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references to statutes and decisions which are almost identical with references to be found in former compilations. As contrasted with the extent of the new compilation, the instances cited in the brief of the appellant are not so numerous, and of such character, as to justify the interference of a court of equity. The legislature having determined that the public interests required a new compilation of the laws of the state, and the work having been completed, the court should not interfere by injunction, unless the right to the relief asked is clearly manifest from the evidence. In our judgment, the plaintiff has not made such a case as would justify the interposition of a court of equity by injunction. The order denying the injunction is affirmed.
ELEOTRIC CAR CO. OF AMEIUCA et al. v. NASSAU ELECTRIC R. CO. (Circuit Court of Appeals, Second Circuit. No. 98.
December 7, 1898.)
The Condlct patent, No. 393,323, for a controlling switch for electric motors, was not anticipated nor affected in its scope by the Paine patent, No. 321,749, for a method of regulating electric lights, and Is Infringed by a d"vice In Which, when a change is made from series to multiple, instead of the resistances being cut in preparatory to the time of changing the connections, they are cut in during the transitional positions which result In a change from series to multiple.
Appeal from the Circuit Court of the United States for the Eastern District of New York.
On final hearing of the bill In equity of the present complainants against the Hartford & West Hartford Railway Company In the circuit court of the United States for the district of Connecticut a decree was entered by Judge Townsend which declared that claims 20, 21, 22, 27, 28, 29, and 31 of letters patent No. 393,323, dated November 20, 1888, issued to George Herbert Condiet for an Improvement In switches for electric motors, had been infringed by the defendant's use of electric car controllers manufactured by the Walker Company, and known In the case as types Bl and B2, and directed an injunction. 87 Fed. 733. In a bill In equity which was thereafter brought by the same complainants against the present defendant In the circuit court of the United States for the Eastern district of New York, an order was entered by Judge Lacombe which directed a preliminary injunction upon the sanie claims against the use of four forms of electric car controllers used by the defendant. 89 Fed. 204. This appeal \s from that order.
George J. Harding, for appellant. Frederic H. Betts, for appellees. Before WALLACE and SHIPMAN, Circuit Judges. SHIPMAN, Circuit Judge. A "controller" is the easily recognized cylinder-shaped electric mechanism of an elecrtric car at the left hand of the motorman, which is operated by a handle which is constantly being swung to and fro, and is the visible means by which the speed of the car is retarded or is promoted. The controller, as a whole, is a device for regulating or controlling the current delivered to an electric motor, and thereby regulating the speed of the car. Before the
date of the Condict patent, there were two'different methods for regulating the supply of the current. "Originally," Judge Townsend says, "the supply was regulated by coils of wire known as rheostatic or resist· ance coils. These coils were either switched in series into a single wire circuit carrying the current from generator to motor, or into paral. leI or multiple wire paths or circuits. In the first, or series arrange· ment, the total resistance was the sum of the number of coils; in the second, or parallel arrangement, the total resistance was decreased in proportion to the number of parallel paths. This method, known as the 'rheostatic,' or dead resistance, method, was defective because of its waste of energy, inasmuch as the potential thus obstructed and not expended in propelling the car was converted into heat, and lost." The second method was that called "the series parallel control" method, which substituted for these resistance coils the coils of the motor, and changed from time to time the connections of its circuits. This method of control was impracticable for two reasons, which are clearly stated by Mr. Jenks, one of the complainants' experts, as follows:
"First. If changes of circuit connections involving large changes of internal resistance were made, the electrical and magnetic disturbances incident to such circuit changes were too- severe to be borne by the apparatus, and were often dangerous to the motorman and passengers on the car. Second. If the possible circuit changes were so numerous as to. involve only slight and very gradual changes of internal resistance, the apparatus became too complicated for practical uses, and the numerous and various magnetic changes involved in a system of this kind were too serious to be borne by the apparatus, as a matter of constant practice."
Condict combined these two methods, and says in his specification that, in order to overcome the dangers incident to a change of motor connections, "I have constructed my switch so that at the time of changing the connection I insert resistances more or less great according as to the resistance of the motor connections; that is to say, if the motor resistance is great, the auxiliary resistances would be small, and vice versa. I also so arrange the switch that the resistances are all cut out of circnit as soon as the new motor connection is made. Their function is to reduce the current :flowing, so that at the time of making the change in the motor connections the current is small com· pared with what it would be if these resistances were not inserted; and, furthermore, these resistances are gradually cut in and out, so as not to suddenly change the resistance to the current beyond a given amount." His controller therefore utilizes each system by the move· ment of one handle, so that the shock which would be caused by a sudden change of motor connections is prevented by the introduction of dead resistance before or at the time of such change. The switch can also be used for slight changes in the resistances "when slight variations in the speed or power of the motors is required." The specification thus describes a main and a minor invention, and contains two groups of claims, one of which comprises claims 27, 28, 29, and 31, wherein the main invention was described. The minor invention of the second group, comprising Claims 20, 21, and 22, consists in the use of resistances for slight variations in speed which are cut in and out, as formerly, but "in a switch combination which embodies the main invention." These claims are as follows:
"(20) The combInatlon of a source of electric energy, the coils of one or more electrlclllotors, a swItch for connecting said coils in different ways to val:ythe moitor re,sistance, one or mqre ,resistan,ces,. and a switch to put said resistances. info or, out of the motor without. changing the motor connections to vary the power of the current fiowingthrough the motors. "(21) The combination of a source of, electric energy, the coils of one or more electric motors, a flwitch for connecting' said coils in different ways to vary the motor resistance, andOI;le or more resistances; said switch being adapted to put the said resistances in succession into or out of the motor circuit without changing the motor connections to vary the power of the current flowing ' through the motors. "(22) The combination of a source of· electric supply, a switch for coupling up the calls of a motor or motors iu .l;L predetermined order, a series of resistances, a contact block on said switch in circuit with the motor and resistances and having contact edges for cutting in or out the resistances one at a time, contact brushes for sald resistances, and connected to the source of electric supply, and r.esting on the contact block, and adapted to be brought into or out of COJ;lt/lct with it in succession, whereby the resistances may be Ipto or out of the motor circuit without varying the connection of the motor' colls." "(27) The combination of an electric motor, a source of electric power, a motol"(lircuit, a motor switch to vary the power of the motor, two or more resistances, a resistance switch to cut said resistances gradually into or out of the'motor circuit, and a connection between the ,sald switches, whereby a movement of the motor switch will first cut in one or more of the resistances, and, after .changing the power of the motor, .ll,utomatically cut the resistances out ofclrcuit agaln.. ,. "(28) '.rhe combination of a motor llaving separate colls, a motor circuit, a motor switch for coupling up said coils so as to vary the internal resistance of the motor, a resistance, and a resistance switch to cut in and out the said resistance upon shifting the motor switch to vary the coupling of the motor , . colIs.. . "(29) The combination of a motor having separate coils, a motor circuit, a motor switch for coupling up said calls so as to vary the internal resistance of the motor, a resistance, a 'resistance switch to cut in and out the said resistance upon shifting the motor switch to vary the coupling of the motor coils, 8.lldmeans controlled by the motor switch for operating the resistance switch." "(31) The combination of two motors, a source of electric power, a motor circuit,· a switch for coupling the calls of the motors in series or multiple to vary their internal resistance, a resistance, a switch to insert the resistance when the motor switch is being shIfted. and a connection between said to operate both simultaneously."
The ultimate question upon this appeal is whether the four varieties of the defendant's mode of regulating the current are within, the patent as the record enables us to construe it. The defendanfs contention is that the danger which Condict wanted to avoid was that from sparking, which arose from the fact that at the time of changing the motor cOnnections the resistance of the motors was more or less cut out,and that to overcome this danger his invention was an insertion of resistances, So that,' before the motor switch had effectively moved, there were in place dead resistances in the circuit. It is asserted that this method is the one literally stated in claim 27, "whereby a movement of 'the motor switch will first cut in one or more of the resistances," and thafthe language in the other claims of the same group, ''before shifting the motor switch/, or "when the motor switch is being shifted," means an insertion preparatory tocii'euit changes, or before the switch has moved· sufficiently' to disturb the motor connections. There is no doubt that the danger from sparking was the great one present in the
ELECTltlC CAR CO. V. NASSAU ELECTRIC R. CO.
patentee's mind, and that the insertion of a resistance prior to a changp. of connection is probably the best way in which to use the mixed system. The question of construction upon this appeal from the order of Judge Lacombe is whether, as construed by Judge Townsend, or-the record in the Hartford Case not being before us-whether, in view of any additionallight which is presented in this record, the claims tie up the invention to a particular order of time, and exclude an insertion during the brief period of time while the handle is being continuously moved to effect the rearrangement of the motor circuits. The language of Judge Townsend's opinion does not speak with precision upon this emct question. We think that it was one of the questions before him upon the subject of the extent of the invention and of infringement. He, however, enjoined the use of type B\ in which a resistance was not introduced anterior to any rearrangement. There was no break in the current. One motor was cut out, whereby the entire current was thrown upon the other. The first motor was then reconnected in parallel, and in the act of shifting connections resistance was introduced, so that too much current should not be thrown upon the single motor. Judge Townsend defined his construction of the patent by the conclusion that the defendant's IP was the mixed controller of the claims in controversy. Does the record upon this appeal indicate that Judge Townsend's construction was either erroneous or of doubtful validity? It cannot be denied that Condict's combination of two existing systems for regulating the supply of current to an electric car motor was previously unknown, and that the invention was of much importance. It is also true that in his specification and drawings he shows four progressive ways or positions in which the coils of the motor are coupled, and that in changing from the first position of broken circuit to the second position of open circuit, a resistance coil is switched into circuit. The patentee also said in his specification: "It is evident that, while only four ways of coupling up the coils of the motor are known, a large variety of connections might be made involving the same general principles." It is also obvious that the mixed controller systelll is in use, whether the insertion is preparatory to or accompanies the shifting of the motor switch, and that in all the forms used either by the defendant in this case or by the defendant in the Hartford Case auxiliary resistance was brought in at the time of making the change to parallel, by which we mean during the series of transitional movements which are made without stopping for an appreciable time and which effect the change in the conl).ections of the motor. This is true, notwithstanding the fact upon which the defendant relies that the counter electro motive force which is developed by the motors in action sets the current back, and creates resistance; but the character of that kind of force is variable, and dead resistance is in fact needed to be somewhere used to protect the motor from too sudden shock. There is, and there must be, a substantial use and an enjoyment, more or less partial, of the benefits of the Condict idea and system, although the insertion of the dead resistance takes place during the transitional positions which result in a change from series to multiple. If, however, the specification requires, or the claims demand, a limitation of the
patent to a preparatory insertion of dead resistance, the claims must be construed accordingly. Claim 31, which perhaps describes the principal invention with as much precision as anyone of its group, calls for a switch for coupling the coils of the motors in series or multiple to vary their internal resistance, a resistance, a switch to insert the resistance when the motor switch is being shifted, and a connection between said switches to operate both simultaneously. The invention of the resistance is not required in this claim to anticipate, or to be preparatory to, or to be previous to the change of the circuit connections, but can be made when the change is in progress. Claims 28 and 29 call for a resistance switch to cut in and out the resistance upon shifting the motor switch to vary the coupling of its coils, and, so far as the time when the insertion of a dead resistance is to be made is concerned, do not differ from claim 31. The defendant uses four methods of coupling for the purpose of regulating the current. In form 3 a resistance is introduced before the motor connections have been disturbed, and half of the reSistance remains in the circuit after the change, and the form is conceded to infringe claim 27 under the present record. It also infringes the other and broader claims. In form No. 1 the motors are in series in the fourth position, are reorganized and are in multiple in the eighth position. In the fifth position one motor was cut out of circuit, dead resistance was interposed in positions 5 and 6, was cut out and the motors thrown into multiple. In form No. 2 the motors are at series in the fourth position, and are at multiple in the eighth position. Positions 4, 5, 6, and 7 are the same as in form No.1, and resistances are used in positions 8 and 9, in which the .motors are in multiple. The resistances are not removed at position 8, but are withdrawn during changes 9 Jl-nd 10. The positions from 5 to 9, inclusive, are transitional positions. In form No. 4 there is no resistance at position 4 where the motors were in series, the circuit was opened in position 5, and in position 6 the external resistance appears with the motors in multiple. During the reorganization, and simultaneously with the change from series to parallel, the resistance was introduced. Forms 1, 2, and 4 are an infringement of claims 28, 29, and 31. One assignment of error is that the Nassau controllers Nos. 1 and 2 employ substantially the method of control described in the patent of W. & J. & S. B. Paine, No. 321,749, dated July 7,1885, for a method of regulating electric lights, a patent which was not considered by Judge Townsend in the Hartford suit. The object of the Paine patent is said by the appellant to gradually vary the illuminating effects of a number of incandescent electric lamps and to be especially applicable to the control of lights in the borqer of a theater, and it is said to show a group of lamps first placed in Series and then in multiple, a resistance inserted in series successively, and a switch which changes the lamps from series to multiple, and inserts and cuts out resistances. If the assertions of the appellant's witnesses are all accurate, the patentability or the scope of the Condict patent is not altered. There is a manifest difference between the necessities of a system for vary"ing the illuminating effects of incandescent lamps in a room and the needs of electrio mechanism for regulating the current to be conveyed to electrio
motors, and thus regulating the speed of a car. The Paine patent, with its groups of incandescent lamps, told nothing to the inventor who was trying to protect an electric car motor in action from the inflow of a current dangerous both to machinery and to passengers. It followR that claims 20, 21, and 22 were also infringed·. The order of the circuit court is affirmed, with costs.
AMERICAN BOX-MACH. CO. v" HUGHES et at. (Circuit Court of Appeals, Second Circuit. No. 26.
The Munro patent No. 298,879, for an improvement in box covering and trimming machines, construed, and held not infringed.
Appeal from the Circuit Court of the United States for the Southern District of New York.
This is an appeal from an interlocutory order of the circuit court of the United States for the Southern district of New York, which granted an injunction pendente lite against the infringement of claims 2 and 3 of letters patent No. 298,879, dated May 20, 1884, to Gordon Munro, for an improvement in box covering and trimming machines. Munro had received letters patent, dated July 26, 1881, and numbered 244,919, for a machine for applying a single external covering of paper upon boxes, which patent was sustained by Judge Blodgett in the Seventh circuit. Box Co. v. Wilson, 50 Fed. 425. Patent No. 298,879 waS for a machine of the same general character, but which applied two or more external coverings simultaneously upon boxes, was calied the double-strip patent, and was sustained by Judge Butler in the Third circuit (Machine Co. v. Day, 32 Fed. 585), and by Judge Coxa in this circuit, who delivered an oral decision. Tbe question upon this appeal was that of infringement.
Lysander Hill, for appellant. Edmund Wetmore, for appellees. Before W ALLAOE and SHIPMAN, Circuit Judges. SHIPMAN, Circuit Judge. The machine of the patent in suit had a reel containing a roll of covering paper, which was adjustable later· ally on its shaft, in either direction, by being clamped between two disks or washers. The patentee says in his specification that he was thus enabled to put any number of reels or rolls upon one shaft, and confine each roll by clamping disks, I'whereby the material will be properly fed to the paste roller, and be kept in right lines with the guides and the trimming material." A second reel, upon which' was wound the second or trimming material, was also supported upon a separate shaft at a different level, and contained the appliances and reel-locating disks of the first reel. After the strips of material have been pasted, they pass through guides, which are metallic rods, in which are formed bends or recesses, "which are made of such size as will conform, respectively, to the width of the covering and the trimming material being used; and these guides should have as many such recesses as there are separate strips of the covering or the


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Joshua Jackson Suffers Bad Allergic Reaction
July 24, 2011 by Post Team
Joshua Jackson Suffers Bad Allergic Reaction, Joshua Jackson was rushed to hospital this afternoon after suffering a severe allergic reaction. Fringe actor was seen at a hospital in Santa Monica, California today, but fortunately after receiving medical treatment he was able to walk a couple of hours later with his girlfriend Diane Kruger. A representative of the former star of Dawson Creek told TMZ: "Josh has had an allergic reaction (no asthma attack). [He] is perfectly fine." Not yet revealed the cause of the adverse reaction, but we know that Joshua suffers from a peanut allergy.
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"Rude consultant and inexperienced doctor"
About: Queen's Hospital (Romford) Queen's Hospital (Romford) Romford RM7 0AG
Posted by Anonymous
I was diagnosed with gall stones in Jan 2013 (have put up with it for nearly a year now). In July / August of this year, was referred to a hospital consultant, and found her to be rude and it was a humiliating experience for me because she started screaming at me and reprimanding me like I was a school child, for getting panicky during the endescopy. Next time, I saw a doctor at the hospital, I think around October and she told me 'it looks like you are coping fine with the gall stones' - except that she hadn't even bothered to ask me how I was coping with them. When I pointed this out to her, then she asked me, and I told her I was feeling nauseau, diarrhea, severe dull pain in my middle and left upper abdomin which kept moving to my back (at one point I thought I was having a stroke as the pain had got that bad), shaking and sweating. I'm not keen to have surgery to have my gall bladder removed as I have spoken to numerous people who have had this done and they said their diarrhea / pain hasn't stopped. I have been informed by A&E, as well as the hospital doctor that this is my only option, otherwise, I just need to put up with it. I asked her what could be done about the diarrhea and pain caused by the gall stones. She dismissed the fact that the diarrhea was occuring as a result of the gallstones, and thereby concluded that she suspected that I was lactose intolerant (despite having scan done twice over a period of 6 months, which had first confirmed two gall stones, and thereafter showing that this had turned into multiple). Go figure ....
Response from Queen's Hospital 3 years ago
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The relationship between whole spectrum of Ejection fraction (EF) and cardioembolic stroke (CES) outcome has not been fully described yet. Notably, it remains unclear whether borderline EF (41∼49%) is related with poor outcome after CES. We sought to evaluate whether lower ejection fraction and borderline EF could predict the outcome in patients with CES.
Method and Results
We evaluated the relationship between EF and functional outcome in 437 consecutive patients with CES. EF was introduced as continuous and categorical (EF≤40%, EF 41∼49%, EF≥50%) variable. Patients with CES and the subgroup with AF were evaluated separately. Poor short-term outcome (modified Rankin Score≥3at discharge or death within 90 days after stroke onset) and long-term mortality were evaluated. A total of 165 patients (37.8%) had poor short-term outcomes. EF tends to be lower in patients with poor short-term outcome (56.8±11.0 vs. 54.8±12.0, p-value 0.086). Overall cumulative death was136 (31.1%) in all CES patients and 106 (31.7%) in the AF subgroup. In a multivariable model adjusted for possible covariates, the hazard ratio for mortality significantly decreased by 3% for every 1% increase in ejection fraction in CES patients and 2% for every 1% increase in the AF subgroup. Reduced EF (EF≤40%) showed higher mortality (HR 2.61), and those with borderline EF (41∼49%) had a tendency of higher mortality (HR 1.65, p-value 0.067)compared with those with normal EF.
Citation: Byun J-I, Jung K-H, Kim Y-D, Kim J-M, Roh J-K (2014) Cardiac Function and Outcome in Patients with Cardio-Embolic Stroke. PLoS ONE 9(4): e95277. https://doi.org/10.1371/journal.pone.0095277
Editor: Claudio Moretti, S.G.Battista Hospital, Italy
Received: October 1, 2013; Accepted: March 26, 2014; Published: April 23, 2014
Copyright: © 2014 Byun et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: This study was supported by the Seoul National University Hospital Research Fund (04-2012-0990). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing interests: We have the following interests. JKR serves as an associate editor for the Journal of Alzheimer's Disease. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials. JKR no longer serves as an associate editor for Laboratory Investigation.
Heart disease is a major risk factor for stroke following age and hypertension [1]. Ejection fraction (EF), the proportion of left ventricular volume emptied during ventricular systole, is a reliable measure of left ventricular (LV) systolic function [2]. Reduced EF provides objective documentation of cardiac dysfunction [3].Previous studies identified low EF as a predictor of mortality in stroke patients [4]–[6]. However, there are limitations in the previous studies. First, EF was arbitrarily dichotomized and evaluated as a categorical variable. In consequence, the relationship between full spectrum of EF and stroke outcome was not properly evaluated, especially those with borderline EF. Second, previous studies evaluated stroke patients regardless of its subtype. Cardioembolic stroke (CES) is known to cause more severe stroke [7], [8] and higher mortality [9], [10] than other stroke subtypes. Moreover, atrial fibrillation (AF), the most common source of CES [11], is known to be independently associated with higher case fatality in CES. Decreased EF may have more impact on CES outcome, especially on those with AF. This study attempted to address this shortcoming by exploring the influence of EF as continuous and categorical variable in patients with CES. We sought to evaluate whether lower ejection fraction and borderline EF could predict outcome in patient with CES and in subgroup with AF.
Ethics statement
The guidelines and procedures of this registry were approved by the Institutional Review Board of the Seoul National University Hospital. Written informed consent to participate was obtained from all patients or their next of kin if the inclusion criteria were met.
Study population
We performed a retrospective cohort study based of consecutive patients with CES. Among acute stroke patients consecutively registered in the Seoul National University Hospital Stroke Registry (SNUHSR) between January 2002 and December 2010, those with cardioembolism subtype were included in this study. Patients with transient ischaemic symptom or those without documented EF measurement were excluded. The SNUHSR is a prospective hospital based registry for patients with acute ischemic stroke or transient ischemic attack admitted within 7 days after symptom onset. The registry dataset included information of demographics, stroke subtypes, vascular risk factors, investigations performed in the hospital and neurological outcomes at discharge. Clinical, radiological and laboratory evaluations allowed us to disclose the stroke etiology and the diagnosis of CES was made according to the Trial of ORG10172 in Acute Stroke Treatment (TOAST) classification [12].
Vascular risk factors and cardiac evaluation
We collected demographics, vascular risk factors and in- hospital evaluation and management for each patient. Vascular risk factors included history of previous stroke, hypertension, diabetes mellitus, hyperlipidemia and smoking. Hypertension was defined as a systolic blood pressure >140 mm Hg, a diastolic blood pressure >90 mm Hg and/or current use of anti-hypertensive agents. Diabetes mellitus was diagnosed by the relevant clinical or drug history or the biochemical evidence of at least two measurements of fasting blood glucose readings >7 mmol/L. Dyslipidemia was defined as current use of lipid-lowering agents or at least two elevated serum lipid measurements (total cholesterol >6.2 mmol/L or low-density lipoprotein-cholesterol >4.1 mmol/L). Smoking was defined as tobacco use within 1 month of admission [13]. Hemorrhagic transformation was documented when initial or follow-up brain imaging revealed hemorrhage on the site of ischemic stroke. The severity of the stroke was evaluated by a trained neurologist using National Institute of Health Stroke Scale (NIHSS) and disability was accessed using modified Rankin score (mRS) at admission and at discharge. NIHSS is a 11-item neurologic examination stroke scale for use in acute stroke therapy trials [14].The modified Rankin scale is a commonly used scale measuring disability or dependence in activities of daily life in stroke patients [15].
Standard cardiac evaluation included 12-lead electrocardiography (ECG)and transthoracic echocardiography. Holter monitoring or transesophageal echocardiography was performed when standard cardiac evaluation did not reveal any cardioembolic source in high clinical suspicion of CES. Diagnosis of AF was made when there was a documented history of paroxysmal AF or ECG data showing AF during hospitalization. Both chronic and paroxysmal AF was included. Echocardiogram was performed with the patient resting supine in the left lateral position during hospital admission and interpreted by a trained cardiologist. EF was calculated by biplane modified Simpson's method [16].
Outcome parameters
Poor short-term functional outcome and long-term mortality were evaluated. Poor short-term outcome was characterized by mRS≥3at discharge or death within 90 days after stroke onset. Mortality data were obtained from the Korean National Vital Statistics system with currency of December 2010. In Korea, all deaths must be reported to the National Vital Statistical Office by law and the data are known to be reliable [17].
Statistical analysis
Statistical analysis was performed to evaluate the relationship between EF and outcome parameters. Patients with CES and the subgroup with AF were evaluated separately. All data in this study are expressed as mean ± standard deviations (SD) or numbers (percentages). Continuous variables were tested for normal distribution with the Kolmogorov-Smirnov test. Mann-Whitney U test was used to compare EF according to short-term functional outcome. EF according to mRS and 90 days mortality was separately analyzed using Kruskal-Wallis one-way analysis of variance and Mann-Whitney U test respectively. Predictors for outcome were determined by multivariate logistic regression analysis. All variables except for age, EF and NIHSS were dichotomized. EF was first introduced as continuous variable. And we divided EF into three groups (≤40%, 41∼49%, >50%) and introduced it as a categorical variableto further evaluate the relationship between EF and CES outcome. Age was introduced as continuous variable and NIHSS was categorized into three groups following the usual criteria [18]: NIHSS score <7, NIHSS 7–14 and NIHSS score >14. Comparisons between groups were analyzed as follows: continuous variables by Student's t-test (2-sided) or Mann-Whitney U test and categorical variables by Pearson's chi square test. Variables with p-value <0.1 in univariate analysis were entered into the multivariate model.
To identify relationship between EF and long-term mortality, we first used multivariate Cox regression model introducing EF as a continuous variable. The model adjusted possible predictors of mortality and morbidity including age, sex, previous history of stroke, hypertension, diabetes, dyslipidemia, smoking, NIHSS at admission, intra-venous or intra-arterial thrombolysis, hemorrhagic transformation and warfarin at discharge. To further evaluate the relationship between EF and long-term mortality, we divided the range of EF into 3 groups as previously described: normal (>50%), borderline (41–49) and reduced (≤40%) [3]. Kaplan-Meier analysis was used to estimate survival condition and the log-rank test was used to compare rate estimates according to EF. The same Cox regression model was applied to evaluate relationship between long-term mortality and the three EF groups. The variables were cross tabulated to discard multicollinearity. Probability values of <0.05 were considered statistically significant. SPSS software (SPSS 12.0, SPSS Inc., Chicago, IL, USA) was used for the analysis.
Patient characteristics and cardiac sources of embolism
Of 2,543 patients registered in SNUHSR between January 2002 and December 2010, 467 patients with CES were initially enrolled. Thirty patients were excluded from this study: 20 with transient ischemic symptom and 10 without documented EF. Finally, a total of 437 patients were included in this study. (Figure 1) The median age of the patients was 69 years (IQR, 61–76) and 57.4% were male. Patients in the subgroup with AF were older, had a higher vascular risk burden and presented with more severe deficits than those without AF. (Table 1) The mean EF was 56.02±11.40% (median EF 57.0%). The distribution of EF is shown in Figure 2. Patients with decreased EF were predominantly male, but prevalence of vascular risk factors and stroke severity were similar between groups. (Table S1 in File S1).
Abbreviations: SNUHSR: Seoul National University Hospital Stroke Registry, CES: Cardio-embolic stroke, TIA: Transient ischemic attack, EF: Ejection Fraction.
Abbreviations: EF:Ejection fraction, CES: Cardioembolic stroke.
In terms of CES etiology, atrial dysrhythmia without structural heart disease was documented in 232 (53.1%) patients, structural heart disease with sinus rhythm in 71 (16.2%) of patients, and combined disease in 104 (23.8%) patients. The remaining 30 (6.8%) patients showed other etiologies: 3 with LA myxoma, 5 with LA thrombus, 5 with LV thrombus and 16 with PFO. The most frequent cardiac source of embolism was AF (76.4%), followed by systolic HF (11.6%). Detailed etiologies of CES are shown in Table S2 in File S1.
Functional outcome at discharge and short-term mortality
The median mRS score at discharge was 2 (IQR, 1–4) in CES patients and in the AF subgroup. All patients were followed up in OPD clinic at 3 months and a total 165 patients (37.8%) had poor short-term outcome. While EF was not significantly different according to the discharge mRS (p-value 0.124), EF tended to be lower in patients with poor short-term outcome (56.8±11.0 vs. 54.8±12.0, p-value 0.086). Twenty seven CES patients (6.2%) died within 90 days after admission and EF was significantly higher in the living group. (Figure 3) EF was able to predict 90 day mortality (adjusted OR 0.94) in the multivariate analysis. Older age (adjusted OR = 1.05), initial stroke severity (adjusted OR = 13.18) and warfarin after discharge (OR 0.33) were also associated with 90 day mortality. In the AF subgroup analysis, the 90 day mortality rate was 6.3% and EF showed a tendency to be associated with the 90 day mortality (adjusted OR 0.96), along with the initial stroke severity (adjusted OR 12.63). Age (adjusted OR 1.06) diabetes (adjusted OR 3.42) and warfarin by discharge (adjusted OR 0.35) were independently associated with the 90 day mortality. (Table 2)
ns: not significant, ***: p-value <0.01. Abbreviations: ns: not significant, EF, Ejection fraction.mRS: modified Rankin Scale, CES: Cardioembolic stroke.
Long-term mortality
Overall cumulative death was136 (31.1%) in all CES patients and 106 (31.7%) in the AF subgroup. The relationship between EF and long-term mortality is shown in Table 3. In a multivariable model adjusted for possible covariates, the hazard ratio for mortality significantly decreased by 3% for every 1% increase in ejection fraction in CES patients and 2% for every 1% increase in the AF subgroup. Older patients and those with severe stroke had higher mortality. Patients with hyperlipidemia and statin prescription were protective of long-term cumulative death. (Table 3, Table S3 in File S1).
Survival curves are illustrated in Figure 4. Patients with reduced EF (EF≤40%) had a significant higher mortality (HR 2.61) than those with normal EF. Those with borderline EF (41∼49%) had tendency of higher mortality with a lower HR (HR 1.65, p-value 0.067). In the AF subgroup, decreased EF was associated with higher mortality, but with lower HR and less significance. Borderline EF was not associated with mortality. Increasing age and stroke severity were independent predictors of long-term mortality in both CES patient and AF subgroup. Smoking significantly increased mortality in the AF subgroup only. (Table 3, Table S4 in File S1) The mortality data of 34 patients were missing among 136 patients who died. Among others, 38 (37.3%) had vascular death (fatal stroke with ICD code I60–64 or ischemic heart disease caused by myocardiac infarction with ICD code I21–34 as previously defined [19]). Patients with decreased EF had higher HR with vascular death (HR 3.54, p-value 0.003 in CES, HR 2.81, p-value 0.064 in AF subgroup).
Abbreviations: EF, Ejection fraction. CES: Cardioembolic stroke, AF: Atrial fibrillation.
Our results show an inverse relationship between EF and long-term cumulative mortality not only in CES patients, but also in the AF subgroup. About 11.7% of our patients had decreased EF (EF≤40%), which is higher than in previous reports (5% to 8%) [4],[5]. Sources of CES were similar compared with previous studies. Decreased EF (EF≤40%) was an important predictor of mortality in patients with CES and in the AF subgroup. Borderline EF of 41∼49% was a poorer predictor of mortality in CES patients and was not predictive of mortality in the AF subgroup. To the best of our knowledge, this is the first study evaluating the relationship of EF as a full spectrum on functional outcomes after CES.
Our data revealed a high association between EF and 90 days mortality which is in line with previous studies. Low EF was identified as an independent predictor of higher short-term mortality in some studies. In a single center study with 503 stroke patients, systolic HF (symptoms and signs of HF and EF<50%) was independently associated with poor outcome (mRS from 3 to 6) in 90 days with an odds ratio of 3.01 [18]. In a study with 130 stroke patients who received thrombolysis, decreased EF (EF<40%) was independently associated with a higher 90-day mortality rate (OR 9.88) along with the clinical diagnosis of HF (OR 4.17) [5]. However, there are conflicting results with regard to the relationship between reduced EF and long-term mortality. A recent publication, evaluating stroke patients with EF≤35%revealed low EF is an independent predictor of 1 year mortality along with increasing age, stroke severity and AF [6]. In contrast, in a study with 283 stroke patients with HF, cumulative mortality up to 10 years was not associated with low EF (EF<40%), but with the severity of heart failure and stroke [4]. Although these studies evaluated a direct association between low EF and long-term mortality after stroke, they are limited by several factors. First, they included stroke patients with heterogenous subtypes. Those with lower EF may have a higher prevalence of CES, which can distort the true relationship between EF and poor outcome. CES is known to cause highest mortality and worst functional outcome [9], [10]. Our study is unique evaluating patients with single stroke subtype. We found a significant relationship between EF and long-term cumulative mortality in patients with CES and notably in the subgroup with AF. Second, previous studies have arbitrary dichotomized the EF spectrum. There is a lack of consensus with regard to the cut-off value for defining decreased EF and various indicators (EF<40% [5], EF<50% [18], and EF<55% [16]) have been used as a criteria for reduced EF. Dichotomization of EF prevents us from evaluating EF as a whole, especially those with neither preserved nor decreased LVEF (Borderline EF) and can result in a biased outcome. We applied EF as both continuous and categorical variable to evaluate a true association between EF and outcome after CES and found a significant association even when possible covariates were adjusted. We also evaluated EF as a categorical variable to further evaluate the true relation between EF and stroke outcome. As expected, the association between reduced EF≤40% and long-term mortality was high. Patients with borderline EF (41∼49%) showed a tendency of higher mortality than patients in the normal EF group, which was neglected in the previous studies. This reinforces the concept that lower EF is related with a higher mortality in CES. In the AF subgroup, decreased EF had a weaker association with long-term mortality compared with total CES patients. AF itself is known to cause greater disability and mortality in stroke patients [20], [21]. In our study population, patients with AF had higher vascular risk burden and worse deficits than non-AF patients. Influence of AF may have masked the effect of lower EF on mortality. Nonetheless, it is important to note that low EF is an independent predictor of long-term mortality even in the AF subgroup.
There are several explanations for a poor outcome after stroke in patients with decreased cardiac function. Patients with decreased EF have elevated LV filling pressure, causing decreased stroke volume. Moreover, decreased EF impairs cerebrovascular reactivity, compromising cerebral autoregulation, eventually causing chronic cerebral hypoperfusion [22], [23]. Some investigators explain that patients with low EF are complicated with other co-morbidities that increase atherosclerotic burden, though this was not significant in our study.
There are some limitations in our study. First, this study is a single-center study and our result has to be confirmed in other populations. Also Stroke recurrence was not evaluated in this study as a common complication among CES patients causing high mortality [2]. Although we included previous stroke as a covariate in the analysis, to document stroke recurrence after enrollment was impossible through registry data. Cause of death was not properly evaluated. Even though mortality data are partial, a higher HR of decreased EF on vascular mortality suggests more CES patients with decreased EF died due to vascular causes. In addition, baseline functional status was not considered in our study and the discharge mRS data were used as short-term outcome instead of the 3 months mRS. Other inevitable limitations are possible selection bias of a single center study and the possibility of missing confounding factors while applying multivariate logistic analysis.
A strong association was found between lower EF and outcome after CES. As expected, decreased EF (EF≤40%) had a strong relationship with higher mortality. Patients with borderline EF (EF 41∼49%) showed a tendency of higher mortality which has not been evaluated in previous studies. This result was independent of patient age, sex, vascular risk factors, stroke severity, in-hospital management and hemorrhagic transformation. Moreover, we found associations in the subgroup of patients with AF, which are known to have higher mortality. No significant association was found between borderline EF and long-term mortality in the AF subgroup. Taken together, our study suggests the importance of echocardiographic evaluation in CES patients, even in patients with AF.
Supporting Information
File S1.
Contains Table S1, baseline characteristics by EF groups in CES. Table S2, etiology of CES. Table S3, adjusted hazard ratio for long-term mortality. Table S4, multivariable model hazard ratios for long-term outcomes.
Author Contributions
Conceived and designed the experiments: JIB KHJ YDK JKR. Performed the experiments: JIB KHJ JMK. Analyzed the data: JIB JMK. Contributed reagents/materials/analysis tools: JIB JMK. Wrote the paper: JIB KHJ.
- 1. Appelros P, Nydevik I, Seiger Å, Terént A (2002) Predictors of Severe Stroke: Influence of Preexisting Dementia and Cardiac Disorders. Stroke 33: 2357–2362.
- 2. Pullicino PM, Halperin JL, Thompson JLP (2000) Stroke in patients with heart failure and reduced left ventricular ejection fraction. Neurology 54: 288.
- 3.
Allen LA, Magid DJ, Gurwitz JH, Smith DH, Goldberg RJ, et al. (2013) Risk Factors for Adverse Outcomes by Left Ventricular Ejection Fraction in a Contemporary Heart Failure Population. Circulation: Heart Failure.
- 4. Vemmos K, Ntaios G, Savvari P, Vemmou AM, Koroboki E, et al. (2012) Stroke aetiology and predictors of outcome in patients with heart failure and acute stroke: a 10-year follow-up study. European Journal of Heart Failure 14: 211–218.
- 5. Palumbo V, Baldasseroni S, Nencini P, Pracucci G, Arba F, et al. (2012) The coexistence of heart failure predicts short term mortality, but not disability, in patients with acute ischemic stroke treated with thrombolysis: the Florence area Registry. Eur J Intern Med 23: 552–557.
- 6.
Milionis H, Faouzi M, Cordier M, D'Ambrogio-Remillard S, Eskandari A, et al. Characteristics and early and long-term outcome in patients with acute ischemic stroke and low ejection fraction. International Journal of Cardiology.
- 7. Ferro JM (2003) Cardioembolic stroke: an update. Lancet Neurol 2: 177–188.
- 8. Arboix A, Alio J (2010) Cardioembolic stroke: clinical features, specific cardiac disorders and prognosis. Curr Cardiol Rev 6: 150–161.
- 9. Stead LG, Gilmore RM, Bellolio MF, Jain A, Rabinstein AA, et al. (2011) Cardioembolic but not other stroke subtypes predict mortality independent of stroke severity at presentation. Stroke Res Treat 2011: 281496.
- 10. de Jong G, van Raak L, Kessels F, Lodder J (2003) Stroke subtype and mortality. a follow-up study in 998 patients with a first cerebral infarct. J Clin Epidemiol 56: 262–268.
- 11. Bogousslavsky J, Cachin C, Regli F, Despland P-A, Melle GV, et al. (1991) Cardiac sources of embolism and cerebral infarction—clinical consequences and vascular concomitants: The Lausanne Stroke Registry. Neurology 41: 855.
- 12. Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, et al. (1993) Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke 24: 35–41.
- 13. Jung K-H, Lee S-H, Kim BJ, Yu K-H, Hong K-S, et al. (2012) Secular Trends in Ischemic Stroke Characteristics in a Rapidly Developed Country: Results From the Korean Stroke Registry Study (Secular Trends in Korean Stroke). Circulation: Cardiovascular Quality and Outcomes 5: 327–334.
- 14. Brott T, Adams HP Jr, Olinger CP, Marler JR, Barsan WG, et al. (1989) Measurements of acute cerebral infarction: a clinical examination scale. Stroke 20: 864–870.
- 15. Sulter G, Steen C, De Keyser J (1999) Use of the Barthel index and modified Rankin scale in acute stroke trials. Stroke 30: 1538–1541.
- 16. Lang RM, Bierig M, Devereux RB, Flachskampf FA, Foster E, et al. (2006) Recommendations for chamber quantification. Eur J Echocardiogr 7: 79–108.
- 17. Kim HC, Choi DP, Ahn SV, Nam CM, Suh I (2009) Six-year survival and causes of death among stroke patients in Korea. Neuroepidemiology 32: 94–100.
- 18. Ois A, Gomis M, Cuadrado-Godia E, Jimenez-Conde J, Rodriguez-Campello A, et al. (2008) Heart failure in acute ischemic stroke. J Neurol 255: 385–389.
- 19. Nam HS, Kim HC, Kim YD, Lee HS, Kim J, et al. (2012) Long-term mortality in patients with stroke of undetermined etiology. Stroke 43: 2948–2956.
- 20. Steger C, Pratter A, Martinek-Bregel M, Avanzini M, Valentin A, et al. (2004) Stroke patients with atrial fibrillation have a worse prognosis than patients without: data from the Austrian Stroke registry. European Heart Journal 25: 1734–1740.
- 21. Lamassa M, Di Carlo A, Pracucci G, Basile AM, Trefoloni G, et al. (2001) Characteristics, Outcome, and Care of Stroke Associated With Atrial Fibrillation in Europe: Data From a Multicenter Multinational Hospital–Based Registry (The European Community Stroke Project). Stroke 32: 392–398.
- 22. Choi B-R, Kim JS, Yang YJ, Park K-M, Lee CW, et al. (2006) Factors Associated With Decreased Cerebral Blood Flow in Congestive Heart Failure Secondary to Idiopathic Dilated Cardiomyopathy. The American Journal of Cardiology 97: 1365–1369.
- 23. Georgiadis D, Sievert M, Cencetti S, Uhlmann F, Krivokuca M, et al. (2000) Cerebrovascular reactivity is impaired in patients with cardiac failure. European Heart Journal 21: 407–413.


text:
Daleen Enslinstrydom
Daleen Enslinstrydom Poems
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Under The Shade Of The Big Old Oak Tree
Under the shade of the old oak tree Jafta sit
and his mind wanders back as he reflects on his life
while the sun sets in the west.
He is overcome with sorrow to braking point,
he knows his time is running out and that the sun
of his own life is also setting
and that there is no return.
Life was so much easier
when he was stile younger,
yesterday is gone
and it will never return.
His eyes are weary and he looks downhearted,
he does not even see his beloved grassland
and does wonder why life does have to hurt so much?
He gazes into ...
Predators On The Hunt
Stars light up the night sky,
through the darkness the full moon shines
like a jack-lantern
as if it was lit from within
and everywhere the night awakes,
the predators are prowling,
sneaking through the bush
to find something to eat.


text:
Reply to W.B. Grant 'Re: Vitamin D deficiency among northern Native Peoples'
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- International Journal of Circumpolar Health 1239-9736
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- Co-Action Publishing
- Publication Date
- Volume
- 71
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- DOI: 10.3402/ijch.v71i0.18435
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doi:10.3402/ijch.v71i0.18435 Reply to W.B. Grant 'Re: Vitamin D deficiency among northern Native Peoples' Peter Frost* a/s Bernard Saladin d'Anglure, De´partement d'anthropologie, Pavillon DeKoninck, Universite´ Laval, Que´bec, QC, Canada Dear Editor: Dr. Grant seems to assume that all humans share the same vitamin D metabolism, an assumption that is doubtful even on theoretical grounds (1). We know that natural selection can alter the way the human body synthesises, transports and uses this vitamin. We also know that the relevant selection pressures (from solar UV and skin color) vary from one human population to the next. So it is not necessarily unhealthy for a population to have low blood levels of vitamin D. The underlying metabolism may simply be different. Vitamin D levels are normally low not only in northern Natives but also in other darker-skinned humans, even those who still live in the tropics and are routinely exposed to strong solar UV (2). Indeed, if we look at the human species as a whole, the outlier actually appears to be lighter-skinned humans and their relatively high levels. This outlier, however, also tends to decide what is medically normal and what is not. Therein lies part of the problem. Why do these differences in metabolism exist? At present, we can only speculate. Lighter-skinned humans can more easily synthesise vitamin D on their own and may thus use it less efficiently. Conversely, darker-skinned humans may have had to ration its use and develop alternate metabolic pathways. This has been especially true at high northern latitudes, where solar UV is too weak for synthesis in the skin. An alternative is to consume fatty ocean fish, but this food source was formerly available only in coastal regions. The interior of Alaska and northern Canada had few natural sources of vitamin D. Over time, northern Natives should have adapted to this situation through natural selection. And they had time: so


text:
Date: July 22, 2015
Time: 5:30 pm – 7:30 pm
Join us for a get together and fundraiser at Mercedes-Benz of Orlando in Maitland! We'll have food, drinks, music, available dogs, and a raffle too so make sure to join us!!
Follow Poodle and Pooch Rescue on Facebook at https://www.facebook.com/PoodleandPoochRescueofFlorida.
Mercedes-Benz of Orlando
810 N Orlando Ave
Maitland, FL
(407) 680-0784


text:
The 2nd secret World of New Super Mario Bros. 3 (Silver-zoroark's version). World Leaf is the second secret world. It is high up in the clouds, with rainbows and Lakitus. Lakithunder is known to rule this World.
Level Leaf-1
This level is in the sky with lots of clouds. There are enemies called Amp Chains flying around and Mario has to go on platforms to get to the end.
Level Leaf-2
A self-scrolling level where Mario has to stay on a platform while Pirahna Plants and Wigglers drop on it.
Level Leaf-3
An under-water level with lots of Deep-Cheeps and Bloopers.
Level Leaf-Tower
There are Amps and grates everywhere. Also some secret doors.
Level Leaf-4
A level under-ground with Monty Moles and Squigglers. There is a Chain Chomp at the end.
Level Leaf-5
This is a self-scrolling level with Bullet Bills and Banzai Bills. There is also a secret mini pipe.
Level Leaf-6
A level with ice, Snow Spikes, and Mine Carts. It is accessed by getting the secret flag in Level Leaf-S.
Level Leaf-Castle
A large Castle with Snake Blocks and Conveyer Belts. Pipes too, and Bone Pirahna Plants are in plenty of different places. And the boss of the Castle is Lakithunder, who rules World Leaf.
Enemy Course
Easy: 2 Chain Chomps
Medium: 4 Chain Chomps
Hard: 6 Chain Chomps


text:
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Cilla Dining Set: Rectangular Table, Black Chairs
Boat shaped clear tempered glass dining table. Sleek stainless steel columns and Black marble base. Also see matching occasional tables.
Cilla Dining Room Set Offer:
1 x Cilla Pedestal Dining Table
1 x Cilla Side Chairs Upholsted in Black
Modern/Contemporary Style
Pedestal Table Type
Upholstered Chairs
Chintaly Imports
Dining Table: 70.86" x 39.37" x 29.92"
Side Chair: 18" x 18.50" x 39.50"
Table Assembly Required


text:
A cup of coffee is one of life's simple pleasures, like sleeping late or burning your trash. Warm up with this Groupon.
$39 for a Two-Hour Coffee 101 Class ($80 Value)
During a hands-on Coffee 101 class, students learn to imitate Ipsento's precise brewing methods so they can brew barista-quality cups at home. A coffee instructor explains each bean's journey from tree to cup before letting attendees experiment with different methods of brewing that are easy to replicate at home. The class also covers different varieties of coffee from around the world, and helps students develop their palates and discover which regions and roasts they prefer. Ipsento provides snacks to nibble alongside endless sips of coffee.
Ipsento Coffee
Attention to detail is key at Ipsento, where staffers artfully decorate lattes and taste test roasted coffee beans daily to guarantee their perfection. This kind of culture starts with Ipsento's owner, who flies around the world sampling coffee while building rapport with bean producers and paying them more than fair-trade and market prices.
Ipsento serves its freshly roasted coffee in a cozy café where patrons can chat or type studiously on a fake laptop made out of cardboard. Behind the counter, talented baristas steam milk and pull shots from a state-of-the-art Slayer espresso machine. Using Jo Snow and other locally made syrups, they create cardamom-rose lattes and the signature Ipsento latte, flavored with coconut milk, honey, and a pinch of cayenne pepper. A small set of stairs leads to the back room, which is decorated with framed photos and windows repurposed as wall art. In this serene environment, music plays as patrons sip coffee and eat made-to-order sandwiches on croissants or sliced bread.


text:
18K Gold Medium Heavy O' Chain Bracelet
$ 2,700.00
Fluid, feminine and timeless, this recycled 18K gold bracelet is designed to be piled on. Inspired by iconic gold chains from the 70's, the O' link was created. The outside diameter of the small O' link measures approximately 6mm in width and 6mm in height. The outside diameter of the large O' link measures approximately 8mm x 8.5mm. The bracelet measures 7 ½" long and is finished with a cross locking link closure and a figure eight safety catch.


text:
Philip Morris & Son was established in 1845 as a retail store in Hereford with well trained staff and a wide selection of products in all of our departments. Departments include, Country Clothing, Shooting Accessories, Housewares, Gardening and Hardware, Bathroom Accessories and Tabletop. Philip Morris & Son stock over 13000 stock lines including high street brands such as Barbour, Musto, Brabantia, Samuel Heath, Weber, Broil king, Gnu, Arthur Price and many more ensuring that we also provide a quality product with exceptional customer service.
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text:
Austin Collie
October 10, 2010 by staff
Austin Collie, There is a chance Indianapolis Colts receiver Austin Collie will not play Sunday against Kansas City.
ESPN's John Clayton reports that Collie is likely to miss the game. Indianapolis beat writers have not even said he may miss the game so we will wait before declaring him out but it seems that something with him.
No glue or even a limited number of Collies is good for the Chiefs.
Number of Collie – and it's not even the No. 1 target – are impressive. In four games he has 398 receiving yards with games of 163 and 171 meters.
When it is hot, really hot.
That would be just one more receiver heads would not have to worry about.
Unfortunately for the Chiefs, it appears that the Colts can put any there and become a star (Collie itself is a good example of this).
The Colts will release its final report injuries this afternoon.
Please feel free to send if you have any questions regarding this post , you can contact on
Disclaimer: The views expressed on this site are that of the authors and not necessarily that of U.S.S.POST.


text:
I know a lot of new MMO games out there are starting to focus heavily on PvP, which on a personal note i really dont care for. Some games dont have a option to have a server without PvP. So for this game the question is will there be much PvP in game or will it be totally optional? I am hoping it will be like FFXI as far as PvP go's to wear it was very limited or at all.
Thanks in advance for all your help.
Edited, Sep 4th 2010 10:13am by Zalessa


text:
Well done to our AWTF youngsters who had a rare insight into the world of work at Highagte´s popeseye Steak restaurant
19th August 2015
Valentine´s Day at Allie´s Sanctuary
13th February 2015
Treat yourself at Allie's Sanctuary this Friday to our Valentine's Day offers.
6th September 2014
Come along to AWTF's annual Pinknic in the Park Fundraiser! If you want to try your hand at archery, enjoy a delicious barbecue with friends or challenge your kids to an obstacle course then make sure you're in Waterlow Park on Saturday 6 September!
22th June 2014
On Sunday 22nd June we will have a fabulously pink stall at the East Finchley Festival in Cherry Tree Woods
13th May 2014
On Saturday 14 June we will have a fabulously pink stall at the family fun Fair in the Square in Pond Square, Highgate Village.


text:
Positive Psychology to Improve Healthy Behaviors After an Acute Coronary Syndrome (PEACE II)
This study has been completed.
Massachusetts General Hospital
National Heart, Lung, and Blood Institute (NHLBI)
Information provided by (Responsible Party):
Jeff C. Huffman, MD, Massachusetts General Hospital
ClinicalTrials.gov Identifier:
First received: December 3, 2013
Last updated: May 2, 2017
Last verified: May 2017
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In this proof-of-concept study, the investigators will assess the ease and usefulness of a positive psychology program in patients with acute coronary syndrome and less-than-optimal adherence to health behaviors. The investigators believe that positive psychology (a field that studies boosting positive emotions rather than simply reducing negative emotions) will help this cardiac population to be more healthy. The investigators want to determine whether this positive psychology program has the potential to be an adjunctive treatment for cardiac populations.
|Acute Coronary Syndrome
|Behavioral: Positive psychology intervention
|Study Type:
|Study Design:
|Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
|Official Title:
|Study of a Positive Psychology Program to Improve Healthy Behaviors After an Acute Coronary Syndrome: Proof of Concept Study
Further study details as provided by Jeff C. Huffman, MD, Massachusetts General Hospital:
Primary Outcome Measures:
- Rate of Exercise Completion [ Time Frame: 8 weeks ]Rate of exercise completion will be measured by the number of participants who have a good rate of completion of exercises. There are 8 exercises in total. A good rate of completion will be defined as an average of 5 or more exercises completed per subject.
- Ease of Exercises [ Time Frame: 8 weeks ]Ease of exercises will be measured by a self-report 10-point Likert scale (0=not easy to complete, 10=very easy to complete). Ease will be defined as an average score of 6 or more on this scale.
- Self-reported Psychological Impact of Exercises [ Time Frame: 8 weeks ]Psychological impact of exercises will be measured by two self-reported 10-point Likert scales. One scale measures optimism after completing the exercise (0=not optimistic, 10=very optimistic), and the other scale measures happiness after completing the exercise (0=not happy, 10=very happy). Psychological impact will be defined as an average score of 6 or more on both of these scales.
Secondary Outcome Measures:
- Objective Psychological Impact of Exercises [ Time Frame: 8 weeks ]
Object psychological impact of exercises will be measured by clinician-administered questionnaires given at baseline and again at 8 weeks. These questionnaires include:
- Life Orientation Test-Revised (scores range from 6-30; a high score means higher optimism)
- Positive and Negative Affect Schedule (scores range from 10-50; a higher score means higher levels of affect)
- Hospital Anxiety and Depression Scale (scores range from 0-42; a high score means higher depression and anxiety).
Objective psychological impact will be defined as having significantly improved scores at 8 weeks as compared to scores at baseline.
|Study Start Date:
|November 2013
|Study Completion Date:
|September 2014
|Primary Completion Date:
|September 2014 (Final data collection date for primary outcome measure)
|Assigned Interventions
Experimental: Positive psychology
Positive psychology intervention
|Behavioral: Positive psychology intervention
|Ages Eligible for Study:
|18 Years and older (Adult, Senior)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- Adult patients admitted to one of three cardiac inpatient units at Massachusetts General Hospital.
- Primary diagnosis of acute coronary syndrome (myocardial infarction or unstable angina).
- Less-than-optimal adherence to health behaviors. This will be defined as a mean score of less than 15 on the Medical Outcomes Study Specific Adherence Scale (scores range from 3-18, with higher scores indicating better adherence).
Exclusion Criteria:
- Cognitive deficits, assessed via a 6-item cognitive screen used to assess appropriate participation of medically-ill patients in research studies.
- Patients not prescribed aspirin at discharge.
- Inability to communicate in English.
- Inability to participate in physical activity.
Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.
Please refer to this study by its ClinicalTrials.gov identifier: NCT02004158
Please refer to this study by its ClinicalTrials.gov identifier: NCT02004158
|United States, Massachusetts
|Massachusetts General Hospital
|Boston, Massachusetts, United States, 02114
Sponsors and Collaborators
Massachusetts General Hospital
National Heart, Lung, and Blood Institute (NHLBI)
|Principal Investigator:
|Jeff Huffman, MD
|Massachusetts General Hospital
More Information
Keywords provided by Jeff C. Huffman, MD, Massachusetts General Hospital:
Additional relevant MeSH terms:
ClinicalTrials.gov processed this record on August 23, 2017
|Responsible Party:
|Jeff C. Huffman, MD, Director, Cardiac Psychiatry Research Program, Massachusetts General Hospital
|ClinicalTrials.gov Identifier:
|NCT02004158 History of Changes
|Other Study ID Numbers:
1R01HL113272-01A1 ( U.S. NIH Grant/Contract )
|Study First Received:
|December 3, 2013
|Results First Received:
|March 22, 2017
|Last Updated:
|May 2, 2017
Keywords provided by Jeff C. Huffman, MD, Massachusetts General Hospital:
Acute coronary syndrome
Health behavior
Mental health
Additional relevant MeSH terms:
Acute Coronary Syndrome
Pathologic Processes
Myocardial Ischemia
Heart Diseases
Cardiovascular Diseases
Vascular Diseases
ClinicalTrials.gov processed this record on August 23, 2017


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Shay Mitchell was born Shannon Mitchell in Toronto, Ontario, Canada, to a Filipino mother and a father of Irish and Scottish descent. Even as a young child, she was interested in the performing arts, declaring to her parents that she would pursue such a career. Shay began dance lessons at the age of five, and she and several of her classmates toured the city to compete with a variety of other dance schools.
At the age of 10, Shay's family moved west to Vancouver, British Columbia. Within a year of their arrival, an international modeling agency held an open casting call for teen and pre-teen girls who were vying for representation. Shay was one of the girls selected.
By her late teens, Shay had successfully modeled for a variety of companies in cities as varied as Bangkok, Hong Kong and Barcelona. Wanting to focus on her true passion, Mitchell returned to Toronto and began to study acting with great focus and determination.
Name: Shay Mitchell
Known for: Pretty Little Liars
BirthDay: 10, Apr ,1987


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'When making life-or-death, war-or-peace decisions, a president can't just pop off or lash out irrationally,' she said on behalf of the Democratic presidential nominee at La Salle University in Philadelphia. 'We need an adult in the White House. I guarantee you.'
Obama criticized Trump over his spreading of the birther conspiracy theory, continuing a rebuke she first made earlier this month while stumping for Clinton in Virginia.
'There are those who questioned and continue to question for the past eight years whether my husband was even born in this country,' Obama said to boos. 'And let me say: hurtful, deceitful questions deliberately designed to undermine his presidency. Questions that cannot be blamed on others or swept under the rug by an insincere sentence uttered at a press conference.'
The first lady denounced the 'negativity' and 'name-calling' in the election and urged supporters to 'choose the right person to lead our country forward.'
'So if a candidate is erratic and threatening, if a candidate traffics in prejudice, fear and lies on the campaign trail, if a candidate thinks that not paying taxes makes you smart or that it's good business when people lose their homes, if a candidate regularly and flippantly makes cruel and insulting comments about women — about how we look, how we act — well, sadly, that's who that candidate really is,' she said.
The first lady was referring to a variety of attack lines Clinton has used to hit Trump in recent days and at Monday's debate, including his 2006 remark that he hoped for a real estate market crash, his criticism of a former Miss Universe's figure and his spreading of the 'birther' falsehood.
She continued: 'Experience matters. Preparation maters. Temperament matters. And Hillary Clinton has it all. She's the real deal.'
Via: supremepatriot.com


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Foraminal stenosis is a variation of spinal stenosis, a medical condition that causes the spinal canal to narrow and compress upon the spinal cord and nerves.
Foraminal Stenosis vs. Central Stenosis
Stenosis most commonly occurs in two ways: central stenosis, which is the narrowing of the entire spinal canal, and foraminal stenosis, a narrowing of the foramen through which the nerve root exits the spinal canal.
The first symptoms of stenosis are lower back pain and neck pain, which over time may lead to limping. Other symptoms include pain or abnormal sensations in the legs, thighs, feet or buttocks and loss of bladder or bowel control.
Diagnosing Stenosis
The best way to diagnose stenosis is the use of an MRI or CAT scan, which can determine the exact type of stenosis and the degree of degeneration.
Surgical Treatments
Stenosis can be treated with a laminectomy, which is a removal of the lamina or "roof" of the spinal canal in order to relieve the pressure. This procedure is usually combined with spinal fusion procedures in order to prevent destabilization of the spine.
Risk of Recurrence
A laminectomy is not without risk. After the procedure, there is a possibility that scar tissue can form where the lamina was removed from the spinal canal, creating similar pressure and symptoms in the patient.


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What is JotForm?
JotForm is a free online form builder which helps you create online forms without writing a single line of code. No sign-up required.
At JotForm, we want to make sure that you're getting the online form builder help that you need. Our friendly customer support team is available 24/7.
We believe that if one user has a question, there could be more users who may have the same question. This is why many of our support forum threads are public and available to be searched and viewed. If you'd like help immediately, feel free to search for a similar question, or submit your question or concern.
Form crashes on some browersAsked by sspradling on December 30, 2016 at 01:56 PM
one computer the form won't work in any brower
JotForm Support
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text:
Chandler's Crabhouse Send to Phone
OpenLunch Mon.-Fri., Dinner nightly, Brunch Sat.-Sun.
- Parking available
- Dress code: Casual
- Full bar
- Heart-healthy dishes
- Outdoor dining
- Private room(s)
- Reservations suggested
- View
* Click here for rating key
Text data on Chandler's Crabhouse to your phone, or a friend's cell phone.
Find out which restaurants and chefs top the list of GAYOT's 2016 Annual Restaurant Awards.


text:
A MAN who was left fighting for life after a 'tragic accident' in Clayton-le-Moors at the weekend has died, police said.
Paul Hart was cut free from the wreckage of the Fiat Stilo car after it collided with a small roundabout outside All Saints Church near to Mercer Park in Grange Street at around 8.20pm on Saturday.
The 49-year-old died on Wednesday, police said.
It's believed that he may have suffered a heart attack at the wheel.
Police said the blue car was travelling along a left-hand bend from Grange Street on to Church Street when it collided with a lamppost and railings forming a small roundabout.
A passenger was taken to Royal Preston Hospital but his injuries were not thought to be life threatening.
Clayton-le-Moors Cllr Tim O'Kane, who knew Mr Hart, said: "This news is very sad and it was a tragic accident.
"It's very sad that it happened in the shadow of a church and the whole community were shocked by what happened last weekend.
"We have never had a fatality at that spot before but now that we has been one we will have to consider extra safety measures.
"It has never been considered to be a dangerous area."
Officers closed the road for four hours on Saturday as firefighters fought to free the pair from the wreckage and investigators gathered clues.
A spokeswoman for the police said that the investigation was still on-going and that the family were in contacts with officers. She couldn't confirm if the passenger was still in hospital recovering from his injuries.


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World War II
During World War II, victory gardens were important to Americans around the country. The steel and tin industry was working hard on supplying the army with weapons, so there were not enough raw materials to make these and tin cans for vegetables. Trains were being used to carry soldiers instead of civilian food supplies. And, to make matters worse, Japan controlled most of the rubber factories overseas, which meant there was no rubber for new tires on trucks that carried food across the country.
This readalike is in response to a customer's book-match request. If you would like personalized reading recommendations, fill out the book-match form and a librarian will email suggested titles to you. Available for adults, teens, and kids. You can browse the book matches here.
The Zookeeper's Wife: A War Story by Diane Ackerman
The true story of how the keepers of the Warsaw Zoo saved hundreds of people from Nazi hands. When Germany invaded Poland, Stuka bombers devastated Warsaw—and the city's zoo along with it. With most of their animals dead, zookeepers Jan and Antonina Żabiński began smuggling Jews into empty cages. Another dozen "guests" hid inside the Żabińskis' villa, emerging after dark for dinner, socializing, and, during rare moments of calm, piano concerts. Jan, active in the Polish resistance, kept ammunition buried in the elephant enclosure and stashed explosives in the animal hospital. Meanwhile, Antonina kept her unusual household afloat, caring for both its human and its animal inhabitants—otters, a badger, hyena pups, lynxe—and keeping alive an atmosphere of play and innocence even as Europe crumbled around her. (catalog summary)
The Zookeeper's Wife is a 2017 British-American war drama film directed by Niki Caro and written by Angela Workman. The film stars Jessica Chastain, Johan Heldenbergh, Michael McElhatton and Daniel Brühl. The film is scheduled to be released on March 31, 2017, by Focus Features. View the offical HD Trailer below the book recommendations.
Looking for a war-time drama like The Zookeeper's Wife? Check out these other titles.
A Blessing on the Moon by Joseph Skibell
At the center of A Blessing on the Moon is Chaim Skibelski. Death is merely the beginning of Chaim s troubles. In the opening pages, he is shot along with the other Jews of his small Polish village. But instead of resting peacefully in the World to Come, Chaim, for reasons unclear to him, is left to wander the earth, accompanied by his rabbi, who has taken the form of a talking crow. Chaim's afterlife journey is filled with extraordinary encounters whose consequences are far greater than he realizes. (catalog summary)
For women caught in war zones, there are choices to be made. Try to get by as best you can, protecting your family if you have one, or throw in with the men defending your country, risking your own life. The 15 women whose stories are told in Women Heroes of World War II, the Pacific Theater all made difficult choices. Even so, as much as they were able, they resisted the invaders who overran their countries.
When I was a child, Thalhimer's meant shopping—Christmas shopping in Richmond. It was one of the last grand old department stores before shopping malls took over, and it got itself gussied up for the holidays. We might come home with bars of marzipan or hermit crabs but always with stars in our eyes. It was a place of sweet and inventive dreams. Little did we know that the store's founder had played an important part in making dreams of safety come true for many Jewish teenagers in World War II.
Robert H. Gillette's previous book, The Virginia Plan: William B. Thalhimer and a Rescue from Nazi Germany, gave an overview of how Mr. Thalhimer managed it. In Gillette's current work, Escape to Virginia: From Nazi Germany to Thalhimer's Farm, readers learn the in-depth stories of two of the rescued teenagers.
At dawn on December 7, 1941, America was at peace, although it was clear a war was coming. Nazi Germany had overrun most of Europe and was literally at the gates of Moscow. Britain was slowly starving as Nazi submarines sank the ships carrying food and medicine the British needed. Although the United States sent huge amounts of war supplies to Britain and Russia and had greatly expanded its own Army and Navy, Americans were unwilling to go to war against enemies who had never attacked us.
Horses have long been an important part of culture in peace and war. An enormous amount of effort has gone into creating breeds that are the swiftest, strongest, bravest, hardiest, and most intelligent, depending on need. Partly a matter of status and partly a matter of practicality, the search for The Perfect Horse was one of the matters occupying the Nazi elite during World War II.
History is complicated, and people's lives are even more so. In the short biography and video clip that Facebook has to share, Irena Sendler is presented as a Catholic woman who saved approximately 2,500 Jewish children. That is true, as far as it goes. Irene was certainly a courageous woman, and she came from Catholic roots and was devoted to the Church during her later years. But there is more to her story. Real heroes often lead complicated lives, as readers of Tilar J. Mazzeo's Irena's Children will discover.
After bouncing all night in cold, cramped steel boats, then waiting all day in broiling heat, the men of the Allied Expeditionary Force got the word: shortly after sundown, they would finally be getting off their floating, seasick prisons.
All they had to do then was run straight into machine gun fire, smash the Nazi army, and liberate Europe.
Margret Rey and her husband, H.A. Rey, had no children themselves, but thousands of kids across the world have made friends with their little monkey, Curious George.
Margret was born in Hamburg, Germany, on May 16, 1906. She studied art at the famous Bauhaus School and elsewhere before moving to Brazil in 1935. Margret married a fellow German artist, Hans Augusto (H. A.) Rey, and together they started the first advertising agency in Rio de Janeiro. They came back to Paris during some of its cruelest days, just before the Nazi occupation. Somehow, funny and delightful Curious George was created during those difficult times.
All the Light We Cannot See by Anthony Doerr: "Shifting among multiple viewpoints but focusing mostly on blind French teenager Marie-Laure and Werner, a brilliant German soldier just a few years older than she, this novel has the physical and emotional heft of a masterpiece. The main protagonists are brave, sensitive, and intellectually curious, and in another time they might have been a couple. But they are on opposite sides of the horrors of World War II, and their fates ultimately collide in connection with the radio-a means of resistance for the Allies and just one more avenue of annihilation for the Nazis. Set mostly in the final year of the war but moving back to the 1930s and forward to the present, the novel presents two characters so interesting and sympathetic that readers will keep turning the pages hoping for an impossibly happy ending." (Library Journal)
If you enjoyed All the Light We Cannot See, you may also like these titles:
Code Name Verity by Elizabeth Wein
"In 1943, a British fighter plane crashes in Nazi-occupied France and the survivor tells a tale of friendship, war, espionage, and great courage as she relates what she must do to survive while keeping secret all that she can." (Book Description)
Hotel on the Corner of Bitter and Sweet by Jamie Ford
"Set in the ethnic neighborhoods of Seattle during World War II and Japanese American internment camps of the era, this debut novel tells the heartwarming story of widower Henry Lee, his father, and his first love Keiko Okabe." (Book Description)


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Interestingly, I did the Myers-Briggs last night. Albert went for the course. I am ENFP- extrovert, intuitive, feeler and perceiving.
ENFPs are outgoing and are project-oriented. They tend to be playful and clever.
ENFPs learn best in flexible situations where they know the teacher takes a personal interest in them. They like to be able to interact with their peers, but not too much so. They want to feel free to dig into subjects that are of interest to them. Having both flexibility and creativity rewarded is encouraging to them. While they may not enjoy deadlines, if they value the assignment, they will meet those deadlines. Deadlines may force ENFPs to decide that their work is "good enough" to turn in.
Subjects that hold a great deal of interest for them are learned readily. They will often do extra work in their attempt to learn as much as possible about something of interest. They often read assignments carefully and then work their creativity into the given framework of the assignment. Thus it may appear that they did not pay careful attention to the details of the assignment in their reinterpretation. It is best if they have teachers who appreciate their unique approach and who do not hold them to the letter of the law.
At work, ENFPs are adaptable, welcoming to new ideas and information, well aware of people and their feelings, able to relate to others, albeit with some psychological distance. ENFPs dislike telephone interruptions and work well alone, as well as with others. They are patient with complicated situations, but impatient with routine details. They can make errors of fact, but seldom of values. Their career choices may be toward the ministry, missionary work, college teaching, science, music, architecture, and psychology, but away from business. They seem willing and are usually able to apply themselves scholastically to gain the necessary training for professional work, often doing better in college than in high school. They have a natural interest in scholarly activities and demonstrate, as do the other NF's, a remarkable faculty for languages. Often they hear a calling to go forth into the world to help others; they seem willing to make the necessary personal sacrifices involved in responding to that call, even if it means asking others to do likewise. ENFPs can make outstanding novelists and character actors, for they are able to efface their own personalities in their portrayal of a character in a way other types cannot.
enfps often follow a nonlinear career track and nontraditional routes to obtaining knowledge, qualifications, and skills. when they are committed to what they do, they are enthusiastic to the point of preaching to the entire world about it. for an enfp, work must be fun and must contribute to something larger than merely collecting a paycheck.
the preferred work setting for enfps contains imaginative people focused on human possibilities. enfps want a work environment that is both physically and mentally colorful. they prefer a participative and collegial atmosphere in which employees are included in the decision making. enfps are less productive where there is disharmony because they pay more attention to the relationships between people at work than they do to the tasks. their ideal job would offer variety, novelty, challenge, and freedom from tight supervision; it would be idea oriented and imaginative, and would have lively, energetic people enjoying themselves and their tasks.
common occupations picked by enfps include artist, clergy, consultant, counselor, entertainer, journalist, public relations worker, social scientist, social worker, teacher, and other occupations that allow enfps to use their creativity and insight
For the ENFP, love is a very deep commitment, and one that is not easily attained. They have ideals, and therefore reality may be carefully scrutinized.
With their ideal firmly envisioned, the first date with that special person is carefully planned and prepared for, and often every aesthetic thing is taken care of. The flowers are in place, the right wine is ordered, and the proper meal is prepared.
ENFPs may have difficulty sharing their feelings about others. They keep so many of those feelings inside that they may forget to tell their partner how much they love and appreciate them. They also need reminders of their partner's love.
When things go wrong in a relationship, the ENFP takes it to heart but does not readily discuss it with others. They may not be willing to communicate to let others know how they are feeling. When scorned, they are very hurt and may overreact in an almost maudlin way.
Conclusion: i don't like mundane , got bored with mundane task, not good with details, I am perceiving and insightful, meaning i seek meaning in what i do, want to see the "big picture" , and connect
MBTI is meant to find out our natural trait, like writing with my right hand... hence, i am not comforting with my job at the moment, because i am writing with my left hand ..


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London Buses route 14 is a Transport for London contracted bus route in London, England. Running between Putney Heath and Warren Street, it is operated by London General.
From 1949 route 14 ran from Hornsey Rise to Putney (Monday to Friday) and beyond to Kingston at weekends with a joint allocation between Putney Bridge garage and the original Holloway (Holloway Road) Garage (J) using RT type buses. The route number had previously been used for a service to Putney in the 1920s prior to the formation of the London Passenger Transport Board. A RTW allocation was introduced at Putney Bridge from May 1955. On 6 May 1953, the route was extended on Sundays beyond Kingston to Hampton Court, for the summer months (May to October). This Summer Sunday extension continued annually until 1965. On 26 November 1958 the Monday to Friday service was withdrawn between Kingston and Putney. Following the closure of Putney Bridge garage, part allocation of the route also transferred to Putney (AF) Garage. By 1965 the whole route had a Routemaster (RM) allocation, and by 1968 the route had gradually converted to the longer RML type.
In 1957 the route was used as the basis for a New Scientist magazine study into congestion on London streets. Vehicles on the central section of route between Euston and Hyde Park Corner were found to spend 68% of time in motion, and only 11% loading and unloading passenger.
On 18 April 1970, Putney's Sunday allocation was withdrawn, although this was reintroduced on 2 January 1971 when the route was withdrawn between Putney and Kingston, being replaced by the re-introduced Sunday route 85. During September 1971 Holloway (J) garage closed, and the associated part allocation transferred to the previously named Highgate (HT), now renamed Holloway (Pemberton Gardens), Garage.
The late 1980s saw revisions to the Northern end of the route, on 7 February 1987 the main route was cut back to run between Putney Heath Green Man and Euston (or Tottenham Court Road Station]] Monday to Saturday evenings). The Sunday services consisted of a morning extension to Hornsey Rise, and a further extension to Turnpike Lane station, via Crouch End, on Sunday afternoons, with meal relief journeys running to Wood Green Garage. The withdrawn Euston to Hornsey Rise section was replaced by a new route 14A (now route 91). On 26 September the off peak Monday to Friday service was withdrawn between Tottenham Court Road and Euston. The Sunday afternoon service was withdrawn between Crouch End and Turnpike Lane on 26 March 1988.
On 24 February 1990 Sundays Putney allocation was withdrawn again, with Holloway running the full Sunday allocation until April 1993, when Victoria ran the Sunday service before returning to Putney during July. On 10 October 1992 the route was withdrawn between Euston and Crouch End, being replaced by route 91 and on 29 January 1994 withdrawn further between Tottenham Court Road and Euston. During 1996, the late evening and early morning service was operated using OPO buses, Northern Counties Palatine bodied Volvo Olympians and later Wright Eclipse Gemini bodied Volvo B7TLs from route 74. By September 2001 the Sunday daytime service had been reverted to crew operation.
On 23 November 2002, the route was retained by London General.
On 24 January 2004, the service became a 24-hour service.
On 23 July 2005, the route was converted to one man operation with the AEC Routemasters replaced by brand new Wright Eclipse Gemini bodied Volvo B7TLs.
On 13 January 2007, the route was extended from Tottenham Court Road to Warren Street Station.
On 14 November 2009, the route was retained by London General.
Due to the temporary closure of Putney Bridge, on 14 July 2014 the route temporarily had its southern terminus relocated from Putney Heath to Putney Bridge. It resumed operating to Putney Heath on 28 September 2014.
On 19 November 2016, the route was retained by London General.
In December 2016, the Wright Eclipse Gemini bodied Volvo B7TLs were replaced by brand new Enviro 400 MMC bodied Alexander Dennis E40Hs.
Current routeEdit
Route 14 operates via these primary locations:
- Putney Heath Green Man
- Putney
- Putney Bridge
- Fulham Broadway
- South Kensington
- Harrods
- Knightsbridge
- Hyde Park Corner
- Green Park
- Piccadilly Circus
- Tottenham Court Road
- Warren Street


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- familism
- noun Date: 1925 a social pattern in which the family assumes a position of ascendance over individual interests • familistic adjective
New Collegiate Dictionary. 2001.
New Collegiate Dictionary. 2001.
Familism — Fam i*lism, n. The tenets of the Familists. Milton. [1913 Webster] … The Collaborative International Dictionary of English
familism — [fam′ə liz΄əm] n. a form of social structure in which the needs of the family as a group are more important than the needs of any individual family member familistic adj … English World dictionary
familism — ˈfaməˌlizəm noun ( s) Etymology: family + ism 1. sometimes capitalized : the tenets and practices of the familists men who follow Anabaptism, familism, antinomianism, and other fanatic dreams John Milton 2. : a social pattern in which the family… … Useful english dictionary
familism — familist, n. familistic, adj. /fam euh liz euhm/, n. Sociol. the subordination of the personal interests and prerogatives of an individual to the values and demands of the family: Familism characterized the patriarchal family. [1635 45; FAMIL(Y)… … Universalium
familism — noun A form of social structure in which the needs of the family as a group are more important than the needs of any individual family member … Wiktionary
familism — fam·i·lism … English syllables
familism — Близость … Вестминстерский словарь теологических терминов
amoral familism — Social action persistently oriented to the economic interests of the nuclear family . In a controversial account of poverty in a village in southern Italy (The Moral Basis of a Backward Society, 1958), Edward C. Banfield argued that the… … Dictionary of sociology
William Crano — Dr. William Crano is the Oskamp Distinguished Professor of Psychology at the School of Behavioral and Organizational Sciences (SBOS), Claremont Graduate University. Crano is a Fellow of the American Psychological Association (APA) and American… … Wikipedia
Familismus — Fa|mi|lịs|mus 〈m.; ; unz.; Soziol.〉 Überbewertung des familiären Bereichs als Quelle für soziale Kontakte [<engl. familism <family "Familie"] * * * Fa|mi|lịs|mus, der; [engl. familism, zu: family = Familie < lat. familia, ↑Familie]… … Universal-Lexikon