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Thought Vibration: The Law Of Attraction In The Thought World
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Thought Vibration: The Law Of Attraction In The Thought World

Regular price $ 6.95

Author: William Walker Atkinson

Edition: Reprint

ISBN: 1440484686

Number Of Pages: 100

Publisher: CreateSpace Independent Publishing Platform

Release Date: 2008-12-17

Details: Thought Vibration ~ The Law of Attraction in the Thought World ~ by William Walker Atkinson ~ First published in 1908 ~ Edited by Rev. Lux Newman & the Quimby Philosophical Society ~ 2008 The Universe is governed by Law - one great Law. Its manifestations are multiform, but viewed from the Ultimate, there is but one Law. We are familiar with some of its manifestations but are almost totally ignorant of certain others. Still, we are learning a little more every day - the veil is being gradually lifted.... When we come to see that thought is a force - a manifestation of energy - having a magnet-like power of attraction, we will begin to understand the why and wherefore of many things that have heretofore seemed dark to us. There is no study that will so well repay the student for his time and trouble as the study of the workings of this mighty law of the world of thought - the Law of Attraction. ~ William Walker Atkinson ~ This is NOT a scanned-in copy of a pdf. This is a real text book, nicely designed.

EAN: 9781440484681

Package Dimensions: 9.0 x 6.0 x 0.2 inches

Languages: English

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Case Report Open Access
Copyright ©2010 Baishideng. All rights reserved.
World J Gastrointest Oncol. May 15, 2010; 2(5): 242-246
Published online May 15, 2010. doi: 10.4251/wjgo.v2.i5.242
Intermittent gastric outlet obstruction caused by a prolapsing antral gastric polyp
Mehul Parikh, Brian Kelley, Gabriel Rendon, Bincy Abraham
Mehul Parikh, Brian Kelley, Gabriel Rendon, Bincy Abraham, Department of Internal Medicine, Baylor College of Medicine, Houston, TX 77030, United States
Author contributions: Parikh M, Kelley B, Rendon G, Abraham B treated the patient and were responsible for writing the paper and looking up the background references; Parikh M was responsible for over all coordination and final proof reading; all the above-mentioned authors read and approved the final manuscript.
Correspondence to: Mehul Parikh, MD, Department of Internal Medicine, Baylor College of Medicine, Houston, TX 77030, United States.
Telephone: +1-404-2472161 Fax: +1-770-9959109
Received: October 27, 2009
Revised: November 30, 2009
Accepted: December 7, 2009
Published online: May 15, 2010

Most gastric polyps have an asymptomatic presentation and are an incidental finding on upper endoscopy. Symptomatic presentations can range from an ulcerated polyp leading to anemia and occult bleed to complete gastric outlet obstruction. We report a case of an 89-year-old woman who presented with postprandial nausea and early satiety. Her upper endoscopy revealed a 2 cm pedunculated hyperplastic polyp arising from the antrum of the stomach which was seen prolapsing into the pylorus causing intermittent gastric outlet obstruction. In the present report, we statistically analyzed 39 prolapsing gastric polyps previously reported in the English literature and demonstrate the current utility of monopolar snare polypectomy in establishing a histological diagnosis while offering simultaneous treatment. Additionally, we review the literature for the management of all hyperplastic gastric polyps in relation to advancements in digestive endoscopy.

Key Words: Hyperplastic polyps, Stomach, Endoscopy

Gastric polyps are usually an incidental finding on upper endoscopy with an incidence of 1%-5%[1-2]. Rarely, larger gastric polyps can present with symptoms. Symptomatic presentations can range from an ulcerated polyp leading to anemia and occult bleeding to complete gastric outlet obstruction. We describe a case of intermittent gastric outlet obstruction by a hyperplastic antral polyp and its subsequent management. We also review the literature for the management of hyperplastic gastric polyps in relation to advancements in digestive endoscopy.

An 89-year-old woman with hypertension presented for evaluation of intermittent postprandial nausea and dull epigastric pain for 3 mo. She complained of early satiety and a 2.3 kg weight loss. She denied dysphagia or any change in bowel habits. On exam, her abdomen had normoactive bowel sounds and mild tenderness over the epigastrium. She had a negative Murphy’s sign. The liver and spleen were not palpable. At admission, laboratory tests revealed hemoglobin of 11.2 g/dL with a mean corpuscular volume of 78.5 fl. Serum iron was 57 μg/dL and total iron-binding capacity was 346 μg/dL. Upper and lower gastrointestinal endoscopies were recommended because of the patient’s epigastric pain and iron deficiency anemia. Upper endoscopy exposed a 2 cm pedunculated polyp arising from the antrum of the stomach. This polyp was seen prolapsing into the pylorus of the stomach causing intermittent gastric outlet obstruction (Figure 1A and B). The polyp was excised with monopolar snare polypectomy and sent for pathology. Pathology revealed a hyperplastic polyp without metaplasia, dysplasia, or malignancy (Figure 2). Furthermore, the surrounding antrum was biopsied for pathology, which showed chronic inactive gastritis and negative staining for Helicobacter pylori (H. pylori). Colonoscopy was unremarkable. After excision of the polyp, the patient returned to the GI Clinic 2 wk post procedure with complete resolution of her Abdominal pain symptoms.

Figure 1
Figure 1 Polyp was seen prolapsing into the pylorus of the stomach causing intermittent gastric outlet obstruction.
Figure 2
Figure 2 Pathology revealed a hyperplastic polyp without metaplasia, dysplasia, or malignancy.

This patient had a hyperplastic antral gastric polyp causing intermittent gastric outlet obstruction. These cases are sporadically reported in the literature. Short et al[3] reviewed 30 prolapsing gastric tumors reported in the English literature up to 1965. In the present report, we analyzed the past 39 gastric polyps leading to gastric outlet obstruction found in the English- literature[4-36] (Table 1). Furthermore, we reviewed the literature for the management of both symptomatic and asymptomatic hyperplastic gastric polyps. Prior to the advent of endoscopy, physicians relied on characteristic intraluminal filling defects on radiography and subsequent laparatomy for definitive treatment of symptomatic gastric polyps[4]. Nonoperative endoscopy has reduced the surgical risk of open laparatomy. One of the first reported cases treated by endoscopy was by Brandt et al[5] in 1973. He removed a 1.5 cm pedunculated adenomatous polyp with snare polypectomy in a sixty-five year old female who presented with postprandial midepigastric pain.

Table 1 Characteristics of gastric polyps leading to gastric outlet obstruction.
Adults (n)36
Sex (n)
Age (yr)
Size of all polyps (cm)
Size of endoscopy removed (cm)
Size of surgically removed (cm)
Histological subtype (n)
Benign unspecified6

Gastric polyps causing gastric outlet obstruction seem to be more prevalent in elderly females with a 64 percent female predominance (23 patients) and a median age of onset of 72 years in female[4-11,17,19,22,23,25,27-29,32-35] adults. Race was not specified in the majority of cases. Only four pediatric cases have been reported[13,14,16,18]. The pediatric cases presented within the first year of life, mimicked pyloric stenosis, and required surgical removal. In adults, case presentations ranged from mild epigastric pain to more dramatic presentations of severe iron deficiency anemia[26] and even acute pancreatitis[22,29]. The majority of symptomatic gastric polyps had an antral location with a median size of 5 cm (range 1.5-13 cm)[4,6,8,10-12,15,17,19-22,25-27,29,30,33,35]. The median size of polyps removed endoscopically was 3 cm (range 1.5-8 cm)[6,11,17,21,25-27,29,30,33,35], while the median size of surgically removed polyps was 6 cm (range 3.5-13 cm)[4,8,10,12,15,17,19,20,22,36]. Kumar et al[17] have reported the largest endoscopically treated polyp causing intermittent gastric outlet obstruction to date. They removed an 8 cm polyp: two-thirds of the polyp was snared and the remainder excised at a subsequent visit. Histologically, there were 15 hyperplastic polyps[7,11,17,19,21-23,25-27,30,34,35], 5 adenomas[5,8,10,17,31], 4 adenocarcinomas[8,12], 3 lipomas[15,20,24], 2 inflammatory[32,33], and 1 leiomyoma[17]. The other cases only specified the polyp as benign[4,6,9,28,29]. Of the polyps reviewed, 7 harbored malignancy[7-8,12,31].

The particular importance of gastric polyps is their tendency towards malignancy. In our patient, we were not only able to establish a histopathological diagnosis at the time of upper endoscopy but also offer definitive therapy. However, there are no set guidelines for the optimal management of all gastric polyps at the time of initial upper endoscopy. For a symptomatic polyp, endoscopic or surgical excision is often pursued to relieve symptoms and to achieve a histological diagnosis. The management strategy is less clear in asymptomatic gastric polyps. Certainly, the rate of malignant transformation varies among the different histological subtypes of gastric polyps. Fundic gland and inflammatory fibroid polyps have virtually no malignant potential. Hyperplastic polyps have up to a 2.1% rate of malignant transformation[37,38], and the rate is significantly higher for adenomatous polyps (up to 40%)[39].

Unfortunately, besides fundic gland polyps which have a clear typical feature, upper endoscopy cannot reliably distinguish the type of gastric polyp by gross inspection. Therefore, it is important to make a histopathological diagnosis, although whether to biopsy or excise gastric polyps is not always clear. Forceps biopsy can come with sampling error[40,41], and polypectomy has its own risks, such as bleeding and perforation with rates of 7.2% and 0.45%, respectively[40].

Because of the risks associated with polypectomy, some authors have recommended conservative medical management and endoscopic surveillance of smaller hyperplastic polyps. Although the exact pathogenesis is not known, hyperplastic polyps have been associated with chronic inflammation and irritation of the gastric mucosa. H. pylori infection is the most commonly associated condition that predisposes hyperplastic gastric polyp formation. H. pylori associated hyperplastic polyps show increased cyclooxygenase-2 (COX-2) expression. The importance is that COX-2 expression plays an important role in tumor enlargement, partly through enhanced angiogenesis[42]. Several prospective studies have demonstrated the regression of hyperplastic polyps after eradication of H. pylori infection[43-45]. However, not all hyperplastic polyps are associated with documented H. pylori infection, and there are no data demonstrating regression of hyperplastic polyps greater than 1 cm in diameter after H. pylori treatment. Less common associations include autoimmune gastritis, environmental gastritis, chemical gastropathy, Zollinger-Ellison syndrome, cytomegalovirus gastritis, amyloidopathy, gastric antral vascular ectasia, post-antrectomy stomach[46], and post solid organ transplant recipients[47,48].

A hyperreparative process in response to these tissue insults gives hyperplastic polyps their characteristic histological features. Hyperplastic polyps consist of dilated, elongated, architecturally distorted foveolar epithelium with a surrounding edematous stroma holding varying degrees of active and chronic inflammation. Rarely, dysplasia and carcinoma may occur within and around the polyp. If adenocarcinoma is found after polypectomy, a synchronous adenocarcinoma in another part of the stomach maybe found in up to 30% of cases[49]. Therefore, it is prudent to investigate surrounding polyps and to biopsy the surrounding gastric mucosa for associated gastritis and pathology.

The possible relationship between gastric hyperplastic polyps and gastric cancer remains unknown. Different molecular biologic factors in hyperplastic gastric polyps have been investigated for gastric carcinogenesis. Jain et al[50] reviewed the literature for these mechanisms and found over expression of p53 gene mutation, Ki-67 labeling indices, and microsatellite instability as the most implicated markers. Other markers such as ERB-2, APC, DCC, LOH at 17p have not been found in association with dysplasia. Future studies which are designed to identify the utility of analytical tests such as gene array and microsatellite instability testing to predict which hyperplastic polyps carry malignant potential are needed. Currently, the only prognostic factor is polyp size. Ginsberg et al[51] demonstrated that cancer risk increases with polyp size and recommended all polyps greater than 0.5 cm be removed regardless of the histological subtype.

The clinical significance of larger gastric polyps is this risk of malignancy. As a result most gastroenterologists advocate the excision of polyps greater than 0.5 cm with biopsies of the surrounding gastric mucosa. Most labs use electrocautery snare polypectomy, but some polyps, specifically sessile polyps, may not be amenable to this technology because of the risk of bleeding and perforation. Endoscopic mucosal resection (EMR) techniques have successfully removed sessile polyps with accurate histological assessment[52]. Again, the risk of bleeding and perforation exists. Immediate surgical intervention is indicated in the case of large perforations. Endoscopic closure using metallic clips or suturing is appropriate for small perforations after therapeutic endoscopic procedures[53].

Larger sessile polyps have a greater propensity to bleed because of larger feeding vessels. Endoscopic ultrasound (EUS) would theoretically minimize the risk of bleed by visualizing the blood vessels at the base of the gastric polyp. Bardan et al[54] evaluated the use of preprocedure EUS with snare polypectomy in 102 patients to minimize the risk of bleeding. However, no significant difference among bleeding rates between patients undergoing polypectomy with and without preprocedure EUS was found. A potential explanation is that bleeding after polypectomy may originate from blood vessels undetected by the EUS technique[54]. However, these data were not collected using more advanced EUS technologies such as newer mini probes with higher frequencies that may detect smaller vessels and better delineate submucosal margins.

Other techniques have been explored. Lo et al[55] studied the proficiency of endoscopic band ligation (EBL) used to minimize bleeding risk in the removal of seventy hyperplastic polyps. Although they demonstrated the effectiveness in minimizing bleeding risks with bleeding polyps and even sessile hyperplastic polyps, this technology may have limited utility for larger polyps and gastric adenomas at risk for malignant transformation[55]. EBL does not allow for complete resection and complete histological evaluation of these polyps. Additional electrocautery would be needed. Therefore, this technology is rarely employed. Methods such as hypertonic saline epinephrine injection, endoloops, and endoscopic hemoclips are currently utilized to control bleeding with polypectomy.

Most adenocarcinomas found within hyperplastic polyps are the differentiated type and few signet ring cell carcinoma have been reported[56]. Data specific to gastric hyperplastic polyps and gastric cancer are not available because of limited case reports. We recommend surveillance endoscopy and EUS staging for early gastric cancer. EUS allows for imaging of the gastric wall, the degree of invasion, and regional lymph node involvement. Lymph node metastasis is present in about 10% of cases of early gastric cancer[57]. The mainstay of treatment is gastrectomy. Newer EMR and endoscopic submucosal dissection technologies are gaining popularity in the absence of lymph node metastasis. Takekoshi et al[58] reported an 85% cure rate in a series of 308 patients. The five-year survival rate was 86%, a rate similar to more aggressive surgical approaches[58]. Hiki et al[59] reported a recurrence rate of 4.2% in their series. The main disadvantage of endoscopic methods is the risk of incomplete tumor resection. Ryu et al[60] investigated 344 gastric adenocarcinoma and concluded that in cancers with greater than 500 μm of submucosal invasion or a mucosal cancer larger than 3 cm, surgery should be considered because of the risk of lymph node metastasis.

Newer technologies are emerging to distinguish the histological subtype at the time of initial endoscopy. Li et al[61] demonstrated the use of confocal laser endomicroscopy with upper endoscopy to characterize gastric hyperplastic polyps and adenomas. This development would obviate the need for initial biopsy and eradicate unnecessary polypectomy and associated risks. However, not all endoscopy labs have access to this technology. More accessible technologies such as magnification chromoendoscopy and narrow band imaging need larger prospective trials to prove their utility. The optimal management strategies for hyperplastic polyps have not yet been defined. As our knowledge of hyperplastic polyps continue to grow and advancements in digestive endoscopy continue to develop, our case demonstrates the current utility of diagnostic and therapeutic monopolar snare polypectomy in a symptomatic hyperplastic gastric polyp.

Peer reviewer: Keishiro Aoyagi, MD, PhD, Department of Surgery, Kurume University, School of Medicine, 67 Asahi-mach, Kurume City, 830-0011, Japan

S- Editor Li LF L- Editor Hughes D E- Editor Yang C

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34.  Iso Y, Sawada T, Rokkaku K, Shimoda M, Kubota K. Ball-valve gastric tumor associated with anomalous junction of the pancreatico-biliary ductal system and a right-sided round ligament: report of a case. Surg Today. 2008;38:458-462.  [PubMed]  [DOI]
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36.  Clemente G, Sarno G, De Rose AM. Electronic clinical challenges and images in GI. Giant gastric polyp prolapsing into the duodenum. Gastroenterology. 2009;136:e5-e6.  [PubMed]  [DOI]
37.  Daibo M, Itabashi M, Hirota T. Malignant transformation of gastric hyperplastic polyps. Am J Gastroenterol. 1987;82:1016-1025.  [PubMed]  [DOI]
38.  Zea-Iriarte WL, Sekine I, Itsuno M, Makiyama K, Naito S, Nakayama T, Nishisawa-Takano JE, Hattori T. Carcinoma in gastric hyperplastic polyps. A phenotypic study. Dig Dis Sci. 1996;41:377-386.  [PubMed]  [DOI]
39.  Orlowska J, Jarosz D, Pachlewski J, Butruk E. Malignant transformation of benign epithelial gastric polyps. Am J Gastroenterol. 1995;90:2152-2159.  [PubMed]  [DOI]
40.  Muehldorfer SM, Stolte M, Martus P, Hahn EG, Ell C. Diagnostic accuracy of forceps biopsy versus polypectomy for gastric polyps: a prospective multicentre study. Gut. 2002;50:465-470.  [PubMed]  [DOI]
41.  Sung HY, Cheung DY, Cho SH, Kim JI, Park SH, Han JY, Park GS, Kim JK, Chung IS. Polyps in the gastrointestinal tract: discrepancy between endoscopic forceps biopsies and resected specimens. Eur J Gastroenterol Hepatol. 2009;21:190-195.  [PubMed]  [DOI]
42.  Kawada M, Seno H, Wada M, Suzuki K, Kanda N, Kayahara T, Fukui H, Sawada M, Kajiyama T, Sakai M. Cyclooxygenase-2 expression and angiogenesis in gastric hyperplastic polyp--association with polyp size. Digestion. 2003;67:20-24.  [PubMed]  [DOI]
43.  Ohkusa T, Takashimizu I, Fujiki K, Suzuki S, Shimoi K, Horiuchi T, Sakurazawa T, Ariake K, Ishii K, Kumagai J. Disappearance of hyperplastic polyps in the stomach after eradication of Helicobacter pylori. A randomized, clinical trial. Ann Intern Med. 1998;129:712-715.  [PubMed]  [DOI]
44.  Ljubicić N, Banić M, Kujundzić M, Antić Z, Vrkljan M, Kovacević I, Hrabar D, Doko M, Zovak M, Mihatov S. The effect of eradicating Helicobacter pylori infection on the course of adenomatous and hyperplastic gastric polyps. Eur J Gastroenterol Hepatol. 1999;11:727-730.  [PubMed]  [DOI]
45.  Ji F, Wang ZW, Ning JW, Wang QY, Chen JY, Li YM. Effect of drug treatment on hyperplastic gastric polyps infected with Helicobacter pylori: a randomized, controlled trial. World J Gastroenterol. 2006;12:1770-1773.  [PubMed]  [DOI]
46.  Abraham SC, Singh VK, Yardley JH, Wu TT. Hyperplastic polyps of the stomach: associations with histologic patterns of gastritis and gastric atrophy. Am J Surg Pathol. 2001;25:500-507.  [PubMed]  [DOI]
47.  Amaro R, Neff GW, Karnam US, Tzakis AG, Raskin JB. Acquired hyperplastic gastric polyps in solid organ transplant patients. Am J Gastroenterol. 2002;97:2220-2224.  [PubMed]  [DOI]
48.  Jewell KD, Toweill DL, Swanson PE, Upton MP, Yeh MM. Gastric hyperplastic polyps in post transplant patients: a clinicopathologic study. Mod Pathol. 2008;21:1108-1112.  [PubMed]  [DOI]
49.  Carmack SW, Genta RM, Graham DY, Lauwers GY. Management of gastric polyps: a pathology-based guide for gastroenterologists. Nat Rev Gastroenterol Hepatol. 2009;6:331-341.  [PubMed]  [DOI]
50.  Jain R, Chetty R. Gastric hyperplastic polyps: a review. Dig Dis Sci. 2009;54:1839-1846.  [PubMed]  [DOI]
51.  Ginsberg GG, Al-Kawas FH, Fleischer DE, Reilly HF, Benjamin SB. Gastric polyps: relationship of size and histology to cancer risk. Am J Gastroenterol. 1996;91:714-717.  [PubMed]  [DOI]
52.  Szalóki T, Tóth V, Németh I, Tiszlavicz L, Lonovics J, Czakó L. Endoscopic mucosal resection: not only therapeutic, but a diagnostic procedure for sessile gastric polyps. J Gastroenterol Hepatol. 2008;23:551-555.  [PubMed]  [DOI]
53.  Katsinelos P, Beltsis A, Paroutoglou G, Galanis I, Tsolkas P, Mimidis K, Pilpilidis I, Baltagiannis S, Kamberis E, Papaziogas B. Endoclipping for gastric perforation after endoscopic polypectomy: an alternative treatment to avoid surgery. Surg Laparosc Endosc Percutan Tech. 2004;14:279-281.  [PubMed]  [DOI]
54.  Bardan E, Maor Y, Carter D, Lang A, Bar-Meir S, Avidan B. Endoscopic ultrasound (EUS) before gastric polyp resection: is it mandatory? J Clin Gastroenterol. 2007;41:371-374.  [PubMed]  [DOI]
55.  Lo CC, Hsu PI, Lo GH, Tseng HH, Chen HC, Hsu PN, Lin CK, Chan HH, Tsai WL, Chen WC. Endoscopic banding ligation can effectively resect hyperplastic polyps of stomach. World J Gastroenterol. 2003;9:2805-2808.  [PubMed]  [DOI]
56.  Fry LC, Lazenby AJ, Lee DH, Mönkemüller K. Signet-ring-cell adenocarcinoma arising from a hyperplastic polyp in the stomach. Gastrointest Endosc. 2005;61:493-495.  [PubMed]  [DOI]
57.  Seto Y, Nagawa H, Muto T. Impact of lymph node metastasis on survival with early gastric cancer. World J Surg. 1997;21:186-189; discussion 190.  [PubMed]  [DOI]
58.  Takekoshi T, Baba Y, Ota H, Kato Y, Yanagisawa A, Takagi K, Noguchi Y. Endoscopic resection of early gastric carcinoma: results of a retrospective analysis of 308 cases. Endoscopy. 1994;26:352-358.  [PubMed]  [DOI]
59.  Hiki Y, Shimao H, Mieno H, Sakakibara Y, Kobayashi N, Saigenji K. Modified treatment of early gastric cancer: evaluation of endoscopic treatment of early gastric cancers with respect to treatment indication groups. World J Surg. 1995;19:517-522.  [PubMed]  [DOI]
60.  Ryu KW, Choi IJ, Doh YW, Kook MC, Kim CG, Park HJ, Lee JH, Lee JS, Lee JY, Kim YW. Surgical indication for non-curative endoscopic resection in early gastric cancer. Ann Surg Oncol. 2007;14:3428-3434.  [PubMed]  [DOI]
61.  Li WB, Zuo XL, Zuo F, Gu XM, Yu T, Zhao YA, Zhang TG, Zhang JP, Li YQ. Characterization and identification of gastric hyperplastic polyps and adenomas by confocal laser endomicroscopy. Surg Endosc. 2010;24:517-524.  [PubMed]  [DOI]


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The best pop-up tent

A built-in groundsheet is a feature of pop-up tents, simplifying the pitching process while also keeping out bugs and minimizing drafts.

BestReviews is reader-supported and may earn an affiliate commission. Details.

Which pop-up tent is best?

Camping is great fun, but setting up your tent can be a hassle, especially if you’re inexperienced, arrive at the campsite after dark, or simply don’t have much time. Pop-up tents take just seconds to pitch and peg down, and you’re free to enjoy your getaway.

This guide contains all the information you’ll need to choose your perfect pop-up tent. We’ve also included a few of our favorites at the end, such as the Coleman Four-Person Pop-Up Tent, which features taped seams and a rainfly to keep water out.

Considerations when choosing pop-up tents

Instant tents vs. pop-up tents

Instant tents fall into the pop-up tent category, although they don’t technically pop up. What’s the difference between the two?

A true pop-up tent has all its poles built-in and fully in place. It can be bent in such a way as to fold the tent flat and fit in its storage bag. When you open the bag and remove the tent, it automatically pops up into a full-size tent ready to peg down and sleep in. These tents are the easiest to pitch but have some constraints — they’re usually on the small side and may not keep the elements out entirely.

An instant tent doesn’t pop up when you remove it from its bag, but it does have built-in poles. These poles separate in places so you can pack the tent down, but it does mean you need to attach the poles together in order to pitch the tent. Depending on the tent size, this can take anywhere between one and five minutes, so it’s still a quick process.

All pop-up tents list their sizes in terms of how many people they can fit inside. Pop-up tents range in size from two-person up to 12-person, though it’s rare to find a true pop-up tent that sleeps more than four people — instant tents are the ones more likely to have larger options. It’s worth noting, however, that the listed capacity is the maximum. For example, a six-person tent fits six adults shoulder to shoulder, but if you want a little more room or to sleep on air beds, it probably sleeps three people comfortably with a little room for gear.

Pop-up tents features

Make sure your chosen pop-up tent has some ventilation — such as roll-up or pop-out windows lined with mesh — to keep you comfortable on hot days.

Want to keep your tent tidy? Storage pockets on the inside walls of the tent can hold some of your belongings, freeing up floor space.

Pop-up tents price

You can find some small, basic pop-up tents for less than $50, but high-end models can cost $300 or more.

Pop-up tents FAQ

Q. Are pop-up tents waterproof?

A. This depends on the model you choose. True pop-up tents generally aren’t designed for camping in extreme weather, so they may be water-resistant but are rarely 100% waterproof. That said, some high-end models are fully waterproof. Instant tents are more likely to be completely waterproof since they’re halfway between true pop-up tents and standard tents, but always double-check before buying if you require a tent to keep out heavy rain.

Q. Are pop-up tents suitable for experienced campers?

A. Pop-up tents are often considered an option for inexperienced campers only, but there’s no reason why an experienced camper can’t use one. They may not be right if you’re camping on a mountain ridge or in the middle of winter, but for a quick overnight trip in good weather, even experienced campers can enjoy the benefits of a pop-up tent.

Pop-up tents we recommend

Best of the best

Coleman Four-Person Pop-Up Tent

Coleman Four-Person Pop-Up Tent

Our take: A true pop-up tent that takes mere seconds to pitch and sleeps two comfortably or four at a push.

What we like: Taped seams and rainfly make this tent actually waterproof rather than water-resistant like most similar models. Well-ventilated. Built-in storage pockets.

What we dislike: Tricky to pack away.

Where to buy: Sold by Amazon

Best bang for your buck

AbcoSport’s Pop-Up Tent

AbcoSport’s Pop-Up Tent

Our take: This highly affordable pop-up tent is perfect for a single camper, though it can fit two if you don’t mind getting close and giving up storage space.

What we like: Extremely easy to pitch. Lightweight and compact. One door on each side for easier access. Plenty of ventilation.

What we dislike: Not 100% waterproof.

Where to buy: Sold by Amazon

Worth checking out

CORE’s 9-Person Instant Cabin Tent

CORE’s 9-Person Instant Cabin Tent

Our take: Sleeps up to nine but fits just two queen beds, which cuts the capacity to four if you want to sleep in style.

What we like: Tall center height of six and a half feet. Central room divider. Fully waterproof. Well ventilated. Takes less than five minutes to set up.

What we dislike: Not great at retaining heat due to high ceilings so better for warm weather camping.

Where to buy: Sold by Amazon

Sign up here to receive the BestReviews weekly newsletter for useful advice on new products and noteworthy deals.

Lauren Corona writes for BestReviews. BestReviews has helped millions of consumers simplify their purchasing decisions, saving them time and money.

Copyright 2021 BestReviews, a Nexstar company. All rights reserved.

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Medical Studies Involving Children Often Go Unpublished

Even when results from studies involving children are available, they frequently aren't published in medical journals.
Even when results from studies involving children are available, they frequently aren't published in medical journals.

Many medical studies involving children never end up being put to use because scientists frequently don't publish the results of their work, according to an analysis published online Thursday.

The findings raise both scientific and ethical issues regarding research on this vulnerable population.

Previous studies have documented that about a third of all clinical trials conducted in the United States end up as largely wasted effort, because the scientists doing that work don't take the effort to publish and share their results with the scientific community.

Pediatricians Florence Bourgeois and Natalie Pica at Harvard Medical School and Boston Children's Hospital wondered whether researchers focusing on children took this obligation to publish more seriously. As they report in the journal Pediatrics, the experience with childhood research is just about as bad.

The report, reviewing clinical trials started in 2008-10, finds that 19 percent of the studies that recruited children didn't run to completion. That was often because researchers weren't able to recruit as many volunteers as they needed to run the experiments. And of the 455 trials that were completed, the results from 30 percent weren't published.

"That means all the participants who are enrolled in these studies aren't able to contribute in a meaningful way to our clinical information and knowledge," Bourgeois said. One reason may be that scientists didn't get the results they were hoping for. It's less rewarding to publish results that report a failed trial, but Bourgeois says it's just as important for science to do so.

"The harm is we end up with scientific literature that only shows all the things that do work," she said. "It may falsely appear that certain interventions do work. So our literature may become biased and may not be representative of the true efficacy or safety of an intervention."

One result of that is that other scientists may try to run the same failed experiment, and end up down the same blind alley as scientists who had tried it before. "That leads to a lot of inefficiency and waste," she said.

Parents volunteer their children for these studies with an understanding that their efforts are contributing to the advancement of medical science.

Vincent del Gaizo, the parent of a child with a hard-to-treat form of juvenile arthritis, is passionate about that commitment. He's taken a very active role in managing his son's disease. When his son was about 9, he suffered from a flare-up so acute that he couldn't bend his right elbow at all. Del Gaizo learned of a clinical trial of an experimental drug near his home, in Hackensack, N.J., and decided to take the risk that the drug would help.

Del Gaizo paid close attention to how the drug affected his son. But he also cared about how the work benefited the community more broadly. "It is hugely important to me as a patient-family," for scientists to publish their results and explain them clearly, he said. It's important "not only for the patient-families but also for the clinicians," del Gaizo said. Doctors need to know what works — and what doesn't work — to guide their treatment of children who aren't participating in studies.

The results of the clinical trial his son participated in were eventually published: The drug worked better than an injection of plain salt water but hasn't ended up on the market to treat this condition. But del Gaizo says he talks to many other families, as a patient advocate, and finds they frequently don't learn the results of the experiments involving their children. "Just having information available to you ... would make it so patient-families like us can sleep at night with the decisions we have to make on a daily basis."

The shortcomings of pediatric research come as no surprise to Dr. Joseph Ross at the Yale School of Public Health. He arrived at similar results when he analyzed clinical trials that include adults. Scientists have many explanations for why they don't publish their results. "Maybe the results don't show what the investigator wants and they move on," Ross said. "But more often people are busy and people don't focus enough time and attention on getting those results out."

Ross considers this an ethical lapse. "When you do a clinical study and you're asking patients to participate and subject themselves to a risk, in order to inform science and generate knowledge, you have an ethical obligation to disseminate those results to the wider scientific community," he said.

Copyright 2020 NPR. To see more, visit https://www.npr.org.


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(Bloomberg) — The European Central Bank would be stuck
with record-low interest rates for another five years if it
decided to adopt a policy of temporary price-level targeting
floated by former Federal Reserve Chairman Ben Bernanke — with
potentially negative consequences.
Joerg Kraemer, Commerzbank’s chief economist, argues that
the ECB would face “the risk of dangerous bubbles” in markets
and real estate if it kept its benchmark rate at zero for much
longer in pursuit of faster price growth.

Central banks around the world have struggled to bring
inflation back into line with their goals since the financial
crisis, triggering alternative policy suggestions. In 2017,
Bernanke highlighted the idea that officials could allow
inflation to overshoot target to make up for previously weak
Olli Rehn, governor of Finland’s central bank and one of
the contenders to succeed Mario Draghi as ECB president in
November, embraced the concept last year. He said it needed a
thorough analysis as part of a policy review he’s advocating.
“The fixation on preventing low inflation rates is
exaggerated,” Kraemer wrote in a note published Wednesday.
“Instead, the ECB needs a strategy of comprehensive
stabilization” that would also focus on financial stability.
The ECB last month prolonged the period of record-low rates
until at least the end of this year, and Draghi said that a
weaker economy will delay but not derail the return of inflation
to the goal of just under 2 percent. The Governing Council is
scheduled to meet next Wednesday.

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City of Washington names employee who died in mowing accident

WASHINGTON, N.C. (WNCT) — The City of Washington on Friday released the name of the public works employee who died in a rollover accident while mowing a ditch on Tuesday.

City Manager Jonathan Russell announced in an email the employee who died was Redden Woolard, 61. Funeral arrangements are pending.

Earlier this week, Russell informed the public of Woolard’s death but, at the time, did not release his name.

“It is with a heavy heart that I am sending you this email to inform you that our City of Washington Team has suffered a tragic loss. A public works staff member was involved in a rollover accident while mowing a ditch bank yesterday that resulted in a fatality. This comes as a shock to the organization and the community. An investigation is currently being conducted by OSHA and the City of Washington. We will provide more information as we are able to. Please keep the employee’s family in your thoughts and prayers.

Copyright 2021 Nexstar Media Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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Visual art ...

This new bath's deep.  Much deeper than the other one.  It's great for doing some physio and pain releif every morning.

It's also good for other things.

I was sat there enjoying the water when I saw these bubbles coming up ... ever so sloooowly from the depths of the bath.  I remember sitting there thinking - 'Wow. Look at those bubbles, aren't they beautiful.  Look how slowly they rise.  Beautiful, almost mettalic.'  My reflection on the art form continued until the first bubble hit the surface and burst ... literally.  I then found myself trying to backstroke away from the immediate area quite quickly.

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'Mexican Loop' pattern, 'Cheyenne' variation, Gallatin-Meanea style. Originated in E. L. Gallatin & Co.Saddle Shop. Cheyenne, Wyoming Territory c. 1873. Later made popular by Gallatin's nephew, F. A. Meanea. The Collins Brothers Saddle Shop, also of Cheyenne, made a similar holster. All were characterized by the 'tear drop' toe plug and main seam swell between loops. Made for Colt SAA's, S & W American and Schofield, RemingtonM-1875, Ruger and replicas. Standard tooling shown. Made in two lengths for 5 1/2 and 7 1/2 inch barrels.

NOTE: will work for many double action revolvers. Call for information, 307-745-4171

  • Please specify make of gun and barrel length ( measure barrel from cylinder face to muzzle), right or left hand or cross-draw. Ornimentation is standard as shown ( see each holsters specifications). Please remember to state color preference as russet (as shown) or black when ordering . Black leather is $5 extra except on early military holsters or as shown. Orders made to custom specifications not included or pictured in this catalog may not be returned for refund.

    Unconditional guarntee: If you are not satisfied with any item, return it with origional order form within 10 days for a refund or credit. You must pay return shipping.

    For questions call (307) 745-4171 or email mrwolf@vcn.com


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A Weekend With The Richardses

Billy On His Way Back

Billy Rafferty at Molineux when the ground looked a whole lot different.

Billy Rafferty at Molineux when the ground looked a whole lot different.

Billy Rafferty is relishing the thought of his impending return to Molineux – and looking forward to meeting the mates who helped make his stay a happy one.

The burly striker turns 65 in December and is savouring the prospect of chatting over old times when he attends the Daventry Wolves Supporters Club 40th anniversary dinner next weekend.

“I can’t exactly remember when I was last there,” Rafferty said. “I recall being at a dinner some seasons back and also at a match against Arsenal when Thierry Henry was playing. But I’m struggling to put years on when they were. I know I sat next to Bert Williams at the dinner.

“We were happy living in Tettenhall when I was at Wolves and we’re looking forward to staying again with Pam and John Richards.

“John and I roomed together. He was our main man and my job was to sing him off to sleep so he was well rested come kick-off time! I used to favour the Rod Stewart song, Sailing.

“I don’t think he goes to many matches these days but Willie Carr does, so I hope to go with him to Wolves v Middlesbrough in the afternoon.

“I knew Willie from playing alongside him at Coventry and I actually felt very familiar with many of the Wolves lads before I signed there, purely because I had faced them plenty of times from a young age.

“I left soon after Andy Gray signed in 1979. I had been to see the manager a few times but I know Richie Barker wanted me to stay. I just couldn’t see myself getting a regular game.

“Apart from him and John, Mel Eves was pushing hard and Wayne Clarke and Norman Bell were around as well. As it happened, I might have played a few because Andy and John had their injury problems.”

As events transpired, Rafferty departed to Newcastle after 50 games and eight goals for Wolves, who he had joined from Plymouth in 1978 during the Sammy Chung reign.

“I felt frustrated that I couldn’t show more at Wolves,” he added. “I picked up an ankle injury after four or five games and it dragged on for ages, although I played through it.

“I suppose reaching the FA Cup semi-final in 1979 was the highlight of my time there. We played poorly against Arsenal but it was an achievement to reach the last four and I remember we still had a good night out afterwards.

“We ended up at Romano’s Italian in Tettenhall, which was one of our favourite restaurants. And I remember watching the highlights of the game on Match of the Day with the other lads.

“There was no rotation of players in those days and I pushed for a move because I could only see myself playing in the reserves. It was only when I played in Portugal a few years later that I first saw the squad system.

“One or two clubs were after me, including Luton and Derby, but I chose Newcastle because they had such potential.

“Unfortunately, I picked a bad time to go there. Bill McGarry was the manager but there was trouble in the boardroom and that seemed to affect things on the pitch.

“Our son, who is a golf teaching professional, has just moved homes in the locality up here in Carlisle and it got us talking about how we must have moved 20 times.

“My wife Elaine, who I’ve been married to for just over 40 years, did most of the work, of course, and we often seemed to move from one end of the country to the other.

“I went from Coventry to Blackpool and then from Plymouth to Carlisle and on to Wolves. There was never any chance of staying in the same house!

“The biggest upheaval, though, was when I went from Newcastle to Portsmouth. I remember there being two feet of snow in the garden when we left the north-east. When we reached the south coast, I was in just my t-shirt.”

Billy in his casuals in recent years.

Billy in his casuals in recent years.

The quietly spoken Glaswegian also reports favourably on the fortunes of former Wolves skipper Keith Curle in his role as manager at Carlisle.

“They won again yesterday and he has got them trying to play it our from the back. They needed to tighten things up at the back because they were conceding too many goals but they generally score plenty when their strikers are fit.”

Thomas Publications


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womens clothes wholesale suppliers

Finding Reliable Wholesale Clothes Suppliers – Tips For Business Owners

In the market today, there are a lot of wholesale women’s clothes that you can find. Because of the numerous number of available choices, finding the right one is not an easy task at all. There are so many wholesale women’s clothes to choose from, but which ones would be the best to shop? How can you narrow down your choices and get the very best deals?

To help you find the right wholesale women’s clothes that you are looking for, it is important that you have a list of wholesale women’s clothes suppliers that you can consult. This will make it easier for you to narrow down your choices based on the supplier’s styles, products, and prices. Here are some tips that you can use when you are researching for the perfect wholesale supplier for women’s clothes.

– You can look through the internet for women’s clothes wholesale suppliers. There are a lot of websites that offer clothes that are made by different companies, brands, or designers. You can browse through these sites and search for a supplier that can provide you with the latest trends in the fashion industry.

– Aside from using the internet, you may also want to check your local directory listings for clothes wholesale suppliers. If there are any businesses listed in your local directory, it doesn’t mean that they don’t have other customers. You just have to find out more about them and see if their products are really worth buying from them. Make sure that your chosen supplier has excellent services and a professional business image.

– Always ask for a sample of the women’s clothing that you are planning to purchase. Most manufacturers allow their customers to try the products before they are being purchased in bulk. This is a must in wholesale fashion business. This is the only way to ensure that you are getting the right size and quality of product that you are paying for. Clothes that do not fit are not a good choice. Thus, you have to make sure that all your wholesale purchases are well-fitted.

– Ask about their payment methods and policies. You have to inquire about the cost of payments and shipping procedures so you will know how much you will be spending on each order. You should also ask about the return and refund policies and the amount of time before a shipment is expected to be completed. Knowing these things will help you decide which suppliers are worthy of your business.

– Check the quality of their products. You have to make sure that your chosen suppliers can provide you with quality items. You can either check them online or visit them in person. If you are going to deal with wholesalers that are based far away from your place, you can avail of a risk-free trial order. It will allow you to give the supplier’s a few items to check if their products really pass the durability and fashion test.

To make your clothing business successful, you have to get the right wholesale suppliers. This is actually the secret of your success. Of course, quality comes at a price, but nothing comes for free. You have to exert more effort in looking for the best wholesalers in the market. It may even take a lot of time and money. But in the end, you will see that your effort is worth it because you will earn more profit in the long run.

– Do some research on the background and reputation of each of your prospective suppliers. Find out if they are legitimate and reliable suppliers. Ask your friends or business acquaintances about their experiences dealing with them. You can also look for comments or feedbacks on their website.

– Always ask for a receipt. A reputable wholesaler would always deliver you the item in a prompt manner. This should serve as your proof that you purchased the wholesale item from the legitimate supplier. Remember that there are people out there who will never pay for the goods that they have ordered in advance. The last thing that you want is to get cheated by a supplier and then be left with useless products that you have spent your money on.

These are just a few of the tips that business owners can use in finding the most dependable wholesale suppliers. Keep in mind that doing the right research can be one of the most important things that you will ever do in your business. Choosing the best suppliers can help you succeed with your business in the long run. Good luck!


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• actonacademyannarbor

Learning from exhibitions, whether a success or catastrophic failure

Session exhibition

As Acton heroes prepare for their third public exhibition of the year, I am reminded of how unique and wonderful learning is at Acton Academy; as well as how challenging for these courageous beings. It is these real-world challenges that foster deep learning and nurture tomorrow's leaders and thinkers.

When I was in grade school, I remember being in a school performance about parts of speech. I was to recite one line, as was each classmate. I was so focused on my one line that I lost sight of how it fit into the bigger picture of learning. In a conversation with a parent last year about a very similar experience had by her child, I came to realize how unique Acton Academy truly is. In both experiences, the performances came across polished because they were micromanaged and choreographed by the adults. Each was a successful "show"...for the adults. For her child and myself, nothing was gained because the children had no ownership of the learning or process.

Exhibitions at Acton Academy are owned entirely by the heroes and are an integral part of the Acton learning process, whether considered a success or a catastrophic failure. They are not meant to be polished nor are they a finality to learning. Learning is in the preparation when peers work together to create and encourage. Learning is in finding the courage and confidence to articulate the process and experiences to others. Learning is found in the feeling of being successfully prepared. Learning is found in being ill-prepared and having to expose your failures.

It is in the reflection afterwards that our young heroes learn to be.

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Geraldine Road, Malvern

Guide price

  • Bedrooms: 4
A very handsome 1920s detached family home, set in a generous plot, in a popular residential location. Comprising, porch, hallway, sitting room with bay window and dining room which opens to garden, breakfast room, kitchen and cloakroom, first floor landing, four bedrooms, family bathroom. The property has a generous driveway and detached garage, with large, flat gardens to the front and rear, offering privacy at the back and a view of the Malvern Hills to the fore. With potential to extend subject to planning permission, the property is situated in a popular residential location, close to local schools, shops, facilities and railway station. We highly recommend an early viewing to appreciate the position and accommodation offer.

Low brick wall, uPVC construction overlooking front garden and view of the hills, original wooden front door with stained glass details, opens to:

Solid wooden staircase leads to first floor, wooden parquet floor, radiator, picture rail, doors to:

5.07m x 3.39m max into bay window (16'7 x 11'1 m

Front facing uPVC bay window, radiator, recessed fireplace with wooden mantle and marble hearth, television and broadband points, picture rail.

4.70m x 4.85m max into bay window (15'5 x 15'10

Rear facing uPVC bay window includes uPVC door opening to garden, original oak fireplace, Canadian cast iron fire and wooden mantle surround, tiled hearth, radiator, picture rail, wall light points.

3.54m x 2.77m (11'7 x 9'1 )

Front facing uPVC window, under stairs storage, two built in storage cabinets either side of chimney breast, radiator, picture rail, original pine built cupboards, door to:

2.38m x 2.59m (7'9 x 8'5 )

Rear facing uPVC window, overlooking rear garden, range of eye and base level fitted units with a work surface over, inset sink and drainer unit with a mixer tap, integrated Bosch electric oven and gas hob with extractor hood over, space and plumbing for dishwasher, space for further appliances, tiled floor, spot lighting, door to:

uPVC door to rear garden, continued tiled floor, wooden latch door to utility/storage cupboard, with plumbing for washing machine, Worcester Bosch gas boiler.

Rear facing obscure uPVC window, high level WC, radiator, continued tiled floor.

Generous open landing with front facing uPVC windows looking towards the Malvern Hills, continued original wooden staircase and banister, loft access, radiator, picture rail, doors to:

4.72m x 3.78m (15'5 x 12'4 )

Rear facing uPVC window, radiator, picture rail, built in airing cupboard housing hot water tank.

5.25m x 3.40m (17'2 x 11'1 )

Front facing uPVC bay window with a view of the Malvern hills, radiator, picture rail.

3.04m x 3.58m (9'11 x 11'8 )

Front facing uPVC window with a view of the Malvern Hills, radiator, picture rail.

2.39m x 1.95m (7'10 x 6'4 )

Rear facing uPVC window overlooking rear garden, radiator.

2.50m x 1.35m (8'2 x 4'5 )

Rear facing with two obscure uPVC windows, panel bath with shower over, low level WC, wash basin, radiator.

Driveway with off road parking for two - three cars to the fore of the detached timber garage, low brick wall to front boundary, garden is laid to lawn with established shrub planting, path leads to porch.

Generous and private rear garden, enclosed by fencing with gated side access, laid to patio seating area across the rear with a generous flat lawn, mature shrub borders and mature trees, the rear of the garden is more woodland like including mature apple trees and the mature foliage provides privacy, substantial shed and further play shed.

From the Allan Morris office on Worcester Road, proceed down the hill turning onto Church Street. Continue along Church Street through the traffic lights continuing into Barnards Green Road, follow the road along until you reach the traffic island, continue straight at the round, go past the traffic lights taking the first turning on your right into Geraldine Road, where the property can be found on the left as identified by our for sale board. For more details or to book a viewing, please call our Malvern office on 01684 561411

TENURE: We understand the property to be freehold but this point should be confirmed by your solicitor.

FIXTURES AND FITTINGS: Only those items referred to in these particulars are included in the sale price. Other items, such as carpets and curtains, may be available by separate arrangement

SERVICES: Mains gas, mains electricity, water and drainage are connected. Please note that we have not tested any services or appliances and their inclusion in these particulars should not be taken as a warranty.

OUTGOINGS: Local Council: Malvern Hills District Council (01684 862151); at the time of marketing the Council Tax Band is: E

SCHOOLS INFORMATION: Local Education Authority: Worcestershire LA: 01905 82270

Marketed by Arrange viewing 01684 561411

Allan Morris - Malvern

3/3A Worcester Road, Malvern, Worcestershire

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Top 10 Best Military / Army Schools in India

Almost all the Military and Army schools are affiliated with the Central Board of Secondary Education. While most of the Rashtriya Military Schools are run by Ministry of Defence, Govt of India, Army Public schools are controlled by Army welfare education society. Most of them give priority to the children of defence and armed personnel. But admissions are open for civilians as well. Medical Facility and CSD canteen facility is provided to almost all cadets. These schools/institutes, pave the way for those who long to serve the nation. As a Digital marketing school in Chandigarh, CIDM offers social media services, search engine services, and website design services. CIDM creates, execute and manage social media campaigns for its students.  You can learn marketing in Chandigarh from CIDM school of digital marketing in Chandigarh.

Lets check out the list of top defence schools in india:

10. Army Public School, Pune

Army Public School, Pune

The Army Public school was established in 1988, to give high standard education for children of army personnel. The school is spread on a large area of lush green land that encourages nature inspection and sporting ability. It offers academic education from standard 1 through 12.

9. Rashtriya Military School, Belgaum

Rashtriya Military School, Belgaum

It’s located in Belgaum, Karnataka. This one’s also residential school for boys studying in class VI to XII. The medium of instruction is English while Hindi is a compulsory subject for students studying in classes VI to X. The school stresses on academic excellence.

8. Rashtriya Military School, Ajmer

Rashtriya Military School, Ajmer

It’s located at Ajmer, Rajasthan. The school is spread over 92 acres of land. Several alumni of this school are serving the motherland in the armed forces. Adequate stress is laid on academic and extracurricular activities. The school also offers hobby courses.

7. Shri Shivaji Preparatory Military School, Pune

Shri Shivaji Preparatory Military School, Pune

It’s a residential school and houses the youngest cadets, from age 4 up. The rooms are well ventilated, imparting academic and co curricular studies. Apart from CBSE curriculum; it also has a dedicated NCC wing.

6. Army Public School, Mumbai

Army Public School, Mumbai

It was established in 1984 primarily for imparting quality education to the children of Defence Personnel at an affordable cost. However, they also admit civilians. The school is from standard 1-12. It’s a great school for Primary children; the school has adopted play way method. No H.W, no exams from class 1-5.

5. Rashtriya Military School, Bangalore

Rashtriya Military School, Bangalore

It was founded in 1946 for the children of armed forces and civilians. It has a sprawling lush green campus, in Bangalore, Karnataka, and has all the necessary facilities that a defence aspirant requires. It offers education from grade 6th to 12th. It’s aimed at preparing students for applying in National defence Academy.

4. Rashtriya Military School, Chail

Rashtriya Military School, Chail

It’s a residential school in Chail, Himachal Pradesh. The world’s highest cricket ground is located in Chail and is used as a training and playground for cadets. The school prepares the cadets for CBSE 10th and 12th and for Entrance Examination for National Defence Academy.

3. Rashtriya Military School, Dholpur

Rashtriya Military School, Dholpur

It’s the youngest of the Rashtriya Military schools set up after independence, in 1962. It’s spread over an area, of 1500 acres in Dholpur, Rajasthan. The school has all the modern amenities like digital classrooms; Internet enabled Computer Lab, Modern science lab, sports facility, a decent library and auditorium.

2. Army Public School, Dhaula Kuan

Army Public School, Dhaula Kuan

This one’s located in Delhi and imparts education to kids of defence personnel. The school has an area of over 33 acres of land that includes, four wings, one auditorium, three cafeterias, a children’s science park, and a hostel for boys. It has six basketball courts, two football field and one hockey field, two tennis courts, two volleyball courts, a huge slide, a gym, a bank, and lots more! It is indeed the best Army Public School in India. It has received several awards for academic excellence.

1. Rashtriya Indian Military College, Dehradun

Rashtriya Indian Military College, Dehradun

It is one of the oldest institutes established in 1922. After independence, it came under the Ministry of Defence, Govt. of India. It’s a boarding school. Admissions are open for children of armed forces personnel as well as civilians, who have cleared 7th grade and are under 13 yrs of age. It is the best feeder institute for the National Defence Academy. Its former cadets, have gone on to achieve high ranks in Army, Navy and Air force corps.

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Transport and infrastructure in Turkmenistan

Our listing of the primary kinds of transport compares the infrastructure of Turkmenistan with the average of all countries in Asia. The net of streets and highways has a total length of 58,592 km. Theoretically, this is 9.71 meter for each of the 6.0 millions inhabitants of the country. Turkmenistan hereby ranks 52nd in a worldwide comparison.

With a length of 0.85 meters of railway tracks per person Turkmenistan come 14th worldwide.

The given length of waterways and number of harbours are only refered to inland traffic on rivers and canals. There is no direct access to the open sea in Turkmenistan.

Airports in Turkmenistan

Back to overview: Turkmenistan

 totalper 1 mio
per km2
Roadways58,600 km9,714.84 km120.04 m
Railroads5,100 km847.76 km10.48 m
Waterways1,300 km215.55 km2.66 m
Commercial harbors7111.770.000

 total per 1 mio
per km2
Roadways14,699,500 km3,192.38 km459.66 m
Railroads345,900 km75.12 km10.82 m
Waterways260,300 km56.53 km8.14 m
Commercial harbors44,7339.710.001
Turkmenistan: AirportsLargest airports and airlines in TurkmenistanThe biggest airports and Turkmenistan in Turkmenistan with further information and data
Turkmenistan: ClimateClimate details in TurkmenistanA climate analysis for Turkmenistan incl. temperatures, humidity, rain days per month, hours of sunshine, Water temperature, Rainfalls
Ranking: MegacitiesMega cities - the biggest cities all over the worldRanking of the biggest cities worldwide. On top: Shanghai, Beijing and Delhi


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The Phoenicians and the West: Politics, Colonies and Trade

Server Costs Fundraiser 2021

Please help us pay for the servers and web services required to operate our non-profit organization's website. Any donation helps, no matter how small: If every visitor were to give only $1 we would be fully funded within a day.

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Mark Cartwright
published on 08 June 2016
Send to Google Classroom:
Rating: star star star star star
Audience: University
Difficulty: Medium

The Phoenicians and the West: Politics, Colonies and Trade

A must-have book for a more complete understanding of the political, commercial, and colonial aspects of Phoenicia, one of the ancient Mediterranean's most influential cultures.

The Phoenicians were one of the most influential ancient Mediterranean cultures, and so it is surprising how few general history books there are on the market which cover this fascinating civilization. In addition, of the few books generally available a good proportion are hopelessly outdated, seminal works though they might have been in the first half of the 20th century. Maria Eugenia Aubet's The Phoenicians and the West, therefore, makes an important contribution to the literature on the topic.

The book is divided into ten chapters which cover not only the most famous of Phoenicia's contributions to Mediterranean history - maritime trade and colonization – but also their origins, the evolution of the great cities of the Levant from the Iron Age onwards, their political structures, religious practices and architecture, and international relations with contemporary cultures in Egypt, the Aegean, and the Near East. Aubet is a Professor of Archaeology at the Universidad Pompeu Fabra and her arguments are robustly presented. She discusses prevailing theories, long-held misconceptions, and new evidence to arrive at convincing conclusions based on the knowledge presently available.

The books strongest and most interesting contributions concern the history of Phoenician trade with a discussion of theories of how that may have functioned, who participated in it and controlled it, and how it drove the Phoenicians westwards. The chapter on the maritime skills of the Phoenicians and just how far they might have sailed beyond the Pillars of Hercules is also a highlight. The presentation of the chronology of the colonisation process and how interlinked colonisation and trade were for these ancient commercial seafarers is another important contribution, as is Aubet's discussion of the latest theories concerning the tophet and child sacrifice for which the Phoenicians gained, unjustly it seems, an infamous reputation throughout history.

Ancient sources on Phoenicia and archaeological evidence is much patchier than with other ancient cultures, nevertheless, Aubet stitches these together to present what remains the most balanced and complete coverage of what we know of the Phoenicians. This is a book clearly destined for a university library or academic's bookshelf, and there are some sections a general reader might see fit to skim over such as the presentations of mercantile theory and exchange mechanisms, but there is much here of interest to the general reader. Aubet's consistent presentation of what was once held as true and what is now held as true is also of great use and redresses the biases of ancient sources, the prejudices of earlier historians, and lack of archaeological evidence that most earlier works on this topic suffer from.

In conclusion, with a smattering of black and white photographs and illustrations, maps, tables, extensive bibliography, and index this volume is absolutely essential for a more complete understanding of the Phoenicians from a political, commercial, and colonial perspective. Highly recommended.

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Aubet, M. E. (2016, June 08). The Phoenicians and the West: Politics, Colonies and Trade. World History Encyclopedia. Retrieved from

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FDA head calls for inquiry into Alzheimer’s drug review

US & World

FILE – This image provided by Biogen on Monday, June 7, 2021 shows a vial and packaging for the drug Aduhelm. On Thursday, July 8, 2021, U.S. health regulators approved new prescribing instructions for the controversial Alzheimer’s drug that are likely to limit use of the expensive therapy, which has faced an intense public backlash. (Biogen via AP, File)

WASHINGTON (AP) — The acting head of the Food and Drug Administration on Friday called for a government investigation into highly unusual contacts between her agency’s drug reviewers and the maker of a controversial new Alzheimer’s drug.

Dr. Janet Woodcock announced the extraordinary step via Twitter. It’s the latest fallout over last month’s approval of Aduhelm, an expensive and unproven therapy that the agency OK’d against the advice of its own outside experts.

Woodcock made the request to the Department of Health and Human Services’ inspector general, the watchdog agency that oversees the FDA and other federal health agencies. The move comes after numerous calls for a probe into the approval from medical experts, consumer advocates and members of Congress. Two congressional committees have already launched their own review.

“We believe an independent assessment is the best manner in which to determine whether any interactions that occurred between the manufacturer and the agency’s review staff were inconsistent with FDA’s policies and procedures,” Woodcock wrote on Twitter. Biogen pledged to cooperate with the inquiry.

Last month, the health news site Statreported on the unusually close collaboration between Aduhelm drugmaker Biogen and FDA staff. In particular, the site reported an “off-the-books” meeting in May 2019 between a top Biogen executive and the FDA’s lead reviewer for Alzheimer’s drugs.

The meeting came after Biogen stopped two studies because the drug didn’t seem to slow the disease as intended. Biogen and the FDA began reanalyzing the data together, concluding the drug may actually work. The collaboration ultimately led to the drug’s conditional approval two years later, on the basis that it reduced a buildup of sticky plaque in the brain that is thought to play a role in Alzheimer’s disease.

FDA interactions with drug industry staff are tightly controlled and almost always carefully documented. It’s unclear if the May 2019 meeting violated agency rules.

When Biogen and FDA brought the drug before the FDA’s panel of outside advisers in November, the group was nearly unanimous in urging its rejection.

The FDA isn’t required to follow the group’s advice. And the FDA lead staff reviewer — who had been working with Biogen for months on the drug’s data — called it “exceptionally persuasive,” “strongly positive” and “robust.”

The consumer advocacy group Public Citizen called for an investigation into the collaboration after the November advisory meeting. The group’s health director Dr. Michael Carome welcomed Woodcock’s request for an inquiry.

“We’re pleased to see that belatedly she has made this request that should have been made months ago,” Carome said. “The signs of an inappropriate collaboration have been clear to us since November.”

The FDA has faced intense backlash since approving the drug, which costs $56,000 a year and requires monthly IVs.

Three of the FDA advisers who opposed the drug resigned over the decision. Among other issues, they protested that the agency did not disclose that it was considering approving the drug on a conditional basis, based on its effect on brain plaque, rather than any actual benefit to patients. Aduhelm is the first Alzheimer’s drug approved in that manner.

“I think all the different parts of the decision are worthwhile for an independent investigation,” said Harvard University researcher Dr. Aaron Kesselheim, one of the three advisers who resigned. “The trust that we have in FDA’s ability to make independent decisions is very important.”

On Thursday, the FDA took the unusual step of vastly scaling back prescribing information on the drug. The agency and Biogen announced the new label would recommend that it only be given to patients with mild or early-stage Alzheimer’s. That came after many doctors criticized the original label as too broad, because it said the drug could be given to anyone with Alzheimer’s.

Aduhelm hasn’t been shown to reverse or significantly slow the disease. But the FDA said that its ability to reduce clumps of plaque in the brain is likely to slow dementia. More than two dozen other drugs have previously tried that approach without yielding positive results. Biogen is required to conduct a follow-up study to definitively answer whether it really works. Other Alzheimer’s drugs only temporarily ease symptoms.

Woodcock has been serving as the agency’s acting commissioner since January. Previously she spent more than 25 years directing the agency’s drug center. While widely respected among government and drug industry circles, she has also been criticized for often pushing aggressively to approve new therapies, even when their benefits aren’t certain.

Follow Matthew Perrone on Twitter: @AP_FDAwriter

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

Copyright 2021 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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NewsRegion C Palm Beach County

Heat, rain creating breeding ground for toxic toads, iguanas in South Florida

Wildlife experts say bufo toads can pose danger to pets, young children
Posted at 3:57 PM, Jun 10, 2020
and last updated 2020-06-10 17:55:14-04

PALM BEACH COUNTY, Fla. — The heat, humidity, and recent rain have created the perfect storm, allowing toxic toads and iguanas to reproduce and pose a major threat to your pets and possibly young children.

"We had a lot last year. We’re seeing even more this year," said Jeannine Tilford, the owner of Toad Busters, a poisonous toad removal company.

Wildlife experts are issuing a new warning after an explosion of toxic toads.

The invasive species has been multiplying through the winter months with a lack of cold weather, and is now posing even more of a danger.

"The amount of feces that they leave in the pool and around the deck is just not healthy for kids to be stepping in or dogs to be stepping in and bringing into the house," said Tilford.

And if threatened, the cane toads or bufo toads secrete a white substance that’s could cause seizures and kill dogs or cats.

With all our recent rain, Cuban tree frogs are not only causing a disturbance, but they are also toxic.

"In basically one night, I’ve got like 50 calls because people can’t sleep because they come out late and they’re so loud," said Tilford.

Toad Busters is bringing them in by the hundreds, and now the company is teaming up with Iguana Busters.

Large iguanas are wreaking havoc in South Florida, and we’re told there are now reports of them in Martin County.

"When they burrow, they can go as deep as 10 to 15 feet, collapsing sea walls and any type of cement foundation, including sidewalks," said Steve Kavashansky with Iguana Busters.

Tilford said the bufo toads and Cuban tree frogs can also cause an allergic reaction if you rub your face after touching them.

So if you’re handling them, make sure to wash your hands thoroughly and also wear gloves.

Tokyo Olympics Medal Count as of late July 31, 2021


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Lisa King dominates Bert - GI feet match

Luscious Liverpool lovely Lisa King makes a welcome return to the MWC mats where she finds herself pitted against the ever-willing Bert.

Both are kitted out in there Gi gear with Lisa looking particularly ravishing in her pink outfit. And she is quickly on the attack, taking down her rival and catching him between her strong legs.

Bert tries to battle against her but Lisa is cooking and soon using his face as a footstool while locking on an excruciating arm bar. His tap is as swift as it is inevitable!

Lisa King chokes Bert with her feet

Unperturbed, Bert comes out fighting straight away but Lisa is more than ready for him and skilfully throwing him back down to the mats to continue working him over.

And she certainly knows how to use her feet! Catching him in a choke to take further control of him before employing her considerable wrestling skills to cause him more anguish.

The taps and anguished looks on Bert’s face start becoming alarmingly regular from his point of view as Lisa works her way through her arsenal of weapons.

She catches him in head scissors, figure four locks, arm bars, head locks, leg locks, pins, face sits and of course chokes using her glorious feet.

Bert is trapped between Lisa's strong thighs

Bert’s cries of pain get louder and louder and the submissions become quicker and quicker as he struggles to find an answer to the beautiful blonde’s onslaught.

Time and time again she finds a way through his increasingly weakened defences using her speed and agility and wrestling know-how to demolish him.

She puts the cherry on her domination cake when she once again downs him and chokes him using her feet - this time sending him to never never land!

Bert is left out cold on the mats while lovely Lisa celebrates a stunning and incredibly dominant performance!

#LisaKing #GiFeet #MixedWrestling #Bert #Clips4Sale

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What is an estate plan?

An estate plan is a collection of documents, each serving an important and different purpose.  They are designed to communicate your wishes regarding your assets, healthcare, whom you wish to administer your estate, and whom you wish to make decisions on your behalf in the event that you become incapacitiated.

Estate Planning Documents include:

  • Power of Attorney - This document allows you to name someone to manage your property and financial and legal affairs in the event of an incapacity.  It is also used to name someone to make healthcare decisions if you are unable to do so.

  • Advanced Care Directive (Living Will) - This document is a directive from you to your physician indicating your wishes regarding treatment in certain limited medical situations.

  • Last Will & Testament - This document tells the courts how you want your property distributed after your death. It also allows you to name a guardian for minor children and pets and provide instructions for your funeral.

  • Trust - This document describes how property will be managed by someone for the benefit of you or a third party.

How We Can Help

Let The Law Office of W. William Robinson, III, PLLC be the solution for your estate planning needs.  Whether you are seeking a new estate plan or need to make changes to a pre-existing estate plan, we have the skills to assist you.  Contact us today to set up a free consultation!


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Wall Street's New Watcher

Benjamin Lawsky, head of New York's new financial regulator.

Stony Brook University

Two weeks after moving into a skyscraper near Wall Street to start assembling a muscular new agency overseeing banks and insurers in New York, Benjamin M. Lawsky got a surprise during an introductory meeting with a midlevel manager: His power was even broader than he thought.

The 41-year-old former federal prosecutor, who spent the last four years as Andrew Cuomo's confidant and adviser in the New York attorney general's office, learned that he had greater latitude to pursue criminal fraud cases than he initially knew.

As the head of the New York State Department of Financial Services, which officially opens its doors Monday, he says he plans to use that authority to put the new agency on the map.

Since the June meeting, Mr. Lawsky has been contacting Federal Bureau of Investigation agents, lawyers and other trusted allies from his past as part of his plans to "exponentially" increase the criminal division from the current handful of employees, he says. But he adds that he will use the power of his new office judiciously.

"I'm strategically aggressive," says Mr. Lawsky, who went after a slew of banks, securities firms and top executives while working in the attorney general's office.

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