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John Dyer born in Ruishton, Somerset is an English painter, focusing on colourful landscapes, architecture, gardens and notable events, especially in Cornwall.
His first published work aged 12 was landscape photography in Amateur Photography magazine. In his Foundation year at Falmouth College of Arts he was already selling images to publishers like Athena. He returned to lecture at Falmouth College of Arts in John completed his BA Hons Graphic De studies at Middlesex Polytechnic in London, winning a bursary from Thames TV as best Sherwood Park free online streaming of his year to photograph and record the Amazon rainforestthe first of many overseas and outdoors painting trips [1].
John Dyer is the official artist for the Cornish section of the Burlington massage midtown.
This continues a commission partnership with Falmouth Art Gallery for the Brunel bicentenary incelebrating the "Gateway to Cornwall" of the Royal Albert Bridge in carrying the Great Western Railway over the River Tamar which opened up Cornwall to tourism, Sex kiss Canada and the famous art colonies of Newlyn Abbotsford massage capitola St Ives. As a painter of celebrations and events, John Dyer also painted the armada of ships celebrating the safe arrival of Ellen MacArthur to Falmouth in after her non-stop single-handed round the world sailing trip Hot sex Saint-Hyacinthe 27, miles.
Falmouth harbour and Pendennis Castle feature regularly in his paintings including of the Solar Eclipse on 11 August From Wikipedia, the free encyclopedia. John completed his BA Hons Graphic De studies at Middlesex Polytechnic in London, winning a bursary from Thames TV as best student of his year to photograph and record the Amazon rainforestthe first of many overseas and outdoors painting trips [1] John Dyer is the official artist for the Cornish section of the www.
: 20th-century English painters English male painters 21st-century English painters births Living people Alumni of Falmouth University. Namespaces Article Talk. Views Read Edit View history. Languages Add links.
Facts about John Dyer
They are free on the NHS, as is aftercare and battery replacement. Spanish Swedish Swiss. Butler's Lives of the Saints. In the case of Transexual St. Catharines club work from the very early days which are some of my favourites.
Free granny sex Quebec can also find out more about the Newborn Hearing Screening Programme on gov.
Health Visitors screen babies Cornwall dyer biography personal life they Vernon musical instruments between 10 and 14 days old, at home, as part Singles in Blainville vt the primary visit. Visual reinforced audiometry VRA We use this test for children approximately six months and older who are able to turn their he and have been demonstrating curiosity with sounds.
As this story involves a new California-Cornish Clan it is well to have these things well established.
Cornwall dyer biography personal life
What does the test involve? If the child is interested in the sound they may turn and we record the level of the sound required to obtain this result.
By these you can test Cornishmen. It is impossible to produce work like mine using only the primary colours as they only mix a certain range of Flirt work in Canada. ❶Michaels Mount is a favourite place of Chat with girls Saint John people will walk across to the Mount all day and assume they will be able to walk home.
The Observer.
List of people from Cornwall
This was what loomed up before me. Sunday July 29th, my birthday, was the feast day of our Parish of St.
The House on the Strand by Daphne du Maurier. Audiometry From around school age we also use a test similar to adult testing, where your child may be able to press a button when different sounds are heard. It was Longueuil beach singles good place to grow - I sat at a good table, had a nice room, plenty of exercise, association with fine people and could visit my own home within ten minutes.
It required patience and time.
What does the test involve? This article needs additional citations for verification. A Cornish youth Massage new Levis by the sea would not be deterred by fear. Your child will sit on your lap Saint-Leonard massage springvale south a table.|This is a list of people from Cornwalla county of England in the United Kingdom.
Those included are either native Cornish people or others who have been long-term residents.
The demonym of Cornwall is Cornish. This list is arranged alphabetically by surname if available. There is also a List of Women in Cornwall and the Isles of Scilly dedicated Leisure massage north Longueuil the notable women of Cornwall and the Isles of Cornwall dyer biography personal life to address the gender gap on Wikipedia. From Wikipedia, the Haircut and massage Jonquiere encyclopedia.
Wikimedia list article. This article needs additional citations for verification. Please help improve this article by adding citations Joma massage Greater Sudbury Canada reliable sources. Unsourced material may be challenged and removed. This Locanto women looking for men Peterborough is incomplete ; you can help by expanding it.
Cornwall portal. Cornwall: a history 2nd revised ed.
Fowey: Cornwall Richmond sex drama Limited.] Frank Dyer was born in Golant, Cornwall, in Before One should be able to claim a spot for his birthplace more definite than the whole of Cornwall. "I have been surrounded by artists and paintings throughout my life. My father Ted Dyer is an artist, and from a very early age I have spent time painting and people enjoying themselves on the beaches and in the World of sex Regina towns of Cornwall".
Islington dyer biography personal life. personal life, is a wonderful introduction to the John Dyer is Cornwall's best known and best loved contemporary artist.


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Many studies have reported the risk factors for exacerbations in patients with 2019 novel coronavirus (2019-nCoV). This study aims to perform the meta-analysis of risk factors for the exacerbation of the novel coronavirus-infected pneumonia (NCIP). PubMed, Embase and Google scholar have been searched. We included the cohort studies involving risk factors for the exacerbation of NCIP. This meta-analysis compared the risk factors of patients between intensive care (ICU) group and non-ICU group. Two cohort studies were included in this study. After comparing the patients between intensive care (ICU) group and non-ICU group, several important factors were found to significantly increase the risk of exacerbations in patients with NCIP, and they included hypertension (RR=2.34; 95% CI=1.21 to 4.51; P=0.01), cardiovascular diseases (RR=2.28; 95% CI=1.13 to 4.58; P=0.02), COPD (RR=7.65; 95% CI=1.24 to 47.13; P=0.03), dyspnea (RR=2.89; 95% CI=2.05 to 4.08; P<0.00001), myalgia or fatigue (RR=1.24; 95% CI=1.01 to 1.52; P=0.04), but several factors such as gender, Huanan Seafood Wholesale Market exposure, diabetes, chronic liver disease, malignancy, fever, cough, expectoration, headache and diarrhoea appeared to have no obvious effect on the exacerbation of pneumonia. In addition, as the exacerbation of pneumonia, some complications had the high probability to occur according to the meta-analysis of acute respiratory distress syndrome (ARDS) (RR=13.95; 95% CI=6.20 to 31.41; P<0.00001), shock (RR=24.29; 95% CI=4.66 to 126.69; P=0.0002), acute cardiac injury (RR=10.32; 95% CI=3.05 to 34.96; P=0.0002) and acute kidney injury (RR=5.90; 95% CI=1.32 to 26.35; P=0.02) between two groups. Several risk factors were confirmed to significantly improve the risk of exacerbation in patients with NCIP, which was very important for the exacerbation prediction and treatment of these patients.
AssuntosBetacoronavirus , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Lesão Renal Aguda/epidemiologia , Lesão Renal Aguda/etiologia , Adulto , Idoso , China/epidemiologia , Estudos de Coortes , Comorbidade , Diabetes Mellitus/epidemiologia , Progressão da Doença , Dispneia/epidemiologia , Dispneia/etiologia , Exposição Ambiental , Fadiga/epidemiologia , Fadiga/etiologia , Feminino , Cardiopatias/epidemiologia , Cardiopatias/etiologia , Humanos , Hipertensão/epidemiologia , Hepatopatias/epidemiologia , Masculino , Pessoa de Meia-Idade , Neoplasias/epidemiologia , Síndrome do Desconforto Respiratório do Adulto/epidemiologia , Síndrome do Desconforto Respiratório do Adulto/etiologia , Fatores de Risco , Choque/epidemiologia , Choque/etiologia , Avaliação de Sintomas
The novel coronavirus disease 2019 (COVID-19) with its early origin from Wuhan city in China has evolved into a global pandemic. Maximal precautionary measures and resources have been put forward by most nations in war footing to mitigate transmission and decrease fatality rates. This article was aimed to review the evidence on clinical management and to deal with the identification of high-risk groups, warning signs, appropriate investigations, proper sample collection for confirmation, general and specific treatment measures, strategies as well as infection control in the healthcare settings. Advanced age, cardiovascular disease, diabetes, hypertension and cancer have been found to be the risk factors for severe disease. Fever lasting for >five days with tachypnoea, tachycardia or hypotension are indications for urgent attention and hospitalization in a patient with suspected COVID-19. At present, reverse transcription-polymerase chain reaction (RT-PCR) from the upper respiratory tract samples is the diagnostic test of choice. While many drugs have shown in vitro activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there are insufficient clinical data to promote or dissuade their usage. Among the currently available drugs, hydroxychloroquine and lopinavir/ritonavir may be considered for patients with severe COVID-19 infection, awaiting further clinical trials. Stringent droplet and contact precautions will protect healthcare workers against most clinical exposures to COVID-19.
AssuntosAntivirais/uso terapêutico , Betacoronavirus , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Monofosfato de Adenosina/análogos & derivados , Monofosfato de Adenosina/uso terapêutico , Corticosteroides/uso terapêutico , Manuseio das Vias Aéreas , Alanina/análogos & derivados , Alanina/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Antimaláricos/uso terapêutico , Estado Terminal , Humanos , Hidroxicloroquina/uso terapêutico , Imunização Passiva , Pandemias , Gravidade do Paciente , Choque/terapia , Manejo de Espécimes , Avaliação de Sintomas , Populações Vulneráveis
INTRODUCTION: Kawasaki disease (KD) is a systemic inflammatory disease. Standard imaging features of KD include interstitial and lobular inflammatory lesions in the lungs, while KD shock syndrome (KDSS), complicated with substantial consolidation and atelectasis in the lung, is rarely reported. PATIENTS CONCERNS: Herein, we report a single case of a 5-year-old female patient who manifested KDSS on the seventh day of the course of KD. Chest enhanced computed tomography indicated large-area consolidation in the lower lobes of the bilateral lungs. DIAGNOSIS: The patient was diagnosed with KDSS complicated with non-infective lung consolidation. INTERVENTIONS: The patient received human intravenous immunoglobulin (2âg/kg) and aspirin (30-50âmg/kgd), methylprednisolone, a vasoactive agent, and albumin. Infective factors were excluded. OUTCOMES: The consolidation in the lower lobe of the bilateral lungs was completely recovered after 3 days of treatment. CONCLUSIONS: Children with KDSS may present with pulmonary lesions such as substantial consolidation and atelectasis; thus, infective factors should be excluded. If there is no etiological evidence, antibiotics should be used with caution.
AssuntosSíndrome de Linfonodos Mucocutâneos/complicações , Atelectasia Pulmonar/etiologia , Choque/etiologia , Pré-Escolar , Feminino , Glucocorticoides/uso terapêutico , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Fatores Imunológicos/uso terapêutico , Metilprednisolona/uso terapêutico , Síndrome de Linfonodos Mucocutâneos/diagnóstico , Síndrome de Linfonodos Mucocutâneos/terapia , Norepinefrina/uso terapêutico , Atelectasia Pulmonar/diagnóstico por imagem , Atelectasia Pulmonar/terapia , Choque/terapia , Tomografia Computadorizada por Raios X , Vasoconstritores/uso terapêutico
We report a rapidly deteriorating coronavirus disease 2019 (COVID-19) patient, a-58-year-old woman, with severe acute respiratory distress syndrome and shock with hyperpyrexia up to 41.8°C, probably due to the cytokine storm syndrome. Considering extracorporeal membrane oxygenation (ECMO) as the last resort, we applied therapeutic temperature modulation for management of hyperpyrexia. The patient demonstrated rapid improvement in oxygenation and shock after achieving normothermia, and fully recovered from COVID-19 three weeks later. Therapeutic temperature modulation may have successfully offloaded the failing cardiorespiratory system from metabolic cost and hyperinflammation induced by hyperpyrexia. The therapeutic temperature modulation can safely be applied in a specific group of patients with cytokine storm syndrome and hyperpyrexia, which may reduce the number of patients requiring ECMO in the global medical resource shortage.
AssuntosInfecções por Coronavirus/patologia , Infecções por Coronavirus/terapia , Crioterapia/métodos , Febre/terapia , Pneumonia Viral/patologia , Pneumonia Viral/terapia , Betacoronavirus , Estado Terminal/terapia , Síndrome da Liberação de Citocina/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Pandemias , Choque/terapia
Objective: To explore the influence of inhalation injury on fluid resuscitation of massive burn patients during shock stage. Methods: A total of 74 massive burn patients (65 males and 9 females, aged 21 to 65 years) admitted to the Second Affiliated Hospital of Air Force Medical University (n=57) and Yan'an University Affiliated Hospital (n=17) from May 2009 to December 2019 were enrolled in this retrospective cohort study. Patients were divided into inhalation injury group (n=56) and non-inhalation injury group (n=18) based on clinical symptoms, vital signs, and results of bronchofibroscopy. Then 26 patients in inhalation injury group and 13 patients in non-inhalation injury group were 1â¶2 matched by case-control matching based on the difference of total burn surface area. The total fluid replacement coefficient, crystalloid replacement coefficient, colloid replacement coefficient, glucose input volume, ratio of crystalloid to colloid, urine volume, and cumulative ratio of input to output volume during the first 24 h post injury, the second 24 h post injury, and the third 24 h post injury, heart rate, respiratory rate, mean arterial pressure (MAP), and hematocrit (HCT) at post injury hour (PIH) 24, 48, and 72 were recorded and compared between the two groups. Data were statistically analyzed with analysis of variance for repeated measurement and Bonferroni correction, t test, Fisher's exact probability test, and Mann-Whitney U test. Results: (1) After matching, during the first to third 24 h post injury, the total fluid replacement coefficient and glucose input volume of patients in inhalation injury group were significantly higher than those in non-inhalation injury group (F=4.202, 10.671, P<0.05 or P<0.01). During the first, second, and third 24 h post injury, the total fluid replacement coefficient, crystalloid replacement coefficient, colloid replacement coefficient, and ratio of crystalloid to colloid were similar between the patients in two groups(t=-1.336, -1.452, -1.998; -0.148, 0.141, 0.561; 0.916, -0.046, -0.509; -1.024, 0.208, 0.081, P>0.05). During the first, second, and third 24 h post injury, the glucose input volume of patients in inhalation injury group were respectively (2 996±1 176), (2 659±1 030), and (2 680±1 509) mL, which were significantly higher than (2 125±898), (1 790±828), and (1 632±932) mL in non-inhalation injury group (t=-2.334, -2.639, -2.297, P<0.05). (2) After matching, in overall comparison between groups, during the first to third 24 h post injury, the urinary output volumes and cumulative ratios of input to output volume of patients in inhalation injury group were significantly lower or higher than those in non-inhalation injury group, respectively (F=12.158, 9.111, P<0.01). At PIH 24, 48, and 72, heart rate of patients in inhalation injury group were significantly higher than those in non-inhalation injury group (F=4.675, P<0.05). There were no statistically significant differences in heart rate, respiratory rate, MAP, and HCT between patients in the two groups at PIH 24 and 48 (t=-0.039, -1.688, 1.399, 1.299, -1.741, 0.754, -0.677, 0.037, P>0.05). During the first and second 24 h post injury, the urine volume and cumulative ratio of input to output volume of patients in inhalation injury group were respectively significantly lower and higher than those in non-inhalation injury group (t(urine volume)=2.421, 2.876, t(cumulative ratio of input to output volume)=-2.687ã-2.943, P<0.05 or P<0.01). At PIH 72, the heart rate and HCT of patients in inhalation injury group ( (114±13) times/min, 0.42±0.06) were significantly higher than those in non-inhalation injury group ( (98±18) times/min, 0.38±0.06, t=-3.182, -2.123, P<0.05 or P<0.01), there were no statistically significant differences in respiratory rate and MAP between the patients in two groups (t=0.359, 1.722, P>0.05). During the third 24 h post injury, there were no statistically significant differences in urine volume and cumulative ratio of input to output volume between the patients in two groups (t=1.664, -1.895, P>0.05). Conclusions: The presence of inhalation injury can lead to increased fluid requirement in massive burn patients during shock stage. An appropriate increase of fluid volume in the fluid resuscitation of burn patients combined with inhalation injury would be beneficial for maintaining ideal urine output.
AssuntosQueimaduras por Inalação/terapia , Queimaduras , Hidratação/métodos , Ressuscitação/métodos , Choque , Adulto , Idoso , Queimaduras por Inalação/complicações , Coloides , Feminino , Humanos , Exposição por Inalação , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
AssuntosQueimaduras , Choque , Adulto , Hidratação , Humanos , Ressuscitação
OBJECTIVE: To explore the progress of microcirculation research in shock and sepsis from 2000 to 2019 based on knowledge visualization analysis. METHODS: The literatures related to microcirculation of shock and sepsis published in Web of Science and Wanfang databases were collected from 2000 to 2019. Then, data collected was sorted out and used to make bar charts and curves reflecting the growth trend of the literatures using Excel software. The information about country, institution and author were extracted by CiteSpace 5.0 R1 for generating co-occurring network, to find the main research power and each cooperative relation. This software was also used to analyze the related-keywords and cited reference, so that the map of co-citation reference was drawn subsequently to explore the frontiers and hot spots in this field. RESULTS: There were a total of 2 000 Chinese "papers" or "dissertations", 1 823 English "articles" or "reviews", collected preliminarily. The Chinese literatures were only statistically described for the amounts, institutions and authors, however, all retrieved English literatures were enrolled in the visualization analysis eventually. From 2009 to 2019, the number of English literatures rose steadily; however, the number of Chinese literatures had been sliding since 2011. On terms of quality, the impact factors of most literatures were under 6, lacking high quality ones, and the number remained stable every year. According to the analysis of English literatures, the top three countries that published related papers around the world were Germany (n = 430), the United States (n = 401) and Netherlands (n = 223). In the aspect of research institutions, the University of Amsterdam (Netherlands) ranked first in the Web of Science (n = 113), while the institution in China with the most publications was the Southern Medical University (n = 71). According to the analysis of co-occurring author network, there were three major globe scientific groups in which Can Ince, Daniel De Backer and Jean-Louis Vincent contributed most to this research field. The top three authors who published most Chinese papers were Niu Chunyu (n = 20), Zhao Zigang (n = 18) and Duan Meili (n = 13). By generating the co-occurring keyword mapping, the research hot spots mainly focused on "blood flow", "nitric oxide", "hemorrhagic shock" and "perfusion". However, these burst keywords, including "cardiogenic shock", "acute kidney injury", "fluid resuscitation", "sublingual microcirculation", "mortality", "oxidative stress", and "critically ill patient", represented the frontiers in microcirculation research of shock and sepsis field. Finally, the results of co-citation reference analysis showed that "sublingual microcirculation" and "mottling score" were most active, indicating that the research of microcirculation monitoring technology could be considered as a hot spot and also the frontier in this field, which was consistent with the results of co-occurring keywords network. CONCLUSIONS: Knowledge visualization analysis can visually exhibit the hot spot and trend of microcirculation research in shock and sepsis. The power was mainly focused on a few developed countries in Europe, and the trend was more inclined to the related microcirculation monitoring technology.
AssuntosMicrocirculação , Sepse , Choque , China , Europa (Continente) , Humanos
AssuntosBetacoronavirus , Sistema Cardiovascular , Infecções por Coronavirus , Inflamação , Choque , Criança , Humanos , Pandemias , Pneumonia Viral
COVID-19 has changed the nature of medical consultations, emphasizing virtual patient counseling, with relevance for patients with diabetes insipidus (DI) or hyponatraemia. The main complication of desmopressin treatment in DI is dilutional hyponatraemia. Since plasma sodium monitoring is not always possible in times of COVID-19, we recommend to delay the desmopressin dose once a week until aquaresis occurs allowing excess retained water to be excreted. Patients should measure their body weight daily. Patients with DI admitted to the hospital with COVID-19 have a high risk for mortality due to volume depletion. Specialists must supervise fluid replacement and dosing of desmopressin. Patients after pituitary surgery should drink to thirst and measure their body weight daily to early recognize the development of the postoperative syndrome of inappropriate antidiuresis (SIAD). They should know hyponatraemia symptoms. The prevalence of hyponatraemia in patients with pneumonia due to COVID-19 is not yet known, but seems to be low. In contrast, hypernatraemia may develop in COVID-19 patients in ICU, from different multifactorial reasons, for example, due to insensible water losses from pyrexia, increased respiration rate and use of diuretics. Hypernatraemic dehydration may contribute to the high risk of acute kidney injury in COVID-19. IV fluid replacement should be administered with caution in severe cases of COVID-19 because of the risk of pulmonary oedema.
AssuntosAntidiuréticos/administração & dosagem , Infecções por Coronavirus/terapia , Desamino Arginina Vasopressina/administração & dosagem , Diabetes Insípido Neurogênico/terapia , Hidratação/métodos , Hipernatremia/terapia , Hiponatremia/terapia , Síndrome de Secreção Inadequada de HAD/terapia , Pneumonia Viral/terapia , Lesões Encefálicas/complicações , Infecções por Coronavirus/complicações , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Desidratação/terapia , Diabetes Insípido/complicações , Diabetes Insípido/terapia , Diabetes Insípido Neurogênico/complicações , Gerenciamento Clínico , Humanos , Hiponatremia/etiologia , Hiponatremia/prevenção & controle , Soluções Hipotônicas/uso terapêutico , Procedimentos Neurocirúrgicos , Pandemias/prevenção & controle , Pneumonia Viral/complicações , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Complicações Pós-Operatórias/terapia , Guias de Prática Clínica como Assunto , Solução Salina/uso terapêutico , Choque/etiologia , Choque/terapia
AssuntosAngiotensina II/uso terapêutico , Infecções por Coronavirus/tratamento farmacológico , Pneumonia Viral/tratamento farmacológico , Choque/tratamento farmacológico , Vasoconstritores/uso terapêutico , Idoso , Betacoronavirus , Estudos de Coortes , Infecções por Coronavirus/complicações , Feminino , Humanos , Infusões Intravenosas , Itália , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Respiração Artificial , Choque/etiologia , Vasodilatação
BACKGROUND: Community transmission of coronavirus 2019 (Covid-19) was detected in the state of Washington in February 2020. METHODS: We identified patients from nine Seattle-area hospitals who were admitted to the intensive care unit (ICU) with confirmed infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Clinical data were obtained through review of medical records. The data reported here are those available through March 23, 2020. Each patient had at least 14 days of follow-up. RESULTS: We identified 24 patients with confirmed Covid-19. The mean (±SD) age of the patients was 64±18 years, 63% were men, and symptoms began 7±4 days before admission. The most common symptoms were cough and shortness of breath; 50% of patients had fever on admission, and 58% had diabetes mellitus. All the patients were admitted for hypoxemic respiratory failure; 75% (18 patients) needed mechanical ventilation. Most of the patients (17) also had hypotension and needed vasopressors. No patient tested positive for influenza A, influenza B, or other respiratory viruses. Half the patients (12) died between ICU day 1 and day 18, including 4 patients who had a do-not-resuscitate order on admission. Of the 12 surviving patients, 5 were discharged home, 4 were discharged from the ICU but remained in the hospital, and 3 continued to receive mechanical ventilation in the ICU. CONCLUSIONS: During the first 3 weeks of the Covid-19 outbreak in the Seattle area, the most common reasons for admission to the ICU were hypoxemic respiratory failure leading to mechanical ventilation, hypotension requiring vasopressor treatment, or both. Mortality among these critically ill patients was high. (Funded by the National Institutes of Health.).
AssuntosBetacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Estado Terminal/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Idoso , Asma/complicações , Asma/tratamento farmacológico , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Estado Terminal/mortalidade , Glucocorticoides/efeitos adversos , Glucocorticoides/uso terapêutico , Hospitalização , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Pulmão/diagnóstico por imagem , Pulmão/patologia , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/mortalidade , Radiografia , Respiração Artificial , Insuficiência Respiratória/etiologia , Choque/etiologia , Tomografia Computadorizada por Raios X , Washington/epidemiologia
BACKGROUND: Emphysematous pancreatitis (EP) is an unusual medical emergency that presents with intraparenchymal pancreatic air in the setting of necrotizing infection. We aimed to determine the differences in the epidemiology, etiology, clinical presentation, symptoms and outcome of EP between elderly and nonelderly patients. MATERIALS AND METHODS: A PubMed search was performed using the keywords "emphysematous pancreatitis," "gas-forming pancreatitis" and "pancreatitis and pneumoperitoneum" from March 1959 to February 2019. Forty-two EP articles with 58 patients were enrolled in our study. We divided the patients into ≥65 (elderly, n = 25) and <65-year age groups (non-elderly, n = 33). Data on patient age, sex, comorbidities, symptoms, clinical findings, etiologies, laboratory results, treatments, outcomes and mortality were collected and analyzed using the Student's t test and chi-square test using IBM SPSS 20. P values < 0.05 (2-tailed) indicated statistical significance. RESULTS: Alcohol- and biliary pancreatitis-related EP were 4.95- and 4-fold, respectively, more frequent in the elderly than in the nonelderly (36% versus [vs.] 9.1%, P < 0.05). Fever was more frequent in the nonelderly than in the elderly (69.7% vs. 36%, P < 0.05). The elderly presented with more severe shock status (68% vs. 33.3%, P < 0.05) and received more surgical interventions than the nonelderly (60% vs. 30.3%, P < 0.05). CONCLUSIONS: Biliary pancreatitis is the most common type of EP in the elderly and has an atypical presentation with less fever, more severe shock, and more surgical interventions. In treating elderly patients with pancreatitis, immediate administration of adequate antibiotics, assisted drainage and early surgical intervention are needed to prevent shock.
AssuntosEnfisema/diagnóstico , Enfisema/cirurgia , Pâncreas/microbiologia , Pancreatite Necrosante Aguda/diagnóstico , Pancreatite Necrosante Aguda/cirurgia , Dor Abdominal , Adulto , Idoso , Idoso de 80 Anos ou mais , Enfisema/mortalidade , Feminino , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Pancreatite Necrosante Aguda/mortalidade , Choque/complicações
Coronavirus disease 2019 (COVID-19) stands out as the major pandemic that we have experienced in the last century. As it affects every social structure, it brought the importance of intensive care support once again to the agenda of healthcare system after causing severe acute respiratory syndrome. The precautions to be taken against this virus, where our knowledge is extremely small, intensive care units take an indispensable place in pandemic planning. In this review, we aimed to emphasize the crucial points regarding intensive care management of COVID-19 patients, which we have written not only for intensivists but also for all healthcare professionals.
AssuntosInfecções por Coronavirus/terapia , Estado Terminal/terapia , Unidades de Terapia Intensiva/organização & administração , Pneumonia Viral/terapia , Betacoronavirus , Reanimação Cardiopulmonar , Humanos , Controle de Infecções/métodos , Pandemias , Terapia Respiratória , Sepse/complicações , Choque/complicações
The treatment of critically ill patients with coronavirus disease 2019(COVID-19) faces compelling challenges. In this issue, we'd like to share our first-line treatment experience in treating COVID-19. Hemodynamics need be closely monitored and different types of shock should be distinguished. Vasoconstrictor drugs should be used rationally and alerting of complications is of the same importance. The risk of venous thromboembolism (VTE) needs to be assessed, and effective prevention should be carried out for high-risk patients. It is necessary to consider the possibility of pulmonary thromboembolism (PTE) in patients with sudden onset of oxygenation deterioration, respiratory distress, reduced blood pressure. However, comprehensive analysis of disease state should be taken into the interpretation of abnormally elevated D-Dimer. Nutritional support is the basis of treatment. It's important to establish individual therapy regimens and to evaluate, monitor and adjust dynamically. Under the current epidemic situation, convalescent plasma can only be used empirically, indications need to be strictly screened, the blood transfusion process should be closely monitored and the curative effect should be dynamically evaluated.
AssuntosInfecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Betacoronavirus , Transfusão de Sangue , Infecções por Coronavirus/tratamento farmacológico , Estado Terminal , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Hemodinâmica , Humanos , Apoio Nutricional , Pandemias , Embolia Pulmonar/diagnóstico , Embolia Pulmonar/prevenção & controle , Choque/diagnóstico , Choque/terapia , Vasoconstritores/uso terapêutico , Tromboembolia Venosa/diagnóstico , Tromboembolia Venosa/prevenção & controle
BACKGROUND: The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of a rapidly spreading illness, Coronavirus Disease 2019 (COVID-19), affecting thousands of people around the world. Urgent guidance for clinicians caring for the sickest of these patients is needed. METHODS: We formed a panel of 36 experts from 12 countries. All panel members completed the World Health Organization conflict of interest disclosure form. The panel proposed 53 questions that are relevant to the management of COVID-19 in the ICU. We searched the literature for direct and indirect evidence on the management of COVID-19 in critically ill patients in the ICU. We identified relevant and recent systematic reviews on most questions relating to supportive care. We assessed the certainty in the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, then generated recommendations based on the balance between benefit and harm, resource and cost implications, equity, and feasibility. Recommendations were either strong or weak, or in the form of best practice recommendations. RESULTS: The Surviving Sepsis Campaign COVID-19 panel issued 54 statements, of which four are best practice statements, nine are strong recommendations, and 35 are weak recommendations. No recommendation was provided for six questions. The topics were: 1) infection control, 2) laboratory diagnosis and specimens, 3) hemodynamic support, 4) ventilatory support, and 5) COVID-19 therapy. CONCLUSION: The Surviving Sepsis Campaign COVID-19 panel issued several recommendations to help support healthcare workers caring for critically ill ICU patients with COVID-19. When available, we will provide new evidence in further releases of these guidelines.
AssuntosInfecções por Coronavirus/terapia , Unidades de Terapia Intensiva/organização & administração , Pneumonia Viral/terapia , Guias de Prática Clínica como Assunto/normas , Betacoronavirus , Estado Terminal , Técnicas e Procedimentos Diagnósticos/normas , Humanos , Controle de Infecções/métodos , Controle de Infecções/normas , Unidades de Terapia Intensiva/normas , Pandemias , Respiração Artificial/métodos , Respiração Artificial/normas , Choque/terapia
Since the outbreak of coronavirus disease 2019 (COVID-19), clinicians have tried every effort to understand the disease, and a brief portrait of its clinical features have been identified. In clinical practice, we noticed that many severe or critically ill COVID-19 patients developed typical clinical manifestations of shock, including cold extremities and weak peripheral pulses, even in the absence of overt hypotension. Understanding the mechanism of viral sepsis in COVID-19 is warranted for exploring better clinical care for these patients. With evidence collected from autopsy studies on COVID-19 and basic science research on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and SARS-CoV, we have put forward several hypotheses about SARS-CoV-2 pathogenesis after multiple rounds of discussion among basic science researchers, pathologists, and clinicians working on COVID-19. We hypothesise that a process called viral sepsis is crucial to the disease mechanism of COVID-19. Although these ideas might be proven imperfect or even wrong later, we believe they can provide inputs and guide directions for basic research at this moment.
AssuntosBetacoronavirus/patogenicidade , Infecções por Coronavirus , Citocinas/metabolismo , Pulmão , Pandemias , Pneumonia Viral , Sepse/virologia , Autopsia , Transtornos da Coagulação Sanguínea/virologia , Infecções por Coronavirus/complicações , Estado Terminal , Endotélio , Epitélio , Humanos , Inflamação , Pulmão/imunologia , Pulmão/patologia , Macrófagos , Pneumonia Viral/complicações , Índice de Gravidade de Doença , Choque/etiologia
Injury severity scores (ISS) and shock index (SI) are popular trauma scoring systems. We assessed ISS and SI in combat trauma to determine the optimal cut-off values for mortality and trauma outcomes. Retrospective analysis of the Department of Defense Trauma Registry, 2008-2016, was performed. Areas under receiver operating characteristic curves (AUROCs) were calculated for ISS and SI on mortality, massive volume transfusion (MVT), and emergent surgical procedure (ESP). Optimal cut-off values were defined using the Youden index (YI). 22,218 patients (97.1% male), median ages 25-29 years, ISS 9.4 ± 0.07, with 58.1% penetrating injury were studied. Overall mortality was 3.4%. AUROCs for ISS on mortality, MVT, and ESP were 0.882, 0.898, and 0.846, while AUROCs for SI were 0.727, 0.864, and 0.711 respectively. The optimal cut-off values for ISS on mortality, MVT, and ESP were 12.5 (YI = 0.634), 12.5 (YI = 0.666), and 12.5 (YI = 0.819), with optimal values for SI being 0.94 (YI = 0.402), 0.88 (YI = 0.608), and 0.81 (YI = 0.345) respectively. Classic values for severe ISS underrepresent combat injury while the SI values defined in this study are consistent with civilian data.

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WENATCHEE — In years past, the Washington Apple Education Foundation would be gathering together scholarship recipients, their parents and donors for annual scholarship celebration luncheon events held in late July in Yakima and Wenatchee.
With the restrictions on group gatherings, this year the foundation gathered videos from students instead. These videos were pulled together in a six-minute celebration film honoring the recipients. The film released last week on social media.
The Scholarship Celebration Film titled "Celebrating Our Future" is on the foundation's website, waef.org, on its Facebook, YouTube and LinkedIn pages and can also be accessed by texting the word "Apple" to 56512.
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The Scholarship Celebration Luncheons are presented by Northwest Farm Credit Services. Additionally, sponsorship support this year came from AgroFresh, Alegria & Co., Allan Brothers, Chelan Fresh, CliftonLarsonAllen, CMI Orchards, Columbia Valley Fruit, Conover Insurance, Cowiche Growers, CPC International Apple Co., Crunch Pak, Gilbert Orchards, Good Fruit Grower, GS Long, Heritage University, Homchick Smith & Associates, HR Spinner Corp., Kershaw Companies, Key Bank, Legacy Fruit, Matson Fruit, McDougall & Sons, Moss Adams LLP, North Cascades Bank, Northwest Farm Credit Services, Orchard-Rite, PayneWest Insurance, Sage Fruit, T&G Global, Tree Top, USI, Valley Tractor & Equipment, Washington Fruit & Produce, Wells Fargo Commercial Banking, Yakima Pomological Club and Yakima Valley Community Foundation.
The Washington Apple Education Foundation supports more than 300 students annually with scholarship support in excess of $1 million. Funds for the scholarships are raised through annual donations from fruit growers, packers, suppliers and interested community members. For information, visit waef.org or call 663-7713.
Jennifer Witherbee is executive director of the Washington Apple Education Foundation, the state tree fruit industry's charity organization. She can be reached at 663-7713.


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Mixed Messages on Mask Enforcement; Tulsa Braces for a Weird Weekend—Coachella Valley Independent Daily Digest: June 19, 2020June 19 2020
Happy Juneteenth, everyone.
Here's today's news:
• Gov Gavin Newsom said today that he intends for the statewide face-coverings order to be persuasive—but didn't rule out punishment, via the Division of Occupational Safety and Health and the Department of Alcoholic Beverage Control. "We're not looking to fine people. We're looking to educate people, encourage people," Newsom said, according to the Los Angeles Times. "And to the extent that people flaunt and abuse, which may be the exception, then we have many tools in the tool kit."
• It's a good thing the state is willing to find ways to enforce the ordinance if needed. Later in that article, the Orange County sheriff said he didn't think it was the job of law enforcement to make sure people comply, and the Sacramento County sheriff said his agency would not enforce the law, "due to the minor nature of the offense, the potential for negative outcomes during enforcement encounters, and anticipating the various ways in which the order may be violated."
• There's face-covering progress being made in Arizona, aka our neighbor to the east, aka the nation's newest COVID-19 hot spot: Gov. Doug Ducey recently revoked an order forbidding local governments from issuing face-mask requirements stronger than the state's (non-) requirements—and as a result, various cities, including Tucson and Phoenix, are now requiring face coverings. Lives. Being. Saved.
• Meanwhile, in Nebraska, Gov. Pete Ricketts is being a complete idiot: "He's told counties that they won't receive any of the $100 million in federal COVID-19 money if their 'customers' are required to wear masks," according to the Omaha World-Herald.
• LG's Prime Steakhouse is closing both of its locations for a couple of weeks after an employee tested positive for the coronavirus. Read the company's statement here—and don't be surprised to see more such announcements as the pandemic rolls on.
• Gov. Newsom has signed into law a bill requiring that every active voter get a mail-in ballot for November's election.
• Disneyland is planning on reopening in several weeks. However, unions representing 17,000 Disneyland employees don't think it's safe to do so yet, and are asking Disney to delay.
• Remember that aircraft carrier captain who walked off his coronavirus-stricken ship to thunderous applause, when he was removed after expressing concerns about the outbreak? Well, his firing has been upheld.
• The New York Times points out there was a lot of coronavirus business news today: Apple is closing stores in four states where cases are rising (but not here) (yet?); and AMC reversed course and said it'll require customers to wear face coverings, after the CEO (stupidly) said yesterday the theater would not.
• Carnival Cruise Line had previously said it would start resuming some cruises on Aug. 1. However, that company—and all other major cruise lines—announced today that they'd voluntarily suspend operations until at least Sept. 15.
• Medpage Today offers a fascinating if wonky look at a study in China of asymptomatic people with COVID-19. Remember that all studies these days need to be looked at skeptically and with that grain of salt we keep talking about, but takeaways include: "Asymptomatic individuals carrying SARS-CoV-2 shed the virus longer than those with COVID-19 symptoms," and asymptomatic people were less likely to develop certain antibodies.
• Apparently, breathing in through your nose and out through your mouth can help you battle viral infections. Who knew? A UCLA professor, writing for The Conversation, explains that it has to do with nitrous oxide.
• Are you worried about welcoming back housekeepers or other workers who come into your home? You're not alone; The New York Times explains how to do so in the safest way possible for everyone.
• A bunch of big-name artists are calling on the federal government to help save our country's independent music venues—which remain closed for the foreseeable future. Here's hoping Congress heeds their call.
• The Chinese government throws some serious shade at the president in this short, weird YouTube video.
• The New York Times takes a wonderful look at the role of comedy in addressing police brutality—especially the comedy of the late, great Richard Pryor. Check it out.
• Finally, pray for Tulsa. Tomorrow very likely is going to be a dangerous day there, because the chief executive of the country has decided he doesn't need to listen to experts anymore, and he wants to have a damn rally.
That's enough for today. Please have a fantastic—and safe—weekend. Wear a mask. No, really, wear a mask. Wash your hands. If you appreciate quality local journalism, please consider becoming a Supporter of the Independent. The Daily Digest will be back Monday.
On this week's mask-wearing weekly Independent comics page: This Modern World listens in as conservatives ponder recent news; Jen Sorensen watches "The GOP Presents: War of the Worlds 2020"; (Th)ink does an appropriate word scramble; Red Meat has complaints about one of Earl's hobbies; and Apoca Clips watches as Li'l Trumpy discusses his Tulsa rally with his good friend Stephen Miller.
June Arts Listings From ArtsOasis!June 01 2014
Kathy Griffin
The famous, profane and controversial comedian brings her comedy and D-list fame to the desert for two shows. 9 p.m., Friday, June 6; and 8 p.m., Saturday, June 7. The Show at the Agua Caliente Casino Resort Spa, 32250 Bob Hope Drive, Rancho Mirage. 888-999-1995; www.hotwatercasino.com.
Wayans Brothers Live!
In 1990, the world of comedy welcomed an irreverent sketch comedy that changed the playing field. In Living Color debuted to critical acclaim and adoration by millions of American fans. Leading the charge was trailblazing creator, writer, director, producer and actor Keenen Ivory Wayans. He and his brothers take the stage together. 8 p.m., Saturday, June 21. $29 to $59. Fantasy Springs Resort Casino, 84245 Indio Springs Parkway. 760-342-5000; www.fantasyspringsresort.com.
20,000 Leagues Under the Sea
20,000 Leagues Under the Sea is the only science-fiction film produced by Walt Disney himself and remains one of the most highly regarded live action films of Walt Disney Productions. Infusing fresh life and color into the Jules Verne classic, the film doesn't shy away from the challenges of its ocean setting, featuring outstanding underwater sequences, a legendary special-effects battle with a giant squid, and a regrettably "true to the text" depiction of "cannibal island." 5:30 p.m., Friday, June 13. Free. Palm Springs Art Museum in Palm Desert, 72567 Highway 111, Palm Desert. 760-322-4800; www.psmuseum.org/palm-desert.
Movies in the Park: Cloudy With a Chance of Meatballs 2
Bring chairs, kick back and enjoy the start of summer! The movie will begin the second the sun goes behind our mountains. 5 p.m., Friday, June 13. Free. Thousand Palms Community Park, 31189 Robert Road, Thousand Palms. 760-343-3595; apm.activecommunities.com/desertrecdistrict.
Palm Springs International Shortfest and Film Market
Palm Springs International ShortFest is renowned worldwide for the extraordinary community of filmmakers it attracts, and for the quality and scope of its programming. ShortFest 2014 will present more than 300 short films from more than 50 countries. Tuesday, June 17, through Monday, June 23; times, prices and venues vary. General public sales begin June 10; www.psfilmfest.org.
Uncle Boonmee Who Can Recall His Past Lives
Winner of the Palme d'Or at the 2010 Cannes Film Festival, Uncle Boonmee Who Can Recall His Past Lives is a mystical, surreal and challenging film exploring questions of memory, reincarnation and the afterlife. On the edge of the florid jungle lies a man on the edge of death, who begins to recall his past lives in the company of his deceased wife and son who have returned in non-human form to usher him into the afterlife. 5:30 p.m., Friday, June 6. Free. Palm Springs Art Museum in Palm Desert, 72567 Highway 111, Palm Desert. 760-322-4800; www.psmuseum.org/palm-desert.
America created a sound of their own with their flawless blend of contrasting genres, consisting of pop rock, folk-jazz and even Latin-leaning rhythms. Since the 1970s, America band members Gerry Beckley and Dewey Bunnell have been producing inspiring music that has brought them chart-topping success. 8 p.m., Saturday, June 7. $35 to $55. Spotlight 29 Casino, 46200 Harrison Place, Coachella; 760-775-5566; www.spotlight29.com.
Art Laboe Summer of Love Jam III
The show features El Chicano, Rose Royce, MC Magic, Amanda Perez and Club Noveau. 7 p.m., Saturday, June 14. $35 to $65. The Show at the Agua Caliente Casino Resort Spa, 32250 Bob Hope Drive, Rancho Mirage. 888-999-1995; www.hotwatercasino.com.
Christina Bianco
Drama Desk and MAC Award-nominated actress, singer and impressionist Christina Bianco has become a worldwide YouTube sensation thanks to her diva impression videos going viral. Christina also just sold out a critically acclaimed extended run headlining at London's famed Hippodrome. 8 p.m., Saturday, June 21. $20 to $40 with a two-drink minimum. Copa, 244 E. Amado Road, Palm Springs. 760-322-3554; www.coparoomtickets.com.
Hot as Hell Pool Party With Zulluu
Zulluu is an Anglo-African fusion band/theater group, pioneering a new trend of blending world beats and sounds into a mix of theater, music and dance. They are highly vocal, singing lyrics in both English and the African language of Zulu. Bring your swimsuit! 7 p.m., Monday, June 2. Free. Sidebar Patio and Circa 59 at Riviera Palm Springs, 1600 N. Indian Canyon Drive, Palm Springs. 760-327-8311; www.psriviera.com.
Special Events
Desert Chiefs Football Presents Desert Bowl
Juneteenth in the Coachella Valley
The event promises good food, exciting entertainment and an atmosphere that inspires community unity and support. All proceeds will directly benefit the Family Health and Support Network foster-care program. The evening will include a performance by special guest artist and renowned vocalist Ms. Alfreda James. 6 p.m., Saturday, June 14. $65; $85 VIP. La Quinta Resort and Club and PGA West, 49499 Eisenhower Drive, La Quinta. 760-340-2442; www.juneteenthcv.com.
Visual Arts
California Dreamin': Thirty Years of Collecting
The exhibit includes art works purchased by the Palm Springs Art Museum with funds provided by the Contemporary Art Council and other contributors since 1984. The acquisitions were created by contemporary artists who worked in California or were influenced by spending some time in California during their artistic careers. This is the first time these artworks have been on exhibition together. The exhibit is a celebration of the commitment of the Contemporary Art Council to growing the museum's collection of significant contemporary artists, and is a survey of art in California since the 1980s. On display through Thursday, July 31. Included with museum admission (free to $12.50). Palm Springs Art Museum, 101 Museum Drive, Palm Springs. 760-322-4800; www.psmuseum.org.
Submit your free arts listings at calendar.artsoasis.org. The listings presented above were all posted on the ArtsOasis calendar, and formatted/edited by Coachella Valley Independent staff. The Independent recommends calling to confirm all events information presented here.
A Multifaceted Event: Juneteenth Shines a Light on Fathers, the Need for Foster Homes, and African-American CultureJune 06 2013
Sandra Austin doesn't think fathers get the respect they deserve.
She tells a story about a man she knows whose significant other passed away. They had been raising six kids together—and four of them aren't biologically his own. Nonetheless, he's carrying on: He's now a single father, and doing everything he can for those six kids.
"He stepped up," Austin says. "That's commendable. He needs support."
That's one reason why Austin—the co-founder of the Family Health and Support Network—has given the nonprofit organization's annual Juneteenth in the Coachella Valley event the theme "Fatherhood: Dispel the Myth."
The sixth-annual event, presented by Augustine Casino, takes place on Saturday, June 15, at the La Quinta Resort. The celebration of African-American culture and heritage is a benefit for the Family Health and Support Network's foster-care program. Performers include gospel/soul singer Gina Carey, and headlining singer L. Young. E.M. Abdulmumin, the founder of the DuBois Institute and the developer of Riverside County's Building Resilience in African-American Families program, will offer the keynote address.
Every year, Juneteenth has had a different theme. However, Austin feels so strongly about the need to support good fathers that she says she may give the event a focus on fatherhood every year from now on.
"It's really needed in our community," she says.
While Juneteenth in the Coachella Valley focuses on African-American heritage—Austin says she's been trying for years to "motivate" the valley's black population to show off its culture—FHSN's foster-care efforts involve the entire community. Frankly, the foster-care community needs all the support it can get, especially here in the Coachella Valley.
FHSN has contracts with Riverside, San Bernardino and Orange counties to place children who need foster care. Austin says FHSN—which she co-founded a decade ago—currently works with around 38 foster homes, and about 10 of those are in the Coachella Valley.
That's not nearly enough.
"We're one of the very few agencies physically located in the Coachella Valley, so we often get the calls (for Coachella Valley kids needing foster homes) first," Austin says.
More than half of the time, when FHSN receives a call about a foster child needing placement, FHSN has to say no, Austin says: There aren't enough qualified foster homes in the valley. That means those children get placed by other agencies in homes that are farther away from the area those kids know.
"Our primary goal is to put out the plea for foster parents," Austin says. "… Maybe it's because we have the reputation for being a resort town or whatever; there wasn't much awareness. Some people didn't even know they receive financial assistance (when they take in a foster child)."
So this year's Juneteenth celebration has multiple goals, according to Sandra Austin. It's a fundraiser for the foster-care program; it's an event to honor African-American culture; and it's an opportunity to give the community's good, caring fathers a much-needed shout-out.
"That's been my focus, that people will become aware that there is an African-American community here. And there's a need for foster parents. And there's a need for elders—African-American (and other) men to work with the youth population," she says.
Juneteenth in the Coachella Valley, presented by Augustine Casino, takes place on Saturday, June 15, at the La Quinta Resort and Club, 49499 Eisenhower Drive in La Quinta. The theme for this year's event, a benefit for the Family Health and Support Network, is "Fatherhood: Dispel the Myth." The evening begins at 6 p.m. with a VIP reception, and is followed by dinner, performances, the keynote and the Pioneer Awards ceremony at 7 p.m. Guests are encouraged to wear "smart casual white." Tickets are $60 for general admission, and $50 for FHSN foster parents; VIP tickets are sold out. For more information or to buy tickets, call 760-340-2442, or visit www.juneteenthcv.com. For more information on the Family Health and Support Network, visit www.fhsnet.org.


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Parque Nacional Los Glaciares El Calafate
This ice is really blue, of all shades, very beautiful. Views are excellent from everywhere, trekking to the glacier was short-lived, only an hour, but there were a lot of impressions. The road goes through the forest, also very beautiful, you can dine in the house or on the veranda overlooking the glacier. It was one of the most memorable days in Argentina.
Other News by This Author
Este lugar solo se puede ver desde el lado argentino. Una enorme cascada en el rincón más remoto del parque nacional. Si llegas temprano, no puedes hacer cola para tomar fotos. ¡Esta es una de las vistas más memorables del lado argentino! Aunque no es fácil llegar hasta aquí.
It is a large and multinational city. Its central square, the Plaza de Mayo, is surrounded by magnificent 19th-century buildings. Among them, the famous palace of Casa Rosada - the residence of the Argentine president. Among the other attractions of the city is the grand opera house "Colon" with a hall for 2500 seats, opened in 1908, as well as the modern Museum of Latin American Art.
It is very beautiful and it's a pleasure to walk here)
Other News El Calafate
Here you need to visit at least once in your life, be sure to take a track on the ice, you will take insanely beautiful photos and get a share of adrenaline when passing the route along a real glacier!


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Photographer's Note
This photo was taken this morning from the promenade at the Harbour Grand Hotel in Fortress Hill.
The view is towards Hung Hom on the Kowloon peninsula.
There is an iron railing stopping people from getting to the water's edge, but fishermen climb over, as do young people in the evenings. It looks as if somebody had a few beers last night too!
I am not sure if it was pollution, fog or mist, but something strange was happening on the other side of the water.
Yesterday, the Hong Kong air pollution index reached a record high of 500 - the maximum possible reading - in several areas.
At least 128 people, including an 8-year old boy, were admitted to hospital yesterday and almost 1,900 elderly people sought help.
Let's hope it was just misty this morning!
Update: May 21, 2010
Here is a YouTube video taken from the same promenade - but on a very clear day!
YouTube video link : the harbour view from the Harbour Grand Hotel
Critiques | Translate
BennyV (31046) 2010-03-24 2:49
Hello Andrew,
Probably a combination of all three, I'd say. Full-on saturated colours and an intersting sight, although the beer doesn't add much to the view. And being Flemish, I guess the Heineken bottles would fall under pollution ;)
yeln (11516) 2010-03-24 4:43
hello Andrew
Google Translate
wonderful view through the fog. great that you did not cut the foreground.
details are worth admiring
good pov, colors and sharpness
Congratulations! TFS!
jhm (198611) 2010-03-24 5:44
Hello Andrew,
What a story with the air pollution, I live on 25km of a great industrial plant, regular when the wind choose the direction than is this here very bad.
Your picture is very nice, you shows us the reallity
What a lovely composition.
Well presented and well shared.
Very well done, TFS.
Best regards,
faletiz (10113) 2010-03-24 6:30
Hallo Andrew, whatever it is certainly scary! Anyway your picture is really nice for the light, colors and the beautiful bright first floor with beer bottles that seem to frame the scene. Ciao Letizia
holmertz (89254) 2010-03-24 6:34
Hello Andrew,
Whatever the reason for those clouds, they provide for a fine composition. One highrise building stretching over the fog, one colourful ship safely in front of it and the quay with the beer bottles and a can in the foreground. It was a good idea to show the quay from the diagonal, and you also have a number of vertical lines, as well as a nice combination of colours from the water and the quay.
Kind regards,
edge (7409) 2010-03-24 20:34
Hello Andrew, Well whatever that is mist, smoke, fog etc, it adds a mysterious element to the picture. I like the effect. Nice composition and how was the beer? I like Hong Kong, I have been there four times, but all of them, long ago when it was still a British Protectorate. Good job. Roger
Tobin (216) 2010-03-24 22:20
Dust storm from the north?
Photo Information
- Copyright: Andrew Orme (orme) (7219)
- Genre: Lieux
- Medium: Couleur
- Date Taken: 2010-03-24
- Categories: Vie quotidienne, Transports, Architecture
- Camera: Nokia N97 mini
- Exposition: f/2.8, 1/1000 secondes
- Versions: version originale
- Thème(s): Hong Kong's harbour life [view contributor(s)]
- Date Submitted: 2010-03-24 1:50


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07/10/2020 | News release | Distributed by Public on 07/10/2020 18:54
Small businesses like yours are important. They create jobs, support a competitive marketplace, and lift up local communities. As a small business owner, you've worked hard to start your business and make it into something you can be proud of. That's why it's important to know how to protect your employees and customers from a range of cyber and financial threats.
In our Protecting Small Businesses playlist, you'll find some key steps you can take to keep your small business safe from fraud. Each video gives clear, concise information that you can act on to protect your data and hard-earned money.
From defending against ransomware to securing your network devices, this playlist from the FTC gives tips on how to avoid common scams and cyber-attacks that could target your small business. There's also helpful guidance on what to do if you think your business has experienced a data breach.
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The corrosion performance of the weathering steel members of the bridges inspected during this study varies considerably from one bridge to another and between different components of a given bridge. The majority of the bridges were observed to be in good condition with few corrosion problems; however, exceptions do exist. Based on a critical review of the corrosion performance of the inspected bridges, the following three factors have been identified as being most influential to the performance of weathering steel bridges: deck type, span type (e.g., stringer, arch, frame, etc.), and crossing (e.g., stream, highway, railroad, etc.). A discussion of the influences of each of the deck, span, and crossing types encountered in weathering steel bridges in West Virginia follows. Various additional factors relating to the environment of a bridge site have previously been set forth by other researchers as being influential to the performance of weathering steel. Some of these environmental factors include: proximity to industrial locations, surrounding vegetation, clearance over bodies of water, and terrain that shelters the bridge site from sunlight. A broad range of site environments were investigated in this study including bridges that were: near two different power plants, immediately adjacent to a coal field, in urban environments, located in rural areas, and densely sheltered by terrain and vegetation. While it will not be disputed that these factors may affect the corrosion characteristics, for the broad range of site environments investigated in this work, it is believed that these factors alone are not sufficient to create a situation where the performance of the weathering steel is unsatisfactory. Instead, these factors may only intensify a corrosion problem caused by some other source, as discussed below.
A deck consisting of a continuous, solid surface should be provided. Reinforced concrete decks with or without stay-in-place metal deck forms are recommended. Conversely, the use of timber decks and metal grid decks (filled with concrete or unfilled) is highly discouraged as these decks do not prevent water from reaching the girders and in many cases act to trap water on the top flange of the girders, exacerbating the situation. Construction joints in concrete decks should be grouted. These joints should be carefully inspected during biennial inspections to monitor water penetrability. In many newer bridges, a construction joint located approximately 10 ft from the abutments was observed; consideration should be given to revising design practices to eliminate this joint. The overhang width should be extended as wide as feasible to provide additional shelter to exterior girders.


text: Shelby Forums - Shelby of the Month - January 2009 1/2009 clove9414 Shelby Forums username :clove9414 Year: 1968 Make: Shelby Model: GT500KR Shelby Number: 8T03R205293-03276 Engine: 428 COBRA JET Trans: FOUR SPEED MANUAL Exterior color: HIGHLAND GREEN Interior color: Black Selling Dealer: LARSEN FORD, INC Options: This car was built on 05/24/68 at the Metuchen plant. Here is a complete list of options for #03276: 3.50 Traction-Lok axle ratio Four-Speed Manual Transmission Power Front Disc Brakes Power Steering Shoulder Harness Radio-AM Push Button Tilt-Pop Steering Wheel Black Decor Bucket Seats Highland Green Paint Black Power Convertible Top w/Glass Backlite Only 16 identical GT500KR convertible cars were equipment this way, four shipped to New York State. Note from current owner: This is my 1968 GT500KR convertible. I bought it from the original owner in September of 1971 and it has been in my possession since. It has never been altered except for keystone mag wheels that I put on shortly after buying the car. The original hubcaps were stored in my parent's basement for thirty-six years which accounts for their "like new" conditions. Two months ago a complete frame off restoration was completed which took seven years. I resisted the temptation to make modifications to the car and it is completely stock. The same condition as it was when it was shipped from the factory. The Le Mans strip is of course dealer added. The restorer tried to get me to delete it from the car when it was repainted but, to me, it is part of the personality of the car and it would not be the same without it. That strip says "Look at me, I'm something special" very boldly. This car is listed in the SAAC registry and I have the Marti report for it. It was shipped on 6/6/68 to: LARSEN FORD, INC. 80 WESTCHESTER AVENUE WHITE PLAINS, NEW YORK It was subsequently sold to another dealer: LYMAN D. GRIDLEY LINCOLN MERCURY ELMIRA, NEW YORK I saw this car on their lot as a new car. It was sold to Grant Storms of Elmira, N.Y. in 1968 and I purchased the car from him in 1971. According to Marti this car is one of sixteen identical cars, four of which were shipped to dealers in New York State. It was restored to it new factory condition and won a "Judges Choice" award at it's first car show appearance. Charles Alterations: Signed by Carroll Shelby Pictures