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I have had a bilateral mastectomy. I have under the muscle silicone implants. I had radiation treatment on the right breast and the implant is uncomfortable when using my arm and my muscle is very tight. Is it best to have my implants placed over the muscle? I had gone through the expander process before the implants.
Over the Muscle Implant Placement After Radiation Therapy?
Doctor Answers 18
Breast reconstruction and radiation
In general, there is a higher chance of scar tissue forming around breast implants following radiation therapy. Other techniques for reconstruction (flaps) may be helpful. Tissue from the abdomen (diep flap), thigh (tug flap), buttocks (sgap), or back (latissimus or tap flap) may be used to reconstruct the breast.
Implants After Radiation...
When radiation is used in the treatment of breast cancer, non-cancerous tissues in the path of the radiation are also affected. Radiation therapy can mean a significant loss of skin elasticity, which can profoundly affect the aesthetic results of breast reconstruction. And because the body's wound-healing mechanisms are altered by exposure to radiation, complications from all types of reconstructive breast surgery occur at a higher rate.
Radiation is especially problematic for women who undergo implant reconstructions, regardless of whether the radiation is administered before or after the implant is placed. Natural-tissue reconstruction has the benefit of bringing non-radiated, healthy, well-vascularized tissue to the mastectomy site, and this can actually aid in the healing process.
It sounds like you are having tightness from a capsular contracture. Capsular contracture is the primary reason many women are unhappy with implant reconstructions after readiation. Switching the implant to a position "above the muscle" as you suggested, may make the problem even worse, and possibly create new problems such as erosion of the implant through the surgical scar.
Because of the potential complications associated with implants, breast reconstruction using natural tissue is generally considered the best method for women who will require or have already had radiation.
While radiation therapy can complicate breast reconstruction surgery, with proper preparation most women can achieve a satisfactory reconstruction even if radiation therapy is part of their treatment plan. Perforator flaps including the DIEP flap, SIEA flap and SGAP flap are all used routinely with excellent results to reconstruct patients who have required radiation therapy.
Learn more: http://www.davidgreenspunmd.com
Reconstruction after Radiation
I generally recommend some form of autologous reconstruction after radiation therapy. If you are a good candidate, I would likley suggest a DIEP or TRAM flap to bring new healthy tissue and blood supply to your radiated chest wall to facilitate healing. Please visit with a board certified PS to learn more about your options.
Dr. Basu
Houston, TX
You might also like...
Tightness of implants
After radiation you may have sustained a tight capsule. You may need alternative reconstruction to keep the implant protected and soften the pocket.
Learn more: http://www.stevenwallachmd.com
Breast implant suggestions
You might be better served by taking the implants out. The tissues around the implants frequently respond to radiation therapy by becoming very prone to scar formation (encapsulation) and this can be painful. Implant removal (although not pretty) usually relieves this pain. An alternative reconstruction can be planned using your own tissues. These are still a bit more problematic after radiation therapy but are more likely to be successful.
Your own tissues or new pocket reconstruction
Radiation increases the chance of having capsule contracture and a tight deformed breast.
The classic teaching is to switch from an implant to an autologous reconstruction (your own tissues from the back or the tummy).
However, practically this is not always feasible or practical. Another option would be to perfrom a total capsulectomy (removal of all the internal scars), exchange the implant and use alloderm to create a new pocket. A muscle flap from the back could be used as well if needed. Hope that helps!
Learn more: http://newportplastic.com/breast-reconstruction/
Implants should stay under the muscle following radiation
Dear Jenny:
It appears that what you are experiencing is something called a capsular contracture. This is a condition in which the scar tissue, that normally forms around a breast implant, becomes hard causing pain or possibly distortion of the breast.
Attempting to change the location of the implant will increse the possibility of wound breakdown leading to infection and possibly implant extrusion, which will result in the need for implant removal.
If the condition is not tolerable or worsens, you may need to have the capsule partially or completely removed. This will allow the implant to reside in a softer pocket decreasing your pain and improving the appearance of your breast.
One note of caution however, be sure your discomfort or appearance is something you can no longer tolerate before deciding to proceed with surgery. The incidence of problems is increased any time you operate on tissue that has undergone radiation.
Good luck.
Post radiation implant switch from unders to overs?
I would strongly advise that you refrain from changing the position of your implants. You will be at an exceptionally high rate of capsular contracture, visibility and infection or wound breakdown
Not an option
Jenny from Canada,
Implant placement above the muscle is not an option in breast reconstruction with or without radiation. The symptoms that you describe are an unfortunate side effect of radiation therapy. A discussion with your board certified plastic surgeon will shed some light on the options to ease your discomfort. Good luck!
In breast reconstruction the implants must go under the muscle
In breast reconstructions, especially with radiation, the implants must go under the muscle. You need to have adequate soft tissue coverage to protect the implant. Breast reconstruction is completely different than cosmetic breast augmentation. Additionally, radiation significantly affects the quality of the tissue covering the implants.
Learn more: http://www.RealPlasticSurgery.com
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.


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Hello all,
My parents have recently signed to purchase a new home (in Ontario, Canada) as first-time buyers. We had a structural upgrades meeting with the decor centre (will have a decor meeting later on) and are now trying to decide which upgrades to do through the builder and which we can do externally after closing.
We have a $20k 'free upgrades' promotion so we're trying to cover as many of the important items we can in that amount. The builder also offered full hardwood flooring throughout the house (main floor and second floor, not unfinished basement) as a promotion instead of the $20k but we chose to go with the $20k.
Here are the items we've decided we want: http://i.imgur.com/MUOSawV.png
Here are the items we're not sure about: http://i.imgur.com/N3qjQbS.png
Some notes:
1) The decor meeting will no doubt come up with additional costs (we want to extend a bit of the kitchen countertop, move the sink and dishwater wiring from the island to the main countertop, perhaps add wall tiles in the kitchen, maybe they'll charge us for certain cabinetry, etc) so we're trying to keep that in mind too. Unfortunately, the builder doesn't give prices until the meeting and they're rushing us to finalize and provide payment for the structural upgrades before said decor meeting.
2) We plan on buying a gas stove so we were wondering if we should just do the gas line rough-in through the builder or if it's possible and cheaper to do later externally (will it mess up our walls or flooring?)
3) The builder provides (California knockdown) stipple ceilings in all rooms except for wet areas (kitchen, washrooms, laundry), which have smooth ceilings. Is this an upgrade we have to do now as opposed to later? We're already planning on doing the main floor through them but are wondering if we should do parts of the 2nd floor too.
4) We plan to one day (several years down the road) finish the basement and possibly make 2-3 rooms down there to rent out and such. We're already planning on having the 3-pc rough-in for the future bathroom ($950) installed by the builder but should we also do the electrical wiring for a 'bar' fridge ($179), 200 amp electrical service upgrade ($1,365), and side door entrance ($4,225) right now too? I assume it'll be very difficult or impossible to do the last two later on, especially since they'll have to tear down the brick for the side door?
5) Should we do any hardwood flooring through the builder? We're thinking of doing the stairs and stair landings because that could be very hard later but should we do any other areas? My parents want the dining room and main floor hallway done for now. I'm wondering if we should drop that too but their fear is the new walls and such becoming dirty if we do do hardwood externally after closing.
Sorry for the long post. As it's our first experience, we have a lot of fears and are learning a lot as we go. The builder rushing us to make our decisions doesn't help either.
Even if you can provide advice on one or two things, I'll be really grateful.
Thank you.
Hi There,
If I were you and based on your explanation I would ask builder to do side entrance, the basement window high enough that can be used as second means of egress.
Ask him to do 200 AMPs service.
3pc rough in for wash room ( you do your planning now and locate the wash room and give points accordingly (if he agrees to give it that way)
Rest of the items you will be able to do it cheaper later, like hard wood floor, gas line, fire place, water line, gas line etc.
For the things I have mentioned if you do it later there will be permits required and has to be done legally, where as all is done by builder. Cosmetic items can be done as time permits and of your selection and choice.
My 2 cents may be helpful.
Thank you for the response, Nitin!
Yes, we are planning to add in the side entrance door. Just to clarify, will it cost much more later on?
Likewise for the 200 amps service, will it also cost more later or will it just be more difficult to do?
To relocate the 3-pc rough-in for future basement washroom, it'll cost $347. We'll try our best to plan where it would fit best but, unfortunately, we really don't know its ideal position for a future finished basement that we could take years to work on.
Wouldn't the gas fireplace be difficult to do later since it'll mean having to destroy the wall and such?
Thank you for the help.
I would suggest you go ahead with the side door entrance at this point as this is something that would be much cheaper to install while they are framing the house. This would leave the option to create a basement suite apartment (if you decided to down the road, or for potential resale) as a dedicated entrance is important.
As well, it is much cheaper to install additional windows in a basement at the onset of a build, compared to installing them later on. A big challenge with any basement is ensuring there is sufficient natural light, and so any additional windows installed would go a long way in increasing this. It would be a good idea to have the "future layout" of the basement 100% determined now, so the basement window placement as well as the bathroom plumbing rough-ins will be in the right places for when you develop the basement later on.
I would also agree with the upgrade to 200 amp service now, as it would leave a lot more flexibility down the road for finishing the basement. It is cheaper in the long run to have an upgraded panel installed at the get go, as opposed to later on (it can still be done, however it is just more costly).
Getting the future basement bathroom plumbing roughed in is a definite must as well. This is something that is significantly cheaper to do during the time of the build. If not, then any future bathroom in the basement would mean jackhammering up the basement floor, running lines and then pouring concrete etc.
If you aren't finishing your basement right away, then running gas lines to the appliances on the main floor & bbq should be fairly straightforward for any plumbing contractor to do after the build is complete. The pricing noted by your builder for the gas lines appears to be a little bit hig.
Contrary to what some people may think, the "california knockdown" style ceiling is in most cases cheaper than perfectly smooth/flat ceilings. The reason for this is due to the additional labor time it takes to ensure the ceiling is perfectly smooth. The knockdown textured ceiling does have some hiding features and so it is usually a cheaper option.
Hardwood can be installed at any point after a house is complete. One thing to consider would be if you went ahead with some rooms now...if you decide to install hardwood in other areas it could be difficult to match the existing hardwood. Even if you purchased the same style & brand, certain hardwoods (as with any flooring) can start to slightly change colour over time due to sunlight.
One last thing to note is that many of the "cosmetic upgrades" (e.g. the backsplash tile) can be upgraded at any time after the initial build, and would not have any real difference as far as pricing.
Good luck with your new home build!
Read my reply and its very straight forward with lots going behind the statement.
All cosmetic would be cheaper and can be done later.
Derrick saved me a lot of typing! Well said.
As a side note, if you are thinking of renting out a section of your place, I would consider putting in the 200 amp service with separate meters and panel now. While you do not need to put a meter in the second spot until it is needed, you can do all the "heavy lifting" in advance and then just get the interior wiring done at a later date.
I would not want my tenant on the same electrical meter as me.
Also if you are looking at renting, look into the fire separation requirements that are required before covering up anything.
John Kuehnl-Cadwell
Master Electrician
Datawise Solutions Inc
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subset: commoncrawl


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NewswireToday - /newswire/ -
Dubai, UAE, United Arab Emirates, 2010/06/17 - New communications device offers affordable, reliable and simple alternative to IP Desk Phones (Nasdaq: ININ).
Interactive Intelligence Middle East, the regional arm of Interactive Intelligence (Nasdaq: ININ), a global provider of unified IP business communications solutions, has announced the release of the Interaction SIP Station, a new communications endpoint device designed as an affordable, reliable and simple alternative to IP desk phones.
"While IP desk phones increasingly offer sophisticated functionality, their complexity and cost are barriers for adoption among many organizations," said Drew Kraus, research vice president with Gartner. "Though the use of USB headsets with softphones offers an alternative, reliability issues often preclude their use. We've been telling clients for awhile now to lower their infrastructure costs by deploying low-cost phones, while supporting advanced telephony features via PC-based call control applications. By further distilling that endpoint device down to its core functionality, organizations can realize even more savings while still maintaining a clear voice signal and advanced features."
With a dedicated chip-set delivering high quality audio, the Interaction SIP Station has no hand set, display, or dial pad. Instead, the device is designed to work in conjunction with a headset and the Interactive Intelligence Interaction Client(R), a PC-based call control software application that includes sophisticated features, such as call recording, call rules, conferencing, presence management, company directory look-up, queue monitoring, call history, and more.
"By providing a dedicated audio path for reliability, and using our client application for rich functionality, the Interaction SIP Station provides all the features a company needs in an endpoint device -- and none that they don't," said Mr. Shaheen Haque, Territory Manager, Turkey and Middle East for Interactive Intelligence Middle East. "What makes this device a market-first, however, is that we're offering this reliability and simplicity at a price point that's roughly half that of a basic IP phone, and a fraction of what high-end multimedia phones cost."
Measuring just 4.5 in. x 4.5 in. x 1.5 in. (11.4 cm. x 11.4 cm. x 3.8 cm.), the Interaction SIP Station also consumes less desk space than a traditional phone. More secure and simple to use, the device's physical buttons include pick-up/disconnect, mute, volume control, emergency speed dial, and a multi-function status LED. The Interaction SIP Station uses power over Ethernet (PoE), thus further enhancing reliability by making it easier and more efficient to supply back-up power.
The Interaction SIP Station is targeted at mid-size to large contact centers and enterprises, and will be sold as an optional device with the Interactive Intelligence all-in-one IP communications software suite, Customer Interaction Center (CIC). Worldwide, it will be distributed through the Interactive Intelligence channel of more than 300 resellers, and through the company's direct sales force.
To learn more about the Interaction SIP Station visit inin.com/SIPStation.
Written by / Agency / Source: Procre8
Availability: All Regions (Including Int'l)
Traffic Booster: [/] Quick Newswire Today Visibility Checker
Distribution / Indexing: [+]


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Tweets from @TBHomeTeam/writers
MORE from our HomeTeam writers.
Fri. May 31, 2013 | Matt Baker | Email
Two quick recruiting updates from the North Suncoast:
Pasco TE/DE R.J. Scaife picked up his third Division I offer today, from Western Kentucky, Pirates assistant Chad Hatfield announced on Twitter. Scaife also landed D-I offers from Florida International and Middle Tennessee State earlier this week. The 6-foot-6, 255-pound senior switched from tackle to tight end this spring.
Hernando LB/RB Jeremiah Jackson landed offers from Samford and Youngstown State, he said via text messages. Both programs offered him as a linebacker; the only Division I-A offer he holds, from UMass, is at running back. Jackson, a 6-foot, 215-pound senior, is a two-time all-North Suncoast player who rushed for 500 yards and racked up 132 tackles last fall.


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Watching a plant grow and develop roots can be a long and tiresome process. But seeing plant development, as it unfolds, can expose to what happens to a genetically modified organism and how certain plant gene modifications can make plants do certain things. Robotic cameras and computerized motion control systems are making this process easier.
Plant physiology researchers at the Univ. of Wisconsin-Madison designed an automated image acquisition system, using robotic camera CCD imagers and XYZ vertical robotic gantry system "PhytoBot", to create time-lapse movies of plant growth in action. The system collects images of the plants that have been genetically altered with the intention of understanding of how the genetic manipulation affects their growth and development.
Researchers placed plant samples in an LED-illuminated 6xx6 grid of Petri plates, mounted on a vertical tubular aluminum frame, to conduct 36 experiments in parallel. IntelLiDrives' robotically controlled vertical XYZ gantry moves a pair of cameras between samples of growing plants. An array of infrared light-emitting diodes were mounted behind the fixture to provide illumination for the imaging system.
The XYZ gantry consists of computer-controlled linear actuators, each integrating brushless linear servo motor with high resolution linear encoder, moves the CCD cameras over a 1-m by 1-m area with a positioning resolution of 10 micrometers. Additional linear axis allows change of camera's field of view to acquire well focused images of seedlings in Petri plates. Robotic camera snaps pictures every 30 secs, capturing the curling, twisting motion of germinating seeds putting out new roots.
After capture, the images were analyzed to determine cellular growth rates in the root as well as the angle and curvature of the root tip. Computer vision algorithms studied the camera's time-lapse videos and measured the sizes of seeds, plants' cellular growth rates, the angle and curvature of the roots and more.
The XYZ robot with the computer vision system gave researchers the ability to automate the plant growth time-lapse image acquisition and processing and to increase throughput of experiments to track the plants growth and development. Researchers were able to quickly find the genes that control plant's root growth and have fundamental importance to crop improvement. The system helps lay the foundation for discoveries that will help improve plants for human purposes.
Source: IntelLiDrives


text:
ddie Murphy stars as shy Dr. Sherman Klump, a kind, brilliant, 'calorifically challenged' genetic professor. When beautiful Carla Purty joins the university faculty, Sherman grows desperate to whittle his 400-pound frame down to size and win her heart. So, with one swig of his experimental fat-reducing serum, Sherman becomes 'Buddy Love', a fast-talking, pumped-up , plumped down Don Juan.Overview from themoviedb.org
<> Free subtitles & video converter from freemake company


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April 11, 2011 at 10:58 am #3822
This thread is devoted to the numerous issues that I've encountered when trying to get this theme working the way that I want it to. If you are having trouble with aspects of your own, you may find the answer here.
Sorry for the multiple posts as I can't edit my previous and I want to keep all the info for my various questions together. Some of the answers will no doubt raise further questions, I'll try to keep this obvious.
My site is a directory of craft patterns: http://www.intatters.com/knots/
My initial questions:
1. My navigation bar had disappeared
2. How to remove popup boxes on the home page
3. Ratings are not working at all
4. How to change the size of the featured image in the post page itself
5. How to change the way that the thumbnails are generated so that the created one is more useful (the rollover image there is much better than the standard top left corner image)
6. Alternatively how to force it to use the alternative thumbnail option which doesn't seem to be working
7. How to make search work on tagsApril 11, 2011 at 11:09 am #43806
1. Navigation bar disappeared
Solution: I had to create a menu with the links which I wanted going across the top, the first item is the one covered by the home icon so I added in a link to the home page for that. No code, just add them in under Appearance > Menus
2. Popup boxes on home page
Solution: I found a new custom.js file by Dude in another thread on this topic – http://www.kriesi.at/support/topic/ (Purchase code hidden if logged out) I downloaded the file at http://www.mediafire.com/?yp4ssf1g42fjo7y and installed it and the pesky popups were gone.
4. Change size of image on single post page
Solution: In the functions.php file I changed
$k_option['custom']['imgSize']['L'] = array('width'=>610, 'height'=>260); // big preview pic for posts
$k_option['custom']['imgSize']['L'] = array('width'=>500, 'height'=>375); // big preview pic for posts
7. Make search work on tags as well
I added in the search everything plugin and set it up accordingly.
New questions added:
8. How to centre the image on the single post page (I'm not a php coder, I can't seem to figure this one out)
The topic 'Lots of questions related to configuring Expose to suit my needs' is closed to new replies.


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Michael Hitzges denies drinking on campus day after arrest
It was a typical Tuesday at Broad Run High School in Ashburn except for one notable absence.
A day after Broad Run biology teacher Michael Hitzges was arrested on accusations that he was drunk on campus, he says that by no means was he drinking on campus.
"I wasn't drinking at school," Hitzges said outside his Loudoun County apartment. "I had some drinks the night before, woke up and went to work.
"I wouldn't do that. I wouldn't put anyone in jeopardy."
Hitzges, who was charged with public intoxication, says that he was not drunk from the night before, either.
Loudoun County Sheriff's officials say that a school resource officer reported to administration that Hitzges appeared to be intoxicated at Broad Run on Monday. In an email to parents, Principal Doug Anderson said that the school was cooperating fully with authorities in the investigation.
Hitzges, 47, has been teaching at Broad Run since 2004, and parents remain concerned about the example being set.
"I don't think it's a very good influence for teachers to be at school, drunk, with teenagers," Broad Run parent Karen Haywood said.


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Staff Writer
DE LUZ CANYON -- Flames pushed by Santa Ana winds gusting more than 40 mph raced up the walls of De Luz Canyon on Wednesday, threatening homes and forcing evacuations.
By early evening, the fire had scorched about 130 acres, said Joanne Evans, spokeswoman for the California Department of Forestry.
"If the winds stay calm tonight, they should be able to get a good handle on the fire," Evans said. The fire's cause was suspicious and is under investigation, Evans said.
As flames spread in the rural agricultural area west of Temecula, fueled by avocado trees full of ripe fruit, residents rushed to their homes along De Luz and Carancho roads and gathered up pets and valuables. Some drove out of the rural area, while others stood beside firefighters, with home sprinkler systems dousing nearby landscaping, and watched a wall of fire move up the canyon walls toward their homes.
Christine Michaels of nearby Tortuga Road was among the first to spot the fire and call the Fire Department.
She and her husband then drove to their neighbor's house on Carancho Road to warn them.
"There was nobody home, but I got into the house and was able to rummage through some papers and find a phone number to call them," Michaels said.
Michaels said her neighbors had moved into their newly built home less than a month before. CDF crews and the homeowners arrived as the flames approached. Michaels and several others helped load valuables and pets into several vehicles. Flames never reached the home.
"We had four homes that were threatened but the crews were able to keep the flames away," Evans said. "It was tough to get our equipment and bulldozers in there because of the terrain."
Residents' efforts to remove brush from around their homes was a key to the buildings being saved.
"Every one of them did a really good job clearing that brush, and that really helped," she said.
The fire broke out about noon in the rugged canyon area about a mile south of the Santa Rosa Plateau Ecological Reserve and moved west, pushed by the strong winds.
"When we got here, it was just a small fire, but the winds really made it take off," CDF Battalion Chief Howard Windsor said.
Steady winds of more than 20 mph, with gusts of more than 40 mph, and relative humidity plummeting to just 10 percent contributed to the fast spread of the flames.
For most of the afternoon, a single CDF helicopter swooped inside the canyon, dropping water on flaming avocado trees that exploded as flames reached them.
"We had asked for two additional air tankers, but I guess they're busy with that fire down in San Diego County," Evans said.
Several CDF aircraft stationed at Hemet-Ryan Airport were sent earlier in the day to battle a blaze near Alpine in eastern San Diego County.
As darkness approached, two other helicopters joined the De Luz Canyon fire battle.
Twenty-three fire engines, four hand crews and 140 personnel did their best to surround the fire and keep it away from homes. No injuries were reported.
Riverside County and the rest of Southern California are currently under a "red flag" fire danger condition because of dry, windy weather and a lack of rainfall.
"However, this is really the off-season for fires, so we're not up to the capacity of fire equipment and personnel that would be available during the regular fire season," Evans said.
Contact staff writer John Hunneman at (909) 676-4315, Ext. 2603, or firstname.lastname@example.com.


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"Patients and doctors have found marijuana to be an effective treatment for suffering caused by debilitating medical conditions, Oregonians suffering from debilitating medical conditions should be allowed to use small amounts of marijuana without fear of civil or criminal penalties when their doctors advise that such use may provide a medical benefit to them and when other reasonable restrictions are met regarding that use."
We take pride in providing immaculate customer service for our Oregon medical marijuana patients and medical marijuana dispensaries.
Baked by coco © 2013


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The Ngäbe-Buglé (pronounced NAW-BEY) indians are Panama´s fastest growing indigenous group, with a total population of almost 200,000. At the the time of the Spanish conquest the Ngäbe lived around the coastal areas, but retreated into the mountains to escape the Spanish. They remained semi-nomadic until the 1960s, when the Panamanian government began building hospitals and schools in the predominately indigenous areas. In 1997, after centuries of struggle, the Ngäbe-Buglé succeeded in establishing their own Comarca (autonomous district), which has both traditional and modern authorities.
For centuries, the social structure of the Ngäbe was communal and the harvest was shared among everyone who helped during the planting season. Most families within the Comarca still practice subsistence agriculture and supplement their income with migrant labor in the coffee harvest and the sale of artisan work. A tradition that has not been lost is the use of the nagua, the brightly colored dress that most Ngäbe women wear. A Ngäbe legend explains that the triangle design is based on a pattern of snake skin. Long ago, a snake fell in love with a young Ngäbe girl and when her brother found them together, he lashed out at the snake and broke the pact of peace between humans and serpents.
Right now, the Comarca is at a crossroads between modern ways and ancient beliefs. As development becomes more prevalent in the Comarca, Ngäbe beliefs and traditions are dying out. One of the greatest challenges that faces the Ngäbe-Buglé is fiinding a way to live in the modern world without losing their unique culture.
The language of the Ngäbe people is Ngäbere – part of the Chibchan language family. The Chibchan languages extend from northern Columbia to the east of Honduras; however it is in the area of the Panama-Costa Rican border that the greatest variety of Chibchan languages exist. In Panama, four other languages are part of this same family – Kuna, Bugle, BriBri and Naso (Teribe).
Ngäbere is learnt by children from their mothers and families and the Comarca has its own local Ngäbere radio station. However, many people in Soloy and throughout the Comarca also speak Spanish and the children are taught in Spanish at the local schools. The need for indigenous Panamanians to speak Spanish is undoubtedly important – as it is often a means to access valuable educational and health resources as well as being instrumental in the defense of their rights. However, this can put pressure on native languages. According to UNESCO's Atlas of the World's Languages in Danger http://www.unesco.org/culture/languages-atlas/, Ngäbere is considered 'vulnerable,' – the lowest category that can be awarded after 'safe. ' Whilst Ngäbere is by no means nearing extinction and is spoken by most children it is limited to the certain domains such as the home. The Ngäbe are proud of both their culture and language, and as a visitor to the region it can be incredibly worthwhile taking the time to learn a little about Ngäbe culture and the Ngäbere language.
A variety of traditional artesanias are made by Ngäbe women. Naguas are dresses that are made from a bright colorful fabric called dacron and are worn by many Ngäbe women. Chacarás are traditional bags which have a variety of uses – from carrying large bags of rice and plantains to mobile phones and schools supplies. Chacarás are made from local plant fibers and natural dyes and artisan women often spend several weeks gathering the fibers from the forest and preparing them, before they are ready to use. The whole process from start to finish can take up to a month to make depending on the intricacy of the pattern. The Ngäbe also make beaded necklaces called chaquiras or in Ngäbere, ngununkua and hats called sobros. There are many traditions and rituals associated with the ancient practice of making artisanias. To learn more: http://medo.awardspace.com/ritualscustoms.htm
In Soloy there are many different faiths such as Methodist, Evangelical, Catholic and even Ba'hi. There is also form of traditional religion called Mama Tata (Mom and Dad). The Mama Tata religion was the revival of traditional beliefs by a woman named Besikö. Besikö had a vision which involved seeing the Virgin Mary who instructed her to preserve Ngäbe culture, as it was in danger of disappearing. This revival lead to the naming of the district Besiko in her honour and Besiko spent her life committed to the preservation of the Ngäbere language and Ngäbe traditions.


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Artist description:
this is my first ever drawing with the help of my wacom and the tutorials..thanks everyone:)
Flash Draw Created Jun 28, 2008 470 x 338px Unless noted Copyright 2008 mona.roman.
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Whao! Attitude position! Like it! 5
yeah its beautiful just had to say again Lol
its awesome really great yo


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ISO 13485:2003, specifies requirements for a quality management system that consistently provides medical devices and related services that meet customer and regulatory requirements specific to this industry.
"I am very proud that we have been awarded these certifications to demonstrate our commitment to the continuous improvement of our processes and to customer satisfaction," stated Martin Kunz, CEO of Eurofins MWG Operon, Inc. "These certificates are also an important step in the expansion of Eurofins MWG Operon products and services beyond research use only applications and into the diagnostics market."
The certificates can be viewed and downloaded at www.operon.com/company/certificates.aspx
About Eurofins MWG Operon
Eurofins MWG Operon, a member of the Eurofins Group with major offices and production facilities in the United States, Europe, and Asia, is an international provider of DNA sequencing services, DNA synthesis products, and bioinformatic services for academic and industrial research. The company's strengths are its strong customer orientation, fast service, and high quality. For further information, please visit our website at: www.operon.com.
Contact Information:
Paul Brown
Head of Marketing


text:
Results 1 to 5 of 7
Thread: I'm a proud godmother :)
Threaded View
May 22nd, 2013 09:23 AM #1
I'm a proud godmother :)
With permission from the proud mother i'm delighted to tell you the birth of my goddaughter.
Lovisa Adele were born on May 20th. She is the most beautiful little girl i have ever seen. Her mother and i have known each other since we were kids and i'm so happy to have the honor to be the godmother of her first child.
In a couple of years, it will be the other way aroundName nerd. Cat lover. Proud aunt to Ellen Lizzie 3/17/2015
Lovely Girls
Iris Margareta*Alma Josephine*Ophelia May*Ramona Juliet*Willow Beatrice*Phoebe Amelia*
Alice Theodora*Matilda Jane*Florence Mary*Edith Grace*Audrey Elisabeth*Rose Viviana*
Handsome Boys
James Henry*William August*Owen Frederick*Isaiah Paul*Sebastian Charles*Louis Andrew*
Caleb James*Wyatt Nicholas*Thomas Emilio*Alexander John*Samuel Evan*Gabriel Matthew*


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This article walks through updating an WDS infrastructure such that Hyper-V RTM bits are "slipstreamed" into the operating system installation. Given that Hyper-V has reached RTM (release to manufacturing), it was time to refresh my test deployment environment in my office anyway. I have an entirely private network segment here with its own domain controller and WDS server. I use this environment extensively for quickly deploying test operating system installations to both physical and virtual machines. (It's also helpful as I can get full dedicated gigabit networking – something which I can't get from corporate services here at Microsoft – this alone almost halves the overall installation time 🙂 )
There are a few resources you need to refer to start with:
1. Mikes posts on servicing from which I'm borrowing many of these instructions
2. The download for KB950049 x64 – This is the Hyper-V RTM bits for Windows Server 2008
3. The install.wim from Windows Server 2008 x64 RTM media. The WIM is present in the sources directory of the media.
4. The boot.wim from Windows Server 2008 x64 RTM media (for preparing the WDS server – outside the scope of this post)
5. The Automated Installation Toolkit (AIK) for Windows Vista SP1 and Windows Server 2008
6. KB928636 to provide more information on extracting an MSU
The first step is to expand the MSU into a directory by entering the following command "expand –F:* <pathtomsu> <folder>"
There are four files created. Windows6.0-KB950050-x64.cab is the file we are going to add to our master image. We need to now see what the list of images is in the WIM file. For the purposes of this walkthrough, I'm using Windows Server 2008 en-us x64 Volume License media which has six images in it.
From an elevated AIK Tools command prompt: enter imagex /info <pathtoWIM>
In order, the images are: Standard Full, Enterprise Full, Datacentre full, Standard core, Enterprise Core, Datacentre Core. To perform the update, you need a directory for a mount point. In my case, e:\mount.
For each of the images which are relevant to you, execute the following commands from an elevated AIK Tools Prompt:
- imagex /mountrw <WIM> <WIM Image Index> e:\mount
- start /w pkgmgr /ip /m:e:\950050\Windows6.0-KB950050-x64.cab /o:e:\mount;e:\mount\windows /s:%temp% (see note below)
- imagex /unmount /commit e:\mount
CAUTION: This procedure appears to hit a bug in the servicing engine and may not work correctly if you have previously run pkgmgr and have some stale files left over in the directory specified by the /s: parameter. It would be safer to either create a new blank directory and use that as the parameter value for /s:, or ensure that you completely remove the contents of %temp% before running the command. You may wish to add /l:<kbnumber>.txt as another parameter to the pkgmgr command, and look at the output log file <kbnumber>.txt.txt generated. It should be obvious if you are seeing servicing trying to match to an incorrect KB number.
Note that the second and third steps can take a little while to complete.
Now we need to add those images to the WDS server. For this walkthrough, I'm going to add an image group called "Hyper-V RTM Windows Server 2008 Images". From administrative tools, start Windows Deployment Services, navigate down to Install Images, right click and add an image group entering the appropriate name.
Once the image group is created, right-click on it and select Add Install Image. Use the wizard to walk through adding all the available images. I'm just using the default names for this walkthrough, but rename them as appropriate.
At this point, you're pretty much set.
Before we can use WDS, you also need to have prepared the boot images on the WDS server if you haven't already. I'd already previously added both x86 and x64 architectures. (Lots of information on this can be found in WDS documentation).
So let's PXE boot a physical server and install Windows Server 2008 Enterprise edition with Hyper-V RTM installed in the image. (I'm using an HP iLO on a Proliant DL380 G5 if you're wondering).
As I have both x86 and x64 boot images installed on the WDS server, I select my architecture. In this case, x64 is what I want as Hyper-V is not present as a role in Windows Server 2008 x86 SKUs.
Run through Windows setup as normal.
Once installation has completed and you log on, you will notice that KB950050 now appears out of the box as installed under Control Panel, Programs and Features, Installed Updates.
We still need to enable the Hyper-V role. Just use Server Manager on the Add roles button in Initial Configuration Tasks, walk through the wizard and reboot. Hyper-V Manager will then be present under administrative tools.
And, of course, you can use exactly the same mechanism to install Virtual Machines, the Windows Server 2008 x86 or Windows Vista SP1 x64 or x86 management tools (KB952627). Just add the right package to the right WIM. It's really that simple. There is a gotcha here for Vista SP1 virtual machines which I'll cover in a separate post soon. Also, there's one follow up post I'll do which shows you how to deploy Windows Server 2008 with Hyper-V RTM from WDS and get the Hyper-V role enabled at the same time, saving even more time on the overall installation.
Here's a Virtual Machine being installed from the WDS server. And the real beauty of this – I will have all the right components already installed in the virtual machine once installation completes. No need to use the Actions/Insert Integration Services Setup Disk and run setup in the virtual machine.


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- VFA and VFB: 150° Max.
- Model VFA: 5% of full scale
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Model VFA Dimensions
- Dimensions: 4-3/16 in. H x 1 in. W x 1-1/4 in. D
- BV or SSV (open): 2-1/16 in.
Model VFB Dimensions
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Visi-Float® Series Flowmeters are available from Amron in a broad selection of flow ranges and direct reading scales for air, gas or water.
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No, the flowmeter must be mounted in the vertical position.


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UFC welterweight Jason High was expected to take on newcomer Baneil Dariush at UFC Fight Night 35 on January 15, however an unexpected appendix surgery has forced High to withdraw from the bout.
High announced the fact that he wasn't able to fight via his official Twitter account.
Fuck appendicitis & anybody that love him. @MikeKogan Sorry @UFC & Beniel. Obviously wont be able 2 fight. *sad face* pic.twitter.com/9cunxK0g6x
— Marcelino Evil (@KCBanditMMA) January 2, 2014
After losing his UFC debut, High (18-4) has gone on to win two in a row. At UFC Fight Night 27 he defeated James Head via a nasty first round guillotine and followed that up with a unanimous decision win against Anthony Lapsley at UFC 167 in November.
No word as to whether the UFC is seeking a replacement for Dariush.
UFC Fight Night 35 goes down on January 15 from the Arena at Gwinnett Center in Duluth, Ga. The main event is a middleweight showdown between Luke Rockhold and Constantinos Philipppou.


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RELATED GRAPHIC: Map of Lyndhurst Street
GALLERY: A week on Lyndhurst Street
SERIES: A week on Lyndhurst Street
She let the strangers keep coming back after they gave her $20.
But Georgianna Richardson, 38, knew what was going on inside her kitchen and living room. The strangers were drug dealers, and they were snorting, packaging, and selling cocaine, all the while inviting outsiders to her first-floor apartment, she said yesterday.
Residents say that is the problem at 14 Lyndhurst St., one of two red-brick buildings at the center of the troubled area they call the Hell Zone.
Drug dealers take over some of the low-income apartments near Washington Street, and the tenants let them do it. The police know it happens. The neighbors know it. And even the landlord knows it. But despite drug busts, evictions, and community meetings, the problem does not go away.
''We've made hundreds of arrests, but we live in the world of probable cause," said Boston Police Captain Frank Armstrong, commander of Division C-11.
''If we hear of drug deals, we get down here," Armstrong said. ''My guys get set up, they observe, but they've got to see the sale."
Armstrong said he knows that some of the people who live in the Queen Anne-style mansions on the Allston Street end of Lyndhurst's single block would like him to order officers to arrest everyone who looks suspicious and hangs out on the Washington Street end, at the two troubled apartment complexes there.
But he said his job is to protect the rights of people living on both ends of Lyndhurst.
Some residents say landlords have to do more to ensure that crime does not happen on their property.
''Where are they?" asks Shirelle Gomes, who lives just two houses away from the Hell Zone. ''Why are they letting these people in their buildings?"
''I'm trying to clean it up," said Ted Ahern, who purchased 12 and 14 Lyndhurst Street last August for more than $1.1 million, according to state registry records.
Since he purchased the 12-unit building, Ahern, a lifelong Dorchester resident, said he has evicted 10 people, including Richardson, whom he kicked out last month because of her involvement with drugs.
Ahern rents to those willing to pay the market rate and to those who receive government assistance, including recovering addicts.
But before he lets them in, he said, he runs a criminal background and credit check.
And if there is any sign of trouble, Ahern said, he tries to find legal cause for eviction, such as an arrest record, he said. But that does not stop new dealers from moving in.
Sitting on the stoop of her old apartment building, Richardson, who said she was visiting friends, said she was a recovering addict.
She began living on Lyndhurst Street when her treatment center recommended it to her three years ago as a low-income option.
''I looked outside my window for weeks, and all I saw was drugs, people selling drugs, people doing drugs," said Richardson, who now lives in a homeless shelter. ''I'm a recovering addict. This place is not healthy for me."
But the dope dealers, she said, prey on the weak.
At first, Richardson refused to let the strangers into her apartment. A female drug dealer stabbed her in the arm. The woman also punched a hole through her window. The hole is still there.
Eventually, the dealers got in, she said. ''What they do is they knock on the door and ask to use your bathroom," she said. ''Then when they leave they hand you a $20 bill. They get you because they know you're in the heat of an addiction. They say here take this."
Richardson does not think she should have been evicted.
''We're the users, not the dealers," she insisted. ''I mean, I know I'm part of the problem, but I'm not the problem."
Drug dealers are among the problems the Rev. Bruce Wall has vowed to clean up during his weeklong occupation of Lyndhurst Street.
Yesterday, in response to a challenge from a man who warned Wall not to bring his people to Mora Street, Wall surprised the residents of Mora by showing up with police, including Commissioner Kathleen M. O'Toole and members of the Nation of Islam.
''You can't tell me that I can't come here," Wall said.


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How to Make the TV Remote Control Work for Your Brand
July 13, 2011
Michael Finn, president, and Kristin Youngling, design intelligence director, BrightLine, discussed interactive television (iTV) advertising and how marketers can use it to increase consumer engagement with their brands.
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text:
Ten years ago I got saline implants (just under 400cc). I went from an "a" to a "dd." they are soft and very natural looking but I feel they are too far apart. I know an implant alone will not fix this. Is it safe/possible to have a fat graft during an augmentation surgery to create closer/full cleavage?
Implant Plus Fat Graft Safe?
Doctor Answers 5
Breast Implant Plus Fat Grafting?
Fat grafting has become a very powerful procedure for secondary breast augmentation procedures. This can be very effective in creating better cleavage, upper pole fullness, or increase the tissue thickness over the implant. It has become almost routine to perform fat grafting to the breast while performing breast augmentation revisions.
Fat transfer
It's a bad idea. It probably won't work, but in addition it will increase your risk of infection. Breast implants often fall to the side with time. A more effective procedure is to have the lateral implant pocket closed off by suturing it from the inside. However, it also has the risk of the implants gradually working their way apart from each other over time. If the implant separation is only slight, I would advise against surgery.
Fat grafting to breasts to add cleavage
Hi Blair,
It is highly unlikely that a fat graft would correct the problem you are describing not to mention all the related risks and complications associated with fat grafts to breasts. Tightening the pockets laterally to push the implants toward the center will usually fix the problem. Best wishes,
Dr. H
You might also like...
Fat grafting in revisional breast surgery
The first question I would ask is whether the fundamental problem is related to the implant position or whether it is related to the fundamental structure of the breasts.
If your breasts were not originally widely spaced, then this may be a matter of the implants drifting off to the side. Surgery to tighten the implant pocket on the sides might help to return the implants to their proper position.
On the other hand if your fundamental breast structure is widely spaced, then fat grafting may be helpful.
Please be aware that this procedure carries some controversy and it is important to discuss your plan in detail with a board certified plastic surgeon who is highly experienced in revisional breast surgery.
Implants, Fat Grafting, cleavage
Without seeing pictures of you it is impossible to render an informed opinion. That having been said, your implants may be too far apart due to your anatomy or due to lateral drift of your implants. If excessive lateral drift is the problem, closing off the lateral aspect of the implant pocket may improve your cleavage. Of course a bigger/ wider implant may do the same but that is usually temporary as the increased weight of the implant stretches the pocket back out. Fat grafting is unlikely to help with your stated goals. Hope this helps!
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.


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Search Results
Entries tagged with "
Social Signal"
April 15, 2007 5:24 PM
SPOS #47 - Word Of Mouth Chatting tagged "Social Signal"
Welcome to episode #47 of Six Pixels Of Separation - The Twist Image Podcast. There are some killer word of mouth marketing insights here. This includes a very special What Is Your Blog And/Or Podcast? and a twelve minute tea-induced... Read more


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I draw my inspiration from the countryside, towns, villages and the sea close to my home, as well as the wooded valleys and the moorlands of the region.
I try to capture the spirit of these places I know so well and visit so often and I find the energy and architecture of urban spaces irresistible.
I absolutely love drawing on location, trying to capture the scene in front of me in that moment in time.
Original Artwork
Original artwork, including watercolours, inks, acrylics and pastel paintings all created using Artist quality materials.
Limited Edition Prints
Limited edition prints on heavyweight fine art paper signed by the artist. Light fast and fade resistant for up to 80 years
Mini Prints
Produced on heavyweight top quality fine art paper, fits a standard 8 x 10in photo or picture frame, complete with mount.


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Product ID: 041-8434
The Nikon SlugHunter 3-9x40 Matte BDC-200 Shotgun Riflescopes 8434 have one piece main body tube construction. Nikon's SlugHunter 3-9x40 Riflescope multicoated lenses allows for (92%) light transmission and sharpest image quality and Quick Focus Eyepiece allows the shooter to instantly bring the reticle into sharp focus. The 100% Waterproof,Shockproof and Fogproof construction of these Nikon SlugHunter 3-9x40 BDC-200 Shotgun Riflescopes 8434 is engineered to meet the demands of the most extreme hunters. The Versatile Magnification Range (3-9 Power Zoom) of these Nikon 3-9x40 Riflescopes provides outstanding flexibility for up-close shots as well as long-range shots. The Nikon's SlugHunter 3-9x40 Shotgun Patented BDC 200 Reticle integrates unique,easy-to-see ballistic circles that provide instant aiming points and take the guesswork out of holdover at longer ranges. The Nikon's SlugHunter Rifle Scope's precise 1/4-minute click reticle hand-turn adjustment gets you zeroed-in quicker and maintain your setting even with heavy recoil. This Nikon SlugHunter 3-9x40 Riflescope is the perfect choice for hunters. Compact size of this Nikon SlugHunter Shotgun ideal fit for high-caliber slug guns. This Nikon SlugHunter BDC 200 Shotgun designed specifically for Sabot Slug Gun loads like the Hornady SST,Remington Copper Solid,Winchester Partition Gold,Federal Premium and Lightfield Hybrid. Nikon is so confident in the fact that your Nikon SlugHunter 3-9x40 BDC-200 Shotgun Riflescopes 8434 are durable and reliable,that they offer a generous Lifetime Full Warranty. In addition,Nikon also offers a No-Fault Policy - which means that if the service or repair required for your Nikon SlugHunter 3-9x40 BDC-200 Shotguns 8434 is not covered by the original Lifetime Full Warranty,Nikon will still repair or replace the Riflescopes,even if the damage was your fault,for just $10 plus return shipping and handling. This will not only save money,but will also give you the much needed peace of mind in knowing that the Riflescope you have purchased is a high quality product with a well known and respectable company behind it.
Features of Nikon SlugHunter 3-9x40 Matte BDC 200 Shotgun Riflescopes 8434


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An Argument Against Cuts to Medicare and Social Security
Republicans have proposed changes to so-called entitlements such as social security and Medicare to reduce the U.S. deficit. But Max Richtman of the National Committee to Preserve Social Security and Medicare says these aren't entitlements, but earned benefits. He tells Judy Woodruff why these programs shouldn't be changed.
Aired: 12/06/12


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WWR Stardom: Women's Wrestling!
Discuss wrestling happening everywhere that isn't WWE or TNA.
Post Reply
Re: WWR Stardom: Women's Wrestling!
Hojo is going to WWE?! Solid acquisition. They already have Evie, now they've got Hojo, I can't help but feel that Kellie Skater might have gotten her chance too.
As of April 1st, 2016,the first entry in my Gold & Steel fantasy series, As Fierce as Steel, is on sale. Visit www.thegoldandsteelsaga.com for more!
Re: WWR Stardom: Women's Wrestling!
I wrote a thing. From the bottom to the top: The Journey of Mayu Iwatani: https://www.reddit.com/r/stardomjoshi/c ... y_of_mayu/
Re: WWR Stardom: Women's Wrestling!
I wrote another thing. This time a detailed beginner's guide to Stardom: https://www.reddit.com/r/stardomjoshi/c ... _you_ever/
Re: WWR Stardom: Women's Wrestling!
A free match from Stardom: HZK & AZM Vs Jungle Kyona & Natsuko Tora:
https://twitter.com/we_are_stardom/stat ... 2017985536
https://twitter.com/we_are_stardom/stat ... 2017985536
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text:
Effect of Spinal Ketorolac After Acute Opioid Exposure
- Full Text View
- Tabular View
- Study Results
- Disclaimer
- How to Read a Study Record
This research study is being done because pain is a significant problem for patients with a variety of medical problems and following surgery or traumatic injury. Currently available pain medications may not treat all types of pain or may treat pain only at doses that produce side effects and complications. The medication in this study may have a role in better treatment of pain. The goals of this study are to see if a dose of ketorolac (non-narcotic, pain reliever), given into the fluid in the back near the spine has any effect on pain or discomfort in the skin sensation that will take place after applying capsaicin (chili pepper) cream. The sunburn-like sensation that people experience after having capsaicin cream applied is similar to, but much milder than, the pain that some people have after surgery and after certain types of nerve injuries. This study will test the effects of combining two medications that are often given together to control postoperative pain or pain from a nerve injury. The investigators are especially interested in answering two questions about the effects of ketorolac (non-narcotic pain reliever) and remifentanil (intravenous [IV] narcotic painkiller):
- How much does remifentanil (narcotic painkiller) affect the sunburn-like painful area on your skin, which develops after applying capsaicin cream?
- What pain relieving effects does spinal ketorolac have when given with IV remifentanil?
|Drug: ketorolac Drug: placebo Drug: remifentanil Drug: Capsaicin
|Phase 2
|Study Type:
|Study Design:
|Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary Purpose: Basic Science
|Official Title:
|Effect of Intrathecal Ketorolac on Mechanical Hypersensitivity Following Acute Opioid Exposure
- Hyperalgesia [ Time Frame: 24 hours ]Total Area of hypersensitivity (measured in centimeters) were assessed approximately 24 hours post intrathecal ketorolac injection by the method of using a von Frey filament
- Cerebrospinal Fluid (CSF) Prostaglandin E2 (PGE2) Concentration [ Time Frame: 2.5 hours ]Concentration of prostaglandin E2 (PGE2) in Cerebrospinal fluid (CSF) 2.5 hours post injection of intrathecal ketorolac
|Study Start Date:
|December 2007
|Study Completion Date:
|January 2011
|Primary Completion Date:
|October 2010 (Final data collection date for primary outcome measure)
|Assigned Interventions
Experimental: Intrathecal Ketorolac
In the presence of a remifentanil infusion subject will receive a single intrathecal injection of ketorolac 2 mg Each subject will receive the topical capsaicin model for hyperalgesia and allodynia assessment.
Drug: ketorolac
single intrathecal injection of ketorolac 2 mg
Other Names:Drug: remifentanil
All subjects will receive a remifentanil infusion
Other Name: ultivaDrug: Capsaicin
Topical capsaicin pain model utilized for each subject
Placebo Comparator: Placebo intrathecal injection
In the presence of remifentanil the subject will receive a single intrathecal injection of placebo (preservative-free normal saline) Each subject will receive the topical capsaicin model for hyperalgesia and allodynia assessment.
Drug: placebo
subject will receive a placebo (preservative free normal saline) spinal injectionDrug: remifentanil
All subjects will receive a remifentanil infusion
Other Name: ultivaDrug: Capsaicin
Topical capsaicin pain model utilized for each subject
Detailed Description:
Intravenous (IV) remifentanil stimulates spinal COX activity, leading to increased Cerebrospinal fluid CSF) prostaglandin E2 (PGE2) concentrations and areas of capsaicin-induced mechanical hypersensitivity after remifentanil infusion, and these effects will be blocked by intrathecal ketorolac.
Areas of mechanical hyperalgesia and allodynia will be established by topical capsaicin + intermittent heat in healthy volunteers, who will be randomized to receive intrathecal saline or ketorolac during remifentanil infusion, with primary outcome measure area of hyperalgesia and secondary outcome measure Cerebrospinal fluid (CSF) prostaglandin E2 (PGE2) concentration after stopping remifentanil.
|Ages Eligible for Study:
|18 Years to 55 Years (Adult)
|Sexes Eligible for Study:
|Accepts Healthy Volunteers:
Inclusion Criteria:
- healthy
- American Society of Anesthesiologist (ASA) I or II classification
- between the ages of 18-55
- weigh less than 250 pounds
- without chronic pain
Exclusion Criteria:
- taking analgesics in the last 2 weeks
- positive urine drug screen
- pregnancy
- currently taking any prescription antidepressants or other medications that are mood altering
- liver or kidney disease
- stomach ulcers
- allergies to ketorolac, lidocaine, or capsaicin cream
- lung disease (COPD)
Please refer to this study by its ClinicalTrials.gov identifier: NCT00693160
|United States, North Carolina
|Wake Forest University Health Sciences
|Winston-Salem, North Carolina, United States, 27157
|Principal Investigator:
|James C. Eisenach, M.D.
|Wake Forest University Health Sciences
|Responsible Party:
|James C. Eisenach, M.D., Professor, Wake Forest University Health Sciences
|ClinicalTrials.gov Identifier:
|NCT00693160 History of Changes
|Other Study ID Numbers:
|Study First Received:
|February 15, 2008
|Results First Received:
|May 15, 2013
|Last Updated:
|January 29, 2017
Keywords provided by James C. Eisenach, M.D., Wake Forest University Health Sciences:
healthy volunteers
Healthy subjects
Additional relevant MeSH terms:
Ketorolac Tromethamine
Analgesics, Opioid
Central Nervous System Depressants
Physiological Effects of Drugs
Sensory System Agents
Peripheral Nervous System Agents
Hypnotics and Sedatives
Anesthetics, Intravenous
Anesthetics, General
Anti-Inflammatory Agents, Non-Steroidal
Analgesics, Non-Narcotic
Anti-Inflammatory Agents
Antirheumatic Agents
Cyclooxygenase Inhibitors
Enzyme Inhibitors
Molecular Mechanisms of Pharmacological Action
Dermatologic Agents
ClinicalTrials.gov processed this record on September 21, 2017


text:
Here on offer is our Ex-Display Project debut MKIII in silver, The Turnatble is in mint condition with all accessories and with the original box (although this is a little tatty)
A great budget turntable with amazing performance and able to get the most from your records, the Project Debut MkIII turntable comes with an Ortofon OM5E cartridge fitted as standard. Featuring a low noise, decoupled AC motor driving a sub platter and main platter with 1.3kg sheet steel for improved inertia via a flat rubber drive belt. The MDF plinth is available in five different finishes and is isolated from viabration by four soft rubber feet which also enable leveling . The Project 8.6 aluminium tone arm is fitted with an Ortofon OM5e cartridge and is ready to be plugged into a standard phono amplifier input. A clear acrylic dust cover completes the package.
There are no reviews for this product yet. Be the first to write a review.
Providing your item is in stock, the order is usually dispatched within 24 hours. Please remember that postage and packing is completely free for orders over £50*. Out of stock items will be dispatched as soon as they become available, out of stock items can take between 4 to 21 days for dispatch.
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Time in Norway: 10:42 PM
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From some of the founding artists of the Washington Color School movement to some of the greatest representational painters today, many of the regions most notable artists have taught at The Art League over the last 60 years. Showcasing extraordinary works of art, "Influence and Inspiration" highlights the League's finest past and present faculty in the historic Athenaeum space.
Works by famed Washington Color School artists and past Art League instructors Sam Gilliam and Lou Stovall will be featured alongside current faculty including Kurt Schwarz, Danni Dawson, Ted Reed, and Rob Liberace. This collection of artwork represents the immeasurable amount of influence and inspiration League faculty have provided to tens of thousands of students, Alexandria, and the region over the last six decades.
In addition to the faculty exhibit, a narrative video featuring student experiences, journeys, and testimonials will be on view.
Exhibit dates: August 7–September 21, 2014
Exhibit location: The Athenaeum, 201 Prince Street, Alexandria, VA 22314
Exhibit hours: Thursday & Friday: 12:00 noon–4:00 pm; Saturday: 1:00–4:00 pm; Sunday: 12:00 noon–4:00 pm; Closed Monday–Wednesday
Reception: Sunday, September 7, 4:00–6:00 pm
This exhibit is free and open to the public.
Promotional support for this 60th Anniversary event has been generously provided by the Alexandria Marketing Fund.


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On Mon, 19 Jul 1999, Stuart Rison wrote: > Another 'lost' mirror is http://sunsite.doc.ic.ac.uk/www.postgresql.org/ > > the server is currently down for major repairs but the mirror seems to have > been discontinued long before that (you could still get a page but it was > the 'pre-blue period' mostly yellow elephant page). > > Is it lost forever? The only mirror I have for the UK is: postgresql.rmplc.co.uk The mirrors and sites pages on http://www.postgresql.org/ are updated regularly. Vince. -- ========================================================================== Vince Vielhaber -- KA8CSH email: vev(at)michvhf(dot)com flame-mail: /dev/null # include <std/disclaimers.h> TEAM-OS2 Online Campground Directory http://www.camping-usa.com Online Giftshop Superstore http://www.cloudninegifts.com ==========================================================================
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Issued by the Falkland Islands in 1990, this 4 coin set has a total Gold content of 1.85 Troy ounces. This set celebrates the 90th birthday of Elizabeth Bowes-Lyon, the Queen Mother. As the mother of Queen Elizaberh II, she remained in the public eye for decades, and was always a very popular figure for Britons. This set has a limited mintage of 750, and is complete with box and COA from the British Royal Mint! Listed in Krause as PS8.
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The University of South Australia Alumni Taiwan keeps graduates connected to the networks and resources of the University and offers graduates living in Taiwan access to a range of activities for professional, personal and career development.
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PRZOOM - /newswire/ -
San Jose, CA, United States, 2011/02/03 - Nagarro, Inc.a high-end software development firm specializing in complex projects, is reporting a significant jump in spending by large enterprise customers in 2010. Last year, Nagarro signed new contracts with several multi-billion dollar company.
News Facts:
In 2010, Nagarro signed new outsourced software development deals with eight multi-billion dollar global enterprises across the US, Latin America and Europe, spanning a broad range of industries including industrial manufacturing, retail, healthcare, technology, consumer goods and automotive. New enterprise customer engagements in 2010 were heavily focused on business intelligence and custom analytics applications, resulting in a 50% jump in the growth of Nagarros enterprise analytics practice since 2009.
Nagarro also won additional business from many of its existing enterprise customers, who increased their overall spending by 95% in 2010, nearly doubling spending over the previous years totals.
Nagarros new enterprise customers include: Swedish-owned Assa Abloy, the worlds largest seller of high-end locking mechanisms; CCM (a subsidiary of Heineken), a major Mexican beer bottler and bottling manufacturer; Oxxo, Mexicos largest convenience store chain, with more than 7,000 outlets; a US-based global provider of premium skin care, makeup, hair care and fragrance products; a US-based technology and industrial company serving automotive and construction customers in over 150 countries; a leading global enterprise software application vendor; a US-based provider of automotive market forecasting and advisory services; and a large North American rail industry equipment and services provider.
In addition to considerable growth in the enterprise customer market, Nagarro signed on more than two dozen new small and midsize customers in five countries, maintaining the companys established track record of growth and profitability across its worldwide operations. Nagarros new U.S. customer wins in 2010 include: The Fund for Public Health in New York, Inc.; Prenova, Inc.; Vanderbilt University; and several others.
Other European customer wins in 2010 include Helveta, Ltd., a provider of supply chain management and asset management software for extended global supply chains. Major international airline company Lufthansa was one of numerous existing Nagarro customers who ramped up spending on Nagarros application development services last year. Overall revenue from European customers more than doubled in 2010.
Nagarros Latin American operations expanded significantly in 2010, launching two new enterprise customer engagements. The company has brought on a Director of Sales, Rodrigo Cruz, who heads up Nagarros Mexican sales team.
Nagarros new customers are driving the companys hiring and growth in core technical offerings such as analytics, SharePoint, leading business intelligence tools, Microsoft .NET and Java development services, and Nagarros SAP consulting practice.
Summary of Nagarro highlights in 2010:
Named to the International Association of Outsourcing Professionals® 2010 Global Outsourcing 100® List and 2010 Global Services 100 List.
Selected as an SAP BPM best practices case study showcased at SAPPHIRE 2010 and featured in SAPs industry publication, Applying Real-World BPM in an SAP Environment.
Hired more than 350 new employees across India, the US, Sweden, Mexico and Germany.
More than doubled its enterprise sales growth in 2010.
Doubled its analytics application services business in 2010.
Assa Abloy has been highly impressed with Nagarros work for us to date. The quality of Nagarros development teams and their sense of responsibility for our core business objectives have made it possible for Assa Abloy to exceed its goals. We look forward to a successful and expanding long-term relationship with Nagarro. - Ardeshir Nahani, R&D manager, Assa Abloy
In 2010, Nagarro was able to add more value to our enterprise clients than ever before. Not only did we bring on new large enterprise clients by helping them with their key strategic initiatives, we took the relationships with our existing clients to unprecedented levels. In particular, we are seeing a boom in custom analytics and business intelligence projects for the enterprise, with strong signs of continued momentum in 2011. - Vikas Sehgal, CEO, Nagarro, Inc.
About Nagarro, Inc.
Nagarro (nagarro.com) builds complex, business-critical products and applications that help companies meet their core business goals and gain competitive advantage. Nagarros complete commitment to the success of every project, unmatched engineering skill and quality, and deep domain expertise in numerous industries build on a shared vision of success between Nagarro and each of its customers. Founded in 1996, Nagarro has offices in the US, Mexico, Germany, Sweden and India.
Agency / Source: Nagarro, Inc.
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Waldorf shooting: Teresa Bass shot to death, husband critical
Police say a man and woman were shot while walking their dog on a path behind Westlake High School in Waldorf Friday evening.
Police say a man walked up to the couple and opened fire. It appears to have been a random attack.
Teresa Ann Bass, 40, died at the hospital shortly after. Her husband, whose name will not be released, remains hospitalized in serious condition.
Katie O'Malley-Simpson of the Charles County Schools says there was a football game at Westlake, but there was no impact on the game.
A medical helicopter landed on school property to transport one of the patients because of the space available to land and its close proximity to the shooting scene,. O'Malley-Simpson says.
A neighbor tells ABC7's Richard Reeve at least two shots were heard.
Police say there is no known suspect or motive in the shooting. A reward leading to an arrest has tripled to $15,000.
The suspect is described to be a black man in his early twenties with a light complexion. Police say he's about 6'0 with a slim build and he may have short, curly hair.
"Anyone who knows our agency knows we will leave no stone unturned and will pursue every investigative lead to identify the suspect. We hope the increase in the reward will generate tips and we strongly encourage anyone with information to call our detectives or the Crime Solvers line. Callers can remain anonymous," said Sheriff Rex Coffey.
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Y&R Summer Press Tour Photo Gallery
All My Children
It's no secret that Erica and Krystal aren't exactly best friends, however they do have one major thing in common. What could that be? Aside from both of them being Mrs. Adam Chandler at one time or another, these over protective mothers want to keep their children away from each other. Why's that? You can probably figure that out for yourselves, but how will they go about it? Will they team up to make sure Babe and Josh stay on opposite ends of town? It's possible, but if they do, these ladies are losing their touch as Josh and Babe go away on business together. Awfully cozy, maybe even a little too cozy. Will anything romantic transpire between the two? You'll have to watch to find out, all we know is Babe tries to keep her little excursion a secret from her husband. Will she succeed? Or will JR find out about it all on his own? Meanwhile, Lily turns to the Internet to chat up new friends. Will she meet anyone she can feel comfortable with? It seems so as she starts chatting with a friendly teen and agrees to meet with him in person. Is this a good idea, or is she setting herself up for trouble? It appears to be the latter, because as we already know, the "teen" turns out to be none other than Terry the predator. What will happen when Lily goes to meet her new "friend?" Will she find herself in danger or will she figure things out before it's too late? Find out if Lily walks into or avoids Terry's trap this week when you tune in to All My Children.
As the World Turns
Meg is back to work at the hospital. How did she swing that? It doesn't really matter as the nurse is back in action, but how will her first day go? Let's just say her first patient proves to rub Meg the wrong way. Who does she tend to? Unfortunately for her, it turns out to be Emily. But what does Emily need and will Meg be able to remain professional? Across town, Gwen finds a photo of Casey with a mask on. What's the significance? Apparently, it's the same mask the slasher wears. Uh-oh, does Gwen have reason to be worried for her safety? Maybe not as he tells her the mask is actually Maddie's. So what's the deal, could either Casey or Maddie be the slasher? Will this mask be the clue that brings them closer to his/her identity? Can't say for sure, but it looks like the teens all head up to the lake for a little escapism. Can they kick back and relax or do they have reason to fear the slasher even there? Across town, Jack gets upset with J.J. Why's that? What's his adopted son done now? We hear he starts talking in an Australian accent. That can't go over well, but what will Jack do when faced with Simon's perceived intrusion in his family's lives? You'll have to watch and see, but does this mean Simon and Carly are spending more time together and getting cozier? They just might as Carly later walks in on Simon naked. Is this just a coincidence or is it planned? More importantly, will they act on the situation or will Carly run out of the room embarrassed? Get the low down on all things Oakdale this week on As the World Turns.
The Bold and the Beautiful
It looks like Stephanie comes across a bound Taylor and an unconscious Hector in a burning house. Will she save them? Eventually maybe, but not until she gets some of her questions answered. What does she want to know and will it satisfy her curiosity enough to rescue them? Meanwhile, Lt. Baker gives Thorne some things to think about. What does he tell the grieving husband? Whatever it is it brings Thorne to a devastating realization. Does this mean Taylor's secret is out? Does Thorne now believe Taylor was responsible for Darla's death? As for the third accessory after the fact, Phoebe is found in a delusional state. What's happened to her and who finds her? The buzz is her grandfather comes upon the distraught Forrester. How does he find her and can he bring her back to reality? In the meantime, our sources tell us "an epic must see moment" is in the works that will change the lives of your favorite characters forever. What will happen? We can only tell you that it's an edge of your seat week, so don't miss a second of The Bold and the Beautiful.
Days of our Lives
Abby is furious and directs her anger at someone specific. Who's she so mad at? That would be her almost stepdad, Frankie. But why's she so upset? We only know she wants him out of their lives for good. How will Frankie take her tirade? Furthermore, how will Jennifer react to what her daughter has to say? Meanwhile, it looks like the cat's out of the bag as...
Lexie tells Shawn and Philip they should submit to a DNA test in regards to Claire. How did they find out Philip might not be her father? Will they get to the bottom of her true parentage? And just how will Philip take this latest blow to his and Belle's relationship? As for Belle's sister, Sami finds herself arrested. What'd she do this time? We don't have those details, but we do know EJ is involved. Is he the reason she ends up in the slammer? More importantly, will this affect her wedding? Find out if Sami spends her wedding night in jail or makes it to the altar this week on Days of our Lives.
General Hospital
As memories of Stone's death continue to plague her, Robin struggles to deal with the effect AIDS has had on her life. Will she ever be able to put his death behind her? She certainly tries, but current events prevent her from doing so. What happens this week to trudge up old memories? Sadly, her new friend April dies on what would have been Stone's birthday. Talk about a tragic coincidence. How will this impact an already emotional Robin? Understandably she's devastated and tries to push Patrick away when he offers to console her. But will he walk when Robin puts up her defenses? Or will Dr. Drake stick by the women he professes to maybe someday love? Elsewhere, Sam is reeling from the news that Alexis has cancer. How will she handle this turn of events? The only way she knows how and that's to turn to Jason for support. Will he be there for the woman he's spent months pushing away? Will this be the catalyst that brings them back together? We can't give out all the answers, but we can tell you that even in her time of need Sam reaches out to help someone else. Whose back does she have? That would be Elizabeth's as she promises to keep her secret about sleeping with Jason. Mighty big of her, but will Sam truly be able to do that and will Liz be able to keep Lucky in the dark about her one night stand? It's gonna be an emotional rollercoaster, so grab a hankie, strap in and go along for the ride this week on General Hospital.
Guiding Light
Alan-Michael continues to pursue Ava in regards to working for him. Will she take him up on his offer? It seems she's unsure and Coop weighs in with his opinion. Does he encourage her to work for his niece's ex-boyfriend? Or does he think it's a bad idea? Meanwhile, Lizzie is arrested. What's happened? Oh that's right, she shot her grandfather. But did she do any damage? Will she go to the slammer or will the charges be dropped? Don't know for sure, but it looks like things get worse for the young mother-to-be when she's served with papers claiming she's an unfit mother. Who would petition such a thing? Only one person we can think of. So does this mean Alan's bounced back from the shooting so soon? Meanwhile on the internet, SpringfieldBurns.com has more than one person in their sites this week. Who do they take aim at? Our sources tell us they target Olivia in addition to Josh and Cassie. What do they post in regards to them? What are they after? Will the person behind this website ever be revealed? Don't know, but you can bet everyone wants to know who it is as a bounty has been placed on the blogger. Will this prove successful in drawing the mystery person out? Elsewhere, while pondering the fate of her marriage, Mel tries her hand at two other men in town. Who is she after? Apparently, she goes out with a colleague and then throws herself at Jeffrey. What exactly is going on? Will anything come of these interactions? More importantly, does this mean she's done with Rick for good? Or could she possibly change her mind? But if she does will it be too late? Juicy things are in store, so make sure you tune in to Guiding Light all week.
One Life to Live
After Blair accepts Spencer's marriage proposal, Todd becomes more suspicious of her than ever before. Will he get to the bottom of what she's been up to? It appears so, but not before he figures out Starr has been faking her amnesia. How does he uncover what his precocious daughter has been doing? Will he tell Blair? It seems not, but he does confront his ex-wife on what her real motives are with good ole Spence. What will she have to say for herself? Perhaps she can't take Todd hating her anymore because she finally confesses all to the man she loves. How will he take this new twist? Pretty well apparently, as the exes end up making out and then making love. So is all forgiven? Will they be able to put their relationship back together after Blair reveals all she's done to make things right with Todd? Or will he remain stubborn and refuse to forgive her? Don't miss this major step in the Manning's relationship this week on One Life to Live.
With the leverage he has over him, Spike forces Chris to help him out of a tight situation. What has Spike got involved in now? Will Chris help him out? It looks that way as Spike later orders Chris to betray Sheridan again. What does the slimeball want Sheridan's husband to do? Will Chris be able to go through with it? Meanwhile, it looks like Luis is on to Chris as he...
receives proof of a link between him and Spike. What does he discover and who sent it to him? More importantly what will he do with this newfound information? Whatever happens, it seems Luis has other things to tend to as he has a steamy encounter with Fancy. Under what circumstances do they find themselves drawn to each other? Will they act on it? In other parts of Harmony, Jared helps Theresa. How does he do this? Word around town is he assists her in standing up to Julian and Ethan. But why does she need his support and what is she going head to head with them about? You'll have to watch to find out, but we also hear Jared later accepts Theresa's offer. What's on the table? Does it have to do with work or something else? Jump in and mix things up with Harmony's finest this week on Passions.
The Young and the Restless
Nick's committed to a new relationship, but that doesn't mean he's forgotten about his old one. What happens to make him worry about Sharon? Will he reach out to his ex in order to help her out? More importantly, would she accept his assistance? Meanwhile, Jack apparently embarks on a cruel stunt that would prohibit Gloria from mourning John. What does he do to his step mother? Don't know for sure, but it certainly leaves Michael, Lauren and Kevin more than a little upset. Will they be able to do anything on their mother's behalf? Or will Jack have the last laugh? At the same time, Colleen is crushed by her grandfather's death and turns to someone for comfort. Who does she go to? JT of course, but does this mean they've put everything behind them? Or does she just need him to get through her grief? Visit Genoa City this week for the inside scoop on The Young and the Restless.
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With two teenagers, I cannot tell you how many times a day I hear "What can I have for a snack?" My 14 year old alone eats enough for two people and still manages to be thin. I try very hard to be aware of what snack foods I bring into the house. Yes, we splurge occasionally, but for the most part I make sure we have healthy food in the house for the kids to snack on. If they are healthy and gluten free, that's an even better choice since my daughter is gluten intolerant.
Probar Fruition gluten free bars
We're very familiar with ProBars gluten free bars. I love their original and Halo bars for snacks because they are not only good for you but they taste good. ProBar has a new gluten free bar out that I haven't seen yet in our grocery stores called Fruition. Fruition is a fruit based superfood snack bar that is gluten free. They contain dates, gluten-free raw oats, chia seeds and cashews and are available in six real fruit flavors. Each Fruition bar contains and entire serving of fruit. This is a great way to get your kids to eat healthier. These gluten free bars are available in peach, blueberry, strawberry, lemon, chocolate orange, cherry, and cran-raspberry. The bars have 4 grams of fiber and only 2 grams of fat! Each bar has between 160 and 170 calories which is totally doable for a snack. I love that they are certified organic as well!
I try a lot of healthy snacks because I tend to be rather picky. I've noticed that some snack bars that are labelled as high fiber and healthy are very dry which is a total turn off for me. Like the other types of ProBars I've tried in the past, the Fruition are actually very moist and pleasantly chewy. The fruit flavors really come through wonderfully and the chia seeds give them a great texture. After trying each of the flavors, I think that the peach is my favorite although it was hard to choose and the strawberry came in a very close second.
I hope to find this variety of ProBar gluten free bars in my store soon. They do have a store locator on their site that you can use or they can be purchased online.
One of my lucky readers will win a mixed box of ProBar Fruition gluten free bars to try!
Disclosure of Material Connection: I received one or more of the products or services mentioned above for free in the hope that I would mention it on my blog. Regardless, I only recommend products or services I use personally and believe will be good for my readers. I am disclosing this in accordance with the Federal Trade Commission's 16 CFR, Part 255: "Guides Concerning the Use of Endorsements and Testimonials in Advertising"


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The Elk River Elks dominated the second half against a cold-shooting Brainerd team and defeated the Warriors 49-29 at home Saturday afternoon.
Senior forward Clay Elrod had just four points at halftime with the Elks up just 21-17, but poured in 16 in the second half for a game-high 20, along with 11 rebounds. Elrod was 6-for-6 at the line and 2-for-6 on three's.
Junior guard Mitchell Weege added 13 points for the Elks (8-2), who shot 16-for-41 from the field and 13-for-16 at the line. They were 4-for-17 on three's.
Brainerd (4-5) made just 22 of 72 shots. Top scorers were Kobe Ahonen with nine points and Clark Hickman with eight.
Elk River will resume conference play hosting Maple Grove on Friday.
Elk River scoring — Matt Keller 2, Jarin Haywood 5, Zeke Delain 4, Clay Elrod 20 (11 reb), Mitchell Weege 13, Devell Miller 5