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be in line for(redirected from am in line for)
be in line for
To be a likely recipient of something, such as a job or award. I'm pretty sure I'm in line for Connie's position once she retires. My daughter is a great student, so she's in line for many academic awards at graduation.
See also: line
be in line for something
COMMON If you are in line for something, it is likely to happen to you or you are likely to get it. Izzy's in line for a presenter's job. He had been at the paper for long enough to be in line for a lifetime achievement award.


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See Tim Burton's off-beat fairy tale tonight at Citi Pond at Bryant Park for the third installment in our Winter Film Festival. New York Times critic Janet Maslin noted the high and low points of the film in her original 1990 review, paying homage to Mr. Burton's vast imagination and far reaching attempts to create a dark, surreal wonderland.
Edward Scissorhands
By Janet Maslin
December 7, 1990
At the far end of a suburban enclave, where the houses huddle together like a candy-colored wagon train, there stands a monument to lonely genius. Atop a forbidding gray mountain, in yet another of the strange and ingenious outposts that the heroes of Tim Burton's films ("Batman," "Beetlejuice," "Pee-wee's Big Adventure") call home, Edward Scissorhands lives in isolation. He uses his extraordinary gifts to create magical artworks that, he imagines, no one will ever see.
Edward has apparently hidden here for a long time, with nary a trip to the grocery store. But one day, as seems perfectly reasonable in the ripe, fanciful pop universe in which "Edward Scissorhands" unfolds, a thoughtful Avon lady (Dianne Wiest) pays a visit. Seeing Edward, she immediately grasps that he has a problem and sweetly imagines that it can be solved with kindness, not to mention the makeup base of exactly the right hue. So the Avon lady brings the outcast back to her home, where he amazes the neighbors with his rare feats of snippery. He's a wizard when it comes to poodles.
In a sense, Mr. Burton is too. His "Edward Scissorhands" is as crazily single-minded as a majestic feat of dog barbering, with much the same boldness, camp ebullience and fundamentally narrow wit. Like a great chef concocting an exquisite peanut butter-and-jelly sandwich, Mr. Burton invests awe-inspiring ingenuity into the process of reinventing something very small. In the case of "Edward Scissorhands," which opens today at the Ziegfeld, that something is a tale of misunderstood gentleness and stifled creativity, of civilization's power to corrupt innocence, of a heedless beauty and a kindhearted beast. The film, if scratched with something much less sharp than Edward's fingers, reveals proudly adolescent lessons for us all.
On, then, to the better side of "Edward Scissorhands": the tremendous cleverness with which Mr. Burton brings these ideas to life. As embodied by Johnny Depp, Edward himself is a stunning creation, with a blackish cupid's-bow mouth and plaintive expression to offset his fright hairdo, abundant scars and potentially lethal hands.
Those hands, which quiver uncontrollably when Edward experiences strong emotion, are the one aspect of the young man that his creator (played by Vincent Price, who was a hero of Mr. Burton's when the director was still a young Disney animator) neglected to complete. The inventor died just before he could equip Edward with human hands, thus leaving him with these scissor-bladed prototypes. They make a great sight gag, if not a great metaphor.
As in each of Mr. Burton's films, the production design is the central good idea, perhaps even the sole one. This time, with production design by Bo Welch ("Beetlejuice") and cinematography by Stefan Czapsky, it involves bright colors in unlikely combinations, for instance, a lavender-suited Avon lady driving a dandelion-yellow car) and fashionably ridiculous late-1950's artifacts placed prominently throughout the characters' bunkerlike homes. On the lawns of these houses, more and more of Edward's singular topiaries -- in the forms of a ballerina, a penguin, a set of bowling pins and so on -- begin to appear.
It is very much in keeping with the film's fearless, defiant illogic that these shrubbery sculptures should appear where no shrubs grew before. Similarly, the film makes no bones about depicting Winona Ryder as a white-haired granny in the not noticeably futuristic prologue, and as a high school girl, circa 1960, when most of the action takes place. Ms. Ryder, in the former capacity, promises to explain to a grandchild what the story of Edward Scissorhands has to do with snowfall. It's also in keeping with the film's reasoning that the explanation for this, when finally revealed, isn't nearly as interesting as promised.
Ms. Ryder plays Kim Boggs, the daughter of the Avon lady, Peg, and a dryly deadpan patriarch (played by Alan Arkin). As lovely as she is diffident, she makes an enchanting Beauty to Mr. Depp's poignant, bashful Beast. When Edward first arrives in suburbia, he is so flustered that he scares Kim away. (He also inadvertently punches holes in her waterbed.) But he soon becomes part of the household and part of the community, despite insensitive questions -- like "Do you know about bowling?" -- from the locals.
Soon Edward is so much at home that he is virtually a household convenience, helping Peg snip threads when she sews. He also becomes extremely popular with the women of the neighborhood, some of them fascinated by his knack for inventing odd haircuts, and one (played with funny flamboyance by Kathy Baker) especially interested in discovering his other talents. The women in the film, with the exceptions of Peg and Kim, are ninnies, but the men are no more flatteringly presented. Kim's boyfriend (Anthony Michael Hall) is a lout, a bully and the cause of Edward's eventual undoing.
Among the film's more haunting visual touches, all of which linger much longer than the possible reasons for their inclusion, are the peculiar shrinelike assemblage of clippings in Edward's fireplace; the bladelike beams that open a hole in his roof to the heavens and the inventor's cherished machinery, so pleasantly antiquated that the machines seem to have animal faces. The traces of warmth that spring up unexpectedly, even in the sequence that finds Edward and Kim amid snow and ice, are what save "Edward Scissorhands" from its own potential archness and give it the sweetness of a bona-fide fairy tale.
Monday, February 6, 2012
Classic Film Reviews: Edward Scissorhands
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FLO TV available for partnership opportunities
After admitting that FLO TV had not met Qualcomm's expectations with regard to consumer adoption, CEO Paul Jacobs said the company was open to partnership opportunities or outright sale of the mobile broadcast unit. At the company's developer conference in San Diego, Jacobs again said that FLO TV's future is in expanding beyond broadcast to become a general data delivery platform for connected devices.
FLO TV President Bill Stone also mentioned electronic magazine delivery as a possible future revenue stream for the company and that Qualcomm is developing an add-on antenna for a wide range of phones, giving consumers the chance to receive FLO TV service without a dedicated FLO device. The lack of enough FLO TV-compliant handsets has been a problem throughout the company's history.


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Happy Valentine week Craftwell Fans!!!
I made a fun Hugs and Kisses (X's & O's) Game Box for my grand kids and hope to inspire you to create a few for your family or make as gifts!!!!
I began by painting the inside an out of a 8" x 8" Matchbox.
Once dry ... cut one side of the top of box so it will be easier to get into the game box to play.
Cover the sides of the box inside and out using pretty Valentine Paper.
I used Graphic 45 Mon Amour Collection.
Die cut nine 2" square red squares from card stock.
Run them through your Craftwell Cut N Boss using Teresa Collins So In Love Embossing Folder.
Run border strips and embossed squares through the Xyron Creative Station.
Adhere to the bottom of the box in rows of 3.
Die cut X's & O's from pattern paper using the platform, shim, metal plate and two A plates.
Run through Craftwell's Cut N Boss.
Change the permanent adhesive to the laminate cartridge.
Laminate the X's and O's.
Cut around each piece with scissors to separate.
Your game is ready to play and game pieces are protected.
Decorat a small premade envelop to place all the game pieces in,
it will help to keep them together also.
To decorate the top of the Hugs and Kisses Game Box...
First, die cut doily and star from the Teresa Collins Lover's Lane Pocket Die Set
using the platform, shim, metal plate and two A plates.
Also the Heart Border...
Adhere to top of prepared box.
Add the Love Heart to top with pop dots.
Add key and enamel dots to top.
Place some fun metals to form the closure along with ribbon to tie the box together once the game board has been set inside.
Adhere the heart banner to top of the box top along with a few buttons to finish decorating the top of the Hugs and Kisses Game Box.
I hope you enjoyed my Hugs and Kisses Game Box and remember this is to inspire you!!!
So think of other games you might be able to create not just for Valentines but other holidays and birthdays. My next one is a rendition of Connect Four!!!
Craftwell Design Team
I'm so happy to be a Craftwell Design Team Member and help promote their wonderful products. They so generously supply us with so many fabulous dies, embossing folders and Cut N Boss Die Cutting Machine to work with like those that I'm using today.
Follow Craftwell:
Pinterest: https://www.pinterest.com/teamcraftwell/
Instagram: https://instagram.com/craftwell/Twitter: https://twitter.com/Craftwell


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Macedonia's Digital Muck-Up: Politics as Usual Means "No TV for You!"
15 March 2016 By Zaklina Hadzi-Zafirova and Xhelal Neziri
Digitization of broadcasting was hoped by many in Macedonia to pave the way for new voices to enter the media market. Instead, a digital dictatorship was established.
The 35 residents of the village Novo Selo, in Demir Hisar municipality in southwestern Macedonia, do not have much choice on their TV sets. They learn about what is happening beyond their homesteads solely from the three channels aired by the country's public broadcasting service, MRTV, including one parliamentary channel showing essentially what lawmakers discuss in Skopje, the country's capital city.
People invested in new devices in anticipation of what was supposed to be a digital revolution. As of 1 June 2013, households with older models of TV sets in Macedonia had, in fact, to buy new devices to be able to capture TV signals as, according to the state plan for digital migration, transmission in analog signal was discontinued. In short, without a new device set owners would not have been able to watch TV anymore.
In Macedonia, a country in which most mainstream media are strictly controlled by the government, many people dreamed about what digital TV would bring them: not only new ways to search for programs, sparkling TV images and even the opportunity to shop online, but what swathes of viewers are missing most: more voices on television and better journalistic content.
But the people in Novo Selo are still denied even minimal benefits of digitization. And they are not alone.


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Arvada Center Blog
Arvada Center Voted "Best Local Theater"
Arvada Center
Best Local Theater
The Arvada Center for the Arts and Humanities is far and away the winner by voters. The center has produced memorable plays for years and continues to raise the bar with difficult productions that require advanced staging such as "Miss Saigon" (complete with the iconic helicopter scene). READ MORE HERE
King of rock 'n' roll painting… (Associated Press)
King of rock 'n' roll painting gets own exhibit
By CATHERINE TSAI, Associated Press Writer
Friday, July 16, 2010 at 2:46 a.m.
ARVADA, Colo. — Billed as the two-fisted art attack, painter Denny Dent made his name creating quick-draw portraits to live music, sometimes before thousands of concertgoers.
Using as many as three brushes in each hand, Dent splashed paint over sprawling canvases and himself, with subjects ranging from Jimi Hendrix to John Lennon to President Bill Clinton.
Dent was more a performance artist than studio painter…
CLICK HERE to read the full article.
"All Shook Up" is a hunka summertime fun
By John Moore – Denver Post Theater Critic
Posted: 07/15/2010 01:00:00 PM MDT
For the sake of civility and expediency, what say we dispense with (most of) the many reasons recycled tripe like the Elvis knockoff "All Shook Up" is the scourge of the contemporary American musical.
It's also fun. Maddeningly and begrudgingly. And, as they say in both theater and youth soccer: "If you had fun, you won."
Even though exploiting existing song catalogs from the Four Seasons to Green Day is the most bottom-feeding, laziest form of artistic creation, there's nothing lazy — not a single thing —
CLICK HERE to Read the Full Review
Elvis lives again in Arvada's 'All Shook Up'
July 14th, 2010, 4:38 pm · Post a Comment · posted by twallinger
Grade: B+
The press release describes it as "Twelfth Night†meets "Music Man†meets "Pleasantville.†As I was watching it, I was thinking "Footloose†meets "As You Like It†with some "Romeo and Juliet†and "A Midsummer Night's Dream†mixed in.
No, the show is not exactly original. But it is a whole lot of fun. And that makes it the perfect musical for these lazy, laid-back days of summer.
CLICK HERE to Read the Full Review
Takashi Nakazato coming to Arvada Center
For all you Takashi Nakazato fans… Takashi will arrive in Denver on July 16th, and will probably come to the Arvada Center late that day. He will be working in the ceramics studio for a week, starting on July 17th. We will not be offering a workshop from Takashi this year, BUT he is always open to having people come to the studio to watch him work. (And if you have not seen the man work his magic, it truly is a must see!)
Arvada Center Presents Figurative Sculptor Esther Shimazu, July 20
Esther Shimazu, a figurative sculptor from Hawaii, will present a lecture and visual presentation on her work at the Arvada Center on Tuesday, July 20, at 7:00 p.m. in studio 24B. There is no charge and the public is welcome.
For information on the artist:
"Most of the imagery is of bald, nude chunky Asian women, unconcerned about clothing and hairdo, comfortable in their own skins. There is the occasional male figure or companion animal. All invite the viewer to play, but underneath, there's a hint that they might bite.†– John Natsoulas, Center for the Arts
Channel 12
In Focus with Eden Lane
Sunday, June 27 at 11:00 pm on Channel 12.1
Eden Lane gets all the details on the Arvada Center's "Centerfest" part of Summer at the Center. Mark Arnold gives us the rundown on the local artists, and a glimpse of the national acts coming to the amphitheater. (READ MORE HERE)


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Looking For An Adventurous Dining Experience in Paraty?
May 16, 2011
You really work up an appetite after swinging from ropes and splashing around the waterfalls!! So why not extend your adventurous day of experiences by heading to Villa Verde for lunch! To get there, you have to walk across Indiana Jones style rope bridge (see below)
Once you make it across get ready to be enchanted by the beautiful gardens, full of floral and fauna. The bungalow style restaurant structure allows for a perfect view from any location. The menu has a number of delectable options, we went for the fresh made pesto pasta (best I have had since I got to Brazil) and the Brazilian style ribs with banana farofa.
Enjoy your meal while listening to the waterfalls cascading in the background then take a walk around the beautiful property before heading back on the road. A truly adventurous dining experience!


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The Book Report Network
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The longest and most expensive journey you will ever make is the one to yourself. Some people never even purchase a ticket. Some only get halfway. Some stand like Moses glimpsing the Promised Land. For some, that's about as good as getting there.
Award-winning author Jill McCorkle takes us on a splendid journey through time and memory in this, her 10th work of fiction. LIFE AFTER LIFE is filled with a sense of wonder at our capacity for self-discovery at any age. And the residents, staff and neighbors of the Pine Haven retirement center (from 12-year-old Abby to 85-year-old Sadie) share some of life's most profound discoveries and are some of the most true-to-life characters that you are ever likely to meet in fiction.
There's retired third-grade teacher Sadie Randolph, who has taught every child in town and believes we are all eight years old in our hearts; Stanley Stone, a prominent lawyer, now feigning dementia to escape life with his son; Marge Walker, the town's self-appointed conveyor of social status, who keeps a scrapbook of every local murder and heinous crime; Rachel Silverman, recently widowed, whose decision to leave her Massachusetts home and settle at Pine Haven is a puzzle to everyone but her; C.J., the pierced and tattooed young mother who runs the beauty shop; and Joanna Lamb, the hospice volunteer who discovers that her path to a good life lies in helping people achieve good deaths. As each character begins to connect with another, the mysteries and consequences of their lives are revealed. What they eventually learn about themselves and one another will profoundly transform them all.
Delivered with her trademark wit, Jill McCorkle's constantly surprising novel illuminates the possibilities of second chances, hope, and rediscovering life right up to the very end. With LIFE AFTER LIFE, she has conjured up an entire community that reminds all of us that grace and magic can --- and do --- appear when we least expect it.
-Click here to read more about the book.
-Click here to read an excerpt.
-Click here to visit the book's website.
*If you are experiencing problems with the contest form, click here.
Copyright © 2020 The Book Report, Inc. All Rights Reserved.


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Adrenal insufficiency ranges from mild nonspecific symptoms to life-threatening shock condition. Adrenal insufficiency is a diagnosis that will not be made unless the clinician maintains a level of suspicion. The decreasing or suppressed adrenal function may be masked until stress or illness triggers an adrenal crisis.[1][2][3]
An important distinction in these patients is the presence of mineralocorticoid deficiency. Those with secondary or tertiary adrenal insufficiency will typically have preserved mineralocorticoid function due to the separate feedback systems. Mineralocorticoid levels are regulated by the renin-angiotensin system, independent of hypothalamic or pituitary signals.
Another important distinction is acute versus chronic nature of the disease. Acute adrenal insufficiency patients often present in a critically ill state while chronic presentations can be insidious.
Most cases of Addison disease are iatrogenic and caused by long-term administration of glucocorticoids, which suppress the feedback mechanisms. This suppression can be so severe that during a stress period, the brain and adrenal gland may not be able to respond adequately. Alternatively, if the exogenous glucocorticoids are discontinued without a taper, the patient may have an adrenal crisis.[4]
The most common cause of primary adrenal insufficiency relates to autoimmune damage to the adrenal cortex. Other insults to the adrenal gland that lead to primary insufficiency include adrenal hemorrhage, cancer, infections (HIV, syphilis, TB, bacterial), and certain drugs such as etomidate, ketoconazole, fluconazole, metyrapone. Phenytoin and rifampin increase metabolism of cortisol and can, therefore, precipitate adrenal insufficiency in those predisposed.
Adrenal hemorrhage can occur in patients on anticoagulation medications or a bleeding diathesis, or in the postoperative setting.
Primary adrenal insufficiency can also be congenital. Congenital adrenal hyperplasia has been extensively studied and described in the literature. Panhypopituitarism and many genetic conditions can cause adrenal insufficiency. Pituitary hemorrhage or infarction (Sheehan syndrome) can cause secondary adrenal insufficiency.
As many as 144 million individuals in the developed world may have Addison disease. When treated properly, patients can have a roughly normal lifespan. Untreated patients have a high mortality rate.[5][6]
The autoimmune form of adrenal insufficiency and has male-female predisposition based on the type of autoimmune condition. Females are more likely to have the polyglandular form while isolated adrenal damage is more common in males in the first two decades. By the fourth decade, the isolated form is more common in women.
Due to the diverse causes of adrenal insufficiency, no distinct group of individuals is at increased risk of disease.
The epidemiology of adrenal insufficiency in children is not well-defined. Congenital adrenal hyperplasia (CAH) is the most common etiology of primary adrenal insufficiency in children, occurring once in 14,200 live births.
The pathophysiology of adrenal insufficiency depends on the etiology. With most forms of autoimmune (primary) adrenal insufficiency, the patient has antibodies that attack various enzymes in the adrenal cortex (though cell-mediated mechanisms also contribute).
Secondary adrenal insufficiency refers to decreased adrenocorticotropic hormone (ACTH) stimulation of the adrenal cortex and therefore does not affect aldosterone levels. Traumatic brain injury (TBI) and panhypopituitarism are common causes.
Tertiary adrenal insufficiency refers to decreased hypothalamic stimulation of the pituitary to secrete ACTH. Exogenous steroid administration is the most common cause of tertiary adrenal insufficiency. Surgery to correct Cushing disease can also lead to tertiary adrenal insufficiency.
The other forms of adrenal insufficiency usually relate to destruction by infectious agents, or infiltration my metastatic malignant cells. Hemorrhagic infarction occurs due to sepsis with certain organisms (Neisseria species, tuberculosis, fungal infections, Streptococcus species, Staphylococcus species) or due to adrenal vein thrombosis. Death associated with adrenal insufficiency is usually of septic shock, hypotension, or cardiac arrhythmias.
Patients with adrenal insufficiency often present with hypotension, altered mental status, anorexia, vomiting, weight loss, fatigue, and recurrent abdominal pain. Reproductive complaints typically occur in women (amenorrhea, loss of libido, decreased axillary, and pubic hair). Salt craving and orthostatic hypotension are common in patients with primary adrenal insufficiency, due to the volume depletion from the reduced mineralocorticoid function. Obtaining a history of exogenous corticosteroid use is crucial in making the diagnosis, especially in cases of chronic adrenal insufficiency.
Patients may have poor skin turgor and increased skin pigmentation. Patients may also manifest neuropsychiatric signs and symptoms. One might notice signs of Cushing syndrome, such as skin atrophy, striae, edema, obesity, muscle wasting, and neuropsychiatric disturbance.
As many as half of the patients will develop shock with no preceding hypotension. Hypotension can be present in any form of adrenal insufficiency. Fever should lead to investigation for infectious etiology, although it can be present in any form of adrenal insufficiency.
Diagnosis of primary adrenal insufficiency requires suspicion. Hyponatremia with hyperkalemia and hypoglycemia may be present. Serum cortisol, ACTH, renin, aldosterone, and chemistry panel should be obtained early. Serum cortisol levels can help make diagnoses in the presence of elevated ACTH and plasma renin activity. The ACTH test can be performed to determine if the cause is central or peripheral.[7]
Patients with secondary adrenal insufficiency are more likely to have hypoglycemia, but will not have dehydration, hyperkalemia or skin hyperpigmentation.
Consider testing for HIV and tuberculosis in patients with unclear etiology.
The most common laboratory findings in chronic primary adrenal insufficiency are anemia, hyponatremia, and hyperkalemia.
The treatment of Addison disease is glucocorticoid replacement. If the infection is the inciting event of a crisis or the cause of primary adrenal failure, it must be treated aggressively. Patients in shock will require intravenous hydration and often, dextrose.[8][9][10]
In patients with established adrenal insufficiency, hydrocortisone is the treatment of choice, with 100 mg IV every 8 hours being the standard dose. Hydrocortisone has some mineralocorticoid effect in case the patient has deficient aldosterone. In an undiagnosed patient, dexamethasone (4 mg initial bolus) should be used, as this does not interfere with cortisol assays. Mineralocorticoid replacement with fludrocortisone may be required but is not usually necessary in an acute adrenal crisis.
If patients with adrenal insufficiency require surgery, a stress dose of glucocorticoids must be given and continued for 24 hours after the procedure.
As mentioned above, patients in adrenal crisis manifest nonspecific symptoms and therefore can be difficult to diagnose. Those physicians who prescribe the glucocorticoids such as prednisone must also be aware of the need to limit the length of time the patient is on the medication and taper when discontinuing.
Adrenal insufficiency is a life-threatening disorder which if not recognized can lead to very high morbidity and mortality. Because of the varied presentation, it is best managed by an interprofessional team that consists of an endocrinologist, radiologist, an infectious disease specialist, intensivist, critical care nurse, and a pharmacist. While the cause of adrenal insufficiency is being investigated, the patient should immediately be managed with corticosteroids and mineralocorticoids because even with treatment, mortality rates remain high. The pharmacist should assist with medication reconciliation and appropriate dosing. Once treatment is initiated patients need close monitoring by a specialty trained critical care nurse with open and rapid communication to the clinicians. Any type of infection or stress can precipitate adrenal crises leading to death, hence patients and families should be educated by the nurses about the symptoms and when to return immediately to the emergency department. Finally, all patients with a diagnosis of adrenal insufficiency should be urged to wear a medical ID bracelet. [11][12](Level V)
|Ceccato F,Scaroni C, Central adrenal insufficiency: open issues regarding diagnosis and glucocorticoid treatment. Clinical chemistry and laboratory medicine. 2018 Nov 14 [PubMed PMID: 30427776]
|Shaffer ML,Baud O,Lacaze-Masmonteil T,Peltoniemi OM,Bonsante F,Watterberg KL, Effect of Prophylaxis for Early Adrenal Insufficiency Using Low-Dose Hydrocortisone in Very Preterm Infants: An Individual Patient Data Meta-Analysis. The Journal of pediatrics. 2018 Nov 8 [PubMed PMID: 30416014]
|Kang TS,Choi HY,Park SH, Adrenal Insufficiency in a Patient with Acute Myocardial Infarction Plus Shock. Korean circulation journal. 2018 Dec [PubMed PMID: 30403022]
|Harbeck B,Lehnert H, [Diagnosis and Management of Adrenal Insufficiency]. Deutsche medizinische Wochenschrift (1946). 2018 Sep [PubMed PMID: 30231280]
|Rushworth RL,Torpy DJ,Stratakis CA,Falhammar H, Adrenal Crises in Children: Perspectives and Research Directions. Hormone research in paediatrics. 2018 [PubMed PMID: 29874655]
|Meyer G,Badenhoop K, [Addisonian Crisis - Risk Assessment and Appropriate Treatment]. Deutsche medizinische Wochenschrift (1946). 2018 Mar [PubMed PMID: 29544234]
|Cole S, Evaluation and Treatment of Adrenal Dysfunction in the Primary Care Environment. The Nursing clinics of North America. 2018 Sep [PubMed PMID: 30100004]
|Nour MA,Gill H,Mondal P,Inman M,Urmson K, Perioperative care of congenital adrenal hyperplasia - a disparity of physician practices in Canada. International journal of pediatric endocrinology. 2018 [PubMed PMID: 30214458]
|Yamamoto T, Latent Adrenal Insufficiency: Concept, Clues to Detection, and Diagnosis. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. 2018 Aug [PubMed PMID: 30084678]
|Groleau C,Morin SN,Vautour L,Amar-Zifkin A,Bessissow A, Perioperative corticosteroid administration: a systematic review and descriptive analysis. Perioperative medicine (London, England). 2018 [PubMed PMID: 29977522]
|Annane D,Pastores SM,Rochwerg B,Arlt W,Balk RA,Beishuizen A,Briegel J,Carcillo J,Christ-Crain M,Cooper MS,Marik PE,Umberto Meduri G,Olsen KM,Rodgers S,Russell JA,Van den Berghe G, Guidelines for the diagnosis and management of critical illness-related corticosteroid insufficiency (CIRCI) in critically ill patients (Part I): Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM) 2017. Intensive care medicine. 2017 Dec [PubMed PMID: 28940011]
|Guignat L, Therapeutic patient education in adrenal insufficiency. Annales d'endocrinologie. 2018 Jun [PubMed PMID: 29606279]


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Sen. Jeff Flake gives "maiden speech"
Arizona's newest senator, Republican Jeff Flake, gave his first speech to the Senate Tuesday. Among the items he addressed, bipartisanship was the focus.
Republican Sen. Jeff Flake of Arizona (Photo courtesy of the Office of Senator Jeff Flake)
"There is a time and a place for using super-majority rules to block legislation and/or nominees from coming to the Senate floor, "said Flake. "There is a time and a place for partisanship, but not every time and not every place."
Flake included that the time the senators have together should be more constructive.
"There are profound and meaningful differences between the parties," said Flake. "But I want to spend more time exercising my franchise, while debating the legislation itself, and less time on whether the legislation should be debated on the Senate floor."
Foreign and domestic issues, such as terrorism and transparency, were also identified by Flake. He advocated for tighter legislation on federal agencies, such as the Internal Revenue Service.
"The parade of missteps and abuses of the IRS and other federal agencies stand as exhibit A for more robust legislative and direction oversight," said Flake.
Flake is the 10th senator from Arizona to serve for the United States. He joins Sen. John McCain.
Click here to listen to Flake's entire speech.


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You may have noticed we are working to update our website. We will be moving some items around and adding new categories. If you are browsing on Internet Explorer, the drop down menus may not be working for you at this time. We hope to have this issue cleared up soon, but in the meantime you can do the following to correct the problem . . .
Go to "tools"
Select "internet options"
Then "delete browsing history"


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"Looking unto Jesus the author and finisher of our faith." Hebrews 12:2
Be careful of making a savior of faith. There is a danger, and it cannot be too vigilantly guarded against, of substituting the work of the Spirit for the work of Christ; this mistake it is that leads so many of God's saints to look within, instead of outside of themselves, for the evidences of their calling and acceptance; and thus, too, so many are kept, all their spiritual course, walking in a state of bondage and fear, the great question never fully and fairly settled; or, in other words, never quite sure of their sonship. The work of Christ is a great and finished work; it is so glorious that it can admit of no comparison, so complete that it can allow of no addition, and so essential that it can give place to no substitution. Precious as is the work of the Holy Spirit in the heart, and essential as it is to the salvation of the soul, yet he who places it where the work of Jesus ought only to be, deranges the order of the covenant, closes up the legitimate source of evidence, and will assuredly bring distress and uncertainty into his soul. "Righteousness, peace, and joy" are the fruit of a full belief in the Lord Jesus Christ, and he who looks for them away from the cross will meet with disappointment; but they are found in Jesus. He who looks away from himself, from his vileness, guiltiness, emptiness, and poverty, fully, and believingly unto Jesus, shall know what the forgiveness of sin is, and shall experience the love of God shed abroad in his heart.
If, then, your faith is feeble and tried, do not be cast down. Faith does not save you; though it be an instrument of salvation, and, as such, is of vast importance, it is but the instrument. The finished work of Immanuel is the ground of your salvation, yes, it is your salvation itself. Then, make not a savior of your faith; despise it not if it is feeble, exult not in it if it is strong, trample not on it if it is small, deify it not if it is great: such are the extremes to which every believer is exposed. If your faith is feeble and sharply tried, it is no evidence that you are not a believer; but the evidence of your acceptance in the Beloved is to arise from Jesus alone; then let your constant motto be, "looking unto Jesus;" looking to Him just as you are; looking unto Him when faith is feeble; looking unto Him when faith is tried; looking unto Him when faith is declining; yes, looking unto Him when you fear you have no faith. Look up, tried and tempted soul! Jesus is the Author, the Sustainer, and He will become the Finisher of your faith. All you need is in Him; one glimpse, dim though it be, of His cross, one touch, trembling though it be, of His garment, will lift you from your lowest depths, lighten your heaviest burden, gild your darkest prospect, and when you arrive at Jordan's brink, will bear you safely through its swellings, and land you on the sunny and verdant shores of Canaan.


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NNPC FORENSIC AUDIT REPORT BY PwC
• Total gross revenues generated from FGN crude oil liftings was $69.34bn and NOT $67 billion as earlier stated by the Reconciliation Committee for the period from January 2012 to July 2013.
• Total cash remitted into the Federation accounts in relation to crude oil liftings was $50.81bn and NOT $47bn as earlier stated by the Reconciliation Committee for the period from January 2012 to July 2013.
• NNPC has provided information on the difference leading to a potential excess remittance of $0.74 billion (without considering expected remittances from NPDC). Other indirect costs of $2.81billion which were not part of the submission to the Senate Committee hearing have been defrayed to arrive at this position.
• The resulting potential excess remittance indicates that the Corporation operates an unsustainable model. Forty six percent (46%) of proceeds of domestic crude oil revenues for the review period was spent on operations and subsidies. The Corporation is unable to sustain monthly remittances to the Federation Account Allocation Committee (FAAC), and also meet its operational costs entirely from the proceeds of domestic crude oil revenues, and have had to incur third party liabilities to bridge the funding gap. Furthermore, the review period recorded international crude oil prices averaging $122.5 per barrel (Average Platts prices for 2012). As at the time of concluding this report, international crude oil prices average about $46.07 per barrel2, which is about sixty two percent (62%) reduction when compared to the crude oil prices for the review period. If the NNPC overhead costs and subsidies are maintained (assuming crude oil production volumes are maintained), the corporation may have to exhaust all the proceeds of domestic crude oil sales, and may still require third party liabilities to meet costs of operations and subsidies, and may not be able to make any remittances to FAAC.
• We therefore recommend that the NNPC model of operation must be urgently reviewed and restructured, as the current model which has been in operation since the creation of the Corporation cannot be sustained.
• The report reflects the fact that $3.38 billion was spent on DPK subsidy for the review period. We also confirmed using third party vessel tracking platforms that all vessels carrying NNPC cargoes arrived in Nigeria within the periods disclosed by PPPRA.
• A major consideration centers on the ownership of oil and gas assets controlled by NPDC. Subject to additional information being provided, we estimate that the NNPC and NPDC should refund to the Federation Account a minimum of $1.48billion as summarised in the next page.
• A determination is required as to whether all or a portion of 'other costs not directly attributable to crude oil operations can be defrayed by NNPC.
• $0.98 billion over claim of subsidy by NNPC
Our review of the subsidy documentation revealed that the subsidy due to NNPC between January 2012 and July 2013 on PMS and DPK import was $8.99billion compared to the $9.97 billion stated by the Reconciliation Committee. The difference was due to the following:
o Exclusion of October 2011 - December 2011 subsidy claims of $1.2billion. This does not relate to the review period of January 2012 to July 2013.
o $0.13billion increase in PMS subsidy claimed for the 19 months period. o $0.09billion increase in DPK subsidy claimed for the 19 months period
• Duplicated discharges noted in subsidy computations
Our examination of the PMS and DPK import verified by PPPRA revealed that some discharges were apparently verified and subsidy advised to NNPC more than once.
The repeated subsidy for PMS amounted to N3,709,879,190 ($23,954,796).
The repeated subsidy for DPK amounted to N6,169,502,266 ($39,836,652).
• $36.05 million over-statement in PPPRA's PMS subsidy Payment Advice to NNPC
o Our review of the Subsidy Payment Advice sent by PPPRA to NNPC for discharges between January 2012 and July 2013 revealed that PPPRA applied the pre-2012 Ex-Depot Price (N49.51) on some discharges in 2012 instead of the approved Ex-Depot Price of N81.51.
o A total of 174,449,778 litres of PMS was affected in these PPPRA computations.
o The error in computation resulted in an over-statement of PMS subsidy by N5.6 billion ($36.05 million).
• Estimated $205 million DPK subsidy over-charge by NNPC
o Our review of a sample of the copies of the Pro Forma Invoices (PFIs) issued to the other marketers of DPK across different geopolitical zones of Nigeria, revealed that the 0ther marketers bought DPK from NNPC/PPMC prior to arrival at NNPC depot in Nigeria at N40.90.
o The marketers are thereafter required to incur the Lightering expenses10, NPA charges, Jetty Throughput Charge and Storage Charges before bringing the product into Nigeria.
o Subsidy is calculated as Landing Cost minus Ex-Depot Price;


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Phil's Quick Capsule Review:
Academy and BAFTA winning animated feature Spider-Man: Into The Spider-Verse could well be the best Spider-Man film yet. Yup I know Spider-Man 2 was superb and Homecoming was a real return to form after the more forgettable Sony efforts but Into The Spider-Verse is just so much… everything. It's fun, has a great soundtrack, its funny, the animation is stand out with a great voice cast and killer set pieces. It has heart, surprises, delivers a top draw story and it's pace never lets up but also never outstays it's near two hour run time. In short Spider-Man: Into The Spider-Verse out Marvel's Marvel and offers Lord & Miller reception after their recent Star Wars issues! Near perfect (and finally Spider Redemption for Sony)
Best Bit: Sticky!
Buy, Stream, Avoid: Buy
If You Liked this Try: Spider-Man 2, Spider-Man: Homecoming, Spider-Man
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Phil Hobden is the former Film Editor & Writer for renowned martial arts focused COMBAT MAGAZINE in the UK. He is also a filmmaker in his own right, having produced two cult Independent action films in LEFT FOR DEAD and TEN DEAD MEN. He was the host for the award nominated Filmsploitation podcast for 4 years, currently co-hosts Ross And Phil Talk Movies and is a writer/editor for his own blog Phil's Quick Capsule Review…


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- 1 Definition
- 2 History
- 3 Components
- 4 Types of Recording Electrodes
- 5 Placement of electrodes
- 6 Preparation of the patient
- 7 Normal ERG responses under scotopic and photopic conditions
- 8 Factors affecting the ERG
- 9 Types
- 10 Abnormalities in various disease states
- 11 References
The electroretinogram (ERG) is a diagnostic test that measures the electrical activity generated by neural and non-neuronal cells in the retina in response to a light stimulus. The electrical response is a result of a retinal potential generated by light-induced changes in the flux of transretinal ions, primarily sodium and potassium. Most often, ERGs are obtained using electrodes embedded in a corneal contact lens, which measure a summation of retinal electrical activity at the corneal surface. The International Society for Clinical Electrophysiology of Vision (ISCEV) introduced minimum standards for the ERG in 1989. The ERG can provide important diagnostic information on a variety of retinal disorders including, but not limited to congenital stationary night blindness, Leber congenital amaurosis, and cancer-associated retinopathy. Moreover, an ERG can also be used to monitor disease progression or evaluating for retinal toxicity with various drugs or from a retained intraocular foreign body.
The first known recording of an ERG was performed on an amphibian retina in 1865 by the Swedish physiologist Alarik Frithiof Holmgren. James Dewar of Scotland subsequently performed it in humans in 1877, however widespread clinical application did not occur until 1941, when American psychologist Lorin Riggs introduced the contact-lens electrode. In 1908, Einthoven and Jolly separated the ERG response into three components: a-wave, b-wave, and c-wave, which are further described below. Many of the observations and analyses that serve as the basis for understanding the ERG components today were conducted by Ragnar Granit for which he won the Nobel Prize for Physiology and Medicine in 1967. Granit's studies were primarily conducted on dark-adapted, rod-dominated cat retina with which he was able to demonstrate the physiology of the receptor potential of each component of the ERG.
a-wave: initial corneal-negative deflection, derived from the cones and rods of the outer photoreceptor layers
This wave reflects the hyperpolarization of the photoreceptors due to closure of sodium ion channels in the outer-segment membrane. Absorption of light triggers the rhodopsin to activate transducin, a G-protein. This leads to the activation of cyclic guanosine monophosphate phosphodiesterase (cGMP PDE) eventually leading to a reduction in the level of cGMP within the photoreceptor. This leads to closure of the sodium ion channels resulting in a decrease of inwardly directed sodium ions, or a hyperpolarization of the cell. The a-wave amplitude is measured from baseline to the trough of the a-wave.
b-wave: corneal-positive deflection; derived from the inner retina, predominantly Muller and ON-bipolar cells
The hyperpolarization of the photoreceptor cells results in a decrease in the amount of neurotransmitter released, which subsequently leads to a depolarization of the post-synaptic bipolar cells. The bipolar-cell depolarization increases the level of extracellular potassium, subsequently generating a transretinal current. It is this transretinal current that depolarizes the radially oriented Muller cells and generates the corneal-positive deflection. The b-wave amplitude is generally measured from the trough of the a-wave to the peak of the b-wave. This wave is the most common component of the ERG used in clinical and experimental analysis of human retinal function.
c-wave: derived from the retinal pigment epithelium and photoreceptors
The c-wave is a reflection of the resulting change in the transepithelial potential due to the hyperpolarization at the apical membrane of the RPE cells and the hyperpolarization of the distal portion of the Muller cells. The c-wave generally peaks within 2 to 10 seconds following a light stimulus, depending on flash intensity and duration. Due to the c-wave response developing over several seconds, it is susceptible to influences from electrode drift, eye movements, and blinks.
d-wave: off bipolar cells.
Dark adapted Oscillatory potentials: Responses primarily from the amacrine cells/inner retina.
Latency of response refers to the onset of the stimulus to the beginning of the a-wave.
Implicit time or peak time is a measure of the time interval from onset of the stimulus to the peak of the b-wave. For single-flash ERGs, in cases of Xenon flash tube, the duration of flash is less than a milisecond. Light emitting diodes (LEDs) produce longer flashes upto 5 milisecond, and peak time in such cases should be measured from the midpoint of the flash to compensate the effect of flash duration on the peak time, according to the current ISCEV guidelines (2015 update).
Types of Recording Electrodes
- Burian-Allen Electrode- (commonly used electrode for flash ERG) variable lens sizes consisting of an annular ring of stainless steel surrounding the central polymethylmethacrylate (PMMA) contact-lens core with a lid speculum.
- Dawson-Trick-Litzkow Electrode- low-mass conductive Mylar thread consisting of individual fibers impregnated with metallic silver
- ERG-Jet Electrode- a disposable plastic lens with a gold-plated peripheral circumference
- Mylar Electrode- aluminized or gold-coated Mylar
- Skin Electrode- may be used as a replacement for corneal electrodes by placing an electrode on the skin over the infraorbital ridge near lower eyelid; due to decreased amplitudes and variable responses, the skin electrode is primarily used for screening purposes only
- Cotton-Wick Electrode- Burian-Allen electrode shell fitted with a cotton wick which is useful for minimizing light-induced artifact
- Hawlina-Konec Electrode- Teflon-insulated thin metal wire (silver, gold, platinum) with three central windows, 3 mm in length, molded to fit into the lower conjunctival sac
Placement of electrodes
Recording electrodes: over cornea, bulbar conjunctiva or skin of lower eyelid
- Protect corneal surface with non-irritating ionic conductive solution (artificial tears or contact lens solutions containing sodium chloride and no more viscous than 0.5% methyl cellulose)
- Topical anesthesia for contact lens electrodes-
Reference electrodes:
- This electrodes connects to the negative input of the system
- Bipolar electrode- incorporated within the contact lens-speculum assembly- may produce lower amplitude than the monopolar electrode at a separate area
- Monopolar electrodes may be attached to skin near each temporal obrbital rim, avoid placing over muscle masses
Common electrodes:
- Connected to common input of the system
- Earlobe/mastoid/forehead
Preparation of the patient
According to ISCEV 2015 guidelines:
- Maximally dilate the pupils
- Before Dark adapted protocols- 20 min of dark adaptation
- Before light adapted protocols- 10 min of light adaptation
- Present low strength flashes before stronger flashes- so that the partial light adaptation due to bright light does not occur
- Insert corneal contact electrodes (when these are used) under dim red light after dark adaptation period. Avoid strong red light. Allow 5 min of extra dark adaptation after insertion of contact lens electrode.
- Allow at least 30 min recovery time in ordinary room illumination after use of strong light for retinal imaging (fundus photography, fluorescein angiography and others).
- Request the patient to fix and not move eyes. Ocular movements can change the positions of electrodes, can cause blockage of light by eyelids or electrode and may induce electrical artifacts.
ISCEV standard ERG series
This includes 6 protocols named according to the strength of the stimulus in candela. second/square meter (time integrated luminance).
- Dark-adapted 0.01 ERG (a rod-driven response of on bipolar cells).
- Dark-adapted 3 ERG (combined responses arising from photoreceptors and bipolar cells of both the rod and cone systems; rod dominated).
- Dark-adapted 10 ERG (combined response with enhanced a-waves reflecting photoreceptor function).
- Dark-adapted oscillatory potentials (responses primarily from amacrine cells).
- Light-adapted 3 ERG (responses of the cone system; a-waves arise from cone photoreceptors and cone Off- bipolar cells; the b-wave comes from On- and Off-cone bipolar cells).
- Light-adapted 30 Hz flicker ERG (a sensitive cone-pathway-driven response).
Normal ERG responses under scotopic and photopic conditions
The rod and cone photoreceptor function responses can be separated using a variety of ERG techniques. Scotopic (rod) responses are isolated by dark-adaptation for a minimum of 20 minutes per ISCEV standards followed by a short wavelength stimulus as a single flash or 10 Hz flicker. Although the resulting response has rod and cone components, the rod component is dominant and the primary contributor to the increased amplitude and increased implicit time.
Photopic (cone) responses can be obtained either before or after dark-adaptation. Since rods cannot follow a flicker stimulus greater than 20 Hz, cone photoreceptor function is primarily measured under light-adapted conditions for at least 10 minutes with either single flash (stimulus wavelength greater than 680 nm) or 30 Hz flicker stimulus. Photopic responses result in small b-wave amplitudes with a short latency (30-32 ms), whereas scotopic (rod) conditions produce much larger b-wave amplitudes with a longer latency (60 ms).
Oscillatory potentials (OP) are high-frequency, low-amplitude wavelets on the ascending limb of the b-wave with a frequency of about 100 to 160 Hz. Although it is not known for certain, it is suspected that OPs are generated from the amacrine cells located in the inner retina.
Factors affecting the ERG
- Duration of stimulus
- Size of retinal area illuminated
- Interval between stimuli
- Size of pupil
- Systemic circulation and drugs
- Development of Retina
- Clarity of Ocular Media
- Age, Sex, and Refractive Error
- Anesthesia
- Diurnal Fluctuations
Separation of Rods and Cones
Rods and Cones can be separated using ERG in multiple ways:
- After dark adaptation using low flash strength (ISCEV Dark Adapted 0.01 ERG) a rod driven response in documented. After light adaptation, using strong flash cone systems are evaluated (ISCEV Light adapted 3ERG)
- Rods cannot respond to stimulus with a flickering rate of more than 20Hz. Cone response thus can be recorded using ISCEV light adapted 30Hz flicker ERG.
- Peak wavelength sensitivity of rods and cone-groups is different (510 nm and 560 nm respectively). Using specific color filters or colored flashes specific response from a specific system may be recorded.
Reporting of ERG according to ISCEV standards
The reports should include
- At least 20 ms of baseline recording before stimulus for single flash ERGs
- Indicate stimulus time with marker
- At least 2 responses from each stimulus conditions to validate consistency or know the variability
- The time integrated luminance of the stimulus and background in absolute values.
- Include reference values and range
- Any deviations from standard ISCEV protocol
- Time of testing
- Pupil diameter
- Type and position of corneal electrodes
- Any sedation/anesthesia
- Level of compliance
The focal ERG (fERG; also known as the foveal ERG) is used primarily to measure the functional integrity of the fovea and is therefore useful in providing information in diseases limited to the macula. A variety of techniques have been described in the literature for recording fERGs. Differing field sizes varying from 3 degrees to 18 degrees and light stimulus frequencies have been used in the various methods, however each technique deals with the challenge of limiting amount of light scattered outside the focal test area. Focal ERG is useful for assessing macular function in conditions such as age-related macular degeneration, however requires good fixation from the subject. The full-field ERG (Ganzfeld; ffERG) measures the stimulation of the entire retina with a flashlight source under dark-adapted (scotopic) and light-adapted (photopic) types of retinal adaptation.This is useful in detecting disease with widespread generalized retinal dysfunction i.e. cancer associated retinopathy, toxic retinopathies, and cone-rod dysfunction. Due to the massed retinal electrical response, small retinal lesions may not be revealed in ffERG recordings.
The multifocal ERG (mfERG) simultaneously measures local retinal responses from up to 250 retinal locations within the central 30 degrees mapped topographically. This new technology was developed by Erich Sutter in the early 1990s and involves powerful computers and high –intensity display monitors. The light stimuli are presented on a video monitor in one of a large number of arrays consisting of hexagonal elements. The hexagonal elements in the array are distributed so that the focal retinal responses have an approximately equal signal-to-noise ratio. The central hexagons are smaller than those in the periphery. The elements are stimulated in a pseudo-random sequence of light and dark, called a maximum length sequence (or m-sequence). The resulting waveforms are similar to those of the ffERG: initial negative deflection (N1 or a-wave), followed by a positive deflection (P1 or b-wave), and a second negative deflection (N2 or c-wave). MfERGs are useful in detecting localized abnormalities within the retina in conditions such as retinitis pigmentosa, branch retinal artery occlusion, fundus flavimaculatus, and Stargardt's disease. Degree of retinal toxicity related to certain drugs such as hydroxychloroquine or ethambutol is better detected using mfERG compared to ffERG. Early visual field defects due to glaucoma may also be detected sooner using mfERG compared to automated perimetry.
The pattern ERG (PERG) uses pattern-reversal stimuli similar to VEP testing and captures retinal ganglion cell activity predominantly in the N95 waveform component. The PERG is used to detect subtle optic neuropathies. In demyelinating optic neuropathy, the PERG is relatively normal, while it may be abnormal in ischemic optic neuropathies. P50 evaluates the macular function.
Abnormalities in various disease states
| Disease entity
| Full-field ERG findings
| Multifocal ERG findings
| Multiple evanescent white dot syndrome (MEWDS)
| Initially depressed a- and b-wave responses with return to normal values
| Focal areas of retinal dysfunction
| Vitamin A deficiency
| Marked rod dysfunction and elevated threshold of rods and cones on dark adaptation
|Cone dystrophy
|Markedly depressed photopic response and less affected scotopic response
|Cancer associated retinopathy (CAR)
|Significantly reduced a-wave and b-wave amplitudes
|Melanoma associated retinopathy (MAR)
Extinguished rod responses, normal a-wave, reduced b-wave (electronegative ERG)
|Retinitis pigmentosa
|Minimal or sub-normal a- and b-wave amplitudes (response primarily from cone system)
|Congenital Achromatopsia (typical (rod) monochromat)
|Non-detectable cone response, normal or subnormal rod response
|Congenital Achromatopsia (atypical (cone) monochromat)
|Normal ERG responses
|Congenital Red-Green Color Deficiency
|Normal ERG responses
|Congenital Hereditary Stationary Night Blindness (Schubert-Bornschein type)
|Normal scotopic a-wave with selectively reduced b-wave; implicit time of b-wave is approximately the same under scotopic and photopic conditions
|Oguchi disease
|Normal photopic responses with predominantly reduced scotopic b-wave amplitudes
|Fundus Albipunctatus
|Reduced scotopic amplitudes which improve to normal values after longer (variable) perior of dark adaptation
|Fleck Retina of Kandori
|Reduced b-wave amplitudes relative to a-wave in scotopic and photopic conditions
|Stargardt Macular Dystrophy (Fundus Flavimaculatus)
| Extent of reduced a- and b-wave amplitudes depends on extent of fundus pigmentary changes; longer duration of
dark-adaptation may be necessary for scotopic amplitudes to reach normal values
|Best Vitelliform Macular Dystrophy
|Normal ERG responses with an abnormal EOG
|Pattern dystrophies
|Normal ERG responses
|North Carolina Macular Dystrophy
|Normal ERG responses
|Progressive Bifocal Chorioretinal Atrophy
|Subnormal 30-Hz flicker and single-flash scotopic responses
|Fenestrated Sheen Macular Dystrophy
|Initially normal ERG responses with reduced scotopic and photopic responses in later stages
|Familial Internal Limiting Membrane Dystrophy
|Reduced b-wave amplitudes
|Gyrate Atrophy
|Significantly reduced or extinguished rod and cone responses
|Reduced a- and b-wave amplitudes in both scotopic and photopic conditions; increased rod and cone b-wave implicit times
|X-linked Juvenile Retinoschisis
|Reduced photopic and scotopic b-wave amplitudes
|Goldmann-Favre Syndrome
|Non-detectable ERG response
|Wagner Disease
|Normal or mild to moderately reduced photopic and scotopic responses (variable depending on extent of fundus involvement)
|Autosomal Dominant Neovascular Inflammatory Vitreoretinopathy
|Selective reduction of b-wave amplitude
|Autosomal Dominant Vitreoretinochoroidopathy
|Initially normal ERG with only mild to moderately reduced amplitudes in older patients
|Familial Exudative Vitreoretinopathy
|Normal ERG responses (diminished oscillatory potentials may be observed)
|Birdshot Retinochoroidopathy
|Selective reduction in b-wave amplitude more prominent in scotopic than photopic responses; delayed photopic and scotopic b-wave implicit times
|Acute Zonal Occult Outer Retinopathy
|ERG amplitudes vary from normal to subnormal with prolonged b-wave implicit times
|Pseudo-Presumed Ocular Histoplasmosis Syndrome (Multifocal Choroiditis)
|Moderate to severely reduced rod and cone responses
|Behcet Disease
|Initially loss of oscillatory potentials in flash ERG with subsequent reduction of b-wave amplitude
|Sickle Cell Retinopathy
|Normal ERG in the absence of peripheral retinal neovascularization, reduced amplitudes of ERG components when peripheral retinal neovascularization is present
|Takayasu Disease
|Initially decreased oscillatory potentials, later stages involve reduced a- and b-wave amplitudes
|Carotid Artery Occlusion
|Reduced b-wave greater than a-wave amplitudes depending on extent and severity of occlusion
|Central and Branch Artery and Vein Occlusions
|Reduced scotopic b-wave amplitudes in CRAO and CRVOs; slight b-wave reduction or normal ERG in branch retinal artery or vein occlusions
|Hypertension and Arteriosclerosis
|Initially reduced oscillatory potentials followed by reduced a- and b-wave amplitudes
|Chloroquine and Hydroxychloroquine toxicity
|Normal ERG responses unless presence of advanced retinopathy; cone function initially more affected than rod function
|Decreased photopic and scotopic a- and b-wave responses depending on degree of fundus changes
|Transiently decreased a- and b-wave amplitudes under both photopic and scotopic conditions with recovery after 24 hours
|Reduced a- and b-wave amplitudes
|Significantly reduced ERG amplitudes
|Vitamin A deficiency
|Reduced ERG amplitudes particularly under scotopic conditions
|Kearns-Sayre Syndrome
|Reduced ERG amplitudes
|Initially a transient supernormal response then negative pattern followed by non-detectable response in severe cases (rod function more affected than cones; reduction of b-wave amplitude more than a-wave)
- Bach, Michael, et al. "ISCEV standard for clinical pattern electroretinography (PERG): 2012 update." Doc Ophthalmol 126 (2013): 1-7.
- Berrow, Emma J., et al. "The electroretinogram: a useful tool for evaluating age-related macular disease?" Doc Ophthalmol. 121 (2010): 51-62.
- Electrophysiologic Testing in Disorders of the Retina, Optic Nerve, and Visual Pathway (Pearls Series) by Gerald Allen Fishman M.D. Publication Date: January 2, 2001 | ISBN-10: 1560551984 | ISBN-13: 978-1560551980 | Edition: 2
- Vincent, Ajoy, Anthony G. Robson, and Graham E. Holder. "Pathognomonic (Diagnostic) ERGs a Review and Update." Retina, the Journal of Retinal and Vitreous Diseases. 33.1 (2013): 5-12.
- Young, Blair, Eric Eggenberger, and David Kaufman. "Current electrophysiology in ophthalmology: a review." Current Opinion Ophthalmology. 23 (2012): 497-505.


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Thoughts Are Things
Whilst we have discussed The Law of Attraction at length in the context of, as in the title of your newsletter subscriber opportunity this week suggests - "Consciously Creating Circumstances" - we must also keep in mind that every thought is Energy, a causal force that must immutably manifest a corresponding effect in accordance with the Principle of Causation of which The Law of Attraction is an aspect.
So every positive thought will attract a positive effect in the same direction and quality of the thought.
Likewise every negative thought will manifest a negative causal effect in the same direction and quality of the thought. In addition, should that thought be a negative thought directed at another person, there will always be a karmic price to pay. There are no exceptions to these immutable principles.
Of course, transient, fleeting thoughts will only give rise to effects of comparative strength, while persistent thought, especially over a long period of time and charged with emotions will give rise to a much stronger and resilient effect, often manifesting into physical experiential reality.
For these reasons we must always be mindful of our thoughts at all times. There are no excuses or reprieves for a "careless thought", especially if directed at others.
Being Mindful of our thoughts involves developing absolute control over our thoughts, feelings and emotions, thereby consciously and mindfully steering the direction in which we wish our experience to go.
By knowing what we need, wish for and desire, and only allowing thoughts of the same nature into our consciousness, we can confidently chart our path though life without fear of "unexpected events". To a person who has gained absolute control over their own Mind Power there are no surprises but rather a steady flow of expected, wished for and welcome effects that can be enjoyed.
All negative thoughts, particularly those that are not consistent with your needs wishes and desires must be instantly rejected by, for example saying or thinking "cancel! cancel! cancel!" until they have dissipated, and can no longer exert an effect.
So in summary:
1. Know your wishes, needs and desires
2. Only allow thoughts that are consistent with these
3. Instantly "cancel!, cancel!, cancel!" all negative, contrary thoughts.
I will conclude with this very appropriate little verse:
I hold it true that thoughts are things;
They're endowed with bodies and breath and wings;
And that we send them forth to fill
The world with good results, or ill.
That which we call our secret thought
Speeds forth to earth's remotest spot,
Leaving its blessings or its woes
Like tracks behind it as it goes.
We build our future thought by thought,
For good or ill, yet know it not.
Yet, so the universe was wrought.
Thought is another name for fate;
Choose, then, thy destiny and wait,
For love brings love and hate brings hate.
-- Henry Van Dyke


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Short Terms
Promotion open to ROI & NI residents employed in the licenced trade, 18+ only. Runs weekly between 26.02.18 to 30.03.18. Internet required. To enter follow @SchweppesIreland on Instagram, and take photos or a video of your cocktail mixing experience with the Schweppes 1783 mixer, using hashtag #MySchweppesMix. Prize: Each week £80/€100 One4all voucher & 1783 stock. Judging each week from all valid entries closing each Tuesday. Normal exclusions apply, employer's permission required, see full T&Cs: LINK Promoter:
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These Terms and Conditions prevail in the event of any conflict or inconsistency with any other communications, including advertising or promotional materials. Entry and claim instructions are deemed to form part of the terms and conditions. Please retain a copy for your information
Promoter: Coca-Cola Ireland, Ground Floor, 2 Ballsbridge Park, Ballsbridge, Dublin 4. Unless otherwise specified, no entries should be sent to this address.
Eligibility to enter / opening and closing dates
1. This promotion is open to residents Republic of Ireland and Northern Ireland residents only who are employed in the licenced trade. Employees of
2. Entrants must be aged 18 years or over and have access to the internet, an email account and active Instagram account. Proof of ownership of the social media account and proof of age may be required. If you do not have an Instagram account you will need to create one to participate
3. This promotion opens at 00.00.00 on 26th February 2018 and there are weekly competitions that close at midnight each Tuesday, until the last weekly competition closes on 30th March 2018. Any entry received outside these promotional will not be valid. An overall winner will be selected from all weekly winners.
4. Each prize competition will be judged and the winner notified within 3 working days following the day each closing period.
a. Competition 1 selecting 1 winner from all valid entries between 00:00:00 on 26th February and 23:59:59 on 6th March 2018
b. Competition 2 selecting 1 winner from all valid entries between 00:00:00 on 5th March and 23:59:59 on 13th March 2018
c. Competition 3 selecting 1 winner from all valid entries between 00:00:00 on 12th March and 23:59:59 on 20th March 2018
d. Competition 4 selecting 1 winner from all valid entries between 00:00:00 on 19th March and 23:59:59 on 27th March 2018
5. One overall winner from all previous week's winners between 00:00:00 on 27th March 2018 and 23:59:59 on 30th March 2018 will take place within 5 working days of the final closing date of the competition
6. There is no maximum entry per person per week.
7. Maximum of one weekly win per person
8. No purchase is necessary to enter this promotion.
9. Entrants must have the permission of their employer to enter
How to enter
10. Visit instagram.com/SchweppesIreland and follow our page. To enter from a private account you must amend your account settings to a public account in order for entry to be accepted. The account must remain public until the end of the promotion to be contacted in the event your entry is a winning entry.
11. Entries will be subject to Instagram's terms of service which are available online at www.instagram.com
12. Share your photo/ video of your mixing experience with Schweppes on Instagram, using #MySchweppesMix by providing one of the following options only:
Cocktail photo + ingredients used + chosen 1783 Flavour
Mixing showmanship via video + chosen 1783 Mixer
Image carousel to show mixing process + chosen 1783 Bottle
All entries must include the entire recipe in their captions
13. Any submission containing the following content will not be permitted and the entrant will be disqualified:
- Content which is distasteful or offensive, or is of a sexual nature.
- Content for the intended purpose of harassing, threatening or embarrassing individuals or multiple individuals.
- Content featuring:
- Individuals without the consent of all featured parties.
- Individuals smoking tobacco, drinking or appearing to be under the influence of alcohol.
- Any images which contain alcohol being handled, served or deemed socially irresponsible, being portrayed as a challenge or enhancing attractiveness, containing individuals who are or deemed to be under 25
- The use, depiction or incitement to use drugs or any banned substances.
- Political parties, political messages or demonstrations.
- Blasphemous or religious imagery or any image deemed to incite religious hatred.
- Potentially defamatory or otherwise actionable material.
- Any image which infringes any copyright, trademarks or other intellectual property rights of any third party, save for the ingredients used in the cocktail.
- Third party promotional packaging, material or advertising.
- The depiction of the assembly of explosive materials, firearms or items deemed to be weapons of any nature.
- The depiction of individuals' or companies' names, phone numbers, email or postal addresses, or any other personal information deemed sensitive, private and/or unacceptable by the promoter.
- Any children under the age of 18.
- Any Instagram name and Instagram profile photograph which contravene the above will be void, and any entries will not count towards the competition
- Content sourced from commercial or third party libraries (e.g. Getty Images, Google images etc).
- Any content the Promoter in its sole discretion considers to be inappropriate to use.
14. The Promoter reserves the right at its sole and absolute discretion to permanently remove any material that is deemed to be distasteful, degrading or will in any way cause offence or to disqualify any individual found to be attempting to circumvent the promotion by tampering with the operation of the promotion, setting up multiple accounts, using multiple identities, using rude, inappropriate, or profane statements or to be acting in any manner deemed by the Promoter to be in violation of the terms and conditions; or to be acting in any manner deemed by the Promoter to be disruptive.
15. Anyone, who in the Promoter's absolute discretion, is acting in a manner that undermines the operation and integrity of the promotion or in any way that gives an unfair advantage, will be disqualified and any persons seeking to use such information gained will be disqualified. Any appropriate content may be forwarded to the appropriate authorities for further investigation.
16. All entries will be strictly monitored by the Promoter and their third-party adjudicators throughout and any attempts to manipulate or otherwise unfairly influence the results will result in disqualification of entry or suspension of the promotion.
17. In the event of circumstances outside the Promoter's reasonable control and only where circumstances make this unavoidable, the Promoter and those partnered with the promotion reserve the right to cancel or amend the promotion or these Terms and Conditions at any stage but will endeavor to minimize the effect to entrants to avoid undue disappointment.
18. The person who has uploaded the entry is the individual who is entered in to the promotion.
19. Entrants and employers need to be aware that they could be responsible for their respective tax implications if selected as the winner.
Selecting the winner
20. All valid entries each week will be judged against the stated criteria using an independently verified process. This process will be carried out by a judging panel who will consist of 2 individual members (Rindert Sinnema and Richard Linden) from All Bar None.
21. All entries will be judged on merit based on the criteria of being the most:
Cocktail Innovation – how skillful the individual has been in the preparation and use of ingredients etc.
Content Creativity – how good is the overall idea, imagination and presentation.
The judge will score and rank all entries to find a weekly winner. In the event of a tie situation, the independent auditor will cast the final deciding 'vote' based on Taste and use of all the ingredients.
Each weekly winner will be notified via direct message to the Instagram account used to participate in the promotion within 3 working days of the closing date. The winner will be contacted via an Instagram response asking the winner to follow next steps to be verified and they will be required to send their full name and address within 14 days of being notified that they are a winner. All reasonable steps will be taken to contact the winner, but if this cannot be achieved within a further 14 days the Promoter reserves the right to cancel the prize entitlement and award the prize to the entry with the second highest rank /score as awarded by the judge.
22. Entrants will be required to provide the Promoter with information including their name, a valid home address, photo I.D and additional contact details to assist with fulfilling the claim and arranging the prize. Inaccurate information may result in the prize being forfeited.
23. At the end of the weekly competitions an overall winner will be chosen using the same criteria and judging process from the 4 weekly winners. The overall winner will be contacted by Kameleon Social Agency in London.
The Prize
Each weekly prize will consist of a €100/£80 One4All card voucher + 1783 Stock (1 cases of each flavour) for your bar/place of work.
The One4All Card is a prepaid card, which can be used at participating retailer outlets. Additional money can be added onto the card if required. Admin charges apply after 12 months. You will be responsible for the card and the money on it once in use. See https://www.one4all.ie/terms-conditions for full information on use.
The overall competition prize is €1000 / £800 holiday voucher with Cassidy Travel for ROI https://www.cassidytravel.ie/ and Oasis Travel for NI https://www.oasis-travel.co.uk/ The voucher must be used within 1 year of issue to book travel through either of the travel agents. Certain exclusions may apply. Check T&Cs for the respective agent and discuss conditions before you book your travel.
Notification and delivery of the prize
24. The weekly winners and overall winner will be notified by direct message to the Instagram account that they used to enter the competition and via a comment underneath their entry.
25. The Promoter will make reasonable efforts to contact the weekly winners. However, if a weekly winner has not responded to notification within 28 days, or if a selected weekly winner is ineligible, otherwise in breach of these terms and conditions, or unable to take up the prize for any other reason, the Promoter reserves the right to select an alternative weekly winner judged next in line at the same time as the original using the same process referred to above in these terms and conditions.
26. All prizes will be provided to the winners in person and confirmed by email, or in the case of potential issues with dates will be available from the "ENTRY" point at the event on production of the winning communication and proof of id. The Promoter accepts no responsibility for failed delivery due to provision of incorrect contact details by entrants. Any prize that is returned undelivered will be assumed unwanted and the Promoter reserves the right to select an alternative winner to receive the prize using the same process referred to above in these terms and conditions.
27. The winner is responsible for all expenses not expressly stated in these terms and conditions as being included as part of the prize if applicable.
28. Incomplete, illegible, erroneous, corrupted entries, or those which are otherwise not in accordance with these terms and conditions will not be valid. The Promoter accepts no responsibility for failure to receive an entry where such failure is due to circumstances outside the Promoter's control.
29. This promotion is in no way sponsored, endorsed or administered by, or associated with Instagram. Any information you provide as part of this promotion is provided to the Promoter and not to Instagram. Entrants to this promotion hereby release Instagram from any claim or liability suffered in connection to this promotion.
30. The Promoter reserves the right at its sole and absolute discretion to permanently remove any material containing content which it considers inappropriate, thus disqualifying the entrant. The Promotor reserves the right to remove and disqualify any entries which are deemed to contain unlawful, threatening, defamatory, racist, obscene, deceptive, false, fraudulent, inflammatory or profane material or any material that could constitute or encourage conduct that would be considered a criminal offence, give rise to civil liability, or otherwise breach any law or any non-public information about a person or a company without the proper authorisation to do so.
31. Any person posting, or seen to be posting, comments to the Promoter's Instagram page or elsewhere during the promotion that are considered bullying, spiteful or upsetting to other participants, fans of 'Schweppes' or directly aimed at the Promoter, will have their comments removed and will be disqualified from the promotion. The Promoter reserves the right to alert Instagram to any such behaviour, which may result in the person's account being frozen pending investigation.
32. By submitting an entry:
o The entrant confirms that the photo/video/mix does not infringe the copyright or other intellectual property rights of any third party, save for the ingredients used in the cocktail. Any entry found to be copied will be disqualified;
o The entrant agrees not to assert any moral rights in relation to the use of the photo/video/mix by the Promoter where the moral rights in respect of the content are the entrants to assert, and procures that any moral rights of any third party will similarly not be asserted;
o The entrant further warrants that the materials submitted are his/her original works and have not been copied, in whole or in part, from any third party and the entrant has full authority to grant these rights; and
o The photograph/video/mix does not disclose any personal or confidential information belonging to the entrant or anyone else.
o The contents of all entries submitted become property of the promoter. The promoter reserves the right to use any of the contents of the entry submissions provided by entrants, for editorial, advertising, product, marketing and promotional purposes, without further compensation or notice, unless prohibited by law. Each Eligible entrant grants permission for promoter to use the contents of his/her entry submission for editorial, advertising, product, marketing and promotional purposes in any and all media and the licensed trade now known or hereafter discovered, worldwide, in perpetuity, without compensation, notification or permission.
o If individuals do not want to grant the Promoter these rights, please do not submit an entry.
o The entry does not contain constitute a virus, worm, Trojan horse, Easter egg, time bomb, spyware, or other computer code, file or program that is harmful or invasive or may, or is intended to damage or hijack the operation of, or to monitor the use of, any hardware, software, or equipment;
33. Prizes are non-transferable and cannot be sold or auctioned. No cash or other alternative to a prize will be offered save for in the event of unforeseen circumstances, in which the Promoter reserves the right to offer an alternative prize of equal or greater value than the original.
34. The Promoter and its agents will only use personal information supplied by entrants to this promotion for the purposes of administering this promotion, unless consent is received to use such information for any other purpose. Further details on The
35. If there is any reason to believe that there has been a breach of these terms and conditions, or of the spirit of this promotion, the Promoter may at its sole discretion refuse to accept an entry.
36. The Promoter's decision is binding in all matters relating to this promotion, and no correspondence shall be entered.
37. To the extent permitted by law, the Promoter accepts no liability for any damage, loss or injury suffered due to entering this promotion or taking up a prize.
38. The names of all winners together with their respective cocktail details will be made available on request by writing to Tara Byrnes,
39. The weekly winners and overall winner may be required to take part in publicity relating to this promotion.
40. If any of these clauses should be determined to be illegal, invalid or otherwise unenforceable then it shall be severed and deleted from these terms and conditions and the remaining clauses shall survive and remain in full force and effect.
41. These terms and conditions (and any non-contractual disputes/claims which arise out of or in connection with them) will be governed by relevant country's' law and entrants submit to the exclusive jurisdiction of the relevant country's courts.
Related links
- Celebrating a Summer of Schweppes
- Thrive Project in London: Hear from our class of 2019
- Doireann Garrihy and Pete Snodden reveal Thank You Fund's final shortlist
Athy Food, Drink and Skills Innovation Hub:
Coca-Colasupported project set for 2020 completion
Coca-ColaChristmas Truck Tour 2019: Find your nearest stop!


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"Rocky Road"
Please respond to the following:
Based on the lecture and Webtext materials and some outside research, address the following:
200 words.
Some of the most serious abuses taking place in developing countries deal with child labor, human slavery, sweatshops, bad governance, and environmental degradation.
1. Select one (1) developing country, and examine the extent to which two (2) of these five (5) issues are occurring.
2. Support your response with specific examples.
Be sure to cite the sources you used in-text and with full citations at the end of your essay
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What's the first rule of the Grocery Store Club? You do not talk about . . .Wait, wrong club. The first rule of going to the grocery store – don't go hungry.Yet, I do it ALL the time.
It's really a bit of a sad picture when I do. You know that feeling where you are so focused on your hunger that the words on your grocery list blur. You know that healthy, satisfying options are available, but you are so desperate to satisfy the immediate hunger that you will take whatever option first catches your eye. I go for a quick fix.
My personal "drug" of choice is sugar – in all of its glorious forms – cookies, ice cream, cake, candy. I call it a drug because that is what it is. And, my behavior surrounding sugar is much akin to what is seen in addicts. I grab something quick "just to take the edge off" while I shop. Then, I feel guilty. And, faster than David planned the demise of his lover's husband, I hide the evidence, disposing of wrappers or containers before I get home.Read more


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Pre-Adolescent Zach 4
This comic is actually based on real life. When my I was young and my mom went to the mall or what have you, she'd drop me off at the arcade with no money (we Cranors are a poor, lowly, scabby folk). She said when she came back, I'd be drenched in sweat from intensely "playing" the title screens of games. This story is not just a great way to introduce yourself to ladies at the club, but also something to use when complaining about "kids these days!" as a crotchety old man.


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Either TMNet is really, really incompetant, or Allah Almighty wants to test my patience, or I must be cursed or something. Or it could be all three at once, who knows.
In any case, the DSL light to my modem is off. For the upteenth time, again. Of course I reported the problem to Streamyx TMNet Centre, but since it will only be attended to "within two working days", it looks like it is going to be the cybercafe for me this weekend.


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The return of FOX's already established single-camera sitcom is still jam-packed with an impressive joke density. Somehow outliving its contemporaries (read as 2 Broke Girls), the almost unlikely final season we're getting now had done a sizable time jump that promises to get everything right in its last hurrah.
#NewGirl final season watch thread pic.twitter.com/1g2sb6WbwP
— Lesley 🐊 (@ethananarchy) April 10, 2018


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Top-50 Hot topics
Hypotheses corresponding to your request:
Singularities: Among these potential major changes which one will occur the first? : AI singularity / Extraterrestrial contact / Virtual reality preference / Immortality / Human augmentation from BG will end on 01/09/2020 13h57
Religions: religious beliefs are often associated with a high degree of anthropocentrism. Which discipline will provide the first proof against human-centered view of the world, and consequently religions? : artificial intelligence / genetics / extraterrestrial life / philosophy / Other from BG will end on 06/10/2021 22h43
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