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Originally published on MatthewGorelik.io
Welcome to this month's continuation of Understanding Real Estate Terms. We covered A-L in August with Part One. Now it's time for Part Two!
Real Estate terms can be confusing, especially when you're knee-deep in a process you are unsure of. Use this glossary any time you stumble across a term you don't recognize!
Multiple Listing Services (MLS) – This is a special database available only to real estate agents and brokers. Industry professionals have the opportunity to submit listings and information to the database, effectively allowing them to search and compare listings beyond the scope of their own practice.
Points – The concept of points can be somewhat tricky. At it's most basic, it is a fee paid to the lender in an effort to reduce the interest rate on your mortgage. The fee is equal to 1 percent of the total amount of the loan.
PITI – An acronym that stands for Principle, Interest, Taxes, and Insurance. Together, these items make up the primary costs associated with most mortgage payments.
Preapproved – Preapproval is only obtained after a lender conducts an in-depth review of the borrower's financial background. It is only obtained after completing a thorough application, paying the required fees for processing, and submitting any documentation requested by the lender. If the application is approved, the buyer receives a "conditional commitment" from the lender for a particular loan amount. It does not guarantee that the loan will be issued.
Prequalified – Prequalification is the process of having a lender or specialist determine how much a particular buyer can afford to borrow. It is not an in-depth review and it does not guarantee that a loan will be granted. It merely serves as a starting point for the buyer to realistically assess property.
Private Mortgage Insurance (PMI) – This is a type of insurance for the lender. It serves to protect them in the event that the encounter a loss on the money they have lent (if a borrower defaults on their loan, for example). Lenders require this insurance be purchased on any conventional loan without a 20 percent down payment.
Rate Lock – An agreement between the lender and the borrower that states a specific interest rate and a predetermined length of time. The specified interest rate will be guaranteed for the indicated length of time, meaning it can not increase or decrease as market rates do.
Title Insurance – An insurance policy designed to pay out if the the property title defects or is subject to other title complications after the closing has been completed. Depending on the situation, it may be paid to the lender or the buyer.
Under Contract – Under Contract is a term given to any for-sale property that has accepted an offer, but not yet closed or met contingency requirements.


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Our Prices, plus delivery
BCA Tracker 3 avalanche transceiver test and review, we used the new Tracker 3 for a full season and to sum up, yep the size and features really do make this a good choice for the more experienced user.
Size wise the added benefits of the slim profile and comfy carry case really did make this a joy to wear, those of you who have fallen on your transceiver will know what I am talking about! The buttons and display again are super easy to use even with ski gloves on, battery life looks about correct, however I thought it did not last as well as some of the others out there, but in saying that I was doing quite a few training searches as well as just transmit. As with any transceiver we reckon don't let the battery get below 50% as this does mess up the search function somewhat.
In terms of searching with the Tracker 3 then its pretty easy, the only draw back is the dual read out when searching for multiple burials, if you have used a transceiver before then this will not be an issue, so we would say the Tracker three is better suited for the more advanced user rather than a beginner, if its your first transceiver then look at the Ortovox Zoom or the Ortovox 3 Plus.
Price wise its a little higher than some out there but the build quality and backup are well worth it.
I will be using mine again all next winter!
Copyright © Snowshepherd 2019

subset: commoncrawl


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Wettest July since The Founding of the Republic of Iceland Featured
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This July in Iceland was the wettest in decades. We have not seen more rain in Akureyri (the capital of the North) since the founding of the Republic of Iceland. Akureyri saw 73.1 mm of rain this July, more than double the average precipitation.
Also little sun this summer in Iceland
The extreme rain was not only apparent in the North but throughout most of Iceland. On top of that there was little sunshine in South and Southwest Iceland.
Reykjavík had 89.3 mm of rain this July which is over 70% above the average rain. More rain has not been seen in the city in July since 1984 - for 30 years.
The average temperature this July in Reykjavík was 11.8°C (53°F) and sunshine hours were measured 116 which is 88 hours below the last 10 years average. We have not had fewer sunshine hours since 1989.
The highest measured temperature this July in Iceland was 23.3°C (74°F) in Húsavík, North Iceland.
Labor Day Weekend in Iceland
The Labor Day Weekend in Iceland is always following the first Monday of August each year.
The first weekend of August is a long weekend throughout Iceland and most stores are closed on the Monday. Icelanders, by the thousands, take to their cars and head out of town to camp in the wilds or join in one of the organized events that are held throughout the country. These range from teetotaling family festivities to to outdoor loud rock festivals.
One of the most popular festivals takes place in Vestmannaeyjar ("The Westman Islands") and is called Þjóðhátíð. The photos below are from there.


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Once an athlete, always an athlete. You never lose it. Your entire life, you have certain values ingrained in you that make you who you are. Teamwork, goal-setting, discipline, competitiveness, leadership, fair play… we all know how it works.
So when a friend of mine sent me a link for a feature by Curve magazine which profiles women over the age of 30 who are becoming amateur athletes, I wasn't at all surprised.
The piece is entitled "All American Girls," and profiles women over the age of 30 who are becoming amateur athletes in sports they're trying for the first time. From surfing and power lifting to flag football and rugby, the stories of these women should inspire all of us to leave our fears and doubts about injuries and time commitments behind and take to the fields of games we've been itching to try since we were young. They might not be professionals, but as far as athletic competition is concerned, it's just the beginning.
One of these profiles really caught my eye, and it's about Mona Rayside who plays in a rugby club in Washington, DC.
Mona Rayside is 30 years old and has been playing rugby since 1991. Although rugby has been famously dubbed "the barbarian's sport played by gentlemen," it started attracting ladies in the mid-1970s and now rivals softball for popularity. Rayside plays for the Maryland Stingers, one of the top women's club teams in the nation.
Rayside likes the sport because it resembles "female power." She says, "When I started playing, it was a revelation, because all of a sudden people were excited to see a big ol' girl come on the field," she recalls, a smile in her voice. "Rugby … helped me recognize and find my own strength, and to realize that I was physically strong and that that was something to be desired."
As a basketball player, one of the aspects about Rugby that I am particularly jealous of is the sense of community among its players, or, "ruggers." First, they're tough people in general. To go out there and take a hit with no padding on has GOT to hurt. But they encourage each other to get right back up and keep playing.
Second, after the match, they DRINK (party + eat) with their opponents! Often dubbed a "drink up," this great tradition ingrains sportsmanship and respect for the sport in each of the athletes.
Third, I love the sense of community. I am jealous of the clubs set up for those of us out of college in cities around the world. These serve as "families" of sort (much like my college basketball team was for me). It's a great way to meet people and have fun. I miss that sense of community, and having moved to a new city, I wish I had it here. Unfortunately, when it comes to basketball, it seems that level of organization seems to dissipate after college.
Although I'd love to try it, I don't have the time to commit to learning rugby right now. And I don't think or want to think that I'd enjoy taking a hit that hard.
Plus, my "love" is with basketball. My community is found among basketball players, or "ballers." I've been playing the sport competitively since I was about six years old.
With the overwhelming national popularity of women's basketball, I really wish there would be more formalized "clubs" that we could join and participate in as adults . I'm not talking about just rec leagues. I'm talking about clubs, membership-oriented communities of adults who fund raise, practice on a regular basis and travel to play in tournaments on the weekends in various cities.
Ballers, where are we? It's time to get organized. Maybe we can learn a few things from our "rugger" friends.


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Rocket City Rover
Article Excerpt: "... Rocket City Rover offers rides on a 14-person party trolley through downtown Huntsville. With 12 comfy bike seats, 2 of which are pedal-free, and a two-person bench in the back, you can choose to pedal to the music, or relax while others chauffeur you in style to exciting downtown destinations. Book online to save the date for your "whole bike private party" or for a small group. They have regularly scheduled mixer rides daily..."
Reference: www.huntsville.org


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Game Design News
October 08, Almost Midnight : Evil has returned. Beware. Beware. LISTEN TO ME!! IT'S PURE EVILLLEEE. Oh, it's just Grimdaze. Welcome back. :) :)
September 15 : New Tic-Tac-Toe sprite sheet released.
September 15 : Main page fixed. Sorry about that.
September 12 : The developer of CoolBasic, Zero, promises that "a new generation" is under development in his forum. See this CB forum post.
September 10 : GDN's front page gets a much needed makeover.
page revision: 140, last edited: 08 Oct 2007 06:35


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Alan Silvestri
Alan Silvestri top 20 songs
Alan Silvestri biography
Alan Anthony Silvestri (born March 26, 1950) is an American composer and conductor who works primarily in film and television. He is best known for his frequent collaboration with director Robert Zemeckis, including composing major hit films such as the Back to the Future trilogy and Forrest Gump, as well as the superhero films Captain America: The First Avenger and Marvel's The Avengers. Silvestri grew up in Teaneck, New Jersey and attended Teaneck High School. He went to Berklee College of Music for 2 years and is of Italian descent. Silvestri started his film/television composing career in 1972 at age 21, composing the score for the low-budget action film The Doberman Gang. From 1977 to 1983, Silvestri served as the main composer for the TV show CHiPs, writing music for 109 of the show's 139 episodes. Silvestri met director Robert Zemeckis when the two worked together on Zemeckis's 1984 film Romancing the Stone. Since then, Silvestri has composed the music for all of Zemeckis's movies, including the Back to the Future trilogy (1985, 1989, 1990), Who Framed Roger Rabbit (1988), Death Becomes Her (1992), Forrest Gump (1994), Contact (1997), Cast Away (2000), The Polar Express (2004), Beowulf (2007), A Christmas Carol (2009), and Flight (2012). Silvestri is also known for his work on Predator (1987) and Predator 2 (1990), both of which are considered preeminent examples of action/science fiction film scores. Since 2001, Silvestri has also collaborated regularly with director Stephen Sommers, scoring the films The Mummy Returns in 2001, Van Helsing in 2004, and G.I. Joe: The Rise of Cobra in 2009. His most recent work includes Captain America: The First Avenger in 2011, The Avengers in 2012 and The Croods in 2013. Silvestri has also composed music for television shows, including T.J. Hooker (one episode), Starsky & Hutch (three episodes), Tales From The Crypt (seven episodes) and Manimal (five episodes). In 2013, the Carolina Crown Drum and Bugle Corps used portions of the theme from The Abyss as the ballad in their 2013 Drum Corps International World Championship-winning show "E=MC2". On 31 January 2014, it was announced that a stage musical adaptation of Back to the Future was in production. The show, which is being co-written by original writers Robert Zemeckis and Bob Gale, is expected to be performed in 2015, on the 30th anniversary year of the film. Silvestri will team up with Glen Ballard to compose a new score, with the addition of original songs from the film, including "The Power of Love", "Johnny B. Goode", "Earth Angel" and "Mr. Sandman". Silvestri owns a vineyard, Silvestri Vineyards, located in Carmel Valley, California. Silvestri has received two Academy Award nominations, one for Best Original Score for Forrest Gump (1994) and one for Best Original Song for "Believe" on The Polar Express soundtrack. He also received two Golden Globe nominations: Best Score for Forrest Gump and Best Song for The Polar Express. He has also received four Grammy Award nominations, winning two awards – Best Song Written for a Motion Picture, Television or Other Visual Media, for "Believe" from The Polar Express in 2004 and Best Instrumental Composition, for "Cast Away End Credits" from Cast Away in 2002. His other nomination was for Best Soundtrack Album, for Back to the Future. During the 2005 Grammys, Josh Groban performed "Believe." He has won the Saturn Award for Best Music three times, for his scores for Predator (1987), Back to the Future Part III (1989/90) and Van Helsing (2004). On September 23, 2011, he was awarded with the Max Steiner Film Music Achievement Award by the City of Vienna at the yearly film music gala concert Hollywood in Vienna.
- Johann Strauss I - Radetzky-Marsch, Op.228 (Arr.
- Art Of Noise - Paranoimia '89
- Johann Strauss I - Radetzky Marsch
- M.s. Subbulakshmi - Vishnu Sahasranamam
- Disturbed - Inside The Fire
- Art Of Noise - Paranoimia
- Johnny Hallyday - Le Chant Des Partisans
- Queen - The Show Must Go On
- Queen - Another One Bites The Dust
- Woody Guthrie - Dust Pneumonia Blues
- Abba - I Do, I Do, I Do, I Do, I Do
- Pink Floyd - Another Brick In The Wall Part
- The Vamps - All Around The World
- Karaoke - Aisa Desh Hai Mera
- Boys 2 Men - It's So Hard To Say Goodbye To Yesterday
- Alabama - Jesus Is On The Main Line
- The Beatles - Here Comes The Sun
- Bruno Mars - Just The Way You Are
- Guetta - Memories
- Zed - Partymix
- Abba - I Do, I Do, I Do, I Do, I Do
- Pink Floyd - Another Brick In The Wall Part
- The Vamps - All Around The World
- Karaoke - Aisa Desh Hai Mera
- Boys 2 Men - It's So Hard To Say Goodbye To Yesterday
- Alabama - Jesus Is On The Main Line
- The Beatles - Here Comes The Sun
- Bruno Mars - Just The Way You Are
- Guetta - Memories
- Zed - Partymix


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London - Stoke City have signed Nigerian striker Peter Odemwingie from Cardiff City with Kenwyne Jones moving in the opposite direction in a player-exchange deal, the Premier League clubs announced on Tuesday.
Odemwingie, 32, has signed an 18-month contract with Stoke and could make his debut in Wednesday's league game away to Sunderland.
"We're delighted to have signed Peter," Stoke manager Mark Hughes told the club website.
"Things haven't perhaps gone as well for him at Cardiff as he would have hoped and he's really keen to start afresh with us.
"He has a good goal-scoring record in the Premier League and will bring a different dimension to our attacking options. I've no doubts he will prove to be an excellent addition to our squad."
Nigeria international Odemwingie joined Cardiff from West Bromwich Albion last September, but he had to play second fiddle to Fraizer Campbell during his time in the Welsh capital.
"Maybe in the past few months I didn't get too many goal-scoring opportunities but I am sure that will change here at Stoke," Odemwingie told the Stoke website.
"I feel I am a different player to Kenwyne Jones. He is more of a target man but I am somebody who likes the ball at my feet and I also like to get in behind the defence as often as possible, too.
"I am sure that the manager and his staff know about me and I am certain they will use me to my strengths."
Cardiff confirmed the arrival of 29-year-old Jones on their website.
"Cardiff City Football Club are delighted to announce that Kenwyne Jones's move from Stoke City to the club has today (Tuesday) been finalised, subject to FA (Football Association) clearance," the club said in a statement.
"The striker will be available for selection for the first time this Saturday in the Barclays Premier League home game against Norwich City."


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28-12-2008 00:00
Physicians for Human Rights-Israel, Al-Mezan Center (Gaza) and the Palestinian Medical Relief Society (Ramallah)
Emergency Gaza Update 28.
2008 - The health system in Gaza is in a state of collapse - A medical supplies store was bombarded today - Referrals to medical care outside the Gaza strip are suspended Since the start of the Israeli military strikes against the Gaza Strip, true to Sunday, 16:00, 282 dead (including 20 children and 9 women) and about 700 wounded persons (including 130 children and 28 women) have been identified by Gaza hospitals, including more than 100 seriously wounded.
According to local estimates, dozens are defined missing, presumed to be trapped beneath destroyed buildings.
The Palestinian ministry of health in Gaza claims that the number of dead is even higher.
The Gaza health system is in a state of collapse and cannot provide an adequate response to the growing needs.
The closure imposed by Israel on all Gaza crossings, including the total closure of Erez Crossing since last Friday, prevents the evacuation of patients and wounded persons and deepens the human tragedy occurring in the Gaza Strip.
Governmental hospitals full to overflowing Hospitals in Gaza cannot deal with the heavy load of injured people continuing to arrive since Saturday, and today as well.
In the two main hospitals in the Gaza Strip there is a shortage of beds, despite the fact that all wards were evacuated in order to admit wounded people.
As a result, wounded people are filling the corridors of the hospitals.
The endless flow of new wounded and the need for beds has led to a suspension of care for dozens of other patients, including cancer patients, cardiac patients and other chronically ill patients.
These were sent to their homes for the duration of the crisis.
Shifaa' hospital According to Dr.
Hassan Khalaf, director general of the hospital, true to Sunday at 13:30, 240 wounded people had been admitted to the hospital and the numbers of wounded were continuing to rise hourly.
The majority of injuries were a result of direct hits, of shrapnel and of shock waves, caused by bombardments from the Israeli air force and buildings collapsing on top of their inhabitants.
The hospital has operated in emergency mode since Saturday, and its 12 operating rooms have been working 24 hours a day, with all medical teams on site.
The heavy overload of wounded and the shortage of operating rooms led to the use of four of the wards in the obstetrics departments as general surgical rooms, and the hospital has stopped admitting women for deliveries.
The outpatient clinics in the hospital, and four Intensive Care Units in the burns department of the hospitals are now being used for hospitalization of the wounded from the Israeli attacks.
The European hospital in Khan Younis According to Dr.
Zaki Zakzouk, a senior oncologist in the hospital, 30 seriously wounded people are hospitalized there.
Most of them are suffering from head and neck wounds and are in urgent need of complex neurosurgical procedures.
All these need a pulmonary intensive care unit, but due to the severe shortage of beds in the department, only half are connected to ventilating machines, and others are ventilated manually.
There is also a shortage of type O minus blood.
A shortage of refrigeration rooms and of ambulances is preventing transfer of blood from Shifaa' hospital.
Nationalisation of private medical centers As part of the attempt to deal with the emergency, private clinics including 'Almamdawi', the Red Cross clinic and others, have stopped their regular activities and are now functioning as hospitalization units for the wounded, to which governmental hospitals are now referring patients.
Damage to medical equipment stores Today, 28.
08, the largest medicines and medical supplies store of the ministry of health in Gaza was bombarded.
It mainly serves Shifaa hospital.
The store, located next to the Falastin football stadium was completely destroyed and a large amount of medical supplies was destroyed.
Referrals out of Gaza suspended Erez Crossing has been hermetically closed since the morning of Friday 26.
2008, and the soldiers have been evacuated from the crossing.
Physicians for Human Rights-Israel has been informed that the authorities at the crossing would not longer be handling applications for transfer of patients and wounded persons to medical care outside Gaza, including urgent and lifesaving cases.
This information was confirmed by representatives of the Palestinian Subcommittee for medical referrals, who told us that their attempts to coordinate passage or even communicate with Erez Crossing authorities had failed.
Of the hundreds of wounded, PHR-Israel has the full details of 25, all of whom are suffering from serious injuries and must be urgently referred to external advanced medical centers: 14 of these are unconscious in the ICU at Shifaa hospital and are in immediate danger of their lives.
Seven others suffer severe orthopedic injuries and are in danger of losing limbs.
Four others suffer from internal injuries.
All tried to apply to Erez crossing for permission to exit Gaza and all failed so far.
Jordan has declared its willingness to admit wounded people, but in order to access Jordan, patients must receive an exit permit from the Israeli authorities to exit via Erez Crossing.
Rafah crossing Despite the declaration of the Egyptian government according to which it would open Rafah crossing to the wounded, no wounded people have been evacuated via this crossing, for several reasons: • Political disconnection between the Hamas government in Gaza and the Egyptian Government due to the Israeli attacks prevent proper coordination between Egypt and Hamas.
Egypt claims that Hamas is preventing the passage of patients to Egypt through Rafah.
• The severity of the cases: dozens of wounded people are not transferred to Egypt due to the severity of their condition.
The majority of these are head injuries and internal injuries.
Most are unconscious and are in need of artificial ventilation and a medical team to accompany them on ambulances to advanced medical centers in Cairo, a six hour journey from the Rafah Crossing, Doctors in Gaza fear that many of the wounded may not survive the journey.
• Shortage of ambulances: As already reported by PHR-Israel in detail on 22.
08, only half of Gaza's 58 ambulances are functional.
The remaining ambulances are working full time since Saturday and cannot be spared.
The Israeli military is issuing threats to civilians Many patients have phoned PHR-Israel over the past 24 hours, reporting that during the night they had received recorded threats over the telephone.
The first recorded message ordered them to leave their homes due planned bombardments.
The second message warned that anyone aiding militants or hiding arms would be exposed to bombardments.
Appeals for humanitarian assistance Today Israel enabled the opening of Kerem Shalom crossing for entry of some humanitarian goods.
However, according to the Palestinian ministry of health in Gaza, these supplies are not sufficient.
Due to the severe shortage of medical supplies and medicines (105 sorts of medicine, 225 types of medical items and 93 types of laboratory supplies are missing), as detailed by PHR-Israel on 22.
08, PHR-Israel and PMRS today received an urgent appeal from the Gaza Ministry of Health for transfer of medical supplies.
Among the supplies asked for are basic sterilization equipment, clothing for medical teams, needles, dressings, anaesthetics, catheters, medical gases, oxygen, monitors and medicines.
The overall value of necessary supplies requested from PHR-Israel is half a million US dollars.
PHR-Israel is working to find funding sources and to coordinate transfer of the supplies.
PMRS has initiated an emergency call to support First aid, ambulances services, Individual relief and rehabitation of injured people the call is for 1 million$ Summary The current attack found the health system in Gaza in a state of near-collapse due to the blockade imposed upon it for the past year and a half, as well as previous closures.
Even before this crisis the system was working in a severely restricted manner.
Now it must handle wounded people who are in need of complex care by expert professionals, which in the current situation it cannot provide.
Targeting of civilians and/of medical facilities is a breach of international humanitarian law.
The targets chosen by the Israeli military include also clearly civilian installations.
As occupying power currently in effective control of the area, Israel, which is currently carrying out a massive military operation in the Gaza Strip, must bear responsibility for the wounded of the attack, enable their access to hospitals able to care for them, respect medical neutrality of related facilities and allow entry of all necessary medical supplies for hospitals to be able to handle the wounded people.
For further details contact: Ran Yaron, PHR-Israel, 0547 577696 ranyaron@phr.
il; Bahia Amra, Palestinian Medical Relief Society, 0599407847 bahiaamra@hotmail.
com; Mahmoud Abu Rahma, Al Mezan Gaza, 0599609310, mahmoud@mezan.


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Find below a quick video showing some of the news of 3DViewStation WebViewer V2019.0:
We are the graphics of the new product configurator at DAF trucks. The solution has been nominated for a technology award. And we are proud to announce, that we won in the category "Digital Innovation Of The Year". See also press release on DAF web site.
We have released a new 3DViewStation WebViewer version v2018.0 with a series of enhancements, described below.
SMEs (small and medium enterprises) internally typically work file based, storing all their CAD and project files in folders of their file server. But employees of SMEs are mobile too and we all know the situation of getting an urgent call while travelling, being asked for immediate assistance.
What can we do, if we now would need access to our 3D CAD models, 2D drawings or any project related documentation?
The easy solution is a Web based application that – after logon of course – will provide a "file open" dialog, which we all know from our Desktop applications. But in the case of working Web based this "file open" dialog needs to point to a directory of one of OUR servers, allowing to browse through files and sub folders, and open files from there. Of course the server of this Web application will run on our infrastructure – so in the same network, where our files reside.
Advantages of this approach are:
Here is an example of a solution and how it could look like on a Smartphone. More details here.
We have done a new video showing the news of Kisters 3DViewStation WebViewer v2016.1. Available here as MP4 or on YouTube.
a little video showing the upcoming 3DViewStation WebViewer 2015 version on various devices. 3DViewStation WebViewer 2015 and 3DViewStation Desktop & ActiveX will have same performance, same functionality, same APIs. English version here.


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Shaman Maria Amanchina stands over the tomb of the Ukok Princess Kadyn. Photo © Gleb Raygorodetsky.
The sacred Ukok Plateau at the heart of the Golden Mountains of Altai World Heritage Site, Russia, is changing because of climate. For local people, dealing with climate change means restoring and sustaining the role of the ancestral burial kurgans and other sacred sites in protecting Altai and its people.
On a warm summer's day twenty-four centuries ago, a noblewoman of the nomadic Pazyryk tribe was buried in a large ancient burial tomb, or kurgan, on the Ukok Plateau — now a region of the Russian Altai that borders China, Mongolia and Kazakhstan. Mummified with herbs, bark and marten fur, she was placed in an oversized sarcophagus hewn from a single larch log. Six sacrificial horses, richly saddled and harnessed, were laid to rest on the northern side of the burial chamber, ready to carry her to the realm of her ancestors.
In the summer of 1993 the noblewoman was unearthed by a team of Russian researchers from the Novosibirsk Centre of the Russian Academy of Sciences. The find was hailed as one of the greatest archaeological discoveries of the century, providing insights into Pazyryk life previously unknown to modern science. Yet, the nature of the noblewoman's status in Pazyryk society and her relationship with modern-day Altai people has eluded the scientific community. Who was she? A ruler or a holy woman? A revered bard or a healer?
This petroglyph of an ancient horseman pursuing mountain sheep was carved two and a half millennia ago. The Altai region has served as a home or migration route to nomadic cultures through conquests, revolutions and wars. Today, the etched horseman and its quarry face different obstacles, including increasing erosion due to climate change. Photo © Gleb Raygorodetsky.
Local people know her as Ukok Princess Kadyn and, unlike scientists, have absolutely no doubt about her role in the past, present and future of the Altai. Like many powerful kams (shamans) before her, this daughter of the Altai was buried on the sacred mountain plateau of Ukok to ensure the peace and well-being of her people.
The Russian authorities dismiss such sentiments as unscientific and backward, arguing that the research has not shown even morphological or genetic links between the Princess's remains and the modern Altai peoples.
This argument befuddles the local people who see the Princess Kadyn and the Altai region as one. Since the Princess was unearthed, the local people have seen many signs that the Princess' continued absence is upsetting the balance in the region — from the nightmares reported by the archaeologists during the excavation to the near-crash of the helicopter as the sarcophagus was being airlifted from Ukok, to subsequent powerful earthquakes, one of which levelled an entire Altai village.
Altai people feel that to restore the order of things, the Princess Kadyn must be returned to her rightful place on the Ukok Plateau.
The fate of Ukok
In my global search for stories of local answers to the challenges of climate change, I came to the Altai in the summer of 2009 as part of a small group of researchers, filmmakers and custodians of sacred sites from different parts of Central and Inner Asia to attend a workshop entitled "Sacred Sites and Protected Areas of Altai". After the workshop, we travelled over 500 kilometres southeast from the Altai's capital, Gorno-Altaisk, to the ultimate destination of our three-day trek — the excavated and later backfilled kurgan of the Princess Kadyn on the Ukok Plateau; a place that the Greek historian Herodotus named the Pastures of Heaven and one that is now included in the UNESCO Golden Mountains of Altai World Heritage Site.
Maria Amanchina, a local kam, has a special and intimate relationship with the Ukok Princess Kadyn. She had joined our group to conduct a ceremony reaffirming her commitment to bring the Princess back home from the Novosibirsk Centre of the Russian Academy of Sciences, so that the noblewoman can continue playing her vital role of keeping the Altai and its people in balance.
Maria Amanchina came to the Ukok Plateau to conduct a ceremony reaffirming her commitment to bring the remains of Princess Ukok back home from Novosibirsk Centre of the Russian Academy of Sciences, so that the noblewoman could continue playing her vital role of keeping the Altai and its people in balance. Photo © Gleb Raygorodetsky.
Strings of multi-coloured beads and cowry shells dangled from Maria's long sleeveless kaftan, tinkling rhythmically as she walked slowly around the kurgan. As the rest of our group wandered around, each of us connecting with this sacred place in our own way, Maria knelt by a large upright boulder and lit her pipe, puffs of smoke escaping from the corners of her mouth. Her eyes closed, she bowed in silent prayer. As if trying to chase a headache away, she pinched the bridge of her nose with her fingers — perhaps the fate of Ukok was the source of her pain.
All that is left of the ancient burial tomb is a circle of boulders strewn around a pile of rocks at its centre — a giant stone target scarred into the flesh of the Ukok Plateau. Today, the Ukok Plateau is indeed a target for many — from Russian Jeep enthusiasts criss-crossing the fragile wetlands in their mud-splattered 4×4 vehicles to researchers looking at the impacts of warming climate on the permafrost that still keeps many kurgans well-preserved; and from development companies planning a major industrial corridor to China to local people struggling to protect these sacred lands.
Even if Maria succeeds in overcoming the government opposition to her quest and is eventually allowed to rebury the Princess' remains on the Ukok Plateau, can there really be any hope for the Ukok Princess of ever coming home? The permafrost that preserved the remains of the Altai's ancestors in burial kurgans for thousands of years is disappearing, melting away because of steadily rising air and ground temperatures in the region. Climate change is literally melting away the cultural heritage of the Altai people, a rich and irreplaceable part of the global heritage. At least this is what worries scientists.
As our vans began a slow climb toward a mountain pass at the edge of the Ukok Plateau on our departure, two Russian UAZ jeeps tumbled down the mountain pass toward us. Several men stepped out of the vehicles to greet us. They were members of a large Belgian-Russian team of researchers from UNESCO and Ghent University, documenting, monitoring and developing plans for preserving the "Frozen Tombs of Altai", as part of a UNESCO World Heritage conservation project.
For centuries, Altai people herded livestock across the plateaus and through mountain passes at the modern-day crossing of the Russian, Mongolian, Kazakh and Chinese borders. The outstanding universal value of this landscape gained recognition with the designation of the Golden Mountains of Altai World Heritage Site by UNESCO in 1998. Photo © Gleb Raygorodetsky.
During a brief exchange interspersed with energetic handshakes, and cigarette and lighter swaps, the UNESCO-Ghent team quickly sketched out what they fear is in store for the Altai's frozen tombs. Although permafrost has been relatively stable in the Altai since the Late Pleistocene glaciation about 18,000 years ago, during the 20th century the average ground temperature in the Altai increased by about 0.8 degrees Celsius. At the lower edge of the permafrost extent, exactly where many Altai kurgans are located, even this slight warming is enough to push permafrost dangerously close to the melting point.
And in many parts of the Altai, it is already melting. As air temperatures continue to rise — scientists predict an increase of 3 to 6 degrees Celsius by 2080 — permafrost will disappear completely in many areas of the Altai Mountains.
Concerned about the future of the kurgans, UNESCO and Ghent University, along with their Russian partners, have been cataloguing the Altai's frozen tombs to help develop conservation and preservation plans. Some of the proposed solutions include elaborate schemes to shade each individual tomb from direct sunlight to stabilize its temperature.
Making an offering, Maria dips a wooden spoon into a small pot before sprinkling tiny pearls of milk over the fire. Puffs of pearly steam mix with the trails of pale smoke drifting from the smoldering sticks toward the infinite Altai sky. Photo © Gleb Raygorodetsky.
Sacred balance
The day after we returned from our pilgrimage to the Ukok Princess's kurgan, Maria invited me into her ail, a traditional Altai house. The late afternoon light seeped through the open smoke hole in the roof. Silently mouthing a chant, Maria knelt by the fire holding a small pot of milk. Making an offering, she swished the wooden spoon through the air a few times and tiny pearls of milk spattered over the fire, jumping, popping and hissing on the searing, soot-covered rocks. Puffs of pearly steam mixed with the trails of pale smoke rising from the smouldering logs. Maria pulled on her pipe and wafts of blue pipe smoke drifted up, mixing with the pale smoke from the hearth. Over the next couple of hours, with occasional breaks for hot Altai tea, we talked about her worries and hopes.
When in her twenties Maria became quite ill, a local healer told her that she had to heal herself by answering the call of the Spirit of Altai. And so she set off on a journey to become a shaman, relying on the guidance of her dreams, visions and intuition. Over the next twenty years, little by little she became the powerful healer she is today. Photo © Gleb Raygorodetsky.
Maria's parents were shamans and people would come to them to be healed. Such practices were strictly forbidden during the Soviet times, but her parents would help people in secret. It was through her mother's family line that she became a shaman, discovering as a little girl that she was able to heal people and to see into the future. She hadn't really known that she would become a strong healer until she grew older.
"Once, when I was in my teens," remembered Maria, "I was looking after some sheep grazing on a summer pasture and I dozed off. I dreamed of a white-bearded man all clad in white. He told me that it was time for him to leave the Altai and its people, but promised to return in twenty years. He said that, as a proof of his promise, he would send my sheep back home. When I awoke, I saw a white rider galloping away in the distance. When I returned home, the sheep were already there. My father then explained to me that I had met the Spirit of Altai, our protector, whose home is Belukha Mountain."
As they prepare to travel to the sacred Ukok Plateau, Maria (wearing a headscarf) guides her guests — clockwise: Liz Hosken, director of the UK-based Gaia Foundation; Niall Campbell, a traditional healer from Botswana ; and Chagat Almashev, Director of the Foundation for Sustainable Development of Altai — through a purification ceremony over wafts of smoke from a sacred juniper fire. Photo © Gleb Raygorodetsky.
In her late twenties, Maria became quite ill. A local healer told her that nobody could cure her malady — that she had to heal herself by answering the call of the Spirit of Altai. And so she set off on a journey to become a shaman, relying on the guidance of her dreams, visions and intuition. Over the next twenty years, little by little she became the powerful healer she is now.
The Spirit of Altai returned to Belukha as promised. He sought Maria out in her dreams warning her about a coming earthquake — the Altai's response to the violation of Princess Kadyn's kurgan. He gave her detailed instructions on how to conduct rituals over the next three years to spare the lives of local people during the earthquake. She followed his instructions judiciously and while the 2003 earthquake destroyed many buildings throughout the southern part of the Altai, and even levelled an entire village, no humans perished.
As Maria explained it to me, the relationship between the people of the Altai, the sacred Ukok Plateau and ancestors buried in the kurgans is direct, ever-present and vital. The Spirit of Altai and the Ukok Princess Kadyn are strongly linked with each other, she told me. Both play important roles in maintaining the well-being of the Altai and its people. The Ukok Plateau has traditionally been a sacred resting place for powerful Altai shamans and healers, a place from which they could continue protecting the Altai and its people whether from diseases and enemy invasions, or droughts and severe winters.
At the sacred Dzhumalinskyi springs, two custodians of sacred sites from Kyrgyzstan, Samankul Azyrankulov (standing) and Kadyrbek Dzhakypov (laying), make offerings to reconnect with the sacred landscape that nourished their ancestors, including Manas — the hero of the longest Kyrgyz epic poem who was born in the Altai over a thousand years ago. They hope to bring healing energy back to their homeland to help address local challenges, from inter-ethnic conflict to climate change. Photo © Gleb Raygorodetsky.
Disturbing such a sacred place disrupts the ebb and flow of life, the Universe, the Altai. Without the Princess on the Ukok Plateau, the Altai people are struggling to maintain the balance in their lives — whether they have to overcome daily strife, deal with climate change, or fight new development. This is why for the past six years Maria has been working so hard to bring the Princess back to her Ukok home.
"Whether we are healers or commoners," Maria says, "all of us are flawed mortal human beings. On our own, we have no hope of ever healing anybody or fixing anything. We can do it only by asking the Creator and the spirits of animals, plants, and places to help us with the task of healing the Earth. If we are honest and true to the task, then help is given to us."
The ail's door squeaked and the driver poked his head inside. He was apologetic. If we were to make it to Gorno-Altaisk by nightfall, we would have to leave soon. His timing was good, though, as Maria was worn out by our long conversation. I thanked her, making her promise to resume our discussion when I returned to the Altai.
"Did you feel the energy of Ukok?" Maria asked me, her tired face aglow, as I was about to step outside of the ail. "It feels so soft and gentle, as if you're swimming in a fresh mountain spring."
As the car rattled and bumped on our way to the city, I thought back to our meeting with the UNESCO team conserving Altai kurgans. For Maria and her people, even such a well-intentioned initiative may seem misdirected. For them, the Altai kurgans are not randomly scattered burial mounds filled with precious objects, but intricate structures created by their ancestors to enhance and propagate the energies of a particular sacred landscape, like the Ukok Plateau. Once such a sacred site is disturbed, whether through archaeological work or development, it can no longer perform its function until it is restored and revived.
As the climate changes, the future for the Altai tombs that Maria and her people seek, is not about keeping ancient artifacts encased in permafrost. They want to restore and sustain the role of the ancestral burial kurgans and other sacred sites in protecting Altai and its people from various challenges. The ability of Maria and her people to face the challenges of climate change and development depends on the help of the Ukok Princess Kadyn. So, without a doubt, the Princess must come home.
Additional Resources:
• Restoring the Sacred Web of Life in Siberia's Golden Mountains
• Sacred Lands Film Project
• Pacific Environment
• "Land is breath — Rediscovering Altai's human-nature relationships" on United Nations University YouTube Channel
• Altai Mir University
• Altai Assistance Project
• The Altai Project
• Fund for 21st Century Altai
• Gazprom's Altai Pipeline
• ♦ •
This article, originally posted by OurWorld 2.0, is part of the Healing the Earth project of Land is Life, a founding member of the Conversations with the Earth (CWE) initiative. CWE is a multimedia platform that brings Indigenous voices on climate change to the global audience. Follow CWE on Facebook or Twitter @ConversEarth.


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This flax seed granola parfait calls for healthful, homemade flax seed granola, but in a pinch store-bought granola will do. Slideshow: Granola Recipes
How to Make It
Place most of the granola and half of the blueberries in the bottom of a small serving dish or cup, and cover with the yogurt. Top with the remaining granola and blueberries. Garnish with fresh mint and serve.


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A Prospective Randomized Trial of Drug-Eluting Balloons Versus Everolimus-Eluting Stents in Patients With In-Stent Restenosis of Drug-Eluting StentsThe RIBS IV Randomized Clinical Trial
Author + information
- Received February 5, 2015
- Revision received April 17, 2015
- Accepted April 20, 2015
- Published online July 7, 2015.
Author Information
- Fernando Alfonso, MD∗∗ (falf{at}hotmail.com),
- María Jose Pérez-Vizcayno, MD†,
- Alberto Cárdenas, MD†,
- Bruno García del Blanco, MD‡,
- Arturo García-Touchard, MD§,
- José Ramón López-Minguéz, MD‖,
- Amparo Benedicto, MD∗,
- Mónica Masotti, MD¶,
- Javier Zueco, MD#,
- Andrés Iñiguez, MD∗∗,
- Maite Velázquez, MD††,
- Raúl Moreno, MD‡‡,
- Vicente Mainar, MD§§,
- Antonio Domínguez, MD‖‖,
- Francisco Pomar, MD¶¶,
- Rafael Melgares, MD##,
- Fernando Rivero, MD∗,
- Pilar Jiménez-Quevedo, MD†,
- Nieves Gonzalo, MD†,
- Cristina Fernández, MD†,
- Carlos Macaya, MD†,
- RIBS IV Study Investigators (under the auspices of the Interventional Cardiology Working Group of the Spanish Society of Cardiology)
- ∗Hospital Universitario de La Princesa, Madrid, Spain
- †Hospital Universitario Clínico San Carlos, Madrid, Spain
- ‡Hospital Universitario Vall d'Hebron, Barcelona, Spain
- §Hospital Universitario Puerta de Hierro-Majadahonda, Madrid, Spain
- ‖Hospital Universitario Infanta Cristina, Badajoz, Spain
- ¶Hospital Universitario Clinic de Barcelona, Barcelona, Spain
- #Hospital Universitario Marqués de Valdecilla, Santander, Spain
- ∗∗Hospital Universitario de Meixoeiro, Vigo, Spain
- ††Hospital Universitario 12 de Octubre, Madrid, Spain
- ‡‡Hospital Universitario La Paz, Madrid, Spain
- §§Hospital Universitario de Alicante, Alicante, Spain
- ‖‖Hospital Universitario Virgen de la Victoria, Málaga, Spain
- ¶¶Hospital Universitario General de Valencia, Valencia, Spain
- ##Hospital Universitario Virgen de las Nieves, Granada, Spain
- ↵∗Reprint requests and correspondence:
Dr. Fernando Alfonso, Departamento de Cardiología, H. Universitario La Princesa, Diego de Leon 62, Madrid, Madrid 28006, Spain.
Background Treatment of patients with drug-eluting stent (DES) in-stent restenosis (ISR) remains a major challenge.
Objectives This study evaluated the comparative efficacy of drug-eluting balloons (DEB) and everolimus-eluting stents (EES) in patients presenting with DES-ISR.
Methods The study design of this multicenter randomized clinical trial assumed superiority of EES for the primary endpoint, in-segment minimal lumen diameter at the 6- to 9-month angiographic follow-up.
Results A total of 309 patients with DES-ISR from 23 Spanish university hospitals were randomly allocated to DEB (n = 154) or EES (n = 155). At late angiography (median 247 days; 90% of eligible patients), patients in the EES arm had a significantly larger minimal lumen diameter (2.03 ± 0.7 mm vs. 1.80 ± 0.6 mm; p < 0.01) (absolute mean difference: 0.23 mm; 95% CI: 0.07 to 0.38), net lumen gain (1.28 ± 0.7 mm vs. 1.01 ± 0.7 mm; p < 0.01), and lower percent diameter stenosis (23 ± 22% vs. 30 ± 22%; p < 0.01) and binary restenosis rate (11% vs. 19%; p = 0.06), compared with patients in the DEB arm. Consistent results were observed in the in-lesion analysis. At the 1-year clinical follow-up (100% of patients), the main clinical outcome measure (composite of cardiac death, myocardial infarction, and target vessel revascularization) was significantly reduced in the EES arm (10% vs. 18%; p = 0.04; hazard ratio: 0.58; 95% CI: 0.35 to 0.98), mainly driven by a lower need for target vessel revascularization (8% vs. 16%; p = 0.035).
Conclusions In patients with DES-ISR, EES provided superior long-term clinical and angiographic results compared with DEB. (Restenosis Intra-Stent of Drug-Eluting Stents: Drug-Eluting Balloon vs Everolimus-Eluting Stent [RIBS IV]; NCT01239940)
Drug-eluting stents (DES) are widely used to treat ischemic coronary artery disease. Their dramatic ability to inhibit neointimal proliferation clinically translates into a significantly reduced need for repeat revascularization (1,2). Rarely DES may develop in-stent restenosis (ISR), especially when used in complex clinical and anatomic scenarios (3,4). Importantly, treatment of DES-ISR remains challenging. Several studies have demonstrated that angiographic and clinical outcomes of patients treated for DES-ISR are poorer than those found in patients with bare-metal stent (BMS) ISR (3–7). Indeed, the therapy of choice for patients with DES-ISR remains unsettled (3,4). Data from controlled clinical trials suggest that repeat DES implantation constitutes an attractive therapeutic strategy in this setting (7–10). Alternatively, drug-eluting balloons (DEB) also provide excellent late angiographic and clinical outcomes in patients with either BMS- or DES-ISR (11–18). In these patients, DEB are superior to conventional balloon angioplasty and at least similar to first-generation DES (11–18).
Second-generation DES are safer and more effective than first-generation DES (19,20). In particular, recent studies have shown uniquely favorable long-term results in patients treated with everolimus-eluting stents (EES) (19,20). The value of newer DES has also been demonstrated in complex lesion subsets, including BMS-ISR and DES-ISR (21). However, the relative efficacy of second-generation DES versus DEB in patients with DES-ISR remains unsettled.
The RIBS IV (Restenosis Intra-Stent of Drug-Eluting Stents: Drug-Eluting Balloon vs Everolimus-Eluting Stent) study is a prospective multicenter, open-label, controlled, randomized clinical trial comparing DEB and EES in patients with DES-ISR (Online Appendix). The study protocol was published previously (22). Inclusion and exclusion criteria were similar to those of previous RIBS trials (7,8,18,21). Eligible patients presented with angina or objective evidence of ischemia and showed DES-ISR on angiography (>50% diameter stenosis on visual assessment). Any type of DES presenting ISR was eligible, but patients in whom stent type could not be identified and those with unclear stent location were excluded. Patients with small vessels (≤2.0 mm in diameter), very long lesions (>30 mm in length), or total occlusions (Thrombolysis In Myocardial Infarction = 0) were also excluded (7,8,18,21). To avoid the possibility of including patients with stent thrombosis, patients with very early (<1 month) DES-ISR, those presenting with acute myocardial infarction (MI), or those with obvious angiographic thrombus were excluded. However, patients with multiple interventions at the target lesion, including those with >1 stent layer, were eligible. Patients with edge-ISR were only included when stent-edge involvement could be demonstrated. In this regard, the use of multiple angulated angiographic images was recommended to establish the relationship between the lesion and stent border. In addition, the study protocol suggested intracoronary imaging to confirm stent edge involvement. Patients with narrowing affecting the DES margin and extending into the adjacent segment were eligible. Patients with severe peripheral vascular disease or anticipated difficulties with angiographic follow-up, as well as those with severe systemic conditions or a life expectancy <1 year, were excluded. Patients with contraindications to aspirin or clopidogrel also were not eligible (7,8,18,21). Written informed consent was obtained from all patients.
Twenty-three university hospitals in Spain participated in this trial (Online Appendix). Telephone-based randomization was performed at the coordinating center (Clínico San Carlos, University Hospital, Madrid) using a computer-generated code. Randomization (1:1) was stratified according to ISR length (≤10 mm or >10 mm) and lesion location (intrastent- vs. edge-ISR) (22). Clinical and angiographic outcome assessors were masked to the allocated treatment strategy; patients and treating physicians were not.
Data monitoring, collection, management, and analysis were organized by the coordinating center (22). The study was an investigator-driven initiative organized under the auspices of the Working Group on Interventional Cardiology of the Spanish Society of Cardiology using unrestricted research grants from B. Braun Surgical and Abbott Vascular. The study followed the provisions of the Declaration of Helsinki and was approved by the Institutional Ethics Committee of all corresponding centers. The primary endpoint was the comparison between the 2 arms of the in-segment minimal lumen diameter (MLD) at the 9-month follow-up (22).
Patients received pre-procedural aspirin and clopidogrel, with a loading dose (300 to 600 mg) administered to clopidogrel-naive patients. Unfractionated heparin was used during the procedure with an initial bolus of 100 mg/kg, followed by additional boluses as necessary, to maintain an activated clotting time >250 s. The protocol mandated careful lesion pre-dilation. Initially, lesions were dilated with relatively short balloons at low pressures to avoid damage to the adjacent coronary segment. Then high pressures were systematically recommended. If underexpanded stents were identified, the use of short noncompliant balloons at very high pressures was recommended (22). Once adequate lesion pre-dilation was obtained, patients received the allocated treatment, with special attention paid to prevent "geographic miss" phenomena. In patients allocated to DEB (SeQuent Please, B. Braun Surgical, Melsungen, Germany), a 1.1:1 balloon-to-artery ratio was selected using nominal pressures (12 to 14 atm) for 60 s. Crossover to bailout stenting was strongly discouraged in this arm. However, crossover was allowed in cases of dilation failure (>50% residual diameter stenosis) or major (>type C) residual dissections. Alternatively, EES (Xience Prime, Abbott Vascular, Abbott Park, Illinois) were deployed using a 1.1:1 final balloon-to-artery ratio and high (>14 bar) pressures. Although post-dilation with noncompliant balloons was recommended, the final strategy was at the operator's discretion. However, the protocol emphasized the need for post-dilation using noncompliant balloons at very high pressures in all patients with suboptimal angiographic results or residual underexpanded stents (22). Special care was indicated to ensure that all high-pressure balloon inflations were performed within the stent boundaries.
Intracoronary imaging techniques (intravascular ultrasound or optical coherence tomography) were recommended in the protocol to: 1) assess the underlying substrate and stent expansion; and 2) optimize procedural results. Selection of technique and the criteria used for final optimization were left to the operator. Patients treated under intravascular guidance were included in pre-defined imaging substudies.
Enzymatic determinations were serially obtained, including serum creatine kinase (with MB analyses for values above the local upper normal limits) and troponin levels. Likewise, 12-lead electrocardiograms were obtained every 8 h during the first day (22). Clopidogrel (75 mg/day) was recommended for 1 year after EES implantation but only for 3 months in patients treated with DEB. Aspirin was used indefinitely.
Patients were followed at 6 to 9 months and 1 year; they will be followed annually for 5 years. Late angiographic follow-up was scheduled at 6 to 9 months, but coronary angiography was performed earlier in patients with recurrent symptoms. Electronic case report forms were completed by the local investigators, monitored, and submitted to the coordinating center, where data were critically reviewed for consistency. Missing data requests and specific queries were sent to sites when necessary. The validated dataset was entered into a dedicated relational database used in all previous RIBS studies (7,8,18,21). Source documents were obtained for all patients with adverse events. Clinical events (death, MI, and target vessel revascularization [TVR]) were adjudicated by an independent and blinded clinical events committee. Deaths were considered cardiac unless a noncardiac cause could be clearly established; MI diagnosis remained unchanged in the RIBS trials (7,8,18,21) and included 2 of the following: prolonged (>30 min) chest pain; rise in creatine kinase levels more than twice the local upper normal values (with abnormal MB fraction); and development of new persisting ischemic electrocardiogram changes (with or without new pathological Q-waves). By protocol, all repeated interventions had to be clinically justified (angina, objective evidence of ischemia, or fractional flow reserve <0.80). In patients requiring TVR, all corresponding angiograms were carefully analyzed at the core laboratory to identify the repeat revascularization's exact location (in-segment vs. a different segment). The Academic Research Consortium definition was used to assess stent thrombosis (23).
Angiographic analysis
All angiograms were analyzed at the central core laboratory by trained and blinded personnel using standard methodology (7,8,18,21). Lesion morphology was assessed using the Mehran (24) and American College of Cardiology/American Heart Association (25) angiographic classifications. Following administration of intracoronary nitroglycerin, 3 orthogonal projections were selected, taking care to avoid vessel foreshortening and overlap of major side branches. Matched projections were repeated after interventions and at late follow-up. A validated automatic edge-detection system (CAAS II System, Pie Medical, Maastricht, the Netherlands) was used for quantitative analysis (18,21,22). Both in-lesion (narrowing and references automatically identified by the system) and in-segment (lesion + complete treated segment + 5-mm adjacent margins) quantitative analyses were performed. Reference vessel diameter, MLD, and percent diameter stenosis were measured pre-procedurally, post-procedurally, and at late follow-up. Acute lumen gain, net gain, late loss, loss index, and binary restenosis rate (>50% diameter stenosis) were determined.
Sample size
Immediately after conventional balloon angioplasty, an MLD of 2.2 ± 0.5 mm was found in the RIBS I and II trials (7,8). A previous study of DEB for BMS-ISR showed late lumen loss of 0.17 ± 0.42 mm (12). However, larger late loss was anticipated in patients with DES-ISR. In a previous acute mechanistic study, we found an "early lumen loss" of 0.4 mm after conventional balloon angioplasty (26). Likewise, ISAR-DESIRE 3 (Intracoronary Stenting and Angiographic Results: Drug Eluting Stents for In-Stent Restenosis 3), recently reported a late loss of 0.37 mm after DEB for DES-ISR (17). Assuming the worst case scenario (late lumen loss of 0.4 mm), an MLD of 1.80 ± 0.6 mm at follow-up was estimated in the DEB arm (22).
Results of EES in patients with DES-ISR were not available when the trial was designed so sample size calculation required major assumptions. Again, based on the previous RIBS studies, we assumed an MLD of 2.6 ± 0.4 mm immediately after stent implantation (7,8). In patients with BMS-ISR treated with sirolimus-eluting stents (SES), the RIBS II study showed a late loss of 0.13 mm (8), whereas the ISAR-DESIRE 1 study showed a late loss of 0.32 mm (9). However, in patients with DES-ISR, the ISAR-DESIRE 2 trial reported larger late loss (0.4 mm) using first-generation DES (10). Assuming a worst-case scenario, a late loss of 0.6 mm after EES was assumed for the current study. Accordingly, an MLD of 2.0 ± 0.6 mm at follow-up was estimated in the EES arm (22).
Using a superiority design (null hypothesis of EES not different than DEB), with an 80% power and an alpha value of 5%, 142 patients per arm were required to prove superiority of EES over DEB (comparison of means in MLD at follow-up; STATA version 11.0, StataCorp LP, College Station, Texas). To compensate for losses in angiographic follow-up (assumed <10%), 310 patients (155 per arm) needed to be enrolled (22).
Statistical analyses
Categorical data (values and percentages) were compared with the chi-square or Fisher exact test. The Kolmogorov-Smirnov test was used to determine normality in data distribution. Continuous data are presented as mean ± SD or median and interquartile range, as required, and were compared using the Student t test or Mann-Whitney test. Main effect estimates are presented with their 95% CI. Event-free survival was estimated from Kaplan-Meier curves and compared with the log-rank and Breslow exact tests. Hazard ratios and 95% confidence intervals were assessed using Cox models and compared with the Wald test. Results of main outcome measure were examined according to 10 pre-specified, relevant clinical and angiographic variables previously detailed in other RIBS trials (7,8,18,21). Interactions were tested by 2-way analysis of variance. Analyses were performed according to the intention-to-treat principle, unless otherwise specified. SPSS Statistics version 15.0 (SPSS Inc., Chicago, Illinois) was used. A p value <0.05 was considered statistically significant.
Authors from the coordinating center (F.A., M.J.P-V., A.C., C.F.) had full access to the study's entire dataset, performed the statistical analysis, and decided to submit the study for publication and take full responsibility in this regard. Statistical analyses were performed at the clinical epidemiology department at the coordinating center.
From January 2010 to August 2013, a total of 309 patients with DES-ISR were enrolled and randomly assigned to DEB (n = 154) or EES (n = 155) (Figure 1). Baseline clinical and angiographic characteristics were well balanced in the 2 groups (Table 1), and procedural characteristics were similar. Although both arms used very high dilation pressures, higher pressures were used in the EES arm. Angiographic success was obtained in all patients (100%). Crossover was required in 5 patients (3%) in the DEB arm (4 treated with EES and 1 with BMS) and in 1 patient (0.6%) in the EES arm (the stent could not be advanced to the lesion site; therefore, a DEB was used instead).
During hospitalization, 1 patient with severe left ventricular dysfunction suffered an anterior non–Q-wave MI and died in cardiogenic shock 4 days after an angiographically successful DEB treatment of a lesion in the left anterior descending coronary artery. Two additional patients developed a non–Q-wave MI despite angiographic success: 1 patient with ISR on a saphenous vein graft treated with EES and 1 patient in whom DEB treatment was complicated with a flow-limiting coronary dissection that finally required crossover to EES. No other major in-hospital complications occurred.
Baseline angiographic characteristics were similar in both arms (Table 2). Immediately after the procedure, EES patients obtained a significantly larger acute lumen gain and final MLD, plus showed lower residual stenosis (Table 2). Late angiographic follow-up (median 247 days in the DEB group and 248 days in the EES group; p = 0.95) was obtained in 272 patients (90% of those eligible). In-segment MLD at follow-up (primary study endpoint) was significantly larger in the EES arm (2.03 ± 0.7 mm vs. 1.80 ± 0.6 mm; p < 0.01; absolute mean difference 0.23 mm; 95% CI: 0.07 to 0.38) (Table 2, Figure 2). Notably, the analysis of the primary endpoint according to 10 pre-specified variables showed consistent results in all subgroups without any significant interaction after formal testing (Figure 3). Other late angiographic findings, including percent diameter stenosis (Central Illustration), net angiographic gain, and loss index, were significantly better in the EES arm. There were strong trends for reductions in the binary restenosis rate (11% vs. 19%; p = 0.06) and in angiographic late loss (median 0.06 mm vs. 0.14 mm; p = 0.06) in the EES group (Table 2). Importantly, based on in-lesion analysis, all major late angiographic findings (including binary restenosis rate and late loss) were significantly better in the EES arm (Table 2).
One-year clinical follow-up was obtained in all 309 patients (100%). Clinical events during the first year are summarized in Table 3. During this time, 7 patients died (3 in the DEB arm and 4 in the EES arm), 4 of them from cardiac causes (2 in each arm). Seven patients experienced an MI (5 in the DEB arm and 2 in the EES). Definitive stent thrombosis occurred in 3 patients (2 in the DEB arm and 1 in the EES). Importantly, those cases in the DEB arm were patients who first developed ISR that was treated with DES and subsequently experienced stent thrombosis. There were 2 additional cases of probable stent thrombosis (1 in each arm) that presented as a late MI. Target lesion revascularization (TLR) was required in 27 patients; 2 underwent coronary surgery (1 in each arm) and 25 percutaneous intervention (19 in the DEB arm and 6 in the EES arm). EES use significantly and consistently reduced TVR and TLR rates (Table 3, Central Illustration, Figure 4). A clinical justification for TLR could be documented in all but 3 patients who nevertheless presented with severe (2 functional occlusions) angiographic ISR on visual assessment. The main clinical outcome measure (cardiac death, MI, and TVR) was significantly reduced in the EES arm (Central Illustration). Angiographic and clinical results in the as-treated analysis were similar to those in the intention-to-treat analysis.
This is the first randomized clinical trial comparing the results of DEB with those of second-generation DES in patients presenting with DES-ISR. These interventions constitute the best currently available therapeutic modalities for these challenging patients (3). In this study, we selected a specific DEB (that uses iopromide as a hydrophilic spacer) that has consistently demonstrated efficacy in patients with ISR (11–18). Likewise, we selected EES as the second-generation DES because it has clearly demonstrated significant improvements in late angiographic and clinical outcomes compared with first-generation DES (19,20). The results of the present study demonstrated that in patients presenting with DES-ISR, EES provided significantly better late angiographic results compared with DEB. These included in-segment MLD and other major secondary late angiographic parameters. Notably, the superior late angiographic findings of EES were consistent using both in-segment and in-lesion analyses, suggesting that final results were not affected by edge-related problems. The meticulous protocol used in both arms to prevent damaging adjacent coronary segments and avoid geographic miss phenomena may have been beneficial in this regard.
The superior late angiographic findings achieved with EES stemmed partially from better acute procedural results compared with the DEB arm. This was found consistently in all previous studies comparing stent- and balloon-based strategies for ISR (7–9,12,17,18). However, despite using very high dilation pressures, the acute lumen gain and MLD obtained immediately post-procedure were lower than anticipated (22). Although affecting both arms, this problem was particularly evident in the EES group. The reason for this remains speculative but may be secondary to the unfavorable substrate of DES-ISR, the presence of resistant DES underexpansion, or both. The underlying pathological substrate of DES-ISR appears to be particularly adverse and frequently includes neoatherosclerosis (3,27,28). On the other hand, superior late angiographic results with EES were also a consequence of the profound antirestenotic efficacy of this new-generation DES, even in this adverse anatomic setting. Indeed, the late loss and loss index were favorable after EES for both in-segment and in-lesion analysis. This is relevant because the classic angiographic dictum "the more you gain, the more you lose" (29) was not observed in the present study, likely a result of the unique antiproliferative efficacy of EES. Therefore, EES not only led to larger acute angiographic gain but also showed less late loss at follow-up. Additionally, our findings were consistent for 10 pre-specified subgroups, emphasizing that the relative efficacy of EES compared with DEB was maintained in diverse clinical and angiographic scenarios.
Importantly, superior late angiographic findings obtained with EES translated into significantly better long-term clinical outcomes (Central Illustration). The main clinical outcome measure was significantly reduced in the EES arm, mainly driven by a significant reduction in repeat revascularization. Indeed, both TVR and TLR were significantly reduced in the EES arm. Notably, in our study, repeated coronary revascularizations had to be clinically indicated and not just a result of the "oculo-stenotic" reflex. Finally, episodes of stent thrombosis were rare and similar in the 2 arms, suggesting that both strategies are safe in this adverse anatomic setting. Notably in the DEB arm, stent thrombosis was found in only 2 patients who had recurrent ISR treated with DES implantation, but no patient suffered an acute vessel closure directly after DEB treatment.
Previous studies
Several randomized clinical trials have demonstrated the value of first-generation DES in patients presenting with BMS-ISR or DES-ISR. In patients with BMS-ISR, the RIBS II study (8) demonstrated the superiority of SES compared with balloon angioplasty, whereas the ISAR-DESIRE 1 study (9) demonstrated that both SES and paclitaxel-based DES were superior to balloon angioplasty. Subsequently, the ISAR-DESIRE 2 trial (10) suggested that in patients with SES-ISR, use of paclitaxel-based DES or another SES provided comparable long-term results. Likewise, many randomized clinical trials have consistently demonstrated the efficacy of DEB in patients with BMS-ISR and DES-ISR (11–18). Overall, DEB provided superior results compared with conventional balloon angioplasty and equivalent results to those obtained with first-generation DES. Accordingly, recent revascularization guidelines have suggested that both strategies (DEB and DES) may be used in patients with ISR (class I, level of evidence A for the 2 therapies) (30).
However, scant information exists on the relative value of second-generation DES versus DEB in patients with ISR. In patients with BMS-ISR, the RIBS V randomized study (18) recently demonstrated that EES provided superior late angiographic results compared with DEB; however, those improved late angiographic findings failed to translate into a significant reduction in the clinical need for revascularization during follow-up. Actually, both strategies provided excellent angiographic results (including very low late loss and single-digit rates of binary restenosis) and satisfactory long-term clinical outcomes (18). Another interesting mechanistic study (using optical coherence tomography) suggested that in patients with BMS-ISR, DEB are less effective than EES (31).
A large observational study confirmed that DEB were also less effective in patients with DES-ISR than in those with BMS-ISR (32). Although the reasons are unclear, drug resistance or the presence of underlying neoatherosclerosis (a relatively common finding in patients with DES-ISR) have been proposed as potential explanations (3). Recently, the ISAR-DESIRE 3 trial (17) compared the efficacy of DEB, paclitaxel DES, and conventional balloon angioplasty in patients with limus DES-ISR. DEB provided equivalent clinical and angiographic results to paclitaxel DES; both were clearly superior to balloon angioplasty. This was an elegant study design because only patients with SES were included and the 2 active treatment arms used the alternative drug (paclitaxel). Moreover, a control arm (conventional balloon angioplasty) was available for comparative purposes (17). The results of a recent multicenter randomized trial that included 220 patients with DES-ISR (16) also demonstrated a relatively large late lumen loss in the DEB arm (0.46 mm) that, nevertheless, was noninferior to the paclitaxel DES arm (0.55 mm). However, paclitaxel-eluting stents remain first-generation devices, meaning the question of whether second-generation DES may be superior to DEB in patients with DES-ISR remains of utmost clinical interest.
Our study provides novel and clinically relevant information for the treatment of patients with DES-ISR. Although EES provided superior angiographic and clinical results than DEB in this challenging setting, both therapeutic strategies produced poorer results than those found in patients treated for BMS-ISR. Importantly, we used the same inclusion/exclusion criteria and methodology as in the RIBS V trial that compared exactly the same strategies but in patients with BMS-ISR (18). In the current study, late loss seen after EES and DEB were 4-fold and 2-fold higher, respectively, than those found in the RIBS V study. Therefore, it appears that the uniquely adverse scenario of DES-ISR was able to unravel the superiority of EES compared with DEB, not only with regard to late angiographic findings but also late clinical outcomes.
Study limitations
First, this remains a relatively small study, even though it is one of the largest trials in patients with DES-ISR, which fortunately remains a relatively rare clinical entity (3,4). Further studies with a large number of patients and longer follow-up will be required to confirm the clinical superiority of EES over DEB in these patients. Second, we used a specific DES only. Although it is tempting to suggest that similar results might be obtained with other second-generation DES, dedicated studies are required to confirm whether current findings constitute a class effect that may be generalized to other second-generation DES. Third, although we found that EES were superior to DEB in most relevant clinical and anatomic scenarios, our subgroup analysis was largely underpowered to definitively answer this important question. It remains possible, therefore, that DEB are equivalent, or even superior, to new-generation DES in specific patient subsets; further studies are certainly warranted to address this intriguing possibility. In clinical practice, DEB remain very attractive in patients already presenting several metal layers at the target site (recalcitrant ISR), in those with relatively large side branches emerging from the stent, and especially in patients unable to maintain a prolonged dual antiplatelet regimen or at high bleeding risk. Further studies are required to unravel the subsets of patients with DES-ISR who benefit from the use of DEB. Finally, because this was an open-label study, reinterventions might have been favored in a specific treatment arm (17). However, our protocol ensured that investigators only performed clinically driven reinterventions, making this possibility unlikely.
This study demonstrated the superior efficacy of EES compared with DEB in patients with DES-ISR. Our findings strongly suggest that EES should be considered the therapy of choice in this vexing and challenging anatomic scenario.
COMPETENCY IN MEDICAL KNOWLEDGE: Everolimus-eluting stents provide greater freedom from in-stent restenosis and late target lesion revascularization than drug-eluting balloon angioplasty in patients with in-stent restenosis of coronary drug-eluting stents during near-term follow-up.
TRANSLATIONAL OUTLOOK: Longer-term studies are needed to establish the optimum device type for percutaneous coronary revascularization in patients who develop in-stent restenosis of coronary drug-eluting stents.
For a complete list of study investigators, coordinators, and sites, please see the online version of this article.
This study was conducted under the auspices of the Working Group of Coronary Interventions of the Spanish Society of Cardiology. This trial is an investigators-driven initiative. Data monitoring, entrance into the database, database maintenance, general and statistical analyses, and drafting and submission of the final manuscript was exclusively performed by the investigators. There was an unrestricted grant from B. Braun Surgical and Abbott Vascular to support this study. These companies, however, played no role in the design of the study, data analysis, data interpretation, writing of the report, or the decision to submit it for publication. Dr. Moreno has received lecture fees from Abbott Vascular. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Listen to this manuscript's audio summary by JACC Editor-in-Chief Dr. Valentin Fuster.
- Abbreviations and Acronyms
- bare-metal stent(s)
- drug-eluting balloon(s)
- drug-eluting stent(s)
- everolimus-eluting stent(s)
- in-stent restenosis
- myocardial infarction
- minimal lumen diameter
- sirolimus-eluting stent(s)
- target lesion revascularization
- target vessel revascularization
- Received February 5, 2015.
- Revision received April 17, 2015.
- Accepted April 20, 2015.
- American College of Cardiology Foundation
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Archive for the 'del.icio.us' Tag
Del.icio.us feed is up
I've decided to post a link to my delicious account on my blog where i hope to constantly update it with interesting general tech news as well as sites that reflect on information we are learning in inb346. I think this is a perfect resource tool everyone could embrace as a class, as it offers a great way to catalogue the hundreds of sites we visit. I've been tagging all my links with inb346, I hope you find them useful!!


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Raspberry Pi: 22 Interesting Hacks for Absolute Beginners With a Raspberry Pi
- $7.99
- $7.99
Publisher Description
The Raspberry Pi has changed the face of home electronics and this new face is the size of a wallet and has a USB and wi-fi port for its features. What began as a method for teaching people to program in a hands on environment has become a new platform for hobbyists to put computers in everything they can get their Raspberry Pi into, to make all the electronic items in their home automatic and to disregard giant corporations for homemade game consoles and digital cameras.
This book takes you into the world of the Raspberry Pi and outlines 22 hacks and projects that can be done with a little graft and a pair of pliers. Whether you are a beginner or an enthusiast there are fresh ideas here for getting the most out of your Raspberry Pi and creating practical and fun projects that can save you time and money. Each project is told in a fun and user friendly fashion and created bold ideas for the possibilities now open you.
In this book you will:
-Learn how to replace your current desktop with the Raspberry Pi's deceptively powerful workings and increase productivity by working distraction free,
-Revolutionize how your films and music find their way around your home and onto your television screen. Create a miniature home cinema or take the movies to the train or the car,
-Discover uses for the Raspberry Pi that take it beyond a teaching aid or a novelty and turn it into an essential component of your home.


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"Microsoft has revealed its latest product prop: a ridiculously large Xbox One in Vancouver. Straight reports that the console is 40 feet long and 20 feet wide, and that the prop will 'unlock' if enough people 'pledge' their gamertags — hinting that the next-generation monument could be preparing for some sort of human sacrifice."
Is this the prototype that had the power brick inside?
- Reposted by


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A united, culturally sensitive church. What a blessing and privilege to be part of God's mission, sharing the good news of Christ's love and His soon return
The Great Task Before Us
Being a united, culturally sensitive church
By Ted N. C. Wilson
This article is adapted from a sermon given by Pastor Wilson on January 30, 2016, in Linthicum Heights, Maryland. Elements of oral style have been retained.—Editors.
What a blessing and privilege to be part of God's mission, sharing the good news of Christ's love and His soon return in these last days of earth's history! But if we don't go out of our way to come into contact with people, how will they know?
In Luke 15:1, 2 we read, "Then all the tax collectors and the sinners drew near to [Jesus] to hear Him. And the Pharisees and scribes complained, saying, 'This Man receives sinners and eats with them.' "
The rabbis were angry and shared their disgust. "This man associates with sinners and even eats with them." Throughout history, whenever selfish, self-centered interests take control of the heart, various classes have developed: those who have and those who have not; those who are educated and those who didn't have those advantages; those who are exclusive and those who have no one to speak for them; saints and sinners.
Certainly we are all sinners and need to come to the foot of the cross every day, accepting Christ's robe of righteousness and His transforming power. We are to humble ourselves every day before the Lord. No one is immune from self-seeking and self-centered thinking.
Cross-cultural Understanding
As mission-minded Seventh-day Adventists, let's learn through the Holy Spirit's guidance how to use cross-cultural understanding in proclaiming the three angels' messages of God's love and Christ's soon return. Let's be more sensitive to differing cultures and settings, realizing that the Advent message is the same everywhere, but the method of sharing it can vary greatly. Let's also be sensitive to local settings so that our behavior doesn't stand in the way of our important work.
I remember arriving in Moscow to take up my work in the Euro-Asia Division, whistling down the division office hallway. A church official quietly cautioned me that whistling indicated that you were an uneducated person, and some people believed that whistling summoned evil spirits. For three years I had the hardest time not whistling. But I carefully complied, since that behavior could have hurt my ability to influence God's work positively.
Another lesson I learned in avoiding a misunderstanding was to pray in the proper manner. I was praying one day with my hands behind my back. I was later instructed by the same leader that you always pray with your hands folded in front of you, otherwise you show disrespect to God. I quickly adapted, since it was not a moral issue.
It's important to humble ourselves and do away with ethnocentric thinking, asking God to help us modify behavior that may inhibit our efforts to lift up Christ. Christocentric thinking must take the place of anything that brings friction and misunderstanding. Let our offices, homes, churches, and interactions be filled with the great themes of the Advent message, with Christ and His righteousness at the center. All our internal and external squabbles and jostling for prominence will sink away when Jesus in His fullness, with all His precious doctrines, ts lifted up.
Doctrine and Belief
In all cultures Christ's teachings and doctrine are core to what we believe and share. Saying that all we need to do is focus on Jesus and not His doctrines is to accept a superficial manner of belief without the solid substance of Christ's message. Doctrine and belief emanate from Christ. His fullness and rich breadth of love signifies the enormous field of truth that is Christ. Ellen White observed: "Christ is the center of all true doctrine."1
Jesus is the rich embodiment of Christ-centered doctrine and belief. Never let anyone suggest that we need to eliminate doctrine to see Christ. Christ and His doctrines go together to produce the Advent message that we proclaim today as a unified, cross-cultural church.
In various places I see detrimental effects of the emerging church movement pushing its way even into the Seventh-day Adventist Church. This movement focuses on experiential understanding, and much less on the cognitive, Bible-based beliefs that we hold dear and that are vital for our close relationship with Christ every day.
Be very aware of this subtle effort to diminish biblical, doctrinal belief thus crippling the Seventh-day Adventist message by neutralizing our distinctive message. Ask for the Holy Spirit's leading in helping us to work cross-culturally in proclaiming the distinctive three angels' messages and counteracting mystic and emerging church influences.
The Great Task Before Us
The great mission before us as a united, culturally sensitive church is to fully embrace the task God has entrusted to us for these last days. We must never veer away from the truth as it is in Jesus. Everywhere we look, the world seems to be disintegrating. Now is the time to rally in a culturally sensitive way to God's unique call.
You and I are part of the last proclamation of hope for the world, the culmination of Revelation 14. We are not to hesitate in our final proclamation of this Advent message. Ellen White challenged us: "We are not to cringe and beg pardon of the world for telling them the truth: we should scorn concealment. Unfurl your colors to meet the cause of men and angels. Let it be understood that Seventh-day Adventists can make no compromise."2
The unfortunate fact is that Seventh-day Adventists in various places are succumbing to "political correctness," pressure, and conformity to unbiblical moral and social changes, in addition to a neutralizing of precious biblical truths. Let's stand firm on all God's truths and principles for personal and church life as we cross-culturally interact with people, pointing them to the One who brings everything into perspective.
The Lord's coming is soon, and we all must follow Christ's example, making cross-cultural connections with all who will listen. We must socialize with them for mission under the leading of the Holy Spirit. We can't witness by proxy. We can't give a personal testimony by remote control. We can't socialize by using a drone. To make an impact, we must come into contact with people.
Research shows that personal contact, under the Holy Spirit's guidance, is the greatest single factor in bringing people to Christ and our beliefs centered in Him. We need television, radio, Internet, publications, community services, health outreach, and many other ways to draw attention to truth, but it finally comes down to personal interaction and witness.
Seeking the Lost
Christ had a burning desire to see all people saved. He didn't look with indifference at those who were sinners and outcasts. God asks us to follow His example in seeking the lost, reaching souls with cross-cultural sensitivity and love, and to be active participants in the last proclamation to this world.
As we become closer to our Savior, are we taking on His character of love for others? Are we willing to do anything necessary to seek out those who wander away from truth?
"Every soul whom Christ has rescued is called to work in His name for the saving of the lost," wrote Ellen White. "When you turn from those who seem unpromising and unattractive, do you realize that you are neglecting the souls for whom Christ is seeking? . . . Angels pity these wandering ones. Angels weep, while human eyes are dry and hearts are closed to pity. . . . O for more of Christ's spirit, and for less, far less, of self!"3
Our work is to follow Christ's example in daily interfacing and proactively seeking those who need to hear of God's grace and power that will change their lives. Whether by telephone, e-mail, letter, personal contact, public meetings, God wants us to socialize with others as Christ did, carefully and prayerfully pointing people to complete Bible truth and a knowledge of Christ's plan for their redemption, culminating with His soon Second Coming. Let's allow the Holy Spirit to help us socialize in the right way with the right approach, recognizing that we too are all sinners in need of Christ's saving power.
In the Garden of Gethsemane Christ agonized for you and me. Ellen White described it: "He accepts His baptism of blood, that through Him perishing millions may gain everlasting life. He . . . left the courts of heaven, where all is purity, happiness, and glory, to save the one lost sheep, the one world that has fallen by transgression. And He will not turn from His mission."4
Christ offers a cross-cultural mission to us today—Total Member Involvement in God's remnant church, empowered to proclaim the last message of love and warning. Christ went to the cross, died for us, rose for us, is interceding in the Most Holy Place of the heavenly sanctuary now for us, and will soon return to take us home to heaven.
I can't wait! Let's prepare for His soon coming, and let's prepare others by befriending them for mission.
Ted N. C. Wilson is president of the Seventh-day Adventist Church.
1 Ellen G. White, Counsels to Parents, Teachers, and Students (Mountain View, Calif.: Pacific Press Pub. Assn., 1913), p. 453.
2 Ellen G. White, Evangelism (Washington, D.C.: Review and Herald Pub. Assn., 1946), p. 179.
3 Ellen G. White, Christ's Object Lessons (Washington, D.C.: Review and Herald Pub. Assn., 1900), pp. 191, 192.
4 Ellen G. White, The Desire of Ages (Mountain View, Calif.: Pacific Press Pub. Assn., 1898), p. 693.


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Beer is an alcoholic drink that probably one of the most popular and not to mention most loved beverage of all time. A friend recently made a side trip to Calgary Brewery during his visit to his relatives, and was able to have a personal tour with one of their long time serving staff. I'm pretty sure you know that it is made through fermentation of starches derived from grains under the process called brewing, but here are some additional facts you should know about your favourite hangout drink:
- The average alcohol by volume (ABV) content of beers is 5%.
Almost all brewed beers are produced within the range of 5% to 7% alcoholic content. But there is a brew created by a company called Brewmeister, that has a whopping 67.5% ABV making it the world's strongest beer. The drink is called the 'snake venom' and will definitely burn your stomach if you chug a whole bottle down in one sitting. I'd rather stick to the normal Calgary craft beers, thank you.
- Guinness Book of World Records has a title for World Beer Chugging Champion.
How fast can you drink a liter of beer? For Steven Petrosino, it only took him 1.3 seconds to finish this task. Because of chugging down in the same speed our eyelids take to blink, he earned the title of World Beer Chugging Champion in 1977. I wonder how he was able to fit all that liquid and drain it down to his stomach so quickly?
- The study of beer and beer making is zythology.
Beer was taken so seriously even back in the days that there is a scientific field that deals with its creation and study. Zythologists are the experienced beer connoisseur who is familiar with the ingredients and the brewing process of beer. It is also imperative that zythologists be able to explain in simple terms the art of beer tasting and its process.
- Czech Republic tops any other country in drinking beer.
In this fact you can easily say what nation loves beer the most. Czech Republic has a record of per capita beer consumption of almost 40 gallons a year. If you were to sit in a table with someone from this country, then its probably not a good idea to test your limits and drink with them; you'll be on the floor before you know it while they're left alone still drinking the night.
- Oktoberfest is the world's largest beer festival.
This beer festival is celebrated yearly in Munich, Germany and millions of people from all over the world fly in just to attend this funfair. It runs for two whole weeks from late September to early October. It's also a known fact that Germany takes its beer brewing seriously, so if you're planning on attending one next year, I'm sure you'll be tasting good quality beer.
It is no wonder why this alcoholic drink has remained part of our world's evolution and development through the years. There are already hundreds of varieties of beer, but one thing is for sure: beer has been part of our hangout and party times, and it will stay that way.


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Results for pages tagged with "ranching in the south"
5 Results found
Small Grains Breeding at Noble Research Institute
Small grains breeding has been an integral part of the Noble Research Institute work since the early 1950s.
Happy Calving Season!
It's my favorite time of year. Brand new baby calves take their first steps into the world, and it's a beautiful thing. I still remember the first one I watched, and I've been hooked on it ever...
Welcome to Our Love County Research Ranches
Crisp fall leaves scatter across the wide open pastures in southern Oklahoma. The sun is just beginning to peek over the horizon and welcome a new day. Small pockets of steam rise up from huddled...


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Click here: Overview of Primary Education
The National Curriculum (2014) is operational across the whole school and the teachers plan engaging programmes of study with the statutory frameworks to ensure coverage across all subject areas. We usually run mixed age classes (often. mixed Years 4 and 5 and 6 ), so we have to operate a rolling programme across two years to ensure a class will have experience of the curriculum for both age groups in each class.
We make use of the PIXL Primary assessment resources for English and Maths across the year groups from Year 1 to Year 6. It provides tracking and target setting information for teachers that is regularly shared with the pupils and their parents. It identifies through regular assessments, the standard that the children are working at, their targets to aim for and the progress they are making towards those targets. It identifies those children who are not reaching their expected levels and signposts the focus needed for the support that will help them to improve. It also provides a skills assessment that helps us to identify gaps in knowledge in the basic Mathematics and English skills and ensures we can track progress on a weekly basis.
In writing we work in a broad range of genres to ensure the children can write on a range of subjects in different genre, using real experiences where we can. The assessment of writing is based on teacher's judgement of whether the children have matched the age related expectations laid down in the National Curriculum.
We no longer assign a level of achievement to a child as we have moved to a "life without levels" as dictated by the Department for Education. We are developing assessment and tracking systems using the Pupil Asset tracking system where we record the children's achievements against the age related expectations. This is constantly under review as it is for most schools and we will share more information as it develops but it will be based on whether your child is at an emerging, expected or at greater depth stage.
We track progress of individual children, groups of children and classes termly and write an annual record of achievement in the Spring term for all pupils except those in their Reception year; their report will come out in the Summer Term. All parents in Year 1-6 receive and end of year achievement summary.
We know well how beneficial parental support can be to a child's education. We can offer support and guidance to parents if you are at all unsure how best to help with your child's learning. Your time, full attention, praise and interest in what they are doing at school and in their homework is a really good place to start.
Homework comes in three forms: regular reading, spelling practice weekly; Maths and/or English exercises that build on work done in class; and half termly Home Challenges which are a creative opportunities that can be interpreted by the children in a range of ways.
The "jigsaws" reflect a breakdown of the curriculum into year group allocations of the National Curriculum. There is variation in this for our school as we have to run the rolling programme of curriculum maps to ensure we can teach our mixed age classes with one topic at a time but still meet the requirements of the curriculum. Over the two year period, the teachers blend topics from both year groups relevant to their class.
School Performance
School performance: we are waiting for the validated results to be released for 2018 These will be available later in the academic year. Please see Key Stage 2 results tab for most recent results. The last Ofsted inspection was in July 2015 where the school was recognised as being 'Good'.
Y2 Overview
Y3 Overview
Y4 Overview
Y5 Overview
Y6 Overview