This website is dedicated to my follow collectors, all the coins exhibited on these pages, and to the art of capturing those coins through photography. It is a celebration of the magnificent color of naturally toned coins and to splendor of their design and rich history. The first four pages (that are linked to the first four, leftmost, navigation buttons above) display coins in my personal collection. The following 11 pages, from Raisinet to Larry Gallery, display coins owned by others that I have photographed. My many thanks and appreciation goes out to all the owners of those coins. I feel extremely fortunate and proud to have been allowed to photograph these gorgeous pieces of history, each coin unique in its beauty and color.
My thanks goes out to Todd, also known as blue62vette on most of the Coin Discussion boards. He is a great coin photographer and has a loyal following. It was his advice that led me to hosting these images on my own website.
None of this would be possible without the tireless genius of my CoinTalk friend WingedLiberty. The design & layout, as well as the banners & navigation buttons, were done by him. My only contributions were the coin images and a thank you note. I enthusiastically recommend WingedLiberty to anyone who needs or wants a website. You will not find anyone that will work as proficiently or with as much passion. He is not only good, he absolutely loves the process of web design.


Hepatitis C nurses and staff from the AIDS Committee of North Bay & Area (ACNBA), Réseau Access Network Sudbury and the Sault Ste. Marie Group Health Centre was in Wawa yesterday. Despite the cool windy day, people enjoyed a BBQ lunch featuring hot dogs, chili and juice.
This M*A*S*H tour "Mobilizing Access to Services for Hepatitis" is a whirlwind, five-day tour visiting the northern communities of Espanola, Wawa, Pic Mobert, Chapleau, Cochrane, Timmins and Kirkland Lake from September 12 – 16, 2016.
ACNBA nurse practitioner, Keri McGuire Trahan explained that this tour offers not only a testing opportunity but provides an opportunity to discover what other services there are to support an individual with Hep C. Hep C can be detected by a blood test, which if positive means that an individual has to be tested further to determine the progression of the disease and treatment. That could mean a needle biopsy of the liver, or with a piece of equipment that travels between these communities and similar to ultrasound can detect the 'firmness' of one's liver.
If your liver is the consistency of ricotta cheese – soft, that's good. But if your liver is like a fine, aged cheddar – hard, you would experience medical issues and treatment necessary. There are effective medications out there, expensive and possibly out of reach for some of the people who suffer from Hep C – but this is a slow acting disease, and there are options to get help. It was explained that there has never been an instance where a client was unable to get treatment despite their financial circumstances.
This Mobile M*A*S*H unit travelled to Pic Mobert last night and is now headed on the road again.


text:
Suspect found dead after mass shooting in Monterey Park, CA that killed 10, injured 10
by OneAdmin
Authorities said on Sunday that the suspected gunman who allegedly shot 20 people — killing 10 — at a dance studio near a Lunar New Year celebration in the Los Angeles suburb of Monterey Park has been found dead of a self-inflicted gunshot wound. The shooting took place in a community of 61,000 that is 65% Asian. Ten people died at the scene — five men and five women — and 10 others were transported to local hospitals in conditions from stable to critical. As of press time, seven remain hospitalized.
Los Angeles County Sheriff Robert Luna said Sunday night that the suspect, Huu Can Tran, 72, was found dead inside a white van in a strip mall parking lot in Torrance, Calif., about 30 miles southwest of Monterey Park, where the massacre occurred. Authorities said they found a handgun and other evidence inside the van. Sources told CNN that Tran had a regular presence at the dance studio, including meeting his ex-wife there.
The shooting occurred at 10:22 p.m. at the Star Ballroom Dance Studio on the eve of the Lunar New Year, which was mostly frequented by Asians in San Gabriel Valley. Monterey Park is about 7 miles east of downtown Los Angeles. The same gunman was later linked to an incident at 10:30 p.m. at another dance studio in the neighboring suburb of Alhambra, north of Monterey Park, in which a man fled and a weapon was seized by two community members. The sheriff's department said that "several pieces of evidence" linked to both incidents were found inside the van used by the suspect, including a handgun. They added that no outstanding suspects are linked to the massacre and there is no danger to the area. LA Country Sheriff Luna said: "We still are not clear on the motive … The investigation continues … we want to know how something this awful can happen."
Gov. Gavin Newsom posted on Twitter: "No one should have to fear going to a celebration with their community. Our thoughts are with the victims and all those impacted." And President Biden ordered all U.S. flags at public buildings to be flown at half-staff to honor the victims, releasing a statement: "Even as we continue searching for answers about this attack, we know how deeply this attack has impacted the Asian American and Native Hawaiian, Pacific Islanders (AA and NHPI) community. Monterey Park is home to one of the largest AA and NHPI communities in America, many of whom were celebrating the Lunar New Year along with loved ones and friends this weekend."
Editorial credit: Elliott Cowand Jr / Shutterstock.com
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This photo would look a lot different if you had red-green colorblindness.
Nike and the NFL had the New York Jets and Buffalo Bills wear bright, unicolor jerseys during Thursday Night Football this week, as part of a promotion called "Color Rush" that involves alternate uniforms worn one day a week.
It looked like your typical half-hearted marketing stunt — until a big problem arose. The Jets were outfitted in all green, while the Bills were decked out in all red. Soon after the game started, a small army of people with red-green colorblindness took to Twitter complaining that they could not at all tell the two teams apart.
These are the unis the Jets and Bills wore Thursday night.
Here's a screengrab of a play during the game, according to a simulation run by Deadspin of what it looked like to fans with red-green colorblindness.
You'll quickly notice that it appears impossible to tell the two teams apart. According to the National Eye Institute, red-green colorblindness is the most common form of the affliction, effecting up to "8 percent of men and 0.5 percent of women with Northern European ancestry."
Now here are a bunch of NFL fans with red-green colorblindess who were royally ticked off that they couldn't really watch Thursday night's game.
To the NFL and Nike: Good job, good effort and better luck next time.


Born in Ghana, Godfred moved to the US when he was 8 and redefined the term "student athlete." A former wrestler, track athlete, and football player, we wonder how he found the time to get his Master's in Exercise Physiology and Kinesiology. Godfred provides expert sports training elements to his sessions, incorporating range of motion and strength and conditioning elements to get the most out of his clients. Oh, did we also mention he was MMA and boxing conditioning experience? Prepare to sweat.


We write today about the main wall of the Rio de Janeiro Yacht Club (Iate Clube do Rio de Janeiro), located in the pleasant neighborhood of Urca.
Giant as the tradition of the club it protects, the wall was constructed between 1946 e 1947 and goes through a good portion of Pasteur Avenue, which communicates Urca with the Cove of Botafogo (Enseada de Botafogo). We have particular interest in the left part of the wall, starting from the main door to the left and going just until the next gas station near the cove`s entrance.
Built in the form of waves – 53 ups and downs, more precisely -, the wall is protected by the City Hall since 2016. In each of its elevations – with the exception of a few gaps -, lies a set made of 16 square tiles with their vertices facing up and surrounded by a blue mortar frame – always decorated with nautical or marine motifs. There are 48 tile sets, total.
According to the critic Frederico Morais in his book "Azulejaria Contemporânea no Brasil", the original drawings belong to the couple Arpad Szenes and Maria Helena Vieira da Silva – she, most probably. The production, however, we owe to another couple, Anna Soares Mandescher and Adolpho Mandescher, hence the signature A. Soares in many of them.
I registered all the sets, some in terrible conservation. 21 of them are shown below.
 The club was initially baptized Fluminense Yachting Club, as it was created in the headquarters of Fluminense Football Club, in March 25th, 1920, during the administration of Arnaldo Guinle.
 I went there and counted the number of sets, but if anyone would like to do same, to confirm the information, please be my guest.
 I thank my friend Angelica Galetti for such a precious information.


Janet is your girl! My makeup was FLAWLESS on my wedding day. She traveled to the hotel and was also able to accomodate the rest of my family at the last minute too! My hair was beautiful!! And stayed beautiful the whole night even with the crazy dancing and jumping up and down!


Anyone out there remember that commercial?
Do you also remember when the coffee choices at the grocery store were pretty much Folgers and Maxwell House?
Depending on what study you believe, I either drink too much coffee or I have just the right amount of coffee to get all the great antioxidant benefits.
I just enjoy coffee. And I enjoy a great variety in my coffee. This explains why there at least eight different blends in my pantry right now. And three different machines for preparing them on my kitchen cabinet.
I am closing in on my 10th anniversary at Harvest Baptist Association, but back when I was still pastor of Eagle Mountain Baptist Church, Cross Timbers Coffee Company (CTCC) in Azle was my office annex. I had so many meetings there over good cups of coffee – so many conversations, so many prayers – and probably a few too many paninis and muffins (but I digress).
When CTCC was about to close, I asked if I could buy one of the house mugs with the logo. The coffee, the friends and the place had been such a big part of my life that I wanted a memento.
So what brought about this little trip down memory lane today? I woke up and poured myself a cup of coffee and started thinking about the best part of waking up. As much as I enjoy my coffee, it is only part of the picture.
The best part of waking up is seeing Mrs. Sweetie right there next to me where she has been for almost 34 years. It continues as I select two cups from our varied collection and pour whichever blend I prepared the night before.
The best part continues when I take her cup to the bedroom and mine to my rocking chair by the living room window. Then I sip the coffee, open God's word and spend time with the One who made me, the One who gave me the gift of a soul mate, a roof over my head, good coffee and a cup from which to drink it.
The Bible says, "Every good and perfect gift is from above, coming down from the Father of the heavenly lights, who does not change like shifting shadows." (James 1:17) That means I didn't earn any of the blessings I have. I might have worked hard for them and purchased them, but even the job I go to is a gift from God.
The best part of waking up is knowing that our lives matter to God. He has provided more than we deserve, and He has a purpose for us to honor Him in all of it.
Put that in your cup and savor it. It's good to the last drop.


A simple space calls for a simple accent. Wallpaper your fireplace to be the focal point of your room!
Hi. I love this wallpaper. I live in London; is this paper available over here? If so can you tell me what the name / make is. I also love love love your style.
My apologies but I don't know where this wallpaper is from. If you print out this image and go into a wallpaper store, they should be able to guide you to finding one similar.


In today's fast-paced technology age we are overwhelmed with the volume of information there is to read. Every day we get bombarded with emails, texts, articles and other data. In addition, we have books, studies, research, and other information to consume. We spend time with our family, friends, and manage to find down time too. Often we sacrifice comprehension and recall. Keeping up with information seems virtually impossible.
Now is the time to action. Take a proactive approach toward improving your reading by learning Phenomenal Reading! When you decide to enhance your reading skills you take action to improve the quality your life. Better reading improves work performance, school performance, productivity, family life and more. What is time and information retention worth to you? Priceless!


05/29/11 He Did, So We Should!
Intro: "Memorial Day". It is more than just another holiday. It is more than just a day off from work. It is more than a day that we can go to the lake or a day that we can have a barbeque. It is "Memorial Day." It is a day set aside to remember those who have given their lives for the freedom that we as Americans all share. Freedom has never come cheaply. More than a million Americans have died in wars fighting for the freedom that we enjoy today. In the Civil War, 498,000 Northern soldiers were killed, and 133,000 soldiers from the South died. In World War One, 116,000 American soldiers died. In World War Two, 407,000 American soldiers died. 54,000 American soldiers died in <?<span>Korea, 58,000 died in Vietnam, 148 died during Desert Storm. As of May 21, 2008 there were 4,079 American Soldiers that have died in Iraq. Of course there were conflicts and causalities as well. More than a million Americans have died in wars around the world fighting for the freedom that we enjoy in this country.
We have the freedom to vote for our leadership in this nation. We have the freedom to debate who one should vote for – or not to vote for. We even have the freedom to poke fun at those who are running office and we have the freedom to say our peace when they win. We also have the freedom to worship – or not to worship as we please. But let me say it again – freedom has never been free. And so we gather today to remember. We as Americans enjoy the freedom that we have because someone has paid the price for that freedom – freedom is not free but it comes with a price. We who are gathered here today realize this fact and we pause on this day to remember.
Today, on this very day in America, people of all ages, ethnic backgrounds and faiths are joining together to remember the sacrifice that our service men and women – in wars past and present – have made so that we can enjoy our freedom. Those brave men and women who have made the ultimate sacrifice so that you and I can gather here and remember. And we do – remember. "No one has greater love than this – that one would lay down his life for his friends." Our service men and women have been willing to do that very thing since the founding of our nation. When is the last time you heard of someone dying for an enemy: Christ Did. Christ laid down His own life so we who are his enemy could live!
When was the last time you were willing to lay down your life for a friend?
Let's ponder that thought for just a moment! "Gave Himself for us!" I'm sorry I have to say this: I really wonder if some of us deserve anyone, let alone Christ – die for us. Christ died in our place, in our stead, as our substitute. Christ tells us: "I am the good shepherd: the good shepherd giveth his life for the sheep" John 10:11. "As the Father knoweth me, even so know I the Father: and I lay down my life for the sheep" John 10:15.
We have a hard time grabbing the idea of sacrifice. Let's face it, it is hard to even give up our place in line - in a 10 items or less line and we have ten items and the person behind us has one. To offer them the chance to go before us, I DON'T THINK SO!
He did so we should!
We need to come alive in the spiritual realm!


text:
Contact Lenses for Keratoconus- Current Practice
Marilita M. Moschos1, *, Eirini Nitoda1, Panagiotis Georgoudis2, Miltos Balidis3, Eleftherios Karageorgiadis3, Nikos Kozeis3
1 Department of Ophthalmology, Medical School, National & Kapodistrian University of Athens, Greece
2 Queen Victoria Hospital NHS Trust, East Grinstead, United Kingdom.
3 Institute of Ophthalmology and Ocular Microsurgery 'Ophthalmica', Thessaloniki, Greece
Issue: Suppl-1, M8
Publisher Id: TOOPHTJ-11-241
© 2017 Moschos et al.
* Address correspondence to this author at the Department of Ophthalmology, Medical School, National & Kapodistrian University of Athens, Greece, 6, Ikarias street, Ekali, 14578, Athens, Greece; Tel: +306944887319; Fax: +302104122319; E-mail: moschosmarilita@yahoo.fr
Keratoconus is a chronic, bilateral, usuallly asymmetrical, non-inflammatory, ectatic disorder, being characterized by progressive steepening, thinning and apical scarring of the cornea. Initially, the patient is asymptomatic, but the visual acuity gradually decreases, resulting in significant vision loss due to the development of irregular astigmatism, myopia, corneal thinning and scarring. The classic treatment of visual rehabilitation in keratoconus is based on spectacles and contact lenses (CLs).
To summarize the types of CLs used in the treatment of keratoconus. This is literature review of several important published articles focusing on the visual rehabilitation in keratoconus with CLs.
Gas permeable (GP) CLs have been found to achieve better best corrected visual acuity than spectacles, eliminating 3rd-order coma root-mean-square (RMS) error, 3rd-order RMS, and higher-order RMS. However, they have implicated in reduction of corneal basal epithelial cell and anterior stromal keratocyte densities. Soft CLs seem to provide greater comfort and lower cost, but the low oxygen permeability (if the lens is not a silicone hydrogel), and the inability to mask moderate to severe irregular astigmatism are the main disadvantages of them. On the other hand, scleral CLs ensure stable platforms, which eliminate high-order aberrations and provide good centration and visual acuity. Their main disadvantages include the difficulties in application and removal of these lenses along with corneal flattening and swelling.
The modern hybrid CLs are indicated in cases of poor centration, poor stability or intolerance with GP lenses. Finally, piggyback CL systems effectively ameliorate visual acuity, but they have been related to corneal neovascularization and giant papillary conjunctivitis.
CLs seem to rehabilitate visual performance, diminishing the power of the cylinder and the high-order aberrations. The final choice of CLs is based on their special features, the subsequent corneal changes and the patient's needs.
Keywords: Keratoconus, Cornea, Contact lens, Visual rehabilitation, RMS, GP.
Keratoconus (KCN) is a chronic, bilateral, usuallly asymmetrical, non-inflammatory, ectatic disorder, being characterized by progressive steepening, thinning and apical scarring of the cornea [1]. Its prevalence was considered to be 1 in every 2000 individuals until the development of corneal topography devices, which raised the number to 54, 1190, 2300, 3.3 and 20 per 100,000 in the USA, France, India, Iran (Tehran) and Middle East, respectively [1-3]. Structural abnormalities in the corneal epithelium, Bowman's layer and mainly stromal collagen along with altered tear components are responsible for its clinical features. The latter include declined focusing at all distances due to progressive myopia and irregular astigmatism, increased corneal high order aberrations (mainly coma) affecting primarily visual quality, inducing haloes and image distortions. These visual disorders may have major impact on the quality of life [1, 2]. Keratometric, retinoscopic or slit lamp findings are important diagnostic tools for clinical keratoconus, while the subclinical type exhibits only mild topographic changes [1].
1.1. Pathogenesis of Keratoconus
Biomechanics, enzymology, proteomics, and molecular genetics are implicated in the pathogenesis of keratoconus. Altered expression of extracellular matrix proteoglycans, such as decorin, lumican, biglycan and keratocan, and proteins, along with decreased stromal collagen content are the basic structural changes observed in keratoconus [4, 5]. The changes in extracellular components result in the distortion of collagen fibers and lamellae, eliminating corneal strength and transparency [4, 5]. Additionally, alteration in cell junctions are associated with decreased levels of transforming growth factor beta (TGF-β) [5]. Accumulation of proteolytic enzymes, including cathepsin-B, -G, -V/L2 and lysosomal enzymes is implicated in degradation of collagen and cell death [5]. Furthermore, cathepsins regulate cell apoptosis and mitochondria function, contributing to oxidative stress. Increased mtDNA content in patients with keratoconus may indicate mitochondrial respiratory chain defects [6]. An imbalance between matrix metalloproteinases-2 (MMPs-2) and their tissue inhibitors (TIMPs), which exhibits anti-apoptotic properties, has also been related to corneal thinning. The expression of MMPs and cell apoptosis are impaired by the high levels of interleukins, which are released by eye rubbing and chronic contact lenses wearing. High levels of transforming growth factor (TGF-β1), and dual-specificity phosphates 1 (DUSP1) messenger ribonucleic acid (mRNA) have also been measured in eyes with keratoconus [7].
Although keratoconus is usually sporadic, a genetic predisposition with increased incidence in familial and monozygotic twins has been described [4, 8]. The modes of keratoconus inheritance are dominant and recessive, but in autosomal dominant inheritance, the disease shows incomplete penetrance with variable phenotype [8]. Moreover, it has been related to systemic and ocular conditions, including Leber congenital amaurosis, anterior polar cataract, Down syndrome (10–300-fold higher prevalence) and Ehlers Danlos syndrome [4]. VSX1 (Visual system homeobox 1), TIMP3, TGFBI, ZEB1, filaggrin (FLG) and several collagen genes, such as COL4A3, COL4A4 AND COL5A1, have been associated with keratoconus, while the distinct potential loci, which have been described, include 3p14-q13, 5q21, 5q32 and 14q11. Furthermore, LOX, FOXO1, FNDC3B, RXRA-COL5A1, MPDZ-NF1B, COL5A1 and ZNF469 are single-nucleotide polymorphisms (SNPs), exhibiting high risk of keratoconus [4, 5, 8].
Environmental factors, including eye rubbing, atopy, and sun (UV) exposure have been implicated in pathogenesis of keratoconus [9]. Moreover, a positive familial history and the parental education and socioeconomic status seem to impair the development of the disease. Keratoconus exhibits different distribution, depending on geographic location and race. Asians (Indians, Bangladeshi, and Pakistani) living in the English Midlands have an incidence of the disease 4.4 times higher than in whites. Moreover, Northern Europe, Japan and the Urals have low prevalence, as well as northern USA. On the other hand, it is relatively high in the countries of Middle East, India and China. Finally, the age seems to affect the development of keratoconus; the mean diagnostic age ranges from 20.0 years (±6.4) to 24.05, whereas it seldom appears after the age of 45 years [9].
1.2. Clinical Features and Diagnosis
Keratoconus is a progressive condition which usually stabilizes by the fourth to fifth decade of life [9]. Initially, the patient is asymptomatic, but the visual acuity gradually decreases, resulting in significant vision loss due to the development of irregular astigmatism, myopia, corneal thinning and scarring. Although the disease develops unilateral, the majority of patients eventually develop bilateral keratoconus [9]. The early signs of keratoconus include Fleischer's ring, which is a partial or complete circle of iron deposition in the epithelium surrounding the base of the cone and Vogt's striae, fine vertical lines produced by compression of Descemet's membrane. Oil droplet reflex can be seen with direct ophthalmoscope, while retinoscopy reveals an irregular scissor reflex. As the disease progresses, a Munson's sign appears, being characterized by a V-shaped deformation of the lower lid, when the patient looks downwards [10]. Rizzuti's sign is another feature of disease progression and it represents a bright reflection of the nasal area of the limbus [11]. Less common are breaks in Descemet's membrane, resulting in hydrops, which are described by stromal edema, vision loss, and associated pain [10].Corneal scarring is a common sign of wearing contact lenses [12].
The basic diagnostic examinations for keratoconus include placido disk–based corneal topography, Orbscan I (Bausch & Lomb, Rochester, New York, USA) and II slit topography, Pentacam (Oculus, Wetzlar, Germany) Scheimpflug imaging, wavefront aberrometers and spectral domain optical coherence tomography (SD-OCT). On the other hand, confocal microscopy, Ocular Response Analyzer (ORA, Reichert Inc., Depew, New York, USA) and Fourier Transform Infrared (FTIR) spectroscopy are more advanced diagnostic devices, not specific for keratoconus and still under investigation. The Placido videokeratography map of keratoconus displays a zone of increased corneal power surrounded by zones of decreasing corneal power, inferior-superior asymmetry in corneal power and skewing of the steepest radial axes above and below the horizontal meridian [13]. Although this is a highly sensitive and specific diagnostic tool, it only evaluates the anterior surface of the cornea.
The anterior and posterior corneal elevation as measured by Orbscan II could be useful in differentiating clinical and possible subclinical keratoconus from normal eyes [14]. Jafarinasab et al. estimated the mean posterior corneal elevation to be 106.80 ± 43.98 μm, 36.60 ± 22.80 μm and 25.00 ± 9.15 μm in clinical and subclinical keratoconus and in normal eyes, respectively. 49.35 ± 21.60 μm, 15.07 ± 7.48 μm and 11.05 ± 4.03 μm were the values of mean anterior corneal elevation μm in clinical and subclinical keratoconus and in normal eyes, respectively [14]. A cutoff point of ≥ 51 μm was highly sensitive (89.23%) and specific (98.58%) for posterior corneal elevation and a cutoff point of ≥ 19 μm was highly sensitive (93.85%) and specific (97.16%) for anterior corneal elevation to differentiate clinical keratoconus from normal subjects [14].
The Scheimpflug imaging used by Pentacam provides a combination of corneal refractive (keratometric), topometric, tomographic, and pachymetric data. It can evaluate the indices of surface variance (measure of corneal surface irregularity), vertical asymmetry (value of curvature symmetry), height asymmetry (the difference between superior and inferior height values), height decent ration (the value of the decent ration of elevation data in the vertical direction), minimum radius of curvature (measurement of the smallest radius of sagittal corneal curvature), keratoconus index (the ratio between mean radius values in the upper and lower segment) and central keratoconus index, as well [15]. Kanellopoulos et Asimellis supported that these indices of surface variance and of height asymmetry are more sensitive and specific tools to see visual acuity in early diagnosis and for evaluation of progressive keratoconus [15].
The ORA have been used to calculate corneal hysteresis (CH) and corneal resistance factor (CRF), which represent two biomechanical corneal parameters. Both parameters are considered reliable to differentiate normal from keratoconic eyes [16]. Recently, the keratoconus match index (KMI) - which is the outcome of seven waveform scores and represents the similarity of the waveform of the examined eye against the same average waveform scores of the keratoconus eyes in the machine's database-, and the keratoconus match probability (KMP) - which attempts to quantify the probability that a certain eye is actually normal, suspect or keratoconic- estimated by ORA [17]. Labiris et al. estimated that KMI exhibited an overall predictive accuracy of 97.7%, with a sensitivity of 91.18% and specificity of 94.34%. The cut-off point, below which corneas are probably ectatic, was defined as 0.512. Furthermore, they associated the stages 2-3, 3 and 3-4 of Amsler-Krumeich classification with KMP mild, moderate and severe classification, respectively [17].
The OCT pachymetric measurements are accurate and highly repeatable [18, 19]. OCT can overcome limitations of topography resulting from corneal irregularity and tear film break up. Moreover, pachymetric measurements are considered to be more repeatable than those obtained with Scheimpflug imaging in keratoconic eyes [20]. The correlation of OCT-derived epithelial mapping with established Scheimpflug-derived asymmetry topometric indices reveals the OCT reliability in early and advancing keratoconus diagnosis [21].
1.3. Treatment of Keratoconus
Although the classic treatment of visual rehabilitation in keratoconus is based on spectacles and contact lenses, the modern surgical techniques include intraocular lenses, collagen cross-linking (CXL), intrastromal implants, microwave remodeling, and anterior lamellar keratoplasty. Collagen cross-linking was clinically introduced in 2003 to delay cone progression, based on photochemical reactions of UVA radiation, riboflavin and oxygen [22]. Until today, it is considered the basic surgical technique to slow keratoconus, changing the steepening of the topographic K-readings in keratoconus patients [23]. The biomechanical modifications achieved with collagen cross-linking are usually accompanied by improvement in visual acuity and spherical equivalent both in younger and individuals over 35 years old [24, 25]. However, haze, bacterial keratitis, corneal melting and band keratopathy are referred as complications of cross-linking and they are estimated to range between 2.6% and 3.9% [23, 25].
Intrastromal corneal ring segments (ICRS) are an alternative treatment for keratoconus in patients with clear corneas and contact lens intolerance [26-28]. The technically demanding manual construction of the intrastromal tunnel for ring implantation was related to complications, including epithelial defects, melting and perforation [26, 27]. The latter explain the attempt to replace the manual technique of tunnel construction by the femtosecond assisted. Ferenczy et al noted that ICRS implanted using femtosecond laser is a safe method to decrease curvature of the cone apex in the topographical analysis, and as well as corrected diopters postoperatively [29].
Penetrating keratoplasty (PK) has been considered as the definitive procedure for the treatment of keratoconus over the past few decades, being accompanied by the risk of allograft endothelial rejection and subsequent risk of graft failure. On the other hand, deep anterior lamellar keratoplasty (DALK) eliminates this risk, involving the removal of anterior diseased cornea and leaving the deeper tissue intact. Femtosecond laser-assisted deep anterior lamellar keratoplasty has been proposed as better surgical option for visual rehabilitation in patients with keratoconus [30]. However, the subsequent final refractive errors and higher-order aberrations may severely affect the visual outcome, even if the surgery is successful [31]. Epikeratoplasty seems to stabilize astigmatism in patients with keratoconus, suffering from intolerance of contact lens, irrespective of astigmatism and corneal thickness [32]. Post-operative complications such as, persistent epithelial defect (PED), severe anterior segment inflammation during early post-operative period, graft melting and interface haze during the intermediate post-operative period, hypoesthesia, peripheral corneal ulcer and posterior sub-capsular cataract during the late post-operative period, have been reported [33-39]. The genes implicated in the pathogenesis of keratoconus open up perspectives for the application of gene therapy in the treatment of the disease [40].
2. CONTACT LENSES IN KERATOCONUS
2.1. Fitting and Optical Principles of Contact Lenses in Keratoconus
2.1.1. General Fitting Considerations
Keratoconus correction aims to create homogeneous optics in the whole optical system of the eye, free from aberrations of low and high order. Furthermore, the lens choice should be such as, according to the level of ectasia, the keratoconic cornea, to maintain the increased necessities of physiology, keeping in consideration that these patients would ideally use the lenses for long wearing times [41, 42].
Ectatic cornea has decreased tensile properties and reduced thickness as a result of structural alterations at the molecular level of collagen fiber interconnection. It is also a well-known correlation between eye rubbing and acceleration of ectasia. Therefore lenses that are fitted in keratoconic eyes should be in minimum contact with the surface, without applying pressure, because the presence of pressure in conjunction with any rubbing effect could further deteriorate the ectasia or create localized nebulae.
In more advanced cases, the cellular layers, are reduced numerically, adding one more factor of fragility and thus increased need of preserving normal corneal physiology.
Limbus has its importance when contact lens fitting is concerned. The presence of stem cells has an essential role in the corneal physiology and regeneration. Therefore the contact with the limbal area has been minimal, or even absent without rubbing with hard or high modulus hydrophilic materials.
The palpebral conjunctiva is in continuous contact with the lenses in a dynamic manner, between millions of blinks. Therefore contact lens surface has to be well polished, minimizing the interaction between the conjunctiva papillae and the surface or edge of the lens. In the opposite case, the giant papillary conjunctivitis may occur, due to mechanical friction and foreign body material interaction.
2.2. Soft Toric or Spherical Lenses (Fitting Aspects)
Regardless of mass production or made to order manufacturing procedure, the material is preferred to have high oxygen permeability. The material modulus, important factor in order to assure gentle contact with the corneal and conjunctiva, has to be lower than 0.60MPa. The fit has to be centered with a normal movement of 0.50 mm following blinking.
Spherical or toric lenses, are ideal in cases where optical correction with spectacles, achieves visual acuity of 1.0, free from double images or increased image shadows.
2.3. Soft Lenses for Keratoconus or Irregular Cornea (Fitting Aspects)
The lenses designed for Ectatic corneas, have increased thickness in optical zone. This varies between 300 to 700 microns. Furthermore, most of the designs incorporate tonic correction and some form of axis stabilization, prismatic or prismodynamic. Therefore in certain areas the lenses are thicker because of the stabilization system [43, 44].
The presence of increased thickness brings the need of materials with high oxygen permeability. Material of Dk more than 80 is preferred. On the other hand, the material modulus has to be the lowest possible, thus below 0.60MPa, because an increased volume lens could become more stressing to the ocular tissues involved.
The combination of the above lens characteristics brings the need of more precise fitting parameters. The base or peripheral curves or the lens diameter are chosen according to the general rules and tests valid for all soft contact lenses [44].
2.4. Corneal Rigid Gas Permeable Lenses (RGP) (Fitting Aspects)
The corneal RGP lenses are probably the most used globally for the keratoconus cases, for two reasons. They offer a stable optical surface, correcting the optical aberrations through the tear film between the lens and the cornea. Additionally, their manufacturing method is relatively undemanding. They can be produced even with manual lathing technology for the simpler designs. Furthermore, the superb gas permeable materials, offer an excellent option, for more than fifty years, in contact lens technology. They are a reliable alternative even in complex ocular surfaces, when modern CNC technology was not available. An important safety characteristic is that the lens user has to respect the lens or eye physiology limit. Careless handling could lead to irritation which provokes symptoms and the user is obliged to limit the lens wearing schedule.
Historically, the corneal RGP lenses were fitted applying some pressure on the cone area, offering a better high contrast visual acuity and suggesting that mild pressure could contribute to sustain corneal shape. Based on newer physiological data through OCT imaging [45], it is not allowed to fit lenses on keratoconus, applying pressure on the cone, but distributing the eye lens contact to a larger area, permitting tears passing under the lens after each blink. In conjunction with high permeable material of Dk 100 or more, corneal physiology can remain intact.
The palpebral conjunctiva is the tissue that needs extra attention, because depending on the edge design and parameters of lens, could present an increased interaction. Therefore, the optimal edge design is to lift away from the cornea to allow tear passage and at the same time be kept close enough to the surface to avoid mechanical irritation to the mucosal tissue [46, 47].
As far as the limbal area is concerned, in most of the cases, corneal RGP lenses are fitted, limbal area is free from any lens interaction.
2.5. Hybrid Lenses with Central RGP and Soft Peripheral Skirt (Fitting Aspects)
Hybrid lenses are used in the last decades and have gained preference for their optical correction properties, since they function as RGP lenses but as well as for their initial comfort because of the soft peripheral part [48].
According to their fitting design, the lenses ideally distribute the contact with the tissue evenly, between cornea and conjunctiva or are supported to the peripheral cornea and conjunctiva only. In the latest case the material modulus should be as low as possible in order to respect the corneal and conjunctiva. Because of the soft skirt of the lens, which will dehydrate at a certain level, often a suction effect is present, minimizing any tear circulation that might present during insertion [49].
2.6. Scleral Lenses (Fitting Aspects)
Scleral lenses are historically the oldest type of lens existing, since middle 1800. At that time, lenses were produced in glass and later in PMMA. The material options were the main reason for their diminished use, blocking any oxygen passage to the cornea [50]. The latest years, scleral lenses have gained a diffuse success for two reasons; the use of high permeable materials of at least 100 Dk and the use of micro precision CNC manufacturing, enabling proper fitting, reproducibility, production of sophisticated designs and customized optical correction, when needed [51, 52].
The fitting principles of scleral lenses are two, but very important to be respected. First the absence of contact with the corneal and limbal region and secondly, the even distribution of contact on the scleral zone that supports the lens. Lens geometries that are in contact with the peripheral cornea or limbus could create symptoms following two to three months wear.
Since the lens almost seals bulbar conjunctiva, minimal tear exchange is occurring under the lens. Therefore, it is important that the user interrupts the wearing schedule every six to nine hours to refill the lens with physiological saline solution [53].
Important aspect of scleral lens design is the lens periphery, anterior and posterior, in order to minimize the lens volume, maintaining the stability and reducing the lens lid interaction [54, 55].
Optical correction principles and lens characteristics.
2.7. Soft Lenses for Keratoconus (Optical Correction)
Hydro gel lens for the Ectatic corneas are widely adopted for the leading practitioners but as well as for the patients, for their comfort. Further advantages consist of prolonged wearing schedule and possibility of fitting them soon after CXL treatment, interfering minimally to the strengthening therapy of the cornea. In addition, they can be used in conjunction with RGP lenses for more dynamic or leisure activities, when comfort is more important.
Their correcting principle is based on creating an external optical surface (the anterior of the lens) more homogeneous, topographically and thus with less high order aberrations. The topographical blending is achieved through the increased thickness of the optical zone and the front surface asphericity. In addition with the correction of low order aberrations (spherical and cylinder correction), the keratoconic eye can achieve an improved or optimal visual acuity.
In more sophisticated lens types, asymmetric optical corrections could be incorporated, correcting the main optical aberration in keratoconus, the vertical coma. On these lenses optical power is different on the superior and inferior part of the optical zone. For example, the upper part could have a power of -1.00 D and the lower -5.00 D [56].
Controlling objectively the result of these lenses is straightforward, performing a corneal topography over the lens in vivo. Any residual surface aberration is evident, which in some cases could contribute to neutralize the ones created from the posterior corneal surface.
Technical characteristics include increased optical zone thickness from 300 to 700 microns, spherical correction from -40.00 to +30.00 D, cylindrical correction up to 12.00 DC, base curve more commonly from 8.00 to 9.20 mm. The materials used are hydrogels with medium to high water content, or silicone hydrogels with Dk of 50 to 60.
2.8. Corneal Rigid Gas Permeable Lenses (Optical Correction)
The corneal RGP lenses are the most widely used lenses for the keratoconus cases, providing optimal high contrast visual acuity. Moreover they are easily fitted by experienced practitioners due to the fact that fitting is evident with fluorescein staining the tear film under the lens. Over refraction is straightforward using spherical correction to the majority of the cases. From the optical point of view, low order astigmatism and high order aberrations are corrected with the tear fluid under the lens. In many cases, a gentle touch of the cone area, corrects the residual coma of the posterior corneal surface [57, 58].
Disadvantage of the corneal RGP lenses is the quality of vision when the lens is not centered properly or tilt in the lens is present. Resultant high order aberrations might be present and even if Snellen acuity is optimal, contrast sensitivity is reduced.
To improve the result, current contact lens designs have large optical zones (7.50 to 8.00 mm). In addition, they use aspheric surfaces to coincident to the ectatic cornea, with increased lens diameters up to 10.00 or 11.00 mm. The fitting of large diameter lenses is becoming more complicated though, because, it could lead to the areas of increased unwanted pressure on the cornea [59-60].
2.9. Hybrid Lenses (Optical Correction)
Hybrid lenses usually are composed of a rigid part of 8.00 mm in the centre and a flexible hydrogel part with 14.50 mm of total diameter. The correction principle is identical to the corneal RGP lenses described above. Some designs claim to imitate the correction principle of scleral lenses, having a distance from the central cornea [61]. Hybrid lenses are well centered due to their soft skirt providing a centered optical correction. The over refraction in these lenses is spherical, so there is no possibility of incorporating more complex toric or asymmetric aberrations correction.
2.10. Scleral Lenses (Optical Correction)
In the latest years, more sophisticated designs of lenses enable the practitioners to fit relatively smaller lens diameters [61], in respect to the past, of 16 to 20 mm, yet achieving optimal fit for the most demanding cases. In general, the diameter of scleral lens varies between 16 to 24 mm . Generally accepted minimal diameter in order to have a corneal and limbal area free from pressure is 16 mm. The optical correction with this type of lenses is achieved with the liquid, well-centered space, between lens and cornea. Therefore any optical aberration of the front corneal surface is neutralized. Disadvantage of the scleral lens correction is the remaining aberrations from the back corneal surface. Modern lens designs incorporate two options; front custom aspheric surface, correcting spherical aberration or front toric correction, manufactured on the front surface of the lens. The stable and highly gas permeable material assured the optical result throughout the wearing schedule, maintaining at the same time continuous corneal lubrication and protection [50, 51].
The correction of refractive disorders in keratoconus, using lenses, includes gas permeable (GP) contact lenses, soft or scleral lenses, hybrid contact lenses and piggyback systems. GP lenses range in size from 8.0 to 10.0 mm in diameter, fitting better in small central or mild cones [62]. They have been found to achieve better best corrected visual acuity (BCVA) compared to spectacles, depending on their types (51.85%, 43.39%, 4.23% and 0.53% in rigid gas permeable (RGP), semi-gas permeable (SGP), polymethyl methacrylate (PMMA) and hard-soft gas permeable contact lenses, correspondingly). Furthermore, they have been estimated to eliminate 3rd-order coma improving the quality of vision. Both an apical-touch and three-point-touch fitting seem to reduce corneal asphericity and astigmatism and lower higher-order aberrations. However, they have implicated in the reduction of corneal basal epithelial cell and anterior stromal keratocyte densities [54, 63].
Various soft contact lenses, with base curve between 6.0 to 7.0 mm, are indicated in early or decentered keratoconus and in GP intolerance. Although they provide greater comfort, low oxygen permeability, (with the exception of silicone hydrogel), and the inability to mask moderate to severe irregular astigmatism are major disadvantages of soft contact lenses. On the other hand, scleral contact lenses ensure stable platforms, which eliminate high-order aberrations and provide good centration and visual acuity. However, prolonged discomfort period and handling complexity limit their use. Furthermore, they induce corneal changes, including corneal flattening scarring and weakening [64, 65].
Modern hybrid contact lenses, are usually chosen when there is poor centration, poor stability or intolerance with GP lenses. Nevertheless, they require special training to fit. Finally, piggyback contact lens systems are an alternative for patients who exhibit intolerance to scleral or rigid corneal lenses. Although silicon hydrogel contact lenses are widely used in these systems, Dk RGP lens materials and aspheric designs are available, providing the cornea, a required amount of oxygen. Furthermore, they improve vision, correcting astigmatism and the high-order aberrations. In piggyback users, corneal epithelium and endothelium seem; to be unaffected. However neovascularization and giant papillary conjunctivitis have been reported in few patients [61, 62, 66, 67].
No Animals/Humans were used for studies that are base of this research.
All authors have no conflict of interest to declare and no financial support was offered for the present review. The authors alone are responsible for the content and writing of this paper.
ACKONWLEDGEMENTS
[1] Serdarogullari H, Tetikoglu M, Karahan H, Altin F, Elcioglu M. Prevalence of keratoconus and subclinical keratoconus in subjects with astigmatism using pentacam derived parameters. J Ophthalmic Vis Res 2013; 8(3): 213-9.
[2] Hashemi H, Khabazkhoob M, Yazdani N, et al. The prevalence of keratoconus in a young population in Mashhad, Iran. Ophthalmic Physiol Opt 2014; 34(5): 519-27.
[3] Bialasiewicz A, Edward DP. Corneal ectasias: study cohorts and epidemiology. Middle East Afr J Ophthalmol 2013; 20(1): 3-4.
[4] Davidson AE, Hayes S, Hardcastle AJ, Tuft SJ. The pathogenesis of keratoconus. Eye (Lond) 2014; 28(2): 189-95.
[5] Wojcik KA, Blasiak J, Szaflik J, Szaflik JP. Role of biochemical factors in the pathogenesis of keratoconus. Acta Biochim Pol 2014; 61(1): 55-62.
[6] Abu-Amero KK, Kondkar AA, Azad TA, Sultan T, Kalantan H, Al-Muammar AM. Keratoconus is associated with increased copy number of mitochondrial DNA. Mol Vis 2014; 20: 1203-8.
[7] Saee-Rad S, Raoofian R, Mahbod M, et al. Analysis of superoxide dismutase 1, dual-specificity phosphatase 1, and transforming growth factor, beta 1 genes expression in keratoconic and non-keratoconic corneas. Mol Vis 2013; 19: 2501-7.
[8] Jeyabalan N, Shetty R, Ghosh A, Anandula VR, Ghosh AS, Kumaramanickavel G. Genetic and genomic perspective to understand the molecular pathogenesis of keratoconus. Indian J Ophthalmol 2013; 61(8): 384-8.
[9] Gordon-Shaag A, Millodot M, Kaiserman I, et al. Risk factors for keratoconus in Israel: a case-control study. Ophthalmic Physiol Opt 2015; 35(6): 673-81.
[10] Kanski Jack J. Clinical ophthalmology, a systematic approach. Sixth edition. Corneal ectasias p288 2006.
[11] Romero-Jiménez M, Santodomingo-Rubido J, Wolffsohn JS. Keratoconus: a review. Cont Lens Anterior Eye 2010; 33(4): 157-66.
[12] Barr JT, Wilson BS, Gordon MO, et al. Estimation of the incidence and factors predictive of corneal scarring in the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study. Cornea 2006; 25(1): 16-25.
[13] Fernández Pérez J, Valero Marcos A, Martínez Peña FJ. Early diagnosis of keratoconus: what difference is it making? Br J Ophthalmol 2014; 98(11): 1465-6.
[14] Jafarinasab MR, Shirzadeh E, Feizi S, Karimian F, Akaberi A, Hasanpour H. Sensitivity and specificity of posterior and anterior corneal elevation measured by orbscan in diagnosis of clinical and subclinical keratoconus. J Ophthalmic Vis Res 2015; 10(1): 10-5.
[15] Kanellopoulos AJ, Asimellis G. Revisiting keratoconus diagnosis and progression classification based on evaluation of corneal asymmetry indices, derived from Scheimpflug imaging in keratoconic and suspect cases. Clin Ophthalmol 2013; 7: 1539-48.
[16] Luz A, Fontes BM, Lopes B, Ramos I, Schor P, Ambrósio R Jr. ORA waveform-derived biomechanical parameters to distinguish normal from keratoconic eyes. Arq Bras Oftalmol 2013; 76(2): 111-7.
[17] Labiris G, Gatzioufas Z, Sideroudi H, Giarmoukakis A, Kozobolis V, Seitz B. Biomechanical diagnosis of keratoconus: evaluation of the keratoconus match index and the keratoconus match probability. Acta Ophthalmol 2013; 91(4): e258-62.
[18] Qin B, Chen S, Brass R, et al. Keratoconus diagnosis with optical coherence tomography–based pachymetric scoring system. J Cataract Refract Surg 2013; 39(12): 1864-71.
[19] Rabinowitz YS, Li X, Canedo AL, Ambrósio R Jr, Bykhovskaya Y. Optical coherence tomography combined with videokeratography to differentiate mild keratoconus subtypes. J Refract Surg 2014; 30(2): 80-7.
[20] Szalai E, Berta A, Hassan Z, Módis L Jr. Reliability and repeatability of swept-source Fourier-domain optical coherence tomography and Scheimpflug imaging in keratoconus. J Cataract Refract Surg 2012; 38(3): 485-94.
[21] Kanellopoulos AJ, Asimellis G. OCT corneal epithelial topographic asymmetry as a sensitive diagnostic tool for early and advancing keratoconus. Clin Ophthalmol 2014; 8: 2277-87.
[22] Wollensak G, Spoerl E, Seiler T. Riboflavin/ultraviolet-a-induced collagen crosslinking for the treatment of keratoconus. Am J Ophthalmol 2003; 135(5): 620-7.
[23] Lang SJ, Messmer EM, Geerling G, et al. Prospective, randomized, double-blind trial to investigate the efficacy and safety of corneal cross-linking to halt the progression of keratoconus. BMC Ophthalmol 2015; 15: 78.
[24] Chow VW, Chan TC, Yu M, Wong VW, Jhanji V. One-year outcomes of conventional and accelerated collagen crosslinking in progressive keratoconus. Sci Rep 2015; 5: 14425.
[25] Baenninger PB, Bachmann LM, Wienecke L, Kaufmann C, Thiel MA. Effects and adverse events after CXL for keratoconus are independent of age: a 1-year follow-up study. Eye (Lond) 2014; 28(6): 691-5.
[26] Kanellopoulos AJ, Pe LH, Perry HD, Donnenfeld ED. Modified intracorneal ring segment implantations (INTACS) for the management of moderate to advanced keratoconus: efficacy and complications. Cornea 2006; 25(1): 29-33.
[27] Bourcier T, Borderie V, Laroche L. Late bacterial keratitis after implantation of intrastromal corneal ring segments. J Cataract Refract Surg 2003; 29(2): 407-9.
[28] Ertan A, Bahadir M. Topography-guided vertical implantation of Intacs using a femtosecond laser for the treatment of keratoconus. J Cataract Refract Surg 2007; 33(1): 148-51.
[29] Ferenczy PA, Dalcegio M, Koehler M, Pereira TS, Moreira H, Luciane Bugmann M. Femtosecond-assisted intrastromal corneal ring implantation for keratoconus treatment: a comparison with crosslinking combination. Arq Bras Oftalmol 2015; 78(2): 76-81.
[30] Chen Y, Hu DN, Xia Y, Yang L, Xue C, Huang Z. Comparison of femtosecond laser-assisted deep anterior lamellar keratoplasty and penetrating keratoplasty for keratoconus. BMC Ophthalmol 2015; 15: 144.
[31] Leccisotti A, Aslanides IM, Moore JE, Shah S. Keratoconus and keratoectasia: advancements in diagnosis and treatment. J Ophthalmol 2012; 2012: 526058.
[32] Panda A, Gupta AK, Sharma N, Nindrakrishna S, Vajpayee R. Anatomical and functional graft survival, 10 years after epikeratoplasty in keratoconus. Indian J Ophthalmol 2013; 61(1): 18-22.
[33] Kaminski SL, Biowski R, Lukas JR, Koyuncu D, Grabner G. Corneal sensitivity 10 years after epikeratoplasty. J Refract Surg 2002; 18(6): 731-6.
[34] Teichmann KD, Wagoner MD. Mooren ulcer following epikeratoplasty for keratoconus. Arch Ophthalmol 1998; 116(10): 1381-2.
[35] Bechara SJ, Grossniklaus HE, Waring GO III. Sterile stromal melt of epikeratoplasty lenticule. Arch Ophthalmol 1992; 110(11): 1528-9.
[36] Shands PR, Lass JH. Severe anterior segment inflammation following corneal surgery for keratoconus. Ophthalmic Surg 1990; 21(9): 645-6.
[37] Morgan KS, Beuerman RW. Interface opacities in epikeratophakia. Arch Ophthalmol 1986; 104(10): 1505-8.
[38] Price FW Jr, Binder PS. Scarring of a recipient cornea following epikeratoplasty. Arch Ophthalmol 1987; 105(11): 1556-60.
[39] Hemady RK, Bajart AM, Wagoner MD. Interface abscess after epikeratoplasty. Am J Ophthalmol 1990; 109(6): 735-6.
[40] Farjadnia M, Naderan M, Mohammadpour M. Gene therapy in keratoconus. Oman J Ophthalmol 2015; 8(1): 3-8.
[41] Edrington TB, Szczotka LB, Barr JT, et al. Rigid contact lens fitting relationships in keratoconus. Optom Vis Sci 1999; 76(10): 692-9.
[42] Mrazovac D, Barisić Kutija M, Vidas S, et al. Contact lenses as the best conservative treatment of newly diagnosed keratoconus--epidemiological retrospective study. Coll Antropol 2014; 38(4): 1115-8.
[43] Barnett M, Mannis MJ. Contact lenses in the management of keratoconus. Cornea 2011; 30(12): 1510-6.
[44] Gumus K, Kahraman N. A New Fitting Approach for Providing Adequate Comfort and Visual Performance in Keratoconus: Soft HydroCone (Toris K) Lenses. Eye Contact Lens 2016; 42(4): 225-30.
[45] Elbendary AM, Abou Samra W. Evaluation of rigid gas permeable lens fitting in keratoconic patients with optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2013; 251(6): 1565-70.
[46] Kamar S, Vervaet C, Luyten GP, Jager MJ. Pancorneal contact lens with a toric edge: a new concept in keratoconus. Eur J Ophthalmol 2011; 21(6): 685-90.
[47] Romero-Jiménez M, Santodomingo-Rubido J, González-Méijome JM. The thinnest, steepest, and maximum elevation corneal locations in noncontact and contact lens wearers in keratoconus. Cornea 2013; 32(3): 332-7.
[48] Yildiz EH, Erdurmus M, Elibol ES, Acar B, Vural ET. Contact lens impact on quality of life in keratoconus patients: rigid gas permeable versus soft silicone-hydrogel keratoconus lenses. Int J Ophthalmol 2015; 8(5): 1074-7.
[49] Acar BT, Vural ET, Acar S. Effects of contact lenses on the ocular surface in patients with keratoconus: piggyback versus ClearKone hybrid lenses. Eye Contact Lens 2012; 38(1): 43-8.
[50] Schornack MM, Patel SV. Scleral lenses in the management of keratoconus. Eye Contact Lens 2010; 36(1): 39-44.
[51] Soeters N, Visser ES, Imhof SM, Tahzib NG. Scleral lens influence on corneal curvature and pachymetry in keratoconus patients. Cont Lens Anterior Eye 2015; 38(4): 294-7.
[52] Bruce AS, Nguyen LM. Acute red eye (non-ulcerative keratitis) associated with mini-scleral contact lens wear for keratoconus. Clin Exp Optom 2013; 96(2): 245-8.
[53] Pullum KW, Stapleton FJ. Scleral lens induced corneal swelling: what is the effect of varying Dk and lens thickness? CLAO J 1997; 23(4): 259-63.
[54] Bennett ES. New findings from the 2008 Global Keratoconus Congress. A report on what's new in the etiology, evaluation and management of keratoconus and irregular corneas. Contact Lens Fitting in 2008. Available at: http://www.clspectrum.com/printarticle.aspx?article=101654. 2008. Accessed March 23, 2011
[55] Rosenthal P, Croteau A. Fluid-ventilated, gas-permeable scleral contact lens is an effective option for managing severe ocular surface disease and many corneal disorders that would otherwise require penetrating keratoplasty. Eye Contact Lens 2005; 31(3): 130-4.
[56] Jinabhai A, O'Donnell C, Tromans C, Radhakrishnan H. Optical quality and visual performance with customised soft contact lenses for keratoconus. Ophthalmic Physiol Opt 2014; 34(5): 528-39.
[57] Gumus K, Gire A, Pflugfelder SC. The impact of the Boston ocular surface prosthesis on wavefront higher-order aberrations. Am J Ophthalmol 2011; 151(4): 682-690.e2.
[58] López-Gil N, Castejón-Mochón JF, Fernández-Sánchez V. Limitations of the ocular wavefront correction with contact lenses. Vision Res 2009; 49(14): 1729-37.
[59] Negishi K, Kumanomido T, Utsumi Y, Tsubota K. Effect of higher-order aberrations on visual function in keratoconic eyes with a rigid gas permeable contact lens. Am J Ophthalmol 2007; 144(6): 924-9.
[60] Kazanci B, Ozek D, Anayol A, Balikçi A, Ileri D, Yilmazbaş P. Applications of different types of gas-permeable contact lenses in keratoconus and their visual results. Eur J Ophthalmol 2014; 24(6): 835-41.
[61] Carracedo G, González-Méijome JM, Lopes-Ferreira D, Carballo J, Batres L. Clinical performance of a new hybrid contact lens for keratoconus. Eye Contact Lens 2014; 40(1): 2-6.
[63] Ozkurt Y, Atakan M, Gencaga T, Akkaya S. Contact lens visual rehabilitation in keratoconus and corneal keratoplasty. J Ophthalmol 2012; 2012: 832070.
[64] Schornack MM, Pyle J, Patel SV. Scleral lenses in the management of ocular surface disease. Ophthalmology 2014; 121(7): 1398-405.
[65] Rathi VM, Mandathara PS, Taneja M, Dumpati S, Sangwan VS. Scleral lens for keratoconus: technology update. Clin Ophthalmol 2015; 9: 2013-8.
[66] Romero-Jiménez M, Santodomingo-Rubido J, Flores-Rodríguez P, González-Méijome JM. Short-term corneal changes with gas-permeable contact lens wear in keratoconus subjects: a comparison of two fitting approaches. J Optom 2015; 8(1): 48-55.
[67] López-Alemany A, González-Méijome JM, Almeida JB, Parafita MA, Refojo MF. Oxygen transmissibility of piggyback systems with conventional soft and silicone hydrogel contact lenses. Cornea 2006; 25(2): 214-9.


Bluebeam offers the full licensed version of Bluebeam® Revu® to students and educators at significantly discounted prices.
Pricing is only available for current students and educators.
Customers must use their academic ID number and email address –".edu.au".
Only current students can apply for an Academic license.


text:
Ceci est une liste des membres du Sénat du Canada, actuels et anciens, représentant une des divisions sénatoriales du Nouveau-Brunswick.

Sénateurs actuels

Anciens sénateurs

Sources
Liste des sénateurs représentant le Nouveau-Brunswick - Site du Parlement du Canada

Voir aussi
 Liste des sénateurs canadiens

Notes et références

redpajama_set_name: RedPajamaWikipedia


Solar-powered LED lighting for roads and parking lots that harness the sun's energy to provide high-output illumination .
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Scientists working on the Event Horizon Telescope have taken the very first pictures of a black hole – commonly known as M87* (the * in the title represents a black hole).
M87* is a super-massive black hole at the centre of the M87 galaxy. This galaxy is also known as Virgo A and is part of the constellation Virgo.
Here are four things we've learned about this black hole.
Black holes are defined by the fact they can trap light. So how does one see an object that traps light in the vast, black expanses of space?
OK, that's still really hard. But the biggest black holes are believed to lurk at the centres of galaxies, which aren't quite so empty.
There is quite a bit of stuff around to fall under the sway of the black hole's powerful gravitational pull.
We have found evidence for both stars and clouds of hot plasma orbiting these super-massive black holes. The closer the plasma is to the black hole, the faster it will be orbiting the black hole (just as Mercury orbits the Sun in 88 days, but Neptune takes 165 years).
It looks like the plasma in the image is moving at a significant fraction of the speed of light. So, we have electrons in this plasma that are being spun very quickly in a circle around the black hole.
This is a super-sized version of the Australian Synchrotron, using a black hole's gravity instead of magnets to keep the electrons circling around at relativistic speeds.
Just like the Australian Synchrotron, these electrons emit light (synchrotron radiation) which then traveled from M87* to Earth to make this beautiful image.
However, some of that light is intercepted by the black hole in the middle. The black hole leaves a shadow against what would otherwise be a bright disk.
One prediction of general relativity is that the size of a black hole is linearly proportional to its mass. If the mass of a black hole doubles, the diameter of the event horizon (the region where light cannot escape) doubles as well.
The LIGO gravitational wave detections confirmed the size of black holes with masses of tens of solar masses. The Event Horizon Telescope image has now measured the size of a black hole more than six billion solar masses. That's a mass range of 100,000,000 (or a hundred million).
The general relativity relationship between mass and size has held true across this entire range, limiting some alternative theories for gravity.
3) How massive IS the SUPERMASSIVE black hole?
We already had an idea of how massive M87* was by measuring the velocities of gas and stars near the centre of the galaxy. However, the estimates disagreed by about a factor of two.
The dynamics of the gas suggested masses near 3.5 billion solar masses while stellar measurements preferred a higher mass near 6.6 billion solar masses.
The size of the black hole's shadow in the new image comes down solidly in favour of the higher mass estimate. M87* weighs 6.5 billion solar masses, plus or minus 10 per cent. This extreme mass is also why our first black hole image is of M87*.
The more massive a black hole is, the larger and easier they are to see. We expected the two largest (in terms of apparent size) black holes to be M87* and the Milky Way's own black hole, Sagittarius A*.
Sagittarius A* is clearly much, much closer to us (a mere 26,000 light-years instead of 53 million light-years), but it's also much, much smaller at four million instead of six billion solar masses.
The net result is that M87* has nearly the same apparent size as Sagittarius A*.
We already had a number of reasons to think that most galaxies host a giant black hole near their centre. However, as the saying goes, seeing is believing.
Imaging the black hole at the centre of the M87 galaxy confirms the presence of supermassive black holes at the centres of galaxies.
But how did we manage to image a black hole 53 million light years away?
The Event Horizon Telescope built up an image of the black hole by using a technique called interferometry to combine data from eight different telescopes across the globe, including, my personal favourite, the South Pole Telescope in Antarctica.
The image analysis even took advantage of the Earth's rotation between observations (effectively moving the relative positions of the telescopes and the black hole).
Combined, these instruments provided an effective telescope nearly the size of the Earth – that is, a diameter of almost 13 million metres. And it will probably be a while before we build a mirror that big.


text:
Learn Exactly Where To Start With Marvel Comics
Kathryn Calamia
27 Jun 2020 • 10 min read
As a comic book critic, the most frequently asked question I get about comic books is "Where do I start?" With this in mind, I had the idea to do a beginners guide to Marvel Comics sharing a roadmap for someone interested in getting started with the "All-New, All-Different Marvel", a conceptual re-branding, we are still seeing take shape event today.
Personally, I've found that the best way to recommend comic books is not by simply naming your favorite titles because comic books are ultimately a very subjective medium. Instead. I am going to recommend to you comics, character-by-character. As we have a lot of ground to cover, let's jump right in!
The Avengers, first appearance in "Avengers #1"
Team Members: Jane Foster (Thor), Sam Wilson (Captain America), Sam Alexander (Nova), Kamala Khan (Ms. Marvel), Tony Stark (Iron Man), Vision, Miles Morales (Spider-Man)
With a series that debuted on November 11th, 2015, the All-New, All-Different Avengers are a team that mixes experienced Avengers and new heroes on a single roster. The old heroes learn from the new heroes (aka "legacy heroes") and vice-versa.
Read All-New, All-Different Avengers #1-10 Now
Team Members: Steve Rogers (Captain America), Rogue, Johnny Storm, Deadpool, Synapse, Brother Voodoo
Originally created to heal a social divide between mutant and non-mutants, Uncanny Avengers brings the X-Men and Avengers together onto one team. There have been many X-Men characters who have been a part of the Avengers in the past but this was a great next step in merging the heroes of the Marvel Universe.
Read Uncanny Avengers Volume 3 #1-9 Now
Team Members: Sunspot, Squirrel Girl, Hulking, White Tiger, Wiccan, Power Man, Songbird, Hawkeye, Cannonball
A new team for All New, All Different Marvel era utilizing a name that has gone before (through three previous series actually). This one includes a nice list of known and lesser known heroes who take over A.I.M. (Advanced Idea Mechanics) and rebrand the former super-villain organization as Avengers Idea Mechanics with a field team titling itself the New Avengers.
Read New Avengers Volume 4 #1-12 Now
Spider-Man / Spider Woman, first appearance "Amazing Fantasy #15" and "Marvel Spotlight #32"
The Amazing Spider-Man (Peter Parker)
In October of 2015, Marvel launched All-New, All-Different Marvel (an event you will see me reference to a lot in this article). In The Amazing Spider-Man Volume 4, Peter has a new status quo. He's not just the friendly neighborhood Spider-Man, but rather the friendly global Spider-Man. Peter Parker moves into the role of international businessman as he balances his life as Spider-Man with his work and inventive creativity overseeing Parker Industries.
Read The Amazing Spider-Man Volume 4. #1-14 Now
Spider-Man (Miles Morales)
Previously living in the Ultimate universe, Miles Morales made the move to the regular Marvel universe with the debut of All-New All-Different Marvel. Miles is now trying to make his own name as Spider-Man all the while balancing high school, spending time with his family, and being an Avengers team player.
Read Spider-Man #1-4 Now
Spider-Gwen (Gwen Stacy)
Spider-Gwen was introduced to the Marvel universe in 2014 in Edge of Spider-Verse #2. The character became so popular she received her own comic book series. The first volume lasted five issues and then the series was relaunched for All-New, All-Different Marvel. The current series is ongoing and going strong. The series deals with Gwen being a wanted hero and trying to be a functional young adult in New York City.
Read Edge of Spider-Verse #2, Spider-Gwen Volume 1 #1-5, Spider-Gwen Volume 2 #1-9 Now
Silk (Cindy Moon)
Cindy Moon was introduced in The Amazing Spider-Man Volume 3 #4 in 2014. Shortly after, Marvel released Silk's very own ongoing series. The story here focuses on Cindy trying to find her family as she deals with PTSD from being trapped in a bunker alone for over a decade. This series was seven issues long leading into Marvel's Secret Wars. After Secret Wars Marvel launched the second volume of Silk. In this volume, Cindy goes "evil" teaming up with the Black Cat.
Read The Amazing Spider-Man Volume 3 #4, Silk Volume 1 #1-7, and Silk Volume 2 #1-8 Now
Spider Woman (Jessica Drew)
In 2015 Marvel launched a new volume of Spider Woman, which led Jessica Drew down a very new life path. She had been defined by her Avengers status for years, and wanted a more grounded life. This adventure started in Spider Woman Volume 4 #5. The volume ended with issue 10 leading into Secret Wars. The series relaunched with a new status quo for Jessica, being nine months pregnant. Jessica is now a new mother balancing her life with a child as a superhero.
Read Spider Woman Volume 4 #5-10, Spider Woman Volume 5 #1-8 Now
Thor, first appearance "Journey Into Mystery #83"
Jane Foster, the new Thor, was first introduced in Thor Volume 4. Jane is the original Thor's on and off again girlfriend but in the current series she suffering with breast cancer. Jason Aaron kept Thor's identity a secret until the last issue of this volume building a mix of fan speculation. After Secret Wars, the Thor series relaunched and now that Thor's identity stands revealed this volume focuses on the tension between Odin and the new Thor, and showcases Jane's battle with cancer. Thor is also an Avenger and you can read her adventures in All-New, All-Different Avengers Now
Read Thor Volume 4 #1-8, Thor Volume 5 #1-8 Now
Captain America, first appearance in "Captain America Comics #1"
Captain America (Sam Wilson)
Sam Wilson is one of two currently active Captain Americas, appointed as so by Steve Rogers in Captain America #25. You can find him on the Avengers roster in All-New, All-Different Avengers and in his own title, Captain America: Sam Wilson.
Read All-New, All-Different Avengers #1-10, Captain America Sam Wilson #1-8, Captain America #25 Now
Captain America (Steve Rogers)
Steve Rogers has just recently returned to action after the events of Avengers: Standoff. This comic event helped him spin-off into his own title Captain America: Steve Rogers. This became a very controversial series met with some outrage after a cliffhanger issue 1 ending which had Captain America saying "Hail Hydra" and shocking fans.
Read the Avengers crossover event Avengers Standoff, Captain America Steve Rogers #1 Now
Winter Soldier (Bucky Barnes)
If you have been watching the Captain America films (or you're a long time Captain America comic book fan), the character of Bucky Barnes, the Winter Soldier, should be embedded in your fandom. Bucky is currently in the team book Thunderbolts.This ragtag crew serves as renegade heroes and they are now under the leadership of Winter Soldier.
Read Thunderbolts #1-2 Now
Iron Man, first appearance in Tales of Suspense #39
Iron Man (Tony Stark)
Tony Stark has come front and center once again this year in the Marvel universe. He's in a war with Captain Marvel in Civil War 2, trying to unravel the mystery of his real parents in International Iron Man, and gains a new assistant in Invincible Iron Man. For a billionaire, he has his hand very full.
Read Civil War 2, International Iron Man #1-4, and Invincible Iron Man #1-10 Now
Captain Marvel / Ms. Marvel debuted Ms. Marvel #1 / Captain Marvel #17
Captain Marvel (Carol Danvers)
Just like Iron Man, Carol Danvers has moved to the front and center in the Marvel universe because of Civil War 2. She has a lot of responsibilities as a team member on the Ultimates and recently became the captain of SPACE, an organization charged with guarding the earth from extraterrestrial threats in her own title Captain Marvel.
Read Civil War 2, The Ultimates #1-7, and Captain Marvel #1-5 Now
Ms. Marvel (Kamala Khan)
Kamala Khan has quickly become one of the most beloved heroes in the Marvel universe. She's an Avenger and high schooler trying to balance her life as a superhero and normal teenage girl and she approaches it all with a wit and charm that endears the character quickly with the reader.
Read Ms Marvel #1-7, All-New, All-Different Avengers #1-10 Now
The Inhumans, debuted Fantastic Four #45
Team Members: Medusa, Black Bolt, Beast, Human Torch, Triton, Reader
The Inhumans must deal with the spread of the Terrigen Mist and new Inhumans emerging around the world. Some non-Inhuman characters are featured in this title (like Human Torch and Beast) adding a little spice to things. The presence of the Human Torch in particular. In this post-Fantastic Four world, his presence introduces a bit of a love triangle to the title drawing in Crystal and Medusa.
Read Uncanny Inhumans #1-10 Now
Team Members: Crystal, Gorgon, Grid, Flint, and Ash
This series also deals with the Terrigen Mist but thus far the series has been more focused on a field team of Inhumans led by Crystal. The team is tasked to help the NuHumans who are being changed by the mist and it's pulled them all around the globe.
Read All New Inhumans #1-8 Now.
Deadpool, debut in New Mutants #98
Deadpool (Wade Wilson)
You can find Deadpool in his own title working with his team the Mercs for Money. That said, Deadpool is teaming up with a lot of characters these days including Spider-Man in their own ongoing series Spider-Man/Deadpool and several mini-series like the recent Deadpool V Gambit. Adding to the team theme, you can also find the Merc With A Mouth in Uncanny Avengers. These days, the character is most certainly getting around.
Read Deadpool Volume 4 #1-14, Uncanny Avengers 1-9, Deadpool V Gambit mini series, and Spider-Man/Deadpool #1-5 Now
Gwenpool (Gwen Poole)
Gwen is just like us… no, I really mean it. She comes from our world! She wants to be a hero and finds out quickly that it's a lot harder to be a hero when you come from the world of reality than you would think.
Read Gwenpool #1-2, Howard the Duck 1-3, and Gwenpool Holiday Special #1 Now
X-Men debut in X-Men #1
Team Members: Storm, Magik, Colossus, Old Man Logan, Jean Grey, and Nightcrawler
It's been a pretty tough decade if you're a mutant and the rise of the Terrine Mist has been the evolutionary icing on the cake. The mists which are increasing the ranks of Inhumans are killing mutants. Here, an X-Men Team led by Storm works to deal with the ramifications of the mists and hold together a dwindling mutant race.
Read Extraordinary X-Men #1-10 Now
Team Members: Archangel, Magneto, Psylocke, Sabretooth, and Monet
"Bigger threats require more threatening X-Men" was the tagline for the current Uncanny X-Men series and with Magneto leading a team of anti-hero mutants, it's certainly living up to that assertion. Here, Magneto is taking the fight to the opposition and all options for resolution are on the table.
Read Uncanny X-Men #1-8 Now
Team Members: Laura (Wolverine), Young Beast, Young Iceman, Young Cyclops, Young Angel, Kid Apocalypse and Oya
The All New X-Men continue to serve up a blast from the past as we follow a group of young mutants, including the first class X-Men time travelers as they work to find a place in the modern world and come to grips with the way their older selves turned out. Since their arrival, they've made their mark on the X-Men titles. Will they one day return home? Time will tell.
Read All New X-Men #1-10 Now
He comes from another version of earth and the Old Man Logan series follows the troubled character as he tries to prevent the horrid future he sees as still to come. Working his way through the Marvel universe, you can follow his adventure in the main series and in Extraordinary X-Men.
Read Old Man Logan #1-7 and Extraordinary X-Men #1-10 Now
Wolverine (Laura)
Laura, the original Wolverine's clone and air to his legacy, takes over Logan's role as the All New Wolverine. The series opens with the reveal that Laura has three clones of her own and so far she's doing everything in her power to save them.
Read All New Wolverine #1-9 and All New X-Men #1-10 Now
So, what are you waiting for? You've got a lot of comics you could be reading. In this mix you'll find pathways to other series and an eventual comic book pull list that will have you feeling right at home enjoying the Marvel universe. Your new favorite comic shop awaits!
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Kung-Yee Liang
National Health Research Institutes
Kung-Yee Liang received his Ph.D. in Biostatistics from University of Washington in 1982 and has been a faculty member at the Department of Biostatistics, Johns Hopkins University since then for 28 years. He served as the Graduate Program Director for the department from 1996 to 2003.
Liang has served as the Vice President, National Health Research Institutes (NHRI), Taiwan from July, 2003 to August, 2006 and was the Acting President for six months beginning in January, 2006.
In August, 2010, Liang became the sixth President of the National Yang-Ming University, the first medical university in Taiwan. In December, 2017, Liang stepped down from the post to become the sixth President of NHRI and his primary appointment is with the Institute of Population Health Science.
Among the honors and awards, Liang received the Snedecor Award (with Scott Zeger) in 1987 by the American Statistical Association for best publication in biometry for 1986, the Spiegelman Award by the American Public Health Association in 1990 for outstanding accomplishments in the field of health statistics, the Rema Lapouse Award by the American Public Health Association in 2010 for significant contributions to the scientific understanding of the epidemiology and control of mental disorders, the Karl Pearson Prize (with Scott Zeger) in 2015 by the International Statistical Institute for contemporary research contribution that has had profound influence on statistical theory, methodology, practice, and/or applications, and the Heritage Award in 2016 by the Johns Hopkins Alumni Association for outstanding service to the progress of the University over an extended period of time. Liang is an Elected Fellow of the American Statistical Association in 1995, an Elected Academician, Academia Sinica, Taiwan in 2002, an Elected Member, Academy of Sciences for the Developing World (TWAS) in 2012, an Elected Member, the National Academy of Medicine, USA in 2015 and an Elected Member, Johns Hopkins Society of Scholars in 2016. In 2020, Liang was one of the 50 alumni from around the world recognized as changemakers for their distinguished service and achievement across public health disciplines and settings in celebration of University of Washington School of Public Health's 50th anniversary.
Liang's research interest has primarily been on developing new statistical methods for analyzing correlated data derived from longitudinal and genetic epidemiological studies, and on developing statistical theory for inference in the presence of nuisance parameters. Liang is a co-author of the book on "Analysis of Longitudinal Data", published by the Oxford University Press in 1994 and in 2002 (2nd edition). He is also the author of the monography on "Generalized Linear Models, Estimating Equations and Multivariate Extensions", published by the Institute of Statistical Science, Academia Sinica in 1999, as a part of the Invited Lecture Series in Statistical Science.
Current Advances in Precision Health in Taiwan
By 2025, Taiwan will be facing serious health crises including becoming super aging society, increasing health expenditure due to rise in chronic diseases and disparity in rural areas. In this talk, we first examine some global trends leading to the current interest in precision health of all ages, which we will elaborate. We then focus on some recent developments in Taiwan pertained to precision health: (1) constructing of conceptual framework in precision health and welfare, (2) Establishing the National Biobank Consortium, (3) Initiating the multi-governmental "Health Big Data Platform Program" and (4) Building the "Service Window" for health big data. These components serve as the fundamental infra-structures for the implementation of precision health in Taiwan. We end with a brief discussion concerning the challenges to face with.


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News , Television
Jazmyn Simon Cast In Michael B. Jordan's Netflix Family Superhero Drama 'Raising Dion'
Trey Mangum
Jazmyn Simon has been cast in the upcoming Netflix series from Michael B. Jordan, Raising Dion.
She joins the previously-announced Jordan and Jason Ritter.
The streaming giant greenlit Raising Dion for a 10-episode, straight-to-series order. It is based on Dennis Liu's viral short film of the same name which revolves around a black mother who discovers her young son has multiple and constantly changing abilities.
The Netflix series will follow a woman named Nicole Reese, who raises her son, Dion, after the death of her husband, Mark (Jordan). The usual dramas of raising a son as a single mom are amplified when Dion starts to manifest several magical, superhero-like abilities. Nicole must now keep her son's gifts secret with the help of Mark's best friend, Pat, and protect Dion from antagonists out to exploit him while figuring out the origin of his abilities.
Simon's character will be Kat, "a surgical resident and Nicole's sister. Easy to say, she's the one that has her life together and can't help but correct Nicole on her life and parenting. All in all, she's a wonderful and supportive aunt and sister but has a hard time biting her tongue as she watches her sister make mistakes."
Jordan will executive produce. Carol Barbee is on board and wrote the Netflix adaptation and will serve as showrunner and will executive produce. Liu will direct and executive produce. MACRO's Charles D. King, Kim Roth and Poppy Hanks are also executive producing along with Kenny Goodman and Michael Green. This is the first TV series order for MACRO.
Simon, who currently recurs on HBO's Ballers, also recently appeared in Tyler Perry's Acrimony and USA Network's Psych: The Movie.


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Man Down Shakka feat. AlunaGeorge Download 'Man Down' on iTunes
Trey Songz Home
Trey Songz And Chris Brown Joined By Nicki Minaj On 'Between The Sheets' Tour
Trey Songz Brings Out Nicki Minaj in LA for "Between The Sheets" Tour
Watch what happened when Nicki made a surprise appearance on stage in Los Angeles.
Nicki Minaj made a surprise appearance during Chris Brown and Trey Songz' 'Between The Sheets' tour in Los Angeles.
The rapper appeared on stage during Trey's performance of 'Touchin' Lovin' to spit her verse - you can watch the video above. (Warning: the video contains strong language that some people may find offensive.)
Chris Brown and Trey's performance in Los Angeles also saw surprised appearances from Ty Dollar $ign, A$AP Ferg, Snoop Dogg and Big Sean.
Recently, Trey Songz announced a one-off gig in London that will coincide with his support slot on Nicki Minaj's UK tour.


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<?php

/**
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 * @package CRM
 * @copyright CiviCRM LLC (c) 2004-2015
 * $Id$
 *
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/**
 * BAO object for crm_email table
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class CRM_Contact_BAO_SubscriptionHistory extends CRM_Contact_DAO_SubscriptionHistory {
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  /**
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    parent::__construct();
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  /**
   * Create a new subscription history record.
   *
   * @param array $params
   *   Values for the new history record.
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   *   $history  The new history object
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  public static function &create(&$params) {
    $history = new CRM_Contact_BAO_SubscriptionHistory();
    $history->date = date('Ymd');
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redpajama_set_name: RedPajamaGithub


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Boorabbin was a location on the narrow gauge Eastern Goldfields Railway in Western Australia.  It was half way between Southern Cross and Coolgardie.

It was the location of a water tank used during the era of steam power on the railways. Construction of the tank began in 1896; it had a capacity of five and a quarter million gallons.

The townsite was gazetted in 1898.  It was named by C.C. Hunt in 1865.

It is in the area of the Boorabbin National Park, and Boorabbin Rocks.

The locality was identified as the nearest to a tragedy on the Great Eastern Highway when three truck drivers were killed by bushfire across the highway in 2007.

Notes

Towns in Western Australia
Goldfields-Esperance


Had to do a factory restore on puter and just getting vuze back up for use again. Downloaded latest update but my 360 is not showing up in the devices...even when I attempted search for it 4x. :( is vuze no longer supporting 360?
Nothing's changed in XBox support - could it be a firewall/AV setting that is preventing Vuze from communicating with the XBox?
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Home Nintendo Nintendo Unveils New Portable Switch Console
Nintendo Unveils New Portable Switch Console
Caleb Dune 11/07/2019 Leave a Comment
Lovers of Mario, Donkey Kong and Link will soon have a more affordable option for their favorite video games to follow in their travels. Nintendo announced Wednesday a new version of its Switch console entirely dedicated to the portable mode.
As the Switch Lite is a portable console and not a hybrid console like the Switch, its features are slightly limited compared to its elder.
First, the Switch Lite can not connect to a TV. Second, she does not have detachable Joy-Con controllers. The controllers are directly integrated into the console, in a form reminiscent of the Wii U Gamepad, the PS Vita or even the Game Boy Advance.
These controllers are themselves slightly different from the Joy-Con. The four buttons on the left side have been replaced by a directional cross, while the infrared sensor normally below the right joystick has disappeared. Joystick vibration has also been removed.
Some games already on the market will not be compatible with the Switch Lite and others will require the purchase of additional Joy-Con controllers (and a charging station for Joy-Con).
According to Nintendo, all games suitable for portable mode already on sale will work with the Switch Lite.
To check the compatibility of a game, check the back of the case before you buy it. Three icons can be found: a TV, a console unfolded with the remote control, and a console in portable mode with the handles attached. This last icon indicates that the game is suitable for portable mode.
The Switch Lite will be launched on August 20, 2019 for $ 259.99, $ 120 less than the Switch.
Caleb Dune
Caleb Dune is just getting his start as a journalist. Caleb attended a technical school while still in high school where he learned a variety of skills, from photography to coding. Apart from being a contributor to the site, Caleb also helps keep Game Nerd up and running, he also keeps our social media feeds up-to-date.
Nintendo Switch System Update 8.1.0 Is Now Live
Pokémon Sword and Shield to be Released November 15th on Nintendo Switch
Loot boxes will need to be more transparent on Android
Tamagotchis, still alive and more connected than ever
© 2019 GameNerd.Net - Game Nerd LLC


Yes, fans of the macabre – Halloween is in full swing at East Hartford's Haunted Mansion at the Veterans Memorial Clubhouse and the experience is Spooktacular! Please remember that this is a quote from the article – I would never write a word like spooktacular.
Ghost hunters will get their chance to investigate Beauregard Parish's Old Gothic Jail, where two convicted killers were executed nearly eight decades ago.
Is anyone here traveling for Halloween? I'm not, but I'd love to hear your haunted house and ghost hunting stories!
Years ago, I lived in an apartment on the 3rd floor of an old house that the 2 bottom floors were a museum. This was in Terre Haute, Indiana. The house was an old mafia house from years gone by and was beautiful after being restored by the historical society.
The 1st floor housed the big pieces, such as a wooden, hand-carved Indian that had been outside one of the original stores. He stood about 6 feet tall. There was also a clown that was from an original candy store. He was huge…standing about 6 feet tall and about 5 feet around…fat. He was all hand-painted and had been restored to some extent.
When I rented the apartment, the lady who I rented from told me that I "might hear" some occasional noises at night, but to not be afraid as there was nothing harmful. It was just the clown moving from room to room. She said he would get tired of being in one room and would travel to another room to get a better view or to see "a friend." I just laughed…I was about 22 y/o at the time, thinking to myself that this lady had just too much time on her hands and had been in the museum way too long.
I moved in and totally enjoyed the spacious 1 bedroom apartment, tall ceilings, large kitchen and my own space. However, one night, something woke me out of a sound sleep. I heard what sounded like something rolling across the hard-wood floor, but not in my apartment, somewhere else in the house. It stopped and I went back to sleep. The next day, I noticed, when I came home, that the clown and the Indian were in different windows of the 1st floor facing the street. I didn't think much about it and certainly wasn't afraid. When I went to pay my rent for the next 2 weeks, the lady asked if everything was all right. I told her yes, but I had heard something rolling across the floor about 3 weeks before, but, it had stopped and I wasn't worried. She told me that the clown and the Indian had traded places because Mr. Clown was tired of looking out the side window, so, he got the Indian to trade with him so he could face the front of the house. I just looked at her. I wasn't understanding her. She then told me that the Indian and Mr. Clown had been the only two items that had been saved from a fire that had taken down 3 full blocks of the downtown area in the early, early 1900's. They had resided at stores that were side by side and had burned to the ground. Both owners had lived upstairs above their stores and had died in the fire. It was said that the two male owners had manifested their spirits in the Indian and Mr. Clown and the museum was renowned for the "moving" Indian and Mr. Clown.
I moved about a month later to live with a girl friend. I was pretty glad to get out of the museum, only because I was worried Mr. Clown or Mr. Indian would/could climb the stairs to my 3rd floor apartment some night.


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You are here: Home Page > Law > Environment & Energy Law > Climate Change Law and Policy
Climate Change Law and Policy
EU and US Approaches
Cinnamon P. Carlarne
Innovative examination of the challenges faced by the international community when negotiating an answer to climate change
Thorough comparative analysis of two of the major players in climate change law: the EU and the US
Explores the implications of the relationship between the EU and the US for efforts by individual States and the international community to effectively address climate change
Assesses the successes and failures of current climate change policies and suggests areas for improvement
Existing climate change governance regimes in the US and the EU contain complex mixtures of regulatory, market, voluntary, and research-based strategies. The EU has adopted an approach to climate change that is based on mandatory greenhouse gas emission reductions; it is grounded in 'hard' law measures and accompanied by 'soft' law measures at the regional and Member State level. In contrast, until recently, the US federal government has carefully avoided mandatory emission reduction obligations and focused instead on employing a variety of 'soft' measures to encourage - rather than mandate - greenhouse gas emission reductions in an economically sound, market-driven manner. These macro level differences are critical yet they mask equally important transatlantic policy convergences.
The US and the EU are pivotal players in the development of the international climate change regime. How these two entities structure climate change laws and policies profoundly influences the shape and success of climate change laws and policies at multiple levels of governance. This book suggests that the overall structures and processes of climate change law and policy-making in the US and the EU are intricately linked to international policy-making and, thus, the long-term success of global efforts to address climate change. Accordingly, the book analyses the content and process of climate change law and policy-making in the US and the EU to reveal policy convergences and divergences, and to examine how these convergences and divergences impact the ability of the global community to structure a sustainable, effective and equitable long-term climate strategy.
Part I: The Politics of International Climate Change
1:The Role of the United States and the European Union in International Climate Change Politics
Part II: Climate Change Law and Policy in the USA
2:Climate Change Laws and Policies in the United States
3:Sub-Federal Climate Change Law & Policy-making in the United States
4:Alternative Forms of Climate Change Law & Policy-making in the United States
Part III: Climate Change Law and Policy in the European Union
5:Climate Change Laws and Policies in the European Union
6:Member State Climate Change Laws & Policies in the European Union
Part IV: A Comparison of United States' and European Union's Climate Change Laws and Policies
7:United States and European Union Climate Change Laws and Policies Compared
8:Socio-Legal Factors Influencing Climate Change Law and Policy-making in the United States and European Union
Part V: The Future of International Climate Change Policies
9:Conclusions & the Way Forward
Cinnamon P. Carlarne, Assistant Professor, University of South Carolina, School of Law & School of the Environment
Energy Justice and Energy Law
Iñigo del Guayo, Lee Godden, Donald D. Zillman, Milton Fernando Montoya, José Juan González
The Paris Agreement on Climate Change
Daniel Klein, María Pía Carazo, Meinhard Doelle, Jane Bulmer, Andrew Higham
EU Environmental Law and Policy
David Langlet, Said Mahmoudi
Environmental Protection and Transitions from Conflict to Peace
Carsten Stahn, Jens Iverson, Jennifer S. Easterday
EU Waste Law
Professor Geert Van Calster
The UN Convention on the Law of the Non-Navigational Uses of International Watercourses
Laurence Boisson de Chazournes, Makane Moïse Mbengue, Mara Tignino, Komlan Sangbana, Jason Rudall
International Environmental Law, Policy, and Ethics
Alexander Gillespie
Emissions Trading Schemes under International Economic Law
Treaties on Transit of Energy via Pipelines and Countermeasures
Danae Azaria
Fresh Water in International Law
Laurence Boisson de Chazournes
Energy Law in Europe
Martha Roggenkamp, Catherine Redgwell, Anita Ronne, Inigo del Guayo
Law > Environment & Energy Law
Law > International Law > Public International Law > International Environmental Law