text:
Ophthalmologic Manifestations of Sjogren Syndrome
- Author: Alexandra Herzlich, MD; Chief Editor: Hampton Roy, Sr, MD more...
Sjögren syndrome is a chronic inflammatory disorder characterized by exocrine gland dysfunction and a variable systemic course. Lymphocytic infiltration of the lacrimal and salivary glands results in the classic sicca complex characterized by dry eyes (keratitis sicca or keratoconjunctivitis sicca [KCS]) and dry mouth (xerostomia).
Exocrine dysfunction at other sites may result in dryness symptoms involving the skin, nose, throat, trachea, or vagina. Systemic complications may develop, resulting in disease or dysfunction of the heart,[1] lungs,[2] liver, renal system,[3] nervous system,[4] muscles, joints, skin, vasculature,[5] and blood. An increased incidence of lymphoma is well documented, and a subset of patients with certain clinical variables demonstrates increased mortality (purpura, mixed monoclonal cryoglobulinemia, and low C4 levels).
This article will focus on the ophthalmologic manifestations of Sjögren syndrome. Severe dry eyes can cause corneal scarring, ulceration, infection, and even perforation; thus, although the prognosis is good for most patients with Sjögren syndrome and ophthalmologic features, individuals with complications have a much guarded prognosis.
The differential diagnosis includes conditions such as adult blepharitis, dry eye syndrome, and juvenile idiopathic arthritis uveitis, as well keratopathies (eg, superficial punctate, filamentary, neurotrophic, exposure).
Historical information
The first clinical description of Sjögren syndrome was by Mikulicz, who described a 42-year-old with bilateral parotid and lacrimal gland enlargement in 1892. In 1933, the Danish Ophthalmologist Sjögren compiled a clinical and histopathologic description of a series of patients with the "sicca complex" of dry eyes and mouth.[6] Sjögren syndrome may occur alone (primary) or in association with another autoimmune disease (secondary).
For patient education information, see Sjögren's Syndrome and Corneal Ulcer.
See also Sjögren Syndrome and Pediatric Sjögren Syndrome.
Developments in the fields of immunology and molecular biology have contributed significantly to the understanding of the pathogenesis of Sjögren syndrome. One report in 1985 showed human leukocyte antigen DR (HLA-DR) expression in epithelial cells of salivary gland biopsy specimens taken from patients with Sjögren syndrome.[7] The predominant lymphocytic infiltrate consisted of helper T cells. Other studies found that lymphoproliferation in the lacrimal glands consisted predominantly of B and CD4 lymphocytes along with a small percentage of CD8 lymphocytes. Studies using polymerase chain reaction (PCR) reported detection of Epstein Barr virus (EBV) genomic sequences in peripheral blood mononuclear cells, lacrimal glands, and tears of patients with primary Sjögren syndrome.[8, 9]
EBV genomes can be detected in 35% of normal lacrimal glands. EBV genotype analysis by PCR revealed that only type I EBV genomes could be detected in 35% of normal lacrimal glands. EBV genotype analysis by PCR revealed that only type II EBV nuclear antigens (EBNA-2-deleted) gene sequences were amplified from normal lacrimal glands. In contrast, type I EBV genomes (but not EBNA-2-deleted EBV sequences) were amplified from lacrimal gland biopsy specimens obtained from patients with Sjögren syndrome. All of this information suggests that persistent EBV infection plays a role in the lacrimal gland pathology of Sjögren syndrome. Human T-cell lymphotrophic virus type-1 (HTLV-1) has also been implicated.[10] The genomic search for critical genes is difficult as a result of the multigenic pattern of inheritance and the strong role of undefined environmental factors.
Patients with dry eye associated with Sjögren syndrome have been found to have elevated levels of interleukin 6 (IL-6) and tumor necrosis factor (TNF)–alpha in their tears.[11] The IL-6 level is associated with disease severity and was found to correlate with tear film and ocular surface parameters (eg, tear film break-up time, Schirmer test, tear clearance, goblet cell density, keratoepithelioplasty score).[11] Recently, Zhu et al found that co-stimulatory molecules Ox40 and Ox40L on peripheral blood mononuclear cells is higher in Sjögren patients than in normal controls. The levels correlated with clinical outcomes and therapeutic responses.[12]
Even in patients with Sjögren syndrome with marked sicca, biopsy specimens have revealed that 50% of glandular cells are still present. These results emphasize the importance of immune factors, such as cytokines, matrix metalloproteases, and autoantibodies, in decreasing neurosecretory circuits and inducing glandular dysfunction. An antibody against muscarinic M3 receptor has been implicated leading to the development of orally administered agonists of the M3 receptor.
The keratoconjunctivitis in Sjögren syndrome is classically described as an aqueous tear deficiency. However, this assumption has been challenged in more recent years; some studies suggest that pathologic changes induce global tear dysfunction, including alterations in meibomian gland function.[13] An analysis of patients with Sjögren syndrome with aqueous tear deficiency (SS ATD) compared with non–SS ATD patients demonstrated increased evaporation in the SS ATD group relative to the non–SS ATD group.[13] The SS ATD group also demonstrated decreased meibomian gland expressibility with a deficient lipid layer.[13]
Whether due to an altered ocular environment, chronic topical medication use, or both, patients with Sjögren syndrome also demonstrate a disruption of the natural flora with a marked increase in antibiotic-resistant organisms in comparison to controls.[14]
Clinical Evaluation
Ocular signs and symptoms of Sjögren syndrome are similar to those seen in dry eye states. Subjective complaints of ocular irritation may vary and include the following:
Foreign body sensation
Lid irritation and swelling
Ocular fatigue
Mucoid discharge
Dry eyes vs Sjögren syndrome
Two important clues that the patient may have dry eyes include diurnal fluctuation and exacerbation of symptoms during specific activities or environmental conditions. It is common for symptoms to become worse at night or upon awakening, because tear production decreases during sleep. Air conditioning, smoky or windy conditions, and airplane travel may worsen the symptoms by creating excessive drying of the deficient tear film. Activities, such as reading, working at the computer, or watching television, may make the patient more symptomatic, as the blink rate decreases with prolonged visual effort.
Sjögren syndrome triad
Sjögren syndrome typically presents with a triad of dry eyes, dry mouth, and an autoimmune disease. At least 2 of the 3 clinical components need to be present to qualify for diagnosis. For a definitive diagnosis of Sjögren syndrome, all criteria listed in the Biopsy and Histologic Features section should be met; however, 3 of the 4 criteria are sufficient for a presumptive diagnosis.
Three objective findings are useful in determining the ocular component of Sjögren syndrome, as follows:
Absence of nasal-lacrimal reflex tearing
Degree of ocular surface alteration by rose bengal or fluorescein staining
Presence of autoantibodies in serum
Accelerated tear break-up time may be noted. Note that nasal stimulation may dramatically increase tearing in patients who do not have Sjögren syndrome.
In the presence of a significantly compromised ocular surface, there is some reluctance to use topical anesthetic and applanation tonometry. Although the intraocular pressure recording may not be necessary at each particular visit, it should clearly be performed and its results indicated on the chart at periodic intervals. Additionally with the anterior segment ocular surface disorder, routine follow-up care of the posterior segment also may be compromised. Care should be taken to perform either dilated fundus examinations or, at the very least, fundus examinations without dilatation at intervals that are appropriate for the patient's age and general status.
Diagnostic Tests
Laboratory tests to evaluate ophthalmologic manifestations of Sjögren syndrome include tear osmolarity, fluorescein clearance test, and tear function index. The following clinical tests may be useful to establish an aqueous tear deficiency:
Reduced tear break-up time
Schirmer test
Rose bengal staining
Lissamine green B
Phenol red thread test
All of these tests have variable specificity and sensitivity; however, controversy surrounds the validity of many of these objective tests. One evaluation of the Schirmer test demonstrated a sensitivity of only 42% and a sensitivity of 76% for Sjögren syndrome.[15]
Serologic examination can include antinuclear antibody (ANA), rheumatoid factor (RF), or Sjögren syndrome specific antibodies (ie, anti-Ro [SS-A], anti-La [SS-B]). However, a significant number of patients with Sjögren syndrome will have typical sicca symptoms and pathologic findings but normal serology. Negative serology results does not rule out Sjögren syndrome and should be followed by biopsy when clinical suspicion is high.[16]
Other specific systemic markers are often ordered by the rheumatologist during evaluation.
Biopsy and Histologic Features
A significant proportion of patients with sicca symptoms due to Sjögren syndrome will have negative serology; therefore, biopsy should be considered in seronegative patients when clinical suspicion is high.[16]
For a definitive diagnosis of Sjögren syndrome, all the following criteria should be met; however, 3 of the 4 criteria are sufficient for a presumptive diagnosis:
An abnormally low Schirmer test with clinical evidence of keratitis sicca (keratoconjunctivitis sicca [KCS]) defined by the presence of rose bengal or fluorescein staining
Objective evidence of decreased salivary gland flow
Evidence of lymphocytic infiltration of the labial salivary glands, proven by a biopsy specimen containing at least 4 glandular lobules with an average of at least 2 foci of 50 or more lymphocytes/4 mm 2 of tissue
Evidence of a systemic autoimmune process as manifested by the presence of serum autoantibodies, including antinuclear antibody (ANA), rheumatoid factor (RF), or Sjögren syndrome specific antibodies (ie, anti-Ro [SS-A], anti-La [SS-B])
Biopsy of accessory salivary glands is preferred over biopsy of lacrimal glands because of their easy accessibility and less potential for complications. Under local infiltration with 2% lidocaine with epinephrine, 5 or 6 lobules of accessory salivary glands are removed and fixed in formalin. Impression cytology can also be used for diagnosis.
The Sjögren's International Collaborative Clinical Alliance assembled a large cohort of patients to aid in the establishment of standardized classification and diagnostic criteria for Sjögren syndrome. In an early report, a subgroup of patients with rapidly clinical progression was identified based on detectable changes in serial labial salivary gland biopsies.[17]
Histologic findings
Impression cytology of buccal mucosa may be helpful in establishing a diagnosis. In one study, this technique showed a 97% agreement with labial salivary gland biopsy.[18] Conjunctival impression cytology in early onset of Sjögren syndrome may show an increased number of goblet cells. In severe and long-standing cases, the conjunctiva shows loss of goblet cells and squamous metaplasia. Lymphocytic infiltration of the accessory lacrimal glands may also be identified on biopsy. In addition, histopathology of conjunctival specimens may show evidence of squamous metaplasia and keratinization of the conjunctival epithelium.
Normal conjunctival epithelial cells contribute to tear film stability through secretion of tear mucins, promotion of tear adherence to the glycocalyx, and provision of increased surface area for tear adherence via the microvilli. A transmission electron microscopy study by Koufakis et al evaluating conjunctival surface changes in patients with Sjögren syndrome demonstrated significant alterations of the apical conjunctival epithelium.[19] The study found a decreased number of microvilli per epithelial length, decreased microvillus height and height-width ratio, and a decreased number of secretory vesicles per epithelial cell in patients with Sjögren syndrome as compared with controls.[19] Furthermore, the ocular surface glycocalyx (OSG) in patients with Sjögren syndrome was either not detectable (in most cases) or severely altered in configuration compared with the OSG of healthy controls.
An in vivo confocal study by Villani et al demonstrated morphologic alterations in corneal thickness, cells, and nerves in patients with dry eye associated with Sjögren syndrome.[20] A decrease in the central corneal thickness was observed and was hypothesized to be due to inflammatory processes. In addition, a reduced number of subbasal plexus fibers was noted and may explain the phenomenon of decreased corneal sensitivity observed in patients with Sjögren syndrome.[20]
Therapeutic Considerations
After diagnosing Sjögren syndrome, treatment is aimed at maintaining the integrity of the tear film through preservation, augmentation, and/or replacement of the deficient tear secretion.
Oral omega-6 essential fatty acids have been demonstrated to improve signs of ocular surface dryness and associated symptoms of ocular discomfort in Sjögren syndrome.[21]
Fluid-ventilated, gas permeable scleral lenses have been successful in treating severe ocular surface diseases including Sjögren syndrome.[22]
For many years, systemic corticosteroids have been used in a variety of inflammatory conditions. Due to limited efficacy and high incidence of complications, they are not widely used in Sjögren syndrome. Topical corticosteroids are widely available in a variety of dosages, often combined with antibiotics and preservatives, and may be useful for short-term treatment of ocular surface inflammatory conditions. They are usually available in 5, 10, or 15 mL dispensers or in 1/8 ounce ointment form.
Note that patients with Sjögren syndrome who have well-controlled keratoconjunctivitis can develop exacerbations refractory to treatment following laser-assisted in situ keratomileusis (LASIK) surgery.[23] In addition, topical nonsteroidal anti-inflammatory drugs (NSAIDs) should be used with caution in patients with Sjögren syndrome due to demonstrated reduction of corneal sensitivity in normal and dry eye patients and risk of corneal melting.[8]
In any individuals with Sjögren syndrome and ophthalmologic manifestations who are treated with immunosuppression, it is extremely important that the ophthalmologist be aware of the patient's status regarding follow-up laboratory studies. It is also important for these patients to have contact with their internist and/or immunologist. This should be noted clearly on the medical record at each patient visit.
Other considerations
One study found that significant subjective improvement occurred with anti-inflammatory treatment. However, this occurred despite no evidence for increased tear secretion, suggesting their effects may be independent of improved tear film dynamics.[24]
It was previously hypothesized that systemic use of corticosteroids or androgen hormones may suppress the immune-mediated component of lacrimal gland dysfunction present in Sjögren syndrome and improve lacrimal gland secretory function. However, a 6-month trial with oral prednisone, in which patients received 30 mg on alternate days, demonstrated no improvement in functional or histologic parameters in primary Sjögren syndrome. It was therefore concluded that the risks of long-term corticosteroid use outweigh the possible benefits.
The Wilmer Eye Institute at the Johns Hopkins University School of Medicine looked at interventional studies of treatments for Sjögren syndrome–associated dry eye from English-language articles published from 1975-2010. Their findings showed a lack of rigorous clinical trials to support therapy recommendations, with the efficacy of oral secretagogues greater in the treatment of oral dryness than ocular dryness. Although commonly prescribed to patients with Sjögren syndrome to lessen fatigue and arthralgias, oral hydroxychloroquine lacks strong evidence in its effectiveness for dry eye.[25]
Tretinoin (all trans -retinoic acid) was found to be effective in increasing comfort and reducing rose bengal staining in squamous metaplasia in one study.[26] In that nonrandomized trial, tretinoin ointment was used for treating various dry eye conditions, including keratitis sicca associated with Sjögren syndrome. Numerous subsequent studies have failed to confirm any positive benefit of this medication when used independently or in conjunction with surface lubricants.
Although many animal models have been studied, no clinical gene transfer studies have been performed on patients with Sjögren syndrome. Recombinant serotype 2 adeno-associated virus (rAAV2) vectors have shown promise as vectors for gene therapy in mouse models of Sjögren syndrome.[27] Future therapeutic modalities may include local delivery of an antiapoptotic or immunomodulatory transgene to reduce lacrimal gland inflammation.
Tear Secretion Preservation
Preservation of existing tear film can be achieved through punctal occlusion to decrease tear drainage. Additionally, a small lateral tarsorrhaphy can decrease the ocular surface area and provide significant relief. Humidification of the environment decreases evaporative loss and can be achieved by wearing swimmer's goggles or taping a plastic shield or wrap over the eyelids.
Hydrophilic bandage lenses have been used for decades in the treatment of dry eye and still have a role; however, if nonpreserved medications and/or hydrophilic bandage lenses are used, one must always be aware of the significant potential for secondary infection. These risks should be explained to the patient prior to initiating these forms of therapy. Prophylactic antibiotic drops must be used concurrently (standard of care).
In some cases, short-term results in the treatment of dry eye have been achieved with amniotic membranes, particularly in the presence of active corneal ulceration.
Tear Production/Secretion Augmentation
Augmentation of tear production/secretion has been attempted with medications such as bromhexine and 3-isobutyl 1-methylxanthine (IBMX). These have been tried outside of the United States, although neither rose bengal staining nor ocular discomfort improved with the use of bromhexine. The mode of action is to increase lacrimal gland secretion directly.
Agents to stimulate muscarinic receptors (pilocarpine and cevimeline) have been approved by the US Food and Drug Administration (FDA) for oral use. Oral pilocarpine has been demonstrated to increase the number of goblet cells and to improve the overall health of the conjunctival epithelium in Sjögren syndrome as evidenced by impression cytology.[28] This may account for subjective reports of reduced ocular discomfort in Sjögren syndrome after 1-2 months of oral pilocarpine treatment.
Systemic immunosuppressive agents may be necessary to improve tear production and to resolve severe keratoconjunctivitis in recalcitrant primary or secondary Sjögren syndrome.[29]
For the systemic component as well as for the treatment of local immune effects, modification of the immune response with methotrexate, antimalarials, cyclophosphamide, leflunomide, or tumor necrosis factor (TNF) antibody has been advocated. A pilot study and 1-year follow-up open trial with infliximab, a monoclonal antibody to TNF-alpha, demonstrated improvement in all tested objective and subjective measures of Sjögren syndrome disease activity. However, a follow-up randomized, double-blind, placebo-controlled trial with infliximab and etanercept, a human TNF-alpha-p75 receptor, demonstrated no benefit. Further studies of TNF-alpha antibodies are therefore needed to determine therapeutic effect.
Cyclosporin A
Cyclosporin A, a powerful suppressor of T-cell function, has been evaluated for treatment of Sjögren syndrome. Although this agent has been used orally to suppress T-cell function in patients who have had organ transplants, in Sjögren syndrome, its use is experimental and reports have not been encouraging. Cyclosporin A 1% or 2% in liquid or ointment form has been used topically following the initial report that its use increased lacrimal gland function in dogs.
In one study, although oral cyclosporin A (5 mg/kg/d) led to subjective improvement of dry mouth symptoms compared with placebo in most patients with primary Sjögren syndrome, only 20% of patients noted improvement in ocular irritation. No difference in aqueous tear production evaluated by Schirmer testing was reported between the 2 groups.
A pilot trial of 1% cyclosporin A ophthalmic ointment showed marked subjective improvement of symptoms when compared with placebo. Patients treated with topical cyclosporin A had less ocular surface rose bengal staining than control subjects; however, there was no difference in Schirmer test values or tear break-up times between the 2 groups.
Topical 2% cyclosporin A solution has been reported to successfully treat paracentral corneal ulcers in patients with rheumatoid arthritis and secondary Sjögren syndrome. Cyclosporin A functions as a secretagogue for the lacrimal gland and also inhibits T-cell activation, thereby limiting lymphocyte-induced apoptosis of acinar cells. Apoptosis-related markers were found to decrease in conjunctival epithelium after 6 months of treatment with topical cyclosporin A. Topical cyclosporin A is approved by the US Food and Drug Administration (FDA) as a treatment of dry eye.
Meibomian therapy with a novel device
A publication by Spiteri et al demonstrated significant improvement in ocular comfort in patients with dry eye symptoms with and without Sjögren syndrome after using a novel device designed to promote meibomian sebum release into the tear film in response to thermal energy.[30]
Tear Replacement
Symptomatic relief through lubrication of the ocular surface can be achieved through artificial tears and lubricating ointments. A large variety of preparations is available as nonprescription items, but none is as efficacious as the patient's own tears. Individual formulations have proprietary pH, retention time, osmolarity, and viscosity characteristics.
Topical autologous serum eye drops have demonstrated therapeutic benefit, but preparation is labor-intensive and expensive. Lubricating preparations provide only temporary symptomatic relief.
In general, these therapies are available compounded with preservatives or in a nonpreserved sterile state. To avoid toxicity from preservatives (eg, benzalkonium chloride) or for individuals who are sensitive, preservative-free, small-dose units are recommended. Most practitioners believe that the use of liquid tear substitutes with preservatives 4-6 times a day is reasonable, but, at higher usage levels, nonpreservative forms may provide less ocular surface toxicity over the long term.
In addition, lubricating ointments play an important role in moistening the ocular surface during sleep when tear production is decreased. Using lubricating ointment during the day can significantly blur vision.
Lacriserts in the form of small soluble rods can be placed in the inferior fornix and are expected to dissolve and biodegrade over a 12-hour period. This sustained-release lubricant preparation is infrequently used as therapy because of problems associated with insertion, comfort, blurred vision, and the tendency for displacement.
Recently, local radiotherapy to the lacrimal gland has been attempted with success, with full restoration of viscus and regression of infiltration.[31]
Wearing spectacles or goggles is beneficial in preventing ocular surface drying secondary to exposure. In addition, avoidance of desiccating environments, such as proximity of open fireplaces or smoke-filled rooms, should be considered. The placement of air conditioning or heating ducts at home and at the workplace should also be considered.
Systemic medications can adversely affect the ocular surface. Reduction or elimination of such medications could decrease the drying of the ocular surface.
Patients should know to seek ophthalmic care if their eyes become red or painful, or if they develop a mucopurulent discharge.
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OCI Advances to 2-Week High on Supply Outlook: Seoul Mover
OCI Co., South Korea's biggest polysilicon maker for solar cells, rose to a two-week high after a smaller rival filed for court receivership, triggering speculation an industry oversupply will ease.
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My stay at Palazzo Stern was very wonderful. The staff was very friendly and helpful even before we got there, I had a few questions before I arrived and I emialed them; they were quick to respond and extremely nice and helpful. The hotel is in a good location, and the room was clean, spacious, and very nice.
- Official Description (provided by the hotel):
- Hotel Palazzo Stern is an historical Moorish Palazzo on the Grand Canal. The location is very convenient: easy to reach, close to the main attractions and at the same time in a very Venice area. If you are looking for a unique venetian experience in the real Venice and far from the crowd of the mass tourism we are the right place to choose. ... more less
- Reservation Options:
- TripAdvisor is proud to partner with Booking.com, Hotels.com, Expedia, Hotwire, Odigeo, Travelocity, Agoda and Jetsetter so you can book your Hotel Palazzo Stern reservations with confidence. We help millions of travelers each month to find the perfect hotel for both vacation and business trips, always with the best discounts and special offers.
- Also Known As:
- Palazzo Stern Hotel
- Palazzo Stern Venice


text:
Two people shot dead at University of California, Los Angeles; campus on lockdown
At least two people were shot dead at the University of Cal...
California schools to have richer content on ancient India
The framework now has mention of Vedic sages, Hindu teachings and philosophy, bhak...
Watch: All about Carborundum Universal
Know all about Carborundum Universal and its stocks with ET Now.
'Big Bounce' behind birth of universe?
The universe is currently expanding and it is believed to have burst into existence from a point of infinitely dense and hot material, an event dubbed as the Big Bang.
Reform subterranean universe of UNSC sanctions regimes: India
Akbaruddin questioned why efforts at transparency are not extended to the "subterranean universe, where more decisions are taken than in formal meetings".
Tezpur University accredited 'A' grade by NAAC
The 10-member high powered team was led by Professor Anil K Bhatnagar, Former Vice Chancellor of 'Pondicherry' University and presently the CSIR-Chair Professor, School of Physics, University of Hyderabad, Tezpur University Media Cell Chairman Rajiv Doley told PTI.
Indian universities not a big draw for foreigners
A headcount of foreign students by the HRD ministry for 2013-14 showed that enrolment of international students in Indian varsities was up by a modest 11,000 to touch 31,126.
Ratan Tata's RNT Associates ties up with California University
Ratan Tata is partnering with UC Investments, to invest in Indian startups, new companies and enterprises in the country.
Not blacklisted by US, say two California universities
he two California-based universities have said they have not been blacklisted by the US which was cited as reasons for the recent deportation of 14 Indian students.
Nalanda University enters UNESCO's World Heritage List
The Nalanda archaeological site got included in the Tentative List of World Heritage on January 9, 2009.
Firefighters advance on deadly central California wildfire
Federal fire officials said containment on the 68-square-mile blaze increased from 10 per cent to 40 per cent.
IIT-B ranked 13 in QS University Rankings BRICS 2016
IIT Bombay ranks second in India, seven ranks below the Indian Institute of Science (IISc) in Bangalore at six.
Bangalore university split: Skill-based courses on offer at new varsities
The new university, along with its twin Bangalore Central University - also to be carved out of Bangalore University, will start functioning from next academic year.
Universal Sompo seeks to extend ON Singh's tenure again
ON Singh is slated to become the non-executive chairman of the company as per its new management policy.
Thousands of California college students homeless and go hungry
The students who reported being homeless said they often "couch-surfed" or slept in their cars, in tents, in parking lots or railway stations.
Apollo Hospitals inks pact with Stanford University
Healthcare major Apollo Hospitals has signed a pact with Stanford University to gain insights into cardiovascular risks reduction in South Asians.
Welingkar Institute to host health hackathon with Tel Aviv University, Israel
Teams with the most promising ideas will be given cash prizes, several months of mentoring, the possibility of joining either the Pears Challenge accelerator in Israel
Rules for deemed universities streamlined
Under the new regime, deemed university applications will be processed within six-seven months, unlike the earlier trend of six years, Irani said.
Post-Brexit, Britain may need "Hotel California" model
Once the dust settles, Britain could "check out" of the EU by handing in its notice, but effectively stay half-way in the world's biggest trading bloc by joining the European Economic Area along with Norway.
University of California Irwin returns USD 3 million grant for Hindu studies chair
In another letter, UCI students and faculty expressed concern over DCF donation, and the impact it might have on the credibility of Hindu studies at the university.
'Make in India' more nationalistic than realistic: University of California Chancellor Pradeep K Khosla
'Make in India' seems more nationalistic than realistic and adequate infrastructure and logistics are needed to make the strategy real, says Khosla.
Common tests may make Delhi University cut-offs history
Vice-chancellor confirmed that such a proposal is under consideration and will be examined in detail as soon as this year's admission process is wrapped up.
Indian-American to lead University of California's investment fund
A prominent Indian-American businessmen will lead a venture to collect funds for University of California with an aim to invest in innovation opportunities.
California-based University of the People planning collaboration with India for online education
University of the People, the world's first non-profit tuition-free varsity, is looking at India as a major destination for students.
Five ways to fly high in California wine country
Sip on your favourite wine in California in a hot-air balloon or in an aerial tram or try the chopper to sip your wine and get mesmerised.
Govt asks students on way to 2 California universities to defer departure
The external affairs ministry on Wednesday advised Indian students seeking admission in two California-based universities to defer their departure.
Texas University to set up tech accelerator in Tirupati
The program already has applications trickling in, from which 33 technology startups would be shortlisted to enter the four-month long session.
Working to have a deemed university status for FDDI: Nirmala Sitharaman
Keen to resolve the issue, Sitharaman had conducted about a dozen consultation meetings with the concerned ministries, departments.
British universities fear Brexit funding fallout
In the wake of the referendum, numerous universities have sought to reassure their students from other EU countries, notably on question of tuition fees.
I&B Ministry working for Deemed University status for IIMC
The official said the proposal will have to be submitted to the HRD Ministry for evaluation and according of Deemed University status to Indian Institute of Mass Communication (IIMC).
Cabinet okays name change of Rajendra Central Agricultural University
The bill to upgrade this university in Bihar into a central university was passed by Parliament in May.
Indian-American Dr Kinshuk named US university dean
An Indian-American professor with a diverse set of academic experience in the field of science and technology has been named the dean of a leading US university.
Outperform Carborundum Universal, target Rs 258: IDFC
The management expects margins to improve to 18 per cent in the next 2-3 years. Restructuring of South African entities will improve cost structure, and boost profitability.
Volkswagen to pay $86 million in penalties to California over emissions: State attorney general
The payment comes on top of the settlement of about $15 billion between Volkswagen and US officials announced last week, Harris said.
PM Modi interacts with alumni from Indian universities in Durban
Prime Minister Narendra Modi interacted with alumni from Indian universities in Durban.
Road to 270: Donald Trump stuck on GOP's California dream
Trump's challenge: unite Republicans while finding millions of new supporters in a state where Democrats hold every statewide office and both chambers of the Legislature.
Universal Multifunction Accelerator wants to solve your battery woes
Manjeera recently bagged an order from the Indian Space Research Organisation (Isro), where they are using UMA for high-speed computation in the radar signal processing.
Snapdeal establishes its data sciences centre in California
The data sciences centre will be led by Nitin Sharma, senior VP at Snapdeal. The number of hires made by the company for the centre, however, has not been disclosed.
Chinmaya Mission universities likely to receive deemed university status
Chinmaya Mission is learnt to have requested the PMO to help expedite the Smriti Irani-led HRD ministry's nod.
Sea urchin haven disturbed by Santa Barbara oil spill
Stephanie Mutz makes a living plucking sea urchins from the Santa Barbara coast and selling the prickly treasure to upscale restaurants in southern California.
Delhi University to announce second cut-off tonight for UG admissions
Some of the colleges, however, are likely to close admissions for a few courses where seats have been filled under the first list.
Digest this: VC of a 'university' in UP is a churan seller
"The university is fake," says a book seller whose shop is beside Sharma's. "But you can meet the VC 'sahab'. Aaj kal churan bechte hain'
Manish Sisodia calls for entrance exam in Delhi University, weightage for Delhiites
Sisodia, who is also the Delhi Education minister, suggested that an entrance test should replace the cut-offs method for enrollment of students in DU.
Delhi University admission likely to start late
The change has nothing to do with DU Teachers' Association's boycott of admission process, but is due to OBC-category candidates seeking more time.
UGC approves new guidelines for Deemed Universities
The new guidelines also gives a time bar of seven months for the UGC and HRD ministry to take a call on setting up new centres.
Delhi Technological University increases BTech seats by 15%
Over and above 12 seats have been added for NRI/ PIO quota through direct admission of students abroad (DASA)," an official statement said.
California to revise how India is portrayed in textbooks
The committee debated dozens of specific sentences in the history curriculum framework, which is more than 400 pages.


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As the two "big name" WRs that were acquired by us and the Hawks, I would say that there is no question Harvin is the more dynamic player who can score from anywhere on the field. He will cause us problems on the field, and also cause the Hawks problems in the locker room.
One thing I gotta point out regarding what I like about Boldin even if he is gettin a little slow...do you all remember when Boldin got absolutely crushed by a helmet to helmet hit a few years back when he was with AZ? It was the hardest helmet to helmet hit I have ever seen. When Boldin hit the ground, his arms remained pointing towards the sky while he was out cold for at least 10 seconds. If I remember correctly, he wound up getting like 40 screws in this face from that hit. Scary thing is...he was playing THREE weeks later. How long would "Headache Harvin" have been out if he had taken that hit? Probably three years.


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Bayside Police Chief Bruce Resnick introduced two new officers to the Village Board this week. Officer Gina Kleeba, sworn in on Jan. 2, is now attending the Police Academy. Kleeba was a village dispatcher prior to being sworn in. She will be back in the village in about three months when her schooling is completed. Resnick said he misses her computer skills and will be happy to see her back.
Cory Fuller, who speaks both French and Spanish, is the other addition to the department. Fuller spent a year teaching in France, Resnick said. While his French language skills might not be needed often, Resnick said his Spanish will likely be a help to the department. Fuller is on-the-road under the supervision of a training officer while he does his field training.
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Top Definition
Gaining an intense wave of energy and focus courtesy of Daft Punk playing in the background.
This paper is killing me and it's already midnight, I need some derezzin' to finish it!
dari RedFoxMan Sabtu, 16 April 2011
Trending Now
Email dikirim dari firstname.lastname@example.com. Kita nggak bakalan nge-spam kamu kok :).×


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The Belly of Paris (Paperback)
On Our Shelves Now
Unjustly deported to Devil's Island following Louis-Napoleon's coup-d'etat in December 1851, Florent Quenu escapes and returns to Paris. He finds the city changed beyond recognition. The old Marche des Innocents has been knocked down as part of Haussmann's grand program of urban reconstruction, replaced by Les Halles, the spectacular new food markets. Disgusted by a bourgeois society whose devotion to food is inseparable from its devotion to the Government, Florent attempts an insurrection. Les Halles, apocalyptic and destructive, play an active role in Zola's picture of a world in which food and the injustice of society are inextricably linked.
This is the first English translation in fifty years of Le Ventre de Paris (The Belly of Paris). The third in Zola's great cycle, Les Rougon-Macquart, it is as enthralling as Germinal, Therese Raquin, and the other novels in the series. Its focus on the great Paris food hall, Les Halles--combined with Zola's famous impressionist descriptions of food--make this a particularly memorable novel. Brian Nelson's lively translation captures the spirit of Zola's world and his Introduction illuminates the use of food in the novel to represent social class, social attitudes, political conflicts, and other aspect of the culture of the time. The bibliography and notes ensure that this is the most critically up-to-date edition of the novel in print.
About the Series: For over 100 years Oxford World's Classics has made available the broadest spectrum of literature from around the globe. Each affordable volume reflects Oxford's commitment to scholarship, providing the most accurate text plus a wealth of other valuable features, including expert introductions by leading authorities, voluminous notes to clarify the text, up-to-date bibliographies for further study, and much more.
About the Author
?mile Zola was a French writer who is recognized as an exemplar of literary naturalism and for his contributions to the development of theatrical naturalism. Zola s best-known literary works include the twenty-volume Les Rougon-Macquart, an epic work that examined the influences of violence, alcohol and prostitution on French society through the experiences of two families, the Rougons and the Macquarts. Other remarkable works by Zola include Contes ? Ninon, Les Myst?res de Marseille, and Th?r?se Raquin.
In addition to his literary contributions, Zola played a key role in the Dreyfus Affair of the late nineteenth and early twentieth century. His newspaper article J Accuse accused the highest levels of the French military and government of obstruction of justice and anti-semitism, for which he was convicted of libel in 1898. After a brief period of exile in England, Zola returned to France where he died in 1902. ?mile Zola is buried in the Panth?on alongside other esteemed literary figures Victor Hugo and Alexandre Dumas.
Brian Nelson is Professor Emeritus of French Studies and Translation Studies at Monash University, Melbourne, and a Fellow of the Australian Academy of the Humanities. His publications include Perspectives on Literature and Translation: Creation, Circulation, Reception (co-edited with Brigid Maher, 2013), The Cambridge Companion to Emile Zola (Cambridge, 2007) and translations of the novels of Emile Zola.


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Static display at the MIA15.
On a practice display during sunset time.
Royal Navy Avenger at the Malta International Airshow 2015.
Based here for Valletta Summit and CHOGM 2015
"Tiger1" on final runway 23 from HMS Bulwark. It is 1 of 2 RNY Merlins to be based here for the Valletta Summit & CHOGM 2015. (1600 pix)
Onboard HMS Illustrious.
Royal Navy Black Cats Resting On Apron 4 At The Malta International Airshow.
Royal Navy Sea King HC4 ZF116 ready for take off while two Army Air Corps Apache AH1 pass by during one of the rehearsals for RNAS Yeovilton Air Day 2015
Malta International Airshow 2015


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355 search results for christmas special
'Doctor Who' Christmas Special gets a title, will focus on the return of River Song
Type: Post | Date: Tuesday, Dec 1, 2015Moffat also gives the Doctor a new [REDACTED].
River Song is back in this new 'Doctor Who' Christmas Special trailer
Type: Post | Date: Monday, Dec 14, 2015Hello sweetie? Spoilers? Oh River, how we missed you!
Sofia Coppola and Bill Murray's Netflix Christmas special gets a new poster
Type: Post | Date: Monday, Nov 9, 2015The holidays all happen at once on December 4th on Netflix this year
Merry Christmas: One Direction got their own holiday TV special
Type: Article | Date: Wednesday, Nov 12, 2014And it broadcasts close to the actual holiday, for once
I Love Lucy Christmas Special
Type: Event | Date: Friday, Dec 20, 2013CBS offers up two colorized "Lucy" episodes tonight.
11 photos of the 2014 'Doctor Who' Christmas Special
Type: Gallery | Date: Monday, Dec 8, 2014The jolly old elf meets the cantankerous Time Lord.
Get ready for Bill Murray's Netflix Christmas special. Here's a teaser.
Type: Post | Date: Friday, May 22, 2015
11 new 'Doctor Who' photos capture the spirit of 'Last Christmas'
Type: Article | Date: Monday, Dec 8, 2014The jolly old elf meets the cantankerous Time Lord.
Michael Buble's 3rd Annual Christmas Special
Type: Event | Date: Wednesday, Dec 18, 2013Michael Buble is on NBC tonight celebrating the holiday.
Recap: 'Doctor Who' - 'Last Christmas' has a lot of layers, like an onion or parfait
Type: Post | Date: Thursday, Dec 25, 2014What is reality? Are we awake right now?


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There is not enough darkness in the world to snuff out the light of even one small candle.
Marian Wright Edelman (1939 -)
Source: Internet
Contributed by: denise
" Whoever said anybody has a right to give up?"
Contributed by: Sprinklez o;
Never work just for money or for power. They won't save your soul or help you sleep at night.
Contributed by: Kat
We must not, in trying to think about how we can make a big difference, ignore the small daily differences we can make which, over time, add up to big differences that we often cannot foresee.
Contributed by: Angelina
If you as parents cut corners, your children will too. If you lie, they will too. If you spend all your money on yourselves and tithe no portion of it for charities, colleges, churches, synagogues, and civic causes, your children won't either. And if parents snicker at racial and gender jokes, another generation will pass on the poison adults still have not had the courage to snuff out.
Contributed by: thinq4yourself
Service is the rent we pay for being. It is the very purpose of life, and not something you do in your spare time.
Contributed by: Zaady
No one, Eleanor Roosevelt said, can make you feel inferior without your consent. Never give it.
Source: The Measure of Our Success, 1992.
Parents have become so convinced that educators know what is best for children that they forget that they themselves are really the experts.
Source: Psychology Today, 1975.
Political history is largely an account of mass violence and of the expenditure of vast resources to cope with mythical fears and hopes.
Source: Politics as Symbolic Action
Service to others is the rent you pay for living on this planet.
Source: Words of Women Quotations for Success, by Power Dynamics Publishing, 1997.
Copyright © 2016 Gaiam, Inc.


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Dental products for NZ Healthcare Professionals
From gloves and consumables through to Dental Units, Lasers and Digital Radiography equipment, we pride ourselves on our ability to quickly supply a great range of products needed to efficiently run your dental practice.
Browse our online shop or for personal service contact our Customer Service team.
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|Message view
|« Date » · « Thread »
|« Date » · « Thread »
|Armin Le Grand <Armin.Le.Gr...@me.com>
|Re: About Team OpenOffice.org
|Fri, 23 Dec 2011 20:12:40 GMT
Hi Raphael, On 23.12.2011 20:13, Raphael Bircher wrote: > Am 23.12.11 20:00, schrieb Armin Le Grand: >> Hi Götz, >> >> On 23.12.2011 19:37, Götz Wohlberg wrote: >>> Hi Pedro, >>> >> [..] >>> >>> (2) Finding service customers at this point in time is also not >>> promising as AOO 3.4 is not out yet. >> >> Why don't you just help doing that? Waiting for it will not make it >> happen earlier. It would show the world that you have an active roll >> in OpenOffice development, also to your possible customers. It's also >> a goal of your organization, isn't it? > I think you can easy say that, if you get your Money from IBM. I think, > Team OOo has to focus there work on that, wath the money come from. And > if costumers request a 3.3.1 then they request a 3.3.1, Then they won't > hear: "But we working on 3.4." So that's probabily a different > situation. End doing Business with the Core development of OOo is maybe > one of the hardest jobs you can do. SUN fail, Oracle fail, so this guys > has a load of courage. You are right and I see their courage. I wish them all the best and I hope it all leads to possibilities to work together with them in the future. I press thumbs that they will be able to create chances for some of my former colleagues, this would help everyone. > Greetings Raphael > > Happy Christmas Raphael! Armin -- ALG
|View raw message


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Fancy Appendix mare available for sale. Shown successfully on the Quarter Horse circuit in halter, showmanship, hunter under saddle, equitation, horsemanship…SOLD
Cory is a wonderful 6 year old gelding with lots of miles. Cory is very sound, sane and quiet- he would do well in a pleasure type of home and has been…SOLD
Located in West Chester, PA at Maui Meadow Farm "Socks" is a 2009 gelding who is looking for his next, special home. This mannerly gelding is sweet and…SOLD
Located: Morgantown, Pa 19543 Cairo is a lovable 5 year old paint miniature stallion. He is broke to lead, loves to be scratched, and is easy to handle…SOLD
Rosie came to us as a brood mare this summer, after weaning her from her foal. Surprise!!!! we started riding her, someone has put some time on Rosie…SOLD
WBF Doubloon's Lucky Dream was imprinted at birth and is worked with daily using natural horsemanship methods. He is an amazing young man with a love…SOLD
Raz is a gorgeous, athletic, and sound 10 year old bay Quarter Horse. She is the ideal trail horse, a steady, level-headed mare that can handle any obstacle…SOLD
Mingo is a BLM Mustang Gelding, he is freeze branded and I have his BLM papers. His absolutely gorgeous grullo coat catches eyes from afar. He has very…SOLD
Gainesville, TX


text:
Need 250.000 YT Views
This project received 10 bids from talented freelancers with an average bid price of $43 USD / hour.Get free quotes for a project like this
Skills Required
Project Budget$2 - $8 USD / hour
Total Bids10
Project Description
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Local News
Three Hurt in Crash On North Broadway in Salem
Salem Police say a southbound car driven by 77-year-old June Allison of South Broadway in Salem made a left turn in front of a northbound SUV driven by 54-year-old Cheryl Olafsson of East Lyford in Salem. The impact caused the Olafsson jeep to roll over on the driver's side. Both drivers along with a passenger in the Olafsson vehicle, 23-year-old Cory Pitts of East Lyford in Salem, were injured and taken to Salem Township Hospital for treatment.
Salem Fire Protection District firemen had to extricate Olafsson and Pitts from the vehicle. Firemen had to cut the roof open. A medical helicopter had originally been dispatched to the scene, but it was later cancelled. Allison was ticketed for failure to yield when turning left.
The wreck occurred at 6:46 Wednesday night. Traffic had to be detoured off North Broadway for about 45 minutes. The Salem Emergency Management Agency and Marion County Sheriff's Department assisted with traffic control.
See other LocalNews news:Police Beat for Saturday, July 30th, 2016
States' Flag-Burning Laws Unconstitutional, But Persist
Drew Peterson Gets 40-Year Sentence in Murder-For-Hire Case
Rauner signs law extending contraceptive insurance coverage
Rauner Signs Plan Limiting Mentally Ill from Owning Guns


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- List of properties
- Properties on map
166 commercial properties for sale found
5,274 sq ft
Retail Property (high street) for sale Trafalgar House Juniper Drive, London, SW18
Prime road facing commercial unit, in excess of 75,500 vehicle movements per day. Up to 5,274 sq ft (492.3 sq m) of commercial space available for sale or to let. More details ›
2,586 sq ft
Commercial Property for sale 48 Woodlawn Road , Fulham, SW6 6PW
A unique, contemporary family home measuring just under 2,600 sq ft. Located in the heart of the Alphabet streets, this stylish home marries period features with an attractive modern layout. This enclosed property, has an abundance of living space with a smart open plan kitchen and living room (s... More details ›
5,034 sq ft
Restaurant for sale Unit 10 Chelsea Creek Tower, Park Street, London, SW6
Waterside RESTAURANT OPPORTUNITY in London s latest dockside development. The PERFECT LOCATION for any business adjacent to Imperial Wharf, Chelsea Harbour and Lots Road. A prominent WATER FRONTING UNIT, with the benefit of a 3 sided return. More details ›
2,670 sq ft
Commercial Development for sale The Robin Hood & Little John, 123, Flaxman Road, London, SE5 9EA
Comprising an approximate rectangular shaped site containing a former public house, which would need to be demolished to allow development. The proposal is to demolish the existing building and construct 3 no. 1 bedroom, 3 no. 2 bedroom and 1 no. 3 bedroom apartments totalling 4,885 sq ft (454 s... More details ›
£1,220,000 Guide Price
Guide Price £1,220,000
Commercial Property for sale Forest Hill Road, London
Freehold shop and upper parts consisting; Ground floor former laundrette approx 700 sq ft benefitting from a 27 ft forecourt and ancillary space. First Floor; Newly refurbished 2 double bedroom flat, fully equipped open plan kitchen/living area, bathroom, benefittin... More details ›
1,564 sq ft
Retail Property (high street) for sale 2 Park Street, London, SW6
RETAIL UNIT - FOR SALE - A1, A2, A3, A4 PLANNING USES POSSIBLE More details ›
1,184 sq ft
Shop for sale McCluskey's Free Off LicenceBloomfield Road,Kingston Upon Thames,KT1 2SE
McCluskeys free Off Licence occupies substantial two-storey premises. The business is situated within a small parade of complimentary shops and businesses and benefits from a high volume of footfall and passing trade. The business has built up an enviable reputation. More details ›
£750,000 Guide Price
Guide Price £750,000
2,934 sq ft
Retail Property (high street) for sale 303 London Road, Croydon, Surrey, CR0
PROMINENT COMMERCIAL UNITS CURRENTLY UNDER CONSTRUCTION IN AN EXCELLENT RETAIL POSITION More details ›
1,463 sq ft
Mixed Use for sale Fulham Palace Road,London,W6
Freehold Investment/Development Sale in W6 More details ›
1,320 sq ft
Retail Property (high street) for sale Unit B Distillery Wharf Chancellors Road, London, W6
Fulham Reach is located on one of the most dramatic stretches of the River Thames with views that stretch across to Hammersmith Bridge and beyond, set in beautifully landscaped gardens. More details ›
Thank you.
Your information has been sent to 0 out of 15 agents who have property to sell in the area you specified.


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Alpha Omega Veterans Services, Inc.
Rating: 4.8 stars 15 15 reviews 500
1183 Madison Avenue Memphis TN 38104 USA
Alpha Omega Veteran Services provides social services and short- and long-term transitional housing programs to homeless veterans with the end goals of securing permanent housing, independent living and total societal re-integration.
Since our inception, it has been our pleasure to have served more than 8,000 displaced and/or disabled veterans. Our facilities include a drop-in/outreach center with a 19-bed transitional center, 32 one-bedroom permanent housing apartments, permanent housing in eight townhouses serving 32 veterans, 10 Single Room Occupancy (SRO) permanent housing units for the chronically homeless, a 15-bed transitional housing facility, and an 8-bed hospice-like transitional facility known as the "Life House" that serves the medically fragile.
Target demographics:
disabled and displaced military veterans
Direct beneficiaries per year:
over 300 military veterans.
Geographic areas served:
Memphis, Tennessee
food, clothing, housing, transportation, vocational assistance and rehabilitation assistance that are administered by a staff comprised of over 30 trained professionals
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Reviews for Alpha Omega Veterans Services, Inc.
Alpha Omega Verterans Service...great people who care and organization!!!
1 person found this review helpful
Alpha Omega is an amazing group to work with. They worked with us to give our students an amazing service experience with veterans. They really worked to help our students understand what this agency was able to offer and how we could continue to support this organization. They are kind, comprehensive, and truly amazing.
1 person found this review helpful
I have the honor of working with Alpha and Omega in conjunction with the release of my first book.
Since its inception, this organization has been on the forefront of veterans issues. You can see the difference it is making in the lives of the veterans that they serve. It is a great organization that is postured to do even greater things in the future.
I am a veteran who has a history of mental health issues. As a part of my recovery I became a mental health advocate and have been for over 10 years. I now work for and fully support the mission of Alpha Omega Veterans Services.
Alpha Omega Veterans Services serves those who have put their lives on the line to protect the rest of us. The men and women who have paid a terrible price, their minds and bodies broken by their service or its aftermath, deserve our total and unconditional support to help them attain any goal they want.
I would not be here if I did not feel passionately about this mission, to help my battle brothers and sisters.
Alpha Omega Veterans Services is the best nonprofit for disabled and displaced veterans! They have helped over 9,000 veterans to date. AOVS extends a hand to veterans during their time of need and rehabilitates them to become functional civilians again. Thank you AOVS for everything you do!!
They are a great organization that does help veterans
Outstanding organization that does amazing work with our American Heroes
Great people & great organization helping our Veterans. I've gotten to know several people there & have made lasting friendships.
AOVS saved my life. They have my best interest in heart. AOVS has heart for veterans. Thanx AOVS


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WAG! The Musical Gallery
A CONTEMPORARY comedy musical set in a major city centre department store, WAG! The Musical stars Tim Flavin, Lizzie Cundy, Pippa Fulton and Alyssa Kyria as Ariadne the Greek Wag, and continues at Charing Cross Theatre until August 24, 2013. Check out some production images…
Roll your mouse over the left and right-hand sides of the image and then click to view more pictures.
12 of 12
Recent Galleries:
- The Secret Garden - Production Images
- The Secret Garden - Rehearsal Images
- Alice in Wonderland in Abney Park - Photo Gallery
- Groundhog Day - first look at Andy Karl as Phil Connors
- Jesus Christ Superstar - production images
- Daniel Portman and Lily Loveless rehearsing for The Collector
- Gary Tushaw as Joseph Taylor, Jr in Allegro
- Wicked on tour
- Jesus Christ Superstar - rehearsal images


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Cars McQueen Hardshell Bicycle Helmet and Protective Pad Value Pack (Toddler)
We don't know when or if this item will be back in stock.
- Enter your model number to make sure this fits.
- Protective multi-sport design with gloss finish
- Top and front vented design for better airflow and comfort
- Easy to adjust webbing for a comfortable fit
- Featuring Lightning McQueen from the hit movie Cars!
- Bonus pad set can be used for knees or elbows
There is a newer model of this item:
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Technical Details
|Item Dimensions
|15 x 10 x 5.75 inches
|Item Weight
|1.1 pounds
|Shipping Weight
|1.1 pounds
|Sport Type
Product Description
Product Details
Customer Reviews
Top Customer Reviews
Nice quality helmet. I recommend it...
The helmet is very nice. Fashionable and the Cars theme goes over well for the little guy. He just turned three years old, and the helmet fits him perfectly.
Customer Images
Most Recent Customer Reviews
After having this for over 4 years, tossed around, scratched, and bumped. This helmet is still in very good shape. Read morePublished on June 12, 2014 by Palestrina George
We've had this helmet for maybe 4 years now. It's been passed from kid to kid and still works. I guess that's worth something. Read morePublished on May 15, 2014 by Drew V
This very heavy and large for todller. My son just tried it and never used again so we bought aonther hemet. I will not recommend.Published on January 1, 2014 by Francois K. Pirayesh
Does what it is meant to do. I got it for my lil one for safety reasons and so far so good. It's well made and adjustablePublished on October 25, 2013 by nana
This has been a great helmet and still fits my 6 year old son after 3 years! He had a matching bike to match it for a few years too!Published on August 28, 2013 by "Stay at home mom of two"
I know this says toddler, but my son is now 5 (we got it when he was 3) and I don't see how it will ever fit well. It flops around and his forehead is always exposed. Read morePublished on August 22, 2013 by KristinJN
Hat is a little big for my 3 yr. old grandson. He can't wear it yet because it flops off. Still a nice product.Published on August 31, 2011 by Grandma2


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- Swimmer Ryan Lochte reveals one of his worst dates - US Weekly
- Get the latest on Dr. Dre's arrest - TMZ
- Despite rumors, Eddie Murphy's daughter is not pregnant - Gossip Cop
- The Vampire Diaries star Michael Trevino steps out for a good cause - Just Jared Jr
- Are Blac Chyna and Kylie Jenner on good terms? - Radar
- Blue Ivy is just as stylish as her mom Beyonce! - Lainey Gossip
- This Narcos star confirms he's not coming back for another season of the show - The Hollywood Reporter
03 February 2013 at 2:30 AM
Jordin Sparks: Super Bowl Party for the Giving Back Fund!
About this photo set: Jordin Sparks poses with NFL player Victor Cruz at the Giving Back Fund's 2013 Big Game Big Give Super Bowl Celebration on Saturday (February 2) in New Orleans,… Read More Here
Photo #: 2803679
Posted to 2013 Super Bowl, Anthony Mackie, Jordin Sparks, Michael Bay, Victor Cruz
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Sep. 2, 2015, 1:08 PM
- The Pimco High Income Fund (PHK -8.6%) cuts its monthly distribution by just under two cents to $0.10346. With the fund trading at about a 33% premium to NAV as of the close yesterday, there's plenty of room for investors to show disappointment.
- Look out below, warned SA's Value With A Catalyst in a particularly well-timed article in early April (PHK was then trading at a 65% premium to NAV). With a change in managers following Bill Gross' departure, the fund made a sizable reduction to leverage, and the author said a dividend cut would be a must. The fund is lower by about 30% since.
- Two other Pimco CEFs hiked payouts this month, the Pimco Dynamic Income Fund (PDI -0.1%) boosted by a penny to $0.22, and the Pimco Dynamic Credit Income Fund (PCI +1.5%) by just under a penny to $0.164.
Sep. 26, 2014, 11:49 AM
- Pimco's closed-end funds and ETFs are plunging in the wake of Bill Gross' exit to Janus: PHK -8.7%, PGP -8.5%, PTY -6.2%, PCN -4.2%, RCS -4.3%, PFL -3.6%, PFN -2.7%, PKO -2.5%, PDI -2.2%, PCI -1.4%, BOND -0.2%.
- "A lot of people bought into Pimco because of Bill Gross, who was the face of the organization, and so they're shooting first and asking questions later," says Motley Fool Asset Management CIO Bill Mann. "Investing is a personal business, and the market is saying it trusted Bill Gross."
- Meanwhile, headlines indicate Dan Ivascyn, Pimco's (OTCQX:AZSEY, OTCPK:ALIZF) deputy chief investment officer, will succeed Gross and take over portfolio management; WSJ had written earlier this week that Ivasycn already was growing in popularity among Pimco investors, who had been putting more money into his fund even as they were pulling it from Gross' fund.
Aug. 13, 2013, 12:44 PM
- Tumbling Treasury prices - with TLT carving out a new 52-week low today - are again hitting income favorites.
- Leading mREITs (REM -1.4%) lower are Invesco (IVR -3.3%), Annaly (NLY -2.3%), American Capital (AGNC -2%), and Western Asset (WMC -1.6%).
- A number of income CEFs not long ago were so much in favor they commanded large premiums to NAV. They're now at seemingly growing-by-the-day discounts. Among the movers today is the Pimco Dynamic Income Fund (PDI -1.4%) selling for $27.45 against yesterday's closing NAV of $30.23. Others include: PCI, PFN, and PFL.
- Still trading at premiums to NAV are the Pimco High Income Fund (PHK -0.9%) and the Pimco Corporate & Income Fund (PTY -1.1%).
- Municipals (MUB -0.6%) slip as well, hitting Muni CEFs: NXZ -0.9%, IIM -1.2%, VKQ -0.7%.
- Related ETFs: MORT, MORL, SUB, MUNI, PVI, PZA, SHM, TFI, VRD, HYD, ITM, MLN, PRB, SMB, GMMB, SMMU, RVNU, NY .
May 28, 2013, 1:01 PM
Heavy selling hits a number of Pimco income funds, notably the High Income Fund (PHK -4.3%) with heavy exposure to high-yield paper and the financial sector. The decline narrows the fund's premium to NAV to a still-whopping 34%. The Income Opportunity Common Fund (PKO -2.2%) trades at just a slight premium, while the Dynamic Income Fund (PDI -2.8%) sells for about a 5% discount. Others: (PTY -3.6%), (PCN -2%), (PGP -5.3%), (PFN -1.5%).| May 28, 2013, 1:01 PM | 3 Comments
Company Description
The Fund will seek to achieve its investment objectives to produce total return for shareholders by utilizing a dynamic asset allocation strategy among multiple fixed-income sectors to invest in a portfolio of fixed-income securities and related instrument
Sector: Financial
Industry: Closed-End Fund - Debt
Country: United States
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Enable Flexible Working
The nature of work has changed fundamentally and forever and it continues to evolve rapidly. Geographic distance and borders are increasingly irrelevant and transparent. The traditional roles of employees and employers, the 9 to 5 working day and places of work are all shifting. Underpinning these macro shifts is the advent of very fast Internet, paired with other mobile and collaborative technologies. Organisations that are not embracing a new way of working and communicating risk not just impacting productivity but the ability to recruit and retain the next generation of employees. The Flexible Working whitepaper looks at why the workplace is changing, the benefits of supporting a more flexible work environment and how to build a Roadmap to "tomorrow's workplace".
Today's enterprises have higher than ever demands for data and application availability. The rapid digitisation of business processes and increasing expectations from customers and partners for constant uptime is ushering in a new era for IT which is less restricted by manual data protection practices. Telsyte research shows 75 per cent of IT budgets are spent on operations and transformation programs with only 25 per cent left for innovation. To drive more innovation, CIOs must address their number one business priority — reducing operating expenses — and free their organisations from a complex collection of backup, storage and virtualisation systems to ensure applications are online and protected from failures and cyber attacks. Download whitepaper »
Application availability is the name of the game for IT organisations. IDC research has determined that application downtime costs exceeding $100,000 per hour is the median, although that cost can run substantially higher for some organisations. Consequently, organisations are willing to invest considerable sums in availability solutions that avoid downtime and ensure smooth business operations. Download whitepaper »
The consequences of a cyber-attack can be devastating, such as loss of customer confidence, ruined reputation and costly legal ramifications. Not to mention the potential destruction of your entire business. To be fully effective, cyber security must be proactively managed and owned at board level. Not not just by the IT department. It needs to be broad in scope, and senior management needs to recognise that it's a whole of business challenge. Download whitepaper »
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- Working pressure up to 6,000 psi with burst pressure of 12,000 psi
- Thermoplastic material for flexibility
- For use only with hand-operated Alemite grease gun models; not to be used with power-operated models
- Overall length of 12"
- 1/8" NPTF male at both ends
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+ $4.69 shipping
Alemite B337595-A1 Grease Gun Hose, 12" Length, 6,000 psi Working Pressure, Thermoplastic, 1/8" NPTF
|$11.50 & FREE Shipping on orders over $49. Details
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Product Description
This Alemite B337595-A1 grease gun hose is made of thermoplastic, is 12" in length, has a 6,000 pounds per square inch (psi) working pressure, a 1/8" NPTF (National Pipe Thread Fuel) end, and is used to extend a grease gun to reach grease fittings that are otherwise difficult to get to. It's for use only with hand-operated Alemite grease gun models and should not to be used with power-operated models. This extension hose fits onto the outlets of grease guns that inject grease into standard grease fittings and are used for applications such as lubricating motor vehicles, construction and industrial equipment, and aeronautics.
Oil and grease guns are handheld tools that inject lubricant (dispensed from the barrel or cylinder cartridge) into metal mechanical assemblies. Electric and air-powered grease guns can dispense large volumes of lubricant in commercial applications, while battery-powered (cordless) grease guns are more suitable for mobile and remote applications. Manual grease guns (lever, pistol-grip, screw-type, push-type, and suction) vary in duty and have either a rigid or flexible hose extension for attaching nozzles or a nozzle with coupler for standard grease fittings. Oil and grease guns are used in a broad variety of applications including vehicles of all types, construction equipment, factory and agricultural machinery, and aeronautics, among others.
Alemite manufactures lubrication and fluid handling systems and components. The company, founded in 1918, is headquartered in Fort Mill, SC.
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|Musicology Colloquium
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Thursday, July 28 11:57 pm
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Thursday, July 28 11:57 pm
|Midday Music
Wednesday, September 14 12:30 pm
Sage Chapel
Midday Music for Organ: Annette Richards presents 17th- and 18th-century English and Italian music, playing the Augustinus Vicedomini organ from 1746.
Saturday, August 20 4:30 pm
Sage Chapel
Cornell University Chorus and Glee Club; Robert Isaacs, conductor. "Choral Showcase" features Cornell's premier choral ensembles and their a cappella subset groups, After Eight and the Hangovers. Stick around afterward for a reception and information about auditions!


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September 7, 2013
I have Nikon D300S with two prime lens, 50mm F1.8 and 35mm f1.8G. I also have a SB900 external flash, Tripod and 32 inches soft box.
I do mostly outdoor family, couple and children portraits. My dream is to become a wedding photography, hopefully my dream would come true.
I started with photography 5 years ago as beginner with beginner level DSLR camera. I'm seeking for connection with other photographers to gain more experience in such mentor.
I'm opening for any kind of meet up especially photography workshop.
I'm currently using Adobe Light Room 3 and Adobe Photoshop CS3. I run these two softwares on my macbook pro laptop.
My name is Navoth Sor. I live in Cherry Hill NJ. I'm full time employee as a computer engineer. I want to turn my photography hobby to a career. I'm currently a self learning in photography and seeking to connect to experienced photographers in areas
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In Star Wars: A New Hope, Han famously makes a comment about Wookiees ripping people's arms off. This got me to thinking whether this was a reasonable generalisation. Has Han Solo ever met another Wookiee aside from Chewbacca? Canon preferred but Legends is acceptable,
Yes, but after A New Hope
In the recent marvel comic six issue crossover event, Darth Vader Down, Han and Chewie encounter Black Krrsantan, a Wookie warrior.
While this comic is considered canon, it takes place after A New Hope, so it won't help explain Han's comment.
In the Star Wars Holiday Special Han Solo meets several members of Chewbaca's family, and actually participates in a large wookie ceremony with dozens if not hundreds of other Wookies.
While this takes place after a New Hope, Solo is very familiar with the planet suggesting he'd been there before. Additionally, since this is Chewbacca's family, it seems reasonable that Solo had met them early in his relationship with Chewy.
I'm not sure if the Holiday Special counts as canon, but it certainly has all the original actors. Now, whether or not you want to scar yourself by watching it is another matter.
YouTube link (courtesy of Richard).
Since ibid covered Disney canon, let's cover EU/Legends for completeness.
The origin of "Ripping people's arms off" meme, retconned in-universe, is Han Solo's friend/caregiver/surrogate mother, Wookie Dewlanna (full name Dewlannamapia).
His relationship with her while being a juvenile criminal on Shrike's crew is described in Han Solo trilogy by Crispen (especially, Paradise Snare).
In the book, while helping Han escape Trader's Luck, she broke Larrad Shrike's arm easily, but in that fight was mortally wounded, which cemented his warm feelings towards Wookies and ensured he would be set upon his path when he met Chewbacca as an Imperial slave.
As this answer explains, in the novel Star Wars - Journey to The Force Awakens: Aftermath by Chuck Wendig1, Han and Chewie travel to the Wookiee homeworld of Kashyyyk and liberate it from Imperial control. It is all but impossible to imagine anyone going to a Wookiee planet and failing to meet at least a few Wookiees. Furthermore, Han specifically mentions that they should contact a group of a half dozen Wookiee refugees, including Roshyk, Hrrgn, and Kirratha. It's pretty clear that he and Chewbacca already know these six Wookiees, at the very least.
1Poorly written - very poorly written - but canonical nonetheless, this story takes place in the months following the Battle of Endor, the destruction of the second Death Star, and the death of Vader and Palpatine