I surfed at this beach when I went to college in Charleston. This is not the type of story you like to hear and lucky no one was actually hurt. These beach is very popular with the surfers and provides descent waves because of the river's channel running along the beach making it a shallow to deep fast compared to Hilton Head where is stays shallow further out. Bull Sharks are found through out the world in coastal areas and has even been found in certain fresh water rivers around the world.
An 8-foot bull shark bit a boy's surfboard during a competition on Folly Beach, but the 10-year-old boy was able to swim to safety.
The Post and Courier of Charleston reports (http://bit.ly/19cuqTA ) the boy was able to escape Sunday when he unhooked his leash. Two other surfers swam out and helped the boy to shore.
Nancy Hussey is a director of the Southern South Carolina District of the Eastern Surfing. She says she saw the scene unfold and thinks the shark got tangled in the leash.
After the attack, contest workers cleared the water and the remaining competitions were postponed until next month.
Bull sharks are known for their aggression and swimming in warm, shallow waters. But officials say such attacks in the area have been rare.
An interesting Shark tale in the paper the other day which to share with you since we see small sharks feeding along the banks in the creeks.
COLUMBIA — Scientists have discovered a new species of shark in the ocean off South Carolina and have named it for the region where it was found.
The "Carolina hammerhead," thought to reach 11 feet long and weigh about 400 pounds, has been identified cruising the waters of St. Helena Sound near Beaufort, Bull's Bay north of Charleston, and in the Charleston harbor.
William "Trey" Driggers is pictured with a Carolina hammerhead.
Biologists suspect these hammerheads occur worldwide, since evidence of them has been found in the past from Brazil to the Indian Ocean. The number of Carolina hammerheads is thought to be small, however.
"It is a distinct species," said William "Trey" Driggers, a marine scientist with the National Oceanic and Atmospheric Administration's fisheries division.
Driggers, a 45-year-old Sumter native and Clemson University graduate, was among a team of scientists with NOAA, the University of South Carolina, the University of New Orleans and the S.C. Department of Natural Resources that made the discovery after more than a decade of research.
Much of the work was done in the laboratory of USC professor Joseph Quattro, he said. Veterinarians in Columbia also collaborated on the discovery.
Driggers said it's almost impossible to tell the difference between a Carolina hammerhead and the well-known scalloped hammerhead — except for one major distinction: The newly identified species has fewer vertebrae than their cousins.
Carolina hammerheads have 83 to 91 vertebrae, while scalloped hammerheads have 92 to 99 vertebrae.
While the distinction between scalloped and Carolina hammerheads is subtle, NOAA officials say it's significant to the conservation of the species. Scalloped hammerhead numbers are dwindling in some areas, so Carolina hammerhead numbers would be even fewer, they said.
Evidence of a hammerhead with fewer vertebrae dates to a single reference in a 1967 research paper, but only in the past decade have scientists obtained more detailed information.
Some 56 sharks used to identify the Carolina hammerhead were all collected off the South Carolina coast.
Carolina and scalloped hammerheads are the second largest sharks found in Palmetto State waters, behind the great hammerhead. The animals are distinguished by their wide, anvil-like heads.
Another recent sad news article I read about our favorite water creatures we enjoy seeing.
Bottlenose dolphins are washing up dead in unusually high numbers along the U.S. East Coast this summer—a "very alarming" situation that has experts scrambling to decipher the cause.
Nearly 120 corpses have washed ashore in coastal states from New York to Virginia in July and the first week of August, which is much higher than the normal number of strandings attributed to natural deaths. Virginia has had the highest mortality, with 64 animals found during that period.
One of the dolphins tested positive for morbillivirus, a measles-like, airborne virus that's often fatal in dolphins.
Trained responders examine a dead male dolphin on Ocean View Beach in Norfolk, Virginia, on August 1.
A morbillivirus epidemic hit East Coast bottlenose dolphins in 1987 and 1988, wiping out at least 900 animals and striking a major blow to that population of migratory dolphins.
"Because of the sheer number of animals [dying] over multiple states, people are very concerned that this might be a repeat," said Trevor Spradlin, a marine mammal biologist for the U.S. National Oceanic and Atmospheric Administration's (NOAA) National Marine Fisheries Service.
Several potential causes of death being investigated include other diseases or pathogens caused by viruses or bacteria; biotoxins caused by harmful algae blooms; pollution or chemicals, especially from concentrated spills; ship strikes; or acoustic trauma from ships or other infrastructure, he said.
The spike follows a general trend in more dolphin strandings—or, in scientific speak, unusual mortality events—that have occurred in recent decades in the United States.
The "concern is we're doing more and more to protect dolphins from harm, yet dolphin strandings are on the rise," said Matthew Huelsenbeck, a marine scientist at the nonprofit Oceana.
But many are working to find out. For example, NOAA has a stranding network of experts who report and collect the corpses of recently deceased dolphins in an effort to determine causes of death.
A corpse is first taken into the lab for evaluation and basic triage to see if it has any visible marks that may point to the cause of its demise. Next, a tissue sample is taken and tested for viruses, which could identify a direct cause.
Then there's a longer-term investigation that involves testing blubber and organs, such as kidneys, for traces of heavy metals. Studies have shown that stranded dolphins have heavy metals in their systems.
Pneumonia often occurs in dolphins with low immunity.
"Just like in humans, if you have certain afflictions affecting your immune system, you're more susceptible to pneumonia," he said.
What's more, he noted, most of the East Coast dolphin deaths have occurred in areas with heavy human footprints, like the Chesapeake Bay.
Gregory Bossart, the Georgia Aquarium's chief veterinarian and pathologist, has been studying the impact of infectious disease and pollutants on bottlenose dolphins in Florida's Indian River Lagoon (map) for several years.
He's found that many of the lagoon's dolphins carry toxic mercury at 20 times the level permitted in human food by the U.S. government.
Even so, Bossart cautioned that no one should jump to the morbillivirus conclusion for the current East Coast deaths before all the information is in—much more pathology work needs to be done in the lab.
"The possibilities are wide open," he said.
Overall, the experts pointed out that the dead dolphins may be alerting us to troubles in our oceans.
Said NOAA's Spradlin, "Marine mammals are like the canary in the coal mine"—many bottlenose dolphins live on the same coasts and eat the same fish that we do.
Came across an article in Kayak Fishing Magazine and wanted to share it with you. It is good for all to know the rules when it comes to the Coast Guard and Kayak fishing. Article below.
For many of us, the encroaching warmth of summer signifies a seasonal increase in kayak angling opportunities. With the longer and brighter days, however, come tales of tragic and often preventable on-water disasters. For seasoned veterans and first time boaters alike, it is always a good idea to review the rules and regulations put forth to ensure our safety. The time is also right for kayak anglers to take stock of their existing safety gear, and to make sure that it is in top condition. A few minutes spent in preparation can truly make a world of difference on the water.
The rules governing navigation and navigable waters within the United States are governed by Title 33 of the Code For Regulations (CFR). Here is a list of equipment required while you are on the water kayak fishing.
A Personal Floatation Device (PFD) in good serviceable condition (see Title 33 CFR 175.15).
A Sound Producing Devices such as a whistle or horn (see Title 33 CFR 83.33).
"An electric torch or lighted lantern showing a white light which shall be exhibited in sufficient time to prevent collision" (see Title 33 CFR 83.25).
Visual Distress Signals at the very least suitable for night use if out between sunset and sunrise (see Title 33 CFR 175.110) if your kayak is less than 16 feet.
The specific sections of Title 33 CFR referenced above are linked to the actual wording included below.
§ 175.15 Personal flotation devices required.
(b) No person may use a recreational vessel 16 feet or more in length unless one Type IV PFD is on board in addition to the total number of PFDs required in paragraph (a) of this section.
(2) Below decks or in an enclosed cabin.
(3) The PFD is used in accordance with requirements in its owner's manual, if the approval label makes reference to such a manual.
(b) Canoes and kayaks 16 feet in length and over are exempted from the requirements for carriage of the additional Type IV PFD required under § 175.15(b).
(c) Racing shells, rowing sculls, racing canoes and racing kayaks are exempted from the requirements for carriage of any Type PFD required under § 175.15.
(d) Sailboards are exempted from the requirements for carriage of any Type PFD required under § 175.15.
(e) Vessels of the United States used by foreign competitors while practicing for or racing in competition are exempted from the carriage of any PFD required under § 175.15, provided the vessel carries one of the sponsoring foreign country's acceptable flotation devices for each foreign competitor on board.
§ 175.21 Condition; size and fit; approval marking.
(c) Legibly marked with its approval number, as specified in 46 CFR part 160.
(2) Webbings or straps used to secure the PFD on the wearer that are ripped, torn, or which have become separated from an attachment point on the PFD; orbr/>(3) Any other rotted or deteriorated structural component that fails when tugged.
(3) Loss of buoyant material or buoyant material that is not securely held in position.
(5) Inflator status indicators that are not broken or otherwise non-functional.
(d) The inflation system of an inflatable PFD need not be armed when the PFD is worn inflated and otherwise meets the requirements of paragraphs (a) and (c) of this section.
§ 83.25 Sailing vessels underway and vessels under oars (Rule 25).
(b) Sailing vessels of less than 20 meters in length. In a sailing vessel of less than 20 meters in length the lights prescribed in paragraph (a) of this Rule may be combined in one lantern carried at or near the top of the mast where it can best be seen.
(c) Additional lights. A sailing vessel underway may, in addition to the lights prescribed in paragraph (a) of this Rule, exhibit at or near the top of the mast, where they can best be seen, two all-round lights in a vertical line, the upper being red and the lower green, but these lights shall not be exhibited in conjunction with the combined lantern permitted by paragraph (b) of this Rule.
(d) Sailing vessels of less than 7 meters in length; vessels under oars.
(1) A sailing vessel of less than 7 meters in length shall, if practicable, exhibit the lights prescribed in paragraph (a) or (b) of this Rule, but if she does not, she shall have ready at hand an electric torch or lighted lantern showing a white light which shall be exhibited in sufficient time to prevent collision.
(2) A vessel under oars may exhibit the lights prescribed in this Rule for sailing vessels, but if she does not, she shall have ready at hand an electric torch or lighted lantern showing a white light which shall be exhibited in sufficient time to prevent collision.
(e) Vessels proceeding under sail. A vessel proceeding under sail when also being propelled by machinery shall exhibit forward where it can best be seen a conical shape, apex downward. A vessel of less than 12 meters in length is not required to exhibit this shape, but may do so.
§ 83.33 Equipment for sound signals (Rule 33).
(a) Vessels of 12 meters or more in length. A vessel of 12 meters or more in length shall be provided with a whistle and a bell and a vessel of 100 meters or more in length shall, in addition, be provided with a gong, the tone and sound of which cannot be confused with that of the bell. The whistle, bell and gong shall comply with the specifications in Annex III (§ 86.05) to these Rules. The bell or gong or both may be replaced by other equipment having the same respective sound characteristics, provided that manual sounding of the prescribed signals shall always be possible.
(b) Vessels of less than 12 meters in length. A vessel of less than 12 meters in length shall not be obliged to carry the sound signaling appliances prescribed in paragraph (a) of this Rule but if she does not, she shall be provided with some other means of making an efficient sound signal.
§ 86.05 Sound signal intensity and range of audibility.
(c) 250-2100 Hz, for a vessel 12 meters but less than 20 meters in length.
Note. The range of audibility in the table above is for information and is approximately the range at which a whistle may usually be heard on its forward axis in conditions of still air on board a vessel having average background noise level at the listening posts (taken to be 68 dB in the octave band centered on 250 Hz and 63 dB in the octave band centered on 500 Hz).
§ 175.110 Visual distress signals required.
(a) No person may use a boat 16 feet or more in length, or any boat operating as an uninspected passenger vessel subject to the requirements of 46 CFR chapter I, subchapter C, unless visual distress signals selected from the list in § 175.130 or the alternatives in §175.135, in the number required, are onboard. Devices suitable for day use and devices suitable for night use, or devices suitable for both day and night use, must be carried.
(b) Between sunset and sunrise, no person may use a boat less than 16 feet in length unless visual distress signals suitable for night use, selected from the list in § 175.130 or § 175.135, in the number required, are on board.
§ 175.130 Visual distress signals accepted.
(1) An electric distress light meeting the standards of 46 CFR 161.013. One is required to meet the night only requirement.
(2) An orange flag meeting the standards of 46 CFR 160.072. One is required to meet the day only requirement.
(3) Pyrotechnics meeting the standards noted in Table 175.130.
(b) Any combination of signal devices selected from the types noted in paragraphs (a) (1), (2) and (3) of this section, when carried in the number required, may be used to meet both day and night requirements. Examples —the combination of two hand held red flares (160.021), and one parachute red flare (160.024 or 160.036) meets both day and night requirements. Three hand held orange smoke (160.037) with one electric distress light (161.013) meet both day and night requirements.
1 These signals require use in combination with a suitable launching device approved under 46 CFR 160.028 .
2 These devices may be either meteor or parachute assisted type. Some of these signals may require use in combination with a suitable launching device approved under 46 CFR160.028 .
3 Must have manufacture date of 1 Oct. 1980 or later.
Launchers manufactured before 1 January, 1981, which do not have approval numbers are acceptable for use with meteor or parachute signals listed in Table 175.130 under § 175.130 as long as they remain in serviceable condition.
A recent article about putting to use the sometimes abundant pest which drift with our currents. We see them in the creek and wash up on the beach when walking along the shore. And there are a few of us who have been on the wrong end of the stingers. But what are they good for or is there demand for them? A recent article answers some questions but raises others. Articles below.
A seafood processing company would bring as many as 250 jobs to the Beaufort area under a plan that would rehabilitate the Port Royal shrimp docks and build a processing plant in Gardens Corner.
"Our goal is to create a fishing area the town of Port Royal can be proud of," Millenarian Trading Co. representative Steven Giese told Port Royal Town Council during a work session Wednesday night.
The project, code named "Operation Blossom," was first referenced by town manager Van Willis during a meeting in February. On Wednesday, he said council is considering a five-year lease for the docks. The property is owned by the S.C. State Ports Authority and will be given to the town in a swap, if the Port of Port Royal is sold to a developer. In the meantime, the town has an agreement to run the shrimp docks. Under the terms of the town's lease with the ports authority, such an operation is allowed, Willis said.
The hope is to reach an agreement quickly so Millenarian can start fishing for Cannonball jellyfish, also called jellyballs, before the end of their season in May, Giese said. The Beaufort/Port Royal area is near the end of the migration route for the fish, so the jelly fish are large and plentiful in the area, he said.
The season starts up again in November, providing time for repairs to docks and to get ready for increased fishing and processing. Since jellyball season is opposite shrimp season, it will provide income opportunities for shrimpers during what is typically a slow period, Giese said. The company will also process blue crabs, whelks, conches and other seafood.
The seafood will be brought into the Port Royal shrimp dock and prepared for shipping to the processing plant. Land has already been purchased in Gardens Corner, Giese said.
Within 18 to 24 months, Giese expects the operation to employ between 150 to 250 people, most at the processing plant. The salt-drying of the jellyballs is very labor intensive, he said. He said he has already started interviews for management positions.
Giese said the intent is not to compete with local, established seafood companies. He hopes to improve their businesses through networking and a better seafood industry.
"I think this will set a new model for the fishing industry up and down the coast," he said.
An overnight curfew and no-trucking hours during high-traffic times in the morning and evening.
Special trucks designed to prevent leaks from seafood containers during transport to the processing plant.
Substantial renovations to the shrimp docks and market.
Assistance retrofitting boats for catching jellyfish, which can cost between $3,000 to $4,000 per boat.
Dolphins have names as well?
Came across an interesting article the other day and wanted to share it with you. So many have a fascination and would like to see the dolphins while on vacation. Who would have known that familiar dolphin call each other by name. We have a pod or family which likes to come in the creek to feed. If we were to stick our head under water like at the beach or when we see dolphins in the creek, you can hear clicking sounds. Not only are they talking too each other but also looking for fish and maybe calling out to you so see if you answer back.
NuCanoe will officially be announcing the new 10′ Frontier in the coming weeks. More marketing information will follow then, but they gave us the OK to mention it coming since it is in the new price list.
Based off popular setups and many customer request. NuCanoe has re-added fishing package setups to the order catalog based off some popular setups. You can view these setups in the PDF catalog list below and the prices are in the Rev 2013 Price List. The Prices and accessories we offer through NuCanoe is below. Since there are so many options, we can help walk you through and setup a custom boat to fit your needs.
The packages can be added to Frontier 10 & Frontier 12 models in any color.
Boats and accessories still ship separately, so "assembling" the packages on the boats is up to you.
Packages require no drilling, screwing, or cutting to install – nothing is permanent.
Packages offer a choice of color for Max 360 Seats and style for rod holders – spinning, fly, or tube.
Some good news and an update to the story along the coast, story below.
State officials scoured the Lowcountry coast by air late last week but did not find other stranded whales like the one that swam ashore and later died on Hunting Island.The short-finned pilot whale that beached itself Thursday in the Fripp Inlet, between the Hunting Island pier and the bridge to Fripp Island, was one of three found stranded last week. Pilot whales also swam aground on Edisto Beach and the Story River on Fripp Island.
The S.C. Department of Natural Resources surveyed the waters between Fripp and Bulls Bay, near Charleston, on Friday but saw no other stranded animals.
However, three other pilot whales have been reported in the St. Helena Sound area, and more strandings are possible, according to National Oceanic and Atmospheric Administration biologist Wayne McFee.
As of Monday, none of the necropsies, or animal autopsies, on the three whales had produced an explanation for their behavior. Scientists should have a better idea of what went wrong when pathology test results are available, but that could take weeks or even months, McFee said.
None of the three juvenile males had food in their stomachs, so it's likely they had not eaten in a while, McFee said. The Edisto Beach whale had signs of possible intestinal infection. The Hunting Island whale had some minor parasitism, and the Fripp Island whale was too decomposed to provide many answers.
Pilot whales are social mammals that usually live in groups of 20 to 200. The species is known for group strandings, in which one dies and others follow. That usually occurs in the same place, which makes these separated strandings unusual, McFee said.
"This area has a lot of interesting currents and inlets that could have separated them, and they get into these marsh situations and they aren't familiar with marsh and mud and that could have freaked them out," he said.
The last mass pilot whale stranding in South Carolina was in 1974, when about 14 died on the shore of Kiawah Island near Charleston, McFee said.
DNR and NOAA officials said people should not approach stranded whales, and pushing them back into the water will not likely prevent them from swimming ashore again and dying. Instead, those who spot stranded whales should call DNR at 800-922-5431.
Local students have been help out with a few sad stories in the area, story below.
Three University of South Carolina Beaufort biology students have helped respond to three strandings in the past two weeks — one dolphin and two pilot whales — and viewed in real life the bones, muscles and organs they've been studying in textbooks."It is sad, but at the same time it's interesting. Not many people get to see a whale that close," said senior Marvin Brown.Brown and seniors Rebecca Rawson and Steven Vega have participated in necropsies, or animal autopsies, alongside National Oceanic and Atmospheric Administration officials.
It's not yet clear what has caused the strandings, or if the strandings are connected. The dolphin was found Dec. 1 at Mitchelville Beach on Hilton Head Island. The pilot whales were stranded late last week off Hunting Island and along the Story River on Fripp Island.
Rawson said parasites were found in the whales' lungs and stomachs, but that's not unusual.
Results from tissue samples of organs were still pending Monday, NOAA marine biologist Wayne McFee said.
McFee said students occasionally participate in the necropsies, but they're not usually undergraduates, he said.
The partnership with USCB students is recent. Professor Eric Montie worked with McFee at NOAA in the late 1990s and early 2000s. In the past year, the two began to talk about how USCB students could help.
Rawson, Vega and Brown have all taken classes with Montie and volunteered to help with strandings.
Montie said his students will continue to help by taking measurements of the animals and notes during the necropsies. The students also are working to discover, based on dorsal-fin identification, if the stranded dolphin was a resident of local waters.
Montie said he hopes the experience will boost students' understanding of the marine life they have studied in classrooms and textbooks.
Vega said the largest animal he had dissected before encountering the dolphin and whales was a foot-long squid. Both he and Rawson marveled at the size of the larger animals' organs.
Some sad wildlife news has been in the paper lately, story below.
In the end, there was nothing to do but handle the body gently.A crane arm extended slowly over the Hunting Island marsh at the Fripp Island Bridge on Thursday evening.Workers slipped the rope over the 13-foot pilot whale's tail and gave the signal.
The glistening black animal slowly rose from the marsh, it's huge body spinning slowly clockwise as the crane eased it up and over the bridge, before carefully lowering it into a trailer for a final journey to Charleston.
The young whale was one of several that beached themselves on Lowcountry shores over the past two days, and researchers are seeking clues to what went wrong.
"The more we know about it, then we can try to piece the puzzle together as to why these animals might have stranded," Wayne McFee, National Oceanic and Atmospheric Administration marine biologist, said.
The whale will be examined for signs of infection, illness or other issues that could have lead to the stranding, which are reportedly occurring along the coast from Beaufort to Charleston.
"Pilot whales are known for mass strandings, so if you get one, generally the whole crowd is coming," S.C. Department of Natural Resources veterinarian Al Segars said.
The first sign of trouble came Tuesday when a 15-foot whale washed up on the shores of Edisto Beach, Segars said. It died quickly.
The necropsy, or animal autopsy, showed the animal had signs of an intestinal infection but it was not clear if that caused the beaching behavior.
McFee said officials will have a better idea of what occurred after the results of pathology tests come in. Those results could be weeks to months away, he said.
The NOAA is heading up the investigation and was assisted on Hunting Island by volunteers, state park rangers and DNR.
Overall, three deaths have been confirmed and several others reported as of Thursday, McFee said.
The recent strandings are unusual because the whales typically go ashore in the same place and are not separated by miles, McFee said. The whales migrate through the area, but typically stay 10 to 20 miles offshore, McFee said. The animal who died on Hunting island was a short-finned pilot whale, which has a more southern range than long-finned pilot whales, he said.
The last mass pilot whale stranding in South Carolina was in 1974, when about 14 whales died on the shore of Kiawah Island near Charleston, he said. He did not know what caused those strandings.
People should resist the natural urge to help the animals.
Do not approach stranded whales, McFee said. Instead, residents should call 1-800-922-5431 to report the animals to DNR officials.
Segars said there is little to do beyond helping the animals die humanely. If the Hunting Island whale had not died naturally, Segars said it would have been given a injection in the heart.
Whit Suber of Fripp Island saw the whale swimming around Fripp Inlet on Thursday morning and thought it was odd because the water there is pretty shallow.
When the whale swam up the rocky marsh, Suber, who was on the bridge with his daughter Sarah, 13, knew something was definitely wrong.
He stood with his daughter as the whale was removed Thursday evening.


Big bird, small bird and some other things.
This is the small bird, did it on myself. And no, it's not Woody the woodpecker, it's Mr. Horsepower.
The original character is coloured, but I wanted it in black'n'gray.
Added this to my personal collection as well. It's piece from the optical llusion genre -a blivet, also known as the devil's fork.
Been also working on some One Eyed Morse's shirt designs, more news about it soon!
Just finished this nice lil' piece – papercrane on ribs.
Also, lately been working a lot on my new electronic solo project, Blood Pavilion.


1) In postmenopausal women 50 to 79 years of age, does hormone replacement therapy (HRT) increase the risk for stroke? 2) In postmenopausal women ≥ 65 years of age, does HRT increase the risk for probable dementia or protect global cognitive function?
The Women's Health Initiative (WHI) hormone therapy study of estrogen plus progestin was a randomized (allocation concealed*), blinded (clinicians, participants, data collectors, outcome assessors, and monitoring committee),* placebo-controlled trial with a mean follow-up period of 5.6 years. The Women's Health Initiative Memory Study (WHIMS) was an ancillary study to the larger WHI hormone trial with a mean follow-up of 4.2 years.
39 of 40 WHI U.S. clinical centers also participated in WHIMS.
16 608 community-dwelling postmenopausal women 50 to 79 years of age (mean age 63 y) who had an intact uterus participated in the WHI trial of estrogen plus progestin. Exclusion criteria included participation in other trials, predicted survival < 3 years, alcoholism, drug dependence, diagnosed mental illness, and dementia. WHI follow-up was 100%. 4532 women enrolled in WHI who were ≥ 65 years of age and free of probable dementia were recruited to participate in WHIMS. WHIMS follow-up was 97%.
Women were allocated to HRT consisting of conjugated equine estrogen, 0.625 mg, plus medroxyprogesterone acetate, 2.5 mg daily (n = 8506 and 2229 for WHI and WHIMS, respectively), or placebo (n = 8102 and 2303 for WHI and WHIMS, respectively).
WHI: incidence of overall stroke and stroke subtypes centrally adjudicated by stroke neurologists. WHIMS: incidence of dementia and global cognitive function both measured annually by the Modified Mini-Mental State Examination (3MSE) (range 0 to 100, higher score reflecting better cognitive functioning).
Analysis was by intention to treat. WHI: The incidence of ischemic and hemorrhagic strokes combined and of ischemic stroke alone were greater in the HRT group than in the placebo group (Table). The groups did not differ for incidence of hemorrhagic stroke (0.2% vs 0.2%; hazard ratio 0.82, 95% CI 0.43 to 1.56). Subgroup analysis showed that the excess risk for all stroke was apparent in all age groups; in all categories of baseline stroke risk; and in women with and without hypertension and history of cardiovascular disease, use of hormones, statins, or aspirin. WHIMS: The incidence of probable dementia was greater in the HRT group than in the placebo group (Table). Increase from baseline in global cognitive function (3MSE scores) was lower in the HRT group than in the placebo group (Table). The results (effect of HRT on global cognitive function) were not altered by sensitivity analysis that consisted of removing women by censoring them after adjudicated dementia, mild cognitive impairment, stroke, or nonadherence to study protocol. The results were also not influenced by previous HRT use or timing of previous HRT initiation with respect to the final menstrual period.
1) In postmenopausal women 50 to 79 years of age, hormone replacement therapy was associated with an increased risk for stroke. 2) In postmenopausal women ≥ 65 years of age, hormone replacement therapy increased the risk for probable dementia.
Sources of funding: Wyeth Pharmaceuticals and National Heart, Lung, and Blood Institute.
For correspondence: Dr. S. Wassertheil-Smoller, Albert Einstein College of Medicine, Bronx, NY, USA. E-mail smoller@aecom.yu.edu. Dr. S.A. Shumaker, Wake Forest University Health Sciences, Winston-Salem, NC, USA. E-mail sshumake@wfubmc.edu. Dr. S.R. Rapp, Wake Forest University School of Medicine, Winston-Salem, NC, USA. E-mail srapp@wfubmc.edu.
†WHI = Women's Health Initiative; WHIMS = Women's Health Initiative Memory Study; 3MSE = Modified Mini-Mental State Examination. Other abbreviations defined in Glossary; RRI, NNH, and CI calculated from data in article.
‡Statistically significant difference favors placebo.
The 3 studies by Wassertheil-Smoller, Shumaker, and Rapp and their respective colleagues extend the string of bad news from the WHI (1). Since the early termination of the estrogen-plus-progestin arm, a possible benefit of preventing cognitive impairment seemed to be the last best hope for long-term HRT. Unfortunately, rather than the hoped-for summer blockbuster, these reports look more like a rerun of the disappointing findings linking estrogen plus progestin and heart disease. The expectations of a protective effect against dementia were based on a compelling combination of basic science and epidemiology. In animal studies, estrogen has favorable effects on neurotransmission, cell growth, and prevention of β-amyloid accumulation and oxidative damage (2). Most observational studies reported substantially lower risk for dementia among women who had used HRT (3). Yet, as with heart disease, WHI observed worse outcomes among women in the HRT group than in the placebo group.
Neither the stroke nor cognitive function findings from these studies are a complete surprise. The 31% increase in total stroke risk is compatible with a 12% increase in a recent meta-analysis (4) and with known prothrombotic effects of HRT. In the Heart and Estrogen/progestin Replacement Study (HERS) trial, however, the same regimen produced only a nonsignificant 9% increase in stroke and transient ischemic attacks, possibly because of the high rate of aspirin use (80%) in the HERS patients, all of whom had heart disease. HERS also found no benefit of estrogen plus progestin on global cognitive function after 4 years of treatment (5). In some earlier short-term trials, estrogen alone improved some cognitive measures such as number recall, but benefits were not consistent across different measures and were largely confined to younger women with postmenopausal symptoms (3).
Most surprising are the findings of a small increase in clinically important declines in cognitive function and a 2-fold increase in probable dementia among women > 65 years of age who received estrogen plus progestin. The reasons for this are unknown but may relate to small subclinical cerebral thromboses (2).
Is it possible that HRT was given too late in WHI to protect against dementia? This scenario seems unlikely given that identical effects were seen in the 20% of women who had used HRT before the study. Furthermore, many of the earlier studies reported benefits in a broad spectrum of HRT users—current and past, short- and long-term. It seems more plausible that earlier studies fell prey to the same biases that affected studies of HRT and heart disease (3). The protective effects observed in nonrandomized studies may have resulted not from HRT itself but from other characteristics of the women who were prescribed HRT, for example, better education and better health, 2 factors that substantially reduce risk for dementia.
The last remaining hope is that unopposed estrogen will prove safer and more effective than estrogen plus progestin. In 1 cohort study, current estrogen plus progestin users were the only group of HRT users whose cognitive scores declined (3). The estrogen-only arms of WHI and the WHIMS substudy are continuing, indicating that neither significant benefits nor significant harms have been observed so far. Until those results are available, these reports reinforce the original messages from WHI. For women without menopausal symptoms, the harms of estrogen plus progestin exceed benefits. HRT remains a suitable option for women with bothersome menopausal symptoms, but women should understand that there are some risks involved and should regularly reassess their need for treatment with their physician. It is prudent to use the lowest effective dose for the shortest possible period, but we should not assume that different formulations or lower doses of HRT will avoid all the risks observed in WHI.


2019 Lexus CT Design, Interior, Engine and Price – Soon after latest changes, it is basically very clear that the 2019 Lexus CT will not likely feature greater changes. A popular crossbreed hatchback obtained most recent up-dates recently, indicating there is definitely not, some even bigger changes in up coming couple of years.
The unique variation of this eye-catching compact hatch out arrived in 2010. It is nevertheless in the initial technology, but we have now observed two upgrades thus far. The very first a single is in 2014, although the 2nd emerged only recently, for the existing 2018-year model. Each changes incorporated numerous changes in graphic element, as nicely in conditions of products.
On the opposite side, Powertrain and aspects are probably planning to keep unaffected till the full redesign. Contemplating all of this, it is just about confident that 2019 Lexus CT proceeds with out changes. This able compact car will feature just about the very same design and other listing of normal functions, with handful of feasible developments.
In relation to base design features, the 2019 Lexus CT continues without the need of changes. The company actually introduced this compact hatchback in 2010 and stuff stayed just about the exact same with this factor. Things such as proportions and dimensions, as nicely as comprehensive aspects are totally the identical.
On the opposite side, we have now observed two changes that delivered different aesthetic changes. The initially upgrade was 4 years in the past. It integrated generally aesthetic changes. Ever since then, this model capabilities brand's most up-to-date design terminology. For the next upgrade, which occurred final year, we now have also observed number of novelties in conditions of style. There is a new fine mesh routine on the grille and Brought day time lamps. At the rear finish, you will discover new taillights, which feature the exact same design but new images. Ultimately, there is a new rims design, as nicely as couple of new external hues.
Communicating of interior, a latest upgrade provided couple of changes as properly. There are new coloration systems, but the base cabin format stays the exact same. All those new shades are Dark/Red-colored, Dim Camel/Respectable Dark brown and the airy Chateau. The dash panel appears acquainted, but there is a new greater 10.3-inches touchscreen, which is certainly a showcase with regards to interior changes. Another excellent novelty will come in terminology of safety measures. This hatchback now capabilities the Lexus Security Method , as a portion of common gear. This package consists of a total set of sophisticated solutions like Pre-Crash Method (Computers), Powerful Radar Vacation cruise Handle, Lane Leaving Warn (LDA) with controls manage functionality and Automated Great Ray (AHB) front lights. Thinking of all of this, it is tough to assume some other significant novelties for 2019 Lexus CT.
As opposed to the outside and interior design, issues beneath the hood have continued to be the exact same for all those these many years. So, we do not count on the 2019 Lexus CT neither of them. This compact hatchback is available in an individual powertrain alternative. It is a crossbreed program, which is made up of a common 1.8-liter fuel engine and electronic motor with 1.3-kWh electric battery package. The total process outputs about 134 hp and 155 lb-toes of torque. Transmission is an ECVT auto. This combo offers pretty decent shows, even with that result phone numbers are not so outstanding. Together with reasonable shows, this hatchback gives rather incredible gas economy. It is going close to 60 mpg, which is anywhere all around 4 liters for each 100 km.
The 2019 Lexus CT can come someplace delayed in the year. Though stopping in North America, it is continue to within Europe, Melbourne, Asia and Japan. Base models go all around 32.000 bucks, when best models might cost approximately 46.000 $.


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Odyssey Landscapes takes out the Silver Award at the Queensland Garden Expo 2019
From 3D Design To Real life
A big big thank you!
The QLD Garden Expo has provided the team at Odyssey Landscapes with an amazing opportunity to showcase our passion and creativity for landscaping to thousands of people from all over Australia and the Sunshine Coast.
The opportunity to create an amazing oasis within such a small space was a challenge from the get-go What do you build? How are we going to build it? What do we want to show people?
These were the questions going through our heads while planning our garden layout for the QLD Garden Expo. So we took the time to step back and think about exactly what families & entertainers want from their backyards these days? Such a difficult question to answer, as no two people are the same … which is why every one of our landscapes are custom designed to suit our clients' lifestyles.
With all of this in mind, we set out to create a landscape that ticked nearly every box we could think of!
Key Goals
Maximise the Small Space
When we originally picked our spot, we were attracted to it for its unique placement and the potential of creating a large-feeling space within a small physical area. The space we choose measured 18m x 8m (this is smaller than the average backyard, but by no means the smallest garden we've designed!).
We decided to turn our project sideways & really utilise the length of the space to our advantage. By doing this we were able to create 'full depth' effect using screening plants and plenty of layering to distract attention from the narrowness of the area.
This method uses subconscious boundaries and barriers that draw your eyes down through the landscape and gives a sense of vastness that encourages the user to go on a journey and find out more. To this end, we built a large, luxurious cabana at the end of the block in order to stimulate the user — the idea is to provide an 'end goal' or an area to reach and obtain,
Make it Functional & Usable
The old saying "form & function are king" is very true. If we build a landscape based entirely on aesthetics, it might look amazing, but we need to consider the functionality of the space so people will use and enjoy the area. The landscaping must account for the occupants' lifestyle in the design.
You have 3 young children and they need an area to play or a trampoline
Have way to many fur babies & these guys need a bathroom!
That you live a busy lifestyle and need something that looks amazing but doesn't take your weekends away from you
That you enjoy entertaining and showing of your new things whilst having a beverage or two with your friends
Perhaps you love to meditate or simply enjoy having your own private space to drift away from the day-to-day grind and have that ahhhhh (Deep breath) (Relax) moment in the privacy of your home
Include different elements to draw people outside
At the end of the day, we need to find a way to draw people outside, to be able to create a sense of interest that makes people hungry to connect with nature and get away from that office chair.
We love to include different elements and materials in our projects, which always keep you guessing. The use of small but effective spaces is so crucial in smaller gardens, particularly in regards to the use of materials.
In this landscape, we used a cool-colour Silver Travertine for the curved pathway, in a french pattern, that led up to a warm sunken fire pit! The fire pit has been cladded in beautiful hardwood (Yellow Belau) to create a wonderful warm area that is sure to attract people on the cold nights.
The large and luxurious cabana at the back of the garden is the star of the show, along with the water feature that mimics a curtain of rain brushing up against the lush foliage of Magnolia Teddy Bears — all in a space measuring 144m2.
Create Depth & Interest within the Space
Nothing is more boring than a flat landscape. As humans we are inquisitive creatures – our curiosity always gets the better of us. Much like when you go for a long drive, if the roads are long and straight, we often find them stale after the first 10 minutes. However, when we find a long winding road ahead of us, not knowing what we're going to find around the next bend, our sense of curiosity starts to emerge.
With landscaping, it's no different. By creating different level changes within the landscape we create depth and interest. This was one of the most-challenging design considerations we faced! By building up the garden using retaining walls around the entire plot, we created a sense of height on approaching the area. Then we played with the levels further by incorporating a sunken fire pit and a raised cabana, creating that sense of entering a landscaping Odyssey.
Must be Low Maintenance
Like most people these days, our lives are only getting busier. We're working longer hours and harder than ever before to achieve our goals. This leaves us in a predicament — we want our weekends free to spend time with our loved ones, not doing manual labour the backyard pulling weeds and hedging plants.
The landscaping display we designed for the QLD Garden Expo achieved exactly this. We exclusively incorporated plants that only require yearly pruning and at that will look amazing year-round. The lawn is a deep lush prestige Buffalo (Should Plug Terence here) that handles the SE Queensland climate year-round (so no dead grass come spring!) and is ready to show you how strong the fence line is when there trying to peak over.
Easily Obtainable for the Modern Family
Importantly, we wanted to ensure the landscape design and implementation was completely attainable for everybody!!! Whether you're a DIY'er or maybe looking to have it built by a professional, this garden will ultimately add value to your property and improve your lifestyle.
"You can build an amazing house with all the bells and whistles… but it's not a home until the gardens are done"
In the lead up to the expo, we documented the entire construction process. If you're interested in learning more about how we work, please check it out below.
To complete this garden, the Odyssey Landscapes Team took on the challenge to build the display in just 4 days.
We started the day at the QLD Garden Expo by marking out our design and organising the spaces & getting the team onboard with the future masterpiece we were about to create. We then got into digging holes for the Cabana so we could set the posts and frame for the decking. Whilst this was happening, a separate team worked on digging footings for a retaining wall & our sunken fire pit!
By this stage, the team had finished working in the dark the night before, and we were back on site before sunrise to start installing our sunken fire pit. After this was complete, we moved on to building the frame for our elevated tiled area that surrounds the sunken fire pit. Meanwhile, the other team is off and away building the Cabana.
CABANA = DONE! The team has done a fantastic job so far — the frame for the tiled area has been completed and the teams are laying down some silver travertine. This is when it feels like the job is starting to come together! One of the teams has started to build the retaining wall now, since it's a job that takes time to ensure it's built correctly.
We're getting closer… it's crunch time now! The retaining wall is done and the team has started to level the lawn area, and look at putting the water feature together. We've never attended the QLD Garden Expo before and people are always wary of water (things might go wrong when you have water features in your display). Fingers and toes crossed that it all comes together smoothly but only time will tell. If not, we better come up with a plan B quickly! The 2nd team is working on putting all the plants into the display — in a matter of only 30 minutes, the garden changes from a blank and empty shell into a full landscape, bursting with a canvas of colour.
We've scrapped in by the skin of our teeth, we were up till late last night in the expo show grounds (until we got kicked out by security). But we can say it's done! We've built our water feature with no hiccups at all, and the display is ready to go.
NOW FOR THE NEXT 3 DAYS OF SHOWING WHAT WE CAN DO!
landscape design sunshine coast
qld garden expo
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Retaining Walls – "Why do I Need One?"
Jess Gilpin September 23, 2019 At 12:55 pm
Awesome job team!!

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text:
Complication rates following Chiari malformation surgical management for Arnold–Chiari type I based on surgical variables: A national perspective
Peter G Passias1, Sara Naessig1, Ashok Para1, Waleed Ahmad1, Katherine Pierce1, M Burhan Janjua1, Shaleen Vira2, Daniel Sciubba3, Bassel Diebo4
1 Departments of Orthopaedic and Neurosurgery, Division of Spinal Surgery, NYU Medical Center, NY Spine Institute, New York, NY, USA
2 Department of Orthopaedic Surgery, University of Texas Southwestern, Dallas, TX, USA
3 Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
4 Department of Orthopaedic Surgery, Suny Downstate, New York, NY, USA
Date of Submission 19-May-2020
Date of Web Publication 14-Aug-2020
Peter G Passias
Departments of Orthopaedic and Neurosurgery, Division of Spinal Surgery, NYU Medical Center, NY Spine Institute, 301 East 17th Street, New York 10003, NY
DOI: 10.4103/jcvjs.JCVJS_69_20
Introduction: This study aimed to identify complication trends of Chiari Malformation Type 1 patients (CM-1) for certain procedures and concomitant diagnoses on a national level.
and Methods: The Kids' Inpatient Database was queried for diagnoses of operative CM-1 by International Classification of Disease-9 codes (348.4). Differences in preoperative demographics and perioperative complication rates between patient cohorts were assessed using Pearson's Chi-squared test and t-test when necessary. Binary logistic regression was utilized to find significant factors associated with complication rate. Certain surgical procedures were analyzed for their relationship with postoperative outcomes.
Results: Thirteen thousand eight hundred and twelve CM-1 patients were identified with 8.2% suffering from a complication. From 2003 to 2012, the rate of complications for CM-1 pts decreased significantly (9.6%–5.1%) along with surgical rate (33.3%–28.6%), despite the increase in CM-1 diagnosis (36.3%–42.3%; all P < 0.05). CM-1 pts who had a complication were younger and had a lower invasiveness score; however, they had a larger Charlson Comorbidity Index than those who did not have a complication (all P < 0.05). CM-1 pts who experienced complications had a concurrent diagnosis of syringomyelia (7.1%), and also scoliosis (3.2%; all P < 0.05). CM-1 pts who did not have a complication had a greater rate of operation than those that had a complication (76.4% vs. 23.6% P < 0.05). The most common complications were nervous system related (2.8%), anemia (2.4%), and acute respiratory distress (2.1%). CM-1 pts that underwent an instrumented fusion (3.4% vs. 2.1%) had a greater complication rate as well as compared to those who underwent a craniotomy (23.2% vs. 19.1%; all P < 0.05). However, CM-1 pts that underwent a decompression had lower postoperative complications (21.3% vs. 28.9%; all P < 0.05).
Conclusions: Chiari patients undergoing craniectomies as well as instrumented fusions are at a higher risk of postoperative complications especially when the instrumented fusions were performed on >4 levels.
Keywords: Chiari malformation, outcomes, trends
Passias PG, Naessig S, Para A, Ahmad W, Pierce K, Janjua M B, Vira S, Sciubba D, Diebo B. Complication rates following Chiari malformation surgical management for Arnold–Chiari type I based on surgical variables: A national perspective. J Craniovert Jun Spine 2020;11:169-72
Passias PG, Naessig S, Para A, Ahmad W, Pierce K, Janjua M B, Vira S, Sciubba D, Diebo B. Complication rates following Chiari malformation surgical management for Arnold–Chiari type I based on surgical variables: A national perspective. J Craniovert Jun Spine [serial online] 2020 [cited 2022 Jan 18];11:169-72. Available from: https://www.jcvjs.com/text.asp?2020/11/3/169/291916
Chiari Malformations (CMs) are a group of congenital hind brain anomalies caused by structural defects in the brain and spinal cord that occur during fetal development.[1] A hallmark of CM is decrease in volume of the posterior fossa of the skull resulting in cerebellar tonsillar herniation through the foramen magnum into the foramen magnum.[1],[2] CM can have association with several abnormalities such as hydrocephalus, spina bifida, hydromyelia, syringomyelia, spinal deformity (kyphosis/scoliosis), and tethered cord syndrome.[2] Chiari Malformation type 1 (CM-1) is the most common subtype of CM; can be asymptomatic in childhood and is commonly identified on neuroimaging as an incidental finding. Patients with CM-1 tend to develop symptoms such as suboccipital headaches, unsteady gait, impaired coordination, dizziness, and/or ventral brain stem compression symptoms in early to late childhood to adolescence and many of them ultimately require surgical management to alleviate their symptoms.[1],[2],[3]
Given that symptomatic CM-1 patients require decompressive surgery and some of them may require an upfront occipitocervical fusion, further investigation into trends in complications related to surgical management of CM-1 can lead to improved perioperative and postoperative planning. The purpose of this study is to utilize the Kids' Inpatient Database (KID) to identify trends in complications and surgical variables related to surgical management of CM-1. To the authors' knowledge, this study is the largest study investigating complication rates after surgical management of CM-1. The authors hope that this study provides surgeons with the information that will allow them to minimize complications in the postoperative period and ultimately lead to more effective patient care.
The KID is the largest pediatric accessible all-payer (age < 21 at admission) inpatient health-care database in the United States. The Agency for Healthcare Research and Quality's Healthcare Cost and Utilization Project (HCUP) created this KID database. KID sampling includes complicated and uncomplicated births, as well as other pediatric inpatient procedures from community, nonrehabilitation hospitals. The KID database contains 107 data elements, using the International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) format to code all of the diagnoses and procedures. With over 3 million hospital stays per 3-year database, it is designed to allow accurate calculation of medical condition incidences using HCUP-provided trend weights.[1] A detailed overview of the KID design is available at (https://www.hcup-us.ahrq.gov/kidoverview.jsp).
Patient sample
The KID was queried for patients with E-Codes (ICD-9-CM codes) pertaining to CM-1 from 2003 to 2012 (348.4).
Multi- and univariate analyses, identified basic demographics, and surgical characteristics for CM-I patients. Trends in surgical and complication rates as well as surgical invasiveness were assessed from the year 2003 to 2012. Differences of those CM-1 patients that experienced a complication versus those who did not were assessed through Chi-square and t-tests, as appropriate. Binary logistic regression was performed to find significant factors associated with the complication rate. Decision tree analysis was utilized for the associated predictive variables of postoperative complications to identify significant thresholds. All statistics were done using SPSS Statistics version 23.0 (IBM Corp., Armonk, NY, USA). A statistical cut off value of P < 0.05 was considered statistically significant.
Demographic overview
Thirteen thousand eight hundred and twelve CM-1 patients were isolated. Average age was 10.12 ± 6.3 years, 49.2% were female, and the average Charlson Comorbidity Index (CCI) was. 063 ± 1.3. Of these Chiari patients, 56.5% had private insurance, 34.4% had Medicaid, 2.6% were self-pay, 0.2% were medicare, and 7.3% were other [Table 1]. Patients diagnosed with M1 were older (10.12 years vs. 3.62 years) and had a higher Charlson Comorbidity Score (0.62 vs. 0.53; all P < 0.05) than those that were not diagnosed with CM-I.
Table 1: Basic demographic
Surgical overview
By surgical approach, 1.3% of CM-1 patients received a posterior approach, 0.1% received an anterior approach, and 0.1% received a combined approach. 27.8% of CM-I patients underwent a laminectomy, 28.3% a decompression, and 2.2% had a spinal fusion.
Complication rate
About 8.2% (1, 1128) of CM-I patients experienced a postoperative complication. The most common complication was nervous system related (2.8%), anemia (2.4%), and acute respiratory distress (2.1%). CM-1 pts who had a complication were younger (9.73 ± 6.8 years vs. 10.2 ± 6.3 years), and had a lower invasiveness score (0.35 ± 1.0 vs. 0.41 ± 1.0); however, they had a larger CCI (1.10 ± 1.6 vs. 0.6 ± 1.3) than those who did not have a complication (all P < 0.05). Significantly different comorbidities are shown in [Table 2]. CM-1 pts that underwent a fusion (3.4% vs. 2.1%) had greater complication rates as well as those that underwent a craniectomy (23.2% vs. 19.1%; all P < 0.05). However, CM-1 pts that underwent a decompression had lower postoperative complications (21.3% vs. 28.9%; all P < 0.05).
Table 2: Comorbidities of Chiari patients based on postoperative complication
Trends in surgical characteristics
From 2003 to 2012, the rate of CM-I diagnosis increased while the surgical rate and postoperative complications significantly decreased during this time period [Table 3]; P < 0.05]. However, the rate of adverse events (superficial site infection, urinary tract infection (UTI), venous embolism and thrombosis [venous thromboembolism (VTE)]) increased. More specifically, UTI significantly increased from 1.9% to 2.6% (P = 0.03).
Table 3: Trends in Chiari patient outcomes
Factors associated with postoperative complications
After controlling for baseline differences, CM-1 patients who received a fusion were significantly associated with having a postoperative complication (1.4 [1.0–2.1]) as well as if, the fusion was 2–3 levels (2.1 [1.2–3.6]; all P < 0.05). Patients who underwent a suboccipital craniectomy were associated with an increased risk of complications (1.32 [1.1–1.5]; P < 0.001). Having a postoperative complications were significant increased risk of prolonged length of stay (11.7 [10.9–12.4]; P < 0.001).
Despite decades of experience and research, the management of CM-1 continues to raise more questions than answers. Controversy abounds in every aspect of management, including the indications, timing, and type of surgery, as well as clinical and radiographic outcomes.[4] The lack of conclusive evidence in the literature calls for further investigation into the management of CM-1 and its associated complications. This study aims to identify complication trends and surgical variables related to CM-1 for specific procedures and concomitant diagnoses on a national level.
Previous studies have reported that the rate of surgical treatment for CM-1 in pediatric patients has increased significantly, reflecting a rise in CM-1 diagnosis.[4] Our analysis similarly discovered a significant increase in CM-1 diagnosis, however, we have found a significantly decrease in rate of surgery, perhaps revealing that more CM-1 patients are being managed conservatively in recent years. The most commonly performed procedures were laminectomies, decompressions, and spinal fusions. 8.2% of the patients in our cohort experienced a postoperative complication, the most common being related to nervous system issues, anemia, and respiratory distress. Patients who experienced complications were younger and had a greater comorbidity index than those who did not experience complications. The most prevalent comorbidities in patients who experienced complications were malignancy, cerebrovascular, pulmonary, and renal issues. Our findings suggest that delaying elective procedures until patients are more physically mature and addressing associated comorbidities prior to the surgery may decrease complication rates in CM1 patients.
Scoliosis and syringomyelia were the two most prevalent concomitant diagnoses in the cohort of patients who experienced complications. Scoliosis is frequently associated with CM-1, and is even more frequently associated with CM-1 in the setting of syringomyelia.[5] Spinal fusion and decompression procedures are commonly utilized to manage CM-1 patients with spinal deformities. Our analysis revealed that CM-1 patients who underwent spinal fusion procedures, especially fusions of 4 or more levels, had significantly higher complication rates. Previous studies have also shown that spinal fusion in cases of scoliosis associated with CM-1 reported higher rates of perioperative complications.[5] Therefore, surgeons may want to further weigh the risks and benefits of spinal fusions prior to operating on CM-1 patients to reduce complication rates. Conversely, patients who underwent decompression procedures had significantly lower complication rates, thus surgeons may consider utilizing decompression procedures over alternative procedures when deemed appropriate.
Our analysis revealed an overall decrease in complication rates over the course of the study; however, the rate of never events such as surgical site infection (SSI), UTI, and VTE have increased. SSI and UTI are common complications in spine surgery that may lead to increased morbidity, readmission to the hospital, reoperation, poorer outcomes, and increased costs.[6],[7] Prolonged intraoperative and postoperative immobilization in spine surgery places patients at increased risk for VTE, but strategies such as mechanical compression, and prophylactic anticoagulation have been developed to reduce perioperative and postoperative VTE.[8] The overall decrease in complications suggests that management strategies for CM-1 are improving with time and current management of CM-1 and is more effective than it was a decade ago. However, the increase in adverse events should be taken seriously and quality improvement programs should focus on reducing rates of SSI, UTI, and VTE to further minimize complications in CM-1 patients.
As with most studies that are retrospective in nature, this study was subject to selection biases and confounding variables. Although analysis of a large, nation-wide database lends our study to increased generalizability; it also may result in a biased patient population, as patients are identified exclusively by ICD-9 codes. Similarly, complication outcomes were also tracked using ICD-9 codes, introducing the possibility of coding bias in outcomes analysis. Although this study represents a step forward, no prospective randomized studies have been performed investigating complication trends, and surgical variables for specific procedures and concurrent diagnoses in the setting of CM-1. Well-designed prospective studies exploring complications related to CM-1 treatment are needed to reinforce the findings that our analysis identified.
Patients with CM-1 who are younger and have a greater comorbidity index are significantly more likely to experience a perioperative or postoperative complication, most commonly nervous system issues, anemia, and respiratory distress. Patients who underwent a spinal fusion procedure and a suboccipital craniectomy are more likely to experience a complication, whereas those who underwent a decompression procedure are less likely to experience a complication. Although an overall complication rates have decreased throughout in our study, emphasis should be placed on preventing never events such as SSI, UTI, and VTE.
Chiari Malformation Fact Sheet. National Institute of Neurological Disorders and Stroke; 2020. Available from: https://www.ninds.nih.gov/disorders/patient-caregiver-education/fact-sheets/chiari-malformation-fact-sheet. [Last accessed on 2020 May 04].
Chiari Malformation-Symptoms and Causes. Mayo Clinic; 2020. Available from: https://www.mayoclinic.org/diseases-conditions/chiari-malformation/symptoms-causes/syc-20354010. [Last accessed on 2020 May 04].
Peach, B. The Arnold-Chiari malformation morphogenesis. JAMA Neurology 1965;12:527-35.
Alexander H, Tsering D, Myseros JS, Magge SN, Oluigbo C, Sanchez CE, et al. Management of chiari I malformations: A paradigm in evolution. Childs Nerv Syst 2019;35:1809-26.
Kelly MP, Guillaume TJ, Lenke LG. Spinal deformity associated with Chiari Malformation. Neurosurgery Clinics of North America 2015;26:579-85.
Anderson PA, Savage JW, Vaccaro AR, Radcliff K, Arnold PM, Lawrence BD, et al. Prevention of surgical site infection in spine surgery. Neurosurgery 2017;80:S114-23.
Tominaga H, Setoguchi T, Ishidou Y, Nagano S, Yamamoto T, Komiya S. Risk factors for surgical site infection and urinary tract infection after spine surgery. Eur Spine J 2016;25:3908-15.
Buchanan IA, Lin M, Donoho DA, Ding L, Giannotta SL, Attenello F, et al. Venous thromboembolism after degenerative spine surgery: A nationwide readmissions database analysis. World Neurosurg 2019;125:e165-74.
[Table 1], [Table 2], [Table 3]
Passias PG
Naessig S
Para A
Ahmad W
Pierce K
Janjua M B
Vira S
Sciubba D
Diebo B


The $92 million modernization of Roosevelt High School will begin starting this spring. Over the next two and a half years, Roosevelt will undergo a complete renovation through a multi-phase construction process.
Students will remain on campus during the modernization period, moving to different buildings. The project team has been working with the high school staff to minimize the disruption to the students.
Pre-construction starts during spring break with the closing of the gym and nearby classrooms. This will allow the first phase of construction to begin this summer. The initial focus is to renovate the historic theater building, a new visual arts wing and an upgraded gymnasium.
By the summer of 2016, construction will move into the historic main building of Roosevelt, updating offices and classrooms with seismic upgrades, new plumbing systems and all new IT technology throughout.
In 2017, the new student commons will be completed and open to students. Older buildings such as the library/arts wing, temporary facilities and the old cafeteria will be demolished and, lastly, site landscaping will begin. Landscaping is expected to finish in the winter of 2017.
The construction is part of a $482 million school improvement bond measure approved by Portland voters in 2012. The bond will also fund the modernization of Franklin and Grant high schools and provide seismic upgrades to other area K-12 schools.
To help prepare students, families, and community members, Portland Public Schools will be hosting a community forum on Thursday March 5 at 6p.m. in the Roosevelt Cafeteria.
The forum will discuss the phases of construction including the order of construction and the plans for setting up temporary facilities. The meeting will address how the project will affect extracurricular activities and the new academic programs being developed and expanded through the remodel.
Information will be provided regarding how construction will impact the neighboring community in terms of logistics, noise and parking.
Light refreshments and translators for Spanish and Somali will be provided. All interested St John's residents and Roosevelt Families are encouraged to attend. This forum is free and open to the public.
Portland Public Schools will have a groundbreaking ceremony for the Roosevelt High School modernization on May 2.


text:
Bio & Photos
Event Photos...
Endless Christmas CD / lyrics
Everyday Miracles CD / lyrics
One Wondrous Star CD / lyrics
Steal Away Home CD / Spirituals
Threads CD / lyrics
Art Bio...
Art Shows...
Art: Originals
Wood Collages
jonibishop.com
Reviews...
".....Bishop is a vocalist and acoustic guitarist of considerable strength and passion,
and her songwriting is deep, and thoughtful - and hopeful,
which makes her something of an uncommon delight
in this era of mopey and fatalistic musical wordsmithery. "
- Bill Deyoung / CONNECT, Savannah -
".....Joni Bishop's country/folk style draws comparisons to Joan Baez.....
unaffected delivery, and a warmth that's lacking
in much popular music today."
- Fresno METRO NEWS -
"....a female James Taylor. The songs are uniformly bright and melodic, touching on aspects of the human condition, and definitely easy to listen to."
~ Steven E. McDonald, ALL MUSIC GUIDE -
On Joni's songwriting:
" 'Wild Blossoms'...has been recorded by a number of well known artists
including one of my favorites, Sara Watkins of Nickel Creek.
...an exquisitely crafted song!"
- Fingerpick MAGAZINE
"I wasn't familiar with the work of Joni Bishop, so I had no idea what a treat I was in for when I first listened to Endless Christmas! ....these superb arrangements of Christmas favorites will spend a lot of time in my CD changer this season....she wraps her Christmas offering with unusual new upbeat tempos, creating a very expressive and pleasing gift....and she offers catchy arrangements of several new songs, including the title track (Endless Christmas).
I enjoyed listening to every song on the CD.....What a gem!"
- Richard Banks, UK REVIEW -
"....an enormously talented artist and a great singer/songwriter.....
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Karl Marx Peak, Russian Pik Karla Marksa, mountain peak in the extreme southwestern Pamirs in Gorno-Badakhshan autonomous oblast (province) of Tajikistan. At an elevation of 22,067 feet (6,726 m), it is the highest summit of the Shakhdarin Mountains, which extend in a roughly east-west direction between the valleys of the Shakhdara River to the north and of the Panj to the south. The peak was first climbed from the Shakhdara valley by Soviet alpinists in September 1946.


NEW YORK - It isn't easy being Killmonger.
Michael B. Jordan opened up about the toll playing the villain in "Black Panther" took on his mental health.
"I went to therapy, I started talking to people, starting unpacking a little bit," he said.
Jordan discussed his process for getting into character Tuesday in conversation with Oprah Winfrey at the taping of her "SuperSoul Conversations" TV special.
"I was by myself, isolating myself," Jordan said when Winfrey asked where he went to "get all that nastiness" to play the Marvel super villain.
"Of course it's an extreme, exaggerated version of the African diaspora from the African-American perspective, so to be able to take that kind of pain and rage and all those emotions that Erik kind of represents from being black and brown here in America … that was something I didn't take lightly," Jordan said.
"I didn't have a process" for being Killmonger, Jordan added, "I just did whatever I felt I needed to do or whatever I felt was right in the moment every step of the way."
However, "I didn't have an escape plan, either," he confessed.
"When it was all over, I think just being in that kind of mind state … it caught up with me," Jordan said.
"It was a little tough for me at first," Jordan said about getting out of the mindset of his character.
"Readjusting to people caring about me, getting that love that I shut out," he continued. "I shut out love, I didn't want love. I wanted to be in this lonely place as long as I could."
He said that seeing a therapist "helped me out a lot," despite the criticism men face about receiving mental health treatment.
"Your mind is so powerful. Your mind will get your body past a threshold that it would have given up on way before," Jordan said. "Honestly, therapy, just talking to somebody just helped me out a lot. As a man you get a lot of slack for it. … I don't really subscribe to that. Everyone needs to unpack and talk."


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Özil sends message to injured Arsenal teammates ahead of Watford clash
Mesut Özil has sent a message to Per Mertesacker, Gabriel Paulista, and Aaron Ramsey ahead of our FA Cup quarter final clash with Watford, wishing the trio a speedy recovery after their injuries this past Tuesday.
The German was an unused substitute during our 4-0 win over Hull City in midweek, and has been handed an extended rest ahead of this weekend's game.
Mertesacker, Gabriel, and Ramsey all featured briefly, but all three were injured during the course of the match. Özil took to Twitter to wish them well, while also congratulating the team on their place in the FA Cup quarter finals.
We made it to the #FACup 1/4 finals! But now let's hope for a quick recovery of Per, Gabriel & Rambo! #HCFCvAFC #GetWellSoon #COYG
— Mesut Özil (@MesutOzil1088) March 8, 2016
It would be a real blow to be without the trio for any length of time, as injuries have already destroyed our season. We'd be left extremely short in defence without two of our main centre-backs, and other injuries already sustained mean we really can't afford to be without Ramsey in midfield either.
Mertesacker's injury looked the least serious, and assuming the swelling has gone down it's not impossible to think he might be fit for this weekend's game. Gabriel could be out a little longer, but again you would hope his injury isn't too serious. With Ramsey however, you could tell by the look on his face that it could potentially be a bad one.
Hopefully Özil gets his wish and all three recover quickly, and we're able to build on this week's victory and push on in the FA Cup and the Premier League.
More Stories: Arsenal, FA Cup, Gabriel Paulista, hull, Mesut Ozil, Per Mertesacker, Watford


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Time Warner Cable Inc. (NYSE:TWC) today announced that its Senior Executive Vice President & CFO Robert Marcus will participate in Deutsche Bank's 2009 Media and Telecom Conference on Wednesday, March 4, 2009 in Palm Beach, FL.
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Reading: Limnology of Kandy Lake before the outbreak of a cyanobacteria bloom in May 1999. III. Phyto...
Limnology of Kandy Lake before the outbreak of a cyanobacteria bloom in May 1999. III. Phytoplankton composition and succession
E.I.L. Silva ,
About E.I.L.
Institute of Fundamental Studies, Hantana Road, Kandy, Sri Lanka
S.R.M.S. Samaradiwakara
About S.R.M.S.
Composition and succession of the phytoplankton community in Kandy lake were examined from September 19% to August 1998, with a view to understand the community structure and its seasonal and spatial distribution patterns. Thirty-seven species of phytoplankton belonging to eight taxonomic groups were identified. The number of species per sampling occasion ranged from 15 to 25 with an average of 20. There were 15 Chlorophyceae species but only seven species were important in the community structure. Pediastrum simplex appeared as either dominant or sub-dominant species. Cyanophyceae, the second most important group was represented by nine species with moderate densities of Micorcystis aeruginosa and Merismopedia punctata. The diatom, Aulacoseira granulata, was also found as either a dominant or a sub-dominant species with three other diatom species of minor importance.
The occurrence of A. granulata and P. simplex showed a rhythmic oscillation under wet and dry weather conditions until the latter was curtailed by other species from April 1998 onwards. The phytoplankton density was low during the peak rainy season. Four functional species of phytoplankton were identified. These were a) large chain forming centric diatom, A. granulata dominating during the wet weather (K-strategist); b) a colony forming Chlorophyceae, i.e., P. simplex common during the dry weather (K-strategist); c) Colony forming Cyanobacteria namely scum forming M. aeruginosa (r-strategist); and d) M. punctata, a small colony forming non-heterocystous cyanobacteria, appearing in moderate numbers throughout the year (K-strategist).
How to Cite: Silva, E.I.L. and Samaradiwakara, S.R.M.S., 2005. Limnology of Kandy Lake before the outbreak of a cyanobacteria bloom in May 1999. III. Phytoplankton composition and succession. Sri Lanka Journal of Aquatic Sciences, 10, pp.55–71. DOI: http://doi.org/10.4038/sljas.v10i0.7460
Published on 15 Jun 2005.
Silva, E.I.L. and Samaradiwakara, S.R.M.S., 2005. Limnology of Kandy Lake before the outbreak of a cyanobacteria bloom in May 1999. III. Phytoplankton composition and succession. Sri Lanka Journal of Aquatic Sciences, 10, pp.55–71. DOI: http://doi.org/10.4038/sljas.v10i0.7460
Silva EIL, Samaradiwakara SRMS. Limnology of Kandy Lake before the outbreak of a cyanobacteria bloom in May 1999. III. Phytoplankton composition and succession. Sri Lanka Journal of Aquatic Sciences. 2005;10:55–71. DOI: http://doi.org/10.4038/sljas.v10i0.7460
Silva, E. I. L., & Samaradiwakara, S. R. M. S. (2005). Limnology of Kandy Lake before the outbreak of a cyanobacteria bloom in May 1999. III. Phytoplankton composition and succession. Sri Lanka Journal of Aquatic Sciences, 10, 55–71. DOI: http://doi.org/10.4038/sljas.v10i0.7460
1. Silva EIL, Samaradiwakara SRMS. Limnology of Kandy Lake before the outbreak of a cyanobacteria bloom in May 1999. III. Phytoplankton composition and succession. Sri Lanka Journal of Aquatic Sciences. 2005;10:55-71. DOI: http://doi.org/10.4038/sljas.v10i0.7460
Silva EIL and Samaradiwakara SRMS, 'Limnology of Kandy Lake Before the Outbreak of a Cyanobacteria Bloom in May 1999. III. Phytoplankton Composition and Succession' (2005) 10 Sri Lanka Journal of Aquatic Sciences 55 DOI: http://doi.org/10.4038/sljas.v10i0.7460
Silva, E.I.L., and S.R.M.S. Samaradiwakara. 2005. "Limnology of Kandy Lake Before the Outbreak of a Cyanobacteria Bloom in May 1999. III. Phytoplankton Composition and Succession". Sri Lanka Journal of Aquatic Sciences 10: 55–71. DOI: http://doi.org/10.4038/sljas.v10i0.7460
Silva, E.I.L., and S.R.M.S. Samaradiwakara. "Limnology of Kandy Lake Before the Outbreak of a Cyanobacteria Bloom in May 1999. III. Phytoplankton Composition and Succession". Sri Lanka Journal of Aquatic Sciences 10 (2005): 55–71. DOI: http://doi.org/10.4038/sljas.v10i0.7460
Silva, E I Land S R M S Samaradiwakara. "Limnology of Kandy Lake before the outbreak of a cyanobacteria bloom in May 1999. III. Phytoplankton composition and succession". Sri Lanka Journal of Aquatic Sciences, vol. 10, 2005, pp. 55–71. DOI: http://doi.org/10.4038/sljas.v10i0.7460


Are you interested in learning how to make high-performance software tools to decypher reads data?
Are you a little familiar with C++ programming?
Are you happy to come to Spain during Spring 2017?
The Genscale team will hold a GATB Special Session during the 5th International Work-Conference on Bioinformatics and Biomedical Engineering (IWBBIO 2017).
To attend to this third GATB Programming Special Session, you have to register to the IWBBIO conference, here.
In addition, fill in this very short form so that we know you will attend to the GATB Special Session; this is important for us to setup the session appropriately, given the number of attendees.


text:
Q: Is there a way to target element by its tag type with an attr selector? Recently the warning policy where I work changed, so now styles with tag type are forbidden somehow. Like this:
p{somestyle}

This causes huge amounts of stylesheets to become wrong.
My question is, can you target an element by its tag type using attribute selectors? Something like:
[tagType=p].someclass{somestyle}

A: No of course. There are no any reasons to use other type of selector for tag name except tag name itself. Actually the only such thing could've been selector priorities, but there are usually no reasons to enlarge priority of tag-only selectors.
Actually you can try something like :matches (:-moz-any, -webkit-any) pseudoclasses, but the right way is to keep tag selectors as the are.

redpajama_set_name: RedPajamaStackExchange


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Thursday, Dec 20, 2007, 10:49
Gold to end higher for seventh year running
Gold is on course to close 2007 at least $100 higher, setting the yellow metal up for its seventh consecutive year of gains in 2008.
An ounce of gold cost $629,80 at the start of 2007 and was trading close to $800 an ounce by mid-December after touching $841,10 in November –- its highest level since 1980. Gold has been rallying since the Q2 of 2001 and at its November high was more than three times the $254,75/oz it bottomed at in April 2001. Needless to say, the metal has come a long way since the beginning of the 1970s when gold was trading at about $35/oz.
What gold's rise since the 1970s proves is that while the yellow metal may not be as cyclical as other commodities, it is vulnerable to occasional violent shakeouts – often preceding a new rally. Profit-taking has seen the price see-sawing on either side of the $800/oz mark in the days leading up to the end of 2007, but most analysts don't believe that the bull run is over and are predicting that the price will deliver more of the same in 2008. More than any other factor, the US economy is seen as the main driver of gold in the year ahead. Aside from the greenback's fall from grace, the subprime crisis and the ongoing risk of a US recession have backed the flight to safe-haven investments like gold. Inflationary pressures and geopolitical instability have further fanned the flames. And analysts are saying that the factors that have supported gold's upward trend are likely to remain unchanged in the medium term, despite the short-term gyrations.
"Indeed, in many respects, the current environment is almost ideal for gold. We are seeing a continued erosion of confidence in the US dollar, which has been the cornerstone of the world financial system since -– and even before -– a formal link to gold was cut in 1971," said Dominic McCormick, chief investment officer at Australia's Select Asset Management. The dollar and gold generally move inversely, as gold is often seen as a hedge against inflation, and if the US Federal Reserve continues to cut interest rates, the dollar will keep falling against foreign currencies and the gold price is likely to rise as investor demand grows. "The dollar is highly unlikely to strengthen until 2009," said Jessica Cross, chief executive of commodities consultancy the VM Group, which believes the gold price will rise to $900/oz during 2008. But Gold Field Mineral Services' chairperson Philip Klapwijk has suggested that spot gold prices might even breach the psychological mark of $1 000/oz in 2008.
The major investment banks have also upgraded their forecasts for gold. JP Morgan increased its gold price forecast for next year to $814/oz from $716/oz and for 2009 to $767/oz from $698/oz – an increase of almost $100. US economic jitters aside, JP Morgan said it expected strong demand from India, China and the Middle East to remain positive for gold next year. In the meantime, Credit Suisse calculated that for every one-cent change in the US dollar exchange rate, the gold price moved by $8/oz. It said in a gold note at the end of October that dollar weakness, higher oil prices and increasing geopolitical trends would push gold through the $800/oz level by the new year. But in the longer term it foresaw the gold price hitting $1 050 an ounce by 2012 as dwindling supply of the precious metal combines with increased demand. Precious metals analyst David Davis said the dynamics surrounding gold supply and demand has begun to change inexorably towards a diminishing supply of gold and increasing investment demand. "Our studies indicate in the long term global gold production [primary supply] will begin to decline as the diminishing number of new reserves fails to compensate for dying mines," Davis said in his note.
While Credit Suisse believes the US dollar would continue to underpin the gold price, "supply and demand factors will begin to make their presence felt to such an extent that they alone (or in combination) could trigger a quantum upward change in the gold price, enough to sustain a new gold price/$ equilibrium". The VM Group concurred, saying 2008 is likely to be "one of the most volatile for many years" with supply and demand levels already in a delicate balance. It anticipates a supply surplus of 123 tons on total supply of 3,75 million ounces and total demand of nearly 3,63 million ounces in 2008. However, since the surplus is so small it could turn into a deficit if any of the major components change, including sources of supply, such as mine supply or central bank sales, and sources of demand, such as jewellery consumption, ETFs and dehedging. So it could be argued at these levels, gold still looks cheap. What is more, gold's longer-term total returns by far exceed those of equities. According to Fidelity Management & Research, maintaining a position in gold since November 2002 would have provided a significant boost to the returns of a diversified portfolio since gold has soared 153% in that time while stocks and bonds gained only 73% and 26% respectively. (Mail Guardian)
MNB Raising Lenders' Reserve Ratio
Economy Finance | Jan 26, 2023, 10:00
MNB Leaves Base Rate on Hold at 13%
MNB Lifts Suspension of Clearance for Alteo Acquisition