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A review, a review!
My kingdom for a review!
I have tutored VCE (and younger year levels) Chemistry and Biology over the past 10 years. I also tutor chemistry to university students. I completed my PhD in chemistry in 2015, during which I became a first year chemistry university lecturer at Monash University. Following my PhD I moved to Ireland to work at Trinity College Dublin to lecture first year and third year chemistry.
A typical lesson would involve looking into content learned that week in the classroom and clarifying any points of confusion. Towards the end of our session I would then give some background into what you will learn during class next so you can stay on top of the material while it is being taught in the classroom. Each session will also cover 3 - 5 practice exam questions on the topic being studied to prepare you for SACs and the style of exam questions to expect.
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The biggest gift spiritual direction offers is the listening presence of another, be it individual or group spiritual direction, face-to-face or virtual.
This "Spiritual Practice for the Day" from spiritualityandpractice.com (one of my all-time favorite spiritual resources) helps us understand why:
Many years ago, I read about a study in which people from different walks of life were asked: What is the most profound way you feel loved? The number one response was: "When someone's really listening."
—Mary Manin Morrissey in No less Than Greatness by Mary Manin Morrissey
To Practice This Thought:
Give someone your undivided attention.
Can you think of someone for whom your undivided attention would be welcome today?

subset: commoncrawl


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Case study14th June 2017
The primary goal of this project was to conduct the first phase of the Ophelia process to identify the health literacy needs and capacities of the residents of the Lavender Hill community, and to generate ideas for potential solutions to health literacy-related issues.
Location: Outskirts of Cape Town, South Africa Type of organisation: non-profit organisation
Mothers Unite is a non-profit organisation that provides holistic after-school care and recreation for children, and facilitates other initiatives to engage families of the Lavender Hill community, which is situated on the outskirts of Cape Town, South Africa. Lavender Hill has widespread poverty and high rates of violence, accidents, chronic disease and unemployment, and is a resource-poor community where residents have limited access to timely health services including emergency care. Mothers Unite runs a branch of the Emergency First Aid Responder (EFAR) program. This program, an extension of Cape Town's emergency medical services, trains local lay volunteers to be first aid responders to emergency incidents in townships – including formal and informal settlements – that surround Cape Town. The partnership between the EFAR program and Mothers Unite enables residents to engage local EFAR trainees and adapt the program to local needs, language and context.
What was the problem?
Locally trained EFARs expressed interest in extending their services beyond emergency response. Ideas include EFARs communicating with local physicians and officials about the health needs of the community. The primary goal of this project was to conduct the first phase of the Ophelia process to identify the health literacy needs and capacities of the residents of the Lavender Hill community. The secondary goal was to determine potential differences in health literacy between EFARs and other community members.
In early 2014, health literacy and demographic data were collected from 293 Lavender Hill residents. Participants recruited were EFARs (n=93), community members who had no EFAR training (n=100), and patients from the Retreat Community Health Clinic (n=100), a primary care clinic where residents receive most of their health care. All participants were at least 18 years old, and fluent in English, Afrikaans or both languages. Results from the survey were discussed in solutions workshops with healthcare providers, Department of Health employees, community leaders, EFARs, and EFAR leaders. Overall findings were:
· Many Lavender Hill residents did not feel understood and supported by their healthcare providers, did not feel they had sufficient information to manage their health, and did not feel they could find good health information or navigate the healthcare system.
· There were minimal differences in health literacy between EFARs, community members and patients, however, EFARs scored higher on navigating the healthcare system.
What solutions were found?
Discussions in the solutions workshop lead to four potential intervention ideas:
1. Healthcare provider training to support provision of evidence-based health information to community members.
2. Group interventions to support community members to better manage their health.
3. Improved individual patient empowerment to encourage active self-management of health.
4. Development of a large-scale campaign to educate community members about how to access healthcare services.
What was the impact?
This is the first systematic health literacy needs assessment study in a South African population. The intervention ideas generated by this community are directly related to the needs and capabilities of the residents of Lavender Hill.
This case study is based on original work by Jennifer Bress for her Master of Science Degree in Emergency Medicine.


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Come visit our new Pilates Studio!
Since September 1, 2013 Isabel and Jon are the proud owners of Studio A Pilates, located in Berlin-Wilmersdorf. Studio A Pilates has been providing quality Pilates training in Berlin Wilmersdorf since 2008 (before September 2013 under the leadership of Anja Schuhmann).
We offer Pilates Personal Training and Duo Training, as well as Group Classes with no more than 6 participants in a calm and pleasant atmosphere. That way we can pay attention to everybody's individual needs and ensure the correct execution of the exercises.
We also offer Massage and Shiatsu, Pre- and Postnatal Classes and Präventivkurse, which are supported by the health insurance, absolute Pilates beginner classes and floor barre. On a regular basis we offer introductory workshops to Pilates newcomers.
Studio A Pilates is very conveniently located at Blissestrasse 12, 10713 Berlin, only 200 meters from the U7 stop Blissestraße. The Bus Lines 101, 104 and 249 stop nearby as well. If you are in Berlin, come and check us out! You can reach us via email or via phone at 011.49.30.38203128.
Teaching Stuff: Pilates
Isabel's teaching Pilates schedule, ongoing classes:
At Studio A:
Mondays, 6:30 - 7:30 pm Pilates Introductory class
Tuesdays, 8:45 - 9:45am Pilates Mat Level 2 and 10 - 11am Pilates Mat Level 1
Tuesday, 7:30 - 8:30 pm Pilates Introductory class
Thursdays, 5:45 - 6:45 pm Pilates Level 1 and 7 - 8 pm Pilates Level 2, and 8:15 - 9:15 pm Pilates Level 1
Fridays 4:30 - 5:30 pm Pilates Introductory class
all at Studio A, a Pilates Studio in Wilmersdorf, Berlin.
Classes at other studios:
Mondays 8:10 - 9:00 pm Pilates Level 1 at Holmes Place Gendarmenmarkt, Berlin
Tuesdays 12 - 12:50 pm Pilates Level 1 at Holmes Place Gendarmenmarkt, Berlin
Wednesdays, 7:15 - 8:30 pm Group Reformer Class at Body in Balance, a Pilates Studio in Kreuzberg, Berlin.
Jon's teaching Pilates schedule, ongoing classes at Studio A:
Wednesdays 5:45 6:45 pm, 7 - 8 pm and 8:15 - 9:15 pm, All Pilates Level 1
Plus, both Jon and Isabel are available for Personal Training sessions and Jon offers Massage at the Studio.
Ongoing Education at Studio A Pilates:
We continue a tradition initiated through the previous owner of Studio A: Workshops with the renowned Master Trainer and Educator Madeline Black, from Sonoma, CA!
This year we offered three workshops with Madeline, to serve the European Pilates Community.


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Trenton Meade
Levisa Lazer
Eastern Kentucky University
I first applied for an internship through the Kentucky Press Association with no real intention on getting a call back. My interest in the position was strong, but the realization of starting a ten-week tenure with someone I had no prior relationship with was rather daunting. Even though I have confidence in my writing style and how I have previously done articles, it made me question if I was good enough for the position. I want to excel as a journalist and later become an author – one that does everything correctly and becomes well-known.
Going into the internship, I had no clue what to expect. I knew I would be doing a lot of work but not a clue on how much. My summer with The Levisa Lazer opened my mind to the world of journalism; it is much more than writing a simple story. During my summer, I wrote many articles, went to events, took pictures, learned how to operate an online news source and understood the importance of reaching out to locals for information and more. It was more than I imagined; it was not easy.
Every day was different from the last. Some days might have been slow, when all I would do is write and others would have so much news available, that I would have to take (spur of the moment) pictures, go to events late in the evening, grab new information from the courthouses and sheriff's office, etc… I was kept on my toes nearly every day.
Dr. Mark Grayson made sure my experience was well worth the time. He made sure to give me as much insight and knowledge as he could, so that my career as a journalist can continue. Prior to arriving, I had no former experience with Joomla. After my ten weeks, I am now confident in using Joomla and most of what comes with the online program. I took a lot of time studying this program to help further the website and help it grow substantially.
This internship was one of the most insightful and best learning experiences that I've had as a student journalist. Being on-call and ready for anything makes this a completely new experience for those that have never been in this position. I recommend an internship through KPA for any of my fellow classmates, friends and those wanting to further their career.


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Functional (mathematics)
In mathematics, the term functional (as a noun) has at least two meanings.
- In modern linear algebra, it refers to a linear mapping from a vector space into its field of scalars, i.e., to an element of the dual space .
- In mathematical analysis, more generally and historically, it refers to a mapping from a space into the real numbers, or sometimes into the complex numbers, for the purpose of establishing a calculus-like structure on . Depending on the author, such mappings may or may not be assumed to be linear, or to be defined on the whole space .
This article is mainly concerned with the second concept, which arose in the early 18th century as part of the calculus of variations. The first concept, which is more modern and abstract, is discussed in detail in a separate article, under the name linear form.
Commonly, the space is a space of functions; thus the functional takes a function for its input argument, then it is sometimes considered a function of a function (a higher-order function). Its use originates in the calculus of variations, where one searches for a function that minimizes a given functional. A particularly important application in physics is searching for a state of a system that minimizes the energy functional.
Functional details
The mapping
is a function, where x0 is an argument of a function f. At the same time, the mapping of a function to the value of the function at a point
is a functional; here, x0 is a parameter.
Provided that f is a linear function from a vector space to the underlying scalar field, the above linear maps are dual to each other, and in functional analysis both are called linear functionals.
Definite integral
Integrals such as
form a special class of functionals. They map a function into a real number, provided that is real-valued. Examples include
- the area underneath the graph of a positive function
- Lp norm of a function on a set
- the arclength of a curve in 2-dimensional Euclidean space
Vector scalar product
Given any vector in a vector space , the scalar product with another vector , denoted or , is a scalar. The set of vectors such that is zero is a vector subspace of , called the null space or kernel of .
If a functional's value can be computed for small segments of the input curve and then summed to find the total value, the functional is called local. Otherwise it is called non-local. For example:
is local while
is non-local. This occurs commonly when integrals occur separately in the numerator and denominator of an equation such as in calculations of center of mass.
Functional equation
The traditional usage also applies when one talks about a functional equation, meaning an equation between functionals: an equation F = G between functionals can be read as an 'equation to solve', with solutions being themselves functions. In such equations there may be several sets of variable unknowns, like when it is said that an additive function f is one satisfying the functional equation
Functional derivative and functional integration
Functional derivatives are used in Lagrangian mechanics. They are derivatives of functionals: i.e. they carry information on how a functional changes when the input function changes by a small amount.
Richard Feynman used functional integrals as the central idea in his sum over the histories formulation of quantum mechanics. This usage implies an integral taken over some function space.
See also
- Hazewinkel, Michiel, ed. (2001) [1994], "Functional", Encyclopedia of Mathematics, Springer Science+Business Media B.V. / Kluwer Academic Publishers, ISBN 978-1-55608-010-4
- Rowland, Todd. "Functional". MathWorld.
- Lang, Serge (2002), "III. Modules, §6. The dual space and dual module", Algebra, Graduate Texts in Mathematics, 211 (Revised third ed.), New York: Springer-Verlag, pp. 142&ndash, 146, ISBN 978-0-387-95385-4, MR 1878556, Zbl 0984.00001


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Haudenosaunee and HCA Set Dates for 2018 Harvest
Haudenosaunee Deer Harvest Begins November 12
The Haudenosaunee Wildlife and Habitat Authority (HWHA) and Hamilton Conservation Authority (HCA) have agreed to a Specific Agreement for the 2018 season based on the existing Protocol to address the Treaty Rights of the Haudenosaunee on HCA owned lands.
Deer harvesting for the 2018 season will be conducted concurrently in two areas of the Dundas Valley Conservation Area (DVCA) designated as Schedule A and Schedule B (link below). The area designated in Schedule B has no public access or a managed trail system.
Documents and Maps
- 2018 Specific Agreement
- Protocol between the Haudenosauneee Wildlife & Habitat Authority and the HCA
- Schedule A Map
- Schedule B Map
Harvesting will only occur on HCA owned lands in Schedule A & B on Mondays, Tuesdays, Wednesdays, and Thursdays only, between November 12 and December 6, 2018. There is no January harvest scheduled.
The number of deer to be harvested is limited at 60 deer. The Hamilton Police Service and Ministry of Natural Resources and Forestry staff have been consulted with respect to public safety and advised of the harvest and corresponding area closures. Appropriate trail signage and notification to adjacent residents will be provided about the harvest and area closure.
Deer harvesting has been a long standing tradition of the Haudenosaunee dating back thousands of years and serving an important role in their way of life. With regards to the DVCA, the Nanfan Treaty or the Treaty at Albany of 1701 gives the Haudenosaunee the right to harvest and fish in this area.
In 2011, the Ontario Government recognized and fully supported this Treaty and encouraged the HCA to continue collaboration with the Haudenosaunee. The HCA recognizes the importance and validity of the Nanfan Treaty and also respects the important cultural role that deer harvesting plays in the Haudenosaunee's way of life.
In 2011, the HCA's Board of Directors authorized entering into an agreement with the HWHA to establish a protocol regarding deer harvesting on HCA owned lands. An agreement was made and continues to be in effect allowing the HWHA to harvest a set number of deer in selected parts of the DVCA.
Paul Williams of the HWHA says, "We're confident that we have been able to find a place where it is safe for our hunters to go; where we can exercise legal traditional rights carefully. And we're grateful that we are able to work with partners who share our ecological values. Of course we intend to conduct the harvest safely, humanely, and consistent with best conservation practices. And the deer taken will go to longhouses for ceremonies and to elders, as well as to feed hunters' families".


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During Member Appreciation Day, your Elements Team will be in your office to thank you for your membership to our credit union. We will have lots of gift cards and goodies to give away! As always, we will also be highlighting the variety of services Elements Financial offers. Service providers such as Loan Specialists and Personal Financial Managers are on hand to answer any questions and steer you in the right direction.
Stop by for your chance to win gift cards and other cool prizes!
This workplace workshop is open to employees of OneAmerica. If you are interested in hosting this workshop at your organization, contact your Elements Relationship Manager today.


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If you set up a new water heater, and you begin to have a leak from the pressure relief valve, you could want an enlargement tank installed. The stress increases when the functioning of the water heater is being performed properly. Due to this fact, with your new water heater, it may be necessary to have an enlargement tank as effectively. If you are going on vacation, look for individual valves beneath each of your sinks. Flip off water for every appliance. If you happen to reside in an apartment constructing, you won't be able to close off your system completely however must flip off individual valves to prevent any leak from ruining your residence.
By understanding your plumbing and how it works, as was said before, can prevent loads of money and time. There's nothing worse than a plumbing accident to mess up your day. So, utilizing the recommendation from this article, you possibly can make sure to save your self a giant headache! Is not doing your personal plumbing a variety of fun? As you've seen on this article, there are quite a lot of ways this can be carried out and no two strategies or equipemnt will yield the identical results. There are also a lot of customizable choices that may work with your home and price range.
Solder with safety in thoughts. Whenever you solder a copper pipe you wish to direct the flame on the copper pipe. The flame of the torch needs to be 4 inches away from the piping. The flame needs to be targeted directly at the point where the copper piping must be disconnected. If the water strain on your street exceeds 60 pounds, you a lot wish to consider installing a strain reducing valve. Too much water pressure is definitely dangerous to your plumbing system and could trigger excess water stress. A stress lowering valve cuts down your water pressure by almost 50 %.
In conclusion, tackling any plumbing subject does not must be troublesome. When you have the right instruments and the appropriate data to assist you, you can do any plumbing task that will come up. Simply use the tips that have been provided within the article above and your plumbing issues can be a factor of the previous. Pump your septic tank each 5 years to maintain it working well. Having it cleaned out prevents the sediment from accumulating in the septic tank and creating a sewage backup in your house or triggering the meltdown of the entire septic system. It's a small worth to pay now to keep your septic in good working order and forestall having to pay for a serious repair caused by a backup.
All the time check your bathroom and make sure it is not leaking.
In conclusion, plumbing is a ability that it is best to find out about – plain and simple. It is one thing that you will always be able to use and also you may be able to save yourself a lot of money and frustration sooner or later. Hopefully this article was helpful to you. Many people complain of low water pressure. While there are several issues that may cause this, one must not be missed when starting your investigation. What kind of pipes do you have got? If your piping is galvanized, you're higher off simply replacing your piping which is able to get rid of the difficulty.
Have your pipes in your plumbing system frozen? You'll be able to skip the price of hiring a plumber by using this technique. First, open the faucet so steam produced by the thawing process can escape. Start thawing close to the faucet, and transfer down the road as every section thaws out. Use a hair dryer or a heat lamp to heat along the pipe. Regardless that this technique consumes fairly a bit of time, it's safer than most other heating strategies. Furthermore, it requires no cleanup.
Use strainers in all drains to catch hair and different objects. It will prevent all the fabric from taking place the drain and inflicting a clog, which might trigger a much bigger problem down the line. Clear out the strainers daily in order that you do not start getting backup of water in your sink or tub. Frozen pipes can result in many issues, most of them costly to fix. So that you need to keep away from that in any respect costs. To avoid frozen pipes, ensure the temperature in your house never drops beneath fifty five degrees. Search for any air leaks round your pipes and make sure they're sealed up.
When leaving on trip or leaving your vacation house, make sure you flip off the main water earlier than you allow. If one thing occurs when you are gone you possibly can trigger some serious harm from a flooded basement or a damaged pipe in the wall that leaks for weeks till you return. A sink with poor water pressure can typically be corrected by cleaning the constructed-up sediment out of the aerator. Disassemble the fixture to take away the aerator, after which scrub it with vinegar and a small brush. Rinse and reassemble the aerator, then reattach it to your faucet. This could assist enhance the water stress, as a result of any obstacles in the aerator can have been eliminated.
Verify the water within the bowl after a half hour or so. If any of the coloring agent is seen within the water within the bowl, the tank is leaking, and you will have to have it repaired.


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The GapGeneral Musings
Although it may appear so, I have not been entirely neglecting my duties here at Celestial Thoughts. In point of fact, I have been very busy. It simply does not appear so, I understand. I also understand the disappointment caused by lengthy gaps between posts. I eagerly await new posts from a variety of bloggers.
The next post is a long one. I've been working on it for a few weeks and I think I've wrung about all I can from the subject for now. It is an important subject as I've run across its effects now from a number of people. Most are quite intelligent but their eyes are fully engulfed by the wool of celebrity caused by their adoration of certain brethren.
I hope I have not beat a horse well passed its demise with the length of this next post. My humble apologies if you think I could have covered the material by simply saying, "Wake up, people!" I sincerely wish it was that simple.
The other activity that has occupied much time, besides, of course, the issue of attracting additional filthy lucre, bills being what they are, is a task I've been pondering over for a year or more. The time has come according to definite promptings to stretch a bit. I'm not particularly of a mind that I will be at all good at the activity but I'm going to start a YouTube channel.
I have not seen anyone with quite the attitude I bring to the table so I hope to add something to the video realm that will be profitable for, at least, some. For those who would rather watch and listen, this will be a good adjunct to the written blog. While I have made audio recordings of some of my posts, a video blog will add a new dimension to the work.
When the first episodes are posted, I'll make an announcement here so I can embarrass myself before as many folks as possible. Some have said I might actually be somewhat good at the endeavor. We'll see. I'm simply making the attempt to contribute what I can, where I can.
That's it.


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Spolupráce na kosmických projektech 2012-2019:
VesselSat-I weighing 28.7 kg is a microsatellite developed and built by LuxSpace of Luxembourg. The sattelite carries AIS (Automatic Identification System for ships) receivers to detect signals automatically transmitted by Vessels at sea in the region covered by the satellite footprint. The satellite carries two of such receivers, each with a dipole antenna composed of two 1.7m deployable elements.
Photo ESASpolupráce G.L.Electronic na satelitu Vesselsat2
Odkaz: Fórum vesmíru


text: France centralized and maintained power in many different ways. One of the ways was through war and fighting to claim territories. An example of this is when King Charles VIII invaded Italy in 1494, capturing Milan and threatened to do the same with Rome and Naples. These threats terrorized the other cities, and thus maintained French power. Its ability to compromise around religious strife, allowed French royalty to maintain its power and leadership. France also maintained a strong level of power by having the heirs of the ruler be someone who was relatively familiar with the throne. In King Henry II's case, his widow followed him in power, and then her three sons, Frances II, Charles X, and Henry III, followed her in power.


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- Research article
- Open Access
- Open Peer Review
The Carpentier-Edwards Perimount Magna mitral valve bioprosthesis: intermediate-term efficacy and durability
© Loor et al. 2016
- Received: 21 October 2015
- Accepted: 12 January 2016
- Published: 27 January 2016
The Carpentier-Edwards Perimount Magna mitral valve bioprosthesis (Edwards Lifesciences, Irvine, CA) is a low-profile version of the earlier Perimount valve that uses the ThermaFix process for enhanced calcium removal. The Magna valve has been in use since 2008, yet no publication, until now, has verified its intermediate-term safety and efficacy.
From 2008 through 2011 (our 4-year study period), 70 Magna valves were implanted in the mitral position at a single institution (the Cleveland Clinic). Echocardiograms were prospectively interpreted. For this study, we reviewed patients' charts; endpoints included hemodynamic measurements, in-hospital morbidity and mortality, valve-related events, resource utilization, and 5-year survival rates.
The mean patient age was 68 years; 43 % of the patients had New York Heart Association (NYHA) class III or IV disease, and 51.4 % had moderately severe, or worse, mitral regurgitation (MR). For 43 % of the patients, the Magna valve implantation was a reoperation. For 83 %, the Magna valve implantation also included a concomitant cardiac procedure. The median survival rate was 4.7 years and 90 % of patients were free from significant structural valve degeneration at 5 years. Preoperative atrial fibrillation, ischemic MR, intraaortic balloon pump placement, cardiogenic shock, cardiac arrest, and renal failure were associated with increased mortality. Right ventricular systolic pressure decreased from 50 mmHg preoperatively to 40 mmHg postoperatively, according to our matched-pair analysis (P = 0.003). Per their final echocardiogram during our study period, 98 % of surviving patients had trivial or no MR, one patient had mild MR, and one patient had severe MR.
Our 5-year experience indicates that the Magna valve offers excellent intermediate-term durability and substantial echocardiographic improvement; its low-profile design make it ideal for reoperations and for concomitant cardiac procedures, including valve replacement.
- Left Ventricular Outflow Tract
- Mitral Valve Repair
- Effective Orifice Area
- Ischemic Mitral Regurgitation
- Leave Ventricular Outflow Tract Obstruction
Each year, more than 20,000 mitral valve operations are reported to the Society of Thoracic Surgeons database [1]. Despite the increased emphasis on valve repair, at least 30 % of patients with mitral valve disease still undergo valve replacement [2–4]. Reasons include extensive comorbidities, previous valve operations, complex jets, and mitral stenosis [3]. The ideal replacement valve would be durable, would not require anticoagulation, and would be small enough to avoid distortion of the mitral annulus while preserving left ventricular geometry.
A mitral valve bioprosthesis avoids anticoagulation, but is associated with a higher reoperation rate than a mechanical valve. For patients older than 70 years and for patients with a contraindication to anticoagulation, a mitral valve bioprosthesis is the preferred replacement option [1, 5–8]. Several are commercially available and approved by the U.S. Food and Drug Administration (FDA). Among the most popular are the St. Jude Medical Biocor (St. Jude Medical, St. Paul, MN) and the Carpentier-Edwards Perimount mitral valve bioprosthesis (Edwards Lifesciences, Irvine, CA). With both of those valves, the published short- and long-term hemodynamic and clinical data have suggested good outcomes [7, 9–12].
In 2008, Edwards Lifesciences modified that initial Perimount model to provide a lower profile and to enhance removal of calcium-binding sites through its ThermaFix process. This modified model is referred to as the Carpentier-Edwards Perimount Magna mitral valve bioprosthesis, or the Magna valve for short. It protrudes less into the left ventricular outflow tract (LVOT) than its predecessor, so it is appealing for patients with small ventricles undergoing multiple valve procedures or reoperations. It is also predicted to have less structural valve deterioration, thanks to the ThermaFix process.
The Magna valve, building on the proven durability of the initial Perimount model, has now been implanted in centers around the United States. Yet no publication, until now, has verified its short- and intermediate-term safety and efficacy. Herein, we report our 5-year outcomes with the use of the Magna valve in 70 patients implanted between 2008 through 2011 at a single center (the Cleveland Clinic)—including short-term in vivo echocardiographic data, which can be used as a reference for outcomes analyses and for future valve modifications.
Study population
In general the Cleveland Clinic prefers mitral valve repair whenever possible. When replacement is needed, we have primarily used either the St. Jude Medical Biocor or the Carpentier-Edwards Perimount mitral valve bioprosthesis; however, since 2008, our experience with the Magna valve has been gradually accumulating.
After querying the Cardiovascular Information Registry, we reviewed patients' electronic medical records and entered their clinical data into our own working database for analysis. This database was approved for use by the Cleveland Clinic's Institutional Review Board, which waived the need for consent from individual patients. Clinical data included demographic variables, comorbidities, operative details, postoperative outcomes, and intermediate-term follow-up results. To confirm preoperative atrial fibrillation, we reviewed the preoperative electrocardiogram. Coronary artery disease was defined as ≥50 % obstruction of a coronary vessel that may or may not have been amenable to bypass. Emergency operations were performed within 24 h after the clinical diagnosis. Carotid artery disease was defined as ≥50 % obstruction, per carotid artery duplex scan findings. Pulmonary hypertension was defined as right ventricular systolic pressure (RVSP) ≥40 mmHg, per echocardiography findings.
Endpoints were postoperative hemodynamic measurements, in-hospital morbidity and mortality, valve-related events, resource utilization, clinically significant structural valve degeneration and intermediate-term survival rates. To define in-hospital morbidity (perioperative myocardial infarction, respiratory failure, sepsis, renal failure, and neurologic complications), we used the Society of Thoracic Surgeons national Adult Cardiac Surgery database. For surviving patients, we used hospital length of stay as a surrogate marker for resource utilization. Clinically relevant structural valve degeneration was defined as the need for reoperation or severe regurgitation or stenosis preceding death.
Hemodynamic measurements
For the echocardiography findings, we retrieved the last available transthoracic study from our server for each patient; for all quantifications, we used Syngo software (Siemens AG, Munich, Germany), with interpretations made by two experienced echocardiologists (A.S and W.S.). For the 2D echocardiography analysis of LVOT diameter, left ventricular ejection fraction (EF), and stroke volume (SV), we used the biplane method of disks (modified Simpson's rule). We also recorded RVSP, peak and mean transmitral gradients (mmHg), left atrial (LA) size, left ventricular internal diameter (LVID), and effective orifice area (EOA).
To calculate the LVOT systolic velocity time integral (VTI), we used the mean of three waveforms acquired by LVOT pulse-wave Doppler; then, to calculate SV, we multiplied LVOT diameter by LVOT VTI. If systolic LVOT VTI was not available, we obtained SV by using the biplane method of disks (modified Simpson's rule).
To calculate the peak transmitral gradient, we obtained measurements from mitral diastolic continuous-wave Doppler assessment and then used the simplified Bernoulli equation. To calculate the mean transmitral gradients, we obtained measurements from the diastolic waveform VTI. For both the peak and mean measurements, we used the mean of three waveforms.
To calculate the mitral valve area (MVA), we used the pressure half-time (t1/2) method (MVA = 220/t1/2). To calculate the mitral EOA, we divided SV by the mitral diastolic VTI. To calculate the EOA index, we divided the EOA by body surface area.
To assess the presence and degree of mitral regurgitation, we used the four-chamber view per color flow Doppler imaging, according to the semiquantitative approach recommended by the American Society of Echocardiography. In six of the 70 patients, postoperative transthoracic 2D echocardiograms were not available for analysis.
Data analysis
Continuous demographic variables are expressed as the mean ± the standard error of the mean (SE); categorical values are expressed as the n (percentage). To compare pre- and postoperative echocardiography findings, we used the paired Student t test. To assess intermediate-term survival (in months) after Magna valve implantation, we used the Kaplan-Meier method, with censoring (N = 70, with n = 16 deaths, 54 censored). To assess freedom from structural valve degeneration we used the Kaplan-Meier method (N = 70, with n = 2 events, 68 censored). To analyze the relationship between dichotomous variables and survival, we used the 2-tailed Fisher exact test.
Patient characteristics (N = 70)a
Age, years
68 ± 1.6
36 (51 %)
34 (49 %)
Preoperative clinical and laboratory values
BMI,b kg/m2
26.5 ± 0.7
Hematocrit, %
35.8 ± 0.7
Creatinine (mg/dl)
1.6 ± 0.2
Disease acuteness
NYHA functional class
I or II
40 (57 %)
III or IV
30 (43 %)
Emergency operation
3 (4.3 %)
67 (96 %)
IABP use
3 (4.3 %)
67 (96 %)
Cardiac comorbidities
Coronary artery disease
21 (30 %)
55 ± 1.2
Moderately severe, or worse, MR
36 (51 %)
Severe MS
21 (30 %)
History of heart failure
22 (31 %)
48 (69 %)
Previous MI
10 (14 %)
60 (86 %)
Preoperative cardiogenic shock
9 (13 %)
61 (87 %)
History of peripheral artery disease
4 (5.7 %)
66 (94 %)
Previous cardiac operation
30 (43 %)
40 (57 %)
Previous mitral valve repair or replacement
19 (27 %)
51 (73 %)
Preoperative AF
19 (27 %)
51 (73 %)
History of hypertension
53 (76 %)
17 (24 %)
Noncardiac comorbidities
Previous stroke
8 (11 %)
62 (89 %)
History of carotid artery diseaseb
26 (37 %)
43 (61 %)
History of smoking
29 (41 %)
41 (59 %)
History of COPD
11 (16 %)
59 (84 %)
History of DM
17 (24 %)
53 (76 %)
History of renal disease
20 (29 %)
50 (71 %)
Operative factors and findings (N = 70)a
Operative factors
49 (70 %)
19 (27 %)
10 (14.2 %)
Attempted repair
7 (10 %)
63 (90 %)
Minimally invasive Magna valve implantation
1 (1.4 %)
No (i.e., full sternotomy)
69 (99 %)
Technique for Magna valve implantation
Transseptal approach
49 (70 %)
Left atriotomy
21 (30 %)
Subvalvular leaflet preservation
56 (80 %)
Magna valve sizeb (mm)
28 ± 0.3
18 (26 %)
16 (23 %)
19 (27 %)
16 (23 %)
1 (1.4 %)
Rheumatic disease
12 (17 %)
Myxomatous disease
4 (5.7 %)
Ruptured chordae
5 (7.1 %)
Degenerative disease
28 (40 %)
10 (14 %)
38 (54 %)
Ischemic MR (posterior restriction)
3 (4.3 %)
Concomitant procedures
58 (83 %)
6 (8.6 %)
AVR, TVR, ASD repair, and/or myectomy
33 (47 %)
CABG + AVR, TVR, ASD repair, and/or myectomy
11 (16 %)
24 (34 %)
Triple valve procedures
6 (8.6 %)
Antiarrhythmic procedure (Cox maze procedure, PVI, and/or LAAL)
7 (10 %)
Thirty eight patients had at least some MAC documented in the operative note. Moderate to severe MAC was noted in 29 of these cases (57 %). MAC involved the anterior annulus in 22 cases (57 %) and the posterior annulus in 36 cases (94 %). In 17 cases (44 %) the MAC was left undisturbed.
Twelve cases (31 %) required at least some debridement and nine cases (23 %) required extensive debridement. Annular reconstruction with a patch was used to avoid AV rupture if adipose tissue was visible on the ventricular side of the annulus after debridement. Three cases (8 %) used a bovine pericardial patch and 1 case (3 %) used a felt patch. Only one case required an additional bypass run for mild-moderate perivalvular regurgitation to reinforce a separation along the anterior rim. The rest had either no or trivial MR at the conclusion of the replacement.
Postoperative course and complications (N = 70)a
Hospital LOS,b days
11.6 ± 0.8
Cardiogenic shockc
6 (8.6 %)
IABP use
2 (2.9 %)
4 (5.7 %)
Any renal failure
17 (24 %)
Renal failure requiring dialysis
6 (8.6 %)
Reoperation for bleed
4 (5.7 %)
50 (71 %)
Heart block
19 (27 %)
16 (23 %)
Permanent pacer
3 (4.2 %)
Wound infection
1 (1.4 %)
Cardiac arrest
3 (4.3 %)
In-hospital death
5 (7.1 %)
2 (2.9 %)
Valve-related complications
0 (0 %)
0 (0 %)
1 (1.4 %)
0 (0 %)
AV groove disruption
1 (1.4 %)
Factors associated with increased mortality (N = 70)a
Survivors (n = 62)
Nonsurvivors (n = 8)
P b
14 (23 %)
5 (63 %)
Ischemic MR
1 (1.6 %)
3 (38 %)
IABP use
0 (0 %)
2 (25 %)
Cardiogenic shock
2 (3.2 %)
4 (50 %)
Cardiac arrest
1 (1.6 %)
2 (25 %)
Any renal failure
15 (24 %)
6 (75 %)
Pre- and postoperative echocardiography findings (N = 70)a
Left ventricular EFb
Preoperative, %
54.8 % ± 1.25 %
Postoperative, %
52.3 % ± 1.67 %
Difference, %
−2.50 % ± 1.57 %
Preoperative, mmHg
50.1 ± 3.23
Postoperative, mmHg
39.8 ± 2.18
Matched-pair difference, mmHg
−10.3 ± 3.23
LA sized
Preoperative, cm2
5.557 ± 0.560
Postoperative, cm2
4.641 ± 0.113
Matched-pair difference, cm2
−0.915 ± 0.558
Preoperative, cm
4.705 ± 0.883
Postoperative, cm
4.598 ± 0.863
Matched-pair difference, cm
−0.107 ± 0.098
Our 5-year study is the first to objectively evaluate the hemodynamic and clinical outcomes with the Magna valve, a modification of the earlier Carpentier-Edwards Perimount mitral valve bioprosthesis. We found excellent intermediate-term durability with this versatile design, which is well suited for complex situations; even at the lowest valve sizes, this new model provided patients with excellent hemodynamics.
Most of the patients in our series had extensive comorbidities, a high NYHA class, severe valve disease, and previous cardiac operations, many of which involved the mitral valve. Thus, our patients were typical of those undergoing mitral valve replacement in the current era [1, 4, 13]. While the survival rate at 2 years of 84 % was excellent, the survival rate of 40 % at 5 years was commensurate with this cohorts' extent of illness. For comparison, the St. Jude Medical Biocor valve series from Rizzoli et al. noted a 5-year survival rate of 54 % [12]. The 15 year experience with the original Perimount bioprosthesis showed a 5 year survival of 76 %, although their cohort had fewer comorbidities and less reoperations than observed in the current study [7]. We also observed significant postoperative morbidity, including renal failure, cardiogenic shock, and respiratory failure. One patient suffered a death due to AV groove disruption which was related to severe MAC rather than the Magna valve itself. One reoperation was required at 2 years due to LVOT obstruction from a strut. These cases highlight the need for caution even with this low-profile design. The freedom from structural valve degeneration of 90 % was excellent and compares favorably with that observed in other series [7, 12]. One reoperation was due to structural valve degeneration at 6 months and one patient died due to severe MR at 2 years without a reoperation.
We identified several factors associated with increased mortality in our patients, including atrial fibrillation, cardiogenic shock, IABP use, cardiac arrest, and ischemic mitral regurgitation. Wang et al. also found significantly increased mortality in patients with preoperative atrial fibrillation, but they found improved survival with a concomitant Cox maze and LA ligation [14]. In our series, despite the 27 % incidence of preoperative atrial fibrillation, only 10 % of our patients underwent an antiarrhythmic procedure—perhaps a reflection of the length and complexity of the procedures, along with the frailty of the tissues, which discouraged ancillary procedures that were not absolutely necessary in these older patients.
De Bonis et al. recently showed that ischemic mitral regurgitation in sicker patients was associated with lower survival when the mitral valve was replaced rather than repaired [15]. Conversely, Gillinov et al. found no difference in survival between repair and replacement in patients with a higher NYHA class and complex regurgitant jets [4]. This is consistent with the randomized controlled prospective trial of Acker and colleagues that showed no survival benefit for repair over replacement and greater durability with valve replacement [16]. We believe it is reasonable to use the Magna valve for ischemic mitral regurgitation, although repair should be considered in appropriate candidates.
What are the advantages of a lower-profile bioprosthesis? Patients receiving a mitral prosthesis have a natural reduction in the LVOT [17]. In addition, the struts of a bulky bioprosthetic can protrude into the LVOT, causing a clinically significant increase in gradients [18]. A smaller, lower-profile valve reduces such concerns. Reoperative or multiple-valve procedures in patients with mitral annular calcification or degenerative disease pose additional restrictions on the prosthesis size. The exposure in such procedures is challenging; the mitral annulus and left ventricular cavities are often restricted. Most patients in our series underwent a full sternotomy, with transseptal mitral exposure and with implantation of a small Magna valve (25 to 29 mm). In addition, in patients with ischemic mitral regurgitation, the Magna valve's low-profile design is more likely to allow preservation of the subvalvular apparatus which may be associated with improved survival [19, 20]. In our series, 80 % of patients had preservation of some portion of the subvalvular apparatus, with no reported outflow obstruction.
The mean gradients achieved with the Magna valve in our series compared favorably with those reported in previous publications on other mitral bioprostheses [10–12]. Our lowest gradients were achieved with the 27 and 31-mm Magna valves, although the gradients achieved with the 25-mm Magna valve were only slightly higher. Thus, the 25-mm valve size is a reasonable option for patients with a constrained annulus or small ventricle, especially when left ventricular outflow tract obstruction (LVOTO) is a concern. While the low profile design may reduce the incidence of LVOTO, care must still be taken to keep the struts out of the way of the LVOT as one case in this series did demonstrate LVOTO resulting in redo-replacement.
The valve size of 25 was the second most common size used in this series which suggests small working annuluses. This could be explained by variations in patient anatomy or surgical technique, high rate of MAC with limited debridement, and/or the presence of reoperations. We tend to use either inverting (ventricular to atrial) or everting (atrial to ventricular) suture techniques depending on anatomy and ease of placement. We favor inverting sutures in the setting of MAC which places the sewing ring on the atrial side of the mitral annulus. If everting sutures are used then the valve may sit slightly intra-annular. We will infrequently construct a neo-inner annulus as described by Di Stefano and colleagues to avoid debridement in the setting of severe MAC [21]. The presence of favorable mean gradients suggests that the range of Magna sizes can accommodate the operator's preference and/or patient's anatomy.
The favorable hemodynamic profile of the Magna valve is further supported by the significant reduction we observed in RVSP. It is anticipated that a persistent reduction in RVSP could correlate with improved long-term survival, but we did not have a large enough sample size or long enough follow-up to definitively show any correlation [22]. The suggestion that even smaller Magna valve sizes produce favorable hemodynamics is supported by the fact that we saw no appreciable difference in EOA index across valve sizes, except for the 31-mm valve.
Our study supports the use of the Magna valve as a replacement option, but we acknowledge several important limitations. First, echocardiographic follow-up was not as standardized as it is for repairs and not all patients had echos at their longest follow-up interval. Echocardiography was generally obtained if a clinical indication was met. Thus, our review of structural valve degeneration was limited to the causes of death, reoperation and the last available echo prior to these events. The Magna valve design is based on the previous Perimount model, which is associated with 14 years' worth of data showing freedom from explantation and from structural valve deterioration, so we are confident that the newer model will do at least as well. Additionally, the prospective evaluation of the echocardiograms by two experienced cardiologists was crucial as it standardized the valve's performance measures. But it was limited to a mean follow-up of 5 months with a broad range of intervals. We elected to evaluate the last echos to avoid an unfair advantage from early postoperative performance. We noted a high interobserver variability for the calculation of the EOA index in our series, making it difficult to reach conclusions about the actual value for any given Magna size. However, we were able to make statistical comparisons for changes in the EOA index across valve sizes. Our study was underpowered for a multivariate analysis, although trends were established by univariate measures.
The peak gradient for the 25, 29 and 31 mm valves gradually decreased as expected. However, the peak was higher for the 29 mm valve than the 27 mm valve. Similarly, the 25, 27 and 31 mm mean gradients gradually decreased as expected. But the mean for the 29 and 25 mm valves were not statistically different. Peak and mean gradients can be affected by various transient factors such as cardiac output, heart rate, and volume status. In addition, the patient population was heterogeneous and we did not have an equal distribution of patients throughout the various valve sizes. Thus, we can conclude that the peaks and means decreased in our series with larger valve sizes as expected but we cannot give definitive estimates of these relative gradients that would translate to a broader population.
In conclusion, this is the first published report on outcomes after implantation of the Magna valve. Modifications are regularly made to valves; it is important that at least short-term results are made available. In our 5-year study, we found excellent freedom from structural valve degeneration, excellent short term survival, good hemodynamics at even the lowest valve sizes, substantial echocardiographic improvement, and minimal valve-related events. The Magna valve's low-profile design and ThermaFix process make it ideal for patients who have small ventricles, extensive comorbidities, or complex valve disease, as well as for those who need reoperations and concomitant cardiac procedures, including valve replacement.
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Authors' Affiliations
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- Ruel M, Chan V, Bedard P, Kulik A, Ressler L, Lam BK, et al. Very long-term survival implications of heart valve replacement with tissue versus mechanical prostheses in adults <60 years of age. Circulation. 2007;116(11 Suppl):I294–300.PubMedGoogle Scholar
- Eichinger WB, Hettich IM, Ruzicka DJ, Holper K, Schricker C, Bleiziffer S, et al. Twenty-year experience with the St. Jude medical Biocor bioprosthesis in the aortic position. Ann Thorac Surg. 2008;86(4):1204–10.View ArticlePubMedGoogle Scholar
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When your pipes system is damaged, it is now that you find yourself rushing to discover someone in order to help you to repair it. It is nevertheless not easy to obtain emergency situation plumbings ready to resolve your situation immediately since you could not make sure that you would locate one that is not involved. It could for that reason be prudent to think about doing your search early and also have them away.
Discovering the Most Effective Plumbers in Gwynn Oak MD
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Hurricane Michael hit the Florida Panhandle with 155 mph winds, near a Category 5, on the afternoon of Oct. 10, and officials said it is likely the most powerful storm to hit the area in recorded history.
According to the U.S. National Hurricane Center, the storm made landfall before 2 p.m. ET.
Florida Gov. Rick Scott urged residents to stay put.
4 to 8 inches of rain is expected along the path of the storm, and 12 inches could fall in some parts.
President Trump spoke about how the federal government plans to offer aid to areas affected by the hurricane.
Read full story
Trump Signs Bills to Eliminate Pharmacy Gag Orders
Insurance companies and pharmacy benefits managers (PBM) will no longer be able to strong-arm pharmacies into keeping quiet when customers pay more than they need to for drugs, thanks to two bills President Donald Trump signed on Oct. 10.
The bills, Know the Lowest Price Act and Patients Right to Know Drug Prices Act, target an industry practice of insurers and PBMs, which manage drug benefits for health care plans, putting "gag orders" in contracts with pharmacies that prevent them from telling patients if the cost of their copay is more than the cost of the drug if they had paid out of pocket.
The Know the Lowest Price Act, sponsored by Debbie Stabenow (D-Mich.), addresses Medicare Part D providers and goes into effect in 2020. The Patients Right to Know Drug Prices Act, sponsored by Sen. Susan Collins (R-Maine), covers all health insurance companies and PBMs and goes into effect immediately. Both passed the House and the Senate last month with bipartisan support.
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Turkish Media Identifies 15 Saudis Allegedly Involved in Journalist's Disappearance
A pro-government newspaper in Turkey said they have identified a 15-member intelligence team allegedly involved in the mysterious disappearance of Saudi journalist Jamal Khashoggi.
The Daily Sabah published images and security video of the so-called "assassination squad" as they entered the Saudi Arabia consulate in Istanbul where Khashoggi—a prominent Saudi journalist and regime critic—was last seen entering on Oct. 2.
Turkish officials believed that 59-year-old Khashoggi, also a Washington Post contributor, was murdered inside the consulate. Saudi Arabia has strongly denied all such reports. As of writing, they have not commented on the 15 nationals.
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Deputies Save Choking Newborn at Mall
A group of Sheriff's deputies visited the baby whose life they helped save.
Jessie Siefer and Kaylob Harmon were at the mall when their one-week-old daughter stopped breathing. They tried to revive her and called 911.
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Layered griefs and pleasures
I've just read Michael Ondaatje's latest masterpiece, 'Warlight'. It's the opposite of a page turner – a novel composed of writing so exquisite you want to linger over every paragraph, savouring the writing. It's a book to break a writer's heart; with people who can write like this in the world, why do I even bother?
In one chapter the protagonist, Nathaniel, describes Sam Malakite, a market gardener he works with for a couple of summers as a teenager, in a remote part of Suffolk in the years after WW II.
'I trusted each step I took with him. HE knew the names of all the grasses he walked over. He'd be carrying two heavy buckets of chalk and clay towards a garden, but I knew he was also listening to a certain bird. A swallow knocked dead or unconscious from hitting a window silenced him for half a day. It remained with him, that bird's world, its fate. If I said something later that encroached on the event, I'd see a shadow in him… He always knew the layered grief of the world as well as its pleasures.'
Coming into the season where we celebrate the God who we believe created the universe, who we believe chose to live among us, as one of us, this puts me in mind of the Jesus who is recorded as saying, 'Aren't two sparrows sold for a small coin? But not one of them will fall to the ground without your Father knowing about it already.'
I love this incarnated, human Jesus who noticed the fallen sparrow, the children his followers forbade from bothering the great man, the terrified bleeding woman in the crowd, stretching a trembling hand towards the hem of his garment, yearning for wholeness, the short, despised tax collector cowering up a tree, the woman taken in adultery, the dirt-poor widow slipping her meagre coin into the collection box.
Jesus knew the layered grief of the world, and he rejoiced in its pleasures too, eating and drinking with his friends and with others at whose table no respectable citizen would be seen. He relaxed with his friends Martha, Mary and Lazarus, walked in the fields with his followers, climbed mountains and sailed on vast inland lakes, cuddled children on his knee.
I want to follow this incarnated God who knows not only every sparrow that falls, but also the layered griefs of my life that have almost slayed me these past few years and, of course, all the griefs, far more numerous, more complicatedly layered than mine, that afflict so many of God's adored children. I want to see more clearly this Jesus who rejoices in my pleasures, the simpler the better, who smiles when I run rejoicing into the surf, hold my beloved or curl, warm and safe and drowsy, into bed.
And I want to be like Jesus, like Sam Malakite, open to my own joys and pain and confusion and also deeply attuned to the pleasures and the layered griefs of the world around me: our groaning planet and its threatened creatures, my family and my friends and anyone else whom the God of love places in my path, to minister to each other.
This was published in the December issue of The Melbourne Anglican


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Floral Guernsey was originally set up by the States of Guernsey in 1992 to promote our horticultural achievements and our floral and natural features.
In 2015 we became a charitable foundation with activities based around four areas.
- Community support including the Community Competition in association with the RHS and Britain in Bloom
- Legacy Projects that secure lasting and sustainable enhancements
- Education through schools support and competitions and the biennial Magical Days in the Park
- Open Gardens programme from April to October that allow local charities to raise money for various causes.
Creating Islands of Flowers' is our strapline and we aim to achieve:-
A highly visible year round enhancement of the built environment by means of seasonal floral displays and permanent plantings.
Preservation and conservation of our natural environment.
The undertaking of long – term larger projects that will make a major contribution for local enjoyment and as tourist attractions.
Bailiwick – wide recognition of the importance of maintaining high standards in public areas.


text: October 3, 2016 Ivy Ready Team Helix wrestler heading to Ivy League - The San Diego Union-Tribune October 3, 2016 Ivy Ready Team Ivy Ready Team Click the above link to continue to the article. To learn more about Ivy Ready Evaluation, Click here. Follow @IvyReady Share Subscribe for Special Updates


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A Feast Of Wire
It's got 'Quattro' on it, which is my favourite Calexico song ever.
Feast of Wire
ps, worst cover art ever? POSSIBLY.
It's annoyingly awful when placed next to the music on the album.
It's not that bad, is it?
I've seen much, much worse.
Feast Of Wire also, I'm afraid. It is great. Sunken Waltz is an incredible tune.
seems fairly unanimous
so I won't rock the boat. And the best Calexico song is Woven Birds...
Feast Of Wire is a terrific album. The follow-up, Garden Ruin, isn't quite as consistent or as interesting but has a few great songs, especially All Systems Red.
Hot Rail
The first album they really had it all come together perfectly.
all systems red is fantastic.
Another vote...
...for Feast of Wire, definitely - their most consistent album and it shows off their varied strengths.
If you like what you hear and you want to dig deeper, I'd suggest The Black Light for album No.2. Its a fine example of their earlier, more minimal sound - more whispered vocals and some incredibly moody & magnificent instrumental tracks...
they're all good
looks like i'm against the grain here, but reckon garden ruin is best, with the strongest songs.
feast of wire is the worst of a good bunch, it's not bad, but a bit samey and try-hard, too many strings for attempted emotion.
1 garden ruin
2 hot wire
3 spokes
4 the black light
5 feast of wire
think that's the lot


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G's Poppyseed Coffee Cake
This cake is famous in our family.
For as long as I can remember, every time we visit my wonderful Grandma ("G" as we affectionately call her) in Cape Cod, she always bakes one of her out-of-this-world Poppyseed Coffee Cakes for us.
The base is a buttermilk cake studded with poppy seeds with a cinnamon sugar ribbon swirled throughout the center. Once cooled the cake is dusted with confectioners sugar. It is absolute perfection.
I love this cake for breakfast with coffee, for brunch, lunch, snacking and dessert. It is that good.
Typically, G makes this cake with regular all-purpose flour, however the last time I went up to visit she surprised me and made a gluten-free version so that I could have some! I was craving a slice last week so I set out to bake my very first gluten-free Poppyseed Coffee Cake.
The exterior of the cake forms the slightest crust. It's still soft, but has a bit more texture than the inside of the cake. The interior is moist and fluffy.
And while it might look intimidating, the cinnamon sugar ribbon is very simple to create. Start by pouring half of the batter into a prepared baking pan.
Then evenly spread out the cinnamon sugar mixture.Top with the remaining batter.And voila! Your beautiful cake will have a surprise cinnamon sugar swirl throughout the center. Dust the top of the cooled cake with confectioners sugar.I love eating this cake both at room temperature and heated up for ten seconds in the microwave. It also freezes really well! Just slice the cooled cake up and wrap each slice really well before freezing.I bet this cake will soon become a family tradition for you, too.
Hugs, kisses + yummy dishes… xoxo
Poppyseed Coffee Cake
- Total Time: 70 minutes
- YIELDS 1 cake
- For the Cake:
- 1/2 cup poppy seeds
- 1 cup buttermilk
- 1 teaspoon vanilla extract
- 1 cup butter, room temperature
- 1 1/2 cups granulate sugar
- 4 large eggs
- 2 1/2 cups gluten-free all-purpose flour
- 2 teaspoons baking powder
- 1 teaspoon baking soda
- For the Cinnamon-Sugar Swirl Mixture:
- 1/2 cup granulated sugar
- 1 teaspoon cinnamon
- For Decoration:
- to taste confectioners sugar
- Preheat oven to 325 degrees.
- Grease a heavy bundt cake pan.
- In a small bowl, combine poppy seeds, buttermilk and vanilla and set aside.
- In a separate small bowl combine the flour, baking powder and baking soda and set aside.
- In a stand mixer (or electric hand mixer) fitted with the paddle attachment, cream the butter and sugar until light and fluffy.
- Add eggs, one at a time, until fully incorporated.
- Slowly add the dry ingredients to the creamed mixture, alternately with the buttermilk mixture, beginning and ending with the dry ingredients. Mix on low-medium speed just until fully incorporated.
- Pour half of the batter into a well-greased bundt cake pan.
- In a small bowl combine the sugar and cinnamon for the cinnamon-sugar swirl mixture. Sprinkle this over the batter in the pan.
- Pour the remaining batter on top of the cinnamon-sugar mixture.
- Bake for 50 minutes, until a toothpick inserted comes out clean.
- Let the cake cool in the pan for 10 minutes, then carefully remove from the pan to complete cooling.
- Once the cake is completely cooled, dust the top with confectioners sugar.
- Slice and enjoy! Excellent at room temperature or heated up in the microwave for a few seconds. (This cake also freezes incredibly well! Just slice the cake, wrap each slice individually in plastic wrap, and then in tinfoil. Remove slices from the freezer and let come to room-temperature before enjoying.)


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Ocean City, resort town, Worcester county, southeastern Maryland, U.S. Ocean City lies along a 10-mile (16-km) barrier beach between a chain of bays (Sinepuxent, Isle of Wight, and Assawoman) and the Atlantic Ocean, 29 miles (47 km) east of Salisbury. It is the state's largest seaside resort, with a summer population of 300,000. The Ocean City Inlet (which had long been silted up until it was opened by a great storm in 1933) connects the bays with the ocean. The bays offer safe harbour for boats and amenities for deep-sea fishing, bathing, and surfing. The site, with its sandy beaches, began to attract tourists after the building of the Atlantic Hotel in 1875. The arrival of the railroad in 1878 facilitated the development of this resort town; later highways from the Baltimore–Washington, D.C., area provided access to the city. Ocean Downs Raceway is noted for harness racing. Assateague Island, a narrow barrier island and national seashore, is across the ocean inlet at the southern end of Ocean City's barrier beach. Stephen Decatur, the naval hero, was born (1779) on a farm near Berlin, a few miles west on the mainland. Inc. 1880. Pop. (2000) 7,173; (2010) 7,102.
Learn More in these related Britannica articles:
Maryland: Drainage and soils…end the resort town of Ocean City, formerly located mid-island. The southern portion is now Assateague Island National Seashore, whose territory is shared with the state of Virginia. The inlet between the two islands has become a boon to Ocean City's resort fishing fleet. It has been kept open by…
Sandbar, submerged or partly exposed ridge of sand or coarse sediment that is built by waves offshore from a beach. The swirling turbulence of waves breaking off a beach excavates a trough in the sandy bottom. Some of this sand is carried forward onto the beach…
Bay, concavity of a coastline or reentrant of the sea, formed by the movements of either the sea or a lake. The difference between a bay and a gulf is not clearly defined, but the term bay usually refers to a body of water somewhat smaller than a gulf. Numerous…
Salisbury, city, seat (1867) of Wicomico county, southeastern Maryland, U.S., at the head of the Wicomico River in the south-central part of the Delmarva Peninsula, south of the Delaware state line. It was established in 1732 and named for the English city of Salisbury in Wiltshire. Historic landmarks include Old…
Assateague Island National Seashore
Assateague Island National Seashore, natural area including Assateague Island (a barrier island) and several nearby islets off the Atlantic Ocean coast of southeastern Maryland and eastern Virginia, U.S. The island is 37 miles (60 km) long, and the park, established as a national seashore in 1965, occupies some 75 square…
More About Ocean City1 reference found in Britannica articles
Assorted References
- Maryland


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File photo
There have been only three boating fatalities this year for 2018 – almost an all-time low - but already Maritime NZ is warning boaties not to become part of the usual "statistic spike" this summer.
Wellington wharf-jumper and incoming Chair of the Safer Boating Forum*, Maritime NZ Deputy Director Sharyn Forsyth, says the annual wharf jump is a reminder for boaties to "Prep, check and know" or prepare their boats, check their gear and know the rules.
"Nineteen boaties died in 2017 and while only three boaties have died this year there is a pattern of fatalities spiking over the warmer summer months. We know that boaties start getting in the water after Labour Weekend and we want to urge them to make sure they are ready for it."
Safer Boating Week starts this Friday with a splash when boating leaders in Wellington, Auckland and Niue put their lifejackets on and jump into their respective harbours.
"Jumpers will be put through their paces with lifejacket checks and a comprehensive health and safety briefing before leaping into the freezing harbour," she says.
"During Safer Boating Week we'll also be reminding boaties to 'Check your lifejacket' as we know that some lifejackets are failing which is a serious safety hazard.
"Checking lifejackets is something every boatie should do each time before going out on the water. It's too late if you discover a fault when you've capsized and really need your lifejacket."
Manufacturers advise modern lifejackets will last about 10 years.
"If your lifejackets are 10 years old, check them thoroughly with an eye to replacing and destroying them," she says. "Don't sell them or give them away – that creates a safety problem for another family.
"Worryingly, many Kiwi boaties are still relying on kapok-filled lifejackets that are 30 to 50 years old and should be destroyed immediately."
Research shows that two-thirds of recreational boating fatalities may have been avoided if people wore lifejackets all the time.
"If you are on the water when you discover a problem with your boat or equipment, or that you do not know an important safety rule, then it is too late and people are in danger."
More information for boaties can be found at:
Safer Boating Week www.saferboating.org.nz
Safer Boating NZ Facebook www.facebook.com/saferboating
Lifejackets www.maritimenz.govt.nz/lifejackets
Prep, check, know
Safer Boating Week is traditionally the week before Labour Day weekend, which is when many boaties start getting back on the water. It uses the slogan "Prep, Check, Know," to encourage boaties to take simple steps to get their boats and themselves ready before they get back on the water.
Prep your boat service the engine, check and change the fuel, check the battery, and generally give the boat a good once-over.
Check your gear make sure your lifejackets are still fit for purpose and you have enough, service any inflatable lifejackets, ensure you have two reliable forms of communication equipment – usually, marine VHF radio is best, check the marine weather forecast.
Know the rules ensure you know the rules of the road on the water, and check your local bylaws to make sure you understand what the requirements are in your area.
A week of boating events, and news media and social media activity has been planned by councils and boating organisations all around the country, details at www.saferboating.org.nz and on Facebook at Safer Boating NZ.
Boating by the numbers 2018
- 1.51 million adults in New Zealand (about 42% of the adult population) took part in recreational boating last summer
- Kayaks were again the most popular form of recreational vessel owned or used by boaties (33%), followed by power boats up to 6 metres (22%) and dinghies (11%).
Some long-term statistics:
- 90% of fatalities are men aged about 40 and older
- 85% of fatalities occur in boats less than six metres long
- For 75% of fatalities in boats less than six metres capsize is a major factor; 28% for vessels over six metres
- 2/3 of fatalities would likely be prevented if lifejackets were worn
- For around 58% of fatalities, no effective communications is a major factor
- 19-20 boaties, on average, die each year (based on last five years); 19 last year and three this year as at October 1.


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The Teamsters and Kent County YMCA stepped up when it was learned the Rhode Island Convention Center was looking to donate 10 pallets of food – most of it perishable – Friday afternoon. As the Teamsters agreed to get the food to the Y, Y director Julie Casimiro quickly got on the phone to alert area food pantries of the bounty. They showed up at the Y, while others made deliveries to shelters. Foods included boxed ready-to-cook meals, yogurt and pizzas ready for the oven. Assisting to offload the food was off-duty members of the Warwick Fire Department.
Many thanks and congratulations to the Teamsters and especially to the Warwick Firefighters that donated their time and efforts to this great cause. The off-duty firefighters in Warwick deserve our respect for jumping in to help with little or no notice.
Did you hear that Rob Cote? They were off-duty! How about giving them credit for it, and don't use the words "but" or "however". Just, for once, give credit where credit is due. Fair enough?
Happy Summer everyone.
Rick Corrente
The Taxpayers Mayor
And the most cringe-worthy comment goes to......
Give the make-believe mayor time, Cat. He is certain to humiliate himself even more in future comments.