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Early Christian Prayer
Where does the following prayer ending orginate? "..., through Jesus Christ our Lord, who lives and reigns with you and the Holy Spirit, one God, now and forever." It was apparently included at the end of a letter from the Church at Rome, accredited by some theologians to Clement of Rome, to the Church at Corinth, and is also used in our hymnal.
While Clement of Rome might have used this doxological formula, others likely did as well. Most sources say that the Collects (at least in comprehensive form) date from the fourth century and later – no doubt compiling prayers that had been in use for some time and following a pattern in wide use. It is probably difficult to determine a precise date or source for the origin of the familiar closing pattern that you quote.
The New Dictionary of Sacramental Worship (Peter Fink, ed) states:
Doxology generally terminates prayer…. Particular forms of doxology include … the conclusion of the collect…. This doxology expresses, in highly compressed and simple fashion, the theology of Christian liturgical prayer, namely, that it is directed to the first person of the Trinity, through the mediation of Christ, in the power of his abundant and life-giving Spirit.
One author writes:
The concluding statement of mediation, "through Jesus Christ our Lord" (or its longer trinitarian version "through Jesus Christ our Lord, who lives and reigns with you and the Holy Spirit, one God, now and forever"), is particularly significant as a source of trinitarian piety and formation. This statement offers explicit acknowledgment of a trinitarian theology of worship as a graced event, much discussed in the recent renaissance of trinitarian theology. Jesus Christ and the Holy Spirit are active agents in our prayer and worship, prompting and perfecting our prayers, and making prayer less an act of heroic self-confidence and more an act of gracious participation in God's own action. (John Witvliet)
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Construction work is ramping up throughout the site despite the problems with the Freedom Tower. The temporary PATH terminal is going to be relocated to Vesey Street from its current location on Church, so that the permanent PATH terminal designed by Santiago Calatrava can be built. The new temporary PATH terminal entrance will eventually be replaced by Frank Gehry's performing arts center.
The Post reports that the size of the WTC memorial is shrinking in response to the call by Pataki, Bloomberg, and others to get the costs under control.
Gov. Pataki and Mayor Bloomberg got their first look at the proposed design changes during a closed-door meeting with builder Frank Sciame, who was tapped several weeks ago to help bring the memorial's soaring costs under control.It certainly appears that the Arad design is being completely reworked because the costs were out of control and safety concerns required massive expenditures to provide adequate access to the site in an emergency.
Among the proposals delivered by Sciame - designed to slash the memorial cost from $1 billion to $500 million - is a dramatic scaling back of the galleries beneath the plaza, where architect Michael Arad had envisioned displaying the names of all the victims on parapets ringing the two reflecting pools, sources said.
Under the new plan, the names would be inscribed at the plaza level, a move many victims' relatives strongly favor.
Eliminating most of the public space beneath the plaza would also reduce the number of entrances and exits needed to move people from one level to the other, lowering both construction and operating costs, sources said.
A 9/11 museum, however, would remain under the plaza, with its own entrance, according to plans reviewed by Pataki and Bloomberg.
Sciame was able to reduce the $300 million in estimated infrastructure costs at the memorial to $150 million, of which the Port Authority has already committed to pay $100 million out of savings extracted from its new deal with developer Larry Silverstein.So, we've gotten to within $50 million of the figure needed to get the infrastructure for the memorial done. That's good. So where is the remainder going to come from and should the Port Authority kick in the extra $50 million just to get the whole process going?
Sources said the builder suggested that additional savings could be found by shifting responsibility for construction of the project from the World Trade Center Memorial Foundation to the Port Authority - an idea that was first floated several months ago.
Meanwhile, some thefts of 9/11 related materials, including donated supplies to relief workers and artifacts taken from Ground Zero were not prosecuted.
Kieger Enterprises of Lino Lakes, Minn., dispatched trucks to a Long Island warehouse and loaded hundreds of thousands of dollars worth of donated bottled water, clothes, tools and generators to be moved to Minnesota in a plot to sell some for profit, according to government records and interviews.
Dan L'Allier said he witnessed 45 tons of the New York loot being unloaded in Minnesota at his company's headquarters. He and disaster specialist Chris Christopherson complained to a company executive, but were ordered to keep quiet. They persisted, going instead to the FBI.
The two whistleblowers eventually lost their jobs, received death threats and were blackballed in the disaster relief industry. But they remained convinced their sacrifice was worth seeing justice done.
They were wrong.
As a result, most Americans were kept in the dark about a major fraud involving their donated goods even as new requests for charity emerged with disasters like Hurricane Katrina. And Christopherson and L'Allier were left disillusioned.
"I wouldn't open my mouth again for all the tea in China," L'Allier said. Added Christopherson, a 34-year-old father of two: "I paid a big price."
As firefighters searched for survivors after the Sept. 11 attacks, heat from the World Trade Center's smoldering ruins burned the soles off their boots. They needed new ones every few hours, and Christopherson made sure they got them. The moment that crushed Christopherson's faith was when his employer dispatched the trucks to the warehouse for those supplies, donated by Americans.
The government ultimately gave the whistleblowers $30,000 each after expenses, their share in a civil settlement against KEI. They say the sum was hardly worth their trouble.
Technorati: World Trade Center, WTC, Pataki, LMDC, urban policy, Freedom Tower, IFC, International Freedom Center, spitzer, silverstein.
Labels: 9/11, Eliot Spitzer, FBI, Freedom Tower, George Pataki, Ground Zero, infrastructure, Larry Silverstein, LMDC, Michael Bloomberg, natural disasters, New York City, PANY-NJ, PATH, urban policy

subset: commoncrawl


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What's Happening - Three members of the Boise State University men's tennis team will compete in their first tournament of the Fall season, the Baylor Tournament, this weekend in Waco, Texas.
The Players - The Broncos will send three members of their team to compete in the tournament including Luke Shields who entered the season ranked 33, according to the Intercollegiate Tennis Association. Shields enters the seasons as the second ranked individual in the Western Athletic Conference. Last season Shields led the Broncos with 25 individual victories and tied for team led in doubles victories with 25.
Luke Shields will be joined by his brother Clancy Shields and Steve Robertson.
All three members of Boise State will compete in the individual competition but Robertson and C. Shields will be competing as a doubles team as well.
Last season Shields and Robertson won 84 percent of their doubles matches to post a record of 21-4 for the season. Both earned first-team All-WAC honors for their play as a doubles team.
Clancy Shields was also named first-team All-WAC for his individual play.
Last season the Broncos return eight members from their 2005-06 team that captured the WAC Championship in Boise, Idaho.


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Symbiosis Gathering 2015 - 10 Year Re:Union
- Music
- 28 Mile Road, Oakdale, CA, 95361
Free EXTREME COUPONING event in Stockton, June 6!
The Stockton Record
Thursday, June 6, 2013 from 7:00 PM to 8:30 PM (PDT)
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Thursday, June 6
Record Press Club in the Stockton Arena
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Parking details: Parking is free to all attendees. The parking lot North of the arena which is shared by the waterfront hotel and Stockton Arena and the lot next to the Banner Island ball park is available for attendees to use this evening.
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YIELD: Serves 4
Heat vegetable oil in heavy large saucepan over medium heat. Add onion and garlic and sauté until tender, about 5 minutes. Add cumin and stir until fragrant, about 30 seconds. Add cubed turkey breast and ground turkey. Sauté until no longer pink, about 4 minutes.
Add 3 cups stock, barley, jalapeños, marjoram and summer savory to turkey mixture. Cover and simmer until barley is almost tender, stirring occasionally, about 40 minutes.
Add cannellini and garbanzo beans to chili. Simmer uncovered until barley is tender and chili is thick, about 15 minutes. Season with hot pepper sauce, salt and pepper. (Can be made 1 day ahead. Cover and chill.Bring to simmer before serving.)
Serve chili, passing green onions, cheese and sour cream separately.


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ntil about 15 years ago in theworld of the U.S. government, technology transfer was a bad word, not a buzzword. It was deemed "inconsistent with mission of the Atomic Energy Commission" because it was perceived to detract from government research and draw talented personnel from national laboratories. But times have changed. Since the passage of federal laws in the 1980s, technology transfer has evolved into an important mission of national research facilities.
Oak Ridge National Laboratory, once an Atomic Energy Commission research facility and now a Department of Energy (DOE) laboratory, has always been ahead of the game in this arena. Since the 1960s, ORNL researchers have formed spin-off companies that manufacture and market technical products. As early as 1962, ORNL Director Alvin Weinberg established an Office of Industrial Cooperation to speed the adoption of scientific advances by the private sector. In the 1970s and 1980s, the federal government made it easier to transfer national laboratory technologies to the private sector by setting up mechanisms such as licenses, collaborative research agreements, and cooperative research and development agreements (CRADAs). Today the Oak Ridge Complex is a leader in technology transfer, responsible for nearly 20% of the total number of CRADAs entered into by DOE facilities. Oak Ridge also consistently places among the DOE leaders for its number of active licenses of patents.
Technology transfer is more of an art than a science. The beauty in this art lies in the ability of technology transfer to leverage the talents and funds of the government and private sectors to accelerate, enhance, and cuts costs of DOE mission work. The results benefit American industry because cutting-edge technologies from the national laboratories are being used to give U.S. businesses a competitive edge.
Bill Martin considers technology transfer a sound business practice.
In Oak Ridge, technology transfer is not a business theory that just sounds good on paper; it's a sound business practice. Technology transfer comes in many forms such as licenses of intellectual property, CRADAs, personnel exchange, user facility agreements, technical assistance, work for others, and information exchange. The Laboratory continually pursues beneficial partnering with other entities through combinations of these mechanisms and through other novel approaches.
For example, ORNL collaborated with 3M Corporation to invent a "candle filter" for DOE's Fossil Energy Program that makes possible the next generation of cleaner, more energy-efficient coal power plants. Successful scale-up of the ORNL invention was the major technical constraint; however, this hurdle was overcome through a strategic technology transfer partnership. ORNL issued a competitive procurement for a development subcontract to mature the technology. The subcontract was granted to 3M because it met the primary criteriait was willing to share the cost and it was committed to commercializing the ORNL technology.
According to Rod Judkins, an ORNL principal investigator, 3M provided six of the ten researchers assigned to the project and contributed expertise in materials science and filter technology. The DOE power plant program was thus advanced by an estimated 10 years, and ORNL work in developing heat exchangers for these power plants was accelerated by 5 years. (For more details on this technology transfer story, see "Technology Transfer.")
Other examples of the transfer of ORNL technologies described in this issue are gelcasting (described in the article "ORNL's Gelcasting: Molding the Future of Ceramic Forming?") and production and use of nickel and iron aluminides (described in the article "Nickel Aluminides: Breaking into the Marketplace"). Like the candle filters, these technologies received R&D 100 awards in 1995. Gelcasting may become the process of choice for making ceramic products such as certain automotive parts, accelerator magnets, and possibly even artificial bone. ORNL-developed nickel aluminides are being used as furnace furniture for the manufacture of auto parts and as rollers for shuttling steel plates into furnaces for heat treatment.
Technology transfer projects are much more successful than some critics will admit. They are a cost-effective means of leveraging private and government dollars and talent to accomplish government missions efficiently while strengthening the competitiveness of private U.S. industry. Independent estimates place the market value of the ORNL-3M candle filters at $200 million per year by 1998 with a total market of approximately $7 billion from now to 2003. Because the ORNL-developed candle filter is the first of its kind to enter the market and is superior to competitors, it likely will dominate both the U.S. and world markets. DOE will benefit from considerable royalty income, 25% of which is eligible to be returned to the division that produces the licensable technology for maturation of other technologies. The top ORNL divisions receiving technology maturation funds from this source include Metals and Ceramics, Engineering Technology, and Health and Safety Research.
Product sales of inventions and services based on DOEOak Ridge technologies topped the $110 million mark in fiscal year 1995. The number of licenses that will produce such royalties is climbing steadily also, with more than a 50% jump from 1994 to 1995 alone.
Together, Lockheed Martin Energy Systems (which manages the Oak Ridge Y-12 Plant and K-25 Site) and Lockheed Martin Energy Research Corporation (which manages ORNL) have 287 CRADAs and 154 licenses. ORNL alone has 168 CRADAs and 130 licenses.
Department of Energy benefits from technology transfer continue to increase in number. Since 1992, the number of full-time equivalent employees who were actually guest workers contributing to mission work increased more than 80%. Partner contributions to CRADAs as a percentage of total R&D budget have also continued to rise since 1992.
Whatever the nametechnology transfer, industrial partnerships, or research collaborationspartnering with the private sector, academia, and other government entities will remain a vital function for practicing the most efficient R&D possible and for turning the cutting edge of science and technology into the competitive edge of U.S. business.
[ Next article | Search | Mail | Contents | Review Home Page | ORNL Home Page ]


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One of the funniest women on the small screen landed her first major fashion magazine cover! Fashionable star and creator of The Mindy Project, Mindy Kaling, is gracing ELLE's annual Women in TV issue. Her best friend/ex-boyfriend BJ Novak says of Mindy, "She's a gangster and guys respond to that. This is not a girl who waits by the phone. This is a girl who picks up the phone and calls whoever she wants."
If you're familiar with The Mindy Project then you know Mindy has a pretty good track record for quirky, fun and vibrant outfits. There's even a blog dedicated to finding the exact items Mindy wears on the show. Can we be best friends already?!
Mindy is in good company, too. The issue has three other covers featuring ladies who play our favorite characters on little shows like Girls, New Girl and Parks and Recreation. Yup, we're talking Allison Williams, Zooey Deschanel and Amy Poehler.
ELLE's Women in TV issue will be hitting newsstands January 14th so be sure to grab your copy. Check out the three other covers below and tell us who's your favorite!


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Watson: Dry Weather Creek … by the numbers
April 12, 2012 in West Central Tribune
April 12, 2012 in West Central Tribune
April 12, 2012 in West Central Tribune
When Albert Angrimson began farming this land in western Chippewa County in 1910, just about every community had its own mill to grind wheat to flour. Continue Reading
March 22, 2012 in The Dickinson Press
Dry conditions and wind gusts of almost 50 mph rekindled a fire about five miles east of Dickinson on Thursday, blocking Interstate 94 with a thick wall of gray smoke, officials said. Continue Reading
March 20, 2012 in The Dickinson Press
WILLISTON (AP) Dry and windy conditions have fueled grass fires in western North Dakota. Continue Reading
March 17, 2012 in The Dickinson Press
With little precipitation in the area and Saturday's record-breaking temperatures in Dickinson expected to continue today, red flag warnings and fire bans remain in place for southwest North Dakota, officials say. Continue Reading
March 3, 2012 in The Daily Republic
MINNEAPOLIS A relatively snow-free winter in the Upper Midwest has some officials worried about damage to agriculture if the dry weather persists into spring planting. Continue Reading
February 22, 2012 in The Dickinson Press
MANNING A mix of low moisture and increased oil activity has Dunn County leaders preparing for a dustier-than-usual spring. Continue Reading
January 4, 2012 in The Daily Republic
SIOUX FALLS (AP) The lack of snow in South Dakota is causing concerns for winter wheat and alfalfa farmers, but the mild temperatures so far this winter have been good for livestock. Continue Reading
December 28, 2011 in The Daily Republic
Mitchell firefighters have readied all of their grass fire vehicles. Continue Reading
December 14, 2011 in The Daily Republic
No snow to plow but fire risk is high and 2012 ag concerns growing.


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Loterija Slovenije
History, Mission, Vision
Loterija Slovenije is a leading organiser of classic games of chance in the Republic of Slovenia with a very long tradition. We have been organising games independently since 1972, and acquired the status of a public limited company in 1998.
Our mission is, in meeting the basic human need for playing games, to fulfil the expectations and needs of players, owners, the state, and our employees. Through the payment of concession fees to two foundations (Foundation for Financing Organisations for the Disabled and Humanitarian Organisations, and the Foundation for Financing Sports Organisations), our company provides for the stable financing of organisations for the disabled, humanitarian and sports organisations.
As stated in our vision, we shall continue to be the best in perceiving the desires of players and translating them into games of chance while observing the rules of socially responsible gaming.
Fulfilment of Social Responsibility
At Loterija Slovenije, we are aware of the strategic advantages of a socially responsible approach to business operations. Social responsibility is therefore interwoven into all levels of our company's management, business processes, and development of business ethics.
Commitment to the socially responsible organisation of games of chance (SROGC) is a key pillar of the corporate social responsibility of Loterija Slovenije, which encompasses responsibility to all participants and is the fundamental guide of all employees in the Company.
In 2009, Loterija Slovenija acquired the Responsible Gaming Certification issued by an independent panel of the World Lottery Association (WLA).
Sales Network
The games of Loterija Slovenija are sold at 1,181 sales outlets: our complete sales programme is sold at 845 sales outlets (specialised sales outlets, Petrol service stations, and units of the Slovenian Postal Company), and part of our sales programme (instant tickets) is sold at 336 sales outlets (3Dva tobacco shops and units of the Slovenian Postal Company).
Each sales outlet offering a complete range of our games covers on average 2,400 inhabitants. At present, our sales outlets can be found at 340 locations across Slovenia.
Sales Programme
The sales programme of Loterija Slovenije comprises:
Key Performance Indicators
In EUR
The Future
The speed of technological developments across the globe is exceeding all expectations, and Loterija Slovenije is keeping up with this trend. We are members of the European and World Lotteries associations (https://www.european-lotteries.org, http://www.world-lotteries.org), are preparing to connect with other European operators of games of chance, and are developing new projects while remaining committed to our goal of socially responsible operation of games of chance.


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I get really annoyed at the riding school I am at.
The horses are really, really dead to the leg. Even though it's clear they have some training they usually just don't want to move so much that you can hardly focus on anything else but getting them moving. The instructor has told me I have done better than most people at getting them moving forward but it is just constant leg and seat just to get them to stay moving, much less push them into collection.
I feel like I can't learn anything because even if correct my aids have no effect. It depends on your school, but in some places I think you can only go so far on horses that constantly ruined by dodgy riders.


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A New Zealand court ruled on Friday that the US does not have to hand over all its evidence against Megaupload founder Kim Dotcom, a setback for the German national who is trying to resist extradition from NZ for alleged online piracy, fraud and money laundering.
The Court of Appeal overturned a lower court ruling that the FBI should disclose all its evidence so Dotcom, released on bail last February, could fairly contest the case against him.
The FBI accuses Dotcom, who founded the Megaupload file-sharing site, which housed everything from family photos to blockbuster films, of leading a group that netted $175 million since 2005 by copying and distributing copyrighted content without authorisation.
Lower courts had ruled twice that Dotcom should have access to all material the FBI was basing its extradition case on.
The Court of Appeal said the US government had a duty of "candour and good faith" in making an extradition bid, but a summary of the evidence held would suffice.
"It is for the requesting state to decide what information it wishes to put before the requested state in support of its request," the court said.
It said there were safeguards for any accused, such as the New Zealand courts and government seeking more information if they are not satisfied there is a prima facie case to be answered.
Appeal considered
Dotcom maintains that Megaupload, one of the world's most popular websites before it was shut down in January last year, simply provided online storage services and should not be held responsible for stored content.
William Akel, one of Dotcom's lawyers, said an appeal to New Zealand's Supreme Court was being considered.
"How can you determine whether or not there has been compliance with candour and good faith if you don't know what documents are being relied on to support the case?" he said on Radio New Zealand.
Since the initial raid, the courts have ruled that search warrants used in the raid were illegal, unfrozen some of Dotcom's assets for living and legal expenses, relaxed restrictions of travel, and ordered extensive evidence disclosure.
A New Zealand government spy agency was also found to have illegally spied on him, bringing an apology from the prime minister, and opening the way for a damages claim.
Dotcom, who also goes by the name of Kim Schmidt, is a German national but with residency in New Zealand, which made it illegal to spy on him.
The extradition hearing for Dotcom and the other three defendants is scheduled to be held in August.
Issue: 339 | June 2015
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Britain's best-selling period homes magazine
ABOVE (click on gallery image to view larger picture): The luxurious, hand-forged Tree of Life four-poster iron bed, from And So To Bed, brings an element of forest fantasy to the bedroom, with a contemporary silver patina finish, from £1,375.
Elegant, romantic and harking back to an era of nightcaps and candlesticks, a metal bedstead is an investment buy that will ensure you'll sleep soundly for years to come. Choose from strudy brass beds or ornate designs.
There is no type of bed so reassuringly sturdy and likely to create wow factor as one with a metal frame, and from elegant, curvy models popular in the Victorian era, to ornate, intricately cast designs, there's a huge variety on offer.
For a large boudoir, high head and foot boards will add to the grandeur – but do opt for a king-size model, which measures 5ft , to ensure there's plenty of space for a comfortable night's sleep. Smaller bedrooms are best complemented by a metal frame with a low end which will not encroach on the space. To create the ultimate focal point, opt for a four-poster bed frame with ornately cast posts; this type of bed can often be dressed with fabrics to soften the look.
A reclaimed metal bed will add instant period charm, but bear in mind the fact that some antique models will be a non-standard size, meaning you'll have to factor in the cost of having a bespoke mattress made.
1 The Bronte Victorian-style double bedstead from 1907 Beds has antique brass finials and is available in black and cream, from £200.
2 Original Bedstead Company's Arigna iron bedstead is a beautiful design with curves in all the right places, available in ivory and satin black, from £549 for the bedstead and from £359 for a headboard.
3 The Rosie brass finish double bedstead, £869, Wrought Iron & Brass Bed Company, would be perfectly suited to a country-style bedroom.
4 The Florence bed frame, £645, from Loaf, mixes antique styling with a white finish for a clean look.
5 Laura Ashley's new Hasting Ivory brass bed is a classic design, which costs £800 for a double bed frame.
6 The handmade Bedknobs brass bed from Heal's is based upon the Victorian assembly method, with hand-cast knuckle joints that enable the bed to be assembled without bolts, from £2,495.
7 Dreams' Glacier metal bedstead, in a brushed steel finish, is fit for a princess; the poles have a teardrop design with a reflective finish. Only available in king size, it costs £1,999.
8 Feather & Black's Highgrove bed is a strong, powder-coated iron design without any fuss; it costs from £699.
All prices and stockists correct at time of publishing
Interior Finishes & Landscaping
Consultants, Labour & Finance


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Fainting and Related Phenomena a Lay Review
[ Home ] [ Search ] [ Orthostatic Stress Testing & instrumentation ] [ Circulatory Measurements ] [ Circulatory Autonomic Testing ] [ Initial Orthostatic Hypotension ] [ Research Studies ] [ Comments ] [ Links ] [ Fainting and Related Phenomena a Lay Review ] [ Orthostatic Intolerance ] [ Orthostatic Hypotension ]
blood pressure
up or upright
inability to tolerate the upright stance
relived by recumbence
relived by recumbence
heart rhythm, irregular, too fast (tachycardia), too slow (bradycardia)
little blood
electrical heart abnormality that can produce dangerous arrhythmias
of the heart muscle
by an interaction between the nervous system and the circulatory system
to blood vessels and their contraction
cranial nerve which when stimulated causes heart slowing (among other
descriptive term for syncope associated with blood vessel (vaso) dilation
(widening) and heart rate slowing (bradycardia).
VVS comprises postural and p[hobic forms.
The term was most famously by Sir Lewis Thomas in 1931
part of the nervous system regulating many involuntary actions such as the
heart rate and blood pressure. It comprises the sympathetic,
parasympathetic and enteric nervous systems.
part of the heart which receives blood returning from the body
collection of blood or body fluids in dependent portions of the body
of small arteries provides resistance against which our heart pumps blood.
Different vessel resistances account for redistribution of blood
throughout our body
refers to arterial resistance in more peripheral parts of the body: e.g.
limbs, skin
spleen and digestive tract: major venous reservoir
receptors intimately involved with the response to orthostasis
from the heart and lungs which affect vascular function; these are less
involved with the normal response to orthostasis
involved with blood pressure regulation
a motorized table with foot support which can take a patient from supine
to upright or any angle in between. HUT is the de facto orthostatic stress
to the flow of blood
chamber of the heart
inherited form of autonomic failure seen only in Ashkenazi Jews
part of the nervous system which when activated increases heart rate and
blood pressure and causes vasoconstriction among other actions.
Sympathetic receptors are of 2 main types designated " and $
Syncope (fainting) is a reasonable starting point. In
principle, it is familiar to all of us because it is common. Perhaps 40% of all
people will have one or more faints during their lifetime. However, it
represents a sudden change in well-being that often stimulates fear in families
and discomfort among physicians. Syncope translates from the Greek as "a
cutting short" (1). It is defined as a sudden transient loss of consciousness
with loss of postural tone and spontaneous recovery caused by impaired blood
flow to the central nervous system. Syncope may occur supine or upright and
under a wide variety of conditions. It may be due to medication, cardiac
disease, most commonly arrhythmic disease, or severe impairment of cardiac blood
flow by mechanical pump failure or obstruction. It may be due to transient
impairment of central nervous system function as in a transient ischemic attack
(mild stroke) but this is less common. However, although convulsive-like
movements may occur during syncope, it is distinct from a seizure disorder, and
is distinct from coma in which loss of consciousness is not transient at all.
Cardiac syncope is often quite serious and should be
regarded as life-threatening. Although cardiac syncope is not often closely
associated with orthostasis it may be. Causes of cardiac syncope include the
long QT syndrome, arrhythmogenic right ventricular dysplasia, cardiomyopathies,
left ventricular outflow obstruction, myocardial infarction, primary pulmonary
hypertension, and most commonly ventricular tachycardia (fast heart rate),
bradyarrhythmias (overly slow heart rate) and related arrhythmic events (3). The
first job in evaluating syncope is to evaluate the patient for possible cardiac
syncope. When specific cardiac disease is found, it is treated specifically.
Thus, for example, ventricular tachycardia is treated with antiarrhythmics,
bradyarrhythmias causing syncope are treated with a pacemaker, long QT syndrome
with medication and a defibrillator if needed, and aortic valve disease with
surgery. Cardiac syncope may first manifest during exercise, which is the best
and most physiologic stressor of the myocardial circulation and overall cardiac
function. Exercise related syncope should raise a "red flag" for underlying
heart disease (4). Nevertheless, despite flag-waving, the large majority of
exercise related syncope cases are non-cardiogenic in origin, at least for
children and adolescents. Cardiogenic syncope has been well described in
numerous texts including those already referenced and is not the central topic
for discussion here because it accounts for a small percentage of syncope in
children and of those many have previously known cardiac conditions.
Approximately 90% of syncope in children is either
vasovagal or "unexplained". Often the unexplained variety is
reclassified as vasovagal once tilt table testing has been performed (5).
"Neurocardiogenic" has also been used in the place of vasovagal.
Fainting is mediated
through a combination of inappropriate vascular (blood vessel) and heart rate
control. It is rarely fatal but it can be injurious. Some patients with VVS may
have cardiac standstill ("asystole") of abrupt onset resulting in
severe injuries. There is little compelling evidence
for a primary role for the heart in neurocardiogenic syncope, once cardiogenic
syncope has been ruled out. The term neurocardiogenic is thus somewhat misleading. Synonyms for
neurocardiogenic include neurally mediated syncope and reflex syncope although
the latter often includes situational syncope as well. Almost
all syncope in children is vasovagal. On the other hand
adult syncope is much more likely to be cardiogenic – about a 50/50 split with
neurocardiogenic syncope. Vasovagal syncope almost always occurs in the upright
position, which may sometimes include sitting. Therefore it is regarded as a
form of orthostatic intolerance.
Orthostatic Intolerance
Defining Characteristics glossary
means standing up. Orthostatic intolerance can be defined by the inability to
tolerate the upright posture because of signs and symptoms relieved by lying
. If symptoms initiate while supine, then there is
no OI. Transient OI is commonly experienced during dehydration or infectious
disease. Typical signs and symptoms include: loss of consciousness or lesser
cognitive deficits (memory loss, decreased reasoning and concentration); visual
difficulties; lightheadedness;
headache; fatigue; either increases of BP (hypertension), decreases
(hypotension) of BP; weakness; nausea and abdominal pain; sweating;
tremulousness; and exercise intolerance
. Unless in harm's way (e.g. standing on a cliff)
OI is not lethal. Some OI findings, such as nausea and sweating pertain directly
to autonomic activation. However, loss of consciousness, severe lightheadedness,
and neurocognitive loss relate to central nervous system (CNS) dysfunction and
oblige recumbence. CNS symptoms are produced by altered brain blood flow perhaps
involving the brainstem. Cerebral
autoregulation may be compromised
as in POTS
and VVS
. CBFv
may be reduced by hyperventilation and hypocapnic cerebral vasoconstriction.
Involuntary postural hyperventilation, mostly hyperpnea, is observed in all VVS
and 50% of POTS patients in my laboratory
. Trigeminal, sympathetic, or parasympathetic nerve
activity may also affect orthostatic CBF
Physiology of Orthostasis
supine, blood volume within the central thoracic vasculature is relatively
large, although a disproportionate amount (25-30%) of blood is stored within the
splanchnic venous reservoir
. Standing transfers >500ml of central blood
caudally, further increasing the volume of the splanchnic pool and filling veins
of the lower extremites An initial period of instability follows, denoted
"initial orthostatic hypotension"
(IOH) during
which BP can decrease by 30% or more, reaching its nadir at 10-20 seconds after
standing. Reflex tachycardia occurs. BP is restored within 30-60 seconds. IOH
results from the normal delay of arterial baroreflex detection and response to
gravitational blood volume redistribution. Lightheadedness, postural instability
and occasionally brief loss of consciousness occur and are relieved by
recumbency making IOH a form of orthostatic intolerance. Thereafter, HR
decreases but remains elevated compared to supine, and BP is restored by
arterial vasoconstriction, by elastic recoil of venous blood in dependent veins,
and by active venoconstriction in splanchnic veins
. After
IOH recovery, upright blood volume slowly decreases because of microvascular
. Decreased venous return decreases central blood volume and cardiac output (CO)
by 20% despite baroreflex mediated vasoconstriction, increased cardiac
contractility, and increased HR. Cerebral blood flow velocity (CBFv) decreases
by 3-12% partly because of reduced cerebral perfusion pressure by 20mmHg
. Cerebral autoregulation (unchanged CBF despite changing BP) is blunted during
orthostasis. Unless the muscle pump is evoked, standing still places us at risk
for decreased CO and CBF.
posture (orthostasis) stresses regulatory capabilities of the circulatory system including
an intact heart, intact vascular structure and function, adequate blood volume,
and intact physical pumps comprising the skeletal muscle pump - leg muscles that
compress leg veins - and the respiratory-abdominal muscle pump which enhances
systemic venous return during respiration
. Upright stance causes dependent venous pooling.
Muscle pumps propel blood back to the heart when upright and during exercise
. Enabling
the skeletal muscle pump forms an important class of physical
"countermeasures" against orthostatic intolerance
Apart from muscle pumps, rapid orthostatic circulatory adjustments depend
on the autonomic nervous system (ANS) comprising sympathetic and parasympathetic
arms forming a framework for heart rate (HR) and blood pressure (BP) stability.
The myogenic response
and flow dependent mechanisms
, and co-transmitters neuropeptide Y and ATP
to produce arterial vasoconstriction and
venoconstriction, increase cardiac contractility and HR, stimulate adrenal
epinephrine release, and control the neuroendocrine and vascular function of the
kidney and long term BP control. The parasympathetic arm via vagal nerve
efferents contributes most to heart rate changes at rates less than the
intrinsic rate
. Recent work indicates strong vagal influences on
and important effects on nitrergic (nitric oxide
containing nerves) vasodilation of the large cerebral arteries
. Endocrine and local systems (e.g. nitric oxide,
local angiotensin) impact the vascular milieu but are slower to develop, often
acting to modulate or set tonic activity of the ANS
. Autonomic control of HR and BP during orthostasis
is provided by subsystems designated "baroreflexes" (pressure reflexes),
loosely grouped as arterial and cardiopulmonary baroreflexes, which maintain BP
under changing conditions such as orthostasis
Apart from muscle pumps, rapid orthostatic circulatory adjustments depend
on the autonomic nervous system (ANS) comprising sympathetic and parasympathetic
arms forming a framework for heart rate (HR) and blood pressure (BP) stability.
The myogenic response
Patterns of Orthostatic Intolerance-Orthostatic Stress Testing
and Head-up Tilt
Patterns of orthostatic intolerance are best defined by an orthostatic
stress test – i.e. a means by which upright standing stress can be imposed in
a controlled fashion and the physiological response monitored in detail. While
standing can be used, individual differences and patient motion may make this
difficult. Moreover, standing has only recently benn validated against upright
tilt for adults and similar validation has not been performed in the young. Therefore the standard of orthostatic assessment
in the young is the head-up tilt
table test. Although head-up tilt was used to evoke autonomic reflexes in early
NASA experiments, it was first used as a provocative agent in 1986 by Richard
Sutton.. This
device comprises a table driven by an electrical motor with a supportive
footboard enabling positioning of a patient at varying angles of upright tilt.
Although it would seem that an angle of 90o is most physiologic, this
usually induces too many "false positives" (patients with no history of
orthostatic intolerance who have intolerance induced during testing). Therefore
lesser angles such as 60o or 70o are customarily used. Following a resting period, the patients are placed upright and their
response over a period of tilt assessed – this is usually anywhere between
30-45 minutes. At a minimum, blood pressure
and continuous electrocardiography are assessed. Typically a form of continuous
blood pressure assessment such as a finger plethysmography or an arterial
tonometer is used and respirations are also assessed on a moment to moment
basis. Other researchers have used methods to directly assess sympathetic
activity (microneurograaohy). peripheral, thoracic
(chest), and central nervous system blood flows which are methods still consigned
to the research domain. Many laboratories use medications to enhance the
fainting response, sometimes isoproterenol but more often sublingual
nitroglyceron. The central purpose of a tilt table test is to reproduce
symptoms of orthostatic intolerance in a setting in which hemodynamic variables
(blood pressure, heart rate, blood flow) can be assessed. Most often there is
correlation with changing physiological signs, but the definition of orthostatic
intolerance requires symptoms. Thus for example the incidence of false
positive faints during head-up tilt is high. If the complaining symptoms are not
reproduced but the patient has a simple faint, the test is judged as negative.
For example, my son fainted during his tenure as a HUT control patient. He has
no history of fainting and the episode bore no relation to any prior complaints.
This is a false positive and not a sign of orthostatic intolerance.
Other patterns of hemodynamic disturbance (see below) seem invariably
associated with symptoms and are more reliable indicators of chronic impairment.
normal response to HUT is a modest increase in heart rate (with an increased heart rate by 10-20 beats/min),
a small increase in systolic BP and a larger increase in diastolic pressure.
Systolic blood pressure should not fall. Abnormal tilt test responses can be used to categorize patterns of
orthostatic intolerance. The overall patient assessment of chronicity and
severity of impairment should be combined with these lab data to reach any
conclusion concerning the nature of orthostatic intolerance in a particular
patient. In addition to the normal pattern, three typical patterns of
orthostatic intolerance are depicted in the figure, which
shows the systolic blood pressure and heart rate in-patients during tilt.
is depicted in the figure . Typically patients easily
tolerate the early parts of tilt with little change in blood pressure or
sensorium (phase 1). Following a variable period of time – on the order of 7 to 20
minutes, patients develop orthostatic symptoms of nausea, dizziness, heat, heavy
breathing, and sweatiness initiated by a slow
fall in blood pressure (phase 2). Later, there is an abrupt drop in blood pressure and
heart rate with loss of consciousness (phase 3). Phase 1 is associated with an
increase of arterial vasoconstriction but reduced cardiac output. Phase 2 with a
slow fall of arterial resistance along with cardiac output. Phase 3 with
arterial vasodilation and variable cardiac output.:
a) If the episode occurs rapidly the patients can be
injured. It is estimated that approximately 15% of patients with simple faint
are injured overall during a faint. This can take relatively innocuous forms as
a superficial cut while falling or can be more pernicious when a car is
overturned. In the latter case it is evident that treatment for fainting is
b) Fainting usually is short lived; upon assuming recumbence
the patient usually awakes after a few seconds. But some patients do not awake
immediately and prolonged sleep-like states have occurred. These may mimic post-ictal
(post seizure) states.
c) A patient persistently maintained upright in a severe
simple faint (for example proceeding to asystole) can potentially die. There is
no reported pediatric death during HUT. A corollary is that such testing is
potentially risky and should be performed by experienced personnel. Similar
events may also occur in the real world, so called "telephone booth
syncope'. This has decreased since telephone booths are largely anachronistic.
However, recently one of my patients with known vasovagal syncope managed to
prop herself up with impending faint and nearly required a full resuscitation.
Patients should be placed supine or allowed to fall to a recumbent position.
Recumbence invariably resolves all symptoms and signs.
for Vasovagal Faint
The most popular proposed
mechanism holds that fainting results from an errant stretch reflex (aki to the
Bezold=Jarisch chemoreflex) from the
left ventricle. The reflex is activated by an underfilled (due to reduced venous
return), overly contractile (due to sympathetic activation), left ventricle.
This results in a "paradoxical reflex" mediated by unmyelinated C-fiber
nerves coursing from the ventricle to the CNS and causing vagally mediated
bradycardia as well as vasodilation. For the most part this explanation has
become untenable.
Reflex is an "an eponym for a triad of responses (apnea, bradycardia, and
hypotension) following intravenous injection of veratrum alkaloids in
experimental animals." The response to mechanical stimulation is much
weaker. Aviado DM, Guevara AD. The Bezold-Jarisch reflex. A historical
perspective of cardiopulmonary reflexes. Ann N Y Acad Sci. 2001;940:48-58.
This mechanism was proposed despite the fact that any stimulus could only be
short lived and baroreceptors would immediately be unloaded. Hainsworth R.
Syncope: what is the trigger? Heart. 2003;89:123-124.
Relatively few afferent nerves were excited in the original Oberg and Thoren
hemorrhaged cat model. Oberg B, Thoren P. Increased activity in left
ventricular receptors during hemorrhage or occlusion of the caval veins in
the cat. A possible cause of the vasovagal reaction. Acta Physiol Scand
VVS can occur in a ventricular denervated transplant recipient given the SNP.
Scherrer U, Vissing S, Morgan BJ, Hanson P, Victor RG. Vasovagal syncope
after infusion of a vasodilator in a heart-transplant recipient. N Engl J
Med. 1990;322:602-604.
•The heart before syncope need not be empty nor hypercontractile. Novak V,
Honos G, Schondorf R. Is the heart "empty' at syncope? J Auton Nerv
Syst. 1996 Aug 27;60(1-2):83-92. Liu E et al Left ventricular geometry and
function preceding neurally mediated syncope. Circulation. 2000 Feb
Other theories of fainting include epinephrine or renin surges (which
would rationalize the common use of isoproterenol as adjunctive provocation). Such surges do indeed occur in those who faint and take some minutes to
develop. However, it remains unclear whether these changes are the cause of the
hemodynamic abnormalities or an effect of them acting as compensation for decreased blood
pressure and peripheral resistance during faint. A decrease in cerebral blood
flow has also been shown to occur in syncopal patients and may precede a large
fall in blood pressure. However, blood flow is similarly impaired in
chronic orthostatic intolerance in which hypotension (low blood pressure)
does not usually occur. Other proposed mechanisms include various
changes in CNS neurotransmitters such as serotonin, norepinephrine, neuropeptide
Y and substance P. Causation has not been established. In summary it is fair to
say that we still have no precise understanding of the mechanics or the
mechanism of simple faint.
of Vasovagal Faint
Without a clear
mechanism there is no clear treatment. Moreover, many patients with infrequent
simple faints, who do not injure themselves and who do not have convulsive
syncope, may require no specific therapy above training in aversive maneuvers.
The simplest of these maneuvers is lying down although leg crossing, bending at
the waist, squatting and other maneuvers may also be effective. Increased fluid
and salt intake is always helpful in ameliorating the initial thoracic
hypovolemia of orthostasis. Lower body exercise, particularly isometric
exercise, can be a genuine help by enhancing the muscle pump and by increasing
venous tone in the lower extremities. Elastic support hose can be useful at
times but are often unacceptable to children. Other investigators
have advocated a regimen of progressively longer quiet standing as a form
of "orthostatic training".
VVS is not deadly unless in harm's way.
date, no single pharmacological intervention has been proven effective
above the placebo effect in younger patients in large clinical trials
. Placebo exerts 30-40% benefit
in these studies.
and even ferritin deficiency aggravates VVS
athletes have increased risk of VVS compared to untrained persons
and water supplementation can be helpful but a large amount of salt is needed
compensatory physical countermaneuvers are the recommended treatment
fainting prodrome must be recognized for countermeasures to be effective.
First faints are rarely countered because patients don't understand what's
Countermeasures: immediate lying down or
squatting cause postural VVS to cease; with prolonged prodrome
counterpressure such as leg-crossing, buttocks clenching, fist clenching, may
be effective
supine, the patient should not immediately stand. Instead, I suggest a 16 oz
bottle of water and remaining supine for >20 minutes following the episode.
If there is no prodrome or if there is abrupt onset
with injury, then consider asystolic vasovagal faint or an arrhythmia
and evaluate by loop recording electrocardiography
. Holter monitoring 24-hour is inadequate for
arrhythmia determination
total loss of consciousness is not transient, then it is not a faint, it
is coma. VVS is less than 2 minutes of total loss of consciousness, as a matter
of consensus. Rarely, fainting promotes an underlying seizure disorder via
cerebral ischemia.
2) Orthostatic
in this group are patients with true "neurogenic orthostatic hypotension" defined by
the American Autonomic Society to be a sustained fall in systolic blood
pressure of >25 mmHg within 3 minutes of assuming the upright position . This
is discussed in more detail elsewhere in this website. This group harbors patients with autonomic failure. Autonomic failure includes
primary forms such as primary autonomic failure and multiple system atrophy, and
more common secondary forms occurring with Parkinson's disease and diabetes.
Dysautonomia may also be drug induced. Pediatric causes are rare and include
familial dysautonomia as the only "relatively" common variants (32). Acute
forms may occur during infectious and inflammatory diseases or be related to
peripheral nerve disease.
Chronic Orthostatic Intolerance and the Postural Tachycardia
orthostatic tachycardia syndrome is a disabling disease state described at least
since 1940 (33) and is the most common reason for referral for orthostatic
intolerance in adults. It is an emerging form of orthostatic intolerance
in children. Patients have day-to-day disability - a feature not shared with
those with simple faint. With some exception, traditional tests of autonomic
function are normal in these patients. Patients are often unable to hold jobs or
attend schools. Dr. David Robertson of the Vanderbilt autonomic laboratories,
has stated that this is the most common form of chronic orthostatic disability,
and is present in virtually every patient with day-to-day orthostatic
intolerance. He has therefore
initially named the illness "Chronic Orthostatic Intolerance" (COI). Our understanding
of its pathophysiology remains incomplete.
The central physical finding is upright tachycardia without concurrent
hypotension. Hypotension can be induced with unusually prolonged standing.
A resting tachycardia may also be present. An operational definition of the
syndrome most often called POTS for the postural tachycardia syndrome includes symptoms of orthostatic intolerance associated with an
increase in heart rate from the supine to upright position of more than 30 beats
per minute or to a heart rate greater than 120 beats per minute within 10
minutes of head-up tilt (HUT). Recent literature indicate that higher increases
in HR are found in younger patients.
Onset of symptoms often follows an infectious
disease and may be related to inflammatory mediators (42). We reported the first
pediatric cases of POTS. Our data showed that POTS physiology underlies
orthostatic intolerance in the large majority of adolescents with the chronic
fatigue syndrome (CFS) . POTS is common, affecting an undisclosed number
of patients mostly in the age range of 12 to 50 years, mostly female
(approximately 80%). There is an as yet undetermined but increasing apparent
prevalence in children and adolescents (43).
is caused by alterations of the autonomic nervous system, although, mild to
moderate all-cause hypovolemia mimics POTS.
Vagal Withdrawal and the Sinus
In some mildly ill individuals, POTS is related to loss of parasympathetic
slowing of the heart with few peripheral circulatory abnormalities. Upright
heart rates rarely exceed 120 bpm. Oten agents that increase cardiac
parasympathetic activity such as beta blockers
, cardiac glycosides
, acetylcholinesterase inhibitors (pyridostigmine)
or ivabradine
(not FDA approved) relieve symptoms.
Vagal Withdrawal and the Sinus
may have excessive beta adrenergic sensitivity of the sinus node. This condition
is denoted "inappropriate sinus tachycardia"
, and is regarded as distinct from POTS but less
common. Supine heart rates >100bpm are observed, symptoms are less severe
than in POTS, and beta blocker therapy can be efficacious.
POTS and Hyperadrenergic POTS
The remainder of patients are often partitioned among "neuropathic
POTS", in which "partial dysautonomic" adrenergic denervation
occurs, and "hyperadrenergic POTS", in which sympathetic overactivity
Neuropathic POTS
originally described, decreased adrenergic vasoconstriction in the legs causes
decreased norepinephrine spillover
, vasodilation
, and increased blood flow even supine
. When upright, redistributive central hypovolemia
caused by leg blood pooling leads to reflex tachycardia
. In another neuropathic variant decreased
adrenergic vasoconstriction and redistribution of central blood to the
splanchnic vasculature
causes reflex
tachycardia. Intense leg vasoconstriction produces acrocyanosis. Autonomic
autoimmune neuropathy
, presenting as POTS, causes similar reflex
tachycardia. Central hypovolemia produces hyperpnea and hypocapnia in 50% of our
. Treatment with vasoconstrictors (e.g. midodrine)
and pyridostigmine can help.
adrenergic synapse can be altered at pre-synaptic or post-synaptic levels.
Pre-synaptic abnormalities include increased sympathetic nerve activity even
when supine. While this has been reported
, the finding is not consistent
synaptic norepinephrine is observed in the norepinephrine transporter (NET)
deficiency heterozygote
, and in more prevalent epigenetic NET
. Pre-synaptic
and post-synaptic adrenergic activity may be enhanced by local chemical milieu,
including angiotensin-II excess caused by ACE-2
deficit and nitric oxide deficiency - a
hyperadrenergic variant with tachycardia, pallor, vasoconstriction and absolute
hypovolemia. Angiotensin [type 1] receptor blockers have shown benefit. Beta
blockers may also help.
among POTS Variants, a Matter of Opinion
among POTS variants may be difficult for the pediatrician (and for the OI
expert) despite apparent straight forward differences. Some would say that POTS
with increased upright blood pressure is hyperadrenergic, others would say that
increased plasma catecholamines (or better, increased norepinephrine spillover)
is required. Excessive orthostatic BP is a matter for consensus since both
systolic and diastolic BP normally increase upon standing: how much is too much
is unclear. As a heuristic, POTS patients with high supine HR, cool to touch and
pasty white in appearance when supine, often have hyperadrenergic POTS. Standing
HR is elevated to the 130-180 range during quiet standing indicating
hyperadrenergic drive; vagal withdrawal alone increases HR to the 100-120 range.
Those with upright HR < 120bpms are more likely neuropathic. Recent
(unpublished) work with sympathetic nerve recordings have demonstrated normal
sympathetic activity when supine, and supranormal activity upright. This
supports adrenergic enhancement (NET deficiency, Ang-II excess) in patients with
"hyperadrenergic POTS". Confusing matters further, neuropathic patients can
have increased upright catecholamines even though spillover is decreased in the
lower extremities
Deconditioning – Caveat Bedrest!
One confounding and alarming issue is the tendency for POTS patients to bedrest.
Prolonged bedrest emulates microgravity and has deleterious effects
including OI
, profound reductions in blood volume and cardiac
size, redistribution of blood, osteoporosis, skeletal muscle pump atrophy and
. Vasoconstriction is impaired
. Bedrest causes a self-perpetuating state of OI
which can emulate or intensify POTS. It is paramount for POTS patient to
leave bed and recondition. Well-structured exercise protocols are essential and
must accommodate patients start off bedrested
. Reconditioning invariably improves patient
well-being. Recent work support the idea that POTS patients are also exercise
deconditioned compared to matched volunteers
. While exercise deconditioning may or may not be
causal in POTS, it is clear that exercise reconditioning is beneficial and
should be advocated for all POTS patients.
treatment for chronic orthostatic intolerance is being developed but will depend
on specific etiologies as these are discovered. For the moment we continue to
use some of the medications outlined in the vasovagal section. Of these florinef, midodrine,
beta blockers and pyridostigmine seem to be most effective with an emerging use of SSRI's.
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UpSearchOrthostatic Stress Testing & instrumentationCirculatory MeasurementsCirculatory Autonomic TestingInitial Orthostatic HypotensionResearch StudiesCommentsLinksFainting and Related Phenomena a Lay ReviewOrthostatic IntoleranceOrthostatic Hypotension


text:
A double from Spanish striker Michu was enough for Swansea to get the better of Arsenal at The Emirates Stadium. Michu also went joint top of the top scorers table along with Robin Van Persie and Luis Suarez.
Arsenal 0-2 Swansea
Swansea had the better of the first half although chances were few and far between. Arsenal did threaten slightly in the 28th minute when Carl Jenkinson swung in a dangerous cross but Chico Flores was alert to head away from the approaching Gervinho.
Swansea nearly went ahead 2 minutes after when Michu beat Per Mertesacker in the air to flick it on for Nathan Dyer. The winger managed to get on the wrong side of Thomas Vermaelen but took an extra touch and hesitated which allowed the Belgian defender to get back and make an important block.
At the hour mark a mazy run from Swansea right back Angel Rangel nearly resulted in a goal for the Welsh team. He sprinted through the challenges of Theo Walcott and Santi Cazorla and his vicious effort was just tipped wide by Wojciech Szczesny.
In the 71st minute, Mikel Arteta attempted to dink a cross in to the penalty area but it was headed out only as far as Cazorla who hit a fine volley but Gerhard Tremmel in the Swansea goal made a good save.
Just 4 minutes after the Cazorla chance, Arsenal had claims from Olivier Giroud for a penalty. It followed sloppy passing from the Swansea defence which nearly allowed the Frenchman to get behind but Flores got the slightest of touches to knock the ball away from Giroud and Referee Mark Clattenburg, recently cleared of racism charges made by Chelsea, made the right call.
Swansea ramped up the pressure on The Gunners after that penalty scare and very nearly opened the scoring in the 84th minute after a neat one-two between Dyer and substitute Dwight Tiendalli saw the latter in on goal but Szczesny stood tall to deny the Swansea man a goal on his Premier League debut.
2 minutes later, Alex Oxlade-Chamberlain swung in a cross which was accidentally flicked on to Vermaelen by a Swansea defender but he couldnt quite get enough power in the header to beat the keeper.
Swansea kept on pressing and were to get their just reward when, in the 88th minute, Michu struck. He initially mis-controlled the ball in the centre but the ball bobbled to Dyer. He played the ball in for Michu who had continued his run and he responded with a composed finish past the helpless Szczesny.
Michu then made it 2 in the 91st minute when Jenkinson was dispossessed resulting in Michu having time and space to pick his spot before calmly passing the ball into the net. Boos rained down on to The Emirates Stadium pitch and shortly after, the final whistle was blown.
Its yet another disappointing result for The Gunners which sees them drop to 10th in the table, 5 points behind North London rivals Tottenham Hotspur in 4th place. Swanseas impressive season continues as they move up to 7th.


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The boys' soccer team from Port St. Joe Jr./Sr. High School will host a Jamboree this Saturday as the season kicks into gear.
The teams, including PSJHS, Tallahassee Godby and Rocky Bayou, will play at the Lamar Faison Soccer Complex directly behind Port St. Joe Elementary School.
The action gets underway at 1 p.m. ET with Port St. Joe facing Godby on Field 1.
Godby will compete against Rocky Bayou at 3 p.m. on Field 2 and Rocky Bayou will play the host Tiger Sharks at 5 p.m. ET on Field 1.


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Admiral Chopra is known to have been a distinguished student in school and college. We learn that he stood first in every subject in every class doing his B.Sc. (Hons.) in Physics and Chemistry switching on to Economics for his Master's Degree followed by LLB and MBA. He says that left to him, he would still like to be a student.
In his career, he rose to the highest rank in the Navy available to him then. After retirement, he held very senior position in the corporate world. He has been very actively associated at the highest level with the National Organisations like the Indian Council of Child Welfare, Rural Rehabilitation Commission, Fourth Pay Commission, Chinmaya Mission, Business and Law Schools in India and abroad. His other interests include study of scriptures, particularly Quran and Bhagwat Geeta. He speaks fluent French, Persian and Urdu.
Despite his other achievements, his passion continues to be Education and association with children. He believes that proper education for a child in India is the only pillar on which the Indian Society will sustain and develop itself. Presently, he is engaged in research, along with some distinguished and experienced Educationists on the Theme " What should be the nature of Educational Curriculum at the School and Professional level which prepares a child to be a responsible global citizen, yet retaining his national identity".
Junior School
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text:
Successful Latinos Reception
December 2013 UNCW Hispanic/Latino graduates will be recognized at a reception to be held at 5 p.m. on Dec. 13 in the Clocktower Lounge, Fisher Student Center.
Heavy hors d'oeuvres will be served and certificates of achievement will be handed out to the students. Students will have an opportunity to honor faculty/staff who have made an impact on their educational path, and red graduate cords will be given to the students to wear during the graduation ceremony.


text:
This profile for Yz Organization Inc is located in Jupiter, FL. Yz Organization Inc industry is listed as Business Services at Non-Commercial Site.
Sharon Weise served as the Director and has interests in other corporate entities including Yz Partners, LLC, Yz Airplane Leasing Corporation .
Key roles for Yz Organization Inc
Sharon Weise
Comprehensive Insight Plus Report
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|The D&B Comprehensive Insight Plus Report for Yz Organization Inc combines D&B's proprietary statistical scoring with business, payment and financial information all in one report.
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|The D&B U.S. Company Profile contains basic information such as address and telephone number, executive names and titles, line of business and SIC codes, D-U-N-S Numbers, organization status, and year and location of incorporation for Yz Organization Inc.


text: We have had a super long day yesterday. We got up at 3:30am to go to Immigration Canada this morning to sort out some other stuff for our Permanent Residence. When we got home, the very last thing I felt like doing was making a cake. Napping – yes, Cake-ing – not so much. But it's my baby's birthday, and a Mum's gotta do what a Mum's gotta do:)


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Cocktail Science: Simpler Simple Syrup
What could be simpler than simple syrup? Grab some sugar, add water, put it on the stove, and—stop. You've already gone to more trouble than you need to. Here's why. More
What could be simpler than simple syrup? Grab some sugar, add water, put it on the stove, and—stop. You've already gone to more trouble than you need to. Here's why. More
Making your own vanilla syrup at home is easy. Makes a great addition to coffee, tea, or cocktails. More
Mojitos are such a refreshing way to chase the sticky morning heat; but if you're like me, the last thing you want is a big mouthful of yard clippings every time you take a sip. And lot of mojitos are so cloying that they leave me even thirstier, rather than slaking a sticky throat the way a proper cocktail should. Clearly this wheel, while not needing reinvention, needed a little tuning. More
Classic simple syrup is a essential ingredient to have around, but at times you might want something a little more interesting. Perhaps you want to add a subtle flavor component to a cocktail or maybe you want to highlight your spirit with a complementary spicy note. Flavored simple syrups come in handy here. More
Simple syrup is one of the easiest ingredients you can prepare at home, and it's a basic, indispensable part of the cocktailian's arsenal. Here's the easiest method and a few variations for you to try. More
Umami Mart's Happy Hour column offers up a two-part primer on simple syrups. In this week's installment, it explores fruit-infused simple syrups and offers several recipes, including this "spring-beckoning" cocktail: If you're as ready for spring as I am, you'll enjoy this next recipe which incorporates the Meyer lemon syrup and sparkling sake for an amazingly refreshing drink I call a Sparkling Sake Lemonade. Even if you don't booze it up, the rambutan or Meyer lemon syrups would be great just mixed with a glass of seltzer. [via David Lebovitz]... More


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Who's Online:
I loved this poem! I've played the violin for, (*counts on fingers*), eight years; and this poem has a rythymn. Keep up the good rob!!
I loved the part about the faery cutting your heart into harp strings-very original and beautiful.
I just came across this poem and WOW! I'm surprised I haven't discovered it earlier. It was very, very, very good! :-)
Author's Response: Thanks for the encouraging review, Brassen!
Wow. Such a beautiful poem! I thought the way you started every stanza with 'I' was very effective. I loved it!
That was, in one word, beautiful. I especially liked the last few stanzas. I mean, even the unpleasant things mattering more than being cooped up forever? That was really touching. Kudos. :)
every stanza starts with "I".
Is there a meaning behind it?
Lovely, keep writting!
Author's Response: Perhaps there is? :D Thanks!
I wish I had more time to dream, though I suppose that if I was trapped in a cage I would have the time eh?
I love this poem! You really used your imagination!
Author's Response: Thanks Gilraen! Yes, the bird is lucky to have all that time to dream, although time comes - as everything does - with a price.
Wow. Careful planning obviously went into this. It was spectacular, and I look forward to seeing many more like it. Fantastic work!
Author's Response: Thanks, bodobodot1! I am writing more poem/poem fics/song fics in the future.


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By PAUL SIMS
email@example.com [2]
In days gone by, architecture professors would go about in a cart – known in French as a charrette – to gather designs from their students.
The students would climb on to the charrette to make last-second revisions.
Mississippi Main Street Association – a key player in an upcoming event in Starkville – laid out this explanation of a charrette in a statement and likened it to what will take place in the community in the coming days.
The MMSA has conducted about 20 charrettes in the state and with one set for Starkville next week, all of the cities in the Golden Triangle – including Columbus and West Point – will have completed the process, organization officials said in a statement.
Charrettes have "created new business and jobs, stimulated private and public reinvestment, as well as landscape and streetscape development, and helped to ignite newfound pride and enthusiasm in the community," said MMSA Executive Director Bob Wilson.
The Starkville charrette will take place Tuesday through Friday.
The community will play a role in this process, organizers said.
"The team of professionals that will conduct all the input meetings both private and public (are) very skilled and experienced in building consensus and really trying to get citizens and those involved to think outside the box as well as voice any current ideas or concerns or vision they might have in seeing Starkville move forward," said Jennifer Gregory, Starkville Main Street manager. "This will be specifically evident in the town hall public input sessions where opinions and ideas that are expressed will most definitely be used to lead the team toward their recommendations for the final vision plan."
Because part of the effort will involve talking to so many stakeholders and leaders in Starkville, "we we feel like the final vision plan will be one that is well representative of the goals and ideas of a large group of our community," Gregory said.
Private sessions will include meetings on such areas as tourism, city beautification and business. "The purpose of those meetings being closed is so that a concise group of people can get together with the team and talk details," she said. "The conversation will hopefully be very productive since these meetings will be for a short time period only."
Those not invited to the private sessions will have the "opportunity and are encouraged to attend the public input session to voice any concerns or ideas that they might have to the charrette team. They should know that those concerns and ideas will be heard and will be considered," Gregory said.
She said the community will "get out of the charrette as much as we put into it, so it's imperative that members of the community participate in the public input session Tuesday and attend the final vision plan session Thursday."
Both sessions will be at 6 p.m. at the Greensboro Center.
"We hope this process will create consensus throughout the community in a solid vision for growth and moving forward in Starkville," Gregory said.
The primary geographic focus of the charrette will the community's central business district, which includes the Cotton District, Central Station, Cotton Crossing, College Park, the traditional downtown area and parts of Highway 182, she said. The area basically runs from Henderson Ward Stewart School on Highway 182 east to Mississippi State University, then from First United Methodist Church on Lampkin Street east down Russell street to MSU, Gregory said.
Special consideration will be given to the rehabilitation and revitalization of Highway 182 because of the $25,000 Appalachian Regional Commission grant supporting the effort, she said.
Also included in the charrette scope will be focus on marketing and branding in the city in general as well as design and landscaping.
Michelle Jones, the local Main Street Association's president, says: "There are so many great organizations that do so many great things in Starkville. The charrette process is just an opportunity for us to create a common vision so we're all moving toward that vision in our individual projects. That's why it is so important that we have great public participation because this vision needs to include all the people of Starkville and not just some."
She says the private sessions "will be more focused," adding the "process is meant to be transparent so that all people feel like they are involved."
When the charrette team gives its final presentation, it will include a number of practical things the community can do and will break them down into action steps spaced out over time, Jones said.
"The great thing about the recommendations, it will prevent us from doing things piecemeal," she said. "It allows us all to be working toward what we all want and it lets us all know what we all want. It's a very useful tool for us all getting the Starkville that we want."
Mayor Parker Wiseman said the the big-picture view of the charrette is "to have a general direction or road map to follow that is built from the grassroots up." Plus, the program should result in "tangible goals that the community at large has a great ownership in," the mayor said.
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How are you using Chrome at all? When I tried it, the browser opened, but lots of basic functionality either didn't work or simply crashed the browser. Has that been worked around or something? If so, is there a link to the old beta version anywhere? I'd love to use it if it works
Couldn't find an extra apk. :( you wouldn't happen to have a screen shot would you? Also, I broke my gallery moving files around... I restored every file I touched but my gallery still doesn't exist :(
Edit: I just tried flashing the latest gapps, and the "gallery2.apk" disappeared from my /system/app/ directory completely :[
I'd really rather not have to redo my entire ICS install.. Can anyone help me?
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