Author: Admin

<div class=Small aircraft crashes into building in New York City
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Small aircraft crashes into building in New York City

Wednesday, October 11, 2006

A small aircraft struck an apartment building in New York this afternoon, killing the pilot and a flight instructor. Cory Lidle, a pitcher for the New York Yankees baseball team, was the registered owner of the aircraft and is believed to have been piloting it; his passport was found on the scene. The flight instructor was Tyler Stanger.

The plane, a Cirrus SR20 with registration number N929CD, hit the 26th floor of the Belaire Condominium, a 50 story brick luxury residential building on the Upper East Side at 524 East 72nd Street at York Avenue near the East River in Manhattan, New York City, of which the first 20 floors are a hospital. An eyewitness, present half a block from the building, reported that the plane hit the building, creating an enormous fireball, broke in two and crashed down onto on the street below. Authorities received a 911 call reporting a crash at 2:42 p.m. Eastern time.

New York City mayor Michael Bloomberg gave a press conference at approximately 5:20 p.m. Eastern time to report that the plane was occupied by a flight instructor and a student pilot, but as next-of-kin had not been able to be notified, the identities of the two people on the plane would not be released at this time.

Apartments were seen to be engulfed in flames. The FBI has stated that it was not an intentional attack. The New York area was grey and overcast during the time at crash; however, visibility was not hampered.

After an hour and a half, the fire was extinguished by the FDNY. According to CNN Television ten people have been injured, six of them firefighters. The New York Times, however, reports that eleven firefighters have been injured.

Initial reports suggested that a helicopter was involved, but the FAA has stated that it was a fixed-wing aircraft. CNN Television reported that it was a single-engine fixed-wing plane which left Teterboro Airport, a busy General Aviation airport in New Jersey, circled the Statue of Liberty was tracked on radar until it was lost near the 59th Street Bridge, that the plane may have been having fuel problems or fuel pump problems, and that it was “a pilot in distress.”

Wallace Sines, a source for CNN stated he believes the plane was a Cirrus SR-20 with an installed parachute, which did not deploy. The whole-plane parachute system may have saved the lives of the aircraft occupants had it been safely deployed clear of buildings, but the system is not designed to prevent the trauma associated with a plane impacting a builing. The Cirrus SR-20 was introduced in 2001 and the Cirrus line of 4-seater aircraft has since become one of the most purchased single engine aircraft in the world. The SR-20 does not normally carry an airline-style flight-data recorder, but some are equipped with GPS equipment which logs flight direction, speed and altitude.

The aircraft was owned by baseball player Cory Lidle. He was on board reported by AP. Lidle was killed, according to reports. CNN Television reported that the FBI stated he was at the controls as the only occupant of the plane, and that his passport was found on the ground below the accident.

A little over an hour and a half after the crash, the fire was extinguished after 39 fire units and over 100 fire fighters responded.

The White House has said that there has been no change in the terror threat alert level and that President Bush is being updated constantly.

La Guardia airport was temporarily restricted to no take offs from other airports, however by 4:10 Eastern Time, CNN Television reported that all New York-area airports were open.

CNN Television announced at 3:50 p.m. Eastern Time that as of a few minutes earlier, NORAD is putting fighter aircraft on patrol over certain major American cities as a precautionary measure similar to the actions taken after the 9/11 attacks as a “just in case” measure. It also reported that tomorrow is the 6th anniversary of the attack on the USS Cole in Aden, Yemen.

Moments after the crash, there was a drop in the New York Stock Exchange, however it quickly returned to normal after it was reported that the crash was an accident.

The New York Yankees organization confirmed the plane is registered to Cory Lidle of the New York Yankees, who was planning to fly from New York to Florida, and that some unnamed member of the Yankees organization was on the plane.

One eye-witness interviewed by the BBC stated: “I was wondering why the plane was doing acrobatics and then the next thing I knew was that it had crashed into the building.”She also added that the plane was a small, white, 4-seater winged aircraft and not a helicopter as many news agencies were reporting it to be.

CNN Television broadcast reports from eyewitnesses who reported:

  • A pilot who saw the impact stated, “It looked like a pilot who was desperately trying to get to an airport.”
  • Another eyewitness who saw the event from the Brooklyn-Queens Expressway, also referred to the incident as appearing as if the plane was “desperately trying to get to LaGuardia” and that as to whether he “clipped” the building, or struck it directly, that “he hit it dead on.”
  • “I heard a buzzing noise and then an explosion which looked like a mushroom cloud.”
Retrieved from “https://en.wikinews.org/w/index.php?title=Small_aircraft_crashes_into_building_in_New_York_City&oldid=3123134”
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<div class=Wikinews interviews biologist Chris Simon about periodical cicadas
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Wikinews interviews biologist Chris Simon about periodical cicadas

Wednesday, June 12, 2013

In May, periodical cicadas with 17 years life cycle emerged on the East Coast of the USA after underground development as juveniles since 1996. Researchers and scientists worked to map and study the rare wave, and the locals prepared for the noisy event. First recorded in 1666, the Magicicada septendecim species recently emerged in 1979, 1996, this year, with a next wave due in 2030.

This week, Wikinews interviewed Chris Simon, an ecology and evolutionary biologist at University of Connecticut, about the cicadas.

((Wikinews)) What caused your initial interest in periodical cicadas?

Chris Simon: As an undergraduate student, I was interested in the formation of species so when I went to graduate school I looked for a study organism that was likely to be in the process of forming new species. I chose periodical cicadas because they are broken up into reproductively isolated broods (or year classes). Reproductive isolation leads to speciation so I planned to study biochemical differences among the broods.

((WN)) You study the emergence of the periodical cicadas. What do you study? What observations are you making?

CS: We record exactly where each cicada population emerges (using GPS automated mapping and crowd sourcing). We record the presence or absence of each of the three morphologically distinct species groups of periodical cicadas (Decim group, Cassini group, and Decula group). We collect specimens for DNA analysis. We look for cicadas coming up one and four years early and late. We dig up cicada nymphs and monitor their growth rates.

((WN)) What equipment do you use?

CS: Nets, shovels, automated GPS recorders, cameras, laptop computers, automated DNA sequencers.

((WN)) Do you study the periodical cicadas with anyone else? What is their role?

CS: Yes, there are a large number of people studying periodical cicadas in my lab and in other labs. My lab is made up of Research Scientists, Postdoctoral Researchers, a technician, graduate students, and undergraduates. Research Scientist John Cooley is the leader of the GPS mapping project; he invented the automated GPS recorder; he built our crowd-sourcing website, and he is instrumental in public outreach. Postdoctoral research David Marshall also participates in the mapping project and leads the part of the research related to the mapping of stragglers. John and Dave and Technician Kathy Hill all study periodical cicada mating behavior and conduct mating and hybridization experiments. One of my graduate students Beth Wade has participated in the nymph collections and will soon start genetic work involving genome wide association mapping designed to locate genes related to life cycle. My graduate student Russ Meister is studying the genes of the bacterial endosymbionts of cicadas. My current undergraduate honors student Erin Dwyer is also studying the development of Magicicada nymphs and is helping to design a lab exercise for college students around the eastern US to do the same. Many of my past undergraduate students have studied the biochemical genetics and development of periodical cicadas. See the Simon Lab website.
CS: We are collaborating with Teiji Sota at the University Kyoto and Jin Yoshimura at Shizuoka University in Japan. They are studying the phylogeography of Magicicada. We are collaborating with John McCutcheon of the University of Montana who is studying the endosymbiont genomes.
CS: We are also collaborating with ecologists Rick Karban and Louie Yang, both professors at UC Davis who have an interest in cicada population dynamics and nutrient cycling in the ecosystem.

((WN)) You studied the periodical cicadas in 1979 and 1996 too. What changes with time?

CS: I have studied periodical cicadas since I was a student back in 1974. What changes with time is increased human development constantly shrinking the patch size of cicada populations.

((WN)) What are your thoughts on the long life span of the periodical cicadas? Why could it be so? What advantages and what disadvantages does it have?

CS: Most or all cicadas have long life cycles compared to your typical annual insect. Examples have been found of two-year to 9-year cycles in different species. Periodical cicadas evolved an even-longer life cycle and I think that part of this relates to the evolution of their synchronized life cycles and peculiar safety-in-numbers strategy for survival. To become synchronized, periodical cicadas had to evolve an exact length life cycle and all adults would have to appear in the same year. Because the nymphs grow at different rates underground, a longer life cycle and a way of counting years must have evolved so that the individuals that get to the last nymphal (underground juvenile) stage first would wait long enough for all other individuals in the population to become ready to emerge.

((WN)) News reports mention this is ‘Brood II’ of the periodical cicadas. What are the distinctive features of this specific species and what is its full scientific name?

CS: The same species exist in multiple broods. No species is restricted to Brood II. The three species present in Brood II are: Magicicada septendecim, M. cassini, and M. septendecula. These same three species are found in every 17-year brood (except the farthest north which only has M. septendecim).

((WN)) At what depth do the cicadas juveniles live underground?

CS: Most live within the top foot of soil but some have been found deeper. We do not know if they go deeper in winter. We need to do much more digging to understand the nymphs.

((WN)) How do people prepare for the cicada emergence?

CS: Of course various people prepare in different ways. Ideally, everyone prepares by studying information available on the web (especially on our websites Magicicada Central and Magicicada.org).

((WN)) Do cicadas affect transport in the local area?

CS: No, not really. Occasionally individuals can be seeing flying across highways and sometimes they smash into cars.

((WN)) Do cicadas usually stay outside or do they also invade houses too?

CS: They stay outside. One might accidentally fly in through an open window but that would be rare.

((WN)) What do the cicadas eat?

CS: Cicadas suck xylem fluid (the watery fluid coming up from the roots of plants) in deciduous forest trees and herbs. Essential amino acids in the cicada diet are supplied by their bacterial endosymbionts. There are two species of endosymbionts. One makes 8 essential amino acids and one makes two essential amino acids.

((WN)) Do cicadas damage crops or city vegetation? What damage?

CS: Cicadas do not chew leave so they do not damage crops like other insects. They can inflict some damage by their egg laying. Cicadas lay eggs in pencil-sized tree branches. If there are not enough branches available, too many female cicadas may lay eggs in a single branch weakening it and making it susceptible to breakage by wind. This can sometimes cause damage in fruit orchards. If the branches break, the eggs die so this behavior is selected against by natural selection.

((WN)) Thank you.

CS: You’re welcome. I am happy to have this opportunity to communicate with your readers!
Retrieved from “https://en.wikinews.org/w/index.php?title=Wikinews_interviews_biologist_Chris_Simon_about_periodical_cicadas&oldid=2283939”
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When To Get A Construction Permit In Hollywood, Fl

When To Get A Construction Permit In Hollywood, Fl

byAlma Abell

In the case of building, renovating or simply updating, it is better to be safe than sorry. Some homeowners take on the attitude that they can do whatever they want to with their property and if the city requires permits or inspections they can have them done if they are caught. Understanding that if you are indeed in violation of building on your property without the proper Construction Permit in Hollywood, FL you may be in deeper trouble than just paying a few fines.

[youtube]http://www.youtube.com/watch?v=L4zpVFETVgE[/youtube]

In some cases, when a construction job has been completed without the proper documentation on file with the city or other governing boards, fines are the just the start of the homeowner’s problems. In some instances, if the permits were not obtained the site may be forced back to its original make-up before consideration of other jobs are taken. What’s worse, is that if there is a home loan on the property, the financial institution may find you in default of your mortgage.

Not to scare off a homeowner to maintaining or upgrading their home, but there are proper ways to getting a Construction Permit in Hollywood, FL so that everyone is protected. It does not take much to get a permit. There are a few steps and some costs involved but it is worth the planning to do it right the first time. If you wonder if your current job on the home requires a permit, it is better to ask. As a general rule any updating of the mechanical, building, electrical or construction of the home is being done a permit is required. What that means is that a simple job like window replacement requires a permit but painting or changing the wallpaper does not.

There is no need to worry in pulling a permit for your job site. If it is just a step that you are not comfortable with there are companies like Your Permit Solution that will handle the paperwork for you. Contractors, agents or homeowners are allowed to pull the permits as long as their is the appropriate documentation showing the job that is going to be done. Most permits can be applied for and received in one to two business days with obviously bigger, multi-permit jobs taking more time.

<div class=Wikimedia Foundation announces departure of general counsel Mike Godwin
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Wikimedia Foundation announces departure of general counsel Mike Godwin

Wednesday, October 20, 2010

This article mentions the Wikimedia Foundation, one of its projects, or people related to it. Wikinews is a project of the Wikimedia Foundation.

The Wikimedia Foundation, a non-profit organization which administers online collaborative websites including Wikipedia and Wikinews, announced yesterday that its general counsel Mike Godwin will leave his position this Friday. The author of Cyber Rights: Defending Free speech in the Digital Age, Godwin is a former fellow at the Yale Center for Internet Studies and staff counsel for the Electronic Frontier Foundation who has served as chief lawyer for the Wikimedia Foundation since July 2007.

Executive Director of the Wikimedia Foundation Sue Gardner announced the news in a public email. She wrote, “Hi folks, I want to let you know that as of this Friday, October 22, 2010, Mike Godwin will be leaving his role as General Counsel for the Wikimedia Foundation. Mike’s transition out of the role will be a fairly lengthy one: he will continue to be available to the Wikimedia Foundation to provide information and advice for several months to come.”

The Wikimedia Foundation believes Mike has always acted in what he believes to be the Wikimedia Foundation’s best interests.

Gardner stated in a “Q and A” below the text of her email that Godwin was leaving the organization due to “a confidential personnel issue”, and explained that the foundation would not elaborate upon this due to privacy concerns. Gardner noted, “The Wikimedia Foundation believes Mike has always acted in what he believes to be the Wikimedia Foundation’s best interests.”

Godwin has focused his legal career in the areas of free speech and Internet law. In an article regarding his 1999 selection as a fellow at the Yale Center for Internet Studies, The Hartford Courant characterized Godwin as “a noted cyberspace lawyer and civil libertarian”.

He is noted for writing “Godwin’s Law”, an Internet maxim which states, “As an online discussion grows longer, the probability of a comparison involving Nazis or Hitler approaches one.”

Godwin became the first attorney to join the Electronic Frontier Foundation after its formation in 1990. In a 2007 interview with The New York Times, Godwin commented on the issue of defamation online, “The fear of defamation on the Internet is very strong. We’re going to be riding that social panic for a little bit.” He described his role at the Wikimedia Foundation, “Part of my job is to prevent restrictive rules from being put in place that prevent people from participating in massively democratic participatory media. And then let the new norms settle.” He acknowledged he empathized with others that had been criticized on the Internet, “Look, I have been smeared online. I know how bad it feels. It hurts. If democracy were comfortable, everybody would have it.”

Retrieved from “https://en.wikinews.org/w/index.php?title=Wikimedia_Foundation_announces_departure_of_general_counsel_Mike_Godwin&oldid=3299961”
Posted in Uncategorized
<div class=U.K. doctors successfully transplant a beating heart
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U.K. doctors successfully transplant a beating heart

Monday, June 5, 2006

British doctors have successfully transplanted a beating heart into the chest of a 58-year old man, the first operation of its kind in the United Kingdom.

The “trial” surgery was performed at Papworth Hospital just outside of London, England in Cambridge. The operation could be “equivalent if not superior” to the current transplanting methods, doctors said. The method has only been performed two other times, in Germany.

Usually hearts would be injected with potassium, which stopped the heart from beating, after which it would be covered with ice. This put the heart in “suspended animation” but gave doctors only a six-hour window to examine and transplant, doctors said.

“Normally the heart is in suspended animation but they still start to deteriorate,” said Professor Bruce Rosengard, head of the team of doctors who operated on the man.

The new method involves connecting the heart to a machine that pumps warm, oxygen enriched blood through the heart. The heart is able to keep beating with this method. The new process allows surgeons to look more closely and longer at the heart for any signs of damage. It also allows them to find a match for whoever may need it.

“Once hearts are hooked up to the device, which takes about 20 minutes, any deterioration is fully reversed. If we look at resuscitating hearts that are currently unusable, the number of transplants could be tripled or quadrupled,” added Rosengard. “The goal of this trial is to demonstrate that this is at least equivalent if not superior,” he added.

The director of transplants in the United Kingdom Chris Rudge also says that doctors are working on using the same new method with different human organs.

“In the longer term it is not just hearts that can be handled by such systems but other organs too, particularly the liver,” said Rudge.

The 58-year old man is doing “extremely well. At his exam one week after the operation, all his functions were absolutely normal,” Rosengard said.

At least 19 more operations are planned in the U.K. and in Germany.

Retrieved from “https://en.wikinews.org/w/index.php?title=U.K._doctors_successfully_transplant_a_beating_heart&oldid=2583725”
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A Review Of Make Your Knowledge Sell

A Review Of Make Your Knowledge Sell

By Brian Garvin

Whether you are looking for a way to supplement your income, or you are looking for a way to break onto the scene with the important new information that you have, you’ll find that there is plenty of good information out there, and that you have to learn to package it appropriately.

More and more, people are discovering that they need to package their information into an eBook, and with that in mind, you need to make sure that you are taking advantage of the information that is presented clearly and directly in Make Your Knowledge Sell. With this information, you’ll learn everything about ebooks, and you’ll find that this might be the best way for you to market your information.

The first thing that you need to keep in mind is that this information is letting you start from scratch. You’ll find that you can learn all about how to make sure that your thoughts make it on to the page. As any writer can tell you, this is harder than it looks, but it is also easier than you might believe!

[youtube]http://www.youtube.com/watch?v=znBlH-kyR1k[/youtube]

You’ll find that Make Your Knowledge Sell can help you organize your thoughts and put them in a way that is going to make sure that your information is all there and ready for your readers. Not only will your ebook’s package look great, you’ll find that it will also ensure that your content is readable and accessible.

You’ll also find that you will be given information on how to publish your ebook. There are plenty of different publishing options out there, and you may have heard of one or two, but here you’ll find out about all of the choices you need to make, and you’ll discover which one will be the best for your situation. There is a great deal of good information out there, no matter what you are thinking of when it comes to content, and there is a good way to sell it, too! Take the time to learn a little bit about your market and to make sure that this ebook can be your guide.

Finally, you’ll find a way to make sure that this information that you have pulled out of your brain will sell online. You’ll discover that this is an important part of it. You won’t be selling anything if you don’t make an effort, no matter how good the information is. You’ll also find that there are a number of different options online for you to take advantage of. You’ll be able to get your book out there to the best and most receptive audience, which is extremely important for online publishers.

There are plenty of reasons to take a look at Make Your Knowledge Sell, but one of the best ones is that you already have the resources to make it work. You already know a lot about something, and chances are, there are people out there who are curious about what you have to offer, so don’t miss out on a fun and profitable chance to tell them!

About the Author: Let

Site Sell

Review Kings Brian Garvin and Jeff West teach you more about

Make Your Knowledge Sell

. Feel free to use this article but please leave all links and author bio intact.

Source:

isnare.com

Permanent Link:

isnare.com/?aid=318675&ca=Marketing

<div class=Wikimedia Foundation announces departure of general counsel Mike Godwin
" />

Wikimedia Foundation announces departure of general counsel Mike Godwin

Wednesday, October 20, 2010

This article mentions the Wikimedia Foundation, one of its projects, or people related to it. Wikinews is a project of the Wikimedia Foundation.

The Wikimedia Foundation, a non-profit organization which administers online collaborative websites including Wikipedia and Wikinews, announced yesterday that its general counsel Mike Godwin will leave his position this Friday. The author of Cyber Rights: Defending Free speech in the Digital Age, Godwin is a former fellow at the Yale Center for Internet Studies and staff counsel for the Electronic Frontier Foundation who has served as chief lawyer for the Wikimedia Foundation since July 2007.

Executive Director of the Wikimedia Foundation Sue Gardner announced the news in a public email. She wrote, “Hi folks, I want to let you know that as of this Friday, October 22, 2010, Mike Godwin will be leaving his role as General Counsel for the Wikimedia Foundation. Mike’s transition out of the role will be a fairly lengthy one: he will continue to be available to the Wikimedia Foundation to provide information and advice for several months to come.”

The Wikimedia Foundation believes Mike has always acted in what he believes to be the Wikimedia Foundation’s best interests.

Gardner stated in a “Q and A” below the text of her email that Godwin was leaving the organization due to “a confidential personnel issue”, and explained that the foundation would not elaborate upon this due to privacy concerns. Gardner noted, “The Wikimedia Foundation believes Mike has always acted in what he believes to be the Wikimedia Foundation’s best interests.”

Godwin has focused his legal career in the areas of free speech and Internet law. In an article regarding his 1999 selection as a fellow at the Yale Center for Internet Studies, The Hartford Courant characterized Godwin as “a noted cyberspace lawyer and civil libertarian”.

He is noted for writing “Godwin’s Law”, an Internet maxim which states, “As an online discussion grows longer, the probability of a comparison involving Nazis or Hitler approaches one.”

Godwin became the first attorney to join the Electronic Frontier Foundation after its formation in 1990. In a 2007 interview with The New York Times, Godwin commented on the issue of defamation online, “The fear of defamation on the Internet is very strong. We’re going to be riding that social panic for a little bit.” He described his role at the Wikimedia Foundation, “Part of my job is to prevent restrictive rules from being put in place that prevent people from participating in massively democratic participatory media. And then let the new norms settle.” He acknowledged he empathized with others that had been criticized on the Internet, “Look, I have been smeared online. I know how bad it feels. It hurts. If democracy were comfortable, everybody would have it.”

Retrieved from “https://en.wikinews.org/w/index.php?title=Wikimedia_Foundation_announces_departure_of_general_counsel_Mike_Godwin&oldid=3299961”
Posted in Uncategorized
<div class=Jindal signs Intelligent Design law
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Jindal signs Intelligent Design law

Saturday, June 28, 2008

Louisiana Republican Governor Bobby Jindal signed a controversial bill hailed by intelligent design supporters, such as the Discovery Institute, and Louisiana Family Forum, a creationist group. Critics of the bill, including several major science organizations, say it allows for the teaching of “creationism” in public schools.

The law, Louisiana Science Education Act, allows teachers to use “supplemental materials” when discussing evolution, but it does not state what the materials would be.

Citing the 1987 Supreme Court ruling in Edwards v. Aguillard, “Louisiana has a long and unfortunate history of trying to substitute dogma for science in classrooms,” said Reverend Barry W. Lynn, an executive director for Americans United for Separation of Church and State. In addition, the American Association for the Advancement of Science, National Center for Science Education, and the Louisiana Coalition for Science opposed the bill arguing it would cause detriment to students’ education by letting in unapproved curriculum.

According to Reuters, Jindal’s office declined to comment on Friday.

Similar Academic Freedom bills have been promoted by the Discovery Institute in other states, but so far they have failed.

Retrieved from “https://en.wikinews.org/w/index.php?title=Jindal_signs_Intelligent_Design_law&oldid=772056”
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Tips To Follow When Sport Betting Online

Tips To Follow When Sport Betting Online

Sports betting is a great enhancement to the lives of people watching sports. Not only do you get excited about your favorite team winning, you also have the chance of making profit. Sports betting even enhances satisfaction because of the introduction of sports betting online. With sports betting online, it is so much easier to do betting. One can just go to an online sportsbook and place their bets. Everything is done on the Internet and you do not have to leave the house to do your betting activities. Aside from this, sports betting online is enhanced by the Internet. You can research stats and information about different sports teams with just a few clicks of the mouse. Many sports fans and non-sports fan love sports betting online because it is practical and exciting. We want to help you enjoy sports betting so here are a few tips to follow to assure you of winning money while enjoying the games.

Betting Tip # 1: Always have a budgeted bankroll. Before you decide to wager on anything, it is important that you apply good money management to your sports betting activities. Sit down, get a piece of paper and pen plus a calculator and compute the amount of money you can put aside for sports betting. The same concept applies in budgeting your dinners at restaurants or the money you spend on clothes. The amount of money you should be willing to spend for sports betting online is an amount you can afford to lose. When you have a number, stick with that figure. Apply discipline to your bankroll management and it will make you more money rather than spill money.

Betting Tip # 2: Look around for the best sportsbook. It is important you checkout all the bookmakers and sportsbooks available. Most of the popular bookmakers have online versions so you will not have a hard time looking for them on the web. Sometimes, especially in sports like college basketball, these oddmakers will have different numbers. Choose the bookie with the best odds and numbers. Be careful with the numbers because it can go as low as just three points and that three points can make the difference between a win and a loss.

Betting Tip # 3: Avoid making sports bets when you’re drunk. Your judgment will be impaired and you will regret it in the end. You not only lose money, you also end up with a bad and expensive hangover.

Betting Tip # 4: Research, research and do more research. Know everything there is to know about the particular sport you are betting on. Research about the teams, the issues they face and detailed information such as injuries of key players.

<div class=Cleveland, Ohio clinic performs US’s first face transplant
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Cleveland, Ohio clinic performs US’s first face transplant

Thursday, December 18, 2008

A team of eight transplant surgeons in Cleveland Clinic in Ohio, USA, led by reconstructive surgeon Dr. Maria Siemionow, age 58, have successfully performed the first almost total face transplant in the US, and the fourth globally, on a woman so horribly disfigured due to trauma, that cost her an eye. Two weeks ago Dr. Siemionow, in a 23-hour marathon surgery, replaced 80 percent of her face, by transplanting or grafting bone, nerve, blood vessels, muscles and skin harvested from a female donor’s cadaver.

The Clinic surgeons, in Wednesday’s news conference, described the details of the transplant but upon request, the team did not publish her name, age and cause of injury nor the donor’s identity. The patient’s family desired the reason for her transplant to remain confidential. The Los Angeles Times reported that the patient “had no upper jaw, nose, cheeks or lower eyelids and was unable to eat, talk, smile, smell or breathe on her own.” The clinic’s dermatology and plastic surgery chair, Francis Papay, described the nine hours phase of the procedure: “We transferred the skin, all the facial muscles in the upper face and mid-face, the upper lip, all of the nose, most of the sinuses around the nose, the upper jaw including the teeth, the facial nerve.” Thereafter, another team spent three hours sewing the woman’s blood vessels to that of the donor’s face to restore blood circulation, making the graft a success.

The New York Times reported that “three partial face transplants have been performed since 2005, two in France and one in China, all using facial tissue from a dead donor with permission from their families.” “Only the forehead, upper eyelids, lower lip, lower teeth and jaw are hers, the rest of her face comes from a cadaver; she could not eat on her own or breathe without a hole in her windpipe. About 77 square inches of tissue were transplanted from the donor,” it further described the details of the medical marvel. The patient, however, must take lifetime immunosuppressive drugs, also called antirejection drugs, which do not guarantee success. The transplant team said that in case of failure, it would replace the part with a skin graft taken from her own body.

Dr. Bohdan Pomahac, a Brigham and Women’s Hospital surgeon praised the recent medical development. “There are patients who can benefit tremendously from this. It’s great that it happened,” he said.

Leading bioethicist Arthur Caplan of the University of Pennsylvania withheld judgment on the Cleveland transplant amid grave concerns on the post-operation results. “The biggest ethical problem is dealing with failure — if your face rejects. It would be a living hell. If your face is falling off and you can’t eat and you can’t breathe and you’re suffering in a terrible manner that can’t be reversed, you need to put on the table assistance in dying. There are patients who can benefit tremendously from this. It’s great that it happened,” he said.

Dr Alex Clarke, of the Royal Free Hospital had praised the Clinic for its contribution to medicine. “It is a real step forward for people who have severe disfigurement and this operation has been done by a team who have really prepared and worked towards this for a number of years. These transplants have proven that the technical difficulties can be overcome and psychologically the patients are doing well. They have all have reacted positively and have begun to do things they were not able to before. All the things people thought were barriers to this kind of operations have been overcome,” she said.

The first partial face transplant surgery on a living human was performed on Isabelle Dinoire on November 27 2005, when she was 38, by Professor Bernard Devauchelle, assisted by Professor Jean-Michel Dubernard in Amiens, France. Her Labrador dog mauled her in May 2005. A triangle of face tissue including the nose and mouth was taken from a brain-dead female donor and grafted onto the patient. Scientists elsewhere have performed scalp and ear transplants. However, the claim is the first for a mouth and nose transplant. Experts say the mouth and nose are the most difficult parts of the face to transplant.

In 2004, the same Cleveland Clinic, became the first institution to approve this surgery and test it on cadavers. In October 2006, surgeon Peter Butler at London‘s Royal Free Hospital in the UK was given permission by the NHS ethics board to carry out a full face transplant. His team will select four adult patients (children cannot be selected due to concerns over consent), with operations being carried out at six month intervals. In March 2008, the treatment of 30-year-old neurofibromatosis victim Pascal Coler of France ended after having received what his doctors call the worlds first successful full face transplant.

Ethical concerns, psychological impact, problems relating to immunosuppression and consequences of technical failure have prevented teams from performing face transplant operations in the past, even though it has been technically possible to carry out such procedures for years.

Mr Iain Hutchison, of Barts and the London Hospital, warned of several problems with face transplants, such as blood vessels in the donated tissue clotting and immunosuppressants failing or increasing the patient’s risk of cancer. He also pointed out ethical issues with the fact that the procedure requires a “beating heart donor”. The transplant is carried out while the donor is brain dead, but still alive by use of a ventilator.

According to Stephen Wigmore, chair of British Transplantation Society’s ethics committee, it is unknown to what extent facial expressions will function in the long term. He said that it is not certain whether a patient could be left worse off in the case of a face transplant failing.

Mr Michael Earley, a member of the Royal College of Surgeon‘s facial transplantation working party, commented that if successful, the transplant would be “a major breakthrough in facial reconstruction” and “a major step forward for the facially disfigured.”

In Wednesday’s conference, Siemionow said “we know that there are so many patients there in their homes where they are hiding from society because they are afraid to walk to the grocery stores, they are afraid to go the the street.” “Our patient was called names and was humiliated. We very much hope that for this very special group of patients there is a hope that someday they will be able to go comfortably from their houses and enjoy the things we take for granted,” she added.

In response to the medical breakthrough, a British medical group led by Royal Free Hospital’s lead surgeon Dr Peter Butler, said they will finish the world’s first full face transplant within a year. “We hope to make an announcement about a full-face operation in the next 12 months. This latest operation shows how facial transplantation can help a particular group of the most severely facially injured people. These are people who would otherwise live a terrible twilight life, shut away from public gaze,” he said.

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