text:
Volume 27, Number 7—July 2021
Non–C. difficile Clostridioides Bacteremia in Intensive Care Patients, France
Guillaume Morel , Guillaume Mulier, Etienne Ghrenassia, Moustafa Abdel Nabey, Yacine Tandjaoui, Achille Kouatchet, Laura Platon, Frédéric Pène, Anne-Sophie Moreau, Amelie Seguin, Damien Contou, Romain Sonneville, David Rousset, Muriel Picard, Guillaume Dumas, Djamel Mokart, Bruno Megarbane, Guillaume Voiriot, Isabelle Oddou, Elie Azoulay, Lucie Biard, and Lara Zafrani
Author affiliations: Hautepierre Hospital—University Medical Center, Strasbourg, France (G. Morel); Hospital Saint Louis, APHP, Paris, France (G. Morel, G. Mulier, E. Ghrenassia, M.A. Nabey, E. Azoulay, L. Biard, L. Zafrani); Hospital Avicenne, Bobigny, France (Y. Tandjaoui); Teaching Hospital, Angers, France (A. Kouatchet); Lapeyronie University Hospital, Montpellier, France (L. Platon); Hospital Cochin, APHP, Paris (F. Pène); Salengro Hospital, Lille, France (A.-S. Moreau); University Hospital, Nantes, France (A. Seguin); Victor Dupouy Hospital, Argenteuil, France (D. Contou); Hospital Bichat, APHP, Paris (R. Sonneville); University Teaching Hospital, Toulouse, France (D. Rousset),; Institut Universitaire du Cancer—Oncopole, Toulouse (M. Picard); Hospital Saint Antoine, APHP, Paris (G. Dumas); Paoli-Calmettes Institute, Marseille, France (D. Mokart); Hospital Lariboisiere, APHP, Paris (B. Megarbane); Hospital Tenon, APHP, Paris (G. Voiriot); University Medical Center, Strasbourg (I. Oddou); INSERM U976, Paris (L. Zafrani)
Release date: Jun 18, 2021; Expiration date: Jun 18, 2022
Assess the background of patients with Clostridioides bacteremia (CB) in the current study
Distinguish clinical features of severe CB in the current study
Assess the microbiology of CB in the current study
Identify risk factors for mortality due to CB in the current study
Dana C. Dolan, BS, Copyeditor, Emerging Infectious Diseases. Disclosure: Dana C. Dolan, BS, has disclosed the following relevant financial relationships: employed by a commercial interest (spouse): Micro C Imaging.
Charles P. Vega, MD, Health Sciences Clinical Professor of Family Medicine, University of California, Irvine School of Medicine, Irvine, California. Disclosure: Charles P. Vega, MD, has disclosed the following relevant financial relationships: served as an advisor or consultant for GlaxoSmithKline.
Disclosures: Guillaume Morel, MD; Guillaume Mulier, MSc; Etienne Ghrenassia, MD; Moustafa Abdel-Nabey, MD; Yacine Tandjaoui, MD; Achille Kouatchet, MD;Laura Platon, MD; Anne-Sophie Moreau, MD; Amelie Seguin, MD; Damien Contou, MD; Romain Sonneville, MD, PhD; David Rousset, MD; Muriel Picard, MD; Guillaume Dumas, MD, PhD; Djamel Mokart, MD, PhD; Bruno Megarbane, MD, PhD; Guillaume Voiriot, MD; Isabelle Oddou, MD; and Lucie Biard, MD, PhD, have disclosed no relevant financial relationships. Frédéric Pène, MD, PhD, has disclosed the following relevant financial relationships: served as an advisor or consultant for Gilead Sciences, Inc.; received grants for clinical research from Alexion Pharmaceuticals, Inc. Elie Azoulay, MD, PhD, has disclosed the following relevant financial relationships: served as an advisor or consultant for Gilead Sciences, Inc.; served as a speaker or a member of a speakers bureau for Astellas Pharma, Inc.; Gilead Sciences, Inc.; Merck Sharp & Dohme; received grants for clinical research from Ablynx NV; Alexion Pharmaceuticals, Inc.; Baxter; Fisher and Payckle, Gilead Sciences, Inc.; Jazz Pharmaceuticals, Inc. Lara Zafrani, MD, PhD, has disclosed the following relevant financial relationships: received grants for clinical research from: Jazz Pharmaceuticals, Inc.
Usually responsible for soft tissue infections, Clostridioides species can also cause bacteremia, life-threatening infections often requiring intensive care unit (ICU) admission. We conducted a multicenter retrospective study to investigate Clostridioides bacteremia in ICUs to describe the clinical and biologic characteristics and outcomes in critically ill patients. We identified 135 patients with Clostridioides bacteremia, which occurred almost exclusively (96%) in patients with underlying conditions. Septic shock and digestive symptoms were the hallmarks of Clostridioides bacteremia in the ICU. We identified 16 different species of Clostridioides, among which C. perfringens accounted for 31% of cases. Despite the high sensitivity of Clostridioides to common antimicrobial drugs, mortality rates were high: 52% for ICU patients and 71% overall at 3 months. In multivariate analysis, the most important factor associated with increased risk for death was the presence of hemolysis. Clostridioides bacteremia often leads to multiple organ failures, which have high mortality rates.
Obligate anaerobic bacteremia is a rare event, accounting for ≈0.1%–10% of positive blood cultures; Clostridioides spp. bacteremia represents 8%–46% of the cases (1–4). Clostridioides (formerly Clostridium) species are ubiquitous, gram-positive, spore-forming (most species), and toxin-producing bacteria (3). The most well-known toxins, C. perfringens α and θ toxins, induce platelet aggregation, diffuse formation of thrombi, cell lysis, and gas gangrene (5). Anaerobic bacteria are not only found in the soil or rotting vegetation but also are commensal constituents of the human microbiome, especially in the gastrointestinal tract or genital organs of women (3,6). Humans are usually infected by direct entry of the bacteria through a wound (C. tetani, C. perfringens) or by contaminated food (C. botulae). However, contamination of a wound by spores is not sufficient to generate the infection because Clostridioides spp. need hypoxic and acidic conditions to proliferate. Conditions such as vascular trauma, atherosclerosis, or malignancies may induce tissue hypoxia. Moreover, the liberation of both α and θ toxin, which induce the formation of occlusive thrombi, may increase tissue hypoxia, sometimes leading to gas gangrene formation (3,7–9).
Thus, Clostridioides infections are especially known to cause myonecrosis with rapid extension and gas gangrene formation, which, if not treated rapidly, may be fatal. This outcome has largely been described in the context of war wounds, trauma, and surgery (10–12). Although C. perfringens is mostly involved in gas gangrene, other Clostridioides subspecies can also be responsible for such infections (13).
Clostridioides bacteria can also cause primary bacteremia, with or without gas gangrene (2,6). Clostridioides bacteremia are usually fulminant and life-threatening infections. Data focusing on Clostridioides bacteremia rely mainly on case reports (14–16), case series on selected populations (17,18), or larger epidemiologic series that contain microbiological data but few clinical descriptions (2,19,20). Although Clostridioides bacteremia often leads to sudden and massive organ failure requiring transfer to a hospital intensive care unit (ICU), no study has focused on Clostridioides bacteremia in the ICU. Therefore, we conducted a multicenter retrospective study of case-patients who were positive for all Clostridioides species except C. difficile to investigate Clostridioides bacteremia in the ICU; we described the clinical spectrum of critically ill patients, ICU admission conditions, microbiological characteristics, and outcomes. We aimed to identify risk factors associated with mortality.
This study was approved by an Institutional Review Board (Comité d'Ethique de la Société de Réanimation de Langue Française no. CE-SRLF 18–38) in accordance with the French regulation on noninterventional studies, which waived the need for signed informed consent for patients included in this database. No data allowing identification of the patients included in the study were recorded. The study was conducted in accordance with the Declaration of Helsinki principles.
We retrospectively recorded cases of Clostridioides bacteremia in the period July 2003–December 2018 in 15 ICUs in France. Patients were identified by review of ICU medical records and hospital microbiological databases; we selected only cases with >1 positive blood culture for all Clostridioides species except C. difficile. Blood samples had been collected with specific anaerobic blood culture bottles and incubated in automated systems, in accordance with routine practice (21). Anaerobes were identified using the API System (bioMérieux, https://www.biomerieux.com) until 2010; as of 2010, matrix-assisted laser desorption/ionization time-of-flight mass spectrometry methods were used in most of the centers to identify anaerobic bacteria (3,22). Antimicrobial susceptibility test results of Clostridioides species, evaluated by diffusion methods according to guidelines of the Comité de l'Antibiogramme de la Société Française de Microbiologie, were also collected for our study.
We reviewed ICU medical records of selected patients for age, sex, underlying diseases, clinical and biologic symptoms at ICU admission, the need for organ support, antimicrobial drug treatment, and outcome. We recorded Charlson index, simplified acute physiology score (SAPS2), and sequential organ failure assessment (SOFA) scores as previously defined (23–25). We defined septic shock according to the Sepsis-3 consensus definition (26) and hemolysis as low hemoglobin level associated with other hemolysis parameters, such as an increase of lactate dehydrogenase (LDH) or unconjugated bilirubin and reduced haptoglobin levels.
We described categorical variables as counts and percentages and quantitative variables as median and interquartile range. We estimated mortality rate at 28 days and 90 days after the date of bacteremia, as a binary variable, and examined factors associated with overall survival as a time-to-event endpoint. We defined overall survival as the time between the date of Clostridioides bacteremia and the date of death or last follow-up, whichever occurred first. We performed survival analysis using a Cox regression model, estimating hazard ratios (HR) and 95% CIs. We checked the proportional hazards (PH) assumption and the log-linearity assumptions for the models; if the PH assumption was not valid, we used time-dependent coefficient for time-varying effect over time; we used a step function, with time-intervals defined based on the Schoenfeld's residuals. Factors which were associated to OS with a p<0.1 in univariate analysis were candidates for a multivariate adjusted model. We selected the adjusted model using a backward stepwise procedure, based on the Akaike criterion. All tests were 2-sided; p<0.05 was considered significant. We performed analyses by using the R statistical platform version 3.6.1 (https://www.r-project.org).
Clinical and Biologic Manifestations
In total, 135 patients with Clostridioides bacteremia were identified in 15 ICUs in France during the study period (Table 1); 60% (n = 81) of the patients were men. Median age at diagnosis was 64 years. Most (96%) patients had >1 underlying medical condition; among patients >65 years of age, diabetes mellitus, neoplasms, and chronic obstruction pulmonary disease (COPD) were the most frequent. Thirty-four (26%) patients had an underlying solid tumor from digestive (n = 14, 41%), gynecological (n = 7, 21%), and pancreatic or biliary (n = 4, 12%) origins. Three patients (9%) had urinary tract tumors, 2 (6%) neuroendocrine tumors, 1 (3%) an Ewing tumor, 1 (3%) oral cancer, and 1 (3%) testicular cancer. In all, 94% of tumors were active at the time of the bacteremia. Nineteen (15%) patients had also received diagnoses of hematological malignancies (7 lymphoma, 4 acute lymphoblastic leukemia, 4 myelodysplastic syndrome, 3 acute myeloid leukemia, and 1 myeloproliferative disorder); 3 of those patients had undergone bone marrow transplantation. Thirty-eight patients (28%) had been treated with immunosuppressive agents. In addition, 13 (10%) patients had experienced recent surgery or trauma, and these situations were associated with a better outcome in univariate analysis (Appendix Figure 1). However, this difference was not significant in multivariate analysis (HR 0.41, 95% CI 0.13–1.32; p = 0.13) (Figure 1).
Clostridioides bacteremia manifested with septic shock at ICU admission in 115 patients (85%), and 26 (19%) patients experienced a cardiac arrest in the ICU (Table 2). Indeed, Clostridioides bacteremia causes severe illness, as assessed by high SAPS2 and SOFA scores, high lactate levels, and substantial need for organ supports during an ICU stay. Of note, digestive symptoms were the main symptoms associated with Clostridioides bacteremia (62% of patients), whereas myonecrosis represented only 16% of ICU admissions. Acute hemolysis, a distinctive biologic signature of Clostridioides bacteremia, was present in 22 (17%) cases (Appendix Table 1). Median hemoglobin level was significantly lower in the hemolysis group (4.9, IQR 3.6–7.0) compared with the rate in patients without hemolysis (10.9, IQR 9.3–12.6; p<0.001). Multiple organ failure, experienced as hepatic cytolysis, acute kidney injury and thrombocytopenia (Table 2), was also common. Of note, aspartate aminotransferase levels were higher than alanine aminotransferase levels, which is commonly found in case of hemolysis. Twenty-seven patients (28%) had <4 × 109 leukocytes/L; 23 (85%) of those had an underlying solid tumor or a hematological malignancy.
Documentation of Infectious Species
In total, 16 different Clostridioides species were identified by blood cultures, including C. perfringens in one third of the patients (Table 3; Figure 2). In univariate analysis, documented C. perfringens infection was not associated with a worse outcome than other Clostridioides species (HR 0.78, CI 95% 0.49–1.23; p = 0.285) (Appendix Figure 2). Blood cultures were mainly performed by peripheral venipuncture (58%), followed by central venous catheter puncture (23%) and arterial catheter puncture (17%). One blood culture revealed Clostridioides bacteremia in 87% of cases. Of note, 49 cases of Clostridioides bacteremia were polymicrobial bacteremia, yielding the presence of >1 type of bacteria in blood cultures, balanced between gram-negative, gram-positive, and other anaerobic bacteria. Nine patients had both gram-negative and gram-positive bacteria cultures. Hematogenous spread with gas-forming abscess was one particular complication, found in 9 patients and leading to death in 5 in the ICU (Figure 3, panels A–C). As suggested by clinical symptoms, cases of bacteremia were mostly from the gastrointestinal tract (74%), followed by myonecrosis (16%) (Figure 3, panels D–E). In total, 110 (91%) of the patients were treated with antimicrobial drugs in the ICU, and 64 (47%) patients underwent surgery that was mostly gastrointestinal surgery (67% of surgery interventions).
Most strains of Clostridioides were sensitive to β-lactam drugs. Clostridioides species were sensitive to clindamycin in 69% of the cases. Two species (C. tertium and C. septicum) were resistant to metronidazole. We did not find any association between specific antimicrobial agents used to treat Clostridioides bacteremia and mortality (HR 1.01, 95% CI 0.57–1.77; p = 0.977) (Appendix Table 2).
Outcomes and Mortality Risk Factors
Although Clostridioides spp. were for the most part efficiently treated by common antimicrobial drugs, Clostridioides bacteremia remained very aggressive and life-threatening; the overall mortality rate at 6 months was 71%. Of 135 patients, 84 died; 70 (52%) of all patients died in the ICU. The 28-day mortality rate was 55% (95% CI 45%–64%), and the 90-day mortality rate was 71% (95% CI 60%–79%). The rapid need for hospitalization after the occurrence of the first symptoms (median days 0, IQR 0–1) highlighted the aggressiveness of Clostridioides bacteremia; direct ICU transfer was necessary in most cases (median time between hospitalization and ICU transfer 0 days, IQR 0–2). Median length of stay in ICU was 2 days for patients who did not survive (IQR 1.25–5.75) and 11 days for survivors (IQR 5–23).
In multivariate analysis for overall survival, factors associated with increased risk for death were increasing age (in 5-year increments) (HR 1.19, 95% CI 1.08–1.31; p<0.001), increasing SOFA score (per point) (HR 1.12, 95% CI 1.06–1.19; p<0.001), and presence of hemolysis (HR 2.39, 95% CI 1.31–4.38; p = 0.005). On the other hand, male sex was associated with a reduced risk for death (HR 0.56, 95% CI 0.34–0.91; p = 0.02) (Figure 2).
In our study, we found that Clostridioides bacteremia is an aggressive and rapidly life-threatening infection, occurring mainly in patients with underlying conditions. Septic shock with digestive symptoms is the usual manifestation. Despite rapid transfer to the ICU, large use of organ support, and active antimicrobial treatment, Clostridioides bacteremia remains highly lethal; 52% of ICU patients died. Massive intravascular hemolysis, associated with fatal complications, should alert clinicians to the possibility of sepsis.
Data on Clostridioides bacteremia consist mainly of case reports (14–16,27) or case series that include a small number of patients (17,28–30). Larger publications focusing on anaerobic bacteremia do not provide details on patients' characteristics and outcomes (2,19). Furthermore, we could find no previous publications on Clostridioides bacteremia in ICU patients, even though anaerobic bacteremia is frequent in this population (2,31). Our study provides a thorough description of the clinical and biologic characteristics as well as the outcomes of this serious condition.
Our results are consistent with earlier reports; most Clostridioides bacteremia cases occur in patients >65 years of age, and prevalence is higher in men (17,29,31). Diseases such as diabetes, chronic kidney disease, heart failure, and COPD, which maintain a baseline degree of organ ischemia and cause chronic organ failure, can lead to Clostridioides proliferation and consequently to bacteremia (1,19,29,31). Cancer patients or patients with hematological malignancies are also at high risk (18,32). Chemotherapy-induced cytopenia may result in neutropenic enterocolitis (33); this impairment of the natural digestive barrier favors the development of Clostridioides bacteremia. Digestive symptoms that have been described as hallmarks of this condition (1,17,29) were frequently associated with Clostridioides bacteremia in the ICU. Of note, although Clostridioides bacteremia is mostly from digestive origins, myonecrosis was identified as the origin of the bacteremia in 16% of the cases in our study, which is consistent with previous reports (17,18,29,31).
Among Clostridioides species, C. perfringens was more often identified as the source of bacteremia, as previously published (1,19,34). Fifteen other Clostridioides species have been identified; distribution is similar to the one described by Leal et al. (19). In this study, we chose to exclude C. difficile infections because this pathogen is mainly responsible for healthcare-associated digestive infections. C. difficile can still present as extradigestive infections; however, few cases of bacteremia have been reported (35,36).
Data on incidence of anaerobic and Clostridioides bacteremia are conflicting. Some authors report an increasing incidence of anaerobic bacteremia since the 1990s, whereas other report decreasing trends (2,6,20,37). The incidence of anaerobic bacteremia depend on patients' age and underlying conditions (especially cancer or cardiovascular illness), and antibiotic selection pressure driven by antimicrobial drug use and environmental conditions. In addition, as suggested by Morris et al. (38), blood cultures for anaerobic bacteria may be influenced by patients' background and clinical symptoms. Indeed, in a recent study evaluating anaerobic bacteremia, 39.7% of the positive blood cultures were considered to be bloodstream infections; the remaining 60.3% were attributed to contaminants (39). The evolution of microbiologic techniques, including growing use of automated techniques and matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, might have also influenced the increasing isolation of anaerobic bacteremia. Although we cannot rule out that some infections may have been overestimated, the severity of clinical presentations in our cohort suggests that these cases resulted from true bloodstream infections.
Of note, Clostridioides bacteremia can present either as a single microbial bacteremia or as a polymicrobial bacteremia (2,28,30,31). Enterobacteriaceae were the most commonly associated bacteria, followed by Staphylococcus species. Cultures for multiple microbes were positive for Clostridioides spp. in 18 patients. Comparable results were also found by Fujita et al. (17). Clostridioides species are largely susceptible to common antimicrobial drugs, except for clindamycin; susceptibility for clindamycin has been reported as reduced by 73%–96% (1,3,5,19,31). High susceptibility to penicillin should alert clinicians to rapidly initiate treatment in identified cases of Clostridioides bacteremia. Because 94% of the patients in our study received adequate antimicrobial drugs within 24 hours of ICU admission, we were not able to find any statistical association between early initiation of drugs and death. However, in a recent study published by Stabler et al. (34), adequate empiric antimicrobial therapy was associated with a better outcome. This result was also highlighted previously by Zahar et al. (18).
Mortality rates for Clostridioides bacteremia reported in the literature were 15%–48% (17–19,28–31), which is lower than the mortality rates reported in our study. However, we focused on critically ill patients. Indeed, Yang (17) and Fujita (31) revealed that patients who developed shock and required transfer to the ICU had worse outcomes than other patients. In those studies, shock was statistically associated with increased deaths. The prognosis for Clostridioides bacteremia patients is also related to underlying conditions that predispose to Clostridioides bacteremia and possibilities of therapeutic interventions in addition to prompt and appropriate antimicrobial drugs. As demonstrated by Rechner et al. (1), patients who required medical intervention to treat Clostridioides bacteremia had lower survival rates than patients who were managed by surgery. Conversely, the presence of massive intravascular hemolysis is a marker of extreme severity, despite appropriate management (16,40). Hemolysis is induced by Clostridioides toxin A (29), which hydrolyzes phospholipids in erythrocyte membranes, causing spherocytosis and subsequent intravascular hemolysis. Present in 17% of patients in our cohort, hemolysis is associated with a dramatic increase in mortality rate and remains a strong prognostic factor identified in our study. Finally, Clostridioides bacteremia in the ICU is associated with a higher mortality rate than that for classic septic shock in the ICU (41,42), which makes Clostridioides bacteremia a particularly difficult infection to deal with in the ICU.
The first limitation of our study is its retrospective nature and the inherently associated bias, such as missing data and unidentified confounding factors that may have been overlooked in the data collection. However, because of the rarity of Clostridioides bacteremia, prospective studies would hardly be feasible. Second, there are no standardized ICU admission policies for these patients, and patient recruitment patterns may have influenced the findings. Given the rapidity of the onset of symptoms and the severity of illness, rapid ICU management was the rule in the participating centers. However, we could not exclude that some patients, because of their advanced age or underlying conditions, were considered too sick for admission to the ICU and may have been denied intensive care.
In conclusion, Clostridioides bacteremia is an aggressive infection that often leads to failure of multiple organs, requiring prompt intensive care management. Particular attention should be paid to patients who have underlying conditions and are experiencing hemolysis. Early administration of antimicrobial agents active against Clostridioides bacteremia is essential, considering that most Clostridioides species are sensitive to β-lactams drugs. Even with prompt and appropriate management, however, Clostridioides bacteremia is associated with a high mortality rate in the ICU.
Rechner PM, Agger WA, Mruz K, Cogbill TH. Clinical features of clostridial bacteremia: a review from a rural area. Clin Infect Dis. 2001;33:349–53. DOIPubMedGoogle Scholar
Gajdács M, Ábrók M, Lázár A, Terhes G, Urbán E. Anaerobic blood culture positivity at a University Hospital in Hungary: A 5-year comparative retrospective study. Anaerobe. 2020;63:102200. DOIPubMedGoogle Scholar
Gajdács M, Spengler G, Urbán E. Identification and antimicrobial susceptibility testing of anaerobic bacteria: Rubik's cube of clinical microbiology? Antibiotics (Basel). 2017;6:25. DOIPubMedGoogle Scholar
Blairon L, De Gheldre Y, Delaere B, Sonet A, Bosly A, Glupczynski Y. A 62-month retrospective epidemiological survey of anaerobic bacteraemia in a university hospital. Clin Microbiol Infect. 2006;12:527–32. DOIPubMedGoogle Scholar
Stevens DL, Aldape MJ, Bryant AE. Life-threatening clostridial infections. Anaerobe. 2012;18:254–9. DOIPubMedGoogle Scholar
Gajdács M, Urbán E. Relevance of anaerobic bacteremia in adult patients: A never-ending story? Eur J Microbiol Immunol (Bp). 2020;10:64–75. DOIPubMedGoogle Scholar
Bryant AE, Chen RY, Nagata Y, Wang Y, Lee CH, Finegold S, et al. Clostridial gas gangrene. I. Cellular and molecular mechanisms of microvascular dysfunction induced by exotoxins of Clostridium perfringens. J Infect Dis. 2000;182:799–807. DOIPubMedGoogle Scholar
Bryant AE, Chen RY, Nagata Y, Wang Y, Lee CH, Finegold S, et al. Clostridial gas gangrene. II. Phospholipase C-induced activation of platelet gpIIbIIIa mediates vascular occlusion and myonecrosis in Clostridium perfringens gas gangrene. J Infect Dis. 2000;182:808–15. DOIPubMedGoogle Scholar
Ohyama K, Fujimoto M, Nakagomi Y, Ohta M, Yamori T, Kato K. Effect of cyproterone acetate on active and inactive renin secretion in patients with precocious puberty and genetic short stature. Horm Res. 1991;36:216–9. DOIPubMedGoogle Scholar
Takazawa T, Ohta J, Horiuchi T, Hinohara H, Kunimoto F, Saito S. A case of acute onset postoperative gas gangrene caused by Clostridium perfringens. BMC Res Notes. 2016;9:385. DOIPubMedGoogle Scholar
North JP. Clostridial wound infections and gas gangrene; arterial damage as a modifying factor. Surgery. 1947;21:364–72.PubMedGoogle Scholar
MacLennan JD. The histotoxic clostridial infections of man. Bacteriol Rev. 1962;26:177–276. DOIPubMedGoogle Scholar
Srivastava I, Aldape MJ, Bryant AE, Stevens DL. Spontaneous C. septicum gas gangrene: A literature review. Anaerobe. 2017;48:165–71. DOIPubMedGoogle Scholar
Shen A, Ologun GO, Behm R. Fulminant hepatic failure and fatal cerebral edema following Clostridium perfringens bacteremia: case report and review of literature. Cureus. 2017;9:e1714. DOIPubMedGoogle Scholar
Wazir M, Jain AG, Nadeem M, Ur Rahman A, Everett G. Clostridium tertium bacteremia in a non-neutropenic patient with liver cirrhosis. Cureus. 2019;11:e4432. DOIPubMedGoogle Scholar
Simon TG, Bradley J, Jones A, Carino G. Massive intravascular hemolysis from Clostridium perfringens septicemia: a review. J Intensive Care Med. 2014;29:327–33. DOIPubMedGoogle Scholar
Fujita H, Nishimura S, Kurosawa S, Akiya I, Nakamura-Uchiyama F, Ohnishi K. Clinical and epidemiological features of Clostridium perfringens bacteremia: a review of 18 cases over 8 year-period in a tertiary care center in metropolitan Tokyo area in Japan. Intern Med. 2010;49:2433–7. DOIPubMedGoogle Scholar
Zahar JR, Farhat H, Chachaty E, Meshaka P, Antoun S, Nitenberg G. Incidence and clinical significance of anaerobic bacteraemia in cancer patients: a 6-year retrospective study. Clin Microbiol Infect. 2005;11:724–9. DOIPubMedGoogle Scholar
Leal J, Gregson DB, Ross T, Church DL, Laupland KB. Epidemiology of Clostridium species bacteremia in Calgary, Canada, 2000-2006. J Infect. 2008;57:198–203. DOIPubMedGoogle Scholar
De Keukeleire S, Wybo I, Naessens A, Echahidi F, Van der Beken M, Vandoorslaer K, et al. Anaerobic bacteraemia: a 10-year retrospective epidemiological survey. Anaerobe. 2016;39:54–9. DOIPubMedGoogle Scholar
Kirn TJ, Weinstein MP. Update on blood cultures: how to obtain, process, report, and interpret. Clin Microbiol Infect. 2013;19:513–20. DOIPubMedGoogle Scholar
Lévesque S, Dufresne PJ, Soualhine H, Domingo MC, Bekal S, Lefebvre B, et al. A side by side comparison of Bruker Biotyper and VITEK MS: utility of MALDI-TOF MS technology for microorganism identification in a public health reference laboratory. PLoS One. 2015;10:e0144878. DOIPubMedGoogle Scholar
Moreno R, Vincent JL, Matos R, Mendonça A, Cantraine F, Thijs L, et al. Working Group on Sepsis-related Problems of the ESICM. The use of maximum SOFA score to quantify organ dysfunction/failure in intensive care. Results of a prospective, multicentre study. Intensive Care Med. 1999;25:686–96. DOIPubMedGoogle Scholar
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83. DOIPubMedGoogle Scholar
Le Gall JR, Lemeshow S, Saulnier F. A new Simplified Acute Physiology Score (SAPS II) based on a European/North American multicenter study. JAMA. 1993;270:2957–63. DOIPubMedGoogle Scholar
Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Bauer M, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315:801–10. DOIPubMedGoogle Scholar
Fukui M, Iwai S, Sakamoto R, Takahashi H, Hayashi T, Kenzaka T. Clostridium paraputrificum bacteremia in an older patient with no predisposing medical condition. Intern Med. 2017;56:3395–7. DOIPubMedGoogle Scholar
Lopez-Fabal MF, Sanz N, Ruiz-Bastian M, Barros C, Gomez-Garces JL. Clostridium perfringens bacteremia, an analysis of 28 cases over 10 years in a university hospital of Madrid [in Spanish]. Enferm Infecc Microbiol Clin. 2018;36:225–8. DOIGoogle Scholar
Shindo Y, Dobashi Y, Sakai T, Monma C, Miyatani H, Yoshida Y. Epidemiological and pathobiological profiles of Clostridium perfringens infections: review of consecutive series of 33 cases over a 13-year period. Int J Clin Exp Pathol. 2015;8:569–77.PubMedGoogle Scholar
Shah M, Bishburg E, Baran DA, Chan T. Epidemiology and outcomes of clostridial bacteremia at a tertiary-care institution. ScientificWorldJournal. 2009;9:144–8. DOIPubMedGoogle Scholar
Yang CC, Hsu PC, Chang HJ, Cheng CW, Lee MH. Clinical significance and outcomes of Clostridium perfringens bacteremia—a 10-year experience at a tertiary care hospital. Int J Infect Dis. 2013;17:e955–60. DOIPubMedGoogle Scholar
Lark RL, McNeil SA, VanderHyde K, Noorani Z, Uberti J, Chenoweth C. Risk factors for anaerobic bloodstream infections in bone marrow transplant recipients. Clin Infect Dis. 2001;33:338–43. DOIPubMedGoogle Scholar
Duceau B, Picard M, Pirracchio R, Wanquet A, Pène F, Merceron S, et al. Neutropenic enterocolitis in critically ill patients: spectrum of the disease and risk of invasive fungal disease. Crit Care Med. 2019;47:668–76. DOIPubMedGoogle Scholar
Stabler S, Titécat M, Duployez C, Wallet F, Loïez C, Bortolotti P, et al. Clinical relevance of Clostridium bacteremia: An 8-year retrospective study. Anaerobe. 2020;63:102202. DOIPubMedGoogle Scholar
Libby DB, Bearman G. Bacteremia due to Clostridium difficile—review of the literature. Int J Infect Dis. 2009;13:e305–9. DOIPubMedGoogle Scholar
Urbán E, Terhes G, Gajdács M. Extraintestinal Clostridioides difficile infections: epidemiology in a university hospital in Hungary and review of the literature. Antibiotics (Basel). 2020;9:16. DOIPubMedGoogle Scholar
Lassmann B, Gustafson DR, Wood CM, Rosenblatt JE. Reemergence of anaerobic bacteremia. Clin Infect Dis. 2007;44:895–900. DOIPubMedGoogle Scholar
Morris AJ, Wilson ML, Mirrett S, Reller LB. Rationale for selective use of anaerobic blood cultures. J Clin Microbiol. 1993;31:2110–3. DOIPubMedGoogle Scholar
Lafaurie M, d'Anglejan E, Donay JL, Glotz D, Sarfati E, Mimoun M, et al. Utility of anaerobic bottles for the diagnosis of bloodstream infections. BMC Infect Dis. 2020;20:142. DOIPubMedGoogle Scholar
Dutton D, Gavrilova N. Massive intravascular hemolysis with organ failure due to Clostridium perfringens: evidence of intracytoplasmic C. perfringens. Blood. 2013;122:310. DOIPubMedGoogle Scholar
Angus DC, Linde-Zwirble WT, Lidicker J, Clermont G, Carcillo J, Pinsky MR. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. Crit Care Med. 2001;29:1303–10. DOIPubMedGoogle Scholar
Shankar-Hari M, Phillips GS, Levy ML, Seymour CW, Liu VX, Deutschman CS, et al.; Sepsis Definitions Task Force. Developing a new definition and assessing new clinical criteria for septic shock. JAMA. 2016;315:775–87. DOIPubMedGoogle Scholar
Figure 1. Survival analysis with Cox regression model for patients with Closteridiodes bacteremia, France. A) Forest plot of multivariate factors associated with overall survival. Predisposing conditions were trauma or surgery. B)...
Figure 2. Flowchart of the repartition of Clostridioides bacteremia in patients in France according to the presence or absence of hemolysis. Hemolysis was associated with a high mortality rate.
Figure 3. Several examples of hematogenous spreads or myonecrosis related to Clostridioides bacteremia in patients in France. All these localizations were associated with air formation. A) Brain abscess associated with pneumocephalus...
Table 1. Global characteristics of patients with Clotristridium bacteremia, France
Table 2. Clinical and biologic characteristics of patients with Closteridiodes bacteremia, France
Table 3. Characteristics of non–C. difficile bacteria in cases of Clostridioides bacteremia, France
Article Title: Non–C. difficile Clostridioides Bacteremia in Intensive Care Patients, France
Which of the following statements regarding the background of patients admitted to the intensive care unit (ICU) with Clostridioides bacteremia (CB) in the current study is most accurate?
Approximately half of patients with CB had no underlying comorbidities
>40% of patients with CB had cancer
>60% of patients had recent surgery or trauma
Septic shock at the time of admission was rare
Which of the following statements regarding the clinical presentation of patients with CB in the current study is most accurate?
Digestive symptoms were the most common presenting symptoms
Myonecrosis was present at admission in most patients
Most patients had evidence of acute hemolysis
Most patients had evidence of acute leukopenia
Which of the following statements regarding the microbiology of CB among patients in the current study was most accurate?
C. perfringens was isolated from > 30% of patients
< 10% of cases were polymicrobial
The rate of Clostridioides resistance to β-lactam antibiotics exceeded 50%
Patients treated with clindamycin experienced lower mortality rates compared with other antibiotics
All of the following factors were associated with a higher risk for death due to CB in the current study EXCEPT:
Older age
Higher Sequential Organ Failure Assessment (SOFA) score
Male sex
The presence of hemolysis
Original Publication Date: June 04, 2021
Table of Contents – Volume 27, Number 7—July 2021
Guillaume Morel, Medical Intensive Care Unit, Hospital Hautepierre—Hôpitaux Universitaires de Strasbourg, 1 Avenue Molière, BP 83049, 67098 Strasbourg CEDEX, France
Page updated: June 18, 2021
Page reviewed: June 18, 2021
July 2021expand
Non–C. difficile Clostridioides Bacteremia in Intensive Care Patients, Franceexpand
Morel G, Mulier G, Ghrenassia E, Abdel Nabey M, Tandjaoui Y, Kouatchet A, et al. Non–C. difficile Clostridioides Bacteremia in Intensive Care Patients, France. Emerg Infect Dis. 2021;27(7):1840-1849. https://doi.org/10.3201/eid2707.203471
Morel G, Mulier G, Ghrenassia E, et al. Non–C. difficile Clostridioides Bacteremia in Intensive Care Patients, France. Emerging Infectious Diseases. 2021;27(7):1840-1849. doi:10.3201/eid2707.203471.
Morel, G., Mulier, G., Ghrenassia, E., Abdel Nabey, M., Tandjaoui, Y., Kouatchet, A....Zafrani, L. (2021). Non–C. difficile Clostridioides Bacteremia in Intensive Care Patients, France. Emerging Infectious Diseases, 27(7), 1840-1849. https://doi.org/10.3201/eid2707.203471.


text:
Geoffrey Becker (born 1959) is an American short story writer, and novelist.

Life
He teaches at Towson University.  Graduated from Colby College in 1980.

His work appeared in Antioch Review, Colorado Review, Crazyhorse, Crescent Review, failbetter.com, Florida Review, Gettysburg Review, Kansas Quarterly, North American Review, Ploughshares, Prairie Schooner, Quarterly West, Roanoke Review, Sonora Review, The Cincinnati Review, West Branch.

He lives in Baltimore, Maryland.

Awards
 1995 Drue Heinz Literature Prize for Dangerous Men
 Nelson Algren Award, for Bluestown
 NEA fellowship,

Works

Short stories

Novels

Anthologies

 The Best American Short Stories (Houghton Mifflin, 2000) "Black Elvis"

References

1959 births
Living people
American short story writers
Colby College alumni
Towson University faculty
American male short story writers

redpajama_set_name: RedPajamaWikipedia


text:
November 5, 2012 by The American Partnership
Who Needs an Election?
By Ryan Devine
Widener University American Government Student
A fundamental principle in American culture has always been our ability and responsibility to vote in elections, especially the Presidential election. For just as long, "experts" have attempted to predict the winner's ahead of time through mock polls, demographic studies, political trends and other methods of taking the pulse of the nation. However, it appears that all of the professional polling companies might need to look elsewhere. There have been a few surprising elements that have an uncanny ability to predict the outcome of elections.
The first indicator that should be looked at is the sale of presidential 7-11 cups. Since 2000, the candidate whose cup created a higher profit for the convenience chain has also gone on to occupy the White House. While admittedly a short sample, going 3 for 3 in all of the elections the gimmick has been around is still impressive.
For a trend with a little bigger sample size, we can look at the most iconic team in sports today, the New York Yankees. Of the last 15 elections, the Bronx Bombers have made the playoffs 9 times. With the exception of 1996, every year that the Yankees have won the World Series, the Republican candidate has won the election and every time the Yankees make the playoffs but loose, the Democrats have won.
While the Yankees have one incorrect year over the 9 elections that their trend has been eligible, Halloween masks have an uncanny ability to be right. Since 1980 the candidate who has had the most replicas of his face sold as a costume for Halloween has won every election (which means Obama can stop working now and take a few days off according to several reports.)
The most popular and accurate best indicator is none other than the District of Columbia's own Washington Redskins. The franchise that has had exactly two winning years in the last 12 years, and on pace for another regardless of RGIII's heroics, is still the best in the world at predicting elections. Since 1937 there have been 18 elections. Anytime the Redskins win their last home game before the election, the incumbent has won the election 17 times. The lone exception was the 2004 election when the Redskins lost but President Bush retained the office. While some argue that since Bush didn't win the popular vote in 2000 the rule could be tweaked so that the party that previously won the popular vote and not the Electoral College was the one actually being predicted by the Redskins which would make them a perfect 18 for 18 it is kind of irrelevant since 17 for 18 is still a 94 percent accuracy rate.
With President Obama selling more masks and the Yankees bowing out to the Detroit Tigers in the ALCS, it appears Mitt Romney and his fellow Republicans will all be sporting brand new Cam Newton jerseys come Sunday when the Redskins host the Carolina Panthers in a game that Vegas currently has the Redskins as a 3 and a half point favorite.
Postscript: The Redskins lost their final home game before the election to the Panthers yesterday.
This entry was posted in Widener Students on Politics and tagged 2012 presidential election, 7-11, election predictions, redskins, yankees. Bookmark the permalink.
← Youngsters Not So Fired Up
Just Go Away Romney →

redpajama_set_name: RedPajamaCommonCrawl


It's been 15 months at Tattenhall Marina so we felt it was time for a change of scenery, on friday night we arrived late at the marina for our last sleep-over. The plan was to get up early and set off so we would reach our destination before the forecasted high winds and bad weather started later on that day. After the alarm went off at 07:30 we decided to stay snug and warm for a little longer.
By 9:20 we were ready to go, the day was looking promising with signs of some sunshine threatening to show through the clouds.
This was our first trip out on D.O.G this year and Buster's first ever trip on a boat as far as we know, he settled in immediately and loved the changing sights, smells and walkies.
It was a good feeling as we passed through the double locks and staircase knowing that we wouldn't have to do them again whenever we wanted to go anywhere, as usual some of the paddles weren't working, one lock took us thirty minutes to fill.
Buster's a very friendly dog and loves to play and meet other doggies, so much so that we have to keep him on the lead at all times as he still needs to learn to come back when we call him.
Mark didn't have Buster on the lead when we went up the locks at Hurleston junction, Buster took his chance for freedom and was off the boat running around the field at the bottom of the reservoir, there was absolutely no chance of catching him, luckily Buster decided to taunt us further by doing some close run by's and came a little bit too close so Mark managed to corner him and got him back under control. Lesson learnt.
The approach into Swanley Bridge Marina.
Corinne and Buster watched as Mark filled up the water.
Buster saying I need a cuddle.


text:
Q: Align  one below another in React Native view I'm trying to set 3  one below another inside my view. However, it is a mess as you can see in the image below.

My render method:
renderItem = ({ item }) => {
    const callIcon = 'https://img.icons8.com/color/48/000000/phone.png';

    return (
      <TouchableOpacity>
        <View style={styles.row}>
          <Image source={{ uri: item.image }} style={styles.pic} />
          <View>
            <View style={styles.nameContainer}>
              <Text style={styles.nameTxt}>{item.name}</Text>
            </View>
            <View style={styles.end}>
              <Text style={styles.details}>Unit: {item.unitName}</Text>
              <Text style={styles.details}>{'\n'}Lease End Date: {item.leaseEndDate}</Text>
              <TouchableOpacity onPress={() => this.sendEmail(item.tenantEmail)}>
                <Text style={styles.details}>Email: {item.tenantEmail}</Text>
              </TouchableOpacity>
            </View>
          </View>
          <TouchableOpacity onPress={() => this.makeCall(item.tenantPhone)}>
            <Image style={[styles.icon, { marginRight: 50 }]} source={{ uri: callIcon }} />
          </TouchableOpacity>
        </View>
      </TouchableOpacity>
    );
  }

  render() {
    return (
      <View style={{ flex: 1 }} >
        <FlatList
          extraData={this.state}
          data={this.state.calls}
          keyExtractor = { (item) => {
            return item.id;
          }}
          renderItem={this.renderItem}
        />
      </View>
    );
  }

And here are my styles:
const styles = StyleSheet.create({
  row: {
    flexDirection: 'row',
    alignItems: 'center',
    borderColor: '#dcdcdc',
    backgroundColor: '#fff',
    borderBottomWidth: 1,
    padding: 10,
    justifyContent: 'space-between',

  },
  pic: {
    borderRadius: 25,
    width: 50,
    height: 50,
  },
  nameContainer: {
    flexDirection: 'row',
    justifyContent: 'space-between',
    width: 270,
  },
  nameTxt: {
    marginLeft: 15,
    fontWeight: '600',
    color: '#222',
    fontSize: 15,

  },
  mblTxt: {
    fontWeight: '200',
    color: '#777',
    fontSize: 13,
  },
  end: {
    flexDirection: 'row',
    alignItems: 'center',
  },
  details: {
    fontWeight: '400',
    color: '#666',
    fontSize: 12,
    marginLeft: 15,
  },
  icon: {
    height: 28,
    width: 28,
  }
});

How can I fix the screen?
BTW... I'm use to bootstrap and frontend development, but I am new with react native, so if I am developing the screen wrong, please let me know

A: Set flexDirection to column in styles.end. Since alignItems is center, they will all be centered, so you can remove that to align them all to the left.
end: {
  flexDirection: 'column',
},

redpajama_set_name: RedPajamaStackExchange


text:
L'Eden dei lunatici è il secondo album in studio da solista del cantautore italiano Umberto Palazzo, pubblicato il 5 luglio 2020.

Il disco
L'idea di realizzare un secondo disco da solista è maturata in Umberto Palazzo in seguito alle restrizioni sociali imposte dalla quarantena causata dalla pandemia da COVID-19. L'album, intitolato L'Eden dei lunatici, è stato scritto, prodotto e registrato dal 17 aprile al 23 maggio 2020 presso lo studio di registrazione di Palazzo. Pubblicato il 5 luglio 2020 solo dopo il termine della quarantena, il disco è stato distribuito da Diggers Factory e anticipato dai singoli Il moscone e La riviera.

Palazzo ha descritto L'Eden dei lunatici come un concept album incentrato sull'estate e un omaggio alla giovinezza, influenzato – da un punto di vista stilistico – dalla musica funk e dal pop soul tipico della canzone italiana degli anni settanta.

Tracce

Note

Collegamenti esterni


text:
Q: user defined functions returning multiple values in sql I have the following tables in sql :

I want to write an function that will take Student_ID as parameter and return the Student_Name and Balance from the above table.
How can I do that  ?

A: CREATE DEFINER=`root`@`localhost` PROCEDURE `myproc`(IN `id` INT)
NO SQL
SELECT student.Student_Name, account.Balance
FROM student INNER JOIN account
ON student.Student_ID = account.Student_ID
WHERE student.Student_ID = id

you can create procedure from phpmyadmin:
How to write a stored procedure in phpMyAdmin?

A: Function can be created as:
CREATE FUNCTION function_name(@Student_ID int)
RETURNS @name_and_balanceTable TABLE
(
    -- Columns returned by the function_name
    Name nvarchar(50),
    Balance int
)
AS
-- Returns the Name and Balance for particular Student_ID
BEGIN
    -- Selecting the name and balance
    SELECT
        @Name = st.Student_Name,
        @Balance = ac.Balance
    FROM Student st JOIN Account ac ON st.Student_ID = ac.Student_ID
    WHERE st.Student_ID = @Student_ID;

    -- Insert these value into table
    BEGIN
        INSERT @name_and_balanceTable
        SELECT @Name, @Balance;
    END;
    RETURN;
END;

This is for sql-server.
For more information use this link...


Stress can affect us in many ways but physiologically, it has a dramatic effect on our adrenal glands & our blood pressure. Hawthorn leaf will help to settle & regulate blood pressure, Withania & Siberian Ginseng will soothe the adrenals & Yarrow will help to settle a stressed tummy. Because we hold out emotions & our immunity in our gut , it is important to relax the tummy muscles & Yarrow is a good herb for doing that.
Ingredients: Hawthorn leaf, Siberian ginseng, Withania, Yarrow.


text:
REVIEW PANELISTS
MENTOR ARTIST FELLOWSHIP
NATIVE NATION PARTNERSHIPS
California's American Indian & Indigenous Film Festival
Barbara Soulé
The Native Arts and Cultures Foundation is proud to support California's American Indian & Indigenous Film Festival (CAIIFF), taking place November 2 – 4, 2017 in Temecula, California. The California Indian Culture and Sovereignty Center (CICSC) at California State University San Marcos (CSUSM) presents its 5th annual film festival celebrating American Indian arts and culture through the medium of film. CICSC provides Southern California movie goers with opportunities to experience American Indian life and culture through uplifting and empowering film narratives that explore what it means to be Indian in the 21st century. They feature films that highlight American Indian storytelling traditions and weave connections through community, identity, history, the past, present, and future. Providing access to these films is another key goal for CAIIFF, so they partner with the Pechanga Resort and Casino as the festival's venue in order to maximize accessibility for local communities. The 2016 festival, also sponsored by the Native Arts and Cultures Foundation, was a huge success, and festival staff anticipate that this year's festival will reach an even wider audience.
This year's lineup includes dozens of films, shorts, and documentaries by American Indian & Indigenous filmmakers, producers, directors, and actors that address the most pressing issues in Native America today. With support from sponsors like NACF, CAIIFF is able to bring in filmmakers and artists, offering several Q&A sessions with the actors. They have also been able to make tickets available for free to high school and college students this year. Below is their main event schedule, to learn more about these events, visit their website at https://www.caiiff.com/
Thursday Session (Opening Night Feature): November 2, 7:30pm
Rumble: The Indians Who Rocked the World directed by Catherine Bainbridge
Performance by Taboo (of the Black Eyed Peas) and Mag7 (Supaman, Zack "Doc" Battiest, Spencer Battiest, Emcee One, Drezus, PJ Vegas, Natalia 'My Verse') after the screening.
Friday Session: November 3, 7:30pm
Friday Night Funnies: A Tribute to Charlie Hill featuring The 1491s
Afternoon Shorts Program: November 4, 12:00pm
#stillhere, Baby, Believer, C&J Forever, Feed the Wolf, Kéwku, Kia Tau (Be at Rest), Missing Indigenous, My Once Life, Nan isht Akokpachi (The Gift), The American Indian Veteran, Three Thousand, Uktena and Thunder (ᎠᏴᏓᏆᎶᏍᎩ ᎠᎴ ᎤᎧᏖᎾ), Unintentional Mother
Saturday Youth Track: November 4, 12:30pm
Workshop with Artist/Filmmaker Steven Paul Judd
Youth Shorts Program: Acorn, Army Manimation, Bzindan (Harmony), Censored Heritage, Dream the Impossible, Nan isht Akokpachi (The Gift), Shaman, Steven Paul Judd, Sun and the Great, The Importance of Dreaming, The Mountain of SGaana, The Theft of Fire, The Wounded Healer, Tribal Pride, Ukaliqu and Kalla Go Fishing, Ya-Ka (Our Water)
Environmental Program: November 4, 2:00pm:
Featured Shorts: Defend the Sacred directed by Kyle Bell (Thlopthlocco/Creek), Unearthed directed by Zulfiya Hamzaki & Erin Semine Kökdil
Featured Film: United by Water directed by Derrick LaMere
Matinee Documentary Film: November 4, 3:30pm:
Mankiller directed by Valerie Red-Horse Mohl
Saturday (Closing Night Feature): November 4, 7:30pm
Hostiles directed by Scott Cooper
"We are thrilled to be holding this special screening of "Hostiles" on tribal lands with invited American Indian political and cultural dignitaries from throughout Indian Country," said Dr. Joely Proudfit, CAIIFF Director. Accompanying the film at the screening will be Director Scott Cooper, and stars Wes Studi and Q'orianka Kilcher.
NACF supports CAIIFF in our ongoing efforts to bring valuable perspectives to contemporary life as well as provoke critical thinking and spark meaningful discussions. Through the medium of film, directors, filmmakers, producers, writers, and actors have the opportunity to share their stories with a diverse audience. CAIIFF's commitment to bring these films to a wider audience helps provide a sense of community to those who see themselves represented on the big screen. We hope that this festival not only brings people together, but can serve as a learning experience to all who come to enjoy the events. On behalf of NACF, Director of Programs Francene Blythe will be attending.
2017, California, Event, Film, Support for Native Arts and Cultures, Youth Engagement
National Headquarters Office
400 E. Evergreen Blvd., Suite 102
native_art_culture
Our hearts are heavy with the loss of Marshall McK
Donate $10 or more today (12/15) to NACF through P
!!TODAY IS A BIG GIVE DAY!! - Donate $10+ through
It's not too late to contribute on #GivingTuesda
TODAY ONLY! Donate $10 or more to NACF today throu
SUPPORT NATIVE ARTS! When you donate to NACF today
All donors who donate $50 or more to NACF today th
#Donate today & your gift will be matched up to 6
Special opportunity today thanks to Patagonia, whe
© 2021 Native Arts & Cultures Foundation


text:
Star Wars Funnies
Star Wars Backgrounds
Star Wars Quotes
Navigate to...TopicsArticlesPhotography;LifestyleSelf ImprovementWordPressSocial MediaMarketingGuest Posts
The Top 10 Must-Have Apps for a Star Wars Nerd
Smart devices. We've all got them, and thankfully, they can run a multitude of Star Wars related apps. It can, however, be somewhat tedious to rake through the muck of the hundreds upon hundreds of Star Wars apps available in the different app stores... Plus, outside of the obvious big-name selections out there, what's good and what's best left untouched? Well, I'm hoping this review will answer these questions for you.
Just for reference, my list of 10 apps is based off of the following things:
1. Star Wars-ness (how true to Star Wars it is)
2. Enjoyability (how much use I found in it)
3. Difficulty (How easy it is to pick up, use/play and enjoy)
4. Availability (How many different devices can use it)
Also, please note that I am testing these apps and games based off of my experience with the following devices (I can't guarantee all of these apps will be available for your specific device):
- Windows 8.1 Laptop (most apps should also run on Tablet devices as well as phones however)
- Apple iPhone 4, iPad 3
- Google Nexus 5 & 10
- PC (for some Apple exclusives that were ported over from Windows)
- Blackberry Playbook
At any rate, disclaimers aside, let's get on to the list.
10. Star Wars Almanac
I really like this app. It's a Windows-only exclusive (and may be the only Windows exclusive to make the list) but it's a well-designed app that provides some good Star Wars information on the go. I haven't used the app extensively yet, but when I have used it, I have been pleasantly surprised. While I like this app however, and the information it provides is invaluable to any Star Wars nerd, it's exclusivity to Windows Phone makes it regrettably unavailable to pretty much everyone. For that reason, even giving it the number ten spot was a stretch (but I did anyways).
Availability: Windows Phone OS
Close Seconds: Star Wars Alphabet and Star Wars Creatures
Similar apps, like "Star Wars Alphabet," (which is really just an almanac for kids if you think about it) is available for Windows Phone OS, and "Star Wars Creatures," an Almanac and sound board combination, which exists for Android, are some great alternatives to the Star Wars Almanac. Not as great in my opinion, but they are some other options to consider.
9. QuizUp
Quiz Up is loads of fun. Granted it's not really a "Star Wars," app, but within the app it has a specific Star Wars section where you can compete against other people to test your knowledge of the Star Wars universe. Not only does this help you feel accomplished when you crush others with your Star Wars expertise, but it's a load of fun and can even be challenging at times. However, while the enjoyability and difficulty of Quiz Up scored very high, the Star Wars-ness and availability brought it right back down to settle in at the number nine spot.
Availability: iOS
Close Second: Star Wars Trivia
A great alternative to Quiz Up is "Star Wars Trivia," for Android. It is a fun, albeit simple, Star Wars trivia game for Android. While enjoyable and challenging, Android exclusivity means that it didn't make the cut.
8. Star Wars Message Sounds
While not the prettiest app around, Star Wars Message Sounds stays true to it's word in bringing some serious Star Wars sound to your phone. Not only is it an awesome soundboard however, it can also be used to change a phone's ringtones right there within the app! How handy! Everything from R2D2's bleep's for a text message tones, to a Darth Vader quote for a ringtone, you can find a wide array of various noises to tickle your fancy within this app (as well as many other similar apps). While Blackberry and iOS are lacking these sorts of apps, Windows and Android have numerous which all do the same function. A great asset to any aspiring Star Wars fan.
Availability: Windows Phone OS, Android
7. Jedi Lightsaber
This app is an app of many names and iterations. Seriously though, there are several different apps that all do the same thing on iOS, Blackberry OS, Android and Windows Phone OS. It's easily the most universally available app on the list. That being said, the level of enjoyment you derive from this app is likely to be linked with number of times you've used it. First time it's pretty cool, it makes sounds and maybe you even try to "duel," with another smart-phone user. Second time, the novelty wears off. Third time you may be tempted to delete it, etc... Any Star Wars fan, however, should at least download one of these apps and use it once. It's simply a must and as such, it makes the list.
Availability: Windows Phone OS, Android, iOS, Blackberry OS
6. Star Wars Pit Droids
This is a Star Wars puzzle game that requires users place colored arrows to direct pit droids into colored holes. That really about sums it up. It can be difficult at times, but for the most part shouldn't be overly taxing on anyone over the age of... let's say, 10? Getting three stars on every level may prove more of a challenge however. Controls and graphics also give this app some bonus points, not to mention, the gameplay is really very conducive to a mobile device, since it favors pick-up-and-play mechanics... Alas, it is an iOS exclusive and loses a lot of points for that. Therefore, even though I really like it, I couldn't give it any higher than 6th spot.
Side note: For those who really want to play this game, you can find PC versions (the game was released on PC first in 1999) on eBay for a very reasonable price. You'll need an optical drive and I'm not sure how they will run on a 64bit Windows 8.1 machine, but it may be worth a try.
5. Star Wars: The Force Collection
I'm not much of a fan of this game to be honest. It's a card collecting app that I've devoted an entire 20 seconds (maybe 30) to. Truth be told, I probably haven't given it as much time as I should to be reviewing it, but it's just not a game I can see myself getting into. That being said, I have read other reviews of the game online. It seems to function similarly to other card-battling games available online, but it does "try to offer a new and compelling story," (http://www.pocketgamer.co.uk/r/iPhone/Star+Wars%3A+Force+Collection/review.asp?c=53575). While maybe not as polished as some other mobile-phone enabled card battling games, it receives mostly positive reviews, and it's available on both Android and iOS (arguably the two most important platforms for any app to survive/thrive). Furthermore, I know a lot of people are into games like this, so I had to give it credit where credit is due. Even though I'm not a fan, I think it's number 5 in terms of ultimate Star Wars apps.
Availability: iOS, Android
4. Star Wars Pinball 1 & 2
I'm a big fan of this game. Sure, Pinball games aren't for everyone, but I think everyone can probably remember 3D Pinball for Windows.
That was a blast, wasn't it? When I tried Star Wars Pinball for the first time the nostalgia blast was crazy great. The controls were a little... clunky at times, and the app itself costs a dollar (most other apps on this list are free) but all-in-all I think this app is a winner. It was annoying that you had to pay to get more boards within the game itself, but I was able to overlook this and just enjoy the pure Star Wars pinball that was both challenging and fun to look at. I'm probably giving this app more credit than it's due, but since it's a simple to understand game that works well for casual gamers (unlike ones like Star Wars Force Collection, for example) I decided to give it the number 4 spot.
Also, I should note that when I went looking for Star Wars Pinball version 1 I actually couldn't find it on any app store, but I swear it exists. The second version wasn't hard to find though.
3. Star War Lego
Lego has really carved a niche for themselves in coming up with fun and often humorous games that showcase their little Lego men in iconic roles such as Lord of the Rings, Batman and more. Star Wars is no exception of course. Lego Star Wars stands as out as one of the highest quality and totally free games on this list. While the story-line is, well, lacking in many ways, the gameplay is great fun and the fun graphics really make for an enjoyable and true-to-Star-Wars experience. Furthermore, while the app is available on iOS and Android, iOS has a second version that actually covers the entire saga (as in the story of the movies)! It looks just like the versions you can find on Xbox or Playstation. I imagine this edition will soon come to Android as well. Gameplay and graphics, combined with 100% on the Star Wars-ness scale easily earn this app the number three spot on this list. The only disadvantage to this game is that, as of yet, the complete saga is only available on iOS. That's it really.
2. Star Wars: Knights of the Old Republic
Star Wars: Knights of the Old Republic isn't just one of the best games on a mobile device, it's one of the best games ever. I won't delve into the story, but if you are a Star Wars fan and you've never played this game then you should be ashamed. Seriously. It's that good. Staying true to the Star Wars name and franchise, this game takes you right into the Star Wars universe thousands of years before the movies transpire. With elements of Action, RPG and even puzzle-solving, this game will challenge you, entertain you, and definitely surprise you. While it is the most expensive app on the list, it is also easily the most impressive! Even this god of the gaming world comes with a couple of cons, however. First, it's a little on the expensive side (though worth every penny). Second, the controls are a little... lackluster (though third-party controller support is likely to come in the future), and finally, it's an iOS exclusive (though it may come to Android eventually UPDATE: It is now available on Android!). I can't rave enough about this game though. A definite must-have for any Star Wars fan.
Availability: iOS, Android, Fire OS
1. Star Wars Angry Birds 1 & 2
Finally, we come to the last app on the list. I realize now that a lot of games have made the list, and I think that's ok, because... Well I'm a gamer at heart and games are fun. Rounding out this list is one of the greatest mobile games available today: Star Wars Angry Birds. If you've never played Angry Birds before, then Star Wars Angry Birds may be the best way to get involved with the franchise. Sure, it's a little ridiculous that they keep milking the angry bird's cow with new versions of the exact same thing, but the Star Wars iteration is definitely worth your time. Not only is the gameplay great, but the Star Wars twist allows for some fun beyond what we've come to expect with Angry Birds. This app stays true to the franchise and provides some of the best pick-up-and-play fun you can get on a mobile device. That, combined with the widespread availability of this app, it's difficulty, and its high level of enjoyment earns Star Wars Angry Birds the number one spot in my list of top ten apps for any Star Wars nerd... And yes, I own and have beat both versions 1 & 2.
Availability: iOS, Android, Windows Phone
Well, that's my list and I hope you liked it! Did I miss your favorite Star Wars app? Please let me know in the comments below and thanks for reading!
Final Honorable Mentions:
Star Wars: Tiny Death Star
If I were to include this app, it would probably fit in at around the #4 or #5 spot. However, this game throws so many annoying notifications at me, and the Star Wars aspect really offers no unique differences over its "Tiny Hotel," predecessor, so I decided to exclude it from the list. Mostly because I'm so sick of the notifications.
Pocket Pazaak
Pazaak, a game that many will recognize from Star Wars: Knights of the Old Republic, is also available as an app... Regrettably, it's only available for Blackberry OS as well as Android. That, combined with the fact that Pazaak really isn't that fun, means that it didn't quite make the cut.
Posted In: Angry Birds, Apps, Star Wars, Star Wars Apps
Kekey Kekey December 9, 2018 at 7:34 PM
Cara mengatasi haid berkepanjangan
Cara mengobati perut begah secara alami
Cara menyembuhkan tumor abdomen
Cara menghancurkan batu empedu secara alami
seo October 13, 2019 at 11:48 AM
Use on screen controls to move the frog. Cross the road and canal, get to the finish line to win the game. Jumpy Frog - Road Cross
Star Wars: The Prequels are Just as Good
ABSTRACT Star Wars is part of a very special club. Few movies have captivated and amazed audiences around the world like the Star W...
Star Wars: When to watch which?
Star Wars fans have long quarreled over the age-old question of viewing order. Of course, for the older generation, there was always just...
Here are some of my favorite Star Wars background pictures! Enjoy! This is just a really well done version of the words, you know? I ...
How to Make a Lightsaber Using Pixlr
I don't pretend to be a Photoshop master, but I know my way around the program pretty well. Well enough that a surprising amount of peop...
Why Boba Fett Isn't My Favorite
Well, the people have spoken, and the winner (by a landslide) was... Boba Fett! I should have guessed as much. Just for the record, I didn&#...
Let's chat about Star Wars: The Force Awakens
We did it (well okay, Disney did it). After 10 years without a Star Wars movie, we finally got to see the adventures of the Skywalker f...
Smart devices. We've all got them, and thankfully, they can run a multitude of Star Wars related apps. It can, however, be somewhat tediou...
An Ode to Ben Quadinaros the Podracer
Do you know his story? Ben Quadinaros was a pod racer of a most peculiar kind, Though he was a Toong, he was brazen and refined, ...
Why so Grievous?
You probably know him, as a ruthless half machine But let me tell you something, he wasn't always mean. He was born on Kale...
How to Market Like a Jedi
I work in the advertising business, and occasionally I write articles for my office's blog. Now I'm passionate about my job, but ...
© 2013 Brian on Star Wars is designed by Templateify
Contact Me — About — Copyright — Privacy — Disclaimer — Sitemap XML


You didn't seriously think i would go through the Easter weekend without adding a really bad Easter related pun in somewhere did you?
On a more sombre note though, yesterday's result saw the grey clouds regather over an already subdued and annoyed Liverpool fan base. There were numerous moments throughout the game that were top of the moaners lists.
Make no bones about it, i had a moan myself, but quite astonishingly it is again clear as to what most fans feel and what most fans are more concerned about at this moment in time.
Whilst my first reaction was the sheer fear of what finishing out of fourth place could do to us. I.e. with Hicks and Gillett already dragging the club into so much debt, they idiotically based our finances on assumption of qualification into the Champions League, failing to do so could see us add another £40million or so to our already unsteady financial situation.
Liverpool were held to a very frustrating and disappointing 0-0 stalemate last night at Molineux. For my first ever experience of seeing the lads play, there weren't too many positives.
After meeting Kenny Dalglish moments before i sat down to watch the match, i was beginning to think nothing could top that now, and it didn't. I also met that Farley bloke after he came into the boardroom to do some of his now famous Liverpool impressions, however, the match that followed would not provide much to smile about.
So the first shock of the night came when i was handed the team sheet in the boardroom, i could not believe Gerrard was starting, i knew it was now highly likely that he would be on the bench, but i would never of guessed he would of started let alone play the full 90minutes.


text:
<?php
require_once dirname(dirname(dirname(__FILE__))).'/index.php';
$modx->request->handleRequest(array('location' => 'system/registry/register'));

redpajama_set_name: RedPajamaGithub


Below you can view all the homes for sale in the Keystone subdivision located in Tarpon Springs Florida. Listings in Keystone are updated daily from data we receive from the Tampa multiple listing service.
To learn more about any of these homes or to receive custom notifications when a new property is listed for sale in Keystone, give us a call at 813-452-4250.


Home LandlordZONE Update The Deregulation Act 2015: Landlords beware!
The Deregulation Act 2015: Landlords beware!
The Deregulation Act 2015 ("the Act") was passed on 26 March 2015 and will be of interest both to landlords and those appointed to deal with residential properties. Below is a brief summary of those points, some of which only apply to properties in England, and the practical implications.
Deposits taken before 6 April 2007, for tenancies which have subsequently moved onto a periodic tenancy on or after this date, now need to be protected in a Tenancy Deposit Protection scheme if the tenancy is still running. If a deposit remains unprotected, the landlord could potentially face a fine.
For deposits taken before 6 April 2007, where the tenancy became periodic before this date, the landlord is not required to protect the tenant's deposit. However, the landlord won't be able to serve a section 21 notice to regain possession of a property unless the deposit is protected.
If a tenancy is renewed or rolls over on a periodic basis, landlords don't need to reissue Prescribed Information to a tenant if the deposit remains with the same authorised scheme, and the parties and premises remain the same.
The legislation has also clarified that the reference to 'the landlord' within the Prescribed Information includes those acting on behalf of the landlord, such as letting agents.
These provisions restrict a landlord's ability to serve a Section 21 notice in circumstances where the tenant has complained about the condition of the premises or the common parts of a building of which the premises form part, and the landlord either did not respond within 14 days, provided an inadequate response or responded by serving a Section 21 notice.
The tenant can then complain to the housing authority which may serve various types of enforcement notices on the landlord. If the housing authority does this, the landlord cannot serve a Section 21 notice within six months of the date of service of the enforcement notice.
These new provisions will apply to ASTs granted on or after 1 October 2015. They will not apply to a fixed term AST granted prior to that date even if, after 1 October 2015, the fixed term AST becomes a statutory periodic tenancy. The position changes, however, after the end of the period of three years, at which point the provisions will apply to any AST in existence.
Before serving a Section 21 notice, consider why it is being served. If the strategy is to recover possession in order for the lender to exercise a power of sale, this strategy should be confirmed in writing before service of the Section 21 notice.
A landlord will not be able to serve a Section 21 notice if the landlord is in breach of a "prescribed requirement". The prescribed requirements will be set out in regulations and will relate to the condition of dwelling houses and their common parts, the health and safety of occupiers of dwelling houses, and the energy performance of dwelling houses. As such, they could be quite wide and may impose onerous obligations on landlords to ensure compliance prior to serving a notice.
The Secretary of State will be able to make regulations requiring a landlord to provide prescribed information about the rights and responsibilities of the landlord and tenant under the AST. The landlord will not be able to serve a Section 21 notice if they are in breach of this requirement.
A landlord will not be able to serve a Section 21 notice within the first four months of the tenancy.
There will be a statutory right for the tenant to claim back rent paid in advance where a Section 21 notice brings the tenancy to an end before the end of a payment period.
The new rules will apply to ASTs granted on or after the date on which the relevant provision (as set out above) comes into force. They will not apply to a fixed term AST granted prior to that date even if, after the relevant date, the fixed term AST becomes a statutory periodic tenancy. The position changes, however, after the end of the period of three years from the date on which the provision came into force, at which point it applies to any AST in existence.
We found out that the Landlord had not placed his deposit into a TPS until Sep 2016 because it had been sat in her Personal account and forgot, bearing in mind they rent other properties out too.
Nor did they provide my partner with an EPC, Gas safety certificate and how to rent guide until my partner put it to them which they responded very quickly in September this year they have not uphered to the Landlords code at all.
As for a repair on the shower it had taken them 6 months to repair from April-October 2016.
Now they have served the first stage of a Section 21 and given a 2 months notice.
Are they Legally allowed to do this.
Providing they met the serving conditions as you mentioned they could be legal. This must serve the version of the right to right guide current at the time of commencement of the tenancy.
However, the deposit rules have been broken including not serving the statutory information, so the landlord would need to refund the deposit to you BEFORE serving the section 21 notice.
You would also be in a position to claim up to three times the deposit as well as the return of the deposit from the landlord.


text:
Small-cell, Wi-Fi backers advancing their technology
Small Cell Forum pushes progress beyond femtocells
Wi-Fi, small cells could disrupt mobile
Wi-Fi Passpoint standard could end hotspot sign-on hassles
3G, 4G, Wi-Fi coming together in small cells
The first LTE small cell from ip.access, for use inside buildings, will include a slot for Wi-Fi
Senior U.S. Correspondent, IDG News Service |
The age of monolithic cell-tower networks with a few Wi-Fi hotspots and home femtocells sprinkled in may come to an end at this year's Mobile World Congress, where a diverse range of small cells and integrated Wi-Fi systems will be on display.
One of the infrastructure vendors stepping up its game will be ip.access, the maker of AT&T's MicroCell consumer femtocell. On Thursday, the U.K.-based company announced plans for the E-100, its first combination 3G and 4G small cell, with a Wi-Fi upgrade slot, for enterprises and indoor public spaces such as malls and stadiums. It will demonstrate the E-100 at Mobile World Congress and expects to have it in field trials in the first quarter of next year.
Mobile operators are looking at smaller cells and Wi-Fi to better cover indoor spaces and crowded areas, with Wi-Fi offering the added benefit of taking users off the carrier's scarce licensed spectrum. New technology is emerging for managing these new types of infrastructure in a larger network and for subscribers to shift between different radios invisibly. But exactly how carriers will use smaller cells and Wi-Fi is still emerging.
Mobile World Congress, beginning Feb. 27 in Barcelona, is expected to become the stage for many debuts in this area. Already, Alcatel-Lucent has announced lightRadio Wi-Fi, a technology to more tightly integrate Wi-Fi with its cellular infrastructure, and will demonstrate it at the show. Last week, Stoke announced an appliance for shifting users onto Wi-Fi hotspots. Earlier this week, BelAir Networks announced performance and management enhancements to its GigXone lineup of small cells and access points. And on Wednesday, the femtocell industry group Femto Forum said it would change its name to Small Cell Forum to better reflect the diversity of smaller cells stretching beyond tiny femtocells designed for homes.
"These guys are doing this because they're hearing this from operators," analyst Peter Jarich of Current Analysis said.
The E-100 is a small cell designed for heavier duty than a consumer femtocell. The device is designed to serve as many as 64 subscribers with 4G LTE (Long-Term Evolution) and simultaneously support 32 users with 3G. It will include 3G UMTS (Universal Mobile Telecommunications Service) technologies up to 42Mbps (bits per second) and will be able to offer 150Mbps on LTE, said Andy Tiller, senior vice president of marketing and strategy at ip.access. All the users on the small cell will share those capacities.
The E-100 will have an integrated antenna and a range of about 100 meters, Tiller said. An Ethernet port will provide both wired backhaul and the power to run the unit. Carriers will also be able to implement other types of backhaul as needed, he said.
The add-on Wi-Fi module is intended to give carriers an alternative network and eventually to supplement the capacity of the cellular radio. Carriers have been asking for this type of capability so they can offload traffic from their traditional outdoor network or get it off the cell network altogether, based on the demand for capacity, Tiller said. Using an emerging standard called IP Flow Mobility, the small cell will be able to use the 3G, 4G and Wi-Fi networks in combination for even more capacity, he added. Client devices as well as the cell would need additional software to make that possible.
The E-100 represents a big step up from femtocells such as the AT&T MicroCell, which forms a closed network for just a handful of users in a home, such as a family. Like most other femtocells, the MicroCell is intended primarily to improve indoor voice coverage. Enterprise-class small cells such as the E-100 are designed to add capacity in indoor settings, where outdoor macro cells may not be able to provide good performance.
A small cell with built-in Wi-Fi gives carriers options for how to provide wireless capacity in an enterprise or public venue, Jarich of Current Analysis said.
"It opens up a new model where you can go in and offer the Wi-Fi side of things, and at the same time catch the 3G side of things for yourself," Jarich said. "There's all sorts of stuff you can do when it's all in that one access point."
However, there are still unresolved issues about small cells, Ovum analyst Daryl Schoolar said. For example, it's not yet clear how small cells will communicate with macro cells to prevent interference between them, he said. To simply add mobile data capacity, many carriers will simply use Wi-Fi, he said.
"Small cell runs the risk of being just a little overhyped," Schoolar said.
Stephen Lawson covers mobile, storage and networking technologies for The IDG News Service. Follow Stephen on Twitter at @sdlawsonmedia. Stephen's e-mail address is stephen_lawson@idg.com
Stephen Lawson is a senior U.S. correspondent for the IDG News Service based in San Francisco.


text:
Bornholm er en dansk dokumentarisk optagelse fra 1914.

Handling
Sejltur langs Bornholms klippekyst: Helligdomsklipperne og Hammershus. Årstal anslået.

Referencer

Eksterne henvisninger

Dokumentariske optagelser
Danske film fra 1914


Get connected to one of the many ministries we have here at Liberty Baptist. God has gifted you in a special way, and we provide places for you to use those gifts! Looking for some direction? Fill out the form below and a Liberty staff member will contact you!


text:
Colorado Family Pictured Vacationing Before Father Allegedly Murdered Wife and Daughters
USZachary Stieber	Aug 23, 2018 ShareFacebookTwitterCopy Link	Comments
The Colorado family of four was vacationing in North Carolina just a few days before the father allegedly murdered his pregnant wife and two daughters, newly released pictures revealed.
The pictures show Shanann Watts, 34, who was 15 weeks pregnant with a baby boy, with one of her daughters.
Chris Watts, 33, is also visible in the pictures that were snapped by a North Carolina woman who was taking pictures of her family at Myrtle Beach earlier this month.
Michele Greer, the woman who took the pictures, told WLTX that she spoke to Shanann Watts while their children played together on the beach. The two families had met while in line for a bungee trampoline at the beach and hung out for a while after meeting.
"She was very sweet and very loveable with the girls; it was all about the girls," Greer told the broadcaster. "She was wonderful with the girls. She told me she was expecting; she was very happy. She was very engaged with her little girls."
Chris Watts, though, wasn't very engaged and seemed to be brooding, Greer added.
Slain family captured vacationing in Carolinas days before the murders https://t.co/TjO9vm2wpb pic.twitter.com/SBfERkzSD4
— NBC Charlotte (@wcnc) August 22, 2018
Chris Watts reportedly confessed to murdering his wife in Colorado, but claimed that she first strangled their two daughters.
He claimed he saw Shanann on the baby monitor strangling one girl, and when he rushed into the bedroom the other one was already dead, lying on the floor.
But investigators dismissed that claim and charged Watts with the murders of Shanann and their two daughters, Bella, 4, and Celeste, 3.
Greer told WLTX that, based on her interaction with Shanann, there's no way the expecting mother would kill her children.
"I don't believe it one bit," Greer said. "The person I saw interacting with her kids is not the person who would kill her children."
Chris and Shanann Watts in a file photo. (Shanann Watts/Facebook)
Bodies Found
The pictures were snapped on Aug. 2; Shanann Watts was last seen around 2 a.m. on Aug. 13 when a friend dropped her off at the Wattses' home after a work trip.
Investigators said the young girls were murdered on Aug. 12 or Aug. 13 and Shanann Watts is believed to have been murdered later on Aug. 13.
A search of the area eventually uncovered the bodies several days later, on the property of Anadarko Petroleum, where both Shanann and Chris worked before the murders.
Shanann was buried in the ground while the two girls were found submerged in oil inside of canisters.
Chris Watts was charged with five counts of murder, two of them because he's accused of killing two children under the age of 12, along with tampering with bodies and an unlawful termination of a pregnancy.
COVID-19 Turmoil Fuels Opioid Crisis: Expert


Build an interdisciplinary roadmap on human vs machine intelligence, potential algorithm's impact on human cognitive capabilities and decision making, and evaluation and regulation needs. Identify future research challenges and practical way to address them.
Build a community of researchers for the HUMAINT project to collaborate with.
Explore research synergies between this community.
Workshop information and details were published at the Science Hub event page.
The workshop gathered more than 45 experts from research and industry working in different disciplines, including neuroscience, psychology, computer science, philosophy, economy, law, health and music. The program was based on a set of short presentations followed by some panel discussions.
Which are the fundamental differences between human and machine intelligence? How do algorithms complement or replace human tasks now and how will they do this in the future? Will algorithms that take over some of our tasks affect the balance between human and machine intelligence?
Joan Serrà. Unintuitive properties of deep neural networks.
Gustavo Deco. Whole brain modelling and applications (slides pdf).
Karina Vold. Extended minds and machines (slides pdf).
Rubén Moreno-Bote. Slow and fast biases in decision making (slides pdf).
How do algorithms, when exploited in different applications, affect human cognitive capabilities? How do algorithms have the potential to modify the way humans make decisions based on them (e.g. influence of recommendations, personalization)? Which are the suitable strategies for effective human-algorithm interaction?
Henk Scholten. Digital Transformation – Governance of human societies.
Nicole Dewandre. Artificial intelligence: an interesting leverage point to rethink humans' relations to machines…and to themselves (slides pdf).
Carlos Castillo. Algorithmic discrimination (slides pdf).
Fabien Giraldin. Experience Design in the Machine Learning Era.
How should algorithms be evaluated in a research vs industrial context? Which are policy needs in terms of the usage of algorithms into real applications? Which is the research needed to support these policy needs?
Alessandro Annoni. Digital transformation and artificial intelligence: the policy-oriented perspective.
Martha Larson. Reality, requirements, regulation: points of intersection with the machine learning pipeline.
Anders Jonsson. Benchmarks and performance measures in artificial intelligence (slides pdf).
Ansgar Koene (UnBias project). The IEEE P7003 Standard for Algorithmic Bias Considerations (slides pdf).
Heike Schweitzer. Algorithmic decision-making by market intermediaries - in need of (which) regulation?
Presentation of several application contexts where there is an interaction between human and machine intelligence.
Sergi Jordà. Enhancing or Mimicking Human [Musical] Creativity? The Bright and the Dark Sides of the Moon (slides pdf).
Miguel Ángel González-Ballester. Machine learning in healthcare and computer-assisted treatment (slides pdf).
Fabien Gouyon. The influence of "intelligent" technologies on the way we discover and experience music. Blagoj Delipetrev. HumanAI (slides pdf).
Luc Steel. Will AI lead to digital immortality?


text:
Q: Clarification of Functions Let $f: \mathbb{Z}^2 \to \mathbb{Z}^2$ be defined as $f(m, n) = (m + n, 2m − 5n)$ . Is $f$ a
bijection, i.e., one-to-one and onto?
Since my function is mapped on the domain consisting of all integers I was wondering if it is valid to have $m$ and $n$ be two non-integers that form an integer. For example is $f(0,1) = (1/7 + -1/7, 2(1/7) - 5(-1/7))$ valid or do $m$ and $n$ have to be integers even before they are used in the equation?
Thanks!!

A: Let $f : X \to Y$. We say $f$ is surjective (onto) if for every $y \in Y$, there is $x \in X$ such that $f(x) = y$.
Note that $x$ must be in $X$, the domain of $f$. Here, $f$ has domain $\mathbb{Z}^2$ so you need $(m, n) \in \mathbb{Z}^2$.

A: From my reading of your first sentence, since the domain of $f$ is $\mathbb{Z}^2$, $m$ and $n$ have to be integers, yes.
So, if you're looking for $m$ and $n$ which map to $(0,1)$, for example, you wouldn't consider numbers like $\frac{1}{7}$ or $-\frac{1}{7}$ as possibilities for $m$ or $n$.

A: The function is clearly one-one since if $f(m_1,n_1)=f(m_2,n_2)$, then $(m_1+n_1,2m_1-5n_1)=(m_2+n_2,2m_2-5n_2)$ which implies $m_1=m_2$ and $n_1=n_2$. Since $f$ maps a finite set to itself and it is one-one it is onto. Hence $f$ is bijective.
Since your domain is $Z_2$ you need $(m,n) \in Z_2$


Working from home provides more flexibility and time with family and friends, but it can also be isolating if you're not careful.
When work is home and home is work, you can easily fall into the habit of rarely leaving the house, or rarely being social. If you're a parent, the issue can be compounded by a lack of time. Although it can be difficult, making time to be social is a very important component in your quality of life. Read along for some tips to stay social as a work from home parent!
Not all social events have to be kid-free! Especially if your kids are very, very young or a bit older, this can be a great option. You can set up fun play dates for your kids while you and your friend(s) grab a cup of coffee or take a walk.
Set up an afternoon in the park while the kids play on the playground and enjoy time chatting with the other moms.
Create a standing date! Set up weekly or monthly time with girlfriends or a group, and make it non-negotiable. A social life can truly make the difference between happiness and feeling isolated and lonely, so it needs to be a priority.
Your spouse, whether they work in a traditional office or not, will also need some time to socialize. If you watch the kids on Monday night, maybe they can do the same on Thursday evening. It's important to trade off so you're both doing things that bring you happiness and socialization.
Additionally, social events don't need to be all day. You can take a few hours to attend a happy hour with a friend, walk a few loops around the block while you chat, or simply meet in a park for an hour. The goal is to socialize on a consistent basis; it doesn't need to be extensive or expensive.
If you don't have many friends or aren't finding the right groups in your area, create your own! Sites such as Meetup.com allow you to create a custom group. You might set one up based on a certain age group, hobby or common interest, or make it for moms only.
When you create your group, you get the added benefit of choosing the activities you love to do. You'll meet like-minded people who likely share a similar lifestyle and enjoy doing the same things.
Being social as a work from home parent may take a little bit of work, but once you create a schedule that works for you and your family, it can become something you truly look forward to. Create the social experiences that interest you and work for you and your family!


1)Android+"serial bluetooth terminal" app connects to a macbook osx Sierra running CoolTerm - no problems. Coolterm uses "bluetooth-incoming-port"
3)Coolterm on the macbook connects to the OBD device, can send commands and I see the OBD receives them and executes, but I was not able to receive anything at all back to CoolTerm running on mac. Using the "OBDII-SPP" port. I guess it's macbook os problem, I wonder if anybody solved this.
Note, that 1 and 2 works, and 1 and 3 uses the same settings in CoolTerm.
If it is indeed a driver issue, then the above apps should exhibit the same problem. If, on the other hand, the above apps work and CoolTerm doesn't, then that would point to CoolTerm as the culprit and something I would need to look into.


text:
Home Real Estate Estate agents' post-election optimism rises
Estate agents' post-election optimism rises
The housing market is expected to gain a boost from the election, with greater political clarity countering the trend of falling sales and cooling prices in November, according to the latest survey of chartered surveyors.
Expectations for residential property sales over the next year are at the highest levels since February 2017, with improvements across all areas covered by the latest monthly survey by the Royal Institution of Chartered Surveyors published on Thursday.
The net balance of respondents reporting rising sales expectations for the next three months reached 11 percentage points in November, up from 5 percentage points in October after sitting in negative territory for most of the previous year.
The proportion of surveyors expecting house price rises over the next 12 months was 33 percentage points higher than those expecting prices to drop.
"Whatever happens in the general election today, it is important that the new government provides reassurance both over the stewardship of the economy and the ongoing challenges around Brexit which continues to be highlighted in a disproportionate number of remarks made by respondents to the RICS survey," said Simon Rubinsohn, RICS chief economist.
Despite improving expectations, the picture for the housing market remained bleak in November with falling house sales and prices.
"The latest set of results indicates that persistent economic and political uncertainty is deterring both buyers and vendors, and anecdotal commentary cites the general election and Brexit as stifling activity," the survey said.
In November, a majority of respondents reported falling house prices with a net balance of minus 12 percentage points, down from minus 5 percentage points in October. The fall is mainly a result of negative price trends across London, the South East and East Anglia, while Northern Ireland and Wales reported house prices gains.
READ Real estate tycoon Sam Zell slams WeWork: 'Every single company in this space has gone broke'
A majority of surveyors also reported falling buyers' inquiries and agreed sales, reflecting a trend that started in early 2017.
"Housing market activity and house price growth showed few signs of improvement at the end of 2019. Indeed, activity has, if anything, been cooling," said Hansen Lu, property economist at Capital Economics.
The RICS survey is a measure of the health of the sector ahead of official statistics.
House price growth has cooled significantly in the past three years, with the annual rate dropping to 1.3 per cent in September, the latest data available, down from 8.2 per cent in June 2016, according to the Office for National Statistics.
London has been the worst performing region, with annual prices contracting since March 2018.
The number of houses sold is down 1.7 per cent in the third quarter compared to the same period last year, according to preliminary figures from HM Revenue & Customs, and 6.6 per cent down compared to the same period in 2015 before the EU referendum.
Previous articleChemists demand clarity on cannabis-related goods
Next articleCupra boss: No bespoke sports cars for now
Barclay brothers in talks to sell Ritz hotel
Shopping centre owner Intu in talks to raise fresh funds
Inequality is the 'root cause of the problem' in Hong Kong amid prolonged unrest, says investor
UK house prices rise at fastest rate on record
Got money troubles? Take this major step to ease your financial stress
U.S. homebuilding is booming. Here's how to trade it
Here's a breakdown of December housing starts
US housing starts jump 40% annually, the highest in 13 years
US housing starts jump in December to highest in 13 years
Housing starts jumped to 13-year high in December
It's time to get more excited about the Chinese property sector, JP Morgan says
Home prices driving home remodeling: KeyBanc Capital's Ken Zener
Extradition hearing begins for Huawei executive Meng Wanzhou in Canada
Australia shares inch lower after five days of gains; NZ up
H.S. ROUNDUP: Southeastern, West Bridgewater show well at league championship meet – Enterprise News
United Security Bancshares Declares Quarterly Dividend of $0.11 (NASDAQ:UBFO) – Tech Know Bits
Connecticut Republican candidate admits to operating Facebook pages defending him while claiming to be pro-Trump groups in other states – MarketWatch
PRESS DIGEST- British Business – Jan 21