![]() Fractures of the Watershed region (Jones Fracture) Avulsion Fractures (pseudo-Jones Fractures)įractures of the base of the metatarsal are often referred to as an avulsion fracture. Here, a small piece of bone is pulled off the metatarsal by a tendon or ligament/fascia during a twisting injury of the foot or ankle. This type of fracture is sometimes called a “pseudo-Jones” fracture. It is very important to distinguish this type of fracture from a Jones Fracture as their treatments and outcomes are quite different. Location specific diagnostic considerations:Īt OrthoArizona, we see three main types of fractures of the fifth metatarsal. At OrthoArizona, advanced imaging such as CT scans or MRI are usually only ordered to diagnose 5th metatarsal fractures when history and physical exam is suspicious for fracture but X-rays are negative. ![]() Physical exam and X-ray is usually all that is needed to diagnose a fifth metatarsal fracture. The main complaint seen in our patients is pain, swelling to the outer half of the foot, and associated bruising which can sometimes be seen in an acute injury. Patients also may have difficulty walking secondary to pain in the foot. Some people may experience some tingling or numbness into the lesser toes if they have a significant amount of swelling, but actual nerve injury is rare. What are the symptoms of a fifth metatarsal fracture? Patients will sometimes be seen to have excessive wear of their shoes on the outer portion of the sole because of the pressure put on that part of the foot and shoe. We see fifth metatarsal fractures in patients of all ages and activity levels but in our region they appear to occur most commonly in middle age or elderly females slightly more than other individuals. Some individuals may also have an anatomic predisposition to sustaining fifth metatarsal fractures. These patients normally have high arched feet and/or an alignment of the lower extremity that tends to load the outside part of their feet. What causes fifth metatarsal fractures?Ĭauses include falls, direct blows, sports, motor vehicle accidents, bony stress overload, and twisting injuries with the latter being the most common cause. High-energy injuries tend to cause multiple metatarsal fractures and usually are not solely responsible for an isolated fifth metatarsal fracture. The fifth metatarsal can sustain a fracture (or break) in several different areas. The vast majority of fifth metatarsal fractures we see occur at the base of the fifth metatarsal compared to the shaft or neck of the metatarsal. At OrthoArizona, metatarsal fractures are some of the most common fractures we see. We typically see several new patients per day with metatarsal fractures. Of all of the metatarsal fractures we see, fractures of the fifth metatarsal are by far the most common.
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It’s great if you’re looking to combine PhotoDirector with PowerDirector, but less useful for astro work. The last creative area is the Create workspace this is where you can make slideshows, gifs, and motion stills like title cards. ![]() Layers can be individually adjusted, as you'd expect (Image credit: Andy Hartup) There are some good object selection and area selection tools here, and we appreciate the ability to quickly adjust every layer without leaving the workspace, but it still feels light. You’re really here to manage and adjust layers, and you don’t get the same level of manual artistic effects as more specialized apps like Photoshop. While most other features are covered in the Guided and Adjustment workspaces, in this area PhotoDirector 13 feels a little light. Once you’re done adjusting your photo, this is where you tackle more substantial edits. You can merge the image manually, using (up to 100) layers and light/color corrections in the Edit workspace, but it’s a little trickier to do and even then this won’t be enough for larger-scale star trail shots. Many of the best astro images can combine 10-20 (or more) photos and star trail images can be 100+, so this feels like an issue with PD13’s suitability. Now, here’s where some astrophotographers may balk at PhotoDirector 13 - you only get a maximum of five images to automatically merge here, which can create workflow problems if you’re trying to combine a large number of night sky images. The guided area will also help with things like HDR and panorama merges too. We were impressed with the control this app gives you over bokeh effects. What doesn’t really impress as much are the sparkle and light hit effects - they lack subtlety, and we just couldn’t find a way to make images better-looking when they were applied. What we love is the ability to freeze any part of the image (by using a brush tool), so you can animate very specific areas. Drawing an arrow onto the image dictates the direction of motion, and there’s a slider for speed. In the Guided area you’ll also find photo animation effects, and they’re surprisingly simple to use. You can even brush in areas of focus or bokeh to really nail the detail of the image you’re trying to craft. We played around with the tool to create a very specific portion of an image sharp-focus, while giving the rest a super-soft focus. Also new to PD13 is the Bokeh edit tool, which is extremely detailed. We love the light ray effects, but would advise you to use them sparingly as it’s easy to over-edit photos with some of these tools. One of the major issues with sky replacement is that it can be hard to get the lighting levels to feel natural, and you’d usually do that with a layer mask, but here it’s all built into the same tool. What we really appreciate is the ability to adjust not only the sky, but also the lighting on the foreground/land too. The accuracy of the blend between ‘new sky’ and foreground is very good, and the process is achieved in less than a second. ![]() The AI-driven sky replacement is new for PhotoDirector 13, and it’s extremely powerful. ![]() There are a series of drop-down menus where you can do things like create animation effects, dispersions, light rays, and sky replacement. Next is the Guided area, and it’s there that all the ‘bells and whistles’ live. ![]() It works by only allowing trusted files to run on your system. It's simple: prevention-based, Default Deny Protection. What makes Comodo's Internet Security product different from the others? More than just an antivirus program, it also includes an award-winning firewall, host intrusion prevention, a sandbox for untrusted software, anti-malware and buffer overflow protection to deliver comprehensive protection against today's diverse range of threats.Ģ. Internet Security is a security suite plus. What makes Internet Security better than my current Antivirus and Firewall combo?
![]() Move - push the Mode button to switch to Bluetooth Roam - push and hold the power button for 2 seconds to switch to Bluetooth Era 100 - hold the Bluetooth button until you hear a chime to pairĮra 300 - hold the Bluetooth button until you hear a chime to pair Hooking up these products is as easy as switching them over to Bluetooth mode, opening the Bluetooth settings of your PC and selecting them from the list, just like you would to connect a mobile device. We’ll show you how to do this in the next section. With Move, Roam and Eras, things are a lot more simple. Move, Roam, Era 100 & Era 300 (Bluetooth) ![]() Therefore, it’s generally a better experience to use the HDMI ARC port with the optical adapter.īeam - use the HDMI port with the Optical adapter Arc - use the HDMI port with the Optical adapter Amp - use either HDMI or Analog audio in connections With Amp, you also have the option to use the RCA Line-In ports, though you should be aware that there will be a minimum of 75ms delay due to the signal processing performed on this input. How to use the Sonos Optical Audio Adapter If that does apply to you, you can check this FAQ to find out how to set up your Beam, Arc or Amp. Unless you are using a TV equipped with HDMI-ARC as your monitor, connecting via HDMI-ARC won’t be possible. You’ll need to make use of the Sonos Optical Audio Adapter that is included with your product (excluding Amp). Most computers send a regular HDMI audio stream over their HDMI ports, whereas these products require an HDMI-ARC audio signal. If you’re using a Beam, Arc or Amp as computer speakers, there’s one extra step. Playbar - use the Digital audio IN port Playbase - use the Digital audio IN port Ray - use the Digital audio IN port Beam, Arc & Amp Simply use an Optical cable to link your Playbar/Playbase/Ray to the Optical out port on your computer just like you would to hook it up to a TV. In most cases, you’ll likely need to use an internal sound card to provide that connection. Most PCs don’t come with these built into the motherboard, though some higher end ones do. These products use a TOSLINK/Optical cable to receive audio, so if you’re looking to use these as PC speakers, your PC must be equipped with an Optical Out port. I’ll group the products with similar connections together to make things a bit easier to follow. Roam & Era 100/300īluetooth links via these models will experience the same delay, as Bluetooth acts as a virtual line-in and also needs buffered for network play.ĭepending on the product you’re trying to connect, the method of connecting it to your computer will be slightly different. If synchronization isn’t an issue for you, you can simply connect the device to your PCs headphone or line out jack like you would a pair of regular headphones. There will be a minimum of a 75ms delay on the audio due to the signal processing performed on the line-in side. While it is possible to use these players with a PC by connecting to their line-in ports (Era models will need the USB-C adaptor), this isn’t a recommended solution if you’re planning on doing something that requires audio/video synchronization. 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Antique Art Nouveau rings might feature depictions of winged insects and fauna as well as women, who were simultaneously eroticized and romanticized, frequently with long flowing hair. The Art Nouveau movement (1880–1910) brought with it rings inspired by the natural world. The late-1700s paste jewelry was a predecessor to what we now call fashion or costume jewelry. Pearls, along with colored gemstones like garnets, rubies and sapphires, were widely used in Georgian jewelry. Named for the monarchies of the four King Georges, who in succession ruled England starting in 1714 (plus King William’s reign), antique Georgian rings, be they engagement rings or otherwise, are also coveted by collectors. The most collectible engagement rings are those from the Victorian, Edwardian and Art Deco eras. Designs for Victorian-era engagement rings often featured repoussé work and chasing, in which patterns are hammered into the metal.Įngagement rings, which are reliably intimidating to shop for, are still widely recognized as symbols of love and commitment. Jewelry devotees have long pined for rings adorned with reptiles, thanks to antique Victorian rings - well, specifically, Queen Victoria’s illustrious engagement ring, which took the form of a gold snake set with rubies, diamonds and an emerald (her birthstone). The serpent is now a popular motif in fine jewelry. Italian luxury jewelry house Bvlgari has become famous for its widely loved Serpenti motif, for example, and its Serpenti ring, like the other accessories in the collection, began as an homage to jewelry of the Roman and Hellenistic eras. 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Each design created in this style - which was crafted with great care and often made from Gold, White Gold and 14k Gold - can elevate any look. Surely you’ll find the exact triple shank ring you’re seeking on 1stDibs - we’ve got a vast assortment for sale. ![]() If Chloe sat on the stage and Justin didn't spray her with deodorant, Wells will mention her implication in drug related activities during the meeting.If Chloe sat on the stage and Justin sprayed her with deodorant, Wells will mention her implication in possible drug-related activities during the meeting.If Justin didn't spray her with deodorant, Wells will comment on how Chloe smells like weed on the stage.If Justin sprayed her with deodorant, Wells will comment on how Chloe doesn't smell like weed on the stage but suspects she masked her scent.At the Blackwell Campus, Principal Wells will smell Chloe.At the Blackwell Campus, Chloe will be worried when Principal Wells walks over as she has weed in her back pocket. ![]() At the Blackwell Campus, Skip Matthews will comment on how Chloe smells like weed, just like Justin.Joyce will comment on how Chloe smells like weed in the kitchen.Chloe will take the rest of the weed with her after she changes clothes.Chloe will be smoking a joint in her bedroom when she wakes up.(Only available if Chloe stole the T-Shirt Vendor's money.) 2.14 Chloe's attitude during the DinnerĮpisode One - " Awake" Firewalk Bouncer.There also exists an "Intimacy_counter" variable for Chloe and Rachel's relationship which counts the decisions the player made and a "CONVINCESERA" variable for convincing Sera to meet Rachel in the ending, which counts the dialogue options chosen by the player in the conversation with Sera at the mill. ![]() Though not all actions, for example dialogue options, will have their consequences pointed out, as often several choices play together to create a certain outcome. The "All Seeing Eye" symbol will appear at the top of the screen after certain choices have been made indicating that "this action will have consequences" and, if it is a major choice, the scene will stop and time will freeze until the player makes their choice, playing a short sound effect immediately afterwards. The protagonist, Chloe Price, is presented with different choices in the form of available actions, dialogue options and optional interactions. For information on Life is Strange 2, see here.Ĭhoices and Consequences is a central gameplay element in Life is Strange: Before the Storm. For information on Life is Strange, see here. "E3_S04_C_CHOICE_S04C_273_NEW_01=".This article is about Life is Strange: Before the Storm. The subtitles of the tabletop game are internally called "_NEW_", e.g.
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Pembrolizumab/Placebo Plus Trastuzumab Plus Chemotherapy in Human Epidermal Growth Factor Receptor 2 Positive (HER2+) Advanced Gastric or Gastroesophageal Junction (GEJ) Adenocarcinoma (MK-3475-811/KEYNOTE-811) MK-3475-975 (KEYNOTE-975)Ī Randomized, Double-blind, Placebo-controlled Phase 3 Trial of Pembrolizumab (MK-3475) Versus Placebo in Participants with Esophageal Carcinoma Receiving Concurrent Definitive Chemoradiotherapy (KEYNOTE 975) MK-7902-015 (LEAP-015)Ī Phase 3, Randomized Study to Evaluate the Efficacy and Safety of Lenvatinib (E7080/MK-7902) plus Pembrolizumab (MK-3475) plus Chemotherapy Compared with Standard of Care Therapy as First-line Intervention in Participants with Advanced/Metastatic Gastroesophageal Adenocarcinoma (LEAP-015) RACE INtegratioN of Trastuzumab, With or Without Pertuzumab, Into periOperatiVe chemotherApy of HER-2 posiTIve stOmach caNcer: the INNOVATION-TRIAL MATTERHORNĪ Randomized, Double-blind, Placebo-controlled, Phase III Study of Neoadjuvant-Adjuvant Durvalumab and FLOT Chemotherapy Followed by Adjuvant Durvalumab or Placebo in Patients with Resectable Gastric and Gastroesophageal Cancer (GC/GEJC) (MATTERHORN) MK-3475-811/KEYNOTE-811 Safety and Effectiveness of Ramucirumab in Patients with Advanced Gastric-Cancer in the European Union and North America: A Prospective Observational Registry (I4T-MC-JVDD) INNOVATION (EORTC 1203) Perioperative Chemotherapy (FLOT Protocol) Compared To Neoadjuvant Chemoradiation (CROSS Protocol) in Patients With Adenocarcinoma of the Esophagus I4-T-MC-JVDD Surgery for adenocarcinoma of the gastroesophageal junction (GEJ) type II: Transthoracic esophagectomy vs.ĬA209-577Ī Randomized, Multicenter, Double Blind, Phase III Study of Adjuvant Nivolumab or Placebo in Subjects With Resected Esophageal, or Gastroesophageal Junction Cancer CA209-649Įfficacy Study of Nivolumab Plus Ipilimumab or Nivolumab Plus Chemotherapy Against Chemotherapy in Stomach Cancer or Stomach/Esophagus Junction Cancer (CheckMate649) CARDIA TRIAL BGB-A317-302Ī Randomized, Controlled, Open-label, Global Phase 3 Study Comparing the Efficacy of the Anti-PD1 Antibody Tislelizumab (BGB-A317) Versus Chemotherapy as Second Line Treatment in Patients With Advanced Unresectable/Metastatic Esophageal Squamous Cell Carcinoma. Introduction: Combination therapy with the anti-HER2 antibody trastuzumab with fluoropyrimidine and platinum is the current standard for patients with HER2+ metastatic gastric or gastroesophageal junction cancer (mG/GEJc). Free Disk Space: 50 MB of free space requiredĭownload R-Wipe & Clean 20 free latest full version offline direct download link full offline setup by clicking the below button.Operating System: Windows 11/10/8/7/Vista/XP.Software Name: R-Wipe and Clean for Windows.Wipe logs and other junk to free up disk space.Cleaning event logs and get the improved workflow.Clean unwanted files from 300+ 3rd party applications.Safe removal of files and improved workflow.Fix broken shortcuts and improve PC speed. ![]() Removes all the temporary files from the browser.Free up disk space and improve PC performance.You can also download System Mechanic Pro 2020 ![]() It provides complete support for NTFS and FAT file systems. 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