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.500, Ho!
The weather around these parts hasn't consistently warmed up yet (a sort of "Prague Spring"), but already the baseball season has reached the quarter-mark, with most teams having played about 40 games.
The baseball has been similarly lukewarm, so far it's mostly been characterized by the high number of teams treading water at a winning percentage of .500 or so. Of the 30 MLB teams, 23 are within five games of either side of the break-even mark. If you wanted to use a tighter standard of say, three games either side of even, there are still 18 teams there, which seems high even at this still early point.
Only four teams are significantly above .500 – the Tigers (24-12), A's (25-16), Giants (26-15) and, perhaps surprisingly, the Brewers (25-15). (I say perhaps in the Brewers' case because they were a consistent contender recently until falling into a big hole last year, when their star slugger Ryan Braun was forced to take an extended timeout for drinking his classmates' apple juice.) The good news is that there are only three teams far below the .500 mark – the Astros (14-27), the Cubs (13-25) and Arizona (16-27). The first two are hardly a surprise, but few expected the D-backs to be this bad. Everybody else is just kind of plugging along, winning a few, losing a few, week in and week out.
There are all sorts of ways to break this down, most of them offering mild to jarring shocks. For example, the two teams who played in last year's World Series – Boston and St. Louis – are a combined one game above .500 (the Cards are even and the Red Sox a breathtaking one game over). The five N.L. teams who made the post-season last year – the Braves, Cards, Reds, Pirates and Dodgers – are a combined one game below, at 98-99. Last year's A.L. entries have fared a little better at 15 games above (106-91), but this is entirely due to the strong play of the Tigers and A's, the others (Red Sox, Rays and Indians) have been average at best.
Obviously, to effect this across-the-board mediocrity, there have been both under- and over-achievers. In the A.L. the under-achievers would include all the East division teams (except maybe the Blue Jays), the Indians in the Central and the Angels and Rangers in the West. In the N.L. the Braves, Nationals, Cards, Pirates, Reds and Dodgers have played below expectations, but some teams (other than the Brewers and Giants) have been surprisingly decent. Both the Mets and Marlins have over-achieved so far (thanks, Jays) and the Rockies and Padres have been pretty good too.
This sort of thing happened years ago in the NFL and its commissioner Pete Rozelle, no marketing slouch, sold the equality as "parity", rather than "parody". To be sure though, the evenness of this baseball season is not entirely a bad thing. While there are clear-cut front-runners in the West and Central divisions of both leagues, the East divisions are entirely up for grabs and this could mean some exciting, multi-team pennant races, especially with the two wild cards in play in each league . Sometimes baseball seasons settle into this pattern of competitive balance, at least in some divisions. A classic example was the 1973 N.L. East. As late as the last week of the season, five of the six teams were within a game or two of first place, each of them passing the others in the night like stealthy submarines in a futile game of Battleship, all of them within inches of .500. The Mets finally took it with a stunningly average record of 82-79, barely ahead of the Cards (81-81), Pirates (80-82), Expos (79-83) and Cubs (who, surprise, surprise, faded late to 77-84). The Mets were a force in the post-season though, beating the Big Red Machine in a famously scrappy NLCS and giving Oakland all they could handle before losing the Series to the A's in seven nail-biting games. It wasn't real pretty but it was exciting and we could be looking at a couple of scenarios like this in the East divisions this year, it's certainly possible. That's the silver lining of having all these middling records so far, there are still plenty of possibilities left.
Nowhere has this flirtation with the median line been more surprising than the A.L. East, where the cumulative record of all five teams is two games below .500 (98-100), believe it or not. This represents a major step down for all of the teams except maybe the Blue Jays, as none of the presumptive juggernauts in the division has really dominated or put anything strong together. The Orioles, who seem to have the best eight-man daily lineup when healthy, looked to be distancing themselves from the pack in first place, but have lost their last four in a row to come back. The Yanks and Red Sox, despite their Rockefeller payrolls, have each struggled with holes and inconsistency to a 20-19 record. The Rays were somewhat surprisingly stumbling around in last place, victims of pitching injuries, bullpen and run-scoring problems, but they've steadied themselves lately and are only 3 1/2 games back.
The Jays' record of 20-21 is nothing to brag about, but represents a step in the right direction from last year, when they were already about ten games below .500 at this point. Despite some obvious weaknesses, they are a considerably better team, as advertised and hoped for. Much of the improvement has been on defense, one of their unforeseen Achilles' heels of last season. Due to the much improved health of Melky Cabrera, Brett Lawrie and (mostly) Jose Reyes, the defense has been much better in left field, at third base and shortstop. The glaringly weak catching situation of last season has been shored up, as both Dioner Navarro and Josh Thole have been solid defensively and have hit well too (although Thole has only had about 40 at-bats, I'll still take .375, thanks). Not to kick a guy when he's (still) down, but J.P. Arencibia is hitting a robust .140 with the Rangers and has yet to throw out a base-stealer. (I don't know what they're thinking down there in Arlington, but the Rangers are going nowhere fast with ex-Jays deadwood like Arencibia and Alex Rios, and the Kinsler-for-Fielder trade looks pretty disastrous too – Kinsler's much better at everything except hitting home runs, but even so, has more RBI and HRs than Fielder so far.) The Jays' situation at second base has been a bit of a revolving door, but at least the defense there has been better than last year, regardless of who's played. The Jays are above average to solid defensively at the other positions and it's helped.
The Jays' offense has been solid too, slightly better than expected despite a low team batting average. They're among the league leaders in important categories like runs, home runs, RBI and slugging percentage. New hitting coach Kevin Seitzer seems to have come up with some plans and approaches tailored to each individual and a lot of them seem to be working. Bautista is showing more discipline than the past two years, he's back to taking bad pitches and not getting over-anxious or too argumentative with the umpires. He's been an on-base machine and the power is there, as always. Adam Lind has looked good with the bat and they've finally figured out how to use him – sit him against lefties, especially tough ones. The batting averages of Colby Rasmus (who I'll never figure out) and Lawrie are not where you'd like them to be, but both have flashed home run power and Lawrie has been extraordinarily efficient with runners in scoring position – he has 24 RBI on 30 hits, which is remarkable. Cabrera's hot hitting has been mostly a matter of his restored health – it's amazing what not having a walnut-sized tumour on the spine can do for a guy. This may seem like a premature exaggeration (and it is), but in Juan Francisco, the Jays may have found their David Ortiz. Francisco reminds me of Ortiz a lot, except Juan seems to have some defensive value too. He's big, left-handed, extremely strong with quick wrists, will hit with a lot of power and for a decent average despite striking out a lot, because he's also patient and disciplined, with a good eye. He's made a difference, the two-through-seven spots in the Jays' batting order have been almost formidable.
The strength of Francisco's bat has led to an interesting conundrum, namely how to keep it in the lineup everyday. Encarnacion and Lind are both hitting well and ensconced as the regular first baseman and DH against right-handed pitching respectively, so the Jays use Francisco as the DH against lefties and to spell the other two occasionally. But with the Ryan Goins experiment shelved and the costly loss of Maicer Izturis cutting down on their options at second base, the Jays have tried an assortment of Munenori Kawasaki, Jonathan Diaz, Chris Getz and Steve Tolleson. Each of them have had their moments, while none has seemed to be the permanent answer with either the bat or glove. With the offense going so well, some think the Jays should choose the best defensive player and carry his bat, which they can afford to do provided it's not too weak. Settling on one guy would help, I'm inclined toward Tolleson. But the Jays have been toying with another possibility – playing Brett Lawrie at second and Francisco at third, which is both intriguing and controversial. Those against this point to the failure of last year's brief Lawrie-at-second experiment, the injury-prone aspect of both Lawrie and that position, his defensive excellence at third, and how shifting could negatively impact his game, given his already volatile psyche. These are all good points, but could be countered with the following: Last year was last year, an entirely different situation. Lawrie was still coming off an early season injury at the time of the switch and his performance, concentration and confidence were all badly shaken, plus they didn't give him much time or warning, the whole business only lasted a few days. He seems much more settled, focused and mature this year, plus he moves all over the diamond in their various shifts anyway, so playing him at second base could work. I can see the value if it gets Francisco's bat in there more often but it will only succeed if they commit to it fully and for some time. Trying it for just two weeks or constantly shifting Lawrie back and forth between or during games isn't fair to him and will sandbag the idea, they need to make up their minds. I think it's worth trying, but of course it isn't just about Lawrie, it's also about how well Francisco can handle third base, which remains to be seen. The other option to maximize Francisco's bat would be to make him the full-time DH and either trade Adam Lind or use him off the bench as a pinch-hitter, utility-DH guy, which they might also try. Mostly, where to put Francisco's bat is a nice problem to have.
So they can catch the ball and hit the ball, but the Jays haven't thrown the ball very well; apart from Mark Buehrle, their starting pitching has been spotty at best and this has cost their bullpen of late. R.A. Dickey has been up and down, but mostly good of late, though he often leaves games earlier than he'd like and with runners on base. It's not saying much, but Drew Hutchison has pitched better than his record shows. Dustin McGowan has been okay but can't seem to get past the fourth inning with any consistency; everybody but Buehrle has walked far too many batters. And then there's Brandon Morrow. Like many, I saw Morrow as the key to the rotation – Buehrle and Dickey could be counted on at the top, the bottom was uncertain, so Morrow with his good stuff in the middle would be the difference-maker. That's all out the window now, because for the third straight year, Morrow will miss significant time with another injury and one wonders if he'll ever have a healthy full season or realize his potential. The only silver lining to his injury was that he was pitching so poorly that they might have had to replace him anyway and this saved them that decision. I can't recall seeing such pitching inefficiency, even in this day and age – he was throwing way too many pitches without getting many outs – usually about 100 by the fourth or fifth inning, by which time he was gassed. As Gregg Zaun pointed out, Morrow has an electric fastball around 95 m.p.h. with good movement, but he was only using it about 50% of the time, which isn't nearly enough, plus he wasn't locating it. This just isn't good enough, the jury's out on Morrow even though he's only 29. So now they have to replace him with J.A. Happ, who may or may not be be marginally better, but it looks like they're going to have to replace McGowan soon too, as they want him in the bullpen, but with who? Either Esmil Rogers or Todd Redmond I guess, Marcus Stroman sure doesn't look to be ready yet. The failure to land an established starting pitcher in the off-season will probably cost them, a shame because they're right there in a division that may be wide open for once.
Indeed, if not for the recent rough patch by the bullpen, the Jays might be in first place right now. The injury to Casey Janssen lasted longer and proved more costly than expected, it moved each reliever's role up a notch and some of them weren't ready for this. Plus they've been overworked because of the general failure of the starters to go more than five or six innings. I still think that long-term, the bullpen is a strength of this team, there's quality and depth there provided they aren't stretched too thin.
Returning to the subject of .500 baseball….The stated aim of many teams whose fortunes are up in the air is to keep close in the early going, stay around .500 until the break, then try to put a run together. It's one thing for teams to utter this cliche, but quite another to see so many of them actually doing it. Maybe it shouldn't be so surprising though; after all, the cumulative win-loss percentage of all teams in all games played since the very beginning of baseball is .500. This may not sound right, but it's true – it has to be, because in every game played, there's a winner and a loser – that adds up to .500, every time. Usually, a few teams are doing more of the winning and a few others are doing more than their share of the losing. The difference so far this year is that most of them are sharing this around equally, a rare kind of baseball democracy.
© 2014, Steve Wallace. All rights reserved.
This entry was posted in Baseball by steve. Bookmark the permalink.
1 thought on ".500, Ho!"
morganchildsjazz@yahoo.ca on May 16, 2014 at 6:58 am said:
Steve, what about packaging up Lind with maybe one of our extra arms in the bullpen for a starter? We've got lots of options in the pen, especially with a healthy McGowan back down there poised to do his best work as a reliever, and Francisco is looking like a good option for a DH, especially with the way Adam has been swinging the bat since he got off the DL. Juan is younger and hence, one hopes, less injury prone… If they manage to get down to 7 guys in the pen, that would leave a bench spot for Gose who is defensively just incredible, and fast as a pinch runner in late-game situations.


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El año 97 () fue un año común comenzado en domingo del calendario juliano, en vigor en aquella fecha.

En el Imperio romano, era conocido como el Año del consulado de Augusto y Rufo (o menos frecuentemente, año 850 Ab urbe condita). La denominación 97 para este año ha sido usado desde principios del período medieval, cuando el Anno Domini se convirtió en el método prevalente en Europa para nombrar a los años.

Acontecimientos
El papa Evaristo sucede a Clemente I.
Nerva escoge a Trajano como sucesor.

Enlaces externos

redpajama_set_name: RedPajamaWikipedia


This list will keep track of all the releases, firings, quits, and "future endeavors" of any kind for the year 2017. Keep checking back throughout the year for new updates on the latest releases and the people that have retired or been fired.
Note: I forgot to update this with a revamped set of predictions after SummerSlam. Apologies!


KIM – Once again a bunch of catching up to do! We finally got out of Toowoomba and instead of trying for Fraser Island we headed south to New South Wales to a place called Kings Plains Castle. We have now been in Queensland, New South Wales, South Australia & The Northern Territories – 4 of the 7 states – not bad!
King's Plains is in the heart of an area known as Celtic Country and I swear you'd believe it. The names of the places and people are straight out of Scotland & Ireland and the land itself is rich, open rolling hills and tall trees. Our hosts were Colleen and Don. They owned 12,000 acres and bought the King's Plains for its additional 3,000 acres of grazing – the 28 room castle was a bonus! So being enterprising souls with surely an excess of energy, they decided to open a B&B! Incredible hospitality,I felt more like I was visiting long lost friends in their home than a commmercial venture. The castle was built in 1906 for a young scottish bride to make her feel at home – nice wedding present, but it didn't take as she divorced and left soon after. Lots of history and ambiance and a glimpse of life in the days of servants, white lawn dresses, afternoon tea, croquet on the lawns and so on!
Colleen and Don run a couple thousand head of Black Angus cattle, about the same number of Merino sheep and two displaced Texas long Horn steers – big fellas!
We only stayed there overnight but I could easily have stayed a lot longer!
Back to our home base of Archer Field for Barb and me via the Gold Coast. The seas were still quite dramatic but boy is it stunning! Especially as we got clearance to fly at 500 feet – practically blow the bathing suits off the surfers!
We spent all day – well I did anyway – SPA DAY. I loved being in the outback and living out of a smallish suitcase and the heat and dust and flies were all at part of that but a girl needs pampering after a while! So hair done – grey begone – mani, pedi, facial and massage and I was a new woman! I just have to have some down time once in a while!
Last night was a bit teary and lots of laughs too. Everyone is heading out their seperate ways today so we had a last get together at a Turkish restaurant down the street from the hotel. Let me tell you the sight of Mark working up a sweat with the belly-dancer defies description!
I shall be sad to say goodbye; I think we have all become very close over the past few weeks and while I'm sure everyone had their moments, the group got on amazingly well. I hope we can all get together to swap photos and reminisce soon!


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MST-School of Pure and Applied Sciences
MST-Department of Plant and Microbial Sciences
MST-Plant and Microbial Sciences
A comparative study of antibiotic resistance profiles among enteric bacteria in broilers and traditional chicken from selected farms in Kericho, Kenya
Mutsami, Anne Naliaka
Antibiotic resistance is a growing concern for public and animal health. Threats to public health could come from the transfer of pathogens from animals to people via indirect contact such as through food or by direct contact with animals during handling process. Development and prevalence of antibiotic resistance of Salmonella and Escherichia coli strains is common. There is also acquisition of pathogenicity by the commensals. The purpose of the present study was to determine the prevalence of the various intestinal bacteria, antibiotic susceptibility of Escherichia coli and Salmonella, possibility of transfer of genes responsible for resistance of isolates from broiler chicken. This was to evaluate the level of antibiotic resistance of the two bacteria strains named above in Kericho District. Isolates from indigenous 'chicken that scavenge were used as control population. Sampling was done in Ainamoi, Belgut, Soin and Kabianga divisions. Data collection was done from September 2008 up to February 2009. Rectal swabs were taken from 321 broilers and 364 indigenous (local) chicken that were randomly sampled. The inocula were cultured on various agars and incubated for 24- 48h at 37°C for identification. The pure isolates were subjected to susceptibility tests to twenty antibiotics using the disc diffusion technique. A proportion of 92.5% were resistant to one antibiotic, 6S.31% to two, 4S.400/O to three, 32.7S% to four, 25.48% to five, 09.64% to six and 02.S7% to seven antibiotics. A total of25 Escherichia coli isolates that were resistant to ampicillin and augmentin, and 17 resistant to nalidixic acid were subjected to in-vitro conjugation using E. coli JS3 strain as the recipient. A total of 16 E. coli isolates underwent successful conjugation. Those that underwent successful conjugation were subjected to plasmid DNA profiling. Plasmids' molecular sizes were determined by coelectrophoresis with plasmids of known molecular size from E. coli strains R39 and VS17 on 1 % horizontal agarose gel. A total of 465 E. coli and 2 Salmonella isolates were analysed. The results showed no significant difference (F = 0.24, P = 0.633) in prevalence of resistance among isolates from indigenous chicken and broiler chicken at 9S% confidence limit. The plasmids containing genes for antibiotic resistance were transferable through conjugation from one bacterium to another. Plasmids of varying molecular weight (l47kb up to 3.0kb) were common in multiple drug resistance (MDR) E. coli. Prevalence of resistance decreased with increase in bird age in isolates from broiler chicken whereas the trend was opposite in those from indigenous chicken. Data was analysed using a computer package MINITAB 13.0. It is therefore important to monitor the susceptibility profiles of Escherichia coli to commonly available antibiotics since they could be a reservoir of genes carrying resistance.
MST-Plant and Microbial Sciences [137]

redpajama_set_name: RedPajamaCommonCrawl


This page takes you through the steps required in order to get historical data from Adjust.
1. Log in to your adjust dashboard on http://next.adjust.com.
2. Use the Adjust Audience Builder to create a segment you want to include in /exclude from Remerge targeting.
3. Send Remerge the Audience URL and describe how you would like to use it for targeting.
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Charlie Sheen in "Heated Battle" With Selma Blair on Set of Anger Management, Sources Confirm
by Kristin Dos Santos | Mon., Jun. 17, 2013 11:53 AM
Frank Micelotta/FX
Charlie Sheen and costar Selma Blair are engaged in a "heated battle" behind the scenes of their FX series, Anger Management, sources confirm to E! News.
As first reported by TMZ, Sheen no longer wants to work with the actress, who plays his onscreen therapist Dr. Kate Wales, after she reportedly complained about his work ethic to Anger Management executives.
NEWS: Denise Richards on Charlie Sheen: "We're Very Close"
"Things have gotten ugly," one source on set tells us, adding that Charlie does not have the exclusive right to fire anyone, but he "certainly can make production impossible."
Sheen has threatened not to show up to work if the issue is not resolved.
FX picked up four years' worth of Anger Management episodes last year, and the series shoots rapid-fire, cranking out two episodes per week instead of the usual one.
NEWS: Denise Richards calls Charlie Sheen "greatest ex" for Mother's Day gift
An FX source says it's possible the show could continue without Blair, but nothing has been decided yet.
FX and reps for both actors did not immediately return E! News' request for comment.
PHOTOS: Famous families
TAGS/ Watch With Kristin , TV , Charlie Sheen , Top Stories
With Love (and Wigs), Catherine O'Hara and Schitt's Creek Finally Broke Through at the Emmys
Lance Bass Apologizes After Claiming Tom Schwartz and Katie Maloney Are Not Legally Married
Gossip Girl Is Coming Back, But Will You Watch Without the Original Cast?


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Stop the Untouchables. Justice for Sergei Magnitsky.
Crimes of the Klyuev Organized Crime Group
The Klyuev Organized Crime Group has been committing crimes on a serial basis since the end of the 1990s.
Its crimes range from kidnapping to tax theft to murder. It is responsible for the theft of nearly $800 million dollars from the Russian people. It arranged the false arrest, torture and murder of Sergei Magnitsky when he exposed its crimes. In addition to murdering Sergei Magnitsky, the group has left many other dead bodies in its wake. The group is protected by the Russian government and Russian government officials comprise some of its key members. Its crimes are therefore state sanctioned and its members are untouchable in Russia.
Klyuev's first arrest (03.06.1998)
Failed assassination attempt on Klyuev (16.03.2003)
First tax refund in 2002 (not yet recognized as a crime by the Russian government)
Attempt to steal $1.6 billion in Mikhailovsky GOK (December 2004 – January 2005)
Investigator Karpov travels with Klyuev, joins the Organized Criminal Group and protects Klyuev (April 2006)
The kidnapping of Fyodor Mikheev and attempt to extort $20 million from his boss (August 2006)
The theft of $107 million in taxes paid by companies managed by RenCap (This theft has not yet been recognized as a crime by the Russian government) (December 2006 – March 2007)
Attack on Hermitage and theft of the $230 million in taxes it paid (Tax theft has been recognized by the Russian government) (May 2007 – December 2007)
Sergei Magnitsky links all tax thefts to the Klyuev Group and is arrested and tortured (2008 – 2009)
The Interior Ministry protects Klyuev and all the corrupt officials (2008-2010)
The Interior Ministry murders Sergei Magnitsky and tries to cover it up (16 November 2009 – Current)
The Klyuev Organized Crime Group goes on to steal another $400 million in taxes (2009-2010)
To learn more about what happened to Sergei Magnitsky please read below
Sergei Magnitsky
Why was Sergei Magnitsky arrested?
Sergei Magnitsky's torture and death in prison
President's investigation sabotaged and going nowhere
The corrupt officers attempt to arrest 8 lawyers
Past crimes committed by the same corrupt officers
Petitions requesting a real investigation into Magnitsky's death
Worldwide reaction, calls to punish those responsible for corruption and murder
Complaints against Lt.Col. Kuznetsov
Complaints against Major Karpov
Press about Magnitsky
Bloggers about Magnitsky
Corrupt officers:
Artem Kuznetsov
Declared income
Pavel Karpov
Olga Stepanova
Offshore Companies
Elena Anisimova
Olga Tsareva
Citizen investigator
Join Justice for Magnitsky group on Facebook
© 2010- 2019 Stop the Untouchables. Justice for Sergei Magnitsky.
Contact us: contact@russian-untouchables.com
Justice for Sergei. ICU Documentary.
Karpov's Illicit and Sudden Wealth
Kuznetsov's Illicit and Sudden Wealth
The Corruption Exposed by Sergei Magnitsky
Interview with Sergei Magnitsky's Mother
William Browder's Interview Immediately After Sergei Magnitsky's Murder
CNN's Fareed Zakaria Interviews Sergei Magnistky's Client William Browder
Russia is a "Criminal State"
Sergei Magnitsky's Lawyer Speaks Out
Sergei Magnitsky's Murder in Pretrial Detention
The Risks of Doing Business in Russia
BBC HARDtalk Investigates the Murder of Sergei Magnitsky
Magnitsky
Who was Sergei Magnitsky?
Crimes Sergei Magnitsky exposed
Denial of justice
Worldwide reaction, calls to punish those responsible
Tribute to Sergei Magnitsky
Crimes and complaints
Theft of $230m from the Russian budget
Theft of additional $240m from the Russian budget by the same criminals
Attempted theft of $21 million from the Russian budget by the same criminals
Magnitsky's false arrest, detention, torture, and murder
Attack on Hermitage lawyers
Kidnapping and extortion
Independent findings of torture and murder
Magnitsky's diaries from pre-trial detention
Complaints about inhumane and torturous conditions
Illness in detention
Requests for medical care
Denial of medical care and continuation of torture
Enforced isolation from family
Magnitsky's testimonies against corrupt officers
False arrest and persecution of Magnitsky
Officers' illicit assets
Presidential Human Rights Council Report
Untouchables
Cardin List of corrupt officials
Crimes and assets of Lt.Col. Artem Kuznetsov
Crimes and assets of Major Pavel Karpov
Crimes and assets of Olga Stepanova
Crimes and assets of Elena Anisimova
Crimes and assets of Olga Tsareva
Complaints requesting investigation of the source of Kuznetsov's family enrichment
Complaints requesting investigation of the source of Karpov's family enrichment
President investigation sabotaged and going nowhere
Petitions requesting investigation into Magnitsky's murder ignored
Magnitsky Murder and Cover-Up Report
Parliamentary Motions, Resolutions & Laws
Campaign for justice
Support visa sanctions
Send information about corrupt officers


Big shout out to our co-op Becca McCready for placing first in the Site Civil Design Competition for the American Society of Civil Engineers (ASCE) Ohio Valley Student Conference (OVSC) this past weekend. Along with her competition partner, Becca represented the University of Cincinnati and achieved first place two years in a row at this competition. When commenting on the win, Becca stated, "I couldn't have done it without the co-op experience I have gained at The Kleingers Group. There are very few classes, if any, at the University that teach CAD skills or civil site design concepts. I am confident that our continued success in this competition is LARGELY attributed to what I have learned at Kleingers since 2015." The Kleingers Group is humbled by Becca's comments and proud of her success! Congratulations!


Please consider making a gift to Syracuse City Ballet! Your support will help us bring the beauty, magic and powerful athleticism of ballet to community members throughout Central New York. To have the most impact, we hope you'll consider joining our Syracuse City Ballet Society with your annual gift of $250 or more. Thank you!


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How does iron overload increase the risk of infection?
September 9, 2020 FA Manian MD, MPHAspergillus;, Cryptococcus;, Cytomegalovirus;, E. coli;, Ehrlichia;, Entamoeba;, Hemachromatosis;, Hemolysis;, Hepatitis B;, Hepatitis C;, Iron;, Legionella;, Listeria monocytogenes;, Listeria;, Mucor;, Mycobacteria;, Oysters;, Parvo virus;, Plasmodium;, Protozoa;, Staphylococcus aureus;, Streptococcus sp;, Toxoplasma;, Vibrio;, Yersinia;Leave a comment
Iron overload, either primary (eg, hereditary hemochromatosis) or secondary (eg, hemolysis/frequent transfusion states), may increase the risk of infections through at least 2 mechanisms: 1. Enhancement of the virulence of the pathogen; and 2. Interference with the body's normal defense system.1-7
Excess iron has been reported to enhance the growth of numerous organisms, ranging from bacteria (eg, Yersinia, Shigella, Vibrio, Listeria, Legionella, Ehrlichia, many other Gram-negative bacteria, staphylococci, streptococci), mycobacteria, fungi (eg, Aspergillus, Rhizopus/Mucor, Cryptococcus, Pneumocystis), protozoa (eg, Entamaeba, Plasmodium, Toxoplasma) and viruses (HIV, hepatitis B/C, cytomegalovirus, parvovirus). 1-7
In addition to enhancing the growth of many pathogens, excess iron may also inhibit macrophage and lymphocyte function and neutrophil chemotaxis .1,2 Iron loading of macrophages results in the inhibition of interferon-gamma mediated pathways and loss of their ability to kill intracellular pathogens such as Legionella, Listeria and Ehrlichia. 2
Not surprisingly, there are numerous reports in the literature of infections in hemochromatosis, including Listeria monocytogenes meningitis, E. Coli septic shock, Yersinia enterocolitica sepsis/liver abscess, Vibrio vulnificus shock (attributed to ingestion of raw oysters) and mucormycosis causing periorbital cellulitis. 2
Bonus pearl: Did you know that the ascitic fluid of patients with cirrhosis has low transferrin levels compared to those with malignancy, potentially enhancing bacterial growth and increasing their susceptibility to spontaneous bacterial peritonitis? 8
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Weinberg ED, Weinberg GA. The role of iron in infection. Curr Opin Infect Dis 1995;8:164-69. https://journals.lww.com/co-infectiousdiseases/abstract/1995/06000/the_role_of_iron_in_infection.4.aspx
Khan FA, Fisher MA, Khakoo RA. Association of hemochromatosis with infectious diseases: expanding spectrum. Intern J Infect Dis 2007;11:482-87. https://www.sciencedirect.com/science/article/pii/S1201971207000811
Thwaites PA, Woods ML. Sepsis and siderosis, Yersinia enterocolitica and hereditary haemochromatosis. BMJ Case Rep 2017. Doi:10.11336/bvr-206-218185. https://casereports.bmj.com/content/2017/bcr-2016-218185
Weinberg ED. Iron loading and disease surveillance. Emerg Infect Dis 1999;5:346-52. https://wwwnc.cdc.gov/eid/article/5/3/99-0305-t3
Matthaiou EI, Sass G, Stevens DA, et al. Iron: an essential nutrient for Aspergillus fumigatus and a fulcrum for pathogenesis. Curr Opin Infect Dis 2018;31:506-11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6579532/
Alexander J, Limaye AP, Ko CW, et al. Association of hepatic iron overload with invasive fungal infection in liver transplant recipients. Liver Transpl 12:1799-1804. https://aasldpubs.onlinelibrary.wiley.com/doi/full/10.1002/lt.20827
Schmidt SM. The role of iron in viral infections. Front Biosci (Landmark Ed) 2020;25:893-911. https://pubmed.ncbi.nlm.nih.gov/31585922/
Romero A, Perez-Aurellao JL, Gonzalez-Villaron L et al. Effect of transferrin concentration on bacterial growth in human ascetic fluid from cirrhotic and neoplastic patients. J Clin Invest 1993;23:699-705. https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1365-2362.1993.tb01289.x
Disclosures: The listed questions and answers are solely the responsibility of the author and do not necessarily represent the official views of Massachusetts General Hospital, Harvard Catalyst, Harvard University, its affiliate academic healthcare centers, or its contributors. Although every effort has been made to provide accurate information, the author is far from being perfect. The reader is urged to verify the content of the material with other sources as deemed appropriate and exercise clinical judgment in the interpretation and application of the information provided herein. No responsibility for an adverse outcome or guarantees for a favorable clinical result is assumed by the author. Thank you!
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What's the evidence that patients with Covid-19 are at high risk of blood clots?
April 29, 2020 FA Manian MD, MPHAfrican-American;, Anti-Xa;, aPTT;, ARDS;, Blood clots;, Caucasian;, Chinese;, Covid-19; Coronavirus;, CVA;, DIC;, DVT;, Factor VIII;, Heparin;, Pulmonary embolism, Stroke, Thrombosis;, VTE;1 Comment
Although we often think of it as a respiratory disease, emerging evidence suggests that Covid-19, particularly when severe, is also associated with high risk of thrombotic events, including pulmonary embolism, venous thrombosis, and arterial thrombotic events.1
A Chinese study found that ICU patients with severe Covid-19 had a venous thromboembolism (VTE) incidence of 25%, with disseminated intravascular coagulopathy (DIC) found in the majority of fatal cases.2
A prospective Dutch study involving critically ill ICU patients with Covid-19 reported VTE in 27% and arterial thrombotic events in another 3.7%, despite standard VTE prophylaxis.3 The authors suggested the use of "high prophylactic doses" of anticoagulants in these patients due to concern over hypercoagulability.
An ICU French study also found high frequency of thrombotic complications in Covid-19 patients with ARDS, with 11.7% of patients having pulmonary embolism vs 2.1% in non-Covid-19 patients with ARDS. As with the Dutch study, thrombotic complications occurred despite standard prophylactic anticoagulation.4
Postmortem studies have also shown marked changes in lung microvasculature with the presence of microthrombi, with some calling it "pulmonary intravascular coagulopathy" to distinguish it from DIC.1
A NEJM letter reported 5 Covid-19 patients less than 50 years of age who presented with large vessel stroke symptoms without an alternative explanation.5 Of interest, 2 of these patients had no other symptoms suggestive of Covid-19. A pre-print article from China reported an acute stroke incidence of 5% in hospitalized patients with Covid-19.6
The finding of a hypercoagulable state in patients with severe Covid-19 is not surprising given the frequent association of this infection with a high inflammatory state and the well-known capability of SARS-CoV-2 to attack the endothelial surfaces of blood vessels. High inflammatory state can promote activation of blood coagulation through release of inflammatory cytokines (eg, IL-6, IL-8, and TNF-alpha).1
Perhaps even more intriguing is the finding of extremely high levels of factor VIII found in some Covid-19 patients which could make them hypercoagulable.7 This phenomenon should be suspected when a patient appears to be resistant to anticoagulation by heparin based on aPTT but not based on anti-Xa assay.7
Bonus pearl: Did you know that the overall incidence of VTE is lowest among Asians-Pacific islanders, followed by Hispanics and Caucasians, with highest rate among African-Americans? 1 ,8
Fogarty H, Townsend L, Cheallaigh CN, et al. COVID-19 coagulopathy in Caucasian patients. Br J Haematol 2020, https://onlinelibrary.wiley.com/doi/epdf/10.1111/bjh.16749
Cui S, Chen S, Li X, et al. Huang C, Wang Y, Li X, et al. Prevalence of venous thromboembolism in patients with severe novel coronavirus pneumonia. J Thromb Haematol 2020, April 9. https://onlinelibrary.wiley.com/doi/epdf/10.1111/jth.14830
Klok FA, Kruip MJHA, van der Meer NJM, et al. Incidence of thrombotic complications in critically ill ICU patients with COVID-19. Thromb Res 2020. https://www.sciencedirect.com/science/article/pii/S0049384820301201?via%3Dihub
Helms J, Tacquard C, Severac F, et al. High risk of thrombosis in patients in severe SARS-CoV-2 infection: a multicenter prospective cohort study. Intensive Care Med 2020; https://www.esicm.org/wp-content/uploads/2020/04/863_author_proof.pdf
Oxley TJ, Mocco J, Majidie S, et al. Large-vessel stroke as a presenting feature of Covid-19 in the young. N Engl J Med. 2020, April 28. https://www.nejm.org/doi/full/10.1056/NEJMc2009787?query=featured_home
Li Y, Wang M. Acute cerebrovascular disease following COVID-19: A single center, retrospective, observational study. 2020. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3550025
Beun R, Kusadasi N, Sikma M, et al. Thromboembolic events and apparent heparin resistance in patients infected with SARS-CoV-2. Int J Lab Hematol 2020, April 20. https://onlinelibrary.wiley.com/doi/abs/10.1111/ijlh.13230
White RH, Keenan CR. Effects of race and ethnicity on the incidence of venous thromboembolism. Thromb Res 2009;123 Suppl 4:S11-S17. doi:10.1016/S0049-3848(09)70136-7
Is there a connection between my patient's blood type and risk of thromboembolic events?
August 9, 2019 November 27, 2019 FA Manian MD, MPHAngina;, Atrial fibrillation, Blood group;, Blood type;, Coagulation;, CVA;, Factor VIII;, MI;, Myocardial infarction;, Peripheral vascular disease;, Stroke, Thromboembolic event;, Thromboembolism;, Type O blood;, von Willibrand factor;, VWF;Leave a comment
The weight of the evidence to date seem to suggest that non-blood group O may be associated with non-valvular atrial fibrillation (NVAF)-related peripheral cardioembolic complications, myocardial infarction (MI) and ischemic stroke. 1-4
A 2015 retrospective Mayo Clinic study involving patients with NVAF adjusted for CHADS2 score found significantly lower rate of peripheral embolization in those with blood group O compared to those with other blood groups combined (3% vs 2%, O.R. 0.66, 95% CI, 0.5-0.8); rates of cerebral thromboembolic events were not significantly different between the 2 groups, however. 1
A 2008 systematic review and meta-analysis of studies spanning over 45 years reported a significant association between non-O blood group and MI, peripheral vascular disease, cerebral ischemia of arterial origin, and venous thromboembolism.2 Interestingly, the association was not significant for angina pectoris or for MI when only prospective studies were included. Some studies have reported that the association between von Willebrand factor (VWF) and the risk of cardiovascular mortality may be independent of blood group. 5,6
Although the apparent lower risk of thromboembolic conditions in O blood group patients may be due to lower levels of VWF and factor VIII in this population 1,4, other pathways likely play a role.7
As for why the rate of peripheral (but not cerebral) thromboembolic events in NVAF is affected by blood group, one explanation is that because of their size, larger clots (facilitated by lower VWF levels) may bypass the carotid and vertebral orifices in favor of their continuation downstream to the "peripheral bed".1
Blustin JM, McBane RD, Mazur M, et al. The association between thromboembolic complications and blood group in patients with atrial fibrillation. Mayo Clin Proc 2015;90;216-23. https://www.sciencedirect.com/science/article/abs/pii/S002561961401043X
Wu O, Bayoumi N, Vickers MA, et al. ABO (H) groups and vascular disease: a systematic review and meta-analysis. J Thromb Haemostasis 2008;6:62-9. https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1538-7836.2007.02818.x
Medalie JH, Levene C, Papier C, et al. Blood groups, myocardial infarction, and angina pectoris among 10,000 adult males. N Engl J Med 1971;285:1348-53. https://www.nejm.org/doi/pdf/10.1056/NEJM197112092852404
Franchini M, Capra F, Targher G, et al. Relationship between ABO blood group and von Willebrand factor levels: from biology to clinical implications. Thrombosis Journal 2007, 5:14. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2042969/
Meade TW, Cooper JA, Stirling Y, et al. Factor VIII, ABO blood group and the incidence of ischaemic heart disease. Br J Haematol 1994;88:601-7. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2141.1994.tb05079.x
Jager A, van Hinsbergh VW, Kostense PJ, et al. von Willebrand factor, C-reactive protein, and 5-year mortality in diabetic and nondiabetic subjects: the Hoorn Study. Arterioscl Thromb Vasc Biol 1999;19:3071-78. https://www.researchgate.net/publication/12709043_von_Willebrand_Factor_C-Reactive_Protein_and_5-Year_Mortality_in_Diabetic_and_Nondiabetic_Subjects_The_Hoorn_Study
Sode BF, Allin KH, Dahl M, et al. Risk of venous thromboembolism and myocardial infarction associated with factor V Leiden and prothrombin mutations and blood type. CMAJ 2013.DOI:10.1503/cmaj.121636. https://www.ncbi.nlm.nih.gov/pubmed/23382263
My patient with anemia has an abnormally high mean red blood cell corpuscular volume (MCV). What conditions should I routinely consider as a cause of his macrocytic anemia?
July 26, 2019 July 26, 2019 FA Manian MD, MPHAcanthocytes;, alcohol, Anemia, Anti-neoplastic drugs;, B12 deficiency;, B12;, Cotrimoxazole;, DNA;, Folate;, Folic acid;, Hypersegmented neutrophil;, Hypogranulated neutrophil;, Liver;, Macrocytic;, MCV;, Mean corpuscular volume;, Pelger-Huet neutrophil;, Reticulocyte;, Reticulocytosis;, Spur cellls;, Trimethoprim-sulfamethoxazole;2 Comments
Anemia with mean corpuscular volume (MCV) above the upper limit of normal (usually ≥ 100 fL) is considered macrocytic anemia. The numerous causes of macrocytic anemia can be divided into major categories (1,2) (Figure 1).
First, a reticulocyte production index should be calculated and if elevated the MCV can be above the normal range due to the large size of reticulocytes. Once high MCV is not thought to be related to reticulocytosis, the majority of macrocytic anemias can be categorized according to one of two major mechanisms: 1. Liver disease; and 2. Impairment of DNA synthesis, which includes nutritional deficiencies (folate, B12), drug effect (e.g co-trimoxazole, anti-neoplastic agents and certain anti-retroviral drugs) and "idiopathic" causes (myelodysplastic syndromes).
Mild macrocytosis can also be seen in hypothyroidism and hypoproliferative anemias such as aplastic anemia. Macrocytosis without anemia or liver disease can also be a manifestation of heavy alcohol intake.
Macrocytic anemia in liver disease is due to excess lipid deposition in the red blood cell (RBC) membrane, not impairment of DNA synthesis. Enlarged RBCs are usually round and often have a targeted appearance in liver disease; acanthocytes (spur cells) may also be present (Fig 2). In contrast, in disorders of impaired DNA synthesis, enlarged RBCs are often oval-shaped (macro-ovalocytes) (Fig 3).
Other common abnormalities seen with macrocytic anemia include hypersegmented neutrophils (eg, induced by B12 or folate deficiency), and in the case of myelodysplastic syndromes, hypogranulated neutrophils and Pelger-Huet neutrophil abnormalities.
Bonus pearl: Did you know that the MCV unit, fL, stands for femtoliters or 1/1,000,000,000,000,000 L?
Figure 1. Major causes of macrocytic anemia. MDS: myelodysplastic syndrome.
Fig 2. Round macrocytes with targeting and abundant acanthocytes (spur cells) in a patient with hepatic cirrhosis.
Fig 3. Oval macrocytes in a patient with large granular cell leukemia and an MCV of 125 fL who received cyclophosphamide.
Ward PC. Investigation of Macrocytic Anemia. Postgrad Med 1979; 65: 203-207. https://www.ncbi.nlm.nih.gov/pubmed/368738
Green R, Dwyre DM. Evaluation of macrocytic anemias. Semin Hematol 2015; 52: 279-286. https://www.sciencedirect.com/science/article/abs/pii/S0037196315000554
Contributed by Tom Spitzer, MD, Director of Cellular Therapy and Transplantation Laboratory, Massachusetts General Hospital, Boston, MA.
What is the significance of teardrop cells (dacrocytes) on the peripheral smear of my patient with newly-discovered pancytopenia?
June 28, 2019 January 24, 2020 FA Manian MD, MPHAutoimmune hemolysis;, beta-thalassemia;, Cancer, Dacrocyes, Extramedullary hematopoeisis;, Granulomatous disease;, Hematologic malignancy;, Leukemia;, Malignancy, Metastasis;, Microangiopathy;, Myefibrosis;, Myelophthisic condition;, RBC;, Red blood cell;, Spleen;, Teardrop cells;, Thalassemia;Leave a comment
The presence of teardrop cells (dacrocytes) (Figure below) in the peripheral blood, named for their tear drop shape, is a prominent feature of myelophthisic (marrow infiltrative) conditions, including myelofibrosis, hematologic malignancies, cancer metastatic to the bone marrow, and granulomatous diseases. Teardrop cells may also be seen in beta-thalassemia, autoimmune and microangiopathic hemolytic anemia and severe iron deficiency (1-4).
When evaluating patients with leucoerythroblastic smears (defined by the presence of early myeloid and erythroid forms), the presence of teardrop cells can be helpful in distinguishing often malignant marrow infiltrative conditions from a benign reactive process. Conditions where teardrop cells are seen with high frequency may also have extramedullary hematopoiesis, particularly in the spleen (1,2).
The mechanism of teardrop cell formation may be multifactorial but appears to involve distortion of the red cells as they pass through marrow or splenic sinusoids.
Teardrop cells resulting from conditions such as cancer metastatic to the bone marrow likely involve primarily a marrow origin of the cells whereas primary myelofibrosis with prominent extramedullary hematopoiesis include a splenic mechanism of teardrop cell formation (2).
Supporting the possible splenic contribution to teardrop cell formation is the observation that teardrop cells may be reduced in number or eliminated entirely after splenectomy in patients with myelofibrosis and autoimmune hemolytic anemia (1,4).
Figure. Teardrop cells
1. DiBella NJ, Sliverstein MN, Hoagland HC. Effect of splenectomy on teardrop-shaped erythrocytes in agnogenic myeloid metaplasia. Arch Intern Med 1977; 137: 380-381. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/586447
2. Gutgemann I, Heimpel H, Nebe CT. Significance of teardrop cells in peripheral blood smears. J Lab Med 2014; DOI: 10.1515/labmed-2014-0005 https://www.researchgate.net/publication/272430111_Significance_of_teardrop_cells_in_peripheral_blood_smears
3. Korber C, Wolfler A, Neubauer M, Robier Christoph. Red blood cell morphology in patients with β-thalassemia minor. J Lab Med 2016-12-10 | https://www.researchgate.net/publication/311564128_Red_blood_cell_morphology_in_patients_with_b-thalassemia_minor DOI: https://doi.org/10.1515/labmed-2016-0052
4. Robier C, Klescher D, Reicht G,Amouzadeh-Ghadikolai O, Quehenberger F, Neubauer M. Dacrocytes are a common morphologic feature of autoimmune and microangiopathic haemolytic anaemia. Clin Chem Lab Med. 2015;53:1073-6. https://www.ncbi.nlm.nih.gov/pubmed/25503671
Why is my hospitalized patient with alcohol withdrawal syndrome so thrombocytopenic?
July 29, 2018 May 19, 2020 FA Manian MD, MPHalcohol, Alcohol withdrawal, Cats;, cirrhosis, Delirium tremens;, Delirium;, Folate;, Folic acid;, Hypersplenism;, Liver;, Platelets;, Portal hypertension;, Seizure;, Thrombocytopenia;, Thrombopeisis;Leave a comment
Although thrombocytopenia associated with chronic alcoholism may be related to complications of cirrhosis (eg, platelet sequestration in spleen due to portal hypertension, poor platelet production, and increased platelet destruction) (1), it may also occur in the absence of cirrhosis due to the direct toxic effect of alcohol on platelet production and survival (2).
In a prospective study of patients ingesting the equivalent of a fifth or more daily of 86 proof whiskey admitted for treatment of alcohol withdrawal—without evidence of severe liver disease, infection or sepsis— 81% had initial platelet counts below 150,000/µl, with about one-third having platelet counts below 100,000 µl (as low as 24,000/ul) (3).
In most patients, 2-3 days elapsed before the platelet count began to rise significantly, peaking 5-18 days after admission. Others have also reported that platelet counts rise within 5-7 days and normalize in a few weeks after alcohol withdrawal (1); bleeding complications have been uncommon in this setting.
Perhaps even more intriguing is the report of the association between thrombocytopenia in early alcohol withdrawal and the development of delirium tremens or seizures (sensitivity and specificity ~ 70%, positive predictive value less than 10% but with a negative predictive value of 99%) (4)! In fact, the authors suggested that, if their findings are corroborated, a normal platelet count could potentially be used to identify patients at low risk of alcohol withdrawal syndrome and therefore outpatient therapy.
1. Mitchell O, Feldman D, Diakow M, et al. The pathophysiology of thrombocytopenia in chronic liver disease. Hepatic Medicine: Evidence and Research 2016;8 39-50. https://www.dovepress.com/the-pathophysiology-of-thrombocytopenia-in-chronic-liver-disease-peer-reviewed-article-HMER
2. Cowan DH. Effect of alcoholism on hemostasis. Semin Hematol 1980;17:137-47. https://www.ncbi.nlm.nih.gov/pubmed/6990498
3. Cowan DH, Hines JD. Thrombocytopenia of severe alcoholism. Ann Intern Med 1971;74:37-43. http://annals.org/aim/article-abstract/685069/thrombocytopenia-severe-alcoholism.
4. Berggren U, Falke C, Berglund KJ, et al. Thrombocytopenia in early alcohol withdrawal is associated with development of delirium tremens or seizures. Alcohol & Alcoholism 2009;44:382-86. https://www.ncbi.nlm.nih.gov/pubmed/19293148
Can native valve infective endocarditis be associated with hemolytic anemia?
July 18, 2018 FA Manian MD, MPHActinomyces israelli;, Anemia, Autoimmune hemolysis;, Coombs test;, Endocarditis;, Hemolysis;, Hypertrophic obstructive cardiomyopathy;, Schistocytes;, Spherocytes;, Spleen;, Splenomegaly;1 Comment
Yes, but it's rare! Hemolytic anemia (HA) in the setting of infective endocarditis (IE) has only been described in a few case reports (1-3). Although diseased valves may cause shearing stress that fragments RBCs, similar to that associated with mechanical heart valves, an autoimmune hemolytic process has also been implicated.
A 2018 case report describes a patient with hypertrophic obstructive cardiomyopathy (HOCM) with left ventricular outflow tract (LVOT) obstruction who had HA secondary to subacute IE due to Actinomyces israelii (1). The anemia completely resolved after treating the IE (1). The cause was most likely mechanical shearing (schistocytes or fragmented RBCs present on peripheral smear) by the diseased valves; autoimmune hemolysis was considered unlikely in this case due to consistently negative Coombs tests and failure to respond to corticosteroids (1).
An autoimmune mechanism was invoked by a 1999 report reviewing 6 cases of HA associated with IE (3). All patients had fragmented erythrocytes, but several also demonstrated an immune-mediated mechanism for their HA, supported by the presence of spherocytes, splenomegaly, and + Coombs test (2,3). The production of anti-erythrocyte antibodies, modification of antigenicity of erythrocyte antigens, or unmasking of antigens in IE may play a role (1,3). Additional evidence in support of an immune-mediated mechanism of HA in IE has been provided by an experimental study demonstrating significantly shorter RBC half-life in rabbits with intact spleen compared to that of splenectomized animals (4).
1. Toom S, Xu Y. Hemolytic anemia due to native valve subacute endocarditis with Actinomyces israellii infection. Clin Case Rep 2018;6: 376-79. https://onlinelibrary.wiley.com/doi/epdf/10.1002/ccr3.1333
2. Hsu CM, Lee PI, Chen JM, et al. Fatal Fusarium endocarditis complicated by hemolytic anemia and thrombocytopenia in an infant. Pediatr Infect Dis 1994;13:1146-48. https://www.ncbi.nlm.nih.gov/pubmed/7892087
3. Huang HL, Lin FC, Hung KC, et al. Hemolytic anemia in native valve infective endocarditis. Jpn Circ J 1999;63:400-403. https://www.ncbi.nlm.nih.gov/pubmed/10943622
4. Joyce RA, Sand MA. Mechanism of anaemia in experimental bacterial endocarditis. Scand J Haematol 1975;15:306-11. https://www.ncbi.nlm.nih.gov/pubmed/1198067
Contributed by Scott Goodwin, Medical Student, Harvard Medical School, Boston, MA.
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Should I order a blood transfusion based on the hemoglobin (Hgb) or the hematocrit (Hct)?
May 17, 2018 May 17, 2018 FA Manian MD, MPHBlood transfusion;, Hematocrit;, Hemoglobin;, MCHC;, MCV;, Mean corpuscular hemoglobin concentration;, Mean corpuscular volume;, RBC;, TransfusionLeave a comment
Despite the frequent interchangeability of Hgb (g/dL) and Hct (%) by a ratio of ~1:3, directly-measured blood Hgb levels may be preferred for assessing the need for blood transfusion for at least 3 reasons:
First, in contrast to the widely-used automated measurements of Hct, Hgb is not affected by conditions that affect the size of the RBCs or the mean corpuscular Hgb concentration (MCHC). This is because the Hct is not a direct measure of Hgb; rather it's the proportion of blood occupied by RBCs which, in automated systems, is derived by multiplying the number of RBCs by the mean corpuscular volume (MCV).1-3
This may not be a significant issue when MCHC is normal, but when MCHC is abnormal, HCT may not accurately reflect the blood Hgb concentration. For example, in patients with hypochromic iron deficiency anemia with RBCs containing less hemoglobin (ie, low MCHC), the Hct may overestimate blood Hgb levels. Conversely in hereditary spherocytosis with its attendant low RBC volume and high MCHC, the Hct may underestimate Hgb levels.
Second, Hct results may also be more subject to technical factors in the lab. For example, blood at room temperature between 6-24 h may be associated with RBC swelling and increased Hct without any change in its Hgb concentration.4
Finally, national and international guidelines on blood transfusion generally target Hgb, not Hct results.5-7
For a related pearl, go to https://pearls4peers.com/2016/11/01/should-i-use-a-hemoglobin-level-of-7-or-8-gdl-as-a-threshold-for-blood-transfusion-in-my-hospitalized-patient.
Tefferi A, Hanson CA, Inwards DJ. How to interpret and pursue an abnormal complete blood cell count in adults. Mayo Clin Proc 2005;80:923-36. https://www.ncbi.nlm.nih.gov/pubmed/16007898
Macdougall IC, Ritz E. The Normal Haematocrit Trial in dialysis patients with cardiac disease: are we any the less confused about target hemoglobin? Nephrol Dial Transplant 1998;13:3030-33. https://academic.oup.com/ndt/article-pdf/13/12/3030/9907456/3030.pdf
Kelleher BP, Wall C, O'Broin SD. Haemoglobin, not haematocrit, should be the preferred parameter. Nephrol Dial Transplant 2001;16:1085-87. https://www.ncbi.nlm.nih.gov/pubmed/11328933
Hayuanta HH. Can hemoglobin-hematocrit relationship be used to assess hydration status? CDK-237/vol 43 no.2, th. 2016 http://www.kalbemed.com/Portals/6/20_237Opini-Can%20Hemoglobin-Hematocrit%20Relationship%20Be%20Used%20to%20Assess%20Hydration%20Status.pdf
Blood transfusion. NICE guideline, November, 2015. https://www.nice.org.uk/guidance/ng24/chapter/Recommendations#fresh-frozen-plasma-2 uk
National Blood Authority: Australia. Patient blood management, November 2016. https://www.blood.gov.au/system/files/documents/nba-patient-blood-management-resource-guide-nov_2016_v3_sm_web_file.pdf
Carson JL, Guyatt G, Heddle NM, et al. Clinical practice guidelines from the AAABB: red blood cell transfusion thresholds and storage. JAMA 2016; 316:2025-2035. https://www.ncbi.nlm.nih.gov/pubmed/27732721
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Can my patient develop "anemia of chronic disease" acutely while hospitalized?
May 3, 2018 April 26, 2019 FA Manian MD, MPHAnemia, Anemia of chronic disease;, Brucella abortus;, Cytokines, Erythropoeisis;, Hepcidin;, IL-6;, Infections;, InflammationLeave a comment
"Anemia of chronic disease" is better termed anemia of inflammation (AI) which may occur in acute as well as chronic inflammatory states. 1 As such, the view that anemia in the critically ill patients is simply caused by excess phlebotomy is inaccurate. 2 The CRIT study demonstrated that AI in critically ill patients develops even within 30 days, often despite blood transfusions. 3
In addition to the usual causes of AI (eg autoimmune disorders), AI can occur during bacterial, viral or yeast infections and sepsis 4,5.
Recent studies implicate both iron sequestration and impaired erythropoiesis as causes of AI. 1 Inflammation stimulates hepatic production of iron-regulatory peptide, hepcidin, which decreases delivery of iron from macrophages to developing erythrocytes. Inflammation also causes production of pro-inflammatory cytokine, IL-6, which suppresses erythropoiesis.
Couple of cool studies using injection of heat-killed Brucella abortus in mice as a model of AI, showed dramatic hemoglobin drop by 7 days.6,7. In addition, not only were iron restriction from increase in hepcidin and transient erythropoiesis demonstrated, erythrocyte lifespan was also shortened in these experiments. AI is truly a multifactorial process.
Frankel PG. Anemia of inflammation: A review. Med Clin N Ame 2017;101:285-96. https://www.ncbi.nlm.nih.gov/pubmed/28189171
Corwin HL, Krantz SB. Anemia of the critically ill: "Acute" anemia of chronic disease. Crit Care Med 2000;28:3098-99. https://www.ncbi.nlm.nih.gov/pubmed/10966311
Corwin HL, Gettinger A, Pearl RG, et al. The CRIT study: anemia and blood transfusion in the critically ill-current clinical practice in the United states. Crit Care Med 2004;32:39-52. https://www.ncbi.nlm.nih.gov/pubmed/14707558
Gabriel A, Kozek S, Chiari A, et al. High-dose recombinant human erythropoietin stimulates reticulocyte production in patients with multiple organ dysfunction syndrome. J Trauma:Injury, Infection, and Critical Care 1998;44:361-67. https://www.ncbi.nlm.nih.gov/pubmed/9498512
Roy CN. Anemia of inflammation. Hematology Am Soc Hematol Educ Program. 2010;2010:276-80. doi: 10.1182/asheducation-2010.1.276. https://www.ncbi.nlm.nih.gov/pubmed/21239806
Kim A, Fung E, Parikh SG, et al. A mouse model of anemia of inflammation: complex pathogenesis with partial dependence on hepcidin. Blood 2014;123:1129-36. https://www.ncbi.nlm.nih.gov/pubmed/24357728
Gardenghi S, Renaud TM, Meloni A, et al. Distinct roles for hepcidin and interleukin-6 in the recovery from anemia in mice injected with heat-killed Brucella abortus. Blood 2014;123:1137-45. https://www.ncbi.nlm.nih.gov/pubmed/24357729
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My 35 year old patient with Crohn's disease has peripheral neuropathy but no anemia or macrocytosis. Could he still have vitamin B-12 deficiency?
January 22, 2018 FA Manian MD, MPHAnemia, B-12 deficiency;, B-12;, Folate;, Folic acid;, Macrocytosis;, Transcobalamin;Leave a comment
Absolutely! A significant number of patients with B-12 deficiency are neither anemic nor have macrocytosis but may still have related neurological symptoms.
A large study involving a nationally representative sample of older U.S. adults (aged >50 y) sponsored by the CDC reported a prevalence of B-12 deficiency without anemia or without macrocytosis of about 4% each . 1 Interestingly, in this study, there was no evidence that mandatory folic acid fortification of certain foods was associated with lower prevalence of B-12 deficiency without anemia or macrocytosis.
In another study, the proportion of subjects with low serum B-12 but without macrocytosis was 70% or higher, irrespective of pre- or post-fortification period.2 Interestingly, in the age group <65 y, the post-fortification was associated with significantly higher proportion of patients without macrocytosis (85% vs. 45% in the prefortification period) in this study.
Younger age groups seem to also be overrepresented among patients with B-12 deficiency but no anemia, with a prevalence of 50% in <60 y age group with B-12 deficiency compared to 38% and 31% among older age groups (60-74 y and >74 y, respectively).3
So, keep B-12 deficiency in mind in the presence of compatible neurological symptoms even in the absence anemia or macrocytosis!
Qi YP, Do AN, Hamner HC, et al. The prevalence of low serum vitamin B-12 status in the absence of anemia or macrocytosis did not increase among older U.S. adults after mandatory folic acid fortification. J Nutr 2014;144:170-76. http://jn.nutrition.org/content/144/2/170.abstract
Wyckoff KF, Ganji V. Proportion of individuals with low serum vitamin B-12 concentrations without macrocytosis is higher in the post-folic acid fortification period than in the pre-folic acid fortification period. Am J Clin Nutr 2007;86:1187-92. https://www.ncbi.nlm.nih.gov/pubmed/17921401
Mills JL, Von Kohorn I, Conley MR, et al. Low vitamin B-12 concentrations in patients without anemia: the effect of folic acid fortification of grain. Am J Clin Nutr 2003;77:1474-7. http://ajcn.nutrition.org/content/77/6/1474.full.pdf+html
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Home > World News > Africa, Asia and Australia
Baku Project Proves One for the Books
A mini-library in the Azerbaijan capital encourages everyone to pick up a book, even if they never return it.
Amani Nazarli Jun 25, 2016 10:00 AM
Public Bookcase curator Zeynab Jahan standing next to Baku's latest, unlikely tourist attraction.Courtesy
Lemony Snicket (the pen name of children's author Daniel Handler) described his idea of a good library when he wrote, "A good library will never be too neat, or too dusty, because somebody will always be in it, taking books off the shelves and staying up late reading them."
And there's definitely no need to be concerned about dust at a special, open-air books project in Baku. There, in the historic and picturesque Icheri Sheher (Old City), you'll find the "Public Bookcase" project, which attracts people in search of a good book and the chance to delve into the world of printed knowledge.
The Bookcase has actually become something of a landmark in the Azerbaijan capital, even being seen as an unlikely tourist attraction.
Since it was set up in 2013, this Book Club-with-a-difference has featured many Azeri publications, as well as some foreign literature.
The organizers had one goal in mind with their project: to provide everyone with the opportunity to take one or more of the books for their own use, or exchange them for another book. Or, as the project's motto puts it, "Take a book, leave a book."
The Azerbaijan Youth Foundation, Azerbaijani Student Network and Global Shapers Community Baku are behind this simple initiative, whose idea originated in Europe.
It's a unique opportunity for bibliophiles to exchange the books they've read, with users seemingly happy to drop finished books off for others to take and read.
This free-for-all outdoors mini-library is designed to serve everyone, irrespective of age or education. It's open all hours of the day, come rain or shine. No registration or documents are needed to use the service, and no restrictions are placed when you take out a book.
skip - IJD LIVE WIDGET
All the organizers ask is that the public uses the facility with respect for the books and other users.
Noble tradition
Zeynab Jahan, the 25-year-old curator of the Bookcase project, says it's "necessary for Azerbaijani people, who are so fond of reading."
The organizers say the project supports the noble tradition of bringing reading to life and inspiring youngsters to pick up a book.
Furthermore, this idea strengthens the culture of reading and actually aids society, since it encourages people to meet while exchanging their favorite books. By seeking access to books, people will step outside their closed circle of family and friends, and interact more freely, organizers hope and believe.
"In some ways, the book-exchange process unites the citizens, as people leave notes in books and in the margins," says Jahan. The most remarkable thing is that "99 percent of the books" in the library have been left by other people, she adds.
Moreover, the Bookcase offers a convenient solution for the many people who feel guilty about throwing books away when they no longer have room for them, or have exhausted their interest in them.
"Most of the books [we display] have become superfluous in the house of their owner. But the key point is that one person's redundant book can become an essential one for another reader," says Jahan.
The Bookcase not only encourages young people to read; it also fights for books' right to exist and be reprinted. The project is also fighting back against the prevailing culture, given the increased use of tablet computers and e-readers.
Generation to generation
Another purpose of the project is to protect the honorable place books have in our daily life, and preserve their right to pass from generation to generation.
The Bookcase is also unusual in another respect. "We don't count missing books," says Jahan. "On the contrary: we actually celebrate when we notice the shortage of books – it means that people cannot bear to part with them."
For now, the project is the only one of its kind in Azerbaijan and is regarded as a test case. What's clear, though, is that local residents are fans of the concept. Jahan says that they have received many requests to see a second Bookcase, to the delight of the organizers.
Indeed, the organizers are working on expanding the project to other regions. Along with a plan to open a second Bookcase in the capital, they are also keen to open other mini-libraries elsewhere in Azerbaijan – for instance, in ancient Ganja.
"That will be an excellent chance for books to find their readers as well," the organizers say.
This article first appeared in Azerbaijani daily AzerNews.


Mocean Dance presented the premiere of Mappa Mundi, choreographed by Toronto's Michael Trent in collaboration with the company, with music by Halifax's Kenneth Doren.
Mocean showcased Roger Sinha's 5 Breaths at the Imperial Theatre as part of this conference bringing together national and international arts presenters.
Mocean Dance performed in the 2006 Dance Gala, marking the 25th anniversary of the creation of the Modern Dance Committee that became Kinetic Studio.
Gala Rouge: a fundraiser for Mocean DanceMocean's 2nd annual fundraising gala. Read more in the press release [doc - 212 Kb].
Mocean performed as part of the Centre's inaugural season. Read more in the press release [doc - 234.5 Kb].
Mocean Dance Co-Artistic Director, Carolle Crooks paired with Halifax personality Fred Connors in a piece choreographed by Sara Harrigan as part of Live Art Dance Productions' Dancing with the Hali-famous.
Mocean Dance conducted a day of workshops for students, actors and performers.
Mocean Co-Artistic Director, Carolle Crooks, performed an excerpt from Mappa Mundi at Ginger's Tavern as part of Live Art Dance Productions' Small Stage.
Mocean Dance presented an excerpt from its latest work, The Reaction Project, at DANSpace in Halifax, accompanied by local company Sometimes in Nova Scotia and Toronto's Susan Lee. Read more in the press release [pdf - 562 Kb].
Mocean Dance performed a collection of old and new repertoire at The Chester Playhouse. Read more in the press release [doc].
A performance for the Chester Playhouse's annual gala.


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Q: Calling web service on Scrolling UITableView Totally Confused !!!...
I have one web-service that accepts the pageNumber as Parameter and gives me some records as JSON response. (This service basically implements the functionality of Paging for Silverlight version.) I want to load these pages one by one when user scrolls the UITableView (means Load the next 20 entries (or second page) when user scrolls).
My Problem :

How and Where to call this service and How to calculate pageNumber ?

I searched about this but didn't get any Satisfied answer.
What I found is :

*

*How to call web service after each certain number of data received and load it into table view

*Load more data from a web service when the user scrolls the UITableView

*how to add elements to tableview on scrolling iphone?
I would love to here your responses in Objective-C Language.
Any Suggestions ?

A: Take one integer set it to 0. Now Used Pull to refresh functionality (Pull To refresh exmaple).
Now in API side you have to set the two extra parameter like pagenumber and pageSize
At very first time you call API with pageNumber=0 and pageSize=20
Now when you pull the table then you have a particular method in which you have to call the API with pageNumber++ and pageSize=20 again and whatever you get in the response add into your NSMutableArray. If you found nothing then remove pull to refresh option

A: I solved my Question with this Code :
- (void)scrollViewDidScroll:(UIScrollView *)scrollView
{
    CGPoint offset = scrollView.contentOffset;
    CGRect bounds = scrollView.bounds;
    CGSize size = scrollView.contentSize;
    UIEdgeInsets inset = scrollView.contentInset;
    float y = offset.y + bounds.size.height - inset.bottom;
    float h = size.height;

    float reload_distance = 10;
    if(y > h + reload_distance)
    {
        lastPageNumber++;
        [[NSUserDefaults standardUserDefaults] setInteger:lastPageNumber forKey:@"PageNumber"];
        // Call the method.
    }
}

Hope, it will be helpful for future Visitors.

A: To make an infinite scroller, you need to know when to start fetching the new items. There are many ways to do this, but the best place is to hook into the UITableViewDelegate's methods. When cellForRowAtIndexPath: is called, check if the row is the last in your data store. If it is, make the call for the new data, then append it to the old data and refresh your view. You can also hook into the table views scroller to see when it it X percent scrolled to the bottom to make this call.

A: In .h :
int lastPageNumber;

In .m :
In cellForRowAtIndexPath delegate method
int rowNum =indexPath.row;
if(rowNum%20==0)
{
     if(rowNum/20>lastPageNumber)
     {
        //call webService
        lastPageNumber++;
     }
}

redpajama_set_name: RedPajamaStackExchange


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Madge Allan is a former English international lawn bowler.

Bowls career
Allan won a bronze medal in the Women's fours at the 1986 Commonwealth Games in Edinburgh with Barbara Fuller, Brenda Atherton and Mary Price.

References

English female bowls players
Living people
Commonwealth Games medallists in lawn bowls
Commonwealth Games bronze medallists for England
Bowls players at the 1986 Commonwealth Games
Year of birth missing (living people)
Medallists at the 1986 Commonwealth Games


Home > Portfolio > Select Portfolio > Novartis Consumer Health Canada Inc.
This project, which was completed for Novartis Consumer Health Canada Inc., one of the world's leading healthcare companies. Novartis' dedication to scientific research, imagination and new technologies has led to the creation of thousands of ground-breaking products and services in the areas of pharmaceuticals, nutrition, eye-care and animal health.
MARANT was retained as the general contractor for the leasehold improvement process related to Novartis' consolidation to a new location in Mississauga, ON. Novartis planned an open office concept with some offices and meeting rooms, however, they were positioned on the core rather than the exterior glazing. They used environmentally friendly finishes including reclaimed wood and glass for their reception feature. The project was very fast tracked with a moderate budget and all project objectives were achieved.


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Hairspray returns to the West End starring Michael Ball, tickets available now
Becki Crossley
Ball reprises his Olivier Award-winning role as Edna Turnblad in April 2020
The huge-hearted, smash-hit musical Hairspray is returning to London's West End for a very limited 12-week run in April 2020. Tickets for all shows are on sale now.
The musical returns with Michael Ball front and center as he reprises his Olivier Award-winning role as Edna Turnblad. Alongside Ball, the original award-winning creative team consisting of director Jack O'Brien and choreographer Jerry Mitchell return to the production at the London Coliseum.
Hairspray details the story of Tracy Turnblad in 1960's Baltimore. Turnblad is a larger than life character with big dreams and big hair. She hopes to make it on the local TV dance show, win the heart of teen heartthrob Link Larkin and bring everyone together – whatever their colour, size or hairdo.
The quintessential feelgood show, Hairspray features infectiously feel-good hits 'Good Morning Baltimore', 'You Can't Stop the Beat' and 'Big, Blonde and Beautiful' The show toured the UK in 2017/2018 and returns to the capital next spring.
Hairspray runs from Thu 23 Apr 2020 at the London Coliseum. Tickets for all shows are on sale now.
Michael Ball reprises his award-winning role as Edna Turnblad for this 12-week limited season of Hairspray.
London Coliseum, WC2N
Thu 22 Apr
Prices to be confirmed / 0871 911 0200
Fri 23 Apr
…and 107 more dates until 28 Aug


Browse all the color schemes on this site in the gallery slide show below. Newest color schemes appear first.
Click the link in the caption to go to the post where you can download the full set.
You are welcome to save, use, and share these color schemes for coloring inspiration, graphic and web design, home decorating, fashion design, mood boards, and whatever else you can think of! See "How can I use the color schemes on this site?" for more information.
Thank you SO much for these! Choosing colors is the hardest part of coloring for me so the color schemes are a huge help!
I love these color schemes! I posted them to my pinterest page and will be going to them whenever I begin a new project!
Absolutely love these color schemes.


The last few weeks has seen me wearing heels a lot more than I ever have before. From dates to Cosmopolitan's #FashFest party and most recently a night out with my sister; my feet have certainly been left to feel a little sorry for themselves.
Scholl came to the rescue and sent me over some products for my feet as they were in need of some TLC! I've seen these heel cushions in shops for years but had never actually tried them out until recently. I usually buy platform heels for comfort but I also have heels without the platform and so it's been these Party Feet Heel Cushions* that have been a real saviour for nights out.
They are like a jelly consistency with a sticky side which you can either stick down onto the heel of your shoe or anywhere that you feel you need a little more comfort. Even better, they can be re-used over and over again. I've been peeling them off and using them in different shoes and they've managed to stay tacky and not budge during the day/night.
After having a pamper day this weekend, I decided to use some of the Dry Skin Instant Recovery Cream* to replenish the moisturised and soft feeling in my feet. It's a really thick cream that you rub into your feet and they are left feeling as good as new. It's as if I never even went out!
Thankfully, my feet are back to normal and ready for another busy week all thanks to Scholl!
My toes are needing a little TLC lately... thanks for the reminder!
The instant recovery cream sounds great and just what my feet need, I always forget to pamper them!


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Silicon Valley Comic Con, filled with costumes and comics, takes a Zen approach
Arts & Entertainment // Entertainment
Peter Hartlaub April 8, 2018 Updated: April 8, 2018 8:40 p.m.
Silicon Valley Comic Con, filled with costumes and...
1of14Jabba the Hut draws a crowd at the Silicon Valley Comic Con in San Jose, Calif. on Saturday, April 7, 2018.Photo: Paul Chinn / The Chronicle
2of14Nathan Criswell, 10, admires light sabers offered for sale with his father Brice at the Silicon Valley Comic Con in San Jose.Photo: Paul Chinn / The Chronicle
3of14Mayor McCheese (Kishore Hari) rides an escalator at the Silicon Valley Comic Con in San Jose.Photo: Paul Chinn / The Chronicle
4of14R2-D2 rolls out of an elevator at the Silicon Valley Comic Con in San Jose.Photo: Paul Chinn / The Chronicle
5of14Hugh Gotts, as Superman, watches over the other attendees of the Silicon Valley Comic Con in San Jose.Photo: Paul Chinn / The Chronicle
6of14Korg (Rohan Dunnigan) strolls past a display of furry creatures at the Silicon Valley Comic Con in San Jose.Photo: Paul Chinn / The Chronicle
7of14Tiny the Clown wanders through the exhibit hall at the Silicon Valley Comic Con in San Jose.Photo: Paul Chinn / The Chronicle
8of14Actress Nichelle Nichols, who portrayed Lt. Uhura in the original "Star Trek" series, introduces NASA astronaut Mae Jemison at the Silicon Valley Comic Con in San Jose.Photo: Paul Chinn / The Chronicle
9of14Leah Jarvis and her son Evan, 7, have an encounter with the Alien (Matthew O'Connor) at the Silicon Valley Comic Con in San Jose.Photo: Paul Chinn / The Chronicle
10of14Christian Hull (left) and his brother Jack pay tribute to the Cuphead video game at the Silicon Valley Comic Con in San Jose.Photo: Paul Chinn / The Chronicle
11of14John Luu works at an anime booth dressed as Challenger Ahri at the Silicon Valley Comic Con in San Jose.Photo: Paul Chinn / The Chronicle
12of14The Blob (Brenden Eloha) takes a look around the exhibit hall at the Silicon Valley Comic Con in San Jose.Photo: Paul Chinn / The Chronicle
13of14Katy Peterson applies a temporary glitter tattoo to Phyllis Verna at the Silicon Valley Comic Con in San Jose.Photo: Paul Chinn / The Chronicle
14of14NASA astrounaut Dr. Mae Jemison delivers a keynote speech at the Silicon Valley Comic Con in San Jose, Calif. on Saturday, April 7, 2018.Photo: Paul Chinn / The Chronicle
Clay Vajgrt was two days into his first comic book convention on Saturday, April 7, selling his paintings in a particularly peaceful corner of the Silicon Valley Comic Con floor.
His booth was filled with dozens of his paintings of superheroes and other pop culture figures — Black Panther, Mr. Spock and Iron Man included — all meditating in full uniforms, viewed from behind in a monk-like cross-legged pose.
"A few years ago I was painting, and I glanced down and happened to see one of my old comic books," Vajgrt said. "It just sort of connected — what if all these warrior types decided to give up their warrior ways for the moment, turn their back on the craziness, and go strong and peaceful?"
Beyond the long lines, packed presentations and the occasional armored space marine walking by with a plasma rifle, the three-day Silicon Valley Comic Con at San Jose Convention Center had a Zen feel in its third year. The convention started by Apple co-founder Steve Wozniak scaled down from last year's event, which had sprawled into a nearby park and City National Civic auditorium. The TV and movie celebrity wattage seemed a little less powerful in 2018 as well, with more high-profile science panels.
The Alien (Matthew O'Connor) and the Stay Puft Marsh mal low Man (Les Marmo) meet at Comic Con on Saturday, April 7.
Photo: Paul Chinn / The Chronicle
"I love this convention," said Ethan Castillo, a 13-year-old South Bay comic artist who has reserved a booth in the convention's Artists Alley all three years. "Even though it's really huge, it doesn't feel big. Does that make sense?"
The lines were still a struggle in the third year — both to get inside the convention center and in the convention itself. A cosplayer in a full furry costume from the animated movie "My Neighbor Totoro" waited in a restroom line 15 people deep. A line to get carne asada and other Mexican food inside the convention center snaked around the hallway during lunch hours.
But the convention floor itself had room to breathe. Matthew O'Connor, a 46-year-old Concord cosplayer who performs in a 50-pound xenomorph costume from the movie "Alien," had space to move his tail around as fans lined up for photos.
"I like the layout. It's a little wider, a little more space," O'Connor said during a break when he could remove his enormous headpiece. "There's no fighting, no arguing, everybody comes together. … If I drop a piece of my costume, I'm going to get it back. It doesn't matter how big (Silicon Valley Comic Con) gets, it's like a family. We all look out for each other."
Matthew O'Connor talks about his cosplaying as an "Alien" xenomorph character. Silicon Valley Comic Con, April 7, 2018. Interview/video by Peter Hartlaub
Video: SFChronicle
Silicon Valley Comic Con was started by Wozniak in 2016, as a blend of pop culture and science and technology. After a successful first year, the 2017 convention expanded with outdoor movies and food trucks in nearby Cesar Chavez Plaza and guests including "Star Trek" captain William Shatner.
This year, the convention's most familiar guest, 95-year-old comics pioneer Stan Lee, spent Saturday in private autograph and photo sessions. Other big names included Mads Mikkelsen, Sean Astin and Christina Ricci, as well as "Jessica Jones" stars Krysten Ritter and David Tennant (also of "Doctor Who"), who appeared together during a panel on the last day of the con on Sunday, April 8.
"There's so much joy in these rooms," Tennant said of his comic-con experiences. "I get really cross when fans of (pop culture) get a bad rap, because as hobbies go ... it's a really cool thing to get excited by."
Astronaut Mae Jemison was inspired by Nichelle Nichols, who played Lt. Uhura on "Star Trek." The Chronicle's Peter Hartlaub interviewed them at Silicon Valley Comic Con.
The onscreen Doctor also gave a nod to the educational-aspect of Silicon Valley Comic Con, which had celebrities like him billed next to rock stars of the science world. A thoughtful and inspiring 100 Year Starship presentation by astronaut Dr. Mae Jemison, with introduction by "Star Trek" co-star Nichelle Nichols, had a strong turnout in the morning. San Francisco resident Adam Savage packed the biggest room for a cosplay presentation and Q&A.
The convention's 2018 theme, "What Does It Mean to be Human?," added to the seriousness at some of the panels.
#SVCC
By Peter Hartlaub
Pioneering astronaut and Lt. Uhura from 'Star Trek' talk...
At Silicon Valley Comic Con, the scientists are the stars
That time Steve Wozniak crashed The Chronicle's Buzz Aldrin...
"It's really, really important that we rise and work to raise a generation of genuine digital natives," Savage told the crowd, answering a question related to recent Facebook data controversies. "The answer is you have to raise children who are able to discuss all the gray areas ... It's important for the furtherment of humanity, that we're conversive in discussing this stuff."
If there's a trend out of Silicon Valley Comic Con, it's that organizers will try anything once. TED talks founder Richard Wurman co-headlined a panel with former "Tonight Show" bandleader (and science buff) Kevin Eubanks, which seemed to stray into 20 different topics.
Back at Vajgrt's "Supermonks" corner, the Healdsburg resident adjusted a large painting of a meditating Superman and marveled at the large crowd, struck by how many strangers walked up and started thoughtful conversations.
"I love that we have found a way to share common mythology," Vajgrt said. "That's the cool thing doing this and seeing the amount of people here. People are all kind of connecting through this pop culture lens."
Peter Hartlaub is The San Francisco Chronicle's pop culture critic. Email: phartlaub@sfchronicle.com Twitter: @PeterHartlaub
Chronicle arts content editor Mariecar Mendoza contributed to this story.
Peter Hartlaub
Follow Peter on:
https://www.facebook.com/SFChronicle/peterhartlaub
Peter Hartlaub is The San Francisco Chronicle's pop culture critic and host of the podcast The Big Event. The Bay Area native has worked at The Chronicle since 2000, and was a Chronicle paperboy from 1982 to 1984. He reviews movies, television and comedy, covers entertainment, creates multimedia projects and writes the Our San Francisco local history column. The Big Event is recorded in The Chronicle's basement archive. Hartlaub lives in Alameda.
'Crawl,' and six more good movies that didn't screen for critics
Apollo 11 advertisements: First Mad Men on the moon
Dan the Automator follows his own lane to food, movies, 'Always Be My Maybe'


text:
Blog PostsOnline Gaming
How To Delete Pokemon Go Account? Right Now
How To Delete Pokemon Go Account? It is estimated that Pokemon Go has been downloaded over a billion times. This popular application has become a worldwide phenomenon, and players or gamers of all ages are enjoying playing this game all over the world.
Developed and published in 2016 by Niantic in collaboration with Nintendo and The Pokémon Company, Pokemon Go is a free to play mobile game of the augmented reality genre that is available on smartphones and tablets. Both iOS and Android devices are supported by the game, which has been developed for both platforms.
Recently, the game has attracted controversy as several governments and users alike have expressed genuine concerns about the security and privacy of the app used by the game, leading to the game attracting controversy in the news.
How To Delete Pokemon Y save file? Right Now
It is important for users to ensure that their personal data is not accessed by apps. Consequently, the growing privacy concern is leading users to leave the app altogether as a result of the growing privacy concerns. # How To Delete Pokemon Go Account?
You don't have to play Pokémon Go anymore. Here's how to do it. You have to do a lot more than simply deleting the app if you wish to remove all the information associated with your account. The process of deleting your Pokémon Go account can be quite easy, but the app does not allow you to do it from within the app itself. If you would like to delete your account, you will have to visit Niantic's website and complete their account deletion request form.
How to delete Pokemon Go account?
You can find support for Pokemon Go on the official website
Request forms require your email address and username.
You can delete your account by choosing 'delete my account' from the dropdown menu under the issue category.
Describe why you want to delete your Pokemon Go account or deactivate it.
You can permanently delete your account by entering the captcha code and clicking submit.
Here are some things to keep in mind:
The process of removing data and deleting the account will take a few days or weeks and it may not be completed immediately.
It is completely irreversible that the account and data will be permanently deleted.
The e-mail ID you used to create your previous Pokemon Go account will not be able to be used to create a new account on Pokemon Go.
Creating a new account and logging in to the game in the future will require you to have a new e-mail ID in case you wish to play the game again.
How do I delete my Pokémon Go account to start over?
Go to the Pokémon Go application and click on the avatar icon located in the top left corner of your screen. This will allow you to delete your Pokémon Go account. Go to the "Settings" menu on the left side of the screen. Click on "Accounts" at the bottom of the screen, then tap on "Remove Account".
In order to delete your account, click on "Delete My Account" and then click on the "Delete Account" button to confirm your decision. # How To Delete Pokemon Go Account?
How to delete all data on Pokémon Go?
It is important to realize that Pokémon Go is a mobile game that requires a lot of data to be downloaded to the device and transferred to the device. By downloading maps for the game, you will be able to exceed the game's storage limit of 500 MB, which may seem like a lot, but it is not impossible.
It is important to know that by deleting all data from Pokémon Go, you will remove both the app itself as well as all the user information it contains, which includes the player's name, e-mail address, as well as any other information that may need to be deleted from it.
How to transfer Pokemon between Pokemon Go accounts?
To transfer Pokemon from one Pokemon account to another, you must use the Transfer option under the Pokeball icon in the game to transfer Pokemon from one account to another. As soon as you select that option, you will be able to select which account you would like to transfer money from and to.
Can I transfer Pokemon from home to go?
There is a possibility that Pokemon can be transferred between your mobile device and the game. The process for this can be done by selecting 'Transfer Pokémon' from the Settings menu on your mobile device. Then you will be able to select which Pokemon you would like to transfer.
How to delete Pokemon linked account on Google?
Delete an account that is linked to Pokemon on Google will require you to log into the Pokemon Company's website and enter your login credentials in order to delete the Pokemon linked account.
Your account can be deleted once you are logged in.
Can I change the email linked to my Pokémon Go account?
It is possible for you to change your Pokémon Go account's linked email address at any time. There is one thing to keep in mind however: this method only works if you have not yet created a Trainer Club account. The easiest way to create a new Pokémon Go account if you already have a Trainer Club account would be to use the email address associated with your Trainer Club account in order to create a new Pokémon Go account.
Please select "Pokémon Go" from the Settings menu on your phone in order to change your email address. # How To Delete Pokemon Go Account?
Can I use 2 Pokemon Go accounts on 1 phone?
On one phone you are able to have two Pokemon Go accounts, so yes, you can do that. This can be done by logging out of the first account and then logging in to the second account as soon as possible after you have done this. # How To Delete Pokemon Go Account?
Can you get banned for Poke Genie?
As far as Poke Genie is concerned, you cannot be banned from playing it. You are not required to have a username or an email address to use this app as it is completely free. # How To Delete Pokemon Go Account?
Can you merge two Pokémon Go accounts?
A Pokémon Go account can be merged with another Pokémon Go account if you wish.
This can be achieved by following the following steps:
1) You must open your phone's settings and tap "Pokémon Go" once you have done that.
2) Tap on "Sign Out" on the first screen, and then "Sign In" on the next screen to sign in.
3) On the next screen, enter the username and password of the account you wish to merge with.
Can you have more than one Pokémon Go account?
As far as Pokémon Go is concerned, you can have more than one account. In case you are caught using multiple accounts to cheat on the game, your accounts will be banned if you are caught.
Is it legal to sell Pokemon Go accounts?
There is no problem with selling Pokemon Go accounts as they are legal. The fact that there are so many websites that provide this service does not prevent them from complying with any terms of service.
How to delete a Pokémon HOME account?
You will need to log out of the Pokémon GO app first after logging in in order to delete a Pokémon GO account. Then go to the settings menu and select "Delete Account" in the bottom left corner of the screen once you've logged out. On the following screen, you will be asked for your password and prompted to tap "OK" in order to proceed.
How to Delete save files in Pokemon sun and Pokemon Moon?
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