The follow-up time was defined as the intervals from admission to death, LT, the last clinic visit, or the end of the study on 31 December 2016. The patients were admitted for 24 h of observation following the procedure, and subsequent outpatient care was provided in an outpatient hepatology clinic. A final angiogram was performed to confirm good blood flow through the TIPS. Post-placement pressure measurements were then obtained. Postplacement dilation was carried out to 10 mm or 12 mm, as per the interventional radiologists’ preference. Gore and Associates, Flagstaff, AZ, USA) were deployed across the liver tract, followed by balloon dilation. The stent length was then measured using a marking catheter, and Viatorr covered stent grafts (W. 12 In brief, the hepatic veins were accessed via puncture of the right internal jugular vein under direct ultrasound guidance, and venography was performed to confirm hepatic venous anatomy. The technique for TIPS placement was performed according to standard clinical practice by experienced interventional radiologists under general anesthesia. 6, 11 Data also were collected on readmission for hepatic encephalopathy within 30 days after TIPS. The MELD-Na score was calculated as MELD score +1.32 × (137 − serum Na) – (0.33 × MELD score × 137 − serum Na). The MELD and MELD-Na scores were calculated from laboratory data obtained within 7 days before TIPS creation in accordance with previously published formulas, with the MELD score calculated as 3.78 × ln serum bilirubin level (mg/dL) + 11.2 × ln (INR) + 9.57 × ln serum creatinine (mg/dL) + 6.43. Excluded were patients who underwent TIPS after LT, TIPS for noncirrhotic portal hypertension or portal vein thrombosis, and those with lack of laboratory data prior to TIPS.ĭata on demographics, underlying liver disease, indication for TIPS, whether TIPS was considered urgent or elective, laboratory values, including serum sodium, serum creatinine, total serum bilirubin, and international normalized ratio (INR), and portosystemic gradients were collected before and after TIPS creation. Two authors manually identified all TIPS recipients to confirm that the ICD-9/10 code corresponded to a new TIPS placement. The TIPS recipients were identified using the International Classification of Diseases (ICD) code (ICD-9: 39.1, intra-abdominal venous shunt or related ICD-10 codes 06183DY and 06184DY) from Johns Hopkins electronic health records and the Johns Hopkins Interventional Radiology database for this cohort study. 5, 9, 10 We conducted this study to investigate the prognostic ability of MELD-Na compared to MELD for 30-day and 90-day mortality among patients with cirrhosis after TIPS placement. There are limited studies comparing MELD with MELD-Na for the prediction of mortality after TIPS in patients with cirrhosis, and the existing studies have conflicting conclusions. 8 Therefore, in January 2016, the MELD-sodium (MELD-Na) was implemented in place of the MELD for organ allocation in LT in the USA. It is particularly true of patients with low MELD scores, where the effect of serum sodium is significantly greater. 8, 9 Hyponatremia has been established as a key predictor of mortality in patients with cirrhosis independent of the MELD score. 6, 7 However, previous studies have shown that subgroups of patients are at a higher risk of mortality than predicted by their MELD score, thus restricting their access to LT. The model for end-stage liver disease (MELD) score was first developed to predict early death of patients undergoing elective TIPS placement and was subsequently adopted for organ allocation in candidates for liver transplantation (LT) in 2002. 3– 5 As a result, several prognostic scoring systems have been developed to assist in patient selection for TIPS placement in patients with cirrhosis. 1– 3 Careful patient selection for TIPS is vital because the resultant shunting of hepatic blood flow leads to an increased risk of post-procedure hepatic encephalopathy, liver failure, and morbidity/mortality in patients with significantly impaired liver function. The transjugular intrahepatic portosystemic shunt (TIPS) is created using percutaneous endovascular techniques to treat complications of portal hypertension such as variceal hemorrhage, refractory ascites, and hepatic hydrothorax.
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Plus, at $79, it's a great price point for a newborn carrier. Based on how comfortable the baby-as well as the parent wearing it-looked, I knew I had to order it. It’s one of the pricer carriers on the market, but with so many options it’s well worth the price tag.īefore my second son was born, I saw the Ergobaby Embrace at a birthday party. However, once your baby is big enough, you can realistically use it for years to come. The biggest con for this carrier is that your newborn must be at least 8 pounds in order to safely use it, so if you have a tiny baby or a preemie you’d have to wait a few weeks to start using it safely. Another positive is that it includes a UPF 25+ sunshade that can be tucked into its own zippered pocket when not needed. That earns it big points for those looking for this option. The carrier is also breastfeeding-friendly, with no straps between parent and baby. It can truly grow with your baby and take you up to the toddler years. One of my favorite things about this carrier is that you can use it for newborns starting at 8 pounds (no infant insert needed), all the way up to 45 pounds. It was easy to set up, and even with so many configurations it is still lightweight. The 5-in-1 design allows you to wear it for newborns, facing in, facing out, on your hip, and on your back. The Journey Go features breathable 3D mesh and moisture-wicking fabric with five different carrying options, making it perfect for long trips. They made an impression: the four Contours I received topped our list, and the Journey GO won best overall. I wasn't familiar with Contours Baby Carriers before product testing, but was very excited to try them out. And you may know that since she's made apperances at anime porn parodies fairly frequently. 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The following commands install ASP.NET Core Runtime, In your terminal, run the following commands: winget install .8 ASP.NET Core Runtime allows you to run apps that were made with. This runtime runs web server apps and provides many web-related APIs. NET Desktop Runtime and ASP.NET Core Runtime instead of this one. This is the base runtime, and contains just the components needed to run a console app. NET Runtime, but doesn't include ASP.NET Core Runtime, which must be installed separately. This runtime supports Windows Presentation Foundation (WPF) and Windows Forms apps that are built with. The following list provides details about each runtime along with the winget commands to install them: The following table describes what is included with each runtime: NET Desktop Runtime and the ASP.NET Core Runtime for maximum compatibility with all types of. NET runtimes you can install, however, you should install both the. NET SDK, run the following command: winget install .8 NET SDK, you don't need to install the corresponding runtimes. NET system-wide, install with administrative privileges. For more information about how to install and use winget, see Use the winget tool. NET through the Windows Package Manager service, using the winget tool. Install with Windows Package Manager (winget) The following table lists the support status of each version of. STS releases get free support and patches for 18 months. LTS releases get free support and patches for three years. The only difference is the length of support. There are two types of supported releases: Long Term Support (LTS) releases and Standard Term Support (STS) releases. Scherzer struck out 10 of the first 21 batters he faced, holding the Mets to just the one run through six.ĭeGrom came back out for the bottom of the sixth, and worked around a leadoff single and two stolen bases in a 16-pitch frame that ended his outing. Scherzer cracked first in the season opener, giving up a two-out solo homer to left-center on a 1-1 changeup to Robinson Canó in the top of the first inning.ĭeGrom held the Nationals to four hits through five, striking out nine of the 19 batters he faced. Fans should be super-excited about what’s going to happen today, and you’re going to see two good ones out there.” “I’ve got to be careful not to be a fan today,” Manager Davey Martinez said, “but you can get caught up in the moment seeing those two guys out there, they’re surely two of the best, so it’s going to be a lot of fun, a lot of excitement. “I’m excited to watch ‘Mad Max’ compete,” Nats’ GM Mike Rizzo said before the first game of the season, adding that he was also excited to, “ the guys grind it out against the Cy Young award-winner, and a team that we’re going to have to battle all season like the rest of the division to win it.” It should be fun though,” Zimmerman said. Ryan Zimmerman was asked if he’s looking forward to the pitching matchup. deGrom won and then Max won for the last few years, so it’s going to be a heck of a pitching matchup and hopefully we can put a few up on them.” Those guys came off unbelievable seasons last year, both of them. “Every year you get the two best pitchers for each team facing off for Opening Day,” Turner added, “so it’s never easy. “We’re going to go face deGrom the first day and it’s not going to be easy,” Trea Turner said, though he acknowledged the matchup is going to be a good one. As a hitter and a leadoff hitter, the task is going to be heavy for all of us to scrape across a couple runs, but that’s again, if you want to be the best you’ve got to beat the best, so why not start on Opening Day.” Fun for baseball people who like good pitching. NL Cy Young winners the last whatever, how many years - I don’t know how many Scherzer has won, but deGrom won last year, right? Shows you how much I pay attention, but he’s a good pitcher. “I think that’s must-see TV,” Adam Eaton told reporters before the final exhibition game of the Spring. How about the rest of the Nationals? How did they feel about the marquee Opening Day pitching matchup and going up against deGrom? And for me, I’m facing their lineup, I’m not necessarily facing Jake, and he’s not facing me, he’s facing our lineup, so really the contest is between us and the hitting coaches.” Everybody is going to be coming out full-tilt, so you expect that. “Nobody is coming out flat the first game of the year. “You’re cognizant when you’re facing someone as good as Jake, you’ve got to bring your A-game,” he explained, “but it’s Opening Day, everybody is going to bring their A-game. Scherzer said that, of course, he wasn’t really “facing” the opposing pitcher. He’s one of the best pitchers in baseball, so I’m looking forward to that matchup.” “That’s who you want to start against,” deGrom said, as quoted on Twitter by MLB.com’s Anthony DiComo. It was the first matchup of first and second-place finishers in the previous year’s NL Cy Young race since 1979.ĭeGrom told reporters earlier this Spring that he was excited about the opportunity to go against Scherzer in the opener. Scherzer and deGrom went head-to-head Thursday, on Opening Day in the nation’s capital. 196/.244/.277 line against in 217 IP, over which he was worth a career-best 9.0 fWAR.Īmong qualified NL starters, deGrom, 30, finished first in quality starts ( tied with Scherzer), opponents’ OBP, fWAR, ERA, ERA+ (216), opponents’ OPS (.521), and opponents’ SLG, and he finished second in total Ks, K/9, K/BB (5.85), WHIP (0.912), innings, and opponents’ AVG with RISP, while finishing fourth in opponents’ AVG. New York Mets’ ace Jacob deGrom, who was one vote shy of a unanimous Cy Young award, finished his fifth season in the majors (10-9) in 32 starts, with a 1.70 ERA, a 1.99 FIP, 46 walks, (1.61 BB/9), 269 Ks (11.16 K/9), and a. Scherzer, 34, led all National League starters in total strikeouts, K/9, K/BB (5.88), in WHIP (0.911), in opponents’ AVG, total innings, and in wins, finished second in opponents’ OBP and fWAR, and ended up third overall in ERA, ERA+ (168), opponents’ AVG with RISP (.153), and opponents’ OPS and SLG. 188/.247/.332 line against in 220 2⁄3 innings pitched, over which he was worth a career-high 7.4 fWAR. Max Scherzer finished the 2018 campaign with an (18-7) record in 33 starts for Washington’s Nationals, with a 2.53 ERA, a 2.65 FIP, 51 walks (2.08 BB/9), 300 strikeouts (12.24 K/9), and a.
They have a nice palette of icons to make maps and tokens with. What I did enjoy was the map making portion, where you can make battle maps or dungeons and then export them for use in other VTTs. Thus, I didn’t much check out those features. I already use Roll20 and Tabletop Simulator for free and for a one time cost, so to me it’s not worth paying a monthly subscription for this. There aren’t much in the way of mobile VTTs out there. What this brings to the table is it is cross platform, working with PC and mobile. This is a virtual tabletop to play D&D type games online with friends. Let us know if you have any other feedback or suggestions. However, in the next build you will be able to download maps on any device. As far as downloading maps, currently you can only do that on the desktop build (which you can download on our website at /theCalamus and log in with your account. I know spider eggs and webs are currently on the drawing board, and I'll suggest some fungi to the artist. Hi! Thanks for the feedback and interest in the app. I’d be willing to pay for a subscription, only if there was much more of a verity of items to chose form and you could save your maps to a device. Unless that is something you get with the subscription. I want to be able to save my maps with out having to screenshot them and have to edit them just to get a whole map. The biggest gripe I have with this is, how do you download saved maps? There’s no way to save them to a device of any type. So that really bummed me out as it’s more work on my part to incorporate them into the maps I’ve spent a lot of time trying to make. but no fungi? That is a main staple of the underdark. I want to be able to make underdark maps and there is a bit to be able to make them like lava, crystals, and chasms. I would like to see a bit more verity with this. It still felt rather limiting with what was offered. While there is an okay selection of things to chose from, as I was able to create a tavern with what was on hand. I love the art style used for everything and after playing around with it to make a basic map, it’s easy to use after you get the hang of the weird menu layout. I basically just downloaded this to make maps, and so far I really like it a lot. Bad, it only has cobblestone, wood, and brick (locked without subscription), and the floors are okay, there’s plenty of options, except you can’t use the dock without a subscription, even tho I’ve used it before, and where are the desert themed items, you have tomb things but not anything related to the most notable tombs ever? And no steering wheel or crows nest without paying, I know you need to get money to keep your app running but I would much rather watch an add every 30 mins than try to fight with not having a steering wheel or torches in my pirate ship, and don’t even get me started on logging in, I like the concept or having a rune password, but once I put it in it shouldn’t freeze and not let me in, and final thing, when I save a map that has water, when I go in to crop it to make print it on to pages, the water turns a light blue instead of the color I need, if you could fix these problems this game could easily rival any map making software If your looking for an easy map maker to throw some maps together this is perfect, but since the “free mode” it has gone downhill, there are things locked that shouldn’t be, torches, bookshelves, a lot of the plants. Washing down your tastings on tap at Soul Slice are brews from Oakland’s Federation Brewery and the Bay Area’s first Black-owned beer company, Hunter’s Point Brewing. “In our house it was made with mackerel,” said Louis “In Kentucky, it was never made with salmon.” The dish is plated with al dente garlic collard greens and roasted sweet potatoes. There’s also a play on salmon croquettes, only this time it’s a catfish croquette, a patty of fresh tender catfish and potato served with “soul sauce,” for a spike of heat. “There are so many ways to use black eyed peas and I think it’s one of the star ingredients of our menu,” Louis said of the dish, which he says is an underutilized day-to-day food beyond the Southern tradition of serving BEPs as a New Year’s day meal. The term “Hoppin’ John” refers to a story in one of the earliest American cookbooks, “ The Carolina Housewife, 1847” in which a man named John “came a-hoppin” when the dish was prepared. Consider the Hoppin’ John, a hearty and vegan dish of pressure-cooked black eyed peas, chives, garlic, onions and Carolina Gold’s rice. Credit: Brandy Collinsīut though Soul Slice’s focus is on “biscuit crust with soul food toppings,” as Lewis puts it, there are also selections on the menu that are presented on their own. Soul Slice’s catfish croquettes with collard greens and soul sauce. There’s even a pizza form of dessert at Soul Slice, a peach cobbler topped with a single large marshmallow, served on that biscuit crust with a dollop of non-dairy ice cream. “It gives more variance … and I try to be inclusive on the menu.” It’s also a nod to his roots in Louisville, Kentucky, where beef hot links are more prevalent. He chose a beef hot link for this particular pie to honor some of his Muslim family members, as well as other folks who eschew pork. “I wanted different expressions of proteins on the menu,” Louis said. The standout element here is the all-beef hot link instead of the pork links one might expect on a traditional soul food menu. Soul Slice’s best seller is its Cajun shrimp pizza, which is topped with Cajun shrimp, beef hot links, tomato, green onion, pickled peppers and tomato sauce. It was captivating to me.” It’s Soul Slice’s second best selling pie, Louis said. “It’s kind of hard to wrap your brain around. “Black eyed peas on a biscuit crust actually taste like meat,” said Louis. Less the alpine cheese, Louis said, the BEP is a vegan pie. The most gutsy pie might be Soul Slice’s black-eyed peas pizza, which contains slightly crunchy but meaty black-eyed peas, the sweetness of sweet potato, and savory roasted garlic, green onion, alpine cheese and (for acidity) tomato sauce. “Our tomato sauce carried all the flavors of the ingredients on the biscuit crust.” If you taste it, it’s a little bit sweet” Louis said. “The tomato sauce is not to mimic the sauce of Italian. And while there are five pies that have a tomato sauce base, Louis says that none of them use oregano or any other Italian seasonings in the flavor profile. The crust contains no butter, is not spun or twirled and doesn’t contain traditional elements of pizza dough, Louis said. The preparation of Soul Slice’s vegan-friendly biscuit crust is one big difference between its offerings and Italian-style pies. It is basically soul food on an open face biscuit with soul food ingredients.” But while Soul Slice uses the word “pizza” on its menu, Louis told Nosh that “We play in the genre of pizza but it is not pizza. For anyone who grew up on traditional soul food, the presentation seems downright sacrilegious. Since then, the restaurant has already gained attention for its menu of unique, biscuit crust “pizzas,” topped with Southern-style foods like black-eyed peas and hot links.ĥ849 San Pablo Ave (at 59th Street), OaklandĪt first glance, Soul Slice’s menu is intimidating and adventurous, a wide selection of traditional soul foods all served in pizza form. After nearly three decades and six brands, Lewis opened his newest venture, Soul Slice, on June 19 in Oakland, a date chosen to honor the Juneteenth holiday and the roots of soul food. “Let’s just change the narrative of soul food,” said Karter Louis, former musician and restaurateur. Donate The black-eyed peas pizza at Soul Slice. Software Usage Terms apply, See eu./legal for full usage rights. exclusively licensed to Sony Interactive Entertainment Europe. Library programs ©Sony Interactive Entertainment Inc. With this guide you will learn not only how to play, as well as the basics, but advanced strategies and calculations Ive come up with myself. This guide will have a very in-depth look at the very simplistic yet advanced game play found in Mini-Metro. The game presents you with a simple and minimalistic. The Mini-Metro Extensive Guide (beta5) By AussieCanuck. See Health Warnings for important health information before using this product. In Mini Metro, your objective is to design and manage an efficient subway system in a growing city. Your city starts with three stations.draw routes between these stations to connect them with subway lines. Sign in to PlayStation Network is not required to use this on your primary PS4, but is required for use on other PS4 systems. Game Description In Mini Metro, you take on the task of designing the subway layout for a rapidly expanding city. Hopefully, you will do a good job to ensure smooth flow of railway traffic. Begin the connection of metro stations with only three to take care of and as the game progresses, more will be put under your supervision. One-time licence fee to download to multiple PS4 systems. It is time to get your strategy making abilities tested while playing Mini Metro in its beta version. See Terms of Service for more important information. If you do not wish to accept these terms, do not download this product. Build with your friends and argue over the best design.ĭownload of this product is subject to the PlayStation Network Terms of Service and our Software Usage Terms plus any specific additional conditions applying to this product. Get 20 OFF + Free International Shipping + 2 FREE gifts with promo code REALCIVILENGINEER at https://. Each has a unique colour theme and set of obstacles. Thank you to MANSCAPED for sponsoring todays video. Stations and passengers appear on a map, and the player builds lines to get people to where they need to be as efficiently as possible. 20 real-world cities to design subways for. Mini Metro is a game about building subway maps. 3 game modes: Normal for quick games, Endless for stress-free play, and Extreme for the ultimate challenge. Compelling, constructive, hectic, relaxed gameplay. How long the city keeps moving is up to you. Each station can only hold a handful of waiting commuters so your subway network will need to be well-designed to avoid delays.Įventually your network will fail. Commuters travel along your lines to get around the city as fast as they can. It sounds like hard work, but the simple Tube-map visuals, calm music, and streamlined interactions make this relaxing, like sudoku. Draw routes between these stations to connect them with subway lines. Mini Metro (2015) is a sequencing strategy game where you create an ordered, efficient underground train system. Perfect casual game.In Mini Metro, you take on the task of designing the subway layout for a rapidly expanding city. “Love it! Simple gameplay, deep tactics. Features Multiplayer: Build with up to 4 friends, argue over the best designs, and collaborate to build the best metro network possible.“Players have one aim: to design a subway system that works.”.“Mini Metro: fun game simulates planning and running public transit system.”.“If you won’t take my word for it that a game about mass-transit system design can be a tense, white-knuckle thriller, go play the free in-browser beta of Mini Metro yourself.”.“It’s a small thing, but I’ve had the tab open with the game running for the past 40 hours.”.“Mini Metro Lets You Design Your Own Minimalist Subway System”.“If you love the city-planning aspect of Sim City but can’t handle the pressure of playing god, then you may have just found your new favorite time-waster.”. Draw routes between these stations to connect them with subway lines. – Emanuel Maiberg, iQ by Intel (article no longer present) In Mini Metro, you take on the task of designing the subway layout for a rapidly expanding city. Random city growth, so each game plays out differently. Over two dozen real-world cities Design subways for London, Paris, New York City, Osaka, Saint Petersburg, So Paulo, Istanbul, Auckland and many more Each has a unique colour theme, set of obstacles, and pace. “Mini Metro is such a perfect marriage of form and content” Build your metro exactly how you want to with the all-new Creative mode.– Philippa Warr, .uk (article no longer present) “Mini Metro is a game which marries city planning and London tube map porn thanks to its ultra-minimalist layout.”.“If you’ve ever wanted to design a subway map, you should play ‘Mini Metro’.”. type C: complete articular, the fracture is distributing the joint surface and separated from the diaphysis.Gartland classification plays a fundamental role in decision-making regarding management and prognosis. Summary Anteroposterior (AP) and lateral x-rays of the distal humerus (not elbow) should be ordered if a supracondylar fracture of the humerus is suspected. B3.1 anterior and lateral flake fracture Supracondylar humeral fractures are widely considered the most common elbow fracture in children.(A) Grade Gartland Type 2, approximately 45 degrees. B2.2 through load-bearing medial condyle Simple (2a) fractures with less than 20 degrees of angulation may be managed.B1.2 through load-bearing lateral condyle.Type C: No part of the joint is attached to the shaft. type B: partial articular, the fracture is involving one part of the articular surface, yet the rest of the joint is still attached to the metaphysis and diaphysis These fractures involve the supracondylar (metaphyseal) area of the distal femur.The AO classification divides the distal femoral fractures into three groups, A, B and C with complexity and severity increasing 1. Simple, over the counter pain killers and applying ice to the area will help to reduce swelling and pain. The distal femur system's prefix is 33, indicating it is the femur (3) and the distal portion of the femur (3). Swelling and bruising at the fracture site is normal. The AO classification of distal femoral fractures is one of the commonly used fracture classification systems in orthopedics.Įach long bone has a single number with the parts of the bone denoted numerically, the proximal end is 1, diaphysis is 2, and the distal end is 3. |
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