text:
|Publication number
|Publication type
|Application number
|Publication date
|Feb 1, 2005
|Filing date
|Apr 2, 2001
|Priority date
|Apr 7, 2000
|Fee status
|Also published as
|Publication number
|Albert S. Lee, Walter J. Koroshetz
|Original Assignee
|The General Hospital Corporation
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (59), Non-Patent Citations (5), Referenced by (15), Classifications (16), Legal Events (4)
|External Links: USPTO, USPTO Assignment, Espacenet
This application claims priority from U.S. Provisional Patent Application Ser. No. 60/195,571, filed on Apr. 7, 2000, which is expressly incorporated by reference herein.
Not Applicable.
This invention pertains to methods and apparatus for thermally affecting tissue, and, more particularly, is directed to methods and apparatus for cooling brain tissue.
The medical profession has long known that the human brain is highly susceptible to injury following the reduction or cessation of blood flow thereto. Such injury often occurs, for example, following stroke, cardiac or respiratory arrest, or as a result of other bodily trauma. The medical profession also has long known that the application of cold to the human body slows the body's metabolic activity.
Based on this collective knowledge, plus the fact that brain injury usually has debilitating, irreversible consequences to a victim thereof, scientific research has focused upon inducing hypothermia to reduce the likelihood and/or extent of such brain injury.
Early research efforts (i.e., those prior to 1970) in this area focused upon global body hypothermia, in which a patient's entire body is cooled, e.g., to approximately 30-32� C., in order to concurrently cool brain tissue. In recent years, however, such techniques have been criticized by those in the art as tending to cause conditions (e.g., depression of systemic immune function, creation of cardiac arrhythmias, reduction of cardiac output) that can result in organ damage.
Consequently, more recent research in this art has focused upon achieving brain cooling through localized hypothermia. Among such research efforts are those described in U.S. Pat. Nos. 5,957,963, 5,916,242, 5,716,386, 5,531,776, and 5,474,533. Also in this vein are the approaches set forth in U.S. Pat. Nos. 3,897,790 and 3,776,241.
The U.S. Pat. No. 5,957,963 patent discloses a catheter that is placed within an artery that carries blood to the brain. Coolant is circulated into the catheter to cool the artery, thus cooling the blood flowing from the artery to the brain, and, in turn, cooling the brain itself.
The U.S. Pat. No. 5,916,242 patent discloses a collar that is worn around the neck to cool the carotid artery, thus cooling the brain via cooled blood flowing from the carotid artery to the brain. It also discloses the use of a tube that is inserted into a patient's trachea until it is in intimate contact with the back of a patient's oral cavity and, thus, in contact with blood vessels located thereat. Coolant is then flowed into the tube to cool the blood vessels, which carry cooled blood into the brain.
The U.S. Pat. Nos. 5,716,386, 5,531,776, and 5,474,533 patents are directed to devices that are positioned within the esophagus such that a heat transfer surface of the device is juxtaposed with a thoracic vessel. Coolant is then pumped through the device to cool the blood contained in the thoracic vessel, which, in turn, flows into and lowers the temperature of a patient's cerebellum.
The U.S. Pat. Nos. 3,897,790 and 3,776,241 patents disclose a technique for achieving brain cooling by locally irrigating the surface area of the nasal mucosa in order to cool the temperature of blood destined for the cavernous sinus which is in proximity to the brain.
Although such techniques are perhaps effective to manipulate brain temperature, they are likely highly inexact. This is because, for example, even after one ceases cooling one or more arteries or vessels using such techniques, the blood being carried to the brain via the vessel(s) or artery/arteries will continue to cool brain tissue for a residual time period until the blood returns to its normal temperature. Furthermore, by cooling specific vessels, one merely cools brain tissue closest to those vessels and their major arteries.
Therefore, a specific need exists for methods and apparatus that are capable of achieving safe, effective and precise localized brain cooling.
Moreover, a general need also exists for methods and apparatus that allow safe, effective and precise thermal affecting (i.e., temperature manipulation) of tissue.
The present invention provides methods and apparatus for thermally affecting (i.e., manipulating the temperature of) tissue. Although the invention is primarily shown and described in conjunction with cooling brain tissue, it is understood that the methods and apparatus of the present invention may be used to thermally affect (i.e., to raise and/or lower the temperature of) any tissue.
In one aspect of the invention, a thermally affecting device is provided as a closed device wherein thermally transmissive fluid is circulated through the device, an outer surface of which is configured to directly contact tissue to thermally affect the tissue. In another aspect of the invention, the thermally affecting device is provided as an open device wherein thermally transmissive fluid is circulated through the device and systematically deployed directly onto tissue to thermally affect the tissue. For example, the device may be placed either within, or in proximity to, epidural or subdural brain space in order to thermally affect brain tissue.
In either aspect of the invention, the device may include one or more temperature and/or pressure measuring elements to measure the temperature/pressure of the thermally transmissive fluid and/or that of the tissue being thermally affected. Moreover, both the closed and open devices may be placed at or near tissue via an existing passage into the body, or by creating an opening specifically for placement of the device. Optionally, a retraction device may be employed in order to facilitate the placement of the device at a tissue site.
The invention will be more fully understood from the following detailed description taken in conjunction with the accompanying drawings, in which:
The present invention provides methods and apparatus for thermally affecting (i.e., raising or lowering the temperature or other thermal characteristic of) tissue. The apparatus can be in the form of either a "closed" device (see
The internal lumen or conduit 14 has an entry port 16 into which thermally transmissive fluid enters from a fluid source 20, and an exit port 18 from which thermally transmissive fluid exits and either is routed back to the fluid source or to a collection area (not shown). As shown in
Thermally transmissive fluid is directed into the entry port 16 and out of the exit port 18 of the internal lumen 14 by suitable equipment/source generally known in the art, e.g., via a circulating pump. The temperature of the fluid source (and, therefore, the thermally transmissive fluid emerging therefrom) is controlled as is generally known in the art, e.g., by heating or refrigeration in conjunction with a set point controller. Exemplary fluids include, but are not limited to, one or more liquids, gases, or combinations thereof.
In an embodiment in which the thermally transmissive fluid is coolant and the tissue being thermally affected is brain tissue, the coolant should be a flowable material that can tolerate a temperature range of between about 50� C. and −10� C. Exemplary coolants in such embodiments include, but are not limited to, liquids and fluids such as water, electrolyte solutions (e.g., saline), or antifreeze solutions.
The implantable member 10 is shaped to maximize the area of its outer surface 12 that contacts the tissue site upon implantation. As shown in
The exact material and/or dimensions of the implantable member 10 may vary depending on several circumstances, such as the desired thermal effect on the tissue, the specific tissue to be thermally affected, etc. The implantable member 10 is generally formed of a flexible, heat conductive, biocompatible material, such as a silicone elastomer, e.g., silastic tubing, but may be formed of other suitable materials.
In an embodiment in which the implantable member is used to thermally affect brain tissue, the cross-sectional length, L, of the implantable member 10 is generally between five millimeters and twenty-five centimeters. Additionally, the cross-sectional width, W, of the implantable member 10 may be substantially uniform as shown in
The device 10 of
The device 10 may either be placed epidurally, wherein it is placed between the skull and the dura 38 (i.e., in epidural brain space 36), or subdurally, wherein it is placed between the dura and the surface of the brain cortex (i.e., in subdural brain space 40). In order to better illustrate these portions of the human head 30, the brain 42 and the areas of the head which surround it are also shown in
Although not shown in the drawings, it is understood that placement of the device 10 at loci other than brain tissue in order to thermally affect other tissue sites can be accomplished by placing the device within one or more existing work areas within a patient, or by surgically (or otherwise) penetrating a patient to define a passage and work area of appropriate size and shape to allow for placement of the device.
As shown in
The backing sheet 44 will generally have a temperature measuring element 46 (see
The temperature measurement element 46 may be connected to a suitable temperature indication element 48, such as a display, as is generally known in the art (e.g., via an analog-to-digital converter) in order to provide a temperature indication. In other embodiments, the device 10 need not include a backing sheet 44, and, in such embodiments, the temperature measuring element 46 (if included) can be attached to the device itself.
As shown in
Exemplary placement options for such temperature measurement elements 46′ include at or near the entry port 16 of the inner conduit 14, and/or at or near the exit port 18 of the inner conduit, and/or at any location therebetween. The temperature measurement element(s) are connected to suitable temperature indication element(s) also as is generally known in the art.
The device of
A hemicraniectomy is often performed following a stroke (when, as explained above, cooling of the brain can prevent potentially devastating brain injury) in order to relieve pressure and to allow for the brain to comfortably swell—since brain swelling is a common side effect following a stroke. Thus, following a hemicraniectomy, when a portion of the skull has already been removed, the device of
Referring now to
Prior to implantation, the implantable member 10′ is placed over a guidewire, causing the member to substantially conform to the shape of the guidewire (see FIG. 10), thus facilitating the positioning of the member within the skull (or other work area). As shown in
The shape memory device 10′ depicted in
Referring now to
The exemplary catheter 100 of
Although the catheter of
One, some or all of the catheters deploy thermally transmissive fluid 110 from their exit ports 106 to thermally affect tissue 142. While or after this occurs, one, some or all of the catheters may be operated as vents or suction returns to retrieve thermally transmissive fluid 110 from the tissue area 142. Exemplary thermally transmissive fluids include water, saline or a mixed fluorocarbon solution. The mixed fluorocarbon solution may be compounded such that it is deployed in liquid form, wherein the liquid undergoes a phase change and transforms to a gas at a tailored boiling point.
The fluorocarbon solution is capable of extracting heat at a high rate per unit volume during its transition from liquid to gas, thus effectively "cooling" the tissue site. This phase transition may be controlled as is generally known in the art to prevent an excessive, and, therefore, potentially harmful, temperature drop. Use of a fluorocarbon solution is further advantageous due to the ease spreading and extraction of a gas, as compared to a liquid, and due to its low viscosity.
Additionally, the thermally transmissive fluid 110 can include a pharmaceutical, neuroprotective agent, e.g., an enzyme inhibitor or a neuro-chemical receptor antagonist/agonist, to ensure that the thermally transmissive fluid does not harm the tissue or surrounding areas which the thermally transmissive fluid may contact.
The plurality of catheters 100 may be used in any circumstance in which a passageway to the tissue site already exists (e.g., following a hemicraniectomy) or can be fashioned.
In an exemplary embodiment depicted in
The exemplary embodiment of
The pressure indication element 182, in turn, may be in communication with an alarm or other visual, audio, or audio/visual warning indicator 184 that is effective to signal an operator to cease or reduce the flow of thermally transmissive fluid from the fluid source 186. Such a warning system to warn of unacceptably high or low pressure levels at the brain tissue treatment site.
Other "open" implementations effective to thermally affect a tissue site/region are also possible. For example, as shown in
In embodiments in which the device 200 is used to cool brain tissue, this location of the suction openings 212 is preferred because it prevents suction of delicate brain tissue 206. Further, any of the thermally transmissive fluid distribution devices described above may include a protective jacket or cage that also is effective to prevent clogging of suction return openings with tissue (e.g., brain tissue and/or dura matter).
The placement of any of the devices described above may be facilitated through the use of a retraction device. For example, such a retraction device may be utilized to separate brain tissue that is to be treated from its protective dura matter (i.e., to clear space within the subdural space).
It is understood that the retraction device 190 may be incorporated into a temperature affecting catheter, e.g., the device of
Another type of retraction device (not shown) includes a port out of which saline (optionally mixed with a pharmaceutical neuroprotective agent as described above) may be infused at a rate and volume sufficient to gently push away the tissue to be treated (e.g., to push away brain tissue from the dura) to create space for the insertion of the thermally affecting device. One of ordinary skill in the art will appreciate that still further retraction devices may also be used in conjunction with any or all of the thermally affecting devices described herein.
In any of the above-described embodiments of the invention, the implantable member 10, 10′ may have a single lumen or multiple lumen arrangement. In a multiple lumen arrangement having two lumens, thermally transmissive fluid is able to flow from a fluid source through a first lumen, while also being capable of simultaneously flowing via suction or other means back through the member via a second lumen in order to return to the fluid source. Other multiple lumen arrangements may alternately be used, including, but not limited to, concentric lumens, a single lumen divided into hemispherical chambers, or side-by-side lumen arrangements.
The device of
Five dogs underwent unilateral craniotomy under general anesthesia to expose their cerebral cortexes. Cooling devices of the type depicted in
Following baseline measurements, the surface of the brain tissue to which the device had thermal contact were found to have been cooled to approximately 26.5� C., reflecting a 13� C. difference relative to contralateral hemisphere controls. Furthermore, thermocouples attached to the devices revealed that brain tissue approximately 10 millimeters below the surface of the brain tissue had been cooled approximately 3� C. from its pre-cooling temperature.
These results demonstrate the ability of such devices to induce effective cooling in healthy brain tissue, and, therefore, in brain tissue following stroke, wherein blood flow into the brain has been curtailed or eliminated, thus making the brain less resistant to cooling.
One skilled in the art will appreciate further features and advantages of the invention based on the above-described embodiments. Accordingly, the invention is not to be limited by what has been particularly shown and described, except as indicated by the appended claims. All publications and references cited herein are expressly incorporated herein by reference in their entirety.
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Owner name: GENERAL HOSPITAL CORPORATION, THE, MASSACHUSETTS
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:LEE, ALBERT S.;KOROSHETZ, WALTER J.;REEL/FRAME:012847/0063;SIGNING DATES FROM 20010731 TO 20020410
|Aug 11, 2008
|Maintenance fee reminder mailed
|Feb 1, 2009
|Lapse for failure to pay maintenance fees
|Mar 24, 2009
|Expired due to failure to pay maintenance fee
Effective date: 20090201


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10124 Inverness Main Street, Englewood CO, 80112
Sold Price:
2 beds , 2 Full/1 Three-Qtr/1 Half baths
2,277 sqft
Status: Sold
Listing Provided Courtesy Of: Re/Max Masters Millennium
Real Living CO Real Estate
(720) 880-2288
Last Updated: 11/19/2017 6:23 PM
Description for 10124 Inverness Main Street Englewood, CO 80112
Beautifully finishes in the "Seine" model Row home, New upgraded carpet, Granite, Tile & Hardwood finishes, Stainless appliances, Main floor Study/Bedroom for Guest, Large front patio & covered patio. "Very Sharp"
Sold Price:
Sold Date:12/17/2015
2 Full/1 Three-Qtr/1 Half
2,277 (approx)
Beautifully finishes in the "Seine" model Row home, New upgraded carpet, Granite, Tile & Hardwood finishes, Stainless appliances, Main floor Study/Bedroom for Guest, Large front patio & covered patio. "Very Sharp"
Listing Information
Metropolitan Homes
2,277 Sq. Ft. (approx)
Community Water
School Information
Room Information
Master Suite
Eat-In Kitchen
Interior Features
2,277 Sq. Ft. Above Ground
Central Vacuum, Cook Top Range, Dishwasher, Disposal, Dryer, Microwave Oven, Refrigerator, Self-Cleaning Oven, Washer
Tile, Carpet, Wood
Central Air
Gas Heat, Forced Air
No Basement
Double Pane
1, Gas logs, Living Room
Security System, Alarm -Smoke/Fire,
Internet Connection, Kitchen Island, Open Floor Plan, Walk-in Closets, Window Coverings
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2 Parking Spaces, Finished Garage
Stucco, Brick
Balcony, Patio
Public Transport
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Englewood Real Estate
Englewood is located in Colorado. Englewood, Colorado 80112 has a population of 33,082.
The median household income in Englewood, Colorado 80112 is $46,776. The median household income for the surrounding county is $62,213 compared to the national median of $53,482. The median age of people living in Englewood 80112 is 36.6 years.
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text:
joelcrosenberg | August 23, 2011 at 6:45 pm | Categories: Uncategorized | URL: http://wp.me/piWZ7-1jO
See: This historic document, known as "Megillat Bush"- This is also a warning to
Two rare earthquakes have hit the U.S. in two days -- a 5.9 magnitude tremor epicentered in southern Virginia on Tuesday shook the White House, Capitol and Pentagon and was felt up and down the Eastern seaboard; and the largest earthquake in Colorado and New Mexico four decades occurred on Monday.
Until now, I'd never experienced an earthquake before. While this one was mild, it made me think of the column I wrote last month, entitled, "The Lord is shaking the nations physically, spiritually, financially: Why, and how should we respond?" A few excerpts might be worth reconsidering today:
- "Americans, too, are being shaken. We face arguably the worst economic crisis since the Great Depression. Nearly half of all Americans believe we are heading towards another Great Depression. Unemployment is over 9%. Housing foreclosures are skyhigh. People have lost enormous sums of money due to depressed housing prices and stock market volatility. The federal government is trying to spend our way to prosperity but is making things worse. Our annual federal budget deficit topped $1.3 trillion last year. This year, it looks like the feds will spend more than $1.5 trillion beyond what they are taking in in revenue. Our debt is skyrocketing. The U.S. is now on the verge of financial default, and hampered further by political ineptitude in Washington that threatens to comp0und an already precarious situation.
- "What if these events are not all random? What if the God of the Bible is allowing these to happen to shake us, to wake us, to get our attention, that we might turn to Him and ask Him to have mercy on us and help us?
- "The Lord said through the ancient Hebrew Prophet Haggai that the nations would be shaken in the future. "For thus says the Lord of hosts, 'Once more in a little while, I am going to shake the heavens and the earth, the sea also and the dry land. I will shake all the nations….I am going to shake the heavens and the earth. I will overthrow the thrones of kingdoms and destroy the power of the kingdoms of the nations." (Haggai 2:6, 7, 21, 22)"
>> To support The Joshua Fund to bless Israel and her neighbors in the name of Jesus — especially at this critical moment — please click here
>>With threats rising against America, Israel, and the Church, encourage your pastor to host "The Gathering Storm" special simulcast on Saturday, October 22nd. For more details — and to see a brief video — please click here.
>> For more information on the Sept. 11 "Wake Up Call" simulcast with Anne Graham Lotz and Joel, please click here
- What is the "War of Gog & Magog" described in Ezekiel 38-39? — notes from a recent conference
- Israel, Prophecy, and the "Day of the Lord": Understanding the Old Testament Book of Joel – notes from a recent conference
- Watch the videos from the 2011 Epicenter Conference online — and/or order the DVD package of all the messages


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Sear-Roasted Beef Tenderloin
Photo by Scott Phillips
- Freshly ground black pepper
- 1 Tbs. Dijon mustard
- 1 Tbs. Worcestershire sauce
- 2 Tbs. olive oil
- Kosher salt
- 1 medium clove garlic, mashed to a paste
- 1 tsp. soy sauce
- + 3 more ingredients
- 1 tsp. finely chopped fresh thyme
- 1 tsp. honey
- 1 trimmed whole beef tenderloin (3-½ to 4 lb.)
Fold the thinner end of the tenderloin under to create an evenly thick roast; secure with twine. Rub the beef all over with 1 Tbs. salt. Wrap it in butcher paper or plastic wrap, put it on a platter or rimmed baking sheet, and refrigerate for at least 2 hours and up to 2 days. Remove the beef fr...
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Miller backing for Broad
National selector Geoff Miller believes Stuart Broad is getting back on form ahead of England's series with India.
Last Updated: 17/07/11 1:50pm
National selector Geoff Miller believes Stuart Broad is starting to get back to his best form ahead of England's Test series with India.
The pace bowler was included in a 12-man squad for the first Test at Lord's despite struggling to take wickets during the recent Test and one-day series with Sri Lanka.
He was dropped for the NatWest Series decider against the World Cup runners-up last weekend to accommodate an extra spinner at Old Trafford.
Instead Broad turned out for county side Nottinghamshire against Somerset and Miller was impressed with the 25-year-old's response, as he took match figures of 6-162.
"We watched him bowl here at Trent Bridge in the four-day game. There were signs he was getting back to where he was," Miller told Sky Sports News.
Broad will likely have to battle Tim Bresnan for a place in the England attack, alongside seamers Chris Tremlett and James Anderson and off-spinner Graeme Swann.
Miller said of Broad: "We know what he is capable of doing, and when he puts on that England shirt we feel sure he will show exactly that and produce the goods and make it difficult for India.
"They (Broad and Bresnan) are two bowlers who can produce on the day, and we are looking forward to them producing at Lord's."
He added: "Pace and bounce would be nice for our bowlers certainly. We've got a strong batting line-up. But it's about producing on the day.
"We've got Matt Prior coming in at number seven, which is special. We're quite happy with our batting strength, and also with our bowling strength as well."
Miller hopes that England take advantage of home conditions against the world's top-ranked Test side, who come into the four-match series on the back of a hard-fought 1-0 victory over the West Indies in the Caribbean.
"It's tough for India to come straight over from the West Indies and play in our conditions. It hasn't been ideal preparation for them," he said.
"They didn't seem to do particularly well with the bat the other day (in their first innings of a Tour match against Somerset) - but that doesn't mean they won't be able to turn it on at Lord's.
"We prepare very thoroughly and are ready. So we hope we can hit the ground running - and I'm sure we will."


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Every year on the anniversary of the prophet Mohammed's (praise and peace be upon him) birth, the 'Eid al-Mawlid, thousands of Moroccans take part in pilgrimages to sacred places: saintly tombs, shrines and grottos, and places frequented by 'junuun,' those non-human beings talked about in the Qur'an and who hold a special place in Moroccan folklore and popular culture.
Last week thousands of pilgrims descend upon Sidi Ali, a near drive from Meknes or Moulay Idriss, to commemorate Sidi Ali ben Hamdush. Culture Vulture's Jessica Stephens and I made the trip in search of the supernatural, the trance, the aura of the junuun, to experience the ritual bath at the spring of Aïsha Kandisha – a jinn said to dwell in rivers and underground water sources.
During the week of the pilgrimage tents and stalls line the streets of the small town. The smell of tea and grilled meat mixes with those of live sheep awaiting slaughter and the sweet incense used in ritual offerings. Music fills the foggy mountain air as impromptu street performances take place in every corner. Families gather round the musicians playing anything from the Ahidous native to the Altas Mountains to Sufi music in the Hamadshi or Gnawa traditions. As midnight nears and we begin making our way to the spring of Aïsha Kandisha, the streets fill with more and more people, some coming from as far as Casablanca.
Along the road leading to Aïsha's grotto, one finds everything they need for the ritual: incense and candles, spices and milk, dried lizards – to be cut in three and burned – as well as lead used for various magical practices. They've even gone to the lengths of preparing all-in-one ritual kits including everything one needs to please the spirits. Not many foreigners come to Sidi Ali, but the herbalists are welcoming and willing to share their knowledge with us.
Walking through the festival bazaar, one has the impression that they are both back in time and in a modern art exhibition at once, Jess remarked, examining a neatly bound string of dried lizards.
The spring of Aïsha sits nestled in the side of the mountain. A rock with a flat surface near ground level is adorned with lit candles, and incense and other offerings are scattered and burned before pilgrims make their way down a few slippery steps to the spring. The waters of 'Aïn Aïsha flow through a crevice revealed by a few uplifted paving stones. Along two sides of the spring, small stalls are used as showers, where pilgrims wash with the spring waters and say a prayer before throwing their underpants over their shoulders and into the ravine. Needless to say, the trees lining the ravine are well-adorned. We didn't dare bathe outside in the freezing cold, however pilgrims continue bathing well into the night.
Light-headed but calm from the sweet smell of incense, and acquainted with Aïsha, it was trance-time. By the time the Gnawis began their laïlat, the rhythmic evening incantation that brings spirits and humans together in remembrance of God, the population of Sidi Ali had gone up drastically. In garages, tents and concrete apartment buildings all over town, the sound of the gambri accompanied by metal castanets echoed as the chant of the gnawis rose in unison.
Slowly spectators were brought into the ritual – dancing, swaying and being offered breaths of incense until some crept into a trance. The kind of bodily involvement in the trance inspired by gnawa is by far the most intense I remember having seen. Women and men in trance rock their heads and sway in sporadic, yet rhythmic motions. When asked by Jess, one young woman from Casablanca said that she highly recommended the trance, that there was no better feeling or sense of release. But not everyone can do it…
[youtube http://www.youtube.com/watch?v=j1Rv0iGeox4&w=289&h=157]
At a moment in one of the Laïla, an older man rolled up his pants and sleeves, revealing scars from the previous nights. Taking deep breaths of incense and calling back and forth in prayer with the gnawi, he readied himself for the knife. I turned away shortly thereafter, but had to come back out of morbid curiosity. As the gnawa musicians picked up the pace, he began rhythmically cutting himself on the arms, the lips, the neck and sides. We mused that the knife wasn't sharp enough to cut very deeply. However, sharp or not, seeing as it was Tuesday we guessed the old hajj was only warming up; and before long some participants in the Laïla were passing bundles of lit candles up and down their skin.
The experience of the Laïla was unlike anything I'd ever seen, however, it struck familiar chords. Participation with the mystic during the pilgrimage of Sidi Ahmed ben Hamdush is very much like all mystic experiences: it requires initiation and belief. For the outsider, the sweet smell of incense and the rhythmic clapping of castanets and chanting of the gnawi form an experience that flows between the spiritual and the sensory – between mere curiosity and more esoteric meanderings.
Hardly advertised, the pilgrimage of Sidi Ali ben Hamdush is known by most Moroccans. As foreigners living in Morocco, we wouldn't have known about it or gone if it weren't for the advice of friends. However, only traveling a few hours from Fez, we relished the opportunity to be transported deep into Moroccan tradition.
Text by: Joe Lukawski/Photos by: Jessica Stephens
Contact Joe at : firstname.lastname@example.com
For more on Joe's work, check out his blogs at:


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Submitted by Mitzi Roberts on
Author Allen Eskens will visit the Watonwan County/St. James Library and speak about his debut novel The Life We Bury. The Life We Bury is about a college student, Joe Talbert, who interviews a nursing home resident as part of an assignment. That resident is a Vietnam Vet and convicted murderer Carl Iverson. Life with never be the same again for Joe.This event is made possible by a grant provided by the Traverse des Sioux Library Cooperative and was funded in part or in whole with money from Minnesota's Arts and Cultural Heritage Fund.
For more information please contact Watonwan County Library: (507) 375-1278
Thursday, June 04, 2015 - 7:00 pm
Target Audience
Sponsoring Library
Watonwan County Library, 125 5th St S, St James, MN


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This book/CD-ROM package describes real-time graphics techniques arising from the research and practice of cutting-edge developers. The book focuses on the programmable graphics pipeline available in today's graphics processing units (GPUs) and highlights tricks used by leading developers as well as fundamental, performance-conscious techniques for creating advanced visual effects. Color examples illustrate techniques on almost every page, and the accompanying CD-ROM contains examples and sample programs. Fernando is affiliated with NVIDIA, as are many of the contributors. Annotation ©2004 Book News, Inc., Portland, OR
This is a great book that every programmer involved in game development and/or real-time computer graphics should have on his/her shelf. For the game programmer it is critical to stay up-to-date with the latest and greatest effects available with modern GPUs in order to remain competitive when creating the gaming experience. For the graphics developer, it is interesting to see how the immense processing power of current graphics hardware can be exploited in graphics applications. This book offers insight on both of these topics and more, and I highly recommend it.


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St. John's Red Storm vs. Xavier Musketeers Pick-Odds-Prediction 2/25/14
Xavier Musketeers (18-9) at St. John's Red Storm (18-10)
College Basketball: Tuesday, February 25, 2014 at 7:00 pm (Madison Square Garden)
The Line: St. John's Red Storm -6 -- Over/Under: See the Latest Odds
TV: Fox Sports One
The Xavier Musketeers visit the garden for a big showdown with the St. John's Red Storm Tuesday at 7PM on Fox Sports One.
Xavier continues on their road trip after being dominated in DC this past Saturday by Georgetown 74-52. The Musketeers shot themselves in the foot in this one with almost no production off the bench and minimal output from their starters. Semaj Christon had 18 and Stainbrook and Martin combined for 25 but were just 8-18 from the floor combined. Xavier had just 8 team assists versus 11 turnovers and the Musketeers forced zero steals and had just 3 blocks for the whole game. The loss dropped the Musketeers to 8-6 in conference play and opens the door for the Red Storm to pull even in the standings Tuesday night.
St. John's put together another very strong performance this past weekend but unfortunately they fell just short this go around with a 57-54 loss at Villanova. The Red Storm were within 3-5 points almost the entire game but failed to come up big on some key possessions down the stretch. Jakarr Sampson had 12 and 10 to lead the Red Storm and star freshman Rysheed Jordan continued his strong play with 13 points and 6 boards. The Red Storm shot the ball poorly from the field with 32% shooting overall and failed to stop the Villanova aerial attack. The loss drops St. John's to 8-7 in conference but the Red Storm have a favorable schedule down the line if they can get past Xavier Saturday.
These two teams face a must win contest here with the 3rd seed in the Big East tournament up for grabs. The Red Storm looked like the much better team on the road this past weekend and I expect that to be the case here at home versus Xavier. Big games from Harrison and Sampson will help the Red Storm get the win and cover at home as they take control of third place with just a few games to play.


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Attached is a map of my proposed hike for Saturday. It is a bit longer than I would like (8 miles) but there is just too much that I want to show everyone! If nothing else it will at least help you sleep well Saturday night
There are several opportunities for people to cut it short and not run a risk of getting lost but I would recommend that everyone stick around for at least the bonsai cypress trees (at the northernmost end of the hike). I'll talk to everyone about it before we leave. There are lots of options to make it possible for just about anyone.


text: Hi guys!:wave2 Mabe you guys could ease my worried mind tonight! Here goes!, when we first made our ressies for the BCV, back in Jan., we told them that my DS & DDIL might fly down, and meet us a few days later. The Rep., who we spoke to said when we were sure, to call back and just have us add thier names to the reservation. So, today I called and said that they WOULD be with us part of the time. The rep. asked for thier names, (which is the same as my DH), and the date that THIER arriving. I thought about what happened after a while, and I just hope that our arrival date didn`t get mixed up with thiers! Did anyone ever have similar experiences, and, ( PLEASE! ), TELL ME THAT IT WAS ALL DOCUMENTED CORRECTLY??!! Thanks, _______________________________________________ Maria


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The Coaching Advent Calendar
Day 1 of the Coaching Advent Calendar.
Think about yourself as an observer and note 5 qualities which you are proud of – personality traits, strengths of your character or just unique talents (it can be anything from good organisational skill, golf playing or baking cakes – they are your skills and qualities)
Write them down.
Minimum 5, you can add more.
Enjoy being yourself!
Day 2 of Coaching Advent Calendar.
Today is the day to notice the world around you.
Ever wondered how many compliments, small kindnesses you receive daily, but you discount them or ignoring.
Pay attention today to each compliment – whether there are kind words from colleagues, friends, even strangers or something bigger, receive it and enjoy. It is all about you.
When you recount them all in the evening, how do you feel?
Share This Post
- The Courage to Think and to Act. November 28 2016
- Mental Toughness in Sport and Life February 18 2014
- STRESS… You know how to handle it, a few more tips to empower you. May 10 2013
- Confidence. In case you need a boost… September 24 2013
- Deal with it, Get over and Get on! March 25 2013
- Wellbeing Day in the Industrial World. October 12 2017
- Is Your Business Affected by Absenteeism? August 22 2017
- Resilience Skills for Holidays and Business June 21 2017
- Oh Those Russians… December 10 2016
- The Courage to Think and to Act. November 28 2016


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February 1, 2013
MDconnectME, the Philadelphia-based maker of a mobile and Web app that lets surgical teams send quick updates to designated family members about surgery progress, has launched a pilot program with the University of Texas M.D. Anderson Cancer Center. Surgeons in the Department of Plastic Reconstructive Surgery will be using the MDconnectME system to update the families of people undergoing...
November 13, 2012
After Hurricane Sandy slammed the Northeast Oct. 29, Mount Sinai Medical Center had to take extra patients evacuated from other New York City hospitals. Busy staff there used an app called MDconnectME to send quick updates to designated family members about the location and condition of their loved ones. Interestingly, Philadelphia-based MDconnectME did not design its app for disaster response. "...
November 6, 2012
A week after Hurricane Sandy swept across the east coast, reports are coming out about the role that digital health applications played during and after the storm. for individuals and for hospitals. During the storm itself, one of the top app downloads was the Red Cross Hurricane App, which combines a storm tracker with emergency functions like a flashlight and alarm. The app also features a...
Editor's Pick
March 18, 2016
February 26, 2016
February 26, 2016
February 23, 2016
March 18, 2016
March 08, 2016


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2015 Microsoft Midwest Cloud Consumption Partner of the Year
2014 Microsoft Midwest Partner of the Year
2014 Microsoft Midwest SMB Cloud Partner of the Year
2013 Microsoft Midwest Partner of the Year
2013 Microsoft Central Region Partner of the Year
Distinguished Recognitions
"Best-in-Class" Gold and Silver Competencies
Peters & Associates is consistently recognized as a top performer with a proven track record of delivering the technology solutions that businesses need to grow and thrive.
We apply award-winning expertise to deliver value to our clients, enabling them to leverage their investments in Microsoft technology.
With over 640,000 partners in Microsoft Corporation's channel, how do you narrow down the short list of the best solution providers? You let Microsoft do it for you. Each year, Microsoft recognizes its top partners, providing a Gold level distinction (top 1%) or Silver level distinction (top 5%) in specific areas.
Peters & Associates is recognized as best-in-class, with Gold and Silver level competencies and recognition from Microsoft for its high degree of proficiency in multiple areas.
"By achieving a gold competency, partners have demonstrated the highest, most consistent capability and commitment to the latest Microsoft technology. These partners have a deep expertise that puts them in the top 1 percent of our partner ecosystem, and their proficiency will help customers drive innovative solutions on the latest Microsoft technology."
Phil Sorgen, corporate vice president, Worldwide Partner Group at Microsoft Corp.


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The final day before the trading deadline was an eventful one. Though no top-level players changed hands, a good deal of players will be donning new uniforms the next time they take the field. The Los Angeles Dodgers traded Josh Bell and Steve Johnson for Baltimore closer George Sherrill. The Pirates traded John Grabow and Tom Gorzelanny to the Cubs for Kevin Hart, Josh Harrison, and Jose Ascanio. The Royals only needed to send cash considerations to the Tigers to obtain Josh Anderson.
Deals to look out for tomorrow: Roy Halladay talks are "dead" according to J.P. Ricciardi, though the team is open to discussing deals tomorrow. The Rangers, Angels, and Red Sox are still in the hunt. Padres closer Heath Bell may be on the move as well. The Marlins are reportedly interested, but are unwilling to part with the players San Diego wants. Bell's teammate Adrian Gonzalez is also said to be the subject of heated talks between the Padres and Sox, but no deal is iminent.
MLB Baseball Tickets are available now!
Categories: Boston Red Sox, Chicago Cubs, Los Angeles Angels of Anaheim, MLB Baseball, Pittsburgh Pirates, San Diego Padres, Texas Rangers


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1 c. sugar 1 c. brown sugar 1 c. margarine 1 c. coconut 2 c. flour 2 c. oatmeal 2 eggs 1 t. soda 1 t. baking powder 1 t. vanilla
Mix ingredients and roll into balls. Flatten with water glass. Bake at 350 degrees for 8-10 minutes.
Servings: 3 Dozen
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Sander unhappy with Real
By Paul Higham
Last Updated: 01/01/70 1:00am
Sander Westerveld was disappointed with the way Real Sociedad treated him.Sander Westerveld was disappointed with the way Real Sociedad treated him.
The Dutch shot-stopper was only told just before the transfer deadline that he was no longer wanted at Estadio Anoeta.
He was then left with hardly any time to find a new club for the new season, something which has not gone down well.
The former Liverpool man says that talks with Athletic Bilbao and an English club collapsed because Real wanted too much money for a player who has just a year left on his contract.
Considering all the obstacles in his way Westerveld still found a good move as he switched to Mallorca on a year's loan with the view to a permanent move next summer, when his Sociedad deal will have expired.
"They told me at the last moment that they weren't going to keep me," Westerveld told Marca.
"It was worrying because all the teams at that moment had finalised their squads, but in the end I have been able to find a side of the quality of Mallorca.
"This is a good opportunity for me.
"Real Sociedad requested é¼3 million. Athletic Bilbao came and another team from England. The president said to me that he would speak with these teams but the price was the problem.
"The truth is that I cannot be happy, it is normal that with a year of my contract left they did not want to pay that amount for me."
Westerveld now has a year to impress Mallorca enough for a permanent deal, and he has every intention of showing his ability.
The 29-year-old is in no mood to sit on the bench as he wants to continue playing with Holland.
"I have signed for a year to see how everything goes. It is a good opportunity to demonstrate my condition. If the club is happy with me we can speak about the future.
"I have not come here to sit on the bench. Certainly I am going to help the other goalkeepers, but I am a 29-year-old and I want to continue being selected for my country and for that I need to play."


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Challenge yourself, friends, family and work colleagues to take on Northern Ireland's highest mountain while raising money for NICHS. It's on our doorstep yet many of us have never ventured up it! The 3–5 hour climb will pass waterfalls, pools, the Ice House and the Saddle before ascending to the 850m summit. This is a wonderful opportunity to take in breathtaking views, enjoy a bit of exercise and support NICHS!
To register your interest, please complete the form below or contact us on email@example.com / 028 9032 0184.


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Home / pets
Weekend Fun
October 20, 2014
Hey all! Hope you had a fabulous weekend…
[Belated] Weekend Recap + I'm Published!
October 8, 2014
events, fitness, goals, indulgences, organic, party, personal training, pets, publications, SIX:02, workouts
Does it count as a weekend recap when you talk about it on… Wednesday?
recipe: tomato basil skillet chicken
July 14, 2014
Is anybody out there? HELLO! I'm back from a week-long California vacation…
fitness gear review: PUMA Fitness
May 12, 2014
blogosphere, bootcamp, crossfit, cycling, exercise class, fashion, fitness, personal training, pets, review, running, sports, tennis, workouts, yoga
Hey everyone! I got hooked up with some PUMA gear to review…
a day in the life of a fitness professional: me!
December 10, 2013
blogosphere, bootcamp, exercise class, fast food, fitness, health, healthy eats, indulgences, nutrition, personal training, pets, pregnancy, pure barre, workouts
As promised, I've broken out a typical day for me, a personal trainer/bootcamp instructor/fitness blogger…
11.11.13: weekend recap
November 11, 2013
Hey guys! I'm pooped today after a busy weekend.
october 2013 round-up
November 1, 2013
blogosphere, events, fitness, goals, health, indulgences, monthly round-up, nutrition, party, personal training, pets, pregnancy, race, running, success stories, workouts
October was a pretty calm month with no weddings, no big parties…
vitamin series: D
August 19, 2013
beverages, health, healthy eats, nutrition, pets, supplements, vegetarian, vitamins + minerals, weight loss
Hey everyone! Welcome back to good ol' Monday. I am SO recharged from a weekend of actual rest. Sleep is a powerful thing!
running with a dog: I need your help!
May 10, 2013
by hayalison
We had a BIG day yesterday.


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ESCONDIDO —— Last spring, after local merchants criticized his hotel and condominium project as being out of character for Escondido's downtown, developer Craig Clark went back to the drawing board to start working on a makeover.
Clark's designers trimmed the condominium project from a monolithic nine-story box to a modern structure that stands eight stories high and features several setbacks and staggered levels. They also rearranged the project's parking layout and added some additional spaces.
Now, Clark and city planning officials will once again take the designs for the $100 million-plus hotel and condo project to the public at a workshop scheduled for Monday.
While the height and design of the condominium project have been altered, some downtown merchants familiar with the new plans say that some unresolved issues remain, and they have a few new criticisms.
"Our concerns are several," said Debra Rosen, chief executive officer of the Downtown Business Association, which represents 800 businesses in the downtown area. "There's still not adequate parking, and some (of our members) are still concerned about an eight-story building."
"But they have definitely gone in the right direction," Rosen said, adding that, overall, the association supports the project.
When Clark originally unveiled his plans last February, they called for a seven-story, 197-room Marriott hotel on West Valley Parkway, sandwiched between City Hall and the California Center for the Arts, Escondido.
They also included a 98-foot-tall building across the parkway that would boast 142 condominiums atop a 554-space parking garage that would be used by the public, hotel and condominium residents.
Both projects would be built over existing public parking lots in the center of downtown.
But in a community forum last May, downtown merchants and many other community members argued that the nine-story condo complex would be out of place alongside the quaint one- and two-story shops that characterize downtown.
They also criticized the project for not creating any new public parking to accommodate the added commercial traffic.
The new design reduces the residential project to 128 condominiums, and lowers the building to 85 feet, the same height as the theater tower at the arts center.
The plan also shuffles around the project's parking. It adds a second level to the garage beneath the hotel to accommodate patrons and workers. And it calls for a 487-space garage beneath the condominiums. Of those spaces, 226 would be open to the public, 21 more than currently exist at the two lots.
Rosen said the new parking designs help but perhaps not enough. She added that the city and developer still need to resolve the matter of where downtown customers will park during construction.
And some merchants are also up in arms about the plan to seal off Maple Street at the corner of Grand Avenue to make way for the condominium entrance. Maple connects West Valley Parkway with Grand, downtown's main street.
Kevin Clark, whose family trust owns the building at that corner, which houses the Bank of Escondido, said Maple Street provides crucial access to the bank's customers, and serves as a gateway to Grand Avenue shoppers.
"It's a corridor to downtown," said Clark, who is not related to the hotel developer. "And if you start interrupting those corridors, then it really causes traffic problems."
Moreover, Clark said, it would eliminate 17 curbside parking spaces along Maple Street, essentially cancelling out the added public spaces in the garage.
Still, this next meeting, much like the last, is an important avenue for the city and developer to learn about such concerns and address them as best they can, Assistant City Manager Jack Anderson said.
"These are things that the (City) Council needs to hear," Anderson said. "(The project) wasn't a done deal, and probably still isn't a done deal."
That is of some relief to Susan McLaughlin, who owns the Lillian Berkley Collection art gallery on Grand Avenue and has been an outspoken critic of the condominium building's original design.
McLaughlin said she believes the new blueprints show that the developer and city planning officials have listened to merchants and tried to resolve their concerns.
But while downtown businesses are excited by the prospect of the potential customers the project will bring, McLaughlin added that it's important to resolve details both big and small that could prove problematic once the hotel opens for business and the condos go up for sale.
"This is a very important project for downtown, and it could go one way or another," said McLaughlin, "It could be really fabulous or it could be a white elephant."
The hotel workshop will take place at 7 p.m. on Monday in City Council chambers, 201 N. Broadway.
Contact staff writer David Fried at (760) 740-5416 or email@example.com .


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For some people, like me, this comes fairly naturally. I can spend hours picking out a specific name for a character yet have fun doing it. Others can just pick any name they want and be fine with it - which is totally okay, too. However, maybe some of you struggle with figuring out the perfect name, or maybe you want to learn how to flesh out your development process. Here's how I begin:
First and foremost - baby naming sources. Like candy in the middle of a salt factory. Baby naming sources can be in the form of books, from specific baby books to character naming books (I own The Writer's Digest Character Naming Sourcebook 2nd Edition). However, for a quick search, and what I use mostly, some websites to try out are babynames.com and behindthename.com (heads up: different sites can contain different origins and meanings. Occasionally you may have to try a few different sources to make sure you have the most accurate). Not only is there a nearly unlimited resource of baby names on these sites, but you can also refine your search for specific gender, origin, and meaning. Do you have an strong-willed Irishman as your protagonist? Perhaps you should call him Liam.
If you want to try a different route other than baby name sources, one idea is to simply compile a list of first, middle, and last names of your family, friends, and acquaintances. You might have a best friend named Emily Jane Gould, a cousin named Hannah Rae Devore, and a co-worker named Audrey Monroe. Mix it together, and perhaps you like Audrey Rae Gould.
Another fun way is to pop in your favorite movie or TV show and take a look at the credits; what are your favorite names on that list? This is also a great resource to use if you want creative names. C'mon, we've all seen those names roll by and do a double take - they're pretty crazy awesome.
The "easy" way out is to look up a name generator site. I'm not condemning this method at all (sometimes I will use it for surname ideas), but for me personally, it takes the fun out of the process.
>>Next week in part 2 we'll flesh this out and discuss how to organize your compiled names.<<
How do you compile a list of favorite character names?


text: RAM Clutch Disc for 1965-1966 170/200 6-Cylinder Mustang with 2.77 3-Speed or Dagenham 4-speed Transmission.8-1/2" diameter clutch disc with 15/16" 10-spline pilot hole for input shaft. Some 1966 models used a 9-1/16" diameter clutch, so be sure which one you have before ordering. Please have the flywheel resurfaced for longer disc life & performance.


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Vayne Build Guide by Xptboy
Not Updated For Current Season
This guide has not yet been updated for the current season. Please keep this in mind while reading. You can see the most recently updated guides on the browse guides page.
Thank You!
Your votes and comments encourage our guide authors to continue
creating helpful guides for the League of Legends community.
Vayne Build
Ability Sequence
Not Updated For Current Season
The masteries shown here are not yet updated for the current season, the guide author needs to set up the new masteries. As such, they will be different than the masteries you see in-game.
Introduction - Why build Vayne somewhat tanky?
(Please read the entire guide before voting, there is good reason why this build is actually very viable in ranked play.)
Hey guys, this will be my fourth guide on Vayne, and unlike my other guides this will stray from the norm and focus on a somewhat different build that some may scoff at. I actually came across this build as I was watching Wickd's stream and he mentioned how stupid a vayne rushing Warmog's is. I agreed with him wholeheartedly, and was surprised to see quite a number of high ELO players using a Warmog's on Vayne as I had always thought that every AD carry should be built as a glass cannon and focus mainly on positioning in teamfights. That was, until I myself, who hovers around the 1500 ELO region currently came across a Vayne who had built warmog's and atmas along with attack speed items and he completely obliterated our team.
After this, I had decided for myself that I would experiment a bit with Vayne and see whether or not I could find a unique item build for Vayne that would work well in ranked and completely own with her. I found myself astounded that an atmog's Vayne could actually deal so much damage whilst still being quite tanky herself. As the game prolonged, it really became a case of, if you focus Vayne, then the team will kill you off because she can't be killed easily and if you don't focus Vayne, then she will destroy your entire team in no time.
Please guys, if you doubt this build, just try her out in game first and see how she is still as dominant early game and simply unstoppable lategame :)
Pros and Cons
- strong early game for an AD carry
- great chasing ability
- huge burst damage and decent sustained damage
- simply unstoppable lategame as you will put the enemy team in a lose-lose situation, should they focus you first and die to your team? or focus you last and die to you?
- tanky yet still capable of doing an amazing amount of damage.
- good at ganking all around the map
- has a built in mini flash
- very squishy early-mid game
- low attack speed until you build some AS items
- this build is OP so really not much else...
Runes and Masteries
Greater mark of desolation x9
The standard AD carry runes are a requirement on Vayne and most other AD carries just to get through that armor that you will be playing against as the game goes on.
Greater Seal of Attack Speed x9
Greater Glyph of Attack Speed x9
Vayne's main weakness as an AD carry is that she lacks attack speed to be able to do her burst damage. So I give my Vayne yellow and blue attack speed runes to negate her biggest weakness. This will also help you take advantage of the fact that with this build you are maxing silver bolts first.
Greater Quintessence of Attack Damage x3
These quints will help you to have some extra AD, and since you are going to build a BF sword, I don't see the need for armor pen runes. However, if you happen to prefer Armor pen quints or attack speed quints then you can go for them, I just think the extra AD comes in handy.
I go 22/0/8 on Vayne because I find that going for a full burst AD build is viable. I don't have any magic damage so I don't see the need to get a point in piercing through their MR, and this still allows me to get good my experience masteries from the utility page. The lower cooldowns are what could make or break a fight as you tumble away or condemn someone into a wall. Also, on any carry I believe it's important to reduce your time spent dead as it's just so important for you to be alive to prevent your towers going down or to turn the tide of a battle.
Summoner Ablities
With Vayne I find it easier to simply smartcast all my abilities, I find it especially important on tumble as I simply have to point to the direction I tumble in rather than actually move in that direction and then press q
Night Hunter
This is a great passive on Vayne that gives her the ability to chase like a boss. Nobody will get away from you as you gain an extra 40 movement speed while moving towards an enemy champion.
This is both a great offensive and escape ability. It is practically a miniflash, allowing you to catch up to and finish off low health targets. It is also great at escaping certain skillshots such as Amumu's bandage toss and the ashe arrow. Early game this is also a decent harassing skill in lane.
Silver Bolts
I level this first mainly because this specific atmog's build requires it as this will be your main damage source that allows you to build tanky yet still do more damage anyone else on your team. The great thing about this ability is that on every third attack you will deal true damage equivalent to 8% of the enemies hp (when maxed out). This ability can also proc with Tumble to do even more additional damage.
This is another amazing ability, however I level this last because it's main purpose is for the utility it brings you and it does not do as much damage. It's a great skill because it pushes the enemy away, so this is of course good if you are running away or trying to save an ally. However another great use of this skill is to shove them into a wall, in which case the enemy champion will be stunned for 1.5 seconds and take bonus damage almost guaranteeing you the kill!
Final Hour
Vayne's ultimate is amazing as it is basically a steroid that gives you additional AD, and movement speed. In addition, it will make Vayne stealthed should you decide to tumble which is also great if you want to fool the enemy. It has a short cooldown, so basically use this whenever a fight starts out.
Summoner spells
Vayne really needs an escape spell, this will do it for her and I find it more useful than ghost as she pretty much already has a ghost with her passive, ultimate and tumble. Flash also works very well in conjunction with Condemn.
I also find this as a necessity on Vayne much more than ignite, because it will reduce the armor, movement speed, attack damage of the enemy. Just a very useful spell overall that synergizes perfectly with Vayne making sure she can kill anyone she wants.
Vayne's basic ganking combo
Vayne has a simple to master combo that wrecks havoc on anybody 1v1 if she is well enough farmed or fed, which should be easy to do.
Basically you want to start of by immediately activing Final Hour to scare the enemy off, however since you are faster, you will activate Tumble and hopefully by now you should be parallel to them and be able to push them into a wall. If you can't push them into a wall, then flash into them and push them into a wall with Condemn. Now exhaust them and just keep autoattacking and tumbling on them. If they have no escape abilities and nobody to help them out then you should be able to kill them easily.
Item build
Core Items
Doran's Blade
Berserker's Greaves
The Black Cleaver
Warmog's Armor
Atma's Impaler
Once you have bought these core items you should build Vayne according to who you are facing and how you are doing.
Explanation of core items
I usually prefer to start off with a Doran's Blade as this simply gives me an extra 100 hp and attack damage as well as a bit of life steal. On my first trip back I either buy another Doran's Blade and Boots of Speed or if I have enough money then I buy my B.F. Sword as this will give me lots of extra damage.
Berserker's Greaves are my standard boots on Vayne as she really needs that extra attack speed to get her silver bolts to be very effective. I prefer to build The Black Cleaver on Vayne because this gives her everything that she will need later on in the game in combination with her atmog's. This gives her additional attack speed, additional armor penetration and a great deal of attack damage as well, so I find this the perfect item that synergizes well with this specific Atmog's build.
This is when I start building my Warmog's Armor, it's a great item that basically turns her from very squishy to rather tanky so you are now capable of taking a few hits. Once I build this I immediately build my Atma's Impaler, this item is great, especially in conjunction with Warmog's because first of all, it gives you extra armor, but in addition to that, it adds to your crit chance and makes you crit hit harder. Finally the best thing about the Atmog's build is that with an Atma's Impaler, your physical attacks deal an additional 2% of your maximum health. Combine this with Silver Bolts and Tumble and you are now tanky, ranged and deal an insane amount of damage!
By now it should be quite lategame and you need to choose between one or two final items to finish off your build. Here is a list of viable items
viable items
Phantom Dancer
Usually, if the game prolongs this long, I will at least get me a Zeal, as this gives me extra attack speed and movement speed and is quite good for its price. Usually I do not find the additional movement speed and attack speed worth getting a phantom dancer for, however sometimes in the case of a very long game, then I will upgrade my zeal into a phantom dancer.
Last Whisper
Great item if the enemy team is now stacking armor to counter you. This will ensure that you remain the tank shredder that you are.
Guardian Angel
Only get this if you need to be even more tanky because for some reason they can shred you to pieces and a second life is always nice.
I find this to be a very underrated item, especially against a team that is very caster heavy. Considering you do not have much MR, this is great is you are quickly getting bursted down by the enemy casters as it not only gives you extra AD but it also ensures that you can't get burst down by the enemy team of casters.
Wit's End
I usually get this instead of a hexdrinker if the enemy has only one or two fed AP carries, as they usually will be unable to burst me down in a single burst anyway, so this gives some nice extra damage, speed and MR.
Madred's Bloodrazor
A great end game item on Vayne that will give her additional armor and additional attack speed as well as additional Attack damage. Another item that I consider just gives her everything she needs. This is really expensive though and I only ever get if it's a legendary long game.
General Gameplay tips
Early Game
Your early game will be played in a very similar way to any other AD carry as you're basically just going to focus on farming the minions whilst sometimes harassing the enemy champion away from the creeps and trying to win your exchanges. But in general, you mainly want to stay behind your creeps and last hit the enemy minions from a distance whilst letting your support try to zone the enemy. Usually, it is best that you are paired with a support that way you can just farm yourself up so you are capable of buying those nice items that are so important to building this Atmog's Vayne.
If the enemy ever overextends, then simply harass him, once you have any advantage in lane as Vayne, it's quite easy to keep it. If you are farming and the other champion is not, then you win the lane. If he is farming, then you can harass him whilst still farming yourself and then kill him, and then once again you win the lane. Vayne is simply one of the best AD carries to play as early game.
Mid Game
I classify mid game as when you get your The Black Cleaver and have started to build your Warmog's Armor with a Ruby Crystal or Regrowth Pendant. At this point you deal an amazing amount of damage and it would be a good idea to gank somebody so you can get fed. Use that combo I showed earlier to pull off a gank. During this phase of the game you want to exchange between farming your lane, and pulling off ganks in conjunction with your team.
Late Game
Late Game is probably where this Atmog's Vayne build is most different from most other Vayne builds that build her as a glass cannon. I find that this build works better because you are able to deal sustained damage and you can pretty much just stand in the same spot the whole time in the middle of a teamfight and right click on whoever it is you want to kill. It's just so easy to play as Vayne in this way because you don't even need to have that good of a sense of positioning, all you need to do is focus whoever you want and kill them, there's simply nothing the enemy will be able to do about you as if they focus you, they will take far too long kill you so your team will deal a lot of damage and you will most likely still come out alive and if they don't focus you then you still deal an absolutely phenomenal amount of damage.
Teamfights lategame are just so easy as you simply have to use your ultimate and then autoattack whoever it is you feel like killing!
Countering Atmog's Vayne
The best thing to do is to make sure she doesn't get fed early game, because she is a hero who simply snowballs so amazingly well. But even if she doesn't get fed, if she is well farmed then she will still be devastating late game with her Atmog's.
There is one item that could really slow her down and that is the Frozen Heart. The tank should always get this when playing against a Vayne so as to slow down Vayne's attack speed so that her silver bolts won't be as devastating. Also, it's just a great item in general.
In teamfights, do not run past the entire enemy team just to kill her as that will result in your death, only focus her if she gets out of position and everyone can pounce on her quickly.


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Somebody said to me earlier while am on my way home, "Relax, it's not that hard". My left eyebrows really raised. When I looked back, it was an old man smiling at me. I wonder I might be looking exhausted or fully-packed face with nothing. I do not know. I looked for a mirror. I checked how am I looking.
I can't exactly think why the old man said that to me. Maybe, he just thought that I need a short break even just for a while. But for now, I don't think I could have that. Our final examinations are still yet to come. But I promise to give myself what it deserves after the exam.
Phew! Later I will be swimming in the flooding notes to study. I am just hoping I could finish what needs to be done before the examinations will start. An hour of sleep might turn into a minute then. I will try not to think of sleeping because coffees are not good for me now. I have been warned again with my cardiologist to stop taking in coffees. Ok ok! This might be the first exam with no burped coffees.
Stolen short break last Oct. 13 at the SM Cebu City car park.


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100 ml (3.4 oz.) or smaller container permitted in carry-on.
Complete Items List
BeveragesCarry On Baggage:Yes (<100ml)Checked Baggage:Yes
Bi-level positive airway pressure (BPAP) deviceCarry On Baggage:YesChecked Baggage:Yes
In order to have a BPAP device screened, passengers may choose to either: 1) bring a clear plastic bag to place the respiratory device into for screening or 2) leave the attachments (tubes and mask) inside the case and place the main electronic unit only in a bin.
Billiard cuesCarry On Baggage:NoChecked Baggage:Yes
Billy clubsCarry On Baggage:NoChecked Baggage:Yes
BiojectorsCarry On Baggage:YesChecked Baggage:YesMust be for personal medical use, and the needle guard must be in place. The person must possess medication that is to be administered by means of the syringe or needle and biojectors, and the medication must be in a container that bears the name of the medication and the name of either the pharmacy that dispensed the medication or the manufacturer of the medication.
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Timing: when will the new sanctions apply?
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Suffolk lawmaker gets his teeth into a nickname
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The office of John Kennedy, the Nesconset Republican who leads the Suffolk Legislature's minority caucus, issued a news release last week touting some of the lawmaker's recent accomplishments. In it, Kennedy is referred to as "the Bulldog," (proper noun) five times in six paragraphs. "The Bulldog was able to get paving done on Townline Road in Commack..." began one sentence.
Will the name stick? Perhaps, if Kennedy's staff keeps repeating it with, yes, a bulldog's tenacity.


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Drunk woman spared jail after decapitating pet snakes – and swallowing heads
A BOOZED-UP pet owner who decapitated her two snakes before eating their heads has escaped jail.
Jennifer Lampe, 28, was found by police with the "still moving" but headless body of her boa constrictor around her neck.
She then attempted to swallow the pair of heads – eventually vomiting them back out and sticking them in her pocket so she could "keep them."
The incident happened after she had downed several cans of lager, and shots of amaretto and whisky.
Admitting the offence, Lampe was given a four-month jail term suspended for two years.
She was also banned from keeping animals for five years.
Telford Magistrates' Court in Shropshire was told how weeks before the decapitations she threw her pet hamster in a fish tank and watched it drown for making too much noise.
RSPCA prosecutor Roger Price said she "put the dead hamster in a chest freezer" but its contents were later emptied.
On another occasion she admitted putting a cat in a carrier bag, taking it on a "long bus ride" and then letting it go.
She had twice tried to get rid of the cat, having successfully disposed of a second cat which she "dumped behind a fence".
Mr Price added that Lampe's dislike of her sister's boyfriend had caused friction which "came to a head" on the day of the incident.
Lampe became agitated, "yelling and swearing", and took a pair of scissors and a knife up to her bedroom where the snakes were.
Mr Price said: "When her sister saw the defendant in her bedroom she had a boa constrictor under her top and was covered in blood.
"About three-quarters of the snake could be seen. The defendant was hysterical."
Police were called to the property by her sister.
Mr Price said when officers turned up they found Lampe with a "long headless snake draped around her neck".
The second snake's body was found upstairs in her bedroom.
Mr Price added: "She believed she would be homeless and did not want to leave the snakes with her sister."
A vet confirmed the snakes had probably been decapitated with scissors but concluded "the death of the snakes was not swift", with signs of several attempts to cut through the animals' necks.
Mr Price said the vet had also found the snakes' "suffering was prolonged and painful".
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Mr Price said: "She managed to swallow them both but vomited them up."
Sarah Cooper, representing Lampe, said her client was a vulnerable "loner" who had "some mental health problems", a drink problem and was currently taking anti-depressants.
She said: "It is a bizarre set of circumstances, needless to say, the animals have suffered, they shouldn't have, she knows that."


text:
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An angry woman reportedly stabbed her boyfriend to death following an argument they both had in their home.
According to reports from the Zambia Daily Mail, 48-year-old Reeves Malambo, was stabbed to death by his jealous girlfriend identified as 38-year-old Shabu Benos, in their home in Ibex Hill.
Malambo who was a prominent businessman and was the proprietor of Autoforce in Lusaka, had been involved in a war of words with Benos, before she grabbed a kitchen knife and proceeded to stab him. He was rushed to the hospital where he eventually died 10 minutes after.
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A police spokesperson Esther Katongo, said two more people identified as Beno's brother and sister, were also arrested in connection to the murder.
"We have arrested two more people in connection with the murder of Mr Malambo but I cannot disclose their identity because we are still investigating the matter."
Source: Gossip.naija.ng