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NASSCOM picks its top 10 innovative tech firms of 2019
Nasscom, the trade association for IT services and business process management companies, has made its pick of the top ten most innovative technology products and services startups for the year 2019, seeking out firms that have the potential to scale at speed. The ten startups, which have been picked from Nasscom's Emerge 50 awards finalists, are from a wide range of sectors including Software as a Service, retail technology, healthcare, cyber security, internet of things etc.
TAGS #EFTA #EUININDIA
India and Switzerland MoU on Climate Change
Prime Minister has given ex-post facto approval to the MoU between India and Switzerland on Technical Cooperation in the field of Climate Change and Environment. The MoU was signed in Switzerland on 13th Sept, 2019.
TAGS #climate
India & Switzerland to work together in Rail Transport
The discussions in Joint Working Group focused on Freight and Passenger Cars, Railway Electrification Equipment, Multimodal transport and tunneling technology.
TAGS #railway
MoUs/Agreements signed during the visit of Chancellor of Germany to India
Germany Chancellor Angela Merkel visited India and list of MoUs/Agreements signed during her visit is available.
Government to set up enclave for Swedish companies
The govt. has offered to set up an exclusive enclave for Swedish companies and expatriates, complete with hospitals and educational institutions, as it seeks to woo investors from the European nation to boost the Make-in-India and start-up initiatives. The issue was discussed during the India-Sweden joint economic commission meeting, with commerce and industry minister suggesting the government was willing to offer land for setting up an "Investment Enclave" with plug-and-play infrastructure.
TAGS #EUINDIA
India, Europe 29 nations to cooperate in AI, green energy, IT, pharma, smart-cities
India and the Europe 29 group of Central, Northern and East European countries hold growth potential in areas such as AI, new age technologies, new manufacturing technologies and can be the beacons of growth in a slowing world," Commerce & Industry Minister said. "The two regions have a lot of complementarities in areas such as smart cities, clean and renewable energy, start-ups, IT and ITES and can develop a strong economic relationship with each other," he said at the India-Europe 29 Business Forum.
India ranks 63rd on World Bank's ease of doing business
India took a huge stride in improving its ease of doing business, climbing 14 notches to clinch 63rd place in the list of 190 countries, according to the World Bank's Doing Business Report, (DBR) 2020. India also remained among the world's top 10 improvers for the third consecutive year. China too made it to the list. India's ranking has improved 79 places in the past six years from 142 in 2014.
DPIIT working on mechanism to help investors set up facilities in India
The Department for Promotion of Industry and Internal Trade (DPIIT) is in the process of setting up of a mechanism to handhold investors and help them set up their facilities in India. DPIIT Secretary said that the proposal is being sent to the Commerce and Industry Minister for approval, following which it will set up an investment promotion and facilitation agency Invest India. It will be funded by the DPIIT.
Lower corporate tax rates to boost manufacturing, Make in India: Industry
Finance Minister announced a significant cut in corporate tax – a demand the industry has been putting forward for the past few years. Giving much relief to the corporate companies, the government has slashed the tax rate on all domestic firms to 22%. Further, new manufacturing companies that will come up from October 1 onwards will have to pay tax at 15% rate. With the reduction of tax rate for existing firms and a significantly lower rate for new manufacturing companies, investment is expected to rise.
TAGS #MakeInIndia
In a push for Make in India, govt to curb imports of over 350 items
The government is looking to reduce imports of more than 350 "non-essential" items such as toys, textiles, footwear and electronic goods to give the Make in India initiative a push. Several ministries, including textiles, electronics and IT and commerce and industry, have been asked to take action on the list of identified products. It is also considering the suggestion to do away with global tender for govt. procurement in industries where domestic demand was enough. Read More
Centre to set up working group on proposed new industrial policy
The Centre will soon constitute a working group on the proposed new industrial policy, which is aimed at promoting emerging sectors, reducing regulatory hurdles and making India a manufacturing hub. Earlier, the Department for Promotion of Industry and Internal Trade (DPIIT) had prepared the policy and sent it for the Union Cabinet approval, but certain new suggestions have been made with regard to the policy.
India, EU launch 18 million euro call on research on developing local energy system
The European Commission and India's Department of Science and Technology launched an 18 million euros joint call on research and innovation to develop integrated local energy systems. Proposals should develop and demonstrate novel solutions, integrating all energy vectors (electricity, heating, cooling, water, wastes, etc.), including possibilities offered by batteries and electric vehicles, interconnect them and optimize joint operation with increased share of renewables and a higher energy efficiency, said a EU press statement.


Nancy S. Nelson, author of Duluth's Historic Parks: Their First 160 Years, has been named the 2017 recipient of the Duluth Depot Foundation's 2017 Historic Interpretation & Preservation Award.
The award is part of the foundation's annual Arts & Culture Awards, created to recognize outstanding accomplishments in the areas of initiative, community enrichment, and lifetime achievement.
Nelson is being recognized for the years of research and writing she invested in Duluth's Historic Parks and her past work in preservation, which included the founding of the Skyline Planning & Preservation Alliance.
The 2017 Duluth Depot Foundation awards will be held this Thursday, October 19, during the annual Circle of Friends celebration at the Depot.


"Return flight from Launceston to Sydney Check in was good and through Security quickly Small departures lounge but had enough outlets and seats waiting to board your flight. Flight was OK and service was nothing..."
"Check-in opened 2 hours prior to boarding. There was a fairly long queue but it moved quickly. Boarding went smoothly. The snack was included with the ticket price. It was passable. Drinks were offered twice on..."
"I have flown Premium Economy with Air New Zealand a couple of times and it is excellent. The staff from Air NZ are exceptional. Their premium economy has a good amount of room to stretch out and includes a blanket..."
"This is the third time we have used the Unnaccompanied Minors service with Air New Zealand. Each time the service has been exceptional. The check in staff are friendly and efficient and from the time of Check in to..."
"Good service. Above average food. Very good choice of entertainment. Value for money. Ground staff very accommodative. Average customer service inside the airplane "
"I really enjoyed my 2 flights of Emirates using the 380 plane, but the rest of the trip we had to go on the 777 and on that airplane I was not as comfortable and the service was not as I expected. I dont understand..."
"I booked on Qantas because their website was definitely the best I came across when booking multi-stop flights. I found it easy to try out various scenarios and see the effect on the price without inordinate delay..."
"I am a Qantas Gold frequent flyer! I fly a lot. This was a flight I have done 3 times already this year. Check-in was efficient and friendly - I can do it at the business class counter due to status. No waiting (1..."
Flight stats for Manly - did you know?
Manly is 19 km from Kingsford Smith Airport (Sydney, Australia).


A Newark charter high school has landed at the top of a national ranking that measures how many students take rigorous, college-level Advanced Placement courses.
Uncommon Schools' North Star Academy in Newark was ranked the top five in New Jersey in the Challenge Index, a national ranking based on the percentage of students who take Advanced Placement courses. The Challenge Index, which has been published in both The Washington Post and Newsweek since 1998, is the oldest ranking system in the nation. "It is the only list that does not rely on test scores, which are more a measure of student family income than school quality," according to Jay Mathews, an author and long-time education columnist for the The Washington Post who compiles the ranking.
Click HERE for the full story from TAPinto Newark.


Me and Mum are taking part in a 10000ft skydive for The Royal Marsden Cancer Charity because they looked after my grandpa last year.
I have somehow convinced my poor Mum to keep me company on a 10,000ft free-fall skydive this April. Having lost my grandpa late last year to cancer and seeing what great care The Royal Marsden provided for him there seemed like no better cause to raise money for. Considering my fear of heights this could be interesting, Mum is already frightened to death.


23/02/2018 · - If free space is consumed slowly, I'd make an effort to delete derived data as part of your routine housekeeping. See this SO thread: How do I keep Xcode from filling up my hard drive? Level 9 (13,305 points) KMT Feb 23, 2018 3:23 PM (in response to ShinehahGnolaum)... Hi Noa, I've had that happen once before. I had to delete and re-install it from the app store. Just make sure you're running Sierra, as the version of Xcode in the app store right now will only run on that.
Hi Noa, I've had that happen once before. I had to delete and re-install it from the app store. Just make sure you're running Sierra, as the version of Xcode in the app store right now will only run on that.


Microsoft C#.Net Tutorials: What We Need To Learn .NET?
What We Need To Learn .NET?
To get started with .NET Programming, the programmer must have previous knowledge in the following languages.
Multiple platforms: The system runs on a broad range of computers, from servers and desktop machines, smart phones and cell phones.
Industry standards: The system uses industry standard communication protocols, such as XML, HTTP, SOAP, and WSDL.
Security: The system can provide a much safer execution environment, which can't be hacked or robbed by others.
Supports multiple languages like VC#, VB.NET, VC++.NET, VJ#.NET etc., so that the programmer can write the code in his/her interested language.
Offers more secured environment never before.
Offers flexible data access with ADO.NET.
Supports to develop windows services and web services, which are necessary to handle in the live projects in the modern programming world.
Supports to develop applications for small devices like PDA's, smart phones, mobile phones etc.
Offers ―> platform independency, because it supports to run the .NET applications on other platforms like UNIX, LINUX and Solaris etc., with .NET Mono framework.
Offers easier and faster UI design (with drag and drop technique), when compared with the languages like Java.
Offers the best debugging tools in the industry, which makes the programmer to easily fix the bugs.
Offers improved object oriented programming features like properties, sealed classes, inner classes, delegates, enumerations, collections, interfaces, generics, extension methods, anonymous types, anonymous methods, lambda expressions, named parameters etc.
Offers to share and reuse the code among multiple applications very easily, with the concept of ―> Assemblies.
Offers to write queries in the programming code itself, using the newly added querying technology called ―> LINQ (Language Integrated Query), which is introduced in .NET 3.5.
Offers faster and easier Deployment features, to generate ―Installer packages for installing the .NET application on the client systems.
Offers to create multiple threads and also to manage them for creating Multi-Threaded Applications.
Offers XML support and interaction, which is mostly required in the modern application development environment.
Supports to create user defined graphics like lines, rectangles, bars, circles etc., very easily using "GDI+" (Graphics Device Interface) concepts.
Offers a new and attractive feature called WPF (Windows Presentation Foundation), which is built on Vector based graphics and which enables the programmer to create 2-D and 3-D graphics, animations, games, audio and view players etc. This is newly added feature in .NET 3.0.
Offers another prestigious feature called WCF (Windows Communication Foundation), which integrates the several distributed technologies like .NET Remoting, SOAP enabled web services, named pipes and message queues etc., which helps the programmer to develop service and network oriented applications using .NET. This is newly added feature in .NET 3.0.
.NET Framework: This is the general version, required to run .NET applications on Windows operating system.
.NET Mono Framework: This is required to run .NET applications on other operating systems like UNIX, LINUX and Solaris etc.
.NET Compact Framework: This is required to run .NET applications on other devices like PDA (Personal Digital Assistants), Mobile phones and Smart phones.


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Identity and the Refugee Crisis
The world's refugee crisis has risen to a staggering scale. War, persecution, famine and global environmental issues have displaced more than 68 million people; every two seconds, someone is forced to leave their home.
Most refugees arrive at camps without any form of identification. As a result, it falls on the Humanitarian Aid Organisations to register and identify people in the interim. These independent information databases tend to get siloed within organisations, impacting the delivery of much-needed relief.
Self-sovereign identity systems are user-driven and portable, so identity information can be made easily accessible, as required. Also, the ownership of identity remains right where it belongs — with each person.
The Loss of Identity
According to the United Nations High Commissioner for Refugees, 44,000 people become displaced every day. As they're often required to leave with little to no preparation, many arrive at camps without identification documents. Some lose their papers during the arduous journey to safety, and others belong to the billion-strong group who have never held any proof of identity.
In many countries, proving one's identity is near impossible. A US State Department report on human rights in Syria found that the Syrian government often denies its citizens passports and other identification documents. Refugees from Syria lack an identity by default, which leaves them utterly helpless.
After the collapse of Somalia's previous government, identity documents were unobtainable for citizens. Even now, with a Federal government in place, a National ID card can only be issued in the capital city, after an expensive process and a month-long wait.
Identity is intrinsic to accessing basic human rights, and scores of people are left stranded without it.
The Management of Identity
Digital technologies play a key role in the delivery of relief, where the identification of persons is concerned. To manage this, relief organisations develop systems and processes, but often independently. As information cannot be easily shared with other organisations, isolated records are created, causing one person to have multiple identities, hindering access to aid.
The distribution of funds through mobile payment systems promises to empower people to rebuild their lives. However, the GSM Association found that refugees often aren't able to access this vital resource. International Know Your Customer (KYC) criteria requires a valid identity document to be presented to activate a SIM card or mobile money service.
The UNHCR has launched an initiative that could alleviate this situation — at least within the projects it oversees. Population Registration and Identity Management Ecosystem, or PRIMES, is a collection of information services that promises the refugees a recognised, legal identity tied to a biometric ID card. UNHCR and its partners will use this centralised system to deliver their services.
However, any centralised system has a high risk of data breaches, and those developed by UNHCR and other aid organisations are no exception. The privacy of personal data is a major concern. Rigorous security processes must be put in place to protect refugee identities.
The Self-Sovereign Solution
Humanitarian aid agencies work tirelessly to deliver timely relief and support to displaced people. By empowering refugees with control of their own identity, many of these issues can be resolved.
Self-sovereign identity follows a distributed approach to identity management. Rather than storing information on a centralised server, a self-sovereign system uses blockchain-based distributed storage. Based on open standards, it fosters interoperability, and allows an entire ecosystem to build identity-dependent services. Simultaneously, each user controls who can access their personal information.
To meet the need for reliable information, Sphere Identity has designed a free Personal App. Refugees can use it to scan and save the documents they possess. They can have immediate, access to their records whenever they need it. Security and privacy are built-in features of the Sphere Identity solution.
Refugees flee from unspeakable hardships and nurture the hope of a better future. The ability to prove one's identity can make the difference between getting help and being helpless, between asylum and abandonment, and quite possibly, between life and death.
Article written by Sphere Identity

redpajama_set_name: RedPajamaCommonCrawl


The new Sherriff building was built directly beside and under one of the columns for the PRT. CHANCE Helical Underpinning piers stabilized the base of the column until the building could be constructed and the basement backfilled.
Temporary shoring was required to excavate for the basement of the new hospital. McCloy was able to develop a system using CHANCE Helical Tie-backs with fencing. The system met the building codes at half the cost of sheet piling.
A vertical cut was required under the PRT in Morgantown to provide room to construct the first floor of the new Sherriff building. McCloy used CHANCE soil nails for an earth retention system to stabilize the earth during the construction process.
A slip developed and endangered the stability of this cell tower. McCloy was able to stabilize the foundation of the tower before any movement occurred.
All water towers pose a problem due to one side being pushed into the ground and the other side being pulled out of the ground. CHANCE Helical piers are the perfect application because the product works in compression and tension equally.
A slip developed that endangered the main water line serving southern West Virginia. McCloy was called in the anchor the main line before the slip pulled the pipes apart.
McCloy Construction installed CHANCE Helical piers for all the zip lines, obstacle course and observation deck for the 2013 National Boy Scout Jamboree where over 50,000 scouts used the West Virginia site.


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Packers Pass on Making Pick in NFL Supplemental Draft
Pack-A-Day Podcast - Episode 354 - Packers 2019 Preview Part 1 - Coaches & Special Teams
Jones, Packers' redesigned offense projecting to be a perfect match in 2019
How Should the Packers Handle Their Offensive Line in 2019?
Pack-A-Day Podcast - Episode 353 - Breaking Down the Packers' Schedule - Quarter 4
Cory's Corner: Does A Contract Actually Mean Anything?
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By Chris Peterson on Jul 10, 2019 with 16 Comments
It has been over 20 years since the Green Bay Packers have made a selection in the NFL's Supplemental Draft and despite showing interest in a few of the eligible prospects this year, the organization decided to pass once again.
The top prospect available to be drafted in the Supplemental Draft Wednesday was former Washington State safety Jalen Thompson. However, he ended up getting selected in the fifth round by the Arizona Cardinals.
The #Cardinals have selected Washington State DB Jalen Thompson in Round 5 of the NFL supplemental draft, source said. First one off the board.
— Tom Pelissero (@TomPelissero) July 10, 2019
Thompson seemed to be in line for a big season at Washington State after being a three-year starter, however, after testing positive for a banned substance he said he bought over the counter, he declared for the Supplemental draft.
Thompson is a 6-foot,190-pound safety that has proven to be productive playing for the Cougars in the Pac-12 Conference. He finished with 190 career tackles, 11.5 TFL, 17 pass breakups and six interceptions, all of which came in 2017 and 2018.
The versatile defensive back that also played plenty of snaps in the slot, could have been a valuable addition to the Packers secondary, providing even more depth to a young secondary in need. Many speculated that Thompson could be had with a fourth or fifth-round pick and that proved to be correct. Had Green Bay put in a bid with its fourth-round pick, it would have gotten Thompson. Yet, that didn't happen and he went to Arizona instead. It's not clear if the Packers also put in a fifth-round bid or not.
With his ability to play in the slot, it would have been easy to see him earning a spot on the 53-man roster and who knows, with 39 college starts under his belt, he could be ready to contribute right away.
Yet, the Packers weren't able to select him. Another player Green Bay showed interest in was West Virginia wide receiver Marcus Simms. The Packers reportedly attended one of his workouts.
Much like Thompson, Simms, who racked up more than 600 yards receiving in 2017 and 2018, entered the Supplemental Draft due to off-field issues. He has been charged with two DUIs and brings other character concerns.
Yet, with the Packers need in the secondary and at wide receiver, it made sense that the team at least explore adding Thompson and Simms, even if it ended up without either player on its roster.
After missing the playoffs in back-to-back seasons, the Packers can't afford to ignore any type of player acquisition, which is why it was good to see GM Brian Gutekunst at least kick the tires.
Simms ended up going undrafted, which made him a free agent. It will be interesting to see if the Packers decide to try and sign him. Stay tuned.
Chris is a sports journalist from Montana and has been blogging about the Packers since 2011. Chris has been a staff writer for CheeseheadTV since 2017 and looks forward to the day when Aaron Rodgers wins his second Super Bowl. Follow him @thepackersguru
NFL Categories:
Jalen Thompson
Marcus Simms
Brian Gutekunst
Fan friendly comments only: on Comments (16) This filter will hide comments which have ratio of 5 to 1 down-vote to up-vote.
Sounds like Gute did all his homework regarding Thompson & opted not to spend a future draft pick. -- Still gotta like that the present Pack regime practices "To leave no stone unturned". -- Another reason why you have to like the "new guys in charge".
5 points (5 like | 0 dislike)
4thand1 says:
I've got no complaints.
Coldworld says:
We need another Young WR and one with character issues? I don't think that is really true.
As to Thompson, he is a DB body type. I don't know that I agree that we are short on that type. We have a number of candidates for that backup that I don't see this player as being an obvious upgrade in depth even at FS. Thompson was known as a liability in press and close to the line, so he wouldn't have been an obvious option as SS/box safety. I am not disappointed that we didn't spend a 4th on him.
PackfanNY says:
Did the Packers pass on Thompson or did the Cardinals win because they were ahead in the order and/or offered a 5th? Article is not clear. Maybe information is not released?. Their is a difference between trying and "passing".
Sorry, now I see it. Article says "not clear" for 5th rounder. Pack didn't offer 4th. Cards were ahead of Packers in order before 5th. No big deal I guess.
They passed in rounds one through 4. Don't know yet if submitted a 5th through 7th since Cardinals were higher priority.
Chris Peterson says:
At the time, I was trying to find out if the Packers put in a big for the fifth round but I hadn't heard by then. I haven't seen it anywhere that they put in a bid so my guess is that they didn't.
TheBigCheeze says:
Simms was touted as having terrific foot movement....EXACTLY what the Pack needs for KO and punt returns....get this guy....
dblbogey says:
Yes! He could be the next Jeff Janis.
D Ernie says:
OH please lets hope not. janis is still trying to learn the playbook.
-1 points (0 like | 1 dislike)
Coach JV says:
Wise move... there's no one here who's talent is worth spending a pick in advance.
jannes bjornson says:
Wolf picked Wahle with a Two pick in the supplemental draft. If the talent is there get it. The future is now.
Thegreatreynoldo says:
Actually, isn't that backwards? If awarded to GB, the Packers would have gotten the value of his play (whatever that turned out to be) and paid for it with a draft pick later.
Bama says:
Neither of these players was worth spending a draft choice on, at least not for the Packers. Thompson, according to ProFootballTalk was actually 5' 10", not six feet, and 186 lbs, not 190. That is too small for an NFL S, and I believe the Packers already have talent that's better at both S and CB.
None of the other players was selected, and are now FAs. So if GB is interested in one of them, it can sign them as a minimum priced FA.
flackcatcher says:
There are questions about how Thompson gained the weight, given he played around closer to 175lbs last year. Thompson does have talent, but he needs time for his body to adjust to the extra wight, if he does make a teams roster. Mostly likely FA then PS would be best of him.
Two dwi's isnt so bad. I should have had 30 of them but just lucky I guess.
AgrippaLII says:
No big surprise here. The only crap shoot bigger than the NFL Draft has to be the Supplemental Draft!
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text:
October, 17
Queen honours her Jubilee stars
Singer Gary Barlow, celebrity chef Heston Blumenthal and hundreds of others who helped make the Queen's Diamond Jubilee year a success have been honoured by the monarch.
A glittering Buckingham Palace reception was hosted by the Queen and Duke of Edinburgh for those who made the regional, national and international celebrations events to remember.
Barlow masterminded the triumphant Diamond Jubilee concert - staged during a special bank holiday weekend in June - that featured a host of stars including Stevie Wonder and Sir Paul McCartney who played to a televised audience of millions.
The X Factory judge's anthem Sing, co-written with Andrew Lloyd Webber, topped the singles charts during the summer and a few days after the musical extravaganza Barlow was awarded an OBE for services to the entertainment industry and to charity.
Before the show began, 12,000 ticket holders picnicked in the grounds of the Palace eating delicacies from a hamper created by Blumenthal and the Queen's royal chef, Mark Flanagan.
Blumenthal described the experience as "amazing" and went on to give his recollections of the event: "On the day I was driving around the outside of the palace and we could see thousands of people queuing, they were queuing and lapping themselves and (all I could see was) picnic hampers."
He added: "I'm never happy with what I've done, I always think I could do better, I'm getting a bit better at taking compliments but the reaction was fantastic."
The chef added, joking: "I was very lucky, the food didn't quite hit the top but they got a free hamper, and it was a really nice hamper, to take home with them."
Blumenthal went on to say: "I was really pleased with it, it was the challenge of taking something that had an historical framework and showcasing British produce."
Jennifer Lopez gave the crowd more than they bargained for when she suffered a wardrobe malfunction while on stage in Italy.
Matt Cardle has revealed how his own heartache acted as inspiration for his new album The Fire.
Girls Aloud have unveiled their comeback track as they premiered the dance tune online.
Amy Winehouse's father has given his backing to a campaign aimed at raising awareness of the potentially lethal effects of club drugs and legal highs.
Beyonce is rumoured to be making an appearance on The X Factor final, to sing a duet with one of the contestants.
Fleetwood Mac will embark on a reunion tour in 2012, it has been revealed.
Carly Rae Jepsen has revealed she finds online spoofs of her big hit Call Me Maybe "rejuvenating".
Gary Barlow has lined up his first solo tour for 13 years with a string of dates beginning next month.


text:
Dave Chappelle and Jon Stewart Announce Joint Stand-up Tour
Image via Live Nation Comedy News Dave Chappelle
Two comedy titans are teaming up for a stand-up tour: Dave Chappelle and Jon Stewart announced Monday morning that they'll share stages in Boston, Houston and El Paso for a limited, seven-date run of exclusive shows this June.
Chappelle and Stewart last performed together at New York City's Radio City Music Hall in August of 2017, during Chappelle's residency at the storied Manhattan venue. Chappelle recently released his third and fourth Netflix specials, Equanimity and The Bird Revelation. His first pair of Netflix specials, The Age Of Spin and Deep In The Heart Of Texas, took home a Grammy for best comedy album in January. Stewart, meanwhile, announced his return to stand-up last summer, comprising two HBO specials as part of his exclusive deal with the pay-cable channel. The comedian has been relatively quiet after departing The Daily Show in 2015, but nonetheless retains the star power to share a bill with Chappelle.
To combat scalpers and bots, tickets for Chappelle and Stewart's run are being sold through Ticketmaster's Verified Fan platform, meaning only registered Ticketmaster users will be able to buy them. Registration is open now through Wednesday, May 16 at 10 p.m. ET, with tickets going on sale to registered fans this Friday, May 18 at 10 a.m. local time.
See Chappelle and Stewart's tour dates below.
Dave Chappelle and Jon Stewart Tour Dates:
11 – Boston, Mass. @ Wang Theatre
21 – Houston, Texas @ Smart Financial Centre
23 – El Paso, Texas @ Chavez Theatre
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Netflix's Everything Sucks! Is an Awkwardly Endearing '90s Nostalgia Trip
It's a must watch!
EVERYTHING SUCKS!Scott Patrick Green/Netflix
Everything Sucks!, one of the newest series coming to Netflix this year, is right on trend with all the 90s nostalgia we can't seem to get enough of.
Set in the town of Boring, Oregon in 1996, Everything Sucks! tells the story of Boring High School's A/V and Drama Clubs as they combine forces to make a movie about what a drag high school can be. (By the way, the name of the town is real!) The series stars Sydney Sweeney, Peyton Kennedy, Jahi Winston, Elijah Stevenson, Quinn Liebling, and Rio Mangini and is set to premiere on Netflix in 2018.
The first teaser clip and images give a glimpse of what we can be on the lookout for, aside from, of course, all of our favorite throwback music and the usual mayhem of a teen dramedy. It opens with a teacher rolling in a extra large TV with a VCR player (remember those?!) and then posits some quippy tid-bits about what high school was like back in the day. "When 'erase' had to dry," reads one text bubble next to a kid whiting-out a mistake on a piece of paper. "When posts were iron-on," reads another, next to a backpack with decals on it.
Executive producers Ben York Jones and Michael Mohan told Digital Trends that they think everyone will be able to relate to the trials, tribulations, and general struggle that high school can be. "This is a great time to take a look back at high school and relive the fashion, music, and attitudes of the mid-'90s the way we remember it," they said. "Not sensationalized, not watered down; but desperate, heartfelt, awkward, and exciting." Sounds about right, to be honest. Check it out below:
Related: Kiernan Shipka Explains Why Getting Yelled at on Feud Is "a Complete Honor"
KeywordsEverything Sucks!netflix


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Q: Reading from streams instead of files in spring batch itemReader I am getting a csv file as a webservice call which needs to be laoded. Right now I am saving it in temp directory to provide it as setResource to Reader.
Is there a way to provide stream(byte[]) as is instead of saving the file first?

A: The method setResource of the ItemReader takes a org.springframework.core.io.Resource as a parameter. This class has a few out-of-the-box implementations, among which you can find org.springframework.core.io.InputStreamResource. This class' constructor takes a java.io.InputStream which can be implemented by java.io.ByteArrayInputStream.
So technically, yes you can consume a byte[] parameter in an ItemReader.
Now, for how to actually do that, here are a few ideas :
1) Create your own FlatFileItemReader (since CSV is a flat file) and make it implement StepExecutionListener
public class CustomFlatFileItemReader<T> extends FlatFileItemReader<T> implements StepExecutionListener {
}

2) Override the beforeStep method, do your webservice call within and save the result in a variable
private byte[] stream;

@Override
public void beforeStep(StepExecution stepExecution) {

     // your webservice logic
     stream = yourWebservice.results();

}

3) Override the setResource method to pass this stream as the actual resource.
@Override
public void setResource(Resource resource) {

    // Convert byte array to input stream
    InputStream is = new ByteArrayInputStream(stream);

    // Create springbatch input stream resource
    InputStreamResource res = new InputStreamResource(is);

    // Set resource
    super.setResource(res);
}

Also, if you don't want to call your webservice within the ItemReader, you can simply store the byte array in the JobExecutionContext and get it in the beforeStep method with stepExecution.getJobExecution().getExecutionContext().get("key");

A: I am doing right now with FlaFileItemReader, reading a file from Google Storage. No needed to extends:
    @Bean
@StepScope
public FlatFileItemReader<MyDTO> itemReader(@Value("#{jobParameters['filename']}") String filename) {

    InputStream stream = googleStorageService.getInputStream(GoogleStorage.UPLOADS, filename);

    return new FlatFileItemReaderBuilder<MyDTO>()
            .name("myItemReader")
            .resource(new InputStreamResource(stream)) //InputStream here
            .delimited()
            .names(FIELDS)
            .lineMapper(lineMapper()) // Here is mapped like a normal File
            .fieldSetMapper(new BeanWrapperFieldSetMapper<MyDTO>() {{
                setTargetType(MyDTO.class);
            }})
            .build();
}

redpajama_set_name: RedPajamaStackExchange


A truely classic staple to any pet's wardrobe, a smart navy blue and white checkered accessory like the Vichy Pet Collar Bow Tie. Absolutely the trendiest new addition to your pets wardrobe. These fun collar scarves slip onto your pets collar, ensuring they don't fall off. Totally removable and interchangeable with MOBF Bow Ties and Dog Collars to create unique looks. Make sure to measure your pets collar length and width for optimal fit.


You must define container ID, latitude and longitude of the panorama's position.
NoteYou also can define a pov (heading, pitch and zoom) and others values defined in the official documentation.
Note In the same way, you can define events, like in the Map events example. The events allowed are defined in the official documentation ("Events" section).


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United, American begin selling cheaper economy-class fare
By David Koenig, AP Airlines Writer
DALLAS — American and United have started selling cheaper "basic economy" fares as they battle discount airlines for the most budget-conscious travelers.
American announced early Tuesday that it began selling the new fares for flights starting March 1 on 10 different routes from its hub airports in Dallas, Miami, Philadelphia and Charlotte, North Carolina.
United followed suit later in the day, posting reduced fares on some flights from Minneapolis to seven of its hub cities including New York, Chicago and Los Angeles for travel starting April 18.
Basic economy fares come with severe restrictions. Buyers can't pick a seat when they buy the ticket, they're in the last group to board, and they can only carry a small item that fits under their seat. With a few exceptions, they must pay extra to check a wheeled bag that other economy-class travelers can put in the overhead bin.
But the fares are cheaper.
The savings over a regular economy ticket appear to range from about $24 to $40 for a round-trip ticket on American and United. For example, on two random early-March itineraries between Dallas and Baltimore, economy tickets were listed on American's website at $249 and $309. Those same trips were priced at $209 and $269 on basic economy.
Even on the routes where American sells the new fares, they are usually available only on a small number of flights — sometimes one or two a day — and on some days, none at all.
Bargain hunters will see more basic-economy options when searching one-way flights, rather than round trips, because American will not allow flyers to buy a round trip that combines the new cheaper fare on one leg with a regular economy fare on the other. On one-way flights, the price break can be as little as $12.
American, the world's biggest airline, said it will eventually add basic-economy fares on other routes.
The United offering is even more limited — it only appears on some flights between Minneapolis and seven United hubs around the country. United said it started small to ensure a smooth rollout, but plans to expand the idea to the rest of the U.S., the Caribbean and the closest destinations in Latin America.
Basic economy fares were introduced by Delta Air Lines several years ago in response to growing competition from discounter Spirit Airlines. Spirit and Frontier Airlines offer bargain-basement fares but add on more fees than the bigger airlines, including charging for use of overhead bins. They have gained ground among travelers looking for the cheapest price.
Delta now offers basic economy on about 40 percent of its U.S. routes and plans to cover its entire domestic network by mid-year.
The major airlines are losing customers whose internet searches skip American, United and Delta because of higher economy fares, industry consultant Robert Mann said.
The new discount fares could help the big airlines by stimulating new demand and because some people who intend to buy a rock-bottom fare will pick a traditional economy ticket instead, Mann said. Airline websites warn buyers of the restrictions on basic-economy tickets.


LG Electronics India Limited (LG) today announced that it will launch the LG G5, its flagship smartphone for 2016, in India in the next quarter. The handset, unveiled at the recent Mobile World Congress (MWC) in Barcelona, has already garnered over 33 awards and commendations from some of the most renowned publications and blogs making it one of the best received smartphones so far.
The LG G5 comes with a brand new design with a sleek, metal uni-body featuring a slide-out Battery tray and a Modular Type design that enhances the overall smartphone experience. The handset comes encased in a sleek metal aluminum body, surpassing the visual experience of its predecessor. Its 135-degree, wide angle lens allows you to get more in the shot. It's always-on Display makes notifications just a glance away with the time and date available anytime. The 3D Arc Glass featured in the smartphone's 5.3-inch display creates a gentle curve and a smooth colorful metal surface formed through an advanced microdizing process takes the anodized aluminum finish to a whole new level.
The smartphones described with this article has a great influence in our society. Thanks for this great set.


text:
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news, gossip, photo gallery, movie sites, audio reviews, discussions, usa movie schedules
Idlebrain.com Ilayaraja Exclusive by RS Balaji
A Technical Celebration of Music - Part 1
Song: Tarali Radha Thanae Vasantham…
Film: Rudra Veena
Scale : Hamsadwani
This is the first in the series of articles celebrating the music of Maestro Ilayaraja, from a technical standpoint. The article treats the Maestro's music as a textbook on music composition and presents certain technical and non-technical nuances in his music that may be of interest to students of music composition and orchestration as well as to listeners with a technical background in carnatic and western classical music.
The content presented in this article is just an observation made by the author. Please feel free to indicate any analytical errors that you may find.
This song is based on the symmetric pentatonic scale Hamsadwani (sa ri ga pa ni / C D E G B). In the film, the song plays the role of an entertainer for laborers who are cutting down the woods. Hence the song maintains a lively mood, in general. Note the composer's choice of the scale to evoke this mood. This scale does not have any note pairs with semitonal intervals between them.
The song presents a perfect usage of the Hamsadhwani raga in film music. The pallavi features certain important slides (gamakas) in this raga. The oscillation of the lower ni at the end of the first melody and the slides between ri and ga (in the words gaganaala dhaka….) reflect the image of the raga.
In the charanam of this song, the composer shows the scope of a simple scale like Hamsadhwani. He explores a variety of interesting phrase combinations in this scale. The phrases in general, alternate between ascent and descent i.e. a phrase in the descent is followed by an ascent and vice versa. The first portion of the charanam features a straightforward flow of notes in sequence. This followed by the line "prati madhini…." which connects two different phrases in a interesting manner. The first one (Ri Ri Sa ni Sa Ri Ri) lands on the higher Ri and the second one (ri ri ga pa ga ri) takes off on the middle ri. The sudden shift in the octave is unexpected.
The next line that follows (aedhi sontham kosam ….) sounds a surprisingly long interval between notes: lower ni to the higher Ri. The last portion of the charanam (idhi theliyani…). features the dhatu prayogam (phrase with alternate notes in a sequence) thus bringing out the true image of Hamsadhwani. (Once again note the unusual interval between the previous melody and this one!)
A possibility for using these interesting phrases which sway over three different octaves, could be linked to the underlying situation of the song in the film which demands a active mood.
The interludes in this song follow a certain pattern (vaguely analogous to the concept of forms in western classical music). They comprise of a long flute piece followed by a short counterpoint. The percussions do not sound in the first and last few bars of both the interludes. The guitar and bass lines back up the rhythm pattern throughout the interlude (a typical Ilayaraja!). The three-voice counterpoint at the end of the second interlude is lead by a melody on the flute (from a keyboard). The first part of this melody contains a phrase and its variation (towards the end). It goes as follows: B C B- G B- C B B C B- G E -B C D B. Notice that the first four notes are similar in both the phrases. This pattern is typically found in many of Ilayaraja's melodies. The first two tunes in the charanam also follow a more or less similar pattern.
Thanks to Maestro Ilayaraja, for this wonderful musical lesson!.
- RS Balaji
Tell Balaji how you liked this article
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Continuing its gains for the third consecutive session, the rupee today rose by 13 paise to 53.67 against the dollar in early trade on the Interbank Foreign Exchange market, on sustained selling of the US currency by exporters. Forex dealers said euro's gains against the dollar after the US Federal Reserve opted to keep its easy-money policies in place on the back of lacklustre economic data, also supported the rupee.
The rupee had gained 45 paise to close at nearly three- month high of 53.80 against the dollar in the previous session on Tuesday. The Forex and money markets were closed yesterday for 'Maharashtra Day'.
Meanwhile, the BSE benchmark index Sensex fell by 52.92 points, or 0.27 per cent, to 19,451.26 in early trade today.


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Fordlândia: Henry Ford's Failed Industrial Community in the Amazon
April 27, 2022 Clare Fitzgerald
Photo Credit: Colin McPherson / CORBIS / Getty Images
Deep in the heart of the Amazon Rainforest are the remains of Fordlândia, an abandoned industrial town built by Henry Ford. Intended to bypass East Asia's monopoly over the world's rubber supply, it wound up being a massive failure, costing Ford millions of dollars.
Establishment of a colony in the Amazon
In the 1920s, Henry Ford and his company, Ford Motor Company, were looking for a way to bypass purchasing rubber from East Asian companies, which held a monopoly over the production and supply of the material. Ford decided the best course of action was to set up a colony solely dedicated to its production, and while Central America was at first considered, the decision was made to set up shop in Brazil.
Photo Credit: Joel Auerbach / Getty Images
Ford was attracted to the country after hearing about the rubber trees that grew in abundance in the Amazon. To create his new town, the businessman negotiated a deal with the Brazilian government, in which he was granted 10,000 square kilometers of land in exchange for a nine percent share of the profits. Seven percent would go directly to the government, while the remaining two percent went to local municipalities.
Construction of Fordlândia
Ford's aim was to build a prefabricated town capable of housing up to 10,000 people. Construction began in 1926, and was immediately hindered by a number of factors, including poor logistics and workers succumbing to tropical diseases, such as malaria and yellow fever. There was also no direct road access to the area, which was along the Rio Tapajós, approximately 300 kilometers south of the city of Santarém.
Fordlândia was built to mirror the amenities offered in the United States. American-style houses were built, as were a hospital, power plant, library, school, swimming pool, sawmill, three-story warehouse, golf course and a playground. As the town's population grew, restaurants, bakeries, shoemakers and butcher shops were also erected.
Ford Motor Company sent two merchant ships, the MS Lake Ormoc and Lake Farge, to Fordlândia in 1928. The vessels carried a host of equipment and furnishings, including a 50-meter-tall water tower that was constructed in Michigan. It eventually became the town's symbol.
Operations begin in Fordlândia
Seeking local workers, offices were opened in the nearby cities of Belém and Manaus, and before long Brazilians flocked to Fordlândia to work and reside alongside the town's American managers. It was a tough job. Given the weather conditions, work typically began around 5:00 in the morning and ended at noon. The operation was also divided into different sections, to prevent workers from tapping the same trees successively.
The Brazilian workers were forced to live under strict rules that made it mandatory to live a "healthy lifestyle." They were forced to attend square dances, poetry readings and English-only singalongs, and were forbidden from partaking in alcohol, tobacco use, playing football and engaging sexually with women.
They were also prevented from eating local food – instead given "Americanized" meals – and were made to wear ID badges and work under the hot tropical sun.
To ensure these rules were followed, inspectors would travel from home to home. To circumvent this, contraband was hidden on merchant riverboats and in fruit. As well, a settlement with nightclubs, bars and brothels was set up eight kilometers upstream.
Synthetic rubber and disease led to the town's decline
It wasn't long before Fordlândia began to experience a decline. The land was rocky and infertile, and none of the American managers sent to oversee its operations knew much about tropical agriculture. They failed to realize that rubber trees needed to be planted apart, to protect them from disease and infestation, and before long they were covered with lace bugs, ants, tree blight, leaf caterpillars and red spiders.
Another factor in the town's decline was the Brazilian government's suspicions of foreign investment, meaning it offered little help to Ford.
By 1930, the majority of employees began to refuse work, culminating in a revolt in the town's cafeteria. They cut the telegraph wires and chased the managers into the jungle, where they stayed until the Brazilian Army stepped in to mediate. In the end, an agreement was reached regarding the food the workers were served.
In 1934, Fordlândia was abandoned and the town relocated to Belterra, downstream from the original location. While the conditions were better, things declined in 1945 with the advent of synthetic rubber. Due to this, Ford's grandson, Henry Ford II, sold both towns back to the Brazilian government at a loss of over $20 million.
The Brazilian government tries to rejuvenate Fordlândia
Between the 1950s-70s, the Brazilian government, via the Ministry of Agriculture, set up several facilities in Fordlândia. The houses formally inhabited by Ford's employees were given to the families of Ministry workers, whose descendants continue to occupy them.
Unfortunately, the project was short-lived, largely due to the lack of basic services in the area. For example, medical care could only come to the area by boat. As Ford had before, the Brazilian government abandoned the town.
Fordlândia's population is steadily growing
While Fordlândia was largely abandoned, its population began to steadily rise, beginning in the early 2000s. In 2017, it was estimated that around 3,000 people were occupying the desolate and rundown town.
While the majority of the original buildings are still standing, they are showing signs of wear. The sawmill and its kiln are still standing, but most of the equipment is gone, and the warehouse has been turned into a storage building, housing old hospital beds, a lead coffin, various types of equipment and parts of an X-ray machine. The wooden floor on the second story has largely rotted away, leading to its collapse in some areas.
The water tower, water treatment plant and their original plumbing are still operational, and all but one of the houses in the American Village remain standing. While many were left filled with clothes, silverware and furniture, much of that has been sold by those who have since moved into the residences.
More from us: The Crystal Palace was a Symbol of Victorian England Until It Burned to the Ground
The hospital remained standing until the late 2000s, when looters removed its contents and dismantled the structure. It was the subject of intense controversy, as multiple boxes containing radioactive material used for its X-ray machines were left behind, raising fears of contamination in the area.
« The Crystal Palace Was a Symbol of Victorian England Until It Burned to the Ground
Joyland: A Once-Thriving Amusement Park That Now Sits Open To Looters »


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Year : 2011 | Volume : 1 | Issue : 1 | Page : 5-12
Anaesthetic management of patients with peripartum cardiomyopathy
Rashmi Ramachandran, Vimi Rewari, Anjan Trikha
Department of Anaesthesiology, All India Institute of Medical Sciences, New Delhi, India
Anjan Trikha
Room Number 5020, Department of Anaesthesiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029
Peripartum cardiomyopathy (PPCM) is a disease affecting the parturient during late pregnancy or immediately after delivery. This unique disorder not just endangers the life of mother and progeny but is also a financial burden to the health system due to its potential to cause prolonged and persistent cardiac function insufficiency in the mother. The hallmark of the disease is onset of decreased cardiac ejection fraction either in the late pregnancy or early puerperium. Over the last few decades, the disease has been extensively researched and investigated to formulate diagnostic guidelines and therapeutic approaches. Many theories regarding its pathophysiology have also been proposed. The clinical presentation and the basic and intensive interventional strategies of the disease are more or less similar to that of dilated cardiomyopathy due to any other cause; however, at all points of time the pregnant or lactating state of mother and the subsequent effect of the medication and therapeutic interventions on the fetus or neonate needs to be considered. Apart from intensive care management, these patients may also require anaesthetic intervention for management of painless labor and/or either vaginal or operative delivery. Favorable maternal and fetal outcome require that the basic hemodynamic goals be always kept in mind while choosing the techniques and drugs to provide anaesthesia to the patients with PPCM. Literature search of the anaesthetic management of patients with diagnosis of PPCM undergoing operative delivery reveals both general and regional anaesthesia being used with comparable outcomes.
Keywords: Anaesthesia, cardiomyopathy, heart failure, peripartum, pregnancy
Ramachandran R, Rewari V, Trikha A. Anaesthetic management of patients with peripartum cardiomyopathy. J Obstet Anaesth Crit Care 2011;1:5-12
Ramachandran R, Rewari V, Trikha A. Anaesthetic management of patients with peripartum cardiomyopathy. J Obstet Anaesth Crit Care [serial online] 2011 [cited 2020 Jan 21];1:5-12. Available from: http://www.joacc.com/text.asp?2011/1/1/5/84249
Peripartum cardiomyopathy (PPCM) was first reported in the year 1849. [1] Till the middle of 20 th century it was known as postpartal cardiomyopathy [2],[3] as most of the cases reported had symptomatic onset in the postpartum period only. Demakis et al.[1],[4] were probably the first to realize this as more of a peripartum disease rather than a postpartum one, hence the term peripartum cardiomyopathy was considered more acceptable. The first case series of patients with PPCM was published in the year 1971 [4] by Demakis et al. They described the data about 27 patients who presented in the late pregnancy or early puerperium with heart failure. The authors themselves devised a diagnostic criteria that included development of cardiac failure in the last month of pregnancy or within 5 months of delivery, absence of a determinable aetiology for the cardiac failure and absence of demonstrable heart disease before the last month of pregnancy. [2] Over the years, the diagnostic criteria have remained almost the same with the addition of echocardiography findings as another parameter. [5] As more and more research is being conducted, a lot more is now known about the pathophysiology, epidemiology, diagnosis and clinical outcome of the disease. At the same time, the unique anaesthetic challenge that these patients pose for management of their pregnancy was also recognized. This review will undertake a comprehensive look on the above and give a detailed account of the treatment modalities available for this disease in present times.
Definition and Diagnostic Criteria
One of the most recent definitions of PPCM has been provided by the Heart Failure Association of the European Society of Cardiology Working Group on PPCM which describes it as "an idiopathic cardiomyopathy presenting with heart failure secondary to left ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery, where no other cause of heart failure is found. It is a diagnosis of exclusion. The left ventricle may not be dilated but the ejection fraction is nearly always reduced below 45%." [6]
Earlier, in the year 1997, the National Heart, Lung and Blood Institute and the Office of Rare Diseases of the National Institutes of Health had convened a Workshop on Peripartum Cardiomyopathy to foster a multidisciplinary review and defined the diagnostic criteria [5] based on the work by Demakis et al.[2] [Table 1]. This definition was being followed comprehensively till now, but the European Society definition claims to be more simplified and capable of preventing underdiagnosis of the disease.
Table 1: Criteria for diagnosis of peripartum cardiomyopathy*
Actual incidence of PPCM has not been clearly evaluated in the Indian subcontinent. Pandit et al. report it as 1 in 1374 live births from a tertiary referral hospital from South India, [7] Hasan et al. state this as 1 in 837 in their analysis from Pakistan, [8] while Chee et al. report the incidence as 34 per 1,00,000 live births in a hospital from Malaysia. [9] The incidence of the disease world over has also a wide range with the occurrence of the disease in 1 in 2000-4000 live births in the Unites States, 1 in 1000 live births in South Africa and the highest being reported from Haiti (1 in 300). [10] Many risk factors have been implicated in the development of this disease condition which include advanced maternal age, multiparity, Afro-American race, twin pregnancy, pre-eclampsia and gestational hypertension and diabetes. Use of tocolytics, high sodium salt, deficiency of certain micronutrients and smoking during pregnancy have also been implicated. [9]
Several mechanisms have been postulated to explain the pathogenesis of PPCM although no single factor has ever been implicated in all the cases. The disease is now known to have a multifactorial pathogenesis.
Myocarditis has been shown to be associated with PPCM although the incidence spans a wide range (8.8-78%) [11],[12] in different studies. Bultmann et al.[13] took endomyocardial biopsy from 26 patients with PPCM and analyzed the specimens for detection of viral genomes by polymerase chain reaction. The specimens of eight patients (31%) showed presence of various viral genomes (parvovirus B19, human herpes virus 6, Epstein-Barr virus and human cytomegalovirus). They postulated that changes in immune function during pregnancy may have exacerbated de novo infection or reactivated latent virus in the pregnant females leading to viral myocarditis followed by cardiomyopathy. Activation of autoimmune response has been cited as another causative factor with compelling evidence supporting it. Sera from PPCM patients contain high titres of autoantibodies against normal human cardiac tissue proteins that are not present in the sera of patients with idiopathic cardiomyopathy. [14] Antibodies against fetal cells (which may escape into maternal circulation) and various proteins, such as actin and myosin, released from uterus during delivery have been demonstrated in patients with PPCM. These autoantibodies may cross-react with maternal myocardial proteins and lead to PPCM. [15] In addition, the peripheral blood from PPCM patients demonstrate an abnormal cytokine profile, decreased levels regulatory T cells and a significant reduction in the plasma levels of progesterone, estradiol and relaxin when compared with other normal pregnant non-PPCM patients. [16] Another hypothesis postulated is that PPCM may be an abnormal cardiac response to hemodynamic changes associated with pregnancy. A reversible decrease in left ventricle systolic function has been demonstrated in normal pregnant patients in the second and third trimester. [17] A magnified decrease in left ventricle function in association with increase in cardiac output and decrease in systemic vascular resistance which occurs in late pregnancy can explain features of PPCM. [15] However, scientific evidence to confirm this hypothesis is lacking. Other probable mechanisms proposed are an accelerated myocyte death (apoptosis), increase in proinflammatory cytokines, excessive prolactin production and coronary microangiopathy. [15] A few reports of familial association of the disease have also appeared which may warrant further evaluation for a probable genetic cause of the disease. [18],[19]
Clinical Features and Diagnosis
Clinical features of PPCM are similar to those seen in any cardiac failure. Women in either third trimester of the pregnancy or early peurperium presenting with palpitations, fatigue, shortness of breath, cough and paroxysmal nocturnal dyspnea or orthopnea should raise the doubt of PPCM, especially when the prenatal history has been otherwise uneventful. [10] Other additional features such as abdominal discomfort, dizziness, precordial pain and postural hypotension may also be seen. Majority of patients become symptomatic in the postpartum period. [20],[21] In a prospective follow-up study of 56 patients, Mishra et al. found that 62.5% of the patients presented in the postpartum period, [20] while a similar follow-up study of 33 patients from a hospital in Turkey found the postpartum manifestation of disease in 72.7% of the patients. [22] Clinical signs of PPCM include pedal edema, pulmonary rales, raised jugular venous pressure, hepatomegaly, new regurgitant murmurs and gallop rhythm depending on the severity of disease. Diagnosis of PPCM can be confounded by the presence of some of the mild form of these symptoms in an otherwise healthy parturient also, especially in the late pregnancy or early peurperium. The diagnosis is essentially by exclusion of other causes. Once heart failure has been confirmed in a pregnant patient, it is imperative to rule out other causes of heart failure such as valvular lesions, congenital heart diseases, hypertensive or ischemic heart disease, severe anemia and thyrotoxicosis. The presenting symptom in most of the patients is dyspnea on exertion (NYHA-III or IV) although patients may present with complex arrhythmias [23] or with signs and symptoms of peripheral or pulmonary embolic episodes [24] or even cardiac arrest. Routine blood investigations are required to rule out anemia, electrolyte dysfunction and kidney, liver, or thyroid abnormality. Chest x-ray may reveal radiological signs of heart failure such as cardiomegaly, pulmonary congestion and pleural effusion. Multiple ECG changes have been described in patients with PPCM. In a study undertaken in South Africa involving 97 patients diagnosed with PPCM, 96% had ST-T wave abnormality and 66% of the patients had changes suggestive of left ventricular hypertrophy. [25] Duran et al. identified QRS time of equal to or more than 120 ms in the ECG of patients with PPCM as a predictor for mortality, indicating a potential impact of QRS time on the mortality of patients with PPCM. [22] Echocardiography needs to be done in all the patients suspected with PPCM to clinch the diagnosis. Typical findings include a dilated left ventricle, increase in end-diastolic left ventricular diameter and an ejection fraction less than 45%. Presence of left ventricle clot should also be ruled out by echocardiography. A left ventricular end-diastolic diameter of more than 55 mm or an ejection fraction of less than 27% in echocardiography predicts poor long-term prognosis in these patients. [22] Cardiac magnetic resonance imaging provides more accurate measurement of cardiac dimensions and functions and can also be used to guide the site of myocardial biopsy if required. [26]
The goals of medical management in a patient diagnosed with PPCM should include measures to improve oxygenation and maintain cardiac output so as to improve both maternal and fetal outcome. Interventions are required to decrease both preload and afterload as well as to improve cardiac contractility.
Mild to moderate symptoms may be managed with rest, salt restriction and diuretic therapy. Oxygen may be instituted via face mask, or continuous positive airway pressure may be applied up to a level which does not further jeopardize the cardiac output. Salt restriction helps in preventing further water retention, while diuretics help in decreasing pulmonary congestion. Fluid restriction may not be warranted in patients with mild to moderate heart failure. [27] Hydralazine and nitrates decrease the afterload and are the mainstay of treatment in pregnant patients with heart failure. Calcium channel blockers, except amlodepine, have a negative inotropic effect and should be avoided. Amlodepine may be used if PPCM is associated with pre-eclampsia to control blood pressure. ACE inhibitors, both direct acting or receptor blockers, although the first line of drug for patients in heart failure due to any cause, are however, contraindicated in pregnant females due to the risk of fetal toxicity associated with them. [28] They, however, should be used in all symptomatic patients in the postpartum period and are safe for the breastfed infant. Beta-blockers such as metoprolol decrease the heart rate, improve left ventricular diastolic function and protect against arrhythmias but are only used as a second line of treatment as their prolonged usage in the prenatal period is associated with low-birth weight of the baby. However, their use is considered safe during lactation. Digoxin may be indicated in certain patients for its inotropic effect. Although it is a safe drug to be used during pregnancy and puerperium, its plasma level needs to be strictly maintained in the therapeutic range with close monitoring. [29] Anticoagulation is recommended in patients with PPCM, especially if the ejection fraction is less than 35% and there are other associated risk factors such as severely dilated ventricles, atrial fibrillation and presence of mural thrombus on echocardiography or history suggestive of previous thromboembolic episodes. The risk of venous thromboembolism is per se increased in pregnant patients and associated heart disease and bed rest (if advised for heart failure) may further increase the risk of development of this complication. [30] Warfarin is teratogenic in early pregnancy and can cause fetal warfarin syndrome, while intake in the second and third trimester may lead to fetal cerebral hemorrhage, microcephaly, blindness, deafness and growth retardation. Unfractionated heparin on the other hand has low bioavailability in pregnant patients and is associated with thrombocytopenia. Thus, low-molecular-weight heparins are preferred in pregnancy as they do not cross the placenta, have a lower risk of osteoporosis and thrombocytopenia and their bioavailability is more predictable. [31] In the postpartum period, thromboprophylaxis may be continued with warfarin if required as it appears in the breast milk in very insignificant quantities.
If the patient presents with acute failure, it is important to undertake urgent steps to achieve above goals. Such a patient would usually be managed best in an intensive care unit. The patient is nursed in a propped up position with continuous hemodynamic and oxygenation monitoring which may warrant central venous and arterial cannulation. Pulmonary artery wedge catheter may also be required in patients on high dose of multiple cardiac drug infusions. Noninvasive ventilation with suitable positive end expiratory pressure may be instituted if oxygen by simple face mask fails to improve SpO 2 more than 95%. In case invasive ventilation is required, standard precautions regarding potential for aspiration in a pregnant patient should be taken. Loop diuretics may be more amenable in a patient in acute failure for their efficacy. Nitroglycerine should be given via intravenous infusion to decrease afterload if the systolic blood pressure is more than 110 mm Hg. Nitroprusside, however, may be relatively contraindicated in pregnant patients due to risk of thiocyanate and cyanide accumulation in the fetus. Nitroglycerin (NTG) should be titrated to effect starting from a dose of 10-20 μg/min up to a maximum of 200 μg/min. Dobutamine, dopamine and milrinone can be used to provide inotropic support to the failing heart. These inotropes along with nitroglycerine can be used in pregnancy if conditions exist to warrant their use. [32] Levosimendan is another novel cardiotropic agent that improves cardiac output by increasing the response of myofilaments to intracellular calcium unlike the above mentioned traditional inotropes that do so by increasing the intracellular calcium itself. Levosimendan has been proven to be effective in improving the cardiac output and decreasing mortality [33],[34] in patients with severely low output cardiac failure; however, its safety and efficacy in PPCM have not been evaluated by randomized controlled studies although reports of its successful use in this condition are there in the literature. [35],[36] Levosimendan is used as an intravenous infusion at the rate of 0.1-0.2 μg/kg/min in cardiac failure with or without a loading dose of 3-12 μg/kg over 10 minutes. [37] Hemodynamically unstable pregnant patients who are on multiple drugs should also undergo intensive fetal monitoring and continuous evaluation by obstetricians to prevent fetal loss.
Mechanical assist devices and extracorporeal membrane oxygenators have been used in these patients if medical therapy fails to improve cardiac status. These devices can be used as bridging therapy as in most of the patients partial or complete recovery can be expected within a year of delivery. [38] Up to 11% of patients will eventually require cardiac transplantation. [6]
Anaesthetic Management
It was not until 1985 when the first report of a patient undergoing caesarean section under anaesthesia with PPCM was reported. [39] A literature review done with PPCM and anaesthesia as key words on Pubmed revealed 41 results in English language. A further search on Google revealed another five articles. A total of 46 articles were analyzed, out of which there were six review articles and two reports describing management of patients with familial dilated cardiomyopathy during pregnancy. The 38 case reports were further sieved for postnatal and prenatal diagnosis. Out of these 38 reports, 22 described patients who were diagnosed as PPCM after delivery of the child, either operative or vaginal. The rest of the 16 reports describe 17 patients who had prenatal diagnosis of PPCM and underwent LSCS under anaesthesia. In the latter group of patients, anaesthetic management included general anaesthesia, regional anaesthesia, or both. The data have been tabulated [Table 2] and [Figure 1] for further elucidation.
Table 2: Salient features in anaesthetic management for caesarean section of patients with preoperative diagnosis of peripartum cardiomyopathy
Figure 1: Flow Chart depicting the type of anaesthesia used in various case reports describing patients with peripartum cardiomyopathy undergoing caesarean section. GA: General Anaesthesia, EA: Epidural Anaesthesia, CSE: Combined Spinal Epidural, SA: Spinal Anaesthesia
Patients with prenatal diagnosis of PPCM need to be treated by a multidisciplinary approach with cardiologists, anaesthetists, intensivists and neonatologists being actively involved in the obstetric management. Issues such as whether the pregnancy should be allowed to reach term and the mode of delivery need to be addressed by the team with a tailored approach according to the patient's medical status on a periodical basis. In general, unless there is deterioration in the maternal or fetal well-being, there is no need for urgent or emergent delivery and the pregnancy is allowed to progress to term. The patient may be allowed to deliver the baby vaginally or operatively according to obstetric parameters or patient's wish. The vaginal delivery needs to be done with continuous hemodynamic monitoring and even invasive monitoring has been advocated according to patient's profile. [6] Pain and anxiety associated with labor can increase sympathetic nervous system activity with a resultant increase in cardiac output and peripheral vascular resistance leading to an increase in cardiac afterload. This sympathetic activity also decreases uteroplacental outflow, thus jeopardizing an already compromised fetus. Effective labor analgesia decreases sympathetic outflow and decreases plasma catecholamine levels in the mother. [40] Multiple modalities of labor analgesia can be provided to these patients to prevent increase in cardiac afterload associated with labor pains, but regional anaesthesia (RA) remains the method of choice as the sympathectomy associated with it causes a decrease in cardiac preload and afterload which is beneficial in patients with PPCM. [6],[10],[41] RA, however, may be contraindicated in an anticoagulated patient.
The second stage of labor during vaginal delivery needs to be curtailed by application of forceps or vacuum to expedite the delivery of the baby. It is important to prevent any fluid overload during labor and delivery.
As outlined in the flow chart, multiple modes of anaesthesia have been described in the literature for operative delivery of patients with PPCM. The hemodynamic goals of anaesthesia, however, are common to all approaches. These are to reduce cardiac preload and afterload and to prevent any decrease in the already compromised cardiac contractility. Any technique or drugs resulting in sudden fall in systemic vascular resistance should be avoided. and careful titration of both intravenous and local anaesthetic drugs is important. Wherever possible, it is important to institute invasive monitoring including blood pressure and central venous pressure before commencement of anaesthesia. Perioperative use of pulmonary artery catheter and transesophageal echocardiography has been described in patients with severely depressed cardiac function [42],[43] [Table 2]. In general, RA has been used in patients undergoing nonemergent caesarean section with relatively stable hemodynamics, while moderately symptomatic patients or parturients undergoing emergency surgery have received general anaesthesia (GA). General anaesthesia will have to be given rapidly in a pregnant female to avoid risk of aspiration which may be detrimental in a patient with heart failure at the same time complications of GA such as failed intubation may be avoided by choosing continuous epidural anaesthesia (CEA) as anaesthetic technique. Infiltration anaesthesia has also been described in a patient for caesarean section although the patient died eventually in the postoperative period. [44]
Techniques of RA used include combined spinal epidural (CSE) in six patients, [43],[45],[46],[47],[48],[49] continuous spinal anaesthesia (CSA) in two patients, [42],[46] and CEA in two patients. [50],[51] RA provides many advantages for patients with PPCM. Sympathetic blockade associated with RA is beneficial in a decompensated heart as it decreases both preload and afterload. Use of a catheter gives freedom of titrability of the local anaesthetic drug both in epidural and intrathecal space. Thus, the level of motor and sensory block can be gradually increased so as not to cause sudden hypotension which can lead to sudden decompensation in these patients. Schnaider et al. describe CSE in a morbidly obese patient with an ejection fraction of 20% who underwent caesarean section successfully under RA and had an uneventful perioperative course. [47] They preferred CSE over CEA as it has lower failure rate, better patient satisfaction and pain scores and superior hemodynamic profile than the CEA. Velickovic et al. advocate CSA for its more rapid and effective titrability. [42],[46] They inserted a 19-G flexible single orifice catheter in the intrathecal space and gave small boluses of bupivacaine with fentanyl in dextrose to achieve the desired level of anaesthesia. [42] The catheter was left in situ for several hours postoperatively for management of postoperative pain and possible postdural puncture headache. George et al. have described the management of a patient with PPCM with CEA using bupivacaine with fentanyl in which the level of anaesthesia was slowly allowed to develop over 6 hours. [51] They enumerate many advantages of CEA which include avoidance of cardio-depressant general anaesthetic drugs, easy and slow titrability and improvement in cardiac function due to decrease in cardiac preload and afterload.
GA has been described in six patients. [43],[52],[53],[54],[55],[56] The choice of anaesthetic technique is the anaesthetist's prerogative and if the goals of hemodynamic management are adhered to, the outcome can be expected to be favorable of the anaesthetic technique used. For any urgent or emergent lower segment caesarean section (LSCS), GA is preferred. GA is also preferred in patients with borderline cardiac decompensation as an already dyspneic patient may not be amenable to the procedure of RA. In such a patient, even minor degrees of sympathetic blockade associated with RA may lead to fulminant cardiac failure. Another contraindication to RA is the anticoagulated patient. McCarroll et al. describe the caesarean section in a patient with PPCM under GA with use of remifentanil and propofol. [56] Remifentanil was chosen for its efficacy in controlling intraoperative stress response and rapid recovery independent of duration of infusion. They feel that the hemodynamic responses of the patient during a general anaesthetic technique using appropriate agents are more predictable than those seen with RA. Similarly, Zangrillo et al. believe that potential benefits of cardiovascular effects of RA may not be greater than the risks of maternal hypotension and low cardiac output in such a patient. [54] Excessive reduction of preload may worsen cardiac output, while the decrease in after load can actually jeopardize coronary perfusion in some patients. Opioid-based anaesthesia provides good hemodynamic control and obtundation of response to endotracheal intubation but may require postoperative ventilatory support for both mother and neonate. Thus, it is obvious that favorable maternal and fetal outcome is not dependent on anaesthetic technique, but strict hemodynamic control and meticulous cardiovascular monitoring with close coordination between various involved specialists. Use of other nonanaesthetic drugs intraoperatively should be done with caution. Ergometrine should preferably be avoided and oxytocin should be given as an infusion or slowly titrated to response. Autotransfusion after delivery can be countered by a small dose of furosemide just before delivery of the baby.
PPCM is a disease associated with high morbidity and mortality and can lead to maternal and fetal loss and persistent decrease in quality of life in mother. Early diagnosis, continued monitoring and prolonged therapy may be beneficial in a good amount of patients. Principles of therapy remain more or less same as that in heart failure due to any cause, but careful selection of drugs is important with due consideration to the pregnant or lactating mother. The anaesthetists may be involved in the intensive care management of an acutely decompensating patient or anaesthetic management of labor and operative or nonoperative delivery. In all the situations, careful and intense hemodynamic monitoring and slow and judicious titration of anaesthetic drugs is important to provide good maternal and fetal outcome.
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text:
A 12″ MacBook Pro: I Don't Think So
Trevor Wale - 2007.04.26
2007 – There have been a number of rumours and columns on various Mac websites suggesting that Apple could be preparing to release a "true" replacement for the 12″ PowerBook G4.
Dreaming of a 12″ MacBook Pro
The general consensus is that it would constitute a 12″ widescreen MacBook Pro. It would sit between the high-end 13″ black MacBook and the lower end 15″ MacBook Pro. To make it stand apart from the consumer MacBook line, the 12″ model would sport an anodized aluminum shell and include a graphics chipset with dedicated video memory like its larger siblings.
Additionally, you would get all of the new Macintel bells and whistles, such as a Core 2 Duo CPU, built in iSight, Front Row and the remote, a super fast front side bus, and all of the other benefits the Intel transition has brought to Apple notebooks.
You would have all of this for a couple of hundred pounds more then the high-end black MacBook.
How I See It
This is how I would see Apple positioning such a product – and to be honest I would welcome a 12″ MacBook Pro. Having been an owner of 12″ PowerBook G4 that was a joy to own, I was one of the many Mac fans who mourned its death and subsequent "replacement" by the 13″ MacBook.
Apple stated that the 13″ MacBook is its spiritual successor, but I'm not satisfied. As far as I'm concerned, the MacBook has nothing to do with the 12″ PowerBook. It's larger, uses "vampire video", has a polycarbonate case, and, well, just has none of the "cool factor" or obvious superiority that the 12″ PowerBook had over the iBook (the PowerPC equivalent of the MacBook).
There was something about the 12″ PowerBook that was just so damn cool. It was absolutely tiny – what would practically be considered a subnotebook in the Windows world – but with none of the shortcomings. Every time I removed it from my bag and opened it up, you could almost hear the gasps of awe that would emanate from onlookers. The same thing would happen with most Apple laptops, but with the 12″ PowerBook it was just little more prevalent. All of these factors make me crave a 12″ MacBook Pro.
Don't Expect to See It
Unfortunately, I just don't think it's going to happen. The bottom line is that Apple feel that they have already provided us with a replacement, the 13″ MacBook.
If Apple were seriously intending to replace the 12″ PowerBook with an equivalent MacBook Pro, they would have done it by now. Apple wasted no time in replacing the rest of the Mac line with an Intel version, and a 12″ pro laptop was notable by its absence. By August of 2006, Apple seemed content that they had released every possible Macintel model, and if they felt a 12″ MacBook Pro was necessary, it would have arrived with the MacBooks at the latest. There would be nothing to gain in delaying its release.
I get the impression that Steve Jobs was becoming paranoid that the complexity of the PowerPC Mac line was descending back to the levels of mid 90s convulsion. At one point Apple had several iterations of Macs in an entry, middle, and higher end product matrix, and Jobs did some fine work in pushing aside the clutter and starting again upon his return to the company.
Perhaps he saw the Intel transition as an opportunity to streamline the product matrix, and a 12″ laptop is a casualty of that. Another model might be seen as an unnecessary embellishment on a pristine and compact product line.
As a result of this, the 12″ PowerBook G4 will become a collectors item for people who want a capable Mac that's smaller than any of the current lineup.
The only way to persuade Apple otherwise is to kick up a fuss on websites like Low End Mac and hope Mr. Jobs takes note while he's eyeing up his own 12″ PowerBook.
Update: Apple partially addressed this with the 13″ aluminum MacBook in October 2008, which became the 13″ MacBook Pro in June 2009. It was wider than the 12″ PowerBook G4, but about the same depth. Apple finally released a 12″ aluminum MacBook (although not a MacBook Pro) in March 2015 – nine years after the Intel transition had begun.
Keywords: #12inchpowerbook #12inchpowerbookg4
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