Storified by Matteo Magrini · Wed, Jul 17 2013 13:40:31
"quanto pagheresti per baciarmi adesso?" "Ehh, tanto" "allora aprimi la porta" @numero_F3
Conversation with @__quatrefoil
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La desmentida de Gianinna
Storified by Guido Albamonte · Wed, Jul 17 2013 13:40:32
@gianmaradona No quiero arruinarte la mañana pero están diciendo que estuviste con el ogro fabbiani ??????!!!
@nosotros4 por dios!!!! Nada q ver!!!!!!!!!!
@nosotros4 por dios ya no saben q más dcir d mi...
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SAS Clinical Training | Clinical Programming Training
Course Details: In this course, you will build the fundamental understanding of BI reporting using the Oracle Business Intelligence Reporting. OBIEE training model includes all the technical procedures required to facilitate data modeling and other data related activities which also covers advanced
Storified by Serigor Inc · Wed, Jul 17 2013 13:40:44
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#ResistenciaSocial #RS
Cobertura en las redes de la #ResistenciaSocial en España ante los recortes, corrupción, pérdida de derechos, represión policial, etc.
Storified by periodismohumano.com · Thu, Jul 18 2013 13:52:23
Contando #AdiosMafia en @phumano. Aquí storify de las protestas: http://periodismohumano.com/sociedad/sociedad-destacado/resistenciasocial.html En un ratillo la crónica...
"@shul_evolution: Abogado de guardia de @LegalSol para la movilizacion de hoy #QueSeVayaLaMafia: Jesús Calpe Ruiz. 665225665."
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Joint whereupon a afforestation bench
A similar chitchat was met Michael. Alter ego smoked a joint in there with friends upon accurate advisory body in the ammo dump. After were bilateral John Doe who were babbling beer. When they ended, they came en route to them, drew patrol aviation badge shoplift told them against be located whereupon the abyssal zone. Adapted to searching, it bad apparently that John Doe was transporting a certain Roman candle. Bipartite of them, who displeasing least than fifty percent accurate gram, accommodated to earshot the watch released.
Storified by · Thu, Jul 18 2013 13:52:39
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LIVE COVERAGE: Richmond Reacts to Gang Rape Verdict
A verdict against Marceles Peter, 20, and Jose Montano, 22, is expected shortly at Contra Costa County Superior Court. Both men face life in prison if convicted of charges in connection with the Oct. 24, 2009 Richmond High School gang rape of a 16-year-old girl.
Storified by · Thu, Jul 18 2013 13:53:03
Peter and Montano are charged with gang rape, forced oral copulation in concert and sexual penetration in concert.
#RichmondCA gang rape verdict minutes away. Courtroom quiet, packed, tense w/ anticipation.
Awaiting the verdict:
Media vans line up outside the Contra Costa Court House
The trial and the evidence:
There was "overwhelming evidence" in closing arguments of the trial: http://sfappeal.com/2013/07/closing-arguments-conclude-in-richmond-high-gang-rape-trial-the-evidence-is-overwhelming/
The chronology of events are detailed in the gang rape case: https://richmondconfidential.org/2013/06/24/haunting-chronology-of-events-detailed-in-homecoming-gang-rape-case/
A year after the assault, "horrific details" become clear: https://www.baycitizen.org/news/crime/hearing-reveals-horrific-details-crime/
Coverage of the case over the years:
Officers testify: http://richmondconfidential.org/2010/11/16/officers-testify-in-richmond-gang-rape-case/
Residents say neighborhood where assault happened is safe:http://richmondconfidential.org/2009/10/28/residents-say-neighborhood-is-safe-despite-rape/
Safety measures questioned at Richmond High School: http://richmondconfidential.org/2009/10/27/safety-measures-under-scrutiny/
Community Violence Solutions began holding workshops at Richmond High School following the attack:https://www.baycitizen.org/news/crime/hearing-reveals-horrific-details-crime/
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SMBE 2013 session on microbial genome evolution
SMBE 2013 meeting session I chaired on microbial genome evolution
Storified by Jonathan Eisen · Thu, Jul 18 2013 13:53:59
At #SMBE13 Florent Lassalle: selection on codon usage vs. GC - supported model that GC biased gene conversion interfered w/ selection
At #SMBE13 Florent Lassalle: recombination species (of the 21 species of bacteria/archaea) are always richer in GC than non recombining ones
At #SMBE13 Florent Lassalle: took 21 sets of bacterial/archaeal "species" w/ many genomes in each set; looked at recombination w/in each
At #SMBE13 Florent Lassalle: two main predictions of GC biased gene conversion: recombination correlated w/ GC; GC interferes w/ selection
At #SMBE13 Florent Lassalle: much evidence for GC biased gene conversion in eukaryotes - so why not bacteria?
At #SMBE13 Florent Lassalle: wondered if biased gene conversion could explain some of the patterns of evolution in microbial genomes
At #SMBE13 Florent Lassalle: references Hersberg and Petrov PLOS Genetics paper http://www.plosgenetics.org/article/info%3Adoi/10.1371/journal.pgen.1001115 cc: @PetrovADmitri
Last up in the #SMBE13 microbial genome evolution session -Florent Lassalle on biased gene conversion shaping the bacterial genome landscape
At #SMBE13 @McCutcheonLab - genome of Tremblaya types that do not have Moranella inside of them -are less reduced than those w/ Moranella
At #SMBE13 @McCutcheonLab - compared symbioses across mealybugs - not all have Moranella in Tremblaya structure
Mealy bug symbiont within a symbiont amino acid pathway spans 3 different genomes #smbe13 see @carlzimmer post http://www.nytimes.com/2013/07/04/science/how-simple-can-life-get-its-complicated.html?_r=0
At #SMBE13 @McCutcheonLab - wondered if Tremblaya transferred any genes to its host genome as in organelles
At #SMBE13 @McCutcheonLab - asking how/why does Tremblaya have such a degenerate genome? (only 120 genes or so)
At #SMBE13 @McCutcheonLab: Tremblaya is the smallest known genome "but that may fall any day"
At #SMBE13 @McCutcheonLab - for mealybug the synthesis of essential amino acids comes from combined efforts of host, Tremblaya & Moranella
At #SMBE13 @McCutcheonLab - mealybug has two bacterial symbionts Tremblaya inside bacterial cells & Moranella inside Tremblaya
At #SMBE13 @McCutcheonLab - nutritional endosymbionts of insects have some very weird genomes - small, AT bias, rapid evolution, etc
At #SMBE13 @McCutcheonLab - sap feeding insects make up for amino acids missing from their diet via bacterial symbionts
At #SMBE13 @McCutcheonLab discussing the challenges faced by sap feeding insects on acquiring all the nutrients they need
At #SMBE13 @McCutcheonLab says "this is the best picture of a mealybug you will ever see" & shows pic by @Myrmecos & credits him
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State
Stay up to date on the latest happenings affecting undocumented students state by state with the uLEAD Network State Newsdesk!
Storified by uLEAD Network Newsdesk · Thu, Jul 18 2013 13:54:02
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The evolution of Michael Cera
The Brampton-born actor has come a long way from Pillsbury cookie commercials
Storified by · Thu, Jul 18 2013 13:54:04
When Cera was a child actor living in Brampton, he became used to auditioning against hundreds of other kids in Toronto. One of his first gigs was a Tim Horton's commercial, which went so well he landed this 1999 Pillsbury spot.
Cera was perfect in the role of junior banana stand employee George Michael Bluth in Arrested Development. When he wasn’t pining for his cousin Maeby, George Michael was dating Ann Veal (“Her?!”). The poor guy fell hard and saw something in her that the rest of his family seemed to miss, which is presumably why he’s the only one who thought a “mayonegg” was a cute idea.
Following the abrupt cancellation of Arrested Development, Cera teamed up with Clark Duke for a mockumentary that followed parodies of themselves, trying to write and sell a script. Clark and Michael further established Cera as an awkwardly charming young actor, and featured appearances from colleagues like David Cross, Tony Hale and Jonah Hill.
This wildly popular teen comedy was a raunchy and hilarious hit, starring Cera and Jonah Hill as high school seniors desperate to get some action (and score some booze with McLovin’s fake ID). Cera portrays Evan in his signature sensitive and nerdy style -- especially when he serenades a party with a rendition of “These Eyes.”
Still, in his quest to be Superbad, we begin to see a different side of Cera.
Still, in his quest to be Superbad, we begin to see a different side of Cera.
Cera perfects a penetrative, slightly psychotic gaze for the role of
François Dillinger in Youth In Revolt. The mustachioed teen was a
“supplementary persona” to Nick Twisp, also played by Cera, a painfully
virginal, uber nice 16 year old.
Cera starts off as the familiar, soft-spoken but quietly reckless Scott Pilgrim, who must fight through various levels of comic-infused, arcade-like levels to win the heart of the mysterious Ramona Flowers.
If he learns anything from his overblown battles with her seven evil exes, it’s that he’s not the ordinary kid from Toronto he thought he was.
In the soon-to-be-released Crystal Fairy, Cera skips the awkward phase and begins his quest with a bold imperative: to find a hallucinogenic cactus in the Chilean desert and drink mescaline (something Cera really did, on camera, after consulting the real life Bill Murray).
Cera is judgmental, sarcastic and closed off - but if there’s one consistent theme to his work it’s this: his character surely needs to learn a lesson.
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VPI Home Solutions - 700 ESPN Sports Beat | 7-18-13
Diving into the world of local sports. A daily production of Patchin, Lukens and Osso. Join us daily from 3 p.m to 6 p.m. on 700 AM or www.700espn.com for all the latest in local sports news. [Curated by Sunny Cadwallader]
Storified by Patchin Lukens & Osso · Thu, Jul 18 2013 13:54:15
*** REMINDER: We're broadcasting live today from 3-6pm at Dan Dickau's, The Barbers, 9331 N Newport Highway. Stop by and say hello. ***
The Open: Taming And Claiming
Oh snap moment for Charl Schwartzel
And an American shall lead them. Barely. American Zach Johnson leads the British Open by one shot after shooting a five-under, 66. Two players are one stroke back with five more that are two strokes behind.
The second round gets underway at 11:32 pm PT tonight. You can find tee times for tomorrow's second round action, here.
His day may have been a bit up-and-down, but Tiger Woods finds himself on the under side of the score card after round 1 of The British Open today.
Twitter Tidbit
Despite some complaining of course conditions -- and there was a lot of it -- 20 players broke par ...
Click "here" for more information about VPI Home Solutions.
Mariners: A Look Ahead To MLB's Second Hallf
Will Raul's new regimen keep him producing in the second half?
July means All-Star Break and...trade deadline. What were the top 5 "in-season" trades for the M's?
Twitter Tidbit
Here's awesome #Rainiers news: Jesus Montero reinstated from DL, Gutierrez and Pryor begin rehab assignments. All 3 join TAC in Fresno.
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Clay Starbuck sentencing hearing
Convicted murderer Clay Starbuck is being sentenced Thursday, July 17 for the killing of his ex-wife Chanin.
Storified by kxly · Thu, Jul 18 2013 13:54:30
Clay Starbuck has arrived for his sentencing. He was smiling as he entered the courtroom. #KXLY
Waiting for Clay #Starbuck to be transported to courtroom for sentencing. He's expected any minute. #KXLY
Chanin's mother Melanie along with her sister and brother will speak at today's sentencing. #kxly
Courtroom for Starbuck sentencing is packed. Family for Chanin and Clay will speak. Sentencing starts at 1:30. #kxly
Chanin Starbuck's mother and brother flew in from Florida to be at Clay's sentencing today. #kxly
Clay Starbucks's pre-sentencing report recommends a life sentence without the possibility of parole. #kxly
Convicted killer Clay Starbuck will learn his fate today. He faces up to life in prison for killing his ex-wife. Sentencing at 1:30. #kxly
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Sidewalk Sale 2013
The Downtown Lawrence Sidewalk Sale is July 18. Stay tuned to the Lawrence Journal-World's Storify for the latest and greatest buys, finds and general Sidewalk Sale shenanigans in #Lawrence. Want to submit? Tag your tweets, Facebook posts and Instagram pics with #swsale.
Storified by LJWorld · Thu, Jul 18 2013 13:55:02
It's Sidewalk Sale day! This is the one day in the summer when all of downtown Lawrence puts everything (well, most everything) on sale: Inside the stores and outside on the sidewalk, the deals are most everywhere, making it a staple of the summer time. Scroll through to follow what your fellow Lawrencians are posting about their shopping extravaganzas.
#swsale #duh
Check out these tips, tricks and general good things to know to survive the day:
Get a free $3.99 comic today if you retweet this by 6pm! Our indoor sidewalk sale is going on until 8pm! 10-25% off most items! #SWsale
In the past few hours, @TheRoost920Mass opened for biz. Here's what's on the menu! bit.ly/1aUoCC5 #swsale
Celebrate your #swsale deals with Muffins made with berries grown by the student gardeners of GFGH. #MercEatLocal ow.ly/n5PN1
$5 two topping slice & drink lunch special, today only @PapaKenosPizza #swsale
Good morning #swsale! Remember to stay hydrated and if you get too warm, take a break inside a business w/ AC. #HeatSafety Happy shopping!
We be serving soft tacos and white dip in front of US Bank today at #swsale #downtownlawrence.
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SDCC Digest 2013: 1
Storified by Convention Scene · Thu, Jul 18 2013 13:55:13
Today,I'll be signing session at @Kidrobot booth #4549 in 12-1pm on #SDCC. #kidrobot X SF exclusive figure out here! http://p.twipple.jp/22Imr
My San Diego Comic Con #SDCC schedule is finally cemented! Come see me this week, and share the geeky Love! - http://thedougjonesexperience.com/appearances.htm
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Hon.Chidi llyod absent as Panel leads interrogation on Rivers crisis
Featured Quote:"“I think it is a very simple thing. Whoever he spoke to should have asked him, ‘why have you not reported to the police?’ Whether it’s a summon or invitation or whether he is declared wanted by the police,..." Frank Mba
Storified by SPEECHLOG Africa · Sat, Jul 20 2013 07:45:09
Port Harcourt- RIVERS STATE
(1) Frank Mba (Deputy Force Public Relations Officer (DFPRO)
“He is the majority leader of Rivers State House of Assembly. He was involved in a case of conspiracy, attempted murder, wounding and wilful damage on July 9, 2013,”
“I think it is a very simple thing. Whoever he spoke to should have asked him, ‘why have you not reported to the police?’ Whether it’s a summon or invitation or whether he is declared wanted by the police, it’s more of semantics, the issue is that his attention is requested by the police and since he knows his presence is requested by the police, what stopped him from discharging his responsibility by visiting the police? I just want him to tell Nigerians why he has not made himself available to the police,”
" it was on record that an invitation letter was taken to Lloyd’s house, but he was “curiously not at home; his cook signed for the letter, acknowledged receipt of the letter and ever since then, we have not heard from him.”
“Investigations are designed to achieve empirically verifiable results; the fact, that a set of people were invited today does not preclude the invitation of another set of people tomorrow. It is not possible for any serious-minded investigative team or panel to embark on a riotous journey,”
“Just as people are calling for Mbu’s removal, there are many others describing the CP as the best thing to have happened to Rivers and the best police officer they have ever met,”
“He is the majority leader of Rivers State House of Assembly. He was involved in a case of conspiracy, attempted murder, wounding and wilful damage on July 9, 2013,”
“I think it is a very simple thing. Whoever he spoke to should have asked him, ‘why have you not reported to the police?’ Whether it’s a summon or invitation or whether he is declared wanted by the police, it’s more of semantics, the issue is that his attention is requested by the police and since he knows his presence is requested by the police, what stopped him from discharging his responsibility by visiting the police? I just want him to tell Nigerians why he has not made himself available to the police,”
" it was on record that an invitation letter was taken to Lloyd’s house, but he was “curiously not at home; his cook signed for the letter, acknowledged receipt of the letter and ever since then, we have not heard from him.”
“Investigations are designed to achieve empirically verifiable results; the fact, that a set of people were invited today does not preclude the invitation of another set of people tomorrow. It is not possible for any serious-minded investigative team or panel to embark on a riotous journey,”
“Just as people are calling for Mbu’s removal, there are many others describing the CP as the best thing to have happened to Rivers and the best police officer they have ever met,”
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Festival des Vieilles Charrues 2013
En direct du Festival en Vidéo, Photos et Articles avec Le Phare Ouest
Storified by Le Phare Ouest · Sat, Jul 20 2013 07:48:56
SUPERETS
16:55 / JEUNES CHARRUES
Ces 4 jeunes hypes compilent batterie claquante, guitares surf et piano rétro-dance. Également spécialisée dans l'art de l'apparat, la bande défie les étiquettes en affichant à chaque apparition un design différent. La fine équipe affirme son dogme : l'heure est au twist !
A 16h55 on monte un peu plus la température sur la scène jeunes charrues, si t'es cool tu seras AL ! #Charrues2013 #VieillesCharrues
Love Music
Un public en communion avec les artistes sur les #Charrues2013.
Un public en communion avec les artistes sur les #Charrues2013.
#SoBreizh !
Toi aussi tu aime les bretons ? Ta photo sur Twitter ou Instagram avec le tag #SoBreizh et tu risque fort de te retrouver à la une du Phare Ouest !!!
Toi aussi tu aime les bretons ? Ta photo sur Twitter ou Instagram avec le tag #SoBreizh et tu risque fort de te retrouver à la une du Phare Ouest !!!
FÉFÉ
16:15 / GLENMOR
À la frontière entre soul, blues, hip-hop et chanson, Féfé propose un rap au style unique, un flow décalé et toujours original. De son nouvel album « Le charme des premiers jours » émane une atmosphère réjouissante portée par une belle énergie, des choeurs harmonieux, des mots qui claquent, des notes brutes et un son égratigné. Un savoureux mélange de genres à ne pas manquer !
A l'horizon...
Meilleure vue ? Sans doute ! Confortable ? Pas forcément...
Meilleure vue ? Sans doute ! Confortable ? Pas forcément...
AFTER THE BEES
15:30 / JEUNES CHARRUES
Porté par la voix flamboyante d’Alexandra, le groupe After the Bees délivre des mélodies folk ancrées dans le rock. Tour à tour tendres ou sauvages, les rythmes de la batterie accompagnent un univers à cordes intimiste, où guitare électrique et harpe s’entremêlent sur une basse délicate.
Marie, journaliste au Phare !
Quand elle ne cycle pas et bien elle festival...
Quand elle ne cycle pas et bien elle festival...
WILD BELLE
15:00 / KEROUAC
Le duo américain Wild Belle est avant tout une affaire de famille. La soeur est belle, le frangin est wild, mais à part ça, on n’en connaissait pas grand-chose si ce n’est leur très contagieux « Keep You ». Complices dans la vie comme dans la musique, la voix soul-pop sensuelle et affirmée de Natalie se marie parfaitement à l’univers afrojazz d’Elliot, conjuguant claviers futuristes, groove r’n’b et nappes de cuivres.
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Live: Second Ashes Test, Day Three
Follow our live coverage of day two of the second Ashes Test at Trent Bridge. We'll have all the latest videos, opinion, and reaction from the ground and around the world via social media. All times in AEST.
Storified by FOX SPORTS Australia · Sat, Jul 20 2013 07:45:37
0042: Tea time at Lord's and the crowd will have to wait 20 minutes before they see Joe Root notch his ton. He heads into the sheds not out on 97, with the lucky Ian Bell on 16 and England 4-171. Still only one wicket in two sessions for the Aussies, although they should have had Bell caught on three but for the third umpire's incorrect intervention.
0034: Joe Root hammers Peter Siddle down the ground for FOUR to move into the 90s. England 4-163. Surely they'll push things along soon. Please.
0022: Cricket Australia clearly not a fan of the Ian Bell not out decision. Semi-offensive tweet very quickly deleted, but not before one of our boys snapped a screenshot! ***UPDATE: CA is saying the tweet "didn't emanate from CA's official Twitter presence at Lord's
0034: Joe Root hammers Peter Siddle down the ground for FOUR to move into the 90s. England 4-163. Surely they'll push things along soon. Please.
0022: Cricket Australia clearly not a fan of the Ian Bell not out decision. Semi-offensive tweet very quickly deleted, but not before one of our boys snapped a screenshot! ***UPDATE: CA is saying the tweet "didn't emanate from CA's official Twitter presence at Lord's
0004: NOT OUT! We'll hear more about that one after today's play. Ryan
Harris gets Ian Bell fending and he nicks one to Steve Smith, who takes
it very low down at gully. The Aussies claim it but the umpires send it
upstairs for a review and the decision is overturned. Appalling
decision. The ball clearly bobs up off Smith's fingers and into his
hands, but the third ump rules it hit the ground.
Thought that was out ! !!
Farce #Ashes
0000: Slight delay as the umpires call for a replacement ball. This one must be slightly out of shape after 68 overs of dogged England stonewalling
2353: Almost another one as Harris gets Bell chipping into the leg side, but the nut falls just short of the fielder at midwicket
Of course I was cleaning my teeth. #breakthrough #Ashes
2325: WICKET!! It took an eternity but Australia finally has their first wicket on day three. Pattinson banged another one in short and Bresnan slaps it straight to Chris Rogers at square leg. The Bresnan-Root partnership is snuffed out on 99 and ENG 4-129.
The reward for the Aussies? England's most in-form batsman Ian Bell at the crease.
2321: If you can handle it, here are the low/highlights from the first session...
The reward for the Aussies? England's most in-form batsman Ian Bell at the crease.
2321: If you can handle it, here are the low/highlights from the first session...
“@CricketAus: Bresnan doing a great job as nightwatchman, but he's no Jason Gillespie http://www.youtube.com/watch?v=9sny6UmZJDQ @YCCCDizzy #Ashes” #diz201
2311: JPatt gets Root jumping and inside edging to fine leg for a single. Just 23 runs conceded from his 15 overs but still nada in the W column.
2303: Slow going after lunch but Joe Root slaps our eyes open with a crashing flick off his pads through midwicket for FOUR. Moves to 69 and ENG 3-123.
2300: Not sure the real Richie Benaud would approve, but we'll take it...
2303: Slow going after lunch but Joe Root slaps our eyes open with a crashing flick off his pads through midwicket for FOUR. Moves to 69 and ENG 3-123.
2300: Not sure the real Richie Benaud would approve, but we'll take it...
2253: NOT OUT! First real appeal of the day as Pattinson raps Bresnan on the pads. Ump shakes his head and replays show a small inside edge. Nice to hear some noise out there, finally. Like a funeral in the middle.
2248: Wee bit of reverse there for Sidds. Not that it matters as Bresnan slides him down to fine leg
2248: Wee bit of reverse there for Sidds. Not that it matters as Bresnan slides him down to fine leg
England's morning well played Joe 63* & Bressie 32*.... Partnership of 84* ! Anyway back for the Aussie's ???
2246: Just the one run off that first over and Peter Siddle gets another crack first-up.
2241: We're back for the second session and Joe Root wasted no time, scoring a single off James Pattinson's first ball. ENG 3-115
2218: First session report yours to enjoy...
2241: We're back for the second session and Joe Root wasted no time, scoring a single off James Pattinson's first ball. ENG 3-115
2218: First session report yours to enjoy...
Excellent session for Yorkshire... #Ashes.
2202: Mercifully, the umps call time on the first session on day three at Lord's. Two hours of boredom from the Poms but that will bother them nought, having held onto all seven of their wickets from the start of play. Bresnan has ticked along to 32, while Joe Root passed his half-century and is now not out on 63. ENG 3-114.
2200: Agar continues his work in what should be the final over before lunch.
Click on the box below to check out our rolling story from the first session.
2200: Agar continues his work in what should be the final over before lunch.
Click on the box below to check out our rolling story from the first session.
2141: The Aussie wounds deepen as England pass 100 without losing another wicket on day three. Home side 100-3, with Root 55 and Bresnan 25. Agar, Pattinson, Harris and Siddle have all tried their luck with no success.
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Consejo Descentralizado de Ministros en Puno
Hoy sábado 20 de julio se lleva a cabo el Consejo Descentralizado de Ministros desde la ciudad de Ayaviri, en la provincia de Melgar, Región Puno.
Storified by Pachamama Radio · Sat, Jul 20 2013 07:48:37
9:45 am. En Ayaviri preparan la recepción al presidente de la República, Ollanta Humala, y del gabinete de ministros en pleno.
9:40 am. Este es el salón donde se realizará la sesión del Consejo Descentralizado de Ministros en Ayaviri
9:20 am. Un fuerte contingente policial se encuentra en el aeropuerto
de Juliaca a la espera del presidente Ollanta Humala. En el aeropuerto esperan
03 helicópteros que trasladarán al presidente y los ministros hacia Ayaviri
(Melgar).
9:10 am Autoridades de la región vienen ingresando al auditorio de la Municipalidad de Ayaviri para el Consejo Descentralizado de Ministros en #Puno
Las redes sociales también reaccionaron antela llegada del presidente y sus ministros a la región de Puno.
Presidente Humala encabezará hoy Consejo de Ministros Descentralizado en Puno. bit.ly/132bmTc
Pdte. Humala y Gabinete Ministerial, rumbo al 9no.,Consejo de Ministros Descentralizado,en la ciudad de Ayaviri, Prov. Melgar, Región Puno.
Mauricio Rodríguez anuncia Consejo de Ministros Descentralizado en Ayaviri – Puno bit.ly/13CnHMU #peru #actualidad
Noticias de huaral Sesión descentralizada de Ministros se realizará el 20 de julio en Puno http://ow.ly...
El Consejo de Ministros en Puno será liderado por Ollanta Humala
Así informaron los medios de la llegada del presidente Ollanta Humala y sus ministros a Puno.
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Sudden Cardiac Death in Teen Athletes
In the United States we have a set of pre athletics standards that are in place for sports physicals. Yet every year student die in cardiac related deaths. Do we adhere to the guideline adequately and do parents, coaches and students know what to watch for? Lets take a look at the literature.
Storified by · Sat, Jul 20 2013 07:47:27
Every year American students lose their lives
suddenly during active sports participation.
The statistics show that as many as 1000 students die each year related
to sudden cardiac death. Tragic for
families and fellow students as many of these incidents happen on the athletic
field, court, rink or other sports arena. This
is exactly what happened to Wes Leonard, a 16 year old sports star for the
Fennville, Michigan Blackhawks in 2011.
What Wes’s parents did not know was that his heart had doubled in size
and was repeatedly being beat up while he worked out. The night of the March 3rd, marked
the best game of his career, but also became the last game of his life.
In the United States, student sports physicals are required by the Athletic Associations and students are required by district rules to get the paperwork completed to be allowed to participate in sports. Our screening is minimal and maybe even inadequate. In addition to minimal screening, our current process is applied in what I would describe as a population versus personal based approach, parents, students and coaches alike are often undereducated about the signs of cardiac concerns. How can we begin to protect our students when we do not have approaches in place to screen and educate effectively up front?
High
School athletes are at the greatest risk of sudden cardiac death following
physical activity. In my first research source,
“Athletes at Risk for Sudden Cardiac Death” Kim Subasic reviews the inadequate
current state related to standards for sports physicals. The most common cause of sudden cardiac death
in athletes is HCM, an autosomal dominant disorder effecting 1:500 person in
the United States (19), In 1996 the
American Heart Association supported a public initiative to promote sports
screenings. Although the intent of the
screening is to prevent injury and harm, they are guidelines and are not
mandatory. Even with support from the
American College of Cardiology Foundation, the American Academy of Pediatrics,
and the Council on Sports Medicine and Fitness over the past eight years the
screening process is inadequate and does not require a 12 lead electrocardiogram. What it does consist of is a series of 12
questions designed to increase concerns
specific to family and personal history related to cardiac disease. Physical exams are only required for sports
participation every 2-4 years unless the screening questions raises a positive
concern. In addition to the heart health
history, the practitioner is to do a physical exam including listening for a
heart murmur, checking femoral pulses, screening for Marfans syndrome and
bilateral blood pressure reading.
Although I have been present at several of my
son’s sports physicals, I do not recall anything other than a routine review of
systems and physical exam. For our
family this potential became a real life screening 2 years ago when my oldest
son developed a sudden onset of “stroke like” symptoms, nausea and vomiting and
severe headache following an intensive day of training in the summer heat. He is a show choir student and competes each season. Show Choir may not sound like a sport but when you consider the balance of breathing, singing and dancing for 20 plus minutes, it is easier to consider the cardiac stress of this type of competition. Look closely in the video as they try to hide being winded, during the final song of the set.
The thought of a cardiac event was not top of mind for me at the time It wasn’t until we were sitting in the ER being evaluated did I begin to see the recommendations of the true sports screening being implemented. What we learned is that he has a severe murmur; a true “gallop” so uncommonly noted in teens in the ED that he was turned into “test” subject so staff could listen. The good news is that after a “million dollar” workup including a TEE and bubble study, ECG, Neurology exam, CT , labs and many history reviews…he was cleared as a migraine related to dehydration. Wow…not an event I was expecting.
The thought of a cardiac event was not top of mind for me at the time It wasn’t until we were sitting in the ER being evaluated did I begin to see the recommendations of the true sports screening being implemented. What we learned is that he has a severe murmur; a true “gallop” so uncommonly noted in teens in the ED that he was turned into “test” subject so staff could listen. The good news is that after a “million dollar” workup including a TEE and bubble study, ECG, Neurology exam, CT , labs and many history reviews…he was cleared as a migraine related to dehydration. Wow…not an event I was expecting.
I
was surprised to see that the medical community does not routinely follow the
guidelines for sports physicals.
Why? It seems simple enough to
do. Yet parents and student trek off to
the MD once every 2 years to be cleared to participate. What does that really mean? How would I as a
parent know what to ask or what to look if no one ever told me? Most students who die from sudden cardiac
death experience symptoms of some nature prior to the final event. Several studies referenced in this article
noted that despite adequate guidelines, many states in the US continue to fall
short in meeting them.
The easiest test for cardiac abnormalities is the ECG. This test is required in many countries for participation in sports, why not in the US? Italy implemented this as a requirement and decreased the incidence of sudden cardiac death in its athletes by 89% over a 26 year study (23). In the US there has been a push to forgo the ECG due to costs, and to place more AEDs (Automated External Defibrillators) where sports events take place. It feels a bit like a reactive preparation vs. preventive approach?
The easiest test for cardiac abnormalities is the ECG. This test is required in many countries for participation in sports, why not in the US? Italy implemented this as a requirement and decreased the incidence of sudden cardiac death in its athletes by 89% over a 26 year study (23). In the US there has been a push to forgo the ECG due to costs, and to place more AEDs (Automated External Defibrillators) where sports events take place. It feels a bit like a reactive preparation vs. preventive approach?
So why can’t we do more ECG screening as the recommendation
state? According to my second source, “The
electrocardiogram as an adjunct in diagnosing congenital coronary arterial
anomalies”, Mitchell Cohen et al reviewed the value of the ECG and the ease of application. They noted that for many students abnormalities
of the heart and arteries supporting it are often present at birth but do not
surface as a medical concern until the heart cannot compensate for the increase
in stress.
Athletes place a significant
amount of stress on their bodies during training as well as during competitive
sports events. This study again looked at the decrease in the rate of sudden
cardiac death in athletes after implementing the use of the ECG for
screening. The article also supports a thorough
history and investigation of cardiovascular symptoms such as chest pain,
shortness of breath with activity, period of dizziness or lightheadedness with
exercise (62). They noted that the
physical and history alone are not sensitive enough to detect the kinds of
anomalies that would be a precursor to sudden cardiac death.
They also question our limited approach to
screening athletes only. They state this
view is too narrow and will miss many other children at risk. This study placed as much or more weight on
the value of the extensive history and family history along with additional
testing for any child with a history of signs or symptoms of cardiac
disease. All athletic activities should
be stopped until a full evaluation can be completed to ensure the safety of the
child. Imaging such as the ECK certainly
has a place in the process of evaluation, but should not be a standalone
option.
Do students play a role in the process? Screening can be challenging as children do not always report symptoms accurately based on the study published in my thirds source by Mohammad Movahed et all in 2008 Cardiology in the Young. This study looked at the reporting of cardiac symptoms by both boys and girls in the teenage population. They used portable cardiac monitors to track cardiac activity and to correlate this to symptoms. Unfortunately the study shows that girls in particular, report symptoms more frequently and both boys and girls both report symptoms when no cardiac concerns are noted in the physical testing.
Why is this important? Well if we only use personal history and review as a means of screening for pre-athletic participation, we may be chasing the wrong patient for the wrong reasons and missing those with true cardiac concerns. This again supports the need for regulated standards for screening which include both the history and the testing component before a student is cleared to participate. Parents also need to understand this information and the necessity of a clearly reported history for the student and of the family.
So what is too much and what is enough then when it
comes to sports screenings for students?
Where does the cost of the ECG become too expensive, and who’s choice is
that? As a parent am I comfortable
enough knowing that my kids should have easy access for an AED should something
terrible happen to them while participating in a physical activity at our local
park or school event? With health care
costs rising every year and insurance companies refusing to pay for what they
view as unnecessary, what is the best thing to consider?
In my fourth source, “Sudden Cardiac Death in Young Athletes: Time
for a Nordic Approach In Screening?.” in the Scandinavian
Journal of Medicine & Science in Sports, they
reviewed the Italian practice of screening all elite athletes with ECG. The Nordic approach is looking at a
consistent history and physical as well as family history and utilizing the ECG
when patients meet specific guidelines.
They reviewed the potential financial impact of completing ECGs on all
athletes and considered it a wasteful use of expensive medical resources. I really felt challenged with this. As health care consumers we should have some
ability to help drive the testing we want.
In the United States we can if we have the money to do so. I didn’t think twice about all of the testing
my son went through, even though it took me 6 plus months to pay the final
bill. It was worth it, I felt some peace
of mind knowing his cardiac status had been looked at. As a mom I would be sitting in the stands
waiting for something bad to happen.
Could it still? Nothing is a
sure thing when it comes to medicine.
So what can I say about my research process? First I was shocked at the number of deaths
related to cardiac conditions for athletes.
I had no idea it was as common as 1 in 100,000 annually in the United
States for students between the ages of 5-19 years of age. I know that until faced with a real life
scenario I was clueless even as a nurse.
I considered it something that was a “never” event. Yet as I reviewed the resources it became
clearer to me that the screening most parents rely on is not what we may think
it is. In addition, our children may
miss vital components of the intent of the guidelines even if we take them
every 2 years as required in our district.
As a parent I did not have the correct information, nor was I ever asked
any specific questions about sudden cardiac death before age 40, for anyone in
my family or my husband’s family.
As a
nurse, I feel confident I would know what to look for when it comes to acute
cardiac symptoms, but I might also under report or investigate knowing that
children are not always good reporters. Unfortunately the research I found may
also supported that and I potentially place my kids at risk too. I believe that we all deserve enough
information to be educated and able to protect our children. In the United States we have both the
resources and infrastructure to implement the AHA guidelines for sports
screenings. I’m not content with the
idea that having acute access to an AED is enough when it comes to the welfare
of athletes. We need a more robust
screening adherence as well as parent, coach and student teaching about the
warning signs in order to prevent an event like the one the Leonard family
faced on March 3rd 2011.
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Ashes 2nd Test, 3rd Day: live, with your comments
England v Australia at Lord's
Storified by Ken Borland · Sat, Jul 20 2013 07:48:09
Tea - England 171-4 (78 overs) Root 97* Bell 16*; lead 404
England continue to grind Australia into the dust. Nothing has really gone Australia's way today and even when they clearly had Bell caught in the gully, it was somehow given not out by the Kiwi in the third umpire's box.
Desperate times for Australia - The second new ball is still three overs old and Michael Clarke brings on leg-spinner Steven Smith, who shocked England with three wickets on the first evening. It's not a bad idea with Root in the 90s and chasing his first Test century at Lord's ...
But Smith has bowled a bit short today and his first delivery is no different and Root rocks back and hammers the ball through the covers for 4, taking him to 96 and the lead to 403.
Bell capitalises - Ian Bell makes the most of Hill's largesse as Peter Siddle bowls a short, wide delivery that he neatly dabs for four to bring up England's 150. The next ball is down leg and he tickles it away for four. England lead by 387, the decisions aren't going Australia's way and their bowlers are looking increasingly disheartened and tired.
Tony "over the" Hill - The second major blunder by third umpire Tony Hill. Ian Bell, on 3, plays away from the body and edges Ryan Harris to gully, where Steven Smith dives forward, scrapes the ball off the turf and claims the catch. Bell, rightly, is not sure and the umpires refer it to Hill, who has the luxury of TV replays. You only need one to see Smith has clearly got his fingers under the ball, but Hill mystifies everyone by saying it's not out. Perhaps the most telling factor is the first line of CricInfo's profile of Hill - "Tony Hill came into umpiring without any background in first-class cricket".
Anyone with a feel for the game knows that that was out and Hill has made Steven Smith look like a cheat.
So just 17 runs in the first hour after lunch and credit to Australia, they've bowled very well and claimed the wicket of Bresnan, who had irritated them all day. But England, on 131 for four, still lead by 364 - already more than anyone has made to win a Lord's Test in the fourth innings.
Bresnan out - Tim Bresnan's great effort comes to an end as he flaps awkwardly at a short ball from Pattinson that was on off stump and is caught at midwicket. Perhaps Australia could have tried the short ball more against him?
Tim Bresnan c Rogers b Pattinson 38 (137b, 4x4)
England 129-4 Lead 362, partnership 99
Landmark for Root - Joe Root becomes the first player to score a thousand runs in the English first-class season this year - at an outstanding average of 91. He's on 72 not out here and is chasing his fifth century of the season. England 126-3, lead 359
Root breaks the shackles - There have been just five runs in the five overs since lunch as Peter Siddle and James Pattinson find their line and length straight away, but Joe Root breaks the shackles as he unfurls a classic on-drive for four as Siddle delivers a full inswinger. 123-3, lead 356
Lunch - England 114-3 Root 63* Bresnan 32*
Lead 347
A great session for England and super batting by Root and Bresnan as they added 83 on the third morning. There really wasn't much happening for the Australian bowlers - the pitch finally playing as flat as it looks! - and by the end of the session, Root and Bresnan were picking off runs pretty much at will. They've almost certainly ensured England won't lose this Test.
RT @ZaltzCricket: STAT ALERT: Swann 1st Eng spinner 2 take 5 in innings in Ashes Lord's Test since Verity's 7 & 8 hauls in 1934. #sscricket
Root 50 - Joe Root has his third Test 50 in his eighth match, off 122 balls, with six fours, after just less than three hours at the crease. It's his first as an opener and there's clearly much to be excited about in terms of this 22 year-old's future. Root has driven the ball crisply and beautifully off both front and back foot, and he celebrated his 50 with a cracking square drive off the back foot for four off Pattinson. 91-3, lead 324
50 partnership - Joe Root and Tim Bresnan have really steadied the England innings and their 50 partnership comes up off 134 balls as Root plays a magnificent straight drive for four off Peter Siddle and Bresnan edges Ashton Agar to third man for three. 80-3
Good start for England - Just the first hour England would have wanted as they go to 70 for three. Joe Root has looked good today and has played some lovely back-foot drives through the off side in his 36*. Tim Bresnan is on 17* and has thumped some decent boundaries. Most importantly, the lead is 303 with seven wickets in hand.
50 up - Consecutive boundaries from Tim Bresnan does the trick, but both of them could have been out instead. He edges Peter Siddle just short of Phillip Hughes at third slip and the ball runs away to the third man boundary; the next delivery brings an airborne flick off his legs which is just wide of midwicket and also goes for four.
Bresnan off the mark - Tim Bresnan eventually gets his first run off his 30th delivery, scrambling a pull shot down to fine leg off James Pattinson. He was late on the ball and it hit high on the bat - not very convincing at all.
By way of contrast, Joe Root unfurls a glorious cover-drive for four. 42-3
James Pattinson had his best spell of the match late yesterday and he will bowl the second over of the day, with new nightwatchman Tim Bresnan on strike.
Peter Siddle starts the third day's play with the remarkable figures of 5-3-4-3 but his first ball is a half-volley on Joe Root's pads and he puts it away for 4. Having struggled to 18 off 60 balls last night, it's a great start for the youngster. 35-3
England resume with their top-order blown away again in their second innings, on 31 for three, but after Australia's batsmen were even more inept, that still equates to a lead of 264.
If Australia can bowl England out for around a hundred, then they might still have a chance to win, but it's unlikely. England really just need one solid partnership.
Then again, on this day, July 20, in 1981, Ian Botham strode to the crease with England facing an innings defeat at Headingley ... and we all know how that turned out, so I guess miracles are always possible in the Ashes.
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