New this year – ASPHO is providing the opportunity to interact with a recognized expert on a challenging diagnostic and management issue. Each session is scheduled for 1 hour and will include a 15-20 minute presentation by the expert on their general approach to the clinical problem followed by small group discussion of additional cases shared by the attendees.
Advanced registration is required. Seating is limited to 20. The registration fee is $25.
The 2019 Conference Planning Committee will select abstracts considered the best submissions for the Plenary Paper Sessions.
Discuss new approaches related to diagnosis and treatment in pediatric hematology/oncology.
Examine current research outcomes from a variety of the latest in basic and clinical research.
The ASPHO Young Investigator Award was established to formally recognize excellence in pediatric hematology/oncology research and to promote basic and clinical investigation into the fields of hematology and oncology by fellows and faculty members who are less than 4 years post-fellowship.
Define mechanisms of acquired resistance to the type II JAK2 inhibitor CHZ868.
Discuss the transcription factors that regulate fetal hemoglobin expression.
Generate a high-throughput approach for identifying previously unknown genomic regulatory elements.
Click here for more information about this year's award recipients.
The Early Career Travel Stipend recipients will also be announced during this time.
Examine the current indications for splenectomy for ITP and CHA.
Recognize the risks of splenectomy and assess how to weigh these risks with potential benefits of splenectomy for ITP and CHA versus alternative treatments.
Analyze the current evidence for partial splenectomy in CHA.
For children with chronic or refractory immune thrombocytopenia (ITP) or congenital hemolytic anemias (CHA) of severe phenotype, splenectomy may prove invaluable in improving clinical outcomes. The decision to pursue splenectomy must be balanced with the risks associated with the procedure. In ITP, debate exists regarding splenectomy vs. use of newer second-line agents. In CHA, opinions vary regarding timing and degree of splenectomy (partial vs. total). Partial splenectomy is thought to preserve a degree of splenic function, thereby theoretically reducing the risk of long-term complications associated with total splenectomy. However, long-term data on outcomes of partial splenectomy is limited.
Describe the spectrum of DICER1-related tumors including recently described phenotypes.
Discuss the role of DICER1 testing for individuals with various benign and malignant tumors.
Discuss screening strategies and associated challenges of surveillance for individuals with DICER1 mutations.
An update on phenotypes associated with DICER1 syndrome as well as recent screening and management recommendations for individuals with DICER1 mutations will be interactively discussed during this session. Case presentations highlighting potential benefits and challenges of surveillance will be also be presented. Finally, emerging biologic information from ongoing research studies and tumor models will be discussed.
*DICER1-related tumors include PPB, SLCT, cystic nephroma, Wilms tumor, renal sarcoma, eRMS, pineoblastoma and thyroid cancer.
No CME will be offered for this session.
Recognize that burnout is prevalent, has an impact on patient care, physician wellness and health system functioning.
Identify proactive forms of burnout prevention (such as strengthening resilience) and reactive forms of burnout prevention (such as critical incident stress management).
Recognize that the stressors contributing to burnout among faculty and educators are different than those for trainees.
Identify strategies to sustain physician health, work/life balance, and prevent burnout that can be brought back to each participant's home institution.
Burnout among physicians is epidemic, and pediatric hematology/oncology has not been spared. While there is growing awareness of the impact of burnout on medicine, no standard approach has emerged to address its prevention, alleviation and management. Strategies remain highly variable between institutions and individuals.
In this workshop Jonathan Fish, MD, will present a very brief overview of burnout, after which participants will break into 2 groups where strategies to combat burnout will be discussed and developed. One group will focus on proactive and reactive strategies to burnout alleviation, and will be led by Margaret Rhea, PhD, an expert in resilience development and proactive approaches to burnout prevention, and Patricia Tritt, RN MA, an expert in addressing stress that arises following critical incidents. The second group will focus on addressing the unique factors that contribute to burnout from the educator and trainee perspectives, and will be led by Adam Levy, MD, chair of graduate medical education for Montefiore Medical Center, as well as Adit Tal, MD, and Brittney Whitford, MD, fellows in pediatric hematology/oncology. Half way through the workshop, participants will switch groups. Finally, all participants in the workshop will be invited to form a community of practice by continuing the conversation through different media platforms.
Differentiate normal from heavy menstrual bleeding (HMB), classify abnormal menstrual patterns according to recently proposed terminologies, and recognize predictors of bleeding disorders.
Identify the type and timing of laboratory evaluation required to optimally diagnose bleeding disorders in adolescents presenting with HMB.
Recognize the genetic ramifications and management considerations for adolescents with decreased von Willebrand levels or hemophilia carriership.
Heavy menstrual bleeding (HMB) at menarche is attributed to anovulation. Intuitively, a proportion of adolescents should have an underlying bleeding disorder (BD), but the age of women identified with BD is 35 years, implying that the diagnosis is made late. Management is symptomatic, not attempting to identify the underlying etiology. This workshop, relevant for small and medium sized programs without dedicated Young Women's Hematology Clinics, will discuss diagnostic conundrums surrounding HMB and management of BDs.
When is Heavy Menstrual Bleeding in Adolescents Really Heavy?
Low VWF and Hemophilia Carriership: Medical or Genetic Diagnosis?
Describe the limitations of the HLH-2004 diagnostic criteria.
Identify mimickers, and atypical clinical presentations of HLH.
Discuss improved diagnostic approaches to primary HLH.
Hemophagocytic lymphohistiocytosis (HLH) is characterized by dysregulated immune activation. Primary HLH involves hereditary defects in cytotoxic lymphocytes while secondary HLH is triggered by extrinsic factors. The HLH-2004 criteria are widely used for diagnosis, yet their specificity for HLH, and ability to differentiate primary from secondary disease is unclear. This distinction is critical when a malignancy is the trigger of immune activation. Failure to recognize and treat these conditions can lead to misdirected treatment and fatal outcomes. Such errors can be reduced with increased awareness, appropriate investigations, and use of an alternative diagnostic approach using flow cytometry-based assays.
Identify and discuss the vast difference in diagnosis and cure rates between HIC and LMIC settings.
Describe the impediments to making accurate diagnoses and providing comprehensive care in LMIC settings.
Describe the successful models for performing International Outreach.
While the cure rates for Pediatric Cancer in High Income Countries (HICs) are now > 80%, over 80% of the children with cancer live in Low and Middle Income countries (LMICs), where many are never accurately diagnosed or fully treated. When these children are properly diagnosed, the difficulties of providing appropriate treatment and supportive care result in cure rates that are far less than half of what would be expected in HIC.
Join fellow new members, first-time attendees, and international attendees during this opportunity to connect and network at the start of the ASPHO Conference. ASPHO Board President Patrick Leavey, MD, will make short remarks and ASPHO's Board members will be in attendance to greet attendees.
Join fellow Division Directors for an opportunity to network and connect around topics important to your work.
Advanced registration is required. The registration fee is $100.
ASPHO is holding its sixth annual 5K Fun Run/Walk event.
Advanced registration is recommended. Registration fee is $25, after May 1, fee is $35.
Dr. Karen Albritton, medical director of the Fort Worth AYA Oncology Coalition, will discuss lessons learned through the development of a multi-institutional AYA program. Additionally, we will report results of a landscape survey addressing current hematology/oncology AYA care and workshop attendees will participate in defining next-steps for the SIG.
Kathleen Sakamoto, MD, PhD, Ernest Frugé, PhD, and Sinisa Dovat, MD PhD, will present the survey results of the physician scientist SIG members and Jeffrey Lipton, MD PhD, will discuss various strategies for obtaining research funding, a priority issue identified by the SIG members.
Like it or Not, Now you Have to Learn about Vascular Anomalies: It's in the Boards!
This meeting will provide updates from Research, Practice and Education Committees and review of selected difficult cases. We will also review opportunities to become involved in this exciting community, including ongoing and upcoming research. We welcome trainees and fellowship program representatives, as vascular tumors and malformations are now included in the 2018 ABP Content Outline for the Pediatric Hematology-Oncology Boards.
Identify the optimal testing strategy in real-life clinical scenarios and recognize advantages and limitations of genetic testing in clinical pediatric hematology.
Appreciate implications of complex genomic tests to patients and families.
Assess genetic test results and understand variant classification.
Addressing frequent and often complex genetics questions such as recognition of hereditary disorders, determination of familial recurrence risks, and implication of genetic test results can pose a challenge to clinical pediatric hematology providers, especially in small or medium-sized programs without the support of a genetic counselor. In the era of genomic medicine, with increased availability and clinical utility of genetic testing, providers need to be equipped with tools and resources to successfully navigate these issues with their patients in the pediatric hematology clinic. In this session certified genetic counselors with expertise in clinical pediatric and laboratory hematology genetics will share cases (hemophilia, thrombophilia, hereditary thrombocytopenia, and bone marrow failure) to help audience members optimize testing strategy, educate patients on the complexity and nuances of testing, and integrate even inconclusive results into patient care.
Explain the indications and differences in radiation therapy delivery methods and how to best utilize these technologies for patients.
Describe the use of a radioisotope to treat large or unresectable liver cancers.
Radiation therapy plays a critical role in the treatment and cure of many childhood cancers. Pediatric oncologists may not be fully aware of the pros/cons of the different delivery methods including protons, photons, radiopharmaceuticals and specialized techniques including gamma knife, radiosurgery and stereotactic body radiotherapy. This session will examine these issues for the pediatric oncology audience.
(B9) The Microbiome: What Is It and Why Do We Care?
Discuss how exposure to chemotherapy and antibiotics can alter a host's microbiome.
Recognize that the microbiota composition of pre-HCT is distinct from healthy volunteers and this difference may impact the risk for infections and GVHD post-HCT.
Explain how the modulation of microbiome may affect patients' outcomes.
The microbiome plays critical roles within the context of the development of the immune system. It can alter how a patient will respond to chemotherapy or immunotherapy, and can impact post-transplant morbidity and mortality; all through its ability to educate and modulate the host immune system. The clinician need to be aware of the impact of these interactions to make informed decisions regarding the use of probiotics, antibiotics, and immunosuppressant medications.
Join us in the foyer on the 3rd floor and bring your cases on Radiation Therapy. Speakers from the "Radiation Therapy for Pediatric Cancer Patients: Updates and New Modalities" session will be there to help answer questions and guide the discussion.
Recognize the common presenting signs of stroke based on age, risk factors and predisposing disease states (sickle cell disease, cardiac disease, nephrosis, autoimmune syndromes…etc.), and plan the diagnostic evaluation of a neonatal and pediatric stroke patient.
Identify the indications for anticoagulation and antiplatelet therapy, and recognize the emerging role of and controversies surrounding hyperacute therapies including thrombolysis, thrombectomy and clot retrieval in pediatric arterial ischemic stroke.
Describe the importance of a multidisciplinary approach for the early recognition, diagnosis and management of pediatric stroke patients.
The past decade has marked an increase in incidence and awareness of childhood and neonatal stroke. Albeit rare, pediatric stroke associates with significant morbidity and mortality, and a compelling need exists for early recognition, diagnosis and treatment. Using an interactive review of actual cases, this workshop will address the clinical presentations, differential diagnoses and existing challenges/delays in diagnosis of pediatric stroke in general and in high-risk patient populations, including sickle cell anemia, cardiac disease, nephrosis and autoimmune syndromes. The panelists will also provide a comprehensive review of existing therapies and emerging data on hyperacute interventions such as thrombolysis and thrombectomy.
Discuss the recent clinical trial findings and plan for future trials (and incorporation of new agents).
Describe the biologic advances in pediatric AML, including results of the TARGET project.
Summarize the development of immunotherapies for AML, including DART and CART.
The outcomes for pediatric AML remain relatively poor compared to other hematologic malignancies, with EFS of about 50%. To this end, much research is ongoing including the recent TARGET project, as well as introduction of targeted therapies into treatment regimens, and the development of immunotherapy. These advancements both inform prognosis and therapeutic decisions, and lead to improved patient outcomes. Immunotherapy strategies have not yet been widely adapted for AML, but are likely to be in clinical trials soon, and important for practitioners to be aware of.
(B12) Improving Medication Adherence for Adolescents and Young Adults: Is Technology the Answer?
Describe facilitators of and barriers to medication adherence that are specific in AYA patients.
Compare existing technology based interventions (mobile health applications and websites) for use in clinical practice.
Apply motivational interviewing techniques to improve medication adherence among adolescent and young adult patients regardless of diagnosis.
Lower rates of medication adherence among adolescents and young adults (AYA) contribute to less favorable outcomes compared to younger hematology/oncology patients. Improving adherence requires tools and techniques tailored to the unique needs of this population. Both technology and motivational interviewing have shown promise in engaging AYA, but are not widely used. This workshop will allow participants to test existing mobile health applications and learn evidence based interviewing techniques they can apply to their practice.
ASPHO's annual business meeting allows attendees to learn more about the Society's progress toward meeting the goals of its strategic plan, as well as learn about the Society's financial health. Additionally, outgoing Board members and committee chairs are recognized, a report is presented from the Pediatric Blood & Cancer Journal editor, and the 5K Fun Run winners are recognized.
Discuss pathways to successfully achieve career development goals.
Review the experiences of experts in the field.
Provide trainees and early career members an opportunity to network with leaders in the field of pediatric hematology/oncology.
Attendees will have the opportunity to participate in discussion groups led by experts in defined areas of interest. The purpose of this luncheon is to provide early-career professionals a forum to discuss issues one on one with leaders in the field, ask questions related to career development in a small-group setting, and receive positive reinforcement regarding career goals specific to their interests. One to two discussion leaders will be placed at each luncheon table, with the option for participants to switch tables for further discussion on a wide range of topics.
Advanced registration is required. The registration fee is $30.
Recommended by the Professional Development Committee.
This session will include a "State of the Science" review of recent key palliative care articles. We will discuss clinical problems, educational issues and growth of the field. We will also discuss how to keep the SIG active between meetings and increase its usefulness to members.
This session will begin with a lecture on "The History and Current State of Quality Improvement within Pediatric Hematology/Oncology" followed by a moderated panel discussing multiple themes (career development, mentorship, resources/QI tools, funding). Interactive modalities will be used to find out more about the audience's goals for the SIG.
Small programs are uniquely positioned to care for adolescents and young adults in collaboration with our adult colleagues. However, this population brings different needs and challenges than our younger patients. A panel of AYA experts in hematology and oncology will join us to discuss the care of AYA patients at smaller centers.
ASPHO will present the Northwestern Mutual Award for Excellence in Childhood Cancer Survivorship, funded by the Northwestern Mutual Foundation. The award will recognize an individual who has translated research findings into intervention-based approaches and/or has made outstanding contributions to the clinical care of survivors of childhood cancer.
The annual Frank A. Oski Memorial Lectureship Award gives us an opportunity to remember and honor Dr. Oski and his many contributions to the field of pediatric hematology/oncology. It is awarded to an outstanding clinical or laboratory investigator in pediatric hematology/oncology whose cutting-edge research has significantly impacted the field. This year's lectureship will be presented by Wilbur A. Lam, MD PhD, Aflac Cancer and Blood Disorders Center/Emory University.
Wilbur A. Lam, MD, PhD is a physician-scientist-engineer whose basic research interests involve developing micro/nanotechnologies to investigate the biophysics of hematologic processes at the micro- to nanoscales. Accordingly, the Lam laboratory takes a multidisciplinary approach spanning medicine, cellular biology, physics, and engineering to develop research enabling tools such as microfluidic and microchip-based systems to answer questions in hematology that are technologically infeasible with current assays. Examples include "microvasculature-on-a-chip" systems that function as in vitro models of sickle cell disease or hemostasis/thrombosis. The Lam laboratory is also dedicated to clinically translating the technologies they invent, including home-based anemia tests and several smartphone-based diagnostic platforms as well as novel drug delivery systems for blood diseases. Overall, the Lam laboratory has developed a "basement-to-bench-to-bedside" approach in which the invention, development, and clinical translation of micro/nanotechnologies takes place under one scientific "roof" with the ultimate goal of improving the lives of children and adolescents with hematologic disorders.
Click here for more information about this year's recipient.
Describe the importance of metabolism to cancer and opportunity to consider metabolic pathways as potentially targetable.
Explain that mitochondria is more than responsible for creating ATP and understand its role in cellular/leukemia fate.
Discuss the work being performed in treating patients with pyruvate kinase deficiency.
Cellular metabolism has an unquestionable role in phenotypic diversity and maintenance of tissue function. We will present three talks that will elucidate the importance of metabolism in cell function, the opportunity to explore the potential for vulnerabilities in metabolism in cancer, the role of mitochondria in leukemia cell fate and the exciting work being done to clinically target metabolic deficiencies in pediatric hematological disease.
ASPHO will provide two poster tours during exhibit hours. The Conference Planning Committee selected five highly ranked posters that will be included in a 30-minute tour for all interested attendees. Authors of these selected posters will provide a brief overview of their research and answer attendees' questions. Advanced registration is not required. Attendees should meet in the back of Exhibit Hall and look for a staff member holding a Poster Tour sign. Don't miss the opportunity to receive a quick overview of top-rated abstracts!
Meet in the back of the Exhibit Hall.
Join fellow Fellowship Program Directors for an opportunity to network and connect around topics important to your work.
Advanced registration is required. The registration fee is $85.
The annual George R. Buchanan Lectureship is presented in honor of Dr. Buchanan and his many contributions to ASPHO and the field of pediatric hematology/oncology. It is awarded to an internationally recognized expert in pediatric hematology/oncology. This year's lecture will be presented by Kenneth McClain, MD PhD from Texas Children's Hospital.
Provide the listeners with an overview of how the biology of Langerhans cell histiocytosis has evolved over the past 40 years.
Illustrate a model for studying rare diseases through a designated center of excellence.
Translational research has several barriers which may inhibit success: sufficient numbers of patients to adequately study a disease, technological innovations to uncover the pathophysiology, funding to support the research, and motivated investigators. Contrasts in the trajectory of progress for acute lymphoblastic leukemia (ALL) vs Langerhans cell histiocytosis (LCH) could not be more striking. The organization of cooperative groups to treat ALL led to pooling of thousands of patients and collection of critical specimens for research. Cell surface marker and cytogenetic data quickly led to risk stratification and improved outcomes with treatment modifications. Many impressive molecular discoveries over the past few years have profoundly advanced our understanding of ALL biology. LCH research suffered from a lack of organized tissue acquisition in the international trials and paucity of patients at any one center anywhere in the world. There are no cytogenetic abnormalities in LCH cells. Evaluations of LCH tissue were challenged by lack of technical innovations to separate the pathologic cells from others in biopsy tissue and isolate sufficient amounts of DNA and RNA from purified cells to do molecular research until 2006. Since then advances in our understanding of LCH biology have been impressive, but much is yet to be learned. This lecture will provide an overview about early efforts led to intriguing, but incomplete results and how it was possible to acquire sufficient numbers of patients at a single center, establish critical collaborations, and begin to bring LCH research into the 21st century.
Describe the causes of thrombocytosis in children and describe the workup and management.
Recognize the primary and secondary causes of polycythemia in children and review treatment strategies.
Discuss the causes, work-up, and care of children with eosinophilia.
There is a lack of knowledge surrounding myeloproliferative conditions in children, likely because they are rare in the pediatric population. Anyone who has prepared to see a patient with eosinophilia, or with Budd-Chiari syndrome and a platelet count of 800,000, recognizes how little information is available regarding these disorders in children. This session will give providers the tools they need to feel confident when working-up and treating a child with thrombocytosis, polycythemia, or eosinophilia.
(C15) Multiple Bony Lytic Lesions, but Not Langerhans Cell Histiocytosis (LCH) – Now What?
Formulate the differential diagnosis of multiple bony lytic lesions (solid tumor metastases, histiocytosis (LCH), Gorham-Stout disease or another complex lymphatic anomaly, epithelioid hemangioma) and define required radiological imaging to assess disease extent.
Create a reflex step-wise immunostaining algorithm including the differential diagnosis entities, to maximize use of the biopsied specimen.
Outline the natural history of progression if left untreated, specific to each possible diagnosis. Summarize the management of multifocal bony lytic lesions (disease targeted therapy and "bone protection" agents – bisphosphonates and denosumab).
Multifocal bony lytic lesions as a presentation sign in a pediatric patient opens a wide-range of differential diagnoses: histiocytosis, bone metastases from an unknown source, other primary malignancies (like leukemia or lymphoma), or vascular anomalies affecting the bones. Reaching the correct diagnosis through the least number of invasive or costly procedures is a very difficult task. Once the diagnosis is identified, the therapy should target the etiology but also specifically address the bone lesions to prevent pathological fractures and long-term morbidity.
Four Clinical Cases of Multifocal Bony Disease - What Next?
What Clinical Information Does the Pathologist Need to Get to the Right Diagnosis?
Describe the potential role of a "savior sibling" for pediatric patients for whom hematopoietic stem cell transplantation (HSCT) is a therapeutic option.
Describe the ethical and psychosocial challenges encountered when considering utilization of pre-implantation genetic diagnosis (PGD) to create a savior sibling.
Explore various scenarios in which a savior sibling might be more or less acceptable; and consider how such scenarios might be approached in one's own clinical practice.
With pre-implantation genetic diagnosis (PGD), families can "create" an HLA-matched donor for a child requiring transplantation. Most families know little about this controversial option but express great interest in learning more. Session attendees will become familiar with the potential role for–and numerous challenges inherent in–using PGD to create so-called "savior siblings." They will get to interactively examine their own perspectives on this topic and will be armed with tools for discussing this option with families.
Join us in the Exhibit Hall and bring your cases on Bony Lytic Lesions. Speakers from the "Multiple Bony Lytic Lesions, but Not Langerhans Cell Histiocytosis (LCH) – Now What?" session will be there to help answer questions and guide the discussion.
Speed mentoring is an opportunity to network with leaders in the field through a series of short, focused conversations about specific questions. It is a concept that focuses on quick-hit information, allowing for time-efficient networking. Fellows and early career attendees registering for this session will have the opportunity to meet one-on-one with up to three mentors for 10 minutes each. Mentees will be required to submit a one-page document prior to arriving onsite that addresses a specific topic of interest. Mentees should come prepared with two concrete questions to discuss for their chosen subject. Mentors will review the mentees' documents in advance for meaningful insight and efficient engagement.
Each person will be assigned to one of two sessions (either 10:30 am or 12:30 pm).
The St. Baldrick's Foundation Robert J. Arceci Innovation Award was established in loving memory of Robert J. Arceci, MD PhD. Two awards are presented per year, one to a U.S. or Canadian researcher to be presented at the ASPHO meeting, and one international award to be presented at the SIOP meeting. Each award is $250,000 per year for three years, to support truly innovative childhood cancer research. This year's North American winner will be announced during this session.
Charles G. Mullighan, MBBS MSc MD, the 2016 award recipient, will be presenting the outcomes of his research.
Recent years have witnessed remarkable advances in our understanding in the genetic basis of acute lymphoblastic leukemia, and rapid translation of many of these findings to new diagnostic and therapeutic approaches. The St. Baldrick's Foundation Robert J. Arceci Innovation Award enabled the awardee to expand and develop new avenues of investigation, including the genomic analysis of poorly understood subtypes including mixed phenotype acute leukemia and acute erythroleukemia. These studies have yielded not only fundamental insights into the genetic basis of these diseases, but have resulted in a revised classification of leukemia, identification of new therapeutic targets, the establishment of new experimental approaches to understand the mechanistic basis of leukemogenesis. The award has also facilitated landmark studies of the genomics of clonal evolution in ALL, and in parallel, mechanistic studies that have utilized classical in vivo experimental modeling and functional genomic screens to examine the role of mutations of individual genes, and pathways, in driving treatment resistance. Highlights from these studies will be presented.
Describe how to put genetic screening for inherited bone marrow failure syndromes such as severe aplastic anemia into practice.
Discuss current outcomes with IST in North America and what we know about the short and long-term effectiveness of Eltrombopag in combination with IST as up front therapy in children with SAA.
Describe the effectiveness of up front unrelated donor BMT and use of alternative donors such as haploidentical-related donors in SAA patients who fail IST.
The approach to initial therapy for severe aplastic anemia has traditionally been transplantation (BMT) for those with fully matched sibling donors and immunosuppressive therapy (IST) for all others. With recent improvements in outcomes of unrelated donor transplantation, some European and Asian groups are advocating up front unrelated donor transplantation for those with fully matched donors. At the same time, the addition of eltrombopag to IST has been shown to improve complete remission rates and is now FDA-approved as first line therapy, but data in children is limited and durability of response is poorly understood. Thus, first-line therapy for upfront SAA seems to be shifting and the very best approach is unknown. Finally, with the emergence of genetic screens for SAA, clinicians are also unsure how to fit these results into treatment paradigms.
Summarize unique biological features and current treatment recommendations for breast carcinoma in AYAs and possible modifications in treatment of younger patients.
Summarize unique biological features and current treatment recommendations for colorectal carcinoma in AYAs and possible modifications in treatment of younger patients.
Recognize obstacles to the appropriate treatment of AYAs with cancer and determine methods to improve collaboration between adult and pediatric programs.
Cancer incidence in adolescents and young adults (AYAs) aged 15-39 years is over 4 times greater than in younger children. Care for these patients is complex. AYAs may present with carcinomas more commonly seen in older patients. Often pediatric oncologists are not as familiar with treatment of these tumors and adult facilities do not have the psychosocial resources to care for younger AYAs. Additionally, unique biological features in AYA carcinomas may impact treatment; yet, clinical trial enrollment is lower in AYAs compared with other populations. Collaboration is needed between pediatric and adult specialists to improve the care of AYAs.
Review current research into novel mechanisms to address chronic pain.
Describe evidence for psychological therapies for chronic pain and provide a framework to translate this into clinical practice.
Discuss current evidence around pharmacology, safety, and legality of medical marijuana.
Within the current climate of the opioid crisis, there is increased concern for the use of opioids in children and adults. Current guidelines call for use of non-pharmacologic pain approaches and non-opioid pharmacologic interventions for the treatment of chronic pain. Patients and families are increasingly interested in cannabinoids, although potential benefit must be assessed with consideration of concerns related to safety and legality.
This session will consist of three-15 minute presentations of high impact results, promising studies or other initiatives recently presented at COG or other national/international meetings.
This session will consist of four 15 minute presentations of hematology science - from Hematology Science as presented at the 2018 ASH Annual Meeting.
Describe the molecular pathogenesis, novel diagnostic imaging techniques, and treatment of sickle cell retinopathy.
Review the molecular pathogenesis of bony changes in SCD, including avascular necrosis. Treatments including Vitamin D supplementation will also be covered.
Discuss updates on pathogenesis, diagnosis, and management of sickle nephropathy.
Though the survival for pediatric patients with sickle cell disease (SCD) has substantially improved in the recent years, the mortality has not decreased for adults with SCD. Adults with SCD have excess morbidity and mortality from end organ damage which typically starts in early childhood. Pediatric hematologists must understand the pathogenesis, screening methods and treatment options for these complications so that they can help to prevent excess morbidity and mortality later in life for patients with SCD.
(C21) Defining Pediatric MDS: A Morphologic or Molecular Diagnosis?
Describe the evolving morphologic definition of pediatric MDS and how cellular dysplasia impacts diagnosis, prognosis and therapeutic decision making.
Describe the evolving molecular definition of pediatric MDS and review both primary and secondary molecular predisposition to pediatric MDS.
Review the practical application of the WHO 2016 revised definition of MDS and debate the indications of pharmacotherapy and transplant.
How influential are the morphologic versus the molecular features in the diagnosis and prognosis of pediatric MDS? Comprehensive guidelines to accurately define and prognosticate pediatric MDS remain elusive despite ongoing efforts to revise the WHO classification. We turn to hematopathologists to define cellular dysplasia and, concurrently, have identified an increased number of somatic driver mutations found to impact prognosis. Renewed efforts to organize a unified approach to pediatric MDS will require multidisciplinary cooperation.
Discuss collaborative approaches to clinical management of rare diseases.
Recognize the unique barriers to performing clinical and basic research for rare diseases.
Know the current approaches to overcome challenges of trial design, regulatory issues and funding for rare diseases.
Pediatric hematologists and oncologists often care for children with diseases that are rare in the general population. Yet these conditions can be life-threatening and present tremendous challenges because of a paucity of clinical expertise and lack of evidence-based guidelines for management. Collaborative groups of clinicians and researchers with a common focus in a rare diseases can provide a valuable expertise and resources for patients and primary providers. Advancing knowledge and improving care for rare diseases is hampered by challenges in trial design and limited research funding. Advocacy and collaboration are critical to overcome these barriers.
The Distinguished Career Award is presented annually by ASPHO to a senior physician or other professional who during his or her career has had a major impact on the subspecialty through some combination of research, education, patient care, and advocacy. This session celebrates Elliott Vichinsky, MD, from UCSF Benioff Children's Hospital Oakland, and is followed by a reception to congratulate him on the award.
The Advanced Practice Provider Special Interest Group is dedicated to providing a forum for the exchange of ideas and information among advanced practice providers (APPs) and for promotion of their role in the field of pediatric hematology and oncology. At this year's meeting, we will be highlighting a poster submitted by an APP as well as continuing discussions of issues pertaining to APPs in hematology, oncology and transplant.
The Clinical Immunology SIG workshop will focus on broadening our understanding and application of clinical immunology within pediatric hematology/oncology practice. This will include education related to the diagnosis and management of immunologic disorders pertinent to hematologists/oncologists. We will continue to develop a foundation for the development of future research initiatives.
The Hemoglobinopathy SIG's goal is to promote collaboration among hematologists caring for children and young adults with hemoglobinopathies including sickle cell disease.
(D23) Hematological Manifestations of Immune Deficiencies and Dysregulatory Disorders: When should you look harder for underlying causes of Autoimmune Cytopenias?
Describe the hematological manifestations of Primary Immune Deficiencies (PID) and Primary Immune Regulatory Disorders (PIRD).
Explain how best to work up and treat these patients.
Review potential definitive treatment options for these disorders with transplantation or gene therapies.
New sequencing technologies have shown underlying disorders in many patients with autoimmune cytopenias. Practitioners are unsure which immune deficiency/dysregulatory disorders are associated with hematological manifestations and how to diagnose and treat them. Understanding whether patients have underlying genetic conditions prompting hematological issues is key to proper diagnosis and therapy.
Recognize the need for oncofertility care for pediatric oncology patients.
Identify barriers to providing oncofertility care.
Develop strategies to overcome the barriers to oncofertility care.
Oncofertility is the field of care for oncology patients provided by cancer and fertility healthcare providers. Oncofertility is complex both medically and pyschosocially, which underscores the need for an innovative and multidisciplinary approach. These complexities create barriers that hinder the timely development of oncofertility programs. This workshop will discuss strategies used in established and emerging programs and the logistics of pursuing fertility preservation options. Case-based examples will highlight the role of fertility patient navigators.
(D25) The (Financial) Cost of a "Cure"
Interpret the financial implications of strategies such as gene editing/therapy for nonmalignant hematologic disorders such as sickle cell disease and thalassemia.
Implement strategies to assess use and improve accessibility of novel, but costly, commercially available cellular therapies, such as CAR-T cells.
Discuss the ethical considerations and dilemmas regarding access to and payment of these costly therapies.
There have been exciting new developments using gene manipulation to cure pediatric hematologic and oncologic diseases, such as gene editing/therapy for hemoglobinopathies and CAR-T cell therapy for relapsed/refractory ALL. As these therapies become commercially available, it is critical that providers be aware of their cost, how to navigate access to these therapies and recognize how the cost impacts accessibility on an individual as well as global basis. Ethical dilemmas regarding access of these therapies to all patients needs to be addressed.
The Cost of Customized Cellular Therapy: Can We Afford It?
Melissa M. Hudson, MD will present The Role of Survivorship Research in Advancing Childhood Cancer Care and Quality of Survival followed by four 15-minute presentations of scientific research from selected oncology related abstracts.
Blanche Alter, MD MPH, will present Advancing Discovery in Hematology: Bench to Bedside? No. Bedside to Bench to Bedside.... followed by four 15-minute presentations of scientific research from selected hematology related abstracts.
The Maintenance of Certification (MOC) learning session will feature an American Board of Pediatrics (ABP) Lifelong Learning and Self-Assessment Module. It is intended for those who are enrolled in the MOC process and would like to earn MOC activity points, but also for anyone wishing for a broad review of recent literature relevant to pediatric hematology/oncology. The session will be conducted in an interactive group setting led by authors or experts in their fields. The session will cover multiple-choice questions in the 2019 Pediatric Hematology/Oncology Self-Assessment. Please bring your laptop to enter the answers to each question during the session. At the completion of this session, those enrolled in the ABP MOC program will have been able to submit their answers to the online module for scoring to receive 10 MOC Part 2 points and 6 AMA PRA Category 1 Credits™.
Advanced registration is required. The registration fee is $50.


Hate all the erroneous laws surrounding suppressors?
If you do you're not alone. The ridiculous amount of paperwork, added expense of paying for a tax stamp and the excessive wait time to get a suppressor has lots of gun owners rightfully upset.
Especially when you sit and think about how needless all of the above truly are.
No one in their right mind can honestly call suppressors "crime assistance accessories." But that's exactly what the liberal media and gun control groups label them to be.
If you listen to their attack rhetoric on suppressors you'd think the only reason people get them is so they can sneak around and commit crimes without detection.
Regardless of how the left feels about suppressors the truth is there are millions and millions of Americans who would love to have them. And those 2A supporters have put enough pressure on lawmakers that they've sufficiently changed the game on getting suppressors deregulated as NFA items.
Just this past week a new series of laws packaged together under the SHARE act (Sportsmen Heritage and Recreational Enhancement Act) passed a subcommittee in Congress to help deregulate the ownership of suppressors.
Far more robust than the Hearing Protection Act which was pieced together last year by the gun lobby, the SHARE Act wouldn't just deregulate suppressors…it would also allow anyone who purchased a suppressor post-Oct 22, 2015 to get a refund on their tax stamp.
Here's what Guns.com has to say about this exciting new development.
The Sportsmen Heritage and Recreational Enhancement or SHARE Act, blends popular initiatives to safeguard and expand hunting and fishing rights and practices across public land with one to drop suppressors from National Firearms Act regulation. South Carolina Republican U.S. Rep. Jeff Duncan, the sponsor of the bill, has been working with Democrats within the Congressional Sportsmen's Caucus to try and garner support from across the aisle.
Going beyond the Hearing Protection Act, which would remove silencers and suppressors from NFA requirements that include a $200 tax stamp, the SHARE Act would mandate the more than 1.3 million already registered be deleted from the Bureau of Alcohol, Tobacco, Firearms and Explosives' records within 365 days of the bill becoming law. Further, while states would not be required to allow their sale or possession, they would be barred from establishing their own potentially prohibitive taxes or registration requirements on legal devices.
If this measure passes in the Senate not only would it be a huge win for the second amendment activists and shooters…it would also serve as a huge boon to the gun industry.
Presently the $200 tax stamp and the 12+ month waiting period has pinched the suppressor market.
Manufacturers don't want to design suppressors knowing there's so much red tape standing in the way of consumers buying their products. However, if there were substantially fewer restrictions on them then you'd likely see the number of companies creating these accessories go up…while prices would fall.
Typically a suppressor would run a gun owner $800 – $1,200. If more companies began manufacturing then it's quite possible prices would fall 10-15% as the increase in competition would drive prices down.
Cross your fingers and see if Dems and RINOs in Congress would actually approve the SHARE Act in its entirety.


Issued by International Registration Plan (IRP) jurisdictions to owner-operators hunting for a lessee. This permit allows for operation at unladen weight only. The permit is valid for 30 days from the time and date on the permit. The fee is $15.
Payment may be made with a valid credit or debit card (Visa, MasterCard, Discover or American Express) or ACH (Automated Clearing House) payment from your checking or savings account. Your credit or debit card will be charged a convenience fee for this service. There is no convenience fee charged for ACH payment.


text:
Tigers Unveil Practice Court In Finch Center
Memphis, TN-It's not actually their redesigned homecourt at FedExForum, but it's close. The past two weeks (Aug. 12-23) while school was out of session, the Tigers practice floor at the Larry O. Finch Center went through a makeover.
The Finch Center practice floor is a near-exact replica of the Tigers' FedExForum court minus the Memphis skyline and bridge. The feature of the new floor is the massive center court design of the leaping Tiger M logo, which Sports Floors Inc., President Bruce Gleneck says is the biggest one his company has placed on a floor.
"This is easily the largest center court logo we have ever painted on a floor," said Gleneck. "We love the look. We are a hometown company, and nothing is better than doing work for our hometown team."
Sports Floors Inc., located in Memphis, did what is usually a 3-to-4 week job in 12 days. The project started with sanding the floor down to the bare wood and sealing it. Next, the 3-point areas were stained and the game lines, graphics and letters were painted. The final step was to apply the finish to the floor.
Sports Floors was able to quickly turn around the project by working around the clock, including nights and weekends, with the University of Memphis Athletics Department in making the Finch Center available. Some nights, work on the floor began at 9 p.m. (CT) so that the project would not interfere with the Finch Center's schedule. The end result was well worth the extra work.
"Staining is one of the hardest things to do on maple gym floors, and we were able to use two different tones on this floor," said Gleneck. "This was the University's idea, and it turned out beautiful."
The Tigers begin individual workouts soon on their new Finch Center floor. The official start of practice is Oct. 3, but Memphis Madness is scheduled for Oct. 18.
Written by: Bruce Gleneck

redpajama_set_name: RedPajamaCommonCrawl


At least 20 policemen were killed in Taliban ambushes in southern Afghanistan, officials said, as security forces sought to dislodge fighters in multiple districts.
A doctor at the provincial hospital in Gardez, who spoke on condition of anonymity as he was not authorized to brief media, said that three killed and at least 30 wounded were brought to the hospital by ambulances.
"Hundreds of Taliban rebels launched coordinated offensives in Shah Joi and Deh Chopan districts in the wee hours of today triggering gun battle and so far several attacking militants and 20 police have been killed", Afghanmal told Xinhua.
Separately on Sunday, Taliban claimed responsibility for a deadly attack on Saturday on a bank in Paktia province, which left at least six people dead, including three attackers.
A foreign woman was shot dead by unknown gunmen in Kabul city late on Saturday night, it has been reported.
Before that, more than 40 people were killed during a Taliban attack on an NKB bank in 2011. Responsibility for the attack while anybody on itself did not take. He said Kabul police have begun an investigation.
A second woman, a Finnish national, is missing, possibly kidnapped, officials said early Sunday. There was no immediate comment from the German foreign ministry.
The guest house was run by a Swedish NGO Operation Mercy, whose director Scott Breslin told local news agency TT that the organisation is holding a crisis meeting.
But remember that Ares is an extremely powerful immortal, so the Lasso will not solve all of Wonder Woman's problems. Fans might remember Bruce Wayne researched Wonder Woman's past in Batman v Superman: Dawn of Justice.
It also upheld India's right to consular access, a request Pakistan has denied as many as 16 times. The International Court of Justice at The Hague has ruled in favour of India.
Pence has generously expended his political capital in the Washington establishment to defend his boss. Former White House Deputy Chief of Staff Katie Walsh joined the organization last month.
Manchester City , Liverpool and Arsenal all are chasing success on the final day of the 2016-17 Premier League season. They are fifth in the Premier League , one point behind Liverpool and three behind third-placed Manchester City.
Yepez, 19, signed with the Braves organization as a non-drafted free agent in July 2014, out of Caracas, Venezuela. Freeman was leading the majors in slugging percentage when he was hurt, hitting.341 with 14 home runs.
A number of schools in the Montreal area are closed today due to the flooding, including some with the Lester B. But Coiteux couldn't say when residents who have been forced from their homes will be able to return.
Lewis Hamilton: "This is why I race"
Hamilton got passed on the straight and then Vettel, to maintain his lead, pushed hard, really hard in the two following corners. Bottas was later forced to stop his Mercedes when it started spouting smoke midway through the race.
The package includes tanks, combat ships, missile defense systems, radar and communications and cybersecurity technology. Speaking about the possibility of an accord during the visit, Trump said, "We will get this done".
OPEC members agreed late past year to cut collective production at the start of 2017 by 1.2 million barrels a day for six months. On May 25, leaders from OPEC and other producing countries will meet in Vienna to decide on output policy.
Piazza tried to get up around 3:20 a.m. but fell backward and hit his head on the wood floor, the report said. Kenyon texted Davis that "No one likes him", according to Parks Miller, who asked that behavior end now.
When we went back to the locker room, our training staff and doctors got with him. Thomas did not travel with the team to Cleveland for Game Three on Sunday.


Del B ft. Dice Ailes – 080 Music Mp3.
Del B ft. Dice Ailes – 080 : Nigerian Producer, Del B releases a brand new track titled '080' featuring Chocolate City singer, Dice Ailes. '080' is a soulful R&B gem with the introduction of the mobile phone code in Nigeria. The release will gear up his upcoming mixtape.
Download the mp3 to "080 " by Del B ft. Dice Ailes Below, Don't forget to share.


Don't forget to sign up for our newsletter to make sure you hear about our discounted shopping days first!!
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text:
Trending: Advertising Automotive Business Electrician Industry Insurance
In The News: How Small Businesses are Handling the Coronavirus Pandemic
Published: Mar 27, 2020 by Small Business Editor In Small Business News 0
The way small businesses or companies of any size operate has been upended by the coronavirus. So, addressing how to handle the coronavirus crisis and keep your company productive during this time has become paramount.
And this week's roundup has an article appropriately titled, "How to Handle the Coronavirus Crisis and Keep Your Team and Yourself Productive." It looks at how you and your team can work remotely and the tools you can use to make it happen.
Similarly, another article looks at the anxiety business owners and employees are experiencing brought on by the outbreak. This is a timely read for everyone as it lines out ways you can reduce your anxiety level with tips from experts in the field.
Last but not least is the government response to the coronavirus. From the Families First Coronavirus Response Act to the IRS extending payment and filing deadlines, the roundup has all the information you need.
Take a look at the rest of the roundup below as well as our Coronavirus Business Center page.
How To Handle The Coronavirus Crisis and Keep Your Team and Yourself Productive
With COVID-19 (coronavirus) making its way around the world, hardly any economic sector has been left unaffected. As the wave is sweeping over the United States, a lot of businesses and organizations are taking measures to prepare themselves for possible quarantines and shut-downs.
The Small Business Mindset You Need Right Now
If you're a small business owner, there's really only one question on your mind; how do I stay in business through this COVID-19 crisis? We've never seen anything like this before. But then again, we have had disruptions that have shuttered businesses before.
Coronavirus Response Act Requires Businesses to Pay Sick Leave for Covid-19
The Families First Coronavirus Response Act affects all employers with 1-500 employees. And it also includes protections for those who are self-employed. President Donald Trump signed the Act March 18. And it will become law in 15 days. The act spells out the requirements. Employers pay sick leave for those affected by COVID-19.
Small Business Coronavirus Update
Small Alcohol Distillers Step Up to Meet Hand Sanitizer Demand
With hand sanitizers going out of stock in stores and distribution centers, it is leaving many without during the coronavirus outbreak. Alcohol distillers are trying to fill the gap. This is in part due to the Tax and Trade Bureau giving the green light for alcohol beverage producers a special exemption to make hand sanitizer.
Instacart Adding 300,000 Freelance Drivers to Meet Coronavirus Shopping Demand
To meet increasing customer demand for online grocery deliver and pickup during the COVD-19 pandemic, Instacart has announced plans to bring on an additional 300,000 full-time service shoppers across the United States during the next three months. Instacart's grocery delivery platform allows users to shop from leading grocery stores, such as Costco and Safeway.
Hello Alice Launches Business for All and COVID-19 Business Resource Center
In March 2020, Hello Alice, launched its Business for All movement. The site provides step-by-step guides. You also find expert resources and collaborative communities of fellow entrepreneurs. And all on its small business accelerator platform.
Could Holographic Conferences Replace Live Ones?
Have you seen the hologram of President Reagan, maybe Tupac's concert? Well, the technology has gotten much better and it is now being used to hold conferences and meetings by businesses. Considering the events of the past couple of weeks, this is a technology everyone will want in their homes as soon as it becomes affordable. And eventually, it will be.
IRS Extends Tax Filing Deadline for Individuals and Businesses
US Treasury Sec. Steven Mnuchin officially extended the IRS tax filing deadline to July 15, 2020, to help individuals and businesses adversely affected by the coronavirus pandemic. This updates a previous announcement earlier this week extending the tax payment deadline only to mid-July. Mnuchin made the announcement during a daily coronavirus briefing from The White House on Friday.
What is an Essential Business?
You've likely heard the terms "essential business" and "non-essential business" mentioned on the news quite a bit lately. But these are technically not new concepts.
How to Create an Unforgettable Unboxing Experience for Your Customers
Search for "Unboxing" on YouTube and you will get around 90 million results. Unboxing is a thing, and this, in turn, has made packaging your second product. So, consumers now see a memorable unboxing experience as valuable.
These Old School Marketing Techniques Are Making a Comeback
Old-school marketing tools like store signage and direct mail are enjoying a new popularity. In fact, eighty three percent of marketers surveyed say using tools like direct mail bumps up ROI. Small Business Trends contacted John Patinella, CEO of Money Mailer, and Kristin Gallucci, Director of Marketing of Signarama, to find out why these are popular again.
42% of B2B Marketers Say They Need Better Personalized Marketing
Are your B2B marketing strategies not yielding expected returns? If yes, then chances are you will need to personalize your marketing strategies. According to the latest survey from Folloze, 42% of B2B marketers said that their marketing efforts are not fully personalized.
How to Start Selling Gift Certificates
Gift certificates are being touted as a popular way for small businesses to continue earning revenue during the closures and social distancing procedures enacted due to the coronavirus pandemic. However, selling gift certificates can help a variety of businesses increase sales no matter the situation or time of year.
Small Business Operations
How to Work from Home
Many small businesses are now allowing employees to work remotely because of the coronavirus pandemic. Even aside from this recent reality, working from home has been steadily gaining popularity among business owners and employees for years. It's not all bad, though. About 91 percent of workers actually think they're more productive when working remotely.
How to Deal With Anxiety at Work
The American Psychological Association (APA) defines anxiety as "an emotion characterized by feelings of tension, nervousness, or unease, typically about an imminent event or something with an uncertain outcome. We live in more uncertain times and that heightens anxiety in our lives, but especially in our work life.
5 Business Improvisation Tips for Your Company
When you encounter an uncertain time like this, you could improvise and take this time to do things you were putting off. Business Improvisation Tips Here are 5 business improvisation tips to consider trying. Modify Business Objectives Evaluate if you can repurpose your business and retool to do something that could use the skills and tools that you have.
How Women and Minority Entrepreneurs Can Get the Best Resources
All entrepreneurs face difficulties in getting funding, customers, advice and other resources. But for women and minority entrepreneurs, it has always more been difficult than for the typical small business owners. On the Small Business Radio Show this week, Elizabeth Gore, the co-founder and president of Alice helps businesses launch and grow.
How to Use Voice Assistants For Your Business
With the advent of technology, more business processes are getting automated, easily streamlined and getting efficient. Key to these rapid changes is artificial intelligence or machine learning where bots in programs now allows us to delegate manually redundant tasks to machines. Not only these but machines can now process complicated data and make intuitive projections and forecasts.
What is the Best Platform to Sell Products Online?
Retailing over the internet or e-commerce has forever changed the nature of retailing. The advent of digital technology has enabled small businesses to run their company more efficiently and profitably. By keeping their fingers on the pulse of technological innovations, small businesses can increase their productivity as well as their market share.
For the latest, follow us on Google News.
Image: Depositphotos.com
More in: Coronavirus Biz Advice Comment ▼
Why Analytics Are the Hot Topic at This Small Business Conference
How Can Your Alma Mater Help Your Small Business?
5 Tips for Building a Great Website for Your Business
Texas Rescue Organization Streamlines Processes with Zoho Creator
Should Your Small Business Just Ignore These 7 Technologies?


On October 29 TUSUR Vice Rector for Innovative Development and International Affairs Alexander Uvarov participated in the fourth session of the Innovation Working Group of the U.S.—Russia Bilateral Presidential Commission and told its members about the long experience TUSUR has in cooperation with the countries of North America.
Members of the Commission were particularly interested in learning about the innovative training methods employed by TUSUR, namely, the technology of web-based project learning and project-oriented online courses developed together with ESC SUNY based on the Coursera platform.
TUSUR has been running a joint curriculum with SUNY since 2006, making it possible for its students to receive American education online. This experience was recognized as the best practice and recommended for adoption to other top universities in the country.
Another focus of his speech which was received as enthusiastically was the experience in creating bridges for knowledge and technology transfer between TUSUR and the countries of North America. The many companies founded by TUSUR alumni in the US and Canada served to illustrate the demand for Russian technologies abroad and are a good example of mutually beneficial cooperation between the university and its alumni.
In conclusion of his speech Alexander Uvarov invited the American universities and industrial companies present to join the 2018 CyberSoccer Championship and suggested that the next session of the Working Group should be held in Tomsk in September 2014, simultaneously with the XII Triple Helix International Conference.


When you plan your bathroom remember about all family members. Kids spend a lot of time in bathrooms.
Design you select reflects your personality and your lifestyle.
Celebrate the life every day and feel happy. It is not about bathroom but how they can change your life!
Design you select reflects your lifestyle.
The decision to renovate your bathroom is a big one and the question of who to trust with this special project, shouldn't be taken lightly.
Major renovations We can look after the demolition of your old bathroom if required and all the preparation work including any brickwork and pest spraying. Cost, budget, design and benefits of your new bathroom are just some of the considerations you face with your new design or bathroom renovation, so Chris team offers a consultation service to guide you through the process with minimal fuss. Our experience, professionalism and tailor-made design service will make the project happen on time, on budget and to a standard that exceeds your expectations.
Part of the design consultation process is to plan and understand exactly what is needed in your bathroom and then work with your budget to ascertain what is available to you. Chris will help you select quality items at the best prices through trade store alliances and partners with whom he works closely.
We can manage all aspects of your bathroom renovation on your behalf and we take the time to identify your needs.
We aim to put a smile on your face and to make you proud of your new bathroom. Give us a try. We are here for you.
We're passionate about our business and love helping our clients design and build their ideal bathroom. Our knowledge and expertise in bathroom renovations can make your dream bathroom a reality.
You probably have heard many stories of nightmare renovations and costly over-runs with other renovators.
Below there are few steps you can follow before you meet us. It is not necessary as we will go through detailed plan with you. It might help you though to clarify your needs.
Inventory: Find out what is actually missing in your old bathroom. What would give you this extra comfort ? What would be the most important important element of bathroom renovation? Make a list of everything you need. Remember to cover all needs of household members.
Collecting ideas: There are plenty of resources for bathroom ideas: from magazines, exhibitions or browse the net. Clear your idea is the easiest will be to achieve the perfection you seek.
Floor plan: Draw own floor plan and explore possibilities so you are comfortable with. Tubs & Tiles will help though to design your plan and make sure all will be cost effective.
Plan your budget: Good ideas sometimes cost less than you think, but if you don't have any budget to play with, it can be difficult to plan. Here is a tip: Make two budgets – first one for the full list of features you dream of, and second one for absolute necessity.
Our extensive experience, skills and industry knowledge, are guaranteed to save you time and money, whilst giving you the peace of mind that costly mistakes are avoided and the project will bring the best results for you.


Have you always wondered what it's like to suffer from decompression sickness? No problemo! Today is your lucky day! You can dive freely into the deepest, darkest pits and maybe unearth some treasures! So, don't be septic: who knows what big fish you might find?!
The quantity of Blue Ray, Sickle-Hammerhead Shark, Cod, and Swordfish harvested by fishermen is increased by 150%.
The quantity of giant sea fish harvested by fishermen is increased by 150%.
Kabrok, alias the Black Crow, is an Osamodas from the Wakfu Era. At first sight, his ideas can seem darker than the depths of the Asse Sea, however, this merchant-come-bandit simply dreams of adventure... and of restocking his shop for his dear Miranda!


Allison C. Fay is a licensed CPA located in Hoboken, NJ 07030. Allison C. Fay has been issued a New Jersey license number 20CC03374700. All CPAs, including Allison C. Fay, have at the minimum an undergraduate degree in accounting, passed a rigorous national exam and adhere to mandated continuing education requirements of their states in which they are licensed. CPAs can work in private industry, education or government but most people think of CPAs during tax season as the experts in tax preparation. Their overall training in business and knowledge in principles of general law and taxation provide CPAs with the skills to help individuals with both personal and business financial decisions.
Looking for the best accountants located in Hoboken, NJ? Allison C. Fay is a CPA located in Hoboken, NJ. Allison C. Fay, CPA and other public accountants located in Hoboken, NJ will help you with tax preparation, tax planning, bookkeeping, accounting services, estate and trust taxes, and much more.
Are you Allison C. Fay, a CPA from Hoboken, NJ? Upgrade your basic listing to a featured listing with client reviews and ratings.


Honda Clarity 2020 Specs, Range, Release Date – In case you have water in the power supply, the Being familiar with usually manages throughout in silence being a feasible EV. All of the advantages you have to find out about EVs implements on this page: tons of torque, swift velocity, a relaxing traveling practical experience, and best-doing strength. This may be the very best motor vehicle to function to carry out in just about every time while the sports vehicle is positioned in the storage space holding out all around for that Saturday and Sunday crack. I swear I was able to honestly sensation my heartbeat minimizing as the Honda Clarity 2020 wafted utilizing website traffic. My levels of stress decreased. Additionally, it could really feel the possible lack of electrical generator shake tranquilizing me in a better state of mind.
2020 Honda Clearness especially made 18? Crossbreed Sleek, lightweight aluminum alloy rims introducing a streamlined design and design to help to optimize braking process and performance chilling straight down. The Clarity's little, large, sleek body helps you to improve fuel efficiency, although unusual design aspects bring further design. It is so exceptional with Guided front lights the 2020 Honda Clarity was made to provide you clear view while on a trip, and Directed taillights about the back again stop considerably boost your visual appearance and visibility from the Clarity.
The Honda Clarity 2020 a vast interior with safe seating for all 5 the elderly. The application of high-quality interior resources using the maintainable getting in your head signifies green job does not reach the price of outstanding sincerely sense. Improve a little bit of high-end for your clearness with readily available natural leather minimize seats leather-based and terrain packed manages. The 60/40 separated collapse down back again stop seatback, and under the work surface, dynamic battery positioning far more improves the full freight possible.
By just phone dialing any Honda Clarity 2020 a competitor for the Toyota Prius Exceptional, enthusiasts will expect to frustration, but allow me to determine primarily if i could repair their particular focus by just centering around the truth this Clearness offers a various method to the strength total overall economy request. From the hood is located a 1.5-liter several-tube coming up with 103 hp plus 99 lb-ft. Regarding torque. Engaging in a number of the excellent elevating is really a long term magnet synchronous motor unit model mated in a 17-kWh lithium-ion power supply making 181 HP along with 232 lb-feet of torque. General production could be a wholesome and healthy 212 HP (for brings about we will not get into on this site, the complete manufacturing is not really a somewhat effortless amount of the gasoline-driven engine and electric motor model outputs).
Expenses a Honda Clarity 2020 is relatively simple because it only can be purchased in two trims volumes. The building blocks design commences at $33,400 and comes typically having an 8-10-ins touch screen with Android operating system Apple firm, and Intelligent CarPlay, intelligent Brought front side lighting, Honda Lanewatch, a multiple-viewpoint rearview digicam, the sensible entry with launch-hit option began, Wifi Wireless Bluetooth and warmed up sitting.


text:
uv-emitter
=========

Event emitter in C with an API modeled after Node's EventEmitter using libuv

## install

```sh
$ clib install jwerle/uv-emitter
```

## usage

Using an the `getch()` function which [getch.h](https://github.com/jwerle/getch.h) implements you can get the keys pressed in stdin
```c
#include <assert.h>
#include <emitter.h>
#include "getch.h"

static uv_loop_t *loop = NULL;
static emitter_t *emitter = NULL;

static void
get_key (async_work_data_t *work);

static void
on_keypress (void *ch);

int
main (void) {
  loop = uv_default_loop();
  assert(loop);

  emitter = emitter_new(loop);
  assert(emitter);

  assert(0 == emitter_on(emitter, "keypress", on_keypress));

  async(env, loop) {
    assert(env);
    assert(loop);
    wait(env, 500, get_key);
  }

  uv_run(loop, UV_RUN_DEFAULT);
  return 0;
}

static void
get_key (async_work_data_t *work) {
  int ch = 0;
  while (EOF != (ch = getch())) {
    emitter_emit(emitter, "keypress", (void *) ch);
  }
}

static void
on_keypress (void *ch) {
  printf("key = %c (%d)\n", (int) ch, (int) ch);
}
```

## api

### emitter_new(loop)

Allocates a new `emitter_t *` pointer with a `uv_loop_t *` pointer bound
to it.

#### example

```c
emitter_t *emitter = emitter_new(uv_default_loop());
```

## types

### emitter_event_cb

A function pointer that is a callback bound to an event.

```c
typedef void (emitter_event_cb)(void *data);
```

### emitter_event_t

A structure that represents an event and its associated callbacks.

```c
async_env_t         *env;     // async environment that the emitter is executed in
struct emitter      *emitter; // emitter struct that the event belongs to
char                *name;    // the name of the event
void                *data;    // data, if any, to pass to the associated callbacks
int                 cb_count; // the amount of callbacks associated with the event
emitter_event_cb_t  *cbs[EMITTER_EVENT_MAX_CALLBACKS; // callbacks associated with this event
```

###

## license

MIT

redpajama_set_name: RedPajamaGithub


Happy Monday, Darlings! Yes, another weekend has come and gone ... but more importantly - another season has come and gone too! Now I don't know about you but, personally, I love spring. Why? Well because it's the season for dresses, sandals and, of course, bright and beautiful nails!
Yellow is the colour of happiness (well it's my colour of happiness!) ... that's why I adore this shade from essence's 'The Pastels' range. It's bright and beautiful, and it goes on really well – I like to add two coats for good measure. Finish off with a top coat and you've got nails that are sure to stand out!
2. Mojito Madness From HEAN Pl.
This muted green shade is subtle yet sweet and is a great reflection of the spring season (and perhaps summer too – don't you just love the name?!). One coat may look a bit too thin though so I would suggest applying two coats to get that real pop of colour.
4. Ordinary Misfit From HEAN Pl.
Yes, I've already featured one HEAN shade on this list but both colours are so stunning and I just couldn't choose between the two! This shade by HEAN is a pastel, pretty pink (personally, I believe every girl should own a shade like this). It's simple but it adds a sweet and feminine touch to your nails.
This shade from Morgan Taylor is a brighter pink than the one from HEAN – think feminine but with a slight neon glow. (Again, I just love the name!) It also gives off a shiny finish … though it doesn't hurt to add a top coat to protect against chipping. This is definitely one of those 'notice me' shades.


Flavor: Lightly spiced, semi-sweet. Vanilla and malt.
Tasting Notes: Pours is a fine, cloudy gold with a modest but persistent head. Masterfully brewed and semi-sweet, with a medium-light body and bright flavor.
Profile: Presented by the producer of "Oze no Yukidoke" sake.
Their motto for their beer is to use only malt, hops, water and yeast. They add little twists to traditional beer styles in order to make beers reflective of nature, and suitible for Japanese Cuisine.


text:
Faces in the Fire: And Other Fancies
By Frank W. Boreham
Biography & Autobiography | Literary Collections | Literary Collections : Essays | Philosophy | Religion : Sermons - General
The Floating Press
Though Baptist preacher Frank W. Boreham was born and educated in England and first rose to prominence as a religious thinker there, he spent many of his later years working as a missionary in New Zealand, Tasmania, and Australia. The essays in the collection Faces in the Fire are largely autobiographical in nature, drawing on lessons Boreham learned during his travels.
Faces in the Fire: And Other Fancies ePub (Adobe DRM) can be read on any device that can open ePub (Adobe DRM) files.
Other books by Frank W. Boreham
Mushrooms on the Moor
Frank W. Boreham
The Floating Press, August 2013
A Handful of Stars: Texts That Have Moved Great Minds
The Comforts of Home
Ralph Bergengren
Criticism and Fiction: From "Literature and Life"
Stealing History
Gerald Stern


Can I get coverage for only 3 to 4 months for the riding season?
How fast can I get a policy/ID card?
What is the minimum down payment I can make to start a policy?
Do you offer a discount for completing the motorcycle safety course?
Can I be insured if I don't currently have a motorcycle license and/or permit?
Do you offer guest passenger coverage?
Can I let my friends ride my motorcycle?
If I cancel my policy early, will I get a refund?
Where do I report a claim?
Does my policy cover me if I rent a motorcycle in another state?
Do you have questions regarding obtaining insurance for your motorcycle in the Commonwealth of Pennsylvania? Call us at (800) 825-2925 and we'll be glad to help. You can also ask your questions on Facebook for a quick response!


text:
https://sputniknews.com/20200728/ag-barr-to-roll-out-speech-on-anti-racism-protests-russiagate-during-house-hearing-on-tuesday-1079998474.html
AG Barr to Roll Out Speech on Anti-Racism Protests, 'Russiagate' During House Hearing on Tuesday
Barr's written remarks largely cover the issues of the Black Lives Matter movement sparked by the death of George Floyd in May that triggered a nationwide wave... 28.07.2020, Sputnik International
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© AP Photo / Andrew HarnikAttorney General William Barr arrives to testify during a Senate Judiciary Committee hearing on Capitol Hill in Washington, Wednesday, May 1, 2019, on the Mueller Report.
© AP Photo / Andrew Harnik
Barr's written remarks largely cover the issues of the Black Lives Matter movement sparked by the death of George Floyd in May that triggered a nationwide wave of protests against police brutality and racism. The demonstrations have not always remained peaceful, with riots erupting and federal agents deployed to cities to quell them.
US Attorney General William Barr is expected to attend his first House Judiciary Committee hearing on Tuesday, with his opening statement published on Monday suggesting he will elaborate on the anti-racism movement that has rocked the United States, especially in light of the chaos taking place in Portland, and oppose congressional Democrats by accusing them of trying to discredit him because of his investigation into the origin of the Russia probe.
According to the published text, Barr will briefly touch upon the so-called "Russiagate" issue, in which he is expected to call it "bogus" and lash out at the Democrats for "attempting to discredit me by conjuring up a narrative that I am simply the president's factotum who disposes of criminal cases according to his instructions".
Barr is purportedly set to deny any alleged interference in his decisions by Trump, and to move on to the racial inequality issue.
"Although the death of George Floyd – an unarmed Black man – at the hands of the police was a shocking event, the fact is that such events are fortunately quite rare. According to statistics compiled by The Washington Post, the number of unarmed Black men killed by police so far this year is eight. The number of unarmed White men killed by police over the same time period is 11. Some unarmed suspects, moreover, were physically attacking officers or threatening others at the time they were shot", Barr is expected to say.
He is also set to mention the country's development towards a more inclusive law enforcement system. Then, his remarks move on to say that African Americans engage in violence toward one another as well, mentioning black-on-black crime.
"The threat to Black lives posed by crime on the streets is massively greater than any threat posed by police misconduct", Barr's remarks read. "The leading cause of death for young Black males is homicide. Every year approximately 7,500 Black Americans are victims of homicide, and the vast majority of them – around 90 percent – are killed by other Blacks, mainly by gunfire. Each of those lives matter".
According to his remarks, the number of black people killed by the police so far this year is 8, while 11 whites were killed during the same time period.
Barr is expected to cite the example being seen in Portland, of "hijacking legitimate protests" over the death of George Floyd while in police custody.
"What unfolds nightly around the courthouse cannot reasonably be called a protest, it is, by any objective measure, an assault on the government of the United States", Barr is expected say in reference to the courthouse recently attacked by Portland protesters, to which Donald Trump responded by deploying federal agents to the city, despite objections from the local authorities.
The attorney general is to claim that the rioters "arrive equipped for a fight, armed with powerful slingshots, tasers, sledgehammers, saws, knives, rifles, and explosive devices", while "inside the courthouse are a relatively small number of federal law enforcement personnel charged with a defensive mission: to protect the courthouse, home to Article III federal judges, from being overrun and destroyed".
His remarks then move on to note that we must "agree that there is no place in this country for armed mobs that seek to establish autonomous zones beyond government", or to tear down statues and destroy the property of "innocent business owners".
His written speech comes amid violent protests unfolding in Portland, where riots are being quelled by federal agents, who are daily reported to suffer from injuries. Over the past weekend, at least 14 federal agents were injured.


Having to suffer through their second consecutive Tribal Council, the Ulong tribe banded together to vote out a member who appeared to have lost her will. Tired and depleted, Ashlee Ashby, the 22-year-old student from Easley, South Carolina, refused to eat or join her tribe in celebrating the welcome addition of fire to camp. Ashlee's quiet detachment worried her Ulong tribemates into casting the six votes that eliminated her from SURVIVOR: PALAU. After watching her torch snuffed out, Ashlee simply admitted, "I think they all sensed that I was ready to go home."
RATS! Upon arriving at their new camp, the Koror tribe was far from happy. Due to an outrigger capsize that lost them their Reward, the members of the tribe were not excited about building a shelter. To make matters worse, the castaways found their camp infested with rats. "I know it's mind over matter, and I know if you don't mind it, it doesn't matter, but I mind, and it matters!" whined Janu Tornell, the 39-year-old Vegas showgirl from Las Vegas, Nevada.
To add to Koror's discomfort, the skies above the camp opened up and sent down a torrent of cold rain. The shelter was not completed as the rain fell on the shivering members of Koror. "The rain was worse than the rats, because you could feel every rain droplet, and it was freezing. That moment, so far, has actually been the worst since we've been on the island," complained Coby Archa, the 32-year-old hairstylist from Athens, Texas.
Waking up the morning after their first Tribal Council, the Ulong tribe set to work. They decided that all decisions would be made by a committee with no elected leader. Having received three votes at Tribal Council, Angie Jakusz, the 24-year-old bartender from New Orleans, Louisiana, felt at risk and stayed in the background by listening more than she spoke. Angie explained, "I don't want to be too pushy or forthcoming. I wanna just make myself a valuable asset to this tribe. If I don't, I'll probably be on the chopping block again."
As the tribes met for the Reward Challenge, host Jeff Probst explained that this Challenge would involve balance. The players were to run through a "gauntlet" bridge, requiring them to cross several floating obstacles over water in order to collect flags on the other side. As they were crossing, two opposing tribemembers would be hurling swinging bags of sand at them all the while. If knocked off, the player would be forced to go back to the beginning. The first tribe to collect all 10 of their flags would win a Reward consisting of fins, mask and a Hawaiian fishing sling.
The competition got off to a furious start as Coby and James Miller, the 33-year-old steelworker from Mobile, Alabama, negotiated the course despite the opposing tribe's attempt to sandbag them off. Both tribes found it difficult to complete the course without falling into the water. However, Ulong jumped out to a sizeable lead as Katie Gallagher, the 29-year-old advertising executive from Merced, California, had great difficulty finishing the rope swing.
Mastering the course with ease, Angie collected flag after flag for her Ulong tribe in what was turning out to be a rout. After receiving some tutelage from Willard Smith, the 57-year-old lawyer from Bellevue, Washington, Katie finally made it across the rope swing. But it was too little, too late, as Ulong eventually placed the tenth and final flag into place in order to secure the much coveted Reward.
Invigorated from their Challenge victory, the Ulong tribe wasted no time using their Reward. As some members built a fire, others took to the outrigger to catch fish. Hailed as a hero from the Challenge, Angie gladly accepted the congratulations from her tribemates, knowing that she may finally be off the chopping block. "She went into her Challenge and dominated--I mean, completely dominated--and it totally changed the whole morale of our whole tribe," marveled Bobby Jon Drinkard, the 27-year-old waiter from Troy, Alabama.
After returning to camp from their crushing defeat, the members of Koror decided they would search for the Reward they had previously lost to the sea. As they paddled out into the rough waters, hope began to dissipate into prayer.
After battling the angry currents, Ian Rosenberger, the 23-year-old dolphin trainer from Key Largo, Florida, miraculously emerged with the crate of flint. As Ian put it, "As I got more and more tired, it became more and more difficult to get to the bottom. It became more and more difficult to tread water, and there were a couple times that I was underwater and I didn't know if I was going to make it."
Returning from their fishing expedition with a giant clam, the castaways of Ulong cooked up a clam soup that satisfied the hunger that had been gnawing for the last four days. Neither eating nor joining her tribe to relish in the Reward, Ashlee sadly kept to herself. It was evident to her tribemates that Ashlee was losing her will. "The way we're going to advance ourselves is be a strong team all the way through. And if we have someone slowing us down, I hope that that doesn't bring down our team," noted Jeff Wilson, the 21-year-old personal trainer from Ventura, California.
As the night grew dark and cold at both camps, some castaways of SURVIVOR: PALAU absorbed warmth from the body heat of others. At Ulong, Kimberly Mullen, the 25-year-old graduate student from Huber Heights, Ohio, cozied up to Jeff, while at Koror, Gregg Carey, the 28-year-old business consultant from Chicago, Illinois, snuggled close to Jennifer Lyon, the 32-year-old nanny from Encino, California, and both slept without a care in the world.
After learning Morse Code on the fly, the tribes assembled for the Immunity Challenge, and Jeff Probst explained that they would be tested on brains and brawn. Two heavy foot lockers, filled with mess kits, were resting on the ocean floor. Each tribe must swim out to a marker buoy, dive down, find a rope attached to the foot locker, then pull it 50 feet across the ocean floor. Once the foot locker reaches the start point, the tribes must unlatch the lockers, thus releasing the mess kits. Each tribe member would retrieve one mess kit, then swim back to the beach. Each mess kit had a Morse code letter inscribed on it. The first tribe to decipher the Morse code and spell out the mystery word would win the crucial Immunity Challenge.
Koror fell behind at the start due to Willard's slow swimming, but when it came down to pulling the foot locker across the ocean's sandy floor, Tom Westman, the 41-year-old firefighter from Sayville, New York, proved to be a warrior as he pulled with vigor. Ulong simply couldn't get their foot locker to move despite efforts from the whole tribe, save for Kimberly, who never even attempted the task. While Ulong continued to struggle with the foot locker, Koror opened theirs and raced to shore in order to solve the Morse Code puzzle.
With ease, the members of Koror spelled out the word "Immunity" in Morse Code as Ulong watched from the water. Koror won its second Immunity Challenge in a row, sending Ulong to yet another Tribal Council.
After returning to camp from their decisive defeat, Ulong had the unenviable task of deciding whom to vote off at Tribal Council. It was agreed that the weakest tribe member would be the one to go, but the exactly who was weakest became an issue. Some argued that Kimberly was weakest because she did not even try in the Challenge, while others noted that Ashlee had clearly lost her will and would be of no further use to the tribe. The tribe was split into even factions, thus presenting the very real possibly of a tie.
As Stephenie LaGrossa, the 25-year-old pharmaceutical sales rep from Philadelphia, Pennsylvania, put it, "It's a complete mess, because actually now it looks like four people are voting against Kim and four people are voting against Ashlee, so we're going to have a tie. I don't even know what happens in a tie."
In the end, Stephenie didn't have to find out what happens in a tie, as the Ulong tribe banded together to vote out Ashlee in a six-vote decision. Ashlee's emotional withdrawal concerned her tribemates enough to make her the second castaway voted out of SURVIVOR: PALAU.


text:
Nadežda Peedi-Hoffmann, auch Nadeshda Peedi-Hoffman (*  in Tomsk, Russisches Kaiserreich; † 21. Mai 1938), war eine estnische Schönheitskönigin und Filmschauspielerin.

Leben und Werk
Nadežda (auch Nadja) Peedi-Hoffmann wurde im sibirischen Tomsk geboren und wuchs dort auf. Ihre estnischen Eltern, die in Tomsk arbeiteten, trennten sich nach der Oktoberrevolution in Russland. Die Mutter siedelte mit der Tochter nach Estland um. Sie war die Schwester der Ehefrau des späteren estnischen Staatspräsidenten Konstantin Päts.

Die musisch und sängerisch interessierte Nadežda Peedi-Hoffmann schloss die Mittelschule in Tallinn ab und studierte 1932 im berühmten Studio der estnischen Tänzerin Gerd Neggo (1891–1974).

Am 19. Juni 1932 gewann die 21-jährige brünette Schönheit gegen 32 Konkurrentinnen den nationalen Schönheitswettbewerb Miss Eesti/Estonia. Der Wettbewerb wurde von der estnischen Zeitung Päevaleht mit großem Rummel veranstaltet.

Die Siegerin wurde am 21. Juni 1932 im Konzertsaal Estonia in Tallinn während eines großen Balls gekrönt. Da der Wettbewerb in Estland erst wieder 1988 ausgetragen wurde, war Peedi-Hoffmann über einen Zeitraum von 56 Jahren die am längsten amtierende Schönheitskönigin Estlands. Am 31. Juli 1932 nahm Peedi-Hoffmann als Vertreterin Estlands beim Schönheitswettbewerb International Pageant of Pulchritude im belgischen Spa teil.

Mit dem Sieg im Schönheitswettbewerb der Zeitung Päevaleht war die Hauptrolle in einem estnischen Spielfilmprojekt verbunden. Nadežda Peedi-Hoffmann spielte 1932 eine der Hauptrollen in dem finnisch-estnischen Liebesstreifen Päikese lapsed (zu deutsch "Sonnenkinder"), dem ersten wirklichen estnischen Tonfilm. Regie führte Theodor Luts, der eng mit Päevaleht zusammenarbeitete. Die Dreharbeiten starteten im August 1932. Am 3. November 1932 hatte der Film Premiere.

Nadežda Peedi-Hoffmann war die Muse des estnischen Schriftstellers August Alle (1890–1952).

Peedi-Hoffmann starb im Mai 1938. Sie liegt neben ihrer Mutter Adele Peedi (1876–1951) auf dem Friedhof Liiva in Tallinn begraben.

Weblinks

 Foto im Tallinner Stadtmuseum (estnisch)
 Ilmar Palli: Viimane Eesti miss enne suurt sõda (Maaleht, 10. März 2013, estnisch, abgerufen 7. Juni 2013)

Einzelnachweise

Filmschauspieler
Este
Miss Estland
Geboren 1911
Gestorben 1938
Frau

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text:
National Boards >
General Highway Talk >
Business Route That Misses It's Mark as a Business Route
Author Topic: Business Route That Misses It's Mark as a Business Route (Read 1749 times)
cabiness42
Location: Munster, IN
Re: Business Route That Misses It's Mark as a Business Route
Quote from: kphoger on December 04, 2020, 01:23:05 PM
Quote from: cabiness42 on December 04, 2020, 01:12:09 PM
Quote from: vdeane on December 04, 2020, 12:44:50 PM
My understanding is that interstate business routes were invented by the feds with the intent of preserving small town businesses that were being bypassed. Whether all states used them that way (or if one used to function that way but the businesses are now gone) is a different story. Personally, I'm not exactly a fan of them (or bannered routes, for that matter). If something really needs a number, give it a state route.
I don't know if that's why they were invented, but to me, that's the way that they should be used. A business route should be a brief route off the fastest route where you can find gas stations, restaurants and drug stores. A 10+ mile long business route doesn't make a lot of sense to me. It's impractical to follow through to the other end just to find a place to get gas and lunch.
See, you're looking at business routes from the perspective of a tourist, whereas I'm looking at them from the perspective of a truck driver.
Maybe truck drivers could have their own type of routes. Someone should invent a "Truck" designation for that purpose.
Isn't that designation for roads that truckers are supposed to take instead of the un-bannered route? In the case of business routes, they're free to take whichever they want, based on whether they're going into town or heading elsewhere in the state.
Terry Shea
Then why do most business routes have services like gas, food and lodging listed on signs approaching the exit instead of a list of trucking companies. Truckers generally know where they are going and where they meed to exit to get where they're going, but truckers need services like food and gas too.
Hot Rod Hootenanny
Diplomat of Solid Sound
Location: Middle of Nowhere, Ohio
Assuming states and cities can correctly apply that title to their designated roads.
National Champion: 2001, 2002, 2004 x 2, 2008 X 3, 2009, 2011, 2012, 2013, 2014 X 2, 2015 x 3, 2016, 2017, & 2019.
I was OSU-LSU, before OSU-LSU was cool.
Location: Central North Carolina
There is certainly a need to inform truckers of where there are suitable services that can reasonably accommodate 18-wheelers. Almost weekly, we see truckers exit at the two Hillsborough exits, give up and hop back on. Some is the signage, since northbound traffic at both exits prohibits through trucks. But a quick glance also shows that there is no place for truckers to park.
The Efland exit is a similar story. Many truckers stop in search of a parking space in front of Missy's Grill. There is one wide mud puddle along the fence that is long enough for one big rig to straddle the swail. I'm pretty sure that most truckers get out by backing up onto the westbound off-ramp, or by doing a short back-up and making a wide U-turn in the old Amoco lot (which is now a small taquiero that just opened a few months ago). Once again, most truckers look, give up and hop back on.
Because of my railroading career, I have occasionally needed to upgrade to Trucker Atlases. But I've never seen anything showing where truckers looking for a quick break could stop. Most just show weigh stations (and some show their brand of truck stops).
bing101
Quote from: Max Rockatansky on December 02, 2020, 12:47:21 PM
CA 51 is a worthless Business I-80 given it's a freeway.
How much of this is that CA-99 is rumored to be I-7 or I-9 and CA-51 is keeping the Business 80 designation until they have to renumber into CA-51 or CA-x07 / CA-x09.
Max Rockatansky
Location: Route 9, Sector 26
Quote from: bing101 on December 05, 2020, 12:14:45 PM
Problem there is that CA 51 isn't Interstate standard. That's why I-80 shifted to I-880 in the first place.
Gribblenation.org: https://www.gribblenation.org/
Gribblenation on Facebook: https://www.facebook.com/gribblenation/?ref=bookmarks
TheHighwayMan394
Location: Twin Ports/North Shore
BUS US 24 in Goodland?
People can't wait to leave the Midwest, then realize they never really wanted to leave.
True that's why i am thinking of CA-51 is supposed to be a 3 digit number for CA-x07 or CA-x09 as a state route connected to to the proposed interstate 7 or 9. It's kind of like CA-210 connecting to I-10 in the Inland Empire or the former CA-480 that was connected to I-80.
Considering US 50 between I-80 and CA 51/99 is already FHWA I-305 I would say just use that number for field signage. The number is available and wouldn't require a bunch of highways be renumbered to implement it in field. I would say drop the I-80 Business facade and just sign CA 51 at that point.
Quote from: Terry Shea on December 04, 2020, 09:55:39 PM
Because states sign such services at all exits—whether the intersecting route is a business route, a trunk highway, or a local road. And because states don't sign factories and transportation dispatch centers at any exit—whether the intersecting route is a business route, a trunk highway, or a local road.
Services signage has nothing to do with the function of a road.
No, but the function of the road has everything to do with the service signage.
Disagree. They're only tangentially related.
Services are located at highway exits because of zoning, real estate prices, nearby competition, and traffic patterns and volumes—regardless of what supposed function the crossroad serves. Is the crossroad a business spur, a bypass, a trunk highway, a local street, a six-block-long stretch of urban renewal? The business owners don't particularly care, so long as the customer volume at that location exceeds the cost of operations sufficiently to turn a profit.
And, wherever those services end up being located—business spur or otherwise—highway signage for them is erected. Because travelers in need of services don't particularly care what supposed function the crossroad serves either, so long as they can find the services they need in the close vicinity of the exit.


text:
Q: Getting stuck on "Downloading Javascript bundle 100.00%" in expo app Whenever I click 'run in iOS simulator' after running expo start in terminal, I'm getting stuck at a screen with "Downloading Javascript bundle 100.00%" in the app.
I'm creating a React native application and I tried all solutions including:

*

*deleting Expo app

*restarting simulator

*erasing settings on simulator

*rechecking code for bugs

*Debug remote JS / stop remote debugging

See example of loading screen:
https://i.stack.imgur.com/RzEdZ.png

A: Delete your package-lock.json file, node_modules directory and then,
run npm cache clean -f.
Then run a new npm install as a regular user.
Finally, run an npm start again

A: try clearing the cache with expo start -c

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