text:
Five Save the Children employees working in the detention centre for families on Nauru were suspended during a crackdown on employees seen to be encouraging or engaging asylum seekers who protest peacefully.
Guardian Australia has been told by a number of sources on Nauru that the five employees, one teacher working with children, two recreation staff, and two case managers were suspended last week following requests from the immigration department.
One was suspended after security guards observed her giving a "thumbs up" to a group of women protesting in the family camp, and another two were suspended after they were seen watching the protests from a distance.
Nauru contractors told Guardian Australia that staff are being instructed not to engage with any asylum seekers taking part in the protests.
The suspension of the teacher has meant that teaching aides have been forced to teach classes to some of the 193 children detained on Nauru.
Guardian Australia understands that the allegations were sent by security company Wilson to Canberra where the department requested the suspensions. All allegations were eventually dropped this week, but some of those suspended have already left the island.
Peaceful protests on Nauru began last Tuesday. Guardian Australia has been told by eyewitness sources that three Somali women attempted self-harm and suicide last Friday as part of the protests, one woman attempted to swallow a razor blade, and another attempted to jump from a height.
The self-harm episodes occurred just a day before the group of 157 Tamils held at sea for almost a month were transferred to Nauru in a secret night time operation.
A spokesperson for the immigration minister, Scott Morrison, said: "A number of staff employed by Save the Children Australia at the Nauru offshore processing pentre were removed from frontline services to transferees, pending a review of an incident.
"The review has been completed and the staff have resumed normal duties."
On Saturday Guardian Australia revealed that only 50% of requests and complaints on Nauru were resolved by staff. According to information from a leaked database only 12% of requests for clothing were met by staff. Asylum seekers also regularly complained about vermin in their accommodation.
At the national inquiry into children in immigration detention last week former Save the Children worker Kirsty Diallo said asylum seeker children had begged her for books and clothing when she worked on Nauru.
She described one case of a woman so desperate for clothing that she stitched her child a dress from a mosquito net.
Guardian Australia has revealed a number of cases of verbal, physical and sexual assault by detention centre staff against children.


text: Objective To use the natural experiment of health insurance reform in Massachusetts to study the impact of increased insurance coverage on ICU utilization and mortality Design Population based cohort study Setting Massachusetts and 4 states (New York Washington Nebraska and North Carolina) that did not enact reform Participants All non-pregnant non-elderly adults Tedalinab (age 18-64) admitted to non-federal acute-care hospitals in one of the Tedalinab five states of interest were eligible excluding patients who were not residents of a respective state at the time of admission. insurance from 9.3% to 5.1%. There were no significant changes in adjusted ICU admission rates mortality or discharge destination. In a sensitivity analysis excluding a state that enacted Medicaid reform prior to the WEE1 study period our difference-in differences analysis demonstrated a significant increase in mortality of 0.38% per year (95% CI 0.12 – 0.64%) in Massachusetts attributable to a greater per-year decrease in mortality post-reform in comparison states (?0.37% 95 CI ?0.52 – ?0.21%) compared to Massachusetts (0.01% 95 CI ?0.20% – 0.11%). Conclusion Massachusetts healthcare reform increased the number of ICU patients with insurance but was not associated with significant changes in ICU use or discharge destination among ICU patients. Reform was also not associated with changed in-hospital mortality for ICU patients; however this association was dependent upon the comparison states chosen in the analysis. <0.05 was considered significant. This project used de-identified data and was exempted from human subjects review by the Institutional Review Boards for University of Pennsylvania and University of Michigan. Results Characteristics of the Tedalinab patients who were admitted to ICU There were 2.1 million hospitalizations in Massachusetts and 11.5 million in comparison states from January 1 2003 through November 30 2009 eligible for analysis. A total of 259 240 (14.2%) and 1 562 869 (13.6%) of hospital discharges included an ICU stay in Massachusetts and comparison states respectively. The proportion of uninsured ICU patients in Massachusetts in the post-reform period declined compared to pre-reform (9.1% vs. 5% p<0.001) but increased in control states (9.3% vs. 10.2%). ICU patients in MA appeared to have greater severity of illness as evidenced by the higher proportion of individuals who were mechanically ventilated. ICU patients in the pre-reform compared to post-reform period were otherwise similar in Tedalinab both Massachusetts and the comparison states with regard to general characteristic (Table 1) and primary diagnoses (Table S4). There were no significant differences in the growth of ICU beds between MA and comparison states over the study period (Table S6). Table 1 Characteristics of ICU discharges in Massachusetts and comparison states by insurance reform period Population level hospital and ICU admission rates In the adjusted population-based analyses the per capita hospital and ICU admission rates in Massachusetts remained similar across the reform period (Figures 1a and 1b). In our difference-in-differences analysis there was no significant difference in per capita ICU admission rates when comparing these changes in Massachusetts to those in comparison states (0.01 per year per 10 Tedalinab 0 95 CI ?0.19 to 0.21) (Table 2). Figure 1 ICU utilization in Massachusetts (MA) and control states pre- and post-insurance reform Table 2 Difference-in-differences estimates of the change in ICU utilization rates in Massachusetts (MA) and comparison states in the pre- versus post- insurance reform period ICU admission rates among hospitalized patients In the patient-level analysis we found a nonsignificant net annual increase in ICU admission among hospitalized patients in Massachusetts of 0.25% (95% CI ?0.17 to 0.67) in the post- versus pre-reform period (Figure 1c). In Tedalinab our difference-in-differences analysis there was no significant change in hospital-based ICU admission rates associated with Massachusetts health insurance reform (Table 2). Mortality and discharge destination for ICU patients Risk adjusted in-hospital mortality for ICU patients decreased similarly in both Massachusetts and comparison states across the insurance reform period (Figure 2). In the difference-in-differences analysis Massachusetts reform was not associated with a change in mortality among critically ill patients (annual change 0.22% 95 CI ?0.02 to 0.46% Table 3). For all discharge destinations among survivors there were no significant differences in the trends seen in Massachusetts (Figure S1) and no difference that could be attributable to insurance reform in our difference-in-differences analysis (Table 3). Figure 2.

subset: commoncrawl


text:
Synergy Teaser
Synergy Live is back and this year they're returning to their roots. Rave culture.
What was the inspiration behind our approach to creating this year's teaser video? We decided to dig deep and use their old transcoded VHS footage showcasing the "yesteryears" behind the brand and where its come from.


text:
The last Christmas book tag (at least on this blog)! I was sort of indirectly tagged by Kat at Life and Other Disasters – she tagged everyone – and this tag looks really interesting (and I didn't really have a post planned for today, so I was looking for a cool Christmas tag). So, let's get to it!
On the first day of Christmas, my true love sent to me: a partridge in a pear tree. The partridge stood alone in the pear tree. What is your favorite stand alone?
I feel like everything is a series now, but I love stand alones! One of my favorites is Neverwhere by Neil Gaiman.
On the second day of Christmas, my true love sent to me: two turtle doves. Love is in the air! Who is your one true pairing?
Definitely Elizabeth Bennet and Mr. Darcy from Pride and Prejudice. Always.
On the third day of Christmas, my true love sent to me: Three French Hens. In the spirit of threes, what is the best trilogy you have read?
My absolute favorite trilogy right now is Red Rising by Pierce Brown, but since the final book hasn't actually been published yet, I'll pick something else. Looking back on it, I haven't actually finished that many trilogies. But two I really enjoyed are the Gemma Doyle trilogy by Libba Bray and The Hunger Games by Suzanne Collins
On the fourth day of Christmas, my true love sent to me: four calling birds. Since series usually consist of four or more books, what is your favorite series?
My favorite series is… wait for it… Harry Potter. Was that even a question? I've read them all at least twelve times, and actually have multiple copies. So, yeah.
On the fifth day of Christmas, my true love sent to me: five golden rings. One ring to rule them all! Who is your Favorite Villain/Antagonist?
Don't hate me, but I've got to say Voldemort. Not because I actually like him, but he's such a well-crafted, complex character. I like villains I can understand, even when I really don't agree with them.
On the sixth day of Christmas, my true love sent to me: six geese a laying. Creation is a beautiful thing. What is your favourite world/world-building?
A recent read that has wonderful world-building is the Saga series by Brian K. Vaughn and Fiona Staples. So far, I've read three of the five published volumes, and I love them!
On the seventh day of Christmas, my true love sent to me: seven swans a swimming. Who needs seven swans when all it takes is one good animal sidekick? Who's your favourite animal sidekick?
Oooh… this is a difficult one! I'm going to have to say Hedwig from Harry Potter. (SPOILER AHEAD) I definitely sobbed when she died.
On the eighth day of Christmas, my true love sent to me: eight maids a milking. Milk is so 18th century. Which book or series takes beverages/food to a whole new level?
The Night Circus by Erin Morgenstern. The food is literally part of the atmosphere of the book. I actually have a candle that's supposed to smell like the caramel apples and popcorn at Le Cirque des Rêves.
On the ninth day of Christmas my true love sent to me: nine ladies dancing. Dancing is just one skill of a Lady! Who is your favourite kickass female lead?
Every character that came to mind immediately is not a main character. And most of them are from Harry Potter.
I guess I'm going to go with Katniss from The Hunger Games . Actually, wait! I just thought of a good one! Liesel from The Book Thief.
On the tenth day of Christmas my true love sent to me: ten lords a leaping. How about your favourite leading lad?
Either Darrow from the Red Rising trilogy or Wade from Ready Player One.
On the eleventh day of Christmas my true love sent to me: eleven pipes piping. What is your favourite book or bookish thing with musical influence? (It can be about music, reference music a lot etc.)
One I really enjoyed is Cloud Atlas by David Mitchell. I don't want to spoil anything, but I loved the subtle integration of music into this book – I didn't even realize it until the very end.
On the twelfth day of Christmas my true love sent to me: 12 drummers drumming. Drum roll please…what is your favourite read of this year?
I have so many favorites! The first two that come to mind are Golden Son by Pierce Brown and Ready Player One by Ernest Cline. This was a great year for sci-fi for me!
And that's the end of the Twelve Days of Christmas Book Tag! I hope you enjoyed this post. Since Christmas is tomorrow, I'm not going to tag anyone, but if you want to do this tag, go for it! I had so much fun with all of the Christmas book tags this year! Merry Christmas Eve everyone!
In the comments, I'd love to hear what books you're gifting others this holiday. I just wrapped up two: I'm giving my grandmother a book about the making of Downton Abbey, which she loves (and some Downton Abbey tea I found), and I got my cousin an ArtFolds copy of her favorite Jane Austen book, Sense and Sensibility.


text:
This is one of my favorite booths at Art Angels Arts & Antique Market, in Orlando. This place is huge with many vendors. I think back to just a year ago when I first visited the market. At that time, they just were setting up and the warehouse was pretty empty. They were just beginning to accept vendors. But now it is full of individual booths...each expressing a different style. I just love and look forward to my visits here. There is always something at Art Angels that catches my eye.
I think you will like this next item, a "Vintage Window Box".
How unique and creative. They are made from vintage windows and reclaimed walls from old houses. The wall paper is still attached.
What a creative way to display your favorite collectibles.
Let me know how you like their website...
it was created by me :)


text:
As I mentioned in my previous post we purchased a new crèche while we were living in Warsaw back in 2000 - a new crèche for the new millennium. There was a little shop, lodged in two small rooms in a cellar just off one of the main squares, filled with the work of Polish artisans - weaving, painting, pottery and wood carving. One day we saw a nativity set that took our breath away in its simplicity. In muted colours with figures, that though still showing the carver's knife, had a more natural look than the more traditional Polish figures around it. It was expensive - by the standards of the day - but we knew it was something we wanted to include in our Christmas traditions.
I found it an odd coincidence that in both our crèches the Mary figure is clothed in orange rather than the traditional white and blue. I can't find an iconographic justification or reason for this, so it may have just been one of those serendipitous choices by two artists twenty years and 8,000 kilometers apart. The figures are carved in various attitudes of awareness of this child in the manager. And following the European tradition the carver (we've lost the bill and of course didn't keep any notes so the only thing we know is his initials - CM) included tradespeople amongst the figures - an apple seller and an oil merchant. Unlike many of the Neapolitan figures they are not going about their business but have stopped to adore the new born infant and perhaps bringing offerings of their wares.
And there is a good chance that this is a miracle crèche: the figurines have been known to change position by themselves in the night. Or at least so it would seem if the "I don't know" response to questions like "Who moved the donkey?" are to be believed. Either that or there are two people in this house trying to stage manage the Nativity.
As a sidebar a bit of Vatican gossip: I have it from a close personal friend of the parties involved (as they say in the tabloids) that the outdoor Presepe in Piazza San Pietro may cause a bit of a stir when its unveiled on Christmas Eve. It's the handiwork of artisans in a small Alpine town near Trent and is nontraditional in several respects including the setting. We must get down to see it over the days after Christmas as there is no way we would even attempt to join the crowds on Christmas Eve.
19 decembre - Santa Fausta
Wednesday, December 19, 2007
The Traditions of Christmas - Crèches II
Labels: Crêches, Gossip, Poland, Presepe, The Vatican, Warsaw, Wood Carving
4 comments:
- evilganome said...
The carvings are lovely. They remind me of a Santo that one of my daughter's high school classmates brought for me from a trip to Mexico.
- 3:13 pm, December 19, 2007
Stage manage the Nativity scene? Is this a Broadway show? Who would do that I wonder.
- 11:27 pm, December 19, 2007
I have nothing to do with it. I did not touch them.
- 11:28 pm, December 19, 2007
- Willym said...
EG: Isn't that odd I had never seen the resemblance but you are right. Its odd how folk art has so many common denominators.
Reesie: First - when did you learn to type.
Second - how did you get up to the desk with those tiny legs
- 3:11 am, December 20, 2007
Subscribe to: Post Comments (Atom)


text:
Simple Inventory System
Sorry po sa inconvenience..
Nakalimutan po naming i check ang sa Database, iba pala yung na Export..
Fixed napo e2, download nlng po ninyo ulit..
Salamat ng Marami ^_^
A simple Inventory System..
Just try this one :)
hope u will like it :D
[note: Check the BaseDAO.php file located at app/PHP/CLASSES if there is something you want to change regarding on the connection to database]
[if your database dont have password,just set the $db_user = "root" (usually) and $db_pass = "" ]
cheers! :>
Database Name: IIS_DB (at -db- folder)
By: Marejean Granaderos Perpinosa IMBA (-best prog-)
Note: Due to the size or complexity of this submission, the author has submitted it as a .zip file to shorten your download time. After downloading it, you will need a program like Winzip to decompress it.
Virus note: All files are scanned once-a-day by SourceCodester.com for viruses, but new viruses come out every day, so no prevention program can catch 100% of them.
1. Re-scan downloaded files using your personal virus checker before using it.
2. NEVER, EVER run compiled files (.exe's, .ocx's, .dll's etc.)--only run source code.
Sat, 05/06/2017 - 04:56
when i login the showing problem please replay me
Warning: Unknown: It is not safe to rely on the system's timezone settings. You are *required* to use the date.timezone setting or the date_default_timezone_set() function. In case you used any of those methods and you are still getting this warning, you most likely misspelled the timezone identifier. We selected 'UTC' for '6.0/no DST' instead in Unknown on line 0 Fatal error: Uncaught exception 'PDOException' with message 'invalid data source name' in D:\www\inven3\PHP\CLASSES\Database_connection.php:11 Stack trace: #0 D:\www\inven3\PHP\CLASSES\Database_connection.php(11): PDO->__construct('localhostdbname...', 'root', '[email protected]') #1 D:\www\inven3\PHP\CLASSES\iis_functions_home.php(9): Database_connection->open_connection() #2 D:\www\inven3\PHP\OBJECTS\log_in_validation.php(13): Iis_functions_home->check_username(' granaderos', 'administrator') #3 {main} thrown
adiccb (not verified)
Sun, 04/02/2017 - 04:53
Administrator login
I had use the user granaderos and password marjiecasosa and I can't enter in the system
junnaztic (not verified)
Tue, 03/14/2017 - 15:18
no BASEdao.php file
paki upload po ng file, di po ako maka login sa admin side
dearyl (not verified)
Sat, 02/15/2014 - 09:09
asa man ko mag.start adto?
asa man ko mag.start adto?
pwede vb.net 2008 aq gamiton?
Tue, 01/14/2014 - 22:34
great project. made some
great project. made some changes and it works great for me. can you help me by sending me the documentation of the project, or the thesis how you may call it! i would be very grateful to you! ([email protected])thankyou
mark joseph (not verified)
Mon, 09/23/2013 - 16:05
Fatal error: Uncaught exception 'PDOException' with message 'SQLSTATE[HY000] [1045] Access denied for user 'student2'@'localhost' (using password: YES)' in C:\xampp\htdocs\villaflor\workspace\zxc\app\PHP\CLASSES\Database_connection.php:11 Stack trace: #0 C:\xampp\htdocs\villaflor\workspace\zxc\app\PHP\CLASSES\Database_connection.php(11): PDO->__construct('mysql:host=loca...', 'student2', 'password') #1 C:\xampp\htdocs\villaflor\workspace\zxc\app\PHP\CLASSES\iis_functions_home.php(9): Database_connection->open_connection() #2 C:\xampp\htdocs\villaflor\workspace\zxc\app\PHP\OBJECTS\log_in_validation.php(13): Iis_functions_home->check_username('granaderos', 'cashier') #3 {main} thrown in C:\xampp\htdocs\villaflor\workspace\zxc\app\PHP\CLASSES\Database_connection.php on line 11 pano to masolve :/
Marejean (not verified)
Wed, 08/14/2013 - 20:07
username and password for administrator
Here it goes. :)
username: granaderos
password: marjiecasosa
username and password for administrator
i have used those credentials but it says Unknown user's name! what can i do
error in LOGIN
bakit po everytime na mag login ako may error ?? :(
Fatal error: Uncaught exception 'PDOException' with message 'SQLSTATE[28000] [1045] Access denied for user 'student2'@'localhost' (using password: YES)' in C:\wamp\www\DONAYRE_PERPINOSA_IIS\app\PHP\CLASSES\Database_connection.php on line 11
( ! ) PDOException: SQLSTATE[28000] [1045] Access denied for user 'student2'@'localhost' (using password: YES) in C:\wamp\www\DONAYRE_PERPINOSA_IIS\app\PHP\CLASSES\Database_connection.php on line 11
Raghava (not verified)
Fri, 08/02/2013 - 14:22
Username and Password
Please give me username and password for Admin and cashier
Can't login as admin
What's the username and password for the admin? Please. Thank you.
Thu, 06/06/2013 - 02:49
please guide the clear.
Which line of alter to erase there are so many alter options?
Anonymous (not verified)
Thu, 05/30/2013 - 16:52
Anonymous (not verified)
Wed, 06/05/2013 - 17:27
still not work
he doesnt know how to fix that, i think he is not a programmer
Anonymous (not verified)
Wed, 05/29/2013 - 18:11
Error on database
sir how to solve
SQL query:
-- --------------------------------------------------------
-- Table structure for table `products`
ALTER TABLE table_name ADD CONSTRAINT fk_wew FOREIGN KEY ( fld ) reference tbl_name(
) CREATE TABLE IF NOT EXISTS `products` (
`product_id` INT( 11 ) NOT NULL AUTO_INCREMENT ,
`product_name` VARCHAR( 100 ) DEFAULT NULL ,
`bar_code` VARCHAR( 50 ) DEFAULT NULL ,
`product_price` DOUBLE DEFAULT NULL ,
`number_of_stocks` DOUBLE DEFAULT NULL ,
`stock_unit` VARCHAR( 20 ) DEFAULT NULL ,
`product_genre` VARCHAR( 100 ) DEFAULT NULL ,
PRIMARY KEY ( `product_id` ) showDialogForTransaction
) ENGINE = INNODB DEFAULT CHARSET = latin1 AUTO_INCREMENT =75;
MySQL said:
#1064 - You have an error in your SQL syntax; check the manual that corresponds to your MySQL server version for the right syntax to use near 'reference tbl_name(fld_name)
CREATE TABLE IF NOT EXISTS `products` (
`product' at line 7
Owner (not verified)
Fri, 07/26/2013 - 18:25
Anonymous (not verified)
Sat, 06/01/2013 - 04:37
still not work
i removed that line, but still the same
do you how to fixed it?
Anonymous (not verified)
Thu, 05/30/2013 - 09:34
Error in Database
i got the same problem of the DataBase . i think its the version of the DB.... or something not right....can u fix the error...thx.


text:
Hawa Mahal , Jaipur
Hawa Mahal is a palace in Jaipur, India, so named because it was essentially a high screen wall built so the women of the royal household could observe street festivals while unseen from the outside.
The structure was built in 1799 by Maharaja Sawai Pratap Singh. It was designed by Lal Chand Ustad in the form of the crown of Krishna, the Hindu god. Its unique five-storey exterior is akin to the honeycomb of a beehive with its 953 small windows called jharokhas decorated with intricate latticework.
(Visited 481 times, 1 visits today)


text:
In 2003 and 2007, two big events took place in Potsdam (Germany) and Bratislava (Slovakia). Several hundred participants from Methodist churches all over Europe experienced how these festivals aroused a feeling of enthusiasm and shared identity. In 2018 a new festival will be organized – and it already takes shape.
Within the North Germany Annual Conference of The United Methodist Church, «Staunen!» is already well known – in 2015, this multi-day event inspired and encouraged many people of all generations.
A number of things will be the same, when from May 9-13, 2018, a new «Staunen!» event will take place: the venue will once again be the Dünenhof near Cuxhaven (Germany); there will once again be a colorful program with Bible studies, workshops, leisure and excursion opportunities, as well as plenary events. What is new is the fact that this event is organized in cooperation with the European Methodist Festival – and those responsible for «Staunen!» hope that this European cooperation will make the event even bigger and more colorful. Up to 1'000 people of all generations and from many countries all over Europe are expected to participate in this festival.
The program will be multi-lingual, and it shall include younger and older Christians who do not only come from different countries, but who live out their faith in very diverse religious, cultural, and social environments. The «Staunen!» leaders have begun quite a long time ago to advance the logistic and program-related preparations – with commitment, creativity and the joyful willingness to take over responsibility so that people can start to register for the festival on March 1, 2017.
«You have set my feet in a spacious place.» It is the prayer of many people that this theme, chosen for «Staunen!» 2018 will not only be experienced at the sight of the wonderfully beautiful scenery at the North Sea. Rather then, the participants, as parts of an international and cross-generational community, will hopefully be touched by God in a new way, and they will hopefully be blessed and sent into their respective environment to make a difference in the life of others.
Source: Staunen! / Retired Pastor Karsten W. Mohr / Urs Schweizer
Date: November 16, 2016


text:
|Tuni - 2002-2013
Tuni is at the Rainbow Bridge
It is with a heavy heart that I wanted to update Pugalug about my beautiful Petunia who has gone to the Rainbow Bridge.
I adopted Tuni at 9 years of age through Pugalug in November 2011. She quickly and seamlessly joined our family of four felines and her Pug sister, Mya. She was a delight and a joy and every animal and human she met fell in love with her. In October 2013, she developed hind leg paralysis and deteriorated very quickly. Over the last 2 weeks she experienced complications from the medication she was on. I am a registered Vet Tech so I am fortunate that I was able to keep her comfortable and I have a huge network of veterinary professionals and amazing friends and family who stepped up to help me. Tuni passed away peacefully in my arms on November 21, 2013. I am broken hearted but also feel so fortunate to have had this wonderful dog in my life.
Pugalug is a wonderful rescue group and I recommend you guys to people all the time! When I am ready to add another Pug to my family, you will be the place I come to find my fur baby.
Happy Pugging.
Happy Tails
The addition of Tuni to our family has been so smooth, it is honestly like she has always been here. Her four feline brothers completely accepted her immediately. Tuni is so polite and unassuming, sometimes I have to invite her to do the simplest things, like coaxing her to come to the door to leave in the morning since her little sister Mya is more like a bulldozer and is already outside before Tuni is even off the couch! The only drawback we have found is that Tuni does snore a little more than I am used to! Mya also introduced her to the "treats" in the kitty litter so neither Pug gets left with access to the kitty litter when I am out. Overall, Tuni is a gentle, sensitive soul who seems happy to be anywhere. My niece and nephews are all in love with her because she actually sits quietly to be petted, which is the exact opposite to Mya!! A big thank you to Siobhan and Pugalug for bringing this wonderful dog into my life!!
Adopted, November 29, 2011
Tuni has been an absolute dream to have in our house. Her quiet dignity has been noticed and appreciated during her time with us. Her foster home has 2 small children and she is phenomenal with them. Additionally, she is good with all other kids that come in to the house. She loves to sleep on the big bed (at the foot of the bed). If she went to a home where that would not be okay then her second favourite place to sleep is on a big dog bed beside her people (on the floor)
Her absolute ideal home situation would be one where she would either have a person home with her most of the time or where she would have another dog sibling to hang out with. Tuni doesn't play with other dogs but she does get lonely without something else around to occupy her.
She loves to be near her people and to get lots of love, but she is not assertive in asking for anything and is just happy to be included.
She takes daily drops, in her eyes, to prevent any issues as a result of her being a pug. She has a tendency to develop tartar on her teeth, so she gets a supplement in her water to slow this down. Tuni gets Glucosamine/ Chondroitin twice a day, to ease the arthritis in her front left leg.
She is an older girl but is very healthy and well worth the little bit of extra attention that she requires.
Foster Update, September 30, 2011
She continues to be perfect. She had her last vet visit and her urine gravity test came back perfect so there are officially no issues for her in that regard.
She is a very quiet little girl who likes nothing more than to be near her people. When we come home from anywhere we are greeted with a little wiggling mess of Tuni...her greetings are the best. She only barks when she has been extremely provoked (by Sophie) and loves to meet new people on our walks. She is a very gentle little girl who would never hurt a fly...in fact a chipmunk ran across her toes last week and she didn't even move.
Foster Update, August 13, 2011
Tuni has been to the vet and overall she is healthy. She has normal pug eyes with the markings (as her eyes are in good shape, she gets daily drops to ensure they stay good). Tuni has a bit of arthritis in her front left leg and she is currently taking glucosamine to help. Additionally, Tuni has a tendency to get tartar build up on her teeth, so she is currently on a supplement to try to help with that.
Tuni has just finished her summer vacation and I am attaching some pictures from her vacation. Tuni really enjoyed her boat rides and just hanging out on the beach.
Overall Tuni is officially perfect. She loves nothing more than to just be with her people. She gets along with all dogs that she encounters as well as all people big and small. She does not have a mean bone in her body and will never even defend her self if challenged. She is a very quiet little girl and I can't imagine any dog lover not finding the same.
Introduction, June 15, 2011
Tuni (aka Petunia) is a 9 year old fawn female pug whose had to be given up by an owner who really loved her and looked after her. She arrived on Saturday and is a total doll. She gets along very well with my crew and that includes my 2 small children. She is eating well and sleeping well (on the big bed or in her dog bed). She was sad on Saturday but has perked up since ... I think that she was pining for her people. She loves to participate in anything that we are doing and loves to spend time outdoors. She appears to be the perfect weight for her size. We will be making an appointment for her to see the vet sometime next week and we should have a better update by then.


text:
Cincinnati Magazine posted their Top 45 Burger list and I've been on a quest to try as many as possible. Next up on the list was Wunderbar in Covington!
Wunderbar is down past all the "downtown" Covington stuff on Madison on that new street that has been widened and bricked. There's a decent amount of street parking and you can find it by the giant Einstein mural on the side.
There are no menus - you just look at the wall and order at the bar (it changes often). I won't say the staff was super-friendly - but they did take our order. There are a lot of selections and we definitely had a hard time deciding what to order. It seemed fairly eclectic - from a kebab to bacon & brie to burgers to house-made sausage - it's a variety for sure!
They're also known for their sides - and I'm down with anybody that can do wonders with veggies. They don't make ALL of their sausages - I think the mett and kielbasa were the only two not made in-house. I was really wanting to try the sausage - but this is the burger quest - so I had to pass it up.
Why Should You Go? The burger was okay - it was a bit too rare for me and way too thick - I just ate it with a knife & fork. It was pretty good - but because of the size I probably wouldn't get it again. I would definitely go for the pierogies and I'd love to try their homemade sausages.


text:
There has been some exciting work in the South Africa recently with workflows, first with the H3A cloud workshop in Johannesburg, then with the workshop at UWC with Michael Crusoe as speaker on the Common Workflow Language. Chatting to @ScottHazelhurst yesterday, I was interested to hear that they tried to hack together some H3A workflows with Nextflow as well.
Two things came to mind :
My main question is about what it takes for these workflows to be portable. I think there is some link between TOSCA that @MaricaAntonacci_0e2f was talking about at the summer hackfest earlier this year. While these workflow tools (CWL and Nextflow) derive their portability from natively implementations to interact with their backend execution environment, I think that things like TOSCA try to achieve portability by abstracting the underlying environment.
@ScottHazelhurst could you please give some examples of the work that was done during the hack in JHB ?
We identified four key workflows that the H3A projects will need (GWAS, NGS, metagenomics and imputation) and are building portable pipelines that can be used by H3A groups to do their analyses. We want something that is scalable, and flexible. Portability means being able to run in a different enviroments easily. We lookeed extensively at Docker (but not exclusively). Two groups used CWL and two used Nextflow so we can do some comparison between the technologies.
I worked on the GWAS pipeline using Nextflow. What's great about Nextflow is that you can use the scame script for a range of different environments (a) using or not using Docker (b) running on a single computer or as a head node of a cluster. The only thing that has to change is the command-line parameter when the script is being called.
Is this true when you try to run the parts of the workflow on different resources ? I'm assuming you can do that easily, by just saying "this node you run like this". But then, it seems to me that the workflow is a bit tied to the resource endpoints that are defined in the nodes.
Is my understanding correct, first of all ?
If so, that doesn't sound all that portable. An abstraction, which could separate the endpoint from the execution, would be both more scalable and possibly radder
But let me not get ahead of myself - are the nodes on the workflow themselves portable ? Or is the entire workflow portable ?
I mean by portable that I could run my workflow on my laptop, then by changing one parameter run it on the head node of our cluster, and then by moving to a Docker swarm environment by changing one parameter.
Perhaps my definition of portability is wrong, but when I think of a program as being portable I am using the 1980's definition of the term.
What you seem to be saying is that when you run the workflow you don't want to know where the execution happens. This may or may not be desirable (when you have very large data sets, not so easy).
I'm not 100% sure what you mean by node -- is this the same as the Nextlow term "process" which is the the unit of work (e.g. BLAST this database)/vertex in the workflow graph.
In Nextflow, you can associate a different "executor" with the each process.. So some processes can run on the local machine, some on docker etc. Of course there are limits as there are only a few natively supported in Nextflow itself.


text:
"You can't go back and change the beginning, but you can start where you are and change the ending." ~C.S. Lewis
Imagine how different your life would be if you lived with this truth before your eyes. Fear would be cast out. Doubt, regret, anxiety, and hopelessness would have no place in your life. Think of the worst thing you have done, the one that weighs you down with guilt, that is always present in the back of your mind, reminding you of how worthless you are. Think of the countless times you have fallen back into the same patterns of sin, unable to extricate yourself from the depths of your own depravity. Think about the decisions you made in your life that broke your own heart as well as the hearts of others, those moments you would give anything to change. If you had but one more chance, you would go back and force yourself to make the right choice, altering your future forever.
But God doesn't want you to change your past. Continue reading "Chained by Your Past"


text:
"Most rock journalism is people who can't write, interviewing people who can't talk, for people who can't read."
- Frank Zappa
This is our last blogging assignment for this course.
I like blogging.
After this course is over, I'm going to continue blogging.
Blogs (short for Weblogs) are essentially websites used as journals. Not unlike throwing a message in a bottle in the middle of the ocean, blogging can be a cathartic exercise in narcissism for an audience that may not exist. But it has the potential to be so much more.
Our eight-blogging assignments have re-sparked my interest in writing. I've written in personal journals, created newsletters, and even blogged before but none of them have been like this blog. The platform this blog has given me is comfortable. I'm an educator – this self-learning journey in informal research and reflection suits me, especially if it may be useful to others.
The incredible part of blogging is reading and commenting on the blogs of others. Then it's more like a community. And I have learned a lot from our blogging community. Which brings up the discussion on social media technologies.
We've concentrated on our blogs how emergent social media technologies can be used in education. Through that discussion I developed an interest in using personal learning networks for students to supplement their education, and professional learning networks for professional communities to improve communication and staff development.
Education in the 21st century is already radically different from when I was in school. The fix is obviously in that education will become even more radically different by the time my daughters leave school. Education and professional staff development will become more individualized and available beyond the normal school/work day. Hence the need for personal learning networks.
Researching from a student's perspective is a good example. The availability of legitimate research resources online is beyond what was available even just a few years ago. Information overload is an apt description. Organizing that information is the current direction of social media technologies. Social bookmarking, feeds from Really Simple Syndications (RSS), and newer emergent technologies prevents information overload by organizing the sites and updates on just the information you want to one place - a personal learning network.
The aha moment came to me as I created a personal learning network to keep track of other blogs. It was like the difference between drinking from a water fountain and from a full blasting fire hydrant.
It's been great. Like I said, I'm going to continue blogging. I hope you will too.


text:
Welcome to Fillygree Cards
We are a Devon based company which designs and creates quality handmade greeting cards - perfect for birthdays and special celebrations for your loved ones. Whether it be your Dad's 60th Birthday, your Sister's 21st or your own 15th Wedding Anniversary, we have a card from you! We specialise in those hard-to-find cards for milestone birthdays for relatives and friends. Please have a browse around our shop, and should you wish to place an order, you can be assured that our cards are of the highest quality, and that your purchase is protected by the PayPal Guarantee. You do not need a PayPal account to make a payment, as you can check out as a guest using any credit or debit card. And don't forget: Prices include FREE DELIVERY by Royal Mail 1st Class Post.


text:
George Soros has just made a move that stunned the world. The extent of his philanthropy was well known until now, but not everyone expected that he would make such a large donation, which was on the scale of the likes that are rarely seen. George Soros has gone ahead and donated eighteen billion dollars to charity by transferring his own personal money to the Open Society Foundations, a charitable organization that George Soros founded and which is well known for its work in promoting good and freedom around the world.
George Soros grew up in Hungary, where he was born. He suffered under the Nazi occupation. His family managed to survive by faking papers documents of themselves to hide the fact that they were Jewish. George Soros and his family also helped other families survive by doing the same thing. George Soros moved to London during the time that Hungary was occupied by the Communists. He studied at the London School of Economics. During his time there, he took on various jobs at night to help pay for his studies. George Soros moved to America nine years later. He got started in the financial sector and soon became very successful on Wall Street. He started Soros Fund Management and became one of the most profitable and largest investors in the United States.
Because of his time under Nazi oppression, George Soros knows what it feels like to live as the poor and oppressed do. That is one reason why he has a special empathy for them. He wants to help them out in any way that he could. That is the reason he started Open Society Foundations. He based the name on the title of Karl Popper's book, Open Societies and Their Enemies. According to Karl Popper, freedom democracy are the most important things, and you can not force any one ideology or philosophy on people because there is no one ideology that is the one truth. George Soros created the Open Society Foundations to help protect democracy, freedom, and an open society, hence the name.
The Open Society Foundations focus on fighting hate, hate crimes, fascist governments, authoritative governments, abuses of power by police and other officials, and discrimination. They are especially concerned about discrimination against minorities and people of the LGBT community, who are often pushed to the sidelines. The Open Society Foundation has helped fund treatment for those who suffered during the Ebola outbreak. It has helped fund the education for thousands of students who could not afford an education on their own.
George Soros is expected to donate another two billion dollars to the Open Society Foundations in the coming few years. He has already donated over thirty two billion dollars in his lifetime. Besides the eighteen billion dollars he just donated, which he donated as part of estate planning, George Soros has been donating eight or nine hundred million dollars a year to the Open Society Foundations. It is the second largest such organization in the US now. and more information click here


text:
Toll-free at (800) 536-6999
Serving customers in Detroit
Professional health care professionals with more than 30 years experience!
SPECTRA MED, INC. 3160 Haggerty, Ste H
West Bloomfield, MI 48323
Diabetes often goes undiagnosed because many of its symptoms seem so harmless. Recent studies indicate that the early detection of diabetes symptoms and treatment can decrease the chance of developing the complications of diabetes.
Spectra Med, Inc.
:: All rights reserved ::
Privacy Policy
:: Site Map
Created and Powered by VGM Forbin* Designed according to National Institute on Aging guidelines for senior-friendly Web
3160 Haggerty, Ste H
West Bloomfield,
Phone: 248-669-5757
Toll Free: 800-536-6999
Fax: 248-669-2090


text:
About us
We are a company based in Durban and we pride ourselves in quality, exceptional workmanship and customer satisfaction. With over 30 years experience in the industry we guarantee you will love the work we do. We offer free quotations and we advise clients on what will work best for the space the client has.
We are specialists in kitchen design and all types of built in cupboards.
We are designers and manufacturers of fine quality cupboards, designed according to the latest trends.
We provide the highest quality. We provide our customers with the best quality in design and finishes. Due to the vast experience that we have in the market, we have set up a huge customer base in Durban and surrounds providing our customers with only the best service.
Customers are welcome to come with their own designs or can choose from a vast number of designs which we have on showcase.
Each and every one of our designs starts with a blank sheet of Paper


text:
I Op-Ed: A "Sane Country" Would Not Create a PA Terror State
By Mark Langfan
II Video: A "sane country" would not allow the terminology of outright lies and propaganda overwhelming the world's discourse
By President Mort Klein of the Zionist Organization of America (ZOA).
Upon inspecting the Katyusha damage in Sderot, Israel Minister Lapid remarked "this is a house in which five children live in and which was bombarded by Hamas with missiles during the night. Any sane country will not tolerate a situation in which their kids are being killed on a daily basis."
The problem is Israel does not behave like a "sane country." And Yair Lapid is a minister in a government where he voted and strongly argued against striking Hamas so as to cripple their ability to fire the very rockets Lapid is now complaining about. As he said, "no sane country" would tolerate any rocket fire on their territory. And, Israel's current government allows such attacks to continue unabated.
Let us review the evidence:
1 – 1993 Oslo Accords
Would any "sane country" have allowed a terror state to be created in adjacent land if the "sane country" held the land and its inhabitants openly vowed to annihilate that country? And would its voters have elected leaders like Rabin, Peres, Sharon, and Netanyahu who created new terror enclaves to add to the ones from which Israel's citizens have been murdered for over 100 years?
Before 1993, Rabin, Peres and the delusional peace cultists knew that Arafat's South Lebanese terrorists had fired thousands of katyushas into Israel from Lebanon. So one could easily imagine that if Arafat controlled Gaza, Palestinian Arab terrorists would fire the same rockets from there into Israel Any "sane" leader would have realized that if you gave land to the same people who fired rockets from Lebanon, they would fire them from there, but Israel signed the accords.
2 – Netanyahu's Hevron Retreat and Wye River Memorandum
Would any leader have given away land after hundreds of Israelis were murdered by Palestinian Arab suicide bombers coming from Gaza and Judea and Samaria? Netanyahu gave away land to the terrorists. What's worse, he says he never gave away land.
What was "Wye River"? In Wye, Netanyahu transferred Areas C to Areas B, and Areas B to Areas A. Changing legal designation of land is giving away land. Also, he created the very terrorist cancer of Hevron where the three precious Israeli Jewish boys were murdered.
He also let Arafat get away without amending the PLO Charter that calls for Israel's eradication. Even today, the PMW(Palestinian Media Watch) constantly reports that the PLO Charter clauses are cited verbatim almost daily by the PA TV and newspapers. But Israel doesn't do a thing to stem the torrent of Jew-hate.
3 – 2005 Gaza "Disengagement"
After hundreds of rockets and mortars were fired from Gaza into pre-1967 Israel between 2001 and 2005, would any "sane country" in 2005 have disengaged from Gaza and allowed the terrorists' ability to fire terror rockets on Israel grow exponentially? Prime Minister Sharon along with the Netanyahu voted for the unilateral retreat from Gaza where they knew the trickle of rockets would soon grow into a torrent of rockets.
Would any country cede territory to ISIS or Islamic Jihad if it knew the Islamic terrorists would as a result have better access to murder more of its citizens? No "sane country" would have retreated from Gaza. If it were able to, it would have wiped out any threat with overwhelming military force.
4 – Prisoner Releases to "Negotiate" with Abbas
After all the Israeli Knesset members saw both Fatah and Hamas fire over 16,000 rockets from Gaza between 2001 and 2014, would any "sane country" consider negotiating a retreat from Judea and Samaria (aka "West Bank"), an area which is in katyusha rocket range of 70% of Israel's population and 80% of her industrial base? The Prime MInister of Israel not only sits down with a bunch of Jew-murdering terrorists, he also pays for the right to sit with these suit-wearing Palestinian terrorists by releasing a hundred other blood-stained terrorists.
These released murderous Palestinian terrorists then go on to murder more Jewish Israelis. No "sane country" would have released blood-stained terrorists. They would have executed them.
The Leftist members of the present government are not "sane" for even contemplating ceding any land from which Hamas and/or ISIS and/or Fatah will only try to murder more Jewish Israelis.
5 – "Ceasefire" with Hamas
How pathetic it is to hear the government's pusillanimous offer that "Quiet will be met with quiet." The rational statement should be "Rockets have been (past tense) obliterated, and the Hamas HQs have been leveled with their terrorist leaders inside." Instead, dozens of Israel raids against empty buildings have only yielded 2 dead Gaza terrorists. How can dozens of Israel missiles only kill two terrorists? Because Israel is knowingly firing against empty buildings..
Five examples are enough
It isn't that the Israeli governments have committed just one insane policy. That would have been enough and possibly, excusable. One would think that after Israel's first mistake, the ministers would have rationally understood that their "peace" policies have failed. Instead, they repeated the same policy again and again. Consequently, the string of Israeli governments created a structurally insane entity that committed 5 major blunders plus hundreds of others along the way.
In answer to Lapid's question "Would any sane country" allow its citizens to be bombarded with rockets, the answer is clearly no. But, the Israeli government, and the messianic left-wing opposition parties think of nothing other than creating a new katyusha-terror-state in the very heart of Israel: Judea and Samaria.
And until the Jewish Israeli voters wake up, one can expect even more terror and kidnappings. And, one can rationally expect, of course, even more accurate and more deadly katyusha rockets on Israeli civilians.
The Author: Mark Langfan is a New York-based attorney who writes frequently on Middle Eastern affairs and security issues confronting Israel. He has created a three-dimensional topographical model of Israel to explain the implications of strategic height and depth for Israel's security.
Subscribe: www.israel-commentary.org
Twitter: @israelcomment
II Video with Mort Klein before the Knesset Committee


text:
"Love" is one of my favorite words. I use it to describe my passion for everything from fall weather and Christopher Guest movies to kittens and air hockey. I love love. My boyfriend, on the other hand, is the complete opposite. I've never once heard him drop the L-bomb when referring to anything as mundane as chinese food (okay, who doesn't LOVE chinese food?). I'm trained as a marriage and family therapist, so the core belief in the power of love is what keeps me in business. So, since I have a love affair with the word "love", it makes sense that I'd wear it on my shirt.
Sweater: Old Navy
Cardigan: Old Navy
Skirt: LOFT
Shoes: Jessica Simpson Collection
Bag: Coach
What are you loving this fall?


text:
Thanks for your consideration about onlinedissertationwriting.co.uk ("Online Dissertation Writing"), an online academic writing service provider in the UK.
Please read this document ("Terms & Conditions") carefully to understand our dissertation writing services, before using them. By placing your order with us, you are assumed to agree with all of our exclusive terms and conditions mentioned on this page.
Please understand the terminology of the agreement before reading on.
This terminology applies to the whole of the "Terms & Conditions", "Privacy Policy", "Cancellation Policy", and "Guarantees" pages. Any type of capitalization alterations shall not change the meaning of the terms mentioned above.
These terms and conditions will take effect as soon as the order is accepted and the payment made. Both the parties (the company and the customer) are then subjected to this agreement.
The writing and editing services you receive from us are to be utilized solely by you. You are not allowed to transfer any of the document prepared by our writers for commercial or any other purposes, unless you have a written consent from us to do so. Without any written permission, you can not republish, distribute, or display the content present on this website, or on the delivered academic paper, for sales or sales promotion. Any violation of the above-mentioned terms would immediately lead to the termination of contract, user being liable to the breach.
It is assumed that the written documents you receive from us are going to be utilized for the purpose of study, or reference. If you use the document for the purpose of assignment
submission, then you are required to mention proper citations. However, it is understood that as soon as the customer accepts the delivered paper and the payment is received by the company, the ownership right of the document will be allotted to the user.
In the case of any grievance from customer's end, a complaint can be filed within the seven days of the delivery of the paper. The company assures 24*7 availability for grievance handling. However, if no issue is whatsoever raised about the document within the stipulated time-period, it shall be assumed that the customer is completely satisfied with the product, and thereafter no complaints shall be processed.
Online Dissertation Writing is responsible for delivering the required paper before or on the day of assigned date (the date that was mentioned in the order form). In case, the company fails to provide the on-time delivery of the ordered academic paper, the customer can apply for the total refund, and the company shall be liable for early reimbursement. However, it is expected of the customer to read the "Refund Policy" prior to making any claim.
When a client places an order to us, we know he/she agrees completely with all the points mentioned above. Some of the things that you must consider are:
We have the authority to introduce alterations in the terms and conditions at any point in time. We advise our visitors to keep on viewing the page to keep yourself aware of the changes made by us. We do the modifications with the intend to improve our services so that we can satisfy each one of you successfully!


text:
Return to map
Leasing Info
- Tel: (866) 853-9491
Oak Park Plaza, Blaine, MN
Oak Park Plaza is a 105,561-square-foot grocery-anchored shopping center located approximately 12 miles north of downtown Minneapolis. The property was recently renovated to include a newly constructed Cub Foods store, and upgrades to the landscaping, lighting and parking lot. Junior anchors at the property include Ace Hardware, Any Time Fitness and Star Liquors, while other national and regional tenants include Domino's Pizza, Great Clips and Subway. Over 75,000 people live within a three-mile radius where the average household income is over $79,000.


text:
Our directory uses ASCII (pronounced ASSKEE) character encoding. Originally developed with the English alphabet in mind, it doesn't support some special characters used in languages such as Greek, Cyrillic, Armenian, Hebrew, and Arabic.
You can fix this, however, by using html character codes in place of the special characters in your description. Here's a list of html special character codes: https://ascii.cl/htmlcodes.htm.


text:
Different patterns of atrial activation in idiopathic atrial fibrillation: simultaneous multisite atrial mapping in patients with paroxysmal and chronic atrial fibrillation
Author + information
- Received February 22, 2000
- Revision received August 17, 2000
- Accepted October 4, 2000
- Published online February 1, 2001.
Author Information
- Fiorenzo Gaita, MD∗,* (cardclin{at}provincia.asti.it),
- Leonardo Calò, MD∗,
- Riccardo Riccardi, MD∗,
- Lucia Garberoglio, MD∗,
- Marco Scaglione, MD∗,
- Giovanni Licciardello, MD∗,
- Luisella Coda, MD∗,
- Paolo Di Donna, MD∗,
- Mario Bocchiardo, MD∗,
- Domenico Caponi, MD∗,
- Renzo Antolini, PhD†,
- Fulvio Orzan, MD‡ and
- GianPaolo Trevi, MD‡
- ↵*Reprint requests and correspondence: Dr. Fiorenzo Gaita, Division of Cardiology, Civil Hospital, Via Botallo 4, 14100 Asti, Italy
We aimed to evaluate: 1) the behavior of electrical activity simultaneously in different atrial regions during atrial fibrillation (AF); 2) the difference of atrial activation between paroxysmal and chronic AF; 3) the atrial refractoriness dispersion; and 4) the correlation between the effective refractory periods (ERPs) and the FF intervals.
Little data exist on the electrophysiologic characteristics of the different atrial regions in patients with AF. A more detailed knowledge of the electrical activity during AF may provide further insights to improve treatment of AF.
Right and left atria were extensively mapped in 30 patients with idiopathic AF (18 paroxysmal and 12 chronic). In different atrial locations, we analyzed 1) the FF interval duration; and 2) the grade of organization and, in case of organized electrical activity, the direction of atrial activation. Furthermore, in patients with paroxysmal AF, we determined the atrial ERP, evaluated the ERP dispersion and assessed the presence of a correlation between the ERPs and the FF intervals.
In patients with chronic AF, we observed a shortening of the FF intervals and a greater prevalence of disorganized activity in all the atrial sites examined. In patients with paroxysmal AF, a significant dispersion of refractoriness was observed. The right lateral wall showed longer FF intervals and more organized atrial activity and, unexpectedly, the shortest mean ERPs. In contrast, the septal area showed shorter FF intervals, greater disorganization and the longest mean ERPs.
Electrical activity during AF showed a significant spatial inhomogeneity, which was more evident in patients with paroxysmal AF. The mean FF intervals did not correlate with the mean ERPs.
Atrial fibrillation (AF) is a common arrhythmia associated with significant morbidity and mortality. However, as yet, an effective treatment of AF has not been defined, probably because of the little knowledge of the electrophysiologic characteristics. Atrial activation during AF has been evaluated in some studies by high resolution epicardial mapping techniques, although limited atrial regions (lateral walls) were analyzed (1–4), whereas in other studies, the analysis of atrial activation was performed with endocardial mapping in a limited number of sites (5,6)or without simultaneous multisite mapping (7,8), and patient groups not represen-tative of clinical AF were evaluated (1,2). Furthermore, in humans, little information exists on the behavior of the effective refractory period (ERP) in different atrial locations (9–12), and no data on the relation between atrial refractoriness and the behavior of atrial activity in different regions have been reported, to our knowledge.
The aim of this study was to better understand the electrophysiologic characteristics of different atrial regions in a group of patients with idiopathic AF. The specific study purposes were: 1) to perform simultaneous analysis of atrial activity at different atrial sites during AF; 2) to analyze the differences in atrial electrical activity organization during paroxysmal and chronic AF; and 3) to determine the ERP at the same sites where atrial electrical activity was analyzed in patients with paroxysmal AF, thus evaluating the atrial refractoriness dispersion and the correlation between the ERPs and the FF intervals.
Study group
The study group consisted of 30 patients (24 men, 6 women) with idiopathic AF with no demonstrable organic heart disease. The patients' mean age was 48.4 ± 10.4 years. All antiarrhythmic drugs had been discontinued for at least five half-lives, and no patients had received amiodarone within the preceding six months. Eighteen patients had a history of frequent episodes of paroxysmal AF (>2 episodes/month), and 12 patients had chronic AF, defined as AF >2 weeks in duration (mean duration 14 ± 12 months [range 3 weeks to 42 months]). According to echocardiographic variables, the left atrium was considered normal in 13 patients with paroxysmal AF and in 7 patients with chronic AF. The right atrium was normal in 14 patients with paroxysmal AF and in 7 patients with chronic AF. Patients with moderate atrial enlargement have been considered not to have heart disease, because no other cardiac abnormalities were found. The moderate dilation in these patients was considered a consequence of AF, as suggested by Sanfilippo et al. (13). No difference in mean age and size of both atria was observed between patients with paroxysmal AF and those with chronic AF.
Electrophysiologic study
All patients gave written, informed consent. A multielectrode "basket" catheter with 64 electrodes mounted on eight flexible splines (Constellation catheter, EP Technologies, Inc.) was used to map the right atrium, and two decapolar catheters with 2-mm interelectrode distance and 10-mm distance between each bipole were used (Cordis-Webster, Inc.), one placed retrogradely along the left septum (LS) and the other one inserted in the distal coronary sinus (CS) to map the region of the lateral wall (Fig. 1). In patients with paroxysmal AF, a quadripolar catheter with 10-mm interelectrode distance was used to evaluate the ERP, using a square wave of 2-ms pulse duration at twice the stimulation threshold. This was assessed at each pacing site and pacing cycle length.
Bipolar digitized atrial electrograms from 31 endocardial sites and the surface electrocardiographic (ECG) lead II were simultaneously displayed on a multichannel recorder and stored on magneto-optical disks (Cardiolab, Prucka Engineering, Inc.). If AF was not spontaneously present, it was induced with atrial extrastimuli or atrial bursts.
Data analysis
The atrial activation analysis has been simultaneously performed during AF in different atrial sites. In patients with paroxysmal AF, the shortest duration of either spontaneous or induced episodes of AF chosen for analysis was at least 5 min. The period analyzed was chosen randomly, excluding the first and last minute of AF.
Four different types of analysis were performed: 1) the AF interval (FF) duration was measured at 10 sites—seven in the right atrium (right high lateral [RHL], right low lateral [RLL], right high posterior [RHP], right low posterior [RLP], right high septum [RHS], right low septum [RLS] and right anterior [RA]) and three in the left atrium (left high septum [LHS], left low septum [LLS] and epicardial lateral wall through the CS). The measurements were performed manually for periods of 10 s on the Cardiolab system at a screen speed of 200 mm/s, using screen calipers, and the FF intervals were measured as previously described (5,14). We considered as different F waves the presence of two distinct electrograms clearly separated by an isoelectric space of at least 50 ms. The choice of the limit of 50 ms for the shortest FF interval, which is similar to that used in other studies, and the simultaneous evaluation of the atrial electrograms at the sites adjacent to those analyzed aimed to reduce the interference of double or fragmented and long-duration electrograms. 2) The AF classification suggested by Wells et al. (15)was used to grade the higher or lower regularity of the atrial electrograms at the same sites as those in the FF analysis for periods of 60 s (including the 10 s used for the FF analysis). Type I represents discrete atrial electrograms separated by an isoelectric line free of perturbation. Type II also shows discrete organized atrial electrograms, but with perturbed isoelectric lines. Type III is characterized by the absence of discrete atrial electrograms without clear isoelectric interval. Type IV, which is characterized by type III alternating with type I or II, was not considered, because the duration of types I, II and III at each site was expressed as a percentage of the total duration of the analyzed period. 3) The morphology and sequence of atrial activation was evaluated along the right lateral (RL) and right posterior (RP) wall, along the RA wall, right septum (RS) and LS, and along the CS during the same 60 s of Wells' analysis. This analysis was performed using all bipoles exploring each region. When we observed single potentials (16)separated by an isoelectric interval >50 ms, the atrial activity was considered organized. In this case, we determined the direction of activation as craniocaudal if the activation occurred in a superior to inferior direction, or caudocranial if the activation occurred in the opposite direction, or indeterminable if the direction of activation could not be discerned. Otherwise, in the presence of double and/or fragmented activation waves (15), the activation was considered disorganized. 4) In an attempt to summarize the spatial characteristics of electrical activity during AF in each patient, we classified AF into four different patterns by considering how many and which atrial regions showed disorganized atrial activity. The regions considered were the RL, RP, CS and the septum. If the disorganization was confined to a part of the septum only, we considered the RS and LS separately. A region was considered to be disorganized when we observed fragmented electrograms and/or double potentials in at least two bipoles exploring the region and in >50% of the total time of analysis. Consequently, the resultant pattern was the most prevalent one. The patterns are classified as follows: pattern A is defined by the presence of disorganized atrial activity in one region only; pattern B in two regions; pattern C in three regions; and pattern D in all regions (Fig. 2). For each pattern, we indicated the regions involved. This evaluation was performed during the same 60 s of Wells' analysis.
Furthermore, we evaluated the ERP at the 10 atrial sites considered for FF intervals and Wells' type analysis. At the beginning of the procedure, a stimulation protocol was conducted at two atrial paced cycle lengths of 600 and 400 ms in patients with paroxysmal AF. After every eight-paced beats sequence, a very early atrial extrastimulus was delivered. The extrastimulus was then delayed by 10-ms steps until atrial activation (17). The ERP measurements were performed in all patients with paroxysmal AF before the induction (n = 16) or spontaneous (n = 2) occurrence of sustained AF. If sustained AF (>1 min) occurred or was induced, the stimulation protocol was stopped, and only the patients with at least seven sites evaluated were considered for this analysis. The atrial ERP was defined as the longest S1–S2interval that failed to elicit atrial depolarization. We determined the dispersion of atrial refractoriness (longest ERP − shortest ERP) at both basic cycle lengths.
Statistical analysis
All data, unless otherwise noted, are expressed as the mean value ± SD. Paired and unpaired ttests were used for statistical analysis. In case of multiple statistical comparisons, the probability value was corrected by multiplying it by the number of comparisons (Bonferroni's correction). The results were considered to be statistically significant at p < 0.05.
The FF intervals
A total of 24,646 AF beats were measured. Figure 3shows the different FF intervals at the 10 atrial sites in patients with paroxysmal and chronic AF. Patients with paroxysmal AF showed longer FF intervals at all sites, as compared with patients with chronic AF (p < 0.05). In patients with paroxysmal AF, the FF intervals were significantly shorter at the RS and LS than at the RA wall and right lateral wall (p < 0.05). The patients with chronic AF had very short FF intervals in all locations, with a significant reduction of the differences among different sites.
Wells' types (Fig. 4)
The RA and RL regions, as well as the CS region, presented a more prevalent type I AF, whereas the septal region showed a predominant type III AF. In particular, the RA wall and RL wall had a significantly higher (p < 0.05) incidence of organized activity (type I) as compared with the LS.
Specifically, in paroxysmal AF, the RL and RA wall and the CS region showed a prevalent type I pattern that was present for >75% of the time analyzed. The septal region, mainly the left one, showed a more disorganized atrial activation, with equal representation of a type I, II and III pattern during the period considered (Fig. 4, top).
In patients with chronic AF, the prevalent patterns were types II and III at almost all sites. The RA and RL walls showed a higher percentage of a type I pattern for the time considered, but still for a lesser period in comparison with chronic AF (Fig. 4, bottom).
Regional activation sequences
Figure 5gives the proportion of the different atrial activation sequences and the disorganized activity in the different regions.
In paroxysmal AF, the organized activity was mostly present in the RL wall and CS. In the RL wall, craniocaudal activation was observed to a greater extent than caudocranial and indeterminable activation (p < 0.05). Also, the RP wall had a prevalent craniocaudal direction (p < 0.05). In contrast, in the RS, the caudocranial activation was present for longer periods than those of the craniocaudal sequence (p < 0.05), whereas the LS did not exhibit a prevalent direction. The LS and RP wall had more disorganized electrograms than did the RL wall (p < 0.05). Also, the LS was significantly different from the CS (p < 0.05). The RS had a significant amount of disorganized electrograms, as compared with the RL wall (p < 0.05).
In chronic AF, a significant increase of disorganized activity was observed in all regions, as compared with paroxysmal AF (p < 0.05), especially in the LS, where it was present 100% of the time. Only the RL wall was more organized, with a 30% reduction of disorganized electrograms. No prevalent direction of activation has been noted at all sites.
Patterns of AF (Fig. 2 and 6)
⇓Of the patients with paroxysmal AF, four had pattern A (22%), seven had pattern B (39%), seven had pattern C (39%) and none had pattern D (Fig. 6, bottom). In two patients with pattern A, a preferential involvement of RP wall was present, whereas only the LS was involved in the other two patients. In the seven patients with pattern B, the regions showing mainly disorganized atrial activity were the RP wall and septum in three patients, the RP wall and LS in three patients and the RL wall and LS in one patient. Of the seven patients with pattern C, five had a prevalent disorganization of the CS, RP wall and septum and two had disorganization of the CS, LS and RP wall. The RL wall was disorganized in only one patient.
In patients with chronic AF, seven had pattern D (59%), four had pattern C (33%), one had pattern B (8%) and none had pattern A (Fig. 6, top). In three patients with pattern C, the regions with prevalent disorganization were the CS, RP wall and septum. The only patient with pattern B had long-lasting AF (14 months), and he showed disorganized electrograms exclusively in the LS and CS, with impressive organized activity in all right atrial regions.
Relation between ERPs and characteristics of atrial activity
Four of the 18 patients with paroxysmal AF were not considered for the analysis of ERP because sustained AF was induced before we had evaluated at least seven different sites. Of the remaining 14 patients, the ERP was determined at all sites in both pacing methods in 12, whereas in the other 2 patients, only seven and eight sites, respectively, were available because of AF occurrence. The total number of ERPs determined at the different sites was 129.
The dispersion of refractoriness was longer for a basic cycle length of 600 ms (79 ± 28 ms [range 40 to 140]) than for a basic cycle length of 400 ms (66 ± 18 ms [range 30 to 100]), but without reaching a statistically significant difference. The ERP dispersion was 63 ± 6 and 57 ± 19 ms, respectively, in the right atrium and 48 ± 32 and 32 ± 19 ms in the left atrium. Figure 7(top) shows the ERP at the 10 different atrial sites for both pacing methods. The ERP shortened at all atrial sites during pacing at a 400-ms interval, as compared with a 600-ms pacing cycle length. The shortest mean ERP was obtained in the RL wall and, in particular, in the RHL in both pacing methods. The LS had the longest mean ERP by both pacing methods, with a significant difference when both the LHS and LLS were compared with the RHL and RLL. The ERPs, FF interval and Wells' types in these 14 patients are shown in Figure 7. The RHL and RLL, which are the locations with the shortest ERPs, showed longer mean FF intervals and greater organization of atrial activity, with type I prevalence. In contrast, the LHS and LLS, which are the sites with the longest ERPs, had shorter mean FF intervals and greater disorganization, with less type I and more type III as compared with the other locations. The other sites with intermediate values of ERP did not show homogeneous behavior of atrial activity. In fact, the RA wall and CS had longer FF intervals with greater prevalence of type I, whereas the RP wall and RS had shorter FF intervals and less presence of type I.
There are three major findings of our study: 1) the FF interval duration and AF organization differ significantly between paroxysmal and chronic AF. 2) The electrical activity during AF is spatially nonuniform. The septal region and the RP wall showed the most disorganized atrial activation, whereas the others had more regular electrical activity, especially in paroxysmal AF. 3) In patients with paroxysmal AF, a significant dispersion of refractoriness was observed. The RL wall, the region with longer FF intervals and more organized atrial activity, had the shortest mean ERPs, unexpectedly. In contrast, the LS, with shorter FF intervals and greater disorganization, had the longest mean ERPs.
Differences in atrial organization between paroxysmal and chronic AF
In the present study, a significant difference in the electrical activity was found between chronic and paroxysmal AF. In fact, in chronic AF, both a significant shortening of the FF interval and an increase of atrial activity disorganization were observed at all atrial regions. In patients with paroxysmal AF, the spatial differences were extremely pronounced; in particular, the LS and RP areas were highly disorganized, whereas the lateral region showed more organized atrial electrical activity. In agreement with recent observations (6), when the atrial activation showed an organized pattern, we generally found that the electrical activity in the RL wall had a craniocaudal sequence with caudocranial activity in the RS, whereas the LS showed disorganized activity without a prevalent direction of activation.
In patients with paroxysmal AF, a pattern with one or two disorganized areas always involving the septal or RP region (patterns A and B) was present in 61% of patients. In the remaining 39% of patients, there were three disorganized areas (pattern C). No patient had completely disorganized electrical activity. Of the patients with chronic AF, 58% had pattern D with completely disorganized atrial electrical activity in all atrial regions analyzed. These findings are in agreement with the concept of atrial "electrical remodeling." In fact, several experimental studies (17–21)have demonstrated that prolonged pacing-induced AF favors its own maintenance with a shortening of FF intervals (18–20). This can be attributed to the progressive decrease in atrial ERPs (12,17–21)and conduction velocity (18,19,21). Nevertheless, in some patients (33%) with chronic AF, we found mostly organized atrial activity in the RL wall. This could be, at least partially, explained by the anatomic characteristics of this region.
Effective refractory periods in different atrial regions
Increased ERP dispersion is known to play a critical role in induction and maintenance of AF (11,17,19,22). In our patients with paroxysmal AF, a significant dispersion of refractoriness was observed. The RL wall showed the shortest mean ERP, whereas the LS had the longest ERP. This observation is consistent with the few reports on humans published (9–12). The ERP differences in the various regions could be related to several factors, such as a different response from different atrial areas due to stretching (23)or a vagal stimulus (24). With regard to the relation between ERP and FF intervals, previous reports on animals (18,25–27)and a few studies of humans (22,28)showed discordant and heterogeneous results. In fact, the ERPs (22,25,26)or the functional refractory period (28)were correlated with minimal FF intervals in one study (25), with mean (18,22,28)or median FF intervals in others (26). In most of these studies, the relation was not evaluated in different atrial regions. The right atrial lateral wall was the region most frequently analyzed; no data were given on the septal region; and in some studies, only epicardial recordings were evaluated (18,22,26,27). Moreover, it has been observed that the ERPs and FF intervals may have a good correlation in some animal models of AF (rapid pacing), but not in others (pericarditis model) (29).
The analysis of the characteristics of atrial activity (FF intervals and Wells' types) and local ERPs at 10 different sites of both atria showed that the RL wall, with the shortest mean ERP, had the most organized electrical activity and the longest mean FF intervals; whereas the LS, with the longest mean ERP, had the greatest prevalence of disorganized electrograms and the shortest FF intervals. These data are apparently in contrast with what has been reported in previous studies (2,22,28). A possible explanation for this discrepancy may be the different modality of analysis of the FF intervals, considering that our study analyzed multiple sites. In contrast, our data are in accordance with what was recently observed by Li et al. (27), who evaluated the relation between ERPs and Wells' AF types in both atria in dogs. Such findings may be interpreted bearing in mind that the locations with disorganized atrial electrograms are those with the longest ERPs, which do not allow the maintenance of 1:1 capture or determine low amplitude. Moreover, the spatial dispersion of refractoriness can produce fragmented electrograms by the presence of action potentials in different muscle bundles that are activated out of phase (16). Furthermore, in areas such as the RL wall, the presence of anatomic barriers that reduce the numbers of circulating wavelets, as well as the short ERP, may explain the higher prevalence of single atrial electrograms due to the presence of broad uniform wave fronts propagating across this wall.
Thus, we can hypothesize that in different atrial regions, the local ERP is not the only determinant of the FF interval duration; the characteristics of atrial activity also depend on conduction velocity properties and the presence of the anatomic structures, such as the crista terminalis and the tricuspid ring acting as functional barriers that favor a forced path of the AF wavelets along the trabeculated right atrium.
Study limitations
Atrial mapping was performed by the use of bipolar recordings with a relatively large interelectrode distance. The use of unipolar recordings would have allowed more precise analysis of electrical activity. In addition, although the right atrium was mapped extensively using a basket catheter, the left atrium was mapped only in the septum and in the lateral region (through the CS) using two decapolar catheters. This is a limitation, but the use of a second basket catheter or more multielectrode catheters in the left atrium to obtain more data might have caused additional risk of thromboembolic events or complications related to the transseptal approach.
Potential clinical relevance
Some studies (8,16,21)have suggested that the characteristics of atrial electrograms may be important to identify regions critical for the induction or maintenance of AF. Besides, it has been observed that selective lesions in regions responsible for the induction, or in other regions with more disorganized atrial activity, could be useful for AF ablation (5,18). Therefore, to achieve a greater possibility of success of radiofrequency ablation, it is necessary to increase our knowledge about the spatial characteristics of atrial activity in different groups of patients with this arrhythmia, such as idiopathic AF or AF associated with valvular disease, hypertension, congestive heart failure or coronary artery disease. Our results showed that different patterns of electrical activity during AF may be present. In idiopathic AF, the RP wall and the septal areas are the regions that generally demonstrated more disorganized atrial activity. However, because each patient may show a different AF pattern, extensive atrial mapping to choose different ablative strategies in each patient seems very important. The classification of AF patterns that we used in this study could prove useful, considering its correlation with other evaluations of atrial electrical activity, such as analysis of FF intervals, which requires a longer analysis time.
Anatomic and electrophysiologic factors play a relevant role in how electrical activity is manifested during AF, determining the possible coexistence of areas with much more disorganized activity, together with other more organized areas, especially in patients with paroxysmal AF.
- Abbreviations
- atrial fibrillation
- coronary sinus
- effective refractory period
- left high septum
- left low septum
- left septum
- right anterior (wall)
- right high lateral (wall)
- right lateral (wall)
- right low lateral (wall)
- right posterior (wall)
- right septum
- Received February 22, 2000.
- Revision received August 17, 2000.
- Accepted October 4, 2000.
- American College of Cardiology
- ↵
- ↵
- Konings K.T.S.,
- Kirchhof C.J.H.J.,
- Smeets J.R.L.M.,
- Wellens H.J.J.,
- Penn O.C.,
- Allessie M.A.
- Holm M.,
- Johansson R.,
- Brandt J.,
- Lührs C.,
- Olsson S.B.
- ↵
- Gaita F.,
- Riccardi R.,
- Calò L.,
- et al.
- ↵
- ↵
- ↵
- ↵
- Luck C.J.,
- Engel T.R.
- ↵
- Papageorgiou P.,
- Monahan K.,
- Boyle N.G.,
- et al.
- ↵
- Pandozi C.,
- Bianconi L.,
- Villani M.,
- et al.
- ↵
- Sanfilippo A.J.,
- Abascal V.M.,
- Sheean M.,
- et al.
- Kalman J.M.,
- Olgin J.E.,
- Saxon L.A.,
- Fisher W.G.,
- Lee R.J.,
- Lesh M.D.
- ↵
- ↵
- Konings K.T.S.,
- Smeets J.L.R.M.,
- Penn O.C.,
- Wellens H.J.J.,
- Allessie M.A.
- ↵
- Fareh S.,
- Villemaire C.,
- Nattel S.
- ↵
- Morillo C.A.,
- Klein G.J.,
- Jones D.L.,
- Guiraudon C.M.
- Gaspo R.,
- Bosch R.F.,
- Talajic M.,
- Nattel S.
- Wijffels M.C.E.F.,
- Kirchhof C.J.H.J.,
- Dorland R.,
- Allessie M.A.
- Elvan A.,
- Wylie K.,
- Zipes D.P.
- ↵
- Ramdat Misier A.R.,
- Opthof T.,
- van Hemel N.M.,
- et al.
- ↵
- ↵
- Zipes D.P.,
- Mihalick M.J.,
- Robbins F.T.
- ↵
- Kim K.B.,
- Rodefeld M.D.,
- Schuessler R.B.,
- Cox J.L.,
- Boineau J.P.
- ↵
- Lammers W.J.E.P.,
- Allessie M.A.,
- Rensma P.L.,
- Schalij M.J.
- ↵
- Li H.,
- Hare J.,
- Mughal K.,
- et al.
- ↵
- Capucci A.,
- Biffi M.,
- Boriani G.,
- et al.
- ↵
- Kumagai K.,
- Khrestian C.,
- Waldo A.L.


text:
Canadian Security Professionals (CSP) provides alarm systems and alarm system monitoring in and around the Sarnia area. CSP is an ADT authorized dealer offering Protectron Smart Security. This means that you receive the combined strength and stability of a national company with the convenience and personal touch of a local dealer. Click here to learn how you can take advantage of our free alarm system promotion!
Our toll free phone number: 1 (877) 494-9911
Ottawa police mailing address
555 Christina Street North,
Sarnia, ON
Sarnia Area Police Service website
Sarnia Area Fire Department website
Sarnia Area Medical Services
According to The Observer, crime rates in Sarnia have increased by 9% in recent years [Source]. Sarnia is also included in Canada's top 100 dangerous cities [Source]. CSP Alarms Security Systems help you protect your family and business from crime. Our state of the art security alarm systems give you an advantage. Additionally, CSP Connected allows you to control and monitor your home or office from any internet connected device including your smart phone and laptop! Find out more here.
We Live Where You Live
CSP protects homes and businesses across Ontario and British Columbia including in and around the following major cities; Toronto, Hamilton, Mississauga, Brampton, Milton, Burlington, Barrie, Oakville, London, Kitchener/Waterloo, Guelph, Cambridge, Niagara Region, Woodstock, Brantford, Ottawa, Windsor, Sarnia, Kingston, Burnaby, Surrey, Richmond, Coquitlam, Abbotsford, Mission, Delta, Langley, Maple Ridge and Chilliwack.


text:
This week I tried out the SkinRx Lab MadeCera Express Mask.
After using, my face felt hydrated and super smooth. I also appreciated how the serum on this mask also feels creamy, as opposed to super oily or goopy. It was wet enough, without dripping all over me.
Definitely check it out of you can get your hands on it!
See you soon!
This is not a sponsored post. Some of the items mentioned above may have been sent to me for consideration or given to me as employee gratis. This in no way affects my opinion. As always, any opinions stated above are solely my own.


text:
The premise of the show, in case you don't know, is this: slighted, angry, and denied her own happy ending, the Evil Queen Regina (am I the only time who gets a kick out of that name, or is that just the nerd in me?)(Regina means 'queen' in latin, hence the kick) curses all of Fairy Tale Land. Everyone's memory is wiped and they're stuck in a time loop in Storybrooke, Maine until Emma, Snow White and Prince Charming's daughter, returns to break the spell. The show alternates between revealing each of the character's histories (and I love, love the twists they've put on all the fairy tale's so far), and what's happening in real time as Emma and Henry (a little boy who knows it's all a curse) work to break the spell.
There are many things I love about this show (not least of which is Josh Dallas) is the well rounded, and sympathetic characters. Most of all, Regina. She has the potential to be an incredibly flat, rah-rah go evil! sort of character. But she isn't. Regina has motive; she's been denied a happy ending over and over again. She's also been wronged by Snow White - in this telling, Snow is no innocent victim of her own beauty. She's an active participant in creating the anger that propels most of Regina's narrative.
It's hard (at least for me) to not feel a little sympathy when Regina is spurned by her adopted son in favor of his birth mother, left by Graham in favor of Emma, turned on by any number of people when all she wants is a happy ending. Her moral compass might be a little skewed, and her methods questionable, but her core is something we all understand and recognize. She wants to be loved, she wants friends, she wants to be happy. But the fairy tale dynamic won't allow her to be happy, without removing happiness from someone else -and that's why we think she's evil. Because we think the cost is too high, even though, had it been Snow working for her happy ending, it would have ended the same, just with Regina on the other side.
I think there's a lot to learn from the writers of Once Upon a Time (and why not, since they're also the writers of Lost), and a whole lot to learn from Regina as a villainess. Cardboard villains are all well and good, but the ones that make and enrich a story are ones we understand, who maybe took a wrong turn, but were on the same path until something awful happened. When we understand and sympathize with the circumstances of their creation, we can love and hate them better, and in that way, tell better stories.


text:
Welcome to TMT Travel Phuket
We are one of the leading travel agency's in Phuket with our office located in Patong.
If you're looking for tours, excursions and transfers with very reasonable pricing you came to the right place.
To offer a good service is very important to us and all our staff are speaking decent English.
For enquiries please fill in the contact form and we will get back to you as soon as possible or visit our office between 10 AM and 10 PM every day.
We can meet you also in your place of stay to offer our products at your convenience.
TMT Travel Phuket wishes you a pleasant stay in the land of smiles.
Recommended tours
Phuket Tours
Island Tours
Phi Phi island Tours
James Bond island Tours
Phuket Shows
Adventure Tours
Phuket City Tours
"excellent agency, always kind and always operational, organize any tour, very nice people!!!!"
Enrico Marigliani
Italy 12 April 2017
"The best in Phuket!!!!!!"
Jeremy Driss
France 13 July 2015
"The best travel agency!!"
Marlen Kzt
Russia 24 June 2016
"Me and the family booked Phi Phi island tour online before we travelled to Thailand and it was amazing, we visited the office after and booked 2 more tours.
We really loved it and will come back"
Adrian Warne
Australia February 2018
"I work in Phuket for Russian tourist and use this agency all time they have the best tours and service I recommend anybody to use this agency The best tour is James bond"
Ekaterina Narmenko
Ukraine 11 November 2014
"I've been using this travel agency for six year and the service has been always excellent and very friendly!"
Thomas Finn
Finland December 2012
"My brother got married in Thailand and we stayed 10 days in Phuket, A friend who has a bar recommend this agency.
The weather wasn't good so they advised us the James bond tour with the luxury boat and it was amazing.
We also did the Fantasea show and the price was much cheaper than there.
The best thing is that every staff speaks English and we got everything worked out great."
Carl Doyle
United Kingdom August 2018
"The owner from this agency is from Holland and we also, we contact from the website and he come to meet us in the hotel. This is high season and expensive holiday but he give us very good prices for Raya island tour and Similan tour even our son of 1 year was free so happy We used also for the transfers by private taxi and it was cheapest from phuket"
Rob Geurts
The Netherlands 12 January 2015
"We stay in Phuket Merlin resort and we informed on tours the price was so high and we think ok we can find cheaper
We walk around near Jungceylon shopping and we meet a very nice lady who sell tours and it was more than half price from our hotel!
We booked 2 tours and 1 transfer and she give u even more discount for package price because I was with my wife and 2 children.
We reccomened to friends and they have already use them with success"
Fam. Heinze
Germany 15 October 2012
"Best travel agent in Phuket for me and my friends"
Rakesh satif
Indian 17 December 2016
"Good tour but bus come late"
Qadeer Abdul Ghani
Pakistan -
"We saw the website and decided to book all our tours with tmt travel Phuket, they have very good service and good prices We stay in Kamala and they even come to meet us in the hotel and bring vouchers the girl name Kib is very nice and friendly will sure use again when come back next year"
Hendrik Jan Fledderus
The Netherlands 09 June 2018
"I give this agency 3 stars because the tour not exactly what me and my wife ordered we booked for the speedboat, but we went with the big luxury boat.
The tour was still good, and they offered a free transfer to the airport for us and that was very kind I thought that it was handled okay.
Our transfer back the airport was without struggles"
Ryan Kiel
United states 13 April 2018
"Best agency from Thailand everything good"
loic Revis
France September 2018