Panda Security has released Operation Oil Tanker: The Phantom Menace, a report which details a malicious and largely unknown targeted attack on oil tankers. First discovered by Panda Security in January 2014, the ongoing attack on oil cargos began in August 2013, and is designed to steal information and credentials for defrauding oil brokers. Despite having been compromised by this cyber-attack, which Panda has dubbed the "Phantom Menace," none of the dozens of affected companies have been willing to report the invasion and risk global attention for vulnerabilities in their IT security networks. Panda Security said it is issuing its report in an effort to draw attention to the attack and urge companies in every industry to take precautions against these increasingly sophisticated and insidious attacks.
The Phantom Menace is one of the most unique attacks that PandaLabs has discovered. No antivirus engine was able to detect it when first triggered, primarily because the attackers used legitimate tools in conjunction with a number of self-made scripts to bypass any warnings that traditional AV software would detect. It was only discovered when a secretary opened a nonspecific attachment to an e-mail — a type of file that Panda Security would later identify among ten different companies in the oil and gas maritime transportation sector.
Identifying the source of a cyber-attack is challenging. In most cases, identifying the source of a cyber-attack is tremendously challenging. Once discovered, however, the Phantom Menace had a telling weak spot: the FTP connection used to send out the stolen credentials. Through the FTP connection, PandaLabs was able to identify both an e-mail address and name.
Panda Security says it ready to identify the individual to authorities, but without any credible reports being volunteered by the alleged victims, the authorities are unable to launch their investigations or make any arrests. Panda Security says it hopes the release of its report will shed light on the potential damage of the Phantom Menace and encourage companies to take the necessary steps against the perpetrator.


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Educating Riders
Perched atop Data, a copper-colored chestnut gelding, Allison Hritz checks her stirrup lengths and makes sure the rubber pads are secured just below the balls of her feet. She pulls her hard hat down snug, gathers the reins in both hands and squeezes the horse with her legs. Data picks up speed as they approach the first of eight jumps in Hritz's final class in the show at Miami University. They clear it with ease and move on through the rest of the course of jumps.
Leaning forward with confidence and feeling the horse's mouth through the reins, Hritz holds her breath as she comes off the seventh fence and heads straight for the final jump. She feels the horse quicken but gives a slight check with her reins and sinks deeper into the saddle. The horse steadies himself, and she counts down the strides—three, two, one. Her fingers soften on the reins and she flows forward with his leap. The fence is cleared. The landing is smooth.
Hritz smiles. She knows she's just put in a winning ride. It is, for her and for Xavier, a monumental occasion—the first blue ribbon for the University's newly formed equestrian club. Another member wins two ribbons in the flat class, where riders are judged at the walk, trot and canter, and the team celebrates with pictures.
Today, as a new school year unfolds and a new riding season begins, Hritz and her teammates expect to make giant strides. Last year, they struggled with the competition, which was tougher than expected. But coaches Jim and Gwen Arrigon, seasoned collegiate equestrian program managers, have all eight members returning, and the team has attracted new members, some with national experience.
"We have a lot to offer because we know the collegiate system, so Xavier won't have to muddle through," Jim says. "We hope to have up to 25 to 30 kids in time."
But it's been one step at a time. The first was taken when the Arrigons left Miami University after 17 years of running the college's program. Aware that Xavier did not have a program, they made some contacts to help gauge interest. Flyers appeared last fall, and the phone started ringing. One call was from Hritz, a junior who'd ridden during high school. She became the club's representative, helping it gain recognition and funding from the club sports council, which substantially increased the team's funding for this year.
The Arrigons provide the horses, the training and the equipment at their barn about 45 minutes northwest of campus. Students ride at least once a week under Jim's experienced eye. There are 25 horses to choose from, but the Arrigons insist the students change horses often. "They make you a better rider," says Gwen.
That's also the way college shows work—you ride what you get, saddle and all. "You draw a popsicle stick with a horse's name on it, and that's the horse you ride," Jim says. "You have as little as 15 minutes to get to know the horse." No practice jumps. No warm-up ring. Just a little information about the horse's habits—good and bad—and up you go.
The policy reflects the Intercollegiate Horse Show Association's mission, which is to lower the cost and level the playing field for young riders. "Everyone has the same chance with the different horses," he says.
The association has about 350 member colleges. Xavier is one of nine schools in the Southern Ohio and Northern Kentucky region, competing from October through spring. Last year, Xavier rode in eight shows, struggling until the last two. "The kids sort of underestimated how competitive it would be," Jim says. "But college shows are tough. It took until March to win ribbons."
Hritz is optimistic as she looks forward to the team's first show in October. "We have a month and a half to practice," she says. "I'm looking forward to getting back into it."
Fall 2006 Sports Xavier Magazine
Washington Bound
Bobinski's Back

redpajama_set_name: RedPajamaCommonCrawl


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The average front squat entered by women on Strength Level is heavier than the average floor press.
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The characters found in Happy House have grown up a little and are exploring the streets! Happy house 1 activity book download.
*Use or download Combat Arms VIP Hacks using your Windows, Mac, iOS or Android device. You can unlock the download link and save it for later. DOWNLOAD MIRROR 2. Check Combat Arms reviews, and download Combat Arms. Screenshots, Combat Arms system requirements and more! Free MMO Games. (on PC and Mac. Because the mac wont let u download combat arms what i mean is that the program wont let u download and u need to download windows like hack from you-tube.
Combat Arms by NEXON Corporation and NEXON Europe is a free to player first-person shooter (FPS) that can be played online with other users. Sadly, there was no official release of Combat Arms for Mac, but there are other cool games that you can play over the Internet on your Mac. You cant the only thing is taking it to an Apple store and aksing them to Bootcamp.
Well, Basically Combat Arms is a Free-2-Play game. Which means you never have to pay, But unless you want tobuy 'NX' Which is bought using real world money and with that youcan buy guns, equipment ect. Higher rank then you, But if youdon't want to spend a dime buying nx you can buy guns using GP Alsogp is where you can buy items, the GP guns and gear are quite cheapif you buy it for one day. Nexon has done. Some things that have really decreased the hugepopulation of hackers living on Combat Arms. Barely see any todayif you play in Bravo server, but in Papa Server you'll see some ofthem hangin' there. If you were to buy 'Nx,' it would be half worthit because the NX gear and guns are OP compared to GP weapons andgear.
As 2014 Combat arms is the number 1 fps in the world and counts 14mllion players in the american version. Sorry, i don't exactly know what to do, but whatever you do, DO NOT DOWNLOAD CROSSOVER.
IT IS A COMPLETE WASTE OF TIME, AND A COMPUTER CRASHER. Hope this helps, sorry if it didnt. Pyar ki ek kahani star one serial video download.
Answer 2 Unfortunately Combat Ams isn't a Mac Game. In order to play it, you must use Boot Camp, VMWare Fusion, or Parallels.
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Like the person above says, CrossOver and Wine don't work with Combat Arms. Boot camp is a program that comes built in with your Intel-Mac (No PowerPC). You can install Windows on it and set a hard drive partition for memory. VMWareFusion and Parallels do a similar thing. Hope This Helps. According to my research combat arms can be played on a controller but its a 360 controller from what ppl r saying.so for i have no found a way with any other controller Edit: Get Xpadder, and run it. Get a Controller-USB converter (I use FT8D91) and plugin the controller.
Install any software required to use the hardware, and set up a new controller profile on Xpadder. Calibrate the buttons and create a controller configuration for Combat Arms. Assign the various keyboard buttons used in Combat Arms to the Controller profile. Save it, and have fun playing.
(You might need to search for video tutorials on how to calibrate a controller). Combat arms will not run on a mac by itself. You need to install the Bootcamp program which runs windows as a virtual machine on the mac. I have successfully done this and the game play on the i7 27' screen is ridiculously good. Get rid of your PC and come across to the light/right side. The i7 runs a radeon HD 5750 graphics card so it is more than enough for Combat Arms.
Happy gaming:) UPDATE 13/9/11 Just recently they must have made changes to the game because now Combat Arms will not run with a virtual machine.


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Looking for even more great quilt patterns for your grandbaby? Then you'll love our list of free baby quilt patterns - it's a reader fave!
Thus far in my quilting career, I have only made rag quilts. This is beautiful though and I am thinking how much I would like to try this. My thoughts are that it would be neat to make this but make the edges like a rag quilt. Has anyone tried that? Would it work?


Remember M, Facebook's artificial intelligence assistant for Messenger? Well, it's getting an upgrade – and it's being released in the US.
– Paying or requesting money: M now recognises when people are discussing payments, and gives them the option to easily send or request money.
– Sharing your location: M can give you the option to share your location during a conversation.
– Starting a poll (in group conversations only): M lets you set a poll topic and vote in group conversations.
– Getting a Ride: M suggests "Get A Ride," and provides a Lyft or Uber option.
Send stickers, make plans, make money transfers, or even request a ride – all via M on Messenger!
To get M up and running, all you have to do is engage in everyday conversations with your friends, as you would normally do. M will make sure it offers the appropriate recommendations based on the context of your discussion. It's that easy!
Since Facebook wants to make Messenger your go-to place for everyday tasks, it makes sense for it to endow M with even more features. Facebook is the middleware that sits on devices, thus it is potentially "detachable" from them. Investing in portability and platform independence, Facebook also aims at other services, such as Siri. This is getting very interesting, indeed.
M is expected to roll out globally very soon.


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Hurt: Too many acres targeted for corn plantings
WEST LAFAYETTE, Ind. - U.S. farmers reacted to global markets in making a major shift by intending to plant more acres in corn this year than last, a situation that could add to abundant supplies and result in lower prices for producers, Purdue University agricultural economist Chris Hurt says.
Farmers indicated in a U.S. Department of Agriculture survey they would plant 6 percent more acres of corn this year - 93.6 million, the most since 2013 and the third highest since 1944 - because of a world surplus of wheat and reduced sorghum demand from China.
Farmers expect to reduce their acreage of both wheat and sorghum and replace it with corn and cotton. Cotton acreage would increase by 11 percent.
"The bottom line is that 93.6 million acres is too much corn acreage that with normal yields will cause further building of already-large corn inventories," Hurt said. "Production would be expected to move above 14 billion bushels, with corn prices at harvest falling to the lower $3 per bushel."
The reduction in wheat acreage is related to low prices from the surplus of that crop and increased international competition. The lower demand for sorghum is the result of reduced use in Chinese feeding rations, causing sorghum prices to drop relative to corn.
The shift is less apparent in the Corn Belt. Still, corn there could increase by 1.5 million acres. Somehow, Hurt said, farmers in the Corn Belt also are going to plant 840,000 more acres of soybeans, and more wheat acres as well. This made Hurt wonder whether farmers might have over-estimated their total acreage numbers.
The Prospective Plantings report of the USDA's National Agricultural Statistics Service, released Thursday (March 31), is based on a nationwide survey of 83,000 farm operators. It was conducted in the first two weeks of March.
The estimated corn planting area nationally is up 6 percent from last year's 88 million acres. Indiana farmers indicated they would plant 5.8 million acres in corn, up 3 percent from 5.65 million last year.
Soybean farmers nationally intended to plant 82.2 million acres, down less than 1 percent from 82.6 million from last year. Farmers in Indiana planned the same amount as last year: 5.5 million acres.
Hurt said soybean stock supplies were about 40 million bushels lower than expected, indicating that more soybeans might have been used than expected or the size of the 2015 crop was over-estimated. In addition, soybean acreage nationally was 660,000 acres smaller than pre-report estimates. This means, Hurt said, that the 2016 crop would have U.S. average prices near $9 for the marketing year.
"These reports together suggest that the market prices of corn and soybeans will now adjust to give producers reduced financial incentives to plant corn and increased price incentives to plant more soybeans, spring wheat and other spring-planted crops," he said.
Hurt noted that spring weather also will be important in determining how many acres get planted to each crop. The weather has tended to favor an early start to the planting season, which generally favors corn acreage.
PLANTINGS BY THE NUMBERS:
* Corn nationally: The highest planted corn acreage was 113.02 million in 1932. The closest it has come since then was in 2012, when 97.29 million acres were planted. Planted acres have exceeded 90 million acres 21 times since 1926 but only five times since 2007. The other 16 times occurred between 1926 and 1944.
* Indiana corn: Highest planted acreage: 6.5 million in both 1976 and 2007. At least 6 million acres have been planted 14 years since 1926 but only twice since 2007 (2012 and 2013).
* Soybeans nationally: Highest planted acreage: 83.27 million in 2014. In 2015, planted acres were slightly less (82.65 million). Planted acres have exceeded 70 million every year since 1997 except in 2007 (64.74 million). Before 1997, planted acres exceeded 70 million acres nationally only twice, in 1979 and 1982.
* Indiana Soybeans: Highest planted acreage: 5.8 million in 2002. The first time Indiana saw 5 million acres in soybeans was in 1995, and it has remained at least that high every year since then except in 2007 (4.8 million).
Source: USDA's National Agricultural Statistics Service.
Writer: Keith Robinson, 765-494-2722, robins89@purdue.edu
Source: Chris Hurt, 765-494-4273, hurtc@purde.edu
Agricultural Communications: (765) 494-2722;
Keith Robinson, robins89@purdue.edu
Agriculture News Page


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Yesyestohealth
Region's First TCAR Procedure for Carotid Artery Disease Performed at McLaren Greater Lansing
LANSING, Mich. — McLaren Greater Lansing is the first hospital in the mid-Michigan region to treatcarotid artery disease using a new procedure that dramatically lowers the risk for stroke during and after surgery.
Vascular surgeon Syed M. Faisal Alam, MD, performed a TransCarotid Artery Revascularization (TCAR) at McLaren Greater Lansing Hospital on January 10, 2019. TCAR (tee-kahr) is a clinically proven and minimally invasive approach for high-surgical-risk patients who need carotid artery treatment.
Evart "Dutch" Manshum of Portland was one of those patients. He retired from Lansing General Hospital, now known as McLaren Greater Lansing, 25 years ago before returning to become the first patient to have a TCAR procedure performed at the hospital. One of the two main arteries in his neck that supplies oxygen-rich blood to his brain was 80 percent blocked when he first learned he needed surgery to remove a buildup of plaque. "It felt scary at first," said Manshum. "But I had peace of mind knowing my risk of stroke was lower with the new procedure."
Surgeons go through an extensive training process before performing a TCAR procedure. "TCAR is an easier operation," said Dr. Alam. "It's better for patients, and an example of how a newer technology is changing lives for the better."
Carotid artery disease can often lead to stroke if left untreated, and is estimated to be the source of stroke in up to one-third of cases. With 400,000 new diagnoses of carotid artery disease made every year in the U.S. alone, the TCAR procedure has the potential to revolutionize surgical options.
TCAR is unique because blood flow is temporarily reversed during the procedure so that any small bits of plaque that may break off are diverted away from the brain, preventing a stroke from happening. A stent is then placed inside the artery to stabilize the plaque, minimizing the risk of a future stroke.
Before TCAR, procedures involved a large incision that left a visible scar down a patient's neck, and carried risks of complications that include bleeding, infection, heart attack, and nerve damage. TCAR not only minimizes those risks, but also takes less time to perform. TCAR involves a much smaller incision than previous treatment options for carotid artery disease.
Manshum was out of the hospital just one day after his procedure and felt no pain in his neck where the surgery was performed. "I would recommend Dr. Alam to anybody," said Manshum. "I trust his skills, and I would tell someone who is thinking about having the TCAR not to worry about it at all."
TCAR procedures became a reality in the United States about a year ago, and Dr. Alam is already set to perform at least three more TCAR procedures by the end of the January. "McLaren Greater Lansing and I, with my practice Advanced Cardiac & Vascular, are committed to keeping all patients with vascular problems in Lansing within the city of Lansing," said Dr. Alam. "We are working to provide all treatment for vascular problems at McLaren Greater Lansing so that no one has to leave town for care."


news has produced mixed feelings among Cayman's golf community.
lives. When that gets taken away from us it will be a significant inconvenience.
facility into an 18-hole venue.
would be smooth for local golfers.
for the sport of golf in Cayman.
Blue Tip and the other nine holes developed into some other facility.
immediately after Hurricane Ivan six years ago.
also has a very social element to it.
still develop between now and the opening of the other golf course.


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The Children's Program serves children ages six through twelve living with blindness and vision impairment. The program emphasizes the Expanded Core Curriculum (ECC), which promotes independence. Children in the program have a specialized service plan that is developed to meet each child's goals and needs. The children's program works with each child individually or in a group setting depending on their needs. With the goal of promoting independence, children are taught the ECC components, which include assistive technology, compensatory skills (including communication modes), career skills, recreation and leisure skills, orientation and mobility skills, social skills, sensory efficiency skills, self-determination, and independent living skills. These skills fall outside of the general education curriculum, but are crucial for children who are vision impaired. During the summer months, there will be a summer camp that each child can attend that will focus on further development of the ECC skills.


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From a small hoard of axes, sword hilts, spear points and other artifacts found near the Danube River. Such hoards were often deposited near rivers and wet places like swamps. As these spots were often quite inaccessible, they most probably represent gifts to the gods. The reason that this 3000-year-old Bronze Age artifact is in such fantastic condition is due to the lack of oxygen in the mud which inhibits corrosion.
Seller's Note/ The Celtic Urnfield Culture traded their wares throughout the rivers of Eastern Europe. We're not exactly sure if these three interlocked rings were marketed simply as "ring money" by weight, or were part of a much larger chain. Example of inter-locked Celtic ring money or chains are very rare and rarely seen. Our example of three rings is off the chart and may be unique. Museum quality, our asking price of only $150 is ridiculously low, kids, trust me.


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Solimar of Key Biscayne
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On March 11, 2011, Japan was struck by the largest earthquake it has ever experienced. The severe earthquake caused a tremendous tsunami that led to a serious emergency at the Fukushima Dai-ichi Nuclear Power Plant. This kind of unprecedented multi-dimensional disaster has important lessons for the international community. In light of Japan's experience, it is incumbent on all countries to be better prepared to respond to complex emergencies and to assist one another in such circumstances. Of particular importance is the development of emergency plans for disasters affecting nuclear power plants.
* The Japan Self Defense Forces (SDF) are engaging in the largest disaster relief operations in their history. To support this effort, the United States conducted humanitarian assistance, disaster relief and other activities under Operation TOMODACHI. The success of this large-scale joint response has validated years of bilateral training, exercises, and planning.
* The SDF and U.S. forces established bilateral coordination centers in Ichigaya, Yokota, and Sendai, which were manned by personnel from both countries and served as focal points for communication and operational coordination. This experience will serve as a model for future responses to contingencies of all kinds.
* The response to the nuclear power plant incident involved experts from the public and private sectors of both countries, and multiple agencies of the Japanese and U.S. Governments. The experience demonstrated the importance of bilateral and multilateral mechanisms to promote real-time information sharing, effective coordination, and comprehensive "whole- of-government" responses to complex emergencies.
* The bilateral response to the Fukushima Dai-ichi Nuclear Power Plant incident demonstrated the importance of strengthening the Chemical, Biological, Radiological, and Nuclear (CBRN) Defense Working Group as a venue for policy coordination and cooperation in such areas as information sharing, protection, decontamination, and consequence management.
* The Ministers shared the view that the participation by U.S. forces in disaster drills conducted by local authorities contributes to stronger relations among the U.S. forces and base hosting communities.
The Ministers shared the determination to learn from this experience and to enhance the two countries' abilities to respond to a wide variety of contingencies in the future.


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#881: Minor Felonies – The Mystery of Holly Lane (1953) by Enid Blyton
March 8, 2022 March 7, 2022 / JJ
I don't know if I'd rather the writers and series I love took risks and missed some of the time, or if it's worse for them to settle into a sort of congenial predictability that's less and less exciting though safely fine from book to book.
In the pressure-cooker, twelve-hundred-new-books-a-day atmosphere of modern publishing, I can understand authors being expected to turn out the same thing that sold last time, and I suppose the output of Enid Blyton isn't too dissimilar: she produced maybe twelve hundred books every three days all by herself, so a certain amount of corner-cutting would have crept in. Nowhere is this more obvious than in the seventh entry in the Five Find-Outers series, The Mystery of the Pantomime Cat (1949), which sets up a brilliant crime no-one could have committed…and then resolves it with the sort of solution that would be scrawled in the margin as a "for pity's sake, don't do this" warning for new writers.
But at least …Pantomime Cat was an intriguing book while it lasted. I'm now — to my frank surprise, where does the time go? — on the eleventh of this 15-books series, The Mystery of Holly Lane (1953), and while the familiar beats are pleasing and comfortable to drop back into, they're so familiar and comfortable that I looked at the cover the day after I'd finished it and could not remember how the scene depicted there fitted into the plot. The Five Find-Outers, you feel, are on a downward run from here.
"I can't run these days; bad knees."
The usual rigmarole — Fatty coming back from school; Bets wants an adventure; someone might be Fatty in disguise and isn't (or is, whichever didn't happen last time) — leads us by possibly one of the most awkward conceits ever seen in fiction ("I say, Larry, why don't you dress up as a window cleaner and clean someone's windows — what larks!" — er, sure thing) to an at least moderately engaging problem: a cottage having all its furniture stolen from its living room (a.k.a. "the lounge" if you have social aspirations). Wait, I think some money goes missing first, and then the furniture gets stolen later. Either way, the old man who lives there — in an interesting development, he's blind…but nothing comes of that — loses stuff and, thanks to a Frenchman drawn in subtle shades reminiscent of 'Allo! 'Allo! (1982-92), we have a list of suspects to investigate…
Look, it's fine. As a fan of this series I can appreciate some of the smaller points — the ongoing ribaldry re: Buster the dog and the ankles of Mr. Goon the policeman escalates to the point where Goon pays a boy in the village to capture the terrier and then arranges to have him (the dog, not the boy) shot, which is a little dark, but other than that you know exactly what you're getting. There are false leads, some detection based around tyre marks found at the scene of the crime, and some hilarious and era-appropriate social trappings (someone can't possibly be a suspect if Fatty's mother days they're okay; Bets and Daisy are shut out of the dénouement because two girls can't possibly stand around waiting after going on the cinema visit that's just a pretext to be in the vicinity in the first place…which seems to be reasoning of the most deplorably circular type).
But, honestly, even as a fan of this series I'd be stretching a point to claim there was anything notable in this beyond a novel solution to the missing money that's really the thinnest possible excuse for so much of the shenanigans going on herein. It would be hoped that, having achieved a sort of youthful detection nirvana with eighth title The Mystery of the Invisible Thief (1950), Blyton would have built upon the increasing complexity of her plots to continue to engage her growing (and ageing) audience. But I think that's my naïveté showing, because the woman was wonderfully prodigious and probably far less interested in the complexities of the detective plot than my genre-obsessed mind would like her to have been. Those Noddy books weren't gonna write themselves, and time spent here would have lessened her beloved output elsewhere. I get it, it's just a shame.
"Well if you've got it, don't give it to me…"
I encountered this series for the first time when I wasn't entirely sure what delights or otherwise awaited me in the realm of juvenile fiction, and doubtless latched onto this unsuspected current in the stream of Blyton's outpourings with the excess enthusiasm of a true believer. There's enough brilliant contemporary work being done with legitimate detection for younger readers — the Moon base Alpha and Funjungle series of Stuart Gibbs, the Adventures on Trains series from M.G. Leonard and Sam Sedgman, Sharna Jackson's Nik and Norva books — that the decline in quality of the Five Find-Outers isn't calamitous for my future Minor Felonies intentions. I just wanted it all to be good, or for at least a majority of it to show the same enthusiasm and invention that my early encounters revealed. And, well, it has since become clear that that wasn't Blyton's intent, so it seems churlish to hold it against her.
Nevertheless, with four books remaining — and final title The Mystery of Banshee Towers (1961) seemingly roundly acknowledged as a significant step down, t'was ever thus — it'd be wonderful if she felt the urge to take a few risks, y'know?
The Five Find-Outers series:
1. The Mystery of the Burnt Cottage (1943)
2. The Mystery of the Disappearing Cat (1944)
3. The Mystery of the Secret Room (1945)
4. The Mystery of the Spiteful Letters (1946)
5. The Mystery of the Missing Necklace (1947)
6. The Mystery of the Hidden House (1948)
7. The Mystery of the Pantomime Cat (1949)
8. The Mystery of the Invisible Thief (1950)
9. The Mystery of the Vanished Prince (1951)
10. The Mystery of the Strange Bundle (1952)
11. The Mystery of Holly Lane (1953)
12. The Mystery of Tally-Ho Cottage (1954)
13. The Mystery of the Missing Man (1956)
14. The Mystery of the Strange Messages (1957)
15. The Mystery of Banshee Towers (1961)
Reviews, The Tuesday Night Bloggers
Enid Blyton, Juvenile Mysteries, The Five Find-Outers
← #880: The Decline of the Modern Murder via Castle, Season 2 (2009-10)
#882: Don't Jump, Mr. Boland! (1954) by Norman Berrow →
3 thoughts on "#881: Minor Felonies – The Mystery of Holly Lane (1953) by Enid Blyton"
I can't imagine ever going back to her books TBH but what strikes me most is that it is a very daft series title – Famous Five and Secret Seven are so much easier on the brain! Not that I preferred the actual books though 😆
Were the Famous Five actually famous, though? And the Secret Seven were pretty well-known as a group. At least this lot being "find-outers" — as established in the first book, since they're going around finding things out — makes sense 🙂
"Five otters" or even "Five Nutters" sounds better 😆 … you ever seen the Comic Strip's "Five Go Mad in Dorset" spoof? It's beautifully done and pretty much killed Blyton for me in one fell swoop!


text:
Acupicta delicatum är en fjärilsart som beskrevs av De Nicéville 1887. Acupicta delicatum ingår i släktet Acupicta och familjen juvelvingar. Inga underarter finns listade i Catalogue of Life.

Källor

Externa länkar

Juvelvingar
delicatum

redpajama_set_name: RedPajamaWikipedia


Jaded Richard Grindle is the sleaziest clown working the children's party circuit in Ireland. Arriving late to one birthday, his timing is off, the bratty kids a nightmare and a prank goes horribly wrong – he falls on a kitchen knife and goes to that Big Top in the sky. Years later the same nasty kids attend another more grown up bash. Little do they know, thanks to a black magic clown cult, Stitches will be the uninvited guest of honour seeking revenge on those responsible for his untimely death. Laughs and gore combine in this twisted tale of one very bad clown.


DURHAM, N.C. – The NCAA has granted Duke women's basketball guard Mikayla Boykin a medical hardship waiver for the 2017-18 campaign and will have four years of eligibility remaining with the Blue Devils beginning with the 2018-19 season.
Boykin started the first eight contests last year and averaged 4.6 points, 3.2 assists, 3.2 rebounds and 1.2 steals a game. The 5-9 guard from Clinton, N.C., opened her collegiate career on the road at Grand Canyon with a season-high 12 points.
The 2017 ACC Newcomer Watch List selection injured her left knee on Dec. 10 as the Blue Devils downed Winthrop, 101-30.
Boykin was the Gatorade Player of the Year for the state of North Carolina as a senior at Clinton H.S., while averaging 37.4 points, 13.7 rebounds and 6.5 assists, 5.6 steals.
She continues with her rehab and is expected to play in 2018-19.
Duke will host its annual Blue/White scrimmage Sunday, Oct. 21 at 2 p.m., in Cameron Indoor Stadium and then will welcome Alaska Anchorage for its final exhibition game Sunday, Nov. 4. The season opener will feature the Blue Devils on the road at Northwestern Sunday, Nov. 11.


VK and Kimball's trip to Guatemala. Want to come next year?
"...The cinematic version in contrast to the novel plays down the author's intended cultural satire [...] The inherent violence in the story's premise is toned down in the cinematic telling to enable a PG-13 rating and thus attract a wider and younger audience. Lost in translation is Collins' original cultural critique. Instead, the film plays like a reality TV show on steroids, Survivor with swords.
"We need cultural satire, and with it a renewed sense of moral outrage. We must avoid being numbed to the cartoon violence of a first-person-shooter video game—Call of Duty for tweens. Would it not have been more culturally beneficial and honest to depict The Hunger Games as an NC-17 pornographic slasher film? What happens when satire loses its force as satire? When dystopia—"an imaginary place or state in which the condition of life is extremely bad, as from deprivation, oppression, or terror"—becomes an accepted neighbourhood within the cultural imagination, when it shifts from critique to description? When this happens, something seriously amiss is at work in our cultural psyche. This shift is what The Hunger Games reveals. "
Source: "When Reality Overwhelms Satire: What The Hunger Games Reveals | Cardus Blog." Cardus. N.p., n.d. Web. 8 May 2012. <http://www.cardus.ca/blog/2012/04/when-reality-overwhelms-satire-what-the-hunger-games-reveals/>.


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text:
Law 28-11-1931
Original Language Title: Ley 28-11-1931
AUTOMA "VILES, TRUCKOS Y TRACTORES.â€" It is extended until December 31, 1933, the release of customs and consular rights for the Internation of those vehicles to the Department of Santa Cruz, expanding The franchise to the Great Chaco, Llanos of Manso and Delegate of the East.
CONSTITUTIONAL PRESIDENT OF THE REPAsBLICA
ArtA-ass Only.†" The effects of the Law of 20 December 1928, concerning the release of consular and customs duties on the exchange of cars, trucks, tractors to the department of Santa Cruz, were extended until December 31, 1933. The effects of this law are extended to the Great Chaco and Llanos of Manso and Delegate of the East.
Communicate to the Executive Branch for constitutional purposes.
Session of the H. National Congress.
La Paz, November 25 of 1931.
J. L. Tejada.â € "G. RA-os Bridoux.â €" Gabriel Palenque, Senator Secretary †"Humberto Duchâ€" †"Deputy Secretary. â€" Fernando LAólpez, Deputy Secretary.
Therefore, I enact it so that it has and complies with the law of the Republic.
Palace of Government, in the city of La Paz, at the twenty-eight days of November of a thousand nine hundred and thirty-one years.
DANIEL SALAMANCA.†" Luis Calvo.
V. Fernà ¡ ndez and G.
Chief Government Officer.


text:
White Garden Lily, Quebec
Floral Emblems
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Stamp Info
Date of Issue June 30, 1964
Quantity 19,710,000
Perforation or Dimension 12
Series Floral Emblems
Series Time Span 1964 - 1966
Printer Canadian Bank Note Company, Limited.
Postal Administration Canada
Stamp Values/Prices (Beta Mode*)
M-NH-VF Mint - Never Hinged - Very Fine
Mint - Never Hinged - Very Fine $0.30
U-VF Used - Very Fine
Used - Very Fine $0.15
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Hidden Date
The hidden date for this stamp can be found near the base of the crown in Quebec's coat of arms.
About Stamp
The white trillium of Ontario and the white garden lily of Quebec are the focal points in two new postage stamps to be issued on June 30th by the Canada Post Office. The new issues are the first of a series that will, during the next three years, illustrate the provincial flowers of all ten Canadian provinces. The armorial bearings of the Province of Quebec are a shield showing fleur-de-lys in the upper section, a lion in the middle, and three maple leaves in the lower section. The design is completed by a crown at the top and the motto "Je me souviens" - I remember, at the bottom. The stamps bearing these designs are being rendered in three-colour printing by a combination of offset lithography and steel-line engraved intaglio printing. It is anticipated that all the stamps in the floral emblem series will be produced by this method. The Ontario and Quebec stamps were chosen as the first in the floral series as these two provinces, along with New Brunswick and Nova Scotia, were the first to enter the Confederation in 1867. Stamps depicting the official flowers and armorial bearings of these two Maritime provinces are planned for 1965, as well as those of several other provinces. In addition to being the two largest and most populous provinces of Canada, Ontario and Quebec have played major roles in the development of the Canadian nation. Founded in the 18th Century by explorers from France, Quebec maintains its French traditions of language and culture. Basically English in origin, Ontario was settled and developed much later that its sister province. Together, the two were known as the "Province of Canada" and separately as Upper Canada and Lower Canada. It was political leaders from these provinces who, at Charlottetown in 1864, persuaded representatives of the Maritime Provinces to expand their idea of a union of all the British colonies in North America to a greater Confederation, a union which was achieved by the British North America Act of 1867 and which led to the Canadian nation of today.
Designed by Harvey Thomas Prosser. Picture engraved by Yves Baril. Lettering engraved by Gordon Mash.
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Canada Post Office Department. [Postage Stamp Press Release], 1964.
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text:
Sickle Cell News for October 2020
By norah.elmagraby On October 12, 2020 · Add Comment · In Newsletter
To join or leave the listserv visit https://scinfo.org/newsletter/
Spread the Word About the Sickle Cell Disease Challenge
Do you know college or graduate students who would like to help reduce stigma and improve understanding of sickle cell disease? Encourage them to join the NHLBI's new Challenge to improve sickle cell disease awareness. The NHLBI will award up to a total of $50,000. Learn more about the challenge.
COVID-19 Posing Risk for Sickle Cell Disease Patients
Studies suggest that people with sickle cell disease who also are infected with SARS-CoV-2 are more vulnerable to severe health complications than the rest of the population.
Read more about the research.
Health App Could Help People with Sickle Cell Disease Take Their Meds
A study published earlier this year found that most sickle cell disease patients forget to take the drug hydroxyurea that reduces pain crises. A new mobile phone app, called InCharge Health, could help.
Read how researchers are testing the InCharge Health app.
Portable Sickle Disease Test Could Aid Early Detection in Children
A low-cost portable test could help detect sickle cell disease in children living in areas with low resources, getting them early treatment that could save lives.
Learn more about the test.
Using Genome Editing for Sickle Cell Disease
See how researchers are testing ways to use genome editing to treat sickle cell disease.
Watch the video to learn more.
Sickle Cell Disease Information
The NHLBI provides many resources to help patients, their families, and health professionals learn more about important sickle cell disease topics.
Browse the NHLBI's sickle cell disease information
Addressing Sickle Cell Disease: A Strategic Plan and Blueprint for Action https://www.nationalacademies.org/our-work/addressing-sickle-cell-disease-a-strategic-plan-and-blueprint-for-action
The Department of Health and Human Services (HHS), Office of Minority Health requests that the National Academies of Sciences, Engineering, and Medicine convened an ad hoc committee to develop a strategic plan and blueprint for addressing sickle cell disease (SCD) in the United States. The committee will examine the epidemiology, health outcomes, genetic implications, and societal factors associated with SCD and sickle cell trait (SCT), including serious complications of SCD, current guidelines and best practices for care of patients with SCD, and federal, state and local programs related to SCD treatment and care programs.
Sickle cell on PBS NOVA
Articles in the medical literature
1. Cardiomyopathy in Sickle Cell Disease Cureus. 2020 Aug 8;12(8):e9619. doi: 10.7759/cureus.9619.
Harsimran Kaur 1 , Fahad Aurif 2 , Mahdi Kittaneh 3 , Jeoffrey Patrick G Chio 4 , Bilal Haider Malik 1
Sickle cell disease (SCD) is an inherited disorder that occurs due to point mutation in the beta-globin chain resulting in the production of hemoglobin S that tends to become rigid and sickle-shaped under low oxygen concentration. These sickle-shaped red blood cells (RBCs) obstruct the blood vessels leading to reduced blood flow to the organs, causing ischemia and tissue fibrosis. These sickle RBCs being abnormal in shape are frequently sequestered by the spleen, creating a state of chronic anemia in the body. This chronic anemia leads to a high cardiac output state causing cardiac remodeling. To tackle chronic anemia, patients are frequently treated with blood transfusions that makes them more prone to the risk of iron overload (from newly transfused RBCs and iron release from the RBCs that just got sequestered as well as from volume overload) and volume overload causing left ventricular (LV) dilation. The above-mentioned mechanism of cardiac hypertrophy, along with LV dilation together, makes SCD-related cardiomyopathy unique cardiomyopathy with features of restrictive cardiomyopathy with LV dilation. It is interesting to note here that even though there is a presence of LV dilatation, Systolic dysfunction is very uncommon in SCD-related cardiomyopathy.
Keywords: cardiomyopathy; chronic anemia; diastolic dysfunction; iron overload cardiomyopathy; microvascular occlusion; pulmonary hypertenion; restrictive cardiomyopathy; sickle cell disease. Copyright © 2020, Kaur et al. Full-text links
2. The vaso-occlusive pain crisis in sickle cell disease: Definition, pathophysiology, and management Eur J Haematol. 2020 Sep;105(3):237-246. doi: 10.1111/ejh.13430. Epub 2020 May 19. Authors
Deepika S Darbari 1 , Vivien A Sheehan 2 , Samir K Ballas 3
Early diagnosis, treatment, and prevention of a vaso-occlusive crisis (VOC) are critical to the management of patients with sickle cell disease. It is essential to differentiate between VOC-associated pain and chronic pain, hyperalgesia, neuropathy, and neuropathic pain. The pathophysiology of VOCs includes polymerization of abnormal sickle hemoglobin, inflammation, and adhesion. Hydroxyurea, L-glutamine, crizanlizumab, and voxelotor have been approved by the US Food and Drug Administration for reducing the frequency of VOCs; the European Medicines Agency has approved only hydroxyurea. Other novel treatments are in late-stage clinical development in both the United States and the European Union. The development of agents for prevention and treatment of VOCs should be driven by our understanding of its pathophysiology. Keywords:
L-glutamine; P-selectin; hydroxyurea; pain; sickle cell disease. © 2020 John Wiley & Sons A/S . Published by John Wiley & Sons Ltd. 98 references Publication types Review Grant support Novartis Pharmaceuticals Corporation Full-text links
3. Prognosis of patients with sickle cell disease and COVID-19: a French experience Lancet Haematol. 2020 Sep;7(9):e632-e634. doi: 10.1016/S2352-3026(20)30204-0. Epub 2020 Jun 18.
Jean-Benoît Arlet 1 , Gonzalo de Luna 2 , Djamal Khimoud 3 , Marie-Hélène Odièvre 4 , Mariane de Montalembert 5 , Laure Joseph 5 , Christelle Chantalat-Auger 6 , Edouard Flamarion 3 , Pablo Bartolucci 2 , François Lionnet 7 , Sebastien Monnier 8 , Cécile Guillaumat 9 , Aline Santin 7 Full-text links
4. Temperament in preschool children with sickle cell anaemia Arch Dis Child. 2020 Sep;105(9):900-902. doi: 10.1136/archdischild-2018-315054. Epub 2018 Dec 21.
Michelle Downes 1 2 , Michelle de Haan 2 , Tess O'Leary 1 , Paul T Telfer 3 , Fenella J Kirkham 2
Aims: Few studies have investigated the potential impact of sickle cell anaemia (SCA) on temperament. The aim of the current study was to investigate temperament in preschool children with SCA and to establish the reliability of the Children's Behaviour Questionnaire (CBQ) in this population.
Methods: The CBQ, a parent-report measure of temperament, was completed by parents of 21 preschool children with SCA and a control group of parents of typically developing children, matched for age, ethnicity and socioeconomic status.
Results: A significant difference between groups was identified for the dimension of negative affectivity only, with specific differences observed in the discomfort subdomain. Patients with a greater number of hospital admissions in the previous year were reported to have higher levels of discomfort.
Conclusions: Preschool children with SCA are reported to have higher rates of negative affectivity, particularly discomfort. Future research is required to investigate the potential influence of dysregulated negative emotions and discomfort on disease management and quality of life throughout childhood.
Keywords: child psychology; haematology; pain; sickle cell disease; temperament. © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ. Full-text links
5. Efficacy and safety of recently approved drugs for sickle cell disease: a review of clinical trials Exp Hematol. 2020 Aug 22;S0301-472X(20)30356-8. doi: 10.1016/j.exphem.2020.08.008. Online ahead of print.
Muhammad Ashar Ali 1 , Asrar Ahmad 2 , Hafsa Chaudry 1 , Wajeeha Aiman 3 , Sobia Aamir 4 , Muhammad Yasir Anwar 1 , Anam Khan 5
Sickle cell disease is prevalent in several parts of the world. Most hospitalizations of these patients are related to pain crisis episodes. Moreover, levels of hemoglobin are lower in sickle cell disease patients as compared with the general population. Complications related to sickle cell disease are managed with blood transfusions, hydroxyurea, and opioids. Despite these therapies, patients with sickle cell disease experience multiple pain crisis episodes leading to hospitalizations and end-organ damage. The US Food and Drug Administration has approved three new drugs-L-glutamine, voxelotor, and crizanlizumab-for the prophylaxis and treatment of complications related to sickle cell disease. This review was aimed at assessing the efficacy and safety of recently approved drugs for the treatment of sickle cell disease. A comprehensive search was made on PubMed and clinicaltrials.gov to look for clinical trials reporting the efficacy and safety of recently approved drugs for sickle cell disease. Based on the results of clinical trials, L-glutamine, voxelotor, and crizanlizumab were well tolerated by sickle cell disease patients. L-Glutamine and crizanlizumab reduced the number of sickle cell crisis episodes, while voxelotor improved the level of hemoglobin in sickle cell disease patients. These drugs were effective alone and in combination with hydroxyurea. Copyright © 2020 ISEH — Society for Hematology and Stem Cells. Published by Elsevier Inc. All rights reserved. Conflict of interest statement Full-text links
6. Fetal Hemoglobin in Sickle Cell Anemia Blood. 2020 Aug 17;blood.2020007645. doi: 10.1182/blood.2020007645. Online ahead of print.
Martin H Steinberg 1
Fetal hemoglobin (HbF) can blunt the pathophysiology, temper the clinical course and offer prospects for curative therapy of sickle cell disease. This review focuses on: 1. HbF quantitative trait loci and the geography of β-globin gene haplotypes, especially those found in the Middle East; 2. how HbF might differentially impact the pathophysiology and many subphenotypes of sickle cell disease; 3. clinical implications of person-to-person variation in the distribution of HbF among HbF-containing erythrocytes; 4. reactivation of HbF gene expression using both pharmacologic and cell-based therapeutic approaches. A confluence of detailed understanding of the molecular basis of HbF gene expression, coupled with the ability to precisely target by genomic editing most areas of the genome, are producing important preliminary therapeutic results that could provide new options for cell-based therapeutics with curative intent. Copyright © 2020 American Society of Hematology. Full-text links
7. Ocular Manifestations of Sickle Cell Disease: Signs, Symptoms and Complications Ophthalmic Epidemiol. 2020 Aug;27(4):259-264. doi: 10.1080/09286586.2020.1723114. Epub 2020 Feb 3.
Saif Aldeen AlRyalat 1 , Mohammed Nawaiseh 2 , Barakat Aladwan 3 , Allaa Roto 4 , Zeyad Alessa 5 , Akram Al-Omar 5
Sickle cell disease is an inherited hematological disorder that can affect any organ in the body including the eyes (1-6). Previous studies on ocular manifestations of sickle cell disease generally included samples of less than 100 patients. In this study, we aim to assess the frequency of different ocular signs, symptoms and complications among sickle cell disease patients.
This study was conducted using data from the Cooperative Study of Sickle Cell Disease (CSSCD). Patients with major sickle cell hemoglobinopathies (SS, SC, S β-thal) were eligible for enrollment. Patients from all age groups were included. Patients underwent detailed ophthalmological examination under standardized conditions.
A total of 1904 patients were included in this study, with a mean age of 27.67 (±11.72) years. 1,802 (96.4%) patients had BCVA of more than 20/40 in the better-seeing eye. On slit lamp examination, the presence of vascular loops and segment, representing a positive conjunctival sign, was the most common reported abnormal finding (54.1%). The most common complication was peripheral retinal artery occlusion detected in225 patients (20.3%) bilaterally and 77 patients (6.9%) unilaterally.
In this study that included one of the largest samples ever studied to assess ocular complications of sickle cell disease, we identified the frequency and percentages of different ocular signs, symptoms and complications in different age groups.
Sickle Cell; conjunctival sign; ocular; retinopathy; sunburst. Full-text links
8. What is the place of hematopoietic stem cell transplantation in the management of cerebral vasculopathy in children with sickle cell anemia? Hematol Oncol Stem Cell Ther. 2020 Sep;13(3):121-130. doi: 10.1016/j.hemonc.2019.12.002. Epub 2020 Mar 12.
Françoise Bernaudin 1
Cerebral vasculopathy is the most severe complication affecting children with sickle cell anemia. Significant progress has been made in the management of sickle cell anemia cerebral vasculopathy, including early transcranial Doppler screening, chronic transfusion, andhydroxyurea. Nevertheless, for patients with a potential matched-sibling donor (MSD), stem cell transplantation (SCT) is now the treatment offering the best cerebral vasculopathy outcome. In the absence of MSD,alternative SCT should be recommended only in those with worsening cerebral vasculopathy despite standard treatments, and should be limited to related haplo-identical SCT undertaken in controlled studies. Keywords:
Hydroxyurea; Sickle cell anemia; Silent cerebral infarct; Stroke; Transcranial doppler; Transfusion. Copyright © 2020 King Faisal Specialist Hospital & Research Centre. Published by Elsevier Ltd. All rights reserved. Full-text links
9. Ocular Manifestations of Sickle Cell Disease in Different Genotypes Ophthalmic Epidemiol. 2020 Aug 6;1-6. doi: 10.1080/09286586.2020.1801762. Online ahead of print.
Saif Aldeen AlRyalat 1 , Bahaa Al-Din Mustafa Jaber 2 , Abdulaziz A Alzarea 3 , Abdullah A Alzarea 3 , Wejdan A Alosaimi 4 , Mouna Al Saad 1 Abstract
Sickle cell disease (SCD) is a multisystemic disorder with variable systemic involvement which varies according to genotype. In this study, our aim is to compare ocular complications between HbSS, HbSC, HbS/β+ thalassemia, HbS/β0 thalassemia, SS alpha thalassemia, and S/β0 + alpha thalassemia genotypes.
Data of patients included in this study was recruited from the Cooperative Study of Sickle Cell Disease (CSSCD). Patients with major sickle cell hemoglobinopathies (SS, SC, Sβ- thalassemia, SS alpha thalassemia) were eligible for enrollment, after that, a detailed eye exam was performed. We categorized ocular complications into conjunctival sign, iris atrophy, and both proliferative and non-proliferative sickle cell retinopathy.
A total of 1867 patients were included in this study, with a mean age of 27.7 (± 11.7) years. They were 830 (44.5%) males and 1037 (55.5%) females. The most common genotype was SS with 971 (52%) patients, and the least common form was sickle cell with both alpha and beta thalassemia major with 42 (2.2%) patients. We found a significant difference in the frequency of proliferative sickle cell retinopathy, where SC genotype had the highest frequency and S B0 thalassemia genotype had the lowest frequency. We also found a significant difference in the frequency of conjunctival sign, where SS genotype had the highest frequency and the S B+ thalassemia has the lowest frequency.
We identified ocular complications for major sickle cell hemoglobinopathies, where we confirmed previous small study's findings and identified ocular complications of less common hemoglobinopathies.
Keywords: Sickle cell; eye; genotype; ocular; retinopathy. Full-text links
10. Liver damage and sickle cell disease: genotype relationship Ann Hematol. 2020 Sep;99(9):2065-2072. doi: 10.1007/s00277-020-04113-3. Epub 2020 Jun 22.
Marta Bortolotti 1 , Roberta D'Ambrosio 2 , Mirella Fraquelli 3 , Patrizia Pedrotti 4 , Dario Consonni 1 5 , Margherita Migone De Amicis 6 , Natalia Scaramellini 1 , Elena Di Pierro 6 , Giovanna Graziadei 7
Sickle hepatopathy is a severe and not rare complication of sickle cell disease (SCD), showing mainly a cholestatic pattern. So far, no effective approaches to prevent or treat this condition have been recognized. We conducted a single-center observational study in 68 adult sickle cell patients, encompassing 17 with sickle cell anemia (SCA), 38 with sickle cell thalassemia (HbS/β-Thal), and 13 with HbSC disease. The aim of our study was to assess liver damage in the three main forms of SCD, through the evaluation of clinical, laboratory, and imaging findings. In our population, the role of hepatotropic viruses, high BMI, and alcohol consumption in liver damage was ruled out. SCA and HbS/β-Thal patients with lower Hb (p < 0.001), higher HbS (p < 0.001), and frequent vaso-occlusive crises showed functional (GGT values: SCA and HbS/β-Thal vs HbSC p = 0.047 and p = 0.009, respectively) and structural liver abnormalities, defined by abdominal ultrasound and vibration-controlled transient elastography (liver stiffness values: SCA and HbS/β-Thal vs HbSC p 0.022 and p 0.19, respectively), more severe than HbSC patients. Through univariate and multivariate analyses, male sex, SCA genotype, lower HbF, frequent transfusions, increased GGT values, and abnormal liver ultrasound and stiffness were identified as potentially early markers of sickle hepatopathy. Keywords:
Genotype correlation; Liver disease; Sickle cell disease; Sickle hepatopathy. Publication types Observational Study Full-text links
11. Coronavirus Disease among Persons with Sickle Cell Disease, United States, March 20-May 21, 2020 Emerg Infect Dis. 2020 Oct;26(10):2473-2476. doi: 10.3201/eid2610.202792. Epub 2020 Jul 8. Authors
Julie A Panepinto, Amanda Brandow, Lana Mucalo, Fouza Yusuf, Ashima Singh, Bradley Taylor, Katherine Woods, Amanda B Payne, Georgina Peacock, Laura A Schieve PMID: 32639228 DOI: 10.3201/eid2610.202792
Sickle cell disease (SCD) disproportionately affects Black or African American persons in the United States and can cause multisystem organ damage and reduced lifespan. Among 178 persons with SCD in the United States who were reported to an SCD-coronavirus disease case registry, 122 (69%) were hospitalized and 13 (7%) died. Keywords:
COVID-19; SARS-CoV-2; SCD; United States; coronavirus; coronavirus disease; hemoglobin; respiratory diseases; severe acute respiratory syndrome coronavirus 2; sickle cell disease; viruses; zoonoses.
12. Phytomedicines (medicines derived from plants) for sickle cell disease Cochrane Database Syst Rev. 2020 Sep 25;9:CD004448. doi: 10.1002/14651858.CD004448.pub7.
Oluseyi Oniyangi 1 , Damian H Cohall 2
Sickle cell disease, a common recessively inherited haemoglobin disorder, affects people from sub-Saharan Africa, the Middle East, Mediterranean basin, Indian subcontinent, Caribbean and South America. It is associated with complications and a reduced life expectancy. Phytomedicines (medicine derived from plants in their original state) encompass many of the plant remedies from traditional healers which the populations most affected would encounter. Laboratory research and limited clinical trials have suggested positive effects of phytomedicines both in vivo and in vitro. However, there has been little systematic appraisal of their benefits. This is an updated version of a previously published Cochrane Review.
To assess the benefits and risks of phytomedicines in people with sickle cell disease of all types, of any age, in any setting.
Search methods:
We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Haemoglobinopathies Trials Register, the International Standard Randomised Controlled Trial Number Register (ISRCTN), the Allied and Complimentary Medicine Database (AMED), ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). Dates of most recent searches: Cochrane Cystic Fibrosis and Genetic Disorders Haemoglobinopathies Trials Register: 17 March 2020; ISRCTN: 19 April 2020; AMED: 18 May 2020; ClinicalTrials.gov: 24 April 2020; and the WHO ICTRP: 27 July 2017.
Randomised or quasi-randomised trials with participants of all ages with sickle cell disease, in all settings, comparing the administration of phytomedicines, by any mode to placebo or conventional treatment, including blood transfusion and hydroxyurea.
Data collection and analysis:
Both authors independently assessed trial quality and extracted data.
Main results:
Three trials (212 participants) of three phytomedicines: Niprisan® (also known as Nicosan®), Ciklavit® and a powdered extract of Pfaffia paniculata were included. The Phase IIB (pivotal) trial suggests that Niprisan® may be effective in reducing episodes of severe painful sickle cell disease crisis over a six-month period (low-quality evidence). It did not appear to affect the risk of severe complications or the level of anaemia (low-quality evidence). The single trial of Cajanus cajan (Ciklavit®) reported a possible benefit to individuals with painful crises, and a possible adverse effect (non-significant) on the level of anaemia (low-quality evidence). We are uncertain of the effect of Pfaffia paniculata on the laboratory parameters and symptoms of SCD (very low-quality of evidence). No adverse effects were reported with Niprisan® and Pfaffia paniculata (low- to very low-quality evidence). Authors' conclusions: While Niprisan® appeared to be safe and effective in reducing severe painful crises over a six-month follow-up period, further trials are required to assess its role in managing people with SCD and the results of its multicentre trials are awaited. Currently, no conclusions can be made regarding the efficacy of Ciklavit® and the powdered root extract of Pfaffia paniculata in managing SCD. Based on the published results for Niprisan® and in view of the limitations in data collection and analysis of the three trials, phytomedicines may have a potential beneficial effect in reducing painful crises in SCD. This needs to be further validated in future trials. More trials with improved study design and data collection are required on the safety and efficacy of phytomedicines used in managing SCD.
Trial registration:
ClinicalTrials.gov NCT01771731. Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. Full-text links
13. Randomized Pilot Study: A Mobile Technology-based Self-management Intervention for Sickle Cell Pain West J Nurs Res. 2020 Aug;42(8):629-639. doi: 10.1177/0193945919878821. Epub 2019 Oct 4. Authors
Miriam O Ezenwa 1 , Yingwei Yao 1 , Minh-Nguyet T Nguyen 2 , Molly W Mandernach 2 , Clayton T Hunter 2 , Saunjoo L Yoon 1 , David Fedele 3 , Robert J Lucero 4 , Debra Lyon 1 , Diana J Wilkie 1 Abstract
Little is known about the effects of self-managed relaxation interventions on pain, stress, and autonomic responses in patients with sickle cell disease (SCD). This pre-post randomized controlled pilot study was conducted to determine the feasibility of using computer tablets for relaxation intervention delivery; acceptability of study procedures; and intervention effects on pain, stress, and indicators of relaxation. The 30 research participants ranged in age from 22 years to 59 years. All were African American; 53% were male. They were randomized to an experimental group that watched a relaxation video or a control group that discussed their disease. All participants completed the study, indicating feasibility. Acceptability rates were also high. Data were obtained for the intervention's immediate effect on pain, stress, respiration, pulse, finger skin temperature, and self-reported relaxation. These preliminary findings will guide future, higher-powered studies to determine the intervention's efficacy and mechanism in SCD.The ClinicalTrials.gov Identifier: NCT02729363. Full-text links
14. Administrative data identify sickle cell disease: A critical review of approaches in U.S. health services research Pediatr Blood Cancer. 2020 Sep 17;e28703. doi: 10.1002/pbc.28703. Online ahead of print. Authors
Scott D Grosse 1 , Nancy S Green 2 , Sarah L Reeves 3 4
To identify people living with sickle cell disease (SCD) and study their healthcare utilization, researchers can either use clinical records linked to administrative data or use billing diagnosis codes in stand-alone administrative databases. Correct identification of individuals clinically managed for SCD using diagnosis codes in claims databases is limited by the accuracy of billing codes in outpatient encounters. In this critical review, we assess the strengths and limitations of claims-based SCD case-finding algorithms in stand-alone administrative databases that contain both inpatient and outpatient records. Validation studies conducted using clinical records and newborn screening for confirmation of SCD case status have found that algorithms that require three or more nonpharmacy claims or one inpatient claim plus two or more outpatient claims with SCD codes show acceptable accuracy (positive predictive value and sensitivity) in children and adolescents. Future studies might seek to assess the accuracy of case-finding algorithms over the lifespan.
Keywords: Medicaid; billing codes; diagnostic codes; healthcare use; sickle cell disease. © 2020 Wiley Periodicals LLC. 73 references Full-text links
15. Outcomes of an Emergency Department Observation Unit-Based Pathway for the Treatment of Uncomplicated Vaso-occlusive Events in Sickle Cell Disease Ann Emerg Med. 2020 Sep;76(3S):S12-S20. doi: 10.1016/j.annemergmed.2020.08.007.
Matthew Lyon 1 , Lashon Sturgis 2 , Richard Lottenberg 3 , Marin E Gibson 4 , Jonathan Eck 2 , Abdullah Kutlar 5 , Robert W Gibson 6 Study objective:
This was a prospective, pre-post, 13-year observational study documenting the multiyear implementation of an observation unit sickle cell pathway for patients with uncomplicated vaso-occlusive events.
The sickle cell pathway begins with rapid triage to identify patients with uncomplicated vaso-occlusive events for immediate transfer to the observation unit and initiation of patient-controlled analgesia followed by repeated evaluations of pain and identification of other complications. Data were abstracted from the electronic medical record or observation unit database. The sickle cell pathway was initiated in April 2006. Major revisions of it were carried out in June 2009 (physician evaluation occurs in sickle cell pathway and only patient-controlled analgesia administration of medications) and October 2010 (multidisciplinary management and individual dosing).
Annual ED visits ranged between 287 and 528. The preimplementation hospital admission rate was 33% (123/368), 3-day return rate 16% (60/368), and 30-day return rate 67% (248/368). Refinements to the sickle cell pathway have resulted in a decrease in admission rate to 20% (258/1276); 3-day return rate, to 3.6% (46/1,276); and 30-day return rate, to 41% (525/1,276) for the past 3 years.
The use of a sickle cell pathway for the treatment of uncomplicated vaso-occlusive events has been effective in providing rapid treatment and reducing hospital admissions. However, it was not only the intervention and its refinement that made the sickle cell pathway successful. With the Consolidated Framework for Implementation Research, it was discerned that outer setting factors of organizational commitment to the care of patients with SCD, inner setting factors of learning climate and leadership engagement, individuals, and process contributed to the success of the sickle cell pathway. Copyright © 2020 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved. Full-text links
16. Changing the Clinical Paradigm of Hydroxyurea Treatment for Sickle Cell Anemia through Precision Medicine Clin Pharmacol Ther. 2020 Sep 1. doi: 10.1002/cpt.2028. Online ahead of print. Authors
Min Dong 1 2 , Patrick T McGann 2 3
Sickle cell anemia (SCA) is a common and devastating inherited blood disorder, affecting millions of people across the world. Without treatment, SCA results in tremendous morbidity and early mortality. Hydroxyurea is the primary and most well-established pharmacologic therapy with proven benefits to ameliorate the clinical course of SCA, primarily due to its ability to increase the expression of fetal hemoglobin (HbF), which prevents sickling of red blood cells. The optimal induction of HbF depends upon selection and maintenance of the proper dose that maximizes benefits and minimizes toxicity. Due to the significant interpatient variability in hydroxyurea pharmacokinetics, pharmacodynamics, and dosing, most patients treated with hydroxyurea receive suboptimal doses and have only modest treatment responses. Recognizing this variability, using a precision medicine approach, we developed and prospectively evaluated an individualized dosing model for children with SCA, designed to optimize the hydroxyurea dose and clinical response. We utilize novel laboratory methods and a sparse sampling strategy requiring only 10 microliters of blood collected 15 minutes, 60 minutes, and 180 minutes after a test dose. We use Bayesian adaptive control to estimate hydroxyurea exposure and to select an individual, optimal starting dose. This dosing model has resulted in HbF responses greater than 30-40%, levels beyond what is achieved with traditional weight-based dosing and trial and error dose escalation. This hydroxyurea dosing strategy, if widely implemented, has the potential to change the treatment paradigm of hydroxyurea therapy and improve outcomes for the millions of SCA patients across the world. This article is protected by copyright. All rights reserved. Full-text links
17. Evidence-based dental management in the new era of sickle cell disease: A scoping review J Am Dent Assoc. 2020 Sep;151(9):668-677.e9. doi: 10.1016/j.adaj.2020.05.023.
Lewis L Hsu, Judy Fan-Hsu PMID: 32854869 DOI: 10.1016/j.adaj.2020.05.023
Sickle cell disease (SCD) is an emerging global health issue with rapid progress in therapy especially since 2017. However, systematic reviews found no clinical trials on dental treatment of SCD.
Types of studies reviewed:
Using a scoping review approach, the authors examined citations from 13 national SCD guidelines and 10 books spanning 4 decades. The authors also searched the following databases: PubMed, Cumulative Index to Nursing and Allied Health Literature, ScienceDirect, Scientific Electronic Library Online, and GoogleScholar. Eligibility criteria included SCD, oral health care and dental treatment, related to oral and systemic health, original data, or observations.
Systemic treatment of SCD might have opposing effects on caries, perhaps explaining the conflicting results published. Malocclusion correlates with marrow expansion. Other unusual orofacial findings reflect ischemia. Of 86 full-text articles examined, only 1, a Brazilian esthetic dentistry study, was a randomized clinical trial. No disease-specific data were found on risk of developing bacterial endocarditis, safety of inhaled nitrous oxide, safety of epinephrine with local anesthetic, or the benefit of comprehensive oral health care.
Practical implications:
In SCD, oral health and systemic health could be strongly linked. Penicillin, vaccines, and hydroxyurea might impact caries and bone. The interaction of SCD treatments and oral health merit study.
Sickle cell; caries risk; evidence-based dentistry; guidelines; ischemia; malocclusion; mental nerve neuropathy; osteomyelitis; pulp necrosis; systemic health. Copyright © 2020 American Dental Association. Published by Elsevier Inc. All rights reserved. Full-text links
18. Evaluation of a clinical protocol using intranasal fentanyl for treatment of vaso-occlusive crisis in sickle cell patients in the emergency department Paediatr Child Health. 2020 Aug;25(5):293-299. doi: 10.1093/pch/pxz022. Epub 2019 Mar 7.
Hugo Paquin 1 , Evelyne D Trottier 1 , Yves Pastore 2 , Nancy Robitaille 2 , Marie-Joelle Dore Bergeron 3 , Benoit Bailey 1 Abstract Background:
Vaso-occlusive crisis (VOC) is one of the most frequent causes of emergency visits and admission in children with sickle cell disease (SCD).
This study aims to evaluate whether the use of a new pain management pathway using intranasal (IN) fentanyl from triage leads to improved care, translated by a decrease in time to first opiate dose.
We performed a retrospective chart review of patients with SCD who presented to the emergency department (ED) with VOC, in the period pre- (52 patients) and post- (44 patients) implementation period of the protocol. Time to first opiate was the primary outcome and was evaluated pre- and postimplementation. Patients received a first opiate dose within 52.3 minutes of registration (interquantile range [IQR] 30.6, 74.6), corresponding to a 41.4-minute reduction in the opiate administration time (95% confidence interval [CI] -56.1, -27.9). There was also a 43% increase in the number of patients treated with a nonintravenous (IV) opiate as first opiate dose (95% CI 26, 57). In patients who were discharged from the ED, there was a 49% decrease in the number of IV line insertions (95% CI -67, -22). There was no difference in the hospitalization rates (difference of 6 [95% CI -13, 25]).
This study validates the use of our protocol using IN fentanyl as first treatment of VOC in the ED by significantly reducing the time to first opiate dose and the number of IVs.
19. Risk factors associated with increased emergency department utilization in patients with sickle cell disease: a systematic literature review Ann Hematol. 2020 Aug 27. doi: 10.1007/s00277-020-04205-0. Online ahead of print.
Samir K Ballas 1 , Carlton Dampier 2 3
Sickle cell disease (SCD), a genetic disorder affecting up to 100,000 patients in the USA, impacts multiple organ systems. The emergency department (ED) is frequently utilized by patients with SCD who have severe pain from vaso-occlusive crises. The goal of this systematic literature review is to identify predictors for ED use among patients with SCD in the USA, as high ED reliance is not ideal because of the potential for discontinuity of care as well as higher costs. PubMed and Embase were searched for articles containing the keywords "sickle cell disease" AND ("emergency" OR "acute care") AND ("utilization" OR "health care") published between 2000 and 26 September 2019. A total of 26 publications were identified meeting the following inclusion criteria: report of ED or acute care clinic use; report of health care utilization for SCD; and report of ED visits independent of hospital admission, ED revisits, inpatient care visits, and SCD care unit visits. Articles unavailable in English or those focused on populations outside the USA were excluded. Of the 26 articles included, 4 were prospective and the remainder were retrospective. Qualitative analysis of the articles revealed a higher rate of ED utilization among adults than children, patients with public insurance than private insurance, and patients with more comorbidities, complications, or pain. Age and pain levels were both commonly cited as predictors of ED utilization. Additional prospective and interventional studies are needed to further define predictors of ED utilization and to uncover treatments that decrease ED visits. Full-text links
20. Pregnancy in sickle cell trait: what we do and don't know Br J Haematol. 2020 Aug;190(3):328-335. doi: 10.1111/bjh.16518. Epub 2020 Feb 17.
Samuel Wilson 1 2 3 , Patrick Ellsworth 1 2 3 , Nigel S Key 1 3 4 Abstract
Sickle cell trait (SCT) is the carrier state for sickle cell disease that results from the HBB rs334 missense mutation (p.Glu6Val) in the β-globin chain of haemoglobin. While not associated with any impact on life expectancy, it has been established that SCT is associated with an increased risk of both venous thromboembolism (and in particular, pulmonary embolism) and chronic kidney disease. It is largely unknown what short- or long-term effect, if any, pregnancy has upon the risk or outcomes of these disorders. In addition, SCT has been linked with various adverse outcomes in pregnancy, ranging from maternal complications such as elevated risk of bacteriuria to potentially life-threatening entities such as pre-eclampsia and prematurity. In these scenarios also, no clear association with SCT has been established. Given the high worldwide prevalence of SCT, further studies addressing these issues are warranted.
chronic kidney disease; pregnancy; sickle cell trait; venous thromboembolism. © 2020 British Society for Haematology and John Wiley & Sons Ltd. Full-text links
21. Pica behaviors in pediatric patients with sickle cell disease: a scoping review protocol JBI Evid Synth. 2020 Sep;18(9):2018-2024. doi: 10.11124/JBISRIR-D-19-00241.
Olivia M Clark 1 2 , Renee Williams 1 2
The objective of this review is to explore existing literature regarding pica in pediatric patients with sickle cell disease and to identify associated interventions and outcomes.
Pica is a psychological eating disorder that is characterized by the consumption of items that contain no nutritional value. The ingestion of non-food items causes complications that can be harmful or even fatal. Approximately one-third of patients with sickle cell disease will also develop pica behaviors.
This review will consider studies that include pediatric patients from 18 months to 18 years of age who have been diagnosed with any type of sickle cell disease and have a history of pica. The study will examine interventions used in any setting to treat pediatric patients with sickle cell disease and pica and associated outcomes. Any study type will be considered for inclusion.
Databases to be searched will include CINAHL (EBSCO), Embase (Elsevier), Europe PubMed Central (PubMed), Psychology and Behavioral Sciences Collection (EBSCO), and Scopus (Elsevier). Data will be extracted from included papers by two independent reviewers. The data extracted will include details about the populations, concept, context, and study methods of significance to the review questions and objective. The extracted data will be presented in diagrammatic or tabular form in a manner that aligns to the objectives and scope of this review. Full-text links
22. Prognostic Value of Hyponatremia During Acute Painful Episodes in Sickle Cell Disease Am J Med. 2020 Sep;133(9):e465-e482. doi: 10.1016/j.amjmed.2020.02.017. Epub 2020 Mar 19. Authors
Jean-Simon Rech 1 , Kan Yao 2 , Claude Bachmeyer 3 , Sophie Bailleul 4 , Orlando Javier 5 , Gilles Grateau 6 , François Lionnet 1 , Olivier Steichen 7
Low plasma sodium concentration has been recognized as a prognostic factor in several disorders but never evaluated in sickle cell disease. The present study evaluates its value at admission to predict a complication in adult patients with sickle cell disease hospitalized for an initially uncomplicated acute painful episode. Methods:
The primary outcome of this retrospective study, performed between 2010 and 2015 in a French referral center for sickle cell disease, was a composite criterion including acute chest syndrome, intensive care unit transfer, red blood cell transfusion or inpatient death. Analyses were adjusted for age, sex, hemoglobin genotype and concentration, lactate dehydrogenase (LDH) concentration, and white blood cell count.
We included 1218 stays (406 patients). No inpatient death occurred during the study period. Hyponatremia (plasma sodium ≤135 mmol/L) at admission in the center was associated with the primary outcome (adjusted odds ratio [OR] 1.95, 95% confidence interval [CI] 1.3-2.91, P = 0.001), with acute chest syndrome (OR 1.95 [95% CI 1.2-3.17, P = 0.008]), and red blood cell transfusion (OR 2.71 [95% CI 1.58-4.65, P <0.001]) but not significantly with intensive care unit transfer (OR 1.83 [95% CI 0.94-3.79, P = 0.074]). Adjusted mean length of stay was longer by 1.1 days (95% CI 0.5-1.6, P <0.001) in patients with hyponatremia at admission.
Hyponatremia at admission in the medical department for an acute painful episode is a strong and independent prognostic factor of unfavorable outcome and, notably, acute chest syndrome. It could help targeting patients who may benefit from closer monitoring. Copyright © 2020 Elsevier Inc. All rights reserved. Full-text links
23. Smartphone-based sickle cell disease detection and monitoring for point-of-care settings Biosens Bioelectron. 2020 Oct 1;165:112417. doi: 10.1016/j.bios.2020.112417. Epub 2020 Jul 9. Authors
Shazia Ilyas 1 , Mazhar Sher 1 , E Du 2 , Waseem Asghar 3
Sickle cell disease (SCD) is a worldwide hematological disorder causing painful episodes, anemia, organ damage, stroke, and even deaths. It is more common in sub-Saharan Africa and other resource-limited countries. Conventional laboratory-based diagnostic methods for SCD are time-consuming, complex, and cannot be performed at point-of-care (POC) and home settings. Optical microscope-based classification and counting demands a significant amount of time, extensive setup, and cost along with the skilled human labor to distinguish the normal red blood cells (RBCs) from sickled cells. There is an unmet need to develop a POC and home-based test to diagnose and monitor SCD and reduce mortality in resource-limited settings. An early-stage and timely diagnosis of SCD can help in the effective management of the disease. In this article, we utilized a smartphone-based image acquisition method for capturing RBC images from the SCD patients in normoxia and hypoxia conditions. A computer algorithm is developed to differentiate RBCs from the patient's blood before and after cell sickling. Using the developed smartphone-based technique, we obtained similar percentage of sickle cells in blood samples as analyzed by conventional method (standard microscope). The developed method of testing demonstrates the potential utility of the smartphone-based test for reducing the overall cost of screening and management for SCD, thus increasing the practicality of smartphone-based screening technique for SCD in low-resource settings. Our setup does not require any special storage requirements. This is the characteristic advantage of our technique as compared to other hemoglobin-based POC diagnostic techniques.
Microfluidics; Point-of-care diagnostics; SCD testing; Sickle cell diseases; and Smartphone-based biosensors. Copyright © 2020 Elsevier B.V. All rights reserved. Full-text links
24. Biochemical and therapeutic effects of Omega-3 fatty acids in sickle cell disease Complement Ther Med. 2020 Aug;52:102482. doi: 10.1016/j.ctim.2020.102482. Epub 2020 Jun 9.
Ahmed A Daak 1 , Miguel A Lopez-Toledano 2 , Matthew M Heeney 3
Sickle cell disease (SCD) is a hematologic disorder with complex pathophysiology that includes chronic hemolysis, vaso-occlusion and inflammation. Increased leukocyte-erythrocyte-endothelial interactions, due to upregulated expression of adhesion molecules and activated endothelium, are thought to play a primary role in initiation and progression of SCD vaso-occlusive crisis and end-organ damage. Several new pathophysiology-based therapeutic options for SCD are being developed, chiefly targeting the inflammatory pathways. Omega-3 fatty acids are polyunsaturated fatty acids that are known to have effects on diverse physiological processes. Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are the principal biologically active omega-3 fatty acids. The therapeutic effects of DHA and EPA on chronic inflammatory disorders and cardiovascular diseases are well recognized. The therapeutic effects of omega-3 fatty acids are attributed to their anti-inflammatory and anti-thrombotic eicosanoids, and the novel class of EPA and DHA derived lipid mediators: resolvins, protectins and maresins. Blood cell membranes of patients with SCD have abnormal fatty acids composition characterized by high ratio of pro-inflammatory arachidonic acid (AA) to anti-inflammatory DHA and EPA (high omega-6/omega-3 ratio). In addition, experimental and clinical studies provide evidence that treatment with DHA does confer improvement in rheological properties of sickle RBC, inflammation and hemolysis. The clinical studies have shown improvements in VOC rate, markers of inflammation, adhesion, and hemolysis. In toto, the results of studies on the therapeutic effects of omega-3 fatty acids in SCD provide good body of evidence that omega-3 fatty acids could be a safe and effective treatment for SCD. Copyright © 2020 Elsevier Ltd. All rights reserved. Full-text links
Meetings for the Sickle Cell Community
New York Chapter of the National Sickle Cell Disease Association of America encourages you to apply for the 2020 SCD community health training hosted by the New York State Sickle Cell Advocacy Network, INC. NYS-SCAN.
If you have a passion for community health, have been personally affected by SCD, or want more education about SCD, this training is for you! Free online sessions will be held for 13 consecutive weeks. Sessions will be held weekly on Mondays from 11 am to 1 pm and Wednesdays from 6 pm to 8 pm. You choose which session fits within your schedule. This series will begin September 28, 2020, via Zoom and will cover 1 topic per week.
The program covers the core competencies of SCD such as facts about SCD, transitioning into adult services, complications, treatments, sickle cell trait, healthy living, emergency guide, information for emergency room providers as well as COVID-19 and SCD just to name a few.
Due to the many impacts of the COVID-19 pandemic, we are mindful of the fact that some wanting to participate in the training may be facing financial hardship. Considering this, we are awarding 45 qualifying participants a registration scholarship. This scholarship will award you FREE access to a 3-month Zoom account as well as training materials that are provided by presenters.
To be considered for the scholarship, registrants must complete the series of workshops. If you have any questions please contact us at 718-712-0873 or via email at qscan08@gmail.com.
Participants, please use this link 2020 SCD Community Health Training Registration. Please be on the lookout for our confirmation email which will include Zoom meeting information.
First IASCNAPA Conference
The International Association of Sickle Cell Nurses and Professional Associates (IASCNAPA) Sickle Cell Conference: Treating the Whole Person scheduled for 4/17/2020 in Memphis is cancelled due to COVID-19 concerns. The decision to cancel the conference took into account many important factors, including the risk of unnecessary exposure to our patient population.
The event is rescheduled for April 9, 2021 at the Memphis Hilton.
Your understanding and support are greatly appreciated! For information go to www.iascnapa.org
Save the Date – SCDAA's 48th Annual National Convention 2020 Is Going Virtual Given the current uncertainty regarding COVID-19 and its implications for attendee safety and travel, as well as for public health concerns, the Sickle Cell Disease Association of America's (SCDAA) 48th Annual National Convention is moving to a virtual gathering on October 14-17, 2020. Clear here for more information.


Coming to stardom as a State of Origin Legend of Rugby League, Billy Moore provides so much more than just an Ambassadorial role to the Brisbane Bombers NRL Expansion Bid. A former Division manager on the Sunshine Coast, small business owner and advocate to CSM Australia Corporate Hospitality, Billy provides a wealth of experience in launching new businesses and is one of the stand-outs of corporate networking on the East Coast.
An integral part of the Brisbane Bombers long-term strategy from grass-roots to corporate engagement, Billy brings one of the strongest can-do approaches in Rugby League with the experience to match.


HP Indigo 7800 Digital Press.
Hewlett-Packard is introducing its new HP Indigo 7800 and 30000 Digital Presses, as well as new production-printing services. The firm also announced it would be developing high-volume inkjet-printing solutions with partner Koenig & Bauer Group (KBA) (see below).
HP says its new HP Indigo 7800 and 30000 Digital Presses and new HP Service Advantage portfolio enable print service providers (PSPs) to capture additional business, offering print buyers a broader application range and greater value.
The HP Indigo 7800 and 30000 Digital Presses, winners of Graph Expo 14 MUST SEE 'EMS Awards, and the HP Indigo 10000 Digital Press, a 2013 InterTechTM Technology Award winner, are on display in HP's booth at the Graph Expo 14 trade show being held in Chicago, Illinois.
Since its launch in June 2014, the HP says the Indigo 7800 Digital Press has seen strong worldwide adoption, including two installations at West Chester, Pennsylvania-based ANRO, Inc. The HP Indigo 7800 Digital Press offers ANRO a new color-management experience with an in-line spectrophotometer, improved productivity, and a range of new capabilities, including the ability to print directly on synthetic substrates with One Shot Color technology.
City of Industry, California-based Marrs Printing & Packaging, Inc., which is creating high-quality custom packaging for the hardware and automotive, housewares and appliances, cosmetics and pharmaceutical industries.
Fitchburg, Massachusetts-based Boutwell, Owens & Co., Inc., a full-service designer and manufacturer of printed paperboard packaging, which is expanding into digital printing to grow its folding-carton packaging capabilities for retail applications.
Germany-based Pfaffle, which is also making its first move into digital printing with high-end confectionary applications, complex finishing, and embellishment.
HP says its new HP Service Advantage is an integrated services portfolio that enables predictable printing operations and optimized cost structure. HP Service Advantage includes two new service technologies, HP Predictive Press Care and HP Visual Remote Guidance, in addition to two established technologies, HP Print Care and HP Smart Uptime Kit.
HP Predictive Press Care technology is said to minimize unplanned downtime with early, information-rich alerts, flagging upcoming press issues for preemptive repairs and maintenance. Enabling press operators to resolve issues faster, HP Visual Remote Guidance provides real-time audio and visually guided support from a remote engineer using wearable technology through HP MyRoom.
Also at Graph Expo 2014, HP announced its collaboration with Koenig & Bauer Group (KBA), with which it will develop new roll-to-roll inkjet production-printing solutions for the high-volume corrugated-packaging market. The co-developed solutions will be marketed under the HP brand.
With a market value of $2.5 billion, HP says the corrugated package-printing industry is steadily increasing worldwide due to brand globalization, population growth, and a resurging economy. In parallel, trends such as stock keeping unit (SKU) proliferation, micro-segmentation, and shorter product lifecycles are driving demand for the shorter run lengths enabled by digital print.
To help corrugated converters and print-service providers (PSPs) take advantage of these trends, HP and KBA intend to deliver high-speed, roll-to-roll thermal inkjet solutions that provide value-chain cost savings while meeting brands' quality and volume requirements.
This year, HP also announced its intent to enter the corrugated-packaging segment with its inkjet web-press technology, followed by its first offering, the HP High-speed Inkjet Corrugated Packaging Solution, and the solution's first customer installation at Obaly Morava, a.s. HP says its agreement with KBA demonstrates its continued pursuit of corrugated-packaging opportunities and intention to broaden its portfolio of inkjet products and solutions.
A 197-year-old company and the second-largest press manufacturer worldwide, KBA brings its strengths in paper-handling, manufacturing scale, and knowledge of the packaging market to the joint initiative.


A late-February farm machinery dispersal sale demonstrated that straight from farm equipment continues to be in strong demand. David Williams reports.
The sale was arranged by Cheffins on behalf of Russell Smith Farms and Cheveley Park Farms, Thriplow, Cambs to dispose of surplus equipment due to a change in farming policy. Both farms were previous clients of Cheffins, and the lots on offer ranged from modern tractors and potato planting, harvesting and irrigation equipment to many older items, but all was well maintained and attractive to end users and trade buyers.
Weather on the sale day was unusually warm and dry for the time of year so many local farmers were making the most of the opportunity to establish spring crops and apply early fertiliser but even so, many found time to attend.
Oliver said demand for specialist potato equipment remains strong, and successful bids were from England, Scotland and Ireland. "Downs products sold well, but the overall highlight was a JCB Loadall with more than 5,000 hours recorded which achieved a fantastic price.
The warm weather meant an on-site ice cream van did a good trade too, and a fly-past by a Spitfire from nearby Duxford Imperial War Museum delighted everyone present.
Two similar John Deere 6150R tractors sold well. Furthest from the camera; a 2013 model with AutoQuad Plus 50kph transmission had front axle and cab suspension, air brakes, 4 spools and was on 650/65R38 rear and 540/65R28 front tyres and wheels. It had been on the farm from new and carried a '13-plate'. Hours worked were 5,776 and it achieved a winning bid of £45,200.
The other 6150R was an AutoPowr 40kph model with front axle and cab suspension, Dagenhart front linkage and PTO, 3 spools, Power Beyond and it was Autotrac-ready. It was on 650/65R38 rear and 540/65R28 front wheels and tyres and carried a '63-plate'. It had worked 5,516 hours and made £46,200.
A classic Ford 6410 Series 3, 4wd dating from 1990 made £9,400. It had a Super Q cab, front weights and was on 13.6R38 rear and 12.4R24 front tyres. It had worked 12,021 hours and like most of the other tractors had been on the farm from new and was very tidy for its age.
Vaderstad cultivation machinery and drills are always in strong demand and this 'included' 10.3m Rexius Twin Press didn't disappoint, achieving a winning bid of £45,000.
More items to view on pages 62-65 in April issue.