text:
Symptoms to Diagnosis
An 86-year-old man with unexplained right-sided headache and vision loss
Marc Ohlhausen, BS, Eden Bernstein, MD and Craig D. Nielsen, MD, FACP
Cleveland Clinic Journal of Medicine September 2021, 88 (9) 494-501; DOI: https://doi.org/10.3949/ccjm.88a.20077
Marc Ohlhausen
Medical Student, Case Western Reserve School of Medicine, Cleveland, OH
Eden Bernstein
Internal Medicine Resident, Department of Internal Medicine, Cleveland Clinic, Cleveland, OH
Craig D. Nielsen
Department of Internal Medicine, Cleveland Clinic; Associate Professor, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH; Governor, Ohio Chapter, American College of Physicians; Deputy Editor, Cleveland Clinic Journal of Medicine
For correspondence: nielsec@ccf.org
An 86-year-old man presented to a local hospital ophthalmologist with headache and pain in his right temple without vision loss. Laboratory values for complete blood cell count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were normal. The medical history was remarkable only for a remote history of diverticulitis. He reported social consumption of alcohol and smoking in the past.
Although reassured, the patient returned 2 weeks later with acute loss of vision in his right eye, preceded by eye discomfort, floaters, flashing lights, and worsening right temporal pain and headache. On physical examination, he had no fever and was normotensive. Extraocular movements and visual fields were normal, and visual acuity was unchanged. Heart, lung, joint, and skin examinations were unremarkable.
Given the patient's age and presentation, giant cell arteritis (GCA) was suspected. Key clinical features of GCA in patients over age 50 include abrupt new headache, scalp pain and tenderness, jaw claudication, visual symptoms, polymyalgia rheumatica, temporal artery abnormalities, and elevated ESR or CRP, or both.1,2 Anterior ischemic optic neuropathy due to occlusion of the posterior ciliary artery is the cause in 85% of cases of vision loss in GCA.3
EVALUATING AND MANAGING SUSPECTED GIANT CELL ARTERITIS
1. What is the most appropriate first step for a patient with suspected GCA?
Oral glucocorticoid therapy
Biopsy of the temporal artery
Measurement of serum ESR and CRP
Duplex ultrasonography of the temporal artery
Ophthalmologic assessment
If GCA is strongly suspected, high-dose systemic glucocorticoids should be started promptly to prevent irreversible vision loss and involvement of the other eye.4 Urgent referral for specialist management, ophthalmologic assessment, and temporal artery biopsy are recommended but should not delay administration of glucocorticoids. Temporal artery biopsy is the preferred method of confirming GCA, although a negative result does not rule out disease in cases of high clinical suspicion.1
Initiating glucocorticoids should lead to significant improvement in symptoms. If this does not occur, one should evaluate for alternative diagnoses.
CASE CONTINUED: SYMPTOMS PROGRESS DESPITE STEROIDS
The patient was started on oral prednisone 60 mg for presumed GCA and admitted to the local hospital. ESR and CRP were repeated, and results again were within normal range. A right-sided temporal artery biopsy was performed but showed no evidence of active or healed arteritis. Magnetic resonance imaging (MRI) and computed tomography (CT) angiographic imaging of the head and neck were unremarkable.
The patient was discharged. The diagnosis of GCA was considered unlikely, but prednisone was continued out of concern for possible vision loss in the unaffected eye while other causes were being evaluated. Prednisone was up-titrated to 70 mg due to lack of symptom improvement, with no improvement in vision or headache severity reported.
The patient was referred to the ophthalmology department at a nearby large academic hospital for further workup. On presentation 1 month after his hospitalization, a variety of new signs and symptoms had developed. Ophthalmologic examination revealed right-sided ptosis, eyelid swelling, and chemosis (ie, swelling of the conjunctiva). The right eye was unable to gaze superiorly, inferiorly, or laterally. Vision in the right eye was completely absent, with no light perception. The right pupil was nonreactive to light, and an afferent pupillary defect was present. The fundus appeared normal on dilated fundus examination. Intraocular pressures were 20 mm Hg (reference range 12–22 mm Hg) in both eyes. Tenderness to palpation was noted over the right eyebrow, temple, and forehead. All findings in the left eye were normal.
The patient was admitted for additional workup. Initial laboratory investigations revealed a white blood cell count of 10.47 × 109/L (reference range 3.70–11.00 × 109/L) with 90.9% neutrophils, 5.9% lymphocytes, 3.1% monocytes, 0% eosinophils, and 0.1% basophils. A complete metabolic panel was within normal limits except for an elevated blood glucose level of 170 mg/dL (reference range 74–99 mg/dL), which was attributed to steroid therapy. The ESR was 4 mm/hour (reference range < 30 mm/hour) and CRP was 0.15 mg/dL (reference range < 0.30 mg/dL).
Given the lack of response to prednisone, the normal ESR and CRP levels, and the negative temporal artery biopsy, the diagnosis of GCA was ruled out, and evaluation for other causes continued.
CRANIAL NERVE PATTERN PROVIDES CLUES
2. Involvement of the neural structures at which of these locations best explains the pattern of cranial nerve deficits seen on this patient's examination?
Orbital apex
Cavernous sinus
Superior orbital fissure
The pattern of neurologic deficits localizing unilaterally to cranial nerves II (optic), III (oculomotor), IV (trochlear), and VI (abducens) seen in this patient is most consistent with disruption of structures at the orbital apex.5 The orbital apex is the posterior-most end of the orbit and is made up of bony, neural, and vascular structures (Figure 1). Within the orbital apex are 2 orifices in the sphenoid bone:
The optic foramen, which contains the optic nerve, the ophthalmic artery, and associated sympathetic nerves
The superior orbital fissure, a bony cleft lateral to the optic foramen, through which pass the nasociliary, frontal, and lacrimal branches of the ophthalmic nerve (V1, ie, first division of cranial nerve V [tri-geminal]), superior ophthalmic vein, and cranial nerves III, IV, and VI.
The anatomy of the orbital apex, the most posterior aspect of the orbit. The unilateral cranial nerve (CN) deficits in this patient point to disruption of structures of the orbital apex including the optic, oculomotor, trochlear, and abducens nerves. The optic foramen contains the optic nerve, ophthalmic artery, and associated sympathetic nerves. The nasociliary, frontal, and lacrimal branches of the ophthalmic nerve, superior ophthalmic vein, and cranial nerves III, IV, and VI pass through the superior orbital fissure.
The annulus of Zinn is the common tendinous origin of the recti muscles and surrounds the optic foramen and the central portion of the superior orbital fissure. The contents of this annulus are the optic nerve, ophthalmic artery, oculomotor nerve, abducens nerve, and nasociliary nerve. Because of their confinement, these structures are at greater risk of compression or shear injury.6
The presence of multiple nerve palsies in this patient's presentation indicated that his condition was unlikely due to a primary pathology at the retina or optic nerve.7 In addition, on dilated fundus examination there was no optic nerve pallor and no finding suggestive of central retinal artery occlusion or retinal detachment.
3. Which of these syndromes is most likely to cause optic nerve dysfunction?
Orbital apex syndrome
Cavernous sinus syndrome
Superior orbital fissure syndrome
Rochon-Duvigneaud syndrome
Orbital apex syndrome is the constellation of signs and symptoms resulting from a disease process affecting the orbital apex structures characterized by involvement of cranial nerves II, III, IV, VI, and V1. The most common presenting features are vision loss, ophthalmoplegia, and blurred vision.8,9 Involvement of the oculomotor, abducens, and trochlear nerves causes ophthalmoplegia and diplopia owing to disruption of innervation to the extraocular muscles. Oculomotor nerve palsy also causes ipsilateral ptosis and mydriasis. Involvement of cranial nerve V1 results in hypoesthesia or pain of the ipsilateral forehead and upper eyelid, along with absence of corneal reflex and sensation. Inflammation due to infectious, inflammatory, or neoplastic processes may cause proptosis. Variations in presentation of orbital apex syndrome are common owing to the large number of structures involved.
Due to close anatomic proximity, overlapping clinical features are found in two additional syndromes: cavernous sinus syndrome and superior orbital fissure syndrome (also known as Rochon-Duvigneaud syndrome).8–11 The names of these three syndromes correlate with the anatomic location of their disease processes.
Cavernous sinus syndrome presents similarly to orbital apex syndrome but also involves the maxillary nerve (V2). This results in hypoesthesia of the cheek and lower eyelid, along with facial pain extending farther inferiorly than the periorbital region innervated by the ophthalmic branch.10 On examination, the most useful distinction between cavernous sinus syndrome and orbital apex syndrome is involvement of the optic nerve, which is rare in cavernous sinus syndrome.11 Also of note, cavernous sinus syndrome may cause Horner syndrome (manifested by ptosis, miosis, and anhidrosis) due to the involvement of the sympathetic chain adjacent to the cavernous segment of the internal carotid artery. Vascular etiologies of cavernous sinus syndrome are classically associated with a pulsatile proptosis.8
Superior orbital fissure syndrome occurs with a lesion directly anterior to the orbital apex, affecting structures coursing through the superior orbital fissure at this location. The presentation is similar to that of orbital apex syndrome but without optic nerve impairment. Superior orbital fissure syndrome can be progressive, and patients may go on to develop orbital apex syndrome or cavernous sinus syndrome.8
EVALUATING THE CAUSE OF ORBITAL APEX SYNDROME
Possible causes of orbital apex syndrome are numerous and varied (Table 1)8,10 In the absence of recent surgery or trauma, inflammatory, infectious, vascular, and neoplastic etiologies must be considered.
Causes of orbital apex syndrome
Tolosa-Hunt syndrome is a common inflammatory cause of orbital apex syndrome. It presents with periorbital pain and limited eye movements, most often unilaterally.
Immunoglobulin G4-related disease is a systemic inflammatory condition that can include salivary gland enlargement, lymphadenopathy, retroperitoneal fibrosis, and pancreatitis. Ocular involvement most commonly includes chronic lid swelling and proptosis, but may include visual disturbances from orbital apex syndrome.12
Both Tolosa-Hunt syndrome and immunoglobulin G4-related disease have characteristic findings on neuroimaging and generally respond to steroids.
Vasculitides associated with antineutrophil cytoplasmic antibody (ANCA) (eg, granulomatosis with polyangiitis, microscopic polyangiitis, and eosinophilic granulomatosis with polyangiitis) generally present with pulmonary, gastrointestinal, and neurological involvement but can also have ocular involvement like orbital apex syndrome, as well as corneal ulceration, episcleritis, scleritis, and retinal vascular occlusion.
Sarcoidosis is a granulomatous inflammatory disease that primarily affects the lungs. The most common ocular involvement of sarcoidosis is anterior uveitis, although cases of sarcoid granulomas eroding into the orbital apex have been reported.13
Because immunosuppressive therapy is indicated for inflammatory causes, infectious etiologies should first be considered so as not to exacerbate them with treatment.
Bacterial and fungal infections of the paranasal sinuses can spread to the contiguous orbital apex. Fungal infections are primarily found in immunocompromised patients.
Neoplastic etiologies include meningeal infiltration of leukemia or lymphoma, as well as nasopharyngeal carcinoma, which portends a poor prognosis.14
CASE CONTINUED: FURTHER EVALUATION
A serologic vasculitis workup including ANCA, antinuclear antibodies, and double-stranded DNA antibodies was negative. Human immunodeficiency virus testing was negative. Lumbar puncture was performed to evaluate for evidence of inflammatory, infectious, and neoplastic processes in the central nervous system. Cerebrospinal fluid analysis showed no white blood cells, normal protein, elevated glucose (122 mg/dL, reference range 45–80 mg/dL), and no growth on cultures.
IMAGING THE ORBITAL APEX
4. What is the preferred imaging method for evaluating lesions of the orbital apex?
High-resolution MRI with and without contrast is preferred for evaluating most lesions of the orbital apex.8 MRI provides superior soft-tissue contrast compared with other imaging methods, and orbital fat suppression can also improve lesion visibility.15 A short-tau inversion recovery image or T2-weighted fat-suppressed series can be included to evaluate for inflammatory edema and purulent fluid collections.16
CT is useful for evaluating bone involvement at the orbital apex, especially in the setting of trauma.10 It is also used for patients with magnetic foreign bodies, surgical clips, or other MRI contraindications.
CASE CONTINUED: DIAGNOSTIC IMAGING AND BIOPSY
Brain MRI revealed an irregularly shaped lesion with peripheral enhancement and a central nonenhancing region just inferior to the right optic nerve at the orbital apex (Figure 2). It was thought that this finding might represent a small abscess or area of necrosis. Scattered paranasal sinus mucosal thickening and increasing asymmetric enlargement of the right anterior cavernous sinus relative to previous images were also noted.
Magnetic resonance imaging of the orbit showed lesions (arrows) in axial T1-weighted fat-suppressed series (A) and coronal multiplanar reformation (B) views.
Sinus CT showed corresponding heterogeneous soft tissue at the right orbital apex with smooth bony remodeling and subtle erosive changes, raising suspicion for a neoplasm, infection, or an inflammatory entity. There appeared to be thinning and convexity of the right sphenoid sinus roof in addition to erosion of the right optic strut and along the inferior margin of the right anterior clinoid process.
An endoscopic transnasal intracranial biopsy was performed. An incision made within the right orbital apex inferior to the optic nerve returned purulent material. Frozen sections from the right orbital apex were negative for neoplasm but showed invasive fungal hyphae within fragments of fibrous tissue with focal necrosis. On Grocott-Gomori methenamine silver stain, the organism morphologically resembled aspergillus species. Aspergillus fumigatus was confirmed by fungal culture.
The patient was then diagnosed with invasive orbital aspergillosis with involvement of the orbital apex and cavernous sinus.
ORBITAL FUNGAL INFECTIONS
5. Which pair of organisms most commonly cause orbital mycoses?
Aspergillus and Mucor
Mucor and Candida
Aspergillus and Candida
Candida and Fusarium
Aspergillosis and mucormycosis are the most common causes of orbital fungal infections.17
Candida species are the most common etiologic pathogens of keratitis. Fusarium species are also one of the predominant causes of corneal fungal infections and are the most likely fungal pathogen to cause infection following eye trauma.18
Orbital mycoses are most often a result of contiguous spread from the paranasal sinuses.10
Rhizopus species are the most common cause of mucormycosis, which is classically associated with diabetes.19,20
Orbital aspergillosis
A flavus and A fumigatus are the most common species of aspergillus that affect the orbit.21 Orbital aspergillosis presents in invasive and noninvasive forms.
Noninvasive aspergillosis typically does not display fungal infiltration of tissue but can produce a thick material known as allergic mucin along with extramucosal mycotic proliferations known as fungus balls, which are seen primarily in patients who are immunocompetent. If located in the posterior sphenoid or ethmoid sinus, a large fungus ball may compress the optic nerve and cause vision loss and even orbital apex syndrome.22
Invasive aspergillosis is characterized by bone invasion and fungal tissue that behaves similarly to an inflammatory or malignant process.23 Locally, there is invasion of nearby structures and blood vessels, causing thrombosis and tissue necrosis. In the fulminant form of invasive aspergillosis, there is embolization and multiorgan involvement, potentially leading to death.21 Risk factors for invasive aspergillosis include total neutrophil count of less than 1,000/mm3, T-cell defects (eg, from human immunodeficiency virus), defective phagocytosis, hematologic malignancy, immunosuppressive agents, diabetes mellitus, prosthetic devices, trauma, excessive environmental exposure, residence in an endemic area (eg, Sudan), and advanced age.20 While incidence of invasive disease is much greater in immunocompromised patients, cases have also been reported in immunocompetent hosts.21–30
TREATING INVASIVE ASPERGILLOSIS
6. Which antifungal medication is preferred for the initial treatment of invasive aspergillosis?
Amphotericin B deoxycholate
Isavuconazole
Echinocandins
The Infectious Diseases Society of America 2016 update of practice guidelines for diagnosis and management of aspergillosis recommends voriconazole for initial medical therapy for invasive sinus aspergillosis.30 For patients who are intolerant to voriconazole, the best alternative is a lipid formulation of amphotericin B or isavuconazole. Treatment is recommended for a minimum of 6 to 12 weeks, depending on the degree of immunosuppression, infection location, and evidence of improvement.
Lipid formulations of amphotericin B are less likely to cause nephrotoxicity compared with amphotericin B deoxycholate. Amphotericin B deoxycholate is not recommended for use in invasive aspergillosis unless lipid formulations of amphotericin or other mold-active antifungals (such as voriconazole) are unavailable.30 Hyperbaric oxygen and retrobulbar amphotericin B injections are less commonly used to treat orbital mycoses, but there is some evidence for their viability.31–33 Retrobulbar injections may be useful if aggressive orbital debridement is not favored or if the burden of orbital disease is not substantial.33
In general, combination therapy is not recommended, but the use of voriconazole with an echinocandin may be considered for patients with severe disease, hematologic malignancy, or profound persistent neutropenia.30
In addition to medical therapy, surgical debridement is usually required and may involve exenteration (ie, surgical removal of the entire globe and surrounding structures) in cases of orbital apex involvement.22,30
Invasive aspergillosis carries a significantly worse prognosis than the noninvasive form. Invasion of bone and blood vessels makes surgical access and drug penetration challenging and allows the fungus to spread intracranially. The reported mortality rate associated with invasive aspergillosis is 40%, rising to 50% when there is central nervous system involvement.34
Prognosis is often worsened by initial misdiagnosis owing to presenting features that are largely nonspecific. Initial administration of corticosteroids is also associated with a poorer prognosis as a result of iatrogenic potentiation of the infection.17
CASE CONCLUSION
The patient was started on voriconazole and tapered off prednisone. CT of the chest was performed to investigate the lungs for additional areas of infection and was negative. Oculoplastic surgery was consulted regarding the benefit of right orbital exenteration. Because the infection had already spread to the cavernous sinus, it was determined that exenteration would not improve survival and was therefore deferred.
Three weeks after discharge, the patient continued to experience retro-orbital headaches but rated the pain as 1/10 instead of 10/10, as he had consistently rated it before treatment. His right-sided ptosis was slightly improved, but his right eye blindness, afferent pupillary defect, and complete loss of extra-ocular movements persisted.
TAKE-HOME POINTS
Suspected GCA should be treated immediately with glucocorticoids, but lack of improvement, negative temporal artery biopsy, and normal ESR and CRP should prompt investigation of an alternative diagnosis.
The orbital apex is the posterior-most end of the orbit and contains bony, neural, and vascular structures.
Orbital apex syndrome is characterized by involvement of cranial nerves II, III, IV, VI, and V1.
Cavernous sinus syndrome and superior orbital fissure syndrome present similarly to orbital apex syndrome; specific cranial nerve palsies can help differentiate them on physical examination.
Etiologies of orbital apex syndrome are numerous but fit into these main categories: inflammatory, infectious, neoplastic, iatrogenic, traumatic, and vascular.
MRI is the best imaging method for visualizing the orbital apex, but CT is useful when examining bone involvement or if the patient has MRI contraindications.
Orbital mycoses are most often a result of contiguous spread from the paranasal sinuses and are most commonly caused by aspergillosis or mucormycosis.
Patients with immunodeficiency are at much greater risk of contracting invasive aspergillosis, which carries a significant risk of mortality that further increases with central nervous system involvement.
Treatment of invasive aspergillosis involves a combination of antifungal management and surgical debridement.
Voriconazole monotherapy is the preferred initial medical therapy for invasive sinus aspergillosis, with isavuconazole or lipid formulations of amphotericin B being viable alternatives.
The authors report no relevant financial relationships which, in the context of their contributions, could be perceived as a conflict of interest.
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You are going to email the following An 86-year-old man with unexplained right-sided headache and vision loss
Marc Ohlhausen, Eden Bernstein, Craig D. Nielsen
Cleveland Clinic Journal of Medicine Sep 2021, 88 (9) 494-501; DOI: 10.3949/ccjm.88a.20077
A 60-year-old man with prostate cancer and embolic strokes
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Member Spotlight: Kathryn Caballero
Kathryn Caballero has practiced environmental law in Washington DC for 22 years, first in the environmental practice group at Arnold & Porter, and then with the Environmental Protection Agency. Kathryn is currently the acting Associate Director in the Air Enforcement Division of EPA's Office of Civil Enforcement, and was previously a senior attorney in the Air Enforcement Division and in the Waste and Chemical Enforcement Division. Kathryn has also been a supervisory attorney-advisor in EPA's Office of Transportation and Air Quality (OTAQ). Kathryn is the DC Bar Environment, Energy and Natural Resources (EENR) Community Steering Committee Co-Chair, and co-chair of the Energy and Environmental Law Forum of the Women's Bar Association of DC. Kathryn is also a Senior Fellow and EENR mentor for the EENR Law Fellows Program, which encourages participation in EENR law by those underrepresented in the law.
Kathryn first joined the WBA in 2000 and has been involved as Co-Chair of Energy and Environmental Law Forum. She is currently the co-host of the DC Bar/WBA podcast: "Making a Difference: Inspirational Women Leaders in Energy and Environmental Law".
Kathryn is a new adjunct professor at Notre Dame Law and is teaching Selected Topics in Environmental Law Practice this fall. She is the DC Bar Environment, Energy and Natural Resources (EENR) Community Steering Committee Co-Chair for 2021-24. She is also a fellow and EENR mentor for the EENR Law Fellows Program, which encourages participation in EENR law by those underrepresented in the law.
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I love the genuine commitment to access to justice, and the camaraderie and encouragement of women in the practice of law. I also like to mentor others entering the law, and I think that is a strong draw for those of us who have been practicing law for many years.
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As the mother of four adult children, I've developed prioritization, time-management and organizational skills, but perhaps more importantly, I learned patience and resilience in challenging situations to resolve complex matters efficiently and expeditiously. The joys and challenges of raising children has also helped me to better support others.
By Carol Montoya|2021-09-21T14:38:54+00:00September 22nd, 2021|Blog, Member Spotlight|Comments Off on Member Spotlight: Kathryn Caballero
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Disturbing footage shows the moments before the fatal Uber self-driving-car crash
A still from the footage showing the vehicle operator.
Tempe Police Department
Police have released footage from a fatal crash involving one of Uber's self-driving vehicles.
It is believed to be the first time an autonomous vehicle has killed a pedestrian.
The video shows the vehicle operator looking away and the pedestrian walking across the road.
Police have released footage from the moments before a fatal crash involving one of Uber's self-driving cars and a pedestrian in Tempe, Arizona.
The video, captured by the vehicle, shows both the forward view from the front of the car when the pedestrian enters the roadway and the reaction of Uber's vehicle operator in the driver's seat directly before the crash, which the footage does not show.
The footage from the interior shows the Uber's vehicle operator, who was not controlling the vehicle at the time, periodically looking down and away from the road.
The pedestrian emerges from the shadows on the left lane of the road, pushing a bicycle, as the vehicle drives along the right lane.
You can watch the footage below, but be warned that some may find its contents disturbing.
On Sunday at about 10 p.m. local time, one of Uber's autonomous vehicles hit Elaine Herzberg, 49, in what is believed to be the first time a self-driving vehicle has killed a pedestrian.
Uber has grounded its fleet of self-driving vehicles, and authorities are investigating.
In a statement an Uber representative said: "The video is disturbing and heartbreaking to watch, and our thoughts continue to be with Elaine's loved ones. Our cars remain grounded, and we're assisting local, state, and federal authorities in any way we can."
Police have said the vehicle did not meaningfully slow before the crash. It's not yet clear whether its sensors picked up Herzberg (lidar, a key technology in self-driving cars that uses lasers to detect obstacles, does not require daylight to function).
Speaking to the San Francisco Chronicle earlier this week, Tempe's police chief, Sylvia Moir, said: "I suspect preliminarily it appears that the Uber would likely not be at fault in this accident."
Moir added: "It's very clear it would have been difficult to avoid this collision in any kind of mode" — autonomous or human-driven — "based on how she came from the shadows right into the roadway."
Axel Springer, Insider Inc.'s parent company, is an investor in Uber.
SEE ALSO: A self-driving Uber car hit and killed a woman in the first known autonomous-vehicle death
NOW WATCH: Uber created a fake 'city' to test out its self-driving cars
More: Uber Death self-driving cars
BI Prime Archive


Come join the band for Frostburg's Annual Halloween Parade on Thursday, October 27! The parade will start down Main Street at 6:15pm. It's great fun for the family with treats for everyone. The City Halloween Party will be at City Place following the parade. For more info go to http://www.frostburgcity.com/halloween.html. See you there!
Don't forget about the parade today! Let us know if you get any good pictures of us. Share them on Facebook or with info@arionband.org.


if russia were to launch a nuclear weapon against the u.s., the weapon would be destroyed, as would be the case if any country launched any major weapon against any other country.
please consider not continuing to feed these error to your readers. the time has come where NO MAJOR FORCE will anymore be allowed to strike another in a significant war. the power and capability to stop it is there and has been for a long time. earth's population who continue to rebel will either wake up or be removed individually by whatever force is necessary and with as much care and consideration as possible.
at least allow this kind of editorial disagreement with the errors you are copying to be presented so that both sides can have a voice.
I presume Space Brothers are involved.
seems to me that there was a freemason handshake going on--not to say there was not a paper passed. Pence gives me the creeps-pervy jesuit vibe imo.
please no name or email---when i first saw this video, i immediately saw the sick freemason handshake-a sign of deceit and evil IMO. Then i saw where people were saying like this post does-that Pence passed a noted to the woman in the black uniform--looked several more times-and NOTHING BURGER-she has a white note in her left hand and after she shook hands, she quickly put the note in her right hand and then in her right side pocket. I watched Pence's hands thru the whole thing-he had nothing in either hand at any point. She did not pass that thing to him-and he did not pass it to her-his hands were empty at all points IMO. Show me I am wrong and i will concede-i cannot look at Pence without getting nauseated--he looks like a jesuit paedo to me. SICK AFFECT.
I FINALLY SAW IT-YES-she passed something small to him and he quickly put it in his right coat pocket. whew!!! i must have looked ten times before i saw the WHOLE THING. Good reminder that the eyes see but the mind does not hold everything we see-at least at first.
Yes, I also finally concluded that it looked like she passed Pence something small, perhaps as small as a micro-SD card, something too small to be seen in that video. It seemed to me that his hand lingered as he took a while to get hold of it, and then when he pulled away he kept his fingertips bunched together until his hand went to his pocket. Incidentally, the woman is reportedly Morgan County Alabama Sheriff Ana Franklin who is under investigation by the FBI for falsely obtaining a search warrant for the home of a blogger who was investigating other wrongdoing in the sheriff's department, and then having spyware installed in the blogger's computer. The woman shouldn't have been allowed in the White House.


All events listed in 8 Days a Week are open to the public. To submit a listing, send to FFW, 203 N. College Ave., Fayetteville, AR 72701 or fax to 444-7289, at least two weeks prior to event. Submissions are printed as space allows. Photographs and art are also considered.
SUPPORT LOCAL ARTISTS AND PRODUCTS (SLAAP) ART SALE: 5-8 p.m. today at Kathy Thompson's Studio 3, 3 W. Mountain, Fayetteville. Kathy Thompson, Meredith Boswell, Cindy Arsaga, Joseph Brajcki, Winne Farms, Mary Thompson, Adam Posnack, Laurie Foster, Tonya Tubbs, Jacqueline Shin, Haley Duke and Karen Beaton.
ARTISTS RECEPTION AND SALE: 5-8 p.m. today at ddp gallery, 7 E. Mountain St., Fayetteville. Chris Weaver, Susan Hutchcroft, J.J. McCracken, Gregory Moore, James Kunzelmann, Zack Pinson, Jon Lee, Cicada Books, Amanda Salov, Flannery Grace Horan and Jill Anthes. ddpgallery.com or 442-0001.
PROGRESSIVE SHOPPING PARTY: 5:30 -9 p.m. today in downtown Fayetteville. Limo service between these 12 stores: Dark Star Visuals, Good Things Boutique, Hand Held Heartwood Gallery, Jane's Place, Little Bread Company, Little Mountain Bindery, Nightbird Books, Private Gallery, Something Urban, Terra Tots and World Treasures.
UNIVERSITY THEATRE'S "A CHRISTMAS CAROL": 7 p.m. today, Friday and Saturday, and 2 p.m. Saturday and Sunday at the Walton Arts Center in Fayetteville. $14-$22. waltonartscenter.org or 443-5600.
CHRISTMAS PARADE: 6 p.m. Friday in downtown Eureka Springs. eurekaspringschamber.com.
HOLIDAY MARKET: 10 a.m.-4 p.m. Friday and Saturday at the Botanical Garden of the Ozarks in Fayetteville. Local farmers and other vendors. bgozarks.org or 750-2620.
SANTA IN THE PARK: 5-7 p.m. Fridays and 10 a.m.-4 p.m. Saturdays, through Dec. 20 in Centennial Park in the Rogers Historic District. mainstreetrogers.com or 936-5487.
ART SALE: 7-9 p.m. Friday, and 10 a.m.-5 p.m. Saturday and Sunday at Goodfolk, 229 N. Block St., Fayetteville. Local artists including Marie Demeroukas, Karen Chotkowski, Michelle Berg-Vogel, William Mayes Flanagan, Debra Dubois, Steve Moore, Susan Shore, Victoria McKinney, Elizabeth Nevin and Jessica Robin. 521-1812 or 587-8920.
HOLIDAY GIFT WRAP CLASS: 8:30 a.m.-12:30 p.m. Saturday at the Little Mountain Bindery and Printmaking Studio, 572 W. Sixth St., Fayetteville. $25 includes materials. Several wrapping and decorating techniques. littlemountainbindery.com or 587-0238.
CHRISTMAS TOUR OF HISTORIC HOMES: 2-6 p.m. Saturday in Eureka Springs. Self-guided tour of Victorian homes. Choir music, carolers, refreshments, period costumes. $15 advance $20 at the door. eurekaspringschamber.com.
LUX WEAVING STUDIO OPEN HOUSE ART SALE: 4-8 p.m. Saturday and noon-5 p.m. Sunday at 18 White St., Eureka Springs. Work by Eleanor Lux and Karen Foster. Art sale by the EMRIS Girls Club at 21 White St. 253-9636.
LIVING WINDOWS DISPLAY: Saturday on Historic Main Street in Van Buren. vanburen.org or 474-0332.
CHRISTMAS BALL: Saturday at the Basin Park Hotel in Eureka Springs. Benefits Eureka Springs Historical Museum. Victorian dress optional. eurekaspringschamber.com.
HOLIDAY OPEN HOUSE: 3-6 p.m. Saturday at the Siloam Springs Museum, 112 N. Maxwell St. 524-4011.
JOHN TWO-HAWKS: Peace on Earth Christmas concert at 7:30 p.m. Saturday at The AUD in Eureka Springs. johntwohawks.com or 253-5826.
DANIEL NARDUCCI CHRISTMAS CONCERT: 2 p.m. Sunday at Arend Arts Center, 1901 S.E. "J" St., Bentonville. $5-$25. 855-1968.
ACO YOUTH CHOIR HOLIDAY CONCERT: 3 p.m. Sunday at the Arts Center of the Ozarks. $4-$8. artscenteroftheozarks.org or 751-5441.
WINTERFEST CHORAL: 7:30 p.m. Monday at the Walton Arts Center in Fayetteville. $10. waltonartscenter.org or 443-5600.
GINGERBREAD DECORATING WORKSHOP: 4 p.m. Dec. 11 at the Fayetteville Public Library. Registration required; for children and families. faylib.org or 856-7270.
"OH CHRISTMAS TREE" THEME TOURS: 10 a.m.-4 p.m. Tuesdays through Saturdays, through Jan. 3 at Hawkins House, Rogers Historical Museum, 322 S. Second St., Rogers. rogersarkansas.com/museum or 621-1154.
ILLUMINATED FIGURES: 5 p.m. daily Sunday through Dec. 31 along the drive at the Great Passion Play in Eureka Springs. Free. eurekaspringschamber.com.
CHRISTMAS CAROL HIGH SCHOOL: 7 p.m. Dec. 12-13 and 2 p.m. Dec. 13-14 at the UA Continuing Education Building on the Square in Fayetteville. An original production of Arts Live Theater. $8-$12. artslivetheatre.com or 521-4932.
HOME FOR THE HOLIDAYS: 7 p.m. Dec. 12 at The AUD in Eureka Springs. Music by local musicians; admission by donation. theaud.com or 253-2586.
THE BEST CHRISTMAS PAGEANT EVER: 7:30 p.m. Dec. 12-13 and at 3 p.m. Dec. 13 at the Arts Center of the Ozarks in Springdale. $9-$20. artscenteroftheozarks.org or 751-5441.
CECE WINANS: Holiday Show at 8 p.m. Dec. 12 at the Walton Arts Center in Fayetteville. $20-$45. waltonartscenter.org or 443-5600.
HANUKKAH CELEBRATION FOR CHILDREN: 10:30 a.m. Dec. 13 at the Fayetteville Public Library. Free, registration required. faylib.org or 856-7170.
SWEET TREATS COOKIE TOUR: noon-6 p.m. Dec. 13 at 12 bed and breakfast Inns in Eureka Springs. $20; self-guided tour. allianceofbetterbandbs.com/eureka-springs-cookie-tour.htm.
OZARK HANDBELL ENSEMBLE: 3 p.m. Dec. 13 at the Fayetteville Public Library. Free. faylib.org or 856-7250.
OZARKS CHORALE CONCERT: 7:30 p.m. Dec. 13 at The AUD in Eureka Springs. theaud.org or 253-7788.
CLASSICAL BALLET ACADEMY'S "THE NUTCRACKER": 10 a.m. and 1 p.m. Dec. 12, 7 p.m. Dec. 13 and 2 p.m. Dec. 14 at Arend Arts Center, 1901 S.E. "J" St., Bentonville. $7-$22. classicalballetacademy.net.
HOLIDAY DAZZLE CHRISTMAS SHOW: 8 p.m. Dec. 13 at the Alma Performing Arts Center, 103 E. Main, Alma. $20-$30. almapac.org or 632-2129.
ARTISTS RECEPTION AND HOLIDAY OPEN HOUSE: 5-8 p.m. Dec. 18 at Four Square Fine Art Gallery, 112 W. Center St., Fayetteville. Show and sale through Jan. 10. FourSquareFineArt.com or 422-8607.
ARKANSAS WINDS HOLIDAY CONCERT: 3 p.m. Dec. 20 at the Arts Center of the Ozarks in Springdale. $8-$16. artscenteroftheozarks.org or 751-5441.
FIRST NIGHT FAYETTEVILLE: 6 p.m.-midnight Dec. 31 at the Northwest Arkansas Mall. Music, art and dance. $5-$30. firstnightfayetteville.com or 443-4797.
OMNI CENTER DEMONSTRATION: for U.S. troop withdrawal from Iraq. 1 p.m. Saturday at the corner of Mall Avenue and Joyce Boulevard in Fayetteville. Signs provided. Follow up demonstrations first Saturdays of the month at this location. makejobsnotwars.com or 586-2053.
BATTLE OF PRAIRIE GROVE: Civil War reenactment at 1 p.m. Saturday and Sunday at Prairie Grove Battlefield State Park. Guided tours through Confederate, civilian and Union camps, spinning and lace-making demonstrations. $4 per vehicle. arkansasstateparks.com or 846-2990.
NEW DESIGN SCHOOL SCHOLARSHIP GALA: 7 p.m. Saturday at East Square Plaza on the Square in Fayetteville. Showcasing work by students and instructors; music by DJ SoulFree and DJ Shortfuze. $5-$10. newdesignschool.org or 587-9925.
SHILOH MUSEUM REOPENS: 10 a.m. Monday at the Shiloh Museum after renovation. Open 10 a.m.-5 p.m. Mondays through Saturdays. Free. springdaleark.org/shiloh or 750-8165.
THE WIZARD OF OZ: 7:30 p.m. today and Saturday, and 2 p.m. Sunday at the Alma Performing Arts Center, 103 E. Main, Alma. Alma High School Performing Arts. $5-$15. almapac.org or 632-2129.
CRIMES AND CLUES BOOKCLUB: 10 a.m. Friday at the Fayetteville Public Library. Registration required. faylib.org or 571-2222.
TIM ERNST'S CLOUD JOURNAL: Reading and slide show at 2 p.m. Sunday at the Fayetteville Public Library. Free. faylib.org or 856-7250.
OMNI'S OPEN MIC FOR PEACE: 7 p.m. Sunday at Nightbird Books. Space limited. nightbirdbooks.com or 582-2291.
OZARK POETRY SLAM: 7 p.m. Tuesday at Smiling Jack's in Fayetteville. Haiku Slam. $5 cover. 466-6006.
UA TUBA AND EUPHONIUM ENSEMBLE: 7:30 p.m. today at the University of Arkansas Fine Arts Concert Hall. Directed by Dr. Benjamin Pierce, with Debbie Aulerich, Greg Battista, Juan Garcie, Kevin Graber, Jacob Grewe, Ryan Grover, Brad Helton, David Hendley, Daniel Jordan, Lee Larry, Andrew Moffett, Candice Nugent, Michael Post, Matthew Shipes, Jordonn Smith, Brian Sours and Jason Tacker. Free. 575-4701.
FULBRIGHT TRIO: 8 p.m. Friday at the University of Arkansas Fine Arts Concert Hall. With Stephen Gates, cello, Er-Gene Kahng, violin, and Jura Margulis, piano. Free. 575-4701.
PIANO RECITAL: Students of Jura Margolis at 8 p.m. Saturday at the University of Arkansas Fine Arts Concert Hall. Free. 575-4701.
UA PREPARATORY ORCHESTRA: 3 p.m. Sunday at the University of Arkansas Fine Arts Concert Hall. Free. 575-4701.
GUITAR STUDIO CONCERT: 8 p.m. Tuesday at the University of Arkansas Fine Arts Concert Hall. Mike Sorenson, Joe Kane, Patrick Sallings, Patrick Geogre, Mark Shields, Johnathon Paape, Joel Paul, Josh Richardson, Joseph Ralston, Jameson Burton and Reed Faitak. Free. 575-4190.
SOUTHWEST SERVICE DOGS: Demonstration at 1 p.m. Saturday at the Jones Center in Springdale. Free. southwestservicedogs.org or 646-0886.
DOUBLE DRAWER JEWELRY BOX CLASS: 6-9 p.m. Monday and Tuesday at the Little Mountain Bindery and Printmaking Studio, 572 W. Sixth St., Fayetteville. $125; includes materials. littlemountainbindery.com or 587-0238.
SALSA LESSONS: 8:30 p.m. Fridays at Deja Vu, 3404 S.E. Macy Road, Bentonville. Free. dejavubentonville.com or 464-9677.
DHARMA TALK: 11 a.m. Sundays at Dramis Hardwood Floors, 2275 S. School Ave., Fayetteville. With Tibetan Buddhist Monk Ven. Geshe Thupten Dorjee. tcia.com or 587-8920.
EDIBLE & MEDICINAL PLANTS: Friday, Saturday and Sunday at the Hurricane Creek Wilderness Area. Registration required. $175. ozarktrackers.org.
OVERNIGHT FUN HIKE: Saturday and Sunday from White Rock to Lake Fort Smith State Park. Registration required. 431-8951.
BICYCLE COALITION OF THE OZARKS: Return of the Scorcher at 5:30 p.m. Wednesday at the Fayetteville Public Library. Artistic overview of American cycling culture compared to World Cycling culture. 521-4619.
OZARK SOCIETY — HIGHLANDS CHAPTER: 7 p.m. Wednesday at the First Presbyterian Church, Calvin Road, Fayetteville. 521-4062.
GUN SEASON: through Dec. 28. Be careful during hunting season, and check for trail closures at arkansasstateparks.com.
ARCTIC ADVENTURES: noon-5 p.m. Saturday and Sunday and Dec. 13-14, and 3:30-7:30 p.m. Monday through Dec. 12 at Tricycle Theatre, 120 S. Main St., Bentonville. Family friendly creative play event and performances. $10-$25. triketheatre.org or 866-331-3681.
YOUTHCAN!'S FAMILY DAY: 10 a.m.-4 p.m. Saturday at Community Imagination Studio, 818 N. Sang Ave., Fayetteville. Free; no pre-registration. communityimaginationstudio.org or 442-8585.
TRIKE NIGHT LIVE: 8:30 p.m. Saturday at Tricycle Theatre, 120 S. Main St., Bentonville. $5; family friendly open mic event for teens. triketheatre.org or (866)331-3681.
TEEN ANIME CLUB: 5 p.m. Monday at the Fayetteville Public Library. faylib.org or 571-2222, ext. 4370.
ALICE IN WONDERLAND JUNIOR AUDITIONS: 1-4 p.m. Saturday and Sunday, and 6-8 p.m. Monday at Arts Live Theatre (in the Evelyn Hills Shopping Center), 1378 N. College Ave., Fayetteville. Open to ages, 7-18. artslivetheatre.com or 521-4932.
WRESTLEMANIA READING CHALLENGE: December through Jan. 12 at the Fayetteville Public Library. For grades 5-12. faylib.org or 571-2222, ext. 4370.
A MURDER ANNOUNCED AUDITIONS: 7:30 p.m. Dec. 15-16 at the Arts Center of the Ozarks in Springdale. artscenteroftheozarks.org 751-5441.
KISS ME KATE AUDITIONS: 7 p.m. Jan. 5-6 at the Rogers Little Theater. RogersLittleTheater.com or 631-8988.
CALL FOR ART BY SID SARGENT: Seeking all types of artwork produced by Sid Sargent. All accepted artwork will be catalogued, insured, displayed professionally and returned after close of exhibit. Work will be accepted Jan. 7-13. Exhibition will be Jan. 21 through Feb. 21 at ddp gallery in Fayetteville. dede@ddpgallery.com or 442-0001.
HANSEL & GRETEL AUDITIONS: 7:30 p.m. Jan. 12-13 at the Arts Center of the Ozarks in Springdale. artscenteroftheozarks.org 751-5441.
ANNE KITTRELL ART GALLERY: Arkansas Union, Fayetteville. 575-5255. Multimedia art by Sam King through Friday.
ARSAGA'S: 1582 Crossover Road, Ste. 2, Fayetteville. arsagas.org or 527-0690. Paintings by Ashley Burgos through December.
ARSAGA'S: 2418 N. Gregg Ave., Fayetteville. arsagas.org or 444-6557. Multimedia by WWAM!, Women With A Message, through December.
ARTS CENTER OF THE OZARKS: 214 S. Main St., Springdale. artscenteroftheozarks.org or 751-5441. Artists of NWA Exhibition through Dec. 19.
CITIZENS BANK GALLERY: 116 E. Buchanan St., Prairie Grove. 846-0899. Contemporary ceramics, sculpture, paintings, photography and more.
DDP GALLERY: 7 E. Mountain St., Fayetteville. ddpgallery.com or 442-0001. Small Works Dec. 4 through Jan. 10.
FOUR SQUARE FINE ART GALLERY: 112 W. Center St., Fayetteville. FourSquareFineArt.com or 422-8607.
THE GALLERY: 509 W. Spring St., Ste. 225, Fayetteville. artexponwa.org or 361-1211. An artists' collective.
HEARTWOOD GALLERY: An Artists' Collective. 428 S. Government St., Fayetteville. 444-0888. Jewelry, pottery, glass, handmade books, textiles, sculpture, photography, paintings, drawings, mixed media, music CDs, wood turnings. More than 30 local artists.
JULIE WAIT DESIGNS ART GALLERY: 318 S. First St., Rogers. juliewaitdesigns.com or 631-8706. Works by Robert Glick through Dec. 26.
MULLINS LIBRARY: University of Arkansas, Fayetteville. 575-6702. "The Subjective History of a Tiger" by Tony Tiger through December.
OZARK GLASSWORKS: 675 E Huntsville Road., Fayetteville. 387-6773.
POOR RICHARD'S ART: 116 S. First St., Rogers. poorrichardsart.com or 636-0417.
ROGERS LITTLE THEATER: 116 S. Second St., Rogers. RogersLittleTheater.com or 631-8988. "Candle Series" by Sarah Creasman through Dec. 29.
TERRA STUDIOS, MUSE GALLERY & COFFEE HOUSE: 12103 Hazel Valley Road, off Arkansas 16E in Durham. terrastudios.com or (800) 255-8995. Featuring art work by over 30 artists, 10 acres of gardens in the Art Park with murals and sculpture installations. Home of the Original Bluebird of Happiness. Local artists showcase, Angel Oil Lamps, and Bluebirds of Happiness giveaway through December.
UNIVERSITY OF ARKANSAS FINE ARTS CENTER GALLERY: Fayetteville. 575-7987. "New Hybrids: Ink and Graphite" by John Swindler through Jan. 16.
ROGERS HISTORICAL MUSEUM: 322 S. Second St., Rogers. 621-1154. rogersarkansas.com/museum. "Virgil Lovelace and Life on the Farm" through August 2010. "Down a Lazy River: Float Fishing on the White River" through April 2009. "Discovering the Bluff Dwellers" through Jan. 2009.
SHILOH MUSEUM: 118 W. Johnson Ave., Springdale. 750-8165. springdaleark.org/shiloh. Exhibits of early life in the Ozarks. Original buildings on the grounds. "Ozark Voices: Personal Stories from Northwest Arkansas" through Jan. 17.
SILOAM SPRINGS MUSEUM: 112 N. Maxwell St., 524-4011. "Collector's Collections" through Jan. 14.
CHERRY BEND WORK DAY: Work with the Ozark Highlands Trail Association at 8 a.m. Dec. 13 at the Cherry Bend Trailhead. Bring gloves, food and water. Call first for details. 986-9022.
ASHLEY BURGOS ARTIST RECEPTION: 6-8 p.m. Dec. 13 at Arsaga's on Crossover in Fayetteville. arsagas.org or 527-0690.
WWAM! ARTISTS RECEPTION: 4-9 p.m. Dec. 14 at Arsaga's on Gregg in Fayetteville. arsagas.org or 444-6557.
TOP CHEFS & ROCK STARS: 5:30 p.m. Dec. 15 at the Fayetteville Town Center. Benefits Peace at Home Family Shelter. $50. peaceathomeshelter.org or 444-8310.
MONTY PYTHON'S SPAMALOT: 7 p.m. Dec. 16-18 and Dec. 21, 8 p.m. Dec. 19-20, and 2 p.m. Dec. 20-21 at the Walton Arts Center in Fayetteville. $45-$75. waltonartscenter.org or 443-5600.
THE WIZARD OF OZ: 7 p.m. Jan. 6-8 and Jan. 11, and 8 p.m. Jan. 9-10, and 2 p.m. Jan. 10-11 at the Walton Arts Center in Fayetteville. $20-$58. waltonartscenter.org or 443-5600.
HELEN THOMAS ARTIST RECEPTION: 4 p.m. Jan. 9 at Julie Wait Designs Art Gallery, 318 S. First St., Rogers. juliewaitdesigns.com or 631-8706.
SCENE STUDY 2: Begins Jan. 11 at Nadine Baum Studios in Fayetteville. $180; six-week session. theatresquared.org or 445-6333.
JUNIE B. JONES: 7 p.m. Jan 20 at the Alma Performing Arts Center, 103 E. Main, Alma. $10-$20. almapac.org or 632-2129.
DRUMLINE LIVE: 7 p.m. Jan. 22 and 8 p.m. Jan. 23 at the Walton Arts Center in Fayetteville. $20-$45. waltonartscenter.org or 443-5600.
COMEDIAN BRIAN REGAN: 7 p.m. Jan. 25 at the Walton Arts Center in Fayetteville. $39.50. waltonartscenter.org or 443-5600.
HOT CLUB OF SAN FRANCISCO: 7 p.m. and 9:30 p.m. Jan. 30 at the Walton Arts Center in Fayetteville. $15-$30. waltonartscenter.org or 443-5600.
THEATRE SQUARED'S "RABBIT HOLE": 8 p.m. Jan. 30-31, Feb. 5-7 and Feb. 12-14, and 2 p.m. Feb. 1, Feb. 8, and Feb. 15 at Nadine Baum Studios in Fayetteville. $22. theatresquared.org or 445-6333.
STELLALUNA: 11 a.m. Jan. 31 at the Walton Arts Center in Fayetteville. $10-$16. $5 Family workshop at 12:30 p.m. waltonartscenter.org or 443-5600.
IRA GLASS: 8 p.m. Jan. 31 at the Walton Arts Center in Fayetteville. $20-$38. waltonartscenter.org or 443-5600.


my second trip out on stones dog days , and had a great day , some old faces there and new ones .
Have just had a steaming mug of Poppins tomato and basil soup that she kindly let me blag.
Thanks Stone for a great day .
I can confirm it was a great day out and very informative. The scoff was great - TVM Poppins - and to everyone who put in the effort to make it happen. Thanks.


text:
Spring Festival 2018: Year of the Dog
Spring Festival 2017: Year of the Rooster
Spring Festival 2016: Year of the Monkey
Xi-Trump Summit
Xi US State Visit
Xi UK State Visit
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The Peony Fairy: Peng Liyuan, China's first lady
Unlike previous first ladies, Peng Liyuan is a well-known name in China. Here is a look at her humble beginnings, her rise as a musical superstar and her current administrative position.
Born in 1962, in Yuncheng County in the Shandong province, Peng Liyuan joined the People's Liberation Army in 1980, first as a soldier and then working primarily as vocalist for troops during the Sino-Vietnamese border conflicts.
Mrs. Peng comes from a poor family in contrast to her well-connected husband, whose father was a vice-premier of China.
At 14, Peng Liyuan made an early entry into the Shandong University of the Arts specializing in Chinese Folk songs.
President Xi Jinping and Peng Liyuan in 1987 (Xinhua)
Culture has always been an important part of Mrs Peng's upbringing. Her father was a schoolmaster in charge of the county Culture bureau. He earned 40 yuan a month. Her mother was a member of a small touring opera company, according to BBC.
She is currently the PLA Art Academy dean, vice chairman of Chinese Opera Research Institute, member of the ACWF Executive Committee, a visiting professor for the Chinese Academy of Music at Peking University to name a few, according to an entry in Baidu ( China's version of Wikipedia).
It was the The New Year's Gala on CCTV in 1983 that made her a national celebrity. It was just three years later, in 1986 when the soprano star would meet future President Xi through a mutual friend. At that time, President Xi was the was the deputy mayor of Xiamen City in southern Fujian province and she was already a well known singing superstar. Peng and President Xi have one daughter, 23 year old Xi Mingze who graduated from Harvard in the United States in 2014.
President Xi Jinping with his father, his wife, Peng Liyuan and daughter. (Xinhua)
Unlike China's previous first ladies, who have remained mostly behind the scenes, she is a high-profile political spouse at the top level. In 2015, Forbes listed Peng Liyuan as the 68th most powerful woman in the world.
Image: AP
Popularly referred to as the Peony fairy (referring to the Peony flowers of her hometown), Peng Liyuan has performed all over the world as a Chinese Folk Singer. After President Xi, took office in 2013, she cut down her singing engagements till 2014, when she narrated "a short film about discrimination towards people with HIV for the World Health Organization and also sang the film's theme song. Since 2011, Peng has served as a World Health Organization (WHO) ambassador for Tuberculosis and HIV/AIDS.
Peng Liyuan hugs a child patient during her visit to Federico Gomez Children's Hospital, in Mexico City, Mexico. Photo: Xinhua
She was designated as UNESCO's Special Envoy for the Advancement of Girls' and Women's Education in recognition "of her commitment to empowering girls and women through quality education, her outstanding contribution to fighting inequalities in education, her devoted service to human development and creativity, and her dedication to the ideals and aims of the Organization." on March 27, 2014.
On her birthday in November last year, Massey University in New Zealand conferred her an Honorary Doctorate in recognition of her international contributions to performing arts and health and education.
You can listen to Ms. Liyuan perform here:
Sources: UN Health, Massey University, Forbes, BBC.co.uk, South Morning China Post, The Telegraph and CCTV News.
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There's this kid named Anthony Brown beating me up at school, and he said if I gave him a dollar, he'll truce and be friends with me. I gave him a dollar, and he's been cool with me.
Today at recess, I was on the field. And my friend Samuel was fighting him..
BTW, me and Anthony fight alot, even though we're cool most times.
Anthony through me accross the snow in my jeans I got for Chistmas, and I got up, made a glare, and charged at him.
He through me again, and I screamed bloody murder for help. He made a really suspicious move, he ke[pt running in circles around me while I was on the ground, and every time I tried to run, ke'd kick me into the ground.
I told the teacher at least 5 times.. guest whats happenes the next time?
Sharp, this is very serious, tell your parents.
Yea, this isn't even funny. Its bullying and you should tell a parent, guardian or teacher immediately.
Yea sharp tell ur parents sorry dude u ok??
You need to tell someone about that.
I was being bullied by a group of like four kids at summer school, so I told my mom, and she called the principal.
Also, the battle at the field was really dangerous, that my foot was in extreme pain. Its acking a little bit right now, and I'll tell my teacher tomorrow.
i get beat up all the time it stinks!!!!!
You need to take it to the principal though, if you've told the teacher enough.
i had my first fight and i bloodied up a boys noes Note: i was only like 7.
I've never been in an actual fight, and I've only physically tried to harm other girls at school twice. In third grade, there was this girl called Lexi who was turdy on a few levels, so I pushed her down, and then in 5th grade, Em was bullying my friend Zoe, saying "YOU FREAK YOU YELL AT ME AND HIT ME" even though Zoe wouldn't hurt a fly.
Em was five foot two in third grade, and was almost six foot then, when we were all around the 5 foot mark. And, she was really, freakishly strong. I went up and pushed her. I saw my hand in her gut, looked up, saw her boiling mad, and almost peed myself for my idiocy. She almost broke my arm, twisting it like that.
When I came home that day, before my mom saw the bruise on my forearm, I told her. Bam, like that, Em was expelled, haven't seen her since.
So just whack the freaking Anthony in the face. Or, tell your parents.
oh i remember 4th grade! their was this guy 2 times bigger than me, we fought and i rolled under his legs put him in the head lock, he passed out.
Waaait. I just remembered. Isn't your name Anthony, Sharp?
Hey, thats serious though. Go tell a teacher or parent NOW.
That must be a pain sharp! Well, what I am surprised of is that it sounds like you got back. I wouldn't do that because my brother got a detention for that... You told your parents right???
Subject: Re: Ugh.. Why ME?


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Descriptive Essay: My Country South Africa.
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Descriptive Essay: My Country South Africa South Africa is a country situated on the most southern tip of Africa cradled by the icy Atlantic Ocean on the west and the warm Indian Ocean on the south and east. The southernmost tip jutting out into the ocean is called Cape Aghulhas (Cape of Needles) and separates these two great oceans. To the north are Mozambique, Botswana, Namibia and Zimbabwe.
The South African Revolution also known as the time of the Apartheid took place during 1908-1994. It was a long struggle for the Africans, which included riots, protests, segregation and physical pain. During the period of the Apartheid, blacks were not treated with equal respect to the whites. They weren't allowed to vote, hold office and the children couldn't go to school with whites. It.
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My black South African friends tell me it's easy to tell a Venda from a Shangaan from a Xhosa from a Pedi. "These ones from Venda, they have wide across the nose and high in the cheekbones," they say. But I don't see it; I'm years away from being able to distinguish the nuances of ethnicity. Today, I know these women are Vendas simply because of their clothing: bright stripes of.
South African Short Stories: Apartheid, Civil Rights, and You Ms. Carol Marshall Hingham Public Schools Prepared for Primary Source Summer Institute: Modern African History: Colonialism, Independence, and Legacies (2015) Carol Marshall, Hingham Public Schools 2 Abstract: The legacy of Western colonialism in African history can be seen in much of the South African literature, and specifically.
The essay topics in this lesson will help students increase and showcase their expertise on South Africa. South African History This section offers topics that focus on the history of South Africa.
South Africa is found at the southernmost region of Africa, with a long coastline that reaches more than 2,500 km (1,553 mi) and along two oceans (the South Atlantic and the Indian).At 1,219,912 km 2 (471,011 sq mi), South Africa is the 25th-largest country in the world and is almost the size of Colombia. Njesuthi in the Drakensberg at 3,408 m (11,181 ft) is the highest part in South Africa.
South African literature, the body of writings in either Afrikaans or English produced in what is now the Republic of South Africa.The rest of African literature is treated in African literature. South Africa was colonized by Europeans against the resistance of Africans and was for some time afterward a battlefield between Briton and Boer.
The culture of South Africa is known for its ethnic and cultural diversity. The South African majority still has a substantial number of rural inhabitants who lead largely impoverished lives. It is among these people, however, that cultural traditions survive most strongly; as South Africans have become increasingly urbanized and Westernised, aspects of traditional culture have declined.
However, after 1994, South African society has been changing. For starters, the country now has a bill of rights. This bill of rights which were put into effect in South Africa after 1994 have helped in the transformation of South Africa. In the past whites and non whites did not have equal rights. Non whites were segregated against using laws which were punishable if broken. Now there is a.
South African literature, literary works written in South Africa or written by South Africans living in other countries. Populated by diverse ethnic and language groups, South Africa has a distinctive literature in many African languages as well as Afrikaans (a vernacular derived from Dutch) and English. See also African literature. Although Afrikaans had emerged as a distinctive language.
Corruption in South Africa Essay. Page 1 of 45 - About 450 Essays Positive Effects Of Poverty In South Africa. The continent of Africa is the world 's second largest continent after Asia, with a total surface area, including several surrounding islands of 30,313,000 square kilometres. As people known that Africa is one of the poorest country in the world. Especially in the South, 54% of people.
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The South African court system is organized in a clear hierarchically by Chapter 8 of the Constitution of the Republic of South Africa, specifically s166, and consists of (from lowest to highest legal authority):. Firstly, a number of Magistrates' Courts (both smaller Regional and larger District). Secondly, a single High Court with multiple divisions across the country, both regional.
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Joanie Thresher welcomes an average of 7,000 troops and family members each month to the USO in Columbia Metropolitan Airport.
With basic training behind him, Pfc. Corey Neal of Aiken can relax with a book before traveling to AIT in military intelligence. (Neal was a 2010 Washington Youth Tour student from Aiken Electric Cooperative.) A flight arrivals-and-departures monitor inside the USO center provides convenient updates.
After long days in combat skills training at Fort Jackson's Camp McCrady, soldiers decompress at the USO's on-site day room—playing pool, ping pong or card games and watching movies or ball games on a big-screen TV.
The USO's on-site day room at Fort Jackson's Camp McCrady hosts regular dinners for soldiers who are being deployed. Capt. Michael Hassien, officer in charge, the USO's Katie Kennedy and volunteer Michelle McClain of Gilbert set up a barbecue buffet, courtesy of Hudson's Smokehouse.
Foul weather raged across the Midlands, severe enough to shut down flights out of Columbia Metropolitan Airport. Joanie Thresher vividly recalls that day in 2012 and the 19-year-old soldier with a story to tell.
Thresher was on duty at the airport, as usual, as director of USO South Carolina. She saw a quiet, nice-looking young man come in and settle himself. Hours passed, and he declined repeated offers of food or help, just glad for a comfy place to pass the time. He'd just completed training at Fort Jackson and was headed to his next assignment. But his flight had been canceled; short on funds, he was stranded there for at least a day, maybe two.
"So I told him, not a problem, we'd get him a hotel room," Thresher remembers. She packed a goody bag with snacks and toiletries and escorted the anxious but grateful soldier to his hotel shuttle.
Thresher fights back tears at the memory. But this, she says, is what the USO does best—providing small comforts that make a huge difference to service members who are away from home, and to their families.
Say "USO" and most folks picture Bob Hope and his overseas camp shows, entertaining the troops, from World War II through the Gulf War. Celebrities still visit military bases around the world on USO tours, but much of what today's USO delivers happens in centers like the one at the Columbia airport.
The cozy USO center in the main lobby of Columbia's airport is stocked with snack foods, soft drinks and coffee, all free to military personnel and their families. They can watch TV, use computers to send email, Skype or surf the Web, play Xbox games, or call home. Volunteers answer questions, calm nerves and point them in the right direction when it's time to go.
"Does the bus to Fort Jackson get here at 5? " a new recruit, freshly arrived from Missouri, asks Thresher mid-afternoon one day.
"Is he going to be on our case as soon as he gets here?" the young man persists, more concerned about the drill sergeant.
Thousands of military personnel funnel through the Columbia airport every month on their way to and from Fort Jackson, the U.S. Army's largest basic training site. Many more are traveling to and from Sumter Air Force Base and McEntire Joint National Guard Base in the Midlands or other military installations stretched from Charleston to Greenville. Some are journeying to deployment in Afghanistan, Kuwait or far-flung parts of the world. Others are on the way to specialized training schools.
Most, though, are new recruits arriving for basic training at Fort Jackson, clutching large kraft envelopes with all their paperwork, some traveling outside their hometowns for the first time.
"These young recruits come in, and they have just raised their hand to swear to defend our country, and then they come here, and they have no idea where to go," says Katie Kennedy, programs manager for USO South Carolina.
Recognizing a need, in 2009 the airport donated space for these service members in transit, and Midlands leaders hired Thresher to run it. Together they petitioned the national USO in Arlington, Va., to open a permanent location in Columbia. Since 2010, it has been serving some 7,000 military personnel and their families each month.
Kennedy and Thresher are the only paid staffers at the nonprofit USO South Carolina. The "heart and soul" of the organization, they insist, is the center's 130-plus volunteers—veterans, family members of active-duty military, offspring of military families, grateful citizens. All understand the impact of those "little, little things" the USO does.
When new recruits arrive at the airport, volunteers meet them with a smile, a snack and answers to questions. When trained troops prepare to deploy, volunteers applaud them on their way, providing snacks or personal care items for the journey. When soldiers come home for R&R, volunteers equip their family members with "welcome home" signs to greet them. When active-duty service members, veterans or their families need a respite in their travels, the USO's doors are open.
Pfc. Corey Neal, 20, found a quiet space at a USO table to enjoy a book on his way to advanced individual training (AIT) in Pensacola, Fla. It was Neal's first visit to a USO, but he had heard good things about the Columbia center. He savored his cinnamon roll and Coke—an enjoyable change after weeks of the DFAC (dining facilities) and MREs (meals ready-to-eat).
The airport center is the only staffed and permanent USO location in the state, but the USO also maintains a day room and a portable "USO in a Box" at McCrady Training Center, a S.C. Army National Guard training site at Fort Jackson. Both locations deliver what most personnel are anxious for—computer access, DVDs, video games, outlets to recharge electronic devices, voice-over-Internet phone service.
"Where back in Vietnam and before, our families and loved ones had to wait on the mailman to get that letter—they had to write that letter and make sure that letter got home or got to their soldiers or to their troops overseas—now they're able to communicate via Skype, computers, voice-over phones," Thresher says.
One favorite mode of communication is a national USO partnership called United Through Reading. Deploying soldiers choose from a selection of children's books, and USO volunteers record a DVD of the soldier reading that story for his or her family back home. USO South Carolina offers this program at the Camp McCrady day room for every group of soldiers deploying from Columbia, and they take the service to other parts of the state as needed.
Nationally, the USO provides a range of programs to support active military personnel, the families who wait for them to come home, those who return with illness or injuries, veterans seeking jobs, and other needs. A 2012 TellUSO survey showed that 95 percent of service members believe the USO lets them know their country supports them.
Locally, the focus is on providing a respite from duty—"a cup of coffee, a taste of home, a friendly face," Kennedy says. The USO South Carolina invests every donation into caring for the troops that pass through the Columbia airport or train at a South Carolina installation. They do it 365 days a year, until, as the USO motto says, every one comes home.
Joanie Thresher IS an angel at the USO. NOBODY works harder or is more dedicated to the troops than she is. It has been an honor to know her and support her facility. Her volunteers are among the greatest, most dedicated team I have ever come across and nobody does more.