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The Puggle is a strong and healthy little dog with an energetic spirit, a sense of humor, and an eagerness to please.
On the downside: the Puggle has the potential to be stubborn, selectively deaf, uncooperative, and just not that into you.
The Puggle is a mix between the Beagle and Pug. He's become quite popular among dog owners because of his adorable looks and fun-loving personality.
He gets along with kids and other dogs and can make a great family companion. Just know that the Puggle may enjoy barking.
Although he's intelligent and loving, he's not always eager to please when it comes to training. The Puggle is active. He's not content to laze around the house.
He plays energetically indoors and outdoors. Expect to give him at least 30 minutes of exercise each day.
He's a good walking companion, but he's not the best choice if you want a jogging partner. Agility training is a good way to direct your fun-loving Puggle's need for speed.
Being a social dog, the Puggle gets along well with everyone. He usually enjoys being with children and is not aggressive toward other dogs.
Puggles will bark to let you know when someone comes to the door. But given their friendly nature, they're not guard dogs.
Puggle Puppies – Before You Buy…
What Price are Puggle Puppies?
The price of Puggle puppies is anywhere between $750 to $1,000.
How to Find Reputable Puggle Breeders?
Reputable Labrador Breeders do not put advertisements in the classified ads of newspapers or the internet.
You will not find a well-bred puppy in pet shops, flea markets, or auction sites.
Most reputable breeders will have a private website to showcase their dogs, tell about themselves, their history with the breed, why they breed, and so on.
A reputable breeder will also join some kind of venue with their dogs. These venues can be classified as hunting tests, field trials, conformation shows, or performance events.
Reputable breeders will make sure that before any dog is bred, they are correct in temperament, conformation, and trainability.
They should also have passed all the required health clearances before breeding.
3 Little-Known Facts About Puggle Puppies
- The Puggle first appeared on the scene in the USA in the 1980s. It's the result of crossing a Pug with a Beagle.
- Puggles have taken on many traits of the parent breeds. But how a Puggle puppy will turn out is truly just luck of the draw because it's still a young breed.
- Some Puggles can look more like a Pug and others more like a Beagle, with some being a lovely mixture of the two.
What's constant is the fact that they boast kind and affectionate natures, making them one of the most popular crossbreeds today.
Physical Traits of the Puggle
Puggles can inherit the physical traits of either of their parent breeds, namely the Beagle or the Pug.
Some Puggle puppies have adorable wrinkly faces like a Pug, whereas other puppies in the same litter have a longer nose and look more like a Beagle.
Most Puggles tend to have Pug-like faces.
The only real difference is the length of their nose, which means they are less at risk of suffering from breathing issues associated with brachycephalic breeds like the Pug.
They also usually inherit the very endearing and expressive eyes of both parent breeds.
They have quite thick set, compact bodies and shortish legs, with good shoulders and firm, level backs.
Their loins are nicely muscled and well-rounded which adds to their compact appearance. Their ears tend to droop down, and their tails curl over their backs.
When it comes to their coat, Puggles usually have short, straight coats that lie close to the body.
The colors of the coat are commonly black, lemon and white, black and tan, apricot and tan, and light fawn to dark fawn.
Puggles have masks around their eyes, ears, and on their backs. These can be varying shades. Some of them can also have multi-colored patches in their coats much like the Beagle.
How Big is a Full-Grown Puggle?
Most Puggles are 13 to 15 inches in height and usually weigh 18 to 30 pounds.
What is the Life Expectancy of the Puggle?
The life expectancy of the Puggle is 10 to 15 years.
Intelligence, Temperament and Personality Traits of the Puggle
Puggles are playful and energetic little dogs. They are warm and welcoming to visitors and strangers alike.
Although they love to have fun, Puggles are some of the best cuddlers in the world.
They'll quickly jump onto the sofa and snooze on your lap, but he also expects you to pet him while he dozes off!
Puggles crave attention and make wonderful companions for families in apartments or large estates alike.
Barking and howling seem to be a major complaint of those who own Puggles.
These behaviors usually occur when he is left alone and is believed to be the result of a lack of exercise or separation anxiety.
Digging is also a problem within this hybrid breed.
Puggles are very intelligent and moderately easy to train. They do tend to be stubborn, so the training sessions must be fun and interesting.
Puggles are food-oriented, so training sessions will be more productive if yummy treats are used as rewards.
Plenty of praise will also work wonderfully because they love to make their humans proud and happy. Always use positive training methods when working with Puggles in obedience.
The Puggle's Diet
One of the favorite things that Puggles enjoy doing is eating. They absolutely love to eat. Unfortunately, they will consume so much food that they easily become overweight and unhealthy.
Puggles should be fed high-quality dry kibble. Make sure to feed him only the recommended amount as stated on the package.
The meals can be broken down into two or three smaller portions so that he can eat several times throughout the day. Puggles should never be free-fed.
How Much Exercise Does a Puggle Need?
Puggles need a good dose of daily exercise because of their active and energetic nature.
They like going on brisk walks around the neighborhood to check out the sights, smells, and sounds. A fenced yard will give him plenty of space to play and run without worrying about him getting hurt.
As much as you want to let him roam free, he should not be exercised off the leash because he has the Beagle's chase instincts.
He could just run without looking and get hit by passing cars or pedestrians or get lost in the crowd.
During inclement weather, the Puggle will be more than happy to play games indoors to burn off his energy.
Without proper exercise, the Puggle tends to howl, and he will do so very loudly. This could be a problem for you and your neighbors as well.
Ensuring that your Puggle has plenty of exercise is a much better thing than paying fines or being known as the family with the annoying dog!
Puggle Health and Conditions
Puggles are generally healthy because they are a result of crossbreeding.
However, there are some health issues that they are predisposed to because of the parent dogs, such as patellar luxation, hip dysplasia, cherry eye, hypothyroidism, and epilepsy.
Stenotic nares are also a major problem that causes the inability to breathe.
My Final Thoughts on the Puggle
Lively and full of spunk, the Puggle is a fun-loving little clown. He'll run around and play like a puppy well into his adult years.
His perky attitude and spark of enthusiasm will keep the family laughing day after day.
The Puggle's low maintenance coat and ability to get his exercise indoors make him the perfect dog for city dwellers.
He still enjoys running around outside, so dog parks are a great option as well. A Puggle's temperament will include some common traits of Beagles and Pugs and some unknowns.
They are inquisitive little adventurers and are very loyal and loving to their humans. Fans of Puggles describe them as playful, determined, and happy.
Their detractors say that where their Pug and Beagle sides clash, they become confused and ill-disciplined.
The Puggle can be a cute and cuddly lovebug. Before you fall in love with that adorable wrinkled face, know that you could end up with a dog that displays at least one of the worst characteristics of the Pug and the Beagle.
This includes the respiratory problems of the Pug, the stubbornness of the Pug and the Beagle, the tendency to wander and howl of the Beagle, as well as hip dysplasia and eye problems of both parent dogs.
If you're willing to welcome whatever surprises this little dog brings, you're sure to enjoy life with him.
- Puggle Puppies – Before You Buy…
- What Price are Puggle Puppies?
- How to Find Reputable Puggle Breeders?
- 3 Little-Known Facts About Puggle Puppies
- Physical Traits of the Puggle
- How Big is a Full-Grown Puggle?
- What is the Life Expectancy of the Puggle?
- Intelligence, Temperament and Personality Traits of the Puggle
- The Puggle's Diet
- How Much Exercise Does a Puggle Need?
- Puggle Health and Conditions
- My Final Thoughts on the Puggle


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Now, this is funny! Guaranteed to drive Gun Grabbing Commies wild, and manages to hit another target or two at the same time!
Archive for the 't-shirt' Category
Where can I get one of these shirts?
Posted by Thunder Pig on April 3, 2007
Posted in exposing hypocrisy, fun, gun rights, t-shirt | 1 Comment »

subset: commoncrawl


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Really not trying to make it hard. I did get a new piston with new rings and honed the cylinder and those were my results. I will set the ring gap.
Re: '78 vespa bravo new carb still wont idle
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I forget if I weighed in on this Rebel Flag stuff, because there's so many everybodys weighing in on this Rebel Flag stuff, but I am for putting the flag in a Museum, as opposed to flying it on flagpoles in front of Government Buildings, and I think it is just basically Rude, right now, to display that flag on account of all the Meaning it has accumulated in terms of this Nation's History of allowing the Owning of Human Beings as Property, and attitudes toward the Descendants of Human Beings who were Owned, as Property, by other humans, who said on paper they were all about Liberty and Freedom and stuff, but were mostly just tired of paying too many taxes to the King of England on tea and stuff. It's always about the money.
Anyway, the other day I saw a dude in a pickup truck cruising down Ritchie Highway in Glen Burnie, Anne Arundel County, Maryland, America, and the truck had two flagpoles jammed in the sides of the truck bed, and flapping away in the breeze were the Stars & Stripes on one side and the Stars & Bars on the other.
I think it's totally fair to compare the Rebel Flag to the Nazi Flag, man, and so if you are flying your flag that kinda says HEY BLACK PEOPLE, FUCK WHAT YOU THINK then you need to prepare for what you might think of as an Unreasonable Escalation of Hostilities in terms of your property, because that flag is a big, uh, red flag in terms of being Hostile, which is an extension of being Rude, and people need to stop being so fucking Rude, and if you are Rude in general toward people, then you will probably get some Rude back, you know?
I dunno if that Rebel Flag should be removed from the "Dukes of Hazzard" car from the teevee show, because there's all kindsa Nazi flags all over the place on teevee, in terms of Historical stuff, and there used to be a sitcom called "Hogan's Heroes" that was set in a WWII (The Big one) Prisoner of War camp, and the show was all about goofing on the Germans and the Gestapo and stuff, but there weren't any gags about killing millions of people in concentration camps or anything, because they were trying to keep it light, for entertainment. So I dunno, man, if somebody wants to do a Civil War sitcom, they gotta use that flag, right? For jokes? But if they ever remake that "Dukes of Hazzard" show again, maybe make one of the Duke Boys a KKK member? I dunno.
I guess owning and displaying flags falls under the Freedom of Speech thing we (as in U.S.) are supposed to be so famous for, but there's also the whole thing about yelling "fire" in a crowded movie theater and that's not cool because somebody could get hurt, and like, right now, displaying a Rebel Flag is an inflammatory thing, but I think when you start banning stuff, well, look at how great that's going with anything that's banned in this country, OK?
One way or another we all pay taxes, we all own all the stuff built by our Government, and that includes flagpoles and flags, and it's a whole bunch of people who pay taxes who think that Rebel Flag is not worth it right now, so I think it's better to get it off Official stuff, right? Also, I thought History was written by the Victors, eh? Getting rid of that flag off Official buildings is just The United States of America acting like a Winner, man.
Here in Maryland, My Maryland, we have a pretty good state flag, because it is visually divided to show the historic divisions in the state, so it preserves history and is Educational and stuff, plus it has kick-ass colors, I think.
Do you get crazy when somebody burns the Stars & Stripes? When you see some yahoo on the news yelling and burning a US Flag? I think it's kinda ridiculous to let somebody have that much power to get me all cranked up, just by burning some fabric with colors on it. I mean, fuck you, of course, for burning my flag, you rude asshole.
Meanwhile, I notice at Oriole Park at Camden Yards, they (and you know who They are) have some songs during the Seventh-Inning Stretch, when you are invited to stand up and stretch out of your (generally tiny and uncomfortable and overcrowded) seat, and sing 'Take Me Out to the Ball Game' (Jack Norworth and Albert Von Tilzer), and 'Thank God I'm A Country Boy' (John Martin Sommers), and more recently, there's been an extra Patriotism moment where you are kinda peer-pressured into listening to 'God Bless America' (Irving Berlin) as if it were the National Anthem, which it ain't, but if you blaspheme on this song, you get the stink eye from people who think you do not Support The Troops. Classic Forced Patriotism. I Salute the Troops man, don't tell me how. Now look, I have no problem with this song, it was written by Irving Berlin in 1918, and then edited in 1938 as a reaction to the rise of Adolf Hitler, and at O's games now they are playing 'This Land Is Your Land' (Woody Guthrie), which was a response song to 'God Bless America,' so that's cool, to be doing that, and I really like that song, but I'm not gonna lose my shit if people talk and go get a beer while it's playing.
If you don't, you really should consider clapping your hands during 'Country Boy,' because it's fun, and you should also take a shot at singing along to 'The Star-Spangled Banner' (Francis Scott Key) when they play it and not just do the "O!" part, you know?
And hey, 'Maryland, My Maryland' (to the tune of 'O Tannenbaum,' lyrics by James Ryder Randall), the Official State Song? C'mon, man, I am from Schenectady, New York, in The North. Now that The War is over (we won), I reside happily here in Baltimore, and do not appreciate being singled out in the National Anthem of My State ("Huzza! she spurns the Northern scum!") in such a disparaging manner, OK? I ain't singin' that.
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From Duck to Nags Head, Sushi is On a Roll
Sushi Restaurants on the Outer Banks
From major cities to sleepy towns across the country, sushi is gaining momentum in the restaurant world and there are many Sushi Restaurants on the Outer Banks. There is no exception when it comes to this Japanese favorite. It may be the beach, but when it comes to sushi, a handful of chefs at Sushi Restaurants on the Outer Banks offer some of the most mouthwatering variations of this popular menu item. Here's a rundown of some of the best spots on the beach to satisfy that sushi craving. While they all serve the traditional favorites, each brings its unique flair to the world of sushi.
Sunset Grille & Raw Bar's sushi bar in Duck opens daily at 4 p.m. and offers a menu of more than 20 variations of sushi. Enjoy their famous Spider Roll stuffed with local soft shell crab meat, the Dynamite Roll with blackened tuna and a spicy chili base or the Offshore Roll overflowing with tempura and coconut shrimp, cream crease, avocado, spicy mayonnaise, and eel sauce. These are just a few delicious rolls they offer.
In Kitty Hawk, Sanya Sushi Bistro has a complete sushi bar and offers sushi appetizers and entrees. Open for lunch and dinner, start with White Tuna Tataki or Seafood Carpaccio for starters and move on to their famous sushi entrees such as the Tuna and Salmon Deluxe, the Fancy Maki Combo or the Love Boat, which comes with 15 pieces of sashimi and 12 pieces of sushi with a rainbow roll. Watch us make sushi.
Don't miss Fuji Japanese Steakhouse and Sushi Bar in Kill Devil Hills for lunch or dinner. Fuji specializes in sushi and offer great lunch specials. From the Fuji Roll – featuring smoked salmon, yellowtail, cream cheese, avocado, and scallions – and the Spicy Beach Roll for starters, to the Atlantic Ocean Roll, Blackjack Roll and more, there's something for every sushi lover at Fuji.
Miller's Seafood and Steakhouse, also in Kill Devil Hills, serves sushi daily beginning at 4 p.m. You'll love the OBX Roller filled with tempura fried crispy shrimp, spicy tuna, mango, scallion, message, topped with avocado & crab and served with eel sauce and spicy mayo. Or try the delicious Miller's Roll, featuring tempura fried crispy lobster tail, asparagus, scallion, crispy onion strings and more. These are just a few of the favorites you can choose off of Miller's sushi menu. In action, rolling sushi.
To the south, in Nags Head in the Outer Banks Mall, you'll find Taiko Japanese Restaurant. Customers delight in the special roll offering such as the Nags Head Roll, filled with white fish, eel, shrimp, tamago, avocado, cream cheese, crabsticks and lightly fried. Other specialties include the OBX Roll, the Pirate Roll, and the Sunrise Roll. Open for lunch and dinner, Taiko is closed on Sundays.
And if you are lucky enough to be on the Outer Banks in the off-season, check out sushi night at Tortugas' Lie beginning every Wednesday at 5:30 p.m. From sashimi to fingers, combos, and rolls, it's the place to be mid-week for sushi lovers. Don't miss the Tortuga Roll, filled with mouthwatering tuna, crispy wonton, chili, aoli and masago. Or check out Tortugas' other specialties include the Hatteras Roll, the Fried Oyster Roll, and the Rasta Roll. Wash it all down with a Japanese sake or beer.
But wherever you end up on your quest for this popular Japanese delicacy, you are sure to discover that Outer Banks Sushi Restaurants are rolling out some of the best sushi the East Coast has to offer. Anytime you are hungry on the Outer Banks, click into the Outer Banks Restaurant Guide.


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Rare survey of Sandwich in Kent
- Title
- [Kent] A Mapp of the Downes from an Actual Survey taken in 1736. With a Plan of the Harbour Propos'd in 1744. The Figures on the Sands denote the Depths at Low Water in Feet, and those without, the Depths at Low Water in Fathoms. The Roman Numbers shew the Time of High Water at Full & Change And the Arrows the Setting of the Tide; which rises about 12 feet at Neap Tides, and about 18 feet at Spring Tides. P. Fourdrinier sculp.
- Author
- LABELYE, Charles
- Publisher
- Paul Fourdrinier,
- Publication place
- London,
- Publication date
- 1744
- Dimensions
- 220 by 345mm. (8.75 by 13.5 inches).
- Price
- £1,000
- Reference
- 11318
Engraved map.
Charles Labelye (1705-1762) was a Swiss engineer who settled in England, best known as the architect and builder of Westminster Bridge. However, he was also involved in various schemes for harbour improvements, notably those of Sandwich (1736-1737), Great Yarmouth (1747) and Sunderland (1748).
His survey of Sandwich was published on his two-sheet 'A Mapp of the Downes much more correct than any hitherto published Shewing the true Shape, & Situation of the Coast between the North and South Forelands, & of all the adjacent Sands together with the Soundings at Low=Water, Places of Anchorage, & all the necessary leading Marks By Charles Labelye Engineer ...' (London, 1737), his plan being to extend the harbour at Sandwich so as to afford safe haven for ships in The Downs, and serve as a naval base in the event of war with France. Nothing came of the scheme, perhaps because of the distraction of his involvement with the Westminster Bridge project.
However, in 1744, Fourdrinier, who was presumably the original engraver, reprinted the plates, advertising the chart in the Daily Advertiser (issue 4149) for 4th May:
"Just publish'd, (Price 1s. 6d.) Printed on Two Sheets of Imperial Paper, A Map of the DOWNS, much more correct than any hitherto publish'd; shewing the true Shape and Situation of the Coast between the North and South Forelands, and all the adjacent Sands, together with the Soundings at low Water, Places of Anchorage, and all the necessary leading Marks, from an actual Survey thereof, taken in the Presence of several able Pilots. By Charles Labelye, Engineer. Note, The Situation most proper for the intended new Harbour, and some Account of it, are to be found in this Map only. ..." in relation to a parliamentary discussion on the benefits of building a new harbour near Sandown Castle, on the coast between Sandwich and Deal.
It may well be that this smaller map was published at the same time, distributed to interested parties in the debate. However, this chart shows minor revisions compared to the 1736 survey; it is very similar to a finished manuscript survey by Labelye - 'A Correct Map of the Downes From An Actual Survey thereof taken by Charles Labelye Engineer ... With the Plan of the new Harbour propos'd in 1744' - in the Bibliothèque nationale de France, département des Cartes et plans, GE SH 18 PF 22 Div.2.P6 (part of the archive of the Service hydrographique de la marine).
However, the proposals fell into abeyance, with this example of the map the only one traced.
Unrecorded in ESTC; unrecorded in COPAC


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Meet the Recruiter
Meet the Recruiter
Local Health Care Employers!
Thursday, March 19 @ 3:30 - 5:00 PM.
The event will be in the auditorium of KCTC (Kent Career Technical Center), 1655 East Beltline NE, Grand Rapids, MI 49525.
This is a golden opportunity to get job search information directly from the recruiters themselves! Come hear the inside scoop on what their organizations are looking for in candidates, along with valuable information on the application process, tips for successful interviewing and even their "pet peeves".
Each organization is hiring, so bring your resume! If you are not looking for a job at this time, it is still a great opportunity to educate yourself about how health care positions are secured in today's job market.
Recruiters from Spectrum Health, Mercy Health, Metro Health, Porter Hills, and Metron Integrated Systems will be our guests, and will address the following topics in a moderated panel-style discussion, from the employer's perspective.
- Is there really a demand for health care workers?
- What are your "top tips" to high school students looking at pursuing a career in health care?
- Does volunteering/working in customer service as a high school student really make a difference in hiring?
- What qualities/skill sets (soft skills) are you looking for in new hires?
- How do applicants set themselves apart in an online application process?
- What do students do if they don't have a "work history" for a resume?
- What do you recommend as "interview clothes"?
- Give an example of "DON'Ts" in the application/interview process?
You can ask your questions too!
Space is limited.


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In just a few short weeks, on October 4th, I will again be sorting through all the shiny shaved heads of handsome lean men bolting by (already having weeded out the women, whether shaved-headed or otherwise), looking for my beloved. Cate will be searching with me, holding her bells and her sign. Addie will be hitting buttons on her communication device "Go, Daddy! You're winning the race! Run!"
Michael's 3rd entry into the Lakefront Marathon will have him at the starting gate early that Sunday morning. For the 2nd time, he has created a firstgiving page to raise funds for a foundation supporting Rubinstein-Taybi Syndrome families. It's called Special Friends. Last year with the help of friends, family, strangers and the William Starck Foundation, Michael was able to raise nearly $11,000. This year he is about to reach $5,000.
Michael runs because he loves to run. He runs because he has discipline, endurance and respect for his own well-being. He runs to set an example for our children - one of a healthy lifestyle, of taking time for oneself, of setting and reaching personal goals, of the satisfaction one gets from pushing oneself. He runs for our Addie who has taught us what strength and power really mean - that they are not external things, but things intrinsic that we are each charged with finding and pulling out of ourselves.
We try hard never to lose sight of how fortunate we are that both of our girls are happy and healthy, that they go to good schools and are taught by teachers who see their value, respect them enough to expect contributions from them, that we have the resources where we live to get programming for Addie to keep her healthy, challenged and progressing. We are lucky that we can take advantage of parent education in the world of disability, that we can give back by supporting other parents locally, by addressing future special needs professionals with our perspective as parents, that we have fulfilling relationships with so many involved in both the worlds we are part of.
So Michael runs for himself, but also for our big RTS family out there. Thank you to all of you who have become involved in his cause through your personal support to him, your spreading the word about his run, your direct contributions to his drive. Thanks to my blogfriends for shouting out about the run, too.
There's still a few weeks left - blast the link out there, talk about it, drop a few bucks in the hat... Do it if you run, if you love Michael, if you love Addie, if you love another RTS darlin', if you love someone else with difference. Michael could not and would not do it if it weren't for all of you. When he sees us at the finish line on the 4th, he will know all of you are present by proxy, too. We rarely do anything without you all in tow.
Michael and Addie upon their return from a 6 mile training run. Addie says "Daddy's number 1!"


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There is no greater excitement than capturing an exhilarating motion video using a top action camera. The GoPro Hero 5 and GoPro Hero 4 is among the best out there for action videography due to its tiny proportions and amazing mounting possibilities. Because of such versatility, you can get best GoPro accessories for hero 5 black and hero 4 that can be attached to this camera, revolutionising the way you shoot action videos.
GoPro makes purchasing extra mounts and other accessories very simple and worthwhile. These accessories help you tap the limitless possibilities in action photography. However, you may get a little fazed with the problem of plenty when attempting to get new accessories due to the sheer abundance of choices. So, to help you out, we have listed out some of the best accessories for GoPro hero 5 black and hero 4 that you can opt for and get going.
Best GoPro Accessories for Hero 5 and 4
#1. GoPro Dual Battery Charger
This is among the most fundamental and best GoPro accessories as it enables you to comfortably charge two GoPro Hero 5 Black batteries. The charging can be done using any USB port. There is a dual LED indicator light that shows the charging status. You can use it in conjunction with the GoPro Supercharger accessory for speeding up the charging to up to 45%. For further convenience, it also comes with a spare 1220mAh Li-ion rechargeable Hero5 Black Battery.
#2. GoPro Handler
With the GoPro Handler, you can maintain a firm grip over your GoPro and keep it in place. You get vastly improved steadiness and control with this accessory when doing different tasks with your GoPro such as capturing selfies, POV or follow-cam footage. It is great for all the adventure fans who love activities such as kayaking, surfing, etc. It helps to keep the GoPro afloat so that you can easily shoot in and around the water without any issues. The Handler is very comfortable with an anti-slip build for a nice grip. It comes with a strap and a GoPro thumb screw wrench that also functions as a bottle opener.
#3. GoPro Rechargeable Battery
The Rechargeable Battery is among the must have GoPro accessories and it's the same for the GoPro Hero 5 ad hero 4 model. This is a fantastic spare or replacement option and with the additional 1220mAh lithium-ion rechargeable battery it lets you charge one while using the alternate for your shooting.
#4. GoPro Smart Remote
The Smart Remote is among the best GoPro accessories in 2017 for this all-action camera. It helps to control your GoPro remotely from a distance of up to 600 feet. The remote is both wearable and waterproof suiting dynamic, adventure-packed activities. You can use it easily with gear-mounted shots including powering the camera on or off, adjusting settings, recording videos and capturing photos. The Smart Remote lets you to control a whopping 50 cameras at a single time and also comprises of a 40% enhanced battery capacity in comparison with a regular Wi-Fi remote.
#5. GoPro Mount
This is an extremely versatile GoPro mount that can be put to use in three different ways. First one is to use it as a camera grip, next as an extension arm and finally as a tripod. The folding arm is just apt for POV or follow-cam shoots and also simplifies the capture of selfies without the mount coming into the shot. Once it is removed from the arm, the handle functions as a camera grip, and within this handle is a weightless, mini tripod that can be taken out and utilised as a standalone.
#6. GoPro Remo
One of the more interesting items to have in your GoPro Hero 5 accessories kit, the GoPro Remo is a waterproof voice-controlled remote for the Hero5 Black and Hero 5 Session. You can simply attach it to your clothes or wear it on your wrist or gear. It improves the voice-based control of the Hero5 camera even in noisy surroundings full strong winds. This can be utilised as a one-button remote from a distance of about 33 feet.
#7. GoPro Karma
The Karma helps you to capture some incredible GoPro footage while in the air, either handheld or body mounted. You can fold the Karma Drone, fitting it into its lightweight case so that it is quite convenient to wear while doing any activity. There is a game-style controller that comprises of an integrated touch display enabling you to fly the drone easily and joyfully. This is accompanied by a camera stabilizer that be attached to Karma Grip for amazingly steady, professional looking footage. The product is very intuitive for newbies to use with auto one-button takeoff and landing options.
#8. GoPro Seeker
This is one of the best GoPro accessories for travel. It is an innovative, weather-resistant sportspack with compatibility towards hydration. It has a flexible 16 liter design that offers an abundance of space for your personal stuff and space for up to five GoPro cameras. There are inbuilt chest and shoulder mounts that simplify the process of attaching your GoPro to the pack. The Seeker is ultra-lightweight and is perfectly suitable for travelers and outdoor aficionados. This hydration-compatible pack comes with a compartment that fits a bladder up to 2 liters.
Also Check: Best Anti-theft Bags
#9. GoPro Floaty
This is a nicely designed floatation accessory that can be attached to the frame backdoor of the Hero5 Black, the Super Suit or the Standard Housing Backdoor for previous Hero camera housings. It helps your GoPro to remain afloat. This is a fantastic GoPro accessory for those involved in snorkeling, wakeboarding or other similar water activities. There is an adhesive fulcrum and camera tether for enhanced safety in robust conditions.
#10. GoPro Suction Cup
The GoPro Suction cup gets your camera effectively attached to cars, boats or other vehicles. It is an industrial grade suction cup mount that is tested and proven to function flawlessly even at speeds of 150 plus miles per hour. It is designed for excellent stability and a wide range of mobility. The arms are adjustable giving way to a very-compact mounting. It comes with a standard base and a quick release base for comfortably shifting between shots and locations.
#11. GoPro Chest Mount Harness
This harness enables you to easily shoot super immersive video and photos from the vantage point of your chest. It is one of the best GoPro accessory for those who are interested in skiing, mountain biking, or any such activity that requires a more engaging, a below the helmet view of the scene. This accessory is completely adjustable to suit a whole range of adult sizes. There is also a junior version for kids and young teenagers.
#12. GoPro Casey
The Casey is a smooth travel and storage companion for your camera. It is compact to get fitted inside a backpack but also big enough to accommodate your GoPro cameras along with necessary mounts and accessories. It is resistant to rough weather, semi-rigid shell guards against light rain and snow. There is a protected interior that keeps your camera safe while there are removable dividers allowing you to make individual compartments for any kind of other gear setup.
#13. GoPro Supercharger
The Supercharger, of which we mentioned about briefly earlier here, is the quickest manner in which to charge your GoPro, the 27.5W Supercharger that allows you to charge two GoPro devices at the same time. There is a USB-C port that offers about 20 to 70 percent quicker on fast-charge compatible devices in comparison to use a regular charger. It also helps to continuously charging your GoPro in the middle of long duration shoots.
#14. GoPro Handlebar Seatpost Mount
This is a great accessory for bicycle seatposts and handlebars. It also functions well with stuff like ski poles and more. It fits diameter tubes spanning a range from 0.75" to 1.4" and it also fits smaller diameter tubes spanning 0.43" to 0.7" with adapter included. There can be fastened to a pipe or pole to form a handheld boom. There is also a three-way pivot arm that lets you to aim easily. There is a safeguarding liner that avoids defacement on the mounting surface and increases steadiness.
#15. GoPro The Strap
As the name suggests, this strap for your GoPro lets you strap your camera to your hand, wrist or leg to help shoot ultimately immersive POV footage, exclusive selfies and much more. There is an extended strap included that wraps around the arm, leg or even around bigger things. It also has 360 degree rotation and also has the tilt feature letting your modify your shoot angle in real-time. It is an optimum for various different activities and completely adjustable to suit a wide range of adult sizes.
#16. GoPro Micro HDMI Cable
This is a fairly straightforward accessory using which you can connect your GoPro into your HDTV for remarkable, fluid big-screen playback of your GoPro videos. This comes with a 6 feet length and gives you seamless playback on your favored HDTV for a better experience.
#17. ISPORT Suction Cup
This is a suction cup made from robust nylon mesh and is protective, tough and lightweight in its characteristics. It safeguards the case contents and also is quite convenient to carry. This case is easy to carry with you or have it at home. It also has a comfortable handle at the topside allowing easy transportability, and this makes it the best GoPro case.
#18. GoPro Screen Protectors
These screen protectors for GoPro protect against scratches and smears on the Hero 5 Black's front and back displays. These are lightweight, quick & easy to install and remove and they reduce the glare in vivid lighting or outdoors. You get five sets of screen protector films, a cleaning cloth and a backdoor shield for The Frame for added safety against dust and dirt.
#19. GoPro Wrist Housing
This wrist housing lets you wear your GoPro just like a watch for quick access for shooting videos in a moment. The Wrist Housing helps keep the camera safe and flat against your wrist but with the maneuverability letting you rapidly position it to capture photos or videos. When you are not in recording mode you will be having the freedom to use both hands making it suitable for dynamic activities like surfing, climbing and skiing. It also sits over the ski gloves or jackets with the inclusive adapter and it straps to other gear for capturing possibilities.
#20. GoPro Anti-Fog Inserts
The GoPro Anti-Fog inserts can get dropped into the sides of your camera housing to avoid fogging in extremely trying weather conditions. These inserts can last up to four uses. You dry it out and reuse, heat inserts at 300 degree for about five minutes. They can be stored in an air-tight bag.
#21. GoPro Grab Bag
With the Grab Bag you get a number of mounting choices as it gives you mounts and spare parts. There are included curved and flat adhesive mounts, a couple of mounting buckles, a three way Pivot arm and a whole range of different kinds of screws.
#22. GoPro 3.5mm Mic Adapter
This Mic adapter is used to link any standard 3.5mm external microphone to your camera for bettering the audio capture and to give an enhanced video experience.
With the best GoPro accessories you can get more juice out of your GoPro cameras by extending the possibilities and shooting amazing action videos and photos. What are all the accessories that you will buy for your GoPro camera? Let us know about it. Share your feedback with us on Facebook, Twitter and Google Plus.


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The love he recieved was excruciating while what he gave was staunch.
A friend he is, a person who reflected her thoughts. Hurt and battered, he still had the courage to love. Having courage is what she learnt from him.
He told her things of great consequence but she opposed all of them.
Inside she knew he was right and she followed them too.
His lessons well learnt by her. A survivor who is brave enough in her eyes.
He is a friend who left his mother on her birthday for two hours and met her because she was sad. He is a friend who made her laugh while he did silly tricks on his bike. He is a friend who loved her "yaaayy thing". He is a friend she loves from all her heart. He is a friend she would regret losing. He is a friend who is not disgusted by the way she walks or talks or cry or laugh or think. He knows exactly what she wants, a swing and a sunset with an innocent goat.
We are lovers, we are friends. Friends love each other and we are the loving friends. Lovers are not always a girlfriend and a boyfriend. They can be BEST FRIENDS TOO.
Baby 😂
Dedicated blog 💖
Saturday, 10 January 2015
They Can Be Best Friends Too
The love he recieved was excruciating while what he gave was staunch.
2 comments:


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To filter articles by a specific event, use the dropdown below.
Open Gym Tour: Team CP3 17U
On Saturday, Phenom Hoops traveled out to Winston-Salem, North Carolina for another special open gym feature on Team CP3's 15s, 16s, and 17s. This organization is consistently one of the most talented programs in the state and home to numerous NBA players and overseas professionals. Since basically every player on the roster is a noteworthy name, we will be taking a closer look at some personal...read more
ACC interests picking up for 2021 6'9 Eric Van Der Heijden
In our latest Phenom Hoops' recruitment update, we check in on 2021 6'9 Eric Van Der Heijden from Millbrook high school. Helping his team out to a 15-1 record and already pegged as one of the top teams in the state, Van Der Heijden has been one of the key figures for the program this year.read more
Evening Standouts at The John Wall Holiday Invitational
6'7 '21 Dontrez Styles (Kinston) There's an abundance of talent from the Kinston area, and their current star is quite obviously Styles. He's a long, physical, versatile two-way wing/forward prospect with excellent feel and the ability to cause matchup problems on both ends of the floor. Styles is a great athlete that loves to get downhill and attack the basket but also has the ability to knock...read more
Leesville Road Vs Millbrook: Miles Magical Five
Last night we were treated to a great rivalry matchup between Millbrook High School and Leesville Road High School. Both of these teams are loaded with next level talent, program history, and unbelievable fan support. It was a matchup of the elite guard play of Carter Whitt and the brute force and size that Millbrook brings to the table. Millbrook walked away with an 84-76 victory. Let's take a...read more
Who is North Carolina's Best Public School Team?
Nothing seems to excite folks more than the weekly debate surrounding which teams fall into the upper echelon of rankings. Whether public, private, or both, everyone has a case to represent their cause. That being said, public school basketball in North Carolina has been as impressive as ever through the first month of the season. Three programs, Farmville Central, Millbrook, and North...read more
Is Millbrook the Best Public School Team in NC?! Millbrook vs. Heritage Full Game RAW Highlights
This game was filled with talent. Both teams strewed with college-level players.read more
Final Thoughts from the #NCHSAALivePeriod
The new NCAA Live Period blew past all expectations and, most importantly provided a platform for a vast amount of talent to be displayed in front of dozens of college programs, but there are always improvements to be made in the future. Charlotte, North Carolina- What Year one did was brought in a lot of exposure, and offered the states best a legitimate chance to hoop in front of college...read more
Phenom's North Carolina Top 80 Camp Evaluations: Team 11
Team 11 Coach: Obe Gray #12:5'11 '20 Treyden Williams (North Mecklenburg) Starting things off, we look at a player that showcases a lot of toughness to pair with his extremely well-rounded skillset, Treyden Williams. He's a smart, wiry point guard prospect that offers an excellent balance between scoring, playmaking, and defense. Williams doesn't possess true size, but has the necessary...read more
NC Top 80 2021 Breakouts: Names to jump on TODAY
For the previous six years, Phenom Hoops has been honored to host the North Carolina Top 80, however (as we always say) this is NOT Phenom Hoop's event, this is North Carolina's event. This is the event where players get together to compete and see what the state and other classifications have to offer. However, this is also the event where the very best in the Hoop State get together and show...read more
Coach John Allen's Legendary NC Top 80 Thoughts
Coach John Allen's Legedary NC Top 80 Thoughts Interesting numbers I recall from the Top 80 event. In some ways it could sound like a football offense call from the quarterback 89 55 92 103 on 2. But in reality these are the numbers of players that impressed during stations and then watching them play you start to project what you see translated from stations to the game gives you...read more
The Game of Intrigue: Ravenscroft vs. Athens Drive
This Saturday, Phenom Hoops will be traveling to Trinity Academy in Raleigh, North Carolina for our second annual City of Oaks Classic. We've reached our final preview in the series, but it'll be exciting, as it's going to have the potential to shut the gym down. These two teams share few similarities, but both squads have something to prove. Each team contains a senior committed to a Division I...read more
North Carolina 2021s Poised to Breakout (Part One)
Every year in the #HoopState there's a crop of fresh faces making names for themselves on the court. Although camps and AAU give these kids an opportunity to create exposure for themselves, but there's absolutely nothing like the High School season. Students, fans, and sometimes the entire city will fill the gym in hopes of seeing basketball in its purest form and the hoopers get a...read more
Phenom's Open Gym Tour — Ravenscroft (Raleigh, NC)
Phenom's Open Gym Tour Day 1 Ravenscroft (Raleigh, NC) 2017-18: 20-8 1st Round NCISAA 3A Playoffs The Man No player at Ravenscroft has averaged 20 or more points since Ryan Kelly did so in 2008-09. Since that year, Ravenscroft has had 11 Division 1 players and 7 other college level players. This year that streak could break with 6'8" 2019 Jake Van Der Heijden. The left handed Bucknell commitment...read more
North Carolina's Class of 2021 Overflowing with Frontcourt Talent
North Carolina's Class of 2021 Overflowing with Frontcourt Talent On Saturday, we published our first installment of a new series that dives into the Class of 2021 landscape within the Hoopstate. The purpose of these articles should allow folks to develop a deeper understanding of these younger prospects throughout the various stages of their growth. This class is already shaping up to be...read more
Brandon Lee's Big Three: Phenom CP3 Showcase story lines
Greensboro, North Carolina- Greensboro was the place to be this weekend for Phenom Hoops CP3 Live showcase. The weekend drew in some of the nations top coaches and programs alike, offers were earned and interest was given, now lets recap some action! Eric Van Der Heijden is a real Prospect. At 6'7 Van Der Heijden has nice perimeter skill and he's an inside presence on the defensive end for Team...read more
#PhenomCP3 Morning/Early Afternoon Standouts
We got a lot of the young guys over at Proehlific Park today! Chris Sause, Kedrick Flomo, Myself, and many others will be bringing you all of the action from over here today! Let's take a look at some of the top performers! 5'9 2021 Clay Hodges: Carolina Riptide/Lake Norman Hodges is such a consistent performer for this Carolina Riptide group in the way he sets the tone with his...read more


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Health & Wellness
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Chicago Blue Dolphins is an aquatic fitness business delivering state-of-the-art swim instruction and training programs.
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StandoutEssay: Testimonials
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Nicholas Crapp
Group Chief Audit Executive
Prior to joining RBS in February 2012, Nicholas was International Director of Audit at Goldman Sachs, a position he held since 2008.
Prior to that, Nicholas had held a variety of financial and control roles since joining Goldman Sachs in 1993.
On moving to London in 2006, Nicholas worked in the Executive Office where he was responsible for the leadership of the firm's MiFiD programme.
In 1999 and 2006, Nicholas worked in Hong Kong as Asia Controller before moving to Tokyo to Head the Operations, Finance and Services Divisions (real estate and security) for Japan and subsequently all of Asia.
Between 1998 and 1999, Nicholas was appointed Directeur Générale of a French bank based in Paris, which he had oversight of the support and control functions, during the period from acquisition to operational closure.
In 1992, Nicholas began his career with Goldman Sachs in Global Equities Product Control where he spent 5 years based in New York.
Nicholas started his career with Cooper & Lybrand in London where he qualified as a Chartered Accountant in 1988 and in 1992 was offered the opportunity to move to New York as part of an exchange programme.
Nicholas attends the Board of Governors of Woldingham School. Nicholas and his wife Kathleen, have 2 children, Catherine and Elise, and live in Kenley.
Useful downloads and information
Annual Report and Accounts 2019
Modern Slavery Act (PDF 346KB)
FX Disclosure Notice, May 20, 2015 (PDF, size 15KB)
UK Money Market and Global FX Code
Managing Political Activities (PDF 303KB)


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Basics of Dog Breed : Australian shepherd
Posted on September 21 2018
The Australian Shepherd is a dog that does not lack character. It has a body with beautiful proportions and a medium frame. It is an affectionate, even invasive breed that needs to indulge in sports to be happy. In recent years, this breed is very successful in the hearts of the French.
Breed Information:
|Other names:
|Aussie, Australian Shepherd
|United States
|FCI Group:
|Sheepdogs and Cattle Dogs (except Swiss Cattle Dogs)
|FCI number:
Race history
Contrary to what its name implies, the Australian Shepherd is not native to Australia . Rather, it was American farmers who developed the breed in the 1900s to have a dog capable of gathering livestock. Even if many theories contradict each other, the true origin of this race would be Basque .
In the 19th century, in the region of the Pyrenees between France and Spain, many (including pastors) would have had to move and leave the area, for lack of work. Some would have gone to Australia at the time when the country was becoming a big producer of wool and therefore of sheep. These pastors had dogs very similar to the Australian Shepherd and their skills were highly appreciated for herd management. They would then have taken the road to the United States. The standard of the breed was established in the United States in 1957.
Physical characteristics
His hair : straight, sometimes slightly wavy, he does not fear the weather.
Its color : Australian shepherd blue, red, black or red merle may carry tawny or white spots.
His head : crown of the skull flat or barely rounded. The length of the muzzle and the width of the skull are almost the same.
His ears : triangular and drooping, they are tied up.
His eyes : almond-shaped, they can be amber, brown or blue, even an association of these colors including speckles.
His body : he is less tall than long. The ribs are curved, the rump slightly inclined and a high chest.
Its tail : right, it should not measure more than 10 cm.
Weight and size
|Between 19 kg and 26 kg
|Between 46 cm and 53 cm
|Between 25 kg and 34 kg
|Between 51 cm and 58 cm
An Australian Shepherd dog is classified as a large dog .
Behavior and character
This race is made for action although it is not quarrelsome by nature. The Australian Shepherd is rather facetious and curious. Instinctively, he is quite capable of leading or keeping a flock. Not very fragile, he easily endures long days. It has no trouble adjusting to family life as long as it can be activated.
It can begin at the age of 2 months if you want to properly discipline to make a pet. On the other hand, it is very important to offer him an education that is both firm but without violence . The brutality is unbearable. His permanent activity and his strong character require a good socialization. It is also recommended to share with him a canine activity (agility, canicross, etc ..) To ensure its development.
The Australian Shepherd often presents eye defects (called MOHC: Hereditary Canine Ocular Diseases). Among these eye diseases , it is important to be screened annually for Progressive Retinal Atrophy (RPA), Colley Eye Disease (AOC), and juvenile cataracts. He is also subject to dysplasias of the hip and elbow and epilepsy . Skin diseases have also been noted on several individuals.
Regarding deworming , it is recommended to do it 3 times a year . Beware, ivermectin (substance present in some deworming) represents a real poison for the Australian Shepherd.
|Major concerns
|Minor concerns
|Occasional concerns
|Suggested tests
|Hypoallergenic race
|Scope size
Maintenance & Hygiene
The Australian Shepherd requires some attention. Of deworming every 4 months are recommended in addition to a valid vaccination. His nails should be cut regularly to avoid any risk of cracking. Ears also need frequent cleaning to prevent wax from building up and teeth to be brushed to prevent tartar build-up.
Bath ...
Its self-cleaning hair does however require only one bath a year, it is recommended to use a shampoo for dogs to prevent drying of the hair and skin.
Brushing ...
The Australian Shepherd is subject to 2 moults a year that of the spring is stronger. During these periods of moulting, regular brushing is essential to avoid knots. It is advisable to use a soft bristle brush (iron or plastic), also called "slicker", to release his hair of plant debris after a walk for example. Its thick fur coat fits perfectly to this type of brush.
Physical activity
The Australian Shepherd needs space. A daily walk could be sufficient as long as it lasted 30 minutes minimum. It is also recommended to share with him a canine activity (agility, canicross, Frisbee, game of obedience, etc.) to ensure its development.
Of course, puppies have a lower need for physical activity compared to adults. An Australian Shepherd puppy should not jump or play too hard surfaces to avoid poor skeletal development and any adverse effects it may have on his health.
Living conditions
The Australian Shepherd is not really made for an apartment life. He prefers houses with gardens to give free rein to his sporty temperament . It is a breed that appreciates the company and that requires as much affection as action. It is therefore necessary to think of taking it out often enough and avoid leaving it alone for too long. If he needs authority, it must be served gently.
Industrial brands offer foods that are age, size and weight of the Australian Shepherd with different levels of quality. Of course, we must focus on quality using premium diet products
In terms of rations, it is said that generally an Australian Shepherd needs 320 grams of kibble per day for the male against 280 grams for a female . These amounts are to split into 2 daily meals and to adapt according to the activity and the metabolism of your dog.
Price and budget
The average purchase price of an Australian Shepherd is around 1000 to 1200 euros for a puppy registered in the LOF (called purebred).
Regarding the annual cost , take care of an Australian Shepherd and ensure good health requires a budget of about 1000 euros . For food , with mid - range products, it will cost you a little less than 600 euros . The cost of veterinary fees (vaccination, vermifuge, annual review) will amount to nearly 170 euros . Regarding hygiene (shampoo, grooming, etc.) and accessories (including candies), you will need to pay about 240 euros. For all these major expenses (others may be added depending on the case), the assurance of good health of your Australian Shepherd will require a monthly envelope of about 85 euros .
|Buying price
|700 €
|1500 €


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A retrospective cross-sectional study in La Crete, Canada
A retrospective cross-sectional study in La Crete, Canada
This random retrospective cross-sectional study was done to determine the incidence of uterine malformation in 4 groups of women desiring to conceive during their reproductive years, all of them living in La Crete, a community in Northern Alberta, Canada, with endogamous marriage practices in a 500-year-old restricted gene pool.
During 2003–2006, eight hundred women, suspected of having uterine malformation, were scanned using 2-D abdominal and transvaginal Sonography (TVS). A sub-group of 156 patients was identified with suspected uterine malformations and referred for further diagnostic investigation, including MRI, 3-D Sonography, hysterosalpingography, hysteroscopy, and laparoscopy. This group included 30 women without previous pregnancies (Group 1), 31 women with previous pregnancies and live births (fertile) (Group 2), 40 women with live births and more than 2 miscarriages (Group 3) and 55 women with recurrent miscarriages (infertile) (Group 4).
The overall frequency of uterine malformations was recorded at 19.5% in La Crete women. Ninety-five women with recurrent or some miscarriages had more uterine malformation than the other groups. The incidence in Groups 3 and 4 (infertile) was 60.8% and 39.2% in the fertile Groups 1 and 2. The p <0.01 was significant at a 95% confidence interval.
This study has provided new insights into the increasing number of uterine malformations in the population of La Crete. It was 19.5%, 5.5 times higher than that of the general population (0.1% to 3.5%). This might indicate an increase in uterine malformations among women in a restricted gene pool community. A combination of TVs, hysterosalpingography, 3-D Sonography, an MRI is necessary for the precise classification of uterine malformations. Uterine malformations are not rare but may be increasingly related to consanguinity. The finding of uterine malformation is more frequent in patients with recurrent miscarriages, especially women with septated, unicornuate, or Didelphys uteri.
Keywords: Uterus, Abnormalities, Gene pools, Restricted,
Advances in Knowledge
This study contributes to advances in knowledge as it shows that communities which practice endogamous marriages can see an increase of certain anomalies such as uterine malformation. We can then educate these communities to practice a wider choice of marriage partners in order to lower the genetic risk linked to recurrent miscarriages.
Application to Patient Care
The application to patient care is in the knowledge gained by researchers and doctors that can be applied both to the correct diagnosis of uterine malformation and to the management of patients with these abnormalities. Doctors and sonographers can use this study to improve skills in the difficult diagnosis of unicornuate uteri. The ability to diagnose uterine malformation has been improved by new imaging techniques.
Conflict of interest declaration
The author acknowledges no commercial affiliation or financial conflict of interest.
Little, if any, information exists in the literature regarding incidences of uterine malformation in restricted gene pool communities. Such information would be invaluable to the gynecologists and other health care professionals involved in the care of these patients. La Crete is a small town located 56 km southeast of High Level in Northern Alberta, Canada. The estimated population of La Crete is 3,000, almost 100% of Mennonite origin from a German background and speaking Low German. The entire population is descendent from only 26 different families, who arrived in Canada in 1500s.1 These 26 families have been sharing genetic material for over 500 years. In fact, marriages outside these 26 known families are estimated to occur in La Crete in only less than 1% of cases. Their religion does not allow first or second cousin marriages, though occasionally they do marry fourth or fifth cousins.1
Uterine malformation consists of a group of congenital anomalies of the female genital system. They are the result of four major problems in the development or fusion of Mullerian or paramesonephric ducts during fetal life. 2,3 It is important to diagnose uterine malformation as it is related to miscarriage and infertility.4 Some Mullerian defects do not hinder normal reproductive outcomes.5 In this study, only those women with two or more pregnancy losses were defined as infertile.6 The incidence of Mullerian defects in the general population is not accurately known since they are asymptomatic unless discovered accidentally, or in relation to pregnancy complications. Generally, 0.1 to 3.5% is the number accepted by many authors and these numbers differ according to each type of malformation. 4,7 Almost all structural uterine malformations are due to errors of development occurring in very early pregnancy. Embryologically in the female fetus, the fused caudal ends of the two Mullerian (paramesonephric) ducts form the uterus, cervix and upper vagina, whereas the un-fused cranial ends form the paired fallopian tubes. 3,8 Different types of fusion may occur including malformation of either or both the uterine body and uterine cavity, with subsequent impaired reproductive performance. 9, 10,11 Such malformations affect negatively the reproductive performance of the uterus leading to increased incidence of abortion and pre-term delivery in women with uterine anomalies such as unicornuate, bicornuate, Didelphys and septate uteri.12–16 This is seen clinically as an increased rate of primary infertility (failure to conceive), or more often as an increased rate of early pregnancy loss (impaired implantation and early development). Later in pregnancy, unsuspected uterine malformations may present as impaired intrauterine fetal growth due to abnormal placentation, or abnormal fetal positioning related to mechanical factors in the shape of the uterine cavity. Labour, delivery, and third stage problems may occur related to an incoordinate uterine muscular activity.12–16 A didelphic uterus is a very rare anomaly, 1 in 1 million, and can be up to 1 in 25 million in pregnancies with twins. It can lead to pregnancy failure.17
Mullerian defects are associated with an increased incidence of congenital urinary tract malformation. These incidences are noted more with unicornuate and bicornuate uteri. 18,19 In 1995, Raga reported that the overall frequency of uterine malformation was 4.0% and there was a higher incidence of miscarriages amongst patients with septated forms of uterine malformations, which was recorded at 33.6%.20 Recurrent abortion, i.e. consecutive abortion on three occasions, is less common and the etiology is unknown.21–25 Some of the associated factors include genetic factors such as thrombotic disorders, maternal medical disorders and congenital malformation of the uterus. The relative contributions of these are unknown.20– 25. Most studies demonstrate a spontaneous miscarriage rate of 10–15%. However, the true rate of early pregnancy loss is close to 50% because of the high number of chemical pregnancies that are not recognized in the 2–4 weeks after conception.25 Most of these pregnancy failures are due to gamete failure. 26,27 The term "infertility" has a specific definition, which is the inability to achieve pregnancy despite unprotected, regular and adequate intercourse over a 12 month period. It has been wrongly used in literature to describe women with recurrent abortions.7 3-D sonography is very sensitive and it should be utilized for the diagnosis of uterine malformation.28 The unicornuate uterus is associated with poor reproductive outcomes and high abortion rates up to 22% reported in the first trimester.29 It is important to be precise in the diagnosis of uterine malformation as it can change the management of the treatment30 [see Figures 1–10].
The major disturbances in the development of the Mullerian ducts are 2, 4,8
This was a random cross-sectional and retrospective study of 800 women in La Crete, carried out during 2003–2006. All were referred for sonographic examination for a variety of reasons such as previous miscarriages, early pregnancy, infertility, pelvic informatory disease, or to rule out a polycystic disease. All were scanned utilizing 2-D abdominal and transvaginal sonogram (TVS). The objective was to determine the frequency of uterine malformation among women with endogamous marriage practices. The women's mean age was 31 years. All gave informed written consent to the researcher for the study, including viewing their charts and reviewing the reports from other modalities. The Ethical Committee of the Education Counselling Service in High-Level Hospital approved the study protocol in December 2003. A sub-group of 156 patients was identified with suspected uterine malformations; of these 78 (50%) belonged to four specific families; the other 50% (78 cases) belonged to the other 22 families in the community. Analysis of the patients was done according to the recurrent pregnancy loss status. All 156 women were referred for further diagnostic investigations to reach a definite diagnosis including hysterosalpingography, MRI, 3-D sonography, hysteroscopy, and laparoscopy. Each modality has its own criterion of diagnosis according to the Canadian Association of Medical Radiation Therapy and the Canadian Society of Diagnostic Medical Sonographers [Table 2]. The groups included 30 women with no previous pregnancies and live births, 40 women with previous pregnancies, live births and more than 2 miscarriages, and 55 women with recurrent miscarriages. Infertile women are those who have had two or more miscarriages.6 The same sonographer performed all the sonograms using a Philips unit (Agilent Sonos model 4500) with 3.5Mhz, 5.0 Mhz and transvaginal transducers. The morphology of the uterus was ascertained by different diagnostic procedures and was done in the Edmonton, Calgary, and Grand Prairie hospitals. These diagnostic methods were used to classify the type of uterine malformation. 4,8 All the 156 women who had TVS and transabdominal sonograms were sent for hysterosalpingography (HSG). Forty of them were sent for 3-D sonography. Twenty-two patients were sent to have an MRI. Sixteen were sent to have a hysteroscopy and five patients had a laparoscopy for the treatment of endometriosis. The uterine malformations were classified according to the degree of failure of normal development into 6 major types and according to the American Fertility Society classifications[Diagram 1]. 7, 12, 13,16
Table 2:
The results of the 156 women were tabulated according to uterine malformation [Tables 1& 2]. The overall frequency of uterine malformation in 800 women was (19.5 %). It was 5.5 times higher than in the general population.4 Thirty women (Group 1) without previous pregnancies were diagnosed with varieties of uterine malformations, including 2 hypoplastic, 6 bicornuate, 2 septate, 4 Subseptate, 4 unicornuate and 12 arcuate uteri. Thirty-one women (Group 2) with previous pregnancies and live newborns (fertile) were diagnosed with 3 hypoplastic, 6 bicornuate, 4 septate, 6 Subseptate, 2 unicornuate and 10 arcuate uteri. Forty women (Group 3) with live newborns and some miscarriages were diagnosed with 2 hypoplastic, 8 bicornuate, 4 septate, 7 Subseptate, 12 unicornuate, 1 Didelphys, 6 arcuate uteri. Fifty-five women (Group 4) with recurrent miscarriages (infertile) were diagnosed with 4 hypoplastic, 14 bicornuate, 9 septate, 6 Subseptate, 16 unicornuate, 1 Didelphys, and 5 arcuate uteri. Groups 1 and 2 had 8 sets of twins in bicornuate uteri. In addition, there were two sets of twins in Groups 3 and 4 (one in each Group) in bicornuate uteri. Both sets of twins in Groups 3 and 4 did not survive and died at 13 and 16 weeks gestation respectively. They were in retroverted uteri and both were in the smaller left horn of the bicornuate uterus. Six sets of twins in Groups 1 and 2, in bicornuate uteri, survived and were successfully delivered at 36 weeks. All the patients with twins were sent to ultrasound examination due to large for date pregnancies. These patients with twins were not sent to do any further examinations with other modalities and were followed only with transabdominal sonograms. The diagnosis of bicornuate uteri with twins was made by transabdominal sonography at 12 weeks gestation. Unicornuate and bicornuate uteri were increasingly noted in Groups 3 and 4. Group 1 showed 19.2%, Group 2 showed 19.8%, Group 3 showed 25.6% and Group 4 (infertile) showed 35.2% of uterine malformations. Group 4 showed the highest percentage of uterine malformations. Didelphys uteri were noted in the women with miscarriages and were not found in fertile women. This study also found 42 retroverted uteri; 30 were found in the infertile Groups 3 and 4 and 12 were found in the fertile Groups 1 and 2. In these groups, there were 21.7% unicornuate, 7.0% hypoplastic, 21.7% bicornuate, 1.2% didelphys, 12.1% septate, 14.7% subseptate and 21.1% arcuate uteri. All 22 cases diagnosed by MRI proved correct for the malformations initially note in the HSG. Forty patients were diagnosed using 3-D sonography, 36 uterine malformations were confirmed and 4 cases were missed by 3-D sonography. Twenty four unicornuate uteri in Groups 3 and 4, diagnosed with TVS, had short cervices measuring less than 2.5 cm in length. Sixteen patients were sent to have hysteroscopy and 5 were sent to have laparoscopy for the treatment of endometriosis and to confirm the presence of arcuate uteri after they were found by MRI. All 14 endometrial polyps were missed by TVS, but were picked up by hysteroscopy. There were number of genitourinary tract anomalies in these patients among them absence of one kidney, ectopic kidneys, duplicated renal pelvis, horse shoe kidneys, absence of one ovary, and malposition of kidneys and ovaries. Among the 55 patients in Group 4, three had one miscarriage and five had 2 miscarriages.
Table 1:
Note: 800 women were investigated, 156 of them had malformations (19.5%). Women with 2 or more miscarriages were considered infertile.5
The 800 women studied by ultrasound presented for a variety of reasons such as, determination of early pregnancy, infertility causes, previous miscarriages, and to rule out fibroids, dermoids, uterine malformations, polycystic ovary (PCOD), pelvic inflammatory disease (PID), etc. [Table 1].
The true incidence of uterine malformation in the general population is hard to determine as most data are derived from studies of patients with reproductive problems so that accurate diagnosis and complete assessment of the uterine malformation has not always been performed. The frequency of uterine malformation in most literature is 0.1% to 3.5%.4, 7 There are no studies in the literatures in regards to the frequency of uterine malformation among women belonging to restricted gene pool communities. Part of the problem lies in defining "restricted gene pools" and in quantifying this phenomenon. The entire populace of the study population (La Crete) consists of only 26 distinct families with a long tradition (over 500 years) of marrying only within these families. Of the 156 subjects included in this study, 78 (50%) belonged to only 4 of those families. Higher frequencies of uterine malformation are associated with higher rate of reproductive failure. No rates of uterine malformation for different ethnic groups are available in the literature.
The worst outcomes recorded in this study for miscarriages were 41 patients (26.8%) with septated uteri (complete and partial forms). Twenty six septated uteri (both forms) were noted in Group 3 and 4. This is in agreement with the literature on septated forms of uterine malformations in relation to high incidence of miscarriages. Group 3 had 7.6% and Group 4 had 10.2% unicornuate uteri, producing the second highest incidence of miscarriages. The next highest number of miscarriages was in those patients with bicornuate uteri; Group 3 had 5.1% and Group 4 had 8.9%. This might indicate that this kind of malformation is the one most likely to affect the reproductive outcome and increases the chance of miscarriage.12, 13, 20
There is an increase incidence of unicornuate and bicornuate uteri in the infertile population in Groups 3 and 4 in comparison with fertile patients in Groups 1 and 2. This supports the study done by Green and Harris in 1976 and Acien in 199313, 14 on poor reproductive outcomes associated with a bicornuate uterus. One hundred and fifty six patients with suspected uterine malformation diagnosed by transabdominal sonography and TVS were sent to have hysterosalpingography to confirm the diagnosis. Twenty two of them had an MRI to further prove the diagnosis of subseptate and arcuate uteri, which is difficult to diagnose using other modalities.
Forty patients were sent to have 3-D sonography. Sixteen patients were sent to have hysteroscopy and 5 went to have laparoscopy to treat endometriosis. Four cases of uterine malformations were missed using 3-D sonography due to the presence of fibroids causing the uterine wall to appear convex. The 3-D sonography imaging showed 90% sensitivity and specificity, but was less sensitive in the presence of uterine lesions such as fibroids and polyps. MRI on the other hand showed 100% sensitivity and specificity. It had more accuracy, precision and reliability and so should be the modality of choice after the initial diagnosis with TVS. Six patients had problem with this imaging modality due to its claustrophobic effect. MRI is an expensive procedure and the waiting time can be up to 6 months in Canada. TVS with colour flow can differentiate vascular from non-vascular uterine septation.
Unicornate uteri have the highest rate of cervical shortening and this could affect the reproductive performance. In addition, it is a helpful tool for the sonographer to correlate the shortening of the cervix to the unicornuate uterus, as Groups 3 and 4 had 85.7% cervical shortening. The least frequent malformation noted was the didelphys uterus: two in 800 patients. This finding indicates that this type of rare malformation is very high in this population, knowing that the incidence of didelphys uterus is normally 1/3000.17
The incidence of uterine malformation for fertile patients was recorded at 39.2% and in the infertile patients at 60.8%. This indicates that it is common to have uterine malformation, but it increases in the infertile women by 21.6% in this study. TVS and hysteroscopy were both sensitive, but hysteroscopy was more specific in detecting focal endometrial polyps. Laparoscopy is an invasive procedure and was used for the treatment of the five patients with endometriosis that was discovered by MRI. Forty two retroverted uteri were diagnosed using TVS in the infertile Groups 3 and 4. This might indicate a relationship between retroverted uteri and infertility, but this is not relevant in this study, as the only link is where women have a fixed retroverted uterus on pelvic examination. This might indicate either past serious infection with scarring causing fallopian tube blockage, or scarring due to endometriosis.
The methods of choice to detect uterine malformation should be discussed between the physician and the radiologist to reach the best available method with least invasiveness to the patient. This study showed that the use of 3-D, TVS and transabdominal sonography should be used first followed by the more expensive modality of MRI. HSG is an invasive method, but can provide a faster diagnosis without the claustrophobic effect to some patients of an MRI scanner.
Two women with unicornuate uteri had children; this might indicate that women with this type of malformation can be pregnant and have successful delivery. Eleven hypoplastic uteri were recorded in this study, five in the fertile group and six in the infertile group. More studies are needed in order to know the effect of this malformation on fertility. Double the number of bicornuate uteri was confirmed in the infertile compared to the fertile group. This might indicate a relationship between these types of malformation and increased infertility.
Sixteen septate and subseptate uteri were found in Groups 1 and 2 compared to 26 found in Groups 3 and 4. Again this might indicate the relationship between these types of malformations and infertility. This support many studies regarding the relation of septated forms of uterine malformation to early miscarriages. The size of the septation may influence the reproductive outcome. There were 22 arcuate uteri in the fertile group compared to 11 in the infertile group; this might indicate that this type of malformation does not affect the uterine reproductive performance. This type is difficult to find by TVS or transabdominal sonography and better diagnosed using MRI, 3-D sonography, or laparoscopy. DES (diethylstilbestrol) is a synthetic form of oestrogen that was prescribed between 1938 and 1971 to help women with certain complications of pregnancy. It was linked to uterine malformation and increased incidence of clear cell adenocarcinoma of the vagina and cervix of the unborn female fetus in women who were taking this drug. Therefore DES is not related to congenital uterine malformation classifications, but sonographers should know the effects of this drug.
The limitation in this study was that we did not use 3-D sonography for all patients. It is more accurate than other modalities and less sensitive in the presence of fibroids. Moreover, we did not send all the 800 women to special procedures such as MRI, HSG, hysteroscopy and laparoscopy as we relied upon the normal results of the sonograms. In this way, we may have missed many uterine malformations and that could increase the incidence to even more than the recorded 19.5%. Future studies should divide the groups into fertile, infertile and sterile women. Future studies should also focus on the distributions and the percentages of each anomaly and correlate them with the general population. Correlation with different communities practising endogamous marriages might be beneficial.
Analysis of 800 fertile and infertile patients in the La Crete female population has provided new insights into the incidence of uterine malformations in this population which practices endogamous marriage. La Crete has an incidence of 19.5%, 5.5 times higher than the general population. Arcuate and retroverted uteri may be irrelevant to the reproductive performance of women. The septated versions of uterine malformation and bicornuate uteri increase in the infertile groups depending on the size of each uterine horn. Different diagnostic methods should be used to classify each type of uterine malformation. For precise classification of these malformations, a combination of TVS, 3-D sonography (non-invasive technology) and HSG (invasive) seems to be necessary and less expensive than MRI technology. Uterine malformations are relatively frequent in fertile women, but more frequent in infertile groups and in communities with endogamous marriages. These malformations can impair pregnancy outcomes. Uterine malformations are more common in women with recurrent miscarriages. The reproductive performances of unicornuate and Didelphys uteri were poor. Mullerian defects can permit normal delivery, depending on the type of uterine malformation.
The author wishes to express his appreciation to Dr. K. Hofmann, Dr. P Hughes, Dr. S Desilva, , Dr. Bouta, Mrs. Valetta Lawrence and Siti Arabia, and Dr. R.Friedland.
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