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Thank you. 2016 has been one hell of a year for all of us; and one hell of a year to start a new chapter in life as a business partner. It has been a rollercoaster journey, but one where the continual support of the CIO and innovation leadership community, both user and supply-side has been incredible and I thank you all so much.
Horizon began its life back in June 2015. A series of meetings, both with the community and others revealed a fantastic opportunity in the market and one I had to seize right there and then. Work began for the remainder of that year and then in January of this year it was time to put the ideas into action. Icon Business Media (publishers of the Horizon podcasts, events and website) was born as not only a significant chapter for me personally, but also for Icon Photomedia, a highly successful photography and imagery organisation, as it grew into new areas.
Becoming a business partner is a learning curve that rivals an ascent of the Mont Ventoux and one I am still very much on. Fortunately I have been on one of the most advanced courses you can ask for; eight years of spending time both professionally and at leisure with the UK's best business technology leaders teaches you a great deal about commerce and the ways of dealing with the challenges that you face day in and day out. Though none of us could have predicted just how damaging Brexit would be and when a significant customer goes under in your first half of trading it is an experience you are unlikely to forget in a hurry. But the insights shared by you in the community over lunch, a coffee and even a bike ride gave me the necessary tools of the trade.
Another massive winning card in my pack was business partner Matt Gore. Having been at the helm as founder and leader of one of the UK's most successful photography services business, Matt has known how to navigate the tricky waters of 2016. As with all of us whose formative careers were through the 90s and into this century, Matt has a wealth of editorial and creative skills honed from adaptability. Anyone in business, media and technology from 1995 onwards has lived through some of the most dramatic periods of change and as a result has a skill set that is as wide as it is deep. That creativity and adaptability is what brought us together as a business partnership and has been at the core of our outputs in 2016. Alongside my amazing wife, my greatest thanks goes to Matt Gore.
Probably the most significant moment of the year for me was the Innovation Leadership Summit in September. Having hosted more major conferences than is really good for your health, it was very different to produce, moderate and co-own an event, especially when you have a very important sponsor commitment in a deal you brokered. A special thank you to partner eSynergy Solutions who we will continue to work with in 2017. To see so many CIOs register and then attend the event will be something that will live with me forever. Thank you all so much, the sight of that room, full of so many leading CIOs was almost overwhelming.
I must also say a huge thank you to some stalwart supporters who have been generously sharing advice and time with me for a number of years, but whose support this year made a substantial difference. A particular thank you must go to Mike Altendorf, Ian Cohen, Catherine Stagg-Macey, David Tebbutt, Ian Cox, Tony Westbrook, Richard Sykes, Richard Corbridge, Chris King and Jerry Fishenden.
Throughout the year CIOs, innovators and suppliers have said to me time and again "how can we support your business?" Support us you have and thank you. 2017 looks set to be as exciting a rollercoaster ride as year one; the reception of our new podcast programme has been incredible, our first event for 2017 is already booked in and we promise to continue to be just a bit disruptive, producers of quality journalism whether written, spoken or live, we have some great ideas to revise old formats and most importantly to support you in the community. |
Archive for the 'Gary Clark Jr' Category
Eric Clapton Manchester Arena May 14th 2013 Fifty Years Further On Up The Road
Posted by vintagerock in Eric Clapton, Gary Clark Jr. Tagged: blues, classic rock, concert, concerts, gig, gigs, music, pop, R&B, rock, rock n roll. Leave a comment
Eric Clapton Manchester Arena May 14th 2013
Support from Gary Clark Jr
Great performance by Eric Clapton last night at Manchester Arena. The set was a mix of classics from throughout his career, featuring electric and acoustic sets and some great guitar work. I arrived at the Arena just after 7.30pm and Gary Clark Jr was on stage. Not wanting to disturb people, I watched some of his set from the back of the massive arena. His style was similar to Clapton and he delivered a pretty good set of blues songs to a full arena. His set was short and after a quick break Clapton was on stage just after 8.30pm. The short break gave me a chance to slip into my seat. I'd bought a ticket a couple of days before the show when some new tickets were released and managed to score a spot in the front middle block, ten rows from the stage. Its some years since I've been so close to the front at a Clapton show. Eric's band is excellent, and features Paul Carrack this time around, and some excellent slide guitar from Greg Liesz. My own view is that Clapton has been on great form for several years now. His show represents the blends of style that he has engaged with over the years, from the blues guitar with which he made his name, through acoustic country/folk, and with a smattering of the secret crooner that has crept through over the years. Thinking of the latter (Eric the crooner that is) I remember the first time I saw Clapton at Hammersmith in 1974 he opened with Chaplin's Smile, which I thought very strange at the time. Since then he has played quite a few standards, including tracks like The Folks That Live on the Hill, and Goodnight Irene, both of which feature on his latest album Old Sock. Now ten years ago, I would have cringed at hearing Clapton sing those songs. But now they have become some of the my favourites. I am not sure if it is because I am older, or because Eric has mellowed into an older jazz/blues singer; its probably a bit of both. But I drove down to Manchester listening to Old Sock, and really enjoyed it. Goodnight Irene featured in last nights set, and sounded just great. I've even got used to the acoustic version of Layla, and hold on I actually really like it! Highlights for me were a great version of Badge, which now returns to the song after the strange sudden ending which I always felt wasn't quite right since I first heard in when I bought Goodbye Cream on the day it came out; Blues Power, a great song that I had all but forgotten, Crossroads, and closer Cocaine. Peter Kay (!) came on stage for the encore, encouraging us to shout for more, and joining Clapton for Sunshine of Your Love, playing a mock guitar made out of two shovels (which he played behind his head and with his teeth) and singing a couple of verses. Great stuff! Oh and I haven't really mentioned Eric's guitar playing! Actually it was excellent; probably not as full on as it used to be, and second guitarist Doyle Bramhall II takes quite a few of the solos (and he too is also excellent), but when Eric did turn it up as he did during Badge, Crossroads and the classics his playing was as great as I had ever seen. Indeed he was using tone, distortion, volume and wah wah to great effect and more than I have seen for some time. I was sharp out of the arena during the last song (sorry Eric, but I did have a 130 mile home, and it was getting of for 11pm) into the car park and off across the M62 and up the A1. I was back at 1am. A great gig from a true master who just gets better and better.. Setlist (something like): Hello Old Friend; My Father's Eyes; Tell The Truth; Gotta Get Over; Black Cat Bone; Got to Get Better in a Little While; Come Rain or Come Shine (Paul Carrack on lead vocals); Badge. Acoustic set. Driftin' Blues; Goodnight Irene; It Ain't Easy (Paul Carrack on lead vocals); Layla; Tears in Heaven; Nobody Knows You When You're Down and Out; Lay Down Sally. Back to Electric. Blues Power; Love in Vain; Crossroads; Little Queen of Spades; Cocaine. Encore: Sunshine of Your Love (with Peter Kay on crazy guitar); High Time We Went. Band: Doyle Bramhall II – guitar; Greg Leisz – pedal steel guitar; Chris Stainton – piano, keyboards; Paul Carrack – organ, keyboards; Willie Weeks – bass; Steve Jordan – drums; Michelle John – backing vocals; Sharon White – backing vocals. |
PICTURE PERFECT ENVIRONMENT! Printed on Rolland Enviro 100 paper! Base pricing includes digital imprint of the same design, in 4 colour process, on all 4 sides. Pantone colour matching not available. See Paper Cubes - Sheet Imprint & Other Options for sheet imprinting & paper cube options.
Product Size : Full Pad: 3-1/2" x 3-1/2" x 3-1/2"
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Copy change: $30 each / design. Colour change: $30 each. Printed pre-production sample: $50 per design (50% deductible with order). Number of sheets per cube: approx. 215 / inch. Orders less than minimum quantities: not available. Standard packaging: individual / shrinkwrap. Cubes per box: full cubes - 20 pces; half cubes - 40 pces. |
blood drum spirit in concert in Beijing, China.
blood drum spirit brings a new global vision to music, exploring deep into the world's great traditions through the prism of live jazz performance. Ensemble members have lived, played and toured throughout Africa, the Middle East, Europe, the Americas, and Asia, including four tours of China as featured ensemble at the renowned Beijing Midi Jazz Festival. Percussionist royal hartigan has performed with Kenny Barron and Rudresh Mahanthappa; bassist Wes Brown has toured with Earl 'Fatha' Hines and Ed Blackwell; and saxophonist David Bindman has performed with Wadada Leo Smith and Anthony Braxton.
In 1981 drummer, pianist, and tap dancer royal hartigan, bassist Wes Brown, and saxophonist David Bindman met at Wesleyan University while studying with master artists from Africa and Asia in Wesleyan's renowned World Music program. They later formed blood drum spirit, with pianist Art Hirahara joining the ensemble in 2003. The group has performed at universities and festivals across the United States and Asia, being the headline ensemble for the inaugural and subsequent Cultural Center of the Philippines (CCP) Jazz Festivals in August 2011 and September 2013, and performing in Hong, Kong, Shanghai, Hangzhou, and Beijing, China, in 2001, 2004, 2006, and 2008, and 2013. The ensemble members feel a responsibility to live and share music with people across the globe, learning from others as well as giving: offering residencies that include master classes, ensemble rehearsals, lecture-demonstrations, workshops, and concerts.
blood drum spirit adapts elements of world cultures into its music, including South Indian solkattu rhythms, tala (time cycles), and raga (modes); Javanese gamelan structures and rhythms; Philippine kulintang ensemble instruments and timbres, Turkish usul and hand drum techniques; Gaelic bodhran rhythms, Native American songs; West African instruments, melodies, forms, and rhythms; African American clapping plays, camp meeting shouts, and New Orleans rhythms: all embedded within the fabric of a uniquely American Jazz compositional and improvisational sound and style, as experienced in its two Innova double-CDs.
Our ensemble has collaborated with cutting-edge artists in diverse disciplines including African master drummers and dancers Kobena Adzenyah, Kwabena Boateng, and Saeed Abbas, Chinese instrumentalists Wang Jing and Zhang Weihua, Indian sitarist Koyel Ghosal, percussionist Lillian Gaulden, Poets Ed Roberson, Mwalim 777, Eric Andrade, and Tyrone Henderson, the Price Memorial AME Zion Gospel Choir, the Kekeli African Music and Dance ensemble of UMASS Dartmouth and the University of the Philippines, Philippine vocalist Grace Nono, percussionist Jimmy Biala, trumpeter Stephen Haynes, trombonist Bill Lowe, saxophonist Hafez Modirzadeh, guitarists Kevin McNeal (blood drum spirit double CD 1995, 2004), Ayodele Maakeru, James Robataille, and Marvin Sewell, contrabassist David Zinno, and pianists Richard Harper, Li Xiao Guang, and David Lopato. The group also formed the nucleus for Fred Ho's Afro-Asian Music Ensemble, and currently is the core of the David Bindman Sextet with trumpeter Frank London and trombonist Reut Regev.
Our music is a vehicle to express the spirit of the African American heritage and the musics of the world, who we are, and what we can give to the world's peoples.
Our repertoire includes both original and historic compositions in the American Jazz tradition. Our historical works include 17-19th century Spirituals, Field Hollers, Work Songs, Ring Shouts, and Clapping Plays through ragtime, Hot Music of the 1920s, New Orleans styles, the 1930s swing, 1940s bebop, 1950s cool, to 1960s experimental styles, 1970s fusion, and cross- cultural and world influences on the contemporary scene. The repertoire extends over a diversity of styles, historical eras, world cultural influences, all through the prism of spontaneous Jazz interpretation.
blood drum spirit has built an original, exploratory, ever-growing body of work over 25 years, while acknowledging the complexity of the music itself and the apprenticeship and study required to communicate meaningfully in any given form. In performances, ensemble members invite the audience to 'sit up close'; the performances exist not in a vacuum but in close contact with people listening. Compositions are explained, both for their musical aspects (often audience members are invited to participate through singing melodies and clapping rhythms) and for their context: the meaning behind the titles and themes, In addition to the driving swing feel of jazz, some of the ensemble's pieces employ 5, 7, 11, 15, 23, and 24-pulse time cycles that still groove, such as hartigan's arrangements of A Night in Tunisia, featuring an adapted Afro-Cuban rumba guaguanco in 7/8, Caravan, set in a 15/8 meter, and Invitation in 11/ 8. Double Trouble is a fast 7/8 blues. royal's compositions and arrangements Asante Adowa, Wadsworth Falls, Dagbamba, Eve, Adzohu, and Anlo Kete employ traditional elements from West African music and dance, while the arrangements Papago-Saguaro Song and Navajo Blood/Pontoosuc Waters/ Springside Lands are based on traditional Native American music, adapted into 23 and 11 pulse cycles, respectively. South Indian solkattu rhythmic structures are the foundation for Tala Vadyam in an 11-pulse tala and Gati Shadows Within in a 7-pulse tala. David Bindman's Sunset Park Polyphony employs the ancient tirripugar tala of South Indian music, with poetic phrases the basis for time cycle reductions at different speeds, repeating in sequence. The Pilipinas Suite uses kulintang instruments from the Maguindanao people of the southern Philippines and involves a 5/8 section derived from traditional tidtu playing style.
The group's use of time cycles is from a cultural feel and sound rather than a mathematical technique. David Bindman contributes the multi-movement compositions Threads, High Definition Truth, Crisis in (Now's the) Time, Shape 1, Song for Englewood, Robeson House Echoes, and the ballad Song for Your Return, that explore many aspects of time, tonality, timbre, and form. Wes Brown shares his layered work in 3/4, Form. The group's recorded pieces are all live performances, as experienced in a concert. The recent double CD blood drum spirit: the royal hartigan ensemble live in china was recorded on the group's second tour in China, and includes an arrangement of the Chinese traditional melody Flowing Stream joined with Charles Mingus' Goodbye Pork Pie Hat.
For more information on our work, please go to www.royalhart.com/ensemble. You can also reach us at [email protected] or (508) 999-8572.
royal, David, and Wes, at the China's Great Wall in 2006.
Reviews of royal hartigan's ancestors CD and blood drum spirit's two CDs.
Review of Blood Drum Spirit by David Dupont (five stars) in the All Music Guide ***** .....hartigan integrates elements of the music of Ghana, India, and the Philippines as well as Native Americans into his compositions, …..unlike those who use world music as an exotic flavor, hartigan (and blood drum spirit) integrate these influences deep within the structure of (their) pieces, which are an expression of a worldview that goes beyond music…..(blood drum spirit) soars high, lifted by the thermal currents supplied by hartigan and bassist Wes Brown.
Jazz reviewer Ken Waxman: (Blood Drum Spirit) combines non-Western rhythms with a standard jazz quartet to create a series of impressive originals.
Kofi Ghanaba: Father of African Jazz Drumming royal hartigan has committed himself to living the music of the peoples (of Africa)….. whatever he does in his playing and sharing is from his whole being and is the real thing.
Leon Lee, Beijing, China, 2006: blood drum spirit ensemble is the…..confluence of many different musical traditions. (They) seamlessly incorporate West African, Filipino, and Indian rhythms with the African American jazz tradition.
Murray Gusseck: Tapspace music publisher, author, percussionist, and clinician – royal hartigan is one of the great unsung heroes of the drumming world, and it is time the music community made an effort to sample some of the incredibly genuine sounds of his ensemble, blood drum spirit. royal, his music, and the personality of blood drum spirit convey a consummate aural world view. The looseness, weight, and constant searching of his playing echo the voices.....of Max Roach, Ed Blackwell, Elvin Jones, and Tony Williams.
On paper, combining the musical influences of West Africa, America and Asia can appear a bit overwhelming. That's not the case at all on royal hartigan's Ancestors. The pianist/percussionist's trilogy—Blood Drum Spirit (Innova, 2004), Blood Drum Spirit Live in China (Innov a, 2008), and now Ancestors—reflects a universal viewpoint without being neatly categorized as world music. Jazz is pervasive throughout this collection, and the various musical ethnicities serve as reminders of where the genre came from and where it could go.
Ancestors was born out of hartigan's sense of loss. It is a catharsis without closure and an acutely personal exploration of life, death, afterlife and, mostly, family, in the immediate and universal sense. "Flight/Homecoming" opens the set with saxophonist Hafez Modirzadeh covering a spectrum of emotions including keening a brief mourning. Baomi's wordless vocal improvisation continues the theme of movement and transition, before Modirzadeh returns to transport the vocalist to a spoken word suite reaffirming the continuous cycle of life beyond the physical form. Throughout this opening segment, hartigan alternately augments and drives the music, using bells, dondo, bass drum and hi hat before moving to piano.
Within the two-disc set, hartigan's own family emerges as a Greek Chorus. A poem by his grandfather is carried by Sandra Poindexter's poignant violin work, while hartigan's tap danced "Waltz Clog" is a tribute to both his uncle and mother and in a much lighter vein. Pop standards of past generations, as well as Tchaikovsky's "Violin Concerto," appear as favorites of hartigan's parents, adding personal insight in the midst of more multicultural styles. hartigan's piano brings to mind Jelly Roll Morton on "Hazel's Dance" and "Five Foot Two."
Haritgan is masterful at tying complex themes into a story, but more than that he brilliantly conveys human emotion through the music. Ancestors accepts sadness and loss as a reality, but also celebrates ongoing rebirth and treats time as an elastic continuum. Musically, he manages to incorporate instruments and styles as diverse as stride piano, Turkish bendir and Chinese zither in a collected work that is both universal and tangible at the same time. Ancestors is a blend of musicology and genealogy that is quite unique and memorable.
Track listing: CD1: Flight/Homecoming; Passages; Three Views; Hazel's Dance; Guanshan Yue; James Eagle Eye; La Vie En Rose/All to Myself/Soliloquy; Waltz Clog; Tenderly; Tatao; The Shadow of Your Smile; Cycles; Railroad Banjo To My Heart; Our Family; You'll Never Know Just How Much I Love You; Adzohu Kadodo Reflections. CD2: Hazel's Dance: Orphan Annie; Midnight Sun; Ray Hart; Parting Veil; Syrinx; We'll Be Together Again; New York Rhythm; Meng Jiang Nu; It Had To Be You; Tchaikovsky Violin Concerto In D Major/Midnight; In Moscow; Hanabi; I Know I've Been Changed; Tenderly; Dondo--Tap Conversation For Frank, Edward, Mary & Richie hartigan; Divine Trance; Five Foot Two; Through The Light; Walking Step.
Personnel: Baomi: vocals and narrative poetry; Conrad Benedicto: philippine dabakan drum; yu fuhua: violin; Danongan Kalanduyan: philippine kulintang gongs; Masaru Koga: japanese shakuhachi flute; C. K. Ladzekpo: west african e e atsime u master drum, dondo hourglass drum; Hafez Modirzadeh; soprano and tenor saxophones, persian ney flute, and western flute; Sandra Poindexter: violin; Timothy Volpicella: banjo; Weihua Zhang: chinese guzheng zither; royal hartigan: bells, percussion, piano, tap dance, turkish bendir frame drum, axatse gourd rattle, dondo hourglass drum, drum set.
Good things sometimes fly under the radar; sometimes they are great things. This has never been more the case than with royal hartigans's Blood Drum Spirit, a jazz masterpiece that has languished in obscurity since its 1993 recording to its eventual 2004 release.
It remains largely unrecognized six years later. Jazz, especially in the US, can be almost religiously hierarchical and introducing an unknown quantity to the ranks of Miles Davis, John Coltrane, or Anthony Braxton may well be viewed as profane or pretentious. However, the benefit to fans of good music outweighs the potential backlash. This qualifies as a classic desert island, end of the world as we know it, entry.
hartigan is jazz Renaissance man. An author, educator, and student/teacher of world music, he has incorporated the sounds, native instruments, and cultural nuances of West Africa and Southeast Asia into a two-disc collection where the emphasis is strongly toward jazz rather than the world music that subtly influences it. Like Collin Walcott's earlier efforts, Cloud Dance (ECM, 1976) and Grazing Dreams (ECM, 1977), hartigan has found that elusive ground that emphasizes the pure innovative nature of jazz without excluding the unique attributes of the cultures hartigan has closely studied and been influenced by. Some time back, Esbjorn Svensson Trio was dubbed the "future of jazz." Had royal Haritgan been known at that time, he may have deservedly shared the mantle.
If Blood Drum Spirit has a centerpiece, it is "Eve," a 28-plus minute epic composed of solo, duo, trio, and quartet formats that easily flow into and out of each phase. Suffice to say, "Eve" is worth the price of admission. In many ways it represents the democratic nature of hartigan's collective style and world philosophy. Guitarist Kevin McNeal's deceptively simple chords and David Bindman's opening saxophone sets a bluesy pace that carries throughout. By the time Wes Brown's bass and hartigan's kit transition into a rhythmic African extended duo, a hypnotic effect has established itself and it is not easily broken. hartigan's percussion work is as musical, or more so, than most of the percussion greats who have gone before him. His versatility could be imagined as a solo percussion work, much the way the Art Ensemble of Chicago's drummer Don Moye is.
To single out tracks is counter-productive here; this is a work of symphonic structure. hartigan's quartet exerts equal effort and finesse across the spectrum of tunes here and selectivity would be nitpicking as the work that builds and develops across the entire program. Each band member is given more than ample opportunity to solo and in every case they are stellar performances. Why royal hartigan is unfamiliar to many jazz fans is a subject for another debate. What is clear is that Blood Drum Spirit is a collection that will endure for many years to come.
Track listing: Blood Drum Spirit; Wadsworth Falls; Dagomba; Pilipinas Suite; Solog; Pilipinas; Solog; Caravan; Tala Vadyam; Apartheid Usa Suite; Adzohu; Juba Handclaps; Rodney King Drums; Double Trouble; Adzohu Rodney King Drums; Double Trouble; Navajo Blood/Pontoosuc Waters/Springside Lands; Tie Me Sufre (Teah May Sufray); Papago-Saguaro Song; Eve (Eh Vay).
Personnel: David Bindman: woodwinds; Kevin McNeal: guitar; Wes Brown: bass; royal hartigan: drums, cymbals, and rattles. |
Developing distress
| Indepth
The birth-pangs of development have been faced so far by the downtrodden, but things need to change soon
UPROOTED 4 times in 3 decades. Thirty thousand villagers of Madhya Pradesh were first displaced during the construction of the Rihand dam (late '50s); later, again, when coal was found in the mid-70s; a third time, to make room for industry; and finally, when the Singrauli mega thermal power station was mooted in the late '80s. And since the area has been recently earmarked for compensatory reforestation, they might be shown the door a fifth time.
But these villagers are no exception. "First they grabbed our little finger, then our hand and soon they swallowed us up," said Jasibehn Tadvi, a displaced woman from Bharuch district's Kevadia village. She was ousted during the first phase of the Sardar Sarovar Project (SSP). Jasibehn and many others displaced due to various developmental projects spoke their hearts out during a mid-January workshop organised by the Indian Social Institute in the Capital.
A large number of oustees, along with non-governmental organisations (NGOs), representatives of voluntary agencies, research institutions and mass organisations attended the National Workshop to discuss a series of draft rehabilitation policies prepared by the Union ministry of rural development (MRD) and the Central Water Commission, Coal India and the National Thermal Power Corporation. What emerged from the exercise is a graphic detailing of the price that the "have-nots" pay for development, which benefits the "haves".
There was much ire over the bureaucracy's typically secretive approach. The latest draft, marked "Secret", is signed by Shivraj Singh, joint secretary, land reforms, MRD. Says Singh, "I don't know how my name got in there." But he spoke of a fresh draft being prepared, with comments from all other ministries which are planning developmental programmes. But how are the people sought to be involved in the process? Singh said, "All that will be discussed."
There will be much struggle ahead. And the workshop -- the culmination of discussions at the taluka, district and state levels -- was a part of that struggle. As Jai Sen of the National Campaign for Housing Rights said, "We have to struggle to ensure that the people are part of the decision-making process, which enables them to decide whether the kind of development that displaces them should be allowed at all."
But it is also becoming increasingly clear that growing pressure, both from mass movements and the World Bank (WB), is forcing the government to lend its ears to public opinion. In 1992, the WB was forced to review such of its aided projects which had faced widespread discontent and agitations. Activists insist that the WB has been pressurising the government to come out with a rehabilitation policy.
The draft acknowledges the growing movement against displacement. It says, "The world financial institutions can go to the extent of withholding loan and aid so as to get fulfillment for their ecological concerns."
The beginning Development-related displacement in India can be traced back to the Raj days and the construction of the first state-owned Yamuna Canal system in 1789. The construction of the Upper Anicut dam on the Cauvery in 1863 raised the issue of involuntary displacement. Colonial administration came out with the Land Acquisition Act in 1894. Even after an amendment 90 years later, the Act remains a sore point with oustees.
The Tata Power Company's building of a dam at Mulshi Peta in 1920 near Pune displaced 11,000 people, and triggered off the first satyagraha against forcible displacement. Thirteen hundred Pune residents signed a protest letter, and on April 16, some 1,200 Mavla men, women and children forced the work to a halt.
The era of large dams began with the Mettur dam on the Cauvery in 1930. It was the country's first concrete dam. By 1950, about 100 major dams, with reservoirs having a culturable command area exceeding 10,000 ha had come up. The Bhakra-Nangal and Hirakud dams were touted as symbols of progress. By 1985, some 1,500 large and medium and thousands of minor dams had been commissioned. The public outlay on irrigation projects had reached Rs 20,000 crore.
But apart from dams, industrial and mining projects, national parks and sanctuaries and even tourist resorts have displaced people.
Rehabilitation of the oustees everywhere has been extremely poor. Merely 25 per cent of those displaced during the first 3 decades of planned development have been resettled. One example: of the 2,108 families displaced from Una and Bilaspur districts of Himachal Pradesh by the Bhakra-Nangal project, only 750 have been resettled.
Estimates of the total numbers displaced by dams since 195l vary: 210 lakh till 1985 according to activist-economist Vijay Paranjpye; and 164 lakh, according to Walter Fernandes, convenor of the workshop in the Capital. Fernandes claims that from 1951 to 1990, a total of 213 lakh people have been displaced by dams, mines, industries and wildlife sanctuaries put together.
Reliable data is mostly not available. While the government accepts a figure of 110,000 displaced by the Hirakud project, researchers claim a figure of 180,000.
Fernandes moans, "The nation ignores the 'internal refugees' of developmental projects, whose numbers far exceed the 150 lakh people displaced by the 1947 partition."
Tribals' trauma
Studies show that most of the oustees are tribals and other assetless rural poor who have traditionally depended on the common property resources (CPR), or survived by rendering services to the village.
Official figures, too, show that tribals, comprising less than 8 per cent of the country's population, exceed 40 per cent of those displaced till 1990.
But reliable estimates for dalits (Scheduled Castes) displaced by these schemes don't exist. Extrapolating data from some projects, Lakshman Mahapatra, former vice chancellor of the Utkal University in Orissa, estimates that dalits comprise 20 per cent of oustees.
The proportion of tribal oustees has shot up to 50 per cent in the last 2 decades. This stands true also for wildlife projects in south India. An official report (1990) of the Field Director, Karnataka, claims, "Shifting of tribals and other villagers from a Tiger Reserve has been an accepted principle for proper management by the Government of India and state governments."
Nonexistent planning has added to the miseries of the downtrodden. Multiple displacements, as shown in the case of the Rihand oustees, have been repeated many times over. Fisherfolk families displaced by the New Mangalore Port in the '60s, and resettled as agriculturists, are being displaced again for the Konkan Railway, after they have adapted themselves to their new lifestyle. Tribals displaced in the '70s by the Kabini dam are being dislocated again by a new bio-sphere reserve.
Tribals traditionally depend on common property for survival, unlike caste-based farmers who own land individually. But the government has differing attitudes towards these peoples. Only 18 per cent of the land claimed for the National Aluminium Corporation's Angul project in Dhenkanal (dominated by caste-based farmers) belonged to the government. But in the tribal-belt project in Damanjodi, Koraput district, 58 per cent of the land acquired was common property.
A warped national value system considers the tribal regions as "backward". Their land is assessed at a rate lower than in the "advanced" regions. The Damanjodi oustees received only Rs 6,670 per ha, compared to about Rs 62,000 per ha paid in Angul.
Tribals sometimes sell off land much before a project starts. Most often, non-tribals buy these lands with an eye on the prospects of wiggling out higher compensations as "oustees". This is precisely what had happened in the test-firing range of Baliapal, Orissa.
Nomads, who comprise 5 per cent of the total population, are totally ignored because they are landless. The Van Gujjars of the Rajaji National Park have been resisting their ouster and forced resettlement in a decrepit housing colony at Pathri, near Hardwar.
The onset of a development project does strange things to humans. A destructive streak overtakes the locals, who stop developing their own lands, cut down trees and steal the assets of other people. The communities which hitherto treated forests as a renewable community resource begin to ravage them. This triggers off environmental degradation, which invariably intensifies when resettlement is ignored. The tribals and dalits, the worst sufferers, resist marginalisation at times, but are soon neutralised.
Regime of insecurity
The formal sector's (banks and other institutions) reflexes, conditioned to operate in a milieu of security, do not allow it to give loans and grants to oustees, uncertain about recovering them. Moneylenders, middlemen and other outsiders exploit this regime of insecurity.
It is now widely accepted that the first norm of any displacement or rehabilitation policy should be the involvement and consent of the people. But this has not been done in any project so far. Upendra Baxi, eminent jurist and former vice-chancellor of Delhi University flays this: "The beneficiaries as well as victims of developmental projects must, on the logic of the plan, forfeit their sovereignty to the virtuous and benign bureaucracy, who alone know what is good for them in the short as well as the long run. Any questioning of the present development paradigm leads to being branded as 'anti-poor' or 'anti-development.'"
Development now appears as a new theology in which democratic articulation emerges as a sin against the people, says Baxi. "But which people? Those who benefit or those who pay the price?" he asks.
One key to the democratisation of development processes is information flow, which alone can expose the bureaucracy's double standards. "How long will the government go on saying one thing in international meetings and practising another thing within the country?" asks Sen.
Sen insists that the present practices of the government militate against the basic principles of the Constitution. Various sections of Article 19 and Article 14, guaranteeing right to life and dignity, freedom and right to settle anywhere in the country and right to equality lie violated.
Today, consensus has evolved regarding the government's duties before deciding to relocate communities to make room for developmental projects. Consent should be democratically obtained from the people likely to be affected, after explicitly clarifying to them their larger interests. The proposal should be publicly and nationally declared.
If those required to move decline to do so, there must be a public enquiry and adjudication through a sort of tribunal comprising independent citizens, but if its verdict is unacceptable to the State, the Supreme Court should be approached for a decision. If the tribunal or the Supreme Court directs the people to move, they shall be entitled to total rehabilitation and not just resettlement.
Where people enjoying customary rights over CPR are displaced, they should be automatically entitled to joint ownership of whatever industry or investment that causes their displacement and or of benefits accruing from it. But in no case should anyone be shifted more than once in at least 50 to 100 years. This calls for very comprehensive area planning. Projects are notoriously slow to complete, or even to take off. In case a project is not started or not fully underway within 2 years of displacement, the oustees must be given the option of regaining the ownership and full rights of use of the CPR.
This is crucial. It is a standing practice for the bureaucracy to issue notices for evacuation the moment a project is announced, though the actual shifting might not start for years. A Centre for Social Studies study shows that most of the oustees in the 19 Gujarat villages facing submersion due to the SSP had been issued notices as early as 1980. The actual shifting is yet to take place from many villages. The 557 households who had been shifted by 1988 should have been given a total of 1,118 ha of land, but only 526.5 ha had been actually handed over.
On the whole, the struggling peoples and organisations are perhaps seeing some rays of hope, with the recent pronouncements of the Supreme Court tending to castigate the government; the thrashing meted out last month on the Narmada project is a case to point.
The changing opinion climate in the West is forcing international financial institutions to become more responsible about funding projects in the peripheral nations. And mass protests on environmental issues are being echoed fast and loud by sympathisers in developed countries. Yet, the stubborn mindset of the bureaucracy and their callous indifference will need more than a few bashings to ensure that development projects are for the people, of the people, and have to be approved, first, by the people.
India Displacement Displacement Rehabilitation Rehabilitation NGO Tribals Analysis |
Who choreographed Broadway Melody of 1940?
Who sang for Eleanor Powell?
What did Fred Astaire say about Eleanor Powell?
Who is the fastest tap dancer in the world?
Did Flatley marry?
How many taps a second can Michael Flatley do?
Is there a Broadway Melody 5?
Is Broadway Melody based on a true story?
Busby Berkeley
Had this Broadway MELODY edition been choreographed by Busby Berkeley, who had recently recruited to MGM from Warner Brothers, the "Begin the Beguine" number would have found Astaire and Powell sharing the grand finale spotlight with close to 100 dancers.
Audiences never suspected that Eleanor Powell did not perform her own singing vocals because Metro-Goldwyn-Mayer linked her with ghost singer Marjorie Lane from the outset of her career. Lane had only one other film credit to her name, appearing on camera in a 1930 short subject.
Who was the best female tap dancer?
Eleanor Powell During the Golden Age of Hollywood, Eleanor Powell's dazzling footwork earned her roles in Born to Dance, Broadway Melody of 1938, and Rosalie. She was even named the World's Greatest Tap Dancer by the Dance Masters of America in 1965.
Fred Astaire, who performed with Powell memorably in several films, pinpointed the issue in a couple of interviews, as well as in his autobiography, Steps in Time. "Eleanor Powell, one of our greatest talents, is a bit too powerful for me," he said. "I love Eleanor Powell, but she dances like a man.
April 28, 2016. Share this article: IRISH dancer James Devine is a World Record Holder for the "fastest feet in the world", with an astonishing 38 taps per second.
Who was the better dancer Astaire or Kelly?
I think the answer is clear – Fred Astaire. Singin' in the Rain might be more famous on a purely pound-for-pound basis, but that doesn't make it the better film, nor does it make Kelly the better dancer. The two are a study in contrasts. Gene Kelly's style of dancing was highly athletic and physical.
In June 2006, Flatley began dating dancer Niamh O'Brien, who danced in several of his shows. They were married in a Roman Catholic ceremony in Fermoy, County Cork, on October 14, 2006, with a reception at Castlehyde. He and his wife have a son, Michael St. James, born in 2007.
35 taps per second
In May 1989, Flatley set a Guinness Book world record for tapping speed at 28 taps per second. He subsequently broke his own record in 1998 with 35 taps per second.
What is the musical Broadway Melody of 1940 about?
Broadway Melody of 1940 (1940) Johnny Brett and King Shaw are an unsuccessful dance team in New York. A producer discovers Brett as the new partner for Clare Bennett, but Brett, who thinks he is one of the people they lent money to gives him the name of his partner.
A fifth Broadway Melody film was planned for release in the early 1940s, pairing Eleanor Powell with Gene Kelly, but production was cancelled at the rehearsal stage. Another production was to have been called Broadway Melody of 1944 but was instead renamed Broadway Rhythm.
Broadway Melody of 1940 was based on a story by Jack McGowan and Dore Schary. Schary would go on to be head of production (1948) and then president (1951) of MGM until 1956. |
World Americas 17 May 2019 Donald Trump thinks its 'great' to have gay Presidential candidate
Donald Trump thinks its 'great' to have gay Presidential candidate
A previously little known mayor of South Bend, Indiana, Pete Buttigieg has raced to prominence as one of the top contenders.
Buttigieg is married and if he won the White House, his husband Chasten would likely be known as the "first gentleman." (Photo:AP)
Washington: Donald Trump says it's "great" that a gay Democratic challenger, Pete Buttigieg, is in the 2020 presidential race.
A previously little known mayor of South Bend, Indiana, Buttigieg has raced to prominence as one of the top contenders in a crowded Democratic field -- and as the first major presidential candidate to be openly homosexual.
"I think it's absolutely fine, I do," Trump told Fox News in an excerpt released Thursday of an interview airing Sunday.
"I think it's great. I think that's something that perhaps some people will have a problem with. I have no problem with it whatsoever. I think it's good," Trump said.
Buttigieg is married and if he won the White House -- still a very big if -- his husband Chasten would likely be known as the "first gentleman."
Whether Buttigieg gets his party's nomination or not, his bid has already made him and Chasten the country's most prominent gay couple.
Trump, whose right-wing base is broadly hostile to gay marriage, has delivered a mixed message on his attitude to gay rights over the years.
Tags: 2020 presidential elections, pete buttigieg, donald trump |
\subsection*{LSZ for Matrix Theory}
The $N=2$ Matrix theory Hamiltonian
\be
H= \ft 1 2 P^0_\mu P^0_\mu + \Bigl ( \ft 12 \vec{P}_\mu \cdot \vec{P}_\mu
+ \, \ft 14 (\vec{X}_\mu \times \vec{X}_\nu)^2
+ \, \ft i 2 \vec{X}_\mu\cdot \vec{\theta}\, \gamma_\mu\times
\vec{\theta}\Bigr )\,
\label{MTHam}
\ee
is a sum of an
interacting $SU(2)$ part describing relative motions
and a free $U(1)$ piece pertaining to the
centre of mass. We use a vector notation for the adjoint representation
of $SU(2)$, $\vec{X}_\mu=(Y^I_\mu,x_\mu)$ and
$\vec{\theta}=(\theta^I,\theta^3)$ (with $I=1,2$ and $\mu=1,\ldots ,9$)
and may choose a gauge
in which $Y^I_9=0$.
The model has a potential with
flat directions along a valley floor
in the Cartan sector $x_\mu$ and $\theta^3$.
The remaining degrees of freedom transverse
to the valley are supersymmetric harmonic oscillators in the variables
$Y^I_\mu$ ($\mu\neq9$) and $\theta^I$.
Upon introducing a large gauge invariant
distance $x=(\vec{X}_9\cdot\vec{X}_9)^{1/2}=x_9$ as the separation of
a pair of particles, the Hamiltonian \eqn{MTHam} was shown \cite{PW} to
possess asymptotic two particle states of the form
\be
|p^1_\mu,{\cal H}^1;p^2_\mu,{\cal H}^2\rangle=|0_B,0_F\rangle\,
\ft{1}{x_9}e^{i(p^1-p^2) \cdot
x}e^{i(p_1+p_2)\cdot X^0}
|{\cal H}^1\rangle_{\theta^0+\theta^3}\,|{\cal H}^2
\rangle_{\theta^0-\theta^3}\label{state}
\ee
Here $p^{1,2}_\mu$ and ${\cal H}^{1,2}$ are the momenta and
polarizations of the two particles.
The state $|0_B,0_F\rangle$ is the ground state of the superharmonic
oscillators
and the polarization states are the $\underline{44}\oplus\underline{84}
\oplus\underline{128}$ representation of the $\theta^0\pm
\theta^3$
variables, corresponding to the graviton, three-form tensor and gravitino
respectively.
For the computation of scattering amplitudes
one may now form the $S$-matrix in the usual fashion
$
S_{fi}\, =\, \langle {\rm out}| \exp \{-iHT\} |{\rm
in}\rangle \,
$
with the desired in and outgoing
quantum numbers according to~(\ref{state})
\footnote{The asymptotic states above
are constructed with respect to a large separation
in the same direction for both in and outgoing
particles, i.e.\ eikonal kinematics.
More general kinematical situations are handled by
introducing a rotation operator into the $S$-matrix \cite{PW1}.}.
The object of interest is then the vacuum to vacuum transition
amplitude
\be
e^{i\Gamma(x'_\mu,x_\mu,\theta^3)}=
{}_{x^\prime_\mu}\langle 0_B,0_F| \exp \{-iHT\} | 0_B,0_F\rangle_{x_\mu}.
\label{trans}
\ee
Note that the ground states actually depend on the Cartan variables
$x_\mu$ and $x'_\mu$ through the oscillator mass. Also, both the
left and right hand sides depend on the operator $\theta^3$.
Our key observation is rather simple. In field theory one is accustomed
to expand around a vanishing vacuum expectation value
when computing the vacuum to vacuum transition amplitude for some
field composed of oscillator modes. In quantum mechanics the idea is
of course exactly the same, and therefore if one is to represent \eqn{trans}
by a path integral one should expand
the super oscillators transverse to the valley about a vanishing vev.
One may then write the
Matrix theory $S$-matrix in terms of a path integral with the stated
boundary conditions
\be
e^{i\Gamma(v_\mu,b_\mu,\theta^3)}=
\int_{{\vec{X}}_\mu=(0,0,x_\mu),\, {\vec{\theta}}=(0,0,\theta^3)}
^{{\vec{X}}_\mu=(0,0,x_\mu'),\, {\vec{\theta}}=(0,0,\theta^3)}
{\cal D}(\vec{X}_\mu,\vec{A},\vec{b},\vec{c},\vec{\theta})\,
\exp(i\,\int_{-T/2}^{T/2}L_{\rm SYM}).
\ee
The Lagrangian $L_{\rm SYM}$ is that of the supersymmetric
Yang--Mills quantum mechanics with appropriate gauge fixing
to which end we have
introduced ghosts $\vec{b}$, $\vec{c}$ and the Lagrange multiplier
gauge field $\vec{A}$.
The effective action $\Gamma(v_\mu,b_\mu,\theta^3)$
is most easily computed via an expansion about classical trajectories
$X^3_\mu(t)\equiv x_\mu^{\rm cl}(t)
=b_\mu+v_\mu t$ and constant $\theta^3(t)=\theta^3$
which yields the quoted boundary conditions
through the identification $b_\mu=(x'_\mu+x_\mu)/2$ and
$v_\mu=(x'_\mu-x_\mu)/T$.
Up to an overall normalization ${\cal N}$, our LSZ
reduction formula
for Matrix theory is simply
\bea
S_{fi}&=&\delta^9(k'_\mu-k_\mu)e^{-ik_\mu k_\mu T/2}\nonumber\\
&&\hspace{0cm}
\int d^9x' d^9x \,{\cal N}\,
\exp(-iw_\mu x'_\mu +iu_\mu x_\mu)
\langle {\cal H}^3| \langle {\cal H}^4|e^{i\Gamma(v_\mu,b_\mu,\theta^3)}
|{\cal H}^1\rangle |{\cal H}^2\rangle
\label{superS}
\eea
The leading factor expresses momentum conservation for the centre of mass
where we have denoted $k_\mu=p_\mu^1+p_\mu^2$ and
$k'_\mu=p_\mu^3+p_\mu^4$ for the in and outgoing particles,
respectively, and similarly for the relative momenta
$u_\mu=(p_\mu^1-p_\mu^2)/2$ and $w_\mu=(p_\mu^4-p_\mu^3)/2$.
In a loopwise expansion of the Matrix theory path integral one finds
$\Gamma(v_\mu,b_\mu,\theta^3)=v_\mu v_\mu T/2+ \Gamma^{(1)}
+\Gamma^{(2)}+\ldots$ of which we consider only the first two terms
in order to compare our results with tree level supergravity.
Inserting this expansion into~(\ref{superS}) and
changing variables $d^9x' d^9x \rightarrow d^9 (Tv) d^9 b$,
the integral over $Tv_\mu$ may be performed via stationary phase.
Dropping the normalization and the overall centre of mass piece
the $S$-matrix then reads
\be
S_{fi}=e^{-i[(u+w)/2]^2 T/2}
\int d^9b \,
e^{-i q_\mu b_\mu}\,
\langle {\cal H}^3| \langle {\cal H}^4|
e^{i\Gamma(v_\mu=(u_\mu+w_\mu)/2,b_\mu,\theta^3)}
|{\cal H}^1\rangle |{\cal H}^2\rangle
\label{sfi}
\ee
where $q_\mu=w_\mu-u_\mu$.
It is important to note that in~(\ref{sfi}) the variables
$\theta^3$ are operators
$\{\theta^3_\a,\theta^3_\b\}=\delta_{\a\b}$
whose
expectation between polarization states
$|{\cal H}\rangle$ yields the spin dependence
of the scattering amplitude.
The loopwise expansion of the
effective action should be valid for the eikonal regime, i.e. large
impact parameter $b_\mu$ or small momentum transfer $q_\mu$.
As we shall see below, this limit is dominated by $t$-channel
physics on the supergravity side.
\subsection*{D0 Brane Computation of the Matrix Theory Effective
Potential}
We must now determine the one-loop
effective Matrix
potential $\Gamma (v,b,\theta^3)$, namely
the $v^4/r^7$ term and its supersymmetric completion.
Fortunately the bulk of this computation has already been performed
in string theory by \cite{mss1,mss2} who applied the
Green-Schwarz boundary state
formalism of \cite{gregut1}
to a one-loop annulus computation
for a pair of moving D0-branes. They found
that the leading spin interactions are dictated by a simple zero modes
analysis and their form is, in particular, scale independent.
This observation allows to extrapolate the results of \cite{mss1,mss2}
to short distances and suggest a Matrix theory description
for tree-level supergravity interactions.
Following \cite{mss1,mss2}, supersymmetric D0-brane interactions
are computed from the correlator
\be
{\cal V}=\frac{1}{16}\int_0^\infty \!\!dt \,
\langle B,\vec{x}=0|e^{-2\pi t\alpha^{\prime}
p^+(P^--i\partial/\partial x^+)}
e^{(\eta Q^-+\tilde{\eta}\tilde{Q}^-)}e^{V_B}|B,\vec{y}=\vec{b} \rangle
\label{cyl}
\ee
with $Q^-,\tilde{Q}^-$ being the SO($8$) supercharges
broken by the presence of the D-brane, $|B\rangle$
the boundary state associated to D0-branes and
$V_B=v_i\oint_{\tau=0}\!d\sigma\left(X^{[1}\partial_{\sigma}X^{i]}
+\frac{1}{2}S\,\gamma^{1i}S\right)$
is the boost operator where the direction 1 has to be identified
with the time (see \cite{mss1,mss2} for details). Expanding
(\ref{cyl}) and using the results in
section four of \cite{mss2}, one
finds the following compact form for the
leading one-loop Matrix theory potential (normalizing to one the
$v^4$ term and setting $\alpha^\prime=1$)
\bea
{\cal V}_{\rm 1-loop}&=&
\Bigl [ v^4 + 2i\, v^2\,v_m\ps{m}{n}\, \partial_n
-2\, v_p v_q
\ps{p}{m}\ps{q}{n}\,\partial_m \partial_n\nonumber\\
&&\quad -\frac{4i}{9}\, v_q\ps{q}{m}\ps{n}{k}\ps{p}{k}\,\partial_m\partial_n\partial_p
\nonumber \\
&&\quad + \frac{2}{63}\, \ps{m}{l}\ps{n}{l}\ps{p}{k}\ps{q}{k}\,
\partial_m\partial_n\partial_p \partial_q\Bigr ]\, \frac{1}{r^7} \label{pot}
\eea
where $\theta=(\eta^a, \tilde \eta^{\dot a})$ should be identified with
$\theta^3/2$ of the last section. The general structure of this potential
was noted in \cite{harv} and its first, second and last
terms were calculated
in \cite{dkps},\cite{Kraus97} and \cite{static} respectively.
Naturally it would be interesting to establish the supersymmetry
transformations of this potential; for a related discussion see
\cite{pss1}.
\subsection*{Results}
Our Matrix computation is completed by taking the
quantum mechanical expectation of
the effective potential
\eqn{pot} between the polarization states of
\eqn{sfi}. Clearly one can now study any amplitude involving
gravitons, three--form tensors and gravitini.
We choose to compute a $h_1 + h_2 \rightarrow h_4 + h_3$
graviton-graviton process, and thus
prepare states
\bea
|{\rm in}\rangle&=& \ft{1}{256}\, h^1_{mn}\,
(\ld{1}\gamma_{m}\ld{1})(\ld{1}\gamma_n\ld{1})
\, h^2_{pq}\, (\ld{2}\gamma_{p}\ld{2})(\ld{2}\gamma_q\ld{2})\,
|-\rangle \, .
\label{in}
\nn\\
\langle{\rm out}|&=& \ft{1}{256}\, \langle -|\,
h^4_{mn}\, (\la{1}\gamma_{m}\la{1})(\la{1}\gamma_n\la{1})
\, h^3_{pq}\, (\la{2}\gamma_{p}\la{2})(\la{2}\gamma_q\la{2})
\label{out}
\eea
Note that (following \cite{PW}) we have complexified the
Majorana centre of mass and Cartan spinors $\theta^0$ and $\theta^3$
in terms of
$SO(7)$ spinors $\lambda^{1,2}=(\theta^0_+\pm\theta^3_+
+i\theta^0_-\pm i\theta^3_-)/2$
where $\pm$ denotes projection with respect to $\gamma_9$.
Actually the polarizations in \eqn{out}
are seven dimensional but may be generalized to the nine
dimensional case at the end of the calculation.
We stress that these manoeuvres are purely technical and our
final results are $SO(9)$ covariant.
The creation and destruction operators $\lambda^\dagger_{1,2}$ and
$\lambda_{1,2}$ annihilate the states
$\langle-|$ and $|-\rangle$, respectively.
The resulting one loop
eikonal Matrix theory graviton-graviton scattering amplitude
is comprised of 68 terms and (denoting e.g.\
$(q h_1h_4 v)=q_\mu h^1_{\mu\nu}
h^4_{\nu\rho}v_\rho$ and $(h_1 h_4)=h^1_{\mu\nu}h^4_{\nu\mu}$)
is given by
\begin{eqnarray}
{\cal A}&\,\,= \,\,\frac{\textstyle 1}{\textstyle q^2}\,\,\Biggl\{\,\,&
\ft12(h_1 h_4)(h_2 h_3) v^4
+ 2\Bigr[(q h_3 h_2 v) (h_1 h_4)
- (q h_2 h_3 v) (h_1 h_4)\Bigr] v^2
\nn\\&&\hspace{-.23cm}
+ (vh_2v) (qh_3q)(h_1 h_4)
+ (vh_3v) (qh_2q)(h_1 h_4)
- 2(qh_2v) (qh_3v)(h_1 h_4)
\nn\\&&\hspace{-.23cm}
- 2 (qh_1h_4v) (qh_3h_2v)
+ (qh_1h_4v) (qh_2h_3v)
+ (qh_4h_1v) (qh_3h_2v)
\nn\\&&\hspace{-.23cm}
+ \ft{1}{2}\Bigl [(qh_1h_4h_3h_2q)
- 2(qh_1h_4h_2h_3q)
+ (qh_4h_1h_2h_3q)
- 2(qh_2h_3q)(h_1 h_4) \Bigr ] v^2
\nn\\&&\hspace{-.23cm}
- (qh_2v) (qh_3q) (h_1h_4)
+ (qh_2q) (qh_3v) (h_1h_4)
- (qh_1q) (qh_2h_3h_4v)
+ (qh_1q) (qh_3h_2h_4v)
\nn\\&&\hspace{-.23cm}
- (qh_4q) (qh_2h_3h_1v)
+ (qh_4q) (qh_3h_2h_1v)
- (qh_1v) (qh_4h_2h_3q)
+ (qh_1v) (qh_4h_3h_2q)
\nn\\&&\hspace{-.23cm}
- (qh_4v) (qh_1h_2h_3q)
+ (qh_4v) (qh_1h_3h_2q)
+ (qh_1h_4q) (qh_2h_3v)
- (qh_1h_4q) (qh_3h_2v)
\nn\\&&\hspace{-.23cm}
+\ft18 \Bigl[
(qh_1q) (qh_2q) (h_3h_4)
+2 (qh_1q) (qh_4q) (h_2h_3)
+2 (qh_1q) (qh_3q) (h_2h_4)
\nn\\&&\hspace{-.23cm}
+ (qh_3q) (qh_4q) (h_1h_2) \Bigr]
+ \ft12\Bigl[
(qh_1q) (qh_4h_2h_3q)
- (qh_1q) (qh_2h_4h_3q)
\nn\\&&\hspace{-.23cm}
- (qh_1q) (qh_4h_3h_2q)
- (qh_4q) (qh_1h_2h_3q)
+ (qh_4q) (qh_1h_3h_2q)
- (qh_4q) (qh_2h_1h_3q) \Bigr]
\nn\\&&\hspace{-.23cm}
+ \ft14\Bigl[
(qh_1h_3q) (qh_4h_2q)
+ (qh_1h_2q) (qh_4h_3q)
+ (qh_1h_4q) (qh_2h_3q) \Bigr]
\, \Biggr\}
\nn\\&&\hspace{-.73cm}
+\,\, \Bigl[h_1 \longleftrightarrow h_2\, , \, h_3 \longleftrightarrow h_4
\Bigr]
\label{Ulle}
\end{eqnarray}
We have neglected all terms within the curly brackets proportional
to $q^2\equiv q_\mu q_\mu$, i.e. those that cancel the $1/q^2$ pole.
These correspond to contact interactions in the D0 brane
computation, whereas this calculation is
valid only for non-coincident branes.
\subsection*{$D=11$ Supergravity}
The above leading order result for eikonal scattering in Matrix theory
is easily shown to agree with the corresponding eleven
dimensional field theoretical amplitude.
Tree level graviton--graviton scattering is dimension independent
and has been computed in \cite{San}.
We have double checked that work by a type IIA string theory computation
and will not display the explicit result here
which depends on eleven momenta $p^i_M$ (with $i=1,\ldots,4$)
and polarizations
$h^i_{MN}$ subject to the de Donder gauge condition
$p^i_N h^i{}_M{}^N-(1/2)p^i_M h^i{}_N{}^N=0$ (no sum on $i$).
Matrix theory, on the other hand, is
formulated in terms of on shell degrees of freedom only, namely
transverse physical polarizations and euclidean nine-momenta.
Going to light-cone variables for the eleven momenta $p^i_M$
we take the case of vanishing $p^-$ momentum exchange
\footnote{We
denote $p_\pm=p^\mp
=(p^{10}\pm p^0)/\sqrt{2}$ and our metric convention is
$\eta_{MN}={\rm diag}
(-,+\ldots,+)$.}, i.e. the scenario of our Matrix computation,
\bea
p_M^1=(-\ft12\,(v_\mu-q_\mu/2)^2 ,\, 1\, ,
v_\mu-q_\mu/2 )
&\quad& p_M^2=(-\ft12\, (v_\mu-q_\mu/2)^2 ,\, 1\, ,
-v_\mu+q_\mu/2) \nn\\
p_M^4=(-\ft12\, (v_\mu+q_\mu/2)^2 ,\, 1\, ,
v_\mu+q_\mu/2) &\quad & p_M^3=(-\ft12\,
(v_\mu+q_\mu/2)^2 ,\, 1\, ,
-v_\mu-q_\mu/2) \, .\label{kinematics}
\eea
By transverse Galilean invariance we have set to zero the nine
dimensional centre of mass
momentum. We measure momenta in units of $p_-$ which we set to one.
For this kinematical situation conservation of $p_+$ momentum
clearly implies $v_\mu q_\mu=0$.
Note that the vectors $u_\mu$ and $w_\mu$
of~(\ref{superS}) are simply
$u_\mu=v_\mu-q_\mu/2$ and $w_\mu=v_\mu+q_\mu/2$
We reduce to physical
polarizations by using the residual gauge freedom to set $h^i_{+M}=0$
and solve the de Donder gauge condition
in terms of the transverse traceless
polarizations $h^i_{\mu\nu}$ for which
one finds $h^i_{-M}=-p^i_\nu h^i_{\nu M}$.
Agreement with the Matrix result \eqn{Ulle} is then achieved by
taking the eikonal limit $v_\mu>>q_\mu$ of the gravity amplitude
in which the $t$-pole contributions
dominate\footnote{In the above parametrization,
the Mandelstam variables are $t=q_\mu^2=-2p^1_M p_4^M$,
$s=4v_\mu^2+q^2_\mu=2p^1_M p_2^M$ and $u=4v_\mu^2=-2p^1_M p_2^M=s-t$.}.
One then reproduces exactly \eqn{Ulle} as long as any pieces cancelling the
$t$-pole (i.e. the aforementioned $q^2$ terms) are neglected.
Although we have only presented here a Matrix scattering amplitude
restricted to the eikonal regime, we nevertheless believe
the agreement found is rather impressive.
\subsection*{Acknowledgements}
We thank B. de Wit, S. Moch, K. Peeters and J. Vermaseren
for discussions. Our computation made extensive use of the
computer algebra system FORM \cite{Jos}.
|
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Education Week journalists explore some of the nonacademic issues that bear on students' learning. Find insights, news, and analysis on a wide range of issues including school climate, student engagement, children's well-being, and student behavior and discipline.
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Real Life Bullying Could Be Influenced by TV Storylines, Study Says
By Evie Blad on February 9, 2016 1:01 PM | No comments
By Sarah Sparks. Cross posted from Inside School Research.
From Disney's "Wizards of Waverly Place" to the CW's "The Vampire Diaries," every teen and tween show at some point brings in gossip or bullying to amp up the drama. But years of watching relational aggression on television is linked to more peer bullying in real life years down the line, suggests a new study in the February issue of the journal Developmental Psychology.
Brigham Young University associate professor Sarah Coyne tracked 467 teenagers within a larger longitudinal family life study. She surveyed the students once a year about their television watching and peer relationships beginning at ages 10 to 13 and continuing three years, through the middle-to-high school transition. The students listed their favorite television shows, which were then separately rated for physical and relational violence by more than 750 raters who were in their 20s. Shows like "Pretty Little Liars" and "Gossip Girl," for example, lived up to their names; both were highly popular shows that also rated high on relational aggression. For physical violence, serial-killer drama "Dexter" and teacher-turned-meth-dealer series "Breaking Bad" were teenagers' favorites.
Coyne found students exposed to so-called "relational aggression"--rumor-mongering, ostracizing students, and so on--on television early on were more aggressive to their own friends three years later. For example, boys and girls alike were more likely to agree that, "When mad at a person, I try to make sure that the person is left out of group activities."
Interestingly, while Coyne found students tended to watch more physically violent shows as older adolescents if they had been exposed to them as younger teenagers, that wasn't the case for relational bullying.
Moreover, she noted that while physical violence in television shows was portrayed as negative and abnormal, social bullying was portrayed as more normal. That was echoed in a separate but related study by Coyne's graduate student researcher, Halie Foell Stout, which found that out of 90 top-grossing teen movies from 1980 to 2009, 94 percent included relational aggression. "Acts of relational aggression are portrayed as not justified and not humorous," Stout wrote, "However, acts of relational aggression were portrayed as rewarded."
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Waiter! There's Some Snot in My Soup!
Opponents of the City Council ordinance allowing earned sick days for workers in San Diego continue to stand in front of shopping centers and grocery stores to collect signatures for a referendum suspending the law until June 2016.
That's right, they'd rather have their employees work sick. Think about that next time you eat in a restaurant. Your server (or cook or busboy) may well have opted to work while ill rather than lose a day's pay. After all, according to a study by the Institute for Women's Policy Research, 81% of food service workers don't have a choice.
Okay, okay… I might have neglected to mention the part of the ordinance that increases the local minimum wage by 8.3% on January first, but, hey, if the Chamber of Commerce can pay people to collect signatures based on made up numbers (they say it's a 44% increase) , I should be able to raise the part of the law they're not talking about, right?
The Chamber's drive to suspend this ordinance landed a terrific piece of fluff posing as news yesterday in the Daily Transcript that I'd like to point out as Exhibit A for a discussion about how the media can influence public perceptions by framing an issue.
All the facts are there. The story is actually more informative than most I've seen. But the narrative is phrased in such a way that the truth gets buried. It's the impression people get that counts, and if you didn't read past the first few paragraphs you'd think San Diego is facing an economic calamity.
A Chamber of Commerce poll cited warns that businesses are planning to cut back hours. How many? Oh, 9%. That means 91% per cent are not planning on reducing labor, right?
Oh, no… you see that 9% is UP from 5% in the last survey, which was taken before the current doom and gloom campaign. And that's almost DOUBLE.
While 23% of businesses in the very same survey said they're planing on increasing employee hours, I suppose we could look at this number as 77% are NOT planning on an increase. And never mind that the numbers cited at the top of the story represent an increase in labor hours from the same period last year, according to a poll cited near the end of the account.
Roe. Rhymes with Pinocchio? Coincidence?
On the other hand, only 5 percent of respondents to the August poll listed the minimum wage hike as a "new challenge" to their business, which ranked it in 15th place among their concerns.
The mood shift contrasts with recent employment data that hints at growing expansion plans among San Diego businesses, as well as surveys showing an ambivalent attitude toward the wage hike, which would raise the minimum from the current $9 to $9.75 next January, $10.50 in January 2016 and $11.50 in January 2017.
Nearly 70 percent of small businesses in San Diego feel hikes in the minimum wage will not affect their businesses, according to a recent poll by California Bank & Trust.
By they way, if you are one of the people who signed the Chamber's petition and later found out you'd been tricked, Raise Up San Diego has handy dandy forms that ask the City Clerk to remove your name.
Does anybody remember Proposition A, from back in 2012?
Prop A was pitched as a money saving measure blocking evil unions from demanding Project Labor Agreements (PLAs) on city construction projects. And, sure enough, trade unions disliked the measure.
What was actually going on was an effort sponsored by flakier elements of the building industry to avoid paying prevailing wages, since PLAs actually don't require workers on a project to be in a union.
There were plenty of warnings to the effect that passing Proposition A might actually end up costing the City of San Diego access to State funds for large projects.
A San Diego Superior Court judge issued a tentative ruling today upholding a bipartisan law designed to encourage more of California's charter cities to pay prevailing wages on locally funded construction projects.
SB 7, which took effect in January, only grants charter cities state construction funds if they comply with prevailing wage provisions on all of their public works projects.
While the ruling is expected to be appealed, yesterday's decision doesn't bode well for the state funding for drinking- and waste-water infrastructure in San Diego that's currently in limbo.
"The water board's position is that it's not possible for the water board to execute a loan with San Diego," said Christopher Stevens, an engineer and supervisor with the State Water Resources Control Board.
The city has more than $67.8 million in outstanding loan applications with the state water board, according to the city's Public Utilities Department.
Meanwhile, NBC7 is reporting that Mission Bay Hilton Resort is without water this morning as crews from the city are unable to locate a water main break. There is growing concern–since three attempts at finding the break have failed– that the source of the problem may lie underneath Interstate 5.
Now that could be a nightmare.
I wonder if anybody from the Coalition for Fair Employment in Construction is available to help direct traffic.
The unlikely duo of City Councilwoman Marti Emerald and City Attorney Jan Goldsmith met with the UT-San Diego editorial board yesterday to announce support for a proposal radically transforming the business model for the local taxi-cab industry.
The current legally imposed cap on the number of permits sold for $3000 to operators would be lifted, eliminating a grey market where they sell for as much as $140,000.
She cited a 2013 study by San Diego State University and the Center on Policy Initiatives, which found that 90 percent of licensed taxi drivers rent their cars from individual or business owners, with some lease rates averaging $400 a week for 12 hours a day. Citywide, there are currently 993 taxi permits.
The proposal sounds like a win-win for San Diego, says a UT editorial today.
San Diego Councilwoman Marti Emerald is proposing a free-market reform of the taxi industry that is long overdue. It will no doubt prompt howls, and probably legal challenges, from current taxi permit owners. But it would benefit taxi drivers, whom Emerald likened to the "indentured servants" of the permit holders. And it would bring greater competition to an industry that needs it, ultimately benefiting consumers with better service and lower fares.
Before I go any further here, let me say that I find myself in the highly unusual situation of agreeing with both City Attorney Jan Goldsmith and the UT editorial board.
…I'm skeptical about this proposal ever getting past the city council, at least in its present incarnation.
I do think we'll get to see a lesson on San Diego politics.While the actual number of taxi permit holders may be small, they've invested wisely in politicians of both political persuasions over the years.
Our Republican candidate for the 52nd District Congressional seat has an idea, which is a good thing, since his record of plagiarizing stuff is starting to get a little embarrassing.
Just days after the California legislature voted to restrict innovative ride-sharing services like Uber and Lyft, Carl DeMaio will unveil the first federal law to defend ridesharing services from discrimination and outright bans.
California's move to protect the powerful cab companies' monopoly is reflective of similar displays of crony-capitalism in other states and localities across the country – thus necessitating DeMaio's solution through federal legislation.
There's just one.small.problem. The law he's proposing to have the federal government override didn't make it.
Transportation startups Uber and Lyft today announced support for California Assembly bill AB 2293, a measure that will require "ridesharing" companies in California to insure drivers as soon as they log into a ridesharing app to pick up passengers.
Prior to today, Uber and Lyft had aggressively fought the bill for months. However, the opposing sides reached a surprising compromise today: The bill has been amended and now requires ridesharing companies to provide $200,000 in coverage once a driver turns on their app — down significantly from the originally proposed $750,000.
Don't worry, Carl will probably take credit for the compromise.
On This Day: 1917 – Ten suffragists were arrested as they picketed the White House. 1963 -The March on Washington for Jobs and Freedom—the Martin Luther King Jr. "I Have A Dream" speech march—was held in Washington, D.C., with 250,000 people participating. 1964 – The Beatles appeared on the cover of "LIFE" magazine.
And the U-T ed board actually supports a proposal brought by Marti Emerald; that might also be a first.
Channel 10 went Koch-eyed when its anchor Kimberly Hunt discovered Raise Up San Diego was sending out what she called 'Blockers' to sites where the Paid Petioneers of Jason Roe began gathering their signatures. It wasn't a high point in journalism. The cameras trained themselves on the enemy, a Union Thug who looked more like a city college student who was standing in front of a pillar at the entrance to the market, holding the Don't Sign It board. The nerve of These Thugs!
Kimberly at least twice lingered, Botoxed lips quivering, on the significant words, "they're called blockers," as if she'd found truth and money in the same stew pot.
Boy, do these people have money to waste! |
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Q: Splitting one csv file according to different headers I have a csv file with content in 3 different headers.
Ex:
Name,city,email----file 1-need to create separate csv file with content
aaa,ccc,eee@e
bbb,ddd,eee@e
-blank lines
Name,group,status----file 2-need to create separate csv file with content
aaa,xyz,active
aaa,abc,active
bbb,abc,active
ccc,xyz,active
Name,fullname,org----file 3-need to create separate csv file with content
aaa,aaaxc,ghj
xxx,fguh,dguyfgu
How I can split this csv into different 3 csv files with different headers by using PowerShell?
I tried by giving the row numbers to split but the content will be different in different files
A: $content = Get-Content "your File" -Raw
$nl = [System.Environment]::NewLine
$parts = $content -split ("$nl$nl")
$parts | % -BEGIN { $i=0} -PROCESS { $_ | out-file "file_$($i++)).csv" -Append}
|
Aim Bulletin
Iain Gilbert Sharecast News
04 May, 2020 16:13 04 May, 2020 16:13
Diversified Gas & Oil maintains dividend despite recent volatility in oil prices
Diversified Gas & Oil
Natural gas group Diversified Gas & Oil said on Monday that it would be paying out dividends despite recent volatility in global energy markets.
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Gas, Water & Multiutilities
Diversified Gas & Oil, which will move to the London Stock Exchange's main market later in the month, said it would pay a dividend of 3.5 cents per share after daily production had been maintained at 94,000 barrels of oil equivalent per day throughout the first quarter despite Covid-19 disruptions.
The AIM-listed firm also revealed it had pulled in $78m of earnings during the period, consistent with what it recorded a year earlier.
Chief executive Rusty Hutson said DGOC's handling of market disruptions vindicated its business model.
Hutson said: "Navigating unprecedented market volatility and general economic uncertainty validates the business model DGO defined nearly 20 years ago.
"Having now formally announced our plans to transition from AIM to a premium listing on the Main Market, I remain optimistic as ever about the firm's future as we continue to evaluate ways to create long-term, sustainable value for shareholders."
As of 1500 BST, DGOC shares were up 0.31% at 96.30p. |
Young Borehamwood sportsman paralysed after collapsing with unknown rare condition
"We were told he might not make it and that crushed us"
Charlie ReynoldsMultimedia Journalist
Charlie with his mum, Carole, and dad Lee
Charlie Crosby was 23 years old and had his whole life ahead of him.
The Borehamwood-born man was a promising golfer, footballer and was the life and soul of every room he stepped in.
But during the night of June 6 last year, he collapsed out of the blue and was found by his girlfriend in her room in a pool of his own sick.
In a panic, she called for an ambulance and he was rushed into hospital leaving everyone fearing what had happened to him.
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Nearly a year on, nothing could have prepared them for the hell they would have had to endure.
Hours later, Charlie was transferred to Queen Square hospital, in London, the National Hospital for Neurology and Neurosurgery. Once there, he was rushed down to surgery as doctors discovered a bleed on his brain.
It was all stemming from an arteriovenous malformation (AVM) on the left side of his brain and he had to endure a painstaking eight-hour life-threatening operation. An AVM is described as a tangle of blood vessels - in Charlie's case, the pressure over the years all came too much and it had ruptured.
An AVM can develop anywhere in the body, but it mostly occurs in the spine or brain. Even so, brain AVMs are still rare, and are believed to affect less than one per cent of the population. As the causes of the condition is not clear, most people are born with them, or they can occasionally form them later in life.
He was put in intensive care and placed on a life support machine, something which unbeknown to his loved ones, he would be on for the next two months.
Shocked, petrified and feeling sick to their stomach - Charlie's parents, Carole and Lee, didn't know what to do.
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This however was sadly the tip of the iceberg and was only the start of the hellish roller coaster the family have been on.
To this day, Charlie has had three life-threatening operations, he can't walk unaided, can only speak single words and has looked death in the eye a number of times.
Life for the Crosby family has never been the same.
"We were told he might not make it"
Before this heartbreaking incident, Charlie had a wonderful life.
He had a great job in something he was good at and had great friends, family and a girlfriend.
His competitive nature made him strive at sports and he played both golf and football at semi-pro level.
Charlie in intensive care
He was a fighter - something which his parents think got him through his gut wrenching time in hospital.
Fight was something he needed in the hospital bed as just two days after his first life-threatening operation, he deteriorated and fluid was building on his brain.
He was still in an induced coma and on a life support machine.
Once again, he was rushed into surgery and doctors had to remove a chunk of his skull to ease the pressure on his brain.
Carole and Lee were told the news no parent should hear - "There isn't much more we can do, he might not survive."
They explained: "From that moment on, our lives became hell.
"Our boy was healthy three days ago, nothing was wrong with him and now doctors were telling us he could die.
"They had given him all the drugs they could, all the surgery they could, but nothing was working.
"He had a collapsed lung, pneumonia, his bowels and bladder had shut down at one point and it was horrible.
"It is hard to explain. He is our only child, our pride and joy and he could have been taken away from us.
"They didn't think he'd make it, but he did."
In the days after the operation, Charlie became stable, but he wasn't out of the woods just yet.
Doctors explained that his life after this would be very different and they were proved right - he is paralysed on the right side of his body and struggles speaking.
"Everyday we would sit there and pray that he'd survive"
Charlie and his girlfriend Alicia on his 24th birthday recently
Watching their son on life support, not moving a muscle and attached to multiple machines keeping him alive was hard to take.
Carole and Lee described themselves as "broken people" and were just walking around in a daze, trying to get through day by day.
It ultimately took over their lives.
Everyday, they'd get to the hospital as early as they could and would sit by his bed, praying he'd pull through.
As the days went on, they did everything to make sure he felt like he wasn't alone but they didn't even know if he could hear them.
They would play his favourite music, speak to him, hold his hand and tell him 'everything was going to be alright'.
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They said: "We would sit there day-by-day watching the pressure readings, just staring at it, praying it would go down.
"It was just a horrid time for us.
"When he was in intensive care, it just showed you how cruel life can be.
"Men and women being brought in with the same problems as Charlie and were dying all the time. It was heartbreaking.
"We just can't thank the incredible nurses who were there and saved his life. They are amazing."
"We would cling on to any progress, then it all got snatched away"
Charlie was in intensive care for around two months and coming to the end of that period, he made small progress.
He moved from ward to ward and slowly the Crosby family were seeing glances of the old Charlie.
"At first, doctors would give him less drugs and say his blood pressure was decreasing," said Lee.
"Then we would see his eyes slowly open, it was only the tiniest gap but it would get wider and wider.
"Then one day, he randomly reached out and put a hat on his head and we were gobsmacked.
"He loves wearing hats and we put it on his bed hoping he would remember what it was because really we didn't know because of the impact on his brain.
"That sounds like nothing, but it is a moment we will never forget."
During this critical period, Charlie was making great progress.
With the help of doctors, in August, he got out of bed for the first time and was even playing noughts and crosses with his mum and dad.
He couldn't speak but that was expected.
Days after, Carole and Lee left after spending the day by his bedside in high spirits.
But as they got home, they got a call from the hospital saying Charlie had a bad turn out of the blue and he had vomited and aspirated (breathing foreign objects into the airways).
They were told to 'fear the worst'.
Carole and Lee said: "It was devastating. We didn't sleep that night and he had to go into emergency brain surgery again to reduce the swelling.
"He had to have a shunt fitted in his head to control the pressure and he was back in intensive care on a life support machine again.
"Mentally this destroyed us. We were heartbroken and were back at step one."
The support for Charlie and his parents spurred them all on
Charlie with Rowland Thomas who donated this specialised exercise bike
After that major setback, Charlie began improving again and was moved into the rehabilitation centre of the hospital.
This meant he could see more of his friends and family and could focus on speech therapy, getting movement back into his right side of the body and walking.
Carole recalls the countless times when his mates - 12 of them at times - would come and see him and his face would light up.
"It was like a whole football team," she said.
And it was his friends and family who were supporting him and his parents during their ordeal.
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Knowing he would need private therapy in the future, his friends set up a fundraising page to help pay for it.
People were running marathons and climbing mountains for him and to date, have raised nearly £20,000.
Something which the Crosby family will never forget.
They said: "We can't explain how grateful we are. The generosity shown has blown us away.
"But private therapy is so expensive. We have been unable to work as we could before and funding his rehab isn't realistic.
"So this goes a long way but it won't last - we will do everything we can to help him though, that's not even a question."
"He looks back at photos of himself and gets frustrated and upset - it is so cruel"
Charlie loved playing golf
Up until March this year, Charlie hadn't left the hospital, but he was advised to because of the coronavirus outbreak.
Charlie is clinically vulnerable so he moved back home with his mum and dad, who are now his main carers.
Although it is lovely having him home, there is only so much they can do and they do not hold professional health care knowledge.
Lee said: "We have tried to do what we can with the physio and the therapy and we've done a good job.
"But he still can't walk unaided, can't use his right arm and hand, and struggles with his speech.
"He has to wear a crash helmet because of the part of the skull they took out last year and he just gets so frustrated.
"He is the same person inside and is constantly on his phone looking at how he was before all of this. It is so cruel."
Next week is another hurdle which Charlie has to get over as he is going into hospital for another major surgery to fit a plate into the head where his skull was removed.
One thing that is for certain, which they admit, is the family would have "bitten someone's hand off if they said in a year he would be where he is now."
The family wanted to share their son's journey to raise awareness of the hidden dangers of AVM.
To help the family continue getting the support Charlie needs, you can click here. |
Home » Lists » Top 10 Games Developed by Tales Studio
Top 10 Games Developed by Tales Studio
Posted by David "DDJ" Jerebko on Sep 4, 2012 in Lists | 2 comments
This series of Top 10 lists focuses on several of the companies that have had the most significant impact on the video game industry through their development of many of the most influential and revolutionary video games ever created. More than just an overview of the companies, however, the goal of this list series is to be something of a step back into the shaping of the industry. This series will attempt to take us back through the evolution of the industry, as seen through the eyes of the companies that made that evolution happen. Console design is important, but at the end of the day, the video game industry is an industry of just that: games. The industry is driven by the companies that design the best games.
A few bits of housekeeping before I get started: first of all, game development is an inherently muddled process, and oftentimes it is difficult to draw lines around who developed which game. At times, this may lead to disagreement over who the developer of a particular game truly is; however, with how quickly the industry changes and the speed with which companies are bought, sold, and changed, there is never truly a black and white to what constitutes one developer's library. Secondly, there will be a lot of differentiation in the sizes of the libraries described in these lists. As such, in certain lists, I will refrain from including more than one game from one franchise and instead use one game as a stand-in for the series as a whole; in other lists, multiple games from the same franchise may be listed. Lastly, while I have a list of companies I plan to look at eventually, I am always looking for suggestions on what company to cover next; if you would like to make a suggestion, you can drop by the Top 10 List discussion board, contact me through my contributor profile, or visit either of my websites that cross-post these lists, DDJGames.com or GamingSymmetry.com.
This week, I'll be talking about Tales Studio.
Wolf Team, the company from which tri-Ace emerged, actually had a fairly long history before the fallout over the Tales of Phantasia game that led to studio's release from their former affiliate, loss of the employees that would go on to form tri-Ace, and new partnership with a new game publisher. Wolf Team (referred to in some places as one word, Wolfteam) was initially a unit of the Japanese game development company Telenet. Telenet Japan developed several games in the late 1980s and early 1990s for Sega's consoles and the various PCs floating around, but never developed a sterling reputation. As a result, when Wolf Team embarked on its ambitious Tales of Phantasia project, they looked for a different publisher, eventually settling on Namco. Namco, however, exerted more design clout over the finished product than Wolf Team had anticipated, thus leading to several members of the team departing. The remaining studio, however, formed a close alliance with Namco, becoming the primary driver behind the Tales series shortly thereafter. Namco published Wolf Team's next several releases, all in the Tales series, until finally, in 2003, Namco acquired a controlling stake in Wolf Team and renamed it after its own iconic franchise: Namco Tales Studio. Since then, the studio has gone on to develop a dozen more games, all in the Tales series. The series has gone on to be, in my opinion, one of the most popular and longest-running JRPG series in the world, joining such heavyweights as Dragon Quest, Final Fantasy, and Shin Megami Tensei.
#10: Tales of Phantasia (SNES)
Released in 1995, Tales of Phantasia was the game that changed Wolf Team's entire fortunes and future, both in good ways and in bad. The game was Wolf Team's most ambitious project to date, and as such, they preferred not to partner with their usual publisher and parent company, Telenet Japan, due to its bad reputation. Instead, they partnered with Namco (after a brief flirtation with Enix). Namco, however, ended up exerting more control over the game than the team desired. Originally titled Tale Phantasia after the novel written by the game's programmer, Namco demanded a title change to Tales of Phantasia, leading to the series' moniker by which it's known today. These issue, as well as other internal issues with branding and staffing, led to the game being delayed by over a year, while some of the staff left to form tri-Ace.
Despite all of this, the game went on to become a moderate success. It was especially notable in its day, becoming one of the first games to feature real voice acting. Its battle system was unique compared to other RPGs, allowing the player primary control over only one character at a time (as has, interestingly, become standard) while positioning characters on a 2D side-scrolling battlefield rather than the typical two-sided affair. Though different, that was not revolutionary; the art style of the game, however, was particularly notable, coming on the heels of games like Chrono Trigger that helped popularize anime-style graphics in RPGs.
#9: Sol-Feace (X68)
Before the fallout with Telenet Japan and Wolf Team's subsequent (slow) defection to Namco, they were responsible for several other high-quality but poorly-selling games released primarily in Japan. One of these, released in 1990 for the Sharp X68000 and later ported to the Sega Mega-CD and Sega Genesis, was Sol-Feace (released in North America as Sol-Deace). The game was, in many ways, a prototypical shoot 'em up game: the player controlled a ship on the left side of the screen, firing at strategically placed and maneuvering enemy ships.
The notable elements of the game, though, were the graphics, music, strategy, and certain structural elements. The graphics were among the most advanced released at the time, and it is not beyond the realm of believability to think that the game could have reached the popularity of other recognizable shoot 'em ups with a better publisher backing it. The enemies were more interesting and varied than many other shoot 'em ups of the day, with more complex movement patterns and strategies. The music, especially, was some of the most impressive of the generation, disguising the technical limitations of all the consoles for which it was released. To this day, the music still stands up in quality against music you might see from modern big-budget games. Lastly, the game also provided an underappreciated scrolling feature: although the game scrolled left to right, it also allowed the played to scroll the screen up and down by moving in those directions, an interesting step forward that other games were slow to replicate.
#8: Time Gal (SCD)
First and foremost, Time Gal was not initially developed by Wolf Team – it was developed by Taito, with Toei Animation (now of Dragon Ball fame) handling the animation and graphics. Wolf Team, in turn, was responsible for the port of the game to the Mega-CD. Why, then, do I rank it as one of Wolf Team's best games? Time Gal's localization to the United States represented one of the first and most successful times a game of that genre was actually brought to North America. The game used pre-animated sequences matched with what could possibly be best described as primitive quick-time events to tell its story. Gameplay was at a minimum, as was typical with the interactive movie genre, and the emphasis was on the story and cinematography.
Wolf Team's port of the game to the Mega-CD was not a simple copy, either; the animation was significantly improved. If you go and look up gameplay of the game on YouTube, you'll find that you might mistake the game for an anime outright; the only give-away that the game is actually a game comes in the auditory cues to input button commands. To me, games like this represented an early attempt by the gaming industry to focus on the visual presentation of a story, even at the expense of gameplay. It would be several years before gameplay and cinematographic storytelling could be merged into one, but interactive movies like Time Gal provided one of the starting points for developing toward that accomplishment.
#7: Tales of Destiny (PS)
Tales of Destiny is the second game in the Tales series that eventually gave the studio its namesake, although at the time of its release (1997) the studio was still six years away from its eventual name change. Tales of Destiny itself is in many ways the game that put the franchise on the map; for a long time, it was the best-selling game in the franchise, especially in Japan. Like Tales of Phantasia, Tales of Destiny sticks with an interesting 2D battle layout, positioning the fighters in the game along a straight line, in many ways giving it a flavor more akin to fighting games. The system was also not turn-based, but rather real-time, echoing what would become Tales Studio's (and tri-Ace's) tendency toward active real-time battles rather than the turn-based strategic battles.
Released for the PlayStation, the biggest weakness that Tales of Destiny encountered was timing: Final Fantasy VII was released for the PlayStation twelve months earlier in Japan, and was superior in every immediately visible way. That's not to say that Tales of Destiny was actually a superior game overall, but rather the visual qualities of the game fell far short of anything seen in SquareSoft's now-iconic title. Tales of Destiny was still remarkably ahead of its time, however, as its battle system bares far more resemblance to the types of active battle systems that are popular today than the turn-based systems that were the industry standard at the time of its initial release.
#6: Valis: The Legend Of Fantasm Soldier (MSX)
Commonly credited to its then-parent company, Telenet Japan, Valis: The Fantasm Soldier is one of the games that led to the schism between Wolf Team and Telenet Japan in the first place. In particular, Wolf Team perceived that it was Telenet Japan's poor reputation that led to lackluster sales for what was actually a relatively strong action game at the time. It was no genre-changer, but it stood up against the other popular franchises at the time. The game presented an interesting meld of platforming, action combat, and strategy; in many ways, it plays like a cross between Mario, The Legend of Zelda, and Contra. Like most Wolf Team games as well, the music was among the best around at the time of the game's release. It deserved more recognition than it received, but never sold well.
The franchise went on to have four sequels, most of which were credited to Telenet Japan, although Wolf Team was the primary developer behind them all. This period of the franchise's history is also particularly notable in terms of Wolf Team's history, as it was during this phase that the team began to distinguish itself more and more as an independent studio under Telenet's umbrella rather than an actual member team within the company, as it had started out. It was that development that eventually gave the team the prestige and clout to go looking for its own new collaborator and publisher, leading it to Namco.
#5: Tales of Symphonia (GC)
Released in 2003, Tales of Symphonia was the first game released by the studio after its name change from Wolf Team to Namco Tales Studio, and the fifth Tales game overall. It was also the studio's only entry on the Nintendo GameCube, although it was later supplemented with a PlayStation 2 port, increasing both the game's and the franchise's visibility with an entry on the generation's most popular console. Tales of Symphonia was, in many ways, the game that elevated the Tales series to its modern status; Tales of Phantasia created the franchise and Tales of Destiny gave it its initial visibility, but it was Tales of Symphonia that launched the franchise into the realm of most-popular JRPG series of all time, alongside Final Fantasy, Dragon Quest, and Shin Megami Tensei. In the United States especially, Tales of Symphonia solidified the Tales series' position as arguably the second most-popular JRPG series available.
Like most of Tales Studio's games, the game's highest point of praise was an interesting battle and combat system. The game employed a more active battle system than other RPGs at the time, modifying the classic system used in the previous game to allow for more simultaneous action and to take advantage of the GameCube's and PlayStation 2's graphical capabilities. The game has also gotten better with age, as its renown and recognition has seemed to increase over time; recently, I have even seen it getting some love as potentially one of the best games ever made.
#4: Mid-Garts (MSX)
Released in 1989, Wolf Team's Mid-Garts was a scrolling shooter. On the surface, the game didn't appear to be much different than any other game in the genre, but closer inspection shows that with Mid-Garts, Wolf Team was attempting to elevate the genre past simple repetitive entertainment. The different flavor on the genre is apparent right from the outset; the cover is more like a painting, the game's subtitle echoes a deeper objective than just killing baddies, and the documentation included with the game is enormous; complex back-stories are given on all the characters, locations, and animals in the game. Wolf Team never intended for Mid-Garts to just be another shooter in an already-crowded genre; the game was meant to be more of an experience.
Throughout the game, that dedication to putting a new flavor on the genre is clear. In Mid-Garts, you encounter enemies the likes of which you never would have expected to see in a game of this simple genre. You'll encounter talking severed heads, preserved human fetuses, and even modern-day enemies like the US Navy. The plot that the player embarks on throughout the game is twisting, turning, and utterly unpredictable, and at times even manages to transcend genres, seamlessly moving back and forth between a shooter and a shoot 'em up (two similar genres, granted, but two that are typically kept fairly far apart). With the unique flavor of the game, it's a shame that it was largely relegated to anonymity due to Telenet Japan's influence.
#3: Tales of Xillia (PS3)
Released in Japan in 2011, Tales of Xillia has yet to see localization to North America, making it one of the most hotly anticipated RPG titles in development today. Slated for a 2013 release in both the United States and Europe, its hype is made even stronger by the extremely favorable reception it received upon its Japanese release. Critics hail the game as the greatest Tales game ever, surpassing even the praised Tales of Vesperia and Tales of Graces F. Its sales are also among the best the franchise has ever had. Those numbers, those reviews, and the upcoming direct sequel combine to make Tales of Xillia one of the most hotly-anticipated 2013 releases in North America.
Tales of Xillia might also go down with a more dubious honor: the game may be the last game ever created by Tales Studio. Tales Studio was dissolved and merged into the broader Namco Bandai Games shortly after Tales of Xillia's release. Although the majority of the staff, designers, and programmers from the team are still employed by Namco Bandai Games, only time will tell whether they are kept together as a cohesive unit or not. At present, a direct sequel to Tales of Xillia (Tales of Xillia 2) is projected for a November 1st release, but time will tell whether the recent restructuring will impact that schedule. If nothing else, Tales of Xillia marks the end of an era; even if the same developers are assigned to the new Tales games, we shall never again see a game "Developed by Namco Tales Studio".
#2: Tales of Vesperia (PS3)
I'm writing from the United States, and thus while critics in Japan may have hailed the thusfar Japan-only Tales of Xillia as superior to Tales of Vesperia, I'll believe it when I see it; until then, Tales of Vesperia still receives my vote as the best Tales game yet released. Released in 2008 (with a 2009 Japan-only PlayStation 3 port), Tales of Vesperia was the best of everything the Tales series had to offer and more. It retained the anime-style graphics and characters that had become iconic in the series and the soaring and epic plotline that the studio seems to pull off so effortlessly. The game was so popular that it even caused the Xbox 360, until then something of a dud in Japanese sales, to fly off the shelves. The subsequent PlayStation 3 release, catering more to the most popular console in Japan, sold almost 150,000 copies on the very first day.
Like all Tales Studio games, the highest achievement for the game seemed to come in the battle system. Although the acronym that the studio uses to describe its system gets more convoluted with every generation, the system itself is strong. Most notably, it addresses many common issues with other RPGs' battle systems, such as merging roaming groups of enemies. The only weakness to the game's combat system is a rather primitive skill system, but that minor note isn't sufficient to hamper the game as a whole; with how innovative and unique the other systems are, perhaps having something familiar is desirable.
#1: Arcus 1-2-3 (SCD)
It might be somewhat unfair to give Arcus 1-2-3 an entire entry on this list given that it, itself, is a compilation of three games: Arcus, Arcus II: Silent Symphony, and Arcus III. The three games, however, form such a unique and cohesive experience that it's almost difficult to separate them out, and each are strong enough on their own right to make this list. The series had the potential to be recognized as one of the all-time greatest RPG franchises, and was surely a sign of things to come for the studio that went on to create one of gaming's most beloved JRPG series. In fact, many say it was specifically the lack of commercial success of Arcus that was the final impetus for Wolf Team to find a new publisher in the first place.
Arcus is a series characterized by an intricate plot, a complex and enthralling set of characters, and, perhaps most notably, among the most seamless and elegant mergers of plot and gameplay the gaming industry had yet seen. The combat and leveling systems required significant strategy and nuance; they were not simply races to the strongest spells to spam them at will. The series also featured some of the first in-battle voice acting the industry had ever seen, showing how such a simple feature can significantly improve the feel of a game. Put simply, the entire Arcus franchise had the potential to be referenced alongside Final Fantasy and Dragon Quest among the pantheon of the genre's greatest hits; if you have the means to play it, stop reading this right now and go do so.
Honorable Mentions: Tales of Graces, Tales of the Abyss, Road Blaster, Zan: Yasha Enbukyoku, Arcus Odyssey, Tales of Rebirth, Tales of Eternia, Tales of Legendia, Tales of Destiny 2, Tales of Hearts.
As mentioned above, Tales Studio faces an uncertain future. A year ago, the studio was officially dissolved and merged into the larger whole of Namco Bandai Games as part of a significant restructuring of the company. That does not mean that the actual staffers of the studio are gone, however; by and large, most are still with Namco Bandai Games, albeit in a less specific capacity. Judging from the company's intention to put out a direct sequel to Tales of Xillia later this year, it is reasonable to think that the dissolution might not actually affect the game produces by the now-defunct Namco Tales Studio, and that the restructuring is more of a change in names and organization. On the other hand, it might also be reasonable to assume that Tales of Xillia 2 is merely the remnant of a project in development when the studio was dissolved, and that upon its release Namco Tales Studio will finish its fade into obscurity. Only time will tell whether the restructuring hinders the company's ability to produce more high-quality Tales games, but regardless, the name Namco Tales Studio will no longer be emblazoned across the cover of these releases.
If you'd like to join in on the discussion of this list, I invite you to the Top 10 List discussion board, linked on this page. You're also welcome to contact me directly via the information in my contributor profile, or to come by either of the web sites that co-host these lists, DDJGames.com or GamingSymmetry.com. If you have any suggestions for what company I should review next, please let me know!
Tom / September 5, 2012
I am pretty sure that it was still called Sol-Feace in North America. At least it is called that on the Sega CD copy of the game that I own.
Alice Kojiro / September 5, 2012
Perhaps I can shed some light on this; I believe that the Sega CD version is called Sol Feace, but the Sega Genesis/Mega Drive is called Sol Deace, because I seem to remember playing it and thinking, "Shouldn't it be called Sol Feace, like on the Angry Video Game Nerd video?"
Lists. Thanks to Cracked, one of the most popular forms of writing on the internet today, and the medium through which many of our writers got their start over on GameFAQs. |
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Overboard »
DVD FICTION OVERBOARD
Belle Cooledge has 2
Carmichael has 2
1 of 1 Arden-Dimick DVD FICTION OVERBOARD
2 of 3 Belle Cooledge DVD FICTION OVERBOARD
2 of 2 Carmichael DVD FICTION OVERBOARD
0 of 1 Courtland DVD FICTION OVERBOARD
1 of 2 Elk Grove DVD FICTION OVERBOARD
0 of 1 Fair Oaks DVD FICTION OVERBOARD
1 of 1 Martin Luther King, Jr. DVD FICTION OVERBOARD
1 of 1 North Natomas DVD FICTION OVERBOARD
1 of 1 Pocket-Greenhaven DVD FICTION OVERBOARD
2 of 3 Rancho Cordova DVD FICTION OVERBOARD
1 of 2 Rio Linda DVD FICTION OVERBOARD
3 of 3 Sacramento Public Library Storage DVD FICTION OVERBOARD
2 of 2 Sylvan Oaks DVD FICTION OVERBOARD
1 of 2 Walnut Grove DVD FICTION OVERBOARD
1 of 1 Barber Branch DVD FICTION Overboard
1 of 1 Folsom Adult DVD COMEDY FICTION OVERBOARD 1987
1 of 1 Woodland Public Library DVD FICTION Overboard
[2018] Pantelion Films, 1 videodisc (112 min.) : sound, color ; 4 3/4 in.
1999. Widescreen version. MGM/UA Home Video, 1 videodisc (ca. 1 hr., 52 min.) : sd., col. ; 4 3/4 in.
2014. Twentieth Century Fox Home Entertainment, 1 videodisc (ca. 1 hr., 52 min.) : sd., col. ; 4 3/4 in.
Checked Out/Available Elsewhere
A spoiled, wealthy yacht owner is thrown overboard and becomes the target of revenge from his mistreated employee. A remake of the 1987 comedy.
Amnesia -- Drama
DVD-Video discs
Feature films -- Video recordings for French speakers
Man-woman relationships -- Drama
Revenge -- Drama
Rich people
Rich people -- Drama
Screwball comedy films
Working class families
Working class families -- Drama
Herrmann, Edward.
Greenberg, Rob,film director,screenwriter.
Silvestri, Alan.
Helmond, Katherine,actor.
Baskin, Sonny.
Russell, Kurt,actor.
Twentieth Century Fox Home Entertainment, Inc.,publisher.
Metro-Goldwyn-Mayer.
Sylbert, Anthea,producer.
Marshall, Garry.
Rose, Alexandra,1946-producer.
Faris, Anna,1976-actor.
Derbez, Eugenio,actor.
MGM/UA Home Video (Firm),publisher.
Pantelion Films (Firm),publisher.
McDowall, Roddy,actor.
Rose, Alexandra,1946-
Dixon, Leslie,screenwriter.
Longoria, Eva,1975-actor.
Marshall, Garry,director.
Dixon, Leslie.
Herrmann, Edward,1943-2014,actor.
Sylbert, Anthea.
Star Partners, Ltd. (Firm)
MGM/UA Home Video (Firm)
McDowall, Roddy.
Helmond, Katherine.
Fisher, Bob(Screenwriter),screenwriter,film producer.
Hoenig, Dov.
Hawn, Goldie.
Hawn, Goldie,actor.
Russell, Kurt.
Alonzo, John A.,1934-2001.
d909f7ff-9169-f775-3511-7b5f53811582
Alonzo, John A., 1934-2001.
Derbez, Eugenio,
Dixon, Leslie,
Faris, Anna, 1976-
Fisher, Bob (Screenwriter),
Greenberg, Rob,
Hawn, Goldie,
Helmond, Katherine,
Herrmann, Edward, 1943-2014,
Longoria, Eva, 1975-
Marshall, Garry,
McDowall, Roddy,
Rose, Alexandra, 1946-
Russell, Kurt,
Sylbert, Anthea,
Pocket-Greenhaven
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WDP DVD ADULT
ils:.b25629487 DVD Movies English Pantelion Films, [2018] 1 videodisc (112 min.) : sound, color ; 4 3/4 in.
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Overboard / directed by Rob Greenberg ; written by Bob Fisher, Rob Greenberg, Leslie Dixon ; produced by Eugenio Derbez, Benjamin Odell, Bob Fisher
Overboard [videorecording] / Metro-Goldwyn-Mayer ; produced by Anthea Sylbert and Alexandra Rose ; directed by Garry Marshall ; written by Leslie Dixon
Overboard [videorecording] / Metro-Goldwyn-Mayer presents ; in association with Star Partners, Ltd. ; written by Leslie Dixon ; produced by Anthea Sylbert and Alexandra Rose ; directed by Garry Marshall |
Fairway Group Holdings Corp.
ROBBINS GELLER RUDMAN & DOWD LLP FILES CLASS
ACTION SUIT AGAINST FAIRWAY GROUP HOLDINGS CORP.
New York – February 18, 2014 – Robbins Geller Rudman & Dowd LLP ("Robbins Geller") (http://www.rgrdlaw.com/cases/fairway/) today announced that a class action has been commenced in the United States District Court for the Southern District of New York on behalf of all purchasers of the common stock of Fairway Group Holdings Corp. ("Fairway" or the "Company") (NASDAQ:FWM) pursuant and/or traceable to the Registration Statement issued in connection with Fairway's April 17, 2013 initial public stock offering (the "IPO"), seeking to pursue remedies under the Securities Act of 1933 (the "Securities Act").
If you wish to serve as lead plaintiff, you must move the Court no later than 60 days from February 14, 2014. If you wish to discuss this action or have any questions concerning this notice or your rights or interests, please contact plaintiff's counsel, Samuel H. Rudman or David A. Rosenfeld of Robbins Geller at 800/449-4900 or 619/231-1058, or via e-mail at [email protected]. If you are a member of this class, you can view a copy of the complaint as filed or join this class action online at http://www.rgrdlaw.com/cases/fairway/. Any member of the putative class may move the Court to serve as lead plaintiff through counsel of their choice, or may choose to do nothing and remain an absent class member.
The complaint charges Fairway, certain of its officers and directors and the underwriters of the IPO with violations of the Securities Act. Fairway was founded in 1933 and is headquartered in New York, New York. The Company, together with its subsidiaries, operates food retail stores in twelve locations in New York, New Jersey and Connecticut. At the time of the IPO, the Company had adopted an expansion plan it was then implementing to open hundreds of new stores to expand the Fairway chain to 300 stores nationwide.
On or about September 24, 2012, Fairway filed with the SEC a Registration Statement on Form S-1, which would later be utilized for the IPO following several amendments in response to comments by the SEC. The complaint alleges that the Registration Statement, and the documents referenced and incorporated therein, was negligently prepared and, as a result, contained untrue statements of material facts or omitted to state other facts necessary to make the statements made not misleading, and was not prepared in accordance with the rules and regulations governing its preparation. Specifically, the complaint alleges that the Registration Statement failed to disclose and/or misrepresented the following adverse facts, among others, which existed at the time of IPO: (i) that the Company's operating and management structure were not capable of effectively running its expanding business; (ii) that the Company had millions of dollars of redundant costs built into its budget; (iii) that competitive pricing pressure from grocery chains like Whole Foods and Trader Joe's was negatively impacting same store sales trends and profit margins; and (iv) that the terms of a new store lease in the Chelsea section of Manhattan, were not financially viable.
Following the disclosure of multiple quarters of disappointing financial results following the IPO, several of the underwriters downgraded the Company's stock ratings and at the time of the filing of this lawsuit, Fairway stock was trading at under $8 per share, a decline of more than 37% from the IPO price of $13.00 per share.
Plaintiff seeks to recover damages on behalf of all purchasers of Fairway common stock pursuant or traceable to the Company's April 17, 2013 IPO (the "Class"). The plaintiff is represented by Robbins Geller, which has expertise in prosecuting investor class actions and extensive experience in actions involving financial fraud.
Robbins Geller represents U.S. and international institutional investors in contingency-based securities and corporate litigation. With nearly 200 lawyers in ten offices, the firm represents hundreds of public and multi-employer pension funds with combined assets under management in excess of $2 trillion. The firm has obtained many of the largest recoveries and has been ranked number one in the number of shareholder class action recoveries in MSCI's Top SCAS 50 every year since 2003. Please visit http://www.rgrdlaw.com for more information.
Robbins Geller Rudman & Dowd LLP
Samuel H. Rudman, 800-449-4900
David A. Rosenfeld
[email protected] |
How long do I have to return/replace a product once purchased?
Once you have purchased a product and you wish to return the product, you need to notify Kanwhizz within 14 calendar days of purchase of the product by contacting our customer support team at helpline number or email at [email protected].
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I have changed my mind and would like to retain the product. What should I do?
Incase you have changed your mind to retain our product rather than replacing or returning it, please call our customer service center or send us email at [email protected] to cancel your return/ replace request and we will do the rest. In case the replacement product has already been dispatched you can reject the delivery once at your door.
You can cancel your order anytime before the product has been shipped. Just click on Cancel button against your order in My Orders in My Account. We will cancel it and initiate your refund.
How do I cancel an item(s) from my order?
We may take 2-3 business days to cancel your order and initiate refund if applicable. You will be notified via email once cancellation is completed.
Alternative conditions leading to cancellation of your order?
2. Order receieved from Non-serviceable locations by our logistic partners.
In case, customer opted for COD options, then before accepting order we might require additional information from customer for verification. After verification, Kanwhizz can cancel order if there is any discrepancy in the information provided by customer. |
At 7:30 we will have the Slap the Nipyata drawing and event. Dining through the day on behalf of DREAMS4U allows El Patron to donate a portion of their proceeds to DREAMS4U. A recommended $20 donation at the door, donations receive a raffle tix for a potential whack at the Nipyata (adult pinata) or restaurant certificates/cards. Thank you to those contributing to the raffle tix prizes: Nipyata!, Asian Cafe LKA, Sweet n Sassy BBQ Fredericksburg, Angela's Italian Restaurant Thornburg, Dairy Queen Thornburg, Chick-Fil-A Southpoint, Subway Kentucky Springs, Outback Fredericksburg. |
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Дина́н () — город и муниципалитет в Бельгии, в провинции Намюр, на реке Маас (фр. Мёз). Главный туристический центр провинции.
По состоянию на 1 января 2005 года население муниципалитета составляло 12 907 жителей. Площадь муниципалитета — 99,80 км², таким образом плотность населения составляет 129,33 жителя на квадратный километр.
История
Точное время возникновения данного поселения неизвестно. Само название имеет кельтское происхождение и предположительно переводится как «священная (божественная) долина». По данным археологических раскопок, поселение на месте нынешнего города уже существовало в древнеримские времена, однако первое упоминание города (вернее, моста в городе) в летописях относится к 824 году.
Средневековый город часто был ареной междоусобных войн: за всю свою историю его брали штурмом около двухсот раз, 17 раз город подвергался осаде. Особенно сильно пострадал город в 1466 году при взятии его войском бургундского герцога Филиппа Доброго.
В начале Первой мировой войны (1914) немцами были убиты 674 мирных жителя города, которых подозревали в сопротивлении; это массовое убийство известно во франкоязычной историографии как sac de Dinant. К концу войны были уничтожены 75 % жилых домов. Город также пострадал в ходе Второй мировой войны.
Достопримечательности
Крепость, преимущественно построенная в 1818-21 гг.
с богатым убранством. Она была построена в готическом стиле в XIII—XIV веках у подножия скалы на месте старой романской церкви (которая была уничтожена в 1227 году оползнем, унесшем жизни 36 человек).
, давшее название пиву Leffe.
Музей пива.
Доисторические пещеры Мон-Шаф, Ла-Нолет.
Знаменитые люди Динана
В Динане родились:
Давид Динанский, философ и богослов.
Патинир, Иоахим, художник.
Пир, Жорж, священник-доминиканец, лауреат Нобелевской премии мира.
Адольф Сакс, изобретатель саксофона.
Камилло Эверарди, певец и музыкальный педагог.
Ссылки
Официальный сайт (на французском, нидерландском и английском) |
Our instructors will work with the schools to train and develop these dancers for top-notch performances and competitions.
At the Singapore Youth Festival, 98% of EV Dance's schools received "Distinction".
EV Dance schools clinched the Champion title and the top 3 placings at the prestigious dance competition, Super 24 (Year 2014 to 2016).
Multiple achievements at Danceworks, including many champion titles, top 3 placings and awards such as Best Choreography and Best Theme and defending Champion for 3 years.
Teach the teachers workshops for PAL and SEL Dance Programme – Nan Hua Primary School and Canberra Primary School.
We understand that every school has a different set of shared values to focus on. Hence, our programs are fully customisable.
Contact [email protected] for more information. |
Like other teachers you may well have favourite and often over-used 'Reward Phrases', things you say when your students exhibit desirable behaviour.
Do you use phrases like "Well done", "Good", "Nice work", or "Correct"?
I invite you to be more adventurous and write down what YOU would like someone to say about YOUR best work. |
"... included two six month periods of leave of absence. During those years I worked on several projects and visited several departments at other universities in two wonderful parts of the world. I spend a total of approximately seven months at Dipartimento di Ingegneria Meccanica e Gestionale at Politec ..."
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TechDrake
BioShock: The Collection Officially Announced, Runs at 1080p/60fps
BioShock: The Collection features remastered versions of BioShock, BioShock 2, and BioShock: Infinite, 2K Games has officially announced.
While all three games are being remastered for consoles, BioShock: Infinite is going to remain as it is on PC. According to the developer, the third game in the series still looks good enough at high settings on the Windows platform, and does not warrant any remastering. Hence, BioShock: The Collection is going to include all three remastered games on PlayStation 4 and Xbox One, while on PC it will include the regular (non-remastered) edition of BioShock: Infinite.
BioShock: The Collection works with improved character models, better lighting and textures; ensuring gameplay for all three games at 1080p and "up to" 60 frames-per-second across the three platforms. It will also bundle all released DLC and add-on content for the games, along with new director's commentary. Here is the bonus content you should expect to see:
The video series, "Director's Commentary: Imagining BioShock," featuring Ken Levine, creative director on BioShock and BioShock Infinite and Shawn Robertson, animation lead on BioShock and animation director on BioShock Infinite.
Museum of Orphaned Concepts: Walk through a Rapture-inspired virtual museum that gives you a behind-the-scenes look at discarded concepts that never made it into the original game.
Challenge Rooms: Outside the story of BioShock, tackle puzzles, splicers and Big Daddies. And achievements, of course.
BioShock 2 (No Multiplayer)
Minerva's Den: A self-contained BioShock story, presenting a side of Rapture you've never seen before. Use expanded combat abilities with the experimental Ion Laser and chaotic Gravity Well Plasmid, unique to Minerva's Den, as you face off against the Lancer Big Daddy.
Protector Trials: Take control of an Alpha Series Big Daddy woken out of hibernation just before the events of BioShock 2.
Burial at Sea – Episode 1 & 2 Add-On Packs: This major two-part DLC pack completes the BioShock trilogy by taking the series back to where it all began. Return to Rapture just before the events of the original BioShock!
Clash in the Clouds Add-On Pack: Face 60 waves of challenges across four additional maps for leaderboard glory and unlock areas to explore in The Columbian Archaeological Society hub museum.
Columbia's Finest Pack: Combines the contents of the Industrial Revolution Pack and the Upgrade Pack and includes 500 Silver Eagles, five Lock Picks, six unique Gear items, and two weapon upgrades: Comstock's China Broom Shotgun and Comstock's Eagle Eye Sniper Rifle.
Those who already own BioShock and BioShock 2 on PC will be entitled to a free upgrade to the remastered versions of both games.
BioShock: The Collection is going to be priced at $60 and will launch in North America on September 13, releasing worldwide on September 16.
2K Games, BioShock: The Collection
Saqib Mansoor
The odd man in the group who hates chocolate, cheese, and having to work on Sundays.
PlayStation 4 Slim Could Be Announced in September, Claims Analyst
Windows 10 Anniversary Update Dated, Includes Xbox Play Anywhere |
HomeFemale Jobs
Army Dental Corps Jobs for Females 2021 ,Apply Online ,37 Vacancies
Indian Army invites applications from Indian citizens, both Female and male Candidates, for grant of Short Service Commission (SSC) in the Army Dental Corps. Eligible candidates apply online.
JOIN ARMY DENTAL CORPS AS SHORT SERVICE COMMISSIONED OFFICER FOR A PROMISING & CHALLENGING CAREER: 2021
Name of Post
SSC in Army Dental Corps
Age Limit: The candidate must not have attained 45 Years of age as on 31st December 2021.
Educational Qualifications:
(1) Candidates must be BDS/ MDS (with minimum 55% marks in final year BDS) from a College/ University recognized by Dental Council of India (DCI).
(2) He/ She should have completed one year compulsory rotatory Internship mandated/ recognized by DCI by 31 March 2021 and must be in possession of Permanent Dental Registration Certificate of State Dental Council/DCI valid at least upto 31 December 2021.
Eligibility: Only those candidates (BDS/MDS) who have appeared in the National Eligibility-cum Entrance Test, NEET (MDS)-2021 conducted by National Board of Examinations (NBE), New Delhi, under the aegis of Ministry of Health & Family Welfare, on 20Dec2019, at various examination centers of NBE, are eligible to apply. Candidates must submit the copy of Mark-sheet/Score card of NEET (MDS)-2020 along with the application.
Selection Process: Screening for Calling for Interview, Interview, Medical Examination and Document Verification.
Emoluments: The Civilian Dental surgeons on commissioning in AD Corps will be granted rank of Captain in the pay scale, Level 10 B (₹ 61,300 – 1,93,900) of Defence Pay Matrix as elaborated in Army Pay Rules-2017 (7th Pay Commission).
How to Apply: Eligible candidates are advised to apply online through Join India Army official website from 19th April 2021. The last date for registration of online applications is 18/05/2021. |
from logging.handlers import RotatingFileHandler
import os
LOG_DIR = "log"
class MakeFileHandler(RotatingFileHandler):
def __init__(self, filename, mode='a', maxBytes=0, backupCount=0, encoding=None, delay=0):
try:
os.makedirs(LOG_DIR)
except OSError:
if os.path.isdir(LOG_DIR):
pass
else: raise
RotatingFileHandler.__init__(self, "%s/%s" % (LOG_DIR, filename), mode=mode, maxBytes=maxBytes, backupCount=backupCount, encoding=encoding, delay=delay)
|
The first overall draft pick in 1988 made an instant splash in the NHL, finishing second in Calder Trophy balloting, though the player he lost was the 31 year old Russian, Sergei Makarov who many thought should not have been eligible for the award. While Modano's star was rising, the North Stars would relocate to Dallas and the Michigan born player was set to become the face of hockey in the state of Texas.
The city of Dallas loved their new team and embraced Modano as their new sports celebrity. It was Modano who would be the leader of the Stars and take them to their first (and to date only) Stanley Cup win in the 1998-99 campaign. While this was Dallas' only win in the Holy Grail of Hockey, Modano did take them to another final the year after.
Modano would retire with the most points ever by an American and made hockey relevant in a place where many thought impossible.
Seriously, who else could we have possibly picked?
Acquired: Drafted in the 1st Round, 1st Overall, 6/11/88.
Signed as a Free Agent with the Detroit Red Wings 8/5/10.
See More Info about Mike Modano on Everipedia! |
Film » Reviews
Johnny English Strikes Again strikes out
Rating: **
by Matt Brunson
** (out of four)
DIRECTED BY David Kerr
STARS Rowan Atkinson, Emma Thompson
Rowan Atkinson in Johnny English Strikes Again (Photo: Universal)
As fans of James Bond wait impatiently for the next installment, they can at least take (quantum of?) solace in the fact that there's a new Johnny English film hitting theaters. Then again, Johnny English Strikes Again, the third entry in the spoof series, is so devoid of genuine wit that they might be better off staying at home and spending time mulling over who should play 007 post-Daniel Craig.
Even fans of 2003's Johnny English (raising my hand here) and 2011's Johnny English Reborn (raising only a finger here) will be disappointed in this creaky comedy that finds Rowan Atkinson again essaying the role of the bumbling British agent who's decidedly less Bond and infinitely more Clouseau. The plot this time involves English's efforts to expose a Silicon Valley whiz kid (Jake Lacy) plotting to gain digital control over every nation.
Olga Kurylenko, who played the female lead in the 007 entry Quantum of Solace, appears here as a Russian spy, while Emma Thompson is on hand as the British Prime Minister. Yet only Atkinson matters (although I did appreciate the cameos by the veteran actors playing retired MI7 agents). The British comedian (who, by the way, did once appear in a Bond flick himself, portraying Nigel Small-Fawcett in the non-series effort Never Say Never Again) once again throws himself in his role, but the material just isn't there this time. There are a few bright bits scattered about, but most of the gags are on the moldy order of English getting stuck inside knight's armor or smacking someone with a baguette. Such a reliance on antiquated gags of this nature patently marks this film as a Johnny-come-lately.
Reviews film review Matt Brunson Johnny English Strikes Again Rowan Atkinson Emma Thompson Olga Kurylenko Johnny English |
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A promise of love is fulfilled in the Riviera Maya, surrounded by friends and family, with their little daughter. Katie and Brent get married in March 2019, at the Sandos Eco resorts hotel.
Exciting, romantic a touch of fun, a formula that ends in the best.
Congratulations Katie and Brent. This love will never end. |
Corner these people's attitude quickly, by forbidding them from practice. Then games and finally bench their children. I know, but yeah I mean it, take it out on the kid. Brown had 156 yards receiving. The touchdown plays went for 10, 65 and 58 yards. Bob Jones finished with 419 total yards..
We are story tellers. And we do what we do because we believe it's important for people to see, learn and share what they know. Last week, we spent two days in Thunder Bay photographing a Nishnawbe Aski Nation Special Chiefs Assembly. At KCT, actors are often called upon to play Geese, Goblins, Centaurs, Centipedes, Swans, Foxes, Eagles and Elves. This class focuses on how to jump from the ordinary to the extraordinary through observation, imitation, and transformation in partnered scenes, group exercises and individual journal work. It combines unique movement study with elements of traditional method acting principles to help actors employ of all their tools to make non human characters from the imagination spring to life..
"Inadequate affordable housing has been a long standing concern for this community. We know poor housing is a major determinant of poor physical, social and mental health. Providing affordable, secure housing is going to reduce the physical, mental and economic stress on those living on low incomes.
Both are five stories tall, while the majority of downtown's early 20th Century masonry buildings are between three and four stories. In 1925 the Chamber of Commerce Building (now Wells Fargo Bank) was constructed at 11 stories and became Berkeley's only "skyscraper" until 1970 when the Great Western Building was completed. The Chamber of Commerce had its offices on the top floor of the building, a perfect place to tout the charms of Berkeley's location directly opposite the Golden Gate..
Determined to be responsible for such threats will face legal consequences. If a student or students are involved, they will also be disciplined in accordance with the school Code of Conduct, the statement read. You have any questions or concerns, please contact your child building principal.
Tennell, who had not fallen in 33 jumping passes this season coming into the Olympics, crashed on her first attempt in the short program and stepped out of two landings in the middle of her free skate. Woman internationally this season, good enough to be seeded eighth in the Olympic field. Women's figure skating's struggles did not start in PyeongChang.. |
The client was looking for a new packaging bag design that would hold his product (knee sleeve) in a more eye-catching way rather than using a generic shipping white box. Creating a template, the front allows the customer to view the product through a translucent gold metallic pouch. Just like what I did for the box previously the year before, I used the same concept of using a geometric line pattern that leads the eye to the logomark "W". On the back, a simple inspiring description and motto "Your Only Limit is You" is surrounded by black space allowing the feel of a clean simple design. |
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Futures rose as much as 0.9% in NY after slipping 5% the previous two sessions.
Worries over a supply glut have pushed oil prices to settle below US$40 a barrel for the first time in more than three months.
The supply glut is upsetting industry expectations, with BP, Royal Dutch Shell and Exxon Mobil Corp. reporting second-quarter earnings last week that were worse than estimated.
The US government will issue official inventory data on Wednesday. "Now, are we out of the woods yet?"
Due to below average draws, this summer; the inventories are 30 % above the five-year averages. It hasn't closed below $40 since April 18 when it ended the day at $39.78. Total volume traded was about 46 percent below the 100-day average.
Brent crude was up 11 cents a barrel at $41.91 at 1121 GMT. Gas prices dropped to an average of $2.13 a gallon on Monday, compared with $2.66 this time previous year, according to AAA. The global benchmark traded at a premium of $1.50 to WTI for October. Bank of America Merrill Lynch head of commodities research told Bloomberg Television that oil will likely be back above $50 a barrel towards the end of this year. Oil rallied from a 12-year low near $27 in January to a 2016 high of nearly $53 in June, supported by an initiative from OPEC and outside producers including Russian Federation to freeze output and by hopes that the supply glut would ease.
Supplies at Cushing, Oklahoma, the key delivery point for Nymex crude, fell by 1.12 million barrels last week, the EIA said.
International Brent crude futures were trading at.85 per barrel, up a mere 5 cents from their last close, and failing to retake and maintain.
However, other analysts said recent price falls were overblown, with Citi saying bears, who speculate on falling prices, having "gone wild in oil at United States dollars 40".
Hip-hop star Trina wrote: "I'm praying for @ ToyaWright her mom and her family during this disgusting tragedy". The brothers were discovered inside a vehicle , shortly after midnight on Saturday in the city's 7th Ward.
West Texas Intermediate crude futures are approximately 20 percent, down from their 2016 peaks above $50 a barrel scaled in early June, technically positioning it in bear market territory, as an indication of an ongoing recovery in USA drilling activity shared with elevated stocks of fuel products weighed.
Supplies could swell further as member nations in the Organization of Petroleum Exporting Countries work to restore halted output. Already high stockpiles of these refined products rose further when the demand for the product became significantly less than it should be to consume all the gasoline that had been refined to compensate for low prices.
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Andy Barth, a representative of Howard County Executive Allan Kittleman, confirmed one death and two missing at 9:20 a.m. Police said several people were trapped in partially submerged vehicles in the Woodberry area.
Last week, it was Ivanka Trump introducing her dad, tonight it's Chelsea Clinton introducing her mom. Clinton said Trump is offering America "empty promises" and what she called "bigotry and bombast".
The NPA said that they would only declare a truce, if Duterte investigates his troops, who alleged violated the ceasefire order. According to CNN Philippines , PNP Chief Ronal Dela Rosa said police would follow Duterte's instructions. |
Ewden Valley is a beautiful spot south of Stocksbridge that boasts two reservoirs, some stunning landscapes and...quite a lot of horrible rubbish. Come along and join us help clear up fly-tipping and litter in this beautiful valley on the Pennine Fringe.
Historically some areas of the Ewden Valley (including around the Broomhead and Moor Hall reservoirs) have been used a dumping ground for builders and people too lazy or mean to do the right thing and go to the tip. Well, enough is enough! Local people are organising themselves to get out there and clean up.
We're supporting Stocksbridge Town Council, Bradfield Parish Council and Bolsterstone Community Group at this event, which is also part of Sheffield Environment Week.
There are two cleanup sessions planned: 10am - 12noon and 1pm - 3pm.
Please come and give a hand. Dress suitably with robust footwear and a warm and dry coat. We'll be providing equipment and advice - all you need is enthusiasm and a love of the countryside. |
Q: How does Idris avoid using dot patterns for inaccessible patterns? In Agda one had to use dot patterns to tell the compiler which parts of a function definition cannot be inspected, in particular which variables can be used for pattern matching and which cannot (in new releases it seems that dot patterns are just optional and one can use new variables instead).
Idris apparently does not use any mechanism of this sort, so how does the idris compiler guess which pattern are accessible and which are not in a function definition? How does it get which are the arguments on which pattern match?
Thanks in advance.
|
Charles Patrick Thacker, dit Chuck Thacker (né à Pasadena (Californie) le et mort à Palo Alto (Californie) le ) est un chercheur en informatique américain qui a contribué à fonder les domaines de l'interface graphique homme-machine, des réseaux de communication et des imprimantes laser.
Biographie
Charles P. Thacker étudie à l'université de Californie à Berkeley en Californie où il obtient une licence de physique en 1967. L'année suivante, il rejoint le projet Genie de l'université, qui produit un système à temps partagé. Ce projet devient la Berkeley Computer Corporation. En 1970, comme plusieurs anciens membres de la BCC, Thacker rejoint ensuite le PARC, laboratoire d'informatique du centre de recherche de Xerox à Palo Alto. Pendant les années 1970, il contribue à l'invention d'Ethernet et à la réalisation de la première imprimante laser. En 1983, il rejoint Digital Equipment Corporation, où il met au point Firefly, la première station de travail multiprocesseur. En 1997, il devient membre de Microsoft Research et participe à la conception du Tablet PC.
Distinctions
Charles P. Thacker est docteur honoris causa de l'École polytechnique fédérale de Zurich.
En 2007, il reçoit la médaille John von Neumann pour son rôle central dans la création de l'ordinateur personnel et dans le développement des systèmes informatiques en réseau.
En 2010, il reçoit le prix Turing pour l'ensemble de son œuvre, en particulier pour la conception et réalisation du Xerox Alto et ses contributions à Ethernet.
Notes et références
Liens externes
Personnalité américaine de l'informatique
Étudiant de l'université de Californie à Berkeley
Docteur honoris causa de l'École polytechnique fédérale de Zurich
Lauréat du prix Turing
Membre de l'Académie américaine des arts et des sciences
Naissance en février 1943
Naissance à Pasadena
Décès à 74 ans
Décès à Palo Alto
Décès en juin 2017 |
The yoga spinal twist is talked about in this article for instance of the advantages of one pose or posture. Monday September 26 was the final day on which the Obama administration might ask the Eleventh Circuit Court of Appeals to reconsider its three-judge panel's ruling that the Affordable Care Act's particular person mandate was unconstitutional. The truth that the Justice Department took no action virtually certainly implies that its intent is to ask the Supreme Courtroom to determine the difficulty.
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I am still checking into them a little bit, however hopefully, the association shall be a lot more appropriate. I will say though, that my banker informed me that the perfect guess in dealing with these gyms and bank withdrawals, is to easily arrange a separate checking account, so to control what is obtainable for them to withdraw; and, you possibly can simply shut the account if you are cancelling the contract. I believe that is the best concept. Thanks for the response. Come again quickly. |
The Travel Institute's Destination Specialist (DS) programs span the globe and provide essential knowledge for you to understand the area as well as help you create the kinds of experiences your customers expect – and come back for. It's this type of training that sets you apart from "travel hobbyists" and gives you greater credibility with your clients. It also increases your value and earning power!
Depending on the destination, the course is available in these formats: print, online, or downloadable PDF. An optional online DS exam can be taken, and a grade of 70 or higher is considered passing. Those individuals completing the course and exam are encouraged to promote their expertise by including the designation after their name. For instance, Jane Smith, Alaska Specialist. For those individuals seeking a more advanced concentration of study, a Certified Destination Specialist level is also available for select areas, with Jane Smith, Certified Alaska Specialist as the proper designation. Successful completion of any of these courses qualifies for 10 Continuing Education Units (CEUs), which is an annual requirement of CTA, CTC, and CTIE professionals.
Our DS courses focus on the geography, culture, essential sites and attractions, travel tips, and sample itineraries that help you create memorable vacations for your clients. Along the way, your study will provide you with information to enhance their appreciation of what they will be seeing, tasting, hearing, and even advising them on shopping and souvenirs. Each DS curriculum serves as a helpful resource long after you have completed the course. |
Q: how to make tomcat 6 running mulitple domain with non ROOT application name I am trying to run multiple domain on a tomcat 6 on a linux server.
I got 404 Errors when I follow the steps here
http://tomcat.apache.org/tomcat-6.0-doc/virtual-hosting-howto.html
Here is the conf
server.xml
<Engine name="Catalina" defaultHost="a.mydomain.com">
<Host name="a.mydomain.com" appBase="aapps" autoDeploy="true" unpackWars="true" />
<Host name="b.mydomain.com" appBase="bapps" autoDeploy="true" unpackWars="true" />
</Engine>
<Tomcat>/conf/Catalina/a.mydomain.com/ROOT.xml
<?xml version='1.0' encoding='utf-8'?>
<Context docBase="/opt/tomcat/aapps/portal" reloadable="true" path=""></Context>
<Tomcat>/conf/Catalina/b.mydomain.com/ROOT.xml
<?xml version='1.0' encoding='utf-8'?>
<Context docBase="/opt/tomcat/bapps/portal" reloadable="true" path=""></Context>
What am I doing wrong here?
by the way, tomcat auto generated a portal.xml in the /conf/Catalina/a.mydomain.com/
A: What do your workers.properties and context maps look like?
|
Subject: Summer 2017 Starting Soon!
Summer 2017 Classes Starting Soon!
You are receiving this email because you are currently enrolled in at least one Summer 2017 course.
Undergraduate courses in the 4-week, 6-week (I), and 12-week sessions will begin on Tuesday, May 16, 2017, not Monday, May 15. MyUI reflects "First Session Day is May 16" in the Notes field under Registration Information for any affected courses.
Changes in registration will not be available for students in MyUI once the course has begun. When MyUI has closed, all changes must be processed at the Registrar's Service Center, 17 Calvin Hall.
If a course requires special permission, students should see the department before adding the course in MyUI.
Students can join a waitlist if the option is available in MyUI. Students should not use a Change of Registration Form until the waitlist option is no longer accessible.
Changes in registration for Distance Education Courses (online, GIS, off-campus) can also be processed at the Division of Continuing Education, 250 CEF (319-335-2575) [email protected].
The Change of Registration Form is available on the Office of the Registrar website or MyUI. Please click here to determine the signatures needed.
Students not returning to the University for a summer session must drop their entire summer enrollment before May 15, 2017, to prevent being held for tuition and fee assessment.
All summer courses should be dropped prior to the first day of class in MyUI.
If MyUI has closed, please contact the Registrar's Service Center, in 17 CALH, at [email protected] or 319-384-4300.
Residence hall contracts must be canceled separately by sending a signed letter including your name, address, contact information (phone and email), and University ID number to University Housing and Dining, 4141 Burge Hall, Iowa City, IA 52242.
The first summer session University Bill is due June 22, 2017. You can view and pay online via MyUI. Failure to make the minimum payment by that date will result in a late payment. Contact University Billing, 5 CALH, at [email protected] or 319-335-0071 with questions.
The Summer Academic Calendar is available on the Office of the Registrar's website.
Please contact the Registrar Service Center, 17 CALH, at [email protected] or 319-384-4300, if you have any questions. |
Tung Shing Halong Pearl Hotel is a modern style built hotel, idyllically located in the heart of the city, just a-step away to the beach, within walking distance to major sightseeing, shopping and tourist locations.
This four stars boutique hotel has 181 mainly seafront rooms (30-79sqm) with a gorgeous view over Halong Bay which is one of the most beautiful Bays in the world. Both leisure and business travelers will find all necessary services concerning Accommodation, Food & Beverage, Conference Facilities, Tours and Wellness & Fitness.
Individual service is offered with high quality and privacy is respected to any of our clients. Tung Shing Halong Pearl Hotel team will assist you to enjoy the unique charm & atmosphere of this lovely hotel with balance and harmony.
Tung Shing Halong Pearl Hotel has 181 rooms in the main 12 storey and 2 villas beside the main building with different type of rooms to meet all guests' demand. It is wonderful that guest can relax in comfortable place as well as contemplate Halong Bay and Bai Chay Center.
- Superior (27m2): Superior has 103 Twin - bedrooms and 13 King – size bedrooms. That designed modern and perfect in space warmly and friendly. Superior Room offers partly Halong Bay view or Swimming pool view.
- Deluxe (36m2): 16 King size bedrooms overlooking Halong Bay and 26 Twin- bed rooms with modern equipment and luxurious decorations and impressive. Vision of the room overlooking Halong Bay.
- Suite (68m2) : A suite with a total of 02 King-size bedrooms overlooking Halong Bay. Each room is designed with luxurious style with modern facilities, rooms with large windows, sofa, as well as separate living rooms.
Tung Shing Halong Pearl Hotel offer a wide choice for guests who are looking for both International favorites and new dinning experiences delivered with gracious Viet Nam services.
Elegantly spacious and beautifully designed, Century Restaurant serves European, Asian, Vietnamese favorites and Chinese Cuisine prepared by our Chief Chinese Chef and local Chefs.
For afternoon tea or an evening cocktail with friends and colleagues, the Lobby Lounge is a popular venue for both guests and locals looking to enjoy the classic music and the warm relaxing atmosphere.
Located at top of 12-storey building, the Bay View Bar offers the Guests a chance to indulge themselves with wine, cocktail and fast-food after the long journey while enjoying the magnificent view of the Bay.
Our convention and banqueting facilities provide the ideal venue forever kind of function. With 5 function rooms, 1 grand ball room, seating provide up to 750 guests. Our complete selection of audio-visual equipment and simultaneous translation is up to 6 languages makes Tung Shing Halong Pearl Hotel ideal for meeting, conference, training session and signing ceremony.
Our outdoor Swimming Pool attracts both experienced swimmers and beginners alike. We offer a perfect place for you to hide away from the heat in summer days. Enjoy yourself with moments of relaxation dipping in cool water, feeling fresh breeze and sipping cocktail specially prepared by our pool bar.
An outdoor Tennis Court ideally situated next to Swimming Pool will meet the demand of our sport lover guests.
Massage service using typical herb ingredient, offered by professional masseuse team of a Physiotherapy Clinic will bring you the utmost relaxation and health therapy. |
Chevron acquires Anadarko Petroleum for $50bn
American oil and gas multinational Chevron has acquired all of the outstanding shares of hydrocarbon exploration company Anadarko for $50bn.
The stock and cash transaction for Anadarko's shares is valued at $33bn, or $65 per share. Anadarko's shareholders will receive $16.25 in cash and 0.3869 shares of Chevron for each Anadarko share under the terms of the agreement.
The acquisition of Anadarko is expected to enhance Chevron's upstream portfolio as well as its positions in deepwater, shale and natural gas resource basins. Chevron is expected for benefit from in the Delaware Basin and the Gulf of Mexico, with the combination of the two companies extending Chevron's offshore infrastructures.
Chevron will also gain a resource base in Mozambique to support growing global demand for liquefied natural gas (LNG), described by Chevron as "a very cost-competitive and well-prepared greenfield project" close to major markets.
As a result of predicted higher cash flows, Chevron plans to increase its share repurchase rate from $4bn to $5bn, increasing returns for its shareholders. Chevron also expects its shareholders to benefit from additional cash through reduced debt and spending.
Chevron chair and CEO Michael Wirth said: "This transaction builds strength on strength for Chevron. The combination of Anadarko's premier, high-quality assets with our advantaged portfolio strengthens our leading position in the Permian, builds on our deepwater Gulf of Mexico capabilities and will grow our LNG business.
"It creates attractive growth opportunities in areas that play to Chevron's operational strengths and underscores our commitment to short-cycle, higher-return investments.
"This transaction will unlock significant value for shareholders, generating anticipated annual run-rate synergies of approximately $2 billion, and will be accretive to free cash flow and earnings one year after close."
Anadarko chair and CEO Al Walker said: "The strategic combination of Chevron and Anadarko will form a stronger and better company with world-class assets, people and opportunities."
"I have tremendous respect for Mike and his leadership team and believe Chevron's strategy, scale and operational capabilities will further accelerate the value of Anadarko's assets."
The transaction has been approved by the board of Directors of Chevron and Anadarko, and is expected to close in the second half of 2019, subject to approval from shareholders and regulators as well as other customary closing conditions.
Anadarko Petroleum
International Oil Cos
NCDMB, Waltersmith to support Equatorial Guinea on Modular Refinery Development
CDMB |
Q: QtService application cannot connect to system bus when running as a service I have recompiled Qt with integrated dbus for windows.
Further, I have implemented a QtService application which registers a service and an object at the system bus as follows:
QDBusConnection::systemBus().registerService("com.mycompany.Configuration");
QDBusConnection::systemBus().registerObject("/com/mycompany/Configuration/MySetting", myObject);
Now when I am running the service application with the -e parameter (running as regular application) it works fine and both dbus-monitor and qdbus --system show me the registered service and object.
However, when I am running the application as a windows service it does not register anything at the system bus.
Debugging the service gives me the error message
Not connected to D-Bus server
when calling registerService(...) and registerObject(...).
I have set the environment variables:
DBUS_SYSTEM_BUS_ADDRESS = autolaunch:
DBUS_SYSTEM_BUS_DEFAULT_ADDRESS = autolaunch:
My system.conf file:
<!DOCTYPE busconfig PUBLIC "-//freedesktop//DTD D-Bus Bus Configuration 1.0//EN"
"http://www.freedesktop.org/standards/dbus/1.0/busconfig.dtd">
<busconfig>
<type>system</type>
<fork/>
<pidfile>/pid</pidfile>
<listen>autolaunch:</listen>
<policy context="default">
<allow user="*"/>
<deny own="*"/>
<deny send_type="method_call"/>
<allow send_type="signal"/>
<allow send_requested_reply="true" send_type="method_return"/>
<allow send_requested_reply="true" send_type="error"/>
<allow receive_type="method_call"/>
<allow receive_type="method_return"/>
<allow receive_type="error"/>
<allow receive_type="signal"/>
<allow send_destination="org.freedesktop.DBus"/>
<deny send_destination="org.freedesktop.DBus"
send_interface="org.freedesktop.DBus"
send_member="UpdateActivationEnvironment"/>
</policy>
<includedir>system.d</includedir>
<include ignore_missing="yes">system-local.conf</include>
<include if_selinux_enabled="yes" selinux_root_relative="yes">contexts/dbus_contexts</include>
</busconfig>
Additionally, I have a com.mycompany.Configuration.conf file in the system.d folder:
<!DOCTYPE busconfig PUBLIC
"-//freedesktop//DTD D-BUS Bus Configuration 1.0//EN"
"http://www.freedesktop.org/standards/dbus/1.0/busconfig.dtd">
<busconfig>
<!-- Only root can own the service -->
<policy context="default">
<allow own="com.mycompany.Configuration"/>
<allow send_interface="com.mycompany.Configuration"/>
<allow send_destination="com.mycompany.Configuration"/>
<allow receive_sender="com.mycompany.Configuration"/>
</policy>
</busconfig>
The windows service itself is called com.mycompany.Configuration and is executed as the Local System account.
Moreover, dbus verbose output shows that something is going on when my windows service gets started:
[...]
1292: [dbus\dbus-connection.c(1154):_dbus_connection_release_io_path] locking io_path_mutex
1292: [dbus\dbus-connection.c(1160):_dbus_connection_release_io_path] start connection->io_path_acquired = 1
1292: [dbus\dbus-connection.c(1165):_dbus_connection_release_io_path] unlockingio_path_mutex
1292: [dbus\dbus-connection.c(1522):_dbus_connection_handle_watch] middle
1292: [dbus\dbus-connection.c(4222):_dbus_connection_get_dispatch_status_unlocked] dispatch status = complete is_connected = 1
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(1529):_dbus_connection_handle_watch] end
1292: [dbus\dbus-watch.c(696):dbus_watch_handle] After sanitization, watch flags on fd 1932 were 0
1292: [dbus\dbus-sysdeps-win.c(1110):_dbus_poll] select: to=7875
R:1944 E:1944
R:1936 E:1936
R:1932 E:1932
[dbus\dbus-sysdeps-win.c(1162):_dbus_poll] select: = 1:
R:1932
[dbus\dbus-connection.c(1503):_dbus_connection_handle_watch] start
1292: [dbus\dbus-connection.c(1505):_dbus_connection_handle_watch] LOCK
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(1081):_dbus_connection_acquire_io_path] locking io_path_mutex
1292: [dbus\dbus-connection.c(1085):_dbus_connection_acquire_io_path] start connection->io_path_acquired = 0 timeout = 1
1292: [dbus\dbus-connection.c(1128):_dbus_connection_acquire_io_path] end connection->io_path_acquired = 1 we_acquired = 1
1292: [dbus\dbus-connection.c(1130):_dbus_connection_acquire_io_path] unlocking io_path_mutex
1292: [dbus\dbus-connection.c(1133):_dbus_connection_acquire_io_path] LOCK
1292: [dbus\dbus-transport-socket.c(919):socket_handle_watch] handling read watch 003d6f58 flags = 1
1292: [dbus\dbus-transport-socket.c(345):exchange_credentials] exchange_credentials: do_reading = 1, do_writing = 0
1292: [dbus\dbus-transport-socket.c(446):do_authentication] server auth state:waiting for input
1292: [dbus\dbus-sysdeps-win.c(207):_dbus_read_socket] recv: count=2048 fd=1932
1292: [dbus\dbus-sysdeps-win.c(217):_dbus_read_socket] recv: = 153
1292: [dbus\dbus-transport-socket.c(263):read_data_into_auth] read 153 bytes in auth phase
1292: [dbus\dbus-auth.c(2187):process_command] server: got command "DATA 30333432316532346364316236363730303938303934303836666364653631372063303064313764623036653935643732336665666330396131633131653265353030643632616237"
1292: [dbus\dbus-auth.c(1624):process_data] server: data: '03421e24cd1b6670098094086fcde617 c00d17db06e95d723fefc09a1c11e2e500d62ab7'
1292: [dbus\dbus-auth.c(2134):goto_state] server: going from state WaitingForData to state WaitingForBegin
1292: [dbus\dbus-auth.c(760):sha1_handle_second_client_response] server: authenticated client using DBUS_COOKIE_SHA1
1292: [dbus\dbus-transport-socket.c(345):exchange_credentials] exchange_credentials: do_reading = 1, do_writing = 0
1292: [dbus\dbus-transport-socket.c(460):do_authentication] server auth state:bytes to send
1292: [dbus\dbus-transport-socket.c(180):check_read_watch] fd = 1932
1292: [dbus\dbus-transport-socket.c(226):check_read_watch] setting read watch enabled = 0
1292: [dbus\dbus-watch.c(449):_dbus_watch_list_toggle_watch] Toggling watch 003d6f58 on fd 1932 to 0
1292: [dbus\dbus-transport-socket.c(165):check_write_watch] check_write_watch(): needed = 1 on connection 003d88b0 watch 003d7260 fd = 1932 outgoing messages exist 0
1292: [dbus\dbus-watch.c(449):_dbus_watch_list_toggle_watch] Toggling watch 003d7260 on fd 1932 to 1
1292: [dbus\dbus-transport-socket.c(703):do_reading] fd = 1932
1292: [dbus\dbus-connection.c(1154):_dbus_connection_release_io_path] locking io_path_mutex
1292: [dbus\dbus-connection.c(1160):_dbus_connection_release_io_path] start connection->io_path_acquired = 1
1292: [dbus\dbus-connection.c(1165):_dbus_connection_release_io_path] unlockingio_path_mutex
1292: [dbus\dbus-connection.c(1522):_dbus_connection_handle_watch] middle
1292: [dbus\dbus-connection.c(4222):_dbus_connection_get_dispatch_status_unlocked] dispatch status = complete is_connected = 1
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(1529):_dbus_connection_handle_watch] end
1292: [dbus\dbus-sysdeps-win.c(1110):_dbus_poll] select: to=5641
R:1944 E:1944
R:1936 E:1936
W:1932 E:1932
[dbus\dbus-sysdeps-win.c(1162):_dbus_poll] select: = 1:
W:1932
[dbus\dbus-connection.c(1503):_dbus_connection_handle_watch] start
1292: [dbus\dbus-connection.c(1505):_dbus_connection_handle_watch] LOCK
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(1081):_dbus_connection_acquire_io_path] locking io_path_mutex
1292: [dbus\dbus-connection.c(1085):_dbus_connection_acquire_io_path] start connection->io_path_acquired = 0 timeout = 1
1292: [dbus\dbus-connection.c(1128):_dbus_connection_acquire_io_path] end connection->io_path_acquired = 1 we_acquired = 1
1292: [dbus\dbus-connection.c(1130):_dbus_connection_acquire_io_path] unlockingio_path_mutex
1292: [dbus\dbus-connection.c(1133):_dbus_connection_acquire_io_path] LOCK
1292: [dbus\dbus-transport-socket.c(948):socket_handle_watch] handling write watch, have_outgoing_messages = 0
1292: [dbus\dbus-transport-socket.c(345):exchange_credentials] exchange_credentials: do_reading = 0, do_writing = 1
1292: [dbus\dbus-transport-socket.c(460):do_authentication] server auth state:bytes to send
1292: [dbus\dbus-sysdeps-win.c(267):_dbus_write_socket] send: len=37 fd=1932
1292: [dbus\dbus-sysdeps-win.c(277):_dbus_write_socket] send: = 37
1292: [dbus\dbus-auth.c(2506):_dbus_auth_bytes_sent] server: Sent 37 bytes of: OK 4d63998db68399d8b48494595200cd61
1292: [dbus\dbus-transport-socket.c(345):exchange_credentials] exchange_credentials: do_reading = 0, do_writing = 1
1292: [dbus\dbus-transport-socket.c(446):do_authentication] server auth state:waiting for input
1292: [dbus\dbus-transport-socket.c(180):check_read_watch] fd = 1932
1292: [dbus\dbus-transport-socket.c(226):check_read_watch] setting read watchenabled = 1
1292: [dbus\dbus-watch.c(449):_dbus_watch_list_toggle_watch] Toggling watch 003d6f58 on fd 1932 to 1
1292: [dbus\dbus-transport-socket.c(165):check_write_watch] check_write_watch(): needed = 0 on connection 003d88b0 watch 003d7260 fd = 1932 outgoing messages exist 0
1292: [dbus\dbus-watch.c(449):_dbus_watch_list_toggle_watch] Toggling watch 003d7260 on fd 1932 to 0
1292: [dbus\dbus-transport-socket.c(503):do_writing] Not authenticated, not writing anything
1292: [dbus\dbus-transport-socket.c(165):check_write_watch] check_write_watch(): needed = 0 on connection 003d88b0 watch 003d7260 fd = 1932 outgoing messages exist 0
1292: [dbus\dbus-connection.c(1154):_dbus_connection_release_io_path] locking io_path_mutex
1292: [dbus\dbus-connection.c(1160):_dbus_connection_release_io_path] start connection->io_path_acquired = 1
1292: [dbus\dbus-connection.c(1165):_dbus_connection_release_io_path] unlockingio_path_mutex
1292: [dbus\dbus-connection.c(1522):_dbus_connection_handle_watch] middle
1292: [dbus\dbus-connection.c(4222):_dbus_connection_get_dispatch_status_unlocked] dispatch status = complete is_connected = 1
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(1529):_dbus_connection_handle_watch] end
1292: [dbus\dbus-watch.c(696):dbus_watch_handle] After sanitization, watch flags on fd 1932 were 0
1292: [dbus\dbus-sysdeps-win.c(1110):_dbus_poll] select: to=3484
R:1944 E:1944
R:1936 E:1936
R:1932 E:1932
[dbus\dbus-sysdeps-win.c(1162):_dbus_poll] select: = 1:
R:1932
[dbus\dbus-connection.c(1503):_dbus_connection_handle_watch] start
1292: [dbus\dbus-connection.c(1505):_dbus_connection_handle_watch] LOCK
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(1081):_dbus_connection_acquire_io_path] locking io_path_mutex
1292: [dbus\dbus-connection.c(1085):_dbus_connection_acquire_io_path] start connection->io_path_acquired = 0 timeout = 1
1292: [dbus\dbus-connection.c(1128):_dbus_connection_acquire_io_path] end connection->io_path_acquired = 1 we_acquired = 1
1292: [dbus\dbus-connection.c(1130):_dbus_connection_acquire_io_path] unlockingio_path_mutex
1292: [dbus\dbus-connection.c(1133):_dbus_connection_acquire_io_path] LOCK
1292: [dbus\dbus-transport-socket.c(919):socket_handle_watch] handling read watch 003d6f58 flags = 1
1292: [dbus\dbus-transport-socket.c(345):exchange_credentials] exchange_credentials: do_reading = 1, do_writing = 0
1292: [dbus\dbus-transport-socket.c(446):do_authentication] server auth state:waiting for input
1292: [dbus\dbus-sysdeps-win.c(207):_dbus_read_socket] recv: count=2048 fd=1932
1292: [dbus\dbus-sysdeps-win.c(217):_dbus_read_socket] recv: = 135
1292: [dbus\dbus-transport-socket.c(263):read_data_into_auth] read 135 bytes in auth phase
1292: [dbus\dbus-auth.c(2187):process_command] server: got command "BEGIN"
1292: [dbus\dbus-auth.c(2134):goto_state] server: going from state WaitingForBegin to state Authenticated
1292: [dbus\dbus-sysdeps-win.c(787):_dbus_getsid] _dbus_getsid() returns 1
1292: [dbus\dbus-transport.c(673):auth_via_default_rules] Client authorized as S ID 'S-1-5-18' but our SID is 'S-1-5-21-4012214046-2405994403-1636280286-500', disconnecting
1292: [dbus\dbus-transport.c(503):_dbus_transport_disconnect] start
1292: [dbus\dbus-transport-socket.c(985):socket_disconnect]
1292: [dbus\dbus-transport-socket.c(76):free_watches] start
1292: [dbus\dbus-watch.c(417):_dbus_watch_list_remove_watch] Removing watch on fd 1932
1292: [dbus\dbus-watch.c(417):_dbus_watch_list_remove_watch] Removing watch on fd 1932
1292: [dbus\dbus-socket-set-poll.c(221):socket_set_poll_remove] after removing fd 1932 from 003d2430, 2 en/2 res/9 alloc
1292: [dbus\dbus-watch.c(628):dbus_watch_set_data] Setting watch fd -1 data to data = 00000000 function = 00000000 from data = 00000000 function = 00000000
1292: [dbus\dbus-transport-socket.c(98):free_watches] end
1292: [dbus\dbus-sysdeps-win.c(317):_dbus_close_socket] _dbus_close_socket: socket=1932,
1292: [dbus\dbus-transport.c(514):_dbus_transport_disconnect] end
1292: [dbus\dbus-transport-socket.c(180):check_read_watch] fd = -1
1292: [dbus\dbus-transport-socket.c(703):do_reading] fd = -1
1292: [dbus\dbus-watch.c(628):dbus_watch_set_data] Setting watch fd -1 data to data = 00000000 function = 00000000 from data = 00000000 function = 00000000
1292: [dbus\dbus-connection.c(1154):_dbus_connection_release_io_path] locking io_path_mutex
1292: [dbus\dbus-connection.c(1160):_dbus_connection_release_io_path] start connection->io_path_acquired = 1
1292: [dbus\dbus-connection.c(1165):_dbus_connection_release_io_path] unlockingio_path_mutex
1292: [dbus\dbus-connection.c(1522):_dbus_connection_handle_watch] middle
1292: [dbus\dbus-connection.c(4222):_dbus_connection_get_dispatch_status_unlocked] dispatch status = complete is_connected = 0
1292: [dbus\dbus-connection.c(4184):notify_disconnected_and_dispatch_complete_unlocked] Sending disconnect message
1292: [dbus\dbus-connection.c(567):_dbus_connection_queue_synthesized_message_link] Synthesized message 003d8948 added to incoming queue 003d88b0, 1 incoming
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(4299):_dbus_connection_update_dispatch_status_and_unlock] Notifying of change to dispatch status of 003d88b0 now 0 (data remains)
1292: [dbus\dbus-connection.c(1529):_dbus_connection_handle_watch] end
1292: [dbus\dbus-connection.c(4515):dbus_connection_dispatch]
1292: [dbus\dbus-connection.c(4517):dbus_connection_dispatch] LOCK
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(4090):_dbus_connection_acquire_dispatch] locking dispatch_mutex
1292: [dbus\dbus-connection.c(4104):_dbus_connection_acquire_dispatch] unlocking dispatch_mutex
1292: [dbus\dbus-connection.c(4107):_dbus_connection_acquire_dispatch] LOCK
1292: [dbus\dbus-connection.c(3954):_dbus_connection_pop_message_link_unlocked]Message 003d8948 (signal /org/freedesktop/DBus/Local org.freedesktop.DBus.Local Disconnected '') removed from incoming queue 003d88b0, 0 incoming
1292: [dbus\dbus-connection.c(4563):dbus_connection_dispatch] dispatching message 003d8948 (signal org.freedesktop.DBus.Local Disconnected '')
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(4630):dbus_connection_dispatch] running filter on message 003d8948
1292: [dbus\dbus-connection.c(3126):dbus_connection_preallocate_send] LOCK
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [bus\dispatch.c(216):bus_dispatch] DISPATCH: org.freedesktop.DBus.Local Disconnected (no error name) to peer
1292: [bus\connection.c(198):bus_connection_disconnected] (inactive) disconnected, dropping all service ownership and releasing
1292: [dbus\dbus-connection.c(5526):dbus_connection_remove_filter] LOCK
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(4891):dbus_connection_set_watch_functions] LOCK
1292: [dbus\dbus-watch.c(347):_dbus_watch_list_set_functions] Removing all pre-existing watches
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(4954):dbus_connection_set_timeout_functions] LOCK
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(5268):dbus_connection_set_unix_user_function] LOCK
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(5367):dbus_connection_set_windows_user_function] LOCK
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(5037):dbus_connection_set_dispatch_status_function] LOCK
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [bus\connection.c(1587):bus_connection_drop_pending_replies] Dropping pending replies that involve connection 003d88b0
1292: [dbus\dbus-connection.c(4644):dbus_connection_dispatch] LOCK
1292: [dbus\dbus-connection.c(4653):dbus_connection_dispatch] filter handled message in dispatch
1292: [dbus\dbus-connection.c(4784):dbus_connection_dispatch] ... done dispatching
1292: [dbus\dbus-connection.c(4123):_dbus_connection_release_dispatch] locking dispatch_mutex
1292: [dbus\dbus-connection.c(4131):_dbus_connection_release_dispatch] unlocking dispatch_mutex
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(4801):dbus_connection_dispatch] LOCK
1292: [dbus\dbus-connection.c(4807):dbus_connection_dispatch] before final status update
1292: [dbus\dbus-connection.c(4222):_dbus_connection_get_dispatch_status_unlocked] dispatch status = complete is_connected = 0
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(2670):_dbus_connection_last_unref] Finalizing connection 003d88b0
1292: [dbus\dbus-connection.c(5037):dbus_connection_set_dispatch_status_function] LOCK
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(4991):dbus_connection_set_wakeup_main_function] LOCK
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-connection.c(5268):dbus_connection_set_unix_user_function] LOCK
1292: [dbus\dbus-connection.c(413):_dbus_connection_unlock] UNLOCK
1292: [dbus\dbus-transport.c(484):_dbus_transport_unref] finalizing
1292: [dbus\dbus-transport-socket.c(106):socket_finalize]
1292: [dbus\dbus-transport-socket.c(76):free_watches] start
1292: [dbus\dbus-transport-socket.c(98):free_watches] end
1292: [dbus\dbus-auth.c(430):shutdown_mech] server: Shutting down mechanism DBUS_COOKIE_SHA1
1292: [dbus\dbus-sysdeps-win.c(1110):_dbus_poll] select: to=0
R:1944 E:1944
R:1936 E:1936
[dbus\dbus-sysdeps-win.c(1140):_dbus_poll] select: = 0
1292: [bus\connection.c(828):expire_incomplete_timeout] Running
1292: [bus\expirelist.c(111):bus_expire_timeout_set_interval] Disabled an expire timeout
1292: [dbus\dbus-sysdeps-win.c(1110):_dbus_poll] select: to=-1
R:1944 E:1944
R:1936 E:1936
[...]
I really don't know what the issue could be and would appreciate any help.
Edit:
This one seems to have the same issue: http://comments.gmane.org/gmane.comp.freedesktop.dbus/14895
A: In the end I solved the problem and my service is now able to connect to the system bus.
I made the following changes:
In system.conf I changed the listen property and the authentication property:
<listen>tcp:host=localhost,port=13337,family=ipv4</listen>
<auth>ANONYMOUS</auth>
<allow_anonymous/>
According to that changes I set the system environment variables analogously:
DBUS_SYSTEM_BUS_ADDRESS = tcp:host=localhost,port=13337,family=ipv4
DBUS_SYSTEM_BUS_DEFAULT_ADDRESS = tcp:host=localhost,port=13337,family=ipv4
This answer led me in the right direction.
|
Abstract : This paper very shortly describes some hardware solutions of central processor (CPU) of BESM-6. CPU had very deep instruction pipe with an associative buffer for instructions and an associative buffer for data with original protocol. Logical and storage elements used only domestic discrete components. Main logical unit based on differential amplifier with pyramid of rich diode logic and paraphase synchronization. Original construction without printed plate made wire connections very short and gave possibilities for direct access to every contacts and interchanging modules. All these solutions permitted to achieve high clock frequency, reliability and effective maintenance. |
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Brought to you by RE/MAX Around Atlanta, Office: 404-252-7500 & Collette McDonald, Direct: 770-500-8400. |
1 May 1876 • Monday
Having arranged with various Members to look out after Utah matters in case anything came up to-day, I started on 9.25 a.m. train for Philadelphia. Met the General at his brother's. He had used Bro. Staine's name to avoid remark. He was very glad to see me, and we had a delightful afternoon together. He took me to his Aunt's and also <to> the Centennial grounds. Our conversation was on his Mexican project. I returned to Washington on the 6 p.m. train.
2 May 1876 • Tuesday
At the House. Felt tired to-day.
3 May 1876 • Wednesday
At the House. Busy examining books to get precedents suited to my contest case.
4 May 1876 • Thursday
Made an argument before the sub. Com. on Territories against the Luttrell bill for regulating elections in Utah. I was listened to very attentively for upwards of an hour. Baskin came in just as I had closed. The evident inclination of the Com. is towards a secret ballot for Utah, and for the inflicting of a heavier penalty than our law required for tampering with the ballot box and for illegal voting.
5 May 1876 • Friday
At the House. Busy looking through Baskin's unprinted evidence in contest case. This consisted of transcripts of records of the District Court at Salt Lake City and the Supreme Court and the Record of the Naturalization. Also procuring law books in Cong. Library for Mr. Eldredge.
6 May 1876 • Saturday
Busy at the House. Wrote letter to the President Young. At the Patent Office about patent for burial casket invented by the sons of Jos. E. Taylor of Salt Lake City. A warm day.
7 May 1876 • Sunday
Attended as usual to our duties to-day. I was not well.
At the House. Received a dispatch from Bro. John W. Young asking if I had any invitation for any one beside myself to the opening of the Centennial and stating that his brother-in-law, Mr. Wesley Canfield, would be glad to have us stay at his house while at Philadelphia. I replied and accepted the invitation.
Started at 3 p.m. with my wife Elizabeth and daughter Mary Alice for Philadelphia, having been invited with the other Members of Congress to be present at the opening of the Centennial Exhibition. Were delayed on the road and did not reach the Depot till about 10.3045 p.m. Took a transfer carriage and drove to Mr. Canfield's. They were all in bed. Awakened them (it was raining heavily) and we were admitted; but they were not looking for us, had heard nothing of our coming. We felt somewhat chagrined; for we supposed from Bro. John W's dispatch, they would be looking for us. It seems that Bro. John did not get my reply till late to-night (this he afterwards informed me) and he had not advised Mr. Canfield. But presuming on the latter's invitations to me, given when John W. and I were at his house together, to stop with him when the Centennial Exhibition should be opened Bro. John W. had sent me the dispatch. There was such an immense pile of baggage at the depot could not get our trunk.
10 May 1876 • Wednesday
Arose early this morning and after breakfast started for the Centennial Grounds. Took street car to Girard Ave. expecting to get another to take us out to the grounds; but they were so crowded that people hung on to them like bees. After some delay succeeded in obtaining seats in a transfer Carriage. The streets were thronged with people. The inside of the grounds were crowded. After some little trouble we reached the platform erected for the performance of the ceremonies and obtained our seats in the part assigned to Members of the House of Rep. But we heard nothing of the ceremonies excepting the singing by a choir of 800 or 1000 singers and the Music of the Orchestra. Every place was crowded. There was no order maintained. For aught I could see any one who chose could crowd on to the platform; and when the procession was formed I never saw such disorder and jamming except in the streets of London at the illumination in honor of the marriage of the Prince of Wales. I had to exert my strength to the utmost to keep my daughter Mary Alice from being crushed. We were glad to get into the Main building where we had room to move freely. We remained there and in Machinery Hall until about five o'clock, then (it raining heavily when we emerged from the building) we succeeded in getting a hack (a matter of no small difficulty) and drove to the Depot to look for our trunk and then to Mr. Canfield's where I found Bro. John W. Young. After supper I went to the Baltimore and Ohio Depot and found my trunk there. I called at the Bingham House and had a long conversation with Bro. Theo. McKean who had arrived from his field in New Jersey that day, and whom we had met at the Centennial.
11 May 1876 • Thursday
Arose very early and went down town to get our trunk, which we had not had a chance to open to get any clothing out, and to send it back. Bro. John W. Young loaned us his carriage to take us to the Depot. He is a most generous, and kind and accommodating man. Train started at 11 a.m. we reached Washington about 6.15 p.m. This is the first time I ever was glad to start for Washington. It had <been> hurry-scurry at Philadelphia, a complete jam, and we were glad to get out of it. We were very tired.
12 May 1876 • Friday
At the House.
13 May 1876 • Saturday
At the House. Not well to-day.
14 May 1876 • Sunday
Feeling badly. Went out to Soldiers' Home. The scenery is magnificent.
15 May 1876 • Monday
Found Bro. Jennings and daughters at Willard's this morning. Took breakfast with them. Took them around to various places of interest. Called upon President Grant. Visited the Capitol. Lunched there. In afternoon took carriage to Soldier's Home. Elizabeth and Mary Alice were in company. Dined at Willard's
16 May 1876 • Tuesday
Went through the Treasury, saw the paper currency in all its stages of preparation. Went to Capitol, examined the heating and ventilating apparatus and various points <objects> of interest; also the Botanical Garden. Dined at Willard's
Went to Mount Vernon to-day. I felt very unwell. The folks all urged me to go as they thought the trip would do me good. The morning was showery, the day was cool. Washington had a magnificent home here. The mansion is old-fashioned. The sail on the river is very fine. Reached Washington at 4.30 pm Bro Jennings had to hurry to get off for Philadelphia at 5.30 p.m. Mrs. Grant sent Elizabeth a beautiful basket of flowers, also one to the Sister Jennings. I had a very sick time this evening; I was threatened with chills and fever. I took a liquor sweat – that is, I stripped and sat with blankets around me on a wooden chair under which liquor was burning in a cup.
Went to the House; but suffering from sickness.
Went to the House. A little better to-day.
At the House. Quite unwell.
At one time to-day I was very unwell; but I felt much better in the evening. Attended to Sunday's duties and wrote editorial thought, for the "Juvenile Instructor" (Ethan Allen)
At the House. Notified that the Com. on Elections would take up my case on Thursday. Drew ekolu haneri dala [three hundred dollars] for Mr. Eldredge my lawyer.
At the House
At the room of Com. on Elections. Baskin argued his case for an hour and a half, very cunningly and adroitly. At first the Com. I think were disposed to think he had not much of a case, but before he got through they thought he had a pretty good case. The Chairman (Harris of Va.) and two others spoke in praise to me of his shrewdness and his ability as a lawyer. Went with Mr. Eldredge to Gibson Bro's. to get his brief printed. There were present of the Com. this morning: Harris of Va., Chairman, Thompson of Mass., House of Tenn., De Bolt of Mo., Poppleton of Ohio, Beebe of N. Y., Townsend of N. Y., Baker of Ind., Brown of Kansas. Absent Blackburn of Ky., & Wells of Miss.
Baskin is jubilant. He has told several who have told me that he is sure of getting me unseated. He swears by his Creator that this will be so. I expect he talks to many from whom I do not hear. He is not so sure that he will get the seat himself, but says he it will be a great outrage if he does not get it. He has spread a snare for me, has arranged a trap and dug a pit. He expects I shall be caught. We shall see. He has expected such things before this, and he has been disappointed. My trust is in the Lord. He has never forgotten me, nor delivered me to my enemies. He has rescued me from many troubles and he will not desert me in this.
Reading proof of Mr. Eldredge's brief and argument. At the House. Took Mary Alice to hear the Marine Band at the White House grounds.
Attended to my duties to-day and we enjoyed ourselves.
Mr. Eldredge made his argument before the Com. on Elections in my case and was listened to attentively. He occupied 85 minutes. Baskin occupied 5 minutes afterwards. There were present: Harris of Va., Chairman, Thompson of Mass., House of Tenn., De Bolt of Mo., Townsend of N. Y., Baker of Ind. and Wells of Miss. and Brown of Kansas. Absent Blackburn of Ky., Beebe of N. Y. and Poppleton of Ohio. Mr. Eldredge was credited with having made an able argument.
Decoration Day and a holiday. We walked through the Agricultural and Smithsonian grounds and visited the Smithsonian Institute. In evening visited Lafayette Square; had a talk there with Judge Aldis concerning miracles.
Baskin was around lively to-day circulating his brief and argument. At the House. Bro. Milner left to-day. |
I'm a bit early this morning, got some general living going on later that would cause me not to get my last Guest Designer Spot card posted until to late in the day.The challenge this week at Creative Inspirations is: Monochrome. Very easy to choose one color and various shades of that color to create some stunning cards. So hop over to check out what the Design Team has come up with to inspire all of us.
It's hard to believe that the month of February is almost gone. It has been so much fun having my cards featured with the rest of the Design Team on CreativeInspirations this month. One of my goals is to be on a Design Team and since I've already accomplished a couple of goals on my list I'm thinking I might get up enough courage and apply later on this year if some Design Team calls come open. Thanks to the gals at Creative Inspirations for choosing me for the month of February. My card is so appropriate for all the gloomy weather that's been going on all over the world, but as the inside says,"Blue Skies Ahead."
Just a quick bit of clapping. Yesterday after posting about surprises when I went over to The Play Date Cafe to enter my card in the current challenge I found out I had been picked for 1st prize from the previous challenge--Clapping--and I had won 5 sets of digi stamps from Stamps For Life over at Crazy 4 Challenges--More Clapping! The clapping is kind of for myself, but in actuallity I'm clapping for all the wonderful sponsors who generously supply these great prizes for the challenges.
I'm going to enter my card in a couple of other challenges today.
Pile It On! challenge for this week is Get Well Soon and even though my card doesn't say Get Well, when we're not feeling well it's still nice to hear that blue skies are ahead.
Humble Pie challenge for this week is One Type of Embellishment, so my one lone little ribbon qualifies for that.
Thanks again to all who come and view my artistic endeavors and leave such encouraging comments, they are very much appreciated.
Supplies: Card Blank Blue textured card stock 5 1/4" Square, Papers: Stampin Up-Sweet Slumber Specialty Designer Series, CTMH, Stamps: Stampin Up-Font of You, Printworks-Q004 Caring Thoughts, Ink: CTMH-Z2160 Twilight, Ribbon-FX Hobby Lobby, pop dots.
simple and SO very cute! love it, Bev!
with regards to the comment you left - that paper on Melanie's card is the brand new Origins from BasicGrey. we're all head over heels in LOVE with it!
I love this! So simple and elegant. The ribbon on the umbrella is perfect. Thanks for joining us at Humble Pie this week.
This card is beautiful. Just perfect. Thank you for playing with Pile It On! this week. Hope you join us again.
Stunning little simple card! Love it! Thanks for playing with us at Humble Pie!
Wonderful card sweetie! Love your monochrome card!
Wonderful card, Bev!! I love the blue monochromatic color scheme and I think it is perfect for a get well card with that umbrella and the cute sentiment. So happy to have you joining in the fun with Pile it On this week.
Congrats on all the great recognition you've been getting lately and best of luck in your future DT bids! I think we'll be seeing you on a premier DT soon! |
Scene of the Blog Featuring Christina of The Ardent Reader!
This week's featured book blogger travels quite a bit. No, she's not a pampered jet setter, she's a college student whose home is in Montana and whose university is in Massachusetts. Christina is working on a double major in Economics and Geography (specifically Geographic Information Systems), and if she'd had time for a third major, it would have been History.
I'm always open for book recommendations, but I read what interests me. And whether that be the classics, YA fiction, one off the bestsellers list, or the latest steamy romance, I pick the books I read based on my interests. So if my current interest is the Russian Revolution, science fiction, or Amish culture, be prepared for quite a few books on the subject.
Christina doesn't spend much time talking about the technical side or the mechanics of the books she reads. The Ardent Reader is about her interactions with books-- her feelings, her reactions, her understandings. She reads a very eclectic mix of books, and I enjoy reading what she has to say. I hope you take the time to visit her blog and say hello. You just might find yourself subscribing to The Ardent Reader, just as I did!
Enough chatter! Christina's been waiting to take us on a tour, so let's not keep her waiting any longer!
Because I spend roughly half of the year in New England for university and the other half in Montana, I have two separate locations where I blog and read.
This picture is how my room at home looked when I arrived there last May. Pardon the mess! My family had actually just moved into the house. Normally, my suitcases are put away, the pile of papers to sort through on my desk and dresser is much smaller, and my bulletin board is hung up. Promise.
The chair is my favorite place to sit in read because it's a comfortable, quiet place away from the television and the view out my window is quite beautiful.
When I'm at university, I do most of my blogging at the desk in my room. The desk isn't much to look at so I always try to liven it up with reusable stickers. Where I read depends largely on what I'm reading. If I'm reading something for class, I will usually do it at my desk or in the library. I will normally read in bed if the book is for pleasure reading.
Unfortunately, the view out my dorm room isn't much to look at. I see the main road through the city, the backs of a couple of buildings, and a big parking lot. The view from the library is much more interesting.
I love both your views, Christina! Best of luck with your studies, and I'll keep track of what you've been reading on your blog!
Don't forget to stop by next Wednesday when I'll feature another book blogger from our worldwide community!
Wow, I'm so impressed that she has time to keep up a book blog while she's in college! I'm going to check it out now.
I really enjoy Christina's blog, which I discovered when she took part in our WWII challenge awhile back. Like Kathy, I can't believe she can go to college and blog! I never would have been able to do that. In fact, I don't remember reading for pleasure at all when I was in college! Love the blogging spaces; so neat and tidy!
Lovely views!! I especially like that last photo of Massachusetts in autumn. Beautiful!
I was thinking the same thing. ...keeping up a blog and being a college student has to be a lot of work.
I'm in awe that she can handle school and a blog. The Montana view is outstanding. I'd probably just sit and stare rather than read. Must take a look at her blog.
Thank you all for checking out my scene. Reading for pleasure during college is pretty difficult, which is why I primarily end up blogging about the books I'm reading for school. My reading speed slows down considerably but reading is such a passion of mine that I cannot give it up entirely.
Thanks to Christina for sharing her space and her beautiful mountain view. Now I'm off to check out her blog.
Christina, I love the views! I think your school desk is so cute with the stickers. Thanks for letting us see where you read and blog at. |
Our Lodges
River Lodge
Island Lodge
Lodge Rates
At Royal Chundu
Around Royal Chundu
Explore Victoria Falls
Cape Town, Kruger & Victoria Falls
Kruger, Victoria Falls & Botswana
Zambia & Malawi
Kenya & Victoria Falls
Rovos Rail & Victoria Falls
Building Zambia's Future
Chundu Children's Club
Need to Know Before You Go
Languagesen
Archive for: Zambezi Life
A Home For Man & Elephants on the Zambezi
3 November, 2019 | Tamlin Wightman
Elephant! Elephant! Someone shouted behind us. We couldn't discern who. Everyone was running to the edge of the banks, metres from where a low fence of branches had been erected around the little bay leading up to the Malombo village. Br...
The Beauty of Insect Life on the Zambezi
24 September, 2019 | Tamlin Wightman
"If all mankind were to disappear, the world would regenerate back to the rich state of equilibrium that existed ten thousand years ago. If insects were to vanish, the environment would collapse into chaos." ~ E.O. Wilson Insect activit...
Slow Dancing With Elephants
6 October, 2018 | Tamlin Wightman
If you slow anything down, a scene of a chef cooking ramen, water flowing over a rock, a child running into its parents' arms, the romance in the moment reveals itself. The emotion of a simple gesture. The beauty is revealed because you'...
Together, Side By Side
The Mushekwa village is a short boat ride from our lodge. We sit side by side (with it on our left, if you're looking at the river, not from it). To our right is Muluka, the fishing village. We're far away enough from both to allow for t...
10 Rules of Canoe Etiquette When on the Zambezi
24 August, 2018 | Tamlin Wightman
The Tatler's guide to yachting etiquette calls for "no shoes, swagger or silliness, please." You could say the same rules apply to canoeing down the great Zambezi River. Here are a few of our own polite requests... Our 10 Rules of C...
The Music of the Zambezi River
30 March, 2018 | Tamlin Wightman
"If I were not a physicist, I would probably be a musician. I often think in music. I live my daydreams in music. I see my life in terms of music." - Albert Einstein Growing up, my parents played music at every opportunity. Even camping...
For the Love of Forests
We get rather sentimental when we think about forests. Because of how much they mean to us. It's safe to say that we are living right in the thick of one, in our space on the Zambezi's banks. The island itself is one large green lung tha...
We All Need Somewhere Where We Feel Safe
19 February, 2018 | Tamlin Wightman
A sense of safety is something most of us look for when we travel. It determines our destinations, our journeys, and our well-being before, during and after a trip. It allows us a feeling of calm and peace, so that the real work of trave...
An Appreciation For The Little Things
8 February, 2018 | Tamlin Wightman
It's hard to take a bad photo of Royal Chundu and its surrounds, our guest, Tara Turkington, whose images we feature here, told us after her time at the lodge. While we agree, of course, we think it also has a lot to do with Tara's abili...
The Heart of the Zambezi
31 May, 2017 | Tamlin Wightman
The team at Black Bean Productions have captured what we believe to be the heart of the Zambezi, and they have done so, most elegantly, on video, flowing like the great river itself, from our lodge on the riverbank, down to the Victoria ...
In the Garden of Togetherness
As the saying goes, it takes a village to raise a child. And our village, that of Mushekwa, alongside us on the banks of the Zambezi, has many children. Even the children help in raising children. Young boys that reach only to my hips wa...
Breakfast with Monkeys
18 December, 2016 | Tamlin Wightman
Wild animals have perfected the game of playing hard to get. In our relationship with them - one of equality and respect - they make the first move. Should we get impatient, lose ourselves in the excitement, and venture closer, we only s...
And You Thought BBQs Were Just About Food…
17 November, 2016 | Tamlin Wightman
"When I was young I used to watch the night sky for hours, looking for shooting stars. When they fell, I'd go and look for them in my backyard," the traveller beside me on our sunset cruise said, as she gazed up at the night, waiting for...
As We Say in Zambia – Part 1
10 October, 2016 | Tamlin Wightman
Language reveals so much about a country, about what it values most and least. It is a window to the unwritten laws of the land and its people. The traditional proverbs of Zambia, in particular the area around our setting on the upper Za...
Here Comes the Sun, Little Darlin'
Tell me that you too can never sleep on the last night of a holiday. Tell me that you also stay up thinking about all the things that have been and all the things that could still be. Because while it may seem like a burden, it's surely ...
The Infinite Intrigue of the African Skimmer
Whoever said that long distance relationships don't work never fell in love with the African skimmers of the Zambezi River. Perhaps it's easier with birds, though... The skimmers arrive around the month of July, in the dry season, when l...
The Magic of Strange Chances – A Leopard on the Zambezi
19 July, 2016 | Tamlin Wightman
"Many are the strange chances of the world," said Mithrandir in J.R.R. Tolkien's The Silmarillion. Strange chances... those unexpected moments that make the earth feel shaky underfoot, as your body and mind try to readjust to what lie...
5 Places to Practice the Art of Staring out of Windows
Some of us don't need to be reminded to slow down, to take it easy... some of us have procrastination and idleness down to a T. Cats, for instance. They are connoisseurs of this trait. It's something they practice daily, along with the a...
Run, Parrotfish, Run
27 June, 2016 | Tamlin Wightman
"Hobbies are for pleasure, but rituals keep you going." ― David Mitchell The annual Parrotfish Run on the Zambezi is about more than fishing. Taking place between June and August, it is more than a hobby for those who take pa...
For Dads Who Love to Travel
Dads are a diverse breed. They are not one personality, one role, one age. They speak different languages - some use their words, others their hugs; some communicate through quality time, gifts or acts of kindness. Some prefer calm water...
Night Time Is The Right Time
Following on from our feature on sunsets, we bring you a celebration of the night. "Darkness — like silence, like solitude — belongs to that class of blessings increasingly endangered in modern life yet vitally necessary to the human sp...
An Ode to a Hippo
It was morning, becoming late morning quickly. As it does when your head is under the duvet, denying the intrusion of sunlight. And you, an early riser, always, you let me lie in. You didn't make a sound. I would have heard; I was listen...
Moongazers Anonymous
24 April, 2016 | Tamlin Wightman
When you live close to nature, as we do on the Zambezi River, you find yourself taking on a few rather peculiar practices. Obsessive pattern-searching in the clouds and leaves. Potato bush scent-trailing. And, a Royal Chundu favourite......
The Making of a Morning Person
"The moment when you first wake up in the morning is the most wonderful of the twenty-four hours. No matter how weary or dreary you may feel, you possess the certainty that, during the day that lies before you, absolutely anything may ha...
We went as humans, we return as makishi
There is a saying among the Luvale people in Zambia: "We went as makishi, we return as humans." Canoeing on the Zambezi, I feel something quite the opposite. It is a human, mere human, who embarks on the adventure and a makishi who retu...
Nightswimming With Elephants
"I often think that the night is more alive and more richly colored than the day." - Vincent Van Gogh The starry night without doubt transfixed the painter who once uttered the words above, and it captivates us no less. But even more ent...
The Case of the Elusive Zambezi Otter
"... that's the beauty of encounters with the wild... Every moment is one of fortune. And fortune, we believe, favours the patient and grateful, just as much as the brave." We have been practicing what we preach, this art of pati...
Africa's Leading Destination… The Victoria Falls
Image from Batoka Sky, Seasons in Africa Such is nature... Each year the travel world does a tally, a review of the year that's been, of the people and places that stood out. It's called the World Travel Awards and it's an award we wo...
The Life & Times Of A Zambezi Mokoro
26 January, 2016 | Tamlin Wightman
They slip past slowly like birds on the water. Several times throughout the day, even after the sun begins its descent, you'll see one, here and there, with new faces each time. New men at the helm, for it is almost always men. The Tong...
The Season of the Traveller
In December, everyone becomes a traveller. Even those who stay home for the holidays tend to explore their neighbourhood a little more than they would during the rest of the year. The home becomes the guesthouse, a sanctuary of couch nap...
The Mysterious Language of Trees
3 December, 2015 | Tamlin Wightman
The Birds And The Trees There are months when I have more meaningful encounters with trees than people. Maybe that says more about me than the nature of trees, but it isn't because I loathe mankind. Not at all. It is merely due to the ea...
The Animals You'll Meet on the Zambezi
"Some people talk to animals. Not many listen though. That's the problem," said A.A. Milne, Winnie the Pooh creator and general man of underrated wisdom. In our remote setting on the Zambezi, we often see more animal life than human. T...
How To Be Quiet – Unexpected Lessons From Unexpected Guests
We are very grateful for this blog and are greatly saddened when the noise of the outside world keeps us from it. Partly because it allows us, as Anaïs Nin wrote, to taste life twice, and partly because it reminds of the little things th...
The River of Romance
"What the world needs now is love, sweet love. It's the only thing that there's just too little of. What the world needs now is love, sweet love. No not just for some but for everyone..." Of all of nature's forms, the rivers of the wo...
How To Explore The Zambezi
There are many ways to explore the Zambezi River, but only two ways to approach it. With caution and respect. Think of it as a wild horse. With all its beauty and allure, it is still wild. It does bite. But if you follow the rules, it's ...
Tiger Fishing & The Art of Becoming a Man
8 July, 2015 | Tamlin Wightman
Tiger fishing is not for the faint of heart. Not simply because of the fish itself, with its razor teeth... that Hydrocynus vittatus, considered Africa's equivalent of the South American piranha and the first freshwater fish recorded and...
The Secret Life of the Zambezi Elephant
"There is mystery behind that masked gray visage, and ancient life force, delicate and mighty, awesome and enchanted, commanding the silence ordinarily reserved for mountain peaks, great fires, and the sea." - Peter Matthiessen What w...
The Manketti – Zambia's most useful tree
17 May, 2015 | Marina Smithers
The Manketti tree is a large tree, 7 – 20 metres in height, the diameter up to 60 cm. It gets its leaves in mid to end October, flowers and begin to bear fruits end October towards beginning of November. The fruit ripens from February to...
About Royal Chundu
Welcome to the Royal Chundu blog, our love-notes from Zambia, a space where our lodge comes to life and the Zambezi flows through the tales of our guests and staff. Discover more about The Royal Chundu Experience in the pages that lie ahead.
The Answers to Life in the Touch of a Child's Hand
Our Food Philosophy: Is it Good, is it Sustainable, is it Uplifting?
The Great Rhythms of the Victoria Falls
A Birdwatcher's Guide
A Taste of Zambia
For The Explorer
Royal Chundu News
The Faces of Royal Chundu
The Royal Chundu Cocktail Series
Travellers' Thoughts
Zambezi Life
Royal Chundu @RoyalChundu
Village bounty 🍃💛 Sunday harvests with our family in the Malombo village. #essentialtravel… twitter.com/i/web/status/1…
08:46, Sun
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See you on the jetty 💙 #letscruise #theroyalchunduexperience #fridayfeeling @RelaisChateaux @travellermade pic.twitter.com/7EyRRcuTmu
Relais & Châteaux @RelaisChateaux
GO WILD - Resolution #4 - Choose the road less traveled. to.relais.com/RoyalChunduUS pic.twitter.com/2CbrSeDCHK
10 JanRetweeted by Royal Chundu
Island visits from feathered friends ~ Guide Misheck rescued this little juvenile African pygmy kingfisher (Ispidin… twitter.com/i/web/status/1…
Coffee, cookies and cameras on the boat: our favourite morning ritual, waiting for sunrise 💙… twitter.com/i/web/status/1…
Tailor-Made Tours featuring Royal Chundu
Let us help you plan your African itinerary. Enquire now or call us directly: +27 21 469 2652
Kruger, Victoria Falls & BotswanaThe Wild Three
Cape Town, Kruger & Victoria FallsCoast to Cascade
Zambia & MalawiGreat Rivers to Great Lakes
Kenya & Victoria FallsThe Greatest Show on Earth
Rovos Rail & Victoria FallsAn African Voyage
Stay up-to-date with our day-to-day
The Chitenge ~ A Zambian Icon
by Tamlin Wightman on September 16, 2019
The Joy of Cooking with Others ~ A Zambezi Collaboration
by Tamlin Wightman on August 29, 2019
What You Build Builds You ~ A Look at our Zambezi Food Garden
Consideration, Community & "Chef-ery"
by Tamlin Wightman on July 27, 2019
What Peace Is & What Peace Is Not ~ a Zambezi Lesson
We Are Best When We Are Our Unique Selves ~ Royal Chundu Rules
This is a beautiful island with four villas, the staff are outstanding and you feel like it is your second home. The food is excellent and the rooms magnificent with an outside bath. It also accommodates children and I highly recommend this island lodge.
wildlox, Perth
Royal Chundu
HomeVictoria Falls
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Email: [email protected]
Email: [email protected] |
We look forward to hearing from you! Whether you are looking to purchase locally sourced grains, sell Michigan grown grains, participate in community or educational events, partner on research, or even if you have a totally new idea to share, we can't wait to connect. Call or email us anytime, but please send us a note or give us a call before stopping by! |
IVF patient pregnant with wrong embryos
April 14, 2014 — 6.40am
Rome: A woman who underwent fertility treatment at a clinic in Rome became pregnant with the twins of another couple after their embryos were mixed up.
Italy's Health Ministry said it was launching an investigation into the error, which was only discovered when the woman was three months' pregnant.
The mistake happened on December 4, when four different couples were receiving treatment at a specialist fertility unit at the Sandro Pertini Hospital in Rome, Italy's La Stampa newspaper reported on Sunday. It is not clear whether the mistake led to any of the other women becoming pregnant with the wrong baby.
Health Minister Beatrice Lorenzin said investigators would look at whether the hospital had "respected all the legal procedures" and expressed concern she had only learnt about the mistake through press reports.
"The national standards on assisted fertilisation, which are based on European directives, are very rigorous, and if applied correctly, guarantee the traceability of all biological material used in the reproduction process," she said.
The local health authority in Rome said it only became aware there was a problem of "genetic incompatibility" between the parents and the embryos on March 27.
It said it has halted all embryo implantations at the clinic until further notice.
The investigation will be led by geneticist Giuseppe Novelli and will look into whether there was any further mix-up of the embryos of two of the other women. |
Tyler Priest
Energy and Environmental Historian
Oil in American History
The Offshore Imperative
Global Gambits
Articles and Chapters
Editorials and Invited Essays
History and Science of Oil
American Environmental History (Undergraduate)
American Environmental History (Graduate)
U.S. Energy Policy in Global Context
History of Globalization
Honors Research Seminar
Commencement Address 2017
Shell Oil's Deepwater Mission to Mars
Minerals Management Service (MMS)/Bureau of Ocean Energy Management (BOEM) Studies
Gulf Coast Communities and the Fabrication and Shipbuilding Industries
History of the Offshore Oil and Gas Industry in Southern Louisiana
Petroleum Oral Histories
Presidential Commission on the BP Deepwater Horizon Oil Spill
Offshore Hall of Fame (OEC)
The Art of the Deal (AIPN)
Offshore Pioneers (Brown & Root)
UIowa Projects
Save Iowa History
Energy Cultures in the Age of the Anthropocene
The History of History at Iowa
In 1973, the U.S. Department of the Interior established an Environmental Studies Program (ESP) to support the department's offshore oil and gas leasing program, which was conduced by the Bureau of Land Management until 1982, by the Minerals Management Service (MMS) until 2011, and by the Bureau of Ocean Energy Management (BOEM) since 2011. The ESP's statutory authorization comes from the National Environmental Policy Act (NEPA) of 1970 and the Outer Continental Lands Act as amended in 1978. Section 20 of OCSLA authorizes the ESP and establishes three goals for the program:
to establish the information needed for assessment and management of environmental impacts on the human, marine, and coastal environments of the OCS and the potentially affected coastal areas;
to predict impacts on the marine biota which may result from chronic, low-level pollution or large spills associated with OCS production, from drilling fluids and cuttings discharges, pipeline emplacement, or onshore facilities; and
to monitor human, marine, and coastal environments to provide time series and data trend information for identification of significant changes in the quality and productivity of these environments, and to identify the causes of these changes.
Since the mid-1970s, the ESP has commissioned and published hundreds of studies that fall within three main disciplinary categories: 1) Marine Biology; 2) Physical Oceanography; and 3) Socioeconomics. It has funded more than $1 billion in research. Technical studies of more than 1,200 environmental research projects and 3,400 research reports are available online through the Environmental Studies Program Information System (ESPIS). Since 2000, I have been involved with three MMS/BOEM funded socioeconomic studies for the agency's Gulf of Mexico Region. Descriptions of these studies can be found in the sidebar menu attached to this page.
BOEM, "The Offshore Petroleum Industry in the Gulf of Mexico: A Continuum of Activities"
During 2005-2011, I also served as a member of the Outer Continental Shelf Advisory Committee, which advises the Director of BOEM and the Secretary of the Interior on the scientific quality and value for decision-making of the ESP.
Associate Professor of History and Geography, University of Iowa
280 Schaeffer Hall
[email protected] |
As a CSP, you can see the customer information based upon the service profile requirements you specified. You'll also see the CSP-side information that you'll provide when you accept a pending request.
You can manage your connection requests from your dashboard.
Once a customer makes a connection request, the pending order displays in the "Important For You" section of your dashboard. Click Accept or Reject Connection to view the connection request details page. After reviewing the details, you have the option to accept or reject the request.
If you accept the request, click Accept Connection. In the "Service Provider Connection Details" section, select the required ports and enter the VLAN ID numbers.
If you turn down the request, click Reject Connection. In the "Service Provider Connection Details" section, enter the reason for rejection. Click Confirm Reject Connection. On the customer's dashboard, a "Connection Request Rejected" card displays, with the reason(s) listed. |
using System;
using System.Collections.Generic;
using System.Threading.Tasks;
using Caliburn.Micro.Xamarin.Forms;
using EasyStocks.Model;
using EasyStocks.Settings;
using EasyStocks.ViewModel;
using Xamarin.Forms;
using INavigationService = EasyStocks.ViewModel.INavigationService;
using IXamarinNavigationService = Caliburn.Micro.Xamarin.Forms.INavigationService;
using Caliburn.Micro;
namespace EasyStocks.App.Platform
{
public class XamarinNavigationServiceAdapter : INavigationService
{
private readonly IXamarinNavigationService _xamarinNavigationService;
// container is needed so that we can create view models directly
private readonly SimpleContainer _container;
private int _pageCount = 0; // we count how many pages were added to the root page so we know when we reach the top
public XamarinNavigationServiceAdapter(
IXamarinNavigationService xamarinNavigationService,
SimpleContainer container)
{
_xamarinNavigationService = xamarinNavigationService;
_container = container;
}
public void NavigateToCreateAccountItem(ShareDailyInformation shareInfo)
{
_pageCount++;
// in order to create the view model, the parameters must either be provided
// as dictionary (which does not work for us, since we want to set all parameters at once)
// or by using a single parameter which will be set to the "Parameter" property.
_xamarinNavigationService.NavigateToViewModelAsync<AccountItemCreateViewModel>(shareInfo);
}
public void NavigateToEditAccountItem(IEnumerable<AccountItemId> accountItemIds)
{
_pageCount++;
_xamarinNavigationService.NavigateToViewModelAsync<AccountItemEditViewModel>(accountItemIds);
}
public void NavigateToPortfolio()
{
if(_pageCount > 0)
_xamarinNavigationService.GoBackToRootAsync();
_pageCount = 0;
}
public void NavigateToSearchView()
{
_pageCount++;
_xamarinNavigationService.NavigateToViewModelAsync<SearchShareViewModel>();
}
public async Task NavigateToStorageSelection(ApplicationSettings settings)
{
_pageCount++;
// there is only one instance of this view model, so we can get it from the container
var selectStorageByUser = _container.GetInstance<StorageSelectionViewModel>();
await _xamarinNavigationService.NavigateToViewModelAsync<StorageSelectionViewModel>(settings);
// when the dialog closes, it should set its task state
await selectStorageByUser.ViewModelClosedTask;
}
public async Task NavigateToDropBoxLogin(ApplicationSettings settings)
{
_pageCount++;
var dropboxLogin = _container.GetInstance<DropboxLoginViewModel>();
await _xamarinNavigationService.NavigateToViewModelAsync<DropboxLoginViewModel>(settings);
await dropboxLogin.ViewModelClosedTask;
}
}
}
|
GAIL TRUNICK
studio process and tour
Gail Trunick lives and works in the small, rural northeastern Ohio town of Burghill. Gail grew up eight in a family of nine children. Her father died in a steel mill accident and she was raised by her mother who made her living as a potter. Much of her childhood was enjoyably spent going to outdoor art shows, peddling her mother's smoked stoneware vessels. From this began a lifelong adventure in the arts, not only for her but also for several of her siblings.
Gail graduated with a BFA from Kent State University with a major in painting in 1980. Soon after graduating, and with the subsequent death of her mother, she found herself more and more drawn to the clay and earth that are her roots. Since this time her artistic concentration has been clay and mixed-media sculpture. Her resume includes numerous one-woman and group exhibitions and she has works included in numerous public and private collections.
"I work with gritty, grog-filled clay that lends itaelf to rough, gestural expression. It refuses to smooth or soften into fine detail, but rather gives way to textural statements filled with pronouncements of life's lessons.
My work represents life filled with moments frozen in time, moments where, as humans, we have had to reach for strength, for better understanding and for a deeper depth of meaning.
These stoneware pieces are completed in a single firing and my finishes are created using a variety of methods and materials. Very loose, painterly applications add texture and layers that convey the building up of time and character. As youth is still soft in color, texture and line, age increases the layers and depth. Often incorporating discarded objects into my sculpture, they not only provide contrast in material but add to the narrative with their individual stories and symbolism."
– Gail Trunick
[email protected] |
US President Barack Obama ends his tenure on Friday and would no longer reside in the post of the President of United Sates of America. The 44th President of US Mr.Obama has the highest number of followers on the social media so far. Indian PM Narendra Modi would be the next to have the maximum number of social media followers.
Once after Mr.Obama's exit from the White House to make way for the President-elect Donald Trump, Indian Prime Minister Narendra Modi would become the most followed leader of a country on the Twitter site. Mr.Barack Obama has almost of about 81 million followers ahead of any other global leader in the world.
Indian PM Narendra Modi has got 26.5 million followers, ahead of Mr.Donald Trump, the 45th President of US who has 20.5 million followers. The next most followed account after them was the Prime Minister's Office (PMO) Indian account with 15.5 million followers and 13.6 million followers for the Presidents of the United States (POTUS).
The White House stands the next with 13.4 million followers. Dalai Lama was the next leader to have about 13.1 million followers and Pope with 12.5 million followers.
Indian PM Modi have got even more followers with 39.2 million on the Facebook, 3.2 million on Google+, while his Instagram account has crossed 5.8 million, 1.99 million on LinkedIn and YouTube followings have crossed 5.9 million followers.
PM Modi is also known for the use of social media to campaign, and directly reach out to voters like Obama and Trump. Social networking platforms have also been used widely by various leaders in India, particularly from the ruling party such that to reach out to the public for the day to day activities.
Noteworthily, not all the world leaders were followed more on the social medias rather the entertainers like Katy Perry sets the top position with 95.3 million followers, the second place by Justin Bieber with 91.2 million and Taylor Swift as third with 83.1 million followers.
YouTube is the most followed organization with 66.1 million on Twitter while Twitter itself to have about 58.6 million users.
The most interesting factor are that the number of accounts followed by these leaders. Mr.Donald Trump has the most curated list who just follows 42 accounts whereas Mr.Modi follows 1,641 accounts and the highest being Mr.Obama's Twitter handle that follows a whopping of about 631,987 accounts. |
Trigger For Autoimmune Disease Identified
FeaturedGeneticsNeurologyOpen Neuroscience Articles
Summary: Researchers have discovered a possible trigger for autoimmune diseases such as lupus, Crohn's disease and MS. Findings may explain how women are more susceptible to autoimmune disorders than men.
Source: National Jewish Health.
Newly identified cells help explain why women suffer autoimmune disease more often.
Researchers at National Jewish Health have identified a trigger for autoimmune diseases such as lupus, Crohn's disease and multiple sclerosis. The findings, published in the April 2017 issue of Journal of Clinical Investigation, help explain why women suffer autoimmune disease more frequently than men, and suggest a therapeutic target to prevent autoimmune disease in humans.
"Our findings confirm that Age-associated B Cells (ABCs) drive autoimmune disease," said Kira Rubtsova, PhD, an instructor in biomedical science at National Jewish Health. "We demonstrated that the transcription factor T-bet inside B cells causes ABCs to develop. When we deleted T-bet inside B cells, mice prone to develop autoimmune disease remained healthy. We believe the same process occurs in humans with autoimmune disease, more often in elderly women."
Autoimmune diseases occur when the immune system attacks and destroys the organs and tissue of its own host. Dozens of autoimmune diseases afflict millions of people in the United States. Several autoimmune diseases, including lupus, rheumatoid arthritis and multiple sclerosis strike women two to 10 times as often as men. Overall, about 80 percent of autoimmune patients are women. There is no cure for autoimmune disease.
B cells are important players in autoimmune disease. The National Jewish Health research team, led by Chair of Biomedical Science Philippa Marrack, PhD, previously identified a subset of B cells that accumulate in autoimmune patients, autoimmune and elderly female mice. They named the cells Age-associated B cells, or ABCs. Subsequent research showed that the transcription factor T-bet plays a crucial role in the appearance of ABC.
Transcription factors bind to DNA inside cells and drive the expression of one or several genes. Researchers believe that T-bet appears inside cells when a combination of receptors on B-cell surfaces — TLR7, Interferon-gamma and the B-cell receptor — are stimulated. NeuroscienceNews.com image is for illustrative purposes only.
Transcription factors bind to DNA inside cells and drive the expression of one or several genes. Researchers believe that T-bet appears inside cells when a combination of receptors on B-cell surfaces — TLR7, Interferon-gamma and the B-cell receptor — are stimulated.
Through breeding and genetic techniques the research team eliminated the ability of autoimmune-prone mice to express T-bet inside their B cells. As a result, ABCs did not appear and the mice remained healthy. Kidney damage appeared in 80 percent of mice with T-bet in the B cells and in only 20 percent of T-bet-deficient mice. Seventy-five percent of mice with T-bet in their B cells died by 12 months, while 90 percent of T-bet-deficient mice survived 12 months.
"Our findings for the first time show that ABCs are not only associated with autoimmune disease, but actually drive it," said Dr. Rubtsova.
ABCs have attracted increasing interests since their discovery in 2011. Dr. Rubtsova and her colleagues at National Jewish Health have expanded their study of ABCs beyond autoimmune disease and are looking at their involvement in sarcoidosis, hypersensitivity pneumonitis and chronic beryllium disease.
About this neuroscience research article
Funding: Funding provided by US Public Health Service, National Institutes of Health.
FeaturedNeuroscienceOpen Neuroscience ArticlesPsychology
Placebo Reduces Feelings of Guilt
Source: William Allstetter – National Jewish Health
Image Source: NeuroscienceNews.com image is in the public domain.
Original Research: Full open access research for "B cells expressing the transcription factor T-bet drive lupus-like autoimmunity" by Kira Rubtsova, Anatoly V. Rubtsov, Joshua M. Thurman, Johanna M. Mennona, John W. Kappler, and Philippa Marrack in Journal of Clinical Investigation. Published online February 27 2017 doi:10.1172/JCI91250
Cite This NeuroscienceNews.com Article
[cbtabs][cbtab title="MLA"]National Jewish Health "Trigger For Autoimmune Disease Identified." NeuroscienceNews. NeuroscienceNews, 10 May 2017.
<https://neurosciencenews.com/autoimmune-disease-triggers-6641/>.[/cbtab][cbtab title="APA"]National Jewish Health (2017, May 10). Trigger For Autoimmune Disease Identified. NeuroscienceNew. Retrieved May 10, 2017 from https://neurosciencenews.com/autoimmune-disease-triggers-6641/[/cbtab][cbtab title="Chicago"]National Jewish Health "Trigger For Autoimmune Disease Identified." https://neurosciencenews.com/autoimmune-disease-triggers-6641/ (accessed May 10, 2017).[/cbtab][/cbtabs]
B cells expressing the transcription factor T-bet drive lupus-like autoimmunity
B cells contribute to multiple aspects of autoimmune disorders and may play a role in triggering disease. Thus, targeting B cells may be a promising strategy for treating autoimmune disorders. Better understanding of the B cell subsets that are responsible for the development of autoimmunity will be critical for developing efficient therapies. Here we have reported that B cells expressing the transcription factor T-bet promote the rapid appearance of autoantibodies and germinal centers in spontaneous murine models of systemic lupus erythematosus (SLE). Conditional deletion of T-bet from B cells impaired the formation of germinal centers and mitigated the development of kidney damage and rapid mortality in SLE mice. B cell–specific deletion of T-bet was also associated with lower activation of both B cells and T cells. Taken together, our results suggest that targeting T-bet–expressing B cells may be a potential target for therapy for autoimmune diseases.
"B cells expressing the transcription factor T-bet drive lupus-like autoimmunity" by Kira Rubtsova, Anatoly V. Rubtsov, Joshua M. Thurman, Johanna M. Mennona, John W. Kappler, and Philippa Marrack in Journal of Clinical Investigation. Published online February 27 2017 doi:10.1172/JCI91250
Feel free to share this Neuroscience News.
ABCsage associated b cellsautoimmune diseasesB cellsCrohn's diseaseGeneticsHealthLupusMultiple SclerosisNational Jewish HealthneurobiologyNeurologyNeuroscienceOpen Accessopen scienceSLET cellsTLR7
Julie Hunt says:
Really grateful that someone is looking into AI diseases. It's long overdue. Please keep up the fantastic work.
Betsy RIley says:
Very promising news. Good to see attention given to this class of diseases.
Jeannette says:
I have enjoyed and learned so much from your research findings. As I and a family members have autoimmune diseases, your findings are so helpful. Thank you so much … |
ITMinds Limited signs an agreement with Pakistan Petroleum Limited (PPL) for Back Office Services for PPL's Retirement Funds
CDC/Media Center/News/ITMinds Limited signs an agreement with Pakistan Petroleum Limited (PPL) for Back Office Services for PPL's Retirement Funds
Karachi October 6, 2021: Pakistan Petroleum Limited (PPL) & ITMinds Limited (ITMinds), a wholly owned subsidiary of Central Depository Company of Pakistan Limited (CDCPL), have signed an agreement enabling ITMinds to provide Back Office Accounting Services for PPL's Retirement Funds. This is a continuation of an earlier arrangement between ITMinds and PPL through which ITMinds had been successfully providing these BPO services to PPL.
Through this arrangement, ITMinds will facilitate PPL for the accounting and administration of PPL's Retirement Funds, including Pension, Provident and Gratuity funds, allowing PPL to focus on its investment decisions by leveraging ITMinds' state of the art back office system and IT infrastructure while reaping the benefits of economies of scale.
Commenting on the occasion, Syed Rahat Hussain Naqvi, Senior Manager Finance-PPL, emphasized the importance of automation of back-office services for retirement funds for both process improvement as well as cost optimisation. He further appreciated how this arrangement with ITMinds in the last three years has helped to provide uninterrupted services, especially during the pandemic induced circumstances. Also commenting on the occasion, Mr. Iqleem-uz-Zaman Khan, CEO – ITMinds, said that considering this is an era of specialization, ITMinds' BPO services of fund accounting & administration enable companies to outsource their back office functions to a competent and reliable BPO partner while achieving efficiency, scalability & transparency of processes. The event was also attended by, Mr. Shariq Jafrani CFO-CDC, Mr. Waqas Ashraf CFO- ITMinds, Mr. Muneer Hussain Manager Shared Services-PPL, Mr. M. Tarique Sheikh Senior Accountant-PPL and Mr. Salman Iqbal, Manager- ITMinds. |
Cloning, expression, and characterization of a peptidoglycan hydrolase from the Burkholderia pseudomallei phage ST79
Nittaya Khakhum1,
Umaporn Yordpratum2,
Atcha Boonmee3,
Unchalee Tattawasart2,
Jorge L. M. Rodrigues4,5 &
Rasana W. Sermswan1
The lytic phage ST79 of Burkholderia pseudomallei can lyse a broad range of its host including antibiotic resistant isolates from within using a set of proteins, holin, lysB, lysC and endolysin, a peptidoglycan (PG) hydrolase enzyme. The phage ST79 endolysin gene identified as peptidase M15A was cloned, expressed and purified to evaluate its potential to lyse pathogenic bacteria. The molecular size of the purified enzyme is approximately 18 kDa and the in silico study cited here indicated the presence of a zinc-binding domain predicted to be a member of the subfamily A of a metallopeptidase. Its activity, however, was reduced by the presence of Zn2+. When Escherichia coli PG was used as a substrate and subjected to digestion for 5 min with 3 μg/ml of enzyme, the peptidase M15A showed 2 times higher in lysis efficiency when compared to the commercial lysozyme. The enzyme works in a broad alkaligenic pH range of 7.5–9.0 and temperatures from 25 to 42 °C. The enzyme was able to lyse 18 Gram-negative bacteria in which the outer membrane was permeabilized by chloroform treatment. Interestingly, it also lysed Enterococcus sp., but not other Gram-positive bacteria. In general, endolysin cannot lyse Gram-negative bacteria from outside, however, the cationic amphipathic C-terminal in some endolysins showed permeability to Gram-negative outer membranes. Genetically engineered ST79 peptidase M15A that showed a broad spectrum against Gram-negative bacterial PG or, in combination with an antibiotic the same way as combined drug methodology, could facilitate an effective treatment of severe or antibiotic resistant cases.
A bacteriophage or phage is the virus of bacteria that is very specific to its host. It can replicate, multiply after transfection and either lyse the host or become integrated into its genome (Golkar et al. 2014). Eastern Europe such as Poland and Georgia reported the phage as an alternative therapy for infectious diseases (Abedon et al. 2011). Phage therapy has also been evaluated in the United States (Ho 2001). The discovery of antibiotics changed the paradigm of curing infectious diseases and helped protect enormous numbers of people who suffered from bacterial infections in the twentieth century, however, the numbers of antibiotic-resistant bacteria have also increased (Golkar et al. 2014). Even though the post-antibiotic era is not at hand, the use of broad-spectrum antibiotics has proven to disturb the beneficial bacterial community in humans and animals, especially gut microbiota, that affect immunity (O'Hara and Shanahan 2006; Round and Mazmanian 2009). Therefore, the use of phages as an alternative treatment came under the spotlight again because the phage is highly specific, can overcome antibiotic resistant bacteria and are available in large quantities in nature.
The enzymes related to the lysis mechanism of the phages that are used to lyse the bacterial host during the release of their progeny have been studied and revealed the classical holin-endolysin lysis system found in phages of both Gram-positive and Gram-negative bacteria (Young et al. 2000). Holin is used to make pores in the cytoplasmic membrane that assists endolysin to access and cleave peptidoglycan to lyse the bacteria from the inside out. In addition, some phages of Gram-negative bacteria also have Rz/Rz1 or lysB/lysC accessory proteins that help in the lysis of the process (Berry et al. 2008). Endolysins have been considered as a new class of antibiotics as they can destroy the peptidoglycan (PG) of Gram-positive bacterial cell walls. Endolysin has five specific activities on PG which are muramidase (lysozyme), transglycosylase, glucosaminidase that digests N-acetylmuramic acids (NAM) and N-acetylglucosamine (NAG), amidase that digests NAM and peptides and endopeptidases digested within the peptide chain of PG (Borysowski et al. 2006). The enzymes or the phages themselves are extensively applied in several fields, for example, the food industry and biological control of unwanted bacteria (Ruyter et al. 1997) including pathogenic bacteria in medicine as it shows neither toxicity nor stimulates hyperimmune sera in the mouse model (Jado et al. 2003).
Burkholderia pseudomallei is a Gram-negative soil bacterium that causes severe septic infectious disease called melioidosis. The disease can be found in both humans and animals in endemic areas (Leelarasamee and Bovornkitti 1989). This pathogenic bacterium is intrinsically resistant to several antibiotics and it can produce high levels of biofilms that protect the bacterium from the killing by either antibiotics or the host immune response (Sawasdidoln et al. 2010; Pibalpakdee et al. 2012; Mongkolrob et al. 2015). The drug of choice is a third generation cephalosporin such as ceftazidime that needs long-term treatment to prevent relapse. Currently, there is no commercial vaccine available (Limmathurotsakul et al. 2015). Phages that have shown some specificity in lysing B. pseudomallei have been reported (Sariya et al. 2006; Yordpratum et al. 2011; Gatedee et al. 2011; Kvitko et al. 2012; Guang-Han et al. 2016). The genome of ST79, a novel lytic phage that lyses B. pseudomallei was sequenced and submitted to GenBank (GI:509141608) (manuscript in preparation). The lysis cassette of ST79 was also characterized (Khakhum et al. 2016) and its modified phages were shown to lyse a wide range of B. pseudomallei isolates and could significantly reduce biofilm formation of the bacteria especially at the early stage of attachment (Kulsuwan et al. 2015).
In this study, the peptidase M15A, known as endolysin or peptidoglycan hydrolase from the ST79 lytic phage that could lyse a broad spectrum of B. pseudomallei and other Gram-negative bacteria from within was cloned, expressed and characterized. More information on the enzymes and phages themselves could facilitate the application of them as adjunct standard antibiotic therapy for B. pseudomallei.
Bacterial strains and ST79 phage
Burkholderia pseudomallei strain P37 was isolated from a blood sample from a patient admitted to Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand. The B. pseudomallei lytic phage ST79, isolated from soil in the northeast of Thailand, was used as a source of the peptidase M15A for cloning (Yordpratum et al. 2011). Escherichia coli BL21 (DE3) was used as the host for cloning and protein expression processes (Thermo Fisher Scientific, Waltham, MA, USA). Eighteen Gram-negative bacteria, five of which were E. coli host strains; Top10, LMG194 (Invitrogen, CA, USA), DH5α, BL21 (DE3) and XL1-Blue (Thermo Fisher Scientific, Waltham, MA, USA), two B. pseudomallei isolates, P37 and G1; two Burkholderia mallei isolates, EY2233 and EY2237; Burkholderia thailandensis UE5 (kindly provided by MORU, Mahidol University, Thailand), Klebsiella pneumoniae, Vibrio parahaemolyticus, Pseudomonas vasculitis, P. aeruginosa, Acinetobacter baumannii, Salmonella gr. D, Shigella gr. D and Citrobacter freundii and seven Gram-positive bacteria included Enterococcus sp., Streptococcus epidermidis, Staphylococcus aureus, Bacillus sp., Micrococcus sp., β-streptococcus gr. B and Corynebacterium diphtheria were obtained from the Department of Microbiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand and used in this study. All of bacterial strains and ST79 phage were deposited in culture collection belonging to World Data Centre For Microorganism (WDCM) as MRCKKU (registration number 1130). ST79 phage is available for research collaborators.
Bioinformatic analysis
The peptidase M15A amino acid sequence (YP_008060500.1) from the ST79 phage genome (NC_02134.1) was submitted to BLASTP homology search (Altschul et al. 1997) in the NCBI database (http://www.ncbi.nlm.nih.gov/). The peptidase information resource and sequence analysis were performed by the MEROPS batch Blast tool (Rawlings and Morton 2008). The Interproscan 4 software v.4.8 (Zdobnov and Apweiler 2001) was used to analyze protein functional domains. The protein conserved domain and structure was predicted using Pfam (Finn et al. 2016) and SWISS-MODEL (Biasini et al. 2014).
ST79 phage propagation and DNA extraction
The ST79 lytic phage was propagated in liquid culture using B. pseudomallei strain P37 as the propagating strain (Yordpratum et al. 2011). The phage DNA was extracted with a phenol–chloroform extraction method as described elsewhere (Sambrook and Russell 2001).
Cloning and expression of peptidase M15A and Western blot analysis
The peptidase M15A gene was amplified from the ST79 genomic DNA by the polymerase chain reaction (PCR) using in house designed peptidase M15A forward primer (5′-TATAAAGAGCTCTATGCAGTTGACGGACCATTTC-3′) with SacI restriction site (underlined sequence) and a peptidase M15A reverse primer (5′-ATAATAGGTACCTCATGCGCCCACCGTGTA-3′) with the KpnI restriction site (underlined sequence). The PCR product was cloned into the pQE31 vector (Qiagen, Hilden, Germany) containing the N-terminal 6xhistidine tag and transformed into E. coli BL21 (DE3). E. coli cells containing the recombinant plasmid with peptidase M15A gene were propagated in Luria and Bertani (LB) medium containing 100 µg/ml ampicillin until mid-exponential phase (OD600 nm = 0.6) and induced with 1 mM final concentration of isopropyl-β-d-thiogalactopyranoside (IPTG) (Sigma, St. Louis, Missouri, USA). Cells were further cultured for 4 h and collected as a pellet followed by sonication (10 cycles of 30 s pulses and 30 s rest at 200 Watts in an ice bath, MSE Soniprep 150, MSE, London, UK) in 5 ml lysis buffer (50 mM NaH2PO4, 300 mM NaCl, 10 mM imidazole pH 8.0). The protein supernatant and pellet fractions were separated by 15 % SDS-PAGE (Sambrook and Russell 2001) using the Novex Sharp Pre-Stained Protein Standard (Thermo Fisher Scientific, Waltham, MA, USA) as the protein molecular weight marker, then blotted onto nitrocellulose by a semi-dry blotting system (BioRad, CA, USA). The proteins on the membrane were detected by anti-6X His tag® antibody (HRP) (Abcam, Cambridge, UK) and chemiluminescent SuperSignal West Pico Chemiluminescent Substrate (Thermo Fisher Scientific, Waltham, MA, USA).
The recombinant E. coli BL21 (DE3) containing the peptidase M15A gene-plasmid was induced by IPTG and the His-tagged proteins inside E. coli cells were purified using Ni–NTA agarose (Qiagen, Hilden, Germany) by a gravity-flow chromatography method. SDS-PAGE was used to analyze the eluted fractions for the 18 kDa of the peptidase M15A protein. The fraction containing the protein was refolded by buffer exchanging with 25 mM sodium acetate buffer, pH 6.5 and filtered through the Amicon® Ultra 10 K centrifugal filter device (Millipore, Darmstadt, Germany) according to the manufacturer's instructions. The purified protein was quantified by the bicinchoninic acid assay (BCA assay) (Thermo Fisher Scientific, Waltham, MA, USA) according to the manufacturer's instructions using a Spectronic 20D+ spectrophotometer (Thermo Fisher Scientific, Waltham, MA, USA).
Zymogram analysis
The peptidase M15A enzyme activity was observed using zymogram or renaturing SDS-PAGE (Piuri and Hatfull 2006) with some modifications as follows: An overnight culture of E. coli XL1-Blue (0.2 % w/v) was autoclaved and added to the SDS-PAGE solution (15 % w/v) before polymerization. The purified peptidase M15A enzyme was mixed with 2× sample-refolding buffer (0.5 mM Tris–HCl pH 6.8, 20 % glycerol, 0.2 % bromophenol blue), then loaded into the SDS-PAGE containing E. coli. After electrophoresis, the gel was incubated at 37 °C for 16 h in 1 % triton X-100, 25 mM Tris–HCl pH 8.5 and washed once with water and stained for 3 h with 0.5 % methylene blue in 0.01 % KOH. The peptidoglycan hydrolase activity of peptidase M15A on E. coli lysate was observed as a clear zone.
The outer membrane of E. coli XL1-Blue was permeabilized by chloroform to expose the peptidoglycan for digestion as described by Lavigne et al. (2004) with some modifications and used as the substrate for peptidase M15A. In brief, bacteria were grown until the mid-exponential phase (OD600 nm = 0.6), then centrifuged at 4000g at 4 °C, for 15 min to collect the cell pellet. The outer membranes were permeabilized by chloroform-saturated 0.05 M Tris–HCl buffer, pH 7.5 and gently shaken at room temperature for 45 min. The permeabilized E. coli were then washed, resuspended in 10 mM phosphate buffer, pH 8.0 and adjusted to OD600 nm = 0.6–1.0. The E. coli suspension of 270 µl was added into 96-well BD Falcon microplates (BD Bioscience, San Jose, CA, USA), then the purified peptidase M15A enzyme was added at the amount of 0.1 (0.3 μg/ml), 0.5 (1.6 μg/ml), 1 (3 μg/ml) and 5 μg (16 μg/ml) (30 µl) and the turbidity reduction at OD600 nm was measured by a Gen5 microplate reader (Biotek, Vermont, USA) as the kinetic assay for 15 min (1 min time intervals). The chicken egg white lysozyme (Sigma, St. Louis, Missouri, USA) (3 μg/ml) was used as a positive control and 10 mM phosphate buffer, pH 8.0, was used as a negative control (Briers et al. 2007a).
The effect of pH, temperature and divalent metal ions
To evaluate the effect of pH on enzymatic activity, permeabilized E. coli XL1-Blue cells were resuspended in 900 μl of 10 mM citrate buffer for pH 3.0–5.5, 10 mM phosphate buffer for pH 6.0–7.0 or 10 mM Tris–HCl buffer for pH 7.5–9.0 and then 100 μl of enzyme (5 μg) was added. The percentage of OD600 nm reduction was determined after incubation at 30 °C for 15 min. The effect of temperatures at 25, 30, 37 and 42 °C on enzyme activity were tested in the same manner at pH = 8.0.
The effect of metal ion, particularly Zinc, on enzyme activity was observed using 100 μl (5 μg) of purified peptidase M15A mixed with 900 μl of permeabilized E. coli XL1-Blue cells (OD600 nm ~ 1.0) in various concentrations of ZnCl2 (5, 10, 50 and 100 μM), MgCl2, MnCl2 or CaCl2 (100 and 1000 μM). The relative lytic activity was calculated as follows: {ΔOD600 nm sample (endolysin added) − ΔOD600 nm (buffer only)}/initial OD600 nm (Plotka et al. 2015) and compared with the control without metal ions for 100 % of relative activity (Son et al. 2012).
Spectrum of antibacterial lytic activity
A total of 18 Gram-negative and seven Gram-positive bacteria were tested for the peptidoglycan hydrolase spectrums. Gram-negative bacteria were permeabilized by chloroform and their peptidoglycans were used as substrates for enzyme digestion as previously described (Briers et al. 2007a). For Gram-positives, each strain was grown to mid-exponential phase then centrifuged at 3000g to collect cell pellets. The pellets were washed and resuspended in 10 mM phosphate buffer pH 8.0, the OD600 nm to 0.6–1.0 was adjusted. To test the spectrum of antimicrobial lytic activity, 5 and 20 μg in 100 μl of purified peptidase M15A was added into 900 μl permeabilized cell suspensions of Gram-negative or cell suspension of Gram-positive. The score was estimated from % relative lytic activity after incubation at 30 °C for 15 min. The % relative activity was defined as—(no lytic activity), + (1–30 %), ++ (31–60 %) and +++ (61–100 %) (Son et al. 2012).
The data of OD600 nm in the turbidity reduction test at different pHs and temperatures were analyzed by a Student's t test and with a p value of <0.05 considered as significant.
Peptidase M15A sequence analysis
The protein sequence of peptidase M15A from the lytic phage ST79 showed a conserved domain as Peptidase_M15_3 (PF08291) when analyzed by BLASTP and Pfam (Fig. 1a). The Interproscan 4 (version 4.8) protein functional domain indicated a Hedgehog signaling/DD-peptidase zinc-binding domain (SSF55166). The SWISS-MODEL protein structure prediction was matched with the 1lbu.1.A template, which was muramoyl-pentapeptide carboxypeptidase (MEROPS data). When the MEROPS batch Blast tool was used to detect peptidases and their non-peptidase homologues sequences in ST79 genome, it showed common amino acids among peptidases found in other bacterial genome, such as: B. glumae, B. thailandensis, B. cenocepacia, Burkholderia sp. CCGE1002, Asticcacaulis excentricus and Pseudomonas putida but not B. pseudomallei and B. mallei (Fig. 1b). This study's analysis also identified a homologue catalytic domain from amino acid positions 3 to 134 (total 132 residues) with peptidase from P. putida (MER087996). The active site residues were located at the tryptophan (W117H) position and metal ligands at histidine (H77), aspartic acid (D84) and histidine (H119) (Fig. 1c). The analysis also indicated the presence of motifs HXXXXXXD and WXH, which were typical for peptidase M15 subfamily A.
The bioinformatics analysis of ST79 peptidase M15A protein sequence. a The Peptidase_M15_3 conserved domain analyzed using Pfam; #HMM: consensus of the Hidden Markov Models (HMMs), Capital letters indicated the most conserved positions, #MATCH: the match between the query sequence and the HMM, ' + ' indicates a positive score which can be interpreted as a conservative substitution, #PP: posterior probability, which is the degree of confidence in each individual aligned residue, 0 means 0–5 %, 1 means 5–15 % and so on and 9 means 85–95 %, '*' means 95–100 % posterior probability, #SEQ: query sequence, '-' indicated deletions in the query sequence with respect to the HMM, b Multiple alignment of peptidase protein sequences from the MEROPS database showed identity of peptidase M15A sequence from ST79 phage with peptidase enzymes from B. glumae, B. thailandensis, B. cenocepacia, Burkholderia spp. CCGE1002, A. excentricus and P. putida using the CLUSTAL X program. Conserved amino acids of all sequences were marked with an asterisk. c The full amino acids sequence analysis of ST79 peptidase M15A using MEROPS batch Blast. The peptidase unit was labeled in green, active site in red, metal ion ligand in orange and the conserved domain in underlined letters
Expression, purification and zymogram analysis of the Peptidase M15A
The peptidase M15A gene was successfully cloned and expressed in E. coli BL21 (DE3). The estimated molecular weight of purified peptidase M15A on SDS-PAGE was approximately 18 kDa (with 6xhis tag) (Fig. 2). For zymogram analysis, the peptidase M15A enzyme in the gel lysed the peptidoglycan substrate from E. coli in which it appeared as a transparent band (Fig. 2).
The SDS-PAGE analysis of proteins and zymogram analysis of the lytic activity of Peptidase M15A against E. coli peptidoglycan. The Coomassie Brilliant blue stained SDS-PAGE gel shows protein molecular weight marker (M), induced E. coli cells containing pQE31 vector (lane 1), induced cells containing peptidase M15A/pQE31 plasmid (lane 2), 5 μg of purified peptidase M15A protein (lane 3) and the zymogram that is stained with 0.1 % methylene blue in 0.01 % KOH of SDS-PAGE refolding gel (lane 4). The clear lysis of PG substrate by the enzyme on zymogram located at the same position of the over-expressed protein band in lane 2 and purified enzyme in lane 3. The arrow indicates the 18 kDa lytic band of peptidase M15A
Lytic activity test
At the concentration of 1.6 μg/ml onward at 5 min of digestion, the enzyme reduced the turbidity of permeabilized E. coli XL1-Blue more than the lysozyme. When longer times of 10 and 15 min were observed, the turbidities from each concentration including lysozyme were similar. When the same concentrations of lysozyme and purified peptidase M15A (3 μg/ml) were compared at 5 min of digestion, the lysozyme gave a 22 % relative lytic activity while the peptidase M15A resulted in 52 %. The purified peptidase M15A digested the substrate approximate 2 times more than the lysozyme at this point (Fig. 3).
The turbidity reduction curve of peptidase activity against chloroform-treated E. coli. The peptidase M15A activity of various amounts was used to lyse chloroform E. coli XL1-Blue cell suspensions. The graph of turbidity reduction using peptidase M15A of 0.3 μg/ml (filled triangle), 1.6 μg/ml (filled circle), 3 μg/ml (open triangle) and 16 μg/ml (open circle) were evaluated. Phosphate buffer (filled square) was used as a negative control and 3 μg/ml of lysozyme (filled diamond) was used as positive control. Each point represents the mean of triplicate experiments and error bars indicate the standard deviation (SD)
Effect of pH, temperature and divalent metal ions on the enzyme activity
The peptidase M15A showed highest the activity at pH 7.5–9.0 with relative activity above 60 % (Fig. 4a). The enzyme could work in broad temperature ranges of 25, 30, 37 and 42 °C (Fig. 4b). The enzyme activity was decreased when Zn2+ concentrations were increased (Fig. 5). On the other hand, the 100 μM of Mg2+ and Mn2+ could only increase approximately 10 % of relative activity. When the 1000 μM concentration of Mg2+ and Mn2+ was used, the enzyme activity was reduced to 50.3 and 65.6 %. The Ca2+ ion showed little effect on the enzyme activity as seen by an approximately 6 % increase with 100 μM of the ion and a 5 % decrease when 1000 μM was used (Table 1).
The effect of pH and temperature on the peptidase M15A lytic activity against E. coli XL1-Blue peptidoglycan. The optical density at 600 nm of cell suspensions was used to observe the effects of pH a and temperature b on the peptidase M15A lytic activity against E. coli XL1-Blue peptidoglycan. The grey bars show negative controls without enzyme and black bars indicate the reaction with enzyme. p value <0.05 (*) and 0.01 (**) indicate the significance. Each column represents the mean of triplicate experiments and error bars indicate SD
The percentage of E. coli XL1-Blue peptidoglycan reduction when treated with peptidase M15A in the presence of Zn2+. The effect of Zn2+ on peptidase M15A activity was calculated from the difference between optical densities at 600 nm of enzyme treated cells and untreated cells. Each column represents the mean of triplicate experiments and error bars indicate SD
Table 1 The effect of divalent metal ions on lytic activity of peptidase M15A enzyme
Eighteen chloroform permeabilized Gram-negative and seven Gram-positive bacteria were used for susceptibility tests against 5 and 20 μg of the peptidase M15A (Table 2). The enzyme lysed the peptidoglycan from all Gram-negative bacteria investigated. The enzyme effectively lysed E. coli, K. pneumoniae, Shigella gr. D and C. freundii and moderately lysed Burkholderia spp., V. parahaemolyticus, P. vasculitis, P. aeruginosa, A. baumannii and Salmonella gr. D (36–82 %). For Gram-positive, it only lyzed Enterococcus sp. (49 %).
Table 2 Spectrum of antibacterial lytic activity against Gram-negative and Gram-positive bacteria
The increase in antibiotic-resistant bacteria makes the use of possible phage therapy as an alternative treatment for bacterial infections as one of multiple options for treatment. Similar to the concept of a mixed viral vaccine, phages also could be used as a portion of a cocktail for broad host range lysis and more phage could be added into suit the resistance situation (Chan et al. 2013). PG is the major component of Gram-positive bacteria and also the lining under the outer membrane of Gram-negative bacteria. Endolysins are a group of PG hydrolyzing enzymes well characterized in phages for their function on the release of the progeny out of the bacterial host during the lytic cycle. The information on the specificity of the phage and its enzymes against bacteria could facilitate their use safely.
A novel lytic phage ST79 and its modified phage that lyses B. pseudomallei has been reported to effectively lyse a broad range of the bacterium (Yordpratum et al. 2011; Kulsuwan et al. 2015). ST79 endolysin-like protein, peptidase M15A, was identified from the phage genome sequence and predicted to contain 149 amino acids (approximately 16 kDa) with catalytic but not the binding domain (Khakhum et al. 2016). This was similar to other lysins from phages that infect Gram-negative bacterial hosts, which contain single catalytic domains with a molecular mass of 15–20 kDa (Nelson et al. 2012). Endolysins KZ144 and EL188 from a Pseudomonas phage, however, were shown to contain both lytic and N-terminal binding domains (Briers et al. 2007b).
The peptidase M15A amino acid sequence analyzed by MEROPS showed a high identity with conserved amino acid sequences of the peptidase M15 subfamily A that is typical for metallopeptidases with a metal binding part (Rawlings and Morton 2008). A similar prediction was observed with BLASTP and Pfam results, detecting a conserved domain of peptidase M15_3_superfamily. The peptidase M15A from ST79 phage has 132 amino acid residues with active sites containing a Zn2+ ion-binding site at the following amino acids: His77, Asp84 and His199. The peptidase enzyme of a Streptomyces phage also contains His154, Asp161 and His197 of the D-Ala-D-Ala carboxypeptidase zinc specific cleavage site. When the Zn2+ ion was present, the activity of peptidase M15A from ST79 phage was inhibited while that of Streptomyces works more effectively (Courvalin 2006). Likewise, the Zn2+ inhibition effect is also found in the phage T5 endolysin, in which a 10 mM concentration completely inactivated the enzyme immediately after addition. It was also observed that this specific endolysin requires Ca2+ instead of Zn2+ or Mn2+ at the stage of the phage developmental cycle (Mikoulinskaia et al. 2009). Activity of the peptidase M15A was inhibited with addition of 100 μM Zn2+ (10 % of relative activity remain) while 100 μM of Mg2+, Ca2+ and Mn2+ caused a slightly increased enzyme activity. When 1000 μM of Mg2+, Mn2+ and Ca2+ were used, the activity was decreased. On the contrary, Zn2+ and Mn2+ are required for full enzymatic activity of LysB4 endolysin from the B. cereus-infecting phage B4 (Son et al. 2012) and this requirement is also seen in Ply500 endolysin from the Listeria monocytogenes phages (Loessner et al. 1995).
Characterization of some biochemical properties of the peptidase M15A showed a broad range of optimal pHs varying from 7.5 to 9.0 (% relative lytic activity >60 %), which is in alkalophilic range similar to other previously reported peptidases as observed for phage T5 endolysin (optimum pH 8.5) (Mikoulinskaia et al. 2009), lysB4 (pH 8.0–10.0) (Son et al. 2012), transglycosylase endolysin of the phage SPN1S (pH 7.0–10.5), and the highly thermostable Ts2631 amidase endolysin from the Thermus scotoductus phage vB_tsc2631 (7.0–11.0) (Plotka et al. 2015). The Peptidase M15A worked at 25–37 °C and also 42 °C which is the optimum temperature for cultivation of B. pseudomallei in the laboratory (Chen et al. 2003; Palasatien et al. 2008). The enzyme from phages mostly works in an alkalophilic pH.
In this study, all the chloroform permeabilized Gram-negative bacteria were prepared and used as a substrate to test the specificity of endolysin against PG (Briers et al. 2007a). The PG from 18 strains of Gram-negative bacteria including drug resistant strains B. pseudomallei G1, B. mallei EY2233 can be lysed by ST79 peptidase M15A. The enzyme may be more specific to peptidoglycans of Gram-negatives as the enzyme can lyse only Enterococcus sp. among eight Gram-positive bacteria tested. The amino acid composition and sequence of PG in Gram-negative bacteria is known to have a low variation and the PG type belong to A1γ. Even though PG from C. diphtheriae contains A1γ as in Gram-negative bacteria (Schleifer and Kandler 1972), its cell wall is distinct from others with a predominance of meso-diaminopimelic acid in the murein wall and multiple repetitions of arabinogalactan (Besserer et al. 2006). The PG is A1γ type, similar to Bacillus sp., but has modification like deacetylation and resists lysozyme digestion (Davis and Weiser 2011). Both of them were resistant to the ST79 peptidase M15A. For other Gram-positive bacteria, S. epidermidis, S. aureus, Micrococcus spp. and β- streptococcus group B, their PG belongs to the A3α type (Schleifer and Kandler 1972), preventing lysis by the peptidase M15A. Interestingly, Enterococcus sp., which is a Healthcare–Associated Infections (HAI) bacterium, was effectively lysed by ST79 peptidase M15A. The enzyme could act on the D-Ala-D-Ala termini of Enterococcus cell wall peptidoglycan (Arthur et al. 1996). Therefore, the action of the ST79 peptidase M15A may be specific to the peptidoglycan type A1γ of Gram-negative bacteria and to the Gram-positive Enterococcus sp.
Even though, in general, endolysin cannot attack the PG which is located under the outer membrane in Gram-negative bacteria, but permeabilized the outer membrane for example with 10 mM EDTA in combination with 50 mg/ml of the Pseudomonas endolysin EL188 can decrease the viable P. aeruginosa cells by 3 or 4 orders of magnitude in 30 min (Briers et al. 2011). Interestingly, LysAB2, the endolysin from A. baumannii phage ϕAB2 was reported to have an antibacterial effect against both Gram-negative (A. baumannii, E. coli, Salmonella enterica) and Gram-positive (Streptococcus sanguis, S. aureus, B. subtilis) strains (Lai et al. 2011). LysAB2 contains a C-terminal amphipathic region that is necessary for the antibacterial activity as also reported in the Lys1521 endolysin from a B. amyloliquefaciens phage that contains two cationic C-terminal regions. The cationic region was demonstrated to permeabilize the outer membrane of P. aeruginosa (Muyombwe et al. 1999). It is therefore possible to genetically engineer endolysin to have the cationic C-terminal regions to lyse Gram-negative bacteria from outside the same way as suggested by Nelson et al. (2012).
Lysozyme, also known as muramidase, is a well-known endolysin enzyme that is generally used as a standard for comparisons of endolysin activity. For example, A. baumannii phage phiAB2 endolysin activity was only 30 % activity of chicken egg white lysozyme (Lai et al. 2011). When the ST79 peptidase M15A activity was compared with chicken egg white lysozyme, it could reduce PG substrate approximately 2 times higher in lysis efficiency than lysozyme. Nevertheless, the transglycosylase SPN1S endolysin from Salmonella typhimurium-infecting phage can reduce 50 % OD of a 1 ml EDTA pretreated cell suspension when only 50 nanograms was used. This phage enzyme, therefore, has approximately 30 times higher activity than lysozyme (Lim et al. 2012) and also more than ST79 peptidase M15A.
In conclusion, ST79 peptidase M15A is specific to A1γ PG and cleaves PG at the peptide chains. The enzyme can work in a broad alkaligenic range and temperature, has higher activity when compared to lysozyme and is also active against a broad range of Gram-negative bacterial PG and also Enterococcus sp. that make the enzyme an outstanding one for further development. The cationic amphipathic C-terminal in some endolysins that showed permeability to Gram-negative bacteria may be genetically engineered into ST79 peptidase M15A and used as an adjunct to standard antibiotic therapy for B. pseudomallei infection. The combination of a compound that permeabilizes B. pseudomallei's outer membrane with the enzyme that attacks PG may provide a more effective treatment in severe or drug resistant cases. Intensive investigation is, however, definitely required.
PG:
peptidoglycan
NAM:
N-acetylmuramic acids
NAG:
N-acetylglucosamine
Luria and Bertani medium
IPTG:
isopropyl-β-d-thiogalactopyranoside
Healthcare–Associated Infections
EDTA:
Ethylenediaminetetraacetic acid
optical density
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Khakhum N, Yordpratum U, Boonmee A, Tattawasart U, Rodrigues JL, Sermswan RW. Identification of the Burkholderia pseudomallei bacteriophage ST79 lysis gene cassette. J Appl Microbiol. 2016. doi:10.1111/jam.13151.
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NK, UY, AB, UT, JLR and RWS designed the experiments. NK performed experiments. NK and RWS drafted the manuscript. All authors read and approved the final manuscript.
We would like to thank Prof. James A. Will for editing the manuscript via Publication Clinic, Khon Kaen University, Thailand.
Not applicable since this article does not contain any studies with human participants or animals performed by any of the authors.
This work was supported by The Royal Golden Jubilee Ph.D. program (Grant No. 4.O.KK/52/I.1.N.XX) for NK and RWS and the Higher Education Research Promotion and National Research University Project of Thailand, Office of the Higher Education Commission, through the heath cluster, project "Specific Health Problem in Greater Mekong Sub-region (SHeP-GMS)" of Khon Kaen University.
Department of Biochemistry and Melioidosis Research Center, Faculty of Medicine, Khon Kaen University, 123 Mitraparb Road, Khon Kaen, 40002, Thailand
Nittaya Khakhum
& Rasana W. Sermswan
Department of Microbiology and Melioidosis Research Center, Faculty of Medicine, Khon Kaen University, 123 Mitraparb Road, Khon Kaen, 40002, Thailand
Umaporn Yordpratum
& Unchalee Tattawasart
Department of Microbiology, Faculty of Science, Khon Kaen University, 123 Mitraparb Road, Khon Kaen, 40002, Thailand
Atcha Boonmee
Department of Land, Air and Water Resources, University of California, Davis, 3308 Plant and Environmental Sci. Bld., Davis, CA, 95616, USA
Jorge L. M. Rodrigues
Environmental Genomics and Systems Biology Division, Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA
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Correspondence to Rasana W. Sermswan.
Khakhum, N., Yordpratum, U., Boonmee, A. et al. Cloning, expression, and characterization of a peptidoglycan hydrolase from the Burkholderia pseudomallei phage ST79. AMB Expr 6, 77 (2016) doi:10.1186/s13568-016-0251-7
Endolysins |
Share this Story: Ed Willes: Maybe it's too early to talk playoffs, but Canucks are in conversation
Ed Willes: Maybe it's too early to talk playoffs, but Canucks are in conversation
OPINION: It's fair to ask if (the current) rate of production is sustainable. But there's more to this team than the front-end talent and that's shown up a couple of times this season, most notably in Washington on Saturday
Ed Willes
Captain Bo Horvat of the visiting Vancouver Canucks celebrates after scoring the game-winning goal in the seventh round of a shootout on Saturday against Washington Capitals' goaltender Braden Holtby. Photo by Geoff Burke /USA TODAY Sports
Granted, the opinion wasn't unanimous but at the outset of this season the consensus view of the Vancouver Canucks went something like this:
Yes, the team will be improved and, yes, they should be playing meaningful games in March. But to qualify for the NHL playoffs, they'd have to improve by 12 to 14 points over last season while crawling over four teams that finished ahead of them.
Ed Willes: Maybe it's too early to talk playoffs, but Canucks are in conversation Back to video
For a team that was emerging from four lost years, the playoffs seemed like a bridge too far. Still, as long as the Canucks — everybody now — took another step forward in 2019-20, the faithful could live with another playoff-free spring.
The next question is will they have to?
Travis Green's team is now 24 games into the fight and while a million different things can happen between now and Game 82, those 24 games represent an adequate sample size to draw some conclusions.
First and foremost, they're better than anyone could have reasonably expected. The record — 12-8-4 good for third in the Pacific — is one thing. The larger issue is the in-team improvements that suggest the ledger is an accurate reflection of this ensemble.
Vancouver Canucks #40 Elias Petterson wears the Skate jerseys as they skate prior tp playing the Colorado Avalanche in a regular season NHL hockey game at Rogers Arena, Vancouver, November 16 2019. Photo by Gerry Kahrmann /PNG
Heading into this season, for example, the belief was Elias Pettersson could improve on his rookie campaign. How much he'd improve was a matter of some conjecture but after 24 games, Pettersson is on pace for 34 goals and 99 points.
He's also coming off a standout performance on Saturday when he might have been the best player on the ice against the Capitals in a big boys' game. In no particular order he scored a power-play goal, registered five shots on net, hounded the puck all game and drove the Canucks' offence.
A 70-point centre in today's NHL is a very good player. A 100-point centre is a top-10 player in the league and if Pettersson is that guy, it changes a lot of things for the Canucks.
The in-house improvement also goes deeper than Pettersson. Brock Boeser is on pace for 34 goals and 79 points. J.T. Miller represented a huge variable in the Canucks' equation this season. He's on pace for 30 goals and 79 points.
Vancouver Canucks blueliner Quinn Hughes does the post goal-scoring skate past his team's bench during the Canucks' game against the St. Louis Blues at Rogers Arena on Nov. 5, 2019. Photo by Rich Lam /Getty Images
Everyone was excited about Quinn Hughes at the start of the year but did anyone see a 64-point defenceman who's quarterbacking the league's fourth-ranked power play?
Now, it's fair to ask if that rate of production is sustainable. But there's more to this team than the front-end talent and that's shown up a couple of times this season, most notably in Washington on Saturday.
As is their wont, the Canucks surrendered the game's first goal just over two minutes in. Workhorse defenceman Alex Edler was then lost for the game midway through the first period with an undisclosed injury.
Unfazed, the visitors leaned on a four-man blue-line rotation of Hughes (25:13 of ice time), Chris Tanev (25:41), Tyler Myers (25:21) and Jordie Benn (22:37). Bo Horvat also contributed a bone-wearying 26 minutes, then scored the game winner in Round 7 of the shootout. And Miller chipped in with 24 heavy minutes.
Easy it wasn't but if the Canucks were curious about what lies ahead, they now have a clearer idea, which brings us back to the playoff question.
Washington Capitals right wing T.J. Oshie (77) battles for the puck with Vancouver Canucks defenceman Alexander Edler (23) and Canucks defenceman Tyler Myers (57) in the first period at Capital One Arena. Photo by Geoff Burke /USA TODAY Sports
Again, it's early days but there are a couple of points to ponder as we dream about April. Overall, the Canucks can't complain too loudly about their health. Before Edler went down Saturday, their nine leading scorers had missed, collectively, one game. That was Hughes three weeks ago.
But the Canucks were also missing five regulars from their lineup Saturday, including four who started opening night: Brandon Sutter, Michael Ferland, Jay Beagle and Tyler Motte.
The irrepressible Antoine Roussel is the fifth and some of those players should start returning to the lineup. Collectively, they're not going to light up the scoreboard but they represent size and experience to a team that can use both.
Edler, of course, is a different animal. They can cover his minutes short term but long term, you can't lose your best defenceman without leaving a scar.
In the meantime, the Canucks boast the league's eighth-ranked penalty kill and fourth-ranked power play. Their goaltending, by and large, has been playoff-quality and they're on pace to score 266 goals as a team which would be their highest total since 2009-10.
But here's the most important consideration for the Canucks as their playoff chances are contemplated. While the number fluctuates from year to year, it usually takes 94 to 95 points to qualify in the West.
After 24 games the Canucks are on pace for 96 points. They've also played 14 of those 24 on the road.
To reach 94 points they'll require 66 points over their final 58 games and, suddenly, that ask doesn't seem as onerous.
To borrow from Denny Green, it could be the Canucks are who we thought they were back in October. It's also possible, just possible, they're something different.
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LISTEN:This week's White Towel Podcast sees Ed Willes join Paul Chapman to talk about the recent Canucks struggles, the potential for a goalie controversy, the job security and possible moves for General Manager Jim Benning, and the furor caused by the Canucks wearing their black "Skate" jerseys and whether that's really noteworthy or just social media fluff.
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York-area woman among three shot in 'random' shooting at Tennessee outlet mall
A man with a gun walked up to a Tennessee shopping center on Tuesday afternoon and opened fire outside a store, killing a woman and wounding a man.
York-area woman among three shot in 'random' shooting at Tennessee outlet mall A man with a gun walked up to a Tennessee shopping center on Tuesday afternoon and opened fire outside a store, killing a woman and wounding a man. Check out this story on eveningsun.com: https://www.ydr.com/story/news/2019/04/16/tennessee-shooting-york-woman-killed-random-outlet-mall-attack/3492310002/
Travis Dorman, York Daily Record Published 9:33 p.m. ET April 16, 2019 | Updated 9:58 p.m. ET April 17, 2019
Raw video from the scene of a shooting at Tanger Outlets Mall that left two dead and one injured from a gunshot wound on April 16, 2019. Calvin Mattheis, [email protected]
A man with a gun walked up to a Sevierville shopping center on Tuesday afternoon and opened fire outside a store, killing a woman and wounding a man before turning the gun on himself in what police described as an apparently random shooting.
Officers descended on Tanger Outlets, an outlet mall on the Parkway, after several people called 911 to report a shooting outside the Coach store at 3:49 p.m.
By the time police arrived, the shooter and the female victim were dead, according to Sevierville Police Department spokesman Bob Stahlke.
Authorities identified the gunman as 21-year-old Leon Steven Jones of Newport and Sevierville, and the woman as 24-year-old Olivia Katelyn Cunningham of the York area.
Scene of triple shooting at Tanger Outlets in Sevierville
A Pigeon Forge police cruiser blocks traffic at the scene of a shooting outside of Coach at the Tanger Outlet Mall in Sevierville, Tennessee, on Tuesday, April 16, 2019. Two people, including the assailant, were found dead at the scene with a third suffering from a gunshot wound. Calvin Mattheis/News Sentinel
Investigators walk at the scene of a shooting outside of Coach at the Tanger Outlet Mall in Sevierville, Tennessee on Tuesday, April 16, 2019. Two people including the assailant, were found dead at the scene with a third suffering from a gunshot wound. Calvin Mattheis/News Sentinel
A police officer walks at the scene of a shooting outside of Coach at the Tanger Outlet Mall in Sevierville, Tennessee on Tuesday, April 16, 2019. Two people including the assailant, were found dead at the scene with a third suffering from a gunshot wound. Calvin Mattheis/News Sentinel
First responder investigate at the scene of a shooting outside of Coach at the Tanger Outlet Mall in Sevierville, Tennessee on Tuesday, April 16, 2019. Two people including the assailant, were found dead at the scene with a third suffering from a gunshot wound. Calvin Mattheis/News Sentinel
Onlookers watch at the scene of a shooting outside of Coach at the Tanger Outlet Mall in Sevierville, Tennessee on Tuesday, April 16, 2019. Two people including the assailant, were found dead at the scene with a third suffering from a gunshot wound. Calvin Mattheis/News Sentinel
A Pigeon Forge police van at the scene of a shooting outside of Coach at the Tanger Outlet Mall in Sevierville, Tennessee on Tuesday, April 16, 2019. Two people including the assailant, were found dead at the scene with a third suffering from a gunshot wound. Calvin Mattheis/News Sentinel
First responders stand watch at the scene of a shooting outside of Coach at the Tanger Outlet Mall in Sevierville, Tennessee on Tuesday, April 16, 2019. Two people including the assailant, were found dead at the scene with a third suffering from a gunshot wound. Calvin Mattheis/News Sentinel
A police officer keeps watch at the scene of a shooting outside of Coach at the Tanger Outlet Mall in Sevierville, Tennessee on Tuesday, April 16, 2019. Two people including the assailant, were found dead at the scene with a third suffering from a gunshot wound. Calvin Mattheis/News Sentinel
Sevierville Police spokesman Bob Stahlke speaks to the media at the scene of a shooting outside of Coach at the Tanger Outlet Mall in Sevierville, Tennessee on Tuesday, April 16, 2019. Two people including the assailant, were found dead at the scene with a third suffering from a gunshot wound. Calvin Mattheis/News Sentinel
A police officat the scene of a shooting outside of Coach at the Tanger Outlet Mall in Sevierville, Tennessee on Tuesday, April 16, 2019. Two people including the assailant, were found dead at the scene with a third suffering from a gunshot wound. Calvin Mattheis/News Sentinel
Aeropostale beside Coach is blocked with police tape at the scene of a shooting outside of Coach at the Tanger Outlet Mall in Sevierville, Tennessee on Tuesday, April 16, 2019. Two people including the assailant, were found dead at the scene with a third suffering from a gunshot wound. Calvin Mattheis/News Sentinel
A line of police cruisers at the scene of a shooting outside of Coach at the Tanger Outlet Mall in Sevierville, Tennessee on Tuesday, April 16, 2019. Two people including the assailant, were found dead at the scene with a third suffering from a gunshot wound. Calvin Mattheis/News Sentinel
The male victim, 75-year old John Marr of Templeton, Massachusetts, was taken to the University of Tennessee Medical Center. His condition was unknown Tuesday evening.
"We do not believe that any of the people involved knew each other from everything we have so far," Stahlke told reporters at a news conference Tuesday. "And I'll stress that's so far; it's still preliminary. It appears that this was a random shooting."
More: GoFundMe campaign created for York County woman killed in Tennessee
Investigators believe Jones confronted Cunningham and Marr outside the Coach store, shot both with a semi-automatic handgun and then shot himself with the same weapon. Stahlke said the victims each were at the mall with at least one other family member, and that they just happened to be outside when the gunman came.
A police officer walks at the scene of a shooting outside of Coach at the Tanger Outlet Mall in Sevierville, Tennessee on Tuesday, April 16, 2019. Two people including the assailant, were found dead at the scene with a third suffering from a gunshot wound. (Photo: Calvin Mattheis/News Sentinel)
The shooting left shoppers and employees sheltering in place at the mall on the outskirts of Pigeon Forge, a popular tourist destination in Sevier County that is home to the theme park Dollywood, among other attractions.
The lockdown was lifted after police determined the only shooter was dead and that there was no longer any threat to the public, Stahlke said. The mall — save for the crime scene — reopened by 4:30 p.m. but closed early for the night at 6.
More: Shot fired, couple beaten in North Codorus home invasion robbery, police say
More: Possible child luring attempt investigated after woman offers treat to girl in York County
Investigators conducted dozens of interviews with witnesses and were working Tuesday evening to determine why Jones opened fire on two people he apparently did not know.
"It absolutely could have been worse," Stahlke said. "And again, I don't know what his motivation was. I don't know if he was going to shoot one and two people and then do what he did, or if his intent was to shoot more. I just don't know.
"But all we can do in law enforcement is to get here as quick as we can. And this situation was over when we got here."
Reach Travis Dorman at [email protected]. Follow him on Twitter @travdorman.
A police officat the scene of a shooting outside of Coach at the Tanger Outlet Mall in Sevierville, Tennessee on Tuesday, April 16, 2019. Two people including the assailant, were found dead at the scene with a third suffering from a gunshot wound. (Photo: Calvin Mattheis/News Sentinel)
Read or Share this story: https://www.ydr.com/story/news/2019/04/16/tennessee-shooting-york-woman-killed-random-outlet-mall-attack/3492310002/
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Warner 2835
Stampede, the Doobie Brothers' fifth album, finds the San Jose guitar band continuing to develop their style. One cut, a remake of Kim Weston's Holland-Dozier-Holland hit "Take Me in Your Arms," accomplishes the unprecedented feat of making a Bay Area rock band sound soulful. Even better, the song, despite Tom Johnston's Marvin Gaye-ish vocal and all the Motown trimmings (baritone sax on the bottom, darting strings on the top), ends up sounding like no one so much as the Doobie Brothers.
Original album advertising art.
Click image for larger view.
Other standout cuts include "Music Man," arranged by Curtis Mayfield, and "Sweet Maxine," a more calculated variant on the Doobie style. By drawing upon artists like Mayfield and Holland-Dozier-Holland, as well as by adding guitarist Jeff Baxter (ex-Steely Dan) to their lineup, the Doobies have beefed up their attack and given it a sharper edge; in so doing, they have broadened their style, which becomes increasingly distinctive with each album.
But a style does not a vision make -- or at least not a challenging vision. Lyrically, this band still seems plagued by the spirit of groovy vibrations that made "Listen to the Music" an endurance test for case-hardened cynics. "Neal's Fandango" bumbles along to couplets like "On the hills above Santa Cruz/In the place where I spent my youth," which doesn't even rhyme, much less scintillate.
- Jim Miller, Rolling Stone, 7-3-75.
The jacket pictures show the Doobie Brothers riding horses, and that works with the amorphous, thick-waisted sound of this to remind me of the old Pogo line about a camel being a horse designed by a committee. Like most Doobie Brothers albums, this one sounds like the work of a committee, and I don't think I approve of even the ideaof committees. Committees are essentially political, and the very first song climaxes in the line, "She's got the power, rock and roll," which sounds to me like a attempt by a committee to tell a crowd what the committee thinks the crowd wants to hear. Committees are always compromising, angling toward acceptably low denominators, and few committees could hope to be thought of as stylish; so far the description fits the Doobies pretty snugly. What committees do mostly is bore people, and, regrettably, the analogy with this album continues to hold. If you play anything, try picking along with "Texas Lullaby"; if you make it to the end, you have the kind of boredom threshold that makes you ripe to be tapped by the town fathers for helping plan the next big project aimed at making your burg even duller than it is now.
- Noel Coppage, Stereo Review, 9/75.
Not much doubt that this is headed for the top of the charts, for the Doobies have developed into one of our true supergroups. The sound they produce is a good-time feel which might be termed the California Music of the '70s, much like the Beach Boys' distinctive sound of the '60s. Not that the Doobies deal with any specific West Coast phenomena, but it's a unique sound that seems appropriate to California. Here we get a variety, from "China Grove" type rock, with flowing guitars and harmonies, to more simplistic rock/soul, to covers of Motown hits, to production ballads. Use of horns, strings and backup voices does not interfere with the basic group sound. There's even a good, country blues cut in the vein of "Black Water." Musically, the LP works better than anything the six have come up with in the past. Commercially, it comes at the high point in their career. Best cuts: "Sweet Maxine," "Texas Lullaby," "Take Me In Your Arms," "I Cheat The Hangman," "Rainy Day Crossroad Blues."
With the addition of ex-Steely Dan guitarist Jeff "Skunk" Baxter, the Doobie Brothers became a more musically ambitious and accomplished band, without sacrificing their capability to rock & roll. However, Stampede suffers from the same flaw as What Were Once Vices -- a lack of consistent material. * *
- Stephen Thomas Erlewine, The All-Music Guide to Rock, 1995. |
After the release of Android 5.1 Lollipop few weeks ago, the developers' communities have been developing custom ROM for various android phones, and they have also succeeded in developing the Cyanogenmod 12.1 (Android 5.1 Lollipop) for HTC One M8.
This custom ROM comes with all expected features of the Android OS v5.1 with some other extra features being included. Credits go to the XDA forum for their great work.
Today's stroll, I would brief you guys on how to install cyanogenmod 12.1 on HTC One M8.
Before proceeding to the below guide, make sure that your HTC One M8 has an unlocked bootloader, rooted and also have the latest custom recovery (TWRP/CWM) installed on it.
Step 1: Enable USB debugging on HTC One M8, simply go to settings >> Developers option.
Step 2: After that, download cyanogenmod 12.1 from here, and Google Apps from here and move the downloaded files to the internal storage of your HTC One M8 device.
Once your HTC One M8 is successfully rebooted, then you would notice the new experience of Android 5.1 Lollipop on your device with much amazing features. And just in case your device got stock in welcome screen during reboot, simply switch off and boot to recovery, then wipe cache partition and reboot. |
Need to leave information behind with a client? Pocket folders are great sales tools for keeping your company literature and business cards neat and organized when out on a sales call.
Pocket folders come in a varitey of styles, and we do them all! |
Q: Salesforce search setting "Lookup Auto-Completion" not working inside jquery datatable.for page 2 and above for 1st page it's working fine I am using Salesforce search setting "Lookup Auto-Completion",and i am populating multiple records and for dispaly i used JQuery Datatable.Autocomplete is working for page 1 but not for rest of the pages
this is jquery:
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this is my html :
<table id ="table1"> <thead> <tr> <th>Financial Accounts</th> </tr> </thead> <tbody> <apex:repeat value="{!accts}" var="a"> <tr> <td><apex:inputField value="{!a.Financial_Accounts__c}"/></td> </tr> </apex:repeat> </tbody> </table>
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No matter when you visit, this character-filled New England town has enough alpine charm to flood an Instagram feed. But it's especially vibrant during winter, when skiers and snowboarders come to tackle the miles of trails that crisscross Stowe Mountain Resort's Mount Mansfield (Vermont's tallest mountain) and nearby Spruce Peak. Stowe gets more than 300 inches of snow annually, and many consider it the northeast's best skiing.
The scenic, five-mile byway known as the Stowe Recreation Path is open to cross-country skiers, snowshoers, cyclists, walkers and joggers. It connects the village to the Top Notch Resort on Mountain Road, winding across wooden bridges and past pretty picnic spots, and it's a great way to get a feel for the area when you first arrive. During winter, the ice rink at the Spruce Peak Village Center is a nice option for kids who are feeling a little skied out.
For serious skiers wanting to maximize time and minimize schlepping, the ski-in, ski-out Stowe Mountain Lodge has an ultra-convenient location right at the base of Spruce Peak (spend a week here and you'll wonder how you ever skied without valet service). Rooms are on the splurgy side, but have gas fireplaces, kitchens or kitchenettes. There are a mix of layouts to choose from, most of which can accommodate at least four people, and those looking for a strong après-ski game will be happy to know that the heated outdoor pool is open year-round. The Stowe Motel & Snowdrift is located on the town's shuttle route, and within easy reach of both the mountain and village. Accommodations include classic motel rooms, suites with kitchenettes, apartments and freestanding rental houses.
Sundaes and giant milkshakes (called frappes) are the main attractions at the 1950s-inspired Depot Street Malt Shoppe, which is set in one of the village's classic wood-frame houses and also offers basic diner fare like sandwiches and burgers. |
293 The Kingsway Condos Etobicoke is a new condo project by Malen Capital. The new development will be located at 293 The Kingsway, Toronto ON M9A 3V1. It is in The Kingsway city of Etobicoke. 293 The Kingsway Condos is 9 storey building with 506 number of units.The Estimated occupancy of 293 The Kingsway Condos is in 2021. Sales of 293 The Kingsway Condos From $484,900 to over $1,312,500 CAD.
293 The Kingsway Condos is located in an amenity-rich neighbourhood close to the vast green spaces along Humber River. Close to this Etobicoke new condos are many eateries and many more are minutes away along Dundas St W and Bloor St W. There are plenty of places around to shop. Steps from the condos are Humbertown Shopping Centre shopping mall, and many more such as Kingsway Mills Shopping Centre, Thorncrest Plaza, Valu Mart, and SDM are just a short drive far. Enjoying plenty of greens, minutes away are expansive greenspaces of Lambton Golf & Country Club, Islington Golf Club, Lambton Woods park, James Gardens and more. The neighbourhood has plenty of schools and is highly accessible through the nearby subways of Islington and Kipling.
293 The Kingsway Condos consists of four mid-rise buildings, two of them being six storeys and the other two nine storeys. There will be a total of 506 suites in the four buildings with 1-bedroom, 1-bedroom+den, 2-bedroom, and 2-bedroom+den units. The suites range from 596 sq ft to 1505 sq ft. The condos will include many top-of-the-class amenities such as fully equipped fitness centre, lounges, rooftop terraces, guest suite, 24-hour concierge service, business centre, pet spa, games room, and more. Designed by Quadrangle Architects Ltd., the buildings have contemporary exterior and interiors with floor-to-ceiling windows and private balcony, a luxurious modern home surrounded by amenities.
The name behind 293 The Kingsway Condos, Malen Capital, a full-service investment property owner and its sister company, The Benvenuto Group, a luxury condominium developments firm are creating exceptional living spaces at this mid-rise condo community. The combined expertise of skilled acquisition, focused asset re-development and new property construction allow the builders to create the most sought-after places to live. Malen Capital researches, analyzes and purchases prime real estate based on location. The Benvenuto Group constructs new buildings and transforms existing properties and their adjacent lands into one-of-a-kind residential and commercial projects that are both forward-thinking and ideally suited to the community and the marketplace.
*293 The Kingsway Condos last updated on January 23, 2019 by 99homes.ca. Designated trademarks and brands are the property of their respective owners. 99homes.ca is not liable for the use or misuse of the site's information. |
Q: create object using properties of other object Given these two objects:
firstObject:
var firstObject = {
title: 'value1',
year: 'value2',
contributors: 'value3',
abstract: 'value4'
};
secondObject:
var secondObject = {
title: 'Title',
year: 'Year',
contributors: 'Contributors',
abstract: 'Abstract'
};
How can I create a third object structured like this?:
var thirdObject = {
Title: 'value1'
Year: 'value2',
Contributors: 'value3',
Abstract: 'value4'
};
Basically assigning the properties of the secondObject as the keys of the thirdObject and the properties of the firstObject as the properties of the thirdObject.
Note: I don't want any uppercase of the of the firstObject keys.
A: You can use something like that :
var firstObject = {
title: 'value1',
year: 'value2',
contributors: 'value3',
abstract: 'value4'
};
var secondObject = {
title: 'Title',
year: 'Year',
contributors: 'Contributors',
abstract: 'Abstract'
};
var newObj = {};
$.each(secondObject, function(i){
newObj[this] = firstObject[i];
});
//Vanilla JS version
for(var x in secondObject){
newObj[secondObject[x]] = firstObject[x];
}
console.log(newObj);
http://jsfiddle.net/kq6tcp5L/
A: Example here. This assign "" if key doesn't exists in firstObject.
var firstObject = {
title: 'value1',
year: 'value2',
contributors: 'value3',
abstract: 'value4'
};
var secondObject = {
title: 'Title',
year: 'Year',
contributors: 'Contributors',
abstract: 'Abstract',
extra:''
};
var thirdObject ={};
for(var key in secondObject)
{
if (secondObject.hasOwnProperty(key))
{
thirdObject[key] = (typeof firstObject[key] === "undefined")?"":firstObject[key];
}
}
console.log(thirdObject);
|
Currency: All prices are in Canadian dollars.
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Shipping and Returns: Free delivery within Canada via Canada Post. Shipments anywhere in the U.S. via Canada Post at a flat rate of $22. Within Canada, normally allow 3-5 business days for delivery. For international orders we will negotiate shipping with you at cost. Sorry, no refunds or returns.
All of our products are for topical use only. We aim to provide a very clean natural product and do not include any chemical binders or preservatives. The natural preservative we use is grapefruit seed extract which should provide a shelf life, once opened, adequate to maintain freshness for normal daily use. If you store our product in a refrigerated environment you will extend the shelf life. If the creams look like they are hardening on the top, stir them with a clean utensil such as a clean chop stick. As our products are oil based they may cause staining if not used properly. To ensure quick absorption, apply our creams after a shower or bath while you are clean and your pores are open. Proper absorption before dressing will eliminate staining. If stains do occur, be sure to wash the stain out as you would normally in hot water before drying.
General Disclaimer: All information pertaining to health conditions, products and treatments is based on 6 years of testimonials and feedback and is for information purposes only. We make no medical claims and and are not a substitute for the advice of a physician or other medical professional. This includes all information contained in this website as well as on product packaging or labels. We recommend a patch test to make sure that your are not allergic to any ingredients. Avoid contact with eyes. |
In this recent photograph taken in visible light from the Cassini spacecraft near Saturn, three of Saturn's moons are visible in an unusual grouping. The image shows Tethys (above the plane of the rings), Enceladus (closer to the center), and the smaller Mimas.
This image—captured at a distance of about 837,000 miles from Enceladus—was taken from an angle of 0.4 degrees above the ring plane, and slightly below the orbit of Tethys. The photo shows the apparent eerie smoothness of the rings, as well as the deep scars and pockmarks of many of Saturn's moon, which have met with frequent and violent encounters with objects such as asteroids and meteors.
The image is also a powerful reminder of the elegant and complex ballet of gravity within our solar system, for Saturn has more than 50 objects it calls its moons, ranging in size from the largest (Titan, at 2,201 miles in diameter, it is so large it has its own atmosphere) to small irregularly-shaped objects made of dense rock and ice, including Mimas, pictured here. Mimas is a favorite of astronomers—professional and amateur—for its enormous central impact crater, which, seen from a distance, gives Mimas a striking similarity to the infamous "Death Star" of the early Star Wars trilogies.
The Cassini mission is a collaborative effort of NASA, the European Space Agency (ESA), and the Italian Space Agency (ISA). The cameras were developed, designed and installed by a team at the Jet Propulsion Laboratory in Pasadena, California.
Half Moon, Or Half Enceladus; Thursday Review staff; Thursday Review; January 25, 2016.
Earthrise, 2016: Welcome to the New Year; Thursday Review staff; Thursday Review; January 7, 2016. |
Among several beauty bars and salons in the Leeds, Pastille beauty bar grabs the attention with the quality work carried by their beauticians.
If you are worried about the ageing factor that Millhouse Clinics present in the Birmingham would be the best option undergo skin medications.
The award winning hair salon The Chapel has been in top list ever since they started to function right from the 19th century.
For girl's night out and to do the beauty treatment, Earls & Co would be the perfect destination, where one can find friendly staffs.
The Rye Retreat, from the historic town of Rye of East Sussex has the perfect beauticians where the visitors experience the quality salon and spa service.
The Gloss bar located in the Hertfordshire is the one of the most loved nail polishing center by all, particularly on visiting the place along with the friends.
With the presence of the highly trained professionals, the Jill Zander, A Courthouse Medispa in Surrey is the best place to treat all kinds of skin concerns.
Cardiff's Goji hair salon provides the best hair service in the region which drives many people to visit them again.
The NAF salon located very near to the Glasgow Central Station is the perfect destination for those who loves creative nail arts.
The Samantha Hillerby from the East Yorkshire is the best the real women can get in terms of beauty treatments. |
Q: Xml Requests do not work I cannot get a bare bones Asp.Net Core Web Api project to work using Xml instead of Json. Please help!
I have created a new project and the only adjustments to the default configuration were to add the Xml formatters...
public void ConfigureServices(IServiceCollection services)
{
// Add framework services.
services.AddApplicationInsightsTelemetry(Configuration);
services.AddMvc(config =>
{
config.InputFormatters.Add(new XmlSerializerInputFormatter());
config.OutputFormatters.Add(new XmlSerializerOutputFormatter());
});
}
My Controller also contains simple Get and Post methods:
[Route("api")]
public class MessageController : Controller
{
[HttpPost]
public void Post([FromBody] Message message)
{
}
[HttpGet]
public IActionResult Get()
{
return Ok(new Message
{
TestProperty = "Test value"
});
}
}
When I try calling the POST method with Content-Type: application/xml, the API returns 415 Unsupported Media Type. I have tried adding the Consumes("application/xml") attribute to the controller and still it does not work.
The GET works and returns JSON. However, if I add the Produces("application/xml") attribute to the controller, the GET returns 406 Not Acceptable, even if I provide the Accepts: application/xml header.
For some reason, the API is completely rejecting anything related to xml even though the input and output formatters were added as I have seen in the very few examples I could find.
What am I missing?
A: I have following thing in my startup.cs and it works well with XML and JSON both.
Here I only stick with XML.
Note : ( I have consider my own class for sample)
*
*Startup.cs
public void ConfigureServices(IServiceCollection services)
{
services.AddMvcCore()
.AddJsonFormatters().AddXmlSerializerFormatters();
}
*My HttpClient Code ( You might have missed Content Type setting that I have done in StringCotent)
*
*Two header is important : Accept and Content-Type. Accept help in content negotiation and Content-Type is a way client tell server what type content client is posting.
HttpClient client = new HttpClient();
client.BaseAddress = new Uri( @"http://localhost:5000");
client.DefaultRequestHeaders.Accept.Add(new System.Net.Http.Headers.MediaTypeWithQualityHeaderValue("application/xml"));
HttpContent content = new StringContent(@"<Product>
<Id>122</Id>
<Name>Computer112</Name></Product>",System.Text.Encoding.UTF8 , "application/xml"); // This is important.
var result = client.PostAsync("/api/Products", content).Result;
A: In ASP.Net Core 2.0 you can accept both XML and Json request almost out of the box.
In Startup class in ConfigureServices method, you should have:
services
.AddMvc()
.AddXmlSerializerFormatters();
And controller that accepts complex object looks like this:
[Route("api/Documents")]
public class DocumentsController : Controller
{
[Route("SendDocument")]
[HttpPost]
public ActionResult SendDocument([FromBody]DocumentDto document)
{
return Ok();
}
}
This is an XML to send:
<document>
<id>123456</id>
<content>This is document that I posted...</content>
<author>Michał Białecki</author>
<links>
<link>2345</link>
<link>5678</link>
</links>
{
id: "1234",
content: "This is document that I posted...",
author: "Michał Białecki",
links: {
link: ["1234", "5678"]
}
}
And that's it! It just works.
Request with the same document either in XML or Json to api/documents/SendDocument endpoint is handled by one method. Only remember about correct Content-Type header in your request.
You can read the whole post at my blog: http://www.michalbialecki.com/2018/04/25/accept-xml-request-in-asp-net-mvc-controller/
A: For ASP.NET Core 2.2 use nuget package Microsoft.AspNetCore.Mvc.Formatters.Xml or Microsoft.AspNetCore.App
and add this in Startup.cs
services.AddMvc()
.AddXmlSerializerFormatters()
.AddXmlDataContractSerializerFormatters();
Don't forget to use headers Accept application/xml to get response as xml and Content-Type application/xml for request with xml body.
Check example here http://www.devcode4.com/article/asp-net-core-xml-request-response
|
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Kindle 8 (2016): tech specs, comparisons, reviews, and more
Piotr Kowalczyk ⋮ Published on July 8, 2016
There is a new model: The basic Kindle – feature roundup, tech specs, pics, and more
Here is everything you wanted to know about the newest Kindle, in a handy roundup packed with comparisons, specs, and best pics.
The 8th generation of entry-level Kindle e-reader is thinner and lighter, comes in White and Black, and costs $79.99.
After almost two years, Amazon has presented the update of the most affordable Kindle model.
The all-new Kindle 2016 is 11% thinner and 16% lighter than the 7th generation model. It's the first Kindle that comes equipped with accessibility feature called VoiceView that activates via the built-in Bluetooth audio.
The 2016 Kindle has the same price tag as its predecessor – $79.99 – and comes in two color variants: Black and White.
It's worth mentioning that recently Kindle Paperwhite has been also released in White.
Later in this post, you'll learn about the most important features of Kindle 2016, launch details, and international availability. You'll also find two comparison tables:
between Kindle 8 and it's predecessor,
between Kindle 8 and Kobo Touch 2.0.
Keep reading, and you'll reach the selection of images of the new Kindle, as well as excerpts from first reviews, a full product specification, and a detailed Kindle 8 infographic.
Read also 50 best Kindle covers and sleeves – the 2020-21 edition
Are you looking for refreshingly different alternatives to Kindle covers you have used so far? It doesn't have to take too much time – just have a look at this quick roundup.
Kindle 8 (2016) – prices and availability
Amazon announced the new e-reader on June 22, 2016. The version with ads sells on Amazon.com since July 7. The release of the version without ads is July 30.
Both color variants cost the same. The price differs when you decide to go with or without ads:
Kindle 8 (2016) with special offers – $79.99,
Kindle 8 (2016) without special offers – $99.99.
These prices and release dates refer to the Amazon.com and for US customers, who can also buy the device in five monthly payments.
Kindle 2016 has also been revealed on other Amazon sites. For instance, on Amazon.co.uk it costs £59.99. The release date is July 20, 2016.
In France and other countries in the euro zone, the price is EUR 69.99, and the release date is also July 20, 2016.
What about the version of Kindle 2016 addressed to international customers of Amazon.com? It's there. Kindle 8 (2016) International costs $99.99 (as usual, $20 more than the US version). So far, it's only available in black, but as soon as the white option joins in, we'll inform about it.
And if you don't think the all-new Kindle has been improved enough, there is still a chance to buy the 2014 model. Its price has already been cut to $69.99.
Kindle 8 (2016) – major features
For the first time since 2010 the Kindle e-reader is offered in white color
Many of the features and specs of the Kindle 8 are the same as in the 7th generation model. Some of them, such as the 800 × 600 px screen, seem insufficient for the needs of customers in 2016.
Let's have a look at what has changed and improved.
A choice of two body colors: Black and White
Along with the new Paperwhite, the 2016 Kindle is the first e-reader from Amazon since 2010 that is offered in North America in the white shell. It's also the first Kindle since Kindle Keyboard that comes in two colors.
The old good keyboard e-reader was available in White and Graphite. The new Kindle can be picked in either Black or White.
The white version seems to be a perfect choice for women, as it makes a device look less technical and more pleasing. It also fits women's outfit much better than the heavy-looking black version.
Quite possibly, the "white" is not 100% white, but a very light gray. Based on the photos from Amazon, the color of the shell in Kindle 2016 is the same as the screen. And the E-Ink Pearl screen is not white.
To eliminate the disappointment coming from the fact that the screen is darker than the outside, Amazon has most probably adjusted the color of the plastic to be similar to the screen.
Bluetooth and VoiceView
The 8th generation e-reader from Amazon is the first Kindle that comes with the built-in Bluetooth audio support.
You may wonder whether it will be now possible to upload audio files and listen to the music via Bluetooth headphones. The answer is "no," as music files are not supported by the new Kindle.
The first Kindle e-reader with a built-in Bluetooth audio and VoiceView accessibility feature
The purpose of adding Bluetooth support was different – to make the Kindle accessible by the blind and visually impaired persons.
When you connect the Bluetooth audio device, headphones or a speaker, you can use accessibility feature called VoiceView, known from Amazon Fire tablets.
VoiceView provides spoken feedback to describe the actions that take place on your screen. It reads the content of the screen – including books – without the need for an adaptor.
Smaller dimensions, smoother design
The first thing you'll notice in the 2016 Kindle is its smoother, more rounded shape.
But what's more important, the new device is considerably smaller than its predecessor, while maintaining the same proportions.
Kindle 8 is thinner by 1.1 mm than Kindle 7, what makes an 11% depth reduction. Its height is lower by 9 mm, and weight by 4 mm.
With a considerably smaller weight (161 g vs. 191 g), you'll find it much easier to read books one handed.
Are you counting on keeping the old case cover after updating the Kindle? There's no good news. The dimensions of the new device are reduced to such a level that even cases with corner straps will not be suitable.
Kindle 8 (2016) – comparisons
Kindle 8 costs the same as its predecessor. What added value does it offer? First of all, it's available in two body colors. The white version seems to be a perfect choice for women.
Secondly, the 2016 Kindle features Bluetooth. Thanks to that, the device can be operated by blind and visually impaired, via the connected Bluetooth audio device.
RAM memory has doubled from 256 to 512 MB, but the storage capacity is the same – 4 GB
In the press release, we read that the new basic Kindle has "twice the memory as the previous generation," without specifying what kind of memory it is. Users might have the impression that they will now have a chance to store twice as many books.
Let's clarify. The storage capacity in Kindle 7 and Kindle 8 is the same. It's 4 GB, and about 3 GB are available for the users. Amazon claims it's enough to store "thousands of books."
What has doubled is RAM memory, responsible for how the device operates. The memory has increased from 256 MB to 512 MB. Thanks to that, with the more advanced operating system (now and in the future updates) the device should work seamlessly, and without any lags.
Kindle 8 vs. Kindle 7 – major differences
Body colors White, Black Black
RAM memory 512 MB 256 MB
Bluetooth Yes No
Dimensions 6.3 × 4.5 × 0.36″
160 × 115 × 9.1 mm 6.7 × 4.7 × 0.40″
169 × 119 × 10.2 mm
Weight 5.7 oz / 161 g 6.5 oz / 191 g
Price at launch With ads: $79.99
Without ads: $99.99 With ads: $79.99
Without ads: $99.99
How does the new entry-level Kindle compare to e-readers from Amazon's competitors?
The natural choice for comparison is Kobo Touch 2.0. Released in September 2015, it features the same 167 ppi Pearl touch screen from E-Ink, and has the dimensions similar to Kindle 2016.
Both devices offer 4 GB internal storage but lack front light, 3G connectivity, and external micro SD card slot.
However, with a price tag higher by $10 than the 2016 Kindle ($89.99), Kobo Touch 2.0 doesn't offer Bluetooth and the white body version. What's interesting, its predecessor, the 2011 Kobo Touch was offered in five colors.
When you decide to switch from Kobo to Kindle, or the other way round, you have to remember that changing the ebook platform is a painful process. Amazon and Kobo use different file formats and different DRM systems.
Kindle 8 (2016) vs. Kobo Touch 2.0 (2015)
Kobo Touch 2.0
Release date June 22, 2016 September 9, 2015
Screen 6″ E-Ink Pearl 6″ E-Ink Pearl
Screen resolution 800 × 600 px 800 × 600 px
Screen density 167 ppi 167 ppi
Grayscale 16 levels 16 levels
Front light No No
Storage 4 GB 4 GB
Connectivity WiFi 802.11 b/g/n WiFi 802.11 b/g/n
Micro SD card slot No No
157 × 115 × 9.2 mm
Battery life Up to 4 weeks Up to 8 weeks
Supported text formats azw, mobi, pdf, txt epub, mobi, pdf
Supported comic book formats – cbz, cbr
Ads Depends on version No
Price With ads: $79.99
Without ads: $99.99 $89.99
Kindle 8 (2016) – reviews
Below, you'll find excerpts of the first reviews the new Kindle received from top tech bloggers.
The changes here are as subtle as we've come to expect from Amazon. […] But they do give the cheapest device of the bunch a fresh coat of paint and a slight speed boost. That may push some paper hold-outs toward purchasing an e-reader at last.
–Nick Statt, The Verge
It is much prettier than the 2014 model and it is in every way an improvement, but my enthusiasm is tempered by the fact that I was satisfied with the 2014 model and that I don't need the accessibility features.
–Nate Hoffelder, The Digital Reader
My biggest problem with the new Kindle is how dark and gray the screen looks. Maybe it's partially because I got a white one and it highlights how not white the screen background color is.
–The eBook Reader
Holding the new white Kindle in my hands, I was struck by how solid a device it is. It's roughly the size of a large paperback; but is less than half an inch thick. It weighs less than six ounces – the only Kindle that's lighter is the high-end Kindle Oasis.
–Anthony Karch, The Forbes
There are also a few new reading features, but the entry-level template is otherwise unchanged, and this Kindle still doesn't have a lighted screen.
Kindle 8 (2016) – pictures
Kindle 8 (2016) – full tech specs
Below, you'll find the most important tech specs of the 2016 touchscreen Kindle.
6" E Ink Pearl glare-free
Grayscale levels
Front light
4 GB (3 GB available for the user) – will hold thousands of books
Approximately 4 hours from a computer via USB cable
6.3 × 4.5 × 0.36″ / 160 × 115 × 9.1 mm
802.11b, 802.11g, 802.11n (WEP, WPA, WPA2)
VoiceView screen reader – the feature enables access to the vast majority of Kindle features when a Bluetooth audio device is connected
Micro-USB for connectivity and charging
Supported text formats
azw, azw3 (Kindle Format 8), doc, docx, html, mobi, pdf, prc (Mobipocket), txt
bmp, gif, jpeg, png
Interface languages
You can use the Kindle in English, Spanish, Brazilian Portuguese, French, German, Italian, Japanese, Russian, Dutch, and Simplified Chinese
USB 2.0 charging cable
Release dates (US)
Wi-Fi, with ads – July 7, 2016
Wi-Fi, without ads – July 30, 2016
Wi-Fi, with ads – $79.99
Wi-Fi, without ads – $99.99
Kindle 8 (2016) – infographic
We've included all the most important features of the 2016 Kindle in this handy infographic. it also includes a timeline of all white Kindle models. Enjoy!
Feel free to share this image on your blog or in social media (Creative Commons license).
Kindle 8 (2016) – product chart
Kindle 2016 – 8th generation
White / Wi-Fi
Thin and light for one-handed reading
New—The all-new Kindle is 11% thinner and 16% lighter than the previous generation Kindle, making it easy and comfortable to hold in one hand.
No glare in bright sunlight
Unlike reflective tablet and smartphone screens, the high contrast touchscreen display eliminates glare in any setting—even direct sunlight.
No eye strain, reads like real paper
Kindle uses actual ink particles and proprietary, hand-built fonts to create crisp text similar to what you see in a physical book. The blacks and whites on the screen are uniform, improving text and image quality.
Battery lasts weeks, not hours
Kindle doesn't need the power to maintain a page of text, allowing you to read for weeks on a single charge.
Unlike tablets, no blue light to disturb your sleep
Recent studies have shown that evening exposure to blue light from backlit screens like tablets and smartphones can suppress the body's production of melatonin, a naturally occurring hormone that helps the body fall asleep. Because the Kindle display emits no light, you can read anytime without losing sleep.
Thousands of books, no distractions
Kindle is designed as a dedicated e-reader. Indulge your love of reading without interruptions like email alerts and push notifications.
All images: Amazon, The Verge.
Kindle cases and gifts for 2020-21 season
Based on customer reviews and recommendations from top tech sites.
Fashionable marble & gold Kindle cases
Offered by LuvCase, these gorgeous cases combine marble with golden inserts the way nature would do it. Eight variants to choose from. Available for the basic Kindle and Kindle Paperwhite.
Vintage lamp with speaker – perfect for audiobooks
The lamp offers a steampunk look and adjustable brightness. The flame mode gives soft warm light that resembles flickering of a candle. The wireless Bluetooth speaker can play audiobooks for up to 8 hours.
Adjustable pillow stand – great for hands-free reading
From Lamicall comes a new kind of pillow stands – the one that lets you adjust the viewing angle. The stand is two-sided, with three angles on each side. The stand is made of durable materials and is available in four calming colors.
Keep exploring. Here are more posts for Kindle users:
Black Friday 2020 Kindle price predictions
– November 9, 2020
Prime Day deal for non-members: save huge on 160 Kindle bestsellers!
Kindle 8 (2016): tech specs, comparisons, reviews, and more https://ebookfriendly.com/kindle-2016-white-black/ via @ebookfriendly
The real danger is not that computers will begin to think like men, but that men will begin to think like computers.
– Sydney J. Harris – |
The Harrogate Hub is a place for community. The physical building is a place for all, a place that can feed everyone and anyone regardless of price tag, a place where our community can connect and engage with others or with support if needed. It isn't owned by one church but by many.
Many of our visitors come for a great cup of coffee and wholesome food, to engage with the wider community, to get involved in the events but sometimes because they are seeking more or need some help. The Hub gives a taste of what our wider community offers and can help to signpost people to support they haven't yet found. If you, your organisation or business provides something you feel would be helpful to the people of Harrogate then please get in touch.
Alongside or physical building the Hub is also a network of churches existing to facilitate and enable a shared mission that blesses our town. |
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Gifts in celebration
Brittany Croft receives prestigious award in California
For her cutting-edge study that sheds more light on how a baby's sex is determined, PhD student Brittany Croft has received a top international accolade.
She received the 2019 Lalor Foundation Merit Award at the Society for the Study of Reproduction (SSR) 52nd Annual Meeting in San Jose, California. The acknowledgement recognises the 'most meritorious, well-interpreted and significant research presented by students at a conference'.
At the conference, she also made Australia proud by receiving the award for Best International Abstract.
Ms Croft, who is studying for a PhD under the supervision of Professor Vincent Harley and Professor Andrew Sinclair (MCRI), was given the award in recognition for her research on how a baby's sex is determined, which she was invited to present on at the conference.
"It was a surprise to be awarded the Lalor Foundation Merit award. I felt really lucky to have been given the chance to present my work and to be showcased at the SSR meeting," Ms Croft said.
"This is a win for the project and all of the people who contributed to the Nature Communications paper we published late last year," she said.
Award-winning research
The study Ms Croft received the award for shows sex determination is not just about X-Y chromosomes, but involves a 'regulator' that increases or decreases the activity of a single gene that is needed to become male.
Ms Croft, who was co-first author of the study, said "The Y chromosome carries a critical gene, called SRY, which acts on another gene called SOX9 to start the development of testes in the embryo. High levels of the SOX9 gene are needed for normal testis development.
"However, if there is some disruption to SOX9 activity and only low levels are present, a testis will not develop resulting in a baby with a disorder of sex development," she said.
Lead author of the study, Professor Andrew Sinclair said, "We discovered three enhancers that work together to ensure the SOX9 gene is turned on to a high level in an XY embryo, leading to normal testis and male development.
"The key to diagnosing many disorders may be found in these enhancers, which hide in the poorly understood dark matter of our DNA," he said.
What's next for Ms Croft
"We are currently using the testis enhancers that I identified to assess changes in other sex determining genes," she said.
"This research will increase diagnosis rates for patients with sex development disorders, improving clinical care.
"Based on these findings, we have begun to screen patients with disorders of sex development for changes in these regulators. However, our lab is still the only one in Australia that does this.
"My hope is that diagnostic screens for these regulators will become included as routine prenatal screening across the world."
Ms Croft spent six weeks prior to the course attending the Marine Biological laboratory Embryology course in the USA, where she has been studying developmental biology and advanced scientific technology.
"Currently I am in the process of writing my thesis. Once I'm finished, my next step is to graduate and continue in a career in medical research," she said.
The Lalor Foundation Merit Award
The award is funded through The Anna Lalor Burdick Program, which focuses on improving the lives of young women who have inadequate access to information regarding reproductive health, including the subjects of contraception and pregnancy termination, and as such may be particularly lacking options in their lives.
Hudson Institute Communications
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This news article was posted on 23 July, 2019 .
It was last updated on 25 July, 2019 .
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A Baltimore native, Mr. Schuster joins Curio after several years of working in food and beverage operations. As a certified Lean Six Sigma practitioner, Grant helped Chesapeake Spice successfully implement a number of cost- and time-saving projects. He also created a company-wide, BRC-compliant training program. Grant received his Bachelor's in Business Administration from Emory University's Goizueta Business School in 2013 with concentrations in Organization & Management Consulting, Marketing, and Real Estate. |
Latour-de-Carol (in catalano La Tor de Querol) è un comune francese di 438 abitanti situato nel dipartimento dei Pirenei Orientali nella regione dell'Occitania. Vi si trova la Stazione di Latour-de-Carol - Enveitg.
Geografia fisica
Fa parte della regione storica nota come Cerdagna.
Società
Evoluzione demografica
Note
Altri progetti |
A second former State Department worker has pleaded guilty to illegally peeking at scores of confidential passport application files.
Dwayne Cross admitted in federal court in Washington on Wednesday that from 2002 to 2007, he used a government database to view the passport applications of more than 150 celebrities, actors, musicians, politicians, athletes and personal friends.
At the time, the 41-year-old Cross worked in the Bureau of Consular Affairs at the State Department. He pleaded guilty to one count of unauthorized computer access.
Cross is the second ex-State Department worker to plead guilty to passport prying. In December, a former foreign service officer was sentenced to a year of probation.
The issue of unauthorized peeping into private files came to light in March 2008, when authorities discovered contract passport workers had looked at the files of presidential candidates John McCain, Barack Obama and Hillary Rodham Clinton. Five contract workers were fired.
A follow-up investigation found that 85 percent of the passport files for a sampling of 150 famous Americans had been accessed suspiciously often.
The State Department maintains passport records for about 127 million Americans. |
The number of passengers choosing British Airways plunged by 5.6 per cent last month with 160,000 fewer flying.
The airline admitted last night that trading conditions continued to be 'challenging'.
BA said bookings for future flights were being affected 'by the increased anxiety in financial markets and by the uncertain economic outlook'.
Its planes were 74 per cent full last month compared with 78.3 per cent in September 2007. First class and business class journeys fell 8.6 per cent while economy class traffic was down 4.1 per cent.
Budget airline Ryanair said it had 5.23million passengers last month - a 20 per cent increase on the September 2007 figure.
But the general downturn has forced it to slash 14 per cent of its winter flights from Stansted. |
Free Nissan Murano repair manuals and diagrams – descriptions of Nissan Murano submodels, technical characteristics, disassembly/assembly step-by-step procedures and tools, inspection, testing and troubleshooting, detailed description of works and all necessary diagrams, easy-to-follow photos, exclusive councils of skilled mechanics and many other things… Nissan Murano submodels covered: Nissan Murano 2002-2007, Nissan Murano 2008-2014, Nissan Murano 2014-present. All Nissan Murano repair manuals are written specifically for the do-it-yourselfer.
The 1st generation Nissan Murano was available since 2002 in a 5-door SUV body style (2WD and 4WD models). Two petrol engines were available: 2.5 L QR25DE I4 produced 152 hp (113 kW) at 6,000 rpm and 171 lb·ft (232 N·m) at 4,000 rpm, 3.5 L VQ35DE V6 produced 245 hp (183 kW) at 5,600 rpm and 246-274 lb·ft (334-371 N·m) at 4,400 rpm. The 2nd generation Nissan Murano was available since 2008 in 5-door SUV and 2-door convertible body styles. Two petrol engines and one diesel engine were available: 2.5 L QR25DE I4 produced 152 hp (113 kW) at 6,000 rpm and 171 lb·ft (232 N·m) at 4,000 rpm, 3.5 L VQ35DE V6 produced 260-265 hp (194-198 kW) at 5,600 rpm and 246-274 lb·ft (334-371 N·m) at 4,400 rpm, 2.5 L YD25DDTi I4 produced 188 hp (140 kW) at 4,000 rpm and 330 lb·ft (450 N·m) at 2,000 rpm. The 3rd generation Nissan Murano was available since 2014 in a 5-door SUV body style. Two petrol engines were available: 2.5 L QR25DER I4 produced 250 hp (190 kW) at 5,600 rpm and 243 lb·ft (329 N·m) at 3,600 rpm, 3.5 L VQ35DE V6 produced 245 hp (183 kW) at 5,600 rpm and 246-274 lb·ft (334-371 N·m) at 4,400 rpm.
Follow Nissan Murano repair manuals, you can do it yourself – from maintenance to repairs of the vehicle. |
For the 13th episode of "The Innovation Engine" podcast, internationally acclaimed author and speaker Rowan Gibson joins us to discuss how companies can draft a blueprint for corporate innovation. Many companies and corporate leaders say they want to be innovative, but what does it take to truly make innovation a systemic capability? That's the question we look to get to the bottom of in this episode of the podcast.
Rowan is a world-renowned innovation expert who has served as a keynote speaker on innovation in 60 countries around the world. He is the internationally bestselling author of two major books on innovation, Innovation to the Core and Rethinking the Future, both of which are published in more than 20 languages. Rowan is also co-founder of Innovation Excellence.com, the most popular innovation website in the world, built on an international group of over 22,000 members from 175 countries.
Looking to draft your own blueprint for corporate innovation? Listen to the entire episode via the Stitcher Radio embed below to hear some tips on how to get started.
If you're interested in listening to previous episodes of the podast, you can subscribe to the The Innovation Engine on iTunes or tune in via the podcast's home on Stitcher Radio to listen online, via Android or iOS, or on any device supporting a mobile browser. |
This page is a guide for Getting Started on downloading and playing Last Epoch.
First things first, you'll want to make sure you have a computer that can run the game. Check out the System Requirements for the Game Version you would like to play.
For access to anything other than the publicly released pre-alpha demos, one of the Supporter Packs is required. Alpha Series supporter packs are available from the supporters page on the website.
The official guide for downloading and installing the alpha version can be found on the support website.
Additionally the download links for public pre-alpha versions can be found in the Official Discord in the downloadable-demos channel.
After downloading, the Game Launcher can be used to launch the game, download future patches and read patch notes.
When the game is launched it will open the default unity launcher window from which the player may select their desired screen resolution, graphics quality, monitor and windowed or fullscreen (defaults when windowed is unchecked) to launch the game in.
After launching the game players will be directed to login to their Last Epoch account used to purchase the game.
After logging in players will be taken to a screen displaying their account name, a switch user button that will log them out, and a play button that will take them to the character selection screen.
The account screen when logged in.
From the character selection screen players are able to access and change the Settings and exit the game.
Players will be able to select any of their characters from the dropdown and begin playing them or delete them.
If a player has no characters they will need to click on the "Create New Character" button, and follow the Character Creation guide.
This page was last edited on 24 August 2018, at 06:11. |
Il celtic pop è una variante del celtic rock.
È caratterizzato da suoni più dolci ed orecchiabili del rock, grazie all'allegria e dalla vivacità ritmica (tipica del folk irlandese) fusa con sonorità e metriche moderne, tipiche del pop.
Da molti viene indicato come l'anello di congiunzione tra la musica popolare irlandese, ed il pop moderno, proprio per l'utilizzo di strumenti, come il Fiddle, tradizionalmente impiegati nella musica folk.
Tra gli artisti di maggior successo troviamo i Corrs e il cantautore Christy Moore.
In Italia
Se il celtic rock è stato introdotto da alcune composizioni di Angelo Branduardi già negli anni '70, il celtic pop anche in Italia ebbe il suo momento di gloria nel 2002 (precedentemente era stato proposto anche nella primissima parte di carriera dal duo Paola e Chiara con Amici come prima del 1997), grazie alla canzone Il passo silenzioso della neve e all'album Creatura nuda di Valentina Giovagnini. Proprio la giovane artista toscana (mancata in un incidente stradale il 2 gennaio 2009) si può lecitamente definire la sola fautrice italiana di spicco del celtic pop, prevalente in entrambi i due album da lei pubblicati, Creatura nuda e il postumo L'amore non ha fine.
È da segnalare anche l'esperienza del duo Sonohra, che ha collaborato anche con Hevia, celebre compositore ed esecutore di musica celtica asturiano.
Voci correlate
The Corrs
Christy Moore
Valentina Giovagnini
Musica irlandese
Celtic rock
Pop (musica)
Collegamenti esterni
Celtic
Generi musicali di musica celtica |
from django.contrib import admin
from .forms import LiveSettingsForm
from .models import LiveSetting
class LiveSettingsAdmin(admin.ModelAdmin):
list_display = ('key', 'key_type', 'value')
form = LiveSettingsForm
admin.site.register(LiveSetting, LiveSettingsAdmin)
|
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Home Books Anesthesiology, 2e
Chapter 6. Overview of Preoperative Assessment and Management
Bobbie Jean Sweitzer; Michael Pilla
Sweitzer B, Pilla M. Sweitzer B, & Pilla M Sweitzer, Bobbie Jean, and Michael Pilla.Chapter 6. Overview of Preoperative Assessment and Management. In: Longnecker DE, Brown DL, Newman MF, Zapol WM. Longnecker D.E., & Brown D.L., & Newman M.F., & Zapol W.M.(Eds.),Eds. David E. Longnecker, et al.eds. Anesthesiology, 2e. McGraw Hill; 2012. Accessed February 01, 2023. https://accessanesthesiology.mhmedical.com/content.aspx?bookid=490§ionid=40114687
Sweitzer B, Pilla M. Sweitzer B, & Pilla M Sweitzer, Bobbie Jean, and Michael Pilla. (2012). Chapter 6. overview of preoperative assessment and management. Longnecker DE, Brown DL, Newman MF, Zapol WM. Longnecker D.E., & Brown D.L., & Newman M.F., & Zapol W.M.(Eds.),Eds. David E. Longnecker, et al. Anesthesiology, 2e. McGraw Hill. https://accessanesthesiology.mhmedical.com/content.aspx?bookid=490§ionid=40114687
Sweitzer B, Pilla M. Sweitzer B, & Pilla M Sweitzer, Bobbie Jean, and Michael Pilla. "Chapter 6. Overview of Preoperative Assessment and Management." Anesthesiology, 2e Longnecker DE, Brown DL, Newman MF, Zapol WM. Longnecker D.E., & Brown D.L., & Newman M.F., & Zapol W.M.(Eds.),Eds. David E. Longnecker, et al. McGraw Hill, 2012, https://accessanesthesiology.mhmedical.com/content.aspx?bookid=490§ionid=40114687.
Goals and Benefits
Risk Assessment and Reduction
Preoperative Testing
High-Risk Patients
Clinical Models and Management
The Future of Preoperative Clinics
Comprehensive preoperative evaluation and management improve patient satisfaction, outcomes, and safety.
Inadequate preoperative evaluation and management increase perioperative adverse events and often lead to delays or cancellations of procedures.
At a minimum, the preanesthesia visit should include an interview with the patient to review the medical history (including medications, allergies, comorbid conditions, previous operations, and anesthetics), an appropriate physical examination, review of diagnostic data, assignment of an American Society of Anesthesiologists physical status score, and a formulation and discussion with the patient of the anesthetic plan.
The medical history is the most important component of preoperative assessment.
Findings from the history and physical examination determine the need, if any, for further diagnostic testing.
Diagnostic tests should only be ordered if the results will alter the planned anesthetic or procedure or establish an already suspected diagnosis. "Screening" tests are never appropriate.
Cardiovascular morbidity and mortality are the leading cause of significant perioperative adverse events.
Identification and management of cardiovascular disease is an important goal of preoperative evaluation.
Knowledge of risk factors for cardiovascular disease and familiarity with the American College of Cardiology–American Heart Association guidelines for cardiovascular evaluation for noncardiac surgery is essential.
A determination of functional capacity or the patient's cardiorespiratory fitness can guide further testing and predict a wide range of complications and outcome.
Potentially high-risk patients include those with the following conditions:
Pacemakers, implantable cardioverter-defibrillators (ICDs)
Vascular stents
Poorly controlled hypertension
Advanced age
Difficult airway
Knowledge and management of antiplatelet therapy in patients with coronary stents is imperative in the perioperative period.
Poor communication is a common source of medical errors, patient dissatisfaction, and malpractice claims.
Practice guidelines can standardize care, decrease delays, and improve outcomes.
Anesthesia-directed preoperative evaluation centers can be cost-effective, improve care and safety, and offer services beyond history acquisition, physical examinations, and diagnostic testing.
As the practice of medicine becomes increasingly outcomes driven and cost conscious, clinicians need to reevaluate and streamline methods of patient care. The role of the anesthesiologist as a consultant is more important than ever. No single clinician is better informed and capable than the anesthesiologist to evaluate patients who require anesthesia. Preoperative assessment and management have evolved as the role of the anesthesiologist has expanded outside of the operating theater and as an increasing number of procedures are performed on patients who are not hospitalized before their anesthetics. Reasons for preoperative assessment may entail some or all of the following:
To screen for and properly manage comorbid conditions.
To assess the risk of anesthesia and surgery and lower it.
To identify patients who may require special anesthetic techniques or postoperative care.
To establish baseline results for perioperative decisions.
To educate patients and families about the objectives and risks of anesthesia and the anesthesiologist's role in perioperative care.
To obtain informed consent.
To facilitate timely care and avoid cancellations on the day of operation.
To determine the appropriateness of patients to undergo anesthesia in out-of-operating room or ambulatory surgical facilities.
To motivate patients to stop smoking, lose weight, or commit to other preventive care.
To train personnel in the art and science of preoperative assessment and optimization of a patient's condition.
The Australian Incident Monitoring Study (AIMS) found that 3.1% (197 of the first 6271 reports) of adverse events were unequivocally related to insufficient, and 11% to inadequate, preoperative assessment.1 More than half of incidents were considered preventable. An analysis of the first 2000 reports to AIMS found a 6-fold increase in mortality in patients who were inadequately assessed preoperatively.2 Davis concluded that 53 (39%) of 135 deaths attributed to anesthesia involved inadequate preoperative assessment and management.3 Delays, complications, and unanticipated postoperative admissions are significantly reduced by preoperative screening and patient contact. Others have shown that preoperative health status can predict operative outcomes and resource use. Preoperative preparation and education can facilitate recovery and reduce the incidence of postoperative morbidity. In France, a preoperative consultation has been mandated since 1994. Although debates continue regarding both the financial implications and convenience to society and patients, this process has been associated with a greater than 10-fold decrease in anesthetic-related complications.4 Anxiety, postoperative pain, and length of stay have been positively affected by comprehensive preoperative care. Adequate pain management correlates significantly with patients receiving sufficient preoperative information.5 From the patient's perspective, an opportunity to meet an anesthesiologist (preferably the one providing anesthesia on the day of surgery) is very important. In a study conducted in Canada and Scotland, patients rated meeting the anesthesiologist as the highest priority, above that of information on pain relief, alternative methods of anesthesia, and complications.6
Preoperative evaluation must be efficient for both patient and hospital personnel. It can be cost-effective and can reduce turnover times, cancellations, and length of hospital stays. In a retrospective analysis of practices at one major US teaching hospital, significant reductions in case cancellations were observed for same-day surgery patients (8.4% vs 16.2%) and main operating room patients (5.3% vs 13%) when patients had a preoperative evaluation.7 Preoperative visits should be comprehensive, including plans for postdischarge patient care. Many anesthesiologists perform preoperative evaluations, review diagnostic studies (often chosen and ordered by someone else), discuss anesthetic risks, and obtain informed consent moments before a patient undergoes a major, potentially life-threatening or disfiguring procedure. This choice offers little opportunity to manage comorbid conditions or alter risk. Legally, morally, and psychologically, anesthesiologists and patients are in awkward, and often unpleasant, situations. The effects of extensive disclosure are stressful for patients and families at a time when they may be ill prepared to consider the implications rationally. An increase in preoperative anxiety may adversely affect postoperative outcomes because increased anxiety correlates with increased postoperative analgesic requirements and prolonged recovery and hospital stay. Anxiety impairs retention of information, which could result in legal action because of inadequate communication or discussion of the risks of anesthesia.
At a minimum, the guidelines of the American Society of Anesthesiologists (ASA) indicate that a preanesthesia visit should include the following:8
Interview with the patient to review medical, anesthesia, and medication history
Appropriate physical examination
Review of appropriate diagnostic data (laboratory, electrocardiograms, radiographs)
Assignment of ASA physical status score
Formulation and discussion of the anesthesia plan with the patient or a responsible adult
Table 6-1 outlines the criteria and medical conditions of patients likely to benefit from evaluation in a preanesthetic clinic before the day of surgery.
Table 6-1 General Criteria and Medical Conditions for Which Preoperative Evaluation Is Recommended before the Date of Surgery
Normal activity inhibited
Monitoring or medical assistance at home within 2 mo
Hospital admission within 2 mo
Obesity >140% ideal body weight
Systolic blood pressure >180 mm Hg or diastolic blood pressure >110 mm Hg
Asthma requiring daily medications
Chronic obstructive pulmonary disease (COPD) with symptoms
Exacerbation or progression of COPD within 2 mo
Previous airway surgery
Unusual airway anatomy
Airway tumor or obstruction
Home ventilatory assistance or monitoring
Active thyroid disease
CNS disease (eg, multiple sclerosis)
Myopathy or other muscle disorders
Active hepatobiliary disease or compromise
Renal insufficiency or failure
Kyphosis or scoliosis compromising function
Temporomandibular joint disorder limiting mouth opening
Cervical or thoracic spine injury/disease
Chemo- or radiotherapy within last 2 mo
Significant physiologic compromise from disease or treatment
>75 y, unless surgery is minor (eg, cataract, cystoscopy) and under monitored anesthesia care
Patient or parent/guardian cannot hear, speak, or understand English
Anesthesia related
Patient or family has had previous difficult intubation, elevated temperature during anesthesia, is allergic to succinylcholine, has malignant hyperthermia or pseudocholinesterase deficiency or paralysis or nerve damage during anesthesia
Procedure related
Intraoperative blood transfusion likely
ICU admission likely
High-risk surgery
Patient is pregnant (unless the procedure is termination)
This table has been updated and adapted with permission from Pasternak LR. Preoperative evaluation of the ambulatory surgery patient. Ambulatory surgery. Anesthesiol Rep. 1990;3(1):8.
The current ASA risk classification system was developed in 1941 by Meyer Saklad at the request of the ASA (Table 6-2). This classification was the first attempt to quantify risk associated with anesthesia and surgery. The type of anesthesia and the operation are not even considered in this classification system. Moreover, this system attempted to estimate the mortality rate based only on the patient's preoperative medical condition. Since then, other studies have corroborated an association of mortality and morbidity with ASA physical status (ASA PS) scores. Studies also have shown a correlation between ASA PS and unanticipated intensive care unit admissions, longer hospital stays for some procedures, and adverse cardiopulmonary outcomes. No correlation was shown between ASA PS class and cancellations, unplanned admissions, and other perioperative complications and cost.9 Few studies have evaluated the effect of combining the risk of the surgical procedure and the ASA PS score. Among the first was the Johns Hopkins Risk Classification System.10 Many institutions use a more simplified version of high, intermediate, and low risk.11 Figure 6-1 offers one example of such a risk stratification.
Table 6-2 American Society of Anesthesiologists Physical Status Classification
P1 Healthy patient without organic, biochemical, or psychiatric disease.
P2 A patient with mild systemic disease (eg, mild asthma or well-controlled hypertension). No significant impact on daily activity. Unlikely impact on anesthesia and surgery.
P3 Significant or severe systemic disease that limits normal activity (eg, renal failure or dialysis or class 2 heart failure). Significant impact on daily activity. Likely impact on anesthesia and surgery.
P4 Severe disease that is constant threat to life or requires intensive therapy (eg, acute myocardial infarction, respiratory failure requiring mechanical ventilation). Serious limitation of daily activity. Major impact on anesthesia and surgery.
P5 Moribund patient who is equally likely to die in the next 24 h with or without surgery.
P6 Brain-dead organ donor.
"E" added to the above (P1-P5) indicates emergency surgery.
Adapted from American Society of Anesthesiologists. ASA physical status classification system. ASA Web site. www.asahq.org.
Figure 6-1.
Simplified cardiac evaluation for noncardiac surgery.
ACC, American College of Cardiology; AHA, American Heart Association; METS, metabolic equivalent of task score; MI, myocardial infarction; NYHA, New York Heart Association; TIA, transient ischemic attack.
Goldman et al further advanced risk assessment by identifying risk factors and cardiac complications in noncardiac surgery. Several studies followed, culminating in the joint guideline publication by the American College of Cardiology and the American Heart Association (ACC/AHA) in 1996, which was most recently updated in 2007.11 (see "Heart Disease" later and Chapter 9 for more detailed discussions of the ACC/AHA guidelines.) However, there are limited studies or guidelines addressing specific disease states and their effects on perioperative risk. Pulmonary and renal risk and the implications of certain laboratory abnormalities (albumin and hematocrit levels) have been evaluated.12-15
Some assessment of risk is important to prepare for the anesthetic and surgical procedure. The need for invasive monitoring, blood salvage and hypothermic techniques, postoperative care in the intensive care unit, and special monitoring must be considered. Patients must be informed during the consent process. Technical terms used in the consent may be misunderstood.16 Risk assessment is useful to compare outcomes, control costs, allocate compensation, and assist in the difficult decision of canceling or recommending a procedure not be done when the risks are too high. Yet risk assessment, at its best, is hampered by individual patient variability.
Timing of Assessment
The Practice Advisory for Preanesthesia Evaluation commissioned by the ASA determined that the time of the preanesthesia assessment depends on the patient's condition, the type of procedure, the health care system, and the patient's access to care providers.8 The recommendations, which were based on the opinions of experts and randomly selected ASA members, favor assessments on or before the day of surgery for low to medium invasive procedures and before the day of operation for highly invasive procedures. The consensus is for assessments before the day of surgery for patients with less severe disease if they are scheduled for highly invasive procedures and for patients with severe disease for less invasive procedures. For selected patients, evaluations on the day of surgery can be safe and effective.
The importance of a visit to the preoperative clinic before a surgical procedure cannot be overstated.17 A Canadian survey found that more than 60% of patients thought it was important to see an anesthesiologist preoperatively, more than 30% thought it was extremely important, and more than half indicated that the visit should be before the day of operation.18 Anesthesiologists at Massachusetts General Hospital demonstrated that a preoperative visit before the day of surgery was as good as or better than medication in reducing preoperative anxiety and postoperative pain.
Detecting Disease
Several studies have proved the usefulness of the history and physical examination in deciding a diagnosis. A study of patients in a general medical clinic found that 56% of correct diagnoses were made with the history alone and rose to 73% with the physical examination. In patients with cardiovascular disease, the history established the diagnosis 66% of the time, and the physical examination contributed to 25% of diagnoses. Moreover, routine investigations, mainly chest radiography and electrocardiography (ECG), helped with only 3% of diagnoses, and special tests, mainly exercise ECG, assisted with 6%.19 ECG alone was only 14% predictive in the diagnosis of left ventricular dysfunction in patients with suspected neuromuscular disease.20 History is also the most important diagnostic method in respiratory, urinary, and neurologic conditions. The skill of performing a clinical examination derives from pattern recognition learned by seeing patients and listening to the stories of their illnesses. The diagnostic acumen of the physician is a result of the ability to assimilate information and develop an overall impression, rather than just reviewing a compilation of facts.
One common problem is the variability of the medical history. Asking and recording symptoms in ordinary words leads to greater interobserver agreement between practitioners. History taking is not simply asking the questions; history taking includes interpreting and carefully recording the answers. Complete and thorough histories not only assist in planning appropriate and safe anesthesia care, but they also are more accurate and cost-effective in establishing diagnoses than screening laboratory tests.
The patient's medical problems, past operations, previous anesthesia-related complications, allergies, and use of tobacco, alcohol, or illicit drugs should be documented. Equally important to identifying the presence of a disease is establishing the severity, the stability, and prior treatment of the condition. A screening review of systems needs special emphasis on airway abnormalities, personal or family history of adverse events related to anesthesia, and cardiovascular, pulmonary, endocrine, or neurologic symptoms.
The patient's medical problems, previous operations, and responses to questions elicit further questions to establish the severity of disease, its stability, current or recent exacerbations, and recent or planned interventions. Rarely is a simple notation of diseases or symptoms such as hypertension (HTN), diabetes mellitus (DM), coronary artery disease (CAD), shortness of breath (SOB), or chest pain sufficient. The severity, extent, degree of control, and the activity-limiting nature of the problems are equally important.
A determination of the patient's cardiorespiratory fitness or functional capacity is useful in guiding additional preanesthetic evaluation and predicting outcome and perioperative complications.11,21 Exercise or work activity can be quantified in the metabolic equivalent of task score (METS), which refer to the volume of oxygen consumed during an activity.22 One's ability to exercise is two pronged in that better fitness decreases mortality through improved lipid and glucose profiles and reductions in blood pressure and obesity. An inability to exercise may be a result of cardiopulmonary disease. Several studies show that inability to perform average levels of exercise, equivalent to 4 to 5 METS (walking 4 blocks on level ground, climbing 2 flights of stairs or 1 flight of stairs carrying 20 lb), identifies patients at risk of perioperative complications.
Table 6-3 shows the important components of an anesthesia history. The form can be completed by the patient in person (paper or electronic version), via Internet-based programs, via a telephone interview, or by anesthesia staff. A more detailed discussion of important components of the history for specific medical conditions is presented later (see "High-Risk Patients").
Table 6-3 Sample Patient Preoperative History
At a minimum, the preanesthetic examination should include the airway, a heart and lung examination, vital signs, including oxygen saturation, and height and weight. Increased body mass index (BMI) is one of many factors associated with development of chronic diseases such as heart disease, cancer, and DM, and it can be calculated from an individual's height and weight. The two formulas for calculating the BMI are the English and the metric.
English formula:
Metric formula:
See "Obesity" for further discussion and for definitions of BMI categories for adults.
Components of the airway examination should include the following23:
Length of upper incisors
Condition of the teeth
Relationship of upper (maxillary) incisors to lower (mandibular) incisors
Ability to protrude or advance lower (mandibular) incisors in front of upper (maxillary) incisors
Interincisor or intergum (if edentulous) distance
Visibility of uvula
Presence of heavy facial hair
Compliance of mandibular space
Thyromental distance
Length of neck
Thickness of neck
Range of motion of head and neck
Because of the relatively frequent incidence of dental injuries during anesthesia, a thorough documentation of preexisting tooth and gum abnormalities is useful. Either a tooth chart (Fig. 6-2) or standard nomenclature (eg, right upper central incisor, left lower lateral incisor, or right lower bicuspid) can be helpful.
Dental chart. [From Tintinalli JE, Kelen GD, Stapczynski JS. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004.]
It is important to discuss potential dental risks, especially in the presence of poor dentition.24 A good time to discuss with patients variant options of airway management, including possible fiberoptic intubation when necessary, is after examination of the airway. Findings from the airway examination may predict difficult intubations.25 When challenging airways are identified, advance planning ensures that necessary equipment and skilled personnel are available.
Auscultation of the heart and inspection of the pulses, peripheral veins, and extremities for the presence of edema are important diagnostically and for risk assessment in development of care plans. One should auscultate for murmurs, rhythm disturbances, and signs of volume overload. Murmurs, without a clear etiology (anemia, hyperthyroidism, or pregnancy, with confirmation that the murmur was not present prior to these conditions), warrant further evaluation (see "Heart Disease").
The pulmonary examination includes auscultation for wheezing, decreased or abnormal breath sounds, notation of cyanosis or clubbing, and effort of breathing. Observing whether the patient can walk up 1 to 2 flights of stairs can predict a variety of postoperative complications, including pulmonary and cardiac events and mortality, and aid in decisions regarding the need for further specialized testing such as pulmonary function tests (PFTs) or noninvasive cardiac stress testing.11,26,27 For selective patients (eg, those with deficits or disease who are undergoing neurologic surgery or regional anesthesia), a neurologic examination is necessary to document preexisting abnormalities that may aid in diagnosis, interfere with positioning, or establish a baseline in defense of potential malpractice claims of adverse events.28
Obesity, HTN, and large neck circumference predict an increased incidence of obstructive sleep apnea (OSA). See "Obstructive Sleep Apnea."
Preoperative testing is performed to evaluate existing medical conditions and to diagnose asymptomatic conditions based on known risk factors for particular diseases. Diagnostic tests can aid in the assessment of the risk of anesthesia and operation, guide medical intervention to lower this risk, and provide baseline results to direct intra- and postoperative decisions. The choices of laboratory tests depend on the probable impact of the test results on the differential diagnosis and on patient management. A test is ordered only if the results will have an impact on the decision to proceed with the planned procedure or alter the care plans, The history and physical examination are used to direct test ordering. Table 6-4 contains recommendations for testing based on specific medical conditions. Guidelines in this table are not intended for all patients with those conditions but to aid in diagnosing a disease, to optimize the patient if the disease state is out of control, or for high-risk surgeries.
Table 6-4 Preoperative Diagnostic Testing Order Form for Intermediate- to High-Risk Procedures by Disease and Therapy-Based Indicationsa
□ AST/AlkP Alcohol abuse; exposure to hepatitis; hepatic disease; history of bleeding
□ β-hCG Possible pregnancy
□ BUN/Cr Cardiovascular, hepatic, or renal disease; diabetes; poor exercise tolerance; systemic lupus; use of digoxin, diuretics, steroids; procedures with radiographic dye
□ CBC w/plt Alcohol abuse, anemia; cardiovascular, pulmonary, or renal disease; malignancy; malnutrition; history of bleeding; procedures with significant blood loss
□ CXR Active, acute symptoms especially with cardiovascular or pulmonary disease; rheumatoid arthritis, systemic lupus; smoking >40 pack-years; radiation therapy
□ ECG Alcohol abuse; cardiovascular, cerebrovascular, intracranial, peripheral vascular, pulmonary, or renal disease; diabetes; morbid obesity; poor exercise tolerance; rheumatoid arthritis; sleep apnea; smoking >40 pack-years; systemic lupus; radiation therapy to chest or breasts; use of digoxin
□ Electrolytes Intracranial, or renal disease; diabetes; malnutrition; use of digoxin, diuretics
□ Glucose Intracranial disease; diabetes; morbid obesity; steroid use
□ PT Alcohol abuse; hepatic disease; malnutrition; personal history of bleeding; use of anticoagulants
□ aPTT Personal or family history of bleeding, heparin use
□ Thyroid tests Thyroid disease; use of thyroid medications
□ T&S Procedure with significant blood loss potential
□ Urinalysis Suspected urinary tract infection
AST/AlkP, aspartate transaminase/alkaline phosphatase; β-hCG, β-human chorionic gonadotropin; BUN/Cr, blood urea nitrogen/creatinine; CBC w/plt, complete blood count with platelets; CXR, chest x-ray; ECG, electrocardiogram; PT, prothrombin time; aPTT, activated partial thromboplastin time; T&S, type and screen.
aGuidelines are not for routine testing in all individuals with stated conditions but are only indicated if the medical condition is newly diagnosed, evolving, or unstable or results will alter anesthetic management. Guidelines may not apply for low-risk procedures where testing is rarely indicated except in situations when the patient's medical condition is significantly deranged. With the exception of β-hCG for pregnancy, all tests are valid for 2 months before surgery unless abnormal or patient's condition has changed.
Preoperative tests without specific indications lack clinical usefulness and may actually lead to patient injury because of unnecessary interventions, delay of surgery, anxiety, and even inappropriate therapies. The history is responsible for the diagnosis 75% of the time and is more important than the physical examination and laboratory investigations combined. In addition, the evaluation of abnormal results is costly. Many studies have evaluated the benefits of disease/condition-indicated testing versus screening batteries of tests.29 Few abnormalities detected by nonspecific testing resulted in changes in management, and rarely have such changes had a beneficial patient effect.30 At most 1 in 1000 patients has benefited from findings derived from nonindicated testing.31 Blery et al found that 0.4% of tests without specific indications provided useful clinical information.30 However, 1 in 2000 preoperative tests resulted in patient harm from pursuit of abnormalities detected by those tests; only 1 in 10,000 was of benefit to the patient.9 It has been suggested that not following up on an abnormal result is a greater medicolegal risk than not identifying the abnormality to begin with. Several studies have demonstrated that routine preoperative testing in ambulatory surgery patients is not useful and cite disparity in requirements for tests among anesthesia providers.29,32
Preoperative ECGs are one of the most frequently ordered and costly noninvasive tests. Occult heart disease is common in the middle-age population and increases with advancing age. Preexisting heart disease increases perioperative risk. Recommendations for age-based testing were derived from the high incidence of abnormalities found on ECGs of elderly patients. The Centers for Medicare and Medicaid Services (CMS) do not reimburse for "preoperative" or age-based ECGs; one must provide a supporting diagnosis with an acceptable International Classification of Diseases, Ninth Revision (ICD-9) code. (Centers for Medicare and Medicaid Services. Available at http://www.cms.hhs.org. Accessed May 19, 2010.) Even the ASA Practice Advisory for Preanesthesia Evaluation states, "The Task Force recognizes that age alone may not be an indication for an electrocardiogram."8 A resting ECG is not a reliable screen for CAD and is a poor predictor of heart disease (without a supporting history) in nonsurgical patients. It appears that only some ECG abnormalities are important in the perioperative period (eg, new Q waves and arrhythmias). One study found only 2% of patients had one or both of these abnormalities.33 The frequency of silent Q-wave infarctions found only by ECG in men age 75 years or older (the highest risk group) is approximately 0.5%. Gold et al found that in ambulatory surgical patients, the incidence of abnormal ECGs was 43%. Only 1.6% (12 of 751) of patients had an adverse perioperative cardiac event and in only half (6 of 751) of these was the preoperative ECG of potential value.34 History is far more important. An abnormal ECG will be found in 62% of patients with known cardiac disease, in 44% of patients with strong risk factors for ischemic heart disease, and in only 7% of patients older than 50 years with no risk factors. Results are abnormal in only 3% of patients between ages 50 and 70 years without risk factors for heart disease.35
Some abnormalities may have implications for anesthesia care beyond the detection of CAD. Arrhythmias, such as atrial fibrillation, which can be detected on physical examination and confirmed by ECG, conduction abnormalities, and left ventricular hypertrophy, may alter anesthesia plans. Adjustments may be necessary to avoid hemodynamic instability, ischemia, or pulmonary edema because of drug interactions or the stress of surgery combined with previous, but not necessarily clinically significant, disease. Plans can be made on the day of operation when monitors are placed in the preoperative area or the operating room rather than incurring the expense of a 12-lead ECG beforehand. Many practitioners espouse the need to establish a baseline. However, this approach is misguided and costly. A preoperative 12-lead ECG is rarely comparable with the intraoperative ECG due to varying lead placement. Anesthetic drugs, position, and volume changes affect the ECG. An unchanged ECG does not eliminate the possibility of ischemia; nor does any change on an ECG absolutely establish a diagnosis. A better comparison can be obtained once the patient is in the operating room with the monitoring ECG in place right before induction of anesthesia by printing off rhythm strips of various leads, most importantly leads II, V4, or V5.
The ACC/AHA Guidelines for Perioperative Cardiovascular Evaluation for Noncardiac Surgery no longer consider ECG abnormalities in deciding on further noninvasive stress testing.11 A prospective observational study in patients 50 years or older having noncardiac surgery found abnormalities in 45% of the preoperative ECGs, and bundle branch blocks were associated with postoperative myocardial infarction (MI) and death but had no added predictive value over clinical risk factors.36 The ASA Preoperative Evaluation Practice Advisory recognized that ECG did not improve prediction beyond risk factors identified by patient history.8 Chung et al showed that elimination of testing did not increase risk as long as patients had a clinical evaluation preoperatively.29 In a retrospective study of 23,036 patients, patients undergoing low- to intermediate-risk noncardiac surgery with abnormalities on their preoperative ECG had only a 0.5% increase in cardiovascular mortality as compared with cohorts with normal ECGs.37 In summary, the prevalence of abnormalities on ECG may incur costly evaluation, delaying necessary surgery, and the yield of these workups is quite low. Table 6-4 provides guidance for ECG testing.
Hemoglobin (Hgb) and hematocrit (Hct) levels are frequently abnormal in otherwise healthy patients, but they rarely have an impact on anesthetic care or management unless the planned procedure involves the potential for significant bleeding. Abnormal Hgb levels (both higher and lower than normal) predict postoperative complications and mortality. However, interventions to correct anemia such as transfusion or erythropoietin carry risks of their own. Anemia is often an indication of disease related or unrelated to the planned surgery. If the discovery of anemia will lead to an alteration in surgical plans or prompt further evaluation for disease, such as colonoscopy, and previous laboratory values are unavailable, then testing is warranted.12,15
Coagulation studies (platelet count, prothrombin, or activated partial thromboplastin time) are not recommended unless the patient history suggests a coagulation disorder. If a patient has a negative history for a bleeding disorder, the cost of screening coagulation tests before most surgeries outweighs the benefit. Many practitioners mistakenly believe that a screening prothrombin time (PT) is more likely to be abnormal because of the numbers of patients with liver disease, malnutrition, or warfarin use, conditions that should be readily identified by history. If "screening" tests (not based on history) are ordered, a platelet count and activated partial thromboplastin time (aPTT) are indicated to detect the uncommon patient with thrombocytopenia, an acquired anticoagulant (eg, lupus anticoagulant), or a reduced level of a contact activation factor (eg, von Willebrand disease or factor VIII, IX, XI, or XII deficiencies). Additionally, a short aPTT may be equally as important as a prolonged aPTT. A short aPTT increases the risk of postoperative thromboembolism. The CMS does not reimburse for "routine" or "preoperative" PT/aPTT without an appropriate ICD-9 code.38
There are few data to recommend age-based testing. No correlation has been established, independent of coexisting disease, a positive history, or findings on physical examination, between age and abnormalities in Hgb, serum chemistries, radiographs, or PFTs.31,39,40 Chest radiographs are indicated only in patients with pulmonary signs or symptoms of undetermined cause or severity.13
There is much controversy about and no consensus regarding routine pregnancy testing, especially in adolescents.41 Surveys show that 30% to 50% of practitioners mandate testing in women of childbearing age, primarily because of the unreliability of the history, especially from minors, and the concern over the potential harm to the pregnancy or fetus with anesthesia and surgery, with the attendant medicolegal implications.42,43 Opponents of mandatory testing cite the false-positive rate, cost, the belief that history is reliable if taken in privacy, and the paucity of data establishing risks of anesthesia in early pregnancy. When minors are pregnant, their privacy is governed by state laws. One must be familiar with local statutes and how unexpected positive pregnancy results will be handled. With the high reliability of urine testing, it is best to delay testing until the day of operation instead of testing in the preoperative clinic, unless the patient suspects pregnancy or the menstrual period is delayed. This delay in testing will obviate a negative test days before surgery that may be positive on the day of surgery. The ASA Preoperative Evaluation Practice Advisory "[r]ecognizes the literature is insufficient to inform patients or physicians on whether anesthesia causes harmful effects on early pregnancy. Pregnancy testing may be offered to female patients of childbearing age and for whom the result would alter the patient's management.8
Healthy patients or those with chronic, stable diseases, of any age undergoing low- or intermediate-risk procedures without expected significant blood loss are unlikely to benefit from any tests (Tables 6-4 and 6-5).29 Exceptions are a procedure with the injection of contrast (creatinine level is indicated) or the possibility of pregnancy (a pregnancy test should be done) as shown in Table 6-5. If significant blood loss is expected, Hgb and/or Hct and type and screen are indicated (Table 6-5). Table 6-4 contains the recommendations for diagnostic tests for patients who either have poorly managed coexisting diseases or are suspected of having a condition that has not been diagnosed. Even these tests may not be indicated in this same patient population if they are anticipating low-risk operations, especially with sedation only. In general, tests are recommended only if the results may:
Change, cancel, or postpone the surgical procedure
Change anesthetic and medical management
Change monitoring or intra- or postoperative care
Establish a diagnosis in a patient who has not been adequately prepared
Table 6-5 Basic Preoperative Testing Guidelines
Procedure/Patient Type
Injection of contrast dye Creatininea
Potential for significant blood loss Hemoglobin/hematocrita
Likelihood of transfusion requirement Type and screen
Possibility of pregnancy Pregnancy testb
End-stage renal disease Serum potassiumc
Diabetes Blood glucose on day of surgeryc
Active cardiac condition (eg, decompensated heart failure, arrhythmia, chest pain, murmur) Electrocardiogram
aResults from laboratory tests within 3 months of surgery are acceptable unless major abnormalities are present or a patient's condition has changed.
bA routine pregnancy test before surgery is not recommended before the day of surgery. A careful history and local practice determine whether a pregnancy test is indicated.
cThere is no absolute level of either potassium or glucose that precludes surgery and anesthesia. The benefits of the procedure must be balanced against the risk of proceeding in a patient with abnormal results.
Many facilities have developed diagnostic testing guidelines to improve patient care, standardize clinical practice, improve efficiency, and reduce costs. With implementation of guidelines, one facility reduced the tests ordered by 60%, improved testing by 81%, and saved almost $80,000 per year. The Mayo Clinic reduced preoperative testing and its costs without a change in outcomes. A cost-to-benefit analysis found that routine urinalysis for all knee replacement surgery in the United States would cost $1.5 million to prevent 1 wound infection.44 Interestingly, one study found 50% more routine ECGs and 40% more chest radiographs were done in a fee-for-service versus a prepaid practice.45
Many of these conditions are discussed in greater detail in other chapters of this text, but here is a brief review of some common diseases that often require perioperative intervention. Identification of patients with these comorbid conditions often presents an opportunity for the anesthesiologist to intervene to lower risk. The following conditions are best managed before the day of surgery, which allows ample time for thoughtful evaluation, consultation, and planning.
Cardiovascular complications are the most common serious adverse event perioperatively. It is estimated that 1% to 5% of unselected noncardiac surgical patients will suffer a cardiac morbidity. Next is a brief discussion of a few high-risk issues that are likely to be encountered in the preoperative clinic. The patient with ischemic heart disease, coronary stent(s), heart failure (HF), a rhythm disturbance, an abnormal ECG, an undiagnosed murmur, or a cardiac rhythm management device is discussed. Chapter 9 provides a comprehensive review of cardiovascular disease.
The goals in the preanesthetic encounter are to:
Identify the risk of heart disease based on comorbid diseases (Fig. 6-1)
Identify the presence and severity of heart disease from symptoms, physical findings, or diagnostic tests
Determine the need for preoperative interventions
Modify the risk of perioperative adverse events
The basis of cardiac assessment is the history, the physical examination, and the ECG. The guidelines for cardiac evaluation before noncardiac surgery published by the ACC/AHA are the national standard of care.11 Figure 6-1 presents a simplified approach to the evaluation of patients at risk of heart disease before noncardiac surgery. The complete ACC/AHA algorithm is found in Chapter 9. The goal is to identify patients with heart disease who have a significantly high risk of cardiac morbidity and mortality perioperatively, not to simply find patients with mild or stable ischemic coronary artery disease. Clinical predictors, functional or exercise capacity, and level of surgical risk guide further diagnostic and therapeutic interventions. Not included in the ACC/AHA guidelines are conditions such as chronic inflammatory diseases (eg, rheumatoid arthritis, systemic lupus erythematous); chronic steroid use, and chest irradiation, that either alone or associated with more traditional risk factors, identifies patients at risk for CAD and cardiac complications.46-48
Anesthesiologists who apply the ACC/AHA recommendations and develop practice guidelines (Fig. 6-1) are well positioned to initiate evaluation with stress tests. Results may obviate the need for a cardiac consultation or be available at the time of consultation. Exercise treadmill testing is indicated for patients with normal ECGs who can exercise. Pharmacologic tests, such as dobutamine echocardiography or nuclear perfusion imaging, are necessary for those unable to exercise or who have significant ECG abnormalities that may interfere with the interpretation of ischemia via ECG.
Currently, the benefits versus risk reduction in coronary revascularization before noncardiac surgery are controversial.49 Factors to consider are the urgency of the noncardiac surgery (eg, in cancer cases) and the potential long-term benefits of revascularization. Noncardiac surgery soon after revascularization (bypass grafting and percutaneous coronary intervention with or without stents) is associated with high rates of perioperative cardiac morbidity and mortality.50 Coronary revascularization may offer only moderate protection in patients undergoing elective vascular surgery.51
Patients who have had a percutaneous coronary intervention, especially with newer, drug-eluting stents, require several months, if not a lifetime, of antiplatelet therapy to avoid restenosis or acute thromboses (see "Coronary Stents"). These patients must be identified in the preoperative period and managed in collaboration with a cardiologist. Given that up to half of all perioperative MIs and cardiac deaths can be attributed to plaque rupture in noncritical coronary stenoses, intensive medical management in revascularized patients is likely to be helpful and may account for the lack of benefits of revascularization.49,52 Decisions to revascularize patients before noncardiac surgery should be made only after evaluating the risk of perioperative cardiac-adverse events, the risks and benefits of the various methods of risk reduction, the benefits of the noncardiac surgery, and the patient's preferences. A face-to-face dialogue with all involved parties, similar to "tumor board" discussions, may assist decision making. Because cardiac complications are the leading cause of perioperative morbidity and mortality, anesthesiologists must be current on the latest evidence-based recommendations and be active in decision making and in the management of patients at risk.52
Coronary Stents
More than 1 million patients receive coronary stents each year in the United States. The number of patients presenting for surgery who have stents continues to rise. Bare metal stents (BMS) were the first devices and are still widely used. However, drug-eluting stent (DES) implantation has steadily risen. DES are less likely to cause neointimal hyperplasia and restenosis of the coronary artery, but they are associated with late thrombosis, with an often catastrophic outcome. Thrombosis of either type of stent is more common if antiplatelet therapy is interrupted. Dual antiplatelet therapy with aspirin and a thienopyridine (typically clopidogrel) should not be interrupted for at least 1 month after BMS placement and 12 months after DES insertion.53 See Table 6-6 and Fig. 6-3.
Table 6-6 Recommendations for Perioperative Management of Patients with Coronary Stents Who Are Receiving Antiplatelet Therapy
Health care providers who perform invasive procedures must be aware of the potentially catastrophic risks of premature discontinuation of thienopyridine (eg, clopidogrel or ticlopidine) therapy. Such professionals should contact the patient's cardiologist to discuss optimal strategies if issues regarding antiplatelet therapy are unclear.
Elective procedures involving risk of bleeding should be deferred until an appropriate course of thienopyridine therapy (12 mo after drug-eluting stents [DES] and 1 mo after bare-metal stents [BMS]) has been completed.
Patients with DES who must undergo procedures that mandate discontinuing thienopyridine therapy should continue aspirin if at all possible and have the thienopyridine restarted as soon as possible.
Adapted from Grines CL, Bonow RO, Casey DE Jr, et al. Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents: a science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, with representation from the American College of Physicians. J Am Coll Cardiol. 2007;13;49(6):734-739.
Algorithm for preoperative management of patients taking antiplatelet therapy. ACS, acute coronary syndrome; BMS, bare metal stent; DES, drug-eluting stent; MI, myocardial infarction; PAD, peripheral arterial disease; PCI, percutaneous coronary intervention. *High-risk stents: long (>36 mm), proximal, overlapping, or multiple stents, stents in chronic total occlusions, or in small vessels or bifurcated lesions. **Examples of low-risk situations: more than 3 months after BMS, stroke, uncomplicated MI, PCI without stenting. ***Risk of bleeding in closed space: intracranial neurosurgery, intramedullary canal surgery, posterior eye chamber ophthalmic surgery. In these situations, the risk-to-benefit ratio of upholding versus withdrawing aspirin must be evaluated for each case individually; in case of aspirin upholding, early postoperative reinstitution is important. [Adapted from Chassot PG, Delabays A, Spahn DR. Perioperative antiplatelet therapy: the case for continuing therapy in patients at risk of myocardial infarction. Br J Anaesth. 2007;99:316-328. By permission of Oxford University Press.]
In 2009 the ASA published a practice alert warning practitioners of the risk of premature discontinuation of antiplatelet therapy in patients with coronary stents, and it recommended delaying nonemergency surgery for 1 month in patients following BMS placement and 1 year in patients who had received DES.54 If emergent or urgent surgery is required, it is recommended that aspirin therapy be continued at a minimum through the perioperative period and the thienopyridine restarted as soon as possible after the surgery.54 See Table 6-6, Fig. 6-3, and Table 6-7.
Table 6-7 Preoperative Medication Guidelines
Continue on Day of Surgery
Discontinue on Day of Surgery
Antidepressants, antianxiety, and psychiatric medications (including monoamine oxidase inhibitors)a
Antihypertensives Antihypertensives
Generally to be continued
Consider discontinuing angiotensin-converting enzyme inhibitors or angiotensin receptor blockers 12-24 h before surgery if taken only for hypertension; especially if:
Lengthy procedures, significant blood loss or fluid shifts, use of general anesthesia, multiple antihypertensive medications, well-controlled blood pressure; hypotension is particularly dangerous
Aspirinb *Aspirin
Patients with known vascular disease
Patients with vascular stents
Before cataract surgery (if no bulbar block)
Before vascular surgery
Taken for secondary prophylaxis
Discontinue 5-7 d before surgery:
If risk of bleeding > risk of thrombosis
For surgeries with serious consequences from bleeding
Taken only for primary prophylaxis (no known vascular disease)
Asthma medications
Autoimmune medications Autoimmune
Methotrexate (if no risk of renal failure)
Methotrexate (if risk of renal failure)
Etanercept (Enbrel), Infliximab (Remicade),
Adalimumab (Humira): Check with prescriber
Cardiac medications
Clopidogrel (Plavix)
Patients with drug-eluting stents <12 mo
Patients with bare metal stents <1 mo
Patients not included in group recommended for continuation
Cox-2 inhibitors
If surgeon concerned about bone healing
Diuretics Diuretics
Triamterene, hydrochlorothiazide Potent loop diuretics
Estrogen compounds
When used for birth control or cancer therapy
When used to control menopause symptoms or for osteoporosis
Gastrointestinal reflux medications Gastrointestinal reflux medications (Tums, Maalox, or other particulate antacids)
Herbals and nonvitamin supplements
7-14 d before surgery
Hypoglycemic agents, oral
Type 1 diabetes: take about a third of intermediate to long-acting (NPH, lente)
Type 2 diabetes: up to half long-acting (NPH) or combination (70/30) preparations
Glargine (Lantus): decrease if dose is >1 unit/kg
If insulin pump delivery, continue lowest night time basal rate
Regular insulin (exception: insulin pump, continue lowest basal rate, generally nighttime dose)
Discontinue if blood sugar level <100
Narcotics for pain or addiction
48 h before day of surgery
Seizure medications
Statins Topical creams and ointments
Steroids (oral or inhaled)
Viagra or similar medications
Discontinue 24 h before surgery
Thyroid medications Vitamins, minerals, iron
Cataract surgery, no bulbar block
Warfarinc
Discontinue 5 d before surgery
aNeed consultation for planning ahead of day of surgery.
bExcept when the risk or consequences of bleeding are severe (generally only intracranial, posterior eye procedures).
cBridging may be necessary; check with prescribing physician.
HF affects 4 to 5 million people in the United States and is a significant risk factor for postoperative adverse events. Asymptomatic left ventricular dysfunction predicts cardiovascular events at 1 month and long term in vascular surgery patients having open procedures.55 The goal in the preoperative period is to identify and minimize the effects of HF. Recent weight gain, complaints of SOB, fatigue, orthopnea, paroxysmal nocturnal dyspnea, edema, recent hospitalizations, and recent changes in management are all significant. Physical findings focus on examination for third or fourth heart sounds, rales, jugular venous distension, ascites, hepatomegaly, and edema. Classifying the patient's medical status according to the New York Heart Association's (NYHA) categories is useful.56
Class I: no limitation of physical activity; ordinary activity does not cause fatigue, palpitations, or syncope
Class II: slight limitation of physical activity; ordinary activity results in fatigue, palpitations, or syncope
Class III: marked limitation of physical activity; less than ordinary activity results in fatigue, palpitations, or syncope; comfortable at rest
Class IV: inability to do any physical activity without discomfort; symptoms at rest
Diastolic dysfunction may be as common as systolic dysfunction and predicts a poor prognosis outside the perioperative period. The significance of diastolic dysfunction for anesthesia and surgery is less well defined. In a study of patients undergoing major vascular surgery, isolated diastolic dysfunction diagnosed preoperatively by echocardiography was an independent predictor of postoperative HF.57
An objective measure of left ventricular ejection fraction (LVEF) and ventricular performance is helpful, especially in patients with NYHA class III or IV HF. Normal LVEF is greater than 50%; mildly diminished, 41% to 49%; moderately diminished, 26% to 40%; and severely diminished, less than 25%. Patients with class III or IV heart failure should be evaluated by a cardiologist before undergoing general anesthesia or any intermediate- or high-risk procedure. Very minor procedures under monitored anesthesia care can proceed as long as the patient's condition is stable.
Rhythm Disturbances and Electrocardiogram Abnormalities
Arrhythmias and conduction disturbances are common in the perioperative period. Supraventricular and ventricular arrhythmias are associated with a greater risk of perioperative adverse events because of the arrhythmia itself and because they are markers for cardiopulmonary disease. Because uncontrolled atrial fibrillation (AF) and ventricular tachycardia are high-risk clinical markers, elective surgery is postponed until evaluation and stabilization are complete.11 Patients with preexisting paroxysmal AF who progress to persistent AF have worse outcomes due to increases in major cardiovascular events.58
New-onset AF, recent conversion from paroxysmal to sustained AF, AF with a rate more than 100 beats per minute, symptomatic bradycardia, or high-grade heart block (second or third degree) identified preoperatively warrant postponement of elective procedures and referral to cardiology for further evaluation. Left and right bundle branch blocks on preoperative ECG have been shown to predict major cardiac morbidity and mortality, but they had no added predictive value over the clinical history.36 Brugada syndrome is a congenital disease characterized by right bundle branch block (RBBB) with ST-segment elevation in the right precordial leads and is associated with a risk of sudden death and lethal arrhythmias. If the history and physical do not suggest significant pulmonary or congenital heart disease, no further evaluation is warranted because of an isolated RBBB. If congenital heart disease or Brugada syndrome is suspected, a cardiology consultation is indicated. RBBB in a patient with pulmonary symptoms is suggestive of severe respiratory compromise that warrants a pulmonary evaluation and echocardiography if an intermediate- or high-risk operation is planned. Prolonged QT intervals prompt an evaluation of electrolytes, magnesium, and calcium and a cardiology referral.
The quandary is to determine the cause of cardiac murmurs and to distinguish between significant murmurs and clinically unimportant ones. Diastolic murmurs are always pathologic and require further evaluation. Regurgitant disease is tolerated perioperatively much better than stenotic disease.
Aortic stenosis is the most common valvular lesion in the United States, affecting 2% to 4% of adults older than 65 years of age; severe stenosis is associated with a high risk of perioperative complications.11 Once considered a degenerative lesion with increasing age or a congenital bicuspid valve, aortic stenosis is now thought to have much in common with CAD and is an independent marker of CAD.59
Aortic sclerosis, which also causes a systolic ejection murmur similar to that of aortic stenosis, is present in 25% of adults 65 to 74 years of age and almost half of those older than 84 years of age.59 Aortic sclerosis is associated with a 40% increase in the risk of MI and a 50% increase in the risk of cardiovascular death in patients without a history of CAD.60 There is no hemodynamic compromise with aortic sclerosis.
The cardinal symptoms of severe aortic stenosis are angina, HF, and syncope, although patients are much more likely to complain of a decrease in exercise tolerance and exertional dyspnea. Aortic stenosis causes a systolic ejection murmur that is best heard in the right upper sternal border, which often radiates to the neck. Any patient with a previously undiagnosed murmur needs an ECG, and any ECG abnormality warrants an echocardiogram. Because of the difficulties noncardiologists have in distinguishing murmurs of aortic stenosis from those of aortic sclerosis, an echocardiogram should be ordered even without ECG abnormalities, especially if general anesthesia or an intermediate- or high-risk procedure is planned. Current guidelines recommend echocardiography annually for patients with severe aortic stenosis, every 1 to 2 years for moderate stenosis, and every 3 to 5 years for mild stenosis.61
Mitral stenosis is much less common than aortic stenosis and is usually associated with a history of rheumatic heart disease. Mitral stenosis causes a diastolic murmur and should always be further evaluated with ECG and echocardiography. Patients with hypertrophic obstructive cardiomyopathy are often young and male, and they may be asymptomatic and without murmurs. An ECG and echocardiogram is done if there is a personal or family history of syncope with exertion or sudden death, or if a murmur is detected. LVH and ST-segment and T-wave abnormalities on an ECG in an otherwise healthy nonhypertensive patient need to be further evaluated with echocardiography.
Cardiac Rhythm Management Devices: Pacemakers and Implantable Cardioverter-Defibrillators
It is estimated that more than 100000 new cardiac rhythm-management devices (CRMDs), which include both pacemakers and ICDs, are implanted yearly in the United States. Electromagnetic interference is likely to occur with electrocautery, radiofrequency ablation, magnetic resonance imaging, and radiation therapy, and it can result in malfunction or adverse events.62 Some patient monitors and ventilators may cause electromagnetic interference in patients with CRMDs with rate-adaptive mechanisms. The type of device and the features (eg, rate-adaptive mechanisms) likely to malfunction with electromagnetic interference need to be determined during the preoperative evaluation.
Magnets cause most pacemakers to pace asynchronously at a preset rate. Although most ICDs suspend tachydysrhythmia detection (and therefore therapy) when a magnet is appropriately placed, many can be programmed to ignore the magnet. Placement of a magnet may deactivate the device permanently, requiring a programmer to reenable it. Magnets do not affect the pacing function of ICDs.
Ideally, patients with CRMDs have these devices interrogated preoperatively. Consultation with the device manufacturer, cardiologist, or the electrophysiology service may be needed. Special features, such as rate adaptive mechanisms and anti-tachyarrhythmia functions, need to be disabled or the device reprogrammed to an asynchronous pacing mode before surgical procedures and anesthesia where electromagnetic interference is anticipated.62 Newer-generation devices are more complex, and reliance on a magnet, except in emergency situations, is not recommended. ASA guidelines recommend interrogation of the device and disabling the antiarrhythmic function during the procedure. Patients must be in a monitored setting with defibrillation capabilities until the device is reactivated.62 This requires planning so the appropriate device-specific interrogator and trained personnel are available. This may pose a problem for free-standing ambulatory centers.
Pulmonary Disease or Patients with Risk Factors for Postoperative Pulmonary Complications
Postoperative pulmonary complications develop in 5% of patients undergoing nonthoracic surgery, and as many as 1 in 4 deaths occurring within a week of operation are pulmonary related, making it the second most common serious morbidity after cardiovascular-adverse events.63 Established risk factors for an increased risk of pulmonary complications include the following13:
Poor general health status
ASA PS scores >2
Head, neck, thoracic, upper abdominal, aortic, neurologic, vascular, or emergency surgery
Anticipated prolonged procedures (>2 hours)
Planned general anesthesia (especially with endotracheal intubation)
Surprisingly absent predictors in the preceding list are asthma or results from arterial blood gas (ABG) analysis or PFTs. Risk of complications is surprisingly low in well-controlled asthma and in patients treated preoperatively with corticosteroids.64 Risk is greater in patients with asthma with recent exacerbations, a history of postoperative pulmonary complications, recent hospitalizations, or recent intubations for asthma. ABGs are useful in predicting pulmonary function after lung resection surgery but do not predict risk for complications. The extent of airway obstruction, measured by the forced expiratory volume in 1 second is not predictive of pulmonary complications.65 The predicted postoperative diffusing capacity of the lungs for carbon monoxide predicts postoperative pulmonary complications following thoracic surgery.66,67
The focus is on identifying patients at risk for postoperative pulmonary complications and on optimizing those patients with preexisting pulmonary disease. Rarely, PFTs may be indicated to diagnose disease (dyspnea caused by lung disease or heart failure?) or assess management (can dyspnea or wheezing be improved further?) but not as a risk assessment tool or to deny a beneficial procedure.65
The pulmonary status of patients with recent exacerbations or infections needs to be improved whenever possible. Prescriptions for bronchodilators or steroids, referral to pulmonologists or internists, or delay of surgery might be necessary. Training patients preoperatively in lung expansion maneuvers, such as deep-breathing exercises and incentive spirometry, reduces pulmonary complications more than giving the training postoperatively.68 Additionally, a change in perioperative management, including altering the planned surgical procedure if possible, discussing alternatives to general anesthesia, and educating the patient about the benefits of epidural pain management, may provide effective measures to decrease pulmonary complications.69
Patients with pulmonary arterial hypertension have a high rate of perioperative morbidity and mortality. The patient's care should be coordinated with a pulmonologist. An ECG and echocardiogram are useful in patients with more than mild disease. Signs and symptoms of disease severity include the following70:
Dyspnea at rest
Metabolic acidosis
Right heart failure (peripheral edema, hepatomegaly, jugular venous distension)
History of syncope
Traditionally, especially with children, cases scheduled for elective procedures were cancelled for patients with current or recent upper respiratory tract infections. With modern anesthetic practices, cancellation is not routine.71 In patients with severe symptoms, especially those with underlying conditions that may further compromise a safe anesthetic, elective surgery is postponed for at least 4 weeks. When infection is mild or uncomplicated in healthy patients, there is little risk in proceeding with a procedure to avoid the inconvenience of a cancellation. The dilemma lies with the patients between these extremes. Decisions regarding suitability to proceed should be made on an individual basis. Chapter 20 discusses the pediatric patient with an upper respiratory tract infection in greater detail. Chapter 11 discusses the patient with pulmonary disease in detail.
Sleep-disordered breathing affects up to 9% of middle-age women and 24% of middle-age men; fewer than 15% of these cases have been diagnosed. OSA, the most common serious manifestation of sleep-disordered breathing, is caused by intermittent airway obstruction. OSA is characterized by total collapse of the airway with complete obstruction for more than 10 seconds. Obstructive hypopnea is partial collapse (30% to 99%) associated with at least a 4% arterial oxygen desaturation. OSA severity is measured on the apnea-hypopnea index (AHI), the number of apneic and hypopneic episodes per hour of sleep. Patients with severe OSA have more than 30 episodes per hour.
Cardiovascular disease is common in patients with OSA. These patients have an increased incidence of hypertension, atrial fibrillation, bradyarrhythmias, ventricular ectopy, endothelial damage, stroke, HF dilated cardiomyopathy, and atherosclerotic CAD.72 Mask ventilation, direct laryngoscopy, endotracheal intubation, and even fiberoptic visualization of the airway are more difficult in patients with OSA than in healthy patients. Patients with OSA are at risk of postoperative oxygen desaturation.73 There is an association of OSA with obesity.
The STOP-Bang Questionnaire is useful to identify patients with undiagnosed OSA.74 Preoperative evaluation focuses on identification of patients at risk for OSA and improving associated comorbid conditions. Echocardiography may be indicated if HF or pulmonary hypertension is suspected.75 Patients should be instructed to bring their continuous positive airway pressure (CPAP) devices to the hospital on the day of operation. Chapter 11 discusses OSA in detail.
An overweight person has a BMI of 25 to 29.9 kg/m2; obesity is defined as a BMI of 30 to 39.9 kg/m2. A BMI of 40 kg/m2 or higher defines extreme obesity. See the formulas for calculating BMI earlier in this chapter. An estimated 64% of adults in the United States are overweight or obese, and 4.7% are extremely obese. Annually 300000 US adults die of obesity-related issues, and almost 10% of health care expenditures in the United States are associated with obesity and inactivity. Obesity is an independent risk factor for heart disease. Hypertension, stroke, hyperlipidemia, osteoarthritis, DM, cancer, and OSA are more common in obese people.
Extremely obese patients may have challenging airways that require specialized equipment, techniques, and personnel. They may need prophylaxis for deep venous thrombosis (DVT) with advanced techniques such as inferior vena cava filter placements. They require special operating room tables and gurneys to support excessive weight. Venous access and invasive and noninvasive monitoring can be difficult. Preoperative identification and planning for these contingencies will avoid delays on the day of the operation. Preoperative evaluation is directed toward coexisting diseases (Table 6-4). Chapter 23 discusses this in greater detail.
An estimated 18 million US adults have DM, which increases the risk of CAD, is considered a CAD equivalent, and is a risk factor for perioperative cardiac complications on a par with angina or a previous MI.11,76 Figure 6-1 and Chapter 9 address cardiac evaluation for noncardiac surgery.
Heart failure is twice as common in males and 5 times as common in females with DM as in those without DM. Poor glycemic control is associated with an increased risk for heart failure, and both systolic and diastolic dysfunction may be present. People with diabetes are also at increased risk for renal failure perioperatively (see Chapters 13, 14, and "Renal Disease" later) and for postoperative infections. Patients with poor preoperative management of glucose are likely to be more out of control intra- and postoperatively.77 Obtaining a glycosylated hemoglobin concentration preoperatively can guide glucose management with intensification of therapy well before the procedure.77 Aggressive management of hyperglycemia decreases postoperative complications. The American College of Endocrinologists' position statement recommends a target fasting glucose of less than 110 mg/dL in noncritically ill patients.78
Preoperatively, the focus is on assessing organ damage and the control of blood sugar. Cardiovascular, renal, and neurologic systems should be evaluated. Ischemic heart disease is often asymptomatic in the person with DM. The goals of perioperative diabetic management include avoidance of hypoglycemia and marked hyperglycemia. Table 6-7 has suggestions for hypoglycemic medication management.
HTN, defined by 2 or more measurements of blood pressure greater than 140/90, affects 1 billion individuals worldwide. The incidence of HTN increases with age. In the United States, 25% of adults and 70% of patients older than 70 years of age have HTN, and fewer than 30% are treated adequately. The degree of end-organ damage and morbidity and mortality correlate with the duration and severity of HTN.
Ischemic heart disease is the most common form of organ damage associated with HTN. The odds ratio for an association between HTN and perioperative cardiac risk is 1.31.79 There is little evidence of an association between preoperative blood pressures lower than 180/110 mm Hg and perioperative cardiac risk. Heart failure, renal insufficiency, and cerebrovascular disease are more common in hypertensive patients.
It is generally recommended that elective surgery be delayed for severe HTN (diastolic blood pressure > 115 mm Hg; systolic blood pressure > 200 mm Hg) until the blood pressure is lower than 180/110 mm Hg. If severe end-organ damage is present, the goal is to normalize blood pressure as much as possible before the operation.79 There is no evidence to justify cancellation of an operation when blood pressure is lower than 180/110 mm Hg, although interventions preoperatively are appropriate. Severely elevated blood pressure should be lowered over several weeks.
Guidelines suggest that cardioselective β-blocker therapy is the best treatment preoperatively because of a favorable profile in lowering cardiovascular risk.80 Effective lowering of risk may require 6 to 8 weeks of therapy to allow regression of vascular changes, and too rapid or extreme lowering of blood pressure may increase cerebral and coronary ischemia. The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) showed that effective treatment of HTN is not simply a matter of lowering blood pressure.81 Continuation of antihypertensive treatment preoperatively is critical (Table 6-7). Chapter 9 has more information on the hypertensive patient.
A normal creatinine level is often not an accurate indicator of renal function. A doubling of serum creatinine from 0.8 to 1.6 mg/dL represents a halving of glomerular filtration rate (GFR). Creatinine does not exceed the normal limits until GFR has fallen below 50 mL/min. GFR decreases with age, and the renal reserve of a healthy 80-year-old is less than half that of a healthy 40-year-old. The focus of the preoperative evaluation of patients with renal insufficiency or failure is on the cardiovascular and cerebrovascular systems, fluid volume, and electrolyte status. Chronic metabolic acidosis is common but usually mild and compensated for by chronic hyperventilation.
Chronic renal disease is a significant risk factor for cardiovascular morbidity and mortality and is an ACC/AHA cardiac risk factor equal to a history of known CAD (Fig. 6-1).11 The annual incidence of death from CAD in patients with both DM and end-stage renal disease requiring hemodialysis is 8.2%. A creatinine of 2.0 mg/dL or higher triggers an assessment of cardiac risk using the ACC/AHA guidelines (Fig. 6-1).11 In a study of 23016 patients undergoing cardiac surgery, those requiring preoperative hemodialysis had an increased 30-day morbidity and mortality equal to patients having urgent surgery, valvular surgery, or an ejection fraction less than 30%.82
In elective cases, hemodialysis needs to be performed within 24 hours of the operation, but not immediately before, due to the risk of hypovolemia and electrolyte shifts. Hemodialysis is associated with fluid and electrolyte (sodium, potassium, magnesium, phosphate) imbalance and shifting of electrolytes between intra- and extracellular compartments. Hemodialysis is performed to correct volume overload, hyperkalemia, and acidosis.
Patients at risk for perioperative renal failure include those with preexisting renal insufficiency and DM, especially in combination, and those undergoing procedures with the administration of contrast medium. If all 3 conditions are present, the risk of renal failure may be as high as 50%. Preoperative identification of at-risk patients may change management, such as administration of sodium bicarbonate, hydration, a change in type of contrast medium, and avoidance of hypovolemia or even vigorous hydration. Chapter 14 has a complete discussion of the patient with renal disease.
Predictors of poor perioperative outcome in patients with liver disease include the following83:
Acute hepatitis (viral or alcoholic)
Chronic active hepatitis with jaundice, encephalopathy, coagulopathy, or elevated liver enzymes
Child C cirrhosis (bilirubin > 3 mg/dL, albumin < 3 g/dL, PT > 6 seconds more than control, poor nutritional status, large amount of ascites, and moderate encephalopathy)
Abdominal surgery
PT longer than 3 seconds; prolongation refractive to vitamin K therapy
Salt and water restriction, diuretic therapy (spironolactone is preferred), enteral nutritional supplements, and oral vitamin K (1-5 mg daily for 3-5 days) are indicated preoperatively to correct deficiencies. Delaying elective surgery until after an acute episode of hepatitis or an exacerbation of chronic disease has resolved is appropriate. Chapter 15 discusses the patient with liver disease in detail.
The ASA Task Force on Blood Component Therapy concluded that red blood cells should not be transfused solely because of a Hgb level but rather because of risk for complications from inadequate oxygenation.84 Transfusion is rarely indicated when the Hgb is more than 10 mg/dL and almost always needed when the Hgb is less than 6 mg/dL. Anemia is associated with an increase in postoperative mortality independent of transfusion.12,15 The goal in the preoperative period is to determine the etiology, duration, and stability of the anemia, and to consider the extent and type of surgery, the anticipated blood loss, and the patient's comorbid conditions that may impact oxygenation, such as pulmonary, cerebrovascular, or cardiovascular disease. Type and screen testing before the day of operation and planning for the availability of blood will avoid delay of the procedure (Table 6-5). This can ease the burden on the blood bank personnel for same-day admission or outpatient surgery. A protocol can be instituted with the department of surgery and the blood bank. Intraoperative blood salvage can be planned, if appropriate. In special circumstances, such as a patient's refusal of perioperative blood transfusions or for elective procedures with expected significant blood loss in anemic patients, postponement of surgery to treat with iron may be warranted.
Sickle cell disease is a hereditary hemoglobinopathy, and vasoocclusion is responsible for most of the associated complications. Preoperative assessment focuses on identification of organ dysfunction and acute exacerbations.85 Chapter 16 discusses in detail the patient with anemia.
Neurologic Disease
For a patient with neurologic disease (eg, stroke, seizure disorder, multiple sclerosis), a detailed history is required with focus on recent events, exacerbations, or evidence for poor control of the medical condition. A basic neurologic examination documenting deficits in mental status, speech, cranial nerves, gait, and motor and sensory function is important. This baseline enables postoperative comparison and evaluation of new deficits. If a stroke or transient neurologic deficit is not fully evaluated or occurs within 1 month before the operation, elective surgery is typically delayed pending complete evaluation. A carotid bruit requires a careful history of related symptoms. If symptoms are present, carotid Doppler studies are indicated. Significant abnormalities on Doppler studies should prompt a referral to a vascular surgeon or neurologist.
Routinely ordering tests for serum drug levels of antiseizure medications is not warranted unless toxicity is a concern or the patient is having breakthrough seizures. Patients with good control of seizures may have levels outside the therapeutic range and results may be confounded if the timing of the administration of the drugs in relation to when the test is drawn is not considered. Chapter 12 discusses neurologic diseases in detail.
Patients with a history of cancer may have complications related to the disease or the treatment. Preoperative evaluation focuses on evaluation of the heart, lungs, and neurologic and hematologic systems. Previous head and neck irradiation may cause carotid artery disease, hypothyroidism, or difficulty with airway management.86 Auscultation for bruits, thyroid function tests (thyroid-stimulating hormone levels), and carotid Doppler studies may be needed.
Mediastinal, chest wall, and left breast irradiation can cause conduction abnormalities, cardiomyopathy, valvular abnormalities, and premature CAD even without traditional risk factors.87 Cardiovascular disease is the second most common cause of mortality in survivors of Hodgkin disease. One study found that 88% of patients had echocardiographic abnormalities 5 to 20 years after treatment, most of them asymptomatic. Treatment at a younger age increases risk. These risk factors were not considered in the ACC/AHA Guidelines for Cardiac Evaluation for Noncardiac Surgery, but they may be important predictors of CAD.87 ECG, echocardiography, and stress testing may be indicated.
Patients with cancer may have significant pain associated with their primary illness and take large amounts of narcotics. Consultation with a pain specialist may be necessary in complicated and difficult pain management cases. A discussion with the patient needs to occur preoperatively to help allay patient concerns and fears about inadequate pain control. Similar issues may occur in patients with chronic pain or who abuse substances.
Patients who use alcohol to excess or illicit drugs may not give a reliable history. Addicts may be at risk for a myriad of perioperative complications, including withdrawal, acute intoxication, an altered tolerance to anesthetic and opioid medications, infections, and end-organ damage. Preferably, patients with drug or alcohol dependence should be drug free well before an elective operation. Acute preoperative abstinence in alcoholics, however, is associated with a poorer outcome postoperatively than if drinking is continued.88
Preanesthesia clinic staff should be prepared to refer patients to addiction specialists or programs or prescribe medications to prevent withdrawal in the preoperative period if patients agree to abstinence. Intravenous drug use prompts an evaluation for cardiovascular, pulmonary, neurologic, and infectious complications. Because intravenous access is often limited in users, interventional radiology may be needed to help with line placement. Alcoholics need assessment of cardiovascular, hepatic, and neurologic alterations. Planning for adequate postoperative analgesia is important because these patients often have a higher requirement from chronic abuse and misuse of substances. Testing depends on symptoms and findings from the history and physical. ECG, echocardiography, chest radiography, and chemistry and hepatic panels may be needed. Table 6-4 and Chapter 24 provide additional information.
Patients with or at Risk of Thromboembolism and/or Pulmonary Emboli
Recent arterial or DVT requires postponement of non–lifesaving procedures. Without anticoagulation, the risk of recurrent DVT within 3 months of a proximal DVT is approximately 50%. A month of warfarin treatment reduces the risk to 10%; 3 months of warfarin treatment reduces the risk to 5%. Patients with a hereditary hypercoagulable state, cancer, or multiple episodes of DVT are at higher risk indefinitely. Patients with nonvalvular atrial fibrillation who have had a previous cerebral embolism also are at high risk, as are patients with mechanical heart valves, especially multiple valves. Risk is greater with mitral than with aortic valves. Surgery increases the risk of DVT, but there is no evidence that surgery increases the risk of arterial embolism in patients with atrial fibrillation or mechanical valves.89
An elective operation scheduled for the first month after an episode of venous or arterial thromboembolism should be postponed. If postponement is not possible, then the patient should receive preoperative heparin while the international normalized ratio (INR) is below 2.0.89 Ideally, 3 months of anticoagulation is recommended before an elective operation. In a large cohort study, thromboembolism, excessive bleeding, and death were low when anticoagulation was temporarily suspended for invasive procedures. Patients with cancer had the greatest risk of thrombosis and bleeding as compared with noncancer patients.90 See the section on medication instructions and Table 6-7 for further discussion of warfarin management preoperatively. Chapter 16 discusses patients with coagulation disorders.
Smokers and Those Exposed to Secondhand Smoke
Exposure to tobacco, directly or through "secondhand" smoke, increases the risk of many perioperative complications. Smokers are more likely to experience wound infections, respiratory or airway complications (including oxygen desaturation), and severe coughing.91 Smoking decreases macrophage function, negatively impacts coronary flow reserve, and causes vascular endothelial dysfunction, hypertension, and ischemia. Smoking causes inflammation and may cause immunosuppression. 92 Smokers require longer hospital stays and more often need postoperative intensive care than do nonsmokers.
The greatest benefit of smoking abstinence is probably only realized after several months of cessation. In studies reporting a greater perioperative risk in recent quitters than in smokers, selection bias may have contributed to the results. The patients who were motivated to stop or advised to quit smoking may have been at greater risk because of health status. Soon after a patient quits smoking, carbon monoxide levels decrease, which improves oxygen delivery and use. Cyanide levels decrease, which benefits mitochondrial oxidative metabolism. Lower nicotine levels improve vasodilatation, and many toxic substances that impair wound healing decrease. Patients without a history of ischemic heart disease who smoked shortly before their operation had significantly more episodes of rate-pressure product-related ST-segment depression than did nonsmokers, former smokers, or chronic smokers who did not smoke in the immediate preoperative period.93
A preoperative smoking cessation intervention in patients who underwent knee and hip replacements decreased rates of surgical-site infections from 23% in the conventional group to 4% in those who stopped smoking. The US Public Health Service recommends that "all physicians should strongly advise every patient who smokes to quit because evidence shows that physician advice to quit smoking increases abstinence rates."94 Nearly 70% of smokers want to quit. Patients presenting for surgery are more likely to quit smoking compared with smokers not having surgery.95
Effective interventions include medical advice and pharmacotherapy, such as nicotine-replacement therapy, varenicline (Chantix), and bupropion (Wellbutrin), which are safe in the perioperative period. Nicotine patches, gum, and lozenges are available without a prescription; nasal spray, varenicline, and bupropion require prescriptions. Clonidine is also effective. Varenicline, bupropion, or clonidine should be started 1 to 2 weeks before a quit attempt; nicotine replacement therapy is effective immediately.95 Individual and group counseling may increase rates of long-term abstinence. Many hospitals, insurance companies, and communities offer smoking cessation programs. Excellent resources are available on the Internet and from the US government. Advice and guidelines are available at http://www.surgeongeneral.gov/tobacco/default.htm. Patients can be referred to 1-800-QUITNOW. Tobacco-intervention training during medical school and residency can significantly improve the quality of physician counseling and rates of abstinence.
By the year 2030, almost 70 million persons older than 65 years will be alive in the United States, and a significant portion of these will be 85 years of age or older. The number of patients older than 65 years who will undergo noncardiac surgery will increase from 7 to 14 million by 2025. Chronological age, however, is a less important determinant of operative outcome than are comorbid conditions and physiologic age. Age older than 70 years is an independent predictor of postoperative mortality, cognitive dysfunction, major perioperative complications, and longer hospital stays.13,96 Organ function declines in the elderly, who respond differently to medications and have a greater number of comorbid conditions. Among the conditions are arthritis, hypertension, heart disease, and DM. One study found coexisting disease in 95% of geriatric patients scheduled for surgery. Postoperatively 35% of patients had cardiac or pulmonary complications that were associated with comorbid conditions, and many could have been predicted preoperatively.97 Other studies have found that the rate of perioperative complications among the very elderly (>85 years) is not prohibitive.96
Elderly individuals often do not return home immediately after an operation for various reasons. They need rehabilitation, their recovery takes longer, they have a high incidence of postoperative cognitive dysfunction (41.4% prevalence at discharge, 12.7% at 3 months), or support services are lacking.98 Discharge planning in advance may lessen the costs of perioperative elder care. Preoperative clinics can be designed to offer multidisciplinary care and after-discharge planning that coordinates with surgical, nursing, and social service departments.99
Testing in the elderly patient should be based on disease indications rather than age alone (see Table 6-4 and the section in this chapter on age-based testing, "Preoperative Testing"). Chapter 21 presents an expanded discussion of the evaluation of the geriatric patient.
Cataract Patients
Patients undergoing cataract surgery are often elderly with extensive comorbid disease. The procedure is minor, however, without expected systemic physiologic disturbances or significant postoperative pain. Topical anesthesia is commonly used, and because general anesthesia is rarely required, the risk is lessened. Elective cataract surgery has the enormous benefits of allowing individuals to drive, read, avoid isolation, watch television, and decrease the incidence of falls. The cost of routine medical testing before cataract surgery is estimated at $150 million annually. In a study of more than 18,000 patients randomly allocated to no routine testing before cataract surgery or to a battery of tests, including ECG, complete blood count, and electrolytes, blood urea nitrogen, creatinine, and glucose levels, no differences in postoperative adverse events were found between the two groups.100
The results of this study do not suggest that patients undergoing cataract surgery require no laboratory testing.100 The study of cataract patients eliminated routine tests, not tests indicated for a new or worsening medical problem. The group that crossed over from no testing to some testing had significantly more coexisting illness and poor self-reported health status. This finding suggests that the preoperative care provider screen patients to order tests for those who require them. In the study described, exclusion criteria were general anesthesia or an MI within 3 months. All patients underwent a preoperative medical assessment. More than 85% of enrollees reported good to excellent health status, almost 25% reported no coexisting illnesses (including hypertension, anemia, DM, and heart or lung disease), almost 30% were older than 70 years, and 65% were ASA PS 1 or 2 status, suggesting a fairly healthy group.100 If patients are comparable with those in the study, are routinely evaluated by primary care physicians, have stable mild disease, and will undergo cataract operation under topical or bulbar block, then no special testing is required because of cataract surgery. Serious, poorly controlled conditions must be normalized before surgery, and selective testing suggested by history and physical examination may be necessary. One center showed a 90% savings in laboratory costs in a 4-month period by eliminating routine testing for cataract patients.101
Although testing is rarely necessary because of cataract surgery, patients with limited access to health care services may benefit from medical evaluation. The ACC/AHA Guidelines for Cardiac Evaluation for Noncardiac Surgery consider cataract surgery to be low risk.11
The Difficult Airway
An important part of preoperative evaluation is assessment of the airway. If a patient with a difficult airway can be identified before the day of operation, special equipment or personnel with advanced training and skills in airway management can be available without delaying or postponing procedures or compromising patient safety.1 Patients with the following characteristics may have a challenging airway:
Facial and neck deformities from previous operation
Head and neck radiation
Head and neck trauma
Cervical spine disease or previous operation
The ease or difficulty of laryngoscopy and intubation are discussed extensively in the literature. However, equally, if not more, important is the ability to predict difficulty with mask ventilation.102 The following patient characteristics independently suggest difficulty with mask ventilation:
Age older than 55 years
BMI higher than 26 kg/m2
Lack of teeth
A beard
Snoring history
Patients with Down syndrome or rheumatoid arthritis may have asymptomatic atlantoaxial subluxation and cervical spine instability. A careful history may elicit neurologic deficits or neck and shoulder pain. Patients with neurologic deficits or symptoms and rheumatoid arthritis patients with long-standing, severely deforming disease need cervical spine radiographs with special flexion, extension, and open-mouth odontoid views. Patients with oral piercings are counseled to remove all jewelry on the day of surgery and about the potential risks if piercings are not removed.103
Chapter 10 discusses the evaluation of the patient with a difficult airway. The goals in the preoperative clinic should be documentation of an airway examination, including size of the oral opening, Mallampati score, status of teeth (Fig. 6-2), range of motion of the neck, thyromental distance, body habitus, presence of facial hair, and pertinent deformities. Previous anesthetic records should be obtained and a discussion of awake fiberoptic intubation with the patient may be appropriate. See "Physical Examination" earlier for components of the airway examination.
Anesthesia-Specific Concerns
A personal or family history of pseudocholinesterase deficiency is identified preoperatively. Records from previous anesthetics may clarify an uncertain history. If time allows, a dibucaine number and pseudocholinesterase, chloride, and fluoride levels should be obtained. A history of malignant hyperthermia (MH) or a suggestion of it (hyperthermia, rigidity during anesthesia, or unplanned admission to an ICU following a general anesthetic) either in a patient or family member should be clearly documented and arrangements made before the day of the operation. Chapter 87 provides a comprehensive review of MH, its prevention and management.
Approximately 60% to 70% of surgical procedures are performed on an outpatient basis, and of these, 5% to 8% are performed in an office setting. A study of ambulatory surgery in Medicare beneficiaries older than 65 years found no deaths on the day of operation when the procedure was performed in a physician's office; 2.3 deaths per 100,000 procedures when performed in a freestanding ambulatory surgical center; and 2.5 deaths per 100,000 when performed at an outpatient hospital. The 7-day mortality was 35 per 100,000, 25 per 100,000, and 50 per 100,000, respectively. Age older than 85 years, significant comorbidity, and type of procedure predicted adverse events.104
Almost half of ambulatory surgical procedures are performed in patients 65 years and older. Elderly patients may bring specific problems to the ambulatory setting because they often have multiple chronic conditions and poor eyesight, and they may be unable to perform activities of daily living such as feeding themselves or driving. Some patients have limited support during the stress of recovery from anesthesia and surgery.99
Patients with OSA may require skilled and specialized airway management. They are typically sensitive to anesthetic agents (less airway muscle tone than normal, which leads to airway collapse) and narcotics (greater than average respiratory depression). They may require longer postoperative monitoring, and the American Sleep Apnea Association suggests that some patients with sleep apnea might not be candidates for ambulatory surgery. Patients are told to bring their CPAP machines on the day of surgery.
Obese patients may require specialized equipment to accommodate their weight, which might not be readily available in ambulatory facilities. Patients with a history or family history of MH may require prolonged observation in the recovery period, so planning is important. Whether a patient susceptible to MH is a candidate for ambulatory surgery should be decided well before the day of operation. Individuals with pacemakers and ICDs may not be candidates for freestanding ambulatory facilities if electromagnetic interference is likely or sudden patient movement is undesirable, and personnel are not available to reprogram the devices.62 The ACC/AHA Guidelines for Cardiac Evaluation for Noncardiac Surgery consider ambulatory surgery to be low risk.11
Management of comorbid conditions and interventions to reduce risk is as important as identification and diagnosis of medical disease. If anesthesiologists are not going to intervene to improve new or chronic disease states, then close collaboration with primary care physicians, specialists, and surgeons are essential. Far too many anesthesia practices collect information without having processes in place to follow through to manage patients and risk to improve outcomes and reduce adverse events.
Collaborative care of patients is often necessary and beneficial. Consultation initiated by the preoperative physician should seek specific advice regarding diagnosis and status of the patient's condition(s). Asking specific questions such as "Does this patient have CAD?" or "Is this patient in the best medical condition for planned thoracotomy with lung resection under general anesthesia?" is the first step. Letters or notes stating "cleared for surgery" are rarely sufficient to design a safe anesthetic. A summary of the patient's medical problems and current status, medical therapy, and results of any recent diagnostic tests is necessary.
Close coordination and good communication among the preoperative anesthesiologist, surgeon, and consultant is vitally important. Miscommunication among care providers was central to most reported incidents in the Australian Incident Monitoring Study (AIMS) whenever preoperative assessment was implicated.1
In many practices the cardiology service is most frequently consulted perioperatively. In one survey, however, the usefulness of such consultations was questioned by anesthesiologists. Unfortunately, only 17% of anesthesiologists felt obligated to follow the consulting cardiologist's recommendations. Forty percent of the consultations contained only the recommendation to "proceed with the case," "cleared for surgery," or "continue with current medications." Recommendations regarding intraoperative monitoring or cardiac medications were largely ignored. Part of this responsibility lies with the consulting physicians (be that surgeons or anesthesiologists) and the long-standing practice of asking for or receiving cardiac "clearance." This is a vague request, and a response (often scribbled on a prescription pad) simply stating "low risk" or "cleared for surgery" is meaningless and unhelpful. In general, preoperative consultations are sought for diagnosis, evaluation, and improvement of a new or poorly controlled condition, and for creation of a clinical risk profile that the patient, anesthesiologist, and surgeon use to make management decisions.
Detailed discussions and communication, preferably oral, are essential for the best management of complicated patients. Copies of diagnostic studies that accompany the consultation letter help the anesthesiologist to make an independent decision about patient risk and to plan anesthetic care. Chapter 8 has a detailed discussion of consultations.
An important element for a successful preoperative evaluation system is a uniform, consistent method for assessment and management. Even though individual judgment is necessary, guidelines and policies for the group should be developed. Cancellations, delays, or demands for additional diagnostic testing on the day of operation after a patient has been evaluated and deemed acceptable for anesthesia by the preoperative clinic is detrimental to the success of a preoperative assessment program.
Practice guidelines improve the process of preoperative evaluation and management and affect surgical outcomes. Guidelines minimize variation in clinical practice and make good use of resources. They may help to avoid cancellations or delays on the day of operation when the anesthesiologist in the preanesthetic clinic and the one performing the anesthesia have differences in opinion about the patient's fitness for operation. This will prevent patient inconvenience and disappointment and surgeon dissatisfaction. Guidelines synthesized from the best, most current sources help practitioners stay up to date with recommendations and the literature by assimilating treatments and diagnostics into their practices. Guidelines can be as simple as an organization of the type and timing of care delivered to typical, uncomplicated patients or as complex as instructions for dealing with a specific issue expressed by decision trees in branching logic format.105 Acceptance is more likely when disease-specific algorithms are developed and agreed to by all stakeholders. The intent is not to design inflexible standards but to provide a consistent, straightforward method to evaluate a particular disease such as hypertension or CAD, a finding such as a murmur, or a symptom such as chest pain. Practice guidelines recommend care based on scientific evidence and broad consensus but leave room for justifiable variations in practice.
Practice guidelines typically rely on evidence-based medicine that examines the data from clinical research. Intuition, personal clinical experience, and pathophysiologic rationale are less important. The practice and teaching of evidence-based medicine requires skills that are not part of traditional medical training. Precisely defining a problem and the information required to resolve the problem are important first steps. The pertinent studies from a well-conducted literature search are selected and applied to the treatment of medical conditions found in patients.
Algorithms such as in Figs. 6-1 and 6-3, and guidelines such as in Tables 6-4, 6-5, 6-6, and 6-7, are examples.
Nothing‐by-Mouth Guidelines
Historically, patients have been told to abstain from oral intake (nothing by mouth [NPO]) after midnight regardless of the time of their procedure to reduce the risk of aspiration. Twenty years ago Miller found that a light breakfast (of tea and toast) 2 to 4 hours before an operation did not negatively impact gastric pH or volume. In many European countries today, patients are allowed to eat a "light breakfast" if an operation is scheduled for noon or after. However, this practice has not received widespread adoption in the United States. Because oral fluids have short gastric transit times, many, if not most, departments of anesthesia modified the "nothing after midnight" approach. The ASA recommends that healthy patients who will undergo elective procedures be allowed to drink clear liquids (eg, water, juice without pulp, coffee or tea without cream or milk) until 2 hours before anesthesia; breast milk until 4 hours before anesthesia; and nonhuman milk, infant formula, or a light breakfast until 6 hours before procedures requiring anesthesia (Table 6-8).106 In a prospective cohort study there were no differences in aspiration, and delays or cancellation of cases between groups who followed traditional NPO versus liberalized (clear fluids until 2-3 hours before surgery) guidelines. There were more cases of regurgitation, and rapid-sequence and awake intubations in the NPO after midnight group.107
Table 6-8 Guidelines for Food and Fluids before Elective Surgery
Time Before Surgery
Food or Fluid Intake
Up to 8 h Food and fluids as desired
Up to 6 ha Light meal (eg, toast and clear liquidsb), infant formula, nonhuman milk
Up to 4 ha Breast milk
Up to 2 ha Clear liquidsb only; no solids or foods containing fat in any form
During the 2 h No solids, no liquids
aThis guideline applies only to patients who are not at risk for delayed gastric emptying. Patients with the following conditions are at risk for delayed gastric emptying: morbid obesity, diabetes mellitus, pregnancy, a history of gastroesophageal reflux, a surgery limiting stomach capacity, a potentially difficult airway, opiate analgesic therapy.
bClear liquids are water, carbonated beverages, sports drinks, and coffee or tea (without milk). The following are not clear liquids: juice with pulp, milk, coffee or tea with milk, infant formula, and any beverage with alcohol.
Medication Instructions
Some medications should be continued on the day of operation because of their beneficial effects; others may be harmful or contraindicated.108 Medications associated with withdrawal effects (eg, β-blockers, centrally acting sympatholytics, benzodiazepines, and opioid analgesics) should be continued through the preoperative period. Table 6-7 and Fig. 6-3 describe in detail drugs to be continued or discontinued before an operation.
Most antihypertensive medications, with the possible exception of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor–blocking agents (ARBs) should be taken before operation.109 ACEIs and ARBs may be associated with greater risk for hypotension upon induction of general anesthesia. There is no consensus as to whether these agents should be held before anesthesia. No large studies exist to support any specific recommendation. For high-risk procedures with planned neuraxial blockade or general anesthesia in well-controlled hypertensive patients, it may be beneficial to hold these drugs on the day of operation. In our preoperative clinic patients who will undergo minor procedures with monitored anesthesia care, and those with poorly controlled HTN are advised to continue these drugs on the day of operation to reduce the risk of significantly elevated blood pressure in the pre- and postoperative periods. β-Blockers and centrally acting sympatholytics (eg, clonidine) can be associated with rebound hypertension when withdrawn.
Consensus is lacking on the recommendations to discontinue diuretics preoperatively. Diuretics (eg, hydrochlorothiazide) to treat HTN will likely help to control blood pressure when continued on the day of operation. Withholding potent loop diuretics (eg, furosemide) on the day of operation may decrease the risk of volume depletion and renal insufficiency.110 Intravenous admission by the anesthesiologists on the day of operation is an option.
Medications used by patients with a history of or who are at risk for heart disease, such as β-blockers, digoxin, antiarrhythmics, and statins, should not be withdrawn before operation. Not only are they beneficial, but risk may be increased when they are not taken.11
Aspirin, taken for primary prophylaxis of vascular disease or for pain, and other nonsteroidal anti-inflammatory drugs (NSAIDs) are generally discontinued before the day of operation.111,112 Circumstances may dictate otherwise to prevent MI or stroke, to improve patency of vascular grafts, and to achieve better pain control. There is increasing evidence supporting continuation of aspirin when taken for secondary prophylaxis (ie, patients with established vascular disease).111,112 Aspirin is continued for patients scheduled for vascular reconstruction and for those at high risk for cardiovascular and cerebrovascular complications except for intraspinal and intracranial procedures. Aspirin and other NSAIDs do not need to be discontinued for planned neuraxial or regional anesthesia techniques.113 If the decision to discontinue these agents is made, aspirin is stopped 5 to 7 days and other NSAIDs 48 hours before the operation.114 Many cold preparations and over-the-counter drugs (eg, Alka-Seltzer and Pepto-Bismol) may contain aspirin.
More potent antiplatelet agents, such as clopidogrel (Plavix) may be associated with a substantial risk of perioperative bleeding. These drugs are discontinued 7 days before the operation if appropriate.111,112 Patients with DES placed less than 12 months ago, BMS placed less than 4 to 6 weeks previously, or percutaneous coronary interventions without stents less than 2 weeks before surgery should have only lifesaving surgery, preferably while continuing dual antiplatelet therapy (Table 6-6 and Fig. 6-3).
Statins reduce strokes, renal dysfunction, MI, length of hospital stay, and even death.115-117 Patients having coronary artery bypass grafting who take perioperative statins have a dose-dependent reduction in adverse cardiac events.118 No study of perioperative statin therapy has reported serious risks with the use of these drugs.116 Abruptly stopping statins may be associated with an increased risk, including death.117 Statins are continued in the perioperative period. Serious consideration should be given to starting them in patients with risk factors for or known atherosclerotic disease, especially because these patients have indications independent of surgery. This is an important intervention with long-term benefits.
Pulmonary medications, such as theophylline, inhaled β-agonists, inhaled anticholinergics, and inhaled or oral steroids, should be continued preoperatively. These drugs are prescribed for patients with reactive airways who require optimization.119
Oral hypoglycemic agents typically are held the day of operation to avoid hypoglycemia. Taking small amounts of long-acting insulin on the day of operation presents little risk of hypoglycemia but results in improved perioperative control. Patients with types 1 and 2 DM discontinue all short-acting bolus doses of insulin on the day of operation. Patients with type 2 DM take none or up to one-half dose of long-acting (eg, lente or neutral protamine Hagedorn [NPH]) or combination (70/30 preparations) insulins on the day of operation. Ultra–long-acting insulin (eg, glargine) is best continued as scheduled. People with type 1 DM take a small amount (usually a third to a half) of their usual morning long-acting insulin (eg, lente or NPH) on the day of operation to avoid diabetic ketoacidosis. Patients with an insulin pump continue their basal rate only.
Warfarin may be associated with increased bleeding except for minor procedures such as cataract surgery without bulbar blocks. There is no consensus on the optimal perioperative management of patients on warfarin. The usual recommendation is to withhold 4 to 5 doses of warfarin before operation (if the INR is 2.0-3.0) to allow the INR to decrease to less than 1.5, a level considered safe for surgical procedures and neuraxial blockade. 113 If the INR is higher than 3.0, it is necessary to withhold warfarin longer than 4 doses. If the INR is measured the day before the operation and remains higher than 1.8, a small dose of vitamin K (1.0-5.0 mg orally or subcutaneously) can reverse anticoagulation.90
Substitution with shorter-acting anticoagulants such as unfractionated or low-molecular-weight heparin, referred to as bridging, is controversial and should be individualized.89 Kearon recommends preoperative bridging with intravenous heparin only for patients who have had an acute arterial or venous thromboembolism within 1 month before operation if the procedure cannot be postponed.89
Most medications for neurologic and psychological problems should be continued on schedule in the preoperative period. Antiepileptics, antiparkinson medications, antidepressants, including monoamine oxidase inhibitors (MAOIs), antipsychotics, benzodiazepines, and drugs to treat myasthenia gravis are best maintained to avoid exacerbations of symptoms. Antianxiety and psychiatric medications should be continued up until the time of the procedure. Communication is crucial to alert the day of operation caregivers because alterations in anesthesia may be necessary when caring for patients on these medications, especially for patients taking MAOIs. Highly active antiretroviral regimens to treat human immunodeficiency virus require regular dosing to prevent drug resistance. It is important to maintain these as scheduled. Antibiotics should be taken to complete a prescribed course of therapy.
Patients taking narcotic pain medications are told to continue these medications as needed, including on the day of operation. Missed doses may result in withdrawal symptoms and significant pain with the associated stress response and hemodynamic perturbations.
Thyroid replacement drugs and antithyroid medications are continued on schedule.108 Patients taking steroids regularly take their usual dose on the day of operation.120 Patients who have taken more than the equivalent of 7.5 mg of prednisone a day for at least 3 weeks within the previous year may be at risk for stress-associated adrenal insufficiency.
Postmenopausal hormone replacement therapies containing estrogen increase the risk of perioperative thromboembolic complications and should be discontinued before operation.121 Estrogens must be stopped approximately 1 month before the operation to return coagulation to baseline. Most modern oral contraceptives have low doses of estrogen that increase thromboembolic risk minimally. The risk of unanticipated pregnancy may outweigh the benefits of discontinuing oral contraceptives.
Herbals and supplements may interact with anesthetic agents, alter the effects of prescription medications, and increase bleeding. Many patients do not consider supplements to be medications and will not report them in a list of their medications unless asked. Gingko biloba, echinacea, garlic, ginseng, kava, St. John wort, and valerian may be associated with increased bleeding, or a resistance or increased sensitivity to anesthetic and sedative agents.122 Herbals and supplements are discontinued 7 to 14 days before the operation. The exception is valerian, a central nervous system depressant that may cause a benzodiazepine-like withdrawal when discontinued. If time permits, valerian should be tapered before a planned anesthetic.
Patients who are particularly anxious should be offered a prescription for a short course of benzodiazepines, such as lorazepam, to be taken in the days preceding the operation, as well as on the day of operation.
As the practice of surgery has moved into the outpatient arena with most patients presenting to the hospital within minutes to hours of undergoing complex procedures, anesthesiologists have struggled with how best to accomplish their evaluations. Various models exist. Lee originally proposed an anesthesia-based outpatient clinic in 1949. Some clinics do no more than document information provided by the patient, the medical record, or others who have seen the patient. Some anesthesiologists rely on other physicians operating independently to prepare patients for operation, either based on anesthesia-derived guidelines or not. This allows for review of information but little direct oversight of the process. Practices that do not have preanesthesia clinics need to develop guidelines to direct testing and to prepare patients for anesthesia (Fig. 6-1, Tables 6-4, 6-5, 6-6, 6-7, 6-8, and 6-9).
Table 6-9 Surgeon's Preoperative Checklist
If the patient has not had an anesthesia consultation before the day of surgery, please adhere to the following guidelines:
□ 1. Surgical history and results of physical examination are available on the day of the operation.
□ 2. Preoperative Questionnaire (Table 6-3) is given to the patient with instructions to complete and bring it on the day of surgery or fax it beforehand to __________________
□ 3. Appropriate diagnostic tests are completed and are available. You are responsible for follow-up on any tests that you order (Tables 6-4 and 6-5 and Fig. 6-1).
□ 4. Medical information from outside our health care system (diagnostic tests, blood work, cardiac stress tests, echocardiograms, catheterizations, pulmonary function tests, consultations) is available on the day of the operation.
□ 5. Patient has been given preoperative medication instructions (Table 6-7).
□ 6. Patient has been given NPO guidelines (Table 6-8).
□ 7. "Clearance" letters or notes are rarely sufficient to design a safe anesthetic. A letter summarizing the patient's medical problems and condition and verifying that the patient's medical status is optimized is necessary. Surgery may be delayed or postponed for patients with chronic medical conditions if they have not been evaluated in the Anesthesia Preoperative Medicine Clinic (APMC) and necessary information is not available preoperatively, or their medical status is not optimized. The staff of APMC encourage you to use the clinic for complex patients or those undergoing major operations (Table 6-1).
Many surgeons and anesthesiologists rely on prior screening of patients or referrals to primary care physicians, internists, or specialists to "clear" patients or to manage comorbid conditions. Although this reliance may be appropriate for a few, very select diseases and patients, the management of conditions for everyday life and for reducing long-term complications is very different from the stresses of a surgical procedure and anesthesia. Proficiency in preoperative care is a prerequisite for board certification in anesthesia; internists who are not specifically trained in preoperative care may feel insecure when called on to evaluate the preoperative patient because this important aspect of medicine is not formally taught in many training programs.123 Anesthesiologists are best suited to do preoperative assessments because of our comprehensive understanding of surgical procedures, anesthetic techniques, and the pharmacologic and physiologic responses of patients during procedures.
Anesthesiologist-staffed preoperative clinics improve the satisfaction of patients and physicians, reduce operating room cancellations and delays, and decrease unnecessary testing and costs.7 To expand the anesthesiologist's responsibilities beyond the operating room, an educational system must be developed to train anesthesiologists in preoperative care. Concern has been expressed that current anesthesiology training programs are inadequately preparing practitioners to evaluate and manage patients with complicated medical conditions prior to anesthesia and operation.124 Previously, during residency training, honing the cognitive aptitude for preoperative medicine had not been emphasized because of the inordinate amount of time anesthesiologists spend in the operating room learning technical and procedural skills. One study found that fewer than half of residency programs have a formal preoperative management curriculum.124 Recently, the American Board of Anesthesiology mandated a 1-month requirement in preoperative evaluation training for anesthesia residents.
As anesthesiologists assume a greater out-of-operating room presence and take on the tasks of evaluating and managing patients before operation and anesthesia, expert practices using cost-efficient management, outcomes measures, and practice guidelines must be developed. Diagnostic expertise and clinical decision making should be emphasized. It would be unrealistic to expect anesthesiologists to manage the administrative and clinical roles of perioperative medicine without training in these skills during residency.124 Greater involvement of anesthesiologists in preoperative medicine has potential benefits to patients, institutions, the health care system, and the specialty. Preoperative clinics enable anesthesiologists to be responsible for perioperative care resources, to attract a diverse population of health care providers to the specialty, and to establish an expertise beyond the operating suite. Kluger, from the AIMS study, stated, "Anaesthetists must recognize they are responsible for the overall clinical management of the patient rather than simply providing a technical service.1
Preanesthesia clinics vary widely in services offered and the personnel involved in preoperative evaluation. They are staffed by anesthesiologists, internists, or physician extenders, such as nurse practitioners, physician assistants, registered nurses, or some combination.105 Depending on services that are offered, additional staff might include clerks, phlebotomists, ECG technicians, administrators, social workers, case managers, and physical therapists. When outcomes were compared between patients cared for by nurse practitioners versus primary care physicians, no difference in health status of patients or quality of care was found. In one study, a physician's diagnostic accuracy was improved 20% to 30% after a physician's assistant took a detailed history.125 Little data from preanesthetic clinics exist to guide staffing.
Scheduling is based on the anticipated requirements of the preoperative visit, such as the numbers and types of practitioners (eg, nurses, physicians, physical therapists, phlebotomists) who will be seeing the patient, required diagnostic studies, and the general health of the patient. The general health of the patient is estimated by the ASA PS or a screening mechanism offered by various Internet-based tools, a previsit telephone call, or a patient-completed information form sent from the surgeon's office (Table 6-3). Standardized appointment times for all patients inherently result in delays and long waits. Facilities should consider open-access scheduling that accommodates walk-ins for those patients traveling long distances or who have physical disabilities or unexpected scheduling of operation to prevent inconveniencing them with a return appointment. Reserving a block of time to coordinate appointments with high-volume office visits to surgeons might be useful. Scheduling patients far enough in advance allows time for ordering tests, improving the patient's medical condition, and recruiting social services. Evening and weekend hours afford patients the least disruption from work or family responsibilities.
Because long wait times contribute to patient dissatisfaction, strategies should lessen wait times to improve satisfaction. If patients arrive early or late for an appointment, if practitioners take longer than an appointment time, or if patients without appointments delay the evaluation of other patients, wait times will increase. Scheduling appointments that reflect time needed, using longer appointment intervals, providing necessary clinical information, using a computerized anesthesia record, accepting provider idle time, scheduling breaks, and deliberately expecting many "no-show" patients might decrease wait time.
Improving Patient Experience with Preoperative Evaluation
Patients who are scheduled for operation want information, want to have their concerns addressed, and want their questions answered.126 Patient anxiety is reduced when a patient's coping style is not threatened. Too much information, especially detailed information about the dangers of anesthesia and operation, creates anxiety in patients who prefer to cope by avoidance. Patients without prior anesthetic exposure desire more information than patients who have had previous anesthetics. Patients desire information in layperson language.16 Respecting a patient's feelings, explaining complex issues in a simple manner, and learning effective communication skills can improve patient satisfaction.127 Nonverbal communication, dress, and avoidance of jargon are important.16 Videos about anesthesia can be time efficient and well received. Written instructions, especially regarding NPO guidelines, medications, and when and where to go on the day of operation, are essential.
Patient satisfaction questionnaires are used to improve the processes.128 Some questions that might be asked in such a survey are as follows:
Did the anesthesiologist explain the planned anesthetic in terms you understood?
How well did the anesthesiologist answer your questions and address your concerns?
How well did the anesthesiologist explain what you could expect after your anesthesia?
Did you have to wait long?
Was the staff courteous and respectful to you?
Overall, how satisfied were you with your preanesthetic visit?
How might we improve our services?
Modern, up-to-date information systems streamline acquisition, storage, and transfer of data about patients among primary care providers, the laboratory, consultants, surgeons, and operating room and clinic personnel. Many institutions have developed their own computer-based programs (Figs. 6-4, 6-5, and 6-6), and a variety of commercial products are available. These can be as simple as a questionnaire (Table 6-3) or as advanced as complex systems that include decision support tools for diagnostic testing, suggestions for consultations, physician computer order entry, direct links to laboratory databases, and the capability of printing patient preoperative instructions, as well as a summary of the evaluation.
Computerized patient history.
Computerized patient physical examination and diagnostic test ordering.
Computerized patient assessment and plan, patient medication instructions, and billing documentation.
Computerized order-entry, prescription generation, and management programs can improve patient care and reduce costs. Patients can transfer information via e-mail, facsimile machines, and interactive telephone systems. Simple telephone reminders improve appointment keeping, patient satisfaction, patient compliance, use of services, and medication compliance, and they decrease use of alcohol and tobacco (prevention programs).
Computer-program patient interviews save valuable clinician time and may be convenient for the patient. Computer programs that gather information directly from patients allow planning for needed services in advance, and they can provide patient education and instruction. Internet-based sites and telemedicine have been used for preoperative evaluation.105,129 Airway evaluation is particularly enhanced with telemedicine.129
Electronic technology has enhanced the ease and efficiency of data acquisition, and these data can be accessed for patient care simultaneously by multiple providers in diverse locations. Technology can improve management of clinical studies, be used for cost analysis, and used for staffing, resource allocation, and managed care or capitated contract negotiations.
A computerized preanesthetic evaluation system can improve hospital (not just preoperative clinic) reimbursement by improved documentation of diagnosis-related group codes when ICD-9 codes are changed.130
Medicolegal Culpability
As anesthesiologists broaden their scope of practice and responsibilities, concerns over medical liability arise. Professional negligence, or malpractice, is generally characterized as a failure on the part of the physician to possess or exercise reasonable skill or diligence in the diagnosis or treatment of a patient. The essential elements of a medical malpractice claim include a duty toward the patient, a breach of that duty, and an injury to the patient because of the breach of duty. A physician's responsibility is to act in accordance with national standards of care established by the profession, which are defined in terms of care delivered by an average practitioner, not the best practitioner.
Duties of the preoperative physician include examination of the patient and referral to a specialist if necessary. Part of the examination requires the use of diagnostic information or techniques that an average, reasonable practitioner would use in similar circumstances.
Often physicians are concerned about failure to diagnose a condition by failing to order a diagnostic screening test. The traditional system of ordering standard preoperative tests evolved from the mistaken belief that more information, no matter how irrelevant or expensive, will improve care, enhance safety, and decrease liability. In reality, nonselective screening may increase legal culpability. Unanticipated significant abnormalities on laboratory test results are uncommon. The relationship between these abnormalities and surgical and anesthetic morbidity is weak at best. More than half of all abnormal test results obtained in routine preoperative screening are ignored or not noted in the medical record, which is the document of interest to the courts. Failure to follow up an abnormal result is, from a legal point of view, probably riskier than failure to order the test in the first place.
Physicians without malpractice claims are more likely than physicians with malpractice claims to encourage patients to talk and give their opinions. The physicians clarify what has been discussed, and they keep patients informed about what to expect during a visit. One study found that communication problems were predominant in most of the reported incidents involving a failure of preoperative preparation.1 Chapter 94 discusses legal issues in anesthesiology in greater detail.
Although anesthesiologists do not regularly receive separate payment for preoperative evaluations, the fee for preoperative assessment is part of the total operating room payment, and preoperative assessment by an anesthesiologist is required by both regulatory bodies and CMS.40 One study showed that preanesthetic care can reduce delays and cancellations on the day of operation.7 This can improve revenues by increasing time spent on billable cases rather than incurring personnel costs with an empty operating room. Avoiding delays and cancellations on the day of operation eliminates waste associated with unnecessary setups with disposable products. Preoperative assessment clinics also reduce costs by decreasing unnecessary testing and identifying patients with special needs on the day of operation.
According to CMS, preoperative assessments by anesthesiologists can be billed separately as visits or consultations "if medically necessary" and "beyond a routine preanesthetic assessment."38 When anesthesiologists perform at the level of a perioperative physician by ordering diagnostic studies such as echocardiograms or stress tests, by identifying problems and requesting consultations with specialists, by prescribing therapies such as β-blockers or bronchodilators, and by coordinating care beyond a simple anesthetic plan, they are offering care "beyond a routine preanesthetic assessment" and should bill for consultative services. Chapter 97 describes the criteria required to bill for preoperative consultations.
Physicians working in or administering preanesthetic clinics must become familiar with the CMS Advance Beneficiary Notice (ABN) billing rules. These rules govern whether physicians and other Medicare Part B providers can bill beneficiaries directly if Medicare does not cover services because of a lack of medical necessity. CMS rules relieve beneficiaries from financial liability if the provider fails to disclose that the service is not reimbursable. Unless the physician or facility has followed the ABN rules, payment may not be sought from the patient. ABN rules apply only to outpatient services. Additional information can be obtained from http://www.cms.hhs.gov.
Preoperative clinics are ideal settings for offering comprehensive care beyond anesthesia evaluation. Advanced care and postdischarge planning, respiratory therapy training, counseling about smoking and substance abuse, vaccinations, and end-of-life care discussions have been effectively implemented in preanesthesia clinics.96,131 When a patient is scheduled for operation, the patient may be more focused on health issues and improvement interventions may be particularly successful. These times have been called "teachable moments."95,131
Warner has rightfully challenged the anesthesia community to do its part in reducing the substantial burden of tobacco abuse.95 Physical therapists can offer crutch training, social workers can begin postdischarge planning, especially for patients requiring rehabilitation services, and case managers can coordinate care across many disciplines. A 5-minute intervention in a preoperative clinic significantly increased and improved discussions of advance care planning and increased completion of a durable power of attorney to 25%, compared with 10% by controls.132
Some day it may be possible to identify patients with genetic polymorphisms linked to adverse outcomes during the preoperative assessments. Then pharmacologic interventions and management can directly alter morbidity and mortality.133 Molecular biology is rapidly changing our ability to identify genetic variability and its effects on diseases and responses to therapies. This new approach could dramatically alter the way we perform risk assessment and how we design management plans. It would allow us to move away from expectations of results based on population studies to treatments based on individual patient characteristics. Pharmacogenetics may eventually lead to genetic screening tests to identify patients who are at risk for adverse perioperative outcomes, such as patients with pseudocholinesterase deficiency, halothane hepatitis, and susceptibility to malignant hyperthermia, as well as less familiar traits associated with the duration and response to drugs such as benzodiazepines, opioids, anesthetics, and NSAIDs, and pain tolerance.133
The prevention of complications during and after procedures requiring anesthesia is the most important task for preoperative anesthesiologists. Identification of risk requires fundamentally good medicine, systems of care, clinical and laboratory assessment, and experienced, knowledgeable, and dedicated health care providers. Risk reduction and outcome improvement are the ultimate goals of preoperative assessment and management.
American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery), American Society of Echocardiography, American Society of Nuclear Cardiology, et al. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). Anesth Analg. 2008;106(3):685-712.
American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Practice advisory for preanesthesia evaluation: a report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Anesthesiology. 2002;96(2):485-496.
American Society of Anesthesiologists Task Force on Perioperative Management of Patients With Cardiac Rhythm Management Devices. Practice advisory for the perioperative management of patients with cardiac rhythm management devices: pacemakers and implantable cardioverter-defibrillators: a report by the American Society of Anesthesiologists Task Force on Perioperative Management of Patients With Cardiac Rhythm Management Devices. Anesthesiology. 2005;103(1):186-198.
Bonow RO, Carabello BA, Chatterjee K, et al. 2008 focused update incorporated into the ACC/AHA 2006 guidelines for the management of patients with valvular heart disease. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease). J Am Coll Cardiol. 2008;52(13):e1-142.
Chassot PG, Delabays A, Spahn DR. Perioperative antiplatelet therapy: the case for continuing therapy in patients at risk of myocardial infarction. Br J Anaesth. 2007;99(3):316-328.
Chung F, Yegneswaran B, Liao P, et al. STOP questionnaire: a tool to screen patients for obstructive sleep apnea. Anesthesiology. 2008;108(5):812-821.
Chung F, Yuan H, Yin L, Vairavanathan S, Wong DT. Elimination of preoperative testing in ambulatory surgery. Anesth Analg. 2009;108(2):467-475.
Ferschl MB, Tung A, Sweitzer B, Huo D, Glick DB. Preoperative clinic visits reduce operating room cancellations and delays. Anesthesiology. 2005;103(4):855-859.
Grines CL, Bonow RO, Casey DE Jr, et al. Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents: a science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, with representation from the American College of Physicians. J Am Coll Cardiol. 2007;49(6):734-739.
Horlocker TT, Wedel DJ, Rowlingson JC, et al. Regional anesthesia in the patient receiving antithrombotic or thrombolytic therapy: American Society of Regional Anesthesia and Pain Medicine Evidence-Based Guidelines (Third Edition). Reg Anesth Pain Med. 2010;35(1):64-101.
Howell SJ, Sear JW, Foëx P. Hypertension, hypertensive heart disease and perioperative cardiac risk. Br J Anaesth. 2004;92(4):570-583.
Kearon C, Hirsh J. Management of anticoagulation before and after elective surgery. N Engl J Med. 1997;336(21):1506-1511.
Le Manach Y, Coriat P, Collard CD, Riedel B. Statin therapy within the perioperative period. Anesthesiology. 2008;108(6):1141-1146.
Liao P, Yegneswaran B, Vairavanathan S, Zilberman P, Chung F. Postoperative complications in patients with obstructive sleep apnea: a retrospective matched cohort study. Can J Anaesth. 2009;56(11):819-828.
McFalls EO, Ward HB, Moritz TE, et al. Coronary-artery revascularization before elective major vascular surgery. N Engl J Med. 2004;351(27):2795-2804.
Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: a report by the American Society of Anesthesiologist Task Force on Preoperative Fasting. Anesthesiology. 1999;90(3):896-905.
Shi Y, Warner DO. Surgery as a teachable moment for smoking cessation. Anesthesiology. 2010;112(1):102-107.
Smetana GW, Lawrence VA, Cornell JE. Preoperative pulmonary risk stratification for noncardiothoracic surgery: systematic review for the American College of Physicians. Ann Intern Med. 2006;144(8):581-595.
Tait AR, Malviya S. Anesthesia for the child with an upper respiratory tract infection: still a dilemma? Anesth Analg. 2005;100(1):59-65.
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Interior designing sometimes might be challenging task for home owners. Yes it's quite easy just to buy things and fill up your room but to get the positive vibe and the whole room to get blended the way you have always wished for, you will definitely need a professional help. Whether you are looking forward to design the nursery for your coming baby or want to convert your living room with a rustic look with old interiors and paintings a good interior designer will take care of all the worries for you. HKL Construction Ltd. Is a boutique interior design and home improvement firm. It has been established since 2012, it got the experienced interior designer and the workers and we provide Affordable interior design GTA.
While looking for a good interior designer you might want to have a check on their experience in the field in of interior designing. You can have an idea of their work by asking your interior designer their past project they had completed. Or you can ask for referrals from the members of your friends and family who has been recently hired an interior designer company, and how they have handled the whole project.
While upgrading the interior design of the home most of the homeowners are concerned about the high charges of interior designers. HKL CONSTRUCTION is one of the home improvement, interior designing boutique that offers Affordable interior design GTA. We have worked with clients to transform their existing interior, which was having strict budget constraints and was amazed with the transformation we had provided them. The most important thing when you are going through the process of interior designing is to clearly explain the changes you want in your project in order to make your home or space more functional and visually more appealing and pleasing.
We start the process with your needs and wish-lists, our creative team then start to plan the whole design considering the needs and what you want for your new and improved space. We will plan and create around the layout of your home, and we will help you to make decisions and choices for the best transformation and within your existing budget. Our goal is to deliver exceptional results and to transform the space which our client can admire. For affordable interior design, home improvements; HKL CONSTRUCTION is your right choice.
At HKL Construction Ltd. we are proud to have a certified and specialized team who are brilliant and efficient in their work. Whatever the designs and themes our client might have pictured, our team will try their best to convert it into reality by incorporating some unique classy or elegant pieces of furniture according to the taste of our client and to make their homes feel special for them. We deliver supreme quality pieces in our projects, with the right selection of fabric and colors which will put together the whole space. Our team of interior designer will incorporate the whole project at Affordable interior design GTA.
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Our team keeps a close look on all the deliveries related to the project. Our team tries not to create a communication gap between the suppliers and manufactures who are providing the required pieces for the project. HKL Construction Ltd. is a boutique interior design and home improvement firm providing Affordable interior design GTA. Our designers will use their expertise and skills to make your space admirable and equally functional. |
Background and Aim: MicroRNAs (miRNA) are small noncoding RNA molecules that transcribed by RNA polymerase II. After biogenesis, these molecules act by incorporation into the RNA-induced silencing complex (RISC). MiRNAs are involved in multiple physiological and pathological processes such as proliferation, differentiation, apoptosis and cancer.
Recently several studies reported down regulation of mir-150 during erythropoesis. Since hemoglobin expression is valuable indicator of erythroid differentiation we evaluated the mir-150 downregulation effect on alpha chain expression by Quantitative RT-PCR.
Materials and Methods: K562cells were grown in RPMI1640 in standard condition. K562 cells were transfected by microRNA 150 Inhibitor using transfection kit .Mir-150 downregulation was confirmed by miRNA Real time PCR, followed by Q-RT-PCR to investigate the alpha chain expression changes.
Conclusion: Elevation of alpha chain expression in our study showed that mir-150 downregulation has a crucial role in erythroid differentiation and can introduce as a novel marker in alpha thalassemia. Further researches to find out the detail mechanism and miRNAs genes target could improve our knowledge about miRNAs potential in management of diseases and their applications in gene therapy and regenerative medicine. |
We had a great time with this class before Christmas. There were competitive games on the court and a focus on paddle control with drills. This is a great activity for kids of all ages. It is a mix of tennis and ping pong played on a basketball gym floor. We use a wiffle ball and a wooden paddle to knock the ball back and forth. It will continue the eye hand coordination that anyone may have started to gain from tennis class, and is an activity that improves reflexes and lateral quickness. |
The Taliban and pigeons
I live in a small part of a big world. Where I live, if someone want to raise pigeons, they do, if doing so is permissible by local zoning ordinances. Religion, or politicized religion cannot forbid us the joy of pigeons. I enjoy watching the birds race around and around. Pigeons bring a small measure of joy to our lives. When I read that the Taliban banned raising pigeons while ruling Afghanistan, I was baffled. Why would the Taliban do something so pointless? What possible reason could be offered to justify banning raising pigeons? Does it offend Allah?
I got here today via a photo and it's small blurb.
In this photograph taken on October 22, 2014, Afghan pigeon fancier Habibullah looks on as his birds take flight at his home on the outskirts of Jalalabad. Habibullah has a flock of fifty-five pigeons which he releases daily from the roof of his home for recreation, a practice which was banned during Taliban rule.
Politics and religion are an evil combination. Why is this so hard to see? I've always felt that we can detect intent by looking at the small things like hat does religion attempts to control or ban, or how religion trys to control our behavior. I ask a lot of questions as I read the news. Why is it wrong for me to buy alcohol on a Sunday morning? Why can't our children learn the facts about birth control? Why must we pray before city council meetings? Why must we accommodate religions traditions? These questions weigh on my mind.
Islam|Religion|
Labels: Islam, Religion
Top Scientology leaders caught on video harassing an ex member at L.A. airport
Scientology's true believers are nuts.
Top Scientology leaders caught on video harassing an ex member at L.A. airport:
"A former executive of the Church of Scientology has posted video footage showing high-ranking members of the church yelling obscenities and harassing him in a Los Angeles airport.
The video is the first public glimpse of the secretive church's top management in four years. The footage, posted by Mark Rathbun this Sunday, shows Marc Yager, Dave Bloomberg and Jennifer Linson Devocht — three executives who report to church president David Miscavige. The church members can be seen yelling at Rathbun, telling him to 'get a life,' that his criticism of the church has had 'no effect,' and 'nobody gives a f*ck about you.'"
I've met a few in my time, they all scare me. Crazy always scares me.
Cults|
Labels: Cults
This is why I don't trust Texas
If Texans willingly elect nutball Dan Patrick as lieutenant governor, well, the diverse what they get.
Man Who Believes God Speaks to Us Through "Duck Dynasty" Is About to Be Texas' Second-in-Command:
"A former sportscaster who once defended a football player who'd thrown a reporter through a door (Patrick believed it wasn't the journalist's job to do 'negative reporting'), Patrick became a conservative talk radio host in the early 1990s—Houston's answer to Rush Limbaugh. In 2006, he parlayed his radio fame into a state Senate seat—and kept the talk show going. In office, he proposed paying women $500 to turn over newborn babies to the state (to reduce abortions), led the charge against creeping liberalism in state textbooks, and pushed wave after wave of new abortion restrictions. For his efforts, Texas Monthly named Patrick one of the worst legislators of 2013."
I've come to the point in my life where I think that our democracy has failed. This hater should not be on the ballet, yet he's about to win. I am not proud or our process. It needs to be fixed. We elect the worst possible candidates as if we are proud of it. Any one of the things listed below should disqualify this nutball extremest, but he wears them like a badge and people still vote for him.
He's an intolerant Christian.
He's xenophobic.
He's an egotist.
He's a racist.
He's a fervent right to lifer.
He does not support the separation of church and state
He believes creationism should be taught in school as science.
He thinks God talks to him.
Christianity|Only in Texas|Politics|
Labels: Christianity, Only in Texas, Politics
Got to love them nutballs
Religious nutters are always entertaining.
Woman arrested claiming Jesus Christ will pay her restaurant tab… with cash!
"When asked about her husband, she told them she was legally married to Jesus Christ, but had no marriage license. She also told management that Jesus would be able to walk in and produce U.S. currency to pay for her bill. "
(Via. KSWO.com)
Remember when a pastor's arrest was a good thing?
I remember when I used to look up to pastors like James H. Bryant. It was not that long ago. I miss those days. Religion can be a force for good.
Bryant was arrested in Ferguson protesting against police brutality and misconduct.
Bryant was on the front lines of a crowd of hundreds of protesters and faith leaders marching from a church to the Police Department in Ferguson, the town where unarmed teenager Michael Brown was fatally shot by police two months ago.
In a tweet posted Monday afternoon, Bryant said he had been released.
"Just released from St Louis county!" the message read. "We are being charged with assaulting police & disturbing the peace #NoJusticeNoPeace"
Baltimore pastor arrested at Ferguson protest by Justin George & Justin Fenton. The Baltimore Sun.
It is a rare thing for me to promote the arrest of a pastor as a good thing, but I do so willingly. Go pastor James H. Bryant!
Christianity|Culture|Good News|Politics|Religion|
Labels: Christianity, Culture, Good News, Politics, Religion
Mark Driscoll's resignation and institutional hypocrisy
Mark Driscoll, the former head pastor of the Seattle-based Mars Hill mega church, has resigned. But in doing so, his former church lost an opportunity to hold a stinky turd of a christian pastor accountable for his misdeeds.
"The investigation by a group of elders at the church, Mars Hill, found that Mr. Driscoll 'has, at times, been guilty of arrogance, responding to conflict with a quick temper and harsh speech, and leading the staff and elders in a domineering manner.' But the board also declared that some unspecified accusations against Mr. Driscoll were 'altogether unfair or untrue' and said that 'Pastor Mark has never been charged with any immorality, illegality or heresy.'"
Mark Driscoll Resigns as Pastor of Mars Hill Megachurch - Michael Paulson. N.Y. Times. 10/16/2014
Driscoll admitted to pride, anger and a domineering spirit. He left out the well-documented sexist pig and imperialist bully parts of his tenure. So did Mars Hill. In fact, it would seem that Driscoll and Mars Hill can only agree that he may have done a few things that he had already apologies for… so lets just forget the whole mess. Great job Mars Hill! Way to lead! I'm sure Jesus would be proud.
How about a real investigation run be independent investigators unaffiliated with Mars Hill? How about offering protection to the alleged victims so that they can speak freely about allegations of abuse without fear of retaliation. It's hard to speak freely in front of your peers, but I think Mars Hills knows this because exactly ZERO victims testified during their investigation and this does not seem to bother them at all.
This is institutional hypocrisy. Mars Hills has a reputation to protect. They have skin in the game. They are at least partially responsible for the alleged abuses of Mark Driscoll. How can we expect anything honest in this scenario? At best, we can be thankful that with power-mad pastor is out of a job, but it will only last until his next posting. Mars Hill should have put a stake in Driscoll's empty heart. Now, some other wannabe mega church will hire him and the cycle will start anew.
Christianity|Hypocrisy Watch|
Labels: Christianity, Hypocrisy Watch |
A Detective Story: Unveiling Identities in Medieval Manuscripts using Philology and an Astrolabe
Dr. Josefina Rodriguez-Arribas, Institute for the History of Science, Polish Academy of Sciences, Warsaw
I will present in my talk the case study of a twelfth-century Hebrew text that discusses whether the use of astrology is licit among Jews. This text will serve to show how the traditional tools of philology combined with in-depth knowledge of medieval practical astronomy can be used to produce something other than a good critical edition. The three main characters in the text under consideration — which presents the literary form of a letter addressed to a rabbi — are: the author of the letter, who is a Jewish astronomer; the objector who caused the bitter controversy reflected in the letter; and the addressee of the letter, the religious authority of the Jewish community where the letter was written. Current research keeps identifying the objector with the addressee, 800 years after this letter was written. By using two methodological approaches: philology and knowledge of medieval astronomy and astronomical instruments, I will prove this long tradition wrong. |
The 2020 Buick Enclave Makes Its Presence Known in the High-End SUV Market
Buick is a brand that is synonymous with quality, and the 2020 Buick Enclave certainly doesn't disappoint. With updated technology and a bold new style, Buick's flagship SUV is showing that this iconic American automaker is keeping up with the times. See how the Enclave melds together old-world style and comfort in a stunning new package for 2020 at your local Buick dealership.
Sleek Good Looks -- Inside and Out
The 2020 Enclave is cleverly designed to seat up to 7 people, but the exterior doesn't feel bulky as a minivan and the interior still provides plenty of space to relax. From the distinctive style to the updated color schemes, the Enclave is set to look great on the road when it's introduced later this year.
Powerful Luxury You Can Trust
Drivers can select from 2-wheel or all-wheel drive options, with the 3.6L V6 engine delivering a strong 266 lb-ft of torque and 310 horsepower -- plenty to ensure you'll be able to pass swiftly and efficiently, even if the large SUV is fully loaded. Ready for that extra touch of luxury? Check out the massage chairs in the front seat and the four-way power lumbar adjustments.
Next-Generation Infotainment
Updated digital interaction for drivers and front-seat passengers is all the rage, and the new 8-inch diagonal touchscreen makes it easy to engage with the vehicle. HD Rear Vision Cameras and HD Surround Vision help drivers stay in control of their surroundings at all times.
Are you ready for true driving excitement? Search the full inventory of Buicks online at Cappellino Buick GMC today. Our staff values excellence in each interaction with our clients, and we look forward to providing you with top-notch support before, during and after the sale. Contact our sales team today at 716-650-4471 or check out our business hours and directions to visit in person. |
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1. H.R.3818 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Young, Don [R-AK-At Large] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Education and Labor Latest Action: House - 07/17/2019 Referred to the House Committee on Education and Labor. (All Actions) Tracker:
2. H.R.3817 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Velazquez, Nydia M. [D-NY-7] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Agriculture, Energy and Commerce Latest Action: House - 07/17/2019 Referred to the Committee on Agriculture, and in addition to the Committee on Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee... (All Actions) Tracker:
3. H.R.3816 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Spano, Ross [R-FL-15] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Oversight and Reform Latest Action: House - 07/17/2019 Referred to the House Committee on Oversight and Reform. (All Actions) Tracker:
4. H.R.3815 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Schiff, Adam B. [D-CA-28] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Energy and Commerce, Oversight and Reform, Veterans' Affairs, Ways and Means, Natural Resources, Armed Services, Financial Services Latest Action: House - 07/17/2019 Referred to the Committee on Energy and Commerce, and in addition to the Committees on Oversight and Reform, Veterans' Affairs, Ways and Means, Natural Resources, Armed Services, and Financial Services, for a period to be subsequently determined by the Speaker, in... (All Actions) Tracker:
5. H.R.3814 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Richmond, Cedric L. [D-LA-2] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Natural Resources Latest Action: House - 07/17/2019 Referred to the House Committee on Natural Resources. (All Actions) Tracker:
6. H.R.3813 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Meadows, Mark [R-NC-11] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Veterans' Affairs Latest Action: House - 07/17/2019 Referred to the House Committee on Veterans' Affairs. (All Actions) Tracker:
7. H.R.3812 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. McKinley, David B. [R-WV-1] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Energy and Commerce Latest Action: House - 07/17/2019 Referred to the House Committee on Energy and Commerce. (All Actions) Tracker:
8. H.R.3811 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Matsui, Doris O. [D-CA-6] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Foreign Affairs Latest Action: House - 07/17/2019 Referred to the House Committee on Foreign Affairs. (All Actions) Tracker:
9. H.R.3810 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Lee, Susie [D-NV-3] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Energy and Commerce Latest Action: House - 07/17/2019 Referred to the House Committee on Energy and Commerce. (All Actions) Tracker:
10. H.R.3809 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Lawson, Al, Jr. [D-FL-5] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Agriculture, Education and Labor Latest Action: House - 07/17/2019 Referred to the Committee on Agriculture, and in addition to the Committee on Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee... (All Actions) Tracker:
11. H.R.3808 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Kilmer, Derek [D-WA-6] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Education and Labor Latest Action: House - 07/17/2019 Referred to the House Committee on Education and Labor. (All Actions) Tracker:
12. H.R.3807 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Kaptur, Marcy [D-OH-9] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Ways and Means Latest Action: House - 07/17/2019 Referred to the House Committee on Ways and Means. (All Actions) Tracker:
13. H.R.3806 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Gallego, Ruben [D-AZ-7] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Judiciary Latest Action: House - 07/17/2019 Referred to the House Committee on the Judiciary. (All Actions) Tracker:
14. H.R.3805 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Gallagher, Mike [R-WI-8] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Energy and Commerce Latest Action: House - 07/17/2019 Referred to the House Committee on Energy and Commerce. (All Actions) Tracker:
15. H.R.3804 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Frankel, Lois [D-FL-21] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Judiciary Latest Action: House - 07/17/2019 Referred to the House Committee on the Judiciary. (All Actions) Tracker:
16. H.R.3803 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. DeSaulnier, Mark [D-CA-11] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Ways and Means Latest Action: House - 07/17/2019 Referred to the House Committee on Ways and Means. (All Actions) Tracker:
17. H.R.3802 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. DeLauro, Rosa L. [D-CT-3] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Oversight and Reform, Armed Services Latest Action: House - 07/17/2019 Referred to the Committee on Oversight and Reform, and in addition to the Committee on Armed Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee... (All Actions) Tracker:
18. H.R.3801 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Davis, Susan A. [D-CA-53] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Armed Services Latest Action: House - 07/17/2019 Referred to the House Committee on Armed Services. (All Actions) Tracker:
19. H.R.3800 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Davidson, Warren [R-OH-8] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Education and Labor Latest Action: House - 07/17/2019 Referred to the House Committee on Education and Labor. (All Actions) Tracker:
20. H.R.3799 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Chu, Judy [D-CA-27] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Judiciary Latest Action: House - 07/17/2019 Referred to the House Committee on the Judiciary. (All Actions) Tracker:
21. H.R.3798 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Brownley, Julia [D-CA-26] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Veterans' Affairs Latest Action: House - 07/17/2019 Referred to the House Committee on Veterans' Affairs. (All Actions) Tracker:
22. H.R.3797 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Blumenauer, Earl [D-OR-3] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Energy and Commerce, Judiciary Latest Action: House - 07/17/2019 Referred to the Committee on Energy and Commerce, and in addition to the Committee on the Judiciary, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee... (All Actions) Tracker:
23. H.R.3796 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Bera, Ami [D-CA-7] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Ways and Means Latest Action: House - 07/17/2019 Referred to the House Committee on Ways and Means. (All Actions) Tracker:
24. H.R.3795 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Bass, Karen [D-CA-37] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Judiciary Latest Action: House - 07/17/2019 Referred to the House Committee on the Judiciary. (All Actions) Tracker:
25. H.R.3794 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Gosar, Paul A. [R-AZ-4] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Natural Resources, Agriculture Latest Action: House - 07/17/2019 Referred to the Committee on Natural Resources, and in addition to the Committee on Agriculture, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned. (All Actions) Tracker:
26. H.R.3793 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Horn, Kendra S. [D-OK-5] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Education and Labor Latest Action: House - 07/17/2019 Referred to the House Committee on Education and Labor. (All Actions) Tracker:
28. H.R.3791 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Massie, Thomas [R-KY-4] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Transportation and Infrastructure Latest Action: House - 07/17/2019 Referred to the House Committee on Transportation and Infrastructure. (All Actions) Tracker:
29. H.R.3790 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Dunn, Neal P. [R-FL-2] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Ways and Means, Financial Services Latest Action: House - 07/17/2019 Referred to the Committee on Ways and Means, and in addition to the Committee on Financial Services, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee... (All Actions) Tracker:
30. H.R.3789 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. DelBene, Suzan K. [D-WA-1] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Energy and Commerce Latest Action: House - 07/17/2019 Referred to the House Committee on Energy and Commerce. (All Actions) Tracker:
31. H.R.3788 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Barr, Andy [R-KY-6] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Veterans' Affairs Latest Action: House - 07/17/2019 Referred to the House Committee on Veterans' Affairs. (All Actions) Tracker:
32. H.R.3781 — 116th Congress (2019-2020) To increase the minimum levels of financial responsibility for transporting property, and to index future increases to changes in inflation relating to medical care. Sponsor: Rep. Garcia, Jesus G. "Chuy" [D-IL-4] (Introduced 07/16/2019) Cosponsors: (6) Committees: House - Transportation and Infrastructure Latest Action: House - 07/17/2019 Referred to the Subcommittee on Highways and Transit. (All Actions) Tracker:
33. H.R.3779 — 116th Congress (2019-2020) To amend the Robert T. Stafford Disaster Relief and Emergency Assistance Act to allow the Administrator of the Federal Emergency Management Agency to provide capitalization grants to eligible entities to establish revolving funds to provide assistance to reduce disaster risks, and for other purposes. Sponsor: Rep. Craig, Angie [D-MN-2] (Introduced 07/16/2019) Cosponsors: (5) Committees: House - Transportation and Infrastructure Latest Action: House - 07/17/2019 Referred to the Subcommittee on Economic Development, Public Buildings, and Emergency Management. (All Actions) Tracker:
34. H.R.3773 — 116th Congress (2019-2020) To direct the Secretary of Transportation to prescribe a motor vehicle safety standard requiring new commercial motor vehicles to be equipped with an automatic emergency braking system, to require automatic emergency braking installed in commercial motor vehicles to be used while in operation, and for other purposes. Sponsor: Rep. Johnson, Henry C. "Hank," Jr. [D-GA-4] (Introduced 07/16/2019) Cosponsors: (2) Committees: House - Transportation and Infrastructure, Energy and Commerce Latest Action: House - 07/17/2019 Referred to the Subcommittee on Highways and Transit. (All Actions) Tracker:
35. H.R.3494 — 116th Congress (2019-2020) Damon Paul Nelson and Matthew Young Pollard Intelligence Authorization Act for Fiscal Year 2020 Sponsor: Rep. Schiff, Adam B. [D-CA-28] (Introduced 06/26/2019) Cosponsors: (0) Committees: House - Intelligence (Permanent Select), Ways and Means Committee Reports: H. Rept. 116-151 Latest Action: House - 07/17/2019 The Clerk was authorized to correct section numbers, punctuation, and cross references, and to make other necessary technical and conforming corrections in the engrossment of H.R. 3494. (All Actions) Tracker:
Array ( [actionDate] => 2019-07-11 [displayText] => Reported (Amended) by the Committee on 116-151, Part I. [externalActionCode] => 5000 [description] => Introduced )
Array ( [actionDate] => 2019-07-17 [displayText] => Passed/agreed to in House: On passage Passed by the Yeas and Nays: 397 - 31 (Roll no. 492). [externalActionCode] => 8000 [description] => Passed House )
36. H.R.3305 — 116th Congress (2019-2020) To designate the facility of the United States Postal Service located at 2509 George Mason Drive in Virginia Beach, Virginia, as the "Ryan Keith Cox Post Office Building". Sponsor: Rep. Luria, Elaine G. [D-VA-2] (Introduced 06/18/2019) Cosponsors: (10) Committees: House - Oversight and Reform Latest Action: House - 07/17/2019 Motion to reconsider laid on the table Agreed to without objection. (All Actions) Tracker:
Array ( [actionDate] => 2019-07-17 [displayText] => Passed/agreed to in House: On motion to suspend the rules and pass the bill Agreed to by voice vote. [externalActionCode] => 8000 [description] => Passed House )
37. H.R.2325 — 116th Congress (2019-2020) To designate the facility of the United States Postal Service located at 100 Calle Alondra in San Juan, Puerto Rico, as the "65th Infantry Regiment Post Office Building". Sponsor: Rep. Gonzalez-Colon, Jenniffer [R-PR-At Large] (Introduced 04/15/2019) Cosponsors: (0) Committees: House - Oversight and Reform Latest Action: House - 07/17/2019 Motion to reconsider laid on the table Agreed to without objection. (All Actions) Tracker:
38. H.R.1847 — 116th Congress (2019-2020) Inspector General Protection Act Sponsor: Rep. Lieu, Ted [D-CA-33] (Introduced 03/21/2019) Cosponsors: (1) Committees: House - Oversight and Reform Latest Action: House - 07/17/2019 Motion to reconsider laid on the table Agreed to without objection. (All Actions) Tracker:
Array ( [actionDate] => 2019-07-17 [displayText] => Passed/agreed to in House: On motion to suspend the rules and pass the bill, as amended Agreed to by voice vote. [externalActionCode] => 8000 [description] => Passed House )
39. H.R.1844 — 116th Congress (2019-2020) To designate the facility of the United States Postal Service located at 66 Grove Court in Elgin, Illinois, as the "Corporal Alex Martinez Memorial Post Office Building". Sponsor: Rep. Krishnamoorthi, Raja [D-IL-8] (Introduced 03/21/2019) Cosponsors: (17) Committees: House - Oversight and Reform Latest Action: House - 07/17/2019 Motion to reconsider laid on the table Agreed to without objection. (All Actions) Tracker:
40. H.R.1526 — 116th Congress (2019-2020) To designate the facility of the United States Postal Service located at 200 Israel Road Southeast in Tumwater, Washington, as the "Eva G. Hewitt Post Office". Sponsor: Rep. Heck, Denny [D-WA-10] (Introduced 03/05/2019) Cosponsors: (9) Committees: House - Oversight and Reform Latest Action: House - 07/17/2019 Motion to reconsider laid on the table Agreed to without objection. (All Actions) Tracker:
41. H.R.1327 — 116th Congress (2019-2020) Never Forget the Heroes: James Zadroga, Ray Pfeifer, and Luis Alvarez Permanent Authorization of the September 11th Victim Compensation Fund Act Sponsor: Rep. Maloney, Carolyn B. [D-NY-12] (Introduced 02/25/2019) Cosponsors: (332) Committees: House - Judiciary Latest Action: Senate - 07/17/2019 Read the second time. Placed on Senate Legislative Calendar under General Orders. Calendar No. 153. (All Actions) Tracker:
Array ( [actionDate] => 2019-07-12 [displayText] => Reported by the Committee on Judiciary. H. Rept. 116-152. [externalActionCode] => 5000 [description] => Introduced )
Array ( [actionDate] => 2019-07-12 [displayText] => Passed/agreed to in House: On motion to suspend the rules and pass the bill, as amended Agreed to by the Yeas and Nays: (2/3 required): 402 - 12 (Roll no. 474).(text: CR H5743-5744) [externalActionCode] => 8000 [description] => Passed House )
42. H.R.1250 — 116th Congress (2019-2020) To designate the facility of the United States Postal Service located at 11158 Highway 146 North in Hardin, Texas, as the "Lucas Lowe Post Office". Sponsor: Rep. Babin, Brian [R-TX-36] (Introduced 02/14/2019) Cosponsors: (35) Committees: House - Oversight and Reform Latest Action: House - 07/17/2019 The title of the measure was amended. Agreed to without objection. (All Actions) Tracker:
43. H.R.748 — 116th Congress (2019-2020) Middle Class Health Benefits Tax Repeal Act of 2019 Sponsor: Rep. Courtney, Joe [D-CT-2] (Introduced 01/24/2019) Cosponsors: (369) Committees: House - Ways and Means Latest Action: House - 07/17/2019 Motion to reconsider laid on the table Agreed to without objection. (All Actions) Tracker:
Array ( [actionDate] => 2019-07-17 [displayText] => Passed/agreed to in House: On motion to suspend the rules and pass the bill, as amended Agreed to by the Yeas and Nays: (2/3 required): 419 - 6 (Roll no. 493). [externalActionCode] => 8000 [description] => Passed House )
44. H.R.736 — 116th Congress (2019-2020) Access to Congressionally Mandated Reports Act Sponsor: Rep. Quigley, Mike [D-IL-5] (Introduced 01/23/2019) Cosponsors: (22) Committees: House - Oversight and Reform, House Administration Latest Action: House - 07/17/2019 Motion to reconsider laid on the table Agreed to without objection. (All Actions) Tracker:
45. H.R.582 — 116th Congress (2019-2020) Raise the Wage Act Sponsor: Rep. Scott, Robert C. "Bobby" [D-VA-3] (Introduced 01/16/2019) Cosponsors: (205) Committees: House - Education and Labor Committee Reports: H. Rept. 116-150 Latest Action: House - 07/17/2019 Rule H. Res. 492 passed House. (All Actions) Tracker:
Array ( [actionDate] => 2019-07-11 [displayText] => Reported (Amended) by the Committee on Education and Labor. H. Rept. 116-150. [externalActionCode] => 5000 [description] => Introduced )
46. H.Res.501 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Lewis, John [D-GA-5] (Introduced 07/17/2019) Cosponsors: (57) Committees: House - Foreign Affairs Latest Action: House - 07/17/2019 Referred to the House Committee on Foreign Affairs. (All Actions) Tracker:
Agreed to in House
47. H.Res.500 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Duffy, Sean P. [R-WI-7] (Introduced 07/17/2019) Cosponsors: (0) Committees: House - Financial Services Latest Action: House - 07/17/2019 Referred to the House Committee on Financial Services. (All Actions) Tracker:
48. H.Res.499 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Blumenauer, Earl [D-OR-3] (Introduced 07/17/2019) Cosponsors: (56) Committees: House - Judiciary Latest Action: House - 07/17/2019 Referred to the House Committee on the Judiciary. (All Actions) Tracker:
49. H.Res.498 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Green, Al [D-TX-9] (Introduced 07/17/2019) Cosponsors: (0) Latest Action: House - 07/17/2019 On motion to table the measure Agreed to by the Yeas and Nays: 332 - 95, 1 Present (Roll no. 483). (All Actions) Tracker:
50. H.Res.497 — 116th Congress (2019-2020) No latest title... Sponsor: Rep. Cummings, Elijah E. [D-MD-7] (Introduced 07/17/2019) Cosponsors: (0) Latest Action: House - 07/17/2019 Motion to reconsider laid on the table Agreed to without objection. (All Actions) Tracker:
This bill has the status Agreed to in House
Array ( [actionDate] => 2019-07-17 [displayText] => Passed/agreed to in House: On agreeing to the resolution Agreed to by the Yeas and Nays: 230 - 198 (Roll no. 489). [externalActionCode] => 8000 [description] => Agreed to in House )
51. H.Res.492 — 116th Congress (2019-2020) Providing for consideration of the bill (H.R. 582) to provide for increases in the Federal minimum wage, and for other purposes. Sponsor: Rep. Morelle, Joseph D. [D-NY-25] (Introduced 07/15/2019) Cosponsors: (0) Committees: House - Rules Committee Reports: H. Rept. 116-155 Latest Action: House - 07/17/2019 Motion to reconsider laid on the table Agreed to without objection. (All Actions) Tracker:
Array ( [actionDate] => 2019-07-15 [displayText] => The House Committee on Rules reported an original measure, H. Rept. 116-155, by Mr. Morelle. [externalActionCode] => 5000 [description] => Introduced )
52. H.Amdt.575 — 116th Congress (2019-2020) Amends Bill: H.R.3494 Sponsor: Rep. Kennedy, Joseph P., III [D-MA-4] (Offered 07/16/2019) Latest Action: 07/17/19 On agreeing to the Kennedy amendment (A011) Agreed to by recorded vote: 237 - 196 (Roll no. 491). (All Actions)
53. H.Amdt.571 — 116th Congress (2019-2020) Amends Bill: H.R.3494 Sponsor: Rep. Chabot, Steve [R-OH-1] (Offered 07/16/2019) Latest Action: 07/17/19 On agreeing to the Chabot amendment (A007) Failed by recorded vote: 178 - 255 (Roll no. 490). (All Actions)
54. S.2155 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Warren, Elizabeth [D-MA] (Introduced 07/17/2019) Cosponsors: (4) Committees: Senate - Finance Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on Finance. (All Actions) Tracker:
55. S.2154 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Rosen, Jacky [D-NV] (Introduced 07/17/2019) Cosponsors: (3) Committees: Senate - Armed Services Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on Armed Services. (All Actions) Tracker:
56. S.2153 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Markey, Edward J. [D-MA] (Introduced 07/17/2019) Cosponsors: (0) Committees: Senate - Commerce, Science, and Transportation Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on Commerce, Science, and Transportation. (All Actions) Tracker:
58. S.2151 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Booker, Cory A. [D-NJ] (Introduced 07/17/2019) Cosponsors: (0) Committees: Senate - Judiciary Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on the Judiciary. (All Actions) Tracker:
59. S.2150 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Kennedy, John [R-LA] (Introduced 07/17/2019) Cosponsors: (0) Committees: Senate - Small Business and Entrepreneurship Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on Small Business and Entrepreneurship. (All Actions) Tracker:
60. S.2149 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Booker, Cory A. [D-NJ] (Introduced 07/17/2019) Cosponsors: (0) Committees: Senate - Small Business and Entrepreneurship Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on Small Business and Entrepreneurship. (All Actions) Tracker:
62. S.2147 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Collins, Susan M. [R-ME] (Introduced 07/17/2019) Cosponsors: (5) Committees: Senate - Commerce, Science, and Transportation Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on Commerce, Science, and Transportation. (All Actions) Tracker:
64. S.2145 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Ernst, Joni [R-IA] (Introduced 07/17/2019) Cosponsors: (2) Committees: Senate - Homeland Security and Governmental Affairs Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on Homeland Security and Governmental Affairs. (All Actions) Tracker:
65. S.2144 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Cornyn, John [R-TX] (Introduced 07/17/2019) Cosponsors: (0) Committees: Senate - Banking, Housing, and Urban Affairs Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker:
66. S.2143 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Warren, Elizabeth [D-MA] (Introduced 07/17/2019) Cosponsors: (2) Committees: Senate - Agriculture, Nutrition, and Forestry Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on Agriculture, Nutrition, and Forestry. (All Actions) Tracker:
67. S.2142 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Collins, Susan M. [R-ME] (Introduced 07/17/2019) Cosponsors: (1) Committees: Senate - Homeland Security and Governmental Affairs Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on Homeland Security and Governmental Affairs. (All Actions) Tracker:
68. S.2141 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Markey, Edward J. [D-MA] (Introduced 07/17/2019) Cosponsors: (0) Committees: Senate - Small Business and Entrepreneurship Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on Small Business and Entrepreneurship. (All Actions) Tracker:
69. S.2140 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Durbin, Richard J. [D-IL] (Introduced 07/17/2019) Cosponsors: (10) Committees: Senate - Finance Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on Finance. (All Actions) Tracker:
70. S.2139 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Durbin, Richard J. [D-IL] (Introduced 07/17/2019) Cosponsors: (4) Committees: Senate - Homeland Security and Governmental Affairs Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on Homeland Security and Governmental Affairs. (All Actions) Tracker:
71. S.2138 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Cardin, Benjamin L. [D-MD] (Introduced 07/17/2019) Cosponsors: (0) Committees: Senate - Small Business and Entrepreneurship Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on Small Business and Entrepreneurship. (All Actions) Tracker:
72. S.2137 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Portman, Rob [R-OH] (Introduced 07/17/2019) Cosponsors: (8) Committees: Senate - Energy and Natural Resources Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on Energy and Natural Resources. (All Actions) Tracker:
73. S.2136 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Blackburn, Marsha [R-TN] (Introduced 07/17/2019) Cosponsors: (1) Committees: Senate - Veterans' Affairs Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker:
74. S.2135 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Udall, Tom [D-NM] (Introduced 07/17/2019) Cosponsors: (2) Committees: Senate - Judiciary Latest Action: Senate - 07/17/2019 Read twice and referred to the Committee on the Judiciary. (All Actions) Tracker:
75. S.2071 — 116th Congress (2019-2020) Repealing Existing Substandard Provisions Encouraging Conciliation with Tribes Act Sponsor: Sen. Rounds, Mike [R-SD] (Introduced 07/10/2019) Cosponsors: (2) Committees: Senate - Indian Affairs Latest Action: Senate - 07/17/2019 Committee on Indian Affairs. Ordered to be reported without amendment favorably. (All Actions) Tracker:
76. S.1833 — 116th Congress (2019-2020) Restore the Harmony Way Bridge Act Sponsor: Sen. Braun, Mike [R-IN] (Introduced 06/13/2019) Cosponsors: (3) Committees: Senate - Environment and Public Works Latest Action: Senate - 07/17/2019 Passed Senate without amendment by Unanimous Consent. (All Actions) Tracker:
This bill has the status Passed Senate
Array ( [actionDate] => 2019-06-19 [displayText] => Committee on Environment and Public Works. Reported by Senator Barrasso without amendment. Without written report. [externalActionCode] => 14000 [description] => Introduced )
Array ( [actionDate] => 2019-07-17 [displayText] => Passed/agreed to in Senate: Passed Senate without amendment by Unanimous Consent. [externalActionCode] => 17000 [description] => Passed Senate )
77. S.1321 — 116th Congress (2019-2020) Defending the Integrity of Voting Systems Act Sponsor: Sen. Blumenthal, Richard [D-CT] (Introduced 05/06/2019) Cosponsors: (2) Committees: Senate - Judiciary Latest Action: Senate - 07/17/2019 Passed Senate without amendment by Unanimous Consent. (All Actions) Tracker:
Array ( [actionDate] => 2019-05-22 [displayText] => Committee on the Judiciary. Reported by Senator Graham without amendment. Without written report. [externalActionCode] => 14000 [description] => Introduced )
78. S.886 — 116th Congress (2019-2020) Indian Water Rights Settlement Extension Act Sponsor: Sen. Udall, Tom [D-NM] (Introduced 03/27/2019) Cosponsors: (2) Committees: Senate - Energy and Natural Resources, Indian Affairs Latest Action: Senate - 07/17/2019 Committee on Indian Affairs. Ordered to be reported with an amendment in the nature of a substitute favorably. (All Actions) Tracker:
79. S.375 — 116th Congress (2019-2020) Payment Integrity Information Act of 2019 Sponsor: Sen. Carper, Thomas R. [D-DE] (Introduced 02/07/2019) Cosponsors: (3) Committees: Senate - Homeland Security and Governmental Affairs | House - Oversight and Reform Committee Reports: S. Rept. 116-35 Latest Action: House - 07/17/2019 Referred to the House Committee on Oversight and Reform. (All Actions) Tracker:
Array ( [actionDate] => 2019-05-06 [displayText] => Committee on Homeland Security and Governmental Affairs. Reported by Senator Johnson without amendment. With written report No. 116-35. [externalActionCode] => 14000 [description] => Introduced )
JOINT RESOLUTION
80. S.J.Res.38 — 116th Congress (2019-2020) A joint resolution providing for congressional disapproval of the proposed export to the Kingdom of Saudi Arabia and the United Kingdom of Great Britain and Northern Ireland of certain defense articles and services. Sponsor: Sen. Menendez, Robert [D-NJ] (Introduced 06/05/2019) Cosponsors: (7) Committees: Senate - Foreign Relations Latest Action: House - 07/17/2019 On passage Passed by the Yeas and Nays: 237 - 190 (Roll no. 488). (All Actions) Tracker:
Array ( [actionDate] => 2019-06-20 [displayText] => Passed/agreed to in Senate: Passed Senate without amendment by Yea-Nay Vote. 53 - 45. Record Vote Number: 178.(text: CR S4142) [externalActionCode] => 17000 [description] => Passed Senate )
Array ( [actionDate] => 2019-07-17 [displayText] => Passed/agreed to in House: On passage Passed by the Yeas and Nays: 237 - 190 (Roll no. 488). [externalActionCode] => 8000 [description] => Passed House )
81. S.J.Res.37 — 116th Congress (2019-2020) A joint resolution providing for congressional disapproval of the proposed export to the United Arab Emirates, the United Kingdom of Great Britain and Northern Ireland, and the Republic of France of certain defense articles and services. Sponsor: Sen. Menendez, Robert [D-NJ] (Introduced 06/05/2019) Cosponsors: (7) Committees: Senate - Foreign Relations Latest Action: House - 07/17/2019 On passage Passed by the Yeas and Nays: 238 - 190 (Roll no. 487). (All Actions) Tracker:
82. S.J.Res.36 — 116th Congress (2019-2020) A joint resolution providing for congressional disapproval of the proposed transfer to the Kingdom of Saudi Arabia, the United Kingdom of Great Britain and Northern Ireland, the Kingdom of Spain, and the Italian Republic of certain defense articles and services. Sponsor: Sen. Menendez, Robert [D-NJ] (Introduced 06/05/2019) Cosponsors: (7) Committees: Senate - Foreign Relations Latest Action: House - 07/17/2019 On passage Passed by the Yeas and Nays: 238 - 190 (Roll no. 486). (All Actions) Tracker:
CONCURRENT RESOLUTION
83. S.Con.Res.22 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Sanders, Bernard [I-VT] (Introduced 07/17/2019) Cosponsors: (6) Committees: Senate - Environment and Public Works Latest Action: Senate - 07/17/2019 Referred to the Committee on Environment and Public Works. (All Actions) Tracker:
Agreed to in Senate
84. S.Res.277 — 116th Congress (2019-2020) No latest title... Sponsor: Sen. Menendez, Robert [D-NJ] (Introduced 07/17/2019) Cosponsors: (5) Committees: Senate - Foreign Relations Latest Action: Senate - 07/17/2019 Referred to the Committee on Foreign Relations. (All Actions) Tracker:
85. S.Amdt.917 to S.Amdt.916 — 116th Congress (2019-2020) Purpose: To change the enactment date. Amends: Amends Resolution of Ratification for Treaty Document 111-8 (Protocol Amending Tax Convention with Luxembourg) Sponsor: Sen. McConnell, Mitch [R-KY] (Submitted 07/11/2019) (Proposed 07/11/2019) Latest Action: 07/17/19 Proposed amendment SA 917 withdrawn in Senate. (All Actions)
86. S.Amdt.916 — 116th Congress (2019-2020) Purpose: Of a perfecting nature. Amends: Amends Resolution of Ratification for Treaty Document 111-8 (Protocol Amending Tax Convention with Luxembourg) Sponsor: Sen. McConnell, Mitch [R-KY] (Submitted 07/11/2019) (Proposed 07/11/2019) Latest Action: 07/17/19 Proposed amendment SA 916 withdrawn in Senate. (All Actions)
87. S.Amdt.915 to S.Amdt.914 — 116th Congress (2019-2020) Purpose: To change the enactment date. Amends: Amends Resolution of Ratification for Treaty Document 114-1 (Protocol Amending the Tax Convention with Japan) Sponsor: Sen. McConnell, Mitch [R-KY] (Submitted 07/11/2019) (Proposed 07/11/2019) Latest Action: 07/17/19 Proposed amendment SA 915 withdrawn in Senate. (All Actions)
88. S.Amdt.914 — 116th Congress (2019-2020) Purpose: Of a perfecting nature. Amends: Amends Resolution of Ratification for Treaty Document 114-1 (Protocol Amending the Tax Convention with Japan) Sponsor: Sen. McConnell, Mitch [R-KY] (Submitted 07/11/2019) (Proposed 07/11/2019) Latest Action: 07/17/19 Proposed amendment SA 914 withdrawn in Senate. (All Actions)
89. S.Amdt.913 to S.Amdt.912 — 116th Congress (2019-2020) Purpose: To change the enactment date. Amends: Amends Resolution of Ratification for Treaty Document 112-1 (Protocol Amending Tax Convention with Swiss Confederation) Sponsor: Sen. McConnell, Mitch [R-KY] (Submitted 07/11/2019) (Proposed 07/11/2019) Latest Action: 07/17/19 Proposed amendment SA 913 withdrawn in Senate. (All Actions)
90. S.Amdt.912 — 116th Congress (2019-2020) Purpose: Of a perfecting nature. Amends: Amends Resolution of Ratification for Treaty Document 112-1 (Protocol Amending Tax Convention with Swiss Confederation) Sponsor: Sen. McConnell, Mitch [R-KY] (Submitted 07/11/2019) (Proposed 07/11/2019) Latest Action: 07/17/19 Proposed amendment SA 912 withdrawn in Senate. (All Actions)
91. H.R.3787 — 116th Congress (2019-2020) To amend the Homeland Security Act of 2002 to establish in the Department of Homeland Security an Unmanned Aircraft Systems Coordinator, and for other purposes. Sponsor: Rep. Perry, Scott [R-PA-10] (Introduced 07/16/2019) Cosponsors: (0) Committees: House - Homeland Security Latest Action: House - 07/16/2019 Referred to the House Committee on Homeland Security. (All Actions) Tracker:
92. H.R.3786 — 116th Congress (2019-2020) To amend the Higher Education Act of 1965 to direct the Secretary of Education to carry out a program under which an institution of higher education may elect to cosign Federal student loans made to students attending the institution, and for other purposes. Sponsor: Rep. Perry, Scott [R-PA-10] (Introduced 07/16/2019) Cosponsors: (0) Committees: House - Education and Labor Latest Action: House - 07/16/2019 Referred to the House Committee on Education and Labor. (All Actions) Tracker:
93. H.R.3785 — 116th Congress (2019-2020) To amend title 28, United States Code, to change the residency requirements for certain officials serving in the District of Columbia, and for other purposes. Sponsor: Rep. Norton, Eleanor Holmes [D-DC-At Large] (Introduced 07/16/2019) Cosponsors: (0) Committees: House - Judiciary Latest Action: House - 07/16/2019 Referred to the House Committee on the Judiciary. (All Actions) Tracker:
94. H.R.3784 — 116th Congress (2019-2020) To amend title XXVII of the Public Health Service Act and title XI of the Social Security Act to prohibit surprise billing with respect to air ambulance services. Sponsor: Rep. Neguse, Joe [D-CO-2] (Introduced 07/16/2019) Cosponsors: (0) Committees: House - Energy and Commerce Latest Action: House - 07/16/2019 Referred to the House Committee on Energy and Commerce. (All Actions) Tracker:
95. H.R.3783 — 116th Congress (2019-2020) To amend the Radiation Exposure Compensation Act to improve compensation for workers involved in uranium mining, and for other purposes. Sponsor: Rep. Lujan, Ben Ray [D-NM-3] (Introduced 07/16/2019) Cosponsors: (38) Committees: House - Judiciary, Education and Labor, Energy and Commerce Latest Action: House - 07/16/2019 Referred to the Committee on the Judiciary, and in addition to the Committees on Education and Labor, and Energy and Commerce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the... (All Actions) Tracker:
96. H.R.3782 — 116th Congress (2019-2020) To amend the Older Americans Act of 1965 to support family caregivers. Sponsor: Rep. Levin, Andy [D-MI-9] (Introduced 07/16/2019) Cosponsors: (1) Committees: House - Education and Labor Latest Action: House - 07/16/2019 Referred to the House Committee on Education and Labor. (All Actions) Tracker:
97. H.R.3780 — 116th Congress (2019-2020) To direct the Federal Communications Commission to establish an advisory committee to develop best practices regarding how to combat unlawful robocalls made to hospitals and how hospitals can protect themselves from such calls, and for other purposes. Sponsor: Rep. Dingell, Debbie [D-MI-12] (Introduced 07/16/2019) Cosponsors: (1) Committees: House - Energy and Commerce Latest Action: House - 07/16/2019 Referred to the House Committee on Energy and Commerce. (All Actions) Tracker:
98. H.R.3778 — 116th Congress (2019-2020) To amend the Public Health Service Act to authorize certain grants (for youth suicide early intervention and prevention strategies) to be used for school personnel in elementary and secondary schools and students in secondary schools to receive student suicide awareness and prevention training, and for other purposes. Sponsor: Rep. Cleaver, Emanuel [D-MO-5] (Introduced 07/16/2019) Cosponsors: (17) Committees: House - Energy and Commerce, Education and Labor Latest Action: House - 07/16/2019 Referred to the Committee on Energy and Commerce, and in addition to the Committee on Education and Labor, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee... (All Actions) Tracker:
99. H.R.3777 — 116th Congress (2019-2020) To establish a National Commission to investigate the treatment of migrant families and children by the Trump Administration. Sponsor: Rep. Clarke, Yvette D. [D-NY-9] (Introduced 07/16/2019) Cosponsors: (1) Committees: House - Judiciary, Homeland Security Latest Action: House - 07/16/2019 Referred to the Committee on the Judiciary, and in addition to the Committee on Homeland Security, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee... (All Actions) Tracker:
100. H.R.3776 — 116th Congress (2019-2020) To prohibit Executive agencies from using the derogatory term "alien" to refer to an individual who is not a citizen or national of the United States, to amend chapter 1 of title 1, United States Code, to establish a uniform definition for the term "foreign national", and for other purposes. Sponsor: Rep. Castro, Joaquin [D-TX-20] (Introduced 07/16/2019) Cosponsors: (16) Committees: House - Judiciary, Oversight and Reform Latest Action: House - 07/16/2019 Referred to the Committee on the Judiciary, and in addition to the Committee on Oversight and Reform, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee... (All Actions) Tracker:
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House Communications [18,289]
Senate Communications [152,918]
116 (2019-2020) [8,468]
115 (2017-2018) [18,732]
99 (1985-1986) [16,362]
House [220,180]
Senate [180,894]
Bill Type
Bills (H.R. or S.) [236,830]
Amendments (H.Amdt. or S.Amdt.) [108,271]
Resolutions (H.Res. or S.Res.) [31,790]
Joint Resolutions (H.J.Res. or S.J.Res.) [12,741]
Concurrent Resolutions (H.Con.Res. or S.Con.Res.) [11,442]
Status of Legislation
Introduced [292,740]
Committee Consideration [53,421]
Floor Consideration [46,739]
Failed One Chamber [615]
Passed One Chamber [43,040]
Passed Both Chambers [14,290]
Resolving Differences [4,253]
To President [11,831]
Veto Actions [277]
Became Law [11,581]
Status of Amendment
Senate amendment submitted [87,539]
Senate amendment proposed (on the floor) [32,566]
Senate amendment agreed to [23,731]
House amendment offered [20,732]
House amendment offered/reported by [20,253]
House amendment agreed to [12,108]
Amendment agreed to Committee of the Whole [11,222]
Roll call votes on amendments in House [7,620]
Roll call votes on amendments in Senate [7,413]
House amendment not agreed to [6,057]
Amendment failed in Committee of the Whole [5,894]
Senate amendment not agreed to [2,318]
Amendment agreed to by House [1,073]
Amendment failed by House [165]
Subject — Policy Area
Taxation [25,112]
Health [20,497]
Government Operations and Politics [20,036]
Armed Forces and National Security [17,775]
Congress [17,218]
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House Committee
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Armed Services [8,655]
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House Administration [6,398]
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Merchant Marine and Fisheries [3,298]
Appropriations [2,549]
Small Business [1,446]
Budget [1,417]
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Intelligence (Permanent Select) [715]
Ethics [240]
Joint Atomic Energy [153]
Internal Security [15]
Select Committee on Committees [4]
Joint Deficit Reduction (House) [1]
Outer Continental Shelf (Select) [1]
Senate Committee
Finance [19,461]
Energy and Natural Resources [9,249]
Health, Education, Labor, and Pensions [9,141]
Commerce, Science, and Transportation [6,487]
Homeland Security and Governmental Affairs [6,243]
Foreign Relations [5,532]
Environment and Public Works [5,393]
Banking, Housing, and Urban Affairs [4,538]
Agriculture, Nutrition, and Forestry [3,277]
Rules and Administration [3,105]
Indian Affairs [1,368]
Small Business and Entrepreneurship [718]
Post Office and Civil Service [311]
Intelligence (Select) [226]
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Caucus on International Narcotics Control [9]
Ethics (Select) [9]
Joint Deficit Reduction (Senate) [4]
Impeachment Trial Committee (Hastings) [1]
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Whitewater - Special Committee to Investigate Whitewater Development Corporation and Related Matters [1]
Commission on Security and Cooperation in Europe [3]
House Sponsor
Roe, Robert A. [D-NJ] [1,106]
Young, Don [R-AK] [1,103]
Rangel, Charles B. [D-NY] [977]
Stark, Fortney Pete [D-CA] [888]
Pepper, Claude [D-FL] [883]
Senate Sponsor
Hatch, Orrin G. [R-UT] [5,969]
Metzenbaum, Howard M. [D-OH] [3,311]
McCain, John [R-AZ] [2,655]
Kennedy, Edward M. [D-MA] [2,464]
Dole, Robert J. [R-KS] [2,335]
House Cosponsor
Rangel, Charles B. [D-NY] [11,175]
Norton, Eleanor Holmes [D-DC] [10,553]
Conyers, John, Jr. [D-MI] [10,511]
Frank, Barney [D-MA] [10,246]
Towns, Edolphus [D-NY] [9,750]
Senate Cosponsor
Leahy, Patrick J. [D-VT] [6,713]
Levin, Carl [D-MI] [6,418]
Kerry, John F. [D-MA] [6,358]
Durbin, Richard J. [D-IL] [6,157]
Democratic [218,702]
Republican [179,864]
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Independent Democrat [305] |
Filtered by: Anime & Manga, Arts & Entertainment, Food & Drink, Hiking, History, Hot springs, Landmark, Neighborhoods, Nightlife, Shopping, Sports
Specialities Food & Drink, Nightlife - Osaka's retro-yet-modern vibe gives it the feel of a cult 80s movie set in the future. Images of the kaleidoscope of neon that lines Dotonbori...
Specialities Landmark - The Tokyo Skytree is, in a word, tall. Completed in 2011 at a height of 634 meters, it's the biggest tower in the world and...
Hamanomachi Arcade
Specialities Food & Drink, Shopping - If you're on the hunt for omiyage (souvenirs) for family back home or a bite to eat while in Nagasaki (or both), you'll want to...
Shimabara Castle
Specialities History - Perched on the eastern edge of the Shimabara Peninsula, this five-storied, white castle is a key feature of Shimabara city. What most don't realize...
Specialities Food & Drink - Although only a short train ride away from each other, Yokohama offers a much more relaxed atmosphere than Tokyo with all the charm of a...
Specialities Hiking - Wild and mysterious, the secluded island of Yakushima is unlike anything else in Japan. It's a nature lover's paradise of untouched ancient cedar fore... |
This report summarizes large claim information as reported under Financial Call #31. Please note that beginning with the year-end 2017 valuation, large deductible policies for all states are now included in this report. For specific details on Financial Call #31 data, please refer to NCCI's Financial Call Reporting Guidebook. |
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