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Showing this evening, a fresh cast of crew feature in the ever-popular TV series Below Deck for its fourth season. This time, the drama will be taking place on the 46m/150ft motor yacht 'Ionian Princess' in the Mediterranean.
Whilst we've had a previous season in the Bahamas, and the debut season in the Caribbean, Below Deck Mediterranean will follow a highly entertaining crew as they carry out their duties on luxury charter vacations taking place in Greece.
Unlike the pseudo names used for yachts in earlier seasons, superyacht Ionian Princess reveals her true identity, and is currently available to rent from €145k to €165k (approximately $162k - $185k) per week this summer in Greece, Turkey and other popular areas of the West Mediterranean such as the French Riviera, Corsica and Sardinia.
Like the yacht in Below Deck season 3, Ionian Princess features an impressive variety of amenities sure to keep every kind of guest satisfied.
As we prepare ourselves for some more suitably amplified drama on the water, why not take a look inside the Below Deck Mediterranean yacht.
Sophisticated and full of the latest features, Ionian Princess is sure to keep the cast of Below Deck Mediterranean busy this season
The interior of Ionian Princess is highly opulent, with a sleek black and gold colour scheme running throughout all of the social and private spaces.
With glossy mahogany adorning the walls throughout the yacht, she is effortlessly classy, meaning that the cast of Below Deck Mediterranean will have their work cut out for them when attempting to deliver the kind of premier service which befits her design.
Like the yacht in Below Deck season 2, Ionian Princess is presently for sale, with a current asking price of just over $16m.
As much about entertaining as she is accommodating for her elite guests, the yacht in Below Deck Mediterranean features a private study attached to the expansive master suite.
For relaxing, her main salon is outfitted with an impressive arrangement of seating and sofas for all the guests to unwind in- a spot the Below Deck cast will become familiar with as they serve up some drinks after hours.
Likewise, the highly formal dining space demands a five-star dinner service when it comes to mealtimes, a challenge the crew will no doubt have to step up to if they're to keep their guests satisifed.
As well her elegant and highly furnished interior, luxury charter yacht Ionian Princess has one of the largest sundecks for a yacht of her size.
Complete with a Jacuzzi situated on the upper deck, guests are able to enjoy unobstructed views from a truly enviable position. Similarly, the impressive range of al fresco dining options mean that meals can be enjoyed in the shade, with a cool sea breeze- the only way to eat in the Mediterranean, obviously.
At the rear end of the yacht, guests are able to effortlessly board a number of Jet Skis, dive into the water with snorkelling gear, or even climb aboard a kayak to set out exploring for themselves.
In order to make arrangements for a vacation on-board M/Y Ionian Princess, you'll need to get in touch with your preferred charter broker.
Alternatively, take a look at all luxury yachts in the Mediterranean.
- In pictures: Inside Abeking & Rasmussen M/Y EXCELLENCEHer award-winning, spaceship-style exteriors have been the subject of much acclaim, but her interiors have been kept cl...
- Where are the brand new yachts of 2019 chartering this winter?Whether you're looking to ring in the New Year in St Barts or explore the turquoise oasis of the Indian Ocean by yacht,...
- Where can I charter a yacht in the Bahamas after Hurricane Dorian?YachtCharterFleet brings you the latest information on the current state of the Bahamas and up-to-date advice on where ...
- Seychelles yacht charter special offered by 60m luxury yacht 'St David'Escape to the Maldives and the Seychelles and enjoy no delivery fees when you charter the 60m/197ft motor yacht 'St Dav...
- World's largest superyacht REV arrives in Norway for outfittingThe world's largest yacht, the 183m/600ft expedition yacht REV has completed her journey to Norway, where she is set to...
- 111m superyacht TIS: 33rd largest yacht in the world now for charterLurssen's 111m/364ft motor yacht TIS is now available for crewed yacht charters in the Mediterranean.


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Sometimes, there are excellent reasons for buying a house on your own.. So it would make sense to put the mortgage in your own name if you can. paid at least .125 percent less by having the more qualified buyer apply alone.. Your home is an asset which can be liened or confiscated in some cases.
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Singer, Inetimi Odon, popularly called, Timaya is a year older today. He shared a photo of himself flaunting his Bentley on Instagram.
In one of the photos, the DM Records founder is seen starring at himself in the mirror, and in the caption, he told himself, "Happy birthday boss… I always want to work hard like you."
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Timaya acquired his 2019 Bentley in 2012.


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Count Your Blessings
This painting was one of my first of 2016. The starting of a new year is always a time for me to take stock and be grateful for my life, past and present. The beginning of this year was scary for me, I had an operation that I did not look forward to coming up in the beginning of 2016 but instead of focusing on this I decided to be grateful for all of the greatness in my life. I often look at the new year as a chance to start a new, to TRANSFORM the parts of my life I am not happy with but this year I really did just count my blessings and was truly grateful for my life just as it was. Sometimes what can seem very scary or negative can change our perspective on what is truly important in our life.
Here's to transforming gracefully from one year to the next.
I am truly looking forward to 2017.
This 12″x 12″(1.5″ deep sides,painted red or turquoise) mounted reproduction will be available in the upcoming 'transformation' auction on Jan 4-5, 2017. To get involved with bidding on this piece and the below original painting GO HERE
Auction Give Away
To get involved in the give away for the upcoming auction 'Transitions' go HERE and read the way you can win a set of 10 postcards and a brooch of the painting 'My Protector"
Winter Garden
This is a 8″x24″ mixed media painting on paper covered canvas. The sides are 1.5″ deep and are painted turquoise.
This painting will be available in the upcoming auction "Transformations" for "The Heartful Soul Artist Collective" in January 2017. For more info, please go HERE
In Edmonton we don't usually have much of a fall. We go from summer into winter, often pretty suddenly. I always find it shocking, even though I have lived here form more than 20 years. Like my garden being covered in snow before the leaves are even raked, I look at Imogen and Scarlett (who I have a few more baby years with) and just want to freeze the frame for just a moment so I can catch my breath. Life is ever changing. I have really found this true for the last few years. I can hardly believe how fast they have gone. I look at my 13 year old daughter and ask "who is she?", I look at myself int he mirror and ask the same thing. Like my garden, my dark hair has faded and looks like it is topped with hoar frost. These transformations are so difficult. Turing from a little girl into, I hesitate to even say it … a woman, is painful, confusing and frustrating. I struggle to watch her as she strives to grasp all the things that are happening to her, both physically and mentally. And I go through my own struggles with a body I don't even recognize between weight gain and a double mastectomy. Side by side, we are transforming. We seem to walk parallel to one another, occasionally, and rarer and rarer lately, meeting.
The Winter Garden
I catch my breath in the cold air,
Poppy pods wear little snowy crowns,
Hops cascade down the trellis like a frozen waterfall,
Sunflowers face the sky like frosted treats,
I pause.
Winter .
I stop long enough to see my breath …
But only just.
Maria Pace-Wynters
Heartful Soul Artist Collective Monthly Auction
I am so happy to announce that in the following year I will be a new member of the artist collective, "Heartful Soul Artist Collective Monthly Auction" https://www.facebook.com/groups/1081400241910524/
Sadly Kara Strachan Bullock, Lucy Brydon and Angela Kennedy are taking time off to explore other areas of their careers but will be back as invited guests.
The group collective is made of the following artist:
Marie Ndolo, Olga Furman Annie Hamman, Renata Loree, Lauren RudolphKatrina Koltes, Sara Burch, Lynda Fortin King, Jennifer Bonneteau, Lara Provost.
Please join the group or ask me for an invite on Facebook. "Heartful Soul Artists Collective Monthly Auction" 2017! Our next auction will be January 4th and the theme is 'transformation'.
Thanks you!
January AuctionTheme: Transformation
The theme for the first auction of 2017 will be 'Transformation'.
If you would like more info check out the Facebook page HEARTFUL SOUL ARTIST COLLECTIVE here.
Below are just a few of the paintings that will be available to bid on:
This is the first painting I am working on for the January auction:
Winter Garden Slice
These long tall paintings are so hard to document. It just looks so much better in person. Oh well.
3″ x 30″ mixed media painting on wood. The sides are 1.5″ deep and are painted turquoise.
This painting is available HERE
One kind word can warm three winter months. ~Japanese Proverb
Winter Wonder
5″x7″ mixed media painting on wood. The sides are 1.5″ deep and are either painted red or turquoise.
This painting is available HERE
Nature looks dead in winter because her life is gathered into her heart. She withers the plant down to the root that she may grow it up again fairer and stronger. She calls her family together within her inmost home to prepare them for being scattered abroad upon the face of the earth. ~Hugh Macmillan, "Rejuvenescence," The Ministry of Nature, 1871
Wrap Up Party …Holiday Auction
December 13 is the day of the wrap up party for the Holiday Auction. Please stop by, There are plenty of paintings that have not been snapped up and can be purchased at the starting bid price.
My following paintings are still available for purchase:
To Join the fun, go HERE.
If you would like to be tagged on Facebook for a specific painting, let me know. I'd love to send all of these babies to new homes and help me pay for a heater in my new studio! BRRRR! BABY, IT'S COLD INSIDE! ha, ha!
Also, tomorrow, Dec 12, the very special artist, Jodi Ohl is the featured artist. Please go and check out her amazingly beautiful paintings!
Little Winter Poppy Garden
This little painting is 3″x6″ mixed media on wood. This painting is flat and will need to be matted and framed by you.
This painting is available HERE
Winter Poppies
8″x8″ mixed media painting on wood. This painting will need to be framed and matted by you.
This painting is available HERE
It is so cold outside. It is so cold in my studio. I am actually working with my coat on! Brrrr. The only thing, and I mean the only thing, that I like about snow is how pretty everything looks. I never pull out the dead flowers and hops, they look so pretty with snow and frost dusting them all in white sparkles.
Make love now, by night and by day, in winter and in summer… You are in the world for that and the rest of life is nothing but vanity, illusion, waste. There is only one science, love, only one riches, love, only one policy, love. To make love is all the law, and the prophets.
Read more: http://www.searchquotes.com/quotation/Make_love_now%2C_by_night_and_by_day%2C_in_winter_and_in_summer…_You_are_in_the_world_for_that_and_the/19999/#ixzz4SHl9FGjB


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Hide Details
2019 Sunset Plaza Dr. Los Angeles, CA 90069
- 3 Beds
- 3 Baths
- 5,605 Lot Size
2019 Sunset Plaza Dr.
Situated in LA's most iconic neighborhood just above the legendary Sunset Strip, this stunning 3,000sf+ home offers unobstructed views of Century City, the ocean, and Catalina Island. An additional 1,500sf+ lower level could be converted into livable space for a total of more than 4,500sf. Elaborate Saltillo tile work and hardwood flooring throughout the house complement the cathedral beamed ceilings flowing from the living room to the dining room area. The elegant kitchen is accented with Portuguese tile with a large breakfast area and a matching half bath. The master suite allows ample natural light through floor to ceiling windows and boasts a spacious walk-in closet. The master bath features exquisite Italian marble, dual sinks, and a spa shower. Terraces overlook the yard, which offers enough space for a new pool or spa. 2-car garage and ample street parking along with a spacious front patio.
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Three Lines in History
Logline: October 28, 1942. The date of the second deportation at the Krakow Ghetto when thousands of Jews were sent to certain death. A group of young Jews unites to fight an undefeatable foe. To fight for revenge. To avenge the deaths of their parents, brothers and sisters. One of their leaders rises. "I stay and fight not just for Jewish Honor…. Not just to avenge the dehumanization of our people…. I fight for our three lines in the history books so the world will one day read there were some Jews who fought back….. There were some Jews who stood up against the slaughter of their people."
Written by Mark Easton


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Do Ketogenic Diets Assist You Shed weight?
The ketogenic, or keto, diet regimen is a low-carb means of consuming that has actually been taken on by several wanting to lose weight as well as boost health. The Atkins diet regimen trend of the early 2000s entailed a strict initial two-week ketogenic phase prior to switching over to a low-carbohydrate program. By not eating, you're permitting inflammation to quiet down in your body, which aids with blood sugar level equilibrium and also weight loss. Picture this: You're on a new diet, but as opposed to sensation hangry and also denied, you're brimming with power, your blood sugar level is stable, as well as the weight is thawing off.
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He has because lost more than 100 pounds as well as is complying with a ketogenic diet. When chatting regarding their keto weight loss journeys, they all made use of some comparable techniques. As an example, some strategies combine everyday not eating with a ketogenic diet regimen. However, it's entirely feasible to eat a lot of calories on a ketogenic diet plan by consuming portions that are also large or by snacking on high-calorie foods throughout the day.
Recap When adhering to any kind of diet regimen, it's important to develop a calorie deficit to promote fat burning. After that preliminary transition from burning sugar to fat (I talk more regarding potential challenges including the keto flu here ), they have a lot more power, feel more psychologically concentrated, and no longer obtain sidetracked by hunger as well as cravings that formerly delayed weight loss.
One point is speaking about doing the keto diet, another is, to begin dropping weight and also take pleasure in the many advantages. For several of us, it is not constantly that simple to get to and remain in ketosis, where we are dropping weight. It is why it is very recommended to obtain some BHB salts, like Purefit keto address to make your keto diet plan more efficient.
I see these obstacles happen more often with ketogenic diet plans compared with other strategies. Hypothyroidism, polycystic ovarian disorder (PCOS), Cushing's clinical depression, hyperinsulinemia and also disorder (high insulin degrees) are medical problems that can cause weight gain as well as make it hard to lose weight (,,, ). Whatever nutritional strategy comply with, the secret to healthy weight management is to eat nourishing, whole foods.


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Healthy competition is vital, however crucial to players development is an atmosphere where players feel comfortable and confident to take risks and try new things without fear of recriminations from coaches or team mates when they make mistakes.
Parent Stephen Syrett said 'Our son's experience with NCF Elites has been hugely positive not only in terms of advancing his footballing skills but also his wider personal development. Intensive, well-planned training sessions combined with strong individualised support and mentoring quickly produced notable improvements in skills, tactical awareness, personal fitness and confidence'.


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1. Introduction
An increased risk of venous thromboembolism (VTE) is a known risk with some forms of hormonal contraception and this is an important consideration when health care providers (HCPs) counsel patients about contraceptive options. A patient's medical history may indicate an increased personal risk for VTE; thus HCPs need to know what level of risk the patient's history imparts and the impact of various contraceptive methods on that individual's risk. No single contraceptive method will be a suitable fit for all women so HCPs need to understand the range of available contraceptive options and, with the woman, need to consider the benefits and risks of each.
VTE remains a major cause of morbidity and mortality worldwide. Some estimates suggest that in the USA alone close to 1 million people are affected each year. Of these, deep vein thrombosis (DVT) resulting in pulmonary embolism (PE) kills approximately 60,000 people per year. One quarter of cases of PE present with sudden death and as many as 1/3 of cases die within a month of diagnosis. Among people who survive DVT, one-half will have long-term complications (post-thrombotic syndrome) such as swelling, pain, discoloration, and scaling in the affected limb. These statistics reflect all cases of VTE, many of whom are elderly, immobilized or have major co- morbidities such as obesity or cancer [1] .
Some forms of hormonal contraception are known to be a risk factor for VTE [2] . Because these methods are used by an estimated 100 million women worldwide (10 million in the USA), even though the absolute risk is small, they have the potential to be a significant contributor to overall VTE numbers.
Hormonal contraception is typically used in women ages 12 - 50 and the background rate of VTE in this population varies considerably in published data. In 2007 Heinemann and Dinger published a review of the range of baseline estimates of VTE in this population. They suggested that the variation in quoted risk was partly due to differences in methodology as well as definitions of VTE and the sensitivity of diagnostic tests over time. However they concluded in their analysis that the true incidence in women not using hormonal contraception was approximately 4 - 5 per 10,000 women years [3] .
This article will highlight important clinical considerations for HCPs with regard to VTE risk and contraception. It will start with a review of risk factors for VTE, including the inherited thrombophilias, followed by a review of contraceptive options and their expected influence on VTE risk.
2. Risk Factors for VTE
Traditional teaching about VTE focused on the triad of endothelial dysfunction, hypercoagulability, and hemodynamic changes such as stasis or turbulence. Labeled "Virchow's triad" in the 1950's, long after Virchow's death in 1902, it recognized his important discovery of the association between DVT and PE in 1856. In recent years our understanding of risk factors for DVT has grown steadily.
Risk factors for VTE may be inherited or acquired, and some are modifiable. Evidence suggests these risks related to hormones may act synergistically and in some cases may actually be super additive [4] [5] [6] .
2.1. Pregnancy
Pregnancy is a time of significant risk for VTE even in healthy young women [7] [8] [9] . While the absolute risk of a pulmonary embolism during pregnancy or postpartum is low, pulmonary emboli remain one of the leading causes of maternal death in developed countries [10] [11] . Some studies suggest that the days around delivery bear the highest risk [12] [13] . The MEGA (Multiple Environmental and Genetic Assessment of risk factors for venous thrombosis) study found that the risk of venous thrombosis was 5-fold increased during pregnancy (OR, 4.6; 95% CI, 2.7 - 7.8) and 60-fold increased during the first 3 months after delivery compared with non-pregnant women (OR, 60.1; 95% CI, 26.5 - 135.9) [14] . Translated into women years, per 10,000 women 29 events would occur in pregnancy and over 300 in the postpartum period [15] .
2.2. Obesity
Obesity is an independent risk factor for VTE. Lifestyle and socioeconomic factors have been linked to the increasing prevalence of obesity in the North American population. Obesity defined as a body mass index (BMI) of greater than 30 kg/m2, is associated with an increased risk of thrombosis [16] [17] . Tsai et al. found that the hazard ratios for BMIs greater than 30, 35, and 40 after controlling for age, sex, and race were 2.23 (95% CI 1.5 - 3.11), 1.52 ((5% CI, 0.78 - 2.96), and 2.71 (95% CI, 1.26 - 5.84), respectively. Similar results were obtained in the Copenhagen City Heart Study with a hazard ratio for VTE in individuals with BMI > 30 (compared to BMI < 20) being 2.10 (95% CI, 1.39 - 3.16). In the case-control PILI Genetic Risk monitoring (PILGRIM) Study, Suchon et al. found an Odds ratio of 3.46 (95% CI, 1.81 - 7.03) for patients with a BMI over 35 [18] .
2.3. Polycystic Ovary Syndrome
Women with polycystic ovary syndrome (PCOS) may have the added burden of a genetic risk for weight gain, and may also have an increased risk of VTE above what would be expected based on BMI alone. Women with PCOS, many of whom are prescribed hormonal contraceptives for the non-contraceptive benefits of menstrual regulation and suppression of hyperandrogenism [19] , have increased baseline risk for VTE. Among women aged 18 - 24 with PCOS the adjusted odds ratio for VTE was 3.26 (95% CI, 2.61 - 4.08) [20] . In another population-based cohort study examining VTE risk among women with PCOS who were not using hormonal contraception the relative risk of VTE compared to non PCOS subjects was 1.55 (95% CI 1.10 - 2.19) [21] . This risk of VTE in women with PCOS may be further augmented by exposure to hormonal contraceptives [4] [21] [22] .
2.4. Trauma, Surgery and Immobility
Trauma [23] , surgery [24] and immobility [25] all elevate the risk for VTE although the extent of risk depends on the numerous factors such as type and length of surgery [26] , use of anticoagulation [27] [28] , degree or duration of immobility, etc.
2.5. Malignancy
Malignancy also poses a risk for development of VTE and although most patients will have a known cancer diagnosis prior to a thrombotic event, occasionally this diagnosis is made thereafter [29] [30] [31] .
2.6. Chronic Medical Conditions and Smoking
Chronic medical diseases and smoking may be linked to an increased risk for VTE but the evidence, to date, is conflicting. One meta-analysis of cardiovascular risk factors found the risk of VTE was 2.33 for obesity (95% CI, 1.68 to 3.24), 1.51 for hypertension (95% CI, 1.23 to 1.85), 1.42 for diabetes mellitus (95% CI, 1.12 to 1.77), 1.18 for smoking (95% CI, 0.95 to 1.46), and 1.16 for hypercholesterolemia (95% CI, 0.67 to 2.02) [32] . While smoking was not statistically significant in this analysis, other individual studies have suggested an increased risk. The MEGA case control study demonstrated an Odds Ratio for VTE in current smokers of 1.43 (95% CI, 1.28 - 1.60), while former smokers had an Odds Ratio of 1.23 (95% CI, 1.09-1.38). Heavy smokers with a ≥20 pack-year history had an Odds Ratio of 4.30 (95% CI, 2.59 - 7.14), and women who smoked while using combined hormonal oral contraceptives had an Odds Ratio of 8.79 (95% CI, 5.73 - 13.49) [33] . In the case-control PILI Genetic Risk monitoring (PILGRIM) Study, Suchon et al. found an Odds Ratio for smokers of 1.65 (95% CI, 1.30 - 2.10) [18] .
2.7. Air Travel
Air travel has also been identified as an important contributor to VTE, likely due to a combination of cramped seating, immobility, hypoxia and dehydration [34] . In the MEGA study [35] Cannegieter et al. found an overall Odds Ratio of 2.1 (95% CI 1.5 - 3.0), and they estimated that the odds ratio for women using combined oral contraceptives could be as high as 20-fold. In a case control study, Martinelli et al. also found the overall Odds Ratio to be 2.1 (95% CI, 1.1 - 4.0), and for women using combined hormonal oral contraceptives the Odds ratio was 13.9 (95% CI 1.7 - 117.5) [36] .
2.8. Age
Advancing age is an important contributor to VTE risk. During the reproductive years the background rate of VTE is low but steadily increasing [37] [38] [39] . Occasionally combined hormonal contraception is used in older women during the perimenopausal transition to regulate bleeding and reduce intermittent menopausal symptoms. A Dutch case-control study examined the impact of hormonal contraception on VTE in women beyond age 50. The relative risk of venous thrombosis was especially high in women using oral contraception with one or more thrombophilic defects, with an OR of 16.3 (95% CI, 9.2 - 28.9). When the same analysis was performed using family history as a proxy for genetic thrombophilia the results were very similar OR 14.2 (95% CI, 6.7 - 30.0) for oral contraception use [40] .
2.9. Blood Type
For patients with non-O blood type (compared to O blood type), the risk of VTE is elevated. A cohort study by Sode et al. determined that the hazard ratio for VTE is 1.4 (95% CI, 1.3 - 1.5) and there is an even greater impact when combined with Factor V Leiden and Prothrombin gene mutations [41] . In the case-control PILI Genetic Risk monitoring (PILGRIM) Study, Suchon et al. found an Odds ratio of 1.98 (95% CI, 1.57 - 2.49) for non-O blood type [18] . In post-menopausal women, non-O blood type is associated with a variety of pro-coagulant changes in coagulation factors when hormone replacement treatment is used [42] .
2.10. Family History
Family history of VTE is an independent risk factor for VTE [6] . When the family history indicates a member with a known VTE the Odds Ratio for a thrombophilia is increased 2-fold (OR 2.2, 95% CI, 1.9 - 2.6) and up to 4-fold (OR 3.9, 95% CI, 2.7 - 5.7) when more than one family member has been affected [43] . Accordingly it is important to confirm whether the affected relative was screened for a thrombophilia and if so, the result of that screening. If an underlying hereditary thrombophilia is present in a first degree relative, or when one or more relatives have a documented VTE (especially under age 50) screening for thrombophilia is generally warranted prior to the initiation of hormonal contraception [6] . Universal screening for thrombophilias for all contraception users is not feasible due to excessive cost [44] [45] however, selective screening for thrombophilias in patients with a family history of VTE may be warranted.
3. Inherited Thrombophilias
Inherited thrombophilias are estimated to affect 5% to 8% of the U.S. population. The level of risk varies according to the type of thrombophilia. Coagulation always necessitates a balance between pro-coagulant and anti-coagulant factors resulting in two ways that a thrombophilia can induce hypercoagulability: a deficiency in anti-thrombotic regulating factors or a gain of function for a pro-coagulant factor.
The inherited thrombophilias include genetic defects in both of these categories, leading to variable degrees of hypercoagulability [43] [46] [47] . Gain of function mutations are more common than deficiency mutations.
3.1. Gain of Function Mutations
Mutations in the Prothrombin (G20210A) gene, or the Factor V Leiden gene lead to hypercoagulability by increasing pro-coagulant factors.
3.1.1. Mutations in the Prothrombin (G20210A) Gene
Prothrombin (G20210A) mutation is present in 0.7% - 4% of the European population, with geographic variation noted [48] . In affected individuals, prothrombin levels can be 30% higher than in unaffected individuals and this leads to increased coagulability. The relative risk of VTE compared to unaffected individuals is 2.8 (95% CI, 1.4 - 5.6) [49] .
3.1.2. Factor V Leiden
Mutation of the Factor V Leiden (FVL) gene affects 1% - 8.5% of the Caucasian population, and is the most common thrombophilia in this population [50] [51] . Also referred to as "Activated Protein C resistance", Factor V Leiden leads to a mutation in Factor V that prevents it from being inactivated by the powerful anti-coagulant factor called Protein C. Heterozygous carriers of the Factor V Leiden mutation have an approximately 7-fold increased risk of VTE compared to unaffected individuals. In a case- control study, Price et al. calculated an Odds ratio of 6.6 (95% CI, 3.6 - 12.0) [52] , and homozygous carriers (who account for only 1% of FVL carriers) are estimated to have as much as an 80-fold increased risk of VTE [53] .
Interestingly, the increased risk of VTE in women who are FVL carriers and who use combined hormonal contraception may be increased to a greater degree than would be estimated based on the relative risks of either risk factor alone. In this context, the relative risk of VTE conferred by these two risk factors may be multiplicative rather than additional. In a case-control study, Vandenbroucke et al. found an Odds Ratio of 34.7 (95% CI, 7.8 - 154) for women with both risk factors, compared to women with neither risk factor [46] .
3.2. Deficiency of Function Mutations
Protein C deficiency, Protein S deficiency and Antithrombin deficiency are rare yet important inherited thrombophilias because they increase the risk of clotting significantly in affected individuals. These thrombophilias result from a deficiency in anti- coagulant factors in the clotting cascade.
3.2.1. Protein C Deficiency
Heterozygosity for protein C deficiency is inherited in an autosomal dominant fashion and affects between 0.2% - 0.5% of the population [54] [55] . However, there is a lot of variation in phenotype and many carriers will be asymptomatic. A retrospective cohort family study determined that the relative risk of thrombosis in carriers of protein C deficiency is 7.3 (95% CI, 2.9 - 18.4) [56] , while a case-control study [57] suggests a relative risk of 6.5 (95% CI, 1.8 - 24). A meta-analysis of observational studies [58] demonstrated an odds ratio of thrombosis of 7.51 (95% CI, 3.21 - 17.52). It should be noted that Protein C deficiency can also be acquired, most often in the setting of severe infection or sepsis.
3.2.2. Protein S Deficiency
Protein S is a cofactor of Protein C and confers an anticoagulant effect on the clotting cascade. Mutations in the gene coding for protein S are inherited in an autosomal dominant fashion. The prevalence of protein S deficiency is between 0.03% - 0.13% [59] . A retrospective cohort family study determined that the relative risk of thrombosis in carriers of protein S deficiency is 8.5 (95% CI, 3.5 - 20.8) [56] , while a meta-analysis of observational studies [58] found a slightly lower odds ratio for thrombosis of 5.37 (95% CI, 2.70 - 10.67). Protein S deficiency can also exist in an acquired form, and may be present in conditions such as pregnancy, oral contraceptive use, disseminated intravascular coagulation (DIC), nephrotic syndrome and liver disease.
3.2.3. Antithrombin Deficiency
Antithrombin (also referred to as Antithrombin III) is a naturally occurring enzyme inhibitor with anticoagulant properties. As its name suggests, it inhibits thrombin, but it also has effects on Factor Xa and Factor IXa in the coagulation cascade.
Hereditary deficiency of antithrombin has a prevalence of approximately 0.02% - 0.2% [60] . A retrospective cohort family study determined that the relative risk of thrombosis in carriers of antithrombin deficiency is 8.1 (95% CI, 3.4 - 19.6) [56] , while a meta-analysis of observational studies [58] found a higher odds ratio for thrombosis of 16.26 (95% CI, 9.90 - 26.70).
4. Contraceptive Options and VTE Risk
When counselling patients about contraceptive options, VTE risk is only one of several considerations. Individualized counselling is needed, to ensure that risks, benefits and patient preferences are all considered.
An important consideration in choosing a contraceptive method is the effectiveness of the method in preventing pregnancy. While barrier methods and natural family planning methods carry no risk for VTE, they also have much higher failure rates than hormonal methods [61] . When considering VTE risk, it must be recalled that pregnancy confers a higher risk of VTE compared to the use any hormonal contraceptive method, and thus the risk of pregnancy must factor in to method selection. In an article by van Vlijmen et al. [62] , mathematical modeling was used to estimate the VTE risk for women with factor V Leiden mutations using combined oral contraceptives, intrauterine contraceptives and male condoms, taking into account the VTE risk associated with the contraceptive method itself, as well as VTE risk due to unintended pregnancies related to contraceptive failure. In their analysis, it was estimated that women with Factor V Leiden mutations who used condoms for contraception have an increased risk of VTE compared to those who used COCs, due to the higher risk of contraceptive failure and consequent pregnancy-related VTE. The authors advocate for a rational approach to contraceptive counselling and encourage HCPs not to unnecessarily deny patients access to effective contraception when the potential for pregnancy is higher in contraceptive non-users or users of less effective methods.
Long-acting reversible contraceptives (LARCs) are the most efficacious and include intrauterine devices and contraceptive implants. The copper IUD and levonorgestrel Intrauterine System (LNG-IUS) provide 99.2% and 99.8% efficacy at pregnancy prevention, respectively [61] and are not associated with an increased risk of VTE [63] [64] . The progestin secreting contraceptive implant has a 99.95% efficacy at preventing pregnancy and also does not increase the risk of VTE [65] .
4.1. Copper Intrauterine Devices (IUDs)
Copper IUDs do not increase the risk of VTE and are very effective at preventing pregnancy. This may be a safe choice for women with VTE risk factors. It should be noted that copper IUDs may increase the risk of menorrhagia and/or dysmenorrhea for some women [66] , and therefore their use may not be acceptable to women using anticoagulation (for example, women with a personal history of VTE and/or a high risk thrombophilia).
4.2. Combined Hormonal Contraceptives
Combined hormonal contraceptives (CHCs), whether pill, patch, or vaginal ring, are known risk factors for VTE [15] [67] [68] . With the introduction of the sub-50 μg estrogen combined oral contraceptives there was a fall in VTE risk compared to older higher dose formulations and because of this the risk of VTE has been largely attributed to the procoagulant effects of estrogen. While lowering of the estrogen dose in newer pills to 10 - 20 μg per tablet may further reduce the risk of VTE [39] [69] there is, to date, no compelling evidence to support this premise. Contemporary combined hormonal contraceptives are estimated to double the background risk of VTE from 4 - 5/10,000 to approximately 9 - 10/10,000 women years [3] [70] .
In recent years an apparent increase in VTE risk associated with the progestin component of combined hormonal contraception has ignited a debate about the validity of the research and the potential for confounding by indication. Third generation progestins have been preferentially prescribed to women with higher baseline risk for VTE because they were thought to confer less metabolic risk. Similarly other progestins with strong anti-androgenic effects (cyproterone acetate and drospirenone) have been preferentially prescribed to women with obesity and androgenic features of PCOS [22] [70] [72] .
Several database studies suggest greater VTE risk with combined hormonal contraceptive products containing third generation progestins (desogestrel and gestodene) and those containing drospirenone than with second generation products containing levonorgestrel. Comparing levonorgestrel to other progestins Lidegaard reported a Relative Risk for desogestrel of 2.2 (95% CI, 1.7 - 3.0), gestodene of 2.1 (95% CI, 1.6 - 2.8), drospirenone 2.1 (95% CI, 1.6 - 2.8) [39] . These studies have been criticized for significant methodological deficiencies [15] [71] [72] . Several higher quality prospective cohort studies have shown no differences in VTE risk between products based on progestin formulation [70] [73] [74] [75] [76] . The International Active Surveillance Study of Women Taking Oral Contraceptives (INAS) study reported a RR of 0.8 (95% CI, 0.4 - 1.5) when comparing VTE rates with drospirenone vs levonorgestrel [75] .
The risk of VTE in women on combined hormonal contraception is greatest in the first months of use [70] [76] and may relate to the uncovering of an, as yet, undiagnosed thrombophilia [77] . Discontinuation of combined hormonal contraception returns the risk of VTE to baseline after the first month [78] .
4.3. Progestin-Only Contraceptives
Progestin-only contraceptives (levonorgestrel Intrauterine Systems (LNG-IUS), implants, injectables, and pills) have generally not shown an increased risk of VTE in users [64] [79] . Two meta-analyses that included studies of all forms of progestin-only contraception have been undertaken, and both show reassuring results. In a meta- analysis by Mantha et al. [64] , the adjusted Relative Risk for VTE for users vs. non- users of progestin-only contraceptives was 1.03 (95% CI, 0.76 - 1.39). A Meta-analysis by Bergendal et al. [79] demonstrated an overall Odds Ratio of 1.45 which was not statistically significant (95% CI, 0.92 - 2.26).
Controversy exists over whether or not there is a possible increased risk of VTE with Depomedroxyprogesterone acetate (DMPA) injections. The WHO Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception [80] , a case-control study, demonstrated a statistically insignificant increased risk of VTE in users of DMPA, with an adjusted Odds Ratio of 2.19 (95% CI 0.66 -7.26), while another case- control study by van Hylckama Vlieg et al. [63] demonstrated an adjusted Odds Ratio of 3.0 (95% CI, 1.2 - 7.5), adjusted for BMI, family history of VTE and smoking status. A meta-analysis assessing the risk of venous thromboembolic events in women taking progestin-only contraception included a sub group analysis of DMPA users that included both the WHO and van Hylckama Vlieg studies which revealed an increased relative risk of 2.67 (95% CI 1.29 to 5.53). The authors concluded that further research was necessary as there were only the two studies included within this subgroup [64] . It should be noted that in these case-control studies there may be residual confounding based on potential for prescription bias (patients with a perceived higher risk of VTE could have been preferentially prescribed DMPA) or indication bias (patients may have been using DMPA for indications other than solely contraception).
Progestin-only pills (POPs) do not increase the risk of VTE. The WHO Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception [80] , a case- control study, demonstrated a non-significant increase in VTE risk with POP use, with an adjusted Odds Ratio of 1.82 (95% CI, 0.79 - 4.22). The Transnational Study on Oral Contraceptives and the Health of Young Women [81] , a case-control study, demonstrated an adjusted Odds Ratio of 0.68 (95% CI, 0.28 - 1.66) for VTE in POP users compared to non-oral contraceptive users. A cohort study by Lidegaard et al. [39] demonstrated an adjusted Relative Risk of VTE for users of Norethisterone POPs of 0.56 (95% CI, 0.29 - 1.07) and an adjusted RR for users of Desogestrel POPs of 0.64 (95% CI 0.29 - 1.42). The relative risk for the subgroup of POP users in the meta- analysis by Mantha et al. [64] was 0.90 (95% CI, 0.57 - 1.45).
Progestin-only implants do not appear to increase the risk of VTE, although there are few published studies on this topic. The follow-up analysis by Lidegaard et al. [65] of the registry-based Danish cohort study on non-oral hormonal contraception included an analysis of users of the subcutaneous etonogetrel implant (Implanon®). The adjusted Relative Risk of VTE (compared to non-users of contraception) was non-significant at 1.40 (95% CI, 0.58 - 3.38).
The Levonorgestrel secreting intrauterine systems (LNG-IUS) do not increase the risk of VTE. A retrospective cohort based study by Lidegaard et al. [65] on non-oral hormonal contraception demonstrated an adjusted Relative Risk of 0.57 (95% CI, 0.41 - 0.81), which suggests a protective effect although a physiological explanation for this is not elucidated. In a case-control study, van Hylckama Vlieg [63] also demonstrated a low risk of VTE in users of LNG-IUS, with an adjusted Odds Ratio of 0.3 (95% CI, 0.1 - 1.3), which also suggests a protective effect but does not reach statistical significance. In a meta-analysis that included both the Lidegaard and Vlieg studies, Mantha et al. calculated relative risk of 0.61 (95% CI, 0.24 - 1.53) [64] .
5. Conclusion
Risk factors for VTE should be elicited prior to prescribing hormonal contraception. A positive family history of VTE may be, and positive family history for a thrombophilia should be, an indication for thrombophilia screening prior to prescribing hormonal options. An individualized risk/benefit discussion and knowledge of a range of contraceptive options should minimize the risk of VTE while affording effective contraception. Non hormonal and progestin-only methods appear to offer the greatest margin of safety.


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https://i1.wp.com/www.playwildhorse.com/wp-content/uploads/2019/06/Flag-1.png?fit=800%2C800&ssl=1 800 800 Wildhorse https://www.playwildhorse.com/wp-content/uploads/2017/03/logo-8.png Wildhorse2019-06-06 13:47:522019-06-06 13:47:5275th anniversary of the Invasion of Normandy
Wild Horse was honored this morning by it's first group of golfers. They decided that in honor of the 75th anniversary of the Invasion of Normandy they would play the Star Spangled Banner to kick off their round. What a tribute and God Bless America 🇺🇸❤
Saxophone played by Jack Carlson from North Platte Nebraska.


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Dramatic skies and orange sunset colours over Westminster, Big Ben and the River Thames. The Houses of Parliament dominate this striking image of one of London's most famous views. This picture can be printed on canvas or as an art poster. Photography by Eyal Zarrad.
London Orange Sunset
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SKU: 366-0057 Category: Fine Art Photographer: Eyal Zarrad
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Several Ways that the Technology Had Revolutionized the Music
There can be countless benefits one can get when learning how to be able to play music and at the same time listening to the music and of course when you share it with the other people. With the rise in the music technology, doing these things can be much easier than that before.
First you have to learn the things online. You do not have to drive for long period of time just for you to reach the house of your music teacher. It can be easy now to learn almost any kind of instrument when you have access online. Thus, there will be no reason why you cannot learn guitar or any instrument if it will be your dream for a long time now.
You can also share the music to anyone. The music streaming services will be able to make it incredibly easy to not only share the music with those wider audience but to also discover the new artist that can inspire you with your craft. There are a lot of those famous music artists that have gotten on their career with the aid of the music streaming platforms. You can explore the various music streaming software and try it for yourself if it suits your talent.
The digital software can also be helpful especially in making anyone to be a successful musician. You will not anymore have to shell out those of the serious cash to rent a kind of studio space and then you can lay down some few tracks too. This can be attributed to the continues rise in the digital software, which is considered as the top music technology tool and you can also do this from your own bedroom. You could use variety of effects and then you can select from the various instruments that are in the software and click the record button on that day only. Try to look for the digital software for the list of the musicians in order to see what you can be able to do – and there will be no small business IT services or those costly music producers that is required for this software.
Lastly, you can also try the sound layering with the looper pedals with the latest music technology. If you re obsessed with the creation of the unique harmonies then you can surely benefit with the latest technology. IF you are desiring for the good harmonies, you can take advantage of the loop pedals like the one that is used by those top most performing artists in the world to create a nice music.


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Dream Images Photography
Dream Images Photography is based in historical Simon's Town, Cape Town, and a perfect natural backdrop for any special occasion.
Our up to date techniques ensure that we are able to produce and deliver high end quality work in a timely manner. All photographic work is backed up and secured to back-up media constantly along each step of the process, from image capture to final production.
We want to make your photographic dreams a reality! We are here to capture your special occasion, be it your wedding or special birthday, our mission is to capture those special moments.
Our Photographic Journey includes Engagement and weddings, Events and Family albums, also with a focus on Kids and Pets. To compliment this, we specialize in private residential interiors, interior architecture and design, hotels, historic and heritage buildings.
If you are looking for a summer story, a beach feature, a Christmas house with children and family life, something exotic, contact us… We also do studio and location shoots, be it family, fashion, boudoir, couples, baby & children, utilizing latest lighting techniques.
The art of photography requires constant change to adapt to the ever changing requirements of our varied clients. We paint with light and tell stories with pictures. Two things are of particular importance, the client and the images produced.
Contact Dream Images today, for all your photographic needs and requirements.
Pictures really do set the mood and tell the story quickly; the better the images, the better the story. It is important to communicate to people the services and unique features you offer through good photography, as it is fast and easy for the consumer.


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Many people were feared killed as an oil pipeline exploded in Ijegun -Ikotun area of Lagos this morning.
Thick flame from the petrol tanker that exploded at Sawmill, Ibadan Reports blamed the explosion on the activities of pipeline vandals.
Chaos reigned in the area as residents woke up and ran from their homes. The fire, according to residents, started around 3 am. They said there was no sign of firefighters as at 6 am.
Men of the Lagos State fire services are currently battling to put out a raging fire that started during the night in Ijegun in Lagos.
Eyewitnesses told The Guardian that the fire might have been ignited by petrol thieves who were siphoning fuel in the area.
Already, houses, cars have been razed and a Lagos State Government-owned secondary school has also lost its fence to the fire.


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For the second consecutive quarter, the premium large SUV segment in Europe is faced with declining sales after years of booming, double digit growth. In Q3 of 2017, that turned to double digit decline with a loss of 14%, also bringing the year-to-date figure in the red at -3% to just over 210.000 sales. The segment leader BMW X5 lost market share with a loss of 22%. In fact, the entire top-3 lost with double digits and only 5 of the remaining 19 models improved their sales year-over-year in the third quarter. The other two models on the segment podium are in for a tight race by the end of the year, with the Volvo XC90 back in 2nd place in Q3 and the Audi Q7 down to 4th, behind even the Mercedes-Benz GLE. That leaves the Range Rover Sport in 5th place for the third quarter, even though it loses just 5%, outperforming the overall segment and all four of its closest rivals. Its sister model Land Rover Discovery does even better but does not yet manage to improve its volume at -1% in Q3 despite the arrival of the all-new generation in showrooms which gave the model a 42% gain in Q2. The Disco is up 13% year-to-date, the best performance in the top-9. The third model from JLR in this segment is the top-of-the-line Range Rover, up 8% in Q3 but outsold by the soon-to-be-replaced Volkswagen Touareg. [Read more…]
US sales Q3 2017: Mid-sized SUV segment
Strong growth from segment leaders and new models
Sales in the Mid-sized SUV segment increased by 9% in the third quarter of 2017, perfectly in line with the growth rate so far this year. Sales YTD now stand at 1,447,356, making this the fifth-largest segment, and only some 60,000 cars behind the rapidly-shrinking mid-sized car segment. If the trend condinues like this, the mid-sized SUV segment will jump ahead if not by the end of 2017, then most likely in 2018. That said, with Buick Enclave, Chevrolet Traverse, GMC Acadia and VW Atlas having hit the market recently there is a surprising dearth of new metal coming in 2018, the only exception being the new Hyundai Santa Fe, with the aging Ford Explorer, Jeep Grand Cherokee, Toyota Highlander and Nissan Pathfinder all still some way off from being replaced.
European sales 2017 first half: Premium Large SUV segment
After 3 years and one quarter of booming growth, the premium large SUV segment in Europe has hit a roadblock. Sales were down 6% in Q2, pulling down the year-to-date growth rate to just 2%, less than the overall market. A total of 150.235 large luxury SUVs were sold in the first half of 2017. The BMW X5 is on its way for a fourth consecutive year on top of the ranking, ever since the current generation was launched. The Audi Q7 jumps from 4th place in the first quarter to 2nd in the second quarter and also grabs that position in the first half ranking, outselling the Volvo XC90 (down 30% in Q2) and Range Rover Sport (down 13% in Q2). The XC90 has seen a similar drop in the US, where they blamed it on limited availability due to worldwide demand, especially for the T8 plug-in hybrid version, but the same seems to be happening in Europe now. With less than 1.000 monthly sales, China can't be responsible for the limited availability in Europe and the US, so there must be another explanation. We'll keep you updated as we find out more. [Read more…]
US sales 2017 first half: Mid-sized SUV segment
Sales in the Mid-sized SUV segment increased by 9.5% in the first half of 2017, an improvement on the 4.4% gain the segment experienced in 2016. What's more, the absolute volume of 952,645 put the segment once again within spitting distance of the mid-sized car segment, underlying how the market has shifted in favor of crossovers in the past two decades. That said, 2017 does not seem like the year that mid-sized crossovers overtake the mainstream cars, for while there is plenty of new metal coming to the market (Buick Enclave, Chevrolet Traverse, GMC Acadia and VW Atlas), none of these models are likely to trouble the segment leaders or add that greatly to the segment total. [Read more…]
European sales 2017-Q1 Premium Large SUV segment
Sales growth of premium large SUVs in Europe continues to outpace the overall market, although at a lower rate than in the previous years. In the first quarter of 2017, the segment grew 9% to almost 80.000 sales in a total market up 7,8%. Only one model managed to op 10.000 sales this quarter, the BMW X5 thanks to sales up 10%. That means the X5 consolidates its leadership as the #2 Volvo XC90 sees stable sales compared to last year. Unlike its smaller sibling XC60, the XC90 is unable to grab the top spot in its segment, although Volvo points out to supply issues as a result of high global demand for the model. Range Rover is one of the big winners of the segment this year, with its models the two fastest growing nameplates in the segment, and the Range Rover Sport jumps up to third place at the expense of the much fresher Audi Q7 and the regular Range Rover climbs to 6th place.
US sales 2017-Q1 Mid-sized SUV segment
Sales in the Mid-sized SUV segment increased by 7.3% in the first quarter of 2017, following a 4.4% gain in 2016. Total volume for Q1 was 445,875, which means it's closing in on the midsized sedan segment. Of the 18 models in this segment, 7 showed double digit growth or better, 8 showed double digit declines, 2 showed single digit declines and only one model increased by less than 10%. This year we'll see the introduction of the new, super-conservative VW Atlas, as well as the second-generation Buick Enclave, Chevrolet Traverse and the smaller ("right-sized") GMC Acadia and an updated Ford Explorer. Next year Subaru will join the party too with its Ascent. [Read more…]
New York Auto Show 2017: the Good, the Bad & the Ugly
The annual New York Auto Show is one of the most popular auto shows in the world, it's traditionally held at the Javits Convention Center in Manhattan and this year it runs from Friday April 14 through Sunday April 23. That means it's the last of the major auto shows in North America, after LA in November, Detroit in January and Chicago in February. As a result, the number of real new product launches and concept cars is relatively limited, especially compared to the most important of them all: Geneva. Still, we've had our pick of winners and losers of the show, and as usual we just can't seem to agree on most of them. Let us know your view in the poll or in the comments below.
Production cars:
Acura TLX (facelift)
Kriss: Not
See the new TLX in isolation and you may think to yourself "wow, this is a pretty good-looking car", but wish the grille wasn't quite as big and brash as it is. Well, then, you're in luck – there is a version of this car without this ugly new grille, and it's called the pre-facelift TLX. Now, don't get me wrong, the TLX is still pretty good looking, it's just that with this facelift Acura managed to either botch the changes the TLX needed (the new grille is not an improvement, and does not go far enough to give this car "personality") and not change things at all (the interior still looks no better than on the mass-market Accord). Acura is desperately looking for a car that will change the fortunes of its mainstream offerings, and this is not it, sadly.
Bart: Hot
What a difference a grille makes! Acura pulls trick from the Lexus playbook, using the motto: it doesn't have to be stylish, as long as it's brash. As opposed to Kriss, I think it's an improvement compared to the pre-facelift version. The TLX goes from utter wallflower with its beak-nose to one of the most aggressive designs in the segment with its enormously wide grille. I don't find it particularly sophisticated, or even attractive for that matter (I'd still prefer a C-Class, Q50 or even the aging 3-Series over it), but I just have to admire Acura for finally getting the point that just another vanilla sedan just isn't going to cut it in this competitive segment anymore. Besides the sheer size of the grille, and the graphics inside it, there's one more issue I have with the front end of the updated TLX: the lower part seems visually wider than the rest, which gives it a bit of a "heavy" presence, as if it has a double chin. The rear end has been cleaned up nicely, though.
European sales 2016 Premium Large SUV segment
If you thought (or were hoping) the SUV-boom is going to end anytime soon, think again. Sales of the biggest and most expensive Off-roaders that hardly ever actually go off road rose by another 19% in 2016, which makes this the third consecutive year of double digit growth for the segment. That means in those three years European buyers have scooped up an additional 100.000 large premium SUVs annually to a total of almost 290.000 per year. If there was a clear and dominant leader the year before, in 2016 the #2 and #3 were within 10% of the leader. The BMW X5 still tops the charts but lost 3 percentage points of share as the competition has reloaded with fresh models. In fact, the X5 was in third place in Q4, behind the Volvo XC90 and Audi Q7, albeit by a tiny margin. The Swedish SUV is up 73% to take 2nd place while the Q7 gains 61% to move into 3rd place, both helped by their new generations which replace models that were first launched in 2002 and 2005 respectively. For the XC90 2016 also sets a new volume record, selling just 300 units more than in 2005.
US sales 2016 Mid-sized SUV segment
Sales in the Mid-sized SUV segment increased by 4.4 percent in 2016 to a total of 1,803,382 units, a slightly faster rate of growth then the Compact SUV segment, but considerably slower than the double-digit growth registered by the other two, smaller mainstream SUV segments. 2017 will see the introduction of the new, super-conservative VW Atlas, as well as the second-generation Buick Enclave, Chevrolet Traverse and the smaller ("right-sized") GMC Acadia. [Read more…]
European sales 2016 Q1-Q3 Premium Large SUV segment
Sales of large premium SUVs in Europe are up 25% in the first three quarters of 2016, significantly faster than the overall market at +7,5%, and at double the rate of growth in the US, where this segment grows 13%. However, in Europe this segment takes only 1,9% of total market volume, compared to 3,4% in the United States. The podium remains unchanged from the first half of the year, with the BMW X5 still in the lead, ahead of the two newest entries in the top-10: Volvo XC90 and Audi Q7, unable to fight for the lead despite being much fresher than the X5. In fact, the Mercedes-Benz GLE also outsold them both in Q3 and moves into fourth place year-to-date, passing the Range Rover Sport. The entire top-4 of the segment is available with a plug-in hybrid option, which has helped popularity of the segment as a whole.


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Customer Service
Cyfuture alleges fraud by Freedom 251 maker Ringing Bells, company refutes charge
Ringing Bells has been accused of "fraud" and non-payment of dues by its customer service provider, a charge refuted by the company.
Service innovations required to achieve cost benefits, customer experience: Aircel's Alok Kumar
Aircel is using customer listening strategy and technologies like Big Data and analytics tools to improve subscriber experience, along with methodologies adopted at Aircel call centres to optimise costs
Vodafone seeks more time to stop '111' for customer service
TRAI had asked the company on March 2 to stop use of '111' number as it violated the national numbering plan.
Trai asks Vodafone to stop using 111 for customer services
Trai today directed Vodafone to stop using '111' for offering customer care services, as it violates the national numbering plan, and submit a compliance report by March 10.
Tata Docomo staff hit the field for consumer outreach program
The initiative is a part of Make a Great Impression on Every Customer program
Vodafone unveils branded metro station in Gurgaon; sets up Wi-Fi zone
There is a Wi-Fi zone at the platform to help the customers stay connected with their loved ones at all times. Evolved technology has been displayed at various junctures of the station to befit Vodafone's data paradigm.


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About Laser Skin Resurfacing
Laser skin resurfacing at Ellsworth Plastic Surgery is a nonsurgical cosmetic procedure that uses pulsating beams of light to exfoliate damaged surface skin one layer at a time. The treatment is great for correcting facial lines and wrinkles and for improving skin blemishes, like acne scars, pigmentation, and more. Also called a laser peel, laser skin resurfacing is a great facial treatment for patients desiring softer, clearer, youthful-looking skin. Depending on the condition of the complexion, the laser will be adjusted accordingly. There is some downtime needed with most laser skin resurfacing procedures. Any concerns or questions can be discussed with Houston, TX plastic surgeon Dr. Warren Ellsworth IV during the consultation.
Sciton® JOULE™
Ellsworth Plastic Surgery uses the Sciton JOULE platform, which offers minimally invasive laser treatment to target specific areas. The HALO™ handpiece, an extension of the Sciton JOULE platform, delivers non-ablative and ablative wavelengths, giving patients distinct results without downtime or discomfort. One of the most exciting benefits of this technology is the lack of invasiveness and discomfort that can sometimes accompany other laser skin resurfacing procedures.
"Dr. Ellsworth was the first Doctor that told me, he would NEVER put implants in my breast with my history of Breast Cancer. At that time I wanted a quick fix not realizing his extensive background with women like me, or what was even best for me. It didn't take long to know that he cared a lot about his patients. His hands are definitely a gift from God. I have been on his table 3 plus times, and he is THE BEST PERIOD!!!!! You will know the moment you meet him."- J.D. / Facebook / Oct 18, 2019
"Precise professional, master of body perfections. kind and thoughtful bedside manner and compassion with every explanation. Amazing ❤"- R.I. / Facebook / Aug 29, 2019
"He is an excellent surgeon with wonderful bedside manner! He made me feel completely comfortable throughout my journey, not to mention his proven experience in plastics. (Reconstructive surgery after double mastectomy) Highly recommended!"- J.B. / Google / Jan 30, 2019
"I had my tummy tuck just shy of 7 months ago and I couldn't be more happier with the results. The confidence I have after this surgery is remarkable. His bedside manor is great. Any questions before surgery or after have been explained thoroughly. I highly recommend Dr. Ellsworth to many friends that have been impressed with my results."- E.T. / Facebook / Jan 09, 2019
"The staff at Dr Ellsworth office is amazing . Ally is wonderful with all of your skin care or injections. She makes you feel very comfortable throughout any treatments. Everyone there is awesome 👏"- M.C. / Facebook / Dec 07, 2018
Ideal Candidates
Laser skin resurfacing is designed for anyone who is unhappy with their general complexion. If you have sun damage, acne scars, age spots, lines and wrinkles, redness, or pigmentation concerns, laser skin resurfacing treatment can address these cosmetic flaws. In addition, laser skin resurfacing works well for patients who have scaly patches, rough texture, or other irregularities. This treatment is not recommended if you have very dark skin or active acne.
Procedure Technique
During your session, you will relax in our treatment chair while the laser glides over the skin, precisely targeting specific sections for resurfacing. You will feel the warmth from the laser followed by cold air from the built-in cooling system. The laser works to eliminate dead and damaged skin cells while also stimulating natural collagen production.
What to Expect
All patients should reduce their sun exposure after treatment and apply sun protection frequently. For all peel intensities, the skin will naturally flake, crust, and peel away. It is vital to avoid interfering with the healing process to evade scarring and to protect the treated area from UV exposure. Once the peeling process has been completed, your skin will feel softer while looking clearer, younger, and rejuvenated.
A Softer, Clearer Complexion
A laser skin resurfacing peel offers excellent results if you want a younger-looking complexion. If you are thinking about a laser resurfacing treatment and would like to learn more about them, as well as other nonsurgical treatments Ellsworth Plastic Surgery offers, we invite you to call our office in Houston, TX today to schedule your consultation with Dr. Ellsworth.
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