text:
Frequent Links
Open Access Articles- Top Results for Pneumothorax
Journal of Clinical & Experimental CardiologyPneumopericardium and Contralateral Pneumothorax to Venous Access Site after a Biventricular Permanent Pacemaker Implantation
Journal of Anesthesia & Clinical ResearchPeri-Operative Management of a Patient with Bilateral Giant Bullae and Pneumothorax in the Context of Severe Pulmonary Obstructive Disease
Chest X-ray showing a pneumothorax on the right (left in the image), where the absence of lung markings indicates that there is free air inside the chest
A large right-sided spontaneous pneumothorax (left in the image). An arrow indicates the edge of the collapsed lung
|Classification and external resources
|512, 860
|article/432979 article/424547 article/360796 article/808162 article/827551 article/1003552
|Patient UK
A pneumothorax (pneumo- + thorax; plural pneumothoraces) is an abnormal collection of air or gas in the pleural space that causes an uncoupling of the lung from the chest wall. Like pleural effusion (liquid buildup in that space), pneumothorax may interfere with normal breathing. It is often called collapsed lung, although that term may also refer to atelectasis.
A primary pneumothorax is one that occurs without an apparent cause and in the absence of significant lung disease, while a secondary pneumothorax occurs in the presence of existing lung pathology. In a minority of cases, the amount of air in the chest increases markedly when a one-way valve is formed by an area of damaged tissue, leading to a tension pneumothorax. This condition is a medical emergency that can cause steadily worsening oxygen shortage and low blood pressure. Unless reversed by effective treatment, these sequelae can progress and cause death.
Pneumothoraces can be caused by physical trauma to the chest (including blast injury), or as a complication of medical or surgical intervention. Symptoms typically include chest pain and shortness of breath. Diagnosis of a pneumothorax by physical examination alone can be difficult or inconclusive (particularly in smaller pneumothoraces), so a chest radiograph or computed tomography (CT) scan is usually used to confirm its presence.
Small spontaneous pneumothoraces typically resolve without treatment and require only monitoring. This approach may be most appropriate in subjects who have no significant underlying lung disease. In larger pneumothoraces, or when there are marked symptoms, the air may be extracted with a syringe or a chest tube connected to a one-way valve system. Occasionally, surgical interventions may be required when tube drainage is unsuccessful, or as a preventive measure, if there have been repeated episodes. The surgical treatments usually involve pleurodesis (in which the layers of pleura are induced to stick together) or pleurectomy (the surgical removal of pleural membranes).
- 1 Signs and symptoms
- 2 Cause
- 3 Mechanism
- 4 Diagnosis
- 5 Management
- 6 Prevention
- 7 Epidemiology
- 8 History
- 9 Other animals
- 10 References
Signs and symptoms
A primary spontaneous pneumothorax (PSP) tends to occur in a young adult without underlying lung problems, and usually causes limited symptoms. Chest pain and sometimes mild breathlessness are the usual predominant presenting features.[1][2] People who are affected by PSPs are often unaware of potential danger and may wait several days before seeking medical attention.[3] PSPs more commonly occur during changes in atmospheric pressure, explaining to some extent why episodes of pneumothorax may happen in clusters.[2] It is rare for PSPs to cause tension pneumothoraces.[1]
Secondary spontaneous pneumothoraces (SSPs), by definition, occur in individuals with significant underlying lung disease. Symptoms in SSPs tend to be more severe than in PSPs, as the unaffected lungs are generally unable to replace the loss of function in the affected lungs. Hypoxemia (decreased blood-oxygen levels) is usually present and may be observed as cyanosis (blue discoloration of the lips and skin). Hypercapnia (accumulation of carbon dioxide in the blood) is sometimes encountered; this may cause confusion and - if very severe - may result in comas. The sudden onset of breathlessness in someone with chronic obstructive pulmonary disease (COPD), cystic fibrosis, or other serious lung diseases should therefore prompt investigations to identify the possibility of a pneumothorax.[1][3]
Traumatic pneumothorax most commonly occurs when the chest wall is pierced, such as when a stab wound or gunshot wound allows air to enter the pleural space, or because some other mechanical injury to the lung compromises the integrity of the involved structures. Traumatic pneumothoraces have been found to occur in up to half of all cases of chest trauma, with only rib fractures being more common in this group. The pneumothorax can be occult (not readily apparent) in half of these cases, but may enlarge - particularly if mechanical ventilation is required.[2] They are also encountered in patients already receiving mechanical ventilation for some other reason.[2]
Upon physical examination, breath sounds (heard with a stethoscope) may be diminished on the affected side, partly because air in the pleural space dampens the transmission of sound. Measures of the conduction of vocal vibrations to the surface of the chest may be altered. Percussion of the chest may be perceived as hyperresonant (like a booming drum), and vocal resonance and tactile fremitus can both be noticeably decreased. Importantly, the volume of the pneumothorax can show limited correlation with the intensity of the symptoms experienced by the victim,[3] and physical signs may not be apparent if the pneumothorax is relatively small.[2][3]
Tension pneumothorax
Although multiple definitions exist, a tension pneumothorax is generally considered to be present when a pneumothorax (primary spontaneous, secondary spontaneous, or traumatic) leads to significant impairment of respiration and/or blood circulation.[4] Tension pneumothorax tends to occur in clinical situations such as ventilation, resuscitation, trauma, or in patients with lung disease.[3] The most common findings in people with tension pneumothorax are chest pain and respiratory distress, often with an increased heart rate (tachycardia) and rapid breathing (tachypnea) in the initial stages. Other findings may include quieter breath sounds on one side of the chest, low oxygen levels and blood pressure, and displacement of the trachea away from the affected side. Rarely, there may be cyanosis (bluish discoloration of the skin due to low oxygen levels), altered level of consciousness, a hyperresonant percussion note on examination of the affected side with reduced expansion and decreased movement, pain in the epigastrium (upper abdomen), displacement of the apex beat (heart impulse), and resonant sound when tapping the sternum.[4] This is a medical emergency and may require immediate treatment without further investigations (see below).[3][4]
Tension pneumothorax may also occur in someone who is receiving mechanical ventilation, in which case it may be difficult to spot as the person is typically receiving sedation; it is often noted because of a sudden deterioration in condition.[4] Recent studies have shown that the development of tension features may not always be as rapid as previously thought. Deviation of the trachea to one side and the presence of raised jugular venous pressure (distended neck veins) are not reliable as clinical signs.[4]
Primary spontaneous
Spontaneous pneumothoraces are divided into two types: primary, which occurs in the absence of known lung disease, and secondary, which occurs in someone with underlying lung disease. The cause of primary spontaneous pneumothorax is unknown, but established risk factors include male sex, smoking, and a family history of pneumothorax.[5] The various suspected underlying mechanisms are discussed below.[1][2]
Secondary spontaneous
Secondary spontaneous pneumothorax occurs in the setting of a variety of lung diseases. The most common is chronic obstructive pulmonary disease (COPD), which accounts for approximately 70% of cases.[5] Known lung diseases that may significantly increase the risk for pneumothorax are
|Diseases of the airways[1]
|COPD (especially when emphysema and lung bullae are present), acute severe asthma, cystic fibrosis
|Infections of the lung[1]
|Pneumocystis pneumonia (PCP), tuberculosis, necrotizing pneumonia
|Interstitial lung disease[1]
|Sarcoidosis, idiopathic pulmonary fibrosis, histiocytosis X, lymphangioleiomyomatosis (LAM)
|Connective tissue diseases[1]
|Rheumatoid arthritis, ankylosing spondylitis, polymyositis and dermatomyositis, systemic sclerosis, Marfan's syndrome and Ehlers–Danlos syndrome
|Lung cancer, sarcomas involving the lung
|Catamenial pneumothorax (associated with the menstrual cycle and related to endometriosis in the chest)
In children, additional causes include measles, echinococcosis, inhalation of a foreign body, and certain congenital malformations (congenital cystic adenomatoid malformation and congenital lobar emphysema).[6]
11.5% of people with a spontaneous pneumothorax have a family member who has previously experienced a pneumothorax. The hereditary conditions--Marfan syndrome, homocystinuria, Ehlers–Danlos syndrome, alpha 1-antitrypsin deficiency (which leads to emphysema), and Birt–Hogg–Dubé syndrome—have all been linked to familial pneumothorax.[7] Generally, these conditions cause other signs and symptoms as well, and pneumothorax is not usually the primary finding.[7] Birt–Hogg–Dubé syndrome is caused by mutations in the FLCN gene (located at chromosome 17p11.2), which encodes a protein named folliculin.[6][7] FLCN mutations and lung lesions have also been identified in familial cases of pneumothorax where other features of Birt–Hogg–Dubé syndrome are absent.[6] In addition to the genetic associations, the HLA haplotype A2B40 is also a genetic predisposition to PSP.[8][9]
A traumatic pneumothorax may result from either blunt trauma or penetrating injury to the chest wall.[2] The most common mechanism is due to the penetration of sharp bony points at a new rib fracture, which damages lung tissue.[5] Traumatic pneumothorax may also be observed in those exposed to blasts, even though there is no apparent injury to the chest.[10]
Medical procedures, such as the insertion of a central venous catheter into one of the chest veins or the taking of biopsy samples from lung tissue, may lead to pneumothorax. The administration of positive pressure ventilation, either mechanical ventilation or non-invasive ventilation, can result in barotrauma (pressure-related injury) leading to a pneumothorax.[2]
Divers who breathe from an underwater apparatus are supplied with breathing gas at ambient pressure, which results in their lungs containing gas at higher than atmospheric pressure. Divers breathing compressed air (such as when scuba diving) may suffer a pneumothorax as a result of barotrauma from ascending just Script error: No such module "convert". while breath-holding with their lungs fully inflated.[11] An additional problem in these cases is that those with other features of decompression sickness are typically treated in a diving chamber with hyperbaric therapy; this can lead to a small pneumothorax rapidly enlarging and causing features of tension.[11]
The thoracic cavity is the space inside the chest that contains the lungs, heart, and numerous major blood vessels. On each side of the cavity, a pleural membrane covers the surface of lung (visceral pleura) and also lines the inside of the chest wall (parietal pleura). Normally, the two layers are separated by a small amount of lubricating serous fluid. The lungs are fully inflated within the cavity because the pressure inside the airways is higher than the pressure inside the pleural space. Despite the low pressure in the pleural space, air does not enter it because there are no natural connections to an air-containing passage, and the pressure of gases in the bloodstream is too low for them to be forced into the pleural space.[2] Therefore, a pneumothorax can only develop if air is allowed to enter, through damage to the chest wall or damage to the lung itself, or occasionally because microorganisms in the pleural space produce gas.[2]
Chest-wall defects are usually evident in cases of injury to the chest wall, such as stab or bullet wounds ("open pneumothorax"). In secondary spontaneous pneumothoraces, vulnerabilities in the lung tissue are caused by a variety of disease processes, particularly by rupturing of bullae (large air-containing lesions) in cases of severe emphysema. Areas of necrosis (tissue death) may precipitate episodes of pneumothorax, although the exact mechanism is unclear.[1] Primary spontaneous pneumothorax has for many years been thought to be caused by "blebs" (small air-filled lesions just under the pleural surface), which were presumed to be more common in those classically at risk of pneumothorax (tall males) due to mechanical factors. In PSP, blebs can be found in 77% of cases, compared to 6% in the general population without a history of PSP.[12] As these healthy subjects do not all develop a pneumothorax later, the hypothesis may not be sufficient to explain all episodes; furthermore, pneumothorax may recur even after surgical treatment of blebs.[2] It has therefore been suggested that PSP may also be caused by areas of disruption (porosity) in the pleural layer, which are prone to rupture.[1][2][12] Smoking may additionally lead to inflammation and obstruction of small airways, which account for the markedly increased risk of PSPs in smokers.[3] Once air has stopped entering the pleural cavity, it is gradually reabsorbed.[3]
Tension pneumothorax occurs when the opening that allows air to enter the pleural space functions as a one-way valve, allowing more air to enter with every breath but none to escape. The body compensates by increasing the respiratory rate and tidal volume (size of each breath), worsening the problem. Unless corrected, hypoxia (decreased oxygen levels) and respiratory arrest eventually follow.[4]
The symptoms of pneumothorax can be vague and inconclusive, especially in those with a small PSP; confirmation with medical imaging is usually required.[3] In contrast, tension pneumothorax is a medical emergency and may be treated before imaging - especially if there is severe hypoxia, very low blood pressure, or an impaired level of consciousness. In tension pneumothorax, X-rays are sometimes required if there is doubt about the anatomical location of the pneumothorax.[4][5]
Chest X-ray
Traditionally a plain radiograph of the chest, ideally with the X-ray beams being projected from the back (posteroanterior, or "PA"), has been the most appropriate first investigation. These are usually performed during maximal inspiration (holding one's breath); no added information is gathered by obtaining a chest X-ray in expiration (after exhaling).[2][3] If the PA X-ray does not show a pneumothorax but there is a strong suspicion of one, lateral X-rays (with beams projecting from the side) may be performed, but this is not routine practice.[3][6] It is not unusual for the mediastinum (the structure between the lungs that contains the heart, great blood vessels and large airways) to be shifted away from the affected lung due to the pressure differences. This is not equivalent to a tension pneumothorax, which is determined mainly by the constellation of symptoms, hypoxia, and shock.[2]
The size of the pneumothorax (i.e. the volume of air in the pleural space) can be determined with a reasonable degree of accuracy by measuring the distance between the chest wall and the lung. This is relevant to treatment, as smaller pneumothoraces may be managed differently. An air rim of 2 cm means that the pneumothorax occupies about 50% of the hemithorax.[3] British professional guidelines have traditionally stated that the measurement should be performed at the level of the hilum (where blood vessels and airways enter the lung) with 2 cm as the cutoff,[3] while American guidelines state that the measurement should be done at the apex (top) of the lung with 3 cm differentiating between a "small" and a "large" pneumothorax.[13] The latter method may overestimate the size of a pneumothorax if it is located mainly at the apex, which is a common occurrence.[3] The various methods correlate poorly, but are the best easily available ways of estimating pneumothorax size.[3][6] CT scanning (see below) can provide a more accurate determination of the size of the pneumothorax, but its routine use in this setting is not recommended.[13]
Not all pneumothoraces are uniform; some only form a pocket of air in a particular place in the chest.[3] Small amounts of fluid may be noted on the chest X-ray (hydropneumothorax); this may be blood (hemopneumothorax).[2] In some cases, the only significant abnormality may be the "deep sulcus sign", in which the normally small space between the chest wall and the diaphragm appears enlarged due to the abnormal presence of fluid.[4]
Computed tomography
Computed tomography (CT, or "CAT scan") is not necessary for the diagnosis of pneumothorax, but it can be useful in particular situations. In some lung diseases, especially emphysema, it is possible for abnormal lung areas such as bullae (large air-filled sacs) to have the same appearance as a pneumothorax on chest X-ray, and it may not be safe to apply any treatment before the distinction is made and before the exact location and size of the pneumothorax is determined.[3] In trauma, where it may not be possible to perform an upright film, chest radiography may miss up to a third of pneumothoraces, while CT remains very sensitive.[5]
A further use of CT is in the identification of underlying lung lesions. In presumed primary pneumothorax, it may help to identify blebs or cystic lesions (in anticipation of treatment, see below), and in secondary pneumothorax it can help to identify most of the causes listed above.[3][6]
Ultrasound is commonly used in the evaluation of people who have sustained physical trauma, for example with the FAST protocol.[14] Ultrasound may be more sensitive than chest X-rays in the identification of pneumothorax after blunt trauma to the chest.[15] Ultrasound may also provide a rapid diagnosis in other emergency situations, and allow the quantification of the size of the pneumothorax. Several particular features on ultrasonography of the chest can be used to confirm or exclude the diagnosis.[16]
The treatment of pneumothorax depends on a number of factors, and may vary from discharge with early follow-up to immediate needle decompression or insertion of a chest tube. Treatment is determined by the severity of symptoms and indicators of acute illness, the presence of underlying lung disease, the estimated size of the pneumothorax on X-ray, and - in some instances - on the personal preference of the person involved.[3]
In traumatic pneumothorax, chest tubes are usually inserted. If mechanical ventilation is required, the risk of tension pneumothorax is greatly increased and the insertion of a chest tube is mandatory.[2][17] Any open chest wound should be covered with an airtight seal, as it carries a high risk of leading to tension pneumothorax. Ideally, a dressing called the "Asherman seal" should be utilized, as it appears to be more effective than a standard "three-sided" dressing. The Asherman seal is a specially designed device that adheres to the chest wall and, through a valve-like mechanism, allows air to escape but not to enter the chest.[18]
Tension pneumothorax is usually treated with urgent needle decompression. This may be required before transport to the hospital, and can be performed by an emergency medical technician or other trained professional.[4][18] The needle or cannula is left in place until a chest tube can be inserted.[4][18] If tension pneumothorax leads to cardiac arrest, needle decompression is performed as part of resuscitation as it may restore cardiac output.[19]
Small spontaneous pneumothoraces do not always require treatment, as they are unlikely to proceed to respiratory failure or tension pneumothorax, and generally resolve spontaneously. This approach is most appropriate if the estimated size of the pneumothorax is small (defined as <50% of the volume of the hemithorax), there is no breathlessness, and there is no underlying lung disease.[6][13] It may be appropriate to treat a larger PSP conservatively if the symptoms are limited.[3] Admission to hospital is often not required, as long as clear instructions are given to return to hospital if there are worsening symptoms. Further investigations may be performed as an outpatient, at which time X-rays are repeated to confirm improvement, and advice given with regard to preventing recurrence (see below).[3] Estimated rates of resorption are between 1.25% and 2.2% the volume of the cavity per day. This would mean that even a complete pneumothorax would spontaneously resolve over a period of about 6 weeks.[3] There; however, is no high quality evidence comparing conservative to non conservative management.[20]
Secondary pneumothoraces are only treated conservatively if the size is very small (1 cm or less air rim) and there are limited symptoms. Admission to the hospital is usually recommended. Oxygen given at a high flow rate may accelerate resorption as much as fourfold.[3][21]
In a large PSP (>50%), or in a PSP associated with breathlessness, some professional guidelines recommend that reducing the size by aspiration is equally effective as the insertion of a chest tube. This involves the administration of local anesthetic and inserting a needle connected to a three-way tap; up to 2.5 liters of air (in adults) are removed. If there has been significant reduction in the size of the pneumothorax on subsequent X-ray, the remainder of the treatment can be conservative. This approach has been shown to be effective in over 50% of cases.[1][3][6] Compared to tube drainage, first-line aspiration in PSP reduces the number of people requiring hospital admission significantly, without increasing the risk of complications.[22]
Aspiration may also be considered in secondary pneumothorax of moderate size (air rim 1–2 cm) without breathlessness, with the difference that ongoing observation in hospital is required even after a successful procedure.[3] American professional guidelines state that all large pneumothoraces - even those due to PSP - should be treated with a chest tube.[13] Moderately sized iatrogenic traumatic pneumothoraces (due to medical procedures) may initially be treated with aspiration.[2]
Chest tube
A chest tube (or intercostal drain) is the most definitive initial treatment of a pneumothorax. These are typically inserted in an area under the axilla (armpit) called the "safe triangle", where damage to internal organs can be avoided; this is delineated by a horizontal line at the level of the nipple and two muscles of the chest wall (latissimus dorsi and pectoralis major). Local anesthetic is applied. Two types of tubes may be used. In spontaneous pneumothorax, small-bore (smaller than 14 F, 4.7 mm diameter) tubes may be inserted by the Seldinger technique, and larger tubes do not have an advantage.[3] In traumatic pneumothorax, larger tubes (28 F, 9.3 mm) are used.[18]
Chest tubes are required in PSPs that have not responded to needle aspiration, in large SSPs (>50%), and in cases of tension pneumothorax. They are connected to a one-way valve system that allows air to escape, but not to re-enter, the chest. This may include a bottle with water that functions like a water seal, or a Heimlich valve. They are not normally connected to a negative pressure circuit, as this would result in rapid re-expansion of the lung and a risk of pulmonary edema ("re-expansion pulmonary edema"). The tube is left in place until no air is seen to escape from it for a period of time, and X-rays confirm re-expansion of the lung.[3][6][13]
If after 2–4 days there is still evidence of an air leak, various options are available. Negative pressure suction (at low pressures of –10 to –20 cmH2O) at a high flow rate may be attempted, particularly in PSP; it is thought that this may accelerate the healing of the leak. Failing this, surgery may be required, especially in SSP.[3]
Chest tubes are used first-line when pneumothorax occurs in people with AIDS, usually due to underlying pneumocystis pneumonia (PCP), as this condition is associated with prolonged air leakage. Bilateral pneumothorax (pneumothorax on both sides) is relatively common in people with pneumocystis pneumonia, and surgery is often required.[3]
It is possible for a patient with a chest tube to be managed in an ambulatory care setting by using a Heimlich valve, although research to demonstrate the equivalence to hospitalization has been of limited quality.[23]
Pleurodesis and surgery
Pleurodesis is a procedure that permanently obliterates the pleural space and attaches the lung to the chest wall. Although no long-term study has been performed on its consequences, the best results are achieved with a thoracotomy (surgical opening of the chest)—with identification of any source of air leakage and stapling of blebs—followed by pleurectomy (stripping of the pleural lining) of the outer pleural layer and pleural abrasion (scraping of the pleura) of the inner layer. During the healing process, the lung adheres to the chest wall, effectively obliterating the pleural space. Recurrence rates are approximately 1%.[1][3] Post-thoracotomy pain is relatively common.
A less invasive approach is thoracoscopy, usually in the form of a procedure called video-assisted thoracoscopic surgery (VATS). The results from VATS-based pleural abrasion are slightly worse than those achieved using thoracotomy, but produce smaller scars in the skin.[1][3] Compared to open thoracotomy, VATS offers a shorter in-hospital stays, less need for postoperative pain control, and a reduced risk of lung problems after surgery.[3] VATS may also be used to achieve chemical pleurodesis; this involves insufflation of talc, which activates an inflammatory reaction that causes the lung to adhere to the chest wall.[1][3]
If a chest tube is already in place, various agents may be instilled through the tube to achieve chemical pleurodesis, such as talc, tetracycline, minocycline or doxycycline. Results of chemical pleurodesis tend to be worse than when using surgical approaches,[1][3] but talc pleurodesis has been found to have few negative long-term consequences in younger people.[1]
If pneumothorax occurs in a smoker, this is considered an opportunity to emphasize the markedly increased risk of recurrence in those who continue to smoke, and the many benefits of smoking cessation.[3] It may be advisable for someone to remain off work for up to a week after a spontaneous pneumothorax. If the person normally performs heavy manual labor, several weeks may be required. Those who have undergone pleurodesis may need two to three weeks off work to recover.[24]
Air travel is discouraged for up to seven days after complete resolution of a pneumothorax if recurrence does not occur.[3] Underwater diving is considered unsafe after an episode of pneumothorax unless a preventative procedure has been performed. Professional guidelines suggest that pleurectomy be performed on both lungs and that lung function tests and CT scan normalize before diving is resumed.[3][13] Aircraft pilots may also require assessment for surgery.[3]
A preventative procedure (thoracotomy or thoracoscopy with pleurodesis) may be recommended after an episode of pneumothorax, with the intention to prevent recurrence. Evidence on the most effective treatment is still conflicting in some areas, and there is variation between treatments available in Europe and the US.[1] Not all episodes of pneumothorax require such interventions; the decision depends largely on estimation of the risk of recurrence. These procedures are often recommended after the occurrence of a second pneumothorax.[25] Surgery may need to be considered if someone has experienced pneumothorax on both sides ("bilateral"), sequential episodes that involve both sides, or if an episode was associated with pregnancy.[3]
The annual age-adjusted incidence rate (AAIR) of PSP is thought to be three to six times as high in males as in females. Fishman[26][27] cites AAIR's of 7.4 and 1.2 cases per 100,000 person-years in males and females, respectively. Significantly above-average height is also associated with increased risk of PSP—in people who are at least 76 inches (1.93 meters) tall, the AAIR is about 200 cases per 100,000 person-years. Slim build also seems to increase the risk of PSP.[26]
The risk of contracting a first spontaneous pneumothorax is elevated among male and female smokers by factors of approximately 22 and 9, respectively, compared to matched non-smokers of the same sex.[28] Individuals who smoke at higher intensity are at higher risk, with a "greater-than-linear" effect; men who smoke 10 cigarettes per day have an approximate 20-fold increased risk over comparable non-smokers, while smokers consuming 20 cigarettes per day show an estimated 100-fold increase in risk.[26]
In secondary spontaneous pneumothorax, the estimated annual AAIR is 6.3 and 2.0 cases per 100,000 person-years for males and females,[8][29] respectively, with the risk of recurrence depending on the presence and severity of any underlying lung disease. Once a second episode has occurred, there is a high likelihood of subsequent further episodes.[1] The incidence in children has not been well studied,[6] but is estimated to be between 5 and 10 cases per 100,000 person-years.[30]
Death from pneumothorax is very uncommon (except in tension pneumothoraces). British statistics show an annual mortality rate of 1.26 and 0.62 deaths per million person-years in men and women, respectively.[3] A significantly increased risk of death is seen in older victims and in those with secondary pneumothoraces.[1]
An early description of traumatic pneumothorax secondary to rib fractures appears in Imperial Surgery by Turkish surgeon Şerafeddin Sabuncuoğlu (1385–1468), which also recommends a method of simple aspiration.[31]
Pneumothorax was described in 1803 by Jean Marc Gaspard Itard, a student of René Laennec, who provided an extensive description of the clinical picture in 1819.[32] While Itard and Laennec recognized that some cases were not due to tuberculosis (then the most common cause), the concept of spontaneous pneumothorax in the absence of tuberculosis (primary pneumothorax) was reintroduced by the Danish physician Hans Kjærgaard in 1932.[3][12][33] In 1941, the surgeons Tyson and Crandall introduced pleural abrasion for the treatment of pneumothorax.[3][34]
Prior to the advent of anti-tuberculous medications, iatrogenic pneumothoraces were intentionally given to people with tuberculosis in an effort to collapse a lobe, or entire lung, around a cavitating lesion. This was known as "resting the lung". It was introduced by the Italian surgeon Carlo Forlanini in 1888, and publicized by the American surgeon John Benjamin Murphy in the early 20th century (after discovering the same procedure independently). Murphy used the (then) recently discovered X-ray technology to create pneumothoraces of the correct size.[35]
Other animals
Non-human animals may experience both spontaneous and traumatic pneumothorax. Spontaneous pneumothorax is, as in humans, classified as primary or secondary, while traumatic pneumothorax is divided into open and closed (with or without chest wall damage).[36] The diagnosis may be apparent to the veterinary physician because the animal exhibits difficulty breathing in, or has shallow breathing. Pneumothoraces may arise from lung lesions (such as bullae) or from trauma to the chest wall.[37] In horses, traumatic pneumothorax may involve both hemithoraces, as the mediastinum is incomplete and there is a direct connection between the two halves of the chest.[38] Tension pneumothorax—the presence of which may be suspected due to rapidly deteriorating heart function, absent lung sounds throughout the thorax, and a barrel-shaped chest—is treated with an incision in the animal's chest to relieve the pressure, followed by insertion of a chest tube.[39]
- ^ a b c d e f g h i j k l m n o p q r s t Tschopp JM, Rami-Porta R, Noppen M, Astoul P (September 2006). "Management of spontaneous pneumothorax: state of the art". European Respiratory Journal 28 (3): 637–50. PMID 16946095. doi:10.1183/09031936.06.00014206.
- ^ a b c d e f g h i j k l m n o p q r Noppen M, De Keukeleire T (2008). "Pneumothorax". Respiration 76 (2): 121–7. PMID 18708734. doi:10.1159/000135932.
- ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af ag ah ai aj ak al am an ao ap MacDuff A, Arnold A, Harvey J; BTS Pleural Disease Guideline Group (December 2010). "Management of spontaneous pneumothorax: British Thoracic Society pleural disease guideline 2010". Thorax 65 (8): ii18–ii31. PMID 20696690. doi:10.1136/thx.2010.136986.
- ^ a b c d e f g h i j Leigh-Smith S, Harris T (January 2005). "Tension pneumothorax—time for a re-think?". Emergency Medicine Journal 22 (1): 8–16. PMC 1726546. PMID 15611534. doi:10.1136/emj.2003.010421.
- ^ a b c d e Marx J (2010). Rosen's emergency medicine: concepts and clinical practice 7th edition. Philadelphia, PA: Mosby/Elsevier. pp. 393–396. ISBN 978-0-323-05472-0.
- ^ a b c d e f g h i j Robinson PD, Cooper P, Ranganathan SC (September 2009). "Evidence-based management of paediatric primary spontaneous pneumothorax". Paediatric Respiratory Reviews 10 (3): 110–7. PMID 19651381. doi:10.1016/j.prrv.2008.12.003.
- ^ a b c Chiu HT, Garcia CK (July 2006). "Familial spontaneous pneumothorax". Current Opinion in Pulmonary Medicine 12 (4): 268–72. PMID 16825879. doi:10.1097/01.mcp.0000230630.73139.f0.
- ^ a b Levine DJ, Sako EY, Peters J (2008). Fishman's Pulmonary Diseases and Disorders (4th ed.). McGraw-Hill. p. 1520. ISBN 0-07-145739-9.
- ^ Light RW (2007). Pleural diseases (5th ed.). Lippincott Williams & Wilkins. p. 307. ISBN 0-7817-6957-4.
- ^ Wolf SJ, Bebarta VS, Bonnett CJ, Pons PT, Cantrill SV (August 2009). "Blast injuries". Lancet 374 (9687): 405–15. PMID 19631372. doi:10.1016/S0140-6736(09)60257-9.
- ^ a b Neuman TS (2003). "Arterial gas embolism and pulmonary barotrauma". In Brubakk AO, Neuman TS. Bennett and Elliott's physiology and medicine of diving, 5th Rev ed. United States: Saunders. pp. 558–561. ISBN 0-7020-2571-2.
- ^ a b c Grundy S, Bentley A, Tschopp JM (2012). "Primary spontaneous pneumothorax: a diffuse disease of the pleura". Respiration 83 (3): 185–189. PMID 22343477. doi:10.1159/000335993.
- ^ a b c d e f Baumann MH, Strange C, Heffner JE, Light R, Kirby TJ, Klein J, Luketich JD, Panacek EA, Sahn SA (February 2001). "Management of spontaneous pneumothorax: an American College of Chest Physicians Delphi consensus statement". Chest 119 (2): 590–602. PMID 11171742. doi:10.1378/chest.119.2.590.
- ^ Scalea TM, Rodriguez A, Chiu WC, Brenneman FD, Fallon WF, Kato K, McKenney MG, Nerlich ML, Ochsner MG, Yoshii H (1999). "Focused Assessment with Sonography for Trauma (FAST): results from an international consensus conference". Journal of Trauma 46 (3): 466–72. PMID 10088853. doi:10.1097/00005373-199903000-00022.
- ^ Wilkerson RG, Stone MB (January 2010). "Sensitivity of bedside ultrasound and supine anteroposterior chest radiographs for the identification of pneumothorax after blunt trauma". Academic Emergency Medicine 17 (1): 11–17. PMID 20078434. doi:10.1111/j.1553-2712.2009.00628.x.
- ^ Volpicelli G (February 2011). "Sonographic diagnosis of pneumothorax". Intensive Care Medicine 37 (2): 224–32. PMID 21103861. doi:10.1007/s00134-010-2079-y.
- ^ Keel M, Meier C (December 2007). "Chest injuries - what is new?". Current Opinion in Critical Care 13 (6): 674–9. PMID 17975389. doi:10.1097/MCC.0b013e3282f1fe71.
- ^ a b c d Lee C, Revell M, Porter K, Steyn R (March 2007). "The prehospital management of chest injuries: a consensus statement. Faculty of Pre‐hospital Care, Royal College of Surgeons of Edinburgh". Emergency Medicine Journal 24 (3): 220–4. PMC 2660039. PMID 17351237. doi:10.1136/emj.2006.043687.
- ^ Neumar RW, Otto CW, Link MS, Kronick SL, Shuster M, Callaway CW, Kudenchuk PJ, Ornato JP, McNally B, Silvers SM, Passman RS, White RD, Hess EP, Tang W, Davis D, Sinz E, Morrison LJ (November 2010). "Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care". Circulation 122 (18 Suppl 3): S729–67. PMID 20956224. doi:10.1161/CIRCULATIONAHA.110.970988.
- ^ Ashby, M; Haug, G; Mulcahy, P; Ogden, KJ; Jensen, O; Walters, JA (18 December 2014). "Conservative versus interventional management for primary spontaneous pneumothorax in adults.". The Cochrane database of systematic reviews 12: CD010565. PMID 25519778. doi:10.1002/14651858.CD010565.pub2.
- ^ Light RW (2007). Pleural diseases (5th ed.). Lippincott Williams & Wilkins. p. 310. ISBN 0-7817-6957-4.
- ^ Wakai A, O'Sullivan RG, McCabe G (2007). Wakai, Abel, ed. "Simple aspiration versus intercostal tube drainage for primary spontaneous pneumothorax in adults". Cochrane Database of Systematic Reviews (1): CD004479. PMID 17253510. doi:10.1002/14651858.CD004479.pub2.
- ^ Brims FJ, Maskell NA (2013). "Ambulatory treatment in the management of pneumothorax: a systematic review of the literature". Thorax 68 (7): 664–9. PMID 23515437. doi:10.1136/thoraxjnl-2012-202875.
- ^ Brown I, Palmer KT, Robin C (2007). Fitness for work: the medical aspects. Oxford: Oxford University Press. pp. 481–2. ISBN 0-19-921565-0.
- ^ Baumann MH, Noppen M (June 2004). "Pneumothorax". Respirology 9 (2): 157–64. PMID 15182264. doi:10.1111/j.1440-1843.2004.00577.x.
- ^ a b c Levine DJ, Sako EY, Peters J (2008). Fishman's Pulmonary Diseases and Disorders (4th ed.). McGraw-Hill. p. 1519. ISBN 0-07-145739-9.
- ^ Light RW (2007). Pleural diseases (5th ed.). Lippincott Williams & Wilkins. p. 306. ISBN 0-7817-6957-4.
- ^ Bense L, Eklund G, Wiman LG (1987). "Smoking and the increased risk of contracting spontaneous pneumothorax". Chest 92 (6): 1009–12. PMID 3677805. doi:10.1378/chest.92.6.1009.
- ^ Light RW (2007). Pleural diseases (5th ed.). Lippincott Williams & Wilkins. p. 315. ISBN 0-7817-6957-4.
- ^ Sahn SA, Heffner JE (2000). "Spontaneous pneumothorax". New England Journal of Medicine 342 (12): 868–74. PMID 10727592. doi:10.1056/NEJM200003233421207.
- ^ Kaya SO, Karatepe M, Tok T, Onem G, Dursunoglu N, Goksin I (September 2009). "Were pneumothorax and its management known in 15th-century anatolia?". Texas Heart Institute Journal 36 (2): 152–153. PMC 2676596. PMID 19436812.
- ^ Laennec RTH (1819). Traité de l'auscultation médiate et des maladies des poumons et du coeur - part II (in French). Paris.
- ^ Kjærgard H (1932). "Spontaneous pneumothorax in the apparently healthy". Acta Medica Scandinavica. 43 Suppl: 1–159. doi:10.1111/j.0954-6820.1932.tb05982.x.
- ^ Tyson MD, Crandall WB (1941). "The surgical treatment of recurrent idiopathic spontaneous pneumothorax". Journal of Thoracic Surgery 10: 566–70.
- ^ Herzog H (1998). "History of tuberculosis" (PDF). Respiration 65 (1): 5–15. PMID 9523361. doi:10.1159/000029220.
- ^ Pawloski DR, Broaddus KD (2010). "Pneumothorax: a review". J Am Anim Hosp Assoc 46 (6): 385–97. PMID 21041331.
- ^ "Causes of Respiratory Malfunction". Merck Veterinary Manual, 9th edition (online version). 2005. Retrieved 2011-06-05.
- ^ "Equine trauma and first aid: wounds and lacerations". Merck Veterinary Manual, 9th edition (online version). 2005. Retrieved 2011-06-05.
- ^ "Primary survey and triage - breathing". Merck Veterinary Manual, 9th edition (online version). 2005. Retrieved 2011-06-05.
Unknown extension tag "indicator"
Lua error in Module:Authority_control at line 346: attempt to index field 'wikibase' (a nil value).


text:
The amount of agricultural technology you'll find at Agritechnica is astounding, and sometimes you find products that will be headed across the pond soon. In this gallery we show off a few products we found that were interesting (check out the Russian baler paint job) or innovative (robot tiller and weed killer).
The aim of our coverage this week has been to find the new and interesting. And we've found that in spades. As you peruse this Friday gallery, you'll find some products you'll be able to buy in 2014 and beyond. And some that probably won't make it to our shores, but are interesting just the same.
So check out the gallery and leave a comment if you have a question or a thought about what you've seen.
Note: All photos by Mark Moore.
Check out the Day 1 Gallery from Agritechnica.
Don't miss our Day 2 Gallery from Agritechnica.
View the gallery from Day 3 at Agritechnica.
Visit the gallery from Day 4 at Agritechnica.
And visit our Agritechnica page for all news from the show.
Like oure galleries? Subscribe to Farm Industry News Now e-newsletter to get the photo galleries and more straight to your inbox twice weekly.

subset: commoncrawl


text:
NVIDIA Free-to-Play 2 Review
Earlier this year, NVIDIA launched a Free-to-Play bundle, whereby purchasing select GeForce hardware would reward you with premium, in-game currency for certain free-to-play games. The green team has returned with another Free-to-Play bundle, this time featuring Warframe, Marvel Heroes, and Dungeon & Dragons: Neverwinter. Having reviewed that previous bundle, it only makes sense to review this one as well. The qualifying hardware this time are GTX 650 desktop GPUs and laptops with 700M Series GPUs.
Like the previous F2P bundle review, I am also going to comment on if the titles are 'Pay-to-Win.' For those of you unfamiliar with the term, many (if not all) free-to-play games offer small items for sale, as a means of producing revenue for the developers. Often you will see items such as costumes for sale via these micro-transactions, but sometimes the items can be much more impactful on gameplay. Depending on the impact those items have, gamers may refer to the game as 'Pay-to-Win,' meaning that only by purchasing items can someone complete the game or compete with other players, or that the items would take too long to acquire through in-game effort.
The current bundle gives you $25 worth of the in-game currency in each of the three titles, for a total of $75. Of course it is only if you play the game that you can benefit from the credit, so let us see what is worth playing.


text:
Enjoy your baby What is cot death and how common is it? Cot death is more properly known as sudden infant death syndrome SIDS. It is the term used to describe the sudden death of a baby in its sleep where no cause or reason can be found.
Cot death is uncommon.
About 1 in 3, babies die due to cot death in the UK. That is, about babies a year in the UK. Most cases occur in babies under the age of 1 year. The age range where there is the most risk is months. However, the number of cases in the UK has fallen sharply since the introduction of the 'Back to sleep' campaign in Before this twice as many babies died every year from cot death.
This campaign was launched because research showed that the fashion at the time for placing babies to sleep on their front increased the risk of a cot death. The campaign has resulted in most parents now knowing that the safest position for a young baby to sleep is on their back. In addition to the sleeping position, other factors can reduce the risk of a cot death. These are detailed below. What can I do to reduce the risk of cot death? Research has shown that the risk of cot death can be reduced.
The things you can do fall into four main categories: Sleeping - learn the best way for your baby to sleep. Smoking - create a smoke-free home for your baby. Symptoms of illness - see a doctor if your baby appears unwell. Make sure that any childminders or babysitters know this too. Lay your baby on their back to sleep In other words, do not lay him or her on their front or side.
Cot death is less common in babies who sleep on their back. It is important to put babies on their backs for daytime naps and any other times of sleep, in addition to the longer night-time sleep. The evidence shows that babies who sleep on their back are not more likely to choke than babies who sleep on their front.
This unfounded worry was why it was common to put babies on their front in the past. When your baby is aged about months they will normally start to be able to roll over.
At first, if you find that your baby has rolled over on to their front then turn them back on to their back. However, you do not need to keep on checking in the night. Soon, they will be able to roll over and back again on their own and, like adults, they will toss and turn in their sleep.
When they can do this it is fine for your baby to find their own position to sleep. The risk of cot death falls sharply at this age and it is safe for them to sleep in whatever position they like. Bedclothes Do not use a pillow - just use a firm mattress that fits well into the cot, covered with a sheet. Use layers of sheets and thin blankets to cover your baby. Do not use duvets, quilts, or other soft, loose covers.
Do this at least until the baby is 1 year old. Duvets and loose covers are more likely to cover a baby's face. Also, using several thin layers allows you to put on or take off layers depending on the room temperature. The newer baby 'sleeping bags' mean you do not have to use any additional bedding for your baby.
The baby 'wears' the sleeping bag - a bit like a pinafore dress with the bottom sewn up. They come in different 'tog' weights, just like a normal duvet. This means you can choose a sleeping bag of the appropriate warmth depending on whether it is summer or winter, or whether you live in a hot or cold climate. Your baby can wear a vest, babygro or pyjamas, again depending on the warmth of the room in which they sleep.
The advantage of sleeping bags is that your baby cannot bury himself or herself under the covers; sleeping bags also mean that your baby cannot pull their covers off in the night and become too cold. Sleeping bags can also prevent a younger baby from rolling on to his or her front or side. The sleeping bags are sized according to age and your baby must be a minimum weight to wear one - consult the manufacturers' labels for more information.
This means they are usually not suitable for newborns - only babies who are a few months old. Many parents now choose sleeping bags for their babies, although they can be quite expensive. Do not place soft materials or objects such as pillows, quilts, comforters, or sheepskins under a sleeping baby. Also, keep stuffed toys and other soft objects out of the cot.
If you use bumper pads in a cot they should be thin, firm, well secured and not 'pillow-like'. They should also be free from loose ties that present a strangle hazard. Cover your baby up to their chest and shoulders only The head must be left uncovered. Tuck sheets and blankets under the sides of the mattress to stop them riding up on to the face. Tuck them so they reach up to your baby's armpits but not above.
Some parents prefer not to use any sheets or blankets. They use 'sleeping bags' detailed above that are designed to keep the baby warm without the possible hazard of the head being covered in the night. Lay your baby 'feet to foot' That is, the baby's feet should be just touching the foot of the cot. This means they cannot slip further down the cot under the sheets or blankets.
Temperature Babies need to be warm but not too warm. Being too warm increases the risk of cot death. Have the room at a temperature that is comfortable for you.
If your baby is sweating or feels hot then they are too warm. Do not place a baby's cot next to a heater or radiator, or in direct sunlight. Also, do not use hot water bottles, electric blankets, etc. When you sleep, share a room with your baby - but not your bed A cot or crib next to your bed is the best place for your baby to sleep until they are at least 6 months old. It is best not to share a bed with your baby when you sleep so-called 'co-sleeping'.
There is a risk that you might roll over on to your baby when you are asleep, or your baby may get trapped under the bedclothes. It is normal to feed and cuddle your baby when you are resting in bed but awake.
However, when it is time for you to sleep, the best place for your baby is in a cot next to your bed. In particular, there is an increased risk when bed-sharing if: Your baby was born prematurely, had a low birth weight, or is less than 3 months old. You smoke - or your partner smokes - even if you do not smoke in the home. You are very tired or you are taking medication that can make you drowsy.
You have taken any alcohol or drugs. The baby should be placed in a Moses basket or a cot next to your bed.
What can I do to reduce the risk of cot death? It's a bedside crib with an adjustable height so parents can make it the same level as their bed.
You can also now get cots that attach to the side of your bed. The baby has his or her own area in which to sleep but there are no rails on the side next to you. This means you can feed your baby safely in bed even breast-feeding lying down but once finished, you can just slide the baby over into the cot.
Consider offering your baby a dummy when it is time to sleep Research studies have shown that the use of a dummy can reduce the risk of cot death. It is not clear how but it seems to help. Therefore, consider offering your baby a dummy at the start of each episode of sleep. However, if you breast-feed, do not start to use a dummy until you are well established with breast-feeding. This is normally when the baby is about 1 month old.
However, do not force a dummy on a baby who does not want one. If the dummy falls out when a baby is asleep, just leave it out. Also, never coat a dummy with anything such as sweet liquids or sugar. Clean and replace dummies regularly. Do not fall asleep with your baby on a sofa, armchair, settee, etc This has been shown to increase the risk of cot death.
Cigarette smoke is a main 'risk factor' for cot death. Do not let anyone smoke in the same room as your baby. Smoking whilst pregnant also increases the risk of your baby having a cot death. The greater the number of cigarettes smoked per day whilst pregnant, the greater the risk.
If at all possible, do not smoke when you are pregnant.
Your practice nurse, GP or midwife can give you advice and help if you want to stop smoking but are finding it difficult. There are usually no symptoms to alert parents or carers that anything is wrong. However, sometimes an illness is not recognised and quickly becomes worse. See a doctor if your baby appears unwell. Use your instincts - you know best if something is not right.
В© 2016 - 2018 Business_Blog. All rights reserved | Template by W3layouts


text:
What would the world look like if businesses led a purpose driven life rather than focusing solely on shareholder value?
Should companies strive to be good or simply set the bar at 'don't be evil'?
I recently read a great post by Scott Anthony at Harvard Business Review that explores the question 'How will you measure your company's life?'. Scott's post relies on the writing and thinking of Clayton Christensen encapsulated in his book 'How will you measure your life?'
Both questions fascinate me. I especially appreciate the perspective taken by Clayton and Scot since they approach the questions from a business and data driven perspective; and how could a data geek like me not love that approach?
Many books exhort you to live a purpose driven life. But the notion of trying to lead a purpose driven business is rarely discussed outside faith based organizations. In fact, companies, along with officers and directors of the company, are often sued for doing anything other than worrying about maximizing shareholder value.
Scot's review of Clayton's original work makes this point:
The root problem from Christensen's perspective is that "they didn't keep the purpose of their lives front and center as they decided how to spend their time, talents, and energy." A steady stream of incremental decisions without a clear focus on purpose too often led to unanticipated outcomes.
I don't want to get bogged down into a political debate around the question of whether or not corporations are 'people' with access to certain rights. But I would like you to consider a few questions..
What would it look like if a company led a purpose driven life?
I won't try to define that purpose driven life for any given company should be. I will go out on a limb and suggest that the life of that company would address topics well beyond beyond maximizing shareholder value.
What would the lives of people around you, as individual, look like if part of your purpose was to leave the world a better place, even if it was in just some small way, perhaps affecting just one other person.
What would the world look like if a majority of people led their lives that way?
Here's the kicker.
What would the world look like if businesses led a purpose driven life as well?
Scot's blog post points out:
"the intent to maximize shareholder value has resulted in myopic management overly obsessed with short-term financial returns. Much has been lost in this shift, with thought leaders increasingly arguing that new models need to emerge (the most recent issue of Harvard Business Review had an article in this vein by Jay Lorsch and Justin Fox, "What Good Are Shareholders?")."
Can a business serve shareholders, be profitable, and have a goal or purpose that rises above the holy grail of shareholder ROI? More and more, the most cutting edge business research is suggesting yes.
I'm a strong capitalist. I'm conservative and skew libertarian in many ways. I'm not suggesting that any of this be regulated or forced. It wouldn't work. I don't think that maximizing profit is inherently wrong. However, I do believe that an exclusive focus on this tenet of capitalism can and does lead to destructive greed and poor decisions that make our world and lives less than they can be.
I'm also putting my money where my mouth is. I started my first company more than a decade ago and I recently launched Linchpin People LLC ( www.linchpinepeople.com ) with Andy Leonard (@AndyLeonard) last year. Our motto is 'Change the World. One Career at a time'. We're intentionally building our company and culture with an eye towards goals that are measured more by how we help other people rather than a focus on profits. I don't know if we'll make any money doing that but it's nice to new leading researchers from Harvard endorse the approach. J
My friend and colleague Steve Jones explores his views on this topic in a post called 'The ethics of companies' http://blog.dkranch.net/2012/07/the-ethics-of-industries.html. I know that Andy and I aren't the only ones pondering these questions.
I don't want to pick on Google. I like the company and use many of their products. I have great respect for them. But I've always thought their tag line of 'don't be evil' is lame. I believe they have good intentions behind that motto, but seriously? Don't be evil?
Let's see. You certainly need to do better than the devil. I'm guessing you need to top Hitler and probably Charles Manson. 'Don't be evil' doesn't set the bar very high, does it?
What if a company like Google or Microsoft or the candy store down the corner set the bar at a purpose driven corporate life that included good? What if all companies did that? What if your company did that?
What would the world look like?
P.S. I read the HBR blog on a regular basis. Great stuff. This time I stumbled across the posts I mention here after seeing a tweet from Kevin Kline (@kekline). Thanks Kevin for making me aware of this interesting work!
P.S.S. I strongly encourage you to read the two following blog posts and perhaps even watch Clayton's TEDx talk on the topic.
Here are the two blog posts:
and here is Clayton's TEDx talk


text:
Weil, Andrew is the author of 'Spontaneous Happiness', published 2011 under ISBN 9780316129442 and ISBN 0316129445.[read more]
You can find lots of answers to common customer questions in our FAQs
View a detailed breakdown of our shipping prices
Learn about our return policy
Still need help? Feel free to contact us
View college textbooks by subject
and top textbooks for college
With our dedicated customer support team, 30-day no-questions-asked return policy, and our price match guarantee, you can rest easy knowing that we're doing everything we can to save you time, money, and stress.


text:
What is an economic collapse?
To bring clarity to what we are about to cover, let's define what an economic collapse is. Similar to a financial collapse, the great depression in the 1930s, an economic collapse is the total breakdown of a country, a region or even globally. An economic collapse is basically a severe version of an economic depression, where an economy is in complete distress for months, years or possibly even decades.
You will see civil unrest, extreme poverty levels, major disruptions to basic services such as electricity, water and food supplies. Looting becomes common essentially you can think of how things can be by checking out the movie Madmax.
The Mad Max Movie StoryLine: "Years after the collapse of civilization, the tyrannical Immortan Joe enslaves apocalypse survivors inside the desert fortress the Citadel. When the warrior Imperator Furiosa (Charlize Theron) leads the despot's five wives in a daring escape, she forges an alliance with Max Rockatansky (Tom Hardy), a loner and former captive. Fortified in the massive, armored truck the War Rig, they try to outrun the ruthless warlord and his henchmen in a deadly high-speed chase through the Wasteland."
Of course, the gee is not about the action, it's about the setting of the movie and how chaotic things become after "the collapse of civilization"
Think this is far fetch?
This is already happening in Venezuela
Why are people in oil-rich Venezuela going hungry?
Riots hit Venezuela as food runs short
Venezuela descends further into chaos amid riots for food
Protesters clash with riot police in Venezuela.
This is what happens when people go hungry. You need to feed your family and yourself. Food shortages are the kind of things where people are forced onto the street – or die.
"Supermarket shelves in Venezuela are chronically bare, and power shortages are so severe that government offices are now open only two days a week. The health care system has collapsed, the crime rate is one of the world's worst, and inflation is rapidly eroding what remains of the currency's value.
"The economy has gone from bad to worse to horrific," said Jason Marczak, director of the Latin America Economic Growth Initiative at the Adrienne Arsht Latin America Center, part of the Atlantic Council, a Washington-based research organization. "The Venezuelan government is doing a good job of leading itself into chaos."
According to CNN Money, the headline cries:
"Venezuelans cried at the sight of fully-stocked supermarket shelves in Colombia."
Pregnant women, children and even elderly Venezuelans crossed into Colombia on Sunday after the border was temporarily reopened, allowing them to buy basic foods and toiletries — rare commodities in their home country.
Tearful Venezuelans had gone weeks without basic food items like milk, flour and toilet paper. It's a sad but common part of daily life today in crisis-ridden Venezuela, a country that has the world's largest proven reserves of oil. Colombian officials estimate that about 100,000 Venezuelans crossed the border.
Venezuela is expected to dive deeper into the abyss this year, according to new projections published Wednesday by the International Monetary Fund.
According to AP's report on the Venezuela's Economic Crisis (now a full blown food shortage crisis):
"As Venezuela's lines have grown longer and more dangerous, they have become not only the stage for everyday life, but a backdrop to death. More than two dozen people have been killed in line in the past 12 months, including a 4-year-old girl caught in gang crossfire. An 80-year-old woman was crushed to death when an orderly line of shoppers suddenly turned into a mob of looters — an increasingly common occurrence as Venezuela runs out of just about everything.
The extent of the country's economic collapse can be measured in the length of the lines snaking through every neighborhood. The average Venezuelan shopper spends 35 hours waiting to buy food each month. That's three times more than in 2014, according to the polling firm Datanalisis.
"As the economy breaks down, life is telescoping to be just lines," said Datanalisis president Luis Vicente Leon. "You have masses of people in the streets competing for scarce goods. You're inevitably going to get conflict, fights, tricks, you name it."
What caused the crisis in? Hyperinflation in Venezuela
Hyperinflation is the main cause of the dramatic chaos in Venezuela, while we discuss the flyaway inflation on the internet, real people are starving and dying in Venezuela. Venezuela's inflation is poise to hit 720% in 2016!
Hyperinflation means the $2 denominated Bolivar bank note's value is the same or less than that of a napkin. A classic example of a fiat currency reverting back to it's intrinsic value – ZERO!
In fact in April 2016, Venezuela does not have enough money to pay for its' bolivar!
"The story began last year when the government of President Nicolas Maduro tried to tamp down a growing currency shortfall. Multi-million-dollar orders were placed with a slew of currency makers ahead of December elections and holidays, when Venezuelans throng banks to cash their bonuses.
At one point, instead of a public bidding process, the central bank called an emergency meeting and asked companies to produce as many bills as possible. The companies complied, only to find payments not fully forthcoming."
Since 2014, Venezuela's economic crisis has caused rising prices due to the increase scarcity of goods and their rapidly depreciating currency, price controls imposed by the government which in turn cause higher prices and even worse shortages. Basic commodities such as cooking oil, sugar, corn flour are not available in stores. The Cendas survey showed that over one third of food stuff are not available in supermarkets and basic food like vegetables are getting more expensive every month (by 32%). Prices of meat are going up 22% monthly. What used to be basic Venezuelan dishes (rice and beans) have turned into luxury overnight. On average, Venezuelans have to queue for over 8 hours per week on average just to get basic goods.
Venezuela Crisis Explained
The socialist government is one of the region's most controversial. Since President Hugo Chávez's death in March 2013, his successor Nicolás Maduro is now heading the government. While a lot of blame was placed on the declining price of oil – Venezuela's most important export, fingers are pointing to Chávez's policies which caused storages of food and other consumers products – and of course the government's meddling of the currency control system.
How did such an oil-rich state collapse so badly?
The current Maduro government has blamed the US for its crisis but Maduro has actually inherited a state-run system from Chávez which was already in ruins. Chávez shore up his popularity primarily based on oil money and foreighn debts to fund consumption – he even nationalised more than 1,200 private companies which were deemed not be to acting in the public's best interests. In 2015, oil price fell more than half and Venezuela's reckless finances made it a high-risk debtor – which denies it access to international capital.
Print And Print
Without access capital from the international market, the Maduro government responded by printing more money – causing inflation. it was estimated that the basic groceries' prices that keeps a family going for a week went up by over 25% between March and April then.
To made things worse, Venezuela rationed basic foodstuff and controlled the prices – instead of solving problems, the consequence of this policy was simply forcing goods into the black market. A classic replay by governments who have tried to print their way out of problems throughout history.
According to Transparency International, Venezuela is ranked the 9th most corrupted country in the world. The crisis is likely to get even worse in the near future.
Venezuela's Crisis Explained
Can The Venezuela Crisis Happen In The United States?
Peter Schiff: Venezuela is Amercia's Socialist Future.
Renown economist and author Peter Schiff believes that what's happening in Venezuela can happen in the United States.
Talk of Global Worldwide Economic Collapse
At the end of FY 2016 the gross US federal government debt is estimated to be$19.3 trillion, according to the FY17 Federal Budget.
Can the US debt ever be paid off?
US federal debt is still a all time record high. Hitting a new milestone, the deficit has passed the $1tn mark. As of August 2016, the national debt stands at $19.3 trillion ($19,300,000,000,000)
The US has a population of 318 million people as of 2016. Divided by this population, on average each Amercian citizen owns USD$60,691.
How does the Us borrow money and get into debt? Mainly it's through Treasury Bonds (a fanciful name for a government's IOU when it borrows money). The US government issue government securities which other countries and financial institution buy and thus the US national debt is owned mainly in the US, the rest of it (over $5.4 trillions dollars) are owned predominantly by Asian economies.
So, how does the US borrow money? Treasury bonds are how the US – and all governments for that matter – borrow hard cash: they issue government securities, which other countries and institutions buy. So, the US national debt is owned mostly in the US – but the $5.4tn foreign-owned debt is owned predominantly by Asian economies.
Unlike an individual or a household who is in debt, there are 2 outcomes when one is in debt – 1. You pay it off over time or 2. You simply default on it.
The US government can technically keep printing and printing the USD dollars and print it's way out of debt. (See example of Venezuela above). Unlike the Venezuela's Bolivar, the USD dollar is the world's reserve currency and inflation (caused by printing of US dollars) is exported to the rest of the world.
But the other countries are going to wake up and one way – they will refuse to play this game and accept the US dollar.
US America Economic Collapse
China Economic Collapse
Russia Economic Collapse
Preparing and Surviving The Economic Collapse


text:
Sydney Harbour,
Sydney, NSW
hello a splash with any of the many adventure activities happening in, on and around Australia's waterways. White water raft through Tasmania's World heritage wilderness or set sail on Sydney Harbour. Cage dive with great white sharks or reel in a barramundi big enough to boast about. It doesn't matter whether you're hankering to surf glassy, 10-foot waves or canoe through the towering walls of an ancient gorge. Australia is the place for anyone with a love of water and thirst for adventure. Here are some ideas to whet your adventurous spirit!
Wind surf on Canberra's Lake Burley Griffin, ACT
There's something uniquely Australian about being able to windsurf past the national institutions. On Canberra's Lake Burley Griffin, you can wave to the wigged judges descending the steps of Australia's High Court. Or glide past the imposing buildings housing our national gallery, library and museum. Then there's the city's lush bushland to see. Launch from the sandy beach of Yatralurnla Bay and catch an easterly past the gum trees. Or sail past the East Basin, great for beginners on longboard or slalom. You'll find windsurfing boards to rent from many of the boat hire outfits around the lake.


text:
- Product Overview
Trans-Tool 4 Ft. Free Standing Table with Reservoir Tank. 12 Gauge Steel 33" H X 24" W X 46" Long
- About Company
Trans-Tool has been manufacturing and providing customers with American made, durable and price conscious aqueous washers, tanks and tables, Steelabrators, and automotive tools since 1978. Trans-Tool provides a full line of aqueous washers, tanks and tables, Steelabrators, aftermarket automotive tools and most other shop, fleet and garage needs. Trans-Tool has been providing outstanding customer service for the last 35 years. We are a proud supplier and sourcer of a wide portfolio of aftermarket, fleet and garage tools and equipment.


text:
Murray to face Ferrer in Miami final
Key Biscayne, FL – Andy Murray rallied from a set down to beat a hobbled Richard Gasquet to advance to the title match at the $4.169 million Sony Open.
The second-seeded Murray, the 2009 Key Biscayne champion, took advantage of a toe injury to Gasquet to post a 6-7 (3-7), 6-1, 6-2 victory over the No. 8 seed from France.
"I didn't know exactly when he started feeling it," Murray said of Gasquet's injury in an on-court interview following the match.
The toe appeared to bother Gasquet during the tiebreaker, although he managed to win the set when Murray sent a backhander wide.
Murray rolled in the second set and Gasquet received attention from a trainer prior to the third. His small two toes were taped together.
The native of Great Britain broke in the first and third games of the final set for a 2-1 lead. Murray won the final three games of the match and finished it when Gasquet couldn't handle a hard serve.
Murray will tangle with Spaniard David Ferrer in the finale. Ferrer overcame a dropped set to beat German veteran Tommy Haas Friday afternoon.
The third-seeded Ferrer fired seven aces and earned six break points in his 4-6, 6-2, 6-3 victory over the No. 15 seeded Haas at Crandon Park. It was the first match between the two since 2008 in Dubai, with Ferrer improving to 3-0 against the Hamburg native.
Ferrer, who turns 31 next week, is bidding to capture his second ATP World Tour Masters 1000 Trophy and his third title of the year following triumphs in Auckland and Buenos Aires. He leads the ATP with 26 wins this season.
No Spaniard has ever won here in the tournament's 28-year history, going 0-5 in finals.
As for Murray, the runner-up last year, he's trying for his second title this year and 26th of his career. Murray is 6-5 all-time against Ferrer, and that includes a quarterfinal victory for the Scotsman in the quarterfinals of Wimbledon last year.
This week's big winner will pocket $719,160.


text:
EAST LANSING, Mich. (AP) Jeff Budzien kicked a 27-yard field goal with 7:30 remaining, and Northwestern was able to hold on to this fourth-quarter lead, beating Michigan State 23-20 on Saturday.
Trevor Siemian threw for 165 yards, including a 41-yard pass to Dan Vitale that helped set up the winning kick. The Wildcats (8-3, 4-3 Big Ten) then forced a punt near midfield, and by the time Michigan State (5-6, 2-5) got the ball back at its own 20, there was only 1:29 left.
Northwestern lost fourth-quarter leads in gut-wrenching losses to Penn State, Nebraska and Michigan, but this time Michigan State's Andrew Maxwell threw four straight incompletions to seal the Spartans' fate.
All seven of Michigan State's conference games have been decided by four points or fewer.
It was Northwestern's first win over Michigan State since 2007, and the Spartans must now beat Minnesota next weekend to become bowl eligible.
The Wildcats spoiled Michigan State's home finale despite what was announced as an upper extremity injury to running back Venric Mark, who didn't play in the second half. Siemian and Kain Colter split time at quarterback for the Wildcats. Colter went 13 of 20 for 81 yards and a touchdown.
Northwestern led 13-5 early in the third quarter after David Nwabuisi returned an interception 43 yards for a touchdown. Maxwell seemed shaken up on the play, but he was able to keep playing and quickly led the Spartans on a sharp 65-yard drive that ended with his 15-yard scoring pass to Aaron Burbridge. A 2-point conversion pass to Keith Mumphery tied it at 13.
Colter's 6-yard touchdown pass to Tim Riley gave Northwestern a 20-13 lead, but the Spartans tied it again on a 6-yard scoring pass from Maxwell to Tony Lippett with 9:22 left in the fourth.
Michigan State lost the ball twice inside the Northwestern 5-yard line in the first half. A fumble on the snap gave the Wildcats the ball at their own 2 late in the first quarter, but Colter was hit in the end zone by Max Bullough and William Gholston for a safety that made it 3-2.
Michigan State led 5-3 in the second and had the ball at the Northwestern 1, but star running back Le'Veon Bell was dropped for a loss of 3 on fourth down.
The Wildcats took a 6-5 lead into halftime when Budzien made a 43-yard field goal in the final minute of the quarter, and Michigan State's Dan Conroy missed from 37 at the other end.
Northwestern hangs on, beats MSU
Northwestern hangs on, beats MSU
EAST LANSING, Mich. (AP) Jeff Budzien kicked a 27-yard field goal with 7:30 remaining, and Northwestern was able to hold on to this fourth-quarter lead, beating Michigan State 23-20 on Saturday.


text:
Investors who view Africa solely as a natural resources play are "missing the picture," according to Robert Scharar, fund manager at the Commonwealth Africa Fund.
"There are great opportunities because of an emerging middle class, an increase in education and more transparent governments," Scharar said. (Read More: Investors Eye This African Country)


text:
migya wrote:drfrank wrote:without athleticism, chances are you won't get to show your skill. ask mike dunleavy jr.
Mike Dunleavy - What skill
No athleticism and no skill with our beloved dunnyboy.
A guy like Larry Bird showed that skill is far more important
right on the money.
Bird showed us that skills is the most essential thing in this game of basketball. He became one of the best players to ever stepped on the court being a tremendously skilled player.
and then MJ showed us what great skills mixed with great and athleticism can do - become arguebly the best player of all time.
and you can also see players who rely purely on their athleticism but lack the necessary skills. ie darius miles, kwame brown, pietrus -- players with limited game and are very inconsistent/unreliable throughout the longer course of the seaon.
so basically i've come to a conclusion.
basketball requires skills first and foremost to be able to effectively play the game.
meanwhile, athleticism is an advantage that can take your game to an even higher level of greatness.


text:
The Flyers are in the hunt for 6-foot-4, 208-pound veteran center Vinny Lecavalier, an NHL source confirmed.
In fact, Flyers officials met with the unrestricted free agent on Saturday. Several teams are trying to lure him. Free agents can sign on Friday.
Lecavalier is still productive after all these years. He is a terrific playmaker and would provide the Flyers with some needed size and physicality at center.
A four-time all-star, Lecavalier, 33, had 10 goals and 32 points in 39 games with Tampa Bay this season. Lecavalier's contract was bought out by the Lightning a few days ago. He had over $32 million left on a deal that ran through 2019-20.
Follow Sam Carchidi on Twitter @BroadStBull.


text:
PRINCETON — Eric Miranda, 35, of Princeton has entered an open plea of guilty to the Class 4 felony of resisting a peace officer and to the Class 4 felony of deceptive practices.
Miranda entered his guilty pleas on Nov. 8 before Associate Circuit Judge C.J. Hollerich. The judge ordered the probation department to conduct a pre-sentence investigation and set a sentencing hearing for 9:30 a.m. Nov. 27.
Miranda was represented in court by Dixon attorney Al Henry Williams. Prosecuting the case was Bureau County State's Attorney Patrick Herrmann.
On Nov. 3, 2011, DePue Police Chief Michael West was attempting to execute an arrest warrant on Miranda for driving while license suspended. Miranda was informed he was under arrest on that warrant. Miranda shoved the police chief and then fled on foot. The shove caused the police chief to fall, resulting in a slight injury from the fall. Miranda was originally charged with aggravated battery.
In February 2012, a DePue business reported to the DePue Police Department the business had received several checks from Miranda which were returned for insufficient funds and a closed account. It was determined Miranda had written eight checks to the same business between Jan. 29 and Feb. 1, totaling $203.26. Miranda had only deposited $48 into the account when he opened it in December 2011. Miranda was indicted for deceptive practices on July 13. Then on Nov. 8, a second count was filed in the aggravated battery case; Miranda charged with the Class 4 felony of resisting a peace officer.


text:
Also Todd McFarlane Signing and Panel Times
May 12, 2011
Memorial Day weekend is fast approaching, which means that comic fanatics and pop culture connoisseurs are gearing up for the 2011 Phoenix Comicon, running May 26 through May 29 at the Phoenix Convention Center. This year's con is touted as the biggest comicon to ever hit Arizona! The McFarlane Companies will be well represented with new toy product, give-aways and some first looks at upcoming product! Make sure to stop by and see what's new with TMP for 2011 and beyond, booth #202.
Phoenix Comicon Exclusive
TMP is especially proud to be contributing its first ever Phoenix Comicon Exclusive! Here is a look at this year's con exclusive:
>> HAUNT #16 COVER ART (Phoenix Comicon Exclusive)
Drawn by Todd McFarlane and limited to 1,000 copies, this exclusive comic will be retailing at the comicon for $4. So make sure to stop by the Todd McFarlane booth #202 for your chance to purchase this exclusive comic.
'How to Draw' Panel
On Sunday, May 29 Todd will participate in a 'How to Draw' Panel with the grossly talented Greg Capullo. Todd and Greg will show how they use current technology to produce their artwork. The panel begins at noon and will be held in room 121 of the convention center. The panel is open to anyone attending the comicon, so make sure to grab your sit before they're gone.
Autograph Session
Shortly after the "How to Draw" panel, Todd will be doing a signing from 2:30 to 4:30 p.m. in the Exhibitor Hall portion of the convention center. So dust off that Coyote Issue #11 and get it primed and ready for a McFarlane signature!
For more information on other Phoenix Comicon events and times, check out their website at www.phoenixcomicon.com.
Todd McFarlane Productions
Todd McFarlane Productions is the company behind the monthly comic book Spawn. Created by Todd McFarlane, Spawn debuted in May 1992, selling 1.7 million copies, making it the bestselling independent comic book of all time. Spawn is published in nine languages and distributed in more than 32 countries. Currently, TMP releases the long-running Spawn monthly comic now in its 19th year. Other TMP titles include Haunt, Hellspawn, and Sam & Twitch.
We're Social, are you?
To stay in the know on all things McFarlane — including exclusive content, behind-the-scene coverage, news, events, contests, and giveaways… "Follow Us" on Twitter or "Fan Us" on Facebook!


text:
I have a different take on the �gun� issues facing our county, state and country. Recently I had the privilege of attending a Firearms Safety Class at the Worcester Pistol Rifle Club in Boylston, where National Rifle Association-certified instructors taught us about the proper handling, function and laws regarding guns. At the end of class, we shot six different types of guns. It was an eye-opening experience.
It is time for us to get truly educated about this issue. Rather than banning guns , how about courses in the schools and within the community put on by certified instructors, policemen, former or current military to teach about the safe use of firearms?
Let�s bring back Eddie Eagle and teach our children what to do if they see a gun � I learned a lot about this subject. Do you know what to do if you see/find an abandoned gun? I think the answer will surprise you.
Illegal guns and people using them illegally will always be our enemy. Let�s stop the individuals using guns as weapons by, at a minimum, tougher court sentencing and supporting victims of these lawbreakers.
Support the legal right to bear arms. Our founders wrote the Second Amendment for a reason. Learn why. This is important. Let�s put U.S. civics and U.S. government back in our high schools and earlier grades. Let�s be informed, law abiding, possible gun-owning citizens.


text:
Owner & President of Greenville Mental Health Services Provider Abused Female Employees, Federal Agency Charges
GREENVILLE, N.C. – A Greenville mental health services provider violated federal law when it subjected its female employees to a sexually hostile work environment, the U.S. Equal Employment Opportunity Commission (EEOC) charged in a lawsuit filed today.
The EEOC's suit (Civil Action No. 4:09-cv-00122-F), filed in U.S. District Court for the Eastern District of North Carolina, asserted that Carter Behavior Health Services, Inc. created and maintained a sexually hostile work environment for Dionne Jiles and other women who worked there. According to EEOC, the company owner and president repeatedly asked Jiles to engage in sexual acts and attempted to kiss her. Additionally, the alleged harasser subjected Jiles and other women to unwelcome sexual comments, offensive touching and other sexually offensive conduct. The total number of employees who were subjected to the sexually hostile work environment has yet to be established.
"Sexual harassment is completely unconscionable and illegal, and the EEOC will continue to fight this kind of misconduct," said EEOC Acting Chairman Stuart J. Ishimaru.
The EEOC seeks compensatory damages and punitive damages for Jiles and similarly situated female employees, as well as an injunction prohibiting the company from engaging in sex discrimination and requiring it to take other measures to ensure a workplace free of discrimination for future employees.
"Sexual harassment continues to permeate the American workplace," said Lynette A. Barnes, regional attorney for EEOC's Charlotte District Office. "Employers must take all steps necessary to ensure that employees have a work environment free from harassment. This is especially true where, as here, the alleged harasser is the president and owner."
The EEOC enforces federal laws prohibiting employment discrimination. Further information about the EEOC is available on the agency's web site at www.eeoc.gov.
This page was last modified on July 10, 2009.
Return to Home Page


text:
In the past decade, Jim Cramer has proven that he will go to any length to help his "homegamer" viewers understand the complex world of investing. To pay tribute to the world of investing in order to make sure that his point was fully understood, he has whipped up some crazy costumes. Outfits have ranged from a full HazMat suit, to dressing as National Basketball Association star LeBron James. No stealing ideas for Halloween costumes, Cramerica! Click ahead to celebrate some of the craziest costumes that Cramer has dared to share in the last 10 years.
By Abigail Stevenson, contributed by Drew Sandholm & Tim Dewald
Updated March 11, 2015


text:
|Sign up! | Post a Journal | Ask a Question | Request a Lookup | Active | Newest | Unanswered | Assist | Locations
Join over 80,000 others who are connecting with their cousins and common researchers!
FamilyTreeCircles is easy and free.Join Us
I read and research all the time even when I hit a blank wall or sometimes find that skeleton in the closet. Most of my time is devoted to my four legged companion - an Australian Shepherd named Mick Dundee. My husband passed away six years ago and at that time my married name was Harris but I go by my maiden name HOLMES (proud of the Irish and Scottish roots).


text:
15. Re: What to do about Password protected SSD drive?dbavaria Nov 20, 2010 10:19 PM (in response to zaq)
It would kind of defeat the purpose of a HDD security lock if the manufacture maintained a default password.
Its true though, master passwords exist and are a documented part of the ATA spec, some have been leaked, others have been easily broken.
There are also liability issues.... can anyone prove that they own the data on the drive?
I have the original retail box and drive, surely that would be enough. Either way, I wouldn't expect a manufacturer to unlock the drive for an individual, but more importantly law enforcement. For an individual customer I would expect them to offer to secure erase/reset the drive.
The method I posted above to bypass the hard-drive password comes from the author of HDDerase itself.
Zaq, I haven't had a chance to try out your suggestion but I will soon. The instructions look like they are for drives that are in a security locked state, rather than just drives that have a password...I'm not sure it will work, but I'll try it tomorrow.
16. Re: What to do about Password protected SSD drive?zaq Nov 21, 2010 8:33 AM (in response to dbavaria)
THIS IS IMPORTANT if using HDD erase for an SSD from
use ver 3.3, the new version 4.X does not work on SSDs
enable bios to boot from the bootable media the HDDerase is on ie floppy or USB stick
(PM me if you need easy 15 second info on making a bootable USB stick)
In the bios the boot up method must be changed from AHCI or RAID back to simple IDE
Use a PC with IDE and SATA support on motherboard and make sure the SSD is connected to one of the 4 primary SATA motherboard connectors if there are more than 4 SATA connectors. The HDDerase only recognised drives on the primary 4 slots, so if your drive does not show at the drive selection screen, reboot and change SATA connector on the motherboard.
I pretty sure this method will work
I had a brand new 2tb Hard drive for my kid's PC and a few weeks later I wanted to partition and reinstall with a newer OS
I used HDDerase and kept getting stuck with the same problem you are having even after the reboot.
I had used HDerase dozens of time prior to this and never had this problem, so I read the author's README file and found the solution ie remove the power wire upto the A prompt and then reattach it when the A prompt is visible
(C prompt if using a bootable USB stick which i now use for everything that requires a bootable media)Google thisHow to Secure Erase (reset) an Intel Solid State Drive (SSD) – IISall the details and links for Ver 3.3 are on that siteCIAO
17. Re: What to do about Password protected SSD drive?dbavaria Nov 22, 2010 2:22 AM (in response to zaq)
As I suspected earlier, HDDErase does not work for drives that are password locked. It basically says "The drive is locked..." then gives a set of options to unlock with user/master password before it can continue. As I pointed out earlier, this is documented behavior of HDDErase because this is just how the ATA Password works:
If selected drive is locked with a non-HDDerase password the user is given the option to: 1) unlock with user password, 2) unlock with master password (if high security), 3) secure erase with user password, 4) secure erase with master password, 5) enhanced secure erase with user password (if supported), 6) enhanced secure erase with master password (if supported). If option 3, 4, 5 or 6 is selected any possible HPA and/or DCO areas will not be reset.
Back to the drawing board. Does anyone have a direct email contact to Intel support, I can't seem to get through explaining this one on the phone...
18. Re: What to do about Password protected SSD drive?zaq Nov 24, 2010 2:06 PM (in response to dbavaria)
so the removal of power supply to the SSD prior to booting up HDDerase via bootable media did not work?


text:
Drum magazine is the ultimate guide to gear and drumming styles for dedicated drummers. In each issue you will find amazing features you will enjoy reading. You can read about the latest news regarding drums and drummers, the best gear and drums, interviews, hand drumming, and many other fascinating topics. Order your discount subscription to Drum magazine today!
News and Features
In each issue of Drum magazine, you will be able to read about the latest news related to drums and drummers. With the help of this publication, you will be the first to read about amazing artist collaborations, exclusive interviews, competitions, and more. There are also articles about new ways in which drums are being used, such as in a church setting or at fashion expos. You will love reading all the great articles that are in this magazine each month!
Learn about all the newest and hottest gear through your subscription to Drum magazine. In every edition, you can read about new drumsticks that provide you with better grip, innovative clips for your cymbal stand, the best hardware, various brands and types of drums, and many other items that you will love. With this guide, you can read about all the specs of the items before you purchase them so that you can decide what gear is best for your style and needs!
Not only can you read interviews, news, and learn about gear, but you can also learn many new skills through your Drum magazine subscription! Each issue provides you with great information and tutorials about new strokes that you can add to your drumming repertoire. There are how-to articles for five strokes, linear kicks, double strokes with rolls, rhythm challenges, and more. You will enjoy learning from this publication and becoming an even better drummer.
Get ready to drum by ordering a discount subscription to Drum magazine today!


text:
Bay Area (Hacker's Association|Security Enthusiasts) Meeting![edit]
2nd Sunday of every month, 2pm, at Noisebridge, in the main area. It lasts until it's over.
It's for people interested in security, not the more general "make stuff" kind of hacking.
Date of Meeting:
2pm (1400), Sun 11 Aug 2013
Secure Communications, Privacy, Counter-Surveillance[edit]
This month we present:
Jon Callas
You've read about PRISM, XKeyscore and others. If you suspected that governments were spying for years, you're no longer that crazy person. What's going on? What can you do about it? Does it really even matter? The discussion will be interactive.
About the Author:
Jon Callas is a software engineer, inventor, cryptographer, and entrepreneur. He is a co-founder of PGP Corporation and Silent Circle. He is a designer of security products that have won major innovation awards from The Wall Street Journal and others. He is a co-author of the Skein finalist for SHA3. He has worked on everything from operating systems to user experience on everything from PDP-11s to iPhones.


text:
Style # 210509
Diagonal mix of stripes, a plunging V-neckline and a billowing maxi skirt make this bebe dress a desirable way to land a new-season look. Try it with a pair of wedge sandals and a single statement bracelet.
- 96% viscose, 4% spandex
- Center back to hem: 48" (122 cm)
- Jersey lining
- Dry clean
- Imported
- Model is 5'9" and is wearing a US size S
Striped V-Neck Maxi Dress is rated out of 5 by 1.
Rated 5 out of 5 by Tarra from Summer fun and sexy. Dress fits true to size. There are no leg slits nor extra padding for bra. However, the bra I used fit nicely under the dress without being seen. Fabric is soft and flows. Well worth the money and great summer/spring and I think fall wardrobe addition.
Date published: 2013-06-09


text:
ATLANTIC CITY, N.J. – The team that may have prevented the Bulldogs from capturing their third straight conference regular season title stood in the way of Yale advancing to Saturday night's ECAC Hockey Tournament Championship Game. The No. 3 ranked Elis (26-6-1) used three points from Andrew Miller and a shutout from Ryan Rondeau to beat Colgate 4-0 in the first semifinal at Boardwalk Hall.
Yale takes on Cornell, tonight's 3-0 winner over Dartmouth, at 7:30 p.m. for the 2011 Championship, the night before the NCAA Hockey Committee announces its 16-team field. The Bulldogs and Big Red meet Saturday for the second time in the last three ECAC Championship Games.
The giant-slaying Raiders (11-27-3), coming off playoff series wins at RPI and Union, managed to earn a 1-1 tie at New Haven on the second-to-last day of the regular season, denying the Blue a much needed point before Yale finished one-point out of first place.
Despite being a one-goal game most of the way, today was a different story. Yale outshot Colgate 40-22 and did not score on the power play, while Miller hit the net and handed out two assists.
"They gave us all we could handle tonight. We expected it to be close," said Keith Allain '80, Yale's Malcolm G. Chace Head Coach of Hockey. "We knew how tough they were to beat after the last meeting."
Rondeau, recording his second straight shutout, made 22 saves and stopped six man-advantages on the way to breaking the single-season school (5) record for blankings. He is the only Yale goalie to have two shutouts in post-season play, five days after keeping St. Lawrence off the scoreboard in a series clinching win at Ingalls Rink.
"I just go out and play and have fun. I try not to think too much out there," said the senior Yale netminder who ranks second among Division I goalies in goals against average.
Chris Cahill, Kenny Agostino and Antoine Laganiere had the other goals in the Bulldogs' third straight win. Cahill and Brian O'Neill had two points for the nation's top scoring squad.
Both teams threw eight shots on target in a scoreless opening frame. Yale had the first advantage of the game, it's only opportunity in first period, while the Raiders had two chances to find the net up a man. Both sides had a couple of grade-A chances but Rondeau and Michalik came up with big saves. The closest the Elis came to scoring was a long backhander from Laganiere that hit the pipe squarely in the first minute.
The Bulldogs dominated the second period with 19 shots on goal but could only get to their locker room with a 1-0 lead. Michalik came up big (18 saves), especially on close-range shots. Yale peppered him from every angle, but six of his 18 saves came from players who were low, between the dots.
The Raiders, who had just six shots on target in the period, appeared to take a 1-0 lead 18 seconds in, but a video review confirmed that a Colgate player had kicked the puck into the net. A few minutes later, Yale forward Kevin Limbert had a mini-breakaway but fired the puck over the net from the middle slot to keep the game scoreless.
The Blue finally cracked the egg at 5:07 of the middle frame, and it came off a faceoff won by Miller in the right circle. The sophomore won it back to Cahill who cut across from the boards, took two strides and then unleashed a wrister that hit the back of the net for his 14th of the season.
The Elis continued to pour on the shots in the third. Miller, who had primary helpers on the first two, was in on the tally that made it 2-0 at 6:42. He fired a shot from the high slot that was knocked aside by Mihalik. The puck came out to the right circle where Agostino was in position to snap off a low shot through a small opening for his 11th goal.
Yale used a great penalty-kill to fuel a three-goal lead. O'Neill took a feed in the left circle but had no angle to shoot. He saw Miller cruising into the high slot open and quickly put the puck on his stick. Miller (12th goal) spun to shoot and then sent a rising wrister over Mihalik's shoulder at 14:49.
"He can do a lot of things for us. He played a good game overall," said the Yale head coach about Miller.
The Raiders pulled Mihalik with just under three minutes left after a Yale penalty. The four Eli skaters prevented Rondeau from seeing more than a good look and the empty net eventually grabbed some rubber. Laganiere (4th) intercepted a break-out pass inside the blueline and fired it home with 14.7 seconds left.
Rondeau made eight saves in the third, but the lack of quality rebounds may have been more important. "Tonight was what we've seen from him all season," said Allain. "He's been steady."
The shutout was also a product of Yale's overall defensive effort, which included limiting the Raiders to seven shots on goal over six man-advantages. The Bulldog fore-check was relentless, players got in front of Colgate shots from the point and the Elis took care of the puck in potentially dangerous situations.
"They are so quick to the puck, and they don't give you much time and space," said Colgate head coach Don Vaughan, describing what it's like to play Yale.
BULLDOG BITES: Today's attendance was 3,351... This is the second time the Elis advanced to the conference title contest. The only other time was a 5-0 win over Cornell in 2009... Yale's lineup was the same as the last of the ECAC Quarterfinal series… The Elis arrived on the Jersey Shore early Wednesday evening. Thursday was a practice and media interview day, and also an opportunity to get accustomed to the surroundings before the championship banquet inside Boardwalk Hall (BWH)… This is Yale's fifth appearance at the ECAC Championship Weekend… This was Yale hockey's first game in Atlantic City. BWH, a national historic landmark built in 1929 that hosts the Atlantic 10 Basketball Championships, has not had hockey on a regular basis since the ECHL Boardwalk Bullies called it home from 2001-05. "It's an interesting, old, historic building, and it was neat for us to play here. I think it's a good experience for us to play in a building like this heading into the national tournament," said Keith Allain.
Filed by Steve Conn, Yale Sports Publicity Director