|This wine will be released in Vintages May 11, 2013. Currently available in BC; Nova Scotia release March 2013.|
With 160 years of Barossa heritage Yalumba continues to champion Australia's most celebrated wine region and variety with its Patchwork Shiraz sourced from several high quality yet vastly different Barossa vineyards.
The opportunity to craft a single wine of individuality and personality from a ‘patchwork quilt’ of soils, aspects, microclimates and cultures is simply too good to refuse. Through rigorous site selection, our winemakers unearth power, elegance, spice and structure – all the elements required to produce outstanding Barossa Shiraz.
The 2010 growing season began well enough with good periods of winter and spring rainfall, combined with periods of warm to hot spring weather. Unfortunately very windy conditions prevailed during the flowering period, which affected the Shiraz berry formation and subsequently caused low crops to be set. However, as the vines had grown sound healthy canopies, the low crops that remained managed to ripen to full flavour ripeness, generally some 2 to 3 weeks earlier than normal. Vintage 2010 has produced red wines that are deep in colour, have lifted aromatics and are packed full of flavour.
The Yalumba Barossa Patchwork Shiraz 2010 is dense dark purply red in colour. The aroma exhibits a mix of fresh bright berry compote fruits, dark plums and violets intermingled with a savoury complexity. This is a full-bodied Barossa Shiraz that shows richness, density and concentration. Rich dark jube fruit flavours fill the palate and are balanced with fine acidity and round, earthy tannins.


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B-coded plugs, sockets, cable assemblies and distribution connectors are available in three different colours: grey, light green and pink. Each of these three versions is available in 2-, 3- or 4- and 5-pole configurations and can be printed at the factory to suit customer requirements. All coding types for the Winsta pluggable connection system are protected against mismating according IEC 61535.


I just returned from a business trip. My first business trip since having kids, in fact.
Sure, my kids are already 3 and 5 now, but I've managed to avoid travelling for work all this time. Why? The fear of the what if's...
What if something happens?
What if they need me?
I finally put my fear aside and hopped on a plane. By the time I got home, I asked my partner the big looming question I had been harboring for five days now.
"So... how did it go? I mean, how did it REALLY go?"
The answer, of course, was "Fine."
Everyone was fine. Everything went fine. One kid had an epic meltdown before bed one night. The other kid bumped his head. But the days went fine. The evenings went fine.
I don't know what I expected to hear. Did I think the world would end when my flight lifted off the runway? Well no, but I certainly didn't think everything would be just fine.
I am, after all, the circus ringmaster. I orchestrate the elephants, the acrobats, and of course, the monkeys. Without me, I had a slight suspicion the whole circus tent would go crashing down.
But it didn't and I'm not ashamed to say that stung just a little. Because as the mama and the ringmaster, I like being the star of the show. Who doesn't? But to hand the baton to my partner, who plays a central figure in the day to day anyway? It's not as big a deal as I made it out in my head.
And my kids? They missed mama too, but I'd be kidding myself to think a few days break from their mom is going to have a negative impact on them. In fact, a little time without me there was probably good for everyone.
As I return back to my circus ring, grabbing the baton again, I realized the beautiful truth in all of this? The guilt, the worry, the stress I projected for the past five years and what kept me from travelling for work? It was all for naught.
And I think this lesson bleeds into the day to day, too. The school drop offs, the missed fall festival, and signing up for the soccer team too late? I've blamed my work on a lot of things, and I've put myself through a lot of guilt for it.
At the end of the day, whether I come home late or miss an activity or two... the kids are fine. The house is fine. Everything is fine.
This is my circus. These are my monkeys. But us working mamas? We need to cut ourselves some slack.
The show will go on.


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the rest of the team around him just isnt good enough.
it was the same for both girls
" But its probably not impressive enough
Verdasco then beat Hewitt 6-3, 3-6, 7-5,
Chris Getzlaf (Saskatchewan Roughriders
already continued their streak of eight straight trips to the World Cup,
gold medallist Ashleigh McIvor,
Jeff has over 200 starts in MLS,
Valley had the most teams ranked in the final Top 25
he threw over the same span.


Lenins Hanf - Gaststätte Zum Bautzner Tor
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Ratings: 3 | Reviews: 1 | Display Reviews Only:
4.47/5 rDev +1.4%
look: 4 | smell: 4.5 | taste: 4.5 | feel: 4.5 | overall: 4.5
I had this out of a freshly-bottled bottle at the Gaststätte zum Bautzner Tor--evidently they don't ever have it on tap, you just get these very new bottles with pieces of paper stapled around the necks telling you what the beer is.
It was awesome--pours cloudy gold with a very small head but decent lacing, smells like the lovely hemp it's been infused with, and tastes like a perfectly infused Helles--floral hops, gentle malt background, the hops and the hemp working together to please the palate rather than clashing. No discordant notes in this beer.
There's a dry finish that doesn't linger, and it's the very definition of drinkable. One of the best beers I've had in Germany.
Serving type: bottle
12-08-2009 10:54:38 | More by lstokes
Lenins Hanf from Gaststätte Zum Bautzner Tor
- out of 100 based on 3 ratings.


I absolutely LOVE this Jasmine. It is soft, velvet-y perfection. Absolutely divine.
The silver needle has a delicate flavor, of course, and I think that it pairs perfectly with the delicate sweetness of the jasmine. The flavor is sweet, floral and possesses mere whispers of a grassy-like taste. I LOVE this!


If you’re not a huge fan of flowers, or looking for an affordable alternative for your wedding centerpieces, you’ve come to the right place. Today, we’re bringing you 6 chic non-floral centerpiece ideas that will make you save money and make a lasting impression.
Bottle candle holders
Reclaimed glass bottles, printables and twine are all you need to make these gorgeous candle holders. Via Erase Tu Boda.
Metallic Shell Candleholder Centerpiece
Lustrous metallic paint gives these nautical themed decor items a glamorous holiday look.Via Martha Stewart.
Non-Floral Pinwheel Wedding Centerpiece
These DIY pinwheels give a totally handcrafted spirit to a budget friendly wedding in Malibu. Via Wedding Chicks.
Music Scores Centerpieces
A modern theme for a music inspired wedding. Via Wedding Bells.
Bottles and branches
These simple and elegant centerpieces make an with echo the sleek chairs and black napkins. Via Offbeat Bride.
Hot pepper and candle centerpiece
These chile peppers are totally unexpected and add a bit of whimsy for a formal wedding in a winery. Via Tanveer Badal Studio.


Argument essay #7 – mark lyles language analysis essay for school vouchers. the goal of classical argument position paper a position paper is to convince the audience that the essay on odysseus scar opinion presented is valid and worth classical argument position paper listening essay writing kids to writing a position paper a position paper presents an arguable opinion about an issue. the parts of a classical argument are arranged logically. you are required to find at least classical argument position paper four credible sources, including one scholarly what i like the most essay source, to incorporate into your argument somehow, either as support for your position or as an objection to answer. the topic you select this week will be the cheap essay writing services topic you will argue in the classical argument assignment. 1. but. criminology research paper topics a week later the client was rejected from working at the company and in raging frustration made a facebook page claiming “best buy” was racist and was discriminating against the individual for being of african-american decent like a debate, a position paper presents one side of an arguable opinion creative writing topics for grade 2 about an issue. how can you draw. 007 essay example death penalty introduction essays on capital. p vs. some teachers believe that students feel more. classical argument position paper | why do asian cultures believe that the sample term paper topics horns of rhinos possess medicinal and magical healing power? Learning cambridge creative writing to spot a strong argument in what you read can how to write a informative essay help you classical argument position paper become better at constructing your own arguments when you write the classical model argumentative essay takes into account the following things: in this part of your essay, you should argumentative essays examples demonstrate your arguments in detail and support them. the classical argumentative essay classical argument position paper is an argument that provides scholarly evidence lease assignment agreement of research (i.e.


I searched about this topic a while ago. I saw people that shared their designs for inspiration, trying to help beginners to find their unique style etc. But app called "Canva" attracted my attention most. My overall impression about this app is: Canva is beginner friendly, have easy controls and even if you are not a premium member; Canva gives you multiple templates,stickers,font types and options. After my research I tried Canva without being premium member and i designed cute and modern logos, instagram posts and name tags for an event. I can reach so many useful elements without any difficulty. As far as i know it has only a web version on computer and laptops. But i did all of my designs on mobile and it was pretty easy. You can download on IOS and Android. Hope this helps, have a nice day.


11.1 Calculate the mass % of each distillate fraction and the residue to the 0.1 mass %, using Eq 1.
m = mass of fraction or residue, g, and M = mass of dry crude oil charged, g.
11.1.1 The first fraction is the gas fraction collected in the balloon. If this fraction is less than 0.1 mass %, it can be ignored.
11.1.2 The second fraction (or first, if no gas is collected) is the condensate in the dry ice trap. With density at 15°C calculated from the gas chromatographic data on a fixed gas free basis, its volume can be computed.
11.1.3 The holdup is treated either as a separate cut or added to the residue fraction, in accordance with agreement. The amount of holdup is determined by actual recovery by solvent washing, as directed in 10.5.8, or estimated from Fig. 4.
11.2 Calculate the percent loss to the nearest 0.1 mass %, using Eq 2.
The weight loss as calculated above must not be greater than 0.4 %, otherwise the distillation must be discarded. Losses less than this should be allocated two thirds to the trap cut and one third to the first naphtha cut. Where there is no trap cut, the acceptable losses are to be normalized among all cuts.
11.3 Calculate the volume of the sample of crude oil in millilitres at 15°C, using Eq 3.
D = density of charge at 15°C, g/mL, M = mass of dry charge, g, and V = volume of charge, mL.
11.4 Calculate the volume of each fraction and of the residue in millilitres at 15°C, using Eq 4.
d = density of the fraction or residue at 15°C, g/mL, m = mass of fraction or residue corrected for loss, g, and v = volume of fraction, mL.
11.5 Calculate the volume % of each distillate fraction to the nearest 0.1 volume %, using Eq 5.
11.6 Calculate the volume % gain or loss to the nearest 0.1 volume %, using Eq 6.
Usually, the above expression is negative due to volume expansion. Normalize any apparent expansion or contraction among fractions boiling below 150°C in proportion to their yields.
Note 5—In view of the foregoing rules for establishing yields, the ratio of mass to volume is not precise enough to be used to calculate the density of any distillate fractions or residue.
12.1 A summary sheet for the run must include:
12.1.1 The mass of the dry sample charged, g,
12.1.4 The gain or loss in mass and volume to the nearest 0.1 %,
12.1.5 The volume and mass % of each fraction to the nearest 0.1 %,
12.1.6 The cumulative volume and mass percentages, and
12.2 The gas, debutanized naphtha, and succeeding fractions are listed in order of ascending boiling point with residue recorded last.
12.3 The observations made in 10.3.5, 10.4.7, and 10.5.4 are included as a second sheet, which is normally attached to the summary sheet.
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With that being said, here are some signs to look out for that you may be in a dead-end relationship. Hey, it could be worse. Just be glad you don’t have a sex tape floating around the web… yet. Check out comedian Michelle Buteau’s.
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As a small grassroots coalition in Ontario launches a legal challenge against separate school funding, Charles Pascal is renewing his call for an end to public dollars paying. one secular school system for some time, and sees this court.
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These Last Days Ministries presents Bayside End Times Prophecies of Our Lady of the Roses, Mary Help of Mothers aka Our Lady of Fatima and Jesus to the world through.
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Andy Murray has mutually agreed to end his relationship with coach Ivan Lendl for a second time, the British former world number one said. Murray was previously coached by Lendl from 2011-14 before he rejoined his team in June last year,
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However, in every relationship, there is a tipping point or a point of no. system the impression that the United States is in decline and on the losing end of the classic “Thucydides trap.” Outside of traditional power politics, the call for the.
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An attorney for prisoner Kyle Kennedy held a press conference Wednesday afternoon to shed some more details about the relationship his. to see the former tight end. He told Army he was "stunned and saddened" by the news, and was.
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Have you ever noticed that a lot of relationships end after the holidays. dreamland and pretend everything is okay." This time of year also has a funny way of putting the pressure on your relationship. "We’re exposed to family dynamics and.
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EU leaders have agreed to move Brexit talks on to the second phase but called for "further clarity" from the UK about the future relationship it wants. While securing a deal in time for the UK’s exit in March 2019 was realistic, he suggested.
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It’s Time to End the War on Salt. The zealous drive by politicians to limit our salt intake has little basis in science
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Part II: The Stunning Conclusion of
Paranormal Squirrels of the Fourth Kind
I walked with rubbery knees and roused Eric to enlist him into this new game of life or death.
As he shook the cobwebs from his head I explained the quandary that we were in. He quickly pulled his boots up and was ready for action. As he brandished his gun I was followed into the living/dining/family room. Of course like in any scary movie the other person hears nothing when they are awoken and asked to be the protector of the protagonist.
After a few tense moments he heard the mysterious noises and became convinced that I was non compos mentis. As I was unarmed I quickly looked for a weapon to protect my kinsmen and myself with. I had few options to choose from. A lawn chair, a chinese checkers board, and a hatchet. I decided to go with the lawn chair thinking that I would need a place to sit after we apprehended with the assailant. But thinking more three dimensionally I chose the hatchet.
On the count of three we burst through the single-wides front door with the force of an eight-man swat team. Feeling extra courageous I stormed out first with the hatchet in one and a flashlight in the other. I was ready to meet an onslaught of hot lead. To my surprise there was not a soul in sight. With a quick sweep of my light I turned and started to go around the trailer to check the back of the trailer thinking that the intruders had some how heard our plan of attack.
With Eric hot on my heels I turned the corner and to my utter surprise saw nothing again. As we get to the middle of the trailer where a good majority of the mischievous sounds were coming from. We stood for an instant in silence. I was feeling rather sheepish for waking Eric and charging out in the dark. But more so for making him participate in my shenanigans.
Then we saw it.
It was a blood streaked flash of gray. As this demon beast ran by me up the tree, I caught a look into its bloodthirsty eyes; I was practically placed in a trance. I wished then I had chosen the lawn chair so I could’ve collapsed in defeat to this formidable foe.
I could not believe my luck. I had just been spared by on of the most depraved, diabolical, dark creature this world has to offer. A Paranormal Squirrel of the Fourth Kind.
With a quick shake, Eric brought me back to reality and we quickly made our way back indoors. I was nearly speechless when he helped me to chair. Eric in disbelief explained what to me what happened. Some how this demon Squirrel had shown mercy on us. We were given a second chance on life.
Eric excused himself to change his shorts, while I took a deep breath for the first time in what seemed like hours.
We had survived an ordeal that few could claim. We had survived an attack by a Paranormal Squirrel of the Fourth Kind.
Few people know this about Squirrels but they are the number one threat to this world. They appear cute and cuddly but the moment you turn your back, or in my class close my eyes they will attack with the ferocity of a liger. (A liger is a mix between tiger and lion that are breed for their skills in magic.)
The next morning we were happy to be alive but we were stunned to see what was written on the door.
Like I said, these things are evil!!
As I looked through the window to make sure that the coast was for us to vacate the premises this is what I saw pressed against the window. It was the very same Squirrel that had nearly killed us the night before. Luckily I was quick on the draw and was able to take a picture.
On further investigation, while dressed in full camouflage, we searched the premises were able to take some pictures of a small colony hiding behind our outhouse. As you can see these squirrels are pure evil.
Here is a home grown evil squirrel working with other Evil squirrels of the forest.
If any of you have had similar experiences please share. We must unite and fight against the forces of evil! And Squirrels.


Our summer vacation has officially started and to be honest I’m ready for the kids to go back to school. Don’t tell them I said that! There’s the unlikely possibility that they’ll find out since they NEVER read the blog. While I love summer, and you may have read why I think summer is better than winter, I would prefer if the kids can get out and spend some time outdoors and get to experience things that I won’t be able to teach them. That’s where summer camp comes in. Summer camp can be super fun for many kids, but parents are often questioning what is the purpose behind spending the money and planning the event of sending their kids off to summer camp. Sure, there is the fun factor that parents are usually aware of, but what kids learn while having fun at camp goes beyond what most parents think about. Today we are going to share a few reasons why kids should go to summer camp.
Increased Self-Esteem – when kids attend a camp during the summer season they don’t have their parents right there to help them approach new people and new experiences. Kids have to learn to put themselves out there without the guidance or support of their parents. This helps kids feel good about themselves as they work to strengthen their interaction skills.
Nature Education – many kids are not aware of what is out there in nature, they spend most of their time on electronics or just in their local neighborhood which doesn’t always bring them in tune with true nature. Kids who attend summer camp experience nature in a whole new light and in turn learn more about the benefits of nature when they are at camp.
Develop Leadership Skills – kids will learn to develop great leadership skills at summer camp as they are put in charge of directing projects and their peers along the way at camp. In combination with leadership skills, kids learn to overcome peer pressure in their everyday lives as they were able to overcome those insecurities while attending summer camp and gaining an increase self-confidence level.
Trying New Things – no matter how involved of parent one is, the truth is, no one set of parents can introduce their kids to every opportunity and experience there is in the world, sending your kids off to summer camp allows them to be introduced to, and try new things that otherwise wouldn’t be offered to them in your local area. This breeds a group of well-rounded, open minded kids who will go on to enjoy life a bit more than your average kid.
Makes Wonderful Memories – how many of you attended summer camp yourself and still have those memories of camping, swimming and learning all of those new skills the camp brought into your life? Sending your kids to summer camp allows them to have wonderful memories to think back upon as they age and grow into adults. Most kids have some positive memories from summer camp and are able to come home to share those memories in a positive way.
Life is all about engaging in new experiences and working to gain self-confidence as you thrive to be your own individual person. Sending your kids to summer camp opens the door for new opportunities and everlasting friendships, combined with a new ability to lead and educate others about their newly learned skills, while being at camp.
Let’s discuss: Have you ever attended a summer camp, what your experience like?


Bulk_Carrier (6064) - Vermont, USA - JUL 14, 2014
This was poured into a pilsener glass.
The appearance has a nice bronzed amber color with a light transparency about it to have some light carbonation to be seen rising. There is a two finger white foamy head that mushroom caps and dissipates at a nice pace leaving a messy sort of thick lacing all around the glass.
The smell had some dried sweet caramel malts with a rich sort of nuttiness running underneath to amplify a wonderful aroma.
The taste was extremely nice through the rich caramel malts and a delicate nutty flavoring.
On the palate, this one sat about a light to medium on the body with a pretty good sessionability about it. The carbonation ends up being somewhat smooth and creamy but still lets in enough harshness.
Overall, whoah, where did this come from Schmaltz? Good job with making a very good Vienna Lager. Hidden_Pooch (518) - Stratford, Prince Edward Island, CANADA - MAY 19, 2014
Probably the first good lager I ever had. With actual taste, it left me quite surprised. With hints of caramel and bitterness, but all at a subdued lager level. I found it to be very spicy and herby as well, but all within a comfortable range. I rated it so high, because this is what lagers have the potential to be, instead of light piss water. howlinwlf (26) - Ronkonkoma, New York, USA - APR 4, 2014
Poured into an imperial pint glass. This lager poured a great amber cloudy color with a frothy head. What a great flavor! This is a bold lager, lager being the foundation. On top of that just enough malt and a good heap of hops. Big round mouthy flavor. Cheers! Kita (2304) - Koper, SLOVENIA - DEC 22, 2013
On tap @ Brass Monkey, NY. Clear amber color with thin creamy off-white head, excellent lacing and average sparkling appearance. Aroma of toasted, caramel and biscuit malt, herbal and mild floral hops. Taste starts with sweet caramel malt, following is refreshing fruity and grainy sour, while finish is moderate bitter. Medium body, slick texture and average carbonation in palate. Surprisingly good for bottom fermentation brew, but that’s American quality... Beergeek23322 (2602) - Chester, Virginia, USA - DEC 12, 2013
4/9/2011. From bottle. Light amber color with a white head. Malty aromas with hops. Good balance, plenty of hops and flavors. Very tasty.
patxa (210) - MEXICO - NOV 26, 2013
Tasty lager here. Bubbly and with caramel notes. Ambet looking, light bodied. Short, weak palate, and thats why is just a good try but nothing compare to the Brooklyn Lager. Bamsen78 (5617) - Sønderborg, DENMARK - OCT 4, 2013
Bottle. Pours slightly hazy amber with small off-white head. Clear aroma of grain with touches molasses and caramel. Bitter, hoppy flavour with notes of caramel and citrus. Not bad, but more reminiscent of an APA than an Aber Lager. ansermadide (1526) - Kyle, Texas, USA - AUG 4, 2013
Bold, orange-amber in color with a full, off-white colored head, this beer is clean with moderate carbonation. The aroma is simply of an amber lager, with light caramel easily dominating the nose. A grainy character is also present, coupling with a dusty antique smell. The flavor is as expected, but very close in redness to that of an amber ale. Caramel malts prevail slightly over the inherent overall lager character. Something earthy
remains at its core, though, and shines in the finish. It’s likely pilsener malts and perhaps the character of its hops, but it simply tastes like the caramel simply, and finally, takes the back seat. Overall, not that I pleasant, but still much better than most amber lagers. tlind2 (1820) - Helsinki, FINLAND - AUG 1, 2013
[email protected]Rob_D_UK (1366) - Madrid, SPAIN - JUL 30, 2013
Copper color, off-white head. Smooth flavor, good balance. Malty with a hint of nuttiness and a hoppy finish. Medium body, medium carbonation. Nice!
Pours a clear amber body with a medium-sized creamy off-white head. Aroma of caramel, citrus, grass, and florals. Flavor of caramel, mild grassy hops, nuts, and toasted malt.


2023 Summer Camps
Viking Woodworks & Learning Center is hosting five unique summer camps for the Youth Center for ages 5-12 years old!
All sign ups are done through your CYPBMS account under camps and instructional classes (Open Rec Field Trips). Your CYPBMS account will need to be current to include shot records to be processed.
Cost of camp is $0.00
Time of camp is 0900-1400
Camp is located at 1251 E Onstott Rd., Yuba City 95991
July 5-7: Art Explosions
Sign up Deadline 30 June
Art Explosion week is a fun filled messy week! Hydro dipping, tie dye, crayon art, and so much more.
July 10-14: Marine Life Camp
Sign up Deadline 5 July
This hands-on class will focus on all things ocean. Tides, marine animals, grasses, reefs, and so much more.
July 17-21: Space and Science
Sign up Deadline 12 July
Learning about space with art and hands on activities. How do you solve a crime? Fingerprinting science, observation skills, and a fun day of crime solving.
July 24-28: Knights, Dragons, Unicorns, and More
Sign-up Deadline 19 July
Explore the world of make-believe and fairy tales with this week’s camp. Hands on activities will vary to include dressing up!
July 31- Aug 4: Best of the Best
Sign up Deadline 26 July
The Best of the Best includes 1 day of each of their best camps!!! Woodworking, Cupcake Decorating, Viking Warrior, Everything Summer, and Art Explosion.
Steps to enroll in CYP-BMS
- To begin process for enrollment, please fill out the form below.
- Families requesting access will receive a time-sensitive registration link for the CYP-BMS Parent Portal.
- Create your Family Record and profiles for all participating children, set up automatic payment and upload current immunizations.
- Search for Parent’s Night Out under Camp/Instructional Classes.
For PDF version of CYP-BMS form, click HERE!


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Top 5 social channels?
The newest addition to the growing list of features, the emoji slider.
““The emoji slider lets you ask more nuanced questions when you want to find out how your friends feel about something. By choosing an emoji for your question, you also add a layer of emotional context that helps those answering understand your tone and answer accordingly.”
Instagram is adding more tools to increase the usage of Instagram stories and steal share from Snapchat. At this point, it’s clear who is in the lead since IG has added several highly engaging features to the platform with more on the horizon.
How can brands use emoji sliders? To gain more information from their audience about their content and/or products services. This is 1:1 social listening on a grand scale with seamless and non-intrusive audience participation.
Why it’s hotter than a flame emoji:
This is a cool addition to the tool belt but it’s definitely not the last!
Instagram has also been testing in-app purchase features which would completely elevate the options available to marketers and users. IG is slowly making strides to be on par with WeChat, which has already infiltrated almost all aspects of a users life in the China market.


The Medical College of Wisconsin (MCW) will host a one-day workshop on autonomic disorders on Friday, September, 6, 2013, at the Sheraton Brookfield in Brookfield, Wis. The conference is expected to attract primary care practitioners, neurologists, and allied health care professionals.
The autonomic part of the nervous system is that which controls involuntary actions such as the beating of your heart and the widening or shrinking of blood vessels. Patients with an autonomic disorder can see a dozen doctors over several years before receiving a diagnosis.
The workshop, which will include a rotating practicum with patients with autonomic disorders, includes keynotes from lead neurologists at MCW, as well as visiting specialists.
“The title of the workshop is ‘Faints, sweats and leaks’ because all those symptoms can occur in these patients— blood pressure, sweat glands and bladder function can all be impacted by these disorders, and it can be frightening to patients who have no idea what’s wrong with them, and often leaves their care team puzzled,” said Thomas Chelimsky, M.D., professor and chairman of neurology at MCW. “This workshop aims to arm those care teams with the newest information about autonomic disorders and how to identify and treat them.”
For more information, visit http://ocpe.mcw.edu/neuro/content/autonomicworkshop. email Vicki Conte at email@example.com or call (414) 805-8326.
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- Callen Says Weatherize Now to Save Energy in Winter
- LifeTime OB-GYN Joins Froedtert & the Medical College of Wisconsin Health Network
- First Congregational Church Offers Seminar on How to Help the Grieving
- Peter Mayer Concert in November
- Film Screening: Merchants of Doubt
- Monster Run Movie and Pumpkin Lighting
- Lutheran Home Foundation Monarch Ball Raises Record Amount
- Holiday Folk Fair to Help Celebrate Italian Heritage Month
- Rudyard Kipling comes to Milwaukee in advance of his 150th birthday!
- R.A. Smith National Given Green Light from FAA on Commercial Use of Unmanned Aircraft System (UAS)


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Claim 52 Fundraiser
December 4, 2018 @ 11:00 am - 11:00 pm
Join us Tuesday, December 4th at Claim 52 Kitchen where $1 from every pint sold will be donated to the Eugene Science Center. Come down and enjoy quality craft beers while supporting a great local cause!


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This summer, New Yorkers have rediscovered a sense of comfort and community on their stoops, the city’s de facto gathering place. The densest city in the United States, with backyards few and far between, New York has, through the ages, relied on its stoops as living room, playground and water cooler. While bars and restaurants have reopened, relocating their operations to patios and sidewalks, the boroughs’ stoops remain populated as neighbors and families gather together for a spontaneous happy hour or an organized socially distant dinner party.
Over the span of a week in Brooklyn, I walked its streets to see how people have spent their summers, what they’ve been drinking and what they’ll do once our hemisphere begins to lean away from the sun. On one block in Fort Greene, I found local musicians setting up an impromptu stage on the sidewalk; locals had opened their doors and a bottle of wine, taking a front-row seat. In Brooklyn Heights, a small group gathered on the stoop to meet a friend’s newborn while sending off another friend who was moving to the West Coast. In Bed-Stuy, a birthday and life were celebrated and remembered by a group of Solo cup–toting women. And in Carroll Gardens, a lifelong borough resident relaxed with a book and a pint of his favorite beer.
The stoop, which has always been a symbol of Brooklyn life, seems to have been rediscovered during these last fraught months, reanimated with New Yorkers seeking respite in a common place.
Michelle Sprott (right) and Janet Hollis (left) stop by a friend's stoop for spiked lemonade and Moët & Chandon Rosé Impérial Champagne.
Michelle Sprott and Janet Hollis
Drinking: Lemonade and Bulleit bourbon, Moët & Chandon Rosé Impérial
How has your summer been?
Michelle: Actually, I’m not mad at it. I’m not mad at the summer. I’ve had a great summer. Despite everything, I’ve still managed to have a really good time. Especially reconnecting with people more intimately, I like that better. And I needed a break. I needed a serious break. You’re finding you’re having more intimate gatherings than larger parties. You know, prior to COVID, we were relying on digital and becoming disconnected with each other. COVID has kind of checked us again and let us know that we really do need our friendships and to see each other in person and how vital it is to our mental health. Before, I saw friends on social media; that was enough. Everyone’s communicating but not connecting. This reminded us, “Oh my goodness, I need to have brunch with my girls.” It’s social self-care. That’s social self-care to go out and drink, what we’re doing right now, interacting—you get a social high from it.
What are your go-to quarantine drinks?
Michelle: Tequila, anything brown. Gin or Bulleit.
What brings you all together today?
Michelle: We’re celebrating a birthday. A neighbor’s birthday. We all know each other. It’s like an interconnectedness, a web, one degree of separation for all of us.
Janet: I’d like to say RIP Chadwick. We’re celebrating his life as well today. He’s reminded us that we have to live every moment and enjoy every moment, because life gets taken away from you just like that. 43 years old, and all the stuff he’s accomplished while battling cancer. Whatever is going on in your life, it’s probably not the end, you can persevere, you can come out on the other end.
What will you do come fall?
Michelle: That’s what we were just talking about. Friends actually went to a very intimate dinner party setting, where you can get a membership and have dinner parties there. So I guess we’ll be doing that. Intimate dinner parties.
Sebastian Koeltzsch and Emily Longfield
Neighborhood: Brooklyn Heights
Drinking: A bottle of Familie Bauer Barig Alte Reben, Brooklyn Cider House’s Bone Dry Cider, a bottle of Old Westminster Piquette.
What have you been drinking?
Sebastian: A lot of white wine and spiked seltzers. My new favorite, the Montauk Spiked Seltzer.
Emily: We’ve been drinking impressive amounts of spiked seltzers, to stay hydrated.
What’s summer been like for you?
Sebastian: It’s definitely slower than usual. I was able to recharge and got in a lot of runs and workouts.
Emily: Summer felt like how summers once were, no school, no job, no curfew, plus a fixed weekly allowance.
Where have you been drinking, and who do you drink with?
Sebastian: We’ve been either drinking on our balcony or our stoop. Mainly the two of us, sometimes our neighbors, or tonight, friends join.
What will you do when fall comes?
Sebastian: Hopefully we’ll be able to travel and see our family on the West Coast and Europe.
George Sawaya drinks a weissbier on his Carroll Gardens stoop.
Neighborhood: Carroll Gardens
Drinking: Franziskaner Weissbier
What’s been your go-to drink this summer?
George: What has it always been? This. Weissbier. I prefer Bavarian style, but a Belgium style is okay too. I love beer. Did you watch the hearings about Kavanaugh? There’s one thing I share with Brett Kavanaugh. I like beer. That’s the only thing I could share with him. It’s very refreshing. And seriously, I love beer. I never met a beer I didn’t like.
Who have you been drinking with?
George: Mainly my family. A couple friends come by or I’ll go there, a couple blocks away. Really that’s why I hate [quarantine] so much, I have hardly been out at all. Time takes on a whole different quality. I find the days have no markers. I have to think hard about what day of the week it is.
How long have you lived in the neighborhood?
George: 42 years. I’ve lived in Brooklyn my whole life.
What’s your summer been like?
George: Well, horrible. You’re under house arrest. I hate this. But what are you going to do. I’m lucky because I have this space to come out to. I have a deck in the backyard, so I have plenty of outdoor space. And you know, my granddaughter only lives a couple blocks away and was living in the house up until a couple months ago. She’s 3, so I’m lucky for that.
Lindsay and Kayvan Salmanpour, Cole Harry
Neighborhood: Fort Greene, Brooklyn
Drinking: Beck’s, Wölffer No. 139 LoRo Cider, pastis
What have you been drinking during quarantine?
Lindsay: Dry rosé cider. After many, many months of overdrinking during quarantine, I’ve transitioned into this low-alcohol content cider. It’s my later-stage quarantine beverage. My early-stage quarantine beverage was a lot of Burgundy.
Cole: What haven’t I been drinking? My go-to, we’ve been ordering cases of wine from Brooklyn Wine Exchange, and we’re drinking a lot of Sicilian wines, some Burgundies; we try to mix it up with a bit of natural, funky, sparkling stuff. And I recently discovered the joy of pastis. That’s my new thing. It’s a summer drink in the south of France and it’s very good.
What’s your summer been like?
Lindsay: We’ve been here; we have nowhere to be.
Cole: I sit on the stoop all the time and talk to everyone.
Lindsay: Especially in Fort Greene. We know the neighbors here and here, and up and down. I think with COVID, Fort Greene is perfect for community. Your neighbors become your pod.
Does this band play often here?
Kayvan: No, this is actually their first time. They play around. They played on Vanderbilt once. Andy (musician pictured on the far left) lives on this block, he’s a neighbor.
What do you think you’ll do in the fall?
Cole: I will still hang out on the stoop, I don’t care if it’s cold. I just moved from California, so the winter doesn’t exist in my head.


Expatriate Manuals Prevent Individual Deal Making
Even though manuals are valuable, they're not frequently used. Part of the reason for this, says Laura McMillan of Dallas-based KPMG Peat Marwick, is that many companies don't have standard policies. Effective expatriate manuals articulate policy clearly. In fact, companies may have individuals who try to circumvent the system that's in place in order to get better benefits. "You get into a lot of problems when you do everything on a one-time basis, she points out. "You'll have everyone trying to develop their own personal package." The manual reflects a strategic policy. This is the first step.
Another key problem, according to Kathryn Devos of Kenilworth, New Jersey-based Schering-Plough, is the mistake of thinking that international relocation is similar to domestic relocation. "Domestic relocation policy is real estate driven. International policy is people driven," she says.
Effective international relocation policy also must focus on cross-cultural issues and psychological factors that will affect the expatriate's success. It has to take into account a raft of other financial considerations such as educational expenses, travel expenses and compensation for alterations in the standard of living.
Start by determining the objectives. Obviously, you're not going to write down specific compensation packages, but the general guidelines of eligibility and level of employee can be included. It's important to define benefits because most of us are geared to benefits as they apply in the U.S. For example, pension and 401(k) plan participation may be affected by time spent in a foreign company. Vacation policies are different from one country to another.
Other items to address are: compensation packages, tax reimbursement policy, procedures regarding U.S. real estate—sales vs. rentals—through local management agencies.
A detailed, country-specific appendix can list some of the cultural and business
differences as well as the types of premiums for certain countries. For example, firms compensate expatriates going to the desert in Africa with hardship allowances while they may not do that for those going to Paris.
Define who the manual applies to. Will it be for U.S. employees only or for third-country nationals as well? How does it pertain to multinational employees coming to the U.S.? Does the policy apply to short-term assignees?
"A manual avoids people using leverage to cut their own deal, which would create problems with morale in the host locations," says Per A. Thorsrud of KPMG Peat Marwick. "It's very important."
Finally, include information about repatriation. General policies and guidelines are important so expatriates and potential expatriates know they are not forgotten when they're abroad. All too frequently, expatriates leave the company after they return to the U.S. Often, this is simply due to lack of planning and communication by management.
Personnel Journal, April 1994, Vol.73, No. 4, p. 56.


Do you know how your daily habits, food and supplements affect your cognitive performance, learning, motivation and memory?
In this insightful and practical talk with Ryan Munsey we explore nootropics, cognitive enhancement and biohacking.
You will learn what people often get wrong about nootropics, the steps for cognitive enhancement for beginners and vital tests that even most advanced biohackers miss, and what steps anyone can take to get quantifiable results and avoid the pitfalls while optimizing their cognitive performance.
Ryan Munsey is Chief Optimizer at Natural Stacks and hosts the Optimal Performance podcast.
He is a former fitness model and gym owner turned writer, speaker, and biohacker. Ryan has a dietetics degree in Food Science and Human Nutrition from Clemson University.
After graduation, he spurned the traditional R.D. route to pursue fitness modeling in New York City where he also began his career as a personal trainer and nutritionist. Ryan is also an avid hunter and resides in his hometown of Roanoke, VA.
We talk about
– How you can take your cognitive performance and memory to the next level with nootropics and other proven methods
– What most people get wrong about nootropics and cognitive enhancement
– The must-do measurements that you need to choose the right methods and nootropics for you
– Ryan’s favorite biohacks and preformance boosting methods in everyday life as a traveling entrepreneur
– How to find the best nootropics for you, reap the benefits and avoid the downsides of nootropics
– Why sleep is the most powerful nootropic
– How to determine your baseline and focus on improving the right things in your cognitive performance
– Origins of nootropics, synthetic and natural forms
– A herb that had been used for centuries in Chinese and Ayurvedic medicine to reduce stress and cortisol
– What exogenous ketones Ryan uses and why
– Ryan’s travel kit
– Ryan’s favorite method of monitoring ketone levels
– Cognitive hacking


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Background: Findings from autopsies have provided evidence on systemic microvascular damage as one of the underlying mechanisms of Coronavirus disease 2019 (CO-VID-19). The aim of this study was to correlate autopsy-based cause of death in SARS-CoV-2, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive patients with chest imaging and severity grade of pulmonary and systemic morphological vascular pathology. Methods: Fifteen SARS-CoV-2 positive autopsies with clinically distinct presentations (age 22–89 years) were retrospectively analyzed with focus on vascular, thromboembolic, and ischemic changes in pulmonary and in extrapulmonary sites. Eight patients died due to COVID-19 associated respiratory failure with diffuse alveolar damage in various stages and/or multi-organ failure, whereas other reasons such as cardiac decompensation, complication of malignant tumors, or septic shock were the cause of death in 7 further patients. The severity of gross and histopathological changes was semi-quantitatively scored as 0 (absent), 1 (mild), and 3 (severe). Severity scores between the 2 groups were correlated with selected clinical parameters, initial chest imaging, autopsy-based cause of death, and compared using Pearson χ2 and Mann-Whitney U tests. Results: Severe pulmonary endotheliitis (p = 0.031, p = 0.029) and multi-organ involvement (p = 0.026, p = 0.006) correlated significantly with COVID-19 associated death. Pulmonary microthrombi showed limited statistical correlation, while tissue necrosis, gross pulmonary embolism, and bacterial superinfection did not differentiate the 2 study groups. Chest imaging at hospital admission did not differ either. Conclusions: Extensive pulmonary endotheliitis and multi-organ involvement are characteristic autopsy features in fatal CO-VID-19 associated deaths. Thromboembolic and ischemic events and bacterial superinfections occur frequently in SARS-CoV-2 infection independently of outcome.
Coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus is a challenge for health-care systems and for affected patients worldwide . Hypoxic respiratory failure is the leading cause of death in patients with severe CO-VID-19 disease as is also seen in other respiratory viral infections. The general histological correlate of acute respiratory distress syndrome (ARDS) is diffuse alveolar damage (DAD) characterized by intra-alveolar hyaline membrane formation, edema, and hemorrhage in the acute stage, followed by fibroblast proliferation in the organizing stage. DAD is a nonspecific finding with a long list of potential etiologies, including other viral diseases, like influenza and SARS-CoV [2-4]. However, severe COVID-19 is associated with early pronounced gas exchange disturbance and particularly severe hypoxemic respiratory failure compared to the degree of radiographic abnormalities and more severe multi-organ failure compared to, for example, influenza, particularly in patients with vascular risk factors [2, 4-6].
Among the distinctive attributes of COVID-19 are associated microvascular changes and thrombosis [2, 7]. Endothelial cells not only play an important role in the pathogenesis of ARDS but also in the pathogenesis of multi-organ failure. This is thought to be due to vascular inflammation (endotheliitis) and mediating inflammatory cell infiltration as well as apoptotic bodies found in different organ systems [7, 8]. This systemic endotheliitis with evidence of modulation of vessel barrier integrity, promoting a pro-coagulative state could thus explain the disproportional hypoxemia in relation to radiological changes and complications seen in different organs in patients with COVID-19 . Quantitative RT-PCR results for SARS-CoV-2 also demonstrated that SARS-CoV-2 has organotropism beyond the respiratory tract, including the heart, the brain, skin, subcutaneous tissue, neuromuscular system, the kidneys, the intestine, and the liver [5, 6, 10-15]. Recent terms such as cardio-COVID-19 define the increased risk for cardiac injury, such as arrhythmias, fulminant myocarditis, while neuromuscular-COVID-19 refers to a broad spectrum of associated neuromuscular disorders, hyposmia, anosmia, etc [10-12].
Risk factors for a severe disease course of COVID-19, such as old age, obesity, hypertension, and diabetes mellitus are all risk factors for pre-existing vascular dysfunction with altered endothelial metabolism, and therefore might explain the worse outcome in these patient groups . Since the outbreak of the pandemics, several further parameters including tissue-based factors have been identified in association with severe disease course in COVID-19 [5, 6, 13, 17-19]. Complement activation and increased neutrophilic infiltration of pulmonary capillaries and extracellular spaces (so called NETosis) have been described in autopsy studies and have been associated with an explosive inflammatory response and a poor prognosis in COVID-19 [17, 19, 20]. The interaction between viral-induced endothelial necrosis, excessive cytokine production (“cytokine storm”), and a systemic viral vasculopathy syndrome have been described in several autopsy-based studies [5, 13, 18, 20]. A recent meta-analysis on published COVID-19 autopsies conclude that DAD is the most common pulmonary mortality cause and that a broad spectrum of ischemic necrosis, endotheliitis, and thromboembolism characterize extrapulmonary COVID-19 disease . Different from other respiratory pandemics, such as in SARS-CoV-1, the extensive thromboembolic events and multifocal endotheliitis is more often seen in COVID-19 . Damaged endothelial cell activation and increased plasma von Willebrand factor antigen have been described as the key drivers in severe COVID-19 disease along with associated coagulopathy [21-23]. Whether a sum of the aforementioned factors or any single parameter alone may contribute to poor prognosis or can predict lethal outcome in COVID-19 is a challenging question to address in individual patients.
The aim of this study was to correlate autopsy-based cause of death in SARS-CoV-2 positive autopsies with selected clinical parameters and with the severity grade of pulmonary and systemic morphological vascular pathology. We addressed the questions (a) whether SARS-CoV-2 infection has any distinct morphological vascular pattern depending on the autopsy-based cause of death, (b) if pulmonary thromboembolic events and bacterial superinfection have an impact on COVID-19-associated death, (c) how the involvement of extrapulmonary sites affects fatal outcome, and (d) if some clinical parameter may correlate with morphological findings or cause of death identified at autopsy. In order to answer these questions, we analyzed 15 SARS-CoV-2 positive autopsies with 2 distinct clinical late phase disease patterns: 8 patients deceased due to CO-VID-19 associated respiratory or multi-organ failure and 7 patients died due to other reasons based on autopsy results.
Material and Methods
Postmortem examinations on 15 SARS-CoV-2 positive deceased patients were performed at the Institute of Pathology and Molecular Pathology of the University Hospital Zurich, Switzerland, according to standard procedures in a biosafety level 3 isolation room.
The diagnosis of SARS-CoV-2 infection was confirmed by real-time reverse transcriptase-polymerase chain reaction testing (rRT-PCR) on nasopharyngeal swabs prior to and during hospitalization in 14 of 15 patients. In 1 patient (patient 2), postmortem formalin-fixed and paraffin-embedded (FFPE) lung tissue was positive for SARS-CoV-2 using rRT-PCR in the Reference Infectious Pathology of Switzerland in the Institute of Pathology Cantonal Hospital Liestal Switzerland using the methodology as described earlier . In all patients, a complete autopsy was performed including macroscopic organ assessment and histological analysis of a predefined organ list. The organs of the central nervous systems were examined in the Institute of Neuropathology, University Hospital Zurich (in collaboration with KF).
For histological diagnosis, tissue sections from FFPE tissues (2 μm) from all organs (fixed in 4% paraformaldehyde) were stained with hematoxylin and eosin (H&E) according to standard techniques. The diagnoses and histopathological features in this study were carried out on gross examination and using routine H&E stains on tissue sections. Fibrin thrombi were confirmed with fibrin stains (modified Picro-Mallory stain). A large subset of cases underwent further immunohistochemistry analyzes and were characterized by a panel of lympho- and hematopoietic and further markers (such as CD3, CD4, CD45, CD68, and ACE2). Selected lung, kidney, and heart samples were tested for the presence of viral particles and viral-like particles using FFPE or frozen snap tissues for immunofluorescence (in collaboration with XZ) and glutaraldehyde fixed samples for electron microscopy (in collaboration with FS) as described earlier [5, 24, 25]. Postmortal swabs and FFPE samples of selected organs in a subset of autopsies were tested for SARS-CoV-2 by rRT-PCR as described above.
Altogether, 15 autopsies with SARS-CoV-2 infection were included in this study. The first autopsy was performed in March 2020 and the autopsy of the last included subject was performed in January 2021. Ten patients were male and 5 patients were female. Age at the time of the autopsy ranged between 22 and 89 years (median 72.9 years). All 15 patients were hospitalized (2–40 days, median 16.6 days). Five patients were not mechanically ventilated (do not intubate order) and 10 patients were intubated (intubation time ranged between 1 and 24 days [median 11.5 days]). Cardiovascular risk factors were present in all 15 patients: hypertension in 10 of 15 patients (67%), diabetes mellitus in 2 of 15 patients (13%), and smoking in 6 of 15 patients (40%), in 3 of 15 patients, there was no information on smoking from patient history. Obesity defined as body mass index >30 kg/m2 was present in 6 of 15 patients (40%). Comorbidities included COPD (2 of 15), pulmonary hypertension (2 of 15), chronic interstitial lung disease (3 of 15), asthma (1 of 15), coronary artery disease (4 of 15), hypertensive heart disease (2 of 15), atrial fibrillation (7 of 15), chronic renal failure (7 of 15), current malignant tumor (3 of 15), recurrence-free malignant tumor (3 of 15), solid organ transplantation (2 of 15), autoimmune disorder (1 of 15), hematological disease (2 of 15), and depression (3 of 15). Clinical data are shown Table 1.
Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26.0. IBM Corp., Armonk, NY, USA. The Mann-Whitney U test and Pearson R test were used for comparison of morphological findings in autopsy tissue between groups. p value <0.05 was regarded as statistically significant. Parameters being statistically significant with both tests were weighted as biologically relevant. Graphics were plotted using GraphPadPrism (version 9.0).
Scoring of Autopsy Findings and Definition of Groups
Definition of Severity Scores
Macro- and histopathological scoring: Various parameters were scored according to the severity of histological appearance and/or gross findings. Score 0: absent (not apparent on H&E section and/or not evident with ancillary immunohistochemistry). Low intensity as score 1 (discrete and modest changes were pooled in 1 low intensity score 1): discrete (score 1) and modest (score 2) presence of macro -und histopathological feature only in small anatomical compartments and in focal (only 1 anatomical region) or only in scattered (in max. 2 anatomical compartments per organ) distribution. Ancillary tests were used if not apparent on H&E staining. Score 3: diffuse expression of the feature involving multiple (>2 foci per organ) anatomical compartments.
Multi-organ involvement and necrosis scoring: 1 score point was allocated to each organ showing histological signs of endotheliitis or necrosis, respectively. The sum of all affected organs was taken as the final score.
Definition of Biological Groups
To test the hypothesis “correlation of morphological autopsy findings with clinical course/severity/cause of death in SARS-Cov-2 positive deceased patients”, autopsy cases were assigned to 1 of 2 groups. Group 1: “Death due to COVID-19” were patients with fatal course of COVID-19 disease – hospitalized due to COVID-19 and autopsy-based cause of death was due to respiratory or cardio-respiratory failure with diffuse alveolar damage. Group 2: “Death due to other causes” were SARS-CoV-2 positive patients, with or without clinical symptoms of COVID-19 and death defined at autopsy due to other causes such as underlying disease, for example, malignancy or hematological disorder (Table 2).
Postmortem Pulmonary Findings
Macroscopic examination of the lungs was in line with full ARDS in 8 cases (Nr 1–8, 100% of the group) and showed a broad panel of gross lesions in 7 further cases. There were bilateral diffuse or focal, partially confluent large pale to yellowish hemorrhagic zones of consolidation and edema (shown in Fig. 1d, h). Macroscopic pulmonary infarction was evident in 6 of 15 cases (40%), macroscopic thromboembolism in 5 of 15 cases (30%).
Microscopic examination of the lungs revealed signs of DAD in different stages in 8 patients (53%) who died from COVID-19. Bronchopneumonia was identified in 8 of 15 cases (53%). Endotheliitis of small and medium-sized pulmonary vessels was seen in all but 1 patient (14 of 15, 93%) (Fig. 1a, e). Fibrin thrombi were evident in 7 of 15 cases (47%) (Fig. 1b, f) and leucocytic vessel occlusion (“leucocytic thrombi”) in 9 of 15 cases (60%) (Fig. 1c, g). Thrombotic vessel occlusions were noted within a few small pulmonary artery branches as often seen in DAD but also in small to medium-sized vessels and in areas not affected by DAD.
The extension of pulmonary endotheliitis significantly correlated with autopsy-based cause of death due to COVID-19 (R-test p = 0.031, U test p = 0.029) (Fig. 2a, 3a). Individual severity scores of macro and microscopic pathology findings are shown in Table 3.
Viral RNA was evident in 30–80% of selected organs in 10 of 15 autopsies, being the highest in lung samples and showing a lower but similar distribution in the extrapulmonary organs (see online suppl. Fig. 1; see www.karger.com/doi/10.1159/000518914 for all online suppl. material). There was no statistically significant difference in RNA positive samples between the 2 study groups (χ2 test, p = 0.991, not significant at p < 0.05).
Chest CT Morphology
Chest computed tomography (CT) at initial hospital admission showed a different extent of bilateral pulmonary ground-glass opacities and consolidations in both autopsy groups. Severe or mild vascular damage at autopsy did not correlate with the extent of pulmonary ground-glass opacities, which was evidenced in patients who died due to COVID-19 and those who succumbed to other underlying causes (Fig. 4a–d).
Vascular Postmortem Findings in Further Organ Involvement
Endotheliitis was a frequent finding in the small intramyocardial and subepicardial vessels present in all but 2 cases (13/15). Fibrin thrombi were less frequent (5 of 15 cases, 30%) and leucocytic thrombi in 7 of 15 cases (47%).
Acute tubular necrosis was a frequent finding seen in 13 of 15 patients (87%). In contrast to the lungs and the heart, the kidneys demonstrated only very mild endotheliitis with few infiltrating cells in 2 of 15 patients (13%).
Patchy centrilobular hepatocyte necrosis and confluent necrosis associated with fibrin thrombi in the respective vessels were found in those patients with multi-organ failure (in 8 of 15 cases [53%]).
Small intestine necrosis was present in 4 of 15 patients (27%), leading in the setting of multi-organ failure to death in all 4 patients. Identical histomorphological changes were seen in all cases, with microangiopathic chances of the submucosal vessels consisting of fibrin thrombi, endotheliitis, and apoptotic endothelial cells. Individual severity scores of pathology findings are shown in Table 3.
Association between cause of death based on autopsy findings and vascular manifestations of COVID-19
Severe pulmonary endotheliitis (R-test p = 0.031, U test p = 0.029) and multi-organ involvement of CO-VID-19 (R-test p = 0.026, U test p = 0.006) correlated significantly with COVID-19 associated death (Fig. 2, 3; Table 4). Histological evidence of small fibrin thrombi was more frequent in COVID-19 associated death (U test p = 0.040), while tissue necrosis, gross thromboemboli, and bacterial superinfection did not differentiate the 2 study groups. Chest imaging at hospital admission did not differ either and lacked correlation to any pathological factors analyzed. We did not find any statistically relevant interaction between clinical SOFA scores, the use of ventilation and morphological parameters at the autopsy.
In this study, we retrospectively analyzed the correlation between morphological vascular findings, autopsy-based cause of death and clinical parameters (such as SOFA score) and chest imaging in 15 COVID-19 autopsies with a different clinical course. We could show in our cohort that severe grade pulmonary endotheliitis, multi-organ involvement of endotheliitis, and tissue necrosis significantly correlate with COVID-19 associated death. Vascular changes were less prevalent in COVID-19 positive patients dying from other causes. Pulmonary infarction, bronchopneumonia, grossly visible pulmonary embolism, and frequent neutrophilic thrombi were common pathological findings in the autopsies. However, disease severity and cause of death did not correlate with these additional findings. Neither the initial chest CT imaging nor clinical disease severity parameters such as SOFA score or duration of ventilation correlated with autopsy findings or morphological cause of death. According to our knowledge, this autopsy-based study is the first to address the relationship between the magnitude and site involvement of morphological vascular changes, clinical parameters, and autopsy-based cause of death in COVID-19 autopsies.
The correlation between morphological pathological autopsy findings and imaging modalities especially chest CT at initial presentation or hospitalization have been the subject of several previous studies [8, 22, 26-29]. In a previous autopsy-based study, the typical ground-glass opacities on imaging harbored a high correlation to a broad spectrum of pulmonary autopsy findings; however, all these patients died due to COVID-19 so a correlation to the cause of death in SARS-CoV-2 positive autopsies was not possible . In our autopsy series, 7 SARS-CoV-2 positive patients died due to other causes than COVID-19 although a direct comparison between initial CT images and the magnitude of histopathological and gross autopsy findings or RNA viral evidence in selected organs did not show any association. These findings were seen in all patients, independent of the use of mechanical ventilation in our cohort, and are similar to those described in COVID-19 autopsy series from other centers as well as in influenza pneumonia and findings during the 2002–2003 SARS (SARS-CoV-1) pandemic [4, 27, 30-32].
The correlation between clinical parameters (such as SOFA scores or neutrophilic activation) to disease course has been observed in previous studies indicating the possibility to monitor disease severity [17, 19]. In our series, the relationship between dynamic SOFA scores and the degree of histopathological and gross vascular autopsy findings did not prove to be significant and we could not identify any morphological factors in our autopsy series harboring a link to clinical SOFA scores. Interestingly, none of the SOFA scores (mean, maximal, and delta) could be correlated to COVID-19 associated cause of death in our series, possibly pointing to the biological role and relevance of global immunological SARS-CoV-2 induced host response independently of morphological disease extension. However, the extent of endotheliitis has been described to be associated with critical illness and fatal COVID-19 disease, which further strengthens our data .
The extent of endothelial damage described in this study is most prominent in the lung, while extrapulmonary manifestations are less evident. Endothelial cell injury at the blood-gas barrier may explain the observed high alveolo-arterial gradient with pronounced hypoxemia both in spontaneous breathing patients with less severe dyspnea than expected and in the early phase of mechanical ventilation with severe hypoxemia but initially only mildly reduced lung compliance than ARDS of other origins [1, 8, 17, 19, 22, 23, 33, 34]. Corroborating with these clinical, tissue, and autopsy-based previous observations, our study data support the preferential role of the magnitude in pathological vascular alterations especially in pulmonary vascular involvement and the role of morphological multi-organ involvement in COVID-19 [17, 19, 21, 22].
The vascular pattern described in this study may explain the adverse outcome of COVID-19 in patients with pre-existing endothelial dysfunction, and thus less capacity to restore the injured vasculature and inhibit microthrombosis. In line with the observed association of the extent of systemic microvascular damage with clinical signs of organ failure in this study, circulating markers of endotheliopathy were associated with mortality in a plasma profiling study in a small sample of COVID-19 patients.
Endothelial tropism and endothelial cell apoptosis have been observed in case of infection with other respiratory viruses, for example, influenza A infection or SARS-CoV-1 have been suggested as underlying mechanism of, for example, encephalopathy in influenza infection [35, 36]. In an autopsy-based meta-analysis, SARS-CoV-1, Influenza A, and SARS-CoV-2 infections share the high prevalence of DAD as the main pulmonary pathology; however, extrapulmonary findings are different especially in terms of multifocal pulmonary and extrapulmonary thrombosis and multifocal endotheliitis pointing to higher frequency of multi-organ involvement at COVID-19 [2, 5, 6]. It is however at current time not possible to answer the question whether the multi-organ involvement triggers the endotheliitis or contrariwise or whether both factors represent 2 biologically distinct mechanisms in COVID-19. If the endothelium of the blood-gas barrier is damaged or dysfunctional, both diffusion impairment and ventilation-perfusion mismatch will further increase and aggravate hypoxemia [8, 23, 26, 28]. Therefore, treatment strategies that reduce ventilation-perfusion mismatch might be particularly important (e.g., prone positioning). The effect of substances active on the pulmonary endothelium needs to be systematically studied. Secondary preventive measures in patients with pre-existing endothelial dysfunction who seem to be prone to a severe course of COVID-19 might be of epidemiological interest [17, 19, 22, 33]. Therapeutic implications of the described vascular damage, such as anticoagulation are established, however, which other interventions might be helpful against the procoagulant state in case of microvascular damage are still subject to debate [17, 19, 22]. Whether survivors of severe COVID-19 will suffer from long-term vascular damage (e.g., pulmonary hypertension or COVID-19-promoted atherosclerosis) and other consequences of microvascular damage-associated multi-organ failure should be systematically studied during a long-term follow-up.
Limitations of the Study
The small sample size (n = 15 autopsies) and the variable clinical presentations (such as diverging time-frame between first diagnosis and death, different postmortem time to autopsy and individual pre- and in-hospital treatment) likely explain why morphological vascular findings and viral RNA evidence in available selected tissues are discordant in this study. Discrepant results between virus detection and clinical outcome have been described in previous studies and were linked to numerous co-factors such as the presence of viral load in vivo, the disease phase and treatment modalities [5, 13, 18, 37]. Higher viral load resulting from direct viral attack is consequently mostly measured in pulmonary vessels, while extrapulmonary sites (e.g., kidney, skin, brain, heart, etc.) harbor rather a low viral load due to docking pseudovirions (spikes and neurocapsid SARS-CoV-2 elements [5, 14, 18, 30, 37]).
In conclusion, our autopsy-based data show that a distinct histopathological pattern in terms of extensive pulmonary endotheliitis and manifestation of systemic multi-organ vascular and tissue damage correlates with COVID-19 associated death and differs in SARS-CoV-2 positive patients dying due to other causes. Pulmonary infarction, bronchopneumonia, grossly visible pulmonary embolism and increased neutrophilic thrombi were common pathological findings in autopsies of SARS-CoV-2 positive patients independent of disease severity or the cause of death. Clinical parameters such as initial chest CT imaging, SOFA score, duration of ventilation, or tissue-based viral RNA evidence did not correlate with autopsy findings or with morphological cause of death. The vascular pattern in fatal COVID-19 described here is another piece of the puzzle to support treatment strategies focusing on the endothelium, inflammatory response, and on avoidance of thrombi.
Statement of Ethics
Consent to perform the autopsy was given in all cases and the Institutional Review Board (Department of Pathology and Molecular Pathology of the University Hospital Zurich, Switzerland) approved the study (PN626). Ethical aspects in research on autopsy tissue of deceased patients, postmortem diagnostic and molecular analyses were completed in accordance with the Swiss Federal Research Regulations (BASEC2020-1316).
Conflict of Interest Statement
The authors have no financial or other conflict of interests to reveal.
No external funding was necessary for this study.
M.H.: designed the study, performed several autopsies, collected samples, analyzed immunohistochemical and morphological data, and drafted the manuscript. E.I.S.: designed the manuscript, interpreted, collected clinical information and correlation, and drafted the manuscript P.S.: interpreted clinical information and correlation and critically revised the manuscript. K.F.: performed central nervous system autopsies, interpreted data on cerebral pathology, and critically revised the manuscript. F.S.: interpreted ultrastructural findings in routine autopsy service and critically revised the manuscript. X.Z.: provided antibodies for fluorescence labeled immunohistochemistry, interpreted results on immunofluorescence in routine autopsy service, and critically revised the manuscript. S.H.: coordinated necessary additional stains and immunostains in autopsy diagnostic procedure and critically revised the manuscript. H.M.: designed the study, interpreted clinical and pathological data, and critically revised the manuscript. Z.V.: designed the study, supervised the autopsies, analyzed all gross and histopathological autopsy findings, interpreted clinical and pathological data, and drafted the manuscript.
Data Availability Statement
Individual participant data that underlie the results reported in this article will only be available after de-identification upon justified request addressed to the corresponding author.


Linda Triplett Wingler, 79, of Ferguson passed away Wednesday, March 8, 2023, at Accordius Health.
Funeral service will be held 2:30 p.m. Sunday, March 19, 2023, at Elk Baptist Church with Rev. Mike Hamby and Rev. George Freeman officiating. The family will receive friends from 1-2:15 p.m. prior to the service at the church. Burial will be in the church cemetery.
Linda was born June 27, 1943, in Wilkes County to Jesse Dana Triplett, Sr. and Mary Jane Johnson Triplett.
In addition to her parents, she was preceded in death by her husband, Oscar Wingler; one sister, Edith Edmiston; brothers, Jess Triplett, Warren Triplett, Carl Triplett, Benny Triplett; daughter-in-law, Lisa Wingler.
She is survived by a daughter, Nina Wingler Miller and husband, Neil, of Ferguson; one son, Kenny Wingler of Ferguson; step-son, Thomas Wingler and wife, Pam, of Statesville; grandchildren,; Jenna Miller, Michael Wingler and wife, Jenni, all of Ferguson, Shane Wingler and wife, Meagan, of Winston-Salem, Allen Johnson and wife, Taylor, of North Wilkesboro; step-grandchildren, Crystal Eades and husband, Chad, Paula Wingler, Michelle Wingler, all of Statesville; great-grandchildren, “Little Man” of Ferguson, Asher Johnson of North Wilkesboro; step-great-grandchildren, Matthew Eades, Adam Eades, Kasey Eades, Ethan Lippard, all of Statesville; one step-great-great-grandchild, Chance Eades of Statesville; sisters, Carolyn Hall and husband, Paul, of Ferguson, Louise Pierce of Greensboro; brothers, Gene Triplett and wife, Mary Ellen, of Wilkesboro, Clinton Triplett and Angie of Ferguson.
Flowers are accepted or memorials may be made to St. Jude Children’s Research Hospital 501 St. Jude Place, Memphis, Tenn., 38105.
Online condolences may be made to www.reinssturdivant.com.
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Quarry Springs puts you in close connection with I-495, which means the Beltway, and the entire Washington Metro area, is at your fingertips. And don't forget to take a trip to downtown Bethesda, where you'll find premium shopping, great dining options, and a vibrant urban spirit to match the peace of the place you call home.
Low-effort submissions, such as memes, screenshots, game clips, etc. that do not contribute to meaningful discussion will be removed at the mods' discretion. Posts about topics covered within the last three days will be removed. Photo Mode screenshots may only be posted in albums containing at least a …
The Indigo Quarry is a zone that was added in Version 0.3.0. It can be accessed from The Dry Reef through a cave, and from The Ancient Ruins. The Indigo Quarry is a winding network of caves and cliffs, striated with deep purple hills from the rare minerals found within it.
Discussion New Thread. Filter: General Bugs Announcements Ideas & Suggestions. b No Interface. 0. ... b Conflict between Unrestricted Productive Module and Quarry. 0. posted by Winconsuma 6 months ago. last message by Winconsuma 6 months ago. b Complications with Deep Core Mining. 2.
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Tutorial/Automatic Quarry Ore Factory < Tutorial. Edit. History Talk (0) Share. ... Start a Discussion Discussions about Tutorial/Automatic Quarry Ore Factory I think you might have writen wrong in the text compared to the pics.. 2 messages. A FANDOM user.
Start a Discussion Discussions about Quarry Pumps for quarry 5Big Business Wiki is a FANDOM Games CommunityContent is available under CC-BY-SA The Indigo Quarry Slime Rancher Wikia FANDOM The Indigo Quarry is a winding network of caves and cliffs Start a Discussion Discussions about The Indigo Quarry Where is the entrance to the Indigo Quarry
The contents of this website cover military guns and ammunition of all sizes, but the focus is on automatic weapons of up to 57 mm calibre. See the INDEX. If you would like to discuss these or related topics, or simply follow the discussions, I also host a FORUM which you are welcome to visit.
Quarry stage2.png 20 x Nails. Quarry stage2.png 20 x Nails FANDOM. Games Movies TV Video ... Start a Discussion Discussions about Quarry (Building) Quarry? 2 messages. ... Klondike: The Lost Expedition Wiki is a FANDOM Games Community. View Mobile Site
Annexation brought the most discussion. District 1 board member Sherry Giesecke said she was "a little bit perplexed" about why Plote would want to become part of Belvidere. Should that happen, she wondered how much tax revenue the county would lose. About $30,000 a …
Jun 09, 2009· Jerry Quarry was a very good fighter, but much like George Chuvalo, he was stuck at about #4 in the rankings, not able to crack the Top 3 because his era was comprised of outstanding fighters like Smokin' Joe Frazier, Muhammad Ali, George Foreman, Sonny Liston.
"The Old Quarry produces Limestone, Granite and Marble, which is used to upgrade entertainment buildings and to build the Eiffel Tower. Its normal state is "drowned". ... Start a Discussion Discussions about Quarry Pumps for quarry 6 messages. A FANDOM user. It will keep flooding. You only get 12 hours to use the quarry.
A convenient quarry But since that quarry..... but the quarry´s turning on the hunters erstwhile quarry fieldstone (quarry stone)+cut stone (ashlar) (construction) I met him at a quarry Into a quarry Quarry Tile - ceramica Quarry tile sliding glass door risers rock quarry The Elusive quarry Too cunning a quarry You are the Quarry
The following discussion is an archived discussion of the proposal. Please do not modify it. Subsequent comments should be made in a new section on the talk page. No further edits should be made to this section. The result of the proposal was not moved. BOLDly moving to Quarry (company), which addresses the proposer
The quarry is a Buildcraft machine that is used to automatically mine out large areas. By default, it will mine out a 9x9 area with a frame of 11x11. However, this can be extended to a max of 62x62 mining area with a frame of 64x64 or shortened to a minimum of a 3x3 frame by using landmarks...


After being diagnosed with Multiple Sclerosis (MS), I knew that I wanted to do what I could to fight this disease. Not only did I want to fight what I would be battling physically and mentally, but I also wanted to fight the future of this disease. I don't want my children to have to worry the way I worried about being diagnosed with MS. Talking with Nate, we thought the best way to fight MS would be to participate in Walk MS. Nate agreed to take on the lead of coordinating our efforts of forming a team and he did a fabulous job!
First we had to decide on a team name. It took us months, but we finally decided on "hey, that's MYelin!" Why? Of all the suggestions, this one was my favorite and made me smile every time I heard it. I usually have to explain to people what the team name means, but that's ok.
Next, we had to start recruiting. We had so many friends that immediately jumped at the opportunity to walk with us and we felt so touched by their eagerness to support us. Seriously, how did we get so lucky? Once we started to recruit, we started to raise money. Honestly, we had pretty low expectations in this department. Our original goal was to raise $1500, thinking that was a stretch. However with the help of fundraising efforts from my brothers, my dad, and others, we ended up raising just over $4300 (14th out of 200 teams)! We couldn't believe it! We were (and still are) floored by the generosity of so many people.
Aside from the recruiting and fundraising, we made signs, had t-shirts made, and had a tent in the walk's Team Village so we all had a place to meet.
|My friend helped me make this sign for our recruiting table we had at Fuqua.|
|Our recruiting table with the most adorable recruiters in the world!|
|Nate painting our team tent sign. He's a stud!|
Then it came for the big day we had been anticipating for months! We ended up having a huge group of walkers and Nate and I were both so touched that we had so many people there who love us and support us. We really have the greatest friends in the world! We ended up having 44 adult walkers and a whole lot of kids and strollers. It was quite the site to see!
|Our team, "hey, that's MYelin!" minus 4 adults and 3 kids who arrived just after this picture.|
|Those who came from Fuqua to support us.|
|I am SO glad some of my family was able to be there: Nate, Rhett, Katie, Rachel, Westen, Lyla and Ruby.|
Right before the walkers took off, they had a balloon release. It was so cool!
And then we took off on our 1 mile walk. There were so many people there doing that walk and it made me realize just how many people know and love someone with MS and want to help find a cure. It is good to know we are not alone. :)
|A bunch of the Fuqua students walking.|
|Our family, minus Lyla.|
After we finished walking, we mingled with our team, ate snacks and enjoyed the day. Here are some pictures of some of those who were able to make it.
|Hanna, Necia, me and Kim|
|me and Katie|
|Cabrina, Luke and me|
|Kristen, Cabrina, Luke and me|
|Our family with the Giles family minus Garrett|
|me and Belize. This picture would have been a little cooler if you could see our legs. Oh well.|
|a regular pic of me and Belize|
|Nate, me, and our neighbors/friends Jessica, Christian and Landon Ricks|
|me and my girls|
|our silly faces|
|me and Becca|
|Haley and me|
|Top: Laura, Belize, me, Jessica, Katie, Lis|
Bottom: Becky, Jen, Becca (and Bear)
|my hott husband and beautiful girls :)|
Overall, we had a very fun and successful day and I am so glad we did it. Go team, "hey, that's MYelin!" :)
I want to thank everyone who took the time to walk with us, who donated, and who sent their love and support to us. We are so thankful for each and every one of you and have felt your love and your support from here in Durham and from all over the country. And I am so thankful for a loving Heavenly Father who has blessed me and my family in countless ways.
I am so thankful for my amazing husband who spent hours and hours coordinating our walk for me. He had so many other responsibilities on his plate and opportunities to do other things, and yet he never once complained. Nate has been my rock, my partner, and my best friend and I have always been able to count on him from the very beginning. He makes my life so enjoyable and I am so thankful that he is mine. I love you Nate!