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Exploring Jardin Majorelle
For our last few days in Morocco, we headed back to Marrakech for a brief stopover before making our way to the coast to see El Jadida and then on to Casablanca to catch our flight home.
Our base for our second stint in Marrakech was another riad booked through Airbnb, this time in a different part of the medina. The new location was definitely easier to find than the last one, though it was by no means simple. Being in a different part of town (roughly a 40 min walk across the centre of the medina from our last one) meant that we had easy walking access to some new restaurants and the Jardin Majorelle, the last attraction on our list for this trip.
The riad itself wasn't nearly as nice as the first one. It's not that there was anything wrong with it, the bar had just been set too high. This one did have two pools, which was lovely. The one on the roof, as last time, was really a cold jacuzzi. In addition there was a larger heated pool in the centre of the riad on the main floor . Otherwise it was more dated and clearly used solely for guests, unlike the last one which was a second home for a couple and felt that way.
The femme de menage, Leila, greeted us when we arrived then hung around with her friend awkwardly while we got settled in. Eventually they left, but this was a bit of a theme with her sitting in another room on her phone while we were eating or swimming. Not a big deal, but a little odd. In short, she was definitely no Saida.
Restaurants in Marrakech
This time around we were in Marrakech for two nights which gave us a chance to try two more restaurants. Nomad and L'Altitude 31.
In general the food in Morocco has been good, but not amazing. In Marrakech, we ate well for cheap after our bike tour and the rest of the restaurants have been generally pretty good. The hosts at our first riad had recommended a trio of restaurants with the same ownership, Le Jardin, Cafe Des Espices and Nomad. We tried the first two during our initial stay and both were pretty good.
Nomad, which seemed the most promising, required a reservation so we had booked that for our return to Marrakech. The space was nice but the food was underwhelming, particularly as it was the priciest.
The following night we opted to try L'Altitude 31, a reco from the owners of our second riad. The food here was very good. Perhaps not as good as the soaring descriptions on their website, but tasty nonetheless.
Paying homage to YSL
Not far from our riad, about a 15 min walk, is the Jardin Majorelle. French painter Jacques Majorelle (1886-1962) bought the first parcel of land in 1923, adding to it in later years. An amateur botanist he spent years adding to the plant life, eventually opening it to the public in 1947 to help cover the costs. A series of bad luck (divorce and car accidents) lead to the sale of the garden and his eventual death in 1962.
The garden fell into disrepair and was on the verge of redevelopment as a hotel complex when it was purchased by Yves Saint Laurent and his partner Pierre Berge in 1980. They restored and added to the garden over the years, including the addition of an automatic irrigation system. Today the garden is owned by a foundation they started in Paris.
Visiting the gardens it's easy to see how the two artists, Jacques then YSL, could find inspiration for work in it's peaceful confines. Just don't go looking for it now as the thousands of daily visitors really take away from the serene atmosphere.
Negotiator Katy in her element
Having done some initial reconnaissance walking through the souk during our first few days in Marrakech, it was time for Katy to get her negotiation on. While she set out in search of deals on Berber rugs, Ella and I opted to stay back at the riad and have a splash in the pool.
For rugs, Katy contacted our first riad host's rug guy. He turned out to be a great connection requiring no negotiation and leading to the purchase of two medium size Beni Ourain rugs with a small one thrown in for good measure.
On her way back, Katy stopped at a lamp shop to ruin some poor seller's day. She got a good deal on two traditional lanterns ("you are getting Moroccan price, I get nothing") and kudos from a couple of women who witnessed her hardball negotiations.
All we need to do now is figure out how we're going to get it all home. Up next, a quick stop in El Jedida and a long day's travel back to reality.
bike tour, Jardin Majorelle, Marrakech, Morocco, restaurants, shopping, Souk, Yves Saint Laurent
It's here! Camel Ride Day
El Jadida and the Portuguese Cistern


The flashing banner on the Avery Shorts website reads "to appreciate is to cite." As much as Avery Shorts is a project in short form writing, it is also an exercise in short form reading. We want to know what you are reading! For You Are What You Read, we are asking participants to read aloud an excerpt from a book or essay they find significant, ideally in the range of 300-400 words, that can stand alone as a thought, idea, or argument.
Avery Shorts is a project of Columbia Books on Architecture and the City that explores short-form architectural writing through email.


text:
Prøvelyt
Berlin – The Downfall: 1945
4.37 98 5 Forfatter: Antony Beevor Oplæser: Peter Noble
Findes som lydbog.
Penguin presents the unabridged, downloadable audiobook edition of Berlin by Antony Beevor, read by Peter Noble. Berlin: The Downfall 1945 is Antony Beevor's brilliant account of the fall of the Third Reich. The Red Army had much to avenge when it finally reached the frontiers of the Reich in January 1945. Political instructors rammed home the message of Wehrmacht and SS brutality. The result was the most terrifying example of fire and sword ever known, with tanks crushing refugee columns under their tracks, mass rape, pillage and destruction. Hundreds of thousands of women and children froze to death or were massacred because Nazi Party chiefs, refusing to face defeat, had forbidden the evacuation of civilians. Over seven million fled westwards from the terror of the Red Army. Antony Beevor reconstructs the experiences of those millions caught up in the nightmare of the Third Reich's final collapse, telling a terrible story of pride, stupidity, fanatacism, revenge and savagery, but also one of astonishing endurance, self-sacrifice and survival against all odds.
Sprog: Engelsk Kategori: Historie Oversætter:
Mere info om lydbogen:
Forlag: Penguin Books Ltd
Længde: 18T 9M
SAS: Rogue Heroes – the Authorized Wartime History
D-Day: The Battle for Normandy
The End: Hitler's Germany, 1944-45
The Secret War
Somme: Into the Breach
Paris After the Liberation
The Battle of the Atlantic: How the Allies Won the War
The Last 100 Days
Ardennes 1944: Hitler's Last Gamble
The Rise and Fall of the Third Reich
Hitler's Soldiers: The German Army in the Third Reich
Otto Skorzeny: The Devil's Disciple
D-Day: June 6, 1944 – The Climactic Battle of WWII
The Last Battle: The Classic History of the Battle for Berlin
The War in the West - A New History
Band of Brothers: E Company, 506th Regiment, 101st Airborne, from Normandy to Hitler's Eagle's Nest
Big Week: The Biggest Air Battle of World War Two
The World's War
Hitler's Death: The Case Against Conspiracy

redpajama_set_name: RedPajamaCommonCrawl


Automated percutaneous discectomy is considered experimental, investigational and/or unproven as a technique of intervertebral disc decompression in patients with back pain and/or radiculopathy related to disc herniation in the lumbar, thoracic or cervical spine.
Percutaneous endoscopic discectomy is considered experimental, investigational and/or unproven as a technique of intervertebral disc decompression in patients with back pain and/or radiculopathy related to disc herniation in the lumbar, thoracic, or cervical spine.
Surgical management of herniated intervertebral discs most commonly involves discectomy or microdiscectomy, performed manually through an open incision. Automated percutaneous discectomy involves placement of a probe within the intervertebral disc under image guidance with aspiration of disc material using a suction cutting device. Removal of disc herniations under endoscopic visualization is also being investigated. Endoscopic discectomy involves the percutaneous placement of a working channel under image guidance, followed by visualization of the working space and instruments through an endoscope, and aspiration of disc material.
Back pain or radiculopathy related to herniated discs is an extremely common condition and a frequent cause of chronic disability. Although many cases of acute low back pain and radiculopathy will resolve with conservative care, a surgical decompression is often considered when the pain is unimproved after several months and is clearly neuropathic in origin, resulting from irritation of the nerve roots. Open surgical treatment typically consists of discectomy in which the extruding disc material is excised. When performed with an operating microscope, the procedure is known as microdiscectomy.
Minimally invasive options have also been researched, in which some portion of the disc material is removed or ablated, although these techniques are not precisely targeted at the offending extruding disc material. Ablative techniques include laser discectomy and radiofrequency (RF) decompression which are addressed in a separate policy. In addition, intradiscal electrothermal annuloplasty is another minimally invasive approach to low back pain. In this technique, RF energy is used to treat the surrounding disc annulus which is addressed in a separate policy.
This policy addresses automated percutaneous and endoscopic discectomy, in which the disc decompression is accomplished by the physical removal of disc material rather than its ablation. Traditionally, discectomy is performed manually through an open incision, using cutting forceps to remove nuclear material from within the disc annulus. This technique has been modified by automated devices that involve placement of a probe within the intervertebral disc and aspiration of disc material using a suction cutting device. Endoscopic techniques may be intradiscal or may involve the extraction of non-contained and sequestered disc fragments from inside the spinal canal using an interlaminar or transforaminal approach. Following insertion of the endoscope, the decompression is performed under visual control.
The Dekompressor® Percutaneous Discectomy Probe (Stryker), Herniatome Percutaneous Discectomy Device (Gallini Medical Devices), and the Nucleotome® (Clarus Medical) are examples of percutaneous discectomy devices that have been cleared for marketing by the U.S. Food and Drug Administration (FDA) through the 510(k) process. The FDA indication for these products is for "aspiration of disc material during percutaneous discectomies in the lumbar, thoracic and cervical regions of the spine." FDA product code: HRX.
A variety of endoscopes and associated surgical instruments have also been cleared for marketing by FDA through the 510(k) process.
This policy was created based on a 1990 Blue Cross Blue Shield Association (BCBSA) Technology Evaluation Center (TEC) Assessment. The most recent literature review was performed through March 6, 2017.
Assessment of efficacy for therapeutic intervention involves a determination whether an intervention improves health outcomes. The optimal study design for this purpose is a randomized controlled trial (RCT) that includes clinically relevant measures of health outcomes. Intermediate outcome measures, also known as surrogate outcome measures, may also be adequate if there is an established link between the intermediate outcome and true health outcomes. Nonrandomized comparative studies and uncontrolled studies can sometimes provide useful information on health outcomes, but are prone to biases such as noncomparability of treatment groups, placebo effect, and variable natural history of the condition.
A 2014 Cochrane review of literature through November 2013 evaluated 11 studies of minimally invasive discectomy (MID) compared with microdiscectomy or open discectomy. (1) Included in the MID category were 8 RCTs or quasi-RCTs on percutaneous endoscopic lumbar discectomy (PELD), 2 studies on transmuscular tubular microdiscectomy, and 1 study on automated percutaneous lumbar discectomy (APLD). Seven of the studies had a high risk of bias. For the analysis, the reviewers combined all MID procedures. They reported that MID may be inferior in terms of relief of leg and low back pain, and rehospitalizations; however, differences in pain relief appeared to be small and may not be clinically meaningful. Potential advantages of minimally invasive discectomy included lower risk of surgical site infection and shorter length of stay (LOS).
A 2015 systematic review and network meta-analysis by Lewis et al. compared trials of 21 different treatment strategies for sciatica. (2) Examples of the 21 treatment strategies included in the analysis are conservative care, disc surgery, intraoperative interventions, epidural injections, biologic agents, and percutaneous discectomy. Under the category of "percutaneous discectomy," reviewers combined automated percutaneous discectomy, percutaneous automated nucleotomy, nucleoplasty, and laser discectomy. They searched 28 databases and trial registries through December 2009. Ninety studies were included and 10 involved the percutaneous discectomy category as an intervention. Of the 10, 4 are relevant to this evidence review: 2 case-control studies of percutaneous endoscopic discectomy (2006, 2007), 1 RCT of percutaneous endoscopic discectomy (1993), and 1 RCT of automated percutaneous discectomy (1995). The remaining studies were published in a foreign language or involved the comparators nucleolysis and chemonucleolysis, rather than open discectomy or microdiscectomy. The global effects odds ratio for the category of percutaneous discectomy compared with inactive control was 0.82 (95% confidence interval [CI], 0.39 to 1.72), which was inferior to disc surgery, epidural injections, and intraoperative interventions. The pain intensity weighted mean difference for the category of percutaneous discectomy compared with inactive control was 11.5 (95% CI, -18.6 to 41.6). Reviewers concluded that there was no support for the effectiveness of percutaneous discectomy for the treatment of sciatica. Due to the inclusion of additional interventions into the broad category of percutaneous discectomy in this review, the relevance of these results are limited.
Two systematic reviews by Manchikanti et al. were published in 2013. One investigated the effectiveness of APLD, with a search of databases from 1966 to September 2012. (3) Studies were included if the following criteria were met: for RCTs, greater than 50% of the criteria adapted from the Cochrane Back Review Group; for cohort studies, 7 of 10 criteria from the Newcastle-Ottawa Scale (NOS) for assessing the quality for cohort studies; and for case-control studies, 5 of 10 criteria from the NOS for case-control studies. No RCTs met the inclusion criteria. Nineteen observational studies met the criteria and were identified for this review. With no RCTs meeting the criteria, meta-analysis could not be performed. Within the 19 observational studies, 5515 patients underwent automated percutaneous discectomy, with 4412 reporting positive results. The range of positive results reported in the studies was 45% to 88%. Despite the large number of studies, the reviewers concluded that the literature was limited, because no RCTs met quality inclusion criteria and because the most recent study, published in 2010, reported results from a study conducted in 2000-2002. The second review by Manchikanti et al. focused specifically on disc decompression using the Dekompressor. (4) This review used the same criteria described above. No RCTs met the study inclusion criteria; 3 observational studies did and were included. Reviewers acknowledged that the Dekompressor appeared to decrease pain, but because meta-analysis could not be conducted, the 3 trials selected were relatively small (total N=164 patients), and none provided follow-up data beyond 8 years, they concluded that the evidence was limited for use of the Dekompressor device for the treatment of lumbar disc herniation.
Vorobeychik et al. (2012) (5) and Singh et al. (2009) (6) also conducted reviews on the Dekompressor. Vorobeychik et al. identified the same 3 observational studies as Manchikanti et al. plus a case series while Singh identified the same observational studies as Manchikanti et al. The authors of both reviews also concluded that pain relief was achieved, but the evidence lacked sufficient rigor to support conclusions.
In 2009, Hirsch et al. published a systematic review on APLD, searching databases from 1966 to April 2009. Cochrane review criteria (50 of 100 points were needed for inclusion) were used to assess quality of RCTs and Agency for Healthcare Research and Quality criteria (50 of 100 points were needed for inclusion) were used to assess observational studies. Reviewers assessed 4 RCTs and 76 observational studies evaluating APLD. (7) One RCT (by Revel et al. ) met inclusion criteria and is detailed in the next section on RCTs. (8) The other 3 RCTs failed to meet study quality criteria. In discussing the results of the Revel trial, which showed a lower success rate than the observational studies, reviewers noted that APLD might not have been successful in this trial due to inappropriate patient selection, failure to recruit the number of patients indicated by sample size calculations, and lack of follow-up beyond 6 months. Ten observational studies met methodologic quality criteria for inclusion. Results were consistent among the observational studies, showing APLD effective among approximately 75% of patients. APLD appears to compare favorably compared with open discectomy, microdiscectomy, and chymopapain injection, though evidence lacked RCTs. The evidence for the use of APLD for short- and long-term pain relief is considered level II-2 (well-designed cohort or case-control studies), using the U.S. Preventive Services Task Force criteria.
Freeman and Mehdian assessed the evidence for 3 minimally invasive techniques used to treat discogenic low back pain and radicular pain: electrothermal therapy (intradiscal electrothermal therapy), percutaneous discectomy, and nucleoplasty in a 2008 article. (9) They reported that trials of automated percutaneous discectomy suggested clinical outcomes are at best fair and often worse than with microdiscectomy.
In 2007, Gibson and Waddell updated a Cochrane review on surgical interventions for lumbar disc prolapse, concluding that there was insufficient evidence on percutaneous discectomy techniques to draw firm conclusions. (10) In the same year, a task force of the American Society of Interventional Pain Physicians (ASIPP) reported that percutaneous disc decompression remains controversial. (11) Although all observational studies provided positive findings, the evidence from 4 randomized trials was negative. Questions also remain about appropriate patient selection criteria for this procedure, particularly related to the size and migration of the disc herniation.
The RCTs are described next are considered poor quality and, in general, did not meet most inclusion criteria of the above systematic reviews.
In 1995, Chatterjee et al. reported on 71 patients with lumbar disc herniation randomized to percutaneous discectomy or to lumbar microdiscectomy. (13) A satisfactory outcome was reported in 29% of patients undergoing percutaneous discectomy compared with 80% in the microdiscectomy group. The trial was terminated early due to the inferior outcome.
Revel et al. compared percutaneous discectomy with chymopapain injection in 141 patients with disc herniation and sciatica in a 1993 randomized trial. (8) Treatment was considered successful in 61% of patients in the chymopapain group and in 44% of patients in the percutaneous discectomy group. Thirty-two patients withdrew from the trial, citing therapeutic failure. Within 6 months of the trial, 20% of the patients underwent open laminectomy.
The evidence for automated percutaneous discectomy in individuals who have herniated intervertebral disc(s) includes small RCTs and systematic reviews of RCTs. Evidence from small RCTs does not support the use of this procedure. Well-designed and executed RCTs are needed to determine the benefits and risks of this procedure.
In 2017, Phan et al. published a systematic review and meta-analysis comparing full endoscopic discectomy (FED) and microendoscopic discectomy (MED) with open discectomy for the treatment of lumbar disc herniation. (15) A database search through February 2016 identified 23 studies for inclusion. FED was favorable compared with open discectomy in surgery duration, hospital LOS, and blood loss. MED was favorable compared with open discectomy in terms of LOS and blood loss. Both endoscopic procedures were comparable to open discectomy, as measured on a visual analog scale (VAS) for leg pain and Oswestry Disability Index (ODI) score. In terms of patient satisfaction, FED was more favorable than open discectomy, and MED was comparable to open discectomy.
A 2016 systematic review and meta-analysis published by Li et al. compared FED with traditional discectomy surgery. (16) A literature search was conducted in January 2015 and resulted in the inclusion of 4 RCTs and 2 non-RCTs. FED for herniation (both cervical and lumbar) was favorable compared with traditional discectomy in surgery duration, blood loss, LOS, and return to work days. Clinical outcomes were comparable between FED and traditional discectomy.
A 2016 meta-analysis identified 9 RCTs (total N=1092 patients) through August 2014 that compared endoscopic to open discectomy for lumbar disc herniation. (17) Endoscopic discectomy resulted in clinical outcomes similar to open discectomy, but had significantly greater patient satisfaction, lower intraoperative blood loss, and shorter hospital length of stay (LOS).
In 2013, Smith et al. published a systematic review of endoscopic discectomy for lumbar disc herniation. (18) A search for controlled trials published through September 2012 identified 4 RCTs. None found a significant difference in ODI scores for endoscopic discectomy compared to open discectomy or microdiscectomy. The largest study (Teli et al. , described below; N=240) reported an increase in the number of severe complications in the MED group. (19) Another study (Garg et al. , also described below; N=112) found a shorter hospital LOS with no significant changes in ODI scores or complication rates, but recommended that microendoscopic discectomy not be attempted without appropriate training. (20) The 2 other trials included in the review were small, with 22 and 40 patients.
Several of the larger trials included in the systematic reviews above, larger trials on cervical disc herniation, and trials published subsequent to the systematic review literature searches are described in the next section.
In 2017, Gibson et al. published an RCT comparing transforaminal endoscopic discectomy (TED) with microdiscectomy. (21) Patients with single-level lumbar prolapse and radiculopathy were randomized to TED under conscious sedation (n=70) or to microdiscectomy under general anesthesia (n=70). Both procedures resulted in comparable improvements in outcomes (ODI scores, VAS back pain, VAS leg pain, 36-Item Short-Form Health Survey [SF-36] scores) at 3 months, 1 year, and 2 years compared with baseline.
Eight-year follow-up from a quasi-RCT assessing endoscopic lumbar discectomy and open discectomy was reported by Hussein et al. in 2014. (22) The trial included 185 patients with a large uncontained lumbar disc herniation. Surgery times were similar for both groups. Postsurgical mean hospital LOS was 10.4 hours for the endoscopic group and 82.38 hours (p<0.05) for the open group. Mean time to return to work/normal activities after endoscopic surgery (8.5 days) was significantly shorter than after open surgery (31.4 days; p<0.05). The percentages of adverse events were similar between groups, and 8.1% of patients in each group required reoperation during the follow-up. Improvements in leg pain, back pain, and ODI scores (1.05, 1.43, 21.5%, respectively) persisted at 8 years in the endoscopic group, but deteriorated for back pain (7.53) and ODI scores (59.6%) in the open group.
Garg et al. (2011) reported on a trial randomizing 112 patients with a single-level disc herniation to microendoscopic lumbar discectomy or to open discectomy. (20) The method of randomization and whether patients and assessors were blinded were not reported. Surgical time was significantly longer in the endoscopic group (84 minutes vs 56 minutes) while blood loss (41 mL vs 306 mL) and hospital LOS (3 days vs 12 days) were reduced. ODI scores were similar at baseline (endoscopic, 25.78 vs open discectomy, 21.02) and all follow-up visits through 1 year postoperatively (endoscopic; 1.75 vs open discectomy 2.14).
In 2010, Teli et al. reported on an RCT comparing endoscopic discectomy to microdiscectomy or open discectomy in 240 patients with posterior lumbar disc herniation. (19) Most herniations (60%) were extrusions. The average surgical time was longer in the endoscopic group (56 minutes) than in the micro- or open discectomy groups (43 minutes and 36 minutes, respectively). Follow-up assessments were performed at 6, 12, and 24 months by an independent investigator; 212 (91%) patients completed the 24-month evaluation. Intention-to-treat analysis showed no significant differences in the outcome variables (VAS, ODI, and SF-36 scores). The endoscopic procedure led to more dural tears (8.7% vs 2.7% or 3%), root injuries (3% vs 0% or 0%), and recurrent herniations (11.4% vs 4.2% or 3%) than the microdiscectomy or open approaches, respectively, although differences were not statistically significant.
In 2008 and 2009, Ruetten et al. published 4 RCTs comparing full endoscopic discectomy (FED) with conventional techniques in the lumbar and cervical spine. (23-26) All studies were randomized or quasi-randomized, with assignment described as either order of presentation or balanced block. Follow-up examinations were conducted at day 1 and at months 3, 6, 12, and 24 by physicians not involved in the surgeries. The 4 trials were not blinded due to observable differences in the surgical approaches, and are described below.
• Patients with mediolateral cervical disc herniations (N=120) were randomized to full endoscopic anterior decompression (FACD) or to conventional anterior cervical decompression with fusion (ACDF). (26) Mean surgery time was 32 minutes for FACD and 62 minutes for ACDF. At 24 months, 103 (86%) patients were available for follow-up examinations. Revision rates for ACDF (6.1%) and FACD (7.4%) did not differ significantly. There were no significant differences in clinical outcomes (pain, VAS arm, VAS neck) between groups.
• Patients with clinically symptomatic lateral cervical disc herniation (N=200) were randomized to full endoscopic posterior cervical foraminotomy or conventional microsurgical ACDF. (23) At 24 months postsurgery, 175 (88%) patients were available for follow-up. Ten patients had revisions due to persistent arm pain, recurrences of herniation, or failure of the implant (6 endoscopic patients, 4 ACDF). Postoperative pain was significantly reduced in the endoscopic group (data not reported), and postoperative work disability was shorter (19 days vs 34 days). Other clinical outcomes (VAS scores for neck and arm pain, a German version of the North American Spine Society [NASS] Instrument [Hilibrand criteria]) were similar between groups throughout the 24-month follow-up.
• Patients with clinically symptomatic lumbar disc herniation (N=200) were randomized to FED or to conventional microdiscectomy. (24) Mean surgery time for endoscopic discectomy (22 minutes) was nearly 50% faster than for conventional microdiscectomy (43 minutes), and the complication rate was significantly lower. Postoperative pain and pain medication usage were significantly reduced in the endoscopic group (data not reported), and the postoperative work disability was shorter (25 days vs 49 days). At 24 months after surgery, 178 (89%) patients were available for follow-up. The 2 groups had similar improvements in leg pain, with 85% of endoscopic discectomy and 79% of microdiscectomy patients reporting being pain-free. More patients in the microdiscectomy group (5% vs 1%) underwent revision spinal canal expansion and fusion.
• Patients with recurrent lumbar disc herniation following conventional discectomy who were in need of a revision (N=100) were randomized to FED or to conventional microdiscectomy. (25) Surgery time was significantly shorter with the endoscopic approach (24 minutes vs 58 minutes), and access-related osseous resection was much less frequent in the endoscopic group (3 [6%] cases vs 47 [94%] cases). There were 4 cases of dura injury (1 endoscopic discectomy, 3 microdiscectomy). Overall, serious complication rates were significantly higher in the microdiscectomy group (21% vs 6%). Postoperative pain and pain medication usage were significantly reduced in the endoscopic group, as was postoperative work disability (28 days vs 52 days). At 24 months, 87 (87%) patients were available for follow-up. Seventy-nine percent had no leg pain at follow-up, and there were no significant differences between groups in clinical outcomes (VAS, NASS Instrument, ODI scores).
A 1999 RCT by Hermantin et al. (27) was rated as having a low risk of bias in the 2014 Cochrane review. Sixty patients who had objective evidence of a single intracanalicular herniation of a lumbar disc were randomized into 2 groups: endoscopic microdiscectomy or open laminotomy and discectomy. A similar percentage of patients was considered to have a satisfactory outcome (97% of the microendoscopic group vs 93% of the open group). The mean duration of narcotic pain-relief use (7 days vs 25 days) and return to work (27 days vs 49 days) were significantly lower in the microendoscopic group. This trial did not use validated outcome measures.
In 2016, Gotecha et al. published a prospective study on the use of transforaminal PELD for the treatment of lumbar disc herniation. (28) Efficacy and limitations of the procedure were studied on 120 patients with lumbar disc herniation. Using McNab criteria, 89% achieved excellent (no pain or restrictions) or good (occasional back/leg pain) status at 6 months of follow-up. The authors noted that a limitation of the procedure is that, during surgery on patients with L5 through S1 lumbar disc herniation, the iliac crest may interfere with the angle necessary to perform successful discectomy.
A number of observational studies have also assessed the learning curve (29-31) and the need for longer follow-up for endoscopic discectomy. (32-34) The largest and longest follow-up to date has been reported by Choi et al. (2015), who examined 10,228 patients at their institution who had had PELD over a 12-year period. (34) They found that 4.3% of cases required reoperation in the first 6 weeks due to incomplete removal of herniated discs (2.8%), recurrence (0.8%), persistent pain (0.4%), and approach-related pain (0.2%).
The evidence for percutaneous endoscopic discectomy in individuals who have herniated intervertebral disc(s) includes a number of RCTs and systematic reviews of RCTs. Many of the RCTs were conducted at a single center in Europe. Some trials have reported outcomes at least as good as traditional approaches with an open incision, while an RCT from a different center in Europe reported a trend toward increased complications and reherniations using an endoscopic approach. There are few reports from the United States. Reporting from a number of moderately large ongoing RCTs is anticipated in the next 2 to 3 years.
For individuals who have herniated intervertebral disc(s) who receive automated percutaneous discectomy, the evidence includes randomized controlled trials (RCTs) and systematic reviews of RCTs. Relevant outcomes are symptoms, functional outcomes, quality of life, and treatment-related morbidity. The published evidence from small RCTs is insufficient to evaluate the impact of automated percutaneous discectomy on net health outcomes. Well-designed and executed RCTs are needed to determine the benefits and risks of this procedure. The evidence is insufficient to determine the effects of the technology on health outcomes.
For individuals who have herniated intervertebral disc(s) who receive percutaneous endoscopic discectomy, the evidence includes a number of RCTs and systematic reviews of RCTs. Relevant outcomes are symptoms, functional outcomes, quality of life, and treatment-related morbidity. Many of the RCTs were conducted at a single center in Europe. Some trials have reported outcomes at least as good as traditional approaches with an open incision, while 1 RCT from a different center in Europe reported a trend toward increased complications and reherniations using an endoscopic approach. There are few reports from the United States. Results from a number of moderately large ongoing RCTs are anticipated in the next 2 to 3 years. The evidence is insufficient to determine the effects of the technology on health outcomes.
The National Institute for Health and Care Excellence (NICE) published guidance in 2005 on automated percutaneous mechanical lumbar discectomy, indicating that there was limited evidence of efficacy based on uncontrolled case series of heterogeneous groups of patients, and evidence from small RCTs showed conflicting results. (35) The guidance indicated that, in view of uncertainty about the efficacy of the procedure, it should not be done without special arrangements for consent and for audit or research. The guidance was considered for update in 2009, but failed review criteria; the 2005 guidance is therefore considered current.
A NICE guidance on percutaneous transforaminal endoscopic lumbar discectomy for sciatica was published in 2016. (36) The guidance stated that current evidence is adequate to support the use of percutaneous transforaminal endoscopic lumbar discectomy for sciatica. Choice of operative procedure (open discectomy, microdiscectomy, or percutaneous endoscopic approaches) may be influenced by symptoms, and location and size of prolapsed disc.
A NICE guidance on percutaneous interlaminar endoscopic lumbar discectomy for sciatica was also published in 2016. (37) The guidance stated that current evidence is adequate to support the use of percutaneous interlaminar endoscopic lumbar discectomy for sciatica. Choice of operative procedure (open discectomy, microdiscectomy, or percutaneous endoscopic approaches) may be influenced by symptoms, and location and size of prolapsed disc.
The 2013 guidelines from the American Society of Interventional Pain Physicians indicated that the evidence for percutaneous disc decompression with the Dekompressor was limited. (14) There were no recommended indications for the Dekompressor.
In 2014, the North American Spine Society published clinical guidelines on the diagnosis and treatment of lumbar disc herniation. (38) Table 1 summarizes recommendations specific to percutaneous endoscopic discectomy and automated percutaneous discectomy.
Endoscopic percutaneous discectomy may be considered for treatment.
Automated percutaneous discectomy may be considered for treatment.
Patients undergoing percutaneous endoscopic discectomy experience better outcomes if <40 years and symptom duration <3 months.
LOE: level of evidence; NASS: North American Spine Society.
a Grade B: fair evidence (level II or III studies with consistent findings; grade C: poor quality evidence (level IV or V studies). Level of evidence II: lesser quality randomized controlled trial (e.g., <80% follow-up, no blinding, or improper randomization), prospective comparative study, systematic review of level II studies or level I studies with inconsistent results; level of evidence III: case control, retrospective, systematic review of level III studies; level of evidence IV: case series; level of evidence V: expert opinion.
Currently unpublished trials that might influence this review are listed in Table 2.
CPT code 62287 specifically describes a percutaneous decompression procedure of the lumbar spine. This code is specifically limited to the lumbar region. Although most percutaneous discectomies are performed on lumbar vertebrae, Food and Drug Administration labeling of the Stryker Dekompressor Percutaneous Discectomy Probe and the Nucleotome includes the thoracic and cervical vertebrae.
Effective in 2017, there is a specific CPT code for endoscopic decompression: 62380.
Percutaneous discectomy is also a component of the following CPT codes: 0274T and 0275T.
35. National Institute for Health and Care Excellence (NICE). Automated percutaneous mechanical lumbar discectomy-guidance [IPG141]. 2005; Available at <http://guidance.nice.org.uk> (accessed March 9, 2017).
36. National Institute for Health and Care Excellence (NICE). Percutaneous transforaminal endoscopic lumbar discectomy for sciatica [IPG556]. 2016; Available at <https://www.nice.org.uk> (accessed March 9, 2017).
37. National Institute for Health and Care Excellence (NICE). Percutaneous interlaminar endoscopic lumbar discectomy for sciatica [IPG555]. 2016; Available at <https://www.nice.org.uk> (accessed March 9, 2017).
40. Automated Percutaneous and Percutaneous Endoscopic Discectomy. Chicago, Illinois: Blue Cross Blue Shield Association Medical Policy Reference Manual (April 2017) Surgery 7.01.18.
2/15/2018 Document updated with literature review. Coverage has changed, the word percutaneous was added to the following coverage statement: Percutaneous endoscopic discectomy is considered experimental, investigational and/or unproven as a technique of intervertebral disc decompression in patients with back pain and/or radiculopathy related to disc herniation in the lumbar, thoracic, or cervical spine. The Title has changed from: Automated Percutaneous Discectomy and Endoscopic Discectomy.
8/1/2014 Medical document divided into: SUR712.023, SUR712.037 and SUR712.038. Document title changed from "Intervertebral Techniques to Treat Chronic Discogenic Back Pain". Document updated with literature review. The previous coverage statement was Percutaneous discectomy by any means is considered experimental, investigational and/or unproven as a technique of intervertebral disc decompression in patients with back pain related to disc herniation in the lumbar, thoracic or cervical spine. The following was added to coverage: Endoscopic discectomy is considered experimental, investigational and/or unproven as a technique of intervertebral disc decompression in patients with back pain and/or radiculopathy related to disc herniation in the lumbar, thoracic, or cervical spine.
6/1/2012 Coverage revised, the following was added; Axial lumbosacral interbody fusion (axial LIF) is considered experimental, investigational and unproven. Description, rationale, and references updated.
12/15/2011 Document updated with literature review. Document completely revised. All references to minimally invasive interbody fusion were removed. Title was changed from "Percutaneous Intervetebral Techniques to Treat Chronic Discogenic Back pain".


Megan Mormile, left, Nicholas Murray, Ph.D., Nathan D'Amico and Katelyn Grims attended the American College of Sports Medicine annual meeting in Boston.
Georgia Southern College of Health and Human Sciences graduate students Megan Mormile, Nathan D'Amico and Katelyn Grimes, along with assistant professor Nicholas Murray, Ph.D., and associate professor Barry Munkasy, Ph.D., in the School of Health and Kinesiology, received the Clinical Biomechanics Award for their research abstract titled Assessment of Gaze Stability Within 24-48 Hours of Post-Concussion during the American College of Sports Medicine (ACSM) Annual Meeting in Boston, Massachusetts.
The Award is given annually by the American Society of Biomechanics (ASB) to recognize excellence in biomechanics research, and honors the quality of a given research project, as presented in abstract form.
Researchers on the abstract also include Rebecca Reed-Jones, University of Prince Edward Island, and Doug Powell, Campbell University.
Additionally, Murray served as an expert panelist during the Meeting, and was a highlighted speaker during the concussion symposium where he and fellow colleagues discussed advances in science and technology. Mormile, D'Amico and Grimes were all awarded travel grants through the FASEB/MARC program to attend and present at the Meeting.
To learn more about the participants, visit the Georgia Southern University School of Health and Kinesiology page.


text:
Kenneth J. Pienta is a medical doctor and the Donald S. Coffey professor of urology and professor of oncology and pharmacology and molecular sciences at the Johns Hopkins University School of Medicine. He also serves as the director of research at the Brady Urological Institute.

Pienta attended the University of Michigan as an undergraduate, before ultimately receiving a Bachelor's degree from the Johns Hopkins University in 1983. He stayed at Johns Hopkins to earn his MD in 1986. After medical school, he completed his residency at the University of Chicago Hospital.

His lab focuses on researching the tumor microenvironment and its role in metastasis.

In 2007, he was a recipient of the AACR Team Science Award for the group discovery of fusion genes in prostate cancer.

He is a member of the editorial board of the Cancer and Metastasis Reviews.

References

Year of birth missing (living people)
Living people
American urologists
Johns Hopkins University faculty
Johns Hopkins University alumni

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text:
Doug Bailie From Fair Vote Canada Talks about Electoral Reform
Doug Bailie, one of the organizers behind Fair Vote Canada, an organization looking to reform Canada's electoral system to adopt a system of proportional representation talks about electoral reform in Canada.
Doug Bailie is one of the organizers behind Fair Vote Canada, an organization looking to reform Canada's electoral system to adopt a system of proportional representation.
re:politics (formerly, Maple Leaf Web).com: Tell me a little about Fair Vote Canada.
Doug Bailie: Fair Vote Canada was started last summer when a few of us who had been discussing proportional representation online began to work towards a formal organization. We started up a website and began sending out an e-mail newsletter (which now reaches about 275 people).
Now, we're looking forward to our first national meeting which will be in Ottawa, March 30-31, and that is where we will hammer out a formal statement of purpose and establish the organization's structure.
re:politics (formerly, Maple Leaf Web).com: Besides some scribbling by academics, there hasn't been a strong citizen-based movement to adopt PR in decades. Why do you think the time is right now?
Doug Bailie: I think that now is the right time because of the way the opposition has been fragmented since 1993. That fragmentation has made the distortions of our winner-take-all system more obvious. I think there's a greater degree of frustration among people who feel the pressure to vote strategically. Plus, it has over-emphasized the regional aspects of Canadian politics — giving the Liberals overwhelming dominance of Ontario while they are under-represented in the West and vice-versa for the Alliance.
All of this makes it easier to get people's attention when you talk about voting system reform.
re:politics (formerly, Maple Leaf Web).com: The regionalization you speak of is an important feature of Canada's party system since 1993. How would proportional representation help that?
Doug Bailie: Our current electoral system tends to give more seats to parties which have their votes concentrated in a particular region and fewer seats to those parties which have their votes more thinly spread across the country. So, in both the 1993 and 1997 federal elections, the Tories and the Reform party got about the same number of votes, but Reform had several times more seats than the Tories because Reform voters tended to be concentrated in the West.
Proportional representation would not turn that situation upside down — that is, over-representing parties with broad national support while under-representing parties with regional support — it would simply give everyone their due representation. So, PR is not a solution for regional tension in Canada, but it would not, I believe, exacerbate regional tensions the way the current system does.
re:politics (formerly, Maple Leaf Web).com: One criticism of PR is that it leads to political instability. People hear "PR" and they think of countries with unstable party systems, such as Italy. How do you answer that criticism?
Doug Bailie: There are dozens of democracies in the world which use some form of proportional representation. Opponents of PR always bring up Italy or Israel, which have both had problems with governmental stability, and use that as evidence that PR is flawed. But the experience of Italy and Israel does not reflect that of most PR countries. The truth is there is a broad range of experience ranging from the instability of Italy and Israel to the kind of stability we've seen in Germany, where government leaders tend to stay in office for ten or fifteen years at a time.
The reason there is such a range of experience is because electoral systems are just one ingredient in a country's political soup. It's an important ingredient, but it doesn't make or break the governmental stability of a country.
That said, there is certainly a lot of room for criticizing the particular PR systems which are used in some countries. And it makes sense for those of us in Canada to be aware of the strengths and weaknesses of other countries' electoral systems.
re:politics (formerly, Maple Leaf Web).com: This brings up an important point. There are many kinds of proportional representation. One of the characteristics of the electoral reform movement has been the infighting over the preferred model of PR. Do you think that weakens the cause of PR?
Doug Bailie: It would be hard to argue that it didn't. But my experience has been that the vast majority of PR supporters in Canada are focused on the goal of adopting a more proportional system and they are willing to compromise on their preferred model, if they have one at all.
Perhaps the more serious split is between the supporters of PR and the supporters of the Alternative Vote, which is a majoritarian system. Both groups want to change the electoral system, but they have significantly different criticisms of the current system and significantly different solutions.
re:politics (formerly, Maple Leaf Web).com: What other difficulties do you anticipate in the electoral reform campaign?
Doug Bailie: I think the strength of electoral reform is that it is not a left-vs- right issue. So you can bring together, as we are in Fair Vote Canada, people from across the political spectrum. But the flip side of that is that electoral reform tends to be a government-vs.-opposition issue. And how do you make such a major change in the political system without the support of the government?
I often come across people who think PR is a great idea but it is futile to talk about it because the government — no matter which party forms the government of the day — will always block it. While there's a lot of truth to that, it is not absolutely true. Other countries have managed to change their electoral systems now and then. New Zealand is perhaps the most recent and most relevant example for Canadians to look to. And finally, I guess I believe that citizens can force change in the political system, in spite of entrenched interests, if they band together in sufficient numbers.
re:politics (formerly, Maple Leaf Web).com: It's clear that the Liberals benefit from the current system and don't have much appetite for change. But what about the opposition parties? Is there much will among them for electoral reform?
Doug Bailie: I think it's building. For one thing the attempt to "unite the right" turned out to be much more difficult than many Reform-Alliance supporters expected. While that process is continuing, I think both Alliance and Tory members are more likely to be critical of the electoral system now than they were a few years ago.
Support for voting system reform, and proportional representation in particular, has been growing within the NDP. PR is now official party policy and it was included in last year's election platform. Also, the party introduced a motion in the House for debate on electoral reform last week, which used up one of their opportunities to control the subject of debate in the House — so I think that indicated that the issue is taking on increasing significance for the NDP party and caucus.
There is even some support in the Bloc Quebecois.
I think as the sense that Canada is devolving into a quasi-one-party state, opposition parties will become more and more interested in voting system reform.
re:politics (formerly, Maple Leaf Web).com: If people are interested in learning more about Fair Vote Canada or your Ottawa conference, where can they get more information?
Doug Bailie: They can visit our website http://www.fairvotecanada.org/. Information on the conference, the list of speakers, registration and the agenda are all available online. You can also find more general information about who we are and what we hope to achieve.
Any inquiries can be directed to [email protected] or by calling 416-410-4034.


Flip camcorders just got another utility with a new mobile software application that supports sharing from your BlackBerry, iPhone or Android phone--and the new app is free. At the moment, the app only supports certain model phones within those categories, including the Apple iPhone, iPod touch; Blackberry Curve 8520, Curve 8900, and Bold 9000; Google G1 (T-Mobile) and MyTouch (T-Mobile). You can find the apps at the Flip Share website or in the app store for those phones.
That means you can shoot and share video from any location where your phone's working, and without a laptop--so if you're sending communicators out in the field to gather video or stills, they can post from events and offsite locations directly, without coming back to the office. For iPhone users, the app allows you to create video playlists and favorites, and all the apps allow access to your Flip Channel--a private channel where you can share video with other users. The latter feature means video can be shared from a remote location to colleagues in your office, who can phone in reactions, questions or ideas to the on-site recorder.
Find out more about the the 2nd-generation Flip MinoHD Camcorder with 120-minute capacity or check out all shoot-and-share camcorders on Amazon .


Crudesco is part of a group of companies specialized in water and solid waste management. Having over 165 years of experience in waste solutions and technologies we offer unique concepts with a focus on sustainability and nature friendly solutions.
With offices located in Europe, South-East Asia and the Middle East, we understand the local environment, culture and business of our clients perfectly. Our diverse staff is able to offer customized, regional solutions solving most complex waste issues.
Many solutions offered are unique and dedicated to deliver excellence, with a focus on cost-effective and environmental friendliness. This is strengthened by a proven track record and professional experts.
Besides improving business needs, we also stay ahead of competition. Technology improvements and R&D is very important within our group. Environmental friendly solutions developed for decades helps to improve our nature where possible.
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A cohesive strategy and unique culture demonstrates Crudesco's excellence, integrity and commitment can go along with your success and growth.


text:
RUMOUR MILL: Martial could quit Manchester United, Neville makes case for Wenger's defence, Ranieri favourite for the chop
ALL the latest football transfers and rumours
Neil McGlade
French striker Anthony Martial looks set to quit Manchester United for a return to his homeland with Ligue 1 champions Paris Saint-Germain this summer. (The Sun
Leicester City manager Claudio Ranieri, who guided the club to their maiden Premier League title last season, is now the bookmakers' favourite to be the next Premier League manager to be sacked. (Daily Telegraph)
Manchester City have made it clear striker Sergio Aguero will not be leaving the club at the end of the season. (Manchester Evening News)
Watford have already expressed their desire to make striker M'Baye Niang's loan move from AC Milan permanent in the summer but would need to cough up £13.5 million for the 22-year-old. (Daily Mail)
Liverpool manager Jurgen Klopp says he will accept full responsibility if the club's lack of transfer activity costs them at the end of the season. (Liverpool Echo)
Gary Neville was quick to jump to the defence of Arsenal boss Arsene Wenger after some Gunners supporters called on the club to sack the Frenchman in wake of Saturday's 3-1 defeat at Chelsea. (Daily Express)
Crystal Palace manager Sam Allardyce told his players to report to the club's training ground at 7am on Sunday morning following the 4-0 loss at home to Sunderland the day before. (Guardian)
Bournemouth's Andrew Surman described the 6-3 loss to Everton as very damaging but has urged the squad to stick together. (Bournemouth Echo)
Sunderland are heading to the Big Apple of New York for a four-day team bonding session. (The Sun)
Chelsea's Eden Hazard says the more he gets kicked during games the better he plays. (Daily Star)


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Pompeii (2014)
Bastille song not included
A slave-turned-gladiator finds himself in a race against time to save his true love, who has been betrothed to a corrupt Roman Senator. As Mount Vesuvius erupts, he must fight to save his beloved as Pompeii crumbles around him.
The fact that nobody has brought the story of Pompeii to life as a film is a puzzling thought. The potential is there to bring to life a story of the doomed city, it's just a shame that the director of the Resident Evil films got there first.
The fact that a total of three different screenwriters were hired to work on the script is astounding, due to how inept they seem to be at getting the simplest of things right. The only female character who seems to get anything of importance to do is Emily Browning's Cassia, who is relegated to the tired labels of damsel in distress and obligatory love interest in favour of the men showing off their muscles.
The bromance between Milo and Atticus is meant to be a pairing to match many of the buddy duos who have previously been seen onscreen, but it cannot help but feel rushed, as the two Gladiators go from hostility to brothers in arms over the course of a single day. The main romance seems to have a lot to thank the horses for, as the basis of it seems to be Milo being able to break ones neck and successfully ride another, but neither of the friendship nor the romance is helped by the clunky dialogue.
Jon Snow was far from Westeros
Anderson tries to instil a sense of foreboding towards the final fate of the citizens of Pompeii, but the cuts to the volcano and the dropped hints instead come off as heavy handed, while the political machinations are little more than a dull plot device to bring the antagonists into the titular city. The action would be worth praising, if it weren't for the distractingly choppy direction or the fact that they feel rather tame, especially when memories are evoked due to the similarities with the Spartacus: Blood and Sand TV Series. Thank goodness for the acting, which is competent enough to liven things up, especially whenever Keifer Sutherland appears to chew the scenery.
Pompeii is a confounding film, to say the least, due to the script being handled by 3 different writers and still turning out poor, and the action being directed by somebody who's spent 20 years in the business, but feels like the work of a wet behind the ears amateur. Thank goodness for the acting, which may not be anything remarkable, but managed to pretty much save the film from being one of the years worst.
2 stars 2014 Adewale Akinnuoye-Agbaje Carrie-Anne Moss Disaster Emily Browning Film Historical Jared Harris Keifer Sutherland Kit Harrington Paul W.S. Anderson


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Home Hot Topics Our interview with Jennifer Aniston
Our interview with Jennifer Aniston
Maria Laken
With rumours circulating about a reunion of the hit TV series, Friends, Jennifer Aniston reveals her real besties are actually her dogs…
It has been a few years since the last episode of Friends was filmed, but it is still regularly shown on our screens and is loved by millions around the globe. Jennifer Aniston, who played Rachel in the American sitcom, is quick to tell us that among her closest friends are her dogs."They are real friends," she said. "I have some great human friends, of course, but my dog friends are very special. OK, so they don't text me or buy me flowers, but they do so much more. They pick me up if I need it, they always greet me when I come home and they never complain about anything. I wish I was like that."
Jennifer Aniston was always going to be an actress because she came from an acting background."I was actually born in California, but when I was little, I had some of my growing-up time in Greece – only for about a year, though. A lot of people think I am Greek, but I am only partly Greek – my father was born in Greece.My father and mother – John Aniston and Nancy Dow – were both actors, so I was kind of used to the way of life and meeting other people from the profession from a very early age."I think I was about 11 when I first landed a role. I had been training at the Rudolf Steiner School and they really encouraged the arts. I didn't need much encouraging, of course, but it was a great place to learn and the drama club put on productions, which helped me get in front of an audience. From there, I went for further training as a student at the High School of Performing Arts in New York, probably better known as the Fame school. It was great and I graduated there, which was a huge thrill.
Becoming Rachel
"I got work in a number of stage productions, which was great, although not quite Broadway, and then I landed a role in the TV series Molloy. I thought I had made it and I got several other parts, but nothing very big. Then along came what was going to be called Friends Like These and I was asked to audition for the part of Monica. I didn't really think it was me, so I turned it down. Most people who knew me thought I must be crazy to turn something down, but then I was offered another audition for the part of Rachel Green. That worked and I became Rachel. It was a huge success and people used to ask their hairdressers for 'Rachel' haircuts and people would stop me in the street and call me Rachel. They still do sometimes!"…
Read the rest of the interview by Bernard Bale in the January issue
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Dog lover and animal welfare supporter, who has had previous experience in the magazine industry and has been writing for Dogs Monthly since 2018. To contact this writer please call 01276 858880 or email maria@petsubjects.co.uk


I'm worried about my son Leo.He was always thin but has been putting on a lot of weight since last Christmas. I'm a single dad and try to have healthy meals with fast food and pizza once in a while. Leo is always hungry now and complains if I don't have enough food for him to eat seconds. We went to the pool today and he's beyond chubby now. Any ideas about how I can help him to not eat so much? For example breakfast this morning for him was a big bowl of cereal,orange juice, and 4 pieces of toast.


When you talk about civil rights in America, perhaps no woman is as iconic as Angela Davis. In the late '60s and early '70s, Angela was front and centre in the Black Power movement - fighting to end the racism and injustice she'd known all her life.
Davis grew up in Alabama, in the '40s and '50s, a time when blacks were beaten, raped, and murdered by the Ku Klux Klan. In Davis's neighbourhood, the KKK carried out so many bombings it became known as "dynamite hill".
By the late '60s, Davis had earned a doctorate in philosophy, joined the Communist Party and become part of the Black Panthers. She'd also become a supporter of three black men in the Soledad prison accused of killing a white guard. In 1970, during one of their trials, an escape attempt was made and several people were killed, including the judge. Davis was brought up on numerous charges, including murder - because the gun used was registered in her name. She went into hiding, ended up on the FBI's 10 Most-Wanted list and after her arrest, spent nearly 18 months in jail.
That sparked a global campaign to free her. John Lennon wrote the song "Angela" for Davis, while the Rolling Stones recorded "Sweet Black Angel" in tribute to her. Eventually in 1972 she was acquitted by an all-white jury.
But her quest for justice never ended. Today, Davis is a professor, an activist and the author of eight books. She's also the founder of Critical Resistance - a group that wants the U.S. prison system abolished.
At the moment, Davis continues to pursue justice: she is campaigning to prevent the execution of prisoner Troy Davis in Georgia. A national day of support will take place on September 16th in the U.S.


text:
Q: Can't understand why Zend_Mail::addHeader() strips newlines (Since this is my first SO question, let me just say I hope it's not too Zend-specific. As far as I can tell this shouldn't be a problem. Although I could have posted it in a Zend-specific forum, I feel like I'm at least as likely to get a good answer here, especially since the answer might involve MIME-related issues that transcend Zend Framework. I'm basically trying to understand whether the issue I'm facing should be considered a ZF bug, or if I'm misunderstanding something or misusing it.)
I've been using Zend_Mail to build up a MIME message that gets sent through SendGrid, an email distribution service. Their platform allows you to send emails through their SMTP server, but gives added features when you use a special header (X-SMTPAPI) whose value is a JSON-encoded string of proprietary parameters, which can get quite long.
Eventually, the header I was passing got too long (I think >1000 chars), and I got errors. I was confused because I knew that it was getting passed through PHP's native wordwrap() function before I passed the value to Zend_Mail::addHeader(), so I thought line length should never be a problem.
It turns out that addHeader() strips newlines very deliberately, and with no particular explanation by way of comments.
// In Zend_Mail::addHeader()
$value = $this->_filterOther($value);

// In Zend_Mail::_filterOther()
$rule = array("\r" => '',
              "\n" => '',
              "\t" => '',
);
return strtr($data, $rule);

Ok, this seemed reasonable at first -- maybe ZF wants full control of formatting and line-wrapping. The next method called in Zend_Mail::addHeader() is
$value = $this->_encodeHeader($value);

This method encodes the value (either quoted-printable or base64 as appropriate) and chunks it into lines of appropriate length, but only if it contains "non-printable characters", as determined by Zend_Mime::isPrintable($value).
Looking into that method, newlines (\n) are indeed considered non-printable characters! So if only they hadn't been stripped out of the string in the previous method call, the long header would get encoded as QP and chunked into 72-char lines, and everything would work fine. In fact, I did a test where I commented out the call to _filterOther(), and the long header gets encoded and goes through with no problem. But now I've just made a careless hack to ZF without really understanding the purpose behind the line I removed, so this can't be a long-term solution.
My medium-term solution has been to extend Zend_Mail and create a new method, addHeaderForceEncode(), which will always encode the value of the header, and thus always chunk it into short lines. But I'm still not satisfied because I don't understand why that _filterOther() call was necessary in the first place -- maybe I shouldn't be working around it at all.
Can anyone explain to me why this behaviour exists of stripping newlines? It seems to inevitably lead to situations where a header can get too long if it doesn't contain any "non-printable characters" other than newlines.
I've done a bunch of different searches on this subject and looked through some ZF bug reports, but haven't seen anyone talking about this. Surprisingly it seems to be a really obscure issue. FYI I'm working with ZF 1.11.11.

Update: In case anyone wants to follow the ZF issue I opened about this, here it is: Zend_Mail::addHeader() UNfolds long headers, then throws exception

A: You're probably running into a few things.  Per RFC 2821, text lines in SMTP can't exceed 1000 characters:

text line
The maximum total length of a text line including the  is
  1000 characters (not counting the leading dot duplicated for
  transparency).  This number may be increased by the use of SMTP
  Service Extensions.

A header can't contain newlines, so that's probably why Zend is stripping them.  For long headers, it's common to insert a line break (CRLF in SMTP) and a tab to "wrap" them.
Excerpt from RFC 822:

Each header field can be viewed as a single, logical  line  of
  ASCII  characters,  comprising  a field-name and a field-body.
  For convenience, the field-body  portion  of  this  conceptual
  entity  can be split into a multiple-line representation; this
  is called "folding".  The general rule is that wherever  there
  may  be  linear-white-space  (NOT  simply  LWSP-chars), a CRLF
  immediately followed by AT LEAST one LWSP-char may instead  be
  inserted.

I would say that the _encodeHeader() function should possibly look at line length, and if the header is longer than some magic value, do the "wrap and tab" to have it span multiple lines.

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Enjoy traditional favorites and made from scratch comfort foods at The Coffee Shop, the perfect setting for a memorable Easter gathering.


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Vague Visages Categories
Vague Visages Categories Select Category 12 Angry Films: Sidney Lumet on Justice by Brian Brems 2014 Film Essays 2014 Film Reviews 2015 2015 Film Essays 2015 Film Reviews 2016 2016 Film Essays 2016 Film Reviews 2016 Music Reviews 2017 2017 Film Essays 2017 Film Reviews 2017 Music Reviews 2018 2018 Film Essays 2018 Film Reviews 2018 Music Essays 2018 Music Reviews 2019 2019 Film Essays 2019 Film Reviews 2019 Music Essays 2019 Music Reviews American Cinema American Crime Story: The People v. O. J. Simpson Angelica Jade Bastién Arrow Video FrightFest 2018 ArteKino Festival 2018 At The Cinémathèque by Justine A. Smith Austrian Cinema BAMCinemaFest 2019 Berlinale Berlinale 2018 Berlinale 2019 Blood in the Snow Film Festival 2018 Book Reviews British Cinema Brooklyn Horror Film Festival 2018 Cannes Film Festival Cannes Film Festival 2018 Cannes Film Festival 2019 Capitolo 20 by Q.V. Hough Casting Chat Transcripts Chicago International Film Festival Chicago International Film Festival 2017 Cinemania Film Festival 2018 Clermont-Ferrand 2019 Clermont-Ferrand 2019 Coffee and Cinephilia Columns Critics in Conversation by Manuela Lazic and Adam Nayman Current Columns Dallas International Film Festival Devious Dialogues by Mike Thorn and A.M. Stanley DMG's Jeff Nichols RetroSpecial Dudley's World By Jordan Brooks Dylan Moses Griffin Edinburgh International Film Festival Edinburgh International Film Festival 2019 Fantasia 2017 Fantastic Fest Fargo Fargo Film Festival Featured Festival du Nouveau Cinema FEUD: Bette and Joan Fight Like a Man by Ross McIndoe Film Essays Film Festivals Film Reviews Film Theory Vérité by Alex Landers FilmStruck FilmStruck Essays Freelancer Writers French Cinema Game of Thrones German Cinema Girls Glasgow Film Festival Glasgow Film Festival 2019 Greek Cinema Guadalajara Film Festival Hannibal His Blazing Automatics by Dylan Moses Griffin IFFR 2019 India Kaleidoscope Film Festival IndieLisboa International Film Festival Rotterdam Interviews Italian Cinema Jacob Oller Japanese Cinema Jordan Brooks Josh Slater-Williams Justine A. Smith La Quinzaine des Réalisateurs 2019 La Semaine de la Critique 2019 Las Palmas Film Festival Las Palmas Film Festival 2018 Locarno London Film Festival London Film Festival London Film Festival 2017 London Film Festival 2018 Los Cabos International Film Festival Louie Marshall Shaffer's #FilmStruckFebruary Max Bledstein Mexican Cinema More Than Shadows by Angelica Jade Bastién Music Essays Music Reviews My Summer of Dunst by Kristen Lopez Neaux Reel Idea by Bill Arceneaux Netflix from 5 to 6 by Q.V. Hough New York Film Festival New York Film Festival 2017 New York Film Festival 2018 New York Indian Film Festival 2018 New York Indian Film Festival 2019 News NoBudge Breakdown by Q.V. Hough Oak Cliffs Film Festival Of Love and Other Demons by Justine A. Smith On Performance by Q.V. Hough Once Upon a Time in Tarantinoland by John Brhel Open Roads: New Italian Cinema 2017 Photo Essays Portugese Cinema Preacher Provincetown International Film Festival Q.V. Hough RIDM – Montreal International Documentary Festival RIDM 2016 – Montreal International Documentary Festival Russian Cinema Santiago Festival Internacional de Cine SEMINCI Sheffield Doc/Fest 2017 Sheffield Doc/Fest: Sheffield International Documentary Festival South Asian International Film Festival 2017 Spanish Cinema Sundance Film Festival 2018 Sundance Film Festival 2019 Sundance Film Festival: London 2019 Sunday Spaghetti Swedish Cinema Swiss Cinema The Bottom Line (Action) The Conversation The Criterion Channel The Dueling Cavalier by Max Bledstein The Feminine Grotesque by Angelica Jade Bastién The Leftovers The Night Of The Western Enters the 70s by D.M. Palmer Thessaloniki Documentary Festival 2019 TIFF 2017 TIFF 2018 Trailers Transilvania Film Festival Transparent Tribeca Film Festival Tribeca Film Festival 2018 Tribeca Film Festival 2019 True Detective True/False Film Fest True/False Film Fest 2018 TV Recaps Two Drink Minimum by Jacob Oller Uncategorized Vague Visages Is FilmStruck Vague Visages Short Stories Vague Visages Writers' Room Vaguebande by Q.V. Hough Vinyl VOD VV Shudder Selects We Failed This Film by Dylan Moses Griffin Why Criticism by Justine A. Smith Why Criticism? by Justine A. Smith You Gotta Act by Manuela Lazic
Review: Esteban Crespo's 'Amar'
Sometimes It's Better Not to Know: What a 'Pan's Labyrinth' Novel Brings to the Table
The "Happy" Endings of Ari Aster's Cult Horror Duology
Not Your Trophy: Deer Imagery in Jordan Peele's 'Get Out'
'Whisper of the Heart' and the Tragedy of Yoshifumi Kondō
Martin Scorsese's 'Alice Doesn't Live Here Anymore' and Why His Female Protagonist Matters
12 Angry Films: Sidney Lumet on Justice #1 – '12 Angry Men'
A Serious Investigation: The Coen Brothers' 'Raising Arizona' (1987)
We Failed This Film: Walter Hill's 'Streets of Fire'
'A Serious Man,' the Goy's Teeth and the Coenesque
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Some Kind of Connection: Loss and Technology in the Films of Sophy Romvari
By Mike Thorn on May 10, 2019 • ( Leave a comment )
I initially connected with Sophy Romvari through Twitter about two years ago, after seeing her lyrical short film It's Him. Since then, I have watched almost all of Sophy's films and have been consistently fascinated by the ways that she hybridizes cinematic modes and genres. Her filmography exhibits strong visual aptitude and raises complex questions about the divisions between filmic truth and representation. Sophy and I have chatted sporadically, touching on everything from M. Night Shyamalan to documentaries to the connections between genre and trauma, and I am always curious to hear her ideas about cinema and the creative process. After recently watching In Dog Years, a moving reflection on death and the powerful connections between human and nonhuman animal friends, I reached out to Sophy asking if she would be interested in doing an interview about her work. The conversation below is transcribed from our e-mail exchanges.
Mike: I see all your films as narrative vehicles, but some are explicitly non-scripted or "documentary" (e.g. In Dog Years) while others seem to be scripted (e.g. Let Your Heart Be Light, Nine Behind, It's Him). Pumpkin Movie and Norman Norman, by contrast, seem to fall somewhere in between the two modes. How does your process differ between scripted and non-scripted films? Or does it differ at all?
Sophy: Like most people, I spent the first couple years after film school experimenting with the types of films I wanted to make in school but wasn't allowed to — this is certainly where Nine Behind came from. It was the first time I got to tell a story that was actually personal, but still had somewhat of a shield in casting an actor to play myself. The satisfaction I felt from this experience was tenfold compared to the films I had directed about middle-aged white men having some kind of crisis of identity. It's Him was also a thinly veiled autobiographical film with another Sophy stand-in. Let Your Heart Be Light got even closer, but I flipped roles with my co-director/co-star, Deragh Campbell. She played me, and I played her as "the friend." So I suppose when I break it down, I've slowly been moving to a more and more vulnerable and unshielded place with my filmmaking. This is essentially how I stumbled into becoming a "documentary" filmmaker. The process is not terribly different though. I find, with my more recent films, I have been trying to harness my ability to rely on my intuition, so — for that reason — these films come together rather quickly. There is a long incubation period, but a very short production period. This can also be attributed to my working relationship with Devan Scott, my DP who has shot all of my films (outside of Let Your Heart Be Light, which was shot by the wonderful Nikolay Michaylov). Devan and I have developed a lot of trust. He makes me feel like my vision as a director is supported and valid. I feel incredibly lucky.
Mike: I love the way Norman Norman and In Dog Years subvert the human-centric "talking head" documentary format. I think the non-stagey way you center nonhuman characters subtly calls the audience to think about animals' ways of being in the world. At the same time, both films emphasize familiar, human processes of anticipating loss (whereas a lot of drama typically centers around the aftermath of loss). Did you go into these two projects with the express purpose of reflecting on loss? Or did you maybe want to explore a broader question about the relationships between people and their nonhuman animal friends?
Sophy: It's really interesting to me to retroactively see how themes have arisen in my filmography that I definitely didn't actively plot out. It seems to me now, looking back, that all of my films have been about loss, either having occurred in the past or something imminent. It's a broad theme, but I think something that I am constantly meditating on in my personal life. I think the idea you express about anticipating loss is very interesting, and really hits the nail on the head. For me, making Norman Norman was preventative — I knew I was heading into a difficult phase in my life with losing Norman sometime soon. I made this film in anticipation of losing him, and also to capture this complicated moment that comes in everyone's life: knowing you are about to lose something and not being able to do a damn thing to stop it. I wanted to document it happening in real time, and communicate it through my own experience. I'm so glad that I did. In Dog Years was a way to share that hopefully healing experience with other people who I knew could relate to what I was going through. I think my ultimate goal with filmmaking is to make people feel a little less alone in experiences that nobody really likes to talk about. That's a huge part of how cinema functions in my life, so I hope to be able to do the same for others in some small way.
Mike: I see in all your films a persisting ambivalence about the role of technology in contemporary relationships, and you embed this ambivalence into your narratives in fascinating ways (I'm thinking about everything from Pumpkin Movie's focal Skype conversation to Norman Norman's bittersweet, Streisand-related YouTube rabbit holes). Do you consciously set out to foreground technology in your work? How do you feel about the role of contemporary technology in film narratives?
Sophy: This is another one of those retroactive theme discoveries that I only realized after making Pumpkin Movie! I have joked before that I could screen all my films in a program called "lonely girls on laptops." Nine Behind opens with the main character eating noodles alone at a table, watching David Letterman. There is a lot of screen time in It's Him: the character reviewing footage of her missing brother on her laptop in a dark room, or fixated on the photo on her phone. In Let Your Heart Be Light, she watches one of my favourite films of all time, Meet Me in St. Louis, alone on her laptop. I would say, to answer your question, that it is actually a subconscious choice, but one that I feel communicates this sense of loneliness that I don't know how else to express. It's a form of distraction when faced with anxiety, but also a desperate attempt to feel some kind of human connection, even if it's just the sound of a stranger's voice.
Mike: I think your filmography presents a novel point-of-view, full of unique ideas and visual style. You mentioned that Meet Me in St. Louis is one of your favorite films — where do you get your inspiration? Are there any filmmakers you would cite as key influences? Do you take inspiration from other media?
Sophy: I 100% take inspiration from other media/filmmakers; anyone who says otherwise would be lying! Again, I think this is something that happens on a very subconscious level: you see a film that does something differently and you think "oh wow, you can do that??" And then you incorporate that idea/theme/methodology sometimes without even noticing. Those moments are the best! I'm finding recently those moments have been coming mostly from non-fiction or documentary films, but really, they can come from anywhere. A recent example would be Milla by Valérie Massadian. While watching this film, I came up with the idea for Pumpkin Movie — the two films have actually nothing in common, but while watching Milla, I was struck by the simple fact that so much of the "acting" was just Milla doing. Making a bed, cleaning up, counting change — it actually inspired me more as an actor than anything! So that's when I came up with the idea that during Pumpkin Movie, I would be carving a pumpkin, while having a conversation. It simply inspired me to add something to do with my hands; the concept came afterwards. I was also incredibly inspired by Claire Simon's Premières Solitudes — in my eyes it's the perfect documentary. It documents, while sticking to clear formal choices. Its collaborative, it's honest and earnest, it's funny and it's simple. It's seeing films like this one that make me feel like we are only just beginning to understand the possibilities of cinematic language.
Mike: What's next for Sophy Romvari? What are you working on right now?
Sophy: I am currently wrapping up my master's degree at York University — I shot my thesis film in November 2018 but had to set the footage aside for a little while. I needed some space. I will spend the next few months editing this piece, which I believe will be a mid-length film of a genre that I don't care to define. Outside of that, I have a handful of short film ideas that I am eager to create, but most of all, I am beginning research and development on my first feature film, which I plan to shoot next year if all goes well. With school wrapping up, I'm spending a lot of time investing in my mental health and trying to be proactive about addressing some major pitfalls that I believe are holding me back as an artist. It has been a long-term goal of mine to turn my career toward community outreach via filmmaking as a means of trauma therapy, so as soon as I am feeling stable and have the means to do so, I have some plans on how to begin that journey.
Mike Thorn (@MikeThornWrites) is the author of the short story collection Darkest Hours. His fiction has appeared in a number of magazines, podcasts and anthologies, including Dark Moon Digest and The NoSleep Podcast, and his film criticism has been published in MUBI Notebook, The Film Stage and The Seventh Row. He completed his M.A. with a major in English literature at the University of Calgary, where he wrote a thesis on epistemophobia in John Carpenter's Prince of Darkness.
Categories: Featured, Interviews
Tagged as: 052019, Director, Documentary, Filmmaker, In Dog Years, Interview, It's Him, Let Your Heart Be Light, Mike Thorn, Nine Behind, Norman Norman, Pumpkin Movie, Short Film, Sophy Romvari
Tribeca Film Festival Review: Rania Attieh and Daniel Garcia's 'Initials S.G.'
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Cirrus Logic STEM Track at the 2019 Texas Book Fest
By Lois Kim on September 24, 2019
For the latest conversations about the worlds of science, technology, engineering and mathematics, check out the Cirrus Logic STEM Track at this year's Texas Book Festival. The Cirrus Logic track is your curated guide to big discussions about climate change, internet culture, space flight, psychology at the voting polls, and more.
Forget Astronauts, Introducing The AstroNuts!
11:00 AM – 11:45 AM, Kirkus Reviews Tent
Uh-oh! Looks like humans have no place to go after Earth. Worry not! The AstroNuts are here! Hybridized to find other planets, AstroWolf, LaserShark, SmartHawk, and StinkBug are here to find another planet for humans to live. Join us as this major new series by kid lit legend Jon Scieszka and illustrator Steve Weinberg launches us into outer space adventure!
Authors: Jon Scieszka and Steven Weinberg
In The Hands of Our Hubris: Human Behavior in the Face of Climate Change 11:00 AM – 11:45 AM, C-Span2/BookTV Tent
Building mansions up to the edges of coastlines, disrupting the deserts for oil; short-term human goals consistently come up against the obvious and ongoing effects of climate change. In their new books, bestselling author and conservationist Terry Tempest Williams (Erosion), Pulitzer Prize-winner Gilbert Gaul (The Geography of Risk), and journalist Nathaniel Rich (Lost Earth) examine human hubris in the face of our environment's increasingly drastic cries for help–and its threats if our behavior doesn't change.
Author(s): Gilbert Gaul, Terry Tempest Williams, Nathaniel Rich
Moderator: Juli Berwald
Bring Your Brain to Work: Using Psychology to Make the Most of Your Professional Life
11:45 AM – 12:30 PM, Capitol Extension Room 2.036
If you're in a job interview, how should you think about the mindset of the interviewer? If you've just been promoted, how do you handle the tensions of managing former peers? Join professor, author, and popular radio host Art Markman as he shares the essential elements of a successful career and gets inside our heads, helping us to succeed through a better understanding of ourselves and those around us.
Author: Art Markman
Moderator: Rebecca McInroy
Creative Calculations: At The Intersection of Math and Literature
1:45 PM – 2:30 PM, Capitol Extension Room 2.012
New works of fiction and nonfiction plumb the intersection of analytics and creativity, giving mathematics the spotlight as a fascinating lens on character and history. Catherine Chung (The Tenth Muse) and Karen Olsson (The Weil Conjectures) share their own experiences studying high-level mathematics and how the logic of numbers inspired their new books.
Author: Karen Olsson, Catherine Chung
The High Drama — and Harrowing Hubris — of Big Tech
4:00 PM – 4:45 PM, C-Span2/BookTV Tent
Big pay-offs, epic power struggles and spiraling mega-companies make for dramatic stories of major wins and harrowing hubris in Silicon Valley. In new page-turning accounts, Mike Issac (Superpumped: The Battle to Save Uber) and Ben Mezrich (Bitcoin Billionaires) dive into the headline-making worlds of Bitcoin and Uber, exploring the characters and companies behind big tech windfalls and executive rock bottoms with all of the dazzle, defeat, and indefatigable spirit of the people innovating our future.
Author(s): Mike Isaac, Ben Mezrich
Moderator: Suzi Sosa
Predisposed to Vote: The Evolutionary Science of Our Political Divide
11:00 AM – 11:45 AM, Capitol Extension Room 2.016
Are we evolutionarily predispositioned for the politics we believe in? Psychologist Hector A. Garcia thinks so. In his new book, he breaks down how the most complex political processes can be influenced by our basic instincts and ancestral histories. A new lens on politics and how we evaluate the self, Garcia offers insight into how we might better understand ourselves and people on the other side of the aisle.
Author: Hector A. Garcia
Moderator: Jennifer Stayton
Superpower: One Man's Quest to Transform American Energy
Capitol Extension Room 2.012, 12:45 PM – 1:30 PM
Michael Skelly began working on wind energy in 2000, when many considered the industry a joke. Since then, he has created the second largest wind power company in the country and sold it for $2 billion. Journalist Russell Gold (Superpower) wrote the story of this pioneer of renewable energy and sits down with Skelly today to discuss his incredible story and the future of renewable energy in America.
Authors: Russell Gold, Michael Skelly
Moderator: Shalini Ramanathan
True Stories That Inspire
Next Chapter Tent, 1:15 PM – 2:00 PM
Do you love fun facts? Is social studies your favorite subject? Do you hope for a history lesson? Or do you just really like learning about awesome people from the past? We've got two stories of amazing women from history who took on the challenge of flight and engineering to change the world. Learn how the soared through the clouds and programmed the very first computers!
Author(s): Steve Sheinken, Tami Lewis Brown, Debbie Loren Dunn
Moderator: Diane Hernandez
Vaccines Did Not Cause My Daughter's Autism
Capitol Extension Room 2.012, 3:15 PM – 4:00 PM
Troubled by the decades-long rise of the influential anti-vaccine community and their narrative around childhood vaccines and autism, Houston pediatrician Peter J. Hotez now presents evidence for the genetic basis of autism. He illustrates how the neurodevelopmental pathways of autism are under way before birth, asserting that vaccines definitely do not cause autism—and did not cause his own daughter's autism.
Author: Peter Hotez
American Moonshot: John F. Kennedy and the Great Space Race
Capitol Auditorium, 3:30 PM – 4:15 PM
Award-winning historian and bestselling author Douglas Brinkley takes us to the 1960s to recreate one of the most exciting and ambitious achievements in the history of humankind: America's race to the moon. Bringing together the extraordinary political, cultural, and scientific factors that fueled the birth and development of NASA and the Mercury, Gemini and Apollo projects, this is an homage to scientific ingenuity, human curiosity, and the boundless American spirit.
Author: Douglas Brinkley
Founded in 1984 in Silicon Valley, Cirrus Logic is a leader in high performance, low-power ICs for audio and voice signal processing applications. Cirrus Logic's products span the entire audio signal chain, from capture to playback, providing innovative products for the world's top smartphones, tablets, digital headsets, wearables and emerging smart home applications. Learn more at cirrus.com.