text:
Very exciting model releases here!
Our Face Detection model will return an array of bounding box coordinates for any faces that it finds in a photo and our Age/Gender/Ethnicity model will return just that! (The age, gender and ethnicity of a person)
Check 'em out here and let us know what you think!
Note that these are still in Alpha so they are still being worked on.
Any thoughts on these so far? How accurate was the A/G/E model when you tried it on yourself?
Has the Age/Gender/Ethnicity model been removed? I can't find it anymore in the Docs. Thank you and best regards, Alex.
Hey Alex - this was removed temporarily but it will be back shortly! Sorry about that.
Hi Alex, has this feature back to be available now ?I'm excited to try it.
Should be back shortly Charles! Stay tuned
It's now April, when will we be able to detect gender?
I found general face detection, but I cannot seem to find gender detection.
Hi @ronakdev - just heard from the team that we're looking at 2-3 weeks here while the model is being fine-tuned. Apologies for the delay!


text:
This restaurant offers a gourmet cuisine and a dazzling view of the sea. Be enchanted by every detail in this ambience of design.
Responsable: Ricardo Ferreira
Parking: Yes
Closing days: Sundays, Mondays(Lunch)
Recommended for groups: Yes
Average price: 30.00
Disabled access: Yes
Type of restaurant: Portuguese
Open on Sundays: No
Access for physical disability: Easy accessability
If any of the information is incorrect, please send an email to lifecooler office
Shot to shot
Once upon a time in Portugal...
Celebrating Life
The air is as pure as the waters
One of the most fun and unique rides you can do in Madeira, ...

subset: commoncrawl


text:
You can also find all of our HNW infographics in one place by clicking here.
Individuals and businesses buy products or services because they need to solve a problem. For example, clients engage with HNW advisors for expertise on estate plans, tax plans, investment management, or a number of other services.
In the case of Advicent, financial professionals choose to purchase our software because it helps them more effectively serve their HNW clients. Crafting buyer personas enables your business to understand why your customers buy from your business.
In a financial advisor's perfect world, their book of business would likely contain many HNW clients. Unfortunately, this is often not the case. While it sounds ideal to have a book full of HNW clients, attracting and retaining them in a highly competitive market is an industry-wide struggle.
It is vital that advisors have a plan in place to attract HNW clients instead of hoping for them to walk through the door on their own. One of the most important things an advisor can do is differentiate themselves from their competition while delivering their value proposition to potential HNW clients and piquing their interest for a meeting.
As both large and small firms continue to refine their strategies for the year, many are likely focusing on how to grow additional AUM from their existing client base.
If HNW individuals comprise a significant portion of your AUM, the returns provided by better supporting these clients will be far greater in the immediate future than the returns offered by younger high-earning clients who are likely still saddled with debt and indifference toward the client-advisor relationship.
You can learn more about how Advicent technology drives results for firms of all sizes here.


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|Card Front.
|Image Closeup.
|Sentiment Closeup.
Please hop over to the blog and join in with us.
|Card Front.
|Image Closeup.
|Sentiment Closeup.
absolutely worth that trip out of your comfort zone. This is stunning xxxReplyDelete
Thankyou sooooooooooooooo much for the loverly comment :o)ReplyDelete
WOWSERS!!!!! This is absolutely STUNNING!!!!! It was well worth you taking a trip out of your comfort zone Donna as this is just amazing! WOW I love it every single thing you have created. You should enter this into a few challenges my friend as I am sure you could win.
Big Hugs
Linda xxxx
Awwwwwwwwwwwwwwwww thanks Linda hun xx
Really did JUMP out my comfort zone with this with so many dies and techniques used :o)And even cutting down and altering a die cut butterfly I cut out on my GC xx
Really sweet card Donna with lovely papers and elements. Hugs, Claire xReplyDelete
A gorgeous card,love the fabulous image and layout.xxxReplyDelete
Super sweet card love it... have a good weekend big hugs Jo xxxReplyDelete
Gorgeous card xReplyDelete
Absolutely gorgeous card!ReplyDelete
Thanks for the brilliant comments everyone, I appreciate every one of them xxReplyDelete
so stunning donna,i love all your gorgeous details and fab sweet image :D
Thanks alot Coops xxReplyDelete
Beautiful as always hun xReplyDelete


text:
Jean SHAOUL, Anne STAFFORD and Pam STAPLETON
Manchester Business School,University of Manchester,
United Kingdom
September 2012
Discussion Paper No. 2012-6
Prepared for the Roundtable on: Public Private Partnerships for Funding Transport Infrastructure: Sources of Funding, Managing Risk and Optimism Bias
(27-28 September 2012)
International Transport Forum
A key message of this paper is that it is more costly for the public sector to use the private sector as financial intermediaries. This is due in part to the higher cost of commercial over public debt and the cost of the profit margin of both the private partner and its extensive supply chain. But there are also the not inconsiderable legal and financial advisors' fees to each of the numerous parties to the transaction to structure and negotiate it
Bajar documento


text:
November 11, 2016 – Otun Ekiti Armed Robbery Attack: Robbers Kill Heritage Bank Manager & 3 Others
Not less than 4 people lost their lives in Ekiti state today after some dare devils attacked a bank.
The victims of this tragic robbery attack were shot dead today at Heritage Bank in Otun Ekiti.
The robbers reportedly carted away a huge sum of money from Heritage Bank during the operation.
Here is what Otun Ekiti traditional ruler, Oba Popoola told press men few hours ago:
"I was relaxing with my chiefs in front of the palace when we heard what first sounded like some fireworks and we dismissed it as some of the children's antics as a result of the festive period.
"But later, we heard heavier and more shocking sounds that resembled gunshots and explosives
"That was when we realised it was no child's play as gunshots and explosives rang loud all over the place.
"I couldn't really rationalise the incident as we ruminated on whether it was a robbery, Boko Haram attack or some form of war.
"We later learnt that the robbers planted their men at the four entry points leading into the town",
"The Heritage Bank Manager and cashier, security man at Unity Bank and my own night guard were all killed in the operation
"I immediately reported the case to the governor and he mobilised the security operatives who promptly followed up the governor's instruction.
"But by the time the reinforcement came, the robbers had left the scene,''
"The border towns and local government areas should be given very tight security so that such incidents do not happen again.
"Government should put in more efforts into ensuring the protection of lives and property,''.
The bodies of the victims have been deposited at Usi Ekiti General Hospital mortuary.
May their souls rest in peace.


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[vc_row][vc_column][vc_custom_heading text="Infor Cloud Suite, a proven Solution trusted by Industry Leaders" font_container="tag:h2|text_align:center"][/vc_column][/vc_row][vc_row][vc_column][vc_single_image image="4399″ img_size="large" alignment="center"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]
Infor Cloud Suite lets you choose the best option for deploying your data, providing options that help make your information both portable and secure.
[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]Infor has offered cloud based applications for more than a decade and is leading the migration of core industry processes to the cloud. We believe that the cloud is ready to run an organization's most vital applications, such as ERP, EAM, and SCM.
Etag's cloud computing platform is robust enough to ensure that those applications will keep running efficiently and effectively. Infor Cloud gives unmatched flexibility to respond quickly to changing business requirements.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]
Less Hassle, More Value and True Business Agility is the Bottom line to achieve Modernized technology platform through Infor Cloud.
[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_text_separator title="Infor Cloud can help you:" title_align="separator_align_left"][vc_column_text]Modernize
- Get a clearly defined project scope and complete program for moving to a modernized platform.
- Speed deployment with implementation accelerators and pre-built industry platforms.
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- Get support for hybrid deployments, including Infor and third-party solutions
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- Integrate relevant data, KPIs, and reports to get a comprehensive view of your business.
- Extend the capabilities of your solutions with an expanding range of mobile-enabled offerings.
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- Get comprehensive, industry-driven suites that deliver the capabilities you need out of the box.
- Provide a modernized, consistent user interface across all of your applications.
- Increase response times and productivity with dynamic workflows.
- Improve decision-making with embedded, pervasive industry analytics.
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- Accountability – Our responsive customer service and proactive IT system maintenance philosophy ensure smooth, efficient IT operations.
- Upgrades – Ensure your business stays up-to-date, and up and running on the latest version of your technology solution. Infor Cloud upgrades your solution with minimal disruption to your business operations.
- Our service doesn't end when the power is turned on.
[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]With Infor Cloud, companies don't have to change the business to fit the software, instead can adapt and extend the software to fit the business. Infor Cloud provides unparalleled results for improved workflow and better automation.
Etag Infor Cloud solutions can help open up a world of opportunity for your business and make it easier and more cost-effective to take advantage of a broad range of innovative technologies, from high value extension applications to industry-driven solutions. Infor Cloud helps reduce the total cost of ownership, and build a technology platform with the flexibility and scalability to meet the needs now and as the business changes[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column]


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Facebook advertising gives businesses the opportunity to create and promote custom content to targeted audiences. Although the social-media platform is known for its advertising advantages, that doesn't necessarily mean that businesses are using it properly. Check out our tips for creating successful Facebook ad campaigns:
Determine your objective
Before you begin to develop your ad, you should make sure that you have a clear objective in mind. Your content, budget, and target audience, which will come next in the process, are all dependent on what you decide to promote – and why. You can choose from many different objectives, all of which are broadly categorized as awareness, consideration, or conversion.
Understand your audience
If you haven't used Facebook's Audience Insights tool yet, you need to. Rather than risking your budget by targeting the wrong individuals, this tool will tell you who your target market is, based on people who already view and like your page. Through data collection, you can learn your audience's locations, interests, and behaviors in order to create messages most relevant to them.
Connect your ads to landing pages
Especially if your objective is to specifically increase engagement with your website or convert leads, you'll want to connect your ads to landing pages. For example, if your ad makes reference to a product your business provides, you may decide to direct the audience to a custom landing page that features product information and form they can fill out for a coupon code to use on that product. Simply sending your audience to your homepage – or any other page – without a clear call-to-action not only wastes your budget, but your time as well.
Use eye-catching photos
While the copy within your ad is important, you will need something to grab your target audience's attention as they scroll through their News Feed. Images of your business, product, or service may be the first choice for your ad, but consider images that are specific to your objective as well. While original imagery is ideal, you may consider stock photo websites such as Pexels or Stock Snap. If you use stock photography, we recommend that you take those stock photos one step further, customizing them with text or other design features that will stand out on a crowded platform.
Establish a budget
Facebook's Optimized CPM is a bid type that targets audiences who are more likely to take the action that you want. Paying for impressions, your bid will adjust based on your advertising objective without spending more than your budget. While you can opt out of using the optimized CPM feature, keep in mind that the system may spend more than your target bid in its attempt to fulfill your desired objective.
Analyze your ad report
Creating your ad is just one part of the process. Once the ad is live, you will want to analyze the "Ads Reporting" tool to see the successes (and failures) of your campaign. The report includes data on the reach, frequency, and impressions of the ad. Making the tool even more useful, Facebook allows businesses to export the report for a more in-depth analysis.
Facebook offers businesses much more than they may be aware of, and given that it is a crowded platform, you should consider taking advantage of these options. If you've already invested time in building a Business Page, consider taking the next step in promoting your content and increasing traffic to your website by using Facebook's ad feature. We're always here to help!


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Welcome to the ultimate online store that has great designs of Foo Fighters t shirts. Our listings are amazingly incredible and you will be spoilt for choice. The good thing is that our prices are considerably cheap hence you can afford to buy a number of shirts. We have excellent payment options that offer the convenience you need.
The shirts come in a wide range of colors and sizes which offers you a variety to work with. You will get to enjoy incredible designs of this hugely successful band of this new age. The band which is of American origin, has been performing since their formation back in 1994 when Nirvana drummer Dave Grohl decided to form the band following the dissolution of his original band. An interesting fact about the band is that they got their name from the UFO's that had been reported by allied aircraft pilots, as they were commonly referred to as foo fighters. The band got together with a number of talented individuals who provided a number of their skills to the band. They began with a number of performances in Portland before they could later move on to other areas as they sought to build their popularity.
Some of the available Foo Fighters t shirts have great designs of the band members performing on stage in some of their very explosive performances which they're renowned for. With their tee shirt, you can be a part of the millions of fans that constantly rock to the band's music. The band has had a long list of albums all of which have been widely successful including their 2002 album release titled One by One, the 2005 release titled In Your Honor.
This 2005 release saw the band try out a new blend of acoustic songs and heavy metal content. The band soon after managed to release their sixth album titled Echoes, silence, Patience and Grace. During their tenure, which is still active, the band has had three of its albums bagging Grammy Awards in the category of Best Rock Album. In addition, all their six album releases have also been nominated in the same category which they have won thrice. Their recent album titled Wasting Light was released in 2011.


text:
Tomorrow night, Fullerton streetwear spot Beatnic (BTNC) is hosting a benefit art show with all proceeds going to The Philippine Red Cross to help those impacted by the devastating Typhoon Haiyan in the Philippines last month. The art show features 15 talented local artists including:
Adriano Martinez
Alexander Sia
Dana Harvey
Dennis Padua
Ernie Ortega
Gaby Tiongson
Glen Repol
Jayson Palacio
John Le
Kathleen Le
Nikki Alfonzo
Michael Torres
Rick Garcia
Rhyan Santos
Ryan Aquino
Terence Calacsan
The event will also feature disaster relief tees designed by Rotu and performances by DJ Vendt, Here Between You Me, and All Suits Affair . The event is free to get in and guests are encouraged to bring canned goods as donations. Check the Facebook event for all the details and check out Rotu's dope shirt design below!
related posts
« Nike SB x Concepts "Ugly Sweater Pack" Akomplice Winter Flamingo Capsule Collection »


text:
Go to this issue's Table of Contents.
But it's undeniable that English-speakers now have lower birth rates, on average, than speakers of Hindi and Urdu and Arabic and Spanish. And the countries where these other languages are spoken are, generally, less well developed than native-English-speaking countries. In 1996, according to United Nations statistics, 21 percent of males and 38 percent of females in "less developed regions" were illiterate in every language, as were 41 and 62 percent in the "least developed countries." Nonetheless, the gains that everyone expects English to make must come because it is adopted as a second language or a foreign language by most of the people who speak it. According to "The Decline of the Native Speaker," a paper David Graddol published last year in the AILA Review (AILA is the French acronym for the International Association of Applied Linguistics; the review belongs to the minority of international scholarly journals that still make use of another language in addition to English), the proportion of native English-speakers in the world population can be expected to shrink over the century 1950-2050 from more than eight to less than five percent.
A few more definitions will be helpful here. "Second-language" speakers live in places where English has some sort of official or special status. In India, for instance, the national government sanctions the use of English for its business, along with fifteen indigenous languages. What proportion of India's population of a billion speaks English is hotly debated, but most sources agree it is well under five percent. All the same, India is thought to have the fourth largest population of English-speakers in the world, after the United States, the United Kingdom, and Nigeria -- or the third largest if you discount speakers of Nigerian pidgin English. English is a second language for virtually everyone in India who speaks it. And obviously the United States, too, contains speakers of English as a second language -- some 30 million of them in 1995, according to an estimate by David Crystal.
"Foreign-language" speakers of English live in places where English is not singled out in any formal way, and tend to learn it to communicate with people from elsewhere. Examples might be Japanese who travel abroad on business and Italians who work in tourism in their own country. The distinction between the two categories of non-native speakers is sometimes blurry. In Denmark and Sweden the overwhelming majority of children are taught English in school -- does that constitute a special status?
The distinction between categories of speakers matters, in part because where English is a first or second language it develops local standards and norms. India, for instance, publishes dictionaries of Indian English, whereas Denmark and Sweden tend to defer to Britain or the United States in setting standards of English pronunciation and usage. The distinction also matters in relation to how entrenched English is in a given place, and how easy that place would find it to abandon the language.
One more surprise is how speculative any estimate of the use of English as a second or a foreign language must necessarily be. How large an English vocabulary and how great a command of English grammar does a person need in order to be considered an English-speaker? Generally, even the most rigorous attempts to determine how many people speak what, including the U.S. Census, depend on self-reporting. Do those years of French in high school and college entitle us to declare ourselves bilingual? They do if we want them to. Language researchers readily admit that their statistics on second- and foreign-language use are, as Graddol put it in "The Decline of the Native Speaker," "educated guesswork."
David Crystal, in his Cambridge Encyclopedia of the English Language (1995), observed that only 98 million second-language speakers of English in the world could be totted up with certainty. In English as a Global Language, though, he argued that the true number was more nearly 350 million. Graddol put forward a variety of estimates in "The Decline of the Native Speaker," including Crystal's, and explained why each had its proponents. According to the most expansive of them, the number of second-language speakers was 518 million in 1995. From 98 million to 518 million is quite a range.
Estimates of the number of foreign-language speakers of English range more widely still. Crystal reports that these "have been as low as 100 million and as high as 1,000 million." The estimates would vary, because by definition foreign-language speakers live in places where English has no official or special status. They may or may not have been asked in a national census or other poll about their competence in English or other languages; they may or may not have had any formal schooling in English; their assessment of their ability to speak English may or may not be accurate.
This last point is particularly worth bearing in mind. According to recent "Eurobarometer" surveys described by Graddol, "77% of Danish adults and 75% of Swedish adults for example, say they can take part in a conversation in English." And "nearly one third of the citizens of the 13 'non English-speaking' countries in the EU 'can speak English well enough to take part in a conversation.'" However, Richard Parker, in his book Mixed Signals: The Prospects for Global Television News (1995), reported this about a study commissioned by Lintas, a major media buyer, in the early 1990s:
When ad researchers recently tested 4,500 Europeans for "perceived" versus "actual" English-language skills, the results were discouraging. First, the interviewees were asked to evaluate their English-language abilities, and then to translate a series of sample English phrases or sentences. The study produced, in its own words, "sobering" results: "the number of people really fit for English-language television turned out to be less than half the expected audience." In countries such as France, Spain, and Italy, the study found, fewer than 3 percent had excellent command of English; only in small markets, such as Scandinavia and the Low Countries did the numbers even exceed 10 percent.
So the number of people in the world who speak English is unknown, and how well many of them speak and understand it is questionable. No one is arguing that English is not widely spoken and taught. But the vast numbers that are often repeated -- a billion English-speakers, a billion and a half -- have only tenuous grounding in reality.
I have never seen any tables or charts that rank languages according to the proportions of the world's population expected to be using them as second or foreign languages ten or fifty years from now. The subject is just too hypothetical, the range of variables too great. Consider, for instance, the side effects that the breakup of the Soviet Union has had on the use of the Russian language. Now that no central authority seeks to impose Russian on schoolchildren throughout the Soviet bloc, few countries besides Russia itself require students to learn it, and for the most part the language is less and less used. However, in places including the Caucasus, Russian continues to be valued as a lingua franca, and fluency in it remains a hallmark of an educated person.
Consider, too, the slender thread by which Canada's linguistic fate hung not long ago. In November of 1995 Quebec held a referendum to determine whether most of its citizens were in favor of independence. If 27,000 of the 4.65 million Quebeckers who voted had cast their ballots for secession rather than against, by now Canada's entire population of some 30 million people, all of them in theory bilingual, might conceivably be on the way to being largely monolingual -- the nation of Quebec in French and what remained of Canada in English.
In the United States, discounting the claims that antagonists make about the other side's position, it's hard to find anyone who doesn't think it would be nice if everyone in the United States spoke English. Virtually all the impassioned debate is about whose resources should be devoted to making this happen and whether people should be encouraged to speak or discouraged from speaking other languages, too. All kinds of things have the potential to change the rate at which English as a second language is learned in the United States. Suppose that nationwide, English lessons were available free (as they already are in some parts of the country) and that employers offered workers, and schools offered parents, incentives to take them. Who can say what effect this would have?
Patterns of learning foreign languages are more volatile still. When I visited David Graddol, last fall, The English Company was reviewing materials the Chinese government had created to be used by 400,000 Chinese instructors in teaching English to millions of their compatriots. Maybe this was a step in an inexorable process of globalization -- or maybe it wasn't. Plans to teach English widely in China might change if relations between our two countries took a disastrous turn. Or the tipping point could be something completely undramatic, such as the emergence of an array of Chinese-language Web sites. The information-technology expert Michael Dertouzos told me not long ago that at a conference he had attended in Taipei, the Chinese were grumbling about having to use English to take advantage of the Internet's riches.
UCH of what will happen to English we can only speculate about. But let's pursue an idea that language researchers regard as fairly well grounded: native speakers of English are already outnumbered by second-language and foreign-language speakers, and will be more heavily outnumbered as time goes on.
One obvious implication is that some proportion of the people using English for business or professional purposes around the world aren't and needn't be fluent in it. Recently I talked with Michael Henry Heim, a professor of Slavic literatures at the University of California at Los Angeles and a professional translator who has rendered into English major works by Milan Kundera and Günter Grass. By his count, he speaks "ten or so" languages. He told me flatly, "English is much easier to learn poorly and to communicate in poorly than any other language. I'm sure that if Hungary were the leader of the world, Hungarian would not be the world language. To communicate on a day-to-day basis -- to order a meal, to book a room -- there's no language as simple as English."
Research, though, suggests that people are likely to find a language easier or harder to learn according to how similar it is to their native tongue, in terms of things like word order, grammatical structure, and cognate words. As the researcher Terence Odlin noted in his book Language Transfer (1989), the duration of full-time intensive courses given to English-speaking U.S. foreign-service personnel amounts to a rough measurement of how different, in these ways, other languages are from English. Today the courses for foreign-service employees who need to learn German, Italian, French, Spanish, or Portuguese last twenty-four weeks. Those for employees learning Swahili, Indonesian, or Malay last thirty-six weeks, and for people learning languages including Hindi, Urdu, Russian, and Hungarian, forty-four weeks. Arabic, Chinese, Japanese, and Korean take eighty-eight weeks. Note that all the world's other commonest native languages except Spanish are in the groups most demanding of English-speakers. It might be reasonable to suppose that the reverse is also true -- that Arabic- and Chinese-speakers find fluency in English to be more of a challenge than Spanish-speakers do.
A variety of restricted subsets of English have been developed to meet the needs of nonfluent speakers. Among these is Special English, which the Voice of America began using in its broadcasts experimentally some forty years ago and has employed part-time ever since. Special English has a basic vocabulary of just 1,500 words (The American Heritage Dictionary contains some 200,000 words, and the Oxford English Dictionary nearly 750,000), though sometimes these words are used to define non-Special English words that VOA writers deem essential to a given story. Currently VOA uses Special English for news and features that are broadcast a half hour at a time, six times a day, seven days a week, to millions of listeners worldwide.
But restricted forms of English are usually intended for professional communities. Among the best known of these is Seaspeak, which ships' pilots around the world have used for the past dozen years or so; this is now being supplanted by SMCP, or "Standard Marine Communication Phrases," which is also derived from English but was developed by native speakers of a variety of languages. Airplane pilots and air-traffic controllers use a restricted form of English called Airspeak.
Certainly, the world's ships and airplanes are safer if those who guide them have some language in common, and restricted forms of English have no modern-day rivals for this role. The greatest danger language now seems to pose to navigation and aviation is that some pilots learn only enough English to describe routine situations, and find themselves at a loss when anything out of the ordinary happens.
Something else obviously implied by the ascendance of English as a second and a foreign language is that more and more people who speak English speak another language at least as well, and probably better. India may have the third or fourth largest number of English-speakers in the world, but English is thought to be the mother tongue of much less than one percent of the population. This is bound to affect the way the language is used locally. Browsing some English-language Web sites from India recently, I seldom had trouble understanding what was meant. I did, however, time and again come across unfamiliar words borrowed from Hindi or another indigenous Indian language. On the site called India World the buttons that a user could click on to call up various types of information were labeled "samachar: Personalised News," "dhan: Investing in India," "khoj: Search India," "khel: Indian Cricket," and so forth. When I turned to the Afternoon Despatch & Courier of Bombay (some of whose residents call it Mumbai) and called up a gossipy piece about the romantic prospects of the son of Rajiv and Sonia Gandhi, I read, "Sources disclose that before Rahul Gandhi left for London, some kind of a 'swayamvar' was enacted at 10, Janpath with family friend Captain Satish Sharma drawing up a short list of suitable brides from affluent, well-known connected families of Uttar Pradesh."
Of course, English is renowned for its ability to absorb elements from other languages. As ever more local and national communities use English, though, they will pull language in ever more directions. Few in the world will care to look as far afield as the United States or Britain for their standards of proper English. After all, we long ago gave up looking to England -- as did Indians and also Canadians, South Africans, Australians, and New Zealanders, among others. Today each of these national groups is proud to have its own idioms, and dictionaries to define them.
Most of the world's English-speaking communities can still understand one another well -- though not, perhaps, perfectly. As Anne Soukhanov, a word columnist for this magazine and the American editor of the Encarta World English Dictionary, explained in an article titled "The King's English It Ain't," published on the Internet last year, "Some English words mean very different things, depending on your country. In South Asia, a hotel is a restaurant, but in Australia, a hotel is an establishment selling alcoholic beverages. In South Africa, a robot is a traffic light."
David Graddol told me about visiting China to consult on another English-curriculum project (one that had to do with teaching engineers in the steel industry) and finding a university that had chosen a Belgian company to develop lessons for it. When Graddol asked those in charge why they'd selected Belgians, of all people, to teach them English, they explained they saw it as an advantage that the Belgians, like the Chinese, are not native speakers. The Belgians, they reasoned, would be likely to have a feel both for the intricacies of learning the language in adulthood and for using it to communicate with other non-native speakers.
But by now we have strayed far beyond the relationship between demographics and the use of English. Technology has much to teach us too.
(The online version of this article appears in three parts. Click here to go to part one or part three.)
Illustrations by Christoph Niemann.
Copyright © 2000 by The Atlantic Monthly Company. All rights reserved.


text:
- Review
- Open Access
How to mend a broken heart: a major stab wound of the left ventricle
- Mari-Liis Kaljusto1Email author and
- Theis Tønnessen1
© Kaljusto and Tønnessen; licensee BioMed Central Ltd. 2012
- Received: 23 January 2012
- Accepted: 24 April 2012
- Published: 28 May 2012
A 28-year-old male admitted with a stab wound under his left nipple, underwent emergency surgery because of confusion, a decreasing blood pressure and increasing tachycardia. A median sternotomy incision was made and after establishing cardiopulmonary bypass, a 7 cm wound in the left ventricle and a smaller wound in the left atrium were repaired. An injured segment of lung was resected and the left anterior descending and circumflex arteries were grafted after weaning from cardiopulmonary bypass was initially unsuccessful. Although the patient suffered a stroke, probably due to prehospital hypoperfusion, he eventually recovered without major sequelae. In addition to the case report we present a literature review of the last 15 years pertaining the management of penetrating cardiac injury.
- Cardiac Tamponade
- Glasgow Coma Score
- Cardiac Injury
- Stab Wound
- Trauma Team
Onehundred and sixteen years ago Alex Cappelen repaired a penetrating injury of the left ventricle through a left anterior thoracotomy in Christiania (former name of Oslo), in one of the world`s least violent countries[1]. Cappelen`s operation is considered to be the first report of a cardiac surgical procedure. Today trauma centers all over the world perform complex cardiac repairs due to penetrating trauma but the mortality is still high[2–5].
Overview of the papers on penetrating cardiac injury from 1997 to 2012
Ref nr, author, year, journal and study origin. Study type
Patients/patient group/injury site
Outcomes/performed surgery
Key results
[2] Asensio et al. (1998), J Trauma, USA. Prospective evaluation
2-year prospective evaluation of 105 penetrating cardiac injuries
65% GSW (survival 16%), 35% SW (survival 65%). EDT in 76 pts with 10 survivors (16%)
Presence of cardiac tamponade and the anatomical site did not predict outcome, presence of sinus rythm when the pericardium was opened did
[6] Baker et al. (1998), Arch Surg, USA. Retrospective study + review
106 pts with penetrating heart injury (1989–1995): 60 GSW, 46 SW, 55% overall survival.
6 patients on CPB (4 gunshots, 2 stabs, only 2 GSW survived)
Few survivors due to long time from injury to CPB. Those who were resuscitated >5 min prehospitally had a very poor outcome. SR at admission- good prognostic sign. CPB no good to reverse outbled situation/profound shock, but necessary to repair multichamber injuries/large injuries
[7] Bar et al. (2009), Ind J Thorac Cardiovasc Surg, Israel. Retrospective study
14 pts with penetrating cardiac wound requiring operation (1999–2006) (9 SW, 2 GSW and 2 schrapnel injuries, 1 multipl trauma)
4 sternotomies, 10 anterolat thoracotomies (8 with sternum transsection). 5LV, 6RV, 3RA injuries - all single chamber injuries, no combined.
No CPB, 100% survival, all discharged
Mean interval from injury to surgery 37 min
[8] Barbosa et al. (2011), Interact Cardiovasc Thorac Surg, Argentina. Case report
18 yr male, SW in 4th ic space in the left midclavicular line
Left thoracotomy, suture of right ventricular wound at admittance
Developed pneumonia/lung edema postop, after 30 days AVR for penetrated aortic valve and closure of shunt (RV -> aorta)
[9] Bowley et al. (2002), Ann Thorac Surg, South Africa. Case report
24 yr male, multiple stab wounds
No vital signs, PEA, at EDT: tamponade. 2 cm LV wound with LAD transsection, transsected PDA on the opposite side (RV)
Initially Foley catheter in the wound, mattress sutures, LAD ligation, PDA ligation. VF, hypotension: OPCAB with right gastroepiploic artery . Died of respiratory complications due to Brown-Sèquard lesion (another stab injury to the spinal cord)
[10] Burack et al. (2007), Ann Thorac Surg, USA. Retrospective study
207 pts with mediastinal penetrating trauma 1997–2003, 72 (35%) unstable.
72 unstabel pts, 15% had cardiac injury with 18% survival when explored in ED and 71% when reached OR
With penetrating mediastinal trauma the mortality is 85% when moribund at arrival and 55% when unstable (overall data, not injury specific)
[11] Carr et al. (2011), J Trauma, USA. Retrospective study
2000-2009 penetrating cardiac injuries, both GSW and SW
28 SW with 17 survivors (61%), no information about anatomical site
Functional outcome (5yrs) after: if coronary arteries were not involved - good chance to normal cardiac function at follow up.
[12] Chughtai et al. (2002), Can J Surg, Canada. Review + case report
Cases of 9 pts, 8 managed with CPB in trauma setting from 1992-1998
Only 2 pts of the presented had a sole cardiac injury (LV + coronary artery, RA + intrapericardial vena cava)
The patient with LV and coronary artey injury died (no CPB), the other patient survived without sequele
[3] Clarke et al. (2011), J Thorac Cardiovasc Surg, South Africa. Retrospective study
All patients with penetrating cardiac injury requiring operation from 2006-2009
Of 1062 stab wounds, 104 were operated, 76 had cardiac injury, overall mortality 10%. Approx 50% median sternotomy, 50% left thoracotomy
When data put together with mortuary data: mortality of 30% for SW (in the mortuary cohort of 548 patients with SW, 38% had penetrating cardiac injury). Less than 25% with penetrating cardiac injury reach hospital alive, of these ca 90% survive.
Mostly SW, also mortuary data analyzed. The center has no availability for CPB.
[13] Claassen et al. (2007), J Trauma, USA. Case report
2 male pts : 21 yr and 27 yr
Pas 1: SW in 5th right ic space (axilla) (+ in abdomen), 400ml on chest tube + knife blade in thorax: laceration of right ventricular outflow tract (sutured) + lung resection
Pas 2: SW in left supraclav midline. Tamponade at FAST: pericardial drainage, thereafter stable. Sternotomy after transfer, laceration of the pulmonary outflow tract, sutured, further repaire of aortopulmonary shunt (thrill + TEE)
Think outside the box: SW outside the precordium
[14] Comoglio et al. (2010), Int J Emerg Med, Italy. Case report
75 yr male with chest pain and syncope, had been working with a nailgun
Stable, underwent CT where the nailgun nail was found imbedded in the left ventricular wall. Removed through median sternotomy, suture without CPB
The pt underwent formal coronary angiography to rule out underlying coronary disease
[15] Desai et al. (2008), J Thorac Cardiovasc Surg, Canada. Brief communication
22 yr male, single SW in the left chest
Severe shock, loss of vital signs in the ED. EDT, ROSC after opening of pericardium. Tamponde + through-and-through laceration of the RV, stapled and transferred to OR
CPB, staples had occluded the PDA, the wound in close proximity. Staples removed, wound sutured. Intraoperative fluorescence coronary angiography showed widely patent PDA
[16] Fedalen et al. (2001), J Trauma, USA. Case report
30 yr male, isolated SW to left anterior chest wall
Tension pneumothorax, hypotension, cardiac tamponade. Transfer to OR
Median sternotomy, proximal laceration of LAD with posterior wall of the vessel intact. OPCAB with SVG, intraluminal shunt. Laceration used as anastomotic site. Discharge at postop day 8
[17] Fulton et al. (1997), Ann Thorac Surg, South Africa. Case report
61 yr male, a single SW in right 2nd ic space parasternally. History of right-sided empyema 18 yrs ago treated by thoracotomy and decortication
Stable, enlargened mediastinum at chest X-ray. Arcography showed laceration to innominate artery, left common carotid artery and left subclavian artery. Distal cannulation, repair in deep hypothermic arrest
Uneventful postoperatively, discharge at day 10
[18] Hibino et al. (2003), Journal of Cardiac Surgery, Japan. Case report
39 yr male, SW anterior chest wall, suicide attempt.
Median sternotomy at OR. Injury of the right ventricular outflow tract, repair without CPB
2 yr after aorto-right ventricular fistula (dyspnea), repair with patch and AVR. The authors suggest long term follow-up to detect unindentified lesions
[19] Ito et al. (2009), Gen Thorac Cardiovasc Surg, Japan. Case report
51 yr male, SW in left 5th ic space with the ice pick still in place, suicidal attempt
Ice pick was moving synchronously with heart beat, echo showed tip in right ventricle, cardiac tamponade
CPB, mattress stich. Heart murmur day 12, 5mm ventricular septal defect detected. No surgery, follow up
[20] Jodati et al. (2011), Interact Cardiovasc Thorac Surg, Iran. Case report
24 yr construction worker, shortness of breath and palpitations, unaware of the pneumatic nailgun injury
Nail through RV outflow tract, interventricular septum, through the mitral valve at TEE and CT.
Median sternotomy, CPB. Entry point on RV, nail tip barely visible, not exit wound after LA was opened. Nail removed, anterior leaflet of mitral valve repaired. Discharge at postop day 5
[21] Kang et al. (2009), Injury, New Zealand/Canada. Review
Review about causes of penetrating cardiac injury, pathophysiology, sequelae, initial and operative management
Hihglighted key points for every section, outlining of prognostic factors
Few other conditions in medicine are as lethal; death occurs from cardiac tamponade or exsanguination; the greatest danger is missing the dgn; resuscitation is of limited value; immediate operative intervention is the only meaningful treatment
[22] Karin et al. (2001), Eur J Emerg Med, Israel. Case report and literature review
1. 29 yr male with single SW in left chest. 2. 35 yr male, stabbed in left lower thorax
1. Cardiac tamponade, ED thoracotomy: SW in the LV transsecting LAD (ligated, sutured). CPB with SVG in OR 2. Hemopneumothorax, respiratory distress, chest tubes. FAST: tamponade. Left thoracotmy at OR, distal LAD transsection, ligated.
Both had normal echocardiographies postoperatively and were discharged respectively 10th and 7th postop day
[23] Kurimoto et al. (2007), Surgery today, Japan. Case report
57 yr male, SW in 5th ic space parasternally, suicide attempt
Arrest prehospitally, EDT at admission + pericardiotomy, further percutaneous CPB + repair at ED. 3 cm left ventricular wound near coronary artery
Postop encephalopathy, 3 yrs afterwards at rehabilitation home
[24] Lau et al. (2008), Singapore Med J. Case report
31 yr male, 2 SW: in the left 4th ic space and in the right 2nd ic space
Pulseless with PEA, EDT, SW in the RV, internal cardiac massage to ROSC, transfer to the OR. Suture of the laceration
Discharged to further rehabilitation due to hypoxic encephalopathy
[4] Molina et al. (2008), Interact Cardiovasc Thorac Surg, USA. Retrospective study
237 pts (2000–2006) with EDT for penetrating injury, of these 94 with penetrating cardiac injury
GSW 87%, SW 13%, overall survival 8% (5% for GSW, 33% for SW)
None of the patients who reached OR needed CPB. Predictors of survival: sinus rythm, signs of life at ED, SW vs GSW, transport by police, higher GCS
Mostly GSW -very poor outcome
[25] Moore et al. (2007), Am Surg, USA. Case report
16 yr male, multiple stab wounds
Tachycardia and hypotension, left hemothorax. FAST: pericardial and infraabdominal fluid. LAD injury (ligation), RV (suture).
OPCAB (SVG) due to evolving large anteroseptal MI. Abdominal packing. Discharge postop day 17.
[26] Nwiloh et al. (2010), Ann Thorac Surg, USA/Nigeria. Case report
11 yr boy, arrow in the 4th ic space
Pt admitted 3 days after hunting with arrow in the midline. Attempted retracted at local hospital, referred to the visiting cardiothoracic team from USA. TTE: arrow through right ventricle, ventricular septal shunt
CPB, retraction of the arrow and suture of the RV. Shunt was insignificant, not repaired
[27] O'Connor et al. (2009), J R Army Med Corps, USA. Review
History, demographics and outcome, repair techniques, special occasions etc.
Refer to iv adenosin infusion for temporary arrest to facilitate the repair
[28] Parra et al. (2010), J Thorac Cardiovasc Surg, USA. Case report
81 yr male struck by a stingray in his left chest
CT: left pneumothorax, foreign body through mediastinum. Left anterior thoracotomy at the OR, the barb was found imbedded in the heart, the entry was repaired and pt transferred to a cardiac center
At cardiac center: CPB, barb through both right and left ventricles. RA was accessed and the barb pulled out in an antegrade fashion. Ventricular septal and RV defects closed with pledgeted sutures. Discharge 60 days postop
Splenectomy due to hemorrhage postop day 1 (unidentified injury, the pt fell when attacked by the sting ray)
[29] Seamon et al. (2009), J Trauma, USA. Retrospective study
283 pts with cardiac or great vessel penetrating injury requiring EDT (2000–2007)
88% GSW (survival 2,8%), 12% SW (survival 24,2%)
Predictors of survival in multivariate analysis: GSW and GCS
Multiple GSW almost unsalvagable
[30] Sugiyama et al. (2011), Ann Thorac Surg, USA. Case report
20 yr male, SW in left chest (nipple level)
Cardiac arrest at ED, left anterior thoracotomy, suture of right ventricle
Postop instable, 7. day - 1,9 cm septal defect with left to right shunt (3,7-1), ARDS etc., shunt=VSD repaired 2 mnths afterwards
[5] Tang et al. (2011), Arch Surg, USA. Retrospective study
406 pts with penetrating cardiac injury from 2000-2010
74% SW, 26% GSW. Overall survival 27%.
Focusses on postdischarge complications, 17% had an abnormal echocardiogram at follow-up; all managed conservatively
[31] Tasdemir et al. (2011), Acta Cardiol, Turkey. Case report
19 yr male, SW left chest
Presented in shock, tamponade andcomplete bilat visual loss. SW of LV with LAD injury,
CPB, SV graft to LAD, visus gradually regained
[32] Toda et al. (2007), Interact Cardiovasc Thor Surg, Japan. Case report
50 yr male, 3 SW by 30 cm sashimi knife, (Neck, 4th ic space, right upper quadrant of abdomen), suicidal attempt
Hypotensive, FAST negative, CT showed pneumopericardium and left hemothorax
Median sternotomy, RV laceration, repair by pledgeted sutures. LV laceration near posterolateral branch of CX, without bleeding, covered with TachoComb.
[33] Topal et al. (2010), J Trauma, Turkey. Retrospective study
Penetrating cardiac injury (57 SW, 4 GSW), 2002-2009
53 left thoracotomies, 4 median sternotomies. 2 LAD injuries, ligated. Total mortality 15% (isolated RV −11%, isolated LV 31% (mixed SW and GSW).
95% injury in 1 chamber. Focusses on predictors of outcome: > mortality when uncouncious, BP<50, low Hct, Na, temp and PH. Patients pronounced "dead on arrival" were not assessed in this study.
[34] Topaloglu et al. (2006), Tex Heart Inst J, Turkey. Case report
19 yr male, SW with skrewdriver in 5th left ic space
Dyspnea and hypotension, 1500ml chest tube output. Left anterior thoracotomy at OR, RV wound repair.
1 week later a cardiac murmur occurred, transfer to a cardiac center, TTE: perforation of membranous septum and anterior leaflet of the mitral valve. Median sternotomy, CPB, LA access: pericardial patchrepair of the leaflet, suture of the septal defect through RA. Discharged postop day 5.
[35] Topcuoglu et al. (2009), Thorac Cardiovasc Surg, Turkey. Case report
14 yr male, SW in right 6th icr paravertebrally, stable with knife in place
Right posterolat thoracotomy (knife in situ), at removal bleeding from atrio- inferiocaval junction
Repair on CPB, discharged on 7th postop day
[36] Gwely et al. (2010), Thorac Cardiovasc Surg, Egypt. Retrospective study
73 pts operated for cardiac SW (1998–2008)
Unstable 35%, 20% cardiac arrest prior to EDT. Mortality 23%
Poor prognosis: cardiopulmonary resuscitation (mortality rate 68%), EDT (67%) and shock (50%) on admission
Dead on arrival excluded
Case presentation
A 28-year-old male was admitted to the emergency department (ED) with a 5 cm stab wound (SW) under his left nipple. Pre-hospital treatment included insertion of a left chest drain due to dyspnoea, but this was clamped during transport because of massive hemorrhage. On admission, he was self-ventilating, with palpable carotid pulses, but without a measurable blood pressure. He was agitated and pale with a Glasgow coma score of 12 since he could open his eyes, localize pain and speak. The blood pressure ranged from 80/60 to 100/60 mmHg after starting intravenous fluid therapy and he had a tachycardia of 100–120 beats per minute. When the clamp was removed from the chest drain, 650 ml of blood was rapidly drained. The chest x-ray showed persisting hemothorax and atelectasis and an additional drain was inserted. The arterial saturation varied from 86% to 98% and blood gas analysis showed a haemoglobin of 12.6 g/l, pH 7.17, base excess −9 and lactate 5.5 mmol/l. Focused Assessment with Sonography in Trauma (FAST) revealed no blood in the pericardium and upper abdomen. The neck veins were not distended and so the patient received transfusion of 1500 ml of crystalloid fluid and 250 ml of red cells. The blood pressure decreased as soon as the intravenous therapy was reduced, the tachycardia did not resolve and the patient was therefore transferred to the operating room.
Post-operatively, the patient had signs of a stroke and a CT scan revealed a cerebral infarction. One week after surgery he was transferred to the neurological intensive care unit. After three weeks he was awake and self-ventilating. He was moved to his local hospital and was discharged after 6 weeks with only a minor deficit affecting the left upper extremity.
We report the case of a young male patient with a major cardiac stab wound combined with lung injury. Our patient was stabbed during a violent quarrel, thus being a typical stab victim, however, in Japan suicide attempts seem to be equally frequent[18, 23]. In large series, gunshot wounds (GSW) are the predominant cause of cardiac penetrating trauma[2, 4, 6, 29]. In Norway, this type of injury is obviously less common but still existing[37–39]. Knife is the most common weapon for stab injuries, followed by other sharp items such as screwdrivers[34], ice picks[19], chopsticks, pneumatic nailgun nails[14, 20, 40] but also curiosities as barb from a sting ray[28]. Fractured ribs or sternum are also reported to cause cardiac penetration[41]. Pneumatic nails might be shot without the patient noticing and cause surprise when detected by CT scan or eccocardiography imbedded in the heart[14, 20]. The iatrogenic penetrations of the heart due to different medical devices (pacemaker leads, intracoronary stents, Amplatzer devices) are not discussed in this paper.
Penetrating cardiac wounds are mostly fatal either due to cardiac tamponade, exsanguination or coronary artery injury[1]. Clarke reports that of 1064 patients with stab wounds to the chest 104 were operated and 76 were found to have a cardiac injury[3]. The overall mortality was 10% giving an impression of low mortality in this particular group of cardiac injuries. However, when the data was put together with the mortuary report for the same time, the mortality for penetrating cardiac stab wounds was found to be 30%. Most of the studies are retrospective and the patient selection is determined by the survivors arriving at the hospital and ignorance of the mortuary data. Topal et al. report a mortality rate of 15% in 61 penetrating cardiac cases with predominantly stab wounds but state that "patients pronounced dead on arrival were not assessed in this study"[33]. The only known prospective study reports another reality with a mortality rate of 97% when multichamber penetrating injury is present[2]. Also Molina et al. reports high mortality (67%) in a cohort with mainly stab wounds throughout the last decennium[4].
Our patient maintained suboptimal circulation for approximately two hours before undergoing surgery. The time span taken into consideration, our patient was extremely lucky as the outcome is usually poor when the time from trauma to surgery increases[5, 6]. An Israeli study of 14 patients reports 100% survival (9 SW, 2 GSW, 1 shrapnel injury and 1 multi trauma) with the mean time from injury to surgery of 37 min[7]. In addition to fast admission to surgery, this outstanding result may also be due to the fact that all patients had single chamber injuries and no coronary artery injury. According to Burack et al., patients with penetrating mediastinal trauma triage themselves between operative intervention or evaluation and observation as they present either stable or unstable on admission. In this retrospective study the authors present 207 patients of which 72 were unstable[10]. Of these 15% had cardiac injury with 18% survival when explored in the ED. The survival rate was 71% when patients with penetrating cardiac injury reached the operating room. All patients having cardiac injury in this study were unstable (authors criteria: traumatic cardiac arrest or near arrest and an emergency department thoracotomy (EDT); cardiac tamponade; ATLS grad III shock despite fluid resuscitation; chest tube output >1500 ml at insertion; chest tube output >500 ml in the initial hour; massive hemothorax after chest tube input). The study does not report the use of CPB.
In our patient, there was a large stab wound of the left ventricle running parallel to the diagonal artery as well as a stab wound in the left atrium. Regarding the location of penetrating cardiac injury, the right ventricle is the most common due to its ventral anatomical position, followed by the left ventricle, right atrium and left atrium[2, 3, 11]. The patients with a single right ventricle injury are mostly salvagable whereas those with multichamber injuries have a very high mortality[2, 4, 21]. The concomitant injury of the lung in our patient is not a rarity[3]. Our patient did not suffer from cardiac tamponade as there was a large opening to the left pleural cavity through the wound in the pericardium. This probably saved his life, although profound hypovolemia can conceal signs of cardiac tamponade leading to delayed diagnosis[36]. However, cardiac tamponade in the reviewed studies is not a prognostic factor regarding survival[2, 33].
The role of CPB has been debated in trauma surgery, espescially when it comes to penetrating cardiac wounds[6, 21]. Some series present large cohorts of penetrating cardiac injury without use of CPB[3–5]. In case of complex cardiac injuries with multichamber lacerations the advantages of a bloodless and still operating field is obvious[6, 20, 21]. The required heparinisation for CPB might be deleterious in a trauma patient. However, if the bleeding source or sources can be controlled, the risk of further profound haemmorhage is low. On the other hand, full heparisation might cause severe morbidity, and CPB might initiate consumptive coagulopathy and profound systemic inflammatory reaction[28]. Off pump cardiopulmonary bypass is an alternative when it comes to coronary artery lesions[16, 22, 25]. Establishing CPB in arrested patients or patients in deep haemorrhagic shock is not favourable for the outcome[6]. It could be debated whether or not the aorta should have been cross-clamped in our patient during repair of the left ventricular wall and coronary bypass surgery, but the ECG changes and the suspicion of pre-existing ischemia due to sustained pre-operative hypoperfusion, persuaded us to leave the aorta unclamped in this particular case.
Peroperative fluorescent angiography is a reliable tool to identify suspect coronary artery involvement peroperatively either caused by the injury itself or the surgical procedure[15], unfortunately this technique was not available at our OR. Cardiac stabbings might lead to initially unidentified additional injuries which become apparent first several weeks to years later[8, 18]. One study with a large series of patients report that these injuries seldom need surgical treatment[5]. There is consensus that echocardiographic assessment should be provided during the hospital stay[5, 11].
On admission to the ED, our patient was given a high Glasgow coma score (GCS), yet post-operatively was found to have had a cerebral injury. Unfortunately, the patient was foreign, and despite speaking, nobody could assess his verbal response adequately. Furthermore, he received an intravenous injection of Ketalar a few minutes after admission, following which he needed assisted manual ventilation and was no longer able to communicate. The initial GCS was later reconsidered and probably the patient suffered from major hypoxia in the pre-hospital phase. Nevertheless the patients with lower GCS have poor outcome, Asensio still reports a high mortality rate (27%) for patients with Glasgow Coma Scale >8[2]. However, in an emergency room thoracotomy material GCS was found to be a predictor of survival, despite none of the patients had a score >7[29]. In our patient, it is possible that CPB might have caused cerebral injury by embolization or by giving an insufficient cerebral perfusion pressure. With pre-existing cerebral damage, the standard perfusion pressure during CPB in our patient (mean arterial pressure 50–60mmHg) might not have been high enough to meet the needs of the brain already damaged by hypoperfusion.
Patients with a simple penetrating cardiac injury might be successfully managed without a cardiac surgeon present[2, 3]. However, repair of a severe wound of the left ventricle and the complications that can arise will require the surgical skills of a cardiac surgeon, as demonstrated in the present study and the likelihood of survival will be considerably increased by the immediate availability of a cardiac surgical service. The cases where initial tamponade was managed at a lower trauma care center with further transfer for definite surgery, witness of general surgeon`s competence of the initial management of these patients[13, 28]. In our level I trauma center, a cardiothoracic surgeon in the trauma team has been practiced for decades and we believe provides optimal management of patients with penetrating cardiac trauma.
We present a complicated case of a young male patient with a chest stab wound who served the trauma team both diagnostic and treatment challenges. We provide the reader a review of literature of the last 15 years publications on penetrating cardiac injury, focusing on stab wounds. Our patient suffered a stroke which origin could be multigenetic, prehospital hypoperfusion, air emboli due to major lung injury and/or insufficient perfusion pressure or microemboli during the cardiopulmonary bypass. The patient in our study survived with minor sequelae due to coordinated work of the trauma team in charge. In conclusion, if the patient with a penetrating stab wound in the heart is not obviously dead on arrival, an attempt for cardiac repair should be done with or without CPB.
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- O'Connor J, Ditillo M, Scalea T: Penetrating cardiac injury. J R Army Med Corps. 2009, 155: 185-190.View ArticlePubMedGoogle Scholar
- Parra MW, Costantini EN, Rodas EB, Gonzalez PJ, Salamen OJ, Catino JD, et al: Surviving a transfixing cardiac injury caused by a stingray barb. J Thorac Cardiovasc Surg. 2010, 139: e115-e116. 10.1016/j.jtcvs.2009.02.052.View ArticlePubMedGoogle Scholar
- Seamon MJ, Shiroff AM, Franco M, Stawicki SP, Molina EJ, Gaughan JP, et al: Emergency department thoracotomy for penetrating injuries of the heart and great vessels: an appraisal of 283 consecutive cases from two urban trauma centers. J Trauma. 2009, 67: 1250-1257. 10.1097/TA.0b013e3181c3fef9.View ArticlePubMedGoogle Scholar
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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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"There came a point where I ceased any attempt at rational analysis, and leaned back, simply to enjoy the censor's random sense of national security." Offering insight into the eclectic literary taste of Guantanamo Bay censors, Clive Stafford Smith, director of the legal charity Reprieve, this week published a list of books that censors have barred him from giving to his clients held in the detention camp. Discussing the curious mix of works banned, Stafford Smith outlines the lack of consistency in those books censored, including the Bible and Jack and Beanstalk, and those allowed, such as Orwell's 1984 and Kafka's Trial.
There are few things the literary world loves more than a public stouch – highlighting enemies and allegiances as well as tastes and prejudices. So which have been the most memorable of the year? From Jonathan Franzen's takedown of Amazon, Twitter and Rushdie, to Hilary Mantel vs the Daily Mail and Bret Easton Ellis vs everyone, you can read our rundown of the best literary spats of 2013.
In another 2013 highlight, Julian Barnes has an unusual take on the novel of the year – one that was published in the 1960s, by a dead American author known more as an academic, which Barnes himself had never heard of. "Fifty years after Williams wrote to his agent, Stoner became a bestseller…A bestseller publishers themselves could not quite understand. A bestseller of the purest kind – one caused almost entirely by word-of-mouth among readers." Julian Barnes on the must-read novel of 2013, John Williams' Stoner.
And Amy Tan joins the Guardian Books Podcast this week to talk about the book that made her name, Joy Luck Club, the role of superstition and her own mother's reaction to this novel of Chinese American mother-daughter relationships.
Actor-writer-director-producer-musician-artist and PhD candidate James Franco has published a new work, Actor's Anonymous, a novel that "is both about, and doomed by, the egregious non-anonymity of its author." Hermione Hoby writes that 'Excremental' is the appropriate word for this book, in Franco's "delight in having shitty things, literally, happen to his characters." A novel that seems overwhelmed by its own layers of metafictionality, "Franco makes the sophomore's mistake: performing writing about performance."
TC Boyle's Stories II is lengthy tome – running at 915 pages – that brings together the three short-story collections he has produced over the last 12 years, as well as a new 14-story collection. For Chris Power this "results in an uneven body of work that makes a complete edition feel like an indulgence." The stories range in subject matter from semi-autobiographical tales of junkies and drunks to modern Gothic and folkloric whimsy: "despite a recurrent sense of brilliance being undermined by haste, the pleasures Boyle's better stories offer can be so intense that it makes hacking through the less successful work worthwhile."
Among our nonfiction reviews is Belomor by Nicolas Rothwell a captivating meditation on art, history and spirituality, by a foreign correspondent cum-art critic-cum-chronicler of the Indigenous communities of northern Australia, who is of Czech and Australian parentage. And Alan Douglas and Peter Neal's Starting at Zero: His Own Story by Jimi Hendrix is the closest we'll get to a Hendrix autobiography, which compiles notes, diaries, interviews, letters and pensées to let the great musician speak for himself.


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Peanut Butter Pie (Weight Watcher Style)
8 Graham Crackers (crushed)
2 Tablespoons plus 2 teaspoons Diet Margarine Mix and put into pie pan.
Bake at 350 degrees for 15 min. and cool.
1 pkg low calorie pudding (chocolate)
1 3/4 cup milk
6 T crunchy peanut butter
Cook Pudding.
Add peanut butter while hot and pour into shell.
Refrigerate until set. 4 servings
Weight Watcher Equivalents
1 bread
1/2 protein
2 fats
1 milk


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Digital Africa Foundation
Digital Africa Foundation (DAF) is an organization that is committed to bridging the emerging economic gap by incorporating Youth in our digital agenda with the focus on eCommerce to create sustainable business and employment opportunities. We believe that this will help reduce the growing numbers of youth unemployment and challenges associated with it. This makes it a perfect platform for our Youth who facing various challenges can utilize the readily available Technology by bridging the digital divide and industry gap therefore grow towards a social economic developed nation.


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March 18, 2013
Gossip is Personal
This poem is currently unpublished but here is a soundcloud.
I posted the text and story of this poem in the past here.
Daniel Gallant ©
53.914524 -122.750219
Tags: #SFTU, Bully, Bullying, Gossip, Gossip is Personal, Personal, Poem, Poetry, School yard bully, School yard politics


text: Royalty Free Vectors Flow Abstract Background Vectors Abstract background color flow waved lines stock vector image LicenseLearn More Standard For Print, Advertising, Design Expanded For Resale & Reproduction The license type determines how you can use this image. Std. Exp. Print / Editorial Graphic Design Web Design Social Media Edit & Modify Multi-user Resale Items Unlimited Runs Ways to BuyCompare Single Image $14.99 Credits $1.00 Subscription $0.69 There are three ways to pay for Standard licenses. Prices are $US. Pay with Image Price Single Image $14.99 One-time payment Pay-As-You-Go Credits $1 Download images on-demand (1 credit = $1). Minimum purchase of 30. Subscription Plan From 69c Choose a monthly plan. Unused downloads automatically roll into following month. Ways to BuyCompare Single Image $29.99 Credits $30.00 There are two ways to pay for Expanded licenses. Prices are $US. Pay with Cost per Image Single Image $29.99 One-off payment, no signup needed. Credits $30 Download images on-demand (1 credit = $1). Download Image Files Included Loading Details... Download File/s: ZIP Archive ZIP Archive High-res JPG (300 DPI+) High-res PNG (300 DPI+) Adobe Illustrator (v10+) Vector EPS (v8+) Vector PDF Download ZIP Share on Pinterest Facebook Twitter Download JPG Preview Image Image ID23056254 Artist VECNOYFollow ♥Like +Cart 0.69 USD Similar Images More Flow Abstract Background Images…More More by VECNOY More Images…More Related Searches Flow Abstract Background Color Lines Waved Line Stock Design Vector Graphic Element Backdrop Creative Aqua Wavy White Stream Clean Transparent Smooth Dynamic Motion Fractal Banner Illustration Wave Spring Movement Nature Water Layout Template Idea Modern Leaflet Digital Blend Cover Brochure Purple Curve Website Business Concept Curl Flowing Science Presentation Power Energy Connection


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Because if Valentine's Day doesn't enrage you, you're the problem
Let's face it...Valentine's Day is a blood bath. If you're a girl, you have to hope you're not the only office pariah without any gifts or flowers on the only day that PDA matters. If you're a guy, you have to shell out your hard earned cash just to ensure you're not the biggest A-hole in the universe. It's all very stressful and upsetting, really. Whether you have a significant other, or are swimming in the sea of singles, check out these unapologetically gory movies to get your mind off love and on to more pleasant things... like violent deaths and Satanic possession.
5. "Hostel"
After watching this, you'll consider striking out with that European babe at the bar a blessing in disguise.
4. "The Evil Dead" (the original)
Consider this a case study in what happens when you forget to send flowers.
3. "I Spit On Your Grave"
Revenge is a dish best served angry.
2. "The Silence Of The Lambs"
"Would you f--- me? I'd f--- me." Try getting in the mood after the "Goodbye Horses" scene.
1. "The Human Centipede"
Yeah, this one makes every list... But it speaks for itself.


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Let's Talk Rivers in Depth at Iloilo …
"My River, My Life" so appropriately defines the theme for the 1st International River Summit to be held at Iloilo City in Philippines from May 30 to June 1, 2012. Located in Panay Island, the proud city of roughly 400,000 people is pretty serious when it talks about achieving the status of the New7Wonders of Cities of the world. The vision just might come true under the leadership of Mayor Jed Patrick Mabilog! What's more – both the city and the Summit have the blessing of Philippine's President, Benigno Aquino III. He would be gracing the occasion with a keynote address at the Closing Ceremony on Friday, June 1.
The coming week, the city of Iloilo is all set to show off the huge environmental strides it has made in reviving their beloved river, Iloilo. The river, flowing through the heart of the city, had dangerously deteriorated from lack of environmental regulations and haphazard city development. The stretch of polluted waters was lined with slum dwellings just 5 years back! Today the Iloilo River has become the center of tourism for the city with an impressive esplanade in the works to adorn its banks – a showcase of sustainable urban development.
The International Summit is convening delegations from 10 different countries on the common thread of challenges in river management and best practices. We will be hearing from international experts on the many facets rivers pose to its communities – biodiversity, climate change and disaster mitigation, governance and water quality. Defining issues specially for the densely populated areas in Southeast Asia where hundreds of millions inhabit the river basin and rapid economic development neglects and many times, endangers natural resources.
Event also posted at CITYNET, Rivers of the World Foundation


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We've lost an average of four seconds of concentration since 2000. Which means we've got about another two paragraphs before you wander off and find something else to click.
According to a study conducted by Microsoft on the impact of digital media on concentration spans, the average human's ability to focus has fallen from 12 seconds in 2000 to eight seconds in 2013 - one second shorter than the oft-mocked goldfish.
But there is a payoff: as our habits shift to make sense of the ceaseless array of content offered by the modern media machine, most of us are seeing an improvement in our ability to multitask and concentrate in short sharp bursts. So time for a break. Here's a funny video of a cat. We'll see you in a second.
Good to have you back.
Microsoft's study saw a group of Canadian volunteers plugged up to EEG scanners while watching videos and playing simple games - monitoring how their attention fluctuated with each exercise. The results were then compared to their reported media use, including how often they watched media simultaneously on two screens and how frequently they checked their phones. Which is interesting.
In addition to finding that the average attention span had fallen, the researchers saw that respondents fell into three categories: those with sustained concentration skills; those with selective skills - shifting their focus in the face of competing stimuli - and those who would alternate their concentration between different tasks very frequently.
While most of us who use digital media will have had our attention spans effected in some way, 'early-adopters' (those who have grown up with digital media) will have a tendency to front-load their attention, allowing huge amounts of information to be absorbed before switching their focus to something else, resulting in an increase in bursts of high attention. You can find the full results here.
So if you've managed to work your way to this point in the article without being sidetracked by an instant message or Tweet, chances are you've got some sustained concentration skills. Well done you. Here's another heart-warming pet video to celebrate, and a concise set of findings from the study.
[Via: Microsoft]


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Madame et Monsieur
Reshape Your Body with Weight Loss Electrotherapy! Target Your Stomach, Thighs, Love Handles and Buttocks with the Quick, Easy and Non-Surgical Alternative to Liposuction. Only $65 for Four Treatments ($276 Value) or $89 for Six Treatments ($414 Value)
- Highlights
- Fine Print
- Company
- Reviews
Shed kilos without scary surgery thanks to weight loss electrotherapy from the acclaimed experts at the CBD's Madame et Monsieur
Option One: For $65, blast fat with four 30 minute treatments. Valued at $276
Option Two: For $89, bump it up to six 30 minute treatments. Valued at $414
Treat up to four areas - choose from your stomach, thighs, love handles and buttocks
The revolutionary treatment electronically stimulates the nerves causing the muscles to contract and burn the surrounding fat cells
During the treatment, your muscles do the equivalent of a six hour workout - that's 600 sit-ups, 600 leg-lifts and 600 push-ups!
Great for men and women
What We Like
Madame et Monsieur are world leaders when it comes to slimming procedures; they were the first to develop this highly successful electro-body sculpting and slimming program for the worldwide medical and spa industries
Not only does electrotherapy burn fat, reduce cellulite and improve muscle ton, it can also relieve symptoms related to high blood pressure, poor circulation, lazy lymph glands, high cholesterol, lower back problems, diabetes, arthritis, rheumatism, low energy levels, insomnia, obesity, low sexual libido and other stress-related disorders
Offer expires on 28 November 2013 (bookings must be made before 28 October 2013)
Strictly subject to availability and please be patient with bookings. Please note, evening appointments are limited and cannot be guaranteed, please book early to avoid disappointment
Bookings are absolutely essential and subject to availability. Not valid Saturday or Sunday
Please note, you will be treated by an experienced male therapist
Valid for new clients only
Members can purchase and use up to one voucher for themselves and buy up to ten as gifts for different recipients
Voucher valid for one person and cannot be shared
24 hour cancellation policy applies, non-attendance and late cancellation voids voucher
Treatment not suitable for pregnant or breastfeeding women, those with metal plates or heart problems. If you are unsure please consult your doctor prior to purchasing the deal
Individual results may vary
Not valid in conjunction with any other offer and not redeemable for cash
Redemption instructions can be found on the voucher
The Company
Suite 2, Level 8, 283 George Street, Sydney, NSW
Keeping a reasonable weight and an excellent figure has been my major concern for the past 15 years. For that very reason, I have turned to many different diet programs and recently joined Madame Et Monsieur. Within a few weeks, I lost 9.5 kilos and gained a feeling of well-being. My legs have never looked so good. No more bulges and flabby muscles, and the recalcitrant cellulite disappeared. And dining out is never a problem, I can eat in any restaurant without feeling left out. I would recommend this program to anyone."Michelle, www.weight-loss.com.au
I wanted to lose body fat and also needed to tone and firm my muscles in a quick and healthy way. That is why I joined Madame Et Monsieur. Within 6 weeks I lost 10 kg and 67cm. I have dropped 2 dress sizes and even my cellulite has decreased significantly. I have done many other weight-loss programs and Madame Et Monsieur's unique program has given me the best results by far!!!"Marlene, www.weight-loss.com.au


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Baked Pork Chop Recipes and Other Im-PORK-tant Tips
Easy & Fast Baked Pork Chops
This is an easy and fast recipe everyone enjoys!
6 pork chops
2 tsp. salt
3 Tbs. melted shortening
1 C. uncooked long-grain rice
1/4 tsp. chili powder
1/2 C. chopped green pepepr
1/2 C. tomatoes
6 green pepper rings
1/4 C. shredded processed American cheese
In a large skillet, brown pork chops in shortening for 20 minutes. Drain off excess fat. Add chili powder, salt and pepper and sprinkle over meat. Add rice, chopped green pepper and spoon canned tomatoes over chops and rice. Cover skillet and cook over low heat 30-35 minutes, stirring occasionally. Add to pepper rings, cover and cook for 5 more minutes. Sprinkle over with cheese and cover until cheese melts.
More Baked Pork Chop Recipes
Baked Pork Loin Chops with Orange Sauce
Apple-Baked Pork Chops with Sherry
Baked Pork Chops in Sour Cream
Safe Pork Handling Tips:
- Wash hands with soap and water before and after handling fresh meat.
- Refrigerate meat as soon as possible after purchase.
- Place meat package on a plate or in a container before placing in refrigerator to prevent juices from dripping onto other foods.
- Always defrost in the refrigerator.
- Always place cooked meat on a clean plate, not one that has been used for uncooked meat.
- When using an automatic, clock- controlled oven, do not leave fresh, unfrozen roasts or casseroles longer than one hour before start time.
- For longer periods of time use a frozen product.This is replaced by the Flash content.


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KYY Season 3 : The Hidden Love (Episode 11)
Nandini takes him to SPACE. Manik asks "Which monument is this now?"
Nandini bursts into laughter. "Monument? Like seriously.. You blurt out any silly thing.."
Manik : Then tell me. Why are here?
Nandini : Love.
Manik : Love?
Nandini : Let me complete. Love and friendship. This is where Fab five studied. Now that we are friends I think you should be familiar with our hangouts and hotspots.
Manik : Yep! Great idea. But how will we get in? Its closed right?
Nandini : The fence. We will climb up those wall and reach the other end.
Manik : Are you out of your mind? We cant do that.
Nandini : Okay fine then. You ask the watchman to let you in at this hour of day and then he might take you to the cops at worst scenario and then have fun behind the bars.
Manik : Fine lets climb the wall.!
Nandini asks Manik to help her in climbing. He gives her his hand and Nandini gets on the top of the wall. She gives back her hand to Manik and he also gets there and jumps the other side.
Nandini gets scared as it was at a height. "No Manik. I cant do it." she shrieks in fear.
Manik : Oh common. Don't waste time. Don't worry I ll catch you. Trust me.
Nandini jumps and falls on top of Manik. He holds her weight. They share an eyelock an intense one… And are lost in each others arms. They realise their state of position and straighten themselves.
Manik thinks "I don't know what happens to me whenever i m around her. Its something different. A weird feeling."
Nandini : Ok Manik first we will go to the Jam room. Where you all will practice.
She takes him there. Manik sees the room and says "Wow great place."
Nandini : Really . Anything else? You want to say.
Manik : Nothing really.
Nandini : Okay. Now the Cafeteria.
They go there "How about this place?"
Manik : Splendid!
Nandini : Huh?
Manik : What should I say. I mean why are you asking me. How is this how is that. Its really irritating.
Nandini : Duh huh. Sorry for being so formal.
Manik : Nope its okay.
Nandini tells him "I m hungry. I ll make a sandwich." First of all she keeps money and a sorry note.
Manik : Why is that important?
Nandini : I don't want us to steal.
Manik : Fine just get the sandwich prepared. Till then I will wander around and check out the place.
Nandini : Fine..
Manik goes to the corridor and moves to the store room. Now its the same room where Manik and Nandini were locked up once(Hope you remember.)
Manik gets the glimpses of a girl falling. She cried out. Manik starts feeling heavy and soon falls down unconscious.
Nandini waits for Manik all over but he has not returned yet. She starts worrying for him and looks around him. Alas! she finds him unconscious and gets scared
Nandini : Manik! Are you okay.?
She tries to make him conscious but all in vain. She tries to call Fab five.
Cabir picks up the call.
Nandini : Hello Cabir. Come to SPACE ASAP. Manik has fainted I don't know what to do…
Cabir : Nandu you stay there. We will pick you guys.
Fab five get in their jeep and drive to SPACE. There they encounter the watchman.
Mukti : Our friends are inside. One of them has fainted.
Watchman : What? Lets go quickly.
They rush inside and see Manik knocked unconscious and Nandini continuously crying.
Mukti : Calm down Nandini. Cabir and Dhruv you guys pick him up and take him to the hospital.
Manik is taken in the emergency ward. Meanwhile everybody is tensed about Manik's deteriorating condition.
Aliya : I hope he gets alright soon. I cant see him like this.
Mukti : He will be okay. Don't worry. He is our fighter Manik.
Nandini couldn't utter a word. She was really scared of the thought of losing Manik. "It's all because of me. How could I be so selfish. I love you Manik."she thinks
She sees through the door and sees Manik's face his eyes still closed and his eyebrows crossed.
Dhruv : Nandini and everyone ! I think we should not push him hard. I have already talked to the doctor earlier. He said it would not be advisable to just go and show him everything right away. We have to take care of him like an infant. Otherwise we might…
Mukti : We might????
Dhruv : We might lose him..
Aliya : Oh shut up Dhruv! Say something good. I m dead sure he will be fine.
Dhruv : Aliya I was just..
Aliya : You were just.. You were just trying to get rid of us..
Cabir : You guys stop fighting! Now we have to think about Manik. We have to slow down
Dhruv : No we can't !.
Mukti : Why?
Dhruv : Nyonika and Soha. I m sure they will get to know about Manik's arrival to India soon. So we cant slow down .
Aliya : I think first of all we should make him get into our band with all his blood and flesh. Once he is into fab five it wont be a problem because you know hoe Manik is when it comes to Music and Fab five !
Cabir : Yes you are right.
Nandini was still in trauma. She wanted to rush inside and give Manik a never ending hug and lots and lots of kisses. She starts reminiscing all her moments with him "You don't remember anything Manik?"
Precap : Doctors say Manik might slip into coma due to such attacks. You all have to be careful.
Painful dreadful worst update ever right guys ?? I know you all cant see Manik and anyone in pain! Don't worry he will be alright soon
Drop your feedback down there and please do tell me how you found this season so far… Is it good enough to be continued ?? Waiting for your response like a maniac…….?
@All my readers.. Love you and a tons of hugs ? ..


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Extreme Ireland are the foremost soft adventure tour and walking tour provider in Ireland. We also run mountain skills courses, climbing experiences and international tours
For fantastic sights and a magical experience come on the Cliffs Of Moher Tour to the west of Ireland.
Visit the Giants Causeway and experience one of the most spectacular natural phenomena in Ireland on our day tour from Dublin.
For a selection of day tours from Dublin
This online Tourist Office allows you to plan and book many attractions and tours in the one location.
Cork Day tours and hop on hop off Bus
My Ireland Tour not only offer guided vacations of Ireland, but also customized tours of Ireland, so you can plan a bespoke package tour of Ireland's attractions which private and exclusive to your party.
Global passenger network is a consortium of quality coach companies who have come together to offer quality transport solutions worldwide.
Extreme Ireland are premier providers of day tours and coach hire in Ireland .
To gain the freedom of the countryside and earn a mountain skills accreditation from a highly qualified mountain guide spend a weekend gaining essential mountain skills in the Wicklow mountains
Vivir en Irlanda offer information for Spanish tourists who are interested in visiting Ireland.
T section directory is a web directory which organises some great websites into usable categories


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Today I made my first attempt to apply for Shutterstock. Submitted the first 10 photos and waiting for the result. Below is a collage of the 10 photos I submitted:
In truth, even if I get approved for Shutterstock as well, its not likely that I'll be raking in the money at my rate of only producing one photo in about 3 months… haha. However, I might as well try to get into more platforms so that I will have more chance of selling the photos.
Well, let's just say its the first challenge to an amatuer such as myself to try to get in to Shutterstock as well as iStockphoto. (According to a forum post*, there are about 35,000 contributors on Shutterstock (April 2013) and about 78,000 contributors in iStockphoto (June 2012)… so if I get in, I can probably call myself part of the 100k microstockers in the world… (albeit the one with the lowest productivity and profit… haha))
Anyway, we'll probably have the result from Shutterstock in a few days time… I'll update you guys when I get the result.
* http://www.microstockgroup.com/20179/20179/msg333681/#msg333681


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TNCBKCModström Lavish Garden Stanley print skirt
About the brandModström was born to meet the need for fast fashion. Over the years, they have achieved great success on the Danish and international fashion scenes by making the latest trends readily available to young women everywhere. Their distinct high-street fashion is feminine with a raw touch and contemporary edge, and they are constantly designing new pieces to stay at the top of our game.
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Kimono Silver Songs200510001
by naladesignsRM459.00
Inspired by vintage antique Peranakan jewelry and vintage mooncake moulds, our new authentic Kimono's are the real deal. Inspired by a vintage kimono found in Tokyo. Our kimonos are reversible.
Made from 100% cotton satin.
Machine wash at 30 degrees with similar colours.
*One size fits all


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Seems like the only cards I get posted to my blog are ones linked to Merry Monday - oh well, I do what I can! This week Kristie brings us the challenge of using both ombre and glitter on your Christmas card. I love glitter and went to this Heidi Swapp glitter paper I bought at JoAnn's last week. I started out trying to stamp a text background stamp with an ombre ink pad. Didn't like how that turned out so I decided to try a trio of inks on a large snowflake background.
Here's my card:


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Not only does organization save time and money, and reduce stress, researchers have shown the following: that organized people earn more money, are more likely to be promoted on the job, and their children perform better in school and earn more money as adults. Clutter control is very important in the home and office. and should be maintained as a lifestyle. Managing your possessions and learning how to make choices about their importance is a very teachable skill — we can help.
Organization systems allow you so set up arrangements that really work for you — being able to free your mind and spend more time on things that matter.
Closet Organization
Green Organization General
Office Organization
Collections/Memorabilia/Photograph Management
Garage Organization
Kitchen Organization
We offer personalized shopping services along with clothing and accessory styling to edit your wardrobe for maximum style and an aesthetically pleasing display. Creating a stylish wardrobe does not have to be a huge expense or mean that you must have a ton of clothes. Our objective is to help clients look their very best by making the most of their wardrobe either by mixing and matching what they have or playing up a look with a few key accessories. Sometimes all it takes is the addition of a few items to transform and breathe new life into a wardrobe.
Styling Services Include:
Wardrobe Evaluation
Maximize Your Current Wardrobe
Dress For Your Body
Create Your Own Style Identity
Special Event Shopping
Fashion Do's and Don'ts