text:
Technology Service Board of Directors Leadership Team Intellectual Property
LVX News & Events
LVX System Presents at Florida Aerospace Capital Forum
Visible Light Communication (VLC) technology is advancing to the next stage of development, which entails bringing LVX System's patented technology to a broad marketplace. In North America this new market is anticipated to reach a valuation of $60 billion by 2022.
Chief Development Officer Randy Mortensen took the stage in Orlando, Florida, last week to present LVX System's innovative work at the Florida Aerospace Capital Forum.
The forum, hosted by Florida Venture Forum, in partnership with Space Florida, serves to broaden the spectrum of Florida-based aerospace companies and entrepreneurs in the state as well as to connect private equity, venture capital and angel investors with startups specializing in breakthrough technical solutions and meaningful IP.
This year, 20 companies pitched their innovative ideas to more than 150 attendees including representatives from NASA - National Aeronautics and Space Administration, Lockheed Martin, and Northrop Grumman Corporation
Learn more about the forum.
Space Florida's invitation to present comes during our $4.2 million bridge round of funding as we prepare for the $30 million upcoming A-Round.
We invite you to get involved. Returns for investors are enhanced by our robust patent portfolio, valued at $146 million in a recent independent appraisal. Together, we can all achieve more, and partnerships on multiple fronts are essential to our long-term success.
David Sexton
CEO and President, LVX System
david.sexton@lvx-system.com
ABOUT:LVX System is the inventor and innovative leader in the fast-emerging Visible Light Communication (VLC) and Light Fidelity (Li-Fi) market. As the pioneer and foundational VLC patent holder, in this new frontier of communication through light photons, LVX is poised to monetize this proprietary research at an exponential rate of recurring revenue.
© 2019 LVX SYSTEM

redpajama_set_name: RedPajamaCommonCrawl


text:
Land & water governance
Human rights and gender
Dossiers in the spotlight
About Both ENDS
Investment treaties
Investment treaties must be inclusive, sustainable and fair. That means that they must not put the interests of companies before those of people and their living environment.
International investment flows are currently regulated by some 3,000 bilateral investment treaties (BITs) and other international investment (IIAs). These agreements and treaties were originally set up to promote foreign investment, but very little has come of their promised beneficial effects. The time has come to radically change the international system of investment treaties. It is not only clear that investment treaties do not promote foreign investment, but also that in many cases they seriously harm the interests of developing countries.
Far-reaching rights for investors
The treaties grant foreign investors far-reaching rights and are increasingly used to exert pressure on governments not to take measures that are not in the investors' interests. The Investor-to-State-Dispute-Settlement (ISDS) system allows businesses or investors to lodge charges against states beyond the jurisdiction of international courts. ISDS tribunals are not subject to the laws of countries that are charged and only work in one direction: only businesses may submit complaints, without having to do anything to defend themselves.
Dispute settlement beyond the reach of international courts
Through ISDS, foreign investors can oppose a wide range of national government policies and measures, including social and environmental rules. The rulings of an ISDS tribunal are definitive, binding and internationally enforceable. A large proportion (around 60%) of all ISDS cases are brought by companies against poorer countries, and the number of complaints has risen sharply in the past 10-20 years. In the past five years, one new ISDS case has been submitted per week. At the end of 2017, UNCTAD reported that successful complainants received an average of $522 million in compensation. Countries will often decide not to introduce a certain measure rather than face such high penalties, with all the consequences that will have for its people.
Many ISDS claims from the Netherlands
ISDS claims have already caused considerably harm in many developing countries. The second highest number of ISDS procedures are initiated from the Netherlands, after the US. That is partly because of the almost 100 BITs that the Netherlands has concluded, including with developing countries. There are also many 'letter-box' companies registered in the Netherlands, which can use the Dutch BITs to lodge complaints against countries in which they invest. The increasingly negative effects of ISDS in investment treaties is one of the main reasons why more and more developing countries want to terminate their investment treaties with the Netherlands.
Both ENDS is working to reform and terminate BITs
Both ENDS has long been drawing attention to the negative consequences of investment treaties on developing countries and is particularly concerned about the ISDS mechanisms in the current treaties. To make investment policies fair and sustainable and to ensure that they do not harm people and the environment, the ISDS mechanism included in all these treaties must be removed as soon as possible.
Dutch model BIT
In 2018, the Netherlands is revising the model text of its BITs. As the text will serve as an example for many other European countries, it is important that it is as inclusive and sustainable as possible. Together with Dutch and foreign partners, Both ENDS is providing input for the new text, naturally in the hope that its recommendations are taken up. We are also working with our partners to raise awareness of the consequences of investment treaties and ISDS, with the aim of exerting public pressure on the decision-making process relating to the model text.
Terminating BITS
Outside the Netherlands, we are also making our concerns and criticisms clear in other institutions, like UNCTAD and the European Parliament. We are supporting local groups in Southern countries in their efforts to terminate existing treaties, so that new investment policies can be developed that put people and the environment first and ensure that investments make a positive contribution to sustainable development.
Burghard Ilge
Read more about this subject
Rights for People, Rules for Corporations – Stop ISDS!
Indigenous communities in Paraguay saw their attempts to regain their ancestral lands thwarted by German investors. In Indonesia, US-based mining companies succeeded to roll back new laws that were meant to boost the country's economic development and protect its forests. This is the level of impact that investment treaties can have on social, environmental and economic development and rights. Why? Because of the 'Investor-to-State Dispute Settlement' clauses that are included in many such treaties.
International trade agreements often have far-reaching consequences not only for the economy of a country, but also for people and the environment. It is primarily the most vulnerable groups who suffer most from these agreements.
Fair Green and Global Alliance (FGG)
Together with civil society organisations from all over the world, the Fair Green and Global (FGG) Alliance aims for socially just, inclusive and environmentally sustainable societies in the Netherlands and the Global South.
News / 11 October 2019
Rights for people, rules for corporations: the case of Indonesia
In Indonesia, US-based mining companies succeeded to roll back new laws that were meant to boost the country's economic development and protect its forests. This is the level of impact that investment treaties can have on social, environmental and economic development and rights. Why? Because of the 'Investor-to-State Dispute Settlement' (ISDS) clauses that are included in many such treaties.
Rights for people, rules for corporations: the case of Paraguay
Indigenous communities in Paraguay saw their attempts to regain their ancestral lands thwarted by German investors. This is the level of impact that investment treaties can have on social, environmental and economic development and rights. Why? Because of the 'Investor-to-State Dispute Settlement' (ISDS) clauses that are included in many such treaties.
Publication / 4 April 2019
The Mauritius Convention: Boosting transparency in Treaty-based Investor-State Arbitration
Publication / 7 November 2018
UPOV 91 and trade agreements: Compromising farmers' right to save and sell seeds
News / 19 June 2018
NGO's send letter to Minister Kaag to call for termination of BIT with Burkina Faso
Today, Both ENDS sent a letter, signed by various civil society organisations, to Sigrid Kaag (Dutch Minister of Aid & Trade) reminding her of an important deadline and to urge her to terminate the Bilateral Investment Treaty (BIT) that exists between the Netherlands and Burkina Faso. The treaty, which can be very harmful for a poor country such as Burkina Faso, will automatically be renewed for the next 15 years if it is not terminated before July 1st this year.
External link / 31 May 2018
Uganda: Time for a new and better agreement with the Netherlands (Annual Report 2017)
For several years now, Both ENDS has been drawing attention to the downsides of existing Bilateral Investment Treaties (BITs) between the Netherlands and countries in the Global South. In 2017, an important step was taken, when Uganda decided to terminate its BIT with the Netherlands, as advised by Both ENDS and our local partner SEATINI.
News / 14 September 2017
What to think of the EU's Multilateral Investment Court
Remember the widespread protests against trade agreements TTIP and CETA? One of the main worries was the Investor-State Dispute Settlement (ISDS) mechanism these treaties contain. Now the European Commission has proposed to set up a Multilateral Investment Court. Is that good news?
Event / 20 June 2017
Eurodad-conference 'Alternative policies for a sustainable world'
Eurodad's International Conference is co-hosted by Eurodad's Dutch members ActionAid Netherlands, Both ENDS, OIKOS, Oxfam Novib and SOMO. It will be held in the Caballero Fabriek in The Hague.
News / 26 January 2017
No lessons learnt from TTIP and CETA in current trade negotiations EU - Indonesia
From 24-28 January 2017, the second round of negotiations towards a Comprehensive Economic Partnership Agreement (CEPA) takes place between the EU and Indonesia. The proposed agreement covers far-reaching liberalisation and deregulation that can have severe impacts on society, people and the environment. Civil society organisations, including Both ENDS, released a statement to express their concern and call upon the negotiators to halt the process and fully assess the potential environmental and social impacts of the agreement.
5 alternative arguments against TTIP
Both ENDS will join the protest against trade treaties TTIP, CETA and TiSA on Saturday October 22nd in Amsterdam. These treaties will have negative impacts, not only in the Netherlands and Europe, but also - and maybe even more so - in developing countries.
Publication / 19 September 2016
CETA: Trading away democracy
Publication / 10 March 2016
Book: Rethinking Bilateral Investment Treaties: Critical Issues and Policy Choices
News / 11 December 2015
What are we going to do at the WTO-conference in Nairobi?
Nairobi, Kenya's capital city, will be the epicenter of international trade from 15 to 18 December 2015. The representatives of the World Trade Organisation (WTO), which currently has 162 member countries, will come together to negotiate. The different countries tend to have very different and often conflicting interests, which makes it difficult to reach agreements. Burghard Ilge of Both ENDS travels with Minister Ploumen as an official adviser and mediator from civil society. His role is to inform the Minister about the views and interests of civil society organisations around the world, in order for her to take these positions into consideration during the negotiations. We asked Ilge some clarifying questions.
To change a BIT is not enough
(BITs (admin), 15/06/2018)
Together with environmental justice groups from the Global South, Both ENDS works towards a sustainable, fair and inclusive world. We gather and share information about policy and investments that have a direct impact on people and their livelihood, we engage in joint advocacy, we stimulate the dialogue between stakeholders and we promote and support sustainable local alternatives.
info@bothends.org
Nieuwe Keizersgracht 45,
1018 VC Amsterdam,
Public finance for development
Copyright 2020 BothENDS


At some point, there's a point of diminishing returns on just how much you are are willing to spend versus the probability of someone ignoring all that stuff.
I don't think it's a coincidence that the truck in this article (and some of the links I've seen) are rentals. That leads me to believe these are not professional truck drivers doing it. The one time I witnessed a truck hitting an overpass, it was also a rental truck. People used to driving cars who sometimes drive a truck aren't likely to consider this or think vague warnings are directed at them.
The one time I drove a rental truck across an area bridge, I pulled out the usual fee for cars and had it in hand when approaching the tollbooth. I offered it to the collector, and she gave me a blank look before explaining that I would need to pay a lot more than that! It never crossed my mind until that moment, and luckily I had enough extra cash to pay it.
What if instead of a banner it unfurls a fat man, and what if behind the truck is a busload of kills who will ram into the truck and all be killed because kids on school buses are dancing in the aisles instead of wearing seat belts?!? What would you do then huh genius, what would you do?!?
I like the water-curtain idea, and the lowering the road idea. Here's another potential solution - raise the road to make it obviously too low for trucks.
But it does feel like with this many incidents someone should care to solve this.
But which upgrade? See the link to the FAQ above. Every "easy solution" other than signage and the crash bar is not an easy or cheap as more than a few million dollars solution.
I think Mark's suggestion (or a variant of it) is the only thing that's going to work. @PsiPhiGrrrl has it right that the people driving these things don't realize they're overheight. They're driving a rental or unfamiliar truck and haven't even considered what their height is, so you can warn them all day long about Over 11'8" but they won't realize the warnings are for them.
Bringing down a sign or arm with a 'YES THIS MEANS YOU' is the only thing that's going to register.
I don't think it's a coincidence that the truck in this article (and some of the links I've seen) are rentals.
Of course not. Professional truck drivers are trained to drive trucks and when they get into a truck they mentally shift into truck-driving mode and all the considerations and duties of care click into place, including awareness of the size of their vehicle and load. Ordinary folks driving rentals get behind the wheel and their brains tell them "this is familiar, just like driving a car!" and the result is a bridge with a safety guard that wonders what it did in another life to deserve this.
If it were me I would solve it by lowering the road one foot. It's like the old joke where the farmer complains about his horse's ears hitting the top of the barn door to his neighbor.
Oldtaku and Mark are on to something: It's a message problem.
I'd suggest "You are Overheight -STOP!" or "Your truck's gonna hit this bridge!". Or even a set of Burma Shave-like signs that progressively warn of the danger.
Make the lasers powerful enough, and what's left of the truck won't have a problem getting under the bridge.
The clearance of the bridge is 11' 8". Durham city buses have a clearance of 11' 6".
This is why I think the best solution might be a sign that says "NO TRUCKS" (approximately). People in trucks are better at remembering they're in trucks (I hope).
A few years back I forgot I had a couple of bikes on the roofrack of my car. Drove into a multistory car park and… well, it was spectacular. They hit the restricted height sign just under the handlebars and caused the front mounts of the rack to spring free. This then meant the whole rack (with well secured bikes) rotated up and back, allowing the back end to smash my rear window.
I think the system that they currently have is fine. You only need to hit that bridge once, and you'll never ever do it again.
How about just lie about the clearance? Just say it's 11' 0" and call it a day.
Maybe the answer is in the title of this post.
Make the bridge into a giant face with chomping teeth that close when the light is red.
It wont stop the accidents but watching the bridge literally eat the trucks will be awesome.


Each Absolute-Positioned (AP) Div you draw in Adobe Dreamweaver CS6 is listed automatically in the AP Elements panel (choose Window→AP Elements to display it). The AP Elements panel can help you select, hide, and show any AP Divs on the page. This panel is handy when you have lots of AP Divs on the page and want to navigate among them accurately.
Most of all, because you can modify the properties for any AP Div from its corresponding ID style, the panel helps you figure out which ID style belongs to an AP Div.
The AP Elements panel is often grouped with the CSS Styles panel, just in case you're looking for it.
Choose Window→AP Elements to open the AP Elements panel.
In the panel, locate and select apDiv1 to highlight it on the page.
The Property inspector displays its size and position in addition to other properties.
Using the text boxes in the Property inspector, change the box width by entering a number into the W field and change the box height by entering a number in the H field.
Click the swatch next to Bg Color and choose a color from the pop-up Swatches panel to set a background color for the box.
For additional properties, such as border or padding, add them in the CSS Styles panel.
If the CSS Styles panel isn't already visible, open it by choosing Window→CSS Styles.
Double-click the #apDiv1 ID style that controls the box.
The CSS Rule Definition dialog box appears.
Select the Border category from the left to change the border.
In the Style column, use the Top drop-down list to set a border style (such as Solid) to all four sides.
Use the Top drop-down list under the Width category to select a border thickness (for example, medium) for all four sides. Use the topmost Color Picker under the Color column to assign a border color to all four sides.
To assign different values to any or all sides for style, width, or color, deselect the Same for All check box under their respective columns.
In the Box category on the left, under Padding, set the padding for all four sides of the box to the thickness you want (for example, enter 5 px in the text boxes).
Click OK to exit the panel and apply the changes.
You see how the CSS properties you applied affect the apDiv1 box on the page.
To hide a box shown under the AP Elements panel, click the column to the left of its name (under the Eye icon) until a closed Eye icon appears. To make the box reappear, click the Eye icon until the box opens again.
You may notice the Prevent Overlaps check box, deselected by default, at the top of the AP Elements panel. Because AP Divs can easily overlap each other, selecting this check box overrides that behavior by forcing boxes next to each other and preventing the creation of new boxes on top of each other.


The idea of improving your business whilst also saving money might sound too good to be true. How about improving your business, saving money, and saving the environment?
Although it may seem hard to believe, these complement each other perfectly. In this digital age, there are many changes you can make to help your business run smoother, cheaper, and in an environmentally friendly manner. Take a look at some of the ideas below.
Not only does this save valuable office and storage space, but it means less money spent on endless paper and high-performing printers and ink. As all business owners will know, these are rather expensive.
Furthermore, going paperless is hugely beneficial for the environment.
Old records can be scanned or stored on discs. Bookkeeping, invoicing, and billing can all be done online now, with services and software available to get you started.
This can help improve your business by making your records more organized and accessible. It's much easier to pull up an old record from computer software than it is to search through endless files and papers.
If it's not feasible for your company to go paperless, consider buying recycled paper or double-sided printing. Both of these options are also great money and environment savers.
This goes hand in hand with going paperless – not everything that you keep hard copies of is needed. However, there are many other ways to digitalize your business.
For example, you can digitalize your employees. Depending on your business, you may be able to outsource certain tasks to freelancers instead of local employees. Remote freelancers often ask for a lower fee and do all their work from behind a screen, saving you both money and time.
It's also a great idea to digitalize meetings. Rather than paying for and hiring conference rooms and trying to arrange a time which suits everyone, you can utilize digital conference software. These will allow you to schedule meetings over the phone or the internet and can be used internationally. This is particularly useful if your business involves employees, clients, and customers worldwide.
Investing in quality technology is very important, in particular, if you are taking steps to digitalize your business. A short-term investment may well yield long-term results.
Start by upgrading your existing gear. This is a simple and cost-effective solution to ensuring your business is running smoothly. Sell your Iphone, trade in your laptop, and upgrade to the newest software available.
Once you've done that, you can look into innovative new technology that you can use to improve the running of your business. With technology growing rapidly, you'll be sure to find something suitable.
CoWorking spaces are one of the hottest topics in the business market now. It's cost-efficient, space-efficient, and a networking opportunity all at once.
There's plenty of dedicated office spaces practically everywhere, so you'll be able to find the right fit for your business. You might even be able to switch to a virtual office altogether.
Often, these office spaces are pay as you go, so if you are able to work remotely from time to time you'll save even more.
As they are very popular with start-ups, these spaces are ripe with inspiration and new ideas. You might just find your next business partner here.
Contrary to popular opinion, it is possible to save money whilst improving the running of your business. Furthermore, it's even possible to do this whilst being kind to the environment. Why not try out some of these options to see how they can help improve your business?
Annika is a Senior Editor at Social Media Explorer. She travels full time and has lived on the road working remotely for over two years. You can check out her Instagram to follow her on the road.


For advice on planning applications and planning compliance regarding buildings in a Conservation Area, please contact our Conservation and Design Team at the Planning Service who may recommend you take up the Planning Pre-Application Advice Service.
You can apply online for permission for Demolition in a Conservation Area through the Planning Portal and find details of relevant demolition.
Alternatively, you can apply using the printable application form, the checklist [14kb] and the help notes.


text:
F.D. Mason Memorial Funeral Home
Send Flowers for Jane
Jane Ellen Russ
June 14, 1933 ~ May 13, 2020 (age 86)
Jane E. Russ-Jane Ellen Russ departed life May 13th, 2020 at her home.
Jane was born June 14th, 1933 in Roselle Park, New Jersey to Emma and Melvin L. Brown. In her youth Jane enjoyed playing softball, working, and accounting. She went on to become a homemaker and assisted in running the business she and her husband operated for over 50 years. She was well known in the Youngstown City School System for being an active participant in the PTA while both her daughter and granddaughter were in attendance.
Jane was a long-time active member of Antioch Baptist Church as a Sunday School Teacher, a member of the Senior Choir, and Deaconess.
Jane was an awesome mother, grandmother, and wife who prided herself on taking care of her family. In addition, she raised and or assisted in raising host of family children and caring for her brother and father in law in her home.
Jane was preceded in death by her parents, and a brother Melvin L. (aka Sonny) Brown.
She leaves her husband Oddie Russ; a daughter Loretta Lane (Edwin Moore) from Youngstown; step-son Gregory Russ from Albany, New York; a grand-daughter Janellen Lane (Walter Heard) of Columbus Ohio; her great-grandchildren Asia Lane and Jarel Heard. In addition to a host of nieces and nephews, family, and friends.
Visitation services will be held at Antioch Baptist Church 10:00 11:00 am Friday, May 22, 2020 and a private ceremony for the immediate family thereafter.
Interment will take place at Tod Homestead Cemetery.
The F.D. Mason Memorial Funeral Home, Inc. has been granted the honor to serve the family.
To send flowers to the family or plant a tree in memory of Jane Ellen Russ, please visit our floral store.
110 Funston Ave
Image: Tom Curtis / FreeDigitalPhotos.net
© 2021 F.D. Mason Memorial Funeral Home. All Rights Reserved. Funeral Home website by CFS & TA | Terms of Use | Privacy Policy


Escape the 21st century. Nestled on a bluff along the Missouri River, Arrow Rock is untouched by time. Arrow Rock invites you to enrich the present by visiting the past. Upon arrival in this historic Santa Fe Trail town of the mid-1800's, we will savor a delicious home-cooked country fare at the J. Huston Tavern Restaurant.


2. Combine butter, sugar, salt, and vanilla in a bowl. Beat with an electric mixer until smooth and creamy. Mix in pecans and cocoa nibs (and chocolate bar if used). Blend in the flour.
3. Form dough into 12-inch log a few inches thick. Wrap in parchment and refrigerate for at least 2 hours, preferably overnight (can be frozen up to 3 months).
4. Using a sharp knife, cut the cold dough log into ¼ inch thick slices. Drop cookies at least 1 1/2 inches apart on parchment-lined cookie sheets.
5. Bake until the cookies are light golden brown at the edges (12-14 minutes).
The inspiration for this recipe can be found here on Cake on the Brain's blog.


text:
Man changes locks in the morning, returns to robbed apartment that night
By Julianne McShane
Bay Ridge—Dyker Heights
Change for the worse
A sneaky thief stole $16,350 worth of jewelry from a man's 101st Street apartment on Dec. 6.
The apartment resident said that he discovered that three jewelry items were missing from his apartment after he returned home, between Third and Fourth Avenues, after his superintendent had changed the lock on his front door after the resident left for work around 7:30 am that morning.
Cellular ripoff
A no-goodnik opened a Verizon account in the name of a Bay Ridge Avenue resident and incurred charges of $3,540 on Nov. 7, the Ridge resident reported this week.
The man lives between Third and Fourth avenues, and the perp opened the account at around 10 pm, according to the report.
Thief stooped low
A lowlife stole a laptop valued at $1,150 from a man's Bay Ridge Avenue front stoop on Nov. 24, the man reported to police this week. The thief snagged the package after it was delivered around 5:35 pm to the home between Narrows Avenue and Owl's Head Court.
Connection voided
A good-for-nothing stole a cell phone straight from a package at a Fourth Avenue building on Dec. 1. The perp grabbed the phone from the package when it was delivered to the building between 74th and 75th streets just before 11:30 am.
Easy pickings
A thief stole a woman's wallet from her car parked on Narrows Avenue on Dec. 9, according to police. The woman parked her car between 72nd and 73rd Streets, and the thief made the move around noon. The woman's car doors were left open, according to a police report.
— Julianne McShane
Cops arrest pervy subway pilferer
Gun-simulating wretch bags bottle of wine
Villains brutally rob cash from man


text:
import { Handle } from './storage/handle.js';
import { Consumer } from '../utils/lib-utils.js';
import { InnerArcHandle } from './particle-execution-context.js';
import { HandleConnectionSpec, ParticleSpec } from './arcs-types/particle-spec.js';
import { Relevance } from './relevance.js';
import { Entity, EntityRawData, MutableEntityData } from './entity.js';
import { CRDTTypeRecord } from '../crdt/lib-crdt.js';
import { EntityHandleFactory } from './storage/entity-handle-factory.js';
import { CRDTMuxEntity } from './storage/storage.js';
export interface Capabilities {
    constructInnerArc?: (particle: Particle) => Promise<InnerArcHandle>;
    serviceRequest?: (particle: Particle, args: any, callback: any) => void;
    output?: any;
}
/**
 * A basic particle. For particles that provide UI, you may like to
 * instead use DOMParticle.
 */
export declare class Particle {
    static spec: ParticleSpec;
    spec: ParticleSpec;
    readonly extraData: boolean;
    readonly relevances: (Relevance | number)[];
    handles: ReadonlyMap<string, Handle<CRDTTypeRecord>>;
    handleFactories: ReadonlyMap<string, EntityHandleFactory<CRDTMuxEntity>>;
    private _idle;
    private _idleResolver;
    private _busy;
    private created;
    protected _handlesToSync: number;
    private capabilities;
    protected onError: Consumer<Error>;
    constructor();
    callOnFirstStart(): void;
    /**
     * Called after handles are writable, only on first initialization of particle.
     */
    protected onFirstStart(): void;
    callOnReady(): void;
    setCreated(): void;
    /**
     * Called after handles are synced the first time, override to provide initial processing.
     * This will be called after onFirstStart, but will not wait for onFirstStart to finish.
     */
    protected onReady(): void;
    /**
     * This sets the capabilities for this particle.  This can only
     * be called once.
     */
    setCapabilities(capabilities: Capabilities): void;
    protected invokeSafely(fun: (p: this) => Promise<any>, err: Consumer<Error>): Promise<any>;
    callSetHandles(handles: ReadonlyMap<string, Handle<CRDTTypeRecord>>, handleFactories: ReadonlyMap<string, EntityHandleFactory<CRDTMuxEntity>>, onException: Consumer<Error>): Promise<void>;
    /**
     * This method is invoked with a handle for each store this particle
     * is registered to interact with, once those handles are ready for
     * interaction. Override the method to register for events from
     * the handles.
     *
     * @param handles a map from handle names to store handles.
     */
    protected setHandles(handles: ReadonlyMap<string, Handle<CRDTTypeRecord> | EntityHandleFactory<CRDTMuxEntity>>): Promise<void>;
    private _countInputHandles;
    callOnHandleSync(handle: Handle<CRDTTypeRecord>, model: any, onException: Consumer<Error>): Promise<void>;
    /**
     * Called for handles that are configured with both keepSynced and notifySync, when they are
     * updated with the full model of their data. This will occur once after setHandles() and any time
     * thereafter if the handle is resynchronized.
     *
     * @param handle The Handle instance that was updated.
     * @param model For Singleton-backed Handles, the Entity data or null if the Singleton is not set.
     *        For Collection-backed Handles, the Array of Entities, which may be empty.
     */
    protected onHandleSync(handle: Handle<CRDTTypeRecord>, model: any): Promise<void>;
    callOnHandleUpdate(handle: Handle<CRDTTypeRecord>, update: {
        data?: any;
        added?: any;
        removed?: any;
        originator?: any;
    }, onException: Consumer<Error>): Promise<void>;
    /**
     * Called for handles that are configured with notifyUpdate, when change events are received from
     * the backing store. For handles also configured with keepSynced these events will be correctly
     * ordered, with some potential skips if a desync occurs. For handles not configured with
     * keepSynced, all change events will be passed through as they are received.
     *
     * @param handle The Handle instance that was updated.
     * @param update An object containing one of the following fields:
     *  - data: The full Entity for a Singleton-backed Handle.
     *  - added: An Array of Entities added to a Collection-backed Handle.
     *  - removed: An Array of Entities removed from a Collection-backed Handle.
     *  - originator: whether the update originated from this particle.
     */
    protected onHandleUpdate(handle: Handle<CRDTTypeRecord>, update: {
        data?: any;
        added?: any;
        removed?: any;
        originator?: boolean;
    }): Promise<void>;
    callOnHandleDesync(handle: Handle<CRDTTypeRecord>, onException: Consumer<Error>): Promise<void>;
    /**
     * Called for handles that are configured with both keepSynced and notifyDesync, when they are
     * detected as being out-of-date against the backing store. For Singletons, the event that triggers
     * this will also resync the data and thus this call may usually be ignored. For Collections, the
     * underlying proxy will automatically request a full copy of the stored data to resynchronize.
     * onHandleSync will be invoked when that is received.
     *
     * @param handle The Handle instance that was desynchronized.
     */
    protected onHandleDesync(handle: Handle<CRDTTypeRecord>): Promise<void>;
    constructInnerArc(): Promise<InnerArcHandle>;
    get busy(): boolean;
    get idle(): Promise<void>;
    set relevance(r: Relevance | number);
    startBusy(): void;
    doneBusy(): void;
    inputs(): HandleConnectionSpec[];
    outputs(): HandleConnectionSpec[];
    /**
     * Request (outerPEC) service invocations.
     */
    service(request: any): Promise<unknown>;
    static buildManifest(strings: string[], ...bits: any[]): string;
    setParticleDescription(pattern: any): Promise<boolean>;
    setDescriptionPattern(connectionName: string, pattern: any): Promise<boolean>;
    idFor(entity: Entity): string;
    dataClone(entity: Entity): EntityRawData;
    mutate(entity: Entity, mutation: Consumer<MutableEntityData> | {}): void;
    output(content: any): void;
    fireEvent(slotName: string, event: {}): void;
}

redpajama_set_name: RedPajamaGithub


Let your style do the talking by wearing this palazzo suit presented by Stop. The kurta features a round neck, three quarter sleeves that render it fashionable. Crafted with a good quality fabric, which makes it comfortable to wear. It also features a printed pattern that enhances its appeal, while it also comes with solid dupatta and a pair of palazzos which enhances its visual appeal.
Add to your classic, charming look by wearing this palazzo suit. Pair it up with sandals and some simple Indian jewellery.


text:
Symptom Management: Spasticity
GG defiebre of SRNA is joined by Dr. Jacqueline Nicholas for an ABCs of NMOSD podcast on "Symptom Management: Spasticity." Dr. Nicholas begins by explaining spasticity and tone and how it is affected by NMOSD. She discusses causes of spasticity and why some people experience it while others do not. She describes first-line and second-line treatments for spasticity and how exercise can help. Dr. Nicholas explains how spasticity can affect the ligaments, muscles, and bones.
Intro: [00:00:00] ABCs of NMOSD is a 10-part education podcast series to share knowledge about neuromyelitis optica spectrum disorder, or NMOSD, a rare relapsing autoimmune disorder that preferentially causes inflammation in the optic nerves and spinal cord. ABCs of NMOSD Podcast Series is hosted by SRNA, the Siegel Rare Neuroimmune Association, and in collaboration with the Sumaira Foundation for NMO, the Connor B. Judge Foundation and Guthy Jackson Charitable Foundation. This education series is made possible through a patient education grant from Viela Bio.
GG deFiebre: [00:00:59] Hello and welcome to the ABCs of NMOSD Podcast Series. This podcast is about Managing Spasticity in NMOSD. My name is GG deFiebre, and I'm from the Siegel Rare Neuroimmune Association.
[00:01:13] ABCs of NMOSD is made possible through a patient education grant from Viela Bio. Viela Bio is dedicated to the development and commercialization of novel life-changing medicines for patients with a wide range of autoimmune and severe inflammatory diseases.
[00:01:28] Their approach to drug discovery is aimed at providing targeted treatments for improved outcomes for the thousands of patients who have few or no therapeutic options. For additional information about Viela, please visit vielabio.com.
[00:01:41] For this podcast we were joined by Dr. Jacqueline Nicholas. Dr. Nicholas is a board-certified neurologist specializing in neuroimmunology, multiple sclerosis, and spasticity.
[00:01:52] Dr. Nicholas received her undergraduate degree from Miami University in Oxford, Ohio, and her medical degree from the University of Toledo College of Medicine in Toledo, Ohio. She trained at the University of Pittsburgh Medical Center where she completed an internship in internal medicine and a neurology residency where she served as Chief Neurology Resident.
[00:02:11] Dr. Nicholas completed a fellowship in clinical neuroimmunology, multiple sclerosis, and spasticity at The Ohio State University Medical Center in Columbus, Ohio, while also completing her Master of Public Health degree at The Ohio State University College of Public Health. She received a prestigious three-year Sylvia Lawry Physician Fellowship Award to fund her fellowship training.
[00:02:34] To start, can you just tell us a little bit about what spasticity is and what tone is in NMOSD?
Dr. Jacqueline Nicholas: [00:02:41] Sure. Spasticity is defined as a increase in muscle tone with some type of movement. Clinicians will describe it as a velocity-dependent increase in muscle tone. That means if we just very slowly move someone's limb, around a joint, for instance, flex the arm slowly, we may not pick up any increase in that muscle tone, where we feel some degree of stiffness or a catch. But if we move it really quickly, then we may actually pick up that there's some tightness or a catch there. And that's what we define as true spasticity – when there's some type of movement that leads to an increase in muscle tone. But there are many different symptoms that people experience with spasticity, where it can be described as being: my muscles just feel very stiff, or people will describe having cramping or spasms, or they may describe that when they're trying to move their body or their legs, they can have what's called like an extensor spasm where the legs will stick straight out and remain stiff and it's very hard to bend them back into a seated position. People experience the clinical symptoms of spasticity quite differently.
GG deFiebre: [00:04:03] And then what causes spasticity in NMOSD? What is the reason that it happens?
Dr. Jacqueline Nicholas: [00:04:09] Typically in NMOSD, a common reason for spasticity would be if somebody has had a transverse myelitis and certainly in NMO, the myelitis can be quite severe and obviously many times, longitudinally extensive. When individuals have a transverse myelitis, they would be at an increased risk of developing spasticity. Certainly in NMO, although less common, we can see brain lesions, particularly in the brainstem, and this would be another area, could lead to spasticity. One of the common manifestations that many of my patients have had with that condition is something called dystonic spasms, where they may feel like one side of their body just gets very tight, and the arm may flex and the leg may flex at the hip and the knee, and the individual just can't relax it. And it's truly just caused by the damage within the spinal cord and sometimes the brain. And so anybody that experiences spasticity has to have some type of damage within the central nervous system, which includes the brain or spinal cord.
GG deFiebre: [00:05:19] And by transverse myelitis you mean someone that has had inflammation or damage to the spinal cord within NMOSD?
Dr. Jacqueline Nicholas: [00:05:27] Absolutely.
GG deFiebre: [00:05:28] Okay. And then why is it that some people have spasticity and others don't? Is there a reason within NMOSD that that might be the case?
Dr. Jacqueline Nicholas: [00:05:38] It can be very challenging, and to be frank, there's not a simple answer. So two people who have a lesion in the same level of the spinal cord or had inflammation at someplace in the spinal cord could be entirely different in how their symptoms occur.
So one person may have some weakness but not develop spasticity, whereas another individual could develop quite severe spasticity. But we think it has to do more with the degree of damage within the nervous system that prevents that normal signaling -there's an inhibit inhibitory signal that can occur. When you go to think "I want to catch a baseball" and you lift up your arm to catch that ball coming at you, the muscles that would prevent you from doing that, the antagonist muscles, those should not be contracting. Only the muscle to raise your arm and sort of flex the elbow and open your fingers to catch that baseball. But the problem with spasticity is that agonist and antagonist muscles, the muscles that do the opposite actions, can be contracting at the same time, and so that can prevent movement and be quite problematic.
GG deFiebre: [00:06:51] And you talked a little bit about this, do we know why someone might have severe spasticity and why someone else might not? Two people might both have spasticity, but someone has very severe spasticity. Do we have any understanding of why that might be the case?
Dr. Jacqueline Nicholas: [00:07:06] We tend to see, based on the degree of damage that somebody has had in their brain or their spinal cord, that sometimes that can correlate. Again, it varies significantly from person to person. I can share that in my personal experience as a neuroimmunologist and spasticity doctor, I tend to see patients who have had weakness as one of the problems that they've developed as a result of the damage in their spinal cord or their brainstem in the setting of NMOSD.
[00:07:39] I tend to see that it's more likely to occur in those individuals who've had weakness because it's sort of the body's natural way of helping, where those muscles can stiffen up and sometimes that spasticity can be favorable to some degree. Where if you had a complete weakness in one leg or both legs, it could be very hard to walk on legs that are kind of like jello.
[00:08:03] Whereas that stiffness, if the limbs and the muscles that are very loose, stiffen up, even if somebody's weak, that can help to support them better and allow them to be more effective at moving. But the problem really arises when the stiffness becomes so severe that the individual has trouble moving the limb or bending at the knees or other joints, depending on what the individual is trying to do. So there are some benefits of it and also some, some significant disadvantages as well.
GG deFiebre: [00:08:33] I know you talked a little bit about the benefits, so are there any other benefits to spasticity besides maybe providing some strength to a muscle that would otherwise be weak?
Dr. Jacqueline Nicholas: [00:08:45] I would say that that overall is the true benefit of spasticity because, that, for some individuals, when we manage spasticity, we want to be careful to loosen the muscles significantly enough to provide them with comfort and potentially better function.
[00:09:01] But at the same time we need to sometimes maintain some of that spasticity because that may allow for better function. So for instance, after a relapse of NMOSD where somebody has had a long spinal cord lesion, initially, they could be very weak in their limbs. And if the limbs remained very, very weak and very loose, it'd be very hard for that individual to accomplish certain motor tasks that they may want to carry out. And so that stiffness does help to some degree to be able to do some of the things that someone needs to do. But again, the problem really lies in when that stiffness is so severe that it's causing problems with pain, or it's inhibiting that individual's ability to work with neurophysical therapy or neuro-occupational therapy to really get that good rehab and try to strengthen and improve mobility.
GG deFiebre: [00:09:59] Got it. And then just going back a bit, I know you mentioned that someone can have damage to the spinal cord or the brainstem. Do you see any differences in how spasticity presents, depending on where in the central nervous system the damage is?
Dr. Jacqueline Nicholas: [00:10:14] Interestingly, I don't. As neurologists, we sometimes encounter people who have spasticity for a number of different reasons and can see it quite severe when they have damage within the brain versus the spinal cord and various areas. So I wouldn't say that there's particular areas where we're more likely to see more severe spasticity.
GG deFiebre: [00:10:36] Got it. And then, what is clonus?
Dr. Jacqueline Nicholas: [00:10:40] Clonus is a word that means continuous muscle contraction. So one of the common things that someone's doctor might do while evaluating them would be to put a hand on the bottom of the foot and then to quickly bend that foot up. And sometimes somebody can feel their foot repeatedly just pressing down and it's an involuntary movement where it can just repeatedly jerk.
[00:11:03] Some people that have clonus, again, that's a common sign of damage within the brain or the spinal cord. And we can certainly see that in people that have spasticity. I'd say also that, many people with spasticity will describe that they might be laying down at night to go to bed and they feel that their legs just jerk or repeatedly kind of kick, and it's outside of their control. That's something called myoclonus or a muscle jerk. And again, that's a loss of neuronal control, or those normal signals that normally would inhibit your body from making movements that you don't want to make. But the problem is when that damage occurs, the signaling is confused, and then you can have these motor signals sent to the limbs to just randomly move.
[00:11:53] A lot of times people will notice that if the weather's really cold outside – cold can be a common stimulus for this – or if somebody touches their body, or if they try to move, that can be another trigger. So there are many reasons why that can happen.
GG deFiebre: [00:12:10] Okay, thank you. And then how long does it take spasticity to develop if it is going to happen? Is this something that happens immediately when someone is first having symptoms of NMOSD? What is the course of how spasticity might present?
Dr. Jacqueline Nicholas: [00:12:26] When somebody initially has a neurologic injury, it typically doesn't occur immediately. So, oftentimes when the initial damage occurs, let's say it's occurring in the spinal cord, somebody can have almost what's called spinal shock or such significant weakness and loss of muscle tone, where the limbs can almost feel incredibly floppy and loose. And then over time, over days to weeks to months, people will start to notice that they feel some tightness or some stiffening in those areas. And again, that can be mild to severe in range of how it occurs, but usually it does take some time for that spasticity to develop.
[00:13:12] And, one of the things that's very important for anybody who's experiencing spasticity is to know that it's important to get ahead of it early. Because spasticity can worsen over time and if it's not adequately treated with either stretching, therapy, and/or medications that we'll talk about tonight, sometimes those muscles can become so stiff that they get contracted permanently, where the tendons and ligaments can be fused to the bone. And then that can be very painful and limit mobility significantly, because then somebody can no longer straighten a limb or open their hand. And that can lead to a number of other complications, including trouble with maintaining good hygiene, and leading to things like ulcers of the skin. So it is something that's really important to get on top of when you notice these symptoms.
GG deFiebre: [00:14:08] All right. And that's a great transition to how spasticity is treated. If you don't mind, if you could just go over line treatments for what physicians generally do to treat spasticity in patients with NMOSD.
Dr. Jacqueline Nicholas: [00:14:22] When we evaluate somebody with spasticity, we really want to determine, is this something that is affecting multiple muscles or is it really just a few select muscles? And that sometimes can help to guide our treatment. I would say that most commonly, most individuals are started on a regimen of good stretching exercises. And, making sure that they're well hydrated and that they're minimizing those triggers that we talked about, like getting cold or infection, things that can really increase spasticity.
First-Line Treatments
[00:14:56] And then, very commonly, first-line treatments would include oral antispasmodics. So Baclofen is an oral medication that's often dosed anywhere from once a day to sometimes up to three to four times a day. And that's something that's taken by mouth and usually has to be slowly titrated up because it can make people feel tired. But over time, many people can tolerate that well if it's increased very slowly, although some people still can't tolerate it because it can make them feel too sleepy or have difficulty with her thinking more clearly. So, sometimes other options would have to be used. That medication really activates a receptor called Gabba, which is involved in the overexcitability of the nervous system when there's been some type of damage so that's a very common one. And I would say that one that we see used quite commonly in spasticity associated with NMOSD.
[00:15:54] There are other agents. Tizanidine is another type of muscle relaxer that is commonly used, and that's another one that has pretty similar side effects to Baclofen in terms of sleepiness, but does require some blood work monitoring because it's broken down by the liver.
[00:16:10] And then there are other medicines that I would say are less commonly used, and those would be medications like benzodiazepines. Those would be things like, valium or diazepam, and those medicines we tend to not use as commonly because they can make people very sleepy, and oftentimes they need to be continually increased over time due to tolerance.
[00:16:34] Those oral medications would probably be our most common first line treatments.
Second-Line Treatments
[00:16:39] Second-line treatments would be when the oral medications are not effective enough. Then we would look at if somebody has some severe stiffness. So let's say that somebody feels that their leg is very stiff in terms of noticing that they have trouble bending their knee because maybe their quadriceps muscle feels so tight that it's overpowering the other muscles that would help to bend the knee, like the hamstring muscles. So if that was the major problem, then their doctor could use something called botulinum toxin, which is a neurotoxin that can actually be injected into the muscles with a tiny needle into different areas within the muscle to spread it out. And then, to decrease the communication between the nerve and the muscle junction so that it's not overactive and tight, but to decrease it to where it's a bit looser. And so Botox would be something that's more reserved when there's focal spasticity. So again, certain muscles that are stiff. Sometimes, people who have had lesions from NMOSD can have trouble with a foot turning down and in when they try to walk, and it just is sort of stuck in that position and have trouble getting their heel to the ground, or the toes could curl and be very painful because they're curling under. Those are muscles that are very easily targeted with botulinum toxin injections.
[00:18:03] Now, one of the challenges with Botox is, again, the only way it can be administered is via a needle and so it has to be injected specifically into the different muscles that are affected. Whereas the pills that we talked about taking by mouth, you can take that and then that's spreading out to affect all your muscles.
[00:18:23] Sometimes these options are even used in combination. And then, if somebody has pretty severe spasticity that hasn't responded to those options and is more diffused, Then there's this device called an intrathecal Baclofen pump and intrathecal means that it's giving the medication directly into the spinal fluid.
[00:18:44] That can be really beneficial, because when somebody takes something like Baclofen by mouth, only about 2 to 3% of it is actually getting to where you need it, which is in the spinal fluid to bathe those receptors within the brain and the spinal cord to reduce that spasticity. And then the rest of it is really circulating in your body and leading to the side effects of the sleepiness and those other side effects. So, if somebody is not benefiting enough or having significant side effects and they have severe spasticity, an intrathecal Baclofen pump would be an option. And typically, doctors will do an assessment where they do an injection of liquid Baclofen into the spinal fluid, pretty similar to how we might take spinal fluid if we were to do a lumbar puncture or a spinal tap.
[00:19:33] They would inject in some of the liquid Baclofen into the spinal fluid and then do some assessments over the course of many hours to see if the muscles got looser or not. And if they got looser to any degree, then people would know that that Baclofen pump would actually be an option to treat their spasticity. But there's a lot of ins and outs of that pump, and somebody has to be really committed and know about the potential risks of Baclofen withdrawal and overdose. But it has been a lifesaver for some of my patients with severe spasticity.
[00:20:05] And then I would say that if somebody is having spasticities to the point that we talked about, where they can develop contractures and limbs can be stuck in certain positions, then sometimes that would require a surgical tendon release or something of that sort by an orthopedic doctor to help with that, sometimes podiatrists as well.
[00:20:30] There's a less common treatment that I would say I typically don't see this used in adults, but sometimes it was discussed more in the past for things like cerebral palsy, but something called a dorsal rhizotomy where a surgeon would actually cut some of the neurons within the spinal cord to alleviate some of that spasticity, but also trying to maintain some of the motor function.
[00:20:56] That, again, would be in a more severe case. But I can't stress enough how important those lifestyle factors are. They may not do the whole job of controlling the spasticity, but the regular stretching exercises, making sure you're well-hydrated, and certainly making sure that any active infections are being treated, because any kind of noxious stimuli to the body can actually increase spasticity. And that's why people many times see fluctuations in their spasticity throughout the day or from week to week.
GG deFiebre: [00:21:30] Great. Thank you so much for that overview. That's a really good transition to our next question, which is about how exercise can potentially reduce spasticity. Is there any kind of evidence that this is the case?
Dr. Jacqueline Nicholas: [00:21:43] There is pretty good evidence for this. If somebody is not stretching those muscles, again, as those spastic muscles are tight, it's because the muscles are contracting. If those muscles are allowed to continue to contract and we're not trying to stretch them back out, those muscle tendons can get shorter and tighter and again, eventually could result in a fusion of those muscles and ligaments to the bone to where it couldn't be effectively treated with some of the treatments that we discussed outside of surgery.
[00:22:16] There is quite a bit of evidence about that. And I'll also say that in my experience, any of the medication options that we discussed, it's imperative that somebody do those stretching exercises along with them. I find that when people get botulinum toxin injections, for instance, people who do a really great job with stretching those muscles throughout the day or if they're not sure how to stretch them, working with a physical or occupational therapist, we really see improved benefits in that setting compared to just doing the injections and not stretching over time. And so this has been shown in numerous studies to be beneficial.
GG deFiebre: [00:22:54] Great. Thank you. We did get one question: this person over time, their spasticity has continued to worsen, and they're not necessarily seeing that the spasticity is associated with changes in their MRIs. What are the potential reasons behind, an increase in spasticity like this?
Dr. Jacqueline Nicholas: [00:23:12] That's a really great question, and I think that that's always something that can be perplexing for our patients who are dealing with NMOSD, because they may not have had a new relapse in quite some time. They're doing well on the current medicine they're on to prevent new damage. But, sometimes they can feel that those muscles are getting tighter and tighter over time. Common reasons for that are that after damage has occurred in the spinal cord or the brain or brainstem, we can see, because of the damage has occurred over time, that there can be some accelerated shrinkage of the brain or even the spinal cord. As that is shrinking and muscles are not used as much or not stretched as much, we can certainly see that those muscles become tighter or stiffer. The other thing that we always want to assess for, if we find certainly that there's nothing new happening on the MRI, would be: is there any kind of noxious stimuli to the body that could be increasing this spasticity?
[00:24:16] So again, sometimes people can have infections that they're not aware of, like urinary tract infections, where maybe because of the damage done from the NMOSD, they don't feel it the same way as they may have before when they had a UTI. Just checking some of those basic screening tests for infection can be really important, because sometimes when you then treat that infection, the spasticity returns to the level it was before, significantly reduced.
[00:24:43] Sometimes spasticity could actually be a sign that there's an infection going on. The other thing is also to make sure that there's not any sores or wounds on the body. Certainly with NMOSD, people can have loss of sensation or change in sensation and maybe may not be aware of a change in their skin integrity.
[00:25:05] Another thing that I look for in that case, is I make sure that there's not any ulcers or sores on the buttocks or in between the legs or anywhere where somebody may not be able to see as commonly. Because sometimes that can be a sign that there's some type of wound on the body that needs to be addressed. And again, addressing that then in turn reduces that noxious sensory stimuli to the body and that reduces the spasticity. But it can also be a normal progression over time, that the spasticity just gradually worsens. And so again, another very important reason to get in front of it and treat it and monitor it over time.
GG deFiebre: [00:25:46] Great. Thank you. We got a question from someone who has pain and spasticity all the time, and when it's bad, it can be an 8 to 10 out of 10. And their doctor won't prescribe narcotics for the nerve pain. But this person has tried all the routine meds, and while tizanidine and Baclofen help, they don't decrease their symptoms enough to handle really bad days. And so they're really worn out from the pain and spasticity, and they asked to be referred to another pain doctor, but were sent to someone who handles migraines and headache pain rather than NMO. And so, the spasticity doctor was the one who increased their tizanidine and an added Baclofen. They also use lidocaine, cool showers, CBD cream, cooling mats, and nothing really seems to be working for them. Do you have any additional things that you might suggest that they try to do to help the pain and spasticity in this case?
Dr. Jacqueline Nicholas: [00:26:41] Sure. That sounds pretty unbearable, and I'm sorry to hear about that. I think that, in this individual, it sounds like they're saying that their bad days are quite severe. And that even tizanidine and Baclofen, although it helps a little bit, aren't really targeting or giving them the full benefit. So, it can be a challenge to know exactly what to say to this person without being able to examine them. But I would say I would first check and see, are the tizanidine and the Baclofen at adequate doses. Sometimes, elevating those over time can be helpful. The other thing that I would say is it sounds like there's a pretty significant pain component here.
[00:27:19] Certainly spasticity can cause pain, from the spasms or the tightness, but also with NMOSD, we know that this can be a very painful condition for a number of reasons. And oftentimes, the painful skin sensations or dysesthesias from the neurologic damage can be quite severe. And so sometimes focusing on treating the pain, separate from just loosening the muscles, can help to in turn reduce spasticity.
[00:27:46] So there are a number of neuropathic pain medications that we use and even other medicines that are off label for that use. That would be one area that I might explore. There are certain medications that are called serotonin and norepinephrine reuptake inhibitors [SNRIs], and that class of medication sometimes can also really help, from that different pathway of targeting the pain, to reduce that neuropathic pain.
[00:28:14] In addition, I would want to make sure that that individual is plugged in with neuro-physical therapy and occupational therapy to make sure that they're getting an adequate stretching program. And then if this individual, the neurologic exam would be incredibly helpful to know further what's going on, because if there were muscles that were focal muscles that were really tight, for instance, sometimes people tell me their calves are the worst place or their thighs. Sometimes even using small amounts of botulinum toxin injection in those areas where they're having this significant spasm or discomfort can be helpful. Also if this is somebody who, on exam, was noted to have severe spasticity, another consideration would be that intrathecal Baclofen pump.
[00:29:00] But again, it would be hard for me to know without seeing the patient. And then, I would say that there are also a number of other alternative options that are available. Sometimes pain cannot be treated simply with one mechanism. And that's why we mentioned talking about taking the Baclofen or the tizanidine like they're doing, but also in combination with a neuropathic pain medication. I know I mentioned the SNRIs, but there are also medications like Gabapentin and pregabalin or Lyrica that can be helpful as well. And then sometimes we use tri-cyclic antidepressants, which in my opinion, aren't really great to treat depression, but we use them specifically for pain. Medications like amitriptyline or nortriptyline can be very helpful.
[00:29:43] Some of the alternative treatments can be helpful too, like acupuncture or relaxation therapy, like mindfulness training can be incredibly helpful. Those are really the things that I would start with first in the scope of neurology. And then, there is a significant bit of research that is being done as well to better understand the effect of cannabinoids on pain. I know that that can be a taboo issue and that's something that has been looked at in the setting of diseases like multiple sclerosis, where people can have inflammation in their spinal cord in shorter areas, whereas in NMOSD we certainly see longer areas of inflammation. There are some reports that it's beneficial for spasticity there. Although there's a lot of ongoing studies that I think need to be sorted out so that doctors can better understand long-term and short-term risks and benefits of that.
[00:30:40] But, depending on the state somebody lives in, that would be another option that they could potentially explore. And then if all of those options were not significantly helpful, then seeing a pain specialist who sounds like maybe specializes more in what this person is suffering from. It sounds like this person is more seeing somebody who specializes in pain associated with headaches. Seeing somebody who could really address the whole picture. I think that in certain instances, pain may require a narcotic medication if the neuropathic pain medications aren't helpful.
[00:31:13] So I think it's really a comprehensive approach and look at what could be done, but it sounds like there are a lot of opportunities for improvement for this individual.
GG deFiebre: [00:31:23] Great. Thank you so much. And so we did talk a little bit about Botox, but are there any long-term effects that need to be considered when using Botox long-term?
Dr. Jacqueline Nicholas: [00:31:34] Botulinum toxin, there are a couple of different forms of the toxin. The most common form that's used for spasticity is called onabotulinum toxin A. Really with repeated use, most individuals will continue to respond. It's given every three months, the benefit should last close to three months for that type of toxin. But, some people may develop, after an initial benefit to the toxin, may begin to notice that it's not helping as much over time with subsequent injections. One of the reasons for that could be that somebody has developed an immune response against the toxin.
[00:32:12] If that occurs, typically, I switch the botulinum toxin to a different form. So another common form that's used is called abobotulinum toxin A. Sometimes just switching to a different type of botulinum toxin can result in improved benefits. The other thing that I would say is, one risk of Botox, we kind of start at a low dose, so we think may help and then assess for benefit and then slowly increase over time. Because Botox, again, is blocking that communication between the nerve and the muscle junction.
[00:32:44] We don't want to give so much that we cause somebody to be incredibly weak to where they can't work with therapy, but we also want to give enough to where we've provided comfort and potentially allowed for improved mobility if they do have motor function there. So again, just making sure that the dose isn't being overdone.
[00:33:03] And then the other thing is that sometimes when people get repeated injections, because it's really decreasing that communication there at the nerve muscle junction, if somebody is getting those repeatedly, we can see atrophy of that particular muscle where the muscle is shrinking. Again, that's something that the specialist who's administering that needs to be mindful of and monitoring over time. But there are many people who get this over years and years and years and find significant benefit and don't have any of these issues.
GG deFiebre: [00:33:34] Got it. Thank you. And then is Botox to treat spasticity any good without subsequent rehab?
Dr. Jacqueline Nicholas: [00:33:42] I would say that it is helpful, but it is significantly more beneficial when people receive the Botox to then go for some therapy or rehab to work to stretch those muscles. And once those muscles are a little bit looser, again, sometimes people are then better able to work with a therapist to try to strengthen them. Again, that's not the case for everybody, depending on the degree of injury. But, we definitely see an improvement in the muscle tone and the looseness over time in individuals who do that as opposed to just getting the injections and then not working with therapy to do the stretches.
GG deFiebre: [00:34:22] Okay, thank you. And then, in rehab someone might be using electrical stimulation. Can this be used to treat spasticity as well?
Dr. Jacqueline Nicholas: [00:34:31] I would say that this is a less commonly used treatment. Usually it's done with something like a TENS unit, which can basically be applied over the muscle and provide some electrical stimulation to the muscle. There have been some small studies, particularly in stroke, I would say not as many in NMOSD specifically, that have suggested that it can be beneficial for spasticity in the legs or the lower limbs. Whereas, there hasn't been as much benefit reported in the upper limbs. Sometimes people will do this in the physical therapy setting, or there are portable devices that can be purchased for home use. But I would say that most people that utilize this would do it in combination with other treatment options.
GG deFiebre: [00:35:18] Okay, thank you. Does spasticity change the muscle or bone ligament or other structures over time? And if so, how does it do this?
Dr. Jacqueline Nicholas: [00:35:27] It definitely can, and probably the most concerning part and what we see happen, especially if it's not addressed, is that as those muscles get tighter and tighter, they can shorten. And again, those ligaments and tendons can fuse and fuse to the bone so that there's no longer the ability to move the limb at a joint. So for instance, if somebody has stiffness it's in their arm and the arm is stuck flexed at the elbow – I've seen a number of people where they didn't think it was an issue because they didn't have pain, they noticed that it was tight but just didn't really do the stretches, and then those muscles and tendons and the joint became fused and then they couldn't move it. And then that leads to atrophy of the muscle and certainly a lot of pain when somebody can't move a limb around a joint. And so really it can often be a progressive tightness and stiffening. Now that's not the case for everybody. Sometimes people have more mild spasticity where it manifests more as, just feeling tight or some spasms, but not where it's so tight that it would cause a limb to become stuck. But that would really be the main change that we can see over time.
GG deFiebre: [00:36:39] Got it. And then is there anything else that you want to mention about spasticity?
Dr. Jacqueline Nicholas: [00:36:45] I want to share that neurologists in general, I don't think that we get excellent training in our residency programs and our training programs to become neurologists, to really understand that spasticity is very treatable and that there are a lot of options out there aside from oral medications to treat spasticity. I became very passionate about treating spasticity when I was in my fellowship training and started taking care of people who had NMOSD and other causes of transverse myelitis or brain inflammation, where it was really a symptom that was pretty common.
[00:37:21] For many, they reported the problem but had only been treated with oral muscle relaxers that sometimes they couldn't tolerate. And, as I went on in my training and did a spasticity fellowship, I realized that there are many, many options out there to help somebody with spasticity.
[00:37:37] If you're experiencing it and you feel like nothing you've done has helped, I encourage you to talk with your doctor about it because there are a lot of options, and sometimes a combination of options can help to better improve that. It's one of those symptoms that I think that people just need to know if you think you have it, please bring it up, tell your doctor, and ask them what can be done to help because having that can definitely affect quality of life, and we want to give you the best quality of life possible.
GG deFiebre: [00:38:06] All right. Great. Well, thank you so much for taking the time today. We really appreciate it.
Dr. Jacqueline Nicholas: [00:38:10] Thanks so much.
COVID-19 Vaccines with Dr. Greenberg | Part III
COVID-19 Vaccines with Dr. Greenberg | Part II
COVID-19 Vaccines with Dr. Greenberg | Part I
About Our Guest Speaker
Jacqueline Ann Nicholas, MD
OhioHealth
Dr. Nicholas is a board-certified neurologist specializing in neuroimmunology, multiple sclerosis (MS) and spasticity.
Dr. Nicholas received her undergraduate degree from Miami University in Oxford, Ohio, and her medical degree from the University of Toledo College of Medicine in Toledo, Ohio. She trained at the University of Pittsburgh Medical Center where she completed an internship in internal medicine and a neurology residency where she served as chief neurology resident. Dr. Nicholas completed a fellowship in clinical neuroimmunology, multiple sclerosis and spasticity at The Ohio State University Medical Center in Columbus, Ohio while also completing her Master of Public Health degree at The Ohio State University College of Public Health. She received a prestigious 3-year Sylvia Lawry Physician Fellowship award to fund her fellowship training. She previously served on faculty at The Ohio State University Medical Center. She currently serves as System Chief of Neuroimmunology & Multiple Sclerosis, Director of MS Research and Neuroimmunology Fellowship Director at the OhioHealth Multiple Sclerosis Center in Columbus, Ohio.
She is an Adjunct Clinical Assistant Professor of Neurology for University of Toledo College of Medicine and Ohio University College of Medicine.
ABCs of NMOSD is a 10-part education podcast series to share knowledge about Neuromyelitis Optica Spectrum Disorder – NMOSD, a rare relapsing autoimmune disorder that preferentially causes inflammation in the optic nerves and spinal cord.
This education series is made possible through a patient education grant from VielaBio.*
* The Executive Committee of SRNA with the medical and scientific council determines the content and topics of the podcasts. Sponsors are not able to influence the education program.
Did you find this resource helpful?
Please support our efforts to continue to make educational and research materials accessible to all


Global environmental changes (GEC) such as climate change (CC) and climate variability have serious impacts in the tropics, particularly in Africa. These are compounded by changes in land use/land cover, which in turn are driven mainly by economic and population growth, and urbanization. These factors create a feedback loop, which affects ecosystems and particularly ecosystem services, for example plant-insect interactions, and by consequence agricultural productivity. We studied effects of GEC at a local level, using a traditional coffee production area in greater Nairobi, Kenya. We chose coffee, the most valuable agricultural commodity worldwide, as it generates income for 100 million people, mainly in the developing world. Using the coffee berry borer, the most serious biotic threat to global coffee production, we show how environmental changes and different production systems (shaded and sun-grown coffee) can affect the crop. We combined detailed entomological assessments with historic climate records (from 1929-2011), and spatial and demographic data, to assess GEC's impact on coffee at a local scale. Additionally, we tested the utility of an adaptation strategy that is simple and easy to implement. Our results show that while interactions between CC and migration/urbanization, with its resultant landscape modifications, create a feedback loop whereby agroecosystems such as coffee are adversely affected, bio-diverse shaded coffee proved far more resilient and productive than coffee grown in monoculture, and was significantly less harmed by its insect pest. Thus, a relatively simple strategy such as shading coffee can tremendously improve resilience of agro-ecosystems, providing small-scale farmers in Africa with an easily implemented tool to safeguard their livelihoods in a changing climate.


text:
Q: Using Kafka to Transfer Files between two clients I have kafka cluster setup between to machines (machine#1 and machine#2) and the configuration is the following:
1) Each machine is configured to have one broker and one zookeeper running.
2) Server and zookeeper properties are configured to have a multi-broker, mulit-node zookeeper.
I currently have the following understanding of KafkaProducer and KafkaConsumer:
1) If I send a file from machine#1 to machine#2, it's broken down in lines using some default delimiter (LF or \n).
2) Therefore, if machine#1 publishes 2 different files to the same topic, that doesn't mean that machine#2 will receive the two files. Instead, every line will be appended to the topic log partitions and a machine#2 will read it from the log partitions in the order of arrival. i.e. the order is not the same as
file1-line1
file1-line2
end-of-file1
file2-line1
file2-line2
end-of-file2

but it might be something like:
    file1-line1
    file2-line1
    file1-line2
    end-of-file1
    file-2-line2
    end-of-file2
Assuming that the above is correct (i'm happy to be wrong), I believe simple Producer Consumer usage to transfer files is not the correct approach (Probably connect API is the solution here). Since Kafka Website says that "Log Aggregation" is a very popular use case, I was wonder if someone has any example projects or website which demonstrates file exchange examples using Kafka.
P.S.  I know that by definition Connect API says that this is for reliable data exchange between kafka and "Other" systems - but I don't see why the other system cannot have kafka. So I am hoping that my question doesn't have to focus on "Other" non-kafka systems.

A: Your understanding is correct, however if u want the same order you can use just 1 partition for that topic.
So the order in which machine#2 reads will be the same as what you sent.
However this will be inefficient and will lack parallelism for which Kafka is widely used.
Kafka has ordering guarantee within a partition. quote from documentation

Kafka only provides a total order over records within a partition, not
  between different partitions in a topic

In order to send all the lines from a file to only one partition, send an additional key to the producer client which will hash the sent message to the same partition.
This will make sure you receive the events from one file in the same order on machine#2. If you have any questions feel free to ask, as we use Kafka for ordering guarantee of events generated from multiple sources in production which is basically your use case as well.

redpajama_set_name: RedPajamaStackExchange


The Ahlul-Fatrah are those whom the call of the messengers did not reach.
"What is apparent is that what is correct about this question - which is, 'Do the mushrikun (those who associate partners with Allah) have an excuse due to their being people whom the call of the messengers did not reach or not?' is that they have excuse to it in this world, and that Allah will test them on the Day of Resurrection with a fire which He will order them to enter. So whoever enters it will enter Paradise, and they are those who would have affirmed the truth of the messengers had come to them in this world, but those who refuse to enter the fire, then they will be punished in it, and they are those who would reject the messengers if they had come to them in this world, since Allah knows what the people would have done had the messengers come to them."
What is established from Allah's Messenger and it is a text directly relevant to the matter about which there is no disagreement. So there is no room for disagreement to continue along with it.


Platelets are traditionally recognized for their key role in haemostasis, for example sealing vessel breaches and limiting blood loss. However, in recent years, it has become evident that platelets also have potential as immune modulators and effectors with various inflammatory functions (1).
Systemic viral infections such as hepatitis C or HIV are often associated with thrombocytopenia. Rapidly induced thrombocytopenia in response to viral infection is mediated via increased platelet destruction, whereas thrombocytopenia induced by decreased platelet production is observed at later stages of infection.
Several host-protective mechanisms resulting in virus-induced thrombocytopenia have been proposed to cause fast platelet destruction during early stages of infection (2). Viruses can directly interact with platelets, or platelets can recognize immunocomplexes of immunoglobulins and viral antigens. Viral antigens often show cross-reactivity with platelet surface integrins, which provides another mechanism of virus-induced thrombocytopenia. The virus-induced pro-inflammatory cytokines often lead to platelet activation and destruction in viraemic patients. All these mechanisms lead to increased platelet clearance from the blood. The activated platelets are recognized by circulating leucocytes or by cells in the spleen and liver and rapidly cleared from the circulation (2).
During later stages of infection, viruses can modulate platelet production at various steps of development. They are able to influence the cytokine profile of the host, resulting in altered thrombopoietin (TPO) production in the liver. The hepatitis C virus also directly interferes with TPO production by destroying liver tissue. Furthermore, viruses can influence platelet production via the induction of interferons, which suppress platelet formation and lead to thrombocytopenia. Other mechanisms involve the infection of megakaryocytes or haematopoietic stem cells (2).
Due to the mechanisms of increased platelet destruction in peripheral blood during very early response to viral infection, the low PLT count is often associated with an increased immature platelet fraction (IPF), which reflects the effort of compensating for platelet loss by producing new immature platelets. Later stages of virus-induced thrombocytopenia with decreased bone marrow platelet production would be indicated by low IPF values, reflecting the insufficient megakaryocytic production and release of new platelets into peripheral blood.
Table 1 Mechanisms of virus-induced thrombocytopenia, either via decreased platelet production or increased platelet destruction (2).
1. Jenne CN et al. (2015): Platelets in inflammation and infection. Platelets. 26(4):286-92.
2. Assinger A (2014): Platelets and infection – an emerging role of platelets in viral infection. Front Immunol. Dec 18; 5:649.


Studio MDHR's unique classic cartoon platformer is making its way to Windows 10 and PC when it launches.
Can't wait a few more months? We've got a list of the best PC games to keep you entertained.
If you were upset at the possibility that you might have to pick up an Xbox One to play the cartoony title, you'll be relieved to know that both storefronts will carry the game, with a DRM-free version coming to GOG later, according to Studio MDHR in a reply on NeoGAF.
Cuphead will be releasing on September 29, which isn't a lot longer to wait if you've been really jonesing for something unique to settle in with over the weekend. It looks like it'll offer some crazy-cool platforming segments with its unique art style at the very least.


text:
Dashlane 6 Aims to Be Your All-In-One Online Protection Platform
Danny Zepeda
Dashlane is best known as a password manager, but with its latest version, it's aiming to become something more all-encompassing. The newest version of the service, Dashlane 6, aims to address the growing threat of identity theft.
Dashlane 6 essentially breaks down its digital protection into three categories: prevent, monitor and restore, which will be enacted through a new system called the Identity Dashboard. It will provide users with a complete picture of their online presence, starting with the passwords they use and protect everything from passwords to payments to personal information.
Some of the features Dashlane 6 will offer includes dark web monitoring, credit score monitoring, identity restoration support, VPN service and Identity Theft Insurance worth up to $1 million in claims.
"Managing digital identity has become too complex for almost anyone," said Dashlane CEO Emmanuel Schalit. "Massive data breaches and data abuses affect us all, and while protecting accounts with unique and complex passwords is a crucial step, it is no longer enough."
The new services will be spread out through three different tiers. The basic free tier offers password management; the second Premium tier adds things like dark web monitoring and VPN; and the top of the line Premium Plus offers everything, including the Identity Theft Insurance.
Dashlane 6 is now available for all users.
Clean is Good
The best acne masks to unclog your pores and make your face sparkle
Keep your pores clear and your skin sparkling with the best acne masks in the market. Our top pics are...


Picking up new skills as an adult can be tricky, especially when your energy and free time is precious. But prowess in different areas is not all created equal. Investing in certain abilities can get you big rewards for relatively little effort.
MONEY interviewed dozens of experts in different fields to find out which skills, tricks, and workarounds are most financially worthwhile. Here are 10 moves you can make without much preparation.
The average pay bump from a promotion is about 7%, though it can be even more once you're a manager, according to Mercer. But how do you get one?
"The meeting room is where we exert leadership and develop credibility," says corporate trainer Dana Brownlee of Professionalism Matters. Don't dominate—nudge the group toward concrete goals. If someone can't let go of a point, try saying, "Good idea! I'm writing it down." You've now freed a room of grateful co-workers to move on.
Research by Adam Grant at the Wharton School has shown that successful people do more favors at work, but don't be afraid to ask for tiny favors too. We may actually feel more warmly toward people after lending them a hand—our brains figure we must have done so because we like that person. It's been called the Benjamin Franklin effect: The Founding Father recalled winning over a legislative rival after borrowing a book from him.
"Our attitudes often follow our behavior instead of vice versa," says David McRaney, who writes about such psychological quirks in his book You Are Now Less Dumb.
It's easier than ever to dip a toe into languages with free tools like Duolingo, a site and app that make learning like a game. If you then want to ramp things up, real-world classes run about $300 for 20 hours of instruction.
Invest your time and money wisely: The payoff is in less commonly studied languages. A Wharton/LECG Europe study found that speaking German translated into a higher wage premium than for second languages overall. Ambitious? There's a big market for Mandarin.
Computer-science grads earn $700,000 over the average B.A. holder in a career, but those with English and psych degrees aren't out of luck: There are ways to use technology smarter—and get recognized for it—at all levels.
For example, if there's any need to quantify your business's activity, being the office Excel guru makes you valuable. Two skills to focus on: building charts (great for presentations) and pivot tables (to summarize lots of data). The ExcelIsFun YouTube channel is loaded with lessons.
Want to compete with true techies? Codecademy.com can get you started for free learning code for building websites. Expertise in Ruby on Rails—certification testing is $150—snags an average salary of $110,000, says data crunched by qz.com.
If all this sounds like too much work, at least Google better. Seriously. Say, for example, you need stats about a product's market share: Use "OR" (in caps) to Google for different words that might capture the same thing (like "percent" and "proportion"). And check the image search results: The data you need may be in a chart someone has posted. Go to Google's help center for more power tips.
Avoid fancy words you don't need or understand. "Fulsome" (as in "fulsome praise") does not mean full; it means insincere. If you use hoity-toity words to sound posh, you will look pompous and may say the opposite of what you mean.
Cut unnecessary words. John Kerry once said, "The President is desirous of trying to see how we can make our efforts in order to find a way to facilitate." What he meant was, "The President wants to help." Much better.
Revise. And better still, show it to someone. What's clear to you may not be clear to someone else.
If you run a business or work in marketing, social media like Twitter seem like a great way to get your message out. But remember that users have zero interest in following companies that clutter their feed with ads. Use social to establish your expertise or spark ideas; then when people are in the market for what you sell, they'll remember you.
Hannah Morgan, co-author of Social Networking for Business Success, explains that a good tweet is self-contained and has a discrete piece of information worth sharing. What works well is language like, "Baking cookies? Add eggs one at a time so you can mix in evenly. For more tips check out our Baking 101 guide." Then add a link.
A less effective tweet is something like, "We're having a sale on tins of our delicious chocolate chip cookies. $19.99 all day Friday" because it reads like an advertisement and is therefore is unlikely to be shared.
If you get paid a flat salary, turning a 10-hour day into nine more-productive hours is like giving yourself an 11% hourly raise.
Try three key moves from former Fidelity president Bob Pozen, author of Extreme Productivity: First, handle each email just once. Reply, file, or trash—don't come back to it later.
Second, hide that extra chair; you'll discourage chatty co-workers from lingering. Finally, you might want to consider timing your breaks, since research shows your brain loses focus on a task after about 90 minutes.
"Ten years ago job seekers would write a full-page cover letter," says executive résumé writer Wendy Enelow. A better approach now is an email designed to cut through the electronic clutter.
Use the subject line to note your key selling points. Instead of "Director of sales position," write "Director of Sales—10 Years of Exceeding Sales Quotas—MBA." In the body of the email, spotlight a major accomplishment. Follow up with three big career wins in bullet points.
Some jobs always require a professional but, with a little prep, tasks like painting a room or replacing your car's air filters can be a piece of cake—and save you a solid amount of money. A painting pro, for example, could easily charge $1,600 for a big job, vs. up to $400 in materials on your own.
Rich O'Neil of Masterwork Painting & Restoration in Woburn, Mass., explains that to get professional results you must dust surfaces and tape up edges and moldings you don't want painted. Painting should go in two types of strokes: First apply a thin layer for coverage. Then paint over it to even and smooth.
You can replace your car's air filters yourself every 12,000 miles on newer cars. You'll save about $50 in labor costs, says Mike Forsythe of Haynes, an auto-repair guidebook publisher, and pay 25% less for the filter by getting it at a parts store. To change an engine filter, check the housing in the engine compartment; in most cars there's a cover you can unlatch with your fingers. You'll typically find the cabin filter inside the car, behind the glove box.
Everyone hates paying a late fee just because of a forgotten reminder to pay a bill on time. And few tasks are as irritating as foraging for receipts from months and months ago.
The key to never losing track of important papers is to keep just one bin and make sure to empty your pockets and purse into it every night. Then set a regular date on your calendar to empty the bin and organize the receipts. "If you wait too long, you may not even remember your purchase," says professional organizer Andrew Mellen.
If you find it hard to even check your calendar on a routine basis, pair a daily check with your morning coffee—or any other routine you already have.


Hi Friends We all know that Apple products are lovable, cool, stylish, modish and everyone wants to have those shiny beautiful products. But on the other hand they are expansive as well. According to reports, People in China are doing some crazy acts to get Apple products. Some weeks ago, we came to know that a Chinese Boy sold out his kidney for $3400 to get an iPad 2. And today a shocking news has hit the web that a Chinese girl is offering her virginity for an iPhone 4.
"Biznewschina reported that a female jiulinghou, referring to those born during the 90's, tweeted on Weibo (Chinese version of Twitter) that it is her "dream to own a iPhone4 but her father won't let her get one." She then decided to sleep with someone in exchange for the mobile device. "
The girl has posted a picture of her self along with other basic personal information saying she is willing to "sell" her virginity to anyone that buys her a iPhone 4." Some people are cursing her for this act and some are thinking that someone is using here account and playing a prank. So what do you think? iPhone 4 or her virginity?
Warning:- This post is entirely for information purpose,such kind of indecent proposals could come from any country. The only objective of the post is to show how much youth is crazy for Apple products, without any intention to hurt feelings of our Chinese readers!
0 Respones to "Chinese girl offered her virginity for a iPhone 4"


Terese Marie Mailhot is from Seabird Island, BC. She graduated from the Institute of American Indian Arts MFA program. Her work has been featured in The Rumpus, Yellow Medicine Review, Carve, The Offing, Feminist Wire, and The Toast. She is a columnist for Indian Country Today.


Located at the western end of the Renvyle peninsula, the church of the Seven Daughters or 'Teampaill na Seacht nInion', is believed to have been built by a Leinster King or an Omey Island chief in thanks for cures his daughters received from the nearby holy well.
As a result of their cure, these seven sisters are said to have preached along the Connemara coast. The church is quite ruinous with just three surviving walls. In addition, surrounding the church is a somewhat overgrown graveyard, which hosts some interesting graves and memorials.


Absolute Injury and Pain Physicians offers chiropractic, pain management, and … It has clinics in Jacksonville, St. Augustine, and Fernandina Beach, Florida. … Injuries sustained in a slip and fall can mirror those of a motor vehicle accident.
Chiropractor in Jacksonville, FL At Southside Chiropractic & Car Accident Injury Clinic, we focus on car accident injury cases.The state of Florida requires that car accident victims seek medical attention within 14 days to ensure they can receive compensation for their injuries and medical expenses.
victims of car accident injuries should seek the help of a chiropractor right after the crash so that the DC or Doctor of Chiropractic can assess the physical well-being of the victims right after the incident.