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Delaware Gambling
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Delaware doubles number of locations taking NFL bets
By Chris Sieroty
Delaware is doubling down on sports betting.
The state's lottery is more than doubling the number of retailers, restaurants and taverns where bets on NFL games can be placed this upcoming season.
Gamblers will be able to bet at 66 outlets. Last year, Delaware expanded sports betting beyond the state's three racetrack casinos, allowing 31 retail and tavern locations statewide to take NFL parlay wagers.
"We generated a lot of interest last year," said Vernon Kirk, director of the Delaware Lottery, in a phone interview. "We generated $25.4 million during the football season. For a little state like Delaware, that's pretty good."
Sports betting in Delaware is limited to wagers on NFL games using only parlay cards with a minimum bet of $2. There is a minimum of three games on each card, according to the state lottery.
The expansion beyond the three casinos was approved in June 2012 as part of a new law allowing wagering on slots and table games. The Delaware Lottery's NFL parlay cards were first issued in 2009, generating $10.8 million.
Revenue from NFL parlay cards has increased every year, reaching $12.9 million in 2010, $17.9 million in 2011, and $25.4 million last year.
Kirk said the venues added last year accounted for a 40 percent overall increase in the amount of money wagered on NFL games. The casinos reported a 7 percent increase.
"Expansion did not hurt the casinos one bit," Kirk said. "It looks like a good relationship. It's not about competition, we are all in this together."
The state's share of sports betting revenue last year was $2.4 million, according to financial records.
William Hill U.S., based in Las Vegas, is the exclusive risk manager for the Delaware Lottery through a partnership with Scientific Games. The bookmaker determines the product offering, sets the odds and point spreads and manages the risk. Joe Asher, CEO of William Hill U.S., declined to discuss Delaware's expansion.
The state will start taking bets for the season this month as NFL preseason games continue. Delaware is one of four states that legally can offer sports betting under the 1992 federal Professional and Amateur Sports Protection Act or PASPA.
Nevada is the only state in which full race and sports books operate, while sports wagering is also legal in Oregon and Montana. In New Jersey, voters approved a sports gambling referendum in 2011, and the state enacted a law months later to allow sports betting in Atlantic City casinos and horse tracks.
The NCAA and four professional sports leagues went to court to stop it and succeeded in March when a federal judge ruled the 1992 law limiting sports betting to four states was a proper exercise of Congress' power to regulate interstate commerce.
New Jersey appealed the decision to federal court in Philadelphia. Gov. Chris Christie has said if New Jersey loses its appeal, he will take the issue to the U.S. Supreme Court.
If New Jersey is successful in overturning the ban, Delaware could be next.
"We have the infrastructure in place," Kirk said. "If the federal court rules in New Jersey's favor, we would be able to turn on our system.
That betting system was put in place several years ago as Delaware tried to offer unlimited sports betting only to have a federal judge block their efforts. In 2009, Third Circuit Court of Appeals Judge ruled single-game betting violated PASPA.
The ruling limited Delaware to parlay wagering on NFL games. Delaware offered parlay betting for one year in 1976, earning the state an exemption under the federal law.

redpajama_set_name: RedPajamaCommonCrawl


LifeTech Academy a Michigan Cyber School supports personalized learning options throughout Michigan.
LifeTech Academy partners with parents to support parent engagement educational options.
Parent talks about how LifeTech Academy supports Learners to rekindle a love of learning.


You are not alone. Together, we can make a difference.
Foolish Optimism is a group of young people brought together by Front Lounge with the desire to change the conversation around mental health. We want to let other young people know that they are not alone; that their stories are important; and that together, we can make a difference.
For the remainder of 2018, we are touring Scotland to show our film, "Foolish Optimism", and host a series of creative workshops. We want to provide a platform for young people to talk to each other about mental health; share their stories and experiences; and pursue actionable change in our communities.


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Lambert faces up to toughest week
Published: 1:13 AM September 14, 2009 Updated: 10:54 PM October 10, 2020
Norwich City face the toughest week of their season to date, but Paul Lambert is refusing to treat MK Dons or Charlton any differently. Lambert's first three league games as City manager have pitted him against Wycombe, Hartlepool and Walsall - all in the bottom half of the table - while MK Dons are fifth and Charlton fighting it out with Leeds for top spot.
Norwich City face the toughest week of their season to date, but Paul Lambert is refusing to treat MK Dons or Charlton any differently.
Lambert's first three league games as City manager have pitted him against Wycombe, Hartlepool and Walsall - all in the bottom half of the table - while MK Dons are fifth and Charlton fighting it out with Leeds for top spot.
"There is no doubt that, no disrespect to other teams, they are bigger teams," he said. "In this league, I've been in it long enough to realise when you play your Walsalls and Wycombes and Brentfords it's tough - sometimes they're harder to play against than the bigger teams are.
"So I'm under no illusions how hard it is, but I treat every game as being as difficult as each other. I don't prioritise who's better because I think if you do that you're in danger of being complacent. Every game I go into I think it will be really tough. The league is really unpredictable. You earn the right to get out of it and whoever gets there will definitely earn the right to get out of it. They're a good side, MK Dons, that's for sure."
Lambert never came up against Dons boss Paul Ince as a player, but has crossed paths with him as a manager.
"I knew him obviously when I was at Wycombe," said Lambert. "Top lad he is, really top lad. I've had a few conversations with him on the phone - a really nice guy. He's done a brilliant job at MK Dons. He did well at Macclesfield and well at MK and got a massive opportunity at Blackburn - I don't know how many games Paul got there, but it wasn't enough. For somebody just going into the Premier League it simply wasn't enough games to get his stamp on it. He's found himself back at MK Dons and he's doing well there again."


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Triple B Empowerment Commission: has this watchdog got more bark than bite?
You had to admire the members of the Broad-Based Black Economic Empowerment Commission at last week's hearing of the National Council of Province's (NCOP's) Select Committee on Trade and International Relations.
This barely known state entity within the Department of Trade and Industry has a very broad mandate ‑ to monitor, promote and ensure compliance with B-BBEE legislation. When the Act was amended in 2013 it was recognised that what was missing was a monitoring mechanism to track the implementation of B-BEE, which has proved to be an extremely slippery policy to implement.
Commissioner Zodwa Ntuli explained that at the time it was decided that South Africa cannot introduce legislation that "was so critical to the country without anybody monitoring how it was [being] implemented." The establishment of a B-BBEE Commission took a couple of years, but in August 2015 the Department of Trade and Industry established Codes of Good Conduct. That was the trigger and months later, in April 2016, the entity was duly launched under Ntuli.
The B-BBEE A Commission aims to accelerate productive implementation of the law.
She made the point that this had to indeed be "broadbased" in nature as it covered great swathes of business and labour practice. Above all it requires government implementation, said Ntuli. "Government must implement it thoroughly. They must insist it is compulsory [and] obligatory." Government must provide a standard for B-BBEE implementation.
She reminded the Committee that in terms of the Commission's mission the aim was to accelerate implementation, and she emphasised that this must be "productive implementation". B-BBEE must be applied productively in both private and public sectors. "This requires us to look at the market, see how it is working and assist it to work better."
One of her main concerns, she said, is the lack of change in business ownership patterns seen so far, and she raised as one of its most important roles the Commission's duty to investigate non-compliance with the law.
Listening to the Commissioner addressing the Committee you had to marvel at this intrepid band of investigators who single-handedly are expected to take on the scourge of fronting, which remains a country-wide and deeply entrenched practice that South Africa was quick to catch onto when B-BBEE legislation first emerged.
Commissioner Ntuli told the Committee that fronting accounts for 83% of the 334 complaints it has dealt with since its inception. "Although complaints decreased slightly this year, fronting practice remains constant. We find more and more companies' schemes fronting workers through trusts." She added that there were also more opportunistic intermediaries and existing entities creating new 51% black-owned entities through which they do business.
Fronting is not the Commission's only challenge. At the same time it is expected to deal with the challenge of fraudulent B-BBEE compliance certificates including, for example, those supplied by Gupta family-owned companies to Eskom to secure their illicit deals.
The Commission was asked by the DA whether it was investigating the matter, and if so, what the outcomes had been so far. If the combined efforts of the Hawks, SAPS, SARS and the Special Investigating Unit don't yet have much to show for its efforts to expose the questionable dealings of the Guptas, it is surely unrealistic to expect much more of a this relatively new and under-resourced Commission.
The Chairperson indicated that the Commission was well aware of the challenges that it faced. For example, Ntuli said, the Commission has so far withdrawn 100 fraudulent B-BBEE certificates.
She also acknowledged that President Cyril Ramaphosa's new impetus for investment in South Africa required that the Commission had to up the ante to ensure that B-BBEE is enforced, adding that what was critical was how those who held the capital in South Africa were contributing to transformation.
Listening to the Committee deliberations it is clear that a lot is expected of this Commission, far more than tracking down dodgy B-BBEE certificates. Despite the in-principle support for black economic empowerment by South African industry, and government, challenges persist in lack of political will, shortages of skill, opportunity and resources, as well as outright fraud and corruption. Implementing and enforcing B-BBEE requires no less than massive socio-economic transformation.
So where does that leave the beleaguered B-BEE Commission, whose official mandate declares it responsible for monitoring, supervising and promoting adherence to the B-BEE Act "in the interests of the public" while receiving complaints, initiating investigations, maintaining a register of B-BBEE transactions – all transaction over R25 million have to be registered ‑ as well as providing annual reports and, for good measure, promoting "advocacy, access to opportunities and educational programmes...good governance and accountability".
The Commission is available to provide advice on transactions, guidance on whether these comply with the legislation, conduct investigations into complaints and generally keep an eye open to ensure that this legislation is being accurately and regularly applied. When it receives complaints and its investigations expose non-compliance, corrective action, usually in the form of fines, are imposed.
The Commission reported a number of instances of fronting, where it learns of employees – many ignorant of the law and therefore left vulnerable – who are being "placed" in senior and managerial positions without receiving commensurate remuneration and other benefits. In such cases, the Commission ensures that the employees are appropriately compensated.
It's a lot to ask, especially of a small relatively new Commission which acknowledges it remains underfunded and is still struggling to find adequate office space.
At the Committee hearing, DA members summed up in one word the biggest problem that this team faces. "Corruption," the DA declared, was the Commission's first challenge, and that included the possibility of corruption within the Commission itself.
Committee members expressed concern about the staff of the Commission being susceptible to being bribed and asked whether they had been vetted and were subjected to regular lifestyle audits.
The Committee also pointed out that breaches of the B-BBEE Act, such as fronting, were criminal offences and members wanted to know why the Commission referred criminal matters to the National Prosecuting Authority (NPA) instead of adopting a multi-disciplinary approach in which the Commission and the NPA worked together from the outset. It also proposed that the Commission work closely with the Public Protector.
The Commission confirmed that it had concluded Memorandums of Understanding (MOUs) with, key stakeholders, amongst others, the National Gambling Board and the Competition Commission. MOUs with the South African Revenue Service (SARS) and the NPA had been negotiated but were still to be signed.
Ntuli noted that stakeholder relations were a priority for the Commission, especially relations with the NPA and the South African Police Services (SAPS) who were called upon to deal with the criminal offences it had turned up. But she pointed out that when the Commission had referred one matter on fronting to the SAPS they had to explain what fronting was to the SAPS official involved.
Busisiwe Ngwenya, Commission Director of Compliance, outlined what has been accomplished since the Commission's inception in 2016:
Advice has been requested from and provided to about 1,700 clients and the Commission has issued 153 letters regarding invalid certificates. Of the more than 200 compliance reports received, 190 have been assessed;
The Investigation and Enforcement programme has handled 334 complaints, 83% of which were about fronting. Altogether 101 investigations were conducted. Findings were issued for 45 cases which included 13 summonses and four cases that had been resolved through Alternative Dispute Resolution (ADR) processes.
The Commission undertook annual awareness events. These included a conference on fronting in 2015/16 and a seminar for verification of professionals in 2016/17. It had done 80 outreach programmes in the provinces and intended to roll out a media campaign to local areas using community radio stations. It had also held workshops with government departments where there had been non-compliance.
It's an impressive start, and every little bit counts. But faced by massive fronting and noncompliance, 100 fraudulent certificates, 13 summonses and four resolved cases suggests that the Commission still has a long way to go.
Additional information sourced from the Parliamentary Monitoring Group
Last modified on Monday, 23 April 2018 12:52
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Traditionis Custodes: An Orthodox Perspective
An interesting reaction to TC from the Orthodox world. I would of course disagree with some of the historical descriptions and theological views asserted below. Nevertheless, the conflict the author indentifies between "the unlimited power and obedience that was given to the bishop of Rome" and "the apostolic rite, apostolic disciplines and apostolic faith" gets to the heart od today's crisis. Perhaps only the Orthodox can fully grasp the sheer audacity of the Novus Ordo: (T)o write the new Liturgy and suspend the old one, is the most impious and daring act that belongs only the most mad of heretics. As for the impact of TC on ecumenism with the Orthodox: (The) Orthodox Church cannot be in communion with those who use unapostolic rites.
Source: "Orthodox Church," On the sorrowful Anniversary…
On the sorrowful anniversary of Rome's separation from the Orthodox Church in 1054, Pope Francis has issued a new directive that restricts the use of the Latin Rite Traditional Liturgy and enables liberal and Marxist Roman-catholic bishops to eradicate the traditional form of worship from their jurisdictions. This coincidence is not an accident. It only proves that the Sacred Tradition cannot survive outside the Orthodox Church, from which Rome and it's followers have separated almost 1000 years ago. The Liturgical abuse of the protestant new rite "Novus Ordo" is the ultimate rebellion against God and His apostolic rites. The Latin rite was slaughtered by the unlimited power and obedience that was given to the Bishop of Rome. Once the reformers captured the See of Rome: the apostolic rite, apostolic disciplines and apostolic faith never stood a chance against the charlatan and his clique. Orthodox Church cannot be in communion with those who use unapostolic rites. Although we are aware that mild and minor Liturgical changes do happen over time, these changes always must act as an upgrade, as an addition. So in time the Liturgy becomes more beautiful and more decorated. But to write the new Liturgy and suspend the old one, is the most impious and daring act that belongs only the most mad of heretics. In year 600, Saint Gregory the Great, the Pope of Rome, wrote a very small and beautiful addition to the Roman Liturgy, Rome's Orthodox Population of that time, which did not believe in absolute power and obedience to the Pope of Rome, almost killed St. Gregory for daring to touch the Sacred Liturgy. In time, Rome's heresies corrupted the faith of the western faithful, and in the 20th century Faithful offered little to no resistance to the most impious and blasphemous Liturgical reform. Even if an angel from heaven would come down and offer us new Liturgy (doctrine), we wouldn't accept it.
Indeed, confirming the above critique is Michael Sean Winters of the anything-but-orthodox (in any sense of the word) National Catholic Reporter. He castigates Martin Mosebach for his "truly remarkable ignorance of actual Catholic teaching." For Mosebach had written:
"Tradition stands above the pope. The old Mass, rooted deep in the first Christian millennium, is as a matter of principle beyond the pope's authority to prohibit. Many provisions of Pope Benedict's motu proprio can be set aside or modified, but this magisterial decision cannot be so easily done away with."
Winters, even if his understanding of recent liturgical history is garbled, replies:
Has he (Mosebach) even heard of the liturgical movement, which began in the 19th century and led to the Constitution of the Divine Liturgy, Sacrosanctum Concilium, at Vatican II? The Council – and several popes previously, including the conservative Pope Pius XII and the reactionary Pius X – were constantly renewing our liturgical forms.
Winters thus champions unlimited papal power over the liturgy against Mosebach – who, after all, is relying on Summorum Pontificum (a papal document from 2007!) and, as we see, is stating what would be considered obvious truth in Orthodoxy. For the NCR of all publications to inveigh against "dissent against Pope Francis' decision" does have a through-the-looking-glass quality about it. But it can't be denied that, in many cases, the champions of TC, the Novus Ordo and Pope Prancis are indeed "the most mad of heretics."
Winters, Michael Sean "Traditional Latin Mass advocates prove Pope Francis was right to suppress the old rite"
Published in Traditionis Custodes
From Benedict's Peace to Francis's War (January 3rd, 2022)
News from St Mary's, New Haven (December 29th, 2021)
"Responses to the Dubia" (December 20th, 2021)
The Spirit of Traditionis Custodes (October 27th, 2021)
News From Rome (October 25th, 2021)


text:
#ifndef QPLACERATINGS_H
#define QPLACERATINGS_H

#include <QtCore/QMetaType>
#include <QtCore/QSharedDataPointer>
#include <QtLocation/qlocationglobal.h>

QT_BEGIN_NAMESPACE

class QPlaceRatingsPrivate;

class Q_LOCATION_EXPORT QPlaceRatings
{
public:
    QPlaceRatings();
    QPlaceRatings(const QPlaceRatings &other);

    ~QPlaceRatings();

    QPlaceRatings &operator=(const QPlaceRatings &other);

    bool operator==(const QPlaceRatings &other) const;
    bool operator!=(const QPlaceRatings &other) const {
        return !(other == *this);
    }

    qreal average() const;
    void setAverage(qreal average);

    int count() const;
    void setCount(int count);

    qreal maximum() const;
    void setMaximum(qreal max);

    bool isEmpty() const;

private:
    QSharedDataPointer<QPlaceRatingsPrivate> d;
};

QT_END_NAMESPACE

Q_DECLARE_METATYPE(QPlaceRatings)

#endif

redpajama_set_name: RedPajamaGithub


text:
How to use this website
Dream It!
About the Research Study
Dream Showcase
Falling Uphill: The Secret of Life
This is the true story about a man who bicycles around the world questing for the secret of life. His journey is full of many wonders, but he eventually returns home discouraged—only then does he discover the secret in the last place left to look.
Fluffy Bunny
Here is an award-winning story by our co-author, Sara, that she wrote when she was in the 4th grade. As you can see, Sara always had the dream to be a children's author. Even as a child, she had impressive talent and took the steps of action to make her dream real. Here is her original story with some new illustrations. Sara credits her fourth-grade teacher with having the vision to guide her through the creative process with lots of exercises all leading up to the final story. She also says that her favorite authors, including Beatrix Potter, Roald Dahl and Lucy Maud Montgomery, were part of her inspiration. I think you'll notice those flavors in her writing style.
We're dedicated to teaching kids how to dream and how to turn those dreams into reality. To do that we use traditional pencil-and-paper games and activities that teach important concepts and put them into action right away — because we all know that kids learn by doing — playing.
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text:
Open Journal of Anesthesiology
Vol.4 No.7(2014), Article ID:47796,6 pages DOI:10.4236/ojanes.2014.47021
A Comparison of the Best Place to Fix Endotracheal Tubes for Men and Women When Men and Women Are in the Same Height
Shahram Nafisi1*, Mehdi Rajabi2, Mohammad Afshar3, Morteza Rashidian4, Mitra Mohammadzadeh5
1Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL, USA
2Department of Anesthesia and Critical Care, Kashan University of Medical Sciences, Kashan, Iran
3Faculty of Nursing and Midwifery, Kashan University of Medical Sciences, Kashan, Iran
4Clinical Innovation Ins Trials, Costa Mesa, CA, USA
5Shahid Beheshti University of Medical Sciences, Tehran, Iran
Email: *nafisish@Yahoo.com
Received 25 May 2014; revised 25 June 2014; accepted 8 July 2014
Background: Comparison of the tracheal tube depth over the same body height of men and women based upon intubation depth markings. Methods: Kashan University of Medical Sciences ethics committee approved the study and written informed consent was taken for each patient. Patients undergoing surgery requiring general anesthesia with oro-tracheal intubation were included in a prospective observational study. After induction of general anesthesia, the endotracheal tube was secured at the point at which the cuff was just below the vocal cord on laryngoscopy. Results: In a statistical study of 682 intubated patients which consisted of 499 women and 183 men, 28 cases of laryngoscopic view grade III and IV were excluded from the study. The measurement markings on the ETT at the level of right corner of the mouth were 20.65 ± 0.13 and 18.52 ± 0.08 for men and women respectively (CI 95%). Patient's height has a meaningful correlation with the measurement of the fixation point of the ETT. Pearson correlation coefficient between the securing point of the tube and height was 0.2 and 0.357 for men and women respectively. In most cases of men and women of the same height, Mann-Whitney U test rejected the hypothesis that the tube can be fixed in the particular point. Conclusions: In general, men are taller than women. Comparing the fixation depth of the tube, even when man and woman have the same body height, the endotracheal tube might be placed in a deeper level for men rather than women.
Keywords:Intubation, Endotracheal Tube, General Anesthesia, Height, Cuffed
Unintentional endobronchial intubations are the most prevalent cause of oxyhemoglobin desaturation during an otherwise uneventful general anesthesia [1] . Various maneuvers have been used to prevent such a complication [2] . One common technique that has been proposed by Owen and Cheney is securing the orally placed endotracheal tubes (ETT) at the upper incisor teeth at the 23-cm mark in men and the 21-cm mark in women [3] . We have noticed that proper positioning of the ETT may be dependent on the height of the patient rather than the gender. This study was designed to compare the points of ETT fixation in men and women of the same height when the upper end of the ETT cuff is placed just below the vocal cords after tracheal intubation.
The study protocol was approved by the Ethics Committee of Kashan University of Medical Sciences, Kashan, Iran, and written informed consents were obtained from the patients.
A total 682 patients (183 were men and 499 were women) were included for the investigation which was performed between February 2004, and November 2008. These patients were scheduled to undergo the following surgical procedures: cesarean section, appendectomy, cholecystectomy, hysterectomy, hernia repairs, and other abdominal procedures. Exclusion criteria included; patients with a history of severe gastroesophageal reflux disease, those with anticipated difficult intubations, and edentulous patients. Patients with grade 3 and 4 laryngoscopic views were excluded from the study as well. Anesthesia was induced with either Sodium thiopental or Propofol. After mask ventilation was achieved, Succinylcholine, or a non-depolarizing neuromuscular blocking drug was administered. Assessment was made of the view at laryngoscopy, as described by Cormack and Lehane [4] . The classification was as follows: grade I = most of the glottis visible; grade II = only the posterior extremity of the glottis visible; grade III = no part of the glottis visible, only the epiglottis visible; grade IV = not even epiglottis visible. Laryngoscopic view of the patients was recorded. The trachea was intubated with a size 7, 7.5, and 8 cuffed SUPA (SUPA C E, Tehran, Iran, PVC tracheal tubes, www.supamed.com) tracheal tube (Table 1). Direct laryngoscopy with MacIntosh 3 or 4 blades was performed by S.N. with the head and neck in sniffing position. After placement of the ETT's upper end of the cuff just below the vocal cords, a second operator inflated the cuff. The fixation point of the ETT at the right corner of the mouth was recorded.
Further confirmation of tracheal intubation was verified auscultation of bilateral breath sounds and symmetric chest expansion.
Patient data are presented as mean (SD). Spearman correlation and Pearson's correlation coefficients were used to determine relationship between patient's height and endotracheal tube fixation depth. The Mann-Whitney U test was used to compare appropriate fixation depth of endotracheal tubes of men and women when they are the same height. Independent 2 sample student's t test was used to check the hypothesis of equal mean depth fixation endotracheal tubes for men and women.
The heights of the patients (Table 2) had a meaningful correlation with the measurement of the fixation point of the ETT. Pearson correlation coefficient between the depth of securing point of the tube and height was 0.2 and 0.357 for men and women respectively (Table 3). Table 4 also shows such a correlation. The mean length of the endotracheal tube tip to the fixation point at the right corner of the mouth when the cuff was just below the vocal cords was 20.65 ± 0.13 and 18.52 ± 0.08 for men and women respectively (CI 95%) (Table 5).
Difficult intubations (the total of grade 3 and 4 laryngoscopic view as defined by Cormack and Lehane [4] ) were most prevalent in cesarean cases. The lowest incidence of difficult intubations was in men. Incidence of difficult intubation was higher in cesareans (Table 6). Of the total 682 intubated patients which consisted of 499 women and 183 men, 28 cases of laryngoscopic view grade III and IV were excluded from the study (Table 7).
Table 1. Criteria of SUPA endotracheal tubes (ETT).
Table 2. Patient height.
Table 3. Correlation between patient's height and endotracheal tube fixation depth.
p < 0.05 considered significant.
Table 5. Fixation depth of endotracheal tubes.
Table 6. Difficult intubation (grade 3 and 4 laryngoscopic view).
Table 7. Laryngoscopic view (Cormack classification).
There was no accidental extubation or arterial desaturation.
Statistical analysis was performed using SPSS version 15 (SPSS inc., Chicago, IL).
Independent 2 sample student's t test rejected the hypothesis of equal mean depth fixation endotracheal tubes for men and women. Mann-Whitney U test in body height range of 160 - 173 centimeters rejected the hypothesis of the same point fixation of the ETT when man and woman are in the same height except when a man as tall as a woman was 173 cm or 164 cm (Table 8).
An endotracheal tube cuff leak usually is obvious and is easily handled, while endobronchial intubation may be more difficult to find out, and can lead to hypoxemia secondary to collapse of the contralateral lung and hyperinflation of the intubated lung with resultant tension pneumothorax [2] . Asymmetric ventilation may be difficult to detect clinically and in most cases there is no change in capnography [5] [6] . In cases with grade 1 or 2 laryngoscopic views to prevent accidental bronchial intubation, we recommend to secure the endotracheal tube at the point at which the cuff is just below the vocal cords on laryngoscopy. This method of securing the endotracheal tubes is useful for patients in whom their head are in neutral or extended positions during the operation. It is not recommended in patients whose head may be flexed during operation.
Some anesthesiologists use the technique of Owen and Cheney [3] of routinely securing endotracheal tubes after orotracheal intubation when the 23- or 21-cm marks are at upper incisor teeth for adult men and women patients, respectively. This technique is also routine in our center. Therefore when a woman as tall as a man is intubated, the tube is secured at 21-cm mark in the woman and 23-cm mark in the man. It may result in subsequent migration of the cuff between the cords, especially for woman if she is tall. In reply to an editorial published in Anesthesiology [7] , professor Cheney accepted it. Also in a man endobronchial intubation may happen, especially if he is short stature. Owen and Cheney did not explain how did they find 23- and 21-cm depth mark for positioning of the endotracheal tubes but they verified it by post-intubation radiography. However, their technique is useful for grade 3 and 4 laryngoscopic view, or in ICU, when frequent documentation of the tube position is necessary [7] . Cherng et al. [8] presented endobronchial intubation occurred in two female patient with body heights of 153-cm and 155-cm when endotracheal tube was positioned at 21-cm mark, but they did not mention that the measurement point was the upper incisor teeth or mouth angle. As far as endotracheal tubes are usually fixed in the right corner of the mouth, we consider the right corner of the mouth as the measurement point rather than the upper incisor teeth.
In this study, we have tried to match men and women regarding optimal tube placement when they were in the same body height. This comparison was possible in height range of 160 - 173 cm in which range that we had the same height men and women. We have found out that in most instances the optimal tube placement was
Table 8 . Comparison of appropriate endotracheal tube length fixation.
deeper in men. The reason may be the length of different airway parts are less in female in comparison with the same height male. In our study, only in body heights of 164-cm and 173-cm, optimal tube placement was exactly the same in men and women when the tube was fixed at the mouth angle. We found only one study [9] comparing a man with a woman of almost the same height in which the man's tracheal length was about 2 centimeter more than the woman and the tube was fixed deeper in the man.
Pearson correlation coefficient in my study shows that there is a positive correlation between height of the patient and depth of fixation of the ETT. Interestingly the correlation between a person's height and the length of his or her trachea is poor [9] [10] , so bigger mouth, oropharynx, and laryngopharynx are the reasons of deeper fixation for the ETT in taller persons [10] . We have not found any study that men and women of the same height are matched for the proper endotracheal tube placement. In all references [11] -[13] the tracheal tubes were more deeply inserted in men because generally men are taller than women.
Tracheal length is less than 11 centimeters in many studies [10] . The length from the proximal part of an endotracheal tube cuff to the distal tip of our SUPA tubes is 7 - 7.5 centimeters (Table 1). Some authors believe that the tip of an endotracheal tube should be positioned close to the mid-point of the trachea [10] , others state that endotracheal tube placement is considered adequate by placing the distal tip of the tube at least 3 cm above the carina [3] -[8] .
If the endotracheal tube be secured at the point at which the cuff is just below the vocal cords on laryngoscopy, its tip has passed a few centimeters from the mid-point of the trachea. So we do not recommend a cuff-free sub-glotic laryngeal zone, and despite the view of Salem [5] , when the tube cuff has been noted to be below the vocal cords on laryngoscopy, even in tall patients, we are not permitted to advance the endotracheal tube further, since it increases the probability of endobronchial intubation that is difficult to diagnose.
This study also compares the incidence of difficult intubation between obstetric group, non obstetric women and men (Table 6).
The power of this study is that during the period of about 5-year data gathering, all patients were intubated by the first author and the technique of intubation and recording of the intubation depth was exactly the same in all patients. Our goal was not to synthesize a formula for fixation of endotracheal tubes. We have tried to compare men and women when they are in the same body heights regarding tube placement and to recommend one more reasonable method of fixation of the endotracheal tubes. Keeping in mind that every patient must be judged individually and the presence of a vigilant anesthetist during intubation and securing the tube must not be ignored.
In conclusion, considering the tracheal length and the distance of the proximal part of the endotracheal tube cuff to its tip, tracheal tubes should be fixed at the point at which the cuff is just passed from the vocal cords.
5. Shortcomings
It was not feasible to provide chest X-ray, or fiberoptic bronchoscopy to check the space of the tube tip to carina of the patients.
In grade III and grade IV laryngoscopic view it was not possible to record the exact intubation depth marking when the tube cuff was just below the vocal cord so these patients were excluded from the study.
The authors thank Dr. Hossein Bovjari, Azad University, Kashan, Iran, for his valuable statistical analysis.
Szekely, S.M., Webb, R.K., Williamson, J.A. and Russell, W.J. (1993) Problems Related to the Endotracheal Tube: An Analysis of 2000 Incident Reports. Anaesthesia and Intensive Care, 21, 611-616.
Engoren, M. and de St. Victor, P. (2000) Tension Pneumothorax and Controlateral Presumed Pneumothorax from Endobronchial Intubation via Cricothyroidotomy. Chest, 118, 1833-1835. http://dx.doi.org/10.1378/chest.118.6.1833
Owen, R.L. and Cheney, F.W. (1987) Endobronchial Intubation: A Preventable Complication. Anesthesiology, 67, 255-257. http://dx.doi.org/10.1097/00000542-198708000-00019
Cormack, R.S. and Lehane, J. (1984) Difficult Tracheal Intubation in Obstetrics. Anesthesia, 39, 1105-1111. http://dx.doi.org/10.1111/j.1365-2044.1984.tb08932.x
Salem, M.R. (2001) Verification of Endotracheal Tube Position. Anesthesiology Clinics of North America, 19, 813-839. http://dx.doi.org/10.1016/S0889-8537(01)80012-2
McCoy, E.P., Russell, W.J. and Webb, R.K. (1997) Accidental Bronchial Intubation: An Analysis of AIMS Incident Reports from 1988 to 1994 Inclusive. Anaesthesia, 52, 24-31. http://dx.doi.org/10.1111/j.1365-2044.1997.007-az007.x
Cheney, F.W. (1991) A Caution on the Use of Routine Depth of Insertion of Endotracheal Tubes: In Reply. Anesthesiology, 74, 962-963. http://dx.doi.org/10.1097/00000542-199105000-00042
Cherng, C.-H., Wong, C.-S., Hsu, C.-H. and Ho, S.-T. (2002) Airway Length in Adults: Estimation of Optimal Endotracheal Tube Length for Orotracheal Intubation. Journal of Clinical Anesthesia, 14, 271-274. http://dx.doi.org/10.1016/S0952-8180(02)00355-0
Chong, D.Y.C., Greenland, K.B., Tan, S.T., Irwin, M.G. and Hung, C.T. (2006) The Clinical Implication of the Vocal Cord-Carina Distance in Anaesthetized Chinese Adults during Orotracheal Intubation. British Journal of Anaesthesia, 97, 489-495. http://dx.doi.org/10.1093/bja/ael186
Eagle, C.C.P. (1992) The Relationship between a Person's Height and Appropriate Endotracheal Tube Length. Anaesthesia and Intensive Care, 20, 156-160.
Roberts, J.R., Spadafora, M. and Cone, D.C. (1995) Proper Depth Placement of oral Endotracheal Tubes in Adults Prior to Radiographic Confirmation. Academic Emergency Medicine, 2, 20-24. http://dx.doi.org/10.1111/j.1553-2712.1995.tb03073.x
Reed, D.B. and Clinton, J.E. (1997) Proper Depth of Placement of Nasotracheal Tubes in Adults Prior to Radiographic Confirmation. Academic Emergency Medicine, 4, 1111-1114. http://dx.doi.org/10.1111/j.1553-2712.1997.tb03691.x
Pollard, R.J. and Lobato, E.B. (1995) Endotracheal Tube Location Verified Reliably by Cuff Palpation. Anesthesia and Analgesia, 81, 135-138.
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Two Karnataka High Court orders later, RGUHS students await revised results – The New Indian Express
The university filed a review plea in court, challenging the revaluation method. The petition was rejected on December 14, but the results have not been announced.
Published: 28th December 2022 08:29 AM | Last Updated: 28th December 2022 08:29 AM | A+A A-
Karnataka High Court.
BENGALURU: The students of Rajiv Gandhi University of Health Sciences (RGUHS), Karnataka, are still awaiting the results of their previous exams with the upcoming exams less than a month away. The university has not released the results even though the students have two Karnataka High Court orders in their favour.
The students had filed a petition in the HC, and on November 9, the court ordered that the results be revaluated and announced.
A case was filed by the students regarding the revaluation methods in exams. The previous evaluation methods would have four evaluators for grading. Their average score was the final grade. Under the new revaluation, the grades of only two evaluators were to be considered.
A third-year MBBS student said he and many others have been waiting for a long for the results. The students are confused since they are unaware of what subjects should they prepare for, in case they have failed.
With the next exams starting on January 23, students have only 27 days to prepare. Students are worried about the deadlines for examination fees and repeaters' fees.
Dr Ramakrishna Reddy, registrar, RGUHS, denied that he has not received any orders from the HC against the review petition filed by them. Hence, he said that the results have not been announced. The revaluation method approved by the court was not ideal, he said, adding that initially, four evaluations were asked to be done, and a week later, two.
However, the students claimed the department has received a copy of the order. They have requested that the result be released as the matter has been stretched over two months, and has resulted in problems for the students.
India and France ink pact for submarine's AIP certification; to be fitted onboard INS Kalvari
Tech industry job cuts come rapidly and in big numbers
BSF women personnel to be part of camel contingent for Republic Day Parade
No entry sent from Pakistan for SCO film festival in Mumbai
Judges are not elected, so can't be replaced but people are watching them: Rijiju
Passenger offloaded from SpiceJet plane at Delhi airport over unruly behaviour
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86% Employees In India May Resign From Their Jobs In Next Six Months: Report – India.com
Tech companies back independent watchdog to tackle online … – Reuters


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Q: The last number is being cut off in my sum total on the status bar When I highlight some cells and want to get a quick SUM that shows on the status bar, the last digit in the # is being cut off.  This just started happening recently.  How can I fix that so that the entire # shows?

A: If you right-click on the bar where Sum appears, you can unselect some of the other functions which should realise you some more real estate.

A: Try right-clicking the status bar, then un-selecting and re-selecting the functions in the order of rightmost displayed first to leftmost. For example, on my system this order is Sum, Max, Min, Numerical Count, Count, then Average. This seems to force the summary statistics to redraw with enough space for all the digits to show up.

redpajama_set_name: RedPajamaStackExchange


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This Week in Travel & Tourism — 11/19/2012
November 26, 2012 R&R Partners	Comment
Travel summit notes rise in demand for exotic destinations
Travel agents and tour operators who attended Ensemble Travel Group's recent Las Vegas conference report that travelers are increasingly being drawn to exotic and off-the-beaten-track destinations. "The hot destinations are Ecuador, the Galapagos, Burma, Cambodia, Vietnam, African safaris. People are going for big-ticket items. It's like they want to spend money now because they don't know how things will be later on," said Judy Ruffini, a regional sales manager at General Tours.
Airlift problems hamper tourism in the Caribbean
Air travel between Caribbean islands usually consists of multileg flights that take several hours. This lack of convenient flight options could be one reason that tourism in the region is not growing as rapidly as hoped, tourism experts say. "Intra-Caribbean tourism is down by 40% in the last five years. Make air travel more accessible — get rid of the visa regulations, make it cheaper — and more people will travel. It changes the equation," said Richard Doumeng, president of the Caribbean Hotel & Tourism Association.
Luxury travel is leaning toward uniqueness, customization
Luxury travelers are increasingly demanding customized trips heavy in out-of-the-ordinary experiences, experts said during Signature Travel Network's Sales Meeting and Trade Show in Las Vegas this week. "We have arranged white-linen banquets on the Great Wall and trips down a tributary of the Li River (Guilin) in bamboo rafts. We take clients to studios of major artists and fashion designers. In Beijing, there's a private $300 million art collection, which people can see, and be taught by the owner how to understand Chinese art," said Margot Kong, a vice president with Imperial Tours in San Francisco.
Survey: Holiday travel spending will rise 12% this year
An annual survey by Allianz Global Assistance USA indicates that holiday travel spending this year will reach $72.9 billion — up about 12% over 2011. Forty-five percent of respondents said they are "very confident" that they will take a holiday vacation this year, compared with 42% in the previous year.
Business travel could benefit from U.S. "fiscal cliff," group says
The impending "fiscal cliff" of expiring tax cuts and reduced federal spending could benefit business travel over the long term, the Global Business Travel Association says in a report. "The elimination of tax cuts and reductions in federal spending would lead to reduced deficits and lower interest rates over the long run, resulting in business travel spending and an overall economy that grows more quickly after absorbing the shock of the fiscal cliff," the GBTA said. However, the U.S. economy stands to lose $20 billion in business-travel spending over nine quarters if the economy goes over the so-called cliff, the group says.
U.S. Travel Association grass-roots program will focus on Congress
The U.S. Travel Association has unveiled plans for a grass-roots initiative that aims to cultivate industry advocates in Congress. "Every congressional district in America can thank travel for jobs and economic activity, so we've designed a program to build our bench of champions in Congress, those members who will stand with us and play offense on policies to protect and stimulate increased travel," said U.S. Travel President and CEO Roger Dow. The Travel Blitz program is set to launch next year.
Norwegian overcomes hurdles to become successful in Hawaii
Norwegian Cruise Line's 10% price increase on Hawaii cruises next year is a big improvement from several years ago, when the line's 2,138-passenger Pride of America was struggling.
Virgin Atlantic gains short-haul slots at Heathrow
Virgin Atlantic said it has been offered all of the Heathrow short-haul slots available following International Airline Group's acquisition of BMI. International Airline Group is the parent of British Airways.
DOT approves Delta's route to Tokyo from Seattle
The Department of Transportation has approved the request from Delta Air Lines to transfer service from one of its two routes between Detroit and Haneda Airport in Tokyo to Seattle. The switch will "open Haneda access to a new region of the country," the DOT said.
African safari, Burma, business travel, Cambodia, Caribbean islands, Delta Air Lines, Department of Transportation, Detroit, Ecuador, Galapagos, Hawaii cruises, Heathrow Airport, holiday travel, luxury travel, Norwegian Cruise Line, Seattle, Tokyo, travel and tourism, Travel Blitz Program, U.S. Travel Association, Vietnam, Virgin Atlantic


Poll: Fixed Long Focal mu43 Lens? If yes ?mm/f?
Discussion in 'Native Lenses' started by noelh, Jun 1, 2011.
Maybe I'm of the fringe. Would like to have the option to purchase a mu43 with ois at 200mm or 300mm. At least f4 preferable f2.8 relatively compact.
I'd love an affordable 300mm.
My all-time favorite focal lengths are in the 85mm to 105mm range for 35mm film cameras. AKA portrait lenses. My all time favorite lens is probably the Zeiss 100mm/f 2.0 for the Contax/Yashika mount.
So, to duplicate this in the mu43 format you would need (as I understand it) something like a 50mm/f 1.0.
Voightlander has released a 25mm/f 0.95 in native mu43 format, so perhaps they will step up and do something in the short tele range that is super fast. I believe the 25mm is selling quite well.
As a workaround I'm thinking of getting either the C/Y mount or OM mount adapater for the mu43. The OM 50/1.4 would probably do pretty much what I'm hoping.
All things equal though, I'd like to have the autofocus capability and other benefits of a native lens.
John speaks for me also.
Anything that converts to 35mm or so.
I'd love anything longer. I like to work in the 50-200 range in 35mm. So a native 50mm 1.2, 75mm 1.2 and 100mm f2. Would suit me perfectly. I can already do the first two with MF (voigtlanders with mto m43 adaptors) but I'd love an AF version.
And the 35-100f2 that works on m4/3 would be incredible. Olympus won't do it though, because they know that would be the end of full 4/3.
A 300mm f/2.8 would be nice even though it would be a large lens and quite heavy (the aperture opening would have to be almost 110mm). Keep it simple, forget OS, such a lens would be difficult to get successuful shots hand-held. Without OS, you will get a more compact and lighter lens with fewer optical elements. Olympus cameras have in-body OS anyway.
I would like to see a 14-35mm f/2 zoom as a walkabout lens and a 35-100mm f/2 zoom as a portrait lens. Add to that a 12mm f/2 and I would be set (to complement my 9-18mm Olympus zoom, 20mm f/1.7 Panasonic and 25mm f/0.95 Voigtlander).
Going through some older photos recently it occurred to me that I never felt limited by my f2.8 or f4 Canon zooms up to 200mm, and more so than any other prime lens, these are the type of m4/3 lenses I want to see next.
Cost and size of a 300mm @ 2.8 makes it just a dream lens to own. Realistically if Pany would come out with f/4 or 5.6 @ 300mm sized (~75-85mm x ?mm, ~500gm) & priced similar to the 100-300mm I would be happy. OIS would not be necessary.
Relatively happy with the 45-200mm. Noticed most the images I take with this lens is at 200mm. The other lens I would like would be a f3.5 or 4.0 200mm with OIS. Would be will to lug around another ~75mm x ?mm, ~400gm lens.
Wondering if a fixed focal lens can be designed like the Oly 9-18mm. Compact when not in use & expanding to functional length when in use?


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Aspirations for an Olympic Moment
I know that I will never be on the U.S.A. Olympic team, but why couldn't I be on, say, the Seychelles team? Or why couldn't I represent the republic of Nauru as the country's sole entrant in curling? I found out today that the Jamaican bobsled team used some crowdfunding to get enough cash to cover their traveling expenses, and the third thing I thought after hearing that was, "Why don't people with too much money pay small nations to let them compete under their flags?" (My first thought was of the film Cool Runnings, and my second was, of course, for John Candy.) I suspect the people who run the Olympics have some rules in place to prevent very rich people from making a mockery of the games, but there's always a way around these administrative procedures. Time to launch my Kickstater page to become the first snowlerblader to take on the downhill course (while flying my Cook Islands flag).
Posted by Rocky at 2:00 AM
About The Liquid Astronaut
Rocky Thompson, a cyclist, copywriter, and former skier is the Liquid Astronaut. He lives in Manhattan and is available for freelance work. Contact: rockycthompson@gmail.com.
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See which players were honored by the Associated Press.
Apple Valley's Tre Jones, this year's Star Tribune Metro Player of the Year, won the Associated Press Player of the Year award along with being selected to the all-state first team announced on Tuesday.
Jones, a senior committed to Duke, averaged 23.1 points, 8.5 rebounds, 6.5 assists and 3.5 steals per game this season. He scored a game-high 35 points in the Eagles' 79-78 loss to Cretin-Derham Hall in the Class 4A state title game.
Raiders center Daniel Oturu also earned first-team honors, along with Minnehaha sophomore Jalen Suggs, Rochester John Marshall's Matthew Hurt and Calvin Wishart of Class 3A champion Delano.
View the three all-state teams below.


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Meet the Doctors | Meet the Team | Office Tour | What Sets Us Apart | History of the practice
Sindledecker Dentistry: Our Legacy
Sindledecker Dentistry really began in 1969 when Larry and Maxine Sindledecker tied the knot. The dental practice emerged in 1975 in Boca Raton on Camino Gardens Boulevard. In 1985, the couple purchased the First Unitarian Church on Palmetto Park Road. It was converted to a dental facility, which has been modernized and decorated numerous times to reflect a professional image of cleanliness and excellence.
Larry Sindledecker, DDS, was a board-certified prosthodontist and implantologist. He received his dental degree from the Ohio State University and a master's degree from the University of Michigan. He was a fellow of the American College of Dentists and was honored by many national, statewide, and local organizations for his skill and as an educator in the field of oral reconstruction. He was an excellent dentist and devoted father and community member. Though he passed away in 2005, his work lives on.
Dr. Maxine Sindledecker graduated from the University of Michigan School of Dentistry in 1975, which truly was pioneer times for women in dentistry. She was appointed by the governor as the first woman dentist on the Florida Board of Dentistry and served from 1984-1988. She taught at the University of Florida when they began their dental college, and she served on the Governor's Task Force for Domestic Violence.
Practicing general dentistry and cosmetic dentistry for 45 years and raising three children was no small task. She was a fellow of the American College of Dentists and helped to shape the futures of dentists through mentorship.
The most famous dentist she mentored was Dr. Amanda Sindledecker, who learned from her mother and father's work from a very young age, and spent a good deal of time both observing the way they treated patients and the techniques they used. To this day, she continues to see their work in the smiles of their many satisfied clients.
The Sindledecker Legacy lives on!