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Audi A4 Questions Maintenance & Repair
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2008 Audi A4 Quattro 2.0t - Starts Then Dies
2008 Audi A4 Quattro 2.0T - Starts then dies. I have a manual transmission, can get the car started and revved up to 3500rpm then it idles down to 1000rpms and dies. Changed battery & Spark plugs....
2001 Audi A4, 1.8 Quattro W/turbo
I took my 2001 Audi to the coast a few months back and I was driving back to the place I was staying at and it just shut off on me. Dash lights and everything was still on and working perfectly, b...
Audi A4 V6 3.2l 2007 (1) The Car Cranks Longer Then Expected When Starting...
(1) The car starts just fine as of now, however when I start the engine after being off for sometime (over night) it cranks longer than what I would expect. When I start the engine agin after a shor...
How To Solve?
I was driving my audi home when OIL PRESSURE shows up on the monitor. There was oil in the engine. The engine began run hot. after a few miles the car shuts off while climbing a slope. During the dr...
Audi A4 Won't Start
I took the cluster to have repaired and then I drove it to the gas station a mile down the street. At the gas station I could not get the car started. 1) it would start if I sprayed starting fluid i...
Audi A4 2006 Change Oil A Few Miles Later Get "pressure Oil" Warning On Eng...
Change oil not even 24 hours ago and drive it for about 100 miles when i got the warning. pull over and stop as soon as i could and the engine stop working.
Mass Air Concern
looking for help, 2004 a4 1.8l, po103, replacedass air sensor, got p0102, put old sensor back got p0103 back, bad sensor, ordered another one, put it in ran great until next day start stall start st...
Car Starts An Cuts Out When Gas Pushed
Hi my 98audi 2.4 just cut out when i got home from a drive was idling an cut out won't start but when it starts itl cut out when gas pushed any help would be much appreciated
My car is over heating when I have the air conditioner turned on and I am idling in drive like at a stop light or something. I've been told that it is probably caused by one of the electric fans n...
Radio Code
My car radio is in safe mode. I have the numbers can you please tell me the code. Auz5z4y0174619 & WAUDH68D11A059393.
Hello Guys. I Have An Audi A4 B5 Model And Its Making A "whoooo, Whoooo, Wh...
Hello guys. I have an Audi A4 B5 model and its making a "whoooo, whoooo, whooo, whooooo....." sound when I am moving and it gets louder when I turn left. The sound seems to be coming from the front ...
2002 Audi A4 Replaced Coil Pack Plugs
I replace coil packs spark plugs car still will not start
Audi A4 Quattro Turbo
My check engine light has been on for about 8 months now. Well about the same time when I put gas in the car I have to Rev the gas for it to start. Now more recently the past few months, the car w...
2010 Audi A4 Engine
I just replaced cylinder head and two cylinders along with timing chain and wondering how long it will last after all this repair. Should i keep the car or sell it, thanks.
2002 Audi A4 1.8t Starting And Stalling/sputtering
had some issues a few weeks backmisfire and blown engine timing fuse since then Car was running great with new plugs, wires, coils, and valve gasket response is better then day one so I cleared th...
Audi A4 05 2l Diesel
I am drive today and car stop about 5 times ,hard to start,and some noise in engine when iam press exalerator was big bang!!!and car stop completly and dosnt start any more
Overheating, Engine Misfire, Oil Light, Coolant Light
I bought this car less than a year ago from a dealer. It was fine when I bought it but after driving it a couple times it began to have a miss in every cylinder and originally the temperature gauge...
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lovincake on
I love this look...gives me something new to try!!! Your work is awsome!!!
aminaz on
what tip did you use for the swirls
Biya on
I was looking for inspiration for a birthday cake today. So glad I came across your cake I love the swirls on the side I think I will try it on the cake I'm doing today. Thanks for sharing it's beautiful
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A Holbrook man accused of dealing cocaine is set to be arraigned Monday following a month-long investigation by the South Shore Drug Task Force.
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Police said a 28-year-old Holbrook man was arrested for second offense drunken driving after he pulled into a Braintree lot with an apparent flat tire.
A 39-year old Holbrook man was sentenced to 10-13 years in prison after being convicted of a series of break-ins in Hanson, Marshfield and Pembroke.
HOLBROOK – Stilettos Hair & Spa is showing their appreciation for law enforcement by offering free haircuts and facials to active and retired police officers through the end of July.
HOLBROOK – Every day, an average of 22 veterans kill themselves.To help prevent suicide by veterans, the American Infidels, a motorcycle club for combat veterans, will host the Freedom Festival from 1 to 9 p.m. Saturday at the...
The conservation commission is considering plans for a $1.4 million rehabilitation project for the Great Pond Dam
The woman showed up to her ex-boyfriend's home because she was upset he was with another woman, police said.
After the Whitman police cleared a K-9 Groomers of negligence in the death of a Holbrook dog, the dog's family called parts of a Whitman police investigation "completely false." Police Chief Scott D. Benton stood by the department's...
Bob Lane and Jennifer Balas have been called murderers and their lives have been threatened — all because a viral Facebook post about a tragic dog's death placed the blame at their feet. Even after the police cleared the couple of wrongdoing,...
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Comments about 'Letter: Plague of obesity can be combatted with nutritional guidelines'
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Or we could let people decide for themselves, and keep the government out of it. Now there's a novel idea.
- 8:26 a.m. Oct. 9, 2012
- Like (2)
- Report abuse
Or not...
Free people make poor choices but the worst choice is to give away freedom.
- 2:02 p.m. Oct. 9, 2012
- Like (1)
- Report abuse
Peanut and No One:
Do you feel the same about tobacco, alcohol, meth, cocaine, marijuana, and other controlled substances? Are there no limits to "freedom" in your world? If you're willing to accept government regulation of those harmful substances, why not something equally dangerous to human health and arguably much more widely abused?
- 3:33 p.m. Oct. 9, 2012
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"We could fight it with law limiting the sugar content of candy, soft drinks
and sweet foods."
You got that right. As a pop drinking nation we are getting more and more obese... especially the kids who such on soda pops all day.
The problem is, we can't have the governmnet tell us what to eat and drink, lest we have an autocracy. But I can guarantee that, with Obamacare that's exactly what we will have... We will be told what we can and cannot eat and drink in order to keep health care costs within government guidelines.
- 4:23 p.m. Oct. 9, 2012
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Two more fans for my quest for a casino and neighbourhood pubs in utah:
"Free people make poor choices but the worst choice is to give away freedom."
"Or we could let people decide for themselves, and keep the government out of it. Now there's a novel idea."
Yeah, it would be a novel idea. In utah, that's for sure. And I didn't give my freedom away. They take it every time I get to this side of the state line.
Vive la freedom!!
- 5:31 p.m. Oct. 9, 2012
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So just exactly what constitutes obesity? Don't say BMI, that was discredited by the Mayo Clinic in 2006 where the study they published said BMI is not an indicator of heart or other diseases. So what exactly constitutes obesity?
- 6:34 p.m. Oct. 9, 2012
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The solution is right in front of you i.e. the nutritional label.
Most websites that calculate also calculate daily caloric need (both base & one accounting for activity level). Stay around the 60% carb 20% protein & fat each day.
Eat 500 calories less per day and you lose 1 pound a week.
Drink 1 less Dr Pepper per day & you'd lose 15.6 pounds in 1 yr.
- 7:36 p.m. Oct. 9, 2012
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Obese people cost America $190 billion over healthy people. Time for a head tax and get the fat man to pay his way. 30% body fat percentage or better and charge them $1500 a year. That will work.
- 4:25 p.m. Oct. 10, 2012
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Eliminate sugar, and corn subsidies, and people will start eating more healthy.
- 4:33 p.m. Oct. 10, 2012
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Innovative Bonding and Spray-Forming Techniques for Cost-Effectively Producing High Performance Induction Motors
Award Information
Small Business Information
Satcon Technology Corp.on
161 First Street, Cambridge, MA, 02142
Principal Investigator:
Mr. James O'Rourke
(617) 349-0948
(617) 349-0948
Business Contact:
Mr. Steven St. Germain
(617) 349-0914
(617) 349-0914
Research Institution:
Abstract40816 November 13, 1996 SatCon Technology Corporation While cost-effective, high performance electric motors are crucial to the success of any electric or hybrid-electric vehicle program, their manufacturability is the primary impediment to their development. This project will decrease manufacturing costs by developing new fabrication techniques for rotor assemblies and thinly laminated stator stacks. The rotor assembly concept involves using an innovative bonding technique to assemble a net-shape copper squirrel cage to a net-shape magnetic core. The laminated stack concept involves using an advanced spray-forming process to fabricate cores of arbitrarily thin laminations in a one-step process. Phase I will demonstrate the feasibility of using these techniques to make electric motors with a performance-to-cost ratio that will make them economically viable, thus bringing electric automobiles another step closer to reality. Anticipated Results/Potential Commercial Applications as described by the awardee: Most applications that use rotating machinery or require high power-to-weight ratios can enjoy an efficiency improvement through higher rotational speeds. Electric vehicles and next-generation high-speed turbo machines (e.g., HVAC compressors) are the nearest-term and largest market applications for cost-effective, high-performance electric motors.
* information listed above is at the time of submission.
An Official Website of the United States Government


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ART: ShuRA KK
dauphinofrance asked:
Hey I really love your work and can't wait for your next analysis! Comparing Centibeetles look and pearls space-suit outfit, I find them very similar and can't help but think centibeetle was wearing a space suit as well. Does this shed any light on the character for you?


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Jim Rogers On Geithner's China Summit: "The United States Is The Largest Debtor Nation In The History Of The World"
Video - Jimmy Rogers - May 10, 2011
Video - Jimmy Rogers - May 10, 2011
Video - May 18, 2011
Funny shite. Ah, the public book signing - always fertile ground.
Al Gore confronted at book signing...
Madeleine Albright confronted over war crimes at book signing...
More underwater homes...
It's about time taxpayers stopped subsidizing expensive mortgages, though that hasn't stopped industry trade groups (the NAR), who are pounding doors all over Washington with sob stories of the wealthy and forlorn.
Details inside.
AIG closed barely above $30 today, and 300 million shares won't be easy to place, not with current financials. Daytrading fools kept AIG too high for too long. Institutions are balking at anything above $27, and that means a loss for Treasury, who now threatens to postpone the offering.
He was already a billionaire when he began cheating the system...
Updated on May 11, 2011 at 1:15 AM by DailyBail
Video - Ron Paul on Bloomberg - April 28, 2011
Great clip.
And the poll by Fox News is still open, so click and place your vote. More than 164,000 people have voted and 99% area against raising the debt ceiling. Here was the exact question:
Ron Paul at Republican Presidential primary South Carolina debate...


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@MISC{Russell_newyawl:designing, author = {Nick Russell and Arthur H. M. Ter Hofstede}, title = {newYAWL: Designing a Work ow System using Coloured Petri}, year = {}}
Abstract. Traditional work ow systems focus on providing support for the control- ow perspective of a business process, with other aspects such as data management and work distribution receiving markedly less attention. A guide to desirable work ow characteristics is provided by the well-known work ow patterns which are derived from a comprehensive survey of contemporary tools and modelling formalisms. In this paper we describe the approach taken to designing the newYAWL work ow system, an o ering that aims to provide comprehensive support for the control- ow, data and resource perspectives based on the work ow patterns. The semantics of the newYAWL work ow language are based on Coloured Petri Nets thus facilitating the direct enactment and analysis of processes described in terms of newYAWL language constructs. As part of this discussion, we explain how the operational semantics for each of the language elements are embodied in the newYAWL system and indicate the facilities required to support them in an operational environment. We also review the experiences associated with developing a complete operational design for an o ering of this scale using formal techniques. 1
work ow system
coloured petri
resource perspective
newyawl system
coloured petri net
contemporary tool
control ow
language element
direct enactment
data management
comprehensive support
well-known work ow pattern
newyawl work ow language
business process
newyawl language construct
work ow pattern
newyawl work ow system
traditional work
formal technique
desirable work ow characteristic
operational semantics
operational environment
comprehensive survey
complete operational design
control ow perspective
work distribution
Developed at and hosted by The College of Information Sciences and Technology
© 2007-2016 The Pennsylvania State University


text:
Recent in Company News (page 11 of 40)
Branded Content
Introducing BASF's new Experiential Skin Care – BASF Introduces Experiential Skin Care
What are Oligomers for LED Curable Nail Gel Coatings? – Dymax Corporation
Formulation Friendly and Effective BioTransformed Natural Extracts – BCR
Brightness, High Chroma Effects Focus for New High-Performance Pigments – BASF
A Tailor-made Approach for Achieving a Fair and Even Complexion – Sederma
Ashland Integrates Research and Development Facilities
Nov 20, 2015
Ashland advances the true-to-life consumer and clinical evaluations of personal care ingredients across the globe.
New Systems + New Focus = New SCC
Nov 20, 2015
In desperate need of a system upgrade to meet consumer expectations, the Society of Cosmetic Chemists (SCC) found itself held back. It needed a plan to adapt for both the industry and its the members. That's where we began this discussion with David Smith, executive director of the SCC.
Mibelle Creates New Team
Nov 18, 2015
Mibelle Biochemistry announced a new US-based team to service United States customers.
Ashland Awarded for Ecological Ingredient
Nov 11, 2015
Ashland announced Elixiance biofunctional recently won the silver award for best active ingredients at in-cosmetics Asia 2015 Innovation Zone Awards.
Firmenich Reaffirms Dedication in France
Nov 11, 2015
Firmenich's France center achieves fully integrated certification.
ChromaDex Enters Shareholder Agreement
Nov 11, 2015
Proceeds will be used for additional working capital.
Versum Materials For Air Products Business
Nov 10, 2015
Air Products announced the plan back in September.
Symrise Awarded Best Poster At IFSCC
Nov 5, 2015
Symrise won the IFSCC poster award for the best poster presented at the recent conference.
Gatuline From Gattefossé Wins Bronze Award
Nov 4, 2015
Gattefosse's Gatuline Spot-Light won a bronze award at in-cosmetics Asia.
Croda Welcomes Zinc Oxide into Annex VI of EU Cosmetics Regulation
Nov 4, 2015
EU member states in the EU Commission Working Group on Cosmetics voted in favor of approving zinc oxide as a UV filter in cosmetics in Europe.
Croda Certifies Supply Chains to Handle Sustainable Palm Oil
Nov 4, 2015
Croda announced that the company has met its target to certify all relevant supply chains to handle sustainable palm oil.
Princeton Consumer Research Opens New Facility
Nov 3, 2015
Princeton Consumer Research announced the opening of a new consumer research facility in St. Petersburg, Florida.


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Features & Analysis...
6 Tips for Safer Business Travel
Employers should collaborate with employees who travel to ensure the travelers can stay as safe as possible.
Service Bureaus May Get Boost from Cybercriminals' Use of SWIFT Messages
Bangladesh central bank heist emphasizes importance of security measures.
New Lease Accounting Standard Poses Challenge for Corporates
Many companies will be starting from scratch to assemble data on equipment leases.
Ask (and answer) these questions before the next domino falls.
Switch to "True" Working Capital Metrics
Technology today enables companies to get a more realistic understanding of their performance in working capital management.
- View More
July 22 Calling All Innovators!
Now's the time to enter the 2017 Alexander Hamilton Awards; nomination period closes September 9th.
July 21 ECB May Add Stimulus Amid Brexit
Draghi signals Europe will respond as needed, using 'all instruments available within [the Governing Council's] mandate.'
July 20 Brexit Could Cut $40B from North American Company Profits
FiREapps sees FX volatility dragging down earnings
July 20 HSBC Bankers Charged in U.S. Currency Case
Executives are accused of front-running a $3.5B FX trade.
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Special Report
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When prime funds switch to a floating net asset value this fall, many investors are expected to find other places to stow their cash.
Practical Aspects of the Move to a Floating NAV
Real-World Impact of Derivatives Reforms
Original research project finds that derivatives end users face higher costs and heavier workloads, but they aren't moving away from derivatives for hedging financial risks.View the results
Finalists have been selected for the 20th annual Alexander Hamilton Awards. Stay tuned for a series of feature articles, and webcasts beginning March 30, 2016, that will announce this year's winners.
- Highlights from Treasury & Risk's 19th annual Alexander Hamilton Awards contest.
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But policy maker sees U.S. stuck in low-growth environment for two to three years.
HSBC Bankers Charged in U.S. Currency Case
Executives are accused of front-running a $3.5B FX trade.


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Int'l Lightning Class Association Boat Grant Program recipients named
by Laura Jeffers on 13 May 2014
. .
The International Lightning Class Association's Boat Grant program begins its eighth season by announcing the 2014 grant recipients.
Ben Spector (22) and his team of Jeff Aschieris (23) and Sam Stokes (24) are from Charleston, SC and will be sailing with the Charleston Fleet. Ben is a recent graduate from the College of Charleston. He sailed on the College of Charleston Sailing Team for four years and teamed up with both Jeff and Sam to win two College Sailing National Championships. Ben was named a 2012 ICSA College Sailing All-American. Their mentor will be veteran Lightning sailor Lenny Krawcheck.
Whitney Kent (21) and her crew of Ian Walter (20), Megan McMahon (19), and Katie Hall (20) will be based out of Milwaukee, WI. All four are students at the University of Wisconsin, where they are active members of the UW Sailing Team. Whitney, Ian, and Megan were part of the match racing team that placed fifth at the 2013 ICSA National Championship. Whitney and Megan both grew up sailing in Milwaukee on mostly Lasers and keelboats, including both inshore and offshore racing. Ian grew up in Madison, learned to sail at Hoofers, and races J24s on Lake Mendota. Katie began sailing in high school in Lake Forest, where she raced 420s in the high school and junior sailing circuits. Their mentors for the summer are Bill Faude and Todd Wake, and they are looking forward to a summer packed with Lightning sailing across the country!
According to Co-Chair William Brown, 'It is always difficult to choose between the tremendous applicant pool we receive each year. That said I couldn't think of two more qualified applicants than Ben and Whitney. We are pleased that we will be able to introduce these two teams to the Lightning Class.'
Co-Chair Matthew Schon added: 'As a class we are very fortunate to be able to run this program for eight consecutive seasons. The boat grant program would not be possible if not for the support and donation of time, equipment, and money from ILCA members and suppliers. The Lightning family allows this program to be successful and is one of the reasons we see such tremendous applicants each year.'
More information about the ILCA grant program can be found on the ILCA
, by contacting the ILCA office, or co-chairs Brown and Schon. Applications are accepted each year from October to December for the following year's program.
If you want to link to this article then please use this URL: www.sail-world.com/122083
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Shutter Speed with external Flash
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Lorven • New Member • Posts: 2
Shutter Speed with external Flash
Mar 25, 2013
I am a beginner and trying to shoot the pictures in manual mode with external flash tt560 with Nikon D5000
Could you please let me know what should be the shutter speed that I should use in night time when there is no other lighting available? Thanks in advance.
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Big 12's Bob Bowlsby reveals gross lack of understanding amid Baylor scandal
Monday at Big 12 media days in downtown Dallas, you could practically see the words pass through conference commissioner Bob Bowlsby's mind as he stood on stage in front of roughly 300 reporters crowded into the Omni Hotel: Please, God, someone ask me about conference expansion.
Sports Illustrated | 7/20/2016 |
Randolph Childress' son making his own name at Wake Forest
Brandon Childress is trying to make a name for himself at Wake Forest. That's quite a challenge for the son of Randolph Childress – one of the best players in program history and a current assistant coach at the school. Brandon Childress called it "a gift and a curse being my father's son," but is embracing the tough task that comes with living up to the family name.
Associated Press | 7/19/2016 |
Wolfpack's Jaylen Samuels aims to repeat do-everything all-ACC run
Ask Jaylen Samuels what position he plays for North Carolina State's offense, and he will struggle to give a definitive answer. That's because the returning all-Atlantic Coast Conference performer has proven he can do just about anything for the Wolfpack. And like the defenses he faces, even he is unsure exactly what he'll be asked to do each week.
Associated Press | 7/19/2016 |
Hokies RB Travon McMillian must build on early success
The Roanoke Times, in its offseason countdown, lists running back Travon McMillian as Virginia Tech's fourth most important player -- and for good reason. After McMillian took over the starting job last season, he was a force for the Hokies' often-inconsistent offense, finishing the season with 1042 yards and appearing to secure his spot as one of the top young runners in the country.
ESPN.com | 7/19/2016 |
Report: ACC Network will launch by August 2019
The ACC will launch its own cable channel, the ACC Network, by August 2019, reports ESPN's Brett McMurphy. The new channel will be launched in partnership with ESPN, which already runs the SEC Network and Longhorn Network. The ACC has also extended its grant of rights through 2036, according to McMurphy, which means if Notre Dame joins a conference for football before 2036, it has to be the ACC.
Sports Illustrated | 7/18/2016 |
The No. 1 overall seed in the NCAA Tournament just got a huge reward
Even though the NCAA Tournament is eight months away, we've got a hefty update on some upcoming changes. One twist coming next season: The No. 1 overall seed will be able to choose the location of its first two games of the tournament. So if that team is UNC, or whichever school gets put atop the 1-68 seed list, that program will get to pick where it plays its first and second-round games.
CBS Sports | 7/18/2016 |
Pac-12 partners with Twitter to live stream events
If Pac-12 fanatics want a new place to geek out on conference competition, there's a new place to get that fix. The Pac-12 announced Thursday a new live-streaming partnership with Twitter that includes at least 150 games during the 2016-17 academic year.
Sporting News | 7/18/2016 |
2016 SEC Media Days Takeaways: Highs and lows from Hoover
The circus has left town, so it's time to look back at our favorite acts, most memorable moments and biggest takeaways from SEC Media Days 2016, where you weren't cool unless you screamed at Paul Finebaum at least once.
SEC Country | 7/17/2016 |
Warriors legend, Hall of Famer Nate Thurmond dies
Nate Thurmond, the tenacious defensive center who played with Wilt Chamberlain and was an iconic figure in two cities, died Saturday after a short battle with leukemia. He was 74. The Golden State Warriors announced the death of one of the team's most respected players less than a month after they lost the NBA Finals to the Cleveland Cavaliers in seven games. Both franchises previously retired Thurmond's No. 42.
ESPN.com | 7/17/2016 |
Pat Summitt memorial was a celebration, not a pity party
Pat would have been OK with this gathering. It was no pity party. That's not to say the tears didn't flow Thursday night at the Pat Summitt Celebration of Life service. Summitt died on June 28 from early onset Alzheimer's disease. The long farewell to this singular human reached a crescendo 17 days later in a ceremony that ran an emotional gamut at Thompson-Boling Arena. The crowd ran the gamut, too.
The Tennessean | 7/17/2016 |
Eric Griffin's NBA dream should not end like this
It's the first day of NBA Summer League, and Eric Griffin shakes his head incredulously, staring intently at his flawless white Nikes for what feels like an entire run of a shot clock. He's just been asked why he's here, at lunch on a veranda overlooking a golf course near downtown, when he should be three miles up Interstate 4, on the court at Amway Center.
FOX Sports | 7/17/2016 |
Tom Brady accepts suspension, ends 'Deflategate'
Tom Brady is accepting his four-game Deflategate suspension. The dream is over. Brady announced the decision on his Facebook page. Small scale, that means the Patriots will play their first four games with Jimmy Garoppolo as their quarterback. Brady is eligible to return Week 5 against the Browns.
Sporting News | 7/16/2016 |
Topics as hot as the weather abound at upcoming ACC Football Kickoff
Who's on the hot seat: This is always a popular media day subject, even if there aren't as many candidates as usual because of the large turnover that took place after last season. Of those who can look forward to the inevitable "hot seat" questions, N.C. State's Dave Doeren and Georgia Tech's Paul Johnson figure to be the most likely candidates.
Wilmington Star News | 7/15/2016 |
With scholarship limit, college baseball careers come with a cost
Major-conference athletic departments, flush with cash from football TV deals, are spending on luxurious facilities, coaching salaries and new support staff. But little (if any) has trickled down to the dugouts. Tuition continues to rise, but the Division I scholarship limit of 11.7 doesn't budge. "We all see where college baseball has come and where we are now," Virginia coach Brian O'Connor said.
Omaha World-Herald | 7/15/2016 |
Remembering how incredible Tim Duncan was when he was at Wake Forest
For as incredible as Tim Duncan's career was in the NBA -- all 19 years and five NBA titles with San Antonio -- it speaks to his decades-spanning greatness that people still frequently recall and reflect on his four years at Wake Forest.
CBS Sports | 7/15/2016 |
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Ischemic Stroke Clinical Presentation
- Author: Edward C Jauch, MD, MS, FAHA, FACEP; Chief Editor: Helmi L Lutsep, MD more...
A focused medical history for patients with ischemic stroke aims to identify risk factors for atherosclerotic and cardiac disease, including the following (see Etiology):
Diabetes mellitus
Tobacco use
High cholesterol
History of coronary artery disease, coronary artery bypass, or atrial fibrillation
In younger patients, elicit a history of the following:
Recent trauma
Illicit drug use (especially cocaine)
Oral contraceptive use
Stroke should be considered in any patient presenting with an acute neurologic deficit (focal or global) or altered level of consciousness. No historical feature distinguishes ischemic from hemorrhagic stroke, although nausea, vomiting, headache, and a sudden change in the patient's level of consciousness are more common in hemorrhagic strokes.
Consider stroke in any patient presenting with acute neurologic deficit or any alteration in level of consciousness. Common signs and symptoms of stroke include the abrupt onset of any of the following:
Hemiparesis, monoparesis, or (rarely) quadriparesis
Hemisensory deficits
Monocular or binocular visual loss
Visual field deficits
Facial droop
Vertigo (rarely in isolation)
Sudden decrease in the level of consciousness
Although such symptoms can occur alone, they are more likely to occur in combination.
Establishing the time at which the patient was last without stroke symptoms, or last known to be normal, is especially critical when fibrinolytic therapy is an option. Unfortunately, the median time from symptom onset to emergency department (ED) presentation ranges from 4-24 hours in the United States.[1]
Multiple factors contribute to delays in seeking care for symptoms of stroke. Many strokes occur while patients are sleeping and are not discovered until the patient wakes (this phenomenon is also known as "wake-up" stroke). Stroke can leave some patients too incapacitated to call for help. Occasionally, a stroke goes unrecognized by patients or their caregivers.[4, 56]
If the patient awakens with symptoms, then the time of onset is defined as the time at which the patient was last seen to be without symptoms. Input from family members, coworkers, and bystanders may be required to help establish the exact time of onset, especially in right hemispheric strokes accompanied by neglect or left hemispheric strokes with aphasia.
Physical Examination
The goals of the physical examination are as follows:
Detect extracranial causes of stroke symptoms
Distinguish stroke from stroke mimics
Determine and document for future comparison the degree of deficit
Localize the lesion
Identify comorbidities
Identify conditions that may influence treatment decisions (eg, trauma, active bleeding, active infection)
The physical examination always includes a careful head and neck examination for signs of trauma, infection, and meningeal irritation. A careful search for the cardiovascular causes of stroke requires examination of the following:
Ocular fundi (retinopathy, emboli, hemorrhage)
Heart (irregular rhythm, murmur, gallop)
Peripheral vasculature (palpation of carotid, radial, and femoral pulses; auscultation for carotid bruit)
The physical examination must encompass all of the major organ systems, starting with airway, breathing, and circulation (ABCs) and the vital signs. Patients with a decreased level of consciousness should be assessed to ensure that they are able to protect their airway. Patients with stroke, especially hemorrhagic stroke, can suffer quick clinical deterioration; therefore, constant reassessment is critical.
Ischemic strokes, unless large or involving the brainstem, do not tend to cause immediate problems with airway patency, breathing, or circulation compromise. On the other hand, patients with intracerebral or subarachnoid hemorrhage frequently require intervention for airway protection and ventilation.
Vital signs, while nonspecific, can point to impending clinical deterioration and may assist in narrowing the differential diagnosis. Many patients with stroke are hypertensive at baseline, and their blood pressure may become more elevated after stroke. While hypertension at presentation is common, blood pressure decreases spontaneously over time in most patients.
Head and neck, cardiac, and extremities examination
A careful examination of the head and neck is essential. Contusions, lacerations, and deformities may suggest trauma as the etiology for the patient's symptoms. Auscultation of the neck may elicit a bruit, suggesting carotid disease as the cause of the stroke.
Cardiac arrhythmias, such as atrial fibrillation, are found commonly in patients with stroke. Similarly, strokes may occur concurrently with other acute cardiac conditions, such as acute myocardial infarction and acute heart failure; thus, auscultation for murmurs and gallops is recommended.
Carotid or vertebrobasilar dissections and, less commonly, thoracic aortic dissections may cause ischemic stroke. Unequal pulses or blood pressures in the extremities may reflect the presence of aortic dissections.
Neurologic examination
With the availability of fibrinolytic therapy for acute ischemic stroke in selected patients, the physician must be able to perform a brief but accurate neurologic examination on patients with suspected stroke syndromes. The goals of the neurologic examination include the following:
Confirming the presence of a stroke syndrome (to be defined further with cranial CT scanning)
Distinguishing stroke from stroke mimics
Establishing a neurologic baseline should the patient's condition improve or deteriorate
Establishing stroke severity to assist in prognosis and therapeutic selection
Essential components of the neurologic examination include the following evaluations:
Cranial nerves
Motor function
Sensory function
Cerebellar function
Deep tendon reflexes
Language (expressive and receptive capabilities)
Mental status and level of consciousness
The skull and spine also should be examined, and signs of meningismus should be sought.
National Institutes of Health Stroke Scale
A useful tool in quantifying neurologic impairment is the National Institutes of Health Stroke Scale (NIHSS) (see Table 2, below). The NIHSS enables the healthcare provider to rapidly determine the severity and possible location of the stroke. NIHSS scores are strongly associated with outcome and can help to identify those patients who are likely to benefit from fibrinolytic therapy and those who are at higher risk of developing hemorrhagic complications of fibrinolytic use.
The NIHSS is easily performed; it focuses on the following 6 major areas of the neurologic examination:
level of consciousness
Visual function
Motor function
Sensation and neglect
Cerebellar function
The NIHSS is a 42-point scale. Patients with minor strokes usually have a score of less than 5. An NIHSS score of greater than 10 correlates with an 80% likelihood of proximal vessel occlusions (as identified on CT or standard angiograms). However, discretion must be used in assessing the magnitude of the clinical deficit and resulting disability; for instance, if a patient's only deficit is mutism, the NIHSS score will be 3. Additionally, the scale does not measure some deficits associated with posterior circulation strokes (ie, vertigo, ataxia).[57]
Table 2. National Institutes of Health Stroke Scale (Open Table in a new window)
|level of consciousness (LOC)
|LOC questions (month, age)
|Answers both correctly
Answers 1 correctly
Incorrect on both
|LOC commands (open and close eyes,
grip and release nonparetic hand)
|Obeys both correctly
Obeys 1 correctly
Incorrect on both
|Best gaze (follow finger)
Partial gaze palsy
Forced deviation
|Best visual (visual fields)
|No visual loss
Partial hemianopia
Complete hemianopia
Bilateral hemianopia
|Facial palsy (show teeth, raise brows,
squeeze eyes shut)
|Motor arm left* (raise 90°, hold 10 seconds)
|No drift
Cannot resist gravity
No effort against gravity
No movement
|Motor arm right* (raise 90°, hold 10 seconds)
|No drift
Cannot resist gravity
No effort against gravity
No movement
|Motor leg left* (raise 30°, hold 5 seconds)
|No drift
Cannot resist gravity
No effort against gravity
No movement
|Motor leg right* (raise 30°, hold 5 seconds)
|No drift
Cannot resist gravity
No effort against gravity
No movement
|Limb ataxia (finger-nose, heel-shin)
Present in 1 limb
Present in 2 limbs
|Sensory (pinprick to face, arm, leg)
Partial loss
Severe loss
|Extinction/neglect (double simultaneous testing)
|No neglect
Partial neglect
Complete neglect
|Dysarthria (speech clarity to "mama,
baseball, huckleberry, tip-top, fifty-fifty")
|Normal articulation
Mild to moderate dysarthria
Near to unintelligible or worse
|Best language** (name items,
describe pictures)
|No aphasia
Mild to moderate aphasia
Severe aphasia
|* For limbs with amputation, joint fusion, etc, score 9 and explain.
** For intubation or other physical barriers to speech, score 9 and explain. Do not add 9 to the total score. NIH Stroke Scale (PDF)
Middle cerebral artery stroke
Middle cerebral artery (MCA) occlusions commonly produce the following:
Contralateral hemiparesis
Contralateral hypesthesia
Ipsilateral hemianopsia
Gaze preference toward the side of the lesion
Receptive or expressive aphasia, if the lesion occurs in the dominant hemisphere
Neglect, inattention, and extinction of double simultaneous stimulation, with some nondominant hemisphere lesions
The MCA supplies the upper extremity motor strip. Consequently, weakness of the arm and face is usually worse than that of the lower limb.
Anterior cerebral artery stroke
Anterior cerebral artery (ACA) occlusions primarily affect frontal lobe function. Findings in ACA stroke may include the following:
Disinhibition and speech perseveration
Primitive reflexes (eg, grasping, sucking reflexes)
Altered mental status
Impaired judgment
Contralateral weakness (greater in legs than arms)
Contralateral cortical sensory deficits
Gait apraxia
Urinary incontinence
Posterior cerebral artery stroke
Posterior cerebral artery (PCA) occlusions affect vision and thought. Manifestations include the following:
Contralateral homonymous hemianopsia
Cortical blindness
Visual agnosia
Altered mental status
Impaired memory
Vertebrobasilar artery occlusions are particularly difficult to localize, because they may cause a wide variety of cranial nerve, cerebellar, and brainstem deficits. These include the following:
Visual field deficits
Facial hypesthesia
A hallmark of posterior circulation stroke is the presence of crossed findings: ipsilateral cranial nerve deficits and contralateral motor deficits. This contrasts with anterior stroke, which produces only unilateral findings.
Lacunar stroke
Lacunar strokes result from occlusion of the small, perforating arteries of the deep subcortical areas of the brain. The infarcts are generally from 2-20 mm in diameter. The most common lacunar syndromes include pure motor, pure sensory, and ataxic hemiparetic strokes. By virtue of their small size and well-defined subcortical location, lacunar infarcts do not lead to impairments in cognition, memory, speech, or level of consciousness.
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|Structures Supplied
|Anterior Circulation (Carotid)
|Anterior Cerebral Artery
|Cortical branches: medial frontal and parietal lobe
Medial lenticulostriate branches: caudate head, globus pallidus, anterior limb of internal capsule
|Middle Cerebral Artery
|Cortical branches: lateral frontal and parietal lobes lateral and anterior temporal lobe
Lateral lenticulostriate branches: globus pallidus and putamen, internal capsule
|Anterior Choroidal Artery
|Optic tracts, medial temporal lobe, ventrolateral thalamus, corona radiata, posterior limb of the internal capsule
|Posterior Circulation (Vertebrobasilar)
|Posterior Cerebral Artery
|Cortical branches: occipital lobes, medial and posterior temporal and parietal lobes
Perforating branches: brainstem, posterior thalamus and midbrain
|Posterior Inferior Cerebellar Artery
|Inferior vermis; posterior and inferior cerebellar hemispheres
|Anterior Inferior Cerebellar Artery
|Anterolateral cerebellum
|Superior Cerebellar Artery
|Superior vermis; superior cerebellum
|level of consciousness (LOC)
|LOC questions (month, age)
|Answers both correctly
Answers 1 correctly
Incorrect on both
|LOC commands (open and close eyes,
grip and release nonparetic hand)
|Obeys both correctly
Obeys 1 correctly
Incorrect on both
|Best gaze (follow finger)
Partial gaze palsy
Forced deviation
|Best visual (visual fields)
|No visual loss
Partial hemianopia
Complete hemianopia
Bilateral hemianopia
|Facial palsy (show teeth, raise brows,
squeeze eyes shut)
|Motor arm left* (raise 90°, hold 10 seconds)
|No drift
Cannot resist gravity
No effort against gravity
No movement
|Motor arm right* (raise 90°, hold 10 seconds)
|No drift
Cannot resist gravity
No effort against gravity
No movement
|Motor leg left* (raise 30°, hold 5 seconds)
|No drift
Cannot resist gravity
No effort against gravity
No movement
|Motor leg right* (raise 30°, hold 5 seconds)
|No drift
Cannot resist gravity
No effort against gravity
No movement
|Limb ataxia (finger-nose, heel-shin)
Present in 1 limb
Present in 2 limbs
|Sensory (pinprick to face, arm, leg)
Partial loss
Severe loss
|Extinction/neglect (double simultaneous testing)
|No neglect
Partial neglect
Complete neglect
|Dysarthria (speech clarity to "mama,
baseball, huckleberry, tip-top, fifty-fifty")
|Normal articulation
Mild to moderate dysarthria
Near to unintelligible or worse
|Best language** (name items,
describe pictures)
|No aphasia
Mild to moderate aphasia
Severe aphasia
|* For limbs with amputation, joint fusion, etc, score 9 and explain.
** For intubation or other physical barriers to speech, score 9 and explain. Do not add 9 to the total score. NIH Stroke Scale (PDF)


text:
Live on Earth [w/ Limited Edition Bonus DVD] Limited Edition, Live
|New from
|Used from
MP3 Music, July 16, 2012
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Audio CD, May 15, 2012
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Disc: 2
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Customer Reviews
Top Customer Reviews
The show in Rijssen, Holland, "lifts off", and you're on a nonstop thrillride all the way until the end. Whether the music is loud and the lights are flashing, or it's slowed down and the keyboards are haunting, there's never a dull moment. An amazing array of material is performed, not just Star One. There are about half a dozen Star One songs, and then there are tracks from every Ayreon album. Fans of Into the Electric Castle will really enjoy the spot on (or really, improved) playing of Isis and Osiris, The Amazing Flight in Space (in which Arjen and Joost have a soloing battle/shoving match, truly hilarious), Valley of the Queens (this is a real gem, an accoustic ballad with Floor doing a superb job), The Castle Hall, and in the encore, Two Gates. The rest of the songs are quite flawless as well. Songs like The Dream Sequencer are amazingly improved with the energy of a live setting.
The DVD also includes some bonus features that didn't have to be there, but certainly aren't bad. A humurous set of behind the scenes footage, an additional encore/closing song Space Truckin, which didn't fit on the audio CDs, two songs from the show in Tilburg, and a nice photo gallery. Not shabby.Read more ›
You are really lucky to hear a good live album, especially with the highly overproduced CD's of today. No overdubs and its unlikely that the singer can sing as high or clear as on the CD. But not so here. Arjen surrounds himself with good singers and musicians, and the sound is huge. True, some of the lyrics are cheesy, and Robert doesn't do so well in spots, but the live versions are often better than the studio versions, with a higher energy.
Standout tracks are "Songs on the Ocean", "Dawn of a Million Souls" (my personal favorite), "Into the Black Hole" (Damian is great here), "Valley of the Queens", and "Isis and Osiris". All are much better than the studio tracks and some have different arrangements which make them better live. Russell Allen and Damian are vocally great. Floor and Irene Jansenn mesh together perfectly. Irene compliments Floor's voice very well. Peter Vink's bass and Ed Warby's drums tones are huge. Arjen's guitar tone is also very good.
The DVD is good. According to Arjen's notes he never intended on releasing the DVD. It was recorded with one or two cameras and sound off the board. Then two fans submitted their extra video shots from in the crowd and they mixed them together into the video. It is surprisingly smooth, although a couple of times seems out of sync (hence the previous reviewer's comment on Robert's lip syncing). The stage is really small for so many singers/players. But overall my friend and I liked the DVD.
Arjen's "Human Equation" CD is in my CD player at home and I listen to it all the time. Star One live is my main car CD rotation.
Putting aside petty cash reserved for things like rent, food, utilities, etc, I ordered this DVD/CD set, and days later, it arrived. Before inserting the DVD, I checked out the awesome packaging and the booklet, both of which excited me.
Musically, I was blown away. A mix of Star One and Ayreon material is presented here by a band that isn't used to touring together, but it seems like this is a jam band in their prime. The chemistry between the many, many members is electric. Nothing is stale and tired, this is a band who is as excited to be playing as the fans are to be enjoying. The music is tight, complex, and easy to jam to.
The band itself is insane. I mean this in a good way. A TON of members... 5 vocalists, a drummer, guitarist/synth/vocalist who brings back flashes of Kerry Livgren, bass player, flamboyant keyboardist, and a special flute player for three tracks, as well as a guest vocalist for one of the extras. The vocalists really get into their parts, everyone seems happy to be there.
There are dozens of "moments" here that left me with a big stupid grin on my face. The one that stands out the most at the moment (this changes daily) is when Arjen (guitar) and Joost (keys) have a "war" during Amazing Flight In Space, trying to outdo each other, getting into a shoving match while playing the instruments. It's hilarious, it's amazing, and it's just beautiful.
I really can't express enough how awesome this is.Read more ›
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Most Recent Customer Reviews
I recieved this today, bought it because all reviews stated the it was a two disc and dvd set. I have the two cd's but no dvd, the booklet inside even says enjoy this 2 cd and dvd... Read morePublished on April 10, 2013 by The Giant Viking
There is only one thing wrong with this show, it appears to have been shot on only 2 cameras. One long shot, one close shot. Read morePublished on November 7, 2012 by Ardra
That is assuming this is the same DVD that is sold seperately (Lucassen claims it is). I bought it rather than this because 1) it was cheaper and 2) I can always "Peel" the audio... Read morePublished on July 24, 2009 by JP
Progressive Rock is my favorite genre because it offers great musicianship, texture, complexity, various moods, and provides a sense of hope that music still has a fighting chance. Read morePublished on June 17, 2009 by Evan Jacobson
You will never hear a more perfect Rock voice than Allen. It really shows because he is along side some other very talented singers. Read morePublished on January 24, 2004 by John
This is an excellent CD/DVD package. Musically, this is heavy, progressive and driving, but melodic at the same time. Read morePublished on January 20, 2004
This is a fantastic collaboration of vocalists and Ayreon live. You get the 2 CDs and the show also on DVD. What a bargain! Read morePublished on June 14, 2003
First, it needs to be pointed out that Star One is NOT Ayreon. That's not a knock on Ayreon - I like most of Arjen's work - but Star One is a METAL project, and many fans of... Read morePublished on May 29, 2003 by David M. Sobecki


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ECB Needs More Than a Rate Cut: Morris
May 2 (Bloomberg) -- Daniel Morris, global market strategist at JPMorgan Asset Management, previews today's ECB meeting with expectations for a 25 basis point rate cut and examines earnings in the U.S. and Europe. He speaks on Bloomberg Television's "Countdown."
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22:21 - Edward Morse, global head of commodity research at Citigroup, and Richard Clarida, global strategic advisor at Pimco, examine global oil demand, the net economic positive of lower oil prices, and the link between price and production. They speak on "Bloomberg Surveillance." (Source: Bloomberg)