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Posterior Uveitis and Collagen Vascular Diseases
SARCOIDOSIS-ASSOCIATED UVEITIS
Sapna Gangaputra
H. Nida Sen
Sarcoidosis is a multisystem granulomatous disorder that most commonly affects the lungs, skin, lymph nodes, eyes, central nervous system (CNS), reticuloendothelial system, the heart, and bones.
Epidemiology and Etiology
• Sarcoidosis occurs most commonly in African Americans and Caucasians of Northern European descent.
• The incidence and prevalence varies among different geographic regions and ethnic groups:
In the United States, the prevalence among African Americans is 35 to 82 in 100,000 persons, whereas in Caucasians, it is 8 to 11 in 100,000 persons.
In Scandinavia, the prevalence is 64 in 100,000 persons.
• Most common organs involved are the lungs (90% to 95%), followed by skin (15% to 20%), lymph nodes (15% to 40%), and eyes (12% to 20%).
• Systemic sarcoidosis typically affects young adults, whereas ocular sarcoidosis appears to have a bimodal presentation, with peaks at 20 to 30 years and 50 to 60 years.
• Ophthalmic involvement occurs in up to 50% of patients with systemic sarcoidosis, but most series suggest that the rate is around 25%.
• Sarcoidosis-associated uveitis occurs in 1% to 3% of pediatric and 10% of adult uveitis cases.
Ocular involvement is more common among women compared to men, and in African Americans compared to Caucasians.
Patients typically have a bilateral (98%), granulomatous anterior uveitis. This is the presenting sign of sarcoidosis in 10% to 20% of patients.
The most common site of intraocular involvement is anterior uveitis (two-thirds of patients).
The most common site of extraocular involvement is the lacrimal gland.
• Although the etiology is unknown, sarcoidosis is believed to be immune mediated. Both a genetic predisposition (familial aggregation, HLA-B8, and HLA-DRB1) and environmental factors (environmental allergens and infectious agents) have been suggested.
• Blurry vision, floaters • Redness, photophobia, ocular discomfort
• Respiratory symptoms (shortness of breath) and constitutional symptoms (fever, fatigue, night sweats, and weight loss)
• In 2006, the first International Workshop on Ocular Sarcoidosis developed criteria for the diagnosis of ocular sarcoidosis, which include seven ocular signs considered suggestive of ocular sarcoidosis (Table 7-1).
Mutton-fat (granulomatous) keratic precipitates (KPs), anterior chamber cells and flare, and iris or angle nodules (granulomas). Busacca nodules are in the iris stroma, and Koeppe nodules are on the pupillary margin (Figs. 7-1, 7-2, 7-3, 7-4, 7-5, 7-6 and 7-7).
The KPs may also be nongranulomatous.
Nodules on the trabecular meshwork and/or tent-shaped peripheral anterior synechiae
Vitreous cells, vitreous haze, snowballs sometimes with a "string of pearls" appearance, and snowbanks
Multifocal, cream-colored, peripheral chorioretinal lesions (Dalen-Fuchs nodules), either active or atrophic
Retinal vasculitis, perivenous sheathing (candle wax drippings, also known as taches de bougie), and/or a retinal macroaneurysm in an inflamed eye
Optic disc or choroidal granulomas
Bilaterality
• Other ophthalmic findings include:
Lacrimal gland enlargement
Subconjunctival granulomas
Heerfordt syndrome (uveoparotid fever): anterior uveitis, parotid gland enlargement, facial palsy, and fever
Retinal neovascularization, sometimes with a sea fan appearance
• The major systemic signs include:
Respiratory dysfunction
Skin macules and papules, including erythema nodosum and lupus pernio
Cranial nerve palsies
Ataxia and cognitive dysfunction
Cardiomyopathy and arrhythmias
• Vogt-Koyanagi-Harada (VKH) syndrome
• Sympathetic ophthalmia
• Multifocal choroiditis
• Primary intraocular lymphoma (retinal lymphoma)
• Tuberculosis
• Syphilis
• Lyme disease
• Blau syndrome and juvenile idiopathic arthritis in children
Diagnostic Evaluation
• Definitive diagnosis requires tissue biopsy showing noncaseating granulomas. The granulomas appear as whorls of epithelioid cells surrounding multinucleated Langhans giant cells. Conjunctival biopsies are only performed in the presence of conjunctival granulomas.
• Systemic evaluation and imaging studies: chest radiograph and/or high-resolution chest computed tomography (CT) to identify hilar lymphadenopathy; gallium scan
(not recommended for routine screening); pulmonary function tests (reduction in diffusing capacity); bronchoalveolar lavage (elevated CD4/CD8 ratio); biopsy of the involved tissue; and/or brain magnetic resonance imaging (MRI) if neurosarcoidosis is suspected.
TABLE 7-1. Diagnostic Criteria for Ocular Sarcoidosis from the International Workshop on Ocular Sarcoidosis
Definite ocular sarcoidosis
Biopsy-supported diagnosis with compatible uveitis
Presumed ocular sarcoidosis
Biopsy not done; bilateral hilar lymphadenopathy with compatible uveitis
Probable ocular sarcoidosis
Biopsy not done; chest radiograph normal; three suggestive ocular signs* and two positive investigational tests†
Possible ocular sarcoidosis
Biopsy negative; four suggestive ocular signs* and two positive investigations†
* Clinical ocular signs
1. Mutton-fat KPs (large and small) and/or iris nodules at pupillary margin (Koeppe) or in stroma (Busacca)
2. Trabecular meshwork (TM) nodules and/or tent-shaped peripheral anterior synechiae (PAS)
3. Snowballs/string of pearls vitreous opacities
4. Multiple chorioretinal peripheral lesions (active and atrophic)
5. Nodular and/or segmental periphlebitis (±candle wax drippings) and/or macroaneurysm in an inflamed eye
6. Optic disc nodule(s)/granuloma(s) and/or solitary choroidal nodule
7. Bilaterality (assessed by clinical examination or investigational tests showing subclinical inflammation)
† Investigational signs
1. Negative tuberculin test in a BCG-vaccinated patient or having had a positive PPD (or Mantoux) skin test previously
2. Elevated serum angiotensin-converting enzyme (ACE) and/or elevated serum lysozyme
3. Chest x-ray looking for bilateral hilar lymphadenopathy (BHL)
4. Abnormal liver enzyme tests (any two of alkaline phosphatase, AST, ALT, LDH, or ã-GT)
5. Chest CT scan in patients with negative chest x-ray
ALT, alanine transaminase; AST, aspartate transaminase; BCG, Bacillus Calmette-Guerin; CT, computed tomography; LDH, lactate dehydrogenase; PPD, purified protein derivative; ã-GT, gamma-glutamyl transferase
From Herbort CP, Rao NA, Mochizuki M; members of Scientific Committee of First International Workshop on Ocular Sarcoidosis. International criteria for the diagnosis of ocular sarcoidosis: results of the first International Workshop on Ocular Sarcoidosis (IWOS). Ocul Immunol Inflamm. 2009;17:160-169.
• Laboratory testing: Angiotensin-converting enzyme is elevated in 75% of patients, lysozyme, hypercalcemia, hypercalciuria, anemia, elevated erythrocyte sedimentation rate (ESR)/C-reactive protein (CRP), anergy, elevated alkaline phosphatase.
• When screening for ocular sarcoidosis among patients with active uveitis, the combination of an elevated serum angiotensin-converting enzyme level and chest radiographic findings typical for sarcoidosis increases the sensitivity up to 79%.
• Fluorescein angiography can reveal retinal vascular leakage, early blockage and late staining of choroidal granulomas, retinal pigment epithelial (RPE) window defects, and cystoid macular edema (CME).
• None of the above is specific or diagnostic by itself; therefore, it is a clinical diagnosis, which is supported by imaging and laboratory testing. Tissue biopsy is required for definitive diagnosis.
• Corticosteroids are the mainstay of therapy for both ocular and systemic sarcoidosis, and intravenous pulse steroids may be needed in some very severe cases.
• Sarcoidosis is often responsive to steroids; however, chronic uveitis often requires
immunomodulatory therapy. Methotrexate, cyclosporine, mycophenolate mofetil, and infliximab have all been used successfully in ocular sarcoidosis.
• Local treatment with topical drops, periocular steroids, and intraocular steroid implants can also be considered in select cases.
• The prognosis is good if treated early.
• African Americans tend to have more acute and severe disease, whereas Caucasians tend to have chronic, asymptomatic disease.
• Chronic posterior or panuveitis, glaucoma, CME, older age at presentation, and delay in presentation to a sarcoid/uveitis subspecialist may confer a poor visual prognosis.
• Ocular complications can include glaucoma, cataract, CME, optic disc edema, occlusive vasculopathy, retinal or optic disc neovascularization, vitreous hemorrhage, and retinal detachment.
FIGURE 7-1. Sarcoidosis. A. There are large, granulomatous-appearing (mutton-fat) keratic precipitates in this patient with sarcoidosis. B. Busacca nodules in the iris stroma are typically associated with diseases causing granulomatous uveitis, such as sarcoidosis.
Baughman RP, Teirstein AS, Judson MA, et al. Case control etiologic study of sarcoidosis (ACCESS) research group. Clinical characteristics of patients in a case control study of sarcoidosis. Am J Respir Crit Care Med. 2001;164(10 Pt 1):1885-1889.
Groen F, van Laar JA, Rothova A. Chest radiographic screening for sarcoidosis in the diagnosis of patients with active uveitis. Ann Am Thorac Soc. 2017;14(6):912-918.
Herbort CP, Rao NA, Mochizuki M; members of Scientific Committee of First International Workshop on Ocular Sarcoidosis. International criteria for the diagnosis of ocular sarcoidosis: results of the first International Workshop on Ocular Sarcoidosis (IWOS). Ocul Immunol Inflamm. 2009;17(3):160-169.
Lobo A, Barton K, Minassian D, du Bois RM, Lightman S. Visual loss in sarcoid-related uveitis. Clin Experiment Ophthalmol. 2003;31(4):310-316.
Pasadhika S, Rosenbaum JT. Ocular sarcoidosis. Clin Chest Med. 2015;36(4):669-683.
FIGURE 7-2. Sarcoidosis. A. This patient with severe sarcoidosis has posterior uveitis with granulomas and intense exudates surrounding the vessels. Note the asymmetric involvement between the right and left eyes. The fluorescein angiogram of the left eye (lower right) demonstrates leakage and staining in the late frames. B. Exudates surrounding the vessels, also known as "candle wax drippings" or "taches de bougie," are seen inferiorly.
FIGURE 7-3. Sarcoidosis. "Candle wax drippings" along the major arcade vessels. (Courtesy of Sunir Garg, MD.)
FIGURE 7-4. Sarcoidosis. Sarcoidosis patient with intermediate uveitis with snowballs and retinal vascular sheathing inferiorly (magnified), as well as retinal vasculitis with leakage on fluorescein angiogram. Note that the extent of retinal vascular leakage is significantly more impressive than expected based on the fundus exam.
FIGURE 7-5. Sarcoidosis. There are multiple skin nodules due to sarcoidosis in an African American patient with liver and ocular sarcoidosis. The inferior periorbital skin, the nose, elbow, and perioral skin are involved.
FIGURE 7-6. Sarcoidosis. There are the typical punched-out chorioretinal lesions in a 65-year-old Caucasian patient with ocular sarcoidosis. These lesions are believed to be representative of atrophic Dalen-Fuchs nodules.
FIGURE 7-7. Sarcoidosis. Optic nerve granuloma in the right eye of a 42-year-old African American patient with sarcoidosis.
SYMPATHETIC OPHTHALMIA
Rishi R. Doshi
S. R. Rathinam
Emmett T. Cunningham Jr.
Sympathetic ophthalmia is a bilateral granulomatous panuveitis that occurs when ocular surgery or ocular trauma to one eye (the exciting eye) incites inflammation both in the traumatized eye and in the fellow (sympathizing) eye.
Etiology and Epidemiology
• It has an estimated incidence of 0.03 in 100,000; the incidence is higher after vitreoretinal surgery (1 in 1152 procedures) compared to other ocular surgeries; and surgery has surpassed trauma as the most common inciting event.
• Previously sequestered ocular antigens from the uvea, retina, or choroidal melanocytes stimulate an autoimmune response.
• Historically, men and children were more commonly affected because of higher rates of trauma, but currently, it occurs equally in both men and women with an increased incidence in elderly patients because of higher rates of surgery.
• It may occur after endophthalmitis, with an incidence from 1% to 11%.
• 80% of cases occur within 3 months of surgery/trauma and 90% occur within 1 year, but it has been reported to occur anytime between 1 week and 66 years after injury.
• There is an increased prevalence in patients with HLA-DR4 and HLA-A11.
• Patients often have a prodrome of tearing, photophobia, and blurry vision (loss of accommodation), which may progress to severe vision loss, pain, floaters, and photopsias in both eyes.
• Both eyes have inflammation with:
Anterior uveitis (55%); granulomatous KPs, iris thickening and synechiae, low or high intraocular pressure (from ciliary body shutdown or angle closure), vitritis (47%); disc edema (20%); serous retinal detachment (12%); choroiditis (8%); and macular edema (5%) (Figs. 7-8, 7-9, 7-10, 7-11 and 7-12)
Dalen-Fuchs nodules are yellow-white midequatorial RPE lesions composed of epithelioid cells and histiocytes (30% to 70%).
Late findings may include sunset glow fundus, optic atrophy, choroidal neovascularization, and phthisis.
Systemic findings may include cerebrospinal fluid pleocytosis, hearing disturbances, alopecia, poliosis, and vitiligo (but these are much more typical of VKH).
• VKH (no history of penetrating trauma or surgery)
• Sarcoidosis
• Intraocular lymphoma
• On fluorescein angiography, patients have multiple pinpoint areas of hyperfluorescence with late leakage, choroidal lesions that block early and stain late, and late disc staining.
• Optical coherence tomography can show multifocal serous retinal detachments.
• B-scan ultrasonography demonstrates choroidal thickening and serous retinal detachments.
• Histopathology characteristically demonstrates a diffuse granulomatous non-necrotizing panuveitis with thickening of choroid and early sparing of choriocapillaris.
• First-line therapy is high-dose oral corticosteroids (1 to 2 mg/kg/day), with a slow taper.
• Topical corticosteroids and cycloplegic/mydriatic agents can help alleviate some of the more acute symptoms.
• Corticosteroid-sparing immunosuppressive agents are typically required because most patients need long-term treatment.
• A fluocinolone acetonide implant (Retisert) may be useful in select cases.
• Enucleation of the exciting eye within 2 weeks of the inciting event may decrease the risk of sympathetic ophthalmia; once sympathetic ophthalmia occurs, enucleation should be considered only in a blind, painful eye.
• It is a vision-threatening disease, with only slightly more than half of treated patients retaining visual acuity ≥20/40. One-fourth of patients have vision worse than 20/200.
FIGURE 7-8. Sympathetic ophthalmia. Phthisis bulbi following a ruptured globe in a patient with sympathetic ophthalmia.
• Complications include cataract and glaucoma.
• Predictors of a poor outcome include a traumatic etiology, active, uncontrolled intraocular inflammation, and an exudative retinal detachment.
• Long-term visual loss may result from chorioretinal scars, chronic macular edema, and choroidal neovascularization.
Castiblanco CP, Adelman RA. Sympathetic ophthalmia. Graefes Arch Clin Exp Ophthalmol. 2009;247:289-302.
Galor A, Davis JL, Flynn HW, et al. Sympathetic ophthalmia: incidence of ocular complications and vision loss in the sympathizing eye. Am J Ophthalmol. 2009;148:704-710.
Mahajan S, Invernizzi A, Agrawal R, Biswas J, Rao NA, Gupta V. Multimodal imaging in sympathetic ophthalmia. Ocul Immunol Inflamm. 2016;14:1-8.
Payal AR, Foster CS. Long-term drug-free remission and visual outcomes in sympathetic ophthalmia. Ocul Immunol Inflamm. 2016; 25:1-6.
Rathinam SR, Rao NA. Sympathetic ophthalmia following
postoperative bacterial endophthalmitis: a clinicopathologic study. Am J Ophthalmol. 2006;141(3):498-507.
FIGURE 7-9. Sympathetic ophthalmia. B-scan ultrasound showing a chronic retinal detachment and choroidal thickening in a patient with sympathetic ophthalmia.
FIGURE 7-10. Sympathetic ophthalmia. Characteristic posterior segment findings in two patients who developed sympathetic ophthalmia weeks after uncomplicated pars plana vitrectomy. Color fundus photograph (A) and midphase fluorescein angiogram (B) from the same patient 2 months following vitrectomy showing a macular serous detachment with multiple, pinpoint areas of leakage through the retinal pigment epithelium. C. Color fundus photographs taken approximately 6 months following vitrectomy showing moderate vitreous inflammation and active chorioretinal infiltrates. D. Photograph of the same patient taken approximately 18 months following vitrectomy, after the patient's inflammation had been controlled with high-dose systemic corticosteroids followed by noncorticosteroid immunosuppressive agents. Although histopathologically unverified, many would describe these infiltrates clinically as Dalen-Fuchs nodules. (Reproduced from Doshi RR, Arevalo JF, Flynn HW Jr, Cunningham ET Jr. Evaluating exaggerated, prolonged, or delayed postoperative intraocular inflammation. Am J Ophthalmol. 2010, with permission of Elsevier.)
FIGURE 7-11. Sympathetic ophthalmia. Bullous serous retinal detachment in a patient with sympathetic ophthalmia.
FIGURE 7-12. Sympathetic ophthalmia. A. This patient underwent ruptured globe repair following blunt trauma. B. Several months later, the patient returned complaining of photophobia and blurred vision in the previously healthy right eye. There is disc hyperemia, mild macular striations caused by subretinal fluid, and deep, choroidal yellow plaques characteristic of sympathetic ophthalmia. C. The fluorescein angiogram demonstrates disc hyperfluorescence and pinpoint leakage and staining from the areas of choroiditis. (Courtesy of Allen Chiang, MD, and Andre Witkin, MD.)
VOGT-KOYANAGI-HARADA SYNDROME
Vogt-Koyanagi-Harada (VKH) syndrome is a bilateral granulomatous panuveitis with skin, meningeal, and auditory-vestibular involvement. It is an autoimmune inflammatory condition mediated by T cells that target melanocytes in individuals susceptible to the disease
• VKH has a predilection for pigmented races and is seen in patients from Asia, Middle East, and Latin America. It also occurs in persons with Native American ancestry. It is relatively rare in whites.
• It is most common in the second to fourth decade of life.
• There is a slight female preponderance.
• VKH has a genetic predisposition and has
been associated with HLA-DR4, HLA-DR53, and HLA-DRB1*0405.
• Unlike sympathetic ophthalmia, patients with VKH have no history of penetrating ocular trauma or surgery.
• Blurry vision, floaters
• Headache, vertigo, neck stiffness
• Dysacusis and tinnitus
• Skin changes: vitiligo (skin depigmentation, Fig. 7-13), poliosis (hair whitening, Fig. 7-14), and alopecia in the later stages
• An international committee on VKH nomenclature has revised the criteria for diagnosis as shown in Table 7-2.
This contribution to the work was done as part of the author's official duties as NIH employees and is a work of the U.S. government.
• Sympathetic ophthalmia (these patients have a history of penetrating trauma)
• Bullous central serous chorioretinopathy (these patients have no inflammation)
• Posterior scleritis (eyes have scleral thickening on B-scan ultrasonography)
• Ocular lymphoma
• Uveal metastasis
• Fluorescein angiography: Early in the angiogram, there are multiple pinpoint areas of hyperfluorescence at the level of the RPE which pool in the later frames. Late staining of the disc is often present (Figs. 7-15, 7-16, 7-17, 7-18, 7-19 and 7-20).
• B-scan ultrasonography: demonstrates nonspecific choroidal thickening and serous retinal detachments but can be helpful to rule out posterior scleritis and neoplastic disorders.
• Optical coherence tomography: On initial presentation, eyes may have increased choroidal thickness and serous retinal detachments. Patients can have orthogonal "septae" which are suggestive of VKH.
• Lumbar puncture: The majority of patients will have pleocytosis.
• Laboratory tests to rule out other diseases such as sarcoid and syphilis as needed.
• These patients need prompt and aggressive systemic therapy. Systemic high-dose cortico-steroids (1 mg/kg up to 60 to 80 mg daily) are the first-line agent. Steroids are usually administered for 3 to 6 months with a slow taper.
• Corticosteroid-sparing immunosuppressive agents and biologic agents are initiated early in the treatment of VKH to prevent recurrences and to reduce steroid-related side effects.
TABLE 7-2. Diagnostic Criteria for VKH
No history of penetrating ocular trauma
No clinical or laboratory evidence of other ocular disease
Bilateral ocular involvement
Diffuse choroiditis presenting as
Focal areas of subretinal fluid, or
Bullous serous retinal detachments
If equivocal fundus findings, then must have both of the following:
IVFA showing delayed choroidal perfusion, pinpoint leakage, pooling within the subretinal space, and optic nerve staining
Ultrasound with diffuse choroidal thickening without posterior scleritis
History suggestive of above, or both ii and iii below, or multiple signs from iii:
Ocular depigmentation
Sunset glow fundus, or
sugiura sign
other ocular signs
Nummular chorioretinal depigmented scars, or
RPE clumping, or
Recurrent or chronic anterior uveitis
Neurologic/auditory findings
Meningismus, or
Tinnitus, or
CSF pleocytosis
Integumentary (skin) findings
Alopecia, or
Poliosis, or
Complete VKH requires criteria 1-5
Incomplete VKH requires 1-3, and either 4 or 5
Probable VKH requires 1-3 (isolated ocular disease)
CSF, cerebrospinal fluid; IVFA, intravenous fluorescein angiography; RPE, retinal pigment epithelial; VKH, Vogt-Koyanagi-Harada.
Adapted from Read RW, Holland GN, Rao NA, et al. Revised Diagnostic Criteria for Vogt-Koyanagi-Harada disease: report of an International Committee on Nomenclature. Am J Ophthalmol. 2001;131:647-652.
• The prognosis is generally good with prompt and aggressive therapy.
• In addition to the development of cataracts and glaucoma, subretinal fibrosis and choroidal neovascular membranes may occur.
Li M, Liu Q, Luo Y, et al. Enhanced depth SD-OCT images reveal characteristic choroidal changes in patients with Vogt-Koyanagi-Harada disease. Ophthalmic Surg Lasers Imaging Retina. 2016;47(11):1004-1012.
O'Keefe GA, Rao NA. Vogt-Koyanagi-Harada disease. Surv Ophthalmol. 2017;62(1):1-25.
Rao NA, Gupta A, Dustin L, et al. Frequency of distinguishing clinical features in Vogt-Koyanagi-Harada disease. Ophthalmology. 2010;117(3):591-599, 599.e1.
Read RW, Holland GN, Rao NA, et al. Revised diagnostic criteria for Vogt-Koyanagi-Harada disease: report of an International Committee on Nomenclature. Am J Ophthalmol. 2001;131:647-652.
Yamaguchi Y, Otani T, Kishi S. Tomographic features of serous retinal detachment with multilobular dye pooling in acute Vogt-Koyanagi-Harada disease. Am J Ophthalmol. 2007;144(2):260-265. Epub 2007 May 29.
FIGURE 7-13. Vitiligo. This African American patient with VKH had extensive areas of skin depigmentation (vitiligo). VKH, Vogt-Koyanagi-Harada.
FIGURE 7-14. Poliosis. A single white eyelash (poliosis) was found in this African American patient with VKH. VKH, Vogt-Koyanagi-Harada.
FIGURE 7-15. Vogt-Koyanagi-Harada (VKH) syndrome. Serous retinal detachments in early VKH. A. Multiple small serous detachments in the right macula of an AfricanAmerican male presenting with a 5-day history of blurred vision. B. Fundus autofluorescence showing alterations in the RPE. C. Fluorescein angiogram (FA) in the early arteriovenous phase revealing the classic finding of multiple areas of pinpoint leakage. D. The late phase of the FA demonstrating pooling of fluorescein in the multiple serous retinal detachments. RPE, retinal pigment epithelium.
FIGURE 7-16. Vogt-Koyanagi-Harada (VKH) syndrome. This is a 43-year-old woman from Central America. A. Color photograph demonstrating multiple serous retinal detachments. Deep yellow lesions consistent with choroiditis. B. FA showing multiple pinpoint areas of leakage with pooling of dye in the areas of serous retinal detachment. There is also staining of the optic disc. FA, Fluorescein angiogram. (Courtesy of Sunir Garg, MD and MidAtlantic Retina, the Retina Service of Wills Eye Hospital.)
FIGURE 7-17. Vogt-Koyanagi-Harada (VKH) syndrome. Optical coherence tomography (OCT) demonstrating a serious retinal detachment with subretinal septae, a finding suggestive of VKH. (Courtesy of MidAtlantic Retina, The Retina Service of Wills Eye Hospital.)
FIGURE 7-18. Vogt-Koyanagi-Harada (VKH) syndrome. Sunset glow fundus in late VKH. The orange-red color of the fundus, caused by loss of choroidal melanocytes in this patient with Native American ancestry, can develop 2 to 6 months after disease onset. Changes in the RPE are also visible. RPE, retinal pigment epithelial.
FIGURE 7-19. Vogt-Koyanagi-Harada (VKH) syndrome. Subretinal fibrosis in late VKH. Note the extensive fibrosis and pigmentary changes in an advanced case of VKH with a history of poorly controlled uveitis.
FIGURE 7-20. Vogt-Koyanagi-Harada (VKH) syndrome. EDI OCT helps differentiate from acute CSCR because subretinal septa are only seen in VKH, and decrease in choroidal thickness has been noted in quiescent stages, with increase during recurrences. CSCR, central serous chorioretinopathy; EDI, enhanced depth imaging; OCT, optical coherence tomography.
OCULAR COMPLICATIONS OF RHEUMATOID ARTHRITIS
Sunir J. Garg
Rheumatoid arthritis (RA) is a chronic autoimmune disease that predominantly affects the peripheral joints. Patients with RA can develop extra-articular systemic and ocular involvement.
• RA is distributed worldwide, with a prevalence between 0.3% and 1.5%.
• Women develop RA three times more often than men.
• The incidence increases with advancing age.
• Activated T cells and antigen-antibody complexes cause a microvasculitis that affects joint synovial tissues as well as extra-articular tissues. Immune complex deposition and activation of complement play a pivotal role in the pathophysiology of RA.
• A red eye due to episcleritis is common as is dry eye. As a result, patients may describe a foreign-body sensation and photophobia.
• Patients with scleritis complain of a deep, boring, periocular pain that radiates to the brow and temple.
• Ocular (Figs. 7-21, 7-22, 7-23, 7-24 and 7-25)
Keratoconjunctivitis sicca (dry eye): Rapid tear film breakup time and devitalized corneal epithelium are seen on staining. Schirmer testing demonstrates decreased tear production.
Sterile corneal infiltrates, as well as corneal edema, opacification, vascularization, and/or thinning with marginal furrowing, can occur.
Peripheral ulcerative keratitis (PUK) is a more aggressive form of perilimbal vasculitis.
Episcleritis is characterized by dilated episcleral vessels.
Patients with scleritis have a dilated superficial and deep episcleral vascular plexus that imparts a violaceous hue to the sclera. Unlike episcleritis, the dilated vessels lose their normal radial architecture.
Diffuse anterior scleritis is more common and has a better prognosis than other types of scleritis, including nodular scleritis, anterior necrotizing scleritis, necrotizing scleritis without inflammation (scleromalacia perforans), and posterior scleritis.
• Systemic
Patients initially develop fatigue, morning stiffness, and myalgias. The typical finding is polyarthritis that primarily affects the hands, feet, and cervical vertebrae.
Patients may also develop anemia, pericarditis, pleuritis, glomerulonephritis, neuropathy, and vasculitis of the skin (Fig. 7-26).
• Sjögren syndrome
• Enteropathic arthritis, including Crohn disease and reactive arthritis (Reiter syndrome)
• Psoriatic arthritis
• Systemic lupus erythematosus (SLE)
• Granulomatosis with polyangiitis (GPA) (Wegener granulomatosis)
• Dermatomyositis (DM)
• Polyarteritis nodosa (PAN)
• Specific markers: rheumatoid factor, antinuclear antibodies (ANA), antineutrophil cytoplasmic antibody (ANCA), anti-SS-A, anti-SS-B antibodies, and anti-cyclic citrullinated peptides antibodies
• Nonspecific markers: complete blood count, chest radiograph, ESR, CRP, liver function tests, kidney function tests
• Systemic disease: Three major classes of drugs are used: nonsteroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs, and corticosteroids.
• Ocular disease
For cases of dry eye, artificial tear substitutes and lubricating ointments, topical steroids, or topical cyclosporin A 0.05-2% drops should be used. Temporary punctal plugs and/or permanent punctal occlusion with cautery or permanent tarsorrhaphy are also useful modalities for maintaining adequate ocular lubrication.
Keratitis: Topical and oral corticosteroids and topical 0.05-2% cyclosporin A drops may play a role in the treatment of RA-associated keratitis, particularly nonulcerative keratitis and infiltrative PUK. However, more severe cases may require systemic immunosuppression.
Scleritis: In mild cases, NSAIDS can be used along with, or instead of, low-dose oral steroids. Moderate-to-severe disease, including necrotizing scleritis and PUK, require systemic treatment. If patients cannot achieve disease remission with less than 10 mg of prednisone daily, steroid-sparing agents should be used. Antimetabolites (methotrexate, azathioprine, and mycophenolate mofetil), calcineurin inhibitors (cyclosporin and tacrolimus), and biologic agents (infliximab, adalimumab, and rituximab) have all been used with varying degrees of success. Although etanercept has good efficacy for the treatment of systemic RA, it is less efficacious for the treatment of the ocular disease than other biologic agents.
Nodular scleritis may be treated with injection of triamcinolone over the lesion, and some authors have reported success in treating certain types of anterior scleritis with periocular steroid injections.
If treated early, long-term remission can often be obtained. Acute exacerbations of the disease can be avoided with regular monitoring and titration of the dose of the immunosuppressive agent.
Cao JH, Oray M, Cocho L, Foster CS. Rituximab in the Treatment of Refractory Noninfectious Scleritis. Am J Ophthalmol. 2016;164:22-28.
Gangaputra S, Newcomb CW, Liesegang TL, et al, Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study. Systemic immunosuppressive therapy for eye diseases cohort study. Methotrexate for ocular inflammatory diseases. Ophthalmology. 2009;116(11):2188-2198.
Schargus M, Wolf F, Tony HP, Meyer-Ter-Vehn T, Geerling G. Correlation between tear film osmolarity, dry eye disease, and rheumatoid arthritis. Cornea. 2014;33(12):1257-1261.
Watanabe R, Ishii T, Yoshida M, et al. Ulcerative keratitis in patients with rheumatoid arthritis in the modern biologic era: a series of eight cases and literature review. Int J Rheum Dis. 2017;20(2):225-230.
FIGURE 7-21. Rheumatoid arthritis. Diffuse scleritis is characterized by deep, tortuous, dilated scleral vessels. There is also peripheral corneal melting with iris prolapse in this case. (Courtesy of S. R. Rathinam.)
FIGURE 7-22. Rheumatoid arthritis. There is peripheral ulcerative keratitis in a patient with active, previously undiagnosed rheumatoid arthritis. (Courtesy of S. R. Rathinam.)
FIGURE 7-23. Rheumatoid arthritis. There are several large, injected nodules as well as diffuse scleritis in this patient with nodular scleritis. Posterior synechiae and a cataract are present. (Courtesy of S. R. Rathinam.)
FIGURE 7-24. Rheumatoid arthritis. A. Significant scleral thinning with uveal prolapse. The lack of injection is typical of scleromalacia perforans. (Courtesy of Sunir J. Garg.) B. Significant scleral thinning with an inferior scleral melt. Compared with patients with necrotizing scleritis, patients with scleromalacia perforans have relatively little scleral redness and often have minimal to no discomfort. (Courtesy of S. R. Rathinam.)
FIGURE 7-25. Rheumatoid arthritis. A, B. Rheumatoid arthritis (RA) is a polyarthritis that affects the small joints of the hands and feet more frequently than larger joints. The synovial inflammation leads to joint destruction. These patients have the typical finger joint deformities seen in patients with RA. Prompt and aggressive therapy can dramatically reduce this debilitating aspect of RA. C. Similar joint destruction can also occur in the feet. (Courtesy of S. R. Rathinam.)
FIGURE 7-26. Rheumatoid arthritis. This patient has vasculitis of the skin, which can be seen in some patients with rheumatoid arthritis. (Courtesy of S. R. Rathinam.)
BEHÇET DISEASE
Behçet disease, or Adamantiades-Behçet disease, is a chronic, relapsing multisystem inflammatory disorder that is characterized by intraocular inflammation, oral and mucosal ulcerations, and skin lesions.
• It is more commonly seen in patients from the Mediterranean basin and Japan, along the route of the ancient "silk road." It also occurs in persons with Native American ancestry.
In the United States, the prevalence is 8.6 in 100,000 persons, and is as high as 25 to 400 in 100,000 in Mediterranean countries. • Ocular involvement occurs in approximately 70% of patients with Behçet disease and is typically bilateral (>70%). Posterior/panuveitis is the most common form of uveitis in these patients.
Ocular disease can be the presenting symptom in 10% to 35% of patients and is characterized by recurrent, explosive exacerbations of intraocular inflammation.
• It typically affects young adults (mean age at onset is 25 to 35 years), but it may also occur in children.
• Men are slightly more affected than women.
• Behçet is a multifactorial disease: Genetic factors, environmental factors, infectious agents, and immunologic mechanisms all have been suggested.
Affected patients have a genetic predisposition, and it has been associated with HLA-B51. Recent large population studies confirmed this association and indicated HLA-B*15, HLA-B*27, HLA-B*57, and HLA–A*26 to be independent risk factors for Behçet disease, and HLA-B*49 and HLA–A*03 to be protective for Behçet disease.
Tags: Color Atlas & Synopsis of Clinical Ophthalmology: Uveitis
May 5, 2019 | Posted by drzezo in OPHTHALMOLOGY | Comments Off on Posterior Uveitis and Collagen Vascular Diseases


Search Results for "broken windshield"
1930s: Man gets outside of car, inspects broken windshield. Another car drives off. Words on screen about windshield breaking. Words on screen about safety glass.
Car with broken windshield riding through mountain country village, cow standing in middle of road, backseat passanger view. Summer sunny day.
This is a panning shot of the broken windshield and hood of an old rusty truck.
Teenage driver can be seen through the broken windscreen of his smashed car. No smoke in this clip. Recorded with camera on jib arm.
Barely conscious driver seen through the broken windscreen of his smashed car. No smoke in this clip. Recorded with camera on jib arm.
A man touches the crack on the front window, he considers the cost of repairs.


Pure Natural Forskolin Slim: Ingredients & Where to Buy?
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Pure Natural Forskolin Slim: What Is It?
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Pasadena Triathlon Club closed out the triathlon season with some friendly competition at the PTC Club Championship at Legends Triathlon at Bonelli Park. It was a beautiful, warm, sunny day at the park. PTC parked our trailer right at the finish line to cheer our friends in. We had lots of podium finishers! Check out the fun in the pictures.


Mequon-Thiensville Chamber of Commerce & Industry can be found at 250 S Main St . The following is offered: Chambers Of Commerce . In Thiensville there are 1 other Chambers Of Commerce. An overview can be found here.


CatholicTV programming is now available to Innovative Cable viewers in the Virgin Islands on the islands of St. John and St. Thomas.
Each day CatholicTV programming airs on Innovative Cable channel 16 from 4-8PM Eastern (Virgin Islands time is the same) and also from midnight to 6AM.
Monsignor Jerome Feudjio, Chancellor, Catholic Television in the Virgin Islands encouraged Innovative Cable to carry CatholicTV programming.
CatholicTV is currently seeking to expand its broadcast across the U.S. on as many cable and satellite providers as possible. Interested parties may help to bring CatholicTV to their providers by signing an online petition that will be used to encourage cable and satellite providers to include CatholicTV amongst their channels. Interested parties may sign up at CatholicTVeverywhere.com.


At every point, Clear PR's work aims to improve the number of leads, develop conversion rates and contribute to sales figures. CPR takes a detailed approach to developing a fully rounded PR programme. From building recognition of corporate strengths to highlighting the differentiating details that distinguish the product or service– every aspect is covered.


text:
News Sports Business Go Play Opinion Obituaries E-Edition Legals
Alabama basketball still in search of better leadership ahead of SEC home opener
Alex Byington
TUSCALOOSA — As the huddle broke following a head-scratching timeout late in regulation of Saturday's double-overtime loss at Florida, Nate Oats pulled his star sophomore point guard over to the side for some individual coaching.
The conversation was brief, but the first-year Alabama head coach made clear to the 18-year-old Kira Lewis Jr. that he had other options that didn't involve calling a timeout when the Crimson Tide were up on host Florida 83-81 with 23 seconds remaining.
"I talked to Kira too about playing more aggressive," Oats explained Tuesday. "Any time we're in a situation where they have to foul us, we'll take a layup, so if we can get the ball and run up the floor for a layup, we'd rather do that than have to go to the free-throw line. (But) a lot of that's on me. We have to do a better job in practice practicing that type of stuff."
Lewis' timeout proved especially costly because of what followed as Florida's Noah Locke stole the ensuing in-bounds pass from junior wing John Petty Jr. and immediately turned it into a game-tying layup with less than 21 seconds left in the second half.
And while that late-game sequence isn't the only reason Alabama dropped a 104-98 decision in double-overtime Saturday, it further highlighted an ongoing issue during Oats' inaugural season at the helm — the apparent lack of a true on-court leader to come through in crunch time.
This came after the Crimson Tide (7-6, 0-1 SEC) watched somewhat-helplessly as its 21-point first-half advantage disappeared to nothing within the closing minute of regulation, forcing its first overtime game of the season in Saturday's SEC opener.
"We just have to do better in end-of-game situations to be able to finish that type of game," junior forward Galin Smith said. "We saw we were able to compete with one of the best teams in the conference, we just weren't able to finish."
But this wasn't the first time this season Alabama struggled in close games, with four of its six losses coming in games when it was within five or fewer points in the final minutes of regulation.
Still, just one game into conference play, the Tide will have plenty of more opportunities to prove it can finish over the next two months of the season, including Wednesday night against neighboring Mississippi State (9-4, 0-1 SEC).
That said, where it's going to find that initiative is yet to reveal itself.
With just one senior on the roster — graduate transfer guard James "Beetle" Bolden — Alabama's makeup doesn't necessarily allow for what most consider a traditional go-to veteran leader like then-senior Retin Obasohan in 2016 or the graduate combination of Corban Collins and Bola Olaniyan in 2017.
In fact, much like two years ago when future NBA lottery pick Collin Sexton eventually took command as a true freshman, the lack of any clear-cut captain might require this year's Tide to turn to more nontraditional means for on-court direction when it matters most.
That's where it might require a leader-by-committee approach.
When asked about his team's leadership this season, Oats pointed to three veterans that effectively share those duties: Lewis, Petty and junior wing Herb Jones.
"I don't think you have to have just one leader per say," Oats said. "I mean, it's Kira's team. He's the point guard, he's on the draft boards. We talk about that, but he's also quiet. So maybe he's not going to be that rah-rah, vocal guy.
"I think Petty's a lot more vocal, talks, and he's done a really good job being a good leader, playing hard on both ends, maybe our best two-way player. And then you have a guy like Herb, when the team voted in the offseason, and when we came in here, he was the one everybody pointed to being the leader."
All three were on the court during the late-game collapse — Jones fouled out with 42 seconds remaining in the second overtime period — yet none were able to step up when the moment called for it Saturday on the road.
In fact, Lewis missed his last two field goal tries of regulation, including a potential game-winning 3-pointer in the closing seconds, while Petty missed three straight field goals over the final 4:25 of regulation before a made layup with 29 seconds left.
"Of course, there could always been better leadership on the team," Smith said, "but I feel like we had guys toward the end of the game that stuck it out and didn't quit and kept going."
Added Jones: "We just go with what our coach tells us to do, we don't try to get (too far) outside the game plan. So I think we did what we needed to do (against Florida), we just came up short."
Ultimately though, how Alabama does over its next 17 conference games will determine whether this year's team can find its way back to the NCAA Tournament in Oats' first season, and much of that is dependent on how its on-court leadership develops down the stretch.
"We need (Jones) to lead, we need Petty to keep leading, we need Kira to understand as the point guard and one if not the best player (on the team) by a game-to-game basis, we need the point guard to be great every game and kind of take ownership of the team," Oats said. "It's (got to be) a combination of all those guys. (But) I think our leadership is coming, I think it'll be there. I think our guys are in the right frame of mind even though we're coming off a tough loss, I think we'll see some pretty good leadership moving forward."
MISSISSIPPI STATE at ALABAMA
WHEN: 6 p.m. Wednesday
WHERE: Coleman Coliseum
RECORDS: Mississippi State (9-4, 0-1 SEC), Alabama (7-6, 0-1 SEC)
ON THE AIR: TV — SEC Network. Radio — WXFX-FM 95.1, WDXX-FM 100.1 WTLS-FM 106.5, WTLS-AM 1300
ALABAMA LINEUP: G Kira Lewis Jr. (6-3, So.) 16.6 ppg.; G John Petty Jr. (6-5, Jr.) 16.6 ppg., 7.4 rpg.; G/F Herbert Jones (6-7, Jr.) 9.1 ppg.; F Alex Reese (6-9, Jr.) 8.8 ppg.; F Galin Smith (6-9, R-Fr.) 2.2 ppg.
MISSISSIPPI STATE LINEUP: G Nick Weatherspoon (6-2, Jr.) 12.0 ppg; G Tyson Carter (6-4, Sr.) 14.5 ppg.; G Robert Woodard II (6-7, So.) 11.9 ppg.; F Reggie Perry (6-10, So.) 15.9 ppg.; F Abdul Ado (6-11, R-Jr.) 5.7 ppg.
Alex Byington is the Montgomery Advertiser's Alabama beat reporter. He can be reached by email at abyington@montgome.gannett.com or on Twitter at @_AlexByington.

redpajama_set_name: RedPajamaCommonCrawl


text:
Q: Running a project if has been downloaded from the internet causes errors I copied this project from another computer where it worked correctly, but in this I get these errors.
I have already recompiled the project, can someone help me with the solution?
Error:

The ReportesExport \ sales4.resx file can not be processed because it
  is on the Internet or in a restricted area, or it has the Web mark.
  Remove this mark if you want to process the files

A: Since this was likely downloaded, you need to unblock each of your source files

*

*Right-click on the file and select Properties from the menu.

*Click Unblock on the General tab.

*Click OK.

*Repeat for all files needed

redpajama_set_name: RedPajamaStackExchange


text:
Book Review: Spider Season – Author Billy Hanson
Book Review: Exitors | Author M. Seamus Reed
Book Review: Hammer Complete: The Films, the Personnel, the Company
Home | Film Review: Dead Tone (Aka "7venty 5ive) (2007)
Film Review: Dead Tone (Aka "7venty 5ive) (2007)
Craig McGee 01/03/2011	Uncategorized
A seemingly innocuous pastime involving fun-loving collegians and prank phone calls turns into a lethal cat-and-mouse game in this blood-drenched fright feast starring Rutger Hauer and Brian Hooks. While vacationing at a secluded mansion after finals, a group of university students dials random telephone numbers and tries to unnerve the person on the other end. But their fun is short-circuited when one of them unwittingly connects with a slasher.
Written by: Brian Hooks, Vashon Nutt, Deon Taylor
Directed by: Brian Hooks and Deon Taylor
Starring: Brian Hooks, Jud Tylor, Cherie Johnson, German Legarreta, and Rutger Hauer
QUICK FIX:
A bunch of kids at a sleep over take a page from Bart Simpson's prank phone call book:
Bart: Is Al there?
Moe: Al?
Bart: Yeah, Al. Last name Caholic?
Moe: Hold on, I'll check. Phone call for Al… Al Caholic. Is there an Al Caholic here?
(The guys in the pub cheer.)
Moe: Wait a minute… Listen, you little yellow-bellied rat jackass, if I ever find out who you are, I'm gonna kill you!
But unfortunately for the kids in DEAD TONE, the dude on the other end of the phone isn't Moe spouting harmless threats, it's an axe-wielding psycho who shows up at their house and butchers all the parents who are in the other room having their own party. Fast-forward to years later, and the surviving kids have grown up to not be totally mentally scarred from the ordeal as one would think, but instead have grown into whiny, stereotypical asshats, and apparently are just as stupid now as they were back then and do the same damn thing at a party out in the middle of nowhere – and guess who they get on the other end of the line…again? Yep, same axe-wielding maniac that butchered the parents and spared their lives for the sake of plot advancement and to give Rutger Hauer something to do as a police detective for about five total minutes of screen time throughout the flick, showing up here and there and emoting (or was it looking bored and wishing that his career had taken off like Harrison Ford's? Or these days, even Sean Young's?), picks up the phone, and is just as pissed as he ever was…so guess who winds up being a party crasher?
RAMBLINGS:
Sorry, folks – that one was more of a LONG Fix, but seems I have a lot to say about this one. Originally called 7EVENTY 5IVE (very cool title, by the way), I can very obviously see how big of a part the SCREAM series played into influencing this flick, and I'm all for that – personally, I think two of the best horror movies to come from the 90s were the first two in the series, so yeah – I'm not at all opposed to something influencing a cool phone prank-style horror flick with a crazy killer. In fact, I whole-heartedly welcome it.
But…damn. It has to be done on a somewhat entertaining level. This flick, with its awesome opening, had all the potential in the world to have been a fun, goofy, no-brainer of an old-fashioned slasher tale with an "ooops, I did it again" plot twist to bring a long-dormant killer back into play to finish the job he left open so many years before. Unfortunately for us, the audience, though, it quickly derailed and degenerated quickly after the credits into just another boring tale of a bunch of sh*t-talking, overly stupid silver-spooners bitching at each other and doing ridiculous things just to serve the plot and keep the movie plodding along for the majority of the running time.
I've said it many times before – even with indie flicks that I'm MUCH easier on than Hollywood stuff with big budgets – if the story isn't there, I will not care – the writing's gotta be there, folks. Not a single one of these whiny brat f*ckheads was I able to cheer for, nor was I really able to give two sh*ts about a killer so idiotic that, one – he didn't finish the job in the prologue; and two – he's not stealthy at all…he shows up crashing through a window, waving his axe all around, not really caring if they know he's there or not. But maybe he knows something….maybe he knows that it's not gonna matter and that the kids are so stupid that when faced with a three-on-one situation they don't take his ass down, they run the other way and cry behind a locked door. WHAT??!! This dude is mortal, not Freddy Krueger…gang up on him and kick some maniac ass!!! How else are you supposed to set up the "he really isn't dead at the end" scenario and make it look cool? Think, McFly, think!!!
I really, really tried with this one – hard – because I really, really wanted to like it. But try as I might, I just can't. By half an hour in, I was wishing that at that exact moment, the government would decide to do some nuclear testing on that particular house in the middle of nowhere and put us all out of our misery. If I have no one to root for, even the killer, in a slasher flick, there's nothing that's going to make me want to watch it again or recommend it to anyone else. This is what happens when you get in a hurry and film your 2nd draft without really reading through it and thinking things through before filming the story. With another couple of polishes on the script, maybe this could have been the really cool slasher flick that I wanted it to be. But with whiney, hateful characters; bad plot development; constant p*ssy moves by main characters; and a groan-inducing "shock reveal" plot twist/open ending that even my six year-old son would have seen coming a mile away, this was nothing that I care to revisit.
Tags 7venty 5ive Dead Tone
Is their going to be a dead tone 2 and if their is 4people shouldn't really be dead like kareem,marcus,jody,and kareems girlfriend?


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Q: Load testing tool that can send PUT/DELETE methods I am finding load testing tool that can send PUT/DELETE requests.
Neither ApacheBench nor JMeter supports these methods.
After several hours' googling, I found SoapUI that looks good.
Do you have any other recommendation?
Command line tool like ApacheBench will be better for me.

A: The Grinder is a decent load testing framework that also supports PUT and DELETE.

A: Jmeter supports put and delete methods as of of versions > to 2.5 ( didn't Check for others)


Sensibility and practicality define the 2018 Hyundai Tucson. Under the hood you'll find a 4 cylinder engine with more than 150 horsepower, and all wheel drive keeps this model firmly attached to the road surface. It distinguishes itself from the competition with features such as: 1-touch window functionality, adjustable headrests in all seating positions, a trip computer, an automatic dimming rear-view mirror, power door mirrors and heated door mirrors, power windows, and a split folding rear seat. Features such as automatic climate control and leather upholstery prove that economical transportation does not need to be sparsely equipped. Audio features include an AM/FM radio, steering wheel mounted audio controls, and 8 speakers, providing excellent sound throughout the cabin. Hyundai ensures the safety and security of its passengers with equipment such as: head curtain airbags, front side impact airbags, traction control, a panic alarm, an emergency communication system, and 4 wheel disc brakes with ABS. Brake assist technology provides extra pressure when applying the brakes. We pride ourselves in consistently exceeding our customer's expectations. Stop by our dealership or give us a call for more information.


Pine Bluffs & Red Dot Mine is a layout more than 20 years in the making.
The layout is an 'HO' American round and round layout, built on modular principles by the American Section of Alton Model Railway Group, and centred on a fictional railroad company in Colorado, in the 1950s.
The layout combines the existing modules/layouts Pine Bluffs Depot, which has been converted to DCC and been refurbished, and Pine Bluffs Freight Yard with a new module, Red Dot Mine, to form a layout approximately 6mx4m, with the unusual configuration of viewing scenes on 3 full sides, with the fiddle yard area on a short end.
The full layout made its exhibition debut at Rail-Ex Taunton in October 2016, swiftly followed by Tolworth Showtrain in November 2016, and is available for exhibitions from the start of 2017, although due to the number of operators required and transportation is only likely to be exhibited twice a year.
The layout is currently booked for Woking in 2017, and Farnham and Warley in 2018.
To book Pine Bluffs for your exhibition, please contact Allan Rose on 01420 564262.


Agricultural Service Technician | Hutcheon and Pearce | John Deere Tractors for Sale. Farm Machinery Sales. Ride-on Mowers.
We currently have exciting opportunities for a qualified Diesel Mechanic/Service Technician in our Finley NSW Branch.
Hutcheon and Pearce is a 3rd generation progressive, family owned John Deere Dealership. Established in the NSW Riverina over 64 years ago, we are proudly operating out of 11 rural locations in the Riverina, Southern and Central West NSW. We serve a multitude of customers with quality, well renowned equipment and after sales support and service. We believe that our success comes from the partnerships we form with our customers and the quality of our people.
On offer is a full time position with an annual base salary of $50,000 – $60,000 per annum based upon skills, qualifications and experience (plus overtime, penalties and super), we also offer our service staff performance based incentives as well as continued ongoing training and unlimited career development opportunities!
Hutcheon and Pearce are currently looking for enthusiastic and committed trade qualified Diesel Mechanics (Plant or Heavy Vehicle) for servicing, repairs and maintenance of John Deere agricultural machinery at our Finley Branch. If you are passionate about what you do and are motivated to perform to the best of your ability each day, read on!
At H&P we offer extensive ongoing skills training with the opportunity to learn through the Hutcheon and Pearce High Performance Academy, John Deere University and JD Tech School to polish up on your skills, learn about new machinery and how to further develop and grow your career.


text:
Fiat Chrysler Automobiles NV (NYSE:FCAU) Launches Plans To Boost Production Of Electrified Cars
D. Marie	Jun 6, 2018, 8:05:12 AM
D. Marie
Fiat Chrysler Automobiles NV (NYSE:FCAU) CEO Sergio Marchionne has announced a big investment drive aimed at boosting the production of electric cars. In his announcement, Marchionne said that despite the new plan for electric cars, traditional engines will still dominate its production portfolio.
$10 billion investment plan
During the occasion to launch the company's strategic plan, Marchionne indicated that the company will invest a total of $10.5 billion in a bid to keep hold on the market for fully electric vehicles and gas-electric hybrids. This, he said, will be undertaken without affecting in the main market which requires internal combustion engines. The strategic plan launched will run up to 2022, long after Marchionne has exited the company and his role as CEO.
Marchionne has a strong performance track record
Marchionne is known for lifting Chrysler out of bankruptcy in 2009. At the time, he was the CEO of Fiat. The automaker was in a critical position that many doubted it could be saved. At time, General Motors Company (NYSE: GM), the company's main rival was also in financial turmoil and was being bailed out by the Obama administration. The government was also deliberating whether to save Chrysler or let it die. In the end, the government offered to bail out Chrysler also so as to mitigate the effects of its downfall to the economy. It was argued that in the event of its fall, it would have grievous effects to its suppliers.
In a statement to financial analysts, Marchionne said that the industry as well as the entire society are having a big challenge in trying to reduce dependence on oil. He spoke when he unveiled the business strategic plan, which would also act as his final legacy to the company which he established following the merger of Fiat and Chrysler. According to Marchionne, there is no magic formula or single solution to reducing the overdependence on oil. He added that the problem can only be approached using the right measures that are aimed at striking a balance between cost, consumption levels and efficiency.
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The presentation, which went on for a whole day, mainly revolved around development of new brands that have huge revenue potentials. These are Alfa Romeo, premium brands Maserati, Ram trucks and Jeep SUVs.
Tags: Fiat Chrysler Automobiles NV, Fiat Chrysler Automobiles NV (NYSE:FCAU), NYSE:FCAU
Intel Corporation (NASDAQ:INTC) Showcases Its AI Chops And Chips
Nokia Oyj (ADR) (NYSE:NOK) Announces Changes In Its Leadership Team
Facebook, Inc. Common Stock (NASDAQ:FB) & Instagram To Lock Accounts Of Users Below 13-Years
IBM Common Stock (NYSE:IBM) Sues Groupon Inc Common Stock (NASDAQ:GRPN) For Patent Infringement
Oracle Corporation (NYSE:ORCL) Launches Its Blockchain Cloud Service
Micron Technology, Inc. (NASDAQ:MU) And Intel Corporation (NASDAQ:INTC) Terminate The 3D Xpoint™ Joint Development Program
AT&T Inc. (NYSE:T) Antitrust Legal Battle Moving To Another Level After Purchase Of Time Warmer
Fiat Chrysler Automobiles NV (NYSE:FCAU) To Stop Making Diesel Cars By 2022
Antonio Neri says Hewlett Packard Enterprise Co (NYSE:HPE) Could Evade Impact Of Future U.S Tarrifs
Ford Motor Company (NYSE:F) Hopes To Turnaround Its Declined Sales From The 'Black Friday' Clearance Sale
Planning Commission Considers Interests Of Homeowners To Turn Down Construction Of Verizon Communications Inc (NYSE:VZ) Cell Phone Tower
Facebook, Inc. (NASDAQ:FB) Abandons Helicopter Drone Project
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text:
Q: Weird behaving of pointers and arrays I am new to C.
I am trying to take a char array (a string) and explode it to 2 strings by a delimiter. Here is my code:
#include <stdio.h>
#include <stdlib.h>
#include <string.h>

int main() {
    char line_array[260];
    char *line = line_array;
    scanf("%s", line_array);
    char *line2 = strdup(line);
    char *command = strtok(line2, " "); // WORKS FINE = open
    printf("%s %c\n", command, *(line+4)); // PRINTS: open (prints only command, *(line+4) is empty)
    return 0;
}

What I am trying to achieve after I got the first part of the string (where it says "works fine = open") is to print all the chars from command_array[strlen(command)] to the end of the array, but nothing of what I tried worked.

A: After reading your new updating question and code, I finally know your problem.The problem is that your method of getting string, scanf read string into buffer, but it treats blank or CR/LF as a new start of new inputting.According to your want, you type "abcdefg 9", scanf("%s",value) will only get abcdefg to value, and leave "9" in the stdin buffer.So you need to use gets(value) to get all your input, then strtok.

A: You could use:
printf("%s\n", filename+4);

which prints the string filename from 5th char to end of string
%c prints only one char
*(filename+4) takes the 5th char code from string filename.
filename+4 gives the address of the 5th char of string filename

A: In C's expressions all chars are implicitly converted to ints first. When char arguments are passed to variadic functions (like printf()) they are also implicitly converted to ints. But I'm not seeing a problem with that.
However, what I'm seeing is that explodestr() is missing a return statement returning a char, which is coincidentally an integer.

A: If your goal is to read one single line and split it at its first space character, you could try:
#include <stdio.h>
#include <stdlib.h>
#include <string.h>

int main() {
  char* line = NULL;
  size_t linesiz = 0;
  if (getline(&line, &linesiz, stdin) > 0) {
    char* space = strchr (line, ' ');
    if (space) {
       *space = (char)0; // to end the chunk before
       printf ("first chunk is %s\n", line);
       printf ("after space have %s\n", space+1);
    }
  }
  return 0;
}

Don't forget to enable all warnings in your compiler and to learn how to debug. On Linux, that means compile with gcc -Wall -g  and use the gdb debugger.
BTW, if you know that all lines start with a word (without spaces), then some spacing character (like space, tab, return, newline, ...) then some integer, you could declare
int i=0;
char buf[30];
memset (buf, 0, sizeof(buf)); // zero the buf

then use
if (scanf("%30s %d", buf, &i)>=2) { /* do something with buf & i */ }

You many want to read the man page of feature_test_macros(7)

A: Just call strtok in a loop. Set the first argument to NULL if you're parsing the same string. This will modify the string, but we have made a copy in this example to work with.
#include <stdio.h>
#include <string.h>

int main(void)
{
    char line_array[260];
    char *line, *p;

    fgets(line_array, sizeof(line_array), stdin);
    line = strdup(line_array);

    p = strtok(line, " ");
    while (p) {
        puts(p);
        p = strtok(NULL, " ");
    }

    free(line);
    return 0;
}

A: your last line.....should be
printf( "%s\n", ( line + 4 ) );and you are done what you are expecting.
Reasons:
1. %c can't print except a single character at once.
2. String always deal with the base address in C language, so you need to remove the asterisk too.
Hope your question is answered.


text:
← THE ETERNAL ACTRESS by Nev Fountain
NIGHTMARE CRUISE (1961) by Wade Miller →
Running on Empty (1988)
There are films that you love unconditionally and irrationally, ones so bound up in your own personal circumstances and psyche that it is impossible to truly convey to others why this is so – it simply is. Then there are those you are convinced are fine, even great works but which, to your dismay and incredulity, you frequently find yourself having to defend vigorously, using some of your best reasoned and most persuasive arguments as even those you believed to be in perfect sync with your tastes just don't seem to 'get it'. To my great surprise I have found that as often as not, the 1988 thriller Running on Empty, starring River Phoenix and directed by the late Sidney Lumet, is indeed one of those films. Why?
The following review is offered as part of the Tuesday's Overlooked Film meme hosted by Todd Mason over at his Sweet Freedom blog.
"Why do you have to carry the burden of someone else's life?"
Given the credentials of a cast headed by Judd Hirsch and Christine Lahti and Lumet's imprimatur, one might be surprised to learn that this is a crime movie by any definition though in fact the director was no stranger to genre. But then Lumet was so prolific that he did have a go at nearly every type of film, from contemporary and historical comedies and dramas to satires, musicals, sudsy love stories, stage adaptations, biopics, remakes and so on. Paul Newman said of the director, with whom he worked on The Verdict (1982), a high point in both their careers, that he was so efficient and well prepared that,
I call him Speedy Gonzales, the only man I know who'll double-park in front of a whorehouse.
This may partly explain why this film isn't as well-known as it might be as it hovers in between genres and may have got lost among the vast array of projects that Lumet undertook in his very long career. On the one hand it tells the story of a family on the run from the FBI but on the other it is also a teenage coming-of-age story. It is also a look back at the radicalism engendered by the Vietnam war and the impact it had on some of those who never really gave up the fight against what they believed to be an unjust system.
Hirsch and Lahti play Arthur and Annie Pope, the happily married parents of two boys, Harry (Jonas Abry) and Danny (Phoenix). They are also on the run and have been since 1971, when they sabotaged a napalm lab. A night-watchman, who was not meant to be there at the time, was caught in the blast and was crippled. The boys have never known a permanent home and have never even met their grandparents, living as part of an underground network that keeps them moving from one small town to another while still trying to make a difference in the community even though they are, by necessity, wary of getting too close to anyone they meet for fear of exposure. We begin with the family fleeing from their latest bolt hole after realising they under surveillance. They end up in New Jersey and it is here that Danny's life starts to predominate in the narrative as his talent as a pianist (he has been taught by his mother) gets him noticed by both the school's music teacher and his daughter Lorna, played winningly by Martha Plimpton (she and Phoenix were romantically linked off-screen at the time). Danny is ultra polite to deflect too much attention from himself, but as he grows closer to Lorna he finds it harder and harder not to tell the truth about himself and his family.
This is a carefully constructed film, shot in a discreet but highly controlled style. This is seen at something like its best in a musical sequence in which the family is seen dancing to James Taylor's 'Fire and Rain'. If compared with the equivalent sequence (featuring 'Ain't Too Proud to Beg') from The Big Chill, another film about the later life of 60s radicals, it is interesting to note how that film is very elaborately choreographed and delivered with dozens and dozens of cuts (you can watch it here). Lumet and cameraman Gerry Fisher (a frequent collaborator of John Frankenheimer) do it all in a single take and with one discreet camera move. Both sequences work very well in their own way, but the differing approaches pinpoint the fragmentation of the various characters in the earlier movie while Lumet highlights it as a moment of unity between all those participating.
The focus in the film undulates between Danny's burgeoning romance with Lorna and the strain felt by his loving parents, especially as Arthur finds the stresses of their life of subterfuge increasingly hard to handle now that there is the real prospect of the family 'unit' breaking down as Danny wants to Julliard on a scholarship and remain with Lorna. But of course he is torn because if he comes out in the open, his parents and brother would have to stay underground to avoid prison and would not be able to see him perhaps for years at a time. And for Arthur his family is all he has left. The thriller aspects of the plot kick in when a Gus (actor and writer LM Kit Carson), a comrade from the old Liberation Army days, turns up with a plan to rob a bank at gunpoint. Arthur is horrified and Annie kicks Gus out (he also makes a pass at her, suggesting some unexplained past history there) but he ends up drawing attention to them anyway, leading to a dramatic and heartbreaking climax. This is of course a melancholy story, one in which simplistic happy endings are going to be out of the question. The political commitment of Arthur and Annie, while mainly discussed in terms of what they have had to give up, is never questioned, which is a bold move. It is hard to see it being done in the same way as sympathetically today, given that many would simply classify them as terrorists and close the door on them and their beliefs. But it is as a family drama that Naomi Foner's script really excels, playing to Lumet and his cast's strengths.
Rover Phoenix and Sidney Lumet on the set.
Lumet started as an actor and then moved on to directing live television in the 1950s before making his movie debut with the legal drama 12 Angry Men (1957). He would return to the courtroom over the decades for such films as the aforementioned The Verdict (1982) as well as the enjoyably pulpy Guilty as Sin (1993) and Find Me Guilty (2006), a true-life story closer in spirit to his more celebrated stories of police corruption such as Serpico (1973), Prince of the City (1982) and Q&A (1990). He did however make more conventional mystery dramas such as the Le Carre spy movie The Deadly Affair (1966), the star-studded Agatha Christie whodunit Murder on the Orient Express (1974), the twisty Deathtrap (1982) and The Morning After (1986), which traded on the star wattage of Jane Fonda, Jeff Bridges and Raul Julia to surprisingly anodyne effect.
Running on Empty on the other hand is much more low-key and much more interesting combination of generic elements. It is as a human drama that it is most memorable, though the plot is never forgotten, creating a suspense dynamic for most of the film as we worry about whether the Pope family will be discovered, with Danny's missing school records acting as a MacGuffin here, reminding us constantly of the possibility of the family's exposure and arrest. But it's the intimacy of the scenes you'll remember most, especially Danny's heartfelt confession to Lorna about his real past, making for a sweet and wrenching love scene after so much obfuscation. Equally good but more restrained is the late reunion of Annie with her father (played by Steven Hill, today best known for his long stint on TV as the curmudgeonly DA in Law & Order), a scene seething with barely suppressed emotion that will just drive a fist into your stomach as Annie realises that she is about to replicate a long separation from her own son that she inflicted on her own parents. You need to be made of sterner stuff than I to finish the film without a tear in your eye, with New Jersey guitarist Tony Mottola's plaintive, minimalist score also proving to be a real asset here; as are the lyrics to Taylor's classic song, a refrain of which is echoed in its closing moments:
I've seen fire and I've seen rain
I've seen sunny days that I thought would never end
I've seen lonely times when I could not find a friend
But I always thought that I'd see you again
A great movie – if you haven't already done so, I urge you to see it and then tell your friends.
DVD Availability: This has only ever been made available in bare bones editions, the first a very disappointing panned and scanned release; but the more recent DVD is actually a rather impressive anamorphic version that is well worth seeking out as it ably represents the look and feel of the film, even if sadly bereft of any contextual extras. A Blu-ray would be nice, but this will do nicely until that unlikely day arrives.
Director: Sidney Lumet
Producers: Griffin Dunne & Amy Robinson
Screenplay: Naomi Foner
Cinematography: Gerry Fisher
Art Direction: Philip Rosenberg
Music: Tony Mottola
Cast: River Phoenix, Judd Hirsch, Christine Lahti, Martha Plimpton, Steve Hill
****(5 fedora tips out of 5)
This entry was posted in New Jersey, Sidney Lumet, Tuesday's Overlooked Film. Bookmark the permalink.
27 Responses to Running on Empty (1988)
Sergio – Oh, I liked this film quite a lot too. Now I admit I'm a Judd Hirsch fan, so that helped. But yes, I agree that it's low-key but with the right level of tension and stress. That juxtaposition of the reality of the family's "hidden life" with the fact that Danny just wants a real life with Lorna. And of course the political ramifications add to the plot too. Nice review here for which thanks.
Thanks Margot – another fan – hurrah! I fell in love with this one when it came out but very few people seem to have seen it – glad there's a few of us out there (with taste, I mean)!
Really excellent movie. Free associating on this post:
– Every time I read a review of a River Phoenix movie I get a bit wistful. He was so talented, so unique. Such a loss to the movies and the world.
– Christine Lahti in Housekeeping There's a movie worth watching. I prefer her early screen acting to her later TV stuff.
– Martha Plimpton has had one hell of a career evolution. From Goonies to this to live theater to eccentric TV shows and beyond. Always fascinating to watch. She did quite an impressive turn on "Law & Order " years ago that I still remember. And she shows up on stage out here in Chicago every now and then as part of the Steppenwolf Theater Company.
– Was the "family dancing to an old rock tune" scene a staple of late 80s-early 90s movies? I rem mer a lot of them. There's one in Mermaids with Cher, Winona Ryder and a VERY young Christina Ricci bopping around to "If You Want to be Happy" that was a lot of fun.
With My Own Private Idaho you got the impression that Phoenix's career could have been going somewhere well outside of the Hollywood rut (though his final few films were a litle disappointing I thought). I love Lahti's films from that time – and I know exactly what you mean about her later TV work – she remains excellent but the roles have become much less interesting as she usually gets cast as the hard-as-nails ballbreaker. I loved Plimpton's recurring role in The Good Wife as the eternally preganant and very devious lawyer. I love movies with diegetic song and dance sequences – at one point Hal Hartley (remember him) seemed to always have one in all his films (or seemed to). Personal favourites would have to include the strip club in Barry Levinson's superb Diner with Tim Daly and Steve Guttenberg dancing up a storm.
Yes, I do remember Hal Hartley and I went to every single one of his films when they opened back in the day. The Unbelievable Truth, Trust, Flirt, Simple Men, and Amateur — all very entertaining and quirky. Now you've get me thinking about another loss — Adrienne Shelly. Stop it, Sergio!
Sorry John – that was really saud wasn't it? Here's some dancing to cheer us up (this is why I enjoyed The Artist's ending so much!)
Very cool! But Martin Donovan (rear left, for those who don't know him) can't dance to save his life. Or was that a character choice? ; ^ ) I remember that one very well. And there's another Hartley regular – Elina Löwensohn. Whatever happened to her? Thanks, man. You cheered me up. (And yes I will agree that the final scene in THE ARTIST was a smile inducing romp.)
Let's be generous and give Donovan the benefit of the doubt …
I've heard good things about this but have never found the time to see it. It is going on my watchlist after reading this post.
Love to know what you make of it – I really enjoyed watching it again. Can't believe next year it will be 20 years since Phoenix doed – what a terrible waste …
PS Of course, the great gandaddy of these dance numbers is Godard and that great number from Bande à part:
Patti Abbott says:
Another fan of this film. Also a fan of Bande a part. I do miss River. And Lahti is always great.
Thanks Patti – glad there's a few of us out there!
Nuts! Delete that comment above with that bad link to some hoax video, Sergio. Here's the proper link to scene:
Great fun (way to ruin the end of the movie John 🙂 – of course, the minute I saw Winona (who frankly has better rhythm than Cher in this scene) I got to reminiscing about her performance of the 'Jump in the Line' song from Beetlejuice …
I'm afraid you'll have to put me in the "don't get it" column. I tried to watch it when it first became available to rent but only got about half way through before I gave up.
Nooooh … Well, the pace is slow and studied and I suspect that will put a lot of people off. Most of the people I know haven't even heard of it – at least you gave it a chance!
Oh, that Winona. She can sure shake it! Thanks for all the hip dancing scenes, Sergio. This will be my favorite page to revisit whenever I need to lift my spirits. Got me grinning widely and tapping my feet. Now I'lI have that calypso tune in my head for the rest of the day.
Nothing quite so cheering is there John? Oh yes, I believe it …
I think Lumet veered between conventional and oddball crime films according to circumstances- he'd use a conventional success to be able to make an experimental orradical film which usually tanked and he'd have to make another conventional film to compensate…
The Offence has Sean Connery as a policeman who beats a suspect to death and is the only film ever made with a score by Harrison Birtwhisstle. Despite- or because of- Connery and Trevor Howard playing against type is was a box-office disaster. Strip Search suggested there was no difference between US responses to the WTC attacks and CCP 'investigation' techniques and nazi methods. Lumet's last film- Before the Devil Knows You're Dead- was another chilling masterpiece.
Cheers Roger – I haven;t seen Strip search I'm afraid though I would really like to see that one. Lumet made a lot of terrific films but probably made a few too many as well (I mean how many times did he need to work with Melanie Griffiths before realising that her range was a bit limited …). His 5 films with Connery are a fascinating index of his cinema – a harsh yet fascinating story of life in a military prison that is brilliantly made and endlessly cruel; a satirical and overly elliptical heist movie with aspirations to political commentary; another brutal story of institutional cruelty with one man torturing another; a piece of Agatha Chritie fluff; and a star-laden heist story of three generations of a crime family that of course ends in tragedy.
J. C. Conway says:
Reblogged this on J. C. Conway.
I own and watch a ton of films. "Running On Empty" is in my top 25 list of all time. It's a perfect little film. The acting and the script are incredible. I've seen this film at least 10 times. The scene between Lahti and Hill is possibly the most effecting thing I've ever seen in film. I've never gotten through it without being reduced to a puddle. And then there's River Phoenix's scenes. Ah, I could go on and on. This is an amazing film.
Glad you are also a fan – definitely deserves to be better known
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mpr says:
I must say that this is one of my favourite films of all times, and I've only watched it once and only recently, at that. It was so rich and so real. I just started doing some Googling to see what other fans were out there. Criminally unknown, this film.
Glad you liked it too – deserves to be much better known.


text:
Alexander Rozenfeld
Alex@ClimateImpactCapital.com
Alex has been an active supporter of the energy entrepreneurship community as an energy co-chair of the Houston Angel Network, chair of the Energy Initiative at The Center for Houston's Future, Advisory Board member of the Rice Alliance for Technology and Entrepreneurship, founding member of the Advisory Board for the Houston Advanced Research Center and an active adviser to many energy companies. Under Alex's leadership, Climate Impact Capital launched Texas Innovates, a non-profit hardtech incubator working on energy and water challenges, where Alex is President of the BoD. His work also includes international roles, such as the Advisory Board to the Energy Innovation Initiative at World Economic Forum (WEF). Alex holds BSE magna cum laude and an International Policy certificate from P
Climate Impact Capital (CIC) invests in technology companies and supports our partners to target today's relevant issues in energy and climate change. At our core, CIC creates resilience and prepares our partners, customers and portfolio companies for a world challenged by climate variability and resource scarcity.


text:
CBJ Training Camp 2015
Jackets Sign David Savard to 5-Year Deal
David Savard has been locked up for five more seasons.
By Mike MacLean@mejmaclean Sep 8, 2015, 10:36am EDT
Share All sharing options for: Jackets Sign David Savard to 5-Year Deal
Anne-Marie Sorvin-USA TODAY Sports
The Jackets have signed David Savard to a five-year, $21.5 million extension today, locking up an important member of their defense corps. Savard emerged as an offensive threat from the blueline last season, putting up 11-25-36 and playing in all 82 games.
Congrats to David Savard (@dsavy58) on his new five-year extension! #CBJ FULL STORY: http://t.co/MYyksEhTbP pic.twitter.com/EFs35uDw4Z
— NHL Blue Jackets (@BlueJacketsNHL) September 8, 2015
The contract comes with a cap hit of $4.25 million per season and kicks in after this year. At that point, Savard will have the third-highest cap hit among defensemen currently on the roster, behind only Fedor Tyutin at $4.5 million and Jack Johnson at $4.36 million per season. Thanks to General Fanager for the numbers.
At first glance, the number seems a tad generous given his body of work- I would have expected the team to see what kind of production he could have put up this upcoming season, the last in his two-year post-ELC deal. The brass had obviously seen enough to warrant the extension, making certain that he is a core defender going forward in what should be a very fluid blueline over the next year or so.


We hope you've found the sleeping bag or camp quilt of your dreams by following this five-part series. But don't rest on your laurels, because the arduous journey for warmth isn't over. The perfect bag or quilt won't stay perfect without proper care. Here are a few tips on maintaining your fluffy companion and keeping your bag or quilt in tip-top shape for the next adventure.
Wearing sleep clothing at night will maintain your bag's integrity for extended periods of use. By going to bed with a thin baselayer on, you'll not only sleep warmer by wicking moisture away from your body, but you'll also keep your body oils from negatively affecting the bag or quilt.
If you've noticed small areas on your bag where oil or dirt has built up, we recommend hand washing just that single area initially.
Thoroughly washing your bag or quilt should not be taken lightly. In fact, we only recommend a full cleaning if your bag has seen extended use or you've noticed that extensive amounts of oil and dirt are hindering your bag's loft. The fact is, washing your sleeping bag will remove some of its water resistant qualities. In our research, we've found that retreating your bag or quilt at home will never give you the quality of water resistance you get from the bulk treatment the factory applies.
However, after extended use, body oils can begin to build up on your bag and these will, over time, break down its insulation. So with a thorough wash, you will remove grime that would, if left on, reduce your bag's warmth.
So how should you wash your bag?
Beware: a top-loading washing machine with an agitator can destroy your bag. So seek out a front-loader (found at most laundry mats) and use a non-detergent soap. We also recommend running extra rinse and spin cycles for best results. No front-loader? No problem. Go old-school and hand wash your bag in the tub.
But what if your bag is filled with DWR (Durable Water Repellent) down?
If your dream bag sports treated down that's water resistant (such as Nikwax® Hydrophobic Down™ used in all Therm-a-Rest down sleeping bags and quilts), we recommend using a down-specific wash designed to maintain the insulation's water-repellent qualities. Using a standard detergent will leave water-attracting residues on your down. However, a DWR specific soap (such as Nikwax's DownWash™) will maintain the insulation's water-repellent qualities while removing harmful oil and dirt. After a few washes, it's essential to restore the bag's DWR coating by using Nikwax Down Proof™.
This may seem obvious, but keeping your bag or quilt dry, as often as possible, whether you're in the field or at home, helps preserve its insulating qualities.
If you've washed your bag, we recommend running it through a large industrial dryer at low heat. Keep in mind that a dryer running too hot can melt fabrics on your bag. Low heat is crucial. Also, take care that the bag doesn't expand and get stuck next to the dryer's heater. You can keep your bag moving inside the dryer by tossing in a few tennis balls. This will also help break up the down clusters—restoring the bag's loft.
You can always hang-dry your bag too.
Pro Tip: After cleaning and drying your bag, turn it inside out and give it some sun … literally. Allowing your bag to soak up some rays will kill bacterial, improving your sleep ecosystem.
A critical mistake many people make when storing their sleeping bag or camp quilt is packing it into a stuff sack. This is slowly but surely ruining your insulation by compressing it. Many bags come with an additional storage sack as well as a stuff sack. This sack, usually mesh and much larger, is specifically designed to let your bag breath without compressing the insulation. If you don't have a storage sack, you can hang your bag up or lightly fold it and leave it unpacked.
We hope this series has or will help you find and maintain the perfect sleeping bag or camp quilt. But we understand that there are many choices, so don't hesitate to contact us for further information. Thanks for reading!


text:
Q: Самая частая буква в слове. Python from collections import Counter
import re
def checkio(text: str) -> str:
    text1 = re.findall('[^\W]', text.lower())
    a = (''.join(text1))
    text2 = re.findall('[a-z]', a)
    a1 = (''.join(text2))
    return(Counter(a1).most_common(1)[0][0])

print(checkio("Hello World!"))          # == "l", "Hello test"
print(checkio("How do you do?"))        # == "o", "O is most wanted"
print(checkio("One"))                   # == "e", "All letter only once."
print(checkio("Oops!"))                 # == "o", "Don't forget about lower case."
print(checkio("AAaooo!!!!"))            # == "a", "Only letters."
print(checkio("abe"))                   # == "a", "The First."
print(checkio("a" * 9000 + "b" * 1000)) # == "a", "Long."

Как решить проблему если при "One" должно получиться "e", а при "abe" должна получиться "a"?
Задавали тот же вопрос вот здесь: https://ru.stackoverflow.com/questions/1036053/Самая-частая-буква-в-тексте

A: Я так понимаю, вам нужно отсортировать результат не только по частоте, но ещё и по тому, какая буква идёт раньше в алфавите:
return sorted(Counter(a1).items(), key=lambda x: (-x[1], x[0]))[0][0]

Тогда результат получается какой нужно:
l
o
e
o
a
a
a

P.S. Вернее, можно не сортировку, а минимум прямо брать, это чуть оптимальнее. Но тоже с тем же ключом:
return min(Counter(a1).items(), key=lambda x: (-x[1], x[0]))[0]


A two day workshop running from 10am-4pm each day.
Scotty Cotter has been part of Massive Company since 2006, as an actor, tutor and director. In 2008 he was an international delegate to youth theatre festival 'Contacting the World' in Liverpool, representing Massive. Scotty has performed in many Massive shows, including 'Havoc in the Garden' and 'The Brave.' In 2015 he took part in the Director's Lab, going on to co-direct 'The Wholehearted' and emerging artists' show 'Chance to Ignite' in 2016.
Dominic Ona-Ariki started with Massive in 2006 in 'Up Close Out Loud' and has since performed in 'The Brave' and 'My Bed, My Universe'. He is known for his TV roles on 'Pet Detectives', 'Shortland St' and most recently 'Gary of the Pacific' and 'Filthy Rich'. Dom has recently been working as a lead tutor and director for Massive Nui Ensemble.


text:
Максим Иванович Зязин (1846—1900) — русский .

Биография
Родился  в селе Сайгатка Сарапульского уезда, Вятской губернии (ныне г. ).

В 1866—1874 годах был вольнослушателем в Императорской Академии художеств; в 1869 году получил серебряные медали второго и первого достоинства, в 1872 году — премию в 100 руб. за эскиз «Потоп». В 1871 году по заказу Якутской духовной консистории он исполнил портрет императора Александра II. В 1873 году на академической выставке показал картину «Давид перед Саулом», о которой в ноябре 1873 года И. Н. Крамской в письме И. Е. Репину с иронией писал: «Зязин, как бы это Вам выразить, сотворил такое неприличие с программой, что все старцы пришли в ужас: написал без рисунка, без драпировки каких-то двух дикарей (Саул и Давид с гуслями), в пустом чулане, не домазал холста, об опрятности и помину нет, а между тем — даже драма. Ну, разумеется, его в шею, как смеешь грубить, — всё старая история».

В 1874 году преподавал рисование в Енисейской мужской прогимназии. В середине 1870-х годов преподавал в средних учебных заведениях Оренбурга. В 1881 году он был удостоен звания классного художника 3-й степени.

С 1881 года жил и преподавал в Иркутске; был учителем рисования в Иркутской учительской семинарии, преподавал рисование и чистописание в Иркутском техническом училище и ремесленно-воспитательном заведении Н. П. Трапезникова. Занимался росписью храмов Иркутска; им были выполнены «Евангелисты» в куполе Казанской церкви, построенной на средства А. М. Сибирякова, «Евангелисты» и «Чудеса Св. Иннокентия» в Вознесенском соборе.

В октябре-ноябре 1886 года в Иркутске прошла персональная выставка работ Зязина. В апреле 1900 года он участвовал в городской художественной выставке, где были представлены его картины «Гитарист», портрет И. В. Щеглова — учителя истории губернской гимназии, «Спас Нерукотворный», скульптурный медальон с головой Иоанна Крестителя и др.

Из его произведений также известны рисунки, выполненные для петербургских журналов «Пчела», «Кругозор» и др.: «Сваха» (1875), «Колумб-отрок» (1875), «Молодая крестьянка» (1877), «Гурт баранов в Оренбургской губернии» (1888). По рисункам Зязина в «Восточно-Сибирском календаре на 1885 год» были помещены две литографии: «Иркутский Вознесенский первоклассный общежительный монастырь» и «Ермак — покоритель Сибири».

Умер в Иркутске в 1900 году от цирроза печени; был похоронен на .

Работы М. И. Зязина находятся в коллекциях Пермской государственной художественной галереи, Екатеринбургского государственного музея изобразительных искусств, Иркутского художественного музея.

Примечания

Литература

Ссылки
 Зязин Максим Иванович в энциклопедии «Пермский край»
 Зязин, Максим Иванович  в «Иркипедии»

redpajama_set_name: RedPajamaWikipedia


text:
Gina Alice
Born in Wiesbaden, Germany, in 1994, to German-Korean parents, she started piano at age four. Only three years later, she became a student of professor Irina Edelstein. Since 2009, Gina Alice has been studying piano at the Academy of Music and Performing Arts in Frankfurt, as a junior student of Lev Natochenny's master class. Since 2012, she has been a student of Bernhard Wetz at the Academy of Music and Performing Arts in Frankfurt.
Gina then received more artistic inspirations from Professor Laszlo Simon and Professor Klaus Hellwig at Berlin University of the Arts, and studied with professor Gary Graffman as a fellow of the Lang Lang International Music Foundation.
Gina Alice began playing in public at the age of 8 and quickly became an internationally acclaimed pianist in France and Spain. She also performed in international master classes such as Moulin D 'ande International Academy and Burgos International Music Festival.
When Gina Alice was eight, she became a sensation following a Steinway concert in Farquaford, playing Haydn's piano concerto in D major.
Gina Alice made her TV debut as a piano soloist in April 2007. She performed Mendelssohn's piano concerto in G minor on German national television (ZDF) 's Klassik-kids with the Berlin National Youth Symphony Orchestra and conductor Rasmus Baumann with great success.
Gina Alice's first piano recital in 2009 was well received in the classical world. In the spring of 2012, her debut of Mendelssohn piano concerto no. 1 with the Berlin Philharmonic Orchestra and conductor Kazuo Kanemaki at the Berlin Philharmonie hall was equally well received. In March 2013, she was invited to Berlin again to play the Rachmaninoff piano concerto no. 1.
In January 2013 Gina Alice played a sold out piano recital called "young artist" at Hessischer Rundfunk Sendesaal in Frankfurt, Germany. The entire concert was broadcast on German national radio hr2-kultur on March 7, 2013.
On May 1, 2014, Gina Alice performed for the third time in the Berlin Philharmonie hall, during the final concert of the Berlin Philharmonic season. She performed Rachmaninoff's Variations on a Theme of Paganini as a piano solo and collaborated with the Berlin Philharmonic orchestra.
In 2016, Gina Alice collaborated with the Shenyang Philharmonic orchestra and Guangzhou symphony orchestra in China. In 2017, Gina Alice gave a recital at the Ruhr piano festival, the largest piano festival in the world.
In 2019, Gina Alice and Shenzhen Symphony Orchestra played "the moment of victory".


I am making steady progress with my current painting – Initiation. Much like its namesake this one is testing me, one mark made after another, trusting and letting the map and journeys guide me.
I shall post more about the journeys and medicine of this piece soon.


The world of Spira is not without its mysteries. What was the world like before the Machina War? What could possibly be on those unexplored islands and landmarks that we never got to go to? Was there more to the summoners before they just became weapons capable of destroying Sin? Is there a whole other world full of secrets on the other side of the barrier between life and death?
Any fan speculations, pertaining to the nature of the actual world of Spira or the technical and conceptual world behind the scenes can be posted here.
For example: My theory is that Macalania Woods is based on the Norse myth of Yggdrasil.
Yggdrasil is basically the Genesis of the Norse cosmology; the World Tree. Yggdrasil is a holy ash tree in which the gods visit daily, and has three worlds (wells) connected to its roots. These three worlds have separate guardian creatures protecting them: an eagle, four stags, and a wyrm.
The woods in Macalania is heavily populated by springs. One of Yggdrasil's worlds, Hvergelmir, is actually a spring. The two most famous trees in Macalania is the one at where Tidus and Yuna fall in love (Mysteriously, in X-2, the tree in the middle of the spring is the only one in that area that is still alive.) and the tree at the spring where spherewater is created and collected. It's a bit of a stretch, but these trees could bear some referencing to Yggdrasil, since their roots seem to be making the majority of their structure, and Yggdrasil's roots play a very vital part.
Macalania Woods is also protected by three musicians: Borra, Pukutak, and Doyra. Borra represents a bird-like creature. Pukutak represents a sort of deer-like animal. Doyra could represent a wyrm because of the horns on his head, but his face makes him out to be more of an amphibian, so it might be a stretch.
So: Macalanian Trees = Yggdrasil. Woods = Hvergelmir. Guardians of Macalania: Guardian creatures of Yggdrasil's worlds.