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Healthcare Industry News: retractor
News Release - March 13, 2013
Hospital Acceptance of Vycor's Patented VBAS Minimally Invasive Neurosurgical Device Continues to AccelerateBOCA RATON, FL--(Healthcare Sales & Marketing Network) - Vycor Medical, Inc. ("Vycor") ( OTCBB : VYCO ), a provider of innovative and superior surgical and therapeutic solutions, announced that it continues to experience an increase in the number of hospitals where its patented ViewSite� Brain Access System� ("VBAS") device has been approved for use. VBAS is now approved in over 100 hospitals in the U.S. and the number continues to grow. To date, more than 4,000 surgeries have been performed utilizing VBAS.
VBAS is ISO 13485:2003 compliant, has U.S. FDA 510(k) Clearance for brain and spine surgeries, and regulatory approvals for brain surgeries in Australia, Canada, China, Europe, Japan, Korea and Russia. Vycor holds 2 patents for its VBAS with 14 additional patents pending.
Traditional tools for brain access and retraction have not changed much in more than 50 years. Advantages of the innovative Vycor VBAS over the long-established standard of care device, the "blade retractor," include:
Provision of a minimally invasive approach into the brain which results in reduced "white matter" damage to the surrounding tissue and is likely to lead to improved surgical outcomes for patients.
Improved visibility for the surgeon due to the VBAS transparent tubular form.
Reported to result in reduced surgical time which results in lower costs of procedures.
The ability to be used with IGS (Image Guided Systems).
It is VBAS' minimally invasive profile that has led surgeons to use the device in procedures that they considered previously to be "inoperable."
The product's minimally invasive profile and clinical superiority has been documented in five studies including peer-reviewed articles by leading institutions including John's Hopkins University, University of Illinois at Chicago, and the Cleveland Clinic (Pediatrics Department).
A video highlighting the VBAS, including commentary from several neurosurgeons, can be found at: http://player.vimeo.com/video/39766887
Commenting on the Company's progress, David Cantor, President of Vycor, stated, "We continue to be very excited by the potential we see for our VBAS product which continues to gain traction in both the U.S. and international markets. The annual worldwide addressable market for the current VBAS products is estimated at approximately $400 million -- of which approximately $115 million is in the U.S. In the past two years, our VBAS sales have shown strong growth and we believe that eventually the VBAS device will become the 'Standard of Care' for brain retraction."
About Vycor Medical, Inc.
With corporate headquarters in Boca Raton, FL, Vycor Medical, Inc. ("Vycor") is a publicly traded company ( OTCBB : VYCO ) dedicated to providing the medical community with innovative and superior surgical and therapeutic solutions and has a growing portfolio of FDA-approved medical solutions that are changing and improving lives every day. The Company operates two business units: Vycor Medical and NovaVision, both of which adopt a minimally or non-invasive approach. Both technologies have exceptional sales growth potential, address large potential markets, have the requisite regulatory approvals and are commercialized and generating revenue. The Company has a strong patent portfolio with 31 granted patents and a further 24 patents pending.
Vycor Medical's flagship, ViewSite� Surgical Access Systems (VBAS) is a suite of clear cylindrical minimally invasive disposable devices that hold the potential for speedier, safer and more economical brain surgeries and a quicker patient discharge. VBAS is designed to optimize neurosurgical site access, reduce patient risk, accelerate recovery and add tangible value to the professional medical community. Vycor Medical is ISO 13485:2003 compliant, has FDA 510(K) clearance for VBAS for brain and spine surgeries and regulatory approvals for brain surgeries in Australia, Canada, China, Europe, Japan, Korea and Russia. For an overview of Vycor Medical's VBAS see http://player.vimeo.com/video/39766887
NovaVision develops and provides science-driven neurostimulation therapy and other medical technologies that help improve and partially restore sight in patients with neurological vision impairments. The company's proprietary Visual Restoration Therapy� (VRT) platform is clinically supported to improve lost vision resulting from stroke, traumatic brain injury ("TBI"), or other acquired brain injuries. VRT is the only FDA 510K cleared medical device in the U.S. aimed at the restoration of vision for neurologically induced vision loss and can be prescribed by any ophthalmologist, optometrist, neurologist or physiatrist. VRT also has CE Marking for the EU. NovaVision also provides Neuro-Eye Therapy (NeET) in the EU, aimed at increasing visual sensitivity deep within the field defect. NovaVision also provides a fully portable and ADA-compliant Head Mounted Perimeter (HMP�) which aids in the detection and measurement of visual field deficits. For an overview of NovaVision see http://player.vimeo.com/video/39765566
For the latest information on the company, including media and other coverage, and to learn more, please go online at www.vycormedical.com or www.novavision.com.
Safe Harbor Statement
Information in this document constitute forward-looking statements or statements which may be deemed or construed to be forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. The words "forecast," "anticipate," "estimate," "project," "intend," "expect," "should," "believe," and similar expressions are intended to identify forward-looking statements. These forward-looking statements involve, and are subject to known and unknown risks, uncertainties and other factors which could cause Vycor Medical's actual results, performance (financial or operating) or achievements to differ from the future results, performance (financial or operating) or achievements expressed or implied by such forward-looking statements. The risks, uncertainties and other factors are more fully discussed in Vycor Medical's filings with the U.S. Securities and Exchange Commission. All forward-looking statements attributable to Vycor Medical herein are expressly qualified in their entirety by the above-mentioned cautionary statement. Vycor Medical disclaims any obligation to update forward-looking statements contained in this estimate, except as may be required by law.
Source: Vycor Medical
Issuer of this News Release is solely responsible for its
Please address inquiries directly to the issuing company.


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The National Viral Hepatitis Roundtable Decries the Ban on Use of Federal Funds for Syringe Exchange
The National Viral Hepatitis Roundtable (NVHR) condemns the imposition of a ban on use of federal funds for syringe exchange in the omnibus spending bill. The FY 2012 omnibus, passed today in the House and expected to pass in the Senate tomorrow, reinstates a complete ban on use of federal funding for syringe exchange programs. This reversal of federal policy represents a huge step backwardin the fight to eliminate hepatitis C and other blood-borne viruses, despite numerous studies demonstrating that access to sterile syringes reduces the incidence of HIV and viral hepatitis.
Access to sterile syringes a cost effective life saving measure, and syringe exchange programs also connect people who use drugs to substance use treatment and medical care. "For two years, since the original lifting of the ban, syringe exchange programs around the country have worked closely with local law enforcement and health officials to make syringe access a part of their communities' HIV and viral hepatitis prevention strategies," said Daniel Raymond, chair of NVHR and policy director for the Harm Reduction Coalition in New York City. "In a year when the Department of Health and Human Services'Viral Hepatitis Action Plan endorsed syringe access as a cornerstone of viral hepatitis prevention, this terrible setback will result in new infections and increased medical costs."
"We cannot afford to ignore the evidence and turn back the clock on disease prevention, at a time when many parts of the country – particularly in rural and suburban areas – are reporting rising hepatitis C rates among adolescents and young adults," Raymond continued. "NVHR will continue to fight for syringe exchange and all of the public health tools and strategies needed to prevent a new wave of infections among the next generation of injection drug users. We call upon Congress and the Administration to move swiftly to reverse this damaging policy."
The National Viral Hepatitis Roundtable is a coalition of public, private, and voluntary organizations dedicated to reducing the incidence of infection, morbidity and mortality from viral hepatitis in the United States.

subset: commoncrawl


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Study Compares the Effect of Two Different Methionine Sources in Commercial Broiler Diets
Results indicate both HMTBa and DL-Methionine deliver equal methionine value
ST. LOUIS, Mo. (April 9, 2015) — The Schothorst Feed Research Institute, an independent private research and consultancy institute for animal nutrition, recently performed a trial to determine the effects of graded inclusion levels of added methionine in broilers. Recent works indicate that DL-Hydroxy Analogue of Methionine (HMTBa) and DL-Methionine (DL-Met) have a dose dependent equivalency with different asymptote values. The study aimed to confirm this equivalency by assessing the two sources of methionine.
Over the course of 38 days, researchers compared the supplementation of HMTBa, DL-Met and their combination in broiler diets. In total, 1600 male and female Ross 308 broilers, housed in 80 pens (10 treatments x 4 replicates x 20 broilers x 2 sexes) were fed one of ten dietary treatments, supplemented with HMTBa and/or DL-Met at three graded levels to a basal diet in the starter, grower and finisher phases. Trial results indicate both HMTBa and DL-Met provided equal methionine value (100%) to birds at all doses.
Below are the key findings from this study:
Novus International, Inc., a leader in animal nutrition, is capitalizing on nearly 50 years of experience in the methionine market and science behind the HMTBa molecule. To learn more about Novus's methionine solutions, visit www.novusmethionine.com.
About Novus International, Inc.
Novus International, Inc. is headquartered in metropolitan St. Louis, Missouri, U.S.A. and serves customers in over 100 countries around the world. A global leader in developing animal health and nutrition solutions, Novus International's products include ALIMET® and MHA® feed supplements, ACTIVATE® nutritional feed acid, ACIDOMIX® preservative premixture, CIBENZA® enzyme feed additive, MINTREX® chelated trace minerals, SANTOQUIN® feed preservative, AGRADO® feed antioxidant and many other specialty ingredients. Stratum Nutrition, a division of Novus Nutrition Brands, LLC, focuses on human nutrition through specialty and functional ingredients for manufacturers of foods, beverages and dietary supplements (www.stratumnutrition.com).
Novus is privately owned by Mitsui & Co. (U.S.A.), Inc. and Nippon Soda Co., Ltd. For more information, visit www.novusint.com. ©2015 Novus International, Inc. All rights reserved.


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Has any game in history ever been bashed as badly as Dead Rising: Chop Till You Drop? It's one thing for a game to get bad reviews after the final build is sent out to reviewers, but the situation with Dead Rising: Chop Till You Drop has been something else entirely. Ever since the game was announced last year, it has been mocked by everyone from journalists who have played early builds of the game to folks at home who have only seen video of it.
If possible, I'd like you to forget all the opinions you've already read (or formed yourself) about Dead Rising: Chop Till You Drop. You should also forget everything you know about the original Dead Rising if you can. Comparing Dead Rising and Dead Rising: Chop Till You Drop is something we'll do here at Destructoid very soon, but for this review, I'd like to focus on just one question:
"Is Dead Rising: Chop Till You Drop any good?"
Hit the jump for my answer.
[Editor's note: This review is based on a play-through of the game on Hard difficulty.]
Dead Rising: Chop Till You Drop (Wii)
Developer: Capcom
Publisher: Capcom
Released: February 24, 2009
How much you will enjoy Dead Rising: Chop Till You Drop has everything to do with what you expect from the game. That's the real reason I asked you to forget about the 360 version; if you go into this Wii adaptation expecting the same game you had on the Xbox 360, you're going to be wildly confused by what you get. The two games are in two totally different genres (Dead Rising 360 is a 3D beat-'em-up; Dead Rising: Chop Till You Drop is a third-person shooter) and have totally different gameplay structures (Dead Rising 360 is a time-limited sandbox game; Dead Rising: Chop Till You Drop is a semi-linear, time-ranked adventure game), and as such, they require you to think in totally different ways (Dead Rising 360 requires you to constantly be aware of the time so you don't miss any appointments; Dead Rising: Chop Till You Drop requires you to constantly be aware of your immediate surroundings and what weapon you're holding or else you'll get murdered). All the two titles really have in common is the their story.
What I'm saying is, if Dead Rising is like a bunch of grapes, and Resident Evil 4: Wii Edition is like an apple, then Dead Rising: Chop Till You Drop is a grapple. It sort of tastes like a grape, but clearly, what you're eating is some kind of apple, and we all know what happens when you compare apples and grapes.
That's right: you make an ass out of apples and grapes.
That's why I didn't want to get into that comparison right now, and would rather stick with the question from before: "Is Dead Rising: Chop Till You Drop any good?"
The short answer is, "Yes, it's a hell of a lot of fun." It's the kind of game that you can play for hours longer than you planned, due to that "just one more level" compulsion that has plagued videogame aficionados forever. It's the kind of game that could very well be the last thing you think about before you go to bed at night, and the first thing you think about in the morning. Despite its flaws, it's a game you can fall in love with.
Here's why.
Dead Rising: Chop Till You Drop is the story of a group of humans trapped in a mall overrun by zombies. The game stars Frank West, a photojournalist who initially is driven by nothing more than his own ambition, but by the end of the game, finds more noble reasons to pursue the truth. Like most good zombie films, Dead Rising: Chop Till You Drop is sometimes scary and sometimes funny, but under it all is a message about trust, American culture, and the meaning of life. It's a story that's full of ridiculous moments (cannibal butchers and chainsaw-wielding clowns are commonplace), but at its heart are some pretty interesting themes.
Also interesting is the way the game is played. Dead Rising: Chop Till You Drop isn't really like any other game I've ever played, but the closest thing I could compare it to is Resident Evil 4: Wii Edition's Mercenaries mode. Just like in Mercenaries mode, the zombies here respawn constantly. You can never totally clear an area of enemies; they will always come back, sometimes just seconds after you move forward.
The game uses RE4's control scheme with a few additions, like the ability to use an RE5-style real-time overlay to change weapons and reload. It also allows you to use items in your surroundings as melee weapons: shower heads, TVs, and chainsaws are all potentially at your disposal. Some items, like the frying pan, can be enhanced by stuff you find in the environment. Heat up the pan on a stove top found in one of the mall's restaurants, and you have yourself a weapon capable of frying zombie faces off.
As cool as the melee weapons are, you'll be spending more time using guns to take on your enemies. For the first hour or so of the game, the only enemies you face are regular zombies, who are equally easy to kill with hand-to-hand or distanced combat. After that, though, the mall starts to gradually be overrun with more and more enemies that are next to impossible to take on without the right gun and a decent sense of aim. It starts with zombie poodles and parrots (which behave a lot like Resident Evil's dogs and crows), and then come the giant taser-toting zombies that remain unfazed even when chainsawed in the face. After that come the parrots trained by some maniac to drop grenades on you (ridiculous, I know, but so are chainsaw-wielding clowns), the gun-carrying photographer zombies, and the fast-running, machete-carrying undead.
In case you haven't guessed, these are not your run-of-the-mill Romero-style zombies. They definitely have a lot in common with them; in almost everything they do, they appear mindless. Even when they point their guns at you, they do it with that kind of limp, lifeless automation that most serious zombie fans look for in an undead performance.
Where they differ from Romero zombies is in their level of unpredictability. You never, ever know what these zombies are going to do. In the average group of zombies you come upon (usually 10-30 at a time), half of them may start wandering towards you, three or four may just stand there, and the rest may actually run at you. As the game goes on, the zombies get more skilled at attacking you, and sometimes actually run behind you for an attack.
Keep in mind, this is just the regular brand of zombie I'm talking about. On top of worrying about what those zombies are going to do, you commonly have to worry about the poodles, parrots, or "special zombies" I described earlier. All of these enemies are best dealt with in particular ways that you'll have to learn as you progress through the game. At the very least, you will have to learn to recognize the signature noises each of these zombies make. Since you're constantly surrounded by them, you'll often hear these jerks creeping up from behind long before you can see them.
As you get more experienced in playing Dead Rising: Chop Till You Drop, Frank West will gain experience, strength, and money. Killing zombies in particular ways (usually using some combination of gun and melee attacks) will yield more money and experience points. Most of the time, you'll be killing the zombies around you for self-defense, but you'll also spend some time killing them for profit (and fun).
What this leads to is gameplay that can turn on you instantly. One second, you'll be having a ball cutting 20 or 30 zombies up at a time with a chainsaw just because it feels good; but then your chainsaw is broken and you're surrounded by 20 or 30 angry, sometimes fast-running zombies with nothing but whatever gun you have and your fists to protect you.
The game is pretty hard at times ... at the start. Like many games in the third-person shooter genre, by the end of the game, you're pretty much a walking tank, and even hordes of "super zombies" won't really feel as dangerous anymore. It took me 10 hours to beat the game. In that time, I'd killed a little over 5,000 zombies, and died about ten times. I'd put the overall difficulty of the game right above that of Resident Evil 4: Wii Edition.
Even after you're done with the game, there are tons of extras thrown in to add to the replay value. Though I technically beat the game, there are a lot of things I won't see until I play through it again. In order to unlock all of the content here, you need to get an "S" on each of the campaign mode's "missions." These are usually escort missions in which you are tasked to rescue one of the many survivors trapped in the mall. Since you're dealing with people, though, it's rarely as simple as just finding them and bringing them back to safety. Sometimes, they won't speak English, so you'll need to find a dictionary in a local book store to explain that you're there to help. Another time you have to feed a guy a well-done steak before he'll be willing to go with you. It's little touches like that keep the game feeling fresh, and not like Crazy Taxi on foot in a mall full of zombies.
You can replay the game to get a better grade on missions and see new things (including new missions, weapons, and clothing items). You also unlock a Bionic Commando outfit if you beat the game twice (and who knows what for beating it a third or fourth time). There is also some content that was too difficult and/or too weird for the main game, in the form of "Odd Jobs" and "Second Amendment" bonus missions. This is where you'll fight stuff like invisible zombies, giant zombies, incredibly fast zombies, and all the game's bosses at once.
Speaking of of the game's bosses, they are probably one of the game's weaker features. Though they are usually pretty interesting, and sometimes laugh-out-loud funny, they are almost always too easy. A couple of the bosses in the middle of the game were tough, and the very last boss killed me a few times, but other than that, they all go down without much of a fight.
Another thing I'd change about the game is its technical specifications. This is a $40 game after all, but still, I would have been happy to pay an extra ten bucks for the game if it would have led to Capcom putting a little more money into the game's budget. Sadly, this isn't the ugliest-looking game on the Wii, but it does look substantially worse than RE4, a game made on much weaker hardware. Just like No More Heroes, Dead Rising: Chop Till You Drop is a very PS2-looking game, with occasional pop-in and ugly texture when objects get too close to the camera.
Other than the boss fights and the graphics, there isn't too much I'd change about this game. As a huge fan of Resident Evil 4, Dead Rising: Chop Till You Drop offered a similar take on that experience, but with more enemies on-screen, more melee weapons, more comedy, and more action. As soon as I get done with this review, I plan on getting back into the "Second Amendment" part of the game. If you get an "S" rank on all 20 of these sniper-based sub-missions, you unlock Mega Man's arm cannon. Then I'm heading back into the campaign mode with that gun for a second play-through to unlock the Bionic Commando outfit.
Wish me luck!
Oh yeah, the score ...
Score: 8.0 -- Great (8s are impressive efforts with a few noticeable problems holding them back. Won't astound everyone, but is worth your time and cash.)
reviewed by Jonathan Holmes


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Nation-Wide Facial Recognition Service Being Launched by FBI
I first started working with Biometrics back in the 1970's in helping a graduate student develop a signature recognition system. Back then we were using mainframes, punch cards, a TTY33 and some very grainy EBCDIC artwork to help render the signatures. We never got very far, but we were able to make some interesting inroads. Boy have things changed.
We've talked on the show before about the NFL's ties to the FBI and CIA and how you haven't been able to go to a Super Bowl football game in years without having your photograph taken and analyzed against a database of known terrorists and criminals. This technology has reportedly been used to stop and arrest less than a handful of people over the course of the program.
The UK has become surveillance-central with tens of thousands of cameras capturing images of people's faces, automobiles and tracking them as they move throughout the cities. This information is also being used to fight crime and detour n'er-do-wells.
Now the FBI has stepped in and is planning on rolling out a national-wide Facial Recognition Service which will allow any cop on the street with a smartphone to take your photo and run it through an FBI background check. Police vehicles will end up being equipped with cameras which go beyond their current function of running every license plate of every car within their shot to be fully integrated with the FBI and used to look up your background. Hopefully, they'll catch a few bad guys.
But data has a way of sticking around.
Given a few years, this database of queries against the system will contain incredible information about the movement of people throughout the country and around the world. The government will be able to question you because they think your movements aren't quite what they'd like them to be. They will be able to determine where you work, which restaurants you frequent, which car you drive and much more.
Database analytics has become a very large field for the government, and with the advent of a national facial recognition service, database vendors will be able to look forward to their best growth ever. Citizens, however, must be eternally vigilant to make sure this type of power does not become mis-used.
And the private sector? Google, Facebook and others are pretty excited about using facial recognition to tie all of your photographs together. Kinda nice to be able to find shots of your great aunt Lucy with your Mom and Dad, and the marketing angles are incredible. So are the risks.
Related articles
- FBI Plans Nationwide Face-Recognition Trials In 2012 (yro.slashdot.org)
- FBI Ramps Up Next Generation ID Roll-Out – Will You End Up in the Database? (eff.org)
- Heathrow to get new facial recognition scanners (go.theregister.com)
- As Facial Recognition Improves, New Privacy Controversies Await (readwriteweb.com)
- Facebook: How To Disable Facial Recognition (laydilejur.com)
- You can run but you can't hide! Google buys Facial Biometrics company (yourdaddy.net)
- The Future of PR… Facial Recognition? (journalistics.com)
- Cloud-Powered Facial Recognition Is Terrifying (yro.slashdot.org)


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SMF - Just Installed!
Really? It's a culture reference. Pinocchio?(You were joking, right?)Or he's about to reveal how odd it was that she was able to analyze all of this in such a short amount of time.
Yeah, just that the pinocchio thing makes 0 sense to me in this context. She's smug, and she really is amazing, so why the nose thing? Plus, its a sudden change of comic style, which is just odd (ie up to now there were never such "facial expressions" in the comic). Whatev, just found it strange, personally.
But what about Crest? We miss... actually, I'm not that interested in him.


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Hover to Magnify or Click to Zoom Click to Zoom
Suppliers are subject to change.
Always check for the "Made in the USA" label!
Set includes 2 funnels
View More in Kitchen & Dining Department
Smart Shopping
May 07, 2019
When you shop the aisles of Walmart these days, you will see lots of products sporting new red and blue "Made in the USA" logos. Those labels are part of Walmart's new initiative to commit $250 billion through 2023 to source and promote product...WalmartStore BrandsMade in the USA
Smart Shopping
June 30, 2020
Have you had a chance to read our Guide to Walmart's "Made in the USA" Campaign or visit our database of Walmart's Made in the USA products? If so, you already know that Walmart's initiative to source store-brand products that are made, ass...WalmartMade in the USAStore Brands
Smart Shopping
April 20, 2020
Over the past several years, amid recalls of dogfood, toys, and other foreign-made products, posts have circulated on social media about the importance of buying American and ways to see if what you're buying was made overseas. One of the most p...Made in the USA


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Reorder pages in navigation bar
As you build out your site, you may need to change the order of the pages in your website's navigation bar. If you change your mind later on, you can quickly reorder them again.
- Log in to your GoDaddy account and open your product. (Need help logging in?)
- Click Edit Site.
- Click Pages in the My Site panel.
- In the Pages & Navigation panel, find the page you want to move, click the three small bars on its left, and drag it to its new position.
- Your changes are saved automatically so when you're finished, click Preview to see the results.
- When you're ready to make the changes public, click Publish Site or Publish.


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The 2015 edition of the World Press Freedom Index is out and Kuwait is up a spot from last year and still leading in our region.
Q Kuwait is an online community for everyone living in or interested in the State of Kuwait. All trademarks and copyrights on this page are owned by their respective owners. Q Kuwait is not responsible for any material submitted to the site. Any material posted is not endorsed, reviewed or approved by the Website Owner.
Stay informed on our latest news!
© 2020 Q Kuwait. All Rights Reserved.


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We've all been waiting with bated breath to find out who has won the precious role of golden boy Finnick Odair in the upcoming Hunger Games sequel Catching Fire, but let's not forget that there's a whole flock of new characters that need casting. The latest news? Lionsgate has announced that Academy Award winner Philip Seymour Hoffman has been cast in the role of Plutarch Heavensbee, the new and gregarious Head Gamemaker who will take the place of Wes Bentley's Seneca Crane.
Let's take a moment to celebrate this decent bit of casting news before moving on to focus on more important things, mainly that I once waited on Philip Seymour Hoffman and he ordered six macchiatos that he then consumed by himself over the period of an hour. Stars are not just like us, you guys.
Philip Seymour Hoffman Officially Cast in Catching Fire [Vulture]


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GIRLS BASKETBALL: Thomaston goes into the Berkshire League Tournament as the No. 1 seed
After a great Berkshire League season which couldn't have ended in a more dramatic fashion, the Thomaston Golden Bears won the league title after beating the Nonnewaug Chiefs 55-48 last Friday on the final night of the season.
There is little to no time off though for the girls as the Berkshire League tournament starts today for six out of the seven teams in the tournament.
Thomaston, because they won the league outright with a 16-2 record will be the No. 1 seed and have a bye tonight.
The first round will feature No. 2 Lewis Mills (15-3), who was awarded the second seed after winning a coin toss against Nonnewaug, will host the No. 7 Terryville Kangaroos (8-10) at 7 p.m. on tonight.
The No. 3 seed Nonnewaug (15-3) will host No. 6 Housatonic (8-10) at 7 p.m. and No. 4 Northwestern (13-5) will host No. 5 Litchfield (8-10).
The semi-finals and finals will be held on Thursday and Friday at Thomaston High School.
Record: 16-2 in Berkshire League, won the league championship.
Head Coach: Bob McMahon
Players to Watch: "Our two seniors, Sydney Keith and Maggie Eberhardt, have started since day one. Also junior Abby Hurlbert has basically started since day one," said head coach Bob McMahon. Eberhardt led the Berkshire League with 17.7 points per-game.
Biggest Strength: "Experience in big games, gives us an edge," said McMahon.
Biggest Obstacle: "Northwestern beat us twice this year and we play the winner of Litchfield and Northwestern in the next round," said McMahon.
Northwestern beat Thomaston twice this season 43-42 on January 11 and 54-49 on February 15.
Lewis Mills:
Record: 15-3 in Berkshire League, won coin toss to be No. 2 seed.
Head Coach: Joe Capitani
Players To Watch: Teagan Dunn who led the team with 15.2 points per-game this season. Natalie Ruel added 12.9 points per-game as well for the Spartans.
Reaction to winning tie-break coin toss: "I don't think it means much to be the two or the three. We would of had to have played Housatonic or Terryville which are both strong teams, they both made the state tournament. They have kept pace with us at times during the regluar season. There is no preference in what seeding we were," Capitani said.
Biggest Strength: "Our mental toughness, were motivated to win this tournament. It means alot to us, means alot to the girls to prove that they can play with the top teams in the Berkshire League," Capitani said.
Biggest Obstacle: "We need to focus on our defense and our help position. Terryville has a great player in Olivia Pilarski, who can post up, shoot the three, who can take you off the dribble. Lesleigh Carter is going to defend her one-on-one but we have worked all year playing together, as a unit on the defensive end, we just have to brush up on some things before tomorrows game," Capitani said.
Teams to watch: "I think Nonnewaug and Thomaston are the two toughest teams in the league. We have to focus on taking care of business tomorrow night first before we get to either of those other teams. Both those teams play a role in helping us pinpoint our flaws and trying to improve on them at this point of the season.
Record: 15-3 in Berkshire League, lost coin toss to Lewis Mills to be No. 2 seed.
Head Coach: Adam Brutting
Players To Watch: "Jess Fengler is playing well right now; her confidence is up right now and Ally Rescsanski can hit shots from the outside," said Brutting. Also Katie Burke who was third in the Berkshire League with 16.7 points per-game.
Biggest Strength: "The fact that we never stop we are always working not matter if we are up or down. We showed that last Friday night," said Brutting. "We can't look past any of the teams but, our goal is to get back to Thomaston and play them on their home court."
Biggest Obstacle: "I think any team you face at this time in the season," said Brutting. "Thomaston has beaten us twice, Northwestern can rebound."
Record: 13-5 in the Berkshire League.
Head Coach: Fred Williams
Player To Watch: Rasa Hamel who was second in the Berkshire League in scoring with 16.8 points per game.
Biggest Strength: They are the only team to beat Thomaston this season in the Berkshire League and they did it twice.
Biggest Obstacle: If they get past Litchfield in the first round they will go against Thomaston, who will want to avenge their two previous losses.
Record: 8-10 in the Berkshire League.
Head Coach: Jessica Zenowitz
Player To Watch: Isabelle Binstadt led Litchfield with 13.6 points per game.
Biggest Strength: Along with Binstadt, the Cowboys have Tara Shakley and Sierra Markelson who also scored over 10 points per-game.
Biggest Obstacle: The Cowboys have a tough road ahead; they play Northwestern in the first round and if they get past the Highlanders they will face Thomaston in the semi-finals. The Cowboys are a combined 0-4 against both of those teams.
Record: 8-10 in the Berkshire League.
Head Coach: Frank Hadsell
Player To Watch: Heather Kearns, who scored 14.9 points per-game this season.
Biggest Strength: The beat fellow tournament team, Terryville twice during the season.
Biggest Obstacle: Housatonic will play Nonnewaug in the first round, who they have lost to twice this season. If they can get past the Chiefs, Housatonic would then play either Lewis Mills or Terryville.
Record: 8-10 in the Berkshire League.
Head Coach: Damian Coggshall
Players To Watch: Olivia Pilarski, who led her team with 13.8 points per-game this season and her sister Julia who averaged 10 pointer per-game this season as well.
Biggest Strength: They beat Northwestern this season on opening day.
Biggest Obstacle: Terryville will play against Lewis Mills who they lost to twice this season. If they get past the Spartans they will have to either Housatonic or Nonnewaug.


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In the ongoing struggle between cities and illegitimate massage businesses, the California Massage Therapy Council has proposed new legislation to give cities more power.
The CAMTC Board of Directors voted this week to suggest legislation that would allow cities to shut down any massage establishment that is cited for prostitution, fine the owner $50,000, prohibit a massage business from opening in the same location for the following 10 years and prohibit the owner or his or her company from opening another establishment in the city.
"We hope this legislation will make it clear to local governments that we share the common goals of providing healthy, legal and quality care for the people of California, and working together to distinguish therapeutic massage services from criminal prostitution," CAMTC CEO Ahmos Netanel said in a statement.
The California Massage Law created the CAMTC to facilitate licensing and regulation of massage businesses. Many local cities have complained that the law, which says cities can't pass laws specifically discriminating against massage parlors, has tied their hands in stopping what they say is too many massage businesses coming into their cities.
The issue has been prominent in the San Gabriel Valley for the last few years. For example, South Pasadena recently cited two establishments for prostitution, which were both allowed to remain open after the arrested massage technicians were removed. Recently, cities such as San Gabriel have begun to explore options for reducing the number of businesses in the city, or at least increasing surveillance to eliminate illegal activity.


text:
Get a free audiobook
Hot Blooded
Publisher's Summary
The second novel in the Jessica McClain series is a full on action adventure featuring one angry Goddess and plenty of monsters, demons, and a few newly risen beasties....
It hasn't been the best week for Jessica McClain.
Her newly found mate has been kidnapped by a Goddess hell-bent on revenge, and Jessica is positive she can save him.
But being the only female werewolf in town comes with its own set of rules and powers...if only she understood them.
Aided by two vamps, two loyal Pack members, and one very reluctant human, Jessica must rescue her man while coming to terms with what being a wolf really means.
What the critics say
"Amanda Carlson's debut novel is a fast paced tale with a cliffhanger ending that left me panting for more. Full Blooded left me on the edge of my seat from cover to cover." (New York Times best-selling author Faith Hunter)
"Rising star Carlson is rapidly building a rich world filled with intrigue, betrayal and hidden prophecy; all in all, this series second is a magnificent showing." (RT Book Reviews Top Pick)
"A wild, wolfy ride that will have you howling for more!" (Kristen Painter, author of Blood Rights on Full Blooded)
More from the same
What listeners say about Hot Blooded
Reviews - Please select the tabs below to change the source of reviews.
- Kindle Customer
- 2013-04-26
A good story, but not as good as the 1st
I liked the book; I just didn't like it as much as the first book. If you enjoyed the first book, you will still like this one. I tried to figure out what part I didn't like. What I came up with was the underdevelopment of the secondary characters. Just my personal opinion, of course, but the book would have had a little more depth to it if the secondary characters where a little more developed. Hopefully the main character will mature as the story goes a long. How do you continue to stress that she is only a 1 week old wolf, but all of your supposedly mature wolves have put her in charge? We are not talking power. We acknowledge that she has more power, but she has NO experience but she is suddenly leading everyone, even her father. And another thing that was very irritating to me, were the fight scenes, particularly the last fight scene. No one has time to have so many long drawn out conversations with her wolf and anyone else during the darn fight scenarios. For example: When you first go into the cave, you tell yourself that you have to go straight for the evil goddess because if you don't, she will be able to throw a spell and you will end up trap a long with your mate. BUT, repeatedly throughout the fight instead of following your own advice, you go for your mate. And not only that, you map out a complete scenario of how you are going to do it and why. NO! Just NO! You do not have time to think of all that crap. Honestly, there is no way she could have won the freakin' fight with how the fight scenes were written. I know, I know. I was just frustrated with the entire cave scene. My children were laughing at me because I kept yelling, "You don't have time for that!!!!" lol
I will purchase the 3rd book and I am keeping my fingers crossed that the main character is a little more mature and that the other characters don't seem to sitting or standing around waiting for a 1 week old to make all the decisions.
4 people found this helpful
- Courtney Corbin
- 2016-11-06
Much better reader
This is a mucher better reader. More life-like. You can tell the different characters in the story
- 2016-10-23
Narration makes all the difference
Thank goodness the narrator was changed after the first book. I almost didn't make it through the first one, but I'm glad I did.
- Amazon Customer
- 2015-11-29
over all good, but takes so long
I liked where the story went, but it could have been half as long, if that. I had to listen to it on 2x playback because everything in the story takes a billion more details and side notes than what is needed to get anywhere. Therese Plummer does a great job as usual, it was I little odd getting used to a new image of the characters since a different narrator did the first book. Overall, I'm happy with the series so far.
- Amazon Customer
- 2014-07-07
Just OK.
Maybe I went in to this book with too high expectations but I couldn't help but feel it kinda mostly just sucked.
In my mind the story can be summed up as hiking, fighting, "omg Jessica can do what now?", hiking while pining annoyingly over kidnapped mate whom Jessica has only known for like five seconds, more fighting, Jessica shoots rainbows out her rear and then hikes some more. It felt like the whole plot was taken up in clarifying the extent of Jessica's powers and it just didn't work for me at all.
Having said all that, I did manage to finish the book and it did have just enough plot development to keep me listening. I do kind of feel like the proverbial horse chasing after a carrot on a string and I'm not entirely convinced the author is actually going to deliver said carrot but I'm willing to read the third book to find out.
- Melanie
- 2013-11-05
Amanda Carlson is NOT a one hit wonder
OMG!!!! This was a wonderful, action-packed book. Amanda Carlson is NOT a one hit wonder. We learn of many new Underworld creatures. We get to spend more time with Ray. I can't wait to see where she takes his story-line. I really liked Naomi. I hope we get to see her and Danny together. We've been promised more Rourke in the next book. I'm going to hold her to that.
I think Jessica is going to bring the sects together. She's already doing unprecedented things by working with the vampires.
Amanda definitely leaves you wanting more.
- Eric
- 2013-10-29
Exposition and filler.
Is there anything you would change about this book?
There was just too much of the same, after having listened to the first book in this series, I was hopping some of the exposition would have been shortened or tightened up a bit, but sadly there seems to be a quota that needed to be met of " I don't know what I'm fully capable of" "I don't want you to get hurt/die" and " I won't leave [insert character] behind/ to die" in every chapter and restating these sentiments over and over. I like the story of the first book, I'll listen to the next book because there seems to actually be plot there. This book feels like very draw out setup and foreshadowing for the next book. Every so often the plot seems to stop, introduce new ideas and then fall back to the main story. This makes the book sort of jumbled, where the main plot is kill the goddess, save the mate, that get relegated to almost a side story, we know it will happen eventually but before that you must face the conflicts three, not to mention the side plots of what is happening to the pack out side of the main story, you would think that a confident leader of the largest pack of wolves in america wouldn't need to read his daughter into all of his conflicts or be so short to jump to conclusions as Jess's Dad seems to have become in this book.
What was the most interesting aspect of this story? The least interesting?
I really do like the story overall, and the fight sequences very much so.
What do you think the narrator could have done better?
The narrator has gotten better since the first book, where the first book had noticeable pauses or hesitations that kind of got on my nerves those don't seem to be as common.
Do you think Hot Blooded needs a follow-up book? Why or why not?
It is a meh book, read it to get the the third.


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Is External Fixation Overutilized In Managing Charcot In The Diabetic Foot?
Historically, surgeons have utilized circular and monolateral external fixation for the management of complicated high-energy orthopedic trauma and reconstruction of congenital or posttraumatic deformities through the Ilizarov and deBastiani principles of callotasis and distraction osteogenesis.1-3 Demonstrating success in bone healing and deformity correction in limbs that would have otherwise left patients with permanent disabilities or necessitated limb amputation, external fixation has found its way into the treatment of Charcot foot, arguably one of the most challenging problems for patients with diabetes. As our understanding of the Charcot disease process has evolved in regard to the disease's pathophysiology, the optimal intervention period and identifying limitations with traditional internal fixation methods, external fixation seems to be the next step in Charcot treatment. However, as with anything new that takes center stage, there will always be undefined uses that invite controversy and debate. While the incidence rate for Charcot neuroarthropathy is low (occurring in less than 0.3 to 0.9 percent of patients with diabetes per year), Charcot neuroarthropathy is considered one of the more devastating manifestations of profound neuropathy and longstanding diabetes mellitus.4,5 While the condition is commonly associated with joint destruction, subluxation/dislocation and instability, four- and 10-year retrospective longitudinal studies from diabetes specialty clinics evaluating the natural history of this neuropathic arthropathy revealed that Charcot rarely led to limb loss when patients were diagnosed and managed early in the disease process.4,6 Additionally, researchers found that surgical intervention was only necessary in 25 percent of all patients surgeons followed for acute Charcot neuroarthropathy. Out of this group, surgeons treated 64 percent of patients successfully with exostectomies and only 36 percent necessitated arthrodesis. In their 10-year retrospective series of 115 patients with Charcot, Fabrin et al., reported that 5 percent required surgical intervention with 2 percent undergoing below-knee amputation and 3 percent requiring arthrodesis.4 Achieving stable internal fixation may be difficult in the Charcot foot with localized osteoporotic bone, large spatial defects from either joint destruction or resection of osteomyelitis. Usually, these cases of significant bone loss require bone grafting for structural support and long screws and large plates to span the defect. In cases of longstanding deformities, single-stage corrections may be limited by chronic soft tissue contractures and peripheral scarring of the neurovacsular bundle, leading to complications of inadequate deformity correction, wound dehiscence and local ischemic tissue loss. Complications with wound healing, poor screw purchase, hardware failure, nonunion and recurrence of deformity are potential sequelae of open arthrodesis with internal fixation in Charcot reconstruction. External circular fixation can provide mechanical stability to structurally deficient bone and maintain skeletal alignment where internal fixation options for direct stabilization are limited. A Closer Look At The Ex-Fix Controversy There has been evidence to suggest that external fixation methods can provide advantages in Charcot reconstruction when internal fixation is unsuccessful. However, much of the controversy surrounding external fixation stems from the lack of consensus regarding treatment goals and indications for use. The utilization of circular fixation for Charcot is broad and has been reported for: • the management of skeletal defects associated with surgical resection of osteomyelitis; • acute fracture dislocations; • gradual deformity correction; • static neutralization frames to protect high risk fusion sites in patients not capable of non-weightbearing; • elective rearfoot/ankle fusions; • protecting fasciocutaneous flaps; and • offloading ulcers. As logical as this may seem to some surgeons, this widespread use has not been accompanied with meaningful statistical evidence to justify the role of ex-fix in Charcot foot reconstruction yet there is continued nationwide promotion of its use. Additionally, few studies examine the same outcomes for success. The lack of uniform outcome measures makes it difficult to interpret the existing literature and generate meaningful comparisons as to whether surgical reconstruction is superior to total contact casting, and whether external fixation is superior to internal fixation. External fixation comes with a considerable economic price and patient risk. The cost of external fixation may range from $6,000 to $30,000 per patient for initial application. Additionally, experts have quoted a 100 percent complication rate with external fixation in Charcot reconstruction. Therefore, with a device which requires frequent postoperative follow-up, has high complication rates and is cost prohibitive, the indications of external fixation need to be clear. For external fixation in Charcot reconstruction, the risk to benefit ratio for unconventional applications may be disproportionately high in comparison to that of internal fixation. By using this device on the diabetic foot, you must ask: Are you saving the limb or putting it at risk? Should You Consider External Fixation Over Internal Fixation? In general, most of the literature agrees that one should consider surgical reconstruction when Charcot deformity is: acutely or chronically unstable, nonplantigrade, unshoeable/unbraceable or when it is associated with longstanding ulceration unresponsive to traditional offloading methods. The question is not who is a candidate for external fixation but who is not a candidate for internal fixation. Osteopenic bone. Bone demineralization in the Charcot foot may be the result of disuse of the limb from nonweightbearing or offloading treatments, or may be due to local pathology one may see in the acute Charcot process.7,8 Researchers have considered decreased bone mineral density as a risk factor for complications such as hardware failure and loss of deformity correction due to insufficient stability or purchase of internal fixation.9,10 Osteomyelitis and large skeletal defects. In the presence of infected bone, the introduction of internal fixation may serve as a source for infection involving unaffected areas of adjacent bone. With staged procedures involving wound debridement, one must often excise infected bone and provide long-term parental antibiotic therapy prior to introducing internal fixation for final reconstruction. In addition, structural defects may require a large bone graft with long reconstruction or locking plates and screws to achieve direct stabilization. This method often requires wide surgical exposure, stripping the periosseous blood supply to the bone and increasing the probability for nonunion. External fixation may provide indirect stabilization of the skeletal defect spanning the area of bone resection or to protect bone graft through percutaneous methods that limit soft tissues exposure. Inability to offload the affected limb. Overweight and obese patients are significantly associated with diabetes, cardiovascular disease, arthritis and general poor health status.11 The energy consumption required for five minutes of three-point crutch ambulation is markedly elevated as it reportedly increases the heart rate by 53 percent and oxygen uptake by 32 percent.12 Combined with limited cardiac reserve and obesity, most Charcot patients demonstrate difficulty or an inability to offload the affected limb safely despite physical therapy training. With unintentional weightbearing, the patients' excessive weight may exceed the mechanical limits of internal fixation devices, compromising the purchase of these devices to bone or causing implant failure. External fixation may provide stable reduction of the realignment arthrodesis, simultaneously allowing a shared loading of the fusion site without exceeding the mechanical limits of the fixator maintaining the correction. Unstable or non-braceable limb deformities. Both acute and chronic Charcot neuroarthropathy may result in severe and unstable limb deformities that are not structurally stable for weightbearing. Additionally, one cannot reasonably offload these deformities with casting or bracing without exposing the limb to areas of focal high pressures, leading to ulceration. With joint fragmentation, bone resorption and severe deformity that one sees with acute Charcot, internal fixation may not adequately achieve direct stabilization to maintain alignment of open arthrodesis. External fixation may span areas of demineralized bone and maintain the alignment in arthrodesis. In cases of correction of severe chronic Charcot, osseous correction may be limited by adapted soft tissue and neurovascular structures that may not tolerate acute, single stage correction without complications of soft tissue contracture, wound dehiscence or soft tissue necrosis. One may gradually correct deformities with circular spatial frame or hinge axis methods that allow concomitant soft tissue lengthening and relaxation to occur. Conservative Management: Can It Have An Impact? Plantigrade stable foot. Various authors consider a clinically stable, plantigrade, shoeable/braceable foot a successful and desirable outcome of treatment for Charcot neuroarthropathy.4,6,9,10,13-24 Despite significant radiographic patterns of breakdown that are common to see during the quiescent phase, there is little evidence to support elective prophylactic realignment procedures in these patients with clinically stable plantigrade feet that can be safely fit into extra-depth shoes or braces. Furthermore, complications associated with Charcot reconstruction with internal fixation, including limb loss, may not be considered reasonable risks in this lower risk patient group. Stage 0 and 1. In regard to clinical manifestations of acute Charcot neuroarthropathy in the absence of radiographic signs of joint destruction or deformity, which surgeons refer to as Stage 0 or pre-Charcot, various authors suggest it is best to use compression therapy and subsequent nonweightbearing cast immobilization.22,23,26 This conservative method, including total contact casting, is also widely advocated as the gold standard for Eichenholtz stage I Charcot. In this stage, one may see radiographic signs of early joint fragmentation, destruction and debris formation without significant fracture displacement, joint dislocation or mechanical axis malalignments. However, surgical intervention during these early stages of Charcot is controversial. There is only one level IV retrospective report in the medical literature supporting surgical intervention with internal fixation during the acute Eichenholtz stage I Charcot neuroarthropathy.24 Another report recommended surgical intervention during Eichenholtz stage I only if one encounters severe unstable reducible joint dislocations before seeing radiographic evidence of joint destruction and bone fragmentation.9 There have been anecdotal reports of utilizing external fixation for realignment stabilization for acute Charcot dislocations. However, further investigation is necessary to validate the efficacy of indirect stabilization in cases of Stage 0 and 1 without deformity. What You Should Know About Other Surgical Procedures For Charcot Exostectomy. Charcot rocker bottom foot deformity often leaves plantar osseous prominences, increasing the risk for tissue breakdown. Simple plantar exostectomies are generally successful with a reported average 84 percent healing rate and 20 percent recurrence of skin breakdown.6,9,14,15,21 With the procedure's satisfactory success rates, less technical difficulty and lower complication rates, one may consider exostectomies for stable uncomplicated Charcot deformities with plantar prominences. Surgeons may consider realignment arthrodesis if plantar ulceration recurs. Proponents for arthrodesis may argue that recurrence of ulceration and progression of Charcot may be high with exostectomies as opposed to realignment arthrodesis. However, there is little uniform, long-term data to provide meaningful comparisons between the two treatment groups. Normal bone density. When patients have normal bone mineralization, one may consider internal fixation the method of choice that can provide stable compression to fusion sites and avoid the risk of external fixation complications.19,27 Even in cases of severe dislocations during acute Charcot with the absence of profound joint fragmentation and bone resorption, internal fixation may provide stable fixation and reduction of deformity.9 Early Weightbearing: Is It Worth The Cost And Potential Risks Of Ex-Fix? Patient can maintain non-weightbearing or a partial weightbearing regimen. Facilitating early protected weightbearing while maintaining alignment of the arthrodesis site can be an advantage of external fixation. Ilizarov supported early weightbearing in lower extremity external fixation cases, observing that controlled weightbearing stimulus via "shared loading" promotes bone regeneration. Allowing early weightbearing to stimulate healing of the fusion site has been a common indication for external fixation. However, a patient capable of non-weightbearing with crutches is likely capable of performing touch toe weightbearing for shared loading of the arthrodesis with internal fixation and in a contact cast. If a patient's postoperative regimen for arthrodesis involves non-weightbearing and the patient is able to safely maintain non-weightbearing, external fixation may be unconventional in this circumstance and one may not be able to justify the disproportionate cost of external fixation over the lower cost of internal fixation. Understanding The Importance Of Appropriate Patient Selection Poor rehabilitation and health status. The rationale of limb salvage for some surgeons is the association between increased energy expenditure with loss of limb length and a 66 percent increased incidence of contralateral limb loss within five years.28-30 Though one may attribute the relationship of contralateral limb loss after the index amputation to increased mechanical stress on the remaining limb leading to ulceration and infection, surgeons must also consider the event of limb loss as a marker of the disease state of diabetes. The development of Charcot is not a result of a local phenomenon but is a reflection of the overall disease state of diabetes. Charcot develops as a result of profound neuropathy including autonomic nerve dysfunction, all of which are functions of longstanding diabetes and neuropathy.31,32 Researchers have associated the presence of autonomic neuropathy and renal disease with increased cardiovascular risk and mortality in patients with diabetes.33-35 One retrospective analysis involving diabetic patients with Charcot neuroarthropathy reported a 45 percent mortality rate with a mean interval of 3.7 years.36 This is not considerably different from prospective data on three-year mortality rates (reported near 38 percent) of diabetic patients with major limb amputations.37 With poor rehabilitative outcomes in patients with diabetes and cardiovascular disease, and mortality rates similar in Charcot disease and amputation, limb salvage in cases of severe deformity, ulcer and frank infection may not be an economic nor appropriate option when amputation is likely the ultimate result. One should not consider amputation as a failure but as a reasonable treatment option for Charcot limb deformities in patients who have accumulated risk factors for poor outcomes for limb salvage. Your tolerance of risk. Although one can generally reduce complications with experience, bear in mind that even experts have quoted a 100 percent complication rate when it comes to external fixation with Charcot reconstruction. Common complications of pin tract infections include cellulitis, osteomyelitis, external fixation component failure, unscheduled trips to the operating room for half pin or fine wire exchange, frame loosening requiring adjustments and stress fractures of the tibia. It is not a question of if one will encounter a complication but when. External fixation product training seminars can demonstrate the basic methods of frame application but these seminars cannot prepare surgeons to deal with the more difficult aspect of external fixation — outpatient management. Ensuring successful outcomes of external fixation require weekly pin tract care and surgeon availability. If occurrence of a tibial pin tract infection is sufficient to influence a surgeon to abandon the frame, then one should reconsider the utilization of the external fixator for Charcot reconstruction. Patient acceptance. Reports of depression, destructive behavior, social isolation and sleeping disorders have been associated with external fixation use. Social support systems or groups can provide a practical exchange of information that helps patients cope with common issues regarding external fixation treatment. Without patient acceptance of external fixation, compliance issues and early abandonment of external fixation may compromise the outcomes for success. In Conclusion What is the strongest evidence we have? For the most part, a majority of the current peer-reviewed literature indicates that internal fixation methods for salvaging acute and chronic Charcot deformities have been successful with an average reported fusion rate of 87 percent.9,10,13,16,20,24 The majority of the published information regarding external fixation for Charcot is primarily limited to non peer-reviewed articles, technique descriptions, observational studies and few level IV retrospective analyses.17,19,27,41-47 Only one level II prospective analysis of neutral circular frames for reconstruction of non-plantigrade Charcot midfoot deformities has demonstrated good clinical restoration with plantigrade feet ulcer and infection free at a one-year follow-up.48 Without case controlled, randomized clinical trials, advocates of this method have not produced the level of evidence to demonstrate that external fixation methods improve limb salvage rates beyond traditional offloading practices and internal fixation. In other words, one can successfully manage a majority of Charcot with conservative therapy and external fixation is not a substitute for cases in which internal fixation works well. Is there a place for circular frames in diabetic Charcot neuroarthropathy? The answer is yes. There are promising retrospective analyses, early prospective studies and anecdotal evidence, which deserve further attention. However, we must continue to critically investigate the best indications of external fixation use, moving from an "in my hands" approach to prospective comparative trials. At this point, the indications for Charcot reconstruction with external fixation seem to be few and far between. Dr. Liu is a Clinical Associate Professor in the Department of Orthopaedics at the University of Texas Health Science Center at San Antonio, Tx. He received his fellowship training in trauma and reconstruction at the University Hospitals of Dresden, Germany and Catania, Italy. Dr. Liu currently practices at the Austin Diagnostic Clinic multispecialty group in Austin, Tx. Dr. Steinberg is an Assistant Professor in the Department of Plastic Surgery at the Georgetown University School of Medicine in Washington, D.C.
1. De Bastiani G, Aldegheri R and Renzi Brivio L. The treatment of fractures with a dynamic axial fixator. J Bone Joint Surg Br, 66(4): 538-45, 1984.
2. Ilizarov GA, Lediaev VI and Shitin VP. [The course of compact bone reparative regeneration in distraction osteosynthesis under different conditions of bone fragment fixation (experimental study)]. Eksp Khir Anesteziol, 14(6): 3-12, 1969.
3. Ilizarov GA and Ledyaev VI. The replacement of long tubular bone defects by lengthening distraction osteotomy of one of the fragments. 1969. Clin Orthop Relat Res, (280): 7-10, 1992.
4. Fabrin J, Larsen K and Holstein PE. Long-term follow-up in diabetic Charcot feet with spontaneous onset. Diabetes Care, 23(6): 796-800, 2000.
5. Lavery LA, Armstrong DG, Wunderlich RP, Tredwell J and Boulton AJ. Diabetic foot syndrome: evaluating the prevalence and incidence of foot pathology in Mexican Americans and non-Hispanic whites from a diabetes disease management cohort. Diabetes Care, 26(5): 1435-8, 2003.
6. Armstrong DG, Todd WF, Lavery LA, Harkless LB and Bushman TR. The natural history of acute Charcot's arthropathy in a diabetic foot specialty clinic. Diabet Med, 14(5): 357-63, 1997.
7. MK, Sinacore DR, Fielder FA, and Johnson JE. Bone mineral density during total contact cast immobilization for a patient with neuropathic (Charcot) arthropathy. Phys Ther, 85(3): 249-56, 2005.
8. Petrova NL, Foster AV and Edmonds ME. Calcaneal bone mineral density in patients with Charcot neuropathic osteoarthropathy: differences between Type 1 and Type 2 diabetes. Diabet Med, 22(6): 756-61, 2005.
9. Myerson MS, Henderson MR, Saxby T and Short KW. Management of midfoot diabetic neuroarthropathy. Foot Ankle Int, 15(5): 233-41, 1994.
10. Papa J, Myerson M and Girard P. Salvage, with arthrodesis, in intractable diabetic neuropathic arthropathy of the foot and ankle. J Bone Joint Surg Am, 75(7): 1056-66, 1993.
11. Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS and Marks JS. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA, 289(1): 76-9, 2003.
12. Waters RL Campbell J and Perry J. Energy cost of three-point crutch ambulation in fracture patients. J Orthop Trauma, 1(2): 170-3, 1987.
13. Alvarez RG, Barbour TM and Perkins TD. Tibiocalcaneal arthrodesis for nonbraceable neuropathic ankle deformity. Foot Ankle Int, 15(7): 354-9, 1994.
14. Brodsky JW and Rouse AM. Exostectomy for symptomatic bony prominences in diabetic charcot feet. Clin Orthop Relat Res, (296): 21-6, 1993.
15. Catanzariti AR, Mendicino R and Haverstock B. Ostectomy for diabetic neuroarthropathy involving the midfoot. J Foot Ankle Surg, 39(5): 291-300, 2000.
16. Early JS and Hansen ST. Surgical reconstruction of the diabetic foot: a salvage approach for midfoot collapse. Foot Ankle Int, 17(6): 325-30, 1996.
17. Fabrin J, Larsen K and Holstein PE. Arthrodesis with external fixation in the unstable or misaligned Charcot ankle in patients with diabetes mellitus. Int J Low Extrem Wounds, 6(2): 102-7, 2007.
18. Helm PA, Walker SC and Pullium G. Total contact casting in diabetic patients with neuropathic foot ulcerations. Arch Phys Med Rehabil, 65(11): 691-3, 1984.
19. Pinzur MS. The role of ring external fixation in Charcot foot arthropathy. Foot Ankle Clin, 11(4): 837-47, 2006.
20. Pinzur MS and Kelikian A. Charcot ankle fusion with a retrograde locked intramedullary nail. Foot Ankle Int, 18(11): 699-704, 1997.
21. Rosenblum BI, Giurini JM, Miller LB, Chrzan JS and Habershaw GM. Neuropathic ulcerations plantar to the lateral column in patients with Charcot foot deformity: a flexible approach to limb salvage. J Foot Ankle Surg, 36(5): 360-3, 1997.
22. Schon LC, Easley ME and Weinfeld SB. Charcot neuroarthropathy of the foot and ankle. Clin Orthop Relat Res, (349): 116-31, 1998.
23. Sella EJ and Barrette C. Staging of Charcot neuroarthropathy along the medial column of the foot in the diabetic patient. J Foot Ankle Surg, 38(1): 34-40, 1999.
24. Simon SR, Tejwani SG, Wilson DL, Santner TJ and Denniston NL. Arthrodesis as an early alternative to nonoperative management of charcot arthropathy of the diabetic foot. J Bone Joint Surg Am, 82-A(7): 939-50, 2000.
25. Walker SC, Helm PA and Pullium G. Total contact casting and chronic diabetic neuropathic foot ulcerations: healing rates by wound location. Arch Phys Med Rehabil, 68(4): 217-21, 1987.
26. Yu GV and Hudson JR. Evaluation and treatment of stage 0 Charcot's neuroarthropathy of the foot and ankle. J Am Podiatr Med Assoc, 92(4): 210-20, 2002.
27. Pinzur MS. Neutral ring fixation for high-risk nonplantigrade Charcot midfoot deformity. Foot Ankle Int, 28(9): 961-6, 2007.
28. Goldner MG. The fate of the second leg in the diabetic amputee. Diabetes, 9: 100-3, 1960.
29. Huang CT, Jackson JR, Moore NB, Fine PR, Kuhlemeier KV, Traugh GH and Saunders PT. Amputation: energy cost of ambulation. Arch Phys Med Rehabil, 60(1): 18-24, 1979.
30. Waters RL, Perry J Antonelli D and Hislop H. Energy cost of walking of amputees: the influence of level of amputation. J Bone Joint Surg Am, 58(1): 42-6, 1976.
31. Rajbhandari SM, Jenkins RC, Davies C and Tesfaye S. Charcot neuroarthropathy in diabetes mellitus. Diabetologia, 45(8): 1085-96, 2002.
32. Young MJ, Marshall A, Adams JE, Selby PL and Boulton AJ. Osteopenia, neurological dysfunction, and the development of Charcot neuroarthropathy. Diabetes Care, 18(1): 34-8, 1995.
33. Maser RE, Pfeifer MA, Dorman JS, Kuller LH, Becker DJ and Orchard TJ. Diabetic autonomic neuropathy and cardiovascular risk. Pittsburgh Epidemiology of Diabetes Complications Study III. Arch Intern Med, 150(6): 1218-22, 1990.
34. Rossi E. Cardiovascular disease in diabetes and operative risk. Rays, 22(4): 595-602, 1997.
35. Sibal L, Law HN, Gebbie J and Home P. Cardiovascular risk factors predicting the development of distal symmetrical polyneuropathy in people with type 1 diabetes: A 9-year follow-up study. Ann NY Acad Sci, 1084: 304-18, 2006.
36. Gazis A, Pound N, Macfarlane R, TreeceK, Game F and Jeffcoate W. Mortality in patients with diabetic neuropathic osteoarthropathy (Charcot foot). Diabet Med, 21(11): 1243-6, 2004.
37. Larsson J, Agardh CD, Apelqvist J and Stenstrom A. Long-term prognosis after healed amputation in patients with diabetes. Clin Orthop Relat Res, (350): 149-58, 1998.
38. Martin L, Farrell M, Lambrenos K and Nayagam D. Living with the Ilizarov frame: adolescent perceptions. J Adv Nurs, 43(5): 478-87, 2003.
39. Patterson M. Impact of external fixation on adolescents: an integrative research review. Orthop Nurs, 25(5): 300-8; quiz 309-10, 2006.
40. Roukis TS, Stapleton JJ and Zgonis T. Addressing psychosocial aspects of care for patients with diabetes undergoing limb salvage surgery. Clin Podiatr Med Surg, 24(3): 601-10, 2007.
41. Herbst SA. External fixation of Charcot arthropathy. Foot Ankle Clin, 9(3): 595-609, x, 2004.
42. Jolly GP, Zgonis T and Polyzois V. External fixation in the management of Charcot neuroarthropathy. Clin Podiatr Med Surg, 20(4): 741-56, 2003.
43. Roukis TS and Zgonis T. The management of acute Charcot fracture-dislocations with the Taylor's spatial external fixation system. Clin Podiatr Med Surg, 23(2): 467-83, viii, 2006.
44. Sayner LR and Rosenblum BI. External fixation for Charcot foot reconstruction. Curr Surg, 62(6): 618-23, 2005.
45. Wang JC. Use of external fixation in the reconstruction of the Charcot foot and ankle. Clin Podiatr Med Surg, 20(1): 97-117, 2003.
46. Wang JC, Le AW and Tsukuda RK. A new technique for Charcot's foot reconstruction. J Am Podiatr Med Assoc, 92(8): 429-36, 2002.
47. Zgonis T, Roukis TS and Lamm BM. Charcot foot and ankle reconstruction: current thinking and surgical approaches. Clin Podiatr Med Surg, 24(3): 505-17, 2007.
48. Pinzur MS. Neutral ring fixation for high-risk nonplantigrade Charcot midfoot deformity. Foot Ankle Int 28(9):961-6, 2007.


text: Brighten is a pop rock band from Chico, California, consisting of brothers Justin (guitar, lead vocals) and Jimmy (drums) Richards, and Alex Draper (bass, backing vocals). The band has recently been on tour with This Providence, Cute Is What We Aim For, Eisley, and All Time Low. In 2007, their debut album, King vs. Queen, was released on Carb… Read More


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Generic Pharmaceuticals Producer Creates Nearly 300 Jobs with SBA 504 Loan Program
DORADO, PR -- A couple of years ago, Kentucky-based BLU Pharmaceuticals' president William 'Bill' Luster was on the lookout for a new solid dosage facility to manufacture generic pharmaceutical products as part of his company's growth strategy.
Blu Pharmaceuticals, a certified minority-owned firm, focuses on the manufacturing and distribution of high quality generic pharmaceuticals at competitive prices.
Luster's search for new business opportunities resulted in the purchasing of a 145,000 square foot production plant in Dorado, Puerto Rico that became available when generic pharmaceuticals firm Biovail decided to transfer its manufacturing operations to Steinbach, Canada, leaving hundreds of people unemployed.
"When I started looking at purchasing or building a manufacturing plant I looked in several areas of the mainland and internationally, such as New York, New Jersey, and Argentina and Brazil," said Blu Caribe President Bill Luster. "When I considered building, I was going to build in Kentucky, but where is the talent in Kentucky in pharmaceutical manufacturing? I found Dorado through a facility locator. Candidly, I thought Puerto Rico would not be a choice because big pharma was the strong hold and felt the facilities would be too big and too expensive for our needs."
Luster went on to explain that, as it turned out, purchasing the Dorado facilities was not out of reach financially, and that the company also looked at the tax incentives provided by the Puerto Rico Industrial Development Company (PRIDCO).
"Those [tax incentives] are well published," Luster said. "Those incentives are not ultimately what influenced our decision. Ultimately, the reason we chose Puerto Rico is simple to me, Puerto Ricans are passionate about manufacturing pharmaceuticals. In fact, I believe no one can do it better."
In order to help finance the $10 million project, Luster obtained a $3.6 million loan under the U.S. Small Business Administration's 504 Certified Development Company loan program, which provides long-term fixed financing to purchase land, machinery and equipment and for business expansion. Designed to promote economic development in the community by creating jobs, a 504 loan originates through a CDC – a non-profit corporation that invests in its community's economic development and helps generate jobs—together with a bank.
BLU Caribe's loan was provided with the support of certified development company PYMES Financial Partners Corporation and third-party lender Banco de Desarrollo Económico para Puerto Rico (Economic Development Bank for Puerto Rico).
"The SBA's 504 loan program is one of the agency's best resources for job creation and economic development," said SBA District Director José R. Sifontes. "BLU Caribe is the first pharmaceutical factory to open in Puerto Rico since 2007, and we are thrilled that the company has taken advantage of this program to foster job creation in an industry that has seen its share of difficulty on the island in the past few years."
BLU Caribe began operations in April 2010, by re-hiring close to 100 of Biovail's former employees and producing the first batches of the generic antibiotic ciprofloxacin for the U.S. market. Currently, the plant is producing three additional generic pharmaceuticals.
Since opening day, BLU Caribe has grown to 280 employees and plans to continue hiring. The company had sales of $17 million in 2010 and expects to close 2011 with more than double that amount. The plant also expects to have produced two billion tablets during its first year of operations, and plans to further increase annual production capacity to around four billion tablets by 2013.
BLU Caribe General Manager Sandra Rodríguez-Toledo, one of only three women in Puerto Rico leading a pharmaceutical company said "we have all put in many long hours, including weekends, to make the company what it is today."
Luster attributes the company's success to the high-caliber personnel with many years of combined pharmaceutical manufacturing experience. Currently the manufacturing activities have increased to double the capacity when manufacturing activities started last January. BLU Caribe operates 24 hours a day, seven days a week.
For more information on SBA programs and services, visit www.sba.gov/pr.


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Offering the well-known German brand TELEFUNKEN, our licensee can take part of high brand awareness and positive image in many countries which definitely increases attractiveness and value of your products.
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In the early 20th century, musicians and painters in Hungary shared a desire to seek new forms of expression and a renewal with tradition. Breaking new ground within the European avant-garde, in just a few years they created their own distinctive idiom, a modernity imbued with the traditions of Hungary.
With around one hundred paintings from public collections in Hungary and from private collections, including numerous documents relating to the young Bartók and to the musicians, composers, writers, poets, philosophers and psychoanalysts in his circle (musical scores, photographs, films, archive recordings, etc), the exhibition aims to revive this rich dialogue between music and the arts from early 20th century Hungary.
This exhibition takes place under the high patronage of Monsieur François Hollande, President of the French Republic, and János Áder, President of the Republic of Hungary.
CuratorsClaire Bernardi, curator, Musée d'Orsay
Gergely Barki, art historian, Research Centre for the Humanities - Hungarian Academy of Sciences - INSTITUTE OF ART HISTORY, Budapest
Zoltan Rockenbauer, art historian
Exhibition organised with the special participation of the Budapest Szépművészeti Múzeum.
Avec le soutien de Tollens pour l'apport en peinture.


text: The situation with COVID-19 is changing day by day. To find out if you can still do an activity or if an establishment is still open, don't hesitate to call us or drop us a line by email or chat. Our trip advisors will answer your questions for free! Please note that all photos and videos on this site were taken before the pandemic. For more information about the Government of Québec's directives for each region, go to Quebec.ca/coronavirus.


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Now showing items 1-2 of 2
Estimating leptospirosis incidence using hospital-based surveillance and a population-based health care utilization survey in Tanzania.
(PLoS Negl Trop Dis, 2013)
BACKGROUND: The incidence of leptospirosis, a neglected zoonotic disease, is uncertain in Tanzania and much of sub-Saharan Africa, resulting in scarce data on which to prioritize resources for public health interventions ...
Comparing actual and perceived causes of fever among community members in a low malaria transmission setting in northern Tanzania.
(Trop Med Int Health, 2013-11)
OBJECTIVE: To compare actual and perceived causes of fever in northern Tanzania. METHODS: In a standardised survey, heads of households in 30 wards in Moshi, Tanzania, were asked to identify the most common cause of fever ...


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New York Mets Media Relations Director Jay Horwitz is the king of the accidental phone call. He speaks to WSJ's Wendy Bounds about the technological mystery that is his BlackBerry.
This transcript has been automatically generated and may not be 100% accurate.
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BMW commercial and his colleagues to grow into an ... invitation to me or would you be oriented returns ... sci batter reality show is is Cutler coming your way ... that David Wright reports that he is to get I e mails of players flight itineraries that you were trying to send to an assistant ... in the office and that he would just be polite and for them I'm I'm not bother you with that you think that's one of reasons he became team captain because he religious Opel in the euro getting married you to leave you with peace Corps probably ... going to do with personal gain or lose you drive close to worry ... his funeral by which your city to get him ... he's not ... looking forward ... to prove to be renewed ... this is going to have a year ago ... that and and and former players whom I wanna be brought back on the best team ... ever gotten up I Buchdahl from you and didn't really excited and thought that meant something good for their their fortunes and it turned out that estimates of the need ... for legal to trigger a ... who which was three years ago ... but down from the ... one pictured in ... thinking this would resort to that as we stated an interest in bringing back the jet ... for the doctor was in the chase ... if there any body you have not yet ... bought Dow today that he really would like to ... yet was growing up was the big city for the or work from Cheney for months ... so I really wanted but Darda celebrity or politician Y privilege branch of the baseball diamond ... he didn't feel I want to go into politics where is the key ... criteria for a politician ... in a Democratic politician I can ... when when when when Obama leaves office maybe we can work that out for you and ... you are going for employees outlook due to a network of that a thousand thousand phone numbers in your BlackBerry ... on any that you're dying to have besides the presence that you don't have ... um sure stems ... don't mourn scale ... you are in an interview ... write ... and people wonder this to me my father was also in that span he wondered are you going to do this are you doing this interview right now with the computer ... in your pocket with that makes that easier for your youth you mechanically inclined have uber technologically inclined you think I think of yourself ... really what people are coming to my job is to premium insurance ... which while carrying out whether people agree to ensure two open ... or ... even rub the chicken and meat aren't ... the only kids to their great food volumes and you are on sweater and this isn't to my last question for you J you have been ... on the job since nineteen eighty if he had been the Mexican media guide ... what you've done with your career ice on Twitter follow the view was serving up some NY to know maybe Cook what what what would you then ... Beatrice ever to win a trip to ... Asia agrees to the charity but there are a shuttle and all change over to the frightening and restart your computer challenger ... is what has her work in the summer or get sucked right in the inside track for quite awhile later that ... day my my BlackBerry's buzzing careful on is that ... J is a new ... still no usual Friday ... night do you think you're going to be cut and then I'd say Horowitz think semester being


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by Rick Orlov, LA Daily News
August 22nd, 2012
Even as the city's ban on medical marijuana is facing legal and political challenges, the City Council on Wednesday asked local and federal law enforcement agencies to develop new strategies to enforce the shutdown.
"We need to get out of the way of law enforcement," Councilman Bernard Parks said of his request asking the Los Angeles Police Department to coordinate with the district attorney and Drug Enforcement Administration on an enforcement policy.
"Federal law is clear. State law is clear," said Parks, a former L.A. police chief. "State law allows collectives. It does not allow for the sale of marijuana."
The City Council recently adopted a proposal to close down all the medical marijuana dispensaries operating in the city as of next month and the City Attorney's Office sent a letter to landlords advising them of the law.
However, a lawsuit has been filed challenging the city measure and proponents of medical marijuana have been working to qualify a referendum challenging the law.
Parks said he tried to introduce a similar measure five years ago, but action was never taken on it.
Kris Hermes, spokesman for the pro-medical marijuana group Americans for Safe Access, said they were surprised by the action.
"This proposal is unsettling to have local government work with the federal government to undermine a state law," Hermes said.
"We have maintained that passing a total ban is illegal and we're in statecourt fighting that and are collecting signatures on our referendum. We expect to qualify it in early September when the new city law is scheduled to take effect."