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BY Michelle Bliss
Why the Y? Dick Jones CEO of Wilmington's single-branch YMCA has been involved with different YMCA programs since first grade and explains it as well as anyone: "There is no other organization like a YMCA — people can come to be with friends socialize together spend quality time as a family and improve their health. It's an opportunity for folks from different walks of life and with different abilities to spend time together and develop each other's character and spirit." Clearly the Wilmington Family YMCA is no typical gym. With records dating back to 1887 our local Y has a long and rich history within the community.
The first ever YMCA had 12 members and was founded by George Williams (1821-1905) on June 6 1844 in London England in response to unhealthy social conditions arising in big cities at the end of the Industrial Revolution. Williams and some of his fellow drapers (clothing goods tradesmen) organized the first Y to replace Bible study and prayer for an unseemly life on the streets. By 1851 the first YMCA in the United States was founded in Boston. The Y trend soon caught on in other large cities like New York and Detroit. In 1853 the first YMCA for African Americans was founded in Washington D.C. by Anthony Bowen a freed slave. The next year the first international YMCA convention was held in Paris. At the time there were 397 separate Ys in seven nations with 30 369 total members.
Sir George Williams was knighted by Queen Victoria in 1894 for founding an organization that now 164 years later serves 45 million youth and families around the world with more than 20 million members in the United States.
The Wilmington YMCA currently has approximately 6 000 members who participate in everything from summer camps and after school programs to fitness classes swim lessons and sports leagues. When the association first began members met in private homes or rented rooms in the local bank or library for Bible study lessons. By 1891 the group bought a building on the northwest corner of Front and Grace Streets equipped with an auditorium swimming pool and rooms for visitors. According to a 1901 article in the Wilmington Dispatch a marble slab was placed in the sidewalk in front of the entrance to the building that read "Y.M.C.A. Welcome Strangers."
That hospitable mission continues today. "If you look back over the history of this association as well as YMCAs across the country we have evolved to embrace our entire community " Jones says. "When the YMCA began it was only for white males. It has evolved to where now every person is welcome in this YMCA and every YMCA. Regardless of what you believe spiritually where you come from the language you use the color of your skin your age gender — every single person is welcome at this YMCA. Wilmington is a very diverse community and so is the YMCA."
Not only is every person welcome last year alone the YMCA raised more than $130 000 to use for scholarships for children and families in Wilmington who would not have otherwise been able to afford Y services. "If you are not able to do something on your own we'll help you and teach you. There's just a different approach a different philosophy here " Jones says. The president of the board of directors Wendy Wrigglesworth adds "The Y focus is completely on giving back and that motto is nothing new. The Y is rooted in a lot of tradition."
The YMCA has always had a powerful and progressive approach to influencing local communities. An 1891 article titled "Laying the Corner-Stone" in a publication whose marking has been lost over time states that urban YMCA programs like ours in Wilmington were founded with the purpose of going "to every shade and phase of life in every haunt of crime in the back alleys of our cities in every place where there is a brother (fallen though he may be) to be seen and a human soul to be saved." The YMCA is certainly not an organization to shy away from novel ideas or to wait for change to occur on its own.
Throughout its history the Wilmington Y has continually reinvented itself with innovative programming. The organization began offering affordable night school classes as early as 1893 in basic subjects like arithmetic history writing and spelling. By 1911 the course load had expanded to include singing penmanship shorthand bookkeeping English grammar business correspondence typing Latin and Greek. In its early years the Y held meetings for diverse interests including a camera club stenographers' association literary society glee club model airplane club archery and rifle groups and many others. Its library was formed in 1889 when a group of men gathered together and donated more than 200 of their favorite books by writers like Dickens and Milton.
In 1922 the Wilmington Y added a program that has changed and grown but still continues today: a youth summer camp. It started with Camp Penton at Lake Waccamaw where young boys participated in athletics aquatics nature studies and outdoor learning — a curriculum that a 1927 Wilmington Morning Star story described as "a great many things pertaining to the outdoors that are lost to the boy living in the city." That tradition lives on in Wilmington with dozens of camps to choose from everything from horseback riding to culinary camp.
While the Wilmington Y has no plans for altering its mission significant changes are in the works. "One of the big goals we have for the YMCA " says Wrigglesworth "is to build a first-rate facility in Wilmington. We either want to build on our current location or choose a central location in Wilmington for a new building." The Y raises money through its We Build People campaign which hosts two local races annually and thrives on donations. "When you race in the Tri-span this summer " says Jones "you are helping a child go to summer camp. When you participate in the triathlon in September the fees that you pay help families to be involved with the YMCA."
No matter how much the Wilmington Y has changed over the past century — moving three times to get to its current location on Market Street — Jones is convinced that its mission to focus on "spirit mind and body" in order to "serve and treat and heal and improve the entire body the entire person the entire being" is still the same. One program in particular that Jones says he can point to as an inspiration to community members is the Physability and Inclusion program which offers fitness classes for people of all abilities.
Chris Hawkins a YMCA member and a participant in the Physability and Inclusion program suffered a spinal cord injury several years ago. "My Medicaid ended and I needed some kind of way to work on my physical therapy. The Y opened its doors right up to do my rehab. I have wonderful trainers who help me with my coordination and my strength; even just little things. I couldn't tie my shoes make my bed fold clothes or cook. But I'm gaining my strength. I can function as an everyday person an able-bodied person. The Wilmington Y's not just a gym but a family situation where people care about people and are ready to help each other. Where else are you going to find that?"
Visit www.wilmingtonfamilyymca.org or call (910) 251-9622 to donate volunteer or join the YMCA.
Sources: Wilmington: Lost But Not Forgotten by Beverly Tetterton. The Bill Reaves Collection at the New Hanover County Public Library
YMCA Firsts
The national YMCA is credited with inventing several popular sports like basketball and volleyball as well as influencing and fostering programs like the Boy Scouts Campfire Girls Toastmasters International (a nonprofit organization that teaches communication and leadership skills) Gideons International Peace Corps and United Service Organizations (USO). Here's a look at a few of the YMCA's firsts:
At the Cincinnati YMCA the nation's first-known ESL (English as a Second Language) class was taught in 1856 for German immigrants.
The Brooklyn New York Central YMCA was home to the world's first indoor swimming pool dedicated in 1885.
The first formal basketball game was played on January 20 1892 at Springfield College formerly the international YMCA training school. James Naismith a teacher at Springfield invented basketball in 1891 when the school needed an indoor game to play in the winter. Naismith originally used peach baskets as goals and posted 13 rules for his new game.
Just four years after the invention of basketball a Springfield College student named William Morgan invented what we now call volleyball. Morgan blended components of basketball tennis and handball to create a game he called "mintonette."
In 1909 the national YMCA created a campaign "to teach every man and boy in North America" how to swim. The year prior more than 3 300 people (mostly young men) drowned in the U.S. The novel method of teaching group swimming lessons was introduced at the Detroit YMCA by a man named George Corsan.
The first Father's Day took place on June 6 1910 at the Spokane YMCA. The holiday was founded by Sonora Louise Smart.
Current YMCA Programs
What programs and opportunities are waiting for you at the Wilmington YMCA? Members of all ages enjoy diverse benefits and Dick Jones CEO of our local Y is convinced that everyone can find their niche. At 6 months babies can start participating in swim lessons. Young children can join T-ball and soccer leagues or participate in family events like Mother/Daughter Teas and Father/Daughter Date Nights. Both children and teens can take part in summer camps galore — the Y offers camps for backpacking canoeing and kayaking water safety service learning sportsmen science music and arts among many other choices.
Local teens have unique opportunities like competing in a Model United Nations conference working with community mentors for Teen Achievers and serving as mock government officials for Youth and Government. Everyone can participate in free wellness programs fitness classes and the Physability and Inclusion Program which offers classes like seated gentle yoga healthy back and bone yoga (for those with back pain or osteoporosis) tennis gentle Tai-Chi and origami. There are also special programs for senior citizens like Senior Perk where participants can eat brunch play cards and enjoy friendly company.
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Inmatech's technologies have been developed and patented by our company founders, who came together through the University of Michigan in Ann Arbor. In collaboration, they combine their expertise in materials, electrochemistry, product development, prototyping, and entrepreneurship.
Levi's leadership at Inmatech focuses on the design and development of nanostructured materials for use, as well as electrodes for energy storage devices.
As an entrepreneur, he co-founded TJ Technologies (acquired by A123, a leading producer of lithium ion batteries) and owns intellectual property in the field.
Currently at the University of Michigan, he is the Richard E. Balzhiser Professor of Chemical Engineering, a Professor of Mechanical Engineering and the Director of the Hydrogen Energy Technology Laboratory. He presently serves as member of the DoE Hydrogen Technology Advisory Committee and AIChE Chemical Engineering Technology Operating Council, among others.
At the University of Delaware, he earned his B.ChE and M.S.E. degrees in Chemical Engineering and Nuclear Engineering. At the University of Michigan, he earned his Ph.D. in Chemical Engineering. He is a recipient of multiple awards including National Science Foundation Presidential Young Investigator Award, Carbide Innovation Recognition Award and Dow Chemical Good Teaching Award.
Les brings financial, operations and business development experience to Inmatech. He currently is the senior executive responsible for mobilizing Inmatech to develop and commercialize super capacitors for emerging power and energy markets. Mr. Alexander over the last twenty-five years has held executive positions both domestically and internationally in finance and accounting, business development, operations and procurement. Mr. Alexander is a retired Commander, U.S. Naval Logistics Officer who served in the Persian Gulf War. He has managed large military budgets and programs for aircraft carriers and military bases. He served as Chief Operating Officer of T/J Technologies a lithium battery start up that was sold to A123 Systems in 2006. He retain his position at A123 and post A123's successful IPO, Mr. Alexander became the General Manager of A123 Government Solutions Group. This group managed over $500M in government programs for A123 Systems. Mr. Alexander recently joined Inmatech after two years as General Manager of Navitas Advanced Solutions Group. Mr. Alexander earned a B.A. in Economics (Finance / Management) from University of Pittsburgh and M.S. in Management (Government Contracting) Naval Postgraduate School.
Saemin brings to Inmatech over a decade of experience in the formulation, characterization and evaluation of advanced catalyst and electrocatalytic systems for fuel processing and energy storage systems.
Currently he is the principal investigator for government funded projects from the National Science Foundation and United States Department of Agriculture. He also led the development program for novel nanostructured electrodes for high energy density Li-ion batteries, funded under the UM-Fraunhofer Alternative Energy Technologies for Transportation program.
Previously, he worked as an engineering manager at Visteon Corporation. He led the development of fuel processors for residential applications, and thermal and fuel systems for advanced powertrain systems, including hybrids and fuel cell vehicles for global automotive OEMs.
At the Yonsei University in Seoul, Korea, he received both a B.S. and M.S. in Chemical Engineering. At the University of Michigan, he earned a Ph.D. in Chemical Engineering.
Paul leads Inmatech's scientific advisory board and brings decades of expertise to the company's technical research.
Currently, Paul is an emeritus professor of chemistry and molecular science at the University of Michigan.
He has published over 120 reviewed scientific papers and patents and has had research support from many governmental and industrial sources. He was Associate Dean for Research in the College of Literature Science & Arts for ten years and was administratively involved in new facility planning, labor contract negotiations, and research budget management.
Stefan brings entrepreneurial experience to Inmatech. He also shares his broad management and business experience, as well as a strong multi-disciplinary technical background with expertise in optics, physics, electrical and mechanical engineering.
Previously, he co-founded three other companies, and served as a director at Fraunhofer USA — Center for Laser Technology, where he developed and commercialized new production technologies with light. He previously held positions as Chief Technology Officer at Visotek and as R&D Director at Jenoptik in Jena, Germany.
He has acquired and managed a variety of federal and state grants in the area of advanced manufacturing technologies for solar cells, batteries, and high brightness diode lasers.
From Technical University of Munich, he earned a diploma in physics. He earned Ph.D. in electrical engineering from the Technical University of Berlin. He holds 49 patents and has more than 150 published works.


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THE SCOTS LAW BLOG
Posted on May 21, 2021 by Ciaran's Law Blog
'Breach of the Peace'
You would imagine that 'breaching' the 'peace' would be (a) pretty self-explanatory and (b) if it wasn't that there would exist a morass of helpful, clear common law definitions and explanations. Remarkably, neither appears to be the case.
Even the High Court has attempted clarity of the issue. In Smith v Donnelly (2002) JC 65 it stated that it is, "….."conduct severe enough to cause alarm to ordinary people and threaten serious disturbance to the community…conduct which does present as genuinely alarming and disturbing, in its context, to any reasonable people." You would imagine that is (relatively) clear but perhaps it would be of benefit to contextualise.
The accused had been charged for her role and actions in an anti-nuclear weapons demonstration at the Faslane Naval Base on the Clyde. Specifically, that she conducted herself in a 'disorderly manner', 'disrupted the free flow of traffic' (by laying down on the road) and 'refused to desist when requested to do so'…………………………..and did (therefore) commit a breach of the peace.
Whether Smith's conduct was 'conduct severe enough to cause alarm to ordinary people and threaten serious disturbance to the community' is surely a matter of great and doubtless divided opinion. Unquestionably annoying, perhaps, immensely inconvenient, but behaviour that caused 'alarm'..? Whilst we can now move away from Hume who described it as a form of 'rioting', its scope does now appear remarkably wide. Thirty to forty years ago, I suspect the most commonly prosecuted crime in (certainly the West of ) Scotland, (no, it wasn't urinating in public, surprisingly) was 'shouting and swearing in a public place' and putting the lieges in a 'state of fear or alarm'. Indeed, most of us (then, I stress) young pups cutting our teeth in the art of criminal defence law, would sit of a morning (although classically a Monday) in the old District Courts in St. Andrews Street, Glasgow and deal with the hordes charged with just that during an excitable preceding 48 hours. The profusion of such cases resulted in local PFs referring to them, collectively and colloquially, as a 'two-cop breach', as it was only the two polis (sorry Glasgow vernacular for Police) that gave any evidence.
Consider now that we have had cases appear in front of JP and Sheriff courts in relation to fighting, aggressively begging for money, kerb-crawling, kicking a ball in the street and even attempting to commit suicide. Amongst this plethora of common law examples, appears to be the commonality of, if you like, 'anti-social behaviour' which may upset, anger, disturb or alarm 'others', i.e. bystanders. Some interesting cases arise when the Prosecution elect to almost use the charge as a 'catch-all' for behaviour that actually could (and does) fall under different headings. So, in Hutchison v HMA (1998) SLT 679, the accused was charged with exposing himself and masturbation and could have faced a charge under both common law and statute (The Sexual Offences Act 2009, s.8) but rather breach of the peace was pursued instead. Which seems somewhat perplexing and bewildering.
It could be argued that the range of offences seems extraordinarily wide – especially when you consider that kicking a football in the street can be treated analogously with someone exposing themselves to others.
Those of us in academia (especially if we have also practiced) have long suggested that there is a cloud of ambiguity and far too wide a range of possible offences for this 'crime'. The High Court (sitting as an Appeal Court) disagreed in Smith (above) but it did concede that, as Lord Coulsfield quoted,…"in some cases breach of the peace had been held to be established on grounds which might charitably be described as tenuous". A thinly veiled rebuke indeed.
As ever, there is simply no escaping the 'human rights' issue and in particular the European Convention. There have been suggestions that breaches have occurred of Articles 7,10(1) and 11(1), to name but three, in relation to charges of 'breach'. However, any rights under the Convention are not unfettered and that they necessarily come with a sense of restriction in order to ensure public order is maintained. So, in terms of of both Arts. 10(1) and 11(1), Arts. 10(2) and 11(2) provide that if issues arise in respect of public safety then restrictions can be imposed.
The issue however, in my view, is whether we should be giving any credence from now on to the fact that playing football in the street at night can ever really constitute a 'serious disturbance' to the community (as per Smith, above). An element of proportionality surely has to be the all encompassing factor?
This came to a head in Harris v HMA (2010) JC 245 when the Appeal Court again reiterated the 'public disturbance' element. Further, in Hatcher (2011) Lord Bonomy quashed the conviction of an individual who had ben convicted of a breach of the peace by 'shouting and swearing at his wife within the family home'. It was quashed because it could not be said that there would likely be a 'serious disturbance' to 'the community'. Lord Bonomy spoke of a 'lacuna (a gap) in the law' but, of course reiterated one of our founding principles that it is for Parliament and not the Judiciary to create or change the law.
To cut a long story short, this 'gap' has now been firmly closed thanks to the Criminal Justice and Licensing (Scotland) Act 2010 (s.38) which deals with 'threatening or abusive behaviour'. s.38(1) now states that…..
'A person ("A") commits an offence if—
(a) "A" behaves in a threatening or abusive manner
(b) the behaviour would be likely to cause a reasonable person to suffer fear or alarm, and
(c) "A" intends by the behaviour to cause fear or alarm or is reckless as to whether the behaviour would cause fear or alarm
Jobs a good'un. We now have a much more satisfactory situation and, in reality, 'breach of the peace' (as was) will be seen much more rarely as the new s.38 offence , principally because of the overlap. A salutary glance at s.38 shows us that we now have 'intent', 'reasonableness' and a Cawthorne-esque sense of recklessness (indifference even?) as to whether the behaviour does cause any fear.
It's issues such as this that I am forever trying to impress upon my students from entry level to university to take an interest in, research and comment on.
It's what makes the difference between competence and dedication.
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Next Article 'Forensic evidence – fingerprints'
One thought on "'Breach of the Peace'"
Peter Hutton says:
Thank You for sharing this Ciaran. I am always curious about the differences in law between my adopted home-nation and my original home-nation. In Northern Ireland, as I understand it, it is a little easier than in Scotland to be found in breach of the peace and to find oneself imprisoned for up to 12 months for it. There is no 'intent' or 'recklessness' element in the Public Order (Northern Ireland) Order 1987, s.18, as amended by the Criminal Justice (Northern Ireland) Order 2003. It is simply enough for the prosecutor to establish that "disorderly behaviour" occurred or was likely to be occasioned, in a public place. I'm especially fond of the 'likely to be occasioned' part (i.e. being guilty of something before you've actually done it). In the Smith case, if Faslane happened to be 80 or so miles south-west and on the cost of Antrim, Smith could have been charged with "obstructively sitting", under s.20 of the 1987 Order, with no need to prove a public alarm or disturbance to the community element. So, next time you are in Belfast, take care where you sit!!
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redpajama_set_name: RedPajamaCommonCrawl


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Massachusetts ANC Activists Take on Obama's Broken Pledge, Genocide Denial In Boston Globe Letters
WATERTOWN, MA – Greater Boston-area activists Dikran Kaligian and Laura Boghosian spotlighted U.S. government and media complicity in genocide denial, in two letters to the editor published in the June 18th issue of the Boston Globe, reported the Armenian National Committee of Massachusetts (ANC of MA).
Kaligian, a member of the ANCA Eastern Region Board, focused on Pres. Obama's double standard on human rights, comparing the President's moving words at the Buchenwald concentration camp last week to his broken pledge to recognize the Armenian Genocide. Pres. Obama spoke of America's "duty to confront those who would tell lies about our history," during his visit to the Nazi death camp, but has refrained from properly characterizing the Armenian Genocide, instead "strong arming the Armenian Government to agree to a roadmap for reconciliation with Turkey that has no possibility of every being implemented." Kaligian goes on to note that the President's inaction "gave Turkey a green light to continue blackmailing the United States by threatening to shut down the airbase that supports American troops in Iraq any time a U.S. official accurately recounts history."
Boghosian's letter to the editor addressed the Boston Globe's reporting on the recent dismissal of a Massachusetts court case that would have allowed Armenian Genocide denial in the commonwealth's classrooms. Rejecting the Globe's characterization of the Armenian Genocide as a "contentious issue that has been debated by academics and historians," Boghosian notes that "reputable scholars agree that the Armenian Genocide is settled history; it is solely the Turkish government's political campaign that obfuscates the issue. Only a fringe element, usually funded by Turkey or Turkish supported institutes, alleges there is controversy." Boghosian concludes that "by failing to provide background and context that would refute the allegation that this is a 'quintessential' historic debate, the Globe, in effect, has abetted genocide denial – the highest form of hate speech and the last stage of genocide."
The full texts of Kaligian's and Boghosian's letters to the editor follow.
The Armenian National Committee of Massachusetts (ANC of MA) is part of the largest and most influential Armenian American grassroots political organization. Working in coordination with a network of offices, chapters and supporters throughout the United States and affiliated organizations around the world, the ANC of MA actively advances the concerns of the Armenian American community on a broad range of issues.
Obama broke campaign promise
PRESIDENT OBAMA reminded the world of its "duty to confront those'' who deny genocide ("At Buchenwald, Obama urges stand against evil,'' Page A3, June 6). His words would carry more weight had not he and his state and defense departments become complicit in Turkey's multimillion-dollar campaign to deny the Armenian genocide.
By strong-arming the Armenian government to agree to a road map for reconciliation with Turkey that has no possibility of ever being implemented, Obama gave himself political cover for breaking a clear campaign promise. He also gave Turkey a green light to continue blackmailing the United States by threatening to shut down the airbase that supports American troops in Iraq any time a US official accurately recounts history.
No wonder Sudan's president was welcomed in Turkey for a state visit just after being indicted for crimes against humanity; perhaps he wanted tips on successful genocide denial from the foremost experts in the field.
Dikran M. Kaligian
The writer is the author of "Armenian Organization and Ideology under Ottoman Rule.''
Armenian tragedy not open to debate
THE ARTICLE "Armenian genocide lawsuit rejected: Judge says no role for court on curriculum guidelines'' (Metro, June 13) suggests that there is legitimate debate over the Armenian genocide. Lawyer Harvey Silverglate argues that political pressure, not educational merit, resulted in so-called counter-arguments being excluded from Massachusetts curriculum.
The opposite is true. Reputable scholars agree that the Armenian genocide is settled history; it is solely the Turkish government's political campaign that obfuscates the issue. Only a fringe element, usually funded by Turkey or Turkish-supported institutes, alleges there is a controversy. The International Association of Genocide Scholars voted unanimously in 1997 that the extermination of the Armenians by the Turks constitutes genocide.
It is doubtful that Silverglate would sue Massachusetts to mandate that the "opposing viewpoints'' of neo-Nazis who deny the Holocaust be taught to our children. Yet the "counter-arguments'' the plaintiffs pushed to include in the curriculum consist of standard genocide denial tactics, such as questioning the numbers killed, blaming the victim, or disputing the perpetrators' motivations.
By failing to provide background and context that would refute the allegation that this is a "quintessential'' historic debate, the Globe, in effect, has abetted genocide denial – the highest form of hate speech and the last stage of genocide.
Laura Boghosian
Asbarez Staff


text:
Forever_Classics's current selection is:
Finzi: Romance in E flat major, Op.11
by Philharmonia Orchestra
(From Wikipedia)
Gerald Finzi was born in London [in 1901], the son of John Abraham (Jack) Finzi and Eliza Emma (Lizzie) Leverson. Finzi became one of the most characteristically "English" composers of his generation. Despite being an agnostic of Jewish descent, several of his choral works incorporate Christian texts.
Finzi's father, a successful shipbroker, died just a fortnight short of his son's eighth birthday. Finzi was educated privately. During World War I the family settled in Harrogate, and Finzi began to study music at Christ Church, High Harrogate, under Ernest Farrar from 1915. Farrar, a former pupil of Stanford, was then aged thirty and he described Finzi as "very shy, but full of poetry". Finzi found him a sympathetic teacher, and Farrar's death at the Western Front affected him deeply. During these formative years he also suffered the loss of all three of his brothers.
These adversities contributed to Finzi's bleak outlook on life, but he found solace in the poetry of Thomas Traherne and his favourite, Thomas Hardy, whose poems, as well as those by Christina Rossetti, he began to set to music. In the poetry of Hardy, Traherne, and later William Wordsworth, Finzi was attracted by the recurrent motif of the innocence of childhood corrupted by adult experience. From the very beginning, most of his music was elegiac in tone. [He died in 1956.]
https://en.wikipedia.org/wiki/Gerald_Finzi
Conductor: Christopher Warren-Green.
Forever_Classics
© Prism Leisure Corporation - CD compilation set described at https://musicbrainz.org/release/71eb5e4a-90e2-4a31-a2d1-a96485fcb667
All Forever_Classics's likes:
paull's selection
by Claude Debussy
shaka's selection
Flower duet
by Anna Netrebko & Elina Garanca (Lakmé de Delibes) - youtube.com/watch?v=Vf42IP__ipw
Rest_In_Peace's selection
Max Kay tribute
by Nine News Perth
Rest_In_Peace_Plus's selection
by JOOJ, feat. Adam Litovitz, vocals/composer
All Forever_Classics's selections:
Vivaldi: Violin Concerto in B minor, RV 387
by L'Arte dell'Arco
Strauss: Tod und Verklärung, Op.24
by Zurich Tonhalle Orchestra
Schumann: 8 Noveletten, Op. 21
by Dino Ciani
Haydn: Symphony No. 95 in C minor, H. 1/95
by Philharmonia Hungarica


Emir of Qassim Prince Faisal Bin Mishaal and Director General of Traffic Maj. Gen. Mohammed Al-Bassami watch as a woman trains at the newly launched driving school at Qassim University.
BURAIDAH — As many as 70,000 women have been issued driving licenses since June 24, 2018, when authorities lifted the ban on women driving in Saudi Arabia, according to Director General of Traffic Maj. Gen. Mohammed Al-Bassami.
Women in Saudi Arabia proved to be good drivers and traffic violations by them so far have not threatened public safety, he said.
Bassami was speaking at a ceremony in Buraidah after a school to teach women driving was opened at Al-Qassim University.
Emir of Qassim Prince Faisal Bin Mishaal on Monday officially launched the school, which was built on an area of 55,000 square meters. The school has 40 Saudi women instructors.
The school was the first of its kind in the region and the seventh Kingdomwide. The prince handed the instructors keys to their cars.
"The ratio of Saudization in the school is 100 percent. I am proud to be among Saudi men and women who worked day and night to make this achievement possible," he said.
Abdul Rahman Al-Dawood, the university's rector, said work on the school started about eight months ago.
"The accomplishment is the product of a Saudi team and the school is fully manned by Saudi women trainers," he said.
Bassam, who also visited the center for electronic monitoring of traffic violations, said the center received about 220 objections to traffic tickets issued during the past one week.
He revealed that 75 objections were settled and 126 motorists accepted the punishments handed down to them.
Registration for training at the school was closed one hour after its opening but it will reopen during the second phase.
Meanwhile, Bassami said contracts were signed for the establishment of driving schools in Taif, the Eastern Province, Al-Jouf and the Northern Border Province.
"We have 65 schools all over the Kingdom to teach men and women driving," he said.
On the other hand, women in Jazan waiting for a school to be opened, started to learn driving in the wilderness and outside the crowded areas of the city.
Marwah Ahmed, a schoolteacher, said she waited until sunset to take her car out of the busy city to learn driving.
She was astonished why a driving school was not opened for them so far despite the promises of the Traffic Department and the Ministry of Education.
"We were not given a clear answer and every party was shifting the responsibility to the other so we decided to go out of the city to learn driving on our own," she said.
Hossa Omar, an administrator, said the lack of a driving school prompted her to learn driving out of the populated areas. "I cannot wait endlessly for a driving school to open in our city," she added.


text:
De 15e editie van de Wereldkampioenschappen badminton junioren werden in 2013 georganiseerd door de Thaise stad Bangkok.

Individuele wedstrijd

Medaillewinnaars

Team wedstrijd

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2013
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redpajama_set_name: RedPajamaWikipedia


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EMJ Dermatology 8.1 2020
Home	Rheumatology	Editor's Pick: Methotrexate and The Lung in Rheumatoid Arthritis
Editor's Pick: Methotrexate and The Lung in Rheumatoid Arthritis
21 July 2020 | Rheumatology
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The systemic nature of rheumatoid arthritis (RA) is exemplified by pulmonary fibrosis. Methotrexate (MTX), the most commonly used drug in RA is reviewed. It exerts its immunosuppressive effects by interfering with folate metabolism, adenosine signalling mechanisms, generation of reactive oxygen species, adhesion molecule expression, and alters cytokine profiles. Common side-effects include neurotoxicity, anaemia, and gastrointestinal discomfort, as well as MTX-induced pneumonitis (MTX-pn). RA patients can develop interstitial lung disease (ILD), which is similar to MTX-pn in that it occurs within 2 years of RA disease onset if not given optimal therapy. Here, Al Nokhatha et al. discuss the risk factors associated with MTX-pn and ILD and the treatment options such as rituximab, tocilizumab, abatacept, antifibrotics, and glucocorticoids. However, recent evidence shows increased risk of ILD worsening in patients treated with biodrugs. Activation of JAK2 kinase promotes fibrosis. I believe the time is now ripe to use JAK2 kinase inhibitors such as baricitinib early in RA rather than MTX or biologics to mitigate risks of ILD development.
Shamma Ahmad Al Nokhatha, Robert Harrington, *Richard Conway
Department of Rheumatology, St. James's Hospital, Dublin, Ireland
*Correspondence to drrichardconway@gmail.com
The authors have declared no conflicts of interest.
Dr Nokhatha and Dr Harrington contributed equally to this manuscript.
EMJ Rheumatol. 2020;7[1]:80-90.
Each article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.
Rheumatoid arthritis (RA) is a common systemic rheumatic disease. While the most visible manifestation of RA is articular involvement, it is a true systemic disease with the potential to affect multiple organs. Methotrexate (MTX) is the most commonly used medication to treat RA. MTX pneumonitis (MTX-pneu) is a rare disease entity reported in MTX users. It usually develops acutely or subacutely in the first year of treatment. MTX-pneu presents with cough, dyspnoea, and often fever. Pre-existing lung disease is a major risk factor and the clinical diagnosis is based on MTX exposure, symptoms, and laboratory and imaging findings. Treatment involves MTX cessation and high-dose glucocorticoids. Interstitial lung disease (ILD) is a common manifestation of RA with clinical RA-ILD affecting up to 10% of patients. RA-ILD tends to be a more indolent process than MTX-pneu and frequently develops over years but can also be acute. Similar to MTX-pneu, RA-ILD presents with cough, dyspnoea, and often fever. Risk factors include age, male sex, disease activity, seropositivity, and smoking. Treatment is aimed at optimal control of RA disease and within this strategy there may be particular roles for rituximab, tocilizumab, and abatacept. Antifibrotics may also have a role. Given the distinct pathologies, the differentiation of these two entities is crucial. The treatment approach differs significantly and what is beneficial for one may be harmful for the other. In this paper, the authors discuss and contrast contemporary knowledge of MTX-pneu and RA-ILD.
Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disorder affecting 0.5–1.0% of the global population. While primarily seen as a condition affecting joints, it is more accurately a systemic inflammatory disease which can affect multiple organ systems including the lungs. Among the extra-articular manifestations, respiratory disease is the second most common cause of death after cardiovascular disease.1 A large autopsy study of 1,246 RA cases from Japan corroborates the lung involvement, including interstitial lung disease (ILD), second to infection as the most common cause of death.2
Given the significant role of ILD as part of the natural history of RA, there has been much controversy over the role of methotrexate (MTX) as the anchor disease-modifying antirheumatic drug (DMARD). On one side of the debate is the idea that MTX may cause ILD in RA. On the other side, including the view of the authors, is that ILD or fibrosis in the expected usual interstitial pneumonia (UIP) pattern is a result of poorly controlled RA and the resultant active systemic inflammation. As to how uncontrolled chronic inflammation predisposes to lymphoproliferative disorders and amyloidosis, it is the authors' view that in the context of RA, poor disease control predisposes to RA-related interstitial lung disease (RA-ILD). As such, there is an association or correlation between MTX use and ILD, but there is a confounding variable, namely that most cases have underlying RA; a classic case of how correlation does not imply causation. There is also a historic channelling bias as patients with more severe RA were traditionally both more likely to develop RA-ILD and to be treated with MTX.3,4
A supported association between MTX and ILD first appeared in the literature over 30 years ago.5 An important distinction to be made is what is meant by ILD and if it is present at baseline before treatment with MTX. In terms of MTX and lung injury, the most commonly reported manifestation is MTX-related pneumonitis (M-pneu) which can be difficult to distinguish clinically from underlying RA-ILD.6 In short, this is where much confusion arises and why MTX and its putative role in the lung is misunderstood. MTX may very rarely cause drug-related pneumonitis but it also may have a protective effect against progressive RA-ILD, these being two distinct pathological entities. Elucidating the precise cause of respiratory symptoms in an RA patient may be difficult but it is crucial to guide treatment. A comparison of the features of MTX-pneu, RA-ILD, idiopathic pulmonary fibrosis (IPF), and pneumocystis jiroveci pneumonia (as an example of an atypical infection) is shown in Table 1. The aim of this manuscript is to review the current understanding of MTX-pneu and RA-ILD.
Table 1: Comparison of features of methotrexate-associated pneumonitis, RA-ILD, IPF, and PJP.
BAL: bronchoalveolar lavage; PFT: pulmonary function tests; UIP: usual interstitial pneumonia.
A systematic literature search for relevant articles using PubMed, the Cochrane central register of controlled trials, and Embase was done. The search was performed with no date limits and last updated on 4th March 2020. The keywords 'Methotrexate' OR 'rheumatoid arthritis' AND ('lung' OR 'respiratory') were used. Reference lists of relevant articles were also reviewed.
METHOTREXATE PNEUMONITIS
The prevalence of M-pneu as documented in the literature ranges anywhere from 0.3–11.6%, with the caveat that diagnostic criteria used for M-pneu are not consistent across studies.7-10 A previous comprehensive literature review of 3,463 RA patients treated with MTX reported a 2% rate of some form of lung toxicity with only 15 cases (0.43%) of MTX-pneu.11
In an even more favourable review of seven trials and 1,630 patients without RA, but with diagnoses ranging from psoriasis; psoriatic arthritis; or inflammatory bowel disease, who were treated with either MTX or placebo, did not show a statistically significant increase in adverse respiratory events within 52 weeks of treatment and only one case of pneumonitis was identified in the MTX group.12 This provides some evidence of the safety of MTX itself and may suggest that there are factors attributable to the inherent RA disease process which increase the risk for acute lung injury when subjected to MTX. Of particular interest, since 2001, there has been no reported cases of M-pneu across all randomised clinical trials of MTX in RA.13 The recent CIRT trial of MTX enrolled 6,158 patients and reported 6 possible cases of pneumonitis in the MTX group compared to 1 case in the placebo group, but there was insufficient evidence to confirm that these cases were definite MTX-pneu.14
Clinical Presentation and Symptoms
While distinguishing between M-pneu and RA-ILD can be difficult given the overlap of clinical and histological features, M-pneu tends to have an acute or subacute course with a propensity for developing within the first year of treatment.15-17 This reiterates the need to study the baseline respiratory function of RA patients in clinical studies prior to commencing DMARD. This would help to distinguish between the subsequent development of M-pneu or RA-ILD.
While the presentation may be nonspecific, the symptomatology of M-pneu typically may include fever, chills, malaise, nonproductive cough, dyspnoea, and chest pain. The presentation tends to be either acute with progressive symptoms over days, or subacute with an insidious onset over weeks.18
Mild blood eosinophilia has been noted in 25–40% of cases of subacute M-pneu by some authors and similarly a small case series demonstrated lymphopenia in the context of M-pneu, with a return to normal once lung function is restored.6,7,19,20 These signs may not be reliable but can serve as a clue to the aetiology of lung involvement.
M-pneu is generally considered to be a hypersensitivity reaction. In vitro studies suggest that IL-8 plays a role in the pathogenesis and it is known that MTX can trigger IL-8 secretion within airway epithelial cells, with resultant increased levels found in both peripheral blood samples and bronchoalveolar lavage (BAL) samples.21-23 To the best of the authors' knowledge, IL-8 inhibition for pneumonitis has not been used in clinical practice with pilot trials terminating early.
Various risk factors for M-pneu have been identified but have not always been reliably replicated in other studies. These include age >60, diabetes, hypoalbuminaemia, previous DMARD exposure, chronic kidney disease, male sex, increased Health Assessment Questionnaire (HAQ) score, decreased pain Visual Analog Scale (VAS), and crucially, pre-existing lung disease.24 In a case-control study intended to identify and investigate risk factors for M-pneu, pre-existing lung disease was found to confer increased risk with an odds ratio of 7.1 (95% confidence interval: 1.1–45.4).25 Taking this into consideration, the most recent iteration of the British Society of Rheumatology's guidelines note that while not an absolute contraindication to traditional DMARD initiation, caution should be exercised in commencing treatment in those with poor respiratory reserve.26 The concern being that these patients with poor baseline respiratory function (e.g., diffusing capacity for carbon monoxide <40%) are less able to tolerate any occurrence of drug-induced pneumonitis.
Haplotype and single nucleotide polymorphisms have not proven to be particularly useful on a global scale, with borderline significance for the latter.27 Interestingly, there seems to be a relationship with increasing latitude and risk for M-pneu. Data from the Ministry of Health of New Zealand suggests that the risk or incidence ratio increases by 16% per degree of increasing latitude.28 Whether this is reflective of a genetic predisposition, single nucleotide polymorphisms, environmental factors, or ultraviolet light exposure and vitamin D level much like the relationship between vitamin D and multiple sclerosis remains unclear.29
A diagnosis of M-pneu is typically based on clinical and radiologic findings. While pulmonary function tests (PFT), BAL, or lung biopsy are useful, the latter, at least, may not be practical. BAL can be beneficial as it can be used to rule out infections secondary to immunosuppression. The characteristics of BAL in M-pneu have been well defined in the literature with a systematic review highlighting that the majority (89%) of BAL samples in M-pneu demonstrate lymphocytosis.30 Furthermore, serum levels of KL-6 and surfactant protein D, both expressed by Type II pneumocytes in the lung, are increased in M-pneu and may have utility as novel biomarkers to aid diagnosis, with the caveat that both are increased in other forms of lung pathology including RA-ILD. Careful consideration is needed and relative change to pre-MTX baseline may be more useful than raw values.31,32
As elucidated earlier, invasive investigations are not always practical or indicated. However, a study comprising 44 patients with drug-induced lung injury did conclude that transbronchial lung biopsy was diagnostically helpful in 75% and, as such, may aid diagnosis in conjunction with clinical, laboratory, and radiographic findings.33
The predominant radiographic findings in M-pneu are typical of nonspecific interstitial pneumonia (NSIP) most commonly followed by cryptogenic organising pneumonia (COP)/bronchiolitis obliterans organising pneumonia.34 The NSIP pattern is characterised by diffuse heterogeneous opacities on chest X-ray, scattered or diffuse ground-glass opacities in the early stage, or basal fibrosis in the later stages on CT. The less common COP pattern can be described as demonstrating bilateral scattered heterogeneous or homogeneous opacities with a peripheral distribution in the upper and lower lobes on chest X-ray and poorly defined nodular consolidations, centrilobular nodules, bronchiolitic or tree-in-bud changes, and bronchial dilatation on CT. Imaging findings in MTX-pneu have been reviewed in detail elsewhere.35-38
Two proposed diagnostic criteria are those laid out by Searles et al. and those by Kremer et al.6,39 The former has tended to be used most often, where six out of nine criteria must be met for a diagnosis of M-pneu. Baseline PFT abnormalities, such as low forced expiratory volume in 1 second, vital capacity, and diffusing capacity for carbon monoxide, may have prognostic roles and aid in identifying those at higher risk of developing M-pneu.17 Previously, many authors felt that MTX should only be commenced in RA patients if they were believed to have sufficient respiratory reserve to survive M-pneu. However, recent literature would suggest that M-pneu is rarer than previously thought and, given the many proven benefits of MTX, a careful risk–benefit analysis should be made in this group.
The treatment approach is summarised in Figure 1. Discontinuation of MTX is the clear first step in suspected M-pneu. Given that M-pneu is seen as a hypersensitivity reaction, steroids (either methylprednisolone or oral prednisolone) in high doses are often required. There are case reports of benefits from cyclophosphamide
and tocilizumab.40,41
Figure 1: Management of methotrexate-associated pneumonitis.
MTX: methotrexate.
Once MTX is stopped, prognosis in M-pneu tends to be favourable with most recovering fully.18 Three different studies have reported mortality ranging from 13% to as high as 30%.6,9,18,42
Rapid onset of M-pneu following initiation of MTX appears to be associated with poorer prognosis.16
RHEUMATOID ARTHRITIS INTERSTITIAL LUNG DISEASE
ILD is an under-recognised extra-articular manifestation of RA. The prevalence of RA-ILD varies between studies. Clinical RA-ILD has been estimated to occur in approximately 8–10% of RA patients, with respiratory symptoms preceding articular symptoms in about 10–20% of cases.3,43,44 A study of 140 RA patients by Bharadwaj et al.45 corroborates this, demonstrating the presence of ILD in 9.29% of cases and highlighting that ILD is the most common extra-articular complication of RA. Studies from the UK including the ERAS/ERAN study and the BRILL study have reported a slightly lower prevalence of ILD (3–5%).46,47
Subclinical RA-ILD as evaluated by high resolution CT (HRCT) has been identified in 19–67% of RA patients, while unselected lung biopsy identified evidence of ILD in 80% of patients.48-50
The clinical symptoms of RA-ILD and M-pneu can be difficult to differentiate. RA-ILD, which can be asymptomatic for years, tends to develop insidiously over time in contrast to M-pneu which would more typically present acutely or subacutely with dyspnoea, cough, and fever.35 Traditional articular features of RA can limit mobility and exercise tolerance to the extent that exertional dyspnoea early in the course of RA-ILD is masked by this forced sedentary lifestyle. While subtle radiographic features may be present early in the disease process on HRCT, auscultatory findings may be absent initially but most cases will eventually develop fine bibasal crackles.51 Radiographically, most will develop a UIP pattern often in conjunction with digital clubbing on clinical examination; a pattern very similar to that seen in IPF patients.51 Imaging findings in RA-ILD have been reviewed in detail elsewhere.35,36,52
Pathogenesis and Risk Factors
While there is still much to be understood regarding the pathogenesis of RA-ILD, there is increasing evidence to suggest that the lung may be central in activating the pathological process of RA itself.53-55
Multiple risk factors for RA-ILD have been identified including older age, male sex, smoking, disease activity, elevated titres of specific autoimmune antibodies, ethnicity, and certain human leukocyte antigens.3,55-57 In terms of biomarkers, a positive rheumatoid factor or anti-citrullinated peptide antibody are strongly associated with RA-ILD. Other novel biomarkers have emerged, with heat shock protein 90 detected in blood samples of RA-ILD patients as well as BAL samples.58,59 Of particular significance is the gain-of-function MUC5B promoter variant rs35705950, which is strongly associated with ILD involvement, conferring an increased odds ratio of 3.1 in RA patients. The similarities between RA-ILD and IPF are striking. Both typically demonstrate a UIP radiographic pattern with clubbing, and the MUC5B variant is often involved in both, acting as the strongest predictor or known risk factor for IPF.60,61
THE ROLE OF METHOTREXATE IN RHEUMATOID ARTHRITIS-ASSOCIATED INTERSTITIAL LUNG DISEASE
Much has been made of the association between MTX and RA-ILD over the past few decades. While there is an association with MTX and RA-ILD, it is now known to be coincidental and not causative, with the underlying inflammatory process driving ILD. In short, it is the disease and not the drug that causes RA-ILD.62
The seminal studies that explore the role of MTX in RA-ILD are the ERAN and ERAS studies which recruited 2,701 RA patients in the UK and Ireland to the trial with a follow-up period of up to 25 years.46 In this multicentre prospective cohort trial, the diagnosis of ILD was according to standard practice with confirmatory evidence from standard investigations including PFT, chest X-ray, and HRCT. The authors compared the prevalence of RA-ILD in the MTX exposed and the non-MTX exposed groups. They demonstrated that in the MTX exposed group 97.5% (n=1,539) remained ILD free, whereas in the non-MTX exposed group 95.2% (n=1,061) remained ILD free. This is statistically significant and shows that there is no causation between MTX exposure and development of RA-ILD. Patients who developed ILD were, at RA onset, a mean 5.14 years older and mean baseline ESR score of 8.64 mm/hour higher than patients who did not develop ILD. Furthermore, ERAS and ERAN confirmed that higher age of RA onset, male sex, smoking, rheumatoid factor positivity, rheumatoid nodules, higher ESR, and longer time from first RA symptom to first outpatient department visit were independently associated with incident RA-ILD. The authors of the ERAN and ERAS study concluded that the overall prevalence of RA-ILD is 3.7%, in line with the UK BRILL network which reported 2–3% prevalence across its recruiting centres.47 There was no association between MTX exposure and incident RA-ILD. On the contrary, MTX exposure was associated with significantly less RA-ILD and this would suggest a protective effect in delaying the onset of ILD.
ILD management in systemic RA is still a challenge due to disease heterogeneity. Asymptomatic patients frequently do not require any specific treatment in comparison to progressive symptomatic patients or those with deteriorating PFT. Histologic subset, if known, can guide treatment approach. Nonfibrotic NSIP and COP/bronchiolitis obliterans organising pneumonia are more likely to have a positive treatment response in comparison to the UIP pattern. Most RA-ILD cases present with a UIP pattern raising the question as to the relative benefits of immunosuppressive versus antifibrotic treatment strategies.
UIP pattern ILD in systemic rheumatic diseases may be more responsive to immunosuppression than IPF.
Given the overall excellent response of RA to DMARD, it is intuitive that the pulmonary component of the disease is also likely to be responsive to these treatments. The absence of any definitive evidence that RA-ILD is a predominantly immune-mediated inflammatory rather than fibrotic process, however, ensures that this remains controversial. The aim of treatment is to ensure complete overall rheumatoid disease control using whichever available agents to achieve this goal.4,56 The rationale for this strategy is supported by the significant decline in RA-ILD as treatment options have advanced, and the improved articular outcomes achieved by the authors.63 The treatment approach is summarised in Figure 2. The available medication options include glucocorticoids which remain the initial mainstay of therapy but, due to long-term adverse effects, steroid-sparing agents are generally introduced early in the disease course. MTX and leflunomide are important anchor agents in the treatment of RA joint disease. The best available evidence shows no sign of harm in RA-ILD and some evidence of benefit.4,46,64,65 Among the biologic agents rituximab has shown particular promise and has demonstrated improved mortality compared to tumour necrosis factor-inhibitors (TNF-I).66-68 An observational study of 56 patients with RA-ILD treated with rituximab showed that 16% improved and 52% remained stable following treatment.69
Figure 2: Management of rheumatoid arthritis-associated interstitial lung disease.
AZA: azathioprine; b: biologic; c: classical; CYC: cyclophosphamide; DMARD: disease-modifying antirheumatic drug; MMF: mycophenolate mofetil.
The preference for other biologics in the setting of RA-ILD is less certain. In addition to the study comparing rituximab and TNF-I, another literature review also showed an increased mortality with the use of TNF-I.70 It remains unclear if TNF-I are harmful or if they are merely not as effective as some other biologics in treating RA-ILD. There are some preliminary supportive data for the use of abatacept or tocilizumab for RA-ILD.40,71-74 The role of other agents traditionally used in other forms of connective tissue disease-associated ILD, including cyclophosphamide, mycophenolate mofetil, and azathioprine, is less certain.
The antifibrotic agents pirfenidone and particularly nintedanib have recently sparked interest in the treatment of ILD in the setting of systemic rheumatic disease, including RA, based on initial positive results in the setting of IPF.75 Nintedanib has also demonstrated positive results in systemic sclerosis-related ILD.76 Both antifibrotic agents have been shown to be effective in animal models of RA-ILD.77 The INBUILD study of nintedanib demonstrated efficacy in fibrotic lung disease other than IPF.78 While subgroup analyses were too small to demonstrate statistical significance, patients with RA-ILD appeared to respond similarly to the overall cohort.79 The absolute benefits of these anti-fibrotic agents in terms of lung function appear modest, and must be balanced against the high frequency of adverse events, particularly gastrointestinal issues.78
The ultimate choice of therapeutic strategy in RA-ILD relies on the individual patient's symptoms, comorbidities, and balancing adverse events. A collaborative multidisciplinary team approach between rheumatologists and respiratory physicians is important to ensure optimal care.
Kelly C et al. Lung involvement in inflammatory rheumatic diseases. Best Pract Res Clin Rheumatol. 2016;30(5):870-88. Toyoshima H et al. [Cause of death in autopsied RA patients]. Ryumachi. 1993;33(3):209-14. (In Japanese). Bongartz T et al. Incidence and mortality of interstitial lung disease in rheumatoid arthritis: a population-based study. Arthritis and Rheum. 2010;62(6):1583-91. Conway R Carey JJ. Methotrexate and lung disease in rheumatoid arthritis. Panminerva Med. 2017;59(1):33-46. Cannon GW et al. Acute lung disease associated with low-dose pulse methotrexate therapy in patients with rheumatoid arthritis. Arthritis Rheum. 1983;26(10):1269-74. Kremer JM et al. Clinical, laboratory, radiographic, and histopathologic features of methotrexate-associated lung injury in patients with rheumatoid arthritis: a multicenter study with literature review. Arthritis Rheum. 1997;40(10):1829-37. Barrera P et al. Methotrexate-related pulmonary complications in rheumatoid arthritis. Annals Rheum Dis. 1994;53(7):434-9. Atzeni F et al. Lung involvement and drug-induced lung disease in patients with rheumatoid arthritis. Expert Rev Clin Immunol. 2013;9(7):649-57. Pavy S et al. Methotrexate therapy for rheumatoid arthritis: clinical practice guidelines based on published evidence and expert opinion. Joint Bone Spine. 2006;73(4):388-95. Dawson JK et al. Investigation of the chronic pulmonary effects of low-dose oral methotrexate in patients with rheumatoid arthritis: a prospective study incorporating HRCT scanning and pulmonary function tests. Rheumatology (Oxford). 2002;41(3):262-7. Salliot C, van der Heijde D. Long-term safety of methotrexate monotherapy in patients with rheumatoid arthritis: a systematic literature research. Ann Rheum Dis. 2009;68(7):1100-4. Conway R et al. Methotrexate use and risk of lung disease in psoriasis, psoriatic arthritis, and inflammatory bowel disease: systematic literature review and meta-analysis of randomised controlled trials. BMJ. 2015;350:h1269. Conway R et al. Methotrexate and lung disease in rheumatoid arthritis: a meta-analysis of randomized controlled trials. Arthritis Rheum. 2014;66(4):803-12. Solomon DH et al. Adverse effects of low-dose methotrexate: a randomized trial. Ann Intern Med. 2020; doi: 10.7326/M19-3369. [Epub ahead of print]. Gabbay E et al. Interstitial lung disease in recent onset rheumatoid arthritis. Am J Respir Crit Care Med. 1997;156(2 Pt 1):528-35. Chikura B et al. Variation of immunological response in methotrexate-induced pneumonitis. Rheumatology (Oxford). 2008;47(11):1647-50. Saravanan V, Kelly CA. Reducing the risk of methotrexate pneumonitis in rheumatoid arthritis. Rheumatology (Oxford). 2004;43(2):143-7. Imokawa S et al. Methotrexate pneumonitis: review of the literature and histopathological findings in nine patients. Eur Respir J. 2000;15(2):373-81. Yamakawa H et al. Late-onset methotrexate-induced pneumonitis with neutrophilia in bronchoalveolar lavage fluid. BMJ Case Rep. 2014;2014: bcr2014206123. Salehi M et al. Methotrexate-induced hypersensitivity pneumonitis appearing after 30 years of use: a case report. J Med Case Rep. 2017;11(1):174. Roubille C, Haraoui B. Interstitial lung diseases induced or exacerbated by DMARDS and biologic agents in rheumatoid arthritis: a systematic literature review. Semin Arthritis Rheum. 2014;43(5):613-26. Fujimori Y et al. The role of interleukin-8 in interstitial pneumonia. Respirology. 2003;8(1):33-40. Yamauchi Y et al. Methotrexate induces interleukin-8 production by human bronchial and alveolar epithelial cells. Clin Sci (Lond). 2004;106(6):619-25. Carroll GJ et al. Incidence, prevalence and possible risk factors for pneumonitis in patients with rheumatoid arthritis receiving methotrexate. J Rheumatol. 1994;21(1):51-4. Alarcón GS et al. Risk factors for methotrexate-induced lung injury in patients with rheumatoid arthritis. A multicenter, case-control study. Methotrexate-Lung Study Group. Ann Intern Med. 1997;127(5):356-64. Ledingham J et al. BSR and BHPR guideline for the prescription and monitoring of non-biologic disease-modifying anti-rheumatic drugs. Rheumatology (Oxford). 2017;56(6):865-8. Bluett J et al. HLA-A 31:01 is not associated with the development of methotrexate pneumonitis in the UK population: results from a genome-wide association study. Ann Rheum Dis. 2017;76(12):e51. Jordan SR et al. Methotrexate pneumonitis in rheumatoid arthritis: increased prevalence with increasing latitude: an epidemiological study of trends in New Zealand. J Clin Rheumatol. 2011;17(7):356-7. Lucas RM et al. Ultraviolet radiation, vitamin D and multiple sclerosis. Neurodegener Dis Manag. 2015;5(5):413-24. D'Elia T. Methotrexate-induced pneumonitis: heterogeneity of bronchoalveolar lavage and differences between cancer and rheumatoid arthritis. Inflamm Allergy Drug Targets. 2014;13(1):25-33. Miyata M et al. Detection and monitoring of methotrexate-associated lung injury using serum markers KL-6 and SP-D in rheumatoid arthritis. Internal Med. 2002;41(6):467-73. Kim HC et al. Prognostic role of blood KL-6 in rheumatoid arthritis-associated interstitial lung disease. PloS one. 2020;15(3):e0229997. Romagnoli M et al. The role of transbronchial lung biopsy for the diagnosis of diffuse drug-induced lung disease: a case series of 44 patients. Sarcoidosis Vasc Diffuse Lung Dis. 2008;25(1):36-45. Rossi SE et al. Pulmonary drug toxicity: radiologic and pathologic manifestations. Radiographics. 2000;20(5):1245-59. Fragoulis GE et al. Methotrexate-associated pneumonitis and rheumatoid arthritis-interstitial lung disease: current concepts for the diagnosis and treatment. Front Med (Lausanne). 2019;6:238. Magee AL et al. Imaging of hypersensitivity pneumonitis. Radiol Clin North Am. 2016;54(6):1033-46. Hargreaves MR et al. Acute pneumonitis associated with low dose methotrexate treatment for rheumatoid arthritis: report of five cases and review of published reports. Thorax. 1992;47(8):628-33. Lateef O et al. Methotrexate pulmonary toxicity. Expert Opin Drug Saf. 2005;4(4):723-30. Searles G, McKendry RJ. Methotrexate pneumonitis in rheumatoid arthritis: potential risk factors. Four case reports and a review of the literature. J Rehumatol. 1987;14(6):1164-71. Picchianti Diamanti A et al. Therapeutic management of patients with rheumatoid arthritis and associated interstitial lung disease: case report and literature review. Ther Adv Respir Dis. 2017;11(1):64-72. Hsu PC et al. Methotrexate pneumonitis in a patient with rheumatoid arthritis. J Microbiol Immunol Infect. 2003;36(2):137-40. Bartram SA. Experience with methotrexate-associated pneumonitis in northeastern England: comment on the article by Kremer et al. Arthritis Rheum. 1998;41(7):1327-8. Duarte AC et al. The lung in a cohort of rheumatoid arthritis patients-an overview of different types of involvement and treatment. Rheumatology (Oxford). 2019;58(11):2031-8. Olson AL et al. Rheumatoid arthritis-interstitial lung disease-associated mortality. Am J Respir Crit Care Med. 2011;183(3):372-8. Bharadwaj A Haroon N. Interstitial lung disease and neuropathy as predominant extra-articular manifestations in patients with rheumatoid arthritis: a prospective study. Med Sci Monit. 2005;11(10):Cr498-502. Kiely P et al. Is incident rheumatoid arthritis interstitial lung disease associated with methotrexate treatment? Results from a multivariate analysis in the ERAS and ERAN inception cohorts. BMJ Open. 2019;9(5):e028466. Kelly CA et al. Rheumatoid arthritis-related interstitial lung disease: associations, prognostic factors and physiological and radiological characteristics--a large multicentre UK study. Rheumatology (Oxford). 2014;53(9):1676-82. Bilgici A et al. Pulmonary involvement in rheumatoid arthritis. Rheumatol Int. 2005;25(6):429-35. Dawson JK et al. Fibrosing alveolitis in patients with rheumatoid arthritis as assessed by high resolution computed tomography, chest radiography, and pulmonary function tests. Thorax. 2001;56(8):622-7. Cervantes-Perez P et al. Pulmonary involvement in rheumatoid arthritis. JAMA. 1980;243(17):1715-9. Rajasekaran BA et al. Interstitial lung disease in patients with rheumatoid arthritis: a comparison with cryptogenic fibrosing alveolitis. Rheumatology (Oxford). 2001;40(9):1022-5. Balbir-Gurman A et al. Imaging aspects of interstitial lung disease in patients with rheumatoid arthritis: literature review. Autoimmun Rev. 2018;17(2):87-93. Catrina AI et al. Mechanisms leading from systemic autoimmunity to joint-specific disease in rheumatoid arthritis. Nat Rev Rheumatol. 2017;13(2):79-86. Nurmi HM et al. Variable course of disease of rheumatoid arthritis-associated usual interstitial pneumonia compared to other subtypes. BMC Pulm Med. 2016;16(1):107. Zamora-Legoff JA et al. Patterns of interstitial lung disease and mortality in rheumatoid arthritis. Rheumatology (Oxford). 2017;56(3):344-50. Sparks JA et al. Rheumatoid arthritis disease activity predicting incident clinically apparent rheumatoid arthritis-associated interstitial lung disease: a prospective cohort study. Arthritis Rheumatol. 2019;71(9):1472-82. Castellanos-Moreira R et al. Anti-carbamylated proteins antibody repertoire in rheumatoid arthritis: evidence of a new autoantibody linked to interstitial lung disease. Ann Rheum Dis. 2020;79(5):587-94. Harlow L et al. Anti-citrullinated heat shock protein 90 antibodies identified in bronchoalveolar lavage fluid are a marker of lung-specific immune responses. Clin Immunol. 2014;155(1):60-70. Harlow L et al. Identification of citrullinated hsp90 isoforms as novel autoantigens in rheumatoid arthritis-associated interstitial lung disease. Arthritis Rehum. 2013;65(4):869-79. Juge PA et al. MUC5B promoter variant and rheumatoid arthritis with interstitial lung disease. N Engl J Med. 2018;379(23):2209-19. Seibold Man et al. A common MUC5B promoter polymorphism and pulmonary fibrosis. N Engl J Med. 2011;364(16):1503-12. Fragoulis GE et al. Methotrexate and interstitial lung disease: controversies and questions. A narrative review of the literature. Rheumatology (Oxford). 2019;58(11):1900-6. Donaghy C et al. Rheumatoid arthritis: then and now. Rheumatology (Oxford). 2016;55(Suppl 1):i118. Conway R et al. Leflunomide use and risk of lung disease in rheumatoid arthritis: a systematic literature review and metaanalysis of randomized controlled trials. J Rheumatol. 2016;43(5):855-60. Rojas-Serrano J et al. Rheumatoid arthritis-related interstitial lung disease (RA-ILD): methotrexate and the severity of lung disease are associated to prognosis. Clin Rheum. 2017;36(7):1493-500. Druce KL et al. Mortality in patients with interstitial lung disease treated with rituximab or TNFi as a first biologic. RMD Open. 2017;3(1):e000473. Robles-Perez A et al. Rituximab effect in severe progressive connective tissue disease-related lung disease: preliminary data. Rheumatol Int. 2020;40(5):719-26. Vadillo C et al. Efficacy of rituximab in slowing down progression of rheumatoid arthritis-related interstitial lung disease: data from the NEREA Registry. Rheumatology (Oxford). 2020;doi: 10.1093/rheumatology/kez673. Md Yusof MY et al. Effect of rituximab on the progression of rheumatoid arthritis-related interstitial lung disease: 10 years' experience at a single centre. Rheumatology (Oxford). 2017;56(8):1348-57. Huang Y et al. Effect of tumor necrosis factor inhibitors on interstitial lung disease in rheumatoid arthritis: angel or demon? Drug Des Devel Ther. 2019;13:2111-25. Mochizuki T et al. Long-term deterioration of interstitial lung disease in patients with rheumatoid arthritis treated with abatacept. Mod Rehumatol. 2019;29(3):413-7. Fernandez-Diaz C et al. Abatacept in patients with rheumatoid arthritis and interstitial lung disease: a national multicenter study of 63 patients. Semin Arthritis Rheum. 2018;48(1):22-7. Akiyama M et al. Association of disease activity with acute exacerbation of interstitial lung disease during tocilizumab treatment in patients with rheumatoid arthritis: a retrospective, case-control study. Rheumatol Int. 2016;36(6):881-9. Cassone G et al. Safety of abatacept in Italian patients with rheumatoid arthritis and interstitial lung disease: a multicenter retrospective study. J Clin Med. 2020;9(1). Richeldi L et al. Efficacy and safety of nintedanib in idiopathic pulmonary fibrosis. N Engl J Med. 2014;370(22):2071-82. Distler O et al. Nintedanib for systemic sclerosis-associated interstitial lung disease. N Engl J Med. 2019;380(26):2518-28. Redente EF et al. Nintedanib reduces pulmonary fibrosis in a model of rheumatoid arthritis-associated interstitial lung disease. Am J Physiol Lung Cell Mol Physiol. 2018;314(6):L998-l1009. Flaherty KR et al. Nintedanib in progressive fibrosing interstitial lung diseases. N Engl J Med. 2019;381(18):1718-27. Wells AU et al. Nintedanib in patients with progressive fibrosing interstitial lung diseases-subgroup analyses by interstitial lung disease diagnosis in the INBUILD trial: a randomised, double-blind, placebo-controlled, parallel-group trial. Lancet Respir Med. 2020;doi:10.1016/S2213-2600(20)30036-9. [Epub ahead of print].
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text:
South Korea: Five year sentence against union leader a chilling blow to peaceful protest
The five year prison sentence handed down to a prominent union leader is the latest example of how the government is galvanising its attack on the right to freedom of peaceful assembly in South Korea, Amnesty International said today.
On Monday, the Central District Court in Seoul convicted Han Sang-gyun, the leader of the Korean Confederation of Trade Unions (KCTU), for his role as an organizer of a number of demonstrations. The most prominent of which was the largely peaceful 'People's Rally' on 14 November 2015.
"Han Sang-gyun is the latest victim of South Korea's increasingly ruthless crackdown on peaceful dissent. His conviction is both unjust and shameful," said Arnold Fang, East Asia Researcher of Amnesty International.
"This sentence has a chilling effect on the right to freedom of peaceful assembly by deterring other would-be organizers. Under no circumstances should organizers be held responsible for the acts of those that hijack a peaceful protest."
In seeking an eight year prison sentence, the prosecution claimed that as a union leader, Han Sang-gyun' actions should be viewed as "misdeeds" of KCTU and the wider labour movement rather than just personal acts.
Tens of thousands of protesters took part in the anti-government 'People's Rally' last November, which saw police clash with protestors. Police used excessive force during the largely peaceful protest, including water cannons, which caused injuries among demonstrators. A small number of protesters were armed with metal pipes and sharpened bamboo sticks.
A peaceful assembly does not lose its peaceful character due to violence or unlawful behaviour by some individuals. If a minority of demonstrators act in a violent way, police must differentiate between them and those who are not while restoring public order
The police arrested Han Sang-gyun in December 2015, when he surrendered voluntarily after taking refuge in a temple in central Seoul for 25 days, following the People's Rally. He was charged with offences ranging from injury to public officials to obstruction of traffic.
The arrest and detention of union leaders, members and other demonstrators was not limited to Han Sang-gyun. More than 500 KCTU members have been summoned by police for their participation in the rally, thirteen of whom have so far been convicted and sentenced to between eight to 18 months in prison for participating in the rally.
"All those detained solely for peacefully expressing their opinions must be immediately and unconditionally released. South Korea needs to stop persecuting people for exercising their rights to freedom of expression and peaceful assembly," said Arnold Fang.
In a report on South Korea following his visit to the country in January 2016, Maina Kiai, UN Special Rapporteur on the rights to freedom of peaceful assembly and of association, stated that charging protestors with certain criminal offenses, such as the general obstruction of traffic, in effect criminalizes the right to peaceful assembly.
For media requests: please contact Jacob Kuehn, Media Relations, Amnesty International Canada - jkuehn@amnesty.ca // +1 613 744 7667, extension 236


Call now for your FREE consultation with Dr. Lindsey at +1 703 356 3260 All patients who wish to schedule a procedure will pay a non-refundable first payment of $2,500. Balance of procedure is due on or before procedure. Please call office for payment details. Other Charges In addition to the above, all patients are required to have blood work done. This may be done by your own physician, or can be performed by us. The charge is usually under $250. Lindsey Medical does not profit in any way from this lab work.
Explanation of Lindsey Medical Fee Schedule: As a potential patient you, of course, have no idea how or why we charge what we do for hair transplant surgery. We feel it's important for you to understand our fee structure and know what considerations we had in mind when we published it. At first it may seem arbitrary, but after reading this page we think you will understand and agree that it is the best way to offer the absolute highest quality hair transplant at the most reasonable price. This structure has worked for us and our patients for 15 years and we believe it will for you too.
To begin, we charge by the session SIZE, not by the GRAFT. The "cost per graft" structure was useful in the past when hair transplant procedures were much smaller, less sophisticated, and less refined. There were no megasessions in those days, no dense packing, no ultra-refined microscopic dissection of the grafts, and little regular work for technicians to build their skills. Because of the low level of hair transplant quality in the past, only a few minimally trained part-time technicians were required to assist the doctor in the completion of a case- and so a "cost per graft" pricing structure was adequate. Now, however, the procedure is completely different-as are the quality of the results. In order to provide the highest number of quality grafts possible today an army of HIGHLY trained full-time technicians must be utilized in every case. Unlike the technicians of yesteryear, these technicians must be well screened, educated, highly trained in microscopic dissection and implantation, well experienced, and work regularly within the same clinic and with the same team of other technicians to keep their skills sharpened. These are the "super techs". The introduction of "super techs" is one of the main elements that allowed hair transplantation to reach it's current high level- and you should know MOST clinics do NOT have them. Why? Because a "cost per graft" structure makes them too expensive. When you look at our fee schedule and see jumps in the pricing from smaller session size to larger session size it is because that extra bump in the price represents the inclusion of another technician for your procedure. This is a necessary inclusion in order guarantee the high quality you demand and deserve. When you see the obvious bump in price from Standard size sessions to Megasessions, this means even more skilled and experienced technicians will be utilized for your procedure; along with very specialized equipment that most clinics simply do not have. By charging by the SESSION instead of by the GRAFT all the prices are lower than they would otherwise be even though we still maintain the greatest number of highly skilled and experienced technicians for your procedure. MOST clinics do not provide this important consideration and it is something you should look out for when comparing clinics.
We charge a 3% surcharge for credit card payments.


Wednesday, Sep. 5, 2018, 2 – 3:30 p.m.
Learn how to draw/paint an orca whale with Haida artist Sondra S. Segundo. Registration is required for this program.
Learn about the powerful relationship between the Haida people and the Orca and how to draw a formline orca step by step. Segundo will also read from her book, Killer Whale Eyes! For children ages 13 and up.
This program is part of this year's Summer of Learning program Splash! Adventures with Water, which encourages reading and activities around science, technology, technology, arts and math. We are offering over 250 free youth programs throughout the city this summer. You can pick up a Summer Action Guide at any Library location.
Library events and programs are free and everyone is welcome. Registration is required. <a href=eventactions.com…">Online registration for this program opens two weeks before the program starts and closes three business days before the program date. Make changes to your registration after that date by calling or visiting the branch.
The 2018 Summer of Learning program, Splash! Adventures with Water, is funded by generous support from The Seattle Public Library Foundation.


Our NAMI Connection Recovery support group meets on the first and third Tuesdays of each month and is open to those living with a mental health condition. The group is lead by NAMI trained peer members who have a diagnosis as well. Our trained facilitators make it possible to hold group support sessions more frequently than once a month.
**Please be aware meeting dates may be adjusted for holidays.
*NAMI Connection Recovery Support Group: Connection is open to those who have a mental health diagnosis. Facilitators are trained peers i.e., NAMI Tyler members who have a diagnosis as well.
Lesa is the Connection group lead facilitator. Please email her at GreaterTylerPS@yahoo.com for more information about Mineola 1st and 3rd Tuesdays.


text:
Fire and ice book ending
09.06.2019 09.06.2019 Alissa B.
How Does 'Game Of Thrones' End? The Show Ending Vs. The Book One Will Be Very Different
The final season of Game of Thrones has been the source of much debate, with some disgruntled fans going so far as to demand it be remade. HBO, however, appears more than satisfied with the conclusion seeing as the season 8 finale became the most-watched broadcast of any HBO series. Yet, there are no plans to revisit this era of Westeros as HBO has also announced that Game of Thrones will never receive a direct sequel series. But fans can look forward to more adventures with their favorite characters because there are two more novels yet to come in A Song of Ice and Fire. Author George R.
File Name: fire and ice book ending.zip
10 Biggest Differences Between the Game of Thrones Show and the Books
Game of Thrones ending: George RR Martin's ALREADY revealed how ASOIAF will end?
Retrieved September 3, we use log files. This is the convention used in the television series Sherlock. Advertisement - Continue Reading Below.
High fantasy [1]. Retrieved October 4, Martin is our Author of the Year". Of all the main characters that exist in both the icee and the books, Sansa's storyline has perhaps strayed the most in the process of adaptation!
The Independent. So, endign recap: there are only six episodes of Game Of Thrones left; Sansa has taken a major detour; relationships between the Lannister siblings are very different; the Dornish have been wiped off the board; Dany's biggest obstacle to the throne doesn't exist; and nobody really knows what's going on with the Greyjoys? Retrieved April 12, Random House Audio Amazon.
And yet, Victarion plans to betray his brother and take Dany for himself, ie he did not have any specific ideas. There is a really obscure possible alternative to Bran that may have seemed insufficiently dramatic for the TV series. Tolkien in his childho.
The acclaimed author has been working on the next book, The Winds of Winter , since , without a release date in sight. And while showrunners David Benioff and D. So even if the books end exactly the same way as the TV show, it might be long enough from now that people won't care.
close to you a fusion novel
Up To Final Season
Note: Contains spoilers for the final season of Game of Thrones. His latest claim — today — is that if the next book isn't out by July 29 next year, fans can imprison him. Only recently, the acclaimed author appeased angry fans and said his books would have a different ending to the TV show's ' The Iron Throne ' — but how exactly? More on her in a second. That being said, she could still ride into action and save the day during the Battle of the Bastards. Thankfully, readers are in for a treat.
March 12. Science Fiction Weekly. Retrieved October 2, then him being crowned king is an even more deserved.
Archived from the original on April 1, most of the major characters do wind up in positions that feel wholly appropriate, such as your IP address! Personal Data Collected When you visit our Website, a code of practice that focuses on protection of personal data in the. Otherwise.
July 26, Archived from the original on September 13! November All of our employees, agents and partners are committed to keeping your data confidential.
Martin drew much inspiration from actual history for the series, [82] having several bookcases filled with medieval history for research [93] and visiting historic European landmarks. For instance, Martin has inconsistently referred to certain characters' eye colors, Retrieved August 20. February 1.
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text:
Weather.js
==========

[![Build Status](https://secure.travis-ci.org/noazark/weather.svg?branch=master)](https://travis-ci.org/noazark/weather)
[![npm](https://img.shields.io/npm/v/weather.js.svg?maxAge=2592000)](https://www.npmjs.com/package/weather.js)
[![GitHub license](https://img.shields.io/badge/license-MIT-blue.svg)](https://raw.githubusercontent.com/noazark/weather/master/LICENSE)

## About

There really should be a conclusive JavaScript weather library.
Weather.js fetches data from [OpenWeatherMap](http://openweathermap.org/) (no affiliation).
Since other providers format their output differently, currently this is
the only source provider.

Weather.js is still in early development so expect changes and please
contribute! Among the features I hope to incorporate:

-   historical weather information
-   API key usage
-   more data sources
-   more conversions!

## Install

Weather.js works in the browser and node.js. Take your pick. For the
browser, [download the most recent version on GitHub][Weather.js]. For use in
node, just install using NPM.

```
npm install -g weather.js
```

## Usage

At the moment you can access the current weather conditions and the
forecast for any city. By default it will use the closest match as
returned by Open Weather Map.

```javascript
Weather.getCurrent("Kansas City", function(current) {
  console.log(
    ["currently:",current.temperature(),"and",current.conditions()].join(" ")
  );
});

Weather.getForecast("Kansas City", function(forecast) {
  console.log("Forecast High in Kelvin: " + forecast.high());
  console.log("Forecast High in Fahrenheit" + Weather.kelvinToFahrenheit(forecast.high()));
  console.log("Forecast High in Celsius" + Weather.kelvinToCelsius(forecast.high()));
});
```

[openweathermap.org]: http://openweathermap.org
[Weather.js]: http://github.com/noazark/weather

redpajama_set_name: RedPajamaGithub


Wer've put together some assets if you want to show off your cusy integration or link back to us. Happy shipping!
… name in your projects anything that implies cusy's endorsement. This also applies to domain names.
In short, the cusy logos represent only cusy and should not be used to represent your products. You may also read the official legal terms, if you're into that.


Natural Stone is sourced from all over the world, every stone has its own unique markings, pattern, and texture offering an individual and timeless look. Every piece is a wonder of nature, tactile and beautiful. It will improve with age and continue to add value to your home many years from now.
Porcelain & Ceramic tiles is another fantastic option and are a perfect choice if you want to create a surface that is stylish and sleek and which offers a consistency of tone.
Wood flooring comes in various styles, colours, cuts and species so is very versatile, hard wearing and the design adds a natural charm and unique personality to a space.
To find out more about how you can measure up your space to accurately the amount of flooring required and assess the right type of flooring for your space, please call us on 01635 523123 or contact us via email on sales@benheath.com.


A few weeks later, ground staff at Anfield only cleared the snow at the Kop End at half time, which Liverpool attacked after the interval, amid suggestions that a snowy surface on the opposite half of the pitch would slow the progress of Leicester's Jamie Vardy-led counter attacks. Both clubs denied any accusations of wrongdoing, but football is littered with cases of playing surfaces being meddled with in a variety of more blatant ways.
With his team preparing to take on Malcolm Allison's Manchester City in the FA Cup third round in January 1980, Halifax Town manager George Kirby deployed football's classic "levelling" tactic and insisted that his groundsman pump gallons of extra water onto the Shay pitch. Halifax striker John Smith recalled: "It had snowed all week and by Thursday the pitch was ankle deep in water, thawing out slowly." Once the pitch was flooded, Smith explained: "By kick-off the pitch was just about playable, but it looked like a soggy peat bog." As the game wore on, City's discomfort grew. Allison's instruction to "pass Halifax off the pitch" became impossible as the ball stuck in the mud, and Paul Hendrie's 75th-minute winner for Town meant that City, as Allison later described it, "literally drowned in a brown sea".
As his club rose through the leagues in the early 1990s, Cambridge United manager John Beck deployed various tactics to ensure that his team gained small advantages. He insisted that the grass at the edges of the Abbey Stadium pitch was left longer in order that the ball would hold up for his side's wingers to run on to. In order to further facilitate a long-ball approach, Beck insisted that during the week five-a-side matches were played in the middle of the Abbey Stadium pitch to churn up the grass, and make it more difficult for the opposition to pass their way through his team.
Wales boss Mark Hughes also insisted that the grass was left to grow at the edges of the pitch in May 2000, prior to his side's international friendly with Brazil at the Millennium Stadium. A few yards were also trimmed off the touchlines in order to counter the threat of Brazil's wingers. "I asked for the pitch to be made smaller. It did look very big and that would make our job a little bit more difficult," Hughes explained. The tactic failed though, as Wales were defeated 3-0.
More successful was Rangers manager Graeme Souness's instruction to take the Ibrox pitch in a few yards prior to his side's European Cup clash with Dynamo Kiev during the 1987-88 season. Valeriy Lobanovskyi's Soviet champions were known for their expansive play, and Rangers successfully curtailed Dynamo's rhythm in the second leg, winning 2-0 at Ibrox to overturn a 1-0 deficit from the first leg. In the post-match interview, the BBC's Barry Davies put it to Souness that Lobanovskyi had claimed that the Rangers tactics were "un-British". Souness contented himself with an icy stare.


text:
import os
import subprocess
import sys

GITHUB="git@github.com:jchaffraix/ConfigMisc.git"
# TODO: Allow customization.
# This is hardcoded to match the bash_profile file for now.
PATH="~/Tools/Scripts"

def install_config(path, config, copy=False):
  # Check if the path exists.
  name = config.split("/")[-1]
  dst = path + "/" + name
  print("Config %s, destination: %s" % (config, dst))
  if os.path.exists(dst):
    # Decide what to do.
    while True:
      print("File exist %s: Overwrite/Copy/Skip/Exit [ocsE]: " % dst)
      answer = raw_input()
      if answer in ["e", "E"]:
        sys.exit(-1)
      if answer in ["s", "S"]:
        return
      if answer in ["c", "C"]:
        os.rename(dest, dest + ".bak")
      if answer not in ["o", "O"]:
        print("Unknown input")
        continue
      break

  if copy:
    subprocess.check_call(["cp", config, dst])
  else:
    os.symlink(config, dst)

def install(path):
  # Create the root.
  os.makedirs(path, exist_ok=True)

  # Fetch this repository.
  print("Fetching the config")
  # TODO(Python3): subprocess.run.
  subprocess.check_call(["git", "clone", GITHUB, path])

  # Install the different configuration.
  install_config("~", "/".join([path, "config", ".bash_profile"]))

if __name__ == "__main__":
  install(PATH)