible to abandon the surgery once the donor liver resection is started. Thus keeping a high suspicion of cocoon abdomen in patients with previous history of kochs abdomen and on long term beta blocker therapy is of utmost importance and this can decrease the morbidity and mortality associated with this condition. A 41 year old male known case of chronic liver disease was posted for live donor liver transplantation. After opening the abdomen thick dense adhesions were found around the intestines and the liver. Due to the dense adhesions surgical team was in dilemma whether to proceed further for the surgery or not. Intra-operatively patient had a blood loss of 12.5 litre. Despite massive transfusion the postoperative course went uneventful and the patient was extubated on 2nd post-operative day. He was shifted out of Intensive care unit on the 6th post-operative day. Cocoon abdomen should be suspected in a chronic liver disease patient with previous history of tuberculosis or on long term beta blocker therapy. Proper preparation before surgery can decrease the morbidity and mortality associated with this major surgery. Our case report clearly shows that such types of patients can be taken up for the live donor liver transplantation surgery with a precaution to start donor hepatectomy only after surgeon has assessed the difficulty status of recipient hepatectomy.
Bronchial thermoplasty (BT) is an upcoming treatment for patients with asthma refractory to traditional pharmacotherapy. BT is an invasive procedure which carries a risk of coughing, wheezing, bronchospasm, and laryngospasm during and after the procedure. Some of these complications can be minimized using better anesthetic techniques during BT. We hereby report a case of a 63-year-old female with poorly controlled asthma posted for BT done under general anesthesia (GA) with supraglottic device. GA provides better working conditions for pulmonologists when compared with sedation. But still there is no consensus on what would be the ideal anesthetic technique for BT procedure. Till the time, considering anesthesiologist and pulmonologist's prospective, GA (total intravenous anesthesia) using supraglottic device would be a preferred choice for a safe and effective anesthetic strategy in BT.


Middle Spring Creek is a spring-fed trout stream with tributaries including Branch Creek, Burd Run, Gum Run and Mains Run. The stream runs through the heart of Shippensburg and into Franklin County.
Although the stream has access points within the town, no fishing is allowed in Shippensburg.
Fly Fishing: The main stem of Middle Spring Creek are stocked with Brook, Brown and Rainbow Trout. The upper reaches of Middle Spring Creek (the headwaters of Gum Run and Mains Run) support a wild population of Brown trout.
Fishing: The waters support young Bass, Sunfish, Perch, Chub, Carp, Suckers, Minnows, Daces, Sculpin, and other fish species.


text:
HTF MI
Blockchain in Media and Entertainment Market to See Booming Growth : Accenture, Synereo, Digital Currency Group
New Jersey, USA -- (SBWIRE) -- 10/11/2022 -- The latest study released on the Global Blockchain in Media and Entertainment Market by AMA Research evaluates market size, trend, and forecast to 2027. The Blockchain in Media and Entertainment market study covers significant research data and proofs to be a handy resource document for managers, analysts, industry experts and other key people to have ready-to-access and self-analyzed study to help understand market trends, growth drivers, opportunities and upcoming challenges and about the competitors.
Key Players in This Report Include:
IBM (United States), Microsoft (United States), SAP (Germany), Accenture (Ireland), Oracle (United States), BRAINBOY (Germany), ARK (United States), Auxesis (India), Synereo (Israel), Digital Currency Group (United States), Bitfury Group (United States),
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The entertainment industry is continuously implanting technology advancements and is continuously changing its norms and distribution practices with an aim to reach a vast amount of audience. One of the key factors driving the growth of the Blockchain in the Media and Entertainment market is the rising adoption of blockchain technology for different applications in the media, advertising, and entertainment industry as well as the use of transparent, faster, and secure transactions. Blockchain refers to a distributed ledger technology that keeps digital assets unchanged and transparent through the use of decentralization and cryptographic hashing.
- The increasing adoption of blockchain technology for various applications in the media
- The increasing demand for the integration of blockchain technology-powered solutions in the media
Market Opportunities:
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by Application (Content Security, Licensing and Rights Management, Smart Contract, Pay, Digital Advertising, Online Game, Other), Enterprise Size (Small and Medium-sized Enterprises (SMEs), Large Enterprises), Providers (Application, Middleware, Infrastructure)
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Geographically, the detailed analysis of consumption, revenue, market share, and growth rate of the following regions:
- The Middle East and Africa (South Africa, Saudi Arabia, UAE, Israel, Egypt, etc.)
- North America (United States, Mexico & Canada)
- South America (Brazil, Venezuela, Argentina, Ecuador, Peru, Colombia, etc.)
- Europe (Turkey, Spain, Turkey, Netherlands Denmark, Belgium, Switzerland, Germany, Russia UK, Italy, France, etc.)
- Asia-Pacific (Taiwan, Hong Kong, Singapore, Vietnam, China, Malaysia, Japan, Philippines, Korea, Thailand, India, Indonesia, and Australia).
Objectives of the Report
- -To carefully analyze and forecast the size of the Blockchain in Media and Entertainment market by value and volume.
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- -To analyze and study micro-markets in terms of their contributions to the Blockchain in Media and Entertainment market, their prospects, and individual growth trends.
- -To offer precise and useful details about factors affecting the growth of the Blockchain in Media and Entertainment
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Major highlights from Table of Contents:
Blockchain in Media and Entertainment Market Study Coverage:
- It includes major manufacturers, emerging player's growth story, and major business segments of Blockchain in Media and Entertainment market, years considered, and research objectives. Additionally, segmentation on the basis of the type of product, application, and technology.
- Blockchain in Media and Entertainment Market Executive Summary: It gives a summary of overall studies, growth rate, available market, competitive landscape, market drivers, trends, and issues, and macroscopic indicators.
- Blockchain in Media and Entertainment Market Production by Region Blockchain in Media and Entertainment Market Profile of Manufacturers-players are studied on the basis of SWOT, their products, production, value, financials, and other vital factors.
- Key Points Covered in Blockchain in Media and Entertainment Market Report:
- Blockchain in Media and Entertainment Overview, Definition and Classification Market drivers and barriers
- Blockchain in Media and Entertainment Market Competition by Manufacturers
- Impact Analysis of COVID-19 on Blockchain in Media and Entertainment Market
- Blockchain in Media and Entertainment Capacity, Production, Revenue (Value) by Region (2021-2027)
- Blockchain in Media and Entertainment Supply (Production), Consumption, Export, Import by Region (2021-2027)
- Blockchain in Media and Entertainment Production, Revenue (Value), Price Trend by Type {Payment Gateway, Merchant Account, Subscription Management,}
- Blockchain in Media and Entertainment Manufacturers Profiles/Analysis Blockchain in Media and Entertainment Manufacturing Cost Analysis, Industrial/Supply Chain Analysis, Sourcing Strategy and Downstream Buyers, Marketing
- Strategy by Key Manufacturers/Players, Connected Distributors/Traders Standardization, Regulatory and collaborative initiatives, Industry road map and value chain Market Effect Factors Analysis.
Browse Complete Summary and Table of Content @ https://www.advancemarketanalytics.com/reports/115115-global-blockchain-in-media-and-entertainment-market
- How feasible is Blockchain in Media and Entertainment market for long-term investment?
- What are influencing factors driving the demand for Blockchain in Media and Entertainment near future?
- What is the impact analysis of various factors in the Global Blockchain in Media and Entertainment market growth?
- What are the recent trends in the regional market and how successful they are?
Thanks for reading this article; you can also get individual chapter wise section or region wise report version like North America, Middle East, Africa, Europe or LATAM, Southeast Asia.
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redpajama_set_name: RedPajamaCommonCrawl


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Pat Sajak Buys Vowel, Michael Mann's Rage on Twitter
By Bryan Preston May 20, 2014 1:58 PM ET
Wheel of Fortune's Pat Sajak stirred up a hornet's nest with this tweet Monday night.
I now believe global warming alarmists are unpatriotic racists knowingly misleading for their own ends. Good night.
— Pat Sajak (@patsajak) May 20, 2014
Sajak's tweet stirred up a thoughtful, deliberative discussion of the pros and cons of using government mandates and power to fight what might not even be real science.
Just kidding. Lots of people tweeted at him that he's an awful game show host, despite the fact that he has hosted Wheel since before most of his tweet-muggers were born.
Many also slam Sajak for tweeting about science, when he is a game show host. When Hollywood actors agree with the "climate change" mantra…? Are they smart enough to see the irony?
@patsajak I'd like you to buy a brain. With a vowel.
— Mark Brooks (@MarkBrooksVA) May 20, 2014
@patsajak LOL you suck Sajak
— Peter Henderson (@Henderburn) May 20, 2014
Michael E. Mann of hockey stick infamy chimed in.
Hey @PatSajak, this aint the Wheel of Fortune. If we lose this game, it isn't just one person's misfortune. All humanity pays the price.
— Michael E. Mann (@MichaelEMann) May 20, 2014
And if Mann is wrong, by intent or by accident? Well, we'll have wrecked the economy and condemned many to freeze and starve. Guess he's cool with that.
Many of Mann's fellow tweeters cited the statistic that "97% of climate scientists agree that global warming, er, climate change is occurring."
Even though that statistic is bogus.
Cook's 97 percent consensus claim was rebutted in subsequent analyses of his study. A paper by five leading climatologists published in the journal Science and Education last year found that Cook's study misrepresented the views of most consensus scientists.
The definition Cook used to get his consensus was weak, the climatologists said. Only 41 out of the 11,944 published climate studies examined by Cook explicitly stated that mankind caused most of the warming since 1950 — meaning the actual consensus is 0.3 percent.
Exit question: How long before the high priests of free thought and unfettered inquiry demand that Sajak apologize and repent, or lose his job?
The 4 States That Recovered All Jobs Lost From COVID Have Something in Common


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Multiply substituted isotopologues (or 'clumped isotopes') represent a novel stable isotope technique that offers a versatile and powerful geothermometer. Being able to extract reliable temperature information from any carbonate phase significantly improves the petroleum geologist's ability to reconstruct the thermal history of petroleum basins, or to better constrain diagenetic transformations in reservoir units. There has been a recent increase in the number of laboratories running clumped isotopes, and our group has worked on applying clumped isotope to reservoir-relevant questions with the joint financial support of Qatar Petroleum, Shell, & the Qatar Science and Technology Park. The presentation will attempt to address the advantages as well as challenges of clumped isotopes based on experience gained over the past four years. The first priority of our research is calibrations to reservoir conditions. The current temperature calibrations go up to 50˚C and are thus below most reservoir temperatures. To overcome this we have developed a pressure-controlled rig for carbonate precipitation at temperatures up to 250˚C. Initial results suggest that the slope of the empirical calibration follows a theoretical slope determined by thermodynamic equilibrium, and thus that data agree with theoretical models. Furthermore, as most subsurface fluids are brines, we did a series of experiments comparing the clumped isotope signature of a low-salinity control precipitation batch with a second batch precipitated at the same experimental conditions but higher salinity. This was done to assess potential 'salinity effects' on clumped isotopes analogous to what was observed for δ18O, but initial results suggest that these effects are negligible. Finally, a series of multi-proxy case studies based on outcrop analogues in the Middle East where clumped isotopes were applied to fault-calcite, fracture-related dolomite and matrix dolomite form the basis of a 'best practice' workflow that helps maximize the information gained from clumped isotopes and avoid interpretational pitfalls. We conclude that in all of the cases we have studied, the carbonate clumped isotopes offer a robust dataset that significantly reduces uncertainty in the interpretation of the thermal history of carbonate phases. Temperature calibrations and potential subsurface-relevant effects on clumped isotopes are now being constrained, warranting the use of the technique for subsurface applications.


. biological microscope and is not to be confused with TOYS, which claim to offer higher magnifications but are unable offer CLARITY. English United States.
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Are we going to have inflatable robots?
Did you know there are incredible 3D scans of Notre Dame?
Does this look close to real?
Did you hear about the 3D printed heart?
Did you hear that Musk is thinking about adding giant stainless steel dragon wings to a Starship that could allow his eventually Mars bounspacecraft to keep cool during re-entry?
Why do they want to down load brains.?
Have you heard about the study of mice on the space station?
Will future smart phones recognizes us based on gait, typing patterns, grip, or other physical characteristics?
Can scientist help future explorers grow crops on Mars?
Have you heard about brain electrodes being implanted into rat brains?
Is the thought of a device that can down load our brain a little scary?
How big is the black hole scientist produce an image of?
Did you hear about the three parent baby?
Have you seen the first images of a black hole?
Did you know that a planet size telescope is about to release the first of kind image of the supermassive black hole at the center of our galaxy?


Our grandson turned three last week. Yes, it has been three years since many of you prayed for our one pound, fourteen ounce baby Cooper, and I am so happy to tell you that the prayers worked. Cooper is thriving!
I used red plates and red Solo cups and black and white napkins.
You can only imagine how many times Cooper asked someone to drive the salt and pepper to him, and it wasn't because he wanted to use the salt or pepper.
My rusted-out dump truck carried flowers for the centerpiece.
In my recent post, I couldn't get the commentary to stop centering. When I apologized for it, a couple of people said they liked it centered, so I may continue to do it. One person liked it, because my blog is so wide that the commentary runs into the sidebar. Did you know that you can press the control key, and turn the wheel on your mouse toward you, and it will shrink the view on your computer screen?
We didn't know his cake was going to become interactive, and nobody was sure they wanted a piece after he ran the vehicles through the icing, but we forced ourselves to eat it.
Thank you for celebrating Cooper's birthday with us, and a big thank you to all who prayed for this little miracle when he was born.
You have the cutest ideas. Cooper is adorable, so glad he is doing so well.
That is so cute! Tiger had little cars on his birthday cake last year also, but we didn't have salt & pepper in a truck, such a great idea!
Love the "Wheels" tablescape but most of all I love the picture of Cooper playing wheels in his cake. The only opinion on this table that really mattered was Cooper's and obviously he is delighted.
I did a control minus command for the screen (I usually will do a control plus command when viewing pictures to see the details)and of course it shrank the text and pictures in your post. I can still read the text without my cheater glasses but not so much the comments.


text:
Home/Business/Indiabulls Housing Finance Q4 results: Profit jumps 2-folds to Rs 276 cr
Indiabulls Housing Finance Q4 results: Profit jumps 2-folds to Rs 276 cr
Admin20 May 2021
MUMBAI: Mortgage financier on Wednesday reported a two-fold jump in its profit after tax to Rs 276 crore in the quarter ended March 2021 helped by stable asset quality.
The lender had reported a profit after tax of Rs 137 crore in the corresponding quarter of FY20.
"The quarter was very good. We have been focussing on asset quality, which is very robust. Overall, there has been above 100 per cent increase in our profit from Rs 137 crore in Q4 FY20 to Rs 276 crore this year (Q4 FY21)," the company's Vice Chairman, managing director and CEO Gagan Banga said.
The lender's net non-performing assets (NPAs) were stable at 1.59 per cent. Provisions to loan book stood at 3.7 per cent.
He said collection efficiency of the company stood at 98.5 per cent in March. Cost to income ratio declined to 12.8 per cent in FY21 from 16.2 per cent for FY20 on the back of measures taken to improve cost efficiency, a company release said.
The lender said its funding costs have moderated with incremental funds being raised at sub 8 per cent per annum levels. This has helped bring down the cost of funds on books to 8.5 per cent. Its spread on the book has expanded to 2.7 per cent.
Overall, in FY21, it raised over Rs 34,000 crore through equity, bank lines, bonds and loan sell downs, the release said.
Capital adequacy stood at 30.7 per cent and tier 1 at 24 per cent.
Loan book declined to Rs 66,047 crore in the reporting quarter from Rs 73,065 crore in the same quarter of the previous year.
"We have been saying that we will be de-growing our wholesale loans and increasing our retail disbursement. We have set a goal that by March 2022 we will decrease our wholesale book by 33 per cent," Banga said.
The company has entered into a strategic co-lending partnership with HDFC Ltd to offer housing loans to homebuyers at competitive rates. It will originate retail home loans as per jointly drawn up credit policy and retain 20 per cent of the loan on its books and 80 per cent will be on HDFC's books.
"In FY22, with our co-lending partnerships in place, especially the one with HDFC Ltd, we are now set to grow the retail loan book and grow profitability through our technology-leveraged, retail focused asset-light business model," Banga said.
The company's shares closed at Rs 193.25 apiece, up 0.73 per cent on BSE.
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bitcoin price: Has a long winter set in for Bitcoin? Top analyst says it's just bear market


text:
Q: python if else statements return only the first condition I don't know what is the problem here, its only accepting the first condition the in if statement if I type 480p or 720p it prints me the  "Invalid choice", I'll truly appreciate it if you can find the problem this is taking me crazy. I am trying to make a small project that can solve a daily problem i encounter which is downloading videos from youtube, I know there is a lot of codes similar to this, but i've only read the librarys docs and spent time to make it without looking at any guides.
from pytube import *
import ffmpeg

userurl = (input("Enter a youtube video URL : "))
q = str(input("Which quality you want ?  360p,480p,720p,1080p,4K,Flh :")).lower
yt = YouTube(userurl)
print ("Title of the video : ",yt.title)

def hd1080p():
    global q
    print(yt.streams.filter(mime_type="video/mp4", res="1080p", adaptive = True, fps = 60))
    v = yt.streams.get_highest_resolution()
    print("Downloading HD 1080p video")
    v.download()
    print("Video downloaded")
    return

def hd720p():
    global q
    print(yt.streams.filter(file_extension= 'mp4',res="720p", progressive=True, fps = 60))
    yd= yt.streams.get_highest_resolution()
    print("Downloading HD 720p video")
    yd.download()
    print("Finished.")
    return

def l480p():
    global q
    print(yt.streams.filter(file_extension= 'mp4',res="480p", progressive=True, fps = 60))
    yd= yt.streams.get_highest_resolution()
    print("Downloading 480p video")
    yd.download()
    print("Finished.")
    return

def l360p():
    global q
    print(yt.streams.filter(file_extension= 'mp4',res="360p", progressive=True,fps = 60))
    yd= yt.streams.get_highest_resolution()
    print("Downloading 360p video")
    yd.download()
    print("Finished.")
    return

def hd4k():
    global q
    print(yt.streams.filter(mime_type="video/mp4", res="2160p", adaptive = True))
    v = yt.streams.get_highest_resolution()
    print("Downloading 4k video")
    v.download()
    print("Video downloaded")
    return

if q == "1080" or q == "1080p":
    hd1080p()
elif q == "720" or q == "720p":
    hd720p()
elif q == "480" or q == "480p":
    l480p()
elif q == "360" or q == "360p":
    l360p()
elif q ==  "4" or q == "4k":
    hd4k()
else:
    print("invalid choice")

"""    yt.streams.filter(mime_type="audio")
    a = yt.streams.get_audio_only()
    print("Downloading audio")
    a.download()
    print("audio downloaded")"""

A: I forget to call the method q.lower(), i called it without the parentheses.
Thanks to @Chris Doyle

redpajama_set_name: RedPajamaStackExchange


Over the past nine years The Gallery at Somes Sound has been a proud sponsor collaborating with Friends of Acadia on various programs and events, currently serving on their Team of Business Advisors.
In 1986 Friends of Acadia founders envisioned a membership-based and volunteer-powered organization that would translate their love for Acadia into tangible good for the park. For more than three decades, that vision has guided their work—from modest early volunteer projects and small equipment donations, to major achievements such as Acadia Trails Forever, establishing the nation's first endowed trail system.
ABOUT ACADIA NATIONAL PARK: Protecting more than 47,000 acres on two islands and a mainland peninsula on the rugged coast of Maine, Acadia National Park is a jewel of granite mountains, filigreed coastlines, unique cultural resources, dazzling night skies, and precious communities of plant and animal life. Drawing more than 3.5 million visitors each year, Acadia is one of the ten most popular national parks in the US. It is also one of the smallest and most vulnerable.
The Gallery at Somes Sound is a proud supporter of The Wendell Gilley Museum. The Museum celebrates the life and work of Wendell Gilley, a pioneer in the field of decorative bird carving. It teaches the art of bird carving and presents art exhibitions and educational programs with a special focus on people, nature, and art. The Museum endeavors to inspire appreciation of the visual arts, engagement in artistic creativity, and respect and care for the natural world.


Forum hii ni maalum kwa wanafunzi wa chuo hasa chuo cha usimamizi wa fedha(I.F.M) wenye maoni na dukuduku na wenye uhitaji wa kufahamu mawili matatu.
(MMA) is a full-contact combat sport that allows striking and grappling, both standing and on the ground, using techniques from other combat sports and martial arts. The first documented use of the term mixed martial arts was in a review of UFC 1 by television critic Howard Rosenberg in 1993. The term gained popularity when newfullcontact.com, then one of the largest websites covering the sport, hosted and republished the article. The question of who actually coined the term is subject to debate.
During the early 20th century, various mixed-style contests took place throughout Japan, Taiwan and in the countries of the Four Asian Tigers. In 1980 CV Productions, Inc. created the first regulated MMA league in the United States, called Tough Guy Contest, which was later renamed Battle of the Superfighters. The company sanctioned ten tournaments in Pennsylvania. However, in 1983 the Pennsylvania State Senate passed a bill prohibiting the sport. In Brazil there was the sport of Vale Tudo, in which fighters from various styles fought with little to no rules. The Gracie family was known to promote Vale Tudo matches as a way to promote their own Brazilian Jiu-Jitsu style.
In 1993 the Gracie family brought Brazilian Jiu-Jitsu, developed in Brazil from the 1920s, to the United States by founding the Ultimate Fighting Championship (UFC) MMA promotion company. The company held an event with almost no rules, mostly due the influence of Art Davie and Rorion Gracie attempting to replicate Vale Tudo fights that existed in Brazil, and would later implement a different set of rules (example:eliminates kicking a grounded opponent), which differed from other leagues which were more in favour of realistic fights.
Originally promoted as a competition to find the most effective martial arts for real unarmed combat, competitors from different fighting styles were pitted against one another in contests with relatively few rules. Later, individual fighters incorporated multiple martial arts into their style. MMA promoters were pressured to adopt additional rules to increase competitors' safety, to comply with sport regulations and to broaden mainstream acceptance of the sport. Following these changes, the sport has seen increased popularity with a pay-per-view business that rivals boxing and professional wrestling.
Is Brazilian jiu-jitsu a sport or martial art?
"Judo subdues older martial art forms"


text:
MIKE SHAW
1979 AHS
In 1978, Antioch Panther Mike Shaw capped his prep career with one of the nation�s highest honors for athletically and academically gifted students, the Thom McAn Award. A massive silver cup loaned to the Antioch Sports Legends Hall is a memento of being chosen the winner from among 70 nominees nationwide. Mike, the son of 2007 Sports Legends inductee Worth Shaw and active Sports Legends volunteer Bertha Shaw, was also the recipient of the Scholar-Athlete Award from the Northern California Chapter of the National Football Foundation for his perfect 4.0 GPA and performance as one of the best football players in Contra Costa County in 1978. Antioch High School�s football team captain was MVP of the 1978 season, a First Team All-Diablo Valley Athletic League selection on offense and played in the Contra Costa-Alameda All-Star Classic. Mike was also named Second Team All-East Bay as a running back and received Antioch High�s prestigious Ron Pritchard Award for Outstanding Back for the Panthers in his senior year, scoring eight touchdowns and rushing for 609 yards on 100 carries despite missing two games due to an injury. In a non-league game against Sacramento�s Luther Burbank High, he scored a 50-yard touchdown while rushing for 160 yards. Mike played varsity football all three years at Antioch, earning Second Team All-DVAL (Offense) as a junior in 1977, the year in which he rushed for 287 yards on 58 carries, scoring four touchdowns. Mike�s 13 touchdowns and eight extra points placed him as #10 on the AHS all-time career scoring list at the time, with 86 total points. As a freshman at the University of California, Davis, Mike won the award for Outstanding Freshman (Offense) in 1979. Few players can say they were part of a championship team, but Mike played for five consecutive league winners: as a Panther, in 1977 and 1978, and for three years as an Aggie. Davis was the Far West Conference Champion three times between 1979-1981. After graduation from college in 1983 with a degree in physics, Mike began his career as a scientist, working for Lawrence Livermore National Lab. He completed a doctorate degree from UC Davis in 1991 and continues to work at LLNL where he develops computer codes for lasers. Dr. Shaw spent several years involved in sports as a Little League coach and umpire, having worked behind home plate at the Western Regional Senior Little League tournament in Oregon in 2009.


Castellammare del Golfo is a city in the region Sicily, in the department Trapani and in the borough Castellammare del Golfo. The postal code of the city of Castellammare del Golfo is 91014, the latitude is 38.02002 and longitude is 12.88672.
Holidays Castellammare del Golfo: No results for your search Holidays Castellammare del Golfo.


text:
Kobin ist der Familienname folgender Personen:

 Chris Kobin, US-amerikanischer Drehbuchautor und Produzent
 Wassyl Kobin (* 1985), ukrainischer Fußballspieler

redpajama_set_name: RedPajamaWikipedia


text:
Four reasons to manage China's rise
Dhruva Jaishankar
China shapes almost every global issue, yet the reasons for anxiety about Beijing's ambitions guide how to respond.
Photo: Anton Whoa/ Flickr
Follow @d_jaishankar
No other development has so profoundly transformed international relations in recent years as the rise of China. Over the past 35 years, China has pulled the largest number of people out of poverty in history and, with 39%, has made the largest contribution to global growth since 2008. It is now the world's leader in manufacturing, exports, energy use, and urbanisation. With a growing middle class and national resources, it is only natural that China's international influence should also have increased.
Today, China shapes almost every global issue of note, from climate change to trade, and from regional security in Southeast Asia and the Indian Ocean to investment trends in Africa and Central Europe.
Concerns persist despite Beijing adopting a less confrontational approach over the past few months towards Southeast Asia, Japan, and India.
Why, then, does China's rise generate so much anxiety? Over the past two years, I have travelled across the Indo-Pacific region, from Colombo to Kuala Lumpur, Tokyo to Taipei, Hanoi to Honolulu, Port Blair to Perth, Washington to Wellington, and beyond to Europe and the Middle East. In all of these places and many others, regional political leaders, diplomats, and military officers echo similar concerns about China's rise. Such concerns persist despite Beijing adopting a less confrontational approach over the past few months towards Southeast Asia, Japan, and India among others.
Essentially, they are four reasons for continuing concern about China's rise.
The first – infrequently stated, and rarely in a public setting – is a product of China's continued opacity of decision-making and centralisation of power. This is problematic because China is no longer an isolated and inward-looking country, but a state whose decisions have direct implications for the rest of the world. While many had hoped that China's economic and social integration would be accompanied by decision-making transparency, the consolidation of power by Xi Jinping has diminished such expectations.
Today, even relatively minor actions by China are viewed with a great deal of scepticism. As former Indonesian Deputy Foreign Minister Dino Patti Djalal recently observed, while Washington is a known quantity, China remains an "enigma" in strategic terms. And even hardened realists would acknowledge that opacity of intentions exacerbates security competition.
A second area of growing concern involves China's economic and trade policies, about which anxieties are much more pronounced and public. The continuing dominance of state-backed and heavily-subsidised enterprises, restrictive market access in certain sectors, active industrial espionage programs, and a supply-side approach to development have resulted in market distortions, an uneven playing field, and ballooning debt. Political and policy leaders increasingly believe that China's model has harmed growth and job prospects in their own countries.
The United States under Donald Trump has chosen to contest China's "predatory economics" by slapping tariffs and tightening investment opportunities. In Australia, Chinese investments in critical infrastructure have become a hot-button issue. In India, Chinese dumping has soured business sentiments. China's signature international economic strategy – the Belt and Road Initiative (BRI, also known as One Belt, One Road) – is only exporting and further exacerbating these concerns.
Third, while China is not alone in the region in having territorial disputes, its recent actions concerning disputed territory have been disconcerting. Beijing regularly employs civilian tools – armed fishing boats, dredging vessels, road construction crews, and civil aviation – to impose control or authority over disputed territory. US Secretary of State Mike Pompeo has declared that the Indo-Pacific should be "free from coercion or great power domination," such sentiments find resonance elsewhere.
Such concerns are manifested in actions too: the increased tempo of US freedom of navigation operations (FONOPs) in the South China Sea, Japanese remilitarisation efforts, and Indian attempts at blocking Chinese road-building in disputed territory in the Himalayas. Whether at Doklam or Ieodo or Scarborough Shoal, China's revisionism is adding to regional tensions.
Finally, there are abiding concerns about China's disrespect for international norms. Freedom of navigation and overflight has been a major issue, particularly after China's rejection of international arbitration in the South China Sea. But other concerns, including over cybersecurity, non-proliferation, space, and even the Antarctic Treaty System, are becoming more pronounced.
This extends to another area of incipient competition: connectivity infrastructure. Several countries have now articulated concerns about China's unsustainable financing, opacity of contracts, hidden political strings, swapping of debt for equity, and environmental degradation. In a thinly-veiled reference to China, India's Prime Minister Narendra Modi warned in Singapore that:
Rules and norms should be based on the consent of all, not on the power of the few.
From Thai diplomats to Nigerian central bankers, French presidents to newly-elected Brazilian leaders, broad criticism of China's external policies has been mounting.
A host of new strategies, policies, and informal mechanisms are already evolving to address these concerns. China's rise already offers the subtexts for the US and Japan's "Free and Open Indo-Pacific" strategies; India's Act East Policy and its boycott of the Belt and Road Initiative; Australia's tough legislation on political interference; and South Korea's "New Southern Policy", with its emphasis on Southeast and South Asian engagement. Bilateral and trilateral security partnerships among all four "Quad" countries (the US, Japan, India, and Australia) have deepened, as have all their partnerships with some Southeast Asian countries.
China's rise cannot and should not be contained in a traditional sense. Any effort at labelling criticism of Chinese behaviour as reflective of a "Cold War mentality" is inaccurate, if not deliberately misleading. The language of containment imposes an anachronistic Cold War blueprint on a 21st century set of problems.
However, what countries that share concerns about China's rise can be doing – on their own and in cooperation with one another – is raise the costs of adverse behaviour. Managing China's rise should be understood not as a diplomatic euphemism, but as a distinct strategic objective.
It should not rule out cooperation with Beijing in areas that reflect positive changes – dealings with China cannot be purely competitive. But if concerted efforts can be made using a variety of economic, military, and diplomatic tools to incentivise China's transparency of decision-making, market liberalisation, an equitable settlement of territorial differences, and adherence to accepted international norms, it would not only benefit other countries in the Indo-Pacific and beyond.
This would ultimately sustain and facilitate China's continued rise.
International justice: tackling impunity in Asia
How China changed its language on speech
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Antara Ghosal Singh 15 Mar 2019 06:00
China's "South Asia challenge" for the Belt and Road Initiative
Chinese strategists have identified three trends that pose severe challenges to the promotion of the BRI in South Asia.
Philippe Le Corre 23 May 2017 12:59
Europe's mixed views on China's Belt and Road
In recent years China has demonstrated its ability to divide Europeans by creating new entities such as the 16+1 mechanism.
Greg Earl 14 Feb 2019 12:00
Economic diplomacy: trade ground shifts despite US-China row
Alarm is growing the WTO's dispute settlement mechanism may soon suffer the same credibility loss as its deal-making.


Newark Air Museum has announced its 2019 events calendar, with aerojumbles, special events and open days at its Nottinghamshire venue.
An event dedicated to the Canberra aircraft at the museum and personnel that flew them; it will feature visiting displays and is open to the public.
This annual gathering provides the perfect opportunity for the public to view a diverse range of visiting aircraft cockpits.
A new event to celebrate the helicopters in the museum collection; the event on the Sunday will coincide with the 2019 International Helicopter Day.
A book launch event organised in association with Grub Street publishing and centred on Shackleton WR977. The event will form the focus of a mini-Reunion of former Shackleton air and ground crew personnel.