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Stroke survivors' difficulty in releasing grasped objects may be attributable not only to impaired finger extension but also to delays in terminating activity in the gripping flexor muscles. This study was undertaken 1) to quantify the time needed to initiate and terminate grip muscular activity following stroke and 2) to examine effects of arm support, grip location, and active muscle stretch on the delays recorded in the paretic hand. Delays in initiation and termination of finger flexor muscle activity in response to an auditory stimulus were measured for both paretic and nonparetic hands of ten stroke survivors with chronic hemiparesis and the dominant hand of five neurologically intact subjects. Additionally, the delays for the paretic hand were recorded while an external arm support was used and after 30 min of active muscle stretch. We found that delays in grip initiation and termination were greatest for the paretic hand (1.9 and 5.0 s), followed by the nonparetic hand (0.5 and 1.6 s), and least for the control hand (0.2 and 0.4 s). Arm support reduced delay in grip termination 37% for the paretic hand. Repeated active muscle stretch resulted in 24% reduced delay in grip initiation and 32% increased delay in grip termination for the paretic hand. Therapies and interventions reducing these delays may improve the ability to grasp and release objects and thus increase functional independence for stroke survivors.
Stroke is a leading cause of long-term disability among American adults (AHA 2003). Stroke survivors often experience chronic motor deficits, especially in the hand, resulting in diminished capacity to manipulate objects with the hand affected by the stroke (Gray et al. 1990; Nakayama et al. 1994a,b; Parker et al. 1986). These deficits may relate not only to proper creation of grasp posture (e.g., hand opening and closing; Cruz et al. 2005; Kamper and Rymer 2001), but also to the timely release of the object being held. In the typical paretic upper extremity posture (i.e., flexed elbow, pronated forearm, flexed wrist), gravity can assist object release despite limited active finger extension, provided that the finger flexor muscles are relaxed. Thus the observed difficulties in letting go of objects may result from sustained finger flexor muscle activity or inability to terminate finger flexor muscle activity in a timely manner. Delays in grip force generation and termination following stroke can result in inefficient grip force scaling during grip-and-lift tasks (Nowak et al. 2003, 2007), deficits in timing, and coordination of movement (Nowak et al. 2007) and thus decreased motor function (Chae et al. 2002, 2006).
Previous studies have described delays in initiating general motor activities: index finger movement (Howes and Boller 1975) and arm movement (Jones et al. 1989) in response to a "go" signal have been shown to be slower for the nonparetic hand of stroke survivors, compared with neurologically intact individuals. Also, initiation of motor activities in the arm (Jones et al. 1989), wrist (Chae et al. 2002), and lower limb (Chae et al. 2006) have been shown to be slower for the paretic side than for the nonparetic side. Delays in terminating general motor activities have been shown only for the paretic wrist (Chae et al. 2002) and lower limb (Chae et al. 2006), compared with the nonparetic side, but not for the hand.
The sources of these delays, however, and the factors that influence them have not been well described. Sustained finger flexor muscle activity after a voluntary contraction following stroke has been only anecdotally described (Kamper and Rymer 2001; Kamper et al. 2003; Kline et al. 2007). The duration of this activity is unclear, despite its significant implication in hand function. Due to the presence of persistent coupling between muscles (the flexion synergy) in the upper extremity (Brunnstrom 1970), difficulties with terminating finger flexor muscle activity may be exacerbated by activation of more proximal arm muscles, such as occurs when supporting the hand in space. Similarly, grasp initiation and termination may also vary with location in workspace. Past work has shown, for example, that stroke survivors have more difficulty reaching away from the body than close to the body (Kamper et al. 2002); the proximal muscle activation necessary for a far reach may affect grasp. Furthermore, stretching has often been prescribed for stroke survivors to reduce muscle hyperexcitability (Wu et al. 2006). As such, it may influence sustained muscle activation during release.
Accordingly, the aims of this study were: 1) to examine the time course of grasp by comparing the times needed to initiate and terminate a grip activity for stroke survivors (paretic and nonparetic hands) and neurologically intact individuals and 2) to examine the effects of factors such as external arm support, grip location, and active muscle stretch on these delays. We hypothesized that delay in grip termination for the paretic hand would be shorter when the hand is near the torso compared with when the hand is far from the torso and when the arm is supported than when the arm is unsupported. We also hypothesized that the delays in grip termination for the paretic hand would decrease after upper extremity muscle stretch.
Ten chronic hemiparetic stroke subjects (≥9 mo poststroke) and five neurologically intact (control) subjects participated in this experiment. The inclusion criteria for stroke subjects were 1) the occurrence of a single stroke ≥9 mo prior to the study; 2) no cognitive dysfunction that precludes comprehension of experimental tasks; 3) no history or clinical signs of concurrent medical problems; and 4) Stage 2 to 3 on the Chedoke–McMaster stage-of-hand scale (severe hand impairment level) (Gowland et al. 1995). Stroke subjects were composed of seven males and three females with the mean age of 51 ± 10 yr, with ages ranging from 39 to 68 yr (see Table 1). The mean time since the cerebrovascular incident was 6 ± 6 yr. Of these individuals, seven subjects had involvement of the left side of the body and three subjects had involvement of the right side. Three subjects had impairment of the formerly dominant hand and seven subjects had impairment of the nondominant hand. Control subjects were composed of five males with a mean age of 51 ± 4 yr. All subjects signed the informed consent form approved by the Institutional Review Board of Northwestern University prior to testing.
Each subject participated in a single-session experiment to assess delays in grip initiation and termination using an electromyographic (EMG) signal. For stroke survivors, both the contralesional (paretic) hand and the ipsilesional (nonparetic) hand were tested. For the control subjects, only the dominant hand was tested.
Subjects were seated with a back support in front of a vertical cylinder suspended from the ceiling by a string. The cylinder was 6.7 cm in diameter and its surface was finished with smooth polyester. Its vertical position was adjusted to the height of the subject's forearm when the upper arm was vertical by the trunk and the elbow was flexed at 90°. The paretic hand was placed around the cylinder by the experimenter while the stroke subject was at rest. For the nonparetic and control hands, subjects voluntarily placed their hand around the cylinder. Subjects were instructed to relax the fingers before a trial began. No significant change in limb positions was visually observed during a given trial.
A trial consisted of subjects relaxing the fingers for the first 5 s, gripping maximally for 5 s, and then relaxing the hand for 20 s without moving the location of the hand (see Fig. 1). A computer-generated audible tone was played during the gripping period (5 s) to cue subjects when to start and stop grip exertions. Subjects were instructed to grip maximally, as quickly as possible, in response to the start of the tone, and to relax as quickly as possible as soon as the tone ended. Maximum grip exertions were used as opposed to submaximal exertions. This was done to ensure that 1) subjects recruited muscle fibers as quickly as possible (Kroemer and Marras 1980) and 2) EMG levels during grip exertions were statistically distinguishable from the baseline EMG, especially for the paretic hand that had low EMG levels with high variance.
Bipolar active surface electromyogram electrodes (Delsys, Boston, MA) were placed over the muscle bellies on the forearm about halfway between the medial epicondyle of humerus to the styloid process of the ulna targeting flexor digitorum superficialis (FDS) and about the point from the lateral epicondyle to the styloid process of the ulna targeting extensor digitorum communis (EDC) (Basmajian 1989). The FDS muscle was targeted because this study focused on the initiation and termination of long finger flexor muscle activity in an isometric condition. The FDS muscle has primary involvement in power grip (Kaufmann et al. 2007) and its superficial location allows recording of EMG signals using noninvasive surface electrodes (Perotto and Delagi 1994). The EDC muscle activity was recorded to monitor the antagonist muscle activity. It is possible that the EMG targeting the FDS was contaminated by activities of adjacent forearm muscles such as flexor carpi radialis, flexor carpi ulnaris, and palmaris longus. Likewise, the EMG targeting the EDC could have had cross talk from wrist extensor muscles, especially from the extensor carpi ulnaris. The EMGs were recorded during the entire 30-s trial at 500 Hz using a Delsys amplifier and data acquisition system (NI PCI-MIO-16XE-10 and LabVIEW, National Instruments, Austin, TX). The EMG signals were initially low-pass filtered at 225 Hz. After the experiment, the EMG signals were rectified and low-pass filtered at 10 Hz using MATLAB (The MathWorks, Natick, MA) to create envelopes that clearly displayed the aggregate muscle activity.
Stroke subjects were asked to repeat this grip-and-relax task with the paretic hand for different grip locations, arm support, and stretching conditions. Three grip location/arm support conditions were tested: 1) a comfortable distance from the torso with no arm support, 2) as far from the torso as possible without an external arm support, and 3) as far from the torso as possible with an external arm support. The three conditions, presented to subjects in a random order, were tested again after active repeated muscle stretching (making a total of six conditions). All six conditions were examined for effects in the paretic hand (for the nonparetic hand and control subjects, only the comfortable grip location with no arm support was tested). Three trials were performed for each condition. A break of ≥1 min was given between any successive trials.
Both comfortable and far grip locations were self-determined by the stroke subjects for the paretic hand. The far grip location was limited by the paretic arm's capability to maintain a static posture during a trial. The horizontal distance from the cylinder center in the hand to the mid torso was recorded using a measuring tape. Once the distance for the comfortable grip was determined for the paretic hand, the same distance was used by the nonparetic hand of the stroke subject. Thus within a given stroke subject, the same target (comfortable grip) distance was used for both the paretic and nonparetic hands. The horizontal distance from the hand to the mid torso was 34 ± 6 cm for the comfortable grip location and 48 ± 6 cm for the far grip location (on average across subjects). The distance for the far grip location was significantly greater than that for the comfortable grip location (paired t-test, P < 0.01). The mean comfortable grip distance across all stroke subjects was used for the control subjects (control subjects were tested after all stroke subjects were tested). External support was provided by a gravity-compensating orthosis, the Therapy Assistant Wilmington Robotic Exoskeleton (TA-WREX) (Iwamuro et al. 2008; Rahman et al. 2007). The TA-WREX is a passive orthosis that compensates for the effects of gravity on the arm at any point in the arm workspace.
Stretching consisted of about 30 min of actively performed muscle stretches. Stroke subjects followed a written active muscle stretch protocol with illustrations. The protocol consisted of flexion/extension of the thumb, fingers, wrist, elbow, and shoulder, thumb abduction/adduction, forearm rotation, and shoulder rotation and abduction/adduction across a range of motion. All stretches were performed manually (with no assistive device). Subjects were instructed to use the muscles of the affected side as much as possible and use the nonparetic hand to help as needed. The end position of each stretch was held for ≥5 s. Each stretch was repeated 10 times. The subjects were observed during the active stretch to ensure that they correctly followed the instructions and completed all repetitions for each stretch. On completion of the repeated active muscle stretch protocol, the subjects performed the grip-and-relax trials for the differing grip location and arm support conditions with the paretic hand.
Data analysis
The EMG values for each muscle in each hand were first normalized by the peak value of the processed EMG across all trials for that muscle and hand. Delays in grip initiation and in grip termination were then determined from the forearm flexor EMG: baseline EMG was determined as the lowest value for the EMG averaged across a 0.5-s moving window recorded during the initial resting period at the beginning of each trial prior to the start of the audible tone (referred to as "Baseline" in Fig. 1). The FDS EMG was assumed to have been initiated when all EMG values in a 0.5-s moving window (starting from the onset of the audible tone) surpassed the mean value plus 3SDs of the baseline EMG (Di Fabio 1987). The start of this window was defined as the time of grip initiation. Delay in grip initiation equaled the difference between this time and the beginning of the audible tone (Fig. 1). The FDS EMG was assumed to have terminated when all EMG values in a 0.5-s moving window fell below the mean plus 3SDs of the baseline EMG or its 95% confidence interval overlapped with that of the baseline. The start of this window was used as the time of grip termination. Delay in grip termination equaled the difference between this time and the end of the audible tone (Fig. 1). All analyses were performed using MATLAB.
A repeated-measures MANOVA was first run to determine whether delays in grip initiation and termination varied among the three limb types (paretic, nonparetic, and control hands), as recorded during the sole condition of no intervention and comfortable reach distance. Since the variance in delay was different among the three limb types (with P < 0.05 in the Levene's test of equality-of-error variances), the delay data were transformed into the logarithmic scale (P > 0.05 in the Levene's test of equality-of-error variances after transformation). The significant limb effect in MANOVA then led to the performance of univariate repeated-measures ANOVA for each of the dependent variables, logarithms of grip initiation, and termination times. Tukey's post hoc tests were subsequently performed to examine significant differences among the three limb types.
An unbalanced repeated-measures analysis was performed to determine whether delay varied significantly with grip location, arm support, and/or muscle stretch for the paretic hands, for grip initiation, and termination separately. Because differences in the forearm flexor EMG levels during maximum grip exertion and the forearm extensor EMG levels during grip termination could influence the delay in grip termination, additional analyses were performed. Maximum forearm flexor activation was determined by finding the highest FDS EMG value, averaged across a 0.5-s moving window, during grip exertion. The forearm extensor EMG level was determined as the mean EDC EMG during the period from the end of the audible tone to the termination of the forearm flexor EMG. Unbalanced repeated-measures analysis was performed for the forearm flexor and extensor EMG levels to look for variations across grip location, arm support, or muscle stretch for the paretic hand.
We found that there were systematic differences in delays for grip initiation and termination between the different limb classes studied (paretic, nonparetic, and control; P < 0.05 from MANOVA). Means, ranges, and medians of delays in grip initiation and termination for the stroke subjects' paretic hand and nonparetic hand and the control subjects' hand are summarized in Table 2 and Fig. 2. The delays in grip initiation and termination of the paretic hand for each grip location, arm support, and stretch condition are summarized in Table 3. Specific findings for grip initiation and termination are described in the following text. The forearm flexor EMG level during maximum grip exertion and the forearm extensor EMG level during grip termination did not significantly vary with grip location, arm support, or stretch conditions (P > 0.05 for all).
Grip initiation
Delay in grip initiation was significantly different among the three limb types (P < 0.05), when tested at the comfortable grip location with no arm support. Post hoc testing revealed that initiation delay was significantly different for each of the three limb types: paretic, nonparetic, and control (P < 0.05). The mean delay in grip initiation was fourfold greater for the paretic hand (1.922 ± 0.915 s) than that for the nonparetic hand (0.474 ± 0.147 s) and was twofold greater for the stroke subjects' nonparetic hand than that for the control subjects' hand (0.237 ± 0.110 s) (see Fig. 2). Delay in grip initiation varied significantly for the repeated active muscle stretch (P < 0.05), whereas grip location and arm support did not significantly affect delay in grip initiation (P > 0.05). After the repeated active muscle stretch protocol, mean delay in grip initiation decreased 32% on average (Δ 0.490 s).
Grip termination
Delay in grip termination was significantly different among the three limb types (P < 0.05). Post hoc tests revealed that the termination delays were distinct for the paretic, nonparetic, and control limbs (P < 0.05). The mean delay in grip termination was approximately threefold greater for the paretic hand (5.046 ± 4.334 s) than for the nonparetic hand (1.574 ± 1.552 s) and fourfold greater for the stroke subjects' nonparetic hand than for the control subjects' hand (0.414 ± 0.176 s) for the comfortable grip location with no arm support only (see Fig. 2).
Delay in grip termination varied significantly for the arm support (P < 0.05) and the repeated active muscle stretch (P < 0.05), but not for the grip location (P > 0.05). Use of the arm support TA-WREX resulted in, on average, a 37% reduction in the delay in grip termination (Δ 2.596 s; compared with the comfortable and far grip location conditions without the arm support; stretch conditions pooled). After the repeated active muscle stretch protocol, mean delay in grip termination increased 24% (Δ 1.346 s; grip location and arm support conditions pooled).
As expected from earlier reports, delays in grip initiation and grip termination were significantly greater for the paretic hand than for the nonparetic hand (see Table 2, Fig. 2). Delays for the nonparetic hand were also greater than those for the control hand. The delays in grip termination for the paretic hand could be reduced by using the arm support. Repeated active muscle stretch decreased delay in grip initiation, but it increased delay in grip termination for the paretic hand. Possible mechanisms underlying these results are discussed in the following sections.
Comparison with previous studies
Our study used the same stimulus and testing conditions described in previous studies (Chae et al. 2002, 2006) that measured delays not only in motor initiation but also in termination in the wrist and tibialis anterior (the start and end of an auditory stimulus as cues to initiate and terminate isometric maximal muscular activities, respectively). Mean delays in initiation and termination of isometric maximal paretic muscle activity recorded for the hand with no interventions (comfortable location without arm support before active stretch) in the present study (1.922 and 5.046 s, respectively) are much longer than those reported for wrist and lower limb muscles in stroke survivors (0.4 and 1.6 s, respectively, for wrist muscles; 0.3 and 1.0 s, respectively, for the tibialis anterior) (Chae et al. 2002, 2006). The longer delays seen in this study may be ascribed to the fact that subjects with severe hand impairment participated in the present study, whereas subjects who participated in the earlier wrist study (Chae et al. 2002) were mildly impaired, and subjects with a wide range of motor impairment (from severe to mild) took part in the tibialis anterior study (Chae et al. 2006). The greater delays seen in the present study could also be due to the greater motor impairment typically seen after stroke for the distal upper extremities compared with proximal or lower limbs (Gray et al. 1990; Nakayama et al. 1994a,b; Parker et al. 1986). The greater delay in termination than in initiation for the control subjects in this study (Δ 177 ms) may be due to slower detection of the end of an auditory sensation as opposed to the onset of an auditory sensation (Emmerich et al. 1976; Goldstone 1968; Kemp and Irwin 1979).
Slowed bilateral sensory information processing following stroke
Greater delay in initiation for the nonparetic hand compared with the control hand (Δ 0.237 s) was observed. These delays are in concert with previous studies where simple reaction time was found to be greater for the nonparetic hand than that for a control hand (Howes and Boller 1975; Jones et al. 1989). The increase in delay may be attributable to slower auditory information processing for stroke survivors compared with control subjects because sensory information processing is lateralized on both hemispheres for both visual (Jones et al. 1989) and auditory (Howes and Boller 1975) information. Bilateral activation of sensory cortex following auditory and visual cues in intact humans has been reported (Brouwer et al. 2005; Catalan et al. 1998; Sadato et al. 1996). Therefore disruption of bilateral brain activity following unilateral stroke may have contributed to delays in sensory information processing and subsequent delays in muscle activation and termination of the nonparetic hand.
Disturbed interhemispheric inhibition following stroke
In addition to slowed sensory information processing following stroke, altered interhemispheric inhibition could potentiate the delay in grip termination of the nonparetic hand and the delay in grip initiation of the paretic hand, as evidenced by studies using transcranial magnetic stimulation: termination of voluntary hand muscle contraction was found to be preceded by increased excitability of motor cortical inhibitory circuits (Buccolieri et al. 2004). Decreased inhibition from the lesioned to the nonlesioned hemisphere (Butefisch et al. 2008) and increased excitatory activity with reduced inhibitory activity in the nonlesioned motor cortex (Butefisch et al. 2003; Shimizu et al. 2002) could have furthered the delay in grip termination for the nonparetic hand and thus may explain differences regarding delay in grip termination between the nonparetic hand and the control hand (Δ 0.923 s) after accounting for the slowed sensory information processing for stroke. Likewise, increased inhibition from the nonlesioned hemisphere to the lesioned hemisphere (Duque et al. 2005) may explain greater delay in grip initiation for the paretic hand compared with the nonparetic hand (Δ 1.448 s), as previously demonstrated (Murase et al. 2004).
Intrinsic motoneuron properties and the effect of repeated active muscle stretch
In addition to increased inhibition from the nonlesioned to the lesioned hemisphere, fewer functioning motor units (McComas et al. 1973) and slower motor unit firing rates (Gemperline et al. 1995; McComas et al. 1973; Rosenfalck and Andreassen 1980) for the paretic limb may also be responsible for the greater delay in grip initiation for the paretic hand compared with the nonparetic hand. Delay in grip termination for the paretic hand, however, may be related largely to the plateau behavior of spastic motoneurons in which they remain firing even after a synaptic input is removed (Gorassini et al. 2002a; Heckmann et al. 2005). Plateau potentials could also contribute to reduction of motor unit recruitment threshold following voluntary muscle contractions as shown in humans (Gorassini et al. 2002b). The plateau response has been shown to become larger and more prolonged after repeated muscle stretch and voluntary muscle activity in decerebrate cats (Bennett et al. 1998). The characteristics of these intrinsic motoneuron properties coincide with the decreased delay in grip initiation and increased delay in grip termination seen after repeated active muscle stretch in the present study (Table 3). Enhanced plateau behavior has been shown following administration of monoamines including serotonin (Hornby et al. 2002) along with increase in the resting potential of motoneurons (Wang and Dun 1990) in animal models. Thus sustained finger flexor muscle activity may be related to increased influence of monoaminergic brain stem pathways following stroke.
Flexion synergy and the effect of arm support and grip location
Data support the hypothesis that delay in grip termination decreases with use of an external arm support (Table 3). The arm support has been shown to reduce shoulder and elbow muscle activities (Iwamuro et al. 2008; Prange et al. 2009). The decreased delay in grip termination seen with use of the arm support may have coincided with a reduction in flexion synergy, in which active shoulder abduction produces involuntary flexion at the elbow and hand in stroke survivors (Brunnstrom 1970; Dewald et al. 1995, 1999). Indeed, support of the arm has been shown to lead to improved elbow extension and reaching (Beer et al. 2004, 2007), accompanied by a reduction in involuntary elbow flexion (Iwamuro et al. 2008). This flexion synergy may result from reduced cortical inhibition to the reticulospinal tract (Matsuyama et al. 2004) and subsequent facilitation of the reticulospinal pathway following stroke (Kamper et al. 2003; Kline et al. 2007) because the reticulospinal pathway favors flexion in the upper extremity (Davidson and Buford 2004; Mori 1987; Schepens and Drew 2004; Werner et al. 1997).
In contrast, delay in grip termination was not significantly different between the comfortable grip location and the far grip location. It is possible that the far grip location triggered two mechanisms that counteract each other. First, as initially anticipated, increased proximal arm muscle activity for the far grip location would contribute to increased delays via the flexion synergy (Brunnstrom 1970; Dewald et al. 1995, 1999). Second, changes of the upper arm posture for the far grip location (e.g., shoulder flexion/abduction, elbow extension) and subsequent changes in sensory feedback from the proximal arm muscles may have shifted the balance between descending inputs from the vestibulospinal and the reticulospinal systems toward the vestibulospinal system, resulting in reduced excitability of finger flexor muscles in stroke survivors, as evidenced by others (Ellis et al. 2007; Hoffmann 2008). For example, reduction of stretch reflexes of the finger flexors has been demonstrated for flexed shoulder and extended elbow posture compared with neutral shoulder and flexed elbow posture (Hoffmann 2008). These two mechanisms may have canceled each other with respect to the excitability of the finger flexor muscles, resulting in little change in delays.
The torso posture was not constrained in the present study. Thus for the far cylinder location, subjects could have flexed the torso to move the paretic hand ahead rather than extending the affected elbow, as previously reported in reaching (Roby-Brami et al. 2003). Using this compensatory behavior, the subjects may have been able to maintain the similar level of shoulder and arm muscle activities for the two cylinder locations, thereby mitigating the effect of the different grip locations.
Implication in hand function
Mean delay in grip termination for the paretic hand of 5.046 s (for the comfortable grip location) is significantly longer than the relaxation times for the control (0.414 s) or the nonparetic hands (1.574 s). This sustained grip activity may induce serious impairment in hand function during object manipulation. For example, when stroke survivors attempt to relax the hand and let go of a grasped object, sustained finger flexor muscle activity may prevent the object from being released. This may lead to further frustration and disuse of the arm. It should be noted, though, that the delays were recorded for maximal grip exertions in this study. It is possible that for submaximal grip exertions, which are often used in daily activities, delay in grip initiation could be longer and delay in grip termination may be shorter than those reported in the present study because a smaller number of motor units are recruited in submaximal grip.
This study demonstrated that subjects could instantly decrease delay in grip termination by using the arm orthosis, TA-WREX (Table 3; Δ 2.596 s). It conforms to the previous report that stroke survivors could achieve increased hand function by using the TA-WREX (Rahman et al. 2007). Because the basic role of the arm orthosis is to support the weight of the arm, it is conceivable that simply supporting the affected arm's elbow using the stronger hand or against a table may help shorten the delay in grip termination for the paretic hand, especially when one cannot let go of grasped objects in the hand.
Repeated muscle stretch has previously been shown to improve hand function (Carey 1990). Increased maximum voluntary muscle strength (Selles et al. 2005), reduced spastic muscle tone (Nuyens et al. 2002; Schmit et al. 2000), and decreased delay in grip initiation after stretch (Table 3; Δ 0.490 s) after repeated muscle stretch could contribute to increased hand function. Increased delay in grip termination after 30-min repeated active muscle stretch (Table 3; Δ 1.346 s), however, could adversely affect hand function. Thus the long-term effect of active muscle stretch and exercises on delay in grip termination needs to be investigated. Note that an active muscle stretch protocol was used in this study. Different results may be obtained if passive muscle stretch was used because passive stretch alone may have limited influence on plateau response (Bennett et al. 1998). Last, pharmacological intervention that downgrades the influence of the monoaminergic pathways, the plateau behavior, or the reticulospinal pathway may help mitigate stroke symptoms and decrease delays in grip termination.
This work examined delay in finger flexor muscle contraction and sustained finger flexor muscle activity after grip following stroke. Slowed bilateral sensory information processing, disturbed intercortical inhibition, and the increased influence of the brain stem pathway and the subsequent change in intrinsic motoneuron properties following stroke may be responsible for the delays in grip initiation and termination for both the paretic and nonparetic hands.
Sustained finger flexor muscle activity (threefold longer than that for the nonparetic hand) can impose serious difficulty in stroke survivors' ability to let go of a grasped object. Supporting the weight of the arm can be effective in shortening the sustained finger flexor muscle activity for the paretic hand. Repeated active muscle stretch can shorten delay in grip initiation but lengthen delay in grip termination immediately after the stretch, whereas its long-term effect on delays is unknown. Therapies and interventions that reduce the delays in initiating and terminating finger flexor muscle activity may improve an ability to grasp and release objects and thus increase functional independence for stroke survivors.
This work was supported by the Coleman Foundation and the Galvin Scientist Fellowship.
We thank H. C. Fischer and L. L. Connelly for assistance in subject recruitment and clinical evaluations and B. T. Iwamuro for assistance in the use of the Therapy Assistant Wilmington Robotic Exoskeleton (TA-WREX).
- Copyright © 2009 the American Physiological Society
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2. supplies product to more than 100 countries, build up long term relation with hundreds of partner suppliers.
3,Top Com has been cooperating with more than 20 worldwide brands.
4, Team-working management way provide fastest, most professional and closest service.
5, Best quality, competitive price and hard-working for you is our target.
Q1. Do you accept OEM order?
Yes, OEM & ODM are acceptable.
Q2. What's your payment terms?
We accept T/T(30% down payment and 70% paid before delivery), Pay pal, Western union, and Money Gram.
Q3. What's the minimum order quantity? How long is the delivery time?
Both MOQ and delivery time need to refer to the specific products. Usually, we have stock for our brand products, please contact our sales for details.
Q4. What's the way of transportation?
Express, air and ocean shipments are all available.
Q5. Do you test all your goods before delivery?
A: Yes, we have 100% test before delivery
Q6. Why I choose you?
A. We are manufacturer of kinds of tools related to electronics maintenance. You can buy what you need here at very reasonable price.
B. With 20 years experience in this filed, we have the ability to provide good service and products in low cost.
C. Adequate inventory to make sure that our clients can obtain goods in a short period.

subset: commoncrawl


text:
For the week starting Friday, Jan. 26. Times are E.S.T., subject to change.
Metropolitan Opera (Sat. 2 p.m., ABC). Das Rheingold, with Hotter, Svanholm, Pechner.
NBC Symphony (Sat. 6 p.m., NBC). Toscanini directs Verdi's Requiem.
New York Philharmonic (Sun. i p.m., CBS). All-Brahms program. Guest: Violinist Zino Francescatti.
Theatre Guild on the Air (Sun. 8:30 p.m., NBC). Anne Baxter in Morning Glory.
The Railroad Hour (Mon. 8 p.m., NBC). Dorothy Kirsten and Gordon Mac-Rae in New Moon.
Telephone Hour (Mon. 9 p.m., NBC). Guest: Ezio Pinza.
Boston Pops Orchestra (Mon. iop.m., NBC). Conductor: Arthur Fiedler.
Talent Hunt (Fri. 9 p.m., NBC). A new series, starring Henry Morgan.
Pulitzer Prize Playhouse...


text: Anyone know of one? Both Logitech's and Microsoft's drivers are complete garbage (why the hell would I need several megabytes of crap installed when all I want to be able to do is to customize mouse buttons?). I hope there is something out there that lets you customize mouse buttons without all the extra crap.


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UPDATE: OCTOBER 17th RYANAIR SESSION FOR STUDENTS AND GRADUATES
Next October 17th at 3pm, Barcelona Flight School will hold a Ryanair Conference for current students and past graduates, where we will explain to our audience the conclusions of this interesting meeting.
Topics such as what the Airline is looking for in fresh candidates, how the recruitment process runs and what are the plans of the company for the upcoming future will be covered in depth, so this workshop is going to be a big opportunity for all those interested to apply now or in the future.
Space is limited, please contact us if you want to attend.
We look forward to meeting you there!
Barcelona Flight School was formally invited by Ryanair, last October 4th, to visit their Dublin headquarter and meet with their recruiting team in order to talk about their current Pilot Recruitment Policy and their plans for the future in this regard.
Barcelona Flight School is one of the main professional pilot sources for Ryanair, and as a matter of fact they wanted to meet with our senior staff personally in order to close the loop and keep the stream of well-trained pilots coming to the airline for the foreseeable future.
Both our Sales team and our Head of Training attended the meeting that was also a good opportunity to go in-depth about the company's requirements and preferences when it comes to recruiting fresh pilots coming out of the ATPL or Commercial Pilot courses.
Ryanair has not stopped growing since its establishment, and their future expansion plans are really massive. These large growth scenario makes the company in the need to hire thousands of pilots from now on, to cope for its big fleet that will double in the near future.


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Hot tags Weather Climate Change Planets and Asteroids Archaeology Fossils
Science subject and location tags
This tag library is an archive and is no longer updated. For current content go to ABC News.
RSS | MapSurfing Scientist
Helicopter balloon
Tuesday, 6 March 2012
Surfing Scientist Trick Flying an air-filled water balloon with a straw is child's play. Trying to explain how it flies can be a physics professor's worst nightmare.
Do-it-yourself marble run
Tuesday, 21 February 2012
Trick Predicting how objects roll, fall and trigger each other to move may have more to do with our basic instincts that the laws of probability. Watch this trick and understand why toddlers are excited by something as simple as a rolling ball.
Cotton ball science
Wednesday, 25 January 2012
Teacher demonstration Teaching young children to count? Doing a unit on natural and processed materials, or learning about the properties of water? These super simple demonstrations will amaze them and explain why hot soapy water cleans better than pure cold water.
Haunted straw
Tuesday, 13 December 2011
Surfing Scientist Trick Things that move for no apparent reason give some people the heebie-jeebies. So does maths.
Hanging in water
Wednesday, 30 November 2011 598K
Conundrum Is there a differerence between what something weighs normally and what it weighs in water?
Curved surface illusion
Monday, 14 November 2011
Tricks Tricking the mind can often be more than meets the eye. Using nothing more than a ball or a bowl, you too will be able to discover your myterious sixth sense.
Making waves
Tuesday, 1 November 2011
Lesson Plan Make a cool wave animation and, in the process, learn about the ebb and flow of the surf.
Tea temperature
Wednesday, 21 September 2011 214K
Conundrum Not all tea is poured equally. To keep your mornng cuppa hotter for longer should you pour the milk in straight away or wait a minute or two? This conundrum will have you gulping for answers.
The Charpentier illusion
Thursday, 8 September 2011
Tricks Why do we think smaller objects are heavier than bigger ones even though they weigh the same? Put your back in to it and try not to be fooled by this awesome trick of the mind.
The Mrs Thatcher illusion
Wednesday, 10 August 2011
Tricks Try this amazing trick and you'll never take your amazing brain for granted again. You might never look in the mirror the same way either!
Move the matchstick
Wednesday, 27 July 2011
Tricks Rotating a matchstick, precariously balanced on the rim of a coin, standing on its edge under a cup sounds like an impossible and slightly pointless challenge. Pointless? Perhaps. Impossible? Nope.
Imploding drum
Wednesday, 13 July 2011
Teacher demonstration Teaching solids, liquids and gases, changes of state or meteorology? In this spectacular demonstration, atmospheric pressure crushes a steel drum with an almighty bang.
Column strength test
Wednesday, 15 June 2011
Teacher demonstration Teaching three-dimensional shapes or geometry? Demonstrate the extraordinary strength of the humble cylinder using ordinary paper and a stack of books.
Corked up
Wednesday, 1 June 2011
Tricks Amuse and annoy your friends with this simple challenge: how do you get a cork out of a bottle in one piece?
Iron for brekkie
Wednesday, 18 May 2011
Teacher demonstration Most kids know that many breakfast cereals contain iron but very few realise that most of it is added by the manufacturer. Even fewer realise this iron is a black powder that is attracted to magnets.


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In previous newsletters, I have written about a number of keynote speakers, but these two speakers both entrepreneurs and philanthropists will enlighten you with their model for success.
Frank Aloysius Costa AO is a famous Geelong icon has built his Family's produce company to the largest service wholesaler of fruit & vegetables in the country with operations in five major states into a $100million company. With a few business blunders over the years, nothing was impossible and in 1998, he became president of the Geelong Football Club.
Marcus Veerman CEO and Founder of Playground Ideas struck it lucky being born in Melbourne, which has been voted the world's most liveable city. His favourite play-space growing up was a den in the hollowed-out roots of an old tree. With a background in primary education, outdoor leadership, and design-build learning, Marcus spearheaded the construction of 40 bespoke playgrounds along the Thai/Burma border. He then went on to respond to a wave of interest in international playground building by creating an open-source platform to share best practices. Demand for his services has taken him to Asia, Africa, The Middle East and South America to facilitate playground construction, consult on projects and train teams of playground builders.
Watch the following video to see what we have organised for you.
So why not book now by clicking on this link.
John Pohl
District Governor


text:
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Offer valid in store only, unless explicitly noted otherwise. Limit no more than one manufacturer coupon (paper or Cartwheel digital), one Target coupon and one Cartwheel offer can be combined per item. Manufacturer offers are single-use only. Each Cartwheel offer may be used for up to a maximum of 4 qualifying items per offer per transaction, unless otherwise noted. Limit of 1 Cartwheel barcode per transaction and 6 Cartwheel barcode transactions per day. Cartwheel cannot be applied with price match. Void if copied, scanned, altered, transferred, purchased, sold, or prohibited by law. Item(s) may not be available at all stores. Offer value may not exceed value of item purchased. No cash value.


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Welcome back to this read of The Last Unicorn by Peter S. Beagle. Here, we look into this classic work of fantasy to gain insights into what elements create a great book. To catch up or review previous parts of this read, click here.
Chapter XI
Summary: Prince Lir returns from another heroic deed, but this time, he does not present the spoils of his work to the Lady Amalthea. Instead, he decides that he will love her from afar and seek nothing of her except some small chance that he might be of use to her. Molly encourages him in this endeavor.
Then, he chances to meet her on the stairs and captures her with his gaze as he has learned to capture many creatures. She confesses to being confused and having a horrid nightmare where she's locked in a cage and there's an old woman and a bird and she has four legs like a beast. Lir is horrified at this but seeks to soothe her. He pleads to be of some use, so she asks him to sing to her and gives him the first smile she has bestowed upon him. She bids him to sing so that all the nightmares and this thing that wants her to remember it will go away.
All winter and into what pitiful season Haggard's kingdom calls summer, the Lady Amalthea and Prince Lir fall deeply in love. They sing together. They picnic in the castle. Everything, though the castle is weighed down with darkness, dreariness, and witchery, is like spring to them.
Meanwhile, Molly and Schmendrick slave away for Haggard, too weary and overworked to solve the riddle the cat gave about how to get to the Red Bull's lair.
Then, one day, the Lady Amalthea watches from a tower as Prince Lir returns from another great feat. King Haggard comes upon her and challenges her. He confesses to knowing who she really is, and when she pleads ignorance, demands that she not dare deny herself. He will have her. If she loves a little longer, he will have her. He confesses to having known who she was from the beginning and about how he once saw a pair of unicorns. They were the only things ever to bring him joy, so he told the Red Bull--who follows him only because he has no fear--that he wanted them. One by one, the Red Bull rounded them up for Haggard and drove them into the sea. There, they remain imprisoned, terrified to step foot onto the shore lest the Red Bull get them.
The tide turns, and he bids her to see the unicorns as the waves break against the shore. For once, his voice and manner are young. For once, his face radiates joy. And then he looks at her and sees that there are no longer green leaves in her eyes. He threatens to hurl her from the tower with his own hands if she has forgotten herself. She closes her eyes before him, and at last, he departs.
Then she hears Schmendrick reassuring her that it's over. He has heard all Haggard said and now knows where the unicorns have been hidden. When she turns to him, he sees moisture on her face and says,
"I hope that's spray. If you've become human enough to cry, then no magic in the world--oh, it must be spray. Come with me. It had better be spray." (page 189)
Writer Comments: This chapter covers an extended period of time. It covers several scenes, some quite brief, and it unfurls a crucial turning point for the unicorn. That's a lot to cram into one chapter, which begs the question: What should comprise a chapter?
There are many answers to this, and undoubtedly, you can find pages of opinion if you search online or get a group of writers together to discuss it. However, I think, amidst all the various definitions, that there is one crucial element that must define a chapter, every chapter, of a story: shift.
What is shift? Simply, it is a slight or dramatic alteration in the characters and story. Something must change to raise the stakes or reveal a new layer of the mystery. A new development must come up. A new question must arise. Something must change.
This chapter is all about the change in Lady Amalthea from being the unicorn to embracing her human side and fleeing her unicorn self. Beagle takes us from the moment she takes that first real step by accepting Lir, demonstrates how extensively she turns from her true self, to the point where she is on the brink of losing herself completely. In real time, this takes months, but Beagle can't afford to drag the description of it out and risk boring his readers or at least getting sidetracked. Instead, he highlights the change, the shift, in one powerful chapter.
For stories to be dynamic, they must make small alterations that result in the overall big change that results in the climax. To accomplish this, a writer must make something shift in each chapter and in each scene for that matter. If nothing shifts, take a good hard look at what's written. It almost certainly needs cutting or rewriting.
Thank you for joining me for this read of Peter S. Beagle's The Last Unicorn. We'll resume this read on Monday. Until then, swing back by on Friday for a sneak peak at Jessi Gage's Jade's Spirit, an awesome book about a haunting, hope, love, and redemption.


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Modern luxury apartments and condominiums - Stock image
Abstract Backgrounds, Backgrounds, Balcony, Built Structure, College Dorm
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this photo is of Luxury Apartments and Condominiums in a Modern Building. the picture includes the balcony and sliding glass window at the top floor of a modern building design. the picture is an abstract background of an architectural design. the lighting is natural lighting with sunlight and blue sky is in the background. the picture was taken in a city.


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Separate names with a comma.
Discussion in 'Football' started by CyPride, Dec 29, 2008.
I've heard that the new staff is cutting him loose.......any truth to that?
Cutting him loose? He just signed with Iowa.
I had heard he de-committed and is going to Iowa now...I don't know whether he had a chizdick crush or the coaching staff let him go
I don't think it's the new staff cutting him loose but him wanting out now that Chizik is out.
Maybe verballed with Iowa, but I heard the new staff cut him loose for looking around during a committed status.
Sounds like a spin.
How about a trade? They can have Bofelli and we will take the Van Sloten kid they have. His dad played at ISU and from what I heard he wanted to come here but Chiz did not offer.
not a big loss at all. this kid wants to play TE and he would be far to slow to play in the spread for us. and i heard iowa wants him as an OL and well, after watching him play the last few years, i just dont think hes that good
He will be a better OL then the kid going to Michigan State, but Wood will be better than both...
Ahh, the classic "we didn't want him anyway" in progress.
I'd put a lot of money on this happening
kid can't look into the camera anyways...enjoy gettin pounded by state if he is a Hawk
whats he lookin at down here?
Committed you mean, you can't sign till signing day.
If he has no desire to be a clone or is unsure than he should go. If he wants to be with us then it is sad for him to go.
I dont blame the new coaching staff for cutting him loose...the kid is way too slow for big 12 play...Rhoads would be better off to go into texas and recruit the 5th best player, which would be better than anything from the state of iowa!!!!:biglaugh::biglaugh:
I wish him luck....I fully expected a defection or two..
This would mean Lichtenburg is gone then.
Maybe it is a female photographer?
He didn't want to wear his ISU gear outside the house due to the season we were having....other than the hawks on this board, I don't know a single other person that would say that who is a Cyclone, and based on that comment alone, he can get on the nearest bus. If you aren't man enough (granted he isn't 40) to commit to a school and wear their colors with some pride regardless of the record, you more than likely are going to quit when the going gets tough.
The posters here are delusional.
Unbelievable. This kid never "quit" anything in his life. He is a good kid that was attracted to ISU by a coach who "quit" on us.
Go get signed up for the Iowa board for all of you who now say "he is not good enough for us". Their good at that over there!
Bofelli would have been a good addition to our team and I will always wish good kids, good luck.


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Sioned Roberts, Llion Iwan, Gwawr Lloyd and Gaynor Davies have been appointed as Content Commissioners at S4C on initial 3 year contracts. The four will be responsible for commissioning content and multi-platform digital services for the Channel under the leadership of S4C's Director of Content, Dafydd Rhys.
Each will be responsible for different aspects of commissioning for the programme service (no further details given).
In addition and following internal reorganisation, Geraint Rowlands will take responsibility for some aspects of commissioning and managing certain teams within the Commissioning Directorate as Head of Broadcasting
The appointments are part of S4C's new commissioning strategy announced recently. S4C will move from a system of commissioning decisions being made jointly by the entire commissioning team to a structure where individual commissioners will commission content.
Source: S4C press release


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the local weather people are jizzing themselves about this rain. as, funnily enough, in a place where it rains all the goddamed time, the infrastructure is not equipped to deal with an inch of rain in an hour.
whatever. so long as it's not five inches of rain in 24 hours, i don't care. school has started so there are no screeching children at the park and the rain keeps the meth heads inside. it is WIN/WIN (at least for now. after about two weeks of this shit i will want to jump off a bridge. ugh, it is hideous in the pnw.)


text: su, 2005-07-24 kello 10:13 +0200, Florian Weimer kirjoitti: > How is Debian related to the "Debian Core Consortium"? Why are they > using the name "Debian"? I'm not sure I have ever heard of "Debian Core Consortium". Please don't refer to new phenomena like that assuming everyone knows what you're talking about. Do you have a URL to more information?


text:
Hiking Socks - MensBest prices on Hiking Socks only at Proboardshop! Don't ever again wear thin and flimsy socks while hiking. Save yourself from the blood and blisters with brand new Hiking Socks from brands like Fallen, Helly Hensen, Smartwool, Vans and more. We believe in quality apparel, and that includes the quality of our socks. Purchase a pair of durable Hiking Socks today and we'll have it shipped out with next-day shipment and a 100% customer satisfaction guarantee, Monday-Friday!
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text:
- Please select a date to see the proper prices!
- Meal can be requested on the spot
Best offer
46 € / person / night, no meal
Description of the accommodation:
Rooms, services The guests of Hotel Elisabetha Hanover may stay in 26 nicely furnished, comfortable rooms in Hanover. If you love spending your leisure time actively it may be a good idea to check the bike rental and bowling opportunities nearby. In case you'd bring your laptop along, you may go online via wireless Internet connection (WiFi) available at the hotel. If you wish to learn more about the exact scope of services provided by Hotel Elisabetha Hanover (including any available for an extra fee), you will find them on the information sheet below.
Payment In order to finalize the reservation you may be required to provide credit card guarantee or advance payment by credit card, depending on the chosen room, date and price.
Arrival, opening hours The earliest check-in time is 14:00, the latest check-out time is 11:00. You will be able to speak with the personnel in English and German languages.
Hotel Elisabetha Hanover rooms Rooms
- Please select a date to see the proper prices!
Accommodation services
Free WiFi in shared places
Bowling, Bike rental at the accommodation
Pet friendly (4 €/night), Garden
General Policies
On Saturday and Sunday: 6:00 - 14:00 and 17:00 - 21:00


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Assassins Creed 7″ Action Figure
An assassin's assassin. The hero of Assassin's Creed comes to life as the newest release from NECA's Player Select line of action figures! This supremely detailed Altair figure stands approximately 7-inches tall and includes terrific accessories like a retractable blade, removable swords and daggers, and alternate hands. Bring this video game legend home today! Assassin's Creed is a 3rd-person stealth game developed by Ubisoft Montreal in which the player assumes the role of Desmond Miles, an average bartender who is the last descendant of a long family line of assassins. Desmond has been taken to a facility where he is forced to use the Animus, a machine that traces and recreates the memories of his ancestors during the Third Crusade. Through these memories, the player controls Alta


text:
Marshmallow Circus Peanuts were invented in the 1800's. These peanuts have been produced by many confectionery manufacturers over the years. They were originally introduced as Spring candy items in the then dominant 5 cent and 10 cent variety stores. Many other unwrapped penny candies were also available. The product at that time was considered a Spring seasonal item. However, with the development of polyethylene film in the late 1940's, it became possible to offer Circus Peanuts on a year-round basis.
Spangler Candy is a producer of superior quality Circus Peanuts. Over the years the best selling item has been orange in color, banana in flavor, and peanut in shape - figure that out!? This candy certainly has a loyal following though!
7oz. Includes Spangler's Orange Circus Peanut Gelatin Recipe.
Marshmallow Circus Peanuts 7oz. (SOLD OUT)
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I am on a number of different groups… some Deaf groups, some deaf groups. Some CI groups, some ASL groups… I surround myself with different types of people, and to me I think that is a wonderful thing, seeing different opinions, and different thoughts, nothing then is allowed to be dogma, but I am allowed to see facts for facts.
Recently… I've been thinking about leaving one of the groups, why? Because it seems their main goal is to end ALL cochlear implant surgeries, they are telling lies about how getting a CI isn't a choice for anyone, that it is a death sentence, that Deaf people who choose to get a CI will be ostracized from the Deaf Community, that you will no longer be Deaf, or that getting a CI is promoting Audism… none of this I agree with.
Let me get a few facts out there (that are already in this blog site, but still) 1. I am Deaf, 2. I use ASL as my main Language, 3. I have a CI 4. I HAVE NOT been ostracized from the Deaf Community, nor has anyone I know who has chosen to get a CI been.
Now… there are a few things I do agree with in the most recent post that has gotten me upset… 1. CI's should not be done on infants, 2. all deaf children should have sign language (ASL if in the USA, or the countries sign language), 3. Being Deaf should be accepted as a natural state, 4. CI's are not a "fix", 5. Before getting a CI, you should talk with MANY people who have CI's (this was from a comment, not the original post)
- if a child wants a CI, let them choose a CI when they are old enough to understand what it means to get one.
- Sign language is the natural language of deaf children, and should be taught first. Speech is not the important thing, language is. If you have a solid base for language, then you will be able to learn other languages easier (including the spoken forms of language).
- Deaf is natural, there is nothing wrong with being deaf, it doesn't matter if it is a deaf human, if it is a deaf cat, or if it is a deaf Dalmatian (more on that to come). It is a natural state of being, we have multiple senses for a reason, so we are not relying on only one.
- A CI will not "fix" hearing. For one thing, there is nothing wrong with being Deaf… see #3… a CI may or may not improve the simulation of hearing, give a sense of hearing. A CI should not be seen as a fix for a deaf person, because we are not broken. It will not give a person normal hearing, even if a sound booth test shows near normal results with a CI, because the world is not a sound booth.
- Before anyone chooses to get a CI, they should talk with many people who have had them, be told the good, the bad, as well as the ugly. In some cases, it doesn't work, in some cases it works beautifully. But before you decide, talk to as many people as possible, with all different brands (no brand is honestly better than any other), with all different stories. Don't count out the person who was a teen when she was implanted and suffered severe vertigo from it, or the person who was born deaf and can't understand anything but environmental noise, or the girl who was implanted as a child, but can't have it turned up to where she gets speech sounds because of facial stim, or the adult who chose a CI after progressive loss, and is doing great. Don't count a story out, because you NEED to know the truth, things happen, its not always successful, bad things can happen, but so can good things. CI's, just like life in general, is never black and white….
So, after reading these things, it gets me wondering, if, because I have chosen, not only once, but twice, to receive a CI, and if the following is true: "if it does work, you are likely to be ostracized by Deafs (you have expressed that being Deaf is bad, and want to distance from it)" , where does that leave me? Am I back in that middle ground between Deaf and Hearing where I use to be before I found my Deaf Community? Do I fit anywhere? I know the answers to these questions… because no matter what I am still Deaf, I still use ASL, and my Deaf Community has not turned their backs on me, and I know they never will, they are my family, just as much as blood makes a family.
Now I'm on another group, and I see so often pictures of children, babies even, having CI surgeries, and their parents or grandparents talking about how they are now hearing (LIE… GREAT BIG LIE) and how they don't need ASL, or how they won't respond to their child if they use ASL… or how they only use ASL at bath times (a sign here or there)… and that… it breaks my heart for so many reasons.
These children will never be hearing, they are deaf, and nothing will change that. ASL is still needed, because it doesn't require batteries, it will never break, it is always accessible (even to a deaf blind child), noise doesn't interfere with it… it is the only 100% accessible language to a child. I'm in no way pro infant or child implantation, I believe it is a very personal decision that must be made individually, and a child, especially a baby, has NO way of telling you if it is too loud, if they are feeling funny things (stimulation that can be very uncomfortable, even to the point of pain)… I think the person should make the decision, and it MUST be an informed decision. Before I got my first CI I talked with MANY adults who have CI's, I read blogs, I have friends who's CI's failed, who are candidates, but choose not to get one, who regretted getting their CI, those who wanted explants (removing the CI), and those who were pleased with it. I did my homework, I actually watched a CI surgery (I must find that link), and I think that is something that is VERY important, I knew exactly what was going to be happening when I was under the knife, I knew what to expect (mostly) when I woke up from anesthesia, and I knew there was a very real possibility that it wouldn't work, and that I would never be able to understand speech. Honestly, if you look back, my audiologist told me I was underestimating myself, by saying I wasn't expecting to understand speech, I just wanted to be able to hear (not necessarily understand) music again, and know if someone was talking… my CI has exceeded my expectations yes.
ASL also, it isn't something that is only needed for bath times, in fact, if you use it only at bath time… I think there are issues there… it gives mixed signals to the child, especially if the child's first language is ASL… they may have a hard time telling when its appropriate and when it isn't (I have a lengthy explanation of that here)
So… I also wonder… do I fit in this group? I can share my CI joy, and I love that… but do I fit in with the people who feel their deafness is something to be ashamed of, or that if you can't hear something you are missing out? I don't know… I am not, and will not be ashamed of being Deaf, and I know you can have a full life without hearing a thing… I'm starting to wonder… where do I fit… there are only a few places I know for sure. In my loves arms, in the Deaf community, and with my family (most of it anyways), and this… this I am ok with. I don't have to fit with the Radical Deafies, nor with the Oral deafies, and certainty not with the audist deafs… but their stories I also shouldn't count out… but I shouldn't take anything at face value either…


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Perth, Mar 3: Indian team has performed to its potential in the ICC World Cup so far despite having being "mentally drained" by the preceding tri-series, according to Team Director Ravi Shastri who today dismissed that series as "sheer waste of time and energy".
World Cup Special; Points Table; Photos
India entered the quadrennial extravaganza following a winless tour Down Under, losing the Test series and being knocked out early in the tri-series which had Australia and England as the two other participants.
"I think the team was mentally drained after playing the tri-series. The boys needed to recharge their batteries and freshen up for the World Cup. The break from cricket did them a world of good as they came all guns blazing when it was required. And frankly speaking, I believe that this tri-series that we played was sheer waste of time and energy," Shastri told PTI in an exclusive interview here. (10 facts about India-WI game)
Shastri was not surprised by India's stunning turnaround of fortunes in the mega event where they have already won all their their matches, including the one against South Africa, convincingly.
"I am not at all surprised. In fact, why should I be surprised that the team has started on a magnificent note. I had complete belief in the boys and their abilities. (Amla breaks Kohli's record)
"It was a case of performing to their potential and that's exactly what has happened in the two matches against Pakistan and South Africa. If you ask me, the script went on expected lines," the former Indian captain said.
Heaping praise on batting mainstay Virat Kohli, Shastri said the 26-year-old batsman has been the best-ever Indian performer on Australian soil.
"As far as I am concerned, I have never seen any Indian batsman perform better than Virat on Australian soil keeping Sachin Tendulkar and VVS Laxman in mind as they have done exceptionally well.
'Allow Kohli to play freely'
"I mean show me one Indian batsman who has scored four centuries in four Test matches. He has been phenomenal. He was dominant and that's the reason we carried the attack back to Australian camp in all the Test matches."
When asked if Kohli is destined to break all international batting records, he said, "I think that will be putting too much burden on one individual. He should be allowed to play freely and express himself in the best way possible."
Besides batting and bowling, the Indian fielders have caught the eye with their athleticism on the field, prompting Shastri to go to the extent of calling them one of fittest units in the world. He said this in relation to a question on the 1985 victorious campaign in the Benson & Hedges World Championship, where the former all-rounder was at the forefront.
"I don't love looking back too much into the past nor am I interested in looking too far ahead. But I would like to say this with conviction that this is the best Indian fielding unit that I have seen in many years. This team has some amazing fielders and they are among the fittest in international cricket," he said.
Shatri denies Dhoni-Kohli rumour
Asked about rumours around rift between Dhoni and Kohli, Shastri brushed them aside. "I have little patience or time for nonsense that's spread around. Frankly speaking, I care two hoots about skeptics or doubting thomases spreading some stupid theory. Neither me nor the players are bothered about these stuff.
"If someone feels that he wants to waste his time discussing these issues, they are free to do so. And you will know why the players are least bothered about these issues. Because they all sleep well at night as their conscience is clear."
Asked about who controls the Indian cricket team, Shastri categorically stated that it's Dhoni who calls the shots. "Mahendra Singh Dhoni is the undisputed leader of the Indian cricket team. He has been the boss for last eight years. He has been pro-active and has always led from the front.
"He has been a terrific limited overs cricketer. He has won matches for India and is a calming influence in that dressing room. He has earned respect from his colleagues because he is a true leader," he said.


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Cartoon Crack-Ups Trailer (2004)
Get ready for a totally digital Crack-Up, as 7 of your favorite animated greats come together for the first time ever. Episodes include: The Flintstones: The Swimming Pool, The Jetsons: A Date with Jet Sceamer, Scooby-Doo...Where are You?: Jeepers It's the Creeper, Huckleberry Hound: Spud Dud, Yogi Bear: Bear Faced Disguise, Pixie and Dixie: Heavens to Jinksy, and Top Cat: Maharajah of Pookajee!
Watch the official Cartoon Crack-Ups 2004 trailer in HD below or find more Cartoon Crack-Ups videos on Vidimovie.


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Search RMIT
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Not a local student?
You're viewing program information for international students.RMIT considers you an international student if you are:
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'Changing the score': an Australia-Brazil reconciliation exchange
This action research project focused on an intercultural exchange that would provide opportunities for mutual learning between Australians and Brazilians.
The project focused on the use of sport as a vehicle for reconciliation and social inclusion. This was part of a successful series of 'Reconciliation Journeys', including local-local conversations about how everyday practices can become vehicles for reconciliation and social change. The journeys have been run in partnership by RMIT University, Global Reconciliation and Bluestone Edge, which has played a central role in the sport-focused journeys.
The Australia-Brazil exchange has a research dimension focused on documenting and evaluating the model of exchange, with a view to developing a transferable model of local-local engagement.
Key people
Project team: Elizabeth Kath and Pippa Grange (Bluestone Edge) in partnership with Richmond Football Club, Korin Gamadji Institute and The Brazilian Institute for Innovations in Social Health (IBISS).


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Done, hope someone can mirror it!
Done, hope someone can mirror it!
Don't ask for ETAs -- it's considered bad manners in here. That comes out harsher than I mean it, since I realize you might not have known, judging from your post number, but please take the time to read up on xda etiquette a bit.
General rule: it's done when it's done, and you'll then find out soon enough.
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Welcome to the Editor-in-Chief application system for JBMR and the Open Access Journal. Please carefully read the instructions below. Questions may be directed to Ann L. Elderkin, ASBMR Executive Director, at firstname.lastname@example.com or +1.202.367.1242.
Application Materials
Unless indicated otherwise, applications must include the following materials submitted in MS Word or PDF formats. Applications missing any required documentation by the June 15, 2016 deadline will not be considered by the Editor-in-Chief Search Committee.
Application Instructions


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ARLINGTON, Va. — The Safe Quality Food (SQF) Institute, a division of the Food Marketing Institute here, has added an Ethical Sourcing standard for labor and environmental practices to its supplier auditing programs.
The SQF Institute, which is now pilot-testing use of the standard and training auditors how to check companies for compliance, already audits suppliers worldwide for compliance with food safety and quality standards.
"The Ethical Sourcing standard will help


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Autumn Preview
August 7, 2013
We are starting to get very excited for the changing season. I am always amazed by the beautiful transformation that mother nature makes at this time of year. I love watching the colors change from bright green to deep reds and oranges. Some of my favorite colors come out during fall and it always seems there's a certain calmness about the Earth. I'll admit I'm not much for cold weather, but I love fall fashion. I can't get enough of all the cozy layers and endless possibilities for mixing material and prints. Not to mention, statement jewelry! This year SoulMakes fall range is full of mixed metals, bold textures and beautiful earthy tones. We are loving Pyrite for fall, with it's energizing properties, it is the perfect boost! Stop by the shop and check out our new arrivals!
Hope you all have a beautiful day!
MacK Mars
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Hello there.
Want to have an amazing wedding and make the most of your wedding budget
Work really hard at your job/life and know there just aren't enough hours in the day
Have an amazing Mom/friend/family member who wants to help, but is also starting to drive you a little crazy
Might be a little (or a lot) Type-A
Find satisfaction in checking things off of a list (you may even add something to it after you've done it, just so you can cross it off)
Think that wine and a good book might be the very best treat after a very long day
Dig Harry Potter (see below for which house I'm in)
Really dig Pinterest and already have a wedding board packed with ideas
Love a walk through the woods but also appreciate a stroll through a bustling city
Believe in practical decisions based on logic, but also know when to follow your gut
Hi, I'm Danielle.
The first question you may be asking is: "what the $*#% is DPNAK?!?".
That's easy. "DPNAK" is the shortened version of my full name: Danielle PasterNAK.
I pronounce it "dee-pee-nack".
- I began this company in 2009 after a 41-day cross-country road trip.
In 2016, I started co-hosting a podcast called Put A Ring On It, the anti-boring wedding planning podcast. You should really check it out.
I love to dance, but I'm truly the worst singer you've ever heard. (Just ask my shower)
I have a very healthy and insanely cool obsession with all-things Harry Potter. I'm a Hufflepuff/Thunderbird.
- In 2015, I was named as one of the "Top 26 Most Influential Wedding Planners on Facebook in the United States". That was pretty cool.
In 2016, I was also listed as one of the Top 20 Best Wedding Planners in Philadelphia (out of 247!).
In 2017, I managed to top both 2015 and 2016 accolades and be named in Destination Weddings and Honeymoon Magazine as one of the "World's Top Wedding Planners".
My favorite place to eat in any restaurant is in the kitchen. Second favorite place is at the bar. I love anything that is "behind the scenes".
I have one heck of a life partner who's not only sweet, but crazy talented. His name is Michael.
We have two pups: Mollie (a 7-year-old shih-tzu/bichon mix) and Cooper (a mini Labradoodle puppy). They are both too-cute-to-get-in-trouble.
My whole world revolves around making lists (like this) and getting things done.
I like movies, but I absolutely LOVE watching audio commentaries from movies.
- Carrots are my archnemesis. I will not eat them, Sam I am.
"Danielle is a true professional. She has done this before. She knows what works and what doesn't. But she is also willing to listen to whatever it is YOU want for YOUR day and give you suggestions on how to make that a reality."
Looking to join the DPNAK team?
New assistants are typically interviewed and hired in February/March of each year. To be considered, you must fill out a fun form using the button below. Please know, I only hire for part-time positions assisting on the wedding day. I do not offer any planning or consulting positions at this time.


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Dario Bimbi
Front End Developer
Dario Bimbi has always had a passion for design since his high school and college years. He brings to OVC a significant amount of multimedia design experience across many different platforms. Dario makes use of these talents to perform updates on client websites, create graphics and video overlays, and design marketing materials.
Dario has experience with different website Content Management Systems and creating custom HTML/CSS coding options for websites. He has also put together successful email marketing campaigns on various platforms.
During his off time, Dario enjoys his other passion which includes playing video games. He appreciates the effort it takes to design the immersive experience that video games can offer. Dario also likes spending time with his friends and playing soccer.
- DePaul University, B.S., Computer Game Development
- Google Mobile Sites Certification
- DePaul Scholars' Award
- Global Revenue Assurance Professional Association (GRAPA), Marketing Director
- NicKey Performance, E-Commerce & Website Designer
- Space Dwarves Entertainment Inc., Lead Level Designer


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- Site Template
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ThemeForest The Company Responsive Multi-Purpose Theme 7438138
ThemeForest The Company Responsive Multi-Purpose Theme 7438138
WordPress Theme \ Corporate \ Business
Responsive \ Portfolio \ Restaurant \ Retina \ Woocommerce \ Photography
WordPress Theme - The Company Responsive Multi-Purpose Theme 7438138 by redfactory @ ThemeForest
WordPress Theme \ Corporate \ Business
Last Update: 20 April 14; Columns: 4+; Compatible Browsers: IE9, IE10, IE11, Firefox, Safari, Chrome; Software Version: WordPress 3.8; Compatible With: WPML, WooCommerce 2.1.x, Bootstrap 3; Documentation: Well Documented; High Resolution: Yes; Layout: Responsive; ThemeForest Files Included: Layered PSD, PHP Files, CSS Files, JS Files, PSD; Widget Ready: Yes.
The Company is a multipurpose WordPress theme that will support you in creating your new websites!
Built on top of Twitter Bootstrap 3 and WooCommerce integration, you can easily built your website to whatever you need. If you need a quick launch , just use the Visual Composer that we've included in this new WordPress theme. Whether it's an e-commerce store, a restaurant website, a beauty salon website or a company website, The Company WordPress Theme will help you out!
With the Visual Composer (worth $30) you can easily rearrange your website in infinite ways. Next to that we've included the popular Slider Revolution plugin (worth $19) to easily setup your sliders. Built with HTML5 & CSS3 and Bootstrap, a lot of thought and care went into the making of this theme.
Don't wait any longer and discover the features of The Company WordPress theme!
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- Slider Revolution plugin included – This theme includes the Slider Revolution plugin, saving you $19,-
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Sections can even be re-used on other pages!
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Please do not ask for support via email. Use our support forum instead.
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The Beauty Salon 2; Awesome: The Multipurpose Magento Theme; The Restaurant: Classic Edition; The Vacation Rental; The Beauty Salon; The Vineyard: A WordPress eCommerce Theme; Swerve: Clean Portfolio Wordpress Theme.
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Added to Shopping Bag
Long Chain & Pearl Cluster Necklace
Listed by Karen S.
Price: $20.00
Final Sale (Non-Returnable)
This item is "Final Sale" and may not be returned.
If your item was misrepresented in any way, file a Misrepresentation Claim within 4 days of delivery. Our team will review your claim and you may be eligible for a full refund.
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Long Chain & Pearl Cluster Necklace
$20.00 Shipping Included
Arden B. Long Chain & Pearl Cluster Necklace
Shipping Included
Not available
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Pay with Credit Card, PayPal, or Affirm.
5 people saved this item
This item may have been worn but has no visible signs of wear.
This long length necklace is elegant and sophisticated - perfect to dress up any outfit., A long single chain connects to clusters of pearls and multiple length strands of chains.
Style Tags:
pearls, cluster, chains, long necklace, fashion, statement, Arden B. Jewelry
Mon 11/27/17 - Thu 11/30/17 (5-8 days)
This item is Final Sale and may not be returned. We recommend taking a good look at all item details before ordering.
Final Sale items purchased in the U.S. are eligible for a full refund if the listing is misrepresented. Learn More
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Tradesy only allows the sale of authentic designer goods. If you believe your purchase is a replica, send it to our team for a free evaluation. You'll get a full refund if anything's amiss.*Learn More
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Need help? Have questions? Our team in sunny Southern California is available by phone, email, and chat.Help & Support


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For buying a new policy call 094444 48899. For customer service call 1860 425 0000.
Search The Blog
Benefits of ESC – Electronic Stability Control
Posted by Royal Sundaram on 06 Sep 2016
You may have often heard of car accidents which occur due to lack of control after applying brakes all of a sudden. Skidding and going off the track are common when the driver applies brakes at high speeds.
Controlling a skidding vehicle is difficult, and the driver needs to have precise control over the steering wheel. However, the panic caused due to application of sudden brakes may cause the driver to lose control.
To avoid accidents due to such incidents, technologists have been working on vehicle stabilization technology. The result of their efforts is the launch of ESC – Electronic Stability Control:
What is ESC?
- ESC stands for Electronic Stability Program
- It is a computerised technology that facilitates the steadiness of a vehicle by identifying any imbalance
- It reduces the loss of adhesive friction or skidding
Here is a story to help you understand this well:
Rahul was driving to work on a rainy morning. Given the weather that day, the roads were quite slippery. Rahul was at one of the traffic signals when he applied the brakes all of a sudden. Owing to ESC, the car did not skid, and an unfortunate incident was avoided.
What is the need of ESC?
Previously, everything was manual. It was beyond human control to avoid accidents. With the presence of ESC system it has become possible to prevent mishaps from occurring.
- -ESC can control one-third of the fatal accidents from taking place
- -The sensors present in the system are programmed to respond post any detection of loss of control
- -In a few ESC systems, the engine power can also be reduced
- -The system is so efficient that drivers do not need to search for steering corrections
- -This works very well for Indian roads where accidents are so frequent
- -The feature is available in many cars such as New Ford Figo, Hyundai Creta, and many others.
How does it affect the premium?
As ESC is developed to stabilize the vehicle whenever it skids, it prevents or lowers the chances of occurrence of accidents. Thus, such vehicles have low risk to damage.
- Vehicles with better safety features have lower premium.
- Depending on the type and installation of the ESC system, insurers reduce the premium amount.
So if you are looking forward to get a car insurance policy at a cost-effective price, visit Royal Sundaram Car insurance website, and buy the best protection for your vehicle.
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of your peers and receive our italk (insurance talk) newsletter with actionable advice on travel, motor, health and home needs right in your inbox!
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text:
Phil Mickelson walked off the wind-blown, hot-and-humid course at Hazeltine, unsure whether he would be back for the weekend.
After shooting a second straight 2-over 74 in Friday's second round of the PGA Championship, Mickelson was 4 over for the tournament. That was the wrong side of the projected cut line, at 3 over by mid-afternoon.
Though plenty of groups were still golfing when he finished, the second-ranked player in the world realized he was in real trouble.
"I'm not going to beat many people putting the way I am," said Mickelson, who decided after the first round to do something he hadn't done in a long time: go to the practice green and work on his shoddy short game.
The extra time didn't pay off, though Mickelson insisted he felt better about his putter than the day before.
Beginning on the back nine, he shot into the wind on No. 12 and made birdie. Two holes later, however, he finished with a bogey because of another missed putt.
He amended a double bogey on No. 5 with an eagle on the par-5 seventh hole and had an opportunity to pick up another stroke with a 15-footer on No. 8. It sailed long, and Mickelson waved his hands as if to say, "Come on!"
In all, he needed 77 putts for 36 holes.
"I've got to get this thing turned around," Mickelson said.
Receiving plenty of support from the galleries, one guy yelled, "Keep your head up, Phil!" after he failed to putt for par and made the turn toward the front nine. If it was any consolation, Mickelson's group didn't fare much better than he did.
David Toms followed his first-round 69 with a 75, a high score also attributable to some struggles on the greens.
"You don't see a lot of balls that close to the hole, it seems like," Toms said, assessing the course. "At least not in our group. So then if you're not making your 25- and 30-footers, or a couple of those, it's hard to make birdies."
The last time Mickelson missed the cut in a major was the 2007 British Open, a tournament he skipped this summer to be with his wife and mother, both of whom were recently diagnosed with breast cancer.
Since tying for second place at the U.S. Open in June, Mickelson played only last week's Bridgestone Invitational in Ohio before this. He tied for 58th place at Firestone Country Club.
The assumption is that Mickelson's increased family focus and decreased time on the course has affected his game, but he said that his putting problems were to blame.
"I think the struggling on the greens is carrying over a little bit into, maybe, my focus on some other shots," Mickelson said. "I don't feel I'm hitting it bad, but I'm hitting some bad shots."
Mickelson sent tee shots into the rough, the sand and the gallery over the first two rounds. On Friday, he hit only six of a possible 14 fairways.
"I don't feel like I'm striking it horrendously," he said. "It's just I'm having trouble scoring right now."
This wasn't Mickelson's worst PGA Championship performance; he shot a 78 in the third round in 2002. This is an event, though, that he won four years ago and took second at in 2001. He hasn't missed the cut in the season's last major since 1995, when he was 25.
Perhaps it's because of deepened perspective, the process at home now his priority, but Mickelson didn't sound so down at the end of his rough round. As he crossed the catwalk from the course to the scoring trailer, a few fans yelled encouragement while he flashed a smile during a chat with his caddie.
Mickelson certainly didn't show the same resigned look he had after his missed chance at the U.S. Open. Asked about his plans for the remainder of the season, he declined to speculate other than to confirm his participation at The Barclays in New Jersey later this month.
"I don't want to look too far down the road for at least another year, because we're day to day with everything," Mickelson said, referring to the health of his wife. "Right now things are OK, and I'm planning on playing Barclays and we'll see where I go from there."


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Adios, Rob Ryan: A D Magazine Viking Funeral of Videos, GIFs, and Memes That Remind Us of Our Time With Wolfman Rob
By Bradford Pearson Published in FrontBurner January 9, 2013 9:07 am
"I can eat an entire pizza, easy," says Ryan, whose van is littered with pizza boxes the day he arrives at Valley Ranch after the drive from Cleveland. "Not in an eating contest. I can just do it.
"I can eat anything, except that white one." Ryan is not a fan of pizza bianca.
Please feel free to sign the guestbook below, preferably in marinara sauce. Rob would've loved that.


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Join Men On Edge! Download full-length 1h 4min 7sec movie now!
He hangs there and his executors observes him before approaching his sexy body. Wolf is a sexy gay and he's about to experience a pleasant punishment offered by these two guys. They rub his cock and suck it before whipping him. After that Wolf is being lowered, just enough to touch the floor with his dick
- amadeus
- : 4min
- : 14 May 2013
- Exclusive video
- : Kink Men / Men On Edge
- : Wolf


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Healing Relationships
Event Details
Healing RelationshipS
Presenters: Rosamund Oliver and Steve Noakes
Relationships with others, and with ourselves touches all of us, as we all live in a web of many strands of interconnection with others.
This weekend is for anyone who wants to restore and heal important relationships in their life, including the one with yourself.
In this experiential weekend, with many opportunities for sharing, discussion and practice, participants find out for themselves how to resolve even long-term difficulties using methods drawn from The Tibetan Book of Living and Dying.
Through sharing our story with others and applying meditation and compassion into our relationships, a space of change can open up to more compassionate and meaningful interactions with others, a step towards healing breakages, misunderstandings and even deep pain in relationship.
This workshop is open to everyone. No previous experience of meditation is necessary.
Saturday, 18th Feb, 9:30-5:30 and Sunday, 19th Feb, 10:00-4:30


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by Ryan Mosser
Early rain showers didn't keep these football fans from attending one of the biggest games in the city as 6874 fans arrived amidst the rain and a chilly wind blowing in from Lake Michigan.
The first half was exciting despite only 9 points scored, with Muskegon taking a 6-3 lead into halftime. Both teams had chances to score touchdowns, but a strong defense on each side kept both teams out of the end zone.
Muskegon was the first to score in the second half and had a lead of 13-3 going into the fourth quarter. But the Rams of Rockford refused to lay down, storming back to make it a game. Rockford's Ryan Darby blocked a Muskegon punt midway through the fourth quarter, which was recovered on Muskegon's 24-yard line. It then took just a couple of plays for Rockford to score a 19-yard touchdown on a pass from quarterback Taylor Masiewicz to Neil VanderLaan.
As the Rockford fans rejoiced, they were quickly silenced by a missed extra point attempt. With 5:31 remaining, Muskegon was up 13-9. Muskegon got the ball back and after unsuccessfully gaining yardage, they were forced to punt. Rockford now had the ball at the 45 yard line of Muskegon and needed a touchdown to move ahead, and that is exactly what they did. With 14 seconds left in the game Taylor Masiewicz connected with Zach Haugen on a pass that crushed the Big Reds. The Rams held off for a few last second plays. and the boys from Rockford held on in a close one.
- Show All
- Rockford vs. Muskegon – 2009