text:
Energy Psychology Journal Energy Psychology: Theory, Research, and Treatment is a peer-reviewed professional journal dedicated to reporting developments in the field of energy psychology
Submissions Info
You are here: Home › Getting Today's Medicine Today: The Challenge of Clinical Innovation
Getting Today's Medicine Today: The Challenge of Clinical Innovation
The history of science is littered with examples of technology driving discovery. The Human Genome Project was driven by the availability of gene-sequencing machines. According to a report from the U.S. National Institutes of Health, in 2001, it cost an average of $95,263,072 to sequence the genome of a single human being. In 2014, it cost $4,008 (Wetterstrand, 2014). The accompanying graph shows the reductions in costs. As the technology became available, it was utilized for the scientific enterprise, driving down costs.
Not all technologies have been quickly or widely accepted, and the rapid adoption of new techniques is the exception rather than the norm. The adoption of new therapies such as Energy Psychology has been slowed by the inertia of large organizations. For instance, Emotional Freedom Techniques (EFT) was presented to the Veterans Administration as a treatment for posttraumatic stress disorder (PTSD) soon after the first cohort of veterans began arriving back from deployment in Iraq (Church, Feinstein, Palmer-Hoffman, Stein, & Tranguch, 2014). In 2009, Senator Carl Levin, chair of the Senate Armed Services Committee, wrote a personal letter to then Secretary for Veterans Affairs Eric Shinseki. He enclosed preliminary data on EFT's efficacy for PTSD and urged investigation by the VA. Shinseki took no action on this request.
Frustration with the lack of progress at the VA, knowledge of the growing research base, and anecdotes by constituents who were veterans prompted members of Congress to write another long and detailed letter to Shinseki in 2010, requesting seven concrete actions by the VA. Copies were circulated among other agencies, such as the National Institutes of Health. Two sets of hearings before congressional committees presented the evidence that EFT could remediate PTSD in six treatment sessions. Again, all this activity produced no interest within the VA in exploring or implementing EFT. This inability to translate scientific discovery into practical patient care is called a "translational gap."
The U.S. Congress commissioned a report by the Institute of Medicine (IOM) to determine the extent of translational gaps. It found that it takes an average of 17 years for innovations to jump the translational gap (Committee on Quality of Health Care in America, IOM, 2001; Balas & Boren, 2000). Few innovations even make it that far: An analysis found that only 14% of new discoveries are successfully implemented in patient care; the other 86% are lost (Westfall, Mold, & Fagnan, 2007).
The IOM report characterized the translational gap as a "chasm." The practical consequences of this chasm are that most medical care that patients receive is 14% of what was available 17 years ago.
It's hard to imagine us, as a society, being content with this level of inefficiency in other parts of our lives. Imagine working on a 17-year-old personal computer, with 86% of its capacity disabled. While we'd be outraged at the detriment to our productivity and life enjoyment entailed by a reduction in our computing capacity, as a society we seem perfectly prepared to accept these limitations when it comes to our health care.
When I address this subject in professional circles, some listeners wonder if there's a conspiracy by the drug companies to suppress free and effective behavioral cures. Personally, I don't believe this (or most other conspiracy theories), because there are much simpler explanations. When I was talking to a military psychiatrist, Charles Engel, MD, about adopting EFT, he gave me a reality check. He told me that they can't even get the psychiatrist at the VA to coordinate care with the psychiatrist who has been treating that same patient while on active duty. Faced with fundamental obstacles like this, training in new therapies seems like a pipedream, no matter how effective those therapies may be.
This type of institutional inertia combines with dogmatic skepticism to produce most of the translational gap. That's why German physicist Max Planck remarked that science progresses one funeral at a time. Existing "experts" cling to their outdated worldviews, and not till a new generation has displaced them is there a more open intellectual climate in which new ideas can thrive. Highly effective new treatments sometimes overcome the inertia, however, though it might take awhile.
Seventeenth-century Dutch tradesman Anton van Leeuwenhoek was one of my heroes when I was a teenager. Leeuwenhoek perfected the art of grinding magnifying lenses, and began describing the curious microorganisms he saw through them. His curiosity was boundless, and he used his microscopes to examine organisms existing everywhere from ponds to human saliva.
He began reporting his findings to the newly formed Royal Society in England. At that time in history, the Royal Society was the most prestigious association in the world for the advancement of scientific enquiry. Leeuwenhoek's letters, translated into English, also contained painstaking drawings of the organisms he observed. While contemporary microscopes could magnify to only about 30x, Leeuwenhoek obsessively ground very fine lenses that could magnify an object by up to 200x. He began to see levels of detail in microscopic organisms that had never before been visible to the human eye. However, because these details had never before been observed, many members of the Royal Society greeted Leeuwenhoek's discoveries with hostile skepticism.
This skepticism has impeded the progress of science for centuries. When Ignaz Semmelweiss in 1850s Vienna discovered that washing his hands between dissecting corpses in the morgue and examining patients in the wards reduced infections by 90%, he was disbelieved. He insisted on hospital workers washing their hands before treating patients. Infections in his ward dropped by 90%, while they remained at the same high levels in other wards. Nonetheless, Semmelweiss was vigorously opposed by his contemporaries, and eventually forced from his job. He died in an insane asylum, and his policies were immediately reversed by his successor. The history of science is littered with similar examples, from Lister to Galileo.
Dogmatic skepticism and anti-scientific superstition are alive and well today, impeding patient care as effectively as did Semmelweiss's contemporaries. You can read a contemporary example by looking up "EFT" on Wikipedia. Several years ago, a group of skeptics seized editorial control of most of the CAM (complementary and alternative medicine) pages on Wikipedia. Among the topics they control are homeopathy, energy psychology, and acupuncture.
The early articles were written mostly by experts in their fields. The skeptics deleted those articles, and wrote their own. They tag EFT and similar therapies as "pseudoscience," and whenever experts attempt to correct them, for instance by adding a description of a study newly published in a peer-reviewed journal, the skeptics suppress the amendment. To support their arguments, however, they selectively violate Wikipedia's own rules by citing skeptical websites and non-peer-reviewed (and non-credible) sources such as the Skeptical Inquirer magazine and Quackwatch.
A popular misconception is that anyone can edit a Wikipedia page; in reality, many entries are controlled by informal committees of editors, who can band together around a common philosophy, such as closed-minded hostility to CAM, or anti-scientific skepticism. The skeptics are organized as Wikiproject Skepticism, and they have vandalized hundreds of entries. In addition, certain pages have been locked to prevent open editing. The EFT page is one of them. These gatekeepers can then dictate what goes on a page, depriving the public using the encyclopedia from reading authoritative, balanced, and objective coverage of a topic, entries written by experienced and qualified experts. Another tactic of the Wikiproject Skepticism editors has been to delete or vandalize the biographies of respected scientists, authors, and researchers in the fields they attack.
Having demonstrated their worldview by tagging EFT as "pseudoscience" in the Wikipedia entry, how do they then deal with the inconvenient fact that there are dozens of clinical trials showing EFT's "efficacy". Their solution is to simply not mention them in the article. Research doesn't support their prejudices, so they ignore it, even though clinical trials are routinely reported in entries for conventional therapies not targeted by the skeptics and in the entries for pharmacological drugs.
Wikipedia allows the reader to peer behind the entry to the history of additions and deletions to the article in the "Talk" pages, and the skeptical editors are perfectly clear, in these discussions, about their worldview. When new studies are published in peer-reviewed medical or psychology journals, the editors state that they should not be included in the Wikipedia article, as this might lend credibility to EFT, which in their eyes it does not have. One of the authors of the EFT entry debates "the best way to demonstrate to the reader that this is bullsh*t!" (http://en.wikipedia.org/wiki/Talk:Emotional_Freedom_Techniques/Archives/2011/May).
There is no mention in the Wikipedia article, or the behind-the-scenes discussions, of the standards for empirically validated therapies published by the Division 12 Task Force of the American Psychological Association, APA (Chambless & Hollon, 1998; Chambless et al., 1998). There is no reference to the evidence-based criteria embraced by the U.S. government's National Registry of Evidence-Based Programs and Practices (NREPP), or any description of the randomized controlled trials that have demonstrated EFT's efficacy for PTSD, depression, pain, anxiety, phobias, and other conditions.
Imagine a reputable encyclopedia, perhaps the Encyclopedia Britannica, writing an article by assembling an editorial team with complete ignorance of the topic, hostility to the field, scientific illiteracy, and no relevant academic qualifications. If the article's topic was the nature of the solar system, the team would contain not a single astronomer, physicist, or geologist. The only requirement would be that every contributor be a member of the Flat Earth Society. Absurd though it may seem, that's how most Wikipedia entries for CAM are created.
As comedian Tina Fey quipped, "When you're contemplating open-heart surgery, imagine your reaction to a guy who says, 'I don't have any of those fancy degrees from Harvard Medical School. I'm just an unlicensed plumber with a dream. Now hand me the scalpel.
Leeuwenhoek persisted despite the skepticism. Though he never wrote a book, he eventually exchanged hundreds of letters with members of the Royal Society. As the evidence mounted, the nonsensical superstitions of the skeptics were swept away, and Leeuwenhoek gained a secure place in scientific history.
In the same way, I expect the rapidly accumulating evidence for the efficacy of EFT and other evidence-based CAM interventions to overwhelm the efforts of the skeptics to prevent its dissemination. The system that perpetuates the translational chasm is still firmly in place, however, and until public demand for getting today's medicine today becomes an outcry, it is likely to remain entrenched.
Balas, E. A., & Boren, S. A. (2000). Yearbook of medical informatics: Managing clinical knowledge for health care improvement. Stuttgart, Germany: Schattauer Verlagsgesellschaft mbH.
Chambless, D., Baker, M. J., Baucom, D. H., Beutler, L. E., Calhoun, K. S., Crits-Christoph, P., . . . Woody, S. R. (1998). Update on empirically validated therapies, II. Clinical Psychologist, 51, 3-16.
Chambless, D., & Hollon, S. D. (1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology, 66, 7.18.
Church, D., Feinstein, D., Palmer-Hoffman, J., Stein, P. K., & Tranguch, A. (2014). Empirically supported psychological treatments: The challenge of evaluating clinical innovations. Journal of Nervous and Mental Disease, 202(10), 699-709.
Committee on Quality of Health Care in America, Institute of Medicine. (2001). Cross- ing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.
Westfall, J. M., Mold, J., & Fagnan, L. (2007). Practice-based research: "Blue Highways" on the NIH roadmap. JAMA, 297(4), 403.
Wetterstrand, K. A. (2014). DNA sequencing costs: Data from the NHGRI Genome Sequencing Program (GSP). Retrieved from www.genome.gov/sequencingcosts.
Subscriptions may be purchased here. Single issues may be purchased here.
Abstracts – Energy Psychology Journal Volume 6, Number 1, May 2014
The Healing Power of Energy Psychology: What the Research Published in Energy Psychology Journal Demonstrates
Comment on "The Current Status of Energy Psychology": Growing Evidence for Extraordinary Claims
The Healing Power of Energy Psychology:
What the Research Published in Energy Psychology Journal Demonstrates
Energy Psychology (EP) journal has been publishing research in the field for many years.
Here, editor Dawson Church looks at some of the most noteworthy studies published
in the journal and the range of conditions helped by EP treatment.
Among the topics covered are:
Why EP is the treatment of choice for therapists working with adult victims of sexual abuse
How EFT helps children overcome test anxiety
Quantum Touch and its effects on chronic pain
CBT and EFT in the treatment of victims of sexual violence in the Congo
EFT is effective for the treatment of psoriasis
After the 2010 Haiti earthquake: Using EFT with traumatized orphans and caregivers
Differential expression in 72 genes is found after an hour-long EFT session
EP with survivors of the Rwandan genocide
https://s3-us-west-2.amazonaws.com/healthylife.net/EPJ-edit.mp3
© Copyright 2017 - Energy Psychology Press


Now ranked number eight in the world overall, increasing its ranking by five spots from the previous year, Melbourne has moved into the top ten cities worldwide with best practice sustainability initiatives, while maintaining its number one spot in Australia.
The GDS-Index is a platform that aims to promote the sustainable growth of international meeting destinations, highlighting best practices and responsible business tourism. It looks to bring cities together to benchmark and improve the social and environmental performance of the cities and its business events industry.
Melbourne and Melbourne Convention Bureau's (MCB) sustainability performance was evaluated based on the city environmental performance, social performance, industry supplier support and MCB strategy and initiatives.
Melbourne's highest ranking was in the category of supplier performance scoring 81 per cent followed by convention bureau performance, achieving 80 per cent.
MCB CEO, Karen Bolinger, said MCB has worked hard in partnership with the City of Melbourne to promote the value of sustainable practices for Melbourne's business events industry.
MCB's sustainability focus is on driving initiatives across the business events industry, supported by the provision of a meeting planners tool kit to influence development and improvement of sustainability initiatives, a dedicated sustainability steering committee, access to sustainability resources, stakeholder education opportunities and supporting suppliers to obtain sustainability certification.


text:
package edu.uci.ics.asterix.metadata.cluster;

import java.util.Set;

import edu.uci.ics.asterix.common.api.IClusterEventsSubscriber;

public class RemoveNodeWork extends AbstractClusterManagementWork {

    private final Set<String> nodesToBeRemoved;

    @Override
    public WorkType getClusterManagementWorkType() {
        return WorkType.REMOVE_NODE;
    }

    public RemoveNodeWork(Set<String> nodesToBeRemoved, IClusterEventsSubscriber subscriber) {
        super(subscriber);
        this.nodesToBeRemoved = nodesToBeRemoved;
    }

    public Set<String> getNodesToBeRemoved() {
        return nodesToBeRemoved;
    }

    @Override
    public String toString() {
        StringBuilder builder = new StringBuilder();
        builder.append(WorkType.REMOVE_NODE);
        for (String node : nodesToBeRemoved) {
            builder.append(node + " ");
        }
        builder.append(" requested by " + subscriber);
        return builder.toString();
    }

}

redpajama_set_name: RedPajamaGithub


text:
https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTAwNTMwMy1vdmVydmlldw==
Aspiration Syndromes
Author: Cecilia P Mikita, MD, MPH; Chief Editor: Girish D Sharma, MD, FCCP, FAAP more...
Sections Aspiration Syndromes
Laboratory Studies
Histologic Findings
Diet and Activity
Prokinetic agents
Histamine (H2) receptor antagonists
Aspiration syndromes include all conditions in which foreign substances are inhaled into the lungs. Most commonly, aspiration syndromes involve oral or gastric contents associated with gastroesophageal reflux (GER), swallowing dysfunction, neurological disorders, and structural abnormalities. The volume of refluxate may be significant, usually causing acute symptoms associated with the penetration of gastric contents into airways, or there may be episodic incidents of small amounts of oral or gastric reflux or saliva that enter the airways causing intermittent or persistent symptoms.
GER is very common in infants and children and has been associated with a spectrum of pediatric problems; however, the percentage of reflux that causes respiratory complications is unknown. In 1912, Sir William Osler described the relationship between asthma and GER by stating that "attacks may be due to direct irritation of the bronchial mucosa or... indirectly, too, by reflex influences from stomach." Recent literature describes GER and aspiration syndromes as common occurrences with increasing diagnostic rates. Swallowing dysfunction in conjunction with GER is more likely to cause respiratory symptoms than GER symptoms alone. Eosinophilic GI disorders (eg, eosinophilic esophagitis, gastroenteritis) may also manifest similarly to GER but are refractory to traditional reflux therapies.
Joint clinical practice guidelines for evaluation and treatment of GER in infants and children have been developed by The North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). [1]
Swallowing dysfunction is a known etiology of aspiration in children. Divided into 4 distinct phases, swallowing is a complex action that involves 5 cranial nerves and 26 muscles. The mouth, pharynx, larynx, and esophagus are involved in a coordinated effort to induce swallowing. Any anatomic, neurologic, or physiologic defect in the swallowing mechanism during the preparatory, oral, pharyngeal, or esophageal phases may lead to aspiration.
Cricopharyngeal dysfunction, cricopharyngeal incoordination of infancy, and transient pharyngeal muscle dysfunction are well described in the pediatric literature. Cricopharyngeal dysfunction involves cricopharyngeal muscle spasm or achalasia of the superior esophageal sphincter. Cricopharyngeal incoordination of infancy is noted in infants who have a normal suck reflex but have incoordination during swallowing; this is possibly secondary to delayed maturation of swallowing reflexes or may be associated with cerebral palsy.
Neurological disorders, including congenital and progressive diseases, may manifest as aspiration syndromes in infants and children. Isolated superior laryngeal nerve damage, vocal cord paralysis, cerebral palsy, muscular dystrophy, and Riley-Day syndrome (ie, familial dysautonomia) are a few of the neurological disorders associated with increased risk of aspiration.
Anatomic disorders, such as cleft palate, laryngeal cleft, esophageal atresia, tracheoesophageal fistula, duodenal obstruction, or malrotation, may have associated aspiration risk. Other conditions such as macroglossia, micrognathia, and laryngeal cleft may predispose patients to aspiration. Motility disorders, such as achalasia or connective-tissue disorders, are associated with increased risk of aspiration.
Studies in humans and animal models revealed that aspiration of acidic content (pH < 2.5) into the lungs causes mucosal desquamation, damage to alveolar lining cells and capillaries, and acute neutrophil inflammation. [2]
The act of swallowing is divided into the following 4 discrete phases: oral preparatory, oral propulsive, pharyngeal, and esophageal:
The oral preparatory phase begins when foods and liquids are placed into the mouth, mixed with saliva, and formed into a bolus.
The oral propulsive phase consists of moving the bolus into the pharynx, triggering the reflex swallow, which is the major component of the pharyngeal phase.
During the pharyngeal phase, the larynx elevates and closes at the level of the epiglottis, aryepiglottic folds, and true and false vocal cords. Normally, the laryngeal reflex during the pharyngeal phase of swallowing acts as a protective mechanism against direct or indirect aspiration.
The esophageal phase is initiated when the bolus passes through the relaxed cricopharyngeal muscle and enters the esophagus.
Aspiration may occur when foreign substances enter the hypopharynx, either before relaxation of the cricopharyngeal muscle or before closing of the laryngeal sphincters. In patients with neurological disorders that affect swallowing, the absence of a swallowing reflex within 30 seconds of the completion of the oral preparatory phase results in direct aspiration. Direct aspiration is the aspiration of a food bolus while swallowing, whereas indirect aspiration is the reflux of food from the stomach into the esophagus and pulmonary system.
Patients with structural abnormalities, such as H-type tracheoesophageal fistula, duodenal atresia, and achalasia, may have problems with direct aspiration, indirect aspiration, or both. Patients with H-type tracheoesophageal fistulas often aspirate pharyngeal secretions. If the fistula is distal, indirect aspiration of gastric contents is a risk. Patients with malrotation may have GER with associated aspiration risk.
GER is often caused by transient lower esophageal sphincter (LES) relaxation. Other mechanisms include a low resting LES pressure and increased intragastric pressure. Increased intra-abdominal pressure due to coughing raises the gastroesophageal pressure gradient and increases the risk of reflux. However, GER may be the etiology of chronic cough. This cause-and-effect relationship may be difficult to elucidate.
Several mechanisms, including the cough reflex, pulmonary macrophages, and the mucociliary escalator, are protective if aspiration occurs. If any of these actions are absent, impaired, or overwhelmed, chronic or acute aspiration symptoms may occur. The extent of injury is related to the amount and characteristics of the aspirate, the frequency of occurrences, and the effectiveness of protective lung-clearance mechanisms.
Model and Boysen reviewed the pathophysiology of pulmonary aspiration of stomach contents. [3] Laboratory studies revealed that aspiration of significant amounts of gastric contents, regardless of the nature of the aspirate, causes acute respiratory insufficiency and chemical pneumonitis. Acidic refluxate with pH less than 2.5 appears to be the most caustic to the pulmonary system. Histologically, one may see damage to alveolar lining cells and capillaries, as well as bacterial invasion, mucosal desquamation, and mononuclear cell inflammation.
Respiratory symptoms due to aspiration of gastric contents may occur via several mechanisms. A vagally mediated reflex bronchospasm occurs in response to gastric acid irritation of the distal esophageal mucosa. Thus, reversible bronchospasm often occurs without documented indirect aspiration. Other potential mechanisms include heightened bronchial reactivity and microaspiration. However, as many as 70% of patients with pharyngeal dysphagia with aspiration have no obvious clinical signs of coughing, gagging, or choking. Chronic lung hyperinflation with flattening of the diaphragm decreases the protective reflux barrier of the diaphragm. An increased transdiaphragmatic pressure gradient predisposes to the movement of gastric contents into the esophagus.
Medications used to treat asthma may contribute to symptoms. Beta-agonists and methylxanthines decrease the LES tone. Aminophylline is known to increase gastric acid secretion. Angiotensin-converting enzyme (ACE) inhibitors and inhaled corticosteroids have been reported to cause chronic cough.
Apnea, obstructive and central, has also been associated with aspiration of gastric contents. Laryngospasm manifests as obstructive apnea secondary to reflux. Classically, obstructive apnea occurs within one hour after a feed when a patient suddenly stops, becomes apneic, stares, and develops a rigid opisthotonic posture. Continued ineffective respiratory effort is observed, but coughing or gagging is not necessarily present. If this progresses, pallor, cyanosis, and possible hypotonia ensue. The complete obstruction of the larynx impedes air movement, causing an obstructive picture. If incomplete laryngeal obstruction occurs, stridor may be noted during the examination. Central apnea has also been noted as a result of reflux. The superior laryngeal nerve has been implicated in this mechanism. Central apnea can be differentiated from obstructive apnea by the lack of respiratory effort observed.
Chronic inflammation of the larynx and subglottic space from recurrent aspiration may cause stridor and hoarse voice.
United States statistics
Medical practitioners are diagnosing GER and its respiratory complications more frequently now than in the past. Theories of the increased frequency of GER diagnosis include an increased prevalence of pathologic GER, improvement in diagnostic tests for GER, misdiagnosis, and overdiagnosis. The increase in diagnostic rate probably is multifactorial, but factors such as formula feeding, increased volume of feeds, and prolonged use of infant seating devices in infants too young to sit have been suggested as epidemiologic causes for this increase. [4, 5]
In a study of the diagnostic rate of GER in Army hospitals over a 25-year period (1971-1995), the total diagnoses of GER increased 20-fold, with 84% of cases in infants younger than 6 months. [6] The diagnostic rate for GER diagnosis rose from 0.74 in 1000 persons in 1971 to 8.16 in 1000 persons in 1995. Orenstein states that 40% of healthy infants regurgitate more than once a day, and as many as 20% of children reflux to the extent that parents feel it is a problem. [7, 8, 9] Nelson et al (1998) described that most infants outgrow this physiologic reflux but that as many as 5% of infants have persistent reflux symptoms. [10]
Approximately 7% of infants have reflux severe enough to be brought to a physician's attention. As many as 40-50% of infants with GER present with respiratory symptoms. Approximately 25-80% of children with asthma have GER, [11] but as many as one third of patients with pulmonary symptoms of GER have no esophageal symptoms.
Incidence of eosinophilic GI disorders has increased during the past decade. Eosinophilic esophagitis has been diagnosed in approximately 2 of 10,000 children in the Cincinnati region. [12] Another group of investigators noted that 1% of patients with esophagitis have eosinophilic esophagitis.
The incidence of swallowing dysfunction associated with aspiration syndromes is not known because clinical signs of aspiration may be quite subtle. As many as 70% of patients with pharyngeal dysphagia with aspiration have silent aspiration (ie, no overt clinical signs during aspiration). Sheikh et al published a retrospective review of 112 neurologically normal infants with chronic respiratory symptoms who underwent videofluoroscopic-modified barium swallow study. Almost 12% had evidence of swallowing dysfunction and silent chronic aspiration without evidence of gastroesophageal reflux. [13] . Laryngeal penetration visualized by videofluoroscopic swallowing has recently been associated with an increased incidence of pneumonia in children as compared to children with no evidence of penetration or aspiration. [14]
The incidence of aspiration syndromes associated with anatomic or neurologic disorders is unknown. The incidence of an isolated cleft palate is approximately 0.5 per 1000 live births, whereas the incidence of cleft lip and palate differs by ethnicity. Patients with a cleft palate are at risk for aspiration secondary to an abnormal communication with the nasal and oral cavities. Nasopharyngeal reflux commonly is observed in patients with cleft palate with or without associated cleft lip. Unilateral or bilateral vocal cord paralysis accounts for approximately 10% of all congenital laryngeal lesions. Esophageal atresia occurs in 1 per 3000-4000 live births, with 85% associated with tracheoesophageal fistulas. Patients with vocal cord paralysis and laryngeal clefts were noted to have increased incidence of laryngeal penetration and increased incidence of pneumonia and aspiration. [14]
International data on frequency of aspiration syndromes are not available.
Race-, sex-, and age-related demographics
In Whites, cleft lip and palate occurs in approximately 1 in 1000 births; in Asians, it occurs in approximately 2 in 1000 births. In Blacks, the incidence of cleft lip and palate is approximately 0.41 in 1000 births.
One study revealed an increased incidence of GER in males over females, but no strong prevalence in one sex has been observed. Cleft lip and palate are seen more commonly in males than in females, with approximately 60-80% incidence in males. Isolated cleft palates occur more frequently in females.
Physiologic GER (ie, benign regurgitation) occurs most commonly in the first few months of life but generally resolves by age 1-2 years. Approximately 84% of patients diagnosed with GER in Army hospitals in a 25-year period were younger than 6 months. [6] Patients with anatomic, physiologic, or neurologic disorders associated with aspiration are often diagnosed early. Esophageal atresia with or without tracheoesophageal fistula may be diagnosed in the delivery room or shortly after birth. The prevalence of respiratory complications of GER in infants and children by age is not known.
In general, the prognosis for an infant or child with an aspiration syndrome is good; but this depends partly on the underlying disorder. GER spontaneously resolves in most children by age 1-2 years.
Morbidity/mortality
Patients with an aspiration syndrome are at risk for severe respiratory sequelae and, possibly, death. Patients with a massive aspiration event have a mortality rate of 25%. [15] One study by Kohda et al examined 72 infants with documented aspiration by fluoroscopy for etiology of the aspiration and prognosis. [16] None of the patients without underlying neurologic disorders had evidence of aspiration after one year. In patients with neurological disorders, two thirds of patients had prolonged aspiration on follow-up. In patients who initially presented with a near-miss sudden infant death syndrome, or acute life-threatening episode (ALTE), 3 of 13 patients had prolonged aspiration.
No standard case definition of GER disease is recognized; thus, morbidity statistics are difficult to interpret. In 1959, Carre studied the natural history of severe GER and found that less than 5% of clinically affected patients died as a consequence of reflux. [17]
Chronic lung disease may develop from repeated aspiration of refluxate.
Pulmonary fibrosis may occur over time secondary to repeated aspiration of small volumes of gastric secretions, promoting a progressive fibrotic pulmonary response.
Chronic bronchitis and bronchiectasis are also recognized complications.
Educate patient and family regarding basic and conservative measures to prevent GER and ensuing complications.
For patient education resources from eMedicineHealth, see the Digestive Disorders Center, as well as Bronchoscopy.
[Guideline] Rosen R, Vandenplas Y, Singendonk M, et al. Pediatric Gastroesophageal Reflux Clinical Practice Guidelines: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr. 2018 Mar. 66 (3):516-54. [QxMD MEDLINE Link]. [Full Text].
de Benedictis FM, Carnielli VP, de Benedictis D. Aspiration lung disease. Pediatr Clin North Am. 2009 Feb. 56(1):173-90, xi. [QxMD MEDLINE Link].
Model J, Boysen P. Pulmonary aspirations of stomach contents. In: The Society of Critical Care Medicine Textbook of Critical Care. Philadelphia, Pa:. WB Saunders Co. 1984:272-274.
Callahan CW. Increased gastroesophageal reflux in infants: can history provide an explanation?. Acta Paediatr. 1998 Dec. 87(12):1219-23. [QxMD MEDLINE Link].
Callahan CW, Sisler C. Use of seating devices in infants too young to sit. Arch Pediatr Adolesc Med. 1997 Mar. 151(3):233-5. [QxMD MEDLINE Link].
Callahan CW. The diagnosis of gastroesophageal reflux in hospitalized infants: 1971-1995. J Am Osteopath Assoc. 1998 Jan. 98(1):32-4. [QxMD MEDLINE Link].
Orenstein D. Aspiration pneumonias and gastroesophageal reflux - related respiratory disease. In: Nelson Textbook of Pediatrics. 15th ed. Elsevier Science. 1996:1213-1215.
Orenstein SR. Gastroesophageal reflux. Pediatr Rev. 1999 Jan. 20(1):24-8. [QxMD MEDLINE Link].
Orenstein SR, Orenstein DM. Gastroesophageal reflux and respiratory disease in children. J Pediatr. 1988 Jun. 112(6):847-58. [QxMD MEDLINE Link].
Nelson SP, Chen EH, Syniar GM, Christoffel KK. One-year follow-up of symptoms of gastroesophageal reflux during infancy. Pediatric Practice Research Group. Pediatrics. 1998 Dec. 102(6):E67. [QxMD MEDLINE Link].
Richter JE. Extraesophageal presentations of gastroesophageal reflux disease. Semin Gastrointest Dis. 1997 Apr. 8(2):75-89. [QxMD MEDLINE Link].
Rothenberg ME. Eosinophilic gastrointestinal disorders (EGID). J Allergy Clin Immunol. 2004 Jan. 113(1):11-28; quiz 29. [QxMD MEDLINE Link].
Sheikh S, Allen E, Shell R, Hruschak J, Iram D, Castile R, et al. Chronic aspiration without gastroesophageal reflux as a cause of chronic respiratory symptoms in neurologically normal infants. Chest. 2001 Oct. 120(4):1190-5. [QxMD MEDLINE Link].
Gurberg J, Birnbaum R, Daniel SJ. Laryngeal penetration on videofluoroscopic swallowing study is associated with increased pneumonia in children. Int J Pediatr Otorhinolaryngol. 2015 Nov. 79 (11):1827-30. [QxMD MEDLINE Link].
Yoshikawa H, Yamazaki S, Abe T. Acute respiratory distress syndrome in children with severe motor and intellectual disabilities. Brain Dev. 2005 Sep. 27(6):395-9. [QxMD MEDLINE Link].
Kohda E, Hisazumi H, Hiramatsu K. Swallowing dysfunction and aspiration in neonates and infants. Acta Otolaryngol Suppl. 1994. 517:11-6. [QxMD MEDLINE Link].
Carre IJ. The natural history of the partial thoracic stomach (hiatus hernia) in children. Arch Dis Child. 1959 Aug. 34:344-53. [QxMD MEDLINE Link].
Fiori S, Moretti E, Amador C, et al. Lung ultrasound in young children with neurological impairment: A proposed integrative clinical tool for deaeration-detection related to feeding. Front Pediatr. 2022. 10:932409. [QxMD MEDLINE Link]. [Full Text].
Albanese CT, Towbin RB, Ulman I, Lewis J, Smith SD. Percutaneous gastrojejunostomy versus Nissen fundoplication for enteral feeding of the neurologically impaired child with gastroesophageal reflux. J Pediatr. 1993 Sep. 123(3):371-5. [QxMD MEDLINE Link].
Jancelewicz T, Lopez ME, Downard CD, et al. Surgical management of gastroesophageal reflux disease (GERD) in children: A systematic review. J Pediatr Surg. 2017 Aug. 52 (8):1228-38. [QxMD MEDLINE Link].
Takamizawa S, Tsugawa C, Nishijima E, Muraji T, Satoh S. Laryngotracheal separation for intractable aspiration pneumonia in neurologically impaired children: experience with 11 cases. J Pediatr Surg. 2003 Jun. 38(6):975-7. [QxMD MEDLINE Link].
Leung AK, Hon KL. Gastroesophageal reflux in children: an updated review. Drugs Context. 2019. 8:212591. [QxMD MEDLINE Link]. [Full Text].
Chest radiograph of a child with a tracheostomy and recurrent aspiration reveals patchy infiltrates and increased interstitial markings.
Lateral chest radiograph of the same child as in the previous image reveals increased interstitial markings and patchy and perihilar infiltrates.
Cecilia P Mikita, MD, MPH Associate Professor of Pediatrics and Medicine, Uniformed Services University of the Health Sciences; Staff Allergist/Immunologist, Walter Reed National Military Medical Center
Cecilia P Mikita, MD, MPH is a member of the following medical societies: American Academy of Allergy Asthma and Immunology
Thomas Scanlin, MD Chief, Division of Pulmonary Medicine and Cystic Fibrosis Center, Department of Pediatrics, Rutgers Robert Wood Johnson Medical School
Thomas Scanlin, MD is a member of the following medical societies: American Association for the Advancement of Science, Society for Pediatric Research, American Society for Biochemistry and Molecular Biology, American Thoracic Society, Society for Pediatric Research
Heidi Connolly, MD Associate Professor of Pediatrics and Psychiatry, University of Rochester School of Medicine and Dentistry; Director, Pediatric Sleep Medicine Services, Strong Sleep Disorders Center
Heidi Connolly, MD is a member of the following medical societies: American Academy of Pediatrics, American Thoracic Society, and Society of Critical Care Medicine
encoded search term (Aspiration Syndromes) and Aspiration Syndromes
Gastroesophageal Reflux Disease (GERD) Imaging
Fast Five Quiz: Gastroesophageal Reflux Disease (GERD)
Fast Five Quiz: Gastroesophageal Reflux Disease Management
Pediatric Gastroesophageal Reflux
Sandifer Syndrome
Pediatric Esophagitis
Transgender People in Rural America Struggle to Find Doctors Willing or Able to Provide Care
PPI Use in Type 2 Diabetes Links With Cardiovascular Events
Immune Thrombocytopenia: Protecting Endangered Platelets: New Directions
Growth Disorders: 7 Cases of a Developing Problem
Diseases & Conditions Gastroesophageal Reflux Disease (GERD) Imaging
Challenges in Gastroesophageal Reflux Disease Assessment and Management 0.5 CME / CE / ABIM MOC Credits
Challenges in Gastroesophageal Reflux Disease Assessment and Management
Adherence to Antireflux Lifestyle Factors Shows Benefit in Women
Prebiotic in Development Shows Promise for Reducing GERD Symptoms

redpajama_set_name: RedPajamaCommonCrawl


text:
Chuck Sweeny: Hiking in China nearly fatal for Rockford man
Matt Honson is only 26, but the Rockford native and Guilford alum has already looked death in the eye: Last week he fell down a ravine in China. Miraculously, death blinked, and Matt will live to talk about his harrowing experience.
Honson graduated from Bethel University in St. Paul, Minn., and went to the school's seminary for a year before going to China with his wife, Nora, for an adventure. Since September, they've been teaching English at Jiangxi University of Science and Technology. The school recently gave Matt and Nora a month off to travel around and learn more about China.
Last Wednesday, Matt was hiking in the spectacular but treacherous Tiger River Gorge on the Yangtze River. While doing some exploring off the main trail, he lost his footing and fell more than 20 feet down a ravine, landing on his head. Matt broke his neck and fractured his skull, said his aunt, Lynnea Walsh of Hoffman Estates.
Chris, Matt's hiking companion, climbed gingerly down the ravine and grabbed Matt's cell phone from his pocket. Chris had little hope of reaching anyone because the signal in that rural area had been nonexistent. But he made a call anyway.
"It just so happened that back at the cottage where they were staying, their friend Tanner had just turned his phone on when Chris' call came through. He tried to explain where they were," Walsh said. The lady who owned the cottage gathered some farmers together, and along with Nora and Tanner they made their way for two hours to the place where Matt was lying unconscious. They made a gurney to carry Matt out of the ravine, then put him on the back of a donkey to take him to a primitive hospital in the town of Lijiang, Walsh said. Much of the slow, exhausting trip took place in darkness.
The staff at the hospital spoke no English, and Nora, Chris and Tanner waited for two days to get modern treatment for Matt. The hospital finally contacted International SOS, a worldwide medical services company. SOS agreed to fly a team of doctors and nurses to Lijiang from Beijing, and then to transport Matt to Hong Kong Baptist hospital for surgery. They had to act fast because Matt's condition was critical. There was only one problem: money. SOS needed $77,000 upfront, payable by credit card. Honson family members in Rockford negotiated the total down to $70,000 and raised the money among themselves in four to five hours, in the middle of the night. The money was transmitted by fax to China, and Matt was taken to Hong Kong.
"The surgery took 10 hours. Matt will need to wear a neck brace for four to six months, and he'll probably have to have a metal plate put in his skull. Matt should be fine with no brain damage," his aunt said Monday. "We're calling it a God thing."
Jeff and Ann Honson, Matt's parents, have flown to Hong Kong to be with their son. Jeff Honson is lead pastor of Northridge Community Church in Machesney Park. For many years, he was youth pastor of Temple Baptist Church in Rockford.
Although they're thankful Matt will recover, the family will have hundreds of thousands of dollars in hospital bills to pay. If you'd like to help, make checks payable to Alpine Bank, c/o the Matthew Honson Medical Fund, P.O. Box 6086, Rockford, IL 61125. The tax-exempt ID is 26-4102728.
Chuck Sweeny can be reached at csweeny@rrstar.com or (815) 987-1366.


…..or Anyt'ing Goin' on, or What?
I bought this Lodge cast iron pan at the thrift store so had to make cornbread to justify the purchase. We needed something good to go with the cornbread so I made rouladen.
Turned out tasty but tough. More often Lance makes the stuff and I eat it. He made roast duck.
But I was talking about buying stuff. I buy way more stuff than a person needs but it keeps me out of trouble. Like this picture which cost me all of $4.50 at a thrift store.
If you know me, you know I don't do beige so I painted the mat and the frame and now it is hanging in by bathroom.
Preheat oven to 425°. Put vinegar and liqueur in 9×13 baking dish and add pears cut side down. Bake for 15 minutes then add the water (I don't know if you can do this with a glass dish without breaking it – I used metal pan) and bake for another 10 minutes. Arrange pears on plate cut side up. Crumble half the cookies over the pears then spoon pan juices over them. Crumble remaining cookies on top and serve. If you are worried it doesn't have enough calories, add a knob of good quality vanilla ice cream.
email comments to jgparsons@judypstickletrunk.com – if you know the blog you'll know the comment box doesn't work. If you don't know the blog, I'm telling you, the comment box doesn't work, you have to email.


Product Overview: Recombinant Human CSF3 (Thr27  Pro200, with an Nterminal Met) was expressed in E. coli and produced using nonanimal reagent in an animalfree laboratory.
Description: GCSF is a pleiotropic cytokine best known for its specific effects on the proliferation, differentiation, and activation of hematopoietic cells of the neutrophilic granulocyte lineage. It is produced mainly by monocytes and macrophages upon activation by endotoxin, TNFμ and IFNμ. In vitro, GCSF stimulates growth, differentiation and functions of cells from the neutrophil lineage. It also has blast cell growth factor activity and can synergize with IL3 to shorten the Go period of early hematopoietic progenitors. Consistent with its in vitro functions, GCSF has been found to play important roles in defense against infection, in inflammation and repair, and in the maintenance of steady state hematopoiesis.
Activity: Measured in a cell proliferation assay using NFS60 mouse myeloid cells. The ED50 for this effect is typically 10  60 pg/mL.
Endotoxin Leve: <1.0 EU per 1 μg of the protein by the LAL method.
Purity: >97%, by SDSPAGE under reducing conditions and visualized by silver stain.
Formulation: Lyophilized from a 0.2 μm filtered solution in Acetic Acid with Trehalose. See Certificate of Analysis for details.
Reconstitution: Reconstitute at 0.2 mg/mL in sterile PBS.
Shipping: The product is shipped at ambient temperature. Upon receipt, store it immediately at the temperature recommended below.
Storage: Use a manual defrost freezer and avoid repeated freezethaw cycles. 1. 12 months from date of receipt, 20 to 70 °C as supplied. 2. 3 month, 2 to 8 °C under sterile conditions after reconstitution.


A friend is about to go back to school to Chicago in about a week. She was sad that we didn't get to make anything while she was here all summer, so I told her to come on over Sunday and we made cake pops together.
I must have gotten lucky the first time I make cake pops, cuz I didn't have any issues. These were much more difficult but we learned a lot so hopefully next time will be perfect again.
Lesson 2 – I think some of them were just too big. They started to crack while sitting upright. The smaller ones are okay, so I'll just have to watch the size next time.
Lesson 3 – Mixing red candy melts with white candy melts does not make pink. I guess we could have just colored the white ones, but we really thought it would turn pink. Oh well.
The purple was fun.. it's hard to tell here but it was like a neon purple color.
We made a few stars and hearts… they didn't come out too great, I think they were just too big.
The white candy melts actually have colored dots all in them. SUPER cute.
The best part about these? I made them with STRAWBERRY cake!!


text:
Q: Why does ORACLE cache recovery create uncommited blocks during instance recovery? The following is an excerpt from an ORACLE book

During cache recovery, Oracle replays the transactions from the online redo log files since
  the last checkpoint. During this roll forward operation, both committed and uncommitted
  changes are applied to the data files. At the end of the roll-forward operation, the data files
  will have committed changes, uncommitted changes that were written to the data files to free
  up buffer cache space and uncommitted changes applied by the roll-forward operation. The
  database can be opened as soon as cache recovery is complete.

The sentece in bold above is the one I don't understand. How can a redo log file generate uncommited data since all its information are recorded after COMMIT ?
Further it says

In the transaction-recovery phase of instance recovery, Oracle applies
  undo blocks to roll back uncommitted changes in data blocks that were either written before
  the instance crash or made by the roll-forward operation during cache recovery.

I understand that if dirty blocks were written to disk without a prior COMMIT (if at all possible), during transaction recovery, undo blocks can be used to roll them back. BUT how can undo blocks can be used to rollback uncommitted changes (what arethose changes anyaway...) introduced by replaying redo logs during cache recovery ?
Hmmm I don't get it since online redo log, which should only contain committed information, create uncommited information during instance recovery.

A:
How can a redo log file generate uncommitted data since all its information are recorded after COMMIT ?

LGWR process flushes redo logs from redo log buffer cache to online redo log files when-

*

*A user fire commit explicitly.

*One third of space in redo log buffer is filled.

*Three seconds of time has passed since last redo flush.

*DBWn process writes dirty buffer to disk.

These all triggers redo flush which may include uncommitted transaction.

BUT how can undo blocks can be used to rollback uncommitted changes (what are those changes anyway...) introduced by replaying redo logs during cache recovery ?

Let me give you an example,suppose you have a data block which contains one row with single column with value 5. You simply try to update it using update tbl set col1=6. During this process undo is generated to reproduce it's original value which is 5 and redo is generated to reply the transaction, means to reproduce the latest value which is 6.
Next, if this transaction is uncommitted and unfortunately instance crashes, during the next startup, Oracle(Specifically SMON process) takes the blocks which need to be recovered into the buffer cache and re-apply the changes using redo logs and if someone tries to read the row that you had modified before, Oracle simply rolled back the data block containing the row to its original value which is 5 using undo.
Update:
The following alert log excerpt is extracted from this blog.
ALTER DATABASE OPEN
Beginning crash recovery of 1 threads
Started redo scan
Completed redo scan
read 80458 KB redo, 1721 data blocks need recovery
Started redo application at
Thread 1: logseq 490, block 52626
Recovery of Online Redo Log: Thread 1 Group 1 Seq 490 Reading mem 0
Mem# 0: /home/oracle/app/oracle/oradata/orcl/redo01.log
Recovery of Online Redo Log: Thread 1 Group 2 Seq 491 Reading mem 0
Mem# 0: /home/oracle/app/oracle/oradata/orcl/redo02.log
Recovery of Online Redo Log: Thread 1 Group 3 Seq 492 Reading mem 0
Mem# 0: /home/oracle/app/oracle/oradata/orcl/redo03.log
Completed redo application of 15.26MB
Completed crash recovery at
Thread 1: logseq 492, block 31015, scn 6082434
1721 data blocks read, 1721 data blocks written, 80458 redo k-bytes read
Sun Jan 09 00:50:27 2011

This clearly shows that block number 1721 needs recovery. And in order to do that the block is loaded into the memory(buffer cache) and redo is applied. The block is written back to data file after the recovery.
This is also explained in(Chapter-9 Redo and Undo, How Redo and Undo Work Together, Page ) Expert Oracle Architecture Third Edition book by Thomas Kyte.
From ASKTOM

Hi Tom,

*

*To do the crash recovery , Database needs datablocks(needed recovery) to be brought into SGA. May i know which process will bring them?.

Thanks
Followup
smon will read them and apply redo to them during the recovery phase.

Instance/Crash Recovery

redpajama_set_name: RedPajamaStackExchange


text:
Sharing biochemistry
Teach & run a research group
Work at the bench
Angelika Feldmann
Paula Dobrinic
Charles Underwood
Katherine Rollins
Lauren Turrell
Undergraduate international students
Graduate academic supervisors
Graduate international students
Graduate open days
Cell Biology, Development and Genetics
Chromosomal and RNA Biology
Infection and Disease Processes
Microbiology and Systems Biology
Structural Biology and Molecular Biophysics
The Department of Biochemistry at the University of Oxford
is a place of many exciting job opportunities
We are a part of the University of Oxford, which is a member of the Athena SWAN Charter and holds an institutional Bronze Athena SWAN award.
We are strongly committed to equality and diversity and we operate a flexible working policy for all staff. We hold a departmental Silver Athena award in recognition of our efforts to introduce organisational and cultural practices that promote gender equality and create a better working environment for both men and women.
Expression of Interest for Research Career Development Fellowships 2019
Opportunity for Early Career Researchers to be sponsored for establishing an independent research group
Closing deadline: 7th October 2019
Shortlisting Decision Date: 15th October 2019
Interview Dates: 4th – 5th November 2019
E-mail us to apply
Research Fellowships offered for sponsorship
Wellcome Trust Sir Henry Dale, MRC CDA, BBSRC David Phillips, CRUK Career Development Fellowship, Royal Society – URF and Dorothy Hodgkin, EPSRC Early Career Fellowship
We invite Expressions of Interest from early career researchers who wish to be sponsored for establishing an independent research group, as an externally funded research fellow. Successful candidates will have an outstanding track record in an area that is aligned to the Department's research interests and fits within its five broad research themes: Cell Biology, Development and Genetics; Chromosomal and RNA Biology; Infection and Disease Processes; Microbiology and Systems Biology; Structural Biology and Molecular Biophysics.
We offer a dynamic and multidisciplinary research environment with state-of-the-art facilities and access to excellent infrastructure and expertise in the wider Oxford area. Fellows benefit from a comprehensive mentoring programme and career support, and have the opportunity to recruit outstanding undergraduates and postgraduates.
Shortlisted candidates will present a seminar, attend an interview, and meet members of the department with common scientific interests. Successful candidates will be provided with support from the Departmental Research Facilitator and appropriate group leaders to assist them in their fellowship application.
The University of Oxford is a member of the Athena SWAN Charter and holds an institutional Bronze Athena SWAN award. The Department of Biochemistry is strongly committed to equality and valuing diversity and we operate a flexible working policy for all staff. The Department holds a departmental Silver Athena award in recognition of its efforts to introduce organisational and cultural practices that promote gender equality and create a better working environment for both men and women.
Committed to equality and valuing diversity.
Expression of Interest should include:
Brief CV, including a list of your publications
Outline of your intended research programme (up to two pages)
Details of how your research fits within the research themes of the Department and why you would like to work in the Department
Proposed scheme for which you are eligible
Brief outline of the budgets required for your proposed programme
Brief description of any unusual requirements for laboratory space and facilities
Confidential supporting statements from at least two referees who know your research well, to be sent separately
Apply by e-mail to: recruitfellows@bioch.ox.ac.uk (Informal enquiries welcome)
Other job opportunities:
Associate Professorship of Molecular and Cellular Biochemistry in association with St. Anne's College
Fetching vacancies Loading...
Teach and run a research group
Section Links:
© 2019 University of Oxford -


By visiting Doctors of BC (British Columbia Medical Association) online at www.doctorsofbc.ca, you are accepting the practices described in this privacy notice.
This website has physical and technical measures in place to ensure the security of information. Servers reside in a locked room and are accessible only to a limited group of authorized personnel.
We also use advanced encryption and firewall technology. The entire Physician Members and Physician Non-Members sections of this site are encrypted using industry standard 128 bit SSL. This is the same encryption used by banks for on line transactions.
Encryption ensures that information in transit between your computer and the Doctors of BC server cannot be read or changed. Periodic penetration and social engineering tests are conducted.
Security measures have been integrated into the design, implementation, and day-to-day operating practices of the website as part of our continuing commitment to privacy.
Doctors of BC does not track patterns of usage by any visitor.Doctors of BC does collect information in log files on this server. This information, such as browser type, operating system, time of access, etc., gives us the opportunity to improve service and identify any problems. This information is not released to any third party.
The only exception to this is if we are legally compelled to provide this information. There is an obligation for Doctors of BC to be able to track any unauthorized usage.
Doctors of BC has links to other websites that are not under its control. Doctors of BC is not responsible for the contents of any linked website, any link contained in a linked website, or any changes or updates to such websites. The inclusion of any link does not mean that Doctors of BC endorses that website.
Please be aware that Doctors of BC is not responsible for the privacy practices of other websites that we link to. We encourage you to read the privacy statements of every website that requests personal information from you.
If you have any questions or comments about Doctors of BC's online privacy statement, e-mail our Privacy Officer or contact us at 604 736-5551.
The Doctors of BC Privacy Code is a formal statement of principles concerning the requirements for the protection of personal information provided by Doctors of BC. The objective of the Privacy Code is to promote responsible and transparent practices in the management of personal information, in accordance with the provisions of the Personal Information Protection Act.
These ten principles, which form the basis of the Doctors of BC Privacy Code, are interrelated, and Doctors of BC will adhere to the ten principles as a whole. Doctors of BC will continue to review its Privacy Code to ensure that it is relevant and remains current with changing technologies and laws.
Doctors of BC is responsible for personal information under its control and will designate an individual or individuals who are accountable for the organization's compliance with established privacy principles.
The purposes for which personal information is collected will be identified by Doctors of BC before or at the time the information is collected.
Doctors of BC will ensure that the knowledge and consent of the individual are required for the collection, use, or disclosure of personal information, except where inappropriate.
The collection of personal information will be limited to that which is necessary for the purposes identified by Doctors of BC. Information will be collected by fair and lawful means.
Doctors of BC will not use or disclose personal information for purposes other than those for which it was collected, except with the informed consent of the individual or as required by law. Personal information will be retained only as long as necessary for the fulfillment of those purposes.
If you would like to opt out of any communications from Doctors of BC, please login to your account, click on the My Account button and update your Mail Preferences, Privacy Settings and Subscriptions.
Doctors of BC is responsible for ensuring that personal information is as accurate, complete, and up to date as necessary for the purposes for which it is to be used.
Doctors of BC ensures personal information is protected by security safeguards appropriate to the sensitivity of the information.
Doctors of BC makes information available about its policies and practices relating to the management of personal information.
Upon request, Doctors of BC informs an individual of the existence, use, and disclosure of his or her personal information and the individual has access to that information. An individual has the ability to challenge the accuracy and completeness of the information and have it amended as appropriate.
An individual has the ability to challenge Doctors of BC's compliance with these principles by contacting the designated individual or individuals accountable for the organization's compliance.
For more information please contact our Privacy Officer at privacyofficer@doctorsofbc.ca or call 604 736-5551.


text:
Q: Which is the future limit on schedule notifications on OneSignal I'm trying to use OneSignal to schedule notifications to the future, the problem is if I schedule the notification with send_after for example to 2019 the api returns this message
Schedule Notifications may not be scheduled so far in the future.

This is the setup example:
var message = {
                    app_id:  config.get('oneSignal:appId'),
                    headings: {"en": "head"},
                    contents: {"en": "content"},
                    filters: [
                        {"field": "tag", "key": "email", "relation": "=", "value": user.mail}
                    ],
                    send_after: "2019-06-01 14:00:00 GMT-0700"
                };

And this is the response message
Response:
{ errors: [ 'Schedule Notifications may not be scheduled so far in the future.' ] }

Which is the limit? And it is possible to 'extend'?
thanks

A: Once ask that question. This is response

A: I think their limit might have changed. After testing i can only get it to send notifications up to one month in the future.


text:
Q: vaapi Surface to openGl texture I got video frames decoded with vaapi/ffmpeg into a VASurface. Now I want to render them using an OpenGL texture. I was able to load the frames into software (with vaDeriveImage und vaMapBuffer) and update a texture with the received data. But that was really slow and that is not my goal here. Then I found EGL used in a few other repos.
So I found this repo, which does render the frames entirely with EGL as far as I see. This is not what I want. I need it in texture for later use.
Then I came across fmor's demo program. This looks really like magic to me. There are like 2 steps on init and then he can use the texture with no problems.
//in player.c before the decoding happens:
egl_image = egl_create_image_from_va( &surface, player->video_va_display, player->video_cc->width, player->video_cc->height );
    if( egl_image == EGL_NO_IMAGE )
        goto LBL_FAILED;

    glGenTextures( 1, &player->video_texture );
    glBindTexture( GL_TEXTURE_2D, player->video_texture );
    glTexParameteri( GL_TEXTURE_2D, GL_TEXTURE_MIN_FILTER, GL_LINEAR);
    glTexParameteri( GL_TEXTURE_2D, GL_TEXTURE_MAG_FILTER, GL_LINEAR );
    glTexParameteri( GL_TEXTURE_2D, GL_TEXTURE_WRAP_S, GL_CLAMP_TO_EDGE);
    glTexParameteri( GL_TEXTURE_2D, GL_TEXTURE_WRAP_T, GL_CLAMP_TO_EDGE);
    glEGLImageTargetTexture2DOES( GL_TEXTURE_2D, egl_image  );

//in util.c:
EGLImage egl_create_image_from_va(VASurfaceID* _va_surface, VADisplay va_display, int width, int height)
{
    EGLImage egl_image;
    VASurfaceID va_surface;
    VASurfaceAttrib va_surface_attrib;
    VADRMPRIMESurfaceDescriptor va_surface_descriptor;
    int r;

    egl_image = EGL_NO_IMAGE;
    va_surface = VA_INVALID_SURFACE;

    va_surface_attrib.type = VASurfaceAttribPixelFormat;
    va_surface_attrib.flags = VA_SURFACE_ATTRIB_SETTABLE;
    va_surface_attrib.value.type = VAGenericValueTypeInteger;
    va_surface_attrib.value.value.i = VA_FOURCC_RGBA;

    r = vaCreateSurfaces( va_display, VA_RT_FORMAT_RGB32, width, height, &va_surface, 1, &va_surface_attrib, 1 );
    if( r != VA_STATUS_SUCCESS )
        goto LBL_FAILED;

    r = vaExportSurfaceHandle( va_display, va_surface, VA_SURFACE_ATTRIB_MEM_TYPE_DRM_PRIME_2, VA_EXPORT_SURFACE_READ_ONLY, &va_surface_descriptor );
    if( r != 0 )
        goto LBL_FAILED;

    EGLAttrib egl_img_attributes[] = {
        EGL_LINUX_DRM_FOURCC_EXT, va_surface_descriptor.layers[0].drm_format,
        EGL_WIDTH, va_surface_descriptor.width,
        EGL_HEIGHT, va_surface_descriptor.height,
        EGL_DMA_BUF_PLANE0_FD_EXT, va_surface_descriptor.objects[va_surface_descriptor.layers[0].object_index[0]].fd,
        EGL_DMA_BUF_PLANE0_OFFSET_EXT, va_surface_descriptor.layers[0].offset[0],
        EGL_DMA_BUF_PLANE0_PITCH_EXT, va_surface_descriptor.layers[0].pitch[0],
        EGL_NONE
    };
    egl_image = eglCreateImage( eglGetCurrentDisplay(), EGL_NO_CONTEXT, EGL_LINUX_DMA_BUF_EXT, NULL, egl_img_attributes );
    if( egl_image == EGL_NO_IMAGE )
        goto LBL_FAILED;

    *_va_surface = va_surface;
    return egl_image;
LBL_FAILED:
    if( va_surface != VA_INVALID_SURFACE )
        vaDestroySurfaces( va_display, &va_surface, 1 );
    return EGL_NO_IMAGE;
}

Can someone tell me what is happening here? And how I can reproduce this without using glew?
My hardest guess is that with the EGL_LINUX_DMA_BUF_EXT parameter for the eglImage creation there is some direct memory accessing ongoing. Is vaapi rendering right into the OpenGL texture here?
Also here is vaExportSurfaceHandle used and I don't really get what this is doing.
Edit: I read through a lot of EGL related posts now. I think I understand a bit more now. But when I looked at fmor's demo program again I got confused. There are several calls of eglGetCurrentDisplay() but I can't find where this Display is set, so I can reproduce that. Could it be, that glew is doing something behind the scenes or am I missing something else?
Even eglInitialze() is never called once.
When I try to instantiate an EGLDisplay on my own with eglGetDisplay(native_display), like it was done in ffvademo, what do I put in for the native_display? In ffvademo there got X11 Display or a DRM Display (?) inserted. Both are as far as I know used to render to the screen, or not? Also I think inserting the vaapi Display would be not the right thing here.
I could really use some help here guys...

A: Ok, I found it. GLFW is doing all of the stuff needed. Gonna read through that code to find my answers I guess.


text:
Medical Waste Giant Stericycle Services Abortionist Charged with 10 Counts of Murder
Jan 5th, 2012 by admin
Elkton, MD — The Campaign to Stop Stericycle (CSS) has learned that the medical waste giant had been servicing the "secret" abortion facility of infamous abortionist Steven Brigham, who is now being held on three million dollars bail and is facing murder charges for the deaths of late-term infants. Stericycle continues to collect abortion "waste" from a number of additional sites owned by Brigham.
Brigham owns a known 18 abortion facilities, most of which go by the name of "American Women's Services," and advertises locations in Pennsylvania, New Jersey, Maryland and Virginia. His license was revoked in New York and Florida; he surrendered his license in Pennsylvania, and allowed his license to expire in Georgia and California due to the government's concerns about his conduct. Brigham is known for his attempts to evade New Jersey law, which prohibits second trimester abortions outside of a hospital or licensed ambulatory center, by injecting poison into the baby's heart, then directing patients to an out-of-state location to have the dead baby surgically extracted.
Most recently, Brigham had his license suspended in New Jersey for engaging in another out-of-state abortion scheme. Much like past violations, he administered the injection at his Voorhees, New Jersey location, and then had patients drive to a "secret" location called "Grace Medical Care" an hour away in Elkton, Maryland to have the baby removed. Brigham holds no medical license in Maryland.
In August 2010, investigators raided Brigham's Elkton facility after police were contacted by an 18-year old girl who had been hospitalized after an abortion that ended the life of her 21-week old baby turned awry. Weeks after the last collection stop of the medical "waste" company Stericycle, investigators found 35 late-term babies in Brigham's chest freezer and took the bodies to be examined. Records show that on some occasions, up to six late-term abortions were performed in a day.
On December 28th, 2011, after a lengthy investigation, a Grand Jury leveled five counts of first-degree murder, five counts of second-degree murder and one count of conspiracy to commit murder against Brigham, who was then taken into custody. Nicola Riley, a contracted abortionist that performed the botched procedure on the 18-year old, was also arrested and charged with one of each felony count.
Brigham's "secret" late-term abortion facility in Elkton, Maryland, where Stericycle collected "waste" for the abortionist until he was raided by police.
Through an independent investigation conducted by CSS, it was discovered that Stericycle stopped servicing Brigham's "secret" late-term abortion facility after it was raided by police. However, Stericycle has been and continues to collect abortion "waste" from numerous other locations owned by Brigham. It services all of Brigham's abortion facilities in Maryland, as well as a location in Pittsburgh, Pennsylvania and Virginia Beach, Virginia.
"Stericycle's willing collaboration with abortionist Steven Brigham is sickening and indefensible, and the company is equally as culpable for aiding him in his evil deeds," CSS director Michael Marcavage stated. "During the Nuremburg Trials of the 1940's, those who aided the Nazis in carrying out the Jewish Holocaust were considered to be accessories to murder and were held accountable by the courts. Likewise, Stericycle's executives and employees are accessories to Brigham's empire of death in the abortion holocaust," he added. "We again call upon Stericycle to immediately stop servicing the abortion industry and to put morals over money. Stericycle President Charles Alutto and CEO Mark Miller should be ashamed of their company's involvement with abortionists. Perhaps one day they will be brought to justice, and if it be not in this life, they will be held accountable by God," Marcavage concluded.
According to Grand Jury documents, Stericycle was found last year to have collected "waste" from notorious abortionist Kermit Gosnell, who is also facing murder charges and a string of other criminal counts. The Philadelphia District Attorney's office called Gosnell's abortion facility a "house of horrors" as numerous babies were found in the freezer. Stericycle had serviced Gosnell until he stopped paying his bills.
Aciclovir or Valaciclovir for sale tablets without existing prescription from https://sites.google.com/site/valtrexforsale/ by using it, you will gradually notice that you are being treated thoroughly.
Stericycle was also recently fined over $42,000 for illegally dumping aborted babies into a landfill in the state of Texas. Stericycle is quoted in government documents as stating that "boxes of waste containing fetuses and/or tissue should be sent for incineration."
"Though hand join in hand, the wicked shall not be unpunished." – Proverbs 11:21
Posted in News Releases | No Comments


Veteran NZ jazz drummer Mark Lockett teams up with 2018 'Best Jazz Artist' Tui Award winner Umar Zakaria on bass and guitarist Brad Kang, an alumni of the Grammy-winning University of North Texas One O'Clock Lab Band.
The triple-threat trio presents a collection of originals from their various groups re-imagined for the guitar-bass-drums setting, featuring the premiere of a new original suite 'Nusantara Sun' - inspired by the landscape of the Malay Archipelago in Southeast Asia.
Don't miss this chance to catch these three leading artists on the NZ scene today.


Since its discovery in 1945, NMR (Nuclear Magnetic Resonance) has developed to become the most important spectroscopy method for the structural analysis of organic and biological molecules in solutions. NMR has subsequently developed to also include NMR of solid matters (e.g. organic, inorganic, biomolecules and certain types of metals).
NMR was introduced as a spectroscopy method at the Department of Chemistry, Aarhus University, in 1962 and the first NMR spectrometer was installed in 1964/65.
NMR researchers at the Department of Chemistry are currently recognized internationally for their high level of competence in fluid-phase and solid-state NMR spectroscopy and MR imaging, and they lead the NMR field in Denmark.


Compare Limo Bus Hire prices in Prestonpans. Get a great deal for Party Buses in Prestonpans. Hire Limos is the one of the leading supplier of Party Bus Hire in the Prestonpans area. A huge range of Limo Bus Hire including 16 Seater Party Buses, Starline Party Buses, VIP Party Buses..
Welcome to your local supplier of party bus hire in Prestonpans.
When it comes to sourcing the very best deals for party bus hire around Prestonpans & East Lothian, you've come to the perfect place. Here at HireLimos.com we work alongside a network of approved Party Bus Hire providers based throughout the Scotland. We are able to compare Party Bus Hire quotes across a range of providers for your specific booking until we find the very cheapest price. All it takes is a few simple clicks one phone call to us, to register your journey details and we'll do all the legwork on your behalf, leaving your free to sit back and wait for your cost-effective limo hire quote to fly in.


After months (or even years) of having a side hustle, you've decided that life is too short to not pursue your dreams, and it's time for you to turn your side hustle and hobby into a business.
You have decided to do what very few people have the courage to do and that is taking your future into your own hands, and daring to give yourself the opportunity to live alive and live the life that you were destined for.
Making the courageous decision to start your own business will be very exciting in the beginning, but let me be real with you, it will get so damn overwhelming. I'm sorry for the honesty, but I have to keep it 100 with you. Starting a business can be exciting, hard, confusing, fun, rewarding, and overwhelming all in one. If you are starting a business while working full-time, it can be even more crazy. But sis/bruh, it's the honest truth. Nonetheless, it doesn't matter how crazy it can be, starting a business while working full-time can be done and if you have the right skills, confidence, and work ethic you can do it too.
If you are building a biz while working a 9-5, here are 8 things you can do to remain sane and build your dream.
The moment you decide you want to start a business, you will soon realize that in order for you to be successful, you'll have to set boundaries and prioritize people and things in your life. This means, you will have to have the courage to tell your boo that you can't cake on the phone all day and night, because you have to work on your biz. You'll have to tell your friends that you can't be at every Sunday Funday, brunch, or vacation because the time spent there could be valuable time spent doing work (and also you'll be saving money that can go into your biz). Setting boundaries also means that you cannot catch every episode of Scandal, Real Housewives, or Atlanta because time spent watching TV can be time working. Setting boundaries for people and things in your life will help you successfully prioritize and get more work done.
Having responsibilities at both a full-time job and your new business can be overwhelming and can drive you cray cray.
In order to manage both responsibilities, some people would opt in for creating a long list of things to do, but I recommend creating that list, BUT breaking it down into chunks. Breaking down your goals will make your to-do list look less daunting and intimidating.
Similar to tip #1, prioritizing is key. When you prioritize your life and set a schedule, it will help guide you to stay on track. Working a 9-5 and building your biz can be hectic, so that's why I recommend to create a realistic schedule and stick to it. For instance, schedule yourself and stay focused during the day at your 9-5, so that you can leave on time, and go home and work on your biz. If you are trying to use time after work to build your own biz, this means you cannot spend all of your hours working at your full-time job because you have to leave some time to work on your own biz.
As full-time employees and business owners, our time away from the office is uber important. The time in the morning before work and in the evening after work can be utilized to work on your biz (if you are dedicated and strategic). I've always hated it when entrepreneurs bash people for not waking up early to do work because I believe that some people are just not morning people and they do their best work at other times of the day. For you, figure out what time of the day you work best at and utilize that time to work on your biz.
Want to know the best business resource that I've ever used?
Buffer is a social media scheduling tool and it helps you automate your social media content. With Buffer, I can plan out my posts for the week (or month if I'm being a badass), and while I'm at work, my cute little social media content is easily posting away (on its own). If you are not automating your content, get.into.it.
Next, having the courage to let someone else do work that you either can't do or really don't have time to do is one of the smartest decisions you'll make. Nowadays, sites like Fiverr make it easy for small business to outsource work and focus on other business items.
Although catching your favorite show during lunch or on a lazy Saturday sounds ideal, use that time to work on your business instead. If you are really serious about building your company, you should be working on it every free chance you get.
Have you ever heard someone say that your diet affects your mood? Well, it's true. When you eat a balanced meal, you'll have more energy. Also, when you take care of your body and mind by exercising, it will give you energy and stimulate your mind. During the times when I've decided to eat junk food and skip the gym, I noticed that I became super lazy in my work. But when I've opted in for healthier options and exercise, I have way more energy and confidence.
Building a biz, working full-time, and having a social life on top of all of that will pull you in all types of directions and can be overwhelming. At the end of the day, always remember to pour back into yourself and actively practice self-care. At least one time throughout the day, you should have "me time" where you can relax and unwind (and not doing work).
Are you working full-time and building a biz? How are some ways that you stay sane?


text:
package org.apache.hadoop.raid;

import java.io.IOException;
import java.io.InputStream;

import org.apache.hadoop.fs.FSDataInputStream;
import org.apache.hadoop.fs.FileStatus;
import org.apache.hadoop.fs.FileSystem;
import org.apache.hadoop.fs.Path;
import org.apache.hadoop.conf.Configuration;

public class FileStripeReader extends StripeReader {
  long srcSize;
  FileSystem fs;
  Path srcFile;
  long stripeStartOffset;
  long blockSize;
  public FileStripeReader(Configuration conf, long blockSize,
      Codec codec, FileSystem fs, long stripeStartIdx,
      Path srcFile, long srcSize) {
    super(conf, codec, fs, stripeStartIdx);
    this.blockSize = blockSize;
    this.stripeStartOffset = stripeStartIdx * codec.stripeLength
        * blockSize;
    this.fs = fs;
    this.srcFile = srcFile;
    this.srcSize = srcSize;
  }

  @Override
  public boolean hasNext() {
    return stripeStartOffset < srcSize;
  }

  @Override
  public InputStream[] getNextStripeInputs() throws IOException {
    InputStream[] blocks = new InputStream[codec.stripeLength];
    try {
      for (int i = 0; i < codec.stripeLength; i++) {
        long seekOffset = stripeStartOffset + i * blockSize;
        if (seekOffset < srcSize) {
          FSDataInputStream in = fs.open(srcFile, bufferSize);
          in.seek(seekOffset);
          LOG.info("Opening stream at " + srcFile + ":" + seekOffset);
          blocks[i] = in;
        } else {
          LOG.info("Using zeros at offset " + seekOffset);
          // We have no src data at this offset.
          blocks[i] = new RaidUtils.ZeroInputStream(
                            seekOffset + blockSize);
        }
      }
      stripeStartOffset += blockSize * codec.stripeLength;
      return blocks;
    } catch (IOException e) {
      // If there is an error during opening a stream, close the previously
      // opened streams and re-throw.
      RaidUtils.closeStreams(blocks);
      throw e;
    }
  }

  @Override
  public InputStream buildOneInput(
      int locationIndex, long offsetInBlock,
      FileSystem srcFs, Path srcFile, FileStatus srcStat,
      FileSystem parityFs, Path parityFile, FileStatus parityStat
      ) throws IOException {
    final long blockSize = srcStat.getBlockSize();

    LOG.info("buildOneInput srcfile " + srcFile + " srclen " + srcStat.getLen() +
        " parityfile " + parityFile + " paritylen " + parityStat.getLen() +
        " stripeindex " + stripeStartIdx + " locationindex " + locationIndex +
        " offsetinblock " + offsetInBlock);
    if (locationIndex < codec.parityLength) {
      return this.getParityFileInput(locationIndex, parityFile,
          parityFs, parityStat, offsetInBlock);
    } else {
      // Dealing with a src file here.
      int blockIdxInStripe = locationIndex - codec.parityLength;
      int blockIdx = (int)(codec.stripeLength * stripeStartIdx + blockIdxInStripe);
      long offset = blockSize * blockIdx + offsetInBlock;
      if (offset >= srcStat.getLen()) {
        LOG.info("Using zeros for " + srcFile + ":" + offset +
          " for location " + locationIndex);
        return new RaidUtils.ZeroInputStream(blockSize * (blockIdx + 1));
      } else {
        LOG.info("Opening " + srcFile + ":" + offset +
                 " for location " + locationIndex);
        FSDataInputStream s = fs.open(
            srcFile, conf.getInt("io.file.buffer.size", 64 * 1024));
        s.seek(offset);
        return s;
      }
    }
  }
}


https://sassyandstylish.com is owned and operated by Sassy & Stylish Fashion and Beauty and may contain advertisements, sponsored content, paid insertions, affiliate links or other forms of monetization.
https://sassyandstylish.com abides by word of mouth marketing standards. We believe in honesty of relationship, opinion and identity. The compensation received may influence the advertising content, topics or posts made in this blog. That content, advertising space or post will be clearly identified as paid or sponsored content.
Sassy & Stylish Fashion and Beauty is never directly compensated to provide opinion on products, services, websites and various other topics. The views and opinions expressed on this website are purely those of the authors. If we claim or appear to be experts on a certain topic or product or service area, we will only endorse products or services that we believe, based on our expertise, are worthy of such endorsement. Any product claim, statistic, quote or other representation about a product or service should be verified with the manufacturer or provider.
Sassy & Stylish Fashion and Beauty makes no representations, warranties, or assurances as to the accuracy, currency or completeness of the content contain on this website or any sites linked to or from this site.


We're specialising in various pattern and rarely found shawls and scarves exclusively to person who loves shawls or scarves as their headscarf, body cover, travel 'sejadah', house deco, waistbelt or as neck apparels.
There are also some collection of pashmina and inner/underscarf.
We create our own design and fashion, as we are trying so hard to make our customers, unique than others.
Yes, we always offer the best price for all of you for each of our exclusive pieces.


Die Zahlen beim Spíel 77 und Super 6 wurden nicht wiederholt und bleiben somit gültig.Wie das geht, ist von Anbieter zu Anbieter unterschiedlich.Beim Einfüllen der Lottozahlen in das Ziehungsgerät sind wohl zwei Zahlen auf dem sogenannten Schlitten hängen geblieben.Gewinnabfrage von Lotto Bayern hier online Wer seinen Spielschein in..
Nutzen Sie die Chance mit Zombiezee Geld, wird diese furchtbar Spaß Slot muss man über age legal casino quebec Roll in dein Grab.Welche Möglichkeit und welche Aufstiegschancen sich mit der Ausbildung in den unterschiedlichen technischen Berufen bieten, konnten in diesem Jahr die rund 1000 teilgenommenen Schülerinnen und Schüler..
Get ready for a real Gambling experience to play our slots e-mail m, suggested casinos to play real slots and slot machine games at: Slotland, Win A Day Casino, We hope you enjoyed playing our free slot machines on our free java no download gambling.
The " A-Z " website contains a sortable online casinos list comprising safe and reputable places to play these slot games for real.Listen to the Las Vegas sounds.I am gradually expanding the, games Slot Machines website with new games as and when I find one that interests.US and Australian players will probably be very familiar with.Here you'll find detailed reviews of the slot machine games that can be played online plus slots related articles, poker instructies news, tips and strategies, live progressive jackpot totals, casino payout percentages, a selection of free slot games, slot tournament schedules and more.Before you head off to (hopefully!) play the games, I'd just like to point you at a useful 3rd-Party website that I maintain that you might find very useful if you intend playing slot games for real money at some point.Welcome to the original guide to online slots.Queen Of The Nile 2 slot machine here which is a sequel to the original game but with a more interesting free spin feature.Unlike las vegas, our slots and slotmachines play for free and work on all windows versions.The first site is Vegas Casinos Online which was the original version of this site ( this site was once intended to be a backup should the original ever go uitslag postcode loterij jan 2018 down but it's grown pretty popular in it's own right now, with around 1/4.Deluxe " 10-payline versions.Pharaoh's Fortune slot machine which is available to play online now, while Europeans will probably also want to check out the online version of Novomatic's.Marvel Slots series is the excellent, iron Man 2 slot, an exceptionally playable, if volatile, game with an increasing multiplier during the free spins bonus round and plenty of stacked symbols.From high stake spinners to low variance video slots, we've got every top title in the industry.If for any reason you are wyniki lotto wyniki na zywo unable to access any of the slot machines here or if the site is down then there are two other sites that you could check out to see if you can still access the games for free.It has a unique and very good bonus round where you get a 2x or 3x multiplier and (sometimes!) an " expanding scatter " symbol and an extra wild symbol.
I am sure that most slot regulars will be familiar with IGT's immensely popular.


text:
Vivo indefinitely suspends V19 launch in India
Vivo V19's launch has been canceled in India (image source: Vivo India)
Vivo just announced that it would suspend all launches in the Indian subcontinent. The move comes after the Indian government enacted measures that restricted the operations of 'non-essential' business. The company also announced that it would help Indian authorities fight the epidemic by providing them with medical equipment.
Anil Satyanarayana, Published 03/24/2020
Android Chinese Tech Smartphone
The recent COVID-19 epidemic has thrown a wrench in the plans of a lot of OEMs. A lot of smartphone releases were pushed back due to the epidemic. Physical events gave way to online-only spectacles, and this trend is here to stay, for a while, at least. Vivo has now announced that it has suspended all product launches in the Indian subcontinent.
Nipun Marya, the Director and Brand Strategist of Vivo India, Tweeted that the company will not be releasing any products in India for the foreseeable future. The Vivo V19 was initially supposed to be unveiled on March 26th. The date then got pushed back to April 2nd, and now the launch stands canceled altogether. It isn't surprising, considering that the company just shut down its manufacturing unit in the country yesterday.
The Indian government has instructed all 'non-essential' services to shut down for a week, leaving smartphone makers in the lurch. It'll be interesting to see how other brands go about releasing their products in the market under these restrictions. Vivo also announced that it would help the Indian government with the ongoing crisis. The company is in touch with local authorities and will provide necessary equipment such as face masks to healthcare workers. Here's Vivo's complete statement about the matter.
Vivo launches the V19 in India 05/12/2020
Vivo allegedly patents its first smartwatch 05/05/2020
Vivo takes number two spot from Samsung in India, Realme maintains market share after phenomenal growth 04/28/2020
iQOO Neo3: AnTuTu reveals the phone's 600,000+ score and main specs 04/16/2020
An upcoming Vivo Y-series phone will have a punch-hole display 04/03/2020
Vivo launches the S6 5G, a new Exynos 980 phone 03/31/2020
Vivo may release an Exynos 980 version of the Z6 5G: new leak 03/26/2020
Samsung, OPPO, Vivo and Xiaomi suspend work on their devices at their Indian facilities 03/23/2020
The Vivo Nex 3S 5G's existence is confirmed in a new official leak 03/06/2020
A new 5G phone, the Vivo Z6, is now up for pre-order 03/01/2020
Vivo unveils impressive port-less APEX 2020 concept phone 02/28/2020
Xiaomi, Oppo and Vivo reportedly team up to form their own app-distribution platform 02/07/2020
Vivo Nex 3: new leaks point to a new 5G version 01/19/2020
The Vivo X30 and X30 Pro are now up for pre-order 12/19/2019
SD 865-powered OnePlus 8 Pro placed...
PSA: Do not upgrade your Mi A3 to X...
Anil Ganti - Senior Tech Writer - 1233 articles published on Notebookcheck since 2019
I've been an avid PC gamer since the age of 8. My passion for gaming eventually pushed me towards general tech, and I got my first writing gig at the age of 19. I have a degree in mechanical engineering and have worked in the manufacturing industry and a few other publications like Wccftech before joining Notebookcheck in November 2019. I cover a variety of topics including smartphones, gaming, and computer hardware.
contact me via: @AnilGanti, LinkedIn
> Notebook / Laptop Reviews and News > News > News Archive > Newsarchive 2020 03 > Vivo indefinitely suspends V19 launch in India
Anil Satyanarayana, 2020-03-24 (Update: 2020-03-24)


I love getting a good deal on things, whether it's clothes, home decor, travel, food, anything. I mean who likes over paying or paying full price? Not meeeee! So today I thought I'd do a little round-up for some real vs. steals! Recently there has been a lot of dupes for designer items from shops like Forever21. They look almost identical to their more expensive counterparts but for a fraction of the cost. I'm all about them steals!
Pretty amazing, right? I mean the Forever21 vs. Rebecca Minkoff 'Mini Mac' bag I swear is the same. I have the zippered one from Forever21 and get asked if it's a RM all the time. And if you loved the J.Crew camel cape but couldn't payout the $250 pricetag, this one from MissGuided is super similar and under $100. Annnd if you love the Valentino 'Rockstud' flats these ones from Charlotte Russe are perfect. They also come in black. I have them and they're suuuuper comfortable too. Charlotte Russe, Lulu's and GoJane are all great places to find dupes for designer shoes. I have quite a few pairs from all three that are twinsies to Steve Madden and Valentino.
Found any good dupes to designer favorites? Know of any good places to get them? Leave me and your fellow bargainistas a comment sharing!


We manufacture the Global 'EC' range at our Brisbane factory. We use a mixture of high quality components made mostly in Australia & some American. Our Tapware comply with Australian WaterMark and WELS regulations.