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A Formula for Economic Growth
by David S. Waddell
You may recall from your freshman economics class that GDP = C + I + G + NE. Translation: A nation's economic output equals consumption + capital investment + government spending + exports – imports. To grow an economy you must grow consumption, capital investment, government spending, and net exports in some proportion. However, when assessing a nation's growth capability this equation overcomplicates things. More simply, we can combine a nation's labor force growth rate with the productivity growth rate of that labor force. Therefore, to project a nation's GDP path we only need some demographic data and some productivity projections.
by Jon W. Sparks
innovation: TS23, an antibody that inhibits the molecule regulating clot dissolution as a better therapy to dissolve thrombi, which cause strokes and acute cardiovascular disease.
website: uthsc.edu
Few things are as difficult for a doctor as being unable to save a patient.
"That was one of the most profound things that happened to me in my training," says Dr. Guy Reed, a cardiologist, the Lemuel Diggs Professor of Medicine, and Chair of the Department of Medicine in the College of Medicine at the University of Tennessee Health Science Center. "A patient came in and developed weakness on one side of the body, an indication of a stroke. We gave the best care we could at the time, but he died within 24 hours."
Reed knew there wasn't enough understanding of the causes of ischemic stroke and that there wasn't a safe enough treatment for it. But rather than staying frustrated, he got to work looking for a solution.
For several years now, he's been looking for a better therapy to dissolve blood clots, which cause most strokes. The result is TS23, a blood clot dissolving agent undergoing clinical trials and which holds the promise of providing vastly improved treatment of stroke and acute cardiovascular disease for millions of patients.
by Jon W. Sparks
innovation: Coding training directly to teenagers using three models: summer coding camps, after-school programs, and in-school training. Draws in new students and sends them into the marketplace with the realization that mentoring, networking, and partnerships are all part of building a community that goes beyond being a savvy coder.
website: code-crew.com
Meka Egwuekwe was well aware of the problem.
As a software engineer, he knew that Memphis and the Mid-South were on the wrong side of the digital skills gap. The call for relevant and effective computer programmers was out there but wasn't being met as vigorously as was needed.
So he took action.
In 2012, he founded the Memphis Chapter of Black Girls Code, which would become one of the country's most active efforts to teach girls how to build mobile apps, web pages, video games, and robots.
That would lead him to develop Code Crew in 2015, a program that goes directly to teenagers in schools and community centers, teaching them the nuts and bolts of the jobs of the future.
Hollywood Feed
by Richard J. Alley
Where AutoZone might be your go-to supplier for motor oil, wiper blades, and spark plugs, Hollywood Feed is certainly your first stop for pet food, dog leashes, and catnip. And the two have more in common than just a Memphis base of operations. Hollywood Feed's president, Shawn McGhee, purchased the pet supply company 10 years ago while still an executive vice president for the auto parts retailer.
"There are a number of AutoZone people who have seen our behind-the-scenes, and they all remarked how AutoZone-esque Hollywood Feed is," McGhee says. "Much of the infrastructure and much of the benchmarks are very similar to what AutoZone was a number of years ago when I was there."
Mad Women
by Bianca Phillips
"Success is the best revenge."
Those are words to live by if you're Ceil Walker, the charismatic CEO of Walker & Associates, a locally owned advertising, public relations, and marketing firm that represents clients as large as McDonald's and NASA, and as homegrown as the Memphis Art Park and the Racine + Southern Dance Exchange.
"My mom has little plaques and coasters around the house that say, 'Success is the best revenge.' She's always taught me to gracefully let things go and work as hard as you can to be successful, and the rest won't matter someday," says Cecilia Walker, Ceil's daughter and the senior vice president of business development for the firm.
Ceil has followed her own advice and led the company to its 51st year in business. Walker & Associates also has the distinction of being the largest local ad firm run by a woman and the only such firm in Memphis that's never merged with another firm or been acquired by a larger one.
But there was a time when Ceil had some doubters. Her husband Deloss Walker, who founded the company in 1965, passed away from a stroke in 1996, and Ceil, who was serving as president of the company at the time, took over as CEO.
BRIDGES: 2016 Innovation Awards Winner
by Jon W. Sparks
innovation: CHANGE: The youth-led social program working with students in grades 8 to 12, providing them with opportunities to become leaders who advance social justice through community organizing.
website: bridgesusa.org
At BRIDGES, the idea is to push for a solution — and then push harder.
The nonprofit has long been focused on developing young people as tomorrow's leaders, but the organization is finding that it's imperative to let youth take on leadership as soon as possible.
"Several years ago we took a step back and looked at the Memphis community," says Dana Wilson, vice president of the Bridge Builders youth program. "We saw the education landscape changing and daily lives of students changing, and realized it was important for us to re-evaluate how we work with young people and take it up a notch."
Spurring Innovation
by Meg Crosby
There is a new book on my reading list. The Last Days of Night by Graham Moore is a fictional account of the historical rivalry between Thomas Edison, who invented the light bulb, and George Westinghouse, who improved upon it and ultimately wired the country. So, the question is, which of the two was the innovator? Both! Innovations come in all shapes and sizes — from the groundbreaking invention to the iterative improvement, and from the major disruptor to the better, faster, cheaper. It's all innovation.
Brandon Bell
by Richard J. Alley
The interview begins with the simplest of questions: "What is it you make?" And yet, the answer is anything but simple and Brandon Bell stumbles as he tries to explain what it is he does to the Luddite sitting before him.
"It's funny because whenever people have asked me that I've always had kind of a hard time explaining. I'd say, 'Well, I do design, but I do a lot of interactive, and I do a lot of video and motion graphics.' So I'd sort of list things off and people would ask if I do logos and, yeah, that's part of it."
But even this ludite can find Bell's website and there it is in simple, easy-to-understand, black-and-white pixels: "I make creative digital stuff."
And he does. His stuff is seen by millions from national stages — he's created and produced the virtual sets for the Tony Awards, and designed and produced the screen graphics for Ted Talks Live. Closer to home, he's done online work for Soul Fish Café; designed and developed the website, logo, and packaging for Relevant Roasters coffee company (now French Truck Coffee); and the video animations for the Rock 'n' Soul Museum's ceremonies; among others.
The latest articles from the print version of Inside Memphis Business — plus excerpts from our weeklyTip Sheet.
Uploaded here so you can read and share great new content from IMB.
October 2017


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Alexander WangBlack Leather Ostrich Embossed Zip Around "Adriel" Clutch Bag
Edgy clutch to carry your essentials for a night out. Supple leather construction with embossed ostrich detail. Silver toned hardware. Front open compartment with top magnetic closure. Top double zip around closure. Textile lined interior features one patch pocket. Comes with dsut bag.
Made in: Unknown Color: Black Fabric Content: Leather. Interior: Textile. Condition: Pre-owned. This item is in good condition.Oxidation and faint hairline scratches on hardware due to nature of metal. A few small stains inside exterior compartment and interior due to general wear. Light lint and fibers inside compartment and interior; will most likely come out with cleaning. No other visible signs of wear and tear.
Measurements & Sizing
- Total Height: 6"
- Total Length: 6.75"
- Depth: 1.875"
Returns & Shipping
Luxury Garage Sale guarantees that all items sold on our site are 100% authentic. All products we accept are inspected for brand-specific guidelines and are put through a rigorous authenticity test process.
Handbags, accessories and jewelry are final sale.
LGS is not affiliated with Alexander Wang. We guarantee this Alexander Wang item to be authentic. Alexander Wang® is a registered trademark of Alexander Wang.
Item #: 139902

subset: commoncrawl


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Photo of the Day! @tobiasilvestri going way up + over a @ferrariusa at @mottolino_livigno! Great work by Thomas Confortola. Share your best stitches with us via link in bio! #GoPro


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Nutrakey DHEA Sport Performance 100 Capsules 50mg
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Nutrakey DHEA Sport Performance 100 Capsules 50mg
- Pre-Cursor to Testosterone Production
- Increases muscle strength
- Helps maintain fat-free mass
- Supports cellular energy levels metabolism
- Important anti-aging supplement
- Replace declining DHEA levels
- May help decrease cholesterol levels
- Major antioxidant properties
- May help to maintain youth & health
Product Overview
Nutrakey DHEA Sport Performance 100 Capsules 50mg
Nutrakey DHEA Sport Performance 100 Capsules
AllegroMedical.com presents The Nutrakey DHEA Sport Performance 100 Capsules. Nutrakey focuses on delivering pure, high quality products and ingredients. The Nutrakey line of supplements is formulated with pharmaceutical grade powders and all organic naturals when applicable. Nutrakey provides supplements that contain absolutely no fillers or additives. As a result, the Nutrakey products are not only extraordinarily effective but affordable as well.
Benefit Of Using DHEA:
- Pre-Cursor to Testosterone Production
- Increases muscle strength
- Helps maintain fat-free mass
- Supports cellular energy levels metabolism
- Important anti-aging supplement
- Replace declining DHEA levels
- May help decrease cholesterol levels
- Major antioxidant properties
- May help to maintain youth & health
- 100 Capsules 50mg
DHEA is the sole precursor hormone responsible for the production & regulation of every other steroid & sex hormone in the body.
It has recently been discovered that bodily levels of DHEA decline with age. A typical 70-year old will have about 5-10% the DHEA of what a typical 20 year old produces, leading to the hypothesis that supplementing DHEA can reverse or at least slow the aging process.
DHEA Has a Significant Impact on Lean Body Mass
It is the most abundant adrenal steroid hormone found in the body. This vital hormone is the metabolic precursor to testosterone and supports muscle growth, cellular energy formation and fat metabolism. DHEA is a catalyst for healthier, leaner eating habits, while blocking the catabolic effects that cortisol has on muscle mass. DHEA may have a profound influence on positive body composition supporting the growth of lean muscle tissue. Many bodybuilders use DHEA to ensure their bodies have the raw ingredients needed to produce sufficient testosterone, the muscle-building hormone.
DHEA has Powerful Anti-Aging Benefits
DHEA is essential for well-being and is considered to have strong anti-aging properties. It is a potent antioxidant hormone whose rapid decline after age 30 triggers many degenerative diseases associated with aging. DHEA is considered to be absolutely essential for any anti-aging, longevity program. DHEA levels peak around age 25 for men and 20 for women, and then decline steadily with age. Studies show that DHEA supplementation can potentially slow the aging process, improve testosterone levels and support lean body mass and muscle strength.
Take 1 capsule 2-3 times daily. In the morning right after waking, mid day before lunch, and or before bedtime. Many take DHEA 30 minutes before breakfast, and right before bedtime.
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Nutrakey DHEA Sport Performance 100 Capsules 50mg
Nutrakey DHEA Sport Performance 100 Capsules 50mg Reviews Summary
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Part Number(s): 170 0137
Mfg Part Number(s): 6150046
Scrip Part Number(s): 170 0137
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WWE legend Jerry "The King" Lawler will make his return to the announce desk on Sunday, January 29 at the Royal Rumble event in San Antonio, Texas, WWE announced Tuesday evening:
According to the Wrestling Observer, WWE pulled Jerry "The King" Lawler from all regular programming back in December, which had included the weekly Monday Night RAW and SmackDown Live pre-shows. Lawler is still under contract with WWE, but was expected to be used going forward on "special occasions." This is evidently one of those occasions.
Amy Dumas, better known as former WWE Women's Champion Lita, was also pulled from the same duties.
Lawler was pulled as a SmackDown Live announcer earlier this year after WWE's self-initiated brand split. Lawler's age was likely a factor in the changes, as WWE has instituted younger talents — including former wrestlers Corey Graves and David Otunga — at the announce table.
Lawler has been working with WWE regularly since 1992. Despite suffering an on-air heart attack in 2012 and being 67 years old, Lawler still wrestles on occasion.


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10 Defining 'American Idol' Season 1 Moments
Between Tamyra Gray's shocking elimination and Kelly Clarkson's come-from-behind win, the show's first string of episodes played out like a reality TV fairy tale.
Between Tamyra Gray's shocking elimination and Kelly Clarkson's come-from-behind win, the show's first string of episodes played out like a reality TV fairy tale.
Now that Upfronts 2015 have entered the scheduling phase, we thought most of the major renewals, cancellations and pickups had delivered their biggest surprises. Not so apparently, as FOX has decided to put American Idol out to pasture after 15 seasons, ending the reality singing competition for good next year.
The 'American Idol' finale celebrated the conclusion of its 13th season by inviting big stars onto its stage to perform alongside the former contestants and two finalists. Check out performances by Demi Lovato, Paramore, Phillip Phillips and more.
Good news for 'American Idol' fans! The official list of judges has finally been released. Who will grace the stage?
It's cool, dawg. Randy Jackson is back as an 'American Idol' judge!
Erika Van Pelt courageously took on Whitney Houston's 'I Believe In You and Me ' on 'American Idol' tonight, a big song requiring impeccable vocals. Erika more than lived up to the challenge, filling the shoes of the recently departed Houston.
The 42-contestant herd on 'American Idol' is being thinned out to 24: 12 girls, 12 guys. The final 24 will perform for the first time at the live shows next week. Can you believe we are already at the live shows, 'Idol' watchers?
During an appearance on Ryan Seacrest's radio show on Wednesday, 'American Idol' producer Nigel Lythgoe confirmed judges Jennifer Lopez, Steven Tyler, and Randy Jackson would be back for season 11 of the show.
"I am delighted to say that all three judges, along with the brilliant host of 'American Idol' are back for the next season," he told Seacrest, who happens to be the aforementioned "brilliant host" of 'Idol.'
Randy Jackson is still in it to win it: EW.com has confirmed that the original 'American Idol' judge will return for an 11th season on Fox's top-rated series.
Also returning for season 11 is Aerosmith rocker Steven Tyler — not exactly the most surprising revelation, considering he initially signed on for more than one season, according to EW.com.
'American Idol' is down to the final four!
Last night's elimination show started off quickly, with the remaining five contestants performing 'So Happy Together.' After the mandatory Ford commercial, judge Jennifer Lopez took to the stage to sing her hit single 'On the Floor,' before contestants were quickly divided into two groups, where Jacob Lusk and Lauren Alaina found themselves in the bottom two.
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Latest news, June 2017: Upwind to Hawaii
Sauvage has left Fiji, after a season of birdwatching in Papua New Guinea, Solomon Islands, and an expedition for the search of Amelia Earhart plane , offshore Howland island and a surf season in Fiji. We are sailing upwind to Hawaii. In July we ll be following the tracks of Russian explorers in Hawaii with the same Russian team who has been studying the Russian history inNorth America.
Latest slide show : Bird watching 2017
Latest vidéos
News destinations in 2018 : Greenland and North west Passage
Join SAUVAGE for sailing expeditions in remote places,
SAUVAGE, owned and crewed by the Wattrelot family is a comfortable yacht of 60 feet, built for high latitudes and Trade Winds. It will take you, in cold or warm places to remote islands, wild places, or experience Offshore Passage. Exploring ashore, diving, surfing, kitesurfing, SUP boarding, hiking in forests, beachcombing, snowboarding or climbing mountains...
DISCOVERY CHARTERS CRUISES : Family or adventurous cruising, we offer different ways to explore places like Antarctica, South Georgia, to Alaska or Mexico to Polynesia and South Pacific Islands & other remote places.
EXPEDITION CHARTERS CRUISES : Base camp for mountaineers, divers, surfers, kiters or film makers. A sailing vessel is very often the only means to approach wild life in remote places. It's flexible and versatile.
OFFSHORE CROSSING : Places are available for our offshore passages if you are looking to gain offshore experience or perhaps claim an equator crossing at sea or rounding of Cape Horn.
© Sauvage Expeditions
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Cruises, sailing expeditions in remote places, discovery, surf, kite, dive, SUP boarding, Kayak, snowbord, ski, trek, Bird watching, Whales watching...
Charters cruise in Alaska, Cap Horn, Patagonia, Polynesia, Polynésie (Marquesas, Tuamotu, Bora, Pitcairn, Easter Island), Vanuatu,Bali, Phuket, Malaisie, Thaïland, Mergui, Myanmar, Andaman, Antarctic,, Greenland, North West Passage...


text: lol, that cracks me up.....I remember a few years ago I stuck a "landscapers plant it deeper' sticker on my truck......then went to meet my girlfriends family......don't think I impressed them much! For power, I have the same set-up as paul suggests.....a 300volt AC/DC converter hard wired into the back of the car. My printer is a cannon portable (can't remember model #), I wish I hadn't bought it now as a cheap printer would do just as fine, but guess its handy to have. steve


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Engineered to preserve your tone, BOSS cables deliver superior performance for guitar, bass, and other musical applications. Studio-grade, oxygen-free copper core wire transfers every detail, while cu... Click To Read More About This Product
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Eazy Resort
Select your stay dates to check availability at Eazy Resort
Eazy Resort
About the Hotel
Property Location
A stay at Eazy Resort places you in the heart of Karon, convenient to Kata Porpeang Market and Big Buddha. This hotel is within close proximity of Dino Park Mini Golf and Kok Chang Safari Elephant Trekking.
Make yourself at home in one of the 27 air-conditioned rooms featuring LCD televisions. Rooms have private lanais. Complimentary wireless Internet access keeps you connected, and cable programming is available for your entertainment. Private bathrooms with showers feature complimentary toiletries and bidets.
Rec, Spa, Premium Amenities
Pamper yourself with onsite massages or enjoy recreation amenities such as an outdoor pool. Additional features at this Art Deco hotel include complimentary wireless Internet access, shopping on site, and a television in the lobby.
Satisfy your appetite at the hotel's restaurant, which serves breakfast, lunch, and dinner. Dining is also available at a coffee shop/café, and room service (during limited hours) is provided. While enjoying a refreshing dip in the hotel pool, you can order your favorite drink at the poolside bar.
Business, Other Amenities
Featured amenities include express check-in, express check-out, and a 24-hour front desk. A roundtrip airport shuttle is provided for a surcharge (available on request).
Hotel Facilities
- Express check-in
- Number of buildings/towers - 1
- Total number of rooms - 27
- Outdoor pool
- 24-hour front desk
- Restaurant
- Safe-deposit box at front desk
- Coffee shop or café
- Television in lobby
- Shopping on site
- Designated smoking areas
- Tours/ticket assistance
- Free WiFi
- Poolside bar
- Spa services on site
- Airport transportation (surcharge)
- Pool umbrellas
- Multilingual staff
- Year Built 2010
- Express check-out
- Number of floors - 1
Room Facilities
- Daily housekeeping
- Access via exterior corridors
- Bidet
- Hair dryer (on request)
- Free WiFi
- Individually furnished
- Full-sized refrigerator/freezer
- Separate dining area
- Connecting/adjoining rooms available
- Premium TV channels
- Free cribs/infant beds
- In-room safe
- Lanai
- Slippers
- Private bathroom
- Desk
- Free toiletries
- Phone
- Rollaway/extra beds available
- Iron/ironing board (on request)
- Separate living room
- Cable TV service
- Free bottled water
- Coffee/tea maker
- Shower only
- Individually decorated
- Blackout drapes/curtains
- Room service (limited hours)
- Air conditioning
Hotel Policy
Know Before You Go
- This property offers transfers from the airport (surcharges may apply). Guests must contact the property with arrival details before travel, using the contact information on the booking confirmation.
- Only registered guests are allowed in the guestrooms.
- The property has connecting/adjoining rooms, which are subject to availability and can be requested by contacting the property using the number on the booking confirmation.
- Some facilities may have restricted access. Guests can contact the property for details using the contact information on the booking confirmation.
- In accordance with national/local laws, air conditioning may be restricted to certain hours from 1 February to 1 February.
- No pets and no service animals are allowed at this property.
The following fees and deposits are charged by the property at time of service, check-in, or check-out.
- Airport shuttle fee: THB 800 per room (one way)
- Airport shuttle fee per child: THB 400 (one way), (from 4 to 11 years old)
- Rollaway beds are available for an additional fee
The above list may not be comprehensive. Fees and deposits may not include tax and are subject to change.
Mandatory Fees and Taxes
You'll be asked to pay the following charges at the hotel:
- Deposit: THB 1,500 per stay (for stays between 1 July - 30 June)
We have included all charges provided to us by the property. However, charges can vary, for example, based on length of stay or the room you book.Show all hotel policy Show less hotel policy


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Alveolar hypoxia produces a rapid and widespread systemic inflammation in rats. The inflammation is initiated by the release into the circulation of monocyte chemoattractant protein-1 (MCP-1) from alveolar macrophages (AMO) activated by the low alveolar Po2. Circulating MCP-1 induces mast cell (MC) degranulation with renin release and activation of the local renin-angiotensin system, leading to microvascular leukocyte recruitment and increased vascular permeability. We investigated the effect of dexamethasone, a synthetic anti-inflammatory glucocorticoid, on the development of the systemic inflammation of alveolar hypoxia and its site(s) of action in the inflammatory cascade. The inflammatory steps investigated were the activation of primary cultures of AMO by hypoxia, the degranulation of MCs by MCP-1 in the mesentery microcirculation of rats, and the effect of angiotensin II (ANG II) on the leukocyte/endothelial interface of the mesentery microcirculation. Dexamethasone prevented the mesentery inflammation in conscious rats breathing 10% O2 for 4 h by acting in all key steps of the inflammatory cascade. Dexamethasone: 1) blocked the hypoxia-induced AMO activation and the release of MCP-1 and abolished the increase in plasma MCP-1 of conscious, hypoxic rats; 2) prevented the MCP-1-induced degranulation of mesentery perivascular MCs and reduced the number of peritoneal MCs, and 3) blocked the leukocyte-endothelial adherence and the extravasation of albumin induced by topical ANG II in the mesentery. The effect at each site was sufficient to prevent the AMO-initiated inflammation of hypoxia. These results may explain the effectiveness of dexamethasone in the treatment of the systemic effects of alveolar hypoxia.
- alveolar macrophages
- mast cells
alveolar hypoxia occurs when inspired Po2 is reduced, as in altitude, or in pulmonary diseases presenting regional or global hypoventilation. Rats and mice exposed to low inspired Po2 develop a widespread systemic inflammation within minutes of the onset of hypoxia. This response is characterized by generation of reactive oxygen species (ROS) (35, 42), degranulation of perivascular mast cells (MCs) (36), rolling, adherence, and emigration of leukocytes to the perivascular space, and increased vascular permeability (43, 44). The systemic inflammation has been observed in the mesentery (3, 4, 35, 36, 42–44), skeletal muscle (6, 11, 12, 26, 32), and pial microcirculations (23). The similar characteristics of these responses reflect common underlying mechanisms in these diverse microvascular beds.
A substantial body of evidence indicates that the inflammation is not initiated by low systemic tissue Po2 but by a mediator released from alveolar macrophages (AMO) activated by the low alveolar Po2 (3, 4, 11). The possible role of an AMO-borne circulating mediator as the trigger of inflammation in systemic microvascular beds was suggested by the observation that the inflammation occurs only when alveolar Po2 is reduced, independent of the systemic microvascular Po2 (6, 32), and that topical application of plasma from hypoxic rats and of supernatant of hypoxic AMO induces inflammation in tissues of normoxic animals (6, 11, 26). The AMO-borne mediator, which has been identified as monocyte chemoattractant protein-1 (MCP-1), a chemokine of the CC family, also known as CCL2, is transported by the circulation and activates MCs (3), which release renin and activate the local renin-angiotensin system (RAS) system (5). Angiotensin II (ANG II) generated as a result of the RAS activation initiates the microvascular phase of the inflammatory response (4, 5, 12). The systemic inflammation is abrogated by depletion of AMO (11), stabilization of MCs (36), and blockade of the RAS (12), as well as by administration of antioxidants and nitric oxide donors (42, 43).
Numerous links between hypoxia and inflammation have been demonstrated. At the cellular level, it is now clear that, in addition to reduced tissue Po2, inflammatory agents and ROS are capable of promoting the stabilization of hypoxia-inducible factors and thereby influence the expression of genes that control O2 delivery and uptake (31, 38). At the organism level, acute alveolar hypoxia in humans or laboratory animals is frequently associated with systemic effects that present an inflammatory component: examples are the illnesses of high altitude such as acute mountain sickness and high-altitude cerebral edema (1, 13, 14, 16, 19) and the multiple organ failure secondary to atelectasis (18), acute lung injury (29, 37), and pulmonary contusion (27). Conversely, the edema and tissue swelling of inflammation leads to impaired O2 delivery and tissue hypoxia. Accordingly, the mechanisms responsible for the inflammation of hypoxia, the factors that modify it, and the role of inflammation on the overall mechanisms of adaptation to hypoxia constitute an important and growing research subject.
Dexamethasone is a synthetic glucocorticoid used clinically for its anti-inflammatory properties and, more specifically, to reduce associated edema. Hence, dexamethasone is highly effective in the treatment of acute diseases of high altitude, in particular high-altitude cerebral edema (20). In addition, recent studies also show that dexamethasone improves exercise capacity and pulmonary gas exchange in subjects prone to the development of high-altitude pulmonary edema (10). The present experiments were designed to determine the effect of dexamethasone on the systemic inflammation of alveolar hypoxia and to investigate the possible site(s) of the systemic inflammatory cascade at which dexamethasone may act. Dexamethasone influences AMO and MC function, and has anti-inflammatory effects in various systemic microvascular beds; accordingly, we reasoned that it may act at different sites of the inflammatory cascade of hypoxia. The results show that dexamethasone acts in all key steps of the inflammation and that its effect on each site is sufficient to abrogate the systemic inflammation initiated by activation of AMO.
The Animal Care and Use Committee of the University of Kansas Medical Center, an institution accredited by the American Association for Accreditation of Laboratory Animal Care, approved all procedures.
Dexamethasone Pretreatment
Dexamethasone (0.1 mg/kg) was administered subcutaneously 24 h before the experiments to male Sprague-Dawley rats; a second dose was given 30 min before the initiation of the experiments. Untreated controls were given vehicle with the same schedule.
Primary Cultures of AMO
AMO were harvested by bronchoalveolar lavage (BAL) from dexamethasone-treated and control rats anesthetized with pentobarbital sodium, 40 mg/kg ip. Catheters were placed in the jugular vein (PE-50) and in the trachea (PE-240). After euthanasia with an overdose of pentobarbital sodium (150 mg/kg iv), BAL was carried out as described previously (11). The fluid collected was centrifuged at 1,500 rpm for 10 min, the cell pellet was resuspended in 2 ml DMEM with 10% serum, plated in a sterile flask and placed in an incubator at 37°C, and equilibrated with 5% CO2 in air for 45 min. The supernatant was discarded and replaced with serum-free DMEM equilibrated with 15% O2-5% CO2-80% N2. After 30 min, the equilibrating gas mixture was replaced with a hypoxic gas mixture consisting of 5% O2-5% CO2-90% N2. These gas mixtures provide Po2 values that approximate those to which AMO are exposed in vivo during normoxia and during 10% O2 breathing, respectively. The cultures were gassed via a needle placed through the cap of the culture dish and connected to the gas source. With the use of this approach, steady-state Po2 values are reached within 2–3 min of equilibration (4).
An electrochemical detection system (Apollo 4000; World Precision Instruments, Sarasota, FL) was used to determine H2O2 concentration in the supernatant, as described before (4). At the end of the hypoxic period, a 0.2-ml sample of supernatant was obtained for MCP-1 concentration measurement with enzyme-linked immunosorbent assay (ELISA) (SABiosciences, Frederick, MD). At the end of the experiment, the supernatant was removed, and 2 ml of 0.4% Trypan blue was added to the culture and mixed for 2 min. Photographs of five different areas of the culture, containing ∼200 cells each, were obtained 30 min after Trypan blue addition. Cell viability expressed as the percentage of cells excluding Trypan blue exceeded 98% in all experiments.
Peritoneal Lavage
Peritoneal MCs and macrophages were harvested by peritoneal lavage of control and dexamethasone-treated rats anesthetized with ketamine, 40 mg/kg, and atropine, 5 mg/kg im (4). Before the lavage, a catheter was placed in the jugular vein to obtain a blood sample for determination of plasma concentration of stem cell factor (SCF, c-kit ligand) using an ELISA kit (Ray Biotech, Norcross, GA), after which the animals were killed with 150 mg/kg pentobarbital sodium intravenously. After lavage, MCs were separated from macrophages by differential centrifugation using a Percoll solution. MCs isolated essentially had no contamination with macrophages. The cells were counted using a hemocytometer.
Bright-Field Intravital Microscopy
The procedures for intravital microscopy of the mesentery have been described in detail before (43, 44). Briefly, male Sprague-Dawley rats (225–250 g) were anesthetized with ketamine, 40 mg/kg, and atropine, 5 mg/kg im. PE-50 catheters were placed in the jugular vein and carotid artery for injection of solutions and measurement of arterial blood pressure and heart rate. The abdomen was opened via a midline incision, and the ileocecal portion of the intestine was gently drawn out, exteriorized, and mounted on a transparent plastic stage. The intestinal loop was covered with Saran wrap to prevent drying of the tissue and to minimize the effect of ambient oxygen on the mesenteric microcirculation. The Saran wrap cover was briefly lifted when solutions were applied topically to the mesentery. The animals were covered with a thermal blanket to maintain rectal temperature at 37°C. Postcapillary venules of 20–40 μm diameter were selected for microscopic observation. Adherent leukocytes were defined as those remaining stationary for at least 30 s. Leukocyte-endothelial adherence was expressed as the number of adherent leukocytes per 100 μm vessel. Ruthenium red, 5 mg/100 ml, was used to detect degranulation of MCs. MC degranulation intensity (MCDI) was estimated using image analysis (AnaliSYS software Soft Imaging, Lakewood, CO) and expressed in arbitrary units. At least five MC were analyzed in each experiment. At the end of the experiment, the rats were killed with pentobarbital sodium (150 mg/kg iv).
Measurement of Extravasation of Fluorescent Albumin
Rats were prepared for intravital microscopy of the mesentery circulation as described above. After a suitable venule was identified by bright-field microscopy, fluorescein isothiocyanate (FITC)-labeled bovine albumin was injected intravenously (50 mg/kg), and images were obtained under fluorescence microscopy. To minimize photo bleaching, fluorescence recording was <15 s in any given area. Fluorescence from FITC-albumin (excitation wavelength 420–490 nm, emission wavelength 520 nm) was detected with an F-view SIS camera. Images were analyzed for intravascular fluorescence intensity in an area including the full width of the vessel and 100 μm in length, avoiding areas with underlying vessels. Extravascular fluorescence was measured on both sides of the 100-μm venule segment. The same section of the microcirculation was analyzed in all the images of a given experiment. The magnitude of albumin extravasation was estimated by the ratio of the extravascular-to-intravascular fluorescence.
Exposure of Conscious Rats to Hypoxia
Dexamethasone-treated and untreated rats, 250–300 g, were anesthetized with ketamine, 40 mg/kg, and atropine, 5 mg/kg im. PE-50 catheters were placed in the carotid artery and the external jugular vein, tunneled subcutaneously, exteriorized at the back of the neck, cut at a length of ∼2.5 cm, and flame-sealed. Four to 6 h after recovery from anesthesia, an arterial blood sample was obtained under normoxic conditions, after which the animals were placed in a Lucite chamber where either room air or 10% O2-90% N2 were circulated. Blood samples were obtained at 5, 30, and 60 min of hypoxia. Blood removed was replaced with donor blood. Arterial blood pressure and heart rate and chamber O2 concentration were recorded continuously. At the end of the experiment, the animals were killed with pentobarbital sodium, 150 mg /kg iv.
In a separate series of experiments, dexamethasone-treated and untreated conscious rats were placed in the hypoxic chamber at 10% O2. After 4 h of exposure to hypoxia, the animals were anesthetized with ketamine, 40 mg/kg, and atropine, 5 mg/kg im and prepared for intravital microscopy of the mesenteric microcirculation as described above. The animals breathed 10% O2-90% N2 throughout surgery and the entire experimental procedure. An additional group of untreated animals was placed in the chamber for 4 h under normoxic conditions (FiO2 = 0.21).
Data are presented as means ± SE. Each experiment served as its own control, with the data after a given treatment compared with the corresponding average control. Average control was the mean of all the values observed in the control period. Significance was established with a t-test for paired samples. Intergroup comparisons were carried out with a one-way ANOVA followed by Bonferroni tests for multiple comparisons. A P value <0.05 was considered to indicate a significant difference.
Effect of Dexamethasone on the Inflammatory Response of the Mesenteric Microcirculation to Alveolar Hypoxia
Figure 1 shows representative bright-field (Fig. 1, A–C) and fluorescence (Fig. 1, D–F) photomicrographs of the mesentery microcirculation of normoxic untreated animals and untreated and dexamethasone-treated animals that had been exposed to 4 h of hypoxia in the conscious state. The hypoxic animals were prepared for intravital microscopy while they continued to breathe 10% O2. The bar graphs under the bright-field photomicrographs show average values of inflammatory markers as follows: leukocyte-endothelial adherence, leukocyte emigration, and MCDI, obtained in five rats of each group. The graph below photomicrographs D–F shows the time course of the changes in extravascular-to-intravascular FITC fluorescence intensity ratio. The untreated rats show the typical response of the mesentery microcirculation to alveolar hypoxia (compare Fig. 1A with 1B): increased leukocyte-endothelial adherence, emigration of leukocytes to the perivascular fluid, degranulation of MCs evidenced by uptake of ruthenium red, and increased extravasation of FITC-labeled albumin (compare Fig. 1D with 1E), demonstrated by the continued increase in the extravascular-to-intravascular ratio of fluorescence intensity, documented for 1 h after FITC-albumin injection. It is clear that dexamethasone substantially attenuates the expression of all inflammatory markers generated by exposure to hypoxia for 4 h.
Effect of dexamethasone on the response of AMO to hypoxia.
As expected from previous data (3, 4), AMO obtained from untreated rats showed a rapid and transitory release of H2O2 after 15 min of exposure to 5% O2 (Fig. 2A). This response is the consequence of the generation of superoxide that characterizes the respiratory burst produced by AMO activation (21): H2O2 generated from the dismutation of superoxide produced during the burst is released into the supernatant. Release of H2O2 did not occur when Po2 was lowered in cultures obtained from rats pretreated with dexamethasone or in cultures obtained from untreated rats to which dexamethasone (1 μM) was added to the supernatant before lowering Po2. Each set of data represents the average of five individual primary cell cultures.
The activation of AMO by hypoxia resulted in the expected release of MCP-1 into the supernatant (Fig. 2B and Ref. 3). The inhibitory effect of dexamethasone on AMO activation by hypoxia was reflected in abrogation of the release of MCP-1. This was the case in the cultures obtained from dexamethasone-treated rats as well as in the AMO cultures treated with dexamethasone in vitro, in neither of which MCP-1 concentration differed significantly from the normoxic untreated control.
Effects of dexamethasone on plasma MCP-1 concentration during hypoxia.
Figure 3 shows that alveolar hypoxia induced the expected (3) rapid and sustained rise in plasma concentration of MCP-1 in the untreated rats (n = 5). Dexamethasone completely inhibited this response: plasma MCP-1 remained at prehypoxic levels throughout the 60 min of exposure to hypoxia (n = 5). Mean arterial blood pressure and heart rate of the untreated rats showed the typical response of conscious rats to this level of hypoxia (12): a modest decrease in blood pressure accompanied by an increase in heart rate; both were significantly different from their respective controls only at 5 min of hypoxia. There was no difference between the responses of untreated and dexamethasone-treated rats.
Effect of dexamethasone on the response of the normoxic mesenteric microcirculation to MCP-1.
Topical application of MCP-1 (30 ng/ml) to the mesentery of normoxic untreated rats produced MC degranulation, evidenced by the uptake of ruthenium red, and leukocyte-endothelial adherence (compare with the effect of vehicle, Fig. 4A). These effects of MCP-1 were prevented by dexamethasone (Fig. 4C). Administration of the MC stabilizer cromolyn (8-mg bolus followed by 0.15 mg/ml, 2 ml/h iv) to previously untreated rats prevented the effects of topical MCP-1 on MC degranulation as well as the increase in leukocyte-endothelial adherence (Fig. 4D).
Topical application of MCP-1 to untreated rats produced a significant increase in the extravasation of FITC-albumin, as shown by the progressive increase in the extravascular-to-intravascular ratio of fluorescence intensity above the values observed before MCP-1 application (Fig. 5). In contrast, data of untreated rats administered vehicle show that extravasation of FITC-albumin after 1 h of injection is minimal, as shown by the lack of significant difference between the initial and final values of extravascular-to-intravascular fluorescence intensity ratio in this group. As with the inflammatory markers shown in Fig. 4, dexamethasone prevented the extravasation of albumin that follows topical application of MCP-1. When MCP-1 was applied in control rats pretreated with cromolyn, no increase in FITC-albumin was observed. This, together with the data of Fig. 4, show that dexamethasone prevents the activation of MCs by MCP-1. Furthermore, the finding that MCP-1 has no inflammatory effects in rats treated with the MC stabilizer cromolyn suggests that MCP-1 has no direct effects downstream of MCs.
Effect of Dexamethasone on Peritoneal MC Number and on the Plasma Concentration of Soluble DCF
In the course of these experiments, it became apparent that the number of MCs visualized in the microcirculation was lower in the dexamethasone-treated rats. This was confirmed by counting MC recovered by peritoneal lavage, which showed a significantly lower number of peritoneal MC, but not of peritoneal macrophages, in the dexamethasone-treated rats (Table 1).
The plasma concentration of SCF, a cytokine required for MC development, was significantly reduced in the dexamethasone-treated rats (Table 1).
Effect of Dexamethasone on the Response of the Mesentery to Topical ANG II.
Figure 6 shows photomicrograph obtained 30 min after topical application of vehicle (Fig. 6A) or ANG II (10 nM) to the mesentery of untreated (Fig. 6B) and dexamethasone-treated (Fig. 6C) rats: the typical response to ANG II, leukocyte-endothelial adherence in the absence of MC degranulation, (4) is evident in the untreated rats. Dexamethasone completely blocked the response to ANG II. Figure 7 shows that dexamethasone also prevents the progressive increase in FITC-albumin that follows topical ANG II.
The results show that pretreatment with dexamethasone prevents the inflammatory response of the mesenteric microcirculation to alveolar hypoxia. This is due to inhibitory effects of dexamethasone at each of the key steps of the inflammatory cascade: AMO, MCs, and the leukocyte-endothelial interface. Furthermore, the data show that the effect at each site is sufficient to block the inflammatory response.
Experimental Design
To determine the effects of dexamethasone on the systemic inflammation of alveolar hypoxia, we exposed conscious rats to 10% inspired O2 for 4 h, using a dexamethasone dose comparable to that used in humans (20). While degranulation of MCs by circulating AMO-borne MCP-1 is evident within minutes of the reduction of alveolar Po2 (36), some inflammatory markers such as leukocyte emigration and increased vascular permeability develop with a slower time course (43). Exposing the animals to hypoxia for 4 h ensured the full expression of all inflammatory markers in the untreated rats and provided an adequate background to evaluate the effects of dexamethasone.
The inspired Po2 used in these experiments is equivalent to that of an altitude of 5,500 meters. This value was chosen because the response of rats to this fairly severe degree of hypoxia has been studied extensively (3, 4, 6, 11, 12, 32, 35. 36, 42–44). In addition, since the incidence of altitude illnesses increases with altitude, we reasoned that it would be important to determine the effectiveness of dexamethasone in conditions in which there is a high likelihood of these diseases. While the systemic inflammatory response to this level of hypoxia has been well characterized, there is less information on the systemic effects of more moderate levels of hypoxia, such as those that may be seen in patients with pulmonary disease. Reducing Po2 from normoxic values to ∼65 and to ∼5 Torr produced increasing release of H2O2 in isolated AMO cultures (4). This suggests that AMO are activated at relatively mild levels of alveolar hypoxia and that the intensity of their response is Po2-dependent, although it is not known if the graded release of H2O2 is accompanied by proportionate releases of MCP-1. Similarly, a Po2-dependent increase in microvascular ROS fluorescence intensity, leukocyte-endothelial adherence, and MC degranulation was observed in the mesentery of rats breathing hypoxic O2 mixtures that result in alveolar Po2 values of ∼70, 40, and 30 Torr, respectively (35). Nevertheless, while this evidence suggests that the AMO-initiated systemic inflammation may develop at Po2 levels closer to those seen in pulmonary disease, the present results are applicable only to the relatively severe degree of hypoxia used in these experiments. It is reasonable to assume, however, that, if dexamethasone is effective at low Po2 levels, it would also be effective in less severe hypoxia.
The mesenteric microcirculation was studied because the effects of hypoxia have been well characterized in this microvascular bed (3, 4, 35, 36, 42–44); in addition, exposure of the mesentery is a relatively simple procedure that can be accomplished in a few minutes, thereby limiting the effects of prolonged surgery and anesthesia. The inflammatory responses of mesentery, skeletal muscle, and pial microcirculation have common characteristics such as MC degranulation and RAS activation (3, 4, 6, 11, 12, 23, 26, 32, 35, 36 ,42–44). Thus, data in the mesentery are likely to be a reasonable representation of an inflammatory response initiated by a circulating mediator activating MCs, a cell type ubiquitously distributed throughout the organism.
Pretreatment rather than dexamethasone administration after the onset of hypoxia was done because the inflammation involves several linked processes with different time courses. Given the rapid initiation of the inflammation, the timing of the treatment would introduce another variable in the experimental design. Administration of dexamethasone 24 h before the onset of hypoxia avoided these possible drawbacks. While this approach does not mimic the clinical use of dexamethasone, it does provide useful information on the mechanism of action of this agent.
A major objective of the research was to determine the possible sites of action of dexamethasone in the inflammatory cascade. This was investigated by determining the effect of dexamethasone on the response of each key site to its specific stimulus. Previous work has shown that AMO are activated by low Po2 (3, 4), whereas MCs and the leukocyte-endothelial interface do not respond to a reduction of local Po2 (4, 6, 32). Rather, MCs are activated by circulating AMO-borne MCP-1 (3), and the inflammatory responses at the leukocyte-endothelial interface are the result of ANG II (4, 12) generated by the release of renin from MCs (5).
Finally, it should be acknowledged that, while this experimental design is appropriate to address the questions asked, it is not directed to provide information on the cellular signal transduction pathways affected by dexamethasone. The results obtained provide an overall view of the effects of dexamethasone on the inflammatory cascade at the intact organism level and represent a necessary initial step in the elucidation of the mechanisms of action of dexamethasone in the inflammation of hypoxia.
Activation of AMO by Hypoxia
The results clearly show that dexamethasone prevents the development of the systemic inflammation of hypoxia by acting at each of the key sites of the inflammatory cascade. Dexamethasone prevented the respiratory burst and release of MCP-1 that follows exposure of AMO to hypoxia (Fig. 2). The role of dexamethasone and other glucocorticoids in attenuating the activation of AMO by specific effectors has long been known and is thought to explain the beneficial effects of these agents in some pulmonary diseases such as asthma (2, 7). Dexamethasone inhibits the in vivo and in vitro release of several cytokines and chemokines, including MCP-1 induced by activation of AMO by LPS and other inflammatory agents (2, 24). Our results extend these observations by showing that dexamethasone blocks the effects of AMO activation and release of MCP-1 elicited by a different stimulus, in this case reduced Po2. It should be noted that the response of AMO to hypoxia appears to differ from that elicited by other stimuli such as lipopolysaccharide (LPS), at least within the time frame of the development of the systemic inflammation of alveolar hypoxia: previous results show that from 16 inflammatory mediators investigated, MCP-1 was the only agent released from AMO within minutes of the reduction of Po2 (4).
Dexamethasone had the same effect whether it was administered to the animals or to cultures of AMO harvested from untreated rats (Fig. 2, A and B). Previous studies also showed similar in vivo and in vitro effects of dexamethasone in reducing AMO phagocytic activity and LPS-induced release of tumor necrosis factor-α (24).
As a result of the inhibition of AMO activation by dexamethasone, plasma MCP-1 of the treated rats failed to increase during hypoxia (Fig. 3). The main source of the plasma MCP-1 increase, at least during the first 30 min of hypoxia, appears to be AMO, since this increase is eliminated by AMO depletion with intratracheal clodronate liposome administration (3). After 60 min of hypoxia, however, plasma MCP-1 concentration increases moderately in AMO-depleted rats, suggesting the participation of sources of MCP-1 in addition to AMO. In the present experiments, plasma MCP-1 of the dexamethasone-treated rats failed to increase during the entire 60 min of hypoxia, implying that dexamethasone also blocks the release of MCP-1 from non-AMO sources.
These results provide additional support to the critical role of AMO activation in the initiation of the inflammation and show that the effect of dexamethasone on AMO is sufficient to prevent the systemic inflammation of hypoxia. Depletion of AMO prevents the hypoxia-induced inflammation in skeletal muscle (11) and mesentery (3, 4); dexamethasone has a similar effect, in this case by functionally eliminating the role of AMO in the initiation of the systemic inflammation.
Response of MCs to MCP-1
The second key step in the inflammatory cascade of alveolar hypoxia is the degranulation of MCs by AMO-borne MCP-1. Local tissue hypoxia does not produce MC degranulation if alveolar Po2 is maintained at normal values (6, 32); similarly, reduction of medium Po2 does not activate MC in vitro (4). MCP-1 administered to normoxic rats replicates the microvascular inflammatory response to alveolar hypoxia (Figs. 4 and 5 and Ref. 3); conversely, blockade of MCP-1 receptors with RS-102895 prevents the development of the microvascular inflammation in hypoxic rats (3). Accordingly, MCP-1 is the appropriate agent to investigate the effects of dexamethasone at this step of the cascade. Prevention of MCP-1-induced MC degranulation by dexamethasone was accompanied by inhibition of the downstream responses, leukocyte-endothelial adherence (Fig. 4), and vascular extravasation of albumin (Fig. 5). These responses highlight the central role of MC activation in the AMO-initiated inflammation and are consistent with previous observations that stabilization of MCs with cromolyn blocks all the downstream inflammatory responses to alveolar hypoxia and that MC secretagogues replicate the microvascular inflammation of hypoxia (36).
The data on the effects of the MC stabilizer cromolyn provide additional evidence concerning the role of MCP-1 in the systemic inflammation of hypoxia. Cromolyn prevented MC degranulation by MCP-1, as well as the downstream inflammatory responses that follow the MC degranulation (Figs. 4 and 5). This shows that the effects of MCP-1 on leukocyte-endothelial adherence and in albumin extravasation are mediated by its effect on MCs, rather than by a direct action of MCP-1 on the leukocyte-endothelial interface. These results support previous findings that, although MCP-1 induces MC degranulation and P-selectin-mediated leukocyte/endothelial interactions in the cremaster microcirculation, it does not induce expression of P-selectin in endothelial cells (41).
In addition to preventing the activation of MCs by MCP-1, dexamethasone produced a substantial decrease in the number of harvested peritoneal MCs. The extent of MC depletion observed here is similar to that found before within analogous time frames (34). It is likely that the effects on MC number and on MC activation by MCP-1 are both due to the well-known inhibition by dexamethasone of the synthesis of SCF, a cytokine necessary for MC development and function that regulates proliferation, differentiation, adhesion, and release of inflammatory mediators by MC (30). SCF synthesis is rapidly inhibited by dexamethasone and other glucocorticoids (8). MC depletion was accompanied by a decrease in the plasma concentration of the soluble form of SCF to <50% of the value observed in the untreated rats (Table 1). The decrease in circulating SCF points to a systemic reduction of this agent, and is consistent with observations of dexamethasone-induced MC depletion in various organs (8, 30, 34). Given the central role of MC activation in the inflammatory response, it is likely that the effect of dexamethasone observed in the mesentery extends to other organs where the inflammation of hypoxia is expressed. Because MC stabilization with cromolyn completely blocks the AMO-initiated inflammation (36), the effect of dexamethasone at this step is likely to be sufficient by itself to prevent the inflammation.
Response of the Leukocyte-Endothelial Interface to ANG II
The final step in the inflammatory cascade is the increase in leukocyte-endothelial interactions and in vascular permeability produced by ANG II. Degranulation of MCs by MCP-1 leads to release of MC renin and angiotensin-converting enzyme, activation of the local RAS, and generation of ANG II (5), which acts downstream of MCs to induce microvascular inflammation (Fig. 6 and Refs. 3, 12, and 28). On the other hand, local hypoxia in the absence of alveolar hypoxia fails to elicit increased leukocyte-endothelial interactions (6, 32). In view of these facts, ANG II is the agent of choice to investigate the effect of dexamethasone on this step of the inflammatory cascade.
Dexamethasone prevented the increases in leukocyte-endothelial adherence and in vascular permeability produced by topical ANG II (Figs. 6 and 7). ANG II participates in virtually all the steps of the inflammatory response, including rolling, adhesion, and extravasation of leukocytes as well as increase in vascular permeability (22). The increased leukocyte-endothelial adhesive interactions produced by ANG II in the mesentery are attenuated by fucoidan and anti-P-selectin monoclonal antibody (28), indicating an involvement of P-selectin in this phenomenon. Dexamethasone attenuates the expression of P-selectin in systemic inflammation (45), suggesting a possible mechanism for dexamethasone in hypoxia. A possible role of P-selectin in the systemic effects of altitude hypoxia is suggested by the elevated levels of soluble P-selectin in individuals acutely exposed to altitude (19).
The effects of ANG II on vascular permeability may in part depend on the release of inflammatory agents by adherent leukocytes; in addition, ANG II directly increases vascular permeability, at least in part by increasing the expression of vascular endothelial growth factor (VEGF), a potent permeability factor (46). Dexamethasone reduces VEGF expression, suggesting a possible mechanism for its effect of ANG II- mediated increase in vascular permeability (9, 17).
While it is clear that dexamethasone blocks the systemic inflammation that develops at the onset of hypoxia, it should be kept in mind that alveolar hypoxia is a complex stimulus; in addition to the phenomena described here, additional mechanisms with different time courses, including changes in gene expression, contribute to the overall response to hypoxia. Whether dexamethasone influences these responses and alters the adaptation of intact organisms to more prolonged periods of hypoxia should be the subject of further research.
The present study highlights the extrapulmonary effects of AMO activation. While most known effects of AMO stimulation occur within the lung, evidence of systemic inflammatory effects resulting from substances released by AMO has been accumulating within the past few years. Examples are the bone marrow effects of cytokines released by AMO in idiopathic pulmonary fibrosis (39) or in response to exposure to particulate matter (15). Cytokines released from AMO after particle deposition in the lung are thought to act on the bone marrow to produce the release of platelets and leukocytes into the systemic circulation and stimulate the release of acute- phase proteins (40), leading to systemic endothelial dysfunction and inflammation of characteristics similar to that described here (25). It has been suggested that overspill of inflammatory mediators from the lung contribute to systemic inflammation in pulmonary diseases, including chronic obstructive pulmonary disease (33). This suggests that activation of AMO by various stimuli may represent a mechanism underlying some of the systemic inflammatory processes observed in various pulmonary pathologies. The findings of this study suggest that the effects of dexamethasone and other glucocorticoids in pulmonary diseases involving AMO may extend to the systemic effects of these conditions.
This work was supported by NIH R01 HL-39443 (N. C. Gonzalez). J. Chao was recipient of a Pre-Doctoral Fellowship from the American Heart Association, Midwest Affiliate. Z. Viets was a recipient of a Biomedical Research Scholarship, University of Kansas Medical Center. P. Donham was a Fellow of the Frontiers in Physiology, American Physiological Society.
No conflicts of interest, financial or otherwise, are declared by the authors.
Author contributions: J.C., J.G.W., and N.C.G. conception and design of research; J.C., Z.V., and P.D. performed experiments; J.C., Z.V., P.D., and N.C.G. analyzed data; J.C., Z.V., P.D., J.G.W., and N.C.G. interpreted results of experiments; J.C., Z.V., and N.C.G. prepared figures; J.C. drafted manuscript; J.C., Z.V., P.D., J.G.W., and N.C.G. edited and revised manuscript; J.C., Z.V., P.D., J.G.W., and N.C.G. approved final version of manuscript.
Current address for J. Chao: Department of Surgery, University of Nebraska Medical Center, Omaha, NE 69198–5850.
- Copyright © 2012 the American Physiological Society


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Note: Many thanks to Shai Mitra for recruiting a very capable trip leader for us, and to Tim Healy, who took us to the best current hotspots at the refuge and helped us find and identify lots of great birds. Interesting trivia: Tim, a recent Cornell graduate, participated on our very first field trip as a teenager back in August 2008 (also to Jamaica Bay!).
On Saturday, August 20th, at 8 AM, twelve young birders and their families gathered in the parking lot of the Jamaica Bay Wildlife Refuge Visitor Center. Gulls, American Black Ducks and egrets flew overhead. We went around in a circle, introducing ourselves. When we came to Rion, who recently moved here from Japan, he mentioned that he would like to see a Glossy Ibis. Moments later, his wish was granted as two flew directly overhead.
After introductions, our trip leader, Tim Healy, led us down the road to the East Pond. He warned us before we entered that there would be mud - he wasn't kidding. We were pleasantly surprised to find three Stilt sandpipers, probing the muddy water. We were surrounded by a tempest of birders, nearly as numerous as the birds themselves. There were dozens of egrets, Snowy and Great, standing in a row, like the teeth of a white comb. Big, fat Mute Swans bobbed in the background, while in the foreground, all manner of plover and piper explored the mudflats. Someone found a grebe peering through the marsh grass, as squealing terns wheeled overhead.
We moved down the shore, stopping to examine a small, grassy island where we found all sorts of good things to look at: Black-bellied Plovers, assorted sandpipers, a Ruddy Turnstone, a Red Knot, and a Willet! Heading to the end of the shoreline, we examined an adorable Least Sandpiper, no bigger than a golfball, with bravery far larger than its size, who refused to move despite being surrounded by a dozen eager young birders.
We turned around then, stopping to look at a little Semipalmated Sandpiper hiding in the towering reeds. He had the right idea, hiding in the shade while we baked. We had a third close encounter, this time with a juvenile Yellow-crowned Night-Heron which stared us down with its orange eyes, and didn't fly off until we were all practically on top of it, as we sloshed past. There was a sudden commotion ahead as our fearless, former President, Joe Hernandez, took a wrong turn into a deep mud puddle. I was surprised that more of us had not met this unfortunate fate because the ground was deceiving. It looked solid, but it was thick, smelly, mud. We added one last bird to our list as a pair of lone birders helped us to see a Yellow-billed Cuckoo they had spotted. A beautiful bird!
As cicadas whirred, emphasizing the intense heat, we took a break to rehydrate, grab snacks and take refuge in the wonderful air conditioning of the Visitors Center. We went to the bird blind at Big John's Pond next, where we watched beautiful Black-crowned Night Herons hunt, and spotted a lone solitary sandpiper. We switched places, half of us crowded the bird blind while the other half braved poison ivy on the walkway. Then we ran to the East Pond to find a White-rumped Sandpiper. I found it difficult to discern from the other birds, but eventually with the help of the others I spotted it, my third life bird for the day! Once we had that bird under our belt, our eyes turned to other natural curiosities; Monarch Butterflies, sunlight shining through their orange wings, raccoon tracks on the shore among shattered oyster shells, and a single Gray Tree Frog, clinging to a branch over the trail. We then headed back to the Visitors Center to have a picnic lunch under the shade of the trees, tally up lists, and talk about the birds we had seen over snacks and sandwiches. A fine ending to a fabulous day out on Jamaica Bay.
List of Birds Seen on this Trip by Silas Hernandez
Canada Goose
Spotted Sandpiper
Fish Crow
Species Total: 57


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Aspen Interior Design
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New painting.
May 31, 2014 in Uncategorized
May 31, 2014 in Uncategorized
June 30, 2013 in Art
I am really getting into these scratch boards…
May 5, 2013 in Art
We are going to make magnets up. I am trying to decide which piece to make.
Should I do Self-Portrait with Guitar, or Piedmont Ave Lamp Post?
April 12, 2013 in Art
April 3, 2013 in Art
This is a demented family portrait.
It's about 50% complete… as far as I know.
April 3, 2013 in Art
I am releasing a run of 100 signed numbered 16″ x 20″ giclee prints (image size is approximately 9.5″ x 15″) of my newest painting. The look great. Starting them off at $250
Want one? let me know.
You can see the original painting here
Jess and I are having a show in October at Blue Danube. Will post reception dates soon.
December 31, 2012 in Art
Time lapse video painting "self portrait with guitar" 2010
December 30, 2012 in Uncategorized
You can see it in person Friday April 12 at Redux Gallery
Improved Print… converted to an original acrylic painting.
I found a picture of the print before I defiled it with my vulgar strokes…
Sorry Piet
November 15, 2012 in Art
just finished this up
November 6, 2012 in Art
So walking to get some coffee today I came across this large framed painting on the curb. It was still there when I came back so I brought it home. There was a 5 inch rip in the bottom right hand side of the canvas, which took a few minutes to repair with some acrylic medium.
Here is the painting as I found it. Standard 70's deco furniture store garbage.
I took the photo and put it in photo shop to play with some ideas and came up with a concept that I felt improved greatly on the original work…
Happy with the concept, I threw it on the easel and got to work, here is a midway point showing progress.
And after a days work, here is the completed work, much improved I think you will agree.
Now I just have to find somewhere to hang it…


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Puddle ducks. Mallard Large duck, 2.5-3lbs , 24-28 inches Chestnut chest, white belly, dark rump Blue spectrum with white tips. Male and Female Mallard. In flight. Black Duck. Large 2.5-3lbs Loud quack female low rink male. Pintail. 2-2.5lbs Bill bluish with black stripe down middle
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Mexican duck
Green and Blue Teal
Tree Duck
American cootOther puddle ducks


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10 Hard-Working Rooms That Make Life Easier
Packed with clever built-ins, space-maximizing storage, and nifty organizers, these high-functioning mudrooms, pantries, laundries, and potting rooms offer great ideas to streamline daily life
These helpful buffer zones allow an orderly exit—and reentry—with a place for everything.
Open hooks for airing out damp outerwear
Shelves with bins for corralling accessories
A seat for pulling footwear on and off
Resilient surfaces that dirt can't hurt
This one-wall mudroom can handle a season's worth of athletic gear and outerwear.
Tip: Cheer up a utilitarian space with a colorful indoor-outdoor runner. To clean it, just shake it out or hose it down.
Ample 16-inch-deep cubbies mean each family member has places to stash footwear, sports equipment, toys, and more.
Metal bins, fabric-lined baskets, and color-coded boxes organize small items and store off-season goods.
High-gloss paint resists scuffs, and stone-look porcelain floor tiles won't show scratches. Both are a snap to clean.
A furniture-grade storage unit mounted alongside stairs turns a front foyer into a mini mudroom.
Open lockers with hooks have handsome curved frames that make the unit formal enough for a front entry. The oak, chosen to match the stairs, is finished with water-shedding polyurethane.
Tip: Lockers should be at least 2 feet wide so that there's space for each person's bags and outerwear.
Rarely used items, like binoculars, are tucked up top behind flip-up doors.
The 10-foot bench projects nearly 2 feet from the wall to provide a safe toehold for reaching top cabinets. Arched supports echo the locker frames and divide the slate-tile floor into landing spots for shoes.
Exposed hooks and discreet closets and drawers create a high-functioning, clutter-free drop zone.
Eight-foot-high doors hide away baskets of balls and outerwear not worn every day.
Jackets and bags practically hang themselves up on generous hooks above the bench.
Small, clutter-creating items, such as dog leashes, gloves, and sunscreen, are concealed inside large drawers. Roomy cutouts offer a glimpse of what's inside and a comfortable handhold.
Along with providing a spot for slipping shoes on and off, this perch's lid opens up to stow baseball bats and lacrosse sticks.
Tip: Make cleaning up after muddy feet (and paws) a cinch by sealing porous bricks with a clear coat for masonry.
These kitchen offshoots keep supplies centralized and out of the cooking zone.
Open shelves for quick access and slide-outs for heavy items
Fuss-free surfaces in case of spills
Good lighting for easy hunting
Warm finishes keep the look as polished as the adjacent kitchen, inspiring a sense of order.
These shelves can be raised or lowered to accommodate everything from canned goods and recipe binders to candlesticks and centerpieces.
Tip: To amp up lighting in a closed pantry—and add a style boost—hang a pair of pendants instead of just one.
Rods flanking the center unit allow table linens to hang wrinkle-free, while slim, felt-lined drawers keep silverware from tarnishing.
The granite countertop looks luxe, complements the richly hued wood, and wipes down easily.
Lots of light makes this pantry alcove a practical dishware-storage and food-prep station.
Full-extension hardware ensures access to every inch of these pullouts.
Tip: Stash heavy and frequently used items at waist height.
A 25-inch-deep laminate countertop provides a convenient work surface.
Serving items sit at the ready on open shelves—and double as decor.
Small appliances and bulk grains can be kept cool, dark, and dust-free behind closed doors.
A fully loaded grid of open shelves and cabinets can disappear behind a functional piece of salvage.
The weathered bank-vault door, mounted on a heavy-duty track, adds character, hides clutter, and—unlike a swing-open door—won't block traffic.
Tip: Chalkboard paint can turn a wall or door into an erasable shopping list and message board.
A small, nickel-finished ceiling fixture reinforces the kitchen's vintage look while illuminating items at the back of shelves.
Outlets allow for stashing a wine cooler and other small appliances to clear space in the cooking area.
First-class finishes and a fun hit of color make for a pleasant gardening place.
A deep sink with a raised faucet to fit pots and watering cans
Tall shelves and roomy cabinets for tools and containers
An easy-care work surface and floor
A Dutch door blocks pets while inviting air and light into a workstation for potting plants and filling vases.
Soapstone has an earthy, traditional look, and chips and wear only add character.
Water and potting soil mop up fast when there's no grout to catch them.
Tip: Line a deep drawer with a heavy-duty plastic bag to serve as a soil bin.
A furniture-like potting center combines glass-front and solid cabinet doors for display and storage.
An extra-deep (nearly a foot) cast-iron basin with a raised lip helps contain splashes.
Classic subway tile gives this cottage-inspired setup a pretty-yet-practical backdrop.
Eye-Catching Shelf
An open shelf mounted on corbels is a showcase for cloches, colorful containers, and potted plants.
The nonporous Corian countertop mimics wood but stands up to assaults from liquid fertilizer, thorny rose branches, and heavy ceramic pots.
Tip: Keep track of drawer contents with bin pulls that have apothecary-style label holders built right in.
These well-organized, well-lit rooms help take the dread out of wash day.
Countertop space for folding
Cabinets for containing detergent and other supplies
Sink for hand-washables
Rods or racks for air-drying
The U shape offers space for sorting, washing, folding, and hanging.
Custom cupboards painted a vintage green—complemented by a tall beadboard backsplash with a plate rail for displaying artwork—look inviting and accommodate every laundry necessity, as well as ironing and sewing supplies.
A long run of solid surfacing holds stacks of folded clothes.
Tip: Create an under-counter spot for a laundry basket so that it won't be underfoot.
Charming hinged wood wall racks latch at the top when not in use. A shower-curtain rod in front of the window allows damp laundry to get a full dose of fresh air. A coated-metal mesh rack set into the countertop keeps knitwear flat for drying.
Everything is within easy reach in this compact, light-filled laundry center.
Front loaders topped with a quartz slab create a space-saving folding area.
Laundry on hangers can drip-dry over the sink.
Tip: Install under-cabinet lighting to make treating stains easier.
An adjustable spray helps with rinsing out hand-washables.
Slatted wood pullouts, a generous 27 inches wide and 20 inches deep, can handle bulky wet sweaters.


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Home > Pornstars > Lexi Kartel
Lexi Kartel is a porn star. She was born in the United States. She is listed on our site since 2017. Her current ranking is 8. She has 8 gallery links in section with her pictures and videos.
Lexi Kartel is making new movies, often performing in live shows and posting pics on various sites this year.
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Automotive Repair In Baton Rouge
C & R Automotive is the answer to your automotive repair and maintenance needs. We are a comprehensive repair shop, serving most import and domestic automobiles. We are experts in Japanese cars and trucks, including Nissan, Toyota, Honda and Mazda. We also provide service for domestic cars.
C & R Automotive takes pride in having certified mechanics dedicated to quality work and personalized service. To protect you, we are state licensed, insured and bonded, and guarantee our work with labor and parts warranties.
Our work includes:
Our excellent customer service has helped us build a loyal following in Baton Rouge over the last 29 years. If you need professional automotive repair or maintenance, come visit the specialists at C & R Automotive today!
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Hey you all there is a brand new color called "Black Kraft" at Timeless Twine!!!! Here is a pic of it!
Just go to Timeless Twine and Enter to win this new awesome color! I love the name....sounds witchy!!
OMG ~ this looks FABULOUS!!! Thanks for the heads up!!
Love it!TFS


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Originally published Thursday, April 18, 2013 at 11:00 AM
Frugal pope nixes bonus for Vatican employees
The global economic crisis is hitting Vatican employees in their cassock pockets.
The Associated Press
The global economic crisis is hitting Vatican employees in their cassock pockets.
The Vatican said Thursday that Pope Francis, known for his frugal ways, decided Vatican employees won't be getting the bonus that traditionally comes with the election of a new pope.
In the past, the Vatican's 4,500-plus workers - both religious and lay - would receive an extra little something upon the death of one pope and another upon the election of his successor: In 2005, the total reportedly came to 1,500 euros (nearly $2,000) apiece.
Vatican spokesman the Rev. Federico Lombardi said that given tough economic times - the Vatican posted a 15 million-euro deficit in 2011 - "it didn't seem possible or appropriate to burden the Vatican's budget with a considerable, unforeseen extra expense."


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Farewell Cruel World!
Well, only for a month…I am headed to the Faroe Islands.
I am really excited about this trip, not because I know what I'll find there, but because I have no idea what I'll find.
I do no planning or research when I am planning my trips. I do not look at other people's images from that area. I do not consult the travel guides for the "must see" sites. My only preparation for this trip consists of renting an apartment and car.
Because I want to go with a blank slate, with no preconceived ideas or expectations. I do not want to know how others have seen the Faeroes or photograph the same sites that everyone else has.
That's my goal anyway. My hope is that I'll see something there that inspires my imagination and which will result in a new portfolio.
I'll not be posting much while I'm away, but I will post some iPhone snapshots each day on my Google+ and Facebook accounts:
- Google+ https://plus.google.com/+ColeThompsonPhoto
- Facebook: https://www.facebook.com/ColeThompsonPhotographer
I'll be returning at the end of August.
See you then.


text:
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The preliminary catch for all Washington sport Pacific halibut fishery openings through 10 June is 210,644 pounds, leaving an estimated 35,513 pounds to be harvested. Due to lower fishing effort targeting Pacific halibut in recent weeks, sufficient quota remains to open another all depth fishing day in WDFW Marine Areas: 1 (Ilwaco - Columbia River), 2 (Westport-Ocean Shores), 3 (La Push), 4 (Neah Bay), 5-10 (Puget Sound) for one day on Saturday, 17 June 2017. These fisheries will then be closed for the remainder of 2017.
The Columbia River nearshore area will remain open seven days per week until further notice.
For more information on these updates please refer to:
Washington Department of Fish and Wildlife website:
In all marine areas open to Pacific halibut fishing, there is a one-fish daily catch limit and no minimum size restriction.
Due to the short notice nature of this notification, it is posted to our website only, and no paper copy has been mailed out.
David T. Wilson, Ph.D.
Executive Director, IPHC
Phone: (206) 634-1838
Fax: (206) 632-2983


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"Soler's narration fits the tone of each story and provides unique voices for each character, including a breathy, high-pitched voice for Winter and a harder, cruel voice for Mistress Sybil." - AudioFile Magazine
The #1 New York Times Best-selling Series!
The enchantment continues....
The universe of the Lunar Chronicles holds stories - and secrets - that are wondrous, vicious, and romantic. How did Cinder first arrive in New Beijing? How did the brooding soldier Wolf transform from young man to killer? When did Princess Winter and the palace guard Jacin realize their destinies?
With six stories - two of which have never before been published - and an exclusive never-before-heard excerpt from Marissa Meyer's novel, Heartless, about the Queen of Hearts from Alice in Wonderland, Stars Above is the essential audiobook for fans of the best-selling and beloved Lunar Chronicles.
©2016 Rampion Books, Inc (P)2016 Macmillan Audio
"Shorts from Lunar."
The stories make me want to reread the whole series over again, although most are stories we know, only they are expounded upon in depth here, the real jewel is the last story.
1. The Keeper. Cinders arrival to Earth and the beginning years with Scarlett. 1 hr. 18 mins.
2. Glitches. Cinders arrival at the Lin's home. Cinder meets Iko. 48 mins.
3. The Queens Army. Wolf's induction genetic modification and to the Queens Army. 54 mins.
4. Carswell's guide to being Lucky. Carswell's law breaking beginnings. 1 hr. 2 min.
5. After Sunshine Passes By. Crescent beginnings, be careful what you wish for. 32 mins.
6. The Princess & the Guard. When Winter stops using her gift. 1 hr. 32 mins.
7. The Little Android. A new story that doesn't have anything to do with the main story. Mech 6.0/Star, the android who loved. 1 hr. 18 mins.
8. The Mechanic. When Kai meets Cinder. 31 mins.
9. Something Old, Something New, or Stars Above. The wedding we have all been waiting. The couple is who I thought it would be, which makes me happy. Roughly about 1 hr. 30 mins.
The last part is a preview of the new series Marissa Meyers is coming out with.
"The narration was a little off this book."
So, I love all the other books. and Rebecca Soler was wonderful. This time the narration was off and did hold up to the quality that the other books had in the Lunar Chronicle's. I hope it was a fluke that this book was not up to par....
"Nice addition to the series"
I think Rebecca is a great performer and did a great job with the voice acting HOWEVER she either has a cold or there is something wrong with the audio because she sounds stuffy and I found it very distracting.
"Stories Good, Narrating Horrible"
I've loved every single narration Rebecca Soler has done for Marissa Meyer except for Stars Above. Half the book she had a cold and it was super apparent in they way she narrated and made it VERY hard for me to continue listening. Other than that, I still enjoyed listening to the stories as I loved the Lunar Chronicle series.
"Fairytale ending, utterly delightful!"
Love, love, love this addition! Always ready to read more about my friends whom I miss now that the series is over.
The stories here are cutting-room-floor deleted scenes from Cinder, Scarlett, and Cress. Some people may be annoyed that there is no "advancement" to the stories; we already know these little events in their lives. (Everybody loves watching deleted scenes from movies.) These are the scenes that are the basis of the fairy tales: Red Riding Hood's journey to her grandmother's house, the witch locking Rapunzel in the tower, and the wicked stepmother thrusting Cinderella into the cold kitchen and making her work. These were glossed over in the Chronicles; in this book we get the details: Thorne's episode with the math whiz Falo girl, Cress being imprisoned in the satellite, and Scarlett leaving her lay-about father and traveling by herself to live with her grand-mère, then overhearing the conversation with Lin Garren regarding the princess. Sure, the stories are repetitive since we know what happened from the series books. Sure, you could be annoyed that there is nothing new. But it was all enjoyable and pleasing to revisit. Even when it gets around to Kai's first trip to the fix-it shop in the marketplace, and it sounds just like the beginning of Cinder, we get it from his side, and it is delightful all over again. There are smiles and chuckles all the way through, as we go with our friends to the last, inevitable scene of every fairy tale. And again, as throughout the whole series, it is totally modern, totally believable, not childish or simplistic as most fairy tales are.
And, AND! There is a completely new story in the middle! It really has nothing to do with anything, but it shows M.M's ability to take a tale and make it futuristic and grown-up.
You don't need to check the cover to verify the narrator even though it does not sound like Rebecca Soler at first. Good news is it IS R.S. and she gets over the stuffy head and laryngitis she has at the beginning of the book, and then sounds like herself again. As the hyper-critical listener that I am, I noticed several misplaced emphases that would have delivered better if corrected, but most people won't notice. And her Chinese pronunciation has degraded from the Chronicles readings, but then most readers don't speak Chinese, so, again, they won't notice (I do and I did.) Despite all that, she delivers most of the conversational lines flawlessly, adding to the humor and pathos. I can't imagine anyone else reading these stories.
"Loved it but..."
I agree with another reviewer that poor Rebecca must've been sick because signs of her being stuffy were throughout the stories. It was a bit distracting but what was more distracting was the few parts you could tell had been added later. The quality was different and her voice was higher. It's not her fault, you have to work when you're sick and I don't blame her for that. I do wish that tptb could have found a way to make those other parts flow smoother.
Regardless, Rebecca's telling of these stories is part of the reason why I've loved them so much. And I'd have been way more upset if they had someone else do Stars Above.
"Rebecca has a cold..."
I LOVE Rebecca Soler as the narrator, but it was a bit distracting that she had an obvious cold through 2/3 of the book. Her accents and voices are wonderful, but the cold affected the reading. Glad she was feeling better towards the end!
A nice fill in of the story book!
"An Amazing end"
loved it and the peak into heartless. Carswell Thorne my favorite character " Aces!, they haven't even kissed and already they're making me nauseous!"
"Thank the Stars Above!"
Was holding off for several months because I just didn't want the series to end, Thankfully, this last book really brought it all together with all the inside, behind the scene stories and perfect endings that were so satisfying. The author and reader combined make all these stories a true listening pleasure.
" reading"
Wish Rebecca Soler didn't have a cold while reading. it's a little distracting. still a great book!
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Asin Launches Fair and Lovely Expert Express
Asin launches the Fair & Lovely Expert Express in Hyderabad
Fair & Lovely Expert Express, an endeavor to help women get flawless fairness
New Fair & Lovely Advanced Multivitamin offers expert like fairness treatment
Hyderabad, June 25th, 2012: For the first time the women of Andra Pradesh have an opportunity to get an expert-like treatment on the go. Bollywood's reigning actress Asin Thottumkal, unveiled the Fair & Lovely Expert Express - at an enthralling event today at Park Hyatt, Hyderabad. Fair & Lovely Expert Express that tours Andhra Pradesh, Uttar Pradesh and Bihar till 25th July, 2012 will give women expert skincare advice.
Fair & Lovely Expert Express is a customized luxury bus that comprise of a specialized Skin Analysis Zone, Personalized Consultation Zone and a Fairness Treatment Zone where in Beauty Advisers will offer personalized advice and solutions. As part of the process, women will sign up for a skin analyzer test on completion of which their Fairness Report card along with their customized skin care regime would be given to them.
At the launch, Asin upon receiving her Fairness Reportcard she said, 'I have been a proud user of Fair & Lovely for years and am delighted to be associated with this brand. The New Fair & Lovely Advanced Multivitamin is not just a cream, its a fairness treatment and like most expert fairness treatments, it targets darkness causing problems on the face such as spots, dark circles, sun-tan, dullness and dark skin; giving you flawless cosmetic treatment like fairness everyday. I am sure every woman is simply going to love this product.'
Arun Srinivas, Vice President Skincare, Hindustan Unilever said, 'Fair & Lovely has enjoyed an extensive brand loyalty from consumers across the country and to cater to our discerning consumers, the New Fair & Lovely Advanced Multivitamin is our best skin lightening formulation ever. New Fair & Lovely Advanced Multivitamin is now much more than just a cream; it offers consumers the targeted action of expert fairness treatments. The Fair & Lovely Expert Express will offer the best skin advice to women across Andhra Pradesh, Uttar Pradesh and Bihar'.
Beyond Hyderabad, Fair & Lovely Expert Express will be touring Karim Nagar, Medak, Warangal, Khammam, Vishakapatnam, Guntur and Nalgonda in Andhra Pradesh; Patna, Muzzafarpur and Bhagalpur in Bihar and Jhansi, Lucknow, Kanpur, Agra, Aligarh, Meerut, Moradabad, Bareilly, Gorakhpur, Varanasi and Allahabad in Uttar Pradesh.
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