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Request your free copy of Tortured for Christ 50th Anniversary Edition. Pastor Richard Wurmbrand, whose body bore the scars of 14 years of torture and suffering for Christ in a Communist prison, witnessed the indomitable courage and persistent faith of many persecuted believers. Following his release from prison, he devoted his life to being a voice for persecuted Christians. Now you can receive a free copy of the newly released 50th Anniversary Edition of Tortured for Christ.
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Available ebook formats: epub mobi pdf rtf lrf pdb txt html
Robert Bernhard's 40-year+ career in the sciences includes working at Harvard's Computational Laboratory, MIT's Instrumentation Lab, The Monrobot Laboratory, the ITT (International Telephone and Telegraph) labs, the Grumman Aircraft Research Department, the Molecular Biology Department at the Albert Einstein College of Medicine in New York, and the Medical Education Division at Excerpta Medica (a division of Elsevier). He has worked as editor at IEEE Spectrum, Nucleonics Weekly, and Drug Therapy, and editor-in-chief at Emergency Medicine magazine. He has published numerous papers in peer-reviewed academic journals, including "Correlation Waves in Brain-Like Structures" (Bulletin of Mathematical Biophysics), "Chemical Homologue of Freud's Model" (Psychoanalytic Quarterly), "A Kinetic Model of Memory" and "Irreversible Thermodynamics in Biology" (Journal of Theoretical Biology), and "Adrenoreceptors and the Anxiolytic Effects of Risperidone (The AMA Journal of Neuroscience and Neuropsychiatry). He received the 1980 Communicator of the Year Award from the Institute of Electrical and Electronics Engineers, published two novels, a short computer networking textbook, and played Crimson Tide football (both ways) from 1950–1952.
· · ·He has lectured on software simulations of neoronal networks in the brain, artificially intelligent neural nets, and applications of quantum mechanics methods in neuroscience at the University of Pittsburgh School of Medicine, the Johnson Research Foundation of the University of Pennsylvania, the International Federation of Information Processing Societies Congress (Munich, 1964), the Conference on Engineering in Biology (Chicago), and Queens College of the City University of New York.
· · ·He is listed in American Men of Science (Cattel), and The Bioelectronics Directory (Texas Christian University).

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by, 08-06-2019 at 03:14 AM (97 Views)
Even Worse recall this week. I've been focused on Fortnite. The cringiest game in the world...
First dream had C in it. She just seemed happy that's all.
Jamie is at her computer screen again. I'm inside a dream on the other side of her screen, Her face is giant. She's talking to me and she seems concerned I'll go after C or something, because it seems I've developed a little crush. Don't worry I'll never act on it and I already screwed it up with her majorly.
a couple other dreams with C in it. One I was in an eediting course on fortnite. Can't remember any details. just that she was there.
any other dreams are just too foggy to recall


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|Home | Contact
Made of gel-like plastic, soft contact lenses contain varying amounts of water (ranging from 25% to 79%). Soft contact lenses provide good initial comfort for first-time wearers but must be replaced often. Statistically, more than 80% of lens-wearers choose soft contacts (Mayo Clinic 2005). The water in soft contact lenses is necessary in order for oxygen to pass through the lens and reach the cornea. This also makes the lens comfortable and easy to adapt to in addition to aiding the lens to remain in place easier than gas permeable lenses. Soft contact lenses the choice selection for those with an active lifestyle.
When selecting soft contact lenses, take note of the fact that although daily wear soft contact lenses are not as durable as gas permiable lenses, they are more durable than disposable lenses. It should be noted that soft contact lenses are not as effective when it comes to correcting certain vision problems such as high degrees of astigmatism. Consult your optometrist for further detail.
Gas permeable contact lenses may also be referred to as RGPs, or rigid gas permeable contact lenses. Gas permeable contact lenses should not be confused with hard contact lenses, as they differ in the fact that oxygen is let through to the eye when wearing RGP contact lenses. RGP contact lenses allow for more oxygen to pass through than traditional soft contact lenses as well. This can be attributed to the fact that RGP contact lenses are made out of silicone. Ultimately, this leads to more comfort for contact lens wearers and promotes the maintenance of a healthier eye. According to the FDA, approximately 16% of Americans wear RGP contact lenses. Additionally, the OK RGP contact lens, made by ConTEX, is the first lens designed to correct nearsightedness by temporarily reshaping the transparent tissue covering the iris and pupil (cornea).
Although one of the major downsides to choosing RGP contact lenses is the adjustment period, long term benefits such as crispness of vision (RGP contact lenses do not bend as easily when blinking), durability (due to being constructed out of heavier material) and reduced protein build up are positive points when comparing the value RGP contact lenses to soft contact lenses. RGP contact lenses can last for years as long as the strength in prescription does not fluctuate.
Gas permeable contact lenses should be a consideration for individuals who fit the following categories:
For patients who have an astigmatism, it is now probable that soft contact lenses can be provided to correct eyesight, where once, there was no choice but to wear gas permeable toric, or astigmatism correcting, contact lenses. Toric contact lenses cannot rotate when in the eye due to a special mechanism; they are split into two sections - divided by curvature - consisting of two different powers.
There are many more types of contact lenses, for a pair which best suit your needs, contact Dr. Soma Bose.
|Laser Eye Surgery | Contact Lenses | Prescription Eye Glasses | Eye Exams | Sun Glasses | Diseases
|Site and contents ©2006 somabose.com, all rights reserved


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Community Engagement
We believe the arts change lives and transform communities. By offering our community members many different avenues to explore creativity, we hope to provoke inspirational conversations, deep self-reflection, and inspired celebration in Dayton.
Visual Voices
Dayton Live partners with Shango: Center for the Study of African American Art and Culture, and Willis "Bing" Davis, exhibit curator and director of EbonNia Gallery, to display an exhibit of art by local African-American artists inside the Schuster Center.
Each year, Dayton Live's Education & Engagement team offers one or more in-depth education projects at no charge to participating students and teachers.


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Healthy Living takes a closer look at gallstones
Gallstones are caused by unbalanced diets and malfunctioning gallbladders. It is a condition that is prevalent but many people hardly know they have it. Interestingly, the northern districts are showing the largest number of cases and it is affecting the female population. Healthy Living has more on this topic.
Marleni Cuellar, Reporting
People who have gallstones may live their life and never know they have the condition. Some populations are much more prone to developing stones in their gallbladder and often times don't know it. Gastroenterologist, Dr Irvin Gabourel, sheds light on our more vulnerable populations in Belize.
Doctor Irvin Gabourel, Gastroenterologist & Endoscopist
"These are very prevalent in the world we could say ten to twenty percent of the patients in the United States are said to suffer from gall stones. In Belize we don't really have exact figures but we know it's a very common condition and I may add to that we have much more cases in the north than we do in any other part of the country people from orange walk and Corozal usually suffer a lot from gall stones so we usually here of a lot of surgeries up there."
Diet and malfunctioning gallbladders are often the culprits.
"Our diets are rich in fat and if our body doesn't have the right mechanisms to break down that fat stones will start to precipitate or it will start to arise from that faulty mechanism. We know that males are less frequent to have gall stones than females and usually we apply the four F's for good remembering: female, forty, family and fat."
Gabourel points out that quite often stones are diagnosis during a checkup for other conditions. This is because of the lack of symptoms associated with gallstones.
Doctor Irvin Gabourel
"The majority of people who have gall stones will never have any symptoms. Seventy to eighty percent of people who have gallstones don't have any symptoms. The ten to twenty percent who have symptoms, the symptoms may vary from having what we call dyspepsia, little bit of bloating, little bit of discomfort, basically on the right upper side underneath the ribcage. So if you eat fatty foods and you get a little bit of belching and bloatedness which most of us would have with a meal and not particularly have any gall stones but if with those symptoms you have pain coming along. That is the first symptom that will lead you to the discovery of somebody who has gall stones."
A thorough medical history and an ultrasound of the gallbladder will confirm the presence of stones. Doctor Gabourel's recommendation is to remove the gallbladder to prevent further complications which can be life threatening.
Dr Irvin Gabourel
"If you have gall stones and you can have gall stones for the rest of your life. If you never have what we call a bilairy colic then there is no need to remove those stones. The minute you start falling into the category that you have stones and you have pain then you may have something known as cholestisisis, which is basically bacteria, invading the gall bladder walls and inflaming it and as a result you end up with cholestisisis. You can function without a gall bladder. I'm living proof of it. I haven't had a bladder since 1994. Basically the gall bladder is placed there to aid in digestion. So it's a little pouch that has bile so whenever you eat that gall bladder contracts that bile will be emptied into the duodenum and start the process of digestion. Or aid in the process of digestion. So basically it's an organ you can live without. If you for some reason or the other you have that gall bladder removed it shouldn't be a big deal."
Lastly be mindful that symptoms of gallstones can mimic those of other problems, including a heart attack, so an accurate diagnosis is important.


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Good morning! Have you ever tried to accomplish a task, but it seemed like every step you took forward put you two steps behind? Did you give up on that task or did you keep pushing forward? Join me today as we begin our reading in Acts chapter fourteen. Have a wonderful day. Bible verse … Continue reading The Next Step
Tag: Mary E. White
It Spread
Good morning! Have you ever been a part of something that was so great that it brought joy to your heart? Have you ever worked hard for a great outcome and it turned out well? Well today we are going to read about the fruit of Paul's and Barnabas' obedience to the Lord. Join me … Continue reading It Spread
The Furthest Corners
It's Friday 9/11 and God still reigns. Sometimes we are placed in a position that allows us to be seen by others. Not necessarily because we want attention, but because someone thought it would beneficial to those who would see and hear what we had to say. In this chapter we learned that Paul and … Continue reading The Furthest Corners
Everyone Who Believes
Good morning! The Lord is always on time. Paul and Barnabas was given a divine opportunity to speak a word of encouragement in the synagogue. The word of encouragement was the Good News. It wasn't by mistake or coincidence that Paul and Barnabas had been given the opportunity, it was the leading of the Holy … Continue reading Everyone Who Believes
Not Decayed
Good morning! We are nearing the end of Paul's encouraging message to the people in the synagogue. Paul's interweaving of the Old Testament was so powerful but also delicate for those who were hearing about Jesus Christ the Messiah for the first time. Join us we read on about our Lord and Savior who never … Continue reading Not Decayed


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Jon Smith Subs Franchise - Cost & Information
Jon Smith Subs Franchise - Cost & Profit
Startup Costs: $332,500 - $637,984
Revenue Range: See FDD
Royalty: 6%
Founded: 1988
About Jon Smith Subs
What is this franchise about?
Jon Smith Subs serves the highest quality, overstuffed, marinated grilled sirloin steak and chicken breasts sandwiches, prepared fresh every day.
What does it sell — and how is money made?
- They have a wide selection of steak and chicken sub sandwich options on their menu, as well as grilled specialties and giant deli subs. The meat is sliced daily and marinated right in the store.
- Customers can customize their meals and add soups, drinks, and chips to their sandwich.
- Jon Smith sells food for people on-the-go.
What type of entrepreneur is it perfect for?
Entrepreneurs who knows a restaurant is not just about serving great food, but about the overall dining experience is the perfect franchise owner candidate for Jon Smith Subs.
Jon Smith Subs Franchise Opportunity
Financial Information
Jon Smith Subs Franchise Locations
Jon Smith Subs Franchise Information
By completing this information request you also gain access to FRANCHISING 101: Everything You Need to Know About Franchising. This comprehensive downloadable book on franchising covers a variety of useful franchising topics.
This free informational book will be delivered to your email address upon completion of the form.


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My understanding about rental stuff is that it has to be able to undergo repeated use and cleaning and still stay new-looking. I think that rules our tweed or delicate fabrics like true linen.
The large chain stores don't have a big range of offerings, I found out. I suggest calling the non-chain places to see if they have any ideas. Only they would have the flexibility to special order something for you. Men's wearhouse-type chains (for instance) can only deal in MW products.
There's one place on the South side (name escapes me now) and two places I know of on the North side - King Tux Rentals in Kennesaw and Tuxedo Wearhouse in Cumming.


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There is no Royal Mail industrial action planned this week (2 - 8 November). Alpkit is open for business as always and if you place your order before 2pm (Mon-Fri) we will get your goodies sent out the same day by first class post. For more postal advice visit our shipping page.
Update II: The CWU and Royal Mail have come to some kind of agreement so the industrial action planned for the 6/8 November has been cancelled!
Update: The CWU has announced 2 further days of industrial action.. Fri 6th Nov and Mon 8th November. Bah.


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Chapter IV.4: Neurophysiologic Monitoring During Spinal Cord Stimulation
Marina Abramova, MD - LSU Health Sciences Center, New Orleans, LA
About this chapter
EMG, or electromyography, and SSEP, or somatosensory evoked potentials, are two methods of neurophysiologic monitoring. This chapter describes how they can assist in ensuring correct placement of electrodes in spinal cord stimulation. Particular attention is paid to the mention of epidural paddle electrode systems.
Index of Sections
Section 4.1: General Uses of Neurological Monitoring in Spine Surgery
Section 4.2: Laminectomy Electrode Implantation, General Methods
Section 4.3: Technique of Midline Positioning of the Spinal Cord Stimulator – Tripolar paddle
Section 4.4: New frontiers of intraoperative EMG application
Section 4.5: References
Section IV.4.1: General Uses of Neurological Monitoring in Spine Surgery
Intraoperative neurophysiological monitoring has become a routine procedure in complex spine surgery. Somatosensory-evoked potential (SSEP) recording has been advocated to monitor the functional integrity of the nervous system during surgical manipulation [22-24, 35]. When stimulated, sensory afferents give rise to signals, carried via the dorsal columns (DC), within the spinal cord to the medial lemniscus and spinocerebellar tracts, ending in the primary somatosensory cortex [4]. SSEP monitoring does not involve the motor pathways, which in some clinical situations can lead to false-negative results and postoperative neurological deficits undetected intraoperatively [1-3, 5, 6, 7, 12]. Dermatomal SSEP testing allows for assessment of individual nerve roots during surgery and has been shown to be more sensitive [7, 8]. However, the sensitivity and specificity of this method varies and is less well-liked than electromyographic (EMG) monitoring [8, 9]. EMG has become the standard of practice in complex spine surgery, providing surgeons with accurate feedback about individual nerve root activity during surgical manipulation of neural structures [10-14].
Section IV.4.2: Laminectomy Electrode Implantation, General Methods
For a number of conditions, particularly the "postlaminectomy syndrome" (aka "failed back") [25, 26, 31], and Complex Regional Pain Syndrome (CRPS I and II) [31, 32], spinal cord stimulation (SCS) has been found to be one of the more effective therapies [30, 31] cost effective [27-29]. Originally, it was based, conceptually, on the gate control theory of pain introduced by Melzack and Wall in 1965 [16], which proposed that the activity of large-diameter fibers (α/β fibers) in the DC plays an inhibitory role in transmission of pain signals to the brain. SCS subsequently received FDA approval in 1979 as a class II device for chronic pain of the trunk and limbs. Over 50,000 SCS systems are implanted for pain disorders around the world each year. Certain principles have become clear through the use of SCS: 1) paresthesia coverage must precisely overlap the painful areas, the cathode is the "active" contact and must deliver its energy to the DC, and 2) accurate identification of the "physiological" midline (PM) is essential for treatment of bilateral pain. Displacement of the cathode up to 1 mm from the affected side works well for unilateral pain [18]. Placement of stimulating electrodes in the subdural space was initially described by Shealy [17]. This resulted in a high complication rate leading to placement of the electrodes in the epidural space. Percutaneous placement of spinal cord stimulator electrodes has several advantages including: minimal invasiveness, reduced cost, and increased flexibility in lead repositioning. Percutaneous placement of electrodes is achieved with local anesthesia and fluoroscopic image guidance to ensure the proper placement of the leads [20, 34] and is routinely used for trial electrodes. However, percutaneous placement is still associated with a comparatively high rate of migration of the electrode (up to 13.5%)[19, 20, 34, 41]. Higher power requirements with omni-directional contacts result in increased battery drain and decreased device durability when used for permanent implants. Accordingly, many centers prefer a laminectomy approach with placement of a "paddle lead" configuration. This approach also allows the electrode to be directly anchored to the lamina at the site of entry to the epidural space [21, 33]. Due to its invasiveness and associated patient discomfort, this approach is often performed under general anesthesia with fluoroscopic guidance to determine the anatomic midline by bony landmarks. As mentioned previously, experience has shown that outcome is critically dependent on symmetric placement of the electrode on the PM , and that the physiologic and anatomic midlines are frequently not identical, differing by up to 2 mm in up to 40% of patients [40]. In the author's experience, it is not at all uncommon for comparative midlines to deviate significantly over as little as a single spinal level . The importance of proper positioning of electrodes during SCS is reinforced by the computer models developed by Holsheimer et al. [39], in which they show that thickness of the dorsal CSF layer and precise midline positioning of the electrodes are the most significant factors determining the perception threshold of stimulation-induced paresthesias.
In order to address these concerns, some centers have employed a "wake up test" to demonstrate that the paresthesia maps to the painful areas before closing. This has received very limited acceptance because of discomfort to the patient and the difficulty obtaining trustworthy feedback from an intubated patient. Other centers have gone to laminectomy under only local anesthesia. Difficulty obtaining adequate intraoperative pain control has limited the acceptance of this technique. Some centers perform the procedure under a high (midthoracic) spinal or epidural anesthetic producing a regional anesthesia, which in experienced hands, does not interfere with the distal patterns of paresthesia coverage. However, it is prone to difficulties in execution, which can lead to dense anesthesia or significant additional intravenous sedation inhibiting patient examination.
The remainer of this chapter is devoted to an alternative technique, which allows the comfort and safety of general anesthetic, while determining the PM by objective neurophysiological testing . The identification of PM by use of evoked potentials was introduced by Claudio Feler, who obtained a patent for a device to perform the mapping [US 6,027,456]. While the device did not gain widespread usage, a few centers adopted the methodology using standard intraoperative electrophysiologic monitoring equipment. To obtain the optimal coverage over painful areas, two major criteria must be met: the applied stimulation should be positioned longitudinally along the DC and the PM must be identified. When general anesthesia is used, intraoperative neurophysiological monitoring with evoked potentials becomes the only way to determine the PM. Stimulation of various portions of the dorsal spinal cord produces paresthesia in a given distribution in the conscious patient, as well as reliable patterns of sensory (SSEP) and motor unit action potentials (MUAP's) of the EMG in the patient under anesthesia. In addition, the output data may include interpolations between specific measured points for optimal assessment of applied stimulation between evaluated lateral positions [US 6,027,456].
These fundamental findings have been implemented in practice by the senior author (KA), who began using this approach in 1999, noting a marked improvement in outcomes over the previous flouroscopically guided technique. In this technique, MUAP's via EMG activation are used to determine the PM by examining the symmetry of the evoked potentials with presumed midline stimulation. In addition, it became clear that objective MUAP's via EMG activation of specific muscles corresponded with postoperative induced paresthesia in particular regions depending on laminectomy level. For example, EMG activation of the external oblique muscle from a T9-10 thoracic paddle consistently correlates with low back paresthesia (Figure 4.1).
Figure 4.1: Intraoperative view of thoracic paddle lead implantation. A.: The electrode is behind the body of T9 and T10. Stimulation is right-sided with the cathode at the second position and the anode at the third. B.: With right-sided stimulation, there is right-side gastrocnemius activation, which will correlate to an S1 dermatomal paresthesia.
These correlations are summarized in Table 1. Additional correlations have been made for cervical SCS (Figure 2) and sacral nerve root stimulator (SNRS) (Figure 3) laminectomy placements (Tables 2 and 3).
Figure 4.2. Intraoperative view of cervical paddle lead implantation. A. The electrode is behind the body of C3 and C4, entering at the C4/5 interspace. B. With left sided stimulation, there is left side triceps activation, which will correlate to a C7 dermatomal paresthesia.
Figure 4.3. Permanent retrograde implantation of sacral root paddle leads. A. Stimulation is left sided, with the cathode at the second position and the anode at the third. B. In this older tracing, the stimulation in the second left contact produces primarily adductor hallucis activation, solely on the left side. This correlated with the postoperative paresthesia felt in the S3 perineal region.
EMG activation, muscle group
Induced paresthesia
Table 4.2: Correlations between EMG activation of specific muscles with postoperative induced paresthesia - Cervical Paddle C3-4 (laminectomy C4/5)
EMG activation, muscle group
Induced paresthesia
Adductor Hallucis
Table 4.3: Correlation between EMG activation of specific muscles with postoperative induced paresthesia - Sacral Paddle(s) S2-3 (laminectomy S1)
The general concept of using intraoperative EMG in the placement of the SCS on the PM of the spinal cord is similar with respect to the 2- and 3-column paddle configuration and differs in terms of whether the "expected" pattern should be symmetric (the middle column of a 3-column array) or "equally asymmetric" (a 2-column array). The newest 5 column array (Penta, St. Jude Medical, Plano, Texas) has just begun PM evaluation with this technique.
Section IV.4.3: Technique of Midline Positioning of the Spinal Cord Stimulator – Tripolar paddle
Once the 3-column paddle is placed in the dorsal epidural space, the superior midline contact is stimulated at minimal settings and the EMG trace recording associated with the dermatomal level of stimulation is monitored. The stimulus intensity is gradually increased until MUAP's are seen on EMG. The lowest stimulus intensity needed to elicit a motor response is referred to as the threshold stimulus. MUAP's will be seen bilaterally at the threshold stimulus if the midline contact of the SCS is in line with the PM of the spinal cord. If MUAP's are seen unilaterally, the threshold intensity for that side is recorded and the stimulus is further increased to elicit a response on the other side. A difference in threshold stimulus intensity between the left and right sides indicates the SCS is lateral to the PM. However, medial/lateral repositioning of the SCS is necessary only if the difference in threshold intensity between the two sides is greater than 2 mA. In this case the paddle may not be perfectly flat on the lateral X-ray (Figure 4.4A), thus dissection of the lateral recesses or proximal/superior lamina is further performed until the electrode is perfectly aligned with vertebrae on a lateral view (Figure 4.4B). This assures optimal electrode column symmetry and programmability of the PM. Of course, as a last resort, the laminotomy can be extended to a full laminectomy to allow perfect alignment of the paddle on the PM. In this case, tissue must typically be identified to suture the electrode in place to prevent migration. These tenants hold true for all paddle (1, 2, 3 and 5 column) array configurations.
Figure 4.4: Lateral intraoperative views. A. Lead placed off the midline. B. Perfect alignment on the midline.
Section IV.4.4: New frontiers of intraoperative EMG application
There appears to be a correlation between the muscles with objective EMG activation during intraoperative monitoring and the subjective paresthesia obtained postoperatively, as described in Tables 1-3. Thus, this may be explored to generate a precise model of paresthesia coverage and create a functional dermatomal mapping of perceived stimulation threshold after the surgery. Furthermore, the EMG activation threshold may be a reliable predictor of the patient's perceived paresthesia threshold. It has been the author's experience that EMG activation correlated with pain control at amplitudes lower than the paresthesia threshold (i.e. subthreshold stimulation), and that occasionally persistent EMG activation intra- and postoperatively may be seen lasting as long as 15 minutes after the stimulation is discontinued. These patients typically respond extremely well to the stimulation therapy. It seems likely that these patients are the occasional patients who use their stimulation only intermittently, often having effective long term pain relief while using their systems for only a portion of each day.
Section IV.4.5: References
Ben-David B, Haller G, Taylor P: Anterior spinal fusion complicated by paraplegia. A case report of a false-negative somatosensory-evoked potential. Spine (Phila Pa 1976) 12:536-539, 1987.
Ben-David B, Taylor PD, Haller GS: Posterior spinal fusion complicated by posterior column injury. A case report of a false-negative wake-up test. Spine (Phila Pa 1976) 12:540-543, 1987.
Wagner W, Peghini-Halbig L, Maurer JC, Perneczky A: Intraoperative SEP monitoring in neurosurgery around the brain stem and cervical spinal cord: differential recording of subcortical components. J Neurosurg 81:213-220, 1994.
Ryu H, Uemura K. Origins of the short latency somatosensory evoked potentials in cat--with special reference to the sensory relay nuclei. Exp Neurol. 1988 Nov;102(2):177-84.
Dunne JW, Silbert PL, Wren M. A prospective study of acute radiculopathy after scoliosis surgery. Clin Exp Neurol. 1991;28:180-90.
Meyer PR Jr, Cotler HB, Gireesan GT. Operative neurological complications resulting from thoracic and lumbar spine internal fixation.Clin Orthop Relat Res. 1988 Dec;(237):125-31.
Toleikis JR, Carlvin AO, Shapiro DE, Schafer MF. The use of dermatomal evoked responses during surgical procedures that use intrapedicular fixation of the lumbosacral spine. Spine (Phila Pa 1976). 1993 Dec;18(16): 2401-7.
Owen JH, Padberg AM, Spahr-Holland L, Bridwell KH, Keppler L, Steffee AD. Clinical correlation between degenerative spine disease and dermatomal somatosensory-evoked potentials in humans. Spine (Phila Pa 1976). 1991 Jun;16(6 Suppl):S201-5.
Rodriquez AA, Kanis L, Rodriquez AA, Lane D. Somatosensory evoked potentials from dermatomal stimulation as an indicator of L5 and S1 radiculopathy. Arch Phys Med Rehabil. 1987 Jun;68(6):366-8.
Bose B, Wierzbowski LR, Sestokas AK. Neurophysiologic monitoring of spinal nerve root function during instrumented posterior lumbar spine surgery. Spine (Phila Pa 1976). 2002 Jul 1;27(13):1444-50.
Weiss DS. Spinal cord and nerve root monitoring during surgical treatment of lumbar stenosis. Clin Orthop Relat Res. 2001 Mar;(384):82-100. Review.
Holland NR, Kostuik JP. Continuous electromyographic monitoring to detect nerve root injury during thoracolumbar scoliosis surgery. Spine (Phila Pa 1976). 1997 Nov 1;22(21):2547-50.
Beatty RM, McGuire P, Moroney JM, Holladay FP. Continuous intraoperative electromyographic recording during spinal surgery. J Neurosurg. 1995 Mar;82(3):401-5.
Owen JH, Kostuik JP, Gornet M, Petr M, Skelly J, Smoes C, Szymanski J, Townes J, Wolfe F. The use of mechanically elicited electromyograms to protect nerve roots during surgery for spinal degeneration. Spine (Phila Pa 1976). 1994 Aug 1;19(15):1704-10.
Kleissen RF, Buurke JH, Harlaar J, Zilvold G. Electromyography in the biomechanical analysis of human movement and its clinical application. Gait Posture. 1998 Oct 1;8(2):143-158.
Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965 Nov 19;150(699):971-9. Review. No abstract available.
Shealy CN, Mortimer JT, Reswick JB. Electrical inhibition of pain by stimulation of the dorsal columns: preliminary clinical report. Anesth Analg. 1967 Jul-Aug;46(4):489-91. No abstract available.
Aló KM, Holsheimer J. New trends in neuromodulation for the management of neuropathic pain. Neurosurgery. 2002 Apr;50(4):690-703; discussion 703-4. Review.
Law J: Results of treatment for pain by percutaneous multicontact stimulation of the spinal cord. Presented at the Annual Meeting of the American Pain Society, Chicago, Illinois, November 11–13, 1983.
North RB, Fischell TA, Long DM: Chronic stimulation via percutaneously inserted epidural electrodes. Neurosurgery 1:215–218, 1977.
Villavicencio AT, Leveque JC, Rubin L, Bulsara K, Gorecki JP. Laminectomy versus percutaneous electrode placement for spinal cord stimulation. Neurosurgery. 2000 Feb;46(2):399-405; discussion 405-6.
Mostegl A, Bauer R. The application of somatosensory-evoked potentials in orthopedic spine surgery. Arch Orthop Trauma Surg. 1984;103(3):179-84.
Spielholz NI, Benjamin MV, Engler GL, Ransohoff J. Somatosensory evoked potentials during decompression and stabilization of the spine. Methods and findings. Spine (Phila Pa 1976). 1979 Nov-Dec;4(6):500-5.
Ryan TP, Britt RH. Spinal and cortical somatosensory evoked potential monitoring during corrective spinal surgery with 108 patients. Spine (Phila Pa 1976). 1986 May;11(4):352-61.
Kumar K, Taylor RS, Jacques L, Eldabe S, Meglio M, Molet J, Thomson S, O'Callaghan J, Eisenberg E, Milbouw G, Buchser E, Fortini G, Richardson J, North RB. The effects of spinal cord stimulation in neuropathic pain are sustained: a 24-month follow-up of the prospective randomized controlled multicenter trial of the effectiveness of spinal cord stimulation. Neurosurgery. 2008 Oct;63(4):762-70; discussion 770.
Kumar K, Taylor RS, Jacques L, Eldabe S, Meglio M, Molet J, Thomson S, O'Callaghan J, Eisenberg E, Milbouw G, Buchser E, Fortini G, Richardson J, North RB. Pain. 2007 Nov;132(1-2):179-88. Epub 2007 Sep 12.
North RB, Kidd D, Shipley J, Taylor RS. Spinal cord stimulation versus reoperation for failed back surgery syndrome: a cost effectiveness and cost utility analysis based on a randomized, controlled trial. Neurosurgery. 2007 Aug;61(2):361-8; discussion 368-9. Erratum in: Neurosurgery. 2009 Apr;64(4):601.
Taylor RJ, Taylor RS. Spinal cord stimulation for failed back surgery syndrome: a decision-analytic model and cost-effectiveness analysis. Int J Technol Assess Health Care. 2005 Summer;21(3):351-8.
Kumar K, Malik S, Demeria D. Treatment of chronic pain with spinal cord stimulation versus alternative therapies: cost-effectiveness analysis. Neurosurgery. 2002 Jul;51(1):106-15; discussion 115-6.
Taylor RS. Spinal cord stimulation in complex regional pain syndrome and refractory neuropathic back and leg pain/failed back surgery syndrome: results of a systematic review and meta-analysis. J Pain Symptom Manage. 2006 Apr;31(4 Suppl):S13-9. Review.
Kumar K, Hunter G, Demeria D. Spinal cord stimulation in treatment of chronic benign pain: challenges in treatment planning and present status, a 22-year experience. Neurosurgery. 2006 Mar;58(3):481-96; discussion 481-96.
Taylor RS, Van Buyten JP, Buchser E. Spinal cord stimulation for complex regional pain syndrome: a systematic review of the clinical and cost-effectiveness literature and assessment of prognostic factors. Eur J Pain. 2006 Feb;10(2):91-101. Review.
Spiegelmann R, Friedman WA. Spinal cord stimulation: a contemporary series. Neurosurgery. 1991 Jan;28(1):65-70; discussion 70-1. Review.
Racz GB, McCarron RF, Talboys P. Percutaneous dorsal column stimulator for chronic pain control. Spine (Phila Pa 1976). 1989 Jan;14(1):1-4.
Perlik SJ, VanEgeren R, Fisher MA. Somatosensory evoked potential surgical monitoring. Observations during combined isoflurane-nitrous oxide anesthesia. Spine (Phila Pa 1976). 1992 Mar;17(3):273-6.
Richardson J. Facilitation of spinal cord stimulator implantation with epidural analgesia. Pain. 1996 May-Jun;65(2-3):277-8.
Boswell MV, Iacono RP, Guthkelch AN. Sites of action of subarachnoid lidocaine and tetracaine: observations with evoked potential monitoring during spinal cord stimulator implantation. Reg Anesth. 1992 Jan-Feb;17(1):37-42.
Lang E, Krainick JU, Gerbershagen HU. Spinal cord transmission of impulses during high spinal anesthesia as measured by cortical evoked potentials. Anesth Analg. 1989 Jul;69(1):15-20.
Holsheimer J, Barolat G, Struijk JJ, He J. Significance of the spinal cord position in spinal cord stimulation. Acta Neurochir Suppl. 1995;64:119-24.
Holsheimer J, den Boer JA, Struijk JJ, Rozeboom AR MR assessment of the normal position of the spinal cord in the spinal canal. AJNR Am J Neuroradiol. 1994 May;15(5):951-9.
Washburn S, Monroe CD, Cameron T. A Review of Articles Published on Spinal Cord Stimulation Treatment for Chronic Pain: 1981 - 2008. NANS meeting, Las Vegas, December 4-7, 2008.


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This is an old post I just found in my email account I never posted, So here we go!
Before I got sick, I was a active child with little to no cares in the world. About six months before my chronic pain began, I tried out for a competitive volleyball team, and I made the team. The practices were intensive. 3 hour practices 3 times a week, and tournaments each weekend. I LOVED this, but little did I know in August everything would change while I was playing the sport I once loved. While at a intensively run volleyball camp I developed a severe headache that's I've had ever since. Now I decided to continue playing volleyball when the next season began in late October while dealing with my a undiagnosed and not properly managed pain condition . As my health rapidly deteriorated, I quickly learned that trying to keep up with healthy individuals was not an option, and that my only choice was to quit my team… Tough
This transition was the most difficult time in my childhood. Volleyball was my identity, who I was..and loosing made me feel like I couldn't fit in anywheres. And being sick most of the time made it even harder to make new friends. Loosing the sport I loved from a condition no one understood frustrated me to the high heavens. I began to be hostile to my doctors and health care professionals, ignoring their suggestions, not complying with my medication and many other self destructing activities. Soon I had created a massive "pit of despair" and I just gave up. I was a emotional wreck that pushed everyone away because no health care professional could help me..
I stayed like this for months, numerous ER trips and constantly angry at the world.
This all changed during one trip to the ER. Where I realizes how much I was hurting the people that loved me. My mother sat at my side apologizing for my illness. And I couldn't comprehend why she was apologizing for something she couldn't change. When she explained that she has been seeing myself self destruct in front of her, and how upset she was that she couldn't help, I realized how selfish I had been.. And I vowed to turn myself around..
And here we are today, I am actively involved in patient advocacy, volunteering and absolutely loving each and every day,even with my condition worsening and still little control over my pain levels.
If you can take anything from this story, it's that You realize that can't let a difficult situation knock you down and push you into the dirt. Life happens, and sometimes we don't like the outcome, but you have to roll with it, because sometimes all it takes is a few simple words to change everything.


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The WebOS Smart TV range from LG Electronics has proven to be a major success. Since launching in March this year the simpler Smart TVs have racked up sales of over 1 million units.
The new operating system is a result of LG's purchase of the WebOS system from HP which was designed for the palm range of smartphones. LG revamped the system to use in television sets, it was developed to simplify the display of web content on a TV using an 'intuitive' and 'uncomplicated' interface.
Currently for sale in 45 countries, sales hit 320,000 in North and Latin America. The Korean company said that the million sales are just the start, and that they plan to ship 10 million webOS TVs by mid 2015. LG's senior VP and head of TV, In-kyu Lee said, "Reaching the one million mark in just three months is a significant achievement in the TV industry."
LG say that the new OS which is represented on screen by a scrolling menu of colored cards makes it simpler for the user and easier for developers to create software and apps.
The UI shows the scrolling cards across the bottom part of the screen, so that users can interact and launch content and switch between TV and the web whilst having an uninterrupted viewing experience. Apps available on the system include Netflix, Youtube, Skype and Amazon.
LG's impressive sales could be affected by competing products that are due for release soon. They will have to compete with similar new Smart TV operating systems like the new Android TV from Google, set to launch later this month.


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Writer: John Arcudi
Artist: Tan Eng Huat
Publisher: DC
The book opens with Cliff arriving at the headquarters of the new Doom Patrol, but he discovers he's arrived too late, as the entire team has been possessed by the seven ancient warrior spirits that Tycho is trying send into their next lives. Needless to say the spirits don't exactly welcome Cliff's intrusion upon their ceremony, and as they move to take him down, the book jumps back a bit to look in on the members of Doom Patrol before they came to be possessed. It is during this flashback that we learn the team had gotten back together, and that most of their problems had been resolved, though Ted was using medication to effectively nullify his power, as he pushed it too far, and his future visions were driving him insane. However, the team isn't allowed much time to play catch up as they are set upon by Tycho & his group. The team is then quickly defeated, and is soon playing host to the ancient spirits. We then return to the present where we see Cliff decides to sit back and trust that Tycho isn't doing anything terribly evil, as he's promised that the possessed members of Doom Patrol will be released, when the spirits depart into the next realm. Now while Tycho's promise is kept, the promise the spirits made to Tycho isn't, as he is left blinded for life. We also see Kolodenko, the resident inventor didn't fare all that well in the aftermath of his possession.
There's a odd little moment in this issue that caught me completely off guard, as John Arcudi breaks one of the most sacred rules of the super-hero game by having Cliff take a step back to let the villain finish up whatever evil master-plan they had cooking up before he arrived on the scene. I mean most heroes would've automatically arrived at the conclusion that whatever the villain was looking to accomplish was bad, and when faced with a battle in which they looked to have no chance of victory, they would still fight the good fight. Now one could say that he was simply using his head, and that he understood that there was no way he was going to be able to hold his own against Tycho and the rest of his possessed teammates, so in the interests of self-preservation he conceded defeat before the battle could even begin. On the other hand one could say that he was simply hedging a bet, and that his years of experience dealing with the bizarre & surreal told him that Tycho was telling him the truth. Whatever the case may be the simple fact of the matter is that Cliff's decision to take a step back & give Tycho the three minutes he needed to complete the ceremony was a very unexpected plot development, and it nicely plays up the idea that you never really know what these characters will do when they are backed into a corner.
The back-story for the villains of this story are also quite interesting as we learn how Tycho came to be involved in this plot to release the seven trapped souls, and why he was working so hard to accomplish this goal. Plus in the end he's betrayed by the spirits as they reneged on their promise, and leave him with nothing for his efforts. To this end we see the final panel reveals that Doom Patrol looks to have paid a pretty steep price as well, as one of their own didn't bounce right back after the spirit left his body. This makes Cliff's decision to stand back and let the show play out look less than impressive, but then again the damage had already been done before he arrived on the scene, so in the end the final result would've been the same, with the only difference being that the spirits simply would've found another poor sucker to do their bidding for them, and as such another seven souls would've been placed in danger. The issue also offers up some flashback material to detail how the members of Doom Patrol came to possess the spirits, and it's rather nice to see the team didn't really fair all that well in this contest, as there are times when seeing a team get their heads handed to them acts as a method of building up a sense of excitement, as we can now enter future battles with the knowledge that this team can be defeated.
Tan Eng Huat is a wonderful artist with a lovely design sense and I truly hope that he's lined up for another project at DC, as I do believe he's signed an exclusive contract with them. If nothing else he's proven he's able to handle the demands of a monthly title, as he's delivered 18 of the 21 issues, which is a pretty impressive feat in today's industry. The art itself is what's impressed me though, as this book does call upon the artist to deliver some pretty unusual visuals, and Tan Eng Huat is able to meet the demands of the writing. From the rather unsettling discovery that Cliff first makes when he enters the headquarters of Doom Patrol to the visual explosion in the final pages as the ceremony is completed and the spirits depart, this is another visually impressive show. There's also some nice work on the little details, like smoke rising from the ashtray as Ted quickly discards his cigarette when Ava walks in the room, or Ted's seedy look as he questions Vic about his look at Shyleen's goodies. The suddenness of the attack upon Doom Patrol was also nicely captured by the art, as the opening attack by Gar kicks everything off in a highly charged manner, and the scene upstairs where Vic opens his door and is quickly run through is also quite impressive. The visual designs of the altered members of Doom Patrol is also quite strong, with Vic's lizard-crab man being my personal favorite.
Final Word:
A fairly entertaining issue that managed to catch me completely offguard when Robot Man essentially decides to take a step back and let the villains of the story carry out their mysterious plan. Now while the aftermath would seem to suggest that this was the right move to make, the simple fact of the matter is that one simply doesn't expect a hero to give up, and concede to the demands of the villains. In any event, while this issue arrived at its big climax in a rather unconventional manner, and the slugfest happy fanboy in me is somewhat annoyed that we were cheated out of a fight where Robot Man would get an opportunity to display his fighting prowess, I will give this issue credit for originality, and if nothing else it does play up the idea that Cliff has always been a bit of a reluctant hero. I also enjoyed the fact that the issue continues to present this team as quite inexperienced at the super-hero game, as they are taken out of the fight very easily, and this acts as further proof that Cliff's years of experience are invaluable to this young group.
What did you think of this book?
Have your say at the Line of Fire Forum!


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So now you'll have to be available 78 hours a week for Kronos otherwise you may loose insurance or pay for it out of your pocket ? When all other companies are throwing things at employees to keep them , Whole Foods once again is trying and will succeed in loosing them. Team member happiness does not exist. What kind of Scrooge came up with this scheme of profits before people?
4 replies (most recent on top)
Kronos can only work if everyone on the team has the best availability. However, I doubt that even if our entire team had open 24 hour availability that it could produce a schedule that wasn't entirely garbage. In fact next week I think I'm going to change everyone's availability to open just to see the crazy schedule it puts out. I have to fix everything anyway.
Now that our initial phase of Kronos is over at our store I've completely stopped using it to make schedules and will continue to do so until someone catches me and tells me to stop. I told my STL I was doing this and he was fine with it. I did everything exactly as trained and directed for 3 months and Kronos never once learned anything or made a schedule that wasn't so bonkers I had to spend 4-5 hours fixing it.
Now I simply write the schedule how we need it to be and lock it. There are 2 Tms I let Kronos decide to give some shifts to but I always end up deleting the added shifts.
In order for Kronos to actually work it needs to know:
- What hours we are open. Why schedule a random TM at 3 am on a non load/non m.s. day?
- What days and hours our load arrives and is worked. We work load before the store is open, not at 8am. A huge chunk of grocery labor need to be from 3-8 a.m.
- Who is an overnight Tm? They are designated in Kronos but it will put anyone on overnights and overnighters in the a.m. regardless of their availability in Kronos.
- Finally it needs to know the strengths and abilities of each Tm. For example, don't schedule someone to drive the forklift/use the power jack if they have not been trained and certified.
- Traffic. Kronos will schedule 17 Tms on Monday and 5 on Saturday with huge gaps where no TM is in the store. Our busiest hours are short-staffed and slowest hours overstaffed.
The worst part is there isn't anyone in a regional/global position that could k–l or fix Kronos that isn't fully aware of how awful it is. They are more focused on reducing hours from 40 to 36 which could very easily be monitored without using Kronos.
Yeah i dunno where people get their info. All the docs clearly state this isn't the case for next year's changes
If you can't come in with 24 hrs open availability whole foods cuts your hours when you can't come in on your day off and the store leadership team will hold you to it.
Once we post it don't they have to honor it!
Whole foods leadership is only their to make sure they succeed team members pay for the bills with more hours cut,benefits cut or just losing your job for reporting issues.
Untrue. I'm at 32 hrs. A week and have full benefits. I recently looked into this and they confirmed this.


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Apopka (407) 889-2262
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June 2020
What are Achilles Tendon Injuries
The Achilles tendon is the strongest tendon in the human body. Its purpose is to connect the lower leg muscles and calf to the heel of the foot. This tendon is responsible for facilitating all types of movement, like walking and running. This tendon provides an enormous amount of mobility for the body. Any injuries inflicted to this tissue should be immediately brought up with a physician to prevent further damage.
The most common injuries that can trouble the Achilles tendon are tendon ruptures and Achilles tendinitis. Achilles tendinitis is the milder of the two injuries. It can be recognized by the following symptoms: inflammation, dull to severe pain, an increased flow of blood to the tendon, thickening of the tendon, and slower movement time. Tendinitis can be treated via several methods and is often diagnosed by an MRI.
An Achilles tendon rupture is trickier to heal, and is by far the most painful injury. It is caused by the tendon ripping or completely snapping. The results are immediate and absolutely devastating, and will render the patient immobile. If a rupture or tear occurs, operative and non-operative methods are available. Once the treatment begins, depending on the severity of the injury, recovery time for these types of issues can take up to a year.
Simple preventative measures can be taken as a means to avoid both injuries. Prior to any movement, taking a few minutes to stretch out the tendon is a great way to stimulate the tissue. Calf raises, squats, leg curls, leg extensions, leg raises, lunges, and leg presses are all suggested ways to help strengthen the lower legs and promote Achilles tendon health.
Many problems arise among athletes and people who overexert themselves while exercising. Problems can also happen among those who do not properly warm up before beginning an activity. Proper, comfortable shoes that fit correctly can also decrease tendon injuries. Some professionals also suggest that when exercising, you should make sure that the floor you are on is cushioned or has a mat. This will relieve pressure on the heels. A healthy diet will also increase tendon health.
It is very important to seek out a podiatrist if you believe you have an injury in the Achilles region. Further damage could result in severe complications that would make being mobile difficult, if not impossible.
Arthritic Foot Care
During your lifetime, you will probably walk about 75,000 miles, which is quite a lot of stress to put on your feet. As you get older, the 26 bones and 30 joints in each of your feet will lose flexibility and elasticity. Your foot's natural shock absorbers will wear down as well. Having arthritis added to this mix only makes matters worse. Your joints will become distorted and inflamed, which is why arthritic foot care needs to be something to think about every day.
When dealing with arthritis, having additional foot complications, such as bunions, hammertoes, or neuroma, can be a serious detriment. To avoid these, buy well-fitting shoes with a lower heel and good support. Arthritis causes you to lose your arch, so having shoes with good arch support is also highly recommended.
Aside from getting good arch support, the shoes need to fit comfortably and properly as well. A good place to start is by leaving a finger width between the back of the shoe and your foot to gauge proper size. It is also helpful to have a square or rounded toe box in the front to provide even more comfort. Another thing to look for is a rubber sole that can provide a cushion and absorb shock as you walk. This adds flexibility to the ball of your foot when you push off your heel to walk.
Exercise is another key aspect of arthritic foot care. Exercise not only strengthens and stretches your muscles and joints, but helps to prevent further injury and pain as well. Stretching the Achilles tendon, the tendon located in the back of your heel, will give you added mobility and reduce pain due to stress. Another thing you can do is massage your feet, kneading the ball of your foot as well as your toes from top to bottom.
Stretching the Achilles tendon is a simple exercise that you can do at home anytime. Lean against the wall with your palms flat against the surface while placing one foot forward, towards the wall, and one foot behind you. Bend your forward knee towards the wall while keeping your back knee locked straight, and make sure both your heels are completely touching the ground at all times. This will stretch your Achilles tendon and calf muscles as well. You will feel the stretch almost immediately. You can also stretch your toes in a couple ways. One involves taking a rubber band and wrapping it around both your big toes while your heels remain together. Then, pull them apart to stretch your big toe. You can also place a rubber band around all the toes of one of your feet. Then, try to separate each individual toe, stretching them all.
A final step you can take to help your arthritis is taking non-steroid, non-inflammatory drugs or topical medicines with capsaicin. Unfortunately, there is no complete way to remove all of your arthritic pain. However, following some of this advice can go a long way in staying as pain-free as possible.
Plantar Fasciitis
The plantar fascia is a connective tissue in the heel that stretches across the bottom length of your foot. Plantar fasciitis occurs when the connective tissue becomes inflamed, causing heel pain and discomfort during physical activity. Although the condition is completely treatable, traditional methods can take up to a year to start becoming effective.
Plantar fasciitis is caused by a number of everyday activities, so understanding the condition is important for managing and treating it. One of the most common causes of plantar fasciitis is excessive running, especially with improper fitting or non-supportive shoes. Too much exercise can lead to the plantar fascia being overworked and overstretched, which can cause tears in the tissue. Along with improper fitting shoes, pronation, the rolling of the feet inward, is a common cause of plantar fasciitis. If not treated properly, the plantar fascia becomes overstretched and starts to tear, causing inflammation.
Despite the common causes of plantar fasciitis, there are many different treatment options. For less severe cases, conservative home remedies include taking anti-inflammatory drugs to alleviate pain, applying ice packs to the bottom of your foot and heel, slowly stretching and exercising your feet to re-strengthen the tissue, and using orthotic devices are all ways to help manage your plantar fasciitis.
For more severe cases, shockwave therapy has become a common solution for plantar fasciitis. Shockwave therapy can effectively break up the tissue on the bottom of your foot which facilitates healing and regeneration. This fights the chronic pain caused by plantar fasciitis. Even if this doesn't work, surgery is always a final option. Surgery on the tissue itself can be done to permanently correct the issue and stop the inflammation and pain in your heels.
No matter what the case may be, consulting your podiatrist is the first and best step to recovery. Even the slightest amount of heel pain could be the first stage of plantar fasciitis. Untreated symptoms can lead to the tearing and overstretching of tissue. Because the tearing of tissue can be compounded if it remains ignored, it can evolve into a severe case. The solution is early detection and early treatment. Talk to your podiatrist about the possibilities of plantar fasciitis if you're experiencing heel pain.
Rheumatoid Arthritis in the Feet
Although rheumatoid arthritis attacks multiple bones and joints throughout the entire body, ninety percent of people who actually develop this condition usually do so in the foot or ankle area. Those who develop this kind of arthritis in the feet usually develop symptoms around the toes and forefeet first, before anywhere else. Rheumatoid arthritis appears to have a genetic component. If it runs in the family, then you will be more likely to develop it as well.
Rheumatoid arthritis is an autoimmune disorder in which the body's own immune system attacks the lining of the membranes surrounding the joints. This causes inflammation of the membrane lining, and the gradual destruction of the joint's cartilage and even bone.
Some of the most common symptoms that are associated with RA include pain and swelling of the feet. Stiffness in the feet is also another common symptom that people experience. Those who have RA in the feet usually feel the pain in the ball or sole of their feet. This can get to be very painful at times. A person's joints can even shift and become deformed after a period of time.
In order to properly diagnose RA in the feet it is usually necessary for a doctor or podiatrist to evaluate the area. Your doctor will also question you about your medical history, occupation, etc., to determine whether anything in your lifestyle may have triggered the condition. There are a number of tests that may be performed to help diagnose RA, such as a rheumatoid factor test. There is, however, no one single test that will tell you for sure if you have RA. There are different X-rays that can be taken as well to determine if a person has RA in their feet.
There is a range of treatment options for rheumatoid arthritis. Treatment of RA is usually a lifelong process that includes a variety of methods of treatment and therapy. Your doctor can prescribe special shoes that should help with arch support as well as heel support. A physical therapist can help those with this condition learn exercises which will keep their joints flexible. Surgery may be needed to correct some of the issues with the feet, such as bunions, and hammertoes. Fusion is usually the most successful surgical option for rheumatoid arthritis. However, people need to keep in mind that there are some risks associated with these surgeries.
Foot Pain
Our feet are arguably the most important parts of our bodies because they are responsible for getting us from place to place. However, we often don't think about our feet until they begin to hurt. If you have pain in your feet, you need to first determine where on the foot you are experiencing it to get to the root of the problem. The most common areas to feel pain on the foot are the heel and the ankle.
Heel pain is most commonly attributed to a condition called plantar fasciitis. Plantar fasciitis occurs when the plantar fascia, which is the band of tough tissue connecting the heel bone to the toes becomes inflamed. Plantar fasciitis pain is usually worse in the morning, and it tends to go away throughout the day. If you have plantar fasciitis, you should rest your foot and do heel and foot muscles stretches. Wearing shoes with proper arch support and a cushioned sole has also been proven to be beneficial.
Some common symptoms of foot pain are redness, swelling, and stiffness. Foot pain can be dull or sharp depending on its underlying cause. Toe pain can also occur, and it is usually caused by gout, bunions, hammertoes, ingrown toenails, sprains, fractures, and corns.
If you have severe pain in your feet, you should immediately seek assistance from your podiatrist for treatment. Depending on the cause of your pain, your podiatrist may give you a variety of treatment options.


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Singapore News – The lawyer allegedly linked to the disappearance of more than $33 million of his client's monies has been slapped with eight more charges. Three more clients have also come.
The lawyer was accused to have deceived CCJ Investment in disbursing $6m. JLC Advisors managing director Jeffrey Ong Su Aun who has been alleged to have relations to Allied Tech's missing $33m, was arrested in Malaysia and was also charged with cheating another firm in a court hearing.
Action star Jackie Chan says he wants to work with his son Jaycee on a movie and an album as they mend their relationship after Jaycee was imprisoned on a drug charge. Jaycee Chan. said they would.
German prosecutors said Wednesday they had charged. cheating scandal. "Professor Rupert Stadler and three other defendants. are accused of fraud, falsifying certifications and illegal advertising.
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JLC Advisors managing partner Jeffrey Ong Su Aun – the lawyer in the disappearance of S$33 million held in escrow for Allied Technologies – has been arrested and charged. THE recent episode of missing.
In addition to the prison sentence, he was also fined $15 million and his properties were ordered confiscated. He and two associates were convicted of taking a total of $33.5 million from. with no.
Many people in offices in the nation of 30 million observed a minute's silence as. An international investigation is ongoing, but no one has been arrested. Remembering the victims of Malaysia.
Missing lawyer Jeffrey Ong, linked to $33m case involving Allied Tech, arrested and charged with cheating another firm SINGAPORE – Managing partner of JLC Advisors law firm, Jeffrey Ong Su Aun, who is allegedly linked to missing monies totalling more than $33 million, has been arrested and is now facing a cheating charge.
About 100 million inflators are to be recalled worldwide. April 16, 2016: Unidentified person, Sabah State, Malaysia, 2006 Honda City. Inflator ruptured, no death cause determined. – May 1, 2016:.
SINGAPORE – A lawyer who allegedly went missing along with $33.2 million in an escrow account held by his law firm on behalf of a client now faces another eight cheating-related. The Royal Malaysia.
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Jeffrey Ong Su Aun, the managing partner of law firm JLC Advisors who is allegedly linked to missing monies totalling more than $33 million, has been arrested and is now facing a cheating charge.


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Today's Resource: my 1972 Honda 350Four
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ORANGE marching groups have extended an olive branch to those protesting against them as Glasgow braces itself for a summer of parades disputes.
In a rare peace overture, Scottish Protestants Against Discrimination (SPAD), an umbrella campaign, has offered to sit down with its harshest critics to defuse sectarian tensions on Clydeside.
Their gambit came on the eve of a court challenge by marching groups against a Glasgow City Council decision to force them to re-route processions away from an East End Catholic Church.
Police and other authorities have become increasingly concerned that the church, St Alphonsus in London Road, could become a flashpoint for trouble.
READ MORE: Orange marchers sue council
It was here, last July, that a priest was spat upon during an Orange walk. That prompted a series of counter-protests by a campaign named Call it Out outside Catholic places of worship passed by loyal order parades.
A spokesman for SPAD , whose members include marchers but which does not organise marches itself, said it wanted talks to ease tensions over processions.
LONG READ: 'Political polarisation' fears over Glasgow's 2019 Orange marches
He said: "We need to have dialogue with the council, the police and any groups that are protesting against parades to make sure these tensions do not escalate through the marching season. It should not be hard to sit down and alleviate any problems.We want everybody around the table, including Call It Out. "


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LAKE BUENA VISTA, Fla. — Nikola Jokic picked out two birthday presents for his coach. He just didn't know which one he would be wrapping.
"Before the game I told him, 'Coach, I'm going to give you a really good present — I'm going to get you home or I'm going to get you to the conference finals,"' the Nuggets centre said.
Michael Malone was thrilled with the present he received.
Denver's dynamic duo of Jamal Murray and Jokic led another stunning turnaround as the Nuggets advanced to the Western Conference finals for the first time since 2009.
Murray scored 40 points, Jokic had a triple-double by the third quarter and Denver again overcame a double-digit deficit to shock the Los Angeles Clippers 104-89 in Game 7 on Tuesday night.
Denver became the first team in NBA history to rally from a 3-1 series deficit twice in the same post-season. The team beat Utah in Game 7 in the first round.
"Those guys stepped up on the biggest moment," said Malone, who turned 49 on Tuesday. "You find out a lot about people in these moments. Man, did we pass the character test or what?"
Even more history: The Nuggets are the third team in the U.S. major pro sports to rally from a pair of 3-1 deficits in the same playoffs, joining the 1985 Kansas City Royals and 2003 Minnesota Wild.
Denver will face LeBron James and the Los Angeles Lakers in the conference finals. They'll be the underdogs, of course. That's fine with Murray.
"It's fun to silence everybody," said Murray, who scored 25 in the first half.
They certainly quieted the noise around the Clippers, who hoped the additions of Kawhi Leonard and Paul George would lead them to their first-ever conference finals — and beyond. But LA's stars fell flat.
"It hurts. It hurts. But we move on," George said. "Year 1 together, first run together, of course we wanted to win this. But we've been very optimistic about us being together and building something going down the road."
Leonard finished with 14 points on 6-of-22 shooting, while George had 10 points on 4-of-16 shooting. The Clippers fell to 0-8 all-time in games where they could clinch a trip to the conference finals.
This marked the third time that coach Doc Rivers was on the losing end of a series where his team led 3-1. It also happened when he was with Orlando against Detroit in 2003, and with the Clippers against Houston in 2015.
"I'm the coach and I'll take any blame for it. But we didn't meet our expectations, clearly," Rivers said.
The Nuggets celebrated in style after the game, dumping water on each other and jumping around in the locker room.
"This is a really interesting team," Jokic said. "We don't have many superstars."
That's debatable.
The 7-foot Jokic had a monster game with 16 points, 13 assists and 22 rebounds, which were the most by a Nuggets player in an NBA playoff game. He broke his record of 19 that he set last season and shared with Marcus Camby.
In a familiar trend, the Nuggets found themselves down by 12 in the first half. They also trailed 61-54 with 10:50 let in the third when they caught fire. The Nuggets went on a 35-13 run to build a 15-point lead in the fourth quarter.
They led by as many as 20.
Denver also rallied from double-digit deficits in its last two games to stun the Clippers.
"We were right there. There's no excuses," Leonard said. "We should have finished it off. Like I said, the last three games pretty much mirrored each other."
Jokic insisted the third-seeded Nuggets weren't feeling any pressure. He said Game 7 was just another game. After all, this was Denver's fourth straight Game 7 dating to the playoffs last season.
"Honestly, you could just see the difference in the two teams. That team's been together," Rivers said. "We haven't. And you could see it as the games went on."
Denver's plans were to enjoy the moment — briefly, anyway, before getting ready for the Lakers.
"You have to celebrate the moments," Malone said. "This is a moment. It's my birthday. We're going to go party."
Nuggets: Jerami Grant and Gary Harris each had 14 points.
Clippers: G Landry Shamet turned his right ankle in the first quarter, limped down the floor, hit a 3-pointer and then hobbled to the locker room. He returned just before halftime. … Montrezl Harrell led the Clippers with 20 points.
The Nuggets coaching staff went with their customary all-black outfits (a nod to singer Johnny Cash). The Clippers wore salmon-colored polo shirts that have been lucky for them inside the bubble.
Just coaches being a little superstitious.
"I worked with coaches that knew the record of the ties they wore," Malone said. "Yes, we are a weird group. We'll look at any advantage necessary. As the jump ball goes up, it doesn't matter what we're wearing."


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I know I need to improve re: demonstrating empathy, and the frequency with which I openly express gratitude. And bridging communication gaps is a constant work in progress – I'm not alone with that one – it feels like you can never do enough on that.
It pays to be a lazy and selfish leader
I admit it. I lead selfishly. I put my own needs first.
My needs are to:
- not be dragged into every little situation;
- not work long hours;
- be able to focus on positive, move-forward, what-comes-next kind of work;
- not worry about what is going to screw up next;
- have others figure out the solutions to problems instead of me;
- see our company resources (money, assets, time) treated wisely;
- be able to take a holiday and know that things at work will be taken care of;
- be told when I am wrong; and
- know that the people I work with are challenged to learn and grow.
In order to have these needs met, I have learned to agree on a vision with my team – one of their creation as much as possible, especially in the details – and to share this vision widely, and then to focus on what each person needs while encouraging them to move towards the vision. My sneaky selfish self has learned that I can get by as a leader simply by listening, showing empathy, bridging communication gaps, coaching people through problems, giving honest feedback, assuming good intentions, pitching in when needed, and being openly grateful.
Other, less selfish leaders take the time to meticulously break down the work into tiny bits, to generously watch as each task gets done, and to graciously manage each task their employees do. They also make sure not to burden people with understanding the bigger picture of where they are going or telling them how they are doing. Unlike me, they also do not bother with the indulgence of taking carefree time off. They stay plugged in all the time, helping everyone do things precisely the way they think they should be done.
As I have become more selfish, my effectiveness as a leader and the results my team achieves have increased almost exponentially. Who says it does not pay to be lazy? 🙂
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I totally agree with you, Darryl. Thanks for a great post, and especially listing the components- I have a couple that you've reminded me to enhance. PS – great title! Definitely caught my attention.
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It's the End
PaigeR, Photo Editor
April 30, 2019
Spoiler Warning The Marvel series Avengers has finally and sadly come to a close with Endgame. I personally found it absolutely amazing. Somehow Marvel figured out a way to nicely tie all of the loose ends into a bow. Unlike Infinity War, Endgame focused on the six, original Avengers and thei...


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Not Sweating Enough
Usually, the problem occurs in horses raised in temperate climates and moved to hot, humid climates. Performance horses are most commonly affected. The lack of sweating ability can cause a rise in body temperature, labored breathing, collapse and even death.
Horses with this problem typically show other more visible signs like exercise intolerance, heat stroke, hair coat changes and weight loss. Most commonly it is seen as a "failure to acclimatize" to a hot and humid climate and a failure to perform to expectations.
Code OrangeCall Your Vet at Their First Available Office Hours
your role
What To DoIf you have recently moved your horse to a hotter, more humid climate, be on the lookout for this problem. If you notice that the horse is not sweating at all, or sweating considerably less than what you consider normal, this is a serious concern and warrants a call to your vet. Assess your horse's general health using the Whole Horse Exam (WHE), paying particular attention to heart and respiratory rates, and rectal temperature, especially after exertion.
Skills you may need
Procedures that you may need to perform on your horse.
your vet's role
- Where, geographically, does the horse live?
- How long has the horse lived here and where were they prior?
- Does the horse's appetite and attitude seem normal?
- What are the results of the Whole Horse Exam (WHE)?
Diagnostics Your Vet May Perform
Figuring out the cause of the problem. These are tests or procedures used by your vet to determine what's wrong.
Diagnoses Your Vet May Consider
The cause of the problem. These are conditions or ailments that are the cause of the observations you make.
Treatments Your Vet May Recommend
A way to resolve the condition or diagnosis. Resolving the underlying cause or treating the signs of disease (symptomatic treatment)


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Herzlich Willkommen
"Es ist nicht genug zu wissen, man muss auch anwenden;
es ist nicht genug zu wollen, man muss auch tun."
(Johann Wolfgang von Goethe)
Die Praxis ist umgezogen !!!
Seit dem 1. Juni 2018 Sie finden mich unter folgender Adresse:
Praxis für Naturheilkunde
Gabriele Schikorr
Dannenberger Str. 28
28879 Grasberg
Telefon 04208 – 2055
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Morawa, Western Australia Accommodation
Morawa Accommodation Map
Zoom: Region | Locality | Street. Marker positions are approximate.
Morawa Motor Hotel (1 stars)
Need accommodation? Come and stay at the Hotel or Motel. Meet the friendly staff at the Hotel while having a meal or a drink.
< Accommodation in Western Australia
|Copyright images and original content © 1997 - 2020 Australia Gday Pty Ltd. All rights Reserved.
Information and images may be out of date. Check before travelling.


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It endorses a naturistic approach to sports and community living. Behind that is the joy of the experience of nature or also of being nude itself, without direct relationship to sexuality. The followers of this culture are called traditional naturistsFKK'ler, or nudists.
Nude beach, Cottbus, East Germany, Photo: German National Archive. Germans chilling on the beach with their parts out and such, is out of style.
Adamski, a police officer in Berlin who investigates organized crime, first started going to a nudist camp at a lake outside Berlin after he met his wife, whose family owned a cabin there. One weekend, when he had just about gotten used to stripping in front of his in-laws, he bumped into the highest-ranking colonel in his precinct — who promptly challenged him to a game of table tennis. Adamski said as he prepared to join a triathlon where the swimming and running portions of the race were naked.
Collection of Nudists Family. Nudist Camp Spreading Erections. Nudist Naturist Naked Beach Badminton. Nudist Beach Jakuzure.
By Erin Porter. The truth is, it is quite normal to strip off all your clothes on a sunshiney day in Germany. Nudity is no big deal whether you be in the saunaon the beachor in a park.
One of the aspects of German culture which we Americans often find so shocking is the prevalent open attitude towards nudity, otherwise known as naturalism. One of my good German friends is a big sauna goer and explained once to a group of us that her whole family was into it. This raised alarm bells with the other Americans there.
Naturism is a cultural and political movement practicing, advocating and defending social nudity in private and in public. In late 19th century Germany, the idea of taking off clothes in order to liberate oneself was revolutionary. At the same time doctors of the Natural Healing Movement were using heliotherapytreating diseases such as TBrheumatism and scrofula with exposure to sunlight.
GoNomad 2. My partner, who was born and raised in Germany, explained to me in his patient and slightly condescending European manner that I had a lot of bunk in my head about the reality of these saunas, or spas as they are more broadly referred to. Because I had, to this point, held a certain discomfort about him attending these spas on his various trips home without me. There is nothing sexual about it.
We use cookies to improve our service for you. You can find more information in our data protection declaration. From lakes to saunas and parks: Is Germany's nudist culture, known as FKK, dying out or still making waves?
F or decades Germans have extolled the benefits of free body culture — or being naked in nature. The movement has its roots in the late 19th century when it was promoted as a healthy lifestyle, particularly for workers. For more than 70 years entire sections of beaches, lakesides and campsites have been reserved by law for those who choose to be naked, and the practice — with its strict rejection of any shame about nudity — has seeped into the national psyche. The Nazis largely suppressed it.