text:
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The Woman Problem
by George Will
Hunter Biden Cashed In to Fuel His Drug and Sex Habits
by George Neumayr
Targeting People With Mental Illness and Dementia for Euthanasia
by Wesley J. Smith
A Red Wave Through the Bayou
by Scott McKay
Is Mass Immigration Killing Two-Party Democracy in the U.S.?
by James Delmont
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In Print Fall 2022
How to Bowl Alone
by Nic Rowan
The Enormous Influence of the Decidedly Conservative Ohio Tafts
by Donald Devine
Euro Watch
Jihadist Attack in Spain: One Throat Slit and Two Churches Attacked
by Itxu Díaz
Car Guy
Electrification Is Based on Manufactured Necessity
by Eric Peters
Education Gone Wild
How Restorative Justice Endangers Students and Teachers
by Irit Tratt
Earlier this year America faced the tedious prospect of a new decade without a new oppressed group to liberate. But in one swell fell swoop our Yankee ingenuity conjured into existence a gaggle of downtrodden persons to uplift. We discovered that women need liberating and this discovery has liberated us from creeping ennui.
This oppressed majority will gain Uhuru come Hell or low hemlines. Just ask Barney Rosset, pornographer. Rosset runs Grove Press, an establishment guided by his philosophy: "What's wrong with exciting people? Our whole society — television, movies, fashion is built on exciting people." The Women's Liberation Front recently added a new dimension to the exciting business of pandering to prurient interests.
The WLF sat in at Grove Press to protest commercial "sexism." The men at Grove Press are fierce opponents of repression, but they take a businesslike approach to mixing business and pleasure. They had the WFL protestors arrested. This was good for the Grove Press' property rights but bad for its revolutionary reputation. The WLF promptly announced that Grove Press has "the same mentality as Judge Hoffman" and demanded an end to "one dirty-old-man-rule" at the Press. This reference to Rosset was less than fair. He is only forty-seven.
Most men know that struggling women need dramatic tactics, like bra burning, for it manifests the liberated woman's escape from the roles and stereotypes of a male-dominated society. Hence most men would suffer death, or at least a mild blister, in defense of every American's right — regardless of race, color, creed, national origin or sex — to burn bras.
Yet regrettably this form of bodily witness, so helpful in eliminating false consciousness, causes air pollution. Recent studies reveal that if every woman in America were to burn three slightly padded bras there would develop an enormous increase in air pollution and an enormous glut in Manhattan's garment district.
This is acceptable. As Lenin said, you shouldn't break eggs without making 'an omelette. Besides, the First Amendment is precise and unambiguous: congress shall make no law abridging the right of even the most flamingly symbolic speech. If men have the right to burn draft cards, then the principle of sexual reciprocity stipulates that women have the right to burn bras.
Some male Neanderthals thought female suffrage would suffice to end female servitude. This was rank sociological naivete. Advanced thinkers understand that we must use compensatory programs to correct the terrible legacy of centuries of unbridled male tyranny.
We need an ambitious program to salvage those young women who suffer the cultural deprivation of attending predominantly female colleges. Such a program could be called Upward Curtsey, and could use Federal funds to send (say) Bryn Mawr graduates to Atlanta, Georgia, for a two year hitch in the robust and rehabilitating atmosphere of Georgia Tech. Upward Curtsey would affirm the basic principles of the American Dream by guaranteeing any American girl the chance to grow up to be a Rambling Wreck from Georgia Tech.
It would be even better to directly attack what the "Mrs. Kerner Commission" calls "institutional male chauvinism." Let us begin by distinguishing between De Jure and De Facto discrimination.
De Jure discrimination is that which is established by law, or by the deliberate acts of public officials; such is the ban which bars women from the New York Mets' locker room. De facto discrimination results from community customs or mores, such as the practice of giving a lady your seat on the subway. The Constitution is not only color blind but sex blind, and it is immoral to tolerate laws or customs that take notice of another human being's sex.
Fortunately women have not fallen victim to the wretched condition denoted by the wretched noun "ghettoization." As a result of dumb luck (that is, without HEW guidelines), women are spread evenly across the nation. Balanced residential patterns reduce the need for forced busing to achieve sexual balance in schools. Nevertheless, some busing is needed to eliminate pockets of impacted sexual imbalance.
For example, there was a time when Smith College, Northampton, Massachusetts, actually boasted about being the nation's largest all-female college. Although this "peculiar institution" is becoming co-educational, the pace of Smith's progress is unacceptable. Under the guise of "deliberate speed," Smith is substituting tokenism for meaningful change.
The government must mount a determined attack on all such "private" institutions. Their so-called "privateness" is an illusion, which must not insulate them from public control. After all, every autumn the students get to these colleges by driving over public highways. Therefore the students are engaging in interstate commerce and the colleges are permeated with public aspects.
Such colleges must be compelled to conform with the law of the land, which is that every school must have a sexual composition identical with that of the surrounding community. The Justice Department should seek a court order requiring Smith to bus males from (say) Amherst until the Smith student body has the same sexual composition as the town of Northampton. Forced busing is awkward, but no one can take seriously the disingenuous argument that Smith women and Amherst men will get together without Federal compulsion.
Advanced sociological thinking supports the justice of such busing. Federal officials will soon release the "Mrs. Coleman Report." This is the fruit of a multi-million dollar research project, which proved what it set out to prove, namely, that when young men and women study together they learn some things they might not otherwise learn in school. Therefore, it is monumental hypocrisy to attack de jure sexism while leaving the de facto form untouched. It is time to opt for minimum standards saying "Never!" to deliberate speed, letting the chips fall where they may, and pausing only to pluck the blossom equality from the nasty nettle sexism.
Now after forced busing achieves integration at all schools, we must recognize the justice of women's demands for creative sexual separatism. We must acknowledge the independent dignity of "'female culture" by establishing "female studies programs" that will cleanse the sex-bias from our hairychested university curricula.
The "historical sexism" that lavishes attention on Napoleon while downgrading the contributions of Catherine d'Medici and Katherine von Bora must end. We must demand that the time devoted to Catherine the Great be proportionate to the real uniqueness of her behavior. Fairness demands that if Faulkner is studied, there must be equal time for Eudora Welty. The principle of literary sex parity requires trade-offs between Sinclair Lewis and Ayn Rand, or Norman Mailer and Taylor Caldwell. And breathes there a woman with a soul so dead, who never to herself has said, "One Hemingway deserves a Willa Cather?"
Some persons worry that women's liberation will distract us from the all-important task of fending off environmental apocalypse. But that worry betrays an insufficiently systemic view, for the new science of "issue ecology" teaches that every issue is related to every other issue in this troubled biosphere.
Dr. Mary Calerone, director of the Sex information and Education council of the United States, recently demonstrated awareness of this when she told the Women's National Democratic Club that, "The primary ecological system that all other systems need to serve is the relationship between a man and a women. It, too, is subject to pollution." Clearly there are more forms of pollution under the sun than appear in the Sierra Club's philosophy.
Dr. Calderone understands the charm of "environment" as a political issue. One cannot turn around (or roll over in bed) without rubbing up against environment. This is deliciously egalitarian. Anyone with a grievance is relevant now that "environmental concern" is the measure of relevance.
Fastidious people may claim that Dr. Calderone is contributing to semantic pollution in order to make her cause congruent with this month's priorities. But it is tolerant to believe that pollution is in the eye of the beholder. Anything that bothers you is a pollutant of your environment.
Of course, when we sweep every one of the world's disagreeable features into the "environment crisis" we turn the term "environment" into a classification that doesn't classify. But while the term loses precision, it gains an ability to make one feel au courant, which is how I feel when I can classify bad books, shoddy arguments and Senator Fulbright as "pollutants" and ecological disasters. Women liberators must feel relevant twice over — as freedom fighters and environment cleaners.
Female assertiveness is going to have some dramatic effects on American life. If women shun jobs to which they were once relegated, who will be airline stewardesses? The day may come when the traveler slumps wearily into his seat, only to hear a rich baritone voice asking "Coffee, tea or milk?" Thus the women's liberation movement may rescue the railroad passenger business. Women may break the sex barriers in many occupations. Someday a woman may play tight end for the Baltimore Colts. Then imagine the spectator interest that would arise over a 15-yard penalty for illegal use of the hands and arms?
Finally there is the stigma of servitude attached to the exclusive use of women in the Playboy centerfold. Equity demands a color centerfold of Joe Namath, stapled in the navel. This will give men a sample of the shame and horror women feel when they are cast in the role of pliable sex objects.
There is one basic reason why women are victims of capitalism, male chauvinism, institutional sexism, imperialism, objectification, Hugh Hefner, psychological deformation, moral mutilation and physical exploitation. The reason? Women have nice bodies, and fortunately, government cannot do much about that.
We are much in need of a conspicuous problem, which clearly cannot be solved by government. Some Americans do not believe such a problem exists. But the soft, warm, intractable fact about women's problems may teach these Americans an invaluable lesson about the very finite capabilities of government.
Women's liberation will not be a gift of government. Women must save themselves. Most important, they must not be betrayed into servility by "Aunt Toms," those collaborationists who trade their birthrights for a mess of service. No woman will be free until all women are willing to step on cockroaches. This is a stern test, but as the philosopher said, if women can't stand the heat they should stay in the kitchen.
George F. Will graduated from Trinity College in 1962, received a degree from Oxford University, Magdalen College in 1964 and earned his Ph. D. from Princeton in 1968. Mr. Will is twenty-nine and instructs physical education in Washington, D.C.
It all reminds me of July 1, 1987 when President Ronald Reagan nominated Judge Robert Bork for an opening on the Supreme Court. He had it made in the shade, said my complacent conservative friends. The result was brutal. But we do not have to look back 32 years to see how unruly the leftwing mob can be. Recall the recent fate of Judge Brett Kavanaugh. Only his courage and unscotchable determinate saved him. The simple fact is that the conservatives are often slow on the draw against the American left. Only the Wall Street Journal and the intrepid New York Sun have come out swinging for Moore. It is time for the conservatives to rally around him. He can probably win with the President on his side. He apparently has the votes. Yet the coming battle would be a lot less bloody if the conservative movement were to take the field on Moore's behalf — and make it clear that from now on they are going to wage war for the President's nominees. Print
Golden Boy Gavin
Did Gavin Newsom Kill His Own Mother?
by Ellie Gardey
During his first gubernatorial campaign, now-Gov. Gavin Newsom made a...Read More
George Neumayr, RIP
by Wlady Pleszczynski
Late this morning, we received this dreadful news: "It is...Read More
At Large
The Lingering Fog of War and Lessons From Vietnam
by Mark Moyar
With Americans across the political spectrum increasingly skeptical of massive...Read More
Dismal Science
Al Gore Bombs in Davos With Hiroshima-Fueled Wackiness
by Deroy Murdock
Let's be polite and call Al Gore's recent remarks "colorful." ...Read More
Presswatch
Biden's Classified Documents Scandal Proves the National Media Is Dead
by David Keltz
There is no denying it anymore: the national media is...Read More
Hamline Art Professor Who Showed Image of Muhammad Lawyers Up
by Bruce Bawer
It started last Oct. 6, when an adjunct instructor at...Read More
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text:
help(
[[
This module loads Gate 7.2. Simulations of Preclinical and Clinical Scans in Emission Tomography, Transmission Tomography and Radiation Therapy.
]])

whatis("Loads Gate 7.2 ")

local version = "7.2"
local base = "/cvmfs/oasis.opensciencegrid.org/osg/modules/gate/"..version

prepend_path("PATH",  pathJoin(base, "bin"))
prepend_path("CPATH",  pathJoin(base, "include"))
prepend_path("LIBRARY_PATH",  pathJoin(base, "lib"))

family('gate')
load('gcc/4.9.2', 'clhep/2.3.1.1', 'geant4/10.02', 'root/5.34-32')

redpajama_set_name: RedPajamaGithub


text:
The Tapsbook photo book iOS SDK allows you to easily integrate a native photo book creation and ordering experience directly in your iPhone or iPad app. Our photo book solution offers a quick and simple experience for your app users to preserve memories and showcase their favorite photos in a beautiful way while enabling you to maximize your monetization.  The SDK provides three ready-to-use components to help you integrate our photo book solution within an hour.

1. Simple yet powerful photo book tool for your users to quickly create photo book in a few minutes
2. Beautiful, fully customizable photo book page templates featuring your own branding/logo
3. Full-featured, frictionless eCommerce checkout workflow for processing payments via Stripe APIs

![untitled](https://cloud.githubusercontent.com/assets/842068/12061807/f0ba9ed0-af5d-11e5-977b-0cd03c67273d.gif)

The SDK is integrated with the backend system via REST API to manage the photo book printing workflow by working with our photo book print partners and shipping service providers to offer you a turnkey photo merchandising solution.

To get started, you will need to:

1. Sign up for a free tapsBook developer account: Go to http://search.tapsbook.com to sign up. Shoot us an email help at tapsbook.com before you sign up.
2. Register your app and get an app key.

Binary builds of the SDK is embedded in this repo

- Current release is iOS 8 compatible: 1.1.6 (updated 2015-12-27)
- The binary includes both 32bit and 64bit compiled output
- Total downloadable SDK source file size is 40MB (once integrated with your app, it increases your binary by ~ 4MB)

Sample apps:

 - You can try out the photo book creation and ordering experience offered by TapsBook SDK in our [Cleen app](https://itunes.apple.com/us/app/cleen-books-delete-photos/id926163661?mt=8) available in the App Store
 - This repo contains a demo app that demonstrates how to build a photo book app using the SDK in minutes

Our Quick Start Guide will get you up and going fast:

- [SDK Developer Get Started Guide](http://help.tapsbook.com/kb/development-get-started/tapsbook-ios-sdk-developer-guide)

You must set up your app key and payment before anyone can check out a book in your app.

- [Developing and testing your photo book app](http://help.tapsbook.com/kb/development-get-started/setup-your-photobook-app-for-test-and-production)

Once your photo book app is up and running, you can use our dashboard to manage your orders:

- [Managing your photo book orders](http://help.tapsbook.com/kb/development-get-started/track-and-manage-your-orders-using-tapsbook-backend)


text:
Nothing To see
Excitement! Intrigue! Wombats!
Dirty music, part 1
Why is a Tegan and Sara fan in this mosh pit?
For about two minutes, that was all I could think about. Nevermind that I, a more-than-infrequent listener of Tegan and Sara, was in the mosh pit as well. I couldn't wrap my mind around the presence of this demure-looking 20-something woman directly ahead of me, wearing her Tegan and Sara t-shirt and jumping around to Gogol Bordello with the rest of us. But she was excited. Lord, was she excited. Less so than the woman riding around on her boyfriend's (one assumes) shoulders, flashing the audience. Less so than the man in a superman cape and a translucent faceplate. But still, excited.
I'm an easily distractable person: the more things I have going on in my life at once, the better. If I'm focused on one thing, it's only a temporary condition until I decide to switch back to one of the five other tasks I have running in the background. It's overwhelming, sometimes.
So Coachella should be the perfect event for me. Camping out in a tent with your friends, you're woken up at 8 in the morning when the heat in your tent becomes unbearable. From then on, you have a day of pure, unstopping activity. Wander in to the stage area, and instantly you're presented with a plethora of things to do. Five stages, simultaneously showcasing music by five different bands. Myriad huge art displays, including a crazy multi-story tall bamboo sculpture and a pair of huge Tesla coils. Live DJs in a center stage, playing house music to accompany strange, choreographed modern dance pieces involving actors in nautically-themed circus makeup. Beer to drink. Food to eat. Thousands and thousands of people to watch.
"OK, so I'm going to spend a half-hour watching Devotchka, and then I'm going to walk over to see the last half of MGMT before checking out Stephen Malkmus, and then on to Death Cab For Cutie. Somewhere in there I need to get some food, too, and I think I might check out the Do Lab for a bit. If we time it right, I think we can get close to the stage for Portishead and then rush over to catch the last couple minutes of Flogging Molly before Prince starts up."
It was too much, even for me. By the end I gave up trying to plan, and just resigned myself to the fact that I wasn't going to be able to see all the bands I wanted to, and that was OK. If I just insisted on a few bands I really needed to see and just let the rest flow naturally, everything would work out alright. And it did.
I got to see Devotchka play, accompanied by an impressive pair of curtain acrobats (see: earlier post about clubbing experience. I can't think of a better description of them). The Breeders performed the only song of theirs that I (and, to all appearances, everyone else in the audience) knew. The Raconteurs, as uninteresting as their debut CD is, are enormously entertaining live.
And, much as I can't stand his blandness most of the time, it was weirdly relaxing being sung to sleep by Jack Johnson.
And Prince. Oh, my god, Prince. Before I saw his concert, I was woefully uneducated: I can't name a single Prince piece I'd heard other than Purple Rain. And, I suppose, the soundtrack to Batman -- but that doesn't count. So walking towards the elaborately constructed stage, preparing to be educated, I had no idea what to expect.
He introduced himself by saying "Congratulations, everbody. For the next two hours, you are going to be at the coolest place in the world." And he was right. I was overwhelmed. The man is a hell of an entertainer. I don't even know what he played -- I was so awash in spectacle and performance that I just couldn't keep track. Until very near the end, when a very familiar refrain hit my ear. I can recognize Radiohead anywhere. I don't think I've ever heard quite so unusual a cover of Creep before (hell, I don't think I've ever heard it covered at all), but there he was, up on stage, playing his own weirdly modified version. It was entrancing.
But even that couldn't compare to watching Portishead. Portishead is otherworldly in recorded form but live, they were almost more than I could take. I stood there for an hour, watching the stage, doing my utmost to keep my mind about me as I tried to take everything in, and just barely holding on. It was an incredible experience. I can barely even remember anything about the concert now, apart from the sheer, visceral sense of awe it inspired in me.
And so much for part one. Next post: a confusing incident involving a giant pig and shattered dreams.
Also maybe pictures, if L gets her photos developed and scanned. (who still uses film these days? Honestly!)
Disgorged by Seph at 7:53 PM 3 comments:
Labels: Coachella, heat, music, Portishead, Prince
Crazy scientists
I'm taking a class from a fairly prominent professor whose name I won't be divulging this term. He's one of the more well-known professors in the UCLA CS department -- he formalized the field of causal reasoning, which is what I'm studying this term. It's kind of neat taking a class from someone like that: on the off-chance that I meet someone in the outside world who's ever heard of this field, I can totally brag about how I took a class from a mini-celebrity! Oh, what an exciting life I lead.
In my admittedly limited experience, academics seem to care less and less about social propriety as they go along. A week or so ago, he was lecturing on the concept of Minimality in regards to Bayesian Networks. In essence, this is just a restatement of Occam's Razor, but recast in statistical terms. Basically it just says that, given two models that equally well describe the data, you should prefer the one that makes less assumptions about causal relationships. Very straightforward stuff. But to make sure we got the point, he decided to give us an example.
Prefaced by the very brief disclaimer, "I hope I'm not offending anyone," he launched into a fairly extended diatribe about how science provides a better model for interpreting the universe than religion. Imagine, if you will, with a thick Israeli accent: "You see, the difference is that science sticks out its neck! It sticks out its neck and makes a hypothesis that you can say is wrong! But in religion, something happens that you don't expect, and you say 'God did it!' and you don't explain anything. It doesn't stick out its neck! What good is that? Useless!" This went on for a good several minutes. Mind you, I completely agree with his rant -- it's just not quite the kind of lecture I expected to hear in a computer science class.
Unrelatedly, last weekend I went out to Cal Tech to listen to Stephen Hawking lecture about black holes (what else would he talk about?). Admittedly, I spent a huge chunk of the talk wondering exactly how much of the talk was pre-scripted -- I would have been surprised if he could form phrases fast enough to do a lecture in real-time, but it seemed kind of strange to have a lecture in which the speaker essentially sat still for several hours while a pre-recorded speech was played in the background (which was, in fact, basically what happened). As I sat there thinking vaguely disrespectful thoughts, Hawking makes a vagina joke. Hearing a prominent physicist joke about how the French read suggestive subtext into the name "black hole" caught me more than a little off-guard (apparently, the maxim "A black hole has no hair" only served to reinforce their suspicions).
He also said some other stuff about how information can escape a black hole and stuff like that, but frankly, that wasn't what stuck with me.
And, apropos of nothing, a lesbian stand-up comic called me a male hooker last night.
Disgorged by Seph at 11:25 PM 9 comments:
Labels: blackholes, occamsrazor, religion, scientists
Spring Break!
You know, it never occurred to me until about a week ago that I had never really experienced a spring break. Ever. I mean, I'd certainly had them, since I was in school and all. But I was always working, and never really did anything special for them. No trips to Cancun, no massive parties, nothing. I probably did some fun stuff here and there, but nothing leaps out as memorable. Alright, I guess maybe my freshman year spring break was pretty cool, but I'm not going to write about that here.
But that's the great thing about being back in grad school, right? You can pretend you're back in college again (because, really, you sort of are) and relive all the stuff you never got to do the first time 'round. Which, in retrospect, basically just means getting drunk. A lot.
My friend C decided to come down and visit for our shared spring break, so we spent a week bumming around LA. Mostly just site-seeing and bar-hopping, so nothing that would interest you that much. That being said, a few observations:
* I found a dive bar in Hollywood! Right next to the Walk of Stars! Mind you, a dive bar means that a Long Island costs $8, but that makes me kind of happy. On entering, the bouncer asked if we were cops. Apparently, that's more efficient than actually checking our IDs. Even better, though: It's Danny Boneduce's bar! Halfway through the evening, Danny walked in to the bar, much to my friend J's delight, and ordered a rather ridiculous amount of liquor. Coincidentally, my friend L tells me that he attends AA meetings at the theater where she works...
* If your friend has a tendency towards motion sickness and is drunk off of her ass, it would behoove you to not take her on a jaunt down Mullholland Drive.
* Did you know they're filming a Land of the Lost adaptation? Well, you do now. If you watch it (why wouldn't you?), watch for a scene where a bunch of kids run around screaming in the La Brea tarpits. If you look very closely in the background, you should see some very frustrated techies trying vainly to shoo a pair of 20-somethings off set. Apparently, film crews don't like it when random nerds crash the set trying to figure out what the hell they're filming.
* If you want to go out to karaoke in LA (BYOB karaoke! OMG!), make sure you start early. They close at 3:00 AM on weeknights, and it would be a shame if you only got in 6 hours straight of karaoke, like we did. We tried frantically motioning to the clerk that we wanted one more hour, but apparently there's only so much leeway they're willing to extend to a group that persists on dumping booze all over their songlists.
* Security at Disneyland is lax. Make sure you wrap your flask up in a sweatshirt, and they'll never find it. That way, you too can experience Space Mountain drunk off your ass. It's surprisingly more fun that way.
* Addendum to previous bullet point. Most rollercoasters have cameras on them that take your picture while you ride, which you can buy afterward for a ridiculous sum. If you and everyone else in your car makes coordinated, obscene gestures at said cameras, Disney will thoughtfully censor your pictures and not allow you to buy them. Try it!
* Joshua Tree National Park is gorgeous. The hiking is fantastic, camping is neat, and the scenery is amazing. Also, there are a lot of nifty secluded places where other people can't find you.
While drunkenly stumbling around Hollywood at midnight, we stumbled upon the footprints of a couple of my youthful heroes.
My friend L and I, having found a largish Joshua tree.
A Joshua tree by night.
Labels: camping, disneyland, drunkeness, joshuatree, karaoke, springbreak
Cobra's Shadow
Connected Things
Rip Tatermen
Skewed Snapshots From Tokyo
Sydney's Blog
Twin Ravens Press

redpajama_set_name: RedPajamaCommonCrawl


Use one of our unique kit abilities to buff your playstyle, while communicating with your team to strategize your attack or defence tactics. Check your supply crate daily for armor and other valuable supplies. Use the resources in your glade to grow or cook food, craft weapons and tools, or build defences.
Whether you plan to rush through the maze to destroy other teams, or simply defend your base from attacking opponents, Maze Runner has something for every play style. Your Princess is counting on you!
Want more kits? Purchase ranks here.
Visit the Maze Runner Player Guide here.


text:
NASSCO Affiliates
Bremerton, WA
Ligon Street Yard, Norfolk, Virginia
NASSCO-Norfolk's Ligon Street Yard is located at the confluence of the Southern and Eastern Branches of the Elizabeth River, directly across the river from downtown Norfolk. On NOAA Navigation Chart #12253, the coordinates are 36o 50' 18.27" North Latitude and 76o 17' 19" West Longitude.
Harper Avenue Yard, Portsmouth, Virginia
NASSCO-Norfolk's Harper Avenue Yard is located on 60 acres at Pinners Point in Portsmouth, Virginia next to the Portsmouth Marine Terminal and adjacent to the Elizabeth River. On NOAA Navigation Chart #12253, the coordinates are 36o 51' 7.2" North Latitude and 76o 18' 48.5" West Longitude.
PACNORWEST Headquarters, Bremerton, Washington
NASSCO-Bremerton is the cornerstone of NASSCO-Norfolk's Pacific Northwest business operation, which was established in late 2014 to support the company's new five-year aircraft carrier Multi-Ship/Multi-Option (CVN MSMO) contract. NASSCO-Bremerton is headquartered at 423 Pacific Avenue in Bremerton, with more than 27,000 square feet of additional industrial space located at 6000 Werner Road. NASSCO-Bremerton is also embedded in the Puget Sound Naval Shipyard (PSNS) in trailers located at Piers B and D.
NASSCO-Norfolk
Subcontractor Support
Standard Business Ethics and Conduct (Blue Book)
Security and Access Procedures


text:
Energy and Environment Reporting for Texas
Tracking the players in the ever-growing energy and environmental world.
Oil Production In Texas
Natural Gas Production In Texas
Railroad Commission of Texas (RRC)
Texas Railroad Commission Refutes Study Linking Quakes to Oil and Gas Industry
In the Land of the Oil Bust, the Repo Business Booms
In Some Texas Oil Towns, This 'Downturn' Feels More Like a 'Bust'
Oil Prices Spell Bad News For Texas Budget Forecast
Where politics, government and energy intersect.
Water Issues
The 83rd Texas Legislature
Texas Commission on Environmental Quality (TCEQ)
Obama Rejected Keystone XL, But Crude Flows Through Southern Part of Project
Will State Correct A Big Mistake In What Texans Paid For Electricity?
Power To Choose -Or To Pay More? State Of Texas Website Faulted By Consumers
The Texas Drought's Over, But The Texas Slow-Motion Water Crisis Is Not
Using less and saving more through ingenuity and efficiency.
Texas Solar Power
Texas Wind Power
Non-Wind And Non-Solar Renewable Resources
Electric Reliability Counfil of Texas (ERCOT)
New Tool Predicts Bird Deaths from Wind Turbines
Better Batteries Might Hold Enough To Power Your Neighborhood
NASA Satellite Will Improve Drought Forcasting With a Little Help From Texas
Copenhagen Turns to Two Wheels and Takes Off
Honey, I Shrunk The Windmills! To The Size Of An Ant
July 30, 2014 | 11:25 AM
By Lauren Silverman, KERA News
Comments Off on Honey, I Shrunk The Windmills! To The Size Of An Ant
One of the micro-windmills placed on a penny. UT Arlington
From KERA News Breakthroughs:
Commercial wind turbines stand more than a hundred feet tall, with blades nearly as long. The wind turbines developed by engineers at the University of Texas at Arlington are a bit smaller… just half than the size of an ant.
In a cold lab room at UT Arlington electrical engineering professor J.C. Chiao shows off a windmill. It's mounted on a grain of white rice. The micro windmill is a tiny speck of metal with a rectangular base and three shiny blades the size of ant antenna.
"Just think about it this way," Chiao says, "My interest and research focus is to shrink things."
https://stateimpact.npr.org/texas/files/2014/07/Mini-Windmills-UTA-mp3.mp3
The windmills aren't for a science fiction project. They're meant to harvest wind energy and deliver small bursts of energy to compact devices like remote sensors or cell phones.
Wind Power For Your Cell Phone
UT Arlington
UT Arlington Research Associate Smitha Rao
Smitha Rao, a university research associate at UT Arlington, came up with the design for the tiny turbines.
"We visualized that we could have a panel of these outside to power your outdoor lighting," she says.
The idea developed as Rao and Chiao talked, and Rao says her enthusiasm gave Chiao another idea:
"I was waving my hands and Dr. Chiao was like guess what else you could use it for? To charge your cell phone!"
That's right, a sleeve connected to your phone's battery would have the windmills mounted on top.
"So theoretically if you wave your hand enough you should be able to generate enough power to send that one important text message," Rao says.
Different Design Challenges
Creating windmills with parts a fraction of the diameter of a human hair was a real challenge.
Rao says at first the blades just weren't spinning with her original flat design.
That's when she notice something about her daughter's pinwheel one evening.
"I realized it had this curved structure that made it rotate much faster," Rao says. "Even when she was barely waving it and I said that's what I need to do – I need to create that artificial curvature on the blades to make it move faster."
The problem was in trying to create that curvature at such a small level from two-dimensional metal pieces.
So Rao worked with a Taiwanese electro-mechanical fabrication company on a new layering process. The result are blades that aren't exactly curved, but have a step-like structure that appears smooth and helps with rotation.
J.C. Chiao, a professor of electrical engineering at UT Arlington
A lot of people think small is weak. But Chiao says going small can mean less waste, lower cost and more efficiency. That's why engineers across the country are developing Microelectromechanical systems, or MEMs devices for applications in energy, medicine and transportation.
Still, there are concerns unique to miniature mechanics. Two in particular:
Moisture: "For the big windmill, moisture is not an issue, you can rain and the windmill still works. But for our device, moisture is a major issue. When it is very humid, the water molecule may go into the one micron gap and become glue. So it won't move at all."
Dust: "One small dust gets in there it will jam the device."
Chaio and Rao are still optimizing the mechanics of the windmills. Then, they hope to see them in action, perhaps harvesting energy to recharge your cell phone.
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Yeats, Philosophy, and the Occult
Edited by Matthew Gibson and Neil Mann
Yeats, Philosophy, and the Occult is a collection of essays examining the thought of the Irish poet W. B. Yeats and particularly his philosophical reading and explorations of older systems of thought, where philosophy, mysticism, and the supernatural blend. It opens with a broad survey of the current state of Yeats scholarship, which also includes an examination of Yeats's poetic practice through a manuscript of the original core of a poem that became a work of philosophical thought and occult lore, "The Phases of the Moon." The following essay examines an area where spiritualism, eugenic theory, and criminology cross paths in the writings of Cesare Lombroso, and Yeats's response to his work. The third paper considers Yeats's debts to the East, especially Buddhist and Hindu thought, while the fourth looks at his ideas about the dream-state, the nature of reality, and contact with the dead. The fifth essay explores Yeats's understanding of the concept of the Great Year from classical astronomy and philosophy, and its role in the system of his work A Vision, and the sixth paper studies that work's theory of "contemporaneous periods" affecting each other across history in the light of Oswald Spengler's The Decline of the West. The seventh essay evaluates Yeats's reading of Berkeley and his critics' appreciation (or lack of it) of how he responds to Berkeley's idealism. The book as a whole explores how Yeats's mind and thought relate to his poetry, drama, and prose, and how his reading informs all of them.
Matthew Gibson is Associate Professor of English Literature at the University of Macau. He is the author of Yeats, Coleridge and the Romantic Sage (2000) and Dracula and the Eastern Question: British and French Vampire Narratives of the Nineteenth Century Near East (2006). Neil Mann works as an editor, translator, and teacher, and as an independent scholar, specializing in the works of W. B. Yeats, particularly his esoteric interests and A Vision.
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text:
Cumberland Advisors Market Commentary – New Trends in Charitable Giving & Declining Confidence in Institutions Examined
Author: Gabriel Hament, Post Date: December 19, 2019
Over the last few decades, trust in key public institutions has been eroding.
Here are some recent figures compiled by Gallup (https://news.gallup.com/poll/1597/confidence-institutions.aspx) that document this trend:
In 1973, 42% of respondents said that they had a "great deal or quite a lot" of confidence in Congress. In 2019, only 11% expressed that level of confidence.
In 1979, 60% of the American public said they had a "great deal or quite a lot" of confidence in banks. In 2019, that number had dropped to 30%.
The categories of church/organized religion and public schools have exhibited similar trends.
For a possible explanation of why trust in institutions is evaporating—here in the United States and in other countries—please see this piece from The Atlantic (https://www.theatlantic.com/international/archive/2018/01/trust-trump-america-world/550964/).
Unfortunately, even those institutions focused on eleemosynary activities are suffering from a decrease in public confidence.
According to Edelman, a global communications marketing firm, trust in nonprofit organizations "…dropped nine points from 58 percent in 2017 to 49 percent in 2018" (http://www.give.org/news-updates/2018/01/31/wise-giving-wednesday-drop-in-trust-in-non-profit-organizations-in-u.s).
Although the trend in the public's attitude toward nonprofit organizations mirrored the overall decline seen across other institutions—such as the media and government—respondents believed that nonprofits (29 percent) were most likely to lead to a better future, "followed by business 22 percent, government 15 percent, and media 8 percent."
The Nonprofit Quarterly recently published the first article in a four-part series in which author Shena Ashley, vice president at the Urban Institute, sends up an emergency flare to draw attention to a structural shift underway in philanthropy: the precipitous decline in small and mid-sized donors who are contributing directly to nonprofits, despite the fact that total dollars flowing to charities are reaching all-time highs. The historic levels of giving to independent nonprofits and foundations masks the decrease in the number of donors engaging in traditional philanthropy:
"According to the 2019 edition of Giving USA, giving by individuals totaled an estimated $292 billion… the second-highest amount in nominal dollars on record."
But contrast this record-setting top-line number with the percentage of Americans making financial gifts to nonprofits: 65% made a donation in 2008; 53% in 2016.
Ashley suggests a series of reasons for the change in the behaviors of small and mid-sized donors:
"Kill two birds with one stone" consumerism is supplanting direct charitable giving as consumers purchase goods that support a social mission (e.g. Bombas: " For every Bombas clothing item you purchase, a specially-designed donation clothing item of the same kind is donated to someone in need.")
Via crowdfunding platforms, peer-to-peer philanthropy is proliferating at a rapid clip through social media channels, which allows users to give directly to an individual in need (see http://sparkgrowth.net/funding-continuum-and-landscape/).
The bottom line: "What is made clear by these trends, however, is that donors are seeking impact through forms of giving that are not intermediated by charitable organizations in the traditional sense."
How can independent nonprofits and foundations navigate these trends to ensure long-term financial sustainability?
Many of our readers serve on nonprofit and foundation leadership teams. Others have established donor advised funds at a local community foundation. We welcome conversation on how Cumberland can assist with your philanthropic goals.
Read about the trends that NPQ describes as "an urgent matter for the entire sector": https://nonprofitquarterly.org/why-the-decline-in-individual-donors-should-matter-to-institutional-philanthropy/.
Gabriel Hament
Investment Advisor Representative, Private Wealth & Non-Profits
Email | Bio
Links to other websites or electronic media controlled or offered by Third-Parties (non-affiliates of Cumberland Advisors) are provided only as a reference and courtesy to our users. Cumberland Advisors has no control over such websites, does not recommend or endorse any opinions, ideas, products, information, or content of such sites, and makes no warranties as to the accuracy, completeness, reliability or suitability of their content. Cumberland Advisors hereby disclaims liability for any information, materials, products or services posted or offered at any of the Third-Party websites. The Third-Party may have a privacy and/or security policy different from that of Cumberland Advisors. Therefore, please refer to the specific privacy and security policies of the Third-Party when accessing their websites.
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charitable dollarsGabriel HamentNonprofit


text:
Rancabugel is een bestuurslaag in het regentschap Pandeglang van de provincie Banten, Indonesië. Rancabugel telt 1845 inwoners (volkstelling 2010).

Plaats in Banten

redpajama_set_name: RedPajamaWikipedia


Church of St. Martin in the Fields, where All Are Welcome!
9:15 a.m. worship.together Holy Communion for families with young children - wiggles welcome!
Childcare is offered in the Undercroft (basement) of the church from 8:45 a.m. through the end of the 10:30 a.m. service.
Morning Prayer is offered weekdays at 7:30 a.m. in the Mary Chapel.
This service includes readings from scripture, psalms, prayers and intercessions and are conducted in a quiet, contemplative way. Lasts 30 minutes.
Silent Morning Meditation follows Morning Prayer from 8:15 to 8:45 a.m. weekdays, also in the Mary Chapel.
Join us as we celebrate a spoken Holy Eucharist including noonday prayers and readings from scripture.
Choral Evensong with sermon is held at 5:00 p.m. on the first Sundays of the month from October to June in the Church. Childcare is available for this service.
The Anglican service of evensong dates from the 1549 Book of Common Prayer. The service is the result of the joining of two of the ancient Sarum services—Vespers and Compline—into one service by Thomas Cranmer, first Anglican Archbishop of Canterbury and author of the first Prayer Book. St. Martin's sung Evensong services include sermons by guest preachers. Get information on music, guest preachers, and listen to recordings here.
Compline, "A Nightcap for the Soul" is a beautiful sung, 20-minute service to close out the day.
*During Lent, Compline will be held WEEKLY on Wednesdays at 7:00 p.m., preceded by a either SUPPER or a simple soup dinner.


text:
from twisted.internet import defer  # pylint: disable=import-error
from twisted.spread import pb  # pylint: disable=import-error

class AsyncCommandBase:

    MAX_BUFFER_SIZE = 1024 * 1024  # 1Mb

    def __init__(self, options=None, on_end_callback=None):
        self.options = options or {}
        self.on_end_callback = on_end_callback
        self._buffer = b""
        self._return_code = None
        self._d = None
        self._paused = False

        try:
            self.start()
        except Exception as exc:
            raise pb.Error(str(exc)) from exc

    @property
    def id(self):
        return id(self)

    def pause(self):
        self._paused = True
        self.stop()

    def unpause(self):
        self._paused = False
        self.start()

    def start(self):
        raise NotImplementedError

    def stop(self):
        self.transport.loseConnection()  # pylint: disable=no-member

    def _ac_ended(self):
        if self.on_end_callback:
            self.on_end_callback()
        if not self._d or self._d.called:
            self._d = None
            return
        if self._buffer:
            self._d.callback(self._buffer)
        else:
            self._d.callback(None)

    def _ac_ondata(self, data):
        self._buffer += data
        if len(self._buffer) > self.MAX_BUFFER_SIZE:
            self._buffer = self._buffer[-1 * self.MAX_BUFFER_SIZE :]
        if self._paused:
            return
        if self._d and not self._d.called:
            self._d.callback(self._buffer)
            self._buffer = b""

    def ac_read(self):
        if self._buffer:
            result = self._buffer
            self._buffer = b""
            return result
        if self._return_code is None:
            self._d = defer.Deferred()
            return self._d
        return None

    def ac_write(self, data):
        self.transport.write(data)  # pylint: disable=no-member
        return len(data)

    def ac_close(self):
        self.stop()
        return self._return_code


Peanut (Arachis hypogaea) is a plant which originates by South and Central America, primarily mainly grown on the soil of Mexico.
In appearance a peanut resembles to other tree nuts, such as almonds or hazelnuts, although according to the nomenclature peanut does not belong to nuts, already in legumes.
Peanut starts to grow like a flower. When the fruit grows, it is because of their weight bent to the ground where it place and matures.
Many associate peanuts with strong energy store, which he really did, but peanuts contain a lot of nutrients that are important and necessary for human health.
Among the most important minerals in peanuts are iron and zinc, which many other plants do not possess. In peanut are accommodated and other important minerals: potassium, phosphorus, magnesium, copper, manganese and selenium.
Vitamin composition of peanuts is also a representative; the most represented vitamin E and vitamin B complex (B2, B3, B6, and B9), vitamin C, tocopherol -provitamin of vitamin D.
The membrane peanut that is brown in color, possesses multitude of plant fibbers; but during heat treatment, membrane usually removed, but then is greater availability of protein inside the fruit.
Nutrients that are as important as the minerals and vitamins found in a peanuts are amino acid – arginine and coenzyme Q10.
Studies have shown that intake of peanuts in the form of peanut butter or raw peanuts, especially for breakfast, can reduce blood glucose levels in diabetics.
The peanuts are housed healthy unsaturated fats, and trans fat content is very low. The presence of magnesium, calcium, vitamin E in peanuts has positive influence on blood pressure, heart disease prevention, and reduction of total cholesterol and triglycerides.
Peanut is an energy-rich food, which gives a longer feeling of satiety and compensating for lost energy.
Peanuts contain a lot of vitamin B3, niacin, which, despite numerous medicinal properties, known in that helps the normal functioning of the brain and enhance memory.
Vitamin E which has a lot in peanuts maintains the normal function of screw glands, especially prostate and affects the potency.
The amino acid arginine has proved to be very effective in the fight against tuberculosis. This was confirmed by doctors, which are feed people suffering from tuberculosis on a daily basis with peanuts during treatment.
Peanuts and its oil are effective tools for the secretion of bile. A so-called vegetable milk peanut is very effective in the treatment of ulcers of the stomach and duodenum, gastritis and other gastric diseases.
What are the disadvantages of peanuts?
Peanut belongs to the group of frequent allergens; in sensitive people who consume it can cause severe allergic reactions, which is why those people should avoid peanut.
Because peanuts grow underground, there is a certainty that will be infected with a fungus that produces a toxin – aflatoxin. The presence of aflatoxin is most often on the fruits of which are narrower, due to the oxidation of fats.


The easiest way to grow cilantro is by sowing the seeds directly into the ground or into a container. Since cilantro has a short growing season, you'll want to direct sow seeds every few weeks or so from spring through fall to keep the plant growing. Cilantro isn't too needy as a plant and will thrive with a few light feedings early on and with a regular supply of water throughout the growing season. When you grow cilantro, you can harvest both the leaves and the seeds for cooking.
You can plant cilantro in your garden from either seeds or transplants. Seeds are often ideal, as you'll be able to grow multiple plants from them and can even double your harvest, by planting some seeds in the spring and another batch in the fall.
Transplants give you a headstart on growing cilantro, but come with one major caveat. Cilantro is known for bolting quickly, or producing a flower stalk and going to seed. Transplants are more likely to bolt even more quickly than plants grown from seed, meaning you'll have less time to enjoy the leaves from the plant before it starts producing seeds.
Another reason to start from seeds rather than a transplant is because cilantro just doesn't like to be transplanted. The plant has a taproot, according to Bonnie Plants, which makes transplanting it tricky.
Since cilantro has such a short growing period, it's ideal to start the plant from seed and to plant it in succession throughout the growing season, so that you have a steady crop through the spring, summer and fall. According Vegetable Gardener, some of the cilantro you plant will self-seed, so that you'll be able to enjoy new growth without much effort.
As the video from the Small Town Gardener shows, you don't have to particularly precise when planting cilantro from seed. Scatter the seeds over the growing area, cover with soil or not, and water well. You can thin the seedlings as they begin to grow.
Start your first crop by direct sowing the seeds about two weeks before the last frost date in your area. Plant a few more seeds every two to three weeks after that to keep the crop going. If you live in an area with very mild winters, you can sow seeds through the fall. The plants will survive over the winter and begin producing again in the spring.
Cilantro needs a fair amount of sun, plenty of water, and a decent amount of room to grow well. Thin your seedlings to stand about six inches apart when they are about two inches high.
If you live in an area that doesn't get too hot in the spring or summer, you can plant cilantro in full sun. A spot that gets a bit of shade can be ideal if you do live in a hot area, as it will keep the cilantro cool and delay bolting for some time.
You want to give cilantro some fertilizer, but not too much. Too much fertilizer, especially a nitrogen based fertilizer, will produce a plant that looks good but that doesn't have much flavor. Fertilize with fish or seaweed emulsion right after planting, but limit the feeding to just once or twice during the growing season.
Young cilantro needs more water than more established cilantro. During the first few weeks of the plant's life, give it about an inch of water each week. You can cut back on the water as it grows. Give it enough to keep the soil from drying out, but don't over saturate the soil.
Cilantro grows well in a container, either indoors or out. If you grow cilantro indoors, it's important that you put the container in an spot that gets enough sunlight or put the pot under a grow light. Without adequate light, the cilantro will grow long and lanky, without many leaves.
The trick to getting a full harvest of cilantro from a container is to plant several plants very close together. Instead of thinning each plant to a distance of about six inches, like you would in the ground, you want to grow container cilantro very densely.
A wide, not very deep container is ideal for cilantro. Look for a pot that is about 8 inches deep and about 18 inches in diameter. It should have drainage holes to keep the soil from becoming too moist and soggy.
Fill the pot with container soil, then spritz with water to moisten it. Scatter the seeds across the surface of the soil, then cover with about a 1/4 inch of soil. Water gently.
You can harvest cilantro relatively early in the growing season. The Old Farmer's Almanac recommends harvesting when the plant is low, before it has produced its flower stalk and gone to seed.
When harvesting the leaves, cut about one third of the plant at a time, leaving the rest intact for a later harvest. Cut the stems about an inch or so above the ground. To get the most from your cilantro, harvest a different area each time. By the time you've harvested the third or fourth area of your cilantro planting, the first area will have had time to grow back.
Along with harvesting the leaves of the plant for use in cooking, you can also harvest the seeds from the flower heads. You can either use the seeds, which are called coriander, in cooking or save them for planting in the garden next season.
Wait until the plant has dried out and turned brown to harvest the seed heads. Cut the seed heads off of the plant and put them in a paper bag to finish drying. After a few days in the bag, the seeds will fall off of the heads. Store the seeds in a cool, dry place.
If you can't get enough of cilantro in your cooking, it pays to grow it in your garden. If you leave some of the seeds on the plant, they'll fall onto the ground and sow themselves, meaning you'll have cilantro growing in your garden for many seasons to come.


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text:
SHURA home
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Research at SHU
Library Research Support
Understanding pre-teen consumers social media engagement
LICHY, J, MCLEAY, F, BURDFIELD, C and MATTHIAS, Olga (2022). Understanding pre-teen consumers social media engagement. International Journal of Consumer Studies.
Matthias-UnderstandingPreTeenConsumers(VoR).pdf - Published Version
Creative Commons Attribution Non-commercial.
Official URL: https://onlinelibrary.wiley.com/doi/full/10.1111/i...
Open Access URL: https://onlinelibrary.wiley.com/doi/epdf/10.1111/i... (Published version)
Link to published version:: https://doi.org/10.1111/ijcs.12821
Social media (SM) platforms are frequently used by pre-teen (8–12-year old) consumers for curating their self-identity, developing social relationships and for learning. This paper identifies the building blocks that drive pre-teen SM engagement. We use the Gioia method to analyse interview data collected from 32 pre-teens and parents, in France. Findings show that the primary building blocks are FoMO (Fear of Missing Out) and social inclusive experience, being noticed online, multiplicity, excessive use (without guidelines) and self-regulation. Identity constructs (self-identity and social-identity) are used to explain SM engagement – and to empirically define core conceptual building blocks (aggregate dimensions) that drive SM engagement. We contribute to consumer theory by developing a holistic research framework to examine pre-teen SM engagement. Self-identity and social-identity theories help explain the factors that drive pre-teen SM engagement and explain push/pull influences of parents and schools in encouraging or discouraging certain behaviour. We build on current research into SM usage, drawing from the fragmented existing literature, to reveal causes of both excessive screen-time and SM usage among pre-teen consumers, which may indicate antecedents of future adult behaviour. Practical and regulatory policy issues are considered and addressed.
parent; pre-teen interface; pre-teens (8-12-year olds); school; pre-teen interface; self-identity; Social media; social-identity; 1505 Marketing
https://doi.org/10.1111/ijcs.12821
Symplectic Elements
https://shura.shu.ac.uk/id/eprint/30361


text:
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Ultrasound-guided internal jugular vein access: Comparison between short axis and long axis techniques
Tarek F Tammam1, Eid M El-Shafey2, Hossam F Tammam3
1 Department of Anesthesia, Faculty of Medicine, Suez Canal University Hospital, Egypt
2 Nephrology Division, Department of Internal Medicine, Faculty of Medicine, Tanta University Hospital, Tanta, Egypt
3 Department of Radiology, Nasr Hospital, Cairo, Egypt
The use of real-time ultrasound (US) is advantageous in the insertion of central venous catheters (CVCs) in adults, especially in whom difficulties are anticipated for various reasons. The aim of the present study was to compare two different real-time 2-dimensional US-guided techniques [short axis view/out-of-plane approach (SAX OOP approach) versus long axis view/in-plane approach (LAX IP approach)] for internal jugular vein (IJV) cannulation. In this prospective study, 90 critical care and hemodialysis patients were assigned for insertion of CVCs using either the real-time US-guided (SAX OOP approach or LAX IP approach) or landmark technique (control group). Failed catheter placement, risk of complications from placement, failure on first attempt at placement, number of attempts until successful catheterization, time to successful catheterization, incidence of central line-associated blood stream infection (CLA-BSI) and demographics of each patient were recorded. There were no significant differences in patient's demographic characteristics, side of cannulation (right or left) or presence of risk factors for difficult venous cannulation between the three groups of patients. Cannulation of the IJV was achieved in all patients by using US (SAX OOP and LAX IP approaches) and in 27 of the patients (90%) by using the landmark technique (P = 0.045). Average access time (skin to vein) and number of attempts were comparable between the SAX OOP and the LAX IP approaches while significantly reduced in both US groups of patients compared with the landmark group (P <0.001). In the landmark group, puncture of the carotid artery occurred in 16.7% of the patients, hematoma in 23.3% of the patients, pneumothorax in 3.3% of the patients and CLA-BSI in 20% of the patients, which were all significantly increased compared with the US group (P <0.05). The findings of this study suggest that the SAX OOP and LAX IP approaches were comparable for cannulation of IJV in critical care and hemodialysis patients. Furthermore, both US-guided techniques were superior to the landmark technique for insertion of CVCs.
Tammam TF, El-Shafey EM, Tammam HF. Ultrasound-guided internal jugular vein access: Comparison between short axis and long axis techniques. Saudi J Kidney Dis Transpl 2013;24:707-13
Tammam TF, El-Shafey EM, Tammam HF. Ultrasound-guided internal jugular vein access: Comparison between short axis and long axis techniques. Saudi J Kidney Dis Transpl [serial online] 2013 [cited 2022 Jan 29];24:707-13. Available from: https://www.sjkdt.org/text.asp?2013/24/4/707/113861
Internal jugular vein (IJV) catheterization is commonly attempted to obtain central venous access for hemodynamic monitoring (such as central venous pressure), long-term administration of fluids, antibiotics, total parenteral nutrition and hemodialysis. Many anatomical landmark (LM)-guided techniques for IJV puncture have been described. [1],[2] More than 5 million central venous catheters (CVC) are placed each year in the United States, with an associated complication rate of >15%. [1],[2] Mechanical complications such as arterial puncture and pneumothorax are seen in up to 21%, and up to 35% of the insertion attempts are not successful. [3],[4],[5] The risk of complications depends on several factors, including (but not limited to) operator experience, urgency of placement as well as patient factors such as obesity, prior difficult cannulation and coagulopathy. [4],[6],[7] It has been suggested that ultrasound (US) guidance could improve the success rate, reduce the number of needle passes and decrease complications. [4],[5] Although the US method has been favorably compared with the landmark technique, its widespread use has been hampered by the unavailability of equipment, such as the specially designed US device and the lack of trained personnel. Two different real-time 2-dimensional US techniques can be employed in the insertion of CVCs. The first technique involves real-time US-guided cannulation of the internal jugular vein (IJV) using a short axis/out-off-plane (SAX OOP) approach. The second one involves real-time US-guided cannulation of the IJV using a long axis/in-plane (LAX IP) approach. The purpose of this study was to compare two different real-time 2-dimensional US-guided SAX OOP and LAX IP approaches and to determine whether US guidance could improve the success rate and decrease the complication rate of IJV catheterization compared with the landmark technique.
This prospective study was conducted from December 2009 to November 2010 in 90 critical care and hemodialysis patients assigned for insertion of CVCs. Ethics committee approval was obtained and all patients gave written informed consent. Patients' refusal and local infections were exclusion criteria. The patients were randomly divided into three groups:
Group 1: Thirty patients underwent real-time US-guided cannulation of the IJV with a SAX OOP approach.
Group 2: Thirty patients underwent real-time US-guided cannulation of the IJV with a LAX IP approach.
Group 3: Thirty patients underwent cannulation of the IJV with the landmark technique.
The patients were randomly assigned on a one-to-one ratio. Randomization was performed by means of a computer-generated random numbers table and patients were stratified with regard to age, gender and body mass index (BMI).
Before each procedure, an intravenous access and standard monitoring of electrocardiogram, non-invasive arterial blood pressure and pulseoximetry were established. Mechanical complications were defined as carotid artery puncture, hematoma formation, pneumothorax, hemothorax and catheter malposition. Carotid artery puncture was noted by forceful pulsatile expulsion of bright red blood from the finder needle. All mechanical complications were evaluated clinically by a chest X-ray and by means of ultrasonography, where appropriate.
Patients were placed in a supine position with the head rotated at a 30° angle in the Trendelenburg position. The patient was positioned with a rolled towel under the shoulders and the head turned to the opposite site for IJV cannulation. Physicians followed the standard sterile technique; the neck area including the top of the triangle between the sternal and the clavicular head of the sternocleidomastoid muscle was prepared with povidone-iodine before the placement of sterile drapes. Also, the sonographic probe was covered with ultrasonic gel and wrapped in a sterile plastic sheath (MicroTek Medical, Columbus, MS, USA).
Real-time ultrasound-guided method
The US-guided technique was performed using a portable unit (GE LogiqBook XP Portable Ultrasound Machine; General Electric Company, GE Healthcare - Americas, USA). Adjustments (depth, frequency and gain) were made to obtain optimal images for identifying the IJV and the surrounding anatomical structures using a 10 MHz linear-array US probe. Whatever the US approaches, the procedure proceeded with the standard Seldinger technique under real-time US guidance and continuous dynamic observation of the IJV and the carotid artery.
SAX OOP approach: Real-time 2D images were obtained by placing the transducer parallel and superior to the clavicle, over the groove between the sternal and the clavicular heads of the sternocleidomastoid muscle, imaging of the great vessels (the IJV and carotid artery) transversely (short-axis view), followed by percutaneous out-of-plane cannulation [Figure 1].
Figure 1: Visualization of the needle entering the anterior wall of the right internal jugular vein (RIJV) (short axis/out-of-plane approach) (white arrow). Visualization of the needle entering the venous lumen (long axis/in-plane approach) (black arrow).
LAX IP approach: The transducer was placed perpendicular and superior to the clavicle over the groove between the sternal and clavicular heads of the sternocleidomastoid muscle, visualizing the IJV and carotid artery in the long-axis view. Using the in-plane technique, the needle was introduced at the superior end of the transducer and advanced into the plane, allowing all time visualization of the tip and shaft of the needle during the procedure [Figure 1].
Landmark technique
The "finder" needle connected to a 2 mL syringe was advanced through the skin at a 45° angle in the direction of the ipsilateral nipple. The return of venous blood into the syringe confirmed entry into the vessel. A 16- or 18-gauge needle of CVCs set was inserted using the guidance of the finder needle and, after that, the procedure proceeded with the standard Seldinger technique.
The standard Seldinger technique
After infiltration with 1% lidocaine, the IJV was punctured with a 16- or 18-gauge, 10 cm needle (Cook, Bloomington, IN, USA). The needle was advanced with continuous negative pressure on a 10 mL syringe attached to it. Once blood return was noted, the syringe was removed and a guide wire was advanced through the needle into the internal jugular vein. The needle was removed and the dilator was carefully advanced using to-and-fro rotations and then a vascular catheter (FlexTip, Arrow International Inc., Reading, PA, USA; K-Flow Catheter Dual and Triple Lumen Temporary Hemodialysis, Kimal plc Arundel Road Uxbridge Middlesex UB8 2SA England) was advanced over the wire to 12 cm at the skin and was fixed and secured with a transparent dressing.
All US-guided and landmark-guided catheterizations were performed by well-trained attending anesthetists, nephrologists or intensivists with similar experience (ten years of experience in IJV catheter placements) to minimize the effect of operator experience on the success rate and the rate of mechanical complications. Furthermore, the physicians who performed the US-guided method were well trained and had at least five years of experience in performing this method. In most patients in whom the first attempt (one pass of the introducing needle) at catheterization failed, another physician performed the next attempt. The insertion of a CVC is followed by chest radiography for verification of the catheter's course and the position of its tip after the procedure. Examination was performed by another observer.
Forms containing patients' characteristics and all the pertinent fields for each technique were filled out in a timely fashion. The following data were also recorded: Side of catheterization (either right or left) and the presence of risk factors for difficult venous cannulation, such as prior catheterization, limited sites for access attempts (other catheters, pacemaker and local surgery or infection), previous difficulties during catheterization (more than three punctures at one site, two sites attempted and failure to gain access), previous mechanical complication, known vascular abnormality, untreated coagulopathy (international normalization ratio >2, activated partial thromboplastin time >1.5 and platelets <50 × 10 9 per liter), skeletal deformity and cannulation during cardiac arrest. [3],[8] The outcomes assessed were the access time, the average number of attempts before successful placement (defined as separate skin punctures), the success of placement, the rate of mechanical complications and the incidence of central line-associated blood stream infection (CLA-BSI). Access time was defined as the time between penetration of skin and aspiration of venous blood into the syringe. Preparation times for both techniques were quite similar. The access time was measured in seconds by a stopwatch by other physicians, and the number of attempts and complications were recorded. It is of note that every effort was made to ensure the application of evidence-based catheter insertion practices in both methods. [9] All patients were receiving antibiotic treatment during the study period. CLA-BSIs were defined as only those blood stream infections for which other sources were excluded by careful examination of the patient record and in which a culture of the catheter tip demonstrated substantial colonies of an organism identical to those found in the blood stream. [9]
Data were expressed as mean ± standard deviation. The one-way ANOVA test for independent means or Pearson's chi-square test, where appropriate, were used to identify differences between the two groups. A P-value (two-sided in all tests) of <0.05 was considered significant. SPSS software, version 16.0, was used (SPSS Inc., Chicago, IL, USA).
There were no significant differences between the three groups of patients in gender, age, BMI, side of catheterization or presence of risk factors for difficult venous cannulation, such as prior catheterization, limited sites for access attempts, previous difficulties during catheterization, previous mechanical complication, known vascular abnormality, untreated coagulopathy, skeletal deformity and cannulation during cardiac arrest [Table 1]. In all patients in the US groups (SAX OOP and LAX IP groups), the IJV was visualized and cannulated. Furthermore, three patients in the landmark group in whom catheterization was unsuccessful were converted to the US method [Table 2]. Thrombosis was identified in two cases (which led to anticoagulation of these patients) and anatomical variation of the IJV in the other patient, and these were very likely the reasons for which the landmark method failed. Average access time and number of attempts were both significantly reduced using US compared with the landmark technique (P <0.001) [Table 2]. Meanwhile, no significant difference was found in the SAX OOP group compared with the LAX IP group (P = 0.94 and P = 0.84, respectively).
Table 1: Baseline characteristics of the studied groups.
Table 2: Outcome measures in the ultrasound groups versus the landmark group of patients.
The success rate was significantly lower and the rate of mechanical complications was significantly higher in the landmark group of patients as compared with the US groups (P <0.05) [Table 2]. Furthermore, in the landmark group, only one case of pneumothorax that required therapeutic intervention occurred, but no hemothorax was observed in all the studied groups. All landmark-guided and US-guided catheterizations were performed by well-trained attending nephrologists, anesthetists and inten-sivists with similar experience (ten years of experience in IJV catheter placements); therefore, the effect of operator experience on the success rate and the rate of mechanical complications was non-significant (P < 0.05). Number of CLA-BSIs in the landmark group was similar to that documented in the US groups (SAX OOP and the LAX IP approaches) (P = 0.421) [Table 2]. The type of micro-organisms responsible for the CLA-BSIs in the US group of patients versus those responsible for the CLA-BSIs in the landmark group was similar: Coagulase-negative Staphylococci (50%), Staphylococcus aureus (25%) and Enterococus species (16.7%), being responsible for the CLA-BSIs in both procedures.
CVC cannulation is associated with a number of technical complications. The common ones are arterial puncture (10.6-13%) and hematoma formation (4-8.4%). [7],[10] Using US, Denys and Uretsky found that 8.5% of 200 patients had abnormal IJV anatomy, with a small fixed IJV in 3%, no right IJV at all in 2.5%, an IJV medial to the carotid in 2% and an IJV lateral to the carotid with no overlap in 1%. [11] The position of the IJV in relation to the carotid artery shows high variability. In the majority of patients, the IJV lies lateral to the carotid artery; as one moves more cranially, it comes closer and sometimes even anterior to the carotid artery. In up to 5%, the position might even be medial to the carotid artery. These common anatomic variants may explain the higher complication rates and need for multiple attempts to achieve success using the landmark technique alone.
Real-time US guidance of CVC insertion provides the operator with visualization of the desired vein and the surrounding anatomic structures prior to and during the insertion of the catheter. This method appears to improve the success rate and decrease the complication rate associated with CVC placement. [4],[12],[13]
Using the landmark method, we found that the success rate of IJV cannulation was 90%, which is in consistent with the success rates documented in previous reports ranging from 85% to 99%. [13],[14],[15] The incidence of arterial puncture of the carotid artery using the landmark method (16.7%) was comparable with larger studies [13] but higher than those reported (3-6%) in other series. [14] Also, the incidence of hematoma and pneumothorax (23.3% and 3.3%, respectively) using the landmark method was in the range of previous studies. [13],[14]
The incidence of mechanical complications using the US-guided techniques was negligible, which is in agreement with the previous reports. [6],[13],[15] Using US guidance, the incidence of carotid puncture and hematoma was very low and (as shown before) no cases of hemothorax and/or pneumothorax were observed. [13],[15]
The clinical notion that the additional equipment and manipulation associated with the US method might have increased the rate of catheter-related infection was not confirmed by the present data. We found that the incidence of CLA-BSI in the US group of patients was insignificantly lower compared with that documented in the landmark group. The number of CLA-BSIs was significantly correlated to the number of needle passes in the total study population. We could speculate that repeated attempts might lead to a break-down of the aseptic technique and more colonization of skin-related pathogens. [9]
The use of real-time US guidance prevents the insertion of the catheter into a vein complicated by thrombosis or into a small vein. [8] In our study, IVJ catheterization was not successful in two patients in the landmark group and was performed by the US guidance. In a previous study, ultrasonography imaging detected venous thrombosis in 33% of critical care patients; in approximately 15% of these patients, the thrombosis was catheter related. [16] Also, attempts to cannulate thrombotic veins usually are unsuccessful even when the anatomy is normal. [8]
The present study did not show significant differences between the two different US approaches (SAX OOP and the LAX IP); however, it supports the superiority of real-time US-guided IJV cannulation as compared with the landmark technique in mechanically ventilated, critical care patients. During the US-guided procedure, the IJV can be compressed completely by the needle before the vessel is actually penetrated. Then, the needle must be advanced a little deeper and retracted slightly to be positioned in the center of the lumen. In accordance with this, we recommend to use 2D US images recorded on both short and longitudinal axes during the IJV cannulation. Visualization of the IJV on the short axis was particularly useful for catheterization of the small vessels, whereas the primary advantage of the longitudinal view is to visualize the advancing needle tip.
This study showed that the short axis/out-of-plane approach was comparable to the long axis/in-plane approach for catheterization of the IJV, and could improve the success rate and lower the mechanical complication rate compared with the landmark technique. Interestingly, CLA-BSIs in the landmark group were similar to those in the US groups.
1. English IC, Frew RM, Pigott JF, Zaki M. Percutaneous catheterisation of the internal jugular vein. Anaesthesia 1969;24:521-31.
2. Hayasi H, Ootaki C, Tsuzuku M, Amano M. Respiratory jugular vasodilation. A new landmark for right internal jugular vein puncture in ventilated patients. J Cardiothorac Vasc Anesth 2000;14:40-4.
3. Digby S. Fatal respiratory obstruction following insertion of a central venous line. Anaesthesia 1994;49:1013-4.
4. Randolph AG, Cook DJ, Gonzales CA, Pribble CG. Ultrasound guidance for placement of central venous catheters: A meta analysis of the litarature. Crit Care Med 1996:24:2053-8.
5. Bond DM, Champion LK, Nolan R. Real time ultrasound imaging aids jugular venipuncture. Anesth Analg 1989:68;700-1.
6. Hayasi H, Amano M. Does ultrasound imaging before puncture facilitate internal jugular vein cannulation? Prospective randomized comparison with landmark guided puncture in ventilated patients. J Cardiothorac Vasc Anesth 2002;16:572-5.
7. Karakitsos D, Labropoulos N, De Groot E, et al. Real-time ultrasound-guided catheterisation of the internal jugular vein: A prospective comparison with the landmark technique in critical care patients. Crit Care 2006;10:R162.
8. Hatfield A, Bodenham A. Portable ultrasound for difficult central venous access. Br J Anaesth 1999;82:822-6.
9. Center for Disease Control and Prevention DC. National Nosocomial Infections Surveillance (NNIS) System Report, Data Summary from January 1992-June issued August 2001. Am J Infect Control 2001;29:404-21.
10. Martin MJ, Husain FA, Piesman M, et al. Is routine ultrasound guidance for central line placement beneficial? A prospective analysis. Curr Surg 2004;61:71-4.
11. Denys BG, Uretsky BF. Anatomical variations of internal jugular vein location: Impact on central venous access. Crit Care Med 1991;19: 1516-9.
12. Malloy DL, McGee WT, Shawker TH, et al. Ultrasound guidance improves the success rate of internal jugular vein cannulation: A prospective, randomized trial. Chest 1990;98:157-60.
13. Dennys BG, Uretsky BF, Reddy S. Ultrasound-assisted cannulation of the internal jugular vein a prospective comparison to the external landmark-guided technique. Circulation 1993;87: 1557-62.
14. Sznajder JI, Zveibil FR, Bitterman H, Weiner P, Bursztein S. Central vein catheterization. failure and complication rates by three percutaneous approaches. Arch Intern Med 1986;146: 259-61.
15. Gordon AC, Saliken JC, Johns D, Owen R, Gray RR. US-guided puncture of the internal jugular vein: Complications and anatomic considerations. J Vasc Interv Radiol 1998;9:333-8.
16. Hirsch DR, Ingenito EP, Goldhaber SZ. Prevalence of deep venous thrombosis among patients in medical intensive care. JAMA 1995; 274:335-7.
Eid M El-Shafey
Department, of Internal Medicine, Tanta University Hospitals, Tanta
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