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Keywords: Bupivacaine, magnesium sulphate, motor block, neostigmine, sensory block, subarachnoid block
Kushwaha J, Raikwar S, Rathore S. Comparative clinical evaluation of intrathecal bupivacaine heavy, bupivacaine with magnesium sulphate and bupivacaine with neostigmine for infraumbilical surgeries – A clinical study. Adv Hum Biol 2020;10:120-4
Kushwaha J, Raikwar S, Rathore S. Comparative clinical evaluation of intrathecal bupivacaine heavy, bupivacaine with magnesium sulphate and bupivacaine with neostigmine for infraumbilical surgeries – A clinical study. Adv Hum Biol [serial online] 2020 [cited 2021 Jan 20];10:120-4. Available from: https://www.aihbonline.com/text.asp?2020/10/3/120/295841
Subarachnoid block is the most common and simple technique for ambulatory surgery and for major surgery when combined with long acting intrathecal opioids, extradural or regional lower limb block.
Regional anaesthesia is widely used to let the performance of different surgical procedures including those performed below umblicus.[1] Previous studies have demonstrated that both subarachoid and epidural block tend to have reduced blood loss and occurrence of deep venous thrombosis, less general induced adverse effects such as nausea, vomiting, sore throat, alteration of mental status and cognitive dysfunction and allowing an improved pain control.[2],[3]
Regional techniques may lead to blockade or reduced pain ranged from several hours to several days. Better pain control may result in an earlier hospital discharge and may improve the patient stability in post-operative period.[4] In addition, it is usually easy to administer and readily available.[5]
It has become a common practice to use different therapeutic regimens for treating intra- and post-operative pain and increasing the regional anaesthetic period, because no drug has yet been identified to have this advantage without associated therapeutic side effects.[6] One method to increase the duration and reduce side effects is to administer combinations of other classes of analgesics with local anaesthetics.
Intrathecal neostigmine has been shown to prolong motor and sensory blockade and reduces post-operative analgesic requirements. It inhibits the breakdown of 3 acetylcholine in dorsal horn and spinal meninges, therefore increasing acetylcholine concentration, which causes analgesia through action on spinal cholinergic muscarinic receptors M1 and M2. We choose a dose of 25 μg because this dose would be unlikely to cause side effects and has produced evidence of analgesia in clinical trials.[7],[8]
Magnesium blocks calcium influx and is a non-competitive antagonist to NMDA receptors; it has the ability to prevent central sensitisation from peripheral nociceptive stimulation.
Due to the fact that both neostigmine and magnesium sulphate have shown effects on local anaesthetic effects, we considered these two drugs and compared their equivalent doses effects as an adjuvant. Because the effects of adding these two non-opioid drugs in such a concentration and comparing their effects have not studied formerly.
The purpose of this study was to assess the anaesthetic effects of adjuvant therapies with neostigmine or magnesium sulphate compared with bupivacaine intrathecally, alone in patients undergoing infraumbilical surgeries under subarachnoid block.
In this comparative observational hospital based study, a total of 90 patients of ASA class I and II, aged between 18 and 50 years, of either sex (M and F), scheduled for elective infraumbilical surgeries were included in this study.
After approval from the Institutional Ethics Committee, all the patients were subjected to detailed pre-anaesthetic evaluation with clinical history, thorough physical and systemic examination, routine investigation which include complete blood count, urine (routine and microscopy), blood sugar, renal function test, serum electrolytes, X-ray chest posteroanterior view, electrocardiogram (ECG) and any special investigation if required was done for the study. Informed written consent was obtained from all the patients enrolled for the study.
The patients with neurological disease, spinal or neurological deformity, skin infection at the site of subarachnoid block, bleeding diathesis, history of drug allergy to bupivacaine, magnesium sulphate and neostigmine, severe heart and liver disease were excluded from the study.
The patients were randomly divided into three groups of 30 patients each with the help of a random number table. The groups were assigned as Group I, II, III, respectively. Group I patients received bupivacaine heavy (0.5%) 3 ml (15 mg) +0.5 ml normal saline. Group II patients received bupivacaine 3 ml (15 mg) + preservative free magnesium sulphate 0.5 ml (50 mg). The 50 mg MgSO4 was prepared by 1 ml of MgSO450% plus 5 cc Normal Saline 0.9%. Group III patients received bupivacaine (3 ml) + neostigmine 0.5 ml (25 μg). The 25 μg neostigmine was prepared by 1 cc of neostigmine 0.5% plus 10 cc Normal Saline 0.9%. Materials required for the procedure is Spinal trolley with 25G quinckes type spinal needle, 2 ml and 5 ml disposable syringes, lignocaine 2% vial for local infiltration. All equipments necessary for resuscitation were kept ready such as emergency drugs, cardiopulmonary resuscitative equipment and oxygen sources. Drugs required for the study include, one ampoule of bupivacaine 0.5% (H), one ampoule of neostigmine (0.5 mg/ml) and one ampoule of magnesium sulphate (50% W/V).
After shifting patient in operation theatre, a careful preoperative examination along with history was taken. Peripheral line was secured by inserting intravenous cannula (18–20G), preloaded with ringer lactate solution 15 ml/kg. All the monitoring equipment (like NIBP Cuff, Pulse oxymetry, ECG) were attached to the patient and baseline values of heart rate, blood pressure, SpO2 and respiratory rate were recorded. Patients were kept in supine position. Injection Ondansetron 0.1 mg/kg and injection Ranitidine 0.5 mg/kg was given intravenously to all the patients prior to induction. After strict aseptic precautions, skin and subcutaneous tissue was infiltrated with 2% injection lignocaine, then subarachnoid block was performed in sitting position, using midline approach with 25 G spinal needle in L3–L4 intervertebral space. After the appearance of free flow of cerebral spinal fluid, the mixture of drugs according to assigned group was injected. Utmost care was taken to avoid any leakage of any of these drugs. The spinal needle was removed and patient was immediately turned to supine position.
Various parameters were then assessed and recorded on a prescribed pro forma such as duration of sensory block (time for regression of sensory block to S2 dermatome was), motor block (time to achieve grade 0 motor blockade from grade 3 motor blockade), quality of block[Grade 1-(unsuccessful) patient needs general anaesthesia Grade 2-(moderate) complaints that require supplemental analgesia. Grade 3-(good) minor complaints with no need of supplemental analgesia. Grade4-(excellent) no complaints], duration of analgesia (time from intrathecal injection of drug until the patient request for additional analgesia, which further assessed by visual analogue score of ≥4).
Demographic parameters such as age, height, weight, sex were also recorded on prescribed pro forma. Haemodynamic variables such as heart rate, blood pressure, respiratory rate, systolic and diastolic blood pressure, SpO2 were recorded preoperatively and at 5th min, 10th min and 150th min. The surgical anaesthesia was considered effective when T6-8 dermatome was anaesthetised and grade 3 motor block was achieved. After establishment of adequate level of block up to T10, surgery was started and time of beginning of surgery and duration of surgery was noted. Patients were given oxygen by oxymask at 4 L/min. All the patients were observed for any adverse effects in the intraoperative and post-operative period for 24 h.
All the data in the form were filled using Microsoft excel sheet. Statistical procedures were carried out in two steps that are data compilation and presentation and Statistical analysis. Statistical analysis was done using Statistical Package of Social Science (SPSS Version 20; Chicago Inc. USA). Data comparison was done by applying specific statistical tests to find out the statistical significance of the comparisons. Quantitative variables were compared using mean values and qualitative variables using proportions. Significance level was fixed at P < 0.05. Statistical tests employed for the obtained data in our study were Chi-square test, analysis of variance, Post hoc Tukey HSD (Honestly Significant Difference).
A total of 90 patients were included in the study based on inclusion and exclusion criteria with 30 in each group.
[Table 1] shows age, height and weight distribution in the three groups. All the patients were 18–50 years old. Mean age was 34.67 years in Group I, 33.87 years in Group II and 36.77 years in Group III. Mean height was 167.43 cm in Group I, 167.53 cm in Group II and 165.00 cm in Group III. Mean weight was 54.10 kg in Group I, 55.50 kg in Group II and 56.13 kg in Group III. There was statistically no significant difference found in age, height and weight between three groups.
Table 1: Demographic profile of patients in three groups
[Table 2] shows demographic profile of patients in three groups according to gender. Out of 90 patients 51 (56.7%) were male and 39 (43.3%) were female. There was statistically no significant difference found in distribution of patients according to gender, (P = 0.873).
Table 2: Demographic profile of patients according to gender in three groups
[Table 3] shows comparison of duration of sensory blockade (min) in three different groups. Duration of sensory blockade was maximum in Group II i.e., 397.67 ± 14.003 min and it was minimum in Group I i.e., 183.10 ± 8.185 min. There was statistically highly significant difference found in duration of sensory blockade between three groups, (P = 0.001). Duration of motor blockade was maximum in Group II i.e., 213.67 ± 13.767 min and it was minimum in Group III i.e., 164.67 ± 23.154 min. There was statistically highly significant difference found in duration of motor blockade between three groups, (P = 0.001). [Table 3] shows of analgesia (min.) in three different groups. Mean duration of analgesia was maximum in Group II i.e., 349.00 ± 22.453 min and it was minimum in Group I i.e., 241.33 ± 16.399 min. There was statistically highly significant difference found in duration of Analgesia between three groups, (P = 0.001). It also shows comparison of quality of block in three different groups. Mean quality of block score was highest in Group II i.e., 3.83 ± 0.46 min and it was minimum in Group I i.e., 2.83 ± 0.79 min. There was statistically highly significant difference found in quality of block between three groups, (P = 0.001) The mean duration of surgery was 91.50 min in group I, 93.00 min in group II and 91.00 min in group III. There was statistically no significant difference found in duration of surgery between three groups, (P >0.05).
Table 3: Comparison of duration of sensory blockade,motor blockade,duration of analgesia,quality score and duration of surgery in three groups.
Among the complications, nausea was seen amongst three patients intraoperatively and in one patient in post-operative period in Group III. Shivering was found in two patients intraoperatively in Group I and in one patient in Group III. Bradycardia was seen only in one patient in Group III. Vomiting was seen in one patient postoperatively in Group I, II and III and in two patients intraoperatively in Group III. Pruritus was not seen in any of the patients.
Neuraxial blocks are now a days most popular and commonly used than ever since the late 19th century (1885) for infraumbilical surgeries. Subarachnoid block is preferred over epidural block, because of its rapid onset, good density block, lower failure rates, no catheter-related complications and cost-effectiveness, but has the limitations of shorter duration of block and inability to extend the analgesia into the post-operative period.[9] In recent years, the use of intrathecal adjuvants has gained popularity, with the intention of reducing the dose of local anaesthetics, maintaining haemodynamic stability, delaying the onset of pain during the post-operative period, and thus reducing the demand for post-operative rescue analgesics. Addition of adjuvants ensures faster recovery, enabling patients to return to their routine activity more quickly.[10] Most commonly used adjuvant in central neuraxial blocks are opioids,[11] however, their adverse effects such as respiratory depression, nausea, vomiting, hypotension, constipation and pruritus have prompted further research to develop nonopioid adjuvants with less worrisome side effects.[12]
Magnesium sulphate is NMDA receptor antagonist. N methyl D aspartate receptors play an important role in neuronal plasticity and processes leading to central sensitisation of pain. Intrathecal Magnesium sulphate blocks NMDA receptors at dorsal horn thus preventing central sensitisation to pain and improving anaesthetic and analgesic quality.[13]
Hoodet al. in 1997 reported postoperative analgesia of intrathecal neostigmine, first reported post-operative analgesia of intrathecal neostigmine acholinesterase inhibitor, the effectiveness of which being comparable to morphine. Several studies suggest neostigmine as an effective adjuvant to prolong the duration of the subarachnoid block with better haemodynamic stability.[14] Many studies showed that there is synergism between intrathecal neostigmine with local anaesthetic agents. Considerable evidence exists to implicate the role of cholinergic agonists and anticholinesterase agents in the spinal inhibition of nociceptive transmission.[15] Intrathecal administrations of neostigmine produce antinociception, which is mediated by spinal muscarinic and nicotinic receptors in animals and human beings.[16] It produces analgesia by releasing of nitric oxide and inhibiting the metabolism of acetylcholine and binding to M1 and M3 muscarinic and to nicotinic receptors.[17] Whereas local anaesthetic agents/bupivacaine act by blocking voltage gated Na+ channels in spinal cord.
Since all the groups were demographically similar (P > 0.05 in all the comparisons), it can be presumed that the groups are comparable for the purpose of the study.
All the patients of study group were preloaded with ringer lactate to counterbalance the effect of relative hypovolemia or hypotension.
In this study, we showed that magnesium 50 mg when added to bupivacaine-fentanyl combination for spinal anaesthesia could provide prolonged post-operative analgesia without additional side effects in patients undergoing lower limb orthopaedic surgery and also prolongs the duration of sensory blockade.
Malleeswaran et al.[18] in their study also observed similar results with a combination of bupivacaine-fentanyl and magnesium intrathecally in patients with mild preeclampsia undergoing caesarean section. Arcioni et al.[19] also observed that intrathecal and epidural magnesium sulphate, potentiated and prolonged the motor blockade.
Unlugenc et al.[20] in their study showed prolongation of the duration of sensory block in magnesium group.
Dayioǧlu et al.[21] also concluded from their study that addition of intrathecal magnesium sulphate to subarachnoid block, prolonged the time to first analgesic requirement.
In our study, all the patients were haemodynamically stable in all the three groups with respect to pulse rate, systolic blood pressure and diastolic blood pressure, respiratory rate and SpO2(P > 0.05).
In our study, the incidence of nausea, vomiting and shivering, showed no significant difference among the three groups and this may be related to similar haemodynamic and absence of significant hypotension among groups. Bradycardia was observed only in one patient of Group III. Pruritus was not seen in any patient.
We carried out our study in 90 patients divided into three groups. The study was carried out to compare the effect of intrathecal magnesium sulphate 50 mg, intrathecal neostigmine 25 μg added to intrathecal bupivacaine heavy and found that both can be used to prolong the duration of sensory and motor block, duration of analgesia and quality of block and it is prolonged more significantly with magnesium sulphate as compared to neostigmine.
Breivik H, Norum HM. Regional analgesia-risks and benefits. Tidsskr Nor Laegeforen 2010;130:392-7.
Chelly JE, Ben-David B, Williams BA. Anaesthesia and postoperative analgesia: Outcomes following orthopedic surgery. Orthopedics 2003;26:S865-71.
Tziavrangos E, Schug SA. Regional anaesthesia and perioperative outcome. Curr Opin Anaesthesiol 2006;19:521-5.
Kirkebøen KA, Lindholm E, Raeder J. Choice of anaesthetic approach and anaesthetic drugs. Tidsskr Nor Laegeforen 2010;130:388-91.
Buist RJ. A survey of the practice of regional anaesthesia. J R Soc Med 1990;83:709-12.
Eledjam JJ, de La Coussaye JE, Viel E. Technics of locoregional anesthesia of the lower limb. Phlebologie 1989;42:31-43.
Lauretti GR, Hood DD, Eisenach JC, Lauretti GR. A multi-center study of intrathecal neostigmine for analgesia following vaginal hysterectomy. Anesthesiol 1998;89:913-8.
Krukowski JA, Hood DD, Eisenach JC, Mallak KA, Parker RL. Intrathecal neostigmine for post-caesarean section analgesia: Dose response. Anesth Analg 1997;84:1269-75.
Holmström B, Laugaland K, Rawal N, Hallberg S. Combined spinal epidural block versus spinal and epidural block for orthopaedic surgery. Can J Anaesth 1993;40:601-6.
Shukla D, Verma A, Agarwal A, Pandey HD, Tyagi C. Comparative study of intrathecal dexmedetomidine with intrathecal magnesium sulfate used as adjuvants to bupivacaine. J Anaesthesiol Clin Pharmacol 2011;27:495-9.
Bano F, Sabbar S, Zafar S, Rafeeq N, Iqbal MN, Haider S, et al. Intrathecal fentanyl as adjunct to hyperbaric bupivacaine in spinal anesthesia for caesarean section. J Coll Physicians Surg Pak 2006;16:87-90.
Chaney MA. Side effects of intrathecal and epidural opioids. Can J Anaesth 1995;42:891-903.
Churchill-Davidson HC. Spinal and epidural block. In: Wylie & Churchill Davidson's A Practice of Anaesthesia. 5th ed. Singapore: PG Asian Economy; 1984. p. 856.
Krukowski JA, Hood DD, Eisenach JC. Intrathecal neostigmine for post-caesarean section analgesia: Dose response. Anesth Analg 1997; 84:1269-75.
Khadke SJ, Khadke VV, Patel SJ, Borse YM, Kelkar KV, Dighe JP, et al. Efficacy of spinal additives neostigmine and magnesium sulfate on characteristics of subarachnoid block, hemodynamic stability and postoperative pain relief A Randomized Controlled Trial. Anesth Essays Res 2015;9:63-71. doi: 10.4103/0259-1162.150168.
Kayalha H, Mousavi Z, Barikani AS, Yaghoobi S, Khezri MB. The effect of intrathecal neostigmine added to bupivacaine on postoperative analgesic requirements in patients undergoing lower limb surgeries. M E J Anaesth 2015;23:199-204.
Lauretti GR. The evolution of spinal/epidural neostigmine in clinical application: Thoughts after two decades. Saudi J Anaesth 2015;9:71-81.
S Malleeswaran, N Panda, P Mathew, R Bagga. Intrathecal magnesium improves postoperative analgesia in preeclamptics undergoing caesarean section. Int J Obstet Anesthesia 2010;19:161-6.
Arcioni R, Palmisani S, Tigano S, Santorsola C, Sauli V, Romanò S, et al. Combined intrathecal and epidural magnesium sulfate supplementation of spinal anesthesia to reduce post-operative analgesic requirements: A prospective, randomized, double-blind, controlled trial in patients undergoing major orthopedic surgery. Acta Anaesthesiol Scand 2007;51:482-9.
Unlugenc H, Ozalevli M, Gunduz M, Gunasti S, Urunsak IF, Guler T, et al. Comparison of intrathecal magnesium, fentanyl, or placebo combined with bupivacaine 0.5% for parturients undergoing elective cesarean delivery. Acta Anaesthesiol Scand 2009;53:346-53.
Dayioǧlu H, Baykara ZN, Salbes A, Solak M, Toker K. Effects of adding magnesium to bupivacaine and fentanyl for spinal anesthesia in knee arthroscopy. J Anesth 2009;23:19-25.


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Cody Canada and the Departed in Concert at Love and War
He fronted Cross Canadian Ragweed, the biggest band to ever hit the Red Dirt scene. Hell, they really helped to create it. In the process Cody Canada inspired a new generation of singers and songwriters.
And while Cross Canadian Ragweed, after splitting in 2011, will only live on in our hearts, The Departed carry on the torch ignited by Ragweed twenty years ago.
The Departed released their first album, This Is Indian Land, in June 2011. An album that consisted of covers written by Oklahoma songwriters, served as an introduction to Canada's new reincarnation.
On November 13, 2012, the band released their first original album titled Adventus. In 2014 the band announced a third studio album, and Hippielovepunk, was released on January 13, 2015. Never to be tied down, along the way the band has released two "passion projects." Canada's Some Old, Some New, Maybe a Cover or Two, in 2013, Chip and Ray, Together Again for the First Time, with Canada and Mike McClure in '15, and Jeremy Plato and the Departed's, In Retrospect, in late '16.
Never miss a chance to see a legend in concert, don't miss The Departed's Love and War show this Friday (Jan. 27).
Filed Under: Cody Canada and the Departed
Cody Canada Recalls Early Cross Canadian Ragweed Days — Radio Texas Live Legends, On Demand [Listen]
Cody Canada Releases 'Hard As It Seems', First New Song Since '18
The Full Lineup for Koe Wetzel's Incredible Music Festival: Panther Island Revealed
'Mile 0 Fest' Features Largest Collection of Texas & Red Dirt Acts Outside of Steamboat
Cody Canada and The Departed Lock-in June Release Date for '3', New Music Now
Medicine Stone '18 Full Lineup, Tickets on Sale June 1
What is Red Dirt Music?
Braun Brothers Reunion All Set for Idaho in August
Cody Johnson, Colt Ford, and More Playing 'July Fest' in Gun Barrel City

redpajama_set_name: RedPajamaCommonCrawl


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Random Musing Before Shabbat–Leḥ Leḥa 5777–Embracing the Spirit of Avram
[Introductory note – my regular readers know that I go through periods of using different ways to spell "G"d, " and different preferences in transliteration. I've decided to forego using "ch" or "kh" for now and go back to the academic practice of using ḥ to represent the sound of the Hebrew letters ח and כ/ ך. I may not stay with it long, as it's a pain to do, and only certain fonts contain the necessary characters. Oh, and I settled on the G"d spelling a while back because I felt the double-quotation mark was close in feeling to the double ײ we used to abbreviate G"d's name, so it made it clear that I was not referring to any generic god, but to Ad"nai. Better than a dash or a zero. Philosophically, I'm not all that troubled with writing the Divine name out even when it can be erased or disappear, but call it one of my inconsistent quirks that has personal meaning and value for me.]
Anyone who has ever taught about parashat Leḥ Leḥa to a group of young students (or even adults) has probably asked people to imagine what it would have been like to pick and and move somewhere without having any idea of where you were going and what would happen when you got there. We ask our students how many would be willing to that risk, and hold up Avram/Avraham as an example of a bold and brave person willing to do so. We play role games, imagining the conversation between Avram and his wife Sarai. (In often sadly misogynistic fashion, we imagine Sarai as shrewish wife, sounding like Golde, Yenta the Matchmaker (or even Fruma Sarah,) saying to Avram "You want to do what? Are you out of your mind?" Then Avram reveals that G"d told him to do this. We imagine Sarai saying "What are you, a luftmensch? (airhead.) A lokshen kopf?" (noodle head) Maybe Avram stomps his foot and Sarai obediently falls in line. Or maybe you see Sarai as simply doing what her husband says to do, because what else is there to do? If your group is creative, you might imagine Sarai as the bored middle-class housewife and spoiled princess thinking "anyplace is better than this dump. Let's go!" If your group is even more creative, and able to step out of the misogynist paradigm, you might imagine Sarai's reaction more positively. "Tell me about this G"d," she might ask. "Did he really promise to make us into a great and wealthy nation?" (If you're even more progressive, you might have her asking "Did She really promise…")
The distance from Haran to Sheḥem is about 400 miles, so it obviously took some time. Yet all we read in the text is the end of 12:5 and the beginning of 12:6:
…and they set out for the land of Canaan, When they arrived in the land of Canaan…
Torah is good about leaving out the details when it feels like it (and at other times, is ridiculously detailed.) We've toyed with our little biblio-dramas about the discussion that ensued between Avram and Sarai before they set out. Now imagine the conversations that took place during the journey. Even assuming a theoretically high travel rate of 20 miles per day, it would take 20 days. On foot, with such a large caravan, probably a lot longer.
They arrive at Sheḥem and G"d makes another pronouncement that all this land would be assigned to Avram and his descendants. Then, in just another few brief verses, the caravan makes it way to Bethel, wends it way south into the Negev, and then off into Egypt to escape the famine in Canaan. The text gives us no idea how long Avram and company took to trek the additional 225 miles or so from Bethel and into Egypt (and it never says where in Egypt he went.)
How long they were in Egypt is also unclear. We only know that Avram was sure the Egyptians would take a fancy to Sarai, and pleaded with her to say she was his sister, so they wouldn't kill him so they could take the beautiful Sarai for themselves. She agrees, and of course see is taken to Pharaoh. There are a lot of unspoken possibilities here. Whatever Sarai was doing it Pharaoh's house was good enough to make Avram wealthy and prosperous. The cynical among us – oh wait, that's me – might suggest that Avram prostituted his wife. Kind of hard to conclude otherwise. It says quite clearly in the text that Pharaoh had taken Sarai as a wife (see 12:19.) Then, of course, the inevitable Divine intervention afflicts Pharaoh and his household – so of course, Pharaoh's first assumption is to blame the Jew (well, in this case, the visitor, since there weren't really any Jews yet.) Avram admits his deception and is thrown out of Egypt (and for some reason, gets to take his wife and all his wealth with him. Hardly sounds like an angry Pharaoh. As SNL's church lady used to say "How convenient.")
You remember this story, right? It's the one that must have been really popular with the people, but occurred in all sorts of variants, so that the Torah's creators/redactors wound up using the same tale three times in the text! Who did it really happen to? They couldn't be sure, so they just threw in all three versions!
As usual, I digress. I want to get back to the leḥ leḥa bit. What really got me thinking about how we play biblio-drama around this story is our assumption that picking up and moving simply because G"d said so must be such a brave thing to do. Is it an accurate assumption?
I look at the path of my own life.
1. Born in the Bronx and lived there for two years.
2. Family moved to the Inwood section of Manhattan (north of "the Heights.") and stayed there for 16 years.
3. Family moved to the Bronx next to Yankee Stadium for the last 2 years of High School.
4. Moved to Winston-Salem, North Carolina for college.
5. Lived and worked back home in the Bronx the first summer of college.
6. Winston-Salem, NC for the sophomore college year.
7. Charlotte, NC for a summer job.
8. Winston-Salem for the start of the junior college year
9. Back to home in the Bronx during an apprenticeship in NYC
10. Back to Winston-Salem and school after the apprenticeship
11. Henrico County, VA for a summer job
12. Winston-Salem for the senior college year
13. Back home to Brooklyn, NY (my family had moved)
14. Moved to Doswell, Virgina for a few weeks
15. Moved to Mobile, Alabama for a few months
16. Moved to New Orleans, LA for a year
17. Moved to Clearwater Florida
18. Moved to Largo, FL
19. Moved back to Clearwater, FL
20. Moved somewhere else in Clearwater, FL (total 3 years in FL)
21. Moved to Bristol, Indiana
22. Moved somewhere else in Bristol, IN (total 8 years in Indiana.)
23. Moved to Fargo, North Dakota (for ten years)
24. Move to Nashville, Tennessee
25. Moved somewhere else in Nashville, TN (three years in TN)
26. Moved to Alexandria, VA
27. Moved within the same complex in Alexandria, VA (total of 8 years in VA)
28. Moved to Boyds, Maryland (suburb of DC) for a few months
29. Moved to Amherst, MA (for 3 years)
30. Moved back home to Brooklyn, NY (for 1.5 years)
31. Moved to Skokie, IL (not a full household move)
32. Moved to Deerfield, IL (for 2 years)
33. Moved to Southington, CT (been here for 2 years.)
Now, according to Census data, the average US citizen moves 11.7 times in their lives. Obviously, I'm way above average. Even if we take out the summer college moves, and any others where there wasn't an actual full move of my household goods requiring a professional mover (or me and a rented truck) it's 22 times. If we only include my moves as an adult, it's 20. I have had legal addresses in 13 states, some states multiple times. Where's home? I've lived outside of NYC more than I've lived in it (but still think of myself as a New Yorker.)
I can tell you, after all those moves, that I am truly tired of moving, and hope to never have to do it again, but the chances of my not moving again are between slim and none. I can also tell you that, while it has been a big drag to move so much, I am grateful to have experienced life in so many different places in the United States. I may still be a die-hard east coast liberal progressive, but you can't say I haven't lived in and exposed myself to life in the mid-west and the south, to life in big cities and small communities. I have not lived in a bubble.
Now, I can't compare my situation to Avram's. I didn't have a Divine voice tell me to just pick up and move, and that I'd be told when I've gotten where I'm supposed to go. I moved, as a child, because my family moved, and as an adult because my life took me down that path. We could argue about how many of these moves were truly voluntary as opposed to being a result of circumstances, but that's not really important. (At least one of Avram's moves was necessitated by famine. How voluntary is such a move?)
Nevertheless, having done it so many times, I can tell you that it often does feel like one is going somewhere that is a place you do not know. Not just feels like it, but actually is like it. Think of this Jewish New York City kid discovering the realities of places on the other side of that famous New Yorker Magazine cover, Saul Steinberg's "View of the World from 9th Avenue." More people lived in the city housing project where I spent most of my childhood that lived in some of the places I have lived. (Bristol, IN had 1200 people when I lived there in the 80s, and had just changed over from 5-digit phone numbers. The housing project I grew up in had a population in just its 7 buildings of 2500.) The greater neighborhood of my youth had an equivalent or higher population than a number of places I have lived.
When you move some place new, it can be disorienting, scary, stressful. It can also be invigorating, refreshing, and positively challenging. It takes a while to get to "know" someplace new. Some of the places I have lived remained a "place I did not know" for quite some time. Others became home and familiar quite quickly.
So I'm thinking to myself that, despite how we lift up Avram's example, is it really that bold and brave a thing to do? Seems to me a lot of us do it – perhaps not as a result of a clear Divine call (though who I am my to say that some of us might not have moved on an impulse, some unknown force whispering in our ear?) Some of the times I have moved I didn't really have much choice. Other times, I have had more options, more freedom to choose where I would go. Something caused me to make the choice I did, and I can't always say it was simply a matter of cogitation and logic. I think of the choices I didn't make, and wonder what life might have been like in those other places that I considered moving for whatever reason.
On the other hand, maybe it is special, and I am lucky to have, perhaps, something of Abram's spirit in me, giving me the ability to pick up and move to a new place that I do not know so many times. It is a frightening thing and it does take courage.
Of course, here would come the typical joke about being the wandering Jew. Danger, Will Robinson! Sadly, in our collective Jewish ignorance, few of us know that this is one of the earliest of anti-Semitic tropes. The wandering Jew is a Christian legend of the Jew doomed to wander the earth until the second coming of Jesus for the offense of having taunted and struck Jesus on the road to Calvary. To be a wandering Jew is not a good thing. At least on the basis of that trope.
The story of Avram's willingness to pick up and go serves as metaphor in so many different ways, for so many people. One can choose to place emphasis on it being a Divine call, or one can choose to place emphasis on Avram's willingness to try something new.
Every single time I have moved someplace new (at least since I have had a driver's license) I have made it a point to drive aimlessly around the area of my new home, trying to feel my way around, almost trying to get lost. (What is most interesting to me is how, even though I do this so purposefully, after years of living someplace I can still take a different turn and discover some area I'd never seen before. I love when that happens.) I'm fairly sure that not everyone has the innate ability (and willingness) to get deliberately lost, so I'm thankful for the gift. (No fair, btw, if you use GPS to find your way at any point.)
Once in a while, I still find myself deciding to just go out for a drive, with no destination in mind, and just see where I wind up. I've discovered some very interesting places doing just that. Try it, it's fun. Try it close to home. Try it someplace on vacation or a business trip. Sure, it's fun to look at Atlas Obscura, or turn on Google Field Trip on your phone, and seek out interesting places to go. Imagine how much more interesting it could be to simply just discover someplace interesting randomly. Embrace the spirit of Abraham.
Now, it would be impossible for me to not make some connection between what is happening in this country right now, and this parasha. Many of us are worried and fearful about the future of this country. Many of us are not only scared, but unwilling to go where our newly elected leader may want to take us. Whether we choose to go forth in a spirit of hope, a spirit of concern, a spirit of anger and defiance, a spirit of cooperation, a spirit of love, a spirit of active resistance, a spirit of wait and see, a spirit of give it a chance, a spirit of fear, and so many other options, we must go forth. Some commentators like to raise up the peculiarity of the Hebrew Leḥ Leḥa and its apparent meaning "go forth, for yourself." We must each make the choice, for ourselves, how we will go forth from this point. Whatever your choice, may you have the spirit of Avram to go to a place you do not (yet) know. To go boldly where no person has gone before (that's for you Trekker grammar wonks.) Live long and prosper.
Lekh Lekha 5776 - The Other Siders (Redux 5766)
Lekh Lekha 5775 - More Nodding Heads, Whistlign Airs, and Snickersnees
Lekh L'kha 5774 - Theistic Singularity: Revisiting the Intellectual Ekhad
Lekh Lekha 5773 - The Journey Continues
Lekh Lekha 5772 - Out of Context
Lekh Lekha 5771 (5765, 5760) Things Are Seldom What They Seem An Excerpt from the "Journal of Lot"
Lekh Lkha 5770 - Revisiting the Ten Percent Solution
Lekh L'kha 5769 - Of Nodding Heads, Whistling Airs, and Snickersnees
Lekh Lekha 5768 - The Covenant That (Almost) Wasn't - Excerpts from the Diary of Terakh
Lekh Lekha 5767-Penile Pilpul
Lekh Lekha 5766-The Other Siders
Lekh Lekha 5765 - Redux 5760
Lekh Lekha 5764-Ma'aseir Mikol-The Ten Percent Solution
Lekh Lekha 5763-No Explanations
Lekh Lekha 5761-The Intellectual Echad
Lekh L'kha 5758-Little White Lies
Posted by migdalorguy at 12:25 PM
Random Musing Before Shabbat–Ḥayyei Sarah 5777–Con...
Random Musing Before Shabbat–Leḥ Leḥa 5777–Embraci...
Random Musing Before Shabbat–Noaḥ 5777–Tzur Yisrae...


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Home Scores Bracket Rankings Standings Stats Video Final Four History NIT
Oklahoma State Athletics | March 21, 2016
College basketball: Oklahoma State hires former SFA coach Brad Underwood
With his most recent NCAA Tournament run at SFA, Underwood improved his career record to 89-14.
STILLWATER -- Oklahoma State athletic director Mike Holder has announced the hiring of Brad Underwood as the program's 19th men's basketball coach.
He will be formally introduced to the Oklahoma State fans and media at 1:30 p.m. Wednesday in Gallagher-Iba Arena.
Underwood arrives at OSU following a three-year stay at Stephen F. Austin that ranks as one of the best starts to a head coaching career in college basketball history.
Underwood is a 1986 graduate of Kansas State, where he played for former Oklahoma A&M football and basketball standout Jack Hartman. Hartman learned his hoops craft under legendary Cowboy head coach, Mr. Henry Iba. Underwood was a member of Hartman's final teams at K-State, and helped Hartman become the winningest coach in Wildcat history.
"I named three things that I was looking for in the new head basketball coach at Oklahoma State: character, coaching style and fit," Holder said. "Brad Underwood gets the highest marks in each of those categories. He played in the Big Eight for Jack Hartman, a disciple of Henry Iba. He has coached and recruited in the Big 12, and has been very successful as a head coach in one of our prime recruiting grounds in the state of Texas. K-State is a sister institution with Oklahoma State in a lot of ways, so anyone who graduates from there and lives in Manhattan is probably going to connect quickly with our fans and our people. And as for character, everyone around him speaks of him as the great friend, father and person he is. In my opinion, Brad Underwood is going to be a great fit for Oklahoma State."
With his most recent NCAA Tournament run at SFA, Underwood improved his career record to 89-14, tied with Brad Stevens (Butler, 2008-10) for the most wins by a head coach in his first three seasons at an NCAA school.
What's more, Underwood's .864 winning percentage is tied with Adolph Rupp (Kentucky, 1931-33) for the fourth best by a head coach after his first three seasons in Division I basketball.
The first coach to ever win three straight Southland Conference Coach of the Year awards, Underwood led SFA to the two longest winning streaks in league history. He and the Lumberjacks won 29 straight games in 2013-14, and his team rode a 21-game win streak into Sunday's NCAA Tournament second-round showdown against Notre Dame, which came down to the wire.
Underwood piled up a 53-1 record in conference play during his three-years at SFA and put the Lumberjacks in the national spotlight after an upset win over fifth-seeded VCU in the opening round of the 2014 NCAA Tournament.
He matched that success again in 2016 after taking down No. 3 seed West Virginia in the first round. In fact, the Lumberjacks came within two seconds of a trip to the Sweet 16.
Underwood's SFA teams were known for their defensive prowess, but also for their assist-oriented offenses. This season, the Lumberjacks led the nation in scoring margin (+16.9), turnover margin (+6.5) and turnovers forced (+18.6), and also ranked second in assists per game (18.7) and seventh in steals per game (9.1).
"There's not enough adjectives to describe how excited I am for the opportunity to coach where some of the greatest coaches in the history of college basketball have cut their teeth," Underwood said. "Oklahoma State has unparalleled tradition, history and culture. The fan support, the noise and the home court advantage is what I remember most about Gallagher-Iba Arena, and I couldn't be more excited to be a part of that now. I played in Gallagher-Iba back in the Big Eight days, and then going back as an opposing coach, I can tell you that it's one of the best venues in the nation. We're going to have a lot of fun, and I'm excited as heck about the opportunity to get to know the community of Stillwater, and the OSU family."
Under his guidance, SFA produced eight All-Southland Conference selections, as well as three conference MVPs. Thomas Walkup won each of the last two SLC Player of the Year awards, and helped the Lumberjacks finish the 2015-16 season with a 28-6 mark.
Underwood's quick success at SFA garnered him not just the 2013-14 Southland Conference Coach of the Year honor, but also the 2014 Joe B. Hall Award, given to the nation's top first-year coach, along with being named a finalist for the Jim Phelan award (top Division I coach) and Hugh Durham award (top mid-major coach). Underwood was also named the 2014 Texas Association of Basketball Coaches (TABC) Coach of the Year and the 2013-14 NABC UPS Division I District 23 Coach of the Year.
The `Jacks finished the 2013-14 season 32-3, a program and conference record for most wins in a single season. His first-year success also has him among the NCAA's elite, ranking third all-time in the NCAA's top 10 for best career starts at the Division I level.
The second season with SFA yielded similar results, as Underwood jumped to the top of the NCAA record book with a 61-8 mark though his first two seasons. The 2014-15 team ended with a 29-5 record and came within a win of sweeping the conference for a second straight year, finishing at 17-1. With just one loss at the William R. Johnson Coliseum, the Lumberjacks improved to 32-1 at home under his command.
Prior to Stephen F. Austin, Underwood spent two years as associate head coach at both South Carolina and Kansas State with current Gamecock head coach Frank Martin.
In his final season in Columbia he helped reel in a recruiting class ranked in the national top 40 by ESPN.com. He was also credited with playing a major role in helping revitalize the Kansas State program, which posted 20-win campaigns and advanced to the postseason - including four trips to the NCAA Tournament - during all six of his seasons at KSU.
Underwood spent the 2012-13 season as Martin's top assistant in the staff's first year in Columbia, helping the Gamecocks to four more wins than the previous season. Prior to USC, Underwood served on the Kansas State staff for six years, beginning in May 2006 as the director of operations for then-head coach Bob Huggins. After serving in that capacity for the 2006-07 campaign, Underwood was promoted to assistant coach prior to the 2007-08 season, Martin's first year as the head coach at KSU.
At Kansas State, Underwood helped coach several all-conference players and two All-Americans at his alma mater, while helping the Wildcats win at least 21 games each season and finishing fifth or higher in the Big 12 each year.
Underwood joined the Wildcat staff in 2006, after spending three seasons as the head coach at Daytona Beach Community College in Daytona Beach, Fla. He helped guide the Falcons to a 70-24 (.745) overall record, including three consecutive 20-win seasons and two Mid-Florida Conference Championships from 2003-06. He was twice selected as the Mid-Florida Conference Coach of the Year following the 2003-04 and 2004-05 seasons. He saw 14 players go on to receive scholarships at four-year programs, including Travis Aikens (Marshall), Demetrius Green (Middle Tennessee State), David Lawrence (College of Charleston), Solomon Jones (South Florida) and Blake Young (K-State). An honorable mention All-Big East selection at USF in 2006, Jones was selected in the second round of the NBA Draft by the Atlanta Hawks.
In 2005-06, Underwood guided Daytona Beach to a 25-5 overall record and a runner-up finish in Mid-Florida Conference play with a 12-3 mark. He helped six players earn Mid-Florida Conference honors, including two first-team all-league selections, as well as conference player of the year Blake Young. Young went on to earn honorable mention All-America accolades from the National Junior College Athletic Association (NJCAA) and first-team Region VIII accolades. Young and Demetrius Green were both rated among the top 25 players in the country by JucoJunction.com.
He guided the Falcons to back-to-back Mid-Florida Conference Championships in 2003-04 and 2004-05. His 2004-05 squad produced a 24-10 overall record and runner-up finish in Region VIII. Six players earned all-conference accolades, including four first team selections. David Lawrence was also selected to the NJCAA All-Region VIII first team as well as the Florida Community College Athletic Association (FCCAA) All-State team. Underwood's first team collected a 21-9 overall mark and produced one NJCAA All-Region VIII first-team selection.
Prior to his time at Daytona Beach, Underwood spent 10 years as an assistant coach at Western Illinois under Jim Kerwin. The Leathernecks produced a 135-174 record from 1992-2003, including a 79-97 mark in Mid-Continent Conference play. The team advanced to the finals of the Mid-Continent Conference Tournament three straight seasons (1995, 1996, 1997) and achieved five consecutive seasons of winning at least 16 games. He helped coach 12 all-conference players, including four first-team selections, and four named to the all-newcomer team.
Underwood earned his first head coaching position in 1988 at Dodge City Community College in Dodge City, Kan., where he spent four seasons as the program's head coach, guiding the Conquistadors to a 62-60 record from 1988-93. His 1990-91 squad compiled a 23-9 record and was ranked as high as No. 4 in the nation.
A native of McPherson, Kansas, he and his wife, Susan, have one son, Tyler, and two daughters, Katie and Ashley.
Matthew Wolff joins Tiger, Ben Crenshaw as only golfers to win NCAA and PGA Tour titles in same year
At 20 years old, just off the college circuit with Oklahoma State, the All-American has now won a PGA Tour event and NCAA individual title in the same year – something only Tiger Woods and Ben Crenshaw had achieved before.
Here are the college baseball programs with the most appearances in the College World Series
Let's take a look at the college baseball teams that have found their way to Omaha and the College World Series with the most frequency over the past 73 years.
UCLA wins Women's College World Series against Oklahoma on walk-off single
The 2019 NCAA Softball tournament continues with the Women's College World Series Finals. Check out the bracket, schedule and scores below.


A guy walks a woman to the door after there first date. He asks her if she had a good time. She tells him yes but that to get her really horny, she likes her men to be Rough, Tough & Selfish.
The next week, the guy picks her up for their evening out dressed in a biker's black leathers. He grabs her, throws her on the back of his newly rented Harley, and away they go to the nearest biker's bar. The whole evening is spent drinking and brawling with the bikers.
When they get back to her house, he drags her up to the bedroom.
He asks her "Well, was I rough?" "Yes" she purrs and rubs herself suggestively.
"And was I Tough?" he asks.
"Well then, it's time to be selfish".
So saying, he whips it out and gives himself a hand-job.
The old timer said, "I'm a golfer and that's why I'm in such good shape. I'm up well before daylight and out golfing up and down the fairways."
The doctor said, "Well, I'm sure that helps, but there's got to be more to it. How old was your father when he died?"
The old timer said, "Who said my father's dead?"
The doctor said, "You mean you're 80 years old and your father is still alive? How old is he?"
The old timer said, "He's 100 yrs old and, in fact, he golfed with me this morning. That's why he's still alive, he's a golfer."
The doctor said, "Well, that's great, but I'm sure there's more to it. How about your grandfather? How old was he when he died?"
The old timer said, "No... Grandpa couldn't go this morning because he got married."
The old timer shot back, "Who said he wanted to?"
As a mother was bribing her little boy with a quarter so he would behave, she said, "Why do I always have to pay you to be good; why can't you be good for nothing like your father?"
Thinking he was trying to weigh less with this maneuver, she commented, "I don't think that's going to help."
"Sure it will." he said. "It's the only way I can see the numbers."
The new guy and the wife are VERY attracted to each other right away, but they realize that certain protocols will have to be observed. The husband, oblivious to the new chemistry floating around, is very glad to see the second man there.
The new man is only too happy to help, and in fact volunteers to do the first shift. He climbs up the tall tower and stands watch, scanning the ocean horizon for any ships. Soon the husband and wife start placing stones in a circle in order to make a fire to cook supper. The new man yells down: "Hey, no bonking!"
They look at each other and yell back: "We're not bonking!"
A few minutes later, they start to put driftwood into the stone circle.
Again the new man yells down: "Heeey, no bonking!"
Again they yell back, "We're not bonking!"
Later they are putting palm leaves on the roof of the shack to patch leaks. Once again the new man yells down from high above: "Hey, I said no bonking!!"
They yell back, "And we said we're not bonking!!"
Finally the shift is over and the new man climbs down from the tower and the husband starts to climb up. By the time he gets half-way up, his wife and the new man are already bonking their brains out. Once at the top, the husband turns around and looks down and says to himself: "Son-of-a-gun. From up here it DOES look like they're bonking.
2. Name it "George Bush"?
5. Your PC will ask you, "Do you really want to get rid of "George Bush"?
nurse a sum of money and asked her to go to Italy and have the baby there.
He replied, "Just send me a postcard and write 'spaghetti' on the back. I'll take care of expenses."
Six months went by and then one day the doctor's wife called him at the office and said "Dear, you received a very strange postcard in the mail today from Europe, and I don't understand what it means."
medic stayed back to comfort the wife. He asked what trauma had precipitated the cardiac arrest.
Three expectant fathers, an American, a Jamaican, and a Canadian were in the hospital waiting room. A doctor comes in and announces that he has some good news and some bad news.
"The good news is that you each are the father of a healthy baby boy. The bad news is that we've mixed them up."
The three new fathers walk into the nursery. The American guy goes right to the Jamaican baby, picks him up and starts rocking him.
"What are you doing?" the Jamaican guy asks, "He is obviously my son."
"I know," said the American guy, "but I didn't accidentally want to get the Canadian kid."
Little Johnny was spending the weekend with his grandmother after a particularly trying week in kindergarten. His grandmother decided to take him to the park on Saturday morning. It had been snowing all night and everything was beautiful.
His grandmother remarked, "doesn't it look like an artist painted this scenery. Did you know God painted this just for you"?
Little Johnny said, "Yes, God did it and he did it left handed".
This confused his grandmother a bit, and she asked him "What makes you say God did this with his left hand"?
"Well," said Little Johnny, "we learned at Sunday School last week that Jesus sits on God's right hand"!


Honestly I dont understand why Maelstrom weapons dont drop on normal but give like blues instead of Gold.
I keep trying on vet but its beyond frustrating me.
Finally beat stage five which was just Hell. I am on Stage 6 at the Boss and always almost get her down to around 3% and she always runs up and explodes on me or some crazy crap like one of the pillars not shining for the spiders. The amount of detail you have to put up with to complete this Arena is god awful.
What doesn't make sense is how easy Normal mode is. Its so simple you might as well just hand people the achievement. Vet is just too much going on at once and Ridiculously difficult. I expected hard but not Ironfist edition hard.
As I look around the forums there are literally hundreds of articles and i only got to a few. It needs a Nerf big time is the consensus.
Sorry, this is a L2P issue. Maelstrom does not need to be nerfed.
I recommend training your rotation more, because you're dying to a DPS-check mechanic. Easiest way to deal with the last boss from the 6 arena, is to leave only one altar with webs and explode it on the last boss so it gets stunned for a easy burn.
Alcast's guides will help you a ton. Look one for your setup (mag/stam+class), then look into the vMA guides.
Thank you for the guide, much appreciated. I just mean in general though not just boss 6. They could tweak it down a bit. I dont mean by a lot just a bit.
This is the only content that gives gives you any good challenge and improves you as a overall player.
If anybody is not able to finish it rethink your build , read guides trust me on this once when you finish it you will get amazing sense of achievement and it WILL make you better player and make you fell proud to get the title.
It is as aeverybody said a L2P issue. Learn mechanics, don't just depend on dps, learn when to heal/shield etc.
I know and everyone before me knows that the first time you do vet it's hell on nirn.
But you get better eventually and then after you've beaten it it's just a walk in the park.
I wish you good luck and recommend you'll read some guides or watch some videos if you're struggling.
At the time of its release it dropped thee best weapons in the game for most builds, like the first person said; all it really is at the end of the day is a damage per second check, you have the damage and the brain that understands mechanics its a clear.
You ask for a nerf, 'just a bit' is that for you to just get your complete or are you looking at this objectively? I dont mind old content being tweaked; for I have no use of it and many others. Understand that since orsiniums release the damage cap and set options have been increased by a tremendous amount, so much so that now that piece of content is viewed as modest at worst case scenario. Your time to catch up, remember this is an mmo; old content is content content in the devs eyes. Good luck.
Lol... i wanted to write a post like this when i was struggling through my first vMA experience. Changed my build l, watched you tube clips religiously and just persisted, one arena at a time. All advice i got was 'just keep going, you'll get there'. It never helped, but its the only thing that matters in the end... just persist and you will get there.
Oh and try not to break stuff .. vMA is expensive enough as it is without breaking your real [removed profanity].
But, yep, you guessed it... 'you'll get there'!!!!!!
tried VMA a few days ago and made it to the last boss.. that's when my problems started, resources and health (+shield) dropping from 100% to 0 in an instant and things in my death recap that never hit me or were never visible on the screen.
Looks at Joydivisions guide in the guide section here on the forums. Sigils are your friend if just going for a clear. Plus knowing the mechanics are more important than DPS here.
First clear takes forever. Once you do that you'll be surprised at how much easier it seems. I hadn't done it in ages and tried again with a new build the other night, and got through it easier than I ever have. I'm pretty casual player and don't even run that good a setup, and just use basic stam pots - nothing special... I've cleared it probably 20 times - again not even running it that often.
Keep at it, as people have said it's more about mechanics and how you approach each stage and boss moreso than having just DPS.
First vMA clear took me like four hours on cp160 stamsorc. I did know the mechanics beforehand, Ive watched other people complete it (IRL, so I was able to ask questions, etc.). The first clear is a brutal and furstrating experience, but it gets easier very quickly. Second run took about half the time, soon I wasn't even thinking about it, just playing. To me vMA is just a complicated choreography you have to learn. When and where to kill what and in which order. That's pretty much all about it.
Now consider this. vMA has already been nerfed (directly or indirectly) multiple times. It was much harder at release. Ask veterans here.
I remember when we could not save the progression, I Tried for 8 hours and i did it, with the old stuff and 300 cp.
just outa curiosity, if you leave the Arena and come back does it save your spot or do you have to start the whole thing over?
Once you get it, goes faster. Because you know what to expect, and you've become a better player. I was stuck on last boss for a year. Honestly, I'd probably have been better to start over each time I attempted it.
There's not a single hard DPS check in the entire arena.
Edit: I estimate that my DPS was about 20k when I beat vMA for the first time.
There is, but they are outdated and the numbers "required" are easily achievable to today's standards, or some fights that are so much easier if you have more DPS. 5th last boss for example, is much easier to burn with high DPS. 6th is either a DPS check or you keep stunning the boss over and over which is risky, it's easier to just stun her and burn her with high DPS. 7th arena is easier the less it lasts due to plant RNG, Every Daedroth on final arena was a DPS-check too, it used to require a ult to kill it before it enrages(Fire Breath), and the attack used to be much deadlier too but CP makes it extremely easy as well. Nowadays if you're Stamina, Balista alone melts it.
That's all I can think on the top of my head, by vMA definitly have DPS checks. Not as obvious like the vAA last boss execute phase, but DPS-checks nonetheless.
The reset timer is 5 minutes.
If you leave the Arena but have picked up the quest and come back after 5 minutes, you will resume your run from round 1 of the stage you are on, and if you haven't picked up the quest and come back after 5 minutes, you start from scratch.
Your first time through VMA will be absolute torture. There are punishing mechanics that will kill you. It takes time. It's so frustrating at times. I struggled through the whole thing... but once I beat it once, it got loads easier. I've been through 5 times so far (first complete a few weeks ago). My last run I finished with 8 vitality. First time I've finished with any, because it gets easier each time as long as you stick with it always pick up the quest that way you can leave when it gets to be too much.
I wonder what percentage has not gotten through vma? Bet it's high, and yes l2p issue for sure, first time I beat it was 324 cp Magica nightblade long ago, I imagine it's even easier now.
First run is hell, second run is a lot easier, then it just keeps getting easier after that.
We are getting way off topic here.
EVERYONE died a zillion times when trying to complete it the first time. Yes its easier with every patch cause of the additional cp and the new sets but this doesnt help someone that struggles at his first run there. Nor does when people say "VMA?? cmon its v easy you need to l2p...."
@shiningforce we can help you a bit more if you wanna share your build and tell us what troubles you more. I also saw that someone already mentioned Joy's guide which is amazing when you try to finish it for the first time. Just be patient and remember that every time you try it and every time you die you are making progress even if you dont understand it.
They do not need to nerf vMA, they need to give us a second solo arena - and make it more difficult while you are at it!
Clearing vMA requires a solid build, experience and skill. There are plenty of builds to be found on the internet. Experience comes with time, skills can be developed by practising.
If someone on a potato pc can clear it on a stamdk without trialsets with only 213 cp im pretty sure anyone willing to put the time and effort in, will be able to complete vMA.
I however do agree that the difficulty gap between this games normal and vet content is something completely out of wack.
vMA is a fine mix of masochism and determination. Take it in small bites, adjust your approach, use the heck out of the sigils, and you will make progress.
Take the quest, so you don't have to start from scratch, and work on it a bit at a time.
Once you 'master' a stage ('master' in this case meaning it kicks the crap out of you somewhat less than it used to), do the same for the next stage.
The ultimate thing that will frustrate you with vMA is the bugs. You'll run into them sometimes and there will be little to nothing you can do about it.
If you keep at it, you will progress, you will improve. People online and here will be willing to help you.
Bear in mind, plenty of people thought it was impossible at one point. Many of those later went on to clear.
The other key advice I can offer is don't be afraid to stop. Take a break if it's getting frustrating to the point where it's stressing you far more than you're gaining anything from it.
Step away for 5 minutes, 5 hours, or 5 weeks if you have to. vMA is one of those things that comes in its own time for each person.
People trying to tell you they got first clear in 4 hours are failing to mention the 100's, if not 1000's of times they died trying prior.
It seems impossible now. I assure you it's not, but it does take time, effort, and focus to eventually get there.
I breezed through normal MA, then I remember dying immediately in the first round of VMA and thinking, you have to be kidding me. I worked for several days just to clear stage 2.
Then I realized I needed to build a whole toon for it. Not everyone does, but I did. I work a lot, so that process took me months.
I banged on it again, got to stage 5 and had another serious you have to be kidding me experience.
I spent more weeks on rotations, potions, in optimizing every single thing I could.
Then I had some vacation and decided I WOULD beat it. Stage 6 was damned frustrating. For me, Stage 7 was even worse (lots say its easier but 7 and 9 the hardest ones for me still). Every round, every attempt my hands would be shaking from adrenaline. Especially last round of stage 9. Hundreds of deaths. So many of them agonizingly close. There were a couple of them I felt overcome practically with bleakness.
But I would not be denied. Perservered.
And brother, when you finally win - it is worth it. Any victory you can relish was hard fought, and I still relish it.
And the second full run I did in its entirety in a couple of hours immediately after. You learn.
Everyone but the most gifted experiences this process, in some timeline. And I'll bet every one of us will remember the experience forever. Been playing these games since the beta of Ultima Online. Very few things have given me the same sense of accomplishment.
In this game, being among the first 2-3 people outside of Zos to walk up and see Elden Root in the pre closed beta only comes close. VMA is one of the things they have gotten spot on right in my opinion. Id love to see a 2 man arena, even harder, and to rock it with someone who has beaten VMA. Be some fine gaming right there.
however would not change it for one bit, after that i done it again and finished it under 1hr and later on it was kind of like relaxing running it just lie down in bed and finish it eventually i got everything i wanted and now part of me misses it.
I hope in future they will have new single and duo VMSA runs.


Dean Evans, who served as chief marketing officer (CMO) of Subaru from 2011-2014, will now take on the same role at Hyundai.
In his new position, Evans will be responsible for all marketing and advertising duties in the US market.
For the past year, Evans has served as chief executive and president of the digital marketing automotive platform "LotLinx".
Auto industry observers note that Evans helped Subaru gain surprisingly strong momentum in the digital marketing realm during his time there. He has more than 25 years of experience in the automotive vertical, including leadership roles at Dealix, a dealer lead provider and Dealer.com, one of the two largest dealer website suppliers.
"Dean's proven results-driven approach; a positive, inspiring leadership style; and wide-ranging experience in dealerships, digital marketing and automakers, make him a most valuable addition to the Hyundai executive team."
He officially begins on August 17th and will report directly to Zuchowski.
Hyundai has been without a marketing chief since last year when its vice president of marketing Steve Shannon left the company.


Photogrammetry is not new to the world. It was discovered in the mid-19th century and is the science behind recovering exact positions of surface points meaning that depth and distance can be calculated from just images as long the scale is known.
Today Photogrammetry has it's application in a wide range of industries including topographic mapping, architecture, engineering, manufacturing, quality control, police investigation, and geology.
However a new application is slowly emerging: LOS – short for Large Object (3D) Scanning (I totally coined this).
LOS allows to create detailed 3D objects from just images. The source images are usually taken by Drones and are processed using different workflows. Below is a sample of my attempt to scan my car using my DJI Mavic.
As you see the result was good but not perfect. Shadows and reflections are your enemy and the key to success is how you gathered the images in terms of angle and direction. Tuning the process is another part and it requires definitely post processing.
I am exploring this technology right now in terms of creating a viable workflow that produced consistent quality results that can be scaled.


Artificial Intelligence (AI) and the Internet of Things (IoT) are futuristic, sci-fi, imagery terms; both are responsible for driving innovation today. To experience its complete benefits, organisations need to combine AI technologies and IoT which help machines to become smart and make better decisions without any human intervention. A smart approach for this could be to master the AI course which teaches you about the basic concepts of modern AI, applications, and their use to drive business processes.
A lot has been said about the importance of AI, but what role it plays in IoT is yet to be unveiled completely. If IoT has been part of your organisation, this post will guide you on how increased AI presence can take IoT to a level we have only just imagined.
As AI has become vital for IoT deployments and applications, an apparent shift is seen in the number of organisations opting for AI. Moreover, a sharp rise in venture capital investment in IoT conveys to us that AI is going to be the future of technology-driven companies. Now, organisations try to spread the reach of their products and services worldwide by acquiring other companies which have AI and IoT as their base. They even hunt for vendors who provide integrated AI capabilities.
Due to an AI's ability to quickly make deliverable insights from data, it plays an important role in business decision making. Machine learning is an important AI technology, which helps analyse customer behavior and identify anomalies in the data that devices generate in different forms.
As compared to traditional business intelligence tools, companies find that they have a significant advantage in analysing data better along with making faster operational predictions than threshold-based monitoring systems. These businesses are able to successfully use Big Data and AI to derive useful nuggets of business intelligence. Computer vision and speech recognition are some of the AI technologies, which can provide insight from data that would otherwise need human review. Therefore, AI and IoT make a powerful combination which saves from downtime, boosts up operational efficiency, and develops risk management.
AI and IoT together are a force that cannot be ignored. Not only have they changed the world but are in the process of changing the future. Let's talk a little about what AI and IoT can bring to the technology table.
To understand how AI can control and integrate with IoT, take an example of the thermostat. For this purpose, consider it to be an IoT device. What if it weren't? What would happen if the local power utility experiences brownouts on a hot day? The system would overheat or short circuit, and the utility staff would have to spend a lot of money to bring them back to speed.
However, in an IoT landscape, the staff could check the number of devices connected to the system then decide on how to prevent a brownout, for example, by raising the existing temperature. When the AI is inbuilt, the staff could predict an upcoming brownout and take necessary actions to prevent overheating or short-circuiting. Moreover, the AI can act in a sophisticated way by keeping the thermostats stable at temperature sensitive facilities like refrigerated warehouses. The addition of AI to the system has taken everyday situations to higher levels, which result in better outcomes, particularly prescriptive or proactive.
Humans are attracted by luxury. Apple watches and Fitbit watches are in trend, and these sensors embedded watches have given a way for doctors to recommend better diagnosis. Now, wearable sensors not just read your heartbeat and count calories, they are also capable of sending alerts to your doctors when they detect the risk of a heart attack.
This is one side of the picture. Let's consider when AI is also a part of IoT wearables. In this case, it would map out the closest ambulance at your current location while simultaneously alerting your doctor and hospital. This saves you precious time that could be the difference between life and death. According to a case study, AI has the potential to predict heart attack better than doctors.
AI plays a role in two important areas: system design and security. IoT enrolls different types of sensors from basic to advanced devices that give examples of core programming. The constant effort of making each layer of IoT smarter occurs every day. With the development of AI, a bulk of data generated by IoT devices makes it easy to check where sensors could be embedded in machines to enhance decision making. This can even avoid a system's overbuilding by evaluating what type of data is worth mining and what data needs to be ignored. In this regard, using basic sensors can save you money.
AI makes the IoT world secure by tracking intruders faster than human beings. The role of machine learning in predicting IoT device behaviour can help to fix cybersecurity. This trend is on the rise. Sometimes, intruders can use this technology to analyse a system's weakness and hack them. However, while there are hackers, there are also companies and nonprofit organisations who are working to constantly fix these loopholes (a regular battle of wits, we like to say). All in all, there are many essential benefits that IoT and AI offer if used wisely.
The future is likely that every IoT device uses AI in one or another way. The total experience of IoT comes when you can gain insights from hidden sets of data. Though most existing techniques don't scale to IoT volumes, the future of IoT depends on machine learning to discover patterns and enhance every facet of life.
The author, Danish Wadhwa is a strategic thinker and an IT pro. With more than six years of experience in the digital marketing industry, he says he is more than a results-driven individual, he is well-versed in providing high-end technical support, optimising sales and automating tools to stimulate productivity for businesses.


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Real Human Yoga
rants on brain-workings, body-happenings, societal tendencies, and how to live with it all. for the inflexible and imperfect :)
Book Thoughts : The Accidental Superpower by Peter Zeihan
Partial summary and musings around :
The Accidental Superpower : the Next Generation of American Preeminence and the Coming Global Disorder by Peter Zeihan
In The Accidental Superpower, Peter Zeihan uses geography and its political implications to predict the future of economics and livelihoods. America is the accidental superpower not by merit of wise choices, deft political maneuvers and effective government, but because our abundant natural resources enable it. More so than any other country on the planet, our cup run-eth over.
Our easily developed, bountiful crop producing lands (less labor intensive and competitive than anywhere else on the planet) gave the ability to produce excess food and people in the pre-industrialized era, which with the turn of industrialization allowed us to produce more capital. As if the biggest, most easily cultivated breadbasket in the world wasn't enough, "the world's greatest river network - that of the Mississippi and it's 6,000 miles of navigable tributaries - directly overlies the world's largest piece of arable land, the American Midwest". The vast riverine network not only makes land productive, but connects producers in prosperous ways to their neighbors. Abundance of land and water leads to abundance of people and trade, bolstering economic activity without ever having to leave the country. Combine this with the security of being an essentially island nation (the Canadian Rockies and deserts of northern Mexico complimenting the USA's impenetrability), and its common sense that Americans are the dominating power of the economic, agricultural, and technological world today.
Zeihan uses geography too to explain national cultures - and with regards to America there's a lot I can say. How the abundance of land and resources made possible the entrepreneurship we now associate with American spirit, or the generosity we have towards neighbors and allies. Privileged geography also highlights how sensitive we are to even the slightest broaches in security, how used to getting our way, how change adverse, and volatile our tempers can be when national (or personal) ire is provoked. The increasingly isolationist policies of the US government at present now have historical context - at least for me and my globalist, lefty-leaning sensibilities! A quote from Dr. Martin Luther King echoes in my head : "it's all right to tell a man to lift himself by his own bootstraps, but it is a cruel jest to say to a bootless man that he ought to lift himself by his own bootstraps." Americans hit the bootstrap jackpot. No where else on the planet even comes close (read the book for numbers; it's a LOT of compelling information).
So Americans that could get land, harvest in peace, or in the Industrial Era make their way via simple transport networks to cities for employment prospered. A peaceful country largely untouched by domestic war (completely untouched for the last 153 years, a global anomaly), was able to build its already incomparable infrastructure, enrich itself with carbon-based fuels, and expand ever westward to include more agriculturally useful property (I know the Rockies aren't great, but how about California?). The last two centuries were a pretty great time to be an American, regardless of our internal conflicts. We were strong, with a young population and growing economy, but perhaps not yet the international hegemon that we are today. What changed?
After World War II, the devastation of the developed world was complete (with the exception of the United States). European landscape torn to pieces, armies and civilian populations gutted, and not a single country with a navy that could even begin to rival the United States' complete forces. We were the only game in town, and everyone was invited to play.
The Bretton Woods Agreement of 1944 is the reason we know a globalized economy today. The imperial/colonial competitions of European-style world conquest ruled oceans and so ruled trade for hundreds of years. Zeihan goes into naval advancements and old trading routes that made these advancements possible, but the competitive nature of trade has been the same over the course of history. Find a way to trade faster, cheaper, safer, and your rivals will eventually either catch up or outdo you. Zeihan's argument is that the competition for trade routes, partners, and resources meant constant naval warring among larger economic (re : more capital to build maritime) powers.
Bretton Woods changed all that. The Americans with their ground forces and navies made up most of the remaining Allied war effort; by imperialist standards they should have simply continued to occupy their allies, do the same with their enemies at war's end and establish a huge Pax Americana - an American empire of peace by occupation. The Americans thought that would be a huge drain on time and resources, and didn't play to their naval strength. They made an unexpected (and essentially mandatory) offer : "the Americans said they would open their markets…(and) offered to use their navy to protect all maritime trade…even trade that had nothing to do with the United States would by guaranteed by the overwhelming strength of the American navy." Over the years Bretton Woods grew to include not only Europe, but some South American, African and Southeast Asian countries too, essentially providing an economic block against red Russia. All of this was to the USA's benefit, especially as its international energy import and Cold War security needs grew. But that is now changing. The Cold War ended in earnest over 25 years ago, and Americans are growing more energy independent by the day.
Chapter 7 is titled "The Rise of Shale". Basically, fracking technology, though people like me profess to hate it, is the backbone of continued and growing American economic independence. Energy is one of the reasons Americans have continued to protect global free trade, and that need is going to evaporate. Fracking is only getting safer, cheaper, and faster. It is growing exponentially within America, as we are the only country that has the deep pockets for investment, costly transport infrastructure, skilled work force, and oh yea - natural resource deposits to make this happen. We can't keep it up forever, but for an least the next 15 years the US is going to continue to withdraw from the global energy market.
Eventually we will retreat into ourselves almost entirely, taking the protection and guarantee of our navies with us. Countries that have export-based economies such as China or Saudi Arabia are about to see one of their primary customers vanish. Smaller export-based countries, who have had no need to build up their security forces, are about to see their goods pillaged if not their country occupied by those militarily stronger looking for advantages over their neighbors. New alliances will be made, but only when it is advantageous to the US - and again, we will be nearly the only game in town with a stable economy 3x the size of the rest of global markets.
The second half of The Accidental Superpower is focused on the non-American players. The author makes many predictions, but one thing seems certain : scarce resources will produce conflict just as they have throughout history. The Americans, while not completely invulnerable, will be able to isolate themselves with their abundant resources, young population, and insulated economy.
Overall, this book rocked my world. The notion that "free trade" as we know it has not always been around is mind-boggling - the fact that it could so easily with a couple American pen strokes be destroyed, sending open-market modernity back to imperialist struggles is even crazier. I'm glad to be an American and to be naturally blessed. The hopelessness painted of rapidly aging, resource-poor countries like Japan and China and the inevitable demise of ethnic Russians doesn't instill schadenfreude exactly, but its very ugly cousin of better-you-than-me. It's a reminder to me that while this self-preservation instinct is natural, and the world is separate countries, we are all one. Americans were simply dealt a lucky hand. Economic or governmental policies that would have crippled other countries barely rock the boat here, and our resource richness has granted us the prosperity to defend the world's waters and the entirety of the world's free market. Do we abandon it?
The prosperity and security of the American way of life will only go so far. We're still a part of this planet, not alienated from global changes and challenges. For me, this book is a fascinating historical and modern political lesson, but it begs a more philosophical question. If the world burns, what will we do?
For my fellow Tolkein nerds : "Do we leave Middle-earth to its fate? Do we let them stand alone?"
My Health Bio


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Home / Collections / Cyberpunk Origin Standard
Cyberpunk Origin Standard
by Acelion Team
LIMITED EDITION: Only 2000 printed! Will NOT be reprinted.
This is the third card from Acelion, but also a breakthrough in all aspects of the new - Cyberpunk: Origin
"Welcome to new Asgard."
Cyberpunk: Origin is a mythical epic style playing card that combines magic and science fiction elements, and its worldview was adapted by the Acelion team based on Nordic mythology.
In the Nordic mythology, the final decisive battle launched by the gods, giants and monsters directly led to the death of the world and the birth of a new world. It can be said that it is a famous battle in Nordic mythology that shocked the world and sobbed for ghosts and gods. Called "the final chapter of myth" by later generations, the scene described by the most miserable battle in the history of myth has reached the critical point of human imagination at that time.
Cyberpunk: Origin is about the gods after dusk.
The tuck case of Cyberpunk: Origin is a standard Acelion style double deck box design - the outer box is open at the top, and players can easily pull out the internal card box from the top.
Cyberpunk: Origin standard version tuck case uses the element of laser gilding, and the words and circles on the card box will show laser dazzling color under the light.
Then the second tuck case is open side, from the side you can draw the whole deck.
This time, we focus on flourishing and collecting, so the design of the back of the card is enough for flourishing , which can present a strong visual impact in the case of opening the fan and displaying the card.
The dazzling effect of the circle in the center of the card's back when rotating rapidly.
The deck has a very innovative double background design. The base color of hearts and diamonds is light green, while that of Spades and Clubs is rose red. All the A's and their head cards have the image design in Cyberpunk: Origin, which includes Hela, the goddess of death, Rocky, Thor and so on. Can you recognize them one by one after receiving the cards?
The two-color deck in the actual performance not only does not appear disorderly, but also allows you to open the fan in the front and display the card with great visual expression! After you get shuffled, you can feel it by opening the fan!


Yesterday found Seattle under BRIGHT sunshine, few clouds, and eighty degrees! Heaven! I had a couple of free hours in the middle of the day so off I went to the zoo for a little drawing OUTside. Many of the animals weren't out, though....too hot for all that fur I guess. Others, though, were happily basking in the warm light. Here's a few out of my sketchbook...the elephants Watoto and baby Hansa (Watoto is an African and Hansa's Auntie--Hansa is an Asian elephant), an Emu eating and bleeting/thumping at the same time, and a Kookaburra always keeping watch.
Click on images for larger versions. All are available for purchase...just email me.
It's been a non-stop month...so I'm just now returning back to posting here on the blog. I thought I'd include a few pictures of some of the work I exhibited, including pictures of the hallway leading to my studio where I put a path of MARKS (Gesture drawings) as a Mark-Making Experience for those walking down the hall. I must have hung at least 100 of them and a few quotes about art as well. It was a fun day and many many thanks to all those who stopped by the studio for a visit and viewing. It was a pleasure to see all of you.