text:
Watch Live: White House holds press briefing 16 MIN Breaking News: Sununu calls for patience as state prepares to kick off Phase 1B of vaccinations 3 MIN Breaking News: COVID-19 in New Hampshire: Key data, maps and graphs 14 MIN Breaking News: Live on News 9 at 5:30: Dr. Chan answers your COVID-19 questions Breaking News: LIVE: Executive Council holds hearing about MacDonald's nomination to be chief justice Breaking News: Sign up for our Coronavirus & Rossen Reports Newsletters Closings There are currently 2 active closings or delays <% if ( weatherAlerts > 0 ) { %> Severe Weather <% var weatherAlertsMessage = "There " + ( weatherAlerts > 1 ? "are" : "is" ) + " currently " + weatherAlerts + " active weather " + ( weatherAlerts > 1 ? "alerts" : "alert" ); %>
State health officials highlight efforts to prevent suicide
Officials say help available for those who need it
Mike Cronin
TELLING OTHERS THAT HELP IS AVAILABLE. ROBBIE MILWARD IS A FATHER, VETERAN, AND ABOUT 19 YEARS AGO HE SAYS HE TRIED TO TAKE HIS OWN LIFE. >> I STARTED SEEING A PSYCHIATRIST AND A THERAPIST. AT FIRST IT SEEMED TO HELP. IT WASN'T. MIKE: HE SUFFERS FROM DEPRESSION, ANXIETY, AND PTSD. THROUGH AN INPATIENT PROGRAM MILWARD TURNED HIS LIFE AROUND. >> IT SHOWED ME HOW TO USE MY PAST EXPERIENCES OF STRENGTH TO HELP GET ME THROUGH THE ROUGH DAYS. IT TRULY SHOWED ME HOPE IS REAL. MIKE: ON WORLD SUICIDE PREVENTION DAY STATE LEADERS ARE , HIGHLIGHTING A LEADING CAUSE OF DEATH IN NEW HAMPSHIRE. >> RIGHT NOW, WE'RE SEEING A VERY LARGE SPIKE IN THE SUICIDE CALLS. LAST MONTH IT WAS 169 CALLS RELATED TO SUICIDE. >> WE ARE GOING TO BE PREVENTATIVE. WE'RE GOING TO STAND REALLY SHOULDER TO SHOULDER, THROW POLITICS OUT THE WINDOW AND SIMPLY MOVE THE BALL FORWARD TO GET STUFF DONE. MIKE: AMONG THE STATE'S EFFORTS , THE NORTH COUNTRY IS PART OF A PILOT PROGRAM THAT AIMS TO PREVENT SUICIDE AMONG VETERANS IN RURAL AREAS. AND NEW HAMPSHIRE'S DEPARTMENT OF EDUCATION SAYS ABOUT FIVE -- ABOUT 5000 PEOPLE HAVE BEEN TRAINED IN HOW TO HELP A CHILD IN CRISIS. >> ONE THIRD OF THOSE WE TRAINED 5000 JUST IN THIS LAST SCHOOL YEAR AND WE REALLY CAN'T EVEN KEEP UP WITH THE DEMAND. SO SCHOOLS AND COMMUNITIES ARE RECOGNIZING HOW IMPORTANT THESE TRAININGS ARE. MIKE: MILWARD HOPES TO INSPIRE OTHERS TO FIND HELP. HE SAYS NOT ASKING FOR IT ALMOST COST HIM HIS LIFE. >> OWNING IT HELPS ME LIVE MY BEST LIFE. OWNING IT SHOWS ME AND OTHERS THERE IS NO SHAME. WE WILL WIN THIS WITH COMPASSION. WE WILL WIN THIS WITH UNDERSTANDING. MIKE: IF YOU OR SOMEONE YOU KNOW NEEDS HELP, THE SUICIDE PREVENTION HOTLINE IS 1-800-273-TA
Health officials in New Hampshire are urging people to recognize the warning signs of suicide as the state marks World Suicide Prevention Day.State leaders are highlighting the issue in hopes of telling others that help is available.Robbie Milward is a father and veteran who, about 19 years ago, tried to kill himself."I started seeing a psychiatrist and a therapist," he said. "At first, it seemed to help. It wasn't.">> How to get help: Call the Suicide Prevention Lifeline at 800-273-TALK (8255)Milward said he has depression, anxiety and post-traumatic stress disorder, but through an inpatient program, he was able to turn his life around."It showed me how to use my past experiences of strength to help get me through the rough days," he said. "It truly showed me hope is real."Health officials said suicide is a leading cause of death in New Hampshire."Right now, we're seeing a very large spike in suicide calls," said Cameron Ford, executive director of Headrest, a nonprofit located in Lebanon. "Last month, it was 169 calls related to suicide.""We are going to be preventative," said Gov. Chris Sununu. "We're going to stand really shoulder to shoulder, throw politics out the window and simply move the ball forward to get stuff done."Among the state's efforts are a pilot program in the North Country aimed at preventing suicide among veterans in rural areas and an effort to train thousands of people in the state's schools on how to help a child in crisis."One-third of those 5,000, we trained just in this last school year, and we really can't even keep up with the demand, so schools and communities are recognizing how important these trainings are," said Michelle Myler, administrator of the Office of Student Wellness in the state Department of Education.Milward said he hopes to inspire others to find help. He said not asking for help almost cost him his life."Owning it helps me live my best life," he said. "Owning it shows me and others there is no shame. We will win this with compassion. We will win this with understanding."If you or someone you know needs help, call the Suicide Prevention Lifeline at 800-273-TALK (8255) or go to the organization's website to chat with someone online.
CONCORD, N.H. —
Health officials in New Hampshire are urging people to recognize the warning signs of suicide as the state marks World Suicide Prevention Day.
State leaders are highlighting the issue in hopes of telling others that help is available.
Robbie Milward is a father and veteran who, about 19 years ago, tried to kill himself.
"I started seeing a psychiatrist and a therapist," he said. "At first, it seemed to help. It wasn't."
>> How to get help: Call the Suicide Prevention Lifeline at 800-273-TALK (8255)
Milward said he has depression, anxiety and post-traumatic stress disorder, but through an inpatient program, he was able to turn his life around.
"It showed me how to use my past experiences of strength to help get me through the rough days," he said. "It truly showed me hope is real."
Health officials said suicide is a leading cause of death in New Hampshire.
"Right now, we're seeing a very large spike in suicide calls," said Cameron Ford, executive director of Headrest, a nonprofit located in Lebanon. "Last month, it was 169 calls related to suicide."
"We are going to be preventative," said Gov. Chris Sununu. "We're going to stand really shoulder to shoulder, throw politics out the window and simply move the ball forward to get stuff done."
Among the state's efforts are a pilot program in the North Country aimed at preventing suicide among veterans in rural areas and an effort to train thousands of people in the state's schools on how to help a child in crisis.
"One-third of those 5,000, we trained just in this last school year, and we really can't even keep up with the demand, so schools and communities are recognizing how important these trainings are," said Michelle Myler, administrator of the Office of Student Wellness in the state Department of Education.
Milward said he hopes to inspire others to find help. He said not asking for help almost cost him his life.
"Owning it helps me live my best life," he said. "Owning it shows me and others there is no shame. We will win this with compassion. We will win this with understanding."
If you or someone you know needs help, call the Suicide Prevention Lifeline at 800-273-TALK (8255) or go to the organization's website to chat with someone online.


So you want to win the MoMA PS1 Young Architects Program? This year's champs Matthias Hollwich and Marc Kushner of HollwichKushner (HWKN) shared some insight about their strategy with AN. The competition started with an invited portfolio submission from about 20 young architects. After being selected by the MoMA PS1 panel as one of three finalists, HWKN started in with rigorous research into past winners and the selection process. "We made a book about every entry," Hollwich said. This study provided in-depth knowledge of the different approaches and forms which have won, and also those that have not been successful. The next step was a brainstorming session with their project team that produced 100 ideas. Those 100 were trimmed to 10, and then cut to three, but then Wendy, a striking scheme for a neon blue star, was added, making four. Once the final choice was made, a retroactive analysis helped to assure that they made the right choice and that the design had all the elements they were looking for. "It was not a linear process, but design never is," Kushner said. Wendy is a formal departure from recent winners. MOS' afterparty in 2009, Pole Dance by Solid Objectives - Idenburg Liu (SO - IL) from 2010, and Interboro's Holding Pattern from 2011 all worked as canopy-like structures spanning the courtyard, providing shade by creating spaces with overhead elements. Wendy is an object, and is more autonomous and isolated than previous entries. "I am interested in volume more than surface," Hollwich explained. The competing teams worked together in an unusual way. During the competition process, HWKN was in contact with the other teams regarding site information, which they felt helped create an even playing field between the competitors. As the only team from New York, HWKN assisted out of town firms with measurements and other on-site information. Upon being named winners, the other architects called to congratulate the HWKN team, said Hollwich. But then things got real. "High-speed architecture and prototyping have many hurdles. We are glad that we were already able to jump a couple of them," Hollwich explained. There was some unexpected drama when the question of ambulance access arose, requiring a column to be moved breaking the 3-D grid of scaffolding, but making for an interesting moment in Wendy's final form. A shout-out goes to the intern at HWKN who successfully convinced the leaders of the project to go with the name "Wendy." One late night in the studio, Hollwich received a long email detailing the reasons the name fit. He liked it, but figured Kushner would hate it. Kushner liked it, but thought Hollwich would hate it. "We think of Wendy as a kind of perfect storm, and every perfect storm is named for a woman." Personifying the building breaks with conventional architectural naming, and, the team hopes, invites visitors to fall in love. Construction begins May 15, and is set to be completed June 27th.
New York-based HWKN has been selected for this year's MoMA/PS 1 Young Architects Program. Their proposal, called "Wendy," uses standard scaffolding to create a visually arresting object that straddles the three outdoor rooms of the PS 1 courtyard. Tensioned fabric coated in smog-eating paint provides shelter and programming areas including a stage, shower, and misters. "Their proposal is quite attractive in a number of ways. It's very economical in terms of design," said Pedro Gadanho, the curator of contemporary architecture at MoMA. "One object creates a variety of programmatic and ecological conditions and its scale rivals the height of the PS 1 building." All the materials can be disassembled and reused, and according to Gadanho, the jury was particularly impressed with the combination of standardized parts (the scaffolding) and cutting edge technology (the smog-eating coating). "It's pro-active, it's not apologetic," he said. "It begins to point to a new way to think about sustainability." The designers, led by principals Matthias Hollwich and Marc Kushner and project architect Robert May, estimate the fabric will remove as much smog as taking 250 cars off the road. The pavilion will open in late June.


Solar panels attract birds quite easily due to its installation. They create a perfect space for birds to roost and nest under the solar panels. The warmth emitted from the solar panels will benefit the birds all year around. They create an ideal habitat for birds as well as other insects such as mites and lice. Solar energy is wasted in the process and efficiency is lost. This is the reason that solar panels need to be bird proof to prevent the loss of energy as well as wasting your money in the long run. Here are important reasons to bird proof the solar panels in your home.
Solar panels are a great way to fulfill your energy needs. You can also earn money by selling back excess electricity to the grid. The efficiency of these panels is reduced to a considerable extent due to birds and their droppings. Birds usually nest within the gaps between these panels and the roof. Droppings cut backs the ability of the panels to collect light to generate electricity. The surface of the panel should be maintained in top condition to improve its performance. If bird droppings cover 50% of the cells, there will be a 50% drop in electricity production. If the whole cell is covered with droppings, it can reduce the energy conversion rate to zero Bird proofing the solar panels is extremely important to improve their efficiency and productivity in the long run.
Many solar panel manufacturers in the United Kingdom use effective techniques to bird proof their panels to improve the efficiency and productivity. It will also help prevent any unnecessary damages to the panels. A mesh system is installed over the panels to protect them from birds. The mesh system will deter birds and all other insects from the panels. The mesh systems are usually invisible from the ground level. Your roof will not be screwed or drilled for this purpose. A special variety of clips is used to secure the mesh which will not damage the panels. The mesh system will not interfere with the warranty of the solar panels. In fact, the warranty of the panels will not be affected in any way by the mesh system installed. This is the main reason that you need to consider bird proofing for solar panels today. Do not delay and lose your hard earned money in the long run. Increase the efficiency of your solar panels with this system.


Steve Bonino's debut album is an edgy prog rock, psychedelic pop tour de force. Featuring contributions by Jimmy Keegan, Dave Meros and Ryo Okumoto of Spock's Beard, this is a thinking man's ode to peace.
10. Will the World Mourn?
"Peace March" was originally called "Ode To The Doo Dah Day" and was intended to be a children's tune. This interpretation however places it in Zappa territory.
"Wake Up Call" is me railing against the apathy we all share in the drone of life. Guilty, but getting better.
"Construction" was written back in the 80's with my friends Brad Swanson and Greg "Harpo" Hilfman. It just seemed to us there might be a better way to build this world.
"Dyin For Love" ...Aren't we all?
"Rose Colored Glasses" My good friend, Sheryl has inspired me with her innocent and optimistic view of life. She always says she sees the world through rose colored glasses. Mine are green, bummer.
"True North" is about crossing the oceans (or doing whatever it takes) to find love.
"Paradise Lost" confirms you don't mess with Mother Nature!
"Peace, Love, Truth And Understanding" ...the search goes on.


text:
First Utahn to get plasma treatment for COVID-19 is released from hospital after 25 days
By Sean P. Means
| May 1, 2020, 10:01 p.m.
(Photo courtesy of Intermountain Healthcare) A nurse wheels Cynthia Lemus down the hall of Intermountain Medical Center in Murray on Thursday, April 30, 2020, while medical staff give her a send-off. Lemus, a 24-year-old flight attendant from Magna, was being released from the hospital, after a 24-day stay while being treated for COVID-19 — which included being the first Utahn to be given a transfusion of "convalescent plasma" from a donor who had recovered from the disease.
Editor's note: The Salt Lake Tribune is providing free access to critical stories about the coronavirus. Sign up for our Top Stories newsletter, sent to your inbox every weekday morning. To support journalism like this, please donate or become a subscriber.
Cynthia Lemus can't use her voice at full strength, as she's still feeling the effects of COVID-19.
"I'm just tired, trying to get my energy back," she said Friday. What's important is where she said it: At home.
Lemus, a 24-year-old flight attendant from Magna, was released from Murray's Intermountain Medical Center on Thursday — after spending 25 days being treated for COVID-19, 18 of them in a medically induced coma while ventilator tubes pushed oxygen down her throat into her ailing lungs.
Lemus' release from the hospital, through a hallway of cheering medical workers, came 13 days after she became the first person in Utah to receive "convalescent plasma," the plasma of a recovered COVID-19 patient transfused into her bloodstream.
"Today really is a day of celebration," said Dr. Brandon Webb, chair of Intermountain Healthcare's COVID-19 Therapeutics team, during a Friday virtual news conference to announce Lemus' release. "We're absolutely delighted to see Cynthia looking so good."
(screenshot) Cynthia Lemus, with her husband, Moises Lemus, talks about her experience with COVID-19 and plasma treatment during a news conference on May 1, 2020.
The plasma treatment program, sponsored by the U.S. Food and Drug Administration and coordinated by the Mayo Clinic in Minnesota, has evolved since it began, Webb said. Since Lemus received her transfusion, 10 other hospitalized patients at Intermountain have received the treatment.
"It's too early to comment on whether this particular treatment for COVID-19 is successful," Webb said. However, all 11 patients "are in the process of recovery," he said.
The treatment involves giving plasma, donated by recovered COVID-19 patients who have developed antibodies against the coronavirus, to those who still have the disease. "The theory is that those antibodies would then attach to virus particles and neutralize [them], or cause them to not be able to cause tissue damage," Webb said.
Being the first person in Utah to receive the plasma treatment "is still something I'm processing, still barely being awake for a few days," Lemus said. "It's still something very surreal to me."
Lemus' husband, Moises, insisted on taking her to the emergency room on April 5. "I was feeling the shortness of breath for about two days, before he finally pushed me to go to the E.R.," she said. "I definitely feel I waited just a little bit too long."
The next day, April 6, Cynthia was put on a ventilator. Moises wasn't allowed to be with her at the hospital, because he also had contracted COVID-19, though his symptoms were much milder.
On April 12, Cynthia was hooked up to an extracorporeal membrane oxygenation machine — called an ECMO machine or, colloquially, a heart-lung machine.
The ECMO is commonly used during heart surgery to replace the functions of the heart and lungs, said Dr. David Morris, associate medical director for general surgery in Intermountain's Trauma Services Clinical Program. In recent years, Morris said, the ECMO has been useful in treating patients with severe respiratory failure.
"It is very taxing on the body to be on this kind of support," Morris said. "It's a tribute to Cynthia that she looks as amazing as she does today. Honestly, patients don't typically rebound so quickly after being on this intensive level of support."
"It was a complete nightmare," Moises Lemus said of his wife's ordeal, "getting the updates, seeing how she wasn't improving, how she was getting worse."
"As my body shows, I'm a fighter," Cynthia Lemus said.
Cynthia Lemus received the plasma transfusion on April 17. On April 21, she was taken off the ECMO machine. On April 24, she was taken off the ventilator and woke up.
"It was definitely a little bit scary being there alone, since family isn't allowed to be at the hospital," Cynthia Lemus said. "But I know all the doctors and nurses that were there definitely made me feel like family."
Moises Lemus, 34, who runs his own video-production company, received regular updates from medical staff, but didn't see Cynthia in person again until her release on Thursday.
When he saw her being wheeled out of the hospital, he said, "my heart dropped. It was like she was walking down the aisle again."
Doctors said it probably will be another month of home recovery before Cynthia Lemus is back to full health.
Both Cynthia and Moises Lemus said that, as soon as they can, they intend to donate their plasma, through the American Red Cross, which has been enlisted to find donors of convalescent plasma. (Those interested can go to RedCrossBlood.org to start the registration process.)
For Moises, a donation could happen as soon as 28 days after he recovers from COVID-19, said Dr. Walter Kelley, medical director of the American Red Cross' Utah chapter. Cynthia will have to wait longer; Red Cross rules for blood donations ban anyone who has received a transfusion from donating for 12 months, Kelley said.
The Lemuses hope their story will encourage other young people to take COVID-19 seriously.
"People just don't know how it's going to act on your body," Moises Lemus said. "You see Cynthia. She's 24 years old. She's young. She's healthy. There is absolutely nothing wrong with her. And for the virus to take her that far down the rabbit hole, that's something that we didn't expect."
Cynthia Lemus said she knows what she wants do to when she's 100% healthy.
"Take a vacation," she said with a laugh. "Go somewhere. Explore. Be able to know that I'm me again."
spmeans@sltrib.comFollow @SeanPMeans
'This is a potential public health disaster:' COVID-19 results from TestUtah.com are raising questions
Utah leaders want people to wear face masks. We tracked 1,500 people at stores. Here's what we saw.
In a first for Utah, a COVID-19 sufferer receives plasma transfusion from a recovered patient
Utah workers prepare as state shifts down coronavirus risk level
Salt Lake City School District to decide Tuesday when junior high and high school can resume in person

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a. An iron shaft with claws at one end, usually thrown by a rope and used for grasping and holding, especially one for drawing and holding an enemy ship alongside. Also called grapnel, grappling, grappling hook, grappling iron.
2. Any of various grasping devices having hinged tines or jaws that close around an object or load, used especially in lifting or dragging heavy items.
3. The act of grappling.
a. A struggle or contest in which the participants attempt to wrestle with each other by clutching or gripping.
b. A struggle for superiority or dominance.
1. To seize and hold with a grapple: grappled the prow of the ship.
2. To seize firmly with the hands: "Jules ... grappled the backpack chained over the back of Izzy's bike and began scrabbling through it" (Bella Bathurst).
1. To hold onto something with a grapple: "The 150-odd ships closed and grappled, initiating the most important naval battle of the Hundred Years' War" (Clifford J. Rogers).
2. To use a grapple or similar device, as for dragging.
a. To wrestle with an opponent by clutching or gripping.
b. To struggle or work hard to deal with something: grappled with their consciences; grapple with the political realities of our time.
2. (foll by: with) to cope or contend: to grapple with a financial problem.
1. to hold or make fast to something, as with a grapple.
2. to engage in a struggle or close encounter: wrestlers grappling.
3. to try to overcome or deal: to grapple with a problem.
4. to seize or hold with or as if with a grapple.
6. a seizing or gripping.
7. a grip or close hold.
3. grapple - the act of engaging in close hand-to-hand combat; "they had a fierce wrestle"; "we watched his grappling and wrestling with the bully"
struggle - strenuous effort; "the struggle to get through the crowd exhausted her"
Verb 1. grapple - come to terms with; "We got by on just a gallon of gas"; "They made do on half a loaf of bread every day"
extemporize, improvise - manage in a makeshift way; do with whatever is at hand; "after the hurricane destroyed our house, we had to improvise for weeks"
fend - try to manage without help; "The youngsters had to fend for themselves after their parents died"
hack, cut - be able to manage or manage successfully; "I can't hack it anymore"; "she could not cut the long days in the office"
rub along, scrape along, scrape by, scratch along, squeak by, squeeze by - manage one's existence barely; "I guess I can squeeze by on this lousy salary"
cope with, match, meet - satisfy or fulfill; "meet a need"; "this job doesn't match my dreams"
2. grapple - to grip or seize, as in a wrestling match; "the two men grappled with each other for several minutes"
1. deal, tackle, cope, face, fight, battle, struggle, take on, engage, encounter, confront, combat, contend, wrestle, tussle, get to grips, do battle, address yourself to The economy is just one of the problems that the country is grappling with.
2. struggle, fight, combat, wrestle, battle, clash, contend, strive, tussle, scuffle, come to grips He grappled desperately with Holmes for control of the weapon.
clasp, clench, clutch, grasp, grip, hold.
clasp, clench, clutch, grab, grasp, grip, seize.
Idiom: go to the mat with.
I would not bear sword or weapon against the worm if I knew how else I might proudly grapple with the wretch, as I of old with Grendel did.
Upon anything below they could rain explosives in the most deadly fashion, forts and ships and cities lay at their mercy, but unless they were prepared for a suicidal grapple they could do remarkably little mischief to each other.
Buffalo was on fire to an enormous extent, and there were no signs of any efforts to grapple with the flames.
Ever and again a larger thunder mingled with the rattle and reminded him of the grapple of airships far above, but the nearer fight held his attention.
Year by year the Soldiers and Artisans began more vehemently to assert -- and with increasing truth -- that there was no great difference between them and the very highest class of Polygons, now that they were raised to an equality with the latter, and enabled to grapple with all the difficulties and solve all the problems of life, whether Statical or Kinetical, by the simple process of Colour Recognition.
Under this the Abraham Lincoln attained the mean speed of nearly eighteen knots and a third an hour-- a considerable speed, but, nevertheless, insufficient to grapple with this gigantic cetacean.
I seen him grapple four and knock their heads together--him unarmed.
He had an extremely disturbing air of being everlastingly ready (even when seated at table at my right hand before a plate of salt beef) to grapple with some impending calamity.
My own unaided ingenuity, consulted next, proved quite unequal to grapple with the difficulty.
In Chicago, while her mistress saw one side of social life, Edith Whittlesey saw another side; and when she left her lady's service and became Edith Nelson, she betrayed, perhaps faintly, her ability to grapple with the unexpected and to master it.
One of our miseries is that we can't find a gentleman who will grapple with the hideous difficulties of Falkland.
Here he was already locked in grapples with the great Guggenhammers, and winning, fiercely winning.


text:
Q: Google Chrome weird cursor blink on pages, never seen 'em before As I'm paranoid more with online breach, recently noticed that Google chrome elements upon click showing cursor blink and that's spooky. HTML page elements became editable?   It's not happening with Mozilla, and the extensions enabled on chrome are,

*

*Apollo Client Developer Tools,

*Authenticator

*Vue.JS Tools

On Firefox, it's allowing to select and no cursor blinks and that's the default behaviour.
Demo of problem:

A: There's an option called Navigate pages with a text cursor in Accessibility settings, you'll need to disable this option.
Go to Chrome Settings → Advanced → Accessibility, find the Navigate pages with a text cursor option, and disable it.
Ref. https://support.google.com/chrome/thread/77878717?hl=en

A: Disabled this and now its not showing the cursor blinking

A: Hit the F7 key on the Chrome enable/disable cursor blinking.
You can also enable/disable in chrome setting.
Got to
Chrome Settings / Advanced / Accessibility > Navigate pages with a text cursor option

Disable it.

A: That means caret browsing has been enabled in your browser (i.e. Chrome)

*

*You can press F7 key to disable the caret browsing
straightaway, which is default keyboard shortcut in browsers.

*Otherwise you can also disable caret browsing through Browser
Settings. As of today, the settings are named as:

Navigate pages with a text cursor (Chrome)
Always use the cursor keys to navigate within pages (Firefox)

What is caret browsing?
That allows the user to move around, highlight selections with the keyboard rather than a mouse. Users most familiar with keyboard can opt for caret browsing easier to use for selecting text.
The caret is nothing but the name of the vertical | text cursor.

A: An easy solution is to press the F7 key on the Chrome browser.
This method makes it easy to enable/disable cursor blinking problem.

A: I have the same problem here in all websites.
The problem is not extensions but the Chrome browser on version 86.
I downloaded Chrome 87 beta and problem is fixed.
So wait until release version 87.

A: there is a way to round this issue ==>
by adding this to your global.css you can avoid this blinking cursor
*:not(input) {
  -webkit-touch-callout: none; /* iOS Safari */
  -webkit-user-select: none; /* Safari */
  -khtml-user-select: none; /* Konqueror HTML */
  -moz-user-select: none; /* Old versions of Firefox */
  -ms-user-select: none; /* Internet Explorer/Edge */
  user-select: none;
}

redpajama_set_name: RedPajamaStackExchange


text:
What makes GSK the number one pharmaceutical company in Egypt?
ppconnwpadmin
Nader Rizkalla
MSD Egypt
GlaxoSmithKline (GSK) has firmly acquired the number one position in the Egyptian pharmaceutical market since 2009 and is likely to maintain the grip at least until the end of 2011. GSK's current market share is around 9% with a nice gap separating it from the next competitor (7.7%) (IMS, YTD o8/2011).
The Egyptian pharmaceutical market is considered one of the key emerging markets after BRIC (BMI, Q4/11).
Here are some of the key success ingredients of GSK. Understanding those ingredients, will impart you the essentials of the pharmaceutical market in Egypt.
Access and pricing
GSK has understood the game of access in Egypt earlier than other companies. By buying two successful local manufacturing facilities with their generic brands, GSK has better market access than companies which depend only on their own brands.
It also acquired the primary care portfolios of Bristol-Myers Squibb (BMS) (together with its local manufacturing facility) and UCB, two lines which are driving the bulk of the growth of the company today.
GSK maintains a relatively large field force, reaching the majority of physicians in a market which is very sensitive to promotion. GSK, with its diversified portfolio, therefore reaches more physicians than any other company in the market.
"GSK maintains a relatively large field force, reaching the majority of physicians in a market which is very sensitive to promotion."
Furthermore, GSK is well known for providing its brand products with a price in Egypt that can be a fraction of its regular price in the region. Of the top 20 multinational corporations working in Egypt, GSK has the cheapest average price per unit (second only to German pharma Boehringer Ingelheim). By providing relatively low priced drugs, many customers' segments have access to GSK products.
Egypt has a very large population (85M) but very low purchasing power. The annual per capita pharmaceutical sales are less than US$32. Most of this spent is out of the pocket.
By providing a big portfolio of 140 products with a relative low price, GSK is winning the game of "volume" in the market. This large portfolio also gives GSK the power to push its products along the distribution chain down to the pharmacy level.
"The Egyptian market is unique as it does not follow the global trends regarding the best selling therapeutic areas."
Playing in the right field
The Egyptian market is unique as it does not follow the global trends regarding the best selling therapeutic areas. Two therapeutic areas that sell big in Egypt are antibiotics and NSAIDs. Four of the top 5 selling products of GSK are antibiotics (Augmentin, Duricef, Ceporex and Velosef). Two of them come from BMS. By having four well established – and relatively old – antibiotic brands, GSK is securing almost one-third of its sales!
By contrast, while Seretide is the 4th best selling global brand, in the price-sensitive Egyptian market it contributes only 2% of GSK sales.
Following the revolution in Egypt (January 2011) and the following political turmoil, GSK announced two highly visible moves.
Firstly, it announced a big investment in creating a separate consumer goods unit. This solidified GSK as a "here-to-stay" company in the market.
"…GSK raised the average salary of its medical representatives to match regional standards."
Also, in a move that created a lot of noise in the field, GSK raised the average salary of its medical representatives to match regional standards. It took the lead in this direction and it forced many other companies to revise their pay policies. Whether this will have a positive impact on field force loyalty for GSK is debatable, but certainly it created positive publicity for the company.
But GSK is not infallible. Other agile local companies and multinational companies are constantly challenging its position. What are the other companies are doing? That's another story…
Nader Rizkalla currently leads Business Operations in MSD Egypt. His experience in pharmaceutical business in the Middle East extends back to 1996 when he was working in product management for the Near East-East Africa in Boehringer Ingelheim.
In 2002 he joined Schering Plough and had various positions including running the company operation in Jordan (until the end of 2006), where he achieved the turnaround of SP business. He also led the Primary Care unit in Egypt from 2007-2009 and successfully integrated the newly acquired Organon Women Health Business. He has been an active member of Jordan Country Ethical Review Board (CERB) and he held the position of Vice-Chairman for PhRMA Local Working Group in Jordan.
What pharma companies are on the rise in Egypt?


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[Pinoy voices] Healthy families mean healthy societies
According to Immanuel Kant, the conditions for sustained perpetual peace among and within nations are emotional healing, political and social justice and economic empowerment. In East Timor there seems to have been a lot of emphasis on economic empowerment (especially material infrastructure), but little on emotional healing.
Author Sankaran Krishna once described the "supposed gap between what politics was in reality and its public perception of it" as a "knowing leer [that] essentially bridges the gap between a simplistic view of politics as, at some level at least, the exercise of power for the sake of the betterment of the nation and the people, versus an understanding of politics as a domain constituted by crime, corruption, illegal and unethical activities."
So I present a conversation on the topic between a Korean, a Filipino and a Timorese in Dili.
"What are they doing?"
"Cleaning up the streets in Dili. PM's orders."
"But we just heard about all the sex scandals with state officials and also those in the opposition. Shouldn't they be cleaning that up first? In other countries, high public officials having scandals in their personal lives would be investigated and punished in some way. Here, it seems that no one really cares. Aren't public officials accountable to any ethical standards?"
"But whose ethical standards? Western, African, Confucian? In Africa, it is common for chiefs to have multiple wives and dozens of children. But of course, they also have to own a lot of land and cattle and make sure each wife is treated fairly."
"In Vietnam, the Communist Party would kick you out if you had the kinds of riveting sex scandals you have here in Dili. Don't they have political party reforms here?"
"Some political parties do. But how could the presidents of political parties impose 'party discipline' when they themselves have violated it? They have no moral authority."
"Why is the state not focusing on structural and institutional housecleaning instead?"
"Because it's so much easier to do external street cleaning."
"In Korea, we had all kinds of social problems after the war and throughout the post-conflict recovery for at least another 20 years or more. Things festered until they exploded: When the first woman lawyer opened her office in Korea, she found a huge line of women at her front door, saying, 'I need help. I want to seek justice for me and my children.' And that's how the 'No Mistress Movement' started."
"Amazing! There is a landmark case of an MP, from the opposition party, who abandoned his wife and child for his mistress and refuses to pay child support. He has never been punished for violence against his first wife either."
"In Korea, universities teach courses in domestic violence under faculties of family studies and childhood development. It is not something to keep silent about. We also learned that it is not fair to blame the woman for not leaving a relationship because if the systems and institutions do not support her, it will be very difficult for her."
"Here there is silence, partly due to the long-standing resilience of clandestine practices - no open public discussion of domestic violence. Most people do not even acknowledge womanizing and its consequences - mental, psychological and verbal abuse as a form of domestic violence. They think that violence is only physical."
"Be careful comparing Timor to nations like Korea, which had at least 50 years or more of self-reflection after the war."
"Do you think womanizing and domestic violence is prevalent because of the post-war, post-conflict situation?"
"Not really. In the Philippines, even while they were still waging a revolution, men already behaved badly. The Filipino historian Vina Lanzona wrote an article called 'Love and Sex in the Time of Revolution' where she did research on how the Hukbalahap movement had to come up with disciplinary measures for their party cadres because there was too much sex going on and not enough revolution."
"I thought it was just high-ranking public officials drunk with state power and money who are corrupt and unethical. I didn't realize revolutionaries were as bad. "
"Hey, do you think womanizing has any impact on policy and development?"
"Of course it has an impact. If state officials are busy with 'harem management' [which is how one female lover of a high official described his office]. It is not only time consuming but actually costs a lot of money, not to mention how confusing it can be. As for MPs, no wonder they have no time to pass the domestic violence law."
"But what if the high-ranking official who has the sex scandal is female? Is there a society in this world which accepts multiple lovers for females?
"If she were female, she'd probably be beheaded [or at least be made to die some kind of social death]. Or perhaps not. We don't really know of any society where women publicly have multiple husbands and lovers and still maintain their office."
In the past, Timorese became experts at fabricating scandals in order to fight their Indonesian colonizers. Now, they have become virtuosos of political drama and the sex scandals have become more electrifying than thinking about how to provide basic services like electricity.
There seems to be little serious illumination of the psychological needs of war veterans, and very few in the international community have paid serious attention to the long-term importance of emotional healing and family stability as a basic condition for the achievement of sustainable peace. As one Korean friend put it, "The happiness, resilience and stability of our family is the happiness, resilience and stability of the nation."
The writer is an associate professor at the Seoul National University Graduate S
chool of International Studies.
by Jacqueline Aquino Siapno
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A SOFA IN THE SUN. LOFT is designed to give you a stylish and comfortable place to sit and chat with your friends. The modular system lets you arrange it just the way you like to suit your needs. Available in materials for outdoor and indoor use.


You can dress Batman and his sidekicks, Robin and Batgirl, when you buy your costumes from ChildCostumes.com. Look through our collection of the superhero's costumes to find just the right look for Halloween. Find your child's favorite superhero or villain in our Batman costumes.


Political funerals are naturally light on candour and heavy on encomium, a polite sponge applied to the deceased's public record.
Such prettification, in an Australian Labor setting, typically does without much elevated language — the latter being beyond whichever dim leading lights of today, and fossilized contemporaries of yesteryear, have been selected from among the assembled personages.
Bureaucratic droning is the standard official tribute.
Honest political testament, and quivering oratory, is best sought elsewhere.
In October 1975, Clyde Cameron, a senior member of the Whitlam Cabinet and back-room powerbroker for the ALP Left, delivered a remarkably frank, unvarnished speech in the House of Representatives.
With explicitness born of desperation, he described the role of the Australian Labor Party and trade unions in preserving the existing institutional order from those who would menace it.
Without parliamentary democracy what is there? Why should the masses tolerate this mockery of democracy? What will prevent the masses from becoming a mob and what will then stand between the classes of privilege and the mob once the institution of parliament is destroyed? Who will then man the powerhouses, the oil refineries and the transport systems? Who then will man the ships, mine the coal and man the wharves? The Opposition cannot do that with guns and bayonets. It cannot do that with its wealthy racketeer friends. Revolution does not ever happen until some spark ignites the dynamite. The steps which the Opposition has now taken could be the spark that will bring down all the institutions in this country.
Parliament does not derive its strength, its authority, its respect and power from the shell of masonry that carries the name of Parliament House. Nor does it derive its power and respect from the people who sit in its chambers; it derives its power, respect and authority from the fact that people identify Parliament with a whole wide range of ancient traditions, conventions and principles without which it can no longer act as the barrier between our present way of life and the mob which would seek to change it. And yet, it is they, the privileged sections of the community and the Press barons, who have most to lose from the destruction of the present system. They, the Press barons, the mining magnates, the foreign-owned multinational corporations, the ruling classes generally, the barons of business and the privileged classes are now urging the Opposition to embark upon the course of action which will destroy the only bastion which stands between them and the mob.
Ye are many they are few.
This Parliament stands between the rule of the mob, the law of the streets and society as we know it and have enjoyed it throughout our country.
Very late in life, Cameron joined Socialist Alliance.
His trembling evocation of the mob, given rare expression in Canberra (an urban environment designed to exclude the popular citizenry), was common in nineteenth-century literature. The riot scenes of Dickens and Zola record the physical terror inspired by dense populations of workers and artisans unleashed from authority.
Yet isn't such demophobia pointless, after three decades of relative domestic social peace, if not outright quiescence, in the advanced economies?
Why has the governing elite of this country recently invested so heavily in the machinery of repression (administrative detention, 'control orders', military call-out powers, engorgement of police and intelligence agencies)? Why erect such bastions and barriers between 'our present way of life and the mob which would seek to change it', when the latter are so disorganized, discredited and demoralized, and in any case no longer possess in any great numbers a coherent vision of an alternative society?
Mounting a consistent and effective defence of property rights nowadays compels the honest ideologue to adopt such a position [pragmatic authoritarianism].
For if 'gentle commerce' transforms 'zero-sum warfare into positive-sum mutual profit', this same growth of productivity and cooperative non-rivalry (i.e. the necessity for team production by co-workers in factories and offices) also raises the costs of excluding non-owners from access to resources and enforcing private claims to wealth.
In today's Garrison USA, it takes more than one-quarter of the labour force (up from 6% in 1890 and 7% in 1929) to maintain order and to enforce the existing allocation of ownership claims over economic resources. A colossal number of citizen-soldiers now work as supervisors with the authority to discipline, sanction and fire, or as prison guards, private security personnel, employees of the military, lawyers, etc.
This is what mainstream economics calls the 'technology of conflict', in which resources are devoted to enforcing, adjudicating, seizing or redistributing private claims to social wealth.
At the heart of US society beats a massive disciplinary apparatus, public and private.


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Q: How can I send data to docker? I have the following problem. I want to send data continuing to the smart contract (chaincode) using Hyperledger Fabric. The data are temperature values measured by different pi's. They send the measured data to the chaincode. The problem I'm facing is the fact that the pi's are sending data continuing, means they send it like every second to the chaincode.
The temperature sensors use local binaries, which are not part of the docker repository. My solution is to send local data to the docker network. But I have no idea how.
Does anyone have a better solution or just know how to send local data to the docker network? I would appreciate any kind of help.

A: whenever i invoke chaincode from the cli i use docker exec -it <container name> bash
an example being
docker exec -it cli peer chaincode invoke -o orderer2.example.com:7050 -n mycc -c '{"Args":["set", "a", "20"]}' -C mychannel


I can't find the video of it, not that anybody who I'd want reading my blog is the sort of person who would enjoy it, but there's a new Fido ad out about faggots. The comments to that link describe it well enough.
The question becomes exactly who the ad is supposed to be for. The average fruitcake will probably be offended by a commercial to challenge orthodoxy and utilize the inconvenient truth that people can and do decide to become tinkerbells. What does that leave them as an ad campaign?


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HP Goes Small with AMD Ultraportable That's Lighter Than 1kg
By Michelle Ehrhardt
last updated 29 June 2021
Aero sounds a lot like "air…"
(Image credit: HP)
The best ultraportable laptops are now getting to be so small that they're sometimes easier to carry than traditional pen and paper notebooks. HP's new Pavilion Aero is bringing that concept to HP's budget computers with AMD processors. With that name and less than a kilogram of heft, it's clear that the goal here is to offer a similar experience to the MacBook Air, but for PC users who might be aiming for something a bit more wallet-friendly.
That doesn't mean this laptop doesn't have promising features, though. HP hasn't announced full specs yet, but despite being so light, this computer's chassis is completely made from magnesium-aluminum alloy. We don't have full dimensions yet, but this laptop's also got a 13.3 inch 2560 x 1600 screen. Don't expect to be gaming on this, but that 16:10 aspect ratio and higher-than average resolution provide a lot of screen real estate for productivity.
Speaking of productivity, this computer uses AMD's Ryzen 7 5800U mobile processor. HP purports "up to 10.5 hours of battery life," which is actually a little shorter than we've seen on other, similar computers like the Asus ZenBook 13.
Unfortunately, that's about all the specs HP's told us for now. The device does come in 4 colors, including gold, silver, rose gold and white. Expect the HP Pavilion Aero to release in July at HP.Com and in the Fall at select US retailers for a starting price of $749.
Michelle Ehrhardt
Michelle Ehrhardt is an editor at Tom's Hardware. She's been following tech since her family got a Gateway running Windows 95, and is now on her third custom-built system. Her work has been published in publications like Paste, The Atlantic, and Kill Screen, just to name a few. She also holds a master's degree in game design from NYU.
i got my son one for college and work and he LOVES it! ultra super smooth and fast at everything. He's got the 3500U though, not the super nice 5800X but who cares? it's more than what he needs. Love the aluminum shell and paper thinness
neither of us game on PC, it's just for our work and school for him. his was only $600 on Amazon
kaalus
How is 2560x1280 a 16:10 ratio? It's 2:1.
kaalus said:
Typo. Screen is 2560x1600.
JarredWaltonGPU
Yeah, we've corrected. Math is hard. ;-)
paddycake
Sill waiting for something like this for a Chromebook!! under a kg. and especially 16:10!! ... C'mon HP or Acer!!.. U can do IT..... \(99)/


It doesn't matter what you do for a living; when you decide to look for work, you instantly become a marketer.
As a job seeker, you are required to advertise your qualifications and professional reputation — in other words, your personal brand— to employers and recruiters in your desired field online, in person, and on paper.
One of the most important documents you'll need to update or create for this process is your professional resume. A great resume is written with a specific job goal in mind. It should be tailored for each job application by showcasing your most valuable and relevant skills in a way that positions you as an ideal candidate for the job you want.
In order to ensure that your professional resume is supporting your career goals, gather a few sample job descriptions that describe the type of position you're interested in and qualified for. Then, compare the skills and qualifications on your resume with the desired qualifications in the sample job descriptions.
By reviewing job description examples, you'll be able to identify what technical and soft skills, credentials, and work experience matter most to an employer in your target field.
This will aid your job search in many ways. First, it will help you determine if you're missing any important skills that recruiters are looking for. Once you have this information, then you can take steps to build up those skill sets with courses, certification programs, side projects, or internships to become a more attractive job candidate.
Second, these sample job descriptions will help you decide which of your current qualifications should be highlighted throughout your professional resume and cover letter.
And finally, you can use example job descriptions to find the right words to describe the roles and responsibilities you held in each job listed in your work history.
To help you get started, take a look at the sample job descriptions below. For additional example job descriptions, search for listings on your favorite online job boards, and check out the following links from Workable.com and Monster.com.
Listings that represent the type of position you're currently targeting.
In both of these instances, don't worry about the job's location. For the purpose of this exercise, instead only focus on the job description and its requirements.
Use the sample job descriptions that match titles in your work history to beef up your professional resume's Employment History section. Click on the following link to learn how to use these job listings to brag about your experience.
Once you've found three to five sample listings that describe your job goals, copy and paste the text of each job description into a Word document and bold any phrases that routinely pop up. Then, highlight each term that describes a qualification you possess. Use this information to edit your resume and cover letter so that your key accomplishments and skills match those desired by your target employer. Your end result should be a professional resume that mirrors the employer's requirements.
Need more help gathering all the right information for your professional resume? Download TopResume's free resume worksheet today!
Still need help with your resume? Take advantage of our free resume review today!


The item Marineros de la Armada de EE. UU. : Sailors of the U.S. Navy, por Jennifer Reed represents a specific, individual, material embodiment of a distinct intellectual or artistic creation found in Denver Public Library.
Marineros de la Armada de EE. UU.


In previous post Running NASM inside C inside GDB. Part 1. Integers we created a simple asm function and called it from C code.
We had only 3 arguments in that example. But what happens if we have more? Stack happens.
Okay, we have more than 3 parameters now. How are those passed to the external asm_compute_more?
We can easily cross-check this with the Calling Conventions to see that gcc placed all arguments into registers, but also pushed last two (n7, n8 to the stack).
Ok, so if we are sure we would only run on this architecture with this compiler, it's fine, we can just use registers only and forget about the stack. But let's not do this for now, and use stack.
See some examples here: Calling Convention Examples.


What companies are fueling growth in Dunn? Why are they a great employer?
What jobs are on the rise in Dunn?
What are the best neigborhoods in Dunn?
Where are the best schools or school districts in Dunn?
What are the seasons like in Dunn? How do Dunn dwellers cope?
Food, entertainment, shopping, local traditions - where is it all happening in Dunn?
What are the opportunities for recreation, vacation, and just plain fun around Dunn?
Moving to Dunn - how did you get here?
What causes do people in Dunn care about. Where are the volunteer opportunities?
What are the best local job boards, job clubs, recruiters and temp agencies available in Dunn?


After unsuccessfully trying to find a place to go apple picking last weekend, I decided that pumpkin picking was the next best thing. When we got to the farm, the farm stand was full of pumpkins and the orchard's trees were filled with persimmons and unripe citrus. It was a beautiful overcast afternoon and even though Andrew and I were the only people there without kids (seriously, everyone there had kids!), we had a great time just the two of us.
After walking through the grounds and chatting with the guy at the farm stand, I learned that not only was there no actual pumpkin patch at the farm, but all the pumpkins at the stand were from the Northeast. Apparently people don't grow pumpkins in Texas—how was I supposed to know? Despite being a little disappointed about the imported pumpkins, we still went home with a pumpkin for carving and 2 sugar pie pumpkins for cooking.
The big pumpkin has yet to be carved, but I successfully baked and pureed the little sugar pie pumpkins. I'm used to buying canned pumpkin, so having fresh pumpkin puree to cook and bake with feels extra special.
Some people like to cut their pumpkins in half and remove the seeds before baking, but I prefer to bake my pumpkins whole. It's easier to cut and de-seed pumpkins when they are soft and being the clumsy person that I am, it's the only safe way for me to do it. I haven't decided what I'm going to make with the puree yet. Pie, bread, soup… there are too many options. Suggestions are welcomed!
Preheat the oven to 350 degrees. Clean and dry each pumpkin thoroughly. With a sharp knife, cut a few slits near the top of each pumpkin. Place the pumpkins directly on the middle rack of the oven. Place a baking sheet on the bottom rack of the oven to catch any juices that may run from the pumpkins. Bake for 45 minutes to an hour, or until the pumpkins are soft all way through and a knife can easily pierce through the flesh.
Let the pumpkins cool completely. Remove the seeds and peels, and cut the pumpkin flesh into cubes. Puree the pumpkin cubes in the food processor until nice and smooth. Store in an airtight container in the fridge or freeze for future use.
Pumpkin is one of the reasons I love Fall! Pumpkin whoopie pies are my newest obsession. To roast the pumpkins, how deep should the slits be, just past the skin, all the way through into the hollow area or somewhere in between?
Hi Vic, Pumpkin is one of the reasons I love fall too! As long as the skin has been pierced, it shouldn't matter how deep the slits are. This is just a precaution so that the pumpkins don't explode in the oven (the slits let some of the steam escape).
We've been eating pumpkin roasted with breadcrumbs and sage or in risotto the last few weeks but I feel the need to make something sweet soon. This puree looks like the perfect base for lots of sweet recipes – bookmarking to try!
My favourite use for pumpkin puree is to add some goats cheese and make ravioli! You don't find many sweet pumpkin dishes here in Australia so mostly I'm a fan of it savoury. I'm sure you will turn it into something gorgeous as always!
Connie, you sound just like us…! What do you mean no apple farms around here? Wait…no pumpkin farms?? And then you get to Xmas…no Xmas tree farms! There is another Houston blogger…her blog name is Miusume. She is a doll and I believe around your age. She went up to Dallas to the Botanical Gardens. They have a humongous pumpkin extravaganza display. You should google that. I wish there were something like that here in Houston. Also, I have to say that Whole Foods has an awesome selection of pumpkins. What to do with your pumpkin puree?? Perhaps scones?


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MSLT-II Completion Lymph Node Dissection Trial: Practice Changing but Not Likely Practice Abandoning
By Merrick I. Ross, MD
Merrick I. Ross, MD
PROBABLY THE MOST IMPORTANT advance in the treatment of newly diagnosed primary melanoma has been the incorporation of sentinel lymph node biopsy as part of initial surgical management. The routine use of sentinel lymph node biopsy, often termed "sentinel lymphadenectomy," in appropriately selected patients has provided valuable staging information as well as improved treatment outcomes in the node-positive cohort in terms of melanoma-specific survival, regional disease control, and surgical morbidity.
MSLT-I Trial and Retrospective Series
ALTHOUGH SUCH benefits were observed from many single institutional reports and collaborative multicentered efforts, confirmation was realized from the final results of the prospective randomized Multicenter Selective Lymphadenectomy Trial (MSLT)-I published in 2014.1 In this trial, patients with primary melanoma were randomized to receive either wide excision of the primary lesion and sentinel lymph node biopsy or wide excision alone.
Dr. Ross is Professor, Surgical Oncology, and Chief, Melanoma Section, The University of Texas MD Anderson Cancer.
By design, the patients with a positive sentinel lymph node underwent completion lymph node dissection as "standard of care." These patients experienced a 20% improved melanoma-specific survival compared with patients who developed clinical failure in the observed intact regional nodal basin(s) after randomization to wide excision alone. These results provided proof of concept that patient outcomes can be improved by treating lymph node disease when microscopic compared with delaying treatment until nodal disease becomes clinically apparent. Since completion lymph node dissection was part of the surgical treatment, the routine practice of completion lymph node dissection was supported as the "standard of care."
Theoretically, however, only patients with disease in additional nodes in the same basin (non–sentinel lymph nodes) can derive benefit from completion lymph node dissection, and in reality, less than 20% of these patients actually harbor such disease. Furthermore, several retrospective series demonstrated that patients who had non–sentinel lymph node metastases were found to have a particularly poor prognosis, above what would be predicted by the total number of nodes involved.
The combination of a small percentage of patients who could be impacted by completion lymph node dissection and the observation that these patients may have a poor prognosis despite aggressive surgical treatment led many to challenge the obligatory transition to completion lymph node dissection after a positive sentinel lymph node biopsy. Two prospective randomized trials were designed to address this equipoise and to determine what fractional benefit was afforded by the completion lymph node dissection above what was achieved by the removal of diseased sentinel lymph nodes.
Randomized Completion Lymph Node Dissection Trials
THE TWO TRIALS—DeCOG-SLT2 and MSLT-II3—were of similar design, randomizing sentinel lymph node–positive patients to undergo completion lymph node dissection or nodal basin observation augmented by ultrasonography. Reported at the 2015 ASCO Annual Meeting and published in May 2016, the DeCOG-SLT study was a particularly small trial (279 patients in each arm), with the majority being at relatively low risk of harboring disease in non– sentinel lymph node, as nearly 70% of the patients had less than 1 mm of sentinel lymph nodes tumor burden. No melanoma-specific survival difference was observed after a median follow-up of 3 years, despite a significant increase in the nodal basin recurrence rate in the patients randomized to nodal basin observation.
"It would be difficult to continue to endorse the practice of routinely recommending completion lymph node dissection, and therefore these trial results should be practice-changing."
— Merrick I. Ross, MD
Tweet this quote
The MSLT-II trial results, reported by Faries et al3 and reviewed in the September 25, 2017, issue of The ASCO Post—reflected a median follow-up of 37 months. The patient population was nearly four times the size of the DeCOG trial but still comprised mostly patients at low risk for non–sentinel lymph node involvement, with only 11% of patients who received completion lymph node dissection having additional positive nodes. Similar to the DeCOG-SLT results, no difference in melanoma-specific survival was observed in MSLT-II, despite increased nodal basin disease recurrence in the observation/ultrasound treatment group. It is relevant to note that more patients had recurrence in the nodal basin than would be predicted by the frequency of non–sentinel lymph node involvement, based on the pathologic evaluation of the completion lymph node dissection specimens, suggesting clinically relevant submicroscopic disease exists in nodes undetected by routine pathologic techniques.
Clinical Implications
AS A RESULT OF SURGEON BIAS, both trials can be criticized for not adequately addressing the impact of completion lymph node dissection on melanoma-specific survival in the at-risk patient population. But, on the other hand, the at-risk population may be the least likely to derive a melanoma-specific survival benefit from an aggressive surgical approach, since those patients with microscopic nodal disease that has spread beyond the sentinel lymph nodes appear to have an inherent unfavorable biology in terms of systemic dissemination. Supporting this notion is the multivariable prognostic factor analysis from MSLT-II demonstrating that the presence of non–sentinel lymph node involvement is an important independent predictor of survival. The MSLT-II trial also showed that patients who had completion lymph node dissection experienced increased morbidity.
Given the collective evidence, it would be difficult to continue to endorse the practice of routinely recommending completion lymph node dissection, and therefore these trial results should be practice-changing.
How Should Practices Change?
THE LACK OF SURVIVAL BENEFIT with completion lymph node dissection should not come as a surprise. Assuming the survival benefits achieved in the node-positive cohort in MSLT-I were a function of the removal of microscopic nodal disease that prevents nodal disease progression, and given that more than 80% of sentinel lymph node–positive patients have nodal disease limited to the sentinel lymph nodes, one could have predicted that most of the melanoma-specific survival benefits in the node-positive cohort in MSLT-I were the result of the sentinel lymph node biopsy itself, with little if any contribution from completion lymph node dissection. Once patients became eligible for completion lymph node dissection randomized trials, those in both treatment arms would have already equally derived the benefits of sentinel lymph node biopsy. Therefore, the sentinel lymph node biopsy can now be elevated to a therapeutic as well as staging procedure, and the term "sentinel lymphadenectomy" rather than sentinel lymph node biopsy is an appropriate designation.
Although the survival results of the MSLT-II trial were somewhat predictable, completing the trial was critical to have a prospective assessment of the primary endpoint as well as to provide information regarding other important endpoints such as regional disease control, prognosis, and surgical morbidity. Many surgeons had already altered their practices prior to the results of the MSLT-II trial, given the low probability of meeting the primary survival endpoint, and adopted a selective approach to completion lymph node dissection based on published predictors of non–sentinel lymph node involvement such as sentinel lymph node tumor burden, number of sentinel lymph nodes removed, and primary tumor thickness. Patients with non– sentinel lymph node disease can derive improved regional disease control with lower surgical morbidity. In addition, valuable prognostic information obtained by pathologic assessment of the completion lymph node dissection specimen can help oncologists make rational decisions about the role for adjuvant therapy. Accurate staging, and in turn accurate prognosis assessment, has become a critical issue in light of the new AJCC staging criteria of the 8th edition and the recently published results of the effectiveness of two adjuvant therapy regimens, which almost assuredly will receive U.S. Food and Drug Administration approval for the stage III patient population in the coming weeks. It is relevant to this discussion to note that in these trials, the sentinel node–positive patients did undergo completion dissection.
The majority of the treating melanoma community will likely fall in line, and completion lymph node dissection will no longer be recommended on a routine basis. Some may actually abandon the procedure completely. But the goals of durable regional disease control and enhanced staging information are still valid and laudable in the overall management of patients with melanoma and therefore a selective approach based on the predicted risk of non–sentinel lymph node involvement, the involved nodal basin, the risk of the planned dissection, patient age and underlying comorbidities, and the likelihood of patients receiving adjuvant systemic therapy seems rational.
Based on the recently published data, it would be appropriate and prudent to include active nodal basin observation/ultrasound surveillance as part of the evolving nationally based consensus melanoma treatment guidelines and in this way offer patients with a positive sentinel node more than one viable option and support surgeons who endorse a selective approach to completion dissection. ■
DISCLOSURE: Dr. Ross reported no conflicts of interest.
1. Morton DL, Thompson JF, Cochran AJ, et al: Final trial report of sentinel-node biopsy versus nodal observation in melanoma. N Engl J Med 370:599-609, 2014.
2. Leiter U, Stadler R, Mauch C, et al: Complete lymph node dissection versus no dissection in patients with sentinel lymph node biopsy positive melanoma (DeCOG-SLT): A multicentre, randomised, phase 3 trial. Lancet Oncol 17:757-767, 2016.
3. Faries MB, Thompson JF, Cochran AJ, et al: Completion dissection or observation for sentinel-node metastasis in melanoma. N Engl J Med 376:2211-2222, 2017.
Overview of the Phase III MSLT-II Trial
Mark B. Faries, MD
THE PHASE III MSLT- II TRIAL showed that completion dissection was not associated with improved melanoma-specific overall survival vs observation in patients with sentinel-node metastasis, although a benefit was observed in regional disease control. The findings were...


Join us for a fun filled charity event to celebrate and give together a big message of support to children in Yida refugee camp south sudan, the 6th biggest refugee camp in Africa.
Lonjzouh,6 years on the photo below joined us recently after reunited with his grandma in the camp in 2012. He lives with the hope to see his parents again. He likes to wear the No 11 Red Shirt and aspire to be a goalkeeper. Thanks to public donations we been able to help many children like Lonjzouh.
We would like to make sports accessible to benefit up to 1000 like Lonjzouh in Yida camp. Each child has their own harrowing story and their experiences have had a profound effect on them, which we at Green K are trying help them adjust, move on and rejoin society with a positive view to the future.
We would like to invite you to join us in our long term plans to stabilize young lives.
We have been running our activities in Yida regularly since 2014 and number of children has greatly increased due to the camaraderie and growing self confidence, we only able to support 500 children at moment with only public donations.
We would like to ask you to support for another two years to help stabilise their lives and hopefully improve their chances in life to access further services such as education and security.
We would like to invite you to join us in our long term plans to stabilize young lives.
Green K believes that sports can make a profound and positive impact in helping children to develop stronger relationships with their peers and their cultural community, as well doing something creative and enjoyable.
We hope to see you on Sunday 3rd of December at Folkestone Quarterhouse,2:00- 6:00 pm,Mill Bay,Kent CT20 1BN.
Yida one of Africa biggest refugee's camps, located in Ruweng which previously known as Unity state, South Sudan, a wetland 12 km from Sudan border.
Camp size of >3 km², which is half the size of Gibraltar, with twice the population.
With current population of 61,600 people, nearly 80% of the population are children who have never had any formal education.
All live in flimsy makeshift homes and with no sanitation or piped water, which makes life very challenging, annual risk of infectious diseases include malaria, cholera, typhoid and diarrhoea.


All transformers are passing through our quality on job procedure, pre-test & final type test. Transformers are tested as per BSEN & IEC 60076 standards.
To confirm accuracy of the testing instruments, they are calibrated externally and maintained in good condition by routine internal calibration method.


From TMZ: Chris Brown got a knock on the door last Friday night from cops because someone was worried he's losing his mind after he challenged Offset to show up at his home and revealed his address.
Law enforcement sources tell TMZ someone called LAPD saying they were scared and concerned for Chris' well-being. Friday, he posted his San Fernando Valley address on IG — instantly giving not only Offset, but his more than 50 million followers, a road map to him.
We're told cops showed up around 10:30 PM and spoke to CB's security, who said the singer's fine and added there have been no issues with Offset.


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redpajama_set_name: RedPajamaGithub


I am so happy to report that I'm making progress! They replaced the pad and carpeting yesterday that was damaged by the water last week. Now I can return to organizing that closet and bedroom. It feels so good to have a semblance of order. My knees are still very painful but it isn't consistent ~ at least not the last couple of days. It's a challenge to sleep at night but so far, so good. Of course, I didn't have any decorations out for Christmas...except a glass vase with red balls in it. I saw them somewhere along the way and added that to my kitchen counter.
My hands and nails are so dry...and really scary looking! :-) I'm going for a mani/pedi tomorrow and can't wait. LOVE doing that ~ love feeling pampered! I have a few things to return so plan to do that while I'm out and about.
I am making an effort to visit everyone's blogs and catch up...I've really missed feeling in touch. Hope that your world is bright, fun and blessed!
Welcome back Pat! I was missing for a bit too and I'm slowly making my way around to say Hello.
I'm glad everything is getting fixed at your place. That did not sound good.
Hi Pat, so nice of you to stop by to wish me a happy new year. I see I have missed out on a lot at your blog. Our computer was finally replaced with an new one last night. It was so difficult to manuever around blogland with our old one. I am SO sorry about your knees. My brother in law suffers all the time with his from a fall he had many years ago. Are you facing knee replacement? I'm also sorry about the water damage. What a mess. Sounds like we have have issues with pillows. :) I do hope you get help for your knee pain. Sounds awful!
Thanks for coming by and joining in the fun of my giveaway! Glad to hear you are feeling somewhat better. Happy New Year and I hope 2011 goes well for you!
I hope your mani/pedi make you feel really good....it always helps me! I think the winter is really hard on nails and skin...mine are dry too, and I hate it!
So happy to hear that things are going well for you, my friend! It's great to have you back in the blogosphere. I look forward to what 2011 has in store for you. It's going to be a good year!
Take care of yourself and looking forward to more posts!
Sounds like you've had rather a time of it, but that things seem to be looking up. I hope things continue to improve, and that 2011 will prove to be an amazing year for you.
I hope all is well in your world my friend..Oh girl I love to go get my nais done..
You deserve to be pampered! So sorry about the mess. I hope you continue to feel better too and can sleep peacefully. Keep improving!


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Biden draws ire in recalling 'civility' with segregationists
By BILL BARROW, Associated Press
Joe Biden is under fire from rival Democratic presidential hopefuls for saying the Senate "got things done" with "civility" when he was first elected and served alongside segregationists in the 1970s.
Speaking at a New York fundraiser Tuesday evening, he pointed to long-dead segregationist senators James Eastland of Mississippi and Herman Talmadge of Georgia to argue that Washington functioned more smoothly a generation ago than under today's "broken" hyperpartisanship.
"We didn't agree on much of anything," Biden said, describing Talmadge as "one of the meanest guys I ever knew" and saying Eastland called him "son" rather than "boy," a reference to the racist way many whites addressed black men at the time.
Yet even in that era of the Senate, Biden said, "At least there was some civility. We got things done."
The comments quickly sparked one of the most intense disputes of the Democratic presidential primary, underscoring the risk to Biden as he tries to turn his decades of Washington experience into an advantage. Instead, he's infuriating Democrats who say he's out of step with the diverse party of the 21st century.
Sen. Cory Booker, one of two major black candidates seeking the Democratic nomination, said Biden's "relationships with proud segregationists are not the model for how we make America a safer and more inclusive place for black people and for everyone," and he called for the Biden to apologize.
"I have to tell Vice President Biden, as someone I respect, that he is wrong for using his relationships with Eastland and Talmadge as examples of how to bring our country together," the New Jersey Democrat said in a statement that was especially notable coming from a candidate who entered the 2020 primary with a sunny message, vowing to highlight "the best of who we are and not the worst."
New York City Mayor Bill de Blasio, a fellow Democratic presidential candidate and a white man who is married to a black woman, also offered a sharp retort. "It's 2019 & @JoeBiden is longing for the good old days of 'civility' typified by James Eastland," de Blasio tweeted Wednesday, along with a picture of his family. "Eastland thought my multiracial family should be illegal."
The mayor added that "it's past time for apologies or evolution" from Biden, whom de Blasio cast as "out of step with the values of the modern Democratic Party."
Cedric Richmond, Biden's campaign co-chairman and former chairman of the Congressional Black Caucus, pushed back, saying Biden's opponents are deliberately ignoring the full context of his argument for a more functional government.
"Maybe there's a better way to say it, but we have to work with people, and that's a fact," Richmond said, noting he recently dealt with President Donald Trump to pass a long-sought criminal justice overhaul. "I question his racial sensitivity, a whole bunch of things about his character ... but we worked together."
Likewise, Richmond said, Biden highlighted Jim Crow-era senators to emphasize the depths of disagreements elected officials sometimes navigate. "If he gets elected president, we don't have 60 votes in the Senate" to overcome filibusters, Richmond noted. "He could be less genuine and say, 'We're just going to do all these things.' But we already have a president like that. He knows we have to build consensus."
Bakari Sellers, a prominent black South Carolina Democrat who backs California Sen. Kamala Harris for president, countered that Biden's remarks are nonetheless part of a pattern that calls into question the notion that he's the most electable Democrat.
"It's death by a thousand cuts," Sellers said, noting that Biden's status as a 76-year-old white man from the political establishment may help him with some white voters who backed Trump but could cost him with black voters, women and younger voters necessary for any Democrat to win the White House.
"You aren't going to build the winning coalition like this," Sellers said. "The argument should be, 'Joe Biden is the most electable if he will get out of his own way.'"
For his part, Biden has shown some self-awareness of the political peril of talking about the upside of working with those who hold opposing views. He sometimes notes he will "get in trouble" before making his standard pitch that the "other side" is "the opposition" but not "the enemy."
His riffs are sometimes as innocuous as calling Bob Dole, the 95-year-old former Senate majority leader and 1996 Republican presidential nominee, a "decent guy" or paying homage to "my friend John McCain," the former Arizona senator and 2008 GOP presidential nominee who died in 2018.
But other times he ventures into more controversial territory.
In the months before he announced his bid, Biden clarified remarks in which he called Vice President Mike Pence a "decent guy" after activists noted the Republican vice president's opposition to LGBTQ civil rights protections. Biden said he offered his remarks in a "foreign policy context" and added, "There is nothing decent about being anti-LGBTQ civil rights."
Some Democrats hammered Biden for arguing that Republicans on Capitol Hill will have an "epiphany" and start working with Democrats again once Trump has left office, noting the GOP congressional blockade of President Barack Obama, whom Biden served for eight years as vice president.
Biden has written and spoken for years of his relationships across a spectrum of politicians.
Earlier this year, he eulogized former Sen. Fritz Hollings of South Carolina, who was once a segregationist state legislator and governor. In 2003, Biden gave the same honor to Republican Strom Thurmond, another former South Carolina politician who was among the first "Southern Democrats" to leave the party over its civil rights stances.
At a May fundraiser in New Hampshire, Biden recalled as a young senator wanting to denounce then-North Carolina Sen. Jesse Helms, a racially divisive figure, for opposing a proposed forerunner to what eventually became the American with Disabilities Act. Biden said he thought Helms "had no redeeming social value," but remembered being talked down by another senator who told him that Helms and his wife had adopted a son with cerebral palsy.
Biden's takeaway was to question his colleagues' "judgment" but "not motives."
Associated Press writer Elana Schor in Washington contributed to this report.
Follow Bill Barrow on Twitter at https://twitter.com/BillBarrowAP
More Elections Stories
Beto O'Rourke says he and wife Amy are descendants of slave owners
Democratic presidential hopeful Beto O'Rourke announced on Twitter that he and his wife Amy have a more "personal connection" when it comes to the legacy of slavery in the United States.
O'Rourke posted a tweet Sunday, along with a link from medium.com , saying, "I was recently given documents showing that both Amy and I are descended from people who owned slaves.
Something that we've been talking about in town hall meetings -- the legacy of slavery in the United States -- now has a much more personal connection. I was recently given documents showing that both Amy and I are descended from people who owned slaves. https://t.co/rGKKLqcoKf
Judge: Georgia must allow inspection of election databases
By KATE BRUMBACK, Associated Press
A federal judge has ordered Georgia election officials to allow computer experts and lawyers to review the databases used to create ballots and count votes.
The ruling came Tuesday in a lawsuit that challenges Georgia's election system and seeks statewide use of hand-marked paper ballots.
U.S. District Judge Amy Totenberg gave the state until Friday to turn over electronic copies of the databases to the plaintiffs' lawyers and computer experts.
2020: Democratic field for Georgia's US Senate seat grows
By BEN NADLER, Associated Press
The young Democratic mayor of an Atlanta-area city known for embracing progressive and immigrant-friendly policies announced a challenge of Republican Sen. David Perdue on Wednesday.
Ted Terry is the 36-year-old mayor of Clarkston, Georgia, which bills itself as "the most ethnically diverse square mile in America."
Perdue, a former business executive, has staked out hardline positions on immigration since his election in 2014, emerging as a close ally of President Donald Trump.


Being in a family brings both privileges and responsibilities. The same is true for children in the family of God.
39 Books: Habakkuk – The righteous shall live by his faith.
Habakkuk – The righteous shall live by his faith.
The prophet Habakkuk lives in a difficult time. He has questions for God – and God answers..
Barry Atwell walks us through the Letter of 1 John, pointing out the Top Ten Marks of Conversion. These can give us assurance that we are truly born again. The lack of these marks, or the presence of their opposite, would indicate that our conversion has never happened.
For many people, when we claim that we have eternal life and we know it, it seems like the height of arrogance. Further, we are all plagued by doubts at some level. Despite all of this we should not lose heart.
In John's day, the Greco-Roman world held to a hodgepodge of religious beliefs. With travel and communication being what they are today, the spiritual gumbo is thicker and gooier than ever.
Sin disrupts our fellowship with God. Fellowship with God disrupts our relationship with sin.


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More Cases Filed Against Snapdeal Founders, Now GoJavas Vendors Allege They Haven't Been Paid
April 14, 2017 OfficeChai Team
Snapdeal's creditors have descended upon it en masse.
After the Bangalore Fashion Week organizers had taken it to court for not having paid them their sponsorship dues, and CouponDunia founder Sameer Parwani publicly said that it was months behind on its payments, four separate companies have gone to court over dues that are allegedly owed to them by Snapdeal.
No. 1 Worldwide Express, Mudita Express Cargo, Monopoly Carriers & Cargo and Mituj Marketing Pvt. Ltd have all claimed that they haven't been paid by GoJavas, which is owned by Snapdeal. The four companies have served notice of the civil suit to get their dues back. Monopoly Carriers & Cargo has gone ahead and filed a criminal case against GoJavas directors in the Nagpur courts, which include Kunal Bahl and Rohit Bansal.
And the amounts owed to these companies aren't insignificant. Mituj Marketing, which provided air freight services to GoJavas, claims that it is owed Rs. 1.84 crore. "GoJavas stopped paying us around September 2016 for the services we were providing. Bills amounting to Rs.1.84 crore are due. We were in regular meetings for this, and then one day GoJavas admitted they can't pay us because Snapdeal hasn't paid them," said its owner Amit Bajaj.
No. 1 Worldwide Express says it hasn't been paid Rs. 62.75 lakh, and has sent Snapdeal a legal notice to this effect.
And there are also sellers who are claiming they haven't been paid on social media.
Snapdeal is cheating to the sellers Saying payment ALREDY deposited in the account but frm2 months thy r fooling us pls help CON-8801100020 pic.twitter.com/YIOocP0blS
— Vidhi Groups (@vidhi_groups) April 13, 2017
"I have never come across an incident like this in my two decades as a businessman," says Amit Bajaj from Mituj Marketing. "This has been the worst case. We managed to stay afloat but it has been tough, we had to downsize and cut jobs to avoid shutting down. Rs.1.84 crores is not a small amount. This is a considerable amount for a medium scale business like ours. One crore is a normal man's entire life savings."
This is a refrain that'll find parallels with the Stayzilla case, where Jigsaw Solutions had accused the company of not paying it Rs. 1.72 crore before it had shut down. Jigsaw had dragged Stayzilla to court, and CEO Yogendra Vasupal had been held in a Chennai prison for 25 days before he was able to secure bail. Jigsaw, like the freight companies, had argued that being a small concern, a default that ran into crores was enough to bankrupt the firm.
Snapdeal has been dismissive of the latest charges. "The Company is yet to see the complaint filed against it. The Company will take all appropriate legal steps to defend it and its employees against all baseless allegations," a spokesperson told Business World. But the company has lately been under considerable financial strain. Snapdeal was losing Rs. 9 crore per day until it decided to cut costs and fired 500 employees in February. Founders Kunal Bahl and Rohit Bansal too announced that they were foregoing their salaries to help Snapdeal tide over its crisis.
But this will come as scant consolation for Snapdeal's creditors, who appear to be getting increasingly uneasy about the company's situation. What could be compounding their worries are reports that Snapdeal might soon be acquired by Flipkart. "Hey Kunal Bahl, I know you're busy negotiating your $50M exit, but got time to clear our payments?," CouponDunia founder Sameer Parwani had tweeted. Through its crisis, Snapdeal has been reassuring its employees that it'll take care of their interests in the event of an acquisition. It now turns out that its sellers and vendors might need some reassuring of their own.


Charcoal is carbon & Activated charcoal is charcoal that has been treated with oxygen to open up millions of tiny pores between the carbon atoms. The use of special manufacturing techniques results in highly porous charcoals that have surface areas of 300-2,000 square meters per gram. These so-called active, or activated, charcoals are widely used to adsorb odorous or colored substances from... Remove the filter pad from the filter but leave the filter running for aeration while treating. After treatment is completed, you can use activated carbon (I keep a jar around and just fill little mesh bags when carbon is needed) to remove the medication and add some kind of bacteria in a bottle to the tank.
Keep up the good work K&N, I will be sure to always use your filters from now on!!" Aaron Sydney, Australia The overall performance improvement in my Subaru Outback is outstanding.... Undersink Water Filters. Frees up valuable bench space. All you see is the faucet. NEW RELEASE - KwikTwist™ Easy change, sleek modern design. Premium carbon filtration to remove all chlorine, pesticides residue, lead and giardia parasites...will not remove fluoride.
This is particularly important in the case of activated carbon filters, Canister filters for aquariums use high water pressure, from a properly powered pump, to force water through the dense filter media. A pump can draw water from an under-gravel filter, and run it into a canister for double filtration. Diatom filters. Diatom filters are used only for sporadic cleaning of tanks, they are how to know if she is emotionally cheating on you If you use an air purification system, or are shopping for one, you may be familiar with activated carbon filters. With so many air purifier filters to choose from, you may wonder how an activated carbon filter works or what the benefits of using one are.
Each activated carbon filter is designed to allow a certain flow of water through the filtering process. Costs of carbon filters will vary, as do size, design, intensity, function, efficiency, and lifecycle.
8/03/2013 · I do want to use algaecides occasionally for winterising the pool, etc so if this is going to cause a potential problem, I'd need to know how to select a compatible algaecide. It worries me that the article says that "most algaecides" cannot be used.
Insert the filter.Take the filter out of the cup of water and let the remnants drip in the sink for a second or two. Then place the filter into the pitcher or water cooler. Try to slightly twist the filter, to make sure it has been inserted correctly. There should be no gap between the filter and the base of the pitcher.


And the reason for fiscal conservatives to oppose any and all efforts to increase taxes isn't to oppose tax hikes for the sake of opposing tax hikes. It's to deny government additional funding to grow bigger.
Indeed, if your political philosophy is that of a limited government fiscal conservative, the best strategy for achieving that objective is to "starve the beast." It's just that simple.
Citizen Outreach CEO Dan Burdish recently completed a study of the tax-hike votes by members of the Nevada State Assembly for the 2015 legislative session. He identified 32 recorded votes on bills that increased taxes or fees.
And Hambrick voted for every last one of them.
As did Republican Assembly Majority Leader Paul Anderson and defrocked former Assembly Minority Leader Pat "RINO" Hickey.
Forget the Three Amigos. These are the Three RINOs.
At the opposite end of the spectrum, three Republican Pledge signers had perfect no-new-taxes voting records: Assemblywoman Michele Fiore, Assemblyman John Moore and Assemblywoman Shelly Shelton. The other six Pledge signers only rarely voted for a tax or fee hike, ranging from 2 transgressions to 9.
But not one of them voted for Gov. Brian Sandoval's largest tax hike in Nevada history.
On the other hand, a number of self-described "conservative" Republicans who refused to sign the Tax Pledge literally voted like Democrats.
The best of the worst was Assemblyman David Gardner, who voted in favor of 22 of the 32 tax hikes, including the largest tax hike in history. Assemblyman Chris Edwards voted for 26 tax hikes. Assemblyman Erv Nelson voted for 27 of them. Taxation Committee Chairman Derek Armstrong-Anderson and Assemblyman James "The Big Selloutski" Oscarson voted for higher taxes 29 out of 32 times.
And Carson City Assemblyman P.K. O'Neill, who replaced Tax Pledge signer Pete Livermore this session, voted for 30 of the 32 tax hikes.
The numbers don't lie and the lesson is clear: If you don't want your taxes to go up so the government blob can grow bigger, only vote for candidates who have signed the Taxpayer Protection Pledge.