title: Ivory (wrestler)

text: In early 2002, Ivory served as a trainer in the second series of "Tough Enough". After the World Wrestling Federation was renamed "World Wrestling Entertainment" and the roster was split into two "brands", Raw and SmackDown!, Ivory was drafted to the SmackDown! brand. Continuing to portray a villainess, Ivory engaged in a brief feud with "Tough Enough" co-winners Linda Miles and Jackie Gayda, which led to her facing Miles on the June 8 episode of "Velocity". Ivory won the match after Gayda shoved Miles off the top rope and costing her the match. On the June 13 episode of "SmackDown!", Ivory teamed with Gayda in a losing effort against Miles and Trish Stratus. Along with several other SmackDown! wrestlers, Ivory was traded to Raw in exchange for The Big Show in November 2002. Throughout the remainder of 2002, she teamed with Victoria in tag team matches and feuded with Trish Stratus. In November of that year, she was also part of the WWE Raw Tour in India, becoming the first female performer to tour the country, however only appeared in media events and signings, as she was not booked to compete.


title: Ivory (wrestler)

text: In 2003, Ivory became a face, and wrestled sporadically in the women's division. In June of that year, she had three pinfall victories over the WWE Women's Champion, Jazz, but never received a title match opportunity. Her only pay-per-view appearance in the course of the year was on December 14 at Armageddon, where she unsuccessfully challenged Molly Holly for the Women's Championship, after Molly grabbed her tights for leverage, and managed to capture the victory. She also served as a trainer on the third season of "Tough Enough", and did broadcasting duties at WWE events. Ivory also spent eight weeks working as a trainer at WWE's then-developmental territory, Ohio Valley Wrestling (OVW) and also made one televised appearance against Jillian Hall in a losing effort. In May of that year, she and Todd Grisham began hosting "The WWE Experience", a weekly television show that recapped events from "Raw" and "SmackDown!". On July 22, 2005, several weeks before "WWE Experience" ended in August 2005, WWE announced that Ivory had opted not to renew her contract with the company.


title: Ivory (wrestler)

text: After leaving WWE, Moretti began wrestling sporadically on the independent circuit under her birth name. On November 19, 2005 in Spartanburg, South Carolina at "A Tribute to Starrcade", she teamed with Bambi to defeat Team Blondage (Krissy Vaine and Amber O'Neal) for the CCW Tag Team Championship. On April 21, 2006 in Surrey, British Columbia, Moretti defeated Rebecca Knox for Extreme Canadian Championship Wrestling (ECCW)'s NWA SuperGirls Championship. She also successfully retained her title in a match the following night. Afterward, Moretti decided to stay with ECCW to help create a strong women's division. She held the title for approximately five months before losing it to Nattie Neidhart on October 8, 2006.


title: Ivory (wrestler)

text: On March 5, 2011, Moretti appeared at the Women Superstars Uncensored (WSU) 4 Year Anniversary event, where she was inducted into the WSU Hall of Fame. She also appeared on the event, preventing Rick Cataldo from interfering successfully in the WSU Spirit Championship bout, hitting Cataldo with the "Poison Ivory", between Brittney Savage and Sassy Stephie. As a result, Stephie was able to win, capturing the championship and thanking Ivory for her help.


title: Ivory (wrestler)

text: Ivory took part in the WrestleMania Axxess convention from WrestleMania 31 in March 2015 and later appeared on "The WWE List", a digital series that aired on WWE.com. On January 27, 2016, she appeared on the WWE Network program "Table for 3", alongside fellow wrestlers Alundra Blayze and Molly Holly.


title: Ivory (wrestler)

text: On February 12, 2018, it was announced that Ivory would be inducted into the WWE Hall of Fame class of 2018. At the ceremony on April 6, she was inducted by Molly Holly. On April 8 at WrestleMania 34, she appeared during transmission while she was introduced as part of the 2018 Hall of Fame class.


title: Ivory (wrestler)

text: Ivory made her in-ring return to WWE for the first ever all-women's pay per view, WWE Evolution to compete in a battle royale for a future title shot at the Women's Championship. She lasted longer than all of the returning female legends, only to be eliminated towards the end by Asuka.


title: Ivory (wrestler)

text: On January 29, 2022, Ivory, dressed in her Right To Censor character, entered the Women's Royal Rumble at number 18 and cut a promo on her way to the ring.


title: Ivory (wrestler)

text: She only lasted 25 seconds in the match, before being eliminated by Rhea Ripley. At age 60, she became the oldest woman to enter the women's Royal Rumble, and the 3rd oldest competitor in any Royal Rumble behind Jerry Lawler at 62, and Jimmy Snuka at 64.


title: Ivory (wrestler)

text: Ivory has appeared in nine WWE video games. She made her in-game debut at "WWF WrestleMania 2000" and appears in "", "WWF No Mercy", "WWF SmackDown! Just Bring It", "WWF Raw", "WWE SmackDown! Shut Your Mouth", "WWE 2K17" (DLC), "WWE 2K18" and "WWE 2K19".


title: Ivory (wrestler)

text: Moretti was born In Los Angeles, California and raised in Inglewood, California She has three siblings: two brothers and one sister. She studied public relations at the University of Southern California (USC), and she was a cheerleader for the Los Angeles Express of the United States Football League in the mid-1980s. Prior to beginning her career in wrestling, Moretti worked as a make-up artist for the cosmetic brand Revlon.


title: Ivory (wrestler)

text: After leaving WWE, Moretti began working in the landscaping industry. Moretti also worked with her niece to help the pet population affected by Hurricane Katrina. In addition, Moretti volunteered for an organization called Best Friends Animal Society, which is a no-kill animal shelter (a shelter that does not euthanize to control animal populations) in Utah. She also worked with her local animal shelter on San Juan Island in northwestern Washington, where she has resided since 2000. While working at the shelter, she met her eventual business partner Jessica Ray, with whom she opened Downtown Dog in 2007. The facility is an animal daycare, as well as a training, grooming, and cat boarding company located in Friday Harbor, Washington. In June 2007, they expanded the business to include veterinary care and later the Bow Wow Bus, which takes the dogs on outings. Moretti has taken classes to learn how to groom animals and now grooms them as part of the business.


title: Progressive pop

text: Progressive pop is pop music that attempts to break with the genre's standard formula, or an offshoot of the progressive rock genre that was commonly heard on AM radio in the 1970s and 1980s. It was originally termed for the early progressive rock of the 1960s. Some stylistic features of progressive pop include hooks and earworms, unorthodox or colorful instrumentation, changes in key and rhythm, experiments with larger forms, and unexpected, disruptive, or ironic treatments of past conventions.


title: Progressive pop

text: The movement started as a byproduct of the mid-1960s economic boom, when record labels began investing in artists and allowing performers limited control over their own content and marketing. Groups who combined rock and roll with various other music styles such as Indian ragas and Asian-influenced melodies ultimately influenced the creation of progressive rock (or "prog"). When prog records began declining in sales, some artists returned to a more accessible sound that remained commercially appealing until the 1990s.


title: Progressive pop

text: The term "progressive" refers to the wide range of attempts to break with standard pop music formulas through methods such as extended instrumentation, personalized lyrics, and individual improvisation. "Treblezine"s Ryan Reed acknowledged that the genre "sounds like an oxymoron" and is difficult to discern from other genres "without squinting". He explained that such "elusiveness is what makes 'prog-pop' a slippery term", although the genre is definable to a set of characteristics which follow:


title: Progressive pop

text: Similar to rock and roll, the tonal structure of progressive pop overthrows harmony as its basic organizing structure. However, unlike rock and roll, progressive pop inverts received conventions, playing with them ironically, disrupting them, or producing shadows of them in new and unexpected forms. Some stylistic features include changes in key and rhythm or experiments with larger forms. Electronic techniques such as echo, feedback, stereo, loudness, and distortion may be used to give the music the impression of space and lateral extension.


title: Progressive pop

text: "Progressive pop" was originally the usual term for progressive rock music. The latter genre was influenced by the "progressive" pop groups from the 1960s who combined rock and roll with various other music styles such as Indian ragas, oriental melodies, and Gregorian chants, like the Beatles and the Yardbirds. The genre's initial premise involved popular music that was created with the intention of listening, not dancing, and opposed the influence of managers, agents, or record companies. In general, progressive music was produced by the performing artists themselves.


title: Progressive pop

text: In December 1966, "Melody Maker" attempted to define the recent developments in pop. In this article, titled "Progressive Pop", Chris Welch categorised artists using terms previously associated with jazz; in the most advanced of these, "Avant-Garde", he placed the Beatles, Cream, Love, the Mothers of Invention, Pink Floyd and Soft Machine, while "Modern", the next category, comprised the Byrds, Donovan and the Small Faces. After the release of the Beatles' 1967 album "Sgt. Pepper's Lonely Hearts Club Band", magazines such as "Melody Maker" drew a sharp line between "pop" and "rock", thus eliminating the "roll" from "rock and roll" (which now refers to the 1950s style). The only artists who remained "rock" would be those who were considered at the vanguard of compositional forms, far from "radio friendly" standards, as Americans increasingly used the adjective "progressive" for groups like Jethro Tull, Family, East of Eden, Van der Graaf Generator, and King Crimson.


title: Progressive pop

text: In 1970, a "Melody Maker" journalist described progressive pop as music appealing to the masses, but less disposable than the "six weeks in the charts and the 'forget it' music of older pop forms." By the late 1970s, "progressive pop" was roughly synonymous with "rock music". Authors Don and Jeff Breithaupt define progressive pop in the 1970s and 1980s as a "leaner breed of pomp rock" that was derivative of the Beatles. Producer Alan Parsons, who worked as an engineer on the Beatles' album "Abbey Road" (1969), remembered that even though he considered some of his songs "pure pop", others continued to categorize his band (the Alan Parsons Project) under the "progressive rock" label. Parsons thought "progressive pop" was a better name, explaining that "what made [our music] progressive was the epic sound and the orchestration which very few people were doing that at the time."


title: Progressive pop

text: During the mid 1960s, pop music made repeated forays into new sounds, styles, and techniques that inspired public discourse among its listeners. The word "progressive" was frequently used, and it was thought that every song and single was to be a "progression" from the last. The Beach Boys and the Beatles were among the earliest progenitors of progressive pop via albums such as "Pet Sounds" and "Sgt. Pepper's", respectively. Author Bill Martin recognises the bands as the most significant contributors to the development of progressive rock, transforming rock from dance music into music that was made for listening to. Before the progressive pop of the late 1960s, performers were typically unable to decide on the artistic content of their music. The Beach Boys' leader Brian Wilson is credited for setting a precedent that allowed bands and artists to enter a recording studio and act as their own producers.


title: Progressive pop

text: Citing a quantitative study of tempos in music from the era, musicologist Walter Everett identifies the Beatles' 1965 album "Rubber Soul" as a work that was "made more to be thought about than danced to", and an album that "began a far-reaching trend" in its slowing-down of the tempos typically used in pop and rock music. In mid-1966, the UK release of the Beach Boys' "Pet Sounds" was accompanied by advertisements in the local music press saying that it was "The Most Progressive Pop Album Ever!" "Cleveland"s Troy Smith believes that the album "established the group as forefathers of progressive pop, right from the beginning chords of 'Wouldn't It Be Nice', a Wall of Sound style single". In October, "Pet Sounds" was followed by the psychedelic and elaborately arranged single "Good Vibrations". According to Reed, the song became the "most obvious starting point" in the genre.


title: Progressive pop

text: The Beatles' Paul McCartney intimated in 1967: "we [the band] got a bit bored with 12 bars all the time, so we tried to get into something else. Then came [Bob] Dylan, the Who, and the Beach Boys. ... We're all trying to do vaguely the same kind of thing." In the opinion of author Simon Philo, the Beatles' progressive pop was exemplified in the double A-sided single "Strawberry Fields Forever" / "Penny Lane" (1967). In a further example of the reciprocal influences between themselves and the Beach Boys, the Beatles demonstrated "paradoxical lyrical content matched by music that was at once 'young' and 'old', rock and Tin Pan Alley, LSD and cocoa, progressive and nostalgic" – all features that were shared on "Sgt. Pepper's". Musicologist Allan Moore writes: "At that time, "Sgt. Pepper" seemed to mark rock music's coming of age ... Now, of course, with jaded memories, we think of it as ushering in an era of pomposity, with varying degrees of seriousness ... The question after 1967 was whether 'progressive' pop/rock was to be trusted, because it was dealing with issues 'deeper' than simply interpersonal relationships. In the long run, the answer turned out to be 'no' (at least, that is, until a later generation of bands discovered the delight of pastiching the Beatles)."


title: Progressive pop

text: Towards the end of the 1960s, progressive pop music was received with doubt and disinterest. The Who's Pete Townshend reflected that "a lot of psychedelic bullshit was going on", referring to "garbage" being promoted in the charts, and that many artists who were doing ambitious works were instantly being labelled "pretentious". He believed: "Anybody that was any good ... was more or less becoming insignificant again." In 1969, writer Nik Cohn reported that the pop music industry had been split "roughly eighty percent ugly and twenty percent idealist", with the eighty percent being "mainline pop" and the twenty percent being "progressive pop [developed to] an esoteric feel". He predicted that in ten years, the genre would be called by another name (possibly "electric music"), and that its relationship to pop music would be similar to the one between art movies and Hollywood. While progressive pop did not "shrink to a minority cult", as Cohn wrote one year later, "in England, I wasn't entirely wrong ... But, in America, I fluffed completely – the Woodstock nation has kept growing and, for all his seriousness and pretensions to poetry, someone like James Taylor has achieved the same mass appeal as earlier stars."


title: Progressive pop

text: Progressive rock (also known as art rock) was ushered in the 1970s, directly following the combination of classical grandiosity and pop experimentalism from the 1960s. Although it reached widespread popularity, from 1976 onward, the genre declined in sales and was played with less frequency on FM radio. According to Breithaupt and Breithaupt, this created a vacuum for "a host of new, milder 'serious' bands, whose humor (Queen), pop smarts (Supertramp), and style (Roxy Music, mach two) would ensure their survival into the eighties. ... they met the melodic requirements of AM radio while still producing thoughtful, original work." Bands like Queen and Electric Light Orchestra (ELO) played a type of progressive pop that was grounded in prog-rock without compromising their chart success. Reed cited ELO's "Mr. Blue Sky" as the "definitive statement" by ELO's Jeff Lynne, who "infus[ed] the Beatles’ kaleidoscopic post-"Peppers" sing-alongs with symphonic grandeur."


title: Progressive pop

text: The Buggles' Geoff Downes, who considered his band to be a continuation of ELO and 10cc's progressive traditions, says: "Those early 10cc records such as [1973 debut] "10cc" and "Sheet Music" were pretty out there, and Godley & Creme took that even further. Even ABBA had sections in their music that were quite intricate. We loved all that studio trickery and experimentation. Parallel to that were bands like Yes, who were experimenting in the studio in a more progressive rock format." Porcupine Tree founder Steven Wilson opined that there were "hugely ambitious" progressive pop records in the 1970s and 1980s that were "quite accessible on the surface, but if you [chose] to engage with them on a deeper level, you [could] find layers in the production, musicianship and some thoughtful lyrics."


title: Progressive pop

text: Prog-pop records sold poorly and appeared unfashionable following the emergence of new wave and punk rock. By the late 1970s, the era of record labels investing in their artists, giving them freedom to experiment and limited control over their content and marketing had ended. Corporate artists and repertoire staff began exerting an increasing amount of control over the creative process that had previously belonged to the artists. Some of the major progressive bands transitioned to a more commercial sound and deemphasized the evocation of art music. By the early 1980s, the prevailing view was that the prog-rock style had ceased to exist.


title: Progressive pop

text: Some mainstream pop acts, such as Tears for Fears, continued the traditions of prog-pop. In 1985, Simon Reynolds noted that the New Pop movement attempted to "bridge" the divide between "progressive" pop and its mass/chart counterpart, describing their general relationship as "one between boys and girls, middle-class and working-class." In 2008, "The New York Times" John Wray discussed "the return of the one-man band", observing a recent progressive pop trend that involved large bands or collectives "with a disdain for clearly defined hierarchies", noting examples such as Arcade Fire, Broken Social Scene, and Animal Collective.


title: Policenauts

text: Kojima conceived "Policenauts" while working on "Snatcher" (1988), and began development in 1990. He wanted the production quality to match that of major motion pictures, and created a scripting engine to give him more creative control. Drawing creative influences from American buddy television shows, contemporary social debates on anti-Japanese sentiment and organ transplantation, and Japan's heightened interest in space travel following the first Japanese man's trip to space in 1990, he sought to explore the concept of how living in space may affect human society and life, socially and physiologically. The original PC-9821 release utilized pixel art, while the 3DO, PlayStation, and Sega Saturn ports featured cel animation by Anime International Company.


title: Policenauts

text: An English localization was planned for the Saturn but was eventually cancelled, with Kojima citing technical problems with the translation. After interest in Kojima's work grew following the release of "Metal Gear Solid" (1998), demand for a translation built until a fan translation of the PlayStation version was released in 2009. Critics have praised "Policenauts" for its animation, voice acting, and overall presentation; several commentators have analysed its cinematic influences from films in the science fiction, action, comedy, and buddy genres, while others noted its reflection of Kojima's fascination with science and technology, and have praised its storyline, technical writing and worldbuilding. Along with "Snatcher", which has been retrospectively identified as its spiritual predecessor, "Policenauts" has been called one of the best science fiction works in games, and a foundation for Kojima's later work in the "Metal Gear" franchise.


title: Policenauts

text: "Policenauts" is a graphic adventure game with a point-and-click interface. It has also been called a visual novel and an interactive movie. The player moves a cursor freely across the screen to click on objects to examine them. During conversations, the player is given dialogue options to choose from. Once the right object in the scene has been examined or the dialogue options have been exhausted, the game progresses to the next scene in the story. In versions with cel animation, these scenes the player must examine are stills from the animated cinematics, so the game moves seamlessly between them and cutscenes. There are occasional action scenes where the player must fire a gun at enemies in a first-person perspective. The Sega Saturn version supports a light gun for these segments.


title: Policenauts

text: In 2013, Los Angeles Police Department officer Jonathan Ingram (Hideyuki Tanaka) was one of five "Policenauts", police officers who received astronaut training to protect Beyond Coast, humanity's first functional self-supporting space colony. During the test of a new space suit, an accident causes Jonathan to drift into space, presumed dead by his colleagues. In reality, the cryogenic survival system in the suit preserved him, and he is found and revived 25 years later. During that time, Beyond Coast has become the principal development location for potential interstellar travel, and is protected by a dedicated police force dubbed the Beyond Coast Police Department (BCPD).


title: Policenauts

text: In 2040, Jonathan has become a private investigator on Earth in Old Los Angeles. He is visited by his former wife Lorraine (Chiyoko Kawashima), who remarried while he was presumed dead. Lorraine asks for Jonathan's help in solving the disappearance of her husband, Kenzo Hojo; the only clues are a torn leaf, a set of capsules, and the word "Plato". Jonathan is reluctant to take her case at first, but after Lorraine leaves his office, she is murdered by a man in a black motorcycle suit. After failing to catch the culprit, Jonathan decides to fulfill Lorraine's final request and travels to Beyond, where he is reunited with his former LAPD partner, BCPD Vice Department chief Ed Brown (Shōzō Iizuka), who agrees to help Jonathan investigate the circumstances surrounding Hojo's disappearance and Lorraine's murder along with Vice Unit members Meryl Silverburgh (Kyoko Terase) and Dave Forrest (Bin Shimada).


title: Policenauts

text: During their investigation, Jonathan receives information from Karen (Kikuko Inoue), Lorraine's daughter with Hojo, that Hojo was growing increasingly stressed working at Tokugawa Pharmaceuticals, which is helping research medical solutions to health problems caused by living in space. Jonathan and Ed also run into former Policenauts Gates Becker (Osamu Saka) and Joseph Tokugawa (Iemasa Kayumi), the latter of whom Jonathan suspects of being involved. They receive further leads from a former co-worker of Hojo's; the informant is later killed and used to lure Jonathan and Ed into an unsuccessful booby trap. Hojo's body is eventually found, and Jonathan is framed for the killings. Tokugawa and Becker are revealed to have both been responsible for Jonathan's accident, and the prime movers behind an illegal drug and organ trafficking ring designed to counteract the negative side-effects of being in space for long periods of time.


title: Policenauts

text: Hojo became involved in the conspiracy to save Karen from her terminal bone cancer, but eventually tried to break away and was murdered. With help from Ed and Meryl, Jonathan storms the Tokugawa headquarters, killing Lorraine's assassin and then confronts Becker. When apparently cornered, Jonathan tricks Becker into revealing the whole scheme through a live video feed, exposing the scandal to Beyond Coast. Ed saves Jonathan by killing Becker, while Meryl and the remaining police arrest Tokugawa. Jonathan donates his bone marrow to Karen upon learning that he is her biological father, and returns to Earth.


title: Policenauts

text: "Policenauts" was developed by Konami and directed by Hideo Kojima. Kojima began to explore concepts for "Policenauts" during the development of "Snatcher" (1988) when memory limitation issues prompted them to take a break. He wanted the game to remain in the adventure genre, feeling it was the best method to express what he wanted with video games. He was also growing frustrated with game development and wanted more creative control. After the release of "" (1990), he developed a scripting engine so he could maintain control over when animations and music played instead of the programmers. Development on "Policenauts" began in earnest in 1990 and lasted four years.


title: Policenauts

text: Kojima wanted to explore a near future scenario that could realistically occur rather than outlandish science fiction. The game's story was influenced by news that captured his interest at the time. One such influence was the public debate over organ transplantation and brain death injuries. Another influence was the rise in anti-Japanese sentiment caused by the American crime film "Rising Sun" (1993). Some Asian-Americans held protests, fearing the negative characterization of Japanese in the film would lead to hate crimes. Space travel was also an influence after Toyohiro Akiyama became the first Japanese person to travel to space in 1990. Concurrently, many NASA documents about space travel and its effects on the human body were being published in Japan for the first time and were hot topics among Kojima's friends and family. Kojima was curious as to what effect living in space would have on the human body, relationships, and wondered what facets of humans would be exposed in space. He chose to explore these concepts in "Policenauts". Kojima mixed his space interests with the aforementioned social issues to build the thematic basis of "Policenauts" and hoped the players would ponder these topics.


title: Policenauts

text: Earth was called "Home" in the game while the space colony was named "Beyond", names chosen to reflect a parent-child relationship. "Beyond" also references the colony's distance from Home and the 25 years protagonist Jonathan Ingram passed through during his cryosleep. Kojima hoped that these names would reflect the persistence of human society and relationships, even after extreme technological advances. The colony's cylindrical shape was inspired by "Gundam". "Policenauts" was originally titled "Beyond", but Konami changed the name after they were unable to trademark it.


title: Policenauts

text: Kojima's familiarity with film and television influenced the cinematography in "Policenauts". Though not attempting to use video games as a vehicle for presenting movies, he wanted to fill what he perceived to be a lack of production quality in games. Kojima worked to take the excellence of acting, lighting, direction, and storytelling in filmmaking and match that quality in his games. He took inspiration from American buddy television shows he enjoyed growing up like "Starsky & Hutch". The game was originally going to be marketed as a "Cinematic Virtual Reality". Konami did a trademark search early in development that turned up empty, but by 1994, the "Virtual Reality" term had been trademarked so it was dropped.


title: Policenauts

text: "Policenauts" was first released for the PC-9821 on July 29, 1994. Kojima received a letter from a hearing-impaired player after release, upset that modern games like "Policenauts" with its CD-ROM technology were replacing game text with actual speech. Kojima originally omitted subtitles to evoke a cinematic feel, but he added them for following versions to satisfy the players. The first port was for the 3DO Interactive Multiplayer and released on September 29, 1995. A short demo with a game glossary, artwork, and design documents was released on April 21, 1995 called the "Pilot Disk". The 3DO version and subsequent console ports had a drop in display resolution, and used newly animated full motion video in contrast to the animated stills used in the PC version. The visuals were animated by Anime International Company using traditional cel animation techniques.


title: Policenauts

text: The game was ported a second time to the PlayStation, released on January 19, 1996. A bonus disc called "Policenauts Private Collection" was released concurrently which has most of the same content as the 3DO's "Pilot Disk" bonuses plus storyboards and the game script, as well as select shooting segments from the main game. The full motion videos in this version run slower at 15 frames per second (FPS) compared to 24 on the 3DO. Some story details that suggested subplots were also removed. The PlayStation launched while Konami was still developing "Policenauts" for the PC-9821. Seeing the system's potential, Kojima promised himself he would make a "Metal Gear" game for the system, though first he ported "Policenauts". In contrast to computer games, Sony and other console manufacturers ran quality testing on games for their consoles to check for bugs and rate game content. When "Policenauts" was being evaluated, Shuhei Yoshida of Sony Computer Entertainment told Kojima they were discussing the extent of breast jiggling in the game. This version was re-issued on August 7, 2003 through Konami's online store, and it was re-released digitally on PlayStation Store on May 14, 2008.


title: Policenauts

text: The final port was for the Sega Saturn, released on September 13, 1996. The version comes packaged in a slipcase containing the game case itself and a hardbound art book. It also includes some additional scenes and some modified story details, including the readdition of removed details in the PlayStation version. Kojima insisted that the Saturn port have increased video fidelity, retaining the 3DO's original 24 FPS and not using Cinepak encoding. The port also includes light gun support, a concept Kojima had since the inception of a Saturn port. His hope was that players would feel more emotion using the gun in "Policenauts" than in games like "Lethal Enforcers" (1992) which he felt did not evoke empathy. The Saturn version also has some of the content featured in the "Pilot Disk" and "Private Collection" bonus discs released on previous consoles, such as some of the making-of videos and an interview with voice actress Kikuko Inoue (unlocked after completing the game once), as well as the glossary, which is now accessible during play, allowing players to look up keywords whenever they are first used in the story.


title: Policenauts

text: An official English translation of "Policenauts" was announced for release on the Sega Saturn in 1996 in North America. It appeared in catalogs with promotional box artwork, but the game never materialized. Kojima discussed making an English translation three times, but encountered translation difficulties. As he explained, the Japanese dialogue was parsed into phrases with flags the program could reference, and making English dialogue work with this system would be too difficult. According to Jeremy Blaustein, who worked in Konami's international business department and led the translations of "Snatcher" and "Metal Gear Solid" (1998), there were never plans to localize "Policenauts". He personally felt it was one of Kojima's weaker games, not enjoying the "space cowboy" theme and feeling it lacked the tension and humor of "Snatcher". Industry journalists have speculated in hindsight that Konami may have passed on localization because of "Snatcher"'s commercial failure and "Policenauts"' long scenes and protracted dialogue during an era of heightened consumer interest in 3D action games.


title: Policenauts

text: After the successful release of "Metal Gear Solid", fan interest grew in "Snatcher" and "Policenauts". Around 2000, a petition on the Konami of America online message boards prompted the subsidiary to discuss localizing "Policenauts" with Konami of Japan. Their attempts were unsuccessful because Kojima did not want to work on older games. In response to the PS One re-release in 2003, fans organized an email campaign to pressure Konami to localize the game once again. Their attempt was publicized and supported by "IGN".


title: Policenauts

text: Work on an English fan translation began in 2002. In February 2007, the team announced it was nearing completion with a planned release for the second half of the year. Other help was provided by Youtuber Slowbeef. The translation was finally released two years later in August 2009 as a patch for the PlayStation version. It can be played on an emulator, or a PlayStation modified to read CD-Rs by ripping the game files from retail discs, applying the English patch, and burning the patched game to CD-Rs. Because some fans consider the Sega Saturn version a superior port, fans released a translation patch for it in 2016.


title: Policenauts

text: In Japan, critics praised "Policenauts" for its high level of presentation. Both "Sega Saturn Magazine" and "Famitsu" praised the quality of animation, voice acting, and its engrossing setting. "Sega Saturn Magazine" felt it was more like a movie than a game and praised its unique blend of genres, but found some of the text difficult to understand and warned that its heavy scientific writing may not be suitable for everyone. "Famitsu" described the narrative as "hardboiled". Both publications recommended "Policenauts" to fans of adventure games and anime.


title: Policenauts

text: The game was also reviewed in contemporary Western publications despite its lack of localization. "Computer and Video Games" previewed the 3DO version and considered it a sequel to "Snatcher". They felt the game had an interesting plot, "bizarre and inventive" characters, and appreciated the "level of senseless violence and gratuitous rudity of graphics." "GameFan" reviewed the PlayStation and Saturn ports; they felt it pushed the genre of interactive movies better than previous games in the genre and praised the game's intricate technical details, although they cautioned that its specificity may put off some players. They also praised its suspenseful storytelling, and felt it was worth players' time even though it emphasized text over action. They concluded that "Policenauts" was "a masterful achievement, a near-future scenario so intricately detailed, well thought out and full of originality it puts Hollywood's best attempts at sci-fi to shame." Konami was busy releasing many sports games at the time, so "GameFan" feared it would not be localized.


title: Policenauts

text: "Policenauts" has continued to receive praise for its writing and presentation in retrospective reviews. Critics highlighted Kojima's cinematic influences from science fiction films, buddy cop films, and other Eastern and Western films: in particular, the character designs drew comparisons to "Lethal Weapon" (1987). Mark Ryan Sallee of "IGN" called the game a manifestation of Kojima's film obsessions, and accomplished in its "unique direction and striking moods" thanks to the strength of its animation and vocal performances. Comparing the game's production values to anime of the mid-1990s, Bob Mackey of "1Up.com" liked how the game transitioned seamlessly between cutscene and gameplay, and preferred this style of presentation to games with high-quality cinematics that do not complement the gameplay. N. Ho Sang and Peter Tieryas of "Kotaku" wrote that "Its flashes of "Lethal Weapon"-esque intrigue give way to the deep metaphysical meanderings that makes for the usual Kojima mind meld on top of fantastic production values and mesmerizing art."


title: Policenauts

text: Kojima's fascination with space and future technology was noted in several reviews, and the elaborate detail placed into describing hypothetical technologies and commonplace items was frequently singled out for praise. Critics also felt the game's scientific terminology and dark themes were well-translated by fans into English. Regarding the game's story, Sallee wrote that the "somber dialogue" progressed it in a unique way. Kurt Kalata of "Hardcore Gaming 101" criticized the story as predictable, and described it as "empty, merely a buddy cop film with some sci-fi elements". Parkin found that despite ostensibly being a detective story, the game's narrative was thematically concerned with middle age, and was fascinated by the game's focus on middle-aged characters as opposed to adolescents in most other games. Sam Bishop of "IGN" also praised the game's strong characterization.


title: Policenauts

text: The game did receive some criticism. Some felt its moments of sexual humor — notably the option for Jonathan to grope the breasts of many of the game's female characters ― conflicted with its otherwise serious tone; Mackey explained that this was a remnant of the game's original release on Japanese computers during a time when the market was flooded with hentai games. Concerning criticisms of its slow pace, Mackey wrote that the game requires patience, while Kalata criticized the lack of a dialogue skip option. Parkin wrote that its format is outdated and not for everyone, but still called it "a triumph of gentle interactive storytelling", and felt it could be enjoyed by those with interests in "thrillers, point and click adventures, science fiction homage and Japanese esoterica".


title: Policenauts

text: "Policenauts" was not well known in the West until the fan translation was released 2009. Critics have expressed interest in a re-release or sequel. Sam Bishop of "IGN" included it among a list of games he wanted to see receive a high-definition remaster. N. Ho Sang and Peter Tieryas of "Kotaku" included it on a list of desired sequels, and expressed interest in a proper English port of the original. Writing in 2013, Jon Leo of "GameSpot" wrote that he wanted to see the game re-released for the PlayStation 4, feeling it could be a good mainstream push for visual novels and adventure games. While still working with Konami in 2012, Kojima expressed interest in exploring a follow-up to "Policenauts", but felt it was difficult to carry out from a business perspective. Bob Mackey of "1UP.com" criticized Konami for failing to acknowledge or pursue localization of "Policenauts" and other non-"Metal Gear" games by Kojima.


title: Policenauts

text: In retrospect, the game is often called a spiritual successor to "Snatcher." Sang and Tieryas wrote that ""Snatcher" was a masterpiece. "Policenauts" took it a step further." Both have been called some of the best science fiction works in games, and are credited for establishing Kojima's style that propelled him to excellence with his later games. Some of the "Policenauts" staff went on to hold lead development roles on Kojima's later efforts, including the "Zone of the Enders" and "Metal Gear" series. The character Meryl Silverburgh and the Tokugawa Corporation in "Policenauts" were repurposed for the "Metal Gear" series.


title: Sieve

text: A sieve, fine mesh strainer, or sift, is a device for separating wanted elements from unwanted material or for controlling the particle size distribution of a sample, using a screen such as a woven mesh or net or perforated sheet material. The word "sift" derives from "sieve".


title: Sieve

text: In cooking, a sifter is used to separate and break up clumps in dry ingredients such as flour, as well as to aerate and combine them. A strainer (see Colander), meanwhile, is a form of sieve used to separate suspended solids from a liquid by filtration.


title: Sieve

text: Some industrial strainers available are simplex basket strainers, duplex basket strainers, T-strainers and Y-strainers. Simple basket strainers are used to protect valuable or sensitive equipment in systems that are meant to be shut down temporarily. Some commonly used strainers are bell mouth strainers, foot valve strainers, basket strainers. Most processing industries (mainly pharmaceutical, coatings and liquid food industries) will opt for a self-cleaning strainer instead of a basket strainer or a simplex strainer due to limitations of simple filtration systems. The self-cleaning strainers or filters are more efficient and provide an automatic filtration solution.


title: Sieve

text: Sieving is a simple technique for separating particles of different sizes. A sieve such as used for sifting flour has very small holes. Coarse particles are separated or broken up by grinding against one another and the screen openings. Depending upon the types of particles to be separated, sieves with different types of holes are used. Sieves are also used to separate stones from sand. Sieving plays an important role in food industries where sieves (often vibrating) are used to prevent the contamination of the product by foreign bodies. The design of the industrial sieve is of primary importance here.


title: Sieve

text: The mesh in a wooden sieve might be made from wood or wicker. Use of wood to avoid contamination is important when the sieve is used for sampling. Henry Stephens, in his "Book of the Farm", advised that the withes of a wooden riddle or sieve be made from fir or willow with American elm being best. The rims would be made of fir, oak or, especially, beech.


title: Sieve

text: A sieve analysis (or gradation test) is a practice or procedure used (commonly used in civil engineering or sedimentology) to assess the particle size distribution (also called gradation) of a granular material. Sieve sizes used in combinations of four to eight sieves.


title: Aortic stenosis

text: Aortic stenosis (AS or AoS) is the narrowing of the exit of the left ventricle of the heart (where the aorta begins), such that problems result. It may occur at the aortic valve as well as above and below this level. It typically gets worse over time. Symptoms often come on gradually with a decreased ability to exercise often occurring first. If heart failure, loss of consciousness, or heart related chest pain occur due to AS the outcomes are worse. Loss of consciousness typically occurs with standing or exercising. Signs of heart failure include shortness of breath especially when lying down, at night, or with exercise, and swelling of the legs. Thickening of the valve without narrowing is known as aortic sclerosis.


title: Aortic stenosis

text: Causes include being born with a bicuspid aortic valve, and rheumatic fever; a normal valve may also harden over the decades. A bicuspid aortic valve affects about one to two percent of the population. As of 2014 rheumatic heart disease mostly occurs in the developing world. Risk factors are similar to those of coronary artery disease and include smoking, high blood pressure, high cholesterol, diabetes, and being male. The aortic valve usually has three leaflets and is located between the left ventricle of the heart, and the aorta. AS typically results in a heart murmur. Its severity can be divided into mild, moderate, severe, and very severe, distinguishable by ultrasound scan of the heart.


title: Aortic stenosis

text: Aortic stenosis is typically followed using repeated ultrasound scans. Once it has become severe, treatment primarily involves valve replacement surgery, with transcatheter aortic valve replacement (TAVR) being an option in some who are at high risk from surgery. Valves may either be mechanical or bioprosthetic, with each having risks and benefits. Another less invasive procedure, balloon aortic valvuloplasty (BAV), may result in benefit, but for only a few months. Complications such as heart failure may be treated in the same way as in those with mild to moderate AS. In those with severe disease a number of medications should be avoided, including ACE inhibitors, nitroglycerin, and some beta blockers. Nitroprusside or phenylephrine may be used in those with decompensated heart failure depending on the blood pressure.


title: Aortic stenosis

text: Aortic stenosis is the most common valvular heart disease in the developed world. It affects about 2% of people who are over 65 years of age. Estimated rates were not known in most of the developing world as of 2014. In those who have symptoms, without repair the chance of death at five years is about 50% and at 10 years is about 90%. Aortic stenosis was first described by French physician Lazare Rivière in 1663.


title: Aortic stenosis

text: Symptoms related to aortic stenosis depend on the degree of stenosis. Most people with mild to moderate aortic stenosis do not have symptoms. Symptoms usually present in individuals with severe aortic stenosis, though they may also occur in those with mild to moderate aortic stenosis. The three main symptoms of aortic stenosis are loss of consciousness, anginal chest pain and shortness of breath with activity or other symptoms of heart failure such as shortness of breath while lying flat, episodes of shortness of breath at night, or swollen legs and feet. It may also be accompanied by the characteristic "Dresden china" appearance of pallor with a light flush.


title: Aortic stenosis

text: Angina in setting of heart failure also increases the risk of death. In people with angina, the 5-year mortality rate is 50% if the aortic valve is not replaced.


title: Aortic stenosis

text: Angina in the setting of AS occurs due to left ventricular hypertrophy (LVH) that is caused by the constant production of increased pressure required to overcome the pressure gradient caused by the AS. While the muscular layer of the left ventricle thickens, the arteries that supply the muscle do not get significantly longer or bigger, so the muscle may not receive enough blood supply to meet its oxygen requirement. This ischemia may first be evident during exercise when the heart muscle requires increased blood supply to compensate for the increased workload. The individual may complain of anginal chest pain with exertion. Exercise stress testing with or without imaging is strictly contraindicated in symptomatic patients with severe aortic stenosis. Exercise stress test is now recommended by current guidelines in asymptomatic patients and may provide incremental prognostic value.


title: Aortic stenosis

text: Eventually, however, the heart muscle will require more blood supply at rest than can be supplied by the coronary artery branches. At this point there may be signs of "ventricular strain pattern" (ST segment depression and T wave inversion) on the EKG, suggesting subendocardial ischemia. The subendocardium is the region that is most susceptible to ischemia because it is the most distant from the epicardial coronary arteries.


title: Aortic stenosis

text: Syncope (fainting spells) from aortic valve stenosis is usually exertional. In the setting of heart failure it increases the risk of death. In people with syncope, the three-year mortality rate is 50% if the aortic valve is not replaced.


title: Aortic stenosis

text: It is unclear why aortic stenosis causes syncope. One theory is that severe AS produces a nearly fixed cardiac output. When a person with aortic stenosis exercises, their peripheral vascular resistance will decrease as the blood vessels of the skeletal muscles dilate to allow the muscles to receive more blood to allow them to do more work. This decrease in peripheral vascular resistance is normally compensated for by an increase in the cardiac output. Since people with severe AS cannot increase their cardiac output, the blood pressure falls and the person will faint due to decreased blood perfusion to the brain.


title: Aortic stenosis

text: A second theory is that during exercise the high pressures generated in the hypertrophied left ventricle cause a vasodepressor response, which causes a secondary peripheral vasodilation that, in turn, causes decreased blood flow to the brain resulting in loss of consciousness. Indeed, in aortic stenosis, because of the fixed obstruction to blood flow out from the heart, it may be impossible for the heart to increase its output to offset peripheral vasodilation.


title: Aortic stenosis

text: A third mechanism may sometimes be operative. Due to the hypertrophy of the left ventricle in aortic stenosis, including the consequent inability of the coronary arteries to adequately supply blood to the myocardium (see "Angina" below), abnormal heart rhythms may develop. These can lead to syncope.


title: Aortic stenosis

text: Finally, in calcific aortic stenosis at least, the calcification in and around the aortic valve can progress and extend to involve the electrical conduction system of the heart. If that occurs, the result may be heart block, a potentially lethal condition of which syncope may be a symptom.


title: Aortic stenosis

text: Congestive heart failure (CHF) carries a grave prognosis in people with AS. People with CHF attributable to AS have a 2-year mortality rate of 50% if the aortic valve is not replaced. CHF in the setting of AS is due to a combination of left ventricular hypertrophy with fibrosis, systolic dysfunction (a decrease in the ejection fraction) and diastolic dysfunction (elevated filling pressure of the LV).


title: Aortic stenosis

text: In Heyde's syndrome, aortic stenosis is associated with gastrointestinal bleeding due to angiodysplasia of the colon. Recent research has shown that the stenosis causes a form of von Willebrand disease by breaking down its associated coagulation factor (factor VIII-associated antigen, also called von Willebrand factor), due to increased turbulence around the stenotic valve.


title: Aortic stenosis

text: Notwithstanding the foregoing, the American Heart Association changed its recommendations regarding antibiotic prophylaxis for endocarditis. Specifically, as of 2007 it is recommended that such prophylaxis should be limited only to those with prosthetic heart valves, those with previous episode(s) of endocarditis, and those with certain types of congenital heart disease.


title: Aortic stenosis

text: Since the stenosed aortic valve may limit the heart's output, people with aortic stenosis are at risk of syncope and dangerously low blood pressure should they use any of a number of medications for cardiovascular diseases that often coexist with aortic stenosis. Examples include nitroglycerin, nitrates, ACE inhibitors, terazosin (Hytrin), and hydralazine. Note that all of these substances lead to peripheral vasodilation. Under normal circumstances, in the absence of aortic stenosis, the heart is able to increase its output and thereby offset the effect of the dilated blood vessels. In some cases of aortic stenosis, however, due to the obstruction of blood flow out of the heart caused by the stenosed aortic valve, cardiac output cannot be increased. Low blood pressure or syncope may ensue.


title: Aortic stenosis

text: Aortic stenosis is most commonly caused by age-related progressive calcification (>50% of cases), with a mean age of 65 to 70 years. Another major cause of aortic stenosis is the calcification of a congenital bicuspid aortic valve or, more rarely, a congenital unicuspid aortic valve. Those with unicuspid aortic valves typically need intervention when very young, often as a newborn. While those with congenital bicuspid aortic valve make up 30-40% of those presenting during adulthood and typically presenting earlier (ages 40+ to 50+) than those with tricuspid aortic valves (65+).


title: Aortic stenosis

text: Acute rheumatic fever post-inflammatory is the cause of less than 10% of cases. Rare causes of aortic stenosis include Fabry disease, systemic lupus erythematosus, Paget disease, high blood uric acid levels, and infection.


title: Aortic stenosis

text: The human aortic valve normally consists of three cusps or leaflets and has an opening of 3.0-4.0 square centimeters. When the left ventricle contracts, it forces blood through the valve into the aorta and subsequently to the rest of the body. When the left ventricle expands again, the aortic valve closes and prevents the blood in the aorta from flowing backward (regurgitation) into the left ventricle. In aortic stenosis, the opening of the aortic valve becomes narrowed or constricted (stenotic) (e.g., due to calcification). Degenerative (the most common variety), and bicuspid aortic stenosis both begin with damage to endothelial cells from increased mechanical stress. Inflammation is thought to be involved in the earlier stages of the pathogenesis of AS and its associated risk factors are known to promote the deposition of LDL cholesterol and lipoprotein(a), a highly damaging substance, into the aortic valve, causing significant damage and stenosis over time. Infiltration of inflammatory cells (macrophages, T lymphocytes), followed by the release of inflammatory mediators such as interleukin-1-beta and transforming growth factor beta-1 occurs.


title: Aortic stenosis

text: Subsequently, fibroblasts differentiate into osteoblast-like cells, which results in abnormal bone matrix deposition leading to progressive valvular calcification and stenosis.


title: Aortic stenosis

text: As a consequence of this stenosis, the left ventricle must generate a higher pressure with each contraction to effectively move blood forward into the aorta. Initially, the LV generates this increased pressure by thickening its muscular walls (myocardial hypertrophy). The type of hypertrophy most commonly seen in AS is known as concentric hypertrophy, in which the walls of the LV are (approximately) equally thickened.


title: Aortic stenosis

text: In the later stages, the left ventricle dilates, the wall thins, and the systolic function deteriorates (resulting in impaired ability to pump blood forward). Morris and Innasimuthu et al. showed that different coronary anatomy is associated with different valve diseases. Research was in progress in 2010 to see if different coronary anatomy might lead to turbulent flow at the level of valves leading to inflammation and degeneration.


title: Aortic stenosis

text: Aortic stenosis is most often diagnosed when it is asymptomatic and can sometimes be detected during routine examination of the heart and circulatory system. Good evidence exists to demonstrate that certain characteristics of the peripheral pulse can rule in the diagnosis. In particular, there may be a slow and/or sustained upstroke of the arterial pulse, and the pulse may be of low volume. This is sometimes referred to as "pulsus parvus et tardus". There may also be a noticeable delay between the first heart sound (on auscultation) and the corresponding pulse in the carotid artery ('apical-carotid delay'). In a similar manner, there may be a delay between the appearance of each pulse in the brachial artery (in the arm) and the radial artery (in the wrist).


title: Aortic stenosis

text: The first heart sound may be followed by a sharp ejection sound ("ejection click") best heard at the lower left sternal border and the apex, and, thus, appear to be "split". The ejection sound, caused by the impact of left ventricular outflow against the partially fused aortic valve leaflets, is more commonly associated with a mobile bicuspid aortic valve than an immobile calcified aortic valve. The intensity of this sound does not vary with respiration, which helps distinguish it from the ejection click produced by a stenotic pulmonary valve, which will diminish slightly in intensity during inspiration.


title: Aortic stenosis

text: An easily heard systolic, crescendo-decrescendo (i.e., 'ejection') murmur is heard loudest at the upper right sternal border, at the 2nd right intercostal space, and radiates to the carotid arteries bilaterally. The murmur increases with squatting and decreases with standing and isometric muscular contraction such as the Valsalva maneuver, which helps distinguish it from hypertrophic obstructive cardiomyopathy (HOCM). The murmur is louder during expiration but is also easily heard during inspiration. The more severe the degree of the stenosis, the later the peak occurs in the crescendo-decrescendo of the murmur.


title: Aortic stenosis

text: The second heart sound (A) tends to become decreased and softer as the aortic stenosis becomes more severe. This is a result of the increasing calcification of the valve preventing it from "snapping" shut and producing a sharp, loud sound. Due to increases in left ventricular pressure from the stenotic aortic valve, over time the ventricle may hypertrophy, resulting in diastolic dysfunction. As a result, there may be a fourth heart sound due to the stiff ventricle. With continued increases in ventricular pressure, dilatation of the ventricle will occur, and a third heart sound may be manifest.


title: Aortic stenosis

text: Finally, aortic stenosis often co-exists with some degree of aortic insufficiency (aortic regurgitation). Hence, the physical exam in aortic stenosis may also reveal signs of the latter, for example, an early diastolic decrescendo murmur. Indeed, when both valve abnormalities are present, the expected findings of either may be modified or may not even be present. Rather, new signs that reflect the presence of simultaneous aortic stenosis and insufficiency, e.g., pulsus bisferiens, emerge.


title: Aortic stenosis

text: According to a meta-analysis, the most useful findings for ruling in aortic stenosis in the clinical setting were slow rate of rise of the carotid pulse (positive likelihood ratio ranged 2.8–130 across studies), mid to late peak intensity of the murmur (positive likelihood ratio, 8.0–101), and decreased intensity of the second heart sound (positive likelihood ratio, 3.1–50).


title: Aortic stenosis

text: Although aortic stenosis does not lead to any "specific" findings on the electrocardiogram (ECG), it still often leads to a number of electrocardiographic abnormalities. ECG manifestations of left ventricular hypertrophy (LVH) are common in aortic stenosis and arise as a result of the stenosis having placed a chronically high-pressure load on the left ventricle (with LVH being the expected response to chronic pressure loads on the left ventricle no matter what the cause).


title: Aortic stenosis

text: As noted above, the calcification process that occurs in aortic stenosis can progress to extend beyond the aortic valve and into the electrical conduction system of the heart. Evidence of this phenomenon may rarely include ECG patterns characteristic of certain types of heart block such as Left bundle branch block.


title: Aortic stenosis

text: Cardiac chamber catheterization provides a definitive diagnosis, indicating severe stenosis in valve area of <1.0 cm (normally about 3 cm). It can directly measure the pressure on both sides of the aortic valve. The pressure gradient may be used as a decision point for treatment. It is useful in symptomatic people before surgery. The standard for diagnosis of aortic stenosis is non-invasive testing with echocardiography. Cardiac catheterization is reserved for cases in which there is a discrepancy between the clinical picture and non-invasive testing, due to risks inherent to crossing the aortic valve, such as stroke.


title: Aortic stenosis

text: Echocardiogram (heart ultrasound) is the best non-invasive way to evaluate the aortic valve anatomy and function.


title: Aortic stenosis

text: The aortic valve area can be calculated non-invasively using echocardiographic flow velocities. Using the velocity of the blood through the valve, the pressure gradient across the valve can be calculated by the continuity equation or using the modified Bernoulli's equation: A normal aortic valve has a gradient of only a few mmHg. A decreased valvular area causes increased pressure gradient, and these parameters are used to classify and grade the aortic stenosis as mild, moderate or severe. The pressure gradient can be abnormally low in the presence of mitral stenosis, heart failure, co-existent aortic regurgitation and also ischaemic heart disease (disease related to the decreased blood supply and oxygen causing ischemia).


title: Aortic stenosis

text: Echocardiogram may also show left ventricular hypertrophy, thickened and immobile aortic valve, and dilated aortic root. However, it may appear deceptively normal in acute cases.


title: Aortic stenosis

text: A chest X-ray can also assist in the diagnosis and provide clues as to the severity of the disease, showing the degree of calcification of the valve, and in a chronic condition, an enlarged left ventricle and atrium.


title: Aortic stenosis

text: The use of CT calcium scoring is gaining spread as a diagnostic tool to complement echo in the assessment of patients with aortic stenosis. Aortic valve calcium scoring by multidetector computed tomography (CT-AVC) is used to quantify the degree of calcification of the aortic valve. According to the 2021 ESC/EACTS Guidelines for the management of valvular heart disease the recommended thresholds indicating severe aortic stenosis are > 1200 AU in women and > 2000 AU in men.


title: Aortic stenosis

text: Treatment is generally not necessary in people without symptoms. In moderate cases echocardiography is performed every 1–2 years to monitor the progression, possibly complemented with a cardiac stress test. In severe cases, echocardiography is performed every 3–6 months. In both moderate and mild cases, the person should immediately make a revisit or be admitted for inpatient care if any new related symptoms appear. There are no therapeutic options currently available to treat people with aortic valve stenosis; however, studies in 2014 indicated that the disease occurs as a result of active cellular processes, suggesting that targeting these processes may lead to viable therapeutic approaches.


title: Aortic stenosis

text: Observational studies demonstrated an association between lowered cholesterol with statins and decreased progression, but a randomized clinical trial published in 2005 failed to find any effect on calcific aortic stenosis. The effect of statins on the progression of AS is unclear. A 2007 study found a slowing of aortic stenosis with rosuvastatin. In 2013 it was reported that trials did not show any benefit in slowing AS progression, but did demonstrate a decrease in ischemic cardiovascular events.


title: Aortic stenosis

text: In general, medical therapy has relatively poor efficacy in treating aortic stenosis. However, it may be useful to manage commonly coexisting conditions that correlate with aortic stenosis:


title: Aortic stenosis

text: Aortic valve repair or aortic valve reconstruction describes the reconstruction of both form and function of the native and dysfunctioning aortic valve. Most frequently it is applied for the treatment of aortic regurgitation. It can also become necessary for the treatment of an aortic aneurysm, less frequently for congenital aortic stenosis.


title: Aortic stenosis

text: In adults, symptomatic severe aortic stenosis usually requires aortic valve replacement (AVR). While Surgical AVR has remained the most effective treatment for this disease process and is currently recommended for patients after the onset of symptoms, aortic valve replacement approaches included open-heart surgery, minimally invasive cardiac surgery (MICS), and minimally invasive catheter-based (percutaneous) aortic valve replacement. However, surgical aortic valve replacement is well-studied, and generally has a good and well-established longer-term prognosis.


title: Aortic stenosis

text: A diseased aortic valve is most commonly replaced using a surgical procedure with either a mechanical or a tissue valve. The procedure is done either in an open-heart surgical procedure or, in a smaller but growing number of cases, a minimally invasive cardiac surgery (MICS) procedure. Minimally invasive approach via right minithoracotomy is most beneficial in the high risk patient such as the elderly, the obese, those with chronic obstructive pulmonary, chronic kidney disease and those requiring re-operative surgery.


title: Aortic stenosis

text: Globally more than 250,000 people have received transcatheter aortic valve intervention (TAVI). For people who are not candidates for surgical valve replacement and most patients who are older than 75, TAVI may be a suitable alternative. Conduction abnormalities requiring permanent pacemaker (PPM) implantation remain a common finding after TAVI due to the close proximity of the atrioventricular conduction system to the aortic root.


title: Aortic stenosis

text: For infants and children, balloon valvuloplasty, where a balloon is inflated to stretch the valve and allow greater flow, may also be effective. In adults, however, it is generally ineffective, as the valve tends to return to a stenosed state. The surgeon will make a small incision at the top of the person's leg and proceed to insert the balloon into the artery. The balloon is then advanced up to the valve and is inflated to stretch the valve open.


title: Aortic stenosis

text: Acute decompensated heart failure due to AS may be temporarily managed by an intra-aortic balloon pump while pending surgery. In those with high blood pressure nitroprusside may be carefully used. Phenylephrine may be used in those with very low blood pressure.


title: Aortic stenosis

text: If untreated, severe symptomatic aortic stenosis carries a poor prognosis, with a 2-year mortality rate of 50-60% and a 3-year survival rate of less than 30%. Prognosis after aortic valve replacement for people younger than 65 is about five years less than that of the general population; for people older than 65 it is about the same.


title: Aortic stenosis

text: Approximately 2% of people over the age of 65, 3% of people over age 75, and 4% percent of people over age 85 have aortic valve stenosis. The prevalence is increasing with the aging population in North America and Europe.


title: Aortic stenosis

text: Risk factors known to influence disease progression of AS include factors similar to those of coronary artery disease such as hypertension, advanced age, being male, hyperlipidemia, diabetes mellitus, cigarette smoking, metabolic syndrome, and end-stage kidney disease.


title: Aortic stenosis

text: People on bisphosphonates were found in a 2010 study to have less progression of aortic stenosis, and some regressed. This finding led to multiple trials, ongoing . Subsequent research failed to confirm the initial positive result.


title: Benoît Magimel

text: Benoît Magimel (; born 11 May 1974) is a French actor. He was 14 when he appeared in his first film, and has starred in a variety of roles in French cinema. At age 16, Magimel left school to pursue acting as a career. In 2001, he won the Best Actor award at the Cannes Film Festival for his role in Michael Haneke's "The Piano Teacher" as well as in 2022 for his role in "Peaceful". He also starred in Claude Chabrol's "La Demoiselle d'honneur".


title: Gary Stretch

text: Gary Stretch (born 4 November 1965) is a British actor, model, and former boxing champion. During his boxing career, Stretch won 29 of his 31 fights, 20 of those by KO. He became the WBC International Super Welterweight Champion.


title: Gary Stretch

text: In his modelling career, Stretch modelled for high-end brands including Calvin Klein and Versace. During his acting career, he starred in such films as "The Heavy" (directed by Marcus Warren) and "Alexander" (directed by Oliver Stone). He was also cast in the Shane Meadows’ film "Dead Man’s Shoes" as the psychopathic gangster Sonny for which role he was nominated for a British Independent Film Award for Best Supporting Actor.


title: Gary Stretch

text: Stretch was born in 1965 and brought up in the Haresfinch area of St Helens, Lancashire. His father was a plumber. He attended the town's Cowley High School.


title: Gary Stretch

text: A southpaw fighter, Stretch boxed most of his career as a light-middleweight, rising to become British champion in that division.


title: Gary Stretch

text: He won the WBC International Light Middleweight title, beating Ramon Angel Alegre at the London Arena on 14 February 1990, the fight billed as Valentine's Day Massacre. Stretch, aged 24, stopped the Argentine in the 6th round of a very one sided contest. Stretch relinquished the title due to a management dispute with Frank Warren and subsequently sat out his contract.


title: Gary Stretch

text: Stretch's return to the ring came in 1991 when he challenged Chris Eubank for the WBO world middleweight championship in London, in a fight billed as "Beauty V the Best". Stretch suffered a cut behind the ear in the first round and was shaken by an uppercut in the third. Eubank visited the canvas twice in the fight without a count, in the second and third rounds, and was cut badly in the fourth round by a straight left hand from Stretch. The doctor was called at the end of round 5 to look at Eubank (the cut later needed several stitches), advising the referee to stop the fight. The referee gave the Eubank corner the go ahead for "one more round". In the sixth round Stretch had a point deducted for pushing Eubank onto the canvas; Stretch was shaken by a right hand from Eubank and subsequently took a standing eight count. Stretch was then pushed through the ropes. The fight was stopped in Eubank's favor, a stoppage that was controversial. Stretch was through the ropes, struggling to regain his feet when the referee stepped in. All three judges had Stretch ahead on the scorecard at the time of the stoppage.


title: Gary Stretch

text: Stretch fought only once more after his bout with Eubank before retiring with a career record of 29 wins 1 loss and 1 NC (an accidental clash of heads causing Stretch to be cut on the forehead).


title: Gary Stretch

text: During his time as a boxer, Stretch also worked as a model. His clients included Calvin Klein and Versace.


title: Gary Stretch

text: Stretch was cast as Cleitus alongside Anthony Hopkins, Colin Farrell and Angelina Jolie in Oliver Stone's 2004 film "Alexander". Stone went on to cast Stretch again in "World Trade Center" as a paramedic, and in "Savages". In 2004, Stretch was cast as psychopathic gangster Sonny in Shane Meadows' gritty cult thriller "Dead Man's Shoes" (2004), for which Stretch received a BIFA nomination alongside fellow English actor Paddy Considine.


title: Gary Stretch

text: Stretch also starred in "Freebird" in 2008, directed by Jon Ivay. With Stretch appearing alongside Phil Daniels and Geoff Bell, the film followed three bikers across a drug-fueled ride in the Welsh countryside.


title: Bunheads

text: Bunheads is an American comedy-drama television series created by Amy Sherman-Palladino and Lamar Damon that aired on ABC Family from June 11, 2012, to February 25, 2013. Starring Sutton Foster, the show centers on a Las Vegas showgirl who gets married on a whim and winds up teaching alongside her new mother-in-law at her ballet school. On July 22, 2013, ABC Family canceled the series after one season.


title: Bunheads

text: "Bunheads" is the tale of Michelle Simms, a former 'bunhead' (slang for ballerina) who wound up as a Las Vegas showgirl. Seeing her life and career at a dead end, she impulsively takes up the offer of marriage from her persistent admirer, Hubbell Flowers (Alan Ruck), and moves to his sleepy coastal town, the fictional town of Paradise, California, halfway between Ojai and Oxnard. Once there, Hubbell is killed in a car accident and Michelle struggles to adjust to life in a small town and teaching alongside her mother-in-law, Fanny Flowers (Kelly Bishop), at her ballet school, Paradise Dance Academy.


title: Bunheads

text: In addition to recurring actors that carried over from "Gilmore Girls", including Kelly Bishop, Liza Weil, Gregg Henry, and Rose Abdoo, numerous other known actors, as well as Broadway actors, also appeared in episodes of Bunheads.


title: Bunheads

text: "Bunheads" first appeared on the development slate at ABC Family in September 2010, under the title "Strut", when the show received a cast-contingent pilot order. Lamar Damon wrote the script, and production was originally expected to begin in fall 2010. In September 2011, it was reported that the series was being retooled by Amy Sherman-Palladino, who would serve as executive producer. Originally ABC had been looking for their own answer to the musical series "Glee" but Palladino suggested going in another direction and doing a series in the world of ballet. The series was given a pilot order under the new name "Bunheads".


title: Bunheads

text: On September 28, 2011, it was announced that Broadway star Sutton Foster was set to star in the lead role as Michelle. On February 11, 2012, ABC Family ordered the pilot to series with a ten episode order. Following shortly, on February 15, 2012, it was announced that Kelly Bishop would join the show playing the recurring role of Fanny Flowers, the mother-in-law to Michelle.


title: Bunheads

text: It was announced on June 9, 2012, that singer-songwriter and "Gilmore Girls" composer Sam Phillips would score the music to "Bunheads".


title: Bunheads

text: On August 17, 2012, "Bunheads" received a renewal for the "back end" of the first season (eight additional episodes). "Bunheads" returned on January 7, 2013, after "Switched at Birth". On June 4, 2013, it was announced that Bunheads was one of 31 selected productions to receive California's Film and Television Tax Credit. Earning $5.82 million, the money would help fund a second season should the show be renewed. On July 4, 2013, it was announced that the sets were torn down, leading some reporters to speculate that the show would be canceled. ABC Family later confirmed that it was officially cancelled on July 22, 2013.


title: Bunheads

text: Critics gave a very positive reception to the show, specifically praising Amy Sherman-Palladino's distinct writing and the performances of leading ladies Sutton Foster and Kelly Bishop. Robert Lloyd of "Los Angeles Times" thought "ABC Family's "Bunheads" a cute summer treat. Amy Sherman-Palladino strikes again with that "Gilmore Girls" charm in "Bunheads", with Tony-winning Sutton Foster as a former showgirl mentoring budding ballerinas." "Variety"s Geoff Berkshire said "Sherman-Palladino's snappy banter and slightly melancholic characters only enrich the texture of a series perfectly pitched between comedy and drama." "The Huffington Post"s Maureen Ryan recommended the show saying "the pilot for "Bunheads" moves at a brisk, refreshing clip and it even packs an emotional wallop or two. The relationships that are sketched out in the first hour are promising. Sherman-Palladino has long been interested in characters who are dancing as fast as they can, and in this show, she has a whole new set to play with." "Vanity Fair"s James Wolcott titled the show a "knockout charmer" and singled out particular praise for lead Sutton Foster "revealing a knowing Carol Burnett-ish clowning flair that works beautifully on camera."


title: Bunheads

text: "Newsday" critic Diane Werts noted that ""Bunheads" set [a] multigenerational tone," and praised Sherman-Palladino's style. "Think they've all got a way with words? Some attitude? Smart pop-culture shout-outs? You betcha. "Bunheads" is from "Gilmore Girls" auteur Amy Sherman-Palladino, so it chatters just as giddily, from Gadhafi to Godzilla to Graceland." HitFix's Alan Sepinwall called "ABC Family's "Bunheads" a return to form for Amy Sherman-Palladino." and "Time"s James Poniewozik, though showing some minor concern for the series plot going forward, suggested, "What matters is its voice, and the spring in its step, and its first hour was just so damn enjoyable that I'll gladly season-pass this and see where the season takes it. Out of the gate, "Bunheads" had some impressive moves; I look forward to trying to keep up." Ken Tucker of "Entertainment Weekly" said in his review of the pilot, "Summer TV just got dreamier, dancier...Sherman-Palladino has constructed "Bunheads" cannily to both fit into and transcend ABC Family's programming." On the mixed front, David Wiegand of the "San Francisco Chronicle" thought "Bunheads" "will take some work and it could just as easily become either annoying or likable."


title: Bunheads

text: Popular entertainment website The A.V. Club ranked Bunheads number 15 on their annual "The Best TV of 2012" list writing "At its best, Bunheads scavenges real heart out of its flea-market approach to plot and character. When Foster breathes “The re-usable tote!” and Kelly Bishop replies with satisfaction, “The re-usable tote,” it's time to be thankful Sherman-Palladino is back in business." The New Yorker's Emily Nussbaum included Bunheads among her favorite television shows of 2012, listing the Istanbul (Not Constantinople) dance number closing episode six as the year's most memorable TV moment, saying: "1. This. Television is always the best when it takes you by surprise. Following the season one finale, TIME's James Poniewozik wrote a piece on the show titled "On the Importance of Bunheads." In it he details Bunheads as a necessity in the TV landscape. "Over its first season, it’s been a joy to watch, funny, charming and bittersweet, and that’s reason enough for me to want it to stay on the air, despite not-great-even-for-ABC-Family ratings. But TV also needs this show to stay on the air, to prove that there are different kinds of stories worth telling outside the usual genres."


title: Bunheads

text: Alyssa Rosenberg of ThinkProgress asked "ABC Family, Save Bunheads!" She wrote: "All of this would be enough to make a specific, brilliant, rare show. But Bunheads is something more. Its characters have pop culture addictions that rival Community‘s. It’s the unusual show about women that has good male characters—Carl, Michelle’s maybe-boyfriend bartender Godot, Michelle’s hilariously shiftless brother—but that hasn’t subverted its female characters to their development, creating an unusual degree of gender balance. And it’s a show that’s not afraid of real sadness, but that doesn’t need to beat up on its characters to let them fail: when Michelle accidentally pepper-sprayed her students on the eve of a critically important performance for the school’s financial health, we were allowed to feel the weight of her accumulated past missteps without being disgusted by or feeling distanced from her. That’s a deft balance. And if ABC Family wants to level up on its brand, to be something more than the network where Shailene Woodley worked before she got famous, it should keep it up, and renew Bunheads." Slate magazine's David Weigel explained "Why Bunheads is the best show on TV." In his article, he wrote: "The New York Times has said it on the front page of the Style section, and regular Slate-ster Alyssa Rosenberg has said it eloquently at ThinkProgress. I’ll add my voice: ABC Family needs to renew Amy Sherman-Palladino’s fantastic ballet dramedy Bunheads, the best original, scripted show on TV."


title: Bunheads

text: Nearing a decision regarding renewal, on July 17, 2013, several critics dedicated individual articles urging ABC Family to renew "Bunheads". Emily VanDerWerff of the AV Club wrote an article titled: "Hey, ABC Family: Just renew Bunheads already". In the article she wrote "Fortunately, the qualitative argument is very easy to make for Bunheads. It’s by several orders of magnitude the best show ABC Family has ever aired, and it’s not like that’s an easy task or anything." On Rotten Tomatoes season 1 has an approval rating of 100% based on reviews from 26 critics. On Metacritic season 1 has a score of 74 out of 100 based on reviews from 24 critics.


title: Kimberly Kane

text: Kane was born in Tacoma, Washington, and moved to Los Angeles, California, in 2004 to pursue a career in adult entertainment. Kane officially entered the adult film industry a year before that, in August 2003, when she was 20 years old, and did her first scene for the film "Troubled Teens".


title: Kimberly Kane

text: In 2006, at the age of 23, she directed her first movie for Pulse Pictures entitled "Naked & Famous", which received a 5-star review from AVN Magazine, the highest rating they give. Shortly after, Vivid Entertainment approached Kane to direct for Vivid-Alt, a branch dedicated to providing artists a platform to create high-end adult content with an alternative look to standard pornography.


title: Kimberly Kane

text: After she made her directorial debut with "Naked and Famous" for Pulse Distribution, she went on to direct "Triple Ecstasy", "Morphine", and "Live In My Secrets", three alt porn films produced by Vivid Entertainment.


title: Kimberly Kane

text: Vivid-Alt ended up being where Kane cut her teeth in filmmaking, editing, and photography. Kane used mixed media in her movies, including Super 8mm film, giving her videos a unique aesthetic. During Kane's time at Vivid-Alt, she was also performing in a style of adult movie called "Parody", which recreated some of the world's most beloved films and television shows into mostly campy XXX feature productions. In 2009, Kane was cast to play Dana Scully in New Sensations' "The Sex Files", winning Kane Best Actress across all adult industry platforms.


title: Kimberly Kane

text: In 2012 Kane, along with some of her adult film colleagues, was featured in Maxim Magazine after doing a campaign with The Escapist. Kane also continued to pursue her love of photography. In 2012, her writing and photography were published twice in Vice Magazine, one of which being a portrait series entitled "Girls of Hollywood". During this time, Kane's photography was selected by Dian Hanson for Taschen's book "The New Erotic Photographer Book Vol. 2". Kane also appeared as a cover-model for Taschen's "Big Book of Pussy"; notably Kane asked to be paid in art books for that modeling job.


title: Kimberly Kane

text: In 2013, Kane returned as a lead actress in a new spin on the porn parody genre called "Super Hero". Kane played Wonder Woman in two Axel Braun features, one of them winning Kane Best Sex Scene at the XBiz Awards. Notably the promotional photos of Kane in the Wonder Woman costume went viral on social and mainstream media. Kane later participated in a charity auction where the costume sold to fund the Free Speech Coalition.


title: Kimberly Kane

text: In 2015, Kane signed on as host of Viceland/Munchies Sex+Food, a TV show that explores food fetishes, feeder/feedee, sploshing, food play, and food products related to sex. Also in 2015 Kane signed on with Penthouse Magazine to photograph their celebrity directed photoshoots, called "Pop-Shots".


title: Kimberly Kane

text: Since coming on board with Penthouse, Kane has worked with Keith Hufnagel, skateboarder and owner of HUF WORLDWIDE clothing brand, Neek Lurk, creator of Anti Social Social Club, and comedian/actor Steve Agee.


title: Kimberly Kane

text: On March 22, 2010, Kane participated in an anti-piracy public service announcement for the Free Speech Coalition. In the 2012 United States presidential election, Kane voiced her support for President Barack Obama, stating that she agreed with his views on women's issues, health care, and gay rights.


title: Kimberly Kane

text: In 2013, Kane was approached by a group of fellow adult industry performers who were forming an advocacy group for adult performers. Kane, known for her strong opposition against Measure B 'The Condom Law,' was an obvious choice to be a founding member of the organization that would become APAC (Adult Performers Advocacy Committee).


title: Kimberly Kane

text: Kane acted as Treasurer for APAC and co-wrote Porn 101, an informative video for anyone wanting to join the adult film industry. Porn 101 can be viewed on YouTube and is still relevant for anyone researching the adult industry.


title: Kimberly Kane

text: APAC is now considered the voice of adult performers within the industry and in mainstream media. APAC represents performers in the gay, straight, trans, and queer branches of the adult film industry.


title: Richard Haydn

text: Richard Haydn (born George Richard Haydon, 10 March 1905 – 25 April 1985) was a British-American comedy actor. Some of his better known performances include his roles as Professor Oddley in "Ball of Fire" (1941), Roger in "No Time for Love" (1943), Thomas Rogers in "And Then There Were None" (1945), Emperor Franz Joseph in "The Emperor Waltz" (1948), the Caterpillar in "Alice in Wonderland" (1951), Baron Popoff in "The Merry Widow" (1952), William Brown in "Mutiny on the Bounty" (1962), and Max Detweiler in "The Sound of Music" (1965).


title: Richard Haydn

text: Haydn was born on March 10, 1905, in Camberwell. After working as a music hall entertainer and overseer of a Jamaican banana plantation, he joined a touring British theatre troupe, and then moved into television and film.


title: Richard Haydn

text: Haydn never married nor had children, although he was engaged to the actress Maria Riva for several months in 1943. In the DVD commentary of "Young Frankenstein", Mel Brooks said that Haydn eschewed the Hollywood lifestyle and that he used gardening and horticulture as a means of escape.


title: Richard Haydn

text: Haydn died on April 25, 1985 at the age of 80 following a heart attack. His body was found in his home in Pacific Palisades, California, and was donated to the University of California, Los Angeles.


title: Richard Haydn

text: Haydn was known for playing eccentric characters, such as Edwin Carp, Claud Curdle ("Mr. Music", 1950), Richard Rancyd ("Miss Tatlock's Millions", 1948) and Stanley Stayle ("Dear Wife", 1949). Much of his stage delivery was done in a deliberate over-nasalized and over-enunciated manner.


title: Richard Haydn

text: Notable performances included the voice of the Caterpillar in the 1951 Disney animated adaptation of "Alice in Wonderland", and his small role of Herr Falkstein in the 1974 Mel Brooks comedy "Young Frankenstein". Haydn was the manservant Rogers in the 1945 adaptation of Agatha Christie's "And Then There Were None", and William Brown in the 1962 version of "Mutiny on the Bounty". He was acclaimed for his role in Rodgers and Hammerstein's 1965 film musical "The Sound of Music", in which he played the Von Trapps' family friend Max Detweiler.


title: Richard Haydn

text: Haydn performed as the nosy neighbour and gossip in "Sitting Pretty" with Clifton Webb and Maureen O'Hara in 1948, using his over-nasal voice. He was Prof. Summerlee in 1960's "The Lost World", and in the same year, played opposite Doris Day in "Please Don't Eat the Daisies".


title: Richard Haydn

text: In the 1960 "The Twilight Zone" episode "A Thing About Machines", he portrayed Mr. Bartlett Finchley, a quirky, self-absorbed, technophobe who is confronted by every machine in his home. On April 1, 1964, he reprised his character of Edwin Carp in an episode of "The Dick Van Dyke Show" which saluted several old-time radio performers.


title: Richard Haydn

text: On 11 April 1968 he appeared as a Japanese businessman on the episode of "Bewitched" titled "A Majority of Two". On 23 February 1969, he played the Magician who had twin daughters on the episode of "Bonanza" titled "The Lady and the Mountain Lion" (S10/Ep21). On 12 January 1973, he appeared as Edward the butler in season 4 episode 15 of "Love American Style" titled "Love and the Impossible Gift".


title: Richard Haydn

text: On radio, Haydn played Edwin Carp on "The Charlie McCarthy Show", and he was a regular on "The Swan Soap Show", which featured George Burns and Gracie Allen. Haydn wrote one book, titled "The Journal of Edwin Carp", in 1954.


title: Baby-led weaning

text: Baby-led weaning (often also referred to as BLW) is an approach to adding complementary foods to a baby's diet of breast milk or formula. BLW facilitates oral motor development and strongly focuses on the family meal, while maintaining eating as a positive, interactive experience. Baby-led weaning allows babies to control their solid food consumption by "self-feeding" from the start of their experience with food. The term "weaning" does not imply giving up breast milk or formula, but simply indicates the introduction of foods other than breast milk or formula.


title: Baby-led weaning

text: Current infant feeding recommendations by the American Academy of Pediatrics are that infants should be breast fed for the first 6 months, then be gradually introduced to solid food between the age of 6 months and 1 year. However, for much of the twentieth century, mothers were told to maintain a strict schedule for breast feeding, limiting the time at breast and the frequency of feeds. As a result, many mothers had low milk supply (as breast milk is a supply-demand phenomenon), and therefore their babies “failed to thrive.” Infant formula became increasingly accepted as a way to supplement or replace breastmilk but there was also a move to introduce strained or mashed “baby foods” from a younger age than is now known to be desirable. By the 1930s, a variety of commercial purees were available for purchase, with Gerber leading the way.


title: Baby-led weaning

text: Baby-led weaning (term self-attributed to Michael Barrientos) places the emphasis on exploring taste, texture, color and smell as the baby sets their own pace for the meal, choosing which foods to concentrate on. Instead of the traditional method of spooning pureed food into the baby's mouth, the baby takes part in family mealtimes and is presented with a variety of foods in easy-to-grasp pieces, which he or she can freely choose and explore. Infants are offered a range of foods to provide a balanced diet from around 6 months. Ideally, these will be the same foods that the rest of the family is eating, provided these foods are suitable for the infant.


title: Baby-led weaning

text: Infants often begin by picking up and licking or sucking on the piece food, before progressing to eating. Babies are typically able to begin self-feeding at around 6 months old, although some are ready and will reach for food as early as 5 months and some will wait until 7 or 8 months. The intention of this process is that it is tailored to suit the individual baby and their personal development, and that the infant’s appetite is respected with regard to which foods are chosen, the pace of eating, and how much is eaten.


title: Baby-led weaning

text: Initial self-feeding attempts often result in very little food ingested as the baby explores textures and tastes through play, but the baby will soon start to swallow and digest what is offered. Although breastfeeding is the ideal nutritional precursor to baby led weaning (as the baby has been exposed to different flavors via its mother's breast milk), it is also entirely possible to introduce a formula-fed baby to solids using the BLW approach. Formula-fed babies can successfully wean using BLW.


title: Baby-led weaning

text: Providing an infant with table foods initiates the development of strong oral motor control for chewing and swallowing, including tongue lateralization and eventual bolus formation. When an infant mouths a food texture, the tongue lateralization reflex forces them to move their tongue to the side to lick and taste the food, and engages the phasic bite reflex. Through continued practice, infants learn to volitionally lateralize their tongue and bite—the first step in the development of a munching/chewing pattern.


title: Baby-led weaning

text: BLW is closely linked to the way in which babies develop in their first year, particularly in how their nutritional needs dovetail with their motor development.


title: Baby-led weaning

text: As recommended by the World Health Organization and several other health authorities across the world, there is no need to introduce solid food to a baby's diet until after 6 months. This guidance is based on research indicating that it is from this age that infants begin to need additional nutrients that cannot be supplied by breastmilk or formula alone. The time period from 6 to 18–24 months of age is when the risk of malnutrition is high in infants and the role of breastmilk or infant formula remains important throughout this period. It is important that parents do not decrease the volume of milk feeds until the baby is taking in enough solid foods to support growth (AAP, 2013). Formula or breastfeeding is continued in conjunction with complementary foods and is always offered before solids in the first 12 months.


title: Baby-led weaning

text: By the time most neurotypically developing babies reach six months, their digestive system and their fine motor skills have developed enough to allow them to self-feed. Baby-led weaning takes advantage of the natural developmental progression of the child, both in relation to the age of beginning the transition to solid foods and to the gradual pace of this transition that happens when the infant is in control of the process.


title: Baby-led weaning

text: From infancy, the only oral motor pattern a baby knows is suck-swallow-breathe. This reflexive way of eating allows infants to feed from birth (from a breast or bottle) while protecting their airway and meeting their nutritional needs. The oral motor patterns required for eating and swallowing solids include tongue lateralization, tongue elevation, and munching/chewing, and unlike the suck-swallow-breathe sequence, coordination of these oral motor patterns is learned, not reflexive, although reflexes are present to allow a baby to begin to develop these patterns. When an infant is offered a spoon of puree, the practiced or familiar oral motor pattern is sucking. Purees are thicker than formula or breast milk, but do not require chewing. They are therefore sucked off of a presented spoon and moved in the mouth in a similar fashion to liquid. This is generally seen as an integral part of the process of introducing solid foods and an important step in the acquisition of chewing skills. Conversely, professionals experienced in BLW note that effective chewing tends to appear sooner in infants who are not exposed to purees. The skills required for chewing are vastly different than those required for spoon feeding, and most babies do not need to be taught how to swallow. Swallowing is a deep brainstem reflex present by 15 weeks gestation and well established by full term birth. Babies already know how to swallow--no need to practice! Interestingly enough, thicker textures are actually EASIER and SAFER for babies to swallow (think purees), and young babies who have swallowing difficulty are actually prescribed thickened milk to drink! But purees do teach baby a motor pattern: bring food in, move it back, swallow. Because most solid foods require chewing before you move them back and safely swallow, learning to ingest purees does NOT prepare a baby for chewing.


title: Baby-led weaning

text: Indeed, current research supports that delayed experience with eating lumpy foods leads to poor food acceptance in later years.


title: Baby-led weaning

text: Through playful exploration and handling food, babies learn about texture and are able to practice new oral motor skills without any pressure to eat. BLW also allows them to be in charge of what goes in their mouth, how it goes in, and when. Thus, they gradually develop the oral motor patterns required for mature bolus manipulation, chewing, and swallowing. The baby learns most effectively by watching and imitating others, while allowing her to eat the same food at the same time as the rest of the family contributes to a positive weaning experience.


title: Baby-led weaning

text: Self-feeding supports the child's motor development on many vital areas, such as their hand-eye coordination and dexterity, as well as chewing. It encourages the child towards independence and often provides a stress-free alternative for meal times, for both the child and the parents. Some babies refuse to eat solids when offered with a spoon, but happily help themselves to finger food.


title: Baby-led weaning

text: The originators of BLW assert other strategies which are in line with traditional feeding safety guidelines. For example, it is recommended that infants are seated upright, either on the parent's lap, or in a supportive high chair, for all feeding experiences. This allows for easy expulsion of the bolus by gagging, and decreases accidental movement of the food into the pharynx. Additionally, a child who has the trunk and head control to sit independently though a meal (proximal stability) will more likely demonstrate coordinated ability to move the tongue and jaw for chewing.


title: Baby-led weaning

text: When infants bring solid foods to their own mouth, they are the ones guiding the sensory experience, starting and stopping when they are comfortable and ready. When food does move too posteriorly in the mouth triggering a gag reflex, the "entire" bolus is expelled from the mouth– something that is not possible with a puree. Also, solid food moves slowly in comparison to liquid, and is not often sucked into the pharynx, which would allow for laryngeal penetration or aspiration of the bolus. The food bolus will trigger a gag response first and be expelled before it hits the laryngeal vestibule. Infants therefore utilize the gag reflex for learning three important concepts: the borders of their mouth, desensitizing their gag reflex, and how to protect their airway when volitionally swallowing solid foods. As infants get closer to one year old, the gag reflex moves posteriorly, closer to the laryngeal vestibule. This allows food to move closer to the laryngeal vestibule before triggering a gag. Parents following BLW are advised to avoid classic “choking hazards” or airway shaped foods: whole grapes, coin-shaped slices of hotdogs, cherry tomatoes, etc.


title: Baby-led weaning

text: Very little scientific research has been done regarding baby-led weaning. However, a study headed by child health specialist Charlotte M. Wright from the University of Glasgow, Scotland found that while BLW works for most babies, it could lead to nutritional problems for children who develop more slowly than others. Wright concluded "that it is more realistic to encourage infants to self-feed with solid finger food during family meals, but also give them spoon fed purees."