text:
Investigational ALS Treatment NPT520-34 Begins Phase 1 Trial in Healthy Volunteers
by Joana Carvalho, MSc
NPT520-34, an investigational small molecule for the treatment of Parkinson's disease and amyotrophic lateral sclerosis (ALS), is being tested on healthy individuals in a new Phase 1 clinical trial, its developer Neuropore Therapies has announced.
Brain inflammation is a common feature among many neurodegenerative disorders, including Parkinson's, Alzheimer's disease, and ALS. For that reason, there has been an increasing interest in therapies that are able to minimize or prevent neuroinflammation.
NPT520-34 has been shown to reduce the levels of brain inflammation markers and toxic proteins in the central nervous system (CNS, which comprises the brain, brainstem, and cerebellum) of animal models of Parkinson's, Alzheimer's, and ALS.
The compound is administered orally, and is small enough to be able to cross the blood-brain barrier, a highly selective, semipermeable membrane that isolates the brain from the blood that circulates in the body.
NPT520-34's safety, tolerability, and pharmacokinetic properties are now being tested in up to 48 healthy volunteers participating in a single-center Phase 1 clinical trial. (Pharmacokinetics studies how a drug is absorbed, distributed, metabolized, and eliminated from the body.)
"We are excited to start the Phase 1 clinical trial with NPT520-34 which represents Neuropore's second therapeutic candidate to enter clinical development. We have extensively studied NPT520-34 in several transgenic animal models of neurodegenerative diseases, including [Parkinson's disease], ALS and Alzheimer's disease," Errol De Souza, PhD, president and CEO of Neuropore, said in a press release.
"We are encouraged by the broad and robust effects seen in animal models including decreases in markers of brain neuroinflammation (microglial and astrocytic activation) and decreases in neurotoxic misfolded proteins (for example, alpha-synuclein for Parkinson's, superoxide dismutase 1 for ALS, and beta-amyloid for Alzheimer's)," he added.
The trial will have two distinct phases: an initial single-dose ascending phase, in which NPT520-34 will be administered at a single dose in all participants, with the possibility of incremental adjustments; and a second multiple-ascending dose phase, in which the compound will be administered at different doses, again with the possibility of incremental adjustments.
The study's primary objective will be to assess the safety, tolerability and pharmacokinetic properties of single and multiple doses of the compound. The pharmacokinetic properties of a capsule formulation of NPT520-34 taken with and without food, will be tested separately in another group of healthy subjects. Exploratory outcomes will include the assessment of blood biomarkers indicative of therapy success.
Phase 1 trials assessing the properties of NPT520-34 in patients with neurodegenerative disorders should start in 2020.
"We believe NPT520-34 represents a promising new small molecule therapeutic opportunity for patients with severe unmet needs," De Souza said.
Joana Carvalho, MSc
Joana is currently completing her PhD in Biomedicine and Clinical Research at Universidade de Lisboa. She also holds a BSc in Biology and an MSc in Evolutionary and Developmental Biology from Universidade de Lisboa. Her work has been focused on the impact of non-canonical Wnt signaling in the collective behavior of endothelial cells — cells that make up the lining of blood vessels — found in the umbilical cord of newborns.
Tagged brain inflammation, healthy volunteers, neurodegenerative diseases, Neuropore, NPT520-34, Phase 1 trial.
Previous: #AANAM — Research Examines Clinical, Genetic Features of ALS Type 4
Next:ALS Therapy Development Institute Launches #AskMeAboutALS Effort for ALS Awareness Month
Barbara McLean says:
Where can we get information about trial? What states, what restrictions? Which genetic gene?
Joana Carvalho says:
Hi Barbara. This trial is only meant for healthy volunteers to assess the safety of the treatment. If all goes well, trials in patients should start next year. By then there shall be information on how patients may enroll in the trial.
I am coming up on my two anniversary with ALS and I may not have another year. I am positive person who has daily struggles with my abuser. Everyday I have to adapt and think outside of the box to do everyday tasks. I live alone. I don't understand why healthy people are used. We are already dying, what do we have to lose. With the accelerometers, voice recordings, database with genetics, lifestyle, demographics used by ALS Therapy Institute/ Precision Medicine you can track the progression of patients. I donate skin, blood, fecal, genital nasal, urine samples. Donating my body to research when my life ends. Researchers have had over 100 years and millions of dollars to find cure. But you exclude people with als because of age or because we minimally use a bi pap to try to prolong our life. I want to see my Sons get married next year. I want to see my Grandchild that will born next year. I fight *** everyday and am denied assistance I need and denied by clinical trials. I know patients enter trials – some do not live to end of trial. I know sometimes you have trials that you cannot fill. Think outside of the box and find a better way to conduct trials. This method has not worked for 100 years and needs to be revised. I only allow myself a 10 minutes to vent my negative feelings. You got to join me in my allowed time today. I speak for all *** patients. I had to take money out of my food allowance to make a donation for research. But I want a cure found before another family member of mine has to suffer with ***. I read patients comments on various websites. You are letting us down. We are losing hope. I do not doubt you are dedicated to find cure. But if we could exchange places for just one day I guess we could understand each other better. But then you would not to live one day in my shoes. I am tired of being told NO and promising research in the future What will take it?
Dan D Montgomery says:
I've begged my VA doctor to get me into one of the many clinical trials for ALS treatment but he failed me. I've contacted several clinical trials myself but have been refused treatment for dumb reasons like my diagnosis was more than 2 years ago, my breathing is too weak or that I am just too old. I have tried to invoke the Right-To-Try Law and access treatment from drug companies like BrainStorm for NurOwn but they denied my request. All the new cure money seems to be pouring into Mouse Clinical Trials. Mice! The Rats are getting the better treatment and all the $$$$'s from our donations while I lay here getting weaker and weaker.
~Dreams Flame Out~
I'm watchin' my dreams flame out
As clinical trial requests get turned down
I'm so on fire this ALS hurts like hell
Watchin' all my dreams just flame out
Just watchin' rivers run
Down the IV tube into my vein
It's almost like it's cryin' my tears
I had the world on a string
And then I lost everything
That's how I wound up here
Watchin' my dreams flame out
There's nothing left but an empty heart now
It's all memories now
Smokin' memories that ain't nothin' but ashes
In the no cure low lights
It's done me wrong so tempt me so right
As all my dreams just flame out
If you put your hands on the ALS flame
You've got no right to complain
'Cause you know it's gonna leave a mark
When the glow comes to an end
Like scattered embers in the wind
Means you're lookin' for a brand new spark
Clinical trials I cant get
I'm gonna quit
But who am I kiddin' I just can't lay down
So I keep hangin' around
Sally Ann Lapka says:
How unfair that having a diagnosis date of more than 2 years, makes you ineligible
The clinical trials are so unfair. Less than 40% get into the trials because most don't meet the criteria. Were is all of the money going??? It should be investigated.
If we were healthy with ALS, we wouldn't need a treatment.
Mike Earl says:
Your comment moved me, I have many of the same feelings you do.
Sad that many of us can't get a chance to try some of this treatments, getting worse all the time and would rather they experiment on willing volunteers who don't have much too lose. I want the option for myself to try some of this treatments before it's too late!
Robert Ferson says:
I lost my wife to ALS two years ago and have a great desire to help with any research looking for a treatment. Could I be considered as a participant in this study?
Hi Robert. I am so sorry for your loss. Possibly. Where are you from? As of now the trial is only recruiting patients in the U.S.
Here you can find more information about the trial, including the eligibility criteria, recruitment sites and also the contacts of the researchers carrying out the study:
https://clinicaltrials.gov/ct2/show/NCT03954600
Come diceva il grande poeta Alessandro Manzoni in una sua famosa poesia sulla morte di Napoleone: "Ai posteri l'ardua sentenza!". Beato chi la vede, la fine di questa sperimentazione!
David Loar says:
I know it's really frustrating to feel (or be) excluded from a study with a promising new drug. All I can really say is…this is the very very first Phase of clinical testing in adult humans for this novel therapeutic. The last mammal this drug was tested in was mice.
Remember, the purpose of a Phase I clinical trial is to demonstrate that it's safe enough and well-tolerated enough in a 'healthy' population with minimal variability between participants, so that it can eventually be approved for Phase II. This Phase I trial is designed by the FDA to assess the safety (pharmacovigilance), tolerability, pharmacokinetics, and pharmacodynamics of a drug. Phase I trials usually include dose-ranging/dose escalation, so that the safest dose can be found and to discover the point at which a compound is too poisonous to administer. In other words, for your own safety & for the reliability of the trial data…it's not appropriate or even safe to test a "first in human" drug on those suffering from ANY disease–let alone the disease the drug is designed to treat.
The single reason they test in healthy subjects in Phase I is to reduce data variance…because ANY variability in tolerance, metabolism, adverse side effects, protein interactions, etc will ruin the data. Imagine testing Morphine in only 45 patients…some were children with no tolerance…some were addicts with high tolerance…some were already taking stimulants…some were already taking depressants…some were allergic to naturally occurring opiates…and some had a recent traumatic brain injury. The data would tell you absolutely nothing. Instead, you'd test the drug in healthy adults to see if there is any appreciable toxicity compared to a placebo. Phase Ia & Ib don't even test if the drug actually works. They literally only test if they're safe to ingest.
If they're safe, Phase II will increase the sample population because Phase II data requires the use of more statistical data analysis (which requires larger populations). Phase IIa studies are usually pilot studies designed to demonstrate clinical efficacy or biological activity. In other words…is NPT520-34 actually effective in reducing aggregated alpha-synuclein and lewy body dementia? Will it help reduce neural inflammation in patients with ALS or PD or AD? Which of these 3 conditions does it have the highest statistical significance in treating. In biostats, this is called a t-test…does the patient population receiving the drug do better than the patient population receiving placebo? If yes…then it's on to Phase IIb.
Phase IIb studies look to find the optimum dose at which the drug shows biological activity with the least side-effects. In biostats, this is called ANOVA. Now that you've determined the drug does, indeed, work the way it was expected at a statistically significant rate to justify the possibility of marketing it, what is the best dose? Is there a best dose? For Phase IIb, they would compare the statistical differences between (for example…) the placebo group, the 5mg group, the 10mg group, and the 20mg group. Sometimes the 5mg will have the most biologically significant results AND be the safest. Sometimes 5mg is good, 10mg is better, but 20mg is actually worse.
Perhaps to truly address all these frustrations…it's important to understand efficacy vs. effectiveness:
When a study assesses efficacy, it is looking at whether the drug given in the specific manner described in the study is able to influence an outcome of interest (e.g. tumor size) in the chosen population (e.g. cancer patients with no other ongoing diseases). When a study is assessing effectiveness, it is determining whether a treatment will influence the disease. In an effectiveness study it is essential that patients are treated as they would be when the treatment is prescribed in actual practice. That would mean that there should be no aspects of the study designed to increase patient compliance above those that would occur in routine clinical practice. The outcomes in effectiveness studies are also more generally applicable than in most efficacy studies (for example does the patient feel better, come to the hospital less or live longer in effectiveness studies as opposed to better test scores or lower cell counts in efficacy studies). There is usually less rigid control of the type of patient to be included in effectiveness studies than in efficacy studies, as the researchers are interested in whether the drug will have a broad effect in the population of patients with the disease.
Many thanks for your in-depth reply. It is always important to keep in mind that while the whole process behind clinical trials may be long and become frustrating to some degree, it follows specific rules that try to ensure patients' safety.
Area Man says:
The rules should be different for trials of terminal illnesses. This ain't erectile dysfunction.
Adam Crane says:
Great comments David. Thanks for your in depth reply. I think most of us PALS are concerned about the lack of progress over Phase III trials for items such as NurOwn.


sure I'm all there yet.
My problem was due to using an outdated portmaster pkgng patch.
Note: this is no longer an issue.
Anyway, I ended up with a corrupted pkg database.
I had to update many ports manually.
language) I think portmaster can work with it.
to working with ports only, never with packages.


A NeoCash game, Blumaroll requires players to buy dice packs from the NC Mall before being allowed to play. Then, for each dice bought, you win a special NeoCash prize. There's also the chance to win bonus prizes!
Blumaroll is a periodic game, and shows up at different times during the year. This means that the current prizes retire and the game takes breaks where it is not available to play at all.
To play, you first need to buy dice from the NC Mall - these come in packs of 1, 5 or 10. Then if you click on these in your inventory you will be able to select the "Activate" option so they become available to use for playing.
Once you've purchased and activated your dice, head over to the game to begin playing! Each time you roll you will be asked to confirm that you definitely wish to use up that dice.
Gameplay itself is very simple. Pick up the dice from the playing board by clicking and "holding" it with your mouse. Move your mouse around a bit to roll it, and let go when you're ready to launch the dice!
You will then be shown which prize tier you've achieved. In Blumaroll, unlike the other NeoCash games, you then get to pick your prize out of the 3-6 items available in that tier! Select the prize you want by clicking on it and then hitting confirm.
There is also a chance of obtaining a bonus prize with your dice, which is awarded in addition to whichever prize you pick from the tier.
Blumaroll is now retired from the NC Mall.
Blumaroll Travelling Cases function similarly to Mystery Capsules. Each Travelling Case contains one or more retired Blumaroll item. Additionally, there is a chance to receive a bonus Limited Edition item in a Travelling Case. Apart from containing retired Blumaroll prizes, the Travelling Cases have no connection to playing the Blumaroll game.
Free Blumaroll dice packs have been available.
Blumaroll Dice 1-Pack This dice pack was awarded to players who participated in the Daily Dare event in 2011. The prizes at this time were the Spring 2011 bundle.


Great little unsupported ride from Pheasants Nest, Mittagong, Wollondilly River, Kowmung, Jenolan Caves, eventually ending up at Oberon for a night in the pub. Suitable for all bikes, fuel range about 250k's or so. Jorgo will lead the pack. List here or contact Clarkey on 0409929910. We'll meet at Pheasants Nest at 0800 for a 0830 ride off.


text:
Lube It Up
Your Guide to Body-Safe Lubes and What They're Made Of
Sofia Barrett-Ibarria
When choosing a lube, ingredients matter. Here's a list of some you should avoid.
If you're like me, lube might be something you don't usually think you need, until you really, really need it. I'm kind of embarrassed to admit that my lube literacy hasn't always been great, and I never used to give it much thought beyond the jar of coconut oil I kept in a drawer next to my bed, which actually isn't even a great lube after all. I thought all personal lubricators were basically the same, so why would it matter which one I decided to slather on my own sex toys with? Turns out, lube ingredients make a big difference — there are some body-safe ingredients, while other ingredients should be avoided.
There's a common misconception that lube is an extra add-on that most people don't need unless they're experiencing some sort of "problem" with sex, when really, lube can be used by anyone, anytime. The right lube can heighten pleasurable sensations, and reduce chafing during an all-night sex marathon, but some formulas contain ingredients that some believe may increase the risk of getting a yeast infection or cause other health problems.
Not all lube is created equal, and with so many options available, shopping for lube can feel overwhelming. Before wandering the aisles of your local sex shop or shopping online, it's important to know what lube is good for, which ingredients are going to work for the kind of sex you're having, and which you should avoid.
The Three Big Types of Lube: Oil, Water, and Silicone
While lube can definitely add to almost every sexual experience, all lubes are not alike. Joshua Zeichner, director of cosmetic and clinical research at Mount Sinai Hospital in New York City, says most lube can be divided into three main categories: oil-based, water-based, and silicone-based. "While they all do the job similarly, you must take different precautions depending on your needs," Zeichner says.
Water-based lube
When choosing a product, consider the kind of sex you'll be having and whether you'll be using condoms or adding sex toys. Water-based lubes are typically the easiest to find and are often the more affordable formulas found in drugstores, including some of the offerings from brands like Astroglide and K-Y. They're compatible with sex toys, safe to use with latex condoms, and won't stain fabrics, making water-based products a versatile option for vaginal or anal sex.
Oil-based lube
However, as Archie points out, water-based varieties tend to dry out quickly, have the longest list of ingredients, and won't work for sex in the shower or anywhere else you'll be underwater. While oil-based lubrication formulas often last longer than their water-based counterparts, there's a downside. "Oil-based lubrication may lead to the breakdown of latex, so it may be best to stay away from if you are using condoms," Zeichner explains.
Silicone-based lube
Silicone-based lubes often last longer than water-based lubrication, as well, but in turn, they can be irritating for people with sensitive skin and may damage silicone toys.
Lube Ingredients to Avoid (and Why)
While it's true that different types of lube can work for different needs, some ingredients may cause problems for some people, according to our experts. Some of the most popular, easy-to-find lube brands tend to contain some ingredients people prefer to avoid, and tracking down a body-safe lube isn't impossible if you know what to look out for. Just as you might check the labels on something you're about to eat, get to know your lube ingredients, and if you wouldn't buy a super-cheap sex toy from an unknown seller on Amazon, it's similarly important to make sure the lube you're using won't risk your health or wreak havoc on your sex life.
Flavored lubes
To begin with, Hutcherson recommends steering clear of any flavored lubes during penetrative sex. "When used during intercourse, flavored lube can increase the risk of vaginal infections, especially yeast, due to the sugar component that can't be completely removed from the vagina," Hutcherson says. Glycerin, a popular ingredient in water-based lubes, has been associated with an increased risk of yeast infections according to one 2013, study, and many experts advise that it should also be avoided during vaginal intercourse if you're prone to frequent yeast infections.
Petrolatum, petroleum jelly, and microbicide nonoxynol-9
According to Zeichner, petrolatum and petroleum jelly can interfere with the proper functioning of the skin, alter the vagina's natural pH, and contribute to bacterial overgrowth. Another ingredient, the microbicide nonoxynol-9, has also been found to disrupt the balance of vaginal flora.
Preservatives, including parabens
Parabens, which Zeichner explains are preservatives often used to prevent overgrowth of bacteria in personal care products, are also a common component of many commercial lubes. "While there is no data showing that they are harmful to your health," he says, "many people prefer to stay away from them." Fair enough.
Propylene glycol, benzene, benzoic acid, chlorhexidine, and benzocaine
Further, Zeichner says that ingredients like propylene glycol, benzene, benzoic acid, and chlorhexidine can potentially cause irritation and even allergic contact dermatitis. Benzocaine, a numbing ingredient found in some lubes that dulls the sensation of pain "can produce allergic contact dermatitis and should be avoided," according to the American Society for Colposcopy and Cervical Pathology's "Vulvodynia Guideline."
Lube Basics: Why and When to Use It
Even though many of these side effects sound off-putting, generally speaking, lube is pretty great — and it's gynecologist recommended. "I consider lubricants to be pleasure-enhancers and underappreciated treats," says Hilda Hutcherson, a professor of obstetrics and gynecology at Columbia University Irving Medical Center. As Hutcherson explains, lube can decrease friction during hand play, while using toys, or during intercourse, as well as prevent pain during sex and prevent post-sex soreness. "I recommend that women use lubricants frequently, if not always," Hutcherson says. "It can make great sex even better."
The right lube can prevent pain and injury, make toys more comfortable, and minimize the chance of condom breakage.
According to Archie and Cat, sex educators and lube enthusiasts at Minneapolis sex toy shop Smitten Kitten, people of all genders can use lube for practically any type of sex, whether it's solo or partnered. "Lube can be the difference between painful, uncomfortable sex and dreamy, amazing sex," Cat says. "It reduces friction, maximizes sensation, and protects our pleasure zones from abrasions or tearing."
The right lube can prevent pain and injury during anal sex, make certain toys feel more comfortable, and minimize the chance of breakage when using condoms. In fact, Hutcherson explains that many people with vaginas might need lube during sex for a variety of reasons, including age, time of menstrual cycle, side effects of certain medications, stress, chronic illness or medical issues, inadequate foreplay, or prolonged intercourse.
People of all genders can use lube for practically any type of sex, whether it's solo or partnered.
Cat adds that there's also nothing wrong or shameful about simply wanting a little extra moisture. "There's a nasty myth out there that any time we're sexually aroused, our vaginas will automatically produce enough lube for any kind of sex we want to have. Super not true! Vaginas [sometimes] do self-lubricate under the right circumstances, but there are a million reasons why our bodies sometimes don't produce enough lubrication to make a certain sex act comfortable or possible."
How to Find a Body-Safe Lube
As a general rule, Hutcherson says that any lube with the fewest number of unfamiliar ingredients is a good bet. In fact, this is generally a good rule for most products you'll be putting on your body.
Courtesy of brand
She continues, "The more natural, the better." Archie and Cat recommend silicone- and water-based formulas by Überlube and Sutil Luxe, while Good Clean Love's Origins Love Oil is an oil-based option with easy-to-pronounce ingredients.
Ultimately, choosing the "best" lube for you can be a matter of personal preference. Hutcherson recommends trying a variety of different lube formulas with simple, pared-down ingredients until you find the one that feels best for you and your partners. That's when the real fun starts.
Read more about sex on Allure:
BDSM Sex Tips to Try If You're a Total Beginner
How the Satisfyer Pro 2 Vibrator Made Me Realize I'm Actually a Squirter
Here's How to Ask Your Partner for Oral Sex
What this genderqueer person loves most about the way they look:
Don't forget to follow Allure on Instagram and Twitter.
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redpajama_set_name: RedPajamaCommonCrawl


DE RUBEIS FEDERICA 30/9/2018 PALAZZO D'INVERNO Flash 6c BELLA VIA! NESSUN PASSO IN PARTICOLARE, DISTRIBUITA E TUTTA DA SCALARE.
DE RUBEIS ALESSANDRO 23/9/2018 PALAZZO D'INVERNO On Sight 6c BELLISSIMO E LUNGO MURO A BUONE CONCREZIONI, QUALCHE TACCA E FESSURINO... MAI DURA, TUTTA DA SCALARE... TUTTA DA GODERE.


text:
Bill Nighy Omnibus Theatre
Bill Nighy Helps Omnibus Theatre Celebrate 5th Birthday
Multi-award winning actor Bill Nighy, best known for his work in beloved films including The Finest,The Best Exotic Marigold Hotel, Pride, Hot Fuzz, Harry Potter and The Deathly Hallows and of course Love Actually joined leading Off-West End venue, Omnibus Theatre in South London, to celebrate its 5th birthday.
Bill's special appearance for the birthday celebrations took place in the intimate setting of the award-winning South London venue's 110-seat theatre space where audiences were also treated to an In Conversation With the actor, interviewed by The Guardian's features writer and reviewer Miranda Sawyer.
Bill was also invited to cut a beautifully crafted 5th birthday celebration cake, moulded in the shape of the theatre building, courtesy of leading artisan cake maker, Ann's Designer Cakes. Shortly before Bill's appearance, Dame Judi Dench, who was announced earlier in the week as the theatre's newest heavyweight patron, gave a special birthday message to the audience.
The unique event was also part of a day filled with interactive installations, shows and exhibitions that celebrated the theatre's progress and industry wide support.
Omnibus Theatre was opened in 2013. Notable in-house productions include Woyzeck (2013), Macbeth (2014), Colour (2015), Mule (2016), Spring Offensive(2017) and Zeraffa Giraffa (2017). Omnibus Theatre is led by Artistic Director Marie McCarthy. Patrons include Sir Michael Gambon, Matthew Warchus, Sir Richard Eyre and Maggi Hambling. The venue is a registered charity and receives no core funding.
Victoria Willing's SAD to Premiere at Omnibus Theatre
First Look: Very Special Guest Star at Omnibus Theatre
Interview: Jonny Khan on Very Special Guest Star at Omnibus Theatre
Review: The Girl Who Was Very Good at Lying at The Omnibus Theatre
Interview: Rachael Rooney on The Girl Who Was Very Good At Lying at Omnibus Theatre
First look: The Girl Who Was Very Good at Lying at Omnibus Theatre in Rehearsal


text:
The Grand Tour and Neo-classicism
An etching after Giovanni Battista Piranesi titled 'Veduta dell' Interno dell' Ansiteatro Flavio detto il Colosseo'
The gap year and an opportunity to travel seems, to many of us, a relatively new phenomenon – a chance for our children to broaden their experience of the world. But there is nothing new in this. Georgian polite society would send their sons to the Continent once they had completed their formal education.
The Grand Tour could last anything up to five years. Young men and their tutors would visit the great houses, palaces and cities of Europe. There they would admire the ruins of antiquity and bring back trophies of their tour – objects which were both genuine and imitations. Examples of these pursuits can be found in the collections at Petworth House in West Sussex where the 2nd Earl of Egremont (1710-1763) was a particularly cultured Grand Tourist.
The late Georgian period (1760-1800) would be defined by Neo- classical taste informed by the newly discovered rich Roman interiors at Herculaneum (from 1748) and Pompeii (from 1758). These cities had been hidden from the world by the eruption of Mount Vesuvius in AD 79. 18th century excavations revealed exquisite interiors with delicate symmetrical decorative motifs which inspired artists and designers back home in Britain.
A Gillows of Lancaster Neo-classical specimen marble centre-table
The Neo-classical specimen marble table illustrated is a good example of this and was probably designed by Gillows of Lancaster. By the mid-18th century Gillows had acquired a reputation for manufacturing furniture of the highest quality and by the late 1700s the firm had offices in Lancaster and London. There are records of Gillows supplying tables to Stephen Tempest to support marble slabs purchased by him in Italy. However, this particular table was most recently owned by the late Baroness Herries of Terregles (1938-2014). Lady Anne's father was the 16th Duke of Norfolk and she had grown up at Arundel Castle, the Norfolk's family seat in West Sussex. The circular top is inset with radiating bands of specimen marbles, including lapis lazuli, malachite, porphyry and agates, within a border of verde-antico The table's base is delicately carved with a continuous band of acanthus leaves, raised on a carved tulip cusp stem with a beaded knop, the triform base has carved scroll feet fitted with castors.
The Grand Tour specimen marble table top
The scene depicted by Giovanni Battista Piranesi (1720-1778) is typical of his 'Vedutes' (views), especially of Rome, which once again became an important artistic and cultural centre in the 18th century. Piranesi was an Italian artist famous for his etchings which would inspire a generation of philosophers, architects, artists and academics.
These objects speak loudly of our shared European heritage. I am confident and hopeful that the continuous philosophical and cultural heritage, which forms part of our shared narrative with the nations of Continental Europe, will continue to bless us as our relationships with one another evolve.
Learning and culture were considered and remain important markers of civilisation in Europe.
Posted on March 23, 2017 May 10, 2017 Author RupertCategories Rupert Toovey's ArticlesTags Grand Tour
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text:
Irvin S. Cobb letters
Cobb, Irvin S., (Irvin Shrewsbury), 1876-1944
Journalism--Kentucky
Journalists.
Collection is arranged by format.
Finding aid prepared by Megan Mummey
2011MS134: [identification of item], Irvin S. Cobb letters, 1923, University of Kentucky Special Collections.
Irvin S. Cobb (1876-1944) was a journalist, author, and entertainer born in Paducah, Kentucky. Cobb worked as a reporter for the Paducah Daily News at the the age of sixteen, and became managing editor of the paper three years later. He subsequently worked for newspapers in Cincinnati and Louisville. In New York he worked for Joseph Pulitzer's evening and sunday World from 1905 to 1911. He was a very successful, frequently anthologized author of short stories and a staff contributor to the Saturday Evening Post (1911-1922) and Cosmopolitan magazine (1922-1932). Later in life he worked as a writer and actor in Hollywood.
The Irvin S. Cobb letters include two letters from Irvin S. Cobb, one to Irving R. Boen (undated) and the other to W. J. Funk (February 26, 1923).
The physical rights to the materials in this collection are held by the University of Kentucky Special Collections.


text:
{-| Implements a CSV parsing conduit using Cassava's incremental decodeByName.-}
module Data.Csv.Conduit (decodeByName) where

import qualified Data.Csv as C
import qualified Data.Csv.Incremental as CI
import Data.Conduit
import qualified Data.ByteString as B
import Data.Either (partitionEithers, rights, lefts)

decodeByName :: (C.FromNamedRecord r, MonadResource m) =>
                Conduit B.ByteString m (Either String (C.Header, [r]))
decodeByName = do
    eMsgHp <- decodeHeader
    case eMsgHp of
        Right (header, recordParser) -> decodeRecords header recordParser
        Left msg -> yield (Left msg)

decodeHeader :: (C.FromNamedRecord r, MonadResource m) =>
                Consumer B.ByteString m (Either String (C.Header, CI.Parser r))
decodeHeader = go CI.decodeByName
  where
    go (CI.FailH _ msg) = return (Left msg)
    go (CI.DoneH header recordParser) = return . Right $ (header, recordParser)
    go hp = await >>= maybe (return $ Left "Premature end of input")
                            (go . CI.feedChunkH hp)

decodeRecords :: (C.FromNamedRecord r, MonadResource m) => C.Header -> CI.Parser r ->
                 Conduit B.ByteString m (Either String (C.Header, [r]))
decodeRecords header recordParser = go recordParser
  where
    go (CI.Fail _ msg) = yield $ Left msg
    go (CI.Done ds) = do
        mapM (yield . Left) $ lefts ds
        yield $ Right (header, rights ds)
    -- feedEndOfInput does not force a Parser in the Some
    -- state to Done or Fail.  If we get a Some Parser
    -- yield the results and call next on a new Partial
    -- state parser.
    go (CI.Some ds p) = case partitionEithers ds of
        ([],[]) -> next (CI.Partial p)
        (ls, rs) -> do
            yield $ Right (header, rs)
            mapM_ (yield . Left) ls
            next (CI.Partial p)
    go p = next p
    next parser = do
        minput <- await
        case minput of
            Just bs -> go (CI.feedChunk parser bs)
            Nothing -> go (CI.feedEndOfInput parser)

redpajama_set_name: RedPajamaGithub


The health reform barely passed Congress. Legislators split along party lines. Critics called it an unfunded entitlement.
Yes — the now-beloved Medicare prescription drug program has come a long way from its fraught beginnings in 2003.
For the Affordable Care Act's defenders, Medicare Part D has become Exhibit A for how a health reform can evolve and win support. Today, few see the program as a controversial, partisan reform, but instead as a treasured part of the nation's safety net.
It offers a template for ACA advocates, too: As more Americans reap Part D's benefits, the harder it's become to make changes.
But the drug benefit still has critics like Health Strategy Associates' Joe Paduda, many of whom charge Part D as a key driver of the nation's deficit. And it seems increasingly likely that Part D will be subject to some change, given that legislators are eying across-the-board cuts to government health spending.
Even in the current deficit conversation, Part D's popularity has made it difficult for politicians to call for a sweeping overhaul to the fast-growing program, which represented $52.5 billion in 2009 federal spending and is growing at a rapid rate compared with Medicare Part A or Part B.
President Obama and other legislators instead are targeting safer reforms.
Most significantly, the president has repeatedly urged Congress to align Medicare drug payments with Medicaid's policies. Obama's statement to the deficit reduction "super committee" specifically calls for extending certain Medicaid rebates to Medicare, for an estimated savings of $135 billion over 10 years.
Congress also is seeking savings by targeting the traditional stalking horse: waste, fraud and abuse.
A Government Accountability Office investigation released this week found that about 170,000 Medicare beneficiaries in 2008 exploited Part D to obtain large quantities of painkillers like oxycodone. At a hearing on Tuesday, senators urged CMS officials to crack down on these individuals and root out other unnecessary care.
However, the upside may be limited: The thousands of offenders identified in GAO's investigation represent just 2% of program beneficiaries, and the cost of their additional prescriptions was $148 million, or only 0.3% of total Part D spending that year.
Some advocates say that finding real drug benefit savings will require program changes that go even further.
Writing in a working paper that will appear in Health Economics, scholars Austin Frakt, Steve Pizer and Roger Feldman explore an intriguing possibility: Should Medicare Part D adopt the Veterans Health Administration formulary?
The authors note that VA significantly constricts its formulary in contrast to Medicare. For example, the VA's national formulary covers just 59% of the nation's 200 most popular drugs, whereas the average Medicare Part D plan covers about 85% of those drugs. The VA also negotiates directly with drug manufacturers, whereas Medicare is not allowed under Part D to take advantage of its full purchasing power to bargain down prices.
"If Medicare drug plans restricted their formularies to the level of generosity offered by the VA and obtained VA-like drug prices by doing so, we estimate that the program would save $510 per beneficiary per year or a total of $14 billion per year," Frakt wrote on The Incidental Economist blog.
However, some advocacy groups and policy analysts suggest that Part D is working fine in its current form — and legislators should think twice before touching the program to find short-term savings.
A report commissioned by the Pharmaceutical Research and Manufacturers of America noted that in 2008, more than 121,000 Californians were directly employed in the pharmaceutical industry. A subsequent PhRMA report cautioned that if industry revenues were to be cut by even $20 billion — say, because of reforms to Part D — California would take a $3.4 billion economic hit.
Douglas Holtz-Eakin and Michael Ramlet of the American Action Forum also have warned that introducing Medicaid-style rebates into Medicare Part D would actually raise seniors' premiums by between 20% and 40% per month.
On Oct. 7, the Institute of Medicine is expected to recommend to HHS how it should determine basic coverage standards for the state health insurance exchanges. HHS will use the recommendations for its regulations for the exchanges. IOM spokesperson Christine Stencel said the report will not outline specific benefits standards for the exchanges but will recommend criteria and methods for HHS to use in determining and updating the essential health benefits package (Selyukh, Reuters, 9/29).
Catholic organizations across the country are urging HHS to adopt a broader religious exemption to new rules that will require health plans to cover contraceptive services without member cost-sharing. The new rules are part of a provision in the federal health reform law that will require health plans to cover certain preventive services without copayments, coinsurance or deductibles (Maher, Wall Street Journal, 9/29).
Last week, Virginia Attorney General Ken Cuccinelli (R) filed an appeal to the U.S. Supreme Court seeking a review of an appellate court's decision to reject the state's challenge to the federal health reform law. In the challenge, Cuccinelli argued that the individual mandate is unconstitutional and conflicts with a state law that protects residents from federal insurance mandates (Reuters, 9/30). In September, judges at the 4th U.S. Circuit Court of Appeals dismissed the lawsuit, ruling that the state lacks legal standing to file it (Haberkorn, Politico, 9/30).
The Obama administration and plaintiffs in the multistate lawsuit against the federal health reform law continue to differ on the legality of the overhaul, but the two sides share "a surprising amount of common ground" on the issues. In their recent petitions to the U.S. Supreme Court to review the case, the administration and plaintiffs indicated their desire for a quick resolution to the dispute and urged the high court to review the case in its new term, which began on Monday. In addition, both sides agreed that the dispute about the individual mandate is "about means rather than ends," as there are alternative solutions to ensuring universal coverage (Liptak, New York Times, 9/29).
Last week, Montana Gov. Brian Schweitzer (D) said he plans to apply for a waiver from the federal health reform law's mandate for state-based health insurance exchanges in order to create a single-payer health insurance system for the state. The plan would create just one public insurer for more than half of Montana's population of Medicare and Medicaid beneficiaries and workers with employer-sponsored health insurance. Other residents would have the option of paying into the system if they prefer it to their private insurance (Sanger-Katz, National Journal, 9/29).
During a speech at the Hoover Institution at Stanford University last week, House Budget Committee Chair Paul Ryan (R-Wis.) unveiled a proposal he described as a "replacement" to the federal health reform law (Reuters, 9/27). Ryan suggested that the proposal — which he modeled after a similar plan in his fiscal year 2012 budget blueprint — would provide "structural reforms and real solutions" to the current health care problems (Haberkorn, Politico, 9/27). However, the proposal is unlikely to advance in Congress prior to the 2012 elections (Reuters, 9/27).
Last week, Republican presidential candidate and former House Speaker Newt Gingrich (Ga.) unveiled a new set of legislative proposals — which he named a "Contract With America" — that includes repealing the federal health reform law (Summers, Politico, 9/29). In 1994, Gingrich co-wrote the original "Contract With America" that contained specific legislation Republicans pledged to address if they took control of the House. The new document promises that if Gingrich is elected president he will make 10 specific legislative changes and sign as many as 200 executive orders on his first day in office (Mehta, Los Angeles Times, 9/30).
While Republican presidential candidate and Texas Gov. Rick Perry has criticized various pieces of health legislation, critics and observers argue that Perry's own proposals have been largely ineffective. On the campaign trail, Perry repeatedly has criticized the 2006 Massachusetts health reform law — signed by fellow candidate and former Massachusetts Gov. Mitt Romney (R) — and the federal health reform law, objecting to insurance mandates in both laws. Meanwhile, Texas faces numerous challenges covering its residents, including the highest rate of uninsured individuals in the country and the third-lowest percentage of workers with employer-sponsored health coverage nationwide (Ramshaw, Texas Tribune/New York Times, 9/29).
On Oct. 7, the Institute of Medicine is expected to recommend to HHS how it should determine basic coverage standards for the state health insurance exchanges. HHS will use the recommendations for its regulations for the exchanges. IOM spokesperson Christine Stencel said the report will not outline specific benefits standards for the exchanges but will recommend criteria and methods for HHS to use in determining and updating the essential health benefits package (Selyukh, Reuters, 9/29). Catholic organizations across the country are urging HHS to adopt a broader religious exemption to new rules that will require health plans to cover contraceptive services without member cost-sharing. The new rules are part of a provision in the federal health reform law that will require health plans to cover certain preventive services without copayments, coinsurance or deductibles (Maher, Wall Street Journal, 9/29).
Last week, Virginia Attorney General Ken Cuccinelli (R) filed an appeal to the U.S. Supreme Court seeking a review of an appellate court's decision to reject the state's challenge to the federal health reform law. In the challenge, Cuccinelli argued that the individual mandate is unconstitutional and conflicts with a state law that protects residents from federal insurance mandates (Reuters, 9/30). In September, judges at the 4th U.S. Circuit Court of Appeals dismissed the lawsuit, ruling that the state lacks legal standing to file it (Haberkorn, Politico, 9/30). The Obama administration and plaintiffs in the multistate lawsuit against the federal health reform law continue to differ on the legality of the overhaul, but the two sides share "a surprising amount of common ground" on the issues. In their recent petitions to the U.S. Supreme Court to review the case, the administration and plaintiffs indicated their desire for a quick resolution to the dispute and urged the high court to review the case in its new term, which began on Monday. In addition, both sides agreed that the dispute about the individual mandate is "about means rather than ends," as there are alternative solutions to ensuring universal coverage (Liptak, New York Times, 9/29).
Last week, Republican presidential candidate and former House Speaker Newt Gingrich (Ga.) unveiled a new set of legislative proposals — which he named a "Contract With America" — that includes repealing the federal health reform law (Summers, Politico, 9/29). In 1994, Gingrich co-wrote the original "Contract With America" that contained specific legislation Republicans pledged to address if they took control of the House. The new document promises that if Gingrich is elected president he will make 10 specific legislative changes and sign as many as 200 executive orders on his first day in office (Mehta, Los Angeles Times, 9/30). While Republican presidential candidate and Texas Gov. Rick Perry has criticized various pieces of health legislation, critics and observers argue that Perry's own proposals have been largely ineffective. On the campaign trail, Perry repeatedly has criticized the 2006 Massachusetts health reform law — signed by fellow candidate and former Massachusetts Gov. Mitt Romney (R) — and the federal health reform law, objecting to insurance mandates in both laws. Meanwhile, Texas faces numerous challenges covering its residents, including the highest rate of uninsured individuals in the country and the third-lowest percentage of workers with employer-sponsored health coverage nationwide (Ramshaw, Texas Tribune/New York Times, 9/29).


We might all be aware of the term 'Financial Markets'. In economics, finance and business studies this term 'Financial markets' holds great importance. In this little article, I will try to sum up the core areas related to 'Financial markets'. We will have a look at some 'Instruments of Financial Markets' and we will also study 'Money Market' and 'Capital Market' and will mention some uses and importance of 'Money Market' and 'Capital Market'.
"Financial Markets are generally known as a market where financial securities or/and assets are bought and sold by the buyers and sellers respectively."
After having the basic knowledge about the definition of financial markets and financial markets instruments, let's have a look at the 'Types of Financial Markets'.
The market for short-term debt instruments maturing in one year or less is known as "Money Market".
Following are some commonly used financial instruments used in money market.
The market for certificates of deposit.
Finance house market which facilitates short-term borrowing to finance hire purchase agreements.
A money market provides the lenders a well organized place for dealings in monetary assets and satisfying the short-term requirements of borrowers as well.
A short-term money market provides a medium for the redistribution of loan able funds among banks.
The money market provides a mean of meeting short-term financing requirements for the government also.
Specialized credit institutions also lend a portion of their surplus funds as call-loans.
The market for trading long-term instruments (those that mature in more than one year) is known as a "Capital Market".
The existence of an organized capital market is absolutely necessary to encourage and mobilize savings and to introduce profitable avenues of investment so that capital formation can be promoted to country.
Businesses often raise their fixed capital from capital market through issue of shares.
The government and local authorities also borrow long term finance from capital market.
Issuance of bonds and debentures are an integral part of monetary policy of any economy which is carried effectively through capital markets.
The art of taking multiple-choice-question tests and how to get the right answers.
This is a good read. Yes we need to trust financial institutions and markets because they are a tool in increasing economic efficiency and enhance living standards. Buyers and sellers, savers and borrowers are all benefited directly and indirectly. People just need to know and fully understand how financial market works. Thanks for sharing this.
Yes you are absolutely right. This is the basic ingredient without any doubt.
By the way, I like your line "When the tide rises in a marine, all boats rise"
Well Done. Good or bad or right or wrong, free flow of capital is what improves the standard of living for all. When the tide rises in a marina, all boats rise.
Very informative and enjoyable hub!
@ Neon ... Yes you are right, trust in the financial sector is one of the most important ingredient for any economic development.
@ Nan Maynatt. Oh that's great. And yes you are right, people ARE afraid, these financial things are more often volatile. The recent global financial crisis increased that possibility even further.
To raise the economy people need to begin to trust in financial markets and invest.
Excellent analysis of the markets and investments. I was licensed by the SEC to sell mutual funds for 12 years and resigned when the market was down. Why, because people would not invest, because they were afraid, you have to plan on leaving your money in for at least 10 years before it should return 3'x or at least 2 1/2 your initial investment.


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text:
Лос-Е́бенес () — муниципалитет в Испании, входит в провинцию Толедо, в составе автономного сообщества Кастилия — Ла-Манча. Муниципалитет находится в составе района (комарки) Монтес-де-Толедо. Занимает площадь 676,98 км². Население — 6451 человек (на 2010 год). Расстояние до административного центра провинции — 42 км.

Покровителями муниципалитета почитаются священномученик Власий Севастийский и Пресвятая Богородица (Святая Дева де Финибустерре).

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 Ex escuela hogar «Mirasierra»
 Guía útil de Los Yébenes
 Situación geográfica de Los Yébenes
 Previsión meteorológica de la semana

Муниципалитеты Толедо

redpajama_set_name: RedPajamaWikipedia


For me, this is what Christmas is all about. As I have learned to let go of the extremely high expectations of perfection – magazine worthy decorations, a month filled with traditions and rituals that your child will remember forever (I just hope he doesn't remember all the times I forgot to put a chocolate in the advent calendar!) the feast of the year, not to mention the gallons of mulled wine and mince pies but still trying to fit into that stunning sequinned LBD! – Christmas is now all about nesting, family, letting go of things that I don't need from the year we are leaving behind and getting excited about the possibilities of the year we are about to ring in. Bliss!
I can thank Yoga for teaching me how to release these expectations, let go of the perfectionism and be ok with the (more than likely) occurrence of something not going quite to plan!
When you are super busy, it is so important to be organised and have a plan. But it is equally important to be able to Let Go of this plan if you need to change things and adapt to a new set of circumstances. I absolutely adore this Nick Mulvey quote "the only way to hold on is keep letting go"…If you suffer from the perfectionist affliction (as I do) make this your mantra!
If there is a "To Do List", make sure one of the items is "Me Time". If you are the one who plans, shops, cooks, decorates while doing all of your other "normal" jobs and the extra parties and visits to Santa, you need to prioritize some Me Time! It doesn't have to be an elaborate or expensive spa treatment (although this is certainly nice if you can manage it!). Taking a blissful hour for yourself to do 15 minutes of yoga, 15 minutes of quiet reflection, journaling, reading something inspiring and then a 30 minute soak in the tub, you'll tackle the rest of the list from a calmer place and this will absolutely make you more efficient in the long run.
Practicing Mindfulness and being present in the moment is really what Christmas is all about. It's not about all the gifts or the parties or even the turkey! It is about those moments of joy when your child opens his gift from Santa and the look on his face. It is about having fun with friends you haven't seen all year and dancing to silly Christmas songs. It is about sitting around a table of home cooked food, food made with love, with the people you love and sharing the ups and the downs and ridiculous moments of the past year. So even when you've got a billion other things you need to get done, people you need to see, presents you need to buy, take a moment to breathe, close your eyes, set an intention to be 100 % right here, right now,open your eyes and immerse yourself in the moment. This is what Christmas is all about.
The beauty of all of this is you don't need to buy anything, or wait until a certain thing happens, or wait until next Christmas when you've got it all "together" or "more time"…these tiny little pockets of peace and acts of intention are so doable, right now!
Previous PostSmoothies, Juices + Detoxing; essential or unnecessary in a modern, healthy diet?


text:
Staging Penile Cancer
Need to talk ? Why not call the Orchid National Male Cancer Helpline
Penile cancer is usually diagnosed by obtaining samples of a suspected cancerous area either by taking a biopsy or by surgically removing a small area of skin (wide local excision). These are minor procedures which are performed at a local hospital or clinic. It may also be identified following circumcision in men.
The tissue which has been removed will be analysed by histo-pathologists (medical scientists) who will be able to identify a specific type of cancer. The results will then be discussed by the specialist medical team, usually at a Multi-Disciplinary Team Meeting (MDT); a meeting of urologists, oncologists and other medical specialists who will then decide on the best course of action.
Because penile cancer is so rare men who are diagnosed with the disease will be referred to a regional treatment centre or supranetwork for further assessment. These centres have more specilaised cancer teams with surgeons who specialise in treating penile cancer as well as specialist support services. In the UK the following hospitals act as supranetworks and men will be referred on an urgent basis to the nearest appropriate centre.
St.Georges Hospital, London (Tooting)
University College Hospital, London, Euston Square
The Christie Hospital, Manchester
The Leeds Teaching Hospital NHS Trust
The Norfolk and Norwich University Hospitals NHS Trust
Southmead Hospital, North Bristol NHS Trust
Sunderland Royal Hospital, South Tyneside and Sunderland NHS Trust
The Heart of England NHS Foundation Trust
The Gartnavel General Hospital (Glasgow and Clyde)
The Western General Hospital (Lothian)
Investigations for penile cancer are used to determine the extent to which cancer may be affecting the local area or other parts of the body. These investigations are often referred to as staging investigations and may include some or all of the following.
Fine Needle Aspiration (FNA)
An ultrasound scan can be used to identify any enlarged lymph nodes (see below) around the groin area that may have been affected by possible cancer. A biopsy of these nodes using a surgical needle may be taken. The cells obtained will be sent for laboratory analysis to determine if they are cancerous or not. This procedure is performed under a local anaesthetic.
The Lymphatic System and Lymph Nodes
The human body is covered by a special type of drainage system called the lymphatic system. This system is responsible for transporting excess fluid from the organs and tissues of the body in a fluid called lymph. Lymph fluid will contain various types of cells and substances that are no longer needed. The lymph fluid will be transported through the lymphatic drainage system and pass through small nodules or nodes that act as filters. These are responsible for filtering out the unwanted substances. If one lymph node is not able to filter out the unwanted substances then the lymph fluid will move to the next one. Cancerous cells which break off from an organ which has cancer can also travel along this route and become trapped at the lymph nodes where they can then accumulate and infiltrate a different area of the body.
Computerised Tomography (CT Scan)
A CT scan checks for any signs of cancer which may have spread to other areas of the body. The CT scan takes a series of x-rays, which are fed into a computer to build up a three-dimensional picture of the inside of the body and will take from 10 to 30 minutes. Men may be given a drink or injection of a dye that allows particular areas to be seen more clearly. The scan is painless, but it will mean lying still for 10 – 20 minutes. A scan will be requested on a very urgent basis and will usually be performed within a few weeks of the request.
For further information on having a CT scan please click here
This may be used to find out whether penile cancer has spread beyond the penis or to examine any residual areas of abnormality that remain after treatment to see whether they are scar tissue or whether cancer cells are still present. A PET scan uses low-dose radioactive sugar to measure the activity of cells in different parts of the body. A very small amount of a mildly radioactive substance is injected into a vein, usually in the arm. Areas of cancer which are usually more active than surrounding tissue then show up on the scan. It is not usually used on a routine basis but may be performed after initial treatment.
For further information on having a PET scan please click here
This test can be used to provide further information about the extent of cancer which may be affecting the penis or other parts of the body and may be performed during treatment. It creates cross-sectional pictures of the human body. Some people are given an injection of dye into a vein in the arm to improve the image. During the scan men will be asked to lie very still on a couch inside a long chamber for up to an hour. This can be unpleasant if they don't like enclosed spaces. MRI scanning is also very noisy and men will be given earplugs. The chamber is a very powerful magnet, so before entering the room men should remove any metal belongings.
Sometimes an injection may be given into the penis to cause an erection which may then help provide more detail of the area in the penis affected by cancer.
For further information on having an MRI scan please click here
Dynamic Sentinel lymph node biopsy
This procedure is used to detect cancer cells which may have spread to the nearest lymph nodes to the penis on either side of the groin. It is not a procedure that is available in every part of the UK and men may be referred to a specialist centre for this procedure.
A local anaesthetic will first be applied to several areas of the penis and then a radioactive dye injected. X-rays will be taken of the area to visualise the lymph nodes in the groin. Once the lymph node nearest to the cancer has been identified the area will be marked with a special pen and then a surgical plaster will be applied. This procedure may take several hours.
An operation requiring a general anaesthetic will then be performed usually later on the same day in which a blue dye will be injected into the same areas of the penis as before. The dye will be absorbed by the lymph nodes and a special camera can then be used along with the X-rays from the previous procedure to identify the sentinel lymph nodes. These can then be removed by a small surgical incision. The operation may take around 45 minutes to perform.
Providing that men feel well enough after the operation they will usually be allowed home.
Men will need to have a family member or friend who can make sure they are well for the next 24 hours.
Dressings on the biopsy site can be removed after 48 hours when men should be able to bath or shower normally. They should use a clean towel or gauze dressing to pat dry the area.
There may be small dissolvable stitches at the site of the biopsy and these may take a few weeks to fully dissolve.
Men may experience some bruising or some swelling in the groin area. This is usually due to an accumulation of lymph fluid which will improve as the body heals.
Men should contact their health team if they experience any of the following problems:
Persistent bleeding from the wound.
Uncontrolled pain.
A high temperature and shaking or feeling as if you have a bad cold which could be a sign of infection.
Prolonged swelling, redness or a foul smelling discharge from around your wound site which could indicate localised infection.
Men will be given the results of their biopsy a few weeks later when the need for any further treatment will be discussed.
For information on how penile cancer is assessed (staged), please click here
References available on request.
Reviewed March 2021. Next review 2022.


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text:
<?php

/**
 * Bundle all thrift and Airavata stubs into a include file. This is simple but not so elegant way.
 *  Contributions welcome to improve writing PHP Client Samples.
 *
 */
include 'getAiravataClient.php';
global $airavataclient;
global $transport;

Airavata\Client\Samples\sampleDisabled();

use Airavata\API\Error\AiravataClientException;
use Airavata\API\Error\AiravataSystemException;
use Airavata\API\Error\InvalidRequestException;

use Airavata\Model\AppCatalog\AppInterface\ApplicationInterfaceDescription;

try
{
    if ($argc != 4)
    {
        echo 'php registerApplicationInterface.php <appName> <appDescription> <appModuleId>';
    }
    else
    {
        $appName = $argv[1];
        $appDescription = $argv[2];
        $appModuleId = $argv[3];

        $appInterface = new ApplicationInterfaceDescription();
        $appInterface->applicationName = $appName;
        $appInterface->applicationDesription = $appDescription;

        //Add the module provided in argument. If you would like to add multiple modules, you may modify this script or
        // use the updateAppInterface.php script
        $appModuleList = array($appModuleId);
        $appInterface->applicationModules=$appModuleList;
        var_dump($appModuleList);

        $appInterfaceId = $airavataclient->registerApplicationInterface($appInterface);

        if ($appInterfaceId)
        {
            var_dump($appInterface);
            echo "\n Application Interface $appInterfaceId is registered! \n    ";
        }
        else
        {
            echo "\n Failed to register application interface. \n";
        }
    }
}
catch (InvalidRequestException $ire)
{
    print 'InvalidRequestException: ' . $ire->getMessage()."\n";
}
catch (AiravataClientException $ace)
{
    print 'Airavata System Exception: ' . $ace->getMessage()."\n";
}
catch (AiravataSystemException $ase)
{
    print 'Airavata System Exception: ' . $ase->getMessage()."\n";
}
catch (\Exception $e)
{
    echo 'Exception!

' . $e->getMessage();
}

$transport->close();

?>


As the map shows, Scotbake's direct distribution area is considerable. Island distribution is carried out by a team that ensures that stores in Lewis and Orkney receive their bread on a daily basis. We also deliver 5 days a week direct to the M8 corridor through our third party partners.
We bake and distribute 7 days a week, offering a 'one stop shop' service for bakery products, as well as delivering the Kingsmill, Warburton and Hovis ranges. As a recognised and accredited supplier to Enterprise Foods, we also supply the Food Service sector as well as Scottish Co-ops and all major multiple customers in our area. A fleet of vehicles covers the Highlands & Islands every day, putting in the miles to make sure customers receive their orders at a time that suits.
Thanks to its large delivery fleet and wide distribution area, Scotbake has recently introduced additional distribution services. We are now working with a variety of suppliers to deliver dry product to interested customers, which saves on overall supply costs and reduces road miles.
Thanks to its large delivery fleet and wide distribution area, Scotbake has recently introduced additional distribution services.


Any experience with Radio Frequency Wave abation procedures?
Hi @sam65, I am Gary and a volunteer mentor here at Connect. Welcome and I hope you will utilize what I have found to be an amazing source of support and information. I did a bit of searching and found this: https://www.mayoclinic.org/tests-procedures/radiofrequency-neurotomy/about/pac-2039493. I am a bit confused as I can only find information on the procedure you are inquiring about in relation to pain that originates in the spinal region. If you find any literature that mentions the treatment of neuropathic pain in the feet, please share it. I do not currently have peripheral neuropathy but as a diabetic, I am aware that it could be an issue in the future. I will continue searching and respond with anything I can find and would really appreciate you doing the same.


The netherland dwarf rabbit is one of the smallest rabbit in the world. This rabbit came from Europe, but very popular around the world. It is rank third in the popularity in the United States. There are many sellers across the country, but it is important for you to buy the rabbits from reputable sellers. It can cause you to lose money if you bought the rabbit from unknown vendors. There are cases of people who bought the dwarf rabbits that are sick and after a few days the rabbits died. Buying the rabbits from reputable and license vendors can help to protect you from being scammed. The rabbits is very delicate when come to it health. Therefore, it is important for you to ensure that you bought a rabbit that is healthy.
The dwarf rabbit is popular because of the varieties of colors that the animal have. Many people also find the rabbits to be cute and cuddly. The animals have been breed in Europe for a long time and over time there are many versions of the rabbits. However, the netherland dwarf rabbit seem to be the top choice. It is easy to care for the small rabbits when compare to the ordinary rabbits. It only needs to eat little foods, but it is still important for you to know the suitable diet for the rabbits. Keeping the rabbits healthy will see the rabbits to live up to 10 years. The rabbit is very playful and it will react to your command. The dwarf rabbit have been found to be an intelligent animal. It can be trained to do simple tasks and it can also be trained to use the litter box.
The dwarf rabbit is popular in the American home as pets, but in some parts of the world it is also a popular choice for chef. The meat from netherland dwarf rabbit is said to be good for human and many men eat the meat of the small rabbit to help them perform in bed. For many people the act of eating the little guy maybe look as inhumane, but in some culture eating rabbit meats will help them get a better overall health. In some countries the dwarf rabbits are also being kept as pets and when the time comes the rabbits will end up in the wok of the homeowner. Some countries even turn the small animal into burger meat which is said to have delicious taste compare to the ordinary burger meat.
For more information on the dwarf rabbit you can surf the internet. There is thousands of information on the small guys. You can learn how to choose the right rabbit for your family and you can also learn how to properly keep the dwarf rabbit as pet. If you are thinking to cook the dwarf rabbit after keeping it as pet for some time then the internet would have the perfect recipe for you to use. There is a lot of valuable information that you can get from the internet when come to the netherlands dwarf rabbit.