text:
Finding Finance for UK SMEs
By Tim Vine
Leader Product Management, Trade Credit
Why is Access to Finance so Critical For UK SMEs?
The majority of SMEs have one priority: growth - and critical to this is finance.
In fact, 67% of SMEs say the availability of finance has a significant impact on their business success, according to our report 'UK SMEs: Brexit and Beyond'.
In this blog post, we'll explore SME attitudes towards finding finance; how SMEs can prepare themselves for the future, and whether the government needs to take more action to give small businesses the confidence they need.
Funding matters
The number of SMEs receiving financial support appears to have remained unchanged. In both 2017 and 2018, nearly half (43%) received financial support.
This highlights the important role funding plays in supporting small businesses in their journey to scale. It's a role that won't be diminished in the face of political and economic upheaval – such as with the turbulence caused by Brexit.
In fact, in a world of uncertainty, some sources of finance can represent a sure path. And it's not just the monetary aspect of it – although, of course, businesses do appreciate cash in the bank. Receiving financial support is a huge vote of confidence for an organisation. It's external validation that you will succeed, no matter what the future may bring.
Watch our video below to learn more about why funding is critical for SMEs:
Alternative sources of finance
Our report uncovered a growing trend for SMEs to seek funding outside of traditional financial institutions. The number of small businesses receiving bank loans dropped by 16% from 2017 to 2018.
This could be a direct response to Brexit uncertainty. Right now, it doesn't feel like a wise time to take on debt, even if it will help to develop your company.
Equally, it could be a result of the growing range of funding options. New opportunities are emerging in the form of competitions, crowdfunding, micro-loans and peer-to-peer lending.
SMEs are increasingly accessing funding from these alternative sources, with 15% opting to enter competitions to win finance, and 12% choosing to follow the crowdfunding route.
The number securing funding through competitions – such as the Green Alley Awards, the WorldLabs competition or the programmes run by Amazon Web Services – has increased significantly from 3% to 15% over the last year.
It's fascinating to see that competitions are such a popular avenue to funding. Perhaps the potential of a cash prize, no strings attached, is the most attractive idea in these uncertain times.
However, the array of options could easily become confusing - so it's unsurprising that a quarter of SMEs (24%) would welcome an overview of available funding sources to help them choose which is best for their business.
Is finance enough?
65% of SMEs believe that the government could do more to support them, and this goes beyond fiscal support: there's an advice and mentorship component too.
A quarter (25%) have received non-financial support from banks and insurance companies, while a similar proportion (24%) drew on a forum of their SME peers.
A further fifth (21%) received non-financial support from local government.
This support can entail a variety of things: advice, mentorship, development programmes, networking, sharing of resources and co-working spaces. And it's all crucial for SMEs looking to reach the next level.
Money alone is not enough – which is why two-thirds (65%) of small business leaders believe that the government could do more to support SMEs in non-financial ways.
Understand your own business to find out what's right for you
Ultimately, when it comes to finance, it's all about finding the best option for your business.
There's no question that funding is essential for growth but making the wrong choice can do more harm than good. This means SMEs should always start the process of looking for funding with a careful examination of their own position.
At Dun & Bradstreet, we help businesses assess their own standing by providing access to their credit profile. This means SMEs can understand how their credit score is determined and the ways they can improve it. By accessing the same information available to lenders, small business leaders can ensure that they're able to find finance and supercharge their growth.
Our recent CRA designation also makes us one of only four Credit Reference Agencies able to receive SME credit information from designated banks. Greater access to this data makes it easier for other finance providers to check the credit worthiness of potential SME customers – with the aim of increasing the range of funding available to businesses who are looking to drive growth, and to support start-ups seeking initial capital.
To find out more about the outlook for UK SMEs after Brexit, download our "UK SMEs: Brexit & Beyond" report.
Denied a Loan? Managing Your Cash Flow Can HelpTim Vine23 April 2019Managing your small business cash flow can help you succeed without outside financing. These six steps can help you manage cash flow effectively.Read More
UK SMEs: Keeping Pace with Tech and TalentTim Vine11 June 2019New tech gets released every day, so how do SMEs know what can add true value to their business – and how do they source the right talent to utilise it?Read More
Why are late payments to SMEs getting worse?Tim Vine8 May 2019Small and medium-sized businesses are inherently more vulnerable to late payments than their larger counterparts.Read More
The Impact of Brexit on UK SMEsTim Vine23 April 2019Change is inevitable, especially in the wake of Brexit. In this blog post, we explore the ways SMEs in the UK are being affected by these changing times.Read More
Credit Essentials


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Q: Bounding a function above into a ball of radius $R$ Let $n:[0,T] \to \mathbb{R}$ be a non-negative function. It satisfies
$$n(t) \leq C_1n(0) + C_2$$
where $C_1 > 1$ and $C_2 > 0$.
Is it possible to find a number $R >0$ such that if $n(0) \leq R$, then
$$n(t) \leq R$$
too? $R$ can depend on $C_1$ or $C_2$ but not on $n(t)$ or $n(0)$.

A: No, this is not possible. Let's focus on the smaller class of functions $n$, namely those that  satisfy $n(T)=C_1 n(0)$ and are linear in between $0$ and $T$. Within this class, your question can be stated as: does there exist $R\ge 0$ such that $n(0)\le R$ implies $C_1n(0)\le R$? To which the answer is obviously no: whichever $R$ we pick, the function with $n(0)=R$    gives a counterexample.

redpajama_set_name: RedPajamaStackExchange


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Q: Clickhouse - How often clickhouse triggers a merge operation and how to control it? I read that 10-15 mins after insert into a merge-tree table,  Clickhouse triggers a merge-operations.
Is there a way to tell it to reduce that interval, to make it merge a bit more often?
also, I noticed that even in old partitions, there are several parts and not only one, how come?

A: No control. No interval.
You should not rely on a merge process. It has own complicated algorithm to balance number of parts. Merge has no goal to do final merge -- to make 1 part because it's not efficient and wasting of disk I/O and CPU.
You can call unscheduled forced merge using 'optimize table' command.


Anuschka Hamann is a passioned young photographer. All started when she got herself a Nokia mobile phone with a build in 5 megapixel camera in 2007. Snapshots and random picture taking was part of her everyday routing while going to school, to the city or meeting with friends. After a while though she began to be more interested in capturing architecture and the composition of a picture. Getting a 'real' camera became more and more interesting considering the possibilities one have in creating and capturing moments by changing the aperture or shutter speed, so it was inevitable for her to finally buy a SLR camera in 2010. The camera became her new best friend...but of course she also continues to take pictures with her new mobile phone - an iPhone 4!


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M. Wolf, directorul Observatorului astronomic din Heidelberg, a folosit metoda fotografică pentru descoperirea asteroizilor, în anul 1891. Până atunci, descoperirile se făceau vizual: o regiune a cerului se compara cu o hartă stelară amănunțită. Orice steluță care nu se găsea pe hartă era suspectată de a fi asteroid și atunci observațiile se repetau spre a se vedea dacă presupusul asteroid se mișcă printre stelele vecine. După un număr mai mare de observații, se calcula orbita noului asteroid, care primea un număr și un nume, fiind definitiv recunoscut ca o mică planetă nouă. De cela mai multe ori, descoperirea se făcea întâmplător, cu ocazia observării unui asteroid cunoscut, prin urmare numărul descoperirilor nu putea crește prea repede. Metoda fotografică a lui Wolf a ușurat și a simplificat mult observarea asteroizilor cunoscuți și descoperirea celor noi. A devenit posibilă o cercetare sistematică a cerului (mai ales a regiunii elipticii), în vederea descoperirii noilor asteroizi.

Note

redpajama_set_name: RedPajamaWikipedia


On Nov. 27, 2002, the little cutie on the left welcomed the tiny cutie on the right into our family, and life hasn't been quite the same since.
Any guesses how I can love this guy so easily?
On Thanksgiving, he turned 12. I knew we were in for a beautiful couple days of celebrating when, while out doing Thanksgiving errands, this sundog appeared.
Within a couple hours, I'd gathered up the chicks and we were off — all seven of us in the minivan once again, for the first time in many months.
Well, eight, if you count our reluctant canine, who wasn't so sure about things but managed quite well in the end.
Grandma knew a Thanksgiving boy would easily get bumped from the spotlight so had things party-ready at the hotel when we arrived.
And all that sugar put the sillies in the cousins.
we were stretching from our night at the new Grand Stay hotel in Glenwood. Numero cinco and I got up and ready in time to attend Mass just a few blocks away. Mass on Thanksgiving has not been a tradition, but I'm hoping it will become one. After all, Eucharist, in Greek, means "Thanksgiving." There's no better way to start the day.
And a quick dip in the pool one last time afterward was just the thing.
We arrived at Grandma's and Grandmpa's in time to watch Uncle Mike frying up the Lake Minnewaska born walleye on the deck out back.
It was a grand feast and I can't be more thankful for the blessing of it.
My in-laws are pretty awesome the way they welcome and warm hearts and tummies with their serving attitude. I'm humbled to be one of the blessed recipients of all this giving. I know many are literally left out in the cold on such a day. That we might all be welcomed and warm.
Soon enough, we were back home, with just enough time for birthday boy and I to head to the theaters for some time in the recliners with a big tub of buttered corn. That's a Thanksgiving food too, right?
And now for Black Friday fun. Truthfully, it's the thing I most dread, but I've been lured in by a service project one of the kids signed up to do that required an adult presence. For three hours today, we'll be folding unfolded clothes at a large sporting goods store here in Fargo; all for a good cause. Nevertheless, given the sacrifice quotient, I'm pretty sure I'll be given a few days out of purgatory for this one.
Q4U: Were you serving recipient or giver this Thanksgiving?
I think a bit of both! You jam- packed a lot of holiday in your trip- how wonderful all of you got to go together! That sun dog was a sight to see- and you captured it in all its glory!
What a great celebration you had. Happy Birthday to your boy. And, yes, popcorn is a Thanksgiving food. They serve it on A Charlie Brown Thanksgiving.


Dignity & Respect represents the evolution of how social issues should be discussed and dealt with in our increasingly socially complex world. Currently, when topics such as gun control, mass incarceration, and immigration are discussed, it is done in an overly emotional and divisive manner. Here at Dignity & Respect, Inc. our mission is to make the world a better place for all to live—with all of our differences. We feel that only by improving our cultural awareness and finding common ground, will we be able to tackle the problems our society faces.
My name is Andre Blair, I am 26 years old and was born and raised in California between Los Angeles and the San Francisco Bay Area. The liberal values of the areas where I spent my formative years, coupled with the inclusive tone set by the Clinton administration, would lead you to believe I have not been affected by racism or bigotry. In some ways this is true; I have never been called a racial slur to my face, (online comment sections are an entirely different conversation) I have never been refused service based on the color of my skin, and have never been asked to sit in the back of a bus. However, I certainly do not feel my life chances have been the same as a white male of similar socio-economic status. As a black male, I am ten times more likely to be arrested, twenty percent more likely to drop out of college, and was twice as likely to become a teenage parent. These statistics represent traps I could have very easily fallen into, and have witnessed many of my peers succumb to. I was only able to avoid them due to a very supportive family structure.
What is the reason for these disparities? Are the men and women who decide how our society is organized racist? I do not believe so; the answer is much more subtle. We all come into every interaction with the baggage of all of our previous experiences. Here at Dignity & Respect, we call these filters. For example; a white school administrator, who prior to holding that position had grown up in a middle-class suburb surrounded by only white residents, might enter into any interaction with an African-American or Latino student carrying that baggage. Now imagine this same administrator has also received most of his/her information about minority youth from a mass media that thrives on portraying these demographics as dangerous and untrustworthy. Our fictional administrator is likely going to subconsciously consult these filters when making disciplinary decisions involving minority students. This is a driving factor of the incredible disparities existing between the suspension and expulsion rates of black and white students. Is this evidence of racism? Are these administrators bad people who are actively trying to undermine the success of minority students? I don't believe so. However, many of them lack a reasonable level of cultural awareness which inhibits them from being able to find common ground with their black and latino students.
These subtle issues are the major barriers keeping us from achieving greater harmony in our society. If we enter into interactions with each other while harboring toxic subconscious opinions, we are doomed to end up with negative outcomes. We must work to increase our knowledge of one another; we must break out of our comfort zones and befriend people who do not look or think like us; we must engage those friends and strive to understand their point of view. Only then will we be able to tackle complex issues such as gun control, mass incarceration, and immigration.


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Q: How can I generate a Salt minion key pair using OpenSSL? I am building a Chef cookbook to setup Salt and manage the key exchange between minions and masters.
I am aware that the Salt minion will automatically generate the keys at /etc/salt/pki/minion/minion.{pem,pub} when it first starts, but I cannot depend on the timings of when the information will be available in the script.
From the Salt documentation, I could generate the keys on the master with salt-key --gen-keys=[key_name]. However, for security reasons, I'd rather the key be generated on the minion, so only the public key ever needs leave the machine.
The keys looks like fairly standard RSA keys. What would be the parameters to openssl or ssh-keygen to generate a key that would be accepted by Salt? I am just looking for the bit length and other parameters that Salt is looking for in such a key.
Thanks very much!

A: I would use salt-key to create the key.
[me@elsapo ~]$ sudo salt-key --gen-keys=minion02 --gen-keys-dir=/tmp/testkey

return:
    37:6e:6d:42:ba:c6:da:1d:46:28:fb:bc:ce:27:10:13:7c:a2:d8:de:f9:d5:ba:6a:01:4a:f4:72:ad:bd:1b:20

[me@elsapo ~]$ ls /tmp/testkey

minion02.pem  minion02.pub

Then you can move the pem and pub key files to wherever you want them.

A: I have a similar issue, using Salt inside Vagrant. The correct solution is of course always going to be to run
salt-key --gen-keys=master

In my case, however, the keys need to be generated on the host machine (where Salt is not installed) but the Vagrant salt provisioner expects to find them so it can copy them to the new VM.
You can generate them with OpenSSL. Generate the private key with:
openssl genrsa -out master.pem

and then the public key with:
openssl rsa -in master.pem -pubout -out master.pub

The keys generated this way seem to have the same defaults as those generated by salt-key, but YMMV.

A: The code is in salt/crypt.py: https://github.com/saltstack/salt/blob/2014.1/salt/crypt.py#L88
Looks like it uses from M2Crypto import RSA and then later gen = RSA.gen_key(keysize, 65537, callback=lambda x, y, z: None)
M2Crypto is a wrapper around OpenSSL.
M2Crypto.RSA.gen_key is defined here: https://github.com/M2Crypto/M2Crypto/blob/master/M2Crypto/RSA.py#L314
Returns M2Crypto.RSA.RSA object.
It wasn't easy finding the keysize, it defaults to 4096 in config.py:
https://github.com/saltstack/salt/blob/1bfed117560fbde11c88ad7a013be76dc6eadf0f/salt/config.py#L409
The public key is saved in PEM format.
So it looks like you could do it with OpenSSL.  I've not verified this.


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Over half of Scots struggling with 'life admin' due to poor work-life balance
More than half of people in Scotland are struggling to complete fundamental 'life admin', due to the growing pressures of today's time-poor world and challenging work-life balances, according to new figures.
More than a third of women say they have to sacrifice career progression for work-life balance
More than a third of women have said they feel frustrated at having had to sacrifice their salary and career progression so they can ensure the right work-life balance in bringing up a family.
Report calls for shorter working week to help 'exhausted' staff
A SHORTER working week could help the UK's "exhausted" workforce and boost the economy, a new report argues.
UK found to have worst work-life balance in Western Europe
THE UK has been found to have the poorest work-life balance in Western Europe.
New survey shows 58% of UK workforce would choose to start work before 9am
A NEW YouGov survey conducted among 1800 UK workers, reveals that almost six in ten (58%) would choose to start work earlier than 9am if they could leave earlier than 5pm.

redpajama_set_name: RedPajamaCommonCrawl


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Meet the kids racing electric cars
Would you like to build and race your own car? That's exactly what these kids did! Watch the video to find out more.
Let's talk about black history
Black History Month is a time to remember important people and events in black history. Watch the video to find out more about it.
These Syrian children have travelled to the other side of the world and started a new life in Australia. Watch the video to find out about their experiences.
Lots of people get bullied. Watch this video of kids talking about their experiences and what they think we can do to stop it happening.
It's really important to wash your hands to help you stay healthy. Listen to this song and sing it when you wash your hands!
Do you know how to use the internet safely? Watch this video to find out!
Mr Tumble loves Christmas! Watch him make a fairy to put at the top of the Christmas tree.
Insect extinction
Did you know that insects are disappearing? Watch the video to find out why and what you can do to help.
Do you know Roald Dahl, the author of lots of great kids books like Charlie and the Chocolate Factory? Find out about his life in this video!
What do children need to live a full and healthy life? Watch the video to find out about child rights!
How to memorise anything
Do you have a good memory? Watch the video to find out how to improve your memory.


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Q: How to test if a finite extension contains any zero of an irreducible polynomial? So specifically, if $E/F$ is a finite extension of degree $n$ and $f\in F[x]$ if an irreducible of degree dividing $n$, then is it always true that all zeros of $f$ falls into $E$ ?
If $E=GF(q^n)$ is finite, then $F(a)=GF(q)(a)\cong GF(q^k), k|n, f(a)=0$ but how does it implies that $F(a)\subseteq E$ ? I mean, just because it is isomorphic to a subfield of $E$ doesn't mean that it is a subfield of $E$, right ?

A: In field theory, or more generally in abstract algebra, we are interested in algebraic structures up to isomorphism. So yes technically $F(a)$ may not exactly be a subfield of $E$, but it is isomophic to a subfield of $E$ so we say that $F(a) \subseteq E$. Only the field structure is interesting in that case.
Your question is true for finite field, as there is only one field of order $q^n$ up to isomorphism and $\mathbb{F}_{q^k} \subseteq \mathbb{F}_{q^n}$ if and only if $k \mid n$. In your example, if $f$ is irreducible of degree $k$, all the zeroes of $f$ lies in $\mathbb{F}_{q^k} \subseteq \mathbb{F}_{q^n}$.
In general, this is completely false. For example $[\mathbb{Q}[i] \ : \ \mathbb{Q}]=2$ and $f(x)=x^2-2$ is irreducible over $\mathbb{Q}$ but $\mathbb{Q}[i]$ contains no roots of $f$. The real problem here is that there is infinitely many field extensions of degree $n$ whereas there is only one degree $n$ extension of $\mathbb{F}_q$.

A: It wasn't clear to me from the question that our OP Taylor Huang's main interest lay with finite fields, so I cooked up this counterexample:
I don't think this is true in general:
Take $F = \Bbb Q$ and $E = \Bbb Q(\sqrt[3] 2)$; then
$[E:F] = [\Bbb Q(\sqrt[3]2): \Bbb Q] =3; \tag 1$
now take
$f(x) = x^3 - 2 \in \Bbb Q[x]; \tag 2$
then $f(x)$ is irreducible over $\Bbb Q$, $\deg f(x) \mid [E:F]$, but $f(x)$ has precisely one zero in $E = \Bbb Q(\sqrt[3] 2)$.


With more than a decade's experience in all areas of Melbourne's real estate market and a lengthy list of satisfied, repeat clients, John's belief and commitment is unsurpassed and leads to outcomes that consistently exceed expectations.
An esteemed and passionate property professional, John holds the respect of both clients and peers for his unrivaled knowledge of the Melbourne property market. His success can be credited to his patience, his perseverance and his warm and engaging demeanor.
John's achievements in the property development arena is only matched by his genuine commitment to personalised customer service. He has forged long-term relationships with Melbourne's elite Property Developers which is based on trust, integrity and great results.
John has the ability to lean on his enormous network of 1,500 plus selling agents throughout Melbourne and source multiple off-market opportunities for his client base. His ability to create, research, negotiate and secure profitable development projects holds him in high regard and demand in this niche space.
Outside of real estate, John also enjoys spending quality time with his family and friends and exploring different parts of the world through travelling and holidays.


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Q: How to avoid duplicate rows in my Scenario SQL Server? Here is my sql query and result. I got the result what I expect. But it's adding additional rows in my result.
My query
Declare @store1001 varchar(10)='1001'
Declare @storeAll varchar(10)='StoreAll'

select ID,StoreID,TotalQtyParent into #tempQuantity
From
(
    select ID,@store1001 StoreID,Sum([TotalQtyParent]) TotalQtyParent
    FROM [HQMatajer].[dbo].[ItemRelationQty]
    where StoreID='1001' and TotalQtyParent is not null
    group by ID

    Union

    select ID,@storeAll StoreID,sum([TotalQtyParent]) TotalQtyParent
    FROM [HQMatajer].[dbo].[ItemRelationQty]
    where StoreID<>'1001' and TotalQtyParent is not null
    group by ID
) totalquantity

Above query result

OutPut Query
  select TotalQty.ID, item.ItemLookupCode,item.Description,
    (
        case when TotalQty.StoreID = '1001' then TotalQty.TotalQtyParent
        else 0 end
    ) WHS,
    (
        case when TotalQty1.StoreID = 'StoreAll' then TotalQty1.TotalQtyParent
        else 0 end
    ) Store

FROM
#tempQuantity TotalQty
INNER JOIN #tempQuantity TotalQty1 on TotalQty.ID=TotalQty1.ID
LEFT JOIN HQMatajer.dbo.Item item on item.id=TotalQty.ID

order by WHS desc,Store desc

Final Output

you can see the every second record of ID and the value of Store is Zero(0). I don't want to show that row.
Please don't suggest me to add the condition in where clause where store <> 0. It's showing result because of my first query result,There every ID is two times are available.
  Thanks
UPDATED
  I removed some columns from my output query to understanding purpose

A: Have you considered using PIVOT ?
SELECT
     ID,
     [1001] AS WHS,
     [StoreAll] AS Store
FROM
(
    SELECT
       ID, StoreID, TotalQtyParent
    FROM #tempQuantity
) AS TotalQty
PIVOT
(
    SUM(TotalQtyParent)
    FOR StoreID IN ([1001], [StoreAll])
) AS PivotTable;

And then just use joins...


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7 things to do in Dubai this weekend
Written ByTeam ShortList Hours On August 9, 2017 December 27, 2022 -
The Atlantic Dubai
The chic seafood restaurant has a great weekend offer for couples. For just AED199 pairs will be treated to a bucket of mussels, a dozen oysters and bottle of sparkles – we know, score!
When: 2pm – 11pm, Every Saturday
Where: The Atlantic Dubai, Souk Al Bahar Bridge
Price: AED199
Contact: +971 4 442 5662, website
Bongo's Bingo
After a brief summer break Bongo's Bingo, the party phenomenon started in Liverpool, has returned to its home in the Media One Hotel. If you're unaware of the magic that is Bongo's Bingo, expect a night mixed with a game of bingo (hence the name), music and laughs provided by Johnny Bingo himself.
When: 8pm-2am, Thursday, August 10
Where: ON42, Media One Hotel
There is a new regular night at Provocateur in the Four Seasons, and it is dedicated to deep house, tech house and dark techno. Known as Signal, it is presided over by resident DJ Aidin Karami, a classically trained Iranian musician and now events manager who has been weaving his intoxicating blend of techno since his arrival in Dubai five years ago. We asked what to expect from a Signal party.
When: Friday, August 11
Where: Provocateur, Four Seasons Resort, Jumeirah
Contact: +971 55 211 8222, Bowling at Al Nasr Leisureland
The bowling centre at Al Nasr Leisureland is only one of the most affordable bowling outlets in the city – a game costs just AED20 – it's also one the city's oldest and is the only licensed alley in Dubai. So, if you feel like bonding over drinks and a game that isn't billiards or cards, Al Nasr Leisureland is the place for you.
When: 9am – 3am, Monday to Saturday, 9am – 12am, Sunday
Where: Oud Metha Road
Contact: +971 4 337 1234,
Three more riders of the apocalypse are riding into the Casa Latina to unleash their dark, brooding and distorted dance music to provide an antidote to the polished parties elsewhere in the city. From the dark industrial of Osmosis to the EBM from Der Abyss and the ambient textures of Miya Santa, it's all underpinned by the visuals of Neno Mal Vecino. "Almost everything can be transformed into a sound source," says the latter. This night proves it.
When: From 8pm, Friday, August 11
Where: Casa Latina, Ibis hotel, Al Barsha
Contact: +9714 399 6699,
Dubai Summer Surprises
The final weekend of the Dubai Summer Surprises is upon us. Which means that you now have less than 72 hours to get your hand a bargain before all the glorious sales and offers are over. Be warned, it's going to be packed.
When: Until Saturday, August 12
Where: Various malls across the city
Wind River (18)
Wind River begins when a local game tracker and the film's fulcrum (Jeremy Renner) discovers the frozen body of a teenage girl (Kelsey Chow) miles from the nearest settlement. When a horribly ill-prepared FBI agent (youngest Olsen sister Elizabeth) arrives from Vegas to investigate, it sparks an increasingly tense search for the truth about what happened to her – laced with shootouts, low-level hoodlums and plenty of not-so-subtle references to the marginalisation of America's first inhabitants.
Indeed, the word "trespass" is writ large across the whole production. Even allowing for several missteps – a pepper-spray vision blur scene is more farce than fearful, and all too often the Native Americans are mere bystanders as the action swirls around them – it's all satisfying, engaging stuff that builds to a solid conclusion.
In cinemas now
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The Every
HAMISH HAMILTON
Fiction & Literature; Modern & contemporary fiction (post c 1945); Science fiction
The electrifying follow-up to Dave Eggers' New York Times Bestseller The Circle When the world's largest search engine / social media company merges with the planet's dominant e-commerce site, it creates the richest and most dangerous-and, oddly enough, most beloved-monopoly ever known- The Every.
Delaney Wells is an unlikely new hire. A former forest ranger and unwavering tech skeptic, she charms her way into an entry-level job with one goal in mind- to take down the company from within. With her compatriot, the not-at-all-ambitious Wes Kavakian, they look for the company's weaknesses, hoping to free humanity from all-encompassing surveillance and the emoji-driven infantilization of the species. But does anyone want what Delaney is fighting to save? Does humanity truly want to be free?
Studded with unforgettable characters and lacerating set-pieces, The Every blends satire and terror, while keeping the reader in breathless suspense about the fate of the company - and the human animal.
By: Dave Eggers
Imprint: HAMISH HAMILTON
Dave Eggers is the author of many acclaimed books, including The Circle; What is the What and Zeitoun. He is the founder of the publishing house and magazine McSweeney's and the cofounder of 826 Valencia, a youth writing center that has inspired similar programs around the world. His work has been translated into forty-two languages.
Reviews for The Every
Eggers proposes an uncanny world, on the border between the impossible-to-imagine and the already-in-play. Every reader is implicated. We are all members of that passive army willing to trade freedom for convenience. As digital culture blossomed, people wondered if machines could be made to think like people. The more compelling question is the one Eggers poses in The Every: Are people content to become machines? * Sherry Turkle, author of The Empathy Diaries * Hilarious and horrifying and idealistic. An unusual combination in a novel, or in anything else, really, but here the necessary result of a powerful writer taking on much of what matters most to our future * Mohsin Hamid, author of Exit West *
#3 Ballard & Bosch
Transient Desires
#30 Brunetti
Seven and a Half
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text:
Left bundle-branch block
Palpitations In LBBB, the impulse of ventricular activation is not transmitted through the left bundle of main trunk of His fibers. So the left ventricle is activated later when compared to the right ventricle. The impulse to the left ventricle comes through the interventricular septum from the activated right ventricle. This prolonged ventricular systole is responsible for the prolonged QRS duration in ECG. Palpitations
In LBBB, the impulse of ventricular activation is not transmitted through the left bundle of main trunk of His fibers. So the left ventricle is activated later when compared to the right ventricle. The impulse to the left ventricle comes through the interventricular septum from the activated right ventricle. This prolonged ventricular systole is responsible for the prolonged QRS duration in ECG.
Asymptomatic In some patients left bundle branch block (LBBB) can be asymptomatic. Asymptomatic
In some patients left bundle branch block (LBBB) can be asymptomatic.
History of congenital heart disease Ostium primum atrial septal defect, atrio-ventricular septal defects and tricuspid atresia are recognized congenital heart diseases that are seen in association with LBBB. History of congenital heart disease
Ostium primum atrial septal defect, atrio-ventricular septal defects and tricuspid atresia are recognized congenital heart diseases that are seen in association with LBBB.
History of cardiac surgery Corrective surgery for tetrology of Fallot and ventricular septal defects, septal myectomy and subvalvar aortic resection carry significant risk of LBBB. History of cardiac surgery
Corrective surgery for tetrology of Fallot and ventricular septal defects, septal myectomy and subvalvar aortic resection carry significant risk of LBBB.
Dyspnea on exertion Patients complain of dyspnea on exertion and marked exercise intolerance. They may also complain of fatigue. Dyspnea on exertion
Patients complain of dyspnea on exertion and marked exercise intolerance. They may also complain of fatigue.
Pre-syncope or syncope Patients may complain of presyncope or syncope due to reduced cardiac output and bradycardia. Pre-syncope or syncope
Patients may complain of presyncope or syncope due to reduced cardiac output and bradycardia.
History of certain cardiac diseases Patients with myocarditis, cardiomyopathy, myocardial infarction, rheumatic heart disease and aortic valve endocarditis are at risk of acquired LBBB. History of certain cardiac diseases
Patients with myocarditis, cardiomyopathy, myocardial infarction, rheumatic heart disease and aortic valve endocarditis are at risk of acquired LBBB.
Bradycardia Bradycardia is seen in some patients with LBBB. Bradycardia
Bradycardia is seen in some patients with LBBB.
Abnormal first heart sound First heart sound can be either absent or diminished. Abnormal first heart sound
First heart sound can be either absent or diminished.
Reversed splitting of the second heart sound In left bundle branch block the second heart sound splits during expiration and it is heard as a single sound during inspiration. Reversed splitting of the second heart sound
In left bundle branch block the second heart sound splits during expiration and it is heard as a single sound during inspiration.
ECG The QRS duration of 120 milliseconds or more. This is one of the most important diagnostic criteria. R wave in leads I, aVL, V5, and V6 are broad and notched which is a classic finding in ECG. In leads I, V5, and V6 the Q wave is absent. QRS complex and the T waves are directed opposite to each other. rS pattern can be detected in V1 to V2 leads. ECG
The QRS duration of 120 milliseconds or more. This is one of the most important diagnostic criteria. R wave in leads I, aVL, V5, and V6 are broad and notched which is a classic finding in ECG. In leads I, V5, and V6 the Q wave is absent. QRS complex and the T waves are directed opposite to each other. rS pattern can be detected in V1 to V2 leads.
Echocardiogram Abnormal posterior motion of the interventricular septum is seen in LBBB. Echocardiogram
Abnormal posterior motion of the interventricular septum is seen in LBBB.
Holter monitoring Holter monitoring is helpful in detecting transient LBBB. Holter monitoring
Holter monitoring is helpful in detecting transient LBBB.
Chest X-ray Cardiothoracic ratio is increased in chest X-ray. Chest X-ray
Cardiothoracic ratio is increased in chest X-ray.
Exercise ECG Detects exercise induced LBBB. Exercise ECG
Detects exercise induced LBBB.
Conservative management Asymptomatic patients may not require any treatment. Conservative management
Asymptomatic patients may not require any treatment.
Pacemaker implantation Patients who complain of presyncope or syncope are better treated with a pacemaker implantation. Presence of left anterior hemiblock should also be considered as a risk factor for sudden cardiac death and definitive treatment should be prescribed. Patients with symptomatic bifascicular block should also be treated with pacemaker implantation. Pacemaker implantation
Patients who complain of presyncope or syncope are better treated with a pacemaker implantation. Presence of left anterior hemiblock should also be considered as a risk factor for sudden cardiac death and definitive treatment should be prescribed. Patients with symptomatic bifascicular block should also be treated with pacemaker implantation.
Cardiac resynchronization therapy (CRT) Patients with symptomatic heart failure benefit from cardiac resynchronization therapy. Cardiac resynchronization therapy (CRT)
Patients with symptomatic heart failure benefit from cardiac resynchronization therapy.
ANDERSON NATHAN S., RAMIREZ ALEXIES, SLIM AHMAD, MALIK JAMIL. Exercise Induced Left Bundle Branch Block Treated with Cardiac Rehabilitation: A Case Report and a Review of the Literature. Case Reports in Vascular Medicine [online] 2014 December, 2014:1-4 [viewed 28 June 2014] Available from: doi:10.1155/2014/204805
AZOCAR DAMIáN, RUIZ-GRANELL RICARDO, FERRERO ANGEL, MARTíNEZ–BROTONS ÁNGEL, IZQUIERDO MAITE, DOMíNGUEZ ELOY, PALAU PATRICIA, MORELL SALVADOR, GARCíA–CIVERA ROBERTO. Syncope and Bundle Branch Block. Diagnostic Yield of a Stepped Use of Electrophysiology Study and Implantable Loop Recorders. Revista Española de Cardiología (English Edition) [online] 2011 March, 64(3):213-219 [viewed 28 June 2014] Available from: doi:10.1016/j.rec.2010.10.017
BIAGINI E, ELHENDY A, SCHINKEL AF, NELWAN S, RIZZELLO V, VAN DOMBURG RT, RAPEZZI C, ROCCHI G, SIMOONS ML, BAX JJ, POLDERMANS D. Prognostic significance of left anterior hemiblock in patients with suspected coronary artery disease. J Am Coll Cardiol [online] 2005 Sep 6, 46(5):858-63 [viewed 30 June 2014] Available from: doi:10.1016/j.jacc.2005.05.059
BREITHARDT G, BREITHARDT OA. Left Bundle Branch Block, an Old-New Entity J Cardiovasc Transl Res [online] 2012 Apr, 5(2):107-116 [viewed 28 June 2014] Available from: doi:10.1007/s12265-011-9344-5
BRIGNOLE M., MENOZZI C., MOYA A., GARCIA-CIVERA R., MONT L., ALVAREZ M., ERRAZQUIN F., BEIRAS J., BOTTONI N., DONATEO P.. Mechanism of Syncope in Patients With Bundle Branch Block and Negative Electrophysiological Test. Circulation [online] 2001 October, 104(17):2045-2050 [viewed 28 June 2014] Available from: doi:10.1161/hc4201.097837
CAPPATO R.. The case of chronic bifascicular block: still a worrying ECG finding?. Europace [online] December, 11(9):1140-1141 [viewed 30 June 2014] Available from: doi:10.1093/europace/eup245
FRANCIA PIETRO, BALLA CRISTINA, PANENI FRANCESCO, VOLPE MASSIMO. Left bundle-branch block—pathophysiology, prognosis, and clinical management. Clin Cardiol [online] December, 30(3):110-115 [viewed 28 June 2014] Available from: doi:10.1002/clc.20034
GABRIEL HARALD M, HEGER MARIA, INNERHOFER PETRA, ZEHETGRUBER MANFRED, MUNDIGLER GERALD, WIMMER MARIA, MAURER GERALD, BAUMGARTNER HELMUT. Long-term outcome of patients with ventricular septal defect considered not to require surgical closure during childhood. Journal of the American College of Cardiology [online] 2002 March, 39(6):1066-1071 [viewed 28 June 2014] Available from: doi:10.1016/S0735-1097(02)01706-0
GODMAN M. J., ROBERTS N. K., IZUKAWA T.. Late Postoperative Conduction Disturbances After Repair of Ventricular Septal Defect and Tetralogy of Fallot: Analysis by His Bundle Recordings. Circulation [online] 1974 February, 49(2):214-221 [viewed 28 June 2014] Available from: doi:10.1161/01.CIR.49.2.214
GRINES C. L., BASHORE T. M., BOUDOULAS H., OLSON S., SHAFER P., WOOLEY C. F.. Functional abnormalities in isolated left bundle branch block. The effect of interventricular asynchrony. Circulation [online] 1989 April, 79(4):845-853 [viewed 28 June 2014] Available from: doi:10.1161/01.CIR.79.4.845
MADDALI MADANMOHAN. Cardiac pacing in left bundle branch/ bifascicular block patients. Ann Card Anaesth [online] 2010 December [viewed 28 June 2014] Available from: doi:10.4103/0971-9784.58828
ORAVETZ J., WISSNER S., ARGANO B., LUISADA A. A.. Dynamic Analysis of Heart Sounds in Right and Left Bundle-Branch Blocks. Circulation [online] 1967 August, 36(2):275-283 [viewed 28 June 2014] Available from: doi:10.1161/01.CIR.36.2.275
RAUTAHARJU P. M., SURAWICZ B., GETTES L. S.. AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram: Part IV: The ST Segment, T and U Waves, and the QT Interval: A Scientific Statement From the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society: Endorsed by the International Society for Computerized Electrocardiology. Circulation [online] 2009 March, 119(10):e241-e250 [viewed 28 June 2014] Available from: doi:10.1161/CIRCULATIONAHA.108.191096
ROTMAN M., TRIEBWASSER J. H.. A clinical and follow-up study of right and left bundle branch block. Circulation [online] 1975 March, 51(3):477-484 [viewed 28 June 2014] Available from: doi:10.1161/01.CIR.51.3.477
SAID SA, BULTJE-PETERS M, NIJHUIS RL. Exercise-induced left bundle branch block: an infrequent phenomenon: Report of two cases World J Cardiol [online] 2013 Sep 26, 5(9):359-363 [viewed 28 June 2014] Available from: doi:10.4330/wjc.v5.i9.359
VASSALLO J. A., CASSIDY D. M., MARCHLINSKI F. E., BUXTON A. E., WAXMAN H. L., DOHERTY J. U., JOSEPHSON M. E.. Endocardial activation of left bundle branch block. Circulation [online] 1984 May, 69(5):914-923 [viewed 30 June 2014] Available from: doi:10.1161/01.CIR.69.5.914


text:
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In remote Indian village, teacher turns walls into blackboards to close school gap
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PASCHIM BARDHAMAN, Sept 16 – In a small tribal village on the eastern tip of India, an enterprising teacher has turned walls into blackboards and roads into classrooms, trying to close the gap in learning brought on by prolonged school shutdowns in the country.
Deep Narayan Nayak, 34, a teacher in the tribal village of Joba Attpara in Paschim Bardhaman district of the eastern state of West Bengal, has painted blackboards on the walls of houses and taught children on the streets for the past year. The local school shut down after strict COVID-19 restrictions were imposed across the country in March 2020.
On a recent morning, children wrote on one such wall with chalk and peered into a microscope as Nayak watched over them.
"The education of our children stopped ever since the lockdown was imposed. The children used to just loiter around. The teacher came and started teaching them," Kiran Turi, whose child learns with Nayak, told Reuters.
Nayak teaches everything from popular nursery rhymes to the importance of masks and hand-washing to about 60 students and is popularly known as the "Teacher of the Street" to the grateful villagers.
Deep Narayan Nayak, 34, teaches children, who do not have access to internet facilities and gadgets, in an open-air class outside the houses with the walls converted into black boards in West Bengal, India.
Schools across the country have gradually begun reopening starting last month. Some epidemiologists and social scientists are calling for them to open fully prevent further loss of learning in children.
An August survey of nearly 1,400 schoolchildren done by a scholars' group https://roadscholarz.net found that in rural areas, only 8% were studying online regularly, 37% were not studying at all, and about half were unable to read more than a few words. Most parents wanted schools to reopen as soon as possible, it said.
Nayak said he was worried that his students, most of whom are first-generation learners and whose parents are daily wage-earners, would away from the education system if they didn't continue with school.
"I would see children loitering about the village, taking cattle for grazing, and I wanted to make sure their learning doesn't stop," he told Reuters.
The walls were converted into black boards after schools in West Bengal were closed due to COVID.
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Not only are pineapples a symbol of summer but they are a fruit that should be added to any diet looking for something sweet and loaded with nutrients.
Pineapples are jammed packed with a variety of vitamins and minerals. If your looking for a fruit that's especially rich in vitamin C and manganese, look no further than pineapples!
Pineapples are such a good source of antioxidants, that they may reduce the risk of chronic diseases that range from heart disease, diabetes, and certain cancers. The antioxidant in pineapple is bound, which means they may have longer lasting effects.
Pineapple contains compounds that reduce inflammation and oxidative stress, both of which have been found to be linked to cancer. Additionally, one compound called enzyme bromelain may add to stimulating cell death in certain cancer cells and aid in white blood cell function. Pineapples anti-inflammatory properties may also help boost immune system function.
The anti-inflammatory properties in pineapple may help reduce inflammation, swelling, bruising, and pain that are often the after-effects of surgery. These same properties may also aid in recovery after a tough workout by means of reducing tissue inflammation.
Delicious and Easy to Incorporate into Any Diet!
Not only are pineapples delicious, accessible, and easy to work with, but they can be thrown into a magnitude of dishes or even as a snack when you're looking for something to curb your sweet tooth!
Pineapples may be some of the best fruit out there in terms of health benefits and taste! Although it's easy to go for something less nutritional when it comes to finding something sweet to eat, consider pineapples and incredibly versatile fruit.


text:
My name is Noah Betzen, and I am pursuing a bachelor of science in computer science through the University of Alaska Fairbanks. In August of 2013, I left the United States and travelled to Narvik, Norway to study as an exchange student through the north2north student exchange program.
I spent ten months at Narvik University College (nowadays UiT The Arctic University of Norway) studying nothing but Norwegian language and social studies. There is an old joke that goes: "If you can speak three languages you're trilingual. If you can speak two languages you're bilingual. If you can speak only one language you're an American." This joke was, in essence, my motivation for studying abroad. Studying abroad and learning another language have always been on my list of things to do before I die. I hoped that learning another language would broaden my perspective on life and the world. I wasn't just going to learn another language; I was going to learn another culture by leaving my own. It was like a fresh start.
Before I got to Norway, I had no idea what to expect. I'd never really been out of the US before. I didn't want to put much thought into it either, because in my experience it is best to go with the flow when it comes to big changes. I still had the occasional panic attack when setbacks came up, but for the most part I took things in stride.
When I got to Norway, I knew nothing and I knew no one. Very few people around me were speaking English, and so the background noise was mostly Norwegian. I felt out of place, almost as though the people around me could subconsciously know that I was an American, even though there were no weird glances or stares. I shortly realized that, as far as anyone else was concerned, I was just a normal person. Even if they realized I was American, it's not like it mattered. I stumbled my way through Oslo and eventually to Narvik with English. Luckily, most people under thirty have a decent to excellent grasp of English; it almost felt like cheating when I spoke English.
Noah and his Norwegian class
Learning the Norwegian language was a roller coaster ride. The class itself was a single 30-credit class. We met five times a week for an average of four hours a day. In the beginning, things were reasonably easy. I learned the greetings, farewells, question words, and simple nouns/verbs/adjectives. Pronunciations got difficult with the letters æ, ø, å, and the different pronunciations of letters like o, u, and y. Things began to escalate quickly as we had to write our first 200-word essays in the third week. Shortly after we abandoned speaking English almost entirely. By December we were into advanced grammar and sentence structure. By February we were reading Norwegian novels and giving presentations. By the end of the course, we had gone through three sets of text books, had Norwegian-Norwegian dictionaries we carried around religiously, and I had compiled almost four-thousand words and phrases in an online quiz database. I spoke Norwegian whenever I could.
Now that the entire experience is over, I definitely feel like a changed person. I learned a lot more than a language. I learned a lot about being in new surroundings on my own. I learned to appreciate not only my own country and people but all countries and peoples. I made many good friends with other international students from countries all over the world, each with their own language and culture that was different from my own.
If there is one thing I'm trying to say with this writing, it is this: at least once in your life you should travel or study abroad for an extended period of time. If you can learn another language while you're there, do it. No matter what happens, your experience will be worth it, especially if you embrace the fact that you are in a completely different country.
Preikestolen, Norway
Tags: testimonialsstudent exchangenorth2northmobilitystudy abroadlanguagestudent profile


text:
using System;
using System.Collections.Generic;
using DotNetApis.Common;
using DotNetApis.Common.LogStructure;

namespace DotNetApis.Logic.Messages
{
    /// <summary>
    /// The base type for messages that include a trace log.
    /// </summary>
    public abstract class MessageBaseWithLog : MessageBase
    {
        /// <summary>
        /// The trace log for this request.
        /// </summary>
        public IReadOnlyList<LogMessage> Log { get; } = AmbientContext.InMemoryLoggerProvider?.Messages;
    }
}

redpajama_set_name: RedPajamaGithub


This position supports the Missile Defense Tracking System (MTS) program: a competitive Missile Defense Agency (MDA) space program for a robust satellite system that includes space payload, communications network and ground segment constellation.
Responsible for managing all aspects of product area execution, financial management, and customer interface and support business growth in product area. Coordinates the efforts of other functions to support the mission area business strategy for this product segment through evaluation of customer needs and environmental trends.
Provides top-level leadership in development and execution of the Product and Mission Area: 5 year financial plans, AOP, Assigned investment resources, IPDS Gates.
Leads product area and program managers executing programs including program management oversight for functions. Provides leadership to program managers to ensure that contract deliverables are met, customer satisfaction is strong, and other costs are minimized.
Active DoD Secret security clearance with the ability to obtain a Top Secret/SCI with SSBI.


text:
In the class when we refer to one of the members of the class we prepend `this.`. This denotes that it's a member access.
```typescript
class Greeter {
    greeting: string;
    constructor(message: string) {
        this.greeting = message;
    }
    greet() {
        return "Hello, " + this.greeting;
    }
}

let greeter = new Greeter("world");
```

### Inheritance
```typescript
class Animal {
    move(distanceInMeters: number = 0) {
        console.log(`Animal moved ${distanceInMeters}m.`);
    }
}

class Dog extends Animal {      // inheritance
    bark() {
        console.log('Woof! Woof!');
    }
}
```

### `public`, `private`, `protected` modifiers
* In TypeScript, each member of class is `public` by default.
* When a member is marked `private`, it cannot be accessed from outside of its containing class.
* The `protected` modifier acts much like the `private` modifier with the exception that members declared protected can also be accessed within deriving classes.
* All above were instance members of the class, those that show up on the object when it's instantiated. We can also create `static` members of a class, those that are visible on the class itself rather than on the instances. Each instance accesses this value through prepending the name of the class.

A constructor may also be marked `protected`. This means that the class cannot be instantiated outside of its containing class, but can be extended.
```typescript
class Person {
    protected name: string;
    protected constructor(theName: string) { this.name = theName; }
}

// Employee can extend Person
class Employee extends Person {
    readonly department: string;    // read only property

    constructor(name: string, department: string) {
        super(name);
        this.department = department;
    }
}

let howard = new Employee("Howard", "Sales");
let john = new Person("John"); // Error: The 'Person' constructor is protected
```

### Accessors
Accessors with a `get` and no `set` are automatically inferred to be readonly
```typescript
class Employee {
    private _fullName: string;

    get fullName(): string {
        return this._fullName;
    }

    set fullName(newName: string) {
        if (passcode && passcode == "secret passcode") {
            this._fullName = newName;
        }
        else {
            console.log("Error: Unauthorized update of employee!");
        }
    }
}
```

### Abstract Classes
Abstract classes are base classes from which other classes may be derived. They may not be instantiated directly. Unlike an interface, an abstract class may contain implementation details for its members. The `abstract` keyword is used to define __abstract classes__ as well as __abstract methods__ within an abstract class.
```typescript
abstract class Animal {
    abstract makeSound(): void;     // must be implemented in derived classes
    move(): void {
        console.log("roaming the earth...");
    }
}
```
Methods within an abstract class that are marked as abstract do not contain an implementation and must be implemented in derived classes. Abstract methods share a similar syntax to interface methods. Both define the signature of a method without including a method body.

> __Abstract methods may optionally include access modifiers (setter/getter).__


This is the Heart of Manchester in all its Gothic style. The town hall towers over the square in its architecture splendour and square provides a huge space for many a seasonal events, including the famous Manchester Christmas Markets.
GóbéfestThe UK's only Transylvanian festival of arts and culture, Góbéfest, returns to Manchester's Albert Square from Friday 22-Sunday 24 June 2018.


Matt_the_W writes – "While not particularly new or creative, here are my plans for a simple pneumatic (compressed-air powered) potato cannon. It can also be used for other projectiles, as long as they fit down one of the interchangable barrels. It uses an electrically operated valve, originally made for in-ground irrigation systems." – Link.
The Night Lighter 36 by William Gurstelle. Launch potato projectiles 200+ yards with this stun-gun triggered, high-powered potato cannon with see-thru action. (Good thing potatoes are biodegradable.) MAKE 03 – Page 108.
Other potato cannon projects – Link.


A FLAGSTAFF Christmas....Happy New Year!
Well, the ubiquitous, New Years Resolutions are starting to fill the pages of our screen on social media and over all the commercials...It is the time when people start to really focus on what they want out of life and what they hope to accomplish in the next 12 months. There are those that HATE News Resolutions and those that couldn't live without them...well..I am somewhere in the middle. Every single day I make a new goal...a resolution if you will...and every day I allow myself to start over...if there is one thing I have learned it is that I have to forgive myself....I CARE a lot...about what I do... whether it be in my career, my blogging world or just in my daily life. I trust... a lot...and sometimes I get burned...but I have never been happier going into what I think is my lucky number 5. 2015 is from what I can tell going to be a year where I may just have found my purpose here. I will be 35 next month and for some it's no big deal...but for me...it marks a time when I can remember telling my mom all the things I wanted to do before then...and then I realized somewhere in the middle that it was really all I wanted to BE that was important. Today I will not bore you with all of my I WANNA DO and BE list, we will save that for tomorrow, but I will leave you with this before the clock strikes Midnight.
Every day is a new day...and with that brings so much hope. It won't be easy...and sometimes the road gets a little crazy...but as long as you remind yourself that you are and can be all that you imagine...it will all be ok. Stay focused, learn to accept the bumps in the road and take a new direction...just remember you must re inspire yourself every single day...NEVERSETTLE and Let's start this year off right!
My list is long so I will post it tomorrow but one of them is following through on the Bodybuilding.com Transformation challenge! You guys can join me! Find me on there at +Shana Emily and join in on the fun! I will leave you with some of my favorite times from our recent trip to Flagstaff!! Have a wonderful day!! Love you guys!! See you next year!
One thing I was so excited about was being able to bring our babies!!! We tried to find a place to keep them but in the end it was a blessing in disguise!! If you follow my Instagram you know we took them out on our daily workouts!! Sampson was loving it!
Lots of push ups and lunges!
The hubby joined me on my workout and it was so nice to spend some quality time...freeing our ARSES off and working out!
We woke up bright and early Christmas day to start making the Kilbourn family recipe for potato rolls! They turned out perfect thank you to our hosts who spent all night making sure the dough was perfection!
My hubby'y brother and his wife put together the most FANCY of FANCY Feasts for Christmas dinner! The largest ROAST you have ever seen! They were incredible hosts and chefs!
It was time to start opening gifts!
as you can see I was pretty excited!
When it came time for a family photo you know I had to make everyone laugh. My favorite photos are JUST LIKE THIS.
Hope you guys enjoyed! xoxo Till next year!
Thanks for sharing such feel good photos Shana! I've enjoyed following along your journey this year and look forward to what you motivate us with in 2015! Happy New Year!


text:
Partners and Network
MedRoute is possible thanks to the collaboration with the Istituto di Storia per l'Europa Mediterranea del Consiglio Nazionale delle Ricerche (ISEM-CNR), Cagliari, Italy, and the University of Maryland at College Park, Mayland, USA.
The CNR is the largest public research institution in Italy, the only one under the Ministry of Research and Education performing multidisciplinary activities. It is organized in 7 Departments, 108 Institutes and more than 500 Research Units. In this frame, the ISEM represents the leading Italian Institute aiming, through interdisciplinary approach, at studying political, institutional, social, and economic Mediterranean history. The MedRoute supervisor is Prof Marcello Verga, Professor of History at the Università degli Studi di Firenze and Director of the ISEM-CNR, whereas the responsible for the return phase is Doctor Annamaria Oliva, director of the Roman section of the ISEM.
The University of Maryland is a public research university, the flagship campus of the University System of Maryland, and the original 1862 land-grant institution in the State. It is amongst one of the top twenty public research university of the United States. The Department of History is highly eclectic and integrated, its members working together, crossing chronological, geographical, and thematic boundaries. In the Department are active two Research Centers, the Miller Center for Historical Studies and the Center for Global Migration Studies, while the Centre for Middle East Studies represents a crucial framework for a less Eurocentric approach to Mediterranean Studies. The MedRoute supervisor at UMD is Prof Stefano Villani.
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Old English baþian "to wash, lave, place in a bath, take a bath" (transitive and intransitive), from root of bath (q.v.), with different vowel sound due to i-mutation. Related: Bathed; bathing. Similar nouns in Old Norse baða, Old High German badon, German baden.


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Posted on July 18, 2019 by Demetric Muhammad
MINISTER FARRAKHAN IS INNOCENT: Reactions to Malcolm X Assassination Propaganda
It has been almost 60 years since the death of our brother, Malcolm X, and people are still accusing The Honorable Minister Louis Farrakhan of his murder. Some people have even gone as far to say that it is the reason why they will not work with or join with The Nation of Islam.
Now, please keep in mind that there is no statute of limitations on murder. Meaning, if The Honorable Minister Louis Farrakhan was as guilty as the critics say, and if there was any evidence against him, he could be apprehended at any time. But, unfortunately, that isn't enough to convince the critics from thinking that The Honorable Minister Louis Farrakhan was involved in some way.
The next false claim to justify why they, the detractors, believe The Minister hasn't been apprehended is — "he works for the government." Why would the U. S. Government work so hard to silence a Black leader that they have on pay roll? Now, this doesn't make sense, however, this is the belief of various folks within the Black community. Such beliefs have emerged as a result of the wicked agenda to stop the resurrection and rise of the Black community. The goal is to portray a loving man of God-Minister Farrakhan, who has an insurmountable love for black people, appear as an enemy to black people.
The Honorable Minister Louis Farrakhan has stood boldly in defense of his teacher, The Most Honorable Elijah Muhammad when nobody else did. Malcolm X used the media to slander his teacher, The Most Honorable Elijah Muhammad, The Exalted Christ. No other student stood as strong in defense of The Most Honorable Elijah Muhammad after 1975 as did the Honorable Minister Louis Farrakhan. And in 1992, when Spike Lee produced the movie Malcolm X, many within the Black community took at face value the entire movie and believed that everything they watched in the movie actually happened in real life. And some became harsh critics of the Nation of Islam.
Now, the Minister has expressed on many occasions his love for Malcolm X; Malcolm was his first teacher inside the Nation of Islam. He and Malcolm had a close bond as brothers spending time at each other's homes, sharing meals together and praying together. Most of these critics who try to blame the Honorable Minister Louis Farrakhan for the assassination of Malcolm X usually come with the same regurgitated, non-factual, pseudo-arguments to fit their ridiculous claims. And the Nation of Islam has always rebutted these false claims with the truth contained within historical documentation, empirical evidence, and the use of a logical analysis. As stated earlier, we know The Honorable Minister Louis Farrakhan is innocent because if he was not, he would have been apprehended years ago. This is easily understood when we consider the fact that Minister Louis Farrakhan is hated by the United States government. If they believed that Minister Farrakhan could be implicated in or held responsible for the assassination of Malcolm X, they would stop at nothing in order to imprison him.
We've seen proof of this because the United States Senate has censured Minister Farrakhan. There is even legislation that has his name on it that seeks bi-partisan support to condemn him. Any Black person who has aspired to a position of prominence within the government, and throughout public life in America, will have the experience of being harassed, compelled and ultimately threatened if they have a positive relationship with Minister Farrakhan. Even the 44th President, Barack Obama, was a victim of this wicked litmus test, that is always the used against black people who desire to be successful in the eyes of White America. Our beautiful, warrior sister and leader of the Women's March Movement, Tamika Mallory, has been ridiculed and scorned by the media due to her affiliation with The Honorable Minister Louis Farrakhan, as well. These are small examples of how The Minister is hated by White America, so it's obvious that if The Honorable Minister Louis Farrakhan was guilty of the murder of Malcolm X, his enemies would lose no sleep in arresting him on sight! However, this is not the case because The Honorable Minister Louis Farrakhan is innocent!
Has the Black community forgotten? It was J Edgar Hoover along with the FBI who conspired to kill the heroes of the Black movement. This same government is also responsible for the assassination of Martin Luther King Jr, Fred Hampton, and other heroes of the struggle for liberation. Look within the FBI files and see how much information the FBI has gathered on Malcolm X, Elijah Muhammad and the Nation of Islam. Thousands of pages of documents exist just on the life and work of Brother Malcolm. This is the reason why the Honorable Minister Louis Farrakhan stood up in 1995 and demanded that the government release all of the files on Malcolm X, The Most Honorable Elijah Muhammad and the Nation of Islam! Here are his words on that day:
"So let us open the files up! Lying demons! You know that Farrakhan had nothing to do with the murder of Brother Malcolm X! (The whole stadium INCLUDING Betty Shabazz stands up and applauds)"- The Honorable Minister Louis Farrakhan and Betty Shabazz, A New Beginning, May 6, 1995.
This is very important. Would a man guilty of murder make such a request? Why would he petition the most sophisticated government in the world to open up files on a murder he committed or was in any way involved in? Now our enemies may say "Well, he is doing this to throw the guilt off of himself. He is bluffing." How foolish of you to think so! When the Honorable Minister Louis Farrakhan told the world he was taking a million Black Men to Washington D.C, was that a bluff? Or was his word bond? When The Honorable Minister Louis Farrakhan declared to the world that the Most Honorable Elijah Muhammad was physically alive, was he bluffing or was he serious? When The Honorable Minister Louis Farrakhan declared to the F.O.I during his first F.O.I class as a registered member of the Nation of Islam these words in 1955 "I am going to take this teaching to every nook and cranny, or corner, of the United States of America." Was that bluffing or was he serious? Look at how The Honorable Minister Louis Farrakhan is received today all over the world! The results speak for themselves!
Our beloved Minister is not a murderer and He is not guilty of the assassination of Malcolm X! In fact, the actual trigger man, Thomas Hagan, during an interview with Mike Wallace, said he did kill Malcolm X and he said no other member of the Nation of Islam was present that fateful day Malcolm was killed. At the trial, the name of The Honorable Minister Louis Farrakhan never came up! So, how is he guilty of such a crime when the actual trigger man, himself, didn't even point him out? These wicked lies and false accusations have spread like wildfire. The proof is available for the public to see. The character of The Honorable Minister Louis Farrakhan is impeccable.
You can usually get a good sense of when someone is telling a lie and trying to hide the truth. Telling lies is hard; because it is difficult to remember today the lies you that you told yesterday. The lying person has to always keep track of the lies that they tell so that the truth can remain hidden. I urge those of you who are reading this to really listen to The Honorable Minister Louis Farrakhan. Pay attention when He speaks about our brother Malcolm X and then compare it to the other times he mentioned our brother. Whether it be about how Malcolm brought the Minister up in the Nation or how it was their last meeting together — The Minister's story stays the same! He has never lied! He is a truth teller!
To all of those who love Brother Malcolm, let us not make the mistakes of the past. Minister Farrakhan has sacrificed his entire life for the liberation and salvation of our people and we will allow let the lies against him continue without a response. If you truly love Brother Malcolm and what he stood for, you should likewise love and respect the Honorable Minister Louis Farrakhan.
Dezarae Muhammad is a student of The Honorable Minister Louis Farrakhan, from Muhammad Mosque #92.
Follow her in social media : Facebook: Dezarae Muhammad
Instagram: @dezaraeem
Twitter: @dezaraeem
CategoriesBlog Tagsdefending farrakhan, Dezarae, Malcolm X
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Keeping families and staff informed in a timely manner during school emergency situations is a top priority of the Hudson School District. For this reason, the School District uses an emergency notification system. This system allows the School District to call or send messages to your telephone and or email in the event of a school emergency, such as school closings due to inclement weather.
Your phone caller ID will display the School District's main number 715.377.3700 when an emergency message is delivered.
A message will be left on any answering machine or voice mail system.
If the message stops playing, press any key 1-9 and the message will replay from the beginning.
Make sure your contact information is up to date at your student's school.
Emergency messages are also placed on the School District website and social media pages, along with area television stations (Channels 4, 5, 9, & 11).
The decisions made by the Hudson School District to close, delay or release students early from school are made with the safety of students and staff as a high priority. We are very conscious of the impact school closings have on students, families, and schools. We appreciate parents' understanding in our efforts to get all students to and from school safely.
Information is gathered on road conditions from Safeway Bus Company, local road crews, and weather forecast services to determine the level of safety. We must give careful consideration to the most dangerous roads in our district. Even if your street looks clear, travel elsewhere in the district may be dangerous.
The amount of snow and or ice accumulated.
Whether the conditions are expected to worsen or improve.
Building conditions, such as whether the buildings have electricity, heat, and water.
Parking lot and sidewalk conditions; we keep in constant contact with our maintenance and custodial staff.
Temperature, extreme cold alerts from the National Weather Service and wind chill. We do not publish a specific temperature or wind chill at which schools will be closed as different sources can report different air temperatures. In most cases, schools can remain open even when air temperatures fall below zero. Adjustments are made at each building site with respect to recess being held outdoors and for what length of time based on wind chill concerns.
The decision to close school is the responsibility of the Superintendent or his designee. This decision is based on the above factors and recommendations from key staff members. We make every effort to make a decision by 6:00 a.m. If a decision is made to keep schools open, we will try to avoid an early dismissal. However, if weather conditions worsen once students are in school and early dismissal is necessary, a decision is generally made by midday. Please pay close attention to the district's website, district EMERGENCY MESSAGE communication system, and local television stations for updates. It is important to have an emergency back-up plan in place in the event of an unexpected dismissal.
Please know that regardless of the decisions made by the school district, parents have the right to decide to keep their student(s) home when they feel road conditions in their neighborhood make it too risky to travel to school.
We hope this explanation helps everyone understand the process that the Hudson School District uses to make the best possible decision for everyone involved.


The image was created by Nikon D3200 camera with shoot mode 50.0mm · ƒ/5.0 · 1/800s · ISO 100, gives a photo excellent quality. It was stored in the category "Travel/Vacation", maximum size is 4000×2660 pixels, you can download it to JPG format. We were tagged: Sea, Beach, Hauts De France, Resort, The Touquet.


Did Meteor Strikes Wipe Out the Golden Age?
If, as I have suggested, there was a Tep Zepi, a First Time, a Golden Age civilization that preceded the end of the last Ice Age, why isn't it more evident now? Why are there only small bits and pieces left for us to find? Small bits and pieces that leave us wondering.
The best answer to this question is that there was a great cataclysm that wiped out all evidence of our past and that, as Graham Hancock says, we are now "a species with amnesia." Indeed, the cataclysm would have to be great to wipe out all traces except those we now find in rock and in myths.
It is all about the cycles of time and some cycles of time are within our experience. Winter turns to summer, summer to fall and fall back to winter. But many cycles of time are far outside the memory of anyone living today, or any other day in history.
Take the Taurid meteor showers. They are believed to be the remnants on a much larger comet that broke into pieces. (The largest piece we now know as the comet Encke.) Our planet passes through the Taurid stream May through June and again September through December each year. We only witness the fall display because the spring display happen during daylight hours.
Fire and hot coals and sparks, they all could be associated with a meteor impact. But what about the "blackish appearance"? That can be explained by dust and debris shot up by the impact obscuring the light reflected off the moon.
Indeed, we may have identified the crater caused by the 1178 meteor impact. Wikipedia reports the Giordano Bruno crater was formed "during the span of human history" so it may have happened in 1178. However, and this adds to the mystery, there is no other accounting that describes the event witnessed by the monks. It is more than likely that an event of this magnitude would have been recorded somewhere by someone.
The Tunguska event of June 30, 1908 may also have been related to the Taurid showers. Had this meteor struck earth instead of exploding in the atmosphere, the devastation would have been far greater. Still, it knocked down trees in a 830 square mile area and is now estimated to be 1000 times greater than the bomb that destroyed Hiroshima.
Still, it would seem to be a local event, right? And civilizations in other parts of the world would survive, right?
Not necessarily. Had these meteors struck earth, they would have sent a plume of dust and debris into the atmosphere, shutting off life-giving light to the plants below. They would die and with them, the herbivores, and with them the carnivores. That is called an extinction event.
If it had hit in the ocean, then unimaginable tsunamis would wipe-out the most populated areas of the world—the coastlines.
And if it hit near a fault line, then earthquakes and volcanoes would result.
But meteor streams suggest just that, a stream of meteors hitting multiple locations compounding the problems caused by just one strike. Global fires, acid rains, food-chain collapse and mega-tsunamis—that combination would wipe out all trace of civilization. Just like it did the dinosaurs.
Just this morning I read about an impact, this one 780,000 years ago. So we are discovering new evidence of devastating meteor strikes all the time.
So what about the last Ice Age? Could it be that meteor strikes needed it? Probably not. Indeed it brought about a mini-Ice Age.
It turns out that he end of the Ice Age was a very turbulent time on planet earth and multiple cosmic impacts centered around North America caused what we know as the Younger Dryas—a sudden cooling of the planet as the impact debris shot into the atmosphere and covered the globe. The resulting collapse of food sources severely cripple or wiped-out civilizations just as it wiped out 65% of mammals over 100 pounds. And that would include humans.
But before a few thousand years before that there was an even more devastating event–multiple solar outbursts–but more on that later as I try to substantiate the evidence as it is presented. If something wiped out advanced civilizations, this seems a more likely culprit.
The Metcalf Stone: Racial memories of a pole shift?
Yes, but it gets even more thought-provoking. Not sure I'll do solar storms next, but that is a really interesting theory!


In a large skillet, cook sausage thoroughly, stirring often to crumble.
In a separate skillet, saute spinach and peppers with chili powder until peppers are crisp-tender, about 3 minutes. Set aside.
Warm tortillas in a small pan coated with cooking spray for 1 minute per side.
Evenly divide cooked sausage among prepared tortillas, topped with spinach and peppers. Finish with shredded cheddar, and salsa or sour cream if desired.


Our bodies are made up of molecules, atoms, genes, chromosomes, cells, tissues, organs. The same atoms that make us up are making up the universe. We inherit a set of genes from our parents and we are born with a "pre-set" health. Throughout our lives we change our health through our diet, habit and lifestyle. Can we activate self healing?


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The Epistle of Barnabas
Epistle of Barnabas
Letter of Aristeas
Epistle of Barnabas. Ante-Nicene Fathers, Vol. 1.
Thomas Wilfrid Crafer [1870-1949], ed., The Epistle of Barnabas. Texts for Students, No. 14. London: SPCK, 1920. Pbk. pp.32. pdf [This material is in the Public Domain]
J.A. Kleist, The Didache, The Epistle of Barnabas, the Epistle and Martyrdom of St. Polycarp, the Fragments of Papius, the Epistle of Diogentus. Ancient Christian Writers, Vol. 6. New York: Paulist Press, 1948. Hbk. ISBN: 0809102471. {CBD}
Kirsopp Lake, translator, The Apostolic Fathers. I Clement, II Clement, Ignatius, Polycarp, Didache, Barnabas, The Shepherd of Hermas, The Martyrdom of Polycarp, The Epistle to Diognetus, 2 Vols. London: William Heinemann, 1925. Hbk. pp.409+396. pdf [This material is in the Public Domain]
L.W. Barnard, "The Epistle of Barnabas and the Tannaitic Catechism," Anglican Theological Review 41 (1959): 177-190.
L.W. Barnard, "The Epistle of Barnabas and the Dead Sea Scrolls: Some Observations," Scottish Journal of Theology 13 (1960): 45-59.
L.W. Barnard, "Judaism in Egypt A.D. 70-135," Studies in the Apostolic Fathers and Their Background. New Yorl: Shocken, 1966. pp.41-55.
L.W. Barnard, "St. Stephen and Early Alexandrian Christianity," Studies in the Apostolic Fathers and Their Background. New Yorl: Shocken, 1966. pp.57-72.
L.W. Barnard, "Is the Epistle of Barnabas a Paschal Homily?," Studies in the Apostolic Fathers and Their Background. New York: Shocken, 1966. pp.73-85.
L.W. Barnard, "The Dead Sea Scrolls, Barnabas and the Later History of the 'Two Ways,'" Studies in the Apostolic Fathers and Their Background. New York: Shocken, 1966. pp.87-107.
L.W. Barnard, "The Use of Testimonia in the Early Church and in the Epistle of Barnabas," Studies in the Apostolic Fathers and Their Background. New Yorl: Shocken, 1966. pp.109-135.
Richard J. Bauckham, "Barnabas in Galatians," Journal for the Study of the New Testament 2 (1979) 61-70.
Charles Bigg [1840-1908], The Origins of Christianity. Oxford: Clarendon Press, 1909. Hbk. pp.58-62.
Aecio E. Cairus, "Sabbath and covenant in the Epistle of Barnabas," Andrews University Seminary Studies 39.1 (Spring 2001): 117-123. pdf
J.N.B. Carleton Paget, "Barnabas 9:4: A Peculiar Verse on Circumcision," Vigiliae Christianae 45.3 (1991): 242-254.
J. Carleton Paget, The Epistle of Barnabas: Outlook and Background. Wissenschaftliche Untersuchungen zum Neuen Testament, 2. Riehe, 64. 1994.
J. Carleton Paget, "The Epistle of Barnabas," Expository Times 117.11 (2006): 441-446.
F.L. Cross, The Early Christian Fathers. Studies in Theology 1. London: Gerald Duckworth & Co. Ltd., 1960. Hbk. pp.21-23.
Ken Derry, "One Stone on Another: Towards an Understanding of Symbolism in the Epistle of Barnabas," Journal of Early Christian Studies 4.4 (1996): 515-528.
Jonathan A. Draper, "Barnabas and the Riddle of the Didache Revisited," Journal for the Study of the New Testament 58 (1995): 89-113.
William John Ferrar [1868-1945], The Early Christian Books. Handbooks of Christian Literature. London: SPCK, 1919. Hbk. pp.108. pdf [This material is in the Public Domain]
John J. Gunther, "The Association of Mark and Barnabas of Mark and Barnabas With Egyptian Christianity. Part I," Evangelical Quarterly 54.4 (1982): 219-233.
John J. Gunther, "The Association of Mark and Barnabas of Mark and Barnabas With Egyptian Christianity. Part II," Evangelical Quarterly 55.1 (1983): 21-29.
Henry Scott Holland [1847-1918], The Apostolic Fathers. The Fathers for English Readers. London: SPCK, 188?. Hbk. pp.223. pdf [This material is in the Public Domain]
Reidar Hvalvik, "Barnabas 9.7-9 and the Author's Supposed Use of Gematria," New Testament Studies 33.2 (1987): 276-282.
Reidar Hvalvik, The Struggle for Scripture and Covenant. The Purpose of the Epistle of Barnabas and Jewish-Christian Composition in the Second Century. Wissenschaftliche Untersuchungen zum Neuen Testament 2nd series 64 Tübingen: J.C.B. Mohr, 1994.
Epistle of Barnabas (Peter Kirby)
Menahem Kister, "Barnabas 12:1; 4:3 and 4Q Second Ezekiel," Revue Biblique 97.1 (1990): 63-67.
R.A. Kraft, "Barnabas' Isaiah Text and the 'Testimony Book' Hypothesis," Journal of Biblical Literature 79 (1960): 336-350, 380.
R.A. Kraft, Barnabas' Isaiah Text and Melito's Paschal Homily," Journal of Biblical Literature 80 (1961): 371-373.
R.A. Kraft, "Barnabas and the Didache," Robert Grant, ed. The Apostolic Fathers, Vol. 3. New York: Nelson, 1965.
R.A. Kraft, "An Unnoticed Papyrus Fragment of Barnabas," Vigiliae Christiana 21.3 (1967): 150-163.
Epistle of Barnabas (P. Ladeuze)
L. Legrand, "Paul and Barnabas: Priestly Brotherhood," Clergy Monthly 32.5 (1968): 232-233.
S. Lowy, "The Confrontation of Judaism in the Epistle of Barnabas," Journal of Jewish Studies 11 (1960): 1-33.
James Carleton Paget, "Paul and the Epistle of Barnabas," Novum Testamentum 38.4 (1996): 359-381.
James Carleton Paget, "The Epistle of Barnabas," The Expository Times 117.11 (2006): 441-446. [Abstract]
Mary Pendergraft, "'Thou Shalt Not Eat the Hyena': A Note on 'Barnabas' Epistle 10.7," Vigiliae Christianae 46.1 (1992): 75-79.
P. Richardson, "Barnabas, Nerva and the Yavnean Rabbis," Journal of Theological Studies, n.s. 34.1 (1983): 31-55.
James N. Rhodes, Epistle of Barnabas & Deuteronomic Tradition: Polemics, Paraenesis, and the Legacy of the Golden-Calf Incident. Wissenschaftliche Untersuchungen Zum Neuen Testament 2/188. Tübingen: Mohr Siebeck, 2004. Pbk. ISBN: 3161483774. pp.273.
James N. Rhodes, "Barnabas4.6B: The Exegetical Implications of a Textual Problem."Vigiliae Christianae 58 (2004): 365-92.
Didache | Epistle of Barnabas | Origen's Hezapla | Letter of Aristeas | Shepherd


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Inflammation of the shoulder joint
Shoulder pain syndrome
Irreducible anterior and posterior dislocation of the shoulder due to incarceration of the biceps tendon
Mechanical obstacles may infrequently impede closed reduction of anterior shoulder dislocation. Imaging techniques such as arthrography, computed tomography (CT) and magnetic resonance imaging (MRI) complement conventional radiography by allowing identification of obstacles to reduction.
We present a case of irreducible anterior glenohumeral dislocation resulting from an initial anterior dislocation, converted to a posterior dislocation with an attempt at reduction, then converted back to anterior dislocation with a second reduction attempt. Soft tissue obstacles to shoulder reduction should be suspected when plain films do not identify a bony fragment as the culprit. CT and MRI are useful for identifying the cause of irreducibility and for operative planning.
The glenohumeral joint is the body's most frequently dislocated joint, with over 95% of these occurring in the anterior direction. [1] Most anterior shoulder dislocations are easily reduced. [2] However, mechanical obstacles may infrequently impede closed reduction of an anterior dislocation, necessitating open reductions.
Such obstacles to reduction include: interposition of the long head of the biceps tendon, [3],[4],[5],[6],[7],[8],[9],[10],[11] subscapularis tendon [2],[12],[13] or labrum; [10] impaction of the humeral head on the glenoid rim; [14],[15],[16] as well as dislocated bony fragments from the glenoid [17] or greater tuberosity. [18],1[9],[20] Imaging techniques such as arthrography, computed tomography (CT) and magnetic resonance imaging (MRI) provide crucial adjuncts to conventional radiography by allowing identification of the obstacle to reduction and appropriate planning of operative intervention.
[8] We present a case of irreducible anterior glenohumeral dislocation resulting from an initial anterior dislocation, which was converted to a posterior dislocation with an attempt at reduction, then converted back to an anterior dislocation with a second reduction attempt.
To our knowledge, only three other case reports exist providing CT imaging with surgical correlation of an interposition of the biceps tendon between the humeral head and glenoid, [3],[8],[9] with none reporting this finding secondary to iatrogenic conversion of anterior dislocation to a posterior dislocation during reduction, secondary to biceps incarceration in the glenohumeral joint.
A 57-year-old female with mental retardation initially presented to a private hospital emergency room with complaints of left shoulder pain and decreased range of motion. The patient was a resident of a group home where she used to ambulate minimally and had no witnessed history of trauma, fall, or seizure. She had a medical history significant for mitral valve prolapse, hypercholesterolemia and bipolar disorder.
Additionally, the patient had no reportable history of previous shoulder dislocation or instability. A focused history and exam at the time of presentation revealed the patient to be a poor historian given her mental retardation. On examination, she was found to be obese, with fullness about her left shoulder, and she was neurovascularly intact in the left upper extremity with limitation of range of motion in all planes.
Neurologic exam and MRI were found to be negative for stroke. However, radiographic imaging of her left shoulder was found to be significant for an anterior shoulder dislocation [[Figure 1]a]. At this time, the patient was evaluated by an orthopedic resident and she underwent an attempted closed reduction of her left shoulder under conscious sedation.
Post-reduction imaging, including plain radiographs and CT, revealed that the shoulder was now dislocated posteriorly [[Figure 1]b]. Again, the patient underwent a closed reduction with conscious sedation, with post-reduction radiographs revealing that the humeral head was now again dislocated anteriorly. Further attempts at reduction of this anterior glenohumeral dislocation under conscious sedation were unsuccessful.
The patient was then medically cleared for surgery and repeat CT scan of the left shoulder was performed to assess for any bony defects and reasons for shoulder irreducibility. Oblique coronal and sagittal 2D reconstructions demonstrated the long head of biceps tendon dislocated lateral and posterior to the humeral neck and head. A small Hill-Sachs defect was also noted with a subcoracoid glenohumeral dislocation [Figure 2] and [Figure]
Figure 1: Scapular Y views of (a) anterior and (b) posterior dislocation of the left shoulder
Figure 2: Oblique coronal 2D reconstructions demonstrate the long head of biceps tendon (white arrows) dislocated lateral and posterior to the humeral neck and head. Note a Hill-Sachs defect (curved arrow) (c: coracoid; g: glenoid)
Figure 3: CT images obtained with axial 3 mm collimation demonstrate the long head of biceps tendon dislocated lateral to the (a) proximal humeral shaft and (b) bicipital groove as well as (c) posterior to the greater tuberosity and (d) Hill-Sachs defect. Note failed closed shoulder reduction with anterior subcoracoid dislocation of the humeral head
At this time, the patient was brought to the operating room for attempted closed reduction under general anesthesia. After general anesthesia was administered, attempt at closed reduction was again unsuccessful and open reduction was performed. A standard delto-pectoral approach was then performed with the patient in a beach-chair position.
The interval was identified, the cephalic vein retracted laterally, and dissection down to the humeral shaft was performed. The humeral head was noted to be anteriorly dislocated in a sub-coracoid position. An attempt at reduction was again unsuccessful. The biceps tendon was then identified distally in the bicipital groove and followed proximally where it was noted to be incarcerated in the glenohumeral joint.
The proximal tendon was dislocated from its anatomic position in the bicipital groove proximally and was tethered laterally around the humeral head, preventing reduction of the glenohumeral joint [Figure 4]. The biceps tendon was tenotomized from its origin at the superior glenoid tubercle and the portion of interposed tendon was excised, with a soft tissue tenodesis being performed at the level of the pectoralis major tendon.
Next, the subscapularis was separated from the joint capsule, which was incised and inferiorly dissected off the humeral neck. The labrum was clearly visualized and was found to be intact inferomedially. At this point, the glenohumeral joint was reduced and taken through a full range of motion of internal rotation and external rotation with the arm in adduction and at 90º of abduction.
The subscapularis and capsulolabral complex was then repaired through bony tunnels in the lesser tuberosity with #2 Fiberwire (Arthrex, Naples, FL, USA). The deltopectoral interval was then closed and a standard subcuticular closure performed. Intraoperative and postoperative radiographic imaging confirmed glenohumeral reduction.
This patient had an uneventful postoperative course and was discharged back to her group home with visiting nursing services on the fourth postoperative day. Immediate hand, wrist, and elbow exercises were instituted, with passive range of motion exercises instituted at 2 weeks followed by gentle active assisted range of motion exercises. Active internal rotation was limited for 4 weeks.
Figure 4: Intraoperative photo of long head of the biceps tendon (L) preventing reduction of the humerus (H) (arrow: glenoid)
A review of the literature on irreducible anterior shoulder dislocation identified only 22 cases. In nine of these cases, interposition of the long head of the biceps tendon was the obstacle to closed reduction. [3],[4],[5],[6],[7],[8],[9],[10],[11] In five of the nine cases, a greater tuberosity fracture allowed posterior/lateral subluxation of the biceps tendon. [5],[7],[8],[10],[11] Two of the nine cases were identified with a Hill-Sachs defect, [3],[8] and three of the nine cases showed no bony lesions (other than the ectopic calcification reported by Freeland and Higgins and Rakofsky et al.). [4],[6],[9]
Our patient initially presented with an anterior dislocation which was then iatrogenically converted to a posterior dislocation with attempted reduction, typically a less common injury associated with high-energy trauma or seizure activity. Irreducible posterior dislocation has also been associated with blockage of reduction by the long head of the biceps tendon. However, our patient's dislocation was anterior when its irreducibility became an indication for surgery. For this reason, we classified the case as one of acute irreducible anterior dislocation.
MRI would have provided better visualization of the tendon and other soft tissue structures. [2] However, in our case, CT, in addition to identifying a Hill-Sachs defect, was sensitive enough to allow visualization of the biceps tendon pathology, and was ordered to assess for bony instability as a potential cause for inability to maintain a stable reduction.
Our case represents a unique complication of attempted closed reduction of anterior shoulder dislocation. Soft tissue obstacles to successful reduction of a dislocated shoulder should be suspected when plain films do not identify a bony fragment as the culprit. CT and MRI are useful for identifying the cause of irreducibility and for operative planning.
The authors acknowledge the support of Dr. Jenny T. Bencardino, Clinical Associate Professor of Radiology, NYU Hospital for Joint Diseases, New York, USA.