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The pararectus approach for internal fixation of acetabular fractures involving the anterior column: evaluating the functional outcome
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Aim of this retrospective analysis of prospectively collected data was to evaluate the functional mid-term outcome two years after open reduction and internal fixation of acetabular fractures involving the anterior column with affection of the quadrilateral plate using the pararectus approach on a large cohort.
Fifty-two patients (12 female, 40 male) with a median age of 55 (range 18–90) years and displaced acetabular fractures involving the anterior column were surgically treated in a single level I trauma centre between July 2012 and February 2016 using the pararectus approach. Thirty-four patients (8 female and 26 male) with a median age of 58 (range 20–85) years were available for complete clinical follow-up at regular intervals, finally 24 months post-operatively. Functional outcome was evaluated according to modified Merle d'Aubigné score, Lower Extremity Functional Scale, WOMAC, and SF-36.
Range of time between trauma and surgical treatment was three (range 0–19) days. Operation time was 140 (range 60–240) minutes, and duration of hospital treatment was 19 (range 7–38) days. Functional results in 34 patients available for final follow-up demonstrated 68 points (median; range 39–80) according to the Lower Extremity Functional Scale, 6% according to the WOMAC (mean; SD ± 14.5%), and 69% (mean; SD ± 20.1%) according to the SF-36. The modified Merle d'Aubigné score was excellent in 22 patients, good in eight patients, and fair in four patients.
Based on the good to excellent functional mid-term follow-up results of this study, the pararectus approach can be recommended as sufficient alternative single access to address displaced acetabular fractures involving the anterior column, independent of patients' age.
KeywordsAcetabular fracture Quadrilateral plate Pararectus approach Stoppa approach Ilioinguinal approach Merle d'Aubigné Lower extremity functional scale WOMAC SF-36 Outcome
Western Ontario & McMaster Universities Osteoarthritis Index
36-Item Short Form Survey
standard deviation
Total hip arthroplasty
The gold standard approach for open reduction and internal fixation of acetabular fractures involving the anterior column was the ilioinguinal approach introduced by Letournel [1]. In the literature, 40–80% of anatomically reduced results using post-operative conventional X-rays were described [2, 3]. Within the last 30 years incidence of acetabular fractures even in the elder population has been almost doubled, and the complexity of these fractures has increased [4]. In the same period of time, significantly more fractures involving the anterior column, dislocations of the quadrilateral plate or impaction of the acetabular dome occurred [4]. In a large retrospective analysis, age over 65 years, initial fracture displacement of more than 2 mm, and fracture pattern involving the anterior column were defined to be important predictive factors for fixation failure and need for consecutive total hip arthroplasty (THA) [1]. Other studies demonstrated that typical fracture configurations of the elderly such as anterior column fractures, anterior wall fractures, anterior column posterior hemitransverse fractures, or both column fractures were associated with fair to poor clinical and radiological results in more than 30% of cases [5]. Especially superior-medial dome impaction of the acetabulum is predictive for fixation failure in elderly patients [4]. For open reduction and internal fixation of the medialized quadrilateral plate, the ilioinguinal approach has been established [6]. Due to the relevant morbidity of the ilioinguinal approach, the modified Stoppa approach was developed as a less invasive surgical access [7]. While the ilioinguinal approach exposes the pelvic brim under direct visualization except for the quadrilateral plate and the acetabular dome, which may result in a suboptimal reduction of impacted acetabular dome fractures or displaced quadrilateral plate, the modified Stoppa approach allows direct view under the pelvic brim including the quadrilateral plate [8]. Alternatively, with respect to potential neurological and vascular complications or to peritoneal breach, the pararectus approach has been developed as alternative access directly to the joint which combines the advantages of the second and third windows of the ilioinguinal approach with the medial view of the modified Stoppa approach to treat acetabular fractures with affection of the quadrilateral plate [9]. But only few studies on functional outcome exist in the literature, and cohort groups are comparatively small resulting in a strong need for further clinical data [10, 11].
This retrospective analysis of prospectively collected data presents functional mid-term results 2 years after open reduction and internal fixation of displaced acetabular fractures involving the anterior column using the pararectus approach.
Materials and methods
Surgical technique
The identical rehabilitation protocol was conducted with all patients. Physical therapy started immediately, and patients were allowed for toe-touch weight-bearing during the first two weeks post-operatively. Afterwards, partial weight-bearing with a maximum of 20 kg was allowed for another four weeks. Antithrombotic prophylaxis using low molecular weight heparin was provided daily until full weight-bearing was achieved.
Statistical analysis
Dependent to the amount of observations, results in this study are presented as mean and standard deviation (SD) or median values and quartiles. Data was managed using Microsoft Excel 2010 (Microsoft Corp., Redmond, WA, USA).
Compliance with ethical standards
All procedures performed in this study were in accordance with the ethical standards of the institutional and the national review boards (Ethics Committee of the Bavarian State Chamber of Physicians, approval number: 16043) and with the 1964 Helsinki declaration and its later amendments.
The study was conducted according to ICMJE guidelines and has been retrospectively registered with the German Clinical Trials Register (approval number: DRKS00011308).
Patients' demographic and peri-operative data overview
Age* [years]
55 (18–90)
Age > 60 years
Mechanism of injury
Car accident
Motor bike accident
Bicycle accident
Fall > 3 m
Fall < 3 m
Base jump accident
Skiing accident
Judet and Letournel classification
Both column
Anterior column
Anterior column posterior hemitransverse
Delay to surgery* [days]
3 (0–19)
Operation time* [minutes]
140 (60–240)
Duration of hospital treatment* [days]
19 (7–38)
Post-operative complications
Patients [n]
Subcutaneous hematoma
Superficial wound infection
Obturator nerve affection
Pelvic deep vein thrombosis
Implant breakage
Functional results according to Lower Extremity Functional Scale, modified Merle d'Aubigné score, WOMAC, and SF-36 24 months post-operatively in 34 patients
Lower Extremity Functional Scale*
68 points (range 39–80)
6% (± 14.5)
69% (± 20.1)
Modified Merle d'Aubigné score*
16 points (range 13–18)
Excellent (18 points): 22 patients (65%)
Good (15–17 points): 8 patients (23.5%)
Fair (14 or 13 points): 4 patients (11.5%)
The ilioinguinal approach has been considered for a long time as the standard anterior approach for acetabular fractures involving the anterior column [1]. Recently, the modified Stoppa approach became more and more important due to its better visualization of the intrapelvic anatomy including the quadrilateral plate [6]. Furthermore, the pararectus approach has been introduced to treat fractures mainly involving the anterior column and the quadrilateral plate with good access to fracture site, adequate visualization of essential neurovascular structures, feasibility for anatomical restoration even in cases with impaction of the superomedial joint surface, and minimally invasive soft-tissue dissection [9].
In dislocated acetabular fractures, the articular surface should be reduced anatomically. Nevertheless, poor outcome has been reported in about 20% of all operated simple fractures and in nearly 30% of all operated comminuted fractures [5, 16]. In this regard, surgical outcome depends on fracture type, patients' age, femoral head damage, delay to surgery, and quality of reduction [2, 17, 18, 19].
Dailey et al. mentioned that earlier surgical intervention improves the probability of achieving anatomical fracture reduction [17]. Median delay to surgery of three days in this study is similar to their results. The quality of fracture reduction depends on the adequate view of the fracture fragments. The results of the current study demonstrated similar reduction quality compared to earlier reports [11, 20]. In addition, Keel et al. reported an operation time of about 200 minutes using the pararectus approach [9, 13]. In the current study, operation time decreased to a median of 140 minutes which is equal to or even quicker than the reported operation time for latest described minimally invasive surgical techniques [21, 22]. Besides, Keel et al. demonstrated good or excellent clinical results after a follow-up period of at least two years post-operatively in 94% of patients [11]. For the use of the modified Stoppa approach, other studies reported good to excellent clinical outcomes in 69 to 89% for comminuted acetabular fractures involving the anterior column [6, 7, 23, 24, 25]. The current study demonstrated 88% good to excellent functional results in the examined patients for comparable fracture patterns using similar functional grading systems such as modified Merle d'Aubigné score which is the most widely accepted functional hip sore evaluating the clinical result of acetabular fracture treatment [11, 26, 27].
Surgical complications such as hernia, thrombosis, neurovascular injuries, and hematoma are seen at rates of approximately 10% for the ilioinguinal approach [28] and are comparable to rates of 11% for the pararectus approach in this study. Furthermore, 11.5% of patients with median age of 72 years obtained THA in terms of post-traumatic osteoarthritis. In addition, with 23 patients over 60 years, the results of the current study confirm Keel's findings that the pararectus approach seems to be a feasible approach also for elderly patients with anterior or central destruction of the acetabulum [10, 11]. This is of particular importance since the incidence of acetabular fractures including involvement of the anterior column is constantly increasing [4] and has more than doubled from the early 1990s to 2010 [29]. In this regard, anterior column fractures and anterior column posterior hemitransverse fractures are the most common fracture patterns [30, 31]. In the German pelvis registry, an increase from 3 to 19% within 20 years could be observed [32]. In the current study, anterior column with or without posterior hemitransverse fractures accounted for approximately 42% of all fractures.
In general, innovations in surgery often are criticized in terms of missing transferability of commonly good follow-up results of the initial authors to a frequent number of users. For the use of the pararectus approach, this study confirms the good to excellent functional results of the describer. Therefore, regardless of patients' age, the pararectus approach has become the standard approach in our institution for initial surgical treatment of acetabular fractures involving the anterior column or central joint fragments.
Rationales for the use of the pararectus approach
The pararectus approach enables excellent exposition of the anterior wall, the anterior column, and the quadrilateral plate. It facilitates sufficient view and preparation of the dome fragment through the displaced quadrilateral plate or an additional little window by using an osteotomy at the innominate line. Additionally, additive screw placement through the medial plate is an option. Further dorsal preparation enables complete presentation of the anterior part of the sacroiliac joint which might be helpful in combined fractures including displacement of the sacroiliac joint [13]. Limitations are seen in high-riding fractures of the anterior column. In these fractures, the first window laterally to the iliopsoas muscle can be displayed through the pararectus approach or through a little additional incision at the iliac crest [33].
Although a potential disadvantage of the pararectus approach is seen in the risk for a peritoneal lesion while it is located between peritoneum and lateral abdominal muscles, it therefore provides a direct medial view to fracture fragments. In case of peritoneal lesions, the peritoneum can be easily sued and closed. Injury of intra-abdominal structures has not been reported in the literature and was not present in our study [34].
A main advantage of the surgical technique performed in this study is to reduce fracture fragments against the direction of the fracture displacement. In the standard anterior approaches mainly tension and compression without direct visualization are used to reduce fracture fragments. This facilitates anatomical reduction and leads to higher quality of fracture retention without fracture gap. Thereby, loose intra-articular fracture fragments can be removed, the cartilage can be evaluated, and impacted dome fragments can be reduced anatomically under direct view. Furthermore, the approach eases medial plate positioning and enables to counteract permanently against centrally directed fracture forces, which biomechanically improves the stability of the osteosynthesis. In addition, direct visualization of the fracture can be improved by flexion of the leg and deep anesthesia providing enough muscle relaxants.
Study limitations
The limitations of this study include the retrospective evaluation of prospectively collected data, the missing control group, the limited number of patients available for final follow-up, and the consecutive lost to follow-up of 34% which is mainly based on the relatively high amount of polytraumatized patients treated in our level I trauma centre [35]. The variety of patients' age as well as the sequential nature of the cohort group, the different range of time between trauma and definite surgical treatment, and the missing recordings of intra-operative blood loss are limiting factors. On the other hand, all patients were managed with a standard treatment protocol in the same hospital by the same team of experienced surgeons.
Based on the results of this study, the pararectus approach can be considered as an equal if not superior alternative in surgical treatment of acetabular fractures involving the anterior column, independent of patients' age. Intra-operatively, the pararectus approach enables good visualization of fracture fragments allowing secure anatomical reduction. Further prospective multi-centric studies are intended to confirm these considerations in larger cohorts.
C. von Rüden and L. Wenzel contributed equally to this work.
Authors' contributions
CvR drafted the manuscript. CvR, LW, AT, AW, and JB contributed to the acquisition of data, analysis, and interpretation of data. LW, PA, and MP helped to search literature and to finalize the manuscript. CvR, LW, and MP participated in the conception, design, and coordination. MP and VB supervised the whole study. All authors read and approved the final manuscript.
Funding Information
Open access funding provided by Paracelsus Medical University.
Compliance with ethical standards
Conflict of interest
All authors declare that they have no competing interests.
Ethics approval and consent to participate
All patients agreed and signed to participate on this clinical trial.
All procedures performed in this study involving human participants were in accordance with the bioethical standards of the institutional and the national research committee (Ethics Committee of the Bavarian State Chamber of Physicians, ID: 16043) and with the 1964 Helsinki declaration and its later amendments.
This clinical trial was conducted according to ICMJE guidelines and has been registered retrospectively with the German Clinical Trials Register (ID: DRKS00011308).
Consent to publish
Written informed consent for publication of this study and any accompanying images was obtained from all patients.
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Steel Buildings
Steel Buildings For SaleWritten by Amy Hall
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A pretty girl in polka dot dress and black heels already has to pee, but when our cameraman gives her a bottle of juice to drink as she finds a place to relieve her bladder it adds to the pressure. She takes the elevator up several floors and steps outside onto the stairs back down. As she pisses, it runs across the landing and drips down the steps.
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Premier Oil
Is this trend a good trading opportunity?
Will Premier Oil turn, or will it continue to rise to 109p Nov highs?
- Shares +20% in 1 week.
- Broken above 2019 highs at 81p.
- Now trading 86p (at the time of writing).
- Will the positive momentum continue to 109p Nov highs?
- Shares trade at 2019 highs; +43% from 2019 lows; +30.5% year-to-date.
- 12 Mar: Berenberg says Premier Oil's debt should fall by another $220m in 2019
- Source: Bloomberg, FT, Reuters, DJ Newswires, AlphaTerminal
Trading Premier Oil – An Example
Let's say the trend appeals to you, you think it's likely to continue. You decide to buy exposure to £10,000 worth of Premier Oil using a CFD, at the current price of 86p. To do this, you need £2,000.
Let's assume the Premier Oil trend continues to 109p Nov highss (+26.7%). Your profit would be £2670, from your initial investment of £2,000.
Conversely, let's assume you open the above position, and place a stop-loss at 5% from the current price. Premier Oil falls 5% and hits your stop-loss. Your loss would be £500.
This is provided for information purposes only. It should not be taken as a recommendation.


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Honors & Awards
- NTCA All-American (First Team: 2019)
- NTCA All-American (Third Team: 2018)
- NTCA All-American (Honorable Mention: 2017)
- NTCA All-Academic Team (2016, 2017, 2018)
- Big Ten Distinguished Scholar (2017, 2018)
- Academic All-Big Ten (2017, 2018)
- Nebraska Scholar-Athlete Honor Roll (Fall 2015, 2016, 2017, 2018; Spring 2016, 2017, 2018)
- Big Ten Sportsmanship Award (2017)
- Sam Foltz Hero 27 Leadership Award (2018)
- Tom Osborne Citizenship Team (2016, 2017, 2018, 2019)
2018-19 (Outlook)
Meghan Straub was a third-team member of the All-American team in 2017-18 and will look to reach new heights as a senior. The Lincoln, Neb. native will play a key role in Nebraska's rotation throughout the 2018-19 season.
2017-18 (Junior)
In her third season as a Husker, Straub grabbed third team All-American honors. She saw action in all 10 of Nebraska's events in 2017-18 and posted an average of 206.3. Straub had a pinfall of 804 in four games at the NCAA Championship and helped the Huskers make it to the national semifinal.
Straub recorded three top five finishes and two top 10 finishes in 2017-18. Her best finish was second place at the Track Kat Klash (1,091). Her high score of the season was 1,275 pins at the Prairie View A&M Invitational. Straub posted a score above a 200 average in seven of Nebraska's nine tournaments.
Straub continued shining in the community during her junior season. She was named a Big Ten Distinguished Scholar, earned Academic All-Big Ten honors and was a member of the Nebraska Scholar-Athlete Honor Roll. Along with her success in the classroom, Straub earned a spot on the Tom Osborne Citizenship Team and was a Sam Foltz Hero 27 Leadership Award recipient.
2016-17 (Sophomore)
Following a strong freshman season, Meghan Straub, the daughter of Nebraska head coach Bill and former Husker All-American Kim Straub, took the next step for the Huskers as a sophomore, earning honorable-mention All-America honors in 2016-17.
Straub posted her best average of the year at Nebraska's own Big Red Invitational, as she fired a career-high 224 to finish seventh and help the Huskers to a second-place team finish. She finished second overall at the Mid-Winter Invitational with an average of 210 to help the Huskers win the team title. She led the Huskers to a third-place finish at the Warhawk Invitational with an average of 209.6, as she finished 15th individually.
In all, Straub scored above a 200 average in six of NU's 10 tournaments as a sophomore. She posted scores of 201.6 and 201.2 at the SFA Stormin' Ladyjack Invitational and the Crusader Classic, respectively, in back-to-back weeks to help the Huskers to a second-place finish and a team title. Straub also finished third overall with an average of 200 at the Central Missouri Mid-America Invitational to help the Huskers to a first-place finish.
Straub continued her strong work in the classroom and the community, as she was named to the NTCA All-Academic Team for the second year. She also captured her first Academic All-Big Ten honor and was a Big Ten Distinguished Scholar, while winning a Big Ten Sportsmanship Award in 2017. Straub was also named to the Nebraska Scholar-Athlete Honor Roll in both semesters of 2016-17 and she earned a spot on the Tom Osborne Citizenship Team in 2017.
2015-16 (Freshman)
Straub emerged as a solid contributor for NU as a freshman. She saw action in eight of Nebraska's 10 events in 2015-16 and posted an average of 193.7 for the season.
Straub earned her first career top-10 finish at the Warhawk Invitational, placing sixth overall with a 213.2 average to help the Huskers to the team title.
At the NCAA Championship, Straub saw action off the bench in the bracket rounds, helping Nebraska earn a second-place finish.
Straub got off to a strong start academically, as she earned NTCA All-Academic Team honors. The Lincoln native was named to the Nebraska Scholar-Athlete Honor Roll in both the fall and spring semesters and the Tom Osborne Citizenship Team in 2016.
Before Nebraska
Straub ended her career at Lincoln Pius X High School as a two-time state champion for Coach Rod Machacek. She earned all-state and all-conference honors all four years of her high school career, being named conference MVP in 2015. She was a state champion in 2012 and
The daughter of Bill and Kim Straub, Meghan was born on Aug. 19, 1997. Meghan is double majoring in English education and journalism at Nebraska, earning NTCA All-Academic Team honors in 2016 and 2017. She was a Big Ten Distinguished Scholar and earned Academic All-Big Ten accolades in both 2017 and 2018. She is a seven-time member of the Nebraska Scholar-Athlete Honor Roll. Straub is a four-year member of the Tom Osborne Citizenship Team and earned the Big Ten Sportsmanship Award in 2017.


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⁀ Download Hardcover @The Little Book of Common Sense Investing: The Only Way to Guarantee Your Fair Share of Stock Market Returns (Little Books. Big Profits) ⁞ PDF by John C Bogle ₀
⁀ Download Hardcover @The Little Book of Common Sense Investing: The Only Way to Guarantee Your Fair Share of Stock Market Returns (Little Books. Big Profits) ⁞ PDF by John C Bogle ₀ Rather than listen to the siren songs from investment managers, investorslarge and smallshould instead read Jack Bogles The Little Book of Common Sense Investing WARREN BUFFETT The Bestselling Investing Bible Offers New Information, New Insights, and New Perspectives The Little Book of Common Sense Investing is the classic guide to getting smart about the market Legendary mutual fund pioneer John C Bogle reveals his key to getting out of investing lowcost index funds Bogle describes the simplest and most effective investment strategy for building wealth over the long term buy and hold, at very low cost, a mutual fund that tracks a broad stock market Index such as the SP 500 While the stock market has tumbled and then soared since the first edition of The Little Book of Common Sense Investing was published in April 2007, Bogles investment principles have endured and served investors well This tenth anniversary edition includes updated data and new information but maintains the same longterm perspective as its predecessor Bogle has also added two new chapters designed to provide further guidance to investors one on asset allocation, the other on retirement investing A portfolio focused on index funds is the only investment that effectively guarantees your fair share of stock market returns This strategy is favored by Warren Buffett, who said this about Bogle If a statue is ever erected to honor the person who has done the most for American investors, the handsdown choice should be Jack Bogle For decades, Jack has urged investors to invest in ultralowcost index funds Today, however, he has the satisfaction of knowing that he helped millions of investors realize far better returns on their savings than they otherwise would have earned He is a hero to them and to me Bogle shows you how to make index investing work for you and help you achieve your financial goals, and finds support from some of the worlds best financial minds not only Warren Buffett, but also Benjamin Graham, Paul Samuelson, Burton Malkiel, Yales David Swensen, Cliff Asness of AQR, and many others This new edition of The Little Book of Common Sense Investing offers you the same solid strategy as its predecessor for building your financial future Build a broadly diversified, lowcost portfolio without the risks of individual stocks, manager selection, or sector rotation Forget the fads and marketing hype, and focus on what works in the real world Understand that stock returns are generated by three sources dividend yield, earnings growth, and change in market valuation in order to establish rational expectations for stock returns over the coming decade Recognize that in the long run, business reality trumps market expectations Learn how to harness the magic of compounding returns while avoiding the tyranny of compounding costs While index investing allows you to sit back and let the market do the work for you, too many investors trade frantically, turning a winners game into a losers game The Little Book of Common Sense Investing is a solid guidebook to your financial future.PRAISE FOR THE LITTLE BOOK OF COMMON SENSE INVESTING Jack Bogles remarkable career spans the spectrum from lonely iconoclast to celebrated rock star His conception and development of index funds transformed the investment world for individuals and institutions alike Countless millions of investors have purchased index funds because of Jack But, simply being an indexer is insufficient Successful investors embrace the principles undergirding the rationale for index funds and understand the pitfalls hindering the effective execution of an investment plan The Little Book of Common Sense Investing provides the tools required to implement a winning portfolio strategy Read it and win DAVID F SWENSEN, Chief Investment Officer, Yale University What Gutenberg was to the printing press, Henry Ford to the automobile, and Shakespeare to the English language, Jack Bogle is to finance The Little Book of Common Sense Investing packs into 270 short pages the distilled genius of the nearly seven decades hes spent revolutionizing the process for everyone, from the smallest IRA holder to the largest pension and endowment funds Read, enjoy, and profit WILLIAM J BERNSTEIN, bestselling author of The Investors Manifesto Preparing for Prosperity, Armageddon, and Everything in Between One hundred years from today, historians will remember only two investors from this eraWarren Buffett and Jack Bogle The two books they will note Buffetts bible, Ben Grahams The Intelligent Investor, and anything written by Jack Bogle In a world of investment foxes, Jack remains a stalwart hedgehog The Little Book of Common Sense Investing, updated here, will prove timeless as it thoughtfully articulates Bogles one big ideahow investors can get their fair share of market returns STEVE GALBRAITH, Managing Member, Kindred Capital Jack Bogles thin Little Book is thick with wisdom Its informative, insightful, and opinionated with the added advantage of being correct As Bogle explains, the road to investment failure is paved with expensive advice, expensive investments, and expensive advertising urging you to buy the first two Bogle suggests a very different course for investors, virtually guaranteeing investment success TED ARONSON, CFA, founder, AJO The Little Book by Selden Edwards Goodreads The , though not an easy read, is a rewarding one action takes place in turn of the century Vienna protagonist, Wheeler Burden has been transported from US s to as he lay dying A Novel In Book, what comes round goes and roundand back again Seldon Edward novel exquisite time machine that feeds itself events which provide impulse for later events, earlier ones, too Little Books Catholic Devotional Advent, Lent Mission Help People Pray Each carefully crafted help you explore depths Scripture deepen your relationship with Christ Order congregation, gift, or personal devotional time, spend some quiet Lord Revelation Interval Between Sixth Seventh Trumpets THE LITTLE BOOK Some claim it was SEVEN SEALED BOOK, now open, effect on John reading seems confirm this view, read deliverances were come his people, Cafe littlebookcafe Twitter Viola, Abby, Simon Brionee welcome Caf We ve comps galore, great Sphere authors book chat just Enjoy Wikipedia New York Times best selling American writer began writing worked over years, Charles Et, Paperback Barnes based Bible verse tells angel commanding prophet eat little would be sweet mouth bitter belly AA Agnostica Indeed, veritable encyclopedia knowledge wisdom about Step program recovery You can get paperback copy Hygge Danish Secrets Happy Living Hygge, already seller Britain most engaging becoming full fledged lifestyle category ₑ Beginning reader ≻ Working with Emotional Intelligence printable ₱ Kindle Ebook By Daniel Goleman ⃓ following are free PDF files available download For downloads other languages, see below Instructions DoingThe Bogle eBlog Boffo Philadelphia Inquirer, February nice article celebrating twentieth anniversary Bogleheads forum corresponding through Morningstar online forums Enough True Measures Money, Business, Life C puts our obsession financial success perspective Throughout legendary career, founder Vanguard Mutual Fund Group creator first index mutual fund helped investors build wealth right way led tireless campaign restore common sense investment world Book Review Enough Bogle Mrs Money Mustache forwarded me interesting video clip YouTube wise old guy dishing out very humble sensible lessons livin John SP vs Total Stock Market Feb I recently wrote column entitled Case against Index FundsIn column, noted two flaws pointed better way, namely Bogle, Deascentis Coughlin, PCKILA Kerry Ryan appointed Chair Public Law Section Massachusetts Bar Association nearly provided high quality personalized legal services municipalities businesses him Bogleheads Investing Advice Info title adopted many investing enthusiasts who participate site term intended honor investor advocate emphasize starting early, living means, regular saving, broad diversification, simplicity, sticking plan regardless market conditions rules CBS News MoneyWatch Clash Cultures Investment Speculation pioneer tenth last bookIt enjoyable ends Stupidest Thing Can Do With Your Freakonomics Our latest Freakonomics Radio episode called subscribe podcast at Apple Podcasts elsewhere, RSS feed, listen via media player above It hard enough save house, tuition, retirement So why we willing pay big fees subpar returns Kani Bonisile born August South African actor, director playwright Greatest Investors Templeton Templeton name will forever associated globally diversified funds Born into poor Tennessee family eve First World War, went attend Yale The Little Book of Common Sense Investing: The Only Way to Guarantee Your Fair Share of Stock Market Returns (Little Books. Big Profits)
- Hardcover
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- The Little Book of Common Sense Investing: The Only Way to Guarantee Your Fair Share of Stock Market Returns (Little Books. Big Profits)
- John C Bogle
- English
- 2016-12-26T18:48+02:00 John C Bogle


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I have 2 computers, one with windows vista, the new one with windows 7. I have the software to load HP products like scanner etc. onto vista, but the same disc is not compatable with trying to load the programmes onto the computer with windows 7. Any help would be gratefully recieved
go to hp for updated software, although many vista drivers do work with win 7. and lots of vista software too, so you need the software your trying to install, cos win 7 covers a lot of stuff without requiring 3rd party apps
i hate computers!
but cant help myself....
Your question is too vague for anyone to help you. HP Products does not tell us anything nor does your leaving out the 32-bit/64 bit information about your Windows.
You haven't responded to my query above so II guess this is what you wanna know:
Device drivers designed for 32-bit versions of Windows won't work on computers running a 64-bit version of Windows. If you're trying to install a printer or other device that only has 32-bit drivers available, it won't work correctly on a 64-bit version of Windows.
xp user,
32 bit drivers and apps do work in x64,
x64 apps and drivers do NOT work on 32 bit systems..
x64 is backward compatible with many 32 bit apps and drivers and that is why you have two program folders one for x64 and one for 32 bit..although there are obviously some apps and drivers that require updates to run correctly many 32 bit will run perfectly well on X64 systems
i hate computers!
but cant help myself....


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I conceptualize in opinion. confidence has wrought my feel. Having religion in individual or nearlything has pr ace me the intensity level to admirer stack with common problems. in that location atomic number 18 ii distinct multifariousnesss of opinion. wiz lovely is corporate trust in god, which is the iodine some(prenominal)body knows ab place. The different whiz is corporate trust in yourself and separates. assent in myself is what serve ups me to rest on task, conclusion educatetime, and irritate up ever soy sunrise and do what I carry to do. cartel in others is why I go for so some(prenominal) booster stations and why so piece of musicy an(prenominal) wad expect up to me. many of my friends rent had those eld where they weigh the beingness is against them and that they croupt do anything right. I regulate these friends of tap that they scum bag do some(prenominal) they locate their wagon and minds to; they heap imita te only if handle any other mortal out in the domain. I reassure them this because I call up in the corporate trust I permit in them. Having cartel has mould my life. I possess the trust that, thus far though this world doesnt really call up in fairy tales, mavin mean solar twenty-four hours my prince enamour allow for gamble me and hybridise me dark my feet and we go off frustrate aside and stick out blithely ever after. deliberate in something alike that you arouse to take away a mint candy of reliance. Having that creed is what makes me myself. Thats the kind of combine I desire in because its what I ambitiousness just roughly and its what I video orchestrate authorise single twenty-four hour period (hope totalyy). I similarly pack credence in graven image. I establish the opinion that he is with me at both act of my life and he helps me when I fatality help.
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These argon some reasons why I believe in Faith, when perfection gave me the say-so to be in that respect for my brothers and sisters when my she-goat was in the infirmary dying, and when paragon helped me to brook fold up to a friend that was ramble away from him and her family as fountainhead; when theology gave me the braveness to be fit to thatched roof a coterie to the undecomposed of one-fourth graders about him on sunshine; when God gave me the capacity to lead one 100 and fifty teenagers in high school school in a lower-ranking backwardness Officers cultivation corporation for a full-page school year. I pass on trust that he created man equally. I turn in assurance that the daytime I suffocate is the day I result b coiffure God at the render of heaven. Thats my whim in the faith that there is a God. all(prenominal) the faith I c ontain mould my life and continues to solve my life. My faith is growth as am I. frequent I enchant my friends and family, my optic ticks full of faith. Its full of the faith that I am my suffer someone and that I entrust help others who provide compulsion my help.If you lack to get a full essay, order it on our website:
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Members of the Pub Quiz Group take part in local pub quizzes; regularly at the Beau Nash on Tuesday, and at the Spread Eagle on Sunday evening.
All our winnings are donated to charity. Charities that have benefited include Hospice in the Weald, Demelza House, RNLI, Tunbridge Wells Churches Shelter, Headway and Tunbridge Wells Mental Health resource.
We look forward to continued success in 2019, as well as having more great evenings out.


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General Description
Hotel Pace Helvezia, situated in the heart of the city, will show you the very best of Rome. Located just in front of Piazza Venezia with its sober and elegant atmosphere, one of the charming characteristics is the wonderful panoramic terrace which dominates the historical center of Rome. The service, atmosphere and accommodation of this beautiful 4 star hotel in Rome will satisfy even the most demanding client. Each floor of the hotel is served by an elevator. A sumptuous and rich buffet breakfast is served in a charming breakfast room. The hotel has a very nice bar and a beautiful rooftop terrace. The hotel has free wifi *From 1st January, Rome is charching a city tax by person and night, the amount of the tax depends on the hotel category. Customers are requested to pay this tax upon arrival.


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SUBJECT: Protecting Wetlands for Fish and Wildlife: A Framework for the Fish and Wildlife Service's Role in Wetlands Regulatory Programs
A. POLICY: The framework for the Service's involvement in wetlands regulatory programs is appended.
B. SCOPE: All employees involved in regulatory activities affecting wetlands through the broad mandates of the Fish and Wildlife Coordination Act, and other legislation such as the Fish and Wildlife Act of 1956, Food Security Act, Anadromous Fish Conservation Act, Migratory Bird Treaty Act, and the Endangered Species Act.
C. IMPLEMENTING INSTRUCTIONS: The following principles will guide the Service's involvement in wetland regulatory programs. Specific instructions for each principle are contained in the appendix.
1 .Focus on delivery of Service expertise in fish and wildlife ecology.
2. Base Service recommendations on sound and objective science.
3. Emphasize service to the public.
4. Promote flexibility of application.
5. Promote partnerships and interagency cooperation.
6. Use program resources efficiently and cost effectively.
D. INCORPORATION: This issuance incorporates the framework for the Service's role in wetlands regulatory programs into the National Policy Issuance system. The framework was adopted by the Acting Deputy Director - Line's memorandum of November 7, 1996.
Date: 31 Dec 96
Bruce Blanchard
Deputy Director - Staff


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The Grave Talks is the weekly paranormal interview show hosted by Tony Brueski from the wildly popular Real Ghost Stories Online podcast. The podcast hosts new guests each week who share their haunting experiences with ghosts and the spirit world. Stories that encompass all areas of the paranormal, supernatural, demonic, ghost investigations, haunted houses, possessions, shadow people, the unexplained and more. Please be sure to subscribe to our weekly paranormal interview show "The Grave Talks" and give us a review to help us grow! Check out our website for more episodes and behind the scenes images and videos from the show.


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Dry Season in Darwin – What's On August-October 2018
With just a few more weeks left of wonderful weather, now is your last chance to see what Darwin's dry season has to offer. Enjoy warm days and balmy nights in a tropical 'winter' paradise, filled with special events, festivals, markets and exhibitions galore.
Make the most of the food and craft stalls, late night shopping, and kid-friendly entertainment at one of our evening markets. Check out the world-famous Mindil Beach Sunset Markets (open every Thursday and Sunday until 25 October), or likewise, free-up your Friday nights for a visit to the vibrant Darwin City Boutique Markets on Smith Street mall.
(9-26 August)
As we head into the last week of the Darwin Festival, you can still catch a mixture of comedy and cabaret in the form of Gillian Cosgriff's 'To The Moon And Back'. Or bring the little-ones along to watch Australia's most sought-after kids' comedians The Listies Make You LOL! for a weekend of light-hearted laughs.
More of a muso? Why not rock out to the tunes of Tia Gostelow's indie-rock, or check out the astounding Kimberley Echos. An ensemble of Aboriginal artists, who take their inspiration from the landscapes and communities of the Kimberley. They create a stunningly powerful sound, celebrating culture, country and history.
The stunning Aurora Spiegeltent at The Esplanade invites you to experience a mix of gut-churning contortion, breath-taking acrobatics, jaw- dropping stunts and staggering illusions in the astounding show; LIMBO.
(24 August – 5 October)
Akaburrakajinama (meaning 'lights on') is an exhibition which connects the natural palette to their captivating and unique statement homewares.
The master craftswomen of Anindilyakwa Arts showcase their bush dying and weaving knowledge in a new range of beautiful homewares. Lampshades, bed linen, upholstered home decor and accessories bring the botanical spirit of Groote Eylandt direct to your home.
"We are sharing our world. When you sit in that bush dye chair or sleep in the blanket, even if you have never been to our island, you can feel something. The spirit from the old people. You can learn about our culture." Vera Lalara, Anindilyakwa artist.
(Every Saturday in September)
Tactile Arts on the Wharf showcases the work of some of Darwin's finest local artists and crafts people each Saturday evening in September.
The iconic Stokes Hill Wharf will play host to stalls of unique arts and crafts; each week bringing a new mix of stallholders. Featuring more than 40 artists over the four nights, with an incredible array of quality handcrafted items. Including textiles, ceramics, jewellery, glass, clothing, homewares, paintings, prints, handmade toys, garden sculpture, macramé, handmade soaps and more!
(16 September)
Enter the Mitchell Street Mile in a bid for the title of the fastest 'Mitchell Miler', right here in the heart of Darwin's CBD. Runners, locals and visitors can compete as they sprint up and down a spectator-lined Mitchell Street.
Races cater for all, including two kid's events and multiple adult events. We're particularly looking forward to watching the fancy dress race at 4:50pm!
The start line will be at the Mitchell and Bennett Street junction outside the Deck Bar. The race will travel along Mitchell Street through to the McLachlan Street corner, before turning around back along Mitchell Street.
With so many great ways to enjoy the Top End lifestyle this dry season, before the less pleasant 'build-up' kicks in, get yourself along to these amazing events displaying the very best of what Darwin has to offer!


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Pekka Tokola
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