A lament to deeds softly whispered

May 12 2003

Today's language is fraught with puffery; modesty has become redundant, writes Adam Nicholson.

The obituaries page is a daily reproach. The people whose lives you flit through for a few minutes every morning have done something. They have lived, perhaps only for a few significant moments, in a way that stands outside the norm.

An obituary won't be written about you if all you think about each day is what to give the neighbours for supper or what colour to paint the spare room. And what are you doing? Leafing through a newspaper, wondering how you might delay even further the moment when you, too, might get up out of your chair.

There was one notice earlier this year that struck a particular chord. Pip Gardner, in late February. He was 88 and had spent a large part of his life as managing director and then (until two years ago) chairman of the family firm of heating and ventilation engineers, J.Gardner & Co, in south London. At one point, he sold off the air-conditioning arm, but continued to manage the property side of the business.

He was active in support of the Brunswick Boys' Club in Fulham, for which he had originally raised the money, and which he persuaded the Duke of Edinburgh to open in 1949.

He "was a private man", the obituarist wrote, "of genuine modesty, who never sought the limelight".");document.write("

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No, you might have thought, there is no reason why this Mr Normal - dogged certainly, working until he was 86, but steady, even circumscribed - should ever consider the limelight his natural or even deserved environment.

But it was, because Gardner was, in fact, Captain Pip Gardner, who twice during World War II in North Africa, where he was in the Royal Tank Regiment, performed acts of heart-stopping courage - once at the Halfaya Pass and once at Tobruk, both with the intention of saving wounded British officers - for which he was awarded the highest accolades for bravery, the Victoria Cross and the Military Cross.

After the incident in Tobruk, for which he won the VC, Gardner wrote to his father from hospital: "Don't get alarmed and think I am badly wounded. Just a few odd bits and pieces in my leg, neck and arm, nothing serious."

Of course, he didn't mention, as the citation for the VC described it, how "with complete disregard for his own safety, despite his wounds and in the face of intense fire at close range", he had saved "the life of his fellow officer in circumstances fraught with great difficulty and danger".

Even that language is minimalised, suppressed far below what any of us would now use. What would a modern description of "fraught with great difficulty and danger" sound like? Full of words that tried to mimic in their violence and extremity the conditions they hoped to describe.

We have lost, or are at least in the process of losing, the habit of understatement as a means of conveying the nearly indescribable. When I was a boy in the 1960s, I remember being taught the virtues of litotes - how effective it was to say that Paul was "a citizen of no mean city" - and we absorbed the lesson.

We used to say that a cover drive "wasn't bad", when we meant that Barclay would obviously be playing for Sussex in a couple of seasons. Or that he was a "pretty good" batsman. Now everyone would say he was "brilliant" or "totally f------ amazing".

Of course, Gardner's life was governed by the dignity of understatement, by the outstandingly heroic being described as the perfectly acceptable, if at times slightly tricky. His life did not display or advertise the extraordinary virtues and qualities he clearly had.

The man, who twice in the desert war had done things that no human being could be expected to do, slid back after his investiture by the King in 1945 to an existence of overwhelming normality, with his wife, Rene, and their one son, and the business and the boys' club in Fulham.

A chasm as wide as the Atlantic opens between Pip Gardner's world and the one I have always inhabited.

I have lived my life in a pocket of safety, guaranteed first by people such as Gardner, then by the American nuclear umbrella and now, perhaps, by my son's generation of professional soldiers. It has been five decades of thinking where to go on holiday and what car to buy, what book to write, what film to see.

It has been, in other words, a period in which any kind of courage has not been required and in which, as a result, understatement and modesty have become redundant.

Our belts are loose in a way they haven't been since ... when? Regency England? The Restoration?

Our fears have been the very opposite of Gardner's: that life is not dangerous enough; that it bores; that it's stale; that it lacks "dynamism". And so the language we use about it has been enlarged and inflated into a fat balloon of overstatement, of pumping up an existence we are terrified might be inert or dead.

Will that change now? If, as the Americans and Tony Blair think, our comfortable lives have begun to face a prolonged and continuous threat, will we now turn a corner back towards a world that, in its rigours, Gardner might have recognised as his own?

Few of us think so, but it is difficult to see where else this might go. Forget, for a moment, the war in Iraq. The deep change in public attitude will come with the next September 11. Like the second atomic bomb on Japan, it is the hook after the jab that tells you they are serious.


Protective effect of extract of Astragalus on learning and memory impairments and neurons' apoptosis induced by glucocorticoids in 12-month-old male mice.
Alzheimer's disease (AD) is a chronic neurodegenerative disorder marked by a progressive loss of memory and cognitive function. Stress-level glucocorticoids are correlated with dementia progression in patients with AD. In this study, 12-month male mice were chronically treated with stress-level dexamethasone (DEX, 5 mg/kg) and extract of Astragalus (EA, 10, 20, and 40 mg/kg) or Ginsenoside Rg1 (Rg1, 6.5 mg/kg) for 21 days. We investigated the protective effect of EA against DEX injury in mice and its action mechanism. Our results indicate that DEX can induce learning and memory impairments and neuronal cell apoptosis. The mRNA levels of caspase-3 are selectively increased after DEX administration. The results of immunohistochemistry demonstrate that caspase-3 and cytochrome c in hippocampus (CA1, CA3) and neocortex are significantly increased. Furthermore, DEX treatment increased the activity of caspase-9 and caspase-3. Treatment groups with EA (20 and 40 mg/kg) or Rg1 (6.5 mg/kg) significantly improve learning and memory, downregulate the mRNA level of caspase-3, decrease expression of caspase-3 and cytochrome c in hippocampus (CA1, CA3) and neocortex, and inhibit activity of caspase-9 and caspase-3. The present findings highlight a possible mechanism by which stress level of DEX accelerates learning and memory impairments and increases neuronal apoptosis and the potential neuronal protection of EA.


Q:

Making list inside list from loop

In this code here:
dotted_map = []
for row in range(3):
    dotted_map.append("".join(list(2*'o ' + 'o')))
print(dotted_map)

It is printing
['o o o', 'o o o', 'o o o']

I want it to print this:
[['o o o'], ['o o o'], ['o o o']]

Why is it not doing that?

A:

As pointed out in the comments, you just have to do it this way
dotted_map.append([2*'o ' + 'o'])

In your way, the list() method makes it into a list, but then the join() method, converts the list back into a string.
2*'o ' + 'o' # is a string 'o o o'
list(2*'o ' + 'o') # is a list ['o o o']
"".join(list(2*'o ' + 'o')) # is a string again 'o o o'


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Sequins

FECHA: 26.11.13

Hola! Hoy os traigo este outfit, sencillo con un toque especial gracias a la chaqueta de lentejuelas, la cual encontré en una tienda vintage en mi visita a Madrid. Espero que os guste!Hi! Today I show you this outfit, simple but with a special touch thanks to the sequins jacket, which I found in a vintage store in Madrid. Hope you like!


Tuesday, September 9, 2014

Our Own Art - the kids' art quilt

Whew! I finally have a chance to write the post about the kids' art quilt that I recently finished for Sunshine's school. I'm happy to tell you that I delivered it a week and a half ago, a few hours before they had their back to school bash, and they were beyond thrilled. The art teacher who requested this quilt actually cried when she saw it so I believe that counts a "Mission Accomplished". Therefore I'm happy to reveal to all of you....

Our Own Art

I am totally thrilled with the way this one turned out and I love it even more than the kids art quilt that I made last year. It is just so bright and colorful and fun.

The school's name was appliqued using their actual letterhead font in the school's colors.

Although it is really hard to see in this picture, I straight stitched around the edge of each letter in matching thread.

The school's letterhead has a daisy as the dot for the i so that is what I did too.

As I was trying to quilt this I shared with you my struggles to come up with the right quilting design in the right color. In the end and as a total surprise to me, after testing out all of your thread color suggestions, I ended up liking the most the Glide 10GC3 Cool Gray. If you look at the color on their website, it looks a lot darker than it is in reality and I think it works perfectly on this quilt. It shows up just enough without competing with any of the sashing colors too much.

The right quilting design was my other angst besides the thread color choice and while drawing out many of your suggestions on a photo printout of the top, I had an epiphany that totally changed my complete way of thinking about the quilting design for this one.

I think that one of the biggest problems with what I had been trying, besides the fact that this was only 1 inch wide sashing and I'm not an expert at this yet, is that I was trying to quilt it as an adult would quilt it, all neat and perfectly spaced. Then during the doodling session, I remembered that when the art teacher and I were talking during the planning stages we talked about wanting to make this quilt look like the kids did it, or at least as much of it as possible. So that was my epiphany! I needed to quilt it as if my kids were doing it instead of me. Once I tried that and completed the 1st row, I knew I was on the right track. I quilted it with ribbons as if the kids were trying really hard to make it look good but also knowing that it would be a little wonky. To me this approach totally worked. It truly mimicked the "all over the place" look and feel of the kids' blocks and does look like kids work.

The art teacher provided the border fabric and this helped to reinforce the quilting design since the print is of kids' drawings. I did simple loopy quilting in that area.

The binding is a mix of one half WOF strips from all the solid colors used in the sashing.

As usual, I sewed the first side of the binding as normal but when it came time to sew down the back side, I kept the same epiphany in mind. The kids would not have sewn it down by hand as I had been planning to do, so instead I did a decorative elongated serpentine line, just a little unevenly spaced in areas, that again I think blends well with the rest of the stitching.

The school's director and all the teachers were so happy with the final result. I was a bit worried that they wouldn't understand my quilting design idea but they totally "got" it and agreed with my take on it. To do anything else for the quilting wouldn't have made it look like the kids themselves did it, which is what they wanted.

The quilt is now hanging in the school's front lobby for all to see as they enter and I keep hearing back every day how the kids from last year continue to look for their own blocks and the new kids at the school this year love checking out all of them too. And the new kids are asking if they get to make a quilt block too.

Overall this quilt was a joy to make and I'm so happy that they love it so. It definitely taught me a lesson about how sometimes I need to think outside the box to find the perfect solution.

Good words of quilting advice!I couldn't agree with you more!! It's absolutely adorable. I loved looking at each square! The children's art work is just precious!! This a true gift that will be forever treasured!

This blog and all of its contents is Copyright (c) 2009-2019 by Michele Kuhns of Crayon Box Quilt Studio. All rights reserved. Please do not copy any posts, all or in part, or any pictures without my express written consent.


Roti Kapda Aur Makaan

This is an actual surviving old Bollywood poster of the 1974 Hindi film that was written, produced, directed by and starring Manoj Kumar. The film also starred the biggest superstar of Indian cinema, Amitabh Bachchan in a supporting role.

The title of the movie was based on the bare necessities of life, i.e. Food, Clothing & Shelter. The film was the highest grossing Bollywood movie of 1974 and one of the biggest blockbusters of Manoj Kumar.

Roti Kapda Aur Makaan also boosted superstar Amitabh Bachchan’s film career, who at the time was looking to make a mark in Bollywood, making this poster highly collectible!

Printed and circulated a few years after the original first release run of the film (somewhere in the late 1970s), this vintage Indian Bollywood movie poster was designed and printed for publicity of the film but never ended up being used.

This poster was originally designed on a hand painted canvas by a small time poster design studio in Delhi, giving it a very quirky appearance.

Faces of the entire star cast of the film appear hand painted in a Mount Rushmore like manner in this landscape Bollywood poster. Portraits of Manoj Kumar, Amitabh Bachchan, Shashi Kapoor, Zeenat Aman, Moushumi Chatterjee and Prem Nath are seen from left to right in this vintage Indian film poster.

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Roti Kapda Aur Makaan

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Old school Bollywood poster of the blockbuster Hindi film, Roti Kapda Aur Makaan (1974) for sale.

This is an actual surviving original old Bollywood poster for sale of the 1974 Hindi film that was written, produced, directed by and starring Manoj Kumar. The film also starred the biggest superstar of Indian cinema, Amitabh Bachchan in a supporting role.

The title of the movie was based on the bare necessities of life, i.e. Food, Clothing & Shelter. The film was the highest grossing Bollywood movie of 1974 and one of the biggest blockbusters of Manoj Kumar.

Roti Kapda Aur Makaan also boosted superstar Amitabh Bachchan’s film career, who at the time was looking to make a mark in Bollywood, making this original old Bollywood poster for sale, highly collectible!

Printed and circulated during the original first release run of the film (somewhere in the early 1970s), this old Bollywood poster for sale was designed and printed for publicity of the film but never ended up being used.

This old Bollywood poster was originally designed in hand painted oil on canvas format by one of the greatest Bollywood poster designers of all time, artist V.G. Parchure. The poster bears his signature in the name of his art studio Pamart on the top right hand corner.

True to old school Bollywood poster painter V.G. Parchure’s mastery over the paint brush, brilliantly hand painted portraits of actors Manoj Kumar, Zeenat Aman and Moushumi Chatterjee are seen set against a blue background in this old Bollywood poster.

Share on:

This is an actual surviving old Bollywood movie poster of the 1974 Hindi film that was written, produced, directed by and starring Manoj Kumar. The film also starred the biggest superstar of Indian cinema, Amitabh Bachchan in a supporting role.

The title of the movie was based on the bare necessities of life, i.e. Food, Clothing & Shelter. The film was the highest grossing Bollywood movie of 1974 and one of the biggest blockbusters of Manoj Kumar.

Roti Kapda Aur Makaan also boosted superstar Amitabh Bachchan’s film career, who at the time was looking to make a mark in Bollywood, making this original hand painted Bollywood poster highly collectible!

Printed and circulated during the original first release run of the film (somewhere in the early 1970s), this old hand painted Bollywood poster was designed and printed for publicity of the film but never ended up being used.

This poster was originally designed on a hand painted canvas by one of the greatest Bollywood poster designers of all time, artist V.G. Parchure. The poster bears his signature in the name of his art studio Pamart on the top right hand corner.

Share on:

This is an actual surviving old Bollywood movie poster of the 1974 Hindi film that was written, produced, directed by and starring Manoj Kumar. The film also starred the biggest superstar of Indian cinema, Amitabh Bachchan in a supporting role.

The title of the movie was based on the bare necessities of life, i.e. Food, Clothing & Shelter. The film was the highest grossing Bollywood movie of 1974 and one of the biggest blockbusters of Manoj Kumar.

Roti Kapda Aur Makaan also boosted superstar Amitabh Bachchan’s film career, who at the time was looking to make a mark in Bollywood, making this poster highly collectible!

Printed and circulated a few years after the original first release run of the film (somewhere in the late 1970s), this old hand painted Bollywood poster was designed and printed for publicity of the film but never ended up being used.

This poster was originally designed on a hand painted canvas by a small time poster design studio in Delhi, giving it a very quirky appearance.

A quirky portrait of Manoj Kumar is seen at the center of the poster, signifying his lead presence in the film. He is flanked on either side by supporting actors Shashi Kapoor and superstar Amitabh Bachchan. This old Amitabh movie poster features the superstar painted in a dull white avatar with deep red lips.

This poster has been graded as ★ As Is due to tattered borders, small missing pieces as well as visible water stains seen clearly in the photograph. Please study the accompanying image carefully before making a purchase.


Genocidio en el mediterráneo: Más de 1.500 migrantes se ahogaron en los últimos siete meses

Publicidad

Las cifras son alarmantes porque suponen un aumento de las víctimas mortales en un momento en que está descendiendo el número de llegadas al continente europeo, según informó el Alto Comisionado de la ONU para los Refugiados.

Unas 60.000 personas cruzaron este año el Mediterráneo, según Acnur, en torno a la mitad en comparación con el mismo periodo del año pasado.

El Estado español es en estos momentos, con 23.500 llegadas, el destino principal de los migrantes, seguido por Italia, con 18.500, y Grecia, con 16.000. Con una cuota del 13,5%, los refugiados procedentes de Siria constituyen el mayor grupo.

Acnur hizo un llamamiento a todos los países a lo largo de la ruta a trabajar por desmantelar las redes de traficantes de personas y llevar ante la Justicia a quienes obtienen beneficio de la explotación de personas en peligro.

Los traficantes de personas organizan viajes por mar cada vez más peligrosos en embarcaciones cada vez más precarias prometiendo a los migrantes que en algún momento llegará ayuda.

La muerte de más de 200 inmigrantes y refugiados que perdieron la vida ahogados cuando intentaban alcanzar las costas de Europa este fin de semana eleva el balance en el mar Mediterráneo, según las estimaciones de la Organización Internacional para las Migraciones (OIM).

Este domingo, un lancha neumática llena de inmigrantes volcó cuando navegaba frente a las costas de Joms, una localidad libia situada al este de Trípoli. La Guardia Costera libia rescató a 41 personas y dio por desparecidas a unas 100. El viernes, otras 103 personas murieron en otro naufragio similar, incluidos tres bebés.

En lo que va de 2018, la Guardia Costera de Libia ha devuelto a su territorio a unas 10.000 personas que intentaban abandonar sus costas a bordo de barcos y embarcaciones con destino a las costas europeas.

«Voy a viajar a Trípoli una vez más esta semana y veré de primera mano las condiciones de los migrantes que han sido rescatados así como los retornados a la costa por la Guardia Costera de Libia», ha anunciado el director general de la OIM, William Lacy Swing, en un comunicado.

La OIM, según ha subrayado, está «determinada para garantizar que los Derechos Humanos de los migrantes son respetados» y que todos hacen esfuerzos «para detener el tráfico de personas, que tanto explota a los migrantes».

La agencia de Naciones Unidas ha dicho que su personal se ha desplegado para dar apoyo y primeros auxilios a los 41 migrantes que sobrevivieron al naufragio de la lancha neumática frente a la localidad libia de Joms.

Tras señalar que está dando ayuda en el punto de desembarque de los supervivientes del naufragio del domingo, la OIM ha indicado que también está aportando apoyo psicosocial en el centro de detención de Tajura, al que serán trasladados los rescatados.

«La necesidad de apoyo psicosocial es alta toda vez que los supervivientes pasaron un tiempo traumatizado en el agua porque su motor se averió solo 30 minutos después de salir desde Garabulli», ha contado al OIM.

«Hay un alarmante aumento de muertos en el mar frente a las costas de Libia», ha subrayado el jefe de Misión de la OIM en Libia, Othman Belbeisi. «Los traficantes están explotando la desesperación de los migrantes para que salgan antes de que haya más campañas contra las travesías por el Mediterráneo hacia Europa», ha afirmado.

En su opinión, «los migrantes devueltos por la Guardia Costera no deberían ser automáticamente transferidos a centros de detención». «Estamos profundamente preocupados porque los centros de detención volverán a estar saturados y las condiciones de vida se deteriorarán con la reciente afluencia de migrantes», ha concluido Belbeisi.

Ámbito/ Público/ Acnur/ OIM/ Otras fuentes


Cuckoo for Cookies

Were you aware that Saturday, July 5 was National Cookie Day?! Unfortunately I was not, and did not celebrate accordingly. Although, we did make up for it today thanks to our wonderful listeners who sent some love in the form of delicious cookies.

Phil’s favorite cookie is the Nabisco Famous Chocolate Wafer, but said that he had no idea where to find them. Joann was kind enough to stop at not one, not two, but THREE different stores to hunt down these treats! He was eternally grateful for her generosity, as well as Jim Casey’s for the oatmeal raisin cookies! And who could forget the Girl Scout “Thin Mints” we received from Tenney Lantz? “Once a Girl Scout, always a Girl Scout.”

Thank you so much for sharing your favorite cookies with us on air, and congratulations to the classic Oreo for earning the title of “America’s Favorite Cookie!” Certainly no false advertising there folks!

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Q:

tf.GradientTape can't watch outside 'with' block

TensorFlow tutorials on tensorflow.org show the way to use tf.GradientTape as:
x = tf.convert_to_tensor([1,2,3]);
with tf.GradientTape() as t:
  t.watch(x);

I wonder why I can't move the t.watch(x) outside of with block like this:
x = tf.convert_to_tensor([1,2,3]);
t = tf.GradientTape();
t.watch(x); #ERROR

The error is:
tape.py (59):
pywrap_tensorflow.TFE_Py_TapeWatch(tape._tape, tensor)

AttributeError: 'NoneType' object has no attribute '_tape'

A:

I found out how. The tf.GradientTape class is designed to work within with block, ie. it has enter and exit methods.
So to have it working outside 'with' block, method __enter__ must be explicitly called, however, avoid calling __enter__ directly:
x = tf.convert_to_tensor([1,2,3]);
t = tf.GradientTape();
t.__enter__();
t.watch(x);

Reference:
Explaining Python's '__enter__' and '__exit__'


Quite often with the hectic lifestyles of most families more than one bathroom is necessary to prevent irritation and stress when both husband and wife and perhaps even children need to get ready to leave the home at the same time. Adding a half bath helps but with careful planning the same space allocated for a half bath can be utilized for a second small bathroom. This permits more than one family member to bathe at the same time while a half bath is limited in function. Taking the time to develop a small bathroom floor plan is key to producing a satisfying and useful design. Floor plans do not have to be elaborate undertakings as a simple sketch that includes certain points will suffice.

Toilets with high level cisterns and pull chains are very rare these days but a must have for the country bathroom as are traditional taps for the bath and basin. Just about any kind of free-standing bath will suit the country bathroom. If wishing to have a shower a tiled walk-in shower is the advisable option with a curtain to conceal the area. For the final touch add wicker baskets filled with pot pouri wire basket shelves and stylish wall lamps.

The ultimate luxury in a fantasy bathroom would have to be a waterproof TV. You could even think of doubling the bathroom up as gym complete with exercise bike and rowing machine. Ornaments should be unobtrusive so choose things like small piles of pebbles and modern wall prints over candles and nick-nacks.


Q:

Is TF-IDF necessary when using SVM?

I'm using Support Vector Machines to classify phrases. Before using the SVM, I understand I should do some kind of normalization on the phrase-vectors. One popular method is TF-IDF.
The terms with the highest TF-IDF score are often the terms that best characterize the topic of the document.
But isn't that exactly what SVM does anyway? Giving the highest weight to the terms that best characterize the document?
Thanks in advance :-)

A:

The weight of a term (as assigned by an SVM classifier) may or may not be directly proportional to the relevance of that term to a particular class. This depends on the kernel of the classifier as well as the regularization used. SVM does NOT assign weights to terms that best characterize a single document.
Term-frequency (tf) and inverse document frequency (idf) are used to encode the value of a term in a document vector. This is independent of the SVM classifier.


House Intelligence Committee ranking member Adam Schiff (D-CA) went on with Fox News host Tucker Carlson Wednesday night.

Tucker DESTROYED the liberal Congressman for accusing the Kremlin of interfering in the election.

Democrats are VERY UPSET Wikileaks released truthful information on the DNC, Hillary Clinton, John Podesta and the liberal media.

Schiff at one point accused Carlson of carrying water for the Kremlin.

Wow.

The liberal media is focused on fake news after Hillary Clinton’s defeat in the presidential election. The biggest fake news lie may have been that Russia threw the election to Trump and yet the liberal media constantly repeats this nonsense with absolutely no proof to back up their crazy accusations.

TRENDING: BREAKING: 'At Least 10 Shots' Reportedly Fired at Police By Louisville Black Lives Matter Rioters — UPDATE... At Least Two Officers Shot (VIDEOS)

Via Tucker Carlson Tonight:

Unreal.


Scientists report that the meteorite that rocked Russia early last year may have been sent on a collision course with Earth after smacking into another asteroid as long as 290 million years ago. It's estimated that the parent asteroid — a much larger object from which the so-called Chelyabinsk meteor broke off — impacted another asteroid in space at anywhere from 800 to 3,350 miles per hour (1,440 – 5,400 km/h). That second asteroid, according to the hypothesis, was at least 500 feet (150m) in diameter, and the impact sent the final 65-foot (20m) wide meteor in Earth's direction.

The findings come after scientists studied small fragments of the Chelyabinsk meteor that made it through the massive explosion in Earth's atmosphere and landed on the ground. Lead researcher Shin Ozawa, of Japan's University of Tohoku, and his team found a mineral called jadeite in glass-like veins inside the samples. That mineral could only be produced under massive pressure and heat, such as that from an impact with another asteroid. By studying the shape and structure of the jadeite crystals, they were able to estimate the size, temperature, and duration of the impact. The results were published this week in Scientific Reports. Previously, scientists had used video footage to determine the path of the meteor to Earth, and analysis of the impact found it to be the second largest explosion in recorded history.

Correction: Researchers have not concluded that an asteroid impact caused the meteorite to head towards Earth, they have hypothesized that such events could explain the presence of jadeite in the meteorite. This article has been modified to make the distinction clearer.


Rapid synthesis of DNA deletion constructs for mRNA quantitation: analysis of astrocyte mRNAs.
A rapid method for the synthesis of DNA fragments for competitive PCR analysis is described. This procedure takes advantage of the fact that if PCR is carried out with a mixture of re-ligated restriction digestion fragments, only those fragments containing binding sites for both PCR primers will be amplified. Following electrophoresis of the amplified mixture, the DNA fragment of desired size can be excised from an agarose gel, reamplified, and used for subsequent competitive PCR. We have used this procedure to synthesize deletion constructs for the rat glial fibrillary acidic protein (GFAP) gene, and have used competitive PCR to determine the levels of this mRNA in primary cultures of rat brain astrocytes.


Two of the most noted golf architects in the game today have collaborated on two unique nines to form the nationally recognized design of the Hilton Head National Golf Club. One of the games greatest Champions, Gary Player and architectural award-winning Bobby Weed, have provided the ultimate golf experience with this Lowcountry designed masterpiece. Hilton Head National Golf Club is golf in its purest form, with mother nature as its boundaries and no development in sight. Accessible to all with a private club atmosphere, find out why local residents consider it the best of the best.

Plan to see Hilton Head National and other attractions that appeal to you using our Bluffton vacation trip planner.Source

George H

Great course - best part is no houses anywhere on the course! Course is very well maintained and the staff is fantastic!

Macafee

A wonderful courses with a challenge from the back tees and friendly from the forward tees. Unfortunately the current owners would rather see it as a massive development so it may soon be closed. Lots...
more »

piolou

Sunday mid morning tee time, hardly anyone there. I played solo and had the course pretty much to myself. Boxes, fairways and greens were in excellent condition. I couldn't honestly believe more peopl...
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John Heuer

Love this course! Always able to get tee times, groups aren't jammed together, staff is friendly. There are nicer, more challenging courses in the area, but for the price, National is an awesome stop.

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Scott Parrill

what a scam charge more money through the week then on the weekends, way to go Hilton head National . MORE INFORMATION PLEASE.
Sand traps horrible Where's the sand. Be more friendly everybody! Played many times 2 years ago. Made this my number one stop to play. NOT ANY MORE

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Joseph Wallace

I had reviewed another course unfavorably. However I found this to be beauty. Fairways and greens were excellent. Staff was great and pace of play was perfect.

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Jessica Green

I played here January 2nd 2016 I made my first HOLE IN 1, Par 3 hole #7 did it with my 9 iron... (Needless to say I've only been golfing 2 yrs now) I love it! This course is absolutely wonderful. Hope to come back someday....

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Jackson Welch

A truly fantastic course! I absolutely loved the views. I wish I would have played before they punched the greens but oh well. The course was well maintained and offered beautiful views. I really loved the GPS system built into the golf carts. This is how all golf courses should be! The only thing that I was upset about is that from the tips it plays 6700 and the next step down is 6100. I feel there should be something in-between the two. Overall, I recommend playing this course 110%! Thank you for a great golfing experience.

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Haha, hard to fund decentralized server farms when your members are not trapped on your platform, at least with the way things currently operate. If people would embrace technologies like WebTorrent then the cost of hosting web services would likely plummet to a level sustainable for a free and decentralized internet.


Pittsburgh Steelers linebacker James Harrison knows all about random drug testing. He’s been random drug tested so often that it probably feels part of his weekly routine.

Tuesday morning, a day after he received a letter from the league stating that he must meet with them concerning their PED investigation or face suspension if he doesn’t, Harrison was notified that he had been selected for yet another random PED test.

Harrison made the announcement Tuesday morning in a Facebook video.

“Surprise, surprise, your boy got a random PED test today,” Harrison said in his video.

It’s probably not a coincidence that Harrison shot the video with guard Ramon Foster present as he is the Steelers union representative.

Harrison is currently staring at an indefinite suspension if he doesn’t cooperate with the NFL by the end of next week. In a recent letter sent by NFL Senior Vice President of Labor Policy & League Affairs Adolpho Birch to the NFLPA, Harrison was notified that the league will suspend him indefinitely if he does not agree to an interviewed by Aug. 25 regarding a December Al-Jazeera report.


Thursday, May 22, 2008

some things I remember

In the early 90s a woman I worked with told me that the man downstairs from her was having a sexual relationship with a soap star (who she named but I won't). This story was in part about how she could hear everything that was being said in the immediate vicinity of her home. So the soap star was at the house and the man told him about a friend who had no teeth, and the soap star said, 'Christ, how does the poor cunt eat?' We had a laugh about this story when she told it and she said the line many times over the next few days in imitation of the soap star's hoarse, coarse voice.

********

For a few years I went out with a woman who was prone to chucking berkos at the drop of a hat. Once we were driving to Newcastle and I found that a cassette I had got off the front of a music magazine - you know, Select or Vox or something - was in the glovebox divested of its shrink wrap. I had no interest in the tape in question and would not have expected anyone else to have any interest in it, as it was just the usual major record company puff material that you would have expected on that kind of artefact; I would probably have never taken the shrinkwrap off it, myself. So I asked her if she had removed the plastic. She went ballistic at the accusation and the rant lasted well over an hour (while she continued to drive) - the worst I recall though I could probably think of others if I had to. I think this might have been the time she had to pull the car over to vomit, she was so angry at this accusation. A few weeks later she told me she had thought I had left the tape there for her as a present, and so she had taken the shrink wrap off. And I'm not kidding.

********

Once I was walking along Lennox St, Newtown with a small amount of shopping including some Coco Pops. Two itinerants, man and woman, came up and insisted I give them some money, but I refused. The woman tried to grab my Coco Pops but could not wrest them from me. They moved on and I heard her say to him, 'I almost got his Coco Pops'.

********

The song 'Reminiscing' by Little River Band (LRB) has been played on the radio over four million times. Not all the group wanted to record it at the time but later came to see it was actually a successful hit song.

********The Swedish Chef from the Muppets was in LRB, not many people realise this because in LRB he didn't wear his hat.

4 comments:

I went out with a guy for a couple of years with a terrible temper. The time I remember him most angry was when he was cooking and to help him I selected and peeled the garlic, then started cutting up into pieces — say one clove into ten pieces — and he went off his nut, suggesting that I should either left the garlic whole or minced it, but now it was difficult for him to mince it because the pieces were the wrong size. He screamed at me until I started crying, then he screamed at me for crying.

But at other times he was the charmingest man. Another garlic incident: I was helping him cook again, and when it was nearly done I saw some neatly minced garlic on the chopping board.

"You forgot the garlic!" I said.

"Oh no! It was an overlooktion!"

But our most famous fight was when we were riding a scooter in Asia in 1999, and I said, "Can you believe it is the dawn of a new century? It's incredible! We're about to live into another century!" He's never really been able to explain why it annoyed him so much, but he just immediately hated my guts, he kept saying that I was bullying him into feeling something he didn't feel. It went on for days, with me repeatedly saying, "I don't care what you think about the twenty-first century!" and him saying, "Stop bullying me!!" It was fricken weird.

We were going to get married, but we didn't. He was from Wales, and we've lived together in Asia, the UK and Australia. About a year after we broke up, he told me that he'd been seeing a therapist and had got over his anger. I was like, "Cool. Way to improve the life of your next girlfriend."

Having said all that, he's still one of my dearest friends. He's etched into my heart. And I still use the word "overlooktion".


###### Strengths and limitations of this study

-   This is the first UK study to investigate the frequency of neurocognitive disorders in patients with mild to moderate chronic kidney disease and diabetes.

-   All patients' neurocognitive function was formally evaluated by neuropsychological assessment and application of Diagnostic and Statistical Manual of Mental Disorders version 5 criteria.

-   There was no neuroimaging to confirm or support cardiovascular diagnosis.

-   This was a cross-sectional sample investigation.

Introduction {#s1}
============

Nearly 9% of global populations are diagnosed with chronic kidney disease (CKD), which is strongly associated with older age and cardiovascular risks such as diabetes and hypertension.[@R1] Cognitive impairment in CKD compared with general populations appears to occur quite frequently.[@R5] The Intervention Project on Cerebrovascular Diseases and Dementia in the community of Ebersberg (INVADE) study reported a prevalence of cognitive impairment of around 21% in patients with CKD and the recent Brain in Kidney Disease (BRINK) cohort study investigation reported that overall cognitive impairment was significantly associated with the more advanced stages of CKD.[@R11] Longitudinal investigations have suggested that there is at least a twofold increased risk of developing cognitive impairment in CKD compared with the general population.[@R10] One British cohort investigation of patients with end-stage kidney disease (ESKD) reported a prevalence of cognitive impairment at baseline of around 68% and a 2.5 increased risk of mortality at follow-up.[@R13] The wide variation of reported cognitive impairment in cross-sectional and longitudinal studies is most likely due to the methodological differences such as, inclusion of patients with ESKD alone; gender-specific investigations; samples drawn from at risk or elderly populations or from much larger population investigations.[@R10] However, if patients with cognitive impairment are not recognised at an early stage of their disease journey, this will most likely impinge on their ability to make informed decisions about their current and future care, particularly as the symptoms of CKD progress and its management becomes more complex. Furthermore, identification of patients with CKD with cognitive impairment will also provide more accurate estimates for policy and healthcare planners.

Recent results from population investigations report a slowing in the incidence of dementia, which has been attributed to potentially earlier and more appropriate primary and secondary care interventions specifically targeted at risk population disorders, such as cardiovascular disease.[@R14] Seven potentially modifiable risk factors have been identified including, mid-life obesity, mid-life diabetes mellitus, mid-life hypertension, physical inactivity, smoking, depression and lower educational attainment. It has been suggested that if reductions of between 10% and 25% in the above-mentioned risk factors were made at population level, it could result in the prevention of between 1 and 3 million cases of dementia worldwide.[@R19] While modifiable lifestyle risk factors have been identified, there is still poor public awareness of the role they can play in prevention or slowing of cognitive impairment.[@R20] In view of the established association with ageing, the associated cardiovascular disease risk and CKD, this is one condition where earlier therapeutic opportunities, interventions and management may delay or reduce the risk of individuals developing significant cognitive impairment.

There have not been any population at risk screening investigations for cognitive impairment in patients with established CKD in the UK. This study is the preliminary report from a longitudinal CKD observational cohort investigation in Denbighshire North Wales, UK, which aims first, to report the frequency of neurocognitive disorders (NCDs) ranging from no impairment to major impairment, in a cohort of older adults with mild to moderate CKD and concomitant diabetes attending a specialist renal outpatient's clinic. Second, to explore if the stage of renal impairment as measured by glomerular filtration rate (GFR) is independently associated with neurocognitive function. Lastly, this investigation will explore if there are associations with NCD, and demographic, clinical measures including several blood and urine biomarkers routinely measured in CKD, along with physical function, mood and quality of life.

Subjects and methods {#s1a}
--------------------

Patients aged 55 years and over were recruited from an outpatient renal and diabetic clinic. All of the participants had an established diagnosis of CKD with an estimated GFRs (eGFR based on The Modification of Diet in Renal Disease Study equation) of \<60 mL/min/1.73 m^2^ and confirmed diagnosis of diabetes mellitus. Subjects were excluded if they had previously had suffered a stroke, transient ischaemic attack (TIA), had severe sensory impairment, a significant neuropsychiatric disorder, ESKD (eGFR \<15 mL/min/1.73 m^2^), receiving renal replacement therapy, or if they were in receipt of a transplant.

Based on their eGFR[@R21] at study entry, patients were grouped by stage of CKD as follows:

Stage 3a (G3a)---an eGFR of 45--59 mL/min.

Stage 3b (G3b)---an eGFR of 30--44 mL/min.

Stage 4 (G4)---an eGFR of 15--29 mL/min.

### Assessment and diagnosis of neurocognitive function {#s1a1}

Global cognitive function was assessed with the Addenbrooke's Cognitive Examination III (ACE III).[@R22] The ACE III assesses five cognitive domains: attention, memory, fluency, language, visuospatial abilities. The scoring the ACE III is a sum of the items for each of the five cognitive domains (attention total=18, memory total=26, fluency total=14, language total=26, visuospatial total=16), with a maximum of 100 points, where higher scores indicate better cognitive functioning. Scores of \<88 are suggestive of cognitive impairment.

Executive function was assessed with the Weigl Colour Form Sorting Test (WCFST).[@R23] The WCFST is made up of three geometric shapes, (square, circle, triangle), grouped into four colours (red, green, blue and yellow). Subjects are asked to 'sort the shapes', for example, to shape or colour and when they complete this they are instructed to sort the shapes in a different way. The scoring on the WCFT ranges from 0 to 4 where higher scores indicate better cognitive function.

The term dementia was replaced with major NCD on the introduction of Diagnostic and Statistical Manual of Mental Disorders version 5 (DSM-5).[@R24] The aetiological subtype of the NCD is then specified, for example, Alzheimer's disease, vascular disease, Parkinson's disease, substance abuse, traumatic brain injury. The diagnosis of mild cognitive impairment (MCI) employing Peterson's criteria is now referred in DSM-5 as mild NCD. It is based on patients, caregivers, informants and or clinician-observed reports of symptoms of memory impairment, decline in the ability to perform everyday activities, difficulties with language, perceptual-motor and social skills, in the absence of delirium or dementia.[@R25]

The diagnosis of an NCD in the current investigation was reached by consensus by all of the authors in this study, who also clinically manage all of the patients participating in the study. This was based on patient and informant review, clinical case review, neuropsychological assessment and application of DSM-5 criteria for NCDs.[@R24] To meet this criterion, patients must present with significant deficits in one or more cognitive domains that cannot be explained by delirium or other mental disorder. All patients who met DSM-5 criteria for either a mild or a moderate NCD were signposted to appropriate memory clinic pathways.

In addition to the cognitive assessments, on the day of testing, demographic details, onset and duration of CKD, diabetes and hypertension, CKD stage, cholesterol, non-High-density lipoproteins (HDL)/HDL, Low-density lipoproteins (LDL), blood pressure, mood disorder with the nine item Patient Health Questionnaire (PHQ-9) and Health Related Quality of Life (HRQoL) was assessed with the EuroQol-5D (EQ-5D).[@R27] Anaemia was defined using WHO guidelines as haemoglobin (Hb) in males \<130 g/dL and \<120 g/L in females.[@R29]

Patient and public involvement {#s1b}
------------------------------

Patients and or the public were not involved in the design of the study. However, participants on request will be sent a summary of the findings of the study.

Statistical analysis {#s1c}
--------------------

The demographic characteristics of the patients, as well as their neuropsychological assessments were summarised with descriptive statistics including ratios, mean, SD (±) and median. The normality of the data was inspected by employing the Shapiro-Wilk test and Levene's test. The continuous variables in this investigation were compared with the independent t-tests. The categorical variables in this investigation, for example, stage of CKD, were expressed as proportions and they were analysed employing the χ^2^ test.

The main outcomes in the current investigation were the occurrence of mild to major NCD (coded to DSM-5) and the stage of CKD (bases on eGFR staging). A one-way analysis of variance (ANOVA) was carried out on the individual cohort characteristics between the stages of CKD (3a, 3b, 4). Likewise a similar analysis was completed between the neurocognitive diagnosis of no cognitive impairment (NCI), mild and major NCD. To investigate between group differences post hoc Tukey's honestly significant difference was employed. Where the homogeneity of variances was observed to be violated (Leven's test), the non-parametric Games-Howell test was employed. The Mood's median test (non-parametric alternative to ANOVA) was employed where data were skewed or there was evidence of outliers. For the NCD and CKD outcomes, covariates were adjusted which included, demographics (age, education, gender), chronic conditions, including, ischaemic heart disease, hypertension, mood, blood pressure (systolic/diastolic), Hemoglobin A1c (HbA1c) and lipoprotein results. In addition, the covariates of kidney function eGFR, creatinine and urine albumin to creatinine ratio were adjusted for where appropriate.

To examine the associations between NCD and specific cognitive domains, multiple regression was performed employing a binary logistic model. The variables in this model were explored with backward Wald likelihood ratio logistic regression analysis modelling with adjustment for age, gender, education, hypertension and mood. The results from this analysis are summarised with ORs and 95% CIs. All analyses were performed using SPSS V.22 software. The level of significance was set at p\<0.05.[@R30]

Results {#s2}
=======

We recruited 185 subjects (98 male: 87 female) into the investigation, however, on review, seven patients were excluded from the analysis; three had a history of stroke, two had significant sensory impairments, one withdrew consent and the remaining patient had a severe neuropsychiatric disorder, leaving 178 cases (95 male: 83 female). The descriptive demographic, clinical and blood and urine biomarkers of the cohort are given in [table 1](#T1){ref-type="table"}.

######

Demographic, clinical, blood and urine biomarkers of the cohort: n=178 (mean±SD)

  Age                                  76.1±8.2
  ------------------------------------ ------------
  Gender (ratio M:F)                   97:81
  Education years                      10.9±2.1
  Duration of CKD                      5.9±3.5
  Duration of diabetes                 18.1±10.5
  History of ischaemic heart disease   127 (78%)
  History of hypertension              161 (90%)
  Systolic blood pressure (BP) mm Hg   147.3±16.5
  Diastolic BP mm Hg                   76.7±8.5
  eGFR mL/min                          21.2±10.8
  Addenbrooke's cognitive assessment   84.1±13.2
  Weigl Colour Form Sorting Test       3.2±1.1
  PDQ-9                                4.5±2.5
  EQ-5D                                0.69±0.15
  EQ-5D Visual Analogue Scale %        65.9±13.4
  Creatinine µmol/L                    178.1±29.2
  HbA1c mmol/mol                       58.9±15.7
  Haemaglobin g/dL                     122.2±13.7
  Albumin (serum) g/L                  35.4±9.3
  Cholesterol mmol/L                   4.1±1.0
  HDL                                  1.4±0.6
  LDL                                  1.9±0.8
  Triglyceride mmol/L                  1.9±0.6

BP, blood pressure; CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate.

NCD outcomes and associations with the stage of CKD {#s2a}
---------------------------------------------------

The cognitive assessment outcomes, diagnostic review and application of DSM-5 criteria revealed, 86/178 (48%) of the cohort had an NCD ranging from a mild NCD (n=49), to a major NCD (n=37). There were no cases of delirium observed at the time of testing. The frequencies and percentages of the cohort's NCD status by their stage of CKD are given in [table 2](#T2){ref-type="table"}. The diagnostic outcome review of the mild NCD group (n=49), revealed eight patients with a single domain amnesic impairment and 26 with a multi domain cognitive impairment. The major NCD group (n=37), had six with a possible Alzheimer's disease diagnosis, one with an NCD with Lewy bodies and a further two with an NCD due to Parkinson's disease. The remaining major NCD patients (n=28) were coded as NCD due to other aetiologies.

######

Frequencies of neurocognitive diagnostic outcome and stage of chronic kidney disease

                                              Stage 3a   Stage 3b   Stage 3c
  ------------------------------------------- ---------- ---------- ----------
  No cognitive impairment (n=92)              11 (12)    40 (43)    41 (45)
  Mild neurocognitive disorder (NCD) (n=49)   5 (10)     20 (41)    24 (49)
  Major NCD (n=37)                            10 (27)    9 (24)     18 (49)

In the current investigation, we did not find an association with the stage of CKD and executive, global or sub domain cognitive function (p=0.05; online [supplementary table 1](#SP1){ref-type="supplementary-material"}). As expected, in all of the cognitive domains of the global (ACE III) and executive function (WCFST) assessments, significant differences were observed between the NCI, mild and major NCD groups (p\<0001). A summary and a comparison between the neurocognitive assessment outcome and the cognitive subscales are presented in online [supplementary table 2](#SP1){ref-type="supplementary-material"}. To explore further the associations for worsening cognitive function between the NCI and mild MCI groups, a binary logistic regression was performed. The dependent variable set as the presence or absence of mild NCD and the independent variables of attention, memory, language, fluency, visuospatial and executive function, controlling for age, education (years), mood and gender were entered into a backward model. The logistic regression model indicated that there was a statistical association (χ^2^ (3) 91.9, p\<0.0001) in the cognitive domains of attention, memory, fluency and executive function. This model explained 48.4% (Nagelkerke R^2^) of the variance with 88.5% cases correctly classified. Patients with mild NCD compared with those without cognitive impairment, more likely to have worse attention, (OR 1.9, 95% CI 1.09 to 3.63), memory (OR 1.7, 95% CI 1.37 to 2.09) and fluency (OR 1.8, 95% CI 1.37 to 2.63). The analysis was repeated for the major NCD group which revealed a significant association (χ^2^ (3) 126.4, p\<0.0001). This model explained 62.5% of the variance and correctly classified 97.40% of cases. This group had increased ORs for poorer cognitive function the domains of memory (1.6, 95% CI 1.89 to 2.69), fluency (2.08, 95% CI 1.41 to 3.08) and language (1.67, 95% CI 1.19 to 2.33).

10.1136/bmjopen-2018-023520.supp1

Significant age group differences between the NCI, patients with mild and major NCD were observed, F(2,175)=7.17, p=0.01 ([table 3](#T3){ref-type="table"}). Post hoc analysis established that the NCI group were significantly younger than major NCD group (p=0.001), but not the mild NCD group (p=0.06). Age comparisons between the mild and major NCD groups did not reach significance (p=0.52). Overall there were significantly more males (t=39.9, p\<0.0001) in this investigation, however, this did not remain significant on analysis by neurocognitive subtype (p=0.73; [table 3](#T3){ref-type="table"}). An exploration of mood (PDQ-9) indicted that there were significant differences between the three groups (NCI, mild NCD, major NCD), F(2,175)=2.2, p=0.06. The post hoc analysis ([table 2](#T2){ref-type="table"}) revealed that both the mild and major NCD groups reported significant worsening of mood compared with the NCI group (p\<0.02; p\<0.04). The HRQol (EQ-5D; EQ-5D self-rating scale) among the three groups (NCI, mild and major NCD) differed significantly, F(2,175)=3.67, p\<0.027; F(2,175)=3.93, p\<0.021 ([table 3](#T3){ref-type="table"}). However, on further analysis, only the mild NCD group were associated significantly poorer self-rated HRQoL (p\>0.05). To determine the if diabetic control was associated with NCD, analysis of HbA1c results found that both the mild and major NCD groups had significantly poorer diabetic control (F(5.33), p\<0.005; [table 3](#T3){ref-type="table"}). To further explore this relationship, a binary logistic regression analysis was carried out by dichotomising patients with either normal or poor control of diabetes (HbA1c, \<or \>42 mmol/mol), with age, gender, stage of CKD, mood and CKD as covariates. On analysis, higher HbA1c in the mild and major NCD groups were found to be significantly associated with more attention deficits (p\<0.02). Analysis of the remaining demographic, clinical, blood and markers, by neurocognitive diagnosis did not reveal any other significant associations ([table 3](#T3){ref-type="table"}).

######

Demographic and clinical measures by neurocognitive assessment outcome (mean±SD)

                                   NCI              Mild NCD      Major NCD      P values
  -------------------------------- ---------------- ------------- -------------- -----------
  Age, years                       73.8±8.4\*       77.4±8.6\*    79.2±5.4†      0.001‡
  Gender (ratio M:F)               51:41            28:21         18:19          0.73§
  Education (years)                11.2±2.1         10.6±1.7      10.9±3.5       0.12\*\*
  PDQ-9                            3.9±2.4\*        5.2±2.5\*     5.1±2.6\*      0.006\*\*
  EQ-5D                            0.72±0.13\*^-^   0.69±0.14\*   0.63±0.21\*    0.027‡
  EQ-5D Visual Analogue Scale: %   68.6±13.3\*^-^   64.5±11.9\*   62.5±14.2      0.021\*\*
  Ischaemic heart disease          64 (69.5)        35 (71.4)     28 (75.6)      0.26
  Duration of diabetes (year)      17.2±(10.2)      20.2±(13.4)   17.5±(6.9)     0.29‡
  Systolic BP mmol/L               146.6±16.4       147.3±18.2    147.1±15.2     0.65\*\*
  Diastolic BP mmol/L              75.5±8.1         76.1±9.6      79.8±7.8       0.06\*\*
  Duration of CKD (year)           5.8±3.8          5.9±2.9       6.1±3.1        0.88\*\*
  eGFR mL/min                      31.1±11.8        31.8±12.1     33.3±12.5      0.22‡
  Renal stage                      3.5±0.63         3.5±0.61      3.5±0.61       0.11‡
  Creatinine µmol/L                180.7±62.1       179.5±62.0    163.6±48.2     0.14\*\*
  HbA1c mmol/mol                   57.4±14.9\*†     65.5±18.9\*   55.4±11.3\*†   0.005‡
  Haemaglobin g/dL                 122.1±13.4       122.6±14.8    123.0±13.4     0.89\*\*
  Albumin (serum) g/L              36.5±12.4        34.3±3.8      34.6±2.9       0.29\*\*
  Cholesterol mmol/L               4.1±0.93         4.4±1.2       4.1±0.98       0.19‡
  LDL mmol/L                       2.0±0.90         2.3±1.1       1.9±0.91       0.20\*\*
  HDL mmol/L                       1.4±0.51         1.5±0.78      1.3±0.44       0.49\*\*
  Triglyceride mmol/L              1.8±0.92         1.9±1.1       2.0±1.1        0.38\*\*

\*Markers indicate significant differences between eGFR stages within the same row. For example, '2' indicates a difference from any other group stage on a particular row and '3' marked on a row are different from any other group not marked '3'.

†Means across NCD stages are equal=null hypothesis.

‡Post hoc Games-Howell test calculated if Levene's test of homogeneity was violated.

§χ^2^ test.

\*\*P values calculated form analysis of variance F test, post hoc Tukey's HSD.

BP, blood pressure; CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; HSD, honestly significant difference; NCD, neurocognitive disorder; NCI, no cognitive impairment.

CKD stage and associations with the demographic, clinical, blood and urine biomarkers {#s2b}
-------------------------------------------------------------------------------------

Of the 178 participants in this investigation, 83 (46.6%) had severely reduced eGFR (15--29 mL/min/1.732), 69 (38.8%) had a moderately reduced eGFR (30--44 mL/min/1.732) and 26 (14.6) with a mildly reduced eGFR (45--60 mL/min/1.732). The outcomes of the analysis are shown in [table 4](#T4){ref-type="table"}. The mean eGFR ≤59 mL/min/1.73 m^2^ for the total cohort was 31.4 (11.5). As expected, lower eGFR, higher levels creatinine and a longer duration of CKD were significantly associated with the progression of CKD, F(2,175)=246.14, p\<0.0001. There were significantly more males (t=38.9, p\<0.001), however, these differences did not remain when analysed by the stage of CKD (p=0.05). There were no significant differences observed with age, mood (PHQ-9), HRQoL (EQ-5D), education (years), blood pressure, by the stage of CKD. Hb concentration, controlling for age and gender was significantly associated with lower eGFR in the stage 3b and 4 groups (p\<0.007, [table 4](#T4){ref-type="table"}). Controlling for anaemia within the Hb results, however did not reach significance (p=0.05). Blood and urine makers such as, albumin, urine albumin to creatinine ratio (ACR) and protein creatinine ratio (PCR) and lipid profiles by stage of CKD, controlling for by age and gender, revealed no significant differences (p=0.05).

######

Demographic and clinical measures by stage\* of CKD

                                   Stage 3a      Stage 3b      Stage 4       P values
  -------------------------------- ------------- ------------- ------------- ----------
  Age, years                       74.8±8.2      76.6±8.1      75.9±8.2      0.61†
  Gender (ratio M:F)               51:43         29:21         18:19         0.23‡
  PHQ-9                            4.9±2.6       4.4±2.4       4.8±2.3       0.51†
  Duration education (year)        10.3±1.6¶     11.3±2.6¶     10.7±1.7¶     0.08§
  EQ-5D                            0.68±0.19     0.69±0.17     0.69±0.15     0.90†
  EQ-5D Visual Analogue Scale, %   66.1±14.4     67.8±13.1     64.4±13.2     0.30†
  Duration of CKD (year)           4.2±2.4¶      5.3±2.5¶      6.9±4.1¶      0.001†
  eGFR mL/min                      51.5 ± 8.6¶   34.2±5.6¶     22.8±5.1¶     0.001†
  Creatinine µmol/L                119.9±21.5¶   160.3±39.6¶   210.9±60.7¶   0.001§
  Ischaemic heart disease          22 (84.6)     47 (68.1%)    58 (69.9%)    0.26‡
  Duration of diabetes (year)      20.8±12.1     16.9±8.7      18.1±11.9     0.34†
  HbA1c mmol/mol                   60.4±17.3     60.8±14.9     57.1±15.8     0.3 †
  Haemoglobin g/L                  128.6±10.6¶   123.2±14.5¶   119.3±13.2¶   0.007†
  Albumin (serum) g/L              38.6±16.6     35.7±10.1     34.2±3.9      0.11†
  Urine ACR mmol/L                 4.7           6.0           8.0           0.41\*\*
  Urine protein CR mmol/L          33.0          30.0          40.5          0.26\*\*
  Systolic BP mm Hg                145.6±16.7    146.4±18.5    148.9±14.7    0.49†
  Diastolic BP mm Hg               79.1±7.3      77.5±8.5      75.3±16.5     0.09†
  Cholesterol mmol/L               4.2±1.3       4.1±0.91      4.1±1.1       0.93†
  LDL mmol/L                       2.1±1.1       2.0±0.82      2.1±1.1       0.87†
  HDL mmol/L                       1.4±0.56      1.4±0.48      1.4±0.67      0.89†
  Triglyceride mmol/L              2.1±0.89      1.8±0.98      1.9±1.1       0.83†

Values for categorical values are given as percentages or ratios. Continuous variables are the mean±SD or median

\*CKD Stage: 3a (Mild--Moderate): eGFR: 45--59: Stage 3b (Moderate--Severe): eGFR: 30--44: Stage 4 (Severe): eGFR: 15--29.

†P values calculated from analysis of variance F test, post hoc Tukey's HSD.

‡P values calculated from χ^2^ test.

§Post hoc non-parametric Games-Howell test calculated if Levene's test of homogeneity was violated.

¶Markers indicate significant differences between eGFR stages within the same row. For example, '2' indicates a difference from any other group stage on a particular row and '3' marked on a row are different from any other group not marked '3'.

\*\*P values calculated from Mood's median test.

BP, blood pressure; CKD, chronic kidney disease; eGFR, estimated glomerular filtration rate; HSD, honestly significant difference.

Discussion {#s3}
==========

To our knowledge, this is the first study in the UK to report that cognitive changes occur in a significant number of older adults with CKD and concomitant diabetes. We did not find an association with mild or major NCD by the stage of CKD. This study differs from previous investigations where we investigated the individual cognitive domains rather than analysing global cognitive scores alone. Furthermore, we also explored the relationship with the CKD stage and cognitive function.

This is the initial report from a prospective longitudinal investigation exploring the relationship with patients with NCD and CKD who at the time of assessment were not in ESKD failure, dialysis or a transplant recipient (eGFR, of ≤60 m ≥15 mL/min/1.73 m^2^). The results here confirm that NCD is common in patients with moderate to advanced CKD and diabetes. The overall proportion of patients fulfilling DSM-5 criteria for an NCD being around 48% (mild NCD=49; major NCD=37). These findings support previous investigations into CKD and cognitive function.[@R9] However, the unexpected finding was that prior to cognitive assessment and application of DSM criteria, not any of the cohort had a diagnosis of an NCD. If patients with CDK are not diagnosed through life with an NCD, especially in view of the expected exponential rise of neurodegenerative disorders by the midpoint of this century, our findings suggest that current and future forecasts may significantly underestimate this cognitive burden worldwide.

An examination of the individual cognitive domain scores of the neuropsychological assessment employed in this investigation revealed that it was able to distinguish between patients with and without NCD. The strongest associations were found in the mild and major NCD groups in the cognitive domains of executive function, memory and fluency. It is, however, important to note that mild NCD (usually described as MCI), while a possible risk factor for the progression onto a major NCD, often remains stable, or patients revert to normal cognition.[@R31] However, in other population and disease-specific conditions, MCI has been shown to be a significant predictor for the subsequent development of dementia.[@R32] We suspect that MCI is fluctuant and in addition, the variability in the methodology and cognitive assessment in investigations will give rise to the inconsistency in reported outcomes. Further exploration in this area is warranted to establish the relationship with CKD, MCI and its possible progression to major NCD.

Several investigations have reported that there is an association with declining kidney function and cognitive function in either the early or the end stage of the disease course.[@R8] Whereas others have suggested that cognitive impairment is more likely to occur in the more advanced CKD stage 4 (eGFR \<30).[@R10] The current investigation in contrast found that NCD occurred with a similar frequency in all of the stages of CKD. Likewise, the duration CKD was not significantly associated with the degree of NCD within the cohort. The differences we observed may have arisen because we only assessed patients aged 55 years or more, those in the CKD stages 3a, b and 4(eGFR ≤60 m ≥15 m L/min/1.73 m^2^), and with an additional diagnosis of diabetes mellitus. Previous investigations have included patients from an eGFR of ≥90 with presumably less comorbid disease, through to end-stage CKD (eGFR of \<15), including those in receipt of renal replacement therapy or post-transplantation. However, the Chronic Renal Insufficiency Cohort (CRIC), as we found have recently reported that the stage of CKD is not a necessarily a predictor for the development of cognitive impairment.[@R9]

Other risk factors including vascular disease and diabetes are frequently reported comorbid conditions associated with CKD. The prevalence of lower Hb concentration in general and CKD population investigations has been shown to be associated with impaired cognitive function.[@R34] Anaemia in CKD is common, particularly as kidney function declines and in the current study over 60% of the cohort had Hb concentrations falling into the anaemic range. However, we found no association with the stage of CKD, cognitive function and Hb concentrations. The recent report from the CRIC study group similarly reported no association in patients with CKD with anaemia and cognitive function.[@R36] Diabetes mellitus is also thought to contribute to the development of cognitive impairment and dementia.[@R37] This is thought to be as a result of the increased vascular disease risk, its association with amyloid metabolism and blood glucose levels. Some investigations have reported that poor diabetic control is associated with impairments in the cognitive domains of executive function, memory and global function.[@R39] Although the current investigation found a weak predictive association with attention deficits and increasing HbA1c, no other associations with cognitive function were observed in this investigation. This perhaps is due to the established or increased cardiovascular risk factors, where, for instance, they had a diagnosis of diabetes mellitus, 80% had a history of hypertension and a significant proportion had ischaemic heart disease. It has been suggested that multifactorial clinical and societal and potentially modifiable risk factors, such as reductions in the incidence of diabetes, obesity, may contribute equally if not more than genetic risks such as Apolipoprotein E4 allele (ApoE) status alone for dementia.[@R41] It is possible then that CKD may not be a causative risk per se, but instead the established comorbid risk factors associated with CKD, contribute to an increased likelihood that these patients have a lifetime developmental risk for an NCD. More incident population longitudinal investigations with matched controls controlling for these covariates are needed to resolve this.

The most recent version of DSM has replaced the term dementia with mild and major NCD, because it was felt to be less stigmatising for patients and families. It also allowed for more flexible diagnostic criteria, assisting clinicians in making a decision on the severity of decreased mental or cognitive impairment in patients. The difficulty we found with DSM-5 was that while the most common NCD such as Alzheimer's, Parkinson's, vascular, HIV infection have specific categories, CKD does not. Although the current investigation was able to specify major NCD in 9 (32%) cases, the majority fell into DSM-5 category 'due to other aetiologies'. We did consider possible vascular NCD in significant a number of these patients because of their existing comorbid risk factors for vascular disease as described earlier. The DSM-5 criterion for probable or possible vascular NCD, however, requires evidence of one or more cerebrovascular event, with additional supporting neuroimaging where possible. However, the exclusion criterion in the current study was the history of a stroke or TIA and along with a lack of neuroimaging data makes it difficult to attribute their NCD to vascular disease. We feel that this is potentially a weakness of the current DSM and should be addressed in subsequent revisions of the criteria to include CKD and its association with possible an probable vascular risks and NCD.

The current investigation does have several limitations. We lacked information on other variables such as, neuroimaging to confirm or support cardiovascular diagnosis and ApoE risk status. We employed one executive function assessment and a single multiple cognitive domain neuropsychological assessment. Although more comprehensive multiple assessments may have yielded stronger associations with CKD and cognitive function, the individual analysis of the global assessment was sensitive enough to discriminate between the NCD groups. The participants in this investigation are not necessarily representative of all patients with CKD because we first restricted our recruitment to those with and additional diagnosis of diabetes mellitus Second, the cohort was a cross-sectional population with multiple comorbidities who were at risk of developing cognitive impairment. Lastly, the current investigation lacked a disease-free comparison group. To address these methodological issues, we are currently recruiting and assessing an incident CKD cohort with and without diabetes, along with an age-matched and gender-matched healthy control cohort.

Conclusions {#s4}
===========

Cognitive function is often not routinely assessed as part of the clinical management in CKD, despite the known association with worsening renal function and ageing. The current UK National Institute for Health and Care Excellence guidance does not address cognitive function in the assessment and management of CKD and we would recommend that this is addressed in subsequent revisions.[@R43] Our findings also suggest that the cognitive function of patients with CKD should be screened and monitored routinely. In addition, an agreed set of cognitive assessment battery should be established to allow for data sharing and national and international comparisons.

Supplementary Material
======================

###### Reviewer comments

###### Author\'s manuscript

This study was presented as a poster at the International Congress of the European Geriatric Society, Berlin, Germany, 2018. Eur. Geriatr Med (2018) 9 (Suppl 1): S321: <https://doi.org/10.1007/s41999-018-0097-4>.

**Contributors:** PH and MK conceived and designed the study, collected the data and managed the database. PH and MK contributed to data cleaning and performed the statistical analyses. PH, AL, HN, SW and MK contributed to interpretation of the data. PH, AL, HN, SW and MK wrote the manuscript. All authors critically reviewed the manuscript and approved the final version to be published.

**Funding:** The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

**Competing interests:** None declared.

**Patient consent:** Not required.

**Ethics approval:** Approval was given by the Central Research and Ethics committee, North Wales.

**Provenance and peer review:** Not commissioned; externally peer reviewed.

**Data sharing statement:** No additional data are available.


Dr. Gundry | 2018-09-22

Gundry interviews Dr. Dale Bredesen

On this episode of the Dr. Gundry Podcast, Dr. Gundry sits down with brain health expert Dr. Dale Bredesen to discuss diet, lifestyle, and The End of Alzheimers. Watch now to learn more about the 3rd leading cause of death in America, and how something as simple as tweaking your diet The Plant Paradox way can keep you sharp, focused, and alert as y...

Glidden Healthcare Videos

Interview everyone has been waiting for - MD meets ND

2019-01-26

Dr. Janda, MD sits down with Dr. Glidden, ND to discuss health and the role nutrition plays in it!

Welcome To Dr. Glidden's YouTube Channel!

2019-01-25

Dr. Glidden gives you his 2ND Opinion regarding your health concerns. 30 years of clinical experience as a licensed Naturopathic doctor gives him a unique perspective regarding all-things-medical. Sick and tired of feeling sick and tired? You have come to exactly the right place...

Welcome To Dr. Glidden's YouTube Channel!

2019-01-25

Dr. Glidden gives you his 2ND Opinion regarding your health concerns. 30 years of clinical experience as a licensed Naturopathic doctor gives him a unique perspective regarding all-things-medical. Sick and tired of feeling sick and tired? You have come to exactly the right place...

The Dr. Glidden Show 1.23.19

2019-01-23

BRACA Schmaka; Cholesterol Myth-Busting; Knee Pain Health Hack

The Dr. Glidden Show - Jan 15 2019

2019-01-15

On Today's Show: Everybody is sick, and I know why; Depression and you; Grey Hair Health-Hack


Flight 1462 to Edinburgh, Sunday night. Late boarding, we’re stuck in the ass of the plane. There’s an older chav-like female sitting in the window seat, reading some very pink magazine full of all the important information on world events one should be familiar with such as Britney Spears’ latest alleged lover’s name, the latest photos of Julia Someone-or-Other, and tips on how to do a French manicure at home for only £3.50.

Across the aisle were a couple of kids and some older guy on the window. The 12-ish girl was engrossed in a magazine as her brother sat fumpily looking over her shoulder, turning away whenever she looked up so as not to be caught reading material that was, for the most part, not much different than that which held the woman's attention.

Some twenty minutes after scheduled departure and still at the gate, a waitre… sorry, stewardess/air hostess/cabin crew member asked the man in 32F if he would change seats. He seemed happy at first until he was directed to 32A. They then asked the 40-something Chavette if she’d please move to 32F. Why is BA making them play musical chairs?

"The children are flying unaccompanied and it’s company policy not to seat them next to men."

The man didn’t care too much. The woman said, "I’m not bloody child-friendly," but moved nevertheless. I, unable to help myself, asked what the hell sort of blatantly and accusatorily sexist company policy that was supposed to be.

"It’s not sexist sir, it’s just company policy." I couldn’t help wondering if she’d previously worked for Boetha’s Ministry of Information. "it's not racism, it’s just country policy."

"It’s not sexist?" I asked. "You’re insinuating that be deint of the fact that he’s male, he’s unsuitable to sit next to children in an open aircraft. This isn’t some private room, it’s a well-lit airplane in which everyone is in full view."

"It’s our policy, sir."

That sounded so much better in the original German.

The man sat down and mentioned to me that he’s not traveling alone. Over 60 himself, his wife is sitting 18 rows forward because BA couldn’t or wouldn’t sit them together.

Now here’s where they could’ve been smart. Or clever. Or at least tactful. They could have asked the woman sitting next to this man’s wife to move in back next to the kids so that this man could sit with his wife. That would’ve been subtle. But BA doesn’t give a damn. They’re quite happy to be overtly discriminatory and play along with the insanity that any man is a potential pederast.

Another waitre… sorry, I keep doing that, passenger safety supervisory assistant… backed up the first one and threw in that the parents had asked for that.

I call shenannigans. I can’t think of any parent in the world who would, out of the blue, specifically ask that their kids not be sat next to a male. Worse, I can’t understand why any company in the world would accept such intolerable demands from customers and play along with – much less promote -- such baseless fears.

Not five minutes later, the head wai… ah, to hell with it, waitress came over to me and uttered the magic question, "Is there a problem?" "Yes," I replied, "There is indeed a problem. By virtue of his sex alone you've demanded that this man relinquish his seat and you've forced that woman to sit next to the kids."

"It's airline policy," she interrupted.

"You don't know if that man won a humanitarian award or if that woman was just released from prison for child endangerment." The pink lady looked up. "Nothing personal, just hypothetically speaking here. My point is that solely because he possesses testicles you're assuming that not only is he a child molester but that he'd also be dumb enough to do something on the plane in full view of passengers and crew."

"Sir, if you don't wish to be on the flight you can depart the plane."

"And how would I get to Edinburgh?"

"That's not my concern. My concern is the safety of the passengers."

"It can't be because you have no idea whether that woman could pose a risk to the children. You're assuming that because she has no testicles she presents no danger despite the fact that subtle killings such as poisonings are inevitably done by women. Your supposed policy is outrageous."

"Sir, I don't have time to discuss this. Would you like to leave the plane?"

And that was that. Either shut up or lose my flight.

There has never been a conviction on any charge of molestation in an airplane. There have been accusations, most famously an Indian on Northwest Airlines back in 2001. You have to search hard to find the mention of his acquittal. Not one of the cases was dropped due to a technicality; in each instance there was not only no evidence, what testinmony was given was found to be unbelievable, and in parts, impossible.

So I did the only thing I could do. As soon as we were "free to move about the cabin" I grabbed my laptop and wrote this story in Word, expanding the window to fill the wide-screen LCD monitor and making the headline very large. Every waitress saw it and they were concerned enough about it to get the head waitress who was working up front to come to the back.

Alas, there were no cops waiting for me in Edinburgh when we disembarked. I was able to get the rental car and after 10 minutes of pissing around in the carpark, I finally found the well-hidden exit.

On the way back to Germany I was pulled aside both in Edinburg and again in London for an extra-super-special "security" check. Big surprise, that.

BA is now on my "Do Not Fly" list.


Q:

How do I clean a very dirty refrigerator?

I just got a new house and inherited a very moldy and mildewy refrigerator.  My first though it to get some cleaning spray with bleach and just go to town, but I'm worried the bleach might damage the fridge in some way.  It's close enough to an outside door that I could take it outside and hose it out as well.  I'm wondering if others have had a similar situation and got good results with a particular set of cleaning products.

A:

There's a lot of good advice here on cleaning the inside of the fridge.  One thing I'd like to add:
Don't forget to periodically clean the fridge's coils. The coils are typically found underneath or on the back of the fridge, and are meant to dissipate the heat.  The coils will, over time, get blocked with dust etc. and the fridge runs less efficiently as a result of such buildup.    Keep the coils free of dust and you'll save money and extend the life of the fridge.  Use a vacuum with appropriate connectors, and be careful when moving the fridge, vacuuming the coils, etc.
Here's a good reference: How to Save Energy--Clean Your Fridge Coils

A:

I've cleaned minor mold and mildew with Windex, but if it's that bad, do you really want to store your food in it?
Any harsh chemical cleaner may have a bad effect on any rubber/plastic seal, too, though using occasionally and not letting it sit minimizes the effect.

A:

Just use vinegar and water.


artha

Sex, Money and Spirituality: Past and Present

Is “Sex a sin”? Were you told in subtle or not so subtle ways that “money is the root of all evil”? Can you be “sexual” and also “Spiritual”? Can you be wealthy and also Spiritual?

These messages, in various forms, have been a part of our culture for a long time. I have heard it suggested that these messages were intentional attempts by the Church to ensure that money would continue to come into the Churches. The concept of this argument is simple: convincing you that you are a “sinner” ensures that you will seek out the remedy which is the “church”, and attendance equals donations.

I tend to have a more optimistic view of these things. I do believe that the concept of needing to be saved from sin probably did improve church attendance. But, I also believe that the priests and religious leaders actually believed in the message and, for the most part, were simply serving the best they knew how. Sure, there has probably always been a little corruption here and there. But I think it may be more helpful to examine the concepts and understand why they came about to begin with.

It is easy to dismiss “sex is a sin” and “money is the root of all evil” as ridiculous statements. In their simplest essence, they are lies. And even as we know that, these concepts are so ingrained in our culture and our history, that they linger in the background of our collective subconscious minds creating inner conflicts.

And it can still be seen today, especially in Spiritual communities, that these types of debates continue. It doesn’t matter what religion, be it Christianity, Hinduism or any others. Even in spiritual communities connected to Yoga and Buddhism, you will find variations taught.

I know several yoga teachers and spiritual healers who are plagued by guilt, thinking that it is wrong to take money for what they see as a spiritual service. And I know plenty of Yoga teachers who will still tell you that the Yama of “Brahmacharya” declares that Yogis should be celibate.

These are modern examples of how these messages still interfere with our happiness and our pursuit of spiritual truth.

Rethinking the Past: A Shift in Perspective

If we are able to avoid the “knee-jerk reaction” of declaring these concepts “ridiculous” or accepting them at face value and look to what they are pointing to, then we can consider that the original intention of the advice was well meaning. That it actually points to principles of non-attachment. It reminds us that obsession with anything can send the mind into a downward spiral. We have all likely seen movies about the downfall of a greedy businessman, or the “bottoming out” of an alcoholic, or the destruction of marriage because of sex addiction.

And from the perspective of a Spiritual Path, becoming too obsessed or attached to wealth and pleasure will cause you to focus away from your Spiritual path. It’s kind of like a parent encouraging their child to focus on school studies and be responsible by asking them to be home by 10pm.

They were just warning us about these distractions from a deeper truth. They meant well. It’s just that over a period of time, people forgot WHY it was said, and began to take it as a “rule” that SHOULD be followed. The biggest problem is that these “rules” don’t match out own experiences of being human. Because most everyone will desire pleasure and enjoyment. Most everyone will have sexual desire. And we need money to provide for ourselves and our families.

And when we are being told that our very nature is wrong or that the thing that makes us happy is wrong, that creates a BIG problem. But I don’t think that is what was originally meant by these concepts. We SHOULD heed the warning of being aware of our attachments in general, but that doesn’t mean we can’t enjoy our lives, and our bodies and have some money too.

We really CAN have our cake, eat it too and wear a gold watch while eating it, and STILL be properly following a Spiritual Path. Its TRUE. I PROMISE! (Although, I don’t personally wear a watch.)

Clarity through The Four Goals of Life

Fortunately for us, there is a clear teaching around this in the Yogic Traditions. It is called the “4 Purusharthas”. This is a compound word combining “Purusha” and “Artha”. “Purusha” is a reference to the deeper Divine Spark which is your nature. Some would call it the “Soul”. And “Artha” is usually translated as “wealth”.

So the 4 Purusharthas are things that bring wealth and value to the Soul. In English, we commonly refer to this as “The Four Goals of Life”. They are the Four areas of life that are legitimate goals to pursue in order for the Individual Soul to find balance and happiness in life.

You will notice that “Wealth” and “Pleasure” (including sex) are included within them. So, there is a clear Yogic teaching that says “It’s all good man…” But, don’t run off to the wild orgy on a money covered floor just yet! We still need to understand that context!

So how is it that there is this clear teaching telling us that wealth and pleasure of legitimate goals for the individual to pursuit, and yet what we have heard most is “Sex is a sin” and “money” is evil and opposed to authentic spirituality?

Well, as I said earlier. The warning was to find balance. And we must understand these Four Goals in balance also. So let’s examine each one separately.

Dharma

Dharma is usually thought of in connection to “career” in this context. But at its deepest level, it means that the work and the actions that we take in life should be aligned with a deeper sense of purpose and meaning. The individual will feel greater peace and happiness if what he or she does in the world feels like it is benefiting others or humanity, or is at least serving some purpose beyond “getting up, going to work, and then going to bed”.

Please note, that “dharma” doesn’t tell us WHAT we should be doing. There is no insistence that we all become monks, or that we all operate a charity, or anything like that. Because these rules understand that the diversity of Karma will create a wide variety of different “dharmas” for different people. It is perfectly fine if your dharma is to be an artist, run a business, serve the elderly, become a chef or anything else in the world. So long as what you are doing feels satisfying and provides YOU with a sense of purpose that truly feels good to you, then you are golden, no matter what anyone else thinks about it.

Artha

Having the Material resources that we need to feel safe, comfortable and happy is a worthwhile goal for the individual. But again, because of Karma, we can’t assume this means that everyone is supposed to be Millionaires. What it means instead, is that it is ok to have more than enough. For some that will be a small house, food and clothing. For others it will be a large house, a nice car and the latest iPhone. And for others, it will be millions or billions of dollars and a truly opulent lifestyle.

The larger point is that it is fine to have money and material resources so that your needs are met. It acknowledges that the individual soul will feel more at peace if it feels materially and financially supported.

Kama

This Goal of life declares that the individual Soul will find greater peace if it is allowed to enjoy the pleasures of life. That enjoying the pleasures of the body, food, entertainment, time with friends and other experiences will actually bring greater happiness to the individual. And because of this, it is worth pursuing.

Again, it doesn’t define what the pleasure should be. There is no rule that says “in order to be happy, one must eat at least one dessert per day, and engage in sexual activity a minimum of 3 times per week”. It doesn’t state these rules, because again, it knows that the Karma of each individual is different. Instead it says “It’s ok to enjoy life and find pleasure in the world around you”. How each individual experiences that will be unique.

Moksha

Now we come to the Goal that is most commonly associated with Traditional Yoga. Moksha is the pursuit of Spiritual Liberation. The most valued form of this would be “Enlightenment”. But we could also say that Moksha is the seeking of greater knowledge and wisdom. And that seeking will eventually evolve into the search for Enlightenment.

But at the very least, the individual Soul thrives when it is evolving. When it is learning more about its nature and its relationship to life so that it can refine the choices that it makes and develop a more enlightened perspective on the whole experience.

While the final stage of Spiritual Enlightenment is fairly well defined, the goal of Moksha is still understood to be a different path for each individual because each Soul has different Karma, and therefore needs different lessons and experiences to evolve.

Are All 4 Goals of Life Equal?

According to the teachings on the Four Goals of life, it is made clear that the highest and most important goal is Moksha. And because of this, some people have dismissed the other goals and focused only on Moksha. That approach may work for an individual who is already very evolved. But it isn’t likely to help most people.

But the teaching still emphasizes that Moksha is the most important of these goals in the end, and encourages us to pursuit the first Three Goals with the intention of supporting the Soul’s pursuit of Moksha. This is a very Tantric approach to Spiritual evolution, in that we learn to embrace and enjoy life in the world and use it as a part of our spiritual practice.

There is a quote that is attributed to Buddha that states “You cannot teach a starving man to meditate.” The implication is that if the basic needs of life are not met, that the mind will be so restless and focused on meeting those needs, that it will be unable to find the focus and peace needed to attain a meditative state. In essence, it points to the need to create balance in our outer life first, before we can pursue Spirituality in a more balanced way.

The First Three Goals point to the remedy for this. By embracing that a sense of purpose, material resources and pleasure are needs of the Soul, we can remove the restlessness from the individual by ensuring that these needs are met. If you are doing something purposeful, that is aligned with the Soul’s desires, then you feel more content and happy with your pursuits in the world. You feel fulfilled with what you are doing, creating and/or contributing to your business or to the world.

From that deeper sense of fulfillment in your work, you are then invited to receive the financial rewards. This money, if respected and managed properly, will allow you to have a safe, comfortable place to live, to provide food and clothing for yourself and your family, and also to have enough money in savings so that when the unexpected happens you are able to handle that without worrying about where the money will come from.

With contentment of purpose, and adequate financial resources, you are then free to enjoy life. You are free to buy things that are enjoyable, and also give yourself pleasure through various activities.

When these three goals are embraced and brought into the experience of the Individual soul, then it is able to relax. Its needs are met. It isn’t worrying about where its next meal will come from, or how it is going to pay the bills. Instead, it is happy, peaceful, safe and supported. This removes much restlessness from the mind and from life, and allows a supportive and safe environment for the Individual to be able to pursuit a Spiritual Path.

So, in this way, the pursuit of Purpose (Dharma), Wealth (Artha) and Pleasure (Kama) are understood to be secondary goals which actually support the pursuit of the Primary Goal of Spiritual Liberation (Moksha).

And the original “warnings” that have continued in our culture out of context serve to remind us to not become attached to Status, Money or Pleasure as a primary goal. They serve our evolution, but they are not the most important goals. And therefore they should be approached with a balanced perspective, keeping the Final Goal of Moksha in mind.

Tantra teaches us that everything in life can be used as a Spiritual Practice when properly understood. And we start by embracing the abundance and pleasures that life has to offer as we seek to align with our Soul’s purpose in the world. And from that place of joy, we can bridge our awareness into the deeper Joy of our Liberated Self.


Metacognitive appraisal of memory inconsistency for traumatic events in Dutch veterans.
Although memories of traumatic events are often remembered vividly, these memories are subject to change over time. In our previous study, we found that Dutch infantry veterans who had served in Iraq often reported stressful events at a second assessment point that they had not reported during a prior assessment point and vice versa. In the present exploratory study, we recontacted subjects from this previous study and asked how they explained the discrepancy in their memory reports between post-deployment assessment points 1 and 2. Common explanations were: interpreting the item differently, having forgotten the incident initially, repression and having accidentally incorporated someone else's experience into their own memory. Although such reports are not necessarily revelatory of the mechanisms driving discrepancies in memory reports over time, our study illuminates the metacognitive variables involved.


Short-chain baclofen analogues are GABAB receptor antagonists in the guinea-pig isolated ileum.
A new series of GABAB receptor antagonists, based on short-chain baclofen analogues has been investigated. In guinea-pig isolated ileal preparations, the GABAB receptor-mediated, baclofen-induced depression of cholinergic twitch responses was reversibly and competitively antagonised by the short-chain baclofen analogues 3-amino-3-(p-chlorophenyl)propionic acid (apparent pA2 = 3.5), 2-amino-2-(p-chlorophenyl)ethanephosphonic acid (apparent pA2 = 3.8), and 2-amino-2-(p-chlorophenyl)ethanesulphonic acid apparent pA2 = 4.0). The corresponding des-chloro analogues were all less active. These compounds represent another class of GABAB receptor antagonists which may cross the blood-brain barrier.


Q:

how to take backup log file before its overwritten by other log file?

I have two log files: abc.log and abc.log_old. When abc.log is full, it will override into abc.log_old files. But I am not sure when it will be full and the size of log file is not fixed. The log file is from a different system.
My requirement is to take the backup of abc.log_old file, before it's overwritten by abc.log file. How can take the backup log file before it's overwritten by other log file?

A:

Don't reinvent the wheel. This is a job for logrotate.