text:
Disabilty/Existence-Duration, Dispute of DD IR, Dispute of DD MMI Date, Extent of Injury
This appeal arises pursuant to the Texas Workers' Compensation Act, TEX. LAB. CODE ANN. § 401.001 et seq. (1989 Act). A contested case hearing (CCH) was held on October 15, 2013, in [City], Texas, with [hearing officer] presiding as hearing officer. The hearing officer resolved the disputed issues by deciding that: (1) the compensable injury of [date of injury], extends to bilateral thumb numbness, cervical stenosis C3-7, cervical radiculopathy, arthrodesis at C4-5, aggravation of degenerative disc disease and cervical nerve root irritation, and left shoulder internal derangement; (2) the compensable injury of [date of injury], does not extend to cervical herniations at C3-7; (3) the respondent (claimant) reached maximum medical improvement (MMI) on June 29, 2013; (4) the claimant's impairment rating (IR) is 22%; and (5) the compensable injury was a cause of the claimant's inability to obtain and retain employment at wages equivalent to his preinjury wage beginning on November 25, 2011, and continuing through August 15, 2013.
The appellant (carrier) appealed the hearing officer's extent-of-injury determination adverse to it, as well as the hearing officer's MMI, IR, and disability determinations. The carrier argues that the claimant failed to meet his burden of proof on those issues. The carrier also specifically argues that the MMI/IR certification adopted by the hearing officer provides a rating for cervical radiculopathy without documenting significant signs of radiculopathy. The appeal file does not contain a response from the claimant. The hearing officer's determination that the compensable injury does not extend cervical herniations at C3-7 was not appealed and has become final pursuant to Section 410.169.
Affirmed in part, reversed and rendered in part, and reversed and remanded in part.
The parties stipulated that the claimant sustained a compensable injury on [date of injury], at least in the form of a cervical sprain/strain, cervical spinous process fracture at C5, lumbar sprain/strain, and a compression fracture of L1 vertebral body. We note that in an unappealed finding of fact the hearing officer found that statutory MMI is June 29, 2013. The claimant testified he was injured when he fell from a forklift cage approximately 8 feet in the air, landing on his neck and left shoulder.
The disability issue before the hearing officer was whether the claimant had disability from November 25, 2011, to August 15, 2013, resulting from an injury sustained on [date of injury]. The hearing officer states in Finding of Fact No. 9 and in the decision portion of the decision and order that "[t]he compensable injury was a cause of [the] [c]laimant's inability to obtain and retain employment at wages equivalent to his preinjury wage beginning on November 25, 2011, and continuing through August 15, 2013." However, we note that Conclusion of Law No. 7 incorrectly states: "[t]he compensable injury was a cause of [the] [c]laimant's inability to obtain and retain employment at wages equivalent to his preinjury wage beginning on November 25, 2011, and continuing through the date of the [CCH]." The hearing officer's decision and order contains no specific determination whether the claimant sustained any disability as a result of the compensable injury. We reverse the hearing officer's decision as incomplete, and render a new decision on the issue of disability from November 25, 2011, to August 15, 2013, for the reasons discussed below.
The carrier contended that the claimant did not have disability for the claimed period because he received salary continuation from his employer beginning on the date of injury to the present.
In Appeals Panel Decision (APD) 050565, decided May 2, 2005, the sole issue was disability. The carrier in that case contended that the claimant received salary continuation during the claimed disability period and therefore was not entitled to temporary income benefits (TIBs). The Appeals Panel noted that the issues of payment of TIBs or the accrual date of income benefits were not before the hearing officer or the Appeals Panel, and that the only issue before the Appeals Panel was disability. The Appeals Panel cited to APD 951736, decided December 7, 1995, and APD 941073, decided September 26, 1994, as cases where the claimant continued to receive his salary but did not work because of the compensable injury. The Appeals Panel held in those cases that the claimant had disability because the worker "was not performing personal services for the employer in exchange for the salary continuation," and that the claimant "had disability during that period" (the period that the claimant was unable to work).
In APD 050565, supra, the Appeals Panel held that, insofar as the hearing officer was saying that the claimant did not have disability because he "apparently received salary continuation benefits for a period of time while he was not working," the Appeals Panel reversed and rendered a new decision that the claimant had disability. The Appeals Panel acknowledged that a claimant does not have disability for a period in which the claimant works some kind of light duty status and continues to draw his preinjury wage.
In the case on appeal, the claimant testified that there was no period of time from [date of injury], through the date of the CCH that he was not on salary continuation, and that he made the same wages after the injury as he did before the injury. The claimant also testified that he returned to work sometime "around the end of October, beginning of November 2011," working an 8-10 hour day. The evidence reflects that the claimant has worked for the employer in some capacity during the claimed period of disability. As the claimant has worked for the employer in some capacity and continued to draw his preinjury wage, we render a new decision that the claimant did not have disability from November 25, 2011, through August 15, 2013.
EXTENT OF INJURY
The hearing officer's determinations that the compensable injury extends to cervical radiculopathy, arthrodesis at C4-5, and aggravation of cervical nerve root irritation is supported by sufficient evidence and is affirmed.
The hearing officer also determined that the compensable injury extends to bilateral thumb numbness. At the CCH the claimant testified that he has never claimed an injury to his right thumb or right thumb numbness. The claimant further testified that he has only had left thumb problems. In evidence are medical records dated as early as July 8, 2011, noting that the claimant jammed both of his thumbs when he fell on the date of injury, and that the claimant was reporting left thumb numbness. The medical records do not show that the claimant has complained of right thumb numbness. The medical records support that portion of the hearing officer's determination that the compensable injury extends to left thumb numbness. Therefore, we reverse the hearing officer's determination that the compensable injury extends to bilateral thumb numbness, and we render a new decision that the compensable injury does not extend to right thumb numbness but does extend to left thumb numbness.
The hearing officer also determined that the compensable injury extends to cervical stenosis C3-7, aggravation of degenerative disc disease, and left shoulder internal derangement.
The Texas courts have long established the general rule that "expert testimony is necessary to establish causation as to medical conditions outside the common knowledge and experience" of the fact finder. Guevara v. Ferrer, 247 S.W.3d 662 (Tex. 2007). The Appeals Panel has previously held that proof of causation must be established to a reasonable medical probability by expert evidence where the subject is so complex that a fact finder lacks the ability from common knowledge to find a causal connection. APD 022301, decided October 23, 2002. See also City of Laredo v. Garza, 293 S.W.3d 625 (Tex. App.-San Antonio 2009, no pet.) citing Guevara.
In the case on appeal, the conditions of cervical stenosis C3-7, aggravation of degenerative disc disease, and left shoulder internal derangement are conditions that are outside the common knowledge and experience of the fact finder, and as such require expert medical evidence to establish causation.
The medical records do not contain any explanation of how the compensable injury caused aggravation of degenerative disc disease or left shoulder internal derangement. Therefore, we reverse the hearing officer's determination that the compensable injury extends to these conditions and we render a new decision that the compensable injury does not extend to aggravation of degenerative disc disease or left shoulder internal derangement.
The record contains two statements from doctors regarding cervical stenosis. The first is from [Dr. S], a doctor selected by the treating doctor to act in his place. In her July 26, 2013, narrative report, Dr. S opines only on "cervical herniation at C3 with stenosis," and determined that this condition was "not aggravated by the injury even though it shows on the MRI scan to be narrowed and stenotic."
The other statement is from [Dr. G], the designated doctor appointed by the Texas Department of Insurance, Division of Workers' Compensation (Division) to determine MMI, IR, and return to work. In an addendum dated August 16, 2013, Dr. G stated that the diagnosis of C3 herniation with stenosis "was not directly related and not aggravated by the injury itself." Regarding herniations with stenosis at C4-7, Dr. G stated that these "were aggravated." Dr. G went on to explain that:
. . . [C4-7] were aggravated at the point of injury to the point that they needed to have surgical intervention in order to deal with the problem that was created from the fall. Therefore, the answer is C3 alone was not aggravated. However, with [C4-7] there was stenosis, osteophytes formation, and impingement of multiple nerve roots; these were all aggravated by the injury itself. . . .
Dr. G opined that the compensable injury does not extend to cervical stenosis at C3, and although Dr. G believes cervical stenosis C4-7 was aggravated by the compensable injury, he does not provide an explanation of how the compensable injury aggravated cervical stenosis C4-7. Accordingly, we reverse the hearing officer's determination that the compensable injury extends to cervical stenosis C3-7, and we render a new decision that the compensable injury does not extend to cervical stenosis C3-7.
MMI/IR
Section 401.011(30)(A) defines MMI as "the earliest date after which, based on reasonable medical probability, further material recovery from or lasting improvement to an injury can no longer reasonably be anticipated." Section 408.1225(c) provides that the report of the designated doctor has presumptive weight, and the Division shall base its determination of whether the employee has reached MMI on the report of the designated doctor unless the preponderance of the other medical evidence is to the contrary.
Section 408.125(c) provides that the report of the designated doctor shall have presumptive weight, and the Division shall base the IR on that report unless the preponderance of the other medical evidence is to the contrary, and that, if the preponderance of the medical evidence contradicts the IR contained in the report of the designated doctor chosen by the Division, the Division shall adopt the IR of one of the other doctors. 28 TEX. ADMIN. CODE § 130.1(c)(3) (Rule 130.1(c)(3)) provides that the assignment of an IR for the current compensable injury shall be based on the injured employee's condition as of the MMI date considering the medical record and the certifying examination.
The hearing officer determined that the claimant statutorily reached MMI on June 29, 2013, with a 22% IR per Dr. S.
Dr. S examined the claimant on July 26, 2013, and certified that the claimant reached MMI statutorily on June 29, 2013, with a 22% IR, using the Guides to the Evaluation of Permanent Impairment, fourth edition (1st, 2nd, 3rd, or 4th printing, including corrections and changes as issued by the American Medical Association prior to May 16, 2000) (AMA Guides). Dr. S assessed 6% upper extremity impairment for the claimant's left shoulder based on loss of range of motion (ROM), which Dr. S converted to 4% whole person impairment. Dr. S placed the claimant in Diagnosis-Related Estimate (DRE) Cervicothoracic Category III: Radiculopathy for 15% impairment, and also placed the claimant in DRE Lumbosacral Category II: Minor Impairment for 5% impairment for a compression fracture at L1. We note, as pointed out by the carrier in its appeal, that Dr. S did not document any significant signs of radiculopathy to rate radiculopathy under the AMA Guides. See APD 072220-s, decided February 5, 2008, in which the Appeals Panel held that to receive a rating for radiculopathy the claimant must have significant signs of radiculopathy, such as loss of relevant reflex(es), or measured unilateral atrophy of 2 cm or more above or below the knee, compared to measurements on the contralateral side at the same location.
Dr. S assessed 4% whole person impairment for the loss of ROM of the claimant's left shoulder. Given that we have reversed the hearing officer's determination that the compensable injury extends to left shoulder internal derangement, Dr. S considered and rated a condition that has been determined not to be part of the compensable injury. See APD 110463, decided June 13, 2011, and APD 101567, decided December 20, 2010. As previously discussed, we have reversed the hearing officer's determination that the compensable injury extends to bilateral thumb numbness and rendered a new decision that the compensable injury does not extend to right thumb numbness but does extend to left thumb numbness. We have also affirmed the hearing officer's determination that the compensable injury extends to arthrodesis at C4-5. Further, the parties stipulated that the compensable injury extends to at least a cervical sprain/strain and a lumbar sprain/strain. We note that Dr. S did not discuss these conditions in her narrative report. Dr. S did not consider and rate the entire compensable injury. See APD 110463 and APD 101567. Accordingly, we reverse the hearing officer's determination that the claimant reached MMI on June 29, 2013, with a 22% IR.
The only other MMI/IR certification in evidence is from Dr. G, the designated doctor. Dr. G examined the claimant on March 10, 2012, and certified that the claimant reached MMI on November 24, 2011, with a 10% IR. Dr. G assessed 0% impairment for the claimant's bilateral thumbs and bilateral elbows, and placed the claimant in DRE Cervicothoracic Category II: Minor Impairment for a C5 nondisplaced fracture. Dr. G also placed the claimant in DRE Thoracolumbar Category II: Minor Impairment for a T12 fracture. There is no agreement by the parties that the compensable injury extends to a T12 fracture, nor was that specific condition litigated at the CCH. Dr. G considered and rated a condition that is not part of the compensable injury. APD 110463, supra, and APD 101567, supra. As previously discussed, we have reversed the hearing officer's determination that the compensable injury extends to bilateral thumb numbness and rendered a new decision that the compensable injury does not extend to right thumb numbness but does extend to left thumb numbness. Dr. G considered a condition determined not to be a part of the compensable injury. We have also affirmed the hearing officer's determination that the compensable injury extends to cervical radiculopathy, arthrodesis at C4-5, and aggravation of cervical nerve root irritation. Further, the parties stipulated that the compensable injury extends to at least a cervical sprain/strain, lumbar sprain/strain, and a compression fracture of L1 vertebral body. Dr. G did not discuss these conditions in his narrative report. Dr. G did not consider and rate the entire compensable injury, and as such his MMI/IR certification cannot be adopted. See APD 110463 and APD 101567.
Additionally, we note that Dr. G stated the following in his narrative report regarding the claimant's date of MMI:
The claimant has reached MMI, and according to the [Medical Disability Advisor, Workplace Guidelines for Disability Duration, excluding all sections and tables relating to rehabilitation published by the Reed Group, Ltd. (MDG)] at a maximum of 147 days for light duty, and that was reached on [November 24, 2011].
The Appeals Panel has previously held that the MDG cannot be used alone, without considering the claimant's physical examination and medical records, in determining a claimant's date of MMI. See APD 130191, decided March 13, 2013, and APD 130187, decided March 18, 2013. In this case, Dr. G based his date of MMI solely on the MDG without considering the claimant's physical examination and medical records.
As there is no MMI/IR certification in evidence that can be adopted, we remand the issues of MMI and IR to the hearing officer for further action consistent with this decision.
We affirm the hearing officer's determination that the compensable injury extends to cervical radiculopathy, arthrodesis at C4-5, and cervical nerve root irritation.
We reverse the hearing officer's decision as incomplete and render a new decision that the claimant did not sustain disability beginning on November 25, 2011, through August 15, 2013.
We reverse the hearing officer's determination that the compensable injury extends to bilateral thumb numbness, and we render a new decision that the compensable injury does not extend to right thumb numbness but does extend to left thumb numbness.
We reverse the hearing officer's determination that the compensable injury extends to cervical stenosis C3-7, aggravation of degenerative disc disease, and left shoulder internal derangement, and we render a new decision that the compensable injury does not extend to cervical stenosis C3-7, aggravation of degenerative disc disease, and left shoulder internal derangement.
We reverse the hearing officer's determination that the claimant statutorily reached MMI on June 29, 2013, with a 22% IR, and we remand the issues of MMI and IR to the hearing officer for further action consistent with this decision.
REMAND INSTRUCTIONS
Dr. G is the designated doctor in this case. On remand, the hearing officer is to determine whether Dr. G is still qualified and available to be the designated doctor. If Dr. G is no longer qualified or available to serve as the designated doctor, then another designated doctor is to be appointed to determine the claimant's MMI and IR for the [date of injury], compensable injury.
The hearing officer is to inform the designated doctor that the compensable injury extends to a cervical sprain/strain, cervical spinous process fracture at C5, lumbar sprain/strain, and a compression fracture of L1 vertebral body as stipulated to by the parties. The hearing officer is also to inform the designated doctor that the compensable injury extends to left thumb numbness, cervical radiculopathy, arthrodesis at C4-5, and aggravation of cervical nerve root irritation as administratively determined. The hearing officer is also to inform the designated doctor that the compensable injury does not extend to right thumb numbness, cervical stenosis C3-7, aggravation of degenerative disc disease, left shoulder internal derangement, or cervical herniations at C3-7 as administratively determined. The hearing officer is also to inform the designated doctor that the date of statutory MMI in this case is June 29, 2013.
The hearing officer is to request the hearing officer to determine the claimant's date of MMI, which cannot be after the June 29, 2013, date of statutory MMI, and rate the claimant's entire compensable injury as of the date of MMI, based on the AMA Guides. The hearing officer is to advise the designated doctor to explain how he arrived at his date of MMI, and that the date of MMI cannot be based solely on the MDG.
The parties are to be provided with the designated doctor's new MMI/IR certification and are to be allowed an opportunity to respond. The hearing officer is then to make a determination on MMI and IR consistent with this decision.
Pending resolution of the remand, a final decision has not been made in this case. However, since reversal and remand necessitate the issuance of a new decision and order by the hearing officer, a party who wishes to appeal from such new decision must file a request for review not later than 15 days after the date on which such new decision is received from the Division, pursuant to Section 410.202 which was amended June 17, 2001, to exclude Saturdays and Sundays and holidays listed in Section 662.003 of the Texas Government Code in the computation of the 15-day appeal and response periods. See APD 060721, decided June 12, 2006.
The true corporate name of the insurance carrier is ZENITH INSURANCE COMPANY and the name and address of its registered agent for service of process is
C T CORPORATION SYSTEM
350 NORTH SAINT PAUL STREET, SUITE 2900
DALLAS, TEXAS 75201-4234.
Carisa Space-Beam
Cristina Beceiro


text:
Q: Orientational difference between two poses using axis angle representation I am working on a problem in robotics where I have to compute the orientational difference $\mathbf{e}_O \in \mathbb{R}^{3}$ between a robot's current end-effector pose and a desired pose. I have found the following formula in Robotics - Modelling, Planning and Control
$ \mathbf{e}_{O} = \mathbf{r} sin(\vartheta) $
$ \mathbf{R}_{\Delta} \mathbf{R}_{c} = \mathbf{R}_{d} \iff \mathbf{R}_{\Delta}  = \mathbf{R}_{d} \mathbf{R}_{c}^{-1}$
where $\mathbf{r}$ and $\vartheta$ describe the axis angle representation of the rotation matrix $ \mathbf{R}_{\Delta} = \mathbf{R}_{\Delta}(\mathbf{r}, \vartheta) $. However, from what I understand of the axis angle representation, the angle $\vartheta$ should describe the magnitude of the error already, that the pose has to be rotated about the axis $\mathbf{r}$ to align both pose orientations.
So my question is, where does the sin come from?
An alternative to compute the orientational error $\mathbf{e}_O$ from rotations $\mathbf{R}_{c} = [\mathbf{x}_{c}, \mathbf{y}_{c}, \mathbf{z}_{c}]$ and $\mathbf{R}_{d} = [\mathbf{x}_{d}, \mathbf{y}_{d}, \mathbf{z}_{d}]$ directly is also given as follows
$ \mathbf{e}_{O} = \frac{1}{2} (
\mathbf{x}_{c} \times \mathbf{x}_{d} +
\mathbf{y}_{c} \times \mathbf{y}_{d} +
\mathbf{z}_{c} \times \mathbf{z}_{d} ) $

redpajama_set_name: RedPajamaStackExchange


text:
Q: Rails: url_to scope In the following piece of code (of course in a view) I have <%= post.full_hsh %>	 displaying correctly the value of the field post.full_hsh, but url_for gives an error: No route matches {:controller=>"posts", :action=>"edit", :id=>nil}.
Why is post.full_hsh correct in a row and nil in the row below? Thanks
<% @posts.each do |post| %>

   <%= truncate post.body, :length => 100, :separator => ' ' %>...
   <%= post.created_at %>
   <%= post.full_hsh %>
   <%= url_for :controller => 'posts', :action => 'edit', :id => post.full_hsh %>

<% end %>

EDIT:
my routes.rb file:
get "admin/index"

root :to => 'home#index'

#access posts via /posts/ab123c or /p/ab123c
resources :posts, :path => 'p', :except => [:new, :index, :delete]
resources :posts, :except => [:new, :index, :delete]

match '/p/:id/delete' => 'posts#delete', :as => 'posts_delete'
match '/admin' => 'admin#index'

A: post.full_hsh is an attribute of the post objection.  you probably want :id => post instead
You want to generate the URL based on the object itself, in this case post, not on the attribute of an object (post.full_hsh)


text:
Author`s name David R. Hoffman
22.05.2007 09:32 (Updated: 19.10.2019 14:26)
Ignoring evil in America
Whenever I see images of George W. Bush, Dick Cheney, Karl Rove, Alberto Gonzales, Condoleezza Rice, Donald Rumsfeld, Paul Wolfowitz, Katherine Harris and other minions of, or apologists for, the corrupt, inept, mendacious and venal Bush dictatorship, I am immediately reminded of this line from John Carpenter's classic horror movie Halloween: "What is living behind [their] eyes is purely and simply evil."
Yet in America there is a great reluctance to use the term "evil" when describing the cabal of thugs, hypocrites and war criminals who stole the White House in 2000 and 2004. Although singer/activist Harry Belafonte courageously proclaimed a few years ago that the Bush dictatorship was "possessed of evil," it wasn't until recently that others in positions of prominence began to acknowledge the veracity of Belafonte's statement. A recent episode of the animated comedy Family Guy, for example, showed cartoon portraits of an inanely grinning Bush shaking hands with Saddam Hussein, Osama bin Laden and, ultimately, the "Super Devil" (a being more evil than Satan).
Prior to this, most of the statements concerning the inherent evil of the Bush dictatorship came from foreign sources: Russian President Vladimir Putin indirectly suggested that Bush's foreign policy was analogous to Hitler's Third Reich; Venezuelan President Hugo Chavez compared Bush to Satan; and the Mayan Indians felt compelled to "spiritually cleanse" a sacred site after Bush visited it earlier this year.
But even though more Americans feel emboldened to criticize the Bush dictatorship, there is still a reluctance to acknowledge and denounce its evil. This reluctance often affects some of the dictatorship's most outspoken critics: Former American President, and Nobel Laureate, Jimmy Carter recently retreated from his clearly accurate assertion that the Bush dictatorship has been the worst administration in United States history, claiming his words were "careless or misinterpreted." And syndicated columnist Gwynne Dyer rejected the notion that Bush and/or his minions possessed the evil required to orchestrate the attacks of 9/11, even stressing that Dick Cheney was morally incapable of sanctioning the murders of over three thousand Americans simply to justify the illegal invasion of Iraq.
I disagree. While the Bush dictatorship is the domicile for many monsters cloaked in human attire, Cheney is arguably the monster most likely to promote mass murder for the sake of war profiteering. His very character endorses this reality. He possesses the attributes of many mass murderers—a sadist who often kills defenseless animals in "caged hunts" (where they have no means of escape), and a coward who, during the Vietnam war, obtained deferment after deferment to avoid facing an adversary capable of shooting back, only to become a vociferous warmonger once the prospect of being drafted into military service no longer confronted him.
But even if one does not subscribe to the theory that character presages deeds, the Bush dictatorship still cannot be absolved from culpability in the 9/11 attacks. In the legal realm, crimes can be committed through act or omission. It is undisputed that Bush, shortly after his coup of 2000, planned to invade Iraq. It is also undisputed that several warnings about the possibility of airline hijackings, some provided by foreign governments, were forwarded to the Bush dictatorship.
What most likely occurred was that Bush and his minions were aware of the planned attacks, but underestimated their magnitude, believing any hijacking would be of the "traditional" variety: An American aircraft would be forced to fly to an unplanned destination, followed by a lengthy standoff between the hijackers and the Bush dictatorship. Allowing a hijacking to occur would give Bush the opportunity to blame Iraq, and incite the American media and public into a jingoistic frenzy.
So the question becomes, "Why are Americans so willing to acknowledge the presence of evil when it comes to foreign governments, but so unwilling to acknowledge the presence of evil within their own government?"
One explanation may be the "arrogance syndrome." Americans want to believe they are somehow more "civilized," and therefore less gullible, than other nations of the world. Unfortunately this belief simply makes them more susceptible to being led into unjust and illegal wars. Also, since many Americans possess short-term memories as selective as the one possessed by Alberto Gonzales (America's corrupt attorney-general, who recently answered "I cannot recall" over seventy times during his testimony before Congress), they can be duped into supporting such wars time and again.
Although most corporate-controlled media now refer to the illegal invasion of Iraq as an "unpopular war," just a few years ago these same media were salivating at the ratings and profit potential this war would bring. Reporters and entertainers who criticized, or even questioned, the motives for war or other policies of George W. Bush were fired from their jobs and oftentimes blacklisted. Pro-war rallies drew record numbers of people, and these rallies frequently treated war criminals like Bush, Cheney and Rumsfeld as deities.
Another reason why evil is rarely acknowledged in America is simply because too many powerful people profit from it. Sadly, this has been the case throughout history.
A recent movie, Amazing Grace, recounted how British politician and abolitionist William Wilberforce often invoked the tenets of Christianity during his campaign against the slave trade in the early 1800s. This compelled many so-called Christians to embrace the film as a paradigm of how good can triumph over evil.
Forgotten in this zeal, however, is the sad reality that many Americans used (and in the case of racism continue to use) the Christian faith to justify bigotry and slavery. American abolitionist Frederick Douglass, in his book The Life of an American Slave, describes how a preacher/slaveholder often justified the whipping of his slaves by stating, "He who honors his master must wear his stripes."
Today it is America's military-industrial complex that profits from economic slavery and the exploitation of the poor and middle-class, who fight and die in wars waged by the rich and powerful. And as long as those in power can reward their cronies with lucrative rebuilding contracts, as long as war can be used to divert attention from government criminality and corruption (as demonstrated by the father of George W. Bush, who invaded Panama to divert attention from the "Savings and Loan" scandal that cost taxpayers billions of dollars), and as long as war can be used to increase the ratings and profit potential of the corrupt corporate-controlled media there will be little incentive to denounce evil in America.
A third reason for the failure of Americans to acknowledge evil in their own country is the uncanny ability of human beings to rationalize anything. When I was in law practice, I often noticed that there was little difference between "law breakers" and "law makers." Both demonstrated an enormous capacity to rationalize their actions, no matter how much those actions defied morality or commonsense.
The incentive to rationalize is particularly prominent in today's "sound bite" culture. Corporate-controlled media incessantly select the most "controversial" statements for repeated airplay, often taking them out of context. Meanwhile complex topics, if they are covered at all, are covered only superficially; therefore laypeople often do not have the political or historical background necessary to develop well-informed viewpoints, and thus erect their opinions on tenuous foundations that are frequently devoid of facts.
For example, a recent editorial on the CNN website argued that Americans would be remiss if they failed to honestly debate Texas Congressman Ron Paul's contention that American foreign policy, particularly its proclivity to dominate or overthrow foreign governments for the sake of corporate profits, played a role in the build-up to the 9/11 attacks.
But it is unlikely that such a debate will ever transpire, particularly since former New York Mayor turned presidential candidate Rudy Giuliani has already demonstrated that he will continue to exploit the emotions surrounding 9/11 for his own self-aggrandizement, just as he has opportunistically done in the past.
The final explanation for why the existence of evil in America is often ignored is because the terms "good and evil" often take one into the realm of religion. When science and logic fails, faith often prevails.
But faith can be a positive force or negative force. Since it cannot be disproved, a person does not require logic or science to acquire faith. But without such logic or science, people can often be deceived into believing concepts that have no factual basis at all. Hating another person because of his/her skin color, for example, is as illogical as hating one flower because it's red and loving another because it's yellow, particularly since neither possessed the ability to choose what color it would be. Yet racism is alive and well in America.
This is why charlatans often exploit the faith of others. If a situation has a positive outcome, they can claim it was because of the "strength of their faith," and if a situation has a negative outcome, they can claim it was because their followers "didn't believe deeply enough."
It was this type of faith that made many Americans embrace the lies of the Bush dictatorship, naively believing that Iraq possessed "weapons of mass destruction," that Saddam Hussein was involved in the 9/11 attacks, and that war against Iraq would only be used as "a last resort."
This exploitation of faith has been the modus operandi of the Bush dictatorship and its apologists—strategically designed to conceal their ineptitude, arrogance, dishonesty and evil. It has been so effective that many so-called "Christian" colleges and universities have invited members and supporters of the Bush dictatorship, including Bush himself, to be guest or commencement speakers.
Since I began this essay with a quotation from a movie, I will end it with one as well. In Bryan Singer's remarkable film The Usual Suspects, a character named Verbal Kint remarks, "The greatest trick the devil ever pulled was convincing the world he didn't exist." Sadly, this trick will continue to be effective as long as Americans refuse to acknowledge that their nation is being controlled by people who are "purely and simply evil."
David R. Hoffman, Legal Editor of Pravda.Ru

redpajama_set_name: RedPajamaCommonCrawl


Once an afterthought at most restaurants, customers with vegetarian diets are now the prized dining segment.
Not long ago, dining out wasn't much fun for vegetarians. Options were likely limited to a ho-hum pasta dish, a roasted vegetable plate or, if push came to shove, an entree-sized portion of that appetizer salad.
That was a time when vegetarians, vegans and diners preferring meatless items were a rare breed. But today, vegans and vegetarians aren't the only ones subscribing to a meat-free diet. Carnivores increasingly are opting for meatless dishes as a way to eat healthier, according to Datassential, a food market research firm.
Add the rising costs of proteins like beef to the equation, and it's no surprise that many chefs and restaurateurs are discovering that paying more attention to meatless offerings can help foster new business and build customer loyalty.
New York City-based sandwich chain 'wichcraft caters to a wide audience that includes vegetarians and vegans, as well as folks looking for more healthful quick-serve options. Partner Jeffrey Zurofsky says the local sandwich chain offers information about each menu item not only for nutritional resources, but also to distinguish between items that might have animal byproducts.
"We make sure to let our guests know if something is made with chicken stock or milk so they can make an informed decision," he says. Two popular mainstay items on 'wichcraft's menu happen to be meat-free: chickpea hummus with tahini and mint pesto ($7.35), and zucchini and mozzarella with basil, Parmesan and roasted tomatoes ($7.35).
One segment that could use more meatless attention: kids. According to Food Genius, a restaurant menu trends research firm, vegetarian and vegan items are found on less than one percent of kids' menus. The most common items are rice, mac and cheese and quesadillas.
"When vegetarians dine here, they want more options than the one or two dishes we have on the menu."
Fried shishito peppers with caramelized cauliflower and curried eggplant mousse ($9), and seared silken tofu served with Beluga lentils ($18) nestle in seamlessly among the octopus, rabbit and bone marrow dishes at Chicago Japanese restaurant Kabocha.
"The use of just one item to accommodate vegetarian diners is not conducive to pleasing the customer as they typically feel pigeon-holed and their dining needs are an after-thought," says Malory Scordato, the former general manager.
That said, highlighted vegetarian sections are becoming commonplace on meat-heavy menus. Ardeo + Bardeo in Washington, D.C., has a "vegetables" section, featuring dishes like roasted Hakurei turnips with wilted greens, truffle butter and breadcrumbs ($7). Old Major in Denver designates its menu by The Butcher (meat), The Monger (fish) and The Farmer (vegetables), which features three rotating vegetarian dishes that are available a la carte or as a three-course tasting for $30.
Embracing social media has helped, too. Bowles Kamar will often see customers come into her restaurant whom she has engaged with on Facebook and has increased her community programs, like vegetarian cooking classes, in turn. "It really pays to be plugged in like that with your diners," she says.
Promoting options can help bring in crowds, but a successful vegetarian program means maintaining that same level of commitment to vegetables as proteins. "The beauty of our vegetarian items is that they are delicious and appealing to all diners, and are not marketed as solely vegetarian," Scordato says.
Judy Sutton Taylor writes for a variety of national food and business magazines.


text:
Home Democracy and Governance
Nigeria and Biafra's Wasted Memory, By Okey Ndibe
Much is often made of the hundreds of billions of dollars that Nigeria has frittered away since huge deposits of crude oil were discovered within its boundaries. A contemptible, uncreative elite, its obsession with conspicuous consumption matched by its inability to produce anything of value, has overseen Nigeria's obscene, record-setting squandermania.
This elite's legendary greed and mindless accumulation were able to fester and thrive because of the near-absence of sustained resistance by their victims—especially students, workers, and peasants. Yes, Nigeria has become a particular mess because of its long history of mediocre leadership. But of equal significance—the other part of the equation—is the failure of Nigerians to demand of those who preside over their affairs.
This point deserves to be stressed. On my way to the airport to travel to Toronto to deliver this talk, I tuned my car radio to America's National Public Radio. Fortuitously, the station was interviewing a Nigerian-born guest, Olu Oguibe. Responding to one question, Oguibe, who is a professor of arts at the University of Connecticut, disclosed that he had become dubious of Chinua Achebe's thesis that the trouble with Nigeria—in the late novelist's words—"is simply and squarely a failure of leadership." Oguibe said he had come to question Achebe's implied exoneration of the Nigerian followership. For him—and I am increasingly persuaded by the argument—Nigerians have consistently got the leadership they deserve.
For all the cash that Nigeria has thrown to the wind, I'd suggest that the country's greater tragedy is its refusal to be instructed by the lessons of the Biafran War. And this particular tragedy began just moments after the cessation of the civil war.
Yakubu Gowon's declaration that there were no victors and no vanquished was, on the face of it, noble. Yet, the government's post-war policies did not always conform to the government's lofty sentiment. For one, the idea that the erstwhile Biafrans were not automatically entitled to the houses they owned, before the war, in different parts of Nigeria was at odds with the logic of "no victor, no vanquished." In many cases, the Nigerians who held such homes in trust were honorable enough to return them to their original legitimate owners as soon as hostilities ceased. In other cases, the government deemed the properties "abandoned," thus enabling usurpers to snatch them permanently from their true owners.
It was, in the context of the war, a grave anomaly. It did not make sense to force a people to return to the fold of a country they had renounced—only to turn around and stipulate their alienation from the assets they owned before their attempted secession.
The government's policy of paying every former Biafran a mere twenty pounds as full redemption for any financial assets they held prior to the war was, quite simply, unjust. Like the notion of abandoned property, that financial policy mocked the very idea of insisting on Biafrans' (forcible) re-incorporation into the entity called Nigeria. What was the point of forcing a people to re-enter an unhappy, abusive and unjust relationship?
It can be argued that, more than any other ethnic group in Nigeria, the Igbo, who formed the core of Biafra, had come closest to embracing the promise and possibility of a Nigerian nation. They had been more willing than most to venture beyond their enclave, dispersing and settling in different parts of Nigeria. They made the effort to learn the languages of the areas where they settled, to build homes, and to participate—to a great extent—in the lives of their hosts. In a sense, then, they had been more willing than most to accept the prospect of an evolving trans-ethnic community, and to do their bit to make that community—in other words, Nigeria—a viable one.
When a group so passionate about testing the viability of Nigeria feels such wrenched sense of injustice as to demand a divorce, then there is cause for sober reflection. More than two million people perished in a war to uphold the sanctity of the space called Nigeria. The casualties of that war paid with their blood for Nigeria to germinate, flower, and grow. Alas, post-war Nigeria chose to erase the memory of their great sacrifice. It never seized the opportunity to ask necessary questions about the meaning of this name—Nigeria—in whose name so many lives were cut short, so many more bodies maimed.
Instead, Nigeria returned to its old, reckless ways. It proceeded as if the war had never happened, as if so many lives had not been lost. That return to business as usual—the business being an unjust dispensation—meant that those who had died in the fight for one Nigeria constituted a colossal—betrayed—waste.
The prolonged economic exploitation of the people of the oil-rich Niger Delta would not have happened if Nigeria had learned the right lessons from the Biafran War. The writer Ken Saro-Wiwa and his Ogoni compatriots were unjustly hanged in 1995 because Nigeria had conveniently forgotten the import of Biafra. The 1999 massacre of the unarmed residents of Odi in Bayelsa State was, at bottom, an aftermath of a country gripped by amnesia about Biafra. The 2001 slaughter of the people of Zaki Biam in Benue State was possible in a climate in which Biafra had not registered in Nigeria's memory. If Biafra counted in Nigeria's memory, then the country's leaders would have awakened sooner to the horrors of Boko Haram's decimation of innocents in several northern states.
More than fifty years after Nigeria's "Independence" from Britain, few, if any, Nigerians can say with confidence that they know what it means to be called citizens of Nigeria. Nigerian prisons overflow with so-called citizens being held without trial. Human Rights Watch and other international monitoring organizations have reported a fact that's so morbidly clear to Nigerians: that law enforcement agents in Nigeria carry out widespread extra-judicial executions. Nigerians vote in elections with no guarantee that their votes will count. Instead, a coalition of "powerful" godfathers, electoral officials, security agents and judges conspires to normalize a culture of electoral fraud.
If any idea animates Nigeria, it is this: that the state exists to enable and empower a tiny coterie to steal to their greed's content. That's why the ostensible war against corruption is a joke, taken to new ludicrous heights by President Goodluck Jonathan who has taken up the odd semantic task of splitting hairs between "stealing" and "corruption." The preservation of a Nigeria that remains safe for embezzlers is, from all indications, an urgent mission. If you're in doubt, consider that Nigeria's yawn-inducing national conference is loaded with ex-convicts, pardoned convicts, vacated convicts, and should-be convicts.
As currently constituted, Nigeria does not stand a chance of surviving. It is far from a nation. It is, at best, a collection of strange bedfellows whose elite is bound by a common—looting—interest. At the inauguration of the so-called national confab, President Jonathan declared that the corporate unity of Nigeria was not open to negotiation.
It is a misguided stipulation. It is an ineffectual response to the spate of renunciations of Nigeria by groups in different parts of the country. Let me be clear: I have not given up on the idea of Nigeria, but Nigeria as now constituted is little more than an irritant. And I have the hunch that Nigeria can no longer get away with forcing itself on people. Unless all the groups within Nigeria elect to work, across ethnic, cultural and sectarian lines, to found a nation, it is going to be extraordinary hard (and costly) to maintain the lie of one destiny.
There is no more urgent question facing all Nigerians than contemplating whether we desire to work towards being one. The emphasis is on "work," for the process of building a nation is an arduous, painful, conscious undertaking. It is only after this fundamental question is confronted—and answered—that Nigerians can tackle such other questions as the terms of our engagement, the irreducible content of citizenship, and the central ideas that shape our lives.
This whole declaration of the given-ness of Nigeria amounts to a false affirmation of Nigeria's viability. At best, it represents a wish by those with their lips to the trough of the treasury to perpetuate an entity that has always been a cash cow for the few at the expense of the millions of distressed Nigerians.
This is the second and concluding part of my reflections. Please follow me on twitter @okeyndibe
Emir Sanusi, This Is How You Can Help The North, By Bámidélé Adémólá-Olátéjú
Gerontocracy and The National Psyche, By Tony Rapu
Fiscal Federalism in the Nigerian Debate, By Kayode Oladele


A Scarce Scottish Bowl and Stand, made in Edinburgh in 1729 and 1733 respectively, the bowl by Ker and Dempster and the stand by Aytoun; with Chippendale border. Measuring approx. 5.5" (14cm) diameter for the bowl and 8" (20.5cm) for the stand.


The primary goals of treatment in the infant with craniosynostosis are to correct the deformity and allow for adequate brain growth in as safe and effective a manner as possible. Herein, the authors present the results of treating craniosynostosis using an endoscope-assisted strip craniectomy and postoperative helmet therapy (EASC + PHT) in the hopes of providing further evidence of its role in the treatment of multiple different forms of craniosynostosis. This is a retrospective review of the patients treated with this technique at Children's Hospital Boston.
The electronic medical records of all children with craniosynostosis treated using this technique were reviewed retrospectively. A priori, data were collected for deformity type, patient age at surgery, number of transfusions, operative time, length of hospital stay, and anthropometric measurements.
One hundred seventy-three patients (61 females and 112 males) were treated at our institution between July 2004 and March 2011 with EASC + PHT. The mean operative time was 46.30 minutes. Eight (4.6%) of the 173 patients received blood transfusions. The average length of hospital stay was 1.35 days, with the majority of patients being discharged the day after surgery. All complications and any patient who required additional craniofacial reconstructions are discussed. In addition, a subgroup analysis was done for patients who had undergone surgery and had longer than 1 year of follow-up.
The authors' growing database of patients supports the experiences described by others that early treatment of craniosynostosis with an EASC + PHT is a safe and efficacious technique. In addition, cost reduction due to decreased hospital stay and limitation of blood transfusions are demonstrable benefits associated with the use of this technique.
Abbreviations used in this paper: EASC + PHT = endoscope-assisted strip craniectomy and postoperative helmet therapy; FOA = frontoorbital advancement; HCP = head circumference percentile.
The premature fusion of calvarial sutures, better known as craniosynostosis, is a well-known cause of deformational changes to the skull. It has an estimated frequency of 0.4 of 1000 live births, with the majority consisting of isolated single suture defects.6 The etiology of most cases is sporadic and not well established, although there is a strong genetic component and more than 70 identified syndromes. Early scientific inquiry into this disease entity revealed several theories as to its pathogenesis. Virchow22 first described the fundamental aberrant growth patterns, noting the "compensatory growth" of the calvaria. Moss13 espoused the "fundamental matrix theory," which stated that the active growth of the underlying brain dictated the passive cranial growth along the suture lines. These theories, with the presumption that prenatal abnormalities at the fused suture and/or skull base are the cause of the deformity, represents the foundation for early and minimally invasive approaches using endoscope-assisted surgery with postoperative helmet therapies.
In the 1970s, Tessier20,21 introduced pioneering techniques for treatment of craniosynostosis in which large segments of the cranium were removed, remodeled, and stabilized as the situation required. The limitations of suturectomy for advanced disease fueled these developments, along with the discovery by Delashaw and colleagues4 that the major cause of the cranial deformity was compensatory overgrowth at adjacent sutures. Thus, the desired changes in shape and volume were established intraoperatively, and the bony segments were fixed to maintain the correction. Because the postoperative cranial result was not dependent on postoperative brain expansion, the outcomes of these operations were more predictable than simple or extended craniectomy procedures, and cranial remodeling became the preferred operation for craniosynostosis. However, these techniques are associated with significant blood loss, lengthy surgical times (3–8 hours) and hospital stays (4–7 days), and often the need for postoperative intensive care unit monitoring.18 Surgery is often delayed until the infant is older (6–12 months) to limit operative morbidity, but this allows the deformities to become more severe. The reported complications of the cranial vault remodeling procedures include inadequate calvarial shape correction, improper skull reossification, palpable and visible deformities and asymmetries, loosening of hardware, migration of screws into the brain parenchyma through the dura, extensive blood losses, and problems associated with blood transfusion reactions.7,18 Moreover, many specialists in the field have noted both anecdotally and in published works that even with large repairs, the growth patterns were not normal over time, and there was reversion toward the original dysmorphology.5 Therefore, the cosmetic results of larger procedures are certainly not perfect.
In 1999, Barone and Jimenez2 published the endoscopic approach for suturectomy followed by orthotic therapy. In the first 10 cases, they noted a significant difference in blood loss and the need for transfusions, shorter operative times and hospital stays, and decreased hospital costs with the endoscopic approach than with conventional cranial vault remodeling. They expanded their indications to include coronal, metopic, and lambdoid synostoses.9,10 Other authors have supported the conclusions of Barone and Jimenez.14 For those who believe that the era of suturectomy has already been tried and failed, it is important to note the use of newer technologies in achieving the result. The effectiveness of the surgery is not simply in the release operation, but in the subsequent redirection of skull growth through the use of external orthoses, springs, or distractor devices. Technologies have changed, and dismissing the operation because it had a high failure rate in the past is problematic.
This report describes the experience of a single surgeon (M.R.P.) using EASC + PHT to treat many forms of craniosynostosis. In addition to demonstrating the effect of this operation on cranial shape and volume, we catalog the complications and limitations of this technique.
Infants diagnosed with craniosynostosis who were younger than 6 months of age were considered for the endoscopic approach. Extended discussions on the risks and benefits of open and endoscopic approaches were undertaken with the family. The minimally invasive approach was considered appropriate for all infants younger than 3 months with single suture synostosis and older infants only if they had mild deformity. At our institution, approximately 50% of patients are young enough to be offered endoscopic techniques (this percentage has been increasing over time), and most families have elected to undergo this surgery. The remaining patients undergo open surgery at 8–10 months. We would generally not recommend the endoscopic approach if the child had a significant deformity and was older than 3 months of age. Although there are no absolute guidelines on this, for sagittal synostosis the threshold for endoscopic surgery in a child older than 3 months would generally be a cranial index greater than 0.66–0.68, also subjectively accounting for the more subtle manifestations. For example, the typical saddle deformity responds very well to endoscopic surgery even at older ages, whereas severe frontal bossing and marked bathrocephaly does not. For other synostoses, where objective criteria are less available, the criteria are more difficult to distinguish on an age-related basis. Very profound trigonocephaly in older children and profound turricephaly in children with bilateral coronal synostosis will likely not respond to endoscopic techniques at older ages. Similarly, profound asymmetry in unilateral coronal synostosis is likely best treated when the patient is younger than 3 months. In addition, some patients with multiple suture synostoses were considered for endoscopic release, either as primary treatment or to prevent significant progressive compensatory deformity, with the expectation that another surgery might still be required in the future (that is, to prevent the development of severe turribrachycephaly in children with bilateral coronal synostosis). All infants had routine laboratory samples drawn, and blood was cross-matched and available in the operating room at the start of the case. Computed tomography scans were not routinely obtained for single suture synostosis, but they were acquired when it was thought necessary to establish the diagnosis or guide surgical decisions. For example, we would not perform endoscopic surgery in a child with multisuture synostosis and multiple bony erosions or irregularities on the endocortical surface, as separating the dura from the bone becomes far more complex. In general, endoscopic techniques are feasible because the dura easily separates from the bone at a fused suture, and if preoperative data would indicate that separation is not likely, one should probably not perform the case in a minimally invasive fashion.
General endotracheal anesthesia was used, and 2 intravenous catheter lines were inserted after induction. Early in the series arterial lines were common, but as the technique evolved, they were rarely used. No central lines were used. Precordial Doppler ultrasonography was used in all cases to assess for air embolism.
For sagittal synostosis, the patients were placed prone using a specialized head holder (DORO cranial stabilization, Promed Instruments; Fig. 1) that kept the head extended, with the torso on chest rolls. For metopic or coronal sutures, the patients were supine, and the head was placed on a horseshoe headholder. For lambdoid synostosis, the patient was kept prone with the head supported on a horseshoe headholder. The scalp was prepared with povidone-iodine solution, and the area of intended incision was infused with Marcaine 0.25% and epinephrine 1/200,000.
Photograph of patient positioned in the DORO head holder.
The incisions were generally 1.5–2.5 cm in length and all oriented perpendicular to the involved suture but varied in number and location by suture type as follows: sagittal, 2 incisions in the midline, one just posterior to the coronal sutures and the other at the junction of the lambdoids; metopic, 1 midline incision just posterior to the hairline; unilateral and bilateral coronal, 1 incision at the midsuture(s); and lambdoid, 2 incisions, one at the region of lambda and the other at the inferior end of the suture.
After exposure of the suture, a bur hole was placed directly over the affected suture. A Kerrison rongeur was used to increase the diameter of the bur hole to 1 cm. The periosteum was elevated off the overlying skull along the direction of the suture. Finally, the endoscope was inserted through the bur hole and the dura was dissected from the overlying skull under direct visualization. The endoscope was used in all cases. In some instances, it did not provide better visualization than direct inspection with loupes, but it afforded excellent light and allowed the surgeon to transilluminate and see how far the dissection had proceeded when performed in an operating room with the ambient lights turned off. Since the dura is generally not adherent at a fused suture, dissection was usually done in a blunt fashion with the endoscope and suction. Emissary veins were coagulated with bipolar cautery and divided. Heavy scissors were then used to cut a 1- to 2-cm-wide strip of bone centered on the affected suture, and the bone was removed. (Early in the series, wider craniectomies were performed, as well as barrel staving, but this was believed to be unnecessary to achieve good results, and bone removal has been minimized. Using a cadre of objective and subjective measures, we did not find that a wider craniectomy improved results. In addition, a few patients who received barrel staves developed bone callus at the regions that were cut; therefore, this technique was discontinued.) The callus regions remodeled over about 2 years. The wounds were irrigated, and Gelfoam (Pfizer, Inc.) was placed over the craniectomy site. Bone edges were not coagulated. The galea and skin were closed in layers with absorbable sutures. A pressure dressing along the craniectomy was applied for 12 hours.
As a rule, all of our patients are monitored until 6 years of age, when brain growth is essentially complete. This is true for patients treated endoscopically and by open techniques. In the results, we list separately the overall group and those patients who have had more than 1 year of follow-up since completion of treatment (surgery and helmeting).
Between July 2004 and March 2011, 173 patients were treated with endoscopic strip craniectomy by the senior author (M.R.P.). There were 61 girls and 112 boys. The frequency of involved suture(s) in descending order was as follows: sagittal, 55.5% (96 patients); unilateral coronal, 15.0% (26 patients); metopic, 13.9% (24 patients); bilateral coronal, 6.9% (12 patients); multisuture other than bicoronal, 6.4% (11 patients); and lambdoid, 2.3% (4 patients) (Table 1). The average age at operation was 2.9 months (range 0.79–7.75 months), with a median age at operation of 2.89 months. The mean operative time was 46.30 minutes (range 25.0–93.0 minutes). The mean length of hospital stay was 1.35 days (range 1–3 days, with 1 outlier at 23 days; this patient had multisuture synostosis and significant cardiac abnormalities and remained in the hospital for comorbidities). Three patients with comorbid conditions required an overnight stay in the intensive care unit. Eight patients (4.6%) required perioperative blood transfusions. No absolute hematocrit or hemoglobin nadir threshold dictated blood transfusion; however, in the setting of hemodynamic instability and decreasing hemoglobin and/or visible blood loss, a blood transfusion was provided. The nadir was a hematocrit of 20%. There were no deaths. The mean follow-up from the operative date was 3.99 years (Table 2).
* FU = follow-up; LOS = length of stay.
† The value was calculated without the one outlier in the multisuture group with cardiac anomalies.
In addition, we completed an in-depth analysis of the series of the 111 patients who underwent at least 1 year of follow-up, having thereby completing the treatment protocol. This group of 111 is the subset that was closely analyzed below. Among this subset, the PHT was typically completed in a mean of 7.78 ± 2.55 months (range 2.37–21.55 months).
A total of 61 patients in this group completed helmet therapy and have at least 1 year of follow-up, and all 96 patients are monitored with regular follow-up. The mean duration of helmet therapy was 7.47 months. Patients experienced a 36.85% increase in HCP. Cranial index, as measured by a single observer in all cases (senior author [M.R.P.]), increased from a mean of 0.69 ± 0.04 preoperatively to 0.77 ± 0.04 at the 1-year follow-up and regressed to and stabilized at 0.76 ± 0.03 for patients observed longer than 2 years (Fig. 2). Multivariate regression analysis demonstrated that age at surgery (p = 0.0005) was an independent variable for change in cranial index and increase in HCP. Overall, there was uniformly excellent cosmetic correction (Table 3). Complications included 1 incisional abscess requiring admission for incision and drainage but no long-term antibiotics and 1 sagittal suture refusion and 2 cases of additional suture fusion, all 3 of which required open cranial vault remodeling. Among those patients still undergoing helmet therapy, there were no complications, and surveillance of follow-up data indicates similar improvements in cranial index and HCP as those patients who have completed therapy.
Preorthotic (left) and postorthotic (right) laser scanning report documenting the change in head shape and improvement in cranial index in an infant with sagittal synostosis.
* Includes 111 patients who have 1 year of follow-up since completion of treatment. Seven multisuture patients who have completed therapy are not shown.
Twenty patients completed helmet therapy and have longer than 1 year of follow-up, and all 26 patients are monitored with regular follow-up. Eleven of the patients had a left-sided fusion. Helmet therapy lasted an average of 9.19 months. Patients experienced a 12.14% mean increase in HCP. Cranial asymmetry decreased from a mean of 8 mm (range 6–10 mm) to 3.7 mm (range 1–6 mm) (Fig. 3). There was excellent correction of nasal root deviation, facial asymmetry, and orbital dystopia with a trend toward reduced associated ophthalmological findings (for example, astigmatism and ocular torticollis)5 and good to excellent improvement of forehead symmetry. Although the forehead symmetry was slightly inferior to traditional FOA at 1 year, it continued to improve at each consecutive annual visit. We have analyzed the findings in unilateral coronal synostosis using 3D photogrammetry. Comparing children who had undergone endoscopic versus open techniques, we found statistically significant improvement in facial symmetry in the minimally invasive group and nonsignificant differences in forehead symmetry at a mean age of 2.8 years (unpublished data, 2009). Two patients had persistent deformity for which FOA was recommended. Another patient experienced a small dural tear requiring a larger than average craniectomy at the time of surgery and had a persistent skull defect, which required cranioplasty repaired through the original 1.5-cm incision. Three patients (12%) were diagnosed with Saethre-Chotzen syndrome. One of these patients is currently undergoing helmet therapy. The second patient experienced fusion of the sagittal suture at approximately 2 years of age. He has not developed elevated intracranial pressure and is being observed at this time. The third patient has not had any complications since completing helmet therapy (Table 3).
Preorthotic (left) and postorthotic (right) laser scanning report documenting the change in head shape in an infant with unilateral coronal synostosis.
Nine patients completed helmet therapy, and all 12 patients are monitored with regular follow-up. One patient has been diagnosed with Pfeiffer syndrome (FGFR1 mutation), and another has been diagnosed with Apert syndrome. For those who have completed treatment, helmet therapy lasted an average of 8.63 months. These patients experienced a mean change in HCP of 11.06% and a mean maximum decrease in cranial index of −0.08 (mean preoperative cranial index 0.94 [range 0.84–1.0] and mean postoperative cranial index 0.86 [range 0.81–0.91]) (Fig. 4). Turribrachycephaly was well corrected and forehead projection improved, although the improvement appeared to be less dramatic than with traditional FOA. These are subjective assessments, and we have not correlated them to objective data. Two patients experienced refusion of the coronal sutures, as well as additional sutures, with the sagittal suture in one patient and sagittal and metopic sutures in the other. Both cases were heralded by a falloff in head circumference, and required open cranial vault remodeling. On genetic evaluation, one of the patients was later diagnosed with Saethre-Chotzen syndrome. The genetic workup of the second patient with refusion was negative for TWIST, and FGFR1, 2, and 3. All other patient genetic evaluations were negative (Table 3).
Preorthotic (left) and postorthotic (right) laser scanning report documenting the change in head shape in an infant with bilateral coronal synostosis.
Eleven patients completed helmet therapy, and all 24 patients are monitored with regular follow-up. For those who had completed helmet therapy, the average duration of helmet therapy was 7.20 months. Patients experienced a mean increase of 27.75% in head circumference profile. The midline ridge was very effectively treated and paramidline ridges, although slow to resolve, did improve with time (Fig. 5). The correction of superolateral orbital rim retrusion was not consistent in our assessment, and subjectively we believed that FOA offers a superior lateral brow projection. There was no adequate way to document these discrepancies, as we did not routinely obtain images in the child. Interestingly, families tended to be very happy with the results and no revisions were performed or are pending (Table 3). All genetic evaluations were negative. One of the patients developed a postoperative wound infection and was treated with surgical debridement but no long-term antibiotics.
Preorthotic (left) and postorthotic (right) laser scanning report documents the change in head shape in an infant with metopic synostosis.
Three patients received helmet therapy that lasted an average of 5.43 months, and all 4 patients are monitored with regular follow-up. Patients experienced a mean increase of 29.83% in HCP. Cranial asymmetry decreased from a mean of 6.5 mm (range 6–7 mm) to a mean of 2 mm (range 1–2 mm). There was an excellent reduction of the windswept appearance and occipital asymmetry. In our subjective opinion, the results appeared better than those achieved with open posterior calvarial vault remodeling, which often seems inadequate in correcting this windswept appearance. There were no good objective measures to assess the outcomes, but we believed that they more than rivaled the larger operations (Table 3). No revisions were performed or are pending. No Chiari malformations were present.
Eleven patients had more than 1 fused suture. Three were unable to complete primary helmet therapy due to refusion of the treated suture (1 patient) and/or fusion of additional sutures (2 patients). In these cases, the reclosure was heralded by a falloff in the HCP. One of these patients was later diagnosed with Crouzon syndrome. Genetic anomalies but no syndromes have been found for the remaining patients who experienced refusion. These 3 patients underwent formal cranial vault expansion/remodeling. In addition, 1 patient with sagittal and unilateral coronal synostosis had persistent deformity despite no refusion or additional fusion; FOA was recommended. Seven patients had good results and no complications. An eighth patient is currently undergoing helmet therapy and is being monitored with regular follow-up.
This report confirms prior reports that EASC + PHT allows safe, early treatment of craniosynostosis and results in improvement in cranial shape and head circumference in most patients.2,9,10 Based on available anthropometric measurements and the subjective assessment of our craniofacial team, the shape correction was excellent in patients with sagittal and lambdoid synostosis, good in those with unilateral and bilateral coronal synostosis, and more variable for metopic synostosis. All patients also had a significant increase in HCP after release.
Our data also support the findings of other authors that the most important determinants of success after EASC + PHT is the age at which the suturectomy is done and the compliance with the PHT. We observed that in the subgroup of patients with sagittal synostosis, improvement in shape and HCP was inversely correlated with the age at which the procedure was done. This result is not unexpected given the mechanism by which EASC + PHT works. Because correction is achieved by carefully directed 3D brain expansion, the process is more efficient in younger infants who have the fastest rate and greatest potential for cerebral expansion. Ingraham and colleagues7 noted that age at the time of suturectomy played a significant role in the long-term outcome. They attributed poor outcomes to either a delay in surgery or surgical procedures that did not adequately free the involved bones or maintain their separation for an adequate length of time.7,17 Ingraham et al.7 and Shillito and Matson18 recommended that treatment for synostosis occur at 4–6 weeks of age to allow for maximum growth to occur. Similarly, Jimenez and colleagues9,10 reported that their best results were obtained when patients were referred very early in life. Their conclusions were that the best time to perform this procedure is at or before 3 months of age. It is our recommendation that suturectomy be performed as early as possible, balancing factors such as general infant health and weight, but ideally at or slightly before 3 months.
In our view, surgery alone is not adequate, and the other critical component to the success of EASC + PHT is compliant use of a well-designed orthosis. This is philosophically how the procedure is different from the strip craniectomy procedures of years past, and it appears to be a primary determinant of outcome. Although the utility of the helmet after this procedure has been questioned, in our experience, failure to guide the cranial expansion with an external orthotic is a principal reason for poor or under-correction. For the most part, we saw reversion of the deformity if the helmet was discontinued too early and inadequate results in the few children with poor helmet design or compliance. Conversely, a well-designed helmet really allowed for excellent correction in multiple planes of growth. By controlling growth in most areas, the orthotic acts by focusing most or all of the cranial growth in the areas where it is needed. Thus, the brain becomes a very effective internal distractor. Without a guiding orthotic device, expansion occurs in all directions and the correction is less complete. Jimenez and colleagues9,10 advocated continuing helmet-molding therapy until 1 year of age to prevent reversion. They reported that given cranial growth dynamics, once the patients have obtained normocephaly at 12 months, the shape will be maintained thereafter.9 It has been our practice to maintain helmet-molding therapy until 1 year of age or until normocephaly has been achieved and maintained on serial examination. Our data do demonstrate a small regression from maximal cranial index in patients with sagittal synostosis, most noticeably in the 2nd year of life. Consequently, we now maintain the helmet until the cranial index is greater than 0.8, or until 1 year of age. Relapse has also been observed in patients with sagittal synostosis patients treated with open cranial vault remodeling. Fearon and colleagues5 observed 132 patients for 3–11 years postoperatively (mean follow-up time 4.7 years) and documented initial overcorrection of cephalic index followed by an overall regression of cranial index. They also reported a diminished capacity for head circumference growth; patients had head circumferences significantly above normal preoperatively that decreased to less than 1 standard deviation over the mean. They concluded that there is an overall deficiency in skull growth either as a result of the operative intervention or from inherent osseous undergrowth related to the craniosynostosis. The very slight relapse we observed in our patients suggests that the former explanation is more accurate.
One advantage of early treatment with suturectomy is that it prevents secondary deformity. Numerous investigators have demonstrated that many of the characteristic features associated with craniosynostosis occur because the growth of distant patent sutures is affected by the cranial fusion.16,17,19 For example, patients with bilateral coronal synostosis often develop secondary turribrachycephaly in early infancy in response to limited anterior cranial expansion. Once established, this can be very difficult to treat surgically. Some groups now recommend performing an early posterior release in children with bilateral coronal synostosis simply to avoid the development of turribrachycephaly (unpublished data, 2009). In our experience, early suturectomy in patients with bilateral coronal synostosis prevents the development of significant turribrachycephaly as the brain can expand anteriorly.
Like any operative or medical treatment, EASC + PHT can fail if the management is poorly executed. This is well illustrated by the case report of Kohan et al.,11 wherein they described a pair of twins with sagittal synostosis, one managed by reverse pi procedure and the other by endoscopic release with helmet therapy. They found a posttreatment cranial index of 0.77 in the child managed with cranial vault remodeling and a posttreatment cranial index of 0.63 in the child managed by EASC + PHT.11 Although the authors chose to interpret this isolated example as evidence that the EASC + PHT procedure does not work, our uniformly good results with this procedure in patients with sagittal synostosis, as well as many other reports found in the literature, would suggest that this unfortunate outcome was more likely the result of inadequate surgery, poor compliance with helmet therapy, or inadequate duration of helmet therapy. We ascribe the success of our program to careful and consistent follow-up of the patients and very close collaboration and communication with the orthotist. It is particularly important to ensure that the orthotist understands which areas of the calvaria are to be contained (that is, limit growth) and which areas are to be allowed to grow freely. The location and extent of the release will largely determine the success of the correction. During the first years of our program, we routinely saw patients every 2–3 weeks postoperatively to ensure that the orthotic was fitted and contoured appropriately. As our orthotists became more experienced, the frequency was relaxed. In our opinion, lack of attention to the postoperative orthotic management is the main reason why some surgeons report seeing patients with poor correction following this procedure. Regarding the case report by Kohan et al.,11 anecdotally, our group has treated siblings with sagittal synostosis, one treated with open surgery and the other treated 3 years later with endoscopic surgery followed by helmet therapy. Although both had an acceptable outcome, the cranial index results were better in the child treated with EASC + PHT and the family far preferred the minimally invasive treatment. Given the limited conclusions that can be drawn from such an isolated comparison, we elected not to report this.
Similar to essentially all available studies of surgical technique in the craniofacial literature, our study is limited by it being a retrospective review of a technique with no control group. There was no attempt at randomization, especially as we became more convinced of the efficacy and safety of the minimally invasive techniques. Although we can examine historical controls within our group and the literature, we do not have a direct control group, nor does any other study in the literature. Moreover, the literature and the field are hampered by the lack of objective data by which to interpret and compare results. Even the most objective of our data points, head circumference and cranial index, are often considered poor surrogates by others in the field. In fact, many senior craniofacial experts have argued at national and international meetings that the results in craniofacial surgery are subjective and should not be held to objective standards, and clearly the field is limited by this lack of a firm benchmark. Where available, including the 3D photogrammetry study and the formal ocular studies for unilateral coronal synostosis, we have tried to objectify the data in a fairly subjective field.
As technology has evolved, minimally invasive procedures have grown in popularity in all surgical fields. Gall bladders and colons are removed via laparoscopy, cerebral aneurysms are treated via transarterial embolization, and robots are used in fields such as urology. It is therefore no surprise that the field of craniofacial surgery has seen a similar evolution. For any of these technologies to be adopted, the minimally invasive techniques need to show similar safety and efficacy profiles to the standard open procedures. Not surprisingly, there is often reluctance to accept the newer technologies as equivalent or superior. Our experience with EASC + PHT demonstrates the overall safely and efficacy of this treatment. The treatment is inherently different from what many craniofacial experts consider the failed era of strip craniectomy surgery, because newer technologies substantially change the skull growth patterns after surgery, and refusion of the skull before the correction is achieved is extremely unlikely. In our opinion, and based on a series of objective and subjective criteria, for single suture synostosis, the results can rival or exceed those produced by larger open cranial expansion techniques. The need for revision surgery due to refusion of the operated suture or fusion of other adjacent sutures was higher in children with multisuture synostosis. Failure of shape to improve or a sustained decrease in HCP should alert the physician to this possibility and additional CT scanning is advised. Overall, minimally invasive endoscopic suturectomy offers an excellent alternative to traditional open approaches and should be considered an option for children diagnosed prior to 3 months of age.
Author contributions to the study and manuscript preparation include the following. Conception and design: all authors. Acquisition of data: all authors. Analysis and interpretation of data: all authors. Drafting the article: all authors. Critically revising the article: Proctor, Berry-Candelario, Ridgway, Rogers. Reviewed submitted version of manuscript: Proctor, Berry-Candelario. Approved the final version of the manuscript on behalf of all authors: Proctor. Statistical analysis: Proctor, Berry-Candelario, Ridgway, Rogers. Administrative/technical/material support: Proctor. Study supervision: Proctor, Berry-Candelario.
Address correspondence to: Mark R. Proctor, M.D., Department of Neurosurgery, Children's Hospital Boston, 300 Longwood Avenue, Hunnewell 2, Boston, Massachusetts 02115. email: mark.proctor@childrens.harvard.edu.


text:
Harvard Bookstore
by Defne Karabucak
Photography by Mae Davis
The Harvard Book Store, an independent bookstore not associated with Harvard University, is located in Cambridge. The bookstore has been open since 1932 and recently entered the political drama through political displays criticizing President Trump and the Republican Party.
The displays began with Kellayanne Conway, President Donald Trump's top advisor, who has received backlash for her ability to stretch the truth. Recently Conway has been subject to scrutiny after her creation of the "Bowling Green Massacre."
Conway, in an interview with Chris Matthews on MSNBC's Hardball, cited the "Bowling Green Massacre" as reasoning to promote Trump's immigration ban, claiming the reason people did not know about it was due to the fact that it had "little to no coverage." In fact, there was no such massacre.
In response, the Harvard Book Store created a solemn tribute, through a display in their store, to the lives lost in the "massacre." Along with a sign "Commemorating the Victims" of the nonexistent tragedy, the store offered book recommendations that included titles on fascism, anti-intellectualism, dystopia and "assholes." The titles ranged from George Orwell's 1984 and Farhad Manjoo's True Enough.
The Harvard Book Store hopes the displays will provoke a discussion amongst shoppers. The "Bowling Green Massacre" memorial was put on display on February 8 and since then, other displays have been put up. The store has put #BowlingGreenMassacre on their website with specific books to purchase.
"We're intending to provide deeper resources to think, read, and explore both the current events around this idea of disinformation but also exploring the history of it," said Alex Meriwether, store marketing and event manager.
The store has displays that correspond with current events like trans rights, women's rights and the immigration ban. Special promotions at the shop in recent days have included a shelf of children's books for Muslim youth, along with signs reading, "You Are Welcome" and "You Belong."
After Senator Elizabeth Warren (D-MA) received sharp disapproval for attempting to read a letter by Coretta Scott King and sparked backlash on social media, the Harvard Book Store created a display that read, "#ShePersisted." Senator Elizabeth Warren attempted to read a letter to Congress and was told the words of Coretta Scott King were not suitable for a debate and was stopped from speaking. In his explanation for barring Warren from speaking, Senate Majority Leader Mitch McConnell said, "She was warned. She was given an explanation. Nevertheless, she persisted." He inadvertently turned "She persisted" into a rallying cry for women.
In response to the silencing, the Harvard Book Store put up their display to show their support.
Most recently, after Trump's decision to rescind protection for transgender students that had allowed them to use bathrooms corresponding with their self-identified gender, the Harvard Book Store put up a display with books about what it means to be transgender. They also put up a sign that read, "This display is for everyone," with a gender symbol inclusive of both genders.
"I think the Harvard Book Store has a lot of courage stating their opinion and making a statement," said Jackie Arcoleo (SMG '19). "It's good that they display current events because it will make the students more aware of what is going on in the world and get them talking about it."
The Harvard Book Store shows its continued support for human rights with the goal that through their books and displays, people will become more educated on the topic and discuss it with others.


This package gives your video the right boost.
Your video will be sponsored through social ads, google, and redirect traffic platforms.
The service lasts 10 days, and a report on the campaign will be provided at the end of the service.


Osteopathy in Dundalk, Maryland - Osteopathy in Dundalk, MD: Yellow Pages Directory Inc.
In Dundalk, osteopaths are health professionals who manipulate muscles and bones to promote structural integrity in the body to preserve health. Manipulative measures are often used in combination with conventional treatment.


text:
Q: How to intercept http status code 401 with angular 2? How can I intercept the "401 authorization required" in an angular 2 application with spring then redirect the user to the login page?
For example once I try to access a page if I am not connected. the interceptor must oblige me to connect. And I want this interceptor to listen to all 401 status returned by the server.

A: If you don't want to use any outside packages you can simply create your own rest http service.
All you need to do is to create a service class that extends Http.
Example:
export class RestHttp extends Http {

constructor(backend: ConnectionBackend) {
  super(backened, new RequestOptions (...))
}

get(url: string) {
  return this.catchError(super.get(url));
}

(delete, post, put) (...)

private catchError(res: Observable<Response>) {
  return res.catch((err) => {
    if (err.status >= 400) {
       *your logic*
    }
    return Observable.throw(err);
  });
}

Now you have to provide it inside your module. Something like this:
app.module
(...)
providers: [
  {provide: Http, useFactory: httpFactory, deps: [...]
(...)

export function httpFactory(backend: XHRBackend) {
   return new RestHttp(...)
}


← A Literature community in Twitter is born!
For those who find Dover Beach a challenging poem, I am hereby publishing the poem and underneath a very interesting web site with a complete and quite thorough analysis of the poem.
This entry was posted in LITERATURE S3 2011, LITERATURE S4 2011. Bookmark the permalink.


Best selling! Douthat Side Chair (Set of 2) good design By Canora Grey. Douthat Side Chair (Set of 2) very well made, sleek and simple. Complete your living room furniture with a modern Douthat Side Chair (Set of 2). Its good looking sturdy, attractivce and it looks expensive and a good value for the money. Douthat Side Chair (Set of 2) is one of the most cushy, cozy, beautiful look and exotic Douthat Side Chair (Set of 2) especially for the price and made of fantastic products. Great quality, easy to assemble, delivery on time and in perfect condition. Douthat Side Chair (Set of 2) is good merchandise at fair prices and wonderful free shipping. Guarantee damaged claim by offering to send parts or to keep the item at a discounted price. Great buy would definitely recommend. Shop with our low-price guarantee and find great deals on ##ptitle# and more!. Reading the reviews helped you purchase.
Its very difficult to make a kitchen area without some type of club feces. In fact, barstools have grown to be so popular that its very difficult to not locate one inside a cooking area. That is for a good reason, although, since they permit friends, loved ones, and other guests to simply join you in the kitchen area for any scrumptious dinner and some excellent discussion. But buying the correct bar stools for your kitchen may be a little bit difficult, and this is especially the case if you do not understand how to pick one. In the end, since this is among the most used and many essential rooms in the home, its only natural that you get the very best bar stools for it. Fortunately, we already do the research for you personally, as well as in the paragraphs below we created a list of the very best 10 bar stools you can buy for the kitchen area or club. After you review this list, you will effortlessly be able to purchase the correct barstools for your requirements. Lets check them out!
You cant talk about this couch without talking about its impressive style, durability, and comfort. Should you ever required a comfortable chair, then move quick and obtain your self Coaster Samuel Collection Lotion Leather Sofa. You will like it. This 3 seater couch has thoroughly clean outlines and excellent soft cushions. The soft cushions are affixed to the chair and behind. It is made from leather which definitely is a certain wager that it is long lasting. It also functions tufted back and chairs that certainly adds to its impressive appear. More to the point, it features a springtime foundation that gives it the necessary durability and comfort. Its wood frame causes it to be really sturdy. The lengthy and the short of it is that this sofa is extraordinary in each and every element. You may or may not accept this. But the only way you are able to appreciate this is to buy and try it.
The word this is actually the comfort and sophisticated appear. This established has a tufted back rest and nail head accent that gives it the sophisticated look. Its gray color contributes to its impressive look. It can fit as much as 8 in . mattress. That alone lets you know how comfortable the established can be. Particularly, it does not include a mattress. So you may want to buy one. The trundle features a castor to allow easy access. You may even draw the trundle that people take a seat on. Simply to point out, it may need putting together, however its very easy to put together.
Fluffy, overstuffed loveseat soft cushions are not your lifestyle? This lying loveseat from GDF has crisper, solution lines than your traditional reclining loveseat, which makes it an elegant addition to a middle-hundred years modern, modern, eclectic or contemporary style of house. And, at just 46.46 in . in width, its easy to squeeze into an inferior room, like apartments, dens or offices. Obtainable in several colour and material options, such as charcoal fabric, navy fabric and slate micro-fiber, its simple to find the right complement for your home decorations, and also the durability your loved ones requirements for everyday use. Gone are the days of excellent-looking, but unpleasant Tiffani Reclining Sofa you will no longer need to give up comfort and ease for design. This reclining loveseat functions a big, soft, luxurious-filled chair cushioning with sufficient room for 2 or sufficient space for you to disseminate and relax.
This sofa is appreciated for its distinctive design and comfort. Its impressive flare-equip couch with chairs provides you with maximum space for stretching and relaxing in your living space. So generally the modern couch chaise adds to the great thing about this set. The set includes cushion top arms padded back and seats for optimum comfort. The couch also includes a large part-obstructed wood body that gives the sofa enough sturdiness. The sofa steps 89 in . wide by 62 in . thorough x 4 in . in height making it suitable for moderate size rooms. You may need to do small assembling for example from the thighs.
Carolina Mild Grey Material Sectional Couch is celebrated for its stunning comfort and ease and impressive design. It features a lift-up design that enables for several arrangement choices to meet your requirements.The established features gentle fabric and pushes soft cushions to bring about the desired comfort. More importantly, its of a great dimension to accommodate you together with the family of buddies. With respect to the space as well as your preferred shape, you can combine the I chairs to create a remarkable shape. Its recommended for all those with small rooms and requires a couch.
The best part that makes up for the lost time the consideration of the purchasers is its design effortlessly. Only for the feel of the upholstery, you receive a nice stylish environment. It's available in rich strong shading, emulating as amazing official attire. While maintaining an honorable prominence, the fabric furniture could be cleaned effortlessly. You shouldn't regret after generating a cup of consume on your nice sofa. You just need to clean the stain without end exactly if this strikes the upholstery. Even though good reputation comes with delicacy, it's not the situation here. This incredible couch is fed having a shape growth and development of wood. You're much more unwilling to hear squeaks and walking seems.
This is the subsequent couch on the checklist. It is extra comfortable and very well suited for little areas or attic residing. It is upholstered in polyester material, prospects inset control keys that give a stylish gemstone-tufted style. It is made from durable materials and the legs are constructed with durable wooden to increase its sturdiness. The loveseat has an espresso discolored wooden thighs and non-tagging foot caps. It offers a comfortable foam cushioning and rayon fabric upholstery which makes it extremely magnificent. It features a longue place that provides an exceptional space for relaxing.
This set includes a 1 remaining equip couch established, two armless couch models and something corner couch set. This provides enough room to accommodate your friends and relations. The fabric is 100% rayon for enough comfort and durability. The good thing about this couch established may be the matching and mixing of seats within the available space within the room for any perfect form. As well as allows for fitted even in small rooms. It requires just light putting together.Additionally, it functions drive cushions for optimum comfort and ease. You may want to do this set. It works well.
The word this is actually the comfort and ease and sophisticated appear. This set has a tufted backrest and toe nail head accent that provides the subtle appear. Its grey color contributes to its impressive look. It can fit up to 8 in . bed mattress. That alone tells you how comfortable the established could be. Notably, it doesn't include a bed mattress. So you may want to buy one. The trundle features a castor to enable easy access. You may also draw the trundle that people take a seat on. Simply to mention, it may need assembling, but again its very easy to put together.
Using the current surge in interest in the Middle-Hundred years Contemporary style style, this couch style is a warm item. Regardless of whether accurate vintage items, reproductions or new styles that incorporate Middle-Century Contemporary elements, they are really versatile sofas. Most often utilized in a minimal or middle-century design scheme, they are wonderful for adding a vintage feel to a space. The distinguishing components range from the exposed thighs and straight line framework. Most middle-hundred years sofas but not all of them may have some tufting around the back.
Copyright © Douthat Side Chair (Set of 2) By Canora Grey in Sofas All right reserved.