text:
Saraswati is Goddess of Knowledge and Music and embodies those qualities in her role as an embodiment of Shaktic energy. Her Vedic origins are the banks of the extinct Saraswati River in the Thar Desert where she is believed to be the keeper of the river of knowledge that flows from her consort, Brahma. Saraswati personifies civilized behaviour, refined tastes and artistic talent. She is wife to Brahma and as such created the knowledge and wisdom which brought order to Brahma's formless creation.
Brahma (not to be confused with similar terms; Brahman and brahmin) created good and evil, night and day, and gods, demons, ancestors and humans from formless Brahman. It is said the universe was created when Brahma awoke and opened his eyes and will end when he goes back to sleep at the end of his day – a period of 4.32 million human years – the universe will end. Brahma is an abstract metaphysical ideal of a god, and lacks the earthy dramatic myths and legends of other deities, although he does feature in other god's mythology. He is the bestower of boons upon various demons, boons which invariably create problems requiring divine intervention (and new opportunities) for other gods and goddesses to add to their legends. Brahma is thought to be aloof and unapproachable and isn't worshipped with the devotional ardour of Shiva, Shakti or Vishnu. It is believed his work is done, and it is the various manifestations of Shiva, Vishnu and Shakti which have the power to power to affect our lives. On the next turn of the Wheel of Time, however, after the weary universe is destroyed by Shiva Nataraja, it is a reborn Brahma who will create the world anew. While his image is venerated somewhere in most major temples, only a handful of the half a million or so temples in India are dedicated solely to Brahma.
Brahma is believed to have created The Vedas, dispersing them in the four cardinal directions from his four mouths, although most of the credit ought to go to his wife, Saraswati, Goddess of Wisdom and Knowledge.
Brahma is typically depicted in iconography as standing, his weight evenly upon both feet (samabhanga). He has four faces whose mouths disperse The Vedas in the four cardinal directions and four arms. In one hand he holds The Vedas, in the second he holds rosary beads (mala) symbolizing time, in the third he holds a ladle (sruva or shruk) symbolizing the means to feed a sacrificial fire, and in fourth a water jug (kamandalu) symbolizing the means from where all creation originates. In paintings, he is often depicted with the white beard of a sage. His vehicle (vahana) is a swan or goose.
Brahma – The CreatorTerry Curell2019-11-07T16:47:08-08:00
Saraswati is young, beautiful, graceful, and alongside Uma and Lakshmi, very much the Maha Devi, or Great Goddess. She fearlessly challenges the great male gods when they try to manipulate her and the only female goddess to keep her name, rank and power intact throughout the millennia. It was Saraswati who organized and transcribed The Vedas, again out of the formless Brahman. She is also responsible for all non-Vedic knowledge (note 1), music, yoga, ritual, speech, Sanskrit and the units of measurement and time (note 2). She personifies civilized behaviour, refined taste and the arts.
She is always dressed in spotless white, the colour of light, knowledge and truth, and seated either on a white lotus or swan. She may have four arms or less often just two. If four, she may hold the same attributes as Brahma or a stringed instrument (veena), representing the arts and sciences, and all emotions and feelings expressed in speech or music (anuraga). Finally, Saraswati is often depicted near water, a reference to her ancient Rig Veda history as a river goddess (note 3).
In the Vac Sutra, Saraswati boasts:
"I move among the Gods, I hold them, sustain them… whosoever breathes, sees, hears or eats does so because of me… I create powerful creators and embed them with wisdom and sight… my powers overflow the universe."
Note 1 – On the fifth day of spring, the festival Vasant Panchami honours Saraswati by teaching young children the alphabet. It is also an Indian tradition that if you step on a book (a symbol of knowledge and therefore Saraswati), you must perform a mudra of apology with the right hand.
Note 2 – Time (Kala) is another term for Yama, the god of Death. At the time of one's death the soul (Atman, or essence) may depart one of two ways; the Way of the Gods, which brings it through days, bright fortnights, the half-year of the northern course of the sun, to the full year and eventually to Brahman; or the Way of the Ancestors, through nights, dark fortnights, the half-year of the southern course of the sun, and, failing to reach the full year, eventually back to earth clinging to raindrops. If the soul happens to fall upon a plant and that plant is subsequently eaten by a man, the man may impregnate a woman, and thus the soul may be reborn.
Note 3 – Saraswati is also the name of a river which once flowed in the Thar Desert but lost due to a shift in monsoon patterns. It is believed to be on the banks of the Saraswati that The Vedas were composed.
Saraswati – Goddess of Knowledge and MusicTerry Curell2019-11-07T16:46:15-08:00
Shakti manifests Prakriti, Brahman's dynamic feminine will and creative energy. Shakti is the Divine Feminine and Brahman's Force of Life. Prakriti consists of three types of matter, or gunas, which are the essential elements of all nature. Prakriti and it's counterpart, the male principle of Purusha, consciousness and spirit, are interdependent, equivalent and ineffective without the other.
In mythology, just as Purusha embodies in the form of the male gods, Shakti, as the active, creative power takes physical form as Devi. This form can be one of the three Maha Devis, The Great Goddesses; Saraswati, Goddess of Knowledge, Music and Art, aligned with Brahma, the Creator; Lakshmi, Goddess of Abundance and Good Fortune aligned with Vishnu the Preserver; and Uma, The Mother Goddess of Love and Devotion aligned with Shiva, the Destroyer (note 1). As the creative, regenerative and maintaining forces of the universe each Maha Devi, as well as other goddesses such as Kali, Ganga and Mari Amma, has unique set of roles and characteristics.
"She is the creative joy of life; herself the beauty, the marvel, the enticement and seduction of the living world"
Heinrich Zimmer; Myths and Symbols in Indian Art and Civilization
In pre-Vedic times, India's indigenous peoples venerated powerful, independent goddesses, but as Hinduism spread the divine feminine principle was absorbed into the Vedic pantheon, and in doing so the goddesses lost much of their spiritual status. Hinduism's spiritual source, The Vedas, reflected the values of a patriarchal nomadic culture that suppressed prehistoric feminine power, therefore, the goddesses were relegated to roles as wives and consorts. Devotional hunger for divine feminine energy was not to be denied, however, and powerful deities in their own right have re-emerged; Durga, the dispassionate demon killer; Kali, the fiery protector; and of course, Uma, the cool, sensual beauty and power behind Shiva's cosmic role. Hindu belief continues to evolve into the modern era and as the need for Shakti's energy grows, so does the influence of her Devis.
Note 1 – Uma is known by many names, Parvati chief among them, but our Reference Library is primarily focussed on the Chola Bronzes, therefore, we refer to the deities as they are known in south India.
The Nature of ShaktiTerry Curell2019-11-14T17:51:03-08:00


I know what you're thinking. "Hey Piranha - you've got this funny blog and you haven't added anything funny in a while."
You have a point, I have not because I've been lazy.
I have been maximizing my outdoors time and it's wearing me out. I learned a new trick - and that is to run around the backyard continuously as I am being chased. I can tell I've gained at least 1lb this winter. Lucky for me we are going to be doing a 5k very soon which will help me keep my round and furry figure. Sure, a pudgy, tubby chihuahua is not necessarily what everyone wants. In fact, someone recently said NO WAY I could be a chihuahua being this big! PHOOEY! They just have never seen a big boned chihuahua with a few extra winter pounds. In any case, I have nothing to prove. I've seen a lot of starving chihuahuas whose hind legs and belly sink into their thighs - they don't look robust or lovable, they look like if you hug them, you might break their bones! But I digress... I understand that I need to get in shape - I am walking more (a big plus), treats have been cut down (yay, carrots!) and playtime in the yard has increased by 80% - all good factors to chihuahua weight loss. I will still be huggable, lovable and adorable - every single day -WOOF!


Hello Men With Fibromyalgia! Norman here, and I am proud to be sharing this from my good friend Melissa Swanson, She is a Fibromyalgia Blogger & Advocate who has just written her first book for children. I am excited to share this book by Melissa, "Ravyn's Doll" … How to explain fibromyalgia to your child.
I hope this is a great resource for all of you with children in your lives! So without further ado, here is Melissa to explain Ravyn's Doll and why she wrote it!
I am asked all the time why did I decide to write this book.
Mostly it is because my journey with fibromyalgia began when our daughter was 9 years old. In the beginning when I was trying to figure things and experiencing severe pain days she would have to help take care of me by getting things that I needed, get up off the couch or chair and do the things around the house that I could not do.
I found myself always apologizing and explaining why I could not do things that I used to do. I work in a school district with elementary and middle school children. The kiddo's have asked why I sometimes wear dark sunglasses, wear a tens unit, use ice packs/heating pads or move very slow and wince in pain. I find myself explaining not only to the students but to adults that I encounter.
In addition, my fellow Fibromyalgia sufferers have struggled how to explain how they feel to their friends, family and especially their children. I sat down one day and wrote Ravyn's Doll. I was fortunate to find an amazing publisher & illustrator to bring my story to life.
I am excited to see the change in how invisible illnesses are viewed and how those living with them are treated. In just 3 generations there has been such a significant difference. My generations and previous ones living with chronic pain have faced disbelief from doctors, friends & family that we were really sick. We heard too often that "it is all in your head". My daughter's generation hears about fibromyalgia on television, sees posts on social media and because of groups like the National Fibromyalgia and Chronic Pain Association physicians are beginning to admit that fibromyalgia exists and learning how to treat it and it's "evil sidekicks". I am happy that Ravyn's Doll can help teach Kasey's generation about about invisible illnesses and how to treat those that live with them.
Ravyn's Doll: How do you explain Fibromyalgia to Your Child?
All the kids in class made paper dolls to show someone they love who is hurt or sick. When it's Ravyn's turn to share, she shows a paper doll of her mom — and it looks like there is nothing wrong!
Ravyn teaches the class that even though her mom looks healthy, she's not! Ravyn's mom suffers from fibromyalgia and its evil sidekicks. Ravyn's Doll is a simple and effective way to explain fibromyalgia to your child, in a way that is understandable to children. It also shows that not all illnesses are visible and explains how living with an invisible illness affects families' daily lives. Ravyn's Doll describes and illustrates why mom or dad can't do the things they used to do — things that other moms, dads or other family members can do.
Melissa Swanson is a chronic pain patient, advocate, and author. Through her Fibro Warriors ~ Living Life Facebook page and blog, she offers positive encouragement, medical information, resources, and support to 18,000+ fibromyalgia and chronic pain patients. In addition, Melissa is a writer for ProHealth.com and the National Fibromyalgia and Chronic Pain Association's Advocate Voice newsletter. She has also served as editor and writer for Living Well with Fibromyalgia magazine.


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Stay Current in Pediatric Surgery: Annual Update Course 2017
Aired on 8.10.2017
The Stay Current in Pediatric Surgery: Annual Update Course, an online or on-site, interactive GlobalCastMD event, is coming up on August 10th, 2017.
The full day symposium is designed to give an update each year on the contemporary management of common problems in pediatric surgery.
This course will highlight what's new in pediatric surgery that you NEED TO KNOW!
Several ways to Participate:
August 9: Participate in a lap hernia course (on site or virtual).
August 10: Attend the Stay Current in Pediatric Surgery course (on-site or virtual).
If you would like to travel to Akron, OH for any of the 3 days, please email: AZiegler@chmca.org Reserve ahead of time for special room rates!
Tour The Exhibit Hall
Directors & Faculty
Topics & Objectives
Partners & Exhibitors
The full day symposium is designed to give an update each year on the contemporary management of common problems in pediatric surgery, highlighting new trends that should change your practice.
Mac Harmon, MD
In January 2014, Carroll McWilliams (Mac) Harmon, MD, PhD, was appointed Surgeon-in-Chief at Women & Children's Hospital of Buffalo (WCHOB), Professor of Surgery at the University at Buffalo, The State University of New York and Program Director or the Pediatric Surgery Fellowship Program at Women & Children's Hospital of Buffalo.
George Holcomb, MD
Whit Holcomb is Surgeon-in Chief and Director of the Center for Minimally Invasive Surgery at Children's Mercy Hospital in Kansas City.
Todd Ponsky, MD
Dr. Ponsky is a Professor of Surgery, and the Director of Clinical Growth and Transformation at Cincinnati Children's Hospital, He is also a consultant pediatric surgeon at Akron Children's Hospital.
Daniel Von Allmen, MD
Dr. von Allmen is the Senior Vice President of Surgical Services and Surgeon-in-Chief at Cincinnati Children's Hospital Medical Center. Additionally, Dr. von Allmen holds the Lester W. Martin Chair of Pediatric Surgery. His special clinical interests include pediatric surgical oncology, pediatric inflammatory bowel disease, esophageal disorders, surgical innovation and surgical robotics. He has been a long term participant in the Surgical Section of the Children's Oncology group, the Crohn's and Colitis Foundation of America and the International Pediatric Endosurgery Group.
Mark Wulkan, MD, FAAP
Surgeon-in-Chief, Children's Healthcare of Atlanta. Dr. Wulkan is a pioneer in pediatric advanced minimally invasive surgery with a strong interest in neonatal and thoracic lesions. After initiating the Minimally Invasive Surgery Center at Children's in 2003, he oversaw its growth into one of the most high volume pediatric minimally invasive programs in the country. Additionally, he performed Children's first lap-band procedure to treat adolescent obesity in 2007, was one of the first surgeons in Georgia to perform single-site incision surgery on pediatric patients for routine surgeries in 2009, and performed the first laparoscopic sleeve gastrectomy for adolescent obesity in the Southeast in 2010.
Additional Faculty
Avraham Schlager, MD
Avi recently joined the Akron Children's Hospital Pediatric Surgery Dept. He attended medical school at Mt. Sinai School of Medicine, New York, NY and completed his pediatric surgery fellowship from Emory University, Atlanta, GA
Christian Streck, MD
Dr. Christian Streck graduated from Duke University in 1994 with a BS in biology and an AB in history. He received his medical degree from the Wake Forest University School of Medicine in 1999. He completed general surgery residency in Memphis, Tennessee in 2006. This included a research fellowship studying children's cancer at St. Jude Children's Research Hospital. He completed pediatric surgery fellowship at LeBonhuer Children's Hospital in Memphis in 2008. He is currently board certified in general and pediatric surgery. Dr. Streck is an associate professor of surgery and pediatrics at the Medical University of South Carolina. He is currently the pediatric trauma medical director and the general surgery residency program director.
Mike Rubin, MD
Chairman, Department of Radiology.
Dr. Michael Rubin is a radiologist in Akron, Ohio and is affiliated with multiple hospitals in the area, including Akron Children's Hospital and Akron General Medical Center. He received his medical degree from University of North Dakota School of Medicine and Health Sciences and has been in practice for more than 20 years.
Abdulraouf Lamoshi, MD
Research Fellow at Akron Children's Hospital.
After three academic and two clinical postgraduate degrees, and eight years of clinical practice including five years in the pediatric surgery field, he decided to pursue his career in this sub-specialty as general pediatric surgeon with inclination toward pediatric-trauma and colorectal surgery. As pediatric trauma occurs worldwide and is becoming an increasing global health problem and the complexity of the colorectal problems. He is looking forward to gain more experience, face more challenges, and be a productive pediatric surgeon. Moreover, clinical research plays a fundamental role of health care professionals. He is working to assess the effect of a proposed intervention in reducing morbidity and improving quality of life of his patients.
Ian Glenn, MD
Research fellow at Akron Children's Hospital in Akron, OH.
Reinaldo Garcia-Naviero, MD
Director of Pediatric Gastroenterology, Akron Children's Hospital, Akron, Ohio. Dr. Garcia had been director of the pediatric endoscopy unit at Rainbow Babies & Children's Hospital since 2011 and assistant professor of pediatric gastroenterology at Case Western Reserve University since 2005. Following medical school at Javeriana University in Colombia, Dr. Garcia completed his pediatrics residency at Hospital Episcopal San Lucas in Puerto Rico and his pediatric gastroenterology fellowship at Louisiana State University in New Orleans.
John Clark, MD
Dr. John Clark specializes in diagnosing and treating heart rhythm disorders in children and teens. He is nationally renowned for using cardiac ablation without radiation to cure abnormal heart rhythms. In fact, Akron Children's average X-ray time for cardiac ablations is less than 2 minutes versus the national average of less than 40 minutes. Because of his expertise, Dr. Clark draws patients from across the United States, and fellow pediatric cardiologists come to Akron Children's to learn his techniques. He has been a speaker at multiple cardiology and medical conferences, as well as featured in a number of local, regional and national media outlets.
Sophia Abdulhai, MD
Sophia Abdulhai is currently performing a two-year pediatric surgery research fellowship at Akron Children's Hospital, where she is focusing on outcomes research and innovations. She obtained her medical degree at George Washington University in Washington, DC and is a general surgery resident at East Carolina University in Greenville, NC.
David Rothstein, MD, MS
Attending Pediatric Surgeon at the Women and Children's Hospital of Buffalo, Associate Professor of Surgery at the University at Buffalo, SUNY. Leader of Pediatric Surgery Quality and Patient Safety at Women & Children's Hospital of Buffalo. Dr. Rothstein is a fellow of the American Academy of Pediatrics and the American College of Surgeons. He also belongs to the American Pediatric Surgical Association, the International Surgical Society, the Society of American Gastrointestinal Endoscopic Surgeons, the Association for Academic Surgery and the Children's Oncology Group.
Steve Rothenberg, MD
Chief of Pediatric Surgery at Rocky Mountain Hospital for Children, Denver, Colorado. Professor of Surgery at Columbia University, New York, New York He was a founder and past president of the International Pediatric Endosurgical Group (IPEG), SAGES, Telementoring Task Force Member
Raymond Onders, MD
Director, Adult Minimally Invasive Surgery, UH Case Medical Center, Interim Division Chief, General and Gastrointestinal Surgery, UH Case Medical Center, Professor, Surgery, CWRU School of Medicine
David M. Notrica, MD, FACS, FAAP
Dr. David M. Notrica has been practicing pediatric surgery in Phoenix for the past 15 years. He received his M.D. from Emory University School of Medicine and completed his general surgery training at Emory University Affiliated Hospitals in Atlanta, GA. Dr. Notrica obtained his fellowship in pediatric surgery at Baylor College of Medicine/Texas Children's Hospital in Houston, TX. Dr. Notrica established Arizona's only ACS verified Level I Trauma Center for pediatric patients at Phoenix Children's Hospital in 2008 and continues to serve as its Trauma Medical Director. He is co-director of the joint Chest Wall program at Mayo Clinic-Arizona and Phoenix Children's Hospital. He has served as the President of the Medical Staff and Chief of Surgery at Phoenix Children's Hospital.
Aaron Lipskar, MD
Dr. Lipskar received a Bachelor of Arts degree in Philosophy with a minor in Near Eastern and Judaic Studies from Brandeis University. Dr. Lipskar then went on to earn a Doctor of Medicine (AOA) from Temple University School of Medicine. Dr. Lipskar completed a residency in General Surgery at Mount Sinai. During his residency, he completed a two-year basic science Research Fellowship in Pediatric Surgery at The Feinstein Institute for Medical Research at the North Shore-LIJ Health System, where he studied the anti-angiogenic effects of rapamycin in pediatric solid tumors. Dr. Lipskar returned to Mount Sinai to complete his residency training in General Surgery, and subsequently completed a two-year Clinical Fellowship in Pediatric Surgery at Cohen Children's Medical Center of the North Shore-LIJ Health System.
David Lanning, MD
Professor of Surgery and Pediatrics Co-Surgeon-in-Chief, Children's Hospital of Richmond at VCU.
Dr. Lanning completed his general surgical training in 2002 after having obtained his M.D. and Ph.D, all at VCU. After completing his pediatric surgery fellowship at the Children's Hospital of Michigan, he returned to VCU and joined the faculty in 2004. He currently practices General and Thoracic Pediatric Surgery as an associate professor of Surgery and Pediatrics in the Department of Surgery. Robotic experience: Dr. Lanning was the first surgeon at VCU to perform a surgery using the da Vinci robotic system, assisted by Dr. Claudio Oiticica, and the first pediatric surgeon to use the system in Virginia. The successful surgery was performed in April 2008, on a 17-year-old pediatric patient who had significant gastroesophageal reflux with esophagitis as well as hiatal hernia. Dr. Lanning has gone on to be a robotic proctor for most of the VCU surgeons and continues to advance minimally invasive surgical techniques for children in central Virginia.
David Krpata, MD
Dr. Krpata was born in New York, but later moved to Arizona where he completed undergraduate and medical school. He moved to Cleveland after medical school to complete surgical residency. Following residency, he joined the Cleveland Clinic for fellowship training in Abdominal Wall Reconstruction. He currently practices general surgery at the Cleveland Clinic Main Campus with a clinical and research focus on abdominal wall reconstruction, hernia mesh-related complications and chronic groin pain after hernia surgery.
Karen Diefenbach, MD
Director, Minimally Invasive Surgery, Nationwide Children's Hospital; Assistant Professor, Division of Pediatric Surgery, The Ohio State University College of Medicine, Columbus, OH
Solid Organ Injury Management
Who needs a CT scan for blunt abdominal trauma?
New Concepts in Radiology
Perforated Appendicitis: When to scan for an abscess
Cardiac Symathectomy
Diaphragm Pacing
Gastric Stimulation
Esophageal Disconnect
Novel Therapies in Pilondal Disease
Thoracoscopic Lobectomy Play by Play
Controversies in CDH and ECMO Management
Five Must-Know Presentations from JPS
Five Must-Know APSA Outcomes Committee Review Papers
Mesh selection in abdominal wall reconstruction
Is there finally a way to treat pilonidal disease?
Thoracoscopic lobectomy play-by-play
Esophageal disconnect instead of re-do Nissen?
CT scan for airway foreign body?
New recommendations for solid organ injury management
When to scan for an abscess in perforated appendicitis
Gastric stimulation for gastroparesis
Cardiac sympathectomy for ventricular arrhythmias
New algorithm for abdominal trauma imaging
1. Identify the diagnosis and management of various surgical conditions.
2. Describe newer surgical techniques for common pediatric surgical conditions.
3. Describe methods to improve surgical outcomes for pediatric surgical patients.
updated agenda
CME Link (use code 4763)
Exhibit in this show
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Ohio State Medical Association (OSMA) through the joint providership of Children's Hospital Medical Center of Akron and GlobalCastMD. The Children's Hospital Medical Center of Akron is accredited by the OSMA to provide continuing medical education for physicians.
The Children's Hospital Medical Center of Akron designates this live activity for a maximum of 6.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in this activity.
Disclosure of Faculty Financial Interests or Relationships
Annual Pediatric Surgery Update Course 2017
The potential for a conflict of interest may exist if a faculty member has any relevant interest or other relationship with the manufacturer of any commercial product discussed in her/his presentation.
As required by the Accreditation Council for Continuing Medical Education (ACCME), each speaker is required to complete a Speaker Disclosure Form which outlines any relationship the speaker has with any commercial company whose products he/she will be discussing. The prospective audience must be made aware of the affiliation/financial interest by an acknowledgment in the program or syllabus or in the faculty listing.
The intent of this policy is not to prevent a speaker from making a presentation. It is intended only that any potential conflict of interest should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts.
The following presenters/planning committee members have the following financial disclosure to be made:
George Holcomb III, MD Stock Shareholder: Just Right Surgical
Reinaldo Garcia, MD Speaker's Burea: Med Johnson, Abbott, Nutritica
Raymond Onders, MD Other financial: Synapse Biomedical, founder, chief medical officer and intellectual property for myself, and Case Western Reserve and University Hospitals
David Krpata, MD Consultant: Covidien
Steve Rothenberg, MD Consultant Storz; Stock shareholder: JRS
Todd Ponsky, MD Consultant ConMed; Stock shareholder: GlobalCastMD
All speakers have returned their disclosure forms, indicating that they have no relevant financial interest in any pharmaceutical or medical device company and do not intend to discuss any off-label uses of medications or medical devices in their presentations.
Carroll (Mac) Harmon, MD
Mark Wulkan, MD
Daniel von Allman, MD
David Notrica, MD
Michael Rubin, MD
Chris Streck, MD
David Rothstein, MD
The following CME Committee/Planning Committee members have the following commercial/financial relationships to disclose:
Rajeev Bhatia, MD: Consultant: Merck Medical Manuals (Chapter update)
Susan Klein, MD: Speaker's Bureau: Genomic Health (Spouse)
Todd Ritzman, MD:Grant/Research Support: NIH STTR Grant; Consultant: Orthopediatrics, Medtronic Spine
Speaker's Bureau: Orthopediatrics, Medtronic Spine; Stock Shareholder: Apto Orthopaedics
All remaining committee members have returned their disclosure forms, indicating that they have no relevant financial interest in any pharmaceutical or medical device company and that this activity was developed independent of commercial interest.
TO COMPLETE YOUR EVALUATION GO TO: www.akronchildrens.org/cme
The CME Activity Code is: 4763 (If assistance is needed, please call 330-543-8407)
Please be aware that the evaluation period will remain open for 30 days post activity date as implemented by the Continuing Medical Educations subcommittee
Children's Hospital Medical Center of Akron is accredited by the Ohio State Medical Association to provide continuing medical education for physicians.
The Children's Hospital Medical Center of Akron designates this live activity for a maximum of 6.5 AMA PRA Category 1 Credit TM. Physicians should claim only the credit commensurate with the extent of their participation in this activity.
Show Disclosure

redpajama_set_name: RedPajamaCommonCrawl


text:
Q: How to Sort Sections on TMemIniFile I am using TMemIniFile to store configuration and I need to sort the sections in alpha order.
For that I have created a descendant of TMemIniFile
  TRWStudioMemIniFile = class(TMemIniFile)
  public
    procedure UpdateFile; override;
    procedure GetSortedStrings(List: TStrings);
  end;

{ TRWStudioMemIniFile }

procedure TRWStudioMemIniFile.GetSortedStrings(List: TStrings);
var
  I, J: Integer;
  Strings: TStrings;
begin
  List.BeginUpdate;
  try
    Sections.Sort;
    for I := 0 to Sections.Count - 1 do
    begin
      List.Add('[' + Sections[I] + ']');
      Strings := TStrings(Sections.Objects[I]);
      for J := 0 to Strings.Count - 1 do List.Add(Strings[J]);
      List.Add('');
    end;
  finally
    List.EndUpdate;
  end;
end;

procedure TRWStudioMemIniFile.UpdateFile;
var
  List: TStringList;
begin
  List := TStringList.Create;
  try
    GetSortedStrings(List);
    List.SaveToFile(FileName, Encoding);
  finally
    List.Free;
  end;
end;

but it needs to have access to the Sections (actually FSections: TStringList, that is a private member of TMemIniFile)
I have created a Helper class to expose that member thru a property. However this behavior is not supported anymore in Delphi 10.1
I started copy/paste the TMemIniFile to my unit and after and endless process I am ending up making a copy of the entire System.IniFile, just to access the FSections.
My question is how to access that FSections member without need to duplicate everything from that unit just to gain visibility
OR is there another way that I can Sort the Sections before saving? (I am just calling the TStringList.Sort from FSections)

A: Rather than relying on type-casting and "cracking open" the private member, you can instead get the sections into your own TStringList using the inherited ReadSections() method, sort that list as needed, and then use the inherited  ReadSectionValues() method to read the strings for each section:
var
  sections: TStringList;
  values: TStringList;
begin
  sections := TStringList.Create;
  try
    ReadSections(sections);
    sections.Sort;

    values := TStringList.Create;
    try
      List.BeginUpdate;
      try
        for I := 0 to sections.Count - 1 do
        begin
          List.Add('[' + sections[I] + ']');

          values.Clear; // Just in case
          ReadSectionValues(sections[i], values);

          for J := 0 to values.Count - 1 do
            List.Add(values[J]);
          List.Add('');
        end;
      finally
        List.EndUpdate;
      end;
    finally
      values.Free;
    end;
  finally
    sections.Free;
  end;
end;

redpajama_set_name: RedPajamaStackExchange


text:
Our dear friends, Dick and Carol
Twenty one years ago this month we arrived in Bangladesh when Liz was two and the boys were four and five. Steve started teaching right away in the MK school, set up an ESL class for hospital staff and led a mid week Bible study. It was a wonderful year for us as a family. The work was rewarding and important, but by October we were feeling burnt out and homesick.
In our stress and loneliness we were encouraged and ministered to by Carol Stagg, Aunt Carol to our kids. Dick was the medical director of the hospital, demonstrating the love of Christ with his care, courtesy and kindness in a needy land. Carol had, and still has, the gift of hospitality, encouraging and blessing all who ever had the privilege of entering her home. We will never forget how she miraculously produced a ham for us at Canadian Thanksgiving, and a 17-layer torte, washed down with A&W root beer. Or her house magically decorated at Christmas, with her tree bejeweled with light and a special gift for each of our children nestled beneath its branches.
Her ministry was made all the more remarkable by her indomitable courage. You see, Carol suffers from lupus, a cruel disease which was made worse by exposure to sunlight. Yet in obedience to God, here she was in Bangladesh, where the temperature at midday would rise to 40 degrees Celsius, ministering for Christ in love to all who came her way. We were humbled and strengthened not only by what she did for us, but for her remarkable example of Christlikeness.
Now this dear saint and friend has been diagnosed with lung cancer. We know that she will face this new trial to her health with the same determined spirit, and will continue to witness of God's sustaining presence in the midst of suffering. We would ask for your prayers for this faithful servant of Christ. May He be merciful to one who has borne so much for Him.
One Response to "Our dear friends, Dick and Carol"
Jonathan Wise Says:
I may have been 5, but I remember Uncle Dick and Aunt Carol very well! They were wonderful to us, and will always be a huge part of my memories of Bangladesh.


When I was growing up, wearing clothes from Wal-Mart was pretty much a death sentence for your social career. I shared my thoughts on Wal-Mart once here on the blog.
Anyways, I've found some really cute things for my girls in the children's clothing section. I won't lie. It pains me a bit to tell you that. No, not everything you see in WM is a gem. You have to pass by a lot of size 5T shirts with Elmo and "I'm 2 Cute 4 U" plastered all over the front to find the really adorable stuff. I tend to stick to separates that can be mixed and matched with other pieces.
We can take a few WM outfits and mix them in with cute, well-made consignment sale finds, Target deals, and Gymboree/Crazy 8 clearances.
And you know what? My girls get complimented all the time on their little mini ensembles.
Thought I'd share a few of our recent finds. Preschool starts up soon, and if you don't grab the stuff in your kids' sizes, they tend to go quickly.
I believe these little pleated skirts were around $5 each.
Purple, jeans material, and navy--the weight of the fabric was actually pretty sturdy, and they have the built-in shorts underneath. Those of you with girls know that this is a must if you have a preschool girl!
Love them because they can be mixed and matched to make multiple outfits and can be worn with tights underneath and a sweater when the weather turns cool.
If I could squeeze myself into Natalie's new plaid tunic, I totally would. Don't you love the ruched leggings?
Think that outfit was around $9.50 or so.
Loooving these little matching dresses. The jumpers are heavier, so these will be perfect for cold months. $7 each.
Can we talk about the ruffles on this cotton, long-sleeved top? To quote Rachel Zoe, "I die."
$5 jeans for a two year old. Fabulous!
And these. There are no words.
Ba-nanas. Michaela Byrd had a similar pair last winter and looked so cute that I had to buy these. They'll be perfect with a little jean skirt or with leggings.
So how much fun was that?
I totally take my granddaughters to WM and you can get some cool things. Your finds are fabulous. Loving the boots!
I completely agree, WM has cute stuff for kids. Not to mention the toys are usually cheaper there than anywhere else.
I do think Wallyworld has improved the offerings, across the board...I do love several of their Better Homes & Garden offerings for home. I guess it isn't actually Walmart that I hate...it is the people of Walmart LOL..
Love Rachel Zoe! Sometimes I just say "Rodg....." in a gravely voice like her to make my mom start busting out laughing. :) Cute clothes - and like Kim said above, I applaud you for buying age-appropriate items for your little girls!
OK, I just left WalMart with a broken hearted 3 year old, because I let her pick out a chapstick, she carried it around the entire store so excited to buy it and then we got to the register and had the slowest checker in the entire world who charged me $7 for a cantaloupe(didn't realize that til I got home) and Taylor was having a major melt down, screaming and kicking because I wouldn't let her play with the credit card swiper. Anyway the first thing she grabs off the belt was the chapstick, there was no barcode on it, so she sets it aside until the very end when she finally calls a manager over and the manager has to go somewhere to figure out what to do and Taylor is laying on the floor kicking and screaming by this time, so I told slow-as-molasses cashier to forget it and drug my kids out the door. Kie was so upset, I had to bribe her with a trip to the dollar store after naps just to make her feel better. WalMart....I despise you but since you are the only place in town I will continue to shop there...but only because I have to! By the way I love the clothes, so cute!
I'm going to have to find that plaid tunic and leggings for my little girl!! LOVE!! I got my little one some cute boots last year at WalMart too...I'm hopeful she can still wear them this year (she has the tiniest foot EVER). I used to snub my nose at Walmart clothes, but for kids they do have some cute things...it's just like you said, you have to look for it amongst all that "2cute4u" crap. I love it when I find Healthtex brand stuff there. It's always cute and tends to hold up better in the wash than some of the other brands.
You found some cute things at Wally World. They've remodeled the two closest to me and it has made a big difference. My friend at school wears bunches of Walmart things and you'd never know that that's where she purchases them. It pays to shop and really look for a deal!
I have often wanted to try to fit into my daughter's clothes (wouldn't be a pretty sight though). Love that tunic! I am all about the bargains when it comes to kids clothes!
Your girls will be stylin! At least Walmart has improved their clothes selection over the years. Cute stuff!
Great finds and you're right...your have to look past the elmo, 2 cute 4 u to find the cute stuff. You got some really cute outfits.
The matching outfits, so cute I want to dress my boys in them...errr...perhaps in a masculine version?
It's such a blessing to grow up with a mom who has style!
I couldn't agree more. I buy basics at Wal-Mart. We get tons of mix and match plain t-shirts to embellish and that I make cute pants to go with. That little plaid top is adorable and so are those boots! Sooo cute! Our WM doesn't have little girls boots yet. I've been checking EVERY time I walk in the door.


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"Doctor Faustus" by Gay Elizabethan Christopher Marlowe in Revival by CAE — Reflections from the Director
October 27, 2015 / John Townsend
Michael Ooms as Faustus. Photo by Anya Magnuson.
Christopher Marlowe is the quintessential renegade playwright. His mysterious early death at age 29 is legendary. He was a spy, a playwright, a lover of men, and for a time William Shakespeare's rival. Some feel he would have equaled Shakespeare had he lived longer. Both were born in 1564.
The Bard lived to age 54.
Joseph Papke has directed Michael Ooms as Faustus for Classical Actors Ensemble. He has shared some thoughts on the play: "Subjectively, I feel the show is about free will and human nature. Faustus is a skeptic who questions the dogma of divinity. Though he's repeatedly warned against it, he follows his independent nature, yields to temptation, and makes a choice to give his soul to Lucifer in exchange for knowledge and power. He then has to pay the price for that choice. The play is based on the older, religious morality play format, and, as much as I would love Marlowe to turn the form completely on its head and blatantly say something like, 'there is no moral authority higher than the individual,' or 'there is no spiritual/supernatural world,' he doesn't. He was writing in a much more provincial and strait-laced society than ours. So the metaphysical rules are real and Faustus is punished. But he's had fun. And we've had fun watching his unconventional life and anti-authoritarian actions. This is not a somber, 'let's keep the masses in line' propaganda piece; this play is a subtle subversion, likely to make insightful audience members ask questions — and asking questions is the beginning of the end for any system of absolute authority. Without breaking any Elizabethan societal rules, Marlowe wrote an entertaining play that was a step forward for free thinking. Not that this is a 'gay play,' but in 1590, one could not simply state 'I am a homosexual' or 'I am an atheist.' However, a smart person with that agenda could begin dismantling the structures that make it impossible to state those truths."
Doctor Faustus in repertory with Shakespeare's The Tempest
Through Nov. 1
Minneapolis Theatre Garage, 711 W. Franklin Ave., Minneapolis
www.classicalactorsensemble.org


" I have seen your web-site for more than a few years, and debated as to whether the micro fence was all that it was cracked up to be. After seeing a demonstration at the Baltimore wood show I decided to give it a try. Wish I could find the words to say THANK YOU! It is everything and more than what you described in your seminar. It is truly easy to use, and even I, a fairly new hobby woodworker, am able to get great results. Within 10-15 minutes of using it, I was able to UNDERSTAND how to do router inlays which I have now done a few in the last 2 weeks.
Your products, their ease of use, and especially your after market customer support have been more than I ever expected. Since receiving and using the edge guide, I tried doing some pattern inlays and realize the other products I have been using fall short of giving precision depth guide precision when making inlay cuts. I will soon be ordering your plunge base to take care of this.
This package includes both our Micro Fence Edge Guide and Circle Jig Attachment (for circles from 6″ to 48″), a set of our Stop Collars, and a Stabilizer Bar. This is a great introductory package to bring Micro Fence's accuracy, efficiency, and versatility into your workshop.
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Your career is important, and if you are an active service member, facing criminal charges can be detrimental.
While civilians facing charges may be affected in their personal lives and careers, it is often up to the discretion of the employer. For military personnel, however, these civilian charges are taken extremely seriously and can result in a range of career consequences from restricted duty and denied promotions, to dishonorable discharge.
Each state and military branch has its own specific process and regulations, and having a lawyer who is familiar with the differences and how to handle them is important. Cara P. Oxenham is based in Chesapeake, Virginia, and is highly experienced in Virginia criminal law. Cara will work hard to argue your case with the goal of complete dismissal or deliver the best possible outcome.
If you or another military personnel is facing criminal charges, contact defense attorney Cara Oxenham at (757) 482-4224.


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News Home » World » The FDA approves a new COVID-19 vaccine for children as young as six months old
The FDA approves a new COVID-19 vaccine for children as young as six months old
Randy Mancini 10 December 8, 2022
COVID-19 vaccine is stored at -80 degrees celsius in the pharmacy at Roseland Community Hospital on December 18, 2020 in Chicago, Illinois. (Photo by Scott Olson/Getty Images)
UPDATED 5:51 PM PT – Thursday, December 8, 2022
The Food and Drug Administration (FDA) has changed their emergency use authorization (EUAs) for COVID vaccines to now include children from five years old to six-months-old.
The agency's top vaccine regulator, Peter Marks, announced the emergency use authorization of an updated bivalent COVID-19 vaccine early on Thursday.
This comes after Pfizer and BioNTech sought an authorization from the agency on Monday for the vaccines use in children under the age of five.
Currently, the FDA recommends children to receive doses of the COVID-19 vaccine. Officials are reportedly expecting to receive the data needed to support a fourth dose in January.
CDC data shows that only 6.4% percent of children under the age of two have received at least one dose of a COVID-19 vaccine.


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Anna Khilkevich ended up in bed with Igor Vernik
Last weekend, the entire film world celebrated the professional holiday. To congratulate colleagues on the occasion decided Igor Vernik, however, made it a rather unusual way. In his account Instagram, the actor posted a video where he's having fun in bed young star of "Univer" Anna Khilkevich.
Vernick and Lee looked like the most that neither is true lovers who panted after carnal pleasures. This scene looked very natural and believable that at first shocked and amazed followers of Igor. However, to put everything in its place – wernick just shared a scene from the new film starring Anne — "All about Men", which soon goes in the car.
http://www.starslife.ru/wp-content/uploads/2016/08/14175802_1719844264945886_769169392_s.mp4
By the way, recently, having talked about working with Igor and admitted that their sex scene was filmed on the first day of the meeting: This is the third or fourth draft, when you're in love with a person you didn't even know me. So this time we with Igor Vernik on the first day put him to bed, " laughs Lee. — In the opinion of the Directors, it helps to establish closer contact. Maybe they're right."
Synopsis: the plot of "All about men" some men tell the taxi driver fun and incredible experiences. According to the creators of the film, he in a humorous way expose different facets of man's nature, including heroism, bravado and sentimentality.
The movie will be released very soon — September 1st. In addition to Igor Vernik and Anna Khilkevich, it is also played by Dmitriy Nagiev, Elena Borschev, Sergei Belogolovtsev, Vladimir Epifantsev, Jan Tsapnik and Elena Valyushkina. Directors of Comedy became Michael Garnevski and Leonid Margolin, and her producers made Michael Galustyan and Sarik Andreasyan.
A fan said that Tupac Shakur is alive
Recording of Paul McCartney, which was considered lost for sale at auction
Semyon Slepakov may lose Russian citizenship because of the song


WASHINGTON, DC, MARCH 29, 2013 – The Association of Global Automakers (Global Automakers) and its member companies are pleased that the Environmental Protection Agency (EPA) released its proposed rules for Tier 3 vehicle emissions and gasoline standards.
"We have been anxiously awaiting this rulemaking because it is good for the environment and will help harmonize the federal and California programs for both vehicles and fuels," said Michael J. Stanton, president and CEO of Global Automakers.
Global Automakers believes the proposed EPA fuel standards are especially important because a nation-wide supply of clean, ultra-low sulfur gasoline will enable automakers to meet new and highly stringent vehicle emissions standards, which are also included in the proposed rule and expected to mirror the California LEV III standards. Ultra-low sulfur gasoline is also critical to automobile manufacturer efforts to meet the combined 54.5 MPG fuel economy and greenhouse gas emissions standard by 2025, as mandated by federal and California law. Additionally, the ultra-low sulfur fuel will provide immediate, substantial public health benefits from the existing legacy fleet of nearly 250 million vehicles. According to the National Association of Clean Air Agencies, the impact on the legacy fleet is equivalent in emissions impact to taking over 30 million vehicles off the road.
"With 15 million new vehicle sales a year, automakers need predictable national fuel quality at the retail pump," said Stanton. "Ultra-low sulfur gasoline is already available in California, Europe, and Japan and will enable automakers to use a broader range of technologies to meet the significant environmental challenges facing the industry."


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Harry Thurston
Harry Thurston is a poet, award-winning journalist, and author of more than two dozen books of poetry and non-fiction.
In House: Gaspereau Press
Gaspereau Press of Kentville, Nova Scotia was established in 1997 with the launch of its literary quarterly, The Gaspereau Review, and first three books. Soon partners Andrew Steeves and Gary Dunfield were publishing eight titles a year and by 2000 they had purchased a printing ... Read more


Last year, around May, DynDNS.com has changed their root certificates, causing Dynamic DNS using DynDNS.com no longer to work properly. The error (Network Error) is displayed immediately after adding the account to your Sonicwall.
For 5.9, this is anything after June 2014.


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Staunton District Traffic Alerts: Work schedule for week of March 22-26
(© monticellllo – stock.adobe.com)
The following is a list of highway work that may affect traffic in the Staunton District during the coming weeks. The Staunton District consists of 11 counties from the Alleghany Highlands to the northern Shenandoah Valley: Alleghany, Bath, Rockbridge, Highland, Augusta, Rockingham, Page, Shenandoah, Frederick, Clarke and Warren.
Scheduled work is subject to change due to inclement weather and material supplies. Motorists are advised to watch for slow-moving tractors during mowing operations. When traveling through a work zone, be alert to periodic changes in traffic patterns and lane closures.
*NEW* or *UPDATE* indicates a new or revised entry since last week's report.
ALLEGHANY COUNTY
Mile marker 14 to 15, eastbound and westbound – Alternating lane closures for maintenance of bridge over Route 18, Monday to Friday from 7 a.m. to 5 p.m. through April 2.
*NEW* Mile marker 23 to 25, eastbound and westbound – Right shoulder closures for sign work, March 22-April 2 from 8 a.m. to 5 p.m.
PRIMARY ROADS
Various roads – Flagger traffic control for tree and debris removal, pothole patching, shoulder repairs and brush cutting. Weekdays from 7:30 a.m. to 3 p.m.
SECONDARY ROADS
Route 661 (Midland Trail) – Flagger traffic control between Route 683 (Callaghan Circle) and Route 719 (Bellegray Lane) for maintenance of Ogle Creek bridge, 7 a.m. to 5 p.m. through March 26.
Route 696 (Selma-Low Moor Road) – Temporary traffic signals in operation 24/7 between I-64 and Route 616 (Rich Patch Road) during bridge replacement at Karnes Creek. Estimated project completion in September 2021.
Various roads – Flagger traffic control for pipe replacements, ditch work, tree removal, pothole patching, shoulder repairs and brush cutting. Weekdays from 7:30 a.m. to 3 p.m.
*NEW* Route 220 (Sam Snead Highway) – Southbound right shoulder closures for sign installation work in area of Route 39 (Mountain Valley Road), March 22-April 2 from 8 a.m. to 5 p.m.
Various roads – Flagger traffic control for brush cutting. Weekdays from 7:30 a.m. to 3 p.m.
*UPDATE* Various roads – Flagger traffic control for brush cutting and ditch work. Weekdays from 7:30 a.m. to 3 p.m.
ROCKBRIDGE COUNTY
No lane closures scheduled.
*NEW* Mile marker 192 to 193, northbound – Shoulder closures for sign installation work, Tuesday to Thursday from 7 a.m. to 5 p.m.
*UPDATE* Mile marker 197 to 196, southbound – Shoulder closures for sign installation work, Monday from 7 a.m. to 5 p.m.
Mile marker 200 to 201, northbound – Right shoulder closure for utility work, Monday from 9 a.m. to 3:30 p.m.
Exit 205, southbound – Shoulder closures for utility work along off-ramp to Route 606, Wednesday from 9 a.m. to 3:30 p.m.
*NEW* Route 11 (Lee Highway) – Southbound shoulder closure for utility work in the area of Route 715 (Sunnybrook Road) intersection, Wednesday from 8:30 a.m. to 4 p.m.
*NEW* Route 252 (Brownsburg Turnpike) – Shoulder closures for tree removal operations between Route 606 (Raphine Road) and Route 725 (High Rock Road), Monday to Friday from 7:30 a.m. to 3 p.m.
Various roads – Flagger traffic control for pipe replacement, ditch work, tree removal, shoulder repairs, pavement patching and brush cutting. Weekdays from 7:30 a.m. to 3 p.m.
Various roads – Flagger traffic control for grading, pipe replacement, ditch work, tree removal, pavement patching, shoulder repairs and brush cutting. Weekdays from 7:30 a.m. to 3 p.m.
HIGHLAND COUNTY
Various roads – Flagger traffic control for tree removal, pavement patching and shoulder repairs. Weekdays from 7:30 a.m. to 3 p.m.
Various roads – Flagger traffic control for pipe cleaning, tree removal, pavement patching, ditch work and adding stone to unpaved roads. Weekdays from 7:30 a.m. to 3 p.m.
*UPDATE* Mile marker 89 to 90, eastbound and westbound – Overnight alternating lane closures for inspection of Route 637 overpass bridge, Wednesday and Thursday nights (March 24-25) from 7 p.m. to 7 a.m.
*NEW* Mile marker 94 to 95, eastbound and westbound – Overnight alternating lane closures for inspection of Route 340 overpass bridges, Wednesday and Thursday nights (March 24-25) from 7 p.m. to 7 a.m.
*UPDATE* Mile marker 212 to 213, northbound – Shoulder closures for sign installation work, Monday from 7 a.m. to 5 p.m.
*UPDATE* Mile marker 219 to 223, northbound and southbound – Overnight alternating lane closures for bridge maintenance at various locations, 8 p.m. to 7 a.m. through March 26.
*NEW* Mile marker 224 to 226, northbound and southbound – Traffic restrictions for utility work as follows: Southbound left lane closure from 7 p.m. Saturday to 10 a.m. Sunday (March 20-21). Northbound and southbound slow roll closure for up to 15 minutes on Sunday, March 28, between 7 a.m. and 11 a.m.
Mile marker 233 to 236, northbound and southbound – Overnight alternating lane closures for bridge maintenance at various locations, 8 p.m. to 7 a.m. through March 26.
*NEW* Mile marker 234 to 236, northbound and southbound – Right shoulder closures for sign maintenance, March 22-April 2 from 8 a.m. to 5 p.m.
*UPDATE* Route 11 (Lee-Jackson Highway) – Alternating lane closures for utility work between Route 647 (Christians Creek Road) and Route 1409 (Mitchell Lane), 8 a.m. to 5 p.m. through April 1.
*NEW* Route 250 (Churchville Avenue) – Flagger traffic control and shoulder closures for sidewalk upgrades between Route 42 (Buffalo Gap Highway) and Route 722 (Vinegar Hill Road), Thursday and Friday from 8 a.m. to 6:30 p.m.
Route 250 (Churchville Avenue) – Traffic diversion in place for Bell Creek bridge replacement between Route 732 (Franks Mill Road) and western intersection with Route 840 (Old Churchville Road). Detour uses temporary bridge and portion of Route 732. Work zone speed limit 35 miles an hour. Estimated project completion summer 2021.
Route 256 (Weyers Cave Road) – Westbound right shoulder closures for sign maintenance between I-81 southbound ramps and Route 11 (Lee Highway), 8 a.m. to 5 p.m. through March 26.
*NEW* Route 608 (Draft Avenue) – Flagger traffic control as needed for sidewalk upgrades between Route 610 (Howardsville Turnpike) and Route 1502 (Cambridge Drive), Monday to Wednesday from 8 a.m. to 6:30 p.m.
Route 616 (Humbert Road) – Shoulder closures between Route 865 (Rockfish Road) and Route 608 (Battlefield Road) for utility work, 9 a.m. to 3 p.m. through March 26.
Route 617 (Swisher Road) – Shoulder closures between Route 612 (Laurel Hill Road) and Route 608 (Battlefield Road) for utility work, 9 a.m. to 2:30 p.m. through April 29.
Route 634 (Patton Farm Road) – Shoulder closures between Route 610 (Howardsville Turnpike) and Route 639 (Wayne Avenue) for utility work, 9 a.m. to 3 p.m. through March 25.
*NEW* Route 675 (Broadhead School Road) – Possible flagger traffic control as needed for Rural Rustic Road improvements between Route 11 (Lee-Jackson Highway) and Route 604 (McClures Mill Road), weekdays through November 2021.
Route 732 (Franks Mill Road) – Traffic pattern change for Bell Creek bridge replacement near intersection with Route 250 (Churchville Avenue). Part of Route 732 serves as detour for Route 250 traffic. Work zone speed limit 35 miles an hour. Estimated project completion summer 2021.
*NEW* Route 744 (Leaport Road) – Closed to through traffic March 29-April 8 for bridge replacement between Route 626 (Limestone Road) and Route 745 (Mount Pisgah Road). Follow posted detour.
Route 842 (Horseshoe Circle) – Flagger traffic control as needed for Rural Rustic Road improvements between Route 608 (Cold Springs Road) and 1 mile south of Route 608, weekdays from 8 a.m. to 4 p.m. through July 30.
Mile marker 242 to 249, northbound and southbound – Overnight alternating lane closures for pavement and soil testing, Sunday through Thursday nights from 8 p.m. to 7 a.m. No weekend work and no ramp closures. Estimated completion April 2.
No lane closures reported.
Route 793 (Endless Caverns Road) – Occasional lane closures for pipe repairs between Route 11 (Valley Pike) and Route 850 (Hulings Lane), 8 a.m. to 6 p.m. through April 2.
Route 211 – Eastbound right shoulder closures for sign maintenance between Route 766 (Hamburg Road) and Rout 646 (Oak Leaf Road), 8 a.m. to 5 p.m. through March 26.
Route 211 – Single-lane traffic between Route 615 (Egypt Bend Road) and Route 646 (Oak Leaf Road). Westbound traffic uses median crossover to share eastbound bridge over Shenandoah River South Fork. Work zone speed limit 45 miles an hour. Traffic restrictions are for westbound bridge replacement with estimated completion in summer 2022.
Mile marker 287 to 288, northbound – Right shoulder closures for tree removal operations, Monday to Friday from 8 a.m. to 3 p.m.
Mile marker 295 to 296, northbound – Shoulder closures for sign installation work, Wednesday and Thursday from 7 a.m. to 5 p.m.
*NEW* Route 211 (Lee Highway) – Alternating lane closures just west of Route 620 (Smith Creek Road) for maintenance of bridge over Smith Creek, Monday to Friday from 7 a.m. to 5 p.m.
Route 211 (Lee Highway) – Traffic lane shifts due to tree trimming operations between Route 620 (Smith Creek Road) and Page County line, 7 a.m. to 3:30 p.m. through March 26.
*NEW* Route 601 (Battlefield Road) – Flagger traffic control for inspection of I-81 overpass bridge, Wednesday from 8:30 a.m. to 4:30 p.m.
Route 623 (Coal Mine Road) – Road closed just east of Route 606 (Moores Ford Road) for Cedar Creek bridge replacement at Frederick County line. Follow posted detour. Estimated project completion June 2021.
Mile marker 308 to 309, northbound – Right shoulder closures for sign installation work, Monday and Tuesday from 7 a.m. to 5 p.m.
Mile marker 315 to 313 including exit 313 off-ramp, southbound – Right shoulder closures for sign work, 8 a.m. to 5 p.m. through March 26.
Mile marker 321 to 322, northbound and southbound – Overnight alternating lane closures for inspection of Route 672 overpass bridge, Wednesday and Thursday nights from 8 p.m. to 7 a.m.
*NEW* Route 37 – Northbound and southbound right shoulder closures for sign maintenance between Route 628 and Route 50 interchanges, March 22-April 2 from 8 a.m. to 5 p.m.
*NEW* Route 50/17 (Millwood Pike)– Eastbound and westbound right lane closures for inspection of Opequon Creek bridge at Clarke County line, Thursday from 8:30 a.m. to 4:30 p.m.
Route 50/17 (Millwood Pike) – Westbound right shoulder closures for sign work just west of I-81 interchange, 8 a.m. to 5 p.m. through March 26.
Route 277 (Fairfax Pike) – Both shoulders closed 24/7 between I-81 ramps and Route 1075 for roadway and utility reconstruction project with completion in late 2022.
*NEW* Route 522 (Front Royal Pike) – Southbound right lane closure for pavement milling 0.3-mile north of Route 277 (Fairfax Pike), Tuesday from 8 a.m. to 3 p.m.
Route 623 (Fromans Road) – Closed for bridge replacement at Cedar Creek just west of Route 622 (Cedar Creek Grade) at Shenandoah County line. Follow posted detour. Estimated project completion June 2021.
Route 641 (Double Church Road) – Flagger traffic control between Route 1450 (Driftwood Drive) and Route 1049 (Buckingham Drive), Monday to Friday from 9 a.m. to 2:30 p.m. Traffic restrictions are for utility work and roadway reconstruction through November 2021.
*NEW* Route 7 (Harry Byrd Highway) – Alternating lane closures for pavement patching between Route 7 Business (East Main Street) and Route 612 (Shepherds Mill Road), Wednesday to Friday from 7 a.m. to 3 p.m.
*NEW* Route 50/17 (John Mosby Highway)– Eastbound and westbound right lane closures for inspection of Opequon Creek bridge at Frederick County line, Thursday from 8:30 a.m. to 4:30 p.m.
*NEW* Route 340 (Lord Fairfax Highway) – Alternating lane closures for pavement patching between Route 50/17 (John Mosby Highway) and Berryville town limits, Wednesday to Friday from 7 a.m. to 3 p.m.
*NEW* Mile marker 4 to 7, eastbound and westbound – Shoulder closures for inspection of Route 609 overpass bridge, Monday from 8:30 a.m. to 4:30 p.m.
*NEW* Route 79 (Apple Mountain Road)– Flagger traffic control for inspection of I-66 overpass bridges, Wednesday from 8:30 a.m. to 4:30 p.m.
*NEW* Route 340/522 (Winchester Road) – Alternating lane closures for inspection of I-66 overpass bridges, Tuesday from 8:30 a.m. to 4:30 p.m.
Vegetation management may take place district wide on various routes. Motorists are reminded to use extreme caution when traveling through work zones.
Traffic alerts and traveler information can be obtained by dialing 511. Traffic alerts and traveler information also are available at www.511Virginia.org.
The VDOT Customer Service Center can assist with reporting road hazards, asking transportation questions, or getting information related to Virginia's roads. Call 800-FOR- ROAD (800-367-7623) or use its mobile friendly website at my.vdot.virginia.gov. Agents are available 24 hours-a-day, seven days a week.
The Staunton District Twitter feed is at @VaDOTStaunton. VDOT can be followed on Facebook, Flickr, Twitter and YouTube. RSS feeds are also available for statewide information. The VDOT Web page is located at www.VirginiaDOT.org.


Owning your own small business is a popular notion in the United States. With more than 28 million small businesses in the U.S. representing over 50% of the working population in this country, it's perhaps safe to assume that it's a proven paradigm in our culture that will only continue to increase over time.
And while many small businesses have found their stride and are thriving, there are still a staggering number of Americans who aren't doing enough to secure their financial futures. According to the U.S. Census Bureau, the average savings of a 50-year-old is only $42,797. And over 80% of people between the ages of 30 and 54 don't believe they will have enough money put away for retirement.
As a small-business owner, you have a tremendous opportunity to not only turn a dream into a reality and create jobs for others, but you also have the ability to set yourself up for financial success. It's not enough just to be profitable. You also should be saving money toward your future.
Whether you're a small-business of one or of nearly 500 employees, here's how to leverage your small business for your financial success.
Let's face it. As a small-business owner, you wind up putting your business first and oftentimes neglect your own best financial interests. You direct all your resources into getting your business up and running in the first place, and once you start to find momentum, saving for retirement may not be the highest priority on your ever-growing list of responsibilities.
Once your business is profitable, start paying yourself right away. Your small business can reward you with financial independence if you take action and start saving. Begin by saving 10% of your income, and then increase that amount over time. Ultimately, you want to be saving 15%-20% of your income into a retirement account. If you want to have enough in retirement, this is non-negotiable.
SEP IRA: This is the most common plan for small businesses, largely because they are incredibly easy to set up and maintain. These accounts can be created until your income tax due date and make it possible for you to reduce taxable income from the prior tax year, because all contributions, which can only be made by the business owner, are tax deductible up to 25% of each employee's compensation, up to $53,000 for tax year 2016, or $54,000 for 2017.
Solo-401(k): The great thing about Solo-401(k)s is that they offer the same benefits of a traditional employer-sponsored 401(k) for the solopreneur who has no full-time employees. While these plans can be more expensive to set up, they offer greater options for you and your part-time employees. These plans do not have filing requirements until you reach $250,000.
Simple IRA: These plans offer the same benefits of a traditional IRA, but with higher contribution limits, because you are a small business. You can make contributions of up to $12,500 if you're under the age of 50 (vs. $5,500 for a traditional IRA) and $15,500 for anyone over the age of 50 (vs. $6,500 for a traditional IRA).
As a small-business owner, you have arguably more opportunities, not fewer, when it comes to securing your financial future. Most small businesses start with a SEP IRA and then graduate to other types of retirement accounts as their businesses grow and prosper.
Getting started as early as possible puts you as the business owner in the best position to reap the highest reward from following your dream: financial independence. Don't ignore your ability to secure your future. Instead, consider all the options you have available to you and start taking advantage of some of the tools that have been created with you in mind. What you do today will make all the difference in your tomorrow.
Leveraging your small business for financial success is something only you can do.
Paul Sydlansky, founder of Lake Road Advisors LLC, has worked in the financial services industry for over 17 years. Paul is a CERTIFIED FINANCIAL PLANNER™ and a member of the National Association of Personal Financial Advisors (NAPFA), the Financial Planning Association (FPA) and the XY Planning Network (XYPN).
This article was written by Founder, Lake Road Advisors, Llc, Paul V. Sydlansky and Cfp from Kiplinger and was legally licensed through the NewsCred publisher network. Please direct all licensing questions to legal@newscred.com.


Your guide to the best cashback sites, plus discover how you can get cashback on everything you buy with a cashback credit card.
Reviews of online bank accounts, the cheapest online share dealing, and learn how to trade in shares.
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Looking for c code bitcoin miner ? Download free Mining Software c code bitcoin miner .
Indeed, S9 is more productive with electrical power use. I do think anyone in a country with absolutely free Bitcoin Mining electricty would not treatment which they buy, but when electrical energy prices really are a significant component S9 will Expense less in electric power Expense for every hash than s7.
to be able to be recognized by the remainder of the network, a new block must consist of a so-called evidence-of-perform. The proof-of-work requires miners to locate a selection named a nonce, this sort of that once the block information is hashed combined with the nonce, The end result is numerically smaller compared to network's difficulty focus on.
Some black current market internet sites may perhaps look for to steal bitcoins from prospects. The bitcoin community branded 1 website, Sheep Marketplace, for a rip-off when it prevented withdrawals and shut down just after an alleged bitcoins theft.
It will likely be a protracted sequence of letters and numbers. Each individual wallet has another method of getting the general public Bitcoin deal with but most wallets are rather clear-cut about it. observe that you simply'll require your community bitcoin deal with and never your PRIVATE KEY (which is sort of a password on your wallet).
Now that you've got a wallet you happen to be probably roaring to go, however, if you truly want to make Bitcoin (income), you probably need to have to affix a mining pool. A mining pool is a gaggle of Bitcoin miners that mixes their computing ability to produce far more Bitcoins.
to start with, mining by using a CPU was the sole technique to mine bitcoins and was completed working with the initial Satoshi client. In The search to more secure the community and gain more bitcoins, miners innovated on lots of fronts and For many years now, CPU mining has been relatively futile. you may mine for decades using your laptop without the need of earning only one coin.
right after a long time of debate, the Segwit2x scaling proposal looks like it could play a task in – lastly – having bitcoin a move forward. though the coders and companies involved are actually performing not less than some in the development behind shut doorways, a means of working that some argue operates counter to bitcoin's worth proposition being a decentralized money that no […] The post Top Secret?
you are able to check out a tutorial on how to produce a protected wallet right here. The rationale is should you computer crashes therefore you would not have a copy of the wallet.dat file, you may shed all of your current Bitcoins. They received't go to another person, they will disappear permanently. it is actually like burning cash.
There continues to be a significant shortage of graphics cards in many portions of the entire world. points are receiving from hand in Russia, that Significantly is obvious. a whole new posting shows how cryptocurrency mining inside the nation is buying up.
Apart from computer software wallets, World wide web providers termed on the internet wallets provide equivalent performance but may very well be easier to use. In this instance, qualifications to access cash are stored with the web wallet supplier in lieu of to the user's hardware.
You will find a telegram Bot that you might have read about referred to as Cryptoping which helps altcoin traders and investors keep track of bullish and bearish tendencies in many digital assets. at the moment it can be no cost to utilize, nonetheless it options on becoming subscription based shortly.
Each and every miner can select which transactions are A part of or exempted from a block.[twenty five] A larger variety of transactions in a block doesn't equate to greater computational energy necessary to remedy that block.
Some Argentinians have acquired bitcoins to protect their price savings against substantial inflation or the possibility that governments could confiscate savings accounts.


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The S&P is trading in a fairly narrow trading range with 2835.24 the low and 2843.24 the high. That range has been able to keep the index between the 100 hour MA below at 2833.56 and the 50 hour MA above at 2845.84. The index is trading at 2836.20 currently.
On a break of either MA, should solicit more buying or selling in the direction of the break.
On the topside, moving above the 50 hour MA would look to fill the island gap left on Thursday's gap lower opening. The low on Thursday comes in at 2851.98. Failure to fill that gap is still bearish.
On the downside, in addition to the 100 hour MA is a pretty decent trend line at 2829. That trend line stalled the fall on Friday. A move below would look toward the 200 hour MA at 2808.68. The index price has not traded below the 200 hour MA since July 6th.
As I type, the index has moved down to test the 100 hour MA at 2833.53. The low just reached 2833.38.


 I. Lara Ibeas, R. Nasreddine, V. Person, S. Englaro, S. Le Calvé, Real-time monitoring of airborne VOCs using microdevices, Strasbourg, 1st international workshop MIGRATE, 1-2 July 2016 (oral presentation & proceedings with peer review).
 S. Le Calvé, Méthodes analytiques en temps réel pour la mesure des Composés Organiques Volatils en air intérieur, ATMOSFAIR 2016, Paris, 11-12 October 2016 (invited lecture & proceedings with peer review).
 C. Trocquet, I. Lara Ibeas, R. Nasreddine, P. Bernhardt, V. Person, M. Guglielmino, S. Englaro, S. Le Calvé, Formaldehyde and BTEX microanalysers: development for real time measurement, ATMOSFAIR 2016, Paris, 11-12 October 2016 (oral presentation & proceedings with peer review).
 I. Lara Ibeas, C. Andrikopoulou, V. Person, A. Sharifi, D. Valougeorgis, S. Le Calvé, Conception and development of microfabricated elements for microfluidic analytical devices, Sofia, 2nd international workshop MIGRATE, 29-30 June 2017 (oral presentation & proceedings with peer review).
 A. Sharifi, D. Valougeorgis, I. Lara Ibeas, S. Le Calvé, Modelling of gas flow with VOCs adsorption on a fixed bed preconcentrator, Sofia, 2nd international workshop MIGRATE, 29-30 June 2017 (oral presentation & proceedings with peer review).
 G. Coelho Rezende, D. Newport, S. Le Calvé, Micro Photo Ionization Detector for BTEX analysis: Rewiew report of performance influencing parameters, Sofia, 2nd international workshop MIGRATE, 29-30 June 2017 (oral presentation & proceedings with peer review).
 S. Khan, S. Le Calvé, D. Newport, Optical detection of BTEX: Review of different techniques, Sofia, 2nd international workshop MIGRATE, 29-30 June 2017 (oral presentation & proceedings with peer review).
 I. Lara-Ibeas, C. Andrikopoulou, S. Colin, L. Baldas and S. Le Calvé, Fabrication of a Silica-Coated Micro Gas Chromatography Column for VOC Separation, 5th European Conference on Microfluidics – μFlu18, February 28-March 2, 2018 – Strasbourg, France (oral presentation + Poster & proceedings with peer review). BEST POSTER AWARD.
 I. Lara-Ibeas, A. Rodríguez-Cuevas, C. Andrikopolou, A. A. Kassir, R. Kassem, L. Baldas, S. Colin, S. Le Calvé, A study of alternative granular adsorbent for Benzene and Toluene preconcentration, 3rd international workshop MIGRATE, Bastia, 27-29 June 2018 (oral presentation & proceedings with peer review).
 I. Lara Ibeas, A. Rodríguez-Cuevas, C. Andrikopolou, A. Ahmad Kassir, R. Kassem, L. Baldas, S. Colin, S. Le Calvé, Study of alternative adsorbents for preconcentration of benzene and toluene: improving the sensitivity of a miniaturized GC to ppt levels, µTAS 2018, Kaohsiung, (Taiwan), 11 – 15 Nov. 2018 (Poster & proceedings with peer review).


THE Big Screen is being brought to a special new audience.
In a bid to increase equality on the Rock, Leisure Cinemas will be making films available to the hearing and visually impaired.
Through Entertainment Captioning glasses and headphones, the cinematic experience can now be enjoyed by the hard of hearing and those short of sight.
There will also be will be sensory-friendly screenings for individuals with autism.


How can I change the email address or password of my TeamViewer account?
Re: How can I change the email address or password of my TeamViewer account?
To change your Email address for your account you could follow the steps below.
2.Please click your account at the top right hand side corner and choose "Edit profile"
4. Once saved, an email will be sent to the new email address. Once the link in the email is clicked, your account will have an updated email address/username.
If you cannot access the website, but are signed in to the Computers & Contacts in the TeamViewer application, please follow the steps below.
1. Click your profile in the upper left corner of the TeamViewer application.
2. Click the gear icon and select "Edit Profile" in the drop-down.
3. In the email field, type in your new email address.
NOTE: If you do not have access to attempt these options, the only other solution would be to create a new account.
Please be advised you would lose all contacts and other information associated with the original account.


When I announced in London recently that the USA was the world's biggest wine consumer and that the Chinese are tipped to drink more red wine than anyone else, it was clearly unexpected news for many.
Like many people, I was taken by complete surprise on Friday when the announcement came that Richard Siddle was leaving Harpers. When I read the news I felt like someone had just punched me in the stomach; I genuinely felt sick; and I felt I'd lost a true colleague and friend.
I can count on the fingers of one hand the number of times I've ordered Cognac. Like crystal meth and Bikram yoga, it's simply not something by which I've ever been tempted.
Tampon tax - are you pulling my plonker?
There's no need to ask anyone in the drinks industry whether or not they're fed up with the excessive tax on alcoholic beverages; this is a given! But 'tampon tax', really? Are you serious?
Anne-Claude Leflaive was sometimes described as one of Burgundy's "grandes dames" but there was nothing aloof about the woman who ran the most famous white wine domaine in the Côte de Beaune. Relaxed, friendly, yet intensely focused, Anne-Claude inherited the easy charm and sense of humour of her father, Vincent, who preceded her at the helm of this prestigious property.
Truth: The wine investment industry want you to believe this, after all it's in their financial interest that you buy into this belief, but try telling this to the clients that lost huge amounts of money in this unregulated market.
Wine investment must surely be the dumbest of all things to risk your money on. But where does it stand in the top ten dumb things to bet on; where you're sure to lose your money? Stephen Forward reveals his top ten dumb investment tips.
Though the Chapoutiers had their beginnings in Tain. Michel was quick to recognize the importance of the terroir - and eager to stop selling it to Guigal and put his own name on the label. Even more important, he wanted the wine he made to reflect the terroir, not any "style" of winemaking. So at the age of 24 in 1990 he was able to get a majority share in the family winery and the rest is history, with Michel owning vineyards in many places in France and the world.
Like their collection of boutique restaurants, this hotel also has a theme - it is meant to evoke the elegance and personalized hospitality of pre-war Mayfair. Though I wasn't around during that era, the hotel is extremely elegant and also extremely personalized. In some ways, one feels as if one is stepping inside a Merchant Ivory film. The uniforms are very evocative of some past era, and the gorgeously decorated interior is filled with pictures that seem to have captured the "popular" set of that day.


This non-interventional, minimal risk cohort study will enroll patients with Hemophilia A or B who are planning or have recently switched to a new Factor product. The study will have 2 Arms, prospective and retrospective. The Prospective Arm will enroll patients who plan to switch to a new factor. The Retrospective Arm will enroll patients who have recently switched to a new factor (within the previous 50 weeks). Patient will be seen at baseline and for up to 4 additional visits, and quarterly follow-up by phone. Required study visits will be planned to coincide with routine follow-up visits whenever possible.
Please note that Factor Replacement Products are not being provided by the study.
The primary objective is to assess and characterize the rate of inhibitor development within one (1) year or fifty (50) exposure days, whichever is first, after switching clotting factor replacement products in previously treated patients (PTPs) with hemophilia A or B.
Data collected will include eligibility, demographics, medical history, hemophilia history (clotting history, product history, genotype and family history), inhibitor history, co-morbidities at baseline (i.e., HIV, Hepatitis C.), detailed clotting factor replacement product(s) usage and switching plan, and reasons for switching factor products. Also targeted physical exams will be performed at baseline and during follow-up, and targeted concomitant medication data will be collected. Data collection will also include patient-reported outcome(s) after 1 year, bleeding events, surgeries, laboratory Inhibitor testing and details regarding testing methodology, pharmacokinetic (PK) data (if known), new diagnoses, and co-morbidities (targeted), Safety/Adverse Events using European Union Hemophilia Safety Surveillance (EUHASS) definitions.
This study will evolve to include any newly approved (since January 2013) factors as they come to market. Cohorts will be defined by the brand/type of new clotting factor replacement product approved after January 1, 2013. The current list of specific new Factor VIII replacement products include Eloctate® (Bioverativ) and NovoEight® (NovoNordisk); Factor IX replacement products include Alprolix® (Bioverativ), Rixubis® (Baxalta), and IXinity® (Emergent Biosolutions). Others are both now available and imminent and include: Adynovate®, Idelvion®, Afstyla®, Kovaltry® and Jivi®.
The over-arching rationale for this protocol is that a pragmatic study which is consistent with real world practices across a wide range of patients that is not principally tied to a particular manufacturer or product may be of great advantage to the entire hemophilia community.
Subjects on prophylaxis will be followed on study for up to 1 year. Each subject will be seen during a study visit or contacted by telephone at least once every 3 months (i.e., quarterly). Patients may participate for multiple 'cycles', if they switch factor products more than once while the study is actively recruiting.
Treatment regimen will be at the discretion of the subject's hemophilia caregivers. No treatment is being provided by the study.
Substudies A number of substudies are planned with pharmaceutical sponsors to collect information from patients about their products' use. Participation in these optional substudies (product-specific modules) will be planned to coincide with study visits. These modules will collect information from subjects about their perception and use of factor use/treatment, physical activity levels and other general health questions. These data will be collected via questionnaire, primarily via phone.
Immune tolerance therapy is excluded on study. This includes immunosuppressive treatments used to eradicate inhibitors. Steroid treatments for allergic disorders and asthma, are allowed.
All data collected will be entered into electronic case report forms (eCRFs) within the secure ATHN Study Manager system. Subject Identifiers (IDs) will be generated in Clinical Manager.
Reimbursement will be managed by each participating HTC. Most study centers will reimburse study subjects for travel and parking, but this varies by center.
Moderate or Severe Congenital Hemophilia A or B (FVIII or FIX clotting activity less than or equal to 5% of normal).
Able to give informed consent (by patient or parent/authorized guardian).
Previously treated with plasma-derived or recombinant clotting factor replacement products with at least 50 exposure days (as assessed either from direct clinical records in children under age 5, or by clinical history of dosing in older patients). For Arm B being enrolled retrospectively, this previous treatment must be prior to product switch under study.
Planning to switch, or recently switched within the previous 50 weeks, to a new brand or type of replacement factor VIII or IX, FDA approved after January 1, 2013.
Arm B only: Negative inhibitor screen within the last 6 months prior to switching.
Note: History of prior transient inhibitor or inhibitor eradicated by immune tolerance induction (ITI) are eligible.
Presence of any known bleeding disorder other than hemophilia A or B (i.e., patients with concurrent hemophilia and a second hemostatic defect are NOT eligible). Low Von Willebrand Factor (VWF) without VWF diagnosis are not excluded.
Presence of an active inhibitor >0.6 BU for factor VIII, > 0.4 BU for factor IX at the time of eligibility assessment. Detection of such an inhibitor at the baseline visit prior to dosing with the new product (Arm A), or after dosing with new factor dosing (Arm B), would result in early termination without other study assessments.
Immunosuppressive therapy (cyclophosphamide, mycophenolate, IVIG) within 90 days and Rituximab within 6 months; topical steroid treatments and short course steroids for asthma or allergy allowed.
Previous participation in Phase I, II or III interventional trials of the factor product being switched to.
Dr. von Drygalski is the Director of the Hemophilia and Thrombosis Treatment Center at UCSD (http://health.ucsd.edu/specialties/hemophilia/Pages/default.aspx) and her research interests involve basic, translational and clinical science in the field of hemostasis and thrombosis, specifically hemophilia. Dr. von Drygalski collaborates with Laurent O. Mosnier and John H.