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Prospective evaluation of a hydrogel spacer for rectal separation in dose-escalated intensity-modulated radiotherapy for clinically localized prostate cancer
Clinical and radiation oncology
As dose-escalation in prostate cancer radiotherapy improves cure rates, a major concern is rectal toxicity. We prospectively assessed an innovative approach of hydrogel injection between prostate and rectum to reduce the radiation dose to the rectum and thus side effects in dose-escalated prostate radiotherapy.
Acute toxicity and planning parameters were prospectively evaluated in patients with T1-2 N0 M0 prostate cancer receiving dose-escalated radiotherapy after injection of a hydrogel spacer. Before and after hydrogel injection, we performed MRI scans for anatomical assessment of rectal separation. Radiotherapy was planned and administered to 78 Gy in 39 fractions.
From eleven patients scheduled for spacer injection the procedure could be performed in ten. In one patient hydrodissection of the Denonvillier space was not possible. Radiation treatment planning showed low rectal doses despite dose-escalation to the target. In accordance with this, acute rectal toxicity was mild without grade 2 events and there was complete resolution within four to twelve weeks.
This prospective study suggests that hydrogel injection is feasible and may prevent rectal toxicity in dose-escalated radiotherapy of prostate cancer. Further evaluation is necessary including the definition of patients who might benefit from this approach. Trial registration: German Clinical Trials Register DRKS00003273.
Radiation dose-escalation is a major issue in prostate cancer, since there is convincing evidence that cure rates indicated by biochemical disease-free survival and prostate cancer-specific survival depend on the radiation dose to the target
Advanced treatment delivery such as intensity-modulated radiotherapy (IMRT) and image-guided radiotherapy (IGRT) demonstrated a decrease in rectal toxicity compared to three-dimensional conformal radiotherapy (3D-CRT) with equal radiation doses
A recent technique for better sparing of the rectal wall is mechanical separation of the prostate and rectum by placement of a spacer. Several different approaches are currently under clinical investigation such as hyaluronic acid
The current study reports the first prospective toxicity data of dose-escalated IMRT to 78 Gy in combination with rectal separation by a PEG-based medical device, and evaluates feasibility and acute toxicity.
Eleven patients with histologically confirmed, organ confined (T1-2 N0 M0) adenocarcinoma of the prostate (Gleason score 6–7, PSA levels below 20 ng/ml) were enrolled in a prospective study for evaluation of acute and chronic toxicity of IMRT to 78 Gy to the target volume by using the hydrogel spacer SpaceOAR™ (SpaceOAR™ System, Augmenix Inc., Waltham, MA) for rectal separation. The choice for this PEG-based hydrogel compound was derived from the evaluation of biocompatibility, residence time and costs as discussed by Susil et al.
All patients underwent prostate MRI (magnetic resonance imaging) to exclude extraprostatic spread. The injection of the hydrogel was performed in an outpatient setting using local anaesthesia and oral antibiotic prophylaxis. After transperineal needle insertion between the rectum and the Denonvillier fascia and hydrodissection with saline under ultrasound control, the hydrogel was injected. A subsequent MRI scan was performed to facilitate the radiation planning process by easy visualization of the hydrogel spacer. The distance created between prostate and rectum achieved by the spacer was measured at prostate apex, center and base. To avoid artifacts caused by different filling of seminal vesicles, the prostatic base was defined as prostate 3 mm below the origin of the seminal vesicles.
Radiotherapy was planned on the basis of three subsequent CTs (computed tomography) in the supine position with a slice thickness of 3 mm. The 3 CT datasets were registered with respect to the bony structures using the Treatment Planning Software (TPS) Oncentra Masterplan® (Theranostic GmbH, Solingen, Germany). Image fusion of the post-injection MRI and CT data sets for visualization of the spacer was performed using a mutual information algorithm. Clinical target volumes (CTV) and organs at risk (OAR) were contoured in each of the three CT data sets by two radiation oncologists (ACM, FP) with assistance of a specialized radiologist for prostate cancer (UK). The CTV included prostate only for low risk patients and an additional proximal 1-2 cm of seminal vesicles for intermediate risk patients. OARs comprised rectum extending from the anal verge to the rectosigmoid flexure, entire bladder, large and small bowel if present, bilateral femoral heads, penile bulb and skin.
From the 3 delineated contours for CTV, a single enclosing union was derived to account for interfraction organ motion and volume changes. Expansion of this union by 7 mm isotropically led to the coverage probability planning target volume (PTVCP). Similarly, OAR unions were created from 3 separately delineated contours. The prescribed dose for the PTVCP was 5x2 Gy/week to a total dose of 78 Gy using a coverage probability approach based on an equivalent uniform dose (EUD) concept. The coverage probability approach consists of assigning individual coverage probabilities of the PTVCP and the OARs to each voxel. The cumulative probabilities are then used as local weights in the cost function during IMRT optimization. As described previously, this treatment planning strategy provides robust IMRT plans and optimal rectal sparing in dose-escalated prostate IMRT
IMRT treatment plans were generated with the software package Hyperion® (University of Tübingen, Tübingen, Germany) which uses a Monte Carlo dose engine. Serial constraints were implemented for bladder (k=8) and rectum (k=12) to reach a final maximum EUD of 60 Gy and 65 Gy, respectively
Planning CTs and radiotherapy were performed with a bladder-filling protocol and the use of laxatives. Patients with intermediate risk constellation were offered additional antihormonal therapy for 4–6 months. Acute toxicity was documented weekly during radiotherapy and three months thereafter according to RTOG (Radiation Therapy Oncology Group) classification
The hydrogel spacer was successfully injected in ten of eleven patients treated at our institution from August 2011 to August 2012. Patient characteristics are summarized in Table
With the use of prophylactic antibiotics, no complications such as inflammation, urinary retention or other side effects occurred. Four of the eleven patients reported slight discomfort lasting for a few days post-injection. The hydrogel placement was correct in all injected patients, as shown in the subsequent MRI scans (example in Figure
Figure 1
Example of MRIs (T2 TSE) performed before (a) and after (b) injection of a hydrogel spacer
Example of MRIs (T2 TSE) performed before (a) and after (b) injection of a hydrogel spacer. The respective plan in axial (c) and sagittal view (d) with 70 Gy (light orange) and 74 Gy (orange) isodoses shows the rectal sparing with the use of the hydrogel spacer. Prostate (red), tumor (white), rectum (blue) and hydrogel spacer (yellow, white shading in CT scans) are indicated.
Dose-escalation was possible, prescribed doses and constraints for organs at risk were met in all patients. The mean EUD for the PTVCP was 76.2 Gy corresponding to 78 Gy prescribed to the target volume. While high doses were administered to the spacer, the mean rectal dose was limited to 40.4 Gy (Table
Acute rectal toxicity was mild, as shown in Figure
Figure 2
Acute rectal toxicity
Acute rectal toxicity. Acute rectal toxicity was measured at baseline, weekly during IMRT and 4–12 weeks after treatment according to the RTOG-criteria. * Two patients were graded as RTOG G1 only due to mucous discharge, but not due to any other rectal symptoms.
This is the first report on prospective toxicity data for dose-escalated IMRT to 78 Gy with the use of a spacer for prostate-rectum separation in clinically localized prostate cancer.
The insertion of any spacer in the Denonvillier space creates a distance between prostate and rectum that allows calculation of dose-escalated radiation treatment plans, without exceeding accepted dose restrictions to the rectum. This has also been demonstrated by other groups
No significant side effects occurred in the first ten patients undergoing hydrogel injection on an outpatient basis. Four patients reported slight discomfort directly after the injection. As discussed by Vordermark et al.
For comparison of different IMRT fractionation schedules with regard to rectal toxicity, we calculated equivalent doses with 2 Gy per fraction with an α/β of 4.8 Gy, which was described for late rectal toxicity based on RTOG 94–06
Our prospective data firstly show very low toxicity of dose-escalated IMRT with rectal separation by the use of a hydrogel spacer. The decrease in rectal dose was associated with only mild rectal acute toxicity (no grade 2 or higher) which completely resolved after three months. This may result in a low rate of late toxicity. Overall, this prospective study suggests that hydrogel injection is feasible, leads to low rectal acute toxicity and may therefore prevent rectal late effects in dose-escalated radiotherapy of prostate cancer. Further evaluation is necessary to define which patients might benefit from this approach.
Competing interests
On behalf of all authors, the corresponding author states the following: Augmenix Inc. provided ten hydrogel spacers for the patients.
Authors' contributions
FE: Substantial contributions to interpretation of data, drafting and revising the article and final approval. SA: Substantial contributions to data acquisition, revising the article critically and final approval. FP: Substantial contributions to conception, revising the article critically and final approval. MB: Substantial contributions to conception, revising the article critically and final approval. DZ: Substantial contributions to conception, analysis and interpretation of data, drafting the article and final approval. PS: Substantial contributions to interpretation, revising the article critically and final approval. CG: Substantial contributions to interpretation, revising the article critically and final approval. UK: Substantial contributions to data acquisition, revising the article critically and final approval. DT: Substantial contributions to data acquisition, interpretation of data and final approval. DS: Substantial contributions to data acquisition, revising the article critically and final approval. ACM: Substantial contributions to acquisition, analysis and interpretation of data, drafting the article and final approval. All authors read and approved the final manuscript.
The authors acknowledge the assistance of Elizabeth Krämer in copyediting the manuscript.
Higher-than-conventional radiation doses in localized prostate cancer treatment: a meta-analysis of randomized, controlled trials
EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and treatment of clinically localised disease
Hazards of dose escalation in prostate cancer radiotherapy
Role of intensity-modulated radiotherapy in reducing toxicity in dose escalation for localized prostate cancer
Incidence of late rectal and urinary toxicities after three-dimensional conformal radiotherapy and intensity-modulated radiotherapy for localized prostate cancer
Update of Dutch multicenter dose-escalation trial of radiotherapy for localized prostate cancer
Escalated-dose versus standard-dose conformal radiotherapy in prostate cancer: first results from the MRC RT01 randomised controlled trial
Late gastrointestinal toxicity after dose-escalated conformal radiotherapy for early prostate cancer: results from the UK Medical Research Council RT01 trial (ISRCTN47772397)
Cross-linked hyaluronan gel reduces the acute rectal toxicity of radiotherapy for prostate cancer
Transperineal injection of hyaluronic acid in the anterior perirectal fat to decrease rectal toxicity from radiation delivered with low-dose-rate brachytherapy for prostate cancer patients
Human collagen injections to reduce rectal dose during radiotherapy
A novel device for protecting rectum during prostate cancer irradiation: in vivo data on a large mammal model
Application of a spacer gel to optimize three-dimensional conformal and intensity modulated radiotherapy for prostate cancer
Effects of prostate-rectum separation on rectal dose from external beam radiotherapy
Application technique: placement of a prostate-rectum spacer in men undergoing prostate radiation therapy
Cross-linked hyaluronan gel improves the quality of life of prostate cancer patients undergoing radiotherapy
Robust treatment planning for intensity modulated radiotherapy of prostate cancer based on coverage probabilities
Normal tissue dose-effect models in biological dose optimisation
Toxicity criteria of the Radiation Therapy Oncology Group (RTOG) and the European Organization for Research and Treatment of Cancer (EORTC)
Radiation dose-volume effects in radiation-induced rectal injury
Combination of dose escalation with technological advances (intensity-modulated and image-guided radiotherapy) is not associated with increased morbidity for patients with prostate cancer
Transperineal injection of hyaluronic acid in anterior perirectal fat to decrease rectal toxicity from radiation delivered with intensity-modulated brachytherapy or EBRT for prostate cancer patients: in regard to Prada et al. (Int J Radiat Oncol Biol Phys 2007;69:95–102.)
Estimation of alpha/beta for late rectal toxicity based on RTOG 94–06
Functional outcomes and complications following radiation therapy for prostate cancer: a critical analysis of the literature
Long-term outcome of high dose intensity modulated radiation therapy for patients with clinically localized prostate cancer
Hypofractionated intensity-modulated radiotherapy (70 Gy at 2.5 Gy per fraction) for localized prostate cancer: Cleveland Clinic experience
Analysis of biochemical control and prognostic factors in patients treated with either low-dose three-dimensional conformal radiation therapy or high-dose intensity-modulated radiotherapy for localized prostate cancer
Patients' perspectives on fecal incontinence after brachytherapy for localized prostate cancer
Late fecal incontinence after high-dose radiotherapy for prostate cancer: better prediction using longitudinal definitions
Pre-publication history
The pre-publication history for this paper can be accessed here:


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subset: commoncrawl


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* The reflection staring back at you from the Reflective Collection provides a true look at the whimsy that punctuates your personal decorative style.
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Just in time for Saint Patrick's Day! Alphie McCourt, author of the convivial memoir A Long Stone's Throw and youngest brother of Frank McCourt (Angela's Ashes), releases his reminiscences of the beloved holiday. This story, written and read by the author, strings together retellings of a few of the expatriate Irishman's most memorable Saint Patrick's days here in the USA. In his cordial brogue, Alphie relates the history of the Catholic feast day, and moves candidly, with great warmth and self-deprecation, onward through the past few decades to relate his personal, hilarious highlights of the day when everyone loves to become Irish in the wearing o' the green.
Genre: Biography & Autobiography, Humor
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Interesting list from Adrian Dater on VERSUS.com, which apparently still covers hockey in the offseason: The Top-10 Goalies in the NHL. Dater's list, with the usual helpings of insight and outrage:
1. Ryan Miller(notes), Buffalo Sabres
2. Ilya Bryzgalov(notes), Phoenix Coyotes
3. Martin Brodeur(notes), New Jersey Devils
4. Craig Anderson(notes), Colorado Avalanche
5. Roberto Luongo(notes), Vancouver Canucks
6. Niklas Backstrom(notes), Minnesota Wild
7. Tomas Vokoun(notes), Florida Panthers
8. Henrik Lundqvist(notes), New York Rangers
9. Miikka Kiprusoff(notes), Calgary Flames
10. Jimmy Howard(notes), Detroit Red Wings
Dater later (rhyme time!) added this footnote to the column:
Second-thought, tough omissions a week later: Could Jaroslav Halak(notes), Marc-Andre Fleury(notes) or Cam Ward(notes) be in the top 10? Arguably, yes. Ward might be the one guy I'd stick in there if I had a do-over on this column actually. His saves percentage was better (.916-.913) than Luongo's, for instance. And he's won a Cup and taken a team to a conference final since 2006. And yet, he wasn't brilliant last year, either. A tough call either way.
Yes, he won a Cup. Just like Fleury did with the Pittsburgh Penguins. Not that it ever seems to matter for MAF.
Agree with the list? Disagree? We do both, while asking you: Who are your top-10 goalies in the NHL as of today?
Dater covers the Avalanche for the Denver Post, and acknowledges that might be the reason Craig Anderson is preposterously overrated on his list after one season of strong hockey. Maybe he just erased Steve Mason's(notes) name from last year's list and plugged in Anderson's.
Miller at No. 1 should be universally approved: He's always been fundamentally sound, but in the last two years has started winning games on his own like the great ones do. Dater's justification for Bryzgalov at No. 2:
Talk to a lot of hockey people, and they just love this guy. Yeah, he's a bit of a flake, but that's what goalies have to be to face 100-m.p.h. pieces of vulcanized rubber. He's huge in net, literally and figuratively. He should have been the starter for Russia in the Olympics.
Sorry, not buying it. The toughest thing to figure out about these goalie lists are which players are the beneficiaries of systems and talent around them, and which guys have to do the heavy lifting. In other words: Every debate that's ever raged about Marty Brodeur's place in history.
Bryzgalov put up his best career numbers last season while facing the lowest number of shots on average that he's faced as a Coyotes starter. Coach Dave Tippett and the defense didn't carry him to a Vezina Trophy nomination, but his accomplishments don't warrant second-best-keeper-in-the-league status. Yet.
Our Top 10, off the top of the noggin':
1. Miller
2. Brodeur
3. Vokoun
4. Luongo
5. Bryzgalov
6. Lundqvist
7. Backstrom
8. Rinne
9. Ward
10. Kiprusoff
Vokoun has quietly put together a stellar little career with some pretty bad hockey teams. It's a shame that, at 34, he's not gotten a shot with a legit Cup contender in his career. And that his teammates assault him.
Halak and Anderson have to do more before they can earn this status. One year doesn't cut it for Anderson, and one god-like postseason for Halak doesn't cut it either. Same goes for Jimmy Howard. Just not comfortable putting any of them on this list yet; again, ask Steve Mason why.
All that said: Why Pekka Rinne(notes) of the Nashville Predators, then?
We have a two-year sample for the guy and it's obvious he's turning into something special. Yes, the system helps and, yes, Shea Weber(notes) and Ryan Suter(notes) skating in front of him helps, too. But 14 shutouts in his last 103 starts is damn impressive; Brodeur has 14 in his last 106 starts, for example.
Would you find room for Marc-Andre Fleury on this list? We can sometimes be Fleury apologists here, because the dude takes way too much heat for a competent goalie with a ring. But he remains so inconsistent, in a way the other guys on this list aren't. (Outside of No. 10, that is.)
The two biggest questions, I think, when it comes to rankings like Dater's: How much do you weigh the impact of a defensive system in front of the goalie, and how much do you weigh the postseason, considering that some of these guys (like Vokoun) have yet to really prove themselves in the Stanley Cup tournament?
What's your top 10?
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- At first it seems kinda of stupid, an emperor forced to go to school in order to retain his Incan emperor headdress.... And then I realized: maybe the entire show was an attempt to keep kids in school. Hm.... iamdatroper
- Kuzcos' Aesop Amnesia makes a lot more sense when you remember that he was spoiled his whole life before then, so it would take a while to get over that.
Fridge / The Emperor's New School
Fridge Brilliance


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The most popular doctorate is the Doctor of Philosophy or Ph.D. Ph.D.s and other study doctorates prepare graduate student to launch new plans that add to the common knowledge base of the field. Candidates for and holders of Ph.D.s often seek professions as professors and researchers, but many also go on to different roles in the charitable, public, and private sectors.
It is with no doubt that the world is taking a sounding turn as far as technology is concerned. Everyone would love to understand whatever it takes to run affairs through technology. This is within range for anyone. You can now take a course in technology. For further studies, there is a doctoral degree in technology. The program is available worldwide, and skills learned can be practiced anywhere in the world.
Turkey, officially the Republic of Turkey, is a transcontinental country, located mostly on Anatolia in Western Asia and on East Thrace in Southeastern Europe. Many Turkish universities (both public and private) are participating in pan-European student exchange programs (Socrates, Erasmus, and the like). Some also have agreements with non-European universities, too.
Top Doctoral Programs in Technology in Turkey 2017
The Graduate School of Social Sciences and Humanities at Koc University welcomes applications for its Master and PhD in Design, Technology and Society. [+]
PhD in Design, Technology & Society
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Champagne Jean Diot Cuvée Sélection NV, France October 11, 2016 at 7:17 pm- Comment
Champagne Jean Diot Cuvée Sélection NV, France (£19.95 Richard Dawes Fine Wine)
Attractive mix of ripeness and freshness, young and lively, with toasty brioche notes alongside the raspberry, apple and citrus fruit, and a clean mineral tang to the finish. Not hugely complex but an appealing dainty style, and a keen price too. S-


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If, late in the evening of August 5, NASA's Curiosity rover survives what might be the most daring interplanetary touchdown in history, the six-wheeled robot will find itself in a dramatic landscape ripe with research opportunities: Gale Crater, an enormous basin with a 5-kilometer-tall mountain in the middle, called Mount Sharp. There, Curiosity will look for evidence of water, energy sources and organic carbon — the hallmarks of life-friendly environments, past or present.
By reading the rocky clues hidden in that mountain, the rover will also try to peer back in time and learn what environments on ancient Mars were like. For 98 weeks — one Mars year — the rover and its 75 kilograms of science instruments will attempt to probe the deep Martian past.
Though the mountain is the mission's primary target, scientists hope the rover will first alight on one particularly intriguing patch of rock.
"We don't really know what that material is," says project scientist John Grotzinger of Caltech.
Unlike the rest of the crater floor, this rock appears to be hard and capable of holding onto the heat of the day. In the absence of volcanic activity, that property is suggestive of compounds cemented together by water. Since scientists are interested in studying where water flowed on ancient Mars, the warm, rocky patch would be an ideal place for the rover to start poking around.
But not for too long. Mount Sharp is "going to be there on the horizon, calling to us," says Ryan Anderson of the U.S. Geological Survey Astrogeology Science Center in Flagstaff, Ariz.
The ancient pile of sediments, rising higher above the surrounding terrain than any mountain in the Lower 48, holds in it the rocky clues to understanding ancient Martian environments and past habitability. The evidence takes the form of mineral layers, some of which — like the clays near the mountain's base — require water to form. As the rover climbs Mount Sharp, the clues it deciphers will help scientists understand how a planet that was once more like Earth became the dry, dusty and acidic ball it is today. "Suddenly, the planet seems to have gotten dry," Grotzinger says. "I like to call it the great desiccation event."
The rover will analyze rocks with a variety of instruments. One, the ChemCam, uses a laser to vaporize a small sample of rock or soil from up to seven meters away. Then, scientists can study the ingredients. Another instrument will drill into rocks, creating a powder that the rover can ingest and analyze for signs of things like organic carbon — a job that Grotzinger says is probably the most difficult the rover will encounter. "This is a really hard thing to do, even on Earth," he says. "Even on a planet that's teeming with life, [organic carbon] almost never gets preserved."
Comparing Mars and Earth may help scientists understand how environmental triggers influence the evolution of life. When studying life's origins and diversity on Earth, Grotzinger says, scientists often wonder what would have happened if specific events — such as the flooding of Earth's atmosphere with oxygen about 2.4 billion years ago — hadn't occurred. "Is there some place that you can compare to where that didn't happen?' That's Mars," he says.
Source: Science News / Nadia Drake / Photo Credit: NASA, JPL-Caltech, ESA, DLR, FU Berlin, MSSS


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text:
I have installed software successfully but when I tried to load it using firefox had problems . so I deleted firefox hoping by defaul explorer would do the trick so I copied the problem here it is .
Explanation: An IP address for the website you requested could not be found. As a result, it was not possible to access the site.
Try the following:
- Refresh page: Search for the page again by clicking the Refresh button. The timeout may have occurred due to Internet congestion.
- Check spelling: Check that you typed the Web page address correctly. The address may have been mistyped.
- Access from a link: If there is a link to the page you are looking for, try accessing the page from that link.
If you are still not able to view the requested page, try contacting your administrator or Helpdesk.
|Technical Information (for support personnel)
This topic was created during version 3.2.
The latest version is 7.5.00101.
1 Reply
Dec 23, 2008 at 10:37 UTC
Hi Ahmed,
1. Would you tell me how you are trying to load Spiceworks? Please walk me through the process that you take from the time that you start the application, until the error/problem occurs.
2. Are you performing the steps from the Spiceworks host machine?
3. How are you trying to connect to Spiceworks when it's running? No matter what your default browser is, you can open up the Spiceworks application in another browser using any of the following URL's:
- http:/
/ localhost:PortNumber
- http:/
/Address:PortNumber IP
- http:/
/ 127.0.0.1:PortNumber
4. Do you possibly have an underscore in your machine hostname?
This discussion has been inactive for over a year.
You may get a better answer to your question by starting a new discussion.


text:
1. Select the Ellipse Tool (L).
2. Double-click the borer tip on your sacking to uncap the oval Options talking box.
3. Enter jammy to recollect numbers for Width and Height. E.g., 200 for Width and 50 for Height.Post ads:
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4. Select Selection Tool (V). Bring it completed the conic you have only haggard and pinch the Alt key. Your awl tip should exposition Double Arrows. This effectuation you are equipped to duplicate your oval.
5. Click and cart your oval to lug away a photocopy spare.
6. Select the Rectangle Tool (M).Post ads:
Ambient Weather WS-5300 Wireless Home Weather Station / One Direction- Harry Poster Music Poster Print, 24x36 / Tiny Love Tummy Time Fun Activity Mat, Frog / Wilton Avanti Everglide Metal-Safe Non-Stick 12 Cup Muffin / Rachael Ray Tools Lil Huggers 2-Piece Tong Set, Orange / I'LL LOVE YOU FOREVER, I'LL LIKE YOU FOR ALWAYS, AS LONG / Woodstock Percussion ZENERGY Zenergy Chime - Solo / Ultrak Jumbo Countdown Timer / Fox Run Cotton Rolling Pin Covers, Set of 2 / Venta Ultrasonic Humidifier / Building Blocks Chocolate Candy Mold - Perfect for Lego / 12 Pairs Neon 80's Wayfarer Sunglasses Kids Teen Party / Set Of 2 Casserole Totes Carrying Bags by Winston Brands / Fred & Friends Stone Cold Ice Trays / LEGO Creator Street Rebel 7291 / BISSELL Swift Sweep Sweeper, 2201-2 / George Foreman GRP99BLK 100-Square-Inch Nonstick
7. Double-click the appliance tip on your canvass to expand the rectangle Options dialogue box.
8. Enter the selfsame Width that you have used for the Ellipse. E.g., 200 for our sample.
9. Enter any Height you deprivation.
10. Position the two ellipses just about on the top and pedestal edges of the rectangle. Don't make anxious if they do not string up faultlessly to match a 3-D cylinder.
11. Open your Align reach (Shift F7).
12. Left click your Selection Tool (black arrowhead) and retarding force completed all 3 objects to choice them.
13. Click the Horizontal Align Center lever to align the centers of both ellipses and the parallelogram without blemish finished the halfway band.
14. Click and prize the high ellipse. Press the fluff or up mark as necessary until its sides column up utterly near the top crest of the rectangle.
15. Click and prize the nethermost ellipse. Press the downhill or up mark as needful until its sides dash up utterly with the pedestal boundary of the parallelogram.
16. NOTE: The oval will be absolutely allied beside the parallelogram when the light boxes on both sides of the ellipse's length lines up with the corners of the rectangle. Or, you can likewise prime View > Snap to Point dimension from the primary bill. That way, when you bring up a loop/ellipse concluded a parallelogram beside the very diameter and width, they will touching on easy.
17. Click and select the top oval.
18. Right sound and from the pop-up bill quality Arrange > Bring to front part. The top of your container is done.
19. Select the Direct Selection Tool (A).
20. Click on the pedestal creep of the rectangle and clutch Delete. The lowermost of your container is besides finished.
21. Select the bottom conic and the rectangle and prize Object > Group from the bill to alliance them into a isolated vivid entity.
22. Now color it any way you privation.
23. Then quality the top oval and color it distant. It will mental representation rectangle and darken its top brim.
24. Now prime everything on your setting (Control A) and superior Object > Group from the bill of fare to set everything as a unary written aim.
Your cylinder is ready. You can now modify and use this vector table nevertheless you impoverishment minus losing anything from its resolution.


text:
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Talk Roundup
4 July 2008
Back in the Mumsnet Classics archive is the record of the night that TheArmadillo's DH posed the question, "Do you have a zombie plan?" Lulumama had seen the movies and knew exactly what to do, "I would run around in a skimpy vest and knickers, looking helpless and screaming" and 2-Brooms Boco reassured, "It's fine, if you hit a zombie with a stick they pretty much crumple and break in half." FrannyandZooey asked her DP whether he had a plan but "He looked angry and said 'Is this something to do with Mumsnet by any chance?'" Hunkermunker quizzed her other half and was informed, "He has a sword (don't ask) and that will be used to chop up any zombies who might breach our defences." Furball and her brother had not considered zombies but had a Cyberman plan, "My brother was going to grab his handles on his head and I had to pull his zip down." "The power of MN" observed an anxious Mytwopenceworth, "I now feel I really need a zombie plan."
If your children had been named after the place of their conception what would they be called? asked McDreamy, proud mum to Louis, Linton and Bude. OneLieIn revealed that her children would be named 'Sofa' and 'Shed' "or Sofa could be 'Waiting for a chicken tikka masala to arrive' but I think it sounds a bit long." Worryingly, Melrose would have given birth to a 'Canal tow path' while Idobelieveinfairies would have eight 'Jersey's; "I guess I would have to number them." Tiredemma would have been mum to 'Magalluf and Birmingham', which is pushing it but a definite non-starter on the Baby Names board would have been JudgeNutmeg's 'Westward Ho!'
Panic on the Good housekeeping forum this week when Chloemegjess had impending visitors and a "number 2" in my loo that won't flush. "A plumber's bonus!" chortled BettySpaghetti, and after the initial gasps of horror at her confession that it had been around for 'a few days', polite suggestions were made, such as using boiling water, bashing it with a stick from the garden and mashing it up with a coathanger. Hassled though, in true Mumsnet tradition had been there and done that. Faced with similar circumstances she "sawed a poo in half with one of the old gammy knives that lurk at the back of the cutlery drawer. That did the job (as it were)."
What exactly is Collective worship in primary school? asked curious "humanist/atheist" Dragonbutter, "the term 'worship' is worrying me." RavenAK set her mind at rest, "Everyone troops in to strains of 'Search for the hero inside yourself'. Head or suitable delegate waffles on for a bit about being nice to each other. Brief video of children in developing country foraging on refuse dump. Head/delegate explains that we are now collecting old mobile phones to help dump-foraging children. Football etc results. Bollocking about not keying the staff cars. If time, lame rendition of 'All Things Bright & Beautiful'." "Collective worship at school was probably what turned me into an atheist" reassured Fairymum.
Urgent help - I have trapped a live rat under a bucket panicked ratcatcher Blu this week, "What shall do?" "OH MY GOD. My worst rat scenario," gasped a shocked 2sugars, who has clearly never read American Psycho, "I would have screamed and run." Madlentileater was in a similar situation and tried to gas the rat using cheap household cleaner on a rag, only to make the rat woozy, "I had to grab a spade and kill it, felt like I was using my bare hands, and I was in total shock and swearing and screaming at the top of my voice while the nice girls from the school nearby walked past to their hockey lesson." Cocolepew recalled witnessing the day a rat wandered into her Gran's eyeline, "she grabbed her coal shovel, smacked on it the head, picked it up and threw it in the fire. The whole time carrying on with her conversation as if nothing had happened." Blu's rat was finally despatched by men from the council, "Yes, the council - notorious for its spectacular reaches of dismal incompetence in education, health, housing benefit administration, parking management, planning, regeneration, etc is quick off the mark in live-rat crisis management. They probably have a good zombie plan too."
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Andrei Rublev, the 15th-century Russian artist, left us one of the most poignant representations of the mystery of the Trinity: his painting The Trinity, also called The Hospitality of Abraham. Currently in the Tretyakov Gallery in Moscow, this jewel of Russian art shows the three angels who visited Abraham in his tent. Art historians and Bible scholars agree that these three angels reflect the triune God: "The Lord appeared to Abraham near the great trees of Mamre" (Gen 18:1). Rublev's masterpiece speaks to us through the centuries with the image of the angels' silent peaceful communion, mutual love, unity, and humility.The Gospel writers create a similar image. In our study this month, their Spirit-inspired words will speak to us about the Trinity and worship, the Trinity and truth, the Trinity and God's gifts, the Trinity and the power of God, and more. And as we study various passages in the Gospels, we pray the Lord would draw us into communion with the Great I AM, and to each other through His Spirit—in love, unity, and humility.Thank you for studying the Bible with Today in the Word this month! May we welcome the Lord into our homes and our hearts, as Abraham did near the oaks of Mamre. And may we rejoice in the union we have with God through Christ by His Spirit!
Executive Editor: Bruce Everhart; Content Strategy: Georgia Joseph; Editor: Helen Moline; Managing Editor: Heather Moffitt; Associate Editor: Elena Mafter; Contributing Editors: Jamie Janosz, John Koessler; Writer: Devotionals-Brad Baurain; Art Director: Lynn Gabalec; Graphic Designers: Larry Bohlin, Dana Chen; Business Manager: Paul B. Currie
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Moody Global Ministries is the sole publisher of Today in the Word, copyright © 2017 by Moody Global Ministries. All rights reserved.
Scripture taken from the Holy Bible, New International Version® , NIV® Copyright © 1973, 1978, 1984, 2011 by Biblica, Inc.TM Used by permission. All rights reserved worldwide. Scripture taken from the New American Standard Bible®, Copyright © 1960, 1962, 1963, 1968, 1971, 1972, 1973, 1975, 1977, 1995 by The Lockman Foundation. Used by permission.


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There's a report in the Northern Echo, but not reported widely elsewhere, that Brian Aitken, the former editor of the Journal, has joined Newcastle United as the head of corporate affairs.
Brian's new role will be to bring the Tyneside club closer to the area's business community and get Newcastle involved via partnerships with local industry.
Brian Aitken former editor of the Journal
Aitken left the Journal two years ago and set up his own consultancy business and the news today is that he will work closely with Newcastle United's head of business development, Nicole Atkin.
This is what Brian has said about his new job:
"Newcastle United is the biggest brand in the region; it is open for business, and open to business."
"Managing Director Lee Charnley wants to position the club at the heart of the North-East's business activities."
"It is exploring the formation of a business partnership scheme, to be fully up and running for the 2017-2018 season and I want to talk to as many people as possible to hear what sort of member benefits they would like to see on offer."
"It's a fantastic concept and I'm looking forward to working with Lee, Nicole and the club's corporate sales and partnerships teams."
"With Rafael Benitez bringing the feel-good factor back to St James' Park, there has never been a better time for the process to begin."
Managing Director Lee Charnley runs the club on a day-to-day for owner Mike Ashley and he had this to say about the new appointment:
"We're excited to be bringing Brian on board; he is well-known and respected in the region."
"While the club has many close, established relationships with businesses, we recognise we have, in some respects, become disconnected from the North-East business community."
"We know we need to do more to be part of the vibrant entrepreneurial scene and to give businesses the opportunity to be part of the club."
"St James' Park has the potential to sit at the very heart of regional business and we want to work closely with the business community to understand exactly what they need from us."
"We want to support regional businesses, both through their association with us and by giving them opportunities to do business in an exciting location."
"In turn we know the club will be strengthened by nurturing those relationships."
We wouldn't be at all surprised if this move has been recommended by manager Rafa Benitez, who has offered many suggestions of how the club can be better organized into a modern-day top football club.
And Rafa himself is a savvy businessman with good business sense.
This is another good step to get Newcastle United more connected with the local area – in this case the local area businesses.
Rafa has made it known he sees Newcastle United as the center of everything in the area, so getting involved with local businesses makes good sense for the club.
Comments welcome.


text:
By Gary Thorne, Special for USA TODAY
How about a little hot stove talk about the World Series.
There has been much made of the television ratings for the Series this year. The numbers were not good.
The series averaged an 8.4 rating and a 14 share. Those are the lowest numbers ever for a Series and 17% below the previous low recorded in 2006.
There is no question the short five-game series, the miserable weather in Philly and Tampa being 13th in market size did not help.
As a result, there have been the post-mortem calls for day games, an earlier series start, earlier game starts and consideration of a neutral site World Series to avoid the weather problems.
Those calls have been heard before ... and ignored. Television dominates the decision in every case and so long as rights fees pour in, television will make the calls on those questions with one goal in mind — maximizing audience size for ad sales.
Perhaps there is a common ground regarding the suggested changes and television's search for numbers.
The implementation of earlier game starts and not running the Series into early November, as will happen in 2009, might increase the viewer numbers.
While the television audience may have been down for the last Series, there are some interesting numbers regarding press coverage that deserve thought.
The Pew Research Center's Project for Excellence in Journalism keeps daily tabs on just what the media in this country are covering.
The project analyzes 48 media outlets that include 13 newspapers (The New York Times, the Wall Street Journal, the Arkansas Democrat-Gazette and the Modesto Bee), five websites, seven TV networks, 15 cable outlets and eight radio broadcasts.
The Phillies winning the World Series was the seventh biggest story the week of Oct. 27- Nov. 2 according to the study.
Keep in mind that came during a time when the presidential race was in full swing and the economy was falling apart.
The coverage of the MLB postseason as a whole ranked second among sports events this year.
Of those 48 outlets surveyed, there were 95 stories about the MLB postseason, three times more than the coverage by those outlets of the NCAA basketball tournament.
That is more food for thought in light of the hype that surrounds "March Madness."
So what was number one in media sports coverage for 2008? The Olympics took the cake, the milk and the plate.
The Pew study showed the Olympic stories outpaced all other sporting events by a margin of 8-to-1.
As an aside, the study found "only a little more than half of the coverage (442 stories) was directly related to the events or to athletes."
Much of the Olympic coverage had to do with Chinese political, environmental and diplomatic issues.
I digress.
Even the Super Bowl, speaking of hype, finished behind the MLB postseason, albeit not by much (95 stories to 93).
Still, for MLB, it is a pretty impressive stat to be second only to the Olympics in stories generated.
The study suggests a disconnect between the television numbers and the interest in the postseason by fans.
Some argue fans lose interest if their team is not involved. That certainly has some basis in fact — the numbers for television are always exceedingly high in the home cities.
However, if the Pew study reflects a national consensus, the media outlets at least think the postseason is worthy of coverage no matter who is playing.
That would seem to make sense. While baseball fans of teams other than those in the playoffs might not watch all or any of the television coverage, fans do care to know about the games.
No true baseball fan would say they were ignoring the postseason, no matter how much they might dislike the teams involved.
That brings us back to television. What the study may be saying is while fans will watch their favorite team at whatever the time or season, the rest of the baseball fan world needs convenience and compelling stories to bring them to the tube.
8:30 p.m. ET starts, weather-decimated games and players in parkas just might not be that convenient or compelling.
If we compare postseason television broadcasting to the recent election, television has the votes of fans whose teams are playing locked up, but it needs to capture the independent voters.
An approach that implements some of the above proposals for refurbishing postseason television presentations might just bring those independents to the polling place ... their favorite couch.
Guidelines: You share in the USA TODAY community, so please keep your comments smart and civil. Don't attack other readers personally, and keep your language decent. Use the "Report Abuse" button to make a difference. Read more.


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CSIWiki is a free Web-based construction and design industry encyclopedia — a living document to which any construction professional can contribute. The goal of CSIWiki is to provide common definitions of terms related to construction documentation. With few exceptions, CSIWiki's articles can be edited by anyone with access to the Internet, simply by clicking the "edit this page" link. Construction professionals are invited to add information, cross-references, and citations. Through active participation, the CSIWiki community can create a manual that combines their collective knowledge and experience.
CSI AudioCast
More than 100,000 CSI AudioCast episodes have been downloaded since its launch at audio.csinet.org. CSI's audiocast focuses on news, education, interviews, and best practices for the construction and design industries. This spring, CSI will add two new series to the AudioCast line up – bimWITS (focused on BIM and offered in collaboration with the buildingSMART Alliance) and the Week in Green (focused on innovations in sustainable construction).
CSI Forums
Got a Question? Ask it in the CSI Forums. CSI's forums give you access to CSI's expert members! Right now, people are talking about specs, construction practices, products and systems, certification, MasterFormat 2004 Edition, SectionFormat, UniFormat, and membership and leadership issues.
Join us in Portland, Oregon, for the 2008 NSPE Annual Conference, July 24–27. We've arranged a stellar lineup of top-notch speakers and informative seminars—plus an array of special events to get you out and about in this beautiful city.
Participants can earn up to 19 professional development hours at this year's conference education sessions. Education session topics cover PEs in the LEED world, global energy issues, emerging technologies, sustainable design, risk management, profitability, best practices, stress management, and other current professional topics. In addition, you'll find countless opportunities to network with engineering leaders, make important business connections, and be brought up-to-date on issues impacting our profession and our Society.
While you're there, be sure to take in Portland's rich history and breathtaking sights. Go for a fund-raising Fun Run along the Willamette River . . . play golf at a Robert Trent Jones course…relax while "cruising down the river". . . socialize at an exclusive ice breaker reception . . . visit beautiful northwestern parks . . . experience Oregon wine and brewery venues . . . and much more.
We look forward to welcoming you and offering a dynamic, enjoyable, and highly meaningful conference experience.
Visit the NSPE Web site to register today!
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Covering over 35 disciplines, including the five licensure-eligible disciplines in addition to 30 other recognized branches, the NSPE Engineering Income & Salary Survey is designed to give you the most accurate pay information for all engineering professionals. Participation is free and open to both NSPE members and nonmembers.
Your input is essential to the validity of the survey data. It will enable us to produce a survey with the most accurate representation of the profession, and one that will continue to be purchased as the standard. To promote a broad range of participants, we ask that you encourage other working engineers, both NSPE members and nonmembers, to contribute to this growing database by also submitting their data online. Total confidentiality and anonymity of the survey data is assured, and the data submitted will not be used for any other purpose.
Also, for the first time, a FREE individualized report summary will be available to all who participate in this years survey. This special benefit has been added as an incentive to keep participation growing so that NSPE can continue to provide the most statistically valid data available.
Visit the NSPE Web site to participate in the Salary Survey.
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Join your colleagues for continuing education at the NSPE Fall Semester October 23 - 24, 2008 at the Maritime Institute in Baltimore, Maryland. The exceptional conference facility is conveniently located close to Thurgood Marshall Baltimore-Washington International Airport. With the state-of-the-art meeting rooms and comfortable, moderately priced accommodations, you couldn't have a better environment to support your learning.
Put this excellent educational opportunity on your calendar now. More details will be available on the NSPE Education Web page later in the summer.
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Join your colleagues for continuing education at the NSPE Fall Semester October 23 - 24, 2008 at the Maritime Institute in Baltimore, Maryland. The exceptional conference facility is conveniently located close to Thurgood Marshall Baltimore-Washington International Airport. With the state-of-the-art meeting rooms and comfortable, moderately priced accommodations, you couldn't have a better environment to support your learning.
NSPE Calendar
24-27 NSPE Annual Conference
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Division of Health Engineering
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John Cardarelli II, Ph.D., P.E.
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- Last login Nov 12, 14 @ 6:25 am
Where do you get varsity jackets?
Aye, thanks to yall for helping but i'm going to new york so i might find one in brooklyn. Ayye and i checked, i can't find a "varsity jacket section" anywhere, and JD, you're link doesn't take me to anywhere that sells clothes. Karmaloop is pretty awesome but it doesn't have the nice leather ones.2 Weeks ago in Off Topic
TOP 5 Rappers alive
In my opinion: Big Sean Rick Ross Lil Wayne Tyga Eminem Don't hate, i just thought this up really quick2 Weeks ago in Music Discussion
whats the best...
LMAO, XD that was so funny. Who puts water in their cereal LLS!2 Weeks ago in Off Topic
Where do you get varsity jackets?
Why are they so rare and hard to find? Lol, I shop online (can't even remember the last time i bought stuff from the mall) and i can't find any jackets but i see celebrities wearing them all the time.2 Weeks ago in Off Topic
What are your views on guys doing their eyebrows and shit?
Son, men don't do that son -________-2 Weeks ago in Off Topic


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About Peteski
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Peteski replied to fiberglasscivic's topic in Windows XPthe shutdown event tracker is enabled by default in server 2003 it hardly constitutes as an easter egg, its just so that windows knows why you shut it down
Peteski replied to amit_talkin's topic in Windows Vistafor reference, the original source is here: http://anti-tgtsoft.com/repository/uxtheme/
Peteski replied to YKWIA's topic in Windows XP Media Center Editionbecause then all the shell calls would be run through media center
Peteski replied to YKWIA's topic in Windows XP Media Center Editionor you could just add a startup entry for ehshell.exe it would be a lot simpler, but less efficient
Peteski replied to RBCC's topic in Unattended Windows 2000/XP/2003logon, yes '03 uses the classic logon screen and xp uses the new logonui screen boot, yes the progress bar is a shade of grey instead of blue / green the main branding bmp is also predictably different desktop, kinda by default '03 doesn't use themes so you're in classic mode the start menu default places and pinned items are also different my computer doesn't show my documents or common tasks and the details view is the global default overall, yes there are quite a few changes hardware acceleration is disabled drive mounting is disabled ieharden and shutdown event tracker are both enabled need any specifics ? just ask
Peteski replied to CrazyCanuck,Eh?'s topic in Application Installsyou can take out the guess work of whether its all users or local user by viewing its location via folder properties.
Peteski replied to daedalus123's topic in Customizing Windowsall that you really need in an xp icon is 32bit versions of the 16x16, 24x24, 32x32 and 48x48 if you're using large icons mode the only time you need to go into lower bit versions are when your graphics card cannot support them.
Peteski replied to dirtwarrior's topic in Hardware Hangoutthis could also be a backlight issue, if the image is still shown but extremely faintly. what angle are you using the screen at ?
Peteski replied to FrizzleFry's topic in Unattended Windows 2000/XP/2003i've been trying to do this for some time (glad i'm not the only one to be honest) setting a mixed case value in winnt.sif [unattended] TargetPath= always produces a version in capitals
Peteski replied to Burke's topic in Windows 2000/2003/NT4seems obvious, but have you set audio acceleration to full ? its default value can sometimes create symptoms like the ones you describe.
Peteski replied to roadapathy's topic in nLiteor you could convert it to an inf file and integrate it into nlite.inf
Peteski replied to Livewings's topic in Windows Vistai doubt its real, its more than likely a big collection of hotfixes like all the supposed XP SP3 betas that are floating around
Peteski replied to lonesome21's topic in nLitecould you upload your last session ini file so we can see which changes you have made ?
Peteski replied to soporific's topic in Websites and Boardsmedia fire used to be one of the best, unlimited file size, no wait times, minimal adverts, excellent reliability but they seem to be getting worse with every upgrade now your limit is 100MB, popups and banner ads and its rarely ever online
Peteski replied to ombitsian's topic in Windows 2000/2003/NT4this is more down to searching better, use quotes and other operators


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Miguel Cabeçadas was a Manticoran citizen and the son of John and Laura Cabeçadas.
In February 1922 PD, he and his parents and siblings passed through the space station HMSS Hephaestus on a tourist trip. Tragically, at that time the station was attacked by the Mesan Operation Oyster Bay, and the whole family perished with it. (HH12)


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Whilst the weather is still near its coldest it is the time of the year to be planning summer activities. This article contains a whole heap of ideas for games and activities to play during the warmer months. Click here to view the article.
To view more program ideas click here.


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Ola Ovsienko Retoucher
JRA StudiosMakeup Artist Female Minneapolis, Minnesota, US
My Website: Jana Rose ArtsMy MM URL: http://www.modelmayhem.com/janarosearts
Mayhem # 2604753
About MeI have my little hands in everything. Hair, makeup, photography, design and retouching/photo artworking! I love the entire process. I am an artist before anything else and I am having the time of my life exploring my talents and abilities.
I am passionately creative and constantly inspired. It's exhausting.
I absolutely love what I do and I believe it shows in my work. Looking to expand my business, grow artistically and connect with like - minded, professional, creative, positive & passionate individuals!
Please don't hesitate to say hello or visit Jana Rose Arts/JRA Studios on facebook or www.janarosearts.com. :-)
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