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April 4, 2021 / 8:05 PM
All-Star guard Jrue Holiday agrees to 4-year extension with Bucks
By Connor Grott
Milwaukee Bucks guard Jrue Holiday (21) could make up to $160 million under the four-year extension. File Photo by Jim Ruymen/UPI | License Photo
April 4 (UPI) -- The Milwaukee Bucks and former All-Star guard Jrue Holiday reached an agreement on a four-year, $135 million contract extension, his agent confirmed Sunday.
Holiday's extension contains bonuses that could boost the deal to $160 million, according to ESPN and The Athletic. The extension also includes a player option for the fourth year in 2024-25.
"I'm a Buck for life," Holiday said in a video posted to the Bucks' official Twitter account Sunday. "Just know that I'm glad to be a part of Bucks Nation. Let's do some big things, man. I'm really excited."
The team later confirmed the extension but didn't disclose terms of the agreement.
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"Jrue is one of the top guards in the NBA and we are thrilled to sign him to this extension," Bucks general manager Jon Horst said. "Adding him to our team has made us better on both ends of the floor. He's an elite defender and an impactful offensive player with the ability to score, shoot and facilitate."
"I'm a Buck for life." - @jrue_holiday11 pic.twitter.com/wTVog8z7fc— Milwaukee Bucks (@Bucks) April 4, 2021
The 30-year-old Holiday is averaging 17 points, 5.4 assists and 4.6 rebounds this season, his first with the Bucks. He ranks second in the league in steals per game (1.8).
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The Bucks acquired Holiday in a trade with the New Orleans Pelicans this past off-season. Milwaukee gave up guards Eric Bledsoe and George Hill, first-round draft pick R.J. Hampton and two future first-round selections as part of the four-team swap.
In 751 career games with the Philadelphia 76ers, Pelicans and Bucks, Holiday has averaged 15.9 points, 6.3 assists and 3.9 rebounds. He was an All-Star selection in 2013.
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2004-10-29 Assigned to INDIAN OCEAN MEDICAL INC. reassignment INDIAN OCEAN MEDICAL INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: BRAIN, ARCHIBALD I. J.
2011-08-04 Assigned to THE LARYNGEAL MASK COMPANY LIMITED reassignment THE LARYNGEAL MASK COMPANY LIMITED ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: INDIAN OCEAN MEDICAL INC.
The disclosed laryngeal mask airway device includes an inflatable cuff, an airway tube, and a tab. The cuff defines a central opening at least when inflated. The cuff is insertable through a mouth of a patient to an inserted location within the patient. The cuff surrounds a glottic opening of the patient when inflated and at the inserted location. The airway tube extends from a proximal end to a distal end. The airway tube defines an internal passage. A sealed airway passage extends from the proximal end of the tube through the internal passage to the glottic opening when the cuff is inflated and at the inserted location. The tab is fixed to the airway tube near the proximal end of the airway tube. The tab is disposed outside of the mouth of the patient when the cuff is at the inserted location. The tab extends outwardly from the airway tube in a first direction when the cuff is at the inserted location. A second direction is perpendicular to a line extending from a nose of the patient to a chin of the patient. The first direction is transverse to the second direction.
The present invention relates to a laryngeal mask airway device. More specifically, the present invention relates to a laryngeal mask airway device having a tab disposed near the device's proximal end for facilitating position control of the device.
The laryngeal mask airway device is a well known device that is useful for establishing airways in unconscious patients. One popular laryngeal mask airway device has been marketed commercially for many yeas as the "Classic" by the Laryngeal Mask Company of Cyprus. Such devices are described for example in U.S. Pat. No. 4,509,514. The Classic is a reusable device and is guaranteed to survive at least forty sterilizations, and in practice these devices may generally be sterilized (and reused) more than forty times before becoming too worn for reuse. In recent years, attempts have been made to develop reduced cost, disposable, laryngeal mask airway devices. U.S. patent application Ser. Nos. 09/544,681 and 10/138,806 (Attorney Docket Nos. LMA-3 and LMA-12), which name the inventor of the present application, describe several embodiments of disposable laryngeal mask airway devices.
FIGS. 1A, 1B, and 1C show various views of a prior art disposable laryngeal mask airway device 100 when the cuff is inflated. FIG. 2 shows a partially sectional side view of device 100 when inserted into a patient. Referring to FIG. 1A, device 100 includes an airway tube 110 and a mask portion 130. Mask portion 130 includes a flat plate 132 and an inflatable cuff 134. Mask portion 130 extends from a proximal end 136 to a distal end 138. Mask portion 130 is attached to a distal portion 112 of airway tube 110. Device 100 also includes an inflation line 190 (shown in FIG. 1B) and a check valve 192 for selectively inflating and deflating cuff 134.
In operation, cuff 134 is deflated, and the mask portion is then inserted through the patient's mouth into the patient's pharynx. The device is preferably positioned so that distal end 138 of mask portion 130 rests against the patient's normally closed esophagus and so that the open end 140 (shown in FIG. 1C) of mask portion 130 is aligned with the entryway of the patient's trachea (i.e., the patient's glottic opening). After the mask portion is so positioned, the cuff is inflated and forms a seal around the patient's glottic opening and thus establishes a sealed airway extending from a proximal end 114 of airway tube 110 to the patient's trachea.
For convenience of exposition, the term "fully inserted configuration" shall be used herein to refer to a laryngeal mask airway device that has been inserted into a patient and has the following characteristics: (1) the distal end of the mask portion is pressed against the patient's normally closed esophageal sphincter; (2) the cuff is inflated and forms a seal around the patient's glottic opening; and (3) the airway tube extends from a proximal end located outside the patient's mouth to a distal portion that is coupled to the mask portion, the tube extending through the patient's mouth and the patient's natural upper airway so that the device provides a sealed airway extending from the tube's proximal end to the patient's lungs.
FIG. 2 shows a laryngeal mask airway device 100 in the fully inserted configuration. As shown, the distal end of the mask portion 130 is pressed against the patient's esophageal sphincter 210. Also, the open end of the mask portion forms a seal around the glottic opening 212 thereby enabling the device 100 to provide fluid communication with the trachea 214.
Although prior art disposable laryngeal mask airway devices have performed well, there remains a need for providing improved devices. In particular, there remains a need for providing a disposable laryngeal mask airway device that more reliably remains stably in the fully inserted configuration once the device has been inserted into a patient.
These and other objects are provided by an improved disposable laryngeal mask airway device. The device may include a tab disposed near the proximal end of the airway tube. When the device is inserted into a patient, the tab is disposed near the patient's upper lip. The tab is conveniently located so that adhesive tape may be attached to the tab and the patient's cheeks. The tape applies a force that biases the device generally into the patient and, in particular, biases the distal end of the device against the patient's esophageal sphincter. This allows the device to remain more stably in the fully inserted configuration and reduces the likelihood that regurgitated material will be aspirated into the patient's lungs. The device may also include a flange in the inflatable cuff for supporting the epiglottis and preventing the epiglottis from blocking the airway passage provided by the device.
Still other objects and advantages of the present invention will become readily apparent to those skilled in the art from the following detailed description wherein several embodiments are shown and described, simply by way of illustration of the best mode of the invention. As will be realized, the invention is capable of other and different embodiments, and its several details are capable of modifications in various respects, all without departing from the invention. Accordingly, the drawings and description are to be regarded as illustrative in nature, and not in a restrictive or limiting sense, with the scope of the application being indicated in the claims.
FIG. 1A shows a side view of a prior art disposable laryngeal mask airway device when the cuff is inflated.
FIG. 1B shows a perspective view of the posterior side of the prior art device shown in FIG. 1A.
FIG. 1C shows a perspective view of the anterior side of the prior art device shown in FIG. 1A.
FIG. 2 shows a partially sectional side view of the device shown in FIGS. 1A-1C when the device is in the fully inserted configuration.
FIG. 3A shows a side view of a disposable laryngeal mask airway device constructed according to the invention when the cuff is inflated.
FIG. 3B shows a perspective view of the posterior side of the device shown in FIG. 3A.
FIG. 4A shows an exploded side view of the airway tube of the device shown in FIGS. 3A and 3B.
FIG. 4B shows a top view of the connector portion of the airway tube taken in the direction of arrow 4B-4B as shown in FIG. 4A.
FIGS. 4C and 4D show end views of the connector portion of the airway tube taken in the direction of arrows 4C-4C and 4D-4D, respectively, as shown in FIG. 4A.
FIG. 4E shows a cross sectional view of the integral tube and backplate portion taken along the line 4E-4E as shown in FIG. 4A.
FIG. 5 shows a partially sectional side view of a disposable laryngeal mask airway device constructed according to the invention when in the fully inserted configuration.
FIG. 6 shows a partially sectional side view of a disposable laryngeal mask airway device constructed according to the invention when adhesive tape has been applied to the tab and to the patient's cheeks to help maintain the device stably in the fully inserted configuration.
FIGS. 7A-7G show alternative configurations of tabs constructed according to the invention.
FIG. 8A shows a perspective view of the anterior side of the device shown in FIG. 3A.
FIGS. 8B and 8C show sectional views of the device taken along the lines 8B-8B and 8C-8C, as shown in FIG. 8A.
FIG. 8D shows a view of the epiglottis support flange contained within the cuff shown in FIG. 8A.
FIG. 9 shows one type of support for preventing the epiglottis from occluding the airway passage provided by a laryngeal mask airway device.
FIG. 10 shows a sectional view of the device taken from the same vantage as FIG. 8C when the device is inserted into a patient and the patient's epiglottis is falling into the bowl shaped space defined by the device.
FIG. 11 shows a sectional view of another laryngeal mask airway device constructed according to the invention.
FIG. 12 shows a laryngeal mask airway device that has been partially inserted into a patient.
FIGS. 3A and 3B show side and perspective views, respectively, of an improved disposable laryngeal mask airway device 300 constructed according to the invention. Device 300 includes an airway tube 310 and an inflatable cuff 334. The cuff 334 extends from a proximal end 336 to a distal end 338. Device 300 includes an inflation line 390, coupled to proximal end 336 of cuff 334, and a check valve 392 for selectively inflating and deflating cuff 334. Device 300 also includes a tab 360, which is integrally attached to airway tube 310. As will be discussed further below, tab 360 advantageously facilitates maintaining device 300 stably in the fully inserted configuration.
FIG. 4A shows an exploded side view of airway tube 310 prior to attachment of cuff 334. As shown, airway tube 310 includes a connector portion 400 and an integral tube and backplate portion 450. FIGS. 4B, 4C and 4D show views of connector portion 400 taken in the direction of arrows 4B-4B, 4C-4C, and 4D-4D, respectively, as shown in FIG. 4A.
Connector portion 400 includes a proximal portion 410, a distal portion 420, and a flange 430 located between the proximal and distal portions 410, 420. Tab 360 is formed as an integral part of flange 430. Proximal portion 410 is cylindrical and is configured to couple to standard medical ventilating, or anesthetic devices. Distal portion 420 is oblong and is configured for telescopic insertion into a proximal end 452 of integral tube and backplate portion 450. Airway tube 310 is assembled by telescopically inserting distal portion 420 into the proximal end 452 of integral tube and backplate portion 450 until flange 430 contacts proximal end 452 as shown in FIG. 3A. Connector portion 400 is made of a rigid plastic or polycarbonate material. Connector portion 400 can be made, for example, by injection molding. Connector portion 400 is preferably a single monolithic piece that defines proximal portion 410, distal portion 420, flange 430, and tab 360. Flange 430 and tab 360 are preferably rigid, and are preferably rigidly fixed relative to the rest of connector portion 400. Integral tube and backplate portion 450 is also made of a plastic material such as PVC and is softer than connector portion 400. Integral tube and backplate portion 450 is characterized by a durometer of about 90 on the Shore A scale of hardness. Integral tube and backplate portion 450 may also be made by injection molding and is preferably a single monolithic piece.
FIG. 5 shows a view of device 300 in the fully inserted configuration. As shown, when device 300 is in the fully inserted configuration, tab 360 is disposed near the patient's upper lip. More specifically, the structure defined by flange 430 and tab 360 extends from the connector portion 400 of the airway tube past the bottom surface of the patient's upper lip towards the patient's nose, and tab 360 is generally proximal to the patient's upper lip. As will be discussed further below, locating tab 360 in this position when device 300 is inserted into a patient advantageously facilitates maintaining device 300 stably in the fully inserted configuration.
One problem with prior art disposable laryngeal mask airway devices is that they sometimes do not remain stably in the fully inserted configuration. In particular, in prior art devices it is difficult to insure that the distal tip of the device remains pressed against the patient's normally closed esophageal sphincter. Tab 360 advantageously facilitates maintaining device 300 stably in the fully inserted configuration, and, in particular, in maintaining firm contact between the distal end 338 of cuff 334 and the patient's normally closed esophageal sphincter.
As shown in FIG. 6, once device 300 is inserted into a patient, a strip of adhesive tape 500 may be attached to tab 360 and the patient's cheeks. Tape 500 preferably extends from tab 360 generally towards the patient's ears as shown in FIG. 6. Once tape 500 is attached to tab 360 and the patient's cheeks, the tape 500 applies a force to tab 360 generally in the direction of the arrow F shown in FIG. 6. Airway tube 310 translates this force from tab 360 to the distal end of the device. The force applied by tape 500 acts to generally pull device 300 into the patient and, in particular, to simultaneously bias (a) the tab towards the patient's mouth and (b) the distal end of the device in the direction indicated by the arrow D in FIG. 6. Biasing the distal end of the device in the direction of the arrow D advantageously insures that the distal end 338 of cuff 334 remains generally in firm contact with the patient's normally closed esophageal sphincter. Insuring that the distal end of device 300 remains in firm contact with the patient's esophageal sphincter advantageously reduces the likelihood of regurgitated material being aspirated into the patient's lungs during anesthesia.
FIGS. 5 and 6 show the position of the tab 360 with respect to the patient's head and upper lip when the device is inserted in a "normal" patient. However, the size and shape of patient's airway passages can vary somewhat unpredictably such that in some patients the tab may actually contact the upper lip and in other patients the tab may be spaced further away from the upper lip than is shown in FIGS. 5 and 6 when the device is in the fully inserted configuration. Nonetheless, the tab 360 still facilitates maintaining the device 300 stably in the fully inserted configuration when tape is attached to the tab 360 and the patient's head as shown generally in FIG. 6.
As noted above, and as shown in FIGS. 4A, 4B, and 4D, the distal portion 420 of the connector portion 400 of the airway tube is oblong. The cross section of the integral tube and backplate portion 450 is also oblong rather than cylindrical. FIG. 4E shows a cross sectional view of the integral tube and backplate portion 450 taken along the line 4E-4E as shown in FIG. 4A. As shown in FIG. 4E, the integral tube and backplate portion is generally oblong and defines two longitudinal folds 462 that extend along the left and right sides of the airway tube. As discussed in the above-identified copending U.S. patent application Ser. Nos. 09/544,681 and 10/138,806 (Attorney Docket Nos. LMA-3 and LMA-12), the longitudinal folds 462 advantageously help prevent the airway tube from collapsing, or forming a "kink", when the tube is bent so as to insert the device into a patient. As is also discussed in those copending applications, the patient's natural airway passage is generally oblong rather than cylindrical, and an oblong airway tube fits within the natural airway passage better than a cylindrical tube. Once an oblong airway tube has been positioned within a patient, the anatomical structures that define the patient's natural airway passage tend to prevent the tube from twisting, or rotating, in the direction generally indicated by the arrow R-R shown in FIG. 4E. In contrast, a device with a cylindrical airway tube rotates within the patient, in the direction indicated by the arrow R-R, much more easily.
Although the tab 360 may be used with a variety of laryngeal mask airway devices, it is most advantageously used with devices in which the cross section of the airway tube is oblong (e.g., as generally illustrated in FIG. 4E). Tape applied to the tab 360 applies force along the length of the device, or along a long axis of the device, as discussed above in connection with FIG. 6 and the oblong shape of the airway tube helps prevent the device from twisting about that axis.
Referring back to FIG. 3A, tab 360 extends from flange 430 at an angle theta (θ). Once choice for the angle theta is fifteen degrees. Referring to FIG. 4C, tab 360 extends from flange 430 by a height H. Once choice for the height H of tab 360 is about fifteen millimeters. Referring to FIG. 4A, the line L is parallel to the edges of the proximal portion 410 and the distal portion 420. Flange 430 extends from the proximal and distal portions 410, 420 in directions substantially perpendicular to the line L. In particular, flange 430 extends from distal portion 420 in a direction substantially perpendicular to line L for a distance D, and then angles off, by the angle theta (as shown in FIG. 3A) to define tab 360. One choice for the distance D is five millimeters.
Another way to describe the orientation of tab 360 with respect to the airway tube is that the tab extends from the wall of the tube, which defines the tube's internal airway passage, outwardly, or away from the internal passage. When the device 300 is in the fully inserted configuration, the tab extends from the tube wall outwardly towards the patient's nose. More generally, if an up-down direction is defined as being along a line extending between the patient's nose and the patient's chin, the tab 360 extends generally in the up-down direction when the device is in the fully inserted configuration.
In addition to facilitating holding device 300 stably in the fully inserted configuration, tab 360 also facilitates insertion of device 300 into a patient and also facilitates general manipulation of the device. The proximal end of the airway tube is typically grasped and manipulated as a laryngeal mask airway device is inserted into a patient. Lubricant is typically applied to facilitate passing the mask portion through the patient's natural airway. However, the lubricant can also make the proximal end of the airway tube slippery and difficult to handle. Tab 360, which extends outwardly from the proximal end of the airway tube, provides an additional surface that may conveniently be grasped during insertion and manipulation of the device. Tab 360 thereby generally facilitates insertion and manipulation of device 300.
As discussed above, device 300 has a single tab 360 that projects generally along the patient's upper lip when the device is in the fully inserted configuration. One reason this configuration is convenient is that the patient's upper lip and cheeks are generally immobile with respect to the rest of the patient's head. In contrast, the patient's lower lip and jaw are easily moved with respect to the head and accordingly provide a less stable platform for anchoring the device 300. However, although a single tab projecting along the upper lip is a convenient configuration, it will be appreciated that other configurations of tabs may be used. For example, devices constructed according to the invention can instead include a tab that projects downward along the lower patient's lower lip, or in some other direction. Alternatively, devices constructed according to the invention can include two tabs, one projecting along the upper lip and another projecting along the lower lip, when the device is in the fully inserted configuration, and adhesive tape may be fixed to either or both of the tabs and to the patient's cheeks or to other parts of the face.
Also, provision of tabs, such as tab 360, have been discussed in the context of disposable laryngeal mask airway devices. It will be appreciated that such tabs may also be usefully included according to the invention in non-disposable laryngeal mask airway devices.
Also, tab 360 has been discussed as extending substantially perpendicularly from the distal portion 420 for a distance D and then continuing to extend at an angle theta. It will be appreciated that these are merely preferred choices and that the geometry of the tab can vary considerably. For example, the tab need not extend in a direction substantially perpendicular to a line such as line L, and the tab may instead simply extend in a direction generally transverse, or crosswise, to such a line. Also, the tab need not extend in one direction for a first distance and then continue to extend at the angle theta as shown, and may instead simply be formed, for example, as a single planar piece. However, the tab 360 preferably extends for a distance that is short enough to prevent interference with bodily structures (e.g., short enough to prevent bumping into the nose) and that is long enough to permit easy and reliable attachment of adhesive tape, such that the tape, when applied, reliably biases the tab inwards towards the patient and the tape does not easily slip off of the tab.
It will be appreciated that tab 360 differs markedly from flanges used in prior art devices, such as those illustrated in FIGS. 1A-C. Such prior art flanges did not extend from the airway tube for a sufficient length, or with a suitable geometry, to permit attachment of adhesive tape to the flange and to the patient's head in any fashion that would reliably, and stably, apply a force biasing the device into the patient. It is presently believed that the tab must extend at least about fifteen millimeters from the airway tube to permit reliable attachment of adhesive tape to the tab and to the patient's head such that the tape will reliably remain in place and continuously apply a force to the tab so as to bias the tab towards the patient's head.
FIGS. 7A-7G show a variety of tab configurations embraced within the invention. Each of FIGS. 7A-7G is taken from an orientation similar to that of FIG. 4C. FIG. 7A shows a configuration similar to that of the tab shown in FIG. 4C (i.e., a single tab that projects upwards along the patient's upper lip when the device is in the fully inserted configuration). FIG. 7B shows a single tab configuration in which the tab projects downwards towards the patient's chin when the device is in the fully inserted configuration. FIG. 7C shows a two tab configuration in which the two tabs project upwards and downwards. FIG. 7D shows a single upwardly projecting tab in which the sides of the tab are parallel to one another instead of slanted. FIG. 7E shows a rounded tab that projects along the upper lip. The rounded tab is narrower at the base and wider at the top. If adhesive tape is attached to the base of the tab, the wider portion of the tab near the top can prevent the tape from sliding off of the tab. FIG. 7F shows a single tab configuration in which the sides of the tab slant towards a vertex above the end of the tab. The tab shown in FIG. 7F has a straight top edge. Alternatively, the top of the tab can be located at a vertex of the two slanting sides such that the top of the tab is pointed. As yet another alternative to any of the configurations shown in FIGS. 7A-7F, the edges of the tabs may be curved rather than straight. FIG. 7G shows a single tab that projects along the patient's upper lip when the device is in the fully inserted configuration. In FIG. 7G, the tab is cylindrical, or rod shaped, rather than flat.
FIG. 8A shows a perspective view of the anterior side of device 300. FIGS. 8B and 8C show sectional views of device 300 taken in the direction of arrows 8B-8B and 8C-8C, respectively, as shown in FIG. 8A. FIGS. 8A-8C show the cuff 334 in detail. As shown in FIGS. 8B and 8C, the cuff 334 defines a substantially circular cross section 806, when inflated, and as shown in FIG. 8A, the cuff 334 has a generally elliptical profile. The shape of the cuff 334 is substantially similar to the cuff used in the above-identified device that is commercially marketed as the "Classic". However, unlike the cuff used in the Classic, the cuff 334 also include an epiglottis support flange 810.
FIG. 8D shows an anterior view of epiglottis support flange 810 separated from the cuff 334. The epiglottis support flange 810 is preferably formed as an integral part of cuff 334 (e.g., by injection molding), and would not normally exist as a separate component as shown in FIG. 8D. However, the unnatural view of epiglottis support flange 810 separated from cuff 334 shown in FIG. 8D conveniently shows the shape of the flange 810. The epiglottis support flange 810 is formed from a thin ring-like sheet of material, and defines an outer perimeter 812, an inner perimeter 814, and a central aperture 340. While flange 810 is generally ring-like, it is not perfectly annular in that neither the inner perimeter 814 nor the outer perimeter 812 are circular. Rather, the inner perimeter 814 and the outer perimeter 812 are generally elliptical and match the generally elliptical profile of cuff 334. The flange 810, which is not inflatable, is joined to the inflatable portion of cuff 334.
As shown in FIGS. 8B and 8C, the inflatable portion of cuff 334 defines a circular cross section 806. The outer perimeter 812 of flange 810 is attached to an inner perimeter 802 of the inflatable portion of cuff 334. More specifically, the outer perimeter 812 of flange 810 is attached to the inflatable portion of cuff 334 at an equatorial location (i.e., half way between the top and bottom of the inflatable portion of the cuff, the orientations top and bottom being with reference to the orientation shown FIGS. 8B and 8C).
When cuff 334 is deflated, the presence of flange 810 does not add substantially to the thickness of the device. When cuff 334 is inflated, flange 810 defines a structure that can support the epiglottis when the device is in the fully inserted configuration.
As is known, when a patient is lying in a supine position (i.e., on their back facing upwards), and when a laryngeal mask airway device is inserted in the patient, the patient's epiglottis may fall into the bowl shaped space defined (at least in part) by the inflated cuff and obstruct the airway provided by the device. Various structures have been proposed for preventing the epiglottis from so obstructing the airway. FIG. 9 shows one such structure, which consists of a sheet of material 900 that extends across the central aperture defined by the mask, and which itself defines three apertures 910. Such structures have successfully prevented the epiglottis from blocking the airway passage provided by laryngeal mask airway devices, but such structures can also be difficult to fabricate.
FIG. 10 shows a cross sectional view of device 300 taken from the same orientation as FIG. 8C. However, FIG. 10 shows the device when inserted into a patient and with the patient's epiglottis 1000 falling into the bowl shape defined by the cuff 334. As shown, flange 810 supports the epiglottis 1000 and restricts the space within which the epiglottis 1000 can fall. Flange 810 generally prevents the epiglottis from falling so low as to contact the "floor" of the device, the floor being defined by the integral tube and backplate portion 450 of the airway tube 310. Most importantly, flange 810 prevents the epiglottis 1000 from obstructing the airway passage provided by the device 300, the airway passage being generally indicated by hatching in FIG. 10. Due to the oblong shape of the integral tube and backplate portion 450 of the airway tube 310, the airway passage provided by the device near the cuff is oblong (e.g., rather than cylindrical). The oblong shape of the airway passage decreases the likelihood that the epiglottis 1000 could block the passage. However, in addition to generally preventing the epiglottis 1000 from falling to the "floor" of the device and contacting the integral tube and backplate portion, the flange 810 also generally prevents the epiglottis 1000 from spreading out laterally (to the left and right, as shown in FIG. 10, towards the inflated cuff) and blocking the oblong airway passage provided by the device. Flange 810 also provides support for other anatomical structures, such as the arytenoids, that can fall into the bowl shaped space defined by the device.
When cuff 334 is inflated, the outer wall of the cuff tends to resiliently "spring" back to its original shape whenever any portion of the cuff is depressed, or biased in a particular direction (e.g., by an anatomical structure). This tendency of the cuff to resiliently spring back to its original shape is similar to the fashion in which a child's inflated balloon will return to its original shape when the balloon is squeezed and then released. Since the flange 810 is attached to cuff 334, when cuff 334 is inflated the flange 810 provides a springy, or resilient, support for anatomical structures, such as the epiglottis, that may come into contact with the flange 810.
The wall of the inflatable portion of the cuff 334 and the flange 810 may both be about 0.4 millimeters thick and may both be made of PVC material that is characterized by a durometer of about forty to fifty on the Shore A scale of hardness. The entire cuff, including flange 810 and the inflatable portion, are preferably formed simultaneously by injection molding.
As shown best in FIGS. 8B, 8C, and 10, the flange 810 preferably does not lie in a single plane. Rather, when the device is oriented as shown in FIG. 8B, the inner perimeter 814 is lower than the outer perimeter 812, and the flange is smoothly sloped between its inner and outer perimeters. This configuration helps prevent the flange 810 from presenting a sharp edge to the epiglottis 1000, should the epiglottis fall into the bowl shaped space defined by the device.
Device 300 has been disclosed as including tab 360 and epiglottis support flange 810. It will be appreciated that laryngeal mask airway devices may be constructed according to the invention that include (a) the tab but not the flange; (b) the flange but not the tab; and (c) both the tab and flange.
FIG. 11 shows a sectional side view of another laryngeal mask airway device 700 constructed according to the invention. Like previously discussed devices constructed according to the invention, device 700 includes airway tube 310, inflatable cuff 334, tab 360, and an epiglottis support flange 810. Device 700 also includes a rod 710. Rod 710 extends from a proximal end 712 to a distal end 714. Proximal end 712 defines a hook shape. Rod 710 extends past the connector portion 410 of the airway tube 310 such that the hook shaped proximal end 712 is disposed outside of the airway tube 310. The distal end 714 of the rod 710 is attached or hinged to the epiglottis support flange 810. As illustrated, the distal end 714 of rod 710 is attached to the portion of the flange 810 that is closest to the distal end 720 of the device 700. Rod 710 also defines a visible indicator mark 716 near the proximal end 712. Rod 716 can be fabricated from a flexible, inelastic material such as nylon. Rod 716 can be formed as a generally flat strip that is approximately four to five millimeters wide and 0.5 to one millimeters thick. As will be discussed below, rod 710 advantageously facilitates (1) insertion of device 700 into a patient; (2) confirmation that device 700 has been properly inserted in the fully inserted configuration; and (3) detection of problems that can occur during insertion of device 700 into a patient.
As discussed above, FIGS. 5 and 6 show laryngeal mask airway devices that have been placed in the fully inserted configuration. Placing such a device in the fully inserted configuration involves inserting the distal end of the device into the patient's mouth and then advancing the distal end through the patient's natural airway until the distal end is biased against the patient's normally closed esophageal sphincter. FIG. 12 shows a laryngeal mask airway device that has been partially inserted in a patient. As indicated generally in FIG. 12, during insertion, the distal end of the device temporarily curves generally in the direction indicated by the arrow R to enable the device to follow the patient's anatomical airway passage, and in particular to slide past the back of the patient's tongue 800. After temporarily curving in this direction, the device then straightens out again when it is advanced past the back of the tongue so that it can assume the profile generally illustrated in FIGS. 5 and 6.
Although the laryngeal mask airway device is generally simple to insert into a patient (e.g.,. as compared to an endotracheal tube), problems can occur during insertion. For example, instead of lodging against the esophageal sphincter, the distal end of the device sometimes enters the glottic opening such that the device extends partially into the patient's trachea. Also, the distal end of the device can become folded in the direction indicated by the arrow 1, or by the direction indicated by the arrow 2, during insertion and then fail to straighten out again such that the device never reaches the proper fully inserted configuration. Rod 700 helps detect when such undesirable conditions occur, helps prevent such undesirable conditions from occurring, and can sometimes help correct such undesirable conditions.
When device 700 is in the proper shape for allowing the device to assume the fully inserted configuration, the indicator mark 716 is adjacent to the proximal end of the connector portion 410 as shown in FIG. 11. However, if the device is bent or curved such that the distal end 720 of the device is displaced in the direction indicated by the arrow 1, the indicator mark 716 will no longer be adjacent to the proximal end of the connector portion 410 and will instead be displaced outside of the airway tube in the direction indicated by the arrow 4. Similarly, if the device is bent or curved such that the distal end 720 of the device is displaced in the direction indicated by the arrow 2, the indicator mark 716 will not be adjacent to the proximal end of the connector portion 410 and will instead be withdrawn into the airway tube in the direction indicated by the arrow 3. So, the indicator mark 716 of rod 710 can be used to detect when the device 700 is not in a proper shape for allowing the device to assume the fully inserted configuration. Such use of the indicator mark 716 allows detection of the most common problems associated with insertion of laryngeal mask airway devices.
In addition to using the rod 710 to detect the condition, or shape, of device 700, the rod 710 can also be used to control the shape of device 700. The proximal end 712 may be grasped and pushed or pulled relative to the airway tube 310 in the directions indicated by arrows 3 and 4. Pulling the proximal end 712 in the direction indicated by arrow 4 causes the distal end 720 of the device to move in the direction indicated by the arrow 1. Similarly, pushing on the proximal end 712 in the direction indicated by arrow 3 causes the distal end 720 of the device to move in the direction indicated by the arrow 2. Such motions of the rod 710 can facilitate insertion of the device into a patient. For example, pulling the rod in the direction indicated by arrow 4 can help the distal end of the device to curve around the back of the patient's tongue during insertion. Similarly, pushing on the rod in the direction indicated by arrow 3 can help straighten out the device. If it is not possible to correct the shape of the device by pulling or pushing on the rod, the position of the indicator mark 716 will indicate that the device 700 has not been properly inserted and the device can simply be withdrawn from the patient and inserted again.
In addition to the other advantageous features of tab 360 which have been discussed above, tab 360 also provides a convenient place for holding airway tube 310 while manipulating the proximal end 712 of rod 710. As discussed above, the distal end 714 of rod 710 can be attached to the epiglottis support flange 810. However, the distal end of rod 714 can alternatively be attached to the airway tube 310 itself. In such embodiments, it is generally advantageous to attach the distal end of the rod 714 to the distal most portion of the airway tube 310. Referring back to FIG. 4E, which shows a cross section of the integral tube and backplate portion 450, the portion 450 defines a notch 464 and a groove 466. As discussed in the above-identified copending U.S. patent application Ser. Nos. 09/544,681 and 10/138,806 (Attorney Docket Nos. LMA-3 and LMA-12, notch 464 and groove 466 facilitate insertion of an endotracheal tube through the laryngeal mask airway device. Notch 464 and groove 466 also provide guides for rod 710 that help keep the rod 710 centered within the airway tube and help prevent the rod 710 from being displaced laterally within the airway tube.
Device 700 has been disclosed as including tab 360, epiglottis support flange 810, and rod 710. It will be appreciated that laryngeal mask airway devices may be constructed according to the invention that include the rod with or without either of the tab and flange.
Since certain changes may be made in the above apparatus without departing from the scope of the invention herein involved, it is intended that all matter contained in the above description or shown in the accompanying drawing shall be interpreted in an illustrative and not a limiting sense.
C. a tab fixed to the airway tube near the proximal end of the airway tube, the tab being disposed outside of the mouth of the patient when the cuff is at the inserted location, the tab extending outwardly from the airway tube in a first direction when the cuff is at the inserted location, a second direction being perpendicular to a line extending from a nose of the patient to a chin of the patient, the first direction being transverse to the second direction.
2. A device according to claim 1, the first direction extending from the patient's chin towards the patient's nose.
3. A device according to claim 2, the tab defining two straight side edges and a top edge, the side edges defining lines that intersect at a vertex, the top edge being between the vertex and the patient's nose when the cuff is at the inserted location.
4. A device according to claim 1, the first direction extending from the patient's nose towards the patient's chin.
5. A device according to claim 4, the tab defining two straight side edges and a bottom edge, the side edges defining lines that intersect at a vertex, the bottom edge being between the vertex and a foot of the patient when the cuff is at the inserted location.
6. A device according to claim 1, the tab being disposed near an upper lip of the patient when the cuff is at the inserted location.
7. A device according to claim 6, the tab extending from the airway tube towards a nose of the patient when the cuff is at the inserted location.
8. A device according to claim 7, the tab including a first portion and a second portion, the first portion of the tab extending outwardly from the airway tube, the second portion extending from the first portion at an angle with respect to the first portion, the angle being different than one hundred eighty degrees.
9. A device according to claim 7, the airway tube including a connector portion and a second portion, the connector portion including a proximal portion, a distal portion, and a flange, the flange being disposed between the proximal and distal portions, the distal portion being inserted into a proximal end of the second portion, the proximal portion being cylindrical.
10. A device according to claim 9, the flange defining the tab.
11. A device according to claim 1, the tab being configured to permit application of adhesive tape to the tab and a face of the patient such that the tape, when applied, biases the tab towards the mouth of the patient.
12. A device according to claim 11, the tab being configured to permit application of adhesive tape to the tab, a left cheek, and a right cheek of the patient.
13. A device according to claim 11, the adhesive tape, when applied, biasing a distal end of the device against an esophageal sphincter of the patient.
14. A device according to claim 1, the tab extending from the airway tube for at least fifteen millimeters.
15. A device according to claim 14, the tab extending from the airway tube for fifteen millimeters.
16. A device according to claim 1, the tab including a first portion and a second portion, the first portion of the tab extending outwardly from the airway tube, the second portion extending from the first portion at an angle with respect to the first portion, the angle being different than one hundred eighty degrees.
17. A device according to claim 1, the tab being substantially rigid.
18. A device according to claim 1, a cross section of the airway tube being oblong.
19. A device according to claim 1, the device further including an epiglottis support flange.
20. A device according to claim 1, the cuff defining an inner perimeter that bounds the central opening, the device further including an epiglottis support flange, the flange defining an outer perimeter and an inner perimeter, the outer perimeter of the flange being fixed to the inner perimeter of the cuff, the inner perimeter of the flange defining a second opening, the second opening being smaller than the central opening.
B. an airway tube extending from a proximal end to a distal end, the airway tube including a tube wall that defines an internal passage, a sealed airway passage extending from the proximal end of the tube through the internal passage to the glottic opening when the cuff is inflated and at the inserted location, the airway tube defining a tab, the tab being disposed outside of the mouth of the patient when the cuff is at the inserted location, the tab extending outwardly from the tube wall in a first direction when the cuff is at the inserted location, a second direction being perpendicular to a line extending from a nose of the patient to a chin of the patient, the first direction being transverse to the second direction.
22. A device according to claim 21, the tab extending from the tube wall in the first direction sufficiently far to permit application of adhesive tape to the tab and to a head of the patient when the cuff is at the inserted location such that the adhesive tape, when applied, biases the tab towards the head of the patient.
D. applying adhesive tape to the tab and to a head of the patient such that the tape biases the tab towards the head of the patent.
24. A method according to claim 23, wherein applying adhesive tape comprises applying the tape to the tab and to a face of the patient such that the tape biases the tab towards the mouth of the patient.
25. A method according to claim 23, wherein applying adhesive tape also biases a distal end of the device against an esophageal sphincter of the patient.
C. a flange fixed to the airway tube near the proximal end of the airway tube, the flange being disposed outside of the mouth of the patient when the cuff is at the inserted location, the flange including a first portion and a second portion, the first portion of the flange extending in a first direction outwardly from the tube, the second portion extending from the first portion at an angle with respect to the first portion, the angle being different than one hundred eighty degrees.
C. an epiglottis support flange, the flange defining an outer perimeter and an inner perimeter, the flange comprising a solid sheet of material extending between the outer and inner perimeters of the flange, the outer perimeter of the flange being fixed to the inner perimeter of the cuff, the inner perimeter of the flange defining a single opening, the single opening being smaller than the central opening.
28. A device according to claim 27, the epiglottis support flange being part of the cuff.
29. A device according to claim 27, the device further including a tab fixed to the airway tube near the proximal end of the airway tube, the tab being disposed outside of the mouth of the patient when the cuff is at the inserted location, the tab extending outwardly from the airway tube in a first direction when the cuff is at the inserted location, a second direction being perpendicular to a line extending from a nose of the patient to a chin of the patient, the first direction being transverse to the second direction.
30. A device according to claim 29, a cross section of the airway tube being oblong.
MXPA06002628A MXPA06002628A (en) 2003-09-08 2004-09-01 Laryngeal mask airway device with position controlling tab.
ES04764731T ES2356349T3 (en) 2003-09-08 2004-09-01 Passing device laryngeal mask airway position control.
CH706616A2 (en) * 2012-06-04 2013-12-13 Deltona Innovations Ag Laryngeal mask with a supraglottic tube.
ES2214878T3 (en) 2004-09-16 A device air laryngeal mask.


text:
Marshalls products to protect and serve Northamptonshire Police
Marshalls, the UK's leading hard landscaping manufacturer, has partnered with Northamptonshire Police to help secure its new headquarters in Kettering.
A range of products from Marshalls' Landscape Protection portfolio has been provided to help secure the exterior of the building, including Geo bollards and seating, a Pluto cycle shelter and bespoke concrete planters. The full range of products helps protect public spaces while also fitting seamlessly into the surrounding landscape.
The new Northern Accommodation Building has been developed to replace the outdated police stations in Kettering and Corby and provides modern, fit-for-purpose custody facilities and office accommodation to better support operational policing in the north of the county.
The site comprises a 20-cell custody suite and three-story office building, which can accommodate more than 300 officers and staff. It will house both Northamptonshire Police and Northamptonshire Fire and Rescue Service.
Jaz Vilkhu, Managing Director of Marshalls Landscape Protection, said, "The specification required to protect facilities such as the Northern Accommodation Building means only the most secure products will do. However, it is also vital they fit into and complement the surrounding landscape. Our Landscape Protection products achieve the desired aesthetic aim while also protecting against any potential accidental or criminal damage, ensuring the new building is fit for the future."
Kate Perriss, Estates Manager at Northamptonshire Police, said, "While our new base is state-of-the-art on the inside, we also recognised the importance of securing the building's exterior too. The products provided by Marshalls' Landscape Protection help us do this effectively and subtly, without making the building imposing and enabling us to provide a modern office and workplace to support policing in the north of the county."
Marshalls works with the public sector and businesses to manufacture and recommend Landscape Protection products with the appropriate safety ratings. It employs approximately 2500 people across the UK. The FTSE 250-listed company's Landscape Protection product line consists of specially designed street furniture, which includes benches, planters, litter bins, cycle stands and bollards. These are used to create safe, attractive spaces that protect the public, while integrating seamlessly into the surrounding environment.
Motorola launches cloud-based digital evidence management service
New response vehicle to make lifesaving difference to North West Air Ambulance Charity
COPTRZ launches industry-first drone detection system for police forces
Yorkshire Ambulance Service launches life-saving app
Support your local air ambulance during National Air Ambulance Week
Met Police appoints two new Assistant Commissioners
Preferred candidate for Cheshire Police Chief Constable announced

redpajama_set_name: RedPajamaCommonCrawl


the number of people using it.
whether there are garbage disposal systems.
if there are individuals who are on strong medications that kill the bacteria.
The septic system will be damaged if you wait until it backs up. Regular maintenance is essential.
Some companies claim to sell products that will eliminate the need to pump your system. Biological or chemical additives will, in the end, result in a much higher price tag. There is no replacement for a professional!


text:
cask 'wifispoof' do
  version '3.4.2'
  sha256 'f97d70666a37cde907392378366256f0bf99bde01a573e90d72facedd5ac8620'

  # sweetpproductions.com/products was verified as official when first introduced to the cask
  url "https://sweetpproductions.com/products/wifispoof#{version.major}/WiFiSpoof#{version.major}.dmg"
  appcast "https://sweetpproductions.com/products/wifispoof#{version.major}/appcast.xml"
  name 'WiFiSpoof'
  homepage 'https://wifispoof.com/'

  auto_updates true

  app 'WiFiSpoof.app'
end

redpajama_set_name: RedPajamaGithub


text:
Sheridan on Fylde win
After Tuesday night's 3-1 victory at Fylde, manager John Sheridan stated that the Spireites' first away win of the season was a well-deserved one.
"I'm chuffed to bits for the players and the supporters who travelled," he said to Spireites Digital.
"I thought we were really good all game, even in the first half I felt very comfortable.
"I think we upped our game in the second half.
"We scored some good goals and I thought the work ethic was there.
"If you play like that you've got a good chance to win games in this league.
"I think we thoroughly deserved it."
Curtis Weston opened the scoring before substitute Mike Fondop notched a brace and the Chesterfield boss was full of praise for his goal scorers.
"Curtis gives you 120%," claimed Sheridan.
"He's an experienced player and his attitude in training is unbelievable.
"Mike has come on and affected the game.
"They were two good goals and he's a handful.
"A great header and a great little finish."
The Spireites will be aiming to get a run of victories together when they travel to Wrexham next Tuesday night.
Sheridan put forward that he wants the players to savour the victory, however, he explained that he is fully aware that supporters will be eager for more success.
"I just want the players to enjoy it," said Sheridan.
"You can see that the supporters were relieved.
"They want more and we need to try and give them more."


text:
Q: How to "hardcode" a shapefile's CRS? I am using some shapefiles in an agent-based model I am developing using MASON (a Java-based modeling framework). All the shapefiles I am using have a EPSG: 27700 OSGB 1936/British National Grid CRS.
I have just started to test my model using a different study area and the model is visualising the shapefiles with a different CRS to what appears in QGIS/ArcGIS.
The shapefiles are clipped from the same larger shapefiles that I have used for the other study areas and those display as expected using EPSG: 27700.
I've been told that:

GeoMason is "blind" to the CRS. It simply imports the geometric
  character of each feature, disregarding projections and whatnot. There
  is no problem with this approach, you just have to make sure every
  data set you feed to a particular simulation refers to a single CRS.
GeoMason exports rasters and vectors without setting CRS information,
  although it is tacitly the same CRS as the input data. A pasteriori
  you might hardcode the CRS yourself using a tool like GDAL/OGR (note
  that this is not possible for certain formats like ArcGRID).

I have no idea how to "hardcode" the CRS myself and have never used GDAL/OGR and only have limited Python experience.

A: I suggest to disable On-the-fly-reprojection in QGIS. If the data looks good then, it works ok with Mason too.
And make sure to switch Settings -> Options -> CRS, CRS for new layers to Prompt for CRS to avoid unwanted CRS assignment.

redpajama_set_name: RedPajamaStackExchange


text:
Salvation Army Stores in Stearns County, Minnesota
Salvation Army Stores
There are 2 Salvation Army Stores in Stearns County, Minnesota, serving a population of 155,300 people in an area of 1,343 square miles. There is 1 Salvation Army per 77,650 people, and 1 Salvation Army per 671 square miles.
In Minnesota, Stearns County is ranked 26th of 87 counties in Salvation Army Stores per capita, and 23rd of 87 counties in Salvation Army Stores per square mile.
List of Stearns County Salvation Army Stores
Find Stearns County, Minnesota Salvation Army stores.
Salvation Army Saint Cloud 55 Park Avenue South St. Cloud, MN
Salvation Army Waite Park 506 Division Street Waite Park, MN
About Stearns County Salvation Army Centers
The Stearns County Salvation Army is a branch office of the international Christian, non-profit human services organization whose mission is focused on aiding the poor and other people in need in Stearns County, MN. The organization takes an evangelical approach while providing a vast array of human services through both established, permanent programs as well as in response to disasters and other public emergencies.
You may contact the Salvation Army for questions about:
Stearns County Salvation Army stores and locations
Making donations and volunteering
Stearns County substance abuse programs
Children and elderly care programs
Disaster relief and emergency preparedness
Salvation Army Stores near Stearns County
Other Stearns County Offices
Goodwill Stores
Social Security Offices
Veterans Affairs Departments
WIC Offices


I have learned from my participation in "Changing the Race Dance" that I can keep moving in love and wisdom, working to unravel and loosen the hold racism has on me. This workshop, led by visiting Artist-Scholars Soyinka Rahim and Cynthia Winton-Henry on Apr 20-21, was presented as a part of Interplay's Body Based Methods + Performance Forms and co-sponsored by RCWMS.
As a white, transgender/gender non-conforming (T/GNC) person of Bohemian and German descent, paying attention to how I may move in the world in less harmful ways can bring liberation, respectful interconnection and joyful engagement to me and to us all.
Before participating in "Changing the Race Dance," I wondered, how I can discern what harm is really happening to my body, harm that I may be passing on to others? I feel that we as people move through emotionally charged, hot button issues throughout the day due to experiences of oppression in our daily lives. How do I release the pain and follow the wisdom inside of me for healing and for renewal for me and for those I have harmed?
In the workshop we practiced large, expansive, free flowing movements of play. I learned to follow my body's lead, bringing inter-connected integrity into the dance, freeing my body from staid, tight, self-enclosing, routine movements. Before this workshop, I hadn't questioned nearly enough what I assumed others expected, or actually anticipated, from me.
In the face of the reparation and honoring of grief required by the racist oppression in which I have taken part, that which I might feel too much to bear, I have learned that I can keep moving. The rhythm is inside of me, it is the life-giving love that fills me and binds me through the energy of love to all people and all things. In Soyinka Rahim's words, "BIBO" (Breathe In, Breathe Out) Love.
I have learned from my participation in "Changing the Race Dance" that I can keep moving in love and wisdom, working to unravel and loosen the hold racism has on my ability to live for racial equity and transformation. The dance goes on.


← It's not just me!
After Mimi's candy making party, KT got the bug. She wanted to make more candy. Lots and lots more to give to her family, friends and hapless strangers on the street. What kind of monster had we created? So we took a trip to our local craft store and stocked up on some festive candy molds and all the fixins' to make perfect candy. Of course, being The Season and all we ended up doing a bit more shopping and got home quite late. So we struck a deal that they could start as soon as both girls had awakened on their own and no burning the house down as I didn't want to be woken up.
I'm not sure it was quite light out when KT came into my room the next morning asking if she could please wake up her sister so they could get started. She already knew that the answer was that she would just have to wait. And wait she did. Mimi didn't wake up until nearly 11:00. We probably would have taken pity and woke Mimi up, but it was just too much fun to watch KT agonize about it. Yes, I know, we are cruel parents.
Then the fun finally began. KT was so deliciously meticulous about getting her candy just right. She used small paint brushes, bamboo skewers and squeeze bottles to do her work. Naturally, her father kept stopping by the table trying to eat some of the masterpieces. Not because he actually liked candy, but because he knew it would drive KT nuts. She told him time and again that she would make one for him later.
So between our two wicked children, they did make a very special candy for their daddy. Hidden inside the festive green and red candy was a little extra flavoring in the form of Bertie Bott's Every Flavor Beans. If I recall correctly they gave him earwax, rotten egg and vomit flavored jelly beans. They so sweetly brought him the candy while he happened to be distracted on the phone. With a grin, he took a huge bite and we curiously watched his face transform into one of horror. He didn't want to offend our budding chefs so he managed to calmly say though gritted teeth that he thought there might be something wrong with the candy. His face turned to astonishment when we burst into peals of laughter.
This entry was posted in A Family Affair, KT, That Man O' Mine. Bookmark the permalink.
Oh my goodness!! sounds like the girls really have learned how to deal with shaun!


What's wrong with the foreign aid programs of China, Venezuela, and Saudi Arabia? They are enormously generous. And they are toxic.
My friend was visibly shaken. He had just learned that he had lost one of his clients to Chinese competitors. "It's amazing," he told me. "The Chinese have completely priced us out of the market. We can't compete with what they are able to offer."
Of course, manufacturing jobs are lost to China every day. But my friend is not in manufacturing. He works at the World Bank.
His story begins in Nigeria. The Nigerian government operates three railways, which are notoriously corrupt and inefficient. They are also falling apart. The World Bank proposed a project based on the common-sense observation that there was no point in loaning the Nigerians money without also tackling the corruption that had crippled the railways. After months of negotiation, the bank and Nigeria's government agreed on a $5 million project that would allow private companies to come in and help clean up the railways. But, just as the deal was about to be signed, the Chinese government offered Nigeria $9 billion to rebuild the entire rail network — no bids, no conditions, and no need to reform. That was when my friend packed his suitcase and went to the airport.
It is not an isolated case. In recent years, a variety of wealthy, nondemocratic regimes have begun to undermine development policy through their own activist aid programs. Call it rogue aid. It is development assistance that is nondemocratic in origin and nontransparent in practice; its effect is typically to stifle real progress while hurting average citizens.
China has backed such deals throughout Africa; its funding of infrastructure there has boomed from $700 million in 2003 to between $2 and $3 billion for each of the past two years. Indeed, it is a worldwide strategy. In Indonesia, Beijing agreed to expand the country's electrical grid. Too bad the deal calls for building plants that use a highly polluting, coal-based Chinese technology. No international agency would have signed off on such an environmentally unfriendly deal. In the Philippines, the Asian Development Bank, which lends money at low interest rates to poor countries, had agreed to fund Manila's new aqueduct. It too was suddenly told that its money was no longer needed. China was offering lower rates and fewer questions.
What's behind this sudden Chinese drive to do good around the world? The three short answers are: money, access to raw materials, and international politics. The coffers of China's Central Bank are bursting with nearly $1.1 trillion in foreign exchange reserves — the world's largest. Beijing is increasingly leveraging this cash to ensure its access to raw materials while also boosting international alliances that advance China's growing global influence. What better than a generous foreign-aid program to ensure the goodwill of a petropower like Nigeria or a natural resource-rich neighbor such as Indonesia?
China is not the first country to rely on aid as a tool to advance its interests abroad. The Soviet Union and the United States spent decades giving "development aid" to dictators in exchange for their allegiance. Even today, American largesse to Egypt and Pakistan is rooted in geopolitical calculations. But, beginning in the 1990s, this system slowly began to improve. With greater media scrutiny, many developed countries were shamed into curbing these practices. Today, the projects of organizations like the World Bank are meticulously inspected by watchdog groups. Although the current system is far from perfect, it is certainly more transparent than when foreign aid routinely helped ruthless dictators stay in power.
Nor is China the only regime offering rogue aid. President Hugo Chávez has not been shy in using his nation's oil-fueled international reserves to recruit allies abroad. Indeed, Venezuela's ambassador to Nicaragua, explaining his country's large aid packages to the region, bluntly announced in early January, "We want to infect Latin America with our model." Thus, hopes for Cuba's opening as a result of Fidel Castro's demise and the island's bankruptcy will likely be dashed by the roughly $2 billion in rogue aid that Chávez supplies to Cuba every year. Worse, his generosity ultimately harms Cubans who, because of these artificial lifelines, will be forced to wait even longer for the indispensable reforms that will bring their society opportunities for true prosperity.
Iranian aid to Hamas in Palestine or Hezbollah in Lebanon is equally damaging to the people there. Clearly, this financial support has boosted Iran's influence in the region. Far less clear is whether average Palestinians and Lebanese will ever be better off thanks to Iran's generosity. The same can be said of Saudi Arabia's massive overseas educational aid program. Are Pakistani boys whose parents cannot afford to send them to school well served by attending Saudi-sponsored religious schools that fail to equip them with the skills needed to get a job? They are surely better off going to any school than being in the streets. But why should these be the only two options? Why can't the Saudis fund education, the Chinese pay for infrastructure, and Chávez help Cuba's economy without also hurting poor Pakistanis, Nigerians, or Cubans?
Because their goal is not to help other countries develop. Rather, they are motivated by a desire to further their own national interests, advance an ideological agenda, or sometimes line their own pockets. Rogue aid providers couldn't care less about the long-term well-being of the population of the countries they "aid."
What we have here — in states like China, Iran, Saudi Arabia, and Venezuela — are regimes that have the cash and the will to reshape the world into a place very different from where the rest of us want to live. Although they are not acting in concert, they collectively represent a threat to healthy, sustainable development. Worse, they are effectively pricing responsible and well-meaning aid organizations out of the market in the very places where they are needed most. If they continue to succeed in pushing their alternative development model, they will succeed in underwriting a world that is more corrupt, chaotic, and authoritarian. That is in no one's interests, except the rogues.


The Annual Dinner of the South Devon Railway Association was held at The Dainton Park Golf Club, in Newton Abbot on Saturday, 19th January 2013. The organisers on behalf of the Association were Howard and May Webster. The cold and snowy weather had unfortunately precluded some of our members attending this year, but the attendance was just over 100. Notable absentees were Sheila and David St. John Thomas, our Patron, but then this was very justifiable in view of them not taking the risk of travelling all the way South from their home in Nairn, in the North of Scotland.
The food was of the usual very high standard, and served efficiently by the Dainton Park team. The Speaker was Fiona Iris, a Watch Leader with the Brixham Coastguards, who gave us a brief history of the profession, and outlined their present-day activities. A Draw held on the night, led to many collecting small prizes, but probably the highlight was the chance to ride pillion on a Harley Davidson Motor Cycle.
Before holding the main Annual Draw, the proceeds for which are once again being devoted to assist with the Refurbishment of the SDRA Autocoach W228W, the Chairman outlined the history of the Patrons' Cup. It was noted that this was the tenth year that it had been awarded – previous winners being Bob Saunders (posthumously); Jo Stokes; Allan Lovegrove; Peter Dunning; Nick Perring; Gill and Mike Comben; Chris Woodland; Trevor Stokes and Ron and Margaret Reynolds. The Chairman, using a copy of Bulliver No. 80 issued in the Spring of 1983, highlighted that the Chairman at that stage was Ron Reynolds, the Bulliver Editor was Richard Jones and the Volunteer Footplate Roster Officer was Chris Woodland. All this was by way of getting to announcing the winner of the Cup for the year of 2012, which he declared as Trevor Hodgson – the same man as had been the Project Officer in 1983, and who has served the Association in many ways ever since. The current President, Ron Reynolds, duly made the presentation on behalf of the Patron – see the photograph above.


Michele Brown, president of Choose New Jersey (front center), speaks to chairs, associate deans, and directors from academic support areas about making more New Jersey-based internships available to college students.
Caldwell, N.J., Jan. 29, 2016 – Michele Brown, president and CEO of Choose New Jersey, visited Caldwell University on Jan. 26 to discuss ways to make more New Jersey-based internships available to college students. Speaking to chairs, associate deans, and directors from academic support areas, she said that Choose New Jersey's slogan is "highly educated and perfectly located" and that New Jersey has numerous successful companies and nonprofits where students can find enriching internships and start their careers.
Michele Brown (right), president of Choose New Jersey, was invited by Dr. Barbara Chesler (left), vice president of academic affairs, to speak about Choose New Jersey's work in making more internships in the Garden State available to students.
To encourage New Jersey students to stay in the state for their college education, Brown said Choose New Jersey has launched Smart Students, a pilot program to provide the best and brightest students from Newark and Camden with scholarships and paid internships. According to Choose New Jersey, some 30,000 students leave New Jersey for out-of-state colleges. Brown stressed the importance of encouraging students to stay in the state for higher education so they will remain after graduation, become leaders and contribute to New Jersey's economic growth, which will attract more businesses to the Garden State.
She encouraged university personnel to reach out and to engage in conversations with the business community, form relationships and invite successful alumni to campus to talk to students. We are "enormously proud of our state and all the opportunities that are available, but it is incumbent on us to sell our story," she said.


NOT ALL ROADS LEAD TO HEAVEN !
Someone will say, "We are all just travelling different roads to the same place." The problem with that statement is, all but one of the roads man travels leads to eternal damnation, not eternal bliss.
Jesus said that there is only one way to get to Heaven, and that is through faith in Him.
Although there are many sincerely-held beliefs about life and the hereafter, the Bible says: "There is a way which seemeth right unto a man, but the end thereof are the ways of death" (Proverbs 14:12).
GOD has made a way that we can all be 100% sure we're going to heaven when we die.
You may have reached this site through a Baptist Church Web Page, but remember, the following is not simply a "Baptist" teaching, it is a Bible Teaching.
If you Honestly from a Believing Heart want Jesus to be your Saviour, Pray and Ask Him.
I know I am a sinner and I know that I cannot save myself. I believe that you died on the cross for my sin, that you were buried and that you rose again on the third day. I accept your payment for my sin and ask that you would forgive my sin and be my Saviour. Thank you for saving me and giving me eternal life and a future home in Heaven with you.
ALLOW the Holy Spirit to help you grow in grace by attending church regularly, reading God's Word every day, and praying to God always.


Wandering through the Southeast Asian galleries at New York's Metropolitan Museum of Art over Christmas, I was struck by the glory of the bronzes produced in Java more than 1,000 years ago. And of their prescience. This depiction of the Shakyamuni Buddha suggests that in 10th Century Java, the Gods were already playing with their Blackberrys.


Aam Sandesh is my choice for A under my series of Protein Rich Dishes, featuring A to Z Bengali Sweets. I initially wanted to make Aamshotto, which is Mango leather Rollups, stuffed with Sandesh. Though I was tempted much, I decided starting the series with a simpler dish will be easy for me.
I was lucky that I decided on Aam Sandesh as we still had the fruit in season or rather the fag end of the season. I managed to freeze some Banganapalli and used it for this Sweet. When I was reading about the various options I had, I read that Bengalis are very fond of Aam Sandesh, making the best of the seasonal fruit.
Aam Sandesh was the first dish I made for this series. I was so glad because normally when cooking for Mega BMs, I end up cooking a dish that comes way last. Since I had the fruit frozen, I also wanted to ensure I made this soon. So this was prepared without being clubbed with rest.
When we talk about Sandesh, there are three types of Sandesh, namely Kancha Sondesh/ Kancha Golla, Norom Paak and Kora Paak. Kora Pak requires highly skilled knowledge and hence never tried at home. Even I haven't come across any such recipe for Kora Pak online for my requirement. I have covered both the first types under this series.
I made Sandesh many years ago after much research on the topic. Still, I wanted to document my new found knowledge in this series of A to Z Bengali Sweets on how to prepare soft Chhana for getting soft and silky Bengali Sweets and the method involved in kneading the Chhana.
Puree the mangoes and sieve to ensure there are no lumps.
Heat a nonstick pan, add the mango puree and cook till it is done. This takes about 5 to 7 mins on high.
Add little sugar and combine well, continue cooking.
Next, add the chhana and combine. Continue cooking for a while till everything is mixed.
Next, add the remaining sugar and let the mix get cooked for another 5 mins.
Aam Sandesh combines the best of the season mangoes with soft Paneer / chhanna to result in a melt in the mouth sweet. Very easy and simple to make Bengali Sweet.
Add sugar and combine well, continue cooking.
OMG… A to Z bengali sweets? Wow Valli. 🙂 Awesome. We are still getting some mexican mangoes here. Will definitely try this. Looking forward to other sweets as well.
Paneer is such a wonderful protein based ingredient to work with. I am really excited to seeing A to Z Bengali paneer sweets at one place. Hats off to you for making 26 sweets for the month. The Aam sondesh looks mouth watering.
Sondesh is a light and mild sweet and I am sure the mango flavour must have been so delicious . I am really looking forward to this series , all sweets in one place . What more can we ask for . Fantastic Valli .
Wow what a theme… I am still wondering how you managed to come up with A-Z bengali sweets. . . Hats of to Valli for taking up such challenges. Definitely looking forward to all the recipes. Aam sondesh is very inviting and you have done a lot of research in this area.. Loved reading the post..
Hats off to you Valli for such a beautiful theme selection. I love Bengali sweets and I am sure I will end up bookmarking all your recipes. This aam sandesh is a perfect start to the BM. It looks absolutely inviting..
Srivalli, a to z Bengali desserts sounds so challenging to me!! I am now trying to guess the dishes for the difficult alphabets. Anyways, this dish is such a great one to start the series with. I have never made this but my kids will love this for sure.
I have been drooling ever since I read about your theme. Can't wait for all the awesome sweets. Aam Sondesh is a delectable way to begin. It looks beautiful and lip smacking.
So so excited to read your posts Valli… A- Z Bengali sweets ,I am sure your kids are going to cherish each and every dish.. Aam Sandesh is a beautiful start!!
wow Valli! Looking forward to the virtual sweets fest! Love how you have challenged yourself to make the theme more interesting!!
Its seriously amazing to stick with a theme and you came out with A-Z series,am wowwing here. Thats a fabulous pick and this aam sandesh looks absolutely stunning. Delightful dessert.
A-Z Bengali Sweets… now that's definitely something to look forward to. Lovely Aam Sandesh, I've never made it but have tasted it. Its on my list for this month.
Its really amazing to have A to Z mithai in one region. Love bengali mithai.. its mine favourite. My eyes are on your blog… sondesh looks beautiful.
Hats off to your theme Valli.Going to bookmark so many of your recips as we like Bengali sweets a lot.Looking forward to your sweet recipes..Aam Sandhesh is looking so delicious.
We used to buy our sweets from the Bengali sweet market in Delhi, where they sold a huge variety of delicious Bengali sweets 🙂 Now I can try them at home -thanks!
The aam sandesh looks really delectable. Good thing is you provided step by step process to make chhena.
Such exotic flavours! I a man drooling!
So delectable sandesh these are looking, devine !!
This is such a delightful dessert.❤☝very well explained too!!
wow… A to Z Bengali Sweets…. Superb.
Long time back i had once. Looks delicious.


text:
Q: Raspberry Pi 3 B+ Setup Issue: "error: 'TLSv1_method' is deprecated" I am setting up a Raspberry Pi 3 B+ and connecting it to an IoT hub on Azure by following the instructions in the manual below:
https://azure.microsoft.com/en-us/resources/samples/iot-hub-c-raspberrypi-getstartedkit/
After attempting to build the updated sample solution in step 1.6, the Raspberry Pi's terminal displays this (as the build fails to complete):
    [ 59%] Building C object azure-iot-sdks/c/azure-c-shared-utility/CMakeFiles/aziotsharedutil.dir/src/x509_openssl.c.o
    /home/pi/iot-hub-c-raspberrypi-getstartedkit/azure-iot-sdks/c/azure-c-shared-utility/src/tlsio_openssl.c: In function 'create_openssl_instance':
    /home/pi/iot-hub-c-raspberrypi-getstartedkit/azure-iot-sdks/c/azure-c-shared-utility/src/tlsio_openssl.c:713:5: error: 'TLSv1_method' is deprecated [-Werror=deprecated-declarations]
    tlsInstance->ssl_context = SSL_CTX_new(TLSv1_method());
    ^~~~~~~~~~~
    In file included from /usr/include/openssl/ct.h:13:0,
             from /usr/include/openssl/ssl.h:61,
             from /home/pi/iot-hub-c-raspberrypi-getstartedkit/azure-iot-sdks/c/azure-c-shared-utility/src/tlsio_openssl.c:9:
    /usr/include/openssl/ssl.h:1612:1: note: declared here
    DEPRECATEDIN_1_1_0(__owur const SSL_METHOD *TLSv1_method(void)) /*
    TLSv1.0 */
    ^
    cc1: all warnings being treated as errors
    azure-iot-sdks/c/azure-c-shared-
    utility/CMakeFiles/aziotsharedutil.dir/build.make:950: recipe for target 'azure-iot-sdks/c/azure-c-shared-
    utility/CMakeFiles/aziotsharedutil.dir/src/tlsio_openssl.c.o' failed
    make[2]: *** [azure-iot-sdks/c/azure-c-shared-
    utility/CMakeFiles/aziotsharedutil.dir/src/tlsio_openssl.c.o] Error 1
    make[2]: *** Waiting for unfinished jobs....
    [ 60%] Building C object azure-iot-sdks/c/iothub_service_client/CMakeFiles/iothub_service_client.dir/src/iothub_registrymanager.c.o
    [ 61%] Building C object azure-iot-sdks/c/iothub_service_client/CMakeFiles/iothub_service_client.dir/src/iothub_messaging_ll.c.o
    CMakeFiles/Makefile2:1042: recipe for target 'azure-iot-sdks/c/azure-
    c-shared-utility/CMakeFiles/aziotsharedutil.dir/all' failed
    make[1]: *** [azure-iot-sdks/c/azure-c-shared-
    utility/CMakeFiles/aziotsharedutil.dir/all] Error 2
    make[1]: *** Waiting for unfinished jobs....
    [ 62%] Building C object azure-iot-sdks/c/iothub_service_client/CMakeFiles/iothub_service_client.dir/src/iothub_service_client_auth.c.o
    [ 62%] Building C object azure-iot-sdks/c/iothub_service_client/CMakeFiles/iothub_service_client.dir/__/iothub_client/src/iothub_message.c.o
    [ 63%] Linking C static library libiothub_service_client.a
    [ 63%] Built target iothub_service_client
    Makefile:127: recipe for target 'all' failed
    make: *** [all] Error 2

I am unable to get past this error. Any help would be greatly appreciated. Thanks.


We design all of our audio and video systems for great sound and performance. Sometimes though, things need to look great too.
We can design and build custom cabinetry and furniture to suit your needs and match your existing decor. This can apply to church systems, home theater designs, office systems, anywhere that the technology needs to blend into it's environment.
The cabinet at right has hide-away doors and a removable top that can all be locked when it's buttoned up. Roll-top mixing desks are also very popular.
All of these designs are completely custom from the ground up, built for your specific needs. We can match the style, the stain and fit the space that you have available.


text:
Healthy Inspiration
Promo Features
Check out this month's digital edition!
Find your Healthy Living!
Weighing in on the Keto diet
by James Combs
Written by James Combs
These days, some people are consuming fat to get thin.
Photo: Nicole Hamel
Like many Americans, John Carrasquillo starts his day with coffee; except he adds sugar-free syrup. For breakfast, the 44-year-old Tavares resident consumes a half-pound of bacon daily.
Dinners vary. If he's eating out, he may order a lobster tail drenched in butter or all-you-can-eat grilled chicken wings. At home, his wife, Tracy, uses special recipes to make dishes such as cheeseburger casserole, almond pancakes, and flourless, sugar-free peanut butter cookies. He washes most meals down with Coke Zero.
It's not your typical diet food, but for John, eating this way has yielded tremendous results. He lost 100 pounds in 10 months without exercising.
The trick was limiting himself to 20 net carbs a day.
"I know some people who weigh between 400 and 600 pounds, and they say losing weight is impossible because they're too big to work out," John says. "I wanted to prove to everyone that there's a way to lose weight without any exercise whatsoever."
That "way" is the controversial ketogenic, or keto, diet, a low-carbohydrate, high-fat diet that turns the body into a fat-burning machine. In ketogenic eating, fatty foods such as bacon, butter, coconut, and avocado should comprise 75 percent of a person's daily intake.
On a normal diet, the body breaks down carbohydrates into glucose, which is used for energy. However, when carbs go missing, the body has a plan B fuel supply. A process called ketosis occurs where the body's metabolism burns stored fat as its main source of energy.
In John's case, that process resulted in unwanted pounds melting away. The man who formerly wore size 46 pants is now fitting in size 30 jeans. And after having three blood tests within the first year of starting the diet, his triglyceride and cholesterol levels improved each time.
"This diet has changed my life," John says. "I'm living the dream and feel like I'm on top of the world. For me, keto has proven to be an effective diet."
The no-pasta, no-beans, no-bread, no-fruit diet is on everyone's lips and fingertips these days. In fact, the ketogenic diet—along with the FIFA World Cup and the U.S. midterm elections—was among the most popular search trends last year, according to Google's 2018 Year in Search report. Keto enthusiasts around the country gather on social media sites to discuss keto-friendly recipes and share before-and-after weight-loss photos.
Celebrities have even added fuel to the diet's already-hot fire. Athletes such as LeBron James and actresses like Gwyneth Paltrow have embraced the ketogenic diet.
Of course, its skyrocketing popularity goes beyond shrinking waistlines. Doctors originally developed the ketogenic diet in the 1920s to treat patients with epilepsy. A study conducted by Emory University Health Sciences Center concluded that a high-fat, carb-restricted diet "alters genes involved in energy metabolism in the brain, which in turn helps stabilize the function of neurons exposed to the challenges of epileptic seizures."
There are other health benefits. A study of 349 type 2 diabetic patients who followed the keto diet for one year revealed that their blood-sugar levels (A1C) were reduced from 7.6 to 6.3 percent, they shed 12 percent of their body weight, and their need for insulin was reduced by 94 percent. The journal Diabetes Therapy published the results in 2018.
Ketogenic advocates tout improved mental clarity, as well.
"I feel sharp and can focus better than ever," John says.
However, not everyone is crazy about the keto craze. Some remain skeptical about a diet that promotes bacon over fruit and flips the food pyramid on its head. Among those critics is Anna Gunter, a registered dietitian and nutritionist for Central Florida Health.
She cites the American Cancer Society's nutritional guideline, which recommends 2½ cups of vegetables and fruits each day. Yet, because many fruits and some vegetables contain enough carbs to knock a person out of ketosis, many on the diet avoid them altogether.
"Any diet that eliminates entire food groups can create unhealthy eating behaviors over time," says Anna, who earned a master's degree in nutrition and physical performance from Saint Louis University. "I would not recommend this diet to any of my patients hoping to lose weight."
Equally troubling to her is the severe reduction or elimination of carbohydrates. She says calories—not carbohydrates—are the evil monsters behind obesity and feels a calorie-restricted diet is a healthier alternative. She stated her case in an April 2017 article she wrote and posted on her Facebook page titled, "The Case for Carbs: Why You Should Include Carbohydrates in Your Diet."
"Carbohydrates are actually an essential part of a healthy diet because they provide energy to the cells in the body, particularly the brain," Anna wrote. "In addition, carbohydrate foods are important sources of nutrients that the body needs for health, including vitamins, minerals, and fiber. Eating fiber-rich carbohydrate foods, such as whole grain bread and brown rice, can actually help you lose weight."
She also cautions against consuming too much processed meat. A common misstep among first-time keto dieters is overindulging in hot dogs, salami, sausage, beef jerky, and canned meat.
"Eating a large amount of saturated fat leads to an increase in the level of LDL cholesterol, or bad cholesterol, in the blood" Anna says. "High LDL cholesterol is associated with increased risk for heart disease and heart attack."
Lori Esarey is a lifestyle medicine expert and owner of Total Nutrition and Therapeutics, a weight-loss company in Lady Lake. The ketogenic diet, she says, comes with pros and cons. While she acknowledges its role in reducing blood-sugar levels and helping epileptic patients, precautions must be taken.
"Patients need to understand their current state of health before deciding on any diet," says Lori, who earned master's degrees in nutritional medicine and metabolic medicine from the University of South Florida. "For someone with kidney disease, the keto diet has the potential to make it worse. Work with a medical professional so you can understand what's the best diet for you rather than just guessing."
There are times when Lori prescribes the keto diet for patients hoping to lose weight rapidly, but she keeps them on it for only a maximum of 45 days. After that, she steers them toward a "whole-food, farm-to-plate, nutrient-dense" diet.
"If you're wanting to target body fat, research says using the ketogenic diet is safe short term," she says. "Patients come out of the gate losing weight fast, and it keeps them motivated to keep going because they see immediate results. But long term, it's unrealistic to sustain because it's an all-in or none diet."
While the diet is not designed for those with a sweet tooth, keto devotees such as Mary Wilbanks, of Mascotte, say sustainability can be achieved through culinary creativeness. For Mary, who started the ketogenic diet two years ago, it's a matter of substituting ingredients.
She makes spaghetti with zucchini noodles, pancakes out of almond flour, and macaroni and cheese with cut-up pieces of cauliflower, cream cheese, and butter. She cooks most meals with olive oil and avocado oil—both of which contain anti-inflammatory properties.
"This isn't a deprivation diet," Mary says. "With almost any food, there's a keto-friendly way to make it. I don't feel like I'm on a diet; this is just the way I eat."
However, she does warn potential keto dieters to gradually reduce carbs rather than eliminating them all at once. That approach helped her avoid the dreaded keto flu, a withdrawal phase of headaches and low energy caused by sudden carb depletion.
"I started slow by cutting out pasta, grains, and potatoes," she says. "Then, I started putting tuna on a bed of lettuce instead of bread."
Mary credits the diet for her improved health. Before starting, she could barely walk after suffering fractures of her knee cap, thoracic spine, and leg. Her immobility led to weight gain. That's when her sister introduced her to the ketogenic diet. Today, she has lost 20 pounds and walks without a cane.
"I'm not a medical professional," she says, "but I know what this diet has done for me. I feel less pain, have more energy, and sleep much better at night."
As for John, he realizes the diet has critics, but he's never one to argue with positive results.
"If something is working, then how are you going to bash it?" he says. "I needed to find a way where I could eat like this day-to-day, week-to-week. The ketogenic diet allows me to do that."
A little hoop scoop
How to boost your self-confidence
James Combs
Akers Media Group's James Combs has been a staff writer for several local publications since August 2000. He has had the privilege of interviewing some of Lake County's many fascinating residents—from innovative business owners to heroic war veterans—and bringing their stories to life. A resident of Lake County since 1986, James recently embarked on a journey to lead a healthier lifestyle. He has lost 60 pounds and walks nearly five miles a day. In his spare time, he enjoys target shooting, skeet shooting and watching his beloved Kentucky Wildcats!
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HEALTHY LIVING: From concept to cover
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A shooting attack on Tuesday outside the Israeli settlement of Har Hadar in the West Bank left an Israeli Border Police officer and two security guards dead. The Palestinian attacker was also shot dead at the scene.
The officer killed was identified as Solomon Gabariya, 20, and the two security guards were named as Youssef Ottman, 25, a resident of the village of Abu Ghosh, near Jerusalem, and Or Arish, 25, from Har Adar.
The attacker, Nimr Mahmoud Ahmed Jamal, 37, was from the village of Beit Surik, in the Jerusalem district of the West Bank. According to reports, he arrived with a group of Palestinian workers at the back entrance to the settlement and opened fire after security personnel asked him to stop, deeming him suspicious. A father of four, Jamal had a permit to work in the settlement.
Since October 2015, Palestinians have killed 48 Israelis, two visiting Americans and a British tourist in stabbings, shooting and vehicular attacks. During the same period, Israeli forces have killed over 255 Palestinians over the same period, including attackers, alleged attackers and during demonstrations and clashes.
Following the attack, the army closed all entrances to the village of Beit Surik, only allowing residents to leave for humanitarian reasons. The nearby villages of Beddo, Qatanna, Beit Anan, Beit Iksa, Qabiba, Beit Ijza, Beit Duqqo and Kherab Lahm are also affected by the closures, according to official PA news agency Wafa. In total, 60,000 Palestinians have been unable to move in and out of these villages since yesterday.