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December 2017 Hypercalcemic crisis and primary hyperparathyroidism: Cause of an unusual electrical...
Revista Portuguesa de Cardiologia (English edition)
The Portuguese Journal of Cardiology, the official journal of the Portuguese Society of Cardiology, was founded in 1982 with the aim of keeping Portuguese cardiologists informed through the publication of scientific articles on areas such as arrhythmology and electrophysiology, cardiovascular surgery, intensive care, coronary artery disease, cardiovascular imaging, hypertension, heart failure and cardiovascular prevention. The Journal is a monthly publication with high standards of quality in terms of scientific content and production. Since 1999 it has been published in English as well as Portuguese, which has widened its readership abroad. It is distributed to all members of the Portuguese Societies of Cardiology, Internal Medicine, Pneumology and Cardiothoracic Surgery, as well as to leading non-Portuguese cardiologists and to virtually all cardiology societies worldwide. It has been referred in Medline since 1987.
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Vol. 36. Issue 12.
Pages 959.e1-959.e5 (December 2017)
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DOI: 10.1016/j.repce.2016.12.025
Hypercalcemic crisis and primary hyperparathyroidism: Cause of an unusual electrical storm
Crise hipercalcémica e hiperparatiroidismo primário: causa de tempestade arrítmica invulgar
Tatiana Guimarãesa,
tatiana.oliveira.guimaraes@gmail.com
, Miguel Nobre Menezesa, Diogo Cruzb, Sónia do Valec, Armando Bordaloa, Arminda Veigaa, Fausto J. Pintoa, Dulce Britoa
a Serviço de Cardiologia, Hospital Santa Maria, Centro Hospitalar de Lisboa Norte, Lisboa, Portugal
b Serviço de Medicina Interna, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, Lisboa, Portugal
c Serviço de Endocrinologia, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, Lisboa, Portugal
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Hypercalcemia is a known cause of heart rhythm disorders, but it is rarely associated with ventricular arrhythmias. The authors present the case of a 53-year-old man with ischemic and alcoholic dilated cardiomyopathy and severely reduced ejection fraction, with a cardiac resynchronization therapy-cardioverter-defibrillator (ICD) device, who was admitted to the emergency department due to an electrical storm with multiple appropriate ICD shocks, refractory to antiarrhythmic therapy. Etiological investigation documented severe hypercalcemia secondary to previously undiagnosed primary hyperparathyroidism. The episodes of ventricular tachycardia only ceased after serum calcium levels were reduced.
A hipercalcemia é uma causa conhecida de perturbações do ritmo cardíaco, contudo, a sua associação a arritmias ventriculares é rara. Os autores apresentam o caso clínico de um doente de 53 anos de idade, com cardiomiopatia dilatada de etiologia isquémica e etanólica, e grave compromisso da função sistólica global, portador de sistema de ressincronização cardíaca (CRT) com cardioversor desfibrilhador (CDI), admitido no serviço de urgência por tempestade arrítmica, com múltiplos choques de CDI apropriados, refratária a terapêutica antiarrítmica. Na investigação etiológica foi documentada hipercalcemia grave secundária a hiperparatiroidismo primário até então desconhecido. Somente após redução da calcemia se observou cessação dos episódios de taquicardia ventricular.
Hiperparatiroidismo
Taquicardia ventricular
A 53-year-old Caucasian man with several cardiovascular risk factors (hypertension and heavy smoking and alcohol consumption) had a history of non-ST-elevation acute coronary syndrome at the age of 49 years and severe disease of the mid and distal right coronary artery, which were treated by angioplasty and implantation of two bare-metal stents. Because of persistent severe left ventricular dysfunction (biplane left ventricular ejection fraction of 15%) even on optimal medical therapy, an atrioventricular cardiac resynchronization therapy (CRT)/implantable cardioverter-defibrillator (ICD) system was implanted.
Three years later, he experienced an episode of monomorphic ventricular tachycardia (VT) with a pattern of complete right bundle branch block and superior axis prompting an ICD shock followed by chest pain and elevation of troponin I levels (peak 1.69 mg/l, cutoff <0.07). He underwent repeat coronary angiography that showed in-stent occlusion, treated by angioplasty and placement of three drug-eluting stents. Among the patient's other known personal history were smoking-related chronic obstructive pulmonary disease, erosive gastritis and peptic ulcer. He was medicated as an outpatient with losartan, bisoprolol, spirolactone, furosemide, aspirin, clopidogrel, amiodarone, simvastatin and pantograph. He remained in New York Heart Association class II from that time.
The patient was readmitted to our hospital one year after the previous hospitalization due to multiple ICD shocks, preceded by syncope, with transient recovery of consciousness following each shock, beginning 24 hours previously and increasing in frequency in the hour before admission. He had discontinued his medication in the previous five days due to financial difficulties, since when he had complained of anorexia, asthenia, constipation and dizziness. On admission he was conscious, oriented, and sweating but with no signs of peripheral hypoperfusion. The electrocardiogram (ECG) documented monomorphic VT with complete left bundle branch block and a rate of 300 bpm (Figure 1). A 300-mg bolus of amiodarone was administered followed by intravenous (IV) perfusion at 4 μg/kg/min, but recurrence of VT (with constant morphology on telemetry) was observed; two boluses of IV lidocaine (total 150 mg) were administered but also had no effect. The patient received multiple ICD shocks immediately after arrival at the hospital, resulting in the rapid exhaustion of the generator before the cardiologist was able to inhibit the therapies with the aid of a magnet. During periods of sinus rhythm, the ECG documented QRS with complete right bundle branch block, PR interval at the upper normal level, and corrected QT interval of 405 ms, with no signs of acute ischemia (Figure 2). Transthoracic echocardiography showed a severely dilated left ventricle, with diffuse hypokinesia and severely impaired global systolic function. Interrogation of the CRT-ICD revealed various episodes of VT in the previous 24 hours, with a total of 48 appropriate shocks (Figure 3), and the generator at the end of battery life. Given the patient's worsening heart failure and persistence of the arrhythmic storm, he was intubated and given propofol and midazolam for sedation and analgesia. Laboratory tests at admission showed acute kidney injury (Acute Kidney Injury Network stage 1) with creatinine 1.5 mg/dl and urea 101 mg/dl; mild hypokalemia (potassium 3.0 mmol/l, normal range 3.5-5.1); severe hypercalcemia (calcium 18.5 mg/dl, normal range 8.6-10; Ca2+ 2.46 mmol/l, normal range 1.13-1.32); and slight elevation of troponin I (peak 1.5 mg/dl, cutoff <0.07). The hypokalemia was immediately corrected.
Rhythm strip recording monomorphic ventricular tachycardia with pattern of left bundle branch block and rate of around 300 bpm.
(1.05MB).
Twelve-lead electrocardiogram in sinus rhythm showing QRS with complete right bundle branch block, PR interval at the upper normal limit, and corrected QT of 405 ms.
Record of cardioverter-defibrillator therapies applied in the hours before the patient's admission to the emergency department.
Since the patient's monomorphic VT was not associated with pain or anginal equivalents, and there were no signs of acute ischemia on the baseline ECG, the cause of the arrhythmia was assumed to be the presence of severe hypercalcemia. With the support of internal medicine and endocrinology specialists, pharmacological measures were instituted to correct hypercalcemia with pamidronate, zolendronic acid, furosemide and hydrocortisone. However, since the hypercalcemia was severe and refractory to the above treatment, it was decided to begin continuous venovenous hemodiafiltration (CVVHDF); this resulted in progressive reduction in the frequency and duration of TV episodes, which were no longer sustained and ceased completely when calcemia reached 15.8 mg/dl. The patient was extubated and CVVHDF was discontinued after 48 hours, but furosemide (60 mg/day) was continued to maintain normocalcemia. The possibility of ablation to treat the VT was discussed but was not performed since the arrhythmia did not recur after correction of hypercalcemia.
Etiological investigation of hypercalcemia showed marked elevation of parathyroid hormone (PTH) (1020 pg/ml, normal range 14-72), and normal albuminemia (3.5 g/dl, normal range 3.2-4.9), suggesting primary hyperparathyroidism (PHPT). Cervical ultrasound revealed a well-defined hypoechogenic homogeneous solid mass topographically slightly posterior and inferior to the left lobe of the thyroid gland suggestive of a parathyroid adenoma, and scintigraphy of the parathyroid glands documented a functional lesion of the left inferior parathyroid. These findings did not exclude the possibility of a malignant parathyroid tumor. Left inferior parathyroidectomy was proposed to the patient, who accepted, and the procedure was performed without complications.
Following parathyroidectomy the patient's calcemia and PTH levels normalized and so medical therapy for this purpose was discontinued. The pathology report confirmed parathyroid adenoma. The fact that there was no hypocalcemia or need for calcium therapy suggests that the hyperparathyroidism was recent or a worsening of previously less severe PHPT. Baseline endocrinological assessment at admission also showed elevated levels of gastrin (2130 pg/ml, normal range 13-115), chromogranin A (143.5 mmol/l, cutoff <6), and urinary metanephrines and hydroxyindolacetic acid, although these elevations were less marked and were absent on the second urine tests during hospital stay, thereby excluding pheochromocytoma. Endoscopy of the upper digestive tract revealed an ulcer in the lesser curvature of the stomach, compatible with chronic gastritis, and screening for Helicobacter pylori was positive. The presence of PHPT, previous history of gastric ulcer, and hypergastrinemia raised the possibility of type 1 multiple endocrine neoplasia, but the patient refused to undergo an octreotide scan to confirm this diagnosis.
After 24 days of hospitalization, following a favorable clinical course, the patient was discharged under optimal medical therapy for heart failure. He is being followed in the cardiology outpatient clinic and has had no new events to date.
Hypercalcemia is associated with cardiac rhythm disturbances, most often prolongation of the PR segment and the QRS interval and hence shortening of the QT interval,1 which is usually associated with bradycardia rather than tachycardia. The clinical situation reported here is thus most unusual. Only six cases of PHPT and hypercalcemia associated with ventricular arrhythmias have been described in the literature, the first of which, by Chaieb et al.,2 published in 1988, described a case of hyperparathyroidism and ventricular bigeminy. In 2000 Chang et al. reported the case of a woman without structural heart disease with PHPT and spontaneous sustained monomorphic VT, reproducible in electrophysiological study only following injection of calcium gluconate and terminated by verapamil.3 In 1993, 2003 and 2004 Kearney et al.,4 Kolb et al.5 and Kiewiet et al.,6 respectively, reported cases of polymorphic VT degenerating into ventricular fibrillation. The second case reported to date of monomorphic VT was published in 2004 by Occhetta et al.7
The mechanism by which hypercalcemia can trigger ventricular arrhythmias is the subject of debate. Proposed causes include early4 or late1 afterdepolarizations or reentry circuits secondary to shortening of the absolute refractory period.8 In PHPT, PTH itself, as well as hypercalcemia, has arrhythmogenic potential, which may explain the occurrence of ventricular arrhythmias with lower calcium levels than in the case reported. Studies in rat hearts show that PTH has direct positive inotropic and chronotropic effects, partly mediated by calcium inflow into myocardial cells.9 The combination of reduced conduction speed of the cardiac impulse and shortening of the refractory period thus makes reentrant mechanisms, and hence ventricular arrhythmias, more likely. It has been suggested that the presence of heart disease may contribute to the development of arrhythmic events in patients with hypercalcemia, although this relationship has yet to be confirmed.6
In the case presented, the presence of alcohol- and ischemia-related dilated cardiomyopathy, with transmural scar and impaired global systolic function, together with the patient's failure to take his medication and hypokalemia (even though mild), may have contributed to his VT. However, PHPT and resulting hypercalcemia was the most important factor in this situation, acting as the primary trigger, given that the VT episodes only ceased after significant reduction in calcemia, with restoration of normocalcemia and no recurrence of VT after parathyroidectomy. Nevertheless, the possibility cannot be excluded that high PTH levels also contributed to the patient's condition.
B. Surawicz.
Relationship between electrocardiogram and electrolytes.
Am Heart J, 73 (1967), pp. 814-834
C.M. Chaieb, L. Chaieb, L. Jemni, et al.
Bigeminal arrhythmia associated with hyperparathyroid crisis.
Can Med Assoc J, 138 (1988), pp. 1115-1116
C.J. Chang, S.A. Chen, C.T. Tai, et al.
Ventricular tachycardia in a patient with primary hyperparathyroidism.
Pacing Clin Electrophysiol, 23 (2000), pp. 534-537
P. Kearney, M. Reardon, J. O'Hare.
Primary hyperparathyroidism presenting as torsade de points.
Br Heart J, 70 (1993), pp. 473
C. Kolb, G. Lehmann, J. Schreieck, et al.
Storms of ventricular tachyarrhythmias associated with primary hyperparathyroidism in a patient with dilated cardiomyopathy.
Int J Cardiol, 87 (2003), pp. 115-116
R.M. Kiewiet, H.H. Ponssen, E.N.W. Janssens, et al.
Ventricular fibrillation in hypercalcaemic crisis due to primary hyperparathyroidism.
Neth J Med, 62 (2004),
E. Occhetta, M. Bortnik, A. Magnani.
Primary hyperparathyroidism and arrhythmic storm in a patient with an implantable cardioverter defibrillator for primary prevention of sudden death.
Europace, 6 (2004), pp. 184-188
http://dx.doi.org/10.1016/j.eupc.2004.01.005 | Medline
Role of electrolytes in etiology and management of cardiac arrhythmias.
Prog Cardiovasc Dis, 8 (1966), pp. 364-385
E. Bogin, S.G. Massry, I. Harary.
Effect of parathyroid hormone on rat heart cells.
J Clin Invest, 67 (1981), pp. 1255-1327
Please cite this article as: Guimarães T, Nobre Menezes M, Cruz D, do Vale S, Bordalo A, Veiga A, et al. Crise hipercalcémica e hiperparatiroidismo primário: causa de tempestade arrítmica invulgar. Rev Port Cardiol. 2017;36:959.e1–959.e5.
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Al-Rawi, Farouk N H and George, Andrew (2014) 'Back to the Cedar Forest: The beginning and end of Tablet V of the Standard Babylonian Epic of Gilgameš.' Journal of Cuneiform Studies, 66. pp. 69-90.
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Home News & Event Events 2019 Award Presentation Ceremony Press Release
The Shaw Prize Award Presentation Ceremony 2019
Wednesday, 25 September 2019. At today's presentation ceremony of The Shaw Prize at the Hong Kong Convention and Exhibition Centre, the Honourable Mrs Carrie Lam Cheng Yuet-ngor, Chief Executive of the HKSAR, People's Republic of China, presented the awards to the three Laureates.
After several months of deliberation, the international prize committee selected the Shaw Laureates and announced the results at the press conference on 21 May 2019.
Details of this year's Shaw Laureates are as follows:
The Shaw Prize in Astronomy is awarded to
Edward C Stone
David Morrisroe Professor of Physics and Vice Provost for Special Projects, California Institute of Technology (Caltech), USA
for his leadership in the Voyager project, which has, over the past four decades, transformed our understanding of the four giant planets and the outer solar system, and has now begun to explore interstellar space.
The Shaw Prize in Life Science and Medicine is awarded to
Maria Jasin
Member, Memorial Sloan Kettering Cancer Center (MSK) and Professor, Weill Cornell Graduate School of Medical Sciences, Cornell University, USA
for her work showing that localized double strand breaks in DNA stimulate recombination in mammalian cells. This seminal work was essential for and led directly to the tools enabling editing at specific sites in mammalian genomes.
The Shaw Prize in Mathematical Sciences is awarded to
Michel Talagrand
Former Senior Researcher, French National Centre for Scientific Research (CNRS), France
for his work on concentration inequalities, on suprema of stochastic processes and on rigorous results for spin glasses.
The Shaw Prize was established under the auspices of Mr Run Run Shaw in November 2002 to honour individuals, regardless of race, nationality, gender and religious belief, who have recently achieved significant breakthrough in academic and scientific research or applications and whose work has resulted in a positive and profound impact on mankind. The Shaw Prize consists of three annual prizes: Astronomy, Life Science and Medicine, and Mathematical Sciences, each bearing a monetary award of US$1.2 million. This is the sixteenth year that the Prize has been awarded.
Highlight of the 2019 ceremony will be released worldwide via satellite transmission between Hong Kong time 2230–2300 (GMT 1430–1500). Photographs will be uploaded the same day at Hong Kong time 2230 (GMT 1430) on the website www.shawprize.org. The ceremony programme will be broadcast on HKTVB Jade and Pearl Channels on 28 September at Hong Kong time 2300–2330 and on 30 September at Hong Kong time 1805–1830 respectively.

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Have you heard of Blue Mercury? If not, let me tell you a little bit about it. Recently, I was invited to spend a little time with the ladies at the Blue Mercury located in Southdale Mall in Edina, Minnesota. I am always looking for new beauty products. Some may even say I am a beauty junkie. High-quality skincare is one of my weaknesses. Lucky for me, Blue Mercury carries high-quality skincare as well as cosmetics plus they offer beauty services too! Imagine a place, where you can have your eyebrows waxed, a hot stone massage and more. Plus have every beauty need met. That is what Blue Mercury is. It's a dream come true for me. It's a one-stop beauty spot.
You can try out the brands and products in the store before you buy. I really like being able to try out a beauty product before I buy. What makes Blue Mercury different? In my opinion, it's the quality level of products, the staff and the ability to take care of myself while shopping for beauty products. Each staff member is trained and has expert knowledge. They can answer your skincare questions or any beauty question you have.
Blue Mercury was founded by Barry and Marla Malcolm Beck in the late 90s. The first store was located in Georgetown and was meant to be the neighborhood store for beauty, where clients could find high quality, innovative beauty products and honest, expert advice.
Once they succeeded in Georgetown they started to branch out. Now they have arrived in Minnesota. If your life is crazy like mine, and you find it hard to get out sometimes to run errands, Blue Mercury also has an online store. This is a lifesaver! I've been to Blue Mercury and I know which products I love. If I'm running low I can just hop on line and order more. No need to stress about getting to the store. If you happen to be at Southdale Mall, stop by Blue Mercury inside Macy's. They love walk-ins!


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Richard I. Gouse (born October 29, 1946) is the president of the New England Institute of Technology. Gouse has held that position since 1971. He is one of the longest serving college presidents in American history.

Education
In 1963, Gouse earned a Certificate of Study from the University of Poitiers in France, and in 1968 he earned a Bachelor of Arts degree from Brown University, majoring in Economics and minoring in education.

Career
The Massachusetts Trade Shop School had been founded by Gouse's grandfather, James Gouse, in the 1930s, and his father, Julian Gouse, succeeded his grandfather in running the school in the 1950s. Gouse worked at the Massachusetts Trade Shop School as a laborer in the tool crib for the machine shop in the late 1950s and 1960s.

In 1968, Gouse started at the Rhode Island Trade Shop School and oversaw the initial accreditation of the school by the National Association of Trade and Technical Schools – an organization in which his father was a founding director.

In 1971, Gouse became President of the then New England Technical Institute, which had been founded by Ernest Earle in 1940. The school that Gouse inherited had four programs of study, seventy students and ten employees.

In 1976, Gouse led the effort to change the New England Technical Institute into a not-for-profit degree granting college and renamed it New England Institute of Technology. New England Institute of Technology has over 3,000 students, 35 degree-granting programs of study and 534 employees.

Community involvement

 Member, Board of Incorporators, Kent County Memorial Hospital
 Member, Rhode Island Commodores
 Member, executive board, Brown Football Association
 Member, executive board, Brown Sports Foundation
 Past member, Board of Incorporators, Eastland Bank
 Past trustee, Providence Public Library

Professional involvement
Gouse has served on numerous accreditation committees for the New England Association of Schools and Colleges' Commission on Vocational and Technical Career Institutions. He is a founding director of the Rhode Island College Crusade, and is also a member and former chair of the Rhode Island Association of Higher Education.

Awards and recognitions
Gouse is a 'Special Member' of the Brown University Athletic Hall of Fame, along with his wife Cheryl. He has been recognized by the Ivy League through the Gouse Trophy, presented annually to the Ivy League Women's Tennis Champion. He is also a recipient of the prestigious Joslin Award, the Joukowsky Award, and the Jay Barry Service Award for his contributions to Brown University. Gouse was the lead donor of the Richard Gouse Field at Brown Stadium, a new artificial surface installed on Brown's football field in 2021.

In 2019, Gouse was inducted into the Rhode Island Heritage Hall of Fame and recognized as the longest-serving U.S. college president at that time.

Personal background
Gouse resides in Barrington, Rhode Island, with his wife Cheryl (Connors) Gouse. They have one daughter, Carolyn. His interests include swimming, trapshooting and following his daughter's equestrian career.

References

1946 births
Living people
Heads of universities and colleges in the United States
Brown University alumni

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My grandpa has been one of my strongest influences. As the eldest grandchild, I was responsible for the younger ones, always the first to be asked to sing songs, ask the four questions and speak at family events.
Grandpa was a prolific builder and built a large quantity of housing after the war under the name of Bower Moffatt.
So when he was building his second house in the Isle of Man, he got me involved at the tender age of 5, explaining the model to me and even getting me to help with foundations!
Now, nearing 90, with early dementia, his memory is fading, and physically less able. I was delighted last week to take him on a trip to my projects that are on site, to deliver RIBA signboards to residential sites in Sale, Didsbury and Heaton Mersey and to a commercial project in Irlam.


Joseph E. Atkinson, owner of the Toronto Daily Star, knew of progress in wireless from his son's hobby (call 3EC) and was interested in the promotional value of The Star's being the first newspaper in Canada to broadcast voice and live music.
Arrangements were made secretly with Canadian Independent Telephone Company, Toronto, to broadcast a Star Concert over CITCo's experimental station 9AH. The Star had been presenting frequent free "live" concerts for the public, and arranged for this first radio concert to be received by the public in the Masonic Temple and at the Christie Street Military Hospital.
Ernest Bushnell started in radio as a singer on CFCA.
First concert broadcast at 8:30 p.m. from the CITCo studio in the General Electric factory at Wallace Avenue and Ward Street. The power was 100 watts and the wavelength 450 metres. Artists included Luigi Romanelli's Orchestra, cellist Boris Hambourg, pianist Alberto Guerrero and violinist Henri Czaplinski. CITCo's Dr. Charles A. Culver announced, produced and directed all aspects of the broadcast.
The success of the first broadcast concert was so great that a series was arranged and, in all, CITCo broadcast 19 Star concerts, the last airing on June 14, 1922.
The first of The Star's daily programs were broadcast from 7:00 to 7:30 p.m. on 450 metres. The format included a financial bulletin, sports, a guest speaker or musician, a children's bedtime story and a political bulletin telegraphed from The Star's correspondent in Ottawa.
First of two 80-foot reinforced steel towers completed on roof of The Star Building. Antenna was a five-wire flat-top T-antenna, 200 feet long.
Grand opening of CFCA (wavelength 400 metres), located in a couple of small rooms in The Star Building, 18-20 King Street West. The station was designed and built by Dr. Culver and his CITCo staff, using a CITCo 2-kW transmitter. CITCo also outfitted the Star's little white roving radio van. Announcer and operator was former ham E.J. Bowers.
Kathleen Wilson (Betty Lee) joined CFCA.
On February 8th, 1923, CFCA introduced play-by-play hockey broadcasts, when Toronto Star sports reporter Norman Albert called the third period of an OHA intermediate game at the Mutual Street Arena. As did all hockey games broadcast during that era on CFCA, it began around 9:45 pm with a rinkside summary of the first two periods followed by a play-by-play description of the third period.
On February 16th, with only a few hours notice, Foster Hewitt was given his first hockey broadcast assignment . . . to handle that evening an amateur senior game between the Toronto Argonauts and the Kitchener Greenshirts. He did the broadcast using an ordinary telephone of the era, cramped inside an improvised 4' x 4' glass booth at ice level. The game went into 3 periods of overtime, and the broadcast lasted 3 hours. For a long time, the sports broadcasting facilities were crude and uncomfortable. Foster would help set up the booth - often in an unsafe place to get the best viewpoint.
In February, at the request of Canadian Press, CFCA broadcast the first news service to provincial newspapers when a storm destroyed telephone and telegraph communications.
Foster Hewitt broadcast one of the first horse races from Woodbine track.
CFCA experimented with remote control broadcasting, bringing in the Champlain Tercentenary celebration from Orillia by long-distance telephone.
Jim Montagnes moved from the Toronto Star to CFCA as announcer-operator.
Former ham Gordon W. McLean succeeded Bowers as announcer and chief engineer.
James Montagnes joined CFCA and worked alongside Foster Hewitt.
CFCA was one of the first stations in North America to re-broadcast short wave from Europe - from 2LO, London; two weeks later a program from Australia; then a speech by the Prince of Wales, from London.
After years of sharing its frequency with two other stations, CFCA using 100 watts was awarded a separate frequency at 770 Kcs. enabling it to lengthen its broadcast schedule.
CFCA installed new transmitting equipment to narrow its wave band.
Arthur D. "Cowboy" Kean joined the CFCA staff. In April, Jim Montagnes moved on to freelance work.
CFCA ceased to broadcast. Mr. Atkinson was convinced that the Canadian government was going to set itself up a broadcasting monopoly and take over private stations.
Gord McClain managed CFCA for seven years. He joined CKCL in 1924, moved to CFCA and then went back to CKCL.
Years after CFCA was gone - 1947 - J. E. Atkinson of the Toronto Daily Star - applied for a Toronto FM licence. The FM application was put off later by Atkinson.
When Joseph Atkinson (Toronto Star, ex-CFCA-AM) died in 1948 it was said several thousand shares of SRL (CFRB) were found in his safe. He closed his CFCA-AM in 1933 (opened in 1922) because he was apparently convinced radio was a passing fad. His shares in SRL were acquired by a holding company headed by E.P. Taylor, whose Argus Corp. had quietly held effective control of SRL ever since.


text:
"Unsterblich" (Immortal) is a ballad by Die Toten Hosen. It's the second single and the tenth track from the album Unsterblich.

It is a love song, in which the narrator sings, how he feels like he were immortal, when he's with his beloved.

The CD-ROM track consists of the video of the single, a making-of film and photos.

Music video
The music video was directed by Peter Lindbergh and cinematographed by Darius Khondji. Shot on the Cornish coast, the video consists only of the camera holding on Campino's face, as he sings. At the end of the video Campino morphs into French model (and Lindbergh muse) Marie-Sophie Wilson.

Track listing
 "Unsterblich" (Frege, von Holst/Frege) − 3:46
 "Wofür man lebt (Dub-Version)" (What for one lives) (von Holst, Meurer/Frege) − 3:22
 "Psycho" (Roslie/Roslie) − 1:44 (The Sonics cover)
 "Unsterblich" (Video + CD-ROM Track)

Charts

2000 singles
Die Toten Hosen songs
Songs written by Campino (singer)
Songs written by Andreas von Holst
1999 songs


Dreams Come True is a children's charity working across the UK. Helping children and young people who have a serious or life-limiting medical condition achieve their dreams. Each dream is unique. Some children want to meet their celebrity hero or favourite Disney character, while others want to visit their grandparents abroad, swim with dolphins or work on a fashion magazine. Many want help with their everyday lives and Dreams Come True is delighted to provide vital sensory equipment, wheelchairs or specially adapted bicycles.
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How much of my donation goes to Dreams Come True?
We donate the complete exchange value plus 5% extra to Dreams Come True. There are no fees, neither do we subtract any commission. You will receive a confirmation email, containing the amount donate. We will share this information with Dreams Come True.
You can donate any coins or notes, foreign or domestic. We will exchange whatever currency you send us and will donate the combined exchange value plus five percent extra to Dreams Come True.


text:
José Delitala y Castelví o Castellví (Cáller, también llamada Cagliari, Cerdeña, 10 de noviembre de 1627 - íd., 1703), virrey de Cerdeña y poeta español.

Biografía
Era el menor de los tres hijos que tuvieron Angelo di Girolamo Delitala y Maria Amat y Castelví, de la noble familia de los condes (marqueses desde 1605) Laconi. Su padre fue nombrado caballero de la Orden de Santiago como recompensa por haber combatido en el ejército español con gran honor, sufriendo numerosas lesiones en batalla.

Tras sus estudios en su ciudad natal, a la edad de quince años marchó a España, donde completó su formación. Entonces comenzó una carrera militar en la que alcanzó el grado de coronel. Nombrado caballero de la Orden de Calatrava y Caballerizo de Su Majestad y Pregonero mayor en el Reino de Cerdeña, en 1672 Carlos II de España lo hizo gobernador de los cabos de Cáller y Gallura y en 1686 ejerció las funciones de virrey interino del Reino de Cerdeña en el período anterior el gobierno del Duque de Monteleone, después de la muerte del Conde de Fuensalida, Antonio de Velasco y Ayala.

Reunió sus poemas en Cima del monte Parnaso español con las tres musas castellanas Caliope, Urania y Euterpe, fecundas en sus asuntos, por las varias poesías... (Caller: Onofrio Martín, 1672). La obra está dedicada a Carlos II y es muy amplia. Los autores de los preliminares, entre ellos el hijo del autor, dos canónigos y dos jesuitas, comparan al autor con Francisco de Quevedo y afirman que sus tres musas se añaden a las seis que ya escribió el famoso satírico. Y es cierto que algún influjo de este se advierte en la variedad de los temas y en el estilo empleado; pero también es sensible la huella de Garcilaso de la Vega y los clásicos grecolatinos.

Hay en la colección sonetos a héroes, dedicatorias, temas literarios y morales, canciones y romances religiosos, un epilio en cien octavas reales sobre la vida de San Jerónimo ("Poema épico y sagrado a la vida de san Jerónimo"), un epitalamio al matrimonio del príncipe de Pomblín y María de Alagón y Pimentel, hija de los marqueses de Villasor, versos de circunstancias, un poema donde se testimonia que fue secretario de una academia literaria (probablemente en la casa en Cáller del marqués de Villasor, pues sabemos que se representaban comedias en él por parte de diversos nobles y el actor Luis de Medina, y el mismo José Delitala escribió una loa para una que se representó el 6-XI-1666, loa que fue publicada), 51 sonetos de tema amoroso, algunos mitológicos; catorce, a juicio de Homero Serís, "bellísimas canciones", tres madrigales, una silva, cincuenta sonetos fúnebres y de epitafios a grandes personajes, églogas, décimas y otras muchas composiciones. No se olvidó de su tierra natal, a la que consagró el poema "Montaňas de Cerdeña".

No es un autor desdeñable, pero ha sido olvidado a causa del retiro en que vivió durante la mayor parte de su vida y la extremada rareza del único libro en que se conserva su obra poética.

Obras
Cima del monte Parnaso español con las tres musas castellanas Caliope, Urania y Euterpe, fecundas en sus asuntos, por las varias poesías... (Caller: Onofrio Martín, 1672)
Loa... (Cáller, 1666)

Referencias

Fuentes
Homero Serís, "Libro raro y curioso. Poesías de José Delitala y Castelví (1672). Un clásico olvidado", en Bulletin Hispanique 1941, vol. 43, núm. 43-2, pp. 171-181.
 La Grande Enciclopedia della Sardegna, volume 3, 2007, Editoriale la Nuova Sardegna Spa, a cura di Francesco Floris.
 Pasquale Tola, Dizionario biografico degli uomini illustri di Sardegna, a cura di Manlio Brigaglia, Nuoro, Ilisso, 2001
 Francesco Floris, Dizionario delle famiglie nobili della Sardegna, Edizioni della Torre, 2009
"Delitala y Castelví, José", en Diccionario filológico de literatura española. Siglo XVII. Vol. I / coord. por Delia Gavela García; Pablo Jauralde García (dir.), Pedro C. Rojo Alique (aut.), 2010, ISBN 978-84-9740-346-7, págs. 392-406

Escritores de España del siglo XVII
Escritores en español del siglo XVII
Caballeros de la Orden de Calatrava
Poetas de España del siglo XVII
Virreyes de Cerdeña
Nacidos en Cagliari
Fallecidos en Cagliari


This page presents the Google satellite map (zoomable and browsable) of Werombi in New South Wales.
Geographical coordinates are -33.981800079 and 150.584594726 and its feature type is Locality (bounded). More information below.


No matter what Pres. Obama does, or the Muslim World does, I predict that the unstoppable result will be the total disintegration of the Muslim World and the expansion of the Shining Jewish State of Israel from the Nile to the Euphrates after the ex-Muslims willingly clear out and not only agree to chuck Allah, Muhammad and his Jihad, but beg the Israelis for help in rejoining the human race in a new Middle East that becomes a credit to the world. So Obama's backing of the sick Muslim Brotherhood shall pass, and we shouldn't work up to much steam over it. Remember Ozymandias? How about Obamandias? 🙂 Not that it isn't too late for him to switch to the winner's team, which I sometimes think he might do since he made the smartest move of his presidency by asking Congress to declare war in Syria before making war like the Constitution requires, so he might get smarter and chuck the Muslim Brotherhood and back a Greater Israel as the only true solution to peace in the Middle East. If he does that, I'm sure Congress will back him all the way. Read my Historyscoper's Islam Watch Blog daily and see how it comes out.


Middle aged people should give up alcohol all together if they want to reduce the risk of developing dementia, health watchdogs have said.
The National Institute of Health and Care Excellence (NICE) even go as far as suggesting that even drinking alcohol within the safe limits set by the Government can increases the risk of Alzheimer's.
The current Government guidelines saying that women should drink no more than 2-3 units of alcohol per day (one 175ml glass of wine for example) and men no more than 3 units per day without jeopardising their health are now under review.
People should be encourages to 'reduce the amount they drink as much as possible', advises NICE.
"These guidelines are a hugely welcome shift in public health thinking, highlighting the need for a change in mid-life behavior and lifestyle choices to reduce the risk of dementia.
"This advice needs to be extended to encourage those who go on to develop dementia to live well and prevent the condition deteriorating more quickly." Jeremy Hughes, chief executive at Alzheimer's Society told The Telegraph.
A third of all Alzheimer's disease cases can be linked to lifestyle factors, including alcohol consumption.
"It is well known that smoking, too much alcohol, inactivity and being overweight is bad for our health, but many people don't realise that these things can also increase the likelihood of developing dementia and other causes of poor quality of life in older age." Professor John Britton, professor of epidemiology, University of Nottingham and Nice guideline development group chairman said.
"The evidence we looked at suggested that people can prevent these outcomes by making simple changes in life -- stopping smoking, cutting alcohol, being more active and losing weight," he said.


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Jazz Jennings Net Worth 2019, Bio, Wiki, Age, Height, Surgery
Jazz Jennings is a young girl of 17 years from South Florida who was born to Jeannette and Greg Jennings as a male child. Her parents came to know about her opinion of being a woman soon after Jazz attained the age for taking her own decisions. Belonging to a Jewish conservative family life was quite difficult for Jazz.
The American teenager is been famous for making several YouTube videos, the most popular being "I am Jazz." Jazz is bold enough to deal with the problem of teenage transgender, which are made to choose the gender against their choice. Already within such a short span of time Jazz has been capable of making a considerable amount of net worth amounting to $ 200 thousand. The amount is quite an impressive amount of consideration the age of the American YouTube beauty.
Jazz Jennings is known to her parents as Jared. Her upbringing was in a Jewish family. Her place of birth was South Florida. She was born to Greg and Jeanette Jennings who were later known to be quite supportive parents. The two people to whom Jazz was born are of determined mentality they are quite supportive and has never let Jazz feel down for her complication.
Jared was brought up along with an elder sister named Ari Jennings and two elder brothers who are twins, Griffin and Sanders. In the year 2004, Jared's parents started talking seriously about her critical complication on being diagnosed with a gender disorder, and finally, she accepted the feminine identity.
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She had always got her parents standing beside her during the crisis situations. Jared from her early childhood days started appearing in several television shows as a bold transgender personality and gradually with the passing of time she became known to people for her charming and vivacious nature. She started off dealing with the transgender reform activities and also cultivated interest in writing articles related to the contemporary issue of transgender identity.
Her career started off with the foundation of the Transkids Purple Rainbow. This organization was founded to help all the transgender kids. She was able to take the initiation only because of her parents who were quite involved with her while laying the foundation stone of the association. Soon after she appeared in a documentary film titled "I am Jazz, A family in Transition for Oprah Winfrey Network."
She soon moved on with an initiation to establish the Purple Rainbow Tails, a company that would make the robbers involved in making the mermaid tails. The income she received from this organization was kept reserved for helping the transgender children. She knew the pain of identity crisis and so tried her level best to stand beside the unfortunate children who are not fortunate enough to get parents like Jeannette and Greg.
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Full Name: Jazz Jennings.
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Profession: YouTube personality.
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Safety Signs Launched
The first phase of a safety sign roll out in Dublin Bay has just been launched. This phase involves 31 signs located along the north Dublin coastline at Ring Buoys and Bathing Shelters. Each sign will have its location displayed; this aims to
improve the efficiency of the response of the emergency services when they receive an urgent call for help. A problem often encounter by the Coast Guard is knowing where the exact location of an emergency is, if a casualty is in the water or on a beach directing a lifeboat, helicopter or ground crew to a scene needs to be done without delay. The project is a joint initiative between Dublin Port Company, the Irish Coast Guard and Dublin City Council and is hoped will save time and lives in rescues on the Dublin Bay coastline.
Colin Murray, Officer in Charge, Irish Coast Guard station at Howth noted "Often time is the enemy when it's comes to coastal emergencies, we need to get to the location of the casualty as soon as possible and minimise the time needed to find them. In the case of tourists visiting an area they may not be aware of the correct name of the area they're in, even locals trying to describe what part of Dollymount beach they're on can be difficult. The new signs will help the emergency services with that response".
The Lord Mayor commented that "I very much welcome this initiative between the parties concerned, all working together to come up with a solution. Coming into the summer it's important to ensure the emergency services
have the best information to hand quickly to ensure a speedy response, I've no doubt having the location on the signs will make an important difference".
Pat Ward, Dublin Port Company's Head of Corporate Services remarked "While Dublin Bay provides the key commercial artery for trade on the island of Ireland, it is also renowned for its recreational and leisure craft activities. The importance
of accurate information in an emergency situation is critical and todays initiative plays a huge part in assisting the public and our emergency services when called upon."
Remember if see someone in trouble on the beach, cliff or water act quickly and call that Coast Guard at 112 right away. A false alarm with good intention is always well received by the Coast Guard; a call that's too late could mean tragedy.
Pictured are (left to right)
Pat Ward, Dublin Port Company's Head of Corporate Services
Lord Mayor of Dublin, Oisín Quinn.
Paul Cooper, Deputy Officer in Charge, Irish Coast Guard - Howth Station.


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Curtis Knight
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ST. Ronnie Lott Jersey . PAUL, Minn. - The Edmonton Rush extended their season-opening winning streak to seven games on Saturday, by downing the Minnesota Swarm 14-9 in National Lacrosse League. Jeremy Thompson scored three times, while Mark Matthews, Riley Loewen and Zach Greer had two each for the Rush. Curtis Knight, Chris Corbeil, Robert Church, Jarrett Davis and Nik Bilic got the other Edmonton goals. Jordan MacIntosh had three goals for Minnesota (1-6). Callum Crawford and Logas Schuss scored twice, while Kiel Matisz and Josh Gillam also scored for the Swarm. Aaron Bold made 37 saves for Edmonton. Tyler Carlson stopped 18 of 26 shots for Minnesota, while teammate Zach Higgins blocked 15 of 20. George Mira Jersey . This time, Tebow was in a groove the entire second half -- not just in the waning minutes -- and his teammates on defence were getting gobbled up. Garrison Hearst Jersey . The third-ranked Buckeyes were down eight points to Notre Dame with less than 2 minutes to play and their offence was nowhere to be found.Its been a long wait for Mackenzie Hughes but in just a couple of weeks, hell finally kick off his 2014 season on the Web.Com Tour. The former Canadian Amateur champion, who made his rookie year as a professional a memorable one, has had a long wait to get back on the course and after last season, hes anxious to play. "Its funny that my season really ended in September," he said, noting the end of the PGA Tour Canada schedule. "That was so long ago and Ive had so much time to think about it." Whats probably crossed his mind from time to time has been his great campaign of 2013, where he went from having no status and minimal financial backing to winning the Order of Merit on PGA Tour Canada, which gave him an exemption onto the Web.Com Tour. It was certainly a whirlwind season but one the product of Dundas, Ont., never doubted he could make. After playing for Canada at the World Team Amateur Championship, Hughes turned pro, moved to Charlotte, N.C., and ventured out into the world of mini-tours. "I dont like mini-tours so much," he chuckled. "Youre not playing for a lot of money and its definitely not glamourous." However, thats about all Hughes had at that point. And he did learn a thing or two about life as a professional, which was a definite change from his amateur and college days. "You have to learn on your own pretty quickly," he said. "Youre really on your own." One thing that didnt change, however, was his talent. It didnt take him long to parlay a couple of PGA Tour Canada starts into a regular gig. And, in June, after going through the qualifying and winning a playoff, he made it into the U.S. Open. Although he didnt make the cut at Merion, it was an eye-opening experience. "It showed me that Im not that far off, that I can play at that level," he stated. "And it helped me when I got back to PGA Tour Canada." After missing the cut in his first three stops, Hughes rolled off four top--10 finishes in his next five events. Jimmy Johnson Jersey. . That included a runner-up finish at the Wildfire Invitational and a victory at the Cape Breton Celtic Classic. His success on the course also helped him off it. When he first turned pro, Hughes attempted to find sponsors, even coming up with a plan to sell shares of himself. That didnt work out and in the early going, things were tight. This year, hes signed on with SportBox Entertainment Group, the new Canadian agency thats headed up by former IMGer Danny Fritz and includes as clients Mike Weir, Graham DeLaet and David Hearn. Hes found some stability with sponsorships from Ping and Freedom 55 Financial, but says hes a long way from being on easy street. "Its better for sure, but at the same time, Im going to spend a lot more money this year," Hughes pointed out. "Ill be paying for caddies, more travel, more of everything really. It adds up pretty quick. But if I play well, its not an issue." In addition to learning how to balance his chequebook, Hughes is learning the ropes of another new tour, this one a step up on the competitive scale. The long layoff has made it possible for him to glean lots of information about playing the Web.com Tour, but that has an upside and downside. "Ive talked to a million different people about it," Hughes said. "Ive maybe got too much advice. Im really just trying to figure out whats best for me." He has sought out help from those whove gone before him and hes hoping to play practice rounds with fellow Canadians Roger Sloan and Adam Hadwin to not only learn about courses, but also life on tour. He will also likely join up with another Canadian rookie, Albin Choi to share expenses and experiences. "Im more excited than nervous," Hughes admitted. "I want to test my game against the next level and see where I am." Hughes will get that opportunity when the Tour gets underway Feb. 13 in Bogota, Colombia. ' ' '
United States squared off Baseball on TSN2 at 8pm recognizable members of the
United States squared off
Gold has once again escaped the grasp of Team USA. Sam Perkins Jersey . The mens hockey team will now try to avoid leaving the Sochi Olympics without a medal at all as they battle Finland in the bronze medal game on Saturday. The United States squared off against Canada on Friday in a rematch of the 2010 gold medal game. And like those Vancouver Games, Canada got the better of the U.S. by handing the Americans a 1-0 setback. Jonathan Quick, who finishes the tournament today as the U.S. starting goaltender, was solid in net for the U.S. and posted 36 saves, but an offense that tied Finland for the most goals in the preliminary round (15) failed to get a shot by Canadian netminder Carey Price. Price ended with 31 saves to advance Canada into the gold medal game against Sweden. The only goal allowed by Quick came at 1:41 of the second period as Canadas Jay Bouwmeester unleashed a low, hard shot from the left point that was redirected into the net by Jamie Benn. The defeat dropped the U.S. to 1-4 in Olympic action against Canada since NHL players began competing in 1998. That includes an overtime setback four years ago in Vancouver. Looking to secure a chance at winning its first Olympic gold medal, Finland instead saw its offense struggle as well in a 2-1 setback to Sweden on Friday. Without goaltender Tuukka Rask due to illness, Finland got 23 stops from Kari Lehtonen. Olli Jokinen was the lone Finn to beat Swede goaltender Henrik Lundqvist, who made 25 saves. Rask will get the start in goal for the medal game. Jokinen was in the penalty box when Sweden netted its game-winning goal in the second period as Erik Karlsson scored on a one-time blast with 3:34 on the clock. The Finns had a power-play opportunity midway through the third, but failed to cash in and didnt have many good scoring chances the rest of the way. Finland is looking to secure an Olympic medal for the fifth time in the last six Olympic Games. The Finns won bronze in 2010 after taking silver four years prior. The U.S., which has not won gold since the 1980 Games in Lake Placid, won silver in 2002 and four years ago in Vancouver after being held without a medal in 2006. The last time the Americans won a bronze medal was in 1936. Supersonics Jerseys China . Its been a successful Games for Canada, which will finish near the top of the medal standings again. From repeat gold medal winners to multiple medal winners to undefeated teams to acts that define the Olympic spirit, there are many solid candidates who could be considered to receive the honour. Seattle Supersonics Shirts . As deep as their roster is, they need their superstar. Rose scored 23 points in his return from a five-game absence due to back pain, and Chicago hung on to beat the struggling Atlanta Hawks 90-79 on Monday.For a second consecutive year, Kobe Bryants season will end prematurely. ESPNs Ramona Shelburne reported on Friday afternoon that the torn rotator cuff that the 36-year-old incurred during the Los Angeles Lakers 96-80 loss to the New Orleans Pelicans on Wednesday will cause Bryant to miss the rest of the season. The 17-time All-Star only appeared in six games last season due to a left knee injury. In 35 games this season, Bryant has averaged 22.3 PPG to go along with 5.6 APG, 5.7 RPG and a career-low .373 FG%. The injury to Bryant marks the third serious loss for the Lakers this season. Veteran point guard Steve Nash was ruled out for the year a week before the season, which was to be his last in the NBA, started due to a lingering back injury. David Thompson Jersey . Then, during the Lakers season opener, rookie Julius Randle, the seventh-overall pick in last Junes NBA Draft, broke his right tibia, sidelining him for the rest of the season. On Thursday night, Bryant was announced as a starter for the Western Conference for the NBA All-Star Game to be held in New York City on February 15. The Lakers, 12-31, last in the Pacific Division and currently 13.5 games out of a playoff spot, are next in action on Friday night when they visit the defending NBA Champions, the San Antonio Spurs. ' ' '
Baseball on TSN2 at 8pm
(SportsNetwork. Flames Jerseys 2020 .com) - The LA Angels of Anaheim try to win their third straight series when they close out a three-game set with the Atlanta Braves Sunday night at Turner Field. Catch this game live on Sunday Night Baseball on TSN2 at 8pm et/5pm pt. The Angels dropped the opener of this series, 4-3, then rebounded with Saturdays 11-6 win in 13 innings to even the set. They scored five runs in the top of the 13th inning, as Mike Trout delivered a two-run double and Albert Pujols drove in two with a base hit. Kole Calhoun opened the scoring in the decisive frame with an RBI hit. Angels relief pitcher Cory Rasmus set the Braves down in order in the bottom of the 13th to preserve the win. Trout and Pujols both had big games and each ended with three hits, a home run and four RBI. Erick Aybar had four hits, two runs scored and knocked in a run for the Angels, who ended a two-game slide and won for the sixth time in eight tries. Garrett Richards started on the mound for Anaheim and struck out 10 batters across six shutout innings. After a shaky performance early on from the bullpen, Fernando Salas threw two scoreless innings of relief for the win. "We never quit, they never quit," said Trout. "Youve got to give them props. They scored four runs and put pressure on us. We kept battling, put ourselves in a good position and we won the game." Trout extended his hitting streak to nine games and 16 straight interleague contests. Angels manager Mike Scioscia was not with the team after attending the funeral of his former Dodger teammate and 1990 Cy Young winner Bob Welch. Bench coach Dino Ebel took his place. The Angels are 3 1/2 games behind Oakland for the AL West lead and will visit Cleveland next for four games. Hector Santiago gets the starting nod for the Angels Sunday and he is winless (0-6) in 10 games (8 starts) with a 4.15 ERA. Santiago pitched six shutout innings for a no-decision in a 2-1 win over Oakland on Tuesday and recorded eight strikeouts with one walk. Santiago, a left-hander, has never faced Atlanta and is 0-3 on the road. Atlanta has been inconsistent of late with defeats in seven of the last 11 games. David Hale was saddled with the loss for allowing five runs in 2 1/3 innings of relief and starting pitcher Gavin Floyd gave up four runs in the first 6 1/3 innings. The Braves were able to rally from a 5-0 hole and used a four-run bottom of the ninth inning to tie the game. Jason Heyward drove in a run, B.J. Upton plated two with a triple and Freddie Freeman stroked an RBI ground-rule double to the even the score. Josh Hamilton put the Angels back on top with a run- scoring hit in the 10th and Atlanta knotted the game at 6-6 on another RBI hit from Heyward, who showed no signs of a hand contusion suffered on Friday. Anaheim then exploded for five runs in the 13th. "We had our chances to get the win," said Braves catcher Gerald Laird. "It was an excellent effort coming back in the ninth inning. We battled tonight. Evan Gattis had three hits, including another home run, for the Braves, who are still tied with Washington atop the NL East standings. Gattis has homered in two straight games and has gone deep seven times since May 25. He is riding a career-best 14-game hitting streak. Atlanta will host Philadelphia next for three games. Set to take the mound for the Braves in Sundays rubber match will be Mike Minor, who is 2-4 with a 4.31 earned run average. Minor is winless (0-2) in his past four outings and was hammered at Colorado the last time out on Tuesday to the tune of eight runs and 11 hits in four innings. The left-handed Minor has never faced the Angels and is 1-4 in five starts at Turner Field. Calgary Flames Store .Y. -- AJ Allmendingers journey is almost complete. Stitched Flames Jerseys . Pistorius denied the allegation that he said to the close friend of the girlfriend he killed: "How can you sleep at night?" The accusation by Kim Myers provided a bizarre twist during the trial of the world-famous double-amputee Olympian, who is facing 25 years to life in prison if convicted of premeditated murder for shooting dead Steenkamp, a 29-year-old model, at his home last year.TORONTO -- Mark Buehrle is putting his faith in the fielding of his Toronto Blue Jays teammates and its paying off. "I need defence behind me," Buehrle said. "Its a key. I dont strike out many guys so the ball is put in play." The results showed again for the Blue Jays soft-throwing left-hander who became the first 10-game winner in the major leagues on Sunday in Torontos 4-0 victory over the Kansas City Royals. By working quickly and efficiently, Buehrle pitched eight strong innings and was supported by home runs from Dioner Navarro and Edwin Encarnacion as well as some solid defence. The game was played in a brisk two hours 14 minutes. "Its not luck," Blue Jays right-fielder Jose Bautista said. "Hes pitching great, throwing strikes, keeping people off balance and allowing us a chance to play defence behind him. Its no surprise that every time he pitches there are plenty of good defensive plays made. He keeps everybody engaged in the game because he works quick. Its been awesome to play behind him this year." Buehrle (10-1) held the Royals to six hits and one walk while striking out three to win his sixth straight decision. "I dont know if its one of those things where working fast keeps them on their toes and ready to field stuff," Buehrle said. "I dont if that is the key to it. Again I just try to get the ball and throw it and I know the guys like to play behind you when its a quick game. I need those guys all over the place when Im pitching." Toronto manager John Gibbons thought it was one of Buehrles best performances this season. "Today (Buehrle) was as good as he has been all year," said Gibbons. "He has really been great, seems like every time I come in here you have to describe it the same way. Thats what he does, he keeps you off balance and hits both sides of the plate. Hes a pitcher. ... He topped off a nice home stand for us." Left-hander Aaron Loup took over in the ninth from Buehrle after Encarnacions two-run homer in the eighth had extended the lead to four runs. The Blue Jays (34-24) took the final two games of the four-game series to gain a split with the Royals (26-30) and finish their home stand at 8-2. Toronto has won 21 of their past 28 games to take over first place in the American League East. "(Buehrle) was dynamite," Royals manager Ned Yost said. "Hes traditionally tough on us but hes 10-1 now, hes tough on everybody. Hes a master at what he does. He commands the baseball so well, changes speeds off everything he has. He has the ability to read the hitters reaction to the pitch before to know what hes going to throw next. If the hitter is gearing up, he backs off, if the hitter is backing off, he gears up. "He just pitched a phenomennal game. Custom Calgary Flames Jerseys . Hes just really, really good at keeping you off balance." Royals right-hander Jeremy Guthrie (2-5) allowed eight hits and two runs in seven innings to go 10 starts without a win after winning his first two starts of the season. Guthrie allowed two walks and had five strikeouts before he was replaced by right-hander Aaron Crow in the eighth. Navarro hit his third homer of the season with one out in the second to open the scoring. The Blue Jays scored again in the fourth. Juan Francisco led off with a double on a liner that Kansas City right-fielder Norichika Aoki misplayed into a double. Francisco moved to third on a single by Brett Lawrie. He scored when Anthony Gose forced Lawrie at second on a grounder to shortstop. A key defensive play came in the sixth after a slight lapse. Eric Hosmer led off a bloop to centre that turned into a double when the Blue Jays left second uncovered. But shortstop Jose Reyes cut down Hosmer at third after fielding Billy Butlers grounder and Buehrle finished the inning unscathed. "In a two-run game, thats big," Gibbons said. "Thats what good shortstops do, he knew he had no play at first base. ... Ive seen it, too, through my career that the third baseman doesnt always get there, so (third baseman) Francisco was heads up to get there himself." Encarnacion, who hit 16 homers in May to lead the majors, doubled the Blue Jays lead with his 19th homer of the season in the eighth against Crow. It also scored Adam Lind who had singled with one out. Things are also going Buehrles way. In the sixth inning Lorenzo Cains popup to first dropped in fair territory when Encarnacion lost the ball but it rolled foul. Cain then struck out. "He called me off and then said a cuss word in Spanish which was one of the few Spanish words I know," Buehrle said. "Ive got a horseshoe stuck up my rear end pretty far right now so Im not complaining." NOTES: After the game the Blue Jays returned right-handed pitcher Liam Hendriks to triple-A Buffalo on option. A corresponding move will be made on Tuesday. aThe Blue Jays finished May at 21-9. aRoyals recalled third baseman Mike Moustakas from triple-A Omaha for Sundays game and put third baseman Danny Valencia (left hand muscle strain) on the 15-day disabled list. .... The Royals also recalled left-handed reliever Francisley Bueno (left little finger contusion) from his minor-league rehabilitation assignment with Omaha and returned right-handed pitcher Aaron Brooks to triple-A on option. aThe Blue Jays have Monday off before playing a three-game series in Detroit that opens Tuesday with Drew Hutchison (4-3, 3.88 earned-run average) facing Anibal Sanchez (2-2, 2.49 ERA). ' ' '
recognizable members of the
WINNIPEG -- Long snapper Chris Cvetkovic is retiring from the Winnipeg Blue Bombers after 11 seasons. Robbie Russo Jersey . Cvetkovic finishes his career with 161 games, 66 special teams tackles and will retire as one of the most recognizable members of the community as a Blue Bomber. The 36-year-old came to the Bombers from the Saskatchewan Roughriders in 2003 after spending his rookie season in Regina and has been key part of the Winnipeg organization both on and off the field. "The Winnipeg Blue Bombers would like to thank Chris for his boundless contributions, both on the football field, and in our community, over the past decade plus," said team president Wade Miller in a statement Monday. He was a two-time winner of the Ed Kotowich Award, which recognizes a player for football ability, team camaraderie and extraordinary effort in the community. "His tenacity, desire to win and build team camaraderie was very evident during my time playing with him, and we truly appreciate all of his efforts," said Miller. Cvetkovic has lived in Winnipeg year-round since 2005 and in 2012 started a not-for-profit organization called Cvets Pets that helps local Winnipeg No-Kill Animal Rescue Programs. He also organized a trip to Mexico with other CFL players where they spent time volunteering at an animal sterilization clinic and has worked with several charities. During the winter of 2011, he was one of seven CFL players who travelled to Haiti to aide in tsunami relief efforts through a program called Huddle for Haiti. "He was a great locker-room guy and a player whose efforts both on and off the football field will be missed," said Winnipeg general manager Kyle Walters. Arizona Coyotes Store . Irving played 10 minutes Sunday night before going to the locker room. He had two points and four assists, missing all five of his shots. The All-Star game MVP is the top scorer among Eastern Conference point guards with 21. Fredrik Sjostrom Jersey . Durant finished with 24 points and 13 rebounds, Jackson matched his career high with 23 points on 10-of-14 shooting and Lamb scored 12 points on 5-of-7 shooting, lifting the Thunder to a 94-88 win over San Antonio and snapping the Spurs 11-game winning streak.DETROIT - Jeff Robinson, who helped the Detroit Tigers to an AL East championship as a rookie in 1987 and went on to pitch in the major leagues through 1992, has died. He was 52.Robinsons death was confirmed Monday by both the Tigers and the Kansas-based Natural Baseball Academy, where he served as a pitching director, coach and instructor. They did not release any information about the causse of Robinsons death. Anders Hedberg Jersey . The Natural Baseball Academy said Robinson died Sunday.Robinson went 47-40 and made 117 starts for Detroit, Baltimore, Texas and Pittsburgh. The right-hander went 9-6 in his debut season in 1987, and he was 13-6 with a 2.98 ERA the following year.He made one relief appearance for Detroit in the 1987 AL Championship Series against Minnesota. ' ' '


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Q: Sorting the values of a variable without displaying the data I want to sort a variable x with length(x)>12000. When I run
sort(x)

from RStudio, the r console starts to display the result. Is there a way I can sort without displaying the sorted data?

A: I think there is a broader over-arching question here which is that of the R REPL. You see you are in a Read-Eval-Print Loop in the R interpreter. What it does is:

*

*Reads the input that you have given: sort(x)

*Evaluates the input: finds the sorted vector.

*Prints the output.

*Loops over.

Therefore, when you create a valid object in the interpreter it gets printed whether you explicitly call print or not.
> x <- 5
> x
[1] 5
> print(x)
[1] 5

The only thing that does not get printed is an assignment because, technically, that is a side-effect. Therefore the first statement x <- 5 does not say anything.
Here is an interesting toy to play with:
> f1 <- function (x) x
> f2 <- function (x) y <- x

> f1(5)
[1] 5

> f2(5) # Nothing

The subtle difference is that f1 explicitly returns x while f2 is only using x for a side effect. However if you were to do identical(f1(5), f2(5)) you will get TRUE.
Hope this helps. :)

A: I learned that I could simply store the sorted data in a new variable; such as y <- sort(x). Using invisible(sort(x)) is also another option.

redpajama_set_name: RedPajamaStackExchange


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Lasioglossum subopacum is een vliesvleugelig insect uit de familie Halictidae. De wetenschappelijke naam van de soort is voor het eerst geldig gepubliceerd in 1853 door Smith.

subopacum


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Q: RDP shadowing 2012R2 on custom RDP port I am attempting to shadow existing RDP sessions on Windows 2012 R2 without RDS installed on a custom (not standard 3389) rdp port.
This describes how to shadow RDP in windows 2012 R2. However, when I attempt to do this using for example:
mstsc /shadow:(sessionID)  /v:(ip):(port) /control

I get computer name is invalid.
It appears although mstsc /? shows that one can specify port in the /v parameter it, in fact, does not accept that when coupled with the /shadow argument and results in error message "This computer name is invalid"
Running just mstsc v:IP:port without shadow option is successful, however, obviously this does not result in shadowing.
I have set the registry key
HKLM\SOFTWARE\Policies\Microsoft\Windows NT\Terminal Services
Shadow(DWORD) = 1

To allow shadowing with user permission.
I have also allowed multiple sessions per user in group policy which does result in allowing multiple sessions from one username.

A: When doing shadowing (from what I understand) the communication is done over RPC instead, or at least setup is, and then a "random" port is used for the actual session.
In practice this means that the port specified is ignored.
http://woshub.com/rdp-session-shadow-to-windows-10-user/ mentions HKLM\SYSTЕM\CurrеntControlSеt\Control\Tеrminal Sеrvеr
"AllowRemotеRPC"=dword:00000001
Using qwinsta /server:(servername or ip) would probably be a good test to see if that is working correctly.
Of course this is quite sad because it rules out use over the internet where you don't want to open up RPC ports


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What we're reading: Books and more
By: Workshop Staff
Posted: Sept. 14, 2017 | Tags: journalism
Illustration by Sydney Ling, IRW
What we're reading this month: longer books, six-chapter investigative series and essays. Highly recommended from our new interns:
How Does a 10-Year-Old Boy End Up Hanging to Death?
by Julia Prodis Sulek for San Jose Mercury News
A 10-year-old boy found dead in a San Martin, California, barn bedevils his family. A sheriff's department reopens the case 25 years later. In six chapters, Pulitzer prize-winning journalist Julia Prodis Sulek reveals the trauma, psychology and misinformation surrounding the 1989 hanging of Joshua Sean Klaver.
Sulek's writing, wed with podcast segments, film work and photography, is mountain-stream clear. She deftly navigates readers through grisly subjects while showing the treads she walked to find the truth.
— Zane Anthony
"The Radium Girls: The Dark Story of America's Shining Women"
by Kate Moore
This new book tells the story of the "radium girls" who worked in factories in the U.S. in the mid-20th century. These factory workers painted watch dials with radium paint, licking the brushes for accuracy, as they were taught, and almost all of them ended up dying extremely painful deaths from radium poisoning. Moore's investigation yields a 500-page book that reads like a novel, with every page descriptive of the horrors of death by phosphorus ingestion.
Moore's research for this book was extensive and meticulous, and it shows in the accuracy of how she portrays characters and events. Like any good piece of journalism, she showcases as many sides as possible using historical documents. However, her passion for the girls is also evident, and, at times, overwhelming.
While it can get hard to read at times, given the graphic descriptions of the girls' medical ailments leading to their gruesome deaths, it is well-written and it powerfully illustrates an important part of American history.
— Sarah Gibson
"The First White President" by Ta-Nehisi Coates; The Atlantic
Since Toni Morrison called Ta-Nehisi Coates the "New James Baldwin," he has lived up to the hype, filling an "intellectual void" persistent in American culture. Like Baldwin, Coates lives in a time of uncertainty. Racism and whiteness were, for the first time in a long time, hyper-visible in the forefront of the 2016 election. And these themes continue to take in the political spotlight.
In his essay, Coates explores the resistance of political pundits to examine this undeniable fact: Trump won the White House because a majority of white Americans, in every single demographic, voted for him.
— Erin Logan
Beauty Sick: How the Cultural Obsession with Appearance Hurts Girls and Women."
by Renee Engeln
Dove's "Real Beauty Sketches" captured America's attention in 2013 when the film showed how women underestimate their own beauty. Dove showed these women get teary-eyed comparing self-descriptions to more accurate and beautiful sketches drawn by strangers.
But Dove missed the point. Beauty shouldn't even be a defining characteristic for women. At least that's a prime argument in Renee Engeln's "Beauty Sick: How the Cultural Obsession with Appearance Hurts Girls and Women."
The book's thesis: Women are being held back because of the time, money and head space they put into looking pretty.
Journalists should look to Engeln, a Northwestern University psychology professor, for how to conduct a good interview. She pulls out honest stories on difficult subjects like eating disorders and seemingly lighter ones, such as not feeling comfortable going outside without makeup. She then skillfully pairs these anecdotes with scientific studies.
"Beauty Sick" will make you think twice before you comment "so pretty" on your friend's next Facebook profile picture.
— Angela Swartz


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Home » Podcasts » Why Behavioral Data Matters for Businesses: An Interview with Simon Yencken
Why Behavioral Data Matters for Businesses: An Interview with Simon Yencken
You must have heard that using behavioral data is very important for business owners and marketers. But do you really understand what it is, why it matters, and how to use it for your business growth?
On this episode, Simon Yencken will answer those questions for you. He'll talk about:
The power of user data and how it can help you make more money.
Tips for business owners who want to leverage behavioral data.
How Fanplayr can make it easier for you.
Along with sharing his insights about these topics, Simon also shares fun stuff like the places he wants to visit and the one superpower he would like to get.
Tune in to listen to him talk about it all!
Simon Yencken
Simon Yencken is the CEO and Co-Founder of Fanplayr, which is a global leader in ecommerce and websites behavioral data. Fanplayr technology uses AI to analyze site traffic and provide intelligent, real-time segmentation to personalize every interaction with users. Before co-founding Fanplayr with Rajiv Sunkara and Derek Adelman, Simon had a long career as an entrepreneur, investor, and corporate executive. He started as a partner in Herbert Smith Freehills, a law firm in Australia, and then moved to London to become General Counsel in Thomson Reuters, a news and tech company. There, he took part in their acquisition of TIBCO Software, at which he later became a Senior Executive and Board Member. He has invested in several tech companies. He has expertise in business, social & digital marketing, and internet software and technologies.
Fanplayr


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Autism Report
Read about the autism spectrum – signs to look for and area services.
Updates on prenatal care, labor and delivery, circumcision, and breastfeeding.
Philly for the Family
Lots of history and the arts – fun for the family in big city that's right up the road!
Real Mom on Sick Kids
When to send them to school and when to keep them home.
Diane York | February 2013 : Features
When Erin Redmond's daughter Olivia was born, she was a beautiful baby. But as she developed, her mom was troubled by her lack of speech. While most babies are forming sentences by age three, Olivia was not even using words. Her pediatrician and subsequent doctors initially said she was fine.…
Martha Steger | February 2013 : Features
Presidents' Day is this month. By now, we all know that young George didn't throw a dollar across the Potomac River - and that he didn't chop down a cherry tree, which means he couldn't have come clean about it to his father - demonstrating his moral fiber to all…
Jenny Adlakha | February 2013 : Features
The news of a new baby is accompanied by a range of emotions, from excitement to anxiousness, with a lot of questions in between, shared by new parents, experienced parents, and grandparents alike. When I welcomed a new addition to the family just a year ago, I came to the…
Karen Schwartzkopf | February 2013 : Editor's Voice
It happened on the way to Water Country. My hands were clammy on the steering wheel. I could feel my heart thumping in my ears. A set of deep-breathing exercises did nothing to calm my anxiety as I signaled to change lanes and carefully made my way over to the…
Elizabeth Blanton | February 2013 : Real Moms & Dads
It's six-thirty in the morning. You go into your child's room to wake her up for school, and you find a sniffling, coughing little one asking to stay home. Of course you have a huge presentation at work that morning and your husband is out of town on business.…
Tony Farrell | February 2013 : The DadZone
Here on the icy summit, I don't mind telling you what's flashing through my mind: Do my legs still have it in them? After all, it's been almost 20 years since I last put on skis, and now I've gone and roused my glutes, quads, and hamstrings from their Rip…
A chilly but cheery February greeting to you, RFM readers.
Margaret Thompson | February 2013 : Publisher's Page
With the holidays fading in the rearview mirror, January proved to be an infinitely calmer month in our household. How about in yours? With the exception of the start of basketball season for my older son, the first for that sport in our household, and a last minute decision to…
The Greatest Love Letter Ever Written
Angie Shay | February 2013 : Family Finances
What in the world am I going to do now? It's one of the first questions asked when a recently widowed spouse is referred to my practice. Cash flow analysis shows that once the fog clears, hard decisions are necessary in order to find some level of financial security. A…
Fairy Godmother Project
April Kobos | February 2013 : Reaching Out
Shannon and Doug Hubbel of Richmond found out a little over two years ago that their daughter Emily had a tumor on her adrenal gland. Soon after that, Emily was diagnosed with a type of cancer called neuroblastoma. Since that time, Emily, now a bright and courageous five-and-ahalf- year-old, has…
Prevent Childhood Obesity
Shaival Kapadia, MD | February 2013 : Well Family
Have you weighed your child lately? Last year, when Newsweek named Richmond the second fattest city in America, it was shocking to associate our beloved River City with a serious health epidemic. Yet obesity is increasing at an alarming rate - in Richmond and in cities across the country. Studies…
Kids and Screen Time
Denise Noble | February 2013 : Parental Guidance
Q: We have two children, a 9-year-old boy and a 14-year old girl. It's becoming harder to monitor what movies they watch and video games they play as they start to spend more time with friends. We are not comfortable with some choices that have been made while not under…
Jennifer Kyzer | February 2013 : Pet Stop
As parents, we are sometimes frustrated with the behavior of our children, and sometimes exasperated by our dogs. However, when the interaction between them is the issue, it becomes all the more difficult to correct. Often we need to change the relationship our kids and pup have developed. Pups can…
Small Business Talk
Kelly Hall | February 2013 : Legal Ease
Payroll taxes. Benefits. Worker's compensation. I know, i know. Heavy stuff, but read on, because it may save you the hassle of back taxes and potential lawsuits. If you own a small business, you are probably familiar with the idea of working with independent contractors rather than hiring employees. It's…
Shhhh! Shortcuts!
Christine Wansleben | February 2013 : What's Cooking
February is all about love - love for a spouse, partner, child, or friend. Your love for your sweatpants. Your love for a quiet moment (yes, even if it's in the bathroom). Or your love for quick-cook and just-about-ready-to-serve foods. Creating an inspired, fully homemade meal each night can be…
Shiny & Bright!
VMFA | February 2013 : Kids Can-Do
Jewelry has long been a popular artistic form of cultural expression. In ancient Greece, many designs were inspired by nature, and just as it is today, jewelry was crafted using precious metals and semi-precious stones and glass beads. Starting with a popular household item, you can craft beads for your…
previous post: January 2013
next post: March 2013


Small, parlour-sized bodies, slot headstocks and Depression Era cosmetics have been major trends in the acoustic guitar world during the last 12 months and show no sign of going away any time soon. Likewise torrefaction.
Huw Price: "Most electric guitars can produce passable results with a decent amp or stompbox, but an acoustic guitar either grabs you or not – and if it doesn't there's not much you can do about it.
I immediately liked the Martin 00-17S, and before long I was besotted with it. There are things that I like and dislike about traditional mid-sized Martins. For instance, the touch sensitivity combined with airy, almost delicate treble inspires me to play fingerstyle, but I generally crave more guts and woody fullness in the midrange.
In other words, my ideal medium-bodied Martin would be one that has a bit of Gibson L-00 or J-45 thrown into the mix, and that pretty much describes the sonic character of the Martin 00-17S.
The fact that Martin made it drop-dead gorgeous with slope shoulders, an antique sunburst and wonderful open-geared Golden Age tuners adds to the allure.
This slot-headstock electro is a bluegrass natural and any basslines you pick out balance superbly with strummed chords. It's also tremendous fun for banging out rockabilly rhythms and R&B grooves.
Tap the bridge with your finger and you'll feel a really strong kick-back – this means that very little energy is required to get the soundboard moving, making it a remarkably adept fingerpicker.
After a hiatus of about 70 years, 2016 saw Epiphone get back in the quality acoustic-archtop business.
They may look like relics of the Jazz Age, but the Masterbilt Century models combine deference to the past with modern convenience: the most affordable of the bunch was our favourite.
Zebrano is a lovely timber with an olive or pale coffee hue and dark brown grain lines.
Reputed to lie between rosewood and mahogany on the tonal spectrum, here, on this Californian parlour guitar, it helps squeeze as much sound as possible from its 24-inch scale.
West Virginia-based luthier Andrew White's Production Series contains this all-solid acoustic made from Brazilian cherry.


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of more than 5,000 people with type 2 diabetes found that two injection medications -- a long-acting insulin and liraglutide (Victoza) -- typically worked better than two oral drugs in keeping blood sugar levels in check.
Over five years, patients taking either injection treatment spent more time with their blood sugar in the recommended range -- an average of six extra months.
Still, most study patients were unable to meet that goal for the long haul. Experts said it underscores how difficult that task is for people with diabetes.
"Ultimately, the treatment combinations did not maintain optimal A1C levels in many patients for the long-term management of type 2 diabetes," said researcher Dr. Henry Burch of the U.S. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
A1C is a measure of a person's average blood sugar level over the past three months. When people have diabetes, the goal is to keep A1C below 7%.
In the trial, 71% of patients could not meet that target across the five-year follow-up.
More than 37 million Americans have diabetes, the vast majority of whom have type 2, according to the NIDDK. In that form of the disease, the body loses its ability to properly use insulin, a hormone that shuttles sugars from food into body cells to be used for energy.
As a consequence, sugar builds up in the bloodstream, which can damage blood vessels and nerves over time. Many people with diabetes develop complications such as heart disease, kidney failure, nerve damage in the feet and legs, and potentially blinding eye disease.
Controlling blood sugar is key to reducing those risks. To do that, most people with type 2 diabetes take the oral drug metformin, along with diet changes and exercise.
The new findings -- published Sept. 22 in the New England Journal of Medicine -- come from a trial launched almost a decade ago and funded by the NIDDK. The goal was to determine which diabetes medications, when added to metformin, were most effective at helping patients maintain the recommended A1C target.
Just over 5,000 U.S. adults with type 2 diabetes were randomly assigned to add one of four treatments: insulin glargine (Lantus), a long-acting synthetic insulin; liraglutide; glimepiride (Amaryl), which belongs to a class of drugs called sulfonylureas; or sitagliptin (Januvia), a DPP-4 inhibitor.
Over five years, patients on insulin or liraglutide were most successful at keeping their A1C on target. Around 67% saw their blood sugar go above that target at some point, versus 72% of glimepiride patients and 77% of sitagliptin patients.
On average, patients on the injection treatments had about six extra months in target range, compared to the sitagliptin group.
Patients on all treatments tended to lose weight or remain stable, but weight loss was greatest with liraglutide, which helped people shed an average of 7 pounds. (A different formulation of the drug, sold as Saxenda, is approved as a weight-loss aid.)
On balance, though, no treatment was a home run.
An "important takeaway" from the trial, Burch said, is that when people are not reaching their A1C target, they and their doctors should be open to switching or adding medications -- as well as making healthy lifestyle changes.
There is no one-size-fits-all strategy, according to a diabetes expert who was not involved in the trial.
In the years since the study began, guidelines have put greater emphasis on the importance of individualized treatment, said Dr. Roeland J.W. Middelbeek, from the Joslin Diabetes Center in Boston.
For any one patient, he said, there are multiple factors to consider in making medication choices -- including coexisting health conditions like heart or kidney disease, whether weight management is a goal, and medication costs.
So for patients, Middelbeek said, it's important to work one-on-one with your doctor to figure out the best treatment plan.
There have also been other changes since the trial launched in 2013, the researchers point out. A new group of diabetes drugs, called SGLT2 inhibitors, are now available. They include medications like canagliflozin (Invokana), dapagliflozin (Farxiga) and empagliflozin (Jardiance).
And in the past few years, recommendations have come out supporting SGLT2 inhibitors and GLP-1 receptor agonists (which include liraglutide) as preferred options for patients who have existing heart or kidney disease.
But managing diabetes, and preventing its complications, takes more than blood sugar control. Burch said it's also critical to rein in high blood pressure and high cholesterol, to quit smoking and to aim for a healthier weight.
The U.S. National Institute of Diabetes and Digestive and Kidney Diseases has an overview of type 2 diabetes.
SOURCES: Henry Burch, MD, program director, Division of Diabetes, Endocrinology and Metabolic Diseases, U.S. National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Md.; Roeland J.W. Middelbeek, MD, staff physician, assistant investigator, Joslin Diabetes Center, and instructor, Harvard Medical School, Boston; New England Journal of Medicine, Sept. 22, 2022
Diabetes During Pregnancy
Diet and Diabetes
C-Peptide (Urine)


She smacked me across the chest. "Shut up. You know if anyone should be giving someone hell, it should be me giving you hell. I mean, you're folding laundry on a Thursday night with me. Since when did you become so domesticated?" She grinned.
I pursed my lips together; she was right. It was Thursday night and I had nothing better to do besides stay at her place and help fold her freaking laundry. What the hell was the world coming to?
"Don't call me sweetheart. You know how much I hate your little pet names," she grumbled. "And you know why I'm home. The loser I chose this time was just that, a loser. What's your excuse?" She arched an eyebrow at me.
"I'm a recovering addict; becoming a homebody is logically my next step. If I don't cut myself off from fun, I might relapse." I was kidding, slightly. The last week or so had been tough, and thoughts of using to escape the mental anguish I'd found myself in had been tempting.