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A disjointed past that culminated in their independence in 1991 has now helped to shape a diverse and culturally rich destination that has seen holidays to Croatia from Jet2holidays become the buzz location of the moment. Just across the Adriatic from Italy, Croatia is fast becoming one of the hottest holiday and short break destinations in Europe, rivalling the best beach resorts and coolest cities of the Mediterranean.
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For holidays and short breaks to Croatia, the ancient Adriatic city of Dubrovnik and the surrounding beaches offer the best of all worlds to do as much or as little as you please. Rich in culture, heritage and cosmopolitan appeal, Dubrovnik is well and truly on the map with the Mediterranean jetset and once discovered, few can fail to fall under its spell.
If you are considering a holiday in Mlini no doubt you are keen to enjoy a relaxing break in some of the most picturesque surroundings that Croatia has to offer.
Pula's idyllic coastline of calm, sheltered waters and rich green forestry attracted the Romans as early as 177BC. It eventually moved on to become a principal city of the Roman Empire – trade, battles and executions all took place in this very city!
Montenegro offers beautiful beach holidays with a twist. Beyond the 35 sandy shores you'll enjoy at Budva, the resort invites you to explore the huge national parks close by, with deep white water ravines and rows of staggering mountain peaks.
Bathed in a Mediterranean climate and washed in the warm waters of the Adriatic Sea, Split's coastal line is one of the most picturesque along Croatia's clutch of littoral towns. A holiday to Split – the Adriatic's largest city - will offer plenty of opportunities to explore the area's rich past whilst enjoying all the modern amenities of a Mediterranean resort.
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Guests seeking the serenity of the tranquil Adriatic shores but want to be close enough to enjoy all the Dubrovnik has to offer will find the Villa Lanterna a wonderful retreat. This small, modest guesthouse blends together personal services with a laid back approach perfectly, creating a warm and f...
These modern hotel apartments are centrally located and designed to offer guests comfort and good service to ensure a relaxing holiday.
7-nights Bed and Breakfast
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With a host of family focussed activities including a great range of kids clubs, an aquapark and a fabulous pool area, the Sol Garden Istra is the ideal location for a family holiday. Sports enthusiasts will love the facilities available and for those looking to relax, the spa and wellness centre pr...
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The Hotel Sentido Tara is a stylish and contemporary style hotel situated next to a sandy beach in the popular resort of Becici. Beautiful mountains surround the hotel and create a magnificent backdrop for your holiday here. With a relaxing pool area and modern rooms this hotel is ideal for couples ...
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Situated in a stunning location, overlooking the Adriatic sea on one side and the picturesque town of Cavtat on the other, this luxury hotel provides quality accommodation and an extensive range of facilities. From its spacious terraces enjoy breathtaking views of the Adriatic, Cavtat and the walls ...
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The exclusive five star Hotel More is an elegant boutique hotel located on the waters edge in the picturesque area of Lapad, surrounded by an abundance of fragrant flora, century-old pine trees, turquoise waters, rocky cliffs and enchanting Elaphite Islands. This property would be ideal for guests s...
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Situated on Tiha Bay close to the attractions of Cavtat, this small and friendly seafront hotel is the ideal spot in which to enjoy a quiet, relaxing holiday in Croatia. Guests can enjoy the views from the rooftop sun terrace or the sunbathing platform on the seafront.
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The adults only Melia Coral hotel has a romantic and sophisticated feel, perfect for couples or friends looking for relaxing holidays. With a modern style and elegant décor throughout the hotel, you are guaranteed a luxurious stay. The hotel has a wide range of facilities including a lovely Spa...
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Sessions planned on Hinsdale Hospital's new cancer center
A conceptual drawing of the new Hinsdale Hospital cancer center on Ogden Avenue west of Interstate 294.
Updated: April 8, 2013 6:08AM
HINSDALE – The Adventist Cancer Institute will hold three community information sessions in March to discuss its proposed new facility.
The three sessions will be held at Adventist Hinsdale Hospital, 120 N. Oak St. in Hinsdale, and are scheduled for 8::30 a.m. March 5, at 5:30 p.m. March 6 and 6:30 p.m. March 11.
The sessions are open to anyone looking for more information on the plans for the center.
The Illinois Health Facilities and Services Review Board has approved the certificate of need for the Adventist Cancer Institute. Adventist Hinsdale Hospital is working with the village of Hinsdale on zoning and other local approvals leading up to the start of construction.
The new free-standing facility will be the central location providing care for all cancer patients from Adventist Hinsdale Hospital and Adventist La Grange Memorial Hospital, said Christine Van De Wege, vice president of integrated services with Adventist Hinsdale and La Grange Memorial hospitals.
"We plan to offer personalized cancer care in a comprehensive, state-of-the-art facility," Van De Wege said. "Our new center will better allow us to care for each cancer patient in a meaningful, individualized way within one convenient location equipped with the latest technology to detect and battle cancer."
The hospitals have developed plans for the new center in partnership with the medical staff.
Hospital officials project that outpatient cancer services will grow by 31 percent over the next 10 years, said Michael J. Goebel, chief executive officer at Hinsdale Hospital. Cancer is listed as the leading cause of death in DuPage County by the Illinois Department of Public Health.
"The new cancer center will allow us to serve this growing patient population well into the future," Goebel said.
The center will be constructed on the north side of Ogden Avenue, just west of Interstate 294 in Hinsdale.
To RSVP for one of the community sessions, call (630) 856-7525. More information can be found at www.keepingyouwell.com/ahh.

subset: commoncrawl


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ICC Welcome
As well as a great start to the 2013 Road Race & TT season for many of our senior riders (see here for race results )our youth riders have managed to notch up gold medals & impressive placings in the National Schools racing championships - report & results here
We are proud to announce an exciting new project to get more people cycling, more often and for everyday trips – to work, to the rail station, or just to pop to the shops .The Ilkley go:cycling project will provide:*
- A fleet of hybrid pool bikes – for taster sessions and short term loans!
- Taster sessions – try out cycling on our introductory club rides
- Short term loans – take a bike home, kitted out with a lock, lights and panniers and try it out for your everyday trips
- Adult cycle training – attend a course to get confident cycling on the roads
- Maintenance classes at JD Cycles – learn the skills to be your own road-side assistance
- Dedicated website – for advice on route choice, where to park your bike, how to fix a puncture and how to secure your bike at your final destination
Your club needs you! We are looking for people to help set up and run the project. There are lots of different types of roles to fill so if you have some time, skills or interest and would like to get involved, please contact Leanne Farrow (email@example.com).
Want to become a Cycle Training Instructor? The project will also cover the cost of training four ICC volunteers to become fully qualified Cycle Training Instructors to deliver the adult cycle training sessions for the club. For more information, click here.
*The project will be funded by go:cycling – a new initiative in West Yorkshire funded by the Department for Transport's Local Sustainable Transport Fund – following a successful bid made by ICC.
Our motto is "recreation to racing " and we're proud to continue to support all levels of local bike riders from beginners to experienced racing cyclists. See our Youth page for information on our youth development programme and our rides page for details of our regular club rides, women specific rides, daytime social rides & family rides.
We have regular velodrome trips organised for ICC members & an away trip to Helmsley in North Yorkshire planned (see our 'Events ' page for further details). For our active youth membership we have regular coaching sessions in Ilkley plus track sessions at the Richard Dunn Centre Bradford . We also have a BMX session organised for ICC members at the National Cycling Centre . Upcoming events and details are listed on our Youth Pages
We have a calendar of racing activities planned for this year & we're running the very successful White Rose Classic sportive again in 2013 .
If you're not already convinced to join ICC we have a number of discounts available for ICC members for cycling related activities - details on the "Join Us " Page - You can join or renew your membership to ICC online.
To promote cycling to the people of Ilkley (and surrounding areas) and to those who cycle in or near our town
To provide an avenue for club members to race and compete by having affiliations to governing bodies (British Cycling, Cycling Time Trials, MTB, cyclocross etc)
To provide a focus for recreational cyclists and promote the sport at grassroots level.
To be open to all, and to encourage cycling for everyone.
ICC Constitution & Committee Roles ICC Minutes of Meetings ICC Members Updates
'Go-Ride' Clubmark Accredited Club | Join ICC Online This Month's ICC Rides |
Stage 1 of Le Grand Depart comes to Ilkley in 2014. Stage 2 Bolton Abbey Addingham & Silsdendetails here |


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Police Helicopter, Dogs, Apprehend Armed Car-Chase Suspects in West Somerville [Photos/Video]
Police caught three suspects and a firearm after a car chase through Somerville and Medford.
A state police helicopter and police dogs searched a normally quiet neighborhood in West Somerville Monday night for suspects, at least one of them armed, that had led police on a car chase.
Police in the area around Powder House Boulevard and Leonard Street—right next to the Tufts University campus—had three suspects in custody as of about 11 p.m., and Somerville, Medford, Boston and state police were still searching the neighborhood for a possible fourth suspect.
Police also discovered one handgun, according to Deputy Chief Paul Upton of the Somerville Police Department.
Upton said police initially responded to a report of shots fired on Gilman Street, near McGrath Highway in East Somerville, at around 9:08 p.m.
The shots fired were associated with a white motor vehicle, and moments later a police unit spotted a car—a white Subaru Legacy—that matched the description, Upton said.
When police tried to stop the car, it led police on a pursuit through Somerville, onto Boston Avenue in Medford, and back into Somerville, according to the deputy chief.
The suspects bailed in the West Somerville neighborhood, blocks from the Powder House Rotary, and led police on a foot chase and subsequent manhunt.
"This was a terrific joint effort," Upton said of the cooperation between Somerville, Medford and state police that resulted in the apprehension of the three suspects and firearm.
Want the latest Somerville headlines delivered to you each morning? Subscribe to our daily newsletter and like Somerville Patch on Facebook.
During the search, a state police helicopter hovered over the neighborhood, shining a bright searchlight into back yards as police K9s and state troopers with shotguns searched from property to property looking for the suspects.
Upton said people in the neighborhood were not in danger. That said, at 10:48 p.m. the city's official Twitter account asked people to stay indoors. The Tweet read: "Police pursuit of possibly armed suspect in W. #Somerville Tufts/Powderhouse area is under way. If in the area, please stay inside."
Although police were searching for a possible fourth suspect, the city Tweeted at 11:22 p.m., "All suspects have been apprehended in #Somerville. State Police to remain in area for final sweeps."
danielle mclain
12:11 am on Tuesday, January 8, 2013
So scary to know its right in your neighborhood
J. Melendez
12:15 am on Tuesday, January 8, 2013
I heard the helicopter, thought it was odd... Now I'm connecting the dots. Good thing no one got hurt.
Daniel DeMaina
9:39 am on Tuesday, January 8, 2013
Thanks for the catch Richard—typos slip through when you're working late at night sometimes.
Jo-Ann Fontano
11:11 am on Tuesday, January 8, 2013
Just goes to show our City and State are up to par with the latest Tec, Chopper,and Cars to catch criminals who are treat to our Society.
Danielle DesRoches
1:32 pm on Tuesday, January 8, 2013
What about contacting the media to alert folks who aren't necessarily tech-savvy?


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LG Xpression Cell Phone - Touchscreen, QWERTY, 2MP Camera, microSD, microUSB, GPS, Document Viewer, Organizer, Voice Memo, Red (AT&T - Carrier Locked)Item#: ATTD-1104 | Model#: 65370
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AT&T 65370 LG Xpression Cell Phone
Gain greater advantage in staying connected with the stylish and pocketable AT&T 65370 LG Xpression Cell Phone. The LG Xpression gives you quick, one-touch access to text messaging, email, and social networks. While its 3" Touch Display lets you navigate through the phone's applications and features with ease, its slide-out QWERTY keyboard lets you type faster and more comfortably. Shortcut keys to text, email, and the world wide web, and extras from AT&T, including AT&T Maps, AT&T Address Book, myAT&T, AT&T Navigator,® and YPmobile ® make your mobile experience more enjoyable. The phone is also equipped with a document viewer, organizer, voice memo; Bluetooth connectivity, a microSD slot, a speakerphone and a stylish red design. Connect quickly and conveniently using the AT&T 65370 LG Xpression Cell Phone.
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- Nov 05, 2012
Good first messaging phone for kid
For what it is, a call and text phone, I'm pleased with it. Got it as a first phone for kid and she turned off the ''auto correct'' your spelling feature and started typing all the ''TTYL'' stuff and loves it. It's almost half the price here vs. buying from AT&T with no commitment.
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The Dover I
Ranch Floorplan
- 2,600 Sq. Ft.
- 3 bedrooms
- 2 baths
- 3 car garage
- Office
View Standard Inclusions
The Dover I Sell Sheet
Together we've made a difference for hundreds of Wisconsin families.
Ask about our remodeling services! If you love our model homes and want to create a "Victory feel" in your own home — or if you need to update your home to sell — we can help!
For more information, please contact us at 262-853-8180 or fill out our contact form
Sales inquires: 866-705-7000 (toll free) • Customer Service: 262-252-7100 Fax: 262-252-7109
Copyright ©2013 Victory Homes of Wisconsin. All Rights Reserved.
Model home as depicted may not represent base home plan. *Some restrictions may apply. See a sales associate for details.


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We welcome requests for filming at our Trust and will do our best to accommodate. Please find below a brief overview of the procedure and protocol for filming undertaken at Barnet and Chase Farm Hospitals NHS Trust.
- Patient confidentiality is of utmost importance and written consent to filming must be always be obtained
- Filming must not interfere with the provision of patient services or effective running of the Trust
- Patient and staff safety is paramount at all times
- The privacy of patients must be respected and their dignity preserved
Before filming
All filming requests must go through the Trust's Communications Team. Details of request including dates, specifications and duration must be sent by email to firstname.lastname@example.com.
Once terms of filming are agreed they are only negotiable if sufficient notice is provided.
While filming
The filming crew must be accompanied by a member of Trust staff at all times. Rigorous infection control procedures must be respected at all times. No patients or staff are to be filmed without obtaining proper consent.
There is a schedule of charges for filming, which is available on request. Fees are charged to cover administration and staff costs. Additional costs may be charged if specific equipment is required or supervison is needed out-of-hours.
Fees for not-for-profit organisations are negotiable and may be offered at a discounted rate.
Larger vehicles can be accommodated if sufficient notice is given. Smaller vehicles are able to use the public pay and display car parks within both hospital grounds.
For more details and to arrange filming contact the Communications Team on 020 8375 2180.
"Consistent and professional care, delivered in a friendly way."
More patient comments from NHS Choices"Professional, friendly, caring, calm and clean!"
More patient comments from NHS Choices


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Dead Milkmen Free For All
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When are the Dead milkmen going to tour again?
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Are the Dead Milkmen going to tour again soon?
[ 15 ]
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Total Votes : 25
Joined: 22 Jan 2003
Posts: 17
Posted: Wed Jan 22, 2003 4:13 pm
Post subject: When are the Dead milkmen going to tour again?
Now when people ask this over and over they can add a poll to it! :P
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Joined: 14 Jan 2003
Posts: 386
Location: Saint Petersburg, Florida
Posted: Wed Jan 22, 2003 5:55 pm
Post subject: Poll
You should of added "Maybe" to the choices.
I think it is a maybe...
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Cult Leader Lettuce
Joined: 22 Jan 2003
Posts: 1603
Location: Sandy Springs, GA
Posted: Wed Jan 22, 2003 7:13 pm
Post subject: Well....
You have to remember... Rodney is sick of his job. If he had a chance to tour, I am sure that he would jump on it.
Joe doesn't seem to care too much for his job either.... and if you had Shelly for a boss, you wouldn't either. Maybe the Low Budgets could tour with the Dead Milkmen.
Dean probably couldn't tour with the DM though, he has his wife and kid... but there is a simple solution to that:
Brian (from Touch Me Zoo, Town Managers, and Sock) could do it, that is if he still wants to.
Dave.... is an enigma. Would he tour, or would he not?
Let's just say, the chances are good.... the DM could tour again... you never know. Let's hope they do, though.
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Joined: 21 Jan 2003
Posts: 44
Location: Cornelius, NC
Posted: Thu Jan 23, 2003 7:44 am
Post subject:
I'm sure Zak Starkey is available. He drums for all of the other bands who call themselves by their original name even though at least one original member is not present or dead.
Why, the Dead Milkmen could be like the current Doors. Replace Rodney with that guy from the Cult and Dean with Zak Starkey and Dave (if you can't find him) with some other guy. Joe could be The Dead Milkmen. As long as he sings Punk Rock Girl, all of the doofuses who only know the band through that song will be happy.
If all four won't/can't do it, then they shouldn't do it.
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Joined: 22 Jan 2003
Posts: 236
Posted: Thu Jan 23, 2003 1:55 pm
Post subject: hmmmm
Original Lineup or No Lineup!
3/4 deadmilkmen and some guy
just not the same....
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Joined: 18 Jan 2003
Posts: 6398
Location: Tarpon Springs, Florida
Posted: Thu Jan 23, 2003 1:59 pm
Post subject: how do I vote
okay how the *&$# do I vote?
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Joined: 18 Jan 2003
Posts: 6398
Location: Tarpon Springs, Florida
Posted: Thu Jan 23, 2003 2:06 pm
Post subject: how do I vote
okay how the *&$# do I vote?
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Joined: 14 Jan 2003
Posts: 386
Location: Saint Petersburg, Florida
Posted: Thu Jan 23, 2003 9:56 pm
Post subject: Re: how do I vote
BTO, I think the poll has ended.
The poster can add a time limit on the poll.
BigTimeOperator wrote:
okay how the *&$# do I vote?
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Joined: 22 Jan 2003
Posts: 17
Posted: Thu Jan 23, 2003 10:34 pm
Post subject:
*Shrug* I was just able to vote. I put the time limit to one week as well.
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Joined: 14 Jan 2003
Posts: 386
Location: Saint Petersburg, Florida
Posted: Thu Jan 23, 2003 11:42 pm
Post subject: I know why
I know why I can not vote because I have already voted.
Leon wrote:
*Shrug* I was just able to vote. I put the time limit to one week as well.
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Cult Leader Lettuce
Joined: 22 Jan 2003
Posts: 1603
Location: Sandy Springs, GA
Posted: Sat Jan 25, 2003 12:24 am
Post subject: Re: hmmmm
77 wrote:
Original Lineup or No Lineup!
3/4 deadmilkmen and some guy
just not the same....
Well, actually... Brian's not just "some guy."
First, a little story... once upon a time, there was a band called the Dead Milkmen. They had been around quite a long time when drummer Dean Clean decides that he wants to actually live a normal life... and decides that he will be leaving the band soon. Well, Joe and Dave decide that Brian (from Touch Me Zoo, Joe and Seven (backup vox on I'm Flying Away) Morris' band) would be a good replacement. Well, that never became a possibility, because Rodney soon afterwards also decided to call it quits. That pretty much killed the band, and they set out for one last tour (which Dean Ween (of Ween) wished to have Ween play at the DM's last show, but alas didn't ask until after the fact) and a last album.
It will be interesting to see if anything happens with the Dead Milkmen... but for a 100% lineup... that could only be a possibility for a Philly show (and maybe a few selected venues). Just think back and remember the lack of a "real" Butterfly Joe tour. (I would have given both testicles to have had Butterfly Joe come to Atlanta... but noooooooo... (at least I still have my balls, right?))
whew... I know too much damn useless Dead Milkmen trivia.
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Joined: 23 Jan 2003
Posts: 173
Posted: Sat Jan 25, 2003 4:31 pm
Post subject:
I remember that we considered Seth Baer (Original Sins, Nixon's Head) as
our first choice replacement, but that was only talk. We never asked
anyone. What's the point without Rodney? And as tramfan3 says, if it's not
all four of us, then we shouldn't do it.
By the way, Brian is drumming for Umiak now! They're the band that came
out of the James Love Jackson and Firepussy / Captain Crash breakups.
- Joe Jack
Last edited by JoeJack on Sat Feb 15, 2003 4:01 pm; edited 1 time in total
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Joined: 24 Jan 2003
Posts: 611
Location: Philadelphia, PA
Posted: Sat Jan 25, 2003 7:16 pm
Post subject: Fongo's Plans For A Reunion Show
Even though I doubt that it'll ever happen, my friend, Jerry "Fongo" Fongowski is trying to buy the rights to direct the Milkmen reunion show. Here are his plans:
1. Martial Law shall be ordered on the day of the show, in Philadelphia. No one shall be allowed to walk in the streets, or watch the event. No cameras, no TV. Only a young couple of shepherds will have the privilege to witness the event. So, they can later describe it to the people, by oral speech.
2.Giant loudspeakers shall be put in the streets, playing all day the "concert".
3.Soldiers dressed in Nazi uniforms, will walk in military march in the streets of Philadelphia, arresting who-ever wants to break the law.
4.Hundreds of swans will be left to move in front of City Hall, with pieces of dynamite in their bellies, which will explode in slow motion by special effects. (real living swans, that should be operated for putting the dynamite inside their belly).
5.Giant Navy planes, will fly all day in the sky of Philadelphia, provoking big noise.
6.At 12.00 sharp, in the mid-day, those planes will start the bombardment of Zipperhead's, throwing all of their munitions.
7.Instead of bombs, they shall throw Elephants, Hippopotamus, Whales and Archbishops carrying umbrellas.
["You mean, false archbishops, that is to say plastic or other dolls dressed as archbishops?" I * dared to ask.
"No, young man. When I say Archbishops, I mean real, living Archbishops. Its about time to finish with the church!"]
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Joined: 28 Jan 2003
Posts: 118
Location: keene, NH
Posted: Tue Jan 28, 2003 4:23 am
Post subject: dude.
i'm so at that show.
infinity sprials out creation
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Gary Chickenwing
Joined: 10 Feb 2003
Posts: 3
Posted: Mon Feb 10, 2003 10:36 pm
Post subject: well?
is that a maybe?
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By Danielle Owczarski Far from Burlington, hidden in the low basin of the Nulhegan River in the Northeast Kingdom, awaits a little known National Fish and Wildlife Refuge. The 26,000 acres of refugium established in 1999 encompasses three headwater tributaries to the Nulhegan River, itself a tributary to the 7.2 million acre Connecticut River watershed. [...]
Posts Tagged 'Silvio O. Conte National Fish and Wildlife Refuge'
Natural Destinations: Silvio O. Conte National Fish and Wildlife Refuge
Posted in Natural Destinations, tagged American woodcock, Brunswick, Connecticut River Watershed, Mollie Beattie Bog, Northeast Kingdom, Nulhegan River, Silvio O. Conte National Fish and Wildlife Refuge, Vermont, Wild Brook Trout on October 7, 2011 | Comments Off


text:
GRS Board Question of the Week: 04/17/2012
An 82 year old man comes to the office because he is gradually losing erectile function. He reports that his libido is "not what it used to be". he also reports sleep disturbances, lower energy, and intermittent irritability but no sadness or headache. History includes coronary artery disease, HTN, dyslipidemia, and obesity. He takes aspirin, simvastatin, lisinopril, metoprolol, and a MVI daily.
On examination, he weighs 95 Kg (210 lb, BMI 34); BP is 145/86, pulse 80. CV and pulmonary examination is normal. Testicular volume is 20 cc bilaterally, and no prostate nodules are palpable.
Fasting morning lab results:
Total testosterone: 166 ng/dl
LH 5 mIU/ml
FSH 7.2 mIU/mL
Total cholesterol 190
Which of the following tests should be ordered next?
B. MRI of the pituitary gland with contrast
C. Karyotyppe analysis
D. Prolactin
E. Hematocrit
2/7/12: Question 12
Which of the following agents increases bone mass and reduces fracture risk by stimulating osteoblast activity and promoting bone formation?
A) Oral bisphosphonates
B) Estrogen
C) Human parathyroid hormone
D) Selective Estrogen receptor modulators
E) Zoledronic acid
Answer C
Osteoporosis medications can be considered in terms of whether they act on bone resorption (antiresorptive) or on bone formation (anabolic); Most medications are antiresorptive (ca, vit D, Estrogen, SERM, bisphoshonates, calcitonin).
Teriparatide, human PTH, is the only anabolic therapy for osteoporosis approved by the FDA. It increases bone mass and reduces fracture risk by stimulating osteoblast activity and promoting bone formation.
Teriparatide increases BMD and decreases risk of vertebral and non vertebral fractures in postmenopausal women with prior vertebral fractures or corticosteroid induced osteoporosis. It also increases BMD at the lumbar spine and femoral neck in men with osteoporosis . Its effects on hip fractures has not been assessed.
Treatment with teriparatide is associated with usually transient increases in serum calcium. If the increases persist, they can be managed by decreasing calcium and vitamin D.
A 70 year old Chinese American man comes to the office because he has a widespread maculopapular eruption with formation of flaccid bullae and erosions. For 2 days before the rash, he had fever, odynophagia, and eye pain. Over the next few days, the rash evolved to extensive sloughing and peeling of the skin. History includes HTN, DM, and peripheral neuropathy. Two weeks ago, he started carbamazepine at 200 mg Q 12 hrs for peripheral neuropathy. Other meds include glipizide, felodipine, simvastatin, and enteric coated aspirin.
On examination, the sloughing and peeling involve 40% of the patient's body surface. His oral mucosa has erosions and exudates. He also has bilateral conjunctivitis. The patient is admitted to the burn unit.
Which of the following is the most likely diagnosis?
A) Bullous pemphigoid
B) Staphylococcal scalded skin syndrome
C) Disseminated Herpes Zoster
D) Toxic epidermal necrolysis
Answer: D: TEN
Stevens-Johnson syndrome and TEN are severity variants of the same disease, characterized by epidermal detachment. In SJS, skin detachment affects <10% of the body surface; in TEN, detachment affects >30% of the body. When skin detachment is between 10-30%, the syndrome is considered overlap between SJS/TEN. The mortality for SJS is between 1-3%, and 30% for TEN. Often, fever and mucosal involvement develop days before the rash appears; Initial lesions are macular and can form target lesions with purpuric centers; The lesions can coalesce and progress to superficial flaccid bullae. Usually at least two mucous surfaces are involved;
SJS and TEN are rare reactions to medications, most common are antibiotics, NSAIDS, and anticonvulsants. The risk for SJS or TEN with carbamazepine is significantly increased in patients who have the HLA-B 1502 allele, which is found in individuals with ancestry from across broad areas in Asia, including South Asian Indians. In 2007, the FDA alerted health professionals of changes to prescribing information, including a new boxed warning for carbamazepine: "Patients with ancestry in at-risk populations should be screened for the HLA-B*1502 allele prior to starting carbamazepine. Patients who are positive for this allele should not be treated with this drug unless the expected benefit clearly outweighs the increased risk of SJS/TEN."
Given the Chinese ancestry of this patient, he should not have been given carbamazepine without genetic testing.
12/21/11: Q: A 78 year old man comes to the office because he has fatigue and weakness that have progressed over the past 6 months. He is an avid golfer but is now unable to complete his usual round of golf. History includes dyslipidemia and gouty arthritis well controlled for 10 years. Medications include atorvastatin, colchicine, and allopurinol.
On examination, there is hyper pigmentation over his face and neck, but no rash. He has weakness of the neck flexors, and he cannot rise from a chair without using his arms. Reflexes are diminished in both legs.
Which of the following will most likely Yield the correct diagnosis?
A) EMG and Nerve conduction studies
B) MRI using fat suppression sequence
C) Sural nerve biopsy
D) Muscle biopsy using percutaneous needle
E) Open muscle biopsy
Answer: E
Generalized muscle weakness that is most prominent in the proximal muscle groups suggests myositis. Open muscle biopsy remains the gold standard for differentiating myositis from drug induced and other myopathies, dermatomyositis, polymyositis, and inclusion body myositis. Electrodiagnostic testing will exclude neuropathy but will not distinguish myositis from other myopathies. Needle insertion for EMG can cause tissue damage that may influence muscle morphology and complicate interpretation. MRI can demonstrate inflammation and be useful in selecting which muscle to biopsy but still does not provide a definitive diagnosis. Sural nerve biopsy is most useful in the evaluation of mono neuritis multiplex due to suspected vasculitis, but is not useful for evaluating the cause of myositis or myopathy without nerve involvement. Percutaneous needle biopsy doe snot permit accurate assessment of muscle morphology.
12/13/11: What are the Likelihood Ratios for the following clinical features that increase the probability of an MI in patients presenting with acute chest pain?
1. Chest Pain radiation to both arms: 9.7
2. Chest pain radiation with left arm pain: 2.2
3. Chest pain radiation with right shoulder pain: 2.9
4. Third heart sound present: 3.2
6. Rales on exam: 2.1
7. Diaphoresis: 2.0
9. Hx of MI: 1.5-3
A 65 year old man is brought to the office by his wife because he has recently been falling frequently and becoming more irritable and forgetful.
On examination, blood pressure 110/70. He has poor upward gaze, masked facies, and nuchal rigidity.
Which of the following is most likely to be observed on physical examination?
A) Resting Tremor
B) Autonomic dysfunction
C) Depression
D) Axial rigidity
E) Bradykinesia
Answer: D. Progressive Supranuclear Palsy is marked by supra nuclear gaze palsy with progressive voluntary gaze impairment and marked rigidity. Onset is usually in late 50s, followed by rapid deterioration. Other features of PSP include marked axial rigidity and a less prominent tremor than that seen in PD. Falling and gait disturbance are common in PSP. National Institute of Neurological Disorders and Society for PSP has proposed the following clinical diagnostic criteria: gradual progression, onset after age 40, vertical supra nuclear ophthalmoplegia, and prominent postural instability with falls within 1 year of symptom onset.
An 80 year old woman is admitted to the hospital with altered mental status. It is her third admission in 3 months. She lives with her son, who is her healthcare proxy. He shops for the household and helps her with her medications. History includes DM, atrial fibrillation, macular degeneration, and osteoarthritis. Medications including warfarin, insulin glargine, lisinopril, and metoprolol. After her last hospitalization, the patient received 2 weeks of home health care services; the nurses reported that the son purchased foods inconsistent with a diabetic diet despite receiving nutrition counseling.
On examination, the patient is lethargic and oriented only to her name. Vital signs are within normal limits. Blood glucose concentration is >400, Hgb A1c is 9%, and INR is 1.
The patient's mental status improves with insulin and fluids. She reports that her son went on vacation for one week, and she was unable to administer her own medications. The inpatient team wants to discharge the patient to a SNF for short term rehabilitation, but she states that she wants to return home.
Which of the following is the most appropriate next step in caring for this patient?
A. Notify APS
B. Administer the MMSE
C. Assess her capacity to understand the risks and benefits of her living situation
D. Discharge her to her home with home healthcare services for 4 weeks
E. Contact the patient's healthcare proxy (her son) to obtain permission to discharge her to a SNF
Answer: C
The most appropriate next step is to assess her capacity to understand the risks and benefits of returning home. The first step is to determine whether or not the patient is willing to accept interventions. If she is unwilling, then the physician must determine whether or not she has capacity to refuse interventions.
Which of the following is the most reliable screen for hearing impairment?
A) Screening version of the Hearing Handicap Inventory for the Elderly (HHIE-S)
B) Abbreviated Profile of Hearing Aid Benefit
C) Tinnitus Handicap Questionnaire
D) Whisper Test
Answer: A
"Medicare offers a one time preventive examination. Two self report measures, the screening version of the (HHIE-S) and the Dizziness Handicap Inventory, are recommended for use by physicians. The HHIE-S is widely used to assess hearing handicap -- i.e, hearing loss that interferes with performing ADLs. The HHIE-S consists of 10 questions regarding hearing difficulty in various situations: half o the questions cover self reported emotional consequences of hearing loss, and half cover self reported activity limitations and restrictions. The screen is quick and easy and inexpensive. It has high reliability and validity, as well as adequate sensitivity and specificity. Patients who score >8 should be referred to an audiologist to evaluate hearing and to determine the need for medical or nonmedical interventions.
An alternative screening tool is a hand held otoscope (AudioScope) which generates pure tones at 500, 1000, 2000, and 4000 Hz and at two intensity levels, 25 or 40 dB. Outcome on the HHIE-S predicts need for hearing aids, whereas the AudioScope screen predicts the level of hearing impairment.
The Tinnitus Handicap Questionnaire assesses self reported handicapping effects of tinnitus. It can be used before and after treatment to measure effectiveness of therapy for tinnitus. The Abbreviated Profile of Hearing Aid Benefit is often used to assess outcomes with hearing aids. It quantifies the self reported disabling effects of hearing impairment and assesses ease of communication, reverberation, speech understanding in the presence of background noise, and aversiveness to sound.
The whisper test, in which the tester whispers words at a measured distance from the patient's ear, is not as accurate a screen for hearing loss as the HHIE-S."
9/15/11: Q 226. Which of the following is the most likely cause of new onset vaginal bleeding in a 70 year old woman?
A) Pyometra
B) Endometrial cancer
C) Endometrial hyperplasia
D) Vaginal atrophy
E) Hormonal effect
Answer: D:
Vaginal atrophy is the most common cause of postmenopausal bleeding. In a series of 1,138 postmenopausal women who had bleeding, atrophy was the diagnosis in 59%. Polyp was the next most frequent cause (12%). Endometrial cancer and hyperplasia caused about 10% of cases, and hormonal effect caused 7%. Cervical cancer accounted for <1%.
Even though 95% of postmenopausal bleeding is due to benign causes, all postmenopausal women with unexpected vaginal bleeding should be evaluated for endometrial cancer since it is treatable.
9/07/2011: Q 200. An 80 year old woman comes to the office because she recently has had difficulty eating and swallowing solid food. she notes that when she prepares to swallow, the food scrapes her cheeks and the roof of her mouth. History includes HTN, DM, kidney stones, and major depressive disorder. Medications include HCTZ, metformin, and fluoxetine. For the first time in many years, a recent dental examination revealed several cavities, which were located at the roots of the teeth.
Which of the following is the most likely explanation for these oral problems?
A) Usual aging
B) Salivary ductal stones
C) Adverse effect of metformin
D) Adverse effect of HCTZ and fluoxetine
E) Immune dysfunction
Answer: D
This patient's difficulty with eating and swallowing solid foods in the context of new dental cavities is most consistent with xerostomia, or decreased saliva. Saliva has several functions: it is a protective cleanser with antibacterial activity, a buffer that inhibits demineralization, a lubricant, and a transport medium to taste sensors. These functions are seriously altered in xerostomia. Many conditions and treatments contribute to xerostomia, including radiation or chemotherapy, psychologic, endocrine or nutritional disorders; adverse medication effects (>200 commonly used medications can cause this). Antihypertensives (especially diuretics) and antidepressants (especially first generation SSRSIs) reduce saliva flow. Metformin is not known to decrease salivary flow. Treatment includes good oral hygeine, flouride rinses, reduced alcohol intake, frequent water, saliva substitutes and d/c of offending meds if possible.
Q 194. A 92 year old woman has several stage I and II pressure ulcers on her buttocks and heels one week after treatment for a urinary tract infection and dehydration. She lives in a nursing home and has advanced dementia.
Which of the following is the best tool for monitoring the healing of her pressure ulcers?
A) Braden Scale
B) Bates-Jensen Wound Assessment Tool
C) Norton Scale
D) Waterlow scale
E) Cubbin-Jackson scale
The Bates Jensen Wound Assessment Tool, also called the Pressure Sore Status Tool, is a validated instrument for assessing the healing of pressure ulcers. Developed in 1992 and revised in 2001, it assigns a numeric score for each of the following wound characteristics: size, depth, edges, undermining, necrotic tissue amount, exudate type, exudate amount, surrounding skin color, peripheral tissue edema, peripheral tissue induration, granulation tissue, and epithelization.
Location and shape of the wound are noted but not scored. The Bates-Jensen Wound Assessment Tool is not a risk assessment tool, it is used once a pressure ulcer has developed. Another validated but less time consuming tool for assessing healing is the Pressure Ulcer Scale for Healing (PUSH) which focuses on size of ulcer, amount of exudate, and tissue type.
The Braden, Norton, Waterlow, and Cubbin-Jackson scares are used to assess the risk of developing a pressure ulcer. The Braden scale is widely used, valid and reliable and provides the best estimate of risk. It rates sensory perception, moisture, mobility, nutrition, friction, and shear. A score of <18 on the Braden scale indicates increased risk of development of pressure ulcers.
Q 181. A 75 year old woman is brought to the ED with RLQ pain that has gradually increased in intensity over the past 36 hours, with associated nausea and diarrhea. She reports no relieving or exacerbating factors, and is otherwise healthy.She denies dysuria or history of UTI's.
On exam, she appears uncomfortable. Temp is 36.9, BP 140/85, pulse 94, RR 16. she has RLQ tenderness with no guarding or rebound. Bowel sounds are depressed. CBC is normal with a WBC of 9. U/A demonstrates pyuria. Plain xray demonstrates nonspecific changes.
Which of the following is the best next step?
A. Barium enema
B. Urine Culture
C. CT of the abdomen/pelvis
D. ultrasound of the abdomen
E. Urgent sigmoidoscopy
Answer C: CT of the abdomen/pelvis
Appendicitis accounts for 5% of acute abdominal cases in older adults. Less than 1/3 of older adults have the classic presentation of epigastric abdominal pain that ultimately radiates to the right lower quadrant, with associated anorexia, n/v, fever and leukocytosis.
Fever and leukocytosis are absent in up to 20% of patients.
Inflammation around the ureters (from appendicitis, PID, or other abd/pelvic diseases) can cause pyuria!
Although u/s is used preferentially to dx appendicitis in some settings, CT performs better in head to head comparisons and is especially effective for dx of abdominal pain in older adults in whom multiple intra-abdominal pathologies can present similarly.
GRS Question of the week: 8/9/2011: A 75 year old woman comes to the office because she has had progressive difficulty walking over the past 10 months. The first symptom she noticed was numbness of the feet. Over the next 4 months, the numbness became more marked, ascended her legs, and eventually involved her fingers. As these symptoms progressed, her gait became increasingly unsteady. she now needs assistance to walk and has stopped driving.
She had partial gastric resection for peptic ulcer disease at age 40. History includes HTN and mild osteoarthritis. The HTN is well controlled with an ACE inhibitor and a diuretic. She also takes an "energy-boosting" MVI supplement.
On examination, she has leg spasticity, generalized hyperreflexia, ankle clonus, and extensor plantar responses. She has decreased perception to light touch, pinprick, and position over the toes and fingers, and reduced vibratory sense below the knees bilaterally. Her gait is ataxic, and Romberg's sign is positive. The remainder of the examination is unremarkable.
Vitamin B12: 220
Hgb: 11.9
Methylmalonic acid .18 (normal)
Homocysteine 13 (normal)
Serum electrolytes, creatinine, folate, immunoelectrophoresis, paraneoplastic panel, HIV and HTLV1 are normal/negative. MRI of the spine shows a patchy increased T2 signal in the dorsal aspect of the cord from vertebra C3 to the lower thoracic cord.
Which of the following is the most likely cause of this patient's condition?
A. Vitamin B12 deficiency
B. Zinc deficiency
C. Copper deficiency
D. Vitamin B6 deficiency
E. Vitamin A toxicity
Answer: C, Copper Deficiency
Copper Deficiency Myeloneuropathy is a distinct clinical entity that is being recognized with increasing frequency. The presentation is that of a progressive syndrome with a myelopathy that has predilection for the posterior columns and corticospinal tracts. Red flags include: sensory ataxia, leg spasticity, and peripheral paresthesias -- this may mimic B12 deficiency. As with B12 deficiency, the neurological manifestations may occur without anemia.
A strong association has been found between copper deficiency and a history of partial or complete gastrectomy. Copper deficiency can also be caused or worsened by chronic zinc ingestion because zinc interferes with intestinal copper absorption. Therefore whenever dietary zinc supplements are used, the potential for inducing copper deficiency must be considered.
Although this patient's clinical picture is consistent with B12 deficiency, teh normal serum MMA and homocysteine make this less likely (these concentrations are increased early in B12 deficiency and therefore these tests are very sensitive).


text:
Respiratory SystemThe upper respiratory tract (upper airway) consists of the nose, mouth, sinuses, and throat. The lower respiratory tract consists of the trachea, bronchial tubes, and the structures inside the lungs.
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Skip to page content- What We Do
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Financing your business requires research to find the most appropriate funding model. SBA offers a variety of loan programs for very specific purposes. Take some time to study the programs described in this section to see if you qualify to ... - Venture Capital
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text:
Hello there !
On my mission to climb all 188 of the 2000ft mountains of Wales the most recent ones visited were Gorllwyn and Drygarn Fawr , found high above the Elan Valley , a really remote and desolate place (the hills , not the valley) .Anyway , atop Drygarn Fawr are two huge beehive cairns , and splendid they are too , and though the stones are from the Bronze age (i think) , the cairns were restored early in the last century . There's also an ancient track that passes through the hills . I'm glad i went on a dry day because the whole of the summit plateau between the tops is a vast pathless bog . There's plenty of stuff to visit around here , but sadly didn't get chance , there you go. Cheerz
here's the Wiki : http://en.wikipedia.org/wiki/Drygarn_Fawr
and the Megalithic portal : http://www.megalithic.co.uk/article.php?sid=10037
And some i took :


text:
Thread Tools |
Jan 1st, 2013, 5:28:30 PM | #7301 |
Join Date: Mar 2010
Posts: 1,844
In the world, but not of the world
Reserving a spot.
Take Rivalry the male Heracross/Pinsir. Rivalry is in a constant competition with the rest of your team, and must always have the highest our second highest level in your team. Rivalry must solo a gym and Ash's Pikachu to show that he is the very best okemon bar none. He must use no non-damaging moves or moves under 85 BP against male mons. Lastly, he must score more major battle KOs than any of your other mons. Last edited by Yarnus of Bethany; Jan 1st, 2013 at 7:59:06 PM. |
Jan 1st, 2013, 5:40:47 PM | #7302 |
Join Date: Nov 2012
Posts: 153
inanimate_blob, I edit my post with your challange. Also can you do me a favor and give me a challange for my Scramble?
http://www.smogon.com/forums/showpos...postcount=7235 |
Jan 1st, 2013, 5:58:29 PM | #7303 |
Join Date: May 2011
Posts: 1,162
does this look like the face of mercy
@Phoenix512, take Depressed the Dunsparce. Depressed is upset that it has a terrible BST yet a good movepool, and as such must always have four moves of different types in its moveset. Additionally, Depressed must solo two gyms of your choice and two of Red's Pokémon in order to prove itself as a Dunsparce. As soon as possible, Depressed must also have an Sitrus Berry at all times because it functions as a safety blanket. When the Sitrus Berry gets used up, you cannot use Depressed until you get him another Sitrus Berry.
trumpet gang or die
hoenn 5evur |
Jan 1st, 2013, 6:27:46 PM | #7304 | |
Join Date: Oct 2012
Posts: 624
On top of a giant dragon's back.
EDIT: Phoenix512, take the Dratini from the Game Corner. Until Dratini reaches Lv.40, it can only use Dragon moves. After Dragonair reaches Level 40 (yes, you may evolve when you reach Level 30) you can NEVER use STAB moves again until you evolve to Dragonite. Also, solo Clair with Dragonair. (If this is too hard, just solo her Kingdra instead.) Also, solo Lance's highest level Dragonite.
Bearkiller on PS, and bearhugger on IRC. I play League of Legends, so there's that. Also free Genesect plz. Me in real life. Last edited by Organization Member XIV; Jan 2nd, 2013 at 6:15:36 AM. |
Jan 1st, 2013, 8:34:53 PM | #7305 |
Join Date: Nov 2012
Posts: 153
Here's a quick prologue of my HeartGold Scramble Challange. The challange details are in my sig.
My HeartGold Scramble |
Jan 1st, 2013, 9:08:54 PM | #7306 |
Join Date: Jul 2011
Posts: 1,344
Want a sugar cube?
Glad to see someone trying to write something longhand. I hope you stick with it-we need more writers around here.
Clothes make the man. Naked people have very little influence on society. Scramble Compendium-Beginner Mafia Game (if you're new, come join!) |
Jan 1st, 2013, 9:20:32 PM | #7307 |
Join Date: Aug 2010
Posts: 4,173
inanimate blob you still have space right?
ok, take SWASTIKA the Paras swastika used to be just a normal Paras. he lived in the forest, doing normal paras things. Unfortunately, Johto had fallen into some rough times after they lost the war over the Tohjo Falls and the ensuing treaty basically screwed them. The great Fuhrer HeraHitler arose, speaking of all the greatness he saw in the land of Johto and how the Kantos better not take it from them! Paras grew absolutely infatuated with his great oratory and became a fervent follower. Restrictions: 1) Paras wears a red band around his upper arm. That means he's always wearing a focus sash - equip one ASAP, and if it ever gets consumed, give him another (yes, focus sash is consumed upon use). 2) Paras feels that the words of HeraHitler need to be spread far and wide. Every time he KOes a Pokemon, to spread the superiority of Johto, he goes on to Pokemon SHOWDOWN! chat and says in all caps, "BURN THE JEWS." yes, you must do this. 3) Only after he's spread the word enough does he feel ready to evolve. But the word needs to be received. You must say BURN THE JEWS 10 times without getting kicked or muted before paras can evolve. (yes, you are allowed to explain yourself to try to avoid the mute. I don't want this to be impossible) 4) To demonstrate the ultimate superiority of the Johtos, he must solo either Lance or Koga (your choice, either will be a brutal hell). have fun! ps. i want updates as to your escapades on Showdown |
Jan 1st, 2013, 11:04:56 PM | #7308 |
Join Date: Nov 2012
Posts: 153
Chapter 1
Here is Chapter 1 which covers to capturing the second Scramblemon.
Chapter 1
My HeartGold Scramble |
Jan 1st, 2013, 11:23:00 PM | #7309 |
Join Date: May 2011
Posts: 1,162
does this look like the face of mercy
Great challange, though, made me laugh. Alright, denied. That was just dumb.
trumpet gang or die
hoenn 5evur Last edited by inanimate blob; Jan 1st, 2013 at 11:42:17 PM. |
Jan 1st, 2013, 11:36:10 PM | #7310 |
Join Date: Apr 2011
Posts: 220
I think I'll start a Scramblocke. But I'm not just catching 'mons as I get to them. I use an encounter code to catch one of them each area. Because I'm using an encounter code, I can take /any pokemon in the original 386./ I am playing Emerald, almost certainly, so they can all evolve, too. Basically, I'll take around 10 suggestions, and RNG when I encounter a new area. HOWEVER! I'm using the Notepad clause; I can only have six pokemon at a time, nothing in the box. If I have a full party when I reach a new area, I don't RNG any 'mon, and I can't get a catch there. If I run out of pokemon, I'll ask for more. So, could you all give 10 pokemon? I may or may not document it. (PS: Hacked movesets are fine, if you want that. Just don't overdo it, I don't want 6 pokemon that must all always know splash)
ASB Profile! |
Jan 1st, 2013, 11:39:31 PM | #7311 |
Join Date: Apr 2012
Posts: 7
Hi, guys. I'm interested in doing a Scramble Challenge for Black 2. -No trading. -I don't want my starter Pokemon in my final team. I also don't want any Psuedo-Legendary or Legendary Pokemon. -I don't want my challenge to be too difficult, but I don't want it to be really easy either. (Also, I wasn't able to complete my SoulSilver challenge since I can't find my copy of it for some reason :
Jan 1st, 2013, 11:45:17 PM | #7312 | |
Join Date: Sep 2011
Posts: 2,827
I am an "Andalite Bandit." Shiver in fear while you can, Yeerks. We're coming for you!
Sorry, Mado, my friend, but I am gonna take this guy's as I am slightly confused about yours.
It goes beyond saying that this may or may not be my last appearance here on Smogon. I have been busy elsewhere and Smogon, in the end, comes second to the place I am currently residing. I am so sorry to all of you. Please forgive me.
Jan 1st, 2013, 11:45:27 PM | #7313 |
Join Date: Jun 2010
Posts: 1,305
Madotsuki, RNG for a Nincada. Call it Hollow. Evolve it ASAP and get yourself a Ninjask and Shedinja. You must RNG for one in the route that leads to Petalburg (where Wally gets his Ralts).
Using Ninjask, solo Brawly and his gym trainers with only one move (as if you were Choice-locked) and no healing items. You cannot visit the Pokemon Center between trainers, nor can you switch your move between trainers. Solo Flannery with Shedinja. No restrictions, it's bad enough as it is. If either Pokemon dies before their solo requirement is completed (or during the solo attempt), then just carry on with the remaining Pokemon, however you must switch battle mode in Options to "Set" (not "Shift").
Just A1 for short. Apparenlty people can't spell Treadshot. Recent Scramble link Note: Yes, it is spelt wrong. Deliberately. Shut up, you're not the first to notice. Last edited by Treadshot A1; Jan 2nd, 2013 at 5:10:29 AM. |
Jan 2nd, 2013, 12:09:02 AM | #7314 |
Join Date: May 2011
Posts: 1,162
does this look like the face of mercy
@Madotsuki Take Sad the Deoxys. Sad, being sad, may not use any moves over 60 BP. That is all. Good luck! :3
ALSO I still need two more Pokémon to get this thing started, guys. I denied Pwnemon's since that was a straight impossible (and offensive :3) challange.
trumpet gang or die
hoenn 5evur |
Jan 2nd, 2013, 12:56:16 AM | #7315 |
Join Date: Mar 2007
Posts: 983
Texas (loetke's home)
So Mado is doing a hacked-up version of Emerald 386, essentially. Now Treadshot, who is Ninjask soloing?
Pikachu pwns Groudon, Kyogre, and Rayquaza! Pikachu used Grass Knot! Groudon fainted! Pikachu used Thunder! Kyogre fainted! Pikachu used (ice) Hidden Power! Rayquaza fainted! Pikachu is the winner! (Smogon's Damage Calculator to Verify!) YouTube, My Pokécheck Box, My Scramble Compendium |
Jan 2nd, 2013, 5:11:48 AM | #7316 |
Join Date: Jun 2010
Posts: 1,305
Woops, accidentally deleted that when I was editing in the challenge.
Madotsuki's Ninjask solos Brawly (and his entire Gym's worth of trainers), while Shedinja solos Flannery. [/yeah right. Like Shedinja has any hope of soloing Flannery.]
Just A1 for short. Apparenlty people can't spell Treadshot. Recent Scramble link Note: Yes, it is spelt wrong. Deliberately. Shut up, you're not the first to notice. |
Jan 2nd, 2013, 5:40:53 AM | #7317 |
Join Date: Oct 2012
Posts: 340
By choice or chance, you cannot control what you are not aware of.
reserved for inanimate blob and King of Sushi
@inanimate blob, take Diverse the Spinarak. As monotype challenges usually end up with a lack of different attacking types, Diverse must learn 4 damaging moves of 4 different types ASAP. It starts out with only being able to learn level up moves. Diverse is a diverse, capable fighter, and wants to solo a multitude of people. Therefore, solo 1 Johto gym leader, 1 Kanto gym leader, 1 Team Rocket Boss, 1 elite four/ champion R1, 1 elite four/champion R2 and your Rival once. That's right, 6 solo's. That should be difficult enough as is, so I'll leave it at this. After 2 solo's, Diverse enables the ability to learn tm's. After 4 solo's, Diverse is capable of learning move tutor moves. (-->only possibility to learn good bug type moves) GL @King of Sushi, take Bzzzzzt the Magnemite. Bzzzzzt cannot learn or use STAB attacks. Remove one "z" from its name for every gym leader / team plasma boss it solo's (PWT and the like do not count). When all "z''s are removed, Magnemite can start learning and use STAB attacks and must be renamed Zap. It can now also evolve for the first time. For every new move it learns, add a "z" to Zap. When you are unable to add more "z"'s, Z(...)ap cannot learn new moves anymore. It MUST be renamed Zap before the elite four, so make sure your solo's are completed by then. Have Z(....)ap solo either Ghetsis or Iris. Btw, if you are unable to rename Bzzzzzt after a solo, just remember to change its name as soon as you get to the name rater. GL Last edited by Present; Jan 2nd, 2013 at 6:05:10 AM. |
Jan 2nd, 2013, 6:10:34 AM | #7318 |
Join Date: Oct 2012
Posts: 624
On top of a giant dragon's back.
Madotsuki, RNG an Aggron. Its final moveset must be that of Steven's in Ruby and Sapphire. (It must be caught as an Aggron.) This is EQ, Dragon Claw, Thunder, SolarBeam. That will be Aggron's final moveset. It can never fight any Pokemon it has the type advantage against, and must ALWAYS fight Pokemon it has the type DISADVANTAGE against. Have fun.
EDIT: lol celever is that directed towards moi? :3
Bearkiller on PS, and bearhugger on IRC. I play League of Legends, so there's that. Also free Genesect plz. Me in real life. |
Jan 2nd, 2013, 6:14:08 AM | #7319 |
Join Date: Sep 2012
Posts: 1,142
Merry old England
Damn it! I wanted to do Scyther! Oh well, you get Misty the Spinarak!
Now, one of the most memorable moments of the anime for me was when a spinarak dropped down and Misty started screaming and freaking out about it, and guess what? The spinarak from that moment in the anime is this Spinarak that you will get!!! Unfortunately, Spinarak got quite depressed after Misty screamed at it, and it has started wondering if other's see him as a scary monster, so any moves that make it seem more scary are disallowed, list of scary moves:
Also, Misty (the spinarak) despises Misty (the person), so you must solo Misty with Misty! However, despite the fact that he tries his best not to be sneaky or monstrous, he just can't help it! So in order to get the sneaky advantage over Misty, he must solo Erika BEFORE Misty and get the giga drain TM off of her, and you must max out the amount of PP on giga drain (outside of battle, so you should go into the battle with 16 PP for giga drain). When you solo Misty, you may only use giga drain every other turn (Spinarak tries not to be sneaky, and feels bad about learning giga drain) but if you don't use giga drain 2 turns after either the start of the battle or the last time you use it you MUST use it on the fourth turn. If you don't understand then open the hidden message and see an example:
Enjoy! :D |
Jan 2nd, 2013, 6:19:32 AM | #7320 | |
Join Date: Oct 2012
Posts: 624
On top of a giant dragon's back.
EDIT: Sorry for double posting unlike a baws.
Bearkiller on PS, and bearhugger on IRC. I play League of Legends, so there's that. Also free Genesect plz. Me in real life. |
Jan 2nd, 2013, 6:28:00 AM | #7321 | |
Join Date: Apr 2011
Posts: 220
The only issue I have... some of these challenges require soloing leaders. What if a pokemon has not been caught yet by the time I challenge it? You might want to consider that when choosing restrictions.
ASB Profile! |
Jan 2nd, 2013, 6:45:34 AM | #7322 |
Join Date: Sep 2012
Posts: 1,142
Merry old England
Oh COME ON! There are barely any more bug types left! I hate Beedril after an un-important one kept on critting and hiiting 5 times with fury attack making me fail at a heart gold nuzlocke and that's all that are left (that I can think of!) D:
"Oh no, we're not lost it's just that we don't know where we are" - Brock 19:59 Darknesscrusher Just watch fucking porn man 19:59 Darknesscrusher Lesbo is better anyway |
Jan 2nd, 2013, 7:03:29 AM | #7323 |
Join Date: Oct 2012
Posts: 624
On top of a giant dragon's back.
You can give him a Ledyba. Pineco? that could work.
Bearkiller on PS, and bearhugger on IRC. I play League of Legends, so there's that. Also free Genesect plz. Me in real life. |
Jan 2nd, 2013, 7:04:25 AM | #7324 |
Join Date: Sep 2012
Posts: 1,142
Merry old England
Heartgold scramble, Ledyba is soul-silver exclusive just like Spinarak is heart gold exclusive.
"Oh no, we're not lost it's just that we don't know where we are" - Brock 19:59 Darknesscrusher Just watch fucking porn man 19:59 Darknesscrusher Lesbo is better anyway |
Jan 2nd, 2013, 7:27:31 AM | #7325 |
Join Date: Oct 2012
Posts: 340
By choice or chance, you cannot control what you are not aware of.
Yeah, I was first. *sorry* Anyway, inanimate blob only needs one more pokemon when he accepts mine. You can still choose from paras, yanma, venonat, shuckle. Hope that helped.
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OpenBOR is a continuation of the Beats Of Rage 2D game, which was originally
created by the wonderful folks over at http://www.senileteam.com
This release is for the Dreamcast, PSP, Wii Wiz, GP2x and Dingoo:
Heres whats new;
r3671 | utunnels | 2012-03-03 23:58:31 -0500 (Sat, 03 Mar 2012) | 1 line
Changed paths:
M /engine/openbor.c
Fix a possible loophole that crashes while doing a branch jump. (Hopefully, because it never crashes on my PC anyway).
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General Message:
MPS announces new start and stop times for schools.
Please click here for a message concerning cafeteria charges and Summer Food Fest.
June 10, 2013
Dear Moore Public Schools Family:
We have heard from people across the country who have sent in monetary donations of all sizes, messages of hope and strength, and offers to travel many miles to come and help in person. Moore is a strong community and we will rebuild no matter what, but the love and support we have received from across our state and our country has lifted us up immeasurably. Even through this tragedy, we know we are blessed.
We are actively working to ensure that all of our sites will be up and running for the upcoming school year. Countless employees and volunteers are working tirelessly to get us back to business as usual. It will be a long road but never forget, Moore is OK.
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An Email-Ready Link
As you requested, here is a ready-to-email link to this page. Simply include this URL in an email to friends or family members, and they will be able to reach this page directly. The URL is: http://onlineraceresults.com/race/view_race.php?race_id=23219&relist_record_type=result&upper_bound=40&use_previous_sql=1&order_by=OVERALL
Louisiana Marathon - 2012MarathonJanuary 15, 2012 in Baton Rouge, LANote: these are 2012 results follow this link for 2013 http://onlineraceresults.com/event/view_event.php?event_id=10116 |
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Police appeal after young girl approached by man in Warminster
9:40am Wednesday 30th January 2013 in Latest News
Police are seeking information after receiving a report of a man approaching a young girl in Masefield Road, Warminster at 5.20pm yesterday (January 29).
The man is described as black, with black teeth and is reported to have offered the 10-year-old, who was out alone, a lift. The girl refused and the man then drove off towards Victoria Road.
He is described as having a large black estate car and wearing a distinctive top with red and blue sleeves and a grey body.
Police consider this to be an isolated incident, but if there are any other similar reports then the police do need to know.
Inspector Lindsey Winter said: "I appreciate this is a real worry especially for those living in the vicinity of Masefield Road, but this does appear to be an isolated incident at this time.
"It is really important that if there are any other similar sightings or reports then the police are informed as soon as possible so any searches or patrols can be made straight away."
Work is ongoing to ascertain if the vehicle has been sighted elsewhere in the town especially those areas covered by CCTV.
Any witnesses who may have seen the vehicle or man should contact police on 101.
11:55am Wed 30 Jan 13
1:33pm Thu 31 Jan 13
1:48am Sat 2 Feb 13
Sazzer wrote:Please make sure you let police know of your findings
Cant be many black men with black teeth knocking about?
Mrs Donnyfly
12:54pm Sat 2 Feb 13
redrum wrote:Are you serious? 5.20 PM is hardly late, so what if it's dark. Kindly provide data that proves children are abducted more in the dark.
10 years old and out alone at this time when it is darkl, please tell me this fact is wrong. Thank god she is ok, this time.
4:20pm Sat 2 Feb 13
Mrs Donnyfly
3:30am Sun 3 Feb 13
6:55am Sun 3 Feb 13
9:36am Sun 3 Feb 13
redrum wrote:Most parents love their kids. They all bring them up differently. Your way is not anothers' way. Provided a child is loved, supported and educated beyond just basic need - there isn't a "right" or "wrong" way.
At 10 the furthest myself and my brothers and sisters were was out in the back garden with a locked gate, my kids are no different. You see the gift of children are too precious to take risks with. At what age did you let yours out alone ?, My 13 yr old is allowed to town with friends during the day, my younger ones will not be allowed out until this age too. I have bought my kids up with a good understanding of strangers and there are police close in our family which helps when talking over dangers. However if a child of 10 is alone and in the dark as well there is a high chance of nobody seeing them if they are approached by someone/ dragged into a vehicle. Some may see it as cotton wool, most parents will see it as protecting the most precious people to you. It is the true love of a parent you see.
It's just so darned easy to point the finger at the presumed failings on the part of others though, isn't it?
12:20pm Sun 3 Feb 13
9:49pm Sun 3 Feb 13
12:20pm Sun 3 Feb 13
Each to their own, every parents job is to keep their children safe from harm. It is not about pointing a finger it is about learning from others misfortunes, luckily this child is not harmed and maybe it will make other parents think to avoid this happening again."
Are you blind, or just daft?


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The merriest pull toy ever! Toddler will love pulling this precious penguin family, all decked out in their holiday finery. Best of all: the wooden penguins actually waddle, rolling along on flippers shaped like holiday lights! The baby penguin has a jingle bell tail; kids love hearing it chime as they lead the parade. Wood pull toy is beautifully crafted of maple, with removable, velour caps and jackets. For ages 18 months and up. Imported. See Product Details
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penguin waddle does not waddle
By cc
from milton, de
About Me Grandparent
Comments about HAPE International Penguin Waddle Pull Toy:
something needs to be added to the spindles so they will roll when toy is pulled.
penguins don't waddle
By Chuck
from NY, NY
the product does not waddle, child just drags it across the floor while the "wheels" don't turn. I returned the first one since I thought it was broker. The replacement was the same problem. Can't understand how it was ever introduced.
Nice, but imperfect engineering
By Mr. Parent
from Los Angeles, CA
About Me Working Parent
Imperfect engineering does not actually generate a noticeable waddle as it's described. Otherwise it's cute toy.
(2 of 5 customers found this review helpful)
By Jean
from Chicago, IL
About Me Parent of Two or More Children
It's cute but my son would rather pull around things that are not toys.
(3 of 3 customers found this review helpful)
Penguin Waddle Disappointing
By Grandma Kathleen
from Portland OR
I gave this pull toy to my 2yr old grandson. The pull string was way too short for HIM, and the promised waddle action was sadly lacking. It didn't interest him for long. The fact that the penguin black bodies,faces, and hats are fabric and come off in one washable piece is great!
Find thoughtfully selected products at One Step Ahead to help you and your baby...every step of the way! Shop Online or Call 1-800-274-8440 One Step Ahead Baby © Copyright 2013


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The Northwest Arkansas Education Service Cooperative is proud to launch our new website. Please check back often for exciting new changes throughout our site.
At NWAESC, "Making a Difference!" has become our motto and we proudly wear the starfish pin which symbolizes our commitment to this mission. We place a high priority on an attitude of service and believe in going the "extra mile" to anticipate and meet the needs of our districts, which will help them increase the achievement of their students.
We concentrate on treating smallest districts with the same level of service as the largest of our districts, working on the "little things"… returning phone calls promptly, helping find solutions to problems, and treating every question as if it is the first time it has been asked. We do not feel that we supervise our districts or tell them what to do; rather, we are a resource and we do everything we can to help them accomplish their goals.
Sprindale School District Was recently Announced as One of Seven Schools Statewide to be Awarded a Grant for School-Based Health Centers in a Press Release from The Arkansas Department of Education. Read More


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a. Spellpower will increase this ratio logarithmically to a limit of about 3.4:1. This is the ratio between the talent-modified SP coefficients of LB and LS. b. Mastery will linearly increase this ratio, but at a very slow rate. At the Mastery hard cap (30,120 MR, or 100% chance of Overload,) Mastery has increased the ratio by a factor of 1.92. c. The basic conclusion of (1) remains true up to a ratio of approximately 14:1. As the highest your ratio can get is about 5.4:1, this would be impossible.
a. Above the haste "hard" cap (1.0 sec LB casts,) haste would begin to decrease this value, as the additional FS ticks proc more LvBs. b. Around 7 LBs/lockout, the cutoff number can hit 4. At that point, the best dps is to ES every time you have 6-8 seconds left on FS. To reach that, you would need 0/2 or 1/2 Reverberation and around 90% haste. This is hypothetically possible under Bloodlust conditions.


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[Original Page]
Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact the College by phone or in writing.
Department: Social & Behavioral Sciences Title: Adjunct/Professor
Office Location: Lakewood Ranch Room Number: 09-122 Phone: (941) 363-7199 E-mail: firstname.lastname@example.com Web Page: http://faculty.scf.edu/meltond/index.html


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Crispy Fried Artichokes |
Category: | Entrées |
Source: | From the Wine Enthusiast Pairings Book |
Description: | This recipe is adapted from Anna Dente Ferracci's recipe for whole fried artichokes served at her restaurant, Osteria di San Cesario, outside of Rome. Known as Sora ("sister") Anna, this celebrated chef and her mother, Sora Maria, are queens of the Italian fried artichoke. |
Number of Servings: | Serves 4 |
Ingredients: | 10 tender, small artichokes with stalks 1 lemon, cut into 4 wedges 4 cups (1-liter bottle) extra virgin olive oil Flour, for coating Salt |
Directions: | To prepare the artichokes: With the artichoke on its side, cut off the top half and discard. You should see tender yellow leaves and the pink spiky choke at the center. Snap off the tough dark green outer leaves until you reach the tender ones. With a knife, slice off the woody skin on the outside of the stock, leaving about two inches from the base. Cut the artichoke into halves, then quarters and remove any thistly parts. Cut into eighths or thin wedges and place in a large bowl of water with freshly squeezed lemon juice. (Artichokes oxidize when cut and putting them in lemon water will stop them from turning brown.) To fry the artichokes: Pour the olive oil into a fryer or heavy pot and place over low heat. Coat a ceramic plate with a layer of flour. Gently press the moist artichoke wedges directly into the flour so they are covered evenly. The oil is ready when a drop of water crackles and fizzles to evaporation: Never let the oil get so hot it starts to smoke. Add the floured artichoke wedges to the oil, in batches to avoid overcrowding, and fry until crisp and golden. With a slotted spoon, transfer the artichokes as they are done to paper towels to drain briefly. Arrange the artichokes on a serving platter and serve at once, with salt. |


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