Adverse effects ĭuring clinical trials, the most common adverse effects of trastuzumab emtansine were fatigue, nausea, musculoskeletal pain, thrombocytopenia (low platelet counts), headache, increased liver enzyme levels, and constipation. 6.4 months), along with improved overall survival (median 30.9 vs. This trial showed improved progression-free survival in patients treated with trastuzumab emtansine (median 9.6 vs. Īpproval was based on the EMILIA study, a phase III clinical trial that compared trastuzumab emtansine versus capecitabine (Xeloda) plus lapatinib (Tykerb) in 991 people with unresectable, locally advanced or metastatic HER2-positive breast cancer who had previously been treated with trastuzumab and taxane chemotherapy. In the United States, trastuzumab emtansine was approved specifically for treatment of HER2-positive metastatic breast cancer (mBC) in patients who have been treated previously with trastuzumab and a taxane ( paclitaxel or docetaxel), and who have already been treated for mBC or developed tumor recurrence within six months of adjuvant therapy. Trastuzumab emtansine was developed by Genentech, and is manufactured by Lonza. Food and Drug Administration (FDA) approved marketing on 22 February 2013. 25.1 months) compared to the combination of lapatinib and capecitabine. In the EMILIA clinical trial of women with advanced HER2 positive breast cancer who were already resistant to trastuzumab alone, it improved median overall survival by 5.8 months (30.9 months vs. Because the monoclonal antibody targets HER2, and HER2 is only over-expressed in cancer cells, the conjugate delivers the cytotoxic agent DM1 specifically to tumor cells. Trastuzumab binding to HER2 prevents homodimerization or heterodimerization (HER2/HER3) of the receptor, ultimately inhibiting the activation of MAPK and PI3K/AKT cellular signalling pathways. Trastuzumab alone stops growth of cancer cells by binding to the HER2 receptor, whereas trastuzumab emtansine undergoes receptor-mediated internalization into cells, is catabolized in lysosomes where DM1-containing catabolites are released and subsequently bind tubulin to cause mitotic arrest and cell death. Trastuzumab emtansine, sold under the brand name Kadcyla, is an antibody-drug conjugate consisting of the humanized monoclonal antibody trastuzumab (Herceptin) covalently linked to the cytotoxic agent DM1.
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![]() To find out more about the various multi tools for gardeners, visit our online shop today. Whatever you need to do in the garden, the Stihl Kombi System provides a wide range of multi-tools that will make your life easier. This is especially useful when hedge trimming or pruning. ExtensionsĪmong the various multi-tools are also 1-metre extensions, which allow you to reach areas that other tools might not normally be able to reach. If you know which tools you are likely to need then it’s easy to carry the various options to the garden area you are working on, using their carry bag, without having to haul larger tools back and forth from the garage or storage shed. Busy trimming a bush and need to sweep? There’s a quick replacement attachment for that! Pruning and find a need to blow away some leaves or trim parts of a bush nearby? No problem. Thankfully, the Stihl Kombi System provides the flexibility you need to perform the various tasks. When working in a specific area of the garden, it’s necessary to switch tools. And with the Stihl Kombi harness it ensures you can work for longer periods with increased comfort – what’s not to like? Flexibility Sometimes carrying and setting up multiple tools can be more of a pain as they are physically larger and heavier, so this is the perfect solution for reducing all those separate gardening tools you have whilst increasing the variety of activities you can do in the garden. This means that you can cut back on space and quickly set up the Kombi System to do what you want. You only need one main engine unit for the Stihl Kombi System. Their size and break down of individual attachments also make them better for carrying and transporting. The shaft is narrow and easy to store while the various garden tool attachments that connect to it can be stored away in a single, easy to access space. The Stihl Kombi System makes storing away and accessing tools much easier compared to using various other separate tools, which are typically much larger and heavier. Here are some of the key benefits of using multi-tools for the garden: Easy storage In fact, with the Stihl Kombi System, there aren’t many everyday gardening tasks that you can’t do! Kombi Systems include multi-tools to perform tasks such as hedge trimming, cultivating soil, sweeping and cleaning, leaf blowing, strimming, pruning and much more. By attaching various tools, you can perform a large number of tasks without the need to buy a wide range of different gardening tools, each with their own power unit. The motorhead looks like the end of a trimmer but the shaft, however, separates to allow different attachments to be connected. Garden multi tools such as the Stihl Kombi System are engine powered garden multi-tools which include a motorhead with many interchangeable attachments, making it an 'all-in-one' gardening tool. ![]() At John Miller Garden Machinery, and as Stihl main dealers in Wiltshire, we offer Stihl Kombi Systems to ensure you can enjoy your gardening activities while making tasks easier and quicker to perform. There are many benefits to using multi-tools and garden starter kits when it comes to doing gardening activities at home. There is also a dedicated multi tool powerhead in the efco 2011 catalog not sure how much has changed my favorite the 53cc brush cutter seems to have vanished from their website.We get asked quite a few times ' which multi tools are best for gardening and why?' so we thought we'd share some of our thoughts with you today. Chances are the pole is longer starting with the pole saw. It is also possible to get the DS 3600 4s which has a 35.8 cc honda engine and do similar. One could start out with the trimmer Ds2800 s/t and get the chainsaw and hedge trimmer attachments as well, that is the same engine. And with that little shaft piece I think the angle drive for string or blade will work out. I am growing a living fence and figured out that the hedge trimmer attachment will work on it though you are only supposed to use that with other kinds of handles like loop. I am not real happy with how jumpy the pole saw is but it can be worked around using the tip as the anti kickback smooths that out or using the stop to rest the work. The box had a little perhaps three inch piece of shaft in it. The dealer gave me a box with various stuff (various instruction pamphlets as well) in it that said Whatever the code for the chain saw attachment on it, looks like EP 120 from the pamphlet I have here. I purchaced an efco PT2700 fixed shaft pole saw. Strange you should list those three items. Not sure about the hedge trimmer it all depends on how high. I prefer the bike handles for the string and three prong blade. ![]() The study is published in the scientific journal Comparative Biochemistry and Physiology, Part A.įor more information, contact David Kidwell. This is an experimental study to study the pathological changes in the organs of the mannheimiosis rat model treated with sea cucumber extract, Stichopus. This is the first evidence of Vitamin E and Vitamin E2 reversing hypoxia-induced formation of free radicals in a fish brain. In addition, the results show that during hypoxic stress, administration of Vitamin E or related Vitamin E2 leads to reduced oxygen radical formation in the fish brain, reversing neurological malfunction. 1 : extreme in a way that is not normal or that shows an illness or mental problem He is a pathological liar/gambler. The study demonstrates for the first time in an aquatic vertebrate, that hypoxia increases highly chemically reactive radicals of oxygen (e.g., nitric oxide and the super oxide radical) causing oxidative damage to cells and inhibiting protein expression in the hypothalamus, an important integrative center in the fish brain. Harmful responses were diminished after exposure of the fish to the antioxidant vitamin E and estrogens (female reproductive hormones) restoring reproductive endocrine functions. In vertebrates such as Atlantic croaker, low levels of dissolved oxygen (called hypoxia - below 2 mg/L) and insufficient antioxidant levels in the brain result in the initiation of a complex series of pathological changes leading to decreased energy levels and disruption of neuroendocrine (hormone) functions. The new study explains the influence of antioxidants and steroids on reducing pathological impacts of low oxygen on an aquatic vertebrate animal. ![]() ![]() Although pathological examination is not a feasible method of diagnosis, it can elucidate pathological changes, pathogenesis of the disease, and the cause of death in COVID-19 cases. Credit: NOAA National Estuarine Research Reserve Program. In the initial phase of the current pandemic, a handful of post-mortem case-series revealed COVID-19-related pathological changes in various organs. Atlantic croaker, Micropogonias undulatus (Sciaenidae). ![]() Looking back, I think that was a mistake. We sort of talked, I took her back, and we started going out again. ![]() “I loved her, so I knew I wanted her back, but we had to talk about everything that would happen. (Although, of course, this is a hard metric to measure-how long after an affair does a couple need to stay together to claim “success”?) Some statistics put that number much higher, especially when it comes to married folks clinical psychologist Joseph Cilona, Psy.D., told SELF that, “Despite the ambiguous statistics, it seems reasonable to speculate that more couples are staying together after infidelity than not.” One study found that only about 16 percent of couples who’d experienced unfaithfulness were able to work it out. ![]() In practice, it tends to be uncommon for a relationship to survive instances of cheating. Assumptions like these ignore the complicated web of considerations that go into deciding what to do after infidelity is revealed.Įsther Perel, noted relationship therapist, wrote a book called State of Affairs: Rethinking Infidelity, encouraging people to try to understand how and why affairs happen, but also how a relationship might get better-with lots of work-after infidelity. There’s also a common belief that “once a cheater, always a cheater”-that it’s only a matter of time before it happens again. People often are judged for not standing up for themselves, not having boundaries, or for “letting” themselves be treated disrespectfully. Unfortunately, even in a post- Lemonade world, there is a lot of stigma around staying. Very few suggest trying to work it out, having hard conversations, and practicing the painful art of forgiveness. Most recommend some combination of tequila, several one-night stands, and property destruction. If this post helps to resolve your issue, click the Mark as Answer button at the top of this message.īy marking a post as Answered, you help others find the answer faster.Next to instructions on how to move your ass and young love, one of the most popular topics for hit songs is what to do when someone cheats on you. When castling, the king moves two squares towards the rook, and the rook moves over the king to the next square, i.e., black's king on e8 and rook on a8 move to: king c8, rook d8 (long castling), white's king on e1 and rook on h1 move to: king g1, rook f1 (short castling). * The King and rook must occupy the same Row. * All squares between the rook and king before the castling move are empty. * The king does not move to a square that is attacked by an enemy piece during the castling move, i.e., you may not castle and end the move with the king in check. * The king does not move over a square that is attacked by an enemy piece during the castling move, i.e., when castling, there may not be an enemy piece that can move (in case of pawns: by diagonal movement) to a square that is moved over by the king. ![]() * The rook that makes the castling move has not yet moved in the game. * The king that makes the castling move has not yet moved in the game. It's called 'Castling' and is a way to protect the King when it may be in imminent danger.Ĭastling is a legal move in Chess, but the following conditions must be met: ![]() ![]() to Lowe’s Food Stores headquartered here-it’s easy to see why the city of Winston-Salem is one of the few urban areas that have had more incoming than outgoing local professionals over the past decade. Home to a nationally influential biotechnology center, a thriving local arts scene, ACC sports and many family-friendly cultural opportunities-with corporations from Reynolds American Inc. Just some of the attractions in Winston-Salem include the Reynolda House Museum of American Art, Old Salem Museums & Gardens, BB&T Field, the Children’s Museum of Winston-Salem and much more. Additionally, Bloomberg Businessweek included Winston-Salem among the ten most “Fun, Affordable” cities in the United States.ĬLICK HERE for a list of the Top 30 things you need to know about Winston-Salem before moving here. ![]() Winston-Salem has been nationally ranked among the best places to launch and maintain a business by the likes of Forbes and Money Magazine. With a population of more than 230,000, Winston-Salem is North Carolina’s fourth-largest city, ranked as one of the nation’s “Most Livable” by Partners for Livable Communities. With annual temperatures averaging a pleasant 69 degrees, the “City of Arts & Innovation” is a vital hub halfway between North Carolina’s eastern beaches and western mountains. Anchoring the Piedmont-Triad region of North Carolina, which also includes Greensboro and High Point, Winston-Salem’s balance of urban opportunity and natural beauty consistently earns it high national marks for quality of life. Winston-Salem, NC There are plenty of things to like about Winston-Salem, home of the Wake Forest University main campus. ![]() Since potatoes cannot float in air, the most effective way to achieve the illusion of the levitating potato is making the fork invisible to the spectator.īut the above levitation illusion conveys the point. The job of a magician is to take something mundane, such as a potato stuck on the end of a fork then make it look like the potato is floating. The disadvantage of this half-baked method is not feasible since the performer is unable to talk, and therefore unable to misdirect. In this way, the spectator sees only a levitating potato-a potato floating several inches in front of the performer’s face. The magician may “levitate” the potato by gripping the handle of the fork in his mouth, while facing the spectator. The real question the skeptical spectator should be asking is, “How is the illusionist rendering the wire, cable, magnet, lift, platform, or counter-balancing weight, invisible?”īecause people and objects do not levitate! Is Levitation Real? The goal of the illusionist is to imbue in the spectator’s mind, “How is he/it floating?” ![]() ![]() A hidden platform or hidden wires may be used to levitate a performer or assistant, or standing on tiptoe in a way that hides the foot that is hitting the ground in smaller-scale illusions. To create such levitation illusions, a number of techniques are employed. This has an effect on what spectators see because when light reflects off the objects surface, it creates the an illusion of being higher off the ground. ![]() You probably noticed the magician makes the person or object he is trying to float in a bowl of water, and then uses some other device such as a mirror or “bell jar” to reflect light to it. If you've ever seen the levitation trick performed, you've probably noticed something fishy. Levitation illusion magic tricks levitation Illusion illusion trick illusions illusions levitation levitate levitating levitating illusion levitating trick levitation levitation illusion levitation illusions levitation trick trick illusion illusion trick illusions illusions levitation levitate levitating levitating illusion levitating trick levitation levitation illusion levitation illusions levitation trick trick illusion illusion trick illusions illusions levitation levitate levitating levitating illusion levitating trick levitation levitation illusion levitation illusions levitation trick trick hummer card levitating woman levitation illusions stage illusions magicians magic tricks magic trick street magic shin lim mentalism balducci levitation mirrors wizard david copperfield teller penn and teller deck david blaine card trick toys toy force ghost card magic levitate levitates levitations levitating levitation magnets masked magician magicians optical illusions eye smoke magnetic cigarette closeup prop gravity light bulb zombie ball magic wand asrah levitation reel thumb hummer card levitating woman levitation illusions stage illusions magicians magic tricks magic trick street magic shin lim mentalism balducci levitation mirrors wizard david copperfield teller penn and teller deck david blaine card trick toys toy force ghost hummer card levitating woman levitation illusions stage illusions magicians magic tricks magic trick street magic shin lim mentalism balducci levitation mirrors wizard david copperfield teller penn and teller deck david blaine card trick toys toy force ghost magic magician floating levitate performer tricks box visual air audience to levitate show ground close table magicians step self performed david man perform object. ![]() Below are details regarding each type of melee weapon: Most melee weapons are quicker to recover and block from a miss than after a direct strike. Generally, the first hit has the slowest delay (from the initial click), the second hit has less delay, and the third hit is slightly slower while dealing the most damage. Most melee weapons' attack pattern involve a 3-hit combo. When equipping one-handed weapons, the character can also equip shields. Different types of melee weapon can have different ranges, attack speeds, stamina costs per attack and secondary attacks. Melee weapons are items that can be equipped to increase attack damage.
It’s worth officially codifying the game’s bugs, too. But it would be more impressive if there were anything to fill up that space besides half-hearted stabs at side content and a bunch of collectibles. Congratulations to the people who do research on the period. It’s the one consistent “improvement” every year, and Ubisoft boasts that Syndicate‘s London is the largest of any of the Assassin’s Creed cities. Contrast that with Unity‘s depiction of Paris burning. At one point in the story, characters in Syndicate tell you “all of London is rioting.” If so, it was a very quiet sort of riot-the type where nothing gets broken and people say “Good day” to each other in the streets. ![]() Syndicate‘s London feels stagnant and empty by comparison, with not a single crowd that can match what we saw in Unity last year. Syndicate takes this to an extreme, forcing all of its present-day exposition into tedious cutscenes.Īnd the crowds, which Ubisoft pushed hard in Unity, are apparently a victim of that game’s bug-ridden delivery. The stories are predictable, and the modern-day aspect now resides in a hellish limbo-still present enough to annoy those who don’t care, but minimized to the point it feels inconsequential. But the longer Assassin’s Creed goes without a major overhaul of its core design principles, the more it feels like a weird holdover from another era-say, 2010 when Brotherhood came out.Įven after Unity‘s tweaks the parkour feels stilted, and in Syndicate the introduction of a grappling hook that lets you bound to the top of a building with the press of a button renders your character’s climbing skills almost comically useless. Despite the lackluster and repetitive mission structure, there was much to be admired-the (impressive at the time) parkour, the grim story, the reactive crowds, the size of the world and the way it blended historic fact and legend. I still remember the excitement around the first game in the series, way back in ye ol’ 2007. What’s, I guess, sad to me is that at one point Assassin’s Creed truly was novel. Charles Dickens stays around for slightly longer so you can hunt London’s “ghosts,” giving them a “I would’ve gotten away with it too, if it weren’t for that assassin and his/her hidden blade” moment. Alexander Graham Bell shows up, for instance-and then disappears from the story after you do some menial tasks for him. The rest of the cast is less successful, with cameos that often go nowhere and feel largely interchangeable. It’s not the most unique dynamic, but it keeps Syndicate moving. Even Evie, the more “practical” of the two, is full of witty one-liners, always equipped with a sigh and a snide jab when Jacob inevitably screws up. ![]() Their sibling rivalry leads to Syndicate‘s best moments, the pair leveling barbs at each other and adding some much-needed levity to the proceedings-something the self-serious Assassin’s Creed Unity was sorely missing. ![]() Jacob plays the now familiar role of “Ezio-In-A-Different-Time-Period,” wisecracking his way through situations and generally not giving half a damn about the Creed part of Assassin’s Creed, while Evie is more levelheaded and focused on the brotherhood’s teachings. ![]() If Syndicate is saved from mediocrity it’s because of the quality of its lead characters, the brother/sister Assassin duo of Jacob and Evie Frye. ![]() All of the training is online, contained in the private member only site.ĭuring the course we’ll walk through basic functions and settings, a complete time value of money crash course, basic time value of money calculations, advanced time value of money calcualtions, and several real estate specific practice problems. The training is released in 5 separate modules and consists of easy-to-follow videos, and step-by-step, commercial real estate specific examples. It’s for beginners who want a head start and industry professional who want to plug the gaps in their education. How to Use a Financial Calculator is an online interactive video-based course that teaches you how to use an HP 10BII financial calculator step by step. It is an ideal tool for teaching the power of compounding interest, analyzing potential deals or business ventures, or just doing math problems, and sharing the results of your work with others.What is How to Use a Financial Calculator? ![]() The 10bii Financial Calculator is powerful enough for the professional but accessible enough for everyone. Never has using a financial calculator been so easy or intuitive. Includes standard calculations such as standard deviation, mean, and linear regression forecasting. ![]() A dedicated interface makes adding, editing, deleting, and reordering uneven cash flows a breeze.Įnter and analyze statistical data points, and see graphs based upon the values you enter. Now with 12 Easy Modes!Įasily enter and see diagrams for Cash Flows, including rapid calculation of Net Present Value and Internal Rate of Return. Get answers to common financial questions WITHOUT having to know how to use a financial calculator! With the 10bii Financial Calculator's Easy Modes, answer a few simple questions worded in plain language (rather than Financial-ese) and find out just how much you'll save with that refi, how much you'll have at retirement, how long it'll take you to save up for that big purchase and more. With the 10bii Financial Calculator, you can: The 10bii Financial Calculator's keypad has been specially designed to be easy to use and easy to see.īy expanding on HP's traditional presentation, the 10bii Financial Calculator allows quick and intuitive building and visualization of TVM (Time Value of Money) calculations and Uneven Cash Flows, lets you see the stored values of all of your memory registers in one easy view, graphs your statistical series, and lets you type in whole equations for easy review and one-touch evaluation. It allows you to easily calculate loan payments, interest rates, amortization, time value of money, investment value, and more using a combination of powerful and intuitive equation-writing functionality and helpful worksheets. Modeled after the extremely popular HP 10bII Financial Calculator, the 10bii Financial Calculator app combines precise mathematics, intuitive display, and ease-of-use in one compact package. The 10bii Financial Calculator is a versatile and powerful financial calculator which features more than 105 different functions for financial analysis, business, statistics, and general mathematics. Easy Mode allows everyone to get the financial answers you need!įinally a Financial Calculator for everyone! Whether you are a seasoned investor or you just have questions about paying off your credit card, refinancing your home, or planning your 401(k) contributions, the 10bii Financial Calculator has the answers to YOUR financial questions! Saves Recent calculations so you can easily reload them Draws Cashflow Diagrams for simple TVM or complex Uneven Cashflows ![]() Easily enter your Uneven Cashflows in a spreadsheet-like worksheet Print or Save PDF Amortization Schedules Displays current N, I/YR, PV, PMT and FV values right above buttons wonderful job in integrating visual tools to illustrate financial cash flows. This has become my "go to" app on my iPad. It's downright marvelous! I would recommend it to any financial advisor without reservation." -John L Olsen, CLU, ChFC, AEPĥ Stars: "Awesome Financial Calculator! I use it all the time and love it!" - Tinahart2ĥ Stars: "Great customer service along with the app's ease of use made this purchase a no brainer." - HarborDanĥ Stars: "I am a full-time investor in real estate and notes. In-App Purchase: 10bii+ Features (Bonds, Breakeven, Depreciation, Trig, Probabilities) available!ĥ Stars: "What is the PV of WOW? I'm sure thrilled with everything about this app! Too bad there isn't room for another star!" - Pokeyĥ Stars: "This tool is excellent. Look no further, you have found the best Financial Calculator app available. ![]() Mix a weak bleach solution and instruct the affected workers to use it in decontaminating the exposed areas of their skin.Start triage for those patients, ensuring you obtain their vital signs in order to establish a baseline.As the patient is being assessed, he suddenly loses consciousness. This free practice exam features 415 realistic questions that will help you not only review key EMT concepts. There is a symbol, NFPA704″ with several colors, and within a bluish diamond ‘4’ is written, and another diamond that is yellow. EMT B Practice Test EMT B Practice Test Practice Questions: Questions 1 to 3 pertain to the following scenario: You and your partner are called to the home of a 75-year-old man complaining of severe pain in the chest and nausea. Cognitive Exam It is a computer adaptive test that will be composed of at least 70 to 120 multiple-choice type questions, 10 of which will be unscored. There are no anatomic differences that affect airway management in children versus adults. The National Registry EMT is composed of 2 exams: Cognitive Exam and Psychomotor Exam. a smaller jaw and a proportionally larger tongue. You can search for EMT offices in your state here. You must take the exam from an accredited locationmost often, your local EMT office. Summary: Try our free EMT practice test below. Taking our EMT practice test will help you become more familiar with the actual exam and narrow down your studies to the areas you need to focus on. On reaching the scene, you find a worker at the entrance who informs you of the apparent contamination source, which is huge white tank. What differences in a child’s airway might make airway management more difficult than in an adult longer airway and small tongue. What is the Paramedic Test The Paramedic test is a standardized exam given by the National Registry of Emergency Medical Technicians ( NREMT ). Our test is completely free and includes detailed answer explanations to help you understand complex concepts. The term responsible for dealing with hazardous materials has been sent out, and it is estimated it will arrive at the emergency scene 20 minutes after the accidents. You are immediately informed that the number of employees affected is around 30 and also that there are many whom fumes have affected. You are called to an industrial compound in a neighbourhood where an incident is linked to potentially hazardous material. |
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