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National Monument Wyoming
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A Closer Look at Devils Tower
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Hi! and Welcome to Devils Tower educational programs!
One of the things that I think is so fantastic about Devils Tower National Monument is for its small size there is so much variety here ecologically speaking, there is the Upland communities, the Ponderosa Pine Forest, the tower itself, the low-land communities, the Riparian areas near the Belle Fourche River, there's just so much variety.
My favorite animals are the ones that are most elusive, the ones that we don't see very much of. They're a little bit more shy, some of the nocturnal species, Probably. One of my favorites is, of course the mountain lion. Always looking for signs of mountain lion, And it's exciting that we're putting up some trail cameras throughout the park looking for some of those different species that we don't tend to normally see. A lot of times you put up with trail cameras and you see a lot of White-tailed deer but we're excited that we've documented fifteen species this year on our trail cameras.
Geologically speaking, this area is really awesome, There is so much to see. Right away when you come to the park, besides seeing the Tower as you come up the highway, you'll probably see the red beds. It's really bright red, the red beds also known as the Spearfish formation. It's really unique in the fact that it dates back to the Triassic period which is older than the oldest dinosaurs. The obvious thing is the Tower and it's made of phonolite porphyry, an igneous rock. It's just awesome to see.
The excitement of Devils Tower, the adventure of Devils Tower is that it's a traditional climbing area. A lot of climbing areas are bolt protected, that's masonry fastening devices we put into the climb, and we create where the path goes by putting the bolts in there And it's great, it's good athleticism. But here, there's something that you connect with on a deeper level. You're climbing these cracks that are millions of years old and the cracks dictate the protection that you have.
The American Indian experience is integral to understanding the cultural importance of Devils Tower. Learning about American Indian history and perspective, helps visitors truly appreciate Devils Tower as a sacred place.
We offer two varieties of educational programs here at Devils Tower, one is when you come to the Tower we have the opportunity to actually show you the Tower and take you on guided hikes, and give you presentations right here on site. The second opportunity is especially for those limited to actually getting here, is coming to your class room, we'll bring the program to your classroom, we'll bring Devils Tower to your classroom! We offer a variety of presentations for you, the teacher, and the students. We can tailor make a presentation to fit your needs. We're really excited about doing that! And even if you're not in school and you happen to be out here, organized groups, we can take you on trail hikes, we can show you the Tower, we can tell you stories...
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4 minutes, 44 seconds
Your outdoor guide to Devils Tower
There are several things that climbers should know, in order to make the best out of their climbing trip at Devils Tower. As with any place, researching your climbing destination and planning before you get there makes for the best experiences.
This video is going to briefly discuss topics that can better each visitor's experience at Devils Tower.
People have been climbing the Tower before Theodore Roosevelt declared it a national monument.
In 1906, the summit was first gained in 1893 by two ranchers William Rodgers and Willard Ripley who hammered wooden stakes into a crack to produce a ladder. In 1937 Fritz Weissner made the first ascent of the tower using modern climbing technique.
The following year Jack Durrance made the second ascent. Since then two hundred and twenty routes have been established on the tower. Today we see almost 5,000 climber days per year. Climbing and picnic gatherings over the past one hundred and thirty years are only a small part of the human history at the Tower. Archaeological evidence suggests that Native Americans have been coming to the tower for over ten thousand years. Today there are at least 24 tribes that have a cultural connections Devils Tower and traditional ceremonies will take place in the area. The month of June is important because of the summer solstice when many Native American ceremonies take place climbing the tower is considered disrespectful especially during June.
"This is before the tower was even formed the Lakota people were camped near Devils Tower. Some children who were playing they noticed that there were some bears that came, they ran, a voice came and told them just to stay where they were at they were surrounded by the Bears, as they stood there the ground that they were standing on started to rise. The Bears were clawing at the sides to try to get to the children. They were so high and out of reach when it finally stopped then the children were wondering all day we're gonna get back down same voice came and told them that you know well there's gonna be some birds that came and would fly around the tower they would be able to get on the backs and that was how they got back down to the ground. Mato Tipila, and to us it's a sacred place."
Our climbing management plan and Access Fund strongly promote a voluntary June closure. The closure aims to reduce the number of people entering the inner circle of the tower trail during the month of June. This is a compromise between the Native Americans and the climbing community out of respect for other cultures. I'm sure that the tribe's not only the Lakota tribes but all the tribes who have an interest in Devils Tower with their ceremonial appreciate that very much.
The National Park Service asks that all climbers choose not to climb during the month of June. However, this is at the climbers discretion. The increase of popularity in climbing brings to the foreground the environmental impacts. Visitors can hear you as well as you hear them so be aware of your noise levels. We ask that all climbers stick to existing trails when approaching the climbs and when on the meadows and summit. If you pack it in please pack it out! This includes bodily functions. Bags can be purchased at the visitors center. We want all visitors to practice leave no trace ethics. Each year we close a section of the Tower to promote prairie falcon nesting. Devils Tower is part of their habitat so please observe all closures and find out ahead of time if closures are in effect so you are not disappointed when you get here.
Report any wildlife habitats that you come across to a ranger so we can protect both visitors and the wild life. Your safety is your responsibility helmets are highly recommended because nesting birds and chipmunks from above may knock rocks down. Plan ahead and know the expected weather forecast.
The weather can change quickly in your view of the changing weather can be blocked by the tower. Be aware of the temperature and wind changes. Storms here tend to produce violent wind, lightning, downpours, and large hail. Have information about several routes before getting to the tower. There are often many parties lining up to climb the same route. Plan ahead and know the decent route well, including the length of ropes needed, anchor location and the number of repels. You will often take a different route down. There are only five decent routes. Pay close attention because pitches are long and require two ropes to repel. Repel on the column face and not the crack to prevent getting your rope stuck, which is a common problem here. It takes multiple repels so please look for anchors while repelling and watch for the end of your ropes. We want you to climb with us again and again!
It is mandatory that all climbers and people that wish to ascend to the base register beforehand and that they check back in after climbing. Registration allows us to keep accurate statistics for better management. There are two parts of this card that you will fill out. This larger part is completed before hand, take this smaller part with you and return it after climbing. During peak season registration takes place at the climbing office, where you will also find route descriptions for the Tower and other nearby climbing areas. If the office is closed there's a plaza kiosk near the trailhead with the drop box where you can self register. During the winter season registration takes place in either the visitors center or the kiosk. All visitors are responsible for complying with park regulations.
Some of the basic rules in which you should be aware of are as follows: Please do not leave behind any gear or fixed lines. No new bolts without permission. No trundling or route cleaning. Camp only in designated campgrounds, abide by posted speed limits, smoking is not permitted on any trails, or the tower itself. Pets are not allowed on the trails or at the base. No open alcohol containers except in designated campgrounds and picnic areas.
The park does not have guided tours to the top. There are several guide services that will take new and experienced people climbing. They have all the equipment and are a great resource for inexperienced climbers. There is a list of guides that have commercial use permits in the climbing office. Further information can be found on their websites.
Most accidents happen on repel, stuck ropes are very common here. Please use caution. Rescue is not guaranteed. Please try to leave a favorable impression of climbers in the minds of other visitors. Racking up in the parking lot will draw lots of attention, Stowing gear in a pack, will reduce the endless questions asked by visitors unfamiliar with climbing. Devils Tower is a fantastic place to climb with quality rock and perfect cracks. With your cooperation you can ensure that climbing up the tower will be enjoyed by future generations!
Things Every Climber Should Know Before Climbing Devils Tower National Monument
Here at the Tower, we have two main types of rock, we have the sedimentary rocks that are all around the tower and the rock of the tower itself.
This is our beautiful rock from the tower it's called Phonolite, Phon-o-lite. A lot of people when they look it they think it looks a lot like granite, and it is kind of a cousin of granite but it doesn't have any quartz crystals. And to be granite you have to have quartz crystals, all of these shiny white crystals are actually feldspar. In between some you see some tiny black crystals and also a whole bunch of gray area both the black crystal and the gray area are rich in iron and as they rust they give the tower its color
There have been three accepted theories around for quite a while one is called a stock and that would be just a big blob of rock that kind of stopped underground was about the shape the tower is now but somewhat bigger and that would be called as I said a stock
The next theory is that it came up and found a weak layer still well underground and moved out into that layer and kind of blew up until it became a mushroom shaped big hunk of molten rock that geologists call a laccolith.
The third theory is that it came up and then above the tower there would have been a pipe that goes all the way to the surface, and remember the surface at this time could have been as much as a mile and a half above. Up there you would have had eruptions and the big cone and all that kind of stuff, but that is not where the tower was, the tower was down in the plumming, and that would be called a volcanic plug.
A new theory has come out and that involves ground water. The idea is that when the hot molten magma came up it would find water underground, which happens a lot. When this hot molten rock hit that water it formed a huge amount of steam, which exploded a big pipe and a crater on the surface. And then after things calmed down a bit the rest of that molten rock came up from below, up that pipe that was made weak by the explosion, and cooled in the bottom of the crater, so in this theory the rock would be on the surface right from the beginning, however it would be at the bottom of a big crater, so not at the land surface,
You may have noticed in pictures of the tower that it has columns, how did those columns get created? Well that is part of the cooling process. When you have a big mass of molten rock it starts to cool from the surface and on that surface it will start creating crack pattern, molten rock occupies more space then solid rock does so it has to shrink, and you can imagine that if you have a huge piece of molten rock and it you start to cool it everything starts to shrink from everything else and you will develop a crack pattern.
You may notice that we have a boulder field, and that is from pieces of the rock that have fallen off through the millennia, we do lose a couple of boulder each year they tell us, they bring them down when there is no one around to get hurt by them, but the last time a full column has fallen they say is maybe 10,000 years ago.
A lot of folks want to know what's on top?
The top is fairly flat, a little bit domed from the center and through the years it has developed some soil and actually has plant growing up there, grass is the most common thing but you also have things like cactus, sage brush, and goose berries not only do you have plants you also have animals, there is a whole bunch of small rodents like chipmunks, mice, and wood rats. And whenever you have a banquet like that you have something that likes to eat it so we have snakes up there as well, and of course the birds and the bugs.
5 minutes, 6 seconds
A more in depth look at the Geology of Devils Tower National Monument.
"The Lakota people were camped near Devils Tower, some children were playing, they notice that there are some bears that came, they ran, a voice came and told them just to stay where they were at they were surrounded by the Bears. As they stood there the ground that they were standing on started to rise, the bears were clawing at the sides to try to get to the children. They were so high, and out of reach, and when it finally stopped then the children were wondering how they were gonna get back down. The same voice came and told them that you know well there's gonna be some birds that came and would fly around the Tower. They would be able to get on the backs and that was how they got back down to the ground. Mato Tipila. And to us it's a sacred place."
1492, you had sixty million. Then by the turn of the century you were down to less than 500. Something wrong with that picture. The only way for the whites (the settlers) to beat Indians, was to totally eradicate their food source and their way of life, and that's what they did. Which is tragic, it's heart breaking. As far as the bison, it's definitely a sign to me, he is American, he is us, he is who we are, because without them we would have been nothing. He was our food source, he was our homes, he was everything. They're majestic.
"We were even threatened in the twenties and thirties that they were gonna send us to jail if we danced. When they made us stop the sun dance, we're the only southern tribe that had the sun dance. Like our Norden brothers do. but the government made threats, made us stop."
"I had two Chippewa friends, they spoke their language and of course I was their friend, and I was with them when they got caught speaking their native language, and I was punished along with them. They put us in a linen closet. We had bread and water for five days, but we had fun in there, we made our fun. We found an old blanket, and we unraveled the big strings. Made all kinds of new designs. They had a tournament, and we won the tournament, the basketball tournament! But because we were Indians we couldn't get the trophy. They gave it to our leisure."
"Devils Tower, is the first place any Kiowa goes when they go North. It's a must. From every Kiowa I've ever spoken to. Have you ever been to Devils Tower? Because somehow in our thinking that once you've been there you're really Kiowa, because we had experiences there with the rocks talk to us, and that's the main place we have references to everything there, and when I went with my elders, my co-elders we made sure that we had prayer there, and just some place you go.. You have to do it in your lifetime. Grizzly Bear Lodge."
"A lot of our sacred sites, historical sites, have been practically destroyed Respect for these, don't disturb, don't destroy, don't discredit, don't displace. It was I advocate."
"My biggest fear is that if this is shared with people that after we're gone people aren't going to know what that meant to us. Because they haven't shared the stories with their children."
Devils Tower is associated with many Native American tribes, it has a very interesting history and culture surrounding it.
Prairie dogs are with groups called coteries. Coteries consist of one to two females and a male with several yearlings. The organization is pretty complex they have something different boroughs that they use for different purposes, and harbor the whole family within. The population of prairie dogs in this area is pretty isolated there are no prairie dogs in this immediate area and so the population here at Devils Tower is really important to conserve the species. We'll find the prairie rattlesnake here, he is pretty prolific here, pretty much the only venomous snake in the black hills is the prairie rattlesnake. But the rattlesnake is not anything to be feared, he's more afraid of you than you are of him, and he will avoid you at all cost. He's not out to get you, he's not going to fall out of a tree on your head, he's not gonna chase you down the trail.
When you visit Devils Tower National Monument the most common animals you're probably going to see for wildlife are deer and turkeys... and raccoons. Deer have pretty interesting personalities you get on you watch them they're so common that we forget to sit down and observe them, and watch and appreciate them for what they are, but if you sit down and be quiet, you can just really enjoy them, they are very graceful, very curious pretty funny as well at times. It's a mix of Western and Eastern species of plants. The best conservation for wildfires we can do is reducing the amount of invasives. Come check out our wild flowers next spring! The top of the tower is about the size of a football field about an acre in size and is relatively flat. It's rocky and dry lot more mesic than the rest of the tower. It's mostly grasses and sagebrush up there. Something really cool about top of tower is that there's Wyoming big sagebrush that grows up on the summit and that's pretty cool because you don't really find Wyoming big sagebrush anywhere else in the rest of Monument. So it's a neat little endemic spot that we have within the Tower itself.
Turkeys that we have here at Devils Tower are of the Southwestern variety. The characteristic of the Southwestern subspecies is the really light color of the tips of their tails you can hear them clucking and chuckling throughout the spring when they're breeding. Bald Eagles come in the winter time and they migrate here and they fish along the Belle Forge River. We have prairie falcons, peregrine falcons, and American kestrels. All these birds can breed at the Tower, we have had both prairie falcon and paragon falcons nest on the monument. The most common raptor you'll probably see is the turkey vulture. They are often seen hovering around the Southwest corner of the Tower.
There are many exotic plant species at Devils Tower and some of the most problematic of those are the ones that are perennial, and those are the ones that come back year after year, these plants are predominately rhizomatous. Which means that they spread through their extensive root systems. One exotic plant that we have here that is extremely problematic is leafy spurge. And leafy spurge was introduced as an ornamental plant, back in the 1800's people thought it was beautiful and they planted it and now it is spread. It's extremely invasive it out-competes native plants and that's why it's a problem.
Park visitors can help us to control the spread of invasive plants by looking for seeds that may have attached themselves to their clothes or their backpacks instead of picking those seeds off and on tossing them on ground, Put those in the nearest trash receptacle. As a park visitor you can just be aware what seeds are picking up and spread them to other places, you can certainly do your part.
"I help reduce the amount of invasive plants that we have here at the Tower, I do a lot of herbicides spraying have bio controls which is using other insects to control the plants. We also do manual control which involves seed, head clipping, and pulling of invasives. So this is common mullein this plant can produce up to 200,000 seeds in the environment. One plant can do that. And also the seeds can remain viable in the soil for over a hundred years. So it's really important that we try to collect all of the seed heads."
Prescribed fire is a necessary resource management tool. As people began to settle the western United States, we suppressed fire but in the process because we suppressed fire, fuels built up on the forest floor and what happens now is that there's lightning strike, sometimes those fires can be extremely catastrophic so one tool that we used to manage this we can set prescribed fires, so that we know exactly when the fires going to happen, we can light it under a more controlled circumstance. Fire releases nitrogen back into the soil, the new regeneration that comes back is green and healthy.
Porcupines are rodents, and we find them throughout the park, But they primarily like trees. They're very good climbers, the North American porcupine is a fantastic climber. They're herbivores, they eat leaves flowers and forbes, in the winter time they'll often eat bark and so you'll see their chew marks on trees kinda low to the ground. Sometimes you'll see those chew marks up high in a tree if there's a place where the porcupine has been able to sit on a branch and access the bark. Then you'll see those chew marks there.
One of things that I think is so fantastic about Devils Tower National Monument is for its small size there's really so much variety here ecologically speaking. There's the upland communities, the ponderosa pine forest, the Tower itself, the lowland communities, the riparian areas near the Belle Fourche river. There's just so much variety.
A brief description of the variety of eco-systems, and animal life here at Devils Tower.
Every year, over 5,000 climbers come to Devils Tower; Devils Tower is seen as one of the premier crack climbing locations in the world. Climbing has a long history at Devils Tower. Starting with William Rogers and Willard Ripley and their stake ladder in 1893.Which they used to summit the Tower on July4th. This event drew spectators from all over Wyoming and South Dakota.
In 1895, Linnie Rogers, William Roger's wife, was the first woman to summit Devils Tower, using her husband's stake ladder. In 1937, Fritz Weissner and his team completed the first non-ladder ascent using modern mountaineering techniques.
In 1938, Jack Durrance pioneered the Durrance route, which is still one of the most popular routes on Devils Tower. In 1941, George Hopkins a daredevil parachutist landed on the Tower and was stranded for six days, Jack Durrance and a team of eight other climbers were able to rescue Hopkins on the sixth day. In 1952, Jan Conn and Jane Showacre completed the first female only summit at Devil's Tower.
Today, Devils Tower continues to draw climbers from around the world. The excitement of Devils Tower, the adventure Devils Tower is traditional climbing are. A lot of climbing areas are bolt protected that's masonry fastening devices we put into the climb. We create where the path goes by putting the bolts in there. It's great, it's good athleticism, but here there's something that you connect with on a deeper level. You're climbing these cracks that are millions of years old and the cracks dictate the protection that you have so might be a little bit run out, or might be gear every few inches, but it makes it unique.
Devils Tower is great for climbing because it's crack central! There's not too many places like this in the world where there's almost 250 cracks to climb within a mile walk, it's all in the same area so you can walk around in a circle and have that many amazing crack climbs available to you.
So I grew up here in Crook County, half hour away from Devils Tower. The first day I climbed this was September 22, 2001. I'll remember, because it kindof changed the direction of my life. I was going to college, had a friend of mine whose dad took people climbing, and said "Hey would you like to join us to go climb behind Mt. Rushmore?" That went good, he said "Let's go climb Devils Tower in a few weeks" Went up with five other people, we were the typical go up the Durrance Route with dragging bags and a bunch of people just congesting everything. But it was done in about eight magical hours, I was also the guy with the T-shirt at the very end that said "I climbed Devils Tower" even before I hit the Tower trail.
When I first climbed Devils Tower, it was in the 80's, and we came here and climbed it, and it was about making it to the summit. In subsequent visits to Devils Tower, I've sought out more difficult routes, and routes that have that characteristic nature of Devils Tower which are the cracks and the stemming.
This place is just special, the unique factor of where it's located, in the middle of nowhere, along with what type of climbing it represents really long sustained traditional pitches, just puts this in a classic category a place you can get a good climbing experience at all grade levels.
If you're interested in climbing Devils Tower, make the drive out here, visit beautiful Crook County Wyoming, Check in with the Rangers, Register before you go up on the climb so you know where you're at, and they can count how many people are climbing, it's a really key part of it, and then be prepared, it's adventures climbing, its traditional climbing, you'll be placing your gear and skills like this fist cracks, off-wits, are all very much required here. You're not going to get to the top without being able to climb some sort of wide crack, so have the appropriate equipment and protection and make sure that you're well within your ability.
Definitely be prepared, even though it is really accessible from the road, you want to be aware that weather moves in fast, you got to treat it almost like a mountaines weather terrain. Just the nature of where it comes from, sometimes the rock can block that off. The weather is the number one factor Always bring two ropes, one rope is just gonna get you in trouble, and bring as much gear as you have, because different routes require different things and they're long pitches.
In the spring, be sure to check in at the climbing office, to find out which routes are closed due to prairie and peregrine falcon nesting. And remember there's a voluntary climbing closure during the month of June, out of respect to Native Americans who worship here at that time. Please be sure to fill out the registration form, this is important in keeping track of how many climbers we have, and who was on the Tower at the given time. Be sure to look at the back of the card, to confirm the rules and regulations of climbing at Devils Tower
We welcome you to Devils Tower; we look forward to climbing with you.
A brief history about climbing Devils Tower.
Devils Tower, WY 82714
Devils Tower National Monument Visitor Center Phone Number


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Review of patient-reported outcomes in periprosthetic distal femur fractures after total knee arthroplasty: a plate or intramedullary nail?
Dustin Rinehart ORCID: orcid.org/0000-0002-5848-658X1,
Tyler Youngman1,
Junho Ahn1 &
Michael Huo1
This study reviewed the literature regarding the patient-reported treatment outcomes of using either open reduction and internal fixation (ORIF) with a plate and screw system or intramedullary nail (IMN) fixation for periprosthetic distal femur fractures around a total knee arthroplasty.
A total of 13 studies published in the last 20 years met the inclusion criteria. The studies included 347 patients who were allocated to ORIF (n = 249) and IMN (n = 98) groups according to the implants used. The primary outcome measures were the Knee Society Score or the Western Ontario and McMaster Universities osteoarthritis index. The secondary outcome measures included knee range of motion and the rates of complications, including non-union, malunion, infection, revision total knee arthroplasty, and reoperation. Statistical significance was set at P < 0.05.
The mean Knee Society Scores of ORIF and IMN groups were 83 and 84, respectively; the mean postoperative range of motion of the knee were 99° and 100°, respectively (P < 0.05); the non-union rates were 9.4 and 3.8%, respectively (P > 0.05); the malunion rates were 1.8 and 7.5%, respectively (P < 0.05); surgical site infection rates were 2 and 1.3%, respectively (P > 0.05); the reoperation rates were 9.6 and 5.1%, respectively (P > 0.05); and revision rates of total knee arthroplasty were 2 and 1%, respectively (P > 0.05).
Based on the patient-reported outcome assessments, both ORIF with a plate and screw system and IMN fixation are well-accepted techniques for periprosthetic distal femur fractures around a TKA, and they produce similar functional outcomes.
The incidences of periprosthetic fractures (PPFs) are on the rise around the globe. The reported incidence of PPFs around a total knee arthroplasty (TKA) stand at somewhere between 0.3 and 2.5% [1,2,3]. The risk factors include advanced age, diabetes, elevated body mass index, female gender, and anterior femoral notching during the index procedure [4]. The incidence is expected to increase as more TKAs are being performed annually, and the patients continue to live longer with their TKAs [5]. In addition to the cost associated with the management of PPFs, increased morbidity and mortality also pose challenges [6].
The management of PPFs around a TKA demands significant resource input and incurs high healthcare costs [7]. Moreover, most PPFs require surgical intervention [8]. The surgical options include external fixation, open reduction and internal fixation (ORIF) with a plate and screw system, retrograde or antegrade intramedullary nail (IMN) fixation, and the use of a distal femur replacement (DFR) [9]. Currently, there is no consensus regarding the most effective and safest treatment alternatives. The goals of the treatment include early full-weight bearing, independent ambulation, regaining of adequate range of motion of the knee, and minimal morbidities and complications [10].
Currently, there are no physician-directed or patient-focused outcome measurement scale or instruments specifically designed or validated for PPFs around a TKA. In fact, many published reports did not include the functional outcome assessment [11,12,13]. In TKA, the commonly used assessments include the Knee Society Score (KSS) and the Western Ontario and McMaster Universities (WOMAC) osteoarthritis index. Both scores can be used for assessing the success or failure of TKAs [14, 15].
The purpose of this study was to review the available publications over the past two decades, which included the patient-reported treatment outcomes of distal femoral PPFs around a TKA. The aim of the study was to determine if there were differences between ORIF with a plate and screw system and IMN for periprosthetic fractures around a total knee arthroplasty.
We conducted a literature review by using the key terms "periprosthetic", "distal femur", "total knee arthroplasty", "plate", and "intramedullary" in PubMed. A total of 24 articles published between January 1, 2000 and January 1, 2020 were retrieved and reviewed for selection. We excluded the systematic reviews and meta-analyses (n = 11). We finally included 13 studies for extraction of the relevant primary and secondary outcome measures (Fig. 1). The primary outcome measures were the postoperative patient-reported data consisting of either the Knee Society clinical rating system (KSS) or the Western Ontario and McMaster Universities osteoarthritis index (WOMAC) [16, 17]. The secondary outcome measures included knee range of motion (KROM) and the postoperative complications requiring a reoperation.
Flowchart diagram of 24 studies
The fracture patterns were classified as Rorabeck-Lewis Type 1/2, AO/OTA 33-A1/2/3, Su Type 1/2/3, or Neer Type 2/3 [18]. The type of fracture against each classification system represented a displaced fracture around a stable femoral component of the knee. Because of possible individual variations, the fractures were fixed with either a locked plate and screw system (ORIF group) or an IMN (IMN group).
Descriptive statistics were used to represent the patients' demographics and outcome variables using the average for continuous variables and frequencies. Percentage values were used for the categorical variables. Pooled averages of the continuous variables were calculated by summating the product values of the means and the study populations from each study. Frequency of the complications was presented as percentages cited in each study. P values were calculated on the categorical data utilizing the chi-squared and the Fisher tests. A P < 0.05 was considered statistically significant. The P values could not be calculated on the continuous variables such as KSS scores and the knee ROM given the insufficient data in the literature.
The population data are summarized in Table 1. The pooled patient variables of ORIF and IMN groups are shown in Table 2. The ORIF group consisted of 11 studies (249 patients) [19,20,21, 23,24,25,26, 28,29,30,31]. The mean age was 71.7 years, and 84% of the patients were female. The mean follow-up period lasted 3.6 years. The mean KSS score was 83, the mean WOMAC was 49.5, and the mean knee range of motion was 99°. The IMN group contained 6 studies (98 patients) [20, 22,23,24, 27, 28]. The mean age was 70.6 years, and 78% of the patients were female. The average follow-up period was 3.6 years. The average KSS score was 84, and the mean WOMAC was 37.1. The mean knee range of motion was 100°.
Table 1 Overview of study population of each included study
Table 2 Pooled patient variables by treatment group
The reported complications in the studies included nonunion, malunion, infection, implant failure, loss of reduction, reoperation, and revision TKA (Fig. 2). The ORIF group had higher rates of nonunion (9.4%), infection (2.0%), loss of reduction (3.8%), and reoperation (9.6%). The complication rates of IMN group were 3.8, 1.3, 0.0, and 5.1%, respectively. There were no significant differences in the rates of nonunion, infection, loss of reduction, and reoperation (Fig. 2). IMN group had a significantly higher malunion rate (7.5% vs. 1.8%, P = 0.005) and implant failure rate (5.0% vs. 0.6%, P = 0.04), compared to ORIF group.
Complications of open reduction and internal fixation (ORIF) and intramedullary nail fixation (IMN) groups
For fixing periprosthetic fractures around a total knee arthroplasty, both open reduction internal fixation with a plate and screw system and intramedullary nail fixation produce similar results in terms of Knee Society Scores, Western Ontario and McMaster Universities Osteoarthritis Index, and knee range of motion, as well as the complication rates and functional outcomes of the knee.
The patient-reported outcome assessments are important factors for determining the success and limitations of an intervention. These outcomes are routinely assessed by the patients who have undergone TKAs. The KSS and WOMAC scores are among the most commonly used instruments before and after TKAs. The KSS has previously been validated in total knee arthroplasty patients [15, 32]. It combines both patient-reported responses and surgeon-administered assessments. Higher KSS scores indicate better outcomes [33, 34]. The Western Ontario and McMaster Universities Osteoarthritis index is also validated for assessing pain, stiffness, and the physical function. Higher WOMAC scores are indicative of worse outcomes [35]. Miner et al. [36] demonstrated significantly worse WOMAC scores 1 year after TKA, and the knee movement was less than 95° of flexion, compared to the knees with greater flexion.
The ORIF is a well-established surgical technique for the treatment of distal femur fractures caused by either an acute trauma or PPFs around a TKA, but the clinical outcomes are not uniformly satisfactory [37]. Bezwada et al. [20] compared a cohort of patients treated with ORIF to another cohort treated with IMN fixation. They demonstrated that there was no difference between the two cohorts in the KSS score or knee ROM. They, therefore, recommended the treatment should be determined according to the surgeon's choice and experience. If the femoral component is of the PS design with a closed intercondylar box, most surgeons will choose ORIF rather than IMN fixation. In addition, if there is a pre-existing total hip femoral stem or other implants in the medullary canal, ORIF with a plate and screw system is more likely selected. Bae et al. [26] conducted a sub-group analysis using either locked plates or non-locked plates to treat PPFs around a TKA. They reported no difference in KSS or knee ROM. The patients treated with non-locked plate had a higher nonunion rate. Our data also showed that the nonunion rate of ORIF was higher than that of IMN fixation, but no statistical significance was found due to a small sample size of patients. The malunion rate of ORIF was lower than that of IMN fixation, because ORIF could achieve a more rigid fixation. The reoperation rates were similar because the small sample size produced a statistical bias.
In TKA, the IMN fixation is partially limited by the femoral component design. In addition, the position of the femoral component may also limit the entry point for a retrograde IMN [38]. Our data demonstrated that the failure rate of IMN fixation was higher. Shin et al. [39] reported that the mismatch between the diameters of the retrograde nail designs and the distal femoral metaphysis of the femur may compromise the stability of fixation, especially in the elderly patients with osteopenic bone quality. The IMN fixation is generally a less invasive procedure, which may be associated with higher KSS scores and knee ROM, compared to ORIF. However, the malunion rate of IMN fixation was higher. Pelfort et al. [40] reported that 23% of patients in their series had more than 10° of extension deformity. A mid-term follow-up showed that the malunion, however, did not adversely affect the clinical outcomes of the patients.
Limitations of this study include the lack of available literature over the past 20 years addressing this topic with inclusion of patient-reported outcome measures. Further study is needed with larger sample size to avoid statistical bias. The study is also limited by the fact that the continuous variable of the pooled analysis could not be statistically compared due to the paucity of the reported data throughout.
Based on the patient-reported outcome assessments, both ORIF with a plate and screw system and IMN fixation are well-accepted techniques for PPFs around a TKA, and they produce similar functional outcomes.
All data derived from previously published studies.
Kim KI, Egol KA, Hozack WJ, Parvizi J. Periprosthetic fractures after total knee arthroplasties. Clin Orthop Relat Res. 2006;446:167–75.
Parvizi J, Jain N, Schmidt AH. Periprosthetic knee fractures. J Orthop Trauma. 2008;22(9):663–71.
Ricci WM. Periprosthetic femur fractures. J Orthop Trauma. 2015;29(3):130–7.
Canton G, Ratti C, Fattori R, Hoxhaj B, Murena L. Periprosthetic knee fractures. A review of epidemiology, risk factors, diagnosis, management and outcome. Acta Biomed. 2017;88(2S):118–28.
Della Rocca GJ, Leung KS, Pape HC. Periprosthetic fractures: epidemiology and future projections. J Orthop Trauma. 2011;25(Suppl 2):S66–670.
Jennison T, Yarlagadda R. A case series of mortality and morbidity in distal femoral periprosthetic fractures. J Orthop. 2020;18:244–7.
Reeves RA, Schairer WW, Jevsevar DS. Costs and risk factors for hospital readmission after Periprosthetic knee fractures in the United States. J Arthroplast. 2018;33(2):324–30 e1.
Hoffmann MF, Jones CB, Sietsema DL, Koenig SJ, Tornetta P 3rd. Outcome of periprosthetic distal femoral fractures following knee arthroplasty. Injury. 2012;43(7):1084–9.
Benkovich V, Klassov Y, Mazilis B, Bloom S. Periprosthetic fractures of the knee: a comprehensive review. Eur J Orthop Surg Traumatol. 2020;30(3):387–99.
Cain PR, Rubash HE, Wissinger HA, McClain EJ. Periprosthetic femoral fractures following total knee arthroplasty. Clin Orthop Relat Res. 1986;208:205–14.
Hoellwarth JS, Fourman MS, Crossett L, Goodman M, Siska P, Moloney GB, et al. Equivalent mortality and complication rates following periprosthetic distal femur fractures managed with either lateral locked plating or a distal femoral replacement. Injury. 2018;49(2):392–7.
Christ AB, Chawla H, Gausden EB, Villa JC, Wellman DS, Lorich DG, et al. Radiographic and clinical outcomes of periprosthetic distal femur fractures treated with open reduction internal fixation. J Orthop Trauma. 2018;32(10):515–20.
Matlovich NF, Lanting BA, Vasarhelyi EM, Naudie DD, McCalden RW, Howard JL. Outcomes of surgical management of supracondylar periprosthetic femur fractures. J Arthroplast. 2017;32(1):189–92.
Giesinger JM, Hamilton DF, Jost B, Behrend H, Giesinger K. WOMAC, EQ-5D and knee society score thresholds for treatment success after Total knee arthroplasty. J Arthroplast. 2015;30(12):2154–8.
Lingard EA, Katz JN, Wright RJ, Wright EA, Sledge CB. Validity and responsiveness of the knee society clinical rating system in comparison with the SF-36 and WOMAC. J Bone Joint Surg Am. 2001;83(12):1856–64.
Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the knee society clinical rating system. Clin Orthop Relat Res. 1989;248:13–4.
Escobar A, Gonzalez M, Quintana JM, et al. Patient acceptable symptom state and OMERACT-OARSI set of responder criteria in joint replacement: Identification of cut-off values. Osteoarthr Cartil. 2012;20(2):87–92.
Su ET, DeWal H, Di Cesare PE. Periprosthetic femoral fractures above total knee replacements. J Am Acad Orthop Surg. 2004;12(1):12–20.
Agarwal S, Sharma RK, Jain JK. Periprosthetic fractures after total knee arthroplasty. J Orthop Surg. 2014;22(1):24–9.
Bezwada HP, Neubauer P, Baker J, Israelite CL, Johanson NA. Periprosthetic supracondylar femur fractures following total knee arthroplasty. J Arthroplast. 2004;19(4):453–8.
Gavaskar AS, Tummala NC, Subramanian M. The outcome and complications of the locked plating management for the periprosthetic distal femur fractures after a total knee arthroplasty. Clin Orthop Surg. 2013;5(2):124–8.
Gliatis J, Megas P, Panagiotopoulos E, Lambiris E. Midterm results of treatment with a retrograde nail for supracondylar periprosthetic fractures of the femur following total knee arthroplasty. J Orthop Trauma. 2005;19(3):164–70.
Gondalia V, Choi DH, Lee SC, Hwang BH, Ahn HS, Ong AC, et al. Periprosthetic supracondylar femoral fractures following total knee arthroplasty: clinical comparison and related complications of the femur plate system and retrograde-inserted supracondylar nail. J Orthop Traumatol. 2014;15(3):201–7.
Kilucoglu OI, Akgul T, Saglam Y, Yazicioglu O. Comparison of locked plating and intramedullary nailing for periprosthetic supracondylar femur fractures after knee arthroplasty. Acta Orthop Belg. 2013;79(4):417–21.
Kolb W, Guhlmann H, Windisch C, Marx F, Koller H, Kolb K. Fixation of periprosthetic femur fractures above total knee arthroplasty with the less invasive stabilization system: a midterm follow-up study. J Trauma. 2010;69(3):670–6.
Bae DK, Song SJ, Yoon KH, Kim TY. Periprosthetic supracondylar femoral fractures above total knee arthroplasty: comparison of the locking and non-locking plating methods. Knee Surg Sports Traumatol Arthrosc. 2014;22(11):2690–7.
Lee SS, Lim SJ, Moon YW, Seo JG. Outcomes of long retrograde intramedullary nailing for periprosthetic supracondylar femoral fractures following total knee arthroplasty. Arch Orthop Trauma Surg. 2014;134(1):47–52.
Park J, Lee JH. Comparison of retrograde nailing and minimally invasive plating for treatment of periprosthetic supracondylar femur fractures (OTA 33-a) above total knee arthroplasty. Arch Orthop Trauma Surg. 2016;136(3):331–18.
Kim W, Song JH, Kim JJ. Periprosthetic fractures of the distal femur following total knee arthroplasty: even very distal fractures can be successfully treated using internal fixation. Int Orthop. 2015;39(10):1951–7.
Ha CW, Shon OJ, Lim SW, Park KH. Minimally invasive plate osteosynthesis for periprosthetic distal femoral fractures after total knee arthroplasty. Knee Surg Relat Res. 2014;26(1):27–32.
Darrith B, Bohl DD, Karadsheh MS, Sporer SM, Berger RA. Levine BR, () Periprosthetic fractures of the distal femur: is open reduction and internal fixation or distal femoral replacement superior? J Arthroplast. 2020;35(5):1402–6.
Dowsey MM, Choong PF. The utility of outcome measures in total knee replacement surgery. Int J Rheumatol. 2013;2013:506518.
Noble PC, Scuderi GR, Brekke AC, Sikorskii A, Benjamin JB, Lonner JH, et al. Development of a new knee society scoring system. Clin Orthop Relat Res. 2012;470(1):20–32.
Scuderi GR, Bourne RB, Noble PC, Benjamin JB, Lonner JH, Scott WN. The new knee society knee scoring system. Clin Orthop Relat Res. 2012;470(1):3–19.
Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15(12):1833–40.
Miner AL, Lingard EA, Wright EA, Sledge CB, Katz JN. Knee range of motion after total knee arthroplasty: how important is this as an outcome measure? J Arthroplast. 2003;18(3):286–94.
Chen F, Mont MA, Bachner RS. Management of ipsilateral supracondylar femur fractures following total knee arthroplasty. J Arthroplast. 1994;9(5):521–6.
Jones MD, Carpenter C, Mitchell SR, Whitehouse M, Mehendale S. Retrograde femoral nailing of periprosthetic fractures around total knee replacements. Injury. 2016;47(2):460–4.
Shin YS, Kim HJ, Lee DH. Similar outcomes of locking compression plating and retrograde intramedullary nailing for periprosthetic supracondylar femoral fractures following total knee arthroplasty: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2017;25(9):2921–8.
Pelfort X, Torres-Claramunt R, Hinarejos P, Leal J, Gil-Gonzalez S, Puig L. Extension malunion of the femoral component after retrograde nailing: no sequelae at 6 years. J Orthop Trauma. 2013;27(3):158–61.
Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, 1801 Inwood Road, Dallas, TX, 75390-8883, USA
Dustin Rinehart, Tyler Youngman, Junho Ahn & Michael Huo
Dustin Rinehart
Tyler Youngman
Junho Ahn
Michael Huo
DR, TY prepared the manuscript. JA analyzed and interpreted the data. MH revised the manuscript and was a major contributor in manuscript writing. All authors read and approved the final version of the manuscript.
Correspondence to Dustin Rinehart.
Not required.
Michael Huo is a member of the Editorial Board of Arthroplasty and other authors declare that they have no competing interests. All authors were not involved in the journal's review of or decisions related to, this manuscript.
Rinehart, D., Youngman, T., Ahn, J. et al. Review of patient-reported outcomes in periprosthetic distal femur fractures after total knee arthroplasty: a plate or intramedullary nail?. Arthroplasty 3, 24 (2021). https://doi.org/10.1186/s42836-021-00080-w
Distal femur periprosthetic fracture
Patient-reported outcomes
Open reduction and internal fixation
Intramedullary nail

redpajama_set_name: RedPajamaCommonCrawl


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MANILA, Philippines — Close to 10,000 police officers and force multipliers will be deployed to secure the Soccskargen Region this summer vacation.
In a statement, the Soccsargen Police Regional Office (PRO 12) said a total of 3,518 police officers and 6,413 force multipliers composed of barangay watchmen, traffic enforcers, security guards, and other volunteer groups would enforce security measures in malls, churches, commercial areas, transportation hubs during the summer.
The Soccskargen Region is composed of four provinces — South Cotabato, Cotabato, Sultan Kudarat, and Sarangani.
Police expect that traffic congestion, vehicular accidents, and increased crime during the summer, with events related to Lent, Philippine Veterans Week, Araw ng Kagitingan, Labor Day, National Flag Day, and Flores de Mayo.
There s also the midterm national and local elections on May 13.
PRO 12 will coordinate with the Armed Forces of the Philippines in conducting security operations and daily preventive patrols against possible insurgency and terrorist attacks.
Checkpoints at the entrance and exit points in malls were also put up.
Police also enhanced their intelligence gathering to maximize "social situation and knowing of persons' families, groups or communities" and monitoring of suspicious persons and incidents.
Brig. Gen. Eliseo Tam Rasco, chief of PRO12, assured the public that the entire police force, with the support of citizens, would be well prepared to secure the region.


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Car falls into creek with family onboard in Catbalogan City
A Chevrolet Trailblazer carrying a family of six falls into a creek in Catbalogan City, Samar, after the driver mistook the waterway for a road. Photo: Calbayog Journal/Facebook
TACLOBAN CITY – A Chevrolet Trailblazer carrying a family of six fell into a creek in Barangay 12, Catbalogan City, on Tuesday morning, January 3.
The family, consisting of Mr. Elmer Dauba, his wife, four children, and a cousin, were on their way to Tacloban City from Allen, Northern Samar, when the incident occurred.
According to Mr. Dauba, driving the vehicle at the time, the family had stopped at a gasoline station in Catbalogan City and were on their way to Tacloban. He added that he had relied on the Global Positioning System (GPS) map to navigate the route and had mistakenly assumed that the creek was a road.
Fortunately, no one in the family was hurt in the incident.
Authorities have reminded the public to double-check their routes and stay alert while driving. They also advise drivers to use caution and multiple resources to ensure they take the proper route to their destination. —iTacloban (with reports from Calbayog Journal)
Tags: EASTERN VISAYAS NEWS REGIONAL SAMAR


LL Cool J drops off "Break Your Face" produced by 808 Mafia. On the record which will live on his upcoming G.O.A.T. 2 album, the legendary rapper aggressively raps about breaking faces, calls himself the black KKK, and promises to respond to anybody who disses him.


Six girls from the Metro area have been named to the all-state soccer teams by the Iowa Girls Coaches Association.
Olivia Garcia of Linn-Mar and Sydney Hayden of Kennedy have been named first team all-state in Class 3A as forwards.
Anna Frerichs of Kennedy, Jensen Sevening of Linn-Mar and Mackenzie Serbousek of Prairie were named second team all-state in Class 3A. Frerichs was honored on defense. Sevening and Serbousek were selected as mid-fielders.
Grace McDermott of Xavier was named second team all-state in Class 2A on defense.


BANGKOK, Thailand (March 27, 2017) - Bangkok-based hospitality management company Absolute Hotel Services Group is delighted to announce a new and exciting direction for the future when the group's first Eastin resort in the region as it opens its doors early 2018.
Eastin Thana City Golf Resort Bangkok is located within the Thana City mixed use development which includes the newly renovated Thana City Golf and Sport Club, a mere 25 minutes from the downtown area of the capital as well as only 10 minutes from Suvarnabhumi Bangkok International airport, and will be the first golf resort managed by Absolute Hotel Services. The resort will consist of 194 luxurious rooms in total and guests will be able to enjoy the use of the facilities of the neighbouring golf and sport club, which includes an international-class 18-hole course designed by Greg Norman, the only one in Thailand created by "The Great White Shark".
Absolute Hotel Services Group' CEO Mr. Jonathan Wigley said "After the success of our Eastin Grand Hotels, Eastin Hotels, Eastin Residences and U Hotels & Resorts properties this latest addition to our ever-expanding portfolio is the perfect match for the company's profile. Thana City Golf and Sports Club, after extensive renovations can be considered to be one of the most exciting golf and leisure facilities in the kingdom and we look forward to welcoming a whole new guest base as well as existing loyal Eastin customers to our latest venture".
Eastin Thana City Golf Resort Bangkok will open in early 2018.
For further information please contact +66 2 255 9247.


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Актобе () — село в Аксуском районе Алматинской области Казахстана. Входит в состав Суыксайского сельского округа. Код КАТО — 193277200.

Население
В 1999 году население села составляло 129 человек (61 мужчина и 68 женщин). По данным переписи 2009 года, в селе проживало 125 человек (64 мужчины и 61 женщина).

Примечания

Населённые пункты Аксуского района

redpajama_set_name: RedPajamaWikipedia


It was not to be. A below part first two quarters condemned Pesic's team to defeat on their visit to Tenerife despite 16 points from Thomas Heurtel. The offensive talented of Abromaitis and Vasileiadis were too much for the blaugranes in the end with Tenerife taking an 86-81 win.
The home side started well and Abromaitis and Tobey lead Tenerife to a 21-16 lead at the end of the first quarter. Tomic with six points was the pick of the Barça players in the opening quarter.
In the second quarter Navarro lead a fightback that brought them to within two points at 28-26. Adam Hanga contributed 8 points but Tenerife's shooting from the outside was impeccable and the home side took a 46-32 lead in at the break.
In the third period Tenerife continued to have the better of the game but Hanga and Heurtel dragged the visitors back into the game at 66-59 with their effectiveness in three pointers.
In the final quarter Barça Lassa played their best basketball, coming to within two points of Tenerife. However, despite the efforts of Heurtel and Pau Ribas in the closing minutes Barça Lassa were unable to avoid an 86-81 final score in Tenerife.


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Ottawa Signs Backup Alex Auld
Source: Ottawa Citizen | Jul 3rd 2008, 6:22am EDT
Alex Auld and the Ottawa Senators have agreed on a $2-million two-year contract. "We like his character, we like his ability," Murray said. "We know that, if he gets called upon to go in net, he can do that."
This will be Auld's fifth team (previously - Vancouver, Florida, Boston, Phoenix) since being drafted and is looking to compete with Gerber for the #1 spot. "I feel like I'm capable of being a number one goalie, and I feel Martin Gerber is capable of being a number one goalie." Auld said.


Lagan is a major term maintenance and capital works road surfacing contractor with both public and private sector clients across a range of surfacing and maintenance categories.
Highway Maintenance services represent a complementary extension to our core surfacing activities and enable us to offer a comprehensive service to customers, ensuring increased control and flexibility during project rollout with all services delivered in–house.
Our extensive asphalt surfacing experience spans the entire scope from footpaths and carparks to roads and major highways. Asphalt is laid in accordance with National Highway Sector Scheme (NHSS) 16 and Surface Dressing is carried out in accordance with NHSS 13.
Services offered by our Highway Maintenance division include vehicle restraint system installation, road planing, road stud installation and road markings.
Vehicle restraint systems on public highways are subject to strict safety requirements and erection of these systems must be in accordance with NHSS 2B. Since attaining this accreditation we have gained extensive experience installing and repairing various barrier systems including Tensioned and Untensioned Corrugated Beam, Open Box Beam, Double Rail Open Box Beam and Corus Vetex Proprietary System.
Road planing is an important activity within re–surfacing and structural maintenance operations. Our asphalt planings are recycled and re–used within asphalt mixes at our production plants, contributing to sustainability targets.
Since entering the road markings and road stud installation sector we have significantly increased market share by investing in our people, equipment and product development. We carry out such works in accordance with NHSS 7 and we are a member of the Road Safety Markings Association.
We are a BBA/HAPAS approved installer of the Hitex Textureprint Type 1 Thermoplastic High– Friction Surfacing System which is used as a high–friction surfacing on highways with surface texture depths of between 0.5mm and 2mm. It is commonly applied on approaches to roundabouts, traffic lights and major junctions.


The Curriculum and Achievement Committee will oversee pupil achievement, ensuring the school provides a high quality learning experience and delivers a broad and balanced curriculum in keeping with the school's aims, all pupils and legal requirements. The committee will monitor and evaluate all relevant Equality Objectives.
The Finance, Premises and Personnel Committee will have oversight of finance and personnel issues and ensure that the school operates within the financial regulations of the local authority and complies with Department of Education and Schools Financial Value Standard requirements, responding to any issues arising from the audit of the school's accounts or Schools Financial Value Standard review and ensure value for money. The committee will monitor and evaluate staffing policies and procedures and agree the staffing establishment and structure. It will also have oversight of premises, health & safety and issues relating to the whole school community. The committee will draw up medium and long term plans relating to the repair, maintenance and development of the premises. The committee will monitor the school's contribution to pupil well-being, including the extent to which pupils feel safe, adopt healthy lifestyles and contribute to the school and wider community.
Membership: Bob Lettman (Co-Chair), Brendan Foley (Co-Chair) Graham Callaghan, Oliver Jones, Duncan Holding, Toby Williams, Hariyati Abd-Razak, Hayley Clayton.


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3.3 Publicizing
By using MiT-U, one agrees upon the third party usage, publicizing and transfer of the personal information (both internal and external of the regime) as specified in this Privacy Policy.
Any information about oneself will be shared only when the person uploads or publish those data on MiT-U, or if they are provided with a message that the information provided will be transferred in a specific way and such information is provided by that person. All are requested not to publish or expand private data to the profile of their own which they do not want to make publicly accessible.
An individuals personal information can be shared in unspecified and/or aggregated aspect with third parties for custom analytics ie. Better understanding about the third party who are using the services and how,also for business analysis, demographic profiling, exploration, and further identical objectives.
The service providers who are helping to connect with the undertaking of the assistance may approach and utilize the information provided with. These service providers although have access to the information but that is limited to what is needed for performing a service on behalf of an individual and are bound to maintain the secrecy level in terms of sharing with others or using them for other purpose. These providers compile the data sent from the mobile phone, notebook or desktop computer, and their subsequent use is regulated by their favorable privacy policy.
The app may disclose information about an individual if assigned by legislation or any legitimate process (such as a warrant, permit or court order), or, if any responses to be given to a legal petition from legal councils to reveal such data, or if necessity arises to carry out or refer to this Privacy Policy, the Terms of Service or the other agreements.
If third party acquires or reorganizing of committee arrangement occurs then an individuals information will be switched within the group or to another third party who will be ready to proceed with the project of MiT-U or identical services under the same privacy policy r some different one, the information of which will be furnished to the users by an announcement. The party with whom the personal information is altered may be tracked down, and the Information of a person may be used exterior to one's jurisdiction.
Apart from permissible limit under this privacy policy or else with due consent of an individual, or under any circumstances related to law or legal process, no one is able to transfer the personal information furnished may it be to any third parties for processing related to any purpose.
3.4 Adaptation of Security Measures to Protect the Information
Employment of managerial, biological and electronic standards designed to conserve the data from unauthorized admission, however, apart from taking these efforts, security measures none are excellent or impervious and no technique of data dispatch can be ensured against any interception or further kind of mishandling. In the circumstance that the personal information is risked as an outcome of an infringement of safety, prompt notification is ensured to the individual when the personal information comes to get compromised, as expected by relevant constitution.
With any third parties, with whom personal information of the users are conveyed, thereon satisfactory efforts are made to ensure that those parties must be using the client's personal information (i) in abidance with this Privacy Policy; and (ii) content to any additional instructions provided to them, comprising of any reasonable intimacy and safety standards that are being enforced.
4. How Information can be accessed through?
The information provided can be accessed and revised through an individual's own account.
With a strong belief of non authenticity or precision of any of the information provided to MiT-U can furnish the app with satisfactory evidence considering this and for that via the communication data furnished in this Privacy Policy connection can be made to rectify the unauthentic or incorrect information and logical actions will be taken to honour the petition; moreover, an archived document of the information may be secured as compelled by law and/or for document maintenance intentions.
Once an account is sealed or eliminated, no one will be able to access to the message record, importance or any other data related with the use of the app services. Even after the removal of information from the report or profile, samples of that information may remain visible somewhere else, to the expanse it has been conveyed to others, it was oppositely published pursuant to the secrecy settings, or it was duplicated or reserved by other users. In addition to this, conservation of the personal data even after the account closure, if rather important to acknowledge with lawful commitments (including legislation enforcement requests), regulatory statutes to be met, clashes to be settled, conserving defense, deterring corruption and misusage, or carrying out the Terms of Service. Even after the closure of account retention of de-personalized information is assured.
For some examples the users personal information cannot be discarded, revised or altered and there the individual is informed about the incapability to do so. For example, some proposals may propose disproportionate technological undertaking or incredibly ineffective, or are restricted by legislation.
The user needs to agree to inform once any consistency is observed as MiT-U being operated in numerous jurisdictions may be incapable to specify all the inconsistency between particular terms of this Privacy Policy and the favorable law in a particular jurisdiction. Hence vital methods to eradicate such inconsistency are enforced including eliminating the private information improperly obtained or employed by the app.
For any questions related to the Privacy Policy or any privacy-related issues, please contact via email at contact@mit-u.in .
***END***


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Ben Affleck is reportedly ready to date, plus more news
By Wonderwall.com Editors 12:03pm PDT, May 3, 2017
Ben Affleck is open to dating as he moves into his own house
With their divorce papers filed and Ben Affleck moving out of the house he's shared with Jennifer Garner in recent months, the former couple is entering a new phase — and for Ben, that's likely to include dating. A source tells E! News that while Jen isn't making romance a priority just yet, Ben is open to the idea of meeting someone new. "Being single is a whole new world for Jen. She isn't used to not having the kids around and being able to focus on herself. She is interested in dating, but it's not a major priority. The kids will always come first. If she happens to meet someone, then she is open to that as well. But, she isn't going to set her sights on finding someone," says the source. "Ben is interested in dating," the source elaborated. "He feels ready to date and will be putting himself out there." Ben recently found a new home near Jen, where their three children will spend time with their dad, according to E!
RELATED: Celebrity splits of 2017
Beyonce's mic auctioned off for $11,000
A lucky bee from the Beyhive is the proud new owner of the microphone Beyonce used on her formation tour. TMZ reports the gold, Bey-signed mic was auctioned off for $11,000 at Tina Knowles' Wearable Art Gala in Los Angeles, where top bidder CeCe Hendriks scored the collector's item. According to the website, the mic is imprinted with marks and discolored from the Queen B's hand.
RELATED: Beyonce's big year after 'Lemonade'
Did Sarah Jessica Parker skip the Met Gala because of a grudge?
Why did Sarah Jessica Parker skip the Met Gala this year? While a source told People the longtime fashion lover bailed on her favorite event "to stay and work on her HBO series 'Divorce,'" Celebitchy wonders if SJP may have been holding a grudge against critics of her 2016 Met Gala ensemble, many of whom joked she looked like Lin Manuel-Miranda in "Hamilton" despite the "Manus x Machina: Fashion in an Age of Technology" theme. The criticism was so widespread Sarah even wrote a piece in T magazine defending her look, which she said was inspired by her interest in "fashion in the age of 18th Century technology" after having seen "Hamilton" multiple times, according to Vanity Fair. "What is technology? And what does it mean when applied to fashion?," she asked in the piece. "We didn't want it to be about the electronic screen or something that could turn on and off. We wanted it to be about the technology of thought, of application, of fabrication. The technology of the hand and the machine."
RELATED: Fashion hits and misses from the 2017 Met Gala
Selena Gomez's mom is all about her relationship with The Weeknd
"Glowing, smiling, looking health[y] and equal love." That's how Selena Gomez's mom summed up this pic of the singer with her new man The Weeknd at the Met Gala this week. Adding, "Mama is happy XO," she made her positive feelings about Selena's relationship official (via JustJared). Ya can't beat two thumbs up from mom!
Emma Stone sends flowers to student who asked her to prom
Though Emma Stone wasn't able to join the student who asked her to prom this year, she let him down easy with a sweet gesture. According to the Daily Mail, Jacob Staudenmaier received a corsage and a boutonniere the day of the dance. They had come from Emma, along with a handwritten note. "Jacob, a little something for you and your lucky date tomorrow," she wrote. "Have a great time! Much love, Emma Stone."
Lena Dunham was rushed to the hospital from Met Gala
While her peers hit the Met Gala afterparties into the wee hours, Lena Dunham wrapped her Met Gala night under the care of doctors. According to Page Six , a "medical issue" forced Lena to be rushed to the hospital where she underwent testing before being released. The "Girls" creator recently had a fifth surgical procedure for endometriosis. "My surgery went off without a hitch," she wrote in her Lenny letter last month. "There was no endometriosis left. Between my surgeries and hormonal intervention, I was disease-free. That doesn't mean it can never return, but for now, once my sutures have been removed and my bruises have changed . . . I will be healthy."
Salma Hayek and her mom cover Hola!
Just in time for Mother's Day, Salma Hayek and her mom, Diana Jiménez Medina, share the cover of HOLA! USA's May edition. "I always knew that Salmita would be something big in her life because of her personality, her way of always working for what she wants, but she surprises me," Diana says of her daughter (via E! News). "She continues to surprise me more and more. There was one thing that I wanted: that was for Salma to be free to grow up and do whatever she wanted." In spite of her decades-spanning film career, Salma admits she still experiences serious stage fright. "No one would know it, but I get it really, really bad. If you take the camera away and put me in front of an audience, I just die," she says. "Once I get onto the stage, you can't tell. But then I can't do anything else the rest of the day because I'm so exhausted." When she's not on stage or on set, Salma's busy being a mom to her daughter, 9-year-old Valentina. "Feeling responsible helps you develop as a human being …," she says. "You learn a lot about yourself when you do something for someone else."
Kim Zolciak gives an update on her son's recovery
After being attacked by a dog last month, Kim Zolciak's 4-year-old son Kash is recovering well. That's the message Kim shared on Instagram this week, along with plenty of shoutouts to the medical team that's been in charge of caring for him. "I am so happy to report that Kash is still recovering and so amazingly!! He is the true definition of a pure innocent child," Kim wrote on Instagram. "The injuries sustained to his skin are healing up perfectly because of his amazing doctors, nurses, modern medicine, my homeopathic treatments, his will and his positive attitude. Kroy, I and his doctors are amazed by his progress. Once he is fully healed and we are confident his mental and emotional state is healing back to its original state as well. He is just truly amazing. I love spending everyday with him. I could eat him up, (he is still out of school) Thank you again for EVERYONE'S love, support and prayers. They have not gone unnoticed. And I firmly believe they made all the difference."
Michael Fassbender jokes that he's better looking than Tom Hiddleston
"Alien: Covenant" star Michael Fassbender tries hard to keep his private life out of the public sphere. "Number one, I think it's effective for me as an actor because I want to be able to disappear into the characters I play," he explains in a new interview with the Daily Telegraph (via Celebitchy). "I don't want the audience to be distracted by whatever else is seen of me in the real world I would consider myself a private person. I work in a medium where we rely on the public to go see it. But my own life is for me." Unfortunately, not everyone sees it that way — particularly the peeps who constantly mistake him for Tom Hiddleston. "Happens all the time," Michael admits before joking, "I can see the similarities, but I'm better looking than him [laughs]. Other than that, yes. I like Tom."
Michael Moore wants The Rock for president
We already have a reality star in the White House — could The Rock be next? Michael Moore seems to think so. In an interview with Variety published this week, the director was all about the idea. "Run the Rock! Run the Rock. Who do you want for commander-in-chief? I want the f—— Rock! It would scare anybody that would hurt us," he said, according to the Huffington Post, "Think about how safe we would be if the Rock was president." It wasn't totally out of the blue, either. Last fall, Dwayne "The Rock" Johnson sounded ready to hop on the campaign trail. "I love my country," he said, "I'm extremely patriotic and I also feel, especially now, leadership is so important, great leadership is so important, respected leadership is so important."
Dmac/Stoianov/FAMEFLYNET PICTURE


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1925 Florence 2013
Florence Weiss
October 18, 1925 — December 20, 2013
Florence Weiss, 88, of Breckenridge, MN, died Friday, December 20, 2013 at St. Francis Health Care Campus in Breckenridge, MN. The funeral will be 2:00PM, Monday, December 23, at St. Francis Health Care Campus Chapel, with a visitation one hour prior to the funeral from 1:00 to 2:00 PM. Father Joe Backowski will be the celebrant. The interment will be at Brushvale Cemetery at a later date.
Florence "Flo" P. Weiss was born October 18, 1925, the daughter of John and Laura (Buth) Pechlat, on a farm near Abercrombie, ND. She grew up and attended country school, Abercrombie High School, and Breckenridge High School. She earned her BS Degree at Valley City State University where she graduated with Honors. She was also a member of the Kappa Delta Pi Honorary Society.
Flo was united in marriage to Marvin Weiss on October 4, 1948. The couple lived in Wahpeton, ND. To this union, two sons were born. Flo began her teaching career in Richland County. She then taught in Glenwood, MN; Whitefish, Montana; and Coeur d'Alene, ID.
In 1960, Flo moved with her sons to Seaside, OR, where she took post graduate classes at Portland State University. She taught in the Seaside School District and Astoria High School for the next 9 years. It was then that she traveled overseas and began a teaching whirlwind. She taught in Angola, West Africa; Oran, Algeria; Ahwaz, Iran; Talara, Peru; Santa Cruz, Bolivia; Fukuoka, Japan. Then, for the next five years, Flo was at the Seoul Foreign School in Korea, where she taught Art and directed their school plays. While in Seoul, she also taught English night classes at Yonsie University. Her last post overseas was at Marymount in Santa Marta, Colombia.
Flo made her way back to the United States. For a short time, she worked for Senior Life Magazine in Riverside, CA, but she was drawn back to Seaside, OR, for another teaching position. It was there that she finished a 46 year long career in teaching as an instructor of Art and Writing at Clatsop Community College, Astoria. While she travelled and taught all over the world, Flo continued her own art work. She worked in oils, watercolors, pastels, ink sketches, batiks, and Oriental Brush Painting. She illustrated a book of African sketches that she did while in Angola. She also loved to write; submitting articles for the Korea Times while in Seoul, and for Senior Life Magazine in CA. She authored and published a book called "The Camel Ate My Wig and Other Hair Raising Stories". This book is on display at the Library of Congress in Washington, DC. More recently, she had written and illustrated two children's books entitled, "What the Animals Say around the World" and "Little Bit is Big Enough". Other hobbies included gourmet cooking, reading, crocheting, Swedish weaving, and playing Mah Jong (a tile game from China).
In May of 1995, she moved to Breckenridge to be closer to her sisters. She taught Community Education Classes for the Breckenridge School District, was a member of St. Mary's Catholic Church, the Legion of Mary, and the Christian Mothers. She was past president of the VFW Auxiliary in Wahpeton, a den mother, and held various offices in Education Associations. Her greatest satisfaction was the hundreds of individuals she helped get started in their creative endeavors. Her greatest love was for her children and grandchildren.
Flo is survived by her son, Dennis (Diane) Weiss of Seaside, OR; her grandchildren, Eric Weiss of Warrenton, OR, Shaun (Mike) Haner, Brian Weiss, Tara Eskina, and Kelly Miller all of Seaside, OR; her 4 great-grandchildren, Matthew Haner, Addison and Kyle Eskina, and Lacey Miller; her sisters Louise Abel and Angie Miller both of Breckenridge, and Lucille Duke of Jackson, TN; and John (Ruby) Yuill, who she thought of as her son, of Astoria, OR.
Flo is preceded in death by her parents, John and Laura; her son Kevin (2006); and her sister Cecelia Johnson.
To order memorial trees or send flowers to the family in memory of Florence Weiss, please visit our flower store.


They say rules are made to be broken, and when it comes to mixing metals in your home décor, we agree! Gone are the days when using one metal color throughout the home was the rule of thumb. Today's rule is: mix it up! Combining metal colors adds visual interest and depth to a room, as long as it is done right.
Whether you're seeking a layered, textured space, or a clean and modern look, start by choosing a dominant metal – the metal you want to be the most prominent in the space – and then select one or two accent colors to complement the look. Depending on the size of the room, aim for a minimum of two metals, and a maximum of three. You're seeking harmony, and too many contrasting elements can feel less like a pulled-together look and more like chaos. As a general guideline, go for a 70/30 ratio, where the dominant metal makes up 70% of the look, and the accent metals comprise 30%.
Warm and cool colors can definitely be mixed. Warm metals such as brushed brass, antique bronze, gold, and black give a vibrant pop of color when mixed with cool metals like chrome, nickel, and silver. When mixing metals, err on the side of more contrast, not less. Using too many similar metals makes it look like a mistake, not a design intention.
Then, choose your cabinet hardware, appliances, plumbing fixtures, and accessories by matching one or two of the finish colors from the lighting fixture. Warm toned metals, like brass and bronze, add an eye-catching accent of color when used with cool toned metals such as stainless steel and aluminum.
Take the room's color palette into consideration, too. Warm metal finishes (like brass, bronze, and copper) are best used with warm hues (like beiges and browns). Use cool metal finishes (such as chrome, nickel, and silver) with cool tones (such as blues, greens, and grays).
When working with a neutral color palette, add metallic accents to achieve warmth, texture, and color. With a white or gray color scheme, for example, add a stunning gold chandelier to make your room come to life.
Today, metals are meant to be mixed. Stop worrying about whether they'll go together! Keep in mind the 70/30 rule, and by choosing a dominant metal plus one or two accent finishes, you'll add the perfect mixed, but not mismatched, metal look to your home.


R. Sandyk, "Progressive Cognitive Improvement in Multiple Sclerosis from Treatment with Electromagnetic Fields," International Journal of Neurosci, 89(1- January 1997, p. 39-51.
This article reports on the cases of two multiple sclerosis patients suffering from chronic ataxia who performed poorly on human figure drawing tests administered to measure body image perception.
Treatment with extra cerebral applications of picotesla flux electromagnetic fields led to improvements in gait and balance as well as normalization in body image perception as seen on a repeat of the same test each patient.
R. Sandyk & L.C. Dann, "Weak Electromagnetic Fields Attenuate Tremor in Multiple Sclerosis," International Journal of Neurosci, 79(3-4), December 1994, p. 199-212.
Bioelectromagnetics Association, 3rd International Congress, 29 February – 3 March 1996, Nancy, France.


Shake up the establishment with this politically correct rattle sock and bib set. A young future Republican will look the part this election season in this red, white, and blue baby gear. The tiny socks are complete with a plush elephant head that rattles with each joyous kick.


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Macropophora accentifer is a species of beetle in the family Cerambycidae. It was described by Olivier in 1795.

References

Acanthoderini
Beetles described in 1795


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Experts specially weave the fabric at the renowned Tessuti Monti mill in Italy. The result is a superb softness, breathablity and strength for everyday comfort and long-lasting wear. It is complete with premium Italian Monti red label branding, as well as signature T.M.Lewin contrast threads and piping.
The smart fused collar and classic button cuffs formalise this casual shirt. It is an excellent day-to-evening piece, helping you to transition effortlessly from the boardroom to the bar. Dress it down with navy chinos and tan chukka boots, or smarten it up with a blazer and wool trousers.


Harmonix is a developer I have a fan-crush on. The first game I purchased from them was the original Rock Band in 2007, so I was not really on the ground floor for their meteoric rise in music game stardom. I remember trying the first Guitar Hero game at Jaron's house, however. It was a Franz Ferdinand song on Easy, and it was an unmitigated disaster. Fast forward to Guitar Hero 3's release, when my nephew got it on the Wii for Christmas. GH3 is the first time I really dived into the plastic guitar. I proudly worked my way up to Hard (with some Expert!) and maintained a healthy rivalry with my sister. When I played Rock Band afterwards, I could feel Harmonix's experience in the genre and lessons taken from Guitar Hero games work its way through every part of the game, from the updated, more mature visual asthetics to the new mechanics such as drums gameplay and Big Rock Endings.
So, Microsoft really lucked out when they were able to wrangle Harmonix into creating an exclusive new title for the launch of their Kinect peripheral. Granted, a dance game isn't their usual wheelhouse, but their talent showed through in Dance Central, the most critically well-received Kinect title available. It starts with their simple yet genius and highly applauded approach to menu navigation, a swipe system using either the left or right hand. When it comes down to dancing to the game's expertly curated soundtrack, the game utilizes a flashcard approach for each specific dance move and each card flipping predictably to the beat. The ramp in difficulty introduces more complex moves and increases the number of kinds of moves the player encounters. Combined with a training mode that will break down moves in the song of your choice one by one, dancing on Hard becomes an exhausting yet rewarding experience. Dance Central neatly steps away from weaknesses in the Kinect that other games make more obvious, such as mapping the player's body one-to-one to an on-screen avatar, and what they do use of the Kinect makes the game feel fair and accurate.
Bluntly put, If Dance Central didn't exist, I wouldn't believe in the Kinect's ability to create memorable gameplay experiences as much as I do now. This game seems like proof that a skilled developer with their heads screwed on tight enough can eke out a game for the system that feels fresh and unique from anything else available. This game is proof of a working technology.
And my mom is better than me at doing the salsa.
When I played Unreal Tournament 2003 back in high school, I was wowed right away at the first time I've seen the ragdoll physics characters go into when they died. Something in me got a hilarious kick out seeing corpses flying every which way from rocket fire. I remember the initial wave of weird maps where you jumped off a ledge and your ragdolling character would hit obstacles on the way down and spin about uncontrollably. I guess I have an odd fondness for physics interactions on objects in games. Stuff falling down is neat.
In Angry Birds, stuff is falling down and flying around constantly and I can't get enough of it. With a simple touch interface to control a slingshot, players send the titular birds careening into the enemy pig's various structures in an attempt to eliminate all the pigs in the level. It's one level after another of wanton physics-based destruction. It's a perfect design for a mobile device: I can either pop in a level here and there where I want, or I can sit down and burn through a whole chapter of levels. The simple gameplay supports whatever experience I would want out of the game at any moment in time, anywhere I am. The visuals are light and fluffy as well, and it's just goofy fun to experience this weird world where these animals are in perpetual war over eggs. It doesn't reach for the stars like lots of other games on this list, but it doesn't have to. It's designed to fill that mobile game role and that's all I need out of it. Angry Birds filled in a lot of time in-between responsibilities for me in 2010.
The evolution of mobile game design, spearheaded by titles like Angry Birds, is leading way to massive success for these developers as well as a new paradigm shift in the mobile game market. This is a world where Nintendo DSs once reigned supreme for gaming on the go. While there is still space for traditional mobile consoles, the mobile games market meant for devices like phones and tablets is growing uncontrollably and can't be ignored. When a game like Angry Birds can sell 6.5 million copies on the iOS alone, you can't ignore that market for long.
Hang tight for more posts coming soon!