text:
The Amarillo Blood and Marrow Transplant program has earned an accreditation that will allow patients greater access to cancer treatments.
The Foundation for the Accreditation of Cellular Therapy recognizes a limited number of transplant programs in the U.S., Canada and Australia, according to a news release from Texas Oncology-Amarillo Cancer Center, one of the clinics participating in the program.
Others participating are Northwest Texas Hospital and Coffee Memorial Blood Center.
Accreditation allows Amarillo patients to participate in clinical trials and have access to advanced treatments.
For more information about the program, call Texas Oncology at 806-358-8654.
- Globe-News staff
Amarillo Globe-News © 2016. All Rights Reserved. Terms of Service | Privacy Policy / About Our Ads


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Horses for Sale or Lease - Quarter Horses in Maryland
Find Quarter Horses for sale in our Maryland horse for sale ads. Search by area, discipline, color, and more.
Do you have a Quarter Horse for sale in Maryland? Post your MD Quarter Horse for sale ad - free!
> Paint / Quarter Horse
Must See -Beautiful Paint Quarter Horse Cross 4sale
Paint/Quarter Horse - 9yo 15.2h White Gelding
Fallston, MD

subset: commoncrawl


text: Summary Files Reviews Support Wiki Code ★ Add a Review 0 Downloads (This Week) Last Update: 2013-04-24 Browse Code SVN Repository Description A port of EhCache to .NET Framework TheCache Web Site Categories Frameworks License Apache License V2.0 KEEP ME UPDATED Get project updates, sponsored content from our select partners, and more. By clicking on "Follow" below, you are agreeing to the Terms of Use and the Privacy Policy. Invalid email address. Please try again. Sent to None. Follow You seem to have CSS turned off. Please don't fill out this field. You seem to have CSS turned off. Please don't fill out this field. Write a Review User Reviews Be the first to post a review of TheCache! Additional Project Details Programming Language C# Registered 2008-06-14 Report inappropriate content


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how r you feeling
Sanai Elise April 3, 2013!!!
Sienna Milan born November 4, 2010
Angel Baby August 2009
Comments (4)
Feeling icky, but starting to get better one symptom at a time. I started taking b6 for morning sickness and metamucil and activia to stop the constipation from prenatals. Looking forward to turning 13 weeks and feeling like me again, just a little bigger in the stomach area :)
Thanks! I feel better I am not alone.
Sanai Elise April 3, 2013!!!
Sienna Milan born November 4, 2010
Angel Baby August 2009
I am sooo much more tired this time around! I don't know if it's having a toddler, being a couple of years older, or just that this pregnancy has different symptoms. I wish I could muster up some energy though!
This time it is much different. I'm tired all the time. With my son, I was never nauseous, but i feel like I can hurl anytime of the day (but I never do). I am so looking forward to getting my energy back and getting rid of this queasy feeling!


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At war, at sea: sailors and naval combat in the twentieth century
Penguin Books, Apr 30, 2002 - History - 463 pages
Beginning with a gripping account of one of the most decisive naval battles in history-the 1905 battle of Tsushima between the Japanese and Russians-and ending with the sophisticated missile engagements of the Falklands and in the Persian Gulf, naval historian Ronald Spector explores every facet of the past one hundred years of naval warfare. Drawing from more than one hundred diaries, memoirs, letters, and interviews, this is, above all, a masterful narrative of the human side of combat at sea-real stories told from the point of view of the sailors who experienced it. Exhaustively researched and fascinating in detail, At War at Sea is a monumental history of the men, the ships, and the battles fought on the high seas.
"Superb . . . Spector's account provides evocative and fresh perspectives on cultures, technologies and innovations that influenced sailors' lives and shaped naval warfare." (The San Diego Union-Tribune)
"Monumental . . . Many books have recorded the history of the United States Navy, but few have meshed that history with that of all other major navies-an unusual comparative technique that brings into often startling relief the virtues and flaws of our own navy." (The Washington Post)
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Review: At War at Sea: Sailors and Naval Combat in the Twentieth CenturyUser Review - Goodreads
I listened to this book because my husband is a huge navy history buff and I wanted to know a little more. I found it to be engaging and informative. I especially liked the descriptions of life aboard ... Read full review
Review: At War at Sea: Sailors and Naval Combat in the Twentieth CenturyUser Review - Goodreads
Spector's book is an interesting look at success in naval combat in the 20th century, though it's not as analytical as Spector thinks it is. Read full review
ONE Tsushima May 1905
TWO The Supreme Influence
THREE The Cats Whiskers
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HMCS Iroquois - G89: Chronology June 1944 to November 1945
James P. Dowell
No preview available - 2007
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Double&Twin En-Suites BnB RameltonIrelandCounty DonegalRathmelton
About this listing
On Wild Atlantic Way. 2 comfortable rooms, one with a king sized bed and the second with 2 singles. Rooms have en-suites with power showers. We are in a peaceful location with lovely views, and the historic town of Ramelton with shops, pubs etc is within easy walking distance.
Space where guests can cook their own meals
Towels, bed sheets, soap, and toilet paper
The Space
We have a a modern bright and relaxed home with a large garden and lovely views unto the River Lennon and Swilly estuary. We are on The Wild Atlantic Way and and in a great gateway location for visiting the attractions of the area., i.e Glenveagh National Park, Fanad drive and lighthouse. Inishowen and Malin Head. Previous house guests from Italy, France, Germany Brazil have loved. We are within easy walking distance of the historic heritage town of Ramelton with its pubs and shops. It is a lovely town to walk around, More information can be obtained from the town web-site. (URL HIDDEN) We have 2 bedrooms available and both have full en-suites with excellent power showers. One room has a king size double bed and the other 2 single beds. There is also a communal bathroom. All rooms have wi-fi. There is a separate room with television available. We provide a full Irish breakfast or other combination if requested. Washing machine, dryer and ironing facilities are available. You will be free to make yourself a cup of coffee/tea or prepare snacks. We are only 12 kilometres from Letterkenny which is the principal town of County Donegal. , The area around Ramelton has attractive walks. We are convenient to the beautiful beaches of Donegal, the closest being Rathmullen which there is the possibility of a summer boat ferry to Inishowen. Further along is the beach at Ballymastocker which has been voted one of the most beautiful in the world. The City of Derry-Londonderry is only 50 kilometres. In this area a wide range of sporting facilities are available. We are happy to assist guests with any queries or requests.
As Letterkenny is the main town it has bus links to Donegal towns and to other parts of Ireland. Ramelton is served by buses but they are infrequent. We can collect by car from Letterkenny bus station. Some maps describe the town name as Rathmelton and others as Ramelton. To see all the sights a car is best for touring. There are 2 airports which serve Donegal, an airport within the county at Carrickfinn (Donegal Airport) and City of Derry airport. When you arrive in Donegal you will love. It is very beautiful.
Only ask that guests treat our home as they would their own.


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About GardenGrrl
Gardengrrl likes being outside and watching "Sky-TV"
By: GardenGrrl , 12:17 AM GMT on June 13, 2012
Hi All, thanks for coming by the last blog and leaving your thoughts about whats next in space exploration.
I'm back from vacation and here is a quick blog. Will be working OT for rest of month starting tomorrow so won't be around much. Eat, sleep, work.
We went to Beavers Bend State Resort Park in beautiful Oklahoma. It is the part of the Ouachita Mountain Chain which is made of sedementry rock thrust upward during a collision of North American and South American plates.
I snapped 525 pictures. Here is a quick peak. Have some really neat shots yet to come. Saw lots of wildlife and had a great time hanging out with some of the nicest folks you could ever meet outside of WUville. Our hosts and guides have been coming to Beavers Bend since 1969. They have known each other since grade school and still are tickled with each others company. It was just as fun being with them sharing stories at their camp as walking the trails together.
Time to call it night and get ready for the long work month. Thanks for stopping by.
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Cities of the World
World Regional Urban Development, Fifth Edition
Edited by
Stanley D. Brunn; Maureen Hays-Mitchell and Donald J. Zeigler
Remarkably, more than half of the world's population now lives in cities, and the numbers grow daily as people abandon rural areas. This fully updated and revised fifth edition of the classic text offers readers a comprehensive set of tools for understanding the urban landscape, and, by extension, the world's politics, cultures, and economies.
Providing a sweeping overview of world urban geography, a group of noted experts explores the eleven major global regions. Each author presents the region's urban history, economy, culture, and society, as well as urban spatial models and problems and prospects. Environmental, human security, globalization, and cyberspace topics are fully developed as well. Vignettes of seventy-eight key cities give the reader a vivid understanding of daily life and the "spirit of place." An introductory chapter presents an overview of key terms and concepts, and a concluding chapter projects the world's urban future.
Liberally illustrated with a new selection of photographs, maps, and diagrams, the text also includes a rich array of textboxes to highlight key topics ranging from gender and the city to Islamic fashion and global warming. Bibliographic sources, websites, and an appendix of UN data provide additional resources for helping students understand more about the urban world. Clearly written and timely,
Cities of the World
will be invaluable for those teaching introductory or advanced classes on global cities, regional geography, and urban studies.
Contributions by
: Amal K. Ali, Lisa Benton-Short, Alana Boland, Tim Brothers, Stanley D. Brunn, Kam Wing Chan, Ipsita Chatterjee, Megan Dixon, Robyn Dowling, Ashok K. Dutt, Irma Escamilla, Rina Ghose, Brian J. Godfrey, Mark Graham, Angela Gray-Subulwa, Jessica K. Graybill, Maureen Hays-Mitchell, Corey Johnson, Nathaniel M. Lewis, Linda McCarthy, Pauline McGuirk, Garth A. Myers, Arnisson Andre Ortega, Francis Owusu, George M. Pomeroy, Joseph L. Scarpaci, Dona J. Stewart, James A. Tyner, and Donald J. Zeigler.
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Book Details
Book Details
Rowman & Littlefield Publishers
Pages: 672
Size: 7 1/2 x 10 1/2
978-1-4422-1284-8 • Hardback • December 2011 •
• (£80.00)
978-1-4422-1286-2 • eBook • December 2011 •
• (£80.00)
Social Science / Human Geography
Science / EArth Sciences / Geography
Social Science / Regional Studies
Social Science / Sociology / Urban
Geography; Human & Cultural; World Regional; General
Geography; Human & Cultural; Urban
Urban Studies; Housing & Land Development
Teaching Resources
For access to these
professor use only
materials, please
then email us at
Teaching Resources Available
Stanley D. Brunn
is professor of geography at the University of Kentucky.
Maureen Hays-Mitchell
is professor of geography at Colgate University.
Donald J. Zeigler
is professor of geography at Old Dominion University.
Chapter 1: Contemporary World Urbanization
Donald J. Zeigler, Maureen Hays-Mitchell, and Stanley D. Brunn
Chapter 2: Cities of the United States and Canada
Lisa Benton-Short and Nathaniel Lewis
Chapter 3: Cities of Middle America and the Caribbean
Joseph L. Scarpaci, Irma Escamilla, and Tim Brothers
Chapter 4: Cities of South America
Maureen Hays-Mitchell and Brian J. Godfrey
Chapter 5: Cities of Europe
Linda McCarthy and Corey Johnson
Chapter 6: Cities of Russia
Jessica K. Graybill and Megan Dixon
Chapter 7: Cities of the Greater Middle East
Donald J. Zeigler, Dona J. Stewart, and Amal K. Ali
Chapter 8: Cities of Sub-Saharan Africa
Garth Myers, Francis Owusu, and Angela Gray Subulwa
Chapter 9: Cities of South Asia
Ipsita Chatterjee, George Pomeroy, and Ashok K. Dutt
Chapter 10: Cities of Southeast Asia
James Tyner and Arnisson Andre Ortega
Chapter 11: Cities of East Asia
Kam Wing Chan and Alana Boland
Chapter 12: Cities of Australia and the Pacific Islands
Robyn Dowling and Pauline McGuirk
Chapter 13: Cities of the Future
Stanley D. Brunn, Rina Ghose, and Mark Graham
Cities of the World
offers a general overview of contemporary urbanization. It divides the world into 11 regions (e.g., Europe, Southeast Asia, Middle American, Caribbean) and for each discusses trends in urban growth, the distinctive forms and characteristics of its cities, and future prospects and challenges. These regional chapters open with two lists: key facts and key themes. Basic aspects of urban development (e.g., population size and change, economic activity, public services, urban problems) are covered. Short regional histories are provided; and distinctive or representative cities (e.g., Buenos Aires for South America and Kinshasa for sub-Saharan Africa) are given capsule descriptions. The editors (all academic geographers) begin with an introductory chapter on world urban development and end by reflecting on what cities might be like in the future. . . . Suggested readings for each chapter are included. . . . A basic introduction,
Cities of the World
is best used as a textbook.
Summing Up:
Cities of the World
provides an exceptionally insightful, accessible window into the nature and changing character of contemporary cities. The global coverage of the book makes it possible for readers to appreciate the continuities and contrasts that define urban realms in different parts of the world. With essays penned by a series of distinguished contributors, and with introductory and concluding essays that draw out larger issues and themes, the book offers an unrivaled portrait of the places that are driving much of what happens in the world today.
Alexander B. Murphy, University of Oregon
Cities of the World
is comprehensive and presents in-depth discussions of world cities that are shaped by different historical, geographical, political, and cultural circumstances. I highly recommend this excellent text for undergraduate classes in general education, geography, planning and urban studies, and international development, and to anyone interested in world cities and regions.
(Previous Edition Praise)
Journal Of Geography
Outstanding! This thoroughly updated classic offers a comprehensive portrayal of the character and complexity of the world's cities. Contemporary trends and issues that continue to reshape all corners of the globe unfold here in a thoroughly accessible manner. Whether one considers environmental issues, growth trends, tourism appeal, or historical context,
Cities of the World
delivers for the reader. Appropriate as both a textbook and reference tool, urbanists in all fields will gain from the insights that geographers present here. Students of the humanities, social sciences, and business disciplines will equally benefit.
(Previous Edition Praise)
Truman A. Hartshorn, Georgia State University
A testbank, prepared by the authors, is available in Respondus computerized testbank format.
Respondus LE
is available for free and can be used to automate the process of creating print tests.
Respondus 3.5
(available for purchase or via a school site license) can prepare tests to be uploaded to online course management systems like Blackboard. Visit the
Respondus Test Bank Network
to request a copy of the Brunn
Cities of the World, 5e
testbank. For more information about the testbank, e-mail
PowerPoint slides containing all images, maps, and figures from
Cities of the World, 5e
are available to adopters. E-mail
for access to the PowerPoint slides.
New features
Green cities and urban sustainability
Urban security and privacy issues
New photographs and boxes throughout
Revised test bank questions available at Respondus
Each regional chapter includes new and updated maps
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text:
Warrior of Light Ex Mode 3 by okageoWatch
©2011-2016 okageo
photo thanks to Tiffany Ho
OH MON DIEU, I love this picture! You are just perfect in this cosplay! Great job, I really love it! *^*
looks so badass, looks more art then real : )
It's awesome! <3
Sweet Cosplay.
Oh my god...great!!!
Epicness cosplay you did
That's an awesome cosplay!
wow nice cosplay
Wow - you look awesome!
best warrior of light ever!!!!
beautiful cosplay
OMG!! such a wonderful cosplay!! amazing!!
Wow amazing work, what is your armor made out of?
OMG!!!! the best of WoL ever!!!
your face very handsome!!!
your face very handsome!!!
so... realistic.. unrealistic~ °-° i..mean.. it´s like final fantasy °-° || i realy like it x3
This is so gorgeous. The colour saturation in the photo is beautiful, and your cosplay looks absolutely divine. You make a great Warrior of Light! C:
Looking good. 8D Looking manly!
Damn you make blond hair look good.
Brilliant. Just stunning really.
I love the costume. Is it hand made?
I love the costume. Is it hand made?


text:
Have I mentioned I adore that horse? I brought him tonight and thru him in the arena. I brought over this massive tarp and I mean MASSIVE. Here I am trying to unfold the bloody thing to its flat on the ground and what does he do? He walks right on top of it and start biting the thing with his teeth. Not just that but he did it so much that my attempt at unfolding this thing was interrupted by him making a ball out of it
I guess that training session was a success before it even started...got to go to plan B now


text:
Joel Osteen
Fri, Mar 15, 2013 7:30 pm
Verizon Arena, North Little Rock, AR
Sorry, this event has already taken place. Please see similar events below.
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|Apr 15 Fri 7:30 PM
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|Amway Center
Orlando, FL


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The Perfect Paint Color For Our Farmhouse Fireplace
"Design is a never-ending journey of discovery — for which it helps to pack a healthy sense of humor." -David Carson Ain't that the truth? :-D So, a few weeks ago I told you my gut had been saying "paint the fireplace white" from the time the Blue Yonder went up way back in September. I … [Read More...]
Five Fun Photos I Found On Instagram
Hello! Each Wednesday I share a handful of photos that stopped me in my tracks while I was scrolling on Instagram the previous week. Here are this week's fun five! 1. @MaisonDePax's beautiful staircase: I love the curve, the L-shaped trim moulding on the side of each stair, the taper of … [Read More...]
Word of the Year – 2016
"Imitate God, therefore, in everything you do, because you are his dear children...walk as children of the Light and try to discern what is pleasing to the Lord." -Ephesians:5 Well, it took a little longer than usual for me to figure it out, but my Word of the Year finally chose … [Read More...]
Thought-Full Thursday: Growth
"For a seed to achieve its greatest expression, it must come completely undone. The shell cracks, its insides come out and everything changes. To someone who doesn't understand growth, it would look like complete destruction." -Cynthia Occelli Here's to throwing ourselves out in the open, … [Read More...]
Five Fun Ideas From Instagram
Hello! Each Wednesday I share a handful of photos that stopped me in my tracks while I was scrolling on Instagram the previous week. Here are this week's picks! 1. LittleFarmstead's stump slice stand: Such a GREAT idea. I see those little glass candlestick holders everywhere, and I love … [Read More...]
Four Fun Home Blogs To Follow
Happy Monday! Well, it looks like most of you that voted last week were feeling the same way I was about the color of the fireplace. Here's how the poll turned out... I guess you know how something else will be turning out next week- LOL! ;-) In the meantime, I thought it would be fun … [Read More...]
Farmhouse Fireplace Makeover
Happy New Year!! I'm ready to tackle some more home projects this month, and I've got a fireplace paint color question for you today. Right now, the backdrop of ours is a custom-mixed color I call "Blue Yonder"... (PS- the church window is a dark, natural wood on the flip side) But here's … [Read More...]
Thought-Full Thursday: Goodness
"The world is, in spite of the shadows, a brilliantly bright shining place." -Jedidiah Jenkins Thank you for all the love you left in the comment section on Monday's post, and thank you, thank you, thank you for buying diapers with me! Michael and Starla said they received orders for … [Read More...]
I Just Love…
...the contrast between the dark wall and bright white trim at CarpenDaughter's house: ...the pizza oven at OldSilverShed's house: ...the combination of materials in this kitchen by OldSeagroveHomes : ...the dining room at KindredVintage's house: You can see more photos … [Read More...]
One Of My Favorite Ideas…Ever!
"In any ordinary place, on any ordinary day, the parable can live again, when one will kneel and one will yield. Our Saviour Servant must show us how, through the will of the water and the tenderness of the towel." -Michael Card Wow! The last Monday of the year is here! :-D What a treat to … [Read More...]
Thought-Full Thursday: Merry Christmas
"O come let us adore Him" -John Francis Wade (via Jim LePage) Merry Christmas, y'all! XO … [Read More...]
5 Fun Design Ideas I Love
1. I love Insta-watching DreamyWhitesLifestyle work her magic in their 19th century fixer upper: 2. I love that BornAgainRestored used these colorful old shutters as a backdrop in this bathroom makeover: 3. I love AnisaDarnell's farmhouse kitchen makeover: 4. I love the faux … [Read More...]
Country Christmas Decorating In The Living Room
"One of the most glorious messes in the world is the mess created in the living room on Christmas day. Don't clean it up too quickly." ―Andy Rooney Are you ready for this week's festivities? Kevin and I visited my mom and her husband, and my brother and our nephew this past weekend … [Read More...]
Easy & Affordable Gift Idea For Friends
Happy Friday, y'all! I wanted to put together some little Christmas gift surprises for a couple of my 'Words with Friends' girlfriends so I was pumped when I noticed Michaels had these candles on sale last week... They were on sale four for $10, and there was like 8 different scents to … [Read More...]


text:
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We'll send you updates with the latest deals, reviews and articles for Filadelfia each week.
Filadelfia Hotels
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Up one level: Province of Vibo Valentia


text:
Aladdin Disney images is a collection of One Of Disney' Favourite Character's. Aladdin characters include Princess
Jasmine, Jafar, Lago, Razoul, Genie, The Sultan, Magic Carpet, Raja, Abu, Merchant and Farouk. Cartoon images of
Aladdin characters are for your own personal use.
All Cartoon Image's are on a transparent background and can be shown on any colourful background .


text:
Published on
Founded by Sir Tim Berners-Lee and Nigel Shadbolt, the Open Data Institute
is a independent non-profit focused on catalyzing the evolution of open data culture to
create economic, environmental, and social value. In his presentation Director Stuart
Coleman will emphasize and share ODI's perspective on the crossroads of big vs.
personal data and where open data is delivering economic and social value.
Clipping is a handy way to collect important slides you want to go back to later.


text:
Don't see your question? Visit our help section.
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In a hurry?
Pick Up At Store
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Rated 9.5


text:
Second-Year Event Guidelines
Joint-Year or First-Year Event Guidelines
Off-Campus Events
Event Blackout Periods
Informational Interviews
Pre-Interview Dinners & Sell Days
New and Key Event guidelines are in bold.
All members of organizations hosting multiple events through the CMC or through student clubs are asked to clearly convey to students that they are not asked or expected to attend all events to be considered for employment.
Recruiting activities exclusively for second-year students can begin on September 8, 2015.
If you are new to recruiting at Columbia Business School or have not generated a high number of attendees at past events and are interviewing on-campus for full-time or internship positions, consider participating in the CMC's Career Forum in lieu of a standalone corporate presentation.
The forum, which will be held Thursday, October 6, 2015, from 12:15 to 2:15 p.m. ET, offers firms an opportunity to meet many students in an informal and interactive career fair–style setting prior to application deadlines.
Companies that do not recruit on campus, and instead recruit off campus in the spring, may wish to participate in the CMC's spring networking event, usually held in late March.
Recruiting events of any size planned through the CMC or
with student clubs may not be held during exams. Event
blackout dates are as follows:
Feedback from corporate representatives, students, and faculty members indicates that student visits to corporate offices are best kept to a minimum.
Since repeated student visits to firms are disruptive to both classes and the workplace, companies are encouraged to streamline the informational-interview process and limit visits to each firm to one or two visits per student.
Please e-mail your company's informational-interview policy to Janet Raiffa [3] before September 18, 2015, so the CMC can advise students and assist them in managing their schedules.
Best Practice: Announce your informational-interview policy at your firmwide event and inform the CMC to help publicize it.
RSVPs for events planned by the CMC may be captured in
COIN. Be advised that all venues have capacity limits.
For catering purposes, it is advisable to reduce RSVP numbers by 25 percent.
By assisting companies with RSVPs, Columbia Business School and the Career Management Center take no responsibility for compliance with University, federal, state, or city laws including those involving venue capacity.
Pre-interview dinners are generally not allowed. Exceptions may be made for companies outside the tri-state area. Please consult Mary Kagan [2] or your account manager [4] about your company's circumstances.
Sell Days should never conflict with academic commitments and are therefore best held on Fridays or Saturdays. Additionally, firms may not invite students to sell days or other post interview events until after offers are extended.
[1] http://www8.gsb.columbia.edu/recruiters/sites/recruiters/files/images/corporate-presentation_full.png
[2] mailto:firstname.lastname@example.com
[3] mailto:email@example.com
[4] http://www8.gsb.columbia.edu/recruiters/how/on-campus-recruiting/visiting-campus/contact


text:
Are you Benjamin K C Ong?Claim your profile
Publications (51)127.84 Total impact
Article: Persistence of Hyperdense Middle Cerebral Artery Sign on Follow-Up CT Scan after Intravenous Thrombolysis Is Associated with Poor Outcome[Show abstract] [Hide abstract]
ABSTRACT: The rates and extent of recovery in acute ischemic stroke (AIS) patients treated with intravenous tissue plasminogen activator (IV-tPA) remain highly variable. Hyperdense middle cerebral artery sign (HMCAS) on pretreatment unenhanced computerized tomography (CT) of the brain represents the presence of thrombus, often associated with severe neurological deficits and poor clinical outcome at 3 months. However, HMCAS is reliable only in AIS patients managed conservatively. In patients treated with systemic thrombolysis, HMCAS may disappear (representing clot dissolution) or persist (persisting clot) on the follow-up CT scan of the brain. We aimed at evaluating whether disappearance or the persistence of HMCAS on follow-up CT scan of the brain can predict the final outcome at 3 months. Data from consecutive AIS patients treated with IV-tPA, in a standardized protocol, from January 2007 to March 2010 were included in the prospective thrombolysis registry at our tertiary care center. For this evaluation, posterior circulation stroke was excluded. HMCAS was assessed on admission as well as follow-up CT by 2 independent stroke neurologists, blinded to the patient data or outcomes. Functional outcomes assessed by the modified Rankin Scale (mRS) at 3 months were dichotomized as good (mRS score 0-1) and poor (mRS score 2-6). The data were analyzed for the early predictors of poor functional outcome with SPSS version 19 for Windows. Of the total of 2,238 patients admitted during the study period, 226 (11%) with anterior circulation AIS treated with intravenous thrombolysis were included. Median age of the patients was 65 years (range 19-92), 63% were males and they had a median National Institutes of Health Stroke Scale (NIHSS) score of 16 points (range 4-32). HMCAS was observed on admission CT scan in 109 (48.2%) patients and persisted on follow-up CT in 52 (47.7%) of them. Overall, 108 (47.8%) patients achieved poor functional outcome at 3 months. Admission NIHSS score (OR per 1-point increase = 1.241; 95% CI = 1.151-1.337, p < 0.0005), lesser change in NIHSS score at 24 h (OR per 1-point reduction = 0.730; 95% CI = 0.666-0.800, p < 0.0005) and persistence of HMCAS on follow-up CT scan (OR = 3.352; 95% CI = 1.991-11.333, p = 0.039) were associated with poor outcome at 3 months. Persistence of HMCAS on the follow-up CT scan of the brain in acute ischemic stroke patients treated with IV-tPA can be used as an early predictor of poor functional outcome.
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ABSTRACT: We investigated changes in oxidative damage after ischemic stroke using multiple biomarkers. Serial blood and urine samples of ischemic stroke subjects and age-matched control subjects were assayed for F₂-isoprostanes, hydroxyeicosatetraenoic acid products, F₄-neuroprostanes, 24-hydroxycholesterol, allantoin, and urate. Sixty-six stroke subjects (mean age, 65 years; median National Institutes of Health Stroke Scale 17) and 132 control subjects were recruited. A bimodal pattern of change was observed in plasma and urinary F₂-isoprostanes and plasma 24-hydroxycholesterol. The rise in plasma hydroxyeicosatetraenoic acid products, F₄-neuroprostanes, and allantoin was highest 6 to 12 hours after stroke onset, whereas plasma urate was significantly lower than controls on Days 1 to 3. After adjusting for age and baseline National Institutes of Health Stroke Scale, baseline plasma esterified hydroxyeicosatetraenoic acid products (OR, 1.01; 95% CI, 1.01 to 1.02), plasma urate (1.01; 1.00 to 1.01), and plasma free F₄-neuroprostanes (2.73; 1.76 to 3.93) were associated with 90-day good functional recovery (modified Rankin Scale ≤1). Multiple markers of oxidative damage are increased immediately after stroke and remain elevated for several days. Recognition of these temporal changes may help design better antioxidant treatment trials for acute ischemic stroke.
Article: Feasibility and Safety of Intravenous Thrombolysis in Multiethnic Asian Stroke Patients in Singapore[Show abstract] [Hide abstract]
ABSTRACT: Treatment rates with intravenously administered tissue plasminogen activator (IV-tPA) in acute ischemic stroke (IS) remain low in Asian populations. Various logistic obstacles and higher anticipated bleeding risk in Asians are major concerns. We report on the feasibility and safety of IV-tPA therapy at our tertiary care center. Consecutive acute IS patients eligible for thrombolysis were treated with low-dose (maximum 50 mg) IV-tPA between January 2000 and September 2006 and with standard-dose (maximum 90 mg) IV-tPA between October 2006 and May 2008. The efficacy of IV-tPA was assessed by the modified Rankin Scale (mRS) score at 3 months and by absolute changes in the National Institute of Health Stroke Scale (NIHSS) score at hospital discharge and 3 months. The safety of IV-tPA was assessed by the rate of symptomatic intracranial hemorrhage (SICH). A total of 130 patients were included (mean age, 60±13 years; 60% males; median NIHSS score, 14). A total of 48 patients received low-dose IV-tPA, and 82 patients received standard-dose IV-tPA. The median onset to treatment time was 160 minutes. Some 59% of the patients achieved functional independence (mRS score 0-1) at 3 months with standard-dose tPA, compared with 35% in the low-dose group (P=.011). SICH occurred more frequently with the low dose (14.5%) than with the standard dose (1.2%; P=.004). In a multivariate logistic regression model, lower admission NIHSS score (odds ratio [OR]=0.78 per 1-point increase; 95% confidence interval [CI]=0.70-0.88), lower pretreatment blood glucose level (OR=0.76 per 1 mmol/L increase; 95% CI=0.60-0.95), shorter time from symptom onset to IV-tPA bolus (OR=0.97 per 1-minute increase; 95% CI=0.94-1.0), and standard-dose IV-tPA (OR=12.49; 95% CI=2.9-53.89) were associated with a higher likelihood for functional independence at 3 months. Our data indicate that standard-dose IV-tPA (0.9 mg/kg) was feasible and safe for treating acute IS in our multiethnic Asian population in Singapore.
Article: Multimodal Therapeutic Approach in Acute Ischaemic Stroke with Real-time Neurovascular Monitoring
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ABSTRACT: Data on interethnic differences in the Asian stroke population are limited. We evaluated the relationships among various cardiovascular risk factors, stroke subtypes, and outcomes in a multiethnic Singaporean population comprising consecutive ischemic stroke patients presenting to our tertiary center over a 1-year period. Strokes were classified based on criteria used in the Trial of Org 10172 in Acute Stroke Treatment (TOAST). Functional independence at hospital discharge was defined as a modified Rankin Scale (mRS) score of 0-2. The ethnic distribution of the study population (n = 481; mean age, 64.1 ± 11.9 years) was 74% Chinese, 17% Malay, and 9% Indian. The prevalence of risk factors was similar in the 3 ethnic groups except for diabetes (Chinese, 39.8%; Malay, 67.5%; Indian, 52.3%; P < .001). Hypertension and hypercholesterolemia were the most common cardiovascular risk factors. Lacunar stroke was the most frequent stroke subtype (47.9%). Large-artery atherosclerotic infarctions were more prevalent in Indians (25.0%), whereas lacunar infarctions occured more frequently in Chinese (51.8%; P < .01). No differences in in-hospital mortality and functional independence at discharge were seen among the 3 ethnic groups. Despite the differences in risk factors and in stroke subtypes classified by location or underlying etiology, short-term outcome measures were similar in the 3 different Asian ethnicities in Singapore.
Article: Recanalization Therapies in Acute Ischemic Stroke: Pharmacological Agents, Devices, and Combinations[Show abstract] [Hide abstract]
ABSTRACT: The primary aim of thrombolysis in acute ischemic stroke is recanalization of an occluded intracranial artery. Recanalization is an important predictor of stroke outcome as timely restoration of regional cerebral perfusion helps salvage threatened ischemic tissue. At present, intravenously administered tissue plasminogen activator (IV-TPA) remains the only FDA-approved therapeutic agent for the treatment of ischemic stroke within 3 hours of symptom onset. Recent studies have demonstrated safety as well as efficacy of IV-TPA even in an extended therapeutic window. However, the short therapeutic window, low rates of recanalization, and only modest benefits with IV-TPA have prompted a quest for alternative approaches to restore blood flow in an occluded artery in acute ischemic stroke. Although intra-arterial delivery of the thrombolytic agent seems effective, various logistic constraints limit its routine use and as yet no lytic agent have not received full regulatory approval for intra-arterial therapy. Mechanical devices and approaches can achieve higher rates of recanalization but their safety and efficacy still need to be established in larger clinical trials. The field of acute revascularization is rapidly evolving, and various combinations of pharmacologic agents, mechanical devices, and novel microbubble/ultrasound technologies are being tested in multiple clinical trials.
Article: Real-time Monitoring of Blood Flow Changes during Intravenous Thrombolysis for Acute Middle Cerebral Artery Occlusion
Article: Intravenous thrombolysis is feasible and safe in multiethnic Asian stroke patients in Singapore
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ABSTRACT: Acute vertebrobasilar ischemia is a potentially sinister pathology with high mortality and poor functional outcome in survivors. We report the findings of multi-modal assessment (MRI and cerebrovascular ultrasonography) of cerebral hemodynamics in a patient who suffered from acute brainstem infarction with National Institute of Health Stroke Scale (NIHSS) score of 16 points. Our patient demonstrated reversal of blood flow in the basilar artery on the second day of his stroke and this was associated with significant and rapid clinical recovery over the following 2 days (NIHSS score dropped to 4 points). He had recovered completely when seen in the outpatient clinic 3 months later.
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ABSTRACT: Venous thromboembolism (VTE), including its most serious clinical subtype, pulmonary embolism (PE), is a potentially preventable disease. While current assessment tools do not include ethnicity as a risk factor, studies suggest that Asians have lower risk of VTE compared to Caucasians. This study aims to describe 2006 in-hospital and projected population based incidence rates of VTE and PE in Singapore. Data on 2006 admissions at 3 major NHG hospitals, cases of VTE and their demographics were obtained from the ODS, a large administrative database of the National Healthcare Group (NHG). Demographic characteristics of the 2006 Singapore resident population were obtained from the 2006 Singapore Statistics website. In 2006, there were 860 cases of VTE out of 98,121 admissions in these 3 hospitals. Overall and secondary VTE age adjusted in-hospital burden was 73 and 54 per 10,000 patients, respectively. Caucasians and Eurasians had VTE rates in excess of 100 per 10,000 while Chinese, Malays and Indians each had rates below 100 per 10,000. Assuming that 42.5% of the 2006 Singapore population was served by NHG, the estimated population-based incidence of VTE and PE is 57 and 15 per 100,000, respectively. As patterns across ethnic groups point to lower VTE rates among Asians compared to Caucasians and Eurasians, analytic studies should be considered to test this hypothesis. There may be a need to develop locally applicable risk assessment tools which can be used to support local guidelines for VTE prophylaxis, thus leading to more acceptable and cost-effective care.
Article: Should Right-to-Left Shunts Be Detected Before Thrombolysis in Acute Ischemic Stroke Patients?
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ABSTRACT: To examine the readiness of our hospital for the potential pandemic threat of avian influenza, we developed and implemented simulation case scenarios in our hospital. Two volunteers, who assumed the identity of 'actual' patients, were trained to simulate acute respiratory symptoms following a visit to an avian influenza-affected area, and their identities and locations were kept confidential prior to the readiness exercise. A team of auditors was stationed at high-risk areas to assess adherence to the use of personal protective equipment (PPE) and infection control procedures. A total of 324 healthcare workers and 84 administrators participated in this hospital-wide exercise. Following disclosure of their symptoms, the 'patients' were masked and isolated in negative-pressure rooms. A quarantine order was enforced on 38 inpatients and 45 healthcare workers who were present in the affected wards at the time of the exercise, which mandated the use of PPE. Although all affected healthcare workers were competent in the use of PPE, we observed breaches in PPE and isolation procedures in eight medical and nursing students, and 10 healthcare attendants. The exercise concluded after H5N1 tests returned negative. We recommend the use of case simulation as an effective means of assessing potential breaches in infection control procedures.
Article: Ultrasound Assisted Thrombolysis in Acute Ischaemic Stroke: Preliminary Experience in Singapore[Show abstract] [Hide abstract]
ABSTRACT: Intravenously-administered tissue plasminogen activator (IV-TPA) induces thrombolysis and remains the only FDA-approved therapy for acute ischaemic stroke. IV-TPA thrombolysis has been approved recently in Singapore for acute stroke. Continuous exposure of clot to 2-MHz pulsed-wave transcranial Doppler (TCD) ultrasound during IV-TPA infusion is known to augment thrombolysis. We aimed to determine the feasibility, safety and efficacy of ultrasound-assisted thrombolysis in acute ischaemic stroke in Singapore. Consecutive patients with acute ischaemic stroke due to intracranial arterial-occlusions were treated with standard IV-tPA and continuously monitored with 2-MHz TCD according to the CLOTBUST-trial protocol. Arterial recanalisation was determined with Thrombolysis in Brain Ischemia (TIBI) flow-grading system. Safety and efficacy of ultrasoundassisted thrombolysis were assessed by rates of symptomatic intracranial haemorrhage (sICH) and functional recovery at 1 month, respectively. Five consecutive patients (mean age 58 years, 3 men and 3 of Chinese ethnicity) were included. Mean time elapsed between symptom onset and presentation to emergency room was 98 minutes (range, 50 to 135 minutes) while the mean time interval between symptom onset to IV-TPA bolus was 144 minutes (range, 125 to 180 minutes). Partial or complete recanalisation with reduction in the stroke severity was noted in 4 out of the 5 patients during IV-TPA infusion (mean change in NIHSS = 4 points; range 2 to 8 points). None of our patients developed sICH while 4 patients demonstrated good functional outcome at 1 month. Our preliminary study demonstrates the feasibility, safety and efficacy of ultrasound-assisted thrombolysis in acute ischaemic stroke in Singapore. Continuous TCD-monitoring during IV-TPA infusion provides real-time information, enhances thrombolysis and improves functional outcomes in acute ischaemic stroke.
Article: Electroencephalographic changes and seizures in familial hemiplegic migraine patients with the CACNA1A gene S218L mutation[Show abstract] [Hide abstract]
ABSTRACT: The S218L CACNA1A mutation has been previously described in two families with familial hemiplegic migraine. We present three siblings with the mutation with the novel association of childhood seizures, and highlight the dynamic changes seen on electroencephalography during hemiplegic migraine attacks. Depressed activity contralateral to the hemiparesis was seen on electroencephalography during acute hemiplegic migraine attacks, which may be due to changes to calcium channels caused by the S218L mutation. Both parents were asymptomatic and did not carry the S218L mutation in their blood. This suggests the presence of mosaicism in the transmitting parent.
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ABSTRACT: We describe two Chinese families with a mild form of the myotonia congenita due to novel chloride channel (ClCN1) mutations. In one case, heterozygous I553F and H555N mutations were found. The patient shared the I553F mutation with his healthy father, and his mother had a history of mild myotonia when she was younger. In another family, autosomal dominant myotonia congenita was due to a L844F change. The physiological effects of the mutations were examined by using the two-electrode voltage-clamp technique after expression of the channels in Xenopus oocytes. All mutations drastically shifted the voltage required for half-maximal activation, more under conditions mimicking the homozygous situation, than under conditions mimicking the heterozygous situation. The larger effect was seen in the compound heterozygous situation combining the I553F and the H555N mutations. Our data suggest that myotonia congenita caused by CLCN1 mutations in Chinese have similar variable features to those found in the West.
Article: Neuropsychiatric lupus and reversible posterior leucoencephalopathy syndrome: A challenging clinical dilemma[Show abstract] [Hide abstract]
ABSTRACT: Reversible posterior leucoencephalopathy syndrome (RPLS) has been increasingly recognized and reported in the literature. While the condition has been well described in patients with acute hypertension, pre-eclampsia, eclampsia, post-transplantation and chemotherapy, RPLS has been increasingly identified in patients with autoimmune diseases such as systemic lupus erythematosus (SLE). Though experience in the diagnosis and management of RPLS in patients with SLE is likely accumulating, few have systematically worked out the strategy to distinguish RPLS from neuropsychiatric SLE (NPSLE) and lupus-related complications of the central nervous system (CNS). Prompt recognition of, and differentiation between, these conditions is essential since their clinical presentations substantially overlap and yet their management strategy and subsequent outcomes can be entirely different. Indeed, inappropriate treatment such as augmentation of immunosuppression may be detrimental to patients with RPLS. A high index of suspicion of RPLS, prompt magnetic resonance imaging of the brain, including diffusion imaging, exclusion of CNS infection and metabolic derangement, a comprehensive medication review accompanied by timely and aggressive control of blood pressure and seizure are keys to successful management of RPLS. Such treatment strategy ensures a very high chance of total neurological recovery in lupus patients with RPLS.
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ABSTRACT: The modified essay question (MEQ), featuring an evolving case scenario, tests a candidate's problem-solving and reasoning ability, rather than mere factual recall. Although it is traditionally conducted as a pen-and-paper examination, our university has run the MEQ using computer-based testing (CBT) since 2003. We describe our experience with running the MEQ examination using the IVLE, or integrated virtual learning environment (https://ivle.nus.edu.sg), provide a blueprint for universities intending to conduct computer-based testing of the MEQ, and detail how our MEQ examination has evolved since its inception. An MEQ committee, comprising specialists in key disciplines from the departments of Medicine and Paediatrics, was formed. We utilized the IVLE, developed for our university in 1998, as the online platform on which we ran the MEQ. We calculated the number of man-hours (academic and support staff) required to run the MEQ examination, using either a computer-based or pen-and-paper format. With the support of our university's information technology (IT) specialists, we have successfully run the MEQ examination online, twice a year, since 2003. Initially, we conducted the examination with short-answer questions only, but have since expanded the MEQ examination to include multiple-choice and extended matching questions. A total of 1268 man-hours was spent in preparing for, and running, the MEQ examination using CBT, compared to 236.5 man-hours to run it using a pen-and-paper format. Despite being more labour-intensive, our students and staff prefer CBT to the pen-and-paper format. The MEQ can be conducted using a computer-based testing scenario, which offers several advantages over a pen-and-paper format. We hope to increase the number of questions and incorporate audio and video files, featuring clinical vignettes, to the MEQ examination in the near future.
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ABSTRACT: Patients with POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal or M-protein and skin changes) syndrome exhibit a wide range of clinical manifestations and are often seen by a variety of specialists prior to diagnosis. We describe a case of POEMS syndrome that first presented with significant neuropathy but progressed to develop further manifestations of the condition, including marked gastrointestinal symptoms. The patient was commenced on localised radiotherapy and chemotherapy in addition to immunomodulatory therapy for the neuropathy. We highlight several learning points that may benefit physicians from varied specialties. This case is also unique for its marked gastrointestinal manifestation. To our knowledge, this is the second reported case in the literature with this feature.
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ABSTRACT: The management of psychogenic movement disorders is fraught with difficulties. Empathy and a non-judgmental manner are essential in dealing with patients, and a neurobiological explanation of the symptoms may help to foster trust, acceptance, understanding and recovery. We report a 17-year-old Chinese girl with psychogenic blepharospasm. Her parents refused psychotherapy and pharmacotherapy. Placebo therapy (with parental consent) was prescribed with favourable results. We examine the ethical considerations for and against placebo therapy, and explore the role of placebo therapy in the management of psychogenic movement disorders.
Top Journals
National University Health SystemSingapore
National University of Singapore
Tumasik, Singapore
- Department of Medicine


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Products & ServicesSee also: Categories | Featured Products | Technical Articles | More Information
Specialty Process Controllers - Pneumatic Circuit Boards - Module For Single Input Clamp Control With Foot Pedal Actuator -- VA-08-FPSupplier: Clippard Instrument Laboratory, Inc.
Description: Clippard Instrument Laboratory has pioneered the miniature pneumatic industry. We have an expansive line of components that are used in thousands of applications across many markets. It is this experience and knowledge of our own products that is now available to our customers when collaborating
- Form Factor: Other
Supplier: General Pipe Cleaners
Description: and foot pedal can be stowed away on convenient cord wraps. The XP gives you extra performance and value, enabling you to clear clogged drain lines from 1-1/4" to 4" in diameter with just one machine. The drum easily holds 75 feet of 3/8" or 1/2" cable and features a free floating inner drum
- Type: Electric
- Pipe Diameter (Nominal): 1.25 to 4 inch
- Flexible Cable Length: 900 inch
- Features: Interchangeable Cutter, Stationary, Variable-Speed Cable Feed, Wheeled
Supplier: Tecmark Corporation
Description: with 1/8" or 3/16" I.D. flexible plastic or rubber tubing Available Features Flexible abrasion & UV resistant air transmitters Four Styles Available: Heavy duty foot pedal Light duty foot pedal Heavy duty bulb type Light duty bulb type Tubing attached or sold separately Optional colors
- Type: Electric / Pneumatic Relay
Supplier: Panduit Corp.
Description: Update kit for foot pedal control and positioning device to work with new CT-600-A pneumatic crimping tool.
- Tool Type: Crimper
Supplier: Terra Universal, Inc.
Description: Designed for heavy duty applications Optional digital temperature control Foot-pedal operated for expansive clear work surface At 29 lbs. (13.2 kg), light enough to be easily moved Side-mounted heat and cool timers ensure airtight, watertight operation Jaws have to be locked to operate
- Automation: Manual
- Packaging: Bag / Pouch
Supplier: ValueTronics International, Inc.
Description: Kahnetics KDS834 Features: Vacuum pullback to prevent dripping Foot pedal for hands-free operation Four position push button timer switch for metered shots from 0.01 to 99.99 seconds Input voltage: 115V Output voltage: 24V Air input/output: 0-100 psi Vacuum: 0-18"Hg Timer range: .01
Supplier: Norlok Technology, Inc.
Description: (no electrical hook-ups necessary) Foot pedals operate lower tooling and clinch cycle for increased productivity More than 13 years of design experience Proven reliability and quality Affordably priced Low investment and faster payback When you combine all the features, benefits and quality the LETTERLOK
- Press Type: Clinching Machine
- Operation: Side Punching / Notching
- Press Technology - Drive / Actuation: Air / Pneumatic
- Frame Type & Orientation: Open Back (OBI / OBS)
Supplier: FKN Systek, Inc.
Description: as the panel is not pressed between two points during the cut. The N100 is provided with a quick connect pneumatic port which plugs directly into factory air (80-100 PSI). Stepping on a foot pedal activates the cutting process. The excess material from the tab is stored inside a compartment of the tool
- Type: Ejector Punch
- Point Shape: Rectangle
Supplier: Econo Lift Limited
Description: Tilt Angle 0-85° Safety Velocity fuse on each cylinder to eliminate tilter from collapsing due to hose failure Hold down tabs (3 points) Lowered Height of Tilter Floor level Power Supplies Air/Hydraulic Foot Pedal (80 p.s.i., 20 c.f.m. min.) (hand held pendant optional) A/C 115/60/1 Hand
- Lift Drive / Actuation: Air / Pneumatic, Hydraulic
- Capacity: 6000 lbs
- Stroke: 32 inch
- Length: 40 inch
Supplier: Econo Lift Limited
Description: Controlled Air/Hydraulic Foot Pedal (80 p.s.i., 20 c.f.m. min.) hand held pendants optional A/C 115/60/1 Hand Held Pendant Options Forks - longer/shorter, higher/lower to 2", wider / narrower Adjustable Forks - 6"-36" Slip on Platform Tray Attachments Larger Back Plates
- Lift Type: Pallet Jack
- Lift Drive / Actuation: Foot, Air / Pneumatic, Hydraulic, Other
- Capacity: 6000 lbs
- Stroke: 33 inch
Supplier: H&K Equipment
Description: The BX Platinum Series offers a variety of operator conveniences for enhanced comfort and increased productivity, including a full suspension cloth seat with weight and back-angle adjustment, hip restraint and retractable seat belt. A compact front cowl design offers generous leg and foot room
- Capacity: 3000 to 8000 lbs
- Fuel: Electric
- Tires: Solid / Cushion
Supplier: J&S Machine, Inc.
Description: Single head descending blade Two blade rotation speeds Adjustable tube stop for consistent cut lengths Automatic blade rotation start / stop with cutting cycle operation Cycle start controlled by push button or foot pedal activation Automatic blade rotation stop / return at the end of each
Supplier: Automationdirect.com
Description: NITRA foot pedal air valve for pneumatic directional control, 5-port (4-way), 2-position, spring return spool valve style, body ported, 1/4 inch NPT ports, Cv=0.80, locking with guard
- Valve Type: Directional Valves
- Valve Size: 0.2500 inch
- Number of Ports/Ways: 5
- Connection: Threaded
Supplier: Unidex, Inc.
Description: The PHL Series Workstation is versatile enough for transferring loads high or low in hundreds of applications. The work surface is elevated by means of foot pedal hydraulics. With its cantilevered design, the area between the legs and table/forks is unobstructed, for easy accessibility to racks
- Lift Type: Table Lift / Positioner
- Lift Mechanism: Other
- Lift Drive / Actuation: Foot, Hydraulic
- Capacity: 250 lbs
Supplier: Intek Corporation
Description: Patented INTEK heating element Linear tracking, in-line design Adjustable height Automatic dwell timer (0-60 Sec.) Built-in temperature control Spring loaded column Variable speed drive Lighted on-off switch 9' power cord Foot pedal (opt. limit switch available) Standard sequence
- Dryer Type: Flash / Pneumatic Dryer
- Heat Source / Transfer: Electric, Radiant / Infrared
- Material Form: Bulk Materials / Briquettes, Free Flowing Powders / Granules, Webs / Continuous Sheets
- Applications / Materials Processed: Abrasives / Ceramics, Construction Materials / Cement, Foods / Grains, Metallurgical, Paint / Coatings, Pharmaceutical, Polymers / Molding, Pulp and Paper
Supplier: LS Industries
Description: . Foot pedal of the is built into the base so as not to protrude, the counter punch support is easily adjustable in height; the spindle punch holder has a rapid punch attachment. The accessories and the punches in the standard equipment allow the removal and fitting of any of rivet the complete set
Supplier: Southland Equipment Service
Description: prevent package fall through. Spartan Economy 2 in 1 Truck... Foot pedal release allows easy conversion from 2-wheel to 4-wheel position. 18"W. noseplate for large, bulky loads. Shipped KD in a box. Spartan Jr...Includes 3 frame cross braces to help prevent package fall through. Spartan Sr...Includes
- Type: Hand / Appliance Truck
- Wheel Type: Pneumatic
Supplier: PAC Machinery Group
Description: . The basic model includes automatic bag advance; perforation detection to insure proper bag location for product feeding; two stage pneumatic bag opening; foot pedal activated sealing, or automatic cycling; and automatic bag separation. The 1075 is easy to install and supports a wide range of bag sizes
- Rate: 30 Pieces / Min
- Automation: Automatic
- Packaging: Bag / Pouch
Supplier: Rottler Manufacturing
Description: the valve seat. ACTIVE SPINDLE - Spherical Pneumatic Automatic Alignment System built into the Spindle for fast location of the pilot into the Valve Guide and Accurate Centering (Patent Pending) Air Float Work Head with Foot Pedal Control Heavy Duty Spindle - Diameter 3.150†(80mm
- X-Axis Travel: 43.5 inch
- Spindle Motor Power: 2 HP
Supplier: Fluke Power Quality
Description: calibration routines with real time out-of-tolerance notification and data logging Foot pedal "ENTER key for hands free sequence execution Complete a typical high pressure gauge run in about 20 minutes (20 % ascending increments) Supports 12 units of measure and custom units Push button
Supplier: Mile-X Equipment, Inc.
Description: on passenger cars, vans and light trucks that are raised by an in-ground or above-ground lift. FEATURES Pneumatic primary stage for fast rising is activated by depressing a foot pedal. Hydraulic secondary stage is activated by a fast rising hand pump to raise the load and release a knob to lower
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Tecmark Corporation
Isolate Users From Electrical Current
The convenience of "hands free operation" allows remote control operation from a distance... even up to 100' and it's easy to install. An optional foot shroud with anti-skid base protects the transmitter and helps prevent accidental actuation. . There are two models of Footswitch Available: Momentary Switching Logic - Press and hold for on, release for off. Alternate Action Switching Logic - Press for on, press again for off. (read more)
Browse Foot Switches Datasheets for Tecmark Corporation
J&S Machine, Inc.
Metal Cutting Machines
YL-280CA & YL-350CA. Single head descending blade. Two blade rotation speeds. Adjustable tube stop for consistent cut lengths. Automatic blade rotation start / stop with cutting cycle operation. Cycle start controlled by push button or foot pedal activation. Automatic blade rotation stop / return at the end of each cycle. Pneumatic cutting head and clamp. Easily adjusted cutting head angle, 45 ° left and right. Coolant circulation system for reduced cutting abrasion & extended blade... (read more)
Browse Sawing and Cut-off Machines Datasheets for J&S Machine, Inc.
Conduct Research Top
Medical Device Link .
are Teflon-coated and are available for tubing from 0.062 to 0.375 in. ID. Special jaw sizes for both types are available. The 595AC expander is also supplied with a gauged and regulated foot pedal. , 2010A Lehigh Ave., Glenview, IL 60025. A company offers manual and automatic punching and drilling
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Pneumatic Foot Pedal Feeder .
Open, Laparoscopic and Robotic Hepatic Transection
The system also includes a pneumatic foot pedal used to turn the RF energy on and off.
Laparoscopic Habib™ 4X: a bipolar radiofrequency device for bloodless laparoscopic liver resection
The system also consists of a pneumatic foot pedal used to turn the RF energy on and off.
Liver resection with bipolar radiofrequency device: Habib TM 4X
The system also consists of a pneumatic foot pedal used to turn the RF energy on and off.
Modified radiofrequency‐assisted liver resection: A new device
The system also consists of a pneumatic foot pedal used to turn the radiofrequency energy on and off.
Federal Register > Tuesday, November 23, 1999 > [64 FR 65768] Ergonomics Program
/ Electric or pneumatic foot pedals were used instead of non-adjustable mechanical ones; .
Desiccant Drier Tower Design Solution
• Pneumatic Foot Pedal Offers Consistent Dispensing .
CR4 - Thread: Small Auto Stamping Machine
How hard would it be to work up a pneumatic foot pedal ?
Vacuum Lens-Handling Systems | Edmund Optics
All Vacuum Lens-Handling Systems include vacuum supply unit, straight manual rotating vacuum wand with coiled hose, luer vacuum cup adapter, 10mm Delrin™ cup and pneumatic foot pedal .
General Wire DR Drain-Rooter Basic Unit at PlumberSurplus.com
• Foot Pedal: Pneumatic foot pedal controls variable speed motor.
General Wire P-T3-D Sewerooter T-3 Unit with 1/2" x 100' Cable and Power Feed at PlumberSurplus.com
⢠Pneumatic foot pedal , pressure sensitive to adjust speed .
Comparing different treatment modalities for partial nephrectomies without ischemic period: laser, Hydro-Jet and RF
The sealer can be activated with a pneumatic foot pedal .
New 'Hands-Free' Ionisation System
Product sensing eliminates the need for pneumatic foot pedals or other controls and means that a system can be set up for automatic operation.
Automotive Mechatronics: Operational and Practical Issues
Mechatronic control over ECE shaft or ICE crankshaft output power, through the accelerator (throttle pneumatic valve) foot pedal , mechatronically controls the rate at which the ECE or ICE is operating; at very high values of the ECE shaft or ICE crankshaft angular …
New interventional room of the 1990s: how to upgrade a standard MR suite for minimally invasive surgery
A remote control pneumatic laser foot pedal is present inside the MR roon .


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You are only venting if you do nothing to solve the problem. -dkjay279
Comments (5)
Hmm...how about, when you catch yourself feeling guilty, try to feel good about the fact that you're sparing the other kids (and their parents) at daycare/school from LO's germs! Lots of people just send their sick kids, especially if they're good at hiding it like yours, and we all know where that leads.
I feel the same thing all the time. I don't have easy answers, but I can reassure you that you aren't alone in the guilt.
It may lie in your work ethic (which by the way is a really good one).
I'm a working mother too and I have no problem with the idea of taking off if it is for anything really. Of course my job recognizes sick leave even for things that fall under "mental health days" (I just don't feel like coming in and no questions asked - provided you have the sick leave to cover it & you notify the appropriate person).
But I'm also of the mindset that work is their to faciltate my life. So if work has to be put on the back burner because something came up - well then that is were it goes.
Saying that - I do feel pressure to be here when there is a deadline approaching and I would never cancel a business trip for something that comes up.
ODS (12.26.2002) and YDS (05.20.2011)
Thanks ladies. I do remind myself that I don't want to be THAT parent who sends a sick child to daycare, birthday parties, or whatever and then gets everyone else sick. It helps, but it's more of a tick mark on the side of being a good mom instead of easing the issue of not being a good employee. Does that make sense?
The funny thing is, my employer is HUGE on if you are sick with contagious symptoms (like a fever), they want you to stay home so you don't get everyone at work sick.
You are only venting if you do nothing to solve the problem. -dkjay279
I am slowly getting better at the "work is there to facilitate my life" way of thinking. (removed some stuff that could get me in trouble, sorry)
It is hard to put work before myself...DH does the same thing and we grew up with that philosophy. We did it before we got together and it's only really been an issue since we had our LO. I am proud of having a good work ethic, I just wish I could find a happy medium between it and putting my life before work.
You are only venting if you do nothing to solve the problem. -dkjay279


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I go and get it regardless, draw it like I'm an artist
Lyric Meaning
Even though he is dealing with all this hate and is against the odds, he still makes his money and achieves his goals.
The use of the word draw is in the form of producing, thus he produces/creates regardless of the things that try to stop him.
The usage of the word draw can also be wordplay because the way he makes his money(produces) is by writing rhymes; using a pen/pencil. Thus drawing.
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LeTourneau University will feature "Pinkalicious the Musical," a family oriented production from Vital Theater Company, at 2 p.m., Sunday, April 14, in the S.E. Belcher Jr. Chapel and Performance Center, 2100 S. Mobberly Ave., in Longview. Tickets will be sold through the Belcher Center box office, priced at $11 for children 14 and under, $16 …
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Office Manager jobs
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The position you are looking for is no longer available, but here are some similar jobs that might interest you
Based in London, Oddschecker is the UK's #1 Odds Comparison site. The UK online gambling industry has been one of the fastest growing, exciting and technologically innovative sectors over the last 5 years and Oddschecker sits right in the centre of it. Established 15 years ago, we are now owned by a private equity group (CVC) and together we have big plans for game-changing investment and growth both in the UK and Internationally. This is an incredible time to join our team of 50 motivated, hardworking and fun loving individuals, who are all determined to achieve great things together in the coming years.
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Apply now!
Whilst we'd love to get back to every applicant…
An exciting opportunity has arisen for an Office Manager to join a tuition centre in Dagenham.
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Shepherd Neame Spitfire Pump Clip
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- Item Category: Alcohol & Smoking
- Source: eBay UK
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New Spitfire Pump Clip by Shepherds Neame Brewery, comes complete with a self adhesive clip for the back. A must for collectors.Any questions or for P&P outside UK please email me. I always give combined postage on multiple purchases.


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when i was 15 we all be naked
even a random person came and naked
If you have a swimming pool at your home and fenced in private backyard do you bother to wear a swimsuit?
naked_and_barefoot N.I.T. 2012/09/14 13:52:29
We do not bother to wear swimsuits. We have a private yard and just go naked and so do our friends who come to swim. We do not bother to wear clothes in our home either. Why bother?
Top Opinion
secret 2015/01/02 05:31:48 (edited)
More polls by naked_and_barefoot N.I.T.
Sort By
- secretbutt 2015/02/10 02:28:28
- secret 2015/01/02 05:31:48 (edited)
- secretbutt secret 2015/02/10 02:30:08
- cadwalladr 2013/02/22 20:26:57+2Indeed, why bother? I learned to swim as an adult, and because it was an enclosed pool I asked if I could dispense with my costume. The instructore agreed, and so I had my lessons completely naked. He stripped as well, but he had a splendid body, and was well hung and shaved, so it was a terrific experience. Why can't everybody have this chance; it is much more natural, besides avoiding clinging wet material?
- I love going naked. We live way out in the country so why should we bother wearing clothes when the weather is nice.
- Kezzi Morris 2012/12/27 18:01:14 (edited)
- Kezzi M... naked_a... 2012/12/28 11:20:18
- Kezzi M... naked_a... 2012/12/28 11:24:50Awesome :)
- the sexy one 2012/12/27 03:24:54
- the sex... naked_a... 2012/12/29 00:19:22
- Roger Arnold 2012/10/06 03:39:01
- Ethan_Dalton 2012/09/26 16:13:32
- ikeknight 2012/09/21 20:30:49yes.
- Dave The Canuck 2012/09/21 05:31:09
- NotTargetMaterial 2012/09/17 02:12:11I'm kinda disgusted at looking at myself naked. So I'd probably wear a bee keeper's suit so I don't catch a reflection of myself naked in the pool.
I would be naked under the bee keeper's suit though.
- Cricket 2012/09/15 17:53:30
- marty 2012/09/15 17:36:18+1If I did, I wouldn't wear a suit. I mean, I'd be considerate of my guests and would probably mention that I don't normally wear one. If nudity from someone other than their family/spouse was the only thing that bothered them, I'd probably oblige them and put on some shorts. If they didn't care, yay, we can all get nekkid...and go swimming or play volleyball or something.
- Beat Magnum True Hero 2012/09/14 20:08:01
- And no wet swimsuit clinging to you when you get out.
- Bingo's Faddah 2012/09/14 17:03:23
- Consideration of others is one of the main things of being a nudist. A private setting is completely different then a shared public setting.
- Bingo's... naked_a... 2012/09/15 00:22:19+1Oh, I agree but nudity as a taboo is ridiculous. How veddy proper! Do folks in "civilized" society actually think their kids don't know about sex and the associated parts? Did you when you were 12? I did, and it was a blend of what I heard on the street and what my father told me. Why is a woman's nipple dirty and a man's isn't?
I do believe in being considerate, in fact, it's the law here! I just hate silly taboos.
- Culgan 2012/09/14 17:01:40Let's get nekkid!
- Bibliophilic 2012/09/14 16:41:11No. I don't care who does that as long as I am not forced to look at it.
- Recruit 2012/09/14 16:16:08
- Emma's Dilemma 2012/09/14 15:23:10
- BritPunk naked_a... 2012/09/15 09:46:54
- NotTarg... Emma's ... 2012/09/17 02:14:06
- rand 2012/09/14 15:17:41
- cj 2012/09/14 15:03:11+1Us either. We have an outdoor hottub, not a pool.... but never has a swimsuit been worn in it.... company has never had any objections to that, and of course if they did, there is no issue, we just wouldn't go in it with them... nudity isn't such a big deal if you treat it that way.... all the power to you.
- MYSTIC MYSTIQUE 2012/09/14 14:56:20umm yes........
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Section 2257
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