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Publications (22)27.05 Total impact
Article: Improvement in the Detection Rate of PJI in Total Hip Arthroplasty Through Multiple Sonicate Fluid Cultures[Show abstract] [Hide abstract]
ABSTRACT: The microbiological culture of sonicate fluid (SFC) of explanted endoprosthetic components has increased the rate of bacterial isolation in comparison to conventional microbiological methods. However, this creates the problem of interpreting cases of singular bacterial isolation through SFC, while all other microbiological samples remain negative. The aim of this study was to reference these singular positive SFC against, the histological classification of the periprosthetic membrane (PM), and the utilization of multiple SFC (separate sonication of individual endoprosthetic components). In this prospective study we compared the effect of multiple SFC for detection of periprosthetic joint infection (PJI) in patients with total hip revision surgery. All microbiological results were referenced against PM. Of the 102 cases there were 37 cases of PJI. Single SFC achieved the highest sensitivity of all individual parameters with 89% and a specificity of 72%. When multiple SFC were employed the sensitivity and specificity increased to 100%. There was a concordance of 86% between the PM and SFC. SFC achieved the highest sensitivity and it was possible to further improve the sensitivity and specificity when using multiple cultures. Multiple SFC and PM are beneficial to help reference singular bacterial isolations and achieve the diagnosis of PJI. © 2013 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 9999:1-4, 2013.
Article: Evaluation of sonicate fluid cultures in comparison to histological analysis of the periprosthetic membrane for the detection of periprosthetic joint infection[Show abstract] [Hide abstract]
ABSTRACT: Purpose: The aim of this prospective study was to evaluate the diagnostic efficacy of sonicate fluid cultures (SFC) and the histological analysis of the periprosthetic membrane (PM) for the detection of periprosthetic joint infection (PJI). Methods: The histological samples were evaluated according to the consensus classification of PM as defined by Morawietz and Krenn. All explanted endoprosthesis were subject to sonication. Additionally, a synovial aspiration and microbiological culture of tissue samples were performed for each patient. Twenty three of the 59 patients had an established PJI. Results: Sonication achieved the highest sensitivity out of all diagnostic methods with 91 % and a specificity of 81 %. The PM achieved a sensitivity of 87 % and a specificity of 100 %. In three cases of PJI a pathogen was isolated solely by sonication while all other microbiological methods were negative. In seven cases there was a positive bacterial culture through sonication with negative histology. Conclusions: Our results show a high correlation between the microbiological and histological results. In our patient group sonication achieved the highest sensitivity out of all diagnostic methods and was more sensitive than conventional microbiological methods.
Article: Ultrasound-based computer navigation: An accurate measurement tool for determining combined anteversion?[Show abstract] [Hide abstract]
ABSTRACT: Introduction: The present feasibility study examined the use of an ultrasound-based navigation system (UNS) for reliability of measurement the positions of both the femoral and acetabular components, a prerequisite to adjust the combined anteversion with sufficient accuracy when using a femur-first approach in total hip arthroplasty. Method: Using a UNS, five investigators performed five measurements of the posterior femoral condyles and the anterior pelvic planes (APP) of two cadavers with different body mass index. Deviations in stem and acetabular anteversion resulting from varying acquisition of the respective landmarks were determined relative to the reference measures of anteversion determined in the same cadavers from computed tomography (CT) scans. Here, both a freehand and guided ultrasound measurement methods were used to acquire the posterior femoral condyles. Femoral and acetabular anteversion values were added in order to estimate the combined anteversion of the reconstructed hip. Results: Using an UNS, variations in the freehand technique for the acquisition of the posterior femoral condyles resulted in a mean error in the anteversion of the femoral component of -1.5° (SD 3.4°; -10.8° to 7.0°) while the mean error was -0.9° (SD 3.1°; -7.3° to 10.2°) when the UNS provided additional support to standardize the orientation of the UNS probe. In all cases, UNS navigation enabled to achieve combined anteversion values that fell within a clinically acceptable error range of less than ± 12.5° compared to the CT measures. Conclusion: Our investigations suggest that the anteversion of stem and cup can be measured with accuracy sufficient enough to utilize the concept of combined anteversion using UNS. Hence, the advantage of utilizing UNS's in a femur-first approach is the ability to intraoperatively compensate for deviations from the targeted anteversion of the stem (which is often difficult to control) by adjusting the acetabular anteversion in the final step of the implantation. In doing so, the placement of the components follows the concept of combined anteversion. Avoiding extreme anteversion values of combined anteversion could be an important step towards reducing post-operative complications following total hip arthroplasty (THA).
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ABSTRACT: This feasibility study investigated the accuracy of anterior pelvic reference plane (APP) registration and acetabular cup orientation in two cadavers with different BMIs. Five observers each registered the APP five times in the 2 cadavers (BMIs: 32 kg/m(2) and 25 kg/m(2)) using an ultrasound-based navigation system. By comparison against the CT-derived reference landmarks, the errors in determining the individual landmarks defining the APP, as well as the resulting errors in the orientation of the APP and the acetabular cup orientation were determined. Across all measurements obtained with the ultrasound navigation system, the errors in rotation and version in determining the APP were 0.5° ± 1.0° and -0.4° ± 2.0°, respectively. The cup abduction and anteversion errors determined from all measurements of the five investigators for both cadavers together were -0.1° ± 1.0° and -0.4° ± 2.7°, respectively. The data further demonstrated a high reproducibility of the measurements for the resulting cup adduction and anteversion angle. Our preliminary results confirm that ultrasound navigation is a highly accurate tool that allows a reproducible registration of the APP and thereby enables accurate and precise intraoperative determination of the acetabular cup orientation also in patients with increased BMI.
Article: Use of an Ultrasound-Based Navigation System for an Accurate Acetabular Positioning in Total Hip Arthroplasty A Prospective, Randomized, Controlled Study[Show abstract] [Hide abstract]
ABSTRACT: The purpose of this study was to compare an ultrasound-based navigation system with an imageless navigation system with surface registration in the postoperative acetabular cup position. A prospective randomized controlled study of 2 groups of 40 patients each was performed. In the first group, cup positioning was assisted by an ultrasound-based navigation system, and in the second group, the cup was assisted by imageless navigation system with surface registration. There was significantly more outliers in the imageless navigation group. In addition, there was statistical significance in the anteversion angles and in the anteversion error between the imageless navigation and ultrasound-based navigation groups. Ultrasound-based navigation improves cup positioning in total hip arthroplasty better than an imageless navigation system by reducing the outliers, achieving a higher accuracy of anteversion.
Article: Validation of a CT image based software for three-dimensional measurement of acetabular cup orientation[Show abstract] [Hide abstract]
ABSTRACT: The purpose of our study was to develop a simple and reproducible method for calculating post-operative acetabular cup position based upon computed tomographic images. Next, we sought to examine the reliability, objectivity and accuracy of this method. We developed a 3D CT evaluation software based upon Amira® (data visualisation, analysis and modelling software) to calculate the abduction and anteversion of the acetabular cup relative to the APP (anterior pelvic plane). To test the accuracy of the method, we constructed a special phantom pelvic model as the gold standard, in which the acetabulum was mounted at various abduction and anteversion angles that had previously been measured digitally. This phantom was then CT scanned in 12 different cup positions (30° to 50° abduction, 0° to 30° anteversion) and then evaluated using the 3D CT evaluation software. In addition, we also examined the reliability and objectivity of this method in 10 patients following implantation of a hip prosthesis, as a clinical trial. We observed an average accuracy of the 3D CT evaluation software of −0.3° (range −1.4° to 1.3°; SD 0.6°) for abduction and 0.2° (range −1.4° to 1.4°; SD 0.6°) for anteversion compared with the gold standard. Moreover, a high intra -and interindividual agreement in the resulting ICC well above 0.8 for abduction and abduction values in the phantom study and the clinical trial were observed. This study found that the 3D CT evaluation software provides high reliability, objectivity and accuracy. Thus, the 3D CT software is a method that permits very precise evaluation of the post-operative cup position independent of patient positioning or pelvic tilt.
Article: 3D CT Analysis of Combined Cup and Stem Anteversion in Cases of Cup Navigation in Hip Arthroplasty[Show abstract] [Hide abstract]
ABSTRACT: Navigation of the cup in total hip arthroplasty is well analyzed and shows accurate results, reducing cup outliers of Lewinnek's "safe zone." With regard to the combined anteversion of cup and stem, however, a "new" safe zone with a range of 25° to 50° has been published. The aim of this study was to analyze total anteversion (cup and stem) by postoperative 3D computed tomography in isolated cup navigation cases. In 46 patients, the mean combined anteversion was 34.4° (range, 16.3°-57.3°, SD ± 9.3°) with 10 outliers. The mean cup anteversion was 19.5° (range, 11°-27°, SD ± 3.7°). Regarding Lewinnek's "safe zone" (cup only), we observed 5 outliers. An improvement of technique of stem implantation or navigation may reduce outliers of combined anteversion.
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ABSTRACT: Revision of cup and reconstruction of original center of rotation. High primary and secondary stability. Prevention of additional bone loss. Osseous defects at the anterior-cranial, cranial and posterior-cranial rim of acetabulum. Larger cavitary, medial or oval defects (Paprosky IIb-IIIb). Segmental defects (anterior column up to half of host bone, posterior column up to one third of host bone). Infection of total hip arthroplasty. Pelvic discontinuity (Paprosky IV). Exposure of acetabulum and detection of defects. Complete removal of soft tissue from acetabulum, reaming of sclerotic bone, if necessary. Adaptation of trial augments to close an oval defect to a round defect and to reach an uncontained defect, respectively. Adaptation of trial cup. In case of sufficient stability, fixation of final augment with two or three screws in cranial bone stock. The screws should be directed to iliosacral joint. Augmentation with allogenic bone chips is possible in the region of wedge and acetabulum as well. Sealing of rough augment surface with bone cement. Implantation of cup, fixation with screws. Application of insert. Depending on bone defects, full weight bearing is possible. In cases of severe bone defects, reduction of weight bearing to 20 kg for 6 weeks is recommended. Postoperative physiotherapy is possible in most cases. Between 2005 and 2007, 38 patients with acetabular defects type IIIa und IIIb according to Paprosky underwent reconstruction using the TMT system (Trabecular Metal Technology). After 25 months, a significant functional improvement was seen in all patients. The Merle d'Aubigné Score increased from 6 points preoperatively to 13 points postoperatively, the Harris Hip Score from 29 to 78 points. Two revisions were necessary because of loosening or migration of the cup.
Article: CT evaluation of native acetabular orientation and localization: Sex-specific data comparison on 336 hip joints[Show abstract] [Hide abstract]
ABSTRACT: The reorientation of the acetabular component in total hip replacement is currently carried out under consideration of the safe zone, respecting the best possible range of motion and is influenced by wear debris of different bearings. Is the preferred orientation a reconstruction of the native anatomy and are there sex-specific differences? On the basis of 168 CT datasets (72 women, 96 men) 336 native hip joints were analysed. The abduction and anteversion of the acetabulum as well as the location of the hip center were detected. As a reference the anterior pelvic plane was used. The 144 female hip joints showed a mean abduction of 53.0 degrees (SD 6.14 degrees ) and an anteversion of 24.63 degrees (SD 6.61 degrees ). The 192 male hip joints showed an abduction of 53.58 degrees (SD 6.68 degrees ) and an anteversion of 21.31 degrees (SD 6.17 degrees ). Significant differences were observed on comparison between the sexes in relation to the anteversion and the location of the hip center. Likewise, there was a significant correlation between the position of the hip center and the degree of anteversion. In total hip arthroplasty a reconstruction of the native acetabular orientation is not possible, gender specific characteristics should be considered.
Article: Influence of body mass index and thickness of soft tissue on accuracy of ultrasound and pointer based registration in navigation of cup in hip arthroplasty[Show abstract] [Hide abstract]
ABSTRACT: Precise identification of bony landmarks by use of pointer based navigation systems is influenced by thickness of soft tissue. Ultrasound-based navigation systems try to overcome the problems of positional deviation associated with soft tissue. The aim of the study was to investigate the influence of the BMI and the thickness of the soft tissue on the post-operative cup position and accuracy in the application of an ultrasound-based (US CAOS) and a pointer-based navigation system (P CAOS). 82 patients received a hip replacement in minimally invasive surgery in two cohorts: US CAOS group: using ultrasound navigation (n = 39) and P CAOS group: using a pointer-based navigation (n = 43). There was a significant difference in anteversion and anteversion error between the groups. In addition, we observed a significant correlation between the thickness of the presymphysial soft tissue and the anteversion error in both groups. We also detected a significant correlation between the anteversion error and the BMI in both groups. However, the absolute error in anteversion with increasing thickness of the soft tissue layer was slighter in the ultrasound-based group compared to pointer-based navigation. The accuracy of the ultrasound-based and pointer-based navigation systems are influenced by the BMI and the thickness of the soft tissue layer above the symphysis. However, ultrasound-based navigation seems to have advantages with thicker soft tissue layers, as seen in overweight and obese patients.
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ABSTRACT: Background The distinction between aseptic and septic loosening of a total hip arthroplasty is a diagnostic challenge. Therapy and clinical success depend on the correct diagnosis. Histopathological evaluation of the periprosthetic interface membrane is one possible diagnostic parameter; detailed analysis of tissue characteristics may reflect the cause of failure. This study evaluated the diagnostic value of a published histopathological consensus classification for the periprosthetic interface membrane in the identification of periprosthetic joint infection (PJI). Methods Between 2004 and 2008, a prospective analysis was performed in 106 patients who had revisions because of assumed PJI. Based on clinical presentation, radiography, and haematological screening, infection was assumed, and a joint aspiration was performed. Based on these findings, a two-stage revision was performed, with intraoperative samples for culture and histological evaluation obtained. Final diagnosis of infection was based on the interpretation of the clinical presentation and the preoperative and intraoperative findings. The basis for histopathological evaluation was the consensus classification for the periprosthetic interface membrane. Sensitivity, specificity, and accuracy were calculated for each parameter. Results In 92 patients, a positive diagnosis of PJI could be made. Histopathology yielded the highest accuracy (0.93) in identification of PJI, identifying 86 of 92 infections (69 type II, 17 type III). In 13 of the 14 noninfected hips, histopathology correlated in 13 (93%) cases (10 type I, three type IV). The accuracies of microbiological culture, C-reactive protein, and aspiration were 0.82, 0.86, and 0.54, respectively. Conclusion In the diagnosis of PJI, histopathological evaluation of the periprosthetic interface membrane proved very effective. To analyse the cause of prosthesis loosening, tissue samples of the periprosthetic interface membrane should be evaluated on the basis of the consensus classification in all revision surgeries.
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ABSTRACT: Intraoperative landmarks are used in image-free navigation systems. The ultrasound-based navigation systems try to overcome the problems of positional deviation associated with soft tissue. Our study analyzed the accuracy of ultrasound-based navigation of cup positioning compared with postoperative 3-dimensional (3D) computed tomography scans of cup positioning. Twenty-five ultrasound-navigated total hip arthroplasties (THAs) were analyzed. The difference between the intraoperative cup orientation (navigation) and the postoperative cup position (CT) was evaluated. The average difference between intraoperative navigation and postoperative CT measurements was 2.8 degrees (SD+/-1.8 degrees ) for abduction and 2.2 degrees (SD+/-1.6 degrees ) for anteversion. Therefore, we recommend ultrasound-based navigation as an exact tool for cup positioning in THA.
Article: [Histopathological diagnosis of periprosthetic joint infection following total hip arthroplasty : use of a standardized classification system of the periprosthetic interface membrane].[Show abstract] [Hide abstract]
ABSTRACT: The distinction between aseptic and septic loosening of a total hip arthroplasty is a diagnostic challenge. Therapy and clinical success depend on the correct diagnosis. Histopathological evaluation of the periprosthetic interface membrane is one possible diagnostic parameter; detailed analysis of tissue characteristics may reflect the cause of failure. This study evaluated the diagnostic value of a published histopathological consensus classification for the periprosthetic interface membrane in the identification of periprosthetic joint infection (PJI). Between 2004 and 2008, a prospective analysis was performed in 106 patients who had revisions because of assumed PJI. Based on clinical presentation, radiography, and haematological screening, infection was assumed, and a joint aspiration was performed. Based on these findings, a two-stage revision was performed, with intraoperative samples for culture and histological evaluation obtained. Final diagnosis of infection was based on the interpretation of the clinical presentation and the preoperative and intraoperative findings. The basis for histopathological evaluation was the consensus classification for the periprosthetic interface membrane. Sensitivity, specificity, and accuracy were calculated for each parameter. In 92 patients, a positive diagnosis of PJI could be made. Histopathology yielded the highest accuracy (0.93) in identification of PJI, identifying 86 of 92 infections (69 type II, 17 type III). In 13 of the 14 noninfected hips, histopathology correlated in 13 (93%) cases (10 type I, three type IV). The accuracies of microbiological culture, C-reactive protein, and aspiration were 0.82, 0.86, and 0.54, respectively. In the diagnosis of PJI, histopathological evaluation of the periprosthetic interface membrane proved very effective. To analyse the cause of prosthesis loosening, tissue samples of the periprosthetic interface membrane should be evaluated on the basis of the consensus classification in all revision surgeries.
Article: Comparison Between Pointer-based and Ultrasound-based Navigation Technique in THA Using a Minimally Invasive Approach[Show abstract] [Hide abstract]
ABSTRACT: The use of navigation techniques in primary total hip arthroplasty improves the position of endoprosthetic components, especially cup positioning. An intraoperative registration of the anterior pelvic plane is necessary to define the anteversion and inclination angles on the acetabular side. This study compares the accuracy of manual pointer palpation to ultrasound registration in navigation to determine pelvic plane registration in 60 cases of minimally invasive surgical technique. Findings show more accurate postoperative radiographic anteversion with ultrasound navigation, although both manual pointer palpation and ultrasound registration techniques show a very small standard deviation in anteversion, inclination, and leg length difference. In conclusion, we recommend navigation as a very reliable tool for the positioning of implants.
Article: Diagnosis of periprosthetic infection following total hip arthroplasty – evaluation of the diagnostic values of pre- and intraoperative parameters and the associated strategy to preoperatively select patients with a high probability of joint infection[Show abstract] [Hide abstract]
ABSTRACT: The correct diagnosis of a prosthetic joint infection (PJI) is crucial for adequate surgical treatment. The detection may be a challenge since presentation and preoperative tests are not always obvious and precise. This prospective study was performed to evaluate a variety of pre- and intraoperative investigations. Furthermore a detailed evaluation of concordance of each preoperative diagnosis was performed, together with a final diagnosis to assess the accuracy of the pre-operative assumption of PJI. Between 01/2005 and 02/2007, a prospective analysis was performed in 50 patients, who had a two stage revision because of assumed PJI. Based on clinical presentation, radiography, haematological screening, or early failure, infection was assumed and a joint aspiration was performed. Depending upon these findings, a two stage revision was performed, with intra-operative samples for culture and histological evaluation obtained. Final diagnosis of infection was based upon the interpretation of the clinical presentation and the pre- and intraoperative findings. In 37 patients a positive diagnosis of PJI could be made definitely. The histopathology yielded the highest accuracy (0.94) in identification of PJI and identified 35 of 37 infections (sensitivity 0.94, specificity 0.94, positive-/negative predictive value 0.97/0.86). Intra-operative cultures revealed sensitivities, specificities, positive-/negative predictive values and accuracy of 0.78, 0.92, 0.96, 0.63 and 0.82. These values for blood screening tests were 0.95, 0.62, 0.88, 0.80, and 0.86 respectively for the level of C-reactive protein, and 0.14, 0.92, 0.83, 0.29 and, 0.34 respectively for the white blood-cell count. The results of aspiration were 0.57, 0.5, 0.78, 0.29, and 0.54. The detection of PJI is still a challenge in clinical practice. The histopathological evaluation emerges as a highly practical diagnostic tool in detection of PJI. Furthermore, we found a discrepancy between the pre-operative suspicion of PJI and the final post-operative diagnosis, resulting in a slight uncertainty in whether loosening is due to bacterial infection or not. The variation in accuracy of the single tests may influence the detection of PJI. Level of Evidence: Diagnostic Level I.
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ABSTRACT: Revision surgery after failed anterior cruciate ligament reconstructions has increased tremendously. Reasons for revisions are persistent loss of motion, recurrent joint laxity, a painful knee or joint infections. In a retrospective study with a mean follow-up of 35.2 months 82 patients were examined after revision surgery. Time interval between primary and revision surgery, causes of revisions and treatment modalities were evaluated and compared to subjective, clinical and radiological parameters. In all cases a clinical improvement could be achieved. But results after revision operations are inferior to first reconstructions. The mean Tegner score improved after revision surgery from 2.4 to 4.6 points. The mean Lysholm score increased after secondary surgery from 54 to 76 points. The overall IKDC results of follow-up showed category A - 35.4 %, B - 39 %, C - 13.4 % and D - 12.2 % of the patients. A distinction between patients with preoperative isolated loss of motion and patients with isolated joint laxity seems useful. Revision operations with an improvement of joint mobility showed a higher subjective satisfaction, a lower rate of joint instability and better overall IKDC result compared to those with a high grade of preoperative joint laxity. Better results could be also achieved for early revision compared to late revisions and also for autologous grafts compared to alloplastic revision plasty. Transplant retaining procedures are only possible in selected cases and showed no clinical benefit compared to second revision of cruciate replacements. As a result of this study we conclude that early revision operation and the use of an autologous graft can be recommended but the surgeon has to be prepared to encounter many demanding technical problems.
Article: Imaging of low-grade bone infection with a technetium-99m labelled monoclonal anti-NCA-90 Fab' fragment in patients with previous joint surgery[Show abstract] [Hide abstract]
ABSTRACT: Low-grade bone infection represents a serious clinical problem. Diagnostic options are often insufficient, yet the therapeutic implications of proven disease are important, especially in patients with prosthetic joint replacement. Technetium-99m labelled monoclonal anti-NCA-90 granulocyte antibody Fab' fragment (MN3 Fab') has been shown to be useful in bone and joint infection, but there are no data specifically referring to low-grade bone infection. We therefore analysed 38 scans in 30 consecutive patients (age range, 30-85 years; median age, 62 years) referred for suspected low-grade bone infection. There were 17 patients (21 scans) with total hip arthroplasty (THA), six with total knee arthroplasty (TKA), three who had undergone hip or knee surgery for trauma and five (seven scans) with resected hips and no endoprostheses (Girdlestone situations); one of these five patients had been investigated before with THA in situ and another prior to surgery for low-grade coxitis. There were no patients with rheumatoid arthritis as the underlying disease. Results were verified by means of bacteriological cultures, histopathological findings and/or follow-up and compared with the respective Zimmerli scores, which were used for clinical assessment of inflammatory activity. In one patient, the final diagnosis could not be established. One, 5 and 24 h after intravenous injection of up to 1.1 GBq of MN3 Fab', whole-body and planar scans were performed using a dual-head gamma camera. Scans were analysed visually and semiquantitatively adopting an arbitrary score ranging from 0 to 3. There were 13 true positive, 14 true negative and 10 false positive outcomes, yielding an overall sensitivity of 100%, an overall specificity of 58%, an accuracy of 73% and positive and negative predictive values of 57% and 100%, respectively. In patients with THA or TKA, accuracy was 81% and 80%, respectively, while it dropped to 43% in patients with Girdlestone situations owing to a high proportion of false positive findings (4/7) in this subgroup. Scintigraphic score was 1 in all of the false positive and in 11/13 true positive findings. The two remaining true positive findings displayed scintigraphic scores of 2 and 3, respectively. Scintigraphic and Zimmerli scores were loosely correlated (Spearman rho=0.38, P<0.05). Infection was excluded in 22/24 investigations with Zimmerli scores of <6. In this group, there were 13 scintigraphically true negative, nine false positive outcomes, and just two true positive outcomes. In 11/12 investigations with Zimmerli scores of 6 or 7, infection was verified and scintigraphic outcome was accordingly true positive, while the remaining patient was true negative. In conclusion, MN3 Fab' scintigraphy proved to be highly sensitive but not specific in diagnosing low-grade infections of the hip and knee regions in patients with previous joint surgery. The method seems reliable in excluding but not in proving the presence of infection. MN3 Fab' scintigraphy should not be applied in patients with Girdlestone situations. Assessment of infection using the Zimmerli score was more reliable than MN3 Fab' scintigraphy in this group of patients without rheumatoid arthritis as the underlying disease. Considering results from the literature concerning leucocyte scintigraphy, MN3 Fab' scintigraphy may be clinically useful in evaluating low-grade bone infection in THA and TKA patients with Zimmerli scores above 5 and concomitant rheumatoid arthritis or other inflammatory diseases.
Article: Periprothetische knöcherne Veränderungen 2, 4 und 6 Jahre nach Implantation zementfrei verankerter Zweymüller-Schäfte - eine Querschnittsstudie
Article: Erratum: Imaging of low-grade bone infection with a technetium-99m labelled monoclonal anti-NCA-90 Fab' fragment in patients with previous joint surgery (European Journal of Nuclear Medicine (2001) 29 (547-551))
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Charité Universitätsmedizin Berlin
Berlín, Berlin, Germany
- • Center of Space Medicine Berlin (ZWMB)
- • Medical Department, Division of Rheumatology and Clinical Immunology


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..from a great friend
..from a great friend
I swIrve at english teachers in my car,...and swIrve at cars on my bicycle..
Camcorder .... $700, Bicycle .... $1200 Riding like this ... mindless.
Just what advocacy needs...
"My two favourite things in life are libraries and bicycles. They both move people forward without wasting anything" -Peter Golkin
why did you speed up the video?
The videos are made by a fellow BF poster, JoeyBike. He occasionally post links to his videos here and the resulting threads are always fun to read.
I think these guys are planted in cities by the auto industry in order to encourage hatred of bikes by the general population.
Think that guy in the pickup at the end of the video will be more considerate to cyclists now?
All in all, a successful program for Detroit.
Ironically, there is one place in the world where drivers expect this behavior from cyclists. I won't say where, just in case these guys come and manage to f*** up cycling paradise.
There is no 'I' in swerve.
Never mind ticketing them for blowing red-lights (though I would enjoy seeing either of the two get one) - ticket them for "reckless control of a bicycle." They are more likely to cause harm zooming about as if they were a pair of out-of-control, oversized bullets then if they blow stop lights (not to say that the latter can be equally irritating), and if anything should be ticketed for the greater offense of the two - if it has to be one or the other.
Punched A Truck Today - with video <-truck punch
Evil commute with helmet cam today... <-others
Today's Commute Vid - In The Raw! 10-15-2008
etc, etc. I think as long as a cyclist doesn't violate a motorist's right of way, he/she can run as many lights and stop signs as he/she wants.
at 1:27 you see him yield to traffic with ROW, something that can't be said of the cyclists in the NYC alleycat vids.
Last edited by degnaw; 12-02-08 at 08:35 PM.
lucas production wanna-bee.....
A NOT great video. Boring stuff, Joey should turn it up a notch and start side kicking pedestrians and bunny hopping onto car hoods etc.
pretty sweet
It's hard enough not to have people try to run you down when your on a bike, but mindless, idiotic people like this certainly don't help the cause. Instead they only make more people hate us and the next cyclists those people see will all be lumped together with this idiot (thinking they all act that way). When I ride I actually make sure I'm courteous and follow the rules around cars, stopping at stop signs and staying far to the right etc. In this way I'm hoping that the cars that see me will think that not all cyclist are crazy. It might cut down on my average speed or time, but my safety is a lot more important then getting there in the fastest dumbest way.
Cats are people too.
I can see where cyclists who roll through stop signs when it's clear might lead to the "all cyclists ignore stop signs!" point of view. But JoeyBike is pretty far out there. I don't think that there's any danger that drivers will see him as "typical".
Come on, the video is sped way up, so it looks a lot more wreckless than what it is. Traffic was pretty slow when you realize how many cars they passed, so it wasn't that dangerous.
The riding between traffic on two lane streets was way ballsy. Joey, are you riding 38 cm bars, because with 42s you would have been bumping mirrors!
Il faut de l'audace, encore de l'audace, toujours de l'audace
1980 3Rensho-- 1975 Raleigh Sprite 3spd
1990s Raleigh M20 MTB--2007 Windsor Hour (track)
1988 Ducati 750 F1
The democracy will cease to exist when you take away from those who are willing to work and give to those who would not.
Thomas Jefferson
Exhibit A for the prosecution.
My Book: Drive, Ride, Repeat: The Mostly-True Account of a Cross-Country Car and Bicycle Adventure
I thought the rider was a d-bag from the truck punch thread. now
I see he has a chronic case of d-baggery that could probably only be solved
via a severe beating by some motorist who gets tired of his crap
edit: he is in NO, that is probably punishment enough. ghastly place to live, if you call it that
I like fat bikes
and I cannot lie.
If you need to follow all of the rules, or act as if you were a car at stop lights/signs, you are obviously too far out in space for me to feel remotely safe riding anywhere in your vicinity. Its the idiots stopping at lights who get tagged two blocks down at 40mph by the same cars you were being considerate for while in the mean time you could have been a safe distance down the road; its the same people getting doored while considerately riding on the right side of the road.
Remember, they are far less aware of you then you are of them which leads to real safety for the cyclist in maneuvering around the various 'obstacles', and the faster you go, the more time moving vehicles have to react appropriately. Get your facts straight morons, and do us all a favor, if you can't handle urban cycling just stick to the streetcar.
Last edited by bikepeddler; 12-04-08 at 04:15 PM. Reason: grammar

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Pingback: Trucking News: Fleets, manufacturers tell Congress size and weight increase good for economy, efficiency – iTruckTV
The "twice as many" trucks line is bull, since the companies aren't going to pay to double their fleets, and since truck stops and rest areas are already over-crowded when you try to stop for the night. And since they wouldn't be able to find enough drivers, anyway.
And I'm sure with all the savings companies will realize by shipping more every load, with essentially the same gas mileage, and by not having to buy those trucks they wouldn't buy anyway, they'll pay all their drivers more, right? Oh yes.
Need to fix the roads and bridges first. Increase truck parking by a factor of 25 and in places where its really needed and get some 'intelligent' people to write logbook rules.
Maier, "Imagine a country without resources like WATER & FOOD if the doubling happens, that you refer to". The Ogallala water aquifer is now dn. 50% or more, & continuing to drop. 25% of our food is grown from water from the Ogallala. When will we stop these mindless criminals from sending our food supply & resources out of our country & allowing 10's of millions of foreigners to come into our country. Stop this & we stop all the heavy traffic they are crying about. When will gov & media look at root causes rather than the BS.
Hmm. About the same time the Highway Bill comes up so does the push to increase size and weight. Life was so much simpler when I started in a 40 footer. I'm sure the Old timers then gasped at that. But enough is enough. The proponents claim environment, safety and technological advantages. Big "words" from scare tactic corporations and government. We know the truth. They all just want to make more money and use their power to achieve it. I'm for making money too and using common sense to achieve it. And to be sure I notify every Congressional Representative in my district. Now that makes sense.
LOL,,,,,That is what they need to do..Fmcsa is doing all they can to get rid of the seasoned, SAFE drivers by increased Bullshit safety inspections while they let the big companies with drivers that cannot drive a GOAT to water ride into the sunset……By all means increase the weight limits and see what happens with these new drivers…Safety, LOL, what a joke that will be.
The increase will do nothing for us except make the job more complicated. It will not get us more pay. And they will move freight cheaper; at our cost.
Then they want to repair roads and widen them to 3 or 4 lanes…..then restrict trucks to the right two lanes……real safe?
Even if that idiot people call a president, recalled ALL troops, quit giving money to other country's and spent all tax dollars to fix only the roads in America it would take twenty plus years to fix the roads and bridges in the US. The roads are totaled now so add more weight?
To this day, we are still paying the price for going to 53 footers, especially in the North East. Backing a 53 footer into docks designed for 28 footers pulled by a day cab is the norm up there.
Even many modern day facilities haven't enough room for road trucks to turn around in.
Could they be planning for a Cab Over Comeback?
Pingback: Industry Leaders Ask Congress To Lift Legal Size and Weight Restrictions | Heavy Haul Info
Pingback: Good for who????
"Susan Alt, senior VP for the Volvo Group, said there'd be no safety trade off, as modern technology in trucks helps to mitigate safety concerns." She and the rest of the terrorists in DC need to understand that it hasn't got a damm thing to do with the technology of the truck, it has everything to do with the capabilities of the person driving it. You people want to take someone who's had 14 days at truck driving school and 3 weeks with a quote un quote trainer with barely 6 months experience them self and put them in something bigger and heavier….really? A majority of those I've seen come an go from this industry over the past 15yrs especially can barley handle 75′ and 80,000lbs. and you want to put them in something that's 100 plus feet and 100 plus thousand pounds? Have ALL you corporate and DC IDIOTS BUMPED YOUR F###ING HEADS. And as far as the infrastructure…it's a freeking disaster, why do you think we have bridges falling down under the weight of normal vehicles and now you what to put more weight on them….really?
"Testimony was also brought in favor of reducing or eliminating the Federal Excise Tax on new trucks and replacing it with an increase on diesel tax." Surely you people realize that the one time savings you get on the FET is not even going to come close to making to for the massive tax hike on diesel they will impose. You'll spend way more than you save with in 6 months.
Let me get this straight less loads and I have to be safe with more weight so less available work and I guess my pay per mile wont go up right? what trucker doesn't see who is benefiting here
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text:
I am part of an email distribution list here at MS that is focused on the topic of User Interface Design. Recently, one of the members posted a question to the list asking for input and/or examples of how the task of browsing a physical magazine might be replicated on a computer. While it doesn't have much to do with debugging and will likely never appear as an interface metaphore while debugging, my response does offer some insight as to how I view my job as a debugger UI developer. I am open to any thoughts, comments or suggestions you may have about this or any other debugger and/or user-interface topic. With that, here are example sites cited in the internal mail thread along with my response.
(BTW, I have no interest in any of these companies or magazines other than reviewing their magazine computer interface)
"So these are all nice examples of how the user activity of browsing through a magazine can be replicated via a computer interface. Because it seems appropriate for this alias, I thought it would be interesting to voice some personal opinions of the examples given. I'd be interested to hear what other's think as well.
First, I think all of them are pretty enough and effectively communicate the idea of physical pages being turned. However, I think there are distinct user interactions that must be easily discoverable and mimicked to successfully translate the real-life experience to a computer interface: Here they are (IMHO, of course):
Based on the above if had to pick one as a model to try and emulate, I'd have to say the Zinio interface. There would be absolutely no contest if it rendered a zoomed page in real-time rather than waiting for the user to let go of the mouse button
Some other observations I had:


text:
Definition of as thick as a brick in English:
Very stupid.
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text:
I was stunned when the Lucario appeared. I stood staring. "Well I can't understand why you're staring at me," the Lucario said. "Obviously you've seen Pokémon before. I would just like to know what is wrong with me." I shook my hand and gave a nervous smile.
"Nothing," I said. "Just I thought that we were the only Pokémon in existence!"
"And what gave you that idea?"
"We were the only ones in the prison place that were Pokémon as far as I could tell." I noticed that the girl and Bill were watching us. They could understand the Lucario, but not me.
"Well, I was in there long before you and for a longer time. They turned me into a Lucario, but they couldn't fully change me. I still had my same basic vocal cords and my spikes are made of bone, not metal. I only escaped because of the aura powers that Lucario has. I was also able to destroy most of the experiment, but they obviously recovered the data." He motioned towards us.
"I'm guessing that you don't have your memory." He shook his head. I sighed. The girl clapped her hands.
"Well now that we are acquainted," she said. "Let's get down to business. Bill, if you would." I looked towards Bill, but he was gone. I felt something poke my side I looked and saw a needle come out of the top of my foreleg. It had my blood in it.
"Sorry," Bill said. "But it's a lot easier than trying to force it out of you." I growled at him. "Shut up." I stopped growling. He proceeded to take blood from the others. They willingly did it. I sighed.
"Lucario, can you take them to their rooms?" the girl asked.
"Of course, Sam," Lucario said. "If you four will come with me." He started to walk down the hall he had come from. We followed him. We got to the end of the hall and saw four doors. They all had dog doors attached to them. The last one on the right had the dog door sealed. He pointed to each of them as he said our names. "The Espeon will live here."
"Uhhh, just call us by what Pokémon we are please," Growlithe said timidly.
"Sure. Mightyena is here." Mightyena immediately went into his room. "Umbreon and Growlithe here."
"Wait, Growlithe and I have to share a room?!" I barked.
"That's the plan."
"Son of a bitch. Are you sure you don't have any more rooms? What about that door?" I motioned to the last door on the right.
"That is my room. Now make yourselves at home, tomorrow I'll have to train you I guess."
"Train us for what?" Growlithe asked.
"For combat of course. You need to be ready to fight. You're a part of this whether you like it or not." He went into his room and closed the door after he said that. I heard the lock click. I sighed. Growlithe was already going through the dog door. I followed. The room was pretty spacious. There were two beds. They were in separate corners.
"I get the one on the left," I told Growlithe. I suddenly heard my stomach growl. I realized I hadn't eaten in a while. There was a knock on the door. "Hey guys?" I heard Sam say. "I brought you dinner! Bark twice if you want it now." I barked twice. So did Growlithe. She slid two bowls through the dog door. "Of course it's in bowls," I said with a sigh.
I never realized how much I took opposable thumbs for granted. Eating out of the bowl was demeaning and degrading. I fell asleep after I finished eating. I woke up because Growlithe was shaking me awake. "Whaaaat?!" I moaned.
"Lucario wants us," he replied.
"Five minutes."
"He wants us now." I sighed I slowly dragged myself out of bed and stretched.
"Alright, where do we go?"
"He's waiting for us in the hall." We walked out into the hall. Espeon, Mightyena, and Lucario were waiting there.
"Follow me," Lucario said. We followed him through the lab area. We arrived at a set of double doors. There were no handles on them. They slide open as he approached. We followed him inside. It looked like a large gym. There were a lot of dummies along the wall. "Alright, let's first see what attacks you know. Growlithe you go first." Growlithe walked up to a dummy.
He used Ember on it. It was lite on fire. He turned toward another dummy. He focused on it and eventually ran at it. I bit down on it hard. He stepped away from it and focused on it again. He jumped up and his tail started to glow. He slammed it into the dummy and put a large crack in it. He focused on a different dummy. He stopped focusing pretty soon after. "That's all I know," He said.
"Ember, bite, and iron tail. Pretty good moves," Lucario said. "Mightyena, your turn." Mightyena grunted. He stood up and looked immensely bored. He growled at the dummy he was looking at. Nothing happened. He then charged at the dummy and bit down on it. He backed up then charged at it again. He kicked it with his back leg and took off its hand. He backed up. He charged at the dummy again and tackled it. He knocked it over and fell. He got up only slightly hurt. "Looks like you got growl, bite, thief, and take down. Umbreon."
I walked up to a dummy. I focused on it and tried to do an attack. I jumped at it and head-butted it. I backed away. Before I had time to think, I jumped at it again. I intended to Headbutt it again, but a dark aura appeared around me. When I hit the dummy, it didn't feel like I had hit it as hard as before. I ran at it and bit it. I hopped back and ran at it. I jumped and suddenly appeared behind it. I rammed it. "Headbutt, pursuit, bite, and faint attack. Really good move set for a dark type. Alright Espeon, you're up."
Espeon walked in front of a dummy. She immediately charged at it. She moved with incredible speed. She made contact. She then landed and made a barrier out of nothing. It faded away. She made starts appear out of nowhere and they flew at the dummy. They smashed into it. She then picked up the dummy with her mind. She flung it across the room. It slammed into the other wall. "Wow! Quick attack, reflect, swift, and a very powerful psychic. Amazing."
"So, who wants first swing at me?" He stood smiling. He was ready for an easy fight.
"Why the hell not?" I said. He led me to the center of the room. He stepped on a button nearby. The ground rose up into a large area for us to fight. It was surrounded by a large fence. I got into a battle stance.
Lucario smiled again. I was afraid of him and he knew it. I also knew that dark type attacks were not that effective against fighting types. "Let's begin," he said.
Pokemon tf serum part 6 by wiiking9Watch
©2011-2016 wiiking9
Part 6! YAY! cliffhanger and stuff. Sorry i'm kinda out of it. uhhhh. I'm actualy dissapointed in you people. Not helping me accomplish my goals of doing good writing. shame on you for not doing the create a character. PLEASE i am really bad with coming up with characters. Especially in a story like that one! please!? anyway, yeah part 6.
How did you upload an image inside the text like that? I have a story that would look much nicer if I could put the character art in like that. :3
I honestly haven't uploaded on this new system, but I believe that you just have to go into the edit mode for your story and click on a small pencil icon it the top right area of the upload area. Out of the options it gives you, pick change preview image and pick what you want out of your folders. I hope that helps.
nice contrast, i haven't read the story yet but the picture is excellent
wow, great job, i also love the begining art
This is excellent!


text:
This gated contemporary home is located at 7460 Wildercliff Drive Nw in Atlanta, GA. It boasts 10,314 square feet of living space with 4 bedrooms, 5 full and 2 half bathrooms, formal dining... Read more
This contemporary home is located at 70 Larson Drive in Starwood, Aspen's only gated community and boasts spectacular mountain views. It was built in 2008 and boasts 7,940 square feet... Read more
This Tudor style home is located at 10300 Wildlife Road in Charlotte, NC and is situated on 4.27 acres. It was built in 2006 and boasts 6 bedrooms, 11 bathrooms, elevator, spa, gym, billiard... Read more
This elegant mountain estate, named Elk Crossing, is located at 170 Clay Lane in Aspen, CO and is situated adjacent to the East Owl Creek Ranch subdivision. Designed and built by renowned bu... Read more
This newly built shingle style colonial is located at 88 Livingston Road in Wellesley, MA. It boasts over 6,376 square feet of living space with 5 bedrooms, 6 full and 2 half bathrooms, form... Read more
The massive mega mansion located at 9577 Sunset Boulevard in Beverly Hills, CA may have finally sold. Known as Palais des Anges, the palatial 36,000 square foot home was last on the market f... Read more
This Mizner-inspired Mediterranean waterfront mansion is located at 23 N Beach Road in Hobe Sound, FL. It was built in 2002 and is situated on 1-1/2 acres. It boasts 11,801 square feet of li... Read more
This lavish 8-acre estate boasts a main house with 6 bedrooms, 7.5 bathrooms and an 8-car garage. The spectacular grounds boast 2 ponds! Think you know the square footage? Take a guess! Read more
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This Mediterranean Contemporary estate is located at 6347 E Royal Palm Road in the gated community of Villaresi in Paradise Valley, AZ. It was built in 2003 and boasts 12,998 square feet of... Read more


text:
This page features Wholesale Amethyst products suitable for gifts, display and home decor.
Pikes Peak Rock Shop is a wholesale distributor of fossils, gems and stone products selling direct to Rock Shops, Gift Shops and Souvenir Concessions. We require a minimum of $150 per U.S. order and $350 per international order.
These beautiful Amethyst druzes are all "A" grade and were chosen for their large deep purple points.
Now available in smaller price points!!


text:
"The failure of Lehman Brothers and the near-failure of Merrill Lynch raised the interest rate at which profit-seeking lenders were willing to lend to highly leveraged investment banks. The market thereby forced Goldman Sachs and Morgan Stanley to change their business models drastically and to convert to commercial banks. If that isn't effective regulation, what is? Protecting firms from failure (Bear Stearns, AIG, Fannie Mae, Freddie Mac, Goldman Sachs, Citibank) and mitigating their losses with bailouts renders this most appropriate form of regulation much less effective."
The president's confidence in his capacities is undermining confidence in his judgment. His way of correcting what he called the Bush administration's "misplaced priorities" has been to have no priorities. Mature political leaders know that to govern is to choose -- to choose what to do and thereby to choose what cannot be done. The administration insists that it really does have a single priority: Everything depends on fixing the economy. But it also says that everything depends on everything: Economic revival requires enactment of the entire liberal wish list of recent decades.
The implausibility of this opportunistic hypothesis is deepened by Obama's rhetoric, which says "catastrophe" impends unless everything is done simultaneously. But his budget, in effect, says the danger will soon be gone and the new risk will be whiplash from the economy's sudden acceleration. Although only a small fraction of the supposedly countercyclical stimulus will be spent by the end of the year, the budget assumes that by then the economy will have perked up, and that it will grow robustly -- 3.2 percent, 4 percent and 4.6 percent -- in the next three years. Growth supposedly will cut the deficit in half -- growth and the $1.6 trillion "saved" by first assuming, and then "canceling," a 10-year continuation of the surge in Iraq. Why, one wonders, not "save" $5 trillion by proposing to spend that amount to cover the moon with yogurt, and then canceling the proposal?
The first president whose campaign was his qualification for office continues to campaign. And he is overexposed. His schedulers should remember what a contemporary said of Thomas Babington Macaulay, a prodigiously articulate but oppressively constant talker: "He has occasional flashes of silence that make his conversation perfectly delightful."
One afternoon last week, cable news viewers saw, at the top of their screens, the president launching yet another magnificent intention -- the disassembly and rearrangement of the 17 percent of the economy that is health care. The bottom of their screens showed the Dow plunging 281 points. Surely the top of the screen partially explained the bottom.


text:
Bill Text — Jan 13, 2012
S. 1344 (112th): Arizona Wallow Fire Recovery and Monitoring Act
This bill's text for status Reported by Senate Committee (Jan 13, 2012) is now available.
GovTrack Insider, our Kickstarter-backed work to summarize bills in Congress, has resumed. Here's what we've been up to:
Jul 15, 2011
112th Congress, 2011–2013
This bill was introduced on July 15, 2011, in a previous session of Congress, but was not enacted.
Representative for Arizona's 1st congressional district
Read Text »
Last Updated: Jul 15, 2011
Length: 10 pages
To direct the Secretary of Agriculture to take immediate action to recover ecologically and economically from a catastrophic wildfire in the States of Arizona and New Mexico, and for other purposes.
The bill's title was written by its sponsor.
This is the first step in the legislative process.
This is a House of Representatives bill in the United States Congress (indicated by the "H.R." in "H.R. 2562"). A bill must be passed by both the House and Senate in identical form and then be signed by the President to become law.
The committee chair determines whether a bill will move past the committee stage.
There have been no roll call votes related to this bill.
Legislative action may be ocurring on one of these bills in lieu of or in parallel to action on this bill.
Reported by Committee
Last Action: Nov 10, 2011
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Civic Impulse. (2016). H.R. 2562 — 112th Congress: Wallow Fire Recovery and Monitoring Act. Retrieved from https://www.govtrack.us/congress/bills/112/hr2562
"H.R. 2562 — 112th Congress: Wallow Fire Recovery and Monitoring Act." www.GovTrack.us. 2011. February 13, 2016 <https://www.govtrack.us/congress/bills/112/hr2562>
{{cite web
|title=H.R. 2562 (112th)
|accessdate=February 13, 2016
|author=112th Congress (2011)
|date=July 15, 2011
|quote=Wallow Fire Recovery and Monitoring Act


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Very basic
posted 7 years ago
Basic information that would be good for small children or perhaps those that know nothing about piggies, but for any knowledge beyond the basics, you'll need to consult another book.
Pros: easy read
Cons: very basic information
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|Grassroots Gaming Expo 2012
|News Releases - Sports & Recreation
|Written by Josh Bolinger
|Monday, 01 October 2012 07:45
Entering it's second year, again being held at the Bridge View Center in
Ottumwa, Iowa, the goal of Grassroots Gaming Expo is to promote gaming in
a positive light by giving people the opportunity to experience gaming in
all forms, from it's inception up to present day, while encouraging
positive social interaction.
The Grassroots Gaming Expo is a three day gaming event that celebrates not
only video gaming, but also pinball, tabletop and card games as well as
film. There will be a little bit of everything for everyone at The
Grassroots Gaming Expo. This years expo will feature several firsts. A
Kansas City based company, Gaming Consoles Worldwide will be releasing
their new handheld console, the GCW Zero, to the public for the first
time. It will also be the first time the public will be able to play
Busterball, an iOS title being developed by the local company, Full Sea
Productions. Twin Galaxies International (the official scorekeeper for
the video game industry) will be premiering 14 new trading cards in their
Video Game Trading Card set. Many of the new cards feature celebrities of
the gaming industry that will be in attendance. There will also be a
world premiere trailer for the film, Dungeons & Dragons: A Documentary,
which covers the history of one of the worlds most popular and
revolutionary games.
Grassroots Gaming Expo 2012 will also include many of the things that made
it successful last year. There will be an even bigger BYOC (Bring Your
Own Computer/Console) area, over two dozen tournaments including arcade,
classic console, modern console, PC and new for this year will be a Rock,
Paper, Scissors tournament! There will be 60+ console and arcade games on
free play the whole weekend along with more than a dozen gaming related
films. All day Sunday (Oct. 14) will be Family Fun Day, which will
include games and activities geared towards younger children with a focus
on family participation.
As you can see, there something for everyone at the Grassroots Gaming Expo
This event is being organized and ran by Liz and Josh Bolinger, who have
several years
experience planning and running successful gaming events including
Grassroots Gaming Expo 2011 and the International Video Game Hall Of Fame
And Museum's Launch Party in 2009, which had over 3,500 attendees.
This years expo is scheduled for October 12-14, 2012 at the Bridge View
Center in Ottumwa, Iowa. It will be open from 10am to 10pm on Friday and
Saturday the 12th and 13th, and 10am to 5pm on Sunday the 14th. Weekend
passes for the event are available for $20 online at
www.GrassrootsGamingExpo.com. Single day passes are also availble online
or at the door.
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text:
5 Epic Tech Fails
Yep: These dumb things really happened thanks to "smart" devices.
When a Twitter hacker rocked the stock market
When Apple Maps put people in jeopardy
When Motorola shared personal data
When the Super Bowl had a blackout
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When the Segway didn't catch on
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A group dedicated to operators of the IC-718 HF rig and anyone else interested in the rig or Ham Radio in general.
The group is currently open without moderation. Play nice!
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Type: Posts; User: St810s; Keyword(s):
I was pretty indifferent about the video until it started driving Hawk fans crazy. Now I love it.
I'm with ya. That said, do you start Evans or Lockett this week? It is playoff time, so I don't want to gamble too much. But Evans is so hit and miss and the Seahawks offense is humming right now...
Cat Barber, NC State
Did they not have to sit out this year?
Tayshaun Prince? Long, lanky frame and skilled.
Health screenings, individual consultations, store tours, healthy cooking classes, community events, private or corporate lectures, fat shaming, etc.
(Source: married to a Hy-Vee dietitian)
The people that want Hornacek instead of TJ are probably the same people that were ****** when we hired Hoiberg instead of Billy Gillespie. I don't really care about resumes. I just want someone that...
100% Fresh on Rotten Tomatoes after 31 reviews. Sounds like I'm going to need to see it this weekend...
French Bulldogs have pointy ears. Pugs do not. No pugs in this video. Which is a bummer, cuz they are awesome.
French Bulldog:
The guy said that some kid is going to transfer to ISU. If said kid then transfers to ISU, in what way is he "wrong"?
According to KenPom, South Carolina will be our 2nd most difficult non-conference game behind only Maryland. Don't be surprised to see a low point spread from Vegas.
Question for the fantasy gurus:
If you've got a 2-3 point lead in your matchup and all your opponent's players have played, do you bench your last remaining player (even if it's a stud) for their...
Self: "Alright guys, we've got two plays tonight. For Play A we'll have our 5'9" point guard crash recklessly down the lane and throw up a prayer that hopefully won't get blocked."
Frank Mason:...
Where was KU's spacing last night? They just kept pounding it inside where UK had 3 7-footers waiting for them. It got pretty ridiculous after a while. If they had any shooters at all and some decent...
Futurama - Original run
Archer - Close second
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State focusing on pet store compliance
Published: Wednesday, December 1, 2010 at 9:07 a.m.
Last Modified: Wednesday, December 1, 2010 at 1:19 p.m.
A statewide sweep of pet stores is under way this month to make certain the stores are complying with laws designed to protect consumers.
Tips to consider before buying a pet:
- Don't buy on impulse. Research the size and breed of the animal for suitability with your lifestyle and circumstance.
- Examine the health certificate that is required to be presented upon sale for completeness and compliance with the law.
- If there is a problem with your pet after purchase, contact the seller immediately.
For more information or to file a complaint, contact the Division of Animal Industry at 1-800-HELPFLA (7352) or 850-410-0900.
Source: Florida Department of Agriculture and Consumer Services
Florida Agriculture and Consumer Services Commissioner Charles H. Bronson said officials will be looking for specific things.
For example, officials will be determining whether dogs and cats sold by a store are at least 8 weeks old. They will also by looking for proof that the buyers received a health certificate signed by an accredited Florida veterinarian documenting that the animal has had its required vaccinations, tests and treatments for internal or external parasites.
Officials will also look for is informational handouts stores are required to give buyers that concern their rights, including the right to return and animal or be reimbursed for specific veterinary expenses.
"Pets bring a great deal of joy to families and are often a considerable investment," Bronson said in a news release about the sweep. "So it's important to do business with a reputable pet store or dealer who knows and follows the law to avoid problems from occurring after a purchase of an animal."
Reader comments posted to this article may be published in our print edition. All rights reserved. This copyrighted material may not be re-published without permission. Links are encouraged.


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One of the last PC games I remember playing was Quake 2 – I know I know, it's been a while. The wizards over at http://www.innoveware.com/ have converted this classic into Silverlight – amazing!
Oh yeah and now they want to know what you want them to work on next!
Just wanted to let you know that this is Quake 1, the original and not Q2. ;)
Keep up the good work, love the blog!
cheers Michael - I told you it'd been a while since I played :-)
ditto on your blog dude!


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Getting Involved
Raising awareness about global hunger can be as simple as joining a local hunger coalition or organizing a food packaging event in your community. To find out about more ways you can help, visit the official World Food Day website.
(Photo: GettyImages)
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The 411 on Young People and HIV/AIDS 04/10/2015
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Global Week in Review: Iran, US Talk Historic Nuclear Deal 02/23/2015
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World Lens: Deadly Blast Destroys Mexico Maternity Hospital 01/29/2015
Haiti Uncovered: 6 Photos of the Island's Cuisine 01/27/2015
World Lens: Ebola Vaccine Study Set to Begin in Liberia 01/23/2015


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Serious Decorating Inspiration!meryllevin
I love, love, love Design Sponge (one of the first and best blogs dedicated to all things home and design). So imagine how excited I was to discover their post on amazing kids rooms. There are some seriously cool, unique, clever, and cozy spaces, and a ton of interesting ideas to steal.
Can you get over this tree mural peppered with actual birdhouses? Talk about a fantasy for little girls. But what really makes this room gorgeous is the brave mixing of patterns on the pillows, blankets, rug, and accessories. With so much to glean from just one picture, imagine what you'll get out of the 30 (!) rooms included in the post. See a few more teasers after the jump.
The colors in the room above are unreal, and I love the corner placement of the bed. The room below is a great lesson in making the most of a tiny space. It doesn't feel cramped at all, just clean and cozy, even airy. See the whole roundup on Design Sponge.
Photos: Design Sponge


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Calico Rock Pet-Friendly Lodgings
Jenkins Motel
376 W. Arkansas 56
Calico Rock, AR 72519
Category: Hotel
Policy Confirmed 2014-06-02 | Update this Pet Policy
Update Pet Policy
Please use this form to update this pet policy with regard to pet fees, deposits and size restrictions–or if the lodging is no longer pet friendly.
Looks like no one has submitted a review yet. Be the first to submit your review. You'll be at the top of the list. Cool.
For more information about Arkansas - Toll Free # (800) 628-8725


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Woah, this is awesome. I love the background and the person and the animals.
WOw dude. really
Very miyazaki - reminds me of Ponyo
I thought the same exact thing haha
Like that scene where her and Sasuke are looking for his mom and it's all covered in water
Like that scene where her and Sasuke are looking for his mom and it's all covered in water
Wow, there is such a sense of dreams, childhood, and wonderful imagination in this. Really love it, there's something a bit magical about them staring into the light
Omg I wanna ride tooooooo!!!!!!!!! Scoot ovah make room on da turtle!!!!!!!!!
What a beautiful way to travel through a post apocalyptic swamp!
I'd love to be that traveler *.*
We done
We done
this is wow!!!!! i see so much :]
This is a really amazing artwork.. the concept, the colors, everything about it screams of imagination and absolute possibility.. something like this, though maybe not in the major cities, is a definite possible outcome for rural country areas.. i mean, with the global warming and water levels rising and all, this is possible..
but like i said, this is absolutely amazing!
but like i said, this is absolutely amazing!
Sooooo many Talent!!!
Did you use Hubble photographs for the lens flare? Looks awesome!
The lighting in this made me smile.
This reminded me of the scene in Ponyo with the boat!!!
It makes me think of "Oasis" in Fallout 3. But better!
It makes me think of "Oasis" in Fallout 3. But better!
Luv it!
waaah! poetic and rich. the road sign gives rise to a little melancholy.
That's one beautiful and mesmerizing drawing .. did i mention so adorable too ^_^
Really awesome.
This is such a fantastic concept. I would love to see this idea be made into a movie!
make me thinking of Ponyo
Beautiful. Tranquil, but with a sense of anticipation, exploration - journeying into a familiar unknown.
This sort of reminds me of Hayao Miyazaki's Poyo. Well done.
Love it
you are very imaginative
like it,very,very much
like it,very,very much
definitely artist like you that inspire me to study more and more. I want to be like you when I grow up!.... jejeje
The effects from the light mesmerize me. <3
thats just too awesome! seriously... this forest is mesmerising (:
magical feel
What a great imagination you have. Lovely piece.
I feel like Hayao Miyazaki could take notes from the worlds you create. You're amazing!
I really like this. And those little ducks are so cute!
great work man
Ohhh... I just like these little yellow ducks. They are supercute...
The whole idea is geat. The clous are calm and just RIGHT.
Thank you for your work.
The whole idea is geat. The clous are calm and just RIGHT.
Thank you for your work.
A beautiful, whimsical, just plain lovely work. It has a bit of a dark feel to it as well. I like the work and theme very much.
Wow!..... awe...this...tis is just awesome!!
The little duckies are just the perfect touch!
This little person with the umbrella is so adorrable and the colours and lights are perfect, i love your picture!
I love the mood you set with the color. Beautiful. Reminds me of my youth.
Quote: "you wont stop me you stop sign yoU!''....
so cool, hope i survive to see it
Its brilliant!
breathtaking is what i would describe your work. completely.
the picture make you feel nostalgia.
Beautiful work. It reminds me of a few animes I love. and the odd and sinking / sunken objects add a dash of either surreal or post apoc to the scene.


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On 12 October 1990, Ralph Nader gave a talk on "The Relationship Between the University and Business and Industry" as part of Wayne State University's conference, Ethics and the University. The talk was vintage Nader, a loose argument supported by hundreds of particular details, presented without notes. The conclusion was a call to arms: declining federal support of scientific research has tempted institutions of higher education (hereafter "universities") to turn increasingly to business for help. Particular universities, even particular departments, have forged links with particular businesses. Business interests are taking over the university. The university will lose its soul unless it again becomes a place apart, a source of independent research and impartial judgment. The link between university and business must be broken once and for all.
I was one of two academics asked to respond. My response was not exactly a refutation. Nor will this descendant of that response be. Nader spotlighted an important problem, but he also, I believe, misunderstood it. He did not pay enough attention to its context. In context, the problem is more ambiguous than he made it out to be, and better contained through innumerable small decisions than resolved once and for all, a problem for university administrators rather than for an Old Testament prophet.
What should university administrators do? They should, I shall argue, approve many of the contracts by which university and business create the links Nader fears. However, they should also help formulate general policies governing such links, distinguishing clearly those links with business universities ought to allow or even encourage from those they should discourage or forbid. This chapter may provide a starting point for making such distinctions.


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Teaching in Parables
The Bible does not say that there are secret truths that only certain believers can find in Scripture. Those things that we do not see upon our first reading of a text are not invisible; rather, incomplete knowledge is often ...Read More
The Everlasting King
Because God's kingdom is everlasting, we can be confident that He will overcome all of His and our enemies. No foe can outlast Him, and nothing will ever cause His throne to fall. We should therefore be unafraid that ...Read More
The First Gospel
The protevangelium, or first gospel, of Genesis 3:15 declares that God's kingdom will once more be present in its fullness when Satan is destroyed. Christ came and dealt the crushing blow to the Devil, triumphing over him and ...Read More
The Future Consummation
The responsibilities laid upon us can distract us, preventing us from contemplating the future consummation of God's kingdom. In celebrating the Lord's Supper we are given a special opportunity to reflect on the new creation that is coming ...Read More
The Good News of God's Reign
Restoration requires faith in the Lord, but we are not able to muster up in ourselves faith that will persevere to the end. We need an atonement that covers even our unbelief, and God must create in us new hearts ...Read More
The Gospel of the Kingdom
With the coming of Christ, the kingdom of God is now evident among His people even as we wait for its final consummation at His return. The gospel announces that Jesus has done the work necessary to overcome our natural ...Read More
The Joy of Everlasting Life
Knowing that we have everlasting life comforts us because we know that it is a life grounded in the perfect righteousness of Christ and, therefore, secure forever. It also comforts us because we know that we will experience righteousness, peace ...Read More
The Messiah's Kingdom
Ambrose of Milan comments on today's passage, saying Jesus "is the Lord by nature but a brother by grace" (The Patriarchs, 4.17). God is not a person with whom contact is impossible; He is not "wholly other." Without ...Read More
The Poor in Spirit
Elsewhere, Jesus speaks these same words to the poor (Luke 6:20), because those who have nothing are often able to see their need for salvation most clearly. Still, one does not need to lack possessions to see the kingdom ...Read More
The Second Petition
Today, God's special kingdom of blessing is manifested primarily in the church. It is through the ministry of Word and sacrament that we learn what it means to bow the knee to Christ as Lord. Furthermore, it is through the ...Read More
Tying It All Together
Even though the Bible is filled with a variety of voices and was written over the span of nearly two thousand years, its inspiration by God the Holy Spirit has given it a unity that transcends its variety. There is ...Read More
What Should We Pray For?
Our compassionate and gracious God is far more concerned about our essential needs than we can ever know. That is why we should not be afraid to mention even those needs that we consider the most insignificant whenever we talk ...Read More
‹ Previous 1 2 Next ›


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|Reviews for Argos
| lookingwest chapter 1 . 2/11/2013
Opening - After reading through the entire thing, I had to go back to remind myself what the opening was - I don't think it was as memorable as the end. But in that regard, I do like how you start with the image of Paul smoking and the snow. I liked the dialogue exchange between Cashel and Paul too - I thought it was well written. It had a good cadence and intriguing subject that made me want to learn a bit more about Paul.
Character - I don't really like Paul as a person/narrator. He reminds me of Raymond Carver's narrators a bit - kind of secret assholes who keep to themselves. He wasn't very nice to Kitty or likable in that since, and he had weird generalizations about women liking animals that die - but that foreshadowed the end well. I think you did a good job crafting the unlikable narrator. That's a skill within itself, and it's achieved well here. It's more in his actions and I liked that quality.
Enjoyment - Overall, I liked this piece. I think you did a good job weaving back and forth between Paul and Kitty & Paul and Cashel. That's really the showcase technique of this piece in the writing and I didn't have trouble following it. I remember - I think you're the guy who liked stream-of-consciousness stuff, yeah? The flow of this was reminiscent of that technique. I also enjoyed the motifs you were able to string through the piece too - the sheep, the buddha, the rabbits. There was a motif of small creatures in this that was interesting to follow and see woven into the narrative.
Ending - Enjoyed the ending - I think it came about quite naturally, especially when we get so much dog imagery earlier in the piece with the Labrador and the rabbits. Everything seemed to come together thematically at the end and I liked the grizzly image of the dog still half-alive after the accident. It was chilling and compelling. I almost wonder if the last line should be its own paragraph for some extra punch, but generally I think your last closing paragraphs work well.
When got back he had known - typo


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Good looking
posted 7 years ago
Dogs need warm for winter and need a windbreaker for warmer weather. The wind can be pretty chilling and esp. if your dog is wet.
This windbreaker is neat. Camoflauge...military design. Gives a different look than other dog clothing. But! Do not take your dog in the woods wearing this. Camo.
A drawback is this jacket does not cover much of the dog's back. Otherwise, nice.
Pros: Camo!
Cons: None
0 of 0 people found this review helpful.
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Love this brand
posted 7 years ago
I love all of the pet clothing that Dicken's Closet offers. They have a wide variety of clothing to give your furry friend that added warmth and protection from the elements. I got this camoflauge windbreaker for my parents dog. She is a Shih-tzu mix and I thought it was so cute to see such a cute innocent little dog in a camo coat!
Pros: cute, affordable, added protection for your pet
Cons: nothing
0 of 0 people found this review helpful.
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posted 7 years ago
This is a wonderful accessory if your dog needs protection outside! My neighbor dresses her little terrier up with this windbreaker on extra blustery days. Now my 95 pound Bernese would have said 'no thanks Mom!'.
Pros: protective
Cons: none
1 of 1 people found this review helpful.
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Love Dickens' Closet
posted 7 years ago
Dickens's Closet not only provides the cutest tends for jackets, but they are practical and fit.
My Greyhound need a jacket in the winter and she loves to put on her comfy puffy jacket. She jumps around and prances once she has it on.
The jacket fits excellent as well.
Pros: Fits great
Cons: none
0 of 0 people found this review helpful.
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Our lab wears it unwillingly
posted 7 years ago
Really what dog likes a coat? He is hot natured so when we put this on him, he did not like it. It fit him very good but he was not impressed with it.
Although the weather here does not call for a coat like this, we thought it was cute and when needed he will wear it.
Pros: We like it
Cons: Lab does not
0 of 0 people found this review helpful.
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June 8, 2015 | By Lynn
I've used this product on rescued dogs for years. My last large dog rescued had been an outdoor dog her entire life, living among Lamas where she picked up tapeworms. This product expelled several 2 … more ›
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July 14, 2013 | By Xiaoxiao111
Pink is my favorite color these are wonderful.I will recommend a good website fou you: www.9footballshirt.org


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A CLOSER LOOK: Your smartphone or tablet almost certainly includes a camera or two. The Micro Phone Lens is a tiny pliable lens that sticks to the device without adhesive and turns it into a microscope. The first model magnifies by 15 times, but a new lens in the works will magnify up to 150x. Focus by moving the camera. Once you've finished magnifying things just peel off the lens and store it in its case that can also be used as a stand. Simple.
LOOK, NO WIRES: Wireless charging usually needs to the device to be within a couple of centimetres of the emitter, and the power output can be low. Now researchers at the Korea Advanced Institute of Science and Technology have developed an inductive wireless charging system than can beam power up to five metres away.
A new mechanism called the Dipole Coil Resonant System makes the extra distance possible. One magnetic dipole induces the magnetic field while a secondary coil receives the electric power. At the moment the prototypes are too large to power a phone, but the system could be built into a home or office to power larger equipment such as TVs or fans. Better check the health risks first.
LIGHT AND BRIGHT: On the island of Jersey new street lights should help halve the power bills and have an impact on safety. They're switching to LED lights which use one third of the energy of conventional bulbs, and which should last for 100,000 hours without significant maintenance. Some lights will also be dimmed between midnight and 6 am. Officials also say brighter lights could improve safety of pedestrians wearing dark clothes. Though bright lights can also temporarily blind people and make it harder to see into the shadows.
SKEWED DATA: The Street View in Google Maps often includes images of house numbers that the map needs to interpret and use to help pinpoint locations. One problem though is that house numbers come in all kinds of shapes and forms, including being distorted and made blurry by capture angles. On the other hand, some websites use images of deliberately distorted text known as CAPTCHAs as a barrier to spammers, on the assumption a human being will successfully decode the text while a script won't. And we all know the frustrations of how that works out in practice. It turns out that Google's software can decode those distorted house numbers with 90% accuracy, unlike us mere humans. So who's got things back to front now?
THAT'S A SHOCK: In Japan your doctor might have you wear a LifeVest if you have heart problems. The LifeVest cardioverter defibrillator has 2 sets of electrodes. One set measures electrocardiogram, while the other delivers treatment shocks as required. If the vest detects a a life-threatening heart rhythm it automatically delivers a treatment shock in order to restore the normal rhythm. The vest is essentially a strap around the chest, held up with a halter, and an attached hardware device that can clip on to the belt. It may be of particular use for people with newly diagnosed heart failure. That could give a lot of people both peace of mind and new opportunities for daily life.
Miraz Jordan, knowit.co.nz


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Islamic Banking In India
Rashmita Padhy
Member Level:
: 15
Islamic banking is based on the principles of Shariah. Though at today's context it is not acceptable in India but tomorrow it may find its supporter.
• Islam, just like any other religion believes in the theory of peace and co-operation in all the good deeds.
• Islam also have it's restrictions on gambling, consumption of alcohol and pork.
• Their holy book The Quran suggested that human beings are created to represent the God on earth.
The above mentioned points are some of the basic rules of Islam. The concept of Islamic Banking is built based on these principles.
What is Islamic Banking?
As I have already mentioned in the introductory part, that Islamic Banking activities are very much in consistence with the principles of Islam rulings
. The principles more or less emphasizes on the moral and ethical values.
Islam says those who have wealth should share that with the needy ones with the sole purpose to please the God. By doing this, they can enhance the wealth of the society. It also means one should not lend money by charging interest. Based on this, the most basic and the important feature of the Islamic Banking have been formed,
"prohibition of interest"
. Now the concern is, if no interest has been charged against any loan than why some one will lend you. Bankers are very much confident in putting the statements like, if no interest has been provided for any investments than the investments would dry up!
Everyone knows interest is the reward for saving. So, the question is how the banking system would function if the interest is abolished by law? To understand this, we need to know the Islamic principles in a much detailed way. There are two more Islamic words, we should understand fully in order to know more about this banking system. One is
, the other is
Riba is the payment of charges for renting of money. When somebody borrows money from other, after a certain period he has to pay back the principle to the money lender as well as he has to pay an additional charge to him as compensation. This particular amount is calculated based on a pre-determined rate. This particular payment is a compulsion on the borrower irrespective of the loss or gain he made from that amount. Here the money lender has nothing to lose. This is completely forbidden by Islamic holy book. So, Islamic Banking completely outlaws the use of Riba.
Islam suggests that reward should be there only for bearing the risk of the business. So, Mudarabah is the reward for bearing the business risk. So, if some one borrows money for a particular use and gains from that than he should pay a share of profit to the money lender. It is a kind of business partnership. Though the money lender will not use his business skills but he bears the risk of loss. This is the principle of Mudarabah, which is completely acceptable by Islamic rules.
Now consider this further; when you deposit money in bank's investment account and agree to share the profit, the bank got its fund for investment. And when the business owner takes loan from the bank, the underlying condition is he has to share the profit that he will get from business in a mutually agreed proportion. But any loss from the business will be solely borne by the bank. So, the bank will function as a capital provider and the borrower as manager.
It can be stated as the difference between the regular banking and Islamic banking is reward on a predetermined rate and reward as a share of profit respectively.
Islamic banking also does not allow investing in any activities which is prohibited under Islamic rules.
Islamic Banking In India
In the year 2005, RBI has been ordered by Indian Govt. to look into the feasibility of the Islamic banking system in India. After a year long research and observation, RBI concluded that with the current banking framework, it is not possible to implement the Islamic banking system in India. So, in order to bring in the concept of Islamic banking, there need to be made certain amendments in banking regulation act of India.
Post this announcement, a group of Islamic experts and bankers chalk out a plan of action by taking the suggestions from UK, Malaysia and Singapore.
RBI on 20th May 2010 announced that with the current banking principles it is not possible to adopt Islamic banking system but it can be done through a separate legislation.
In Septemeber'10, Govt. of India once again makes its stand clear while informing the Kerala high court that under the present scenario it is not feasible to implement the Islamic banking system in place.
As far as my opinion goes there is nothing controversial creating a banking system based on some particular religious law. The interesting part is this kind of banking system is not restricted to the Muslims only. Anyone who follows the basic principle of Islam can take part in this system. And legally speaking, a contract of money lending with an intention to share the profit is not wrong at all. We have seen these kinds of practices in most of rural areas.
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