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Without a break in the day-night world to fly, pilots for theWANCHER ASTRONAUT
Is born, beyond the now utterance of the day and night as a watch active, enabled the international businessman
For the first time are known.
Please let me introduce this of as variants of the ASTRONAUT
From WANCHER ASTRONAUT-Marina modelIt will be.
Whereas a predecessor model for sky professional model, this model is
Professional yacht and ship, also a field commanderThe order made.
For an international, professional tools.
"Also, as well as ASTRONAUT,Identification of the day or night at a glanceThe instantaneous time recognition so
Has been designed.
Movement isMechanical automatic movementIs adopted.
Watch easy-to-use in general business scene, and have incorporated many elements
So now, from the picture, you can understand
With texture and general fashion watch, different, special Pro clock is.
ASTRONAUT with a 24-hour clock mechanism,Features special instruments can be said
In the specialized, is a hard watch, we introduce: the ASTRONAUT's
24-hour display functionThe model was formed combining the convenience of everyday purposes, it is.
For added convenience in everyday use test with various patterns of repeat
In return,Main clock features 12 hours total.Has been adopted.
Dial, with ASTRONAUT, excellent 24-hour display index elements
Capture and 12 hours display is easy to read dial.
This letter panel design was not easy. In the dial just a few cm
Adjustment of the micro unitsIn Visual visibility is different.
Come and see better images. Index 12-hour and 24-hour dots,
For each 12 hour and 24 hour engraved on the inside and outside.
That balance is very delicate, easy, perfect for iPad was designed with the
I think you can see it.
Main clock is usually used as the 12-hour clock.
Single adjustable GMT hand is 24 hours a day as the clockSecond time zone display。
Bezel has a reverse rotation prevention features that feeling, in the applied
Bezel made the minutes display more set to fit your hand,
You can measure the elapsed fraction, exactly.
Engine warm machine time measurement、Measurement of remaining oxygen cylinders used in the cave。。
Meeting time, the limited meeting timeSuch as the instant setting and measuring work
Becomes possible.
-Over 24 hours, around the clock face, with GMT function alone that can be manipulated
Mechanisms, mechanical self-winding movement.
-Dense as designed, and easy to recognize, but between 24 and 12 hour display dial.
Two different time zones appears in the small dials in and recognize two times at the same time
Easy to design.
-Unidirectional rotating bezel. Measure no doubt elapsed minutes
Beauty is not only functional by using scratch-resistant metal material,
The combines.
-Heavy and sturdy, stainless steel case.
-Enhance the confidentiality in the watch, screw-in type Crown use
-Hard Sapphire Crystal scratch-free windshield Sapphire
24 pursued for yachts and ocean stakeholders, ground commanders and explore features
Watch hour hand, measurement for unidirectional rotating bezel with a Dateline
Beyond the range Pro to work around the world, globetrotting businessmen and for a long time,
Technicians conduct the missions in the dark from light, such as various
For professionals, and a competent Navigator.
Born from the pursuit of functionality and use, from this clock design just looks
I feel the features beauty goes beyond the practical usability design.
Self-winding mechanical watch so important when the batteries are dead, stuck in
No worry. As well as general mechanical, such as Rolex watches,
Move the hand doing even routine maintenance once a year, every time
Around the rotor of the machine and then charge the internal power, clock keeps running.
Watch this 3: position, date display function is also available.
Adoption of the Cyclops lens zoom date.
In the special, yet easy-to-use, pleased everyone seems good and watch.
Who also does not have the WANCHER's small production model.
|«Product details»
WANCHER ASTRONAUT Ⅱ watch White Dial
|Mechanical automatic (hour hand displays 12 hour)
|Stainless steel case
|Windshield glass
|Sapphire Crystal
|3 ATM (3 atmospheres of pressure performance)
|Approx. 40 mm
|Approx. 13 mm
|Lug width
|20 mm
|None (body only)
|GMT 24 hour meter with the
Fine 24 hours 12 hours dial the
Date display feature
Screwdown Crown
Screwdown caseback
Stainless steel solid band
Brand new unused
|JP Post EMS
|Your order will be shipped to you via Japan Post EMS. Japan Post is a speedy delivery service that delivers to more than 120 countries. With an effective tracking system and insurance program, EMS is able to offer a secure delivery worldwide. You can track your package with the tracking code provided and it will be delivered within a week. See estimated shipping fee
|Credit Card
|We accept credit and debit cards.
The following credit and debit cards can be used:
•American Express
|The "Payment Amount" is calculated as below.
"Payment Amount" = Product price total + shipping fee
Upon confirming your order, we will send you a link to make a payment via Alipay's secure payment page.
You must finish the payment process before the deadline to complete your order.
Please check the payment process from the link here.
PC: https://global.rakuten.com/en/help/payment/alipay_pc.html
: https://global.rakuten.com/en/help/payment/alipay_mobile.html
This product cannot be shipped to United States from the store.
Please contact the store for further information.


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Driving School Website
In today's digital world, a website is essential to most businesses. A driving school website will display the services you offer to anyone who uses mobile phones, tablets and desktop computers.
Today's websites vary from bespoke built to order sites to free content management websites that cost little more than a domain name and a little time to write the content.
Upon deciding that it's time your driving school has a website, you will need to think about how to go about it. There's essentially two options, a free website or a website designed and built by a web design company. There are benefits to both.
Free driving school website
A free website for your driving school is beneficial as of course, it's free. Free website builders can easily be found online. Among many others, Google offer the ability to make a free website for any business.
These websites are based on a content management system (CMS) which means that all structural building of the site is done automatically. All you need to do is add the pages you want such as the services you offer, contact pages etc. Images such as your driving school car can easily be uploaded to your website and text content is simply written and once saved, it will go live on the internet.
Although optional, it's best to purchase your own domain name (www.example.com) as it will provide a more professional looking website, will gain a better ranking in search results and will likely gain more visitors.
The disadvantage of a free website is that they don't usually look quite as professional and refined as a site built by a competent web design company. They can with some effort and time look perfectly acceptable however. Another issue with a free website is search engine optimisation (SEO), or rather a lack of.
If you are intending on using a free website for your driving school, some research into basic SEO is certainly advantageous as it should allow for your website to rank higher in search results for specific queries relating to people searching for driving lessons in your area. Basic SEO can easily be researched online and implemented into a website with relative ease. If you do not possess the time or inclination to do any of this, you may benefit from paying for services of a website design company.
Driving school website designers
Any reputable web design company can design your site, they do not need to be specific to the driving instruction industry. Paying a web design company for your driving school website is all well and good, but do you know if they actually are any good? Essentially, you will need to ask them for some examples of websites they have previously made, look at the design and how professional they look. More importantly however, look how well these sites rank for particular keywords such as the products or services they offer combined with the location of the business. If the SEO is not great and the sites ranking is nowhere to be seen, there's little point in opting for a company to develop your site.
A reputable company that develops quality sites that rank well usually aren't cheap. Avoid basing any decisions on cost alone and primarily focus on quality and SEO. Long-term it works out far cheaper to pay out good money initially for a quality site as the customers gained often come from natural search results and do not require advertising.
What are natural search results?
Natural search results, or organic search results as they are also called are displayed by a search engine because of their relevance of the search term. Natural search results do not include ads.
Some website developers charge a monthly fee stating this is for maintenance costs. If their maintenance costs include updating the site frequently with new pages, text and images, and you intend on making frequent updates, this may be of benefit. Most websites similar to small driving school websites only get updated once or twice per year, if this is the case, pay a one-off initial fee only and pay a separate fee if and when the site needs updating, this should work out cheaper.
Unlike the free websites detailed above, you will need hosting for your new site. Website hosting is basically a computer where your site resides and allows anyone around the world to connect to it via the World Wide Web. Website design companies will offer you hosting, typically free for the first year but invoice you annually for hosting fees. Web design companies frequently charge high prices for hosting and with a little searching you should be able to find far cheaper.
The downside of this however is that you will need the technical knowledge for uploading your new website to the host and connect your new site to your domain name. If that seems too technical, you're probably best off using the web design companies hosting and paying the extra.
Best website for my driving school
Both free and bespoke SEO'd website have their own benefits. Essentially the free website will not perform as well in natural search engine results compared to a well-made site with proper SEO. The free site will likely need advertising such as Google Adwords to make it visible to potential customers. So although no upfront costs are involved, long-term advertising may need to be considered to make the site worthwhile.
A professional site with high quality search engine optimisation will over time gain better rankings in natural search results and will therefore be likely to require less revenue spent on advertising. A professionally developed driving school website is a better long-term investment, although they can be expensive. If cash flow is an issue initially, opt for the free website to run along advertising campaigns and perhaps consider a website upgrade at a later date.
Related information
- Driving school advertising – Free advice for advertising your driving school

subset: commoncrawl


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Monday, October 12, 2009
Freescale Expands Touch Sensor Line
Austin-based chip developer Freescale Semiconductor said this morning that it has expanded its line of products for the touch sensing market. The firm said it has added a new, ultra-low power capacitive sensor and associated, touch sensing software. The new MPR121 product is compatible with Freescale's 8-bit microcontrollers, and can be used for touch sensitive consumer electronics. The firms said the product is already being integrated into MP3 players from Audiovox. Freescale explained that the controller is its second generation of touch sensor devices, and will be available in production quantities in November.


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A solid win for Cronulla Sharks at home tonight to celebrate the 300th #NRL match of stalwart Luke L...
12 hours ago
This is it - Sunday 30 September - Grand Final Day for the NRL, Under 20's and NSW Cup. Get the teamlists today as they're announced!
Make sure you stay tuned for LIVE match updates from midday Sunday!
All times listed are AEST
Tweet #NRL
Tweet #bringthenoise


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Framed Originals
To view framed prints (signed, numbered) visit here.
- All are framed with archival, acid free mats and mounting, and low-glare acrylic glazing (which facilitates UPS shipping).
- We ship once a week. If you need your framed print as soon as possible, please email Rod at the email address below.


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Home > Product Categories > Racks & Cases > Equipment Rack Enclosures > Equipment Rackmounts > SR-10
Item #: SR-10 MFG #: SR-10
List Price:$87.48Our Price:$62.49Quantity Pricing
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RDL DRA-35S STICK-ON DIN Rail Adapter - 1 Module
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Admire the most beautiful places of Montefiore Conca and add them to your basket. YAMGU will create your trip considering distances, opening hours and weather.
The little theatre, housed inside the walls in the same building that houses the Town Hall, was already mentioned in the Census of 1868. The Hall, with U-shaped plant has two tiers of galleries and lacks a decoration. The current appearance dates back to the early 19th century. Declared unusable in 1984, the theatre underwent restoration involving a general consolidation of the structure: from foundations, measures for the Elimination of moisture, the Remaking of the furniture and equipment, in accordance with applicable law. Jobs are now at an end and the forthcoming inauguration. the in


text:
Order Code: M788
Yellow - Industrial Flooring Tapered Edges with Lugs
QTY 10 Per Pack
QTY 10 Per Pack
ex GST
inc GST
Tapered edge connects to Industrial tiles and neatly puts the finishing touch to a fantastic looking floor as well as removing any edge trip hazards that may occur
- Made from yellow high-impact polymer plastic
- Resistant to oils & automotive fluids
- Easy to assemble by simply connecting and snap lock together
- 10 yellow tapered edges with lugs per pack
Product Brochure
Spare Parts Ordering
To assist you in ordering your Spare Part to suit Hafco Machinery simply select from the list below, if your part is not listed below please view "Parts List PDF" to identify your part required (if provided) then simply click the "SEND PARTS REQUEST" Button and fill in the required details. Our Spare Parts and Service Department will contact you as quickly as possible. If you need further assistance please contact us.
Covers 4 Square Metres$160.00 ex GST$184.00 inc GST
$34.00 ex GST$39.10 inc GST
$16.00 ex GST$18.40 inc GST
$16.00 ex GST$18.40 inc GST


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We always considered Skagit Valley Casino a special treat, an upgraded time of entertainment with a great Rewards Club program. On our first trip back after the new Rewards Club program, no one at the Rewards Club desk could explain HOW we accumulate points on slot play. We were told the employees weren't even allowed to know just how points accumulate. I simply wanted to know if it was one point for each dollar played or one point for every 2 dollars played, etc. They won't tell you. What's the big secret? One employee suggested that perhaps points were accumulated faster if you stayed on the same machine playing it over and over, win or lose? Who wants to stay on a machine that continually loses just to gain points? I'd be better off to just say the heck with the points and play in my comfort zone. Or better yet - we won't be making the drive back just for a little upgrade on atmosphere until there's a totally open explanation of HOW points are accumulated and the "rules" are out in the open and in print. No one in their right mind really expects to win every time. The casino couldn't stay in business if everyone won all the time but my husband and I at least expect everything to be up front for the perks.
Own or manage this property? Claim your listing for free to respond to reviews, update your profile and much more.


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Contest health is our measure of how successful a contest is likely to be. If you are not logging into your account or providing feedback to designers, your contest could be marked as 'caution' or 'unhealthy'. This could potentially deter designers from submitting entries to your contest.
Here are some key actions you can take to avoid an unhealthy status:
Logging in and checking on your contest regularly
Rating the designs you like, and eliminating the designs you don't
Leave plenty of useful comments for each of the designs you like
Follow these rules, and you should see some fantastic results!


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Hi, here are some concept art i did for Mountains of Madness, long story why i even did them, but well just take it as fan art..
Alright so let's move on. I actually spent alot of time doing all these, experimenting with geometrical impossiblities, non-euclidean shapes, hopefully
to create something worthy of Lovecraft's writings. I learnt alot from it, understanding how non-euclidean structures are really tricky and might not be able to work in reality.
Many of the concepts probably have got this weird geometrical feel to them.. feel free to share your thoughts. Thank you everyone.
1.Inner part of the city where the masonry and perspectives are warped, ilogical and madness.
2.The structure standing way higher than the mountains, massive, geometrically perverted. Tried to create a structure where it might be unforgettable.
3.Cold icy structure standing in the middle of the antartica
4.When I first thought of madness, i imagined it to be illogical, crazy, nonsensical. Maybe it will look like a mirage, with no clear hints of its form and structure, like an illusion, maybe it really is beyond human understanding.
5.One if the initial creature trial.
And so thank for viewing. It may hardly be a good representation of Madness but still hope you enjoyed them.


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OMG! What a sight! World Of Men have outdone themselves with this scene - seven, yes seven, beefy, masculine studs in an all-out International oral orgy!
Things start off with Dominic Pacifico and Billy Baval making out on the sofa - the guys are wearing nothing except for their jock-straps. Aitor Crash is there too and hears someone knocking at the door and goes to see who it is. Outside in the hallway are four hot and horny tool men, Adam Killian, Damian Boss, Valentin Alsina and Spencer Reed, all still dressed in their overalls after a hard day's work, but ready and willing to strip them off and get this orgy started! Before you can count to three, overalls are going down, hard cocks are coming out to play, mouths and lips are wet and ready for action - everyone gets a grip on one or another's fat cock and we get to sit back and enjoy the sight. Watch as the US Stars Spencer and Adam, get to grips with the British and European hunks in more ways than one - butt licking, face-fucking and cock sucking - seven massive dicks, hard and proud, cut and uncut, all cum together in this 100% prime beef oral orgy!


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Give the kids their very own special hideaway where their imaginations can run wild, and pretend play is at its best! Bazoongi are critical about using quality materials, and superior craftsmanship; their goal is to create long-lasting products that kids will outgrow, not demolish in 10 seconds flat. The kids' are sure to love the lively sense of colour and whimsical imagery, that celebrates the joyful side of life through these inspiring tents!


text: Ocean Wilsons Holdings Limited Company Profile (LON:OCN) Company Profile Analyst Ratings Earnings History Earnings Estimates Dividend History Insider Trade Headlines Social Media Chart About Ocean Wilsons Holdings Limited (LON:OCN) Ocean Wilsons Holdings Limited is an investment holding company. The Company, through its subsidiaries, is engaged in the provision of maritime and logistics services in Brazil. Its segments include maritime services and investments. The maritime services segment provides towage, port terminals, ship agency, offshore, logistics and shipyard services in Brazil. The investment segment holds a portfolio of international investments. Its subsidiaries are Wilson Sons Limited, Ocean Wilsons (Investments) Limited, WILSON SONS DE ADMINISTRACAO E COMERCIO LTDA, VIS LIMITED and EADI SANTO ANDRE TERMINAL DE CARGA LTDA. Wilson Sons Limited's activities include harbor and ocean towage, container terminal operation, offshore oil and gas support services, construction, logistics and ship agency. Ocean Wilsons (Investments) Limited is an investment company, which holds a portfolio of international investments. EADI SANTO ANDRE TERMINAL DE CARGA LTDA is engaged in bonded warehousing business. Industry, Sector and Symbol: Sector: Industrials Industry: Marine Port Services - NEC Sub-Industry: N/A Symbol: LON:OCN CUSIP: N/A Web: www.oceanwilsons.bm Capitalization:Market Cap: £372.2 millionOutstanding Shares: 35,363,000Average Prices:50 Day Moving Avg: GBX 1,042.90200 Day Moving Avg: GBX 1,035.4952 Week Range: GBX 890 - GBX 1,126.54 P/E:Trailing P/E Ratio: 8.26P/E Growth: 0.00Sales & Book Value:Annual Revenue: £457.16 millionPrice / Sales: 0.81Book Value: GBX 15.14 per sharePrice / Book: 0.70Dividend:Dividend Yield: 9.8% Profitability:EBIDTA: £148.68 millionNet Margins: 16.84%Return on Equity: 9.63%Return on Assets: 6.39%Misc:Average Volume: 7,768 shs. Frequently Asked Questions for Ocean Wilsons Holdings Limited (LON:OCN) What is Ocean Wilsons Holdings Limited's stock symbol? Ocean Wilsons Holdings Limited trades on the London Stock Exchange (LON) under the ticker symbol "OCN." How often does Ocean Wilsons Holdings Limited pay dividends? What is the dividend yield for Ocean Wilsons Holdings Limited? Ocean Wilsons Holdings Limited announced a dividend on Monday, March 27th. Investors of record on Thursday, May 11th will be given a dividend of GBX 0.63 per share on Friday, June 9th. This represents a yield of 5.04%. The ex-dividend date is Thursday, May 11th. The official announcement can be seen at this link. View Ocean Wilsons Holdings Limited's Dividend History. Who are some of Ocean Wilsons Holdings Limited's key competitors? Some companies that are related to Ocean Wilsons Holdings Limited include Dart Group PLC (DTG), LSC Communications (LKSD), Gorman-Rupp Co (GRC), GrafTech International Ltd (GTI), Fenner plc (FENR), De La Rue plc (DLAR), Keller Group plc (KLR), Photo-Me International plc (PHTM), Morgan Sindall Group PLC (MGNS), Oxford Instruments plc (OXIG), RPS Group plc (RPS), Paypoint plc (PAY), John Menzies plc (MNZS), Northgate plc (NTG), RealD (RLD), Biffa PLC (BIFF), Restore PLC (RST) and Mears Group PLC (MER). Who are Ocean Wilsons Holdings Limited's key executives? Ocean Wilsons Holdings Limited's management team includes the folowing people: Keith W. Middleton, Finance Director, Executive DirectorMalcolm S. Mitchell, SecretaryJose Francisco Gouvea Vieira, Non-Executive Chairman of the BoardWilliam H. Salomon, Non-Executive Deputy Chairman of the BoardChristopher Townsend, Non-Executive DirectorAndrey Berzins, Non-Executive Independent DirectorColin C. Maltby, Non-Executive Independent Director How do I buy Ocean Wilsons Holdings Limited stock? Shares of Ocean Wilsons Holdings Limited and other U.K. stocks can be purchased through online brokerage accounts that support trading on the London Stock Exchange (LSX). Some U.K. companies can be purchased through major U.S. brokerages in the form of American Depository Receipts (ADRs), which are placeholder equities held in a trust by a bank that represent shares of a foreign stock. What is Ocean Wilsons Holdings Limited's stock price today? One share of Ocean Wilsons Holdings Limited stock can currently be purchased for approximately GBX 1,052.50. MarketBeat Community Rating for Ocean Wilsons Holdings Limited (LON OCN)Community Ranking: 4.6 out of 5 ( )Outperform Votes: 91 (Vote Outperform)Underperform Votes: 9 (Vote Underperform)Total Votes: 100MarketBeat's community ratings are surveys of what our community members think about Ocean Wilsons Holdings Limited and other stocks. Vote "Outperform" if you believe the stock will outperform the S&P 500 over the long term. Vote "Underperform" if you believe the stock will underperform the S&P 500 over the long term. You may vote once every thirty days. Analyst Ratings Consensus Ratings for Ocean Wilsons Holdings Limited (LON:OCN) (How are Consensus Ratings Calculated?) MarketBeat calculates consensus ratings using the most recent rating from each brokerage that has rated a stock within the last twelve months. Since brokers often use different ratings systems, each rating is normalized to a standardized rating score of 1 (sell), 2 (hold), 3 (buy) or 4 (strong buy). Consensus ratings scores are calculated using the mean average of the number of normalized sell, hold, buy and strong buy ratings. Each stock's consensus rating is derived from its calculated consensus ratings score (0-1.5 = Sell, 1.5-2.5 = Hold, 2.5-3.5 = Buy, >3.5 = Strong Buy). MarketBeat's consensus price targets are a mean average of the most recent available price targets set by each analyst that has set a price target for the stock in the last twelve months.MarketBeat will no longer include ratings and price target data in its consensus calculation if a broker drops coverage and MarketBeat has received a report that coverage was dropped. Ratings from certain research firms that issue ratings using purely quantitative methods (such as Zacks, Vetr and ValuEngine) are not included in consensus calculations. MarketBeat's consensus ratings and consensus price targets may differ from those calculated by other firms due to differences in methodology and available data.Ratings Breakdown: No ratings tracked in the last 12 months.Consensus Rating:N/A (Score: NaN)Consensus Price Target: N/A Analysts' Ratings History for Ocean Wilsons Holdings Limited (LON:OCN) Show: Only the Most Recent Rating From Each Brokerage All Ratings For This Stock No equities research coverage for this company has been tracked by MarketBeat.com Earnings Earnings History for Ocean Wilsons Holdings Limited (LON:OCN)No earnings announcements for this company have been tracked by MarketBeat.com Estimates Earnings Estimates for Ocean Wilsons Holdings Limited (LON:OCN)Current Year EPS Consensus Estimate: $96.99 EPS Dividends Dividend History by Quarter for Ocean Wilsons Holdings Limited (LON OCN)AnnouncedPeriodAmountYieldEx-Dividend DateRecord DatePayable Date3/27/2017€0.635.04%5/11/20175/11/20176/9/20173/25/2015€0.634.91%5/7/20155/7/20156/5/2015(Data available from 1/1/2013 forward) Insider Trades Insider Trading and Institutional Ownership History for Ocean Wilsons Holdings Limited (LON:OCN)Insider Trades by Quarter for Ocean Wilsons Holdings Limited (LON:OCN)Transaction DateInsider NameTitleBuy/SellNumber of SharesAverage Share PriceTotal TransactionDetails11/23/2015Vieira,Jose F GInsiderBuy17,500GBX 775£135,62511/19/2015Maltby,ColinInsiderBuy1,000GBX 760£7,60011/17/2015Vieira,Jose F GInsiderBuy1,000GBX 765£7,6503/31/2015Colin MaltbyInsiderBuy3,000GBX 855£25,650(Data available from 1/1/2013 forward) Headlines Headline Trends for Ocean Wilsons Holdings Limited (LON:OCN) Latest Headlines for Ocean Wilsons Holdings Limited (LON:OCN) Source: All Sources Trusted Sources MarketBeat.com Bloomberg MarketWatch Motley Fool NASDAQ Reuters Seeking Alpha The Street The Wall Street Journal Yahoo Finance DateHeadlineOcean Wilsons Holdings Ltd. breached its 50 day moving average in a Bearish Manner : OCN-GB : May 25, 2017finance.yahoo.com - May 25 at 5:14 AMOcean Wilsons Revenue In Brazil Lifted By Container Volumes, Currencywww.morningstar.co.uk - May 16 at 10:04 AMOcean Wilsons Holdings Ltd. : OCN-GB: Dividend Analysis : May 12th, 2017 (record date) : By the numbers : May 12, 2017finance.yahoo.com - May 13 at 12:44 AMOcean Wilsons To Take Steps To Ensure Tecon Salvador Expansionwww.morningstar.co.uk - April 12 at 7:55 PMOcean Wilsons Holdings Ltd. breached its 50 day moving average in a Bullish Manner : OCN-GB : April 4, 2017finance.yahoo.com - April 7 at 11:41 AMOcean Wilsons Holdings Limited Announces Dividend of GBX 0.63 (OCN)www.americanbankingnews.com - March 27 at 3:07 PMOcean Wilsons Subsidiary Signs Second Amendment To Lease Agreementwww.morningstar.co.uk - November 18 at 6:10 PMOcean Wilsons profit rises in face of forex challengeswww.lse.co.uk - August 15 at 6:56 PMWeek ahead: Manufacturing surveys, US jobs report in focusuk.finance.yahoo.com - May 27 at 3:51 PMHalf Year 2016 Ocean Wilsons Holdings Ltd Earnings Release - Before Market Openbiz.yahoo.com - May 12 at 7:07 AM Social Chart Ocean Wilsons Holdings Limited (OCN) Chart for Friday, July, 28, 2017 This page was last updated on 7/28/2017 by MarketBeat.com Staff


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Last Month at the Federal Circuit - November/December 2004
Judges: Rader (author), Friedman, and Dyk
In Frank's Casing Crew & Rental Tools, Inc. v. Weatherford International, Inc., No. 03-1519 (Fed. Cir. Nov. 30, 2004), the Federal Circuit affirmed a district court's decision of no infringement of U.S. Patent No. 5,049,020 ("the '020 patent"). The '020 patent concerns a system for handling sections of well casing suspended within a derrick during oil-field operations. Specifically, the '020 patent claims a system for making up a vertically extending string of interconnected casing sections comprising a derrick, bracket subassembly, and a boom and jaw subassembly. The boom and jaw subassembly includes a means for pivoting and elevating the boom. The district court ruled that the structure corresponding to this claimed means included lift and boom plates disclosed in the specification. Plaintiff argued instead that the relevant corresponding structure is a piston and cylinder subassembly disclosed in the specification. According to the Federal Circuit, the only structure identified in the '020 patent for performing the pivoting function is the lift plate under the boom. Although the '020 patent also discloses a piston and cylinder subassembly, that subassembly, in connection with the lifting function, includes a connection to the lift plate. Moreover, according to the Federal Circuit, during prosecution history, the applicants had stated that the lifting cylinder could not be used when directly connected to the boom, underscoring the essentiality of the lift plate to the claimed function. On the issue of infringement, the Federal Circuit concluded that although the accused product performed the same function recited in the claims, its structure for doing so was not insubstantially different from that in the '020 patent. Thus, the structure did not infringe under 35 U.S.C. § 112, ¶ 6. Moreover, because the lifting mechanism without a lift plate was in use before the filing of the patent, the Court did not find it necessary to conduct a separate analysis under the DOE. The Court affirmed the district court's decision denying attorney fees.


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Are You Ready to Push
(image provided courtesy of and now for sale on Art by Demarti)
Giving birth to a "baby (Purpose, Business, Ministry…)" is a privileged, miraculous, unforgettable experience that should not be taken lightly. The moment you find out that you are pregnant, your whole world shifts. Your mind starts to think differently. You ask yourself many questions. Am I ready for this? Do I have what it takes to pull this off? Will it hurt? Do I have the proper support? Do I tell anybody? Who do I tell? What do I do now? You start to imagine your life after the birth of your baby and all of the possible changes and effects this "baby" can have on your life. Your emotions start to run rampant, for some of us it's excitement and anticipation and for others it's fear, fear of the unknown or fear of all the myths and horror stories coming true in our lives. You hear stories all of the time about people who have given birth before you and all of their successes and failures, but remember everyone's experience is different and nobody can give birth to YOUR "baby" but YOU. Their process is not your process.
Time Lapse
If you are unable to view the video above click here.
I love finding messages in the simplest things. I found a time lapse video by: LoungeV sudio that blessed me and I had to share it with you.
I love looking at the sky. I call it God's Daily Creative Work of Art. It reminds me that He still is... When we look at the clouds and watch them on a minute by minute basis, we see the clouds moving very slowly. There are days where it seems like nothing is happening, the clouds are just siting there. When we look at life on a minute to minute basis, sometimes it looks like the clouds, like things are moving very slowly and for some of us it seems like there is nothing going on, like things are not moving at all. We ask the question "why aren't things happening for me", or we say to ourselves "I keep trying and trying and I'm just not getting anywhere" and we quit. We don't realize that our lives are constantly being shaped and formed into a beautiful piece of art. Our lives are masterpieces right out of heaven. We have to learn to celebrate God's handy work even when we can't see what He's doing in us.
The Flower Speaks
(image provided courtesy of and now for sale on Art by demarti)
I have learned that out of all of that struggle, frustration,
waiting and waiting and waiting,
pushing and pulling for change,
trying to take one step forward to fall two steps backwards,
repeatedly making a list of whys and ways of giving up,
constantly questioning HOW DID I GET HERE?
The ground was being tilled and seeds were being planted.
The Butterfly Effect
(image provided courtesy of and now for sale on Art by Demarti)
The butterfly represents transformation, resurrection, overcoming obstacles and embracing life's expected and unexpected changes.
When we look at the butterfly from afar we think "how pretty", but the real beauty is when you see the butterfly up close, when you can see the gorgeous detail that God created it to be and you can see the true outcome of its life purpose. What you don't always see is its humble beginnings, its struggles, the work and patience it took to get to this glorious stage of living. If I watched the whole transformation, I would appreciate the outcome more because I understand its process and I know the process contributed to the beauty of the outcome.


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Last week I completed a fresh install of Novell's OES Linux from the SP2 .iso CDs, and used rug to update the server with all the available patches. I needed to install NSS, so I went into YaST to add the software, but the server kept hanging at the checking dependencies screen. Rebooting the server didn't resolve this issue, and the log files didn't shed any light on the source of the problem.
I was able to make YaST stop hanging by disabling my two installation sources. Apparently it hung trying to read sources that were no longer valid, specifically /media/cdrom. I deleted the original sources, and manually defined the location of my installation media as/media/cdrecorder. Once I did this, I was able to access the Install and Remove Software program again.


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Books Direct Blog
Posted: 31 Aug 2016 12:00 AM PDT
EXCERPT and REVIEW
Dead Ground
(Simon Ellice Book 1)
by Rod Humphris
Author Rod Humphris stops by today to share an excerpt from Dead Ground, his debut short story introducing the character of his upcoming Simon Ellice series. You can also read my review. Coming soon Go Fast.
In the mountains and passes of Nuristan the men of patrol base Azun grind through their days and nights of constant vigilance. They hunt the Taliban and try to win hearts and minds. Trouble is coming, that is certain. How or when, where and in what form, they do not know. They fear it and also long for it.
Only Lieutenant Simon Ellice, with a clarity born of grief and anger, can see the shape of it. Only he, being beyond care, will do what has to be done and pay the price. Not that he will be the only one to pay.
Dead Ground is a story of the impossibility of the task assigned to British forces in Afghanistan and the heroism of some of those who attempted it.
"Rosy fingered dawn," I said.
The high cloud had softened the light, and the new day was breaking in pink.
"Did she, sir?" Hesketh said.
"Night's candles are burnt out and jocund day stands tiptoe on the misty mountain tops," I said.
"You're an unusual kind of rupert sometimes, sir," Deaks said. "No offence intended."
"None taken. We must have bloody noses and crack'd crowns and pass them current too. God's me, my…"
"Are you alright, sir?" Denton said.
"Don't mind him, corp," Hesketh said. "He gets like this sometimes."
"… horse, I think," I said.
"It's getting light, sir," Denton said.
"Eyes sharp everyone," I said.
"By the way, what are we doing here, sir?" Deaks said. "I don't care like, but I was just wondering. Why today?"
"Do you know what I think?" I said.
"Not usually, sir," Hartigan said.
"I think Wur was green slime."
"Was, sir?"
"Yes, was. I found him behind the stores tent earlier. I think Jadoon and a couple of ANAs killed him and I think it means it's all about to kick off."
"Well fuck me, I'd never of guessed," Hesketh said.
Below us in the base there was a sharp crack and the signals hut collapsed in on itself. Armed men streamed out of the mosque and ran to cross the river at the bridge and at a shallow place downstream of it. As they neared the barriers a heavy machine gun opened up from the house below us.
"You were right, sir," Denton said.
"Comms on. Engage the enemy," I said.
Thompson started working with the gimpy, trying to stop the tide of men surging over the barriers.
[Want more? Click below to read a longer excerpt.]
Praise for the Book
"I have a Master's in Military History and I have been reading military books for well over 40 years. This is one of the best war books I have ever read. It is a must read now that we are stuck in this endless War on Terror. My only issue was that this book wasn't 550 pages. It is such an incredible compelling read that I was saddened it ended so quick. The author captures perfectly the insanity of theatres of war that soldiers have been sent to in this war. [...] I would suggest this brilliantly written, evocative war book is a must read." ~ N. N. Light
"Fast moving, genuinely exciting and a thoroughly cracking read, this short story reminds me of the best of John Buchan, albeit updated for today. It is well written, well researched and quickly creates a very believable atmosphere of what being a modern British soldier is like, warts and all." ~ David Shearer
"The plot hangs together well and skilfully builds to a denouement where the fine details coalesce into a clear pattern. It is well constructed, well written and sustains interest throughout. Simon Ellice is not someone you have to like, but he is both an interesting and complex character whose life and emotional responses are down to the reader to interpret and extrapolate. He is certainly someone you feel you would like to know more about and I look forward to further adventures with anticipation." ~ Emma White
"I read this book in a single sitting, it really is a terrific read. With many years experience of military life I am amazed at the way Humphris has managed to capture the day to day stresses, routines, and unpleasantness of army life. The plot is convincing and fast moving it's tough out there." ~ Colin
"This is a tremendously exciting debut, immediately throwing you into the midst of active army deployment in Afghanistan, with social and psychological conundrums facing senior personnel as they think on their feet in an almost lose-lose situation. Utterly un-put-downable after the first three pages. I await the next Simon Ellice story with relish, Mr Humphris." ~ Bevis Nathan
My Review
By Lynda Dickson
Having recently suffered the loss of someone close to him, Lieutenant Simon Ellice returns to his base camp in the mountains of north eastern Afghanistan, where they train Afghan National Army soldiers. With his trusty band of C Section soldiers, Simon ventures out into the "dead ground" - the ground not visible from the base camp and, therefore, prone to attack - in search of insurgents. As the men are fond of saying, "What could possibly go wrong?"
The story is a bit hard to follow as nothing is spelled out, there are a lot of characters, and it's full of military jargon; an explanation the first time each term is used, or a glossary of terms at the end of the book, would be useful. Nevertheless, the author skillfully creates an atmosphere of foreboding and builds the tension. And once the action hits, all of the pieces come together to complete the puzzle.
Warnings: coarse language, violence.
About the Author
When I was a boy I loved stories of adventure. Inside I'm still a boy and now I love them even more. It's taken me thousands of hours to learn how to write the stories that I do, but it's one of the best things I've ever done. In my opinion anyway.
A few years ago, I started to write about a fast boat on a dark sea. Like doodling, only in words. And then there was Si speaking to me, telling me what was happening and what it felt like. At the time I thought his voice in my head was a new one, but I was wrong; I've known the ruthless, selfish bastard all my life. Since then he's become my constant companion. Or, more accurately, I've become his. We've been to a lot of places together and he's introduced me to some interesting and scary people. It's a journey that has only just begun. Come with us if you want to.
I have no special qualifications to be a writer except that I want to be. I live where I'm from in the West Country in the UK and work in a small room above a pub in Bath, which is possibly the nicest city in the world. I spend my days thinking about, learning about and writing about whatever is interesting to me, which is possibly the best job in the world.
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It only takes a minute to get started. Fill out our simple sign up form and login to the site.
This step is optional but will seriously raise your chances of getting interest from other over 40s members on the site. Write a little something about yourself, your interests and upload any nice photographs of yourself.
Utilise our website's sophisticated search to discover over 40s members who match your desired criteria. Or just leaf through listings and discover daters that interest you.
Identified someone who is attractive to you? Send a note to them or just a wink and see what develops from there. With a little luck you'll be on your way to an amazing adventure.
It's quick and simple


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Swailem The Bullet S02E02
STC promote the effectiveness of their internet speed with a humorous look into the career of 'Swailem The Bullet', the fastest government affairs officer in Saudi Arabia.
BrandSTC الاتصالات السعودية
Mirinda Peach vs Mirinda Berry
Peach or berries? 'Battle of the Flavours' from Mirinda Egypt pits the two tastes against each other through online user voting.
BrandMirinda Egypt
The Pepsi Music Challenge featuring Hassan El Shafei
The 'Pepsi Music Challenge' featuring Hassan El Shafei encourages users to submit their sounds through their app with an interactive 360-degree video.
BrandPepsi Arabia
Moments bring us together with Tropicana Frutz
Tropicana Frutz reminds us of the important moments in life through messages attached to bubbles in this heartfelt video.
BrandTropicana Frutz
Coca Cola: We want to hear your refreshment
Balqees, Ramy Sabry and Tarek from UAT come together to offer refreshment through music in the latest 'Coke Studio' offering.


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If the drive shortage is impacting your business, worth noting that Drobo works with any drives, mix and match, old and new. This flexibility is good for putting together solutions with the shortage.
2 Replies
· · ·
Dec 13, 2011 at 8:48 UTC
Hi Teresa. are there any promos on for the 4 or 5 bay units in CANADA.?
· · ·
Dec 13, 2011 at 2:10 UTC
Hi Andy, thanks for your interest. You will get the best deal by going through the Drobo RFQ, click on the Request a Quote button above. You will also get the $100 Mail in Rebate on your purchase. Let me know how it goes or if you need more help from me.
This discussion has been inactive for over a year.
You may get a better answer to your question by starting a new discussion.


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10K Tri-Tone Gold I Love You Hoop Earrings
Item# 18049213
Tell her how you feel! These 10K tri-toned gold hoop earrings spell out "I Heart you" with a heart in scrolling script across the center. Polished to a brilliant shine, these earrings secure with hinged backs.
Special Offers
Typographic errors are subject to correction. Merchandise enlarged to show detail and may not always be exactly as pictured. Promotions, prices, styles and availability may vary by store and online.


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More results...
Beautiful "Freedom To Love" scene featuring appealing girlfriends Clover and Tina. Two fascinating sweeties distracted from reading the magazine and proceed to strip down and lick each other's pussy tenderly on the white mattress in simply awesome 18OnlyGirls movie teaser.
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Stupidity hurts and if you don't believe me, here's some proof. Even the kid going to Stanford is a fucking idiot. And I never saw a genius try to jump a moving car. But punching your drunk friend is always fun.
i assume their not taking physics classes
sobriety is overrated
Looks like our favorite table dancer is going to be pissing blood for a while.
The Er is always bust on a Thursday night
real pro's right there
I love idiots.
what else can you say but FRWP
Stupid people and video camera's go great together!
white boys just doing what comes natural to them being stupid
^ white men cant jump but black men cant read .. fact!
I see that testosterone has run amok again, but that's okay...these stunts will insure that reproduction from these people will not happen. And I'd like to think that an angel gets his or her wings whenever a nutshot and other various idiotic stunts happen......
Bless you wendi... FINALLY somebody who can spell 'amok' correctly... I think I love you.
No comment needed the video explains it all..
Yes Wendi,the bell rung for all these ass clowns.
Funny dumbasses. Why can't I ever be present to witness and really enjoy these stunts.
what dozer said.
broken ribs. broken jaw, broken ass. yup its a good thursday.
Those three held the answer to the most perplexing intellectual and philosophical questions for humanity, until they cracked their skulls.
And I love dozer's new avatar.
The second video. What a little girl punch,even my wife can knock a fucker out, and she is 4'11 and 100 LBS.


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This post brought to you by Wikibuy. The content and opinions expressed below are that of DailyTekk.
It's not everyday I find something online I can call ingenious, but today definitely qualifies. When I was asked to write about a Chrome extension I thought to myself, "Bo-ring." But as soon as I checked it out I changed my tune to, "Ba-rilliant." I won't keep you in suspense any longer: I'm talking about Wikibuy. In a world where dozens — if not hundreds — of tech startups are born and die every day, it takes more and more to impress me (and consumers in general). And Wikibuy does, for several reasons. Mainly because it does what it claims: finds a better all-in price when you shop on Amazon. Once you have Wikibuy installed in Chrome, just start browsing Amazon as you normally would. When you land on a product page, you'll see the Wikibuy logo down in the left corner: within 10 seconds (and usually much faster) you'll get an offer from Wikibuy. If the item can be had for a lower price than it is on Amazon, Wikibuy will find it and display that price, including shipping, as an offer. You'll also see how long it takes to get the item shipped.
If you use Wikibuy to make a purchase, you'll buy directly from Wikibuy who will handle all the details. In my testing, I checked out several tech items and saw some really great savings! On a Sonos wireless subwoofer Wikibuy was able to save me $116. On a 40″ 4K Samsung TV there was a savings of $67. And on the Nest smart thermostat there was a savings of $67. Pretty stellar. I really like how clean and well designed this plugin is. It's simple and to the point and is very easy to use. I like that you get a side-by-side comparison with Amazon's listing to show exactly how you're saving money and it's easy to see the date your item will arrive by. Finally, you'll also see how long you have to decide if you want to purchase the item at the current price offer.
You'll also see how long you have to return an item (which differs by item — I saw some had 14 days to return while others had 30). There's plenty of other reasons Wikibuy is likable.
- Every price you


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The Fuel of Life
The light bulb above their heads is energized by a renewable source, you have to think. The topically minded PhotoSensitive collective had the bright idea for an exhibit of photographs that focuses on sustainable power sources and ways in which we use, abuse and conserve energy. To Dec. 10. 7 a.m. to 10 p.m. Free. Allen Lambert Galleria, Brookfield Place, 181 Bay St., 416-369-2300 or photosensitive.com.
Jack Chambers: The Light from the Darkness, Silver Paintings and Film Work
The AGO is not alone in celebrating work of the late Ontarian Jack Chambers, a visionary artist. An exhibit of his 1966-67 "silver paintings" (so-called because of his use of aluminum paint) and five of the seven 16-mm "personal" films he shot in the late sixties is now on display at the McMichael Canadian Art Collection. To Jan. 15, 2012. $12 to $15. Kleinburg, Ont., 888-213-1121.
Sunparlour Players
They still sell jams, jellies and other condiments at the merchandise table, but the curious Ontario roots-rock trio passes muster in addition to hawking mustard. Their new album Us Little Devils finds the energetic Andrew Penner and his Players adding balladic niceties to their gospel-tent furor. Dec. 10, 9 p.m. $13.50. Great Hall, 1087 Queen St. W., 888-222-6608.
Johnny Sansone
When told to jump, this New Orleans harmonica pro asks "in what key?" The big-lunged Jumping Johnny Sansone, with an inquisitive local band, does gritty gospel, lively gumbo-music and industrial-strength blues. Dec. 10, 8:30 p.m. $25 to $27.50. Hugh's Room, 2261 Dundas St. W., 416-531-6604.
Vinko Globokar
The great and whimsical French trombonist hasn't played here in 20 years, but we're going to let him slide on that misdemeanour offence because his visit here is a lengthy one that includes workshops and master classes. It all culminates Sunday in a wide-ranging concert that features works spanning four decades, including 2003's Eppure si Muove for solo trombone and an ensemble of eleven disparate instruments, mischievously performed without a conductor. Dec. 11, 8 p.m. $10 to $35. Betty Oliphant Theatre, 404 Jarvis St., 416-961-9594.
André Watts
Because it is that Christmas time of year, U.S. pianist André Watts is making his Lizt and checking it twice. Apologies for that – let's start again. Celebrating the 200th anniversary of the Hungarian wunderkind pianist and composer's birth, Mr. Watts performs an all-Liszt program, Hungarian Rhapsody No. 13 included. Dec. 11, 3 p.m. $39 to $90. Koerner Hall, 273 Bloor St. W., 416-408-0208.
The Life and Times of Mackenzie King
It's good to be the Mackenzie King, but in Michael Hollingsworth's spooky, small-stage satire on wartime politics there are two other prime ministers of the period represented: an ambitious and consistently outwitted Arthur Meighen and a fat, bacon-loving R.B. Bennett. The sly and somewhat absurdist comedy continues at the comfy Cameron House. To Dec 18. $20 to $40. 408 Queen St. W., 416-703-1725.
"Shining, gleaming, streaming, flaxen, waxen – give me down-to-there hair, shoulder length or longer." It's been around a while, but the touring production of the counterculture musical is growing on us. Dec. 13 to 31. $35 to $130. Royal Alexandra Theatre, 260 King St. W., 416-872-1212.
Wizard of Oz
Something tells we're in Toronto when a funky musical version of the yellow-brick classic involves Lady Gaga's Born This Way and a snowboard-loving Dorothy. Another Christmas; another Ross Petty pantomime. To Jan. 6, 7 p.m. $27 to $85. Elgin Theatre, 189 Yonge St., 855-985-5000.
The Story
A unique, walkabout telling of the Nativity is self-billed as "part Beckett, part Monty Python, with a bit of morality play thrown in." An audience follows the action of the biblical narrative through the Evergreen Brickworks and adjacent parkland, where shepherds, weird wise men and a choir are come upon. Dec. 16 to 30 (previews, Dec. 13 to 15). 7:30 pm. $10 to $25 . 550 Bayview Ave., 416-504-7529.
A Very Lupe XmasReport Typo/Error
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Risk factors for virological failure and subtherapeutic antiretroviral drug concentrations in HIV-positive adults treated in rural northwestern Uganda
Little is known about immunovirological treatment outcomes and adherence in HIV/AIDS patients on antiretroviral therapy (ART) treated using a simplified management approach in rural areas of developing countries, or about the main factors influencing those outcomes in clinical practice.
Cross-sectional immunovirological, pharmacological, and adherence outcomes were evaluated in all patients alive and on fixed-dose ART combinations for 24 months, and in a random sample of those treated for 12 months. Risk factors for virological failure (>1,000 copies/ml) and subtherapeutic antiretroviral (ARV) concentrations were investigated with multiple logistic regression.
At 12 and 24 months of ART, 72% (n = 701) and 70% (n = 369) of patients, respectively, were alive and in care. About 8% and 38% of patients, respectively, were diagnosed with immunological failure; and 75% and 72% of patients, respectively, had undetectable HIV RNA (<400 copies/ml). Risk factors for virological failure (>1,000 copies/ml) were poor adherence, tuberculosis diagnosed after ART initiation, subtherapeutic NNRTI concentrations, general clinical symptoms, and lower weight than at baseline. About 14% of patients had low ARV plasma concentrations. Digestive symptoms and poor adherence to ART were risk factors for low ARV plasma concentrations.
Efforts to improve both access to care and patient management to achieve better immunological and virological outcomes on ART are necessary to maximize the duration of first-line therapy.
In 2007, approximately 810,000 adults were living with HIV/AIDS in Uganda, and 25–49% of those requiring antiretroviral therapy (ART) were receiving treatment
Rural programs face numerous challenges concerning HIV care and treatment in Africa, including lack of appropriate tools to diagnose common opportunistic infections and qualified human resources. The scale-up of ART in recent years has not necessarily been accompanied by an increased strengthening of health systems, and this disparity is likely to negatively affect the quality of care in HIV/AIDS programs.
The main objective of this study was to describe clinical and immunovirological response to ART, patients' self-reported adherence, and plasma levels of ARV in HIV-infected adults who received free World Health Organization (WHO)-recommended ARV drug regimens as fixed-dose combinations (FDCs) for 12 or 24 months in Arua, a rural area in northern Uganda. Furthermore, we investigated potential risk factors for virological failure and for subtherapeutic concentrations of non-nucleoside reverse transcriptase inhibitors (NNRTI) or protease inhibitors (PI).
Study population
Since 2002, Médecins Sans Frontières (MSF) in collaboration with the Ugandan Ministry of Health has provided ART free of charge in the regional referral hospital of Arua. The program initially served the whole West Nile region, but decentralization of patients on ART to other district and missionary hospitals was started in 2004. Eligibility criteria for ART are those recommended in the WHO guidelines for scaling up ART in resource-poor settings
Data routinely collected using standardized forms and entered into the FUCHIA software (Epicentre, Paris) were, at program inclusion, date of birth or age, and history of ARV use; and at ART start, date, regimen, clinical WHO conditions diagnosed, weight, height, and CD4 T-cell counts. By November 2005, approximately 8,000 patients were followed in the program, 90% of them were adults, and 45% were alive and followed on ART.
Study design
Before the start of the study (November 2005), we identified patients included in two observational open cohorts of HIV-infected patients who initiated ART in the previous 12 ± 2 months (M12 cohort) and 24 ± 2 months (M24 cohort). Patients found to be alive and still on ART were eligible for participation in a cross-sectional survey if they were contacted within the study window period, were non-pregnant or breastfeeding at the time of the study, and provided written informed consent. The study sample size was calculated assuming that 16% (M12) and 20% (M24) of these patients, respectively, would have detectable VL
Data collection and laboratory testing
During the cross-sectional survey conducted between 28th November 2005 and 2nd May 2006, we used a standardized questionnaire to collect information on diagnosed acute severe illnesses, ARV-related toxicity, anthropometric measurements, and adherence to treatment. Two self-reported indicators of adherence were calculated: the percentage of pills taken in the last 4 days (number of pills taken as a proportion of the total number of pills prescribed); and the percentage of reported adherence in the last 30 days using a 6-point visual analogue scale (30-day VAS). Good adherence was defined as a value ≥ 95% pills or a VAS score >4
Plasma concentrations of nevirapine (NVP), efavirenz (EFV), and nelfinavir (NFV) were determined by high-performance liquid chromatography
Statistical analysis
Retrospective cohort analysis
Probabilities of survival for all patients included in the two cohorts were estimated using Kaplan-Meier methods. Patients missing their last clinical appointment for 2 months or more were considered lost to follow-up (LTFU).
Analysis of cross-sectional survey data
Characteristics of patients, ARV toxicity, and adherence were described using standard statistics. Laboratory ARV toxicity was graded according to the 2004 AIDS Clinical Trials Group criteria
Based on ARV therapeutic ranges, (4,000–8,000 ng/ml for NVP, 1,000–4,000 ng/ml for EFV, and 1,000–4,000 ng/ml for NFV
We investigated predictive factors for virological failure (HIV-1 RNA ≥ 1,000 copies/ml) and low plasma NVP, EFV, or NFV concentrations using a multiple logistic regression analysis. The covariates studied were sex, age (15–34 vs. ≥ 35 years), level of education (primary or no education vs. secondary or higher), ARV-experienced, WHO staging (1/2 vs. 3/4), tuberculosis (TB) diagnosis after ART initiation, baseline or nadir CD4 cell count (<50 vs. ≥ 50 cells/mm3), weight ≤ baseline, cohort (M12 vs. M24), presence of ARV-related toxicity, and poor adherence to ART (95% vs. ≥ 95%). For each outcome, we applied a backwards elimination approach to an initial model including those covariates associated with the outcome in univariate analyses (
The protocol was approved by the Uganda National Council for Science and Technology and the Ugandan AIDS Research Committee.
Retrospective cohort analysis
By the end of the study (May 2006), 130 patients of the 1,523 patients included in the studied cohorts (48/967 of M12 and 82/556 of M24) had died, and 282 (187 of M12 and 95 of M24) had been lost-to-follow-up. Eighty-three percent of the 130 recorded deaths occurred during the first 6 months of ART. Probabilities of survival at 12 and 24 months of ART were 0.91 (95% CI 0.89–0.92) and 0.88 (95% CI 0.86–0.90), respectively, and probabilities of remaining in care were 0.76 (95% CI 0.74–0.78) and 0.70 (95% CI 0.67–0.72), respectively.
Participants in the cross-sectional survey
Of the 967 adults who initiated ART between September 2004 and July 2005 (M12 cohort), 701 (72%) were still alive and on ART at the time of the start of the survey. Of the 556 adults who initiated ART between September 2003 and July 2004 (M24 cohort), 369 (66%) were alive and on ART. A total of 229 (83% of eligible) M12 and 277 (75% of eligible) M24 patients participated in the cross-sectional survey. Reasons for exclusion were pregnancy or breastfeeding, inability to trace the patient, or a screening visit outside the study period (12 ± 2 or 24 ± 2 months of ART) (Figure
Figure 1
Patient cohort profiles at study start (November 2005)
Patient cohort profiles at study start (November 2005).
Survey participant characteristics at ART start
Study patients had been followed in the HIV program of Arua prior to ART initiation for a median time of 6 (M12) and 4 (M24) months, and 98% were ARV-naïve. At ART initiation, median age was 37 years, 88% of patients were in WHO clinical stage 3 or 4, and approximately 17% had a body mass index (BMI) <17 kg/m2 (Table
Table 1
Patient characteristics and outcomes
Patient characteristics
Cohort M12
Cohort M24
Characteristics at ART start
Women (%)
151 (65.9)
173 (62.4)
Median age, years [IQR]
36.8 [32.0–42.3]
36.5 [30.8–42.6]
ARV naïve (%)*
225 (98.2)
273 (98.6)
Median follow-up before ART, months [IQR]
6.2 [3.9–11.4]
3.7 [1.8–7.7]
First ART regimen prescribed d4T/3TC/NVP
226 (98.7)
265 (95.7)
WHO stage 3 or 4 (%)
201 (87.7)
246 (88.8)
Body mass index <17 kg/m2 (%)
38 (17.8); n = 214
43 (16.8); n = 256
CD4 cell count, cells/mm3
n = 133
n = 239
Median [IQR]
100 [45–147]
93 [40–144]
<50 (%)
36 (27.1)
73 (30.5)
Characteristics at time of survey
Non-cumulative WHO stage at survey (%)
n = 223
n = 267
136 (61.0)
160 (59.9)
Stage 1 or 2
63 (28.2)
86 (32.2)
Stage 3 or 4
24 (10.8)
21 (7.9)
Body mass index, kg/m2
Median [IQR]
20.4 [18.9–22.0]
20.8 [19.0–22.5]
<18.5 kg/m2 (%)
43 (18.8)
52 (18.7)
Median weight gain since ART start, kg [IQR]
3 [1–6]
2 [0–7]
ARV-clinical related symptoms (%)
70 (30.7)
84 (30.3)
Digestive disorders
132 (57.6)
146 (52.7)
Neurological disorders
102 (44.5)
111 (40.1)
Dermatological disorders
70 (30.6)
84 (30.3)
Morphological disorders
39 (17.0)
72 (26.0)
CD4 cell count, cells/mm3
Median [IQR]
223 [163–308]
238 [172–321]
<200 (%)
92 (40.2)
100 (36.1)
Median gain since ART start [IQR]
+115 [59–170]
+139 [75–215]
Pills taken in last 4 days (%)
Good adherence
200 (87.3)
258 (93.1)
Poor adherence
29 (12.6)
19 (6.9)
30-day VAS (%)
Good adherence
198 (86.5)
250 (90.3)
Poor adherence
31 (13.5)
27 (9.7)
Plasmatic NVP level (%)
n = 204
n = 258
39 (19.1)
32 (12.4)
115 (56.4)
172 (66.7)
50 (24.5)
54 (20.9)
Plasmatic EFV level (%)
n = 23
n = 18
1 (4.4)
13 (56.5)
11 (61.1)
9 (39.1)
7 (38.9)
VAS, visual analogue scale; IQR, interquartile range
*ARV-naïve does not include women who received PMTCT prophylaxis.
Patient characteristics at survey
At the time of the survey, 10 patients were treated for active TB, and 86% of patients remained on FDC d4T/3TC/NVP. No patients were receiving second-line therapy. All participants reported at least one type of clinical intolerance, most frequently headache and digestive symptoms such as epigastric/abdominal pain or meteorism. Peripheral polyneuropathy and dermatologic disorders were reported in more than 30% of patients in both cohorts. Forty percent of patients had at least one moderate or mild abnormal laboratory result. Seven patients had grade 3 or 4 abnormal laboratory results, 6 had grade 3 neutropenia (3 M12 and 3 M24), and 1 (M24) grade 4 anemia.
Treatment adherence
In the M12 cohort, good adherence to ART, defined as all pills taken in the last 4 days, was reported by 200 (87.3%) patients (or by 198 [86.5%] patients when the 30-day VAS was used). In the M24 cohort, good adherence to ART in the last 4 days was reported by 258 (93.1%) patients (250 [90.3%] using VAS) (Table
Overall, the two measures of adherence were moderately correlated (Pearson's coefficient 0.48) and correlation was stronger for M12 than for M24 measurements (0.59 and 0.35, respectively). Twenty-seven (6.0%) patients considered as having good adherence by VAS reported to have forgotten taking one or more pills in the last 4 days; while 37 (8.1%) of those considered as having good adherence through 4-day recall reported poor adherence with VAS. A total of 85 (16.8%) patients were categorized as poorly adherent to ART by any of the two methods.
Immunological and virological failure
At M12, median CD4 cell count was 223 cell/mm3, immunological failure was diagnosed in 7.9% of patients, and 40% had <200 cells/mm3 (Table
At M24, median CD4 cell count was 238 cells/mm3, immunological failure was diagnosed in 38% of patients, and 36% of patients had <200 cells/mm3. Seventy-two percent of patients (198/277) had HIV viral suppression, and 81.9% (227/277) had <1,000 HIV RNA copies/ml.
Frequency of drug-resistant viruses
We performed genotypic tests for 62 (82.7%) of patients with VL ≥ 1,000 copies/ml (PCR amplification failed for 13 samples) (Table
Table 2
Results of virological and genotypic resistance testing by cohort
Cohort M12
Cohort M24
HIV RNA ≥ 1,000 copies/ml (%)
Available genotypic resistance (%)
20 (80.0)
42 (84.0)
Wild-type virus (%)
6 (30.0)
10 (23.8)
Resistance to ≥ 1 ARV drug (%)
14 (70.0)
32 (76.2)
Resistance to EFV and NVP (%)
3 (15.0)
1 (2.4)
Resistance to 3TC, EFV, and NVP (%)
9 (45.0)
22 (52.4)
Extensive resistance* (%)
2 (10.0)
9 (21.4)
ARV, antiretroviral; EFV, efavirenz; NVP, nevirapine; 3TC, lamivudine
*Resistance to EFV, NVP, 3TC, stavudine, zidovudine, or tenofovir, and didanosine, or multidrug resistance.
The most prevalent NRTI and NNRTI mutations were M184V and K103N, respectively. In the M12 cohort, 3 viruses were resistant to EFV and NVP, and 9 to both 3TC and NNRTIs (EFV and NVP). One virus was resistant to 3TC, d4T, zidovudine (AZT), and NNRTIs (EFV and NVP), and 1 harbored K65R, K103N, Y181C, and G190A mutations conferring resistance to tenofovir (TDF), EFV, NVP, and possibly didanosine (ddI).
In the M24 cohort, only 1 virus was resistant to NVP and EFV, and 22 to both 3TC and NNRTIs. Six viruses with resistance mutations to both 3TC and NVP had additional resistance to d4T and/or AZT. Three viruses harbored a K65R mutation conferring resistance to TDF and possibly to ddI. One virus had a multidrug resistance profile (K65R, T69A, V75I, K103N, F116Y, Q151M, V179S, Y181C, and M184V), conferring resistance to all the NRTIs and to EFV and NVP.
Thymidine analogue mutations (TAMs) conferring resistance to AZT and d4T were observed in 5% and 14% patients at M24, respectively. Resistance to both TDF and ddI were described in 5% (1/20) at M12 and 7% (3/42) at M24. The NRTI multidrug resistance complex (Q151M) was found in 1 patient at M24. None of the viruses had mutations conferring resistance to the new NNRTIs (etravirine). Seven patients were resistant to AZT, d4T, 3TC, NVP, and EFV (6 in M24).
Factors associated with virological failure
Factors significantly associated with virological failure were longer time on therapy (OR 2.0; 95% CI 1.2–3.6 for M24 compared with M12 patients), ≥ 35 years of age at ART start (OR 0.5; 95% CI 0.3–0.8), TB diagnosis during ART (OR 2.3; 95% CI 1.0–5.0), weight less than baseline weight at time of ART initiation (OR 2.2; 95% CI 1.3–3.9), poor adherence (using VAS, OR 3.9; 95% CI 1.9–7.7), low NNRTI plasma concentration (OR 2.4; 95% CI 1.2–4.8), and presentation of general signs or symptoms (myalgia, hepatomegaly, splenomegaly, or lymphadenopathy; OR 2.6; 95% CI 1.5–4.5) (Table
Table 3
Factors associated with virological failure and low plasma NNRTI concentrations
Virological failure
Low NNRTI concentrations
Univariate analysis
Multivariate analysis†
Univariate analysis
Multivariate analysis†
M24 cohort (vs. M12)
1.8 (1.1–3.0)
2.0 (1.2–3.6)
0.6 (0.4–1.0)
0.7 (0.4–1.1)
Age at ART start (vs. 15–34)
≥ 35 years
0.5 (0.3–0.9)
0.5 (0.3–0.8)
1.1 (0.7–1.9)
School level (vs. secondary or higher)
Primary or no education
0.8 (0.5–1.4)
1.5 (0.9–2.6)
1.3 (0.8–2.4)
Non-cumulative WHO stage at survey (vs. asymptomatic)
Stage 1–2
1.9 (1.2–3.3)
1.9 (1.1–3.3)
Stage 3–4
1.1 (0.4–2.8)
0.8 (0.3–2.2)
TB episode after ART
2.1 (0.9–4.3)
2.3 (1.0–5.0)
Weight ≤ baseline
1.9 (1.2–3.3)
2.2 (1.3–3.9)
0.6 (0.3–1.1)
0.6 (0.3–1.1)
ARV-related toxicity
1.6 (0.9–2.8)
1.5 (0.8–2.6)
1.8 (1.1–3.0)
1.7 (0.9–2.9)
1.8 (1.1–2.9)
1.6 (0.9–2.8)
0.9 (0.5–1.6)
General symptoms*
2.3 (1.4–3.9)
2.6 (1.5–4.5)
0.9 (0.5–1.6)
Poor adherence to ART (<95% vs. ≥ 95%)
% pills taken in last 4d
1.8 (0.0–3.8)
1.1 (0.4–2.6)
4.0 (2.1–7.7)
3.8 (1.9–7.4)
30-day VAS
3.4 (1.8–6.4)
3.9 (1.9–7.7)
Nadir CD4+ <50 cells/mm3 (vs. ≥ 50)
1.5 (0.9–2.6)
1.5 (0.8–2.6)
1.1 (0.6–1.9)
Low NNRTI plasma concentration at survey
1.9 (1.1–3.7)
2.4 (1.2–4.8)
TB, tuberculosis; VAS, visual analogue scale; NNRTI, non-nucleoside reverse transcriptase inhibitor; OR, odds ratio; CI, confidence interval.
*General signs or symptoms: myalgia, hepatomegaly, splenomegaly, or lymphadenopathy; VAS.
†Multiple logistic regression using backward elimination approach and controlling for the effect of all variables for which adjusted estimates are shown.
NNRTI plasma concentrations
In the M12 cohort, plasmatic concentrations of NVP and EFV were low in 19.1% (39/204) and 4.3% (1/23) of patients, respectively, and high in 24.5% (50/204) and 39.1% (9/23), respectively. NFV plasmatic concentrations were within normal therapeutic ranges (n = 2). In the M24 cohort, low plasma NVP concentrations were observed in 12.4% (32/258) of patients and high NVP and EFV concentrations in 20.9% (54/258) and 38.9% (7/18), respectively.
Factors associated with low NNRTI plasma concentrations
Overall, the proportion of patients with low ARV concentrations significantly increased with increasing HIV RNA levels (from 12.8% in patients with undetectable VL to 22.7% in those with virological failure,
Figure 2
HIV-1 RNA values by ARV drug plasma level and by cohort
HIV-1 RNA values by ARV drug plasma level and by cohort.
Poor adherence in the last 4 days (OR 3.8, 95% CI 1.9–7.4) and reported digestive disorders (OR 1.7, 95% CI 0.9–2.9) were significantly associated with the presence of low plasma NNRTI or NFV concentrations (Table
In the HIV care and treatment program of Arua, in rural Uganda, more than 70% of the patients remained in care after 1 or 2 years of treatment, but over 35% of patients remained at risk of developing opportunistic infections (<200 cells/mm2). Estimates of retention in care appear to be more favorable than those reported during the early years of the Drug Access Initiative (DAI) program among individuals treated in urban hospitals of Kampala, where patients were requested to pay the care fees (49–56% at 1 year, and 46% at 2 years of ART) and more than 30% were ARV-experienced
Despite the frequency of clinical intolerances reported, the initial ART regimen was well tolerated, and few cases of severe (grades 3 or 4) laboratory-based toxicity were diagnosed. Self-reported adherence at 12 and 24 months of ART was high and similar to that reported in other studies, both in resource-limited countries
The observed immune and virological responses at 1 and 2 years of ART were similar to those reported in other African settings
Overall, 7% of patients with virological failure at M12 and 13% at M24 had resistant virus, which is similar to estimates reported for patients treated with 2 NRTI/1 NNRTI-based therapy in east Africa or South-east Asia after more than 9 months of treatment (9–18%)
Estimates of resistance and virological and immunological failure might also have been underestimated if some of the deaths or patients who were lost to follow-up died as a result of treatment failure and resistance. However, most deaths and losses to follow-up occurred within the first months of therapy when the likelihood of treatment failure was lower. Conversely, because our study is based on outcome data collected at a single time point and no confirmation of laboratory data was obtained in the following weeks, we might have slightly overestimated rates of virological and immunological failure due to measurement errors or to individual temporal variability in biological markers (e.g. HIV viral blips). As in previous studies conducted in patients using primarily d4T/3TC/NVP, the most commonly observed resistance mutations were those associated with the use of NNRTIs (K103N) and 3TC (M184V)
Patients on ART for 2 years were twice as likely as those on 1 year treatment to develop virological failure. Patients diagnosed with TB after ART initiation were also more likely to fail therapy, suggesting that patients' virological response could be impaired when rifampicin-based anti-TB treatment is initiated while a patient is under ART. The potential interaction between NVP and rifampicin in HIV-infected patients treated for TB has been reported in previous studies
Early identification of patients with virological failure and switch to second-line therapy is important to prevent the accumulation of resistance that might compromise the effectiveness of subsequent lines of treatment. In this program where virological monitoring of patients is not routinely performed, patients presenting general clinical symptoms, those with a weight loss below the value observed at therapy initiation, or those reporting poor adherence were more likely to have virological failure. The association between high VL levels and subtherapeutic NNRTI concentrations has been previously reported in Malawi
The pharmacological assessment showed increased plasmatic levels of NNRTI in 23% of patients on NVP-based therapy and 39% of those on EFV. These figures are higher than what has been described in Western countries, and are likely to be related to the lower weight of our patients at ART initiation
In conclusion, in this HIV/AIDS care program implemented in a rural African setting using a simplified scale-up approach and free generic ART, survival and retention in care were satisfactory at up to 2 years of therapy, but efforts to increase earlier access to treatment and to improve patient management and support to achieve better immunological and virological outcomes on ART remain necessary to prolong patient survival. Early identification of poor adherence during follow-up, especially in the presence of intolerance to ARV and when TB treatment is provided, should be considered to maximize the duration of first-line therapy.
Competing interests
The authors declare that they have no competing interests.
Authors' contributions
LA designed and implemented the study, analyzed and managed data, interpreted results, and wrote the manuscript. GG and CO set up and implemented the study in the field and contributed to the interpretations of results. LP performed statistical analyses. PA contributed to the design, set-up, and implementation of the study. M-LC and CLT performed the virological and pharmacological tests and contributed to the interpretation of the results. SB and DO helped to design the study, interpret the results, and draft the manuscript. MP-R performed statistical analysis, interpreted results, and co-wrote the manuscript. All authors read and approved the final manuscript.
The authors would like to thank the patients and their families for their participation in the study and for their motivation and collaboration. We also thank the medical personnel of the Ugandan Ministry of Health and the MSF field team for their support and technical advice in the implementation of this study. Thanks to Oliver Yun for his editorial support. Financial support for this study was provided by Médecins Sans Frontières.
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Pre-publication history
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