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Chapter 83
Cytogenetic, Teratogenic, and Miscellaneous Other Disorders Causing Male Pseudohermaphroditism or Germ-Cell Failure in Males (46,XY) and Females (46,XX)
Joe Leigh Simpson
Table Of Contents
Joe Leigh Simpson, MD
In male pseudohermaphroditism, individuals with a Y chromosome have external genitalia that fail to develop as expected for normal males. External genitalia are sufficiently ambiguous to confuse the gender of rearing. Male pseudohermaphroditism encompasses a wide spectrum of disorders as shown in Table 1. The majority of these disorders have been discussed in previous chapters, specifically Chapters 5-79, 5-80, 5-81, and 5-82. In this chapter teratogenic and cytogenetic forms (45,X/46,XY) of male pseudohermaphroditism, multiple malformation syndromes, and selected disorders otherwise not reviewed in this volume are discussed.
TABLE 1. The Spectrum of 46,XY Sex Reversal (XY females)
XY gonadal dysgenesis without somatic anomalies
Perturbations of SRY (HMG-box)
XY gonadal dysgenesis and Wilms' tumor oncogene (WT1)
Denys-Drash syndrome
XY gonadal dysgenesis and campomelic dysplasia (SOX9)
XY gonadal dysgenesis/∀-thalassemia X chromosome (ATX)
XY gonadal dysgenesis in other malformation syndromes
Ectodermal anomalies (Brosnan)
XY gonadal dysgenesis with autosomal deletions
Del (2p)
XY gonadal dysgenesis with autosomal duplications
Dup (1p)
Germ cell failure in both sexes (46,XY cases)
No somatic anomalies
Leydig cell hypoplasia
Steroid biosynthetic defects
Steroidogenic factor 1 (Star) deficiency
Agonadia (46,XY)
(Simpson JL, Elias S: Genetics in Obstetrics and Gynecology. Philadelphia, N. B. Saunders [in press].)
Despite many claims of genital abnormalities being caused by putative teratogens, virtually no proven examples exist. Nonetheless, if administered in sufficiently high doses in the first trimester to a woman pregnant with a male fetus, several agents would be expected to produce female external genitalia. One example is cyproterone, the mode of action of which is to block the androgen receptor. Cyproterone is present in oral contraceptive formulations in Europe, but not in the United States. Little reported information exists on the consequences of inadvertent ingestion during pregnancy, but presumably problems have either not occurred or been reported. On the other hand, genital ambiguity was unexpectedly reported in association with trimethadione teratogenicity.1 If valid, the mechanism is unclear.
Another potential teratogen is finasteride, which inhibits 5α-reductase. Perturbing this function (5α-reductase) causes male pseudohermaphroditism (see Chapter 5-80). Another agent is flutamide. Both finasteride and flutamide are approved by the U.S. Food and Drug Administration (FDA) for treatment of hirsutism; thus, the risk for teratogenic male pseudohermaphroditism exists. Again, no cases of human teratogenicity appear to have been claimed to be the cause associated with these agents.
Controversy exists concerning whether administration of progestins or progesterones during pregnancy can produce simple hypospadias, that is, without genital ambiguity per se. The overwhelming weight of the evidence seems to be that these agents do not adversely affect male genital development.2,3
In general, C-21 progestogen derivatives (e.g., medroxyprogesterone) do not virilize even in high doses; 19-nortestosterone derivatives (e.g., norethindrone) generally virilize, but there are exceptions (e.g., norethynodrel). In 1962, Jacobson4 reported an 18% incidence of masculinization in female infants whose mothers were given high doses of norethindrone acetate for pregnancy maintenance; virilization occurred in only 1% exposed to medroxyprogesterone acetate. Doses of 19-nortestosterones required for virilization are 10 to 20 mg/day, far in excess of that associated with inadvertent contraceptive exposure during pregnancy. When progestogen therapy at such dosage is currently administered, the compound administered will almost certainly be progesterone, 17α-hydroxyprogesterone caproate, or medroxyprogesterone. Genital ambiguity as a resule of progestogen exposure of female fetuses is thus mostly a topic of historic concern.
The only currently utilized sex steroid that causes virilization when administered in usually administered doses is danazol, a derivative of 17α-ethinyl testosterone. In the study by Brunskill5 on adverse drug reports of pregnant women receiving danazol, 23 of 57 female infants were virilized; male offspring were ostensibly normal. Genital virilization has resulted from doses as low as 200 mg daily, whereas 800 mg daily is the usual dose when danazol is used to treat endometriosis.
45,X/46,XY individuals have a 45,X cell line and at least one cell line containing a Y chromosome. Based on cohort studies of 45,X/46,XY cases detected in utero(prenatal genetic diagnosis), more than 90% of cases are normal males.6 The phenotype of cases ascertained postnatally differs markedly, doubtless reflecting selection basis. Postnatal cases manifest a variety of phenotypes but predominately genital ambiguity or phenotypically normal females.7,8,9 Different phenotypes presumably reflect different tissue distributions of the various cell lines.
Of note, structurally abnormal Y chromosomes are not infrequently present. Given that structurally abnormal chromosomes (e.g., dicentric) are often unstable, it is likely that the 45,X line arises secondarily after loss of the structurally abnormal Y. This may explain why certain infertile males with normal external genitalia, for example requiring intracytoplasmic sperm injection (ICSI), may have offspring with genital ambiguity. In the sons a 45,X line might have arisen secondarily.
45,X/46,XY with Unambiguous Female External Genitalia
These 45,X/46,XY individuals may have Turner's stigmata and be clinically indistinguishable from 45,X individuals in many ways. However, 45,X/46,XY cases may be normal in stature and show no somatic anomalies. External genitalia, vagina, and müllerian derivatives remain unstimulated because of the lack of sex steroids. Breasts fail to develop, and little pubic or axillary hair develops. If breast development occurs in a 45,X/46,XY individual, an estrogen-secreting tumor such as gonadoblastoma or dysgerminoma should be suspected.10 However, virilization has also been claimed to result from gonadotropin stimulation of streak gonads11; studies of such cases would be welcome.
Although streak gonads of 45,X/46,XY individuals may be histologically indistinguishable from streak gonads of 45,X individuals, gonadoblastomas or dysgerminomas develop in approximately 15% to 20% of 45,X/46,XY individuals.12 If retained in a phenotypic XY female, presence of the Yq locus GBY (gonadoblastoma Y chromosome) is believed to predispose to neoplasia. If GBY is deleted, as it is in many deletions of Yq, risk of neoplasia is diminished in gender-reversal females.13
Neoplasia may develop in the first or second decade of life. Even if the presumptive GBY locus were absent, we recommend gonadal extirpation for all 45,X/46,XY individuals having female external genitalia. The uterus should be retained, given that pregnancy may be achievable through donor oocytes or donor embryos.
Gonadectomy can usually be accomplished by laparoscopy14 (Fig. 1). Although preferable to removing only gonads, adnexal removal may technically be necessary as well. Only rarely should laparotomy prove necessary.
45,X/46,XY with Ambiguous External Genitalia
The term asymmetric or mixed gonadal dysgenesis applies to individuals with one streak gonad and one dysgenetic testis. These individuals usually have ambiguous external genitalia and a 45,X/46,XY complement, and usually a uterus. Many investigators believe that the phenotype is invariably associated with 45,X/46,XY mosaicism. Occasionally only 45,X or only 46,XY cells are demonstrable. Ostensibly, nonmosaic cases may merely reflect inability to sample sufficient tissues or cells.
45,X/46,XY individuals with ambiguous external genitalia usually have müllerian derivatives (e.g., a uterus). Presence of a uterus is important diagnostically because that organ is absent in almost all genetic (mendelian) forms of male pseudohermaphroditism. If an individual shows ambiguous external genitalia, bilateral testes, and a uterus, it is reasonable to infer 45,X/46,XY mosaicism actually exists. This statement still applies if both lines cannot be demonstrated cytogenetically. Occasionally the uterus may be rudimentary, or a fallopian tube may fail to develop ipsilateral to a testis.
45,X/46,XY with Nearly Normal Male External Genitalia
45,X/46,XY mosaicism may be detected in individuals with nearly normal male external genitalia. In fact, this is the most common 45,X/46,XY phenotype based on liveborn follow-up of 45,X/46,XY fetuses ascertained at amniocentesis, 90% of whom show a normal male phenotype.15 That 45,X/46,XY neonates far more commonly show genital ambiguity merely reflects biases of ascertainment. Those with male phenotype pass unrecognized.
45,X/46,XY individuals having almost normal male external genitalia do not seem to develop neoplasia as often as 45,X/46,XY individuals having female or frankly ambiguous genitalia.16 If gonads can be assessed periodically within the scrotum by ultrasound or palpation, gonadal extirpation should not be necessary if the male gender of rearing is chosen.
Genital ambiguity may occur in 46,XY individuals having various multiple malformation syndromes. These include the Meckel-Gruber syndrome, Smith-Lemli-Opitz syndrome, brachio-skeletal-genital syndrome,17 esophageal-facial-genital syndrome,18 and other disorders. These disorders are usually inherited in either autosomal recessive or X-linked recessive fashion, and are summarized in Table 1. Many additional syndrome are associated with cryptorchiditism or simple hypospadias, but these rarely pose diagnostic problems.19 Of relevance as well are existence of various syndromes associated with XY gender reversal. These are listed in Table 2 and were discussed in Chapter 5-87. These syndromes include campomelic dysplasia (SOX-9), Denys/Drash and Frasier syndromes (WT-1) autosomal deletions (1q, 2q, 9p, 10q), and autosomal duplication (1q). In each condition the phenotype of affected 46,XY individuals is usually complete gender reversal (female phenotype). However, varied expression exists, some affected cases may occasionally present as male pseudohermaphrodites (genital ambiguity).
TABLE 2. Multiple Malformation Syndromes Associated with Ambiguous Genitalia
Two multiple malformation syndromes characterized by genital ambiguity (i.e., Smith-Lemli-Opitz syndrome and genito-palato-cardiac [Gardner-Silengo-Wachtel] syndrome) are of special interest to obstetrician–gynecologists.
In this common autosomal recessive syndrome, 46,XY individuals show genital abnormalities ranging from hypospadias to genitalia ambiguity. In Ontario, the incidence has been estimated at 1 per 22,700 among individuals of European ancestry.20 An estimate of 1 per 20,000 is accepted.21 A characteristic spectrum of dysmorphic features allows diagnosis by experienced clinicians and geneticists. Mental retardation exists as does craniofacial dysmorphia characterized by microcephaly, low-set ears, ptosis, anteverted nares, inner epicanthal folds, broad maxillary ridges and micrognathia. Syndactly of the third toe is present. Ureteropelvic junction obstruction and renal anomalies (cystic dysplasia, agenesis, duplication of kidneys) are also common. Approximately two thirds have genital problems: usually hypospadias, micropenis, or hypoplastic scrotum are the manifestations; genital ambiguity is less common.
However, a more severe phenotype of Smith-Lemli-Opitz syndrome exists, often called type II. Here external genitalia may be female (gender reversal).22 Both type I and type II Smith-Lemli-Opitz syndrome, if the distinction is truly appropriate, are caused by mutation of a gene the product of which is C7-reductase, the enzyme responsible for converting 7-hydroxycholesteral to cholesterol.23,24 A defect in exon-intronic splicing is the most common molecular perturbation.
Considerable attention is being directed to the feasibility of postnatal as well as prenatal treatment with a high-cholesterol diet. Given its low molecular weight, cholesterol should cross the placenta, making this mode of therapy feasible. During pregnancy, maternal serum estriol is low to nondetectable,25 making detection possible during maternal serum analyte screening. Maternal serum analyte screening is based on low maternal serum alpha-fetoprotein (MSAFP; multiple of mediam [MOM]0.72), μE3 (MOM 0.21) and human chorionic gonadotropin (hCG; MOM 0.76).21 An algorithm based on performing an invasive procedure when risk is 1:100 will yield 71% detection at a procedure rate of only 0.44%.21 Definitive prenatal diagnosis is facile with amniotic fluid, based on molecular studies or presence of the novel compounds dehydroestriol and dehydropregnanetriol. Diagnosis can even be made in maternal urine for in normal pregnancies these compounds are undetectable.26
The existence of a still poorly defined disorder characterized by variable gender sex reversal and characteristic somatic anomalies is accepted. Several authors have arrived at this conclusion27,28,29 with the latter best reflecting consensus as to which cases fit within this spectrum. Greenberg and colleagues29 proposed that this disorder be called palato-genital-cardiac or Gardner-Silengo-Wachtel syndrome and such appellations are usually applied.
In retrospect, Gardner and associates30 reported what is accepted as the first case; however, those authors believed that oral contraception was causative through teratogenic action. This diverted attention from the possibility of a newly recognized syndrome. Silengo and colleagues31 later recounted two cases similar to that of Gardner and colleagues.30 All three were 46,XY with female external genitalia and müllerian derivatives; gonads were bilateral streaks, but in one case Sertoli cells were present. Somatic features included cleft palate, micrognathia, other facial dysmorphias (downward-slanting palpebral features, low-set ears, anteverted nares, carp mouth), clubfoot, or prominent heels. Bernstein and colleagues32 followed with a report of four cases, which may or may not have all had the same disorder. The most thoroughly described cases not only showed 46,XY gender reversal but also duplication of Xp, in a child and its aborted fetal sib. Dup (Xp) was present in several normal (XX) females. This observation served as the basis for postulating that duplication of Xp (later DAX-1) caused gender reversal (see Chapter 5-86). However, no other features of adrenal hypoplasia were evident in the case of Bernstein and colleagues,32 and the somatic features were not those now known to be associated with DAX-1 duplication. On the other hand, cleft palate, hypertelorism, micrognathia, low-set eyes, prominent heels, and ventricular septal defect (VSD) were present. Bernstein and colleagues32 reported three other cases lacking duplication of Xp. These cases showed cleft palate, microcephaly, low-set ears, and post-axial polydactyly. One of the three had VSD. External genitalia in all were female, but their karyotype was not stated. Wolman and colleagues33 described a case with similar somatic findings (cleft palate, micrognathia, clubfeet, thoracic dysplasia. Gender reversal extended to gonads showing seminiferous tubules; a uterus was present.
Greenberg and colleagues29 reported two 46,XY sibling fetuses who were each aborted following prenatal detection (ultrasound) of anomalies. One fetus had female external genitalia and normal ovaries, micrognathia but no cleft palate, low-set ears, flexion deformities of thumbs and toes, and cardiac defects that included VSD. The other aborted sib showed not dissimilar somatic features, plus bilateral cystic kidneys, gastrointestinal defects (agenesis gallbladder, intestinal rotation, Meckel diverticulum). However, external genitalia of this sib were male, with first-degree hypospadias and testes. Beemer and von Ertbruggen34 reported two sibs of consanguineous parents. These sibs may or may not have had the same disorder.29
In this syndrome, X-linked, or less likely autosomal-recessive, XY gender reversal syndrome would seem to exist. Defining somatic features include facial clefts, micrognathia, low-set ears, and other facial dysmorphic features; cardiac defects such as VSD; flexion deformities; and various internal anomalies. Not all cases show the same features, and in some cases Smith-Lemli-Opitz syndrome could be the correct diagnosis. All cases of genito-palato-cardiac syndrome have been 46,XY and almost all show female external genitalia. Gonads show unusual variability: streak gonads, ovary-like gonads comprised of seminiferous tubules or testes (even in the sib of an XY case who showed ovaries).
Certain 46,XY individuals have long been recognized as having bilateral testes devoid of Leydig cells, show female external genitalia, and have no uterus.7 Epididymides and vasa deferentia are present; serum luteinizing hormone (LH) is elevated. Affected siblings have been reported and parental consanguinity observed; autosomal recessive inheritance is accepted.7,35
The molecular basis involves mutations of the LHR gene, located on chromosome 2.36 Leydig cells thus fail to develop because LH cannot exert its effect during embryogenesis, leading to inadequate virilization and lack of gonadal differentiation. Embryonic testes continue to secrete anti-müllerian hormone (AMH), resulting in lack of uterus as expected for 46,XY individuals.
The LHR gene consists of 11 exons and 699 amino acids. Kremer and colleagues37 reported two siblings of consanguineous parents; homozygosity for a missense mutation (C593R) was found. In other cases deletions, point mutations, and stop codons have been recognized.38,39Over a dozen different LHR mutations have been reported in 46,XY "females" having Leydig cell hypoplasia.36 Complete resistance to LH produces XY females, whereas partial resistance leads to males having a small penis or hypospadias.
46,XX cases with LHR mutations also exist, showing primary amenorrhea. In all cases, these women have had a 46,XY sib of nearly identical external phenotype.
In agonadia, the gonads are completely absent, not merely present in the form of streaks as in gonadal dysgenesis. In agonadia the external genitalia are abnormal but female-like. In the original cases of Overzier and Linden40 the clitoris was enlarged and a perineal urethral orifice present. The distance between urethral orifice and anus seemed normal despite nearly complete labio-scrotal fusion. In other cases external genitalia were more normally female in appearance. No more than rudimentary müllerian or wolffian derivatives are present.
In approximately half of the reported cases, somatic anomalies coexist. In considering their own and previous cases (Overzier and Linden,40 Chaptal and colleagues,41 Overzier,42 Schoen and colleagues43) in 1973 Sarto and Opitz44 wondered whether a distinctive somatic malformation pattern existed: skull abnormalities (turricephaly and turribrachycephaly); facial dysmorphia (ptosis, epicanthal folds, nystamus, esotropia); vertebral anomalies; low posterior hairline.
Agondia was once believed confined to 46,XY individuals. However, sporadic cases have been reported in sporadic 46,XX individuals.45,46 In these sporadic 46,XX cases, there were no somatic anomalies, Mendonca and colleagues47 also reported agonadia without somatic anomalies in phenotypic sibs having unlike chromosomal complements (46,XY and 46,XX). Presumably the cases reported by Kennerknecht and colleagues48 represent a distinct syndrome: agonadism, hypoplasia of the pulmonary artery and lung, and dextrocardia in XX and XY sibs.
Pathogenic explanations initially focused on loss of testes early in embryogenesis, a logical hypothesis given that initially all cases were 46,XY. Even in these cases, however, not only absence of gonads, but also abnormal external genitalia and lack of internal genital ducts needs to be consisered. An attractive hypothesis is transient presence of fetal testes, sufficiently long to initiate male differentiation and suppress müllerian differentiation but not long enough to complete male differentiation. Thus, the term testicular regression is favored by some. On the other hand, mechanisms not confined to testes must be invoked in 46,XX cases. Given both heritable tendencies44,49 as well as somatic anomalies, a defect in connective tissue is a logical explanation.
There are still no molecular clues to date. No genetic perturbations have been reported in SRY50,51,52 or other testis-related genes.
Females with germ-cell failure show streak gonads, whereas males show Steroli-cell–only syndrome. When familial aggregates of germ-cell failure are observed, usually affected individuals are of either one or the other gender. Gender of rearing is, almost by definition, not in doubt. In several families, however, male and female sibs have each shown germ-cell failure, despite different chromosomal complements (46,XX or 46,XY). In some cases no anomalies exist outside gonads, whereas in other cases a multiple malformation pattern exists.
Isolated Germ-cell Failure in XX and XY Sibs
In two families, unlike-gender sibs have shown germ-cell failure without somatic anomalies. Smith and colleagues53 reported two female and one male sib of Greek ancestry residing in Australia. Granat and colleagues54 reported a Yemenite Jewish sibship. These families demonstrate that a single autosomal gene can deleteriously affect germ-cell development in both genders. Presumably the gene(s) acts either at a specific site common to early germ-cell development or through a nonspecific mechanism producing meiotic breakdown. Elucidation of such gene(s) could have profound implications for understanding normal gonadal differentiation.
A host of attractive candidate genes exist in mouse and Drosophila, and doubtless will be exploited with contemporary molecular methods. In mouse knockout experiments, surprisingly, not all results would have been predicted to manifest this phenotype but show no other anomalies. For example, a gene knockout for follicle stimulating hormone β causing germ-cell failure is not a surprise, but germ-cell failure as result of knockout of bone morphogenetic protein 15 (Bmp) is less predictive. Murine knockouts have been reviewed by Brunskill.55 Many of these genes offer attractive candidates for the families discussed above. One example is gcd, in which germ cells are deficient in both male and female mice.
Hamet Syndrome
Hamet and colleagues56 reported germ-cell failure, hypertension, and deafness in 3 of 5 sibs (2 females, 1 male) in a French-Canadian family. Blood pressure was elevated by the second or third decade. Fibrous streak were evident at laparoscopy in the one female sib undergoing surgery. The male sib showed hyperplasia of the adrenal zona glomerulosa. Despite extensive endocrine evaluation no precise diagnosis was found; 11β-hydroxylase deficiency was considered, as well as 17-hydroxylase deficiency. The male showed incomplete spermatogenesis at necropsy.
Al-Awadi Syndrome
Al-Awadi and colleagues57 reported three sibs whose parents were first cousins. Ethnic origin was Jordanian, apparently residing in Kuwait. Unusual somatic features included thin scalp hair that was mostly midline; no hair was present on the side of the face, overall producing a mane-like appearance. Eyebrows and eyelashes were normal, and affected sibs were able to perspire. The two affected females showed müllerian hypoplasia and streak gonads. The brother had a normal-sized penis, but did not shave and had small soft testes.
Mikati Syndrome
Mikati and colleagues58 reported four affected sibs from a consanguineous Lebanese couple. Sibs showed mental retardation, microcephaly, short stature, genu valgum, cubitus valgus, and mental retardation. Facial dysmorphia was characterized by narrow forehead, synophrys, abnormal pinnae, loss of teeth, abnormally folded pinnae, micrognathia, and cubitus valgus.
In the males, testes were small, and in one case, undescended. Hypospadias was not present. The single affected sister failed to achieve secondary sexual development. On rectal examinatin a uterus could be palpated. Hypergonadotropism was evident.
Steroidogenic factor-1 (SF-1) plays a potentially pivotal role in hypothalamic-pituary-gonadal axis. An orphan nuclear receptor related structurally to steroid receptors, SF-1 has no known ligand (hence, the designation orphan). SF-1 gene product is encoded by the gene FTZ1, a zinc finger protein encoded on human 9q33. Prior to recognition of human cases, disruption of FTZ1 in mice (gene knockouts) was known to cause not only perturbation of adrenal and gonadal development but also abnormalities of the hypothalamus and pituitary gonadatropes.59,60
The first ostensible human case of SF-1 deficiency, caused by mutant FTZ-1, was reported by Achermann and colleagues.61 This 46,XY individual showed primary adrenal failure, female external genitalia, streak gonads, and normal müllerian derivatives responsive to hormones. The proband was heterozygous for a 2bp substitution at codon 35 of FTZ-1. This mutated glycine is the last amino acid of the first zinc finger of SF-1, and its perturbation should disturb DNA binding. In mice the same (G35E) mutation does not exert a dominant negative effect; thus, homozygosity or compound heterozygous would be expected in humans to produce an abnormal phenotype. In the case described above, compound heterozygosity is presumed to exist, even though the second mutation could not be immediately detected in the coding regions of FTZ-1; SRY, StAR, and DAX1 were normal.
Of significance was the presence of a uterus in this 46,XY individual. This finding supports the hypothesis that SF-1 regulates repression of AMH.
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44. Sarto GE, Opitz JM: The XY gonadal agenesis syndrome. J Med Genet 10:288, 1973
45. Duck SC, Sekhon GS, Wilbois R, et al: Pseudohermaphroditis, with testes and a 46, XX karyotype. J Pediatr 87:58, 1975
46. Levinson G, Zarate A, Guzman-Toledano R, et al: An XX female with sexual infantilism, absent gonads, and lack of Mullerian ducts. J Med Genet 13:68, 1976
47. Mendonca BB, Barbosa AS, Arnhold IJ, et al: Gonadal agenesis in XX and XY sisters: Evidence for the involvement of an autosomal gene. Am J Med Genet 52:39, 1994
48. Kennerknecht I, Sorgo W, Oberhoffer R, et al: Familial occurrence of agonadism and multiple internal malformations in phenotypically normal girls with 46,XY and 46,XX karyotypes, respectively: A new autosomal recessive syndrome. Am J Med Genet 47:1166, 1993
49. de Grouchy J, Gompel A, Salomon-Bernard Y, et al: Embryonic testicular regression syndrome and severe mental retardation in sibs. Ann Genet 28:154, 1985
50. Pivnick EK, Wachtel S, Woods D, et al: Mutations in the conserved domain of SRY are uncommon in XY gonadal dysgenesis. Hum Genet 90:308, 1992
51. Mendonca BB, Russell AJ, Vasconcelos-Leite M, et al: Mutation in 3 beta-hydroxysteroid dehydrogenase type II associated with pseudohermaphroditism in males and premature pubarche or cryptic expression in females. J Mol Endocrinol 12:119, 1994
52. Zenteno JC, Jimenez AL, Canto P, et al: Clinical expression and SRY gene analysis in XY subjects lacking gonadal tissue. Am J Med Genet 99:244, 2001
53. Smith A, Fraser IS, Noel M: Three siblings with premature gonadal failure. Fertil Steril 32:528, 1979
54. Granat M, Amar A, Mor-Yosef S, et al: Familial gonadal germinative failure: Endocrine and human leukocyte antigen studies. Fertil Steril 40:215, 1983
55. Brunskill PJ: The effects of fetal exposure to danazol. Br J Obstet Gynaecol 99:212, 1992
56. Hamet P, Kuchel O, Nowaczynski W, et al: Hypertension with adrenal, genital, renal defects, and deafness. A new familial syndrome Arch Intern Med 131:563, 1973
57. Al Awadi SA, Farag TI, Teebi AS, et al: Primary hypogonadism and partial alopecia in three sibs with mullerian hypoplasia in the affected females. Am J Med Genet 22:619, 1985
58. Mikati MA, Najjar SS, Sahli IF, et al: Microcephaly, hypergonadotropic hypogonadism, short stature, and minor anomalies: A new syndrome. Am J Med Genet 22:599, 1985
59. Parker KL, Schimmer BP: Steroidogenic factor 1: A key determinant of endocrine development and function. Endocr Rev 18:361, 1997
60. Luo X, Ikeda Y, Parker KL: A cell-specific nuclear receptor is essential for adrenal and gonadal development and sexual differentiation. Cell 77:481, 1994
61. Achermann JC, Ito M, Ito M, et al: A mutation in the gene encoding steroidogenic factor-1 causes XY sex reversal and adrenal failure in humans. Nat Genet 22:125, 1999
62. Simpson JL, Elias S: Genetics in Obstetrics and Gynecology. 3rd ed.. Philadelphia, W.B. Saunders, 2003
63. Hornblass A, Reifler DM: Ablepharon macrostomia syndrome. Am J Ophthalmol 99:552, 1985
64. Riccardi VM, Borges W: Aniridia, cataracts, and Wilms tumor. Am J Ophthalmol 86:577, 1978
65. Riccardi VM, Sujansky E, Smith AC, et al: Chromosomal imbalance in the Aniridia-Wilms' tumor association: 11p interstitial deletion. Pediatrics 61:604, 1978
66. Rodriguez JI, Palacios J, Omenaca F, et al: Polyasplenia, caudal deficiency, and agenesis of the corpus callosum. Am J Med Genet 38:99, 1991
67. Sirota L, Shabtai F, Landman I, et al: New anomalies found in the 11q-syndrome. Clin Genet 26:569, 1984
68. Habib R, Loirat C, Gubler MC, et al: The nephropathy associated with male pseudohermaphroditism and Wilms' tumor (Drash syndrome): A distinctive glomerular lesion. Report of 10 cases Clin Nephrol 24:269, 1985
69. Turleau C, Niaudet P, Sultan C, et al: Partial androgen receptor deficiency and mixed gonadal dysgenesis in Drash syndrome. Hum Genet 75:81, 1987
70. Greenberg F, Keenan B, De Yanis V, et al: Gonadal dysgenesis and gonadoblastoma in situ in a female with Fraser (cryptophthalmos) syndrome. J Pediatr 108:952, 1986
71. Gattuso J, Patton MA, Baraitser M: The clinical spectrum of the Fraser syndrome: report of three new cases and review. J Med Genet 24:549, 1987
72. Merrer ML, Briard ML, Girard S, et al: Lethal acrodysgenital dwarfism: A severe lethal condition resembling Smith-Lemli-Opitz syndrome. J Med Genet 25:88, 1988
73. Rutledge JC, Friedman JM, Harrod MJ, et al: A "new" lethal multiple congenital anomaly syndrome: Joint contractures, cerebellar hypoplasia, renal hypoplasia, urogenital anomalies, tongue cysts, shortness of limbs, eye abnormalities, defects of the heart, gallbladder agenesis, and ear malformations. Am J Med Genet 19:255, 1984
74. Koppe R, Kaplan P, Hunter A, et al: Ambiguous genitalia associated with skeletal abnormalities, cutis laxa, craniostenosis, psychomotor retardation, and facial abnormalities (SCARF syndrome). Am J Med Genet 34:305, 1989
75. Cooper CP, Hall CM: Lethal short-rib polydactyly syndrome of the Majewski type: A report of three cases. Radiology 144:513, 1982
76. Silengo MC, Bell GL, Biagioli M, et al: Oro-facial-digital syndrome II. Transitional type between the Mohr and the Majewski syndromes: report of two new cases Clin Genet 31:331, 1987
77. Bialer MG, Penchaszadeh VB, Kahn E, et al: Female external genitalia and mullerian duct derivatives in a 46,XY infant with the Smith-Lemli-Opitz syndrome. Am J Med Genet 28:723, 1987
78. Joseph DB, Uehling DT, Gilbert E, et al: Genitourinary abnormalities associated with the Smith-Lemli-Opitz syndrome. J Urol 137:719, 1987
79. Sofatzis JA, Alexacos L, Skouteli HN, et al: Malformed female genitalia in newborns with the VATER association. Acta Paediatr Scand 72:923, 1983
80. Kallen K, Mastroiacovo P, Castilla EE, et al: VATER non-random association of congenital malformations: Study based on data from four malformation registers. Am J Med Genet 101:26, 2001


text:
U.S. vows to block N. Korea-made goods
U.S. Customs and Border Protection says it is ready to block U.S. imports of seafood - as well as any other goods - produced by North Korean laborers who work in China.
An Associated Press investigation tracked salmon, squid and cod processed by North Koreans working at Chinese factories and shipped to American stores, including Walmart and Aldi. The North Korean workers found in Chinese factories aren't allowed to leave, and receive only a fraction of their pay - most goes straight to the North Korean state. This means that American consumers buying seafood labeled "Caught in the USA, Processed in China" may inadvertently be subsidizing the government of Kim Jong Un as it builds nuclear weapons, and supporting forced labor.
U.S. Customs and Border Protection said it is reviewing the allegations and if warranted, would "pursue all enforcement actions and prohibit goods from importation as appropriate." The companies that responded also vowed to investigate ties with suppliers.
At this point anything made by North Korean workers anywhere is presumed to be made with forced labor, the State Department said in a statement Friday.
"North Koreans sent overseas do not have a choice in the work; the government ultimately assigns them and they are not free to change jobs," said the statement, noting that wages and passports are typically withheld by North Korean supervisors.
GOP Rep. Chris Smith from New Jersey, who has repeatedly called for tougher enforcement, said the Labor Department has already identified trafficking in 12 sectors of goods exported by China.
"CBP should be stopping every shipment from those sectors - and now trafficking-tainted salmon too," he said.
A White House National Security Council spokesman said the North Korean government's scheme to outsource its labor underscores why the U.S. has pushed for restrictions on North Korean foreign workers. The spokesman said all countries should, at a minimum, ban companies from bringing in North Korean crews, as pledged in recent U.N. sanctions.
China is among the countries that have promised to comply, already banning imports of North Korean seafood, and saying no more North Korean workers will be allowed starting next year.
Walmart said its supplier has addressed the problem, although it did not specify how. Walmart and ALDI said they are committed to human rights and fair labor practices, and expect the same from their business partners.

subset: commoncrawl


text:
From the Daily Caller News Foundation:
North Korea may test a nuclear weapon this weekend, according to U.S. government sources.
The North has reportedly installed a nuclear device inside one of the tunnels at its Punggye-ri Nuclear Test Site, reports Voice of America's Steve Herman, citing government and other sources. A provocation is expected Saturday, but it could possibly come sooner.
Saturday is the "Day of the Sun," the 105th anniversary of the birth of North Korean founder. This would be the North's sixth nuclear test.
"We have no comment at this time, but we will be watching closely," a National Security Council official told VOA.
Trending: The Conservative Answer to Reforming the Criminal Justice Sysytem
Reporters in Pyongyang, the capital of North Korea, are being told to be ready to evacuate the city at a moment's notice, signaling that tensions on the peninsula may soon skyrocket.
During March, extensive tunneling was detected extensive tunneling around Mt. Mantap, where the test site is located. The testing area is believed to now be capable of supporting underground tests with higher explosive yields, reports 38 North, a research site run by the U.S.-Korea Institute at Johns Hopkins University's School of Advanced International Studies.
Observers later detected the possible installation of instrumentation and equipment, as well communications cables.
38 North is now reporting that Punggye-ri is "primed and ready."
There is also the possibility that North Korea will test an intercontinental ballistic missile in the days to come. They have threatened to do so multiple times.
News of a possible test comes as the a U.S. Navy carrier strike group led by the USS Carl Vinson sails towards Korea. In Syria, President Donald Trump demonstrated what happens when a country "crosses the line;" however, North Korea's weapons program makes the situation on the Korean peninsula much more complex. A sixth North Korean nuclear weapons test will put Trump's resolve to the test.
The North Korean nuclear threat has puzzled world leaders for decades.
The views expressed in this opinion article are solely those of their author and are not necessarily either shared or endorsed by EagleRising.com


text:
Akintunde J Olowookere1, Samuel Anu Olowookere2, Ademola Oluwasegun Talabi3, Amarachukwu Chiduziem Etonyeaku3, Oluwatoyin E Adeleke4, Oluwatosin O Akinboboye4
1 Department of Accident and Emergency, Obafemi Awolowo University Teaching Hospital, Osun State, Nigeria2 Department of Community Health, College of Health Sciences, Obafemi Awolowo University Teaching Hospital, Osun State, Nigeria3 Department of Surgery, College of Health Sciences, Obafemi Awolowo University Teaching Hospital, Osun State, Nigeria4 Department of Family Medicine, Federal Medical Centre, Owo, Ondo State, Nigeria
Click here for correspondence address and email
Background and Aim: Drug adherence determines a patient's quality of life and delays the development of complications. The study assessed perceived family support and other factors that determine medication adherence among hypertensive patients in a tertiary hospital. Materials and Methods: Descriptive cross-sectional study. Consenting adult patients on antihypertensive attending the Medical Outpatient Clinic of Federal Medical Centre Owo, Ondo State, Nigeria. Results: Four hundred and twenty patients were studied. The mean age of the patients was 60.6 ± 11.7 years (range 21-85 years). There were 206 (49%) males and 214 (51%) females. Most respondents were Yoruba (86.2%), married (76.7%), and had primary education (27.6%). Most (61%) were adherent to antihypertensive therapy. Common reasons for poor adherence include belief of cure (43%), high cost of treatment (33%), and the experiencing of side effects (27%). Patients with good family support had better adherence compared to those with poor family support (P < 0.05). Conclusion: Poor family support and other factors were identified as causes of poor adherence among these hypertensive patients. Strategies targeting these factors will improve drug adherence, thereby preventing poor treatment outcomes among these patients.
Keywords: Adherence to antihypertensives, family support, out-of-pocket payment
Correspondence Address:Samuel Anu OlowookereDepartment of Community Health, Faculty of Clinical Sciences, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Osun State NigeriaSource of Support: None, Conflict of Interest: NoneCheckDOI: 10.4103/1755-6783.162668
Source of Support: None, Conflict of Interest: None


text: Infynis 286 Share Posted January 8, 2016 I've seen some people saying that they believe they will have a hard time connecting with their character if they have to switch bodies frequently, and others who don't seem concerned at all. Personally, I like the idea, and think it will give us the ability to develop parts of our characters' personalities that we wouldn't have otherwise. SkEyesOGrey has already taken advantage of the vessel system in their RP introduction, and I think it worked very well. I'd like to see what we all have to say about it though, as you can't really RP alone. What are your thoughts? Link to post Share on other sites


text:
INDIANAPOLIS, Ind. – An offseason of major change ramps up July 29 when the Indianapolis Colts report to their Indiana Farm Bureau Football Center for the start of training camp.
Over the next week, we'll take a positional look at how general manager Chris Ballard has structured the roster. Is the team equipped to return to the playoffs for the first time since 2014 or will it miss the postseason in three consecutive seasons for the first time in more than two decades (1988-94)?
Today: Defensive backs.
Projected starters: CB Vontae Davis, CB Quincy Wilson, FS Malik Hooker, SS Clayton Geathers/Matthias Farley.
Others: S Darius Butler, CB Rashaan Melvin, CB Darryl Morris, CB Nate Hairston, CB Chris Milton, CB Tevin Mitchel, CB Dante Blackmon, S T.J. Green, S Tyvis Powell, S Andrew Williamson, S Lee Hightower, S Tyson Graham.
Safety first:
How can we not be a bit concerned about the position heading into training camp? The projected starters – Geathers, the veteran, and Hooker, the much-hyped first-round draft pick – missed all of the Colts' offseason work while rehabbing from surgery.
Everyone has been upbeat regarding Hooker's availability for the start of camp, including Hooker. Geathers is a different story altogether. His surgery was to repair a herniated disc in his neck.
"The neck is something serious,'' Geathers said in May. "You don't want to play around with the neck. But I believe in a higher power, and I just pray about it . . . everything will work out.
"I'm just listening to the trainers, listening to the doctors. When I'm ready, I'm ready.''
Until Geathers gains medical clearance – early, late, who knows? – the last line of the Colts' defense rests in the hands of Hooker, one of the nation's biggest playmakers last season at Ohio State, Butler, Green and Farley.
Hooker's charge is to replace departed Mike Adams as a defensive difference-maker. We're not going to revisit the ridiculous hype of him being the second coming of Ed Reed, but there's no denying Hooker's knack for finding the football. Remember, he gobbled up 7 interceptions and returned 3 for TDs last year for the Buckeyes, his only season as a starter.
"They just want me to go out there and be me,'' Hooker said. "They didn't put too much pressure on me to go out there and do anything spectacular. Just get in the playbook and be yourself because that's why they drafted me.''
While Geathers and Hooker looked on from the sideline during the offseason, Butler, who's making the transition from nickel corner, took the majority of the reps at free safety. Green, the 2016 second-round draft pick, initially was the starter at strong safety but soon was supplanted by Farley.
Green struggled as a rookie and no one should be surprised if Farley emerges as Geathers' replacement if Geathers' rehab forces him to miss time. The Colts claimed the rookie off waivers from Arizona in September and he went on to appear in all 16 games.
The DB room belongs to Davis, and it's up to him to be a leader on and off the field. He's the two-time Pro Bowler entering his ninth season in the NFL and sixth with the Colts.
Davis' supporting cast includes four players who have never played at the pro level, including three rookies – Wilson, Hairston and Blackmon. Wilson, taken in the second round of the April draft, likely starts opposite Davis while Hairston, a fifth-round pick, could replace Butler as the nickel corner.
Chuck Pagano pointed out during OTAs Wilson needed to get into "football shape,'' but praised his intelligence, work ethic and potential.
Wilson is ready to challenge for a starting position.
"Yeah, definitely,'' he said. "I just have to come in and compete and show that I have what it takes.''
The backups with experience are Melvin (27 games, 11 starts) and Morris (48 and 3). Melvin started nine games in 16, his first season with the Colts, and contributed seven defended passes and two forced fumbles.
Regardless how the position shakes out, so much hinges on Davis returning to his Pro Bowl form of 2014-15. His overall efficiency has been undercut the last two years as he's battled a variety of injuries.
"I just want to lead by example and do all the right things,'' Davis said. "I have been in the league a long time and I had success in this league. Those guys being young – they probably won't say it – but they're going to come in and look up to me.
"I just want to set a great example.''
There's ample motivation. Davis, 29, will be an unrestricted free agent at the end of the season. Another big payday – the Colts signed him to a four-year, $39 million contract in 2014 – awaits.
"He knows that one way or another, he's either going to get paid or not paid a year from now,'' defensive coordinator Ted Monachino said. "And the way he's going to get that done is by playing at a very high level and being a '1,' and that's what our system requires.''
In the past, the Colts occasionally have assigned Davis to cover the opponent's top receiver. Those instances likely will increase in '17.
"He's extremely motivated,'' Monachino said. "I'll leave it at that.''
Worth noting:
Creating takeaways has been an offseason emphasis, and for good reason. The Colts came up with just 8 interceptions last season, tied for the second-fewest in the NFL and tied for the fewest in franchise history.
Here's where we remind you Hooker collected 7 by himself last year at Ohio State.


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Just like that, all appears to be right in Celtics Nation. Boston got a virtuosic performance form Kyrie Irving and pulled by the Toronto Raptors on Wednesday, 117-108.
Irving exhibited a master class on point guarding and, yes, leadership in the fourth quarter to drive Boston over the NBA's top team. He had 27 points and 18 assists in the game.
The Celtics rebounded from three straight losses on the road to win back at TD Garden.
Subscribe to the Celtics Newsfeed on iTunes, Stitcher, and WATCH on youtube.com/CLNSMedia.
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text:
(p.183) Appendix I The Principle of Contradiction in Metaphysics Γ
(p.183) Appendix I The Principle of Contradiction in Metaphysics Γ
This appendix applies what has been learnt in the De Interpretatione to another famous discussion of contradiction. In Metaphysics, ? Aristotle attempts to establish the principle that the same thing cannot both hold and not hold of the same subject. This 'Principle of Contradiction' is primitive and indemonstrable, but those who deny it, he believes, can be refuted. To do this, he employs material from the early chapters of the De Interpretatione. 'Being a man' and 'being a not man' have separate significations, and if a word 'signifies', then it must stand as a conventional token for some real existent entity. From this the refutation of his opponents follows.
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text:
You've probably seen Grove a million times all over Instagram – people talking about all the natural cleaning products that they've switched to as a first step in getting toxic chemicals out of their houses. It's definitely a step in the right direction, but you might not know that you get way more than cleaning products from the site. I challenged myself to make a couple other swaps this month, and they've been game changers.
I heard about this from Krista Williams on the Almost 30 podcast (I've been listening for over a year and I just LOVE IT) and it just clicked with me. I tried oil cleansing a couple years ago and it was just not for me. My skin reacted horribly to it, and something about washing with oil just doesn't scream "clean" to me. But oil pre-cleansing makes total sense. Just using makeup wipes or cleansing wipes alone doesn't do much but move the makeup around on your face. Totally useless. Instead, I use 100% pure argan oil all over my face and neck beforehand to lift all the makeup, sweat, and grime off my face from a long day. Then, I use my Rooted Beauty cleansing wipes to get it all off.
Since I've started oil pre-cleansing at the end of each night, here's what I've noticed:
SOLD. And both of these are sold at Grove for less than I could find them in the store. In fact, the wipes came as a freebie with last month's order, which is a crazy good deal.
I drink way more water throughout the day when I use a big cup with a straw. I learned that little tidbit about myself when they gave me that GIANT hospital cup after Annie's birth. I love that thing so much, but it's getting a little grimey now. I've tried other reusable straws, like the stainless steel ones, but I don't love that I can't see inside of them. The idea of not really being able to see if the inside of the straw is thoroughly cleaned gives me the serious heeby-jeebies. I found these glass straws for this month's order and I haven't looked back.
The Grove marketplace is filled with tons of other items besides non-toxic cleaning supplies, like probiotics and supplements, insect repellents for summer time, paper goods, and so much more. I always order their 100% recycled trash bags, and they're surprisingly strong! If you want to try it out for a month to get started on oil pre-cleansing, you'll get a 5-piece cleaning set from Mrs. Meyer's with your order, so you'll get your cleaning supplies for the month totally free! Use this link to get started!
there's a first time for everything, and I share those firsts here every week. to chat one on one, follow me on Instagram @becs.lynk


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Staff Directory
Seattle Historical Sites
New Search
Summary for this site is under review and the displayed data may not be fully up to date. If you need additional info, please call (206) 684-0464
Historic Name:
Pincus Residence
Common Name:
25 Tufel Residence
Built By:
Year Built:
This residence is a good and generally intact example of a Colonial Bungalow. Built in 1925, it is associated with 1920s-era development in the Montlake area and is a contributing resource to the Montlake NRHP Historic District. The earliest known owners of this house, in 1928, were Joshua & Nellie Pincus; he was the secretary of the Better Manufacturing Co.. They remained here at least through 1948. In 1958, Gustav (Amcut Diamond Co.) and Josephine Loffler were the owners.
Montlake is generally described as extending from the Washington Park Arboretum west to Portage Bay/15th Avenue E., and from the Montlake Cut on the north to Interlaken Park. The area is a significant and cohesive collection of residential architecture typical of early 20th century Seattle and is eligible as a NRHP historic district under Criterion C. Construction occurred primarily between 1910 and 1940, with a variety of Craftsman and revival styles ranging from modest cottages and builder's houses to high-style architect-designed residences, impressive institutional buildings, and notable parks and natural features. There are few intrusions of newer buildings. In the early 1960s, construction of SR 520 and the unfinished R.H. Thomson Expressway bisected Montlake, but the neighborhood retains its basic integrity as a pre-World War II Seattle neighborhood.
Montlake was incorporated into the City of Seattle in 1891. Although the first plats (Union City 1st and 2nd additions) were filed by Harvey Pike in 1869-1871, development did not really begin until plats were filed by John Boyer (Interlaken, 1905) and H. S. Turner (1907). Montlake Park (north of SR 520) was platted in 1909 by the developers James Corner and Calvin and William Hagan. With the 1909 Alaska-Yukon-Pacific Exposition came a streetcar line on 24th Avenue E. and an impetus for development. In 1916, the Lake Washington Ship Canal was completed and the Montlake Bridge linked the neighborhood to the university area in 1925. A small commercial district grew along the car line.
The 1903 Olmsted Parks and Boulevards Plan of 1903 surrounded Montlake with parks. Montlake Boulevard (then call University Boulevard) connected Lake Washington Boulevard to the A-Y-P grounds. Washington Park, the eastern boundary, was acquired by the City in 1900 and developed as an arboretum in 1936-41. At the southern edge is steep, forested Interlaken Park and boulevard.
By 1915, the neighborhood had developed enough to require a temporary school building; the permanent structure opened in 1924.Soon afterwards came a playfield and shelter house (1933-36) and a library (1944, replaced 2006). Other noteworthy structures include the Seattle Yacht Club (1920), the NOAA Northwest Fisheries Center (1931), the Museum of History and Industry (1952) and St. Demetrios Greek Orthodox Church (1962).
Major Bibliographic References:
King County Tax Assessor Records, 1937-2014.
Becker, Paula. Seattle Neighborhoods: Montlake--Thumbnail History. HistoryLink File # 10170, accessed 12/2/2013.
Gould, James W. Montlake History. http://www.scn.org/neighbors/montlake/mcc_history.Jim_Gould.html
Polk directories of Seattle, 1938-1958.
Smith, Eugene. Montlake: An Urban Eden, A History of the Montlake Community in Seattle. La Grande OR: Oak Street Press, 2004.
This one-story side gable cottage sits above the street on a mid-block lot with a rockery, shrubs and large trees. Cladding is clapboard. The entry, at the east end of the façade, has a newer multilight door and a concrete stoop and stairs with low brick sidewalls. Above is a gabled roof with returns and an arched opening; it has two narrow metal supports and a metal railing. West of the entry is an original tripartite window with leaded upper sash in a 6-15-6 configuration. Other visible windows have 8-over-1 leaded sash with wide surrounds. The east elevation has a square hanging bay. On the west is an exterior brick chimney, a driveway and a detached garage.
Historic Contributing
Detail for this site is under review and the displayed data may not be fully up to date. If you need additional info, please call (206) 684-0464
District Status:
Wood - Clapboard
Concrete - Poured
Roof Type(s):
Roof Material(s):
Building Type:
Domestic - Single Family
Structural System:
Balloon Frame/Platform Frame
No. of Stories:
Unit Theme(s):
Architecture/Landscape Architecture
Changes to Plan
Changes to Interior
Changes to Original Cladding
Changes to Windows
Major Bibliographic References
King County Assessor Property Characteristics Report, database at http://www5.metrokc.gov/ --parcel locator
Photo collection for this site is under review and the displayed data may not be fully up to date. If you need additional info, please call (206) 684-0464
Photo taken Jan 31, 2015
© Copyright 1995-2015
City of Seattle
Privacy and Security Policy
App v


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Hi, connected to app through Shopify. Till downloaded didnt know about the upsell and cross sell terms. just downloaded it. but after downloading i came to support. and i contacted Sarah for support. Sarah provided total guidance for setting up account and explain upsell n downsell n other terms soundly. now i have set up my first cross sell with the help of Sarah. She explained good. Thank you Sarah for support.
Super easy to use, and with the excellent customer service who are always ready to help, even on Sunday afternoon, give us a new horizon of efficiency. Must have!


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Food FactsDip banana slices in lemon juice before adding to the pudding to prevent them from darkening.
Jazz It UpGarnish with chopped chocolate and additional banana slices, if desired.
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Discrimination Lingers in Post-9/11 Era
By Amelia Earnest Published by Yale Daily News. A decade after the Sept. 11 attacks, Yale students are still discussing their effect on the way minorities are perceived in the United States. The South Asian Society at Yale, in collaboration with the Yale Chaplain's Office and two other student groups, held a forum Monday night for reflection on racial profiling in the post-9/11 world as part of a series of University-wide events commemorating the 10-year anniversary of the attacks. The evening's discussion addressed societal issues that have developed since 9/11, such
Yale Groups Combat Anti-Muslim Sentiment
By Everett Rosenfeld Published by Yale Daily News. When Valarie Kaur LAW '11 first heard about Ahmed Sharif, the New York City cab driver who was attacked Aug. 24 by a drunken passenger for being Muslim, she did not know how to respond. "We are witnessing a wave of hate crimes across the country, not fully being covered on the news," she said. "This [situation] is becoming insidious, life-threatening, and serious, but I found myself in a paralysis." Within a week, Matthew Matera LAW '11 came to her room to talk about


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CAGAYAN DE ORO CITY, Philippines – In the second wave of the National Interfaith Humanitarian Mission (NHIM), the internally displaced persons from Marawi City have opened to facilitators on their experience as the conflict there has stretched for more than two months, said a civil society organizer.
The first round of MHIM was conducted by Kalinaw Mindanao and other concerned nongovernment organizations mostly in evacuation centers in the towns of Pantar, Lanao del Norte and Saguiaran, Lanao del Sur on June 13-16, a few weeks after thousands of residents fled Marawi City following the series of fighting between government forces and armed extremists.
"In the first NHIM, it was very difficult for us to reach out because [their emotions were very raw] and most of them are afraid to speak out during the first few days of the implementation of the martial law," said Amirah Lidasan of the Moro Christian People's Alliance, and convener of Kalinaw Mindanao.
Kalinaw Mindanao has been carrying out interfaith responses to crisis-torn areas in Mindanao, including massive displacements caused by the all-out war campaign of the then Estrada administration in Central Mindanao in 2000, in Sulu and Basilan by the Arroyo government in 2005, and in Central Mindanao in 2008 following the rejection of the memorandum of agreement on ancestral domain (MOA-AD).
Lidasan said the evacuees found it hard to recount their ordeal in the first few days of the Marawi siege.
"For those who wanted to get their (IDPs) stories, it was very difficult. But in the second wave of the NIHM, they already felt comfortable with us. That have felt a sense of solidarity with us," she added.
In fact, she said, those who had interactions with the NIHM have organized themselves and are acting as leaders in the evacuation site, even helping humanitarian agencies in the distribution of relief goods to their fellow evacuees.
"These organized IDPs are a big help to help to us in facilitating the evacuees' experience, [especially on] repression and threat" in the hands of state agents while staying in the temporary shelters.
Aida Ibrahim, convener of the group Tindeg Ranao, one of the NGOs assisting in the NIHM, said their visit to the evacuation sites in Pantar and Saguiaran have proven to be fruitful based on the satisfaction of the IDPs who received the relief goods they handed out.
In Saguiaran, the NIHM gave out 600 relief packs to three sites in the Poblacion covered court, People's Plaza and the municipality's central elementary school. At an Islamic school in Pantar, IDPs received cooking pots, pails and bottles of water, she said.
At the evacuation sites in Iligan City, the NIHM distributed fresh vegetables to the IDPs.
"The processed food (canned goods) donated to them has proven to be unhealthy and had made their children sick. That's why we chose to given them fresh vegetables," Ibrahim said.
One of the most pressing concerns of the IDPs, she said, is the lack of services and the feeling of insecurity in the evacuation sites, most especially on health and the presence of the military in the areas.
"Evacuation centers are supposed to be zones of peace but the evacuees are afraid because of the presence of uniformed men," she said.
She said all the evacuees want is to live in peace in their temporary shelter, but most of all, to be able to go back to their homes in Marawi.
In Cagayan de Oro, what the evacuees need aside from food is cash to be used for their children's schooling, said Arabic teacher Hasannoor Sarip.
Sarip said he was able to talk to many of the evacuees staying in their relatives in the city. He found out that they are finding it hard to send their children to school here because of financial constraints.
The IDPs also want to earn money for their family could not provide for them due lack of employment or business opportunities.
As of August 1, there are about 55,627 families of 226,598 individuals living in Northern Mindanao who are either staying in 35 evacuation centers or with their relatives, said the Department of Social Welfare and Development-10 (DSWD-10).
The agency said the total cost of assistance extended to IDPs has reached P149 million, P138.300 million of which come from DSWD-10.
Of the total amount, P107.922 was allocated for family food packs and P30.477 million for non-food assistance.(davaotoday.com)


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Bluestone still looking for finance company buys
Bluestone may have missed out on getting control of Geneva Finance, but it hasn't stopped looking for finance company acquisitions in New Zealand.
Friday, May 2nd 2008, 5:17AM
He says Bluestone is looking for similar opportunities to Geneva and is in "a number of discussions."
While the company has wound back its lending operations it was still active in the home equity release market, and it had an unnamed backer prepared to help fund any finance company acquisition.
As for making any further advances on Geneva, he indicates that is unlikely, although he does say Bluestone would "welcome the opportunity to chat if the company is interested."
He says the Genevea bid was "always a reasonably speculative discussion," and he isn't surprised debenture holders and noteholders supported the recapitalisation plan when the only alternative was receivership.
"Receivership is always fairly unpalatable," he says.
McGuinness still has some concerns people voting on the proposal had no real independent advice on the offer.
Meanwhile Geneva has written to its investors and confirmed that they can convert additional amounts of debt to equity.
To support the offer it has pointed out that the shares will be listed and traded on the NZAX, and that "converting more (debt) to equity may reduce the term of your repayment schedule as additional conversions will start from the final repayment moving up according to the amount of additional conversion."
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Dragons and democracy are coming to Paladins
You'll often hear Hi-Rez described as a company living in Blizzard's shadow. Sometimes, that rings true. Other times, they go ahead and reveal a black female character for Paladins the week after Overwatch fails to – a character named Imani, a mobile damage dealer that can turn into a dragon. You win this round, Hi-Rez.
They've also revealed plans for the Assembly of Champions, an elected group of eight players who'll collaborate with the devs from the start of next year. I'm at the Hi-Rez Expo in Atlanta, and had the chance to ask Paladins brand director Alex Cantatore about both dragons and democracy.
First up, here's the lowdown on Imani:
"This Damage champion wields the elements of fire and ice, casting powerful spells with impactful, martial arts-inspired motions. She surfs through the air on ice, propelling herself with fire. And when she uses her ultimate ability, Imani summons a massive player-controlled dragon, breathing frostfire down upon her foes."
Wizard. I asked Cantatore what she's for – was Imani designed to fill a specific gap in the current roster?
"We saw that players really like damage champions, but almost all of our damage champions feel very like typical shooter characters that have been plopped in a fantasy world – they're not as integrated as they could have been. I think we really saw an opportunity to do a fantasy shooter character, to really capture the essence of what we're trying to do with Paladins."
Which is neat, although I had mechanics in mind rather than lore. Fortunately, Cantatore said more:
"She's kind of like an in and out of the action damage character, she's not just like 'I'm gonna sit here and shoot you with my gun for a while'. And then she ults, she summons this dragon, which I think is a really cool moment when it happens in game. At least in this current version, this could change before we release, but you can use the dragon to capture a point. So if you're about to lose the point, you could summon this dragon and have the dragon hold the point until your frontline respawns."
Cantatore went on to explain how Imani is vulnerable while she ults, incentivising flanking characters to dive in and mess with the opposing team's backline. She sounds like a worthy contribution to Paladins' current 39 strong roster, and will appear on the public test server on December 17th.
Speaking of worthy contributions, Cantatore also explained how the player council will work. Eight player-elected community figures will form the Assembly of Champions. Four of them will be there as specific representatives of each platform, and the remaining four will be whatever mix the public elects. In addition to "bi-monthly" teleconferences, they plan to fly the council out to Atlanta once a year.
The council will be under NDA (non-disclosure agreement), allowing Hi-Rez to get feedback on their ideas at their earliest stages. As Cantatore told me, "They'll get very early looks at concepts, we'll talk ideas and design with them, get their thoughts on if we're solving the communities wants – or even if it's something the community even cares about!"
"Like, we think persistent lobbies is a big thing for us, because we're only of the only shooters that doesn't have persistent lobbies, and it's something that we really want to do next year. But it could be that the community is like 'we're actually fine with this weird mobile hybrid system you have now'. So stuff like that, where we can sit down and have an honest discussion with people."
He also confirmed that the idea was indeed inspired by Eve's player-formed Stellar Management Council – and that several of the people behind the original idea at CCP are current Hi-Rez employees.
If you're thinking of running, more details can be found on the Paladins website.


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Export 156 results:Author [ Title] Type Year
Filters: Author is Doug A Bowman [Clear All Filters]
"Tech-note: rapMenu: Remote Menu Selection using Freehand Gestural Input", in Proceedings of the IEEE Symposium on 3D User Interfaces, 2008, pp. 55-58.,
"A Taxonomy for Designing Walking-based Locomotion Techniques for Virtual Reality", in the 2016 ACM CompanionProceedings of the 2016 ACM Companion on Interactive Surfaces and Spaces - ISS Companion '16, Niagara Falls, Ontario, CanadaNew York, New York, USA, 2016.,
"A Survey of Usability Evaluation in Virtual Environments: Classification and Comparison of Methods. Presence: Teleoperators and Virtual Environments", Presence: Teleoperators and Virtual Environments, vol. 11, pp. 404-424, 2002.,
"Supporting Social Engagement for Young Audiences with Serious Games and Virtual Environments in Museums", in CHI Workshop: Involving the Crowd in Future Museum Experience Design at the ACM Conference on Human Factors in Computing Systems (CHI'16), San Jose, CA, 2016.,
"Supporting Social Engagement for Young Audiences with Serious Games and Virtual Environments in Museums", in Museum Experience Design: Springer Series on Cultural Computing, Cham: Springer International Publishing, 2018, pp. 19 - 43.,
"Supporting Distributed Spatial Collaboration: An Investigation of Navigation and Radar View Techniques", Geoinformatica, vol. 10, pp. 123- 158, 2006.,
"Supporting Cognitive Processing with Spatial Information Presentations in Virtual Environments", Virtual Reality, 2012.,
"Studying the Effects of Stereo, Head Tracking, and Field of Regard on a Small-Scale Spatial Judgment Task", IEEE Transactions on Visualization and Computer Graphics, vol. 19, no. 5, pp. 886-896, 2013.,
"Snap2Diverse: Coordinating Information Visualizations and Virtual Environments", in Proceedings of SPIE Visualization and Data Analysis (VDA), 2004, p. 12 pages.,
"Small Group Learning with Games in Museums: Effects of Interactivity as Mediated by Cultural Differences", in ACM Interaction Design and Children, Medford, MA, 2015. IDC15_Paper_v7_camera-ready.pdf (889.79 KB),
"Slice-n-Swipe: A Free-Hand Gesture User Interface for 3D Point Cloud Annotation", in IEEE Symposium on 3D User Interfaces (3DUI), 2014. Slice-n-Swipe_3DUI_Contest_Submission.pdf (4.35 MB),
"The Simple Virtual Environment Library: An Extensible Framework for Building VE Applications", Presence: Teleoperators and Virtual Environments, vol. 9, pp. 187-208, 2000.,
"Separating the Effects of Level of Immersion and 3D Interaction Techniques", in Proceedings of the ACM Symposium on Virtual Reality Software and Technology, 2006, pp. 108-111.,
"The role of latency in the validity of AR simulation", in 2010 IEEE Virtual Reality Conference (VR)2010 IEEE Virtual Reality Conference (VR), Boston, MA, USA, 2010, pp. 11 - 18.,
"The role of Depth and Gestalt cues in information-rich virtual environments", International Journal of Human-Computer Studies, vol. 69, pp. 30 - 51, 2011.,
"Resizing Beyond Widgets: Object Resizing Techniques for Immersive Virtual Environments", in Proceedings of the ACM Conference on Human Factors in Computing Systems (CHI), 2005, pp. 1601-1604.,
"A Replication Study Testing the Validity of AR Simulation in VR for Controlled Experiments", in IEEE/ACM International Symposium on Mixed and Augmented Reality, Orlando, FL, 2009.,
"Relative Effects of Real-world and Virtual-World Latency on an Augmented Reality Training Task: An AR Simulation Experiment", Frontiers in ICT, vol. 32164019541930201519562223236, 2017.,
"Rapid and accurate 3D selection by progressive refinement", in IEEE Symposium on 3D User Interfaces (3DUI) 2011, Singapore, Singapore, 2011, pp. 67 - 74.,
"Questioning naturalism in 3D user interfaces", Communications of the ACM, vol. 55, no. 9, pp. 78-88, 2012.,
"Quantifying the Benefits of Immersion for Procedural Training", in Proceedings of the ACM SIGGRAPH Workshop on Emerging Display Technologies and Immersive Display Technologies, 2008.,
"Quantifying the Benefits of Immersion for Collaboration in Virtual Environments", in Proceedings of the ACM Symposium on Virtual Reality Software and Technology, 2005, pp. 78-81.,
"Principles for the Design of Performance-Oriented Interaction Techniques", in Handbook of Virtual Environments, Mahwah, New Jersey: Lawrence-Erlbaum, 2002, pp. 277-300.,
"Principles for Designing Effective 3D Interaction Techniques", in Handbook of Virtual Environments: Design, Implementation, and Applications, 2nd ed., Boca Raton, FL: CRC Press, 2015, pp. 285-311.,
"Poster: Designing effective travel techniques with bare-hand interaction.", IEEE Symposium on 3D User Interfaces (3DUI). 2014. Camera Ready - Poster-Designing Effective Travel Techniques with Bare-hand Interaction4.pdf (1.89 MB),


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NECA Shipping Calendar
ATTENTION: All dates indicate the beginning of the period when product starts shipping from our warehouse to retailers.
THESE ARE NOT ON-SHELF DATES. For on-shelf dates, please check with the retailer of your choice
This event has passed.
Godzilla – 12″ Head to Tail Action Figure – 1956 Movie Poster Godzilla
July 1, 2019
NECA goes back to the movie that started the reign of the most famous kaiju in the world!
This version of the beloved monster is based on the one-sheet poster for movie's 1956 U.S. release, Godzilla, King of the Monsters!
The figure measures 6″ tall and 12″ long from head to tail. It features over 30 points of articulation, including an articulated tail! The package insert doubles as a foldable backdrop that brings the one-sheet to life – Godzilla can be posed in the fold of the backdrop creating a 3D version of the poster illustration in toy form.
Comes in collector-friendly window box packaging with opening flap.
Item # 42886
Click Here for more info!


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Jumanji: Welcome to the Jungle Movie Review
March 9, 2018
Justin's Score: 9.5/10
"Entertaining and brilliant"
Aidan's Score: 10/10
"Executed with pristine brilliance"
Rotten Tomatoes Score: 76%
Metacritic Score: 58%
~Note: No major spoilers for this film. Minor spoilers for Jumanji (1996) in Aidan's review~
Now onto the reviews…
Justin's Review: Going into this film, I had incredibly high expectations. There was an incredibly diverse and talented ensemble for the cast, (especially since Jack Black is one of my favorite actors) a big production budget, (around $100 million) and an interesting; modern take on the story of "the mysterious object causing trouble." Jumanji: Welcome to the Jungle is a reboot of Jumanji with Robin Williams in 1995. Throughout this review, I will make comparisons between the two films to help further enhance important details and parts.
After going into the theater and seeing the film with my co-writer, I am happy to admit that my expectations were met and even exceeded. Jumanji: Welcome to the Jungle starts in 1996 with a young man finding the Jumanji board game (and yes, the same Jumanji board game that troubled Robin Williams in the 1995 Jumanji movie) and putting it aside because he gets bored with it after looking at it. The board game, becoming self-aware of the man's lack of interest, turns into a video game console with a cartridge. Now the young man gets interested and starts playing it. Next thing you know "Jumanji" pops onto the screen with "Welcome to the Jungle" by Guns 'N Roses playing. Then it slowly starts focusing on our main characters. There's Spencer, the intellectual yet socially awkward guy, his former best friend, Anthony, a phone-obsessed know-it-all, Bethany, and an intelligent yet socially awkward girl, Martha. These characters all meet together when put into detention. Their jobs were to remove staples from discarded magazines but as they are doing this, they see a retro console with the Jumanji cartridge in it. Seeing it as more fun than pulling staples out of papers, they get the game hooked up and press start. This is when the film really begins…
Let me start off by saying the visual effects in this movie are spectacular and this is the kind of movie you would want to see on the biggest screen possible. Aside from visual effects, all of the actors played their roles perfectly in my opinion. What this movie did surprise me with is the sheer amount of humor cram-packed into its plot. There wasn't a joke that completely fell flat and there were numerous genuinely hilarious moments in it. The reason the humor in this film shocked me so much was because the Jumanji (1995) with Robin Williams was surprisingly not all that funny. Don't get me wrong, there were some genuinely entertaining moments in it but with a movie having Robin Williams, I was expecting it contain some more humor.
All in all, this was a fantastic movie. It had a refreshing and modern take on the original story and it was executed incredibly. That is why I gave this movie an almost perfect score. When you get a movie that intrigues you, gives you some memorable and funny moments, and never has a dull moment, you know you are in for a truly stunning cinematic experience. This is the kind of movie you would want to see more than once and I found it to be much more enjoyable than the original Jumanji.
Aidan's Review: I grew up with the original Jumanji. I started watching it when it was still on VHS. Based on a book called Jumanji by Chris Van Allsburg. The creation of the game is quiet a dark one full of lies, deceit and blood. It all started back in Africa in the 1800's, where the game was purchased from an African Merchant by British Soldiers to help pass the time when making negotiations. Through a misunderstanding, the peaceful alliance was broken and the tribe turned on the soldiers. However, the soldiers got reinforcements and massacred the tribe. One of the soldiers found the game and as he held it, the tribes' shaman placed an evil curse on the game on his dying breath. He promised the soldier that no matter where he went, the evil of the darkest jungle would follow him. Years passed and the game arrived in the New World… Which leads us to the first movie.
The 1995 Jumanji movie started in 1869 with two kids burning the game. For 100 years it lay silent in the ground, until it is found by young Alan Parrish. Drawn to the game by it's sinister drums he uncovers it and later makes the deadly mistake of rolling the dice. He is sucked into the game and he waits there for the next 25 years to escape. Two young kids find the game in Alan's old house and start playing the game. After a few turns they release Alan and he helps them until the game is finally finished. Along the way they release a hunter called Van Pelt. He is no ordinary hunter for his quarry is with people instead of animals. In the end, the game is defeated and thrown into the ocean until it lands on a beach.
When I first heard that there was to be a remake of Jumanji, I was skeptical. I thought to myself "Why would a Robin Williams classic need a remake?" Then I saw that my friend was quite interested in seeing it. I invited him to the local movie theater. It was the first time I had been to a movie theater since I was 7 so I was excited. When we got in the theater and took our seats, the movie began. I was happy that it left off where the first one ended. The movie went on and there was a twist I did not expect… instead of the game releasing its creations upon the players, it brought the players to its creations. I was happy that they kept the drums. Personally, there's no Jumanji without the drums. I was a little confused on how they changed Van Pelt however. He first started out as a hunter than they took him down to a mercenary. To me that seems a step down on the deadly scale. But he still made a good antagonist. In the end I found Jumanji a ten out of ten on my movie scale but it will never be as good as the original. Now to the readers… There is only question that remains… Do you seek to find a way to leave your world behind?


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Asokwa Divisional Police Command has arrested three suspected gangsters/armed robbers from their hideout at Amakom, a suburb of Kumasi, upon a tip-off.
The suspects are Felix Addai Mensah, alias 'Abodam', 22, Prince Boadi, alias 'Stone', 20, and David Acheampong, alias 'Billion', 30.
According to ASP Gordon Ahianyo, Ashanti Regional Public Relations Officer of the Ghana Police Service, the suspects were arrested last Tuesday, the same day they had attacked their victims at gunpoint at Asafo and succeeded in robbing them off a traveling bag containing their personal effects.
As a result of intensive investigations, the victims identified the suspects, upon which they retrieved their stolen items.
ASP Ahianyo disclosed that a locally manufactured pistol and five BB cartridges were found on the suspects following a search on them.
All the three suspects have since been detained in custody, and are assisting in further investigations before being arraigned before court for prosecution, the official spokesman of the Police Service indicated.


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Asked by shireen
Does Acid Reflux Cause Tongue Ulcers And Sore Mouth
Does acid reflux cause tongue ulcers and a sore mouth? I have already taken four packs of lanzrapole, so what is causing it?
Hi there, Shireen --
I know this is a very old question and that you've likely long ago found an answer to this, but I did want to make sure someone from our staff answered you! I'm not a doctor, but I can tell you that mouth sores and tongue ulcers are a common symptom of acid reflux because of acid backing up in the throat.
Did you ever see your doctor about this? If so, perhaps you could come back and tell us what his/her diagnosis was and how the symptoms were treated? It might be helpful to someone else who is having the same issue.
Here are some links on reflux that might be helpful to you, in any case. Be well!


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Since 1991, the town of Vaterstetten located East of Munich offers agricultural businesses a community farming program developed by ECOZEPT. It includes the support of marginal areas, sowing in bee meadows and wild grazing areas and marketing assistance for organically grown products. The goal is to promote the extensive use of space through a financial compensation for all participating farmers while still offering the largest number of farmers the possiblity to participate in the program. The community program, however, should in no way act as a replacement, but rather an augmentation to government subsidized programs (such as the Bavarian Cultural Landscape Program or the Bavarian Contractual Conservation Program).
This active community has other plans as well. During a question and answer session with the farmers, ECOZEPT introduced the community farming program and addressed the farmers' suggestions. Since 2002, an annual conservation prize is awarded to honor the farmers' engagement in environmental matters. In addition, we seek to support interested farmers in their direct sales efforts - for instance, through a walker's guide map in which direct sales businesses are listed.


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V700RGB Alloy
Backlit Mechanical Gaming Keyboard
Mechanical key switches, a single key life of up to 60 million operations, making it durable and reliable in your game. Non-conflict design for 108 keys on the keyboard, allows you to press any number of keys simultaneously, ensuring your every command is registered and executed exactly and rapidly.
All keys on the keyboard are programmable (including single keys, combination keys and macro keys) in the game mode. The simplified game operations allow you to always be one step ahead.
Built-in memory can save the keyboard configuration file in the game mode. You can play the way you want, on any computer without the help of any software.
With RGB backlit, the all key's color and breathing mode can be customized by driver in the game mode. You can switch varities of backlight mode with VPRO combination keys in the office mode.


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Congratulation's Mr. Vanopolis you're the lucky new father of a healthy baby IT! That's great Doc, the wife and I have been trying for years, our higher power has really blessed us.
That was my all too vivid nightmare on Friday; I guess my appetite for disturbing content had ingested too many traumatic videos on You Tube earlier that evening. This transgender phenomenon is disturbing on many levels, there are too many concerning factors that just don't hold up. Despite the elaborate liberal yarn-spinning in an attempt to create heartwarming stories depicting the sense of Universal correctness when a life is reassigned with surgery, it proves nothing more than a dubious fairy tale likeness.
A report that was conducted in the pro- liberal land of Sweden, extending thirty years, shows that a 10 to 15 year period following surgery that the transformed butterflies had become 20 times more likely to swan-dive than their peers.(kill themselves) They are a confused portion of the population, .07 percent, suffering with the delusion that they are a different gender, in some cases they elect to have their sex organs removed and replaced to replicate their desired gender.
The frivolous logic supporting a sex change is not so sensible when applied to other vexing disorders. It's not an issue of a person changing their identity to feel adjusted or legitimized; neither sex knows what the other sex feels like. A woman insisting that she was born a man has absolutely no idea what living as a male really feels like. Simply duct-tapping your breast, cutting your hair and wearing a flannel doesn't make you a man. For that matter either does sewing on a penis or taking testosterone, these are just mere physical adjustments, which I find so ironic.
A woman will never appreciate the inherent indignation or dread that consumes a male when his manhood is challenged in front of his friends or his children. A women will never comprehend a real mans instinct to garner his dad's approval or understand his admiration of a woman's vulnerability and his need to protect her. A male's penis and balls have accompanied him throughout the most prolific and potent years of his existence, age 4 to age 18. This is the precious time that solidifies a man and what he's working with for the rest of his life, his post adolescent years will only add on to what is already there.
However, logic and common sense be dammed, the Democrats have a voting block to manipulate for the next half of century or so, until this star burns out, which might be soon. The validity of the transgender movement does not regress even as people realize that these are a legitimately ill fraction of society in need of help not exploitation, because the "getting help" ship has sailed. Will people realize that civilizations throughout history failed to incorporate these anomalies for a good reason?
Maybe the societal vandalism that arises while incorporating a transgender agenda might become Americans wake-up call; will we realize this has gone too far? California legislature specifically excluded "gender identity" from the states notice and opt-out requirements, meaning parents can't opt-out of the mind bending social propaganda, this fails both parents and children, writes The National Review.
In Rockland Sacramento, a leftist FEMALE teacher (Is there any other kind?) decided it was her right to inundate the minds of Kindergarten students with her social beliefs. She had read from two children's books, one of them titled "I am the jazz" depicting a Transgender kid named Jazz. The teacher, who the article failed to name, looked as if she might be "transitioning soon. Is it coincidence that all militant liberal chicks convinced of their qualifications to decide the beliefs our children should exercise throughout their adolescence have this a-sexual manly look to them?
The transgender America is having an adverse reaction amongst some feminist and the good news is that it won't deviate from this direction anytime soon. I love a good cat fight. Also the Trans agenda will continue becoming a greater irritation to lesbians, in the lesbian camp there is already rumblings of dropping the "T" in LGBTQ.
In Conclusion
I hope that I was at least mildly persuasive in my argument that there are just too many opposing factors to accept the transgender movement as an emotionally healthy condition. At the very least, there is NO way that women can possibly understand the intricacies of being a man. Even if we exclude those two substantial observations, the structural damage inflicted on American society that occurs by validating transgenderism is real and is frightening. Bending over for these socially engineered issues is not an option, which is if we're concerned for the integrity of our collective rectum.


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The municipality of San Miguel de Abona has a relatively short and flat coastline dotted with small sand and black pebble beaches that form at the point where the area's ravines meet the sea, beautiful beaches that are separated by low cliffs. Tourism has prospered on the municipality's coast, which is home to two tourist complexes, Golf del Sur and Amarilla Golf, a must for lovers of this sport. The attractive golf courses are set by the sea and the area's sharp cliffs provide a natural boundary for some of the course. The area also offers a host of other activities such as shopping, eating out and diverse services.
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