text:
|Publication number
|Publication type
|Application number
|Publication date
|Sep 13, 1988
|Filing date
|Jun 29, 1987
|Priority date
|Jun 29, 1987
|Fee status
|Publication number
|Robert Lash, Gregory Hatfield
|Original Assignee
|Md Engineering
|Export Citation
|BiBTeX, EndNote, RefMan
|Patent Citations (3), Referenced by (53), Classifications (12), Legal Events (5)
|External Links: USPTO, USPTO Assignment, Espacenet
In modern medical practice, virtually all surgical procedures require some form of aspiration. Surgical aspiration is generally required to remove fluids from the surgical site to maintain unobstructed visualization of the field. More recently, many surgical instruments and microsurgical devices employ aspiration to draw fluids and tissue into mechanically driven cutters which greatly increase the speed of tissue removal while reducing the effort required by the surgeon. Also, some surgical procedures, such as lipectomy and the like, rely solely on aspiration to remove certain tissue and deposit.
Generally speaking, the aspirate from most of these devices and procedures comprises a mixture of tissue, body fluids, and blood. Because of the presence of the blood component, the aspirate usually is dark red in appearance. It has been observed that the color of the aspirate gives no indication of the amount or relative fraction of the aspirate which constitutes bloos from the patient. Thus the appearance of the aspirate provides no information to the surgeon concerning how much blood has been aspirated from the patient, nor any indication when operative or post-operative transfusion is required. Generally the surgical team monitors the vital signs of the patient, and relies on tests such as complete blood count and hematocrit as well as the gross amount of aspirate to determine the advisability of transfusion. These factors may involve delays in time, or may be imprecise indicators of transfusion requirements.
The present invention generally comprises an apparatus for providing surgical aspiration, and for monitoring the net amount and relative composition of the aspirate. A significant feature of the invention is the provision of a real-time readout of the net amount of blood removed from the patient, so that the surgeon can determine the advisability of transfusion for the patient during the surgical procedure. The relative composition readout also provides the surgeon with an immediate indication of the proficiency of tissue removal relative to removal of body fluids, so that surgical technique can be perfected.
The apparatus for surgical aspiration and monitoring of the aspirated fluids includes a sealable aspiration bottle supported by an electronic weighing scale on a base stand. The bottle cap is provided with a pair of tubing connectors adapted to be secured to a negative gage pressure source and to an aspirating surgical instrument. A pair of electrodes extend from the cap into the bottle and are connected to an electronic circuit which measures the impedance of the fluid/tissue aspirate in the bottle. The base stand includes a bottle shield and interconnect isolation means to prevent incident contact with the bottle that might otherwise cause errors in the weighing scale readout.
The invention includes a microprocessor which is connected to receive the impedance and net weight data of the aspirate. The microprocessor is programmed to correlate this data to determine the relative amounts and net weights of fluid and tissue in the aspirate, and to calculate these factors virtually immediately. A visual display screen supported on the base stand is connected to the microprocessor to receive and display the data calculated thereby. In addition, the relative amounts and net weight of fluid and tissue removed from different portions of the patient's body may be displayed separately, so that in some surgical procedures where it is desirable, such as lipectomy, the amount of tissue removed from differing areas can be substantially equalized.
FIG. 1 is a perspective view of the apparatus for surgical aspiration and aspirate monitoring of the present invention.
FIG. 2 is a perspective view of the aspirate bottle assembly of the present invention.
FIG. 3 is a perspective view of the bottle cap and electrode assembly of the present invention.
FIG. 4 is an exploded view of the aspirate bottle, electrode, and cap assembly of the present invention.
FIG. 5 is a side elevation of the aspirate bottle cap and cap shield assembly of the present invention.
FIG. 6 is a graphic representation of the relative fluid composition of aspirate material as a function of impedance of the aspirate and net weight of the aspirate.
FIG. 7 is a functional block diagram of the electronic circuitry of the aspirate monitoring portion of the present invention.
The present invention generally comprises an apparatus for providing aspiration for surgical procedures, and for quantitatively and qualitatively assessing the aspirate removed from the surgical site. The apparatus is designed to provide to the surgeon an immediate readout not only of the amount of material removed from a surgical patient, but also the relative amounts of tissue and blood which have been removed.
With regard to FIG. 1, a preferred embodiment of the invention includes a base stand 11 having laterally extending legs 12 supported by ground-engaging casters or rollers 13. The legs 12 define an intermediate space 14 dimensioned to receive a vacuum pump adapted to provide negative gage pressure for vacuum aspiration purposes, as will be explained in the following description. A cantilevered table 17 extends laterally from a medial portion of an upwardly extending column 16. The table 17 supports a vacuum aspiration collection bottle assembly, with associated components thereof secured to adjacent portions of the column. Joined to the upper portion of the column 16 is a visual information display 19, which may comprise a cathode ray tube, liquid crystal display panel, or any equivalent device known in the prior art. A recessed handle 21 in a medial portion of the column 16 permits the apparatus to be moved on the casters 13 to any convenient location for easy access to the bottle assembly 18 and direct visualization of the display 19 by the surgeon or other medical practitioner using the invention.
The collection bottle assembly 18 includes a transparent glass or plastic collection bottle 22 having a capacity in the range of 1000-2000 ml. The bottle is supported on the weighing pan 23 of an electronic scale, the scale comprising any of several commercially available digital scales which are self-zeroing and accurate to approximately �1 gram. The scale pan 23 is provided with a shallow, dished recess to receive and center the bottom of the bottle on the pan. A cap assembly 26 includes a stopper portion 27 which fits into the opening 29 of the bottle 22 in pressure sealing fashion. A pair of tubular members 28 extend through the stopper 27 to a block 31 joined to the upper surface of the stopper. Within the block 31 the tubular members 28 are each coupled to one of a pair of tubing nipples 32. The tubing nipples together with their associated tubular members provide flow communication through the stopper when the bottle is sealed thereby. Furthermore, the tubing nipples are formed of a electrically conductive substance, such as surgical stainless steel or the like.
The collection bottle assembly (FIGS. 2-5) also includes a pair of electrodes 33 extending downwardly from the stopper portion 27 and disposed at a mutually downwardly diverging angle. The electrodes are formed of a chemically inert conductive metal which is provided with a high intrinsic resiliency factor. In their free state the electrodes diverge as shown in FIG. 4; however, when the electrodes are placed into the collection bottle 22 and the stopper 27 is inserted into the bottle opening 29, the resiliency of the electrodes causes them to impinge upon and conform to diametrically opposed inner surface portions of the bottle 22, as shown in FIG. 2. This arrangement assures that the electrodes maintain a fixed maximum spacing when disposed within the bottle.
With regard to FIG. 3, the upper ends of the electrodes 33 extend through the stopper portion 27 into the block 31. Each electrode of electrically connected to one of the tubing nipples 32, so that each tubing nipple serves not only as a flow conduit to the interior of the collection bottle, but also as an electrical connection to one of the electrodes within the bottle. The assembly further includes a cap 34 provided with flange portions 37 dimensioned to engage the block 31 in snap engaging fashion for quick assembly thereto and removal therefrom, as shown in FIGS. 2, 4 and 5. The cap further includes two pair of resilient electrical contacts 36, each pair disposed to snappingly engage one of the tubing nipples 32 when the cap 34 is secured to the block 31. Each pair of the contacts 36 is connected to one of a pair of conductors in a cable 38 extending from the cap 34 and terminating in a male electrical plug connector 39.
Extending laterally from the column 16 superjacently of the table 17 is a support bracket 41, as shown in FIG. 2. The bracket 41 includes a pair of channels 42 adapted to receive a pair of tubing members 43 extending to and coupled to the tubing nipples 32. The bracket 41 also includes a female plug (not shown) adapted to removably receive the plug connector 39, so that the electrodes 33 may be electrically connected to the electronics within the base stand. A bottle shield 44 is pivotally secured to a portion of the bracket 41, and dimensioned to pivot downwardly to protect the bottle 22 when supported on the scale pan 23. The shield thus protects the bottle from accidental impat or jostling which would otherwise disrupt the weighing process and lead to erroneous results. Furthermore, the shield 44 can be lowered to protect the bottle 22 only when the tubing members 43 are properly secured in the channels 42 and the cap cable 38 is plugged into the receptacle in the bracket 41. A switch (not shown) adjacent to the shield 44 is actuable when the shield is pivotted downwardly to protect the bottle, and this switch is connected to prevent operation of the apparatus unless the shield is lowered completely, as will be explained in the following. Thus the shield serves not only to protect the bottle and prevent weighing errors, but also to assure that the tubing and cable are correctly connected to the bottle.
It may be appreciated that one of the tubes 43 is connected to a vacuum source, also termed a negative gage pressure source, to create a pressure within the bottle substantially less than atmospheric pressure. The other of the tubes 43 is connected to an aspirating surgical instrument, such as a suction tip, catheter, cannula, mechanical surgical cutting instrument, or the like. The extreme low pressure causes fluids and tissue to be aspirated into the bottle, where they accumulate. The electronic scale provides a constantly updated net weight of the collected aspirate, and the electrodes 33 are employed to determine the impedance of the aspirate. The impedance factor correlates very closely with the proportion of fluids and tissue in the aspirate. The data from the scale and the electrodes are fed into a microprocessor-based electronic apparatus which calculates the amount of fluid and the amount of tissue in the collection bottle. These data are then displayed on the visual readout screen 19 to apprise the surgeon of these factors, and to aid in the surgical procedure being performed.
It is well established in medical literature that the electrical impedance of physiologic fluids and tissues are significantly different. The dissolved electrolytes in the physiologic fluids provides substantial conductivity, whereas the lipid membranes of cells are relative insulators and exhibit relatively high impedance. In general, the impedance measured across the electrodes 33 is inversely related to the weight of the aspirate in the bottle, and directly related to the percentage composition of tissue in the aspirate. Likewise, the impedance across the electrodes is inversely related to the percentage composition of physiologica fluids in the aspirate. Generally, speaking, the primary component of the physiologic fluids is blood, with a minor amount of lymphatic fluid and the like in the aspirate.
Given these relationships of impedance to weight, percentage tissue composition, and percentage fluid composition, it is possible to derive equations which precisely describe these relationships. As shown in FIG. 6, these equations may be plotted as a family of curves on a graph of impedance versus weight, each curve representing a percentage of relative fluid composition of the aspirate. Whenever the weight and impedance of the aspirate is known, this graphic representation will define a unique point on the graph, yielding the percentage fluid composition and, by subtraction, the percentage tissue composition. If that unique point does not fall on one of the plotted curves in the family of curves, a simple interpolation algorithm can determine the actual relative composition.
It may be appreciated that the percentage fluid composition and the percentage tissue composition may be determined by a lookup table and an algorithm provided to search the table for the closest data points for weight and resistivity. In the preferred embodiment, however, the microprocessor is programmed to determine the desired information by solving the equations represented by the family of curves in the plot of FIG. 6. This may be accomplished by first solving for the total bottle bulk resistivity in ohm-cm as a function of weight and impedance: ##EQU1## where K(W) is a function of the weight of the aspirate within the bottle. The percentage composition is then determined as a function of bulk resistivity:
where F(R) is a function of the calculated resistivity. The K and F functions comprise simple algebraic expressions with experimentally determined constants, and are easily derived by those having ordinary skill in the art.
The electronic system for performing the analysis of the aspirate outlined above is shown in block diagram form in FIG. 7. A key component of the system is a single board computer 51, including a programmable microprocessor or the equivalent logic system together with approximately 64k RAM. The board also includes an alphanumeric video display generator which is connected to the video display 19. The computer 51 is connected to a data buss 52, and thence to several peripheral components. For example, the electrodes 33 are connected through the cable 38 and other wiring to an impedance measuring section, which determines the impedance across the electrodes and provides this information in digital form to the buss 52. The electronic scale 54 comprises a digital scale as described previously, and is supported in the table 17. It weighs the contents of the collecting bottle, and transmits this data in digital form through a scale interface 55 to the buss 52. The scale 54 in fact includes its own microprocessor, which zeroes the scale reading the empty bottle weight, together with the tubing, cable, and cap assembly, whenever the system power is first turned on, or whenever the bottle shield is raised (for changing bottles, etc.).
The position of the bottle shield 44 is sensed by a bottle door switch 56 actuated only when the shield is rotated fully downwardly, as explained previously. The state of the door switch 56 is fed through a switch interface 57 to the data buss 52. Also connected to the buss is a read only memory (ROM) 58, which contains the system software. Also, the computer system is provided with a "watchdog" circuit 59 which monitors the operation of the computer 51 every seven seconds. If the computer operation is interrupted, or other electronic fault should occur, the circuit 59 will blank the video display, thus alerting the user to the existence of a fault condition and the need for servicing.
A further feature of the present invention is the provision of left and right switches 61 and 62, respectively positioned directly below the video display, as shown in FIG. 1. The switches 61 and 62 are provided to permit separation of data concerning the amount and relative composition of aspirate removed from bilaterally symmetrical portions of the surgical patient. For example, in a procedure such as lipectomy, in which it is desired to remove substantially equal amounts of tissue from laterally opposed portions of the body, the left switch 61 is actuated before surgery begins on the left body portion, and the right switch 62 is actuated before the procedure commences on the corresponding right side portion. The data relating to these separate body portions is displayed separately on the screen 19 to allow the surgeon to remove generally equal amounts of tissue from both opposed body portions.
The switches 61 and 62 are connected through a switch interface 63 to the data buss 52. The operating program embodied in the ROM 58 directs the microprocessor to interrogate the interface 63, and to separate the aspirate data according to the settings of the switches. The electronic system also includes an isolated power supply, comprising an isolation transformer having a leakage current less than 10 microamperes, coupled to an EMI filter. The output of the filter is connected to power the color video display 19 and the electronic scale 54, and is also used to drive a logic power supply which generates +5 VDC and 9 VAC to power the computer 51 and the system card 65.
To use the apparatus of the present invention, the apparatus is first connected to 115/230 VAC power, the bottle shield 44 is raised, and a clean collection bottle 22 is placed on the scale pan. The bottle is sealed with a cap assembly 26 and connected, as described previously, to a vacuum source and to a surgical aspiration instrument, and the cable plug 39 is plugged into the instrument. The bottle shield is lowered, causing the scale to zero and the video display to zero. As aspirate is drawn into the bottle 22, the net weight and impedance of the aspirate is constantly recalculated, and the relative composition of tissue and fluid is calculated by the microprocessor. This information is displayed immediately as separate left-right pairs of bar graphs on the display 19, with tissue amount shown as yellow bars and fluid amount shown as adjacent red bars.
A significant feature of the invention is that it provides a real-time indication of not only the amount of tissue, but also the volume of fluid removed from the patient. This information is critical in determining the advisability of transfusing the patient, rather than relying on secondary physiological indicators. Furthermore, the immediate readout of relative composition permits the surgeon to optimize the surgical technique, so that the minimal amount of fluid may be removed in relation to a maximal amount of tissue. These features provide information to the surgeon which has been heretofore unavailable, and represent important advances over prior art surgical instrumentation.
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|Den Berg Janwillem Van
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|U.S. Classification
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|Jun 29, 1987
Owner name: M. D. ENGINEERING, 214 LINCOLN CENTRE DRIVE, FOSTE
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST.;ASSIGNORS:LASH, ROBERT;HATFIELD, GREGORY;REEL/FRAME:004733/0912;SIGNING DATES FROM 19870527 TO 19870624
|Apr 14, 1992
|Maintenance fee reminder mailed
|Sep 13, 1992
|Lapse for failure to pay maintenance fees
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|Expired due to failure to pay maintenance fee
Effective date: 19920913
|Nov 24, 1992
|Expired due to failure to pay maintenance fee
Effective date: 19920913


text:
Baymont Inn & Suites Lawrenceburg
Baymont Inn & Suites Lawrenceburg
Hotel Guest Rating: 7.4/10
1000 East Eads Parkway
Lawrenceburg, IN 47025
Hotel Freebies Available*
• On Sale Now -> Save 15% on select dates show dates
• Free Breakfast show dates
• Free Internet in Room show dates
Welcome to the Baymont Inn & Suites Lawrenceburg
A heated indoor pool, free parking and near-casino location are welcome amenities for Priceline guests at the Baymont Inn & Suites Lawrenceburg.
Hotel Features
All 64 contemporary, non-smoking rooms at the three-story Baymont Inn & Suites Lawrenceburg have amenities such as coffeemakers, free Wi-Fi, microwaves and ironing equipment. Pets may stay for a fee. Splash around in the heated indoor pool after working out in the exercise room.
Hotel Location
The hotel is poised for a range of fun four miles from skiing at North Slopes. Gamblers will groove on the fact that it's less than 30 miles from horse racing tracks at Turfway Park and River Downs and less than one mile from Hollywood Casino. Northern Kentucky International Airport is about 13 miles from the property.
Guest Favorites
Priceline guests appreciate that the Baymont Inn & Suites Lawrenceburg is "close to Hollywood Casino," has a "friendly staff."
Baymont Inn & Suites Lawrenceburg Amenities
- 24-hour front desk
- Accessible facilities
- Accessible parking
- Air conditioning
- Alarm clock
- ATM/Cash machine
- Bus parking
- Business center
- Coffee/Tea maker
- Complimentary in-room coffee or tea
- Desk with lamp
- Elevators
- Exercise gym
- Free high speed internet connection
- Free local calls
- Free newspaper
- Heated pool
- High speed internet connection
- Hot breakfast
- Ice machine
- Ironing board
- Meeting rooms
- Microwave
- Non-smoking rooms (generic)
- Outdoor parking
- Parking
- Pets allowed
- Remote control television
- Rollaway bed
- Room service - full menu
- Safe
- Security
- Truck parking
- Vending machines
- Wakeup service
- Wheel chair access
- Wireless internet connection in public areas
Hotel Information
You must show a valid photo ID and credit card upon check-in. Please note that all special requests cannot be guaranteed and are subject to availability upon check-in. Additional charges may apply. Guests are required to show a photo identification and credit card upon check-in. Please note that all Special Requests are subject to availability and additional charges may apply.
Hotel Guest Reviews of the Baymont Inn & Suites LawrenceburgOur hotel ratings and reviews are from real hotel guests. Priceline.com ensures that its reviews are guests-only by proactively sending hotel surveys to customers after they've completed their hotel stays. In the post-stay surveys, priceline.com hotel customers are asked a number of questions about their stay and the hotel. On a scale of 1-10 with 10 being the best, the survey asks guests to rate their overall experience and specifically rate the hotel's cleanliness, staff and location. Priceline.com does not allow site visitors to post unsolicited hotel reviews.
Sort by: All Travelers | Business Traveler(2) | Solo Traveler(3) | Traveling as Couple(16) | Family with Young Children(4) | Family with Teens(1) | Senior Traveler(2) | Group Traveler(8)
John from Mishawaka, IN
July 12, 2016
July 12, 2016
Its location to the event I was attending
The breakfast could have been better
Verified Hotel Guest from Goshen, IN
June 21, 2016
Group Traveler
June 21, 2016
Group Traveler
Hotel was just fine
Verified Hotel Guest from Palm Coast, FL
April 13, 2016
Solo Traveler
April 13, 2016
Solo Traveler
This guest did not leave comments about this hotel.
Penny from Greenwood, IN
April 12, 2016
April 12, 2016
This guest did not leave comments about this hotel.
Steve from Hamersville, OH
March 7, 2016
March 7, 2016
excellent location to the casino, with friendly free shuttle service.
Allen from Indianapolis, IN
March 1, 2016
March 1, 2016
The location to the hotel
Something kept biting me and I kill roaches and I didn't get any compensation I will not be back
Troy from Norwalk, CT
January 27, 2016
January 27, 2016
GM has not return my calls It's Day 4 No heat in room 17 degrees outside, communicated to front desk Beds were not made. 3 hr later moved to another room appliance didn't work in 2nd room Recommendation needs new management .
Sharing my comments
Verified Hotel Guest from Murfreesboro, TN
January 26, 2016
Group Traveler
January 26, 2016
Group Traveler
Location was great. 10 min from Perfect North.
The heat was very dry, caused sinus issues for us.
Jennfier from Murfreesboro, TN
January 23, 2016
Group Traveler
January 23, 2016
Group Traveler
Location, close to perfect north.
Lori from Cincinnati, OH
December 15, 2015
December 15, 2015
This is a clean and great other option when going to the Hollywood Casino for the evening. They have a free shuttle to drop off and pick you up so nobody has to drive. You can leave the driving to someone else and enjoy yourself.
I have stayed here a number of times and I have never been disappointed .
Reviews of Baymont Inn & Suites Lawrenceburg
(1 - 10 of 37 reviews)
(1 - 10 of 37 reviews)
from $76
- Comfort Inn Lawrenceburg from $94 (0.7mi)
- Doubletree By Hilton Lawrenceburg from $75 (2.0mi)
- Holiday Inn Express Lawrenceburg from $75 (2.5mi)

subset: commoncrawl


text:
|Reviews for Care
| Nerd-life77 chapter 1 . 3/19/2015
Plz update this. It's sooooooooooo good
| Hannah H chapter 1 . 9/13/2014
Don't worry Mori! No one else sneezes in the Host Club either! _ Great idea.
| Peachytastic chapter 1 . 6/29/2014
Please write more! I know this was written a while ago, but no story should go unfinished should it? Besides, you're a great writer and I love the idea!
| Ally chapter 1 . 6/21/2014
Please, please, please write more! I love it! (As much as I love Mori!)
| sourgrapesnape24 chapter 1 . 5/15/2014
More. You need to write more. I ship them. This story is brilliant already, and needs to be continued!
| UndeadOtakuSoldier chapter 1 . 2/10/2014
You will never continue this story will you? TnT Please upload the next chapter!
| guest chapter 1 . 11/10/2013
Please add another chapter to this! I really would appreciate it, I love this!
| air-earth-water-fire-bearer chapter 1 . 10/9/2010
Oh noes! Poor Mori-Senpai!
You really need to keep writing this, it's cute! :3
| Mata7Ashita chapter 1 . 10/6/2010
Really Haruhi, you were thinking too much about it xD
funny and cute, hope you updat soon!
| cliniquehappy chapter 1 . 9/15/2010
hahah cute funny though that no one could notice anyone sneeze (idk if that made sense) but it was cute hope to see another chapter! feel better mori
| theraggedypond chapter 1 . 9/6/2010
OOOOOOOO! I want another chapter! I'm writing a MorixHaruhi too, and this provoked me to write! I've posted my eighth chapter thanks to you! *hugs* Another please?
| paigeydoll chapter 1 . 9/6/2010
Oh no mori. But don't worry - plenty of people would love to nurse you back to health, including me! Oh i love mori so much. Great job - i can't wait to read more.
| Red Amnesia chapter 1 . 9/5/2010
Ahhn! I love sick Mori and caregiving Haruhi! *_* You must keep writing, please!
| MayContainRandomness chapter 1 . 9/5/2010
I liked the chapter, completely random and kinda cute. I hope Haruhi looks after him
| Mooi Mandy chapter 1 . 9/4/2010
Good chapter...


text:
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Using data from InCHIANTI, a prospective population-based survey of older persons, we examined the relationship of peroneal nerve conduction velocity (NCV, a measure of nerve myelination) and compound muscle action potential (CMAP, a measure of axonal degeneration) with calf muscle mass and density, two complementary measures of sarcopenia.
NCV and CMAP were assessed by surface electroneurography of the right peroneal nerve conducted in 1162 participants, 515 men and 647 women, age 21–96 years, free of major neurological diseases. Cross-sectional muscle area and calf muscle density were measured using peripheral quantitative computerized tomography (pQCT). Both nerve and muscle parameters declined with age although in most cases the decline was not linear. In both sexes, CMAP, but not NCV, was independently and significantly associated with calf muscle density. These findings suggest that intrinsic changes in the muscle tissue are partially caused by a reduction in the number of motor axons.
Observational studies conducted in representative cohorts have demonstrated that skeletal muscle mass and contractile force decline with aging. The rate of age-associated decline in muscle mass and force is extremely variable among individuals due to a mixture of genetic and environmental factors [6,12,20,28,31]. Studying factors that determine accelerated sarcopenia in selected individuals may open new opportunities for prevention, early detection and treatment of this important geriatric condition.
Sarcopenia results from the withdrawal of anabolic stimuli to skeletal muscle, leaving catabolic processes unopposed. The strongest anabolic stimulus to skeletal muscle is the continuous neurological activity of motoneurons. The loss of alpha-motoneurons due to pathology and the consequent reduction in neurological input on muscle fibers is a well-established cause of muscle atrophy [21]. Motor unit number estimation and direct counts of nerve axons have shown that the number of alpha-motoneurons tends to decline with aging in rodents as well as in humans [4,19]. Accordingly, researchers have suggested that the age-associated loss of alpha-motoneurons and the reduction of electrical activity are major causes of sarcopenia [19]. In support of this hypothesis, Metter et al. found an independent, direct relationship between median nerve conduction velocity and grip strength in 197 male participants of the Baltimore Longitudinal Study of Aging [24].
Poor nerve conduction velocity (NCV) mostly reflects the degree of demyelination rather than primary damage to the alpha-motoneurons with consequent axonal degeneration. When axonal degeneration is the prominent phenomenon and the largest axons are preserved, the NCV of the residual axons may be within normal limits. However, the amplitude of the compound muscle action potential (CMAP) is substantially reduced, with consequent weaker muscle response [7,8,30]. The discrimination between demyelinating and axonal peripheral neuropathies is unlikely to be clear-cut, especially in the advanced stages of disease. However, cases of relatively isolated mild motoneuron loss are likely to escapes detection since the overall function is preserved.
We analyzed nerve conduction studies performed at baseline in the participants of the InCHIANTI study. We hypothesized that axonal degeneration in the lower motor neurons expressed by CMAP rather than demyelination expressed by NCV, would be associated with a reduced calf muscle mass and muscle density, two complementary measures of age-related sarcopenia.
InCHIANTI is an epidemiological study of factors contributing to the decline of mobility in late life. The InCHIANTI study population is a representative sample of the population living in Greve in Chianti and Bagno a Ripoli, two small towns located in the Chianti countryside of Tuscany, Italy. Participants were all of Caucasian race. The study design, data collection and overall characteristics of the study population were previously described elsewhere [10]. Briefly, 1270 persons aged 65 years or more were selected randomly from the population registry of the two sites. Another 29 subjects were selected randomly from among those who were aged 90 years or older. Finally, men and women randomly sampled from the age strata 20–29, 30–39, 40, 49, 50–59 and 60–64 years were sequentially invited to participate in the study until at least 30 men and 30 women for each decade from 20 to 59 years, and 10 men and 10 women aged from 60 to 64 years had been enrolled.
Of the 1530 subjects originally sampled, 1453 (94%) agreed to participate in the study. Of these, 1263 underwent standard surface electroneurography of the right peroneal nerve. Participants with major neurologic diseases such as stroke (n = 67) and Parkinson's diseases (n = 10) and those receiving treatment with neuroleptics (n = 24) were excluded from the analysis.
The final study population included 1162 persons, 515 men and 647 women, dispersed over a wide age-range (21–96 years). The study protocol was examined and approved by the INRCA ethical committee. All participants received a detailed description of the purpose and design of the study and all signed an informed participation consent.
Standard surface electroneurographic studies (ENG) of the right peroneal nerve were conducted within 3 weeks of the home interview [3]. All studies were performed on an ENG-Neuro MYTO device (Florence, Italy) using standard ENG-Neuro disposable electrodes. A flexible measuring tape was used for measuring distances between stimulating and recording points. The recording electrode was placed on the skin above the extensor digitorum brevis muscle. Stimulation was done using standard supramaximal technique, proximally at the fibular head and distally over the anterior ankle. The measurements were obtained while dorsal foot skin temperature was between 30 and 34 °C [30].
As measures of nerve conduction, we assessed the amplitude of the compound muscle action potential and the nerve conduction velocity. CMAP, which is related to the number of axons that conduct impulses from the stimulus point to the muscle and the number of functioning motor endplates, was measured from peak to peak of the action potential [26,30]. Since the correlation between amplitudes obtained during the proximal and the distal stimulation was very high (r = 0.92; p < 0.0001), we only reported data on distal CMAP in this manuscript. NCV, which reflects the conduction velocity of the fastest motor axons, was calculated by dividing the length of the nerve segment between the two stimulation points by the difference between the proximal and distal time latency [30].
A lower leg pQCT was performed in all study participants using the Stratec XCT 2000. A detailed description of the pQCT exams has been published elsewhere [27]. Standard 2.5mm thick transverse scans at 14 and 38% of the tibial length, proximal to the terminal tip of the tibia were obtained. In this study, we selected measures of the calf cross-sectional muscle area and the average calf muscle density. Muscle density is calculated from X-ray attenuation, expressed in mg/cm3 and is a reliable and valid measure of fatty degeneration of muscle tissue that always accompanies sarcopenia [15]. Images were analyzed using the BonAlyse software (BonAlyse Oy, Jyvaskyla-Finland), and measures of the cross-sectional muscle area and average muscle density were obtained [5].
Weight was measured to the nearest 0.1 kg using a high precision mechanical scale with the participant wearing light clothes and without shoes. Height without shoes was measured to the nearest 0.1 cm. Body mass index (BMI) was calculated as kg/m2.
Levels of physical activity in the year prior to the interview were coded into an ordinal scale, based on responses to a standard questionnaire as: (1) hardly any physical activity; (2) mostly sitting (occasional walks, easy gardening); (3) light exercise (no sweating) 2–4 h/week; (4) moderate exercise (sweat) 1–2 h/week (level 4); (5) moderate exercise >3 h/week; (6) intense exercise (at the limits) >3 times/week. According to this classification, we grouped the participants as: 1–3, inactive or light physical activity; 4–5, moderate physical activity; 6, intense physical activity. Blood samples were obtained from participants after a 12-h fast, and after the participant had been resting in a sitting or supine position for at least 15 min. Hemoglobin levels were analyzed using the hematology auto-analyzer Dasit SE 9000 (Sysmex Corp., Kobe, Japan).
Ankle extension strength was measured with a hand-held dynamometer (Nicholas Muscle Tester, Sammon Preston, Inc., Chicago, IL). Participants were tested while lying in lateral decubitus (opposite to the examined limb) with the hip and knee extended and the ankle in neutral position. The average of two efforts was used for the present analyses. This measure has been previously used as a muscular strength parameter of the lower limb and has been found to have high reliability [1].
Alcohol intake was assessed from the food frequency questionnaire originally developed and validated for the assessment of dietary intake in Italian volunteers participating into the European Prospective Investigation into Cancer and Nutrition (EPIC), a multi-center study conducted in 10 European countries, and aimed at investigating the relationship between diet and cancer [2].
One experienced geriatrician performed all neurological examinations through the entire period of the project, using a highly standardized method [11].
Disease status was ascertained according to standard, pre-established criteria that combined information from self-reported physician diagnosis, current pharmacological treatment, medical records, clinical examinations and blood tests. Diagnostic algorithms were modified versions of those created for the Women's Health and Aging Study [29]. Diseases included in the current analysis were diabetes, hypertension and peripheral artery disease (PAD), defined as an ankle-arm index of 0.9 or less.
All analyses were performed separately in men and women. The relationships between age and muscle and nerve conduction parameters were examined by scatter plots. To test whether the cross-sectional relationship between age and each muscle and nerve parameter was linear, we fitted linear models and second-order polynomial models. In all cases of a non-linearity, a two-segment piecewise model allowing for different slopes was fitted to the data and the age-threshold that best discriminated the two slopes was identified using a recursive method as the value providing the best regression fit (highest R2).
Age- and body mass index-adjusted values of cross-sectional muscle area and muscle density across peroneal NCV and peroneal CMAP were estimated from linear and, where appropriate, piecewise regression models [14]. Relationships were summarized by scatter plots with superimposed plots of linear or piecewise regression predicted values.
Using a piecewise regression recursive approach, we identified the threshold in CMAP that best discriminated participants with low muscle density. Both in men and in women, such threshold was close to 4 mV, which is the threshold considered clinically significant in the literature [26]. Using sex-specific logistic models we tested the hypothesis that a peroneal CMAP <4 mV compared to ≥4 mV was independently associated with at least 1 S.D. reduction of muscle cross-sectional area and muscle density. All analyses were adjusted for potential confounders including age, BMI, physical activity, hemoglobin, ankle extension strength, peripheral artery diseases, diabetes, hypertension and alcohol intake. An age-adjusted logistic regression analysis was utilized to examine the differences between participants having peroneal CMAP <4 mV versus ≥4 mV.
The SAS 8.2 statistical package was used for all analyses (SAS Institute, Inc., Cary, NC, USA).
In both men and women, we found a strong relationship between age and NCV with no significant departure from linearity as confirmed by the lack of improvement in fit in the second-order polynomial compared to the linear model (Table 1 and Fig. 1). Peroneal CMAP, muscle cross-sectional area and calf muscle density were also lower at older ages but in most cases, the form of the relationship was non-linear. A visual exploration of the data (Figs. 1 and and2)2) suggested that such relationships could be summarized as two-segment models where the effect of age on the dependent variable became higher after a certain age-threshold. Thus, we fitted the data again using piecewise regression models (third section of models in Tables 1 and and2).2). The age-threshold that best divided the "slow decline" from the "fast decline" age-ranges was identified recursively as the value yielding the maximum R2-value between 20 and 80 years (Fig. 3). Interestingly, for all the three variables considered (CMAP, cross-sectional muscle area and muscle density), the "fast paced" decline started earlier in women compared to men. The results of the final models are shown in Figs. 1 and and2.2. On average, NCV was higher in women than in men (p < 0.0001), while the rate of age-associated decline was significantly steeper in men than women (p = 0.0074 for the age × sex interaction). Average CMAP, cross-sectional muscle area and muscle density were significantly higher in men compared to women (p < 0.0001 for all three variables). Over the "slow decline" age-range, the rate of age-associated decline was similar in men and women. However, over the "fast decline" age-range, CMAP and muscle cross-sectional area declined more rapidly with age in men compared to women (age × sex interactions p = 0.0011 for CMAP and p < 0.0001 for muscle area).
Independent of age and BMI, in both men and women, peroneal NCV and peroneal CMAP were not associated with cross-sectional muscle area (Table 3 and Fig. 4). Analogously, independent of age and BMI, peroneal NCV was not associated with muscle density (Fig. 5 and Table 3). On the contrary, independent of age and BMI, peroneal CMAP was significantly, although non-linearly associated with calf muscle density (Fig. 5 and Table 3). In the right panel of Fig. 5, the relationship is summarized using a spline. Interestingly, in both sexes, most of the association is limited to values of CAMP below 4mV. We used recursive piecewise model to identify the threshold that best divided the two CAMP regions characterized by different slopes. The changes in R2 associated with all possible thresholds over the range 0.5–8mV are shown in Fig. 6. We found that both in men and in women, the association of CMAP with muscle density was limited to CMAP values below approximately 4 mV. These findings confirm suggestion from the literature that CMAP values <4 mV should be considered clinically important.
In logistic regression models adjusted for age (Table 4, Model A) and for multiple potential confounders (Table 4, Model B), a peroneal CMAP lower than 4mV was associated with a significantly higher probability of having low muscle density (≤1 S.D.). Similar findings were obtained after exclusion of the participants with diabetes and PAD (Table 4, Model C), suggesting that a reduction of the peroneal CMAP is per se independently associated with intrinsic changes in muscle density.
To understand whether participants with low peroneal CMAP could be clinically detected at the neurological examination, we examined the distribution of major neurological signs suggestive of peripheral neuropathy between participants with a peroneal CMAP <4 mV versus ≥4 mV (Table 5).
Adjusting for age, men with low peroneal CMAP were significantly more likely to have a- or hypo-reflexia in the achilleus reflex (p < 0.05) and positive Romberg test with closed eyes (p < 0.05). Women with a low, compared to normal, peroneal CMAP were more likely to have a- or hypo-reflexia (p < 0.05) in the achilleus reflex, impaired touch sensitivity (p < 0.05), impaired vibration sensitivity (p < 0.01) and positive Romberg test (p < 0.05).
Using data from a representative sample of the general population, we found that both in men and in women, peroneal CMAP assessed by surface electroneurography was independently and significantly associated with calf muscle density, but not with cross-sectional muscle area. Surprisingly, we found no relationship of NCV with either calf cross-sectional muscle area or average muscle density.
These findings suggest that intrinsic changes in the muscle fibers and the structural organization of muscle tissue that occur with aging evolve in parallel with a progressive degeneration of the peripheral nerves, and in particular, a progressive loss of motor neurons and consequent reduction of motor axons. In fact, the CMAP amplitude assessed by surface electroneurography is directly related to the number of axons that conduct impulses to the muscle [8,9]. These findings are analagous to the substantial reduction of CMAP amplitude that occurs after nerve injuries or compression, and is followed by muscle atrophy. Our findings of an association between CMAP and muscle density are also consistent with our hypothesis that age-associated muscle atrophy is at least in part secondary to motoneuron loss. In fact, previous research has shown that secondary muscle atrophy is often followed by fatty and fibrous degeneration, which results in reduction of muscle density in tomography images [21]. This is in accordance with the findings of Kaminska et al. who reported extensive muscle fiber fragmentation and fat infiltration in extremely old rats [18].
Interestingly, we could not detect any clear association of either peroneal NCV or CMAP with calf cross-sectional muscle area. This finding suggests that the effect of peripheral nerve derangement on sarcopenia cannot be detected by simply looking at macroscopic changes in muscle mass, but rather, should be addressed by looking at muscle tissue structure.
Age-related sarcopenia is only partially detected by looking at macroscopic changes in muscle mass. This view is also consistent with results reported by Hakkinen et al., who suggested that changes in neural drive cause qualitative rather than quantitative changes in the muscle [16]. It is well documented that the relationship between muscle quality (i.e. force generated per unit of muscle mass) and age appears to be dependent on how muscle mass is estimated [25]. A large body of literature in animal as well as in human studies suggest that the development of sarcopenia evolves through at least three separate processes: (1) changes in the intrinsic force-generating capacity of the actin–myosin sarcomeric complex; (2) reduction in size of muscle fibers (fiber atrophy); (3) reduction in the number of muscle fibers per unit volume of muscle mass assessed macroscopically [17,21,23]. Additionally, studies have shown a progressive muscle fatty degeneration reflected in part by the macroscopic "marbling" of the muscle tissue and in part, at a microscopic level, as the growth of a thin layer of fat between muscle fibers. Both these changes resulted in a reduction of muscle density in CT images. Interestingly, a recent study demonstrated that greater muscle fatty degeneration is a risk factor for loss of mobility in older persons [33].
Considered together, our findings are consistent with the hypothesis that aging is associated with a loss of motoneurons and a consequent loss of motor units as originally defined by Galea [13] and Liddel and Sherrington [22]. Tomlinson and Irving showed a similar patter of motoneuronal loss in humans that had been previously observed in rat and mouse studies. These authors assessed the number of motoneurons in the lumbosacral region of the spinal cord in subjects of different ages (13–95 years) and found little age-related difference before the age of 60 years. However, after 60 years, the number of motoneurons declined rapidly, such that subjects in their 1990s had about 70% of the number of motoneurons of subjects up to 60 years of age [32]. These findings confirm the previous observation by Campbell et al., who showed that from 60 to 95 years of age, the number of motor units in the extensor digitorum brevis declined linearly with age and are consistent with our finding of a decline in CMAP and muscle parameters that is especially steeper after the age of 60 years [4].
Participants with low peroneal amplitude showed clinical features of tendon hypo-reflexia, impaired touch sensitivity, impaired vibration sense and mild imbalance, suggesting that the reduction in CMAP was associated with a parallel reduction of sensory spinal neurons. These results are also in accordance with the observation of Vrancken et al., who reported that neurological symptoms and signs suggestive of impaired peripheral nerves occur frequently in older persons, even in those who are not affected by neurological diseases and functional limitations [34]. Thus, our data suggest that in the older population, the prevalence of a mild pre-clinical form of peripheral neuropathy is higher than previously suggested. Interestingly, the detection of neurological signs suggestive of peripheral neuropathy, such as patellar hypo-reflexia, are often considered as a "normal" finding in older persons.
To the best of our knowledge, our study is the only population-based study where parameters of peripheral nervous system integrity and functioning were correlated with calf muscle density, and providing evidence that the peripheral nerve contribution to sarcopenia is mediated by motoneurons loss rather than demylination. Interestingly, our data confirm empirically, in a population-based sample that the critical threshold below which peroneal CMAP should be considered "abnormal" is around 4mV both in men and in women.
The main limitation of this study is its cross-sectional design, which precludes the determination of causation between observed phenomena. Although we took into account several factors known to influence peripheral nerves, we cannot exclude the possibility of unaccounted residual confounding. Another limitation of this study is the possibility that factors other than motoneuron loss could interfere with ENG amplitude. As recently demonstrated, the thickness of subcutaneous tissue, the recruitment strategy and the peak discharge rates of different motor unit (MU) rates can all affect amplitude [9]. Finally, we studied muscles that are not directly innervated by the nerves that were examined.
According to most literature, the amplitude of the surface ENG is directly dependent on the net MU activity and it has been suggested that amplitude [9] should be used as an index of the level of activation provided by the spinal cord. Thus, the loss of muscle fibers and the decreased number of functioning motor units may be secondary to motor neuron death with an incomplete renervation of abandoned muscle fibers by the surviving motor neurons. Our findings contribute to this literature by showing a close relationship between axonal degeneration of the peripheral nerve and age-associated sarcopenia. These findings should be confirmed in a longitudinal study. Further research is needed to investigate the proportion of muscle loss in old age that is explained by axonal degeneration versus other causes.
Supported as a "targeted project" (ICS 110.1\RS97.71) by the Italian Ministry of Health and in part by the U.S. National Institute on Aging (Contracts 916413 and 821336).
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


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I understand that a multisite instance can only support one BuddyPress network and that this is installed into the main blog.
For this reason I have given each of my two clients a separate WordPress Multisite instance with BuddyPress installed running on their own Linux server.
I would like to host the two sites on a single server.
How do I do this?


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Book your room at Crowne Plaza Lyon - Cite Internationale
Get an overview of this hotelModern Lyon riverfront hotel next to conference center
City center: 10 minutes
Located between the Rhône River and vast Tête d'Or park, this contemporary hotel is adjacent to the Centre de Congrès de Lyon conference center and a 10-minute bus ride from the center of Lyon.
Free WiFi
Complimentary WiFi is available throughout Crowne Plaza Lyon - Cite Internationale. A business center is open 24 hours. Both the restaurant and the bar offer seasonal outdoor dining.
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Modern, light-filled guestrooms face the river or the green parkland. All feature LCD TVs with 42 channels in five languages. Rooms also include laptop safes, minibars, free WiFi, and en-suite bathrooms.Would you like to give us feedback? Share it! Opens in a new window
Crowne Plaza Lyon - Cite Internationale22 Quai Charles De Gaulle Lyon Rhone 69006
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Crowne Plaza Lyon - Cite Internationale is in a quiet area along the Rhône River and just a 10-minute ride from central Lyon. Opened in 2006, the hotel was designed by Italian architect Renzo Piano, most famous for his work on the Pompidou Centre.
The hotel is part of the Cité Internationale complex, which also includes a conference center, office buildings, a cinema, shops, a promenade, the Museum of Contemporary Art, and INTERPOL headquarters.
Free WiFi is available throughout this Lyon hotel, which also offers 3 meeting rooms, a 24-hour business center, a terrace, and a concierge desk. The restaurant called La Scène is open Monday-Friday, serving breakfast, lunch and dinner. 24-hour room service is available. Le Backstage bar is open all day. Seasonal dining terraces face Tête d'Or park.
Secured covered parking is available (surcharge), and guests can keep in shape at the 24-hour fitness center.
- 24-hour business center
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- Conference space size (feet) - 1076
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Available in all rooms: Free WiFi , Free wired high-speed Internet
Available in some public areas: Free WiFi , Free wired high-speed Internet
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Where to Eat
Le Bistrot Rive Gauche - This restaurant serves breakfast, lunch, and dinner, Monday through Friday.
Le Lounge - This bar is open daily.
24-hour room service is available.
Nearby Things to Do
The recreational activities listed below are available either on site or nearby; fees may apply.
- Hiking/biking trails nearby
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To make requests for specific accessibility needs, complete the "Special or Accessibility Requests" section of "Trip Preferences" when you book your hotel.
- Accessible bathroom
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Hotel Policies
Check-in time ends at 1:30 AM
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Extra-person charges may apply and vary depending on hotel policy.
Government-issued photo identification and a credit card or cash deposit are required at check-in for incidental charges.
Special requests are subject to availability upon check-in and may incur additional charges. Special requests cannot be guaranteed.
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- A tax is imposed by the city: EUR 1.65 per person, per night. This tax does not apply to children under 13 years of age.
Optional extras
- Breakfast fee: EUR 22 per person (approximately)
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Hotel Name
- Crowne Plaza Cite
- Crowne Plaza Cite Hotel Lyon Internationale
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We should mention
Children 12 years old and younger stay free when occupying the parent or guardian's room, using existing bedding.
National Rating
This hotel has received its official star rating from the French Tourism Development Agency, ATOUT France.


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Super Science Doc @ Redpath Museum: DinoTasia
Sun, 2014-12-14 15:00 - 16:30
Redpath Museum : Auditorium, 859 rue Sherbrooke Ouest Montreal Quebec Canada , H3A 0C4
Price: Free with donation to Museum.
Through CGI-fueled vignettes, Dinotasia brings to life prehistoric creatures based on cutting-edge research and the latest fossil records.
Source Site: /redpath


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SAN JOSE -– Too many penalties and not enough penalty killing.
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SAN JOSE -– No matter how far the Sharks advance in the upcoming Stanley Cup playoffs, the offseason just got a little bit shorter for five of them.
SAN JOSE –- Tomas Hertl and Roman Polak will suit up for the Czech team, while Sharks rookie Joonas Donskoi was named to Team Finland on Wednesday morning for the upcoming World Cup of Hockey this


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Digitimes Research: Sharp to see Oxide TFT LCD display segment challenges through 2015-2016
Mar 23, 14:32
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Digitimes Research: Taiwan on-cell touch panel shipments to see strong growth, yet offer little profit
Mar 20, 11:36
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Digitimes Research: Taiwan shipments of touch panels used in handsets and tablets to drop in 1Q15
Mar 2, 14:20
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Digitimes Research: Korea TV vendors outsourcing orders in order to secure panels
Feb 16, 21:45
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Digitimes Research: Taiwan 4Q14 small- to medium-size panel shipments up sequentially
Feb 11, 20:04
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Digitimes Research: Samsung, LG outsource TV orders to ODMs to secure panel supply
Feb 10, 15:57
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Digitimes Research: Demand for LCD TV panel area in 2015 to grow 11.2% on year
Feb 10, 11:34
Global demand for LCD TV panels in terms of total area in 2015 is estimated at 126.107 million square meters, increasing on year by 11.2%, according to Digitimes Research.
Digitimes Research: Taiwan shipments of large-size panels expected to reach 60.87 million in 1Q15
Feb 3, 20:42
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Digitimes Research: Taiwan shipments of large-size TFT LCD panels reach 66.99 million in 1Q15
Jan 28, 13:49
Taiwan makers' shipments of large-size (9-inch and above) TFT LCD panels reached 66.99 million in the fourth quarter of 2014, down 1.4% on quarter but up 4.2% on year, according to...
Digitimes Research: Korea makers to expand AMOLED production capacity 36% in 2015
Jan 27, 14:46
The global AMOLED panel industry saw an over 10% on-year decline in sales revenue during 2014 largely due to lagging sales from Samsung Display. Despite the decline, Korea makers...
Digitimes Research: TSMC SSL merger to enhance Epistar in the LED market
Jan 14, 23:15
Epistar has invested NT$825 million (US$25.94 million) to merge with TSMC Solid State Lighting (SSL), helping to enhance Epistar's capability in the lighting industry. Before the...
Digitimes Research: Samsung, LG, Panasonic bent on competing against Android TV
Jan 8, 15:14
Observing major LCD TV brand vendors' strategies for 2015, Google's Android TV has become the official platform for Sony's and Sharp's smart TVs, but vendors such as Samsung Electronics,...
Digitimes Research: AUO, BOE top panel makers in operating margin
Dec 17, 11:22
Among the global top-10 TFT-LCD panel makers, Taiwan-based AU Optronics (AUO) and China-based BOE Technology posted the highest January-September 2014 operating profit margin of 9.1%,...
Digitimes Research: Taiwan small- to medium-size panel shipments reach 329.7 million in 3Q14
Nov 26, 10:46
Taiwan makers' small- to medium-size panel shipments reached 329.7 million in the third quarter of 2014, down 6.2% on quarter and 12.8% on year, according to Digitimes Research.
Digitimes Research: Samsung, white-box players looking to take over 10-15 million feature phone demand from Microsoft Mobile
Nov 19, 15:02
With Microsoft Mobile's announcement in July 2014 it will terminate its feature phone business within a year and a half, Samsung Electronics and China's white-box handset players...
Digitimes Research: Monitor market continuing toward high-end, curved units
Nov 18, 21:02
The monitor market saw various developments in November, namely the release of curved high-end monitor technology from Samsung Electronics and new Ultra HD monitors from Lenovo and...
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text:
Boy Cutting Grass with a Sickle
Vincent van Gogh
Watercolor, black chalk and watercolour
Etten: October, 1881
Kröller-Müller Museum
Otterlo, The Netherlands, Europe
Image Only - Van Gogh: Boy Cutting Grass with a Sickle
"I can't work without a model. I won't say I turn my back on nature ruthlessly in order to turn a study into a picture, arranging the colors, enlarging and simplifying; but in the matter of form I am too afraid of departing from the possible and the true."More Van Gogh Quotes


text:
EA ties up NFL license until 2013
Says so here. Peter Moore will be excited.
There are two deals involved here, one for the NFL itself and one for the NFL's players, which "provide EA continued rights to NFL teams, stadiums and players for its critically-acclaimed and best-selling football videogames through the end of the 2012 season, which culminates in February 2013."
"We are excited about the opportunity to extend and expand our relationships with the NFL and NFL PLAYERS," said Peter Moore, President of EA Sports.
See. Told you he would be.
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text:
Fable II abbott glitch being fixed as "priority," says Lionhead
A game-snapping glitch in Fable II is being fixed as a priority, Lionhead has said.
"We are aware that a minority of people playing Fable II over the last few days have encountered an issue where the Abbot becomes unresponsive at the beginning of Monks Quest in Oakfield," said a spokesperson on the developer's forums.
"This is an isolated issue, but we are currently looking into it as a matter of priority. If you have already encountered this issue, there is unfortunately no work-around at this time, but we will keep you updated on any progress made."
The problem arises if you cut a conversation short with the abbott and leave the area: the game then stops you progressing any further.
As reported by GayGamer, via Kotaku.
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Squeaky Wheel
Artgrease Ep. #647: Just Like Movement, September 2013
The Artists:
Steve Girard stevieeatsworms.tumblr.com
Theo Tagholm theotagholm.com
Dean Moss gametophyte.org
Matt Leaf prgrms.net
Music by JOHNS johns716.bandcamp.com
To submit to ARTGREASE, send an email with subject header that reads: ARTGREASE SUBMISSION to email@example.com with a link to your work (on Youtube/Vimeo, etc). An Artgrease producer will contact you to request a downloadable hi-res QT file if they choose to use your work.
If you are old-school and want to send us a DVD (preferably w/ hi-res QT file), or other formats of media, mail to: Squeaky Wheel, 712 Main St, Buffalo NY 14201. Be sure to label the package ATTN: Artgrease Submissions.
FOLLOW US ON TWITTER @artgrease


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Coatesville, PAView Tutor


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I have the non-pro version and I would like to test an appointment so I can see the emails sent and to insure that the user is returned to the correct pages.
I want to see this function before I use it live. I may purchase the pro version but I need to see this work first.
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Huge Garage/Moving/Warehouse/Tent Sale- 2400 Sq Foot Tent Full Of Quality Items
MOVING TO PUERTO RICO. EVERYTHING FROM OUR HOME AND BUSINESS MUST GO. HUUUGE INVENTORY TO LOOK AT. RENTED A 2,400 SQ FT TENT AND MOVING EVERYTHING INSIDE TENT TO STAY OUT OF THE WEATHER. PARTIAL LISTING OF ITEMS HAND TOOLS, POWER TOOLS, HOME DECOR, FURNITURE, FLORALS, BOOKS, BABY CLOTHES(LIKE NEW), (NEW)… → Read More
Wonderful sale coming up on September 15, 16, and 17. Sale to include: 10 Ft. Enclosed trailer, 2007 Vulcan 1600 Motorcyle Fully Loaded with 12k Miles, Lots of Antique Furniture, Glassware, Pottery, Porcelain, Wicker Set, Bedroom and Living Room Furniture, Office Furniture, Madame Alexander Dolls, Tools....a house full of items. More details on this sale… → Read More
Glass Menagerie Collectors Paradise Found
Designers, Collectors, Vintage searchers, these items are from all over the world and in great condition. More details to follow. Priced to Sell, Dusty GoldEstate SalesHurst sale many collectables, please revisit in a few days for more details. Just Getting Started. just posted tons of pictures please review and hope to see you at the sale. Designers,… → Read More
Home Furnishings And Tools Tools Tools
Great house filled with nice home furnishings and tons of yard equipment and tools. Our seller is a retired electrical contractor. We will have numerous electrical tools and supplies available and many pertaining oil field electrical supplies and tools. So there is something for everyone and all well cared for! Gun smoke look of battered leather loveseats… → Read More
Mid Century Madness Madness Estate Sale By Alamo Aztek Estate Sales
MID CENTURY MADNESS MADNESS ESTATE SALE THURSDAY FRIDAY SATURDAY JULY 28TH-JULY 30TH 2016 FORT WORTH, TX FEATURING AN ABSOLUTELY EXQUISITE ASSORTMENT OF MID CENTURY MODERN FURNITURE & COLLECTIBLES INCLUDING DUNCAN PHYFE DINING SET, MID CENTURY MAPLE DINING SET, HOUSEWARES, MATCHING BEDROOM SET, LADIES HIGH FASHION APPAREL, WHIRLPOOL REFRIGERATOR,… → Read More
Plantation Mansion Estate Sale Of The Century By Alamo Aztek Estate Sales Packed Packed Packed
PLANTATION MANSION ESTATE SALE OF THE CENTURY THURSDAY FRIDAY SATURDAY JULY 14TH-JULY 16TH 2016 POST OAK PLACE GRANBURY, TX PLEASE NOTE THE PLANTATION MANSION SALE HAS MOVED LOCATIONS FROM STEPHENVILLE TO GRANBURY DUE TO TOTAL LACK OF COOPERATION FROM THE CITY OF STEPHENVILLE. WAKE THE NEIGHBORS, PHONE THE KIDS, SHOUT IT FROM THE ROOFTOPS, IF WE… → Read More
Moving Sale - 10409 Stonehill Dr, Benbrook, TX 76126 : Furniture, Golf Clubs, Clothes, Christmas items, Home Decor, Housewares 7:30AM - 1PM Saturday July 30th CASH ONLY… → Read More
Estate Sale-Fri/Sat. 8 Am 7/29
House full of furniture, full kitchen and garage, nice clothes, small household items and decor, some antique furniture. No collectible smalls. Friday at 8:00am. Priced Right! Judy's Sale… → Read More
Art Work Womens Clothing Mens Clothing Kitchen Table Schwinn 230 Recumbent Bike Misc furniture kitchen appliances (juicer, crock pot *never used*, etc) text for info about bike and table to pick up before Saturday. 817-682-6363… → Read More
Furniture and a little bit of everything… → Read More
Big yard sale, tons of stuff, chairs, tables, Desk chairs, etc. come check it out.… → Read More
Cloths and shoes for girls, boys, men and women. All on hangers and easy to look thru. Uniform slacks, dress pants, jeans and shorts. Coats, jackets, vests and sweaters. Dresses, suits, blouses and shirts. Kid, toddler and baby cloths. Dress shoes, hi-heels, sneakers and sandals. Toddler bed with mattress and sheets. Comforters, bed sheets, curtains, lamps… → Read More
Cloths for girls, boys, men and women. All on hangers and easy to look thru. Uniform slacks, dress pants, jeans and shorts. Coats, jackets, vest and sweaters. Dresses, suits, blouses and shirts. Kid, toddler and baby cloths. Dress shoes, hi-heels, sneakers and sandals of all sizes. Toddler bed w/ mattress and bed sheets. Comforters and bed sheets, curtains,… → Read More
Moving/Garage Sale With Tons Of Back To School Items!
Moving/garage sale with tons of educational items, clothes, appliances, tools, and household items.… → Read More
Lots of cheep stuff for sale! Please come by this Saturday the 30th from 9 am to 1 pm at 5705 Royal Club Dr. Arlington, TX… → Read More
BIG GARAGE SALE SHOES ALL TYPES OF CLOTHES LOTS OF TOYS CURTAINS HOME DECOR AND MUCH MORE 7705 Noreast Drive North Richland Hills Texas 76180… → Read More
Lots of clothes (including uniform clothing), housewares, furniture, toys, electronics, DVDs… → Read More
Garage sale at 837 Crestview Dr., Burleson, TX, 76028!!!! Antique dresser/vanity and nightstand in pic is $250 for the set. We also have clothing, girls' decorations/furniture, toys, household items, children's books, Dance wear and shoes, and much more!!! Thursday and Friday for sure! 8am-?… → Read More
Multi-Family Garage Sale/Lawn Store Closing
Multifamily Garage Sale, Lawn & Patio Store Closeout, Emergency Prep items Freshen up your patio now! Lawn, patio, and planters - wrought iron tables, decorative plant holders, terracotta pots, Mexican pottery, crosses, window sills, garden figures, birdhouses, animals, garden butterflies, flower pots and more. Hundreds of items. Clothes, household items… → Read More
Garage sale! Boys clothes from newborn-8yrs, men's XL /women's M-L clothing, power wheels trucks, joovy double stroller, shoes, dining table with 2 chairs, portable heaters, small dog carrier, bikes, tons of toys for babies and kids.… → Read More
BIG GARAGE SALE, KITCHENWARES, HOUSEHOLD, TOYS, CLOTHES, SHOES, FURNITURE, LOVESEAT, DRESSERS, ANTIQUE DRESSERS, FISH AQUARIUMS WITH STANDS, TABLE AND CHAIRS, STROLLERS, CHRISTMAS, PLEASE NO EARLY BIRDS THUR 7-28 7:30-3 FRI 7-29 7:30-3 5245 MACK RD HALTOM CITY, 76117… → Read More
Garage/Carport sale lots of stuff from years of being a pack rat. bed liner dodge, lawn edging, tires, books, truck bed soft cover, truck bed load handler, coleman lantern, coleman heater, fishing stuff, dog bowls, cat box, new in box truck parts mirrors, lenses, belts, exhaust parts, ropes odd lengths, 12v inverter, vacuums, recliner, solid wood flooring… → Read More
Watauga garage sale Thursday Friday and Saturday 7–28 through 7–30 boys clothes shoes toys Nerf gun's teens women's clothes shoes maternity kitchen ... You know the drill… → Read More
Estate/Garage sale: furniture, ceiling fans, antiques, dishes, clothing etc.… → Read More
Having a garage sale Thursday & Friday ONLY. I have a brown microsuede couch and love seat for sale. I also will have adult clothes, a few kids clothes, shoes boots, decorative items, and lots of miscellaneous. Come on out. You never know what you may find. 6520 Newt Patterson Road Mansfield 76063 **First house North of 1187, next to newly open… → Read More
4112 Harlanwood Dr., Fort Worth, 76109 Friday and Saturday, July 29 & 30 (9am - 4pm) Moving and must downsize. Multi-family garage sale. Baby items, Baby and Adult Clothing/Shoes, Office and Home Furniture, Baby Grand Piano, Futon, Car Seats, Books, DVDs, Quilts and Baby Bedding, Toys, Housewares, Bar Ware, Twin Car Seat Stroller and other Twin Items… → Read More
4 family sale 7017 Robinhood Lane, Ft Worth, 76112. Thursday, July 28 thru Saturday, July 30. NO SALES BEFORE 9:00 AM. We have a little bit of everything.… → Read More
New & Used Clothes & Books Garage Sale
SUNDAY July 31st 7 am to NOON. NEW & Used clothing. Men's, Women's and Children's. Shoes, Boots, Jeans, Dresses, Jackets, Coats, Sweaters, Skirts, Dresses, Jackets, Dress slacks, & dress shirts, Suit jackets. School uniforms. ALL IN GREAT CONDITION! SUPER LOW PRICES!! Sizes from infant up to XXL and 3X Save money on back to school… → Read More
Willow Park Estate Liquidation
Television pearl drums vending machines furniture housewares TCU helmet guitar project table and chairs sofa table dressers chest of drawers golf memorabilia much much more Dates & Times: Fri, 29 Jul 2016, 9:00am - 5:00pm Sat, 30 Jul 2016, 9:00am - 5:00pm… → Read More
One Day Multi Family Garage Sale
multi family garage sale deep freeze, dresser, clothing, kitchen items, etc.… → Read More
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My primary interest in life is the study and writing of poetry. I take my art very seriously, to the point that I've spent most years since 2001 in abject poverty.
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Fowler shares Firestone lead, Tiger toils to 71
Akron, Ohio: While Tiger Woods failed to build on his solid start to the WGC-Bridgestone Invitational in Friday`s second round, fellow American Rickie Fowler rocketed into a four-way tie for the lead.
The long-haired Fowler, six strokes off the pace overnight, fired a sizzling six-under-par 64 at Firestone Country Club to post an eight-under total of 132 in the elite World Golf Championships (WGC) event.
Helped by an eagle at the par-four third, where he holed out with a wedge from 110 yards, the 22-year-old ended the round level with compatriots Ryan Moore and Keegan Bradley, and Australian Adam Scott.
Moore carded a 66 and Bradley a 65 while first-round pacesetter Scott, who briefly claimed the outright lead at nine under, bogeyed his final hole for a 70.
Australian Jason Day, who opened with a 63, also got to eight under before he dropped a shot at the par-four 18th for a 70 and a share of fifth with Swede Robert Karlsson (65) and Britain`s Martin Laird.
Seven-times champion Woods, however, was unable to capitalize on the momentum of his opening 68 as he followed up with a roller-coaster 71 to lie seven off the lead on his PGA Tour return.
Fowler, one of the game`s most exciting young prospects who is still seeking his first PGA Tour victory, surged up the leaderboard with a wild mix of eight birdies, an eagle and four bogeys.
"Overall it was a lot of fun today," said the Californian, who played the first two rounds in the company of 18-year-old Italian Matteo Manassero.
"I had a couple mistakes out there and made four bogeys but a lot of positives and a lot of good things came out of today. I made some good putts and I`m building some confidence going into the weekend."
Shot-Making Display
After parring his first three holes, Fowler treated the large gallery watching the young duo to a thrilling display of superb shot-making, offset by a few blemishes.
"It was kind of just go, stop for a second, go, stop for a second," he said with a smile. "But it`s fun. Making a lot of birdies is a good thing.
"I just happened to make a couple of bad swings and mistakes there that cost me a couple of strokes, but hopefully we`ll set those aside for the weekend and move on."
Woods, who carded an encouraging 68 on Thursday in his first tournament in three months, struggled for consistency with a mixture of four birdies, three bogeys and a double bogey.
"I didn`t putt as well as I did yesterday, and consequently I just never got the round going," the 14-times major champion said after finishing at one under.
"I know my stats don`t show it, but just the way I`m driving the golf ball ... I`m so close to putting the ball on a string, so it`s coming."
Woods, who has missed the last two majors because of leg injuries, said he had struggled with his distance control for a second day in a row.
"I got so much more compression and the ball is just going," he said. "I`ve just got to get used to that and trust the number. I`m hitting the ball numbers I`ve never hit before."
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Penwith, England News
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