After working out with Vann recently, I felt stiffness in my left knee when I walked up and down stairs. Uh oh. What's going on inside that knee? What causes me to have occasional joint stiffness, and besides, what's a joint anyway?
Vann told me to take it easy on the knee and instructed me to do a specific stretching exercise, which eased the stiffness rather quickly. But I wanted to learn more about my joints, so I called Osteo Bi-Flex, which manufactures a broad line of supplements for joint health. I'd been seeing their TV commercials a lot lately, and we had started to work with the brand because joint, bone and health concerns surely can impact our lives.
Dr. Susan was a wonderful teacher, and now I have the pleasure of sharing her information-packed lesson with you. Do yourself a big favor and learn it, too!
Geri: Please tell us, in layman's terms, about the structure of our joints.
Dr. Susan: "I'm going to use the knee joint as an example, but for the most part, our joints are all going to be made up of the same types of tissues. The bone in a healthy joint is not touching another bone, but is separated from another bone by a fluid, known as synovial fluid, which is surrounded by the synovial membrane. This fluid is very liquid and provides cushioning and lubrication to the joint. Cartilage, located on the edge of the bone, reduces friction and acts almost as a shock absorber.
Just curious, can someone have strong muscles, but weak joints?
WILL EVERYONE EVENTUALLY EXPERIENCE JOINT COMFORT ISSUES?
ARE CERTAIN PEOPLE MORE PRONE TO JOINT COMFORT ISSUES?
"Postmenopausal women are definitely more prone. There's a link between lower circulating estrogen levels in menopausal women and increased risk of joint issues.
CAN WE DO ANYTHING TO SLOW JOINT ISSUES, AND WHAT'S THE IDEAL TIME TO START TAKING CARE OF OUR JOINT HEALTH?
1. "Treating an injury kindly. Don't ignore it. "If you 'muscle your way' through an injury, it can lead to further damage. Untreated injuries can lead further damage to the joint or in a muscle that's supporting the bone, or to the cartilage at the end of the bone. So, if you do feel something is off, consult your physician.
2. "Exercising appropriately is one of the best things you can do for your joints, even though it seems counter-intuitive. This will ensure the strength of the muscle around the joints, and help you maintain your flexibility and range of motion. You absolutely want to work your joints in a healthy range of motion. Making sure you like your exercise regimen will help you stick to it. A combination of weight-bearing and non-weight-bearing exercise is best, and flexibility exercise helps you to keep the range of motion.
Osteo Bi-Flex® Triple Strength + Turmeric contains glucosamine which helps strengthen joints while helping to maintain joint cartilage essential for comfortable joint movement.* Turmeric has been a staple of traditional health practices for centuries. The Curcumin in Turmeric is what gives it its antioxidant power.* The Turmeric in our product is specifically designed to provide the most optimal levels of Curcumin available.
CAN WE GET ENOUGH TURMERIC FROM FOOD?
GIVEN THERE IS A RANGE OF OSTEO BI-FLEX FORMULAS, HOW DOES A WOMAN KNOW WHICH ONE WILL BE MOST EFFECTIVE FOR HER?


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Het Stade Omnisport Marien Ngouabi d'Owando is een multifunctioneel stadion Owando, een stad in Congo-Brazzaville. Het wordt vooral gebruikt voor voetbalwedstrijden. In dit stadion worden thuiswedstrijden van AC Léopards gespeeld, een club die uitkomt in Premier League. Ook het nationale elftal speelt hier wel eens internationale wedstrijden. In het stadion kunnen 13.037 toeschouwers.

Het stadion is vernoemd naar Marien Ngouabi (1938–1977), voormalig president van Congo-Brazzaville.

Sportaccommodatie in Congo-Brazzaville

redpajama_set_name: RedPajamaWikipedia


Listed below are homes for sale in Canyon Creek, a neighborhood of Granbury, TX, updated daily from the MLS. For more details about any of these Canyon Creek homes for sale, click the "Request More Information" button on the property detail page of each listing. We can provide you with past sales history, disclosures, dates and prices of homes recently sold nearby, and more.
The waterfront community of Canyon Creek is very unique and rustic! Most of the waterfront properties have deep water at their shores as this community sits right on the main river channel. Canyon Creek waterfront is truly unique in that the south bank shelters the lake from the wind, making this smooth waterfront the ideal place to wakeboard. Clear of flooded timber, the large bay area is deep and wide giving you tremendous views, and opportunities for many lake activities!


Machine learning has taken a significant role in many data initiatives today. Facebook, for instance, is using machine learning to offer personalized ads, whilst Google uses it to learn about its users, and other technology companies are now able to crunch data in a fraction of the time.
Organizations have been looking at machine learning as something that has the most use in looking at optimizing its current markets, but this may not be the case for too much longer. Several companies are now using machine learning combined with predictive analytics to help expand into new markets and exploit opportunities as soon as they come up.
We heard about this from Wolf Rendall, Data Scientist at Auction.com, at last year's Social Media & Web Analytics Innovation Summit. He discussed how machine learning is now taking a leading role in helping to predict locations, times of the year, and other aspects that will affect the housing market and hence have an impact on the site. He was finding that some areas of the site were drying up, while others were being flooded by houses; and whilst some houses were very popular, it meant that others were being ignored.
To fix this, the team at Auction.com looked at trying to create a recommendation engine, similar to that used by Amazon. However, rather than looking at what might compliment what had previously been bought, it was looking at substitutes for what may have been missed. By looking at significant amounts of user data, it was possible to create personalized recommendations based on a number of factors, creating a far more robust and useable system.
Looking at a broader dataset allows companies to make powerful predictions, and when additional data sources are factored in, they become incredibly powerful.
A prime example of how powerful machine learning can be leveraged is in Utilities industry.
By studying the use patterns of specific areas or even individual customers, it is possible to predict the services they could most benefit from to both save them money and improve environmental issues. Drawing in information from the growing number of smart meters could see utility companies creating one terabyte of new data per day. This could even be mixed with other forms of data, such as heat readings from particular areas indicating poor insulation, or faulty electrical appliances. Companies like BuildingIQ, WegoWise, and Ecova have helped companies save millions of dollars by using this kind of data, and with more available, the market for this kind of work is only going to grow.
Another potential area where this can have a big impact is in Healthcare, where machine learning can help to identify where new healthcare facilities should be placed or where specific units could operate most effectively. For instance, Additive Analytics have been working on a machine learning model to help predict hospital readmissions and trying to predict emergency room admissions before they happen. If this could be used across a population, detailing where people come from for specific treatments, it would be possible to strategically place healthcare facilities where they are most needed, giving better patient care and creating better ROI for invested companies.
Similarly, using machine learning and predictive modeling to identify when people with specific conditions are most commonly admitted may allow hospitals to be best prepared for any potential influx of patients. By doing this, healthcare providers drive better care for patients whilst also cutting down on the potential costs of hiring in temporary staff or bringing in full-time staff when they would be under-utilized.


8 Round area Rugs Beautiful Rizzy Home Volare Grey Border Hand Tufted Wool 8 Ft X 8 is free HD wallpaper. This wallpaper was upload at April 16, 2017 upload by in .
8 Round area Rugs Beautiful Rizzy Home Volare Grey Border Hand Tufted Wool 8 Ft X 8 - We hope that , by posting this 8 Round area Rugs Beautiful Rizzy Home Volare Grey Border Hand Tufted Wool 8 Ft X 8 , we can fulfill your needs of inspiration for designing your home. If you need more ideas toSpecial Values - Rugs - Flooring - The Home Depot, you can check at our collection right below this post.


The Bush administration continues to push the more "research" smokescreen rather than commit to solutions that would reduce greenhouse gas emissions and ways that we can somewhat, at least, help us to avoid or adapt to the effects of climate change. We may, though, have a congress that is creative enough and has the political will to actually act in our best interest. We can hope. This This Modern World cartoon by Tom Tomorrow is especially relevant.
WASHINGTON, DC, July 30, 2001 (ENS) - U.S. Environmental Protection Agency Administrator Christine Todd Whitman says the Bush administration will address the problem of global climate change and greenhouse gas emissions by pursuing an approach that stresses research. Market based solutions, technology transfers to developing countries, and increasing cooperative research efforts with allies are also part of the plan.
"These efforts have recently borne fruit, particularly recent agreements with Japan and Italy to collaborate on climate modeling efforts and with El Salvador in a 'forest-for-debt' swap that will preserve tropical forests there that sequester carbon," she said in testimony before the Senate Environment and Public Works Committee. The United States declined to support the Kyoto Protocol, an agreement reached by 178 countries in Bonn July 23. The supplement to the United Nations climate treaty calls for industrial nations to reduce their greenhouse gas emissions an average of 5.2 percent below 1990 levels by 2012.
Whitman reiterated the administration's concerns about climate change. "The administration ... will leverage our national resources to enhance our scientific understanding of global climate change, and develop the advanced energy technologies that the world will need in coming decades to meet its energy and environmental needs."
The Bush administration will introduce legislation later this year to reduce major power plant pollutants, hoping to achieve public health and environmental benefits, she said.
The proposed legislation would require for reductions and a cap on emissions of nitrogen oxide (NOx), sulfur dioxide (SO2) and mercury.
Whitman said the nationwide coordinated reduction of these three pollutants would result in thousands of avoided premature deaths, visibility improvements over large areas including national parks and wilderness areas, and recovery of many freshwater and coastal ecosystems.
The proposed legislation will not limit power plant emissions of carbon dioxide - a key greenhouse gas blamed for global warming.
The hearing July 26 was the first in a series of three or more hearings that will explore how air pollution from energy use affects public health and the environment, said the new committee chairman Senator Jim Jeffords.
A former Republican who changed the balance of power in the closely divided Senate when he resigned from the Republican Party to sit as an independent in May, Jeffords was critical of the Bush administration's global warming policy.
"Unfortunately, the President's policy backs away from a commitment to address carbon dioxide emissions from power plants. I am disappointed about that and the administration's position on the Kyoto Protocol. I am disappointed in the administration's approach to climate change and specifically their refusal to constructively engage the world in a solution," he said.
The administration can refuse to commit to the Kyoto treaty, withhold offering its own alternative to the framework outlined in the treaty, and reduce funding for implementing climate change reduction programs. "That is their choice," Jeffords said.
"But this Congress, this Senate, and especially this Committee will not let our international partners down. We plan to take steps to reduce our nation's contribution to this growing problem by working with industry to reduce carbon emissions," he pledged.


text:
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redpajama_set_name: RedPajamaCommonCrawl


I've always said that having a skin condition such as eczema shouldn't limit you from living your life. However, for some, it does. Especially if the medicine you're taking isn't working, or your flare-up is so bad it lands you in the hospital. Despite the fact that eczema patients are highly alert when it comes to taking care of our skin, we often overlook our work environment. Considering we spend most of our lives working, this is something that should be a top priority.
As someone who's heard too many stories about this, I thought it was important to educate those living with eczema about filing disability in the workplace. ADA, otherwise known as The Americans with Disabilities Act of 1990, is a law that protects discrimination against individuals with disabilities. If you feel that your skin is debilitating to the point where it's affecting your work, then this guide is for you.
If you have a disability, yet are qualified to work, ADA protects you from job discrimination due to your disability. The ADA is to protect qualified, disabled persons from discrimination and to make sure that people with disabilities have the same rights and opportunities as everyone else.
Important to note - you must first be qualified for the position, even with your disability. That is, you must satisfy the employer's requirements for the job. You also must be able to perform the functions of the job with or without reasonable accommodations.
Securing disability rights for eczema may require a little more effort on your part than other kinds of disabilities since the condition is still not widely understood. Your doctor can help you determine whether or not you should apply, but here are a few questions you can ask yourself to determine your next steps.
How severe is your skin condition? Try to define it. You should always be paying attention to your skin. If you find yourself in excruciating pain due to your eczema, that's a problem that could be affecting your work life.
What is the frequency of your flare-ups? Keep a good record of them as well as how many times you have you gone to see a doctor in the last month.
What is your work environment like? Are there factors that contribute to your symptoms?
Do your research. For those that are entering the workforce or are switching careers, do your research. Read thoroughly through the job description and company website. If you are signing a contract, it's extremely important to read the disability section and also disclose your disability if you qualify.
Understand your environment. For example, if you're working in an old office building that is plagued with dust mites, this might contribute to your flare-ups.
Explore your options. If you're someone that loves your job but has a difficult time in the work environment, see if there are work-from-home options or other accommodations that would ease your symptoms.
Ask your doctor. Most importantly, ask your doctor if you think you'll qualify for disability based on your symptoms and/or frequent flare-ups.
Please note that ADA isn't the only form of disability, as there are more options including extended leave.
Having eczema shouldn't prevent you from pursuing meaningful work or limiting your productivity. It's 2018, and it's time to protect yourself and teach others that they can coexist with a NON-CONTAGIOUS skin condition!


The Point offers a blank and intelligent canvas to inspire creativity and can host a wide range of events including dinners, conferences, exhibitions and much more.
With natural daylight and panoramic views of the world famous cricket pitch, The Point is a great place to do business.
Sitting next to the Pavilion at Emirates Old Trafford, The Point's enormous seven-metre windows allow unrivalled and unimpeded panoramic views of the world famous cricket pitch. Highly customisable, The Point is the perfect place to entertain delegates or guests with our exceptional standards of hospitality.
Whether you're planning a conference, exhibition, wedding or an exciting product launch, then our team of experts is ready to deliver an unforgettable experience for you and your guests. Large, full of light, versatile and modern, The Point is an organiser's dream venue. Our luxurious facilities include the Mezzanine and private bar that can cater for all events big and small, hundreds or a handful. There's even a full length balcony, meaning your guests can enjoy the fresh air in between activities.
The Point has a sit-down dinner capacity for up to 1,000 guests – or 850 with a dance floor. Conference and exhibition capacity is also 1,200. The space is sub-divisible into three areas, ideal for large events that need separate rooms or smaller functions. The Point can be easily combined with our Pavilion via the bridge link or for larger events that need extra break-out space.


Budget Electronics is Canada's largest online cell phone accessories wholesaler. We provide screen protectors, cases, headsets, chargers and many other popular products - all available to be ordered online by wholesale customers.
HotVapes has been distributing electronic cigarette hardware and manufacturing eliquid since early 2010. As a charter member of AEMSA (American Eliquid Manufacturing Standards Association) HotVapes believes that quality is paramount. Please visit us.
Portable/Mobile Coin Organizer - holds up to $12.00 in Canadian or U.S. coins. Perfect for car, knapsack, lunch box, laundry, parking, purse, pocket, office or school.
We provide great deals on Quality Kitchen Essentials. Visit our online store to buy great quality kitchen accessories and equipment at a very reasonable price. We ship all over Canada.Shop all popular brands (Breville, All Clad, Saeco, etc) from us.


Pacifica Senior Living Palm Beach is a memory care provider in Greenacres, FL. The staff at Pacifica Senior Living Palm Beach provide supervision and are able to remind residents to attend to activities of daily living such as grooming and toileting. Staff are on service 24 hours a day. There are activities appropriate for seniors with Alzheimer's disease and dementia that help keep residents active and engaged. Pacifica Senior Living Palm Beach was designed specifically to provide memory care. It is a secured property. Residents who are prone to wandering can be accepted. Pacifica Senior Living Palm Beach may allow residents to keep a dog or cat. Pet care is provided. At Pacifica Senior Living Palm Beach, you can rest assured because nurse is on staff and a doctor is on call. Devotional services are provided to residents.
If Pacifica Senior Living Palm Beach isn't quite what you're looking for, take a look at a few other nearby communities that might be a better match.
We could not be more pleased with the quality of care our mom has received at Pacifica. The staff is awesome, the room is homey. The food is amazing and the grounds are gorgeous.
I knew it was time to start looking for my parents. I chose Pacifica because I happen to live in Lake Worth. I toured the property and I was extremly impressed with what I saw. The cottages were... Read the full review.
It was time to start looking for my father. The memory loss was increasing I visited Pacifica and was extremely impressed with the atmosphere and moved dad in.
This is very hard for me. I know my parents need a secure community for their safety. But I am an only child and I am not doing very well handling this. But Pacifica is definetly helping me deal... Read the full review.
My mother has now been at Pacifica for 2 months and we love it! My brother is moving up to New Jersey and discussed moving my mother. Yet upon checking similar living facilities as Pacifica in... Read the full review.


text:
Jeff Carter
Anthony Meier, Candida Alvarez, Judith Russi Kirshner, Susanne Ghez
Jeff Carter lives and works in Chicago, IL. He is a Professor in the Department of Art, Media and Design at DePaul University. Jeff earned his BFA at the University of Colorado, Boulder (1992) and his MFA at The School of the Art Institute of Chicago (1998), where he received a Trustee Scholarship.
Jeff has exhibited his work in Chicago at the Museum of Contemporary Art, the Renaissance Society, and the Chicago Cultural Center. His work has been included in group exhibitions at the Hayward Gallery, London, UK; the Kunsthalle Hamburg, Hamburg, Germany; the Kaohsiung Museum of Fine Arts, Kaohsiung, Taiwan; and the Lewis Glucksman Gallery, Cork, Ireland. His solo shows include Kavi Gupta Gallery, Chicago, IL and Leipzig, Germany; Spencer Brownstone Gallery, New York, NY; and The Mission, Chicago, IL. His work was recently reviewed in Art in America and profiled in the 7th edition of Bauhaus Magazine.
jeff-carter.net/html


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AN INDO-PORTUGUESE ALTARPIECE (RETABLO) WITH CHRIST ON THE CROSS
Goa (?) 17th/18th century
The altar carved and giltwood, with Christ's figure in carved and polychrome ivory under a domed hood, behind him the shining light of God, decorated with many angel-heads on the baroque style columns.
H. 96 x W. 58 x D. 17 cm
H. 41 cm (Christ)
In the 17th century images of the columns made by Bernini for the canopy of Saint Peter were available in Goa and were an inspiration for carvers there. The ivory Christ with the veins clearly visible and the thin split beard is like other examples from Goa. Behind the cross a town is visible and at the foot of the cross, among rocks of the Calvary mountain is a skull and a crawling snake.
The Portuguese really tried to convert the population on the whole of the Indian subcontinent. At one point they even thought they could convert the Great Mughal emperor Akbar. However, Akbar attempted to reconcile opposites in the religious realm as he did in the political field, by promoting a new religion encompassing Islam, Hinduism and Christianity. In Goa, on the other hand, the centre of their presence in India, the Portuguese did build many churches and destroyed the Hindu temples to show the superiority of their new religion. Therefore woodcarving and the production of religious images in wood and ivory became important trades in Goa.


CB Robinson has been acquired by Tully Legal Corporate Solicitors Dublin, please visit the new site at www.tullylegal.ie to get in touch with Conor.
Debt Collection, debt recovery or loss mitigation: what ever you want to call it, it is a crucial element to any business. Without a healthy cash-flow your business is destined to struggle. Having proper debt collection systems in place will ensure a healthy cash flow for your business. Maintaining a healthy debtor's ledger is not only essential in maintaining a healthy business, it can be the difference between success and failure. At a time when every business is experiencing more pressure than ever in collecting money that's owed to it, CB Robinson is offering prompt service in the recovery of debts. Dublin solicitor firm CB Robinson & Co. can assist you in realising debts owed to your company.
How long does debt collection take?
Depending on the amount of money owed to your business, CB Robinson Corporate Solicitors can in some cases collect monies owed in a matter of weeks. In some cases, however, it is necessary to issue court proceedings in order to obtain a judgment that can be enforced quickly and efficiently.
How much do debt collection services cost?
This can cost from as little as €35.00 + vat per letter.
NO hidden charges; All our fees will be agreed upfront.
Contact us today for a free no obligation discussion and tailored fee quotation to suit your requirements.
For further information on debt collection services please feel free to contact a member of our debt recovery team. Also feel free to explore the below links which will provide you with further information on the debt recovery process.


text:
import numpy as np
import healpy as hp
import matplotlib.pyplot as plt

# create a RA and Dec grid
ra_all = []
dec_all = []
for ra in np.arange(0, 360, 0.5):
    for dec in np.arange(-90, 90, 0.5):
        ra_all.append(ra)
        dec_all.append(dec)

ra = np.array(ra_all)
dec = np.array(dec_all)

# convert RA and Dec to phi and theta coordinates
phi = ra * np.pi/180.
theta = (90.0 - dec) * np.pi/180.

# to just plot all points, do
hp.visufunc.projplot(theta, phi, 'bo')
hp.visufunc.graticule()
# more examples are here
# https://healpy.readthedocs.org/en/latest/generated/healpy.visufunc.projplot.html#healpy.visufunc.projplot

## to plot a 2D histogram in the Mollweide projection
# define the HEALPIX level
NSIDE = 32

# find the pixel ID for each point
pix = hp.pixelfunc.ang2pix(NSIDE, theta, phi)

# select all points above Dec > -30
pix_unique = np.unique(pix[dec > -30])

# prepare the map array
m = np.zeros(hp.nside2npix(NSIDE), dtype='u2')

# tag the map array with pixels above Dec > -30
m[pix_unique] = 1

# plot map ('C' means the input coordinates were in the equatorial system)
hp.visufunc.mollview(m, coord=['C'], rot=(0, 0, 0), notext=True, title='', cbar=False)
hp.visufunc.graticule()

plt.show()

redpajama_set_name: RedPajamaGithub


Please read the guidelines at the bottom.
If required, add a code example or a link to a working example (repository).
List all packages that have been changed.
> You can also run `yarn run check` to run all 4 commands at once.
If one of the following checks doesn't make sense due to the type of PR, just check them.


text:
5⃣ Best Jane Austen's Pride and Prejudice Retellings!
Last updated on January 21, 2023 By Naomi Nair
Who doesn't love classics! The unique cultural settings, engrossing plots, interesting characters, and timeless appeal truly make these the best of books the world of literature has ever seen!
Best Pride and Prejudice Retellings!
Of the many classics I have read, the one book I can never get enough of is the hilariously adorable evergreen novel of Jane Austen that most book lovers have unanimously dubbed as a must-read of all time! I'm sure you have guessed it by now. Yes, I am talking about 'Pride and Prejudice'. Originally published under the title 'First Impressions', Jane Austen herself describes this novel as her "own darling child". Of course, every book is precious to an author who painstakingly creates magic with their words, choosing with care the characters and the plot that makes the read an interesting and entertaining one. But it looks like Pride and Prejudice had a special place in Austen's heart the way it does with the millions of readers who have read it, including me. You can get the book here! 📖
Come to think of it, it's been 200 years since the book first opened to highly favorable reviews, and yet, even today, it remains one of the most cherished reads worldwide! So what makes this book special? Yes, the dreamy Mr. Darcy, most definitely. Although he does come across as being standoffish and arrogant at the beginning of the novel, he goes on to steal the hearts of every reader in the way he transforms himself and becomes humble and kind to win Elizabeth's affections. But the success of this novel cannot be attributed to Mr. Darcy alone (although he does play a huge role in it!). It is a combination of the seemingly trivial but indispensable details that came together so beautifully, like the dramatic plot settings involving the hysterics, hypocrisy, and scandal, the whole host of complicated and highly flawed characters, be it the Bennets or Bingleys, the portrayal of class and gender which forms the subtext of the book, and the use of simple but effective figurative language brimming with satire. In fact, we are introduced to her irony and humor in the very first sentence, which remains one of the most original and spellbinding opening lines in the whole of English literature.
15 BEST + MUST-READ Books For Entrepreneurs! 📈 💰
The Order In Which You Should Read Harry Potter Books! 📚
"It is a truth universally acknowledged that a single man in possession of a good fortune, must be in want of a wife."
If you are a true Pride and Prejudice fan like me, you already know these lines by heart. The novel is so loved and enjoyed that it has been adapted and retold by many different authors in many different ways, each spinning their own take of Lizzie and Darcy in truly hilarious ways. And while no retelling can ever hold a candle to the original, it does make for some delightful reads.
🤔 Are You Curious: Why Is "Pride and Prejudice" Still So Popular Even After Two Centuries?
So, of the many adaptations of this evergreen classic, I bring you the Top 5 retellings; they are creative, they are full of life, they are told from multiple points of view, but above all, they come with incredulously large doses of the Darcy – Lizzie titbits and appeal that we readers can never get enough of!
Eligible by Curtis Sittenfeld
"I take it you don't believe in love at first sight." "Does anyone over the age of thirteen? Do you?" "I don't, no," Darcy said. "But I don't rule out for others what I haven't experienced firsthand." ― Curtis Sittenfeld, Eligible
A modern-day version of the classic novel, this book is an absolute treat from start to finish. This one features Lizzie as a magazine writer and Jane as a yoga instructor living in New York City. When their father, Fred Bennet, suffers a heart attack, the sisters rush back to their home at Hyde Park in Cincinnati to care for their father and take charge of his health and home. Soon fate brings Fitzwilliam Darcy, Chip Bingley, Willie Collins, and Jasper Wicks into their lives, and how each of their lives gets entangled with one another forms the rest of the story. Since the plot follows the original closely, much of the events are already known to the reader. However, Curtis Sittenfeld adds a couple of twists and turns of her own, taking the readers by surprise. In a world led by smartphones and dating apps, and cryopreservation, finding a soul mate is a whole new ball game altogether! You can get the book here! 📖
Pride, Prejudice and Jasmin Field by Melissa Nathan
Melissa Nathan is one of my all-time authors. A true Jane Austen fan, she modeled two of her popular novels on Austen's classics. Unfortunately, she died tragically at a very young age, but not before making her mark in the literary world. Her novel, Pride, Prejudice and Jasmin Field, was an instant bestseller and was well–received by readers all over the world.
Everyone knows that Harry Noble, Britain's heartthrob and popular Academy Award winner, along with being a brilliant director, is also unreasonably haughty and scornfully arrogant. But never did Jasmin Field, a happily single journalist working for a popular woman's magazine, expect him to be so disdainfully rude as to call her "the ugly sister" behind her back when she arrives to audition for the stage performance of 'Pride and Prejudice', a play to be directed by none other than Harry Noble. Fuelled by anger, she performs her role impeccably, where to her absolute surprise, she gets cast as Elizabeth Bennet. But with Harry Noble's comment stewing inside her mind, she is quite determined to teach him a good lesson or two during the rehearsals. Full of quirky and amusing British slangs and phrases, this is a book that you will not be able to put down! You can get the book here! 📖
An Assembly Such As This by Pamela Aidan
"She is tolerable, but not handsome enough to tempt me." ― Pamela Aidan, An Assembly Such As This
So we all know how the story pans out from Elizabeth's point of view. Her feelings about marriage, love and Mr. Darcy are made quite clear from the many conversations she has with her sisters and friends at various points in the story. But have you ever thought about how Darcy would have felt attending the Netherfield Ball and meeting the Bennet family, or why he thought keeping Bingley away from Jane was imperative? Well, this book gives you a chance to get into Darcy's mind and be privy to his innermost thoughts as he navigates his way through the many events and situations that brings him closer to Lizzie. While this book has met with mixed reactions and reviews from many readers, it does make for an engaging read, considering how the whole story has been told from the swoon-worthy Darcy's POV. You can get the book here! 📖
Ayesha at Last by Uzma Jalaluddin
The beauty of Pride and Prejudice is that the central theme of the novel is so universal that it can be applied to any culture or country. When marrying daughters on time and finding 'well–settled' sons-in-law is a common concern for most Asian mothers, Ayesha At Last by Uzma Jalaluddin offers a beautifully written and humorous take on the theme with Ayesha and Khalid as central characters. Ayesha's progressive thoughts clashing with Khalid's traditional mindset have been brought out really well by Ms. Jalaluddin. And like Eligible, this book comes with sudden unexpected twists that truly elevate the story! A must, must-read, in my opinion! You can get the book here! 📖
Pride and Premeditation by Tirzah Price
There are so many amazing adaptations that I was quite conflicted as to what final book I should include in my list when quite serendipitously, I happened to read the newly released debut novel 'Pride and Premeditation' by Tirzah Price. Truly, what a book! What makes this novel different from the rest is the murder mystery element presented in it. A classic combined with a thriller; trust me, it doesn't get better than that! In this novel, Lizzie Bennet and Darcy are seen solving a murder set in erstwhile London while battling complicated feelings for each other. A cleverly woven storyline with enough unpredictable twists told in a witty and hilarious manner; this book makes for a wonderful page-turning experience! You can get the book here! 📖
So, there you have it! Some of the most terrific and brilliantly written reimaginings on Pride and Prejudice! Which one are you inclined to read first? Do let me know in the comments!
Tagged Jane Austen
Naomi Nair
Naomi Nair is a passionate bookworm who actualizes in writing and looks to words to help her make sense of the world. She sees life as a long lesson punctuated by impactful insights and is devoted to exploring and experiencing the big adventure one book at a time.


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Building plans are extremely necessary from the very first level of construction all the strategy to the end and if they aren't ready properly there might effectively be problems in the constructing course of. The building plans can also embrace a list of specifications that can cite what supplies and strategies should be used throughout the construction course of. Their function is to work as a team to make sure that the building is secure, game room floor plan useful and that it fulfils the designer's needs and wants. Even the most typical low-odor alkyd paints typically used in the present day to repaint wood work can have a lingering odor for days under the most ventilated situations. 6. Refresh your supply of onions in water because the old ones may have had their fill of vapors by the time your finished the painting. Cut up a few onions and place them in a few bowls of chilly water. The homeowner's Nanny, who was moving into the bedroom next door (and who was also troubled by the smell) used a few bowls of reduce onions in cold water over night time and the odor was gone the subsequent day.
Once the ideas have been determined the plans will then be sent to the mechanical, electrical and structural engineers who will then look over them. If the building plans are accurate and thorough sufficient then the building course of must be just about straightforward and plans make it more possible that the client can be satisfied at the top of the project. Building plans can fluctuate from a single fundamental sketch to a mass of pages detailing each little a part of the construct; all of it will depend on the size and scale of the job. The plans are prepared by architects and engineers and provides an total image of what the finished product should appear to be whilst appearing as a blueprint to be followed throughout the development course of. The advantage of having written plans is that it is less complicated to keep away from miscommunication inside the team and between the architect and the developer.
The architect will act as a go-between between the engineers and likewise as a channel of communication between the proprietor and all the other various members of the design crew. The painting of this room concerned a whole lot of priming to cowl the darkish brown oil paint used by the earlier home owner. The job required a whole lot of smelly primers and sealers to bury a long time of neglect and water injury. As was customary in those days, I added vanilla extract to attenuate the paints' odor (and damage to my mind cells) but the smell wasn't clearing up quick sufficient to deliver the newborn in. Alkyd (oil-primarily based) and shellac or alcohol primers are especially efficient in sealing water harm and previous oil painted surfaces to improve them to Latex high coats. The dangerous information is there are still so many reasons to make use of the smelly stuff, particularly if you're repainting an older residence.
And as it turned out, the baby was born about two weeks early and was ready to come back residence just as I used to be ending the venture. I had spent about 5 weeks changing a badly crumbling and dusty outdated attic room right into a nursery pending the child's delivery. 1. Before you paint, empty the room utterly to ensure there may be nothing that may entice the odors. Homeowners, particularly these with small children, often ask me the right way to do away with paint odors. 7. Keep the windows open and wait until the paint has fully dried and the odors have gone earlier than you substitute the furnishings and other belongings. Before there was such a thing as "low odor paint" we used to add a splash of vanilla extract to each gallon of oil paint to make it "low-odor". Of course, the following pointers are supplied in connection with inside painting however you also needs to try adding some vanilla to your paint when painting the exterior in Alkyd coatings as effectively. Some people are highly allergic to the VOCs (risky natural compounds) contained in paints and the tints used to colour them.
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TORONTO, June 04, 2018 (GLOBE NEWSWIRE) -- Euro Sun Mining Inc. (TSX:ESM) ("Euro Sun" or the "Company") reports that the Company has amended its portion of the joint proposal with Lundin Mining (TSX:LUN) to acquire Nevsun Resources (TSX:NSU) to include CDN$150 million in cash and CDN$150 million in ESM stock. The Company encourages Nevsun's management and Board of Directors to engage as it is in the best interests of all stakeholders. The total proposed consideration of CDN$5.00 per share for the acquisition of all Nevsun stock includes CDN$150M cash from Euro Sun and CDN$600M cash from Lundin Mining along with CDN$150M in Euro Sun stock and CDN$600M in Lundin Mining stock. Euro Sun's stock portion only represents 10% of the total consideration in this proposal.
Since making the proposal public on May 7th, 2018 numerous meetings have been held with shareholders of Nevsun, both in person and via teleconference. To date shareholders representing over 30% of Nevsun shares outstanding have expressed support for the Euro Sun led offer and encourage all parties to actively engage in a friendly transaction.
The Rovina Valley Project is one of the largest mineral deposits on the Western Tethyan mineral belt and consists of three porphyry deposits: Colnic and Rovina, and Ciresta, The project hosts measured and indicated mineral resources of 7.2 million ounces of gold and 1.4 billion pounds of copper in 406 million tonnes at 0.55 gold grams per tonne and 0.16% of contained copper.
Euro Sun is the first mining company to be granted an exploitation license without a state partner. Ratification of the mining license is expected to be completed with signatures from the required ministries shortly and this ratification will demonstrate a clear mandate for mining by the Romanian Government.
The scientific and technical information presented in this press release has been reviewed and approved by Randall Ruff, Vice President Exploration for Euro Sun, who is a Qualified Persons as defined by National Instrument 43-101.


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ALTD Diaries #003
This month, the ALTD team had a chat with Joel Moore AKA Mulga the Artist, a Sydney based artist, freelance illustrator and poet who paints murals, designs t-shirts and runs the Mulga brand. Mulga tells ALTD how he has never had a drink in his life, and nor has his Dad, and what it was like growing up in a country that places alcohol at the centre of its culture...he also explains that he doesn't like cucumber but he does like tzatziki....OK
Please tell us a bit about your work & what you do
I'm an art dude and I like to paint summer inspired characters and scenes focusing on animals, bearded dudes, fruits with moustaches and other good stuff like that. I paint a lot of murals, collaborate with brands and also design and sell my own range of merch.
What are you working on at the moment?
I just finished a long run of murals and have recently finished putting designs together for collabs with a few brands coming out next year. Some collaborations have just been released with Maxwell and Williams and Havaianas which is exciting. I also recently opened a pop-up shop at Westfield Miranda which we open every Christmas, it will be open till 19 January 2020. I also have a small team working on taking my art to Japan, China and Korea. Lots going on.
Is it true you have never had an alcoholic drink, ever? (awesome by the way)
It's a true story.
Can tell us a bit about why that has come to be?
My Dad said his Dad said to him that if you never drink then you'll never become an alcoholic. There must have been someone in my Grand Pappie's life who had problems with the drink. Anyhow, my old man has never had a drink (while I've been alive anyway) and I thought that was pretty cool so I decided to follow suit. It's funny because at a party it seems like he's had the most drinks but he's just a lunatic and is high on life.
What was it like growing up in Australia, surrounded by mates presumably that were drinking, and probably encouraging you to drink?
I remember in Year 8 or 9 at lunch time at school all my mates would talk about was how they were going to get grog or what they drunk on the weekend, it was super boring. Sometimes it was pretty annoying especially when an event is based around drinking. I can tell you that fridge to fridges or bucks party pub crawls were pretty boring when not drinking and going to the pub is not appealing also. Having to drive my buddies around on nights out got old as well. Going to some kind of event where the drinks are included sucks as well, I get to pay for everyone else to get on it. Not cool. Our culture is heavily based around drinking and not drinking you do get left out but what can you do.
Aa far as peer pressure went when I was younger I liked being different and had no problems saying no. My mates were constantly were trying to get me to have a drink but it was never a temptation, I hated the thought of being pressured to do something you don't want to do. I just won't do it. I remember I was at a party once and a friend was trying really trying hard to get me to have a sip of his beer I wouldn't do it so he asked if I would dip my pinky finger in. I did that to shut him up.
Does your not drinking surprise people?
It does every time, most people don't know anyone who has never had a drink, it's just the weirdest thing to them. When I get pulled over for a RBT I never answer the question ''Have you had a drink tonight' with 'I've never had a drink' because they never believe you.
On Friday night your go-to drink is a.. Diet Ginger beer.
Favourite alcohol-free drink?
Share something that most people don't know about you
I don't like cucumber but I do like tzatziki.
You have and are working with amazing brands. Do you have a Favourite collaboration? What makes for a great brand collaboration?
Yes, I've been very lucky to work with some cool brands. Making some art for Slurpee cups was really cool and in some 7/11's my art is wrapped on the slurpee machines or printed on the windows of the shop. That collaboration has been the biggest in terms of reach and awareness. When it first came out when I would go to 7/11s and I was a bit excited I'd say to the shop dude that I did that slurpee art but they didn't believe me.
The last track played on Spotify or heard on the radio was?
Heartbeats by the knife. I have a Spotify playlist called Mulga's favourite songs which has some crackers.
Thanks for the chat and keep up the good work, your drinks are delish.


You may have noticed the plaque next to the water table at the Healy Field playground and wondered how and why a group devoted to improvements to a downtown park chose to contribute to a playground renovation in Roslindale.
[The garage] generates the profits, about $8.6 million a year, to pay for the $76 million development of the park-and-parking-lot; its $2.9 million annual operation; its $1 million local tax bill; and, if things go well, a bit extra to contribute to a maintenance fund for neighborhood parks all over Boston.
In this past year Friends of Post Office Square chose accessible play as a priority for their contributions to neighborhood parks. Their leadership group consulted with the Boston Parks and Recreation Department to learn about projects where accessible play equipment could make a difference to a community. BPRD suggested Healy Field because of the department's ongoing efforts to expand play opportunities throughout Roslindale as well as the strong local support for accessible play.
At Roslindale Wants to Play we are deeply appreciative of Friends of Post Office Square's contributions to Healy Field, which we have previously suggested was the park where a playground renovation could have the greatest impact. We have been thrilled with the outcome of the renovation and we hope that our friends downtown realize how well-loved the new playground has already become. And perhaps the next time you visit Norman B. Leventhal Park (or park your car beneath it) you will have a greater appreciation for the organization responsible for its existence.


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Vol 5, No 6 (December 2015) /
Prof. Randall Starling: left ventricular assist device therapy for advanced heart failure
Submitted Apr 21, 2015. Accepted for publication May 13, 2015.
doi: 10.3978/j.issn.2223-3652.2015.05.07
Prof. Randall Starling, MD, MPH (Figure 1), is Head of the Section of Heart Failure and Cardiac Transplant Medicine, the Medical Director of the Kaufman Center for Heart Failure and a Staff Cardiologist in the Robert and Suzanne Tomsich Department of Cardiovascular Medicine. He also serves as Vice Chairman of Cardiovascular Medicine, Operations. His expertise has been focusing on congestive heart failure, cardiac transplantation, cardiomyopathy and mechanical circulatory support devices.
Figure 1 Professor Randall Starling.
Prof. Starling has been a main investigator on numerous clinical trials, including National Institutes of Health (NIH) grant-funded trials and numerous industry-sponsored trials. He has published over 300 articles scientific and professional journals and authored numerous chapters in related medical textbooks.
During April 10th-12th, 2015, the 17th South China International Congress of Cardiology was held in Guangzhou Baiyun International Convention Center, China. Prof. Starling was invited to present a lecture on "Left Ventricular Assist Device Therapy for Advanced Heart Failure". I was honored to meet Prof. Starling after his speech and invited him to share his expertise regarding left ventricular assist device (LVAD) as treatment for advanced heart failure.
CDT: Mechanical circulatory support is now a well-known therapy for patients with advanced heart failure and cardiogenic shock. What is the impact of mechanical circulatory support devices?
Prof. Starling: Mechanical circulatory support has been used for over 20 years. There are two categories. The first one is temporary mechanical circulatory support, which is used when a patient is in the hospital and cannot be discharged. The second one is permanent mechanical circulatory support.
Temporary mechanical circulatory support can be placed percutaneously by a catheter. A catheter-based system can deliver 2-5 L of flow, used in the setting of acute myocardial infarction or cardiogenic shock. It is also applied to complex ventricular tachycardia ablation in heart failure patients and complex percutaneous coronary interventions. The duration is typically from hours to at most 5-7 days. In addition, temporary mechanical support can also be used in patients in cardiogenic shock with chronic heart failure. Because these patients are very ill the goal is to stabilize them; improving renal and hepatic function prior to taking the patients to operating room for durable mechanical support is an important strategy.
For longer term mechanical circulatory support an approved LVAD is implanted by a cardiac surgeon via sternotomy. Such devices used today have percutaneous drivelines. They are very durable and could last for easily 5 years with an external power supply. Normally, patients could be discharged from the hospital in 10-14 days after the operation. Permanent mechanical circulatory support can be also used in patients waiting for heart transplant for months or years, or be offered as a definitive therapy for patients with severe chronic heart failure.
CDT: Could you make a brief introduction about the development of the mechanical circulatory support devices?
Prof. Starling: The first generation LVAD was a large pump. It can deliver up to 10 liters of flow and it has a stroke volume of about 80 cc. The limitations of the first generation pump are stroke, and infection. In addition, the durability of the devices was very poor. The most commonly used device in the United States and Europe was known as the HeartMate XVE pump. But it would last for 18-24 months and then it had to be replaced.
So 10 years ago the HeartMate II, an axial flow pump, was developed. It has an axial rotar that operates at speeds of 8-10,000 rpms. It is silent, light and very durable. However, all pumps with bearings are subject to developing thrombosis within it. To reduce the risk of thrombosis heparin immediately after the implant, as well as chronic treatment with aspirin and warfarin with therapeutic INR of two to three is required. Even when these conditions are met, pump thrombosis may occur and if a patient encounters hemorrhagic stroke or gastrointestinal bleeding that requires stopping or reducing anticoagulation, then the risk may increase.
The pumps we use today are excellent and have saved many lives, but they are not perfect. The newest pumps are developed without bearings and has a system known as magnetic levitation or a hydrodynamic interface eliminating a traditional bearing. Magnets reside in the pump housing itself and suspend the rotar to receive the blood, as well as to generate the force and the flow. It has been used in clinical trials throughout the world. The newest pump would have magnetic levitation and no bearings, which is a significant advance in the field with less complications anticipated. The other area under development that remains unclear is the importance of the continuous flow pump and pulsatility. Continuous flow pumps with reduced pulsatility are suspected to have additional complications related to continuous flow, including gastrointestinal bleeding. Heart failure resolution depends on how well the left ventricle is unloaded and if there is shifting of the interventricular symptom into the left ventricle due to suction from the LVAD. If a continuous flow pump is completely unloading the left ventricle, the aortic valve will never open. Patients can develop fusion of aortic valve leaflets and aortic insufficiency. The newest pumps will have software algorithms to generate pulsatility to maintain the opening of the aortic valve as well as magnetic levitation to eliminate bearings and hopefully pump thrombosis.
CDT: LVADs are more and more used as a bridge to transplantation or as a destination therapy in advanced heart failure patients. Comparing to the optimal medical therapy, what are the advantages and disadvantages of LVAD?
Prof. Starling: The chronic mechanical circulatory support devices are frequently used in the US and Europe. The impact of heart transplantation on patients with heart failure is very small, which is estimated to be about 2-5% of patient in the USA with advanced heart failure. We estimate that 100,000-250,000 adults in the USA have advanced heart failure and less than 2,500 heart transplants are performed yearly. Of those patients waiting for heart transplantation in the United States, over 50% spend time on LVAD before they get a transplant because the waiting time is so long. In many countries in Europe, patients with advanced heart failure receive LVAD and will get transplant if they develop a complication on the LVAD. But if they do well on the LVAD, they will have that therapy indefinitely. Destination therapy has originally been offered in the US, always to patients who are not eligible for a heart transplant. Eligibility for a heart transplant in the US varies from hospital to hospital. Some hospitals base the decision on the age of patients. However, the majority base the decision on the age and overall health of the patient, as far as known diseases, such as diabetes and profound vascular diseases. Such hospitals try to recommend transplant to patients who have the fewer risk factors, expecting to have the best outcome with transplant. So in the US, most of patients who receive destination LVAD are the patients with more comorbidity and less optimal renal function. However, these patients have very few options because chronic inotropic therapy is offered to some advanced patients who have extremely high mortality which is approximately 90% at 1 year and 50% 6 months. Thanks to the LVAD, the survival rate now is 80-90% at 1 year and the quality of life has been improved.
So I think the future of LVAD is extremely bright and encouraging. The further growth and proliferation of LVAD may be related to two major issues. Firstly, it is the reduction in cost, which is now significant. It takes 200,000 dollars for hospitalization and implantation of the device. Secondly, some complications after LVAD that result in hospitalization must be improved with the development of technology. In addition to bearingless pumps, completely implantable system long life batteries and everything inside the body will reduce infection. I believe as long as the cost is down, LVAD will be a major form of therapy throughout the world for patients with advanced heart failure because there is no good medical therapy or device therapy other than inotropic therapy which is applied to a small subset of patients as palliative treatment. Medical therapy and inotropic therapy potentially improve the quality of life but they have a very high mortality rate.
CDT: Considering the limitations of LVADs, who you think is suitable to use LVADs as destination therapy? And when could they benefit from this therapy?
Prof. Starling: The patients with advanced heart failure, who fall into Class IV listed in New York Heart Association (NYHA) Functional Classification, could consider the LVAD. Because, first of all, they have been hospitalized for at least once or twice within the last 6 months for exacerbation of heart failure. Secondly, most of these patients become so ill that they no longer tolerate typical medications including beta-blocker and ACE inhibitor therapy. Finally, some of these patients will develop compromised cognitive and exercise function. Some patients will be asked "can you walk one block?" or "can you walk one flight of stairs?" If the answer is no, they will be told that they have poor quality of life and should be considered for an LVAD. The European Society of Cardiology defines advanced heart failure as the inability to walk 300 m on a 6-minute walk test (6MWT). So the 6MWT is generally used as a screening test. If the duration is less than 300 m LVAD could be an option. The other test commonly to be used is the cardiopulmonary exercise testing, in which we will measure the peak oxygen consumption. If the age and gender stratified peak oxygen consumption is 50% or less than the predicted one, then these patients are considered as having significant functional impairment. Therefore, who is suitable for LVAD is not merely based upon a low ejection fraction, but it is very much based upon a functional limitation which will lead to hospitalization and inability to tolerate standard medical therapy.
It is learned that the highest mortality is seen when patients are medically unstable. For example, if a patient is on mechanical ventilation on an intra-aortic balloon pump, or a temporary percutaneous form or mechanical circulatory support, he/she could have a 30-day perioperative mortality rate of 15-30%. On the other hand, more stable patients who do not meet any of these conditions, typically have a 30-day operative mortality rate at 5%. There is definitely a relationship between the instability of the patient and the time of the operation. So what we like to do is to stabilize and optimize the patients. But we avoid offering the operation to patients with renal and hepatic failure who are critically ill because the mortality rate is high in the surgery.
CDT: Heart failure is a global problem with an estimated prevalence of about 38 million patients worldwide. Although there are some progresses, the prognosis of heart failure is worse than that of most cancers. What could be done to improve the prognosis of heart failure?
Prof. Starling: Prevention through better treatment of coronary artery diseases, hypertension and diabetes would reduce the development of heart failure. I think the most exciting information about heart failure in 2014 is the new medication called LCZ696 that was studied in 8,000 patients with chronic heart failure and the article was published in the New England Journal of Medicine on last September. This trial involved patients worldwide with chronic heart failure with low ejection fraction under 40%. Patients had already received standard medical therapy with beta-blocker, ACE inhibitor and so on. They were randomized to receive enalapril or the new drug LCZ696, a combination of valsartan plus a neprilysin inhibitor.
It is a major breakthrough that this new drug reduces the mortality rate compared to enalapril by approximately 20% and it also reduces the need for hospitalization in these patients by about 20%. So this new drug, which is not yet available in the US but will be in later 2015, could make a big impact on the treatment of heart failure. One of the full stop will be moved out latter. In the US, there are many financial constrictions and limitations related to healthcare. I hope that the insurance company and the government will provide resources for this new medication. Other than prevention, I think that this new medication is the most positive and exciting clinical trial in heart failure in over a decade since the beta-blockers and cardiac resynchronization therapy have made their positive impact.
Plus, we must remember that about half of the patients with heart failure globally have preserved ejection fraction. We know very little now about the impact of medical therapy to be used in patients with preserved ejection fraction. At this point, we have limited experience with the LVAD in patients with some diseases, such as hypertrophic cardiomyopathy and restrictive cardiomyopathy. With respect to LVAD, it has been used in patients with systolic heart failure and for reducing ejection fraction.
CDT: Heart transplantation is said to be a "gold standard" therapy of refractory heart failure, while LVADs have proven to be effective in improving survival and qualities of life. What challenges the multidisciplinary teams are encountering in dealing with advanced heart failure?
Prof. Starling: For LVAD therapy, it does require a significant infrastructure and team to take care of these patients. In the Cleveland Clinic, we implant about 65 to 90 cases of LVAD per year. We have a whole team of physicians and nurses who are trained to perform the LVAD therapy. We have to provide availability of emergency, telephone contact and admissions to the hospital. So the infrastructure and a team of healthcare professionals are very similar in complexity to that of heart transplantation. We also have social workers, pharmacists, dieticians as well as psychologists.
CDT: At first, LVADs were used as bridge in patients who are waiting for heart transplantation, but now they have been used as destination therapy for patients with advanced heart failure. The decision-making process of LVADs has become a challenge both in ethic and clinic. Could you share with us your opinions about the ethical challenges of deactivation of cardiac devices in advanced heart failure?
Prof. Starling: In the US, the requirement of the government and the recommendation for a hospital to implant LVAD is to have a bioethicist as a member of the team. When we identify a patient for destination therapy for LVAD, our bioethicist meets with each patient. The responsibility of the bioethicist is to make sure that the patients have a good understanding of the complexity of the therapy that they agree to. And the bioethicist also tells patients that if the machine or device goes wrong, they may have no further options. So before the operations, patients are encouraged to give consideration, which means many patients will sign a document about whether they want kidney dialysis or mechanical ventilation—the complications after the LVAD. These important documents are referred to as advanced directives.
The other area that we have worked on extensively in conjunction with our palliative medicine team at the Cleveland Clinic is the process of the withdrawal of care. We have done this both with ICD as well as LVAD. For example, if a patient has advanced heart failure with an ICD, the team will have a discussion with cardiologists. And the bioethicist will often see the patient before the electrophysiologist turn off the ICD. They look for proper documentation to make sure the patient understands all decisions. Likewise, for LVAD as far as palliative medicine and bioethics, we request and expect a family meeting with the patient's families and all the doctors involved in the care to make a decision about turning off the LVAD in patients with complications, when everyone agree that the continued use of LVAD is futile and no further options exist.
I think this definitely creates a lot of ethical complexity. Another ethical complexity is whom the devices are offered to. For example, if we see a patient who is extremely elderly such as 85 or 90 years old, the doctors might decide LVAD is not indicated. We will often bring the bioethicist in to have a discussion on it. If a patient has medical complication, there will be disagreement between the doctors, the family and the patient about offering the LVAD to the patient because of the risk involved. In addition, we spend a lot of time trying to analyze the compliance of the patient. We really work hard to make sure that the patient is compliant and motivated and will be involved in his or her medical care. We also want to make sure that he will understand LVAD and be able to look at the controls and alarms. We test patients to see if they know how to disconnect the power and how to change the battery. We have to train the family so they know all of these. In other words, a patient is requested to have a family member or another individual in his house at all time because if a patient becomes unconscious of low battery, he could die unless somebody else could come quickly and change the battery. Lastly, in the US, some of the patients have tobacco use and substance abuse, and they are not eligible for transplant, so they may ask for the LVAD. We typically will not accept patients that are active substance abusers and will request them to go through rehabilitation. All these things create very complex ethical issues.
CDT: Thank you for the interview!
On behalf of the editorial office of Cardiovascular Diagnosis and Therapy, I would like to extend my gratitude to Prof. Starling for sharing his opinion with us. Special thanks also go to my colleague Cecilia Jiang in assistance of transcribing the interview.
Conflicts of Interest: The author has no conflicts of interest to declare.
(Science Editor: Silvia Zhou, CDT, editor@thecdt.org)
Cite this article as: Zhou S. Prof. Randall Starling: left ventricular assist device therapy for advanced heart failure. Cardiovasc Diagn Ther 2015;5(6):488-491. doi: 10.3978/j.issn.2223-3652.2015.05.07
Cardiovascular Diagnosis and Therapy (Print ISSN: 2223-3652; Online ISSN: 2223-3660; Cardiovasc Diagn Ther; CDT) is an open access, peer-reviewed, international English-language journal,...
Phone: +86 20 66355775; Email: editor@thecdt.org


Pinus armandi is one of the most beautiful of the Asiatic Pine species with delicate glaucous long hanging needles. A very decorative moderately sized tree, attractive for its fine foliage and ornamental fruiting cones.
Pinus armandi (familyPinaceae), the Armand pine, David's Pine or Chinese White Pine, is a species of pine native to China, occurring from southern Shanxi west to southern Gansu and south to Yunnan, with outlying populations in Anhui. It grows at altitudes of 2200–3000 m in Taiwan, and ita lso extends a short distance into northern Burma. In Chinese it is known as"Mount Hua Pine".
The scientific name commemorates the French missionary and naturalist Armand David, who first introduced it to Europe. Father Armand David, also known in common names by the French Père David, was a Lazarist missionary Catholic priest as well as a zoologist and a botanist. Father David was one of the first westerners to explore China, and so many plants that we today enjoy were discovered during his missionary duties there. Many plants have been named in his honour, none more deserving than the Dove Tree, Davidia involucrata.


text:
How to Get Educated, Not What to Learn
The Education Department says it has an "education" program to promote "a better quality of life for students."
In reality, the agency's job is to provide money for "cad-related businesses."
The department claims that its Education Department is "providing quality education opportunities to students, and educating the community at large."
The Education Secretary's budget request calls for $2.5 billion for the department, with a $1 billion cut from the Office of Civil Rights (OCR) budget.
That would cut funding for the OCR by 25 percent.
In addition to the $2 billion in cuts, the Ocr includes $3.5 million in cuts from the Department of Health and Human Services (HHS).
The OCR, which oversees federal student aid programs, has been under fire in recent years for its lack of accountability.
In 2012, the government found that it had not adequately implemented its "student success" policy.
In the meantime, millions of Americans had their federal aid cut because of the lack of data on graduation rates, a problem the OCS has been working to address since 2012.
The OCS recently announced a new plan to address the problem of data, saying it would create a new "data-driven" process for tracking progress toward graduation.
But it also recently announced plans to create new "programmatic" funding streams that would funnel the cuts to "programs that serve students in the poorest communities and who are underserved."
That plan also calls for eliminating the OCC's budget, which has been a major source of funding for federal student assistance programs since the 1970s.
A report released by the OCA last week, which was released to the public, shows that the Education Department has already used the OcR budget for more than $1.5 trillion over the past 20 years, and it is responsible for about 40 percent of all federal student support.
The agency has also spent more than 10 years slashing programs and reducing resources to students with disabilities.
It is not surprising, then, that the Ocs budget request has been criticized for "shifting priorities away from ensuring that students can achieve their full potential, and towards prioritizing the needs of the richest students in our country."
The OCA report also shows that while Ocr's proposed cuts are "small and incremental," the department's budget proposal would cut more than half of the programs it funds in the next 20 years.
"The Ocr budget does not provide a credible plan for how to increase federal student enrollment, increase graduation rates or achieve financial accountability for those programs," the Occs report reads.
"Instead, the proposal seeks to provide a range of 'fiscal targets' that are designed to deliver only 'further relief' from the OCLC's current budget."
But it is not just OCR's proposed cut to OCR that is controversial.
It also calls out the Office for Civil Rights for a "significant cut in funding."
In a statement, the department said it was "disappointed by the cuts proposed in the OCRC budget proposal."
The OCC is responsible, it says, for "advocating for student-centered outcomes for students, ensuring that student-led institutions and students have equal access to information and assistance, and supporting students to succeed academically."
The Office for the Protection of Student Privacy also says that the budget proposal "represents a significant reduction in OCR funding."
The office has received more than 20,000 complaints about the OCP in the past five years.
Last year, the federal government paid OCR more than 1 million dollars to investigate and prosecute student fraud.
cad education programsida education program
When it comes to education, a 'no brainer'


As parents, we erroneously believe that the buck stops at providing shelter, clothes, food and a good education for our children. In some cases, we take it a bit further by grounding them in our religions. However, these things are not all that we should do as parents.
Children are gifts who are, more or less, solely dependent on you for their identity. More often than not, who children grow up to be is a direct reflection of the kind of parenting they got.
As you can imagine, it is not merely the clothes, food or schools you provide for your children that shape them. The way you talk to and relate with them generally goes a long way in determining who they become. There is a psychological aspect of parenting that too many of us ignore.
Ideally, it is in the home that children get a true sense of how they are, all they can become through an awareness of their self-worth, which is your duty to instill in them. You see, when they go out into the world, it is their understanding of themselves that helps them decide what to internalize and what to discard.
It is unfortunate that too many of us would rather ignore this hugely important part of parenting in favor of the tangibles. I am not saying those tangible parts are not essential, but even if a high level of self-esteem is all you can give your children then you have done them a world of good.
From today, be mindful of the way you address your children. Correct them in love. Encourage them and build their sense of self-worth in any way you can. Recognize them as individuals deserving of your respect and when they go out into the world, they will demand nothing less.


text:
Elections Have Consequences, Lesson #214
The Dallas Observer's Jim Schutze is a rabble-rouser. Sometimes his rants are spot on. Sometimes not. But he's always worth reading. Dallas needs him. And if you read him with the right squint in your eyes, you could say Richardson needs him, too. His latest report on a vote by the Dallas City Council on a big zoning case at Northwest Highway and the Dallas North Tollway is a case in point.
The Dallas City Council approved 13-0 a zoning change to allow a developer to build "a soaring tower" on 12 acres of land that nearby residents had been assured by the city would be limited to four stories maximum height. According to Schutze, 85% of nearby owners opposed the rezoning. Schutze, who usually defends neighborhoods, says this time it's their own damned fault. There was an election in May. Jennifer Staubach Gates, the council member in whose district the property lies, was re-elected handily.
[Gates] won by a margin of 2 to 1...The district spoke. And Wednesday night when the City Council voted unanimously to support the Gates giveaway, it honored the democratic process the way democracy works at Dallas City Hall, maybe not the way it works in democracy heaven.
Residents of City Council District 13 had one opportunity — a clear opportunity — to defeat the Gates giveaway when they chose between Gates and her challenger, former Dallas Mayor Laura Miller, in the May 4 City Council election. They chose Gates. And that was it. Done deal. The die was cast. No do-overs. When voters of District 13 chose Gates, the incumbent, over Miller, the challenger, they decreed with their ballots...open season for any developer to up-zone any neighborhood.
Source: Jim Schutze .
What does this have to do with Richardson? In Richardson, it was the Palisades development that had the neighborhood united in opposition. There was a hotly contested 2013 mayoral race in which development played a key role. Both candidates said they opposed more apartments near single-family neighborhoods. Laura Maczka was endorsed by the rest of the city council. Maybe she was perceived as getting along better with other council members. In any case, Laura Maczka won. She then voted, along with a majority of the city council that endorsed her, to up-zone the Palisades development, allowing the developer to add hundreds of new apartments.
Clearly, the voters would not put up with it, right? The mayor reneging on an election promise would get her booted out of office, right? Well, no. She ran for re-election in 2015. Not only was she re-elected, she was unopposed. No one even bothered to run against her. If the neighbors were unhappy with her, they weren't unhappy enough to challenge her at the voting booth.
So, which exercise of democracy should we respect? The hundreds of residents who turned out in opposition to the Palisades up-zoning vote in the city council, or the next election when no one even stepped up to oppose the mayor's re-election? I side with Jim Schutze:
The handwriting is on the wall the moment the voters make their choice in a city council election and put a civility type in office in place of a fighter. A vote for civility is a vote for surrender.
The time to protest is not in front of a raucous crowd at a city council meeting. The time to protest is silently, one by one, in voting booths all across the city. Elections have consequences, folks.
Labels: LocalPolitics
Mark Steger
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Ooh! Nice getting in the last word. Look at you!
I must have really hurt some delicate feelings on here... I can't believe you people have nothing better to whine about than an off the cuff remark about how superficial this trailer looked...how long ago?? cowboy and I have had our differences... but I am with him on this one! It seems to have really turned into a "LOOK at ME, LOOk at ME!" scene ...hope you can get over yourselves and get real.Meanwhile...gotta roll!
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text:
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   sInternalValue.setValue( "", 0 );
   dInternalValue = 0.0;
   precision.set( 2 );
   lasttypeset.set( 0 );
}

Groundfloor::BValue::BValue( Groundfloor::BValue *anotherValue ) : Groundfloor::Freeable() {
   setValue( anotherValue );
   precision.set( 2 );

   lasttypeset.set( anotherValue->lasttypeset.get() );
}

Groundfloor::BValue::~BValue() {
}

void Groundfloor::BValue::setValue( const Groundfloor::BValue *anotherValue ) {
   sInternalValue.setValue( &anotherValue->sInternalValue );
   dInternalValue = anotherValue->dInternalValue;

   lasttypeset.set( anotherValue->lasttypeset.get() );
}

bool Groundfloor::BValue::equals( const Groundfloor::BValue *anotherValue ) const {
   return ( dInternalValue == anotherValue->dInternalValue &&
            sInternalValue.match( &anotherValue->sInternalValue ) );
}

Groundfloor::String *Groundfloor::BValue::asString() {
   return &sInternalValue;
}

long Groundfloor::BValue::asInteger() const {
   return static_cast<int>( dInternalValue );
}

double Groundfloor::BValue::asDouble() const {
   return dInternalValue;
}

bool Groundfloor::BValue::asBoolean() const {
   if ( dInternalValue == 0 ) {
      return false;
   } else {
      return true;
   }
}

unsigned int Groundfloor::BValue::asTimestamp() const {
   return static_cast<unsigned int>( dInternalValue );
}

void Groundfloor::BValue::identifyBooleanString() {
    if ( sInternalValue.getLength() <= 4 ) {
       Groundfloor::String tmp;
       tmp.setValue( &sInternalValue );
       tmp.lowercase_ansi();
       if ( tmp.match_ansi( "true" ) || tmp.match_ansi( "yes" ) || tmp.match_ansi( "y" ) ) {
           dInternalValue = 1;
       }
    }
}

void Groundfloor::BValue::setString( const char *sValue ) {
   dInternalValue = 0;
   sInternalValue.setValue_ansi( sValue );

   try {
      dInternalValue = atof( sInternalValue.getValue() );
   } catch ( ... ) {
   }

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      identifyBooleanString();
   }

   lasttypeset.set( FLDTYPE_STRING );
}

void Groundfloor::BValue::setString( const char *sValue, unsigned int iLength ) {
   dInternalValue = 0;
   sInternalValue.setValue( sValue, iLength );

   try {
      dInternalValue = atof( sInternalValue.getValue() );
   } catch ( ... ) {
   }

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      identifyBooleanString();
   }

   lasttypeset.set( FLDTYPE_STRING );
}

void Groundfloor::BValue::setString( const Groundfloor::String *sValue ) {
   dInternalValue = 0;
   sInternalValue.setValue( sValue );

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      dInternalValue = atof( sInternalValue.getValue() );
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   }

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   }

   lasttypeset.set( FLDTYPE_STRING );
}

void Groundfloor::BValue::setInteger( long iValue ) {
   dInternalValue = static_cast<double>( iValue );
   iInternalValue = iValue;

   sInternalValue.setSize( 50 );
   sprintf( sInternalValue.getPointer(0), "%ld\0", iValue );
   sInternalValue.setLength( strlen( sInternalValue.getValue() ) );

   lasttypeset.set( FLDTYPE_INT );
}

__int64 Groundfloor::BValue::asInt64() const {
   return iInternalValue;
}

void Groundfloor::BValue::setInt64( __int64 iValue ) {
   dInternalValue = static_cast<double>( iValue );
   iInternalValue = iValue;

   sInternalValue.setSize( 50 );
   #ifdef GF_OS_WIN32
   sprintf( sInternalValue.getPointer(0), "%I64u\0", iValue );
   #else
   sprintf( sInternalValue.getPointer(0), "%llu\0", iValue );
   #endif
   sInternalValue.setLength( strlen( sInternalValue.getValue() ) );

   lasttypeset.set( FLDTYPE_INT64 );
}

void Groundfloor::BValue::setDouble( double dValue ) {
   dInternalValue = dValue;
   iInternalValue = static_cast<__int64>( dValue );

   sInternalValue.setSize( 100 );
   sprintf( sInternalValue.getPointer(0), "%.*f\0", precision.get(), dValue );
   sInternalValue.setLength( strlen( sInternalValue.getValue() ) );
   sInternalValue.replace_ansi( ",", "." );

   lasttypeset.set( FLDTYPE_DOUBLE );
}

void Groundfloor::BValue::setBoolean( bool bValue ) {
   if ( bValue ) {
      dInternalValue = 1;
      sInternalValue.setValue_ansi( "true" );
   } else {
      dInternalValue = 0;
      sInternalValue.setValue_ansi( "false" );
   }

   lasttypeset.set( FLDTYPE_BOOL );
}

void Groundfloor::BValue::setTimestamp( __int64 iValue, bool bXml ) {
   dInternalValue = static_cast<double>( iValue );
   iInternalValue = iValue;

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      i->tm_year  += 1900;
      i->tm_mon   += 1;

      sInternalValue.setSize( 20 );
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         sprintf( sInternalValue.getPointer(0), "%04d-%02d-%02dT%02d:%02d:%02d\0", i->tm_year, i->tm_mon, i->tm_mday, i->tm_hour, i->tm_min, i->tm_sec );
      } else {
         sprintf( sInternalValue.getPointer(0), "%04d-%02d-%02d %02d:%02d:%02d\0", i->tm_year, i->tm_mon, i->tm_mday, i->tm_hour, i->tm_min, i->tm_sec );
      }
      sInternalValue.setLength( 19 );

      // delete i;   ???
   } else {
      sInternalValue.setValue( "", 0 );
   }

   lasttypeset.set( FLDTYPE_DATE );
}


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