Spina bifida /ˌspaɪnə ˈbɪfɪdə/ (Latin for 'split spine'; SB) is a birth defect in which there is incomplete closing of the spine and the membranes around the spinal cord during early development in pregnancy. There are three main types: spina bifida occulta, meningocele and myelomeningocele. Meningocele and myelomeningocele may be grouped as spina bifida cystica. The most common location is the lower back, but in rare cases it may be in the middle back or neck.

Occulta has no or only mild signs, which may include a hairy patch, dimple, dark spot or swelling on the back at the site of the gap in the spine. Meningocele typically causes mild problems, with a sac of fluid present at the gap in the spine. Myelomeningocele, also known as open spina bifida, is the most severe form. Problems associated with this form include poor ability to walk, impaired bladder or bowel control, accumulation of fluid in the brain (hydrocephalus), a tethered spinal cord and latex allergy. Some experts believe such an allergy can be caused by frequent exposure to latex, which is common for people with spina bifida who have shunts and have had many surgeries. Learning problems are relatively uncommon.

Spina bifida is believed to be due to a combination of genetic and environmental factors. After having one child with the condition, or if one of the parents has the condition, there is a 4% chance that the next child will also be affected. Not having enough folate (vitamin B9) in the diet before and during pregnancy also plays a significant role. Other risk factors include certain antiseizure medications, obesity and poorly controlled diabetes. Diagnosis may occur either before or after a child is born. Before birth, if a blood test or amniocentesis finds a high level of alpha-fetoprotein (AFP), there is a higher risk of spina bifida. Ultrasound examination may also detect the problem. Medical imaging can confirm the diagnosis after birth. Spina bifida is a type of neural tube defect related to but distinct from other types such as anencephaly and encephalocele.

Most cases of spina bifida can be prevented if the mother gets enough folate before and during pregnancy. Adding folic acid to flour has been found to be effective for most women. Open spina bifida can be surgically closed before or after birth. A shunt may be needed in those with hydrocephalus, and a tethered spinal cord may be surgically repaired. Devices to help with movement such as crutches or wheelchairs may be useful. Urinary catheterization may also be needed.

Rates of other types of spina bifida vary significantly by country, from 0.1 to 5 per 1,000 births. On average, in developed countries, including the United States, it occurs in about 0.4 per 1,000 births. In India, it affects about 1.9 per 1,000 births. Europeans are at higher risk compared to Africans.

Types

Spina bifida occulta
 is Latin for 'hidden'. This is the mildest form of spina bifida.
In occulta, the outer part of some of the vertebrae is not completely closed. The splits in the vertebrae are so small that the spinal cord does not protrude. The skin at the site of the lesion may be normal, or it may have some hair growing from it; there may be a dimple in the skin, or a birthmark. Unlike most other types of neural tube defects, spina bifida occulta is not associated with increased AFP, a common screening tool used to detect neural tube defects in utero. This is because, unlike in most of the other neural tube defects, the dural lining is maintained.

Many people with this type of spina bifida do not even know they have it, as the condition is asymptomatic in most cases.
A systematic review of radiographic research studies found no relationship between spina bifida occulta and back pain. More recent studies not included in the review support the negative findings.

However other studies suggest spina bifida occulta is not always harmless. One study found that among patients with back pain severity is worse if spina bifida occulta is present.

Incomplete posterior fusion is not a true spina bifida and is very rarely of neurological significance.

Meningocele

A posterior meningocele () or meningeal cyst () is the least common form of spina bifida. In this form, a single developmental defect allows the meninges to herniate between the vertebrae. As the nervous system remains undamaged, individuals with meningocele are unlikely to have long-term health problems, although cases of tethered cord have been reported. Causes of meningocele include teratoma and other tumors of the sacrococcyx and of the presacral space, and Currarino syndrome.

A meningocele may also form through dehiscences in the base of the skull. These may be classified by their localisation as occipital, frontoethmoidal or nasal. Endonasal meningoceles lie at the roof of the nasal cavity and may be mistaken for a nasal polyp. They are treated surgically. Encephalomeningoceles are classified in the same way and also contain brain tissue.

Myelomeningocele

Myelomeningocele (MMC), also known as meningomyelocele, is the type of spina bifida that often results in the most severe complications and affects the meninges and nerves. In individuals with myelomeningocele, the unfused portion of the spinal column allows the spinal cord to protrude through an opening. Myelomeningocele occurs in the third week of embryonic development, during neural tube pore closure. MMC is a failure of this to occur completely. The meningeal membranes that cover the spinal cord also protrude through the opening, forming a sac enclosing the spinal elements, such as meninges, cerebrospinal fluid, and parts of the spinal cord and nerve roots. Myelomeningocele is also associated with club foot deformity, and Arnold–Chiari malformation, necessitating a VP shunt placement.

Toxins and conditions associated with MMC formation include: calcium-channel blockers, carbamazepine, cytochalasins, hyperthermia, and valproic acid.

Myelocele
Spina bifida with myelocele is the most severe form of myelomeningocele. In this type, the involved area is represented by a flattened, plate-like mass of nervous tissue with no overlying membrane. The exposure of these nerves and tissues make the baby more prone to life-threatening infections such as meningitis.

The protruding portion of the spinal cord and the nerves that originate at that level of the cord are damaged or not properly developed. As a result, there is usually some degree of paralysis and loss of sensation below the level of the spinal cord defect. Thus, the more cranial the level of the defect, the more severe the associated nerve dysfunction and resultant paralysis may be. Symptoms may include ambulatory problems, loss of sensation, deformities of the hips, knees or feet, and loss of muscle tone.

Signs and symptoms

Physical problems
Physical signs of spina bifida may include:
 Leg weakness and paralysis
 Orthopedic abnormalities (i.e., club foot, hip dislocation, scoliosis)
 Bladder and bowel control problems, including incontinence, urinary tract infections, and poor kidney function
 Pressure sores and skin irritations
 Abnormal eye movement

68% of children with spina bifida have an allergy to latex, ranging from mild to life-threatening. The common use of latex in medical facilities makes this a particularly serious concern. The most common approach to avoid developing an allergy is to avoid contact with latex-containing products such as examination gloves and catheters that do not specify they are latex-free, and many other products, such as some commonly used by dentists.

The spinal cord lesion or the scarring due to surgery may result in a tethered spinal cord. In some individuals, this causes significant traction and stress on the spinal cord and can lead to a worsening of associated paralysis, scoliosis, back pain, and worsening bowel and/or bladder function.

Neurological problems
Many individuals with spina bifida have an associated abnormality of the cerebellum, called the Arnold Chiari II malformation. In affected individuals, the back portion of the brain is displaced from the back of the skull down into the upper neck. In about 90% of the people with myelomeningocele, hydrocephalus also occurs because the displaced cerebellum interferes with the normal flow of cerebrospinal fluid, causing an excess of the fluid to accumulate. In fact, the cerebellum also tends to be smaller in individuals with spina bifida, especially for those with higher lesion levels.

The corpus callosum is abnormally developed in 70–90% of individuals with spina bifida myelomeningocele; this affects the communication processes between the left and right brain hemispheres. Further, white matter tracts connecting posterior brain regions with anterior regions appear less organized. White matter tracts between frontal regions have also been found to be impaired.

Cortex abnormalities may also be present. For example, frontal regions of the brain tend to be thicker than expected, while posterior and parietal regions are thinner. Thinner sections of the brain are also associated with increased cortical folding. Neurons within the cortex may also be displaced.

Executive function
Several studies have demonstrated difficulties with executive functions in youth with spina bifida, with greater deficits observed in youth with shunted hydrocephalus. Unlike typically developing children, youths with spina bifida do not tend to improve in their executive functioning as they grow older. Specific areas of difficulty in some individuals include planning, organizing, initiating, and working memory. Problem-solving, abstraction, and visual planning may also be impaired. Further, children with spina bifida may have poor cognitive flexibility. Although executive functions are often attributed to the frontal lobes of the brain, individuals with spina bifida have intact frontal lobes; therefore, other areas of the brain may be implicated.

Individuals with spina bifida, especially those with shunted hydrocephalus, often have attention problems. Children with spina bifida and shunted hydrocephalus have higher rates of ADHD than children without those conditions (31% vs. 17%). Deficits have been observed for selective attention and focused attention, although poor motor speed may contribute to poor scores on tests of attention. Attention deficits may be evident at a very early age, as infants with spina bifida lag behind their peers in orienting to faces.

Academic skills
Individuals with spina bifida may struggle academically, especially in the subjects of mathematics and reading. In one study, 60% of children with spina bifida were diagnosed with a learning disability. In addition to brain abnormalities directly related to various academic skills, achievement is likely affected by impaired attentional control and executive functioning. Children with spina bifida may perform well in elementary school, but begin to struggle as academic demands increase.

Children with spina bifida are more likely than their peers without spina bifida to be dyscalculic. Individuals with spina bifida have demonstrated stable difficulties with arithmetic accuracy and speed, mathematical problem-solving, and general use and understanding of numbers in everyday life. Mathematics difficulties may be directly related to the thinning of the parietal lobes (regions implicated in mathematical functioning) and indirectly associated with deformities of the cerebellum and midbrain that affect other functions involved in mathematical skills. Further, higher numbers of shunt revisions are associated with poorer mathematics abilities. Working memory and inhibitory control deficiencies have been implicated for math difficulties, although visual-spatial difficulties are not likely involved. Early intervention to address mathematics difficulties and associated executive functions is crucial.

Individuals with spina bifida tend to have better reading skills than mathematics skills. Children and adults with spina bifida have stronger abilities in reading accuracy than in reading comprehension. Comprehension may be especially impaired for text that requires an abstract synthesis of information rather than a more literal understanding. Individuals with spina bifida may have difficulty with writing due to deficits in fine motor control and working memory.

Cause
Spina bifida is believed to be caused by a combination of genetic and environmental factors. After having one child with the condition, or if a parent has the condition, there is a 4% chance the next child will also be affected. A folic acid deficiency during pregnancy also plays a significant role. Other risk factors include certain antiseizure medications, obesity, and poorly managed diabetes. Alcohol misuse can trigger macrocytosis which discards folate. After stopping the drinking of alcohol, a time period of months is needed to rejuvenate bone marrow and recover from the macrocytosis.

Those who are white or Hispanic have a higher risk. Girls are more prone to being born with spina bifida.

Pathophysiology
Spina bifida occurs when local regions of the neural tube fail to fuse or there is failure in formation of the vertebral neural arches. Neural arch formation occurs in the first month of embryonic development (often before the mother knows she is pregnant). Some forms are known to occur with primary conditions that cause raised central nervous system pressure, raising the possibility of a dual pathogenesis.

In normal circumstances, the closure of the neural tube occurs around the 23rd (rostral closure) and 27th (caudal closure) day after fertilization. However, if something interferes and the tube fails to close properly, a neural tube defect will occur. Medications such as some anticonvulsants, diabetes, obesity, and having a relative with spina bifida can all affect the probability of neural tube malformation.

Extensive evidence from mouse strains with spina bifida indicates that there is sometimes a genetic basis for the condition. Human spina bifida, like other human diseases, such as cancer, hypertension and atherosclerosis (coronary artery disease), likely results from the interaction of multiple genes and environmental factors.

Research has shown the lack of folic acid (folate) is a contributing factor in the pathogenesis of neural tube defects, including spina bifida. Supplementation of the mother's diet with folate can reduce the incidence of neural tube defects by about 70%, and can also decrease the severity of these defects when they occur. It is unknown how or why folic acid has this effect.

Spina bifida does not follow direct patterns of heredity as do muscular dystrophy or haemophilia. Studies show a woman having had one child with a neural tube defect such as spina bifida has about a 3% risk of having another affected child. This risk can be reduced with folic acid supplementation before pregnancy. For the general population, low-dose folic acid supplements are advised (0.4 mg/day).

Prevention
There is neither a single cause of spina bifida nor any known way to prevent it entirely. However, dietary supplementation with folic acid has been shown to be helpful in reducing the incidence of spina bifida. Sources of folic acid include whole grains, fortified breakfast cereals, dried beans, leaf vegetables and fruits. However it is difficult for women to get the recommended 400 micrograms of folic acid a day from unfortified foods. Globally, fortified wheat flour is credited with preventing 50 thousand neural tube birth defects like spina bifida a year, but 230,000 could be prevented every year through this strategy.

Folate fortification of enriched grain products has been mandatory in the United States since 1998. This prevents an estimated 600 to 700 incidents of spina bifida a year in the U.S. and saves $400 - $600 million in healthcare expenses. The U.S. Food and Drug Administration, Public Health Agency of Canada and the UK Department of Health and Social Care (DHSC) recommended amount of folic acid for women of childbearing age and women planning to become pregnant is at least 0.4 mg/day of folic acid from at least three months before conception, and continued for the first 12 weeks of pregnancy.
Women who have already had a baby with spina bifida or other type of neural tube defect, or are taking anticonvulsant medication, should take a higher dose of 4–5 mg/day.

Certain mutations in the gene VANGL1 have been linked with spina bifida in some families with a history of the condition.

Screening
Open spina bifida can usually be detected during pregnancy by fetal ultrasound. Increased levels of maternal serum alpha-fetoprotein (MSAFP) should be followed up by two tests – an ultrasound of the fetal spine and amniocentesis of the mother's amniotic fluid (to test for alpha-fetoprotein and acetylcholinesterase). AFP tests are now mandated by some state laws (including California) and failure to provide them can have legal ramifications. In one case, a man born with spina bifida was awarded a $2-million settlement after court found his mother's OBGYN negligent for not performing these tests. Spina bifida may be associated with other malformations as in dysmorphic syndromes, often resulting in spontaneous miscarriage. In the majority of cases, though, spina bifida is an isolated malformation.

Genetic counseling and further genetic testing, such as amniocentesis, may be offered during the pregnancy, as some neural tube defects are associated with genetic disorders such as trisomy 18. Ultrasound screening for spina bifida is partly responsible for the decline in new cases, because many pregnancies are terminated out of fear that a newborn might have a poor future quality of life. With modern medical care, the quality of life of patients has greatly improved.

Treatment
There is no known cure for the nerve damage caused by spina bifida. Standard treatment is surgery after delivery. This surgery aims to prevent further damage of the nervous tissue and to prevent infection; pediatric neurosurgeons operate to close the opening on the back. The spinal cord and its nerve roots are put back inside the spine and covered with meninges. In addition, a shunt may be surgically installed to provide a continuous drain for the excess cerebrospinal fluid produced in the brain, as happens with hydrocephalus. Shunts most commonly drain into the abdomen or chest wall.

Pregnancy
Standard treatment is after delivery. There is tentative evidence about treatment for severe disease before delivery while the baby is inside the womb. As of 2014, however, the evidence remains insufficient to determine benefits and harms.

Treatment of spina bifida during pregnancy is not without risk. To the mother, this includes scarring of the uterus. To the baby, there is the risk of preterm birth.

Broadly, there are two forms of prenatal treatment. The first is open fetal surgery, where the uterus is opened and the spina bifida repair performed. The second is via fetoscopy. These techniques may be an option to standard therapy.

Childhood
Most individuals with myelomeningocele will need periodic evaluations by a variety of specialists:
 Physiatrists coordinate the rehabilitation efforts of different therapists and prescribe specific therapies, adaptive equipment, or medications to encourage as high of a functional performance within the community as possible.
 Orthopedists monitor growth and development of bones, muscles, and joints.
 Neurosurgeons perform surgeries at birth and manage complications associated with tethered cord and hydrocephalus.
 Neurologists treat and evaluate nervous system issues, such as seizure disorders.
 Urologists to address kidney, bladder, and bowel dysfunction – many will need to manage their urinary systems with a program of catheterization. Bowel management programs aimed at improving elimination are also designed.
 Ophthalmologists evaluate and treat complications of the eyes.
 Orthotists design and customize various types of assistive technology, including braces, crutches, walkers, and wheelchairs to aid in mobility. As a general rule, the higher the level of the spina bifida defect, the more severe the paralysis, but paralysis does not always occur. Thus, those with low levels may need only short leg braces, whereas those with higher levels do best with a wheelchair, and some may be able to walk unaided.
 Physical therapists, occupational therapists, psychologists, and speech/language pathologists aid in rehabilitative therapies and increase independent living skills.

Transition to adulthood

Although many children's hospitals feature integrated multidisciplinary teams to coordinate healthcare of youth with spina bifida, the transition to adult healthcare can be difficult because the above healthcare professionals operate independently of each other, requiring separate appointments, and communicate among each other much less frequently. Healthcare professionals working with adults may also be less knowledgeable about spina bifida because it is considered a childhood chronic health condition. Due to the potential difficulties of the transition, adolescents with spina bifida and their families are encouraged to begin to prepare for the transition around ages 14–16, although this may vary depending on the adolescent's cognitive and physical abilities and available family support. The transition itself should be gradual and flexible. The adolescent's multidisciplinary treatment team may aid in the process by preparing comprehensive, up-to-date documents detailing the adolescent's medical care, including information about medications, surgery, therapies, and recommendations. A transition plan and aid in identifying adult healthcare professionals are also helpful to include in the transition process.

Further complicating the transition process is the tendency for youths with spina bifida to be delayed in the development of autonomy, with boys particularly at risk for slower development of independence. An increased dependence on others (in particular family members) may interfere with the adolescent's self-management of health-related tasks, such as catheterization, bowel management, and taking medications. As part of the transition process, it is beneficial to begin discussions at an early age about educational and vocational goals, independent living, and community involvement.

Certain locations feature multidisciplinary clinics in order to offer coordinated care between specialists, such as Cincinnati Children's Center for Spina Bifida.

Epidemiology
Rates of other types of spina bifida vary significantly by country from 0.1 to 5 per 1000 births. On average in developed countries it occurs in about 0.4 per 1000 births. In the United States it affected about 0.7 per 1000 births, and in India about 1.9 per 1000 births. Part of this difference is believed to be due to race, with Caucasians at higher risk, and part due to environmental factors. It is most common in the Celtic people (12.5 per 10,000 live births), and it is rare in Asians and people of African descent.

In the United States, rates are higher on the East Coast than on the West Coast, and higher in white people (one case per 1000 live births) than in black people (0.1–0.4 case per 1000 live births). Immigrants from Ireland have a higher incidence of spina bifida than do natives. Highest rates of the defect in the USA can be found in Hispanic youth.

The highest incidence rates worldwide were found in Ireland and Wales, where three to four cases of myelomeningocele per 1000 population have been reported during the 1970s, along with more than six cases of anencephaly (both live births and stillbirths) per 1000 population. The reported overall incidence of myelomeningocele in the British Isles was 2.0–3.5 cases per 1000 births. Since then, the rate has fallen dramatically with 0.15 per 1000 live births reported in 1998, though this decline is partially accounted for because some fetuses are aborted when tests show signs of spina bifida (see Pregnancy screening above).

History
Although Hippocratic doctors were aware of developmental abnormalities involving the lower spine, the first person to describe a spinal spina bifida was a Persian physician named Al-Razi (Rhazes, 865–925 AD). He gave the earliest accurate account of the morbid anatomy associated with spina bifida.

Research
 1980 – Fetal surgical techniques using animal models were first developed at the University of California, San Francisco by Michael R. Harrison, N. Scott Adzick and research colleagues.
 1994 – A surgical model that simulates the human disease is the fetal lamb model of myelomeningocele (MMC) introduced by Meuli and Adzick in 1994. The MMC-like defect was surgically created at 75 days of gestation (term 145 to 150 days) by a lumbo-sacral laminectomy. Approximately 3 weeks after creation of the defect a reversed latissimus dorsi flap was used to cover the exposed neural placode and the animals were delivered by cesarean section just prior term. Human MMC-like lesions with similar neurological deficit were found in the control newborn lambs. In contrast, animals that underwent closure had near-normal neurological function and well-preserved cytoarchitecture of the covered spinal cord on histopathological examination. Despite mild paraparesis, they were able to stand, walk, perform demanding motor test and demonstrated no signs of incontinence. Furthermore, sensory function of the hind limbs was present clinically and confirmed electrophysiologically. Further studies showed that this model, when combined with a lumbar spinal cord myelotomy leads to the hindbrain herniation characteristic of the Chiari II malformation and that in utero surgery restores normal hindbrain anatomy by stopping the leak of cerebrospinal fluid through the myelomeningocele lesion.

Surgeons at Vanderbilt University, led by Joseph Bruner, attempted to close spina bifida in 4 human fetuses using a skin graft from the mother using a laparoscope. Four cases were performed before stopping the procedure - two of the four fetuses died.
 1998 – N. Scott Adzick and team at The Children's Hospital of Philadelphia performed open fetal surgery for spina bifida in an early gestation fetus (22-week gestation fetus) with a successful outcome. Open fetal surgery for myelomeningocele involves surgically opening the pregnant mother's abdomen and uterus to operate on the fetus. The exposed fetal spinal cord is covered in layers with surrounding fetal tissue at mid-gestation (19–25 weeks) to protect it from further damage caused by prolonged exposure to amniotic fluid. Between 1998 and 2003, Dr. Adzick, and his colleagues in the Center for Fetal Diagnosis and Treatment at The Children's Hospital Of Philadelphia, performed prenatal spina bifida repair in 58 mothers and observed significant benefit in the babies.

Fetal surgery after 25 weeks has not shown benefit in subsequent studies.

MOMS trial
Management of myelomeningocele study (MOMS) was a phase III clinical trial designed to compare two approaches to the treatment of spina bifida: surgery before birth and surgery after birth.

The trial concluded that the outcomes after prenatal spina bifida treatment are improved to the degree that the benefits of the surgery outweigh the maternal risks. This conclusion requires a value judgment on the relative value of fetal and maternal outcomes on which opinion is still divided.

To be specific, the study found that prenatal repair resulted in:
 Reversal of the hindbrain herniation component of the Chiari II malformation
 Reduced need for ventricular shunting (a procedure in which a thin tube is introduced into the brain's ventricles to drain fluid and relieve hydrocephalus)
 Reduced incidence or severity of potentially devastating neurologic effects caused by the spine's exposure to amniotic fluid, such as impaired motor function

At one year of age, 40 percent of the children in the prenatal surgery group had received a shunt, compared to 83 percent of the children in the postnatal group. During pregnancy, all the fetuses in the trial had hindbrain herniation. However, at age 12 months, one-third (36 percent) of the infants in the prenatal surgery group no longer had any evidence of hindbrain herniation, compared to only 4 percent in the postnatal surgery group. Further surveillance is ongoing.

Fetoscopic surgery

In contrast to the open fetal operative approach performed in the MOMS trial, a minimally invasive fetoscopic approach (akin to 'keyhole' surgery) has been developed. This approach has been evaluated by independent authors of a controlled study which showed some benefit in survivors, but others are more skeptical.

The observations in mothers and their fetuses that were operated over the past two and a half years by the matured minimally invasive approach showed the following results: Compared to the open fetal surgery technique, fetoscopic repair of myelomeningocele results in far less surgical trauma to the mother, as large incisions of her abdomen and uterus are not required. In contrast, the initial punctures have a diameter of 1.2 mm only. As a result, thinning of the uterine wall or dehiscence which have been among the most worrisome and criticized complications after the open operative approach do not occur following minimally invasive fetoscopic closure of spina bifida aperta. The risks of maternal chorioamnionitis or fetal death as a result of the fetoscopic procedure run below 5%. Women are discharged home from hospital one week after the procedure. There is no need for chronic administration of tocolytic agents since postoperative uterine contractions are barely ever observed. The current cost of the entire fetoscopic procedure, including hospital stay, drugs, perioperative clinical, ECG, ultrasound and MRI-examinations, is approximately €16,000.

In 2012, these results of the fetoscopic approach were presented at various national and international meetings, among them at the 1st European Symposium "Fetal Surgery for Spina bifida" in April 2012 in Giessen, at the 15th Congress of the German Society for Prenatal Medicine and Obstetrics in May 2012 in Bonn, at the World Congress of the Fetal Medicine Foundation in June 2012 and at the World Congress of the International Society of Obstetrics and Gynecology (ISUOG) in Copenhagen in September 2012, and published in abstract form.

Since then more data has emerged. In 2014, two papers were published on fifty one patients. These papers suggested that the risk to the mother is small. The main risk appears to be preterm labour, on average at about 33 weeks.

Placenta
The placenta is a critical determinant of fetal growth, yet placental development has not been well studied in pregnancies with fetal neural tube defects. Folate bioavailability is associated not only with isolated fetal neural tube defects, but is also required for optimal placental development. Pregnancies with folate-responsive neural tube defects may thus be at increased risk for poor placental development. A study comprehensively assessing the prevalence of placental pathology in a large cohort of fetuses with isolated neural tube defects found that these fetuses had higher risk of placental pathology and altered offspring growth outcomes at birth compared to controls, suggesting increased risk of placental maldevelopment that may contribute to poor fetal growth in pregnancies with neural tube defects.

See also
 Meningohydroencephalocoele
 Rachischisis
 Congenital dermal sinus

References

External links

 CDC: Spina bifida

Dermal and subcutaneous growths
Congenital disorders of nervous system
Congenital disorders of musculoskeletal system
Articles containing video clips
Wikipedia medicine articles ready to translate

Spina bifida


The Kerensky offensive (), also commonly known as the July offensive () or Galician Offensive, was the last Russian offensive in World War I. It took place in July 1917. It was decided by Alexander Kerensky, Minister of War in the Russian provisional government, and led by General Aleksei Brusilov. Such a decision was ill-timed, because, following the February Revolution, there were strong popular demands for peace, especially within the Russian Army, whose fighting capabilities were quickly deteriorating.

The Russian provisional government was greatly weakened by this military catastrophe, and the possibility of another revolution by the Bolsheviks became increasingly real. Far from strengthening Russian army morale, this offensive proved that Russian army morale no longer existed. No Russian general could now count on the soldiers under his command actually doing what they were ordered to do. This offensive also helped start the July Days. One last fight took place between the Germans and the Russians in this war. On 1 September 1917, the Germans attacked and captured Riga. The Russian soldiers defending the town refused to fight and fled from the advancing German troops.

Background

Russian War Minister Alexander Kerensky, despite the events in February and March 1917, promised the Entente that Russia could still fulfill its promises for a summer offensive. Supreme commander Aleksei Brusilov planned the attacks, but, according to Prit Buttar, "Brusilov warned Kerensky that there was no enthusiasm amongst the troops in the front line for an attack."  This prompted Kerensky to visit the front lines, "...exhorting the troops to fight heroically in defence of the revolution, which he told them was threatened by German militarism."

Discipline within the Russian Army had reached a point of crisis since the Tsar's abdication. The Petrograd Soviet Order No. 1 tremendously weakened the power of officers, giving an overriding mandate to "soldier committees". The abolition of the death penalty was another contributing factor, as was the high presence of revolutionary agitators at the Front, including Bolshevik agitators, who promoted an anti-war agenda (and whom Kerensky tolerated considerably more than conservative agitators). What is more, the High Command failed to act appropriately, as they failed to effectively combat the democratisation of the army and were sluggish in reacting to the difficulties that the officers had faced. There were very few commands that the Stavka was able to implement in regards to controlling the body of troops and restoring officer power; simply because they would have been ignored by the men.

According to Buttar, "As a result of the weakening of the army by the revolution and a catastrophic fall in output from Russia's munitions factories, the new offensive planned for the summer of 1917 would have to be more limited." On 29 June, the main effort would be along Southwestern Front, the Eleventh Army and Seventh Army would advance towards Lemberg, a distance of .  On 16 July, the West Front would attack, followed by the Northern Front on 18 July, and the Romanian Front on 22 July.  The Eleventh Army, commanded by Ivan Georgevich Erdeli, would attack the seam between Felix Graf von Bothmer's South Army and Eduard von Böhm-Ermolli's Second Army.

Offensive
On 29 June, the Eleventh Army started its artillery bombardment, and, on 1 July, the Russians were able to capture Koniukhy.  On 2 July, the Russians were able to advance through Zboriv. On 3 July, fighting continued, but little territory changed sides.  By then the Russians had lost 40,000 men, while the defenders only 12,500.  According to Buttar, "... gains were modest and bought at huge cost...Although the Russian Army had demonstrated that it still had the ability to mount an offensive, it also showed that its troops...were unreliable, particularly if prolonged fighting was required."  In the meantime, Bothmer was preparing a large counteroffensive.

On 6 July, Lavr Kornilov's Russian Eighth Army commenced its attack on Stanislau, defended by Karl Tersztyánszky von Nádas' K.u.k. Third Army. On 8 July, the Russians had captured Yamnytsia, and on 9 July advanced  from Stanislau to Kalusz. On 10 July, Tersztyánszky was replaced by Karl Křitek, as German reinforcements arrived to stem the Russian advance into Halicz and Nowica.  On 11 July, the Russians were able to take Kalusz, and on 11 July, moved against Voinyliv. On 12 July, Kritek took command of the Third Army, and by 16 July, had retaken Kalusz. The Russian West Front attacks on 7 July made only modest gains, which were soon relinquished, and the Northern Front attacks lasted less than a day. According to Buttar, "It was the high tide mark for the armies of Russia."

However, the Russian advance collapsed altogether by 16 July. On 19 July, the Germans and Austro-Hungarians counter-attacked, led by Arnold von Winckler, meeting little resistance and advancing through Galicia and Ukraine as far as the Zbruch River. The Russian lines were broken on 20 July, and, by 23 July, the Russians had retreated about  (Vinny). "The only limit to the German advance was the lack of the logistical means to occupy more territory".  According to Buttar, "Eleventh Army had effectively disintegrated and Seventh Army was rapidly following suit. To the south of the Dniester, Eighth Army began to pull back..."

On 25 July, the Russians abandoned Tarnopol as was Stanislau. On 2 August, they abandoned Czernowitz.

Aftermath

According to Buttar, "But more important than the change of territory, was the complete disintegration of the Russian Army. Those killed, wounded or taken prisoner exceeded 400,000; the number of deserters was perhaps just as great." Kerensky blamed Brusilov for the failed offensive, and Kornilov replaced Brusilov as commander-in-chief. Kerensky expected Kornilov to restore discipline, and the death penalty for desertion was re-imposed by Kornilov and the Russian Provisional Government as a consequence. This led to a period of unrest in Petrograd known as the July Days.

References

1917 in Austria-Hungary
1917 in Russia
Battles of the Eastern Front (World War I)
Battles of World War I involving Austria-Hungary
Battles of World War I involving Russia
Battles of World War I involving Romania
Battles of World War I involving Germany
Russian Provisional Government
Conflicts in 1917
July 1917 events
Ukraine in World War I
History of Chernivtsi Oblast
History of Ternopil Oblast
History of Ivano-Frankivsk Oblast
History of Lviv Oblast

Kerensky offensive


Kunigunde of Eisenberg (also known as Kunne;  – before 31 May 1286), was a German noblewoman and the second wife of Landgrave Albert II of Thuringia.

She was a daughter of Count Otto of Eisenberg and his wife Anna of Kottwotz.

Life
Kunigunde was a lady-in-waiting of Albert's first wife, Margaret of Sicily. Beautiful and ambitious, she attracted the attention of the Landgrave and became his mistress, bearing him two illegitimate children:
Elisabeth (1269 – ), married before 11 April 1291 to Henry II of Frankenstein (d. 23 April 1326).
Albert, nicknamed Apitz, (1270 – between 1301 and 1305), Lord of Tenneberg from 1290, buried in the St. Catherine monastery in Eisenach.

With her lover's knowledge, is said that Kunigunde attempted the murder of Landgravine Margaret so that she could usurp her position and honours. After some poison attempts, Kunigunde finally managed to so frighten her mistress, that Margaret fled the court the night of 24 June 1270, fearing for her life. According to legend, she bit her son Frederick I in the cheek before she left; this explains his nickname "Frederick the Bitten" (). She died six weeks later in Frankfurt am Main.

Kunigunde's marriage with Albert took place soon afterwards (1272), despite the fact that she was of lower rank. During the ceremony, she concealed her son Apitz under her robe, as this was supposed to procure for natural children, the privileges of legitimacy. However this marriage brought baneful consequences for Thuringia. Estranged from his legitimate sons, the Landgrave disinherited them and proclaimed Kunigunde's son to be his heir. The Thuringian nobility resisted this, which led to a long succession of military hostilities between father and sons. The affair was only able to be settled peaceably when Kunigunde died (before 31 May 1286), aged about forty. She was buried in the St. Catherine monastery in Eisenach.

Was only after her death that Albert divided his territories amongst his legitimate sons.

References
W. K. v. Isenburg: Europäische Stammtafeln, vol. I, table 45, Marburg, 1953, reprinted: 1965
O. Posse: Die Wettiner, Leipzig, 1897, reprinted: 1994
D. Schwennicke: Europäische Stammtafeln, vol. 11, table 152, Marburg, 1998
Cronica Reinhardsbrunnensis 1283, MGH SS XXX.1, p. 635.
Eisenberg, Cunigunde von – (c1245 – 1286) in: abitofhistory.net [retrieved 18 November 2014].

External links

 http://wwperson.informatik.uni-erlangen.de/cgi-bin/l3/LANG=germ/F=Cunigunde/N=v.Eisenberg

13th-century births
1286 deaths
Countesses in Germany
13th-century German nobility
13th-century German women

Kunigunde of Eisenberg


Andromache Karakatsanis (born October 3, 1955) is a Canadian jurist. She was nominated to the Supreme Court of Canada by Stephen Harper in October 2011. She is the first Greek-Canadian judge on the Court. Since the retirement of Rosalie Abella on July 1, 2021, and of Michael Moldaver on September 1, 2022 (he took office the same day as Karakatsanis), she is the longest-serving member of the Supreme Court.

Early life
Karakatsanis was born in Toronto, Ontario, to Greek parents, and raised with an emphasis on her Greek heritage. She grew up near the Don Mills Road and Lawrence Avenue area of Toronto, where her parents owned a restaurant called Top of the Mall which was where Karakatsanis worked as a hostess and helped her father manage the restaurant.

She attended Victoria College at the University of Toronto, graduating with a B.A. in English literature in 1977. She then attended York University's Osgoode Hall Law School, receiving her LL.B. in 1980. She was called to the Ontario bar in 1982.

Career
After her call to the bar, Karakatsanis clerked for the judges of the Ontario Court of Appeal from 1982–1983, after which she entered private practice. In 1987, Karakatsanis was appointed to the Liquor Licensing Board of Ontario as Vice-Chair, becoming Chair and CEO the following year. She held that position until her 1995 appointment as Assistant Deputy Attorney General and Secretary of the Ontario Native Affairs Secretariat.  Karakatsanis was named Deputy Attorney General for the province of Ontario in 1997, and she became Secretary of the Cabinet and Clerk of the Executive Council of the Government of Ontario in 2000.

Karakatsanis's judicial career began when she was appointed to the Ontario Superior Court of Justice in December 2002, where she developed an expertise in administrative law.  She was subsequently elevated to the Ontario Court of Appeal on March 26, 2010, where she served for 19 months prior to her appointment to the Supreme Court.

Her mandatory retirement date will be 3 October 2030, her 75th birthday.

Honours
In 2015, she was made a Grand Commander of the Order of Honour by the Government of Greece.

On October 13, 2023, she received an honorary Doctor of Laws Degree from York University.

Personal life
Karakatsanis is fluent in English, French and Greek. She is married to former lawyer Tom Karvanis, who lives with multiple sclerosis, and has two children: Paul Karvanis, who is counsel at Hudson's Bay Company, and Rhea Karvanis, a graduate of the University of Toronto law school.

See also
 Reasons of the Supreme Court of Canada by Justice Karakatsanis

References

External links

Court of Appeal biography

1955 births
Living people
Justices of the Court of Appeal for Ontario
Justices of the Supreme Court of Canada
University of Toronto alumni
Osgoode Hall Law School alumni
Canadian people of Greek descent
Canadian women judges
People from Toronto
21st-century Canadian judges
21st-century Canadian women judges

Andromache Karakatsanis


According to the 2022 census, Slovaks () in Serbia number 41,730, constituting 0.63% of the country's population. They mainly live in Vojvodina (39,807), where they constitute the third largest ethnic group after Serbs and Hungarians. Like other ethnic Slovaks, they speak the Slovak language, but most of them are Protestant (Evangelical-Augsburg Church, a Lutheran Protestant denomination) by faith and not Roman Catholic, unlike most Slovaks in Slovakia.

Demographics

Most Slovaks live in Kovačica (8,497 Slovaks) and Bački Petrovac (5,773 Slovaks). There are two municipalities in Vojvodina with absolute or relative Slovak majorities: Bački Petrovac (with 66.4% Slovaks) and Kovačica (with 41% Slovaks). The towns of Kovačica and Bački Petrovac are the cultural centres of Slovaks in Vojvodina. Slovak is one of the six official languages of the provincial administration in Vojvodina.

The settlements in Vojvodina with absolute or relative Slovak majority are:
 Bački Petrovac (Bački Petrovac municipality)
 Kulpin (Bački Petrovac municipality)
 Gložan (Bački Petrovac municipality)
 Kisač (Novi Sad municipality)
 Pivnice (Bačka Palanka municipality)
 Lalić (Odžaci municipality)
 Selenča (Bač municipality)
 Lug (Beočin municipality)
 Ljuba (Šid municipality)
 Kovačica (Kovačica municipality)
 Padina (Kovačica municipality)
 Belo Blato (Zrenjanin municipality)
 Hajdučica (Plandište municipality)
 Janošik (Alibunar municipality)
 Slankamenački Vinogradi (Inđija municipality)

History

The modern Slovaks in Vojvodina are descendants of 18th- and 19th-century settlers, who migrated from the territory of present-day Slovakia. First Slovak settlers from area around Tatra migrated to Bačka during the time of Karlo I; in 1720 Slovaks settled in Bajša, in 1740 in Petrovac and Futog, and in 1742 (during the time of Maria Theresa) in Bezdan. Some of them also later moved to Srem. In 1760, 120 Slovak families were settled in Selenča, but they later moved to Stara Pazova in Srem.

In 1783, Slovaks settled in Kisač, Veprovac, Gložan, and Topola. Part of them also settled in Bajša. In 1790–1791, Slovaks settled in Pivnice, in 1792 in Stara Palanka, and in 1793 in Novi Slankamen. In 1784–1787, Slovaks settled in Slovanski Bardan. In 1792 Slovaks settled in Bačka Palanka. Some of them moved in 1788 to Aradac and Ečka, and some of them later also moved to Lalić.

In 1800, Slovaks settled in Kovačica, and in 1806 and 1809 in Padina. In 1806, one group of Slovaks settled in Čoka, and in 1809 in Šupljaja. In 1825, Slovaks settled in Dušanovac, and in 1830 in Stari Lec. In 1850, 20 Slovak families were settled in Grk. In 1868, Slovaks settled in Marienfeld, from where they later moved to Vojlovica. In the same time, some Slovaks also settled in Ivanovo. In 1887, Slovaks were settled in Elizenhajm, and in 1899 in Silađi colony near Apatin.

According to the 1880 census, Slovaks were the sixth largest ethnic group within present-day Vojvodina, and their number was 43,318. Until the end of the First World War, many of the Slovaks were Hungarized. According to the 2011 census, numbering 52,570, Slovaks are the sixth largest ethnic group in Serbia.

Notable people
 Miroslav Benka, screenwriter, director, designer and university pedagogue
 Zuzana Chalupová (Zuzana Halupova), naïve painter
 Dominik Dinga, footballer

See also

Serbia-Slovakia relations
Serbs in Slovakia

References

External sources
 Borislav Jankulov, Pregled kolonizacije Vojvodine u XVIII i XIX veku, Novi Sad - Pančevo, 2003.

External links
 Vojvodinian Slovaks contemporary and native art
 Ústav pre kultúru vojvodinských Slovákov | slovackizavod.org.rs
 Matica slovenská v Srbsku
 Hlas Ľudu weekly magazine

Serbia
Ethnic groups in Serbia
Ethnic groups in Vojvodina
Serbian people of Slovak descent

Slovaks in Serbia


The Ten Stages Sutra (Sanskrit: Daśabhūmika Sūtra; ;  ) also known as the Daśabhūmika Sūtra, is an early, influential Mahayana Buddhist scripture. The sutra also appears as the 26th chapter of the .Modern Buddhist studies scholars generally hold that these Mahayana sūtras first began to appear between the 1st century BCE and the 1st century CE. They continued being composed, compiled and edited until the decline of Buddhism in India.

Contents
In the Daśabhūmika Sūtra, the Buddha describes ten stages of development that a bodhisattva must progress through in order to accomplish full Enlightenment and Buddhahood, as well as the subject of Buddha-nature and the awakening of the aspiration for Enlightenment.

Commentary
There is a commentary which survives in Chinese called the Daśabhūmikavibhāṣā, it is attributed to Nagarjuna.

Another commentary on the Daśabhūmika Sūtra, the Dasabhūmikabhāsya, was written by Vasubandhu in Sanskrit and translated into Chinese by Bodhiruci and others during the 6th century CE.

Chinese Daśabhūmikā school
A Daśabhūmikā school said to have existed in China at one time, which centered on this sutra, but was later absorbed by the Huayan school, as the Huayan school's principal sutra, the , already contains the Daśabhūmika Sūtra. The Daśabhūmika Sūtra can also be found in modified form in the thirty-ninth chapter as part of the journey of the bodhisattva Sudhana. The Huayan school declined in China after the death of its fifth and best known patriarch, Zongmi (780–841), but they provided major foundational teachings for the Mahayana schools which exist today, such as Zen.

See also
 Chinese Buddhism

Notes

External links
 List of Mahayana Sutras
 The Phenomenal Flower Garland

Mahayana sutras
Yogacara
Vaipulya sutras

Ten Stages Sutra


International Clinical Research Center Brno (ICRC) is a conceptually novel project in biomedical research and clinical patient care which is being developed by the Czech Republic and the Mayo Clinic in Rochester,  Minnesota.  The goal of ICRC consists of creating a research platform to allow cutting edge clinical research being conducted in the central Europe,  particularly in Brno, Czech Republic.

Origins of the ICRC Project
At the beginning of the ICRC concept was a close and fruitful collaboration between physicians and researchers in the Cardiology Department of St. Anne's Hospital in Brno, Czech Republic, and their counterparts at the Division of Cardiovascular Diseases at the Mayo Clinic, Rochester, Minnesota. Particularly the stay of MUDr. Tomas Kara, Ph.D. in the laboratory of Dr. Virend Somers at the Mayo clinic in early 2000 established the high yield of such cooperation, and led to the origins of the idea that a new and globally competitive scientific facility would be needed in Brno, Czech Republic, to support the increasing depth and complexity of research projects being conducted by Mayo and St. Anne's Hospital. The team led by Dr. Kara ultimately recommended building of a new facility (ICRC) in St. Anne's Hospital in Brno, Czech Republic which would be sufficiently equipped to support an ongoing global cooperation with the world-wide leader in translational biomedical research, the Mayo Clinic.

Building of ICRC Brno
The ICRC project was supported by both the Mayo Clinic, and by the government of the Czech Republic in a Memorandum of Understanding, and this ultimately led to the beginning of construction of the ICRC scientific facility. The foundation stone was laid on October 7, 2008 in Brno, Czech Republic with the presence of the Prime Minister of the Czech Republic, the Ambassador of the United States to the Czech Republic, the leadership of the ICRC project, and the local government and community leaders from the South Moravia region.

Results of the ICRC Collaboration
The scientific collaboration on the ICRC platform resulted in publications in medical journals, including the New England Journal of Medicine, the Circulation Journal, the Journal of the American College of Cardiology, the Chest journal, the American Journal of Cardiology, and many others. During the 10 years of this Czech-American cooperation more than 30 Czech physicians, bioengineers and other researchers had a chance to visit and work at the Mayo Clinic in Minnesota, and the leading clinical researchers from the Mayo Clinic visited Brno, Czech Republic on a countless number of occasions. The most recent efforts in cardiovascular research are conducted by a broad team of Czech and American researchers, including Dr. Tomas Kara, Dr. Virend Somers, Dr. Samuel Asirvatham, Dr. Alexander Schirger, Dr. John Schirger, Dr. Tom Konecny, Dr. Marek Orban, Ing. Pavel Leinveber, and Ing. Jan Bukartyk. The latest results from the ICRC collaboration are regularly being presented at the most significant international meetings, including the American Heart Association Scientific Sessions (2009), American College of Cardiology Scientific Sessions (2009, 2010), Czech Society of Cardiology Scientific Meeting (2010), American College of Physicians Chapter Meeting (2008, 2009), and others.

References

Business Publications about ICRC Project

Coverage of the ICRC project in Czech Public Television

European Hospital Magazine about ICRC

Interview with Dr. Tomas Kara on Czech Public Television

Medical research

International Clinical Research Center


Ondřej Havelka and his Melody Makers () or simply The Melody Makers, is a Czech retro-band, playing American "jazz standards" and Central European jazz and swing music of the 1920s and 1930s. Carefully studied renditions of the original recordings are interspersed with solos improvised in a style authentic to the period. They are one of very few European big band formations in continual existence over more than a decade, and have been a considerable presence on the swing scene of post-Communist Central Europe.

History
The Original Prague Syncopated Orchestra split in 1995, actor and singer Ondřej Havelka with his colleague Karel Majer leaving to form their own ensemble, with Havelka as artistic director and lead vocalist, and Majer initially as bandleader but leaving after a year. This group eventually adopted the name "Melody Makers".

In recent years the group has performed a number of songs best known from Ella Fitzgerald's recordings, with Gypsy singer Věra Gondolánová as guest vocalist.

Major concerts
 A Tribute to George Gershwin (1998)
 Just for this Single Day (1999)
 The Story of Jazz (2000)
 Memories of Stardust (2001)
 Blues in My Heart (2002)
 Sweet and Burning (Dedicated to Bing Crosby) (2003)
 Echoes of Overseas Songs (2004)
 Ondřej Havelka and His Melody Makers in a Programme of Songs by Jaroslav Ježek and the Voskovec and Werich Duo (2005)
 Something Old again and yet a Brand New Thing (2007)

Discography

CD
 Ondřej Havelka uvádí The Swings (1995, Monitor/EMI)
 Mě to tady nebaví (1998, Monitor/EMI)
 Jen pro ten dnešní den (1999, Monitor/EMI)
 Rhapsody In Blue: Pocta George Gershwinovi (1999, Monitor/EMI)
 Swing It (2000, V.O.X. Music GmbH)
 Vzpomínky na hvězdný prach (2002, Hot Jazz)
 Nejlepší kusy z repertoiru Ondřeje Havelky a jeho Melody Makers (2003, Monitor/EMI)
 Tentokrát zcela Rozvrkočení / This Time Completely off their Noodles (2005, Hot Jazz)
 Ondřej Havelka a jeho Melody Makers vám přejí veselé vánoce. Bílé a oranžové (2005)
 Rhapsody In Blue Room (2007)

DVD
 Ondřej Havelka uvádí Téměř kompletní almanach filmových písní (2007, EMI).

References
 Interview for Radio Prague
 Profile of Havelka at the Prague State Opera
 Profile of Havelka at the National Theatre (Prague)

External links
 Official website

Czech jazz ensembles
Swing revival ensembles

Ondřej Havelka and his Melody Makers


Zaca may refer to:

Huehue Zaca, a 15th-century Aztec noble and a warrior
The Zaca Fire, the second largest wildfire in modern California history
Zaca Creek, an American country music group
Zaca Creek, a tributary of the Santa Ynez River
Zaca Oil Field, along Zaca Creek
Two U.S. Navy ships named

ca:Zaca

Zaca


Clubland TV is a British satellite free-to-air, cable and subscription Dance/Electronica genre music channel. It is based from the Clubland compilation albums. Clubland TV airs various sub-genres of dance/EDM from the 90's to the late 2010s, such as electronica, techno, trance, eurodance, house, garage & dance-pop. Clubland TV is channel 364 on Sky, and channel 292 on Virgin. Clubland TV is available on the Astra 2G satellite network, on the Ku band.

History

The channel launched on 28 January 2008. As of March 2008, the channel had five times the viewing ratings than its main competition MTV Dance. As of July 2019, the channel still dominates the ratings over its main rival MTV Dance (now Club MTV) that was closed on 20 July 2020, so Clubland remains the only UK-based EDM broadcasting music TV channel.

The channel was initially run in partnership with Mushroom TV Ltd, former operator of Channel AKA and Starz TV, as this company had an established system for the operation of viewer-voted music channels. On 17 February 2010 Clubland's broadcasting was changed to a brand new, bespoke playout facility. The text number for song voting changed as did some song voting codes, and the channel is now broadcast in 16:9 widescreen format (having been in 4:3 fullscreen during the Mushroom era.) The channel is now solely controlled (including all playout and technical support services) by the team behind the highly successful Clubland compilation album series.

From January 2014 the channel has been available to stream on mobile devices via TVPlayer. From July 2014 Clubland TV has its own app available on the Google Play Store for Android devices and the App Store for Apple devices where viewers can request videos to be played on the channel.

On 30 April 2015, as part of a music reshuffle, Clubland TV was removed from Freesat, at the request of its operators. It returned along with its sister channels on 1 October 2015 (but was removed on 14 September 2016 along with Chilled TV).

On 12 January 2016, Clubland TV was picked up by Virgin Media. It was originally featured with sister channels Channel AKA (later Now 70s), Now Music (later Now 80s) and Chilled TV (later Now 90s), until Channel AKA was removed in March 2018. The app on Clubland closed on Virgin Media in January 2019.

In August 2016, the channel got a licence to launch on Freeview. It launched on 6 September 2016, in Manchester only, but later was put on channel 271 via streaming service Channelbox along with sister channel Now 90s, now known as Now Rock.

On 9 September 2016, Clubland TV launched changed their on screen graphics. It is one of the few UK music channels to feature an on-screen clock informing viewers of the current time. These on screen graphics were used from 2016 to 2022.

On 20 November 2020, the channel temporarily renamed as Channel U for six hours to promote the film Against All Odds.

On 27 October 2021, the on-screen clock was removed from Clubland TV. It returned some time later and as of February 2022 remains on-screen.

On 23 February 2022, it was confirmed that Clubland TV and the other three AATW channels would launch on Sky Glass in the future, although a specific launch date was not given.

On 31 May 2022, Clubland TV launched new on-screen graphics and a modified logo, featuring a blue and pink colour, with the first song being played following the rebrand being 2 Unlimited's 'No Limit'. Clubland TV also gained a sponsor, FreePrints.

On 17 June 2022, Clubland TV once again changed their On-Screen Graphics, this time to include a new, bolder font.

As of 2022, Clubland TV's playout consists entirely of Old-School dance, the channel formerly focused on a mix of Old-School and brand new Dance, EDM and K-Pop. The channel does, however, occasionally play music from the 2010s.

On 26 October 2022, Clubland TV was delisted from Manchester local community Freeview, due to national expansion on cable and satellite.

References

External links

Television channels and stations established in 2008
Dance music television channels
Music video networks in the United Kingdom
Mass media in Manchester

Clubland TV